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^*£
 
UNITED STATES OF AMERICA
WASHINGTON,  D. C.
GPO  16—67244-1 
 
 
NEW
REMEDIES
FORMULA
FOR THEIR
PREPARATION AND  ADMINISTRATION
ROBLEY  DUNGLISON, M.D.,
   PEOFESSOE OF THE INSTITUTES OF MEDICINE, ETC., IN THE
    JEFFERSON MEDICAL COLLEGE OF PHILADELPHIA.
     SEVENTH EDITION,
WITH NUMEROUS ADDITIONS.
PRODESSB QUAM CONSPICI.
..-con QQn/'s
frs
^'%on D.°*
    PHILADELPHIA:
BLANCHARD & LEA
         1S56. 
P^I6yx
  I8S6.
       fSnteretJ, according to the Act of Congress, in the year 1853,

                   By Robley Dunglison, M. D.,

in the Clerk's Office of the District Court of the Eastern District of Pennsylvania.
\VM. S. YOUNG, PRINTER. 
PREFACE
TO  THE SEVENTH  EDITION.
  Another edition  of  the "New Remedies" having been called for,
the author has endeavoufed to add  every thing  of moment that has
appeared since the publication of the last edition.
  The chief remedial means which have obtained a place, for the first
time,  in this volume, either owing to their having been recently intro-
duced into pharmacology, or to their having received  novel applica-
tions—and which, consequently, belong to the category of  "New Re-
medies"—are the following:—
Apiol.
Caffein.
Carbazotic acid.
Cauterization and  cathetcrism of
  the larynx and trachea.
Cedron.
Cerium.
Chloride of bromine.
Chloride of iron.
Chloride of sodium.
Cinchonicine.
Cod-liver olein.
Congestion.
Eau de Pagliari.
Galvanic cautery.
Hydriodic ether.
Hyposulphite of soda and silver.
Inunction.
Iodide of sodium.
Nickel.
Permanganate of potassa.
Phosphate of lime.
Pumpkin.
Quinidia.
Rennet.
Saccharine carbonate of iron and
   manganese.
Santonin.
Tellurium.
Traumatic ine.
  The articles treated of in the former editions will be found to have
undergone  considerable expansion in this, in  order, that the author
might  be enabled  to  introduce—as far as practicable—the results^ of
the subsequent experience of others, as well as of his own observation
and reflection; and to make the work still  more deserving of the  ex-
tended circulation with which  the  preceding editions  have  been  fa-
voured by the profession.   By an enlargement of the page, the nume-
rous additions have been incorporated without greatly increasing  the
bulk of the volume.                                        ^~~^
                                       ROBLEY DUNGLISON.
  Philadelphia, 18 Girard St.
       Feb., 185u. 
I 
PREEACE
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 phy-
sicians.  The author has, consequently, believed that he would  be rendering
a service to the profession  by concentrating the  results of experience within
reasonable limits, so that they may be readily available to all.  The majority
of the new agents—it will be found—have been furnished by modern  chemis-
try;  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  ob-
tained, are liable to irregularity of action, owing to faulty  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 ob-
servation, 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 thera-
peutist,  a knowledge of every  department  of medical science  is  demanded.
Anatomy, physiology, pathology, and  materia medica  are, indeed, but intro-
ductory to the great object which the practitioner has in view—the alleviation
and removal of suffering.  AVere it otherwise, it would be but necessary to in-
stitute empirical trials,  in every case of disease, with various articles in and
out of the received lists of the materia  medica, and from  such vague  trials to
endeavour to deduce what is termed ''experience."
  The erroneous  idea prevails  too extensively, that every one is capable of
profiting by observation, and that, therefore, alfwho have had the same amount
of experience, must be equally capable of treating disease.   Setting aside, how-
ever,  the consideration  of the differences that must necessarily result from the
varied powers of individuals, it can scarcely be maintained, that he whose at-
tention has not been properly directed to the study of the preliminary branches
which have been  enumerated, and  whose mind has not been- trained in tracing 
vi
PREFACE.
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 the morbid condition, must be correctly
appreciated; the effects which the articles of the materia medica are capable ot
exerting under both those conditions, must be known from  accurate  observa-
tions, and  not until then can the practitioner prescribe with any well-founded
prospect of success.   Numerous errors would be perpetrated, were we to  pro-
fess, 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 phy-
siological, pathological, and  therapeutical bearings of the subject.  In illustra-
tion of this, the well-known case cited by Dr. Paris in his  Life  of Sir Hum-
phry 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 as-
certaining the  temperature of the body by the thermometer placed under the
tongue.   The paralytic, deeply impressed by  Dr. Beddoes with  the certainty
of the success of the remedy, of  which he knew nothing—soon after the ther-
mometer was placed in his mouth, believing this to be the great curative agent
—declared that he felt somewhat better.   Nothing more was, therefore, done;
and he was requested  to return on the following day.   The  same form  was
gone through with  the same results; and, at the end of a fortnight,  the sick
man was dismissed  cured, no agent of any kind having been employed except
the thermometer.
   Now, if the  reasoning powers were not duly exerted, experience would ob-
viously  teach as the result of this case, that the thermometer is an antiparaly-
tic.   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, ani-
mal magnetism, and their  congenerous arts,—amongst articles that act chiefly
through the new impressions which they  make on the senses.
   It might seem to those who are unacquainted with medical  history, that  in
periods  approaching our own, no such  illogical inferences  could be deduced,
and that it has  been the custom with the profession  for ages to bestow all due
caution  and the most  rational inquiry in the  collection  of  facts.   Such how-
ever, 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 suc-
cessfully 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

  i Propterea sola experientia  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 medicinu, lib.
i. cap. xl.   Amstelod. 1639. 
PREFACE.
vii
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 castoreo or "wa-
ter of swallows with castor" in those of Manheim and Wirtemberg.   The lat-
ter preparation was 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 cxsiccati 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,1 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 distin-
guished physician to the Venereal Hospital of Paris—we have an  example of
the pertinacity with which ancient prepossessions and inculcations adhere to
us, and how difficult it is to think and to act according to the unbiassed sugges-
tions of our own observation and  reflection.   In the treatment of blennorrha-
gic epididymitis  or swelled testicle from gonorrhoea, M. Ricord recommends
compression to be made  by means of the "sparadrap," or "plaster of Vigo,"
with mercury.  The history of the plaster of Vigo is singular.  Although still
in the Pharmacopoeia of Paris, it resembles its prototypes but in name.  In the
Pharmacopoeia of "Wirtemberg, 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 vinegar,—the decoction being strained, a'nd added to olive oil, litharge,
oil of bayberries, turpentine, yellow wax, olibauum, 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 antispasmodic virtues  of the castor,
or that the living frogs and earth-worms exerted any efficacy in the sparadrap
dc Vigo—a plaster employed for  compressing tumours, and for which purpose
we use one of simple adhesive constituents.  They have all been properly re-
jected from the lists 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 polyphar-
macal preparations were introduced, and nothing but the blindest devotion  to
authority or to established custom could have occasioned their retention.   It is
not long since the Theriac  of Andromachus—itself but a modification of the
Antidotum Mithridatum—was dismissed from the British pharmacopoeias.  It
consisted of seventy-two articles,  and was a farrago—as Dr. Heberden observed

  1 General Therapeutics, p. 55.  Philad.  1836.  [See, also, his  General Therapeutics
and Mat. Medica, 6th edit. i. 66.  Philad.  1853.] 
viii
PREFACE.
—that had "no better title to the name of Mithridates than—as it so well re-
sembles—the numerous undisciplined forces of a barbarous king, made up ot
a dissonant crowd collected from different countries, mighty in appearance, but
in reality an ineffective multitude, that only hinder each other."  The electu-
ariuni opiatum polypharmacum  of the Parisian codex—the descendant of the
old theriac, with even an additional number of ingredients—contained acrid sub-
stances, 5; astringent, 5; bitter, 22 ; indigenous aromatics, 10; umbelliferous
aromatics, 7; balsams and resinous substances, 8; fetid ingredients, 6;  narco-
tics,  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 opi-
um—which  may be regarded as a principal effective ingredient—being con-
tained in a dram of the compound.  Yet, when the question arose in the Lon-
don College  of Physicians, as to what should be the fate of this  "many-headed
monster," and when  it was proposed by Dr. Heberden, that it should be ejected
from the pharmacopoeia,—on a division, it  was found that there were thirteen
votes for  retaining,  and fourteen  for rejecting  it.   Its ostracism was deter-
mined by a  majority of  one  only, in  a learned body twenty-seven  of whose
members were present.
  Such was the fate  of a "heterogeneous farrago," which, as Dr.  Paris has re-
marked, "can be vindicated upon no principle of combination,"  and yet  en-
joyed the confidence of physicians for ages—a confidence unquestionably founded
in their belief, on experience, but experience based upon defective observation,
and, consequently, on erroneous inferences—the results being consecutive  ra-
ther 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 cf well-assorted facts on
a particular  subject constitutes experience,  whether  these  facts have been
culled in five years or in fifty.  A better system, too, of observation generally
prevails, so  that we have discarded  the  absurd and revolting agents  that  are
still retained in the books of authority  of some European countries.   Much
however, remains to.be done.  The catalogue of the Materia  Medica is  yet
overstocked, and the pruning knife has  still to be applied, to lop off many of
the redundancies which have been proved to be such by the more accurate at-
tention that is daily paid to tracing the  due relation between cause  and ef-
fect.  "To  purchase a clear and warrantable  body of truth,"  as  Sir Thomas
 Browne has well observed, "we must forget and part with much we know."
   Every one will  be compelled to admit, that it is the duty of  the correct the-
 rapeutist 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 unconsequential.
   To enable the profession to form an accurate estimate of the  value  of reme- 
PREFACE.
IX
dies of more recent introduction, or of the older remedies whose use has been
revived under novel applications, the present  volume was  undertaken by  the
author.  In Germany, several works exist on this subject, and that of Riecke
—to which the author has repeatedly referred—served  as a basis for many of
the articles; his observations, however, do not come down farther  than  the
year ls:JG.  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 attention to  the
subject.   He has likewise added  the results of his own 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. 
 
                    ALPHABETICAL  LIST


                                   OF


DISEASES   AND   THEIR  REMEDIES.

             (For Index of Remedies, see the end of the volume.)
Abdomen, chronic inflammation of the (hy-
    drarg. cyanur. 421.)
Abortion, hemorrhage from (matico,  515.)
        threatened (acid, tannic. 59; elec-
    tro-magnetism, 314.)
Abrasions (collodion, 253,  256.)
Abscess, mammary  (compressio,  202.)
        in the axilla  (chloroform, 220.)
Abscesses, large (chlorin.  aq. 209; iodini-
    um, 486, 488.)
  Suppurating (creasoton, 284.)
Absorbents, inflammation of the (iodinium,
    4W.)
Acidity  of the stomach (argilla, 115 ; fel
    bovinum, 719.)
Acne (acid, hydrocyan. 52, 54; conia, 715;
    hydrargyri deuto-nitras, 433 ; sulphur.
    iodid. 674.)
  Indurata (sulphur,  iodid. 674.)
  Rosacea (acid, hydrocyan. 52 ;  creasoton,
    289.)
  Vulgaris (collodion, 254.)
Adiposis  (ballota  lanata,  141;  iodinium,
    480.)
After  pains (ergota, 336 ;  sulphuris carbu-
    retum, 672.)
Air passages, diseases of  the (chlorinium,
    199.)
  Inflamed, (iodin.  492.)
Albugo,  central (electro-punctura, 322.)
Albuminuria, (acid, gallic. 42; acid, tannic.
    59; benzoate  of  ammonia,  39;  urea,
    678.)
Alopecia, (glycerin, 409.)
Amaurosis (acid, hydrocyan.  52; acupunc-
    tur. 73;  ammoniated counter-irritants,
    266;  electro-magnetism,  311,   313;
    electro-punctura,  321 ;  galvanismus,
    o'.iS; haimospasia, 725, 726; nux vo-
    mica, 542; strychnia, 659,  660,  666;
    veratria, 685.)
  Incomplete (electro-punct.  319.)
Amblyopia ^strychnia, 060.)
Amenorrluva  (artemisin, 124; auri praepa-
    rat. 132; bile of the  swine, 720; bro-
    miniuni,  153;  cnincte radix, 161; ca-
    lendula, 163; chloroform, 220; cimici-
Amenorrhoea.
    fuga, 232; electro-magnetism, 311, 315;
    ergota, 336; ferri proto-carbonas, 381;
    ferr. iodid. 363, 360; galvanismus, 398;
    hsemospasis, 725; iodinium, 473; man-
    ganes pra>par. 733; niccoli sales, 735;
    potassii bromid. 589;  potassii iodohy-
    drargyras, 209; strychnia, 661)
Anaemia (acidum  carbazoticum, 702; ferri
    pulvis, 348; ferri  iodidum, 365; ferri
    subcarbonas, 386 ;  manganesium, 733.)
  during parturition (hremostasis, 727.)
Anaemic habits (ferri subcarbonas, 386.)
Anaesthesia, local (congelatio, 713 ; nux vo-
    mica, 543; sulphuris carburetum, 073;
    sumbul, 748.)
Anasarca  (acid,  hydrocyan. 51;  acupunct.
    73, 75;  colchicum, 249;  compressio,
    259;  digitaline, 309; ferri citras, 354;
    ferri iodid. 365; urea, 078.»)
Anchylosis spuria (iodin. 465.)
Aneurism (acetate of peroxide of iron, 723 ;
    acupunct. 74; chloroform, 219;  collo-
    dion, 255; compression, 266 ; electro-
    puncture, 321, 322, 323; zinci  chlori-
    dum, 690.)
  by anastomosis,  (zinci chloridum, 690.)
Angiectasis (zinci chlorid. 690.)
Angina pectoris (galvanism, 400; magnes,
    506.)
Anthrax (iodinium, 488.)
  Malignant (chlorin. aq. 207.)
Aphonia (cauterization of the larynx, 191;
    chlorin. 200;  cubeb.  300; galvanism,
    313;  ol. tiglii, 567:  strychnia, 660.)
Aphtha?, asthenic (acid, tannic. 59; chlorin.
    aq. 2C9.)
Aphthous sores (liq. ferr. persesquinit. 372.)
  Ulceration (creasoton, 298.)
Apncea, see Asphyxia.
Apoplexy (ol. tiglii, 569.)
Arsenic, poisoning by (ferri oxidum hydra-
    turn,  375.)
Arthralgia from lead (iodinium, 472.)
Arthritis (brominium, 153; compressio, 260;
    morphiae acetas, 527, 529.)
Arthrocace (ol. jecinor. aselli, 555.) 
xii
ALPHABETICAL LIST OF
Ascarides  lumbricoides  (oleum morrhuae,
     560; quiniae sulphas, <>27.)
  vermiformes (ferri ferrocyanuretum, 358;
  fuligo, 394; quinia? sulphas, 627.)
Ascites (acupunct. 73; caincoe radix, 160;
     compressio, 259; electro-punctur. 321;
     euphorb. ol. 347; ferri iodid. 365; ferri
     subcarb. 386; iodinium, 466, 483, 485,
     486;  manganese, 733; potassii bromi-
     dum, 5S9.)
Asphyxia (acupunt. 73; electro-magnetism,
     317;  galvano-punctur. 329; soda chlo-
     rinata, 648; sulphuris carburetum, 672,
     673.)
  Neonatorum (electro-magnetism,  314,
     317.)
Asthenia, chronic (potassae chloras, 587.)
Asthma (acidum  nitricum, 704;  aetheriza-
     tion,85; bignoniacatalpa, 147; cauteri-
     zation, &c.,of the larynx, 192; chloro-
     form, 214, 219, 226; compression of ca-
     rotids, 263; creasoton, 295; galvanism,
     398;  iberis amara, 728;  naphthalin,
     734; ol. tiglii, 567; potassae nitras,730;
    quinias  sulphas, 625;  strychnia, 660;
    valerianate of atropia, 128.)
  Humoral (colchicum, 249; sulphur, iodid.
     675.)
  Nervous (magnes, 506.)
  Pulverulentum (acid, hydrocy. 51.)
  Spasmodic  (acid, hydrocyan. 51;  iodi-
    nium, 465; ol. tiglii, 567.)
Atheromatous cysts (electro-punctura, 321.)
Atony {acid, gallic. 42.)
    from  venereal excesses, (compressio,
    263.)
Atrophy (brucia, 156; calcis phosphat. 710;
    ol. jecinor. aselli, 555; sumbul, 748.)
  Of children  (oleum jecoris aselli, 555.)
  Partial (nux vomica, 541.)
Audition, see Hearing.
Bed-sores (collodion, 256; creasotum, 284;
     galvanism, 401;  plumbi iodidum, 583.)
Biles (ammoniated counter-irritants, 271;
    iodinium,  488; ol. jecor. aselli, 558.)
Biliary fistula  (iodinium, 488.)
  secretion  defective (bile  of  the swine,
     720.)    -
Bites of serpents (cainca, 161.)
Black eye (calx chlorin.  168.)
  tongue (potassae chloras, 586.)
Bladder, atony of the (buchu, 158, 159.)
  Catarrh of the (acidum benzoicum,  38;
     cort.  adstring. Brazil. 273.)
  Diseases of the  (buchu, 158.)
  Inflammation of the (fuligo, 393.)
  Irritation of the (acid, benzoic.  38.)
  Paralysis of the (buchu, 158, 159.)
Bleeding from leech bites (collodion, 250;
     creasoton, 282 ;  matico, 514.)
Blennorrhagia, acute (morphia, 527.)
Blennorrhoea (acid, hydrocyan.  52; acidum
     tannicum, 02,  63; buchu, 159; calx
     chlorin. 170; chimaphila, 195; cort. ad-
     string. Brazil. 273, 274; cubeba, 300,
     302, 304; ferr. iodid. 364;  iodin. 475;
Blennorrhoea                       v„i„n
     monesia, 520;  piperina, 578; salicina,
     644;  zinci chloridum, 692.)
   atony from (compressio, 203.)
   Of the bladder (buchu, 158.)
   Of the  eye  (acid,  tannic, 60;   calcis
     chlorid.  169.)
     See Gonorrhoea..
Blepharitis glandulosa (hydrargyri  cyanu-
     retuni,  422.)
Blotches,  syphilitic (argent, prtoparat. 107;
     hydrarg. iodid. rubr. 428.)
Boils, see Biles.
Bones, diseased (iodinium, 478.)
   Pains in the  (iodin. 478;  zinci ferrohy-
     drocyanas, 697.)
   scrofulous  swellings  of the,  (iodinium,
     461.)
   Tumours of the  (auri praepar. 132; po-
     tass,  iodid. 603.)
Bowel complaints (creasotum, 295;  iodini-
     um,  492.)
Bowels, painful affections of the  (acid, hy-
     drocyan. 51;  fel bovinum, 720.)
   Irregular  action of the (electro-magnet-
     ism, 313; magnetismus, 402.)
   obstruction of the (chloroform, 219.)
Brain, chronic affections of the (ammonia-
     ted counter-irritants, 206.)
Breast, cancer of the (arsenic, iodid. 120.)
Breath, fetid, (calx chlorinata, 166.)
Bronchia, dilatation of the (chlorin. 200.)
   Inflammation  of the  (ammoniated coun-
     ter-irritants, 271.)
Bronchial affections (colchicum, 249; spiri-
     tus pyroaceticus, 651.)
  flux, (acid, gallic. 43.)
Bronchitis (acid,  hydrocyan.  50; cauteri-
     zation, &c, of  the larynx, 191; chlo-
     roform, 221;  iberis  amara, 728; io-
     dinium, 463; lactucarium, 505; rnanni-
     ta, 510; oleum morrhuae, 557; spiri-
     tus pyro-aceticus, 651; strychnia, 664.)
   Chronic (acid, gallic. 42; aq. picea, 105;
     chlorin. 200; cimicifuga, 233;  colchi-
     cum,  248 ; creasoton, 292, 296 ;  ferri
     citras, 354;  galeopsis, 397; juglans re-
     gia, 501; monesia, 518;  salicina, 644;
     spiritus pyroaceticus, 651; strychnia,
     660.)
   Convalescence, from (mannit. 510.)
   Nervous (atropia, 127.)
   Summer (nux vomica,  544.)
Bronchocele (ferr. iodid. 303.) See Goitre.
Bronchorrhoea  (creasoton, 293;  monesia,
     518;  spiritus pyroaceticus, 651.)
Brow-ague (ammoniated counter-irritants,
     271.;
Bruises (arnica, 117; glycerin, 409.)
Bubo  (chloric  ether,   227;  chlorin.  aq.
     209;  collodion, 255; iodinium,  460,
     488;  veratria, 686.)
   phagedenic (creasotum, 287.)
   suppurating,  (argenti prajparata, 107.)
   Ulcerated (creasoton, 287.) 
DISEASES AND THEIR REMEDIES.
xiii
Burns, (calcis chlorin. 167, 174 ; collodion,
    253;  compressio, 259; creasoton, 284,
    298;  fuligo, 393;  glycerina, 407;  io-
    dinium, 490;  oleum  morrhuae,  559;
    sodae  chlorid. 648;  sulphuris carbure-
    tum,  673.)
  Severe (compressio, 259.)
Bursa;, inflammation of the (iodinium, 492 ;
    veratria, 686.)
  Enlarged (iodinium, 482.)
Cachexia (acid. acet. empyr. 34; calcis phos-
    phas,  709;  chlorin. 202;  fuligo,  392;
    inunctio, 729; iodide of iodhydrate  of
    quinia, 612.)
  Gaol (oleum morrhuae, 557.)
  Marsh (quiniae sulphas, 625; quinium,638.)
  Mercurial (auri praepar. 130; juglans,501.)
    See Dyscrasy.
  Tuberculous (ol. jecor. aselli, 557.)
Cachexie iodee, 455.
Calculous diathesis (acidum benzoicum,38.)
  Pains (buchu,  158.)
Calculus (chimaphila, 195; lithiae carbonas,
    731.)
  Biliary, (chloroform,  219.)
  Expulsion of fragments of (ergota, 339.)
  Phosphatic (acid. lact. 56.)
  Renal (etherization, 86.)
  Uric acid (ammonia? phosphas, 91, 93.)
  Vesical  (chimaphila, 195.)
Cancer (acid. acet. empyr. 35; atropia, 127;
    aur. nitro-murias,  137; auri praepar.,
    131; calcis chlorid. 166; calendula, 162;
    chloride of  bromine, 111;  conia, 710;
    electro-punctura, 321; felbovinum,719;
    ferriarsenias,318; ferr. iodid 363; ferri
    lactas, 369;  ferr. subcarb. 384; fuligo,
    395; plumbi chloridum, 737; plumbi ni-
    tras, 738.)
  Of the breast, (arsenici iodidum, 120;  ca-
    lendula, 162;  creasoton, 286;  fuligo,
    392.)
  Of the face, (calx  chlorin. 167; creasoton,
    287; fuligo, 392.)
  Of the integuments, (calendula, 163.)
  Of the lip, (creasoton, 287.)
  Of the nose (fuligo, 392.)
  Open (carbo-animalis, 185; chloroform,
    214.)
  Of the pyiorus (chloroform, 212.)
  Of the  skin (chloride of bromine, 154;
    creasoton, 287.)
  Of the tongue  (iodin.  475.)
  Of the uterus (acidum hydrocyanicum,
    52; auri nitro-murias, 137; calendula,
    102;  cannabis, 182; chloroform,  220;
    creasoton, 286;  ferri chloridum, 723;
    ferri  subcarb.  384; morphiae  acetas,
    52!); plumbi nitras, 738.)
Cancerous tumour (auri  nitro-murias, 137.)
  Ulcers (acid, hydrocyan. 54; acid, tannic.
    61;  calendula, 103;  calx  chlorin. 167; '
    carbo-animalis, 186; chlorin. aq. 209; I
    conia, 715; fel bovin. 719; ferriarsenias,
    31S; ferri subcarb. 3S4; plumbi chlo-
    rid. 737:  potass,  iodid.  603;  zinci
    chlorid. 094.)
  Of the face (creasoton, 2S6.}             ,
Cancrum oris (acid. acet. empyr. 35; calcis
    chlorin. 167; chlorin. aq. 209; creasoton,
    280 ; potassae chloras, 585; potassii iodi-
    dum, 601.)
Carbuncle (hydrargyri deuto-nitras, 433.)
  Sloughing (creasoton, 285.)
Carbunculusmalignus(aq. chlorin. 207,209.)
Carcinoma of the face (auri chlorid. 133.)
Cardialgia (argenti oxidum, 113 ; artemisia,
    124;  calendula, 163; creasotum, 294;
    nux vomica,  543;   quiniae  sulphas,
    025; sumbul, 748;  zinci ferrohydrocy-
    anas, 696, 698.)
Carditis (ammoniated counter-irritants, 271;
    veratria, 680.)
Caries of bones (acid. acet. empyr. 35;  ju-
    glans, 501;  ol. jecor. aselli, 558.)
  Of the fibula, &c, (creasoton, 287.)
  Of  the  teeth (calx  chlorin.  108; creaso-
    tum, 290, 297; monesia, 520.)
  Scrofulosa (creasoton,  285,  298; iodin.
    409;  ol. jecoris aselli, 555.)
  Syphilitica (iodinium, 495.)
Catalepsy (strychnia, 661.)
Catamenia, obstruction  of the.   See Ame-
    norrhcea.
Cataract (atropia, 127;  iodinium,  481.)
  Disintegrated  (carbo-animalis, 185.)
  Incipient (ammoniated counter-irritants,
    206.)
Catarrh, bronchial (acid, tannic. 59.)
  chronic (acid, hydrocyan. 50; acid, tan-
    nicum, 59; aq. picea, 104; chimaphila,
    195;  chlorin.  200, 202; emetia, 326;
    galeopsis grandiflora, 397;  iodin. 403;
    iodic acid, 498.)
  pulmonary (galeopsis,  397;  mannitum,
    510.)
Catarrhus urethrae (cubebae, 302.)
  Vesicae (acid, benzoic. 38; aq. picea, 105;
    buchu, 158 ; cainc$e radix, 161; cubebae,
    302;  matico, 514.)
Cellular membrane, sloughing of the (iodi-
    nium, 487.)
Cephalalgia (acidum  carbazoticum,  702;
    acupunct. 73.)
  Chronic (artemisia, 124.)
  Intense (potassii  cyanuretum, 594.)
  Intermittent  (quiniae sulphas, 631, 635.)
  Nervous (acid,  hydrocyan.  51; chloro-
    form, 219; zinci ferrocyan. 697; zinci
    valerianas, 700.)
  Periodical (zinci ferrohydrocyan. 697.)
  Syphilitic (hydrarg.  cyanur.  422.)   See
    Headache.
Cerumen, defective  (acid.  acet. empyr.  36;
    creasoton, 291; glycerin, 408.)
Chalkstones (acidum benzoicum,  38;  am-
    moniae phosphas, 94.)
Chancre (acidum tannicum, 61; argenti prae-
    parat. 107; aurummetallicum, 1,39;  col-
    lodion, 256; creasoton, 287, 298;  hy-
    drarg. cyanur.  422; iodinium, 491.)
  Phagedenic (iodinium, 491.)
Chaps (collodion,  254;  glycerin, 409; ol.
    jecin. aselli, 559; plumbi nitras,  738.)
Chemosis,  (electro-punctura, 321.) 
xiv
ALPHABETICAL  LIST OF
Chest, diseases of the (chlorin. 199.)
  Affections of the (fuligo, 394.)
  chronic inflammation in the (hydrargyri
    cyanuretum, 421.)
  Neuralgic affections  of the (galvanism,
    400.)
Chilblains (calx  chlorin.  168, 175;  collo-
    dion, 250); creasotum,  284, 298;  iodi-
    nium, 489;  oleum morrhuae, 559; po-
    tassii iodidum,  604.)
  Ulcerated (monesia, 520.)
Chlorosis (artemisia, 124; bile of the swine,
    720; ferri citras, 354; ferr. iodid. 363;
    ferr. lactas, 368; ferr. protocarbonas,
    381; ferri pulvis, 348: ferri tannas, 387;
    ferri valerianas, 388; ha?mospasia, 725;
    manganesium, 733; niccoli sales,  735;
    paullinia, 573.)
Cholera  (acid,  tannic.  60;  buchu,  159;
    cannabis indica, 180,183  ; carbonis tri-
    chloridum, 710; chloroform, 213, 221;
    creasotum, 294; ferri nitras, 371; guaco,
    415; iodin. 470: morphiae acetas, 528;
    nux vomica, 547;  oleum tiglii,  568;
    quiniae sulphas, 626; quiniae et cincho-
    niae tannas,  637; strychnia,  662;  sum-
    bul, 748.)
  convalescence  from (berberina, 146.)
  preventive (quiniae sulphas, 627.)
Cholera morbus  (artemisia, 124;  carbonis
    trichloridum, 710; chloroform, 221; cre-
    asotum,  295; ferri et alumin. sulph.
    721; sumbul, 748.) -■
  Infantum (acid, tannic. 59;  argilla pura,
    116; creasotum, 295; fuligo, 392; mo-
    nesia,  519.)
Chordee (iodinium, 492; lupulina, 731; po-
    tassii bromidum, 590.)
Chorea (acid, hydrocyan.  51;  argenti et
    ammoniae chloridum, 110;  artemisia,
    123, 124; atropia, 127; cannabis indi-
    ca, 181, 182; chloroform, 219; cimici-
    fuga, 232; ferri ferrocyanuretum, 357;
    ferri iodidum, 364; ferri  subcarb. 385;
    galvanism,  398; indigum,  438;  iodi-
    nium, 470; nux vomica, 543; ol. jecor.
    aselli,  560;  potassii cyanuretum, 594;
    sanicula marilandica,  741;  strychnia,
    601; sumbul, 748; valerianate of atro-
    pia, 128; veratria, 684; zinci chlorid. 692,
    694; zinci ferrohydrocyanas, 697, 698.)
Chyliferous vessels, affections of the  (ole-
    um morrhuae, 555.)
Colic (chloroform, 219; fuligo, 392;  sum-
    bul, 48.)
  Flatulent (aetherization, 85 ;  chloroform,
    213 ; creasotum, 295.)
  Hysterical  (ol. sinapis, 564.)
  Nephritic (aetherization, 86; chloroform,
    219.)
Colica pictonum (aetherization, 85 ; chloro-
    form, 213; iodinium, 472; nux vomica,
    542.)
Coma (strychnia, 660; ol. tiglii, 509.)
Concretions  of  urate of soda  (ammoniae
    phosphas, 94.)
Concretions of urate of soda
  tophaceous, (acid, benzoic. 38.)
Condylomata (argent, pr.uparat.  107 ;  cre-
    asoton, 287; hydrarg. deuto-iodid. 428,
    429.)
Congestion (electro-magnetism, 317; electro-
    puncture, 321; haemospasia, 725.)
  In the  head (ammoniated  counter-irri-
    tants, 271.)
Conjunctiva, granular (acid, tannic. 60.)
  tumefaction of the (acid, tannic. 60.)
Conjunctivitis (collodion, 257; electro-punc-
    tura, 321; lactucarium, 504; zinci va-
    lerianas, 701.)
  Scrofulous (hydrargyri cyanuretum, 422;
    potassii iodidum, 605.)
Constipation  (aq. picea,  105; bile of the
    swine, 720 ; colchicum, 249 ; fel bovi-
    num,  719; galvanism,  402;  magne-
    sia? citras, 507; mannit. 510;  nux vo-
    mica,  544; ol. tiglii,  570; strychnia,
    603;  veratria,  686.)
Consumption, see Phthisis.
Contagion (calx chlorin. 171; chlorin.  202;
    plumbi nitras, 738;  zinci chlorid. 693.)
Contractions, muscular, (acupunct. 73.)
Contusions (acupunct.  73; creasoton,  284;
    iodinium, 490.)
Convalescence, (berberina, 147.)
  from bronchitis and pneumonia, 510.
  Tedious (paullinia, 573.)
Convulsions (aetherization, 85;  ammoniated
    counter-irritants,  270; auri  praepar.
    128; cimicifuga, 232; compression of ar-
    teries, 263 ; magnes, 506; moxa,  536;
    potass, cyanur. 594.)
  During dentition (chlorin. aq.  206.)
  Epileptic, (chloroform, 213.)
  Hysterical (compression of arteries,  263;
    electro-magnetism, 313; indigum, 437.)
  Infantile (chloroform, 218.)
  Parturient (aetherization, 88; chloroform,
    222;  ergota, 336.)
  Convulsive affections (acupunct. 73.)
    Diseases of childhood (artemisia, 123.)
Cornea, granulations on the (fuligo, 393.)
  Inflamed (acid, tannic. 60; collodion, 257.)
  Obscurity of the  (calx chlorin.  169.)
  Opacity of  the  (acid,  hydrocyan.  52;
    electro-punctura,  321;  hydrarg.  iodid.
    rubr.  428; iodinium, 492;  ol. jecor.
    aselli, 555, 559;  zinci ferrocyanuret.
    697.)
  Scrofulous ulcers of the (ol. ieoor. aselli.
    555.)
  Sparks on the (iodinium, 492.)
  Specks on the (cadmii sulphas,  705;  fu-
    ligo,  393,  395.)
  Spots on the (fuligo, 393; zinci valerianas,
    701.)
  Ulcers  of the (argenti oxidum, 113; ol.
    jecor. aselli, 555;  zinci ferrocyanuret.
    697; zinci valerianas, 701.)
Coryza (cubebae, 302.)
Cough (chloroform, 213;  cimicifuga, 233;
     codeia,  241;  lactucarium, 505.) 
DISEASES AND THEIR  REMEDIES.
XV
Cough
  Asthmatic (napthalin, 734.)
  hysterical, (cauterization, etc., of the la-
     rynx, 192.)
  Nervous (acid, tannic. 59.)
  Spasmodic (chloroform,  214, 219;  chon-
     drus, 230;  lactucarium, 505.)
  dry (fucus crispus, 230.)
  Btomach, (-cauterization, etc., of the larynx,
     192.)
Coxalgia (iodinium, 480.)
Coxarthrocace (ol. jecor. aselli, 559.)
Cramp (ammoniated counter-irritants, 270;
     magnes, 506 ; sumbul, 748.)
  of the stomach (nux vomica, 546; zinci
     ferrohydrocyanas, 696, 697, 698.)
  Writer's (electro-magnetismus, 312.)
Croup (Jiaemospasia,  725;   iodinium, 492 ;
   quinia? sulphas, 625.)
  Hysteric (creasoton, 295.)
  membranous,  (iodinium, 466.)
Crusta lactea (creasoton, 289.)
Cutaneous diseases  (acid,  hydrocyan. 52;
     anthrakokali, 95; aqua picea, 104; ar-
     Benias ammoniae, 118; arsenic.iodidum,
     119; aur. chlorid. 133; aur. cyanidum,
     130; calx chlorin.  168; chlorin. 202;
     chlorin. aq. 209; collodion, 254; crea-
     soton, 288; ferr. carbur..351; fuligo,
     394; fuligokali, 392; glycer. 407; hura
     Brazil., 727; hydrarg. deuto-iodid. 427,
     430;  hydrarg. deuto-nitras, 433; hy-
     drarg. et arsen.  iodid. 435; hyd.  et
     quiniae  protochloridum, 727; hydrar-
     gyri protonitras, 431; iodidum ammonii,
     497; iodid.  sulph. 675; iodinium, 472;
     juglans, 501; manganesii sulphas, 732;
     naphthalin, 735; oleum cadinum, 736;
     ol. jecor. aselli, 555, 558; plumbi nitras,
     738; potassa? chloras, 585; potassii cy-
     anuret.  594; quinia? arsenis, 609; soda
     chlorin.  048; sodae hyposulphis, 743 ;
     solution of gutta percha in chloroform
     in, 258; sulphur, iodid. 674.)
  Syphilitic (hydrarg. iodid. rubr. 427.)
Cynanche (chlorin. aq. 208; cort. adstring.
     Brazil. 273.)
  Tonsillaris, see Sore Throat.
  Of scarlatina (ferri et aluminae sulphas,
     721.)
Cysto-sarcoma (chloride of bromine, 154.)
Cysts, hydatid,  of  the liver,  (iodinium,
     480,.)
  ovarian, dropsical (iodinium,  484.)
  sanguineous, of thyroid (iodinium, 487.)
  serous, &c. (electro-punctura, 321; iodi-
    nium, 482.)
  of the thyroid (iodinium, 488.)

Dacryocystitis  (iodinium, 481.)
Dartrous eruption (fuligo, 393; hydrarg. io-
  did. rubr.  427; iodinium, 472.)
Deafness (acid. acet. empyr. 35; creasoton,
  2H1; cubeba,  300; electro-magnetism,
  311; electro-punctura, 314;  galvanism,
  398; glycerin, 407;  hoemospasia,  725;
Deafness
  injections of air, &c, 441;  sulphuris car-
  buretum, 672.)
  Erethitic, nervous (injections of vapour of
     acetic ether, 445.)
  Nervous, torpid (injections of vapour of
     acetic ether, 445.)
Debility (ferr. iodid. 363; nux vomica, 541;
  piperina, 577.)
  General  (quiniae et  cinchoniae tannas,
     637.)
  Nervous  (acid, tannic. 59;  quiniae sul-
     phas,  633;  zinci  ferrocyanuretum,
     697.)
  Paralytic (ammoniated counter-irritants,
     271.)
Decubitus  gangraenosus (plumb, tannas,
     583.)
Delirium, maniacal (chloroform,  213.)
  peculiar (chloroform,  214.)
  tremens (aetherization, 85; animal magne-
     tism,  405; chloroform, 213,  219;  ol.
     tiglii, 568; sumbul, 748.)
Dentition (chlorin. aq. 206.)
Depositions, morbid (electro-puncture, 323.)
Diabetes insipidus (sumbul, 748.)
  Mellitus  (acid,  gallic.  42;  acid, tannic.
     58; coagulum, 711; creasoton, 295; fel
     bovinum, 719; ferri iodidum, 364; hy-
     permanganate of  potassa, 733 ; oleum
     morrhuae, 557;  strychnia, 663;  urea,
     677.J
Diarrhoea (acid. acet. empyr. 35; acid, car-
     bazoticum, 702; acid, tannic. 59, 62;
     aq. picea, 105 ; argilla, 115 ;  artemisia,
     124;  carbo-animalis, 185;   chondrus,
     230;  creasotum, 294, 297;  ferri et alu-
     mini  sulph. 721; fuligo, 392: indigum,
     437 ;  liq. ferr. persesquinit. 371; mone-
     sia, 519;  nux vomica, 546;  paullinia,
     573;  spiritus pyroaceticus, 651; strych-
     nia, 662; sumbul, 748; veratria, 686.)
  Bloody, (acid, gallic. 41.)
  Choleraic (nux  vomica, 543; strychnia,
     602.)
  Chronic (acid, tannic. 59; argent, chlorid.
     109;  argent,  oxid.  113;  emetia, 320;
     ferri  et alumin. sulph. 721; ferr.  ferro-
     cyanuret.  357;  ferri* iodid. 363; ferri
     nitras, 371; matico, 515; morphiae ace-
     tas, 529;  nux vomica, 544.)
  Of infants (argilla, 117; iodinium, 492.)
  Of phthisis  (ferri  et  alumina? sulphas,
     721;  ferri nitras, 371;  monesia, 519;
     paullinia,  573.)
  serous (acid, gallic.  42.)
Diathesis  phthisica (chlorin.  aq.  209.)
Digestive  function,  torpor of the (cainca,
     160;   chimaphila,  195;  gentiana chi-
     rayita, 406; hippocastanum, 417; mo-
     nesia, 519; salicina, 644.)
  organ-;,  disease of the mucous membrane
     of the (galeopsis grandiflora, 397.)
Diphtheritis (ferri et aluminae sulphas, 721;
     fuligo, 392.)
  of the throat, (chlorinii aqua, 208.) ~ 
xvi
ALPHABETICAL LIST OF
 Diplopia, (acupunct.  73.)
 Discharges from the  meatus  auditorius
     (acid. acet.  empyr. 35.)
   from the nose and ear (iodinium, 476.)
   From the vagina (fuligo, 393.)
   intestinal (matico, 515.) ,
   Mucous (cortex adstringens Brazil. 273 ;
     creasoton, 288; ferri et aluminae sulph.
     721; fuligo, 393;  hippocastanum, 417.)
   Offen-ive (acid. acet. empyr. 35.)
   Urethral, (soda? et argenti hyposulphis,
     744.)
 Disinfection (chlorin. 203; chlorin. aq. 209;
     zinci chlorid. 693.)
 Districhiasis (collodion, 257.)
 Dropsy (acid.  acet. empyr. 35;  acid, hy-
     drocyan. 52; auri chlorid. 133; auri et
     sodii chlorid. 135; auri praeparat. 132;
     ballota lanata, 140; benzoate of ammo-
     nia, 39; caincae radix, 160,161; chima-
     phila, 195; chlorin. aq. 208; cimicifuga,
     231; colchicum, 248; compressio, 259;
     digitalin, 309; electro-punctura, 321;
     ferr. iodid. 365; hippocastanum, 417;
     iberis, 728;  iodinium, 466, 485; ma-
     fias, 511;  nux vomica, 544; ol.  sina-
     pis, 565;  ol. tiglii, 566; potassii  io-
     didum, 601; potassii iodohydrargyras,
     596; quiniae  sulphas,   624;  sanicula
     marilandica, 741; sumbuli radix, 748;
     urea,  677; veratria, 685, 688.)
   After intermittents, (ferri iodid. 365; hip-
     pocastanum, 418; oleum sinapis, 565;
     quiniae sulphas, 624.)
   After scarlatina (colchicum, 248; iodin.
     467.)
   Encysted (acupunct.  75.)
   From induration of the liver (iodinium,
     466.)
   Of the bursa? (iodin. 468.)
   Of the joints (electro-punct. 321.)
   Of the  ovary  (compressio, 259; iodin.
     484; potassii iodidum, 599.)
   Of the  pericardium  (electro-puncture,
     321.)
Drunkenness (sulphuris carburetum, 672.)
Dumbness (galvanism,  398.)
Dyscrasy (ferr. iodid. 365; sulphuris car-
     buretum,  672.)
   After intermittents (ferr. cyanur. 357.)
     See Cachexia.
Dysentery (acid, gallic. 42;  acid,  tannic.
     59; aq. Brocchierii, 103; argenti chlo-
     ridum, 109;  argilla, 115;  artemisia,
     124;  calx chlorinata, 166;  chondrus,
     230;  eau he"mastatique de Tisserand,
     103; ergota, 336; ferri et aluminae sul-
     phas, 721; ferri ferrocyanur.  357; fu-
     ligo, 392; iodinium, 476; nux vomica,
     544, 545, 546; paullinia, 573; sanicula,
     741; spiritus pyro-aceticus, 651; strych-
     nia, 002.)
   Camp (creasotum, 294.)
  Chronic  (creasotum, 294.)
  Putrid (chlorin.  aq. 86.)
Dysmenorrhoea (aetherization, 86;  bile  of
 Dysmenorrhoea
     the swine, 720;  chloroform, 220, 221;
     electro-magnetism, 315;  ergota, 33 i;
     potassii iodohydrargyras, 596;  vera-
     tria, 085.)
 Dyspepsia (acid. lact. 56;  acid, tannic. 59;
     argil, 115; berberina, 116; bile of the
     swine, 720; buchu, 158; carbo-animalis,
     185;  chimaphila,  195;  fel bovinum,
     719 ; ferr. iodid. 303 ; fuligo, 39 1; gen-
     tiana chirayita, 400;  hippocastanum,
     417;  matias,  511; nux vomica,  544;
     ol. sinapis, 505; permanganate of po-
     tassa, 734; potassii  iodohydrargyras,
     590; quinia? sulphas, 619;  salicina, 644;
     strychnia, 661; sumbul, 748.)
     irritable (cerium, 711.)
 Dysphagia (artemisia, 124.)
  Spasmodic (acid, hydrocyan. 51.)
 Dyspnoea (galvanism, 399 ; potass, cyanur.
     594.)
 Dysuria (acidum benzoicum, 38; apis melli-
     fica, 700; chimaphila,  195.)
 Ear affections (cadmii sulphas, 705.)
  Middle,  affections of the mucous  mem-
     brane of the (iodinium, 481. j
  Pain in the (morphia, 520.)
Eclampsia infantum (artemisia, 123, 124.)
 Ectropion (collodion, 257.)
Eczema (acid, tannic. 66; auri chlorid. 133;
     brominium, 153; collodion, 254;  ferri
     arsenias, 348; juglans, 506;  ol. cadi-
     num, 736 ; ol. jecoris aselli, 559 ; solu-
     tion of gutta percha in chloroform, 259;
     sulphur, iodid. 675.)
  Chronic (acidum carbazoticum, 702.)
Effused fluid (electro-magnetism, 317.)
Effusions from sprains, &c. (veratria, 686.)
     rheumatic (electro-magnetism, 311.)
Elephantiasis (ferri arsenias, 3 18 ; iodinium,
     473; hura Brasiliens. 727.)
Emaciation (chondrus, 230.)
Emissions, nocturnal. See Spermatorrhoea.
Empyema (iodinium, 485.)
Engorgements, visceral  (ferr. iodid. 365.)
Enlargements, glandular, scrofulous (potas-
     sii iodohydrargyras, 596.)
Enteralgia (acid, hydrocyan. 51.)
Enteritis (acid, hydrocyan. 50.)
  Chronic (monesia, 519.)
Entropion (collodion, 257.)
Ephelis (hydrarg. et arsen. iodid. 435.)
Epilepsy  (acid,  hydrocyan. 51 ; acupunct.
     73; ammoniated counter-irritants, 270;
     argenti chloridum, 108; artemisia, 122;
     atropia, 127 ;  cauterization, &c. of the
     larynx, 192:  chloroform, 213;  com-
     pression of arteries,  263; conia, 715;
     creasoton, 295; ferr. cyanur. 357; gal-
     vanism, 399 ;  granatum, 413;  indigum,
     437; iodide of zinc  and strychnia, 669;
     iodinium, 470; magnes, 506; nux vo-
     mica, 545;  platinum, 579; strychnia,
     661; sumbul, 748; valerianate of atropia,
     128; zinci chlorid. 6!)2, 694; zinci ferro-
     hydrocyanas, 696, 700; zinci valerianas
     700.)                                ' 
DISEASES AND THEIR REMEDIES.                   XVli
Epistaxis (acid,  tannic.  59 ; argenti oxi-
    dum, 113; cort. adstring. Brazil. 273;
    creasoton, 2S2,295; ergota, 336; ferri
    et alumini  sulph.  721; matico, 516;
    monesia, 520.)
Epithelioma (chloride of bromine, 154.)
Erectile  tumours  (collodion, 255; electro-
    punctura, 321; ol. tiglii, 569.)
Erections, nocturnal (lupulina, 731.)
Favus, Cacid. acetic, empyr. 35; conia, 715.)
Febrile affections (chlorin.  aq.  207 ;  col-
    chicum, 246;  morphia, 521; oleum si-
    napis, 564; potass,  nitras,  730 ; vera-
    tria, 686.)
Feigned  diseases (aetherizatio, 87;  chloro-
    form, 221.)
Fetid discharges (alumina? sales, 96;  plumbi
    nitras, 738.)
Erethism, morbid (creasotum,295; potassae ; Fever  (acid, hydrocyanic. 50.)
    chloras, 584.)
Ergotism, 330.                     f
Eruptions, chronic (fuligo, 393.)
Erysipelas (argilla, 115; chlorin. aq. 208;
    colchicum, 249; collodion, 254;  com-
    pressio, 259; congelatio, 714;  creaso-
    ton, 288;  ferri chloridum, 721; iodin.
    487 ;  ol. jecoris aselli, 559; solution of
    gutta percha in chloroform, 253;  zinci
    chlorid. 693.)
  Of the face (cort.  adstring. Brazil. 273 ;
    haemospasia, 725.)
 Erythema, chronic (collodion, 251.)
 Eustachian tube, obstructed (injections of
    air, &c. 441.)
 Euthanasia, (aetherizatio, 87.)
 Exanthemata, febrile (chlorin. aq. 208.)
 Exanthematous   diseases  (cort.  adstring.
    Brazil. 273.)
 Excitability (acid, tannic. 59.)
 Excoriation from lying (creasoton,  284.)
   Of the skin (glycerina, 409;  oleum jeco-
    ris aselli, 559.)
   Syphilitic (aurum metallicum, 139.)
 Excrescences, adventitious (iodinium, 492.)
   Syphilitic (aurum metallicum, 139.)
 Exhaustion (monesia, 519 ; strychnia, 662.)
 Exostosis (fuligo, 392.)
 Expectoration, excessive (acidum gallicum,
    42.)
   Fetid (calx chlorinata, 166.)
   Of phthisis (argenti oxidum, 113;  iodin.
     463.)
 Eye, black (calcis chlorid. 168.)
   Cancer of the (morphia, 527.)
   Diseases  of the  (cadmii  sulphas,  707;
     iodinium, 461; potass, cyanuret. 593;
     zinci valerianas, 701.)
   Painful affections of the (morphia, 527.)
   Strumous ulcerations of the (aether  sul-
     phuric. 86;  oleum morrhuae, 555.)
 Eyeball, certain diseases of the (strychnia,
     655.)
 Eyelids, inflammation of the (acid.  acet.
     empyreum.  35; creasoton,  290,  298;
     ol. jecoris  aselli, 555 ; zinci  ferrocy-
     anuret. 697  ; zinci valerianas, 701.)
   Granular (auri chlorid. 133;  calx  chlo-
     rin. 169 ;  iodin. 492;  ol. jecoris aselli,
     555, 556.)
   Inverted states of the (collodion, 257.)
   Spasms of the (conia, 715.)
 Fainting, hysteric  (sulphuris carburetum,
     Cu2, 673.)
 Fauces, inflammation, &c. of the (aq. chlo-
     rinii, 210.)
   Ulcerated, (iodinium, 492.)
   adynamic stage of, (bile of the swine,
   720.)
 Brain (compression of arteries, 263.)
 Congestive (quiniae sulphas,  021, 029.)
 Continued (acidum carbazoticum, 702.)
 Epidemic (iodinium,  408.)
 Gastric (artemisia, 124; chlorin. aq. 208.)
 Hay (nux vomica, 544.)
 Hectic (acid, hydrocyan. 50; chlorin. aq.
   209.)
 Intermittent, see Intermittent.
 Irritative (chlorin. aq. 200.)
 Low (potassa? chloras, 587.)
 Masked (salicina, 044.)
 Malignant (quinia? sulphas,  021.)
 Nervous  (chlorin. aq. 206.)
 Of Edinburgh (calx  chlorinata, 166.)
 Paroxysmal (quinhe  sulphas, 621.)
 Pernicious (quiniae sulphas, 021, 029.)
 Petechial (aq.  chlorin. 206.)
 Putrid (acid. acet.  empyr.  35; chlorin.
    aq. 200.)
  Puerperal (potass, nitras, 740.)
  Remittent, see Remittent.
  Summer (quinia? sulphas, 633.)
  Typhoid, see Typhoid.
  Typhous (soda? chloridum, 648.)
  Yellow (guaco, 415;  quin. sulphas, 021;
    simaba cedron, 742.)  See Typhus.
Fissures of the anus (acid, tannic. 60, 02;
    monesia, 520.)
  Of the lips (glycerin, 409.)
  Of the nipple (collodion, 255; glycerin,
    409.)
  Of the  skin (creasoton, 285;  ol. jecor.
    aselli, 559.)
Fistula, biliary (iodinium, 488.)
Fistulae (acid, hydrocyan. 52; calcis chlorid.
    167;  galvanism,  401, 405;  iodinium,
    489;  ol. jecoris  aselli,  562;   potass.
     iodid. 604.)
Fistulous openings (iodinium, 492 ; juglans,
    502.)
Flatulence (creasoton, 294; sumbul, 748.)
Fluor albus, see Leucorrhcea.
Fluxes (acid, gallic. 41.)
Foetor oris (calx  chlorin. 166,  172,
     chlorin. aq.   209;  chloroform,
     creasotum,  297.)
FoUicular affections of the skin (collodion,
     -■>»■>
Fractures, ununited (acupuncture, < 0: iodi-
     nium, 480, 492.)
Freckles (hydrargyri deutonitras, 433.)
Frost bites (calx chlorin. 108, 174.)
     Gangrenous,  (zinci chlorid. 693.)
173;
214; 
\
XV111
ALPHABETICAL LIST OF
Fungoid disease (chloroform, 213.)
Fungous  tumour  (creasoton, 286;  galvan-
    ism,  401; zinci chlorid. 690.)
Fungus of the neck  of  the uterus (aur.
    nitrico-muriat. 137.)
Furunculous  swellings (aq. chlorin. 207;
    hydrargyri iodid. rubr. 428.)
Ganglion (acupunct.  76;  hydrarg. iodid.
    rubr. 428; iodinium, 492.)
Ganglionic  system,  disorder  of the (ferri
    ferro-cyanur. 359.)
Gangrene  (acid.  acet. empyr. 34; calcis
    chlorin.  167, 174;  soda  chlorinata,
    648.)
  Hospital (calx  chlorin. 167, 174;  crea-
    soton, 286; iodinium, 491.)
  Of the lungs (calx chlorinata, 166; chlo-
    rin. 200.)
  Of the scrotum (calx chlorin. 167.)
Gangrenous erethism, (See ergota, 331.)
  Sloughs (monesia, 520.)
Gastralgia  (bismuthi  valerianas, 707; cin-
    chonia, 235;  iodide of zinc and mor-
    phia, 699;  morphia?  acetas, 528;  nux
    vomica, 543;  strychnia, 663.)
Gastricism  (carbo-animalis,  185;  manni-
    tum, 510.)
Gastritis (codeia,  242.)
Gastrodynia (acid, hydrocyan. 51; acupunct.
    73; argenti oxidum, 113; bismuthi vale-
    rianas, 707;  cerium, 711; creasoton,
    294; nux vomica, 513; ol. sinapis, 564.)
Gastro-enteralgia (nux vomica, 543.)
Gastromalacia (acid. acet.  empyr. 35 ; chlo-
    rin. aq. 208.)
Genital organs,  atony of the (cort. adstring.
    Brazil. 273; cubebae, 299 ; nux vomica,
    541.)
  Catarrh of  the  (cortex adstringens, 273.)
Glanders, chronic (creasoton, 295.).
Glands, enlarged (carbon, sesqui-iodid. 187;
    iodinium, 460; plumbi iodid. 582.)
  External, affections of the (oleum mor-
    rhuae, 555, 556.)
  Induration*of the (calendula, 163 ; carbo-
    animalis, 185;  fuligo, 392; hydrarg.
    deuto-iodid. 428, 429.)
  Inflamed (chloric ether, 227.)
  Internal, affections of the (oleum mor-
    rhuae, 555.)
  Lymphatic, of  the neck, (iodinium, 460,
    462.)
  Mammary,  enlarged (veratria, 686.)
  Meibomian, copious secretions  from the
    (calx ehlorin. 169.)
  Mesenteric, enlarged (iodinium, 459.)
  Of the neck, inflamed  (hydrarg. iodid.
    rubr. 428.)
  Scrofulous  swellings of the (calx chlorin.
    168; chlorin. aq. 209; iodide  of chlo-
    ride  of mercury, 499;  iodinium, 460,
    489.)
  Submaxillary, enlarged (carbo-animalis,
    185; iodinium, 459.)
  Strumous (hydrarg. iodid.  424;  potassii
    hydrargyro-iodid. 596.)
  Tumefied (calendula, 163.)
Glandular affections (auri chlorid. 133 5 col-
    lodion, 255; fuligo, 392 ; inunctio, 730;
    iodinium, 459; veratria, 680.)
Gleet (acid, tannic. 59; calx chlorin. 170;
    creasoton, 287;  cubebae, 301;  ergota,
    343; nux vomica,  540; plumbi nitras,
    738; potassii  iodidum, 601; strychnia,
    663, 666.)
Goitre (brominium, 153 ; calcis chlorin. 168,
    175; electro-punctura, 321; hydrarg.
    deuto-iodid. 428;  iodinium, 458, 479,
    182; potassii bromid. 589; potass, iodid.
    0^2; sulphuris carburetum, 072.)
  Impeded  respiration  from  (iodinium,
    494.)
 , Scirrhous (carbo-animalis, 185, 186; sul-
    phuris carburetum, 072; veratria, 686.)
Gonorrhoea (acid, gallic. 42; acidum tanni-
    cum, 59 ;  argenti praeparat. 107 ; auri
    praepar. 131; buchu, 158; calx chlorin.
    166, 170, 172; chlorin. aq.  209; chlo-
    roform, 214;  colchicum, 249;  creaso-
    ton, 287;  cubebae, 299,  301;  ergota,
    336 ; ferri iodid. 307 ;  hydrargyri deu-
    to-nitras, 432; iodide of zinc and mor-
    phia, 699;  iodin.  475; lupulina, 731;
    matico, 514; platinum, 579; zinci chlo-
    rid. 694; zinci iodid. 699.)  See  Blen-
    norrhcea.
Gout  (aconit.  67;  acupunct. 73;  ammon.
    phosphas,  91;  ammoniated counter-
    irritants, 271;  ballota lanata, 141; ben-
    zoate of  ammonia,  39;  chimaphila,
    195; chloroform, 220;  colchicum, 246,
    249, 251; compression  of arteries, 263;
    creasoton, 293;  fraxinus, 723;  glyce-
    rin, 409;  hosmospasia, 724; iodinium,
    479, 488; juglans, 501;  magnes, 506;
    manganesii sulphas, 732;   ol. jecinor.
    aselli, 551, 555; ol. tiglii, 567; spiritus
    pyroaceticus, 651;  succus limonis, 746;
    sulphuris carburetum, 672; veratria,
    684.)
  Atonic (creasotum, 293, 296; hippocas-
    tanum, 417.)
  Chronic (buchu, 158;  chimaphila, 195;
    colchicum, 247;  fraxinus, 724; ol. tig-
    lii, 507 ;  succus limonis,  746.)
  Irregular (strychnia, 661.)
  Rheumatic (auri chloridum,  133;  fraxi-
    nus, 723; succus limonis,  746.)
  Suppressed  (ammoniated   counter-irri-
    tants, 271.)
  Swellings  after,  (ammonia?  phosphas,
    94.)
Gouty diathesis (acidum  benzoicum, 38;
    veratria, 685.)
  Swellings of bones (iodin. 402 ;  ol. jeco-
    ris  aselli, 561; potass,  iodid. 603.)
    Of the joints  (iodinium, 479.)
Gravel (buchu, 159.)
  Uric acid (ammon.  phosphas, 93;  soda?
    phosphas,  744.)
  White  (acid. lact.  56.)
Growths, morbid (baiii iodidum, 142; elec-
    tro-magnetism,  317;  galvanism, 401.)
Gums, affections of the (chloroform, 213.) 
DISEASES AND THEIR REMEDIES.                  XIX
Gums
  Lnflamed and ulcerated (chloric  ether,
    227.)
  Irritation of the (creasoton, 298.)
  Scorbutic  ulcerations of the  (creasoton,
    286, 297; iodin. 480; monesia, 520.)
  Sponginess of the (acid, tannic. 59.)
Gutta rosacea  (fuligo, 392;  sulph.  iodid.
    674.)
Haematcmesis (argent, oxid.  113; creaso-
    ton, 283 ;  ergota, 337; ergotin, 344 ;
    matico,  515.)
Hematocele (iodinium, 484.)
Ha?maturia (acidum gallicum,  41; buchu,
    158; creasoton, 283; ergota,  337.)
Haemoptysis  (acidum gallicum, 41;  acid.
    tannic. 59, 60; aq. Brocchierii, 103: ar-
    gent, oxid. 113;  chondrus, 231; cort.
    adstring. Brazil.  273); creasoton,  283,,
    297; eau hemastatique de Tisserand,
    103; ergota, 337; galeopsis, 397; lactu-
    carium, 595; monesia, 519; plumbi ni-
    tidis, 738;  tannin, 60.)
 Hair, tninness of the (glycerin, 409.)
 Hallucinations  (atropia, 127.)
 Head, congestion in the (ammoniated coun-
    ter-irritants, 271.)
   Fulness of blood in the (ammoniated coun-
     ter-irritants, 271.)
 Headache, intermittent (bebeeria, 144; nic-
     coli sales, 735;  quinia? sulphas, 631,
     635.)
   Nervous (ammoniated  counter-irritants,
     271; iodin 470;  strychnia, 661.)   See
     Cephalalgia.
   Rheumatic (creasoton, 293.)
   Sick  (chloroform,  219; compression of
     carotids, 203.)
 Hearing, defective, from otorrhcea (cubeba?
     300.)
 Heart, diseases of the (aconitia, 68; haemos-
     pasia, 725; veratria, 085.)
   Chronic disease of the (digitaline, 309.)
   Enlargement of  the, (acid, hydrocyanic.
     51.)
   Hypertrophy of the (brominium, 153; di-
     gitaline, 308, 310: iodin.  474;  potass.
     bromid. 589;  potass, iodid. 001,  002.)
   Neuralgia of the (aconitia, 68.)
   Quickened action  of  the  (potassii iodi-
     dum, 602.)
   Spasmodic affections of the (acid, hydro-
     cyan. 51.)
 Hectic fever (acid, hydrocyan. 50; chlorin.
     aq. 209.)
 Helminthiasis  (juglans, 501.)
 Heniicrania (acid, hydrocyan. 51;  aconit.
     08; aetherization, 85;  caffeina,  709;
     chloroform, 214; compression  of arte-
     ries, 264; ferri  subcarb.  385;  paul-
     linia, 573; potassii  cyanuretum,  593
     594; zinci valerianas, 700.)
 Hemiplegia  (electro-magnetism,  311; nux
     vomica, 542; strychnia, 059.)
   Rheumatica (electro-magnetismus, 312.)
 Hemorrhage (acid, gallic. 41;  acid, hydro-
     cyan. 50; acid, tannicum, 58, 59, 62:
I Hemorrhage
     aq. Binellii,  97;  aq. Brocchierii, 99;
     argilla* 115; cort. adstring. Brazil. 273 ;
     creasoton,  280; eau  hemastatique de
     Tisserand,  103; eau de Pagliari, 103;
     ergota,  336,  337,  343; ergotin,  344;
     ferri et alumin. sulphas, 721; ferr. io-
     did. 365; matico, 513; sanicula, 741.)
   Accidental (matico, 514.)
   Active (acid,  gallic. 42; acid, hydrocyan.
     50; ergota, 343.)
   After abortion (creasoton, 283.)
   After lithotomy (creasotum, 283.)
   Capillary, (creasoton, 283; matico, 514.)
   From arteries  of the lower limbs  (com-
     pression of the aorta, 264.)
   From leech-bites  (creasoton,  282; ferri
     et alumina? sulphas, 721; matico, 514.)
   From the bladder (creasotum, 283.)
   From the gums (acid, tannic. 59; creaso-
     ton, 283.)
   From the lungs.  See Haemoptysis.
   From the prostate, (acid, gallic. 40.)
   From the tongue (matico, 513.)
   From  the vagina,  and tongue (matico,
      514.)
   Internal (haemospasia, 725.)
   Intestinal (acid,  tannic.  59;  argenti
      oxyd. 113; creasoton, 283;  eau hemas-
      tatique de Tisserand, 103; ferri nitras,
      372; matico, 514.)
   Passive (acid,  gallic. 42.)
   Traumatic (creasoton, 282, 283; matico,
      516.)
   Uterine (acidum gallicum, 41; acid, tannic.
      58,62; argent, oxidum, 113; cannabis
      indica, 182; compression of the aorta,
      204;  cortex adstringcns  Brasiliensis,
      273; cre'asoton, 282;  electro-magnet-
      ism, 314; ergota, 336;  ergotin, 345;
      ferri chloridum, 723: ferr. iodid. 354,
      304;  haemostasis, 727;  matico, 515;
      monesia, 519; ferri citras, 354.)
  Hemorrhagic  diathesis  ('acid,  gallic. 42;
      acid, tannic. 59;  matici* 513; quiniae
      sulphas, 634.)
  Hemorrhoids  (acidum  chromicum,  703;
      acid, nitric. 703;  acid, tannic. 59, 60;
      chloroform,  220; cotyledon umbilicus,
      716;  galvanic cautery,  405;  matico,
      514;  monesia, 520.)
  Hepatic diseases.  See Liver Affections.
  Hernia humoralis.  See Orchitis.
    Incarcerated (sulphuris carburetum, 672,
      073.)
    Reducible (iodinium, 48:5.)
  Herniary sacs (acupunct. 74.)
  Herpes (acid,  hydrocyan.  52,  54;  aqua
      picea, 104;  auri praeparata, 132; calx
      chlorin.  169;  chlorin. aq.  209,  210;
      collodion,  254;  creasoton, 289;  ferri
      arsenias, 348; ferr. carbur. 351; fuligo,
      392, 394; hydrarg. cyanur.  422; hy-
      drarg.  deuto-iodid.  428;  iodin.  472 ;
      juglans,  501; ol. jecinor.  aselli, 558;
      potass, bromid. 589; potass, iodid. 600,
      002;  sulphur, iodid. 075.) 
XX
ALPHABETICAL LIST  OF
 Herpes
   Circinnatus (ferri tannas, 387; iodinium,
     472.)                   ,
   Exedens (collodion, 2)4;  creasoton, 289;
     potas-ii iodidum, 603.)
   Labialis (collodion, 254.)
   Phagedenic (arsenic, iodid. 120; potassii
     iodidum, 694.)
   Scrofulosus exedens  (hydrargyri  deuto-
     nitras,  433.)
   Zoster  (collodion, 254, 256.)
 Herpetic  ulcers  (acid. acet. empyr.  34;
     creasoton,  287.)
 Hiccough, spasmodic   (aetherization,  85;
     chloroform, 219; compressio, 264 ; ferri
     nitras, 372; magnes,  506; quiniae sul-
     phas, 025.)
 Hip-joint disease (moxa, 537; oleum mor-
     rhuae, 556; quiniae'sulphas, 620.)
 Hoarseness (cauterization, etc. of the larynx,
     192;  chondrus, 230;  iodic  acid, 498;
     ol. tiglii, 567.)
 Hooping-cough (acid, hydrocyan. 50,  54;
     acidum nitricum, 704;  acid, tannic. 60;
     aether hydrocyan. 77 ;  aetherization, 85;
     argent, iodid.  112;  atropia, 127; cau-
     terization, &c. of the larynx, 191; chlo-
     roform, 219; conia, 715;  emetia, 320;
     ferr.  carb.  383; iodin.  466;  ol. tiglii,
     567;  valerianate of atropia,  128; vera-
     tria, 085.)
 Hordeolum (hydrarg. iodid. rubr. 428.)
 Hydrarthrosis (electro-punctura, 321; iodi-
     nium, 482.)
 Hydrocele (acupunct.  75;  chlorin.   202;
     chloroform, 214;   electro-magnetism,
     317;  electro-puncture, 321,  322; iodi-
     nium, 466, 481.)
 Hydrocephalus (compressio, 259; electro-
     punctura, 321; hydrargyri cyanuretum,
     422;  inunctio,  730; iodinium, 467.)
 Hydrocyanic acid,  poisoning  by  (chlorin.
     202.)
 Hydropericardium (electro-punctura, 321;
     iodinium* 483.)
 Hydrophobia (aetherization,  85;  atropia,
     127; cannabisnndica, 180,183; chlorin.
     aq. 208; chloroform, 218; compression
     of the arteries, 265; guaco, 415; mor-
     phia?  acetas, 528; simaba cedron, 742.)
 Hydrops articuli (veratria,  686.)
 Hydrothorax (acid, hydrocyan. 51; colchi-
     cum,  248;  electro-punct. 321;  ferr.
     iodid. 305; iodinium, 466, 483, 485.)
 Hygroma  (iodinium, 468.)
 Hyperaemia  (ammoniated counter-irritants,
     271.)   See Inflammation.
 Hyperaesthesia^conia, 714.)
Hyperemesis (acid, tannic. 00.)
Hypertrophy (barii iodidum, 142; compres-
     sio, 259; ferr. bromid. 350; ferr. iodid.
     365.)
  Of the coats of the stomach (sulph. car-
     buret. 073.)"
  Of the heart (brominium, 153; digitalina,
    308, 310; iberis amara, 728; iodiu. 474;
 Hypertrophy                   .
     potass, bromid. 589; potass, iodid. 001,
     602.)
   Of the mammae  (iodinium, 459.)
   Of the spleen (iodin. 459;  quiniie, 607.)
   Of the thymus (iodin. 459.)
   Of the uterus (ergota, 338.)
   With dropsy (iberis, 728.)
 Hypochondriasis (auri praeparat. 128; chlo-
     rin. 202: chloroform, 214; quiniae sul-
     phas, 627 ;  strychniae,  661;  veratria?,
     684.)
 Hysteralgia (euphorb. ol.  347.)
 Hysteria (letherization, 85;  atropia, 137;
     chloroform, 213; cimicifuga, 231; crea-
     soton, 295; ergota, 337 ; ferri valerian-
     as, 388; fuligo,  394;  galvanism,  398,
     403;  granatum,  413;  indigum, 438;
     lactucarium, 505; strychnia, 601; sum-
     bul, 730;  valerianate of atropia, 128;
     veratria, 684;  zinci ferrohydrocyanas,
     696; zinci iodidum, 699.)
 Hysteric croup (creasoton, 295.)   »
   Convulsions (electro-magnetism, 313; in-
   digum, 437.)
   Fainting (sulphuris carburetum, 672.)
 Hysterics  (ammoniated   counter-irritants,
     271.)

 Ichthyosis (glycerina, 407;  oleum morrhuae,
     558.)
 Impetigo  (acid, hydrocyan.  52, 54;  acid.
     tannic. 61; arsen. iodid. 119; collodion,
     254; creasoton, 289, 297;  hydrarg.  et
     arsen.  iodid. 435; juglans regia, 501;
     oleum  cadinum,  736;  ol. jecin. aselli,
     559.)
 Impotence  (brucia, 156; buchu, 158; cube-
     ba?, 300;  iodinium, 487; nux vomica,
     543, 547.)
 Incontinence of urine  (atropia, 127 ; buchu,
     158; creasoton, 300;  ergota, 339; gal-
     vanismus, 398; iodin. 471; nux vomica,
     541, 543, 546;  potassae nitras, 730.)
     See Urine, incontinence  of.
 Indigestion.  See Dyspepsia.
 Indurated patches (hydrargyri deuto-nitras,
     433.)
 Indurations of the  abdomen (arnica, 117.)
  Chronic (calendula, 163, 164.)
                   Of the mammae (carbo-
     animalis, 185.)
  Glandular, chronic  (carbo-animalis, 185;
     electro-punctura, 321; fuligo, 392 ; hy-
     drarg.  deuto-iodid. 429.)
  Of the liver (iodinium, 459.)
  Of the mammae (calendula, 163.)
  Of the pancreas  (carbo-animalis,  185;
     iodin. 459.)
  Of the spleen (iodinium, 459.)
  Of the stomach (calendula, 163.)
  Of the testes  (iodinium,  459.)
Inflammation (acid, hydrocyan. 50; aconitia,
     65; compression of arteries, 263;  con-
     gelatio, 714; haemospasia, 725.)
  Of the absorbents (iodinium, 488.) 
DISEASES AND THEIR REMEDIES.
XXI
Inflammation
  Of the air-passages (iodinium, 492.)
  Of the bursae (iodinium, 492.)
  Of the bronchia.  See Bronchitis.
  Chronic (acid, hydrocyan. 50; barii iodi-
    dum,  142;  iodic acid, 498;  ol. croton.
    567; potassii iodidum,  001.)
    Of the Eustachian tube (injections into
    the Eustachian tube, 441.)
  Diffuse (iodinium, 491.)
                        Of the lungs and
    stomach (ol. jecor. aselli, 550.)
  External  (compressio,  259;  cotyledon
    umbilicus, 710.)
  Internal (acid, hydrocyan. 50.)
  Of the heart.   See Carditis.
  Of the joints (iodinium, 494.)
  Of the liver (chlorin. aq.  208.)
  Of  the  lungs  (ammoniated  counter-irri-
    tants, 271.)  See Pneumonia.
  Of the mamma (iodinium, 4*8.)
  Of the mouth and fauces (chlorin. aq. 210.)
  Of the pericardium (ammoniated counter-
    irritants, 271.)
  Of the pleura (ammoniated  counter-irri-
    tants, 271; veratria, 686.)
  Of the trachea (ammoniated  counter-irri-
    tants, 271.)
  Of the vagina (collodion,  256.)
  Scrofulous (iodinium, 402.)
  Synovial (compressio, 259.)
  Thoracic (acid, hydrocyan. 50.)
Inflammatory affections of  malarious dis-
    tricts (quiniae sulphas, 021.)
  Diseases (colchicum, 246;  compressio,
    259; cort. adstring. Brazil. 273;  mor-
    phia,  524;  ol. siuapis, 565;   potass.
    nitras, 740; veratria, 684.)
Insanity (a?therization, 85 ; chloroform, 219:
    quinia' sulphas, 027.)
  Moral (galvanism, 403.)
Insomnia (chloroform, 214.)
Integuments, lesions of the (creasoton, 284.)
Intermittent (adansoniadigitata, 703: aether-
    ization, 80 ; argent, limat. 114:  atropia,
    127;  bebeeria, 144;  cetrarina,  194;
    chlorin. aq. 208: chloroform, 213; cin-
    chonia, 235;  cinchonicine, 237; conia,
    715;  cubeba, 300;  digitaline,  309:
    ferri nitras, 372 ;  ferr. subcarb.  385 ;
    ferrocyanur. 357;  gentiana chirayita,
    406;  hippocastanum,  417; indigum,
    43,7;  iodin.  468;  leucoleinum,  730;
    matins, 511 ; narcotina, 513; phloridzi-
    na, 575,  576;  piperina. 577;   quinia,
    600; quiniae arsenias. 008; quiniae nr-
    senis,  609;   quiniae  hydriodas, 612;
    quinia, iodide of  iodhydrate of,  612;
    quinia* et  cinchon. tannas,  633, 637;
    quinia* butas, 613;  quinia? murias, 614;
    quinia? sulphas. 618, 021,  629,  631,
    03,2 : quinia? sulphas impurus, 634, 639;
    quinia* valerianas,  0)3,0;  quinidia, 040,
    041 ; quinoidine, 038, 639; rcsinachina*
    praqiar. 035,  038;  salicina,  643, 044;
    sanicula marilandica,  741; santoninum,
Intermittent
     742: simaba cedron, 742; soda chlorin.
     618; sodii chloridum, 745 ;  strychnia,
     664.)
Intertrigo of children (collodion, 254 ; crea-
     soton, 284.)
Intestinal eruption, chronic (cerium, 711.)
Intestines, atony of  the (ferri ferrocyanur.
     357.)
   Ulceration of the (monesia, 519.)
Iodinia,  455.
Iodine disease, 455.
       stain from   (potassii  cyanuretum.

Iodism, 455.
Iodkrankheit, 455.
Iodophthi-ie, 451.
Iodosis,  455.
Iralgia (quiniae sulphas, 631.)
Iris, adhesion of to the lens, (atropia, 12S.)
Iritis,  (hydrargyri cyanuretum, 422.)
Iron,  sparks  of,  removed from the  eye
     (iodinium, 492.)
Irritable habits (ferri subcarbonas, 386.)
Ischias (oleum sinapis, 564; veratria, 683,
     684.)
Ischuria  (apis  mellifica, 704;  colchicum,
     249; sumbul, 748.)
Issues, formation of (zinci chlorijj. 691.)
Isthmitis, atonic (chloroform, 212; ferri et
     alumina* sulphas, 712.)
Itch (calx chlorin. 169, 174, 175;  chlorin.
     aq.  209, 210; conia, 715;  creasoton,
     289, 297;  fuligo, 392,  394;  iodinium.
     473,; manganesii  sulphas, 732; oleum
     cadinum, 736; sapo mollis, 645; zinci
     chlorid. 693.)
   Inveterate (hydrarg.  iodid. rubr. 427; ol.
    jecor. aselli, 558.)
Itching  (aqua  amygdalarum concentrata,
     96.)

Jaundice (fel bovinum, 718.)
   With liver disease (iodinium, 459.)
Joints, inflamed (iodinium, 488, 494.)
   Anomalous pains of tiie (iodinium, 488.)
   Caries of the (calcis phosphas,  710.)
   Chronic diseases of the (oleum  morrhua?,
     560.)
          inflammation and enlargement of
     the  (iodinium, 488.)
   False  (iodinium, 480.)
   Rheumatic (colchicum, 249; iodin. 489;
    morphia, 525.)
   Scrofulous swellings of the, 401.
   Stiffness of (veratria. 686.)
   Swelled (ammoniated  counter-irritants,
    271; chimaphila, 197; calx chlorin. 168,
    174; iodinium, 461; veratria, 080.)

Keratitis (collodion, 257.)
Kidneys, diseases of the (buchu, 159.)
   Bright's disease of the (acid, gallic. 42.)
Kriebelkrankheit, 330.
Labia  pudendi, infiltration  of (creasotum,
    286.) 
xxii
ALPHABETICAL  LIST OF
Labia pudendi
  Offensive affections of (creasoton, 28.5.)
Labour, premature, inducing (electro-mag-
    netism, 314; ergota, 336, 342.)
  Tedious (cannabis indica, lt2,183; elec-
    tro-magnetism, 31J.)
Languor (acid, tannic. 59.)
Laryngismus  stridulus  (aetherization, 85;
    oleum morrhuae, 560.)
Laryngitis, (cauterization, &c,  of the  la-
    rynx, 191 ;  iodinium, 466.)
  With aphonia  (iodinium, 406.)
Larynx, chronic engorgements of the (iodi-
    nium, 466.)
  Nervous affections of the  (conia, 715.)
  Spasmodic affections of the (veratria, 685.)
Lead poisoning (iodinium, 471.)
Leech-bites, hemorrhage  from  (collodion,
    256;  creasoton, 282; ferri et  aluminae
    sulphas, 721;  matico, 514.)
Lepra  (arsen. iodid.  119;  auri praeparat.
    132; carbon, sesqui-iodid. 187; chlorin.
    202; ferri  arsenias,  348;  glycerina,
    407,409: hura Brasiliensis, 727 ; hyd.
    et arsen. iodid. 435; iodidum ammonii,
    497; naphthalin, 735;  sulphur, iodid.
    674, 675.)
Leucophlegmatia  after  intermittent  (ferri
    fercocyanuretum, 357.)
Leuconhoea (acidum gallicum, 41,  42; acid.
    tannicum, 59; argent, oxyd. 113; chlo-
    rin. aq. 209; colchicum, 249;  cort. ad-
     string. Brazil.273,274; creasoton, 287;
    cubeb;p, 300;  ergota, 336,  343; ferr.
     iodid.303, 366; ferri et alumin. sulph.
    721;  gentiana  chirayita,  406;  iodi-
    nium, 475; juglans regia, 501;  liq. ferr.
    persesquinit.371; matico,514;  monesia,
    519; platin. 579; potassii iodhydrargy-
    ras,596; potassii iodidum, 601; salicina,
    Oil; sanicula, 741.)
   Chronic (iodinium, 476.)
 Lichen (conia, 715; ferri arsenias,  348; gly-
     cerin.409; oleum cadinum,736; potassii
     cyanuretum, 594.)
   Agrius (collodion, 254.)
   Leproides (ferr. cSftbur. 351.)
   Urticatus  (hydrarg.  et  arsenic,  iodid.
     436.)
 Lipomatous cysts (electro-punctura, 321.)
 Lips, chapped (glycerin, 409.)
 Lithuria (acidum benzoicum, 30; ammon.
     phosphas, 91, 93;  lithiae carbonas, 731;
     soda? phosphas, 744.)
 Liver,  affections  of the  (potassae chloras,
     585;  berberina,  146;  chlorin.  202;
     iodin. 459.)
   Enlarged (iodinium, 459.)
   Hydatid cyst  of the (iodinium, 486.)
 1  Induration  of the (hydrarg. deuto-iodid.
     428;  iodinium, 459, 463.)
   Inflammation of the (chlorin. aq. 208.)
   Obstruction of the (hydrarg.  iodid. 424.)
   Tubercles of  the (iodinium, 400.)
 Lumbago  (acupunct. 73; ammoniated coun-
     ter-irritants,  271;   chloroform, 214;
     firing, 272; iodin. 479; veratria, 684.)
Lungs,  affections of the (cimicifuga, 231;
    chlorinium, 199; emetia, 326 ; sanicula,
    741.)
  Gangrene of the (chlorin. 204.)
  And stomach, chronic inflammation of the
    Col. jecor.  aselli, 556.)
  Mucous  affections  of the  (creasotum,
    293.)
  Ulceration of the (chlorinium, 200; crea-
    sotum, 292.)
Lupus (auri chlorid.  133; chloride of bro-
    mine, 154; collodion,  254 ; fern arse-
    nias, 318; ferri protocarb. 383; hydrarg.
    et arsen. iodid. 435; hydrarg.  deuto-io-
    did. 428;  hydrarg. deuto-nitras, 432;
    hydrarg. et quiniae  protochlorid. 727;
    iodin. 473, 489; oleum  cadinum, 736;
    ol. jecoris aselli, 558,560; zinci chlorid.
    693;  zinci iodidum, 699.)
  Non  exedens (collodion,  254;  sulphur.
    iodid. 675.)
  Of  the ala  nasi (ferr. carb. praec. 384.)
  Of  the nose  (creasoton, 287.)
Luxations (buchu, 158.)
Lymphatic glands, indurated (sulphuris car-
    buretum, 672.)
  Suppurating  (calcis phosphas, 710.)
Lymphatism  (ferr. iodid. 363.)
Malignant disease (ferri citras, 351.)
Mammary tumour, chronic (iodinium, 460;
    oleum morrhuae, 559; potassii iodidum,
    603;  veratria, 686.)
Mamma?, abscess of the (compressio, 262;
    iodinium,  188.)
  Hypertrophied (iodinium, 460,  494;  po-
    tassii iodidum, 603.)
  Indurated (calendula, 163; carbo-animalis,
    186 ; iodinium, 456.)
  Inflamed.  See Mastitis.
  Painful  tumours  of the  (potass, iodid.
    603.)
Mania (cannabis  indica, 181.)
  Hydrophobic (chloroform, 218.)
  Puerperal (chloroform, 223.)
Maniacal delirium (chloroform, 213.)
Mastitis (collodion, 255; iodinium, 488.)
Measles (chlorin. aq.  207;  inunctio, 729;
     iodin. 470.)
Meloena (matico, 515.)
Melicerous cysts (electro-punctura, 321.)
Membranes, false (acid, tannic. 59.)
Meningitis, tubercular (iodin. 467.)
Menorrhagia (acidum  gallicum,  40;  acid.
     tannic. 59; argent, oxid. 113; cannabis
     indica, 182; cort. adstring. Brazil.273;
     electro magnetism, 314; ferr.  cyanur.
     358; matico, 514,515; monesia, 519.)
 Mental affections (auri praeparat. 128; ol.
     tiglii, 569.)
 Mercurial poisoning (iodinium, 471.)
 Mesenteric glands.  See Glands, mesenteric.
 Metritis (acid, hydrocyan. 50;  chloroform,
     220.)
 Metrorrhagia  (acid, tannic. 58;  cort. ad-
     string. Brazil. 275; monesia, 519.)  See
     Hemorrhage, uterine.
 Miasmata, destroying (calx chlorin. 171.) 
DISEASES AND THEIR REMEDIES.
XX111
Micturition, involuntary (creasotum, 300.)
Milzbrandkarbunkel (chlorin. aq. 207 ; zinci
    chlorid. 690.)
Moles (hydrargyri  deuto-nitras, 433.)
Mollities ossium (calcis phosphas, 709.)
Mortification, mildew, 331.
Mouth, inflammationof the,chronic (chlorin.
    aq. 210.)
  Offensive conditions of the (calx chlorin.
    168.)
  Ulcers in the (calx chlorinata, 173; crea-
    sotum, 298.)
Mucous  membranes,  inflamed (iodinium,
    475.)
  Irritability and tenderness of the (liquor
    ferri persesquinitrat. 371.)
  Inordinate  secretion  from  (chimaphila,
    195;  ol. sinapis, 565 ; salicina, 644.)
  Ulcerated (iodinium, 475.)
Mutism, paralytic  (electro-punctur. 321.)
Mydriasis  (ergota, 338.)
Naevi (collodion, 255;  creasotum, 291; gal-
    vanic cautery, 106 ; hydrargyri  deuto-
    nitras, 433; iodinium,  492; ol. tiglii,
    509; zinci chlorid. 690.)
Nails, ingrowing of the (collodion, 256.)
Necrosis (iodinium, 461; zinci chlorid. 690.)
Nephralgia (chimaphila,  195; chloroform,
    219.)
Nephritis (acid, hydrocyan. 50.)
Nervous coughs (tanninum, 59.)
  Diseases  (acidum  hydrocyanieum,  51;
    ammoniated counter-irritants, 271; auri
    praeparat. 128; cort. adstring. Brazil.
    273;  creasoton, 295; electro-punctur.
    321;  ferr. carb. proac.  384;  ferr.  cya-
    nur. 357; fuligo, 394; galvanism, 401;
    iodinium,  470;   magnes, 506,  507;
    morphia, 521;  morphiae acetas,  527,
    529;  ol. sinapis,  564; quinia? sulphas,
    634;   sumbul,  730;  veratria,  683;
    zinci ferrohydrocyanas, 696, 697.)
  Chronic  (acid, hydrocyan. 51; liq. argent.
    muriat. ammoniat. 110.)
  Excitement (chloroform,  214;  lactuca-
    rium,  504.)
  Exhaustion (strychnia,  662.)
  Irritation of the stomach (codeia, 242.)
Neuralgia   (acid,   hydrocyan.  51,  52;
    aconitia,  51,   67;  acupunctuva,  74;
    a*therization, 85; ammoniated counter-
    irritants, 271; atropia,  127,  128; be-
    beeria, 144; bismuthi valerianas,  704;
    cannabis indica, 179, 181; chloroform,
    213,  214, 219,  220,  224, 225,  220,;
    cimicifuga, 233,;  cinchonia, 236; com-
    pression  of arteries, 204; conia, 715,
    710;  contra-irritatio, 270; creasoton,
    295,   290;  delphinia,  306;   electro-
    magnet.  311, 313; electro-punct. 318,
    319, 321 ;  ferr.  carb. praec 381;  ferr.
    ferro-cyanur.  358;  galvanism,  398,
    409.  403; glycerin,  409; iodin.  470;
    magnes, 506;  morphia, 525;  morphia*
    acetas, 527; morphia? bimeconas/533;
    moxa, 536; nux  vomica, 543; oleum
    morrhua?, 560;  ol. sinapis,  564; ol.
Neuralgia
    tiglii, 505, 568;  potass,  cyanur. 593,
    594;  quiniae  arsenis, 609;  quiniae et
    cinchoniae tannas, 637; strychnia, 661;
    veratria, 683,  0,87;  zinci ferrohydro-
    cyanur. 697 ;  zinci valerianas, 700.)
  Chronic (oleum sinapis, 564.)
  Faciei  (acid, hydrocyan.  51;  artemisia,
    124;  chloroform, 214;  codeia,  242
    compression of the arteries, 204; conia
    715;  creasotum,  295;  ferri  fei*rocy
    anur.  358;  ferri subcarbonas,  384
    morphia, 525; nux vomica, 543; oleum
    tiglii, 507 ; potassae  chloras, 585; po-
    tassii cyanuretum, 592,593, 594; zinci
    valerianas, 700.)   See Tic Douloureux.
  Frontal (galvanism, 404; morphia, 520.)
  Intercostal (conia, 715.)
  Obstinate (zinci  valerianas,  700.)
  Of the arm (conia, 715; strychnia, 661.)
  Of the chest (galvanism, 400.)
  Of the head (cannabis indica, 181.)
  Of the heart (aconitia, 08 ; magnes, 508.)
  Of  the nervus pudendus  superior (com-
    pression of the arteries, 204.)
  Of the orbitar nerves (compression of the
    arteries, 204.)         „
  Pulmonary (magnes, 506.)
  Rheumatic  (electro-magnetismus,  312;
    oleum sinapis, 564.)
  Sciatic (conia, 715; morphia, 525; potas-
    sii cyanuret. 592.)
Neuralgic affections, local, (electro-magnet-
  ism, 313; electro-punctura, 319.)
  Tumours, (plumbi chlorid. 737.)
Neuropathic diseases (iodinium, 470.)
Neurosis (etherization, 84; chloroform, 218;
    electro-magnetism, 312: granatum, 413;
    iodide of zinc  and strychnia, 669; ol.
     tiglii, 567; zinci  chlorid.  692.)
Nipples,  excoriated (acid. acet. empyr. 35;
    acid, tannic.  00; calx  chlorin.  168;
    chloroform, 220; collodion, 254, 255;
     creasolon, 284; glycerin, 409; plumbi
    tannas, 583.)
  Fissured  (collodion, 255; glycerin, 409;
    plumbi nitras, 738.)       »
Nodes, gouty (sulphur, carb. 673.)
Noli me  tangere (iodinium, 489; zinci chlo-
    ridum, 693.)
Noma (chlorin. aq. 209.)
Nose, discharges from the (iodinium, 476.)
Nymphomania (potassii bromidum, 589.)
Obstetrics  (tetherizatio,  87;  chloroform,

Odontalgia  (ammoniated  counter-irritants,
     271; chloroform, 214;  conia, 715; ol.
     sinapis, 564.)  See Toothache.
  Rheumatic  (sulphuris carburetum, 674;
     ol. croton. 567.)
Odour, offensive (calx chlorin. 168.)
CEdema  (cauterization, etc. of the larynx,
     192; creasoton, 290.)
  After intermittent  (manganese, 733.)
  Meningum, (iodin.  407.)
  Of the feet (acupunct. 73.) 
XXIV
ALPHABETICAL  LIST OF
ffisophagus, stricture of the (iodinium, 481;
    sulphuris carburetum, 672.)
Offensive evacuations, (calx chlorin. 166.)
01iga?mia (ferri  iodidum, 365.)
Onanism, atony from (compressio, 20,3.)
Ophthalmia (acid, hydrocyan. 52 ; acupunct.
    73; aetherization, 86; argent, oxid. 113;
    cimicifuga, 233; creasoton,  290;  ferri
    et alumina? sulphas, 721; hajmospasia,
    725; iodin. 472.)
  Catarrhal (calx chlorin. 169, 174; lactu-
    carium, 504.)
  Chronic (cadmii  sulphas, 705;  calx chlo-
    rin. 169; iodinium, 492; matico,  515;
    oleum  cadinum, 736; oleum morrhuae,
    555.)
  Egyptian (acid, tannic. 60.)
  Neonatorum (calx chlorin. 169.)
  Purulent (acid, tannic. 60; calx chlorin.
    109; monesia, 52(#.)
  Rheumatic  (conia, 715; zinci ferrohydro-
    cyan. 697.)
  Scrofulous  (auri praeparat.  131;  auri
    chlorid.  1.33;  calx chlorin.  169,  174;
    conia,  715;  hydrarg.  et arsen. iodid.
    436;  iodin.  461; juglans regia,  501;
    oleum  cadinum,  736;   oleum  jecoris
    aselli,  555,  556;  potass, iodid.  603,
    604, 605; quinia? sulphas,  626,  633;
    zinci ferrocyanuretum, 697; zinci iodid.
    699.)
  Strumous (bebeeria, 144;  creasoton, 290;
    fuligo, 393;  hydrarg. et arsenic, iodid.
    436; iodin. 492; juglans, 501; matias,
    511; ol. cadinum, 721;  oL jecor. aselli,
    555; potassii iodid. 604.)
  Tarsi (acid. acet. empyr.  35;  creasoton,
    290; hydrarg. deuto-iodid.  428;  zinci
    ferrohydrocyanas, 697;  zinci iodidum,
    699.)
  Varicose, chronic,  (creasotum, 290.)
  YYith photophobia, (atropia, 127.)
Orchitis  (chloroform, 214; collodion, 255;
    compressio,  260; iodinium.  192.)
Os uteri, carcinoma of the (chloro%nn, 220.)
  Congestion of the (iodinium, 496.)
  Induration of the (galvanic cautery, 405.)
  Ulcerations of the (chloroform, 220; col-
    lodion, 250; creasotum,  280;  galvanic
    cautery, 405; iodinium,  496.)
Osteocopi,  syphilitic (conia, 715; hydrarg.
    et arsenic,  iodid.  436;  iodin.  478;
    strychnia, 602 ;  strychnia? acetas, 667 ;
    zinci ferrocyanur. 697.)  See Pains,
    Nocturnal.
Otalgia (conia,  715; ol. sinapis,  564;  ol.
    tiglii,  567.)
Otorrhcea (cadmii sulphas, 705; creasoton,
     281, 291; cubeba?, 300; juglans, 501;
     oleum cadinum, 730 ; potassii bromid.
     589.)
   Fetid (zinci chlorid. 694.)
Ovaries, degenerated (iodin. 474.)
   Dropsy of the (iodin. 474, 484.)
   Indurated (iodin. 474.)
   Inflammation  of the (hydrarg.  cyan. 421.)
Ovaries.
  Tumour of the (iodinium, 484.)
Oza?na (calx chlorin. 166,  174;  carbo ani-
    malis, 185;  iodinium,  476.)
rain, anomalous, of hip and thigh (morphiae
    bimeconas, 533.)
  Nervous and muscular (ammoniated coun-
    ter-irritants, 270; arnica,  117;  moxa,
    535.)
  Neuralgic (chloroform, 213, 225.)
  Nocturnal, in the bones (hydrarg. et arsen.
    iodid. 430; iodinium, 478; zinci  ferro-
    hydrocyanas, 697.)  See Osteocopi.
  Rheumatic (arnica, 117;  buchu,  lo8,159;
    cainca,  161;  chloroform, 213  ; ammo-
    niated counter-irritants, 271; electro-
    punctura, 318; emetia, 326.)
  Severe (acid, hydrocyan. 52,  53.)
Painful affections in general  (chloroform,
    214.)
Pains,  After (ergota, 336;  sulphuris carbu-
    retum,  072.)
  Erratic (iodinium, 470.)
Palpitations (bismuthi valerianas, 707; crea-
  sotum, 295;  emetia, 326; magnes, 500;
  veratria, 085.)
Palsy,  see Paralysis.
Pancreas, induration of the (carbo-animalis,
    185; iodin.  475.)
Pannus (acid, tannic. 60;  ol. jecoris aselli,
    555.)
  Vascular  (ol. jecoris aselli, 555.)
Paralysis (acupunct. 73; arnica, 117; bru-
    cia,  156; delphinia,  306;  galvanism,
    400, 401;   electro-punct.  318,  321;
    haemospasia, 724; iodinium, 470; mix
    vomica, 541, 542, 545, 546; ol. sinapis,
    564; ol. tiglii, 567; paullinia, 573; sum-
    bul,  730;  strychnia,   658;   veratria,
    084; zinci chlorid.  690;  zinci   ferro-
    hydrocyanas, 696.)
  Lead (brucia, 156; iodinium, 471.)
  Local (strychnia, 659, 600.)
  Of the bladder (buchu, 159; ergota, 339;
    galvanism, 402; strychnia, 660.)
  Of the facial nerve (electro-niagnetismus, '
    312;  strychnia, 600.)
  Of the forearm (electro-magnetism, 312.)
  Of the portio dura (firing, 272.)
  Of the rectum (nux vomica, 542 ; strych-
    nia, 660.)
  Of the tongue (electro-puncture, 319.)
  Of   the  upper  eyelid  (ol.  tiglii,  569;
    strychnia, 659.)
  Partial (electro-magnetism, 311; nux vo-
    mica,   542;  strychnia, 659;  veratria,
    684.)
  Rheumatic (electro-magnetism, 311, 312.)
  Succeeding to  apoplexy (brucia,  156;
    nux vomica, 541.)
 Paralytic  debility  (ammoniated  counter-
    irritants, 271.)
 Paraplegia  (ergota, 339;  galvanism, 400;
     strychnia, 059; strychnia? iodas, 608.)
 Parasites (ferri et alumina? sulphas, 721;
     oleum  cadinum, 736.) 
DISEASES AND THEIR REMEDIES.
XXV
Paronychia (chloric ether, 227.)
Paroxysmal diseases (ergota, 338.)
Parturient efforts, defective (cannabis in-
    dica, 182; cimicifuga, 233; ergota, 331.)
Pediculi  (colchicum, 249.)
Pelvic tumours, painful (chloroform, 214.)
Pericarditis (ammoniated counter-irritants,
    271.)
Periodical diseases  (ergota, 338; quiniae
    ferrocyanas, 610; quinia? sulphas, 621.)
Periosteum, diseased (iodin. 478.)
Periostitis (iodinium, 461, 478.)
Peritonitis from constipation  (acidum car-
    bazoticum, 702; mannita, 510.)
Phagedaena (chloroform,  213;  creasotum,
    298; iodinium,  477;  zinci  chloridum,
    690.)
  Of  the cheek (potassa? chloras, 585.)
Phagedenic tuberculous  diseases (arsenic.
    iodid. 120.)
  Sore throat (iodinium,  478.)
  Ulcerated bubo (creasotum, 287.)
Phimosis (lupulina, 731.)
Phlebitis (compressio, 259.)
Phlegmasia (compressio,  259; haemostasis,
    726.)
Phlegmon (iodinium, 487.)
Phosphatic depositions (acid, lactis, 56.)
Photophobia  (conia,  715.)
Phthisical affections  (iodinium, 462.)
Phthisis  (acid. acet. empyr. 35; acid, hydro-
    cyan. 50, 53;  acid, tannic. 59;  aether-
    izatio, 87;  a'tber hydriodicus, 498; aq.
    picea, 104; argilla,  115; calcis phos-
    phas, 709; calx chlorin. 166; carbon.
    sesqui-iodid.  187;  cauterization, etc.
    of the larynx, 191;  chlorin. 199, 200;
    chondrus,  230;  cimicifuga,  223; crea-
    soton, 291, 296; ferri iodidum, 364;
    fucus  crispus,  230;   galeopsis, 397;
    glycerina,  408;  haemospasia, 725; in-
    unctio, 729; iodic acid, 498  ; iodinium,
    462,  405;  lactucarium, 505; matias,
    511; monesia, 519; ol. jecor. aselli, 554,
    656; ol. tiglii,  567;   paullinia, 573;
    potassa?  chloras, 585; sumbul, 748;
    spiritus pyro-aceticus, 650.)
  Cough of (codeia,  241.)
  Mucosa (galeopsis, 397;  iodinium, 465.)
  Pituitosa (chimaphila,  195.)
  Sweats of  (acid, gallic. 41;  acid, tannic.
    60;  argenti oxid. 113;  boletus laricis,
    148: ferri et alumina? sulphas, 721; ga-
    leopsis, 390; iodin. 463; quinia? et cin-
    chonia? tannas, 637.)
  Threatened (galeopsis, 397; iodin. 465.)
Pica (cainca*  radix, 161.)
Pile, bleeding (acidum nitricum,  704.)
Pimples   (ammoniated   counter-irritants,
    271.)
Pitting from smallpox (calx chlorin. 167;
    collodion, 257; iodin. 408.)
Pityriasis (glycerina. 407, 409 ; hydrarg. et
    arsen. iodid. 435; zinci chlorid. 090.)
Placenta  pra?via (aetherizatio, 88; electro-
    magnetism, 314.)
Placenta.
  Retention of the (ergota, 336.)
Plague (chlorin. aq. 206.)
  Prevention of (chlorin. aq. 209.)
Pleuritis, see  Inflammation of the Pleura.
Pleurodyne (acupunct. 73.)
Pneumonia (chloroform, 220; ergota, 337;
     iodine, 465;  mannita, 510; urea, 684;
     veratria, 686.)
  Chronic (hydrarg. cyanuret. 421.)
  Convalescence from (mannit. 510.)
  Purulent, infiltration after (moxa, 537.)
Poisoning by arsenic (ferri  oxyd. hydrat.
     375.)
           By arseniate of copper (ferri oxi-
     dum hydratum, 379.)
           By hydrocyanic acid (chlorin. aq.
     209.)
  Lead (iodinium, 471.)
  Mercurial (iodinium, 471.)
  By opium (electro-magnetism, 317.)
  By rhus radicans, &c.  (iodinium, 491.)
Polypi, cartilaginous (carbo-animalis, 185.)
  Mucous (carbo-animalis, 185.)
  Uterine (ergota, 336.)
Porrigo (acid. acet. empyr. 34, 36; carbon.
     sesqui-iodid. 187; fuligo, 394; hydrar-
     gyri  deutonitras, 433; hydrarg. et. ar-
     sen.  iodid. 435; iodin. 472; juglans,
     501; oleum  cadinum,  736;  ol. jecor.
     aselli, 558, 559;  potassii bromidum,
     589;  sulphur, iodid. 675.)   See Tinea.
  Decalvans (sulphur, iodid. 075.)
  Favosa (creasoton, 290; hydrarg. bromid,
     419;  hydrargyri nitras,  443;  iodini-
     um,  472; potassii bromid. 589.)
  Scrofulous (auri praeparat. 131.)
Priapism  (potassii bromidum, 589.)
Profluvia  (aqua Binellii, 84; monesia, 518.)
Prolapsus ani  (acid, nitric. 704; acid,  tan-
  nic. 59; nux vomica,  543.)
  Uteri (electro-magnetism, 317;  galvanic
     cautery, 405.)
  Vaginae (creasoton, 290; galvanic cautery,
     405.)
Prosopalgia (ol. sinapis,  564; potassa? chlo-
     ras,  585 ; veratria, 683 ; zinci chlorid.
     692, 694.)
Prostate,  disease of the (buchu, 158.)
  Enlargement of the (carbo-animalis, 186;
     iodinium, 459, 478.)
Prostatic  discharges (cubeba, 301.)
Prostration, (chondrus,  230.)
Prurigo (colchicum, 249; conia,  715;  gly-
     cerin, 409; zinci chlorid. 693.)
  Senilis  (aq.  amygd. concentrata, 96.)
Pruritus  (chloroform, 226;  glycerin, 409;
     zinci chlorid.  693.)
  Ani (oleum cadinum, 736; potassii cyanu-
     retum, 593.)
  Pudendi muliebris (calx  chlorin. 169;
     chloroform, 220.)
  Vulva?   (fuligo,  392;   morphiae  sulphas,
     532;  potassii  cyanuret. 593.)
Psora, see Itch.
Psoriasis (chlorin. 202;  conia,. 715; creaso- 
xxvi
ALPHABETICAL INDEX OF
 Psoriasis
     ton, 289;  ferri arsenias, 348; glyceri-
     na, 407, 409; hydrarg. iodid. 424; hy-
     drarg. et arsen. iodid. 435;  iodidum
     ammonii, 497; naphthalin, 735;  oleum
     morrhuae, 559;  solution of  guttaper-
     cha in chloroform, 2 59;  sulphur, iodid.
     674, 675.)
   Palmaris (fuligokali, 396.)
 Pulmonary complaints, chronic (iodin. 463.)
 Pupil,  dilatation of the, caused by bella-
     donna (ergota, 338.)
 Purpura haemorrhagica (acid, gallic.  41.)
 Pustular eruptions  (creasoton,  290;  iodi-
     nium, 478.)
 Pustule maligne (juglans, 503; zinci chlo-
     rid. 690.)
 Putrefaction, checking (calx chlorin. 171.)
 Putrescency, tendency to (quiniae  et cincho-
     niae tannas, 037.)
 Pyrosis  (acid, gallic.  42; argenti  oxidum,
     113; cerium,  711; nux vomica, 544.)
 Ranula (iodinium, 489.)
 Rattlesnake,  poisoning by, (iodinium, 491.)
 Rectum, catarrh of the (cort. adstring. Bra-
     zil. 273.)
   Paralysed  (nux vomica, 542.)
   Ulcerated  (matico, 515.)
   Varicose condition of the  (matico, 515.)
 Remittent fever (bebeeria, 144; ferr.  cyan-
     ur.  357; quinia? sulphas,  022,   628;
     quinia? valerianas, 63(5.)
 Respiratory  organs,  diseases  of  mucous
     membrane  of (galeopsis grandiflora,
     397.)
 Retention of  urine (ergota, 337.)
 Rhachitis (acid, gallic. 42.)   See  Rickets.
 Rhagades (ol. jecor. aselli, 559.)
 Rheumatic diathesis (veratria, 685.)
   gout  (colchicum,  248; succus limonis,
   •  746.)
   effusions (electro-magnetism, 311.)
   Pains  (arnica, 117; buchu, 158,  159;
     cainca,  101;  electro-punctura,  318;
    emetia, 320; hydrarg. deuto-iodid. 428.)
   Swellings  of  the   joints  (ammoniated
     counter-irritants, 271; colchicum, 249;
     chloroform,  213; iodinium,  480,  492;
     potassii iodidum, 601; sulphuris carbu-
     retum, 672.)
Rheumatism  (aconitia, 67;  acupunct. 73;
     ammoniae phosphas, 91; ammoniated
     qounter-irritants,  271;   anthrakokali,
     95 ;  atropia,  127; ballota lanata, 141;
    cainca? radix, 161;  cannabis  indica,
    179,  180;  chimaphila,   195; chlorin.
    202; chloroform, 213; cimicifuga, 231 ;
    cinchonicine, 238; colchicum,  246, 249 ;
    compressio, 259;  compression of arte-
    ries, 203  ; counter-irritants, 271;  cre-
    asoton,  293;  delphin.  306;   electro-
    magnetism,  311,  315;   electro-punct.
    319;  ergota, 337 ; fraxinus, 723 ; fuli-
    go,  394;  galvanism, 398;   glycerin,
    409;  iodinium,   479;  magnes,  506;
    morphiae  acetas, 527 ; ol. jecinor. aselli,
 Rheumatism
     551, 554;  ol. sinapis, 564;  ol. tiglii,
     567, 568; platinum, 579 ; potassae chlo-
     ras, 585; potass, cyanur. 593; potass.
     nitras, 739; quiniae sulphas, 025, 626;
     soda? hyposulphis, 743,; sp. pyro-aceti-
     cus, 651; succus limonis, 746 ; sulphu-
     ris carburetum, 672, 674; ver'atria, 684,
     688.)
   Atonic (creasotum, 293, 296.)
   Of the chest (veratria, 084.).
   Chronic (aconitia, 68;  ammoniae phos-
     phas, 92; anthrakokali, 95; buchu, 158
     chimaphila, 195; colchicum, 248; cube
     bae, 300; electro-punctura,  319,  328
     fuligo, 392, 394; iodin. 479;  morphia.
     525; ol. morrhuae, 554"; ol. sinapis
     564 ; oleum tiglii, 567; potassii cyanu-
     retum,   592;  spiritus  pyro-aceticus,
     651; sulphuris carburetum,  072, vera-
     tria, 686.)
   Local muscular (ergota, 338; firing, 272.)
   Protracted  (oleum sinapis, 564.)
   Subacute (oleum sinapis, 564.)
Rickets (calcis phosphas,  709; ferr.  iodid.
     363; fuligo, 392; ol. jecor. aselli, 551,
     555, 556, 561.)
Ringworm (ammoniated  counter-irritants,
     271.)
   Of the scalp, (oleum morrhuae, 559.)
Roseola (chlorin. aq. 207.)
Rubeola? (chlorin.  aq. 207.)
Rupia  (hydrargyri et arsenic, iodid. 436 ;
     iodinium, 478.)

Sarcina ventriculi  (sodae hyposulphis, 743.)
Satyriasis (potassii bromidum, 590.)
St. Vitus's dance (ammoniated counter-irri-
     tants, 271;  artemisia,  123;  indigum,
     438; liq.  argent, muriat.  ammon. 110;
     nux vomica, 543;  zinci chlorid. 692.)
     See Chorea.
Salivation, mercurial (acid. acet. empyr. 35;
     calx chlorin. 168, 173; creasotum, 284;
     iodinium, 480; potassae chloras, 585.)
  Profuse (acid, tannic. 59; auri praeparat.
     128 ; ferri et alumina? sulphas, 721.)
Sarcomatous  tumour of the  knee (bromin.
     153.)
Saturnine disease (iodinium, 472.)
Scabies (acid. acet. empyr. 35;  chlorin. 202.)
     See Itch.
Scalds  (iodinium, 490.)
Scalp,  dryness of the (glycerin, 409.)
Scarlatina (acid. acet. empyr. 35; acidum
     carbazoticum, 702 ; atropia,  127 ; calx
     chlorin.  168;  chlorin. aq. 207, 208;
     chloroform,  214; colchicum, 249;  ferri
     chloridum, 721;  iodin. 470;  potassae
     chloras, 586.)
Sciatica (acupunct. 74: ammoniated counter-
     irritants,  272; cannabis  indica,  181;
     codeia,  242 ;  electro-magnetism, 311;
     firing, 272 ; inunctio, 728 ; iodin. 479;
     morphia,  525; oleum tiglii, 568; potass.
     cyanur. 592.) 
DISEASES AND THEIR REMEDIES.
xxvii
Sciatica
  Anginosa (chlorinii aqua, 208.)
  Gouty (acid, hydrocyan. 51.)
  Maligna (chlorinii aqua, 208.)
  Rheumatic  (acid,  hydrocyan. 51.)
Scirrhus (auri praepar. 131; calendula, 163;
    ferr. iodid. 363; iodinium, 475; plati-
    num,  579; potass, iodid.  000.)
  Of the lips  (carbo-animalis,  185.)
  Of the mamma?  (calendula, 163: carbo-
    animalis, 185;  ferri iodid. 363 ;  iodin.
    474.)
  Of the prostate (carbo-animalis,  185.)
  Of the pylorus (acid, hydrocyan. 52 ;  auri
    praeparat. 131; iodin.  475; zinci ferro-
    hydrocyanur. 097.)
  Of  the  stomach  (artemisia, 124;  iodin.
    474; platinum, 579.)
  Of the tongue (auri praeparat.  131.)
  Of the uterus (acid, hydrocyan.  52 ;  auri
    pra?par. 131; iodin. 474.)
Scorbutic cachexia (quinium,  638.)
Scorbutus  (acid. acet. empyr.  35 ; ferri iodi-
    dum, 3,(55 ;  iodin. 482 ;  monesia, 520;
    ol. cadinum, 730.)
Scrofula (acid, pyrolign. 35 ;  anthrakokali,
    95; auri cyanur.  136;  auri praepar.
    131,132; barii iodidum, 142 ; bromi-
    nium, 153 ; carbo-animalis, 185; carbon.
    sesqui iodid.  187; chimaphila, 196;
    chlorin. 202; chondrus, 230; ferr.  bro-
    mid. 350; ferr. cyanur. 358; ferr. iodid.
    363, 364 ;  fraxinus, 723 ; fucus cris-
    pus, 230; glycerin, 409; hydrarg. iodid.
    424; hydrarg. iodid. rubr. 428; inunc-
    tio, 729 ;  iodinium, 4(50; iodic acid, 498;
    juglans regia, 500; monesia, 520 ; oleum
    cadinum, 736; ol.  jecoris aselli,  551,
    555, 556; potassii bromid. 589 ; potass.
    iodid.  602;  quinia, iodide  of iodhy-
    drate  of,  612.)
  External (oleum morrhuae,  556.)
Scrofulous abscesses (oleum morrhuae, 518.)
  Affections  (acid.  acet. empyc 35;  auri
    et sodii chlorid. 135;  calcis phosphas,
    709; carbo-animalis, 185; carbon, ses-
    qui iodid. 187; ferri  iodid. 363 ; juglans,
    500; lupulina,  731; soda  chlorin. 048;
    soda?  hyposulphis, 743; zinci iodidum,
    099.)
           Of the bones (oleum morrhua?,
    555.)
           Of the  skin (oleum morrhua?,
    555, 560.)
  Caries (creasoton, 285: iodinium, 409.)
  Diathesis (carbo-animalis, 185.)
  Discharges  from  the  nose and ear (iodi-
    nium, 461; oleum morrhuae, 555.)
  Diseases (bariumiodatum, 142; iodinium,
    461; juglans regia,  40].)
  Habit (auri et sodii  chlorid.  135;  ferr.
    cyanur. 3~8; quinium, 638.)
  Inflammation (iodin. 495.)
  Swellings (barii iodidum,142; brominium,
    153; calx chlorin. 100, 175: carbo-ani-
    malis, 185,186; chlorin. aq. 209; conia,
Scrofulous
     715;  iodid. quiniae, 611; iodinium, 460,
     489;  plumbi iodid. 582;  potassii bro-
     midum, 590; potassii  iodhydrargyras,
     596;  veratria, 080.)
               Of the glands (calx chlorin.
     168;  iodide of chloride  of mercury,
     499;  iodinium, 460;  plumbi iodidum,
     582:  potassii iodhydrargyras, 596; po-
     tassii iodidum, 602; quniae hydriodas,
     611;  veratria, 686.)
              Of the joints, (calx chlorin.
     174.)
   Tumefaction of the testicle (potassii bro-
     midum, 589.)
        Of the upper lip (aur. et sod. chlorid.
     135.)
   Ulcers (calcis phosphas, 709; conia, 715;
     hyd.  et  arsen.  iodid. 435; iodinium,
     495;  juglans regia, 501; monesia, 520;
     potass, iodid.  603; solution of gutta
     percha in chloroform 259; zinci chlorid.
     690.)
Scurvy (creasoton, 286.)  See  Scorbutus.
Sea sickness  (creasoton, 294.)'
Sebiparous organs,  affections of the (collo-
   dion, 254.)
Secretion, undue (acid, gallic. 42;  argenti
   oxidum, 113.)
Sensibility, unusual, of the abdomen (zinci
   ferrohydrocyanas, 0,97.)
Serous cysts (electro-punctura, 321; iodi-
   nium, 482.)
Serpents,  bites of (cainca? radix, 161; fraxi-
   nus, 723; guaco, 414; iodin. 491; simaba
   cedron, 742.)
Serpigo (potass, iodid. 602.)
Sibbens (hydrarg. et  arsen. iodid. 435.)
Skin, irritation  of the (glycerin. 409.)
     Painful affections of the (chloroform,
     220.)
Sleeplessness  (lactucarium, 505;   magne-
     tism, animal, 500; morphia?  bimeconas,
     533.)
Sloughing of cellular  membrane (acid. acet.
     empyreum.  36: iodin. 487.)
   Extensive,  (iodinium, 487.)
   Gangrenous (monesia, 520.)
   Of the  female organs  (calx  chlorinata,
     167.)
   Ulcers (calx chlorin. 166.)
Small  pox, pitting  from (acid, tannic. 61;
     calx  chlorin.  167;  chlorin. aq. 207,
     208;  collodion, 250;  iodin. 408; solu-
     tion of gutta percha in chloroform, 259.)
Snake-bites, (iodinium,  491.)
Somnambulism of children (artemisia, 124.)
Sore mouth,  nurses' (iodin.  481;  oleum
     morrhuae, 558.)
Sore throat (ammoniated counter-irritants,
   271: haemospasia, 725.)
   Atonic  (chloroform, 214.)
   Mercurial (zinci chlorid. 693;  creasotum,
     287.)
   Phagedenic (iodin.  178.)
   Ulcerated  (chloroform,  213.)  See  Cy-
     nanche.) 
xxviii
ALPHABETICAL  LIST OF
 Sores.  See Ulcers.
   Sloughing (acidum pyrolign. 34; iodinium,
     487:  plumbi tannas, W>.)
   Syphilitic (hyd. deuto-iodid. 427.)
 Spasmodic contractions (atropia, 127.)
   Diseases (acid, hydrocyan. 51; acupunct.
     73;  cannabis indica, 181; colchicum,
     249:   compression  of  carotids, 203;
     conia, 715;  indigum,  437;   magnes,
     506;  zinci ferrohydrocyanas,  696.)
   Erethism (creasoton, 295.)
 Spasms (acupunct.  73; ammoniated coun-
     ter-irritants, 270; magnes, 506.)
   Of the eyelids,  (conia, 715.)
   Of the muscles of the face (electro-mag-
     netismus, 312.)
   Tetanic  (chloroform, 218.)
   Violent (chloroform, 214.)
 Specks of the cornea (fuligo, 393, 395.)
 Spermatorrhoea (compressio, 263;  cubeba,
     300, 301; digitaline, 309; ergota, 337;
     lupulina, 731;  nux vomica, 543, 547;
     potassii bromidum, 589.)
 Sphacelus (acid. acet. empyr. 34.)
 Spina bifida (iodinium, 483,  484.)
   Ventosa  (calcis phosphas,  710;  ol. jecor.
     aselli;  555.)
 Spine,  diseases of the (iodinium, 492.)
 Spleen, diseases of the (potass, bromid. 589.)
   Enlarged (cinchonicine, 238; ferri pulvis,
     348;   ferri  subcarb. 385;  hydrarg.
     deuto-iodid. 429;  iodin. 459;  manga-
     nese,   733;  potassii bromidum,  589;
     potassii hydrargyro-iodid. 596; quinia?,
     607; quiniae sulphas, 624.)
   Indurated (iodinium, 459.)
Sprains (arnica, 117; creasoton, 284;  galva-
     nism, 398; glycerin, 409; electro-punc-
     tura,  319.)
  Of the muscles of the back (firing. 272.)
  Violent  (ammoniated  counter-irritants,
     271.)
Squamous  affections  (ferri  arsenias, 349;
     oleum cadinum,  736.)
Staubasthma (acid, hydrocyan. 51.)
Steatomatous cysts (electro-punctura, 321.)
Stiffness (glycerina, 409.)
 Stings  of wasps (iodinium, 492.)
Stomacace (iodinium, 480.)
Stomach, coats  of the, hypertrophy of the
     (sulph. carbur.  673.)
  Derangement of  the (cimicifuga,  232;
     creasoton, 295; ol. sinapis, 565.)
  Induration of the (calendula, 163.)
  Irritability of the (argenti oxidum, 113;
     nux vomica, 544: sp. pyroacet. 651.)
  Irritation of (codeia, 242.)
  Neuropathic disorders of (acid, hydrocyan,
     51; zinci ferrocyanuretum, 698.)
  Scirrhus of  the (artemisia, 124;  iodin
     474.)
  Spasms  of the (sumbul, 730.)
Stomatitis (monesia, 520; potassa?  chloras
     580.)
  Nutricum (oleum morrhuae, 558.)
  Ulcerative (potassa? chloras,  586.)
 Strangulation, internal (strychnia, 663.)
 Strangury (apis mellifica, 703.)
 Stricture of the  Eustachian tube (cathete-
     rism for, 441.)
   Of the oesophagus (iodin. 481;  sulphuris
     carburetum, (573.)
   Of the urethra (iodin. 475: lupuljna, 731.)
   Spasmodic of  the urethra (buchu, 158;
     chloroform,  219.)
 Strophulus (glycerina, 409.)
 Struma, see Scrofula.
   Varicosa (carbo-animalis,  185.)
 Strumous habits (chimaphila, 197; ferri ci-
     tras, 354; ferri ferro-cyanuretum, 358;
     ferri iodidum, 363;  ferri subcarbonas,
     386: zinci iodidum, 699.)
   In children (ferri ferrocyanuretum, 358.)
   Ulcerations of the eye, (tetherizatio, 86.)
 Subinflammatory diseases (oleum sinapis,
     504.)
 Submaxillary gland, strumous induration of
     the (iodinium,  459.)
 Suffocation, sense of, (acid, hydrocyan. 51.)
 Suppuration, profuse (creasoton, 284; sum-
     bul, 748.)
 Surgical operations  (aether sulphuric. 82;
     chloroform, 221.)
 Sweating,  profuse  (acidum  gallicum,  41,
     42; acid,  tannic.  60;  argent,  oxyd.
     113; boletus laricis, 148;  ferri et alu-
     min. sulphas, 721.)
 Sycosis,  (hydrarg. et arsenic, iodid. 435.)
 Synovial cysts (electro-punctura, 321.)
 Synovitis (conia,  715.)
 Syphilide, tuberculous (auri chlorid. 133.)
 Syphilis (argenti praeparat.  106; arg.  et
     ammon. chlorid.  110;  arg.  oxidum,
     113; auri cyanur. 136;  auri chlorid.
     133; auri praeparat. 128, 130; chlorin.
     202; hydrarg. bromid. 418;  hydrarg.
     cyanur.  421, 422; hydrarg. deuto-bro-
     mid. 419;  hydrarg. deuto-iodid. 427;
     hydrarg. proto-nitras, 431;  hydrarg.
     et  arsen. iodid. 435; iodic acid, 498;
     juglans, 501;   manganesii  sulphas,
     732; platinum, 579; potassa? chloras,
     585; sanicula, 741; sodii iodidum, 005.)
  Consequences  of  (ferri iodidum,  363;
     iodinium, 476.)
  Of children (hydrarg. iodid. 425.)
  Old, (ferri iodidum,  363.)
  Secondary (ferr. iodid. 363;  hydrarg. et
     arsenic, iodid. 436; iodinium,*476, 479;
     potassii bromidum, 589.)
  Tertiary (ibdin. 477, 495;  potassii  bro-
     midum, 589; potass, iodid. 599.)
  AVith scrofula (hydrarg. iodid. rubr. 427;
     potass,  iodid. 601; sapo mollis, 646.)
Syphilitic affections (manganesii  sulphas,
     732; platinum, 579;  potassa? chloras,
     585; potassii bromidum, 589.)
  Eruptions (arsen. iodid. 120;  ferr. carb.
     351  ; hyd. et arsen. iodid. 435.)
  Excoriations (aurum metallicum, 139.)
  Excrescences (aurum metallicum, 13/J.j
  Fissures (argenti praeparata, 107.) 
DISEASES AND THEIR REMEDIES.
xxix
Syphilitic affections
  Osteocopi  (hydrarg.  et  arsenic,  iodid.
    430; strychnia, 6(52.)
  Sore throat (hyd. deuto-iodid. 427.)
  Swellings of the bones (potass, iodid. 603.)
  Tubercles (iodin. 477.)
  Ulcers (auri nitro-murias, 137; creaso-
    tum, 285.)
  Vegetations (argenti prneparata, 107.)
Tabes mesenterica (ferr.iodid. 303; inunctio,
    7'->n *.
      730.,
  Taenia  (acid, hydrocyan. 52; argenti oxi-
      dum, 114; brayera anthelmintica, 149,
      150; colchicum, 249 ; creasoton, 295 :
      cucurbita pepo, 717; cuphorb. ol. 347;
      filix  mas,  389;  granatum,  411;   ol.
      croton. 566.)
  Tarsi, inflamed, chronic (acid. acet. empy-
      reum. 35;  creasoton, 290.)
  Tartar of the  teeth  (acidum  tannicum, 63 ;
      calx chlorin. 168.)
  Teeth, affections  of the (chloroform, 213.)
    Caries of the (calx chlorin. 168 ; creaso-
      tum, 297 ;  monesia, 520; piscidia ery-
      thrina,  722.)
    Stopping for  (collodion, 256.)
  Tendons, inflammation of the (veratria, 686.)
  Tenesmus (chloroform, 220 ;  morphia, 527.)
  Testes, enlarged (iodinium, 459;  potass.
      iodid. 603.)
    Indurated (iodinium, 459.)
    Inflamed (compressio, 260.)
    Scrofulous swelling of the  (potassii bro-
      mid. 589.)
  Tetanus  (acid,  hydrocyan.  51;  acupunc-
      ture, 74; aetherization, 84; ammoniated
      counter-irritants,  271;  atropia,  127;
      cannabis indica, 179, 180, 183; chloro-
      form, 218, 220 ;  colchicum, 248;  com-
      pression of carotids, 263 ; galvanismus,
     401.)
   Traumatic (acid,  hydrocyan. 51 ; canna-
     bis  indica,  179;  morphiae acetas, 528 ;
     quiniae sulphas, 625; strychnia, 661.)
 Tetter (iodinium,  472.)   See  Herpes.
   Humid (hydrarg. cyanuret.  422.)
 Thoracic inflammation (hydrargyri cyanur,
     421.)
 Throat diseases  (zinci chlorid. 694.)
   Relaxation of the (acid, tannic. 59.)
   Ulceration of the (chlorinii  aqua. 208.)
 Thymus, hypertrophied (iodin. 460.)
 Thyroid, cyst of the (iodinium, 487, 488.)
     swelled (iodinium,  462.)
 Tic douloureux (acid, hydrocyan. 51 ; aco-
     nitia, 67; ammoniated counter-irritants,
     271;  delphinia,  306; galvanism, 398;
     strychnia, 661; veratria, 683,688; zinci
     valerianas, 700.)  See Neuralgia.
 Tinea (acid. acet.  empyr. 36;  calx chlorin.
     169,175; chlorin. aq. 209, 210;  fuligo,
     392,395; iodid. sulph. 674.)   See Por-
     rigo.
Tinnitus aurium (electro-magnetism, 314.)
Tone, general deficient (ferri citras,  354.
Tongue, induration of the (auri praeparat.
     131.)
  Tongue
    Malignant ulcers  of the (iodinium, 489.)
    Paralysis of the (electro-punctura, 319.)
  Tonsils, enlarged (iodinium, 459, 489; zinci
      iodid. 699.)
    Relaxed (acid, tannic. 60.)
    Ulcers of the (iodinium, 489, 492.)
  Toothache (acid. acet. empyr. 34, 35; acid.
      hydrocyan. 52;  acid, tannic. 61; acu-
      punct. 73 ;  chloroform, 214; collodion,
      256; conia, 715; counter-irritants, 271;
      creasoton, 290, 297; ergota, 338;  liq.
      ferr. persesquinit.  372; magnes, 506;
      morphia, 526;  oleum cadinum, 730;
      piscidia  erythrina, 737; zinci chlorid.
      692.)
    Rheumatic (creasoton, 291;  ergota, 338;
      sulph. carbur. 674.)
  Tophi,  gouty (acidum benzoicum, 38; iodi-
      nium, 479.)
  Tormina (artemisia, 124.)
  Torpor in children (ferri ferrocyanur. 358.)
  Tremors (magnes, 506 ;  strychnia, 660.)
    From mercury (electro-punct. 318.)
  Trichiasis (collodion, 257.)
  Trismus  (acupuncture,  74;   ammoniated
      counter-irritants, 271.)
    Nascentium (cannabis indica, 181.)
 Tubercle  (aether hydriodicus,  499; calcis
      phosphas, 709; inunctio, 729; iodinium,
      462;  ol. jecor. aselli, 556.)
    Indolent (hydrargyri deuto-nitras, 433.)
   Mesenteric (iodinium, 462.)
   Of the lungs (chlorin. 200 ; conia,715; io-
     dinium, 462 ; oleum morrhua?, 556,557.)
   Softening of (moxa, 537.)
   Syphilitic (iodin. 477.)
 Tubercular excavations (cauterization, &c,
     of the larynx, 192.)
 Tuberculous eruptions (brominium, 153.)
 Tumefactions,  indolent  (electro-punctura,
     321; plumbi iodidum, 582.)
 Tumours of the bones (auri praeparat.  132.)
   Erectile (collodion, 255;  ol. tiglii, 569.)
   Glandular (collodion, 255.)
   Hemorrhoidal (acid, tannic. 59.)
   Indolent (plumbi iodid. 582.)
   Of the mammae (ol. jecor. aselli, 559.)
   Pelvic, painful (chloroform, 214.)
   Scrofulous (iodid. quiniae, 611; iodinium,
     489; veratria,  686.)
   Vascular (acid, nitric. 703, 704; ferri lac-
     tas,  369.)
Tympanitis (acidum carbazoticum, 702.)
Typhoid fever (chlor. aq. 206; codeia, 242;
     iodinium,  408; potassa? chloras,  586;
     quinia? sulph. 623; sulphuris  carbure-
     tum* 671; sumbuli radix,  748;  vera-
     tria, 084.)
Typhus (acid, tannic. 59; calx chlorin. 166;
     chloroform, 219;  codeia, 242; chlorin.
     aq.  206;  iodin.  468;  plumbi nitras,
     738;  potassa? chloras, 585; quiniae  et
     einchonia? tannas. 037; soda? chloridum,
    648; sumbul, 748.)
  Abdominalis (chlorin. aq.  200.)
  Bilious (calx chlorin. 166.) 
XXX
ALPHABETICAL LIST OF
Typhus
  Convalescence from (berberina, 157; sum-
    bul,  730.)
Ulcer (acid. acet. empyr. 36; calx chlorin.
    166; chlorin. aq. 210; collodion, 253 ;
    cortex adstringens,271; creasoton,28>;
    galvanismus, 401; iodinium, 490 ; mati-
    co, 513; monesia, 520: ol. jecor. aselli,
    562; plumbi nitras,  7-5S; potassii iodid.
    603; soda chlorin. 648.)
  Atonic (creasoton, 285 ; ferri iodid. 363 ;
    iodinium, 487 ;  ol. jecoris  aselli,  555;
    sulph. iodid. 675 ; zinci chloridum, 690.)
  Cancerous  (acid,  tannic.  61; calendula,
    163, 164; calx chlorin. 166; carbo-ani-
    malis, 186; chlorin.  aq. 209; creasotum,
    286; fel bovinum, 719;  ferri arsenias,
    348; ferr. subcarb.  3,84 ; hydrarg. deu-
    to-iodid. 427  ; hydrargyri deuto-nitras,
    433 ; plumbi chloridum, 737 ; plumbi
    tannas, 583;  potassii  iodid. 603; zinci
    chlorid. 690.)
  Of the face  (creasoton, 286;  plumbi chlo-
    rid.  737;  fel bovinum, 719.)
  Carious (creasoton, 285.)
  Chronic  (hydrargyri  iodidum rubrum,
    428.)
  Erosive (zinci chlorid. 690.)
  Fistulous (creasoton, 285.)
  Flabby (acid. acet. empyr. 34; chlorin.
    aq. 209;  ferri et alumin. sulph. 721.)
  Foul (acid. acet.  empyr.  36; alumina?
    sales, 91; carbon, trichlorid. 710; ferri
    et alumin. sulph. 721; ferri ferro-cya-
    nuretum, 358;  fuligo, 395; zinci chlo-
    rid.  690.)
  From lying (plumb, tannas,  583.)
  Fungous (acid. acet. empyr. 34;  creaso-
    tum, 287; zinci chloridum, 690.)
  Gangrenous (calx chlorin. 166; creasoton,
    280.)
  Herpetic, &c. (acid. acet. empyr. 34; calx
    chlorin.  166; creasoton,  286;  fuligo,
    394;  zinci chloridum, 690.)
  Ill-conditioned  (ferri ferrocyanur. 358.)
  Indolent (creasoton, 285; platin. 580; po-
    tassa?  chloras,  587;  solution of gutta
    percha in chloroform,  259; veratria,
    686.)
  Irritable (argent,  oxid. 113; iodin. 490,
    491.)
  Interciliary (ol. jecor. aselli, 555.)
  Luxuriant  (hydrargyri  iodidum rubrum,
    428.)
  Malignant (conia, 715; creasoton,  285;
    iodinium,  490;   monesia, 520;  zinci
    chlorid. 690.)
  Obstinate  (creasotum,  285; hydrargyri
    iodidum rubrum, 427;  plumbi iodid.
    582.)
  Of the mouth, after salivation (calx chlo-
    rin.  173;  potassae chloras, 585.)
  Of the pharynx (aurum  metallicum, 139.)
  Offensive (chlorinii aqua,  209.)
  Old  (acidum chromicum, 703 ;  iodinium,
   er
    491; soda chlorinata, 648; zinci chlori-
    dum, 693.)
  Phagedenic (calx chlorin. 166; creasotum,
    298;  hydrargyri iodidum,  424,  420;
    iodinium,  487;  monesia,  520;  zinci
    chlorid. 690.)
  Psoric (fuligo, 394.)  ,
  Putrid (chlorinii aqua, 209.)
  Sanious (creasoton, 285.)    i
  Scorbutic'(creasoton, 286.)
  Scrofulo-venereal (hydrargyri iodidum ru-
    brum, 427.)
  Scrofulous (brominium, 153;  calx  chlo-
    rin. 166;  creasoton, 285; hyd. et ar-
    sen.  iodid. 435; hydrarg.  iodid. 424,
    426,  428; hydrarg.  iodid.  rubr.  428;
    iodinium, 495; juglans regia, 501;  mo-
    nesia, 520;  veratria,  686;  zinci chlo-
    rid. 690, 693, 694.)
  Serpiginous  (monesia, 520.)
  Sinuous (zinci chlorid. 690.)
  Sloughing (acid. acet.  empyr. 34;  chlo-
    roform, 213, 214;  creasoton, 286; hy-
    drargyri deuto-nitras,  433; iodinium,
    490; plumbi nitras,  438;  zinci chlori-
    dum, 690.)
       from lying (plumbi tannas, 583.)
  Specific (brominium, 153.)
  Spreading, of the throat (ferri iodidum,
    363.)
  Superficial (creasotum, 285.)
  Syphilitic (argent, praepar. 107; auri  et
    sodii chloridi, 136; aurum metallicum,
    139;  brominium,  153;  calx chlorin.
    166;  creasoton, 285,  280,  287; ferr.
    iodid.  3(53;  fuligo, 394; galvanismus,
    403; hydrarg. cyanuret. 422 ; hydrarg.
    iodid. 424; hydrarg.  iodid.  rubr. 427,
    428; iodinium, 477; iodide  of chloride
    of mercury, 499;  monesia,  520.)
       old (hydrargyri iodidum rubr. 430;
         zinci chlorid. 690, (591.)
       of  the  fauces  (hydrargyri cyanu-
         retum, 422.)
  Torpid, foul, &c. (calx chlorin. 166; ferr.
    cyanur. 358.)
  Unhealthy (hydrargyri deuto-nitras, 433;
    potassa? chloras, 587.)
  Varicose  (acid,  tannic.  61;  creasoton,
    285.)
Ulceration  of os uteri  (collodion, 256; hy-
    drargyri deuto-nitras, 432; iodin. 474.)
  Intestinal (monesia,  519.)
  Interciliary  (oleum morrhuae,  555.)
  Of the mouth (calx chlorin. 167; chlorinii
    aqua, 209;  potassii  chloras, 585.)
  Of the rectum (moxa, 537.)
  Of the sigmoid flexure of the colon (moxa,
    537.)
Ulcerative process (iodinium, 487.)
  Of the throat (chlorinii aqua, 208.)
Urethra, diseases of the  (buchu, 158.)
  Mucous membrane of the, tumefied (car-
    bo-anim.  186.) 
DISEASES AND THEIR REMEDIES.
xxxi
Urethritis  (cubeba, 301;  ergota, 343, 344;
     iodin.  4 92. j
Uric acid  calculus (acid, benzoic. 37; am-
     monia? phosphas,  91;  soda? phosphas,
     714.)
• Diathesis (acidum benzoicum, 38.)
Urinary organs, diseased (cainca, 160; chi-
     maphila, 195, 197.)
Urine, incontinence of (atropia, 127 ; buchu,
     158; digitaline, 309; ergota, 339;  iodin.
     471; potass, nitras, 730 ; sumbul, 748.)
  Retention of (apis mellifica, 704; chloro-
     form, 219; ergota, 337, 339; strychnia,
     661.)
Urticaria  (colchicum,  249 ;  cort. adstring.
     Brazil. 273 ;  ferri  nitras,  372 ; quiniae
     sulphas, 626.)
Uterine contractions, excitant of the (ergota,
     336, 342.)
  Irritation (chloroform, 212.)
Uterus, cancer of the  (auri nitro-murias,
     137; cortex adstringens, 274; ferri chlo-
     ridum, 723; ferr. subcarb. 384.)
  Congestion of the (iodinium, 474.)
  Diseases of the  (argenti  oxidum,  113;
     chloroform, 220; hydrarg. et arsen. io-
     did. 435;  plumbi iodidum, 583.)
  Engorgement of the (ergota, 343.)
  Erosion of the (iodinium, 474.)
  Hard tumours of the  (iodinium, 474.)
  Hourglass  contraction  of  the (electro-
     magnetism, 314.)
  Hypertrophy of  the  (ergota, 338;  ferri
     bromidum, 350.)
  Induration of the (calendula, 163.)
  Inertia of the (electro-magnetism,  311;
     ergotin, 344, 346.)
  Neck of the, fungus of the (aur. nitromu-
     rias, 137.)
              indurations of  the (galvanic
                cautery, 405.)
              ulcerated (hydrargyri deuto-
     nitras, 432; iodinium, 474.)
  Neuralgia of the (chloroform, 212.)
  Pain of the (acid, hydrocyan. 52.)
  Retroflexion of the, (chloroform, 220.)
  Spasmodic pains of the (acid, hydrocyan.
     51.)
  Ulcerated (collodion, 256;  iodin. 474.)
Uvula,  relaxed  (acid,  tannic. 60; ferri et
    alumina? sulphas, 721.)
Vagina, discharges of blood from the  (ma-
    tico, 514.)
  Inflammation of the (collodion, 256; cube-
    ba, 301; ergota, 311; fuligo, 393; mo-
    nesia, 519; zinci chlorid.  692.)
  Fetid discharges from the (alumina* sales,
    91.)
 Varicocele (coModion, 255.)
 Varicose  conditton of the  rectum (matico,
     515.)
   Veins (acupunct. 71; collodion, 254, 255;
     electro-punctura, 321, 323; ferri  chlo-
     ridum, 723.)
 Variola.  See Small-pox.
 Venereal.  See Syphilitic.
   Excesses, atony from  (compressio, 263.)
   Infection, prevention of (chlorin. aq.209.)
 Vomica (cauterization, &c, of the larynx,
     192;  chlorinium, 200.)
 Vomiting  (acid, hydrocyan. 52;  aq. picea,
     105;  argilla, 115; creasoton, 293, 297;
     strychnia, 662; sumbul, 748.)
   Chronic (artemisia, 124; calendula,  163;
     cerium, 711;  chloroform, 213.)
   Nervous (creasotum, 294.)
   Obstinate  (calendula,  163;  chloroform,
     212.)
   Of infarfty (argilla, 115.)
   Of pregnancy (cerium, 711;  chloroform,
     213;  creasotum, 293; nux vomica, 544,
     546.)
   Yeasty  (sodae hyposulphis, 743.)
 Wakefulness  (bimeconate of morphia, 533.)
 Warts, malignant (iodinium, 492.)
 White swelling (chimaphila, 197;  iodinium,
     461;  ol. jecor. aselli, 558;  potassii cy-
     anuret. 5_2 ; potassii iodidum, 603.)
 White tissues, thickening of the (ammoniae
     phosphas, 92.)
 Whitlow  (iodinium, 489.)
 Womb, inertia of the (ergotin, 331.)
 Worms  (cainca? radix, 161; corylusrostrata,
     275;  ferri et alumin. sulphas, 721; filix
     mas, 389; granatum, 411;  juglans, 501;
     oleum cadinum, 736;  oleum morrhua?,
     560;  ol.  tiglii, 566;  quinia? sulphas,
     627; santoninum, 741; zinci ferrohydro-
     cyanas, 696.)
 Wounds (calx chlorin. 167; plumbi tannas,
     583.)
   Contused (calx chlorin. 167,163 ; buchu,
     159; iodinium, 490; plumbi nitras, 738.)
  From dissection  (calx chlor. 167;  iodi-
     nium, 492.)
  From gunpowder (calx chlorin. 168.)
  Lacerated (iodinium, 490;  calx chlorin.
     168.)
  Painful (acid, hydrocyan. 52; conia, 715.)
  Poisoned (argilla, 115.)
  Punctured (iodinium, 490.)
  With fungous formations (zinci chloridum,
     690.)
Wristdrop, from lead  (iodinium, 472.)
Zymotic diseases (chlorinium, 203.) 
3_F $ 
NEW  REMEDIES.
          I. ACIDUM ACE'TICUM EMPYREUMATTCUM.
 Syxoxymes. Acidum Pyro-aceticum seu Ligni Pyro-oleosum seu  Pyrolignosum seu
  Pyroxylicum, Acetum Ligneum seu Pyrolignosum seu Lignorum Empvreumaticum,
  Pyroligneous, and Pyrolignic Acid.
 French. Acide Pyro-aeetique, A. Pyrolignique, A. Pyroligneux, Vinaigre de Bois.
 German. Brenzliche oder brandige  Holzsaure; Holzsaure; Holzessig;
  Holzessigsaure.
   Pyroligneous acid, although brought much into notice—revived as
 it were—in recent times, is by no means the product of those times
 exclusively.  The  cedria, with  which  the Egyptians embalmed  the
 bodies of the dead, it is  presumed, was identical with it.  Pliny re-
 commends cedria, or the oil of tar  got  from the cedar, in  toothach,1
 and Galen unites with him.2  The  virtues of pyroligneous  acid  are
 often also referred to by Boerhaave.3

                      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 empyreumatic oil;  to
 this succeeds the pyroligneous acid, which is formed during distillation.
 If  the  distillation  be  continued, more empyreumatic oil passes over,
 and lastly tar.
   The chief constituent of 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 con-
 taining nitrogen, and  similar to an extract (empyreumatic extract,)
 and spirit of tar [spiritus pyrolignicus.)   Reichenbach discovered in
 it the new substance creasote,4 which seems to be the most important
 ingredient,—its medicinal efficacy appearing to be  dependent  upon
 that substance.
  Impure  pyroligneous acid is of a brownish colour,  and of an acid
 smoky smell and taste.  This is the preparation which is generally

  1 Hist. Nat. xxxiv. 11.
  JDe  Simpl. Medic. Facult. lib. vii. See Cormack on  Creasote, p. 59.  Edinburgh,
1836.
  5Riecke, Die neuern Arzneimittel. u. s. w. S. 6, Stuttgart, 1837.
  * See the article Creasote.
       3 
34
ACIDUM ACETICUM EMPYREUMATICUM.
used externally; but, by chemical means, the acid may be purified so
as to furnish the  acidum aceticum  cmpyreumaticiim rectificatum.
This differs from impure pyroligneous acid in containing less empyreu-
matic resin and extract,  and creasote.  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;  dyspnoea; croupy cough;
hoarseness, &c.  The death of the animal supervenes with symptoms
of suffocation, and the fatal termination is often  rapidly induced.   In-
spection  after death  exhibits  manifest  venous  congestion in the brain,
spinal marrow, lungs, liver, and spleen, and in  the  right side of the
heart,—with, at times, inflammation of the stomach.  According to
Berres,  it occasions  marked  narcotic  effects.   In by no means consi-
derable  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 sensation
of burning in the stomach, and after a time to quicken the pulse, and
augment the cutaneous and renal  depurations.   Others—and  the best
observers, we think—deny it any narcotic properties.1
  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 produced by caries—the acid  being
dropped upon cotton and applied to the hollow tooth.  In most of these
cases, it was generally exhibited both internally and externally.   Nu-
merous  experiments have been made  with it in various affections by
different observers;  but  its  use  has been more especially extolled in
cases of gangrene, in which it corrects foetor, and promotes the sepa-
ration of the dead parts.2   The physicians of  the Berlin Charite  expe-
rimented with it in cases of sloughing gangrenous sores, with such suc-
cess, that they pronounced it  an antiseptic of the highest order.3  Be-
sides the cases  mentioned, it has been advised, mixed with white of

  1 Richter's Specielle Therapie, S. 255.   Berlin, 1828.
  8 T. Y. Simons, in American Journal of the Medical Sciences, vol. v.
  3 Riecke, Op. cit. S. 9. 
                ACIDUM ACETICUM EMPYREUMATICUM.              35

egg, in excoriated nipples,1 in  cancerous and scrofulous affections, in
cancrum oris, by Berres, Klaatsch, Heim and Romberg; in mercurial
salivation by Schfceider; in caries of the bones, and as a gargle in scarlet
fever by Barth.   It  has, moreover, been recommended  by Buchanan3
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; in  scabies; in favus by Berres and Wigan;  in
toothach by Berres.  In  gastromaiacia it has been  recommended  by
Pitschaft3 and Teufel ;4 in phthisis by Harless, and in dropsy, diarrhcea,
putrid nervous fevers, &c,  by Ampach;5 and in scorbutus by Berres;6
yet,  as was before remarked, it is rarely employed 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 for-
mer 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 in-
jection, it may be diluted with six or eight parts of water;  as a colly-
rium, the proportion may be one  part of the acid to twelve of water,
and  it may be employed, of about the same strength,  as a gargle.
   Heim has recommended  the following application in cancrum  oris.

                Mel acidi acetici  empyreumatici.
                      Honey of pyroligneous acid.
                   R. Acid. acet. empyreum. crud. f ^iss.
                      Mellis rosae 3j.   ^-
   To be applied by means of a pencil.

   Buchanan advises the  following form of injection in cases of puru-
lent  discharges from the meatus auditorius.
              Injectio acidi acetici empyreumatici.
                     Injection of pyroligneous  acid.
                     R. Acid, acetic, empyreum. f^ij.
                       Aquae destillatas f ^vj.  M.
  Fiat injectio bis die utenda.

  1 Bursharat, in Gazette M.dicale, and Amer. Journ. of the Medical Sciences, Feb.
1833, p. 503.
  2 Illustrations of Acoustic Surgery, Lond. 1825.
  3 Med. Chirurg. Zeitung, No. 7, 1825.
  * Annal. fur die gesammte Heilkund. unter der Redact, d. Mitglied. der Badensch.
Sanitatsk. 2ter Jahrg. 1825.
  5 Rusts Magazin, B. xvi. II. 2, S. 353,and Richter, Op. cit. B. x. S. 257, Berlin, 1828.
  6 Aschenbrenner,  Die neueren Arzneimittel und Arzneibereitungsformen u. s. w. S. 7,
Erlangen, 1818. 
36                      ACIDUM BENZOICUM.

  The  following drops  he recommends in cases where the cerumen is
deficient in quantity.

               Guttae acidi acetici empyreumatici-

                      Drops of pyroligneous acid.
           R.  Acidi acet. empyreum. crud.
              Olei. terebinth, rectif.
              Sp. a_theris sulphur, comp. aa. partes aequales.  M.

  Two  drops of this compound are to be dropped every night into the
meatus  auditorius.                                     Buchanan.

            Cataplasma acidi acetici empyreumatici.

                    Cataplasm of pyroligneous acid.
      R.  Furfur, loss.
          Lin. pulv. §j.  M. bene et adde.
          Acid, acetic, empyreum. crud. q. s. ut fiat cataplasma.

  To be applied to foul ulcers.

            Unguentum acidi acetici  empyreumatici-

                    Ointment of pyroligneous acid.
              R.  Acid. acet. empyreum. f giij.
                 Sapon. virid. ^ij.
                 Lact. vaccin. f'^iv.  M.

  Employed in tinea capitis maligna.                    Bottcher.

           Linimentum acidi acetici empyreumatici-

                    Liniment of pyroligneous  acid.
                    R.  Acid. acet. empyreum. Ifss.
                        Balsam. Peruvian, gij.
                        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 §ss.
                    Aquae cinnamomi f %\v.
                    Syrup. Mori f §ij.  M.

  Phobus advises this as a wash for the mouth in cases of cancrum oris.
It should he kept in  a glass vessel covered with black paper to prevent
decomposition.
                    II. ACIDUM BENZO'ICUM.

Stnonymes. Acidum Benzoicum per sublimationem, A. Benzoylicum, Flores Benzoes
  seu Benzoini, Benzoic Acid, Flowers of Benjamin.
French. Acide Benzoique.
German.  Benzoesaure,  Benzoylsaure, Benzoeblumen.

  Benzoic acid exists  in  the various balsamic substances, as benzoin
storax, tolu balsam, &c. 
ACIDUM BENZOICUM.
37
                       METHOD OF PREPARING.
  In pharmacy it is obtained from benzoin by sublimation.  The fol-
lowing process is given in the last edition of the Pharmacopoeia of the
United States (1851.)  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 of 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,1 is to
boil  the benzoin in powder with  hydrate of lime, so as to form a ben-
zoate of lime, which is  dissolved in the water, while the resin remains
combined with the lime in the form of an insoluble compound.   Mu-
riatic 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 sparingly 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 work2  the author has remarked:—" The therapeutical
action of  benzoic acid is doubtless excitant, and it has been imagined
by Dr. Pereira3 and others, that  its  influence is principally directed
to the mucous surfaces, and  especially to   the  aerian  membrane.
The  author has no reason for believing in this affinity, and such would
appear to be the general feeling of the profession, as it is now scarcely
used except in one  or two  preparations, in  which it seems to be re-
tained only from old prepossessions and associations." Of late years,
however, it has been introduced for a special  purpose, and on this ac-
count is  noticed here.   In a paper communicated by Mr. A. Ure to
the  Medico-chirurgical Society, January 7th, 1S41,4 he  stated, that
when a certain portion of benzoic acid or of a soluble benzoic salt is in-
troduced 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 beautiful 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 oc-
curring in  the  animal fluids, as soda, 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 benefit
 1 Elements of Mat. Med. and Therap. p. 275, Lond. 1845.
 2 General Therapeutics and Materia Medica, 5th edit.  1. 265. Phila. 1853.
 3 Elements of Mat, Med. and Therap. 2d Amer. edit. 1. 373.  Phila. 1846.
 4 Provincial Medical and Surgical Journal, July 17, 1841. 
38
ACIDUM BENZOICUM.
in the treatment of certain unhealthy conditions of the urine occurring
in subjects of a calculous or gouty diathesis; since it enabled the prac-
titioner to obviate entirely the various depositions  resulting from ex-
cess 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 statements 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,1 although
they established, that  the benzoic acid was converted into the hippu-
ric.2  Neither, therefore, in the uric acid diathesis, nor in cases of the
formation of gouty or  tophaceous  deposits, the chief constituent of
which is  generally urate of soda, can the administration of benzoic acid
be of service, and its inefficiency in  these diseases is now admitted;3
but  from its power of causing increased acidity of the  urine, it  has
been considered to slightly stimulate the mucous membrane of the uri-
nary organs, and has been found useful in catarrh of the bladder, and
in cases where there exists a secretion of granular mucus mixed with
phosphates.4
   The suggestions of Mr.  Ure,  in  regard to  the  action of benzoic
acid on the urates, induced Dr. Walker of Huddersfield,5 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 conditions,—and  he  as-
serts 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 ir-
ritation to the mucous membrane of the bladder.   But it is often of
service where the gravel in  the urine is inconsiderable, 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 re-
marks induced Mr. Soden6 to employ the combination in some urinary
affections, accompanied with vesical irritation and increased secretion
from the  mucous membrane.  The most remarkable result appeared
to Mr. Soden to be its decided efficacy in diminishing, and in some
instances  of  completely 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 may be
very fairly entertained, whether this effect be attributable to the ben-
zoic acid or to the copaiba,  or  to their combination; and in the doubt

  1 Keller, in appendix to Liebig's Animal Chemistry, p. 315, Cambridge 1842
  2oonrr°d; ^°n_" Edinb> and Dubl- Philos- Ma6- 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. 18o.  Phila. 181_.                                              r
  3 Ballard and Garrod, op. cit. p. 408, Lond. 1845.
  "Ballard and  Garrod, p.  409, and Mr. Ure,  Prov. Med. and  Surg. Journ. Feb 11
1843, and Lond. Lancet, Nov. 16, 1844.
  5 Ibid- Feb. 26, 1812.                      6 ibid. July 29, 1842. 
ACIDUM GALLICUM.
39
Mr. Ure deduces no positive inference in regard to the precise agency
of the benzoic acid.1
   It may be concluded, then, that benzoic acid has been introduced as
a remedy in  lithuria on erroneous chemical  deductions:  and hence
that the favourable results recorded have been fallacious, or depending
on other causes.

   Dr. Seymour2 states, that he has frequently  used  the benzoate of
ammonia in gout, in cases in which  the small joints were red and
swollen, or where fluid was deposited in the joint of the great toe; and
also in cases where the urate of soda existed in the joints of the fingers;
and that it was decidedly useful.   He thinks, that  early depositions
were arrested, and large depositions  diminished, under its  use.   He
esteems  it a good diuretic, and especially adapted for those cases of
dropsy, in which an irritable stomach renders the  employment of or-
dinary diuretics impracticable.  He has also seen the albumen in renal
dropsy diminish under its use.

                     MODE OF ADMINISTRATION.
   The dose of benzoic acid may be from five  grains to half a drachm.
              Mistura acidi  benzoici et  copaibse-
                    Mixture of benzoic acid and copaiba.
                        R. Acid, benzoic. 3J-
                           Copaib. f ^ss.
                           Vitell. ovi q. s.
                           Aq. camphor, f^vij.  M.
   Dose.   Two table-spoonfuls three times a day.
                    III. ACIDUM GAL'LICUM.
  Sy\onymes. Gallic Acid.
  French. Acide Gallique.
  German. Gallussaure.
  Gallic acid is by no means so abundant as tannic acid.  A solution
of the latter in water, exposed  to  the air, gradually absorbs oyxgen,
and deposits crystals of gallic acid, formed by the destruction of tannic
acid.
                      METHOD OF  PREPARING.
  This acid has been received into the last edition of the Pharmocopceia
of the United States, (1851.)   Take of galls, in powder, Ibiij ; distilled
water and animal  charcoal, each a sufficient quantity.   Mix the galls
with sufficient  distilled water to form a thin paste, and expose  the
mixture  to the air in  a shallow glass, or porcelain vessel, in  a warm
place, for a month, occasionally stirring with a glass rod; and adding,

  i Ibid. Feb. 11, 1843.
  1 Thoughts on the Nature and Treatment  of several severe Diseases of the Human
Body, vol. i. p. 123, Lond. 1817. 
40
ACIDUM GALLICUM.
from time to time, sufficient distilled water to preserve* the semi-fluid
consistence.   Then submit  the paste to expression, and, rejecting the
expressed liquor, boil  the residue  in a gallon of distilled water for a
few minutes, and filter, while hot, through animal  charcoal.  Set the
hot liquor aside that crystals may form, which may be dried on bibulous
paper.  If the crystals be  not sufficiently free from colour, they may
be  purified by dissolving  them in  boiling  distilled water,  filtering
through a fresh portion of animal charcoal, and crystallizing.
  It  may also be produced by adding  sulphuric acid  to a solution  of
tannic acid, which  causes a precipitation of the  tannic  acid in combi-
nation with the sulphuric: the precipitate is dissolved in dilute sulphu-
ric 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.1
   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 possessed  of
such property; and until its use was revived of late it  had fallen into
disrepute.   Sir Benjamin Brodie, according to  Dr. A. T. Thomson,2
gave a  patient, who had a frightful hemorrhage  from  the  prostate
gland, and in whose case all other remedies had failed, a dose of "Rus-
pini's styptic," and repeated the  dose  twice in the course of twelve
hours.  About half an hour after the first dose  was taken, the bleed-
ing ceased, and it never  recurred.  This  styptic is said to consist  of
gallic acid, a small quantity  of the sulphate 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 solution 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 has been found effica-
cious.
  In a paper read before the Medico-chirurgical Society of Edinburgh,
Professor Simpson3 stated,  that in the previous year he had employed
gallic acid in menorrhagia with the most successful results.   Some  of
the cases, which had yielded under its use, were of  old standing, and
of an aggravated description.  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 Riispini's styptic, after many other remedies had failed.  Pro-
fessor Simpson suggests, whether  the anti-hemorrhagic properties  of
  1 Ballard and Garrod, Elements of Materia Medica and Therapeutics, p. 415, London,
1845.                                                  > r    i       »
  2 Elements of Mat. Med. and Therap.  3d edit., and 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.
  3 Lond. and Edinb. Monthly Journal of Med. Science, July, 1843, p. 661. 
ACIDUM GALLICUM.
41
some of our common astringent drugs may not depend upon the gallic
acid, as much as, or more than, upon  the tannic acid which they  con-
tain, or upon the tannic acid becoming converted into gallic acid within
the body.  Recently, be has stated, as the  result of his experience in
cases of  hemorrhage, that gallic acid was  only occasionally success-
ful.1
   Dr. Stevenson2 has published several cases to show the value of this
acid in uterine hemorrhage and hsematuria ;  and Mr. James S. Hughes3
has  recorded a case of profuse hsematuria, the result of injury  on
the lumbar region, which was treated  successfully by it  in the form of
pill with extract of gentian—two grains and a half of the  acid to  each
pill,—one of these being  given at intervals of three hours; and Hom-
burger4  prescribed it successfully in hsematuria  renalis;  in bloody
diarrhoea accompanying the morbus maculosus; and in the hsemoptysis
of phthisis.   It was administered, with much success, by Mr.  T. P. J.
Grantham,5 in three  cases of Purpura hsemorrhagica,  in the dose of
five  grains, every three hours; compound  rhubarb pills  being given
as an  aperient.  Dr. Christison6 has seen  several cases of menor-
rhagia recover  promptly under its use.  He has likewise seen hse-
maturia repeatedly  yield to it, and in two instances  of hsemoptysis
the hemorrhage rapidly ceased  after the third dose of six grains given
every hour.  Messrs. Ballard and Garrod7  declare it to be one of the
most powerful astringents that chemical art has derived from the ve-
getable kingdom; 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 hemorrhage 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 leucorrhoza, as well as for check-
ing the distressing night-sweats of phthisis.   In the first two of these
especially,  no  astringent that they had employed would  bear a com-
parison with this, either for the rapidity with which the cure was ef-
fected, 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 experience in other cases.   No medi-
cine 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 Gar-
rod state, that if the use of the acid be continued beyond two or three
days, it manifests some constipating tendency, whilst Professor Simp-
son affirms, that it has this advantage over most other anti-hemorrhagic
medicines, that  it has  no  constipating effect.   The observations  of
Messrs. Ballard and  Garrod  are probably  the  most accurate.  They
  1 Association Med. Journ., Feb. 1855, p. 186,  and Obstetric Memoirs and Contributions
of James Y. Simpson, M. D.,  &c, p. 295, Edinb. 1855.
  2 Edinb.  Med. and Surg. Journal, July, 1843.
  3 Dublin Quarterly Journal of Med. Science,  cited in Med. Examiner,  July, 1847,  p.
447.
  * Canstatt and Eisenmann's Jahresbericht iiber die Fortschritte in der Heilkunde im
Jahre 1848, S. 140.
  5 Association Med. Journ. Sep. 9, 1853, and Ranking's Abstract, xviii. 31.
  6 Dispensatory, American edit, by R. E. Griffith, p. 967.  Philad. 1848.
  7 Op. cit. p. 415, Lond. 1845. 
42
ACIDUM GALLICUM.
affirm also, that the excessive expectorations of chronic bronchitis and
phthisis are much influenced by its administration. In leucorrhcea they
have found it highly useful  as an injection, and Mr. Sampson1 gave
it with good  effect in gonorrhoea in  the quantity of a  dram  in the
twenty-four hours, taken in twelve grain doses;  and he places great
confidence in its  use in  cases of albuminuria.   Dr. Christison,2  too,
had his attention turned to its apparent power of arresting the excretion
of albumen in the urine in Bright's  disease of the Kidney, and in a
few instances it appeared to him to  have that effect.  In a paper on
the use  of gallic acid in the hemorrhagic diathesis, and in diseases cha-
racterized by relaxed fibre  or excessive secretion, Dr. Bayes3 thinks
it  is worthy of every confidence in active and passive hemorrhages;
excessive secretions, as  in  pyrosis,  serous  diarrhoea, chronic bron-
chitis,  bronchial flux, profuse night-sweats,  some forms  of dysen-
tery, and perhaps in diabetes; in atonic states generally, and especially
in rhachitis, and as an adjunct to other means in piles, wounds, &c.   His
testimony, in regard to  its  excellent effects in pyrosis, is exceedingly
strong.   On the other hand, Dr. Gairdner4 is skeptical as to  the re-
puted power of gallic acid in hemorrhages, &c.   He has employed it
in large doses, not only in hemoptysis, but in the  sweating of phthisis,
in diarrhoea and in albuminuria;  some of the cases of  which he  re-
lates ; but he cannot satisfy himself,  that it was unequivocally benefi-
cial ; and he  infers that in continuing to administer  gallic acid on the
principle, and in the way indicated  by some of its  advocates, we run
some risk of substituting a  very feeble, if not inert, remedial agent
for other means more deserving of  confidence.   He  remarks, that
tannic acid has more effect  as an astringent in haemoptysis; but Pro-
fessor  Simpson4  says, that  it is  difficult to reconcile this with the
observation of  Wohler, that tannic acid is converted into  gallic acid
in its  passage through the circulation, and, consequently, before it
reaches the lungs.

                     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.

                      Pilulee acidi gallici.
                         Pills of gallic acid.
                     R.  Acid, gallic, gr. ij.—v.
                         Confect. rosae q. s. ut fiat pilula.
                       Injectio acidi gallici.
                        Injection of gallic acid.
                     R.  Acid, gallic. Bj. ad3j.
                        Aquae Oij.  M.

  1 London Lancet, Dec. 1st, 1849.                            2 Op. cit.
  3 Association Med. Journ., June 28,1854, and Ranking's Abstract, xx. 83, Amer. edit.,
Phjlad. 1855.
  4 Assoc. Med. Journ., Feb. 23,1855, and Ranking, op. cit. Amer. edit. xxi. 67.  Philad.
1855.
  6 Assoc. Med. Journ.,  1855, p. 186, and Obstetric Memoirs, &c, loc. cit. 
ACIDUM HYDROCYANICUM.
43
               IV.  ACIDUM IIYDROCYAN'ICUM.
Synoxymes. Acidum Hydrocyanicum Dilutum (Pharm. U.S. 1851,) A. Hydrocyana-
  tum seu Prussicum seu Borussicum seu Zooticum seu Zootinicum; Hydrocyanic, or
  Diluted Hydrocyanic Acid, Prussic, Cyanohydric or Cyanhydric Acid.
French. Acide Hvdrocyanique, Acide Prussique.
German.  Blausaure,  Wasserstoff blausaure, Hydrocyansaure, Cyanwas-
  seistoffsaure, Preussische Saure.
  This acid can scarcely be looked upon as new; yet it is only in  re-
cent 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 constitution, were not un-
derstood until Gay-Lussac published the results of his investigations on
the subject in the year 1815.l

                      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 pharmacopoeias of Paris and Ferrara;
and  the third  by  those of Belgium, Paris, and  the United States.
(Edition of 1830.)
  1. Scheele's Method.—Take of Prussian blue, 128 parts; Red oxide
of mercury, 64 parts;  Distilled water, 105 parts.  Boil for a quarter
of an hour, constantly shaking; strain, filter, and wash the residuum
with Boiling water, 128 parts.  Mix the two liquids together;  intro-
duce them  into a flask, and  add Porphyrized 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 1!*2 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.
  The process of Scheele always affords  an acid mixed with a variable
quantity of water.
  2. Gay-Lussac's Method.—Take Cyanuret of mercury, at pleasure.
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 suf-
ficient to rise above the cyanuret to the height of a finger;  heat gra-
dually and moderately, and receive  the  condensed product into the
bell glass.
          'Annales de Chimie, torn, lxvii. p. 128, and torn. xcv. p. 136. 
44
ACIDUM HYDROCYANICUM.
  The acid obtained in this way is anhydrous, and of the specific gra-
vity, 0.700.
  8. Vaii quel in's Method.—Take of Cyanuret  of  mercury,  1  part;
Distilled water, 8 parts.  Pass a current of sulpholiydric acid gas into
the solution, until the gas is in excess;  pour into the liquid pulverized
subcarbonate of lead in sufficient quantity to remove the excess of suh
phohydric  acid;  shake  the  mixture constantly, and  when it  has no
longer the smell of putrid eggs, and ceases to blacken paper impreg-
nated with acetate  of lead, filter and preserve it carefully.
  The product of this operation has been considered to approximate
the average density of the acid of Scheele.1
  The variable density of the acid  prepared after Scheele's  method
has prevented it from being generally  used in medicine.   The acid of
Gay-Lussac is most commonly employed; but as its degree of concen-
tration  renders it dangerous, it is diluted with distilled water.  Robi-
quet has proposed to bring its density to 0.900, 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,2 Me-
dicinal prussic or Medicinal hydrocyanic acid.  Others have advised
the employment of  a mixture of three parts of water, and one part of
acid, under the name of Acide hydrocyanique au quart, or " Hydrocy-
anic acid of quarter strength."3
  Dr. Bache asserts, that he had the process  (Proust's or Vauquelin's)
of the United States  Pharmacopoeia (1830) repeated,  when he found
the acid obtained to have the specific gravity 0.998.
  In the last two editions of the Pharmacopoeia of  the  United States,
(1842 and 1851,) the following  form is introduced.   It is essentially
that of the London Pharmacopoeia.   Take of Ferrocyanuret of Potas-
sium, ^ij.; Sulphuric acid, §iss.; Distilled water, a sufficient quantity.
Mix the acid with four fluidounces of distilled water, and pour  the
mixture, when cool, into a glass retort.   To this add the ferrocyanuret
of potassium, previously dissolved in ten fluidounces of  distilled water.
Pour  eight fluidounces  of distilled water into a cooled receiver,  and
having attached this to the retort, distil, by means of  a sand bath, with
a  moderate  heat,  six  fluidounces.   Lastly,  add to  the  product  five
fluidounces of distilled water, or as much as may be sufficient to render
the hydrocyanic acid of such strength, that 12.7  grains of nitrate of
silver, dissolved in  distilled water, may be accurately  saturated by 100
grains of the acid.
   When hydrocyanic acid is wanted for immediate use,  the following
formula is recommended.—Take  of Cyanuret of silver, fifty grains

  1 See Notes on Hydrocyanic acid, by R. E. Griffith, in Philad. Journ. of Pharmacy, iv.
17,  Philad. 1833; also, Pereira, Elements of Materia  Medica, 3d Amer. edit. ii. 778,
Phil. 1854.  The Dispensatory of the United States of America, by  Drs. Wood and Bache,
10th edit. p. 805, Philad. 1854, and Mr. David Stewart, Maryland Medical and Surgical
Journal, April, 1840, p. 264.                                           fa
  2 Formulaire pour la  preparation, etc. de plusieurs nouveaux m.dicamens.
  3 Pharmacop.e Universelle, par Jourdan, i. 31.  Paris, 1828. 
ACIDUM HYDROCYANICUM.
45
and a half;  Muriatic  acid, forty-one grains; Distilled water, 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 in-
soluble matter has subsided, pour off the clear liquor and keep it for use.
  The characters that hydrocyanic acid should possess, according 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 cent, of pure anhydrous acid.1
  No matter how prepared, hydrocyanic  acid should be  kept in  well-
stopped bottles from which the light is excluded.

                EFFECTS ON THE ECONOMY IN HEALTH.
  Hydrocyanic acid is usually  classed amongst the narcotic poisons,2
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 experimented
upon can scarcely be removed from the lap of the experimenter before
all signs of  life are extinct.   This rapidity of action has seemed  to be
unfavourable to the idea,  that it acts through the  mass of blood, and
to favour 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.3  The
same objection, however, has seemed to apply to this explanation  as to
that which ascribes the effects to the poison being taken into the blood—
that the fatal result is often too sudden for us to presume,  that it has
entered the blood-vessels; unless we esteem it an agent possessed of
powerfully penetrating properties.
  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,  stag-
gered 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 respiration.  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.4

  1 Pharmacopoeia of the United States, p. 59.  Philadelphia, 1842.
  3 Christison, Treatise on Poisons, 1st Amer. from 4th Edin. ed. p. 582.   Phila. 1845.
  3 An Essay on  the Operation of Poisonous Agents upon the Living Body.  London,
1829.
  4 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. 
46
ACIDUM HYDROCYANICUM.
   M. Damason1 relates the case of a druggist, who had some hydrocyanic
 acid in  a vial with a ground stopper, and, as  it had been prepared
 almost three months, thinking that it was  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  con-
 vulsions  and death, in from  six to fifteen minutes.
   The experiments of Emmert and Coullon seem to have shown that
 the action of hydrocyanic acid is more violent when it is injected into
 the jugular vein, or inhaled in a concentrated form; less so when in-
jected 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.2  On the.other
 hand, when received into a wound in its concentrated state, it  acts
 most violently.   Scharring, who broke a glass containing the acid, and
 received  some of it into the wound produced thereby, died in an hour
 after the accident.
   It is not easy to deduce comparative  results from the 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 dram of a stronger sample, without sustaining any  injury; but
on trying some, which had  been recently prepared by Vauqueli'n, he
was immediately taken ill, and narrowly escaped with life.3  Dr. Pe-
reira* caused the instantaneous death of a rabbit by applying its nose
to a receiver filled with the  vapour of the pure acid: the animal died
without a struggle.   A drop of the pure acid of Gay-Lussac, placed in
the throat of a most vigorous  dog, caused it to fall dead after two or
three hurried respirations.5

  1 Journal de Chimie Medicale.   Juin, 1831.         2 Osann loo cit «! 580
Phil^mfdiCale' XViL 2G5' and Chri;tiS0Q °nPois-s' ^ZlLZ EditL  p. 582.
  * Elements of Mat. Med. &c, 2d  edit. i. 437, London  1842
   Magendie, in Annales de Chimie et de Physique, vi. 347, and Formnlaire, &c. 
ACIDUM HYDROCYANICUM.
47
  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 con-
tact with surfaces, which, owing to their being covered with cuticle, do
not readily absorb.  Orfila1 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,2
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
seconds, and began to  act  in sixty-three; that three  drops, weighing
four-fifths of a grain, in like manner, killed a strong  cat in thirty se-
conds, and began to act in ten; that another was affected by the same
dose in  five, and died in forty seconds; that four drops, weighing a
grain and a fifth, did not affect a rabbit for twenty seconds, but killed
it in ten seconds more; and that twenty-five grains, corresponding with
an ounce and a half of medicinal acid, began to act on a rabbit, as
soon as  it was poured  into its mouth, and killed it outright in ten se-
conds 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.3
   As before  remarked, from the rapidity with which the toxical effects
are observed after hydrocyanic acid has been taken,  it has seemed to
be almost impossible for the poison to have entered the blood-vessels,
and have passed with the current  of the circulation to the great vital
organ on  which its  deleterious agency is exerted.   The well-devised
and carefully conducted experiments of Professor Blake,4 of  St. Louis,
show, however, that in the  case of this poison, as of  every other, the
velocity of the circulatory current is  so great, as to  enable us to un-
derstand  that the deadly influence may be exerted  in all cases  by
the reception of the poison into the  blood.   He found, that sufficient
time always elapses between the application  of the poison and  the first
evidences of its action to admit of such contact.   In an experiment on
a rabbit  with hydrocyanic  acid,5  the animal, immediately after the
contact of the acid with the  lining membrane of the  mouth,  jumped
from the table, and when on the floor was perfectly able  to stand on
its feet.   At two seconds and a half after the application of the poison
it fell on its side, and  in  five seconds was  dead.  " This," says  Dr.
Blake, "is but one of many experiments which  have  been performed
on cats and rabbits, and in no instance have I observed instantaneous
death, or  even the instantaneous action of the poison."6
   If 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,

  1 Toxicologic                     2 Op. cit. p. 592.
  3 Geoghegan, in Dublin Medical Journal, for 1835, and Pereira, Op. cit. p. 242.
  4 Edinb. Med. and Surgical Journal, April, 1839, p. 339, and St. Louis Med.  and Surg.
Journal, Nov. and Dec,  1848.
  5 American Journal of the Medical Sciences, July, 1849, p. 106.
  6 See the Author's General Therapeutics and Materia Medica, 5th edit. i. 96, Phila.
1853. 
48                   ACIDUM HYDROCYANICUM.
 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 pulsations.   In a  more concen-
 trated 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, the other in ten seconds.1
   With regard to the parts of the economy that are primarily  acted
 upon by the hydrocyanic acid after it  has entered the blood, most  ob-
 servers have designated the nervous system.2   In no other way, it has
 been conceived, is it as easy to account for the extreme rapidity  of its
 action in fatal cases.  When mixed with the blood, however, out of the
 body, it altogether changes the character of that fluid, and opposes its
 coagulation ;3 and a recent writer, M. Coze,4 of Strasburg, is of opinion,
 that it affects more  especially the circulatory apparatus; death result-
 ing  from the suspension of  the movements of  the heart, and  the con-
 striction of the ultimate  arterial divisions, whence follow repletion of
 the larger arterial trunks and stasis of the blood—the convulsions being
 owing to a defective supply of blood to the spinal marrow.   Some of
 the German writers5 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 vascu-
 lar systems; vertigo; disposition to syncope; epistaxis as a consequence
 of thinness of the  blood; and a disposition to putrid  diseases.6  Se-
 condly. In  larger doses, the sedative effect of the acid  on the spinal
 marrow, and the abdominal  ganglia, is indicated by feelings of weak-
 ness, numbness, tremors, and other involuntary motions  of the extre-
 mities ; involuntary discharge of the urine and faeces; augmentation of
 the  cutaneous and  urinary depurations; palpitation; anxiety at the
 praecordia; weak pulse; and, according to some, headach, especially in
 the back part of the head;  excoriation of the tongue and inner parts
 of the cheeks,7 and salivation.  This  last symptom is  given by Dr.
 Christison8 on the authority of Drs. Macleod and Granville.9   It has
 been  suspected, however, that salivation, in  these cases, was brought
 about by the use of an impure acid, containing probably a small quantity
 of the corrosive chloride of mercury, particularly if the acid had been
prepared—according to the process of Dublin College—with bicyanuret
 of mercury, muriatic acid and water.   Mercury is, indeed, asserted to
have been actually discovered in the acid by Sylvester's test.   Thirdly.
 In still larger doses, it induces violent  affections of the spinal marrow,
 convulsions, trismus, opisthotonos, emprosthotonos, fainting,  &c.
  1 Annales de Chimie, xcii. 59.
  2 Lonsdale, Edinb. Medical and Surgical Journal, January, 1839, and London Lancet,
June  15th, 1839, p. 440.
  3 Magendie, Lectures on the Blood.  Lect. xvii. in Lancet, for Jan. 26, 1839 p 636,
and Blake, Op. cit.                                              ' r
  4 Bouchardat, Annuaire de Thdrapeutique pour 1850, p. 20   Paris  1850
  5 Richter, Specielle Therapie, Band. x. S. 280.  Berlin, 1828;  andOsann, loc.  cit. S.
52'-     _,   , ,_   .          6 Bncyc. Worterb. B. ii. S. 315.  Berlin, 1828.
  • Born, Rust's Magazm. B. xiii. S. 282.                   8 Qp. citat
  9 Lond. Med. and Phys. Journ. xlvi. 359 and 363. 
ACIDUM HYDROCYANICUM.
49
  From the results of all his observations, Osann1 infers, that  hydro-
cyanic acid acts dynamically on  the nervous system, by diminishing,
depressing, and  annihilating its  life;  and, through the nervous system,
affecting the organs of vegetation or nutrition, and of hgematosis;—that
it incontestably has a specific relation to the spinal marrow, the gan-
glions of the abdomen, and the dependent organs; and hence it is, that,
in comparison with other narcotic  agents, it is less stupefying, whilst it
influences more  deeply the  phenomena  of vegetative or organic life.
He properly remarks, however,  that  the inferences of Jorg,2 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 hydrocyanic acid
being a cumulative poison, although  this has been at  times  suspected.
Its operation must be diligently watched at first, until the proper dose
is ascertained.   This, says Dr. Christison,3 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 decidedly sedative,  allaying  nervous irritability  and vascular
action, and  therefore adapted for all cases in which  these are  inordi-
nately 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 Ger-
many;  yet  in many of the Pharmacopoeias 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 administered; the difficulty of having  it always of the same
strength; the impossibility of administering it undiluted, and the danger
of giving  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 unfortu-
nate results.   Orfila,4 mentions the case of a sick person, who had used
it for a length of time in increasing doses, with advantage; when, being
compelled to send  her prescription to another apothecary, the acid he
employed was so strong as  to produce death, with all the symptoms of
poisoning by hydrocyanic acid.   For these and other reasons, Riecke,
L. W. Sachs, and Osann greatly  prefer the  Aqua laurocerasi and the
Aqua amygdalarum  amararum, which, although in other respects not
less objectionable, are  less dangerous.5  Sir George Lefevre6 affirms
that cherry-laurel water is  a more  effective preparation than hydro-

  1 Loc. citat. S. 526.
  • Materialien zu einer kunstigen Heilmittellehre, B. i. S. 53, 117.
  3 On Poisons, edit. cit. p. 588.                      4 Toxicologic
  5 Die neuern Arzneimittel, u. s. w. von V. A. Riecke, S. 5.  Stuttgart, 1837; O.sann,
loc.  citat., and Eneyclopad. Worterb. ii. 315.
  « An Apology for the Nerves, &c, p.  291.   Lond. 1844.
       4 
50
ACIDUM HYDROCYANICUM.
cyanic acid.   In many nervous affections, as palpitation, hysteria, &c,
he generally prescribes the following draught:
                       R.  Aq. lauro-cerasi tt)/. xx.
                          ------flor. aurant. f §'].
                          Syrup tolut. f^j. M.

  The draught to be taken pro re nata;.
  Possessed of the powerful sedative agency which has been described,
it is not to be wondered at, that hydrocyanic acid should have been
given in a multitude of cases; and, as constantly happens, that unsuc-
cessful trials, suggested by the merest  empiricism, should have been
made with it.
  It is rarely employed in fevers,—intermittent, remittent, or continued.
By many, it has been esteemed beneficial in hectic; but here its agency
must be doubtful.1
  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 anti-
phlogistics.  The followers of the contra-stimulant school esteem it as
one of their most efficacious  contra-stimulants.  In the acute inflam-
mations 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, Magendie, Heller, Elwert, Behr, Roch, &c,
and especially in chronic catarrh, bronchitis, and hooping cough.   In
the last affection it is  conceived by Dr. A. T. Thomson2 to be "the
sheet anchor of the practitioner;" and by Dr. Roe3 to possess a  "spe-
cific" (?)  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.
  In pulmonary consumption it  has been recommended by Granville,
Magendie, S. G. Morton,4 Fantonetti,5 and others, particularly where
there is any inflammatory or spasmodic complication;  but  others, as
Neumann, Weitsch, Sir James Clark, Andral,6 Forget,7 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 phthi-
sis  is to be adopted with caution, as  in many cases, instead of allaying,
it appears to  increase, the cough and fever, diminish the expectoration,
and occasion a sense of suffocation.8  It has been, moreover, asserted,

  1  See the author's General Therapeutics and Mat. Med. 5th  edit. ii. 192, Phila. 1853.
  2  Elements of  Mat. Med.  and Therapeutics, i. 435.  Lond. 1832.
  3  A Treatise on the Nature and Treatment of Hooping Cough, &c., p. 10.  Lond. 1838.
  4  Illustrations of Pulmonary Consumption, p. 131.  Phila. 1834.
  5  Gazette des Hopitaux, 19 Fev., 1839.
  6  Bulletin General de Th6rapeutique, Mars, 1840.
  i  L'Exp_rience, 14 Nov., 1839; and Amer. Med. Intel., Sept. 1, 1840, p. 170.
  8  Schneider, Med. prakt. Adversarien am Krankenbette, Erste Liefer. S. 62, referred
to by Osann. 
ACIDUM HYDROCYANICUM.
51
that its depressing and destructive agency has acted injuriously on the
organism of the consumptive.1
  In chronic nervous diseases, especially when of a spasmodic charac-
ter—as in spasmodic affections of the heart—even  when organic, hy-
drocyanic acid has been  advised as a soothing agent, as well as in spas-
modic asthma; in the sense of suffocation that accompanies hydrotho-
rax and other affections; and in spasmodic dysphagia.   Its efficacy,
too, has been marked, according to Dr. Elliotson,2 in various neuropathic
disorders of the stomach, especially in those in which pain at  the epi-
gastrium was the leading symptom,—in every form, indeed, of gastro-
dynia; and in painful affections of  the bowels, of a similar character
—enteralgia—it has been found useful by Dr. Pereira.3
   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 essen-
tial relief.   In an old person, labouring under anasarca accompanied
by  great pain in the breast, Dr. Rees observed, after the administration
of Vauquelin's acid, great diuresis, with the removal of the dropsy and
its concomitant symptoms.4
   In the asthma pulverulentum of the  Germans, (Staubasthma,)
that is, in the variety to which millers, bakers, grinders and others are
liable, Creutswicher is said to have found it  highly serviceable.5  Its
 efficacy has not been so marked  in epilepsy, chorea, and kindred affec-
 tions ; yet it has been strongly  recommended in tetanus.  Trevezant
 ordered it in a case of traumatic tetanus, after opium had been given
 in  vain, in the dose of from two to twelve drops, with favourable results.6
 On the other hand, Klein gave it in a similar case, with  no other  ap-
 parent effect than  that  of rendering death more easy.7  It has like-
 wise 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 Osann8 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 douloureux, and
 in gouty rheumatic sciatica,  it has been  extolled.  Dr. E. S. Bonnet,9
 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 proper, however, to remark, that
 in two of the three cases described, belladonna was employed in com-
 bination.   The mode of applying 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, previously covered  with  carded  cotton or  cotton
 wadding, were kept constantly wet.  It has likewise been recommended

   1 Siebergundi, in Hufeland's Journal der pract. Heilkund. B. liii. St. 6, S. 15.
   2 On the Efficacy of Hydrocyanic or Prussic Acid in Affections of the Stomach, &c.
 Lond: 1820.
   3 Elements of Mat. Med. and Therap. 3d Amer. Edit, n., 790.  Phila. 1854.
   4 Osann, Op. cit., and Harless, Rhein-Westphal. Jahrbuch. Bd. x. St. 1, 8. 82.
   5 Rusfs Magazin, Bd. xxii. S. 335.    6 Froriep's Notizen, Bd. xiv. No. 15, S. 324.
   7 Heidelberger Klinische Annalen, Bd. ii.  S. 112.            8 Loc. citat., S. 535
   9 North American Archives of Medical and Surgical Science, April, 1835. 
52                   ACIDUM HYDROCYANICUM.
by Dr. Elliotson1 in the cure of vomiting not dependent upon inflamma-
tion.
  These are the chief cases in which its internal use has been prescribed.
It has  been employed  externally in the  following.  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.   Kri-
mer applied it in a dilute  state to painful wounds; and  it has  been
injected with advantage into fistulas.
  In neuralgia, the application of a cataplasm of belladonna  and hy-
drocyanic 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; in similar cases, Dr.
A. T. Thomson, besides the  use of a purgative of  calomel and  colo-
cynth, 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, combined with sarsaparilla, formed  the internal  treatment.2
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 hydro-
cyanic  acid and lettuce water in the proportions mentioned hereafter.
  The acid has likewise been used, in the form of glyster, in scirrhus
of the pylorus, in  the strength  of six drops of Vauquelin's  acid to
eight ounces of water;3 and in uterine pain from scirrhus,  injections of
the acid, combined with infusion of  belladonna,  have been employed
with advantage.
  In ophthalmia, especially of the scrofulous  kind,  with engorgement
of the  conjunctiva, it has been advised by Elwert,4—two drops of the
acid being mixed with a dram of water, and a little dropped frequently
into the  eye; and it has been given in the active inflammatory  stage of
blennorrhoea.5
  Its vapour has been advised  in amaurosis, and  in  opacity of the
cornea;6 but it does not seem to be entitled to much credit in those af-
fections.  In the latter, it  has been proposed by M. De La Flor, along
with acupuncturation,—the needles being dipped in  it.7
  Lastly, when a portion of taenia has protruded from the rectum, it
has been advised by Cagnola, Golnecke, and others, that hydrocyanic
acid should be applied to it with the view of destroying it.8

  iLond. Med. Gazette, 1831, and  Amer. Journ. of Med. Sciences, May, 1831, p 242.
  2 London Medical and Physical Journal, Feb. 1822; and the author's edit, of Magen-
die s Formulary, p. 112.  Lond.  1824.   Philad 1825

  I HoTd^B^%S 228ga2ln' Bd" XiiL' S' 273>    ' * RU8t'S Magazin'  B- liiL S' 182-
  6 Paterson in Lond. Med. Gaz. May 15, 1844 p 808
616Hepnilad IsS' ^ °f Mackenzie's p™ctical Treatise on Diseases of the Eye, p.
  8 °f «'•!?■ f - ^nd ?5S0?1and Jullus- M*gaz. «• ausliindischen Literatur der ge-
RdSitTVi'' ", pA1£?'  H^feland und °8™n'8 Joumal der Prakt-  Heilkund.
Bd. lviii., St. 6, S. 122, and Richter, Op. cit.  S. 313. 
ACIDUM HYDR0CYANICUM.
53
  Such are the principal affections in which  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.1
He has certainly had no evidence, that it can cure  consumption when
not beyond its first stage, as remarked  by Magendie.2   If the practi-
tioner 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 approach
to one in  the catalogue  of the materia medica;  and therefore  its em-
ployment is  clearly indicated in all diseases in which 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 that 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 specific 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,3 that when
left to itself in a close vessel,  it sometimes becomes decomposed in less
than  an  hour, and that it rarely preserves its integrity for more than
a fortnight.
        c_
   The substances that are incompatible  with it in the same prescription,
are most metallic oxides, particularly tljose 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 mixture
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.
                     Aqu« destillataa Oj.
                     Sacchari albi oiss»  ^-

  1 Becquerel, Gazette M.dicale de Paris, 13th Jan., 1840.
  2 The author's edit, of his Formulary, p. 108.            3 Op. citat., p. 104. 
54                    ACIDUM HYDROCYANICUM.

  A dessert-spoonful of this is directed to be taken every morning  and
evening at bed time—the dose being gradually increased to six or eight
spoonfuls in the 21 hours.                               Magendie.

           R.  Acidi hydrocyanici (Scheele's) ^ xij.
               Vin. antimon. f 3j.
               Tinct. opii camphorata. f giiss.
               Aquas caniphorae f ^vijss.  Fiat mistura.

  Dose.—In  hooping cough,  a table-spoonful 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  pudding and
broth.                                                        Roe.
         R.  Acidi hydrocyanici  (Scheele's,) *!£ xx.
              Vin. antimon.
              ----ipecacuanha?  aa f giss.
              Aquae fjxiij.  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 gj.  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 Jss.
               Alcohol, f §j.
               Aqua, destillat. f gxss.

  This was the  lotion employed by  Professor  Thomson in cases of
impetigo.
  The following  was used by  Schneider in herpes.

           R.  Acidi hydrocyanici f 3iss.
               Alcohol, f^vi. M.

  And in the same  cases Magendie employed the subjoined formula.

           R.  Acidi hydrocyanici fgij.
               Aquae lactuca. Oij.  M.

  The distilled water of  the garden lettuce probably contains nothing
to recommend it over common distilled water.
  Dr. Joy1 advises the following lotion in acne and impetigo to correct
itching;  and in ulcerated cancer to diminish pain.

           R.  Acid, hydrocyan. dil. f Ji—£iv.
               Decoct, malva. Oj.  M.

  The bottle  should be shaken before each application.
  All these formulas are  objectionable for the reasons before assigned;
and it is consequently better  to drop  the acid at the time of usino- it,
taking care that  it has  not  lost its properties.

          1 Tweedie's Libr. of Med., v.  288, Lond. 1840, or Amer. edit. 
ACIDUM LACTIS.
55
                       V. ACIDUM LACTIS.
Synoxymi:s.  Acidum Lacteum seu Lactis seu Lacticum, Lactic Acid, Acid of
  Milk.
French. Acide Lactique.
German. Milchsaure.

   This acid has been recommended as a therapeutical agent by Magen-
die.1
                      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 sub-
stances that have not yet been examined.   The alcoholic extract is then
dissolved in water, which occasions a fresh precipitation.   The liquid is
now saturated with carbonate of zinc,  and  by this means a fresh pre-
cipitation is effected, more copious  than the preceding.   By concentra-
tion, 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 perfectly  white crystals: these are washed in boiling
alcohol, in which they are  insoluble; afterwards they are treated with
baryta, and then with sulphuric acid, which  separates the  lactic acid.
This is finally concentrated in vacuo.2
  Mitscherlich3  gives  the  following process for  preparing it pure.
Lactate  of  lead, formed in the usual way, is decomposed by sulphate
of zinc; the sulphate of lead is separated, and the lactate of zinc crys-
tallized by evaporation: this is at first yellow, but by repeated  crystal-
lizations it is obtained of a pure white.   This solution of the lactate is
decomposed by pure baryta; the oxide of zinc is separated, and  the lac-
tate of baryta, which is in solution, is decomposed by sulphuric acid,
and the fluid evaporated; this yields a clear, colourless,  syrupy, not vo-
latile acid, which is decomposed, and leaves a residue of charcoal when
heated at a  sufficiently  high temperature.
  Milk,  which has been suffered to ferment for a long while, and is
  1 Formulaire pour la preparation et l'emploi de plusieurs nouveaux me'dicamens, &c.
Edit. 9eme. Paris, 1836.
  2 Gay-Lussac and Pelouze, Annales de Chimie et de Physique, Avril,  1833. (Tom.
lii. 410.)
  3 Report to British Association, 2d meeting, and Phila. Journal of Pharmacy, vi. 83.
Philadelphia, 1834-5. 
56                        ACIDUM LACTIS.
treated in the same way,  affords lactic acid.  Corriol has likewise de-
tected it in an aqueous infusion of the nux vomica.
   When.concentrated in  vacuo  until it parts with no more water, lac-
tic acid is a colourless liquor of syrupy consistence; its specific gravity
being about  1.215.   It is inodorous, but of a very sour taste, similar
to that of the strongest vegetable acids.   When exposed to the air, it
attracts moisture.  Water and  alcohol  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 afford-
ed him very encouraging  results.   Recently, on similar chemical—but
questionable—considerations, it has been recommended by Dr. Hand-
field Jones,1 who considers it  to be adapted for all cases in which it is
desirable to augment  the tone and energy of the stomach;—-for such
cases as the muriatic  acid is usually presented in.
   In consequence of  the facility with which lactic  acid dissolves phos-
phate of lime, it has been suggested, whether it might not be adminis-
tered with advantage in  cases of white gravel, or, in other words, of
phosphatic  depositions from the  urine.   Magendie  had  not  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 without any results worthy of being communi-
cated to the profession.  He recommends these salts, however,  to the
attention of physicians.
                     MODE OF ADMINISTRATION.
   Magendie gives lactic acid  either in the form of lemonade or of lo-
zenges.
                       Potus  acidi lactis.
                      Lemonade of Lactic acid.
                 R.   Acid. lact. liquid, f 3j. ad giv.
                     Aquae Oij.
                     Syrupifgij. M.

                      Pastilli acidi  lactis.
                      Lozenges of lactic  acid.
                 R.   Acid. lact. pur. 5jij.
                     Sacch. pulv. §j.
                     Gum. tragac. c\. s.
                     01. aether, vanigl. gtt. iv.  M.
  Make into lozenges weighing  half  a dram each.  Let them be kept
in a well closed vessel.   Of  these, from two to six  may be  taken in
the 24 hours without  any evil consequences.

  1 Assoc. Med. Journ., July 14, 1854,  and Ranking's Abstract, American edition, xxi.
76, Philada. 1855. 
ACIDUM TANNICUM.
57
                   VI. ACIDUM  TANNICUM.
 Synonymes. Acidum Quercitannicum, Tanninum Purum, Tannicum, Principium Ad-
  stringens seu Scytodephicum, Materia Scytodephica, 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,1 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 al-
 lowed to digest  for an hour, frequently agitating  it.   It 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.   Tannic 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.
   After the fluid  is poured off, the residue is washed twice  with cold
 water acidulated with sulphuric acid: carbonate of baryta, or carbonate
 of potassa, is then added  to it in small portions, carefully shaking the
 mixture, until there is no farther effervescence, and until a  portion of
 the mass dissolved in water and  tested  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 tannic  acid, and separate it  from the sulphate of baryta
 or sulphate of lime; the alcoholic solution is then poured off  clear, and
 by a gentle heat evaporated to  dryness.
   The following form for its preparation is given  in the last  edition of
 the Pharmacopoeia of the  United States (1851.)  Take  of Galls, in
 powder; Sulphuric ether, each a  sufficient  quantity.   Put into a glass
 adapter, loosely closed at its lower end with  carded 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 capsule, and  evaporate with  a mode-
rate  heat to dryness.   Lastly, rub what remains into powder.   The

  1 Repertorium, B. xxxiv.  H. 3;  also, A. W. Buchner, Neueste Entdeckung.i liber die
Gerbsiiure, 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. Journal
of Pharm. July, 1841,  p. 171. 
58
ACIDUM TANNICUM.
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 alcohol
and in ether.  It reddens litmus paper.1

                      EFFECTS ON THE ECONOMY.
   Tannic acid is a strong astringent,2 which has hitherto been mainly
used in uterine hemorrhage, and especially by the Italian  physicians.
Porta3 was, perhaps, the first who tried it.  He found it very efficacious
in cases  not  dependent upon any organic  mischief in the  uterus.  It
exhibits  its powers,  according  to him, even in small doses—as of two
grains, and is  well  borne by the stomach.  Ferrario4 likewise  admi-
nistered  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 mere atony is present.  He gives it  in the form
of powder or pill, in two grain doses, six  times a day.   The  effect is
generally good:  the hemorrhage diminishes and  soon ceases, and, at
the same time, the strength augments, and recovery succeeds without
any disturbance of the functions.  Giadorow5 details two cases of dia-
betes 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. Dumars6 extols it in the same dis-
ease, administered by the mouth as well  as by the rectum.
   According  to  Ricci,7 tannic acid  has frequently been employed in
Italy, both  in  internal  and external hemorrhages.   G. A. Richter,8
however, affirms, that he has given it in habitual metrorrhagia without
any advantage whatever.   Within the last few years, M. Cavarra9 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 che-
mico-vital action which it does on an inert organic tissue,  or, in other
words, it tans them  as it  tans  leather.   "These parts," he says, "are
the  mucous membranes of the  urethra,  vagina, intestines,  and  lungs.
The action of tannic acid appears to be, to cause such a condensation
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 numerous
experiments and demonstrations.  When tannic acid is taken internally,

  1 Pharm. of the United States, p. 68.  Philad. 1851.
  2 See, on the action of this agent, Mitscherlich, Medicinische Zeitung, No. 43, 1838,
and Bullet. General de Therap. 30 Mars, 1837.
  3 Delpech, Memorial des Hopitaux du  Midi, &c, Fevrier, 1829, p. 51.
  i Annali universali di Medicina, Gennajo, 1829.
  5 Annali universali di Medicina, and Gazette Medical, Sep. 15, 1832.
  6 Cited in the Provincial Medical and Surgical Journal, Nov. 18, 1842.
  7 Bulletin des Sciences Medicales, Sept. 1828.
  8 Arzneimittellehre, Supplement, s.  60; also, Cavalier, in Archiv. Gene"rales, xix. 589.
  9 Bulletin de l'Academie Royale de Medecine, Janvier, 1837; and American  Medical
Intelligencer, Oct. 16, 1837, p. 258.                                    " 
ACIDUM TANNICUM.
59
 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 circulatory system, and, consequently, the tannic
 acid—it is  fair to  presume—must be  absorbed to cure leucorrhcea,
 gonorrhoea,  and  the most  obstinate  chronic catarrhs.   M. Cavarra
 concludes, that of all the effects of tannic acid, two of  the most sur-
 prising  are, the cures operated by it in cases of obstinate nervous coughs,
 and the 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 astringent—can be of much service in the latter mala-
 dy.   Mixed with powdered  sugar, in  the proportion of from two to
 ten  parts of the acid to ten parts of sugar, it  has been blown, with
 advantage, by M. P. de  Mignot,1 into the fauces  to facilitate the ex-
 pulsion of false membranes.
   Dr. S. S. Allison,2 who  had for six years constantly prescribed tannic
 acid internally with much success in various diseases, speaks highly of
 it in chronic bronchial catarrh, chronic  diarrhoea, leucorrhcea, menor-
 rhagia, the  hemorrhagic  diathesis, and albuminuria.  As a local ap-
 plication,  he extols  it in sponginess and hemorrhage of the gums, re-
 laxation of the throat, prolapsus ani, hemorrhoidal tumours, gonorrhoea;
 and as an external application  to the  skin where astringents are indi-
 cated.  He  has found it likewise of  service in dyspepsia; and  as  a
 nervine in several  cases  of nervous debility, languor and excitability.
 In these last cases, he generally combines  it with camphor,  hops, or
 hyoscyamus.
   Dr. Cummings,3 from several years' experience, has found tannic acid
 the most valuable of astringents.  Whenever such agents were needed
 in dysentery, it acted admirably, either alone or combined with opium.
 He says he  could refer to more than  a thousand  cases  of dysentery,
 diarrhoea, cholera  infantum, &c, in which he has prescribed  it, never
 with regret, and almost always  with advantage; and similar testimony
 has been given him by other practitioners.  In the last stage of phthisis—
 the colliquative, and of typhus, he has found it valuable.  In almost
 all cases,  too, of hemorrhage, and, most remarkably,  in haemoptysis,
 it has proved useful; and, when combined with opium and ipecacuanha,
 it is preferable to acetate of lead, and other similar  substances.  In
 hemorrhage from the bowels, resulting from dysentery, it has  great
 power, as  well as in  that of threatened abortion.  In the form of wash,
 it is of  great use in hemorrhoids.  In epistaxis, when snuffed up the
 nose, or blown  through a quill,  it almost always arrests the bleeding.
 In severe  salivation, he affirms,  no astringent is comparable to it, and
 the same may be said of its action in aphthae and other diseases of the
mouth, in  which the gums are spongy  or bleeding.   Used as a gargle,

  1 Bouchardat, Annuaire de Therapeutique, pour 1848, p. 138.
  2 London Journal of Medicine, Jan. 1850, Ranking's Half yearly Abstract, &c, Amer.
edit., xi. 77.  Phila. 1850; and Amer. Jour, of the Med. Sciences, Oct. 1850,  p. 507.
  3 Boston Med. and Surg. Journ. xliii. 40. 
60
ACIDUM TANNICUM.
in relaxation of the uvula and tonsils, its efficacy is marked.  To old
ulcers he has applied it as a disinfectant, in the form of powder, espe-
cially when there was a disposition to hemorrhage.  As a collyrium, he
prefers it to all other substances in the purulent ophthalmia of infants.
He gives it internally in two grain doses.
   M. Subregondi1 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,  and Durr2 speaks highly of a combination of it
with benzoin in the latter stages  of the same malady.   He prepares
powders, each containing  from two to five centigrammes,—gr. ^ to f
—with 50  centigrammes—gr. 8 of sugar; one to be given every two
hours.
   M. Amedee Latour3  has highly extolled it for its efficacy in hemop-
tysis.  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. Charvet4 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 serviceable
in most cases of Egyptian ophthalmia; and  M. Hairons5 used it with
success in  a concentrated solution—one part, for example, to three of
water—in  acute and chronic blennorrhoea of the eye, tumefaction of the
conjunctiva, granular conjunctiva, vascular and ulcerated keratitis, and
pannus.    It has likewise  been advised in hemorrhoids and fissures of
the anus.6
   In the  hyperemesis  induced by ipecacuanha or emetia, it  may be
administered as an antidote;  and in epidemic cholera it was employed
in Berlin,  by the younger  Grafe, in upwards of thirty cases,  several of
which were in the collapsed state, and  of which two only proved fatal.
The dose  was  from five to ten grains, half  hourly  or hourly.  Dr.
Willebrand, of Finland, in reporting this treatment to the Medical So-
ciety of Sweden, stated that he was a witness of this brilliant success.7
   Mr. Druitt8 thinks, that in any case  in which a vegetable astringent
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 de-
compose quickly.   In sore nipples, he found it to be invaluable.  He
employs  it in solution—five  grains to the fluidounce of distilled water

  1 Cited  in Northern Journal  of Medicine, Dec.  1844, and Braithwaite's Retrospect,
Amer. edit. viii. 54.  New York, 1845.
  2 Cited in  Provincial Med. and Surg. Journal, April 3, 1850.
  3 Journal  de M.decine et de Chirurg. Pratiq. Nov.  1839, and Bouchardat, Annuaire
&c, pour  1849, p. 203.
  4 Bulletin  General de Th<_rapeutique, Mai, 1840.
   5 Wahu, Annuaire de Mcdecine, &c, pour 1851, p. 56.
  6 Diday, in Bouchardat, Annuaire de Therapeutique, pour 1847, p. 170. Paris, 1847.
   7 Edinb. Monthly Journ. of Med. Science, July, 1851, p. 62.
   8 Provincial Med. Journ. Oct. 9, 1844. 
ACIDUM TANNICUM.
61
—on lint covered with oiled silk.  He has also found it of great service
in toothach.   The gum around the tooth is first scarified with a fine
lancet, and then a little cotton wool, imbued with a solution of a scruple
of tannic acid, and five grains of mastich in two  fluidrams 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."
  M. Homolle1 has recommended it as an ectrotic in variola.   A mix-
ture, formed of one part  of tannic acid, with 20 parts of tincture  of
benzoin, is used  for this purpose; the eruption on its first appearance
being  touched, four times  a day, with a camel's hair pencil dipped in
it.  Friedrich2 employed it with success in ulcers, caused by mechanical
violence, after erysipelatous inflammation had disappeared, in the pro-
portion of a scruple to an ounce of lard.   He found it of advantage,
also, in varicose ulcers of the feet, and  in several cutaneous affections
of an eczematous and impetiginous character.
  In  a case of open, almost  incurable,  cancerous ulceration, in which
it was applied by Dr.  Michaelsen,3 to arrest the bleeding, it excited a
wonderful  effect on the ulcer  and the  carcinoma itself.
  According  to the experiments of Magendie,4 tannic acid  is one  of
the substances that oppose the coagulation of the blood.

                     MODE OF  ADMINISTRATION.
  It may be given in the form of pill, or draught, or as a lavement.
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.5
            Vinum aromaticum cum acido  tannico.
                    Aromatic  wine with tannic acid.
                        R. Vini aromat. f ^viij.
                           Acid, tannic. 9ij. M.
                        R. Vini aromat. f ^viij.
                           Acid, tannic. 3 ij .
                           Ext. opii purif. 3ss.  M.
  Used as local dressings  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. 9_v.
                          Infunde per minut. x. in
                          Aquae bullientis Oj.
  To be injected slowly into  the rectum in  cases  of uterine  hemor-
rhage.                                                   Dumars.  ■
  1 Bouchardat, Annuaire de Therap. pour 1854, p. 21^.
  2 Canstatt's J ahresbericht, 1851, v. 79.
  3 Med. Chir. Zeitung, xviii. 24, cited in Schmidt's Jahrbucher, v. s. w. No. 6, S. 287.
Jahrgang 1849.
  * Lond. Lancet, Jan. 26, 1829, p. 636.
  5 Cavarra, in Bulletin G£n£ral de Therapeutique, 30 Mars, 1837. 
 02                       acidum tannicum.

                          R. Vin. rubr. f 3 vj.
                             Acid, tannic, gr. xviij.  M.
   Used in chronic blennorrhoea or what is called an old gleet.1
                                                           Ricord.
   In the case of the female, the quantity of tannic acid may be doubled
 or still farther increased.
                       Pilulee acidi  tannici-
                          Pills of tannic acid.
                  R.  Acid, tannic, pulv. gr. vj.
                     Acac. pulv. gr. xij.
                     Sacchar. pulv. gr. lxxij.
                  Syrup, q. s. ut fiat massa in pilulas pond. gr. iv. sing, dividend.
   Dose.—One  to four, morning  and evening, where an astringent is
 needed.                                                  Cavarra.
                Pilulae acidi tannici  compositae.
       Compound pills of tannic acid.—(Pilules de tannin composees.)
                  R. Acidi tannic, gr. xvss., (1 gramme.)
                    Morphia, acetat.
                    Antimon. et potassae tartrat. aa. gr. iss.
                    Confect. q. s. ut fiant pilulae xx.
   Dose.—One or two in the day in hemorrhage, diarrhoea,  &c.
                                                         Jourdain.
                Pilulae acidi tannici cum opio.
     PiUs of tannic acid with opium.—(Pilules narcotiques astringentes.)
                  R. Acid, tannic, gss.
                    Extract, opii gr. f.
                    Confect. rosae q. s. M. et divide in pilulas xx.
   One every hour in uterine hemorrhage.                  Dumars.

                Pulveres  acidi  tannici et opii.
                  Powders of tannic acid and opium.
                 R. Acid, tannic, ^ij.
                    Opii pulv. gr. ss.   Misce et divide in pulveres tres.
   Dose.—One,  morning,  noon, and night;  gradually  increasing the
quantity of tannic acid to four  scruples daily.             Giadorow.

                     Syrupus acidi  tannici.
                        Syrup of tannic acid.
                 R. Acid, tannic, p. v.
                    Syrup, p. 500.—Mix and filter.
                                                     Bouchardat.2
                   Unguentum acidi  tannici.
                        Ointment of tannic acid.
                 R. Acidi tannici, gr.  xvss.
                    Adipis 3"ss.  M.
   This  is  the  Pommade contre les  gercures  de Vanus,  of M. Diday
applied, in fissure of the anus,  on the extremity of the little finger.
                                                           Diday.
  1 La Lancette Francajse, No. 33 Paris, 1838, and Parker, Modern Treatment of Sy-
philitic Diseases, American Med. Library edit., p. 44.  Philada 1840
  2 Annuaire de Therapeutique, pour  1848, p. 138, Paris, 1848.' 
ACONITIA.
63
                     Pessarium  acidi tannici.

                        Pessary of tannic acid.
                          R.  Acidi tannici ^ij.
                              Cerae albae 9 v.
                              Adipis 3yj.  M.

  To be made into a pessary of the size of a walnut, and introduced into
the vagina, where/astringents are needed.                 Simpson}

           Dentifricium acidi tannici compositum.
                   Compound dentifrice of tannic acid.
                  R.  Acid, tannic. §ss.
                     Sacchar. lact. lb. iiss.
                     Carmin. ^iiss.
                     Essent. Month.
                     ------■ Anis. aa gtt. xx.
     *                ------Flor. aurant. gtt. x.  M.
   To prevent accumulation of tartar, and  give tone to the gums.
                                                            Mialhe.2
                     Pomatum  acidi tannici.
            Pomatum of tannic acid.—(Liparole de tannin.")
                  R.  Adipis suill. %x\).
                     Acid, tannic. gij.
                     Aquae pur. f 3ij.

   Dissolve the tannic acid in the water, by triturating, in a glass mor-
tar ; add the fat and mix.3                                    Beral.

                        Lotio acidi tannici.
       Lotion of tannic acid.—(Hydrolotif de tannin pour Vureflire.)
                        R.  Aquae destillat. f^viij.
                            Acid, tannic, gr. xxxij.   Solve.
   Employed in obstinate blennorrhcea.                        Bfral.
                          VII. ACONI'TIA.

Kyxoxymes.  Aconitina, Aconita, Aconitium, Aconitinum, Aconitine.
German.  Akonitin, Aconitin.

  This active principle, which was  discovered by Peschier,4 and  by
Brandes, has been recommended by Dr. Turnbull,5 whose eulogies on the
medical virtues of the natural order Ranunculaceae are evidently, how-
ever, overstrained, and whose subsequent professional course has been
so devious, that it is difficult to arrive  at any precise results from  his
published observations.

  1 Edinb. Monthly Journ. of Med. Science, Nov.  1848, p. 886; and  Obstetric Memoirs
and Contributions of James Y. Simpson, M. D., &c, p. 98.  Edinb. 1855.
  2 L'Abeille Medicale. Mai, 1848, p. 116.
  3 Bulletin General de Th.rapeutique, Janvier, 1838.
  * TrommsdorfTs Journal de Pharmacie, v. 84.
  5 On the medical properties of the natural order Ranunculaceae, and more particularly
on the uses of sabadilla seeds, delphinium staphysagria and aconitum napellus, and their
alcaluids, veratria, sabadilline, delphinia and aconitine.  Chap. iii. Lond. 1835. 
64                           ACONITIA.
                       METHOD OF PREPARING.
  Aconitia was received into the London Pharmacopoeia of 1836; but
it is not in the last: whilst it has been adopted into the last edition of
the Pharmacopoeia of  the  United States, with the same form for its
preparation.1  Take of Aconite bruised, fgij., Alcohol, three gallons; Di-
luted sulphuric acid, Solution of ammonia, Purified  animal  charcoal,
each a sufficient quantity.   Boil the aconite root with a gallon of the
alcohol, in a distillatory apparatus for an  hour.   Pour off the  liquor
and boil the root in the same manner, and for the same length of time,
with  another gallon of the alcohol and the portion distilled.  Again,
pour off the  liquor; boil  as before, with the remaining gallon of the
alcohol  and  the  portion distilled, and decant.   Submit the residue to
expression; mix all the liquors; distil off the alcohol, and evaporate by
means of  a water-bath to  the consistence  of an  extract.   Treat  this
with distilled water; filter  the resulting solution,  and evaporate with a
gentle heat to the consistence of syrup.  To the residue add as much
diluted  sulphuric  acid, mixed with distilled water, as may be sufficient
to dissolve the aconitia.   Precipitate this with  solution of ammonia,
and dissolve  the precipitate  in diluted sulphuric acid, mixed with dis-
tilled water as before.  Mix the animal  charcoal with the  solution;
shake the mixture frequently for fifteen minutes; filter; again precipi-
tate the aconitia with  solution of ammonia;  and, lastly, wash it with
water, and dry it.
  This process, according to Messrs. Ballard and Garrod,2 mostly fails
in procuring  the alkaloid;  and it is said to be defective mainly on ac-
count of the employment of so large an amount of water, the repeated
solutions,  and the use of  animal charcoal, which has the property of
absorbing the alkaloids.  A better form for its preparation is given by
Mr. F. W. Headland.3
  M. Planta purifies the aconitia of commerce in the following man-
ner.  Having dissolved it in ether, he evaporates the solution.  The
syrupy residuum  is dissolved in absolute  alcohol, and  the solution is
poured, by little and little, into cold water, agitating continually.  A
dense, flocculent  precipitate is  thus obtained, which is expressed be-
tween paper, and  dried in  vacuo.4
  Aconitia occurs in the form of an amorphous powder, having  an in-
tensely acrid and  bitter taste.  It is not volatile, and should  leave  no
ash when  heated  to  destruction.   When well prepared, according to
Geiger, it is a firm, colourless, and translucent mass; of a shining ap-
pearance, 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, re-
quiring one  hundred  and  fifty parts  thereof, but only fifty parts of
boiling water.  It is  soluble in  alcohol  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
  1 Pharmacopoeia of the United  States, p. 70.   Philad. 1851.
  2 Elements of _-_at. Med. and Therap. p. 164.  Lond. 1845.
  3 United States Dispensatory, 10th edit. p. 823.  Philad. 1854.
  * Bouchardat, Annuaire de Th.rapeutique, pour 1851, p. 16. 
ACONITIA.
65
that are not cry3tallizable, which readily dissolve both in water and al-
cohol.
                     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
Dr. Turnbull was dissolved in a dram of  alcohol; twenty drops of the
solution  put into the mouth of  a guinea-pig  occasioned  death in a
few minutes.   Other experiments  have been performed, all of which
demonstrate the extreme activity of the substance.   If  a grain or two
of aconitia or veratria or delphinia be mixed with a little lard, or dis-
solved 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 differ-
ence, 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 experienced; to
this succeeds a feeling of numbness and constriction in  the  part, as if
a heavy weight were laid upon it, or as if the skin were drawn together
by the powerful and involuntary contraction of the muscles beneath.
This effect lasts from two or three to twelve or more hours, according
to the quantity 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, occa-
sions contraction of the  pupil according to Dr. Pereira, whilst Geiger
and Hesse affirm, that the aconitia which they obtained  produced dila-
tation of the pupil.  Dr. Pereira states, that the aconitia prepared by
Mr. Morson of London is so powerful,  that one-fiftieth of a grain has
endangered  the life of an individual.   It  is, he considers, the most vi-
rulent poison known, not excepting hydrocyanic acid.1
  Whilst employing aconite itself in his clinical practice,  Dr. Lombard,2
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 considerable time after the
animal has  been  mutilated.  The medicine was introduced into the
stomach or applied locally to the  heart, which was laid  bare after the
animal had been stupified by blows on the head.  He found, that aco-
nite employed internally rendered the pulsations less frequent, but not
irregular,  and consequently that it exerted a decidedly  sedative effect
on the heart; whence he infers, that it is a proper remedy in active
diseases of 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 sus-
pended.3   The homoeopathists regard it as an energetic  antiphlogistic.
  Dr. Eades4  concludes from his own  observations, that the most re-

 1 Elements of Mat. Med., &c, 2d edit. ii. 1811. Lond. 1812.
 2 Gazette Medicale de Paris, Oct. 10, 1835.     3 Orfila Toxicologie, ii. 221.
 1 Dublin Journal of Med. Science, March, 1845, p. 55.
       » 
66
ACONITIA.
  markable symptoms exhibited  by animals from  the use of aconite or
  its alkaloid are,—weakness; staggering; gradually increasing insensi-
  bility of the surface; slowly increasing weakness of the voluntary mus-
  cles, ending, perhaps, in paralysis; great languor of the  pulse; more or
  less blindness, and  convulsive twitchings before death.
    The ablest investigation then undertaken into the actions of aconite,
  according to Dr. Christison,1 is contained in the inaugural dissertation
  of Dr. Fleming2 since  published, and with a copy of which the author
  was  favoured  by Dr. Fleming.   He  found  that the most  remarkable
  symptoms are weakness and staggering, gradually increasing paraly-
  sis of the voluntary muscles, slowly increasing insensibility of the sur-
  face, and more or less  blindness.   He farther observed, that  the pupil
  becomes much contracted; the  irritability of the voluntary muscles is
  impaired; the veins are congested  after death, the blood is unaltered,
  and the heart capable of contracting for some time after respiration has
  ceased.   From its  action on the cerebro-spinal and muscular systems,
  he deduces the following practical inferences.  First,  it is  sedative,
  anodyne and antispasmodic.  Secondly, it is an advisable antiphlogistic
  in apoplexy, phrenitis, or any disease in which the circulation of the
  brain is excited.  Thirdly, it is contra-indicated in head-ach arising
  from anaemia or chlorosis, and wherever there is a  torpid or  paralytic
  condition of the muscular  system, and Fourthly, Its properties suggest
  its employment in convulsive or spasmodic diseases.
    From its action on the  circulation he infers, First, that it is a pow-
  erful antiphlogistic.  Secondly, it is  calculated  to be of great value
  in all  cases  where  there is inordinate activity  of  the circulation.
  Thirdly,, it is contra-indicated when there is obvious mechanical im-
  pediment to the passage of the blood, particularly through the  heart •
  or lungs:  it is requisite, therefore, in every case  before commencing
  its use,  to ascertain that no such obstruction exists;  and fourthly,
  it is contra-indicated whenever there is irritability of the circulation^
  with great diminution  of power, such as occurs after severe hemor-
  rhage.
    Its results on the respiratory system led him to the inference, First,
  that it  will probably be found a highly advantageous  antiphlogistic in
  pneumonia, pleuritis, &c.  Secondly, it seems calculated to be service-
  able in spasmodic asthma.   Thirdly, it is contra-indicated in  difficulty
  of breathing, arising from  any other cause than inflammation or spasm;
  and fourthly, in cases of advanced bronchitis, with excess of secretion,
  it would prove highly injurious  by diminishing still farther the power
  of expectoration.
    Dr. Fleming has  not met with  any convincing evidence that  it is a
  cumulative remedy;  although in two  cases  he  was induced to suspect
  it.  lhe individuals were  affected with general  tremors, severe pain in
  the head and  eye-balls, constant lachrymation, intense  photophobia,
  heat of skm, quick  pulse,  and great  restlessness.   In many  other in-

   1 Treatise on Poisons, Amer. edit. p. 665.  Philad 1845
&  c. ALoX_8__nt° thC ?hySi0l°gy ^ MedidUal Pro^erties of the Aconitum Napellus, 
ACONITIA.
67
stances, however, where  the  administration of the remedy was conti-
nued for weeks, and even months, no such effects were observed.
  More recently, aconitia has been given to the lower animals by Van
Praag,1 with the view of elucidating  its physiological action; whence
he concludes that it retards respiration; has a paralyzing influence on
the voluntary muscles, and a depressing one  on the  brain;  and that
it varies greatly in the frequency with which it diminishes the number
of the  pulsations of the heart.   It causes dilatation of the pupil.   He
regards salivation and increased secretion of the urine as among the less
constant phenomena of its operation.   The animals  died at  length of
exhaustion; if suddenly, by asphyxia.   Schroff2 concluded from his ex-
periments on healthy man and on rabbits, that in adequate  doses aconitia
increases the secretion of urine, and that the action of the  heart is either
immediately depressed, or after a brief period of increased action. When
large doses are administered, he regards these results as  invariable.
   The diseases in which Dr. Turnbull chiefly employed aconitia exter-
nally,  were of the neuralgic  kind;  but he used it as well in gouty and
rheumatic cases;  and its  success, he remarks, fully answered his an-
ticipations.  He employs  it either in the form of  solution in alcohol,
 in  the proportion of one or more grains to the dram,—or of ointment,
 made  according to the following formula.
               R.  Aconitiae 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 extreme severity,
 as much as eight grains was  prescribed in the ointment with the most
 marked benefit.   The best mode of applying it is simply to rub a  small
 portion of it over the whole seat of the affection, until the pain is either
 for the  time removed, or  until the full effect, described above, is in-
  duced 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 aconitia—as well as in that of
 veratria and delphinia—that unless the  friction occasioned a full de-
 velopment of the peculiar impressions  caused by it when rubbed on the
 skin,  no benefit whatever was to be looked for  from its employment;
 and he observes, that if there be the slightest abrasion of the skin, an
  application of such  activity should not be  resorted to; and that  it
  should be carefully kept from coming in contact with any of the mu-
  cous  membranes.
    Aconite and its alkaloid have been used  internally and  externally
  in neuralgia, with marked advantage,  by  Jahn, Tealier,  Hufeland,
  Wildbero-, Fleming3  and others; but Drs.  Copland, A. T.  Thomson

   1 Association Medical Journal, Aug. 17, 1855, from Virchow's Archiv., cited in Amer.
 Journ. of the Med. Sciences, Oct.  1855, p. 489.
   - Priiger Viertel-jahrsch. fur die praktische Heilkunde. Bd. xi., cited in Op. cit.
   5 Op. cit.  p. 56. 
68
ACONITIA.
and  others have prescribed  it in several cases without success.  By
many, the external application of the remedy is considered to be more
likely to be beneficial; whilst others  give  a preference to its internal
use.   Mr. F. C. Skey1 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  mi-
nute or longer, once or twice a day, according to the degree of pam.
  The observations of Turnbull and Skey have been confirmed by Drs.
Roots, Sigmond, Fleming and others.2  In neuralgia of the heart,  Dr.
Copland3 found it highly serviceable.
  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,4 would necessarily limit its  use, had it proved to be
more advantageous than it has.   It would appear, that all its powera
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 care-
fully, and  at a low temperature, the tincture of the dried root of the
plant, prepared as directed in the process for obtaining aconitia, to the
consistence of an extract.   To every dram of this,  eight  or ten drops
of liquor ammoniae should be added, and after the mixture has stood a
short time  in a very gentle heat, to drive off the excess of ammonia, it
may be used in the form of an ointment, according to the following
prescription:
           Unguentum extracti aconiti ammoniati.
               Ointment  of ammoniated extract of aconite.
                   R. Ext. aconit. ammon. gj.
                      Adipis 3_ij.  Misce ut fiat unguentum.
   When this ointment is rubbed upon the skin, it occasions sensations
in the part similar  to those  produced by the aconitia  ointment: 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 ammonia.
The external use of this tincture  of aconite has been recommended in
neuralgia and  chronic rheumatism by Dr. Pereira,5 and Mr. Jos. Cur-
tis ;6 and in hemicrania  by Dr. Fleming.7
   The alcoholic extract of aconite—Extractum aconiti alcoholicum
—which is officinal in the last edition  of the Pharmacopoeia  of the
United States, 1812—has likewise been advised by Drs. Lombard of
Geneva,8 Busse, J. B. Watkins,9 and  others, in articular rheumatism.
  1 London Med. Gaz. Nov. 5,1836.
  2 Dr. Cowan, Provincial Med. and Surg. Journ. May, 1843, and Braithwaite's Retro-
spect, Amer.  edit.  viii. 26. New York, 1844.
  3 Dictionary of Practical Medicine, vi. 893.
  * Pereira, Elements of Mat.  Med. and Therap. 3d Amer. edit. ii. 1092.  Phila. 1854.
  5 Elements of Materia Medica, 2d edit. ii. 1808.  Lond. 1842.
  6 Lond. Lancet,  June 26, 1841.                          t Op. cit. p. 60.
  8 Gazette Medicale, 28 Juin, 1834.  Also, Sigmond, in Lancet for August 5, 1837.
  9 Philad. Med. Examiner, No. 33. 
ACUPUNCTURA.
69
  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, how-
ever, the patient recovered—has been published by M. E. L. Pereyra,
of Bordeaux.1
  The applications of the different preparations of aconite to therapeu-
tics have been given elsewhere.2
                       VIII. ACUPUNCTURA.
Syxoxymes. 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 appears to have been entirely unknown to the
Grecian,  Roman, and Arabian physicians.3    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 agen-
cies.   By these  people it was  systematically taught on  appropriate
phantoms or manneJcins, called Tsoe-Bosi, and  the practice of the ope-
ration was permitted to those only who were able to pass  a rigid ex-
amination thereon.   In Europe, it was first known about 170 years ago,
from the writings of a Dutch surgeon, Ten-Rhyne, who wrote in 1683 ;4
and  attention was subsequently drawn to it  by Kampfer;5 but after
this  it was almost forgotten, until Berlioz, in 1816, drew  attention to its
employment.   His example was soon followed by Beclard,6  Breton-
neau,7 Haime,8 Demours,9 Sarlandiere,10 Pelletan, Segalas,  Dantu, Vel-
peau, Meyranx,11 Dance, in France; by Churchill, Scott, Elliotson,
and  others in England; by Friedrich,13 Bernstein,14 L. W.  Sachs, Hey
felder,  Michaelis,15  Grafe,16 and  others in  Germany;  by Carraro,17

  1 La Lancette Francaise, No. 37, 26 Mars, 1839.
  2 General Therapeutics and Materia Medica, i. 412.  5th edit.  Philad. 1853.
  3 Riecke, Die neuern Arzneimittel, it. s. w. S. 12, Stuttgart, 1837.
  * Mantissa Sckematica de Acupunctural ad dissert, de Arthritide. Lond. 1683.
  6 Amoenitat Exotic. Politico-Physico Medic, p. 583.   Lemgov. 1712;  and  History of
Japan, vol. ii., Appendix, sect. 4, p. 34.
  6 Mem. de la Soci.t6 Medic. d'Emulation, viii. 575.
  7 Journal Universel des Sciences Med. xiii. 35.  Paris, 1817.
  8 Journal Gener. de Medec. torn, xiii., and Journal Univers. des Sciences Me"dic. torn.
xiii. 1819.                                              9 Ibid. torn. xv.
  10 Mem. sur l'Electropuncture.  Paris, 1825.
  11 Archives G_n_rales de M6d. torn. vii.  Paris, 1825.
  12 Med. Chir. Trans, xiii. 467.  Lond. 1827;  and art.  Acupuncture, in Cyclop. Pract.
Med.  Amer. edit. Phila. 1845.      13 Translation of Churchill's work in German, p. 40.
  14 Hufeland's Journal, lxvii.  Berlin, 1828.
  15 Griife und Walther's Journal, B. v. St. 3, S. 552.
  16 E. Griife in art. Acupunctur, in Encyc. Wbrterb. der Medicinisch. Wissenschaft. B. i.
S. 312.  Berlin, 1828.               17 Annali Universali d'Omodei, 1S25. 
70
ACUPUNCTURA.
Bergamaschi,1  Bellini, and others, in Italy;  and  by Ewing,2 E. J.
Coxe,3 F.  Bache,4 and  others, in  this country.   M. Jules  Cloquet
had much to do in reviving its employment in his own country and else-
where, 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 appropriate apparatus;  and, at
one time, it is said, the patients in one hospital actually revolted against
the piqueurs midecins !5

                     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 slowly, in  order  that  they
may be less brittle.   At the blunt extremity 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  acupunctura-
tion,  and it is as effectual as any other.   By various  acupuncturists,
needle-holders or handles of ivory have been devised, to some of which
the needle is permanently attached.   Perhaps  the porte-aiguille or
' needle-holder' recommended  by Dr. F. Bache,6 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 desire, 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 platinum
have  been  used, but it does not appear that one metal is preferable to
another.
   To introduce the needles, the skin is stretched, and the  needle in-
serted by a movement of rotation  performed  in opposite  directions,
aided by gentle pressure.   As a general rule, the seat of pain will in-
dicate 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

  1 Ibid. 1826.       2 N. Amer. Med. and Surg. Journal, ii. 77. Philad. 1826.
  3 Ibid. ii. 276.  Phila. 1826.
  * Ibid. 1. 311. Phila. 1826; and art. Acupuncture, in Cyclop, of Pract. Med. i. 200.
Phila. 1833.                                  5 Riecke, Op. cit. S. 13.
  e Cyclop, p. 202.
J 
ACUPUNCTURA.
71
arteries of a certain size, should be avoided.  Prudence would likewise
suggest, that important 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 physicians, 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 they 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  impor-
tant organs.
  As respects the nerves, Cloquet has seldom or never seen the  punc-
ture of them give rise to so much pain as to  render  it necessary 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 evidence of severe suf-
fering or of  change of function.  Similar experiments were made by
E. Griife with the same  results.1   Nor was inconvenience found by
Delaunay, Beclard and Cloquet to be sustained on puncturing the arte-
ries and veins.   A few drops  of blood  perhaps  issued, but the flow
was readily stopped by pressure with the finger.   The slight ecchymo-
sis  which at times supervened,  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 fascia, and periosteum, Grafe found, that the inser-
tion of needles into them was always very painful,  and he  recommends
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 instituted
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 testicles without the supervention of any unplea-
sant result;  and Bellini2 affirms,  that  he has repeatedly passed them
into the stomach, liver and intestines without injury.
  The pain occasioned by acupuncturation is generally easily tolerated;

  1 Art. Acupunctur. in Encyc. Wo'rterb., r. s. w. S. 317.  Berlin, 1828.
  2 Cited in Brit. & Foreign Medico-Chirurg. Review, for July, 1848, p.  232. 
72
ACUPUNCTURA.
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 operation is, as a general
rule, most successful when it occasions  the least pain.   Cloquet asserts,
that a kind of electric shock is sometimes experienced in the surround-
ing 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 nee-
dles, a more or less regular aureola or  halo of a red colour, and without
tumefaction, is perceptible around  them,  which soon disappears after
they are withdrawn; but when they are suffered to remain  long in the
part it may persist for hours.
   When the  operation is productive of benefit,  relief is speedily ex-
perienced.
   The extraction  of the steel needles is ordinarily accompanied  by
more  pain than  their insertion, especially if they have  penetrated
deeply, and been retained in the flesh for a long time.  The difficulty
is owing to their having become oxidized, and consequently rough on
the surface.  In withdrawing them, it is advisable to give them a move-
ment of rotation, and at the  same time to press  upon  the skin sur-
rounding them with the thumb and index finger.
   In the hospitals of St.  Louis, La Pitie, 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 un-
pleasant.   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  syncope.  Gaultier de Claubry
has  frequently seen  faintness, febrile movements, spasm, and  insup-
portable pain produced by it,  and Heyfelder saw  it followed by con-
vulsions and fainting.  Beclard has  related a case where  the needle
penetrated to the bone, and occasioned intense pain.  The patient re-
mained 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
operation  was practised.
   As to the modus operandi of acupuncturation, we cannot  conceive
its effects  to be any  thing more  than a new  nervous impression pro-
duced by the needle  on the parts which it  penetrates.  The needles
having been found oxidized, especially at the point, it has been sup-
posed  by  some, that the oxidation  is connected with  the remedial
agency, and it has been even  affirmed, that in some diseases they oxi-
dize more readily than in others.1  It is a sufficient reply to this view,
that beneficial results  are obtained from the  use of  needles made of
metals that do not become oxidized, and that  steel needles oxidize in
the sound, as well  as in the diseased body, and even in parts that have
been removed froin the body,  and placed in warm water;  for in the
cold dead  body, it  is  affirmed,  the phenomenon is not observed.   Clo- >
quet and Pelletan  think,  from their experiments, that the effects of
1 Grafe, loc. cit. S. 319. 
ACUPUNCTURA.
73
acupuncturation 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 modified
form by Dr. Bache,1 who  throws out  the  conjecture "that in many
cases of local pain this accumulation of the nervous (electrical)  fluid
depends upon the  altered state of the various  fasciae  or condensed
sheets of tissue, giving them the power, to a certain extent, of insulating
the parts which  they serve to embrace." "
  The explanation is ingenious, but we do not  think it necessary, if
adequate to explain the phenomena.  We  have no doubt, that  the ef-
fects arc owing to a concentration of the nervous power towards the
part transfixed by the needle, so that  a derivation of the nervous in-
flux is induced towards  the seat of pain, or towards the nerves parti-
cularly concerned in the production of the  pain; but farther  than this
we  know not.
  There is  one phenomenon which is  dependent on the oxidation of
the needle.  When the free extremity of an  inserted needle is connected
with the ground by means of a conducting substance, or is put in con-
nexion 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 phenomenon is  dependent upon the oxidation of the metal,
is proved by the circumstance that it does  not take place when an un-
oxidizable metal is  employed.2
  Acupuncturation has been used by Berlioz3 in gouty and rheumatic
cases; by Ilaime in rheumatic, sjjasmodic, and  convulsive  affections,
and by Demours in amaurosis and ophthalmia, the needles  being in-
serted into  the  temples;  Finch advised it in anasarca, practised on
the feet; he also discharged, in this way, the fluid of ascites.4   Pipe-
let5 employed it advantageously in a violent convulsive affection.  The
needles did not remove or markedly diminish the symptoms, but they
postponed their recurrence.   Michaelis6 cured a  case of rheumatism
by  it, but he did not find  it so serviceable in oedema of the feet, as the
fluid did not  flow readily through the minute apertures.   Friedrich
proposed, in cases of asphyxia, when  every other remedy had  been
employed unsuccessfully,  that the cavities  of the heart should be pene-
trated by a needle to excite its  contraction,  and this plan was subse-
quently advised by Carraro,7 who found, from his experiments 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,8 of Philadelphia, were not found to suc-
ceed.   J. Cloquet obtained the happiest results  from acupuncturation
in neuralgia, rheumatism,  muscular contractions, spasms, pleurodyne, ce-
phalalgia, ophthalmia, toothach, epilepsy, gout, gastrodynia, contusions,
lumbago, periodical amaurosis, diplopia,  paralysis,  &c.  A case of
       •
  1 Op. citat, p. 305.                      2 Riecke, S. 16.
  3 Op. citat.  Paris, 1816.                 * Lond. Med. Repos. Mar. 1823.
  5 Journal Complem. du Diet, des Sciences M.dic. t. xvi. Paris, 1823.
  6 Griife und Walther's Journal, B. v. St. 3.
  ' Annal. Univ. di  Medicin, 1825.  Also, Provincial Med. and Surg. Journ., May 15,
1841.                   8 North Amer. Med. and Surg. Journ. ii. 292. 
74
ACUPUNCTURA.
neuralgia, after amputation, has been reported as cured by it.1  The
patient was attacked 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 intro-
duced, 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, and the pain immediately ceased.   After  the needles had
remained in half an  hour, they were removed, and the patient enjoyed
a sound sleep,  and awoke free from pain.  About twenty  days after-
wards, the  pain recurred;  the needles were again applied, and relief
as instantaneously followed.
   Several cases of neuralgia, removed by it, have  been published by
Prof. Riberi, of Turin.2
   A case has  been recently published by Dr. Seller,3 in which it was
employed with beneficial results in protracted lockjaw, connected with
attacks of suppurating sore throat, and  accompanied by hysterical
and also 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. Elliotson4 cured 30 out of 42  cases by it  in St. Thomas's hospital.
In sciatica its efficacy has been evident.5
   By Velpeau  it has been proposed  to cure aneurism  by acupunctura-
tion.   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.6   He found, in his experiments, 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,7 treated
eleven cases of varicose  veins by introducing pins through their cavi-
ties, and allowing them to remain  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 de-
gree of compression, as well as of irritation, on the  sac, he twisted the

  1 Bulletino delle Scienze Medich. Ottobre, 1838, and Brit, and  For. Med. Review, Jan.
1840, p. 252.                    2 Medico-Chirurg. Rev. Aprii, 1841, p. 50l'.
  3 Northern Journal of Medicine, April, 1845, and Braithwaite's Retrospect, Amer. edit.
xi. 189.  New York, 1815.                                 *
  * Art. Acupuncture, Cyclop. Pract. Med. Amer. edit,  by the author.  Philad 1845.
  5 Renton, in Edinb. Med. and Surg. Journ. for 1830, xxxiv. 100; Graves, in Lond. Med.
Gaz. July, 1831, and Lond. Med. and Surg. Journal, April, 1833;  Dr. H. S. Belcombe,
Medical Times and Gazette, Jan. 24, 1852.
  6 Lond. Med. Gaz. cited in Amer. Journal of Med. Sciences, Aug. 1831, p. 510.
  7 Bulletin General de Th.rapeutique, and Dunglison's American Medical Intellicencer,
for Dec. 1, 1837, p. 317.                                            fe 
                          ACUPUNCTURA.                        75

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 after-
wards.   M. Bonnet had treated four cases of inguinal hernia by acu-
puncturation.   In two, the hernia was small, and three weeks sufficed
for the cure: the third was more troublesome.   Caution is  of course
requisite not to injure the spermatic cord.
   In  a subsequent communication, M. Bonnet inculcates the necessity
of  causing  the obliteration of the veins in several  places  separated
from  each other by short spaces.1
   Acupuncturation  has been revived2 in the treatment of hydrocele
by Mr. Lewis,  Mr. King,3 and others.   It consists in carrying a  com-
mon 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  ordi-
nary method of  tapping with a trocar, except  that the needle, which
Bhould  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 areolar tissue of the scrotum becomes
 gradually more  and more infiltrated with  the fluid, which  before dis-
 tended 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, but
 he has seen cases where a radical  cure was effected by it.4  He consi-
 ders the principle of puncturing with a fine  pointed needle not only
 applicable to promote the absorption of the fluid in hydrocele, but in
 every case of  encysted dropsy.5
    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 areolar membrane.   In such  cases larger needles are
 needed; some prefer  them to be  of the size of an ordinary glover's
 needle, and of a triangular shape; a puncture of this kind being less
 likely to close.6
    In the .mass  of cases, it  need  scarcely be said, this course can act
 merely in a palliative manner,—the  cause of the dropsical accumula-

   i Archives Gen.rales de M.decine, Mai, 1839.  Also, Dodd, in Med. Gaz. Dec. 20,1839.
   3 Travers, in Lond. Med. Gazette, Feb. 1837, p. 737.  Lewis, Ibid. Feb. 1837, p. 788. .
 Mr. Robert Keate, Ibid. p. 789.       3 British Annals of Medicine, No. 1, p.  13.
   4 Davidson, in  Edinb. Med. and Surg. Journ. for Jan. 1838.
   5 Lancet, May 7, 1836, and Jan. 14,  1837.  See a case of Ovarian Dropsy, in which
 it was emp'loyed  by Robert D. Thompson, in  Lancet, May 25, 1839, p. 344; and one of
 Ascites, by Mr. Campbell, Lond. Med.  Gaz. Nov. 1838.
   6 Graves, Lond. Med. Gaz. Oct. 1838. Also, King, Ibid. Oot. 7, 1837, and Nov. 2o,
 1837. 
76                    iETHER HYDROCYANICUS.

tion 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 pro-
duce absorption  by means of internal  remedies, another practitioner
was called in, who practised acupuncturation of the lower extremities,
and succeeded completely.
  Mr. Vowell1 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 considerable size
on the extensor tendons of  the foot, which produced not only disfigu-
ration, but some uneasiness.  Mr. Vowell applied blisters, and  after-
wards 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,2 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 movable  fragments of the ulna two
needles,  sufficiently long to  traverse the false articulation from side to
side, and kept them 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 after-
wards, 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 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-puncture, and galvano-puncture.
                  IX. _ETHER HYDROCYAN'ICUS.
 Synoxymes.   ./Ether Prussicus, Hydrocyanic  or Prussic Ether, Hydrocyanate of
   Etherine, Cyanuret of Ethyle.
 French. Ether Hydrocyanique.
 German. Cyanather, Cyanwasserstoffather, Hydrocyanather.

    This preparation was  discovered some years ago  by P61ouze,3 and,
 according  to Magendie,4 it resembles in its effects hydrocyanic  acid,
# without being  so violent a poison,  and, consequently, he esteems it
 worthy of regard as an addition to the  materia medica.

   1 Lancet, Aug.. 25, 1838, p. 770.
   2 Gazette des Hopitaux, Dec. 1843, and Braithwaite's Retrospect. Amer. edit. ix. 186.
 New York, 1844.
   1 Journal de Pharmacie, xx. 339.  Paris, 1833.      * Formulaire: derniere Edition. 
_ETHER SULPHURICUS.
77
            '          METHOD  OF PREPARING.
  Equal parts of sulpho-vinate of baryta and cyanuret of potassium
are mixed intimately together;  put into  a glass retort,  to which 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 et.her, and hydrocyanic acid.  In order to purify it,
it  must be  strongly shaken, and, with four or five times  its  bulk of
water, must be exposed for some time to a temperature of 60° or 70°
centigrade; 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 82° centigrade; is very slightly soluble in
water, but soluble in every proportion in  alcohol and sulphuric ether.
In its pure state, it does not disturb a solution of nitrate of silver.  It
inflames very readily, and burns with a blue light.   Potassa decomposes
it with difficulty, and only when highly  concentrated.

                     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  animal fell on its side, and
convulsions succeeded, with  considerable  motion  of the paws.  This
condition continued for four minutes, after  which the effects gradu-
ally disappeared, and  in the course of half an hour ceased.  Six drops
injected into the jugular vein rapidly caused death, with symptoms simi-
lar to those induced  by hydrocyanic  acid.   According  to Magendie,
these experiments were frequently repeated by him with different mo-
difications after which he ventured upon its administration in disease.
He added six drops of the ether to a mucilaginous linctus, and pre-
scribed it to a patient  labouring under  hooping-cough,  who, in  the
 course of a few days, derived signal benefit from  it, and without com-
plaining of its penetrating, 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 discontinue
 it, on account of the invincible nausea which its smell  induced.   Ma-
 gendie advises it in those diseases in which mixtures of hydrocyanic acid
 have been found of service.
                   X. JETHER SULPHURICUS.
Syxoxy*me3.  -Ether (Pharm. TJ. S.,) _£ther Yitriolicus, Naphtha Sulphuriea, Oleum
  Yitrioli Dulce, Vitriol Naphtha, Ether (Pharm. U. S.,) Sulphuric Ether, Letheon.
French.  Ether Sulphurique.
German.  Schwefelather.
  It is only within the last few years, that a class of agents has been
introduced into the Materia Medica, which have received the name of 
78
iETHER SULPHURICUS.
Ansesthetics, a term used by Dr. Pereira1 synonymously with narcotics,
anodynes and paregorics, as "agents which diminish sensibility or re-
lieve pain;" but he adds, that the term is commonly applied to agents
which diminish common sensibility, or sensibility to pain.  As remarked
elsewhere,3 however, it is most generally employed to designate such
agents, when received into  the lungs in the form of vapours or gases;
and the vapours most  used are those of ether and chloroform.
  It has been long known that the vapour of ether would cause exhi-
laration  and intoxication when breathed from a bladder, a practice
which, as the author has been informed, was a popular diversion upwards
of forty  years ago  in Philadelphia.   As long ago as the year 1805,  it
was used to relieve the distress in the last stage  of pulmonary  inflam-
mation in the case  of  a gentleman in Boston: in  like cases it has been
frequently prescribed  since, and it was so prescribed in the year 1812,
to a member of Dr. J. C. Warren's family, who experienced great re-
lief from it.  The mode of applying it was by moistening a handkerchief
and placing it near the face of the patient.  It was not, however, until
October, 1846, that it was brought forward prominently as an anaesthe-
tic in surgical operations.   Dr. W. F. G.  Morton, a dentist of Boston,
about the middle  of  that month, informed Dr. Warren, that he had
possession of a means  for accomplishing the object;—that he had made
trials of its efficacy in the  extraction of teeth, and was desirous that
Dr. Warren should test its power in surgical operations.3  Accordingly,
at the Massachusetts  General  Hospital, its merits were tested by Drs.
Warren  and  Hayward, and  the  results being satisfactory, the trials
were soon repeated there and elsewhere, in this country and  abroad;
and very speedily  "etherization"—as  it was termed—came to be re-
garded as one of the  most  important gifts presented by science to hu-
manity.   A few days after Dr. Warren had operated for the first time
on a patient, to whom the ether had been administered by  Dr. Morton,  *
Dr.  C. T. Jackson, of Boston, in a conversation  with Dr. Warren, as-
serted, that he had first informed Dr. Morton  of  the value of  ether  in
inhalation for preventing pain in dental operations.
   Although, however, it was first promulgated at the period above de-
scribed,  it  is affirmed by Dr.  C. W. Long,4 of Jefferson, Jackson co.,
Georgia, that as early as the 30th of March, 1842, he removed a tumour
from a patient who inhaled  the vapour of ether  from a towel,  without
any pain being experienced.5

                       METHOD OF PREPARING.
   The officinal sulphuric ether of the pharmacopoeias is usually employed
for inhalation.   The  specific gravity of that of the Pharmacopoeias of

  1 The Elements of Materia Medica and Therapeutics, 3d Amer. edit. i. 238. Lond. 1854.
  8 The Author's General Therapeutics and Mat. Med. 5th edit. i. 380.  Philad. 1853.
  3 Etherization with  Surgical Remarks, by John C. Warren, M.  D., p. 4, Bost., 1848.
 See, on the origin of the inhalation of ether as  a means of preventing pain  in surgical
 operations, the Report of the Board of Trustees of the Massachusetts General Hospital.
 Boston, 1848.  Also, an excellent article on Anaesthesia and Anaesthetic aeents, in Brit.
 and For. Med. Chir. Rev. Jan., 1852, p.  158.
   * Southern Medical and  Surgical Journal, Dec, 1849.
  .? 0n lheDhist-),ry, °f ether inhalation, see Dr. Ranking, in Half-Yearly Abstract, Amer.
 _dit. v. 328.  Philad. 1847 and Report of the Committee on Surgery in Transactions of
 the Amer. Med. Association, i. 179.  Philad. 1848. 
iETHER SULPHURICUS.
79
   the United States and London is 0.750; of the Dublin, 0.765; and of the
   Edinburgh, 0.735, or under.  The last is the best for the purpose.   The
   article employed by Dr. C. T. Jackson was prepared as follows.   The
   strongest and  purest rectified sulphuric ether, which can usually be
   obtained from the  druggists, is  agitated with water for the purpose of
   removing all acid.   It is then freed from the water it  may have taken
   up, by chloride of calcium.   The specific gravity of the product is about
   0.725.1
                   EFFECTS ON THE ECONOMY IN HEALTH.
      The effects of all anaesthetics are  essentially alike; and since their
   introduction numerous experiments have  been made with  them by
   distinguished physiologists and surgeons,—as  by a committee of the
   Surgical Society of Ireland,2 by Flourens,3 Longet,4 Amussat,5  Holmes
   Coote and Thomas Taylor,6 Ville,7 Gruby,8 Thomas  Wakley,9 Gerardin
   and Verrier,10 Snow,11 Chamber.,12 Buchanan,13 Black,14 Schuh,  Jorg,
   Von Bibra, Harless15 and  others, and  the results have been  carefully
   noted.16   All of them, when received into the lungs, readily  enter the
   pulmonary blood vessels, and proceed  to the great nervous centres,  to
   exert on these their  appropriate agency.  As a general rule, perhaps,
   the intellectual  and moral manifestations  first  exhibit  their influence
   through the excitant action of the  anaesthetic  on  the  great cerebral
   and cerebellar ganglia, so that a kind of intoxication  supervenes, with
   imperfect  power of  regulating  the movements.  The sensory  ganglia
   become  subsequently  or simultaneously  affected,  and  sensation and
   motion  are  suspended; and  ultimately,  if the quantity inhaled  be
   sufficient, the medulla oblongata has its action suspended or destroyed;
   respiration ceases, and death is the consequence.17   Yet great irregula-
   rity occurs in the supervention  of these phenomena, as in the hysteroid
   condition  induced by the animal magnetizer.   At times, the intellect
0  appears to be but  little affected, whilst ordinary sensation is obtunded;
   and, at  others, morbid sensation  or pain is blunted, whilst ordinary
   feeling  persists.   The supervention of anesthetization  is known  by
   closure  of the eyelids, if they have been previously open;  failure  to
   respond to questions, and  muscular relaxation.  Whilst the  patient is
   under the influence, the pulse and  the respiration must be carefully
    attended to.   If they fail, or if the pupil, after having been contracted

      1 Warren, Op. cit. p. 93.           2 Dublin Medical Press, Feb. 10,  1S47.
      8 Lancet, April 17, 1847.           4 Archives Generates de Medecine, Mars, 1847.
      5 Comptes Rendus, 22 Fevr. 1847.           6 Lancet, June 19, 1847.
      7 Ibid. July 10, 1847.                     8 Lond. Med. Gazette, Dec. 24,1847.
      9 Lancet, Jan. 1, 1W4S.                  w Comptes Rendus, 27 Dec, 1847.
      11 Lond. Med. Gazette,  Jan. 1848.
      12 Bouchardat, Annuaire de Therapeutique, pour 1848, p. 36.
      13 Lond. Med. Gaz. April, 1847.     14 Provincial Med. and Surg. Journ. May 5,1847.
      15 Canstatt und Eisenmann, Jahresbericht, u. s. w., in Jahre, 1847, iv. 159, Erlangen,
    1S4^.  Good summaries of the experience of observers are given in this work by Klencke,
    in subsequent years, 1S49, 1850,1851, lS52,&c.
     16 See H. J. Bigelow, Anaesthetics, their mode of [exhibition, and  physiological effects,
    in Transactions of the  Amer.  Med.  Association, ii. 197. Philad. 1848.  Also, on the
    whole subject of Anaesthetics, the British and Foreign Medico-Chirurg. Rev.  Jan. 1852,
    p. 158. Philad. Med. Examiner, April, 1852; Ranking's Abstract,  xv. 238.  Amer. edit.
    Philad. 1852.
      17 See, on  the mode of death by anesthetics, Mr. R. E. Bickersteth, Edinb. Monthly
    Journ. Sep. 1853, or Ranking's Abstract, xviii. 136.  Philad. 1854. 
80
2ETHER SULPHURICUS.
becomes dilated, the inhalation must be immediately discontinued, and
the face be sponged with cold water, ammonia be applied as an excitant
to the nostrils and throat, and frictions  to  the extremities; and M.
Ricord1  recommends, in cases of threatened death from chloroform,
the immediate inflation of the lungs, by applying the  mouth  to the
patient's lips.
  It would appear from the experiments of Mr. Nunnely,2 M. Jules
Roux3 and  others, that the  local  application  of anaesthetics, as of
narcotics in general, deadens the sensibility and power of motion of a
part, whilst the nervous centres,  and  the nerves  distributed  to other
parts of the body, may be unaffected.   Mr. Nunnely instituted an ex-
tensive series of experiments on animals, and found, that by immersing
a limb  in  a small quantity  of the  fluid, or by applying the  vapour
topically for a limited period, it might  be  rendered perfectly incapable
of motion and feeling, and be fixed in any desired position.
  It was but natural to suppose,  that the indiscriminate  employment
of so potent an agent,  should, in  some cases, give rise to unpleasant,
and even fatal results.   Yet  when we  reflect on the immense number
of persons who have been subjected to  the inhalation of ether, the
surprise is, that so few examples of injurious consequences should have
been recorded.
  The most remarkable ill effects  noticed  by Dr. Warren,4 were of two
kinds; first, those caused  by the  exclusion of oxygen;  and secondly,
those from excessive etherization orthe nervous centres,—the principal
morbid effect from the latter cause being general convulsions, at times,
so violent as to threaten life; but generally by suspending the inhala-
tion, and employing the free affusion of cold water, the convulsions
ceased.   Cases  in  which  distressing  nervous  and  other phenomena
supervened are related by Dr. Warren, Mr. South, Professor Syme,5
Professor Murphy,6 Mr. Lawrence  of Montrose,7 Mr. Copeman,8 Dr. «
Bennett,9 Mr. Eastman,10 Dr. H. J. Bigelow,11 Dr. N. R. Smith,12 and
others.   Accidents have, however, been ascribed to it on no foundation.
Thus, Dr. Pickford13 states, that a medical friend in Dublin informed
him, that of thirty fatal cases following operations in which ether had
been employed in the various hospitals of that  city, eight were found
to be the subjects of recent tubercles of the lungs,—the. undoubted
product, it was  believed, of inhalation,—a statement which Mr. Mac-
donnell14 denounces as altogether  groundless.
  Professor Syme, Dr. Roberts15 and others, witnessed inconvenient
effects from the  inhalation of ether, and the editor of the Monthly
Journal  of the Medical Sciences  observed great excitement,  cough,

  1 Ranking's Half-Yearly Abstract, xi. 191.  Amer. edit.  Philad. 1850.
  3 On Anaesthesia, and Anaesthetic Substances generally, &c, in Transact, of Prov. Med.
and Surg. Association, vol. xvi. pt. 2.     a  Gazette des Hopitaux, 7 Nov. 1848.
  * Op. cit. p. 24.             5 Monthly Journal of Med. Science, Aug. 1847.
  6 Lancet, Nov. 27, 1847.      ^ Monthly Journal, June, 1847. '
  8 Provincial Med. and Surg. Journal, Feb. 10, 1847.    9 Monthly Journ, June, 1847.
 "> Lond. and Edinb. Monthly Journal, June, 1847.
 11 Transactions of the American Medical Association, i. 209.  Philad. 1848.
 » Ibid. ii. 214. Philad. 1849.        is Edinb. Med. and Surg. Journ. July, 1847.
 u Provincial Med. and Surg. Journ. July 14,1847.
 15 Monthly Journal of Medical Science, April, 1847. 
iETHER SULPHURICUS.
81
with  expectoration  of pus, haemoptysis,  and  convulsions.  In  some
cases, erotic feelings, and even nymphomania occurred in females:  in
others, hysterical symptoms, or those of depression, or intense headach,
which continued several days; and similar phenomena have presented
themselves to  the author.   Fatal cases, too, have occurred, which have
been  ascribed to the inhalation, by M. Jobert, M. Roux. Mr. Nunn,
Dr. Maclagan, Mr. Robbs,  M. Blandin,1 M. Piedagnel,2  Dr.  Paul  F.
Eve,3 Dr.  J.  W. B.  M'Clellan,4 and  others.  Fatal  cases  are, how-
ever,  much more rare than  they were  some  time ago; and this is
probably owing to more care being  taken in its administration, and in
the discrimination of cases  for which it is adapted.
   It  is proper to  remark, that from  tables published  by Professors
Simpson and  Malgaigne,  showing the mortality of surgical operations
in the British and French hospitals, where anaesthetics had been used,
and where  they had  not, it would appear that the  mortality was de-
cidedly greater where they were not employed; and hence it has been
inferred, that where  the  employment of chloroform has  sacrificed  one
life, it may have preserved a hundred.5
   During the inhalation  of ether, the  blood has been observed to lose
its florid colour by Mr. Pring,6 M. Amussat, Dr. Ranking,7 and nume-
rous  others.  M. Lassaigne,8 however, states that such was not the re-
sult of his observations.
   The morbid appearances presented by animals killed by the inhala-
tion of ether  have been similar to those observed in asphyxia; fluidity
of the blood;  accumulation of that fluid on the right side of the heart
and large  veins, with engorgement of the internal viscera.   In a fa-
tal case, seen in  the  Royal Infirmary  of Edinburgh, there were found
double pneumonia, bronchitis, and secondary purulent deposits in the
joints.   In a case  recorded by Mr. Nunn, cerebral  congestion,  en-
gorgement  of the lungs posteriorly,  and uniform fluidity of the blood,
were  found.  In another case, there was no great congestion; but the
blood was  fluid throughout.  The observations of MM. Amussat and
Lassaigne showed, that in  every case it loses its  power of coagulation,
although, with the exception of the presence of a minute quantity of
ether, its chemical characters are unchanged.9
   From a careful comparison of the effects produced on the economy
by different  anaesthetics, Dr. Hay ward10  decidedly prefers sulphuric
ether to either chloric  ether or chloroform,—its  great advantages
being, in his  opinion, "its  entire safety, the ease with which it is ad-

  1 Gazette des Hopitaux, 23 Nov. 1847.  Also, the details of a case at the Hotel Dieu,
of Paris, in Journ. des  Connois. Medico-Chirurg., and Ranking's Half-Yearly Abstract,
Amer. edit. vii. 191.  Philad. 1848.
  2 Cited in the Amer. Journ. of the Med. Sciences, April, 1848, p. 558.
  3 Southern Med. and Surg. Journ. June, 1849.
  4 Transactions of the Amer. Med. Association, i. 192.  Philad. 1848.
  5 Report of the Committee on Surgery, Dr. N. R. Smith, Chairman, in Transact, of the
Amer. Med. Association, ii. 215.  Philad. 1849.         6 Lancet, May 1,1847.
  ■ Half-Yearly Abstract, Amer. edit. v. 335. Philad. 1847.
  8 Cited in Provincial Med. and Surg. Journ. May 5,1847.
  9 Monthly Journal of Med. Science, April, 1S47.
  10 Remarks on the Comparative Value of the different Anaesthetic Agents. Boston, 1850.
        6 
82
iETHER SULPHURICUS.
ministered, and the slight inconveniences which follow its administra-
tion.
               EFFECTS ON THE ECONOMY IN DISEASE.1
  It was in severe surgical operations that anaesthetics were first em-
ployed in the way of inhalation; and until the discovery of chloroform,
sulphuric ether was used almost solely,  and generally with the most
gratifying results.  As soon as the intelligence reached Europe, it was
at once laid hold of  by the most distinguished  surgeons, by Messrs.
Liston, Key, Fergusson, Lawrence, Skey,2 and others, in England; by
MM. Malgaigne, Velpeau, Roux, Robert, Paul Guersant, Leroy d'E-
tiolles, and others3 in France; and by Blumhardt, Dieffenbach, Schuh,
Heyfelder, and others, in Germany.
  Not long after its introduction in this country, nineteen  cases of
surgical  operations performed on patients rendered  insensible by it
were recorded  by Dr. J. Mason Warren,4 of Boston; and since then
the testimony in  its favour has been so  overwhelming and numerous,
that  it is impracticable even to  enumerate the different authorities.
Mr. Wells, of  the English navy, soon reported the favourable results
of one hundred and six cases.5  Fractures and dislocations were happily
arranged under its influence, by Dr. Warren,  Dr. Parkman,6 Mr. De-
hane,7 J. Caunt,8  and others.  Mr. Lawrence9 reported that it had
been used in St. Bartholomew's Hospital in all descriptions of opera-
tive procedures between two and three thousand times without a single
unpleasant result.  Dr.  Snow,10 too, appears  to  have been most for-
tunate in his cases; for with the exception of  headache on one or two
occasions, the only unpleasant  effects he had witnessed were  sickness
and vomiting, and these only occasionally.  Mr. Humphrey,11 in seve-
ral hundred cases, in which ether or chloroform had been inhaled, saw
serious neuropathic phenomena in only four or five cases; and beyond
these never witnessed more  than  headache, sickness, and giddiness,
lasting for a few hours;  and these symptoms supervened but occasion-
ally ; whilst in one hundred and six cases Mr. Wells12 saw no serious
ill effects in any.
  There is scarcely a painful operation practised by the surgeon, ocu-
list, or dentist, in which ether inhalation  has not been  employed.
Among the earlier recorded cases were  an  amputation of the  thigh by
Dr. J. M. Warren; extirpation of a tumour of the mamma by Dr. J.
C. Warren; an operation for necrosis of the tibia by Dr. Townshend;
reduction of strangulated hernia by Dr. J.  M. Warren13 and Dr. Ho-
sack;14 sounding for stone, and lithotrity, by Dr. J. C. Warren;  stricture

  1 See an excellent article on the practical application of Anaesthetics, in Brit, and For.
Med. Chir. Rev. April, 1852, p. 443.                            '
  2 Amer. Journal of the Med. Sciences, April, 1847, p. 506.
  s Bouchardat, Annuaire, 1848, p. 35.
  4 Boston Med. and Surg. Journal, March 24, 1847.
  5 Lond. Med. Gazette, Sept. 1847.                6 Warren, Op. cit. pp. 44 and 46.
  ' Provincial Med. and Surg. Journal, Sept., 1847.    8 Lond> Med G   June 4 1847
  9 Amer. Journ. of the Medical Sciences, April,  1848, p.  551.
 i° On the Inhalation of the Vapour of Ether in Surg. Operations kc  Lond 1817
 " ?r°T1?°lal Med- and Surg- Journ-' Aug- 9' 1848-   12 Lond. Med. Gaz., Sept. 1847.
 « J. C. Warren, Etherization, with Surgical Remarks, p. 53.  Boston, 1848.
 14 Boston Med. and Surg. Journ., Aug. 11, 1847. 
_ETHER SULPHURIC US.
83
of the urethra, with fistulous openings, by Mr. Liston;  lithotomy, by
Mr. Tatum; an operation for fistulous sinuses by the side of the rectum,
by Mr. Keate;x the removal of tumours  in various parts, by Mr.
Syme;2 extirpation of the mamma, by Dr.  Jas.  Bryan;3  amputation
of the thigh, by Dr. Mutter;4 extirpation of the eye, by Mr. Lawrence
and M.Velpeau;5 and it has been inhaled in all cases of removal of
tumours and plastic operations on the eyelids ; but in operations, such
as strabismus, which require, at times, the exercise of volition, anaes-
thetics  are not indicated; and in those for cataract, artificial pupil,
&c,  Mr. Wilde6 considers the amount  of pain does not demand  their
use.   Yet  in such cases, chloroform has been  successfully employed
by Mr. White Cooper,7 and by Mr. Haynes Walton.8
   The following list, the basis of which is one drawn up by Klencke,9
will give a view of many of the operations  in which it is recorded to
have been  used to the year 1847:
   1. Extirpations:—Of encysted tumours, by Schuh,  Strodel, and
Hornig.   Of cancer and similar tumours, by Schuh, Pitha, Heyfelder,
Opitz, Haller, Hayward, Pereshaw, Clement,Velpeau, Malgaigne, Lan-
douzy, Ricord, Roux, Sedillot.   Of cancer  of the lip, by Pitha,  Hey-
felder, Maison-neuve.   Of  ranula, Heyfelder.  Of condylomata, by
Thomson, Fergusson, Bruns, Mikschik, Flor, Schubert and Kraus, and
Von Brunner.    Of  telangiectasis, by Schuh and Pitha.   Of  nasal
polypus, Schulz.  Of glands.—Mammary gland, by Liston, Leblanc,
Brookes, Bouchacourt, Goyrand.  Parotid gland, Heyfelder.  Tonsils,
 Roux.
   2.  Herniotomy.—Key, Partridge, Schuh, Pitha, Von Riffel,  Hey-
felder.   Radical operation (after Gerdy,) Kraus, of Prague.
   3.  Lithotomy.—Morgan, Guersant, Balassa.  Lithotrity,  Leroy
 d'Etiolles.
   4.  Strictures.—Fergusson.   Operations for fistula, Pitha,  Hey-
felder.
   5.  Urethrotomy.—Petrequin.
   6. Phimosis.—Fergusson, Thomson, Schuh,  Sigmund, Opitz, Rei-
 singer, Balassa, Von  Riffel.
   7. Castration.—Sigmund and  Bonnet.
   8. Hydrocele.—Ricord, Jobert, Opitz,  Schuh, Balassa.
   9. Harelip.—Heyfelder, Pitha.
  10. Ligature of the Crural Artery, by Von Riffel.
  11. Amputations.—Of the thigh. Hayward, Lansdown, Coleman,
 Liston, Malgaigne, Jobert, Th. Bell, Chiari, Raymonet, Duncan, Schuh,
 Pitha.   Of the leg.  Hawkins, Leblanc, Sedillot, Haller, Pitha,  Dum-
 reicher, Opitz,  Reisinger.  Of the arm. Velpeau, Schuh, Sigmund.
 Of  the forearm. Liston.   Of the  hand. Velpeau,  Goyot, and Duval.
 Of the finger.  Tctrequin, Kraus, Martin, Heyfelder,  Pitha, Sigmund.

   1 Snow, Op. cit. and Ranking's Half-Yearly Abstract, Am. Ed. vi. 97, Philad. 1848.
   2 Monthly Journal of Medical Sciences. Aug. 18, 1817.
   8 Med. Exam., June, 1817, p. 332.    4 Ibid., Jan., 1848, p. 14.    * Ranking, vii. 248.
   6 Dublin Quart. Journ. of Med. Science, May, 1848.                      f
   ' Assoc. Med. Jour., Jan. 7,1853 ; and Amer. Jour, of Med. Sciences, April, 1853, p. 519.
   ■> Med. Times and Gaz., Jan. 27, 1855, and Amer. Journ., April, lS55,p. 53~\
   9 Canstatt und Eiscnmann, Jahrc-bericht, r. s. w., im Jahre, 1847, iv. 1.3. 
84
iETHER SULrilURICUS.
  12  Exarticulations.—Of the foot-joint, Pitha.  Of the finger,
Guersant, Voillemier, Macmurdo, Von Riffel, Liston, Cooper  \ elpeau
Maison-neuve, Pitha, Opitz, Kraus of Prague, Sigmund, Kahler.   Of
the teeth, Pitha,  Sigmund, Opitz, Fairbrother, Tracy.
  13  Resections.—Removal of sequestra, Miller,  Pitha, Sigmund,
Dumreicher, Sedillot.    Of the shoulder, Nelaton.   Head of the hu-
merus, Pitha,  Heyfelder.   Of the ulna, Pitha.    Of the  head  of the
os femoris, Sigmund.  Of the tibia, Sedillot. Of the ankle-bone, Pitha.
Of the lower jaw, Wattmann, Pitha, Tracy.
   14.  Cartilaginous Concretions in the Joints.—Sigmund.
   15.  Myotomy and  Tenotomy.— Dumreicher,  Schuh,  Sigmund,
Pitha, Behrend, Heyfelder.
   16.  Rhinoplasty.—Dieffenbach.   Stomatoplasty, Liston.
   17.  Operations on  the  Eye.—Blepharoplasty, Sedillot,  Brett.
Extirpation of a tumour, Bigelow, Jungken, Hammer.   Cyst in the
Orbit, Monod.  Strabotomy, Brett, Malgaigne, Lorinser, Heyfelder,
Hammer.
   Cataract, Brett, Cotton.  Extirpation of the bulb, Lawrence.   Sta-
phyloma, Arlt.  Arlt also operated for Trichiasis, Blepharophimosis,
and Fistula lachrymalis.
   Of the bloodless operations—u nblutige Operatione n—the fol-
lowing were performed under the narcosis induced by ether:
   1.  Reduction of incarcerated hernia, by Pitha, Opitz and Hornig.
   2.  Reduction of Luxations, by Velpeau  and  Dumreicher.
   3.  Introduction of the Catheter  and  Bougies, Fergusson, R. Ma-
 kenzie.
   The list of patients who inhaled ether  or chloroform for surgical
 operations in  the Massachusetts General Hospital  to April 1st, 1848,
 as reported by Dr. H. J. Bigelow,1 numbered 154; and included 9 am-
 putations  of  the thigh, 11 of the leg, 4 of the arm, and  12 of the
 breast.  Thirty-seven cases  are reported by Dr. Watson,2 as  having
 been treated  in the  First and Second Surgical Divisions of the New
 York Hospital; 13 cases at the Clinic of  the  University of Pennsyl-
 vania are reported by Dr. II. II. Smith;3  and  45 at the  Clinic of the
 Jefferson Medical College by Dr. Mutter.4  In 32 of  these ether was
 employed; in the remainder chloroform.5
    When the  practice had been followed  less  than a year, Mr. Law-
 rence reported, that  the  trials with ether in a single London hospital
 amounted to  between two and three thousand cases.   One dentist in
 that city, up to the middle of July, 1848, had administered anaesthe-
 tics more than three thousand times.
    The  physician has recourse to etherization in all cases which re-
 quire the employment of powerful  narcotics and antispasmodics.  It
 was found especially valuable in all the
    JYeuroses,  by Kalinsky.6
    1 Transactions of the American Medical Association, i.,  215.   Philad. 1848.
    2 Ibid., p. 218.               s Ibid., p. 220.                * Ibid., p. 220.
    5 See an interesting article on this subject, by Dr. F.  W. Sargent, in Amer. Journal
  of the Med. Sciences, April, 1852, p. 448.
    6 Canstatt und Eisenmann, Jahresbericht, v. s. w., iv. 167.   Erlang. 1849. 
iETHER SULPHURICUS.
85
   Tetanus.—It has been employed successfully for the relief of tetanic
spasm;  but,  as properly remarked by Dr. Warren,1 whilst it may mi-
tigate the distress of the muscular contractions, it cannot  be expected
to overcome  the morbid condition of the  spinal  membranes, or the
medulla they envelop,  which he—in the absence of adequate evidence
and of probability—considers to be ipflammatory.   In cases related
by Dr. W. II. Ranking2 and  M. Roux,3 of  Cherburg, it appeared to
act injuriously; and in another in which it was tried in  France, death
—it was conceived—was  unquestionably hastened  by it;  whilst in
others, reported by Dr. Brady,4 and Mr. Broughton,5 it did not avert
the fatal result.   Cases are, however, recorded of its  successful ad-
ministration in tetanus, by Dr. Pertusio, and Mr.  Hawkesworth;6 but
they  are regarded by Dr. Ranking7 as by no means  satisfactory.   In
cases  related by Mr.  Bransby Cooper,8 Dr. Crawford,9 and Dr. T. L.
Ogier,10 although it afforded temporary relief, it did not arrest the pro-
gress of the disease towards a fatal termination.  A case, however, is
related by Mr. Hopgood,11 in a boy nine  years of age, which was  suc-
cessfully treated by it; another  by Mr.  Chalmers;12 another by Dr.
Theobald,13  of  Baltimore;  another  by Dr. Isaac Parrish;14 and  one
of Tetanus rheumaticus, by Reichert.15
   Hydrophobia.—A case  is  recorded by Mr. Allen,16 in which the
spasms  were temporarily relieved by ether inhalation, without, how-
ever, the fatal event being averted.
   Convulsions in a boy eleven years of age, were much relieved by it
under the direction of Dr. Wyatt;l7 and a case in a  child, five months
 old, was completely cured by Dr. Sabin.18
   Delirium  tremens.—A  case  is related by Dr. Upham,19 in which
 sleep and  quiet  were induced by it; and similar cases are recorded by
 Dr. Anderson.20  Dr.  Stedman, too, used it with  good effect.21
   Insanity.  Ether has been inhaled under the direction of M. Caze-
 nave of Pau, and of M. Jobert22 and of  Dr. Boyd; and  it appears to
 have occasionally tranquillized, without any evil  consequences.23
   Neuralgia.  Its good effects in this disease have been deposed to

   1 Etherization, with Surgical Remarks, p. 54.  Boston, 1848.
   2 Provincial Medical and  Surgical Journal, April 21, 1847.
   8 London Medical Gazette, Sept., 1848.
   * Dublin Med. Press, cited in Ranking's Half-Yearly Abstract, v. 340. Philad. 1847.
   5 Provincial Medical and  Surgical Journal, May 5, 1847.      6 Ibid. May 19, 1847.
   T Half-Yearly Abstract.  Amer. Edit., v. 341.  Philad. 1847.
   8 Lond. Med.  Gaz., Aug. 6, 1847.
   9 British American Journal of Medical and Physical Science, Dec, 1847.
   10 South. Journ. of Med. and Pharm., Nov., 1847.       u Med. Times, Jan. 15, 1818.
   12 Provincial Medical and  Surgical Journal, June 30, 1847.
   13 Amer. Journ. of the Med. Sciences, Jan. 1848.
   14 Transactions of the College of Physicians of Philad., vol. ii. No. 4.
   13 Canstatt und Eisenmann, Jahresbericht, u. s. w., im J;ihre 1848, iv. 177.  Erlang. 1849.
   16 Lancet, Oct. 15, 1847.                n West. Journ. Med. and Surg., Ap., 1848.
   18 Boston Medical and Surgical Journal, April, 1848.
   19 Prov. Med.  and Surg. Journ., Dec. 15, 1847.           20 New York Annalist.
   21 J. C. Warren, Etherization, with Surgical Remarks, p. 83.  Boston, 1848.
   22 Cited in Brit, and For.  Med. Rev., April, 1847.
   23 Drs. Ray and Bell, cited in Trans, of the Amer. Med. Assoc, iii. 79.  Philad. 1-.0. 
86
iETHER SULPHURICUS.
by Kalinsky,1 especially in hemicrania; and by Morris,2 Semple,3 Ho-
nore, Christison,4 and others.
  Hysteria.   A case in which the inhalation of ether proved success-
ful in subduing hysteric symptoms, after every  kind of  treatment had
been  used for four days without effect, is related by Mr. Wilkinson;
and another fortunate case by Ducros.5
  Asthma.  Dr. Willis6 and Mr. Cantrell7 have employed it success-
fully.   The  latter states that he had long  used it  prior to its recent
introduction as an anassthetic.   In
   Obstinate Hiccough, it was prescribed with advantage  by Dr. Christi-
son ;8 and in
  Hooping-cough, it is spoken favourably of by Dr. Willis9 and Max.
Simon.10
  Laryngismus stridulus.  A very severe  case was materially bene-
fited by the use of a sponge saturated with ether.  Dr.  Ranking u saw
the case with Mr. Image, who reports it.   It has also  been used suc-
cessfully  in
  Colica  Pictonum, by M. Bouvier;12 and  in flatulent  colic by Hor-
nig.
  Renal  Calculi.  In the intense suffering  attending  the passage of
a renal calculus—nephritic colic—inhalation of  ether  has  been  pre-
scribed with signal advantage by  Dr. Ware13 and Dr. Griesinger; and in
  Dysmenorrhoea, by Dr. Griscom.14
   Ophthalmia.   In violent cases, M. Guersant15 has employed at the
HSpital des  Enfans Malades, of Paris, a collyrium  composed of one
part of nitrate of silver, and four parts of water, with great advantage.
The pain is often, however, so great, that he has had recourse to the
inhalation of ether with marked  success to enable him to make the ap-
plication.  Dr. Makenzie18 advises  the inhalation  in many forms of
ophthalmia,  especially  where there is much  photophobia; but the du-
ration of  the ophthalmia did not seem to be  curtailed; and Dr. Smith,17
of Cheltenham, by its  agency, was  enabled to  examine and  manipu-
late on the eyes of young  children affected with strumous ulcerations
of the eye.
  Intermittent Fever.  It is affirmed that Mr. J. W. Freer,18 a pupil in
the Chicago Hospital, employed  ether in this malady with the most de-
lightful results.   Two or three inhalations invariably arrested the pa-
roxysm instantaneously during the cold stage; brought on diaphoresis;

  1 Canstatt und Eisenmann, Jahresbericht, u. s. w., iv. 167.  Erlang., 1849.
  2 Medical Times, cited in Ranking's Half-yearly Abstract.  Amer. edit., v. 341.  Phila.
1847.                                    3 Lancet, March 27, 1847.
  * Dispensatory, Amer. Edit., by R. E.  Griffith, p. 152.  Philad. 1848.
  5 Lancet,  July 3, 1847.                        6 Ibid. March 20, 1847.
  7 Prov. Med. and Surg. Journ. May 19, 1847.      8 Op. cit.       9 Op. cit.
 10 Canstatt und Eisenmann, Jahresbericht, u. s. w., im Jahre, 1848, iv. 177.  Erlangen,
1849.         n Half-yearly Abstract, &c, Amer. edit., v. 342. Philad. 1847.
 12 Canstatt und Eisenmann, Op. cit. iv.  177.
 13 Boston Med. and Surg. Journ. May  1, 1847.
 u Transactions of the College of Physicians of Philadelphia, April, 1849.
 13 London Medical Gazette, June, 1847.                 16 Ibid.
 17 Wilde, Report on Ophthalmic Surgery, in Dublin Quarterly Journ. of Medical Science,
May, 1848.                                 "«      /
 18 Illinois and Indiana Med. and Surg.  Journ. for Oct. and Nov. 1847. 
iETHER SULPHURICUS.
87
and  in cases where there was no unusual exertion, the paroxysms did
not recur.
  Phthisis.   In the last  stage of  this fatal malady the inhalation of
ether has been prescribed by Dunker,1 and it has exerted a manifestly
soothing  influence: and it  has been ably and forcibly  urged, too, by
one 2 who has had much to  do with the introduction and promulgation
of anaesthetics in  the treatment of disease, that in incurable affections,
when the melancholy termination  approaches, it  may be highly desi-
rable to administer them with the view of rendering  death easy,—of
inducing euthanasia.5
   Feigned  diseases.  Ether inhalation has been  employed to  detect
them.  M.  Baudens4 records two  cases—one of  simulated, the other
of real infirmity—in which  it detected the fraud.   If volition be over-
powered by it, the deception can no longer be maintained.  M. Bayard,5
however—and the Editor of the  Medico-Chirurgical Review for Oc-
tober, 1849, accords with him—is of opinion, that owing to the occa-
sional results which follow the use  of anaesthetics, especially of chloro-
form, and the uncertainty of the revelations obtained through their aid,
they ought not—and the remark  applies especially to chloroform—to
be employed for the detection of simulated  disease.
   The obstetrician has largely employed the inhalation of ether and
other anaesthetics to relieve  the  intense suffering  that accompanies
severe labour; and experience seems to have shown, that whilst it effects
this, and aids in the relaxation of the parts, it does not  materially—or
at all—diminish  the parturient efforts.  Professor Simpson,6 of Edin-
burgh, was, perhaps, the first to employ the inhalation of ether  in this
relation, and was a strong advocate for its use until he had tested  the
virtues of chloroform, which he now employs exclusively.  His opinion
of the value of ether was supported by the  testimony  of Paul Dubois,7
Professor Siebold,8 M. Roux,9 of Toulon, Dr. Channing,10 Dr. Parkman,11
M. Chailly,12 Dr. Lloyd,13 Mr. Lansdown,14 Dr. Protheroe Smith,15 Dr.
Jonathan Clark,16 Dr. Lindsly,17 Dr. Trask,18 and numerous others.  Ob-
jections have been brought against its use,19 as against that of all anaes-
thetics, many of which do not merit much notice.   The strongest, per-
haps, is the one urged by Drs. Radford,20  Meigs, and others, that in in-
  1 Canstatt und Eisenmann, Jahresbericht, u. s. w., im Jahre, 1848, iv. 177.  Erlangen,
1840.                             2J. C.Warren.
  3 Etherization, with Surgical Remarks, p. 69.  Boston, 1848.
  * Comptes Rendus,  8 Mars, 1847.         5 Annales d'Hygiene, xiii. 165—201.
  6 Monthly Journal  of Medical Science, March, 1847; and notes on the Inhalation of
Sulphuric Ether in the Practice of Midwifery.          ' Lancet, March 6, 1847.
  8 Lond. Med. Gaz., June 11, 1847.       * Gazette Mgdicale de Paris, 9 Octobre, 1847.
  10 A Treatise on Etherization in Child-birth.  Boston, 1848.
  11 American Journal of the Medical Sciences, April, 1849, p.  343.
  15 Archives G.n6rales de Mddecine, Avril, 1847.
  1:1 Medical Times, March 27, 1847.            u Lancet, June 5, 1847.
  15 Lancet, May 1, and July 31, 1847.
  16 Medical Examiner, October, 1847, p. 489, and March, 1848, p.  153.
  17 Transactions of the American Medical Association, vol. L, Philad., 1848; and Me-
dical  Examiner, June, 1848, p. 339.
  18 American Journal of the Medical Sciences, October, 1850, p. 341.
  19 Ramsbotham, Principles and Practice of Obstetric Medicine and Surgery, Amer. edit.
by W. V. Keating, M. D.  Philad. 1855.
  » Lancet, April 7, 1847. 
 88                     iETHER SULPHURICUS.

 strumental deliveries more especially, "as in lithotomy and lithotrity,"
 the sensibility of the patient is a safeguard against injury of the soft
 parts;  but the argument is more specious, perhaps, than solid, as a
 careful  operator  could scarcely perpetrate such a blunder.1  It has
 been very largely and successfully employed in  instrumental  and
 complicated labours.  Two cases of placenta prsevia were trea ted under
 its agency by Dr. Protheroe Smith;2 and examples  of its value, where
 turning was required, are recorded by him as well as by Mr. Gordon,3
 Mr. Pickens,4 and others.  In numerous cases of puerperal convulsions,
 and in  forceps and craniotomy  cases, its value  has been manifested.5

                      MODE OF  ADMINISTRATION.
   Various forms of inhaling apparatus have been devised.   Many are
 referred to by Dr. Ranking;6  and some of them  by the  author7 in
 another work, with figures  representing  them.  The vapour is  most
 conveniently  inhaled from a soft sponge, hollowed out on one side, to
 receive the projection of the nose, and saturated with the purest ether.
 The sponge, thus prepared,  is applied over the  nostrils,  through which
 the inhalation must be made, leaving the  mouth free to receive atmo-
 spheric air, and thus prevent the danger of asphyxia.
   The time required to produce etherization is usually from three to
 five minutes,  and  the quantity generally  found necessary, is about two
 fluidounces; but the effects must be carefully watched.   Dr. Warren8
 remarks, that after careful inspection of two hundred cases of both
 sexes, of all ages,  in a great variety of conditions of health and disease,
 etherized through a sponge,  without reference to quantity, he has seen
 no immediate or  consequent symptoms, which would lead him to em-
 barrass the patient and the surgeon with a complex apparatus; and
 similar  views  are entertained-by Dr. Hayward.9  " The irritability of
 the parts," the latter remarks, "withwhich the ether comes in contact,
 is by degrees  overcome; then  the sponge may  be  applied  directly to
 the face, and, if necessary, compressed in  some measure so as to exclude
 to a  greater degree the atmospheric air.   When  the desired effect is
 produced,  which  is  usually in from three to five minutes, the patient
 has no control over the voluntary muscles; he cannot speak; he cannot
 open his eyes, when directed to do so; his muscles become completely
 relaxed, and  the  pulse, which, at the beginning of the  inhalation, is
 frequent, and often rises during the process to one hundred and forty
 beats in a minute  or more, becomes slower, and  I have very often
 known it fall to sixty.   The patient is then insensible, and unconscious;
 and the surgeon may begin his operation with great  confidence that he

  1 Answer to the Religious Objections advanced against the Employment of Anaesthetic
Agents in Midwifery and Surgery, Edinburgh, 1848; and  Ansesthesia, or the Employ-
pi!h a ?^}or°f0T^ and Ether ln Sur§ery. Midwifery, &c, by J. Y. Simpson, M. D. &c,
rnilad. 1848; and a Correspondence between Professors Simpson and Meigs, in Medical
Examiner, March, 1848, p. 145—April, 1848, p. 205—and May, 1848, p. 269.
   Lancet, July 31, 1847.                     3 Ibid. j^  14 ^
  . Provmcia Med. and Surg. Journ., Sept. 23, 1847.      5 Channing, Op. cit.
  , £  ye,a5. Abstract of the Medical Sciences, v. 330.  Amer. edit.  Philad. 1847.
  | General Therapeutics and Materia Medica, 5th edit. i. 421.  Philad. 1853
   Etherization,  &c, p. 77.  Boston,  1848.
  9 Remarks on the Comparative Value of the Different Anaesthetic Agents. Boston, 1850. 
ALUMINiE SALES.
89
will inflict no suffering.   The sponge  should then be removed, and re-
applied, from time to time, as circumstances may require.   If the ether
is not pure, longer time is necessary to produce the desired effect; the
brain and nervous  system are  more excited, and the patient is occa-
sionally violent for a time, and with difficulty controlled.   Before using
the ether, the sponge should be dipped in warm water, and then strongly
compressed, leaving  it slightly damp.   The evaporation seems  to go
on better in this way, than when  a sponge is used that has  not  been
previously moistened.   In the first instance, the ether should be poured
over the inside of  the  sponge: about two  ounces is enough.  When
more is required, it should be  applied to the outside, as it is best not
to remove the sponge from the face."1
  Ether has likewise been administered per anum,  and M. Pirogoff,
of St. Petersburg, thought that the anaesthetic effects of the vapour
were produced  more  speedily and with much less trouble to the pa-
tient.   He found, that in from  two to four minutes the odour  of the
vapour  was perceptible  in the breath, and the wonted  effects  super-
vened in from three to five minutes.  The quantity  of ether used va-
ried from half an  ounce  to two  ounces.    Similar experiments were
made by MM. Roux and Parchappe; and according to M.Velpeau the
former preceded M. Pirogoff.
                      XL ALU'MIN_E  SALES.
 Stnonymes.  Salts of Alumina.
 French.  Sels d'Alumine.
 German. Thonerdensalze.
   In making experiments on the agency of various substances as an-
 tiseptics, M. Gannal3 discovered 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 satisfactory results.  The ace-
 tate of alumina and chloride of aluminium succeeded perfectly.  A
 mixture of equal parts of chloride of aluminium 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 alu-
 mina, and more soluble in water.  Of all these, the sulphate of alu-
 mina was found to merit the preference, owing to its being of simple
 preparation and moderate price.4  It may be made by the direct  com-

  1 A valuable paper on the application of Anaesthetics to Surgical  Purposes has been
published by Dr. Fleming, Dublin Med. Press, March 12. 1851; and Amer. Journ. of the
Med. Sciences Oct. 1851, p. 489.          2 Gazette M.dicale de Paris, 8 Mai, 1847.
  8 History of Embalming, &c, by J. N. Gannal, Paris, 1838, translated by R. Harlan,
M. D., p. 203.  Philad. 1840.                     4 Ibid. p. 233. 
90
ALUMINiB SALES.
bination ot alumina and sulphuric 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 necessary to in-
ject the blood-vessels,—an  enema of one  quart, and the same quantity
injected into the oesophagus being sufficient for the 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 alumina and potassa.
The  acetate of alumina, thus prepared, at 18° 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 quan-
tities are required.
   In the report  on M.  Gannal's memoir presented to the Institute 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 ulti-
mately 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."  From these experiments  M. Serres concluded, that the liquid
furnished  by M. Gannal,  permitted  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 operative  surgery.   For  his dis-
covery the  Institute of France awarded M. Gannal the grand Mon-
thyon prize of 1600 dollars, which was established  for  the  discovery
of any means calculated to remedy the unwholesomeness 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 or dead-house, where  suspicions of murder required an un-
usual retention of the body above ground.1
   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 solution of chloride
of sodium and other salts,—being equally liable to incrustations, so as
to require a change or renewal of the solution.
1 Harlan, Appendix to Gannal, Op. cit. p. 254. 
AMMONLE PHOSPHAS.
91
  The salts of alumina have been used in this city with the view of tem-
porarily preserving the  dead;  and a case has been published in which
the acetate was employed; but the corrosive chloride of mercury was
used along with it, which was  unnecessary.   In the afternoon of the
day on which  the individual died, the abdominal  aorta was injected
upwards and downwards with  the saturated solution of corrosive chlo-
ride in alcohol; and on  the following day, a saturated solution of ace-
tate of alumina was thrown in, "which," says Dr.  Sharpless,1  "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 putre-
faction in the dead body; but they might be used with eminent ad-
vantage 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 applications.3  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 ot fetid discharges from the vagina.3  After handling patho-
logical specimens, the  author  has found a saturated solution of the
Bait remove the offensive  odour from his hands more speedily and ef-
fectually than any other antiseptic.
                  XII. AMMO'NLE PHOSPHAS.

Syxoxtmes.  Ammonium Phosphoricum, Phosphate of Ammonia.
French.  Phosphate d'Ammoniaque.
German.  Phosphorsaures Ammonium.
   Phosphate of ammonia has been recommended in some of the unoffi-
cial pharmacopoeias and formularies, as an excitant, diaphoretic and
discutient;4 but it could scarcely be said to be employed in medicine,
when it was  brought forward by Dr. Thomas Buckler, of Baltimore,
on chemical considerations, as "a new  remedy for gout and rheuma-
tism, as a solvent of uric acid calculus, and  for diseases, acute and
chronic, connected directly with the lit hie acid diathesis."s

        F'             METHOD OF PREPARING.
   Neutral phosphate of ammonia may be made by saturating a some-
what  concentrated solution of phosphoric acid with ammonia, applying
heat,  and setting the  solution aside, that crystals may form.   Or, it
may be formed by saturating the excess of acid in superphosphate of
lime by carbonate of ammonia.  Phosphate of lime will be precipitated,

  1 Medical Examiner, Aug. 13,1842, p. 513.
  1 J. Pennypacker, Med. Ex., April 1, 1843, p. 63.
  »Ibid. May 27, 1843, p. 112.
  * Morat and De Lens, Diet. Univ. de Mat. Med., &c, _dit. de Bruxelles, 1,115. Brux-
elles, 1838.         6 American Journal of Medical Sciences, Jan., 1846, p. 108. 
92
AMMONIJE PHOSPHAS.
 and phosphate of ammonia obtained in solution, which, being concen-
 trated by a gentle heat, affords, on cooling, the salt in crystals.

                     EFFECTS ON THE ECONOMY.
   From the facts of the frequent existence of lithuria in gout and rheu-
 matism, and the sudden elimination of  uric acid, and  that when  che-
 mists 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 continuously, but in a  state of combination  with
 soda or lime, or both.  The predominance of lithic acid in the urine, he
 considers, generally  heralds recovery from an attack of gout or rheu-
 matism.   "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 sub-
 sequent  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 sufficient doses to answer the end with-
 out 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  remarkably  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
 spda floating in the  round of the circulation, instead of  being depo-
 sited, as it  were, like an alluvial  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 white tissues, of long standing, dis-
 appeared under its continued use;  that it was decidedly serviceable in
 attacks of gout and acute rheumatism, and  that in many  old hospital
cases of chronic rheumatism,  the patients, without a single  excep-
tion, 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 
AMMONL-B PHOSPHAS.
93
for dissolving uric acid calculus; 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 am-
monia in the cases in question.   It is proper also to remark  that, ac-
cording to the analysis of Berzelius, this salt exists  in  the  urine  in
health, and we have no reason to believe that it is not present in gouty
and rheumatic diseases also.  Moreover, although there may be gene-
rally  a predominance of uric acid in the urine, in gout and rheumatism,
it is by no means clear that these diseases are dependent on  contami-
nation of the blood with undischarged urea and uric acid, as has been
maintained by many.1   " Several considerations," say Messrs. Ballard
and  (i arrod2—able  chemists—" prevent our subscribing fully to this
doctrine, which we are not aware to be established upon aught but hypo-
thetical grounds."  Phosphatic deposits are frequently, indeed, observed
in conjunction with  gouty affections, and in many instances, it would
seem, that tophaceous concretions contain no urate of soda, but in its
6tead phosphate of lime.   In numerous cases of gout the phosphatic
predominance is indeed marked.3   Keller,4 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."
   M. Mattei5 of Bastia, has  published some cases which appeared to
him to exhibit the valuable agency of the phosphate in gout and rheu-
matism in the  dose of about 30 grains; and  Dr.  S.  Edwards,6 confirms
its advantages in diseases which appear to  depend upon the presence
of an excess  of lithic acid or lithates in the blood.  In chronic articular
rheumatism, it appeared to be  especially beneficial.   As a solvent or
lithic calculi his experience does not enable him to pronounce upon it,
but his observations  led him  to depose positively as to its powers to
arrest the increase and perhaps the formation of them.   In lithic acid
gravel, he has frequently used it; and  experience has taught him, that
it creates a very rapid decrease and disappearance of the red crystal-
line  sediment.   Subsequently,7  he published his farther  experience.
He had used it, he says, in almost every variety of gout and  rheuma-
ti-sin,  and nearly always with the most beneficial results.  He had fre-
quently warded off  attacks of gout by its early employment.  Before
using it, he generally gave a cathartic; and in acute articular rheuma-

   1 Williams, Principles of Medicine, Amer. edit, by Clymer, p. 131.  Philad. 1844.
   2 Elements of Mat. Med. and Therap., p. 352.   Lond. 1845.
   s A. Ure, Provincial Med. and Surg. Journal, Feb. 11, 1843; and Braithwaite's Retro-
spect,  vii. 47.   Lond. 1843.
   * Liebig's Animal Chemistry, Amer. edit., p. 315.  Cambridge, 1842.
   5 Revue Medico-Chirurgicale, Dec, 1847.
   6 Provincial Med. Journal, Nov. 17, 1847; and Amer. Journ. of the Med. Sciences, Jan.
1, 1848, p. 5239.           7 Amer. Journ. of the Med. Sciences, Oct. 1850, p. 496. 
94
AMMONIiE PHOSPHAS.
 tism, adopted  the usual general and  local treatment.  Dr. Edwards
 had  given it in fifteen cases, and in none had symptoms of heart af-
 fection exhibited themselves.  He had found it of great use in subduing
 the swellings which so  frequently occur after gout, and spoke highly
 of its powers of preventing chalkstones, as well as of arresting them
 when forming.  In some few  cases of  gout, he had used a lotion of it
 with good and soothing effects, especially when a  concretion of urate
 of soda appeared to be forming.
   Sufficient  time has elapsed  for experiments to have  been made on a
 great scale, to test the qualities of the  phosphatic salt  in the cases de-
 scribed 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 can believe that it could have exerted
 any efficacy  in the manner suggested.  So far as the phosphate of am-
 monia 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,Mn the dose of only about three grains, a series  of alarming and
 highly irritative phenomena succeeded, caused, he thinks, by the vio-
 lently 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,2 of the United
 States Naval Hospital, New York, states that  he  has  employed phos-
 phate of ammonia in nine cases in doses of ten grains, repeated 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 prescribed, 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
 dul any amelioration occur in the  symptoms after  the  use of the salt;
 but whether this was owing to  it he could not decide.   Inasmuch, how-
 ever, as no perceptible effects  were induced in any of the other cases,
 his impression was  that the phosphate is useless  in the treatment of
 chronic rheumatism.
   Since then, Dr. H. Hartshorne, resident physician  at the Pennsyl-
 vania Hospital,3 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 ve-
ratria ointment, &c.  These, Dr. Hartshorne  considers, may perhaps
 claim much of the credit of the cures, which were mostly very slow.
 lhe 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.

  1 Med. Examiner, May, 1846, p. !<>89.              2 tu-j  t    -.oa^ «,-,
  3 Ibid. July, 1846, p. 397; aAnuwy, 1849, p. 49.    ^' ^ lM6'^ 
AQUA AMYGDALARUM CONCENTRATA.
95
                     MODE OF ADMINISTRATION.
  The dose of phosphate of ammonia is from ten to twenty grains,
which may be given, dissolved in water, three times a day.
                    XIII. ANTHRAKO'KALI.1
 Synonyme.  Lithanthrakokali.
  German.  Steinkolenkali.
  This article was first proposed by Polya, of Pesth, in the year 1837.
                                                     «
                      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 slacked lime as will separate the
potassa.   The solution thus  obtained  contains  only caustic potassa.
The filtered liquor is placed on the fire in an iron vessel, and suffered
to evaporate until neither froth nor effervescence occurs, and the li-
quid 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 mix-
ture  is stirred and removed 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 sulphur
must be mixed accurately with the coal, and the mixture be dissolved
in the potassa as directed above.

                effects on the econom? in disease.
  Polya affirms, that anthrakokali exerts its influence on the skin ge-
nerally, and especially on chronic cutaneous affections.   It has  also
been given beneficially by Felsach in scrofula  and chronic rheuma-
tism.
   The dose of the simple and sulphuretted preparations is 10 centi-
grammes (gr. iss.) three times a day.
   M. Gibert employs  it externally in chronic cutaneous affections,  in
the form  of ointment,  which may be made of one dram of the anthra-
kokali to from one to three ounces of lard.2

   Fuligokali is an analogous substance.
         XIV.  AQUA AMYGDALA'RUM  CONCENTRATA.
  Synoxymes.  Aqua Amygdalarum Amararum, Water of Bitter Almonds.
  French.  Eau d'Amandes Ameres.
  German.  Bittermandelwasser.

  The water  of bitter almonds has been received into many of the mo-

  1 From ar.paj, avAQaxoc, 'coal,' and kali, 'potassa.'  See MM. Jacobovics, in Gazette
Medicale de Paris, Nos. 9 and 12; and  Riecke, Die  neuern, Arzneimittel, u. s. w. 2te
Auflage, S. 37, Stuttgart,l 810; also, Duhamel, American Journal of Pharmacy, Jan., 1843-
  3 Aschenbrenner, Die Neueren Arzneimittel, u. s. w., S.23, Erlangen, 1848. 
96
AQUA AMYGDALARUM CONCENTRATA.
dern Pharmacopoeias;—into those of Bavaria, Paris, Ferrara, Hano-
ver, Hesse, and Prussia, for example.
                                              ■
                      METHOD of  preparing.
   The Pharmacopoeia of Prussia directs it to be prepared in the follow-
ing manner;—Take two pounds of bitter almonds, bruise 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 vessel, 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 cherry laurel water;  and Jorg,  from hia
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 ex-
tolled by Hufeland for its  uniformity.   Its effect is entirely  like that
of 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 dissolved in water,  and mixed with  emulsion of
sweet almonds;  as  the remedy, prepared fresh  every time when it is
to be  administered, will always possess the same composition.   Seven-
teen grains  of amygdalin  yield one of anhydrous  hydrocyanic acid;
consequently,  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 solution of
one grain of amygdalin in  three fluidounces of  emulsion of sweet al-
monds contains, consequently,  one grain of medicinal  acid  in every
fluidounce of the mixture.1
   Water of bitter almonds  has been used by Dr. Hodgkin9 as a means
of allaying distressing itching, as in prurigo senilis.   In some cases,
it produced immediately a beneficial  effect; in others, it was of no
benefit, and caused smarting and irritation.  Mr. May keeps a solution
of oil of bitter almonds in  the proportion  of one part to seven of alco-
hol. _  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.

  1 Ranking's Half-yearly Abstract of the Medical Sciences, pt. ii., vol. 1, p. 346. Amer.
edit.  New York, 1846.                               '      *
  2 Pharmaceutical Transactions,  Sept., 1841; and Amer. Journ.  of Pharmacy, Jan. 1842, 
AQUA BINELLII.
97
                      XV. AQUA BINEL'LII.
Synonym cs. Aqua Balsarhica Arterialis.
Italian. Acqua Binelli, Acqua Balsamica Arteriale.
French. Kau de Binelli.
German. Binellisches Wasser.

  Many years ago, this Italian nostrum was vaunted throughout Europe
as a styptic in  every kind  of hemorrhage, both when employed inter-
nally and externally.  By several Italian physicians—Cotugno, Anto-
nucci, Santoro  and others—it was found highly serviceable; and Von
Grafe1 thought that he had observed good effects from it.   This opinion
was confirmed  by the  observations of Kosch, Vrolik, Metzger,2  and
Lesser.   Subsequently, however, not  only Von  Grafe,  but Simon,3
Dieffenbach,4 and Dr. John Davy5 found that it was not possessed of
more efficacy than simple  cold water.6  This hsemastatic received its
name, Acqua Binellii, 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,—longitudinally, obliquely,
and 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
these experiments, the liquid was tried on man, and with seeming ad-
vantage; but it was soon found, that the results were not owing  to any
properties of the liquid, but rather to the  cold, moisture, and  appro-
priate pressure.
   The author has given at length in another work7 the results  of the
experiments  and observations of Dr. Davy.  They convey interesting
information as  regards  the physiology, pathology, and therapeutics Of
wounded  vessels, and impart  a useful lesson to the inquirer,—not to
deduce  inferences from inadequate data, without having investigated
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

  1 Griife's Journal, Bd. xvii. S. 650.                    2 Ibid. Bd. xxvii.
  3 Horn's Archiv. 1833, Sept. und Oct. S. 926.
  * Hecker's Literarische Annalen, 1S33, S. 486.
  5 Edinb. Med. and Surg. Journ., July, 1833, or Researches, Physiological and Anatomi-
cal, Amer. Med. Library edit., p. 379.  Philad., 1840.
  6 E. Griife, Art. Kreosot, in Encyclop'ad. Worterbuch der Medicin. Wissensch. Bd. xx.
8. 536.  Berlin, 1S3«).
  7 General Therapeutics and Mat. Med. 5th edit. ii. 119.  Philad. 1853.
       7 
98
AQUA BINELLII.
 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 artery.
   At the meeting of the British Association in 1839, Dr. Macartney,
 of Dublin,1 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  amputation of the
 hand of a child, the  stump was  dressed with lint  kept wet with cold
 water, and in which no ligature  was  applied  or required.   This, Dr.
 Macartney believed to be the first case on  record in which amputation
 had been performed without the  application of a ligature.
   The Acqua Binelli is 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 phenomena.

   M. Bouchardat2 gives the following complex formula for the Ac qua
 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 cala-
 mus  aromaticus, bistort,  consolida officinalis, and tormentilla—each
 250 parts;  oak bark, log  wood,  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;  bcdsamide, 250 parts; Cyprus nuts, 1000 parts;
 white agaric and black pitch, of each 500  parts.  All the ingredients
 must be cut into small fragments, and be macerated in a sufficient quan-
 tity of  water for twenty-four hours.   When  the liquid is wholly ab-
 sorbed, 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.
   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 co-
 agulates albumen.  It is also employed internally in the various  pro-
flu via.
   A substitute for the Acqua Binelli, prepared by Professor Schultz,
 is the following.3

  i London Athensum, Aug. 31, 1839, or Med. Intelligencer, Oct. 15,1839, p. 217.
  2 Annuaire de Tlrrapeutique, kc, pour 1843, p.227. Paris, 1813.  Also an article by
 him on various modern haemastatics in Annuaire de Therap. pour 1853, p. 191.
  3 Bouchardat, p. 229.                                     1 
AQUA BROCCHIERII.
                   Aqua  Binellii  factitia
                    Factitious Acqua Binelli.
                   R.   01. empyreumat. tabaci f ,~ij.
                          animal. Dippel. gtt. xij.
                       Aq. destillat. f ^viij.  M.
Used externally only.
                    XVI.  AQUA BROCCHIE'MI.
 Synonymks. Brocchieri, or Brocchiari Water.
 Italian. Acqua Brocchieri.
 French. Eau de Brocchieri ou Styptique de Brocchieri.
 German. Brocchierisches Wasser.

   This water strikingly resembles the Binelli water, both in sensible
 properties and action; and the same discordance of sentiment in regard
 to its virtues has existed  amongst observers.  It was largely used in
 Paris upwards of twenty  years  ago;  and the profession generally ap-
 pear to have decided at that time that it was devoid of efficacy.   Dr.
 Paris1 examined it, but it appeared to him  to be nothing more  than
 water perfumed by some vegetable 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 fif-
 teen  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 gentle-
 men of that establishment, I made a very careful experiment upon an
 ass without the least effect."
   A few years ago, a gentleman who had visited Paris  brought it over
 to this country, and it was again subjected to various trials, and whilst
 some, deposed  most strongly to its potency as  a hoemastatic, 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,2 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.3  These last gen-
 tlemen thought it certain, that it arrests hemorrhage in a most marked
manner, without either being styptic  or cauterizing in its action.  They

  1 Pharmacologia, Amer. edit, from the 9th London edit, by Lee, p. 122.  New York
 IS i 1.
  2 Boston Medical and Surgical Journal, Jan. 14, 1846,  p. 480.
  3 See the No. for March, 1846, p. 158. 
100                     AQUA BROCCHIERII.
considered that both it and ergotin " operate by a peculiar action upon
the blood, or upon the walls of the artery.   In the case of the Broc-
chieri water, nothing decisive is yet known, although it instated, that
the caliber of the artery is restored to its natural integrity:"—and they
add:—"The composition of this water is unknown.   It is colourless;
of very slight acid reaction, very little taste, and this npt astringent.
Its odour is  aromatic, and the  only idea we are yet capable of form-
ing 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,1 after having experimented
farther with the Brocchieri water, as well as with ergotin and creasote,
they  arrive  at the following conclusions:—First. When Brocchieri
water, ergotin, or a watery emulsion of creosote  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 arrested or not.   If it be placed immedi-,
ately upon the orifice of the cut vessel, the success is certain; if, how-
ever,  the vessel shrink from contact with  the lint, the animal is
almost certain  to bleed to death.   Secondly.  By 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. The sheep is an unfit animal
to try the haemastatic powers  of substances  as regards the human  sub-
ject; 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,  sus-
tained with a little pressure immediately upon the wound  in the vessel,
the hemorrhage 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 ex-
 periments is dependent upon the formation of a clot around the opening,
 and  in  the  cavity of the vessel, it ought,  therefore, to  happen more
 readily  in  them than in man."  Fourthly  and lastly; they conclude,
 that if the  hasmastatic virtues of the agents, which they employed, are
 to be correctly ascertained, it is only by experiments on the human
 subject; and no value, they think, should  be given to those made in
1 Ibid. July, 1846, p. 406. 
AQUA BROCCHIERII.
101
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 no-
tice are:—wound on the hand;  oozing for some time after the opera-
tion for hydrocele; oozing from a tumour on the back,—tried with Broc-
chieri water.  In the first case  there seemed to be  no effect; in the
last two 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 ligature of vessels being supplanted by it.
   Professor Mott, in a clinical lecture delivered on the 10th of January,
1846,l has the following remarks:—" I 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 experiments were strong  and healthy sheep, upon
whose carotid arteries we operated, and we found that  its  power to
stop hemorrhage was next to nothing, and where the bleeding was ar-
rested, it was principally from the pressure made by the large quantities
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 useful 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 hsemoptysis,  are  equally non-
existent."
   The Acqua Brocchieri was brought to the notice of the Medico-Chi-
rurgical Society of Louisiana, at its sitting in March, 1846, by a com-
munication from one of the venders of the nostrum, accompanied by
some bottles of the article, with the request that the Society would
examine and report upon its styptic powers.  The Society, on the
ground  that it would be setting  a bad precedent, declined the propo-
sition.  Several of the  members, however, determined to avail them-
selves of the earliest opportunity to test  its properties, and Dr. A.
Mercier has published the result of his experiments.2  After detailing
two cases of wounds, on which  it was used as a  hoemastatic, he re-
marks:—"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,  rec-
tum, &c, &c, which are so common in this country."
       1 New York Medical and Surgical Reporter.
       - New Orleans .Medical and Surgical Journal, May, 1846,  p. 816. 
102
AQUA BROCCHIERII.
   With  the  same view of testing  the virtues of  this famous fancied
haemastatic, the author's friend  and colleague, Professor Mutter, in
the presence of the late Dr. Kearney of the United States Navy, Dr.
King  of the  Army, Dr. J. 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 ap-
plied, the hemorrhage  ceased in  the course of ten, fifteen, or twenty
minutes;  and  the sheep,  recovering speedily from  its prostration,
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 crea-
sote, tincture of chloride of iron, oil of turpentine, &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  medicatrix natures,
Dr. Wallace divided completely 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 the others.  When the vessel
was partially divided, so as to prevent contraction and retraction, death
speedily  ensued."
   It is proper  to add, that the first experiments  of Drs. 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 minds,
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,1 appointed to investi-
gate the  qualities  of the Acqua Brocchieri, reported, as the results of
their  experiments, First, that it  has no  power of  coagulating 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 accom-
plish 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.  The committee are of opinion, that
the true  and only cause of the arrest of hemorrhage in their experi-
ments, " 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 possessed of the
hsemastatic virtues that have been ascribed to it.
1 American Journal of the Med. Sciences, July, 1846, p. 146. 
AQUA BROCCHIERII.
103
  According to M. Martius,1 Brocchieri water may be made as fol-
lows :—Macerate for twelve hours pine wood (bois de sapin) cut  small
and bruised, in double its weight of water.  Then distil until a pro-
duct 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 separated.   Before using the
water it is necessary to shake it.
  M. Deschamps has proposed the  following substitute for it.  Take of
turpentine, 500 parts; water 600 parts.  Boil for a quarter of an hour,2
then add a sufficient quantity of water to obtain 1000 parts of turpen-
tine and water.   Let it  become cold, and filter.

  Another haemastatic water, under the name Eau hemastatique de
Tisserand, has been experimented with in Paris, and M. Fremy, Interne
at the  Hotel Dieu, reports  several cases in its favour.   M. Becamier
has also  used it, and considers it to be possessed of the same proper-
ties as the Acqua Brocchieri: he esteems it to be even more  advanta-
geous, and affirms that he has succeeded with it in  cases of hsemopty-
sis, intestinal hemorrhage,  and dysentery.  The following formula is
given by M. Bouchardat3  for a haemastatic water which may be sub-
stituted for  the Eau hemastaticjue de Tisserand.
                 R. Sanguin. Dracon.
                    Terebinth (des Vosges,) aa ^iij.
                     Aqua. Oij.
   Digest for twelve hours, and filter.

   More  recently, a new haemastatic  has been  introduced, under  the
name of Eau de Pagliari, which, according to M. Sedillot,4 has the re-
markable property of completely coagulating the blood.   He  gives  the
following formula  for its  preparation, which, he  says, was communi-
cated to him by its inventor.   Take of  Benzoin (Baume de Benzoin,)
250 grammes. (Iviiss.) Sulphate of Alumina and Potassa, 500 grammes
(ixv.)  Water, 5 litres, (Oxss.)   Boil  the whole  for  six hours  in a var-
nished pot,  agitating constantly the resinous  mass, and replacing  the
water as it evaporates, by hot water,  so  that the ebullition may not be
interrupted.  The  liquor is then  filtered, and  kept in glass vessels,
well closed.
   The haemastatic water, thus prepared, is limpid;  of the colour of
Champagne wine;  of  a slightly styptic taste, and  a sweet,  aromatic
odour.  If it be evaporated, it  leaves a transparent deposit  adherent
to the sides of the vessel.
   M. Hepp  substituted white rosin for the benzoin in the preparation
of the Eau  Pagliari, and  obtained a liquid  possessed of exactly the
same power of coagulating blood.

  1 L'Abeille M.dicale, Fevrier, 1846, p. 54.
  2 Bouchardat, Nouveau Formulaire Magistral, 3e _dit. p. 291.  Paris, 1845.
  » Op* cit.
  * Annuaire de Th.rap. de Bouchardat, pour 1S53, p. 199.  This article contains for-
mulae for many of the haemastatic waters. 
104
AQUA PICIS LIQUIDS.
   i

                 XVII. AQUA PICIS LIQ'UID_E.
Synonymes. Aqua Picis seu Picea, Infusum Picis Liquidae seu Picis Empyreuma-
  ticse Liquidse, Potio Picea, Tar Water.
French. Eau de Goudron.
German. Theerwasser.
   This preparation, at one time so much  extolled, and recommended,
on the authority of  the celebrated Bishop  Berkeley, but which had al-
most fallen into total disuse,  has been revived, more especially since
it has been found to contain creasote.  It was first employed exten-
sively in England about the middle  of the  last century, and was drunk
not simply as a therapeutic, but as a prophylactic agent, so that Riecke
facetiously remarks, almost as much tar  water was  consumed  by the
inhabitants of London, as beer and other drinks.1
   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 ul-
timately  neglected  it altogether.   Still, formulae for its  preparation
exist in many Pharmacopoeias—in  those  of  Dublin, Bavaria, Bruns-
wick, Paris, Russia, Saxony,  Sweden, and Wirtemberg, for example.
   Water takes up  from tar a small portion of acetic acid, creasote,
and resinous matter.   Tar water was formerly much praised as a re-
medy in pulmonary consumption, and as  a diuretic; its virtues, how-
ever,  appear to rest almost wholly  on the contained creasote.  Some
years ago, Arnheimer, of Duisburg, recalled the attention of practi-
tioners to it as a  remedy in many chronic cutaneous affections, espe-
cially of the herpetic kind;  and asserted, that he found no remedial
agent more valuable  when its  use was persevered in  for one or two
months to the extent of a pint  or two daily.  Arnheimer  directed pa-
tients 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 mix-
ture 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 generally 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 sub-
sided, filter the liquid, and keep it in well closed jars.
   Since the discovery of creasote, tar water  has  received fresh consi-
deration, 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 it in chronic catarrh, and in different  stages
of phthisis.2   The number of cases reported by him is twenty-three;
of these seven were of chronic catarrh, in which creasote was  given:
            1 Die  neuern Arzneimittel, S. 38. Stuttgart, 1837.
            2 Gazette Medicate de Paris, No. 45,  Nov. 5, 1836. 
AQUA PICIS LIQUID-E.
105
generally the cough was mitigated by it, but in two no effect was pro-
duced 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  dys-
pnoea ceased: in  others, it continued; and in the same  number  of
cases the pain in the breast was relieved.   As  to its effects on the di-
gestive 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 exhi-
bited no influence on an existing diarrhoea, whilst in two others  it ap-
peared to diminish  the number of the evacuations.  In two, it excited
vomiting, and commonly 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. Petre-
quin obtained the following results.   Although, in one  instance,  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, creasote excited burning in  the epigas-
trium 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 aug-
mented.   Four other cases were  of advanced phthisis.   In most,  the
cough was more  or  less improved,—never  increased; the oppression
remained much the same, but in  one case it became more severe.  As
regards the  effects upon the digestive organs, they were much the same
as in the first class of cases.   The improvement in one case was  insig-
nificant ; 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 ap-
peared to act beneficially on  vomiting which accompanied the cough.
The appetite was improved, and in one case diarrhoea seemed  to  be
diminished, whilst in two others existing constipation yielded during its
use.  In all the cases, sleep was restored.   On the urinary secretion
it exerted no influence, and it neither excited thirst nor nausea like
creasote.  In  three cases of incipient phthisis, its  action was more
beneficial than that of creasote.  The cough was always ameliorated,
the expectoration facilitated or diminished,  and the dyspnoea and tho-
racic pain relieved.   In one case, it seemed to act favourably on ac-
companying emesis, and in another to quench thirst.   It excited or im-
proved  the  appetite, and aided  digestion.   In one case of advanced
phthisis, the alleviation produced by tar water was beyond all expecta-
tion, but in another the disease had proceeded so far that it was wholly
unsuccessful. 
106
ARGENTI PR/EPARATA.
   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 question.1   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 expectorants  are
found to be serviceable.   The same has been the fact in the former dis-
ease ; but farther than this no advantage has accrued from its admini-
stration.
   In a  French periodical,2 some cases are  published from the records
of the hospitals for  1829 and 1830, during the attendance of the late
Professor Dupuytren, in which injections of tar water were successfully
administered in catarrhus vesicse, along with the use of pills of turpen-
tine.  The tar water was made by infusing in  the cold for a night, a
pound of tar in ten pounds of spring  water, filtering and warming  the
solution before using it.   Large quantities of this were injected through
an elastic  gum  catheter, which was forthwith withdrawn and the  pa-
tient directed to retain the injection as long as possible.   The injection
was  repeated daily, and Venice turpentine was administered internally
in the form of pill.  A successful case has also been published by M.
Petite
   A syrup of tar may be made by  dissolving  sugar in tar water.4
                 XVIII. ARGEN'TI PR_EPARA'TA.
Synonymes. 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.   The
attention of physicians has, however, been directed to the internal use
of many of those preparations, and especially by M. Serre,5 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
that time, there was an unusual number of syphilitic patients in the
wards, of which the most severe and appropriate were selected for treat-
ment by the preparations of silver—the chloride, cyanuret, and iodide.
Trials  were also made  with divided metalHc silver, oxide  of silver and
chloride of ammonia and silver.  At first they were administered iatra-
leiptically; the chloride,  the cyanuret, and the iodide in the quantity

  1 Deslandes, Diet, de Medec. et de Chirurgie Prat. xi. 233.
  2 La Lancette Francaise, 8 Avril, 1837.
  3 Presse Medicale Beige, and Bouchardat, Annuaire de Therap. pour 1853, p. 111.
  * Soubeiran, Journal de Pharmacie, Janvier, 1842, p. 70.
  5 Bulletin General  de Therapeutique^ 1836. 
ARGENTI PR-EPARATA.
107
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 result-
ing.   The  other preparations were also increased  in the same propor-
tion, with the exception of the chloride of silver and  ammonia, which
requires more precaution than any of the other preparations.   M. Serre
did not restrict himself to the iatraleiptic administration of these sub-
stances, but  employed them internally in the form of pill, and exter-
nally as local applications.
  M. Serre describes several cases of syphilis in which the preparations
of silver were administered.   The first patient was a soldier, 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 circular  ulceration, five or six  lines
in diameter.   After a few days' rest, and the use  of baths, M. Serre
ordered the chloride of silver in friction on the tongue in the quantity
of one twelfth of a grain.   The ulcers were treated with simple cerate
(ceratum Q-aleni) spread on lint.   After the second rubbing, the patient
experienced violent colicky pains, which were not severe enough, how-
ever, to induce a discontinuance of the remedy.   Scarcely had a grain
of the chloride been employed, when the  secretion from the ulcerated
parts became less; the surface of the chancres lost the kind of grayish
border which they possessed, and cicatrization proceeded rapidly.   The
frictions were continued, and the condition  of the patient  went on im-
proving.   At the end of two months, he left the hospital.   In the five
subsequent cases, the same plan of treatment was pursued.   The chlo-
ride was used exclusively according to the  iatraleiptic method.   The
symptoms were various; in addition  to chancres, there was in one  case
a suppurating bubo; in another syphilitic vegetations  at the margin of
the anus;  and in a  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  often caused  by mercury.   Se-
condly.  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
bed-clothes, &c.  Thirdly. Patients can  be treated by them in secret
as well as when travelling, without fear of detection.  Fourthly.  The 
108
ARGENTI CHLORIDUM.
preparations of gold  are to be preferred in these respects; but gold
has the disadvantage of exciting  too  much, and cannot, therefore, be
exhibited to those of  a nervous and impressible temperament, or who
have weak and delicate chests.  In such cases the preparations of silver
merit the preference.   Fifthly.  The  preparations of silver  are much
cheaper than those of gold, and are, therefore,  more available in prac-
tice amongst the poor, and in large hospitals; and, moreover, they are
more  easily prepared, which is a consideration  of some moment as re-
gards the pharmaciens of small towns.   Sixthly, and lastly.  There are
cases in which mercurial and gold preparations fail,  and where prepa-
rations of silver might be of advantage.
  The observation of others  has not  confirmed the assertions  of  M.
Serre.  M. Ricord1 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 ven-
tured 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.2
                  XIX.  ARGEN'TI CHLO'RIDUM.
Synonym es. Argentum Muriaticum  seu Salitum seu Chloratum, Chloruretum Ar-
  genti, Chloride, Chloruret, or Muriate of Silver.
French.  Chlorure d'Argent.
German. Salzsaures Silber,  Chlorsilber, Hornsilber, Silberchlorur.

  Chloride of silver is prepared by the decomposition of a solution of
nitrate of silver by an excess of a solution of chloride of sodium.   The
resulting product or 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 possible.
  Chloride of silver, prepared in this way, is of a white colour, devoid of
taste, and not soluble in water, but soluble in ammonia.   In  the light
it speedily changes, especially when much divided, or when moist; and
assumes a somewhat dark  violet hue, as  the chlorine is given off.   It
suffers no decomposition when united with vegetable matters.   It must
be dried and kept protected from the  light.  Its uses have  been re-
ferred to under the head of the preparations of silver.3
  As nitrate of  silver  is probably always  converted into  chloride of
silver by meeting with the chlorohydric acid in the stomach, it occurred
to Dr. Perry,4 at the time  resident physician of the Philadelphia Hos-
pital, to administer  the chloride, which he  did with advantage in  epi-

  1 J. J. L. Rattier, La Lancette  Francaise, No. 122, Oct. 13,1836.
  2 W. P. Johnson, Medical Examiner, Nov. 23,1839, p. 743.
  3 On the mode of forming the  various preparations of silver, see Chamou,  in Bulletin
General de Therapeutique, No. xvi. Aug. 30,1836.
  4 American Medical Library and Intelligencer, Feb., 1841. 
ARGENTI ET AMMONLE CHLORIDUM.
109
lepsy,  chronic  dysentery,  chronic  diarrhoea, and  other  affections  in
which nitrate of silver is prescribed internally.  Twelve grains given
daily for three  months produced no unpleasant symptoms; and in no
case did discoloration of the skin succeed.  In epilepsy, three grains,
given four or five times  a day, produced effects similar to those of ni-
trate of silver,  but more marked.   In chronic dysentery, half a grain
to three grains, taken three times a day, produced  immediate diminu-
tion in  the number of the  evacuations, and relieved the  tormina; in-
ducing, at the same time, an improvement in the character of the stools
and other symptoms.   Similar testimony is afforded  by Kopp, and
others.   The author has very frequently prescribed the chloride; and
on the whole it has appeared to him to be equal to  the nitrate of silver
in the cases mentioned by Dr. Perry.
   It has been affirmed 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. 111.)
                     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.
          XX. ARGEN'TI ET AMMO'NI_E CHLO'RIDUM.
Synonymes. Argentum Muriaticum Ammoniatum, Chloruretum Argenti et Ammo-
  niae, 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, when we saturate, by the aid of heat,
liquid ammonia, with freshly precipitated and carefully washed chlo-
ride of silver.  The operation must be accomplished  at such a degree
of heat, that the fluid shall boil once;  for if the boiling be continued a
few moments, and in the open air, no crystals will be deposited on cool-
ing.   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 pecu-
liar smell of  ammonia, and a burning, almost caustic, taste.  In the
air, it gradually exhales ammonia, and acquires all  the properties of
simple chloride of silver, without,  however, losing the form of  the ori-
ginal composition.  If  the  crystals be kept in the ammonia in which
they were formed, they do not experience the slightest change in their
colour from the influence  of light.  When treated with distilled water,
the chloride  is decomposed.   A  portion  saturated with  ammonia  is
again dissolved; yet a much greater portion remains undissolved; this 
110
ARGENTI CYANURETUM.
 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 been used with advantage by
 Serre in cases of syphilis.
   Another preparation, Liquor argenti muriatici ammoniati, 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 pra.cipi.au-
 dum.  Pr__cipitatum sedulo ablutum solve in liquoris ammon. caust. §iss.: adde acidi
 muriatici giij. vel q. s. ut praacipitatio evitetur et argentum muriaticum  in statu solu-
 tionis permaneat.   Pondus fluidi filtrati aequale sit unciis duabus cum dimidi-,.1

   This preparation is transparent;  but, under  the effect  of light, it
 suffers black flakes to be deposited.   It is therefore necessary to pre-
 serve it in small bottles, painted black, in a dark place.   In using it,
 acid substances  should be avoided.
   Kopp found the liquor argenti muriatici ammoniati of great efficacy
in St. Vitus''s dance.   It may be given to children of about ten years
 of age, morning, noon  and  night, in doses  of three drops, gradually
raised to six, in a spoonful of distilled water.

               Pilulae argenti et ammoniae chloridi.
                 Pills of chloride of silver and ammonia.
          R.   Argent, et ammon. chlorid. gr. j.
              Irid. florent. pulv. gr. ij.
          Conserva. flor. tiliae q. s. ut fiat massa in pilulas xiv. dividenda.
   For external use.                                           Serre.
                  XXI. ARGEN'TI CYANURE'TUM.
Synonymes. Argenti Cyanidum, Argentum Cyanogenatum seu Cyanicum seu Hydro-
  cyanicum, Cyanuretum Argenti, Cyanide or Cyanuret of Silver.
French. Cyanure d:Argent.
German. Blaustoffsifber, Cyansilber, Cyansaures Silberoxyd
   The following formula for this preparation is given in the last edition
of the Pharmacopoeia of the United States, (1851.)   Take of nitrate of
silver, ferro-cyanuret of potassium,  each  |ij., sulphuric acid, ziss.,
distilled water, a sufficient quantity.   Dissolve the nitrate in a  pint of
distilled water, and pour the solution  into a tubulated retort previously
adapted to the receiver.  Having mixed the  sulphuric acid with four
fluidounces of distilled water,  add  the mixture to the solution in the
retort, and distil, by means of a sand-bath, with a  moderate heat, until

  i "Take of fused nitrate of silver, ten grains; distilled water, two ounces :-Into the
Zctr PfnnUv^lr°HP ^"^o a solution of chloride of sodium to precipitate.  Dissolve
W Lm/nf^hed PreciP',ate ln 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 so ution   ThP  w^iaKt nf tv,_ ah ,. a a -a  u  11 \,     1
to two ounces and a half."    soumon-  x ne  w eig" of the filtered fluid should be equal 
ARGENTI IODIDUM.
Ill
six fluidounces pass over, or until  the liquid that passes produces no
longer a precipitate in the receiver.  Finally, wash the precipitate
with distilled  water, and dry it.
  Messrs. Glassford and Napier affirm, that the best way of  obtaining
cyanuret of silver  is, to add cyanuret of potassium  to a solution  of
nitrate of silver, so long as a precipitate is formed.1
  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
light.  It experiences no decomposition when mixed with neutral vege-
table matters.
  From experiments made by Dr. Letheby,2 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 intro-
duction into the system, no other ill effects follow: but if it be adminis-
tered in a moist state, it is then capable of being absorbed and perhaps
decomposed, "for an albuminous solution 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 con-
vulsions, always coma, paralysis, a peculiar sighing respiration, a flut-
tering, irregular, and tumultuous  action of the heart,  and it ultimately
kills by a gradual exhaustion of the involuntary 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.
                   XXII. ARGEN'TI IO'DIDUM.
Synonymies. Argentum Iodatum, Ioduretum Argenti; Iodide or Ioduret of Silver.
French. Iodure d'Argent.
German. Iodsilber, Silberiodiir.

  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 it is im-
portant, that only so  much  of the  reagent should be added as is neces-
sary for the complete  decomposition of the salt of silver.   A surplus of
the iodide of potassium 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

       i Dispensatory of the United States, 10th edit. p. 896.  Philad.  1854.
       3 London  Med. Gaz. Jan. 9, Feb. 4 and 17, 1845. 
112                      ARGENTI OXIDUM.
the action of light and air, of a deeper yellow.  It has no taste, and is
neither soluble in water nor ammonia.   The latter property serves to
distinguish it from the chloride and the cyanuret  of the same  metal.
Like the chloride, the iodide must be kept in a dry dark place.   Neu-
tral vegetable substances appear to exert no action upon it.   Its  pro-
perties 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 decided efficacy  in hooping-cough......
   It has been already remarked  that a combination  with iodine  is said
to  prevent the  discoloration  apt to  be induced by nitrate of silver.1
The following form for this purpose is given by Dr. Patterson:—

               Pilulae  argenti iodidi compositae-
                   Compound pills of iodide of silver.
                R. Argenti iodid.
                   Potassa? nitrat. aa gr. x.
              Tere simul ut fiat pulvis subtil.; dein adde.
                   Glycyrrhiz. pulv. 3ss.
                   Sacchar. 9j.
                   Mucilag. acacia, q. s.ut fiant pil. xl.
   Dose.—One, three times a day.
                   XXIII.  ARGEN'TI OXTDUM.
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 solution
of nitrate of silver.  The alkaline fluid must be  added in excess, and
the oxide, which is the product of the decomposition, 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 in the last edition of  the Phar-
macopoeia of the United States,  (1851.)
   Take of nitrate of silver, 5iv.; distilled water, Oss.; solution of po-
tassa, Oiss,  or a sufficient quantity.   Dissolve the nitrate in the water,
and to the solution add the solution of potassa so long as it produces a
precipitate.  Wash the precipitate repeatedly with water until the wash-
ings are nearly tasteless.  Lastly;  dry the  powder, and keep it in a
well stopped bottle, protected  from the light.
   In the state of hydrate,  the oxide is black;  when anhydrous, it ap-
pears 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.
        1 Patterson,  Dublin Medical Press, Aug. 25,1842, and April 19,1843. 
ARGENTI OXIDUM.
113
   This preparation, which was also recommended by M. Serre, has been
used by Van Mons in syphilis.1
   Dr. Lane2—under  the idea, that nitrate of  silver is always  decom-
posed  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 administered the oxide of silver,
and with  advantage,  in diseases of the uterine system, in which there
is undue secretion and great irritation.  He gave it for two months, at
intervals, without the  slightest tendency to discoloration; and Dr. Gold-
ing Bird has prescribed it for four months without any bad effects.   Dr.
Lane found it very beneficial in half-grain doses, twice a day, in car-
diulgia and pyrosis; gastrodynia; irritability of the stomach, accom-
panied by gnawing and  constant  pain, nausea, &c.  It seemed, like-
wise, to be beneficial  in uterine hemorrhage, both in the impregnated
and unimpregnated state.
   Dr.  Lane3 gives the oxide  to subdue undue secretion, whether of a
sanguineous or  other character.  In epistaxis and hsemoptysis,  espe-
cially when they occur in chlorotic females; and in the profuse puru-
lent 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 internally and  externally.  In  cases of
irritable ulcer, its  action is highly beneficial; and he thinks it decidedly
preferable to the nitrate, when  the stimulant caustic action of the lat-
ter is not required.   In external forms of ophthalmia, an ointment, of
the strength of a dram to the ounce, often exerts a rapid influence.   In
ulceration of the cornea, with thickening and congestion of the eyelids,
it has proved highly  beneficial.   The ointment 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 sus-
pend its administration for  a few days every month.
   Sir James Eyre4 found the oxide uniformly  successful in curing py-
rosis;  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 hsematemesis and  hsemoptysis: he
does not,  however, restrict himself to the oxide, but  assists it by bleed-
ing, blistering, and other means.   Having found the remedy much su-
perior to all other agents during an active professional 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, hcema-
temesi.s, 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 leucorrhoea.5
  1 Riecke, Op. cit. S. 440.            2 London Lancet, July 10,1841.
  3 Lond. Med. Gaz., April, 1846, p. 640.
  4 Dublin Journal of the  Med. Sciences, May, 1845; and in Practical Remarks on some
exhausting Diseases, 2d edit. Lond. 1851; and The Stomach and its Difficulties. Lond. 18_2.
  6 See AUnatt, Lond. Med. Gazette, May 2, 1845.
       8 
114                    ARGENTUM DIYISUM.
  Dr. Thweatt1 confirms the observations of Dr. Lane and Sir Jas.
Eyre as to the advantages to be derived from it in menorrhagia.   He
goes, indeed, much farther; and, whilst he does  not pretend to claim
for it the appellation of a specific, he "is persuaded that, cseteris pari-
bus, all that is claimed for mercury in syphilis, or quinine in intermittent
fever, can be claimed for the oxide of silver in menorrhagia in its dif-
ferent forms."!   He considers it best adapted for those forms of me-
norrhagia which depend  on an undue excitation of  the uterine organs,
unaccompanied by high inflammatory action.
  Mr. Whittel2 speaks highly of the oxide in taenia, but he had used it
in two  cases only, and in these, other remedies had been employed.
  The  ordinary dose of the oxide is half a  grain  three times a day.
Dr. Thweatt combines it  with a small quantity of opium or morphia.

                   Unguentum oxidi argenti.
                     Ointment of oxide of silver.
               R. Argent, oxid. gr. xx.
                  Adipis ^j. Misce 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.
                  XXIV. 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 limatum,
which agree with it in chemical relations, had been administered many
years before, in  cases of intermittent fever, by Dr. Meyer  of Biicke-
burg.3                                                 '
  Notwithstanding the testimony adduced in its favour, it is probably
wholly inert, or exerts but a mechanical agency.

  The  Hyposulphite  of Soda  and Silver is referred to elsewhere.

  1 Amer. Journ. of the Med. Sciences, July, 1849, p 69
Phila^!1.11'1 Pr°vincial Journal> cited in ^king's Abstract, xii. 66. Amer. edit.
  3 Riecke, Op. cit. S. 436. 
ARGILLA PURA.
115
                     XXV.  ARGIL'LA PURA.
Synonymies. Alumina Pura, Oxidum Aluminii, Terra Aluminosa Pura, Terra Alumi-
  nis, Terra Bolaris seu Argillacea Pura seu Depurata seu Hydrata, Pure Argil or
  Alumina.
French. Alumine Factice.
German. Reine Thonerde; reine Alaunerde;  gereinigte Alaunerde oder
  Thonerde.
  This substance was  known in olden times by the names Armenian
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 employed in hemorrhage,
diarrhoea and dysentery, phthisis, poisoned 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.
   The purest argil is prepared by drying sulphate of alumina and am-
monia, and exposing it for 20 or 25  minutes to a red heat in a cru-
cible : the sulphuric acid  and ammonia  are driven off, and the argil
remains behind in the form of a white powder.   Formerly, it was pre-
pared by dissolving alum in water, and precipitating the argil from
the solution by means of carbonate of potassa or of soda, or by potassa.
It is affirmed, however, that generally, more or less sulphuric acid re-
mains with the earth, so that it requires to be purified  by repeated
washing, until there is 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 peculiar 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  at-
 tended with predominance of acidity; and it was in such cases extolled
 by Ficinus and Seiler.1   According  to  the former, it merits a prefe-
 rence over all other absorbents, inasmuch as it forms astringent salts
 with acids.  He found it  especially useful in diarrhoea and dysentery,
 particularly in children.   Seiler recommends it in the vomiting of  in-
fants, which is usually accompanied 'by  acidity, and  in the diarrhoea
 of older children.   Neumann 2 found it successful in checking diarrhoea,
 which neither starch glyster, nor opium, nor any other therapeutical
 agent had succeeded in diminishing.  He made a mixture of two drams
 of arqil, and four ounces of a decoction of logwood, and administered it
 to children by the tea-spoonful.   Weese3 also employed it  successfully

   1 Zeitschrift fiir Natur-und Heilkunde der Dresdner Professoren, B. 1,  H. 1, S. 82.
   2 Bemerkungen iiber die gebriiuchlichsten Arzneimittel, von Dr. Karl George Neumann,
 8. 55. Berlin, 1840.            3 Rust's Magazin, B. xii. H. 2, S. 247. 
116
ARNICA.
in several cases of infantile  diarrhoea where there  we# evidently a
predominance of acid.   One of the latest encomiasts of argil a depu-
rata is Durr, who,  for several  years,  administered it in the diarrhoea
and cholera of infants, and found it highly efficacious.    _
   The chemical reasons, urged by Ficinus and others, merit attention.
The article is worthy of employment in affections of the intestinal tube,
in which astringents are indicated.  The 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 compound must possess  astringent
properties.
                     MODE OF ADMINISTRATION.
   The dose, in  the 24 hours, for a very young child, is from 5ss. to
3j.; for older children, from 3j. to 3ij.   Small doses are of little or no
avail.  The vehicle is commonly  an emulsion.
   The following forms are given  by Riecke.1—
                        Mistura argillae-
                          Mixture of argil.
               R.  Emuls.  sem. papav. (ex gss. parat.) giiiss.
                   Argillae  pura, 9ij.
                   Syrup. althaea, f gss.  M.
   D0Se.—A teaspoonful to a child two years old affected with diarrhoea.
               R.  Argill. pur. ^ss.
                   Acaciae  3j.
                   Sacch. 3_j.
                   Aq. fcenicul. f ^iij.  M.
   Dose.—The same as the last to a child one year old.
               R.  Emuls.  oleos. cum vitell. ovor. parat. |j.
                   Syrup, alth. f §j.
                   Argill. depurat. 3ss»
                   Aq. cinnarn. simpl. f 3j-
                   Extract, conii gr. ij.  M.
   Dose.—The same as the last two to a  child three months old, affected
with cholera infantum.                                       Durr.
                         XXVI. AR'NICA.
Synonymes. Arnica Montana seu Plauensis, Doronicum Germanicum, Panacea Lap-
  sorum, Ptarmica Montana, Caltha Alpina, Calendula Alpina, Narda Celtica Altera,
  Doronicum Plantaginis Folio, Leopard's Bane.
French. Arnique, Tabac ou Betoine des Savoyards, Tabac de Montagne, Doronic
  d'Allemagne, Tabac des Yosges.
German. Wohlverlei, Fallkraut.
  This plant, which belongs, in the sexual system, to Syngenesia poly-
gamia superflua, and to the natural order  Compositae Synantherea., is
in the secondary list of the pharmacopoeia of the United States, but it
is not much used in this country; nor does there appear to be any clear
1 Die neuern Arzneimittel, S. 41.  Stuttgart, 1837. 
ARSENIAS AMMONLB.
117
appreciation of the cases for which it is adapted.1   Such, too, appears
to be the sentiment of  the French practitioners.   "It may be conclu-
ded," say MM. Merat and De Lens,2 "that we have as yet insufficient
data to pronounce positively on the  affections in which arnica can be
unequivocally efficacious; we must, consequently, always bear in mind
its heating and active qualities when we prescribe it."
  According to Sir George Lefevre,3 the Germans class arnica among
sacred remedies; and its virtues are extolled throughout two pages of
the Pharmacopoeia Ruthensis.   Sir George was much 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 sensi-
ble results.
  In Germany, the flowers and root are much employed in paralysis, as
an excitant to the nervous system; and it is chiefly to introduce the vo-
latile oil—the oleum sethereumfilorum arnicse, Germ. Wohlyerleiol,
Aetherisches  Wohlverleiblumenol,—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 results of the apoplectic condition.
He himself  often administered  it with evident success; the  paralytic
limbs becoming warmer, more  active, and  more serviceable  under its
use.   He  recommends it  also in indurations, especially of the abdo-
men.4   He mixes four drops of arnica oil with half an ounce of spiritus
setheris sulphurici compositus or spiritus setheris  nitrici, and  of this
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 elseosaccharum.5
  A tincture of arnica, made by digesting about two ounces of the flowers,
in a pint of diluted alcohol, for four days, has been, of late years, much
used as a local application in rheumatic and other pains.   Dr. Wood8
states, that it  has recently come into  use in this country, as a domestic
remedy in sprains, bruises, $-c.   It is, however, largely employed also
by many practitioners,  who place great confidence  in  it as  a  topical
narcotic.
                 XXVIL—ARSENTAS AMMO'NIJE.
Synoxymes. Ammonium Arsenicum seu Arsenicicum, Arseniate of Ammonia.
French. Arseniate d'Ammoniaque.
German. Arseniksaures Ammonium, Arseniksaures  Ammoniak.

   This preparation of arsenic has been highly recommended, since the
year  1818, by Biett, in several cutaneous  diseases, and  especially in
psoriasis inveterata.7

  1 Wood, in Dispensatory of the United States, by Wood and Bache, Art. Arnica.
  2 Dictionnaire Universelle de Matiere Medicale, &c. i. 423.  Paris, 1829.
  8 An Apology for the Nerves, p. 292.  Lond. 1844.
  4 Aschenbrenner, Die neueren Arzneimittel, v. s. w.  Erlangen, 1848.
  s Riecke, Die neuern Arzneimittel, v. s. w. S. 337.  Stuttgart, 1837.
  6 Dispensatory of the United States, 10th edit. p. 120.  Philad. 18">4.
  7 Cazenave, in  Diet, de M6d. 2de 6dit. iv. 33; and Cazenave  and Schedel's Practical
Synopsis of Cutaneous Diseases, translated by R. E. Griffith.  Philad. 1829. 
118
ARSENIAS AMMONL-3.
                      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 sufficient to
saturate the acid;—or, as follows:—Take of arsenious acid, one part;
nitric acid, four parts, muriatic acid, half a  part; saturate 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, tljat have been
received into the Pharmacopoeias.   Arsenious acid itself, as well  as
arsenite of potassa and arseniate of soda—the officinal solution
of  the former well known every where under the name of " Fowler's
Solution;" that of the latter known, in continental Europe especially,
under the name of "Aqua Arsenicalis Pearsonii" or Solution de Pear
son—are possessed of precisely the same properties as arseniate of am-
monia, and, like it, have been found equally efficacious in obstinate dis-
eases  of the skin.  Nor is the knowledge of the agency of arsenical
preparations in cutaneous affections new.  In India, the efficacy of arse-
nic in those diseases has been long known: and, in Europe, attention was
directed to it by Fowler,1 and Girdlestone,2 and subsequently by  Wil-
lan,3 Pearson,4 and others; but no one administered the arsenical pre-
parations more extensively in these  diseases than Biett and Rayer  of
Paris, whose situations afforded them ample opportunities for testing
the virtues of the  different articles of the Materia Medica in skin com-
plaints.  They succeeded by  means  of the arsenical preparations,
and especially of  the one now under consideration, in removing seve-
ral  inveterate affections of the skin,  that had resisted every other re-
medy.  The author has found equally beneficial results from this prac-
tice in his  own  experience.   All chronic  cutaneous diseases are de-
pendent upon an  alteration in  the functions of the  capillary vessels,
and system of nutrition of the part affected; and there appear to be but
two ways in  which these can be reached, so that a new action may be
impressed upon them;—in the one case, through the medium of the ge-
neral circulation; and, in the other,  through the agency of topical ap-
plications, made to come in contact  with the diseased surface.  Arse-
nic,—like iodine, mercury in small doses, and certain other alteratives,
—acts in the former way, modifying, after a protracted exhibition, the
fluid of the circulation, in such manner, that it makes an altered im-
pression on the system of nutrition,  and breaks in upon  the diseased
catenation.   In no case, however, has he observed these salutary ef-

  1 Medical Reports.   London, 1786.
  2 Essays on the Hepatitis, &c, of India. London, 1787.
  1 Description and Treatment of Cutaneous Diseases.   London, 1798.
 _ * Observations on the Effects of various Articles of the Materia Medica in the Venereal
Disease, 2d edit. London, 1807. 
ARSENICI IODIDUM.
119
fects, until 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.
                 XXVin. ARSENTCI IO'DIDUM.
Synonymes. Arsenici Teriodidum, Ioduretum Arsenici, Arsenicum Iodatum, Hydri-
  odas Arsenici, Iodide, Teriodide, or Hydriodate of Arsenic.
French.  Iodure a" Arsenic.
German. Iodarsenik, Arsenikiodiir,  Iodarsen.
   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.
   A formula for its  preparation has been  introduced  into  the  last
edition of the  Pharmacopoeia of the United States, (1851.)  It is pre-
pared  as follows: Take of Arsenic, a dram, Iodine, five drams.  Rub
the arsenic in a mortar until reduced to a very  fine powder, free from
metallic lustre; then add the iodine, and rub them together till they
are thoroughly mixed.  Put the  mixture into  a small flask, or a  test
tube, loosely stopped,  and heat it very  gently until  liquefaction  oc-
curs.   Then incline the vessel in different directions, in order that any
portion of the iodine,  which may have condensed on its inner surface,
may be returned into  the fused mass.  Lastly,  pour the melted iodide
on a porcelain slab, and when it is cold, break  it into pieces, and put
it into a bottle, which is to be well stopped.
   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  solution, and white crystalline scales, composed of water,
acid, and iodine in  variable proportions.1

                     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 poison-
ous  a  substance.    Dr. Blake2 twice injected solutions, containing
each six grains of this substance,  into the jugular vein of a dog, with-
out producing the  slightest appreciable  effect  on the  heart.   On in-
jecting a solution containing fifteen grains, the  action of the heart was
immediately arrested.
   Professor A. T. Thomson has employed it in  several cases  of lepra
and impetigo, with  very great  success.3   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 o-rain, as symptoms  of poisoning came  on, and  the medicine had to
be given in  diminished doses.

     1  A. Duhamel, American  Journal of Pharmacy, October, 1840, p.  187.
     2  Edinburgh Medical and Surgical Journal, April, 1839, p. 336.
     3  Lancet, Jan. 19, 1839, p. 621. 
120
ARSENICI IODIDUM.
   Dr. Neligan's1 experience leads him to place more reliance on the
 iodide, in these  and similar chronic cutaneous affections, than on
 any other preparation of arsenic; but although he found it alone ca-
 pable of curing many cases  of psoriasis and lepra, he considers that
 its beneficial action is much augmented by combining  it with iodide of
 potassium and iodine.
   It has been  given with sucoess  in a case of cancerous disease of the
 breast, by Dr.  F. C. Crane.2  The dose was an eighth of a grain, which
 was reduced to  one-twelfth, and gradually increased to a third  of a
 grain, beyond  which it could not be borne.   In a  case of inveterate
tlepra vulgaris, it was carried to  the extent  of  one grain for a dose,
 with the most  decided curative effects.
   Biett has  frequently applied an ointment of it in cases of phagedenic
 tuberculous cutaneous diseases.3

                     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  qualities, and prevents it
 from exciting  too powerfully the mucous membrane  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 mer-
 cury, and has  been much, and successfully,  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.4

                   Unguentum  arsenici  iodidi.
                     Ointment of  iodide of arsenic.
                   R. Arsenic, iodid. gr. iij.
                      Adipis gj.  M.
                                                            Biett.
  _ An extemporaneous preparation, which is considered to combine the
 virtues of both arsenic and iodine, is said to have been employed suc-
 cessfully in Philadelphia.5  It is formed as follows:
                   R.  Liquor, iodin. compos, f ^j.
                      ------potassae arsenit. fgiv.   M.
   When mixed together in these  proportions, a  change is  observed in
 the appearance of the mixture, which  is instantaneously rendered al-
 most colourless.   The dose is five drops.

  1 Dublin Quarterly Journal of Med. Science, Nov. 1849.      2 Lancet, Aug. 31,1839.
  3 See Ballard  and Garrod, Elements of Mat. Med. &c, p. 387  Lond 1845
  * Lond. Med. Gaz., May 12, 1843.
  5 A. Duhamel, Amer. Journ. of Pharmacy, Oct. 1849, p. 187. 
ARTEMISIA VULGARIS.
121
                r XXIX. ARTEMISTA VULGARIS.
Synonyme. Mugwort.
French. Armoise Commune.
German. Beifuss, Gemeiner  Beifuss.

  Almost all  the species belonging to the genus  artemisia are pos-
sessed of bitter and aromatic properties, and several afford (iwormseed."
Artemisia vulgaris was employed by many of the older physicians, but
it had fallen  into oblivion, when its use was revived in  Germany, by
Burdach, a physician at Triebel, near Sorace,1 who recommended it
strongly  as  a preventive of  epilepsy.  Since  that time, it has been
much prescribed in that country, but its employment has not extended
much to  other  countries of Europe, or to this side of  the Atlantic.
The root is the part  preferred:—formerly the herb and  the tops were
solely used.   The root  was employed in epilepsy,  centuries  ago, but
it had been neglected, or was only exhibited as a nostrum, when Bur-
dach entered upon his investigation, of which the following is a sum-
mary.
  ' The root  of  the artemisia should be  dug up in  autumn, after the
stalk has become dry, or in the spring before the  stalk has  shot up;
but  perhaps the  latter  half of November is as good a period as any.
It must be freed from  the adherent  earth by shaking.   Burdach re-
gards 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 (fibrillce,) 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  brittle they must be carefully pre-
served.   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 required  for drying them varies: in moist weather, it
may be 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 efficacious.   The smell of the
well  dried root  is very strong, pungent and  peculiar, especially when
we open a vessel  in which it  has been stored away in quantity.   The
taste is sweetish, sharp  and nauseous.

                 1 Hufeland's Journal, B.  lviii. St. 4 und 5. 
122
ARTEMISIA VULGARIS.
               EFFECTS ON THE ECONOMY IN DISEASE.
  It has been already remarked, that Burdach1 recommends 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 prevents; but if  this be im-
practicable, 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 diaphoresis—care being taken that he does not
expose himself to cold.  This course is to be repeated so long as there
are any traces of mischief.  When the remedy, however, acts favoura-
bly, 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 succinatus, (spiritus
ammonise succinatus,) in an infusion of serpentaria, valerian root and
arnica  flowers; but the effect, he says, was always better when the dia-
phoresis 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 maybe 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 mitigating 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 artemisia es-
pecially well.   It is equally efficacious in the epileptic attacks of young
females from twelve  to fifteen years of age, and prior to the  establish-
ment of menstruation.  Under its use, the  catamenia have  generally
taken place, and the epilepsy has disappeared.   On the other hand, it
was  found to aggravate cases of epilepsy occurring as  a disease of
growth, (Entwickelungskrankheit,) in young  persons from se-
venteen to  twenty-two years old, and as a consequence of great corpo-
real  development.   It was  equally unfortunate  in cases  of epilepsia
nocturna, where the paroxysms came on  irregularly at an interval of
about five,  ten, or  fifteen days, and generally about midnight;  as well
as in that form in  which,—after the patient had suffered for six, seven,
or eight weeks, under violent symptomatic sweats,—a morbid condition
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.2  The

       1 Casper's Wochenschrift, Oct. 22, 1836, S. 675.
       2 Riecke, Die  neuern Arzneimittel, u. s. w. S. 49.  Stuttgart, 1837. 
ARTEMISIA VULGARIS.
123
number of his experiments and observations was considerable, and the
results appear to have been  frequently most happy, especially in the
case of females, who seem to have exhibited themselves more benefi-
cially impressed by the  remedy than males; the  proportion of  cures
being as three to two.  Tosetti1 gives the proportion of cases in women
and children to that of men, as eight to six.
   In the Berlin Charit§, artemisia is said to have been used with  equal
success.   The German journals contain numerous cases, on the autho-
rity of E. Grafe,2 Wagner,3 Van Maanen,4 Wolff,5 Osann, Bonorden,6
Schluter, Bird,7 Lowenhard,8 Geis,9 and others.10  But few physicians,
according  to Riecke, have been  disappointed  in  it, and, where they
have, he ascribes the failure  to its having been given in cases for which
it was  inappropriate, or to the preparation of the artemisia not having
been properly attended to.,11
   In consequence of a German physician having recommended  Arte-
misia  absinthium to Professor A. T. Thomson, Dr. Elliotson12 was in-
duced  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 occurring 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, 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 ef-
fective as the powder.
   Besides epilepsy,  artemisia has been used with advantage  in  other
diseases, as in St.  Vitus's  dance.13 Wutzer employed it successfully in
the convulsive diseases of childhood, and it was recommended by  Bier-
mann14 in eclampsia infantum, occurring during the period of dentition.
He  advised it to be given to children in gradually increasing  doses,
commencing with half a grain; and giving, an hour afterwards, a grain,
and, in two hours, two grains, which is usually the last dose required.
The gradual augmentation of the dose he considers advisable "to pre-
vent the crisis which the artemisia induces from being too turbulent!"
Kolreutter, of  Carlsruhe, administered artemisia in  different diseases,
with great success.  He prefers the extractum  resinosum radicis arte-
misise  vulgaris,—German, Biefusswurzelextract, 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-

  1 Diss, inaug. de Radice Artemis, vulg. remed. antiepilept.  Berolin. 1827; and Osann
in Art. Artemisia, Encyc. AVorterb.  iii. 313.  Berlin, 1829.
  2 Griife und Walther's Journal, B. vi. H. 2.      3 Hufeland's Journal, lix. S. 6.
  * Ibid. lxi. 5.                  5 Ibid. lxii. 3.                  « Ibid. lx. 1.
  * Ibid. lxv. 3.                 8 Ibid. lxv. 3.                 9 Ibid. lxv. 3.
  10 Richter's Specielle Therapie, B. x. S. 377.  Berlin, 1828.
  11 Op. cit. S. 49.                 12 Lancet, July 9, 1836.
  13 Gittermann in Hufeland's Journal, lxii. 1.  Bonorden, Op.  cit.
  » Riecke, Op. cit. S.  50. 
121
ARTEMISIA VULGARIS.
ware vessel, until it has attained the consistence of an extract.  Kol-
reutter employed this advantageously in the eclampsia of children, (in
certain cases after the application of leeches;) in tormina, unaccompa-
nied by inflammation; in the diarrhoea of children and adults; in spo-
radic cases of cholera morbus, and in dysentery, after the bloody evacu-
ations had ceased; in gastric fevers, on their assuming a nervous cha-
racter ; 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 3j.; to small  children, a few
grains.  Neumeister has spoken of its good effects when combined with
assafoetida in chorea^ and in the somnambulism  of children.1
   Such is the chief testimony adduced in favour of artemisia by the
German writers mainly.  It is to be feared, that the advantages  to be
derived from it in epilepsy have been exaggerated.  Where there is no
organic disease  of the encephalon,  substances,  which like it, are nau-
seous, bitter  and  aromatic,  may be productive of advantage as tonics
and revellents.   In one case of this nature it was employed by the au-
thor, but the results were not striking.   When  aided by other means
and appliances,  it appears to be powerfully diaphoretic;  and, doubtless,
therefore, in appropriate cases, especially where there is much nervous
impressibility, it may be productive of the good effects ascribed to it
by Burdach, Kolreutter, and others.  Yet, as Osann  has remarked,2
it must be improper where polysemia, or a tendency to active hyperemia,
is present.  The analysis of Hergt, Hummel, and Janike afforded, along
with traces of volatile oil, some balsamic resin, both of which are  exci-
tants to the living economy.

                    MODE  OF  ADMINISTRATION.
   The following forms for its administration have been adopted by
some of the German authorities: —

                       Tinctura artemisiae.
                         Tincture of mugwort.
                 R.  Artemis, vulg. rad. concis. ^v.
                     Alcohol, dilut. Oij.  M.
   Digest for three days; express  and filter.  Dose,—half a dram to
two drams, four or five times a day, in epilepsy.
                                                   Rademacher.3
                      Decoctum Artemisiae.
                        Decoction of mugwort.
             R.  Artemis, vulg. rad. concis. §j.
                     Coque cum aquae q. s. per semihoram
                     ad. colat. Oj.
   Half a tea-cup full of this may be taken every two  hours, in cases
of epilepsy.                                          Hildenbrand.

  i Journal fur Kinderkrankheiten, Jan. and Feb., 1851;'and Edinb. Monthly Journal
of Med. Sciences, Nov. 1851, p. 480.
  2 Art. Artemisia in Encyc. Worterb. iii. 313.  Berlin, 1829
  3 Aschenbrenner, Die neuern Arzneimittel, v. s. w. S. 37.  Erlangen, 1848. 
ATROPIA.
125
                        Pulvis artemisiae.
                        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.                                   Lowenstein.
                       Mistura artemisiae.
                        Mixture of mugwort.
                R.  Ext. artemis. vulg. alcoholic, gr. iv.
                    Acaciae 9j.
                    Sacch. sjiij.
                    Mist, amygd. f ^iij.
  A coffee-spoonful1 to be given every half hour in eclampsia infantum.
The dose may be gradually raised to two  coffee-spoonfuls.  Kolreutter.
                         XXX. ATROPIA.
Synonymes. Atropina, Atropium, Atropinum, Atropine.
French. Atropine.
German. Atropin.
  This is the active principle of Atropa belladonna, and was discovered
many years ago in the  leaves by Brandes.   To it is probably owing
the whole of the medicinal efficacy of the plant.   In 1825, M. Pauquy
found it  in the root, and affirms, that he detected it also in the stalks
of datura, hyoscyamus, and solanum.2

                      METHOD OF PREPARING.
  The most approved processes for  extracting this alkaloid, according
to Dr.  Pereira,3 are those of Mein and Richter.   The process of Mein
is contained in the Pharm. Central-Blatt for 1833.   The following
is given  in the United States Dispensatory,4 from the Journal de Phar-
macie, 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 86 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 :
the copious precipitate which now forms is separated by filtering; and
diluted sulphuric acid is added, drop by drop, to the filtered liquor till
slightly  in excess.   The sulphate of lime having been separated by a
new filtration, the  alcoholic liquor  is distilled to  one half, then mixed
with six or eight parts of pure water, and  evaporated with a gentle
heat till the whole of the  alcohol is driven off.  The residual liquid is

  1 About two ordinary tea-spoonfuls.
  3 M.;rat  and De Lens, Diet. Universel de Mat. M.d., Art. Atropine.  Bruxelles, 1838.
  s Elements of Mat. Med. and Therap. 3d Amer. edit. ii. 479. Philad. 1854.
  ♦ Tenth  edition, p. 141.  Philad. 1854. 
126
ATROPIA.
filtered, cautiously evaporated to one-third, and allowed  to cool.  A
concentrated aqueous solution of carbonate of potassa is then gradually
added, so long as the liquid continues to be rendered turbid, and the
mixture is afterwards  suffered to rest some hours.  A yellowish resi-
nous  substance, which opposes the crystallization of the atropia, is
thus precipitated.  From this the liquid is carefully decanted, and  a
small additional quantity of the  solution of the carbonate is dropped
into it, till it no longer becomes  turbid.   A gelatinous mass now gra-
dually forms, which, at the end of twelve or twenty-four hours, is agi-
tated, in order to separate the mother waters,  then thrown upon a fil-
ter, and  dried by folds  of  unsized paper.  The  substance thus ob-
tained, which is atropia in an impure state, is dissolved, in five times
its weight of alcohol;  and the solution, having been filtered, is mixed
with six or eight times its bulk of water.   The liquor soon  becomes
milky, or is rendered so by evaporating the excess of alcohol, and, in
the course of twelve or twenty-four hours, deposits the atropia in the
form of light yellow crystals, which are  rendered entirely pure and co-
lourless  by washing with a few drops  of water, drying on blotting
paper, and again treating with alcohol,  as before.
  By  this  process, Mein  obtained, from  twelve ounces of the root,
twenty grains of pure alkali—according to the authors of the  Dispen-
satory;—not quite twelve grains, according .to Dr.  Pereira.1
  Atropia crystallizes in transparent silky prisms, is  devoid of odour,
and is soluble in alcohol and  ether; very slightly so in water.   It dis-
solves in  acids, with which it unites to form salts.  At a temperature
of 212° it is volatilized.
  As atropia is an expensive article, and therefore very liable to adul-
teration,  Mr. Donovan,2 to  insure its purity, advises  that a dram of
commercial atropia be dissolved in an ounce of alcohol.   If there be a
residuum, it must be separated;  and  six ounces of distilled water  be
added, shaking  the mixture.   No change appears  at first;  but  after
twelve or eighteen hours, the atropia crystallizes in beautiful stellated
groups, which adhere  to the sides of the vessel.  These,  after pouring
off the liquor, must be collected  on bibulous paper, and dried.

                      EFFECTS ON THE ECONOMY.
  Atropia is a most virulent poison.  A fatal case is recorded by Dr.
James Andrew,3 in which  about fds of  a grain produced death in  a
young woman 21 years of age.
  When given to dogs and cats, it  causes vomiting, -dilatation of the
pupil, stupor and death.  A  tenth of a  grain produced, on man, mani-
festly poisonous phenomena.   When Brandes applied a  "minimum"
quantity  of the sulphate to  the tongue, headache, with alternate chills
and flushing, trembling, oppression of  breathing, and  weakness and
smallness of  the pulse supervened.4  An imponderable quantity, ap-

  'A process by M Rabourdin, of Orl.ans,  is given by M. Bouchardat in his Annuaire
de Therap.  pour 18ol, p. 6.
  I banking's Half-yearly Abstract, July to December, 1848, Amer. edit., p. 215.
  3 Edinb. Monthly Journal of Med. Science, Jan. 1852, p. 34.
  * Oesterlen, Handbuch der Heilmittellehre, S. 784.  Tubingen 1845 
ATROPIA.                          127
plied to the eye, occasions dilatation of the pupil.  Reisinger1 used it
for this purpose, dissolving a grain in two scruples of water;  and it
has been proposed by Mr. W. W. Cooper,2 surgeon to the North Lon-
don Ophthalmic Institution, and by M. Bouchardat,3 as a  substitute
for belladonna for dilating the pupil in  cases of cataract, &c.  Mr.
Cooper affirms that he has used it, with the greatest satisfaction, in a
considerable number  of  cases,—the proportions being  two grains of
atropia dissolved in  a dram of alcohol and seven drams of distilled
water.  A colourless  solution is the result, which—Mr.  Cooper affirms
—is equally efficacious in its action as,  and much more  elegant than,
the ordinary preparations  of  belladonna,—a full drop  placed in the
eye producing speedy and complete dilatation of the pupil in the gene-
rality of cases, although, in some instances, a stronger  solution may
be required.  He has never seen ill effects from its use, although  he
has  tried  it in the  proportion  of four grains to the ounce; but, he
 thinks, two grains will  be  found  to  answer every purpose.   Dr. Be-
thune,4 however, observed dizziness, and a sensation in  the mouth and
fauces, as  if belladonna had been taken in a large dose, following the
application of one or two drops of a solution of atropia (gr. iiss to f 2J.)
 to the eye of a stout, healthy woman.  Mr.  Cooper directs a drop to
be used night and morning, where he is desirous of keeping up the di-
latation of the pupil.  An objection, which  does not seem to be a very
forcible one, has been made to this preparation,—that it involves the
necessity for the addition of alcohol.  Mr. J. Lloyd Bullock5 proposes,
therefore,  to substitute the salts of atropia, which are neutral and so-
luble in distilled water.  Dr. Jacob 6 considers it more effective  and
convenient than any extract or tincture of belladonna.
   In experiments made with it by  Messrs.  Bouchardat  and Stuart
 Cooper,7 they found it, in the dose of a centigramme—(gr. .1543) pro-
 duce on man all the severe symptoms of the active solanaceae—as  de-
 lirium, coldness of the surface, syncope, depravation of sight, and apho-
 nia ; yet they consider it, owing to the facility of administering it and
 of regulating the dose, to be a most  valuable agent in every case in
 which belladonna and other solanaceae are beneficial;—in epilepsy, hal-
 lucinations, chorea, hysteria, tetanus, and even hydrophobia; neuralgia,
 rheumatism, to relieve the pain of cancer; as a preventive of scarlatina;
 in certain  cases of incontinence of urine, in asthma, hooping cough and
 in nervous bronchitis.   M. Bouchardat affirms, that it will render great
 service in ophthalmia accompanied by intense photophobia, and may be
 usefully employed for the removal of spasmodic contractions of different
 organs, as of the neck of the uterus, the anus, urethra, &c.
   M. Lusanna8 thinks the cases, most favourable for its employment,
 are  centric  or cerebral epilepsy,  neuralgia, chorea and  intermittent

   1 Aschenbrenner, Die neueren Arzneimittel, u. s. w. S. 41.  Erlangen, 1848.
   2 London Lancet, June 8, 1844.
   8 Annuaire de Therapeutique, &c, pour 1847, p.  19. Paris, 1847.
   * Amer. Journ.  of the Med. Sciences, Jan. 1855, p. 66.
   6 Lond. Lancet, June 15, 1841, p. 393.
   6 Dublin Medical Tress, cited in Med. Examiner,  October, 1848, p. 652.
   ' Bouchardat, Annuaire de Therapeutique, pour 1848, p. 10; and Ibid, pour 1849, p. .7.
Also, Ibid, pour 1851, p. 6.
   8 Bouchardat, Ibid, pour 1832, p. 38. 
128
AURI PRiEPARATA.
fever.   In the latter disease he has observed a marked effect from an
eighth and even the fourteenth of a grain; and half  a grain has often
been sufficient to cure the disease.   Dr. Langex also cured with it seve-
ral cases of epilepsy.   The dose was about the 100th part of a grain.[?]
   Its ordinary dose is about one-twelfth of a grain;  or it may be em-
ployed  endermically.
                        Tinctura atropiae.
          Tincture of atropia.  (Gouttes ou Teinture d'atropine.)
                 R.  Atropiae gr. xv.  (1  gramme.)
                     Alcohol. 85 per cent. 3x.  (40 grammes.) M.
   Dose—one to five drops.
                       Unguentum  atropiae.
              Ointment of atropia.   (Pommade d'atropine.)
                 R. Atropiae gr. iv. (25 centigr.)
                    Adipis 3j. and 9j. (5 grammes.)  M.
   The  size of a pin's head to be introduced, night  and morning, be-
tween the eyelids, in cases of adhesion of the iris to  the lens.
                                                     Bouchardat.%
   An ointment, composed of five grains of  atropia to three drams of
lard,  has been  used with advantage  in neuralgia.3  In four severe
cases, affecting  the trigeminal, brachial, and ischiatic nerves, in which
other remedies  had failed, M. L. Crosio,4 produced a speedy cure by
the external application of atropia.
   Atropia is so lethiferous, that  it has not been much employed in-
ternally.
   Of the employment of this and  other alkaloids combined with col-
lodion,  mention is made under  collodion.

   The  Valerianate of atropia has  been given by M. Michea,5 who
considers it a valuable remedy in many spasmodic or convulsive affec-
tions, and especially in epilepsy, hysteria, chorea, hooping cough  and
asthma.
                  XXXI.  AURI  PR_EPARA'TA.
Synonymes. Preparations of Gold.
French. Les Preparations d'Or, Les Composes Auriferes.
German. Goldpraparate.
   The administration of gold in medicine is not modern.  In the times
of alchemy, it was frequently used  in  nervous diseases, convulsions,
hypochondriasis, mental affections, profuse salivation, &c.  Paracelsus,
Horst, and Poterius recommended it, united with  corrosive sublimate,
in syphilis.  Its violent effects, however, brought it into discredit, and
during the decadency of alchemy it fell into entire disuse.6   It is pro-

  1 Schmidt's Jahrbuch. No. ix. 299; and Br. and For. Med. Chir. Oct. 1854, p. 561.
  2 Also, Cunier, in Bouchardat, Annuaire, pour 1848, p.  10. Paris, 1848.
  3 Brookes, Lancet, Jan. 30, 1847.         * Med. Times and Gazette, Aug. 30, 1853.
  D Bouchardat, Annuaire de Therap. 1854, p. 9.
  6 Richter's Specielle Therapie, x. 504, Berlin, 1828; and Nachet, Art. Or, in Diet, des
Sciences Medicales, torn, xxxvii. 
AURI PRiEPARATA.
129
 bable, too, that many preparations were brought forward as containing
 gold, which had  none of it, and this may partly account for the dis-
 credit into which it lapsed.1  M. J. A. Chrestien2 was the first who—
 in more modern periods, (about the year 1810,)—recalled the atten-
 tion of practitioners to the preparations of gold, and  after him many
 physicians employed them, so that the published results of their obser-
 vations have furnished us with a considerable amount of  evidence  in
 relation to their therapeutical properties, and they have, in consequence,
 been received into many of the modern pharmacopoeias.3
   As the different  preparations agree in their effects on the economy,
 it may be well to make a few observations which  apply to all.

                EFFECTS ON THE ECONOM? IN HEALTH.
   Orfila made many experiments  to  discover the action of the  pre-
 parations of gold  on animals.   Three dogs,  into whose jugular veins
 he injected a  small quantity of the chloride dissolved in water,  died
 speedily—death being preceded by difficulty and rattling in breathing,
 cough,  symptoms of suffocation and slight vomiting; these results su-
 pervening immediately after  the injection had entered the blood-ves-
 sels.   On dissection, the lungs were found livid, engorged with blood,
 and without any crepitating noise when cut into; wrinkled, discoloured,
 and scarcely lighter than water;  the  heart  was of a violet colour;
 the left auricle and ventricle full of black blood, and the right cavities
 empty and contracted.   The effect of  the salt supervened with such
 rapidity that the blood of the crural artery—which was opened a few
 minutes after  death—was  of a brownish red, almost black, colour.
 In two dogs, to which he gave the chloride, a torpid condition was in-
 duced, which terminated fatally in a couple of days.  The mucous mem-
 brane of the stomach was found inflamed and ulcerated.
   The effects on  man of agents so potent, in appropriate  doses, have
 been  investigated by many observers.  Experiments  on animals  had
 already exhibited the powerful influence which they are capable of ex-
 erting on the organs and functions of organic life.  One of the most
 striking effects is said  to  be, an increase  of the various secretions;
 commonly, the  urinary  secretion is largely augmented, as well as the
 transpiration, and the  intestinal  and salivary secretions.  Not unfre-
 quently, under the continued administration  of the gold, actual sali-
 vation ensues, which differs, however, from  that induced by mercury.
 It is  always slow in appearing, and is by no means so exhausting;
 nor do troublesome ulcers occur; and the saliva is thinner, and not so
 tenacious.   Like mercury, the preparations of gold occasion excitement
 in the organism, which often ends in a true febrile  condition.  After
 they have been taken for some  time in moderate  doses, there is gene-
 rally a feeling of increased warmth in the stomach, and an augmentation
 of the appetite.  The pulse is rendered  fuller and more  active,  and

  i Riecke, Die neuern Arzneimittel, S. 53.  Stuttgart, 1837.       _--,..   .
  2 Rccherches et Observations sur lesEffetsdes Preparations d'Or du Dr. Chrestien, &c.
Paris 1821.
  3 See Art. Gold, in Encyc. Wiirterb.  der Medicinisch. Wissenschaft. B. xv. S. 77.
Berlin, 1837.
[\ 
130
AURI PRiEPARATA.
the animal heat and vital  activity are augmented, so  that in such as
are predisposed to the affection, hemorrhage is apt to take place.   The
catamenia recur sooner than usual under their influence, and the quan-
tity lost may be greater.1   Sooner  or later, a regular attack of fever.
not unfrequently supervenes,—as indicated  by shivering, and pains
in the limbs, back, and stomach,—which may continue  for a few hours,
but sometimes lasts for days, and at length ends by sweating, deposi-
tions  in the urine, and occasionally by salivation.
   In  very large doses, certain of the preparations of  gold are corro-
sive poisons.   The symptoms, caused by their use, when  they act as
such,  are—oppression in the region  of the stomach; nausea, vomiting,
pains in  the abdomen and diaphragm,  a metallic taste in the mouth,
augmented  secretion of saliva, without the teeth  or gums being af-
fected, pulse excited, and  breathing oppressed.2   As  a general rule,
they are not esteemed proper for impressible individuals; on the other
hand, in persons of torpid constitutions, they would  appear to  have
exerted an excitant influence even on the generative system.  Certain
persons, according to  Chrestien  and Niel,  are not susceptible of this
action;  and, again, there are some, according to  Cullerier, junr.,  who
cannot tolerate them in any form.
   When too large a dose has been given, the remedy should be entirely
discontinued for some  time, or the dose  be diminished;  and the effects
will soon disappear.   One of the  greatest recommendations of gold  over
mercury,  in the eyes of  many, is that it does not act  so destructively
on the organism, and never induces such a cachectic condition as the
latter occasionally does.3

               EFFECTS ON THE  ECONOMY  IN DISEASE.
   The diseases, in which the preparations of gold have been  adminis-
tered, in modern times, are chiefly the following.
   Syphilis.— They have been occasionally used in primary sores, but
have  been mainly employed in  secondary  syphilis, especially in old
cases, where a  doubt often exists, whether more of  mercurial  cachexia
or of  syphilis be present.   They are given, also, where  there is a scro-
fulous complication, and where it is desirable to exhibit some  other re-
medy than mercury; and  lastly, their use is indicated  where mercury
has failed to remove syphilis.4  Many practitioners doubt  whether the
preparations of gold should be esteemed much inferior to those of  mer-
cury.   Numerous experiments instituted, amongst others, by Chrestien,5
Cullerier, junr.,6 S. L. Mitchill,7 Niel, Biett, Lallemand,8 Wendt,9 and
Legrand,10 have shown, that their employment has been most  advanta-
geous in the different forms of syphilis, and that they have rarely disap-
pointed expectation.   Alibert  found them especially useful  in syphilitic

  3 5tCLe'  nP" C-l*-1' ia                  ' Grotener, ™ R™t's Magazin, xxi. 3,
   Riecke,  Op. cit. S. 56.      4 Eber]e( Treati__ . n the -^ Medi ^ edH L 247.
  e ntt at V:  als°'Leitre,a M" Magendie sur les Preparations d'Or, &c. Paris, 1828.
  s Diet, des Sciences Medicales, Art. Or., torn, xxxvii
  * Dyckman's Dispensatory, p. _>()1, and Eberle,  Op  cit
   Journal Umversel des Sciences Medicales, t. xxvii
  9 Rust's Magazin, Bd. xvi. St.  1.
  10 Gazette  Medicale de Paris, Oct. 30, 1837. 
AURI PRiEPARATA.
131
 eruptions.  It must be borne  in mind, however, that when they are
 given in syphilis, their operation is slow, and that, in the first instance,
 the symptoms may appear aggravated:  they are not, therefore, adapt-
. ed for cases  in which it  is important to act speedily, so as to arrest
 the disease at once, and prevent its farther development.
    G-onorrhoea.—In protracted  casesl of gonorrhoea, several physicians
 have extolled the preparations  of gold; others, as Wendt and Ritter,
 have advised them  for the  sequelae of gonorrhoea (Trippernach-
 krankheiten:) it is not probable,  however, that they could be of
 much use in  gonorrheal  affections,  which,  as is well known, are cura-
 ble without any mercurial preparations.
    Scrofula.—The efficacy of the preparations  of gold in scrofula was
 deposed to by Chrestien, Eberle, Niel, Legrand,2 Herrmann, and Kopp.3
 According to observation, it would appear that they effect improvement
 in the mildest cases, and are beneficial where there is much torpor, but
 that they ought to be avoided in  irritable subjects.   In scrofulous
 ophthalmia, and in scrofulous  porrigo, they would seem to  have  been
 most efficacious.
    The preparations of gold have been  employed by M. Baudelocque,
 at the Hopital des Enfans Malades, and by M.  Velpeau at La CharitS.
 At the former institution, they were given in enormous doses.   M.
 Baudelocque  gave the chloride  and the stannate in doses of from ten to
 twelve  grains, without producing any effect  on the disease, and without
 any apparent injury to the constitution of the children subjected to the
 experiment.   The oxide  prepared by potassa was carried as high as
 twenty grains during the day.  At  La Charite, Velpeau gave  fifteen,
 eighteen, and twenty grains of  the chloride and oxide during the  day,
 —and higher doses were not tried, solely on account of the expense of
 the medicine.  These  results differ  greatly from those  of Orfila  and
 Devergie, the former of whom affirms, that the  chloride is more active
 than the corrosive chloride of mercury; and the latter states, that  in
 the dose of one-tenth to one-twentieth of a grain, it produces more or
 less inflammation of the lining membrane of the stomach and intestines.
   Scirrhus and cancer.—The utility of the preparations  of  gold  ap-
 pears to have been most decided in scirrhous induration of the tongue,
 according to the observation of Wendt, Helm, and others; in such case,
 they are rubbed on the tongue; this, indeed, is  the most common form
 of administration.  H. Hoffmann relates a  case of scirrhus of the py-
 lorus, in which the chloride was entirely successful; and frictions with
 the chloride, or the oxide on the  labia pudendi have been recommended
 by Hufeland, Herrmann, Meissner, Grotzncr,  Gozzi,5 and others,  in
 cases of scirrhus and  cancer of the uterus.  In the same affections,
 Krimer has advised them to  be  applied to the os uteri.  Scirrhosities,
 it is affirmed, have been dispersed through their agency; and even in
 open cancer marked improvement has been perceptible.

  1 Grotzner, Op. cit.     2 Bulletin G.neVal de Therapeutique, No. xv.  15 Aoiit, 1837.
  3 Dendwiirdigk. in der arztl. Praxis, iii. 351.
  * L'Experience, No. lxxxvii.; and Lancet, March 23, 1839, p. 31.
  5 8opra l'L'so di Alcuni Reniedii Aurifici nelle Malattie Veneree. Bologn. 1817; and
 Omodei, Aiinal. Univers. di Medicin., vol. v. 
132
AURI CHLORIDUM.
  In tumours of the bones, and in like affections, the  preparations of
gold have been employed successfully by some practitioners, and espe-
cially when the cases originated in syphilis.
  Several forms of lepra have been treated with them by Alibert, and.
A. T. Chrestien, and with the best effects.
  In amenorrhcea,  Carron du Villards employed the cyanuret success-
fully, beginning before the expected menstrual period.
  Lastly.—Wendt, Delafield,  and Grotzner have  administered them
with benefit as diuretics in dropsy.  With others, however, they have
failed.   According to Riecke,1 the results of experience would seem to •
show, that they are  especially adapted for  dropsy dependent upon or-
ganic disease of some viscus.
  None of the preparations of gold are much employed at the present
day, yet their  use is  not abandoned.  "Faithful to the traditions of
Montpellier," says M. Bouchardat,2 "M.Legrand enthusiastically extols
the preparations of gold in scrofulous, syphilitic  and herpetic affec-
tions."   Their expense is a weighty objection, unless there were striking
advantages in adopting  them in special cases of  disease in preference
to other  articles of the Materia Medica.
                   XXXII. AURI CHLO'RIDUM.
Synonymes. Aurum Chloratum seu Muriaticum seu Oxydulatum Muriaticum, Chlo-
  retum seu Murias Auri, Aurum Salitum, Chloruretum Auri, Auri Terchloridum,
  Muriate of Gold, Chloride of Gold, Terchloride of Gold.
French. Chloride d:Or, Muriate d'Or.
German.  Salzsaures Gold, Chlorgold, Goldchlorid, Salzsaures Goldoxy-
  dul, Hydrochlorsaures Goldoxyd, Goldkrystalle.

  This preparation is received into several of  the European Pharma-
copoeias, and is formed, according to the French Codex, by dissolving,
with the aid of heat, one part of gold in three  parts of nitro-muriatic
acid.   The solution to be evaporated until vapours of chlorine begin to
be disengaged, and then allowed to crystallize.
  Ghloride  of gold, prepared  according to this formula, is very acid,
but this property is not owing to its containing any free acid.   The
taste is also styptic  and disagreeable.   It only attracts moisture from
the air when  it contains an excess of muriatic acid, as is the case in
Wendt's preparation.   It is readily  soluble in water, with  which it
forms a solution of a beautiful yellow colour.   Many animal and vege-
table substances,—and especially the epidermis,—are coloured by it of
a purple violet when it is placed in contact with them.   Exposed to a
moderate heat, it passes to the state of protochloride.   When heated
to a greater degree in close vessels, chlorine is disengaged and metallic
gold left behind.

  1 Op. cit. S. 58.
  2 See Annuaire de Th.rap. pour 1851, p. 178 for M/Legrand's opinion of the different
preparations of Gold. 
AURI CHLORIDUM.
133
   The chloride is one of the most active of the preparations of gold.
 It belongs to the class of corrosive poisons,1 and greatly resembles the
 corrosive chloride of mercury in its  operation  on the economy.   It
 must consequently be  administered with caution:—even a tenth of a
 grain has been known  to induce unpleasant irritation of the stomach.8
 It has been given both internally and externally in syphilis, dropsy,3
 and glandular affections.
   M. Chavannes, a pupil of M. P6trequin,4 of Lyons, has published
 an account of the great success of the latter in the treatment of the
• ulcerated form of lupus,  lupus  exedens, by means of this agent,  which
 he has found of great utility in other forms of cutaneous disease, when
 they assume an ulcerated form, as carcinoma of the face, eczema, tu-
 berculous  syphilide, &c.    It is made of  one part of pure laminated
 gold, three parts of chlorohydric acid, and one  part of nitric acid.  It
 produces a temporary, sharp pain, and coagulation of the albuminous
 matter on the surface of the ulcer, which changes its colour succes-
 sively from  an orange yellow  to a purple, violet, and black; a crust
 forms, and, under it, healing takes place without a cicatrix, unless the
 parts have been deeply destroyed.
    In the form of ointment, it  is said to relieve the pain of rheumatic
 gout,  often in a truly  wonderful manner.   The purple  stains caused
 by it are speedily removed by washing  the part with a little wine—a
 fact that was discovered by accident.5
    The dose is from one-sixteenth  to one-twelfth of a grain, once or
 twice a day, gradually but slowly increased.   In the like quantity it
 has been rubbed upon the tongue and gums.   Externally, it has been
 applied in the form of ointment or watery solution—the  latter more
 particularly in ophthalmia, especially of the scrofulous kind, in which
 Jahn found it very efficacious;  and in chronic granular eyelids, Dr.
 W. Clay Wallace6 found a solution of  six or eight grains of it in an
 ounce of  water, vastly superior to  the nitrate of silver.   In  recent
 cases, however, it was inferior.
    The  following  are  some  of the  forms in which  it has been pre-
 scribed:—
                         Boli  auri chloridi-
                       Boluses  of chloride of gold.
                  (Boli  antisyphilitici, Pharmacopoeia  Batava.)
                            Antisyphilitic boluses.
               R.  Auri chlorid. gr. ss. ad gr. ij.
                  Extract, aconit. gr. vj. ad gr. xij.   Fiant boli sex.

    Two of these to be  taken for a dose, and repeated three times a day.

    i Orfila, Toxicolog. i. 593.                      2  Magendie, Formulaire.
    3 Wendt. in Rust's Magazin, B. xxv.
    < Revue Medicate, iii- 45—79, pour 1848; and Brit, and  For. Medico-Chirurg. Rev.
  April. 1849, p. 539.                    ,  _, , _   _.   _. ....
    4 Wilczecoski, in Medicin. Zeitung, and Lond.  Med._Gaz., Mar. t, 184o.
    6 Boston Medical and Surgical Journal, Nov. 3, 1847. 
134
AURI ET SODII CHLORIDUM.
                      Pilulae auri chloridi-
                       Pills of chloride of gold.
             (Pilulce chlorureti auri, Ph. Amstelodamensis nova.)
                    R.  Auri chlorid. gr. x.
                        Glycyrrhiz. pulv. ^iij.
                        Syrup, q. s. ut fiant pilulse cl.
  Dose,—One daily, gradually augmenting the quantity.
       R.  Auri chlorid. gr. i.
           Lycopod. pulv. gr. xv. M. fiat pulv. in part. xvi. dividend.
  One of the powders to be rubbed upon the tongue and gums daily.
                                                        Chrestien.
  Gradually, the same quantity  of the chloride  may be divided into
twelve, and afterwards into ten parts, and be used in  the same way.
                   Unguentum auri chloridi.
                    Oiniynent of chloride of gold.
                       R.  Auri  chlorid. gr. iv.
                 Misce intim£ cum
                            Ung. rosaa 5j.
                                                           Wendt.
                    Collyrium  auri chloridi.
                     Colly rium of chloride of gold.
                        R.  Auri chlorid. gr. ij.
                Solve in
                            Aquae destill. f ^vj.
                              F. collyrium.
  To be applied by means of linen compresses, or dropped into  the
eye.                                             Jahn $• Fischer.
             XXXIII. AURI ET SO'DII CHLO'RIDUM.
Synonymes. Aurum Muriaticum (Pharmac. Borussic.) seu Aurum Muriaticum Na-
  tronatum seu Chloratum  Natronatum. seu Sesquichloratum  Natronatum, Sodii
  Auro-Terchloridum, Perchloruretum Auri et Sodii, Chloretum Auri cum Chloreto
  Natrii, Murias Aurico-natricum, Chloruretum Auri  et Sodii, Chloride of Gold and
  Sodium, Hydrochlorate or Muriate of Gold and Soda, Auro-terchloride of Sodium.
French. Chlorure d'Or et de Sodium, Hydrochlorate ou Muriate d'Or et de Soude.
German.  Salzsaures  Goldnatrium, Chlorgoldnatronium, Goldnatri-
  umchlorid, Natriumgoldchlorid,  Sodahaltiges  Salzsaures  Gold,
  Salzsaures Goldoxynatrium,  Chlorgoldnatrium,  Figuier's  Gold-
  salz.
  This preparation  is  in  the Pharmacopoeias  of Prussia,  Ferrara,
Sweden, &c.  In the French " Codex," it is directed to  be  made by
dissolving 85 parts by weight of chloride of gold, and  16 parts of chlo-
ride of sodium, in a small quantity of distilled  water.   The solution
is evaporated by a gentle heat until a pellicle forms, and is then put
aside to crystallize.
  This preparation has  a beautiful yellow colour,  and appears  under
the form of four-sided prisms.   It attracts moisture from the air, but
to a less degree than the chloride of gold with excess of sulphuric acid.
  The Aurum Muriaticum Natronatum of the Germans is milder than
the preceding  preparations, and is more frequently administered, es- 
AURI ET SODII CHLORIDUM.
135
 pecially in Germany, than any preparation of gold.   It is used both
 internally and  externally.   The dose is about the  same as that of the
 last preparation, but it may be carried higher.
   Kopp1 affirms, that he has frequently employed  it with  advantage,
 in small doses,  in scrofulous tumefaction  of the upper lip.   He pre-
 scribed daily, and once or twice a day, from one twenty-fourth to one-
 thirteenth of a  grain of it, reduced to powder, with  two grains of sugar,
 and rubbed by means of the finger on  the inner  side of the affected
 lip.   In cases of scrofulous, thick, sensible, and slightly inflamed nose,
•in the adult, Riecke2 recommends the ointment, described below, to be
 applied  to the nasal fossae; and three times a day  a powder composed
 of from  one-sixteenth to one-twelfth of a  grain  of the salt of gold to
 two grains of sugar of milk, to be rubbed  on the gums with the mois-
 tened finger.   The salts of gold,  according to Riecke, appear to have
 a specific action on the organs of  the mouth, gums  and nose!!
                   Pulvis auri et sodii chloridi.
                 Powder of chloride of gold and sodium.
                  R.  Auri et sodii chlorid. part. iij.
                      Irid. florent. in pulv. subtil, part. ix.
   Three grains of this represent  three-quarters  of a grain of the salt
 of gold.   These  three grains are divided  into thirty frictions for the
 weakest doses,  and  into three for the strongest.   Starch may be sub-
 stituted for powdered orris root.                          Legrand.
                   Liquor auri et sodii chloridi.
                 Solution of chloride of gold and sodium.
                  R.  Auri et sodii chlorid. gr. ij.
                      Aquae destillat. f gj.  M.
   Ten drops to be given every two or three hours,  in cases of dropsy.
                                                         Grotzner.
                   Pilulae auri et sodii chloridi.
                  Pills of chloride of gold and sodium.
          R.  Auri et sodii chlorid. in aquas destillat. q. s. solut. gr. iv.
              Extract, aconiti 9ss.
              ------dulcam. gj.
              Althaeae pulv. q. s. ut fiant pilulae lxxx.
   Three pills to be taken three times a day.             Grotzner.
          R.  Amyli solan, tuberos. gr. iv.
              Acaciae 3j-
        In mort.  vitr. exacte mistis adde terendo
              Aur. et sod. chlorid.—in 3j. aq. destillat. solut.—gr. x.
              Fiant pilulae cxx.
   Each  of these contains about one-twelfth of a grain.
                                                   A. T. Chrestien.
                   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. acaciae q. s. ut fiant pastilli lx.

   1 Op. cit. B. iii.  S. 351.               2 Die neuern Arzneimittel, u. s. w. S. 442. 
136
AURICYANURETUM.
  Each of these will contain about one-twelfth of *JS™$r£*^

               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.
  Tt  i •  r •  *•,.„                                       Grotzner.
  Used in friction.
               R.  Aur. et sod. chlorid. gr. iiss.
                   Adipis giss.  M.
  The size of a bean to be placed in  the nasal fossse  in scrofulous
cases 1 along with  the iatraleiptic use of the powder before described.
    '     °                                               Riecke.

  In  the quantity of gr. x. to |ss  of simple ointment or lard, the
chloride of  gold and sodium  is applied  by Wassiljeu to  destructive
syphilitic ulcers of the eyelids.2
                 XXXIV. AURI CYANURETUM.
Syxonymes. Auri Cyanidum seu Tercyanidum, Aurum Cyanicum seu Cyanogenatum
  seu Cyanatum seu Hydrocyanicum, Cyanuretum Auricum seu Auri, Cyanuret, Cy-
  anide or Tercyanide of Gold.
French. Cyanure d'Or.
German. Blausaures  Goldoxyd, Blaustoffgold, Cyangold, Goldcyamd.
   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—which is cyanuret of gold—ceases
to be formed.  The chloride of  gold, prior to solution, should be de-
prived of all excess of acid by heating it in a salt water bath.   It is a
yellow powder, which is insoluble in water.3
   In some experiments, Magendie4 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 administration might  per-
haps be found useful.   M. Pourche,5 who has  used  it successfully in
syphilis and scrofula, recommends its administration—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.
                      Irid. floreut. pulv. gr. iij.  M.
                                                         Chrestien.
   i See p. 135.            2 Canstatt's Jahresbericht, 1851, v. 76.
   3 Pereira, Elements of Mat. Med. &c, 3d Amer. edit. ii. 1161.  Lond. 1854.
   * Lecons sur le Sang,  &c., and Translation in Lancet, January 20, 1839, p. 636.
   6 Journal de Pharmacie, xx. 599, and 649. 
                       AURI NITROMURIAS.                    137

  In pills he prescribes it as follows:—
                     Pilulae auri cyanureti.
                      Pills of cyanuret of gold.
                R.  Auri cyanur. gr. j.
                    Ext. Me/.ereon. gr. iij.
                    Althaeas 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 seu Liquor seu Solutio auri cyanureti.
                Mixture or solution of cyanuret of gold.
                R.  Auri cyanur. gr. iij.
                    Aquas alcoholisat. f^viij.  M.
  Dose.—A tea-spoonful  twice a day, gradually increasing the dose.
                                                       Chrestien.
                     XXXV. AURI IO'DIDUM.
Synonymes. Auri Ioduretum, Aurum Iodatum, Iodide or Ioduret of Gold.
French. Proto-iodure d'Or.
German. Iodgold,  Goldiodiir, Goldiodid.
  According to the French Codex, this is made by adding a solution
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.
  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.
                 XXXVI. AURI NITROMURIAS.
Synonymes. Aurum Nitrico-Muriaticum, Nitromuriate of Gold.'
French. Nitromuriate d'Or.
German. Salpetersalzsaures Gold.
  Nitromuriate of gold has been recommended, of late years, by Re-
camier, 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 dis-
solving gold in aqua regia; after this the tumour soon presented another
appearance, and went away in a short time.  Recamier thought it  pro-
bable  that the workman had received some of the  solution upon his
fingers, which had thus been  applied to the tumour.   Under such im-
pressions, he employed it in the case of a female, who was affected  with
an extensive cancer; the disorganized parts resumed their natural tex-
ture, and completely healed, although the cancerous dyscrasy ultimately
proved fatal.  In the case of a female with fun gus of the neck of the
uterus, a complete cure was effected by it; and in cancer  of the uterus
he found it advantageous. 
138
AURUM METALLICUM.
  Recamier prepares it by dissolving six grains of pure chloride of gold
in an ounce of  nitromuriatic acid: and he applies it  like other corro-
sive  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 repeated as often as may be
necessary.  The pain caused by the operation is generally insignificant,
and in cases where it is violent it can be allayed by pledgets dipped in
laudanum.
                    XXXVII. AURI OXTDUM.
Synonymes. Auri Teroxidum seu Peroxidum, Aurum  Oxydatum, Oxide of Gold,
  Peroxide of Gold, Auric Acid.
French. Oxide d'Or.
German. Goldoxyd, Oxydirtes Gold, G.o'ldsaure.
  Oxide of gold, prepared by calcination, is the crocus solis of the
Wirtemberg Pharmacopoeia.  The oxide is received, also, into the Phar-
macopoeias of Ferrara  and Hanover.
  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.1
  In the condition of hydrate,  the oxide of gold is of a yellow colour;
when dried, of a blackish-violet.   It is never entirely soluble in chlo-
rohydric 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 espe-
cially by Westring, Niel, Chrestien,2 and Legrand,3 in the same diseases
as the other preparations.
               XXXVIII. AURUM  METAL'LICUM.
Synonymes. Metallic Gold.
French. Or Metallique,
German. Metallisches Gold.
  Metallic gold is either administered in the form of aurum  limatum,
"gold  filings,"—formed by filing the finest gold with a fine-toothed
file—or in that of pulvis auri, aurum divisum seu pulveratum, (French,
Or divise—Germ. Goldpulver, Fein zertheiltes oderprapa-
rirtes Gold,) which  is obtained by amalgamating gold with quick-
silver,  driving  off the  quicksilver by heat.4   According  to  Tromms-
dorff, a very fine gold powder may likewise be  obtained by precipating

  1 Pereira, Elements of Mat. Med. 3d Amer. edit. i. 834.  Philad. 1852.      * Op. citat.
  3 Op. cit., and De l'Or, de son Emploi dans le Traitement de la Syphilis, &c.  Paris, 1828-
  * Jourdan, Pharmacop.e Universelle, ii. 215.  Paris, 1828. 
AURUM METALLICUM.
139
the gold from a dilute solution of the metal in nitro-muriatic acid  by
means of green sulphate of iron.  The precipitate, thus formed, when
washed and dried, is of a brownish colour, but when polished, exhibits
the most beautiful golden splendour.1
  It may also be prepared by rubbing leaf gold with sulphate of potassa,
sifting and washing with boiling water to remove the sulphate.2
  MM. Chrestien and Niel have  exhibited metallic gold largely, and,
they affirm, successfully;  but, according to AVendt, 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 gen-
tlemen and Gozzi regard it as the mildest  of the preparations of gold,
but equally efficacious with the  others, although  more tardy in pro-
ducing 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 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 aug-
menting 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 saliva are said to
have been serviceable.
    The following formulae are given by Riecke:3

                      Pulvis Auri Compositus.
                       Compound gold powder.
                  R.  Auri divis. gr. vj.
                      Amyli gr. lxvj.
                       M. f. pulv. in part. xij. aequales dividend.
    A powder to be given four times a day.
                  R.  Auri divis.
                     Lyeopod. aa gr.ij.
                       M. f. pulvis.
    A powder to be rubbed once a day upon the tongue.

                            Syrupus auri.
                            Syrup of gold.
                  R.   Auri divis. £j.
                      Syrup, acaciae, 3J.  M.
    Employed to pencil ulcers of the pharynx, and as a  dressing to chart-
    s                                      Hopital de Montpellier.

   i Riecke Die neuern Arzneimit. S. 58. Stuttgart, 1 S3 (.          ,..-„. .,-,.,
   2 Pereira Elements of Materia Medica and Therapeutics, 3d. Amer. editi. 834. Phila.
 jgg2                3 Die neuern Arzneimit. S. 59, Stuttgart, 1837. 
110
BALLOTA LANATA.
                       Pomatum Auri.
                       Ointment of gold.
              R.  Auri divis. -Jj.
                  Adipis ^ss.  M.
To be rubbed on buboes, and applied to blisters.        Legrand.
                  XXXIX. BALLOTA LANATA.
Synonymes. Leonurus Lanatus.
French. Ballote Cotonneuse.
German. Wolliger Wolfstrapp, Wollige Ballota.
  This  plant  belongs to the Natural Family,  Labiatse;  Sexual
System, Didynamia Gymnospermia.  It grows exclusively and com-
monly in Siberia, in dry mountainous  regions.  In its  native country
it  has been long administered as  a  powerful diuretic, especially in
dropsy.  Both Gmelin  and Pallas refer to it in this relation in their
travels in Siberia.  Of late 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;1 and it is important that the genuine Siberian plant should
be used, as the observations of Brera  have shown the cultivated plant
to be powerless.   For medicinal purposes, the whole plant has been
employed, with the exception of the root.   It contains, according to
Orcesi, tannic acid, a bitter, resinoid, aromatic matter—picroballotin—a
green, waxy substance, chloride of sodium,  nitrate of potassa, and salts
of iron and lime.2
  The diseases in which ballota lanata has  been administered abroad—
for it has not been employed in this counffy—are the following:3
  Dropsy.—Rehmann prescribed it several times with  decided  advan-
tage ; and, where organic disease prevented  the cure, the  urinary se-
cretion 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, ultimately, almost black, or of a
deep brown, like the darkest beer.   At times,  when the  accumulation
of fluid was pretty well removed, a pain would occur in the hypochon-
dres, 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 Muhrbeck administered it with the best effects, and Brera4
found it extremely serviceable in hydropic  conditions, especially where
they had been  preceded by, or were  complicated  with, rheumatic or
gouty affections.   Luzzato prescribed  it with equal success; and Hey-
felder, who gave it according to the prescription of the Russian physi-
cians, observed the urine to be of a blackish-yellow hue at the com-
mencement, and,  afterwards, of a very dark colour.  He found, how-

  1 Schmidt's Jahrbuch. der in-und auslandisch. gesammt. Medicin. B. iv. S. 275.
  2 Bouchardat Annuaire de Therapeutique, pour 1850, p 78
  8 R^cke, Op. cit. S. 68.            4 Antologia  Medica, No. 2, Febbrajo, 1835. 
BARII IODIDUM.
141
ever, that, to keep up the diuresis, it was requisite to  combine it with
other diuretics, or to change it for other agents.
  Rheumatism and Gout.—In these diseases, ballota is  administered
in Siberia.   Brera, as well as his compatriots, Ghidella, Fontebuoni,
Santini and Luzzato, have  tested its  efficacy by repeated trials.   The
pains generally soon disappeared under its use, and a  cure took place,
without relapse.
  Adiposis.—In a case of  this kind, it was exhibited in St. Petersburg,
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, which  had  previously been ar-
rested.
                     MODE OF ADMINISTRATION.
  Decoction is the best form for administering the plant; from j^ss to
^j. to  ^viij. of water;—this portion to be divided into two halves, and
to be taken in the course of the day.   Rehmann  boils ^iss. to ^ij. of
the coarsely powdered plant in  Oij.  of water, down to half;  to which
he adds, according to circumstances, some diffusible excitant, or a few
drops of laudanum.   Of this mixture, he directs a cupful to be  taken
morning and evening, gradually increasing the dose.
                      XL. BA'RII IO'DIDUM.
Synonymes. Barium Iodatum,  Barytium Iodatum, Ioduretum  Barytii,  Iodide of
  Barium.
German.  Iodbaryum, Baryumiodiir.
In Solution, Barytas Hydriodas, Hydras Barii Iodati, Baryta Hydriodica, Hydriodate
  of Baryta.
German.  Iodwasserstoffsaure Schwererde; Hydriodsaurer  Baryt.
  This preparation has been introduced of late years.

                      METHOD OF PREPARING.
  Iodide of barium is obtained by boiling baryta earth in a solution of
iodide of iron in water, (made by taking one part of pure iron  filings,
and four parts of iodine, pouring upon them from six to eight parts of
water, agitating frequently, and applying warmth gently, until the fluid
appears clear and almost colourless,) or, what is cheaper, by boiling  a
solution  of iodide of  iron with  carbonate  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 ferrocya-
nuret of potassium:  if it yields a precipitate,  the decomposition 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 re-
moved by exposing  the mixture  to the air, whereby it becomes  con-
verted 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 
142
BEBEERIA.
in the air, and on that account cannot be prescribed in the form of pow-
der, but may be dissolved in some aromatic water.

                     EFFECTS ON THE ECONOMY.
   Jahn instituted several experiments with iodide of barium on plants,
animals and man, in a state of health and disease.   In considerable
doses, it acts as a poison on the organism, and as one of the acrid class.
Administered in very small doses, and with great circumspection, he
found it to be serviceable in scrofulous and similar morbid conditions,
and as an alterative in morbid growths, hypertrophy, chronic  inflam-
mations, &c, in which  conditions  it proved equally useful with chloride
of barium, mercury or iodine.1  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 1830, and  according
to Riecke he has been  since silent on the subject.   Rothamel adminis-
tered 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 three grains were taken
four times  daily.
   Biett has administered it frequently in cases of scrofulous swellings,
and at times externally,  according to the following form:—

                    Unguentum barii iodidi.
                    Ointment  of iodide of barium.
                R.  Barii iodid. gr. iv.
                    Adipis ^j. M. ut fiat  unguentum.
                        XLI.  BEBEE'RIA.
Synoxymes. Bebeerina; Bebeerinum; Bebeerine; Bebeerin: Bibirina.
French. Bebeerine.
German. Bebeerin.
  A tree known in Demerara 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, which, on  examination,
was found by him to  contain a vegetable alkali, to which he gave the
name Bebeerine.   From this alkali  he prepared a sulphate, which he
exhibited with success as  an antiperiodic.  Dr. Maclagan, havino- re-
ceived 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
1 Riecke, Op. cit. S. 71. 
BEBEERIA.                          143
was for some time unknown.   It was supposed, by Mr. Lindley and
Sir William Hooker,  to whom the fruit was sent, to be lauraceous; but
Dr. Maclagan could not discover any genus or tribe of lauraceae to which
it could be referred.   It  is now referred to  Nectandra Rodiei.1  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 sulphu-
ric acid; precipitated the alkaloids by ammonia;  dried the precipitate
over  a water-bath, and purified it by redissolving, by means  of  sul-
phuric acid; treating with  animal  charcoal, 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 matter, a good deal resembling in appearance a transpa-
 rent  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 is separated into two  portions, one soluble, the
 other insoluble  in  that fluid.   Both of these are  distinct vegetable al-
 kalies.  To the former Dr. Maclagan  applied M. Rodie's  name—Be-
 beerine;  the  other he called  Sipeerine, 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  dissolves with
 great facility in  alcohol—pure and  diluted.  Ether takes up a thir-
 teenth 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, uncrys-
 tallizable salts, all of which are very soluble in water, and intensely and
  durably bitter, with a slight degree of astringency on the tongue.  Si-
 peerine is  that portion of the alkaline precipitate which  is insoluble in
 ether.  It is of a dark brown,  shining appearance,  and forms neutral
 compounds 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.2
    Sulphate of bebeerine, as an article of commerce, is usually found  in
  brown, crystalline scales, soluble in water, sparingly so in alcohol, and
  possessing an intensely bitter taste.   The solutions of the salt are neu-
  tral, and ammonia precipitates the alkaloid.3
    Dr. Maclagan was led to institute experiments, with a view of ascer-

    1 Half-yearly Abstract of the Med. Sciences, i. 221.  Amer. edit.   New York, 1845.
    2 Transactions of the Royal Society of Edinburgh, vol. xv. pt. 3, or London and Edin-
  burgh Monthly Journal  of'.Medical Sciences, July, 1843, p. 653.
    4 Ballard and Garrod, Elements of Mat. Med. and Therapeutics, p. 411. Lond. 1845. 
144
BEBEERIA.
taining how far, in point of cheapness, the salts of the alkalies of be-
beeria might be substituted for quinia;  and he found that, by  a modi-
fication of the ordinary processes for sulphate of quinia, he could pre-
pare a sulphate of bebeeria, which could be sold at a price below the
average of sulphate of quinia during late years.   The process for ob-
taining it for medicinal use in Edinburgh is  essentially the same as
that of the Edinburgh  Pharmacopoeia  for sulphate  of quinia.  The
bark is first freed from tannin and colouring matter, by boiling it with
carbonate of soda: it is then exhausted  by boiling in water acidulated
with sulphuric acid,  and the alkaline matter is thrown  down from the
concentrated acid  liquor by means of carbonate of soda.  The  impure
bases, thus separated, are washed, dissolved, and neutralized with weak
sulphuric acid, and the  solution is treated with animal charcoal, con-
centrated, filtered  again, and finally evaporated in thin layers  in flat
vessels.1
   Owing to the  great improvement in the manufacture of the article
for medicinal use, it  is said to  be sold at less than half the price of the
sulphate of quinia.2

               EFFECTS ON THE ECONOMY IN DISEASE.
   Dr.  Maclagan sent some of the sulphate to Demerara, where it was
tried with marked success in  the  treatment of intermittents.   It ap-
pears,  indeed, to possess the antiperiodic properties of the sulphate of
quinia, and has, accordingly,  been found of great service in intermit-
tent and remittent fevers, neuralgia, &c.   Many such cases are  related
by Dr. Maclagan as occurring in his own practice,3 as well as  in that
of Dr. Watt, of Georgetown, Demerara; of Dr. J. Anderson and Mr.
D. Falconer, and of Professors J. Hughes Bennett and Simpson, of
Edinburgh.   The last gentleman made trial of it in periodic neuralgia,
occurring  during utero-gestation, and with beneficial  results.4  Dr.
Gairdner,  of Edinburgh, has  given the  particulars of a case  of in-
termittent 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.   In strumous ophthalmia, it has been re-
commended, by Dr.  Llewellyn Williams,5 as a substitute for sulphate
of quinia, not only on account of the moderate price of the drug as
compared  with the sulphate, but also, because,  according to the testi-
mony of Dr. Maclagan and others, it is better  adapted to some  consti-
tutions and  affections than it; not being so liable to excite the circu-
lation, or  affect the nervous system.   He gave it in the dose  of two
grains night and morning.
   In some trials of  it,  in ague, made by M. Becquerel,6 its antiperio-
dic properties were very evident; and in consequence of the favourable
testimony brought forward  in regard to its powers, it was given by

  1 Christison's Dispensatory, Amer. edit, by R. E. Griffith, p. 969.   Edinb. 1848.
  2 Edinb. Med. and Surg. Journal, April, 1845.
  3 Lond. and Edinb. Monthly Journal, Aug. 1843, p. 685.
  4 Edinb. Med. and Surg. Journal, April, 1845.
  5 Provincial Medical and Surgical Journal, Oct. 18, 1848.
  6 Bulletin de Therap. Oct. 1851, and Ranking's Abstract, xv. 210.  Philad. 1852. 
BERBERINA.
145
Dr. Pepper,1 of Philadelphia, in four cases, in two of which it proved
promptly successful; whilst in the other two, it entirely failed, and had
to be abandoned; "and judging,"  says Dr. Pepper, "from the limited
number of cases in which I have seen this remedy used, it appears to
be less efficacious than the sulphate of cinchonia or quinia, though, at
the same time, it must  be admitted to possess very decided febrifuge,
[antiperiodic,] powers, and may, perhaps, be well adapted for many of
those cases where constitutional peculiarities  render the preparations
of bark objectionable."
   Dr. Patterson2 has reported two cases of obstinate intermittent, in
which a permanent cure was  effected by  it, after the failure of the
sulphate of quinia.   Dr. Edward D. Dailey3 has used it in many cases
with variable success; but is  not  so  satisfied with the results as from
those of the sulphate of quinia.  In his experience, moreover, the sul-
phate of quinia was "by far the cheaper article of the two."
   According to Dr. Christison, it was, when he wrote, in general use
in Edinburgh  and other places in Great Britain, and it was said not
to produce the unpleasant phenomena that occasionally follow the use
of the sulphate of quinia.   Professor  J. H. Bennett4 affirms, that when
it was first introduced he tried it with great success;  but that, of late
years, it seemed to have lost its virtues.   " Certainly its good effects
cannot now be depended upon."
   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 of bebeeru; but
this is not  the conclusion to which a commission of pharmaciens ar-
rived, from a recent examination of it.   According to them, its chief
constituents are,—sulphate of quinia, aloes, saffron, camphor, zedoary
and angelica.5
                     MODE OF ADMINISTRATION.
   Sulphate of bebeeria may be given in the same manner as sulphate
of quinia.   The dose as a tonic is from one to three  grains;  as an an-
tiperiodic, from five grains to a scruple.   Bouchardat6 states its dose
to be double that of quinia.
                        XLII. BERBERI'NA.
Syxoxymes. Berberinum, Berberine, Berberin.
French. Berberine.
(human. Berberin,  Berberisgelb, Sauer d ornbitter.
  The inner bark of Bcrberis vulgaris is of  a yellow colour, and a
bitterish, somewhat astringent taste.   It is cathartic, and was formerly

  1 Amer. Journal of the Med. Sciences, Jan. 1853, p. 13.
  2 Philad. Med. Examiner, .May, 1852.            s Ibid. Sep. 1853, p. 557.
  4 Edinb. Monthly Journal, March 1852, p. 235.
  5 Fuehs, cited in Canstatt und Ei.enmann's Jahresbericht, u. s. w.im Jahre, 1849. Bd. V.,
S. 138; and Supplement aux Formulaires publics jusqu'a ce Jour, &c. p. 37. Paris, 1852.
  6 Annuaire de Therap. pour 1852, p. 165.
       10 
146
BERBERINA.
used in jaundice; originally, perhaps, in consequence of the   signa-
ture " of the yellow colour.1  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 Ilerberger, and its  properties have been investigated by
Brandes.3   Buchner first recommended, at a meeting of  the German
Association of  Naturalists and Physicians, in the  year 1831,  that it
should be received into the Materia Medica;  but hitherto few experi-
ments have been made with it.

                      METHOD OF PREPARING.
  An alcoholic extract of the root of berberis vulgaris is prepared, to
which water is  added.   This throws  down a pulverulent brown sub-
stance;  the fluid is  poured  off; -and the substance dried; it is  then
treated with alcohol, which takes up the berberin, leaving  a small por-
tion undissolved.  By evaporating the alcohol, the  berberin remains.4
  Thus prepared, berberin resembles an extract:  it is of a brownish-
yellow colour, translucent, and smells like the root; its taste is a  pure
bitter, and it becomes soft in the air.   Buchner5 succeeded in obtain-
ing 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 former.   When  crystallized, it re-
quires 600 parts of water for its solution;  whilst in alcohol, at a me-
dium 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 appre-
hended from the administration of berberin as a therapeutical agent.
Of  this he had an opportunity of satisfying himself both on his own
person and on others.  When labouring under indigestion, 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 disturb-
ance of the functions of the liver.  In doses of two,  five or ten grains,
it only aids the appetite; but in larger doses—fifteen to twenty grains
—it acts upon the bowels without inducing  tormina, and  therefore not
as a drastic.
  Within the last few years, Koch has published some observations on
the use of berberin.  He treated several cases with it as  prepared  by
Buchner himself, when he found  all his results confirmed, and  that it
merited a high rank amongst bitter agents.  He gives two cases of marked

  1 Rny, Ilistoria Plant,  ii. 605.            2 Lond. Med. Repos. new series, i. 38.
  r- Archiv. der Apothekervereins, ii. 29.      4 Riecke, Op. cit. S. 442.
  5 Journal de Pharmacie, xxi. 309, and Philadelphia Journal  of Pharmacy, vii. 328.
Philadelphia, 1835. 
BOLETUS LARICIS.
117
disturbance of the digestive function, in which berberin afforded essen-
tial service^ and recommends it highly in convalescence from typhus,
                  XLIII. BIGNO'NIA CATAL'PA.
Synonymes.Catalpa, Catalpa  Cordifolia seu Arborescens seu Arborea, Catalpa or
  Catawba tree.                                                  L
French. Catalpa.
German. Katalpa,  Bignonienbaum.
  Bignonia Catalpa belongs to the Natural  Family, Bignoniacese;
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
(siliqua) to be  a powerful remedy in different  asthmatic affections.
This gave  occasion_ to  several Neapolitan physicians—and especially
Professor Antonucci—to institute experiments in reference to its virtues,
and  their  report was  decidedly favourable.  Brera also extols it in
asthma.  As to the precise mode in which it acts, we have no exact in-
formation.   Dierbach and Richter2 place it amongst the Acria; whilst,
according to the analysis of Grosso,3 it seems  more likely that its ac-
tive principle is of a fatty nature, resembling the butter of  the cacao.
It is 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, administered it  with the following additions:4
   Adde

Or,



   Adde
R.  Catalp. siliquar. 5jss.
    Aquas q. s. ad colatur. f §viij.

Oxymel. scillae f ^ss.

R.  Catalp. siliquar. ^ss.
    Senegas rad.  ^ij.
    Aquae q. s. ad colatur. f §viij.
              Oxymel. scilke f^j.
To be taken by little and little.                          Brera.
                    XLIV. BOLE'TUS LA'BICIS.
Synonymes. Boletus Purgans seu 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

  1 Bouchardat, Annuaire de Therapeutique,  pour 1850, p. 181.
  1 Riecke, Op. cit. 8. 72.                 » Gazette MSdicale de Paris, 1834, p. 8.
  4 Ricettario Clinico, Pad. 1825. 
148
BRAYERA ANTHELMINTICA.
become obsolete.  Still, it has been retained in many Pharmacopoeias;
for example, in those of Amsterdam, Bavaria, Brunswick, Paris, Fer-
rara, Geneva, Hamburgh, Hanover, Oldenburgh,  Poland, Prussia, Sax-
ony, Sweden, Wirtemburg, and AVurzburg.   It  grows  abundantly in
the Rocky Mountains, and is commonly employed by the traders and
inhabitants of  the  mountains  as a  cathartic.   Some trials  of its
cathartic powers  have been  made by Dr. M'Pheeters  of  St. Louis.1
Of late years, it has been administered frequently in the colliquative
sweats of phthisis.   Barbut, of Nismes,  made  many trials with it,2
which were favourable; and  the experience  of  Andral was similar.3
More recently,  however, he has expressed  the opinion, that no  great
advantage has been derived from it.4   By  several of the  German phy-
sicians equally advantageous  results have been obtained—as by Toel
and Trautzsch—so that, according to Riecke,5 it  deserves, perhaps, to
be better known and investigated.   Kopp has added his testimony in
its favour.6
  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, ac-
cording to Barbut, arrests the  sweating, which, Riecke  thinks,  is ef-
fected 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; and
Pisson7 in from four to six, eight, and ten grains.  If it acts upon the
bowels, which is rarely the case, the dose must be diminished,  or a  small
quantity of opium or laudanum be added.

               Pilulae  boleti laricis  cum opio.
                    Pills of white agaric and opium.
                     R.   Bolet. laricis gr. xv.
                        Extract, opii gr. iiss.   M. et
                          divide in pil. vj.
  One or two at bed-time in the colliquative sweats of pihthisis.
                                                        Payer.8
              XLV.  BRAY'ERA ANTHELMINTICA.
Syxonymes.  Hagenia Abyssinica, Banksia Abyssinica, Kosso, Kousso, Kuso, Koso,
  Kwoso, Cosso, Coso, Cousso, Cusso, Gosso, Cotz, Cabotz, Flores Cosso, Habbi.

  This plant is a native of Abyssinia, and belongs to Nat. Ord. Rosa-
cese  Sanguisorbeae (Decandolle,) Sex. Syst. Icosandria Digynia.  It

  1 St. Louis Med. and Surg. Journ. Sep. and Oct. 1852.
  2 Burdach, in Journal der Praktisch. Heilkund. von Hufeland,' Mars. 1830.
  3 Journal de Pharmacie, vol. xx.
  4 Cours de Pathologie Interne, &c, recuelli et r.dige par A. Latour, j>. 157.  Edit.
Bruxelles,  1837  _                                    * Op. cit  S. 73.
  • Denkwurdigk. in der arztlich. Praxis. Frankf. 1836, S. 344, cited by Riecke.
  7 Annales de Therap. Oct. 1847.
  8 Bouchardat, Annuaire de Therapeutique, p. 8, Paris, 1842. 
BRAYERA ANTHELMINTICA.
149
 was first taken from Abyssinia to Europe by Dr. Brayer, from whom
 it received its name.   The flowers are the parts used in medicine, and
 yield, on  examination, an  extractive matter, containing tannic acid,
 which is  most readily taken  up by hot water; and, consequently, the
 decoction is  the best form of preparation.1
   In Abyssinia, the flowers of brayera are said to have been employed
 with great success in tapeworm.  It would seem, that the taenia solium
 especially is endemic in many parts of that  country,—so much so, in-
 deed, that few of the  natives are exempt from it.   They are in the
 habit of  taking the anthelmintic  every two months,  children  commen-
 cing at the age of five or  six  years, and continuing it through life.
 Being a drastic cathartic, it cannot be thus taken indiscriminately with
 impunity, and prolapsus ani  is often induced by it.  The dose varies
 from six to  eight drams,  and is taken in  cold  water, early in  the
 morning.  It usually acts on the bowels in  about a couple of hours,
 the worm—or a part  of it, being generally  expelled in the  third or
 fourth evacuation.2
   In Europe, no experiments  had  been made with them until Dr.
 Plieninger,3 having become acquainted with  a missionary from Abys-
 sinia, and heard  his description  of  their wonderful effects, obtained
 some of them from him,4 which he submitted to 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 hand-
 ful of the blossoms, about ^j. or ^iss. and boiled them in ^xvi. of water
 down to one  half, adding to the strained liquor as much honey as coun-
 teracted,  in some measure, the objectionable taste.  This decoction was
 taken by a delicate woman, about thirty years of  age, who had previ-
 ously used the  extrcctum filicis maris in pilular form,  according to
 Peschier's plan, without success.  In the course  of the day, she passed
 numerous fragments of taenia, mixed with mucous discharges, without
 experiencing any striking inconvenience from the remedy.  From this
 time, she remained free from the  parasite.
   A robust man, thirty-eight  years of age, who had taken large quan-
 tities of tartrate of antimony and  potassa, in consequence of violent in-
 flammation of the lungs,—whilst he lay sick of this disease, discharged
 a great many portions of taenia, without having previously experienced
 any inconvenience from the presence of the entozoon.  In July, 1834,
 he took the same decoction.   Since then, he has had no appearance of
 taenia in his evacuations.
   Although but few cases had then occurred in which brayera had been
 administered in  European  practice, Dr. Plieninger considered it a
 valuable addition to the materia medica, inasmuch as  it can be adminis-
 tered to delicate persons and  children,  without violence being  done to

  1 For a full account of it, see Pereira, Elements of Mat. Med. and Th.rap. 3d. Amer.
 edit. ii. 804. Philad. 1854.
  2 Transactions of the Med. and Physical Society of Bombay, cited in Dublin Journ. of
 Med. Science, March, 1845; and in Ranking's Half-yearly Abstract, Amer. edit. Part I.,
p. 8S.  New York, 1845.   For a good account of it, see  Wiggers, in Caustatt's Jahres-
bericht, 1851, 5  Bd. S. 27.
  s Riecke,  Die neuern Arzneimittel,  p.  73, Stuttgart, 1837.
  « Riecke,  Op. cit. S. 73. 
150
BRAYERA ANTHELMINTICA.
the whole organism, as is the case with many of the true anthelmintics;
but the article had not been imported in sufficient quantities  into Eu-
rope to admit of the necessary trials for fully testing its efficacy.   Since
then, a quantity of the flowers was  brought to Europe by M. Rochet
d'Hericourt, and trials were made with it in Paris, in the service of
MM. Sandras and Chomel, which were entirely successful.   M. San-
dras followed the directions given him by M. Rochet d'Hericourt, and
having kept the patient fasting the evening before the intended  admi-
nistration of the remedy, he gave, on the following morning, the  whole
of an  infusion made from 20  grammes—about five drams—of  the
flowers coarsely pulverized, to 250 grammes—about eight ounces—of
warm water.  At the expiration of about an hour, the cathartic action
of the medicine commenced;  the first evacuations generally contained
portions of the parasite; and, in the third or fourth, it was found ex-
pelled entire.1   It  has also been used successfully in three cases, by
Drs. Budd and Todd;2 and by  Oliari, Masserotti,3 Storer4 and others,
successful cases have  been recorded.   The last gentleman, however,
has referred to a case in which half an ounce of kousso was  adminis-
tered, in infusion, without producing the slightest effect;5 and an un-
successful case has been published by Dr. Geo. Paterson.6  A case of
successful administration  is given by Dr. H. S. Patterson;7 and one
of failure, which was  afterwards cured by pumpkin seeds.  Two suc-
cessful cases are also recorded by Dr. T. H. Silvester.8
   In experiments on tcenia by Dr. Kuchenmeister,9 he found that a de-
coction of kousso in milk proved fatal in half an hour; turpentine and
albumen in from an hour to an hour and a quarter; decoction of  pome-
granate bark in milk or  albumen,  in from three hours to three hours
and a half; ethereal extract of male fern, with albumen, in from three
hours  and a half to four hours; and castor oil, with albumen, in eight
hours.  It would appear, consequently, that kousso is by far the most
destructive  to them.
   A few years ago it was  introduced into this country, where taenia,
however, is rare.   Should  the plant be considered worthy of cultiva-
tion, it is said that a supply can be readily obtained at Massowah, on
the Red Sea.  Being of a hardy nature, it might bear to be transplant-
ed into Europe or  this country.  Hitherto the great drawback  to the
use of kousso has been the difficulty of procuring it, and its enormous
cost.  "At the time when it could be  purchased in  Paris," says Dr.
Pereira,10 "its price was £1 15s. per  ounce, or 17s.  6d. per dose.  M.
Rochet d'Hericourt, the sole  holder  of the medicine, at the present

  1 Bouchardat, Annuaire de Therapeutique, pour 1847, p. 256, Paris, 1847; and Ibid.
pour 1849, p. 254.                       2 Medical Times, April 20, 1850.
  3 Gaz. Med. Ital. Fed. Lombard, xlvi. 1851; Prov. Med. and Surg. Journ. Sept. 15,1852,
and in Ranking, xvi. 98. Amer.  edit. Philad. 1853.
  * Amer. Journ. of the Med. Sciences, July, 1853, p. 76.
  5 Ibid. Oct. 1854, p. 377.
  6 Edinb. Monthly Journ. of Med. Science, July, 1854, p. 39.
  7 Philad. Med. Examiner, Oct. 1852, p. 629.
  8 Prov. Med. and Surg. Journal, and Philad. Med. Examiner, Oct. 1852, p. 677.
  9 Fronep's Tagesberichte, i. 317, cited in  Ranking xvii. 234.
  10 Pharmaceutical Journal, July, 1850; and Op. cit. p. 808. Philad. 1854. 
BROMINIUM.
151
time, refuses to sell any quantity less than his entire stock, at the rate
of one guinea per ounce.   His nephew tells me that his uncle possesses
1400 lbs. of it, which, at one guinea per ounce, will cost 22,400 guineas!
The impossibility of effecting a sale on such terms will, I doubt not, ul-
timately  compel the holder to reduce his demands to something ap-
proaching to reason."  Since then, its price has been greatly reduced,
so as to admit of the trials already referred to in this country and else-
where ; the results of which, however, by no means justify the expendi-
ture.
                       XLVI. BROMINIUM.
 Syxonymes.  Bromium, Bromum, Brominum, Bromineum, Bromina, Muride, Murina,
   Bromine.
 French.  Brome.
 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 more  than to the latter.1  Balard detected it
 whilst occupied in some investigations on the water of salt-ponds, and
 gave it the name bromine—from |3pw^o., "a stench or smell,"—on ac-
 count of its disagreeable odour.   It is met with chiefly in sea water,
 and in certain 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 Pro-
 fessor Silliman, and of Kenawha, by Professor Emmet.  It is in the
 secondary list of the Pharmacopoeia of the United States, (1842,) but
 is elevated into the primary list in that of 1851.

                      METHOD OF PREPARING.
   Balard's mode of preparing bromine consists in passing a current of
 chlorine through bittern, after which ether is added, and the two liquids
 are strongly agitated.   The chlorine decomposes the  bromide of mag-
 nesium—the form in which bromine exists in the bittern—and converts
 the bromide  into a chloride of magnesium, setting the  bromine free.
 The ether dissolves the evolved bromine, the mixture assuming  a hya-
 cinth-red  colour.  The ethereal  solution  is agitated with  caustic po-
 tassa, by which bromide of potassium and bromate of potassa are gene-
 rated ; the ether  becoming colourless and pure, and fit to be used for
 dissolving fresh portions  of bromine.   When a  suflicient  quantity of
 the bromide has been obtained, it is mixed in a retort with peroxide of
 manganese, and acted on by dilute sulphuric acid, by which the bro-
 mine  is given off.   The  sulphuric acid sets free  hydrobromic  acid,
 which, at  the moment  of  its disengagement, is deprived of  its  hydro-
gen by the oxygen of the peroxide of manganese, and is thereby con-
verted into bromine.  The bromine passes over in reddish vapours,
and is made to condense under water contained in an appropriate re-
ceiver.
             1 Glover, Edinb. Med. and Surg. Journ. July, 1842. 
152
BROMINIUM.
  Bromine, at the ordinary temperature, is a fluid of a blackish-red
colour, when regarded in quantities,—but of a hyacinth-red when placed
in a thin layer between the eye and the light.  Its smell is strong, pe-
culiar, acrid and disagreeable, resembling that of chlorine.   Its taste
is acrid.   It colours the skin yellow—the colour gradually disappearing
of itself.   Its  specific gravity is 2.966.  It is readily set  freehand,
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 alcohol, 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 />f the latter.   It forms  acids both with oxygen
and hydrogen.   Its test is the  production of an  orange colour with
starch.
               EFFECTS ON  THE  ECONOMY  IN  HEALTH.
  Experiments have been  instituted  to discover the influence of bro-
mine on the animal economy, and  especially by  Barthez.1   In this
respect  also it resembles iodine, and, like  it, belongs to the class of
irritant poisons.   Twelve grains, dissolved in water, and injected into
the jugular vein of a dog, destroyed 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 cavi-
ties of the heart full of coagulated blood, and the lungs gorged with
the same fluid; in the venae cavse 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 oesophagus was
tied; when, however, the  animal was able to  vomit,  fifty to sixty
drops were  requisite.   The poison acts less intensely when it is given
in conjunction with aliment; it  produces coughing, excitement, nau-
sea  and vomiting.  Constant  sucking  of  the  tongue was noticed,
with frequently extraordinary restlessness  and  anxiety, 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, which
could be readily scraped off with the back of the  scalpel, and left gan-
grenous ulcers exposed.  Barthez recommends magnesia as an anti-
dote to bromine, but he rests his recommendation on a single obser-
vation only.  Butzke obtained similar results from his experiments.
In one case, only, in which a dog died a few hours  after a dose of
three drams, he found the intestines unchanged, and death could only
be ascribed to the paralyzing influence of the poison on the nervous
system.2

  1 De l'Action du Brome, &c, (Th.se) Paris, 1828.  Also, Fournet, in Bulletin General
de Therapeutique, Fe"vrier, 1838.      2 Christison on Poisons, 3d  edit. p. 186. 
BROMINIUM.
153
   Two series of effects, according to Dr. Glover, are produced by its
introduction, in  large doses, into the stomach:  one  arising from  the
volatilized bromine getting into the fauces and air-passages;  and,  the
other, from its corrosive and irritant action on the stomach and intes-
tines.   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 influence
on the workmen who prepare it.1

               EFFECTS  ON THE ECONOMY IN DISEASE.
   Pourche first used both pure bromine and bromide'of  potassium  for
therapeutical purposes.   He found it very efficacious  in scrofula, espe-
cially in dispersing strumous swellings, both when given internally and
applied externally.2  In a  case of  very large goitre, it was  highly
serviceable.  According to Pourche's observation, it excited heat in  the
face, headache, dryness of the throat, &c, which, however, soon disap-
peared.  Pourche gave it internally, diluted  with forty parts of dis-
tilled water, beginning with five or six drops of this mixture, and gra-
dually 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 commonly 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  be-
come  accustomed to its  use.  The chief  diseases in  which  he  gave it
were  scrofula, amenorrhcea, and hypertrophy of the  ventricles  of  the
heart.   It has also been  administered by M.  Fournet,3 in chronic  ar-
thritis, both internally and externally; but his facts,  as he himself  re-
marks, were too few to  enable  him to deduce  any general conclusions
as to the therapeutical value of the remedy in those affections.   He
always gave it in a pure state, in the form of  mixture, with a solution
of gum; and, externally, it was applied in the  form of "alcoholic mix-
ture" to the affected joints.  The dose was at first two drops in four
ounces of  the vehicle; and it has gradually increased by two drops at
a time, until as much as sixty drops were given in the twenty-four hours.
  The alcoholic mixture, used  by M. Fournet  as  an  external  ap-
plication, consisted, at the commencement, of  ten drops of bromine to
an ounce of alcohol: this was augmented  daily by five  drops until it
reached one hundred and  twenty drops.
  Dr. Glover4 considers a solution of bromine in water an elegant and
useful application in scrofulous, syphilitic, and specific ulcers, as well
as in eczematous eruptions.  He gives a case of obstinate tuberculous
eruption, where an ointment of bromine and bromide of potassium—
sight minims of bromine, and half a  dram of the bromide to an ounce
)f lard—effected a cure; and also, a case of sarcomatous tumour  of the
knee removed by a similar but stronger ointment.   He  thinks that, phy-
siologically, bromine and the bromides are nearer the group of chlo-
'ine and the chlorides, than that of iodine and the iodides.   He main-

 1 A. Chevallier, Annales d'Hygiene Publ. &c, Avril, 1842.
 3 Bulletin General de TWrapeutique, No. 14.  30 Juillet, 1837.
 3 Ibid. F.vrier, 1838.               * Edinb. Med. and Surg. Journal, Oct. 1842. 
154
BROMINIUM.
tains, that the chemical and physiological relations are alike, and that
the same is true of the medicinal properties.1

   Chloride of  Bromine, Brominii Chloridum, which is made by
passing chlorine through bromine, and condensing the resulting vapours
by cold, has been recently brought forward by Dr. Landolfi, as an ex-
cellent remedy for the treatment of cancer.   Dr. L. is surgeon-in-chief
of the Sicilian army, and has been  visiting different parts of the
European continent, for the purpose of propagating his curative me-
thod, which, in Paris, has  been regarded as worthy of the appointment
of a medical commission to watch its results.  According to M. Laskgue,2
chloride of  bromine is applied by  Landolfi  externally  as  a caustic,
and  administered internally,—the internal treatment being, however,
of quite secondary importance.   The  chloride *is  made  into a thick
paste, with liquorice powder, and is employed alone, or combined with
other caustics, as in the following formula: Chloride of bromine, three
parts; chloride of zinc, two parts;  chloride of antimony, and chloridi
of gold, each one part.   To be mixed in the open air, on account of
the fumes disengaged.  M. Quevenne3  recommends, that it should be
made of chloride of zinc, deliquesced;  chloride  of antimony,  deli-
quesced ;  chloride of gold, chloride of bromine, each  five grammes,
(3i-J;) flour, twenty grammes, (5v.;) water, eighteen grammes, (3ivss.)
The  chloride of gold to be triturated in' a porcelain mortar with the
chlorides of zinc and antimony: the water  and flour are then to be
added, so as  to make a somewhat liquid paste: the chloride of bro-
mine is now added, and the whole mixed as speedily as  possible with
the rest of the flour.   The chloride of gold may be omitted without
injury to the caustic.
   In open cancer, according to  M. Lasegue, M. Landolfi regards the
chloride of zinc to be indispensable as a haemastatic; and the chloride
of gold seemed to him to  exert a special  action in encephaloid.   Cu-
taneous cancer, epithelioma, lupus and small  cysto-sarcomas may be
treated by an ointment formed of one part  of chloride of bromine to
eight of basilicon.  The healthy parts around the tumour are to be pro-
tected by bands of linen,  one and a half to  two inches  broad, covered
with an ointment of four  parts of chloroform, to thirty of lard,  and
the patient is placed near a window, so  that  the  fumes may escape.
Small compresses, on which the paste has been spread, are gently ap-
plied, in an imbricated manner, to the part, so as to secure exact juxta-
position, keeping them two lines clear of the sound parts.   The whole
is  then covered with charpie and diachylon.   A sharp  burning sensa-
tion  is soon  followed by severe pain, which may continue for several
hours, and is relieved by  repeated doses of anodynes.
   The paste is usually kept  on for twenty-four hours,  and, on its re-
moval, a line of demarcation  is commonly perceived.  Bread, or let-
tuce-leaf poultices, or basilicon ointment, are  then  applied every three

  1 Edinb. Med. and Surg. Journal, Oct. 1842, and Lond. and Edinb.Monthly Journal of
Med.  Science, Nov. 1842,  p. 1011.
  2 Archives Gen6rales de M.d.  Mai, 1855, p. 609: and Brit, and For. Med. Chir. Rev.,
July,  1855, p. 255.
  3 Association Med. Journ. Aug. 17, from Rev. M.d. Chir. April, 1855; and Am. Journ.
of the Med. Sciences, Oct. 1855, p. 493. 
BRUCIA.
155
lours.  About the fourth or fifth day the eschar loosens, and from the
ighth to the fifteenth day it is removable by the forceps.  If, on the
granulating surface which is exposed, any evidence of disease  exists,
t little of the paste must be applied to  it.   The wound is now treated
is a simple ulcer;  and should  there be any deficiency of suppuration,
i lotion must  bo applied, containing from  twenty to thirty drops of
•hloride of bromine in five hundred grammes (^xvj.) of goulard water.
 In very bad cases, the treatment  of  Landolfi is said  to afford very
narked relief; and in hopeless cases, and such  as are inaccessible to
;austic, a lotion, consisting of from ten to twenty drops in five hundred
rrammes of water, may, it is conceived, exercise some useful modifying
power.
 The other preparations of bromine are described in other parts of
this volume.
                        XLVII. BRUCIA.
.yxonymes. Brucina, Brucinum, Bruciurn, Caniramium, Caniraminum, Pseudangus-
 turinum, Vomicina, Brucine.
French. Brucine.
German. Brucin, Kanimarin.
  This alkaloid was discovered by Pelletier and  Caventou, in 1819, in
the bark of the false angustura—Brucea antidysenterica.  It is found
also,  in small quantities, in 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 sulphohydric
acid gas, and the brucia by an alkaline base, for which purpose mag*
nesia may be employed.  The  precipitate from  the magnesia is then
washed,  dried, and treated with alcohol, which lays hold of the 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 maybe procured colourless
by forming an oxalate of brucia,  and treating  it with a mixture of
eijual parts of alcohol and ether.   The oxalate is thus deprived of its
colouring matter; after which 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  parallelogram; 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 crystalline form.   When exposed
to the influence of heat, it melts at a temperature very little above that
Df boilin^ water.  At a higher temperature, it is decomposed, and af-
fords the same products as vegetable  substances that do not contain
nitrogen.   With jwiids, brucia  forms  neutral salts, which  differ from
the salts  of strychnia.  The  sulphate  of brucia crystallizes in very 
156
BRUCIA.
fine needles, and resembles the sulphate of morphia, but it has a much
more bitter taste.  Nitrate of brucia does not crystallize, which con-
stitutes an essential difference between brucia and strychnia.  With an
excess  of  nitric  acid, the  salt has a  beautiful pearly (nacre) aspect.
   M. Bouchardatl  strongly insists  on  employing only the pure and
crystallized article: the commercial often containing strychnia.

                     EFFECTS ON THE ECONOMY.
   Brucia acts energetically on the animal economy in the same man-
ner as false angustura, but much more strongly.   It is similar, in its
operation,  to strychnia, but is considered  to be weaker in the propor-
tion of one to ten,  according  to Pelletier; one to  twelve, according to
Magendie;2 and one to twenty-four, according to Andral.3  It requires
four grains to kill a rabbit, whilst half  a  grain  of strychnia is suffi-
cient.   A  tolerably strong dog,  to which  three grains of brucia had
been  given, was  affected with symptoms resembling 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 prescribed 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 re-
sulting from lead poisoning.  M. Bricheteau, from his observations on
man,  and  M. Bouchardat4 from  his on animals, infer that  brucia ia
more active than is usually admitted.   In paralysis succeeding apo-
plexy, the former  employs it with  much advantage, and accords with M.
Andral in  its  being more manageable than strychnia.   He is of opi-
nion, that  no benefit  is to be  expected from  it in paralysis  until six
months have elapsed  from the attack of apoplexy.   Earlier  than this
it may  induce serious effects, owing to its toxical influence on the cere-
bro-spinal  system.   He commences with about the sixth of a grain,
(un centigramme,) and increases  the dose each day by  the same quan-
tity, so long as no  effect is induced.  Should convulsions supervene,
it must be discontinued, until the effects are decidedly diminished,
when it  must be again augmented  by a sixth of a grain in the day.
M. Bricheteau  has found  that some patients bear as much as three
grains  in  the  day.  Magendie  administered it  with  success in two
cases of atrophy,  one  of the leg, and the other of  the arm; and M. Le-
pelletier,5 suggests its use in impotence.

                     MODE OF ADMINISTRATION.
   Brucia, according to Magendie, may be given either in pills or tinc-
ture,  gradually augmenting the dose.   Andral raised  it  from  half a
grain to five grains.  Magendie  recommends, that the alkaloid should

  1 Annuaire de Therap. pour 1852, p. 50 & p. 62.
  2 Formulaire, &c, des Nouveaux M.dicamens, &c.
  3 Journal de Physiologie de Magendie, Hi. 267,  Juillet, 1823.
  * Annuaire de Th.rapeutique, &c. pour 1847, p. 42. Paris, 1847.     5 Bouchardat,
Op. cit. p. 02.                           *             ■ 
BUCHU.
157
always be that obtained from false angustura,—the brucia of nux vo-
mica being mixed with a portion of  strychnia, which adds to  its  acti-
vity, and renders it'difficult to determine the  dose.   The following
forrauhe are recommended by him:—

                        Pilulae brucise.
                          Pills of brucia.
                R.  Bruci8_ pur. gr. xij.^
                    Confect. rosa. ^ss.  M. exactiss. et fiant pilula. xxiv.
  One pill to be begun with twice a  day.               Magendie.

                      Tinctura bruciae.
           Tincture of brucia.—(French, Alcool de Brucine.)
                R.  Alcohol (36° areom., s. g. 847,) f gj.
                    Brucia- gr. xviij.   M.
  Of this tincture, from six  to twenty-four drops may be given, in the
form of mixture, in any vehicle.                        Magendie.

                      "Mistura brucise-
,               Mixture of brucia.—(Potio stimulans.)
                R.  Brucia. gr. vj.
                    Aquas destillat. f ^iv.
                    Sacchar. 3jij.  M.
  Dose.—A table-spoonful night and morning.         Magendie.

  Like the sulphate of strychnia, sulphate of brucia has been re-
commended by M. Grimaud-1 as an antiperiodic.
                         XLVIII. BUCHU.
 Syxonymes. Diosma, Diosma Crenata (folia;) Barosma Crenata (folia;) Agothosma
  Orenatum (folia;) Bocchoe, Bocho, Boocho, Buckha, Buchu Leaves.
 French. Diosmee crenelee.
 German. Buccublatter; Duftstrauchblatter.

  Buchu is now the officinal name of Diosma, in  the Pharmacopoeias
 of London, Dublin, and the United States;  and the leaves are referred
 to various species of Barosma.
  Barosma or Diosma crenata is indigenous at the Cape of Good Hope.
 It belongs to Natural Family Rutacese; 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 rosemary; by others, to cummin,
 and by others again, to that of the urine of the cat.   The name Diosma
 is, therefore,  by no means expressive,—S.o., " divine," and oopy, " odour."
 That of Barosma is more so, from /.ap.., " heavy," "powerful," and oapy,
 "odour."  The taste  of thevleaves is aromatic; somewhat pungent;
and, in the opinion of Buchner, resembles that of peppermint; without
any particular bitterness, yet disagreeable.   According to the analysis

            1 Bouchardat, Annuaire de Th.rap. pour 1852, p. 160. 
158
BUCHU.
of Buchner, Brandes, and Cadet, the most  important constituents ap-
pear to be a volatile oil of a greenish-yellow colour, a peculiar principle
—diosmin, and a semi-resinous substance.  Diosnrin 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 weak-
er ; 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; taste, somewhat
pungent and sourish.1

               EFFECTS ON THE ECONOMY IN HEALTH.
  The Hottentots  have long used the leaves of several varieties of ba-
rosma, both internally and externally; but they give  the preference to
barosma crenata.  Through them its virtues (buchu) became known to
the European settlers.  It was first brought to the notice of British prac-
titioners by the  notorious Richard  Reece, who is more known for the
part he took in the farce of Joanna Southcotg than for anything else.
In Germany, it  was chiefly promulgated by Jobst, who published an
extract from Reece's observations  in the Repertorium of Buchner.2
Bardili instituted experiments for testing its  action on the  healthy or-
ganism.  It first acts—he says—as  an excitant on the stomach, whence
arises a feeling of increased  heat in that organ*, and the appetite be-
comes  augmented: from the  stomach, the excitement spreads to the
vascular system; the heat of the body is increased; the pulse become-
more frequent, and the transpiration is favoured.  It acts,  likewise, on
the urinary secretion; the urine is  separated in larger quantity, con-
tains 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 action 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  stomachic,
and the Dutch physicians  give  it with success  in indigestion.  It is
said  also to have afforded  essential service in chronic cases  of rheuma-
tism and gout.  Autenrieth  extols  it in rheumatic pains, which  have
had  their foundation in repelled itch; (?)  and its utility in chronic
rheumatism has been confirmed by numerous others.   It has been ex-
tolled, moreover, in hematuria, calculous pains, and in irritated and
suppurative conditions of the bladder, urethra, and prostate. ' The au-
thor has repeatedly  administered it, but has observed no other effects
than those of a moderate excitant, diuretic, and tonic.  Reece says he
found it efficacious in incontinence  of urine, and in catarrhus vesica;
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 externally,
in the form of liniment and baths, as well as of fomentations and  cata-

  1 Journal de Chimie  M.dicale, ii:. 13, and Journal de Pharmacie, xiii. 106.
  2 Band. xxii. S. 51. 
CAINCiE RADIX.
159
plasms, in luxations and rheumatic pains,—and in wounds, especially
the contused.
  It may be remarked, that this—like almost every similar remedy-
has been given in cholera; and, as the Riga physicians assert, fre-
quently with favourable results.

                       MODE OF ADMINISTRATION.
  The dose  of the powder is Jij. in the day: this, at least, is the com-
mon 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, however, there  is not
much difference.   A vinegar, oxymel, liniment, extract, and  tincture
of diosma have been* advised.
  The London, Edinburgh,  Dublin, and United States Pharmacopoeias
have an Infusum Buchu (|j. of the leaves  to Oj. of water, Pharm. U.
S.;) dose f Jiss: and the Dublin, a Tinctura Buchu (3V. of the leaves
to Oij. (Imperial measure) of proof spirit;)  dose, f 3ij. or f 3iij.

                Infusum buchu  compositum.
                     Compound infusion of buchu.
                R. Buchu.
                     Uva. ursi aa. ^ss.
                     Aq. bullient. Oss.
       Digere leni calore in vase clauso per semihoram.   Colatura. adde
                     Syrup, seneg. f^ss.  M.
  Dose.—One  or two  spoonfuls every two hours in blennorrhoea, and
in atony and paralysis of the bladder.                      Clarus.
                R. Infus. buchu f 3vij.
                     Tinct. buchu.
                     ----cubebse, aa. f gss.  M.
  Dose.—Two table spoonfuls three times a day.  This formula is re-
commended  by Dr. Joy1 " in chronic diseases of the prostate, bladder,
kidneys, gravel, &c,"—as if the pathological condition to  be rectified
were, in all  these cases, identical!
                     XLIX. CAIN'C.E RADIX.
Synonymes. Eadix Chiococca., R. Cainanse, R. Caninana., R. Cahincae, R. Kahinca.,
  R. Serpentaria. Braziliensis; Cainca Root.
Portuguese. Raiz Crusadinha, R. Preta.
German. Caincawurzel.
  The plant, which furnishes the root introduced  into Europe  of late
years, and which has since  become known as a remedial agent, is Chio-
cocca anguifuga, of the Family  Rubiaceae;  Sexual System, Pentan-
dria Monogynia.2   The shrub grows wild in the forests of Brazil, espe-

  1 Tweedie's Library of Medicine, v. 311.  London, 1840; or 2d Amer. edit vol  iii
Philad. 1842.
  2 Art. Chiococca, in Encyclopiid. W.rterb. vii. 531. Berl. 1831; and Von Martius, Spec.
Mat. Med. Bra.il, i. 18. 
160
CAINC_E RADIX.
 cially 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 pos-
 sesses 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
 colour; yellower and brighter on the  youngest parts: the epidermis is
 not easily separated.  According to the chemical investigations of Pel-
 letier and  Caventou,1 the following  are found to be the constituents of
 the bark:—1. A  bitter principle, crystallizable in small, white,  silky,
 shining needles; inodorous, and very soluble in hot alcohol, which com-
 municates to the whole plant a degree of astringent bitterness, and at
 the same time has an acid reaction on litmus paper.   In order to sepa-
 rate this acid, which has been  termed by those chemists—acidum ca-
 hincicum seu cainanicum seu cainaniumseu cainanum; German, Cain-
 casiiure,  Caincabitter—in a pure state, the alcoholic  extract of
 the root must be dissolved in water, filtered and precipitated by lime,
 until the fluid loses all its bitterness; the precipitate is then decomposed
 by oxalic  acid, and  boiling alcohol or  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, however,
 some colouring matter is still  united.  2. A fatty, green,  nauseous-
 smelling substance, which communicates to the plant its odour.  3. Yel-
 low colouring matter; and 4. A viscid colouring matter.2

                     EFFECTS ON THE ECONOMY.
   The effect of cainca  root seems to  be especially exerted on the di-
gestive  and  urinary organs.   It occasions  watery evacuations, and
 diuresis.   From the experiments, however, of Albers,3 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 purga-
tives, by the side of helleborus  niger.  Wolff was of the same opinion.
According to Von Langsdorff,4 it is a highly efficacious emmenagogue,
possessing, also—to use his own language—considerable resolvent vir-
tues, and hence employed in dropsies that are connected with obstruc-
tions in the abdomen.  Riecke5 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 pal-
liation ; diuresis was not excited, whilst nausea, colic, and diarrhoea
supervened, so that he discontinued it; he gave it in decoction.  Others
have observed  the same inconvenience from its use, or have found it

  1 Journal General de M.decine,  Mai, 1830, and Philad. Journ. of Pharmacy, iii. 165.
Philad. 1831.                           2 journai de pharmacie, xvi. 465.
  3 Medicin.  Zeitung. No. iv. Sept. 1832.
  « Hecker's Litter. Annal. iv. S. 395, and Rust's Repertorium, B. xiv. S. 458.
  5 Die neuern Arzneimittel, u. s. w. S. 84.  Stuttgart, 1837. 
CAINCiE RADIX.
161
wholly ineffectual; for example, B. Heyfelder, Reinhardt, Bartels,1 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, Solieer, Lowenstein,2  &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,3 Guddoy, Engler, Frangois, Wagner, Solieer, Beral, Robredo,4 &c.
2. Intestinal worms, against which it appears to act like other drastics.
3. Obstructed  menstruation: on this  subject, however, farther trials are
needed.  When it operates as an emmenagogue, it  is  probably alto-
gether like cathartics that act more  especially on the lower part of the
bowels,—that  is, by contiguous sympathy. 4. M. Francois has recom-
mended it highly in catarrhus vesicae, but the experience of others has
not confirmed this.5   It  may be mentioned, that, in its native country,
it is used for rheumatic pains; in a peculiar kind of pica experienced
by the negroes of South America;  and, as already remarked, against
the bites of serpents.

                    MODE OF ADMINISTRATION.
   Cainca is given in various forms—powder, infusion, and  decoc-
tion ; and, besides these, a tincture and an extract have been made
of it.  A syrup and a wine have also  been recommended.  To form
the latter, one ounce of the powdered root is infused in a pint of wine :
the tincture is made with one part of the root and eight parts of alco-
hol at  20°.    The alcoholic extract is considered to be the most
uniform  in  strength, and  has, therefore, been  preferred by  many.
The syrup is  formed by dissolving 3iiss. of the extract  in a little al-
cohol, 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 3ss. in the twenty-four hours.  It
appears, however, to be the most objectionable form,  and to give rise
to unfavourable symptoms more frequently than  the others.  Opinions
vary as to whether the infusion or the decoction should be preferred.
According  to  Caventou  and Pelletier, boiling extracts very well the
efficacious parts of the root; and  there are cases in which the decoction
has rendered essential service after the  infusion had been administered
without success.   Of the decoction, from f 3J. to f 3tij« are given in
the day.  Of  the extract, the dose, in the twenty-four hours, is from
twenty to thirty grains; of the tincture, from f 3j- to from f 3ij.6
   The decoction used by Spitta and others was made as follows:

  1 Griife und Walther's Journal der Chirurgie, u. s. w. xxiv. S. 470.  Berlin, 1836.
  2 De Radice Caincte ejusque in Morbis Hydropicis Yirtute.  Berol, 1828.
  3 Hecker's Litterar. Aunal. iv. 396.
  4 Journal de la  Academia de Medicina de Megico, Oct. 1836; cited in Brit. For. and
Med. Review, p. 562, Apl. 1838.
  5 Bulletin General de Therapeutique, No. 13, Juillet, 1837.
  6 Journal de Chimie M.dicale, Mai, 239-242.  Faris, 1827.
11 
162
CALENDULA OFFICINALIS.
                  Decoctum radicis  caincae.
                      Decoction of cainca root.
                R.  Cainca? rad. ^ij.
         Coque cum aquae Oiss. ad dimidiam partem et cola.
  Dose.—A tablespoonful three times a day.
                                  Von Langsdorff1 and Frangois.
  By others, the following form has been employed:
                R.  Cainc. rad. §j.
                    Aquae Oij.
           Coque ad dimidiam partem et cola.
  Dose.—Two tablespoonfuls three or four times a  day.    Engler.

  Dr. John H. Griscom,2 of New York,  considers  there is a remark-
able 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 Frangois, in the dose of six  grains gradually increased
to fifteen.
                 L. CALENDULA  OFFICINALIS.
Synonymes. Calendula Sativa, Caltha Sativa, Verrucaria, Chrysanthemum, Sponsa
  Solis, Single Marigold, Garden Marigold.
French. Souci, S. Ordinaire.
German. Ringelblume, Gemeine Ringelblume, Todtenblume.
  This plant belongs to Family Synanthereae; Sexual System, Syn-
genesia Necessaria.  It is much cultivated in the gardens of southern
Europe more especially, and grows wild there.  The whole plant has
a feeble aromatic smell, which is not, however, unpleasant.  The taste
is  bitter and somewhat  pungent.  It was examined chemically. by
Geiger and Stoltze,3 who found in it 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 re-
ceived into the lists of the Materia  Medica as an "officinal;"  but it
had become  entirely obsolete, when Westring,4 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
by 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

  1 Hufeland und Osann's Journ. B. lxii.  St.  2.
  » Amer. Journal of the Med. Sciences, for May, 1838, p. 55.
  * Berlin. Jahrb. d. Pharmac. B. xxi. S.  282.
  * Erfahrung iiber die Heilung der Krebsgeschwiire, u. s. w.  Translated from the
Swedish into German, by K. Sprengel.  Hal. 1817. 
calendula officinalis.
163
 the results he was led to infer, that it is perhaps the best agent that
 can be employed in  that frightful malady.   He never, however, em-
 ployed 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 probable
 —ascribable to the associated articles.
   Some time  after Westring's publication, the remedy was used by
 others, and his observations were confirmed.  Rudolph1 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.  Fehr2 found it highly useful not only in incipient, but in
 advanced  scirrhus:  Stein  praises it in cancer  of the integuments,
 (Hautkrebs.)   He forms the  expressed juice  of the  young plant
 and flowers into an  ointment with fresh  butter, and applies it once or
 twice a day by means of lint, having previously washed the ulcers with
 a decoction 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 spee-
 dily becomes  absolute  pain.  This  soon, however, abates, and  almost
 wholly disappears; and if it be too violent, 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 cicatrizable  character.
   Rust,  also, frequently administered the extractum calendulas in can-
 cerous ulcers, and as a discutient in chronic indurations, in  combina-
 tion, however,  with  other efficacious agents.   Schneider  affirms, that
 he prescribed the extract with the best effects in induration of the sto-
 mach, and in tumefaction and decided induration 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.
 Muhrbeck3 used the extract with eminent success in chronic vomiting ;
 Carter4 in extremely  obstinate vomiting; and De Camp in a  case of
 cardialgia, where the excitability of the stomach was  so great, that
 every remedial agent was rejected  before it  had  opportunity to act.
 Fehr also extols it  in amenorrhcea, in which disease it was celebrated
 with the  older  physicians; but, as Riecke5 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 ADMINISTRATION.
   The extractum calendula  is contained  in the Hanoverian and Saxon
 Pharmacopoeias;  in  the latter it is directed to be prepared in the fol-
 lowing manner:—

  1 ITufeland und Osann's Jour, der prakt. Heilk.  B. lviii. St. 1, P. 119.
  2 Verhandlungen der verein. arztlich. Gesellschaft. der Schweiz. Jahrg. 1831, and
Dierbach, in Heidelberger Annalen, B. x. H. 4, S. 501.  Heidelberg, 1834.
  3 Hufeland's Journal der prakt.  Heilk. B. lxii. St. 5, S. 128.  Rust's Magazin der
gesaramt. Heilk. B. xi. S. 350.
  4 London Med. Rep. April, 1820, p. 347. Also, Link und Osann, in art. Calendula, in
Encyc. Worterb. u. s. w. B. vi. S. 520. Berl. 1831.             6 Qp. cit. S. 101. 
164
calendula officinalis.
                 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.1
  The dose  of  the extract is different according to different observers.
Muhrbeck gave four grains five times a day.   Fehr allows 3ij. to  3vj.
Phobus directs  the dose of the extract, prepared according to the Prus-
sian Pharmacopoeia, to be from eight to sixteen grains, gradually in-
creasing  it to 3ss,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 oint-
ments.   The dose of the  decoction of the fresh plant  is  f |j.  to f |ij.
  The Sardinian Pharmacopoeia has a  Conserva florum  calendula,
made by beating together one part of the flowers and two parts of pow-
dered sugar.   It has, also, an Acetum florum calendula, made of one
part of the petals digested in four parts of vinegar;  and the Wirtem-
berg Pharmacopoeia has an Unguentum florum calendula, made of four
ounces of the petals boiled in a pound of fresh butter, until the mixture
is entirely evaporated.   This is used as an emollient and resolvent.

                       Pilulse  calendulse.
                          Pills of calendula.
                 R.  Ferri subcarb.
                     Calend. pulv.
                     Extract, calend. aa gj.
                     Mucilag. acac. q. s. ut fiant pilula. xc.
   Dose.—Five to eight, three times a day, as a soothing agent in can-
cerous ulcers.                                               Rust.
                 R.  Hydrarg. chlorid. mit. 9ss.
                     Antim. sulphur, aur. 9j.
                     Extr. calendul.
                     ----conii. aa 9y.  M. f pil. pond. gr. ij.
   Dose.—Five pills, three times a day, as  a discutient in  chronic in-
 durations.                                                  Rust.
                   Lotio extracti calendulae.
                    Lotion of the extract of calendula.
                 R. Extract, calend.
                     ------anthemid. aa gij.
            Solve in
                     Aq. lauroceras. f ^ij.
            Adde
                     Tine, opii f £j.
   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.
             1 Pharmacop^e Universelle, &c, par Jourdan, ii. 536. 
calx chlorinata.
165
                     LI.  CALX  CHLORINATA.
Synonymes. Calcis Chloridum seu Hypochloris, Oxychloruretum Calcii, Protochloru-
  return Calcii, Chloruretum Oxidi Calcii, Bichloruretum Calcii, Oxymurias Calcis,
  Calx Oxymuriatica, Calcaria Chlorata seu Chlorica seu Chlorinica, Chlorum Cal-
  caria?, Chloretum Calcariae,  Chlorinated Lime, Chloride, 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,  Muriate Suroxigene ou Oxi-
  fjrne de Chaux, Chlorate ou Souschlorate de Chaux, Poudre de Blanchement, Pou-
  dre de Tennaut.
German. Kalkchlorid, Chlorkalk, Chlorigsaurer Kalk, Chlorcalcium-
  oxyd,  Oxydirt Salzsaurer  Kalk, Bleichpulver.
   Chlorinated lime is a compound of chlorine  and oxide of calcium.

                       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 pulverulent 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 pre-
pared 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 ves-
sel, till it is  saturated.   Chlorine is very easily evolved from binoxide
of manganese mixed with chlorohydric acid, by a gentle heat.1   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.
 . 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.2  Its nature and composition are
subjects  of dispute, and hence  the term "chlorinated lime," which has
been adopted by the London, Edinburgh, and  United States Pharma-
copoeias, in place of chloride of  lime.
   M. Hunoux Desfontenelles3  affirms, that having prepared pills of
chlorinated  lime,  extract  of opium  and  honey,  they experienced 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 re-
sult.  It would hence appear that  chlorinated lime  and organic sub-
stances  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, assimilates it to that
of chloride of calcium.  The data have been considered as scarcely, per-
haps, sufficient to determine its precise operation.  It appears, however,

  1 Brande's Dictionary of Materia Medica, p.  135.  Lond. 1839.
  2 Link, Art. Chlor, in Encyc. Worterb. der Medicin. Wissenschaft, vii. 579. Berlin, 1831.
  5 Journ. de Chimie Medicale; and Soubeiran, Journ. de Pharrnacie, F.vrier, 1842, p. 121. 
166
CALX CHLORINATA.
 to act mainly by means of its chlorine, which, being loosely combined,
 is readily disengaged,—all acids,  even the  carbonic, occasioning its
 separation.   It is not  much  employed  internally;  but,  according  to
 Cima, 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 scrofulous
 swellings.   By Cloquet, it was used both internally and externally in
 gangrenous ulcers; and by Grafe, Deschamps, Graves,1 and the author,
 in fcetor oris.   In a  case of pectoral disease, with great fcetor 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,2 it was prescribed in dysentery,
 and in a bilious typhus occurring in summer; and by  Copland3 in the
 last stage of typhus fever,  when the evacuations were highly offensive,
 given in draughts of aromatic water with mucilage.  Dr. Pereira4  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  fever of
 Edinburgh.5   It was  likewise given  by Groh, Cohen, and Schlesier,8
 in phthisis, and by Griife 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 especially
 in ulcers.  According to Trusen, an  aqueous solution  is proper for
 torpid ulcers of almost all  kinds—the phagedenic, the  scrofulous,  &c.
 In syphilitic ulcers, it appears to be of use when the  chancre is slough-
 ing, andeats deeply into the flesh.7   Trusen employed a solution formed
 by rubbing from giij.  to giv. with a pint of water, pouring off the  su-
 pernatant 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 granulations  spring  up.  By the same  kind of
 treatment, phagedenic, herpetic and scrofulous ulcers  generally cica-
 trized speedily and permanently.8   Trusen employed, at the same time,
 crude antimony with cathartics;  and in all cases he directed  strict re-
 pose, and regulated diet.
 ^  Trusen's observations  have been confirmed  by many modern physi-
cians, amongst  whom  may be mentioned Labarraque, Lisfranc, Ekl,
Lemaire, Heiberg, and Kopp.   In ozcena, good effects were  observed

  1 Dublin Hospital Reports, vol. v.
 m 2 Transactions of the Association of Fellows and Licentiates of  the College of Physi-
cians in Ireland, vol. v. 1838.
 » Houlton's Appendix to Translation of Magendie's Formulary, p. 163.
 I ^1ue™«?ts of Materia Medica, and Therap. 3d Amer. edit.  i. 582.  Philad. 1852.
 s Chnstison, Dispensatory, p. 242.   Edinb 1842
 • Casper's Wochenschrift fur die gesammte Heilkunde,  No. 37, 1838.
 7 Mene, in Gazette Medicale, 11  F.v. 1832.
 » See Houlton's Appendix to Magendie's Formulary, p. 162. 
CALX CHLORINATA.                      167
from it by Horner,1 Awl,3 Heron,3 Detmold,4 and Strathing: and a so-
lution  of it, in the form of injection, was found serviceable in fistula,
by Trusen and Ricord.   In cancerous 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 appearance.   Dr. Frohlich5 used it with advantage
in a cancerous affection of the face, in the strength of one part to  six-
teen 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 solution
or of  soft paste.   In cases of wounds, the application  of a  solutiou
of it has been recommended by many, as by Trusen, Ekl, Lisfranc,6 to
promote cicatrization after the inflammation has subsided.  In a case
of punctured wound received in dissecting, and when the  inflammation
was proceeding  up the arm with  alarming rapidity and the pain  and
tension were extreme, the patient experienced immediate relief from a
solution employed as a lotion, combined with the  free use of  leeches.7
  Gubian8 has proposed  to apply it  to prevent pitting from small-pox.
The maturated pustules  are to be opened, and washed with a weak so-
lution; 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 can-
crum oris, by Labarraque, Richter, Berndt, and numerous others;  and
in sloughing affections of the female organs of generation, of  an ana-
logous nature, by Labarraque and Ekl; in hospital gangrene, by Percy,
Labarraque, Siedmogrodzki, Delpech, and Renard;  and in gangrene
of the scrotum, as well as in ordinary gangrene,  by Heiberg and Tru-
sen ; in all of which it was of decided efficacy.9   In  such cases it may
be applied either in the form of the paste above mentioned, or in strong
solution—^ij  to Oj of water.
  In burns of the second and third  degree, when they are  not spread
over too great  a  surface of the body, a solution of chlorinated lime, ac-
cording 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 prepared of it, may  be applied.
  Lisfranc's observations10 entirely accord with those of  Trusen.   He

 1 Amer. Journ. of the Med. Sciences, No. xi.
 2 Ibid. No.  xxii. for Feb. 1833, p. 543.                 s Ibid. Nov. 1836,  p. 271.
 4 Holscher's Annalen, 1843, Bd. v. Heft. 1; cited in Brit, and For.  Med. Rev., Oct.
1841, p. 549.
 5 Medicin. Jahrbiicher des k. k. osterreich. Staaten. B. xvii. S. 168.  Wien, 1834.
 6 Bulletin General de Th6rapeutique, Juillet, 1838.
 T Alcock, Essay on the Use of the Chlorurets, &c.  London, 1827.
 8 Journal de Chimie M6dicale, vi. 315.
 9 Riecke, Die neuern Arzneimittel, u. s. w.  Stuttgart, 1837.
 10 Gazette Medicale, 21 Mars, 1835.  Also, Bulletin General de Therapeutique, Juillet,
1838; and Clinique Chirurgicale de l'Hopital  de la Piti., Paris, 1841. 
168
CALX CHLORINATA.
applies compresses spread with cerate over the burnt parts: the  com-
presses 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 becomes dry.  A solution of
it, as well as of chlorinated soda, may be applied, indeed, with advan-
tage in the first stage of  a burn  or scald; and Mr. Holt1  affirms  that
he knows nothing so efficacious for a "black eye."  Dr. Chopin,2 too, af-
firms, that in  wounds produced  by contusion, laceration, or by the ex-
plosion of gunpowder, where there is much pain, speed; and certain re-
lief is produced by keeping the dressings constantly wet with a solution
of it; he found it, as well as chlorinated soda, very serviceable in cases
of sore nipples.
   In chilblains, it has been used in the form of solution and of liniment
with advantage, not only in the ulcerated condition, but where the skin
was unbroken, by Trusen, Lisfranc, Grafe, and others.  In  many cases,
however, it has been found  advantageous 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 valuable,3 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 mer-
curial fcetor.  In  such cases, the author has frequently employed  it
with advantage, although the affection is not much under the control
of medicine.
   In offensive odours from the mouth, arising from carious teeth, Reg-
nard employed a solution of it, but it excited the  salivary glands in a
disagreeable manner.   On  the  other hand,  E. Grafe recommends it
strongly in this very case,  and even in caries, both  inwardly and ex-
ternally, as a collutory and tooth powder.   In the latter form,  it  is
said to remove speedily the tartar and yellow depositions on the teeth.
   By Chevallier and Kluge, it is strongly recommended for cleansing
the mouth.   The latter gives a formula  for a collutory, which will be
found amongst the prescriptions at the end of  this  article.  It effec-
tually 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.4
   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 likewise been  used
successfully by Werneck  in goitre.

  j Lancet, April 6th, 1834.                    2 Gazette M.dicale, Oct.  31,  1835.
  5 Elliotson, in Houlton's Appendix to Translation of Magendie's Formulary, Amer. edit.
p. 162.  Philad. 1834.                          6             J
  4 Copland, in the Appendix to Houlton's edition of Magendie's  Formulary, p. 163;  S.
Jackson of Northumberland, (now of Philadelphia,) in Amer. Journal of Medical Sciences,
xii. 261 and 550, and Ibid, for May, 1838, p. 56.   (Dr. J. uses chlorinated soda.) 
CALX CHLORINATA.
169
  In several chronic eruptions, it has been much extolled—as in herpes,
by Kopp; in itch, by Heiberg, Derheims,1 Cluzel, Fantonetti,2 Hospi-
tal,3 Wittzack,4 and Napoli.5  Dr. Christison6 affirms that he never uses
any other remedy in itch;—a solution, containing between a fortieth
and a sixtieth part of chlorinated 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.   He has, also, found the same lotion useful in most other erup-
tions  attended with itching,  which symptom it  allays even whore  it
does not remove the disease.   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, ac-
cording to the degree in which  the disease exists, and the length  of
time it has been in the system; put this in a common flask or bottle
full of rain or river water,  so that as much as possible may be dissolved.
In using it, the patient must shake the bottle well, in order that some
of the undissolved lime may  be taken  up.   With  this he washes the
parts affected three or four times a day.  Every third  or fourth day,
when 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 accomplished.  The internal management is the
same  as in other plans of treatment.   In the case of young children,
the mixture must of course be weaker—about  one ounce to a 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 ophthalmia.
Varlez7 cured contagious blennorrhcea of the eye, by dropping upon it a
solution of it.  Colson, Delatte, and Reynaud8 also saw good effects from
it, both in acute purulent ophthalmia, and in chronic ophthalmia with
granulations, in obscurity of the cornea, and especially in  copious secre-
tion from the Meibomian glands.  Guthrie 9 applied a solution success-
fully in three cases of ophthalmia neonatorum ; and Pereira10 advises a
weak solution  in  the same cases.  Farvagnie used it beneficially in
scrofulous and catarrhal ophthalmia}1
   Dr. Radclyffe Hall12 has treated purulent ophthalmia, both in the
adult  and in children, with success, by a saturated solution. His plan
  1 Journal de Chimie M.dicale,  ii. 575.
  2 Bulletin de Therapeutique, 1833; and Amer. Journal of the Med. Sciences, August,
1833, p. 533.
  s Amer. Journ. of the Medical  Sciences, Nov. 1834, p. 240 (extracted.)
  * Casper's Wochenschrift, Feb. 4, 1837, S. 70.
  5 Journ. de Chimie Mod., cited in Amer. Journ. of Pharmacy, July, 1841, p. 172.
  « Dispensatory, Amer. edit, by 11. E. Griffith, p. 302.  Philad. 1848.
  ' Cited in American Journal of the Med. Sciences, i. 459.
  s Journal fur Chirurgie, u. s. w. B. xiv. H. 4.
  • Medical and Physical Journal, Nov. 1827.
 10 Elements of Mat. Med. 2d edit. i. 593, Lond. 1842; or, 3d Amer. edit, by J. Carson,
i.  582.  Philad. 1852.
 11 A'erhandlung. der vereinigt. iirztlich. Gesellschaft. der Schweiz. Jahr. 1829. Zurich.
l£:;u.                       12 Provincial Med. and Surg. Journal, Dec.  1844. 
170
CALX CHLORINATA.
of using it is as follows.  The eyelids are slowly and gently separated,
until the cornea can be seen, when that is practicable; and all  secre-
tion is wiped away with a fine, soft sponge.   A large, bushy camel's
hair pencil, charged with the strong solution, is then insinuated be-
neath the upper eyelid, and swept round the front of the eye; the pen-
cil 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 ef-
fectual, 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 ap-
plications of the solution, it is in perceptibly  diminished quantity, and
the discharge gradually loses its  characteristic yellow colour, and is
seen in  flakes on opening the eyelids.  After three or  more applica-
tions, the eyelids no longer swell, and the pain is much less.  As the
inflammation  lessens,  the eyes must be  kept clean with warm water,
and matter must  never be  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.
  It has likewise been employed advantageously in  other blennorrheas
besides  the one mentioned, and especially in  the gonorrhceal.1   Grafe,
of Berlin,2 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 water, and adding ^ss. of  wine of opium.  His ob-
servations are confirmed by Dr. Radclyffe Hall,3 who observes, that in
the treatment of diseases attended with  a  contagious discharge, it ia
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 ful-
filling 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, provided 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 puffiness  and eversion of the orifice of the urethra, and tender-
ness on pressure, with 'a feeling of unusual firmness  for  two or three
inches down the corpus spongiosum, where these did not already exist.

  1 Alcock, Essay on the Use of the Chlorurets, &c.  Lond. 1827.
  2 American Journal of the Medical Sciences, and Amer. Journal of Pharmacy, 2d series,
vol. n.  86.  Philad. 1838.   Also, M. Roussf, Bulletin General de Th.rap. Janv. 1842.
  3 Op. cit. 
CALX CHLORINATA.
171
 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 attendant  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  previously.  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 in-
 jection will have to be repeated as often as the peculiar tingling sensa-
 tion 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 anterior duration of the dis-
 ease.   In the acute stage of a first attack, Avhere both pain and dis-
 charge are considerable, Dr. Hall  has never seen any harm from em-
 ploying this strong injection,—using, at the same time, mild aperients,
 tartrate of antimony and potassa, and opium internally, enjoining per-
 fect rest and abstinence, 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 materi-
 ally 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 sin-
 gle  injection  has  sometimes cured, after the failure of almost every
 other kind of injection.  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.1   It is admirably
 adapted for preventing and checking putrefaction, and for correcting
 the offensive odour of parts already putrefied:2  and hence its applica-
 tion is most useful in anatomical investigations.3  Some  time  before
 dissection, the body may be enveloped in a cloth wetted with a solution
 of it, (Calc. chlorin.  5ss., Aquce  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 hospitals, jails or  ships;  a little of the solution being
 Bprinkled, from time to time, on  the floors; or  shallow vessels, con-
 taining 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 is practised.   It has been properly doubted,

  1 Labarraque, on the Use of the Chlorides of Soda and Lime, translated by Jacob Porter.
New Haven. 1829.         2 Alcock, Op. cit.         s Magendie, Formulaire, &c. 
172
CALX CHLORINATA.
however,1 whether its use be productive of any advantage in preventing
the spread of infectious, contagious, or epidemic diseases.  It has been
affirmed, indeed, to be positively injurious, by deteriorating the atmo-
sphere, and  in  this there may be truth, unless  the precautions, men-
tioned above, be taken.   In various cases, in  which such diseases have
prevailed, it has destroyed all offensive odour,—acted, in other words,
as an antibromic or deodorizer,—but  the extension of the malady has
not been prevented.2
                      MODE OF ADMINISTRATION.
   Chlorinated lime has been given internally  both in  the form of pill,
solution, and lozenge, the dose being  from gr. ij. to gr. vj. four to six
times a day.  Externally, it is generally applied in solution of different
strengths, (from 3j. to 3iv. to eight ounces of water)—being decanted
to remove the particles of lime from  it, unless where  it  is considered
advisable to employ the turbid solution.
   In cases of very offensive evacuations from the bowels, ten or fifteen
grains may be added to a common enema.   It is, likewise, applied in
the form of  ointment,  and of  liniment, and also of paste made by ad-
mixture with water.
   The following forms have been given for its administration :3
                 Trochisci  calcis  chlorinatse-
                      Lozenges of chlorinated lime.
                 R.  Calcis chlorin. 3y.
                      Sacchar. 3 viij.
                      Amyl. |j.
                      Tragac. 3j. _
                      Carmin. gr. iij.
                 M.  Fiant trochisci. pond. gr. iij. sing.
   One of these to be taken three or four times  a day, and allowed to
dissolve in the mouth, in cases of fcetor oris.            Deschamps.
                  Mistura calcis chlorinatae.
                       Mixture of chlorinated lime.
                 R.  Calcis chlorin. 3j.
                      Mist, amygd. f ^vij.
                      Syrup, acacias f§j.  M.
   A table-spoonful every three hours  in gonorrhoea.      E. Grafe.4
                     Pilul8e calcis chlorinata.
                        Pills of chlorinated lime.
                 R.  Calcis chlorin. gj.
                      Ext. opii. gr. ix.
                      Mucilag. acac. q. s.
                       Divide in pilulas  liv.
   Dose.—One, every two or three  hours,  in  gonorrhoea, gradually in-
creasing the dose until eight, ten or twelve  are taken  every hour.
                                                             Grafe.
  1 Observations on the Chlorides and Chlorine as "disinfecting agents," and as Preven-
tives of Cholera, by H. Bronson.  Boston, 1832.  Also, American Journ. of the Medical
Sciences, for Feb. 1833, p. 481; Albers, in London Med. Gaz. viii.'410, (as to its ineffi-
cacy in cholera;) and Pereira, Elements of Mat. Med.,  &c, 3d Amer. edit. p. 580.
Philad. 1852.                                       2 pereira> ibid. i. p. 581.
  s Riecke, Op. cit. S.  94.           i Journal fur Chirurgie, u. s. w. B. xiv. St. 2. 
CALX CHLORINATA.
173
                  Collutorium calcis chlorinatae.
                      Collutory of chlorinated lime.
                  R.  Calcis chlorin. grs. xv. ad gss.
                      Mucil. acac. f %].
                      Syrup, aurant. f 333.  M.

  A little of this solution to be applied by means of a mop of charpie
to ulcers in the mouth.                                     Angelot.

                  R.  Calcis chlorin. ^iij.
                      Aqua, destillat.
                      Alcohol, aa. f ^ij.
                      01. rosa. gtt. iv.
              Solve et filtra.
                                                          Chevallier.

   A tea-spoonful of this solution is mixed with a glass of water,  and
used in foetor oris.   According to Riecke,1 an analogous nostrum has
been sold at a high price under the name—Pneumokatharterion.

                  R.  Calcis chlorin. 3j.
                Solve, leniter terendo, in
                      Aquae destillat. Ovj.
                tunc adde
                      Alcohol. (.830) f gviij.
  Mist, reponatur in loco frigido per horas xxiv.; tunc filtretur et reserv. in lagena
bene obturate.  ("Let the mixture be put aside in a cold place for twenty-four hours;
then let it be filtered and kept in a well-stopped vessel.")

   It has been recommended that the mouth should  be rinsed  with  this
after the teeth have been brushed.—          Freyburg von Kluge.

                  R.  Calcis chlorin. 3*ss.
                Solve exactiss. trituratione  in
                      Aq.f-gij.
                et post limpid, clarificat. admisce
                      Alcoholis f 51J.
                      01. rosa. gtt. iv.  M.

   The mouth is rinsed, in cases of salivation, with a mixture  made by
adding a tea-spoonful of the solution to a glass of water.    Trusen.

   The Pharmacopoeia of Sweden has an antiscorbutic collutory called
Linctus ad  stomacacen seu oxymuriatis calcici, which is formed as fol-
lows:
                  R.  Solut. calcis chlorin. gss.
                      Aquae,
                      Mellis, aa.  ^vj.   M.

                  Dentifricium  calcis chlorinatae-
                      Dentifrice of chlorinated lime.

                  R.  Calcis chlorin. in pulv. gr. iv.
                      Corailina. rubra. 3ij.  M.

   A tooth-brush should be slightly wetted, then  dipped in this powder,
and rubbed over the teeth.  Employed to give their natural  colour to
teeth.                                                     Magendie.
                             1 Op.  cit. S. 94. 
174                       CALX CHLORINATA.

                     Solutio calcis chln.rinatae.
                      Solution of chlorinated lime.
                 R.  Calcis chlorin. 3iij.
               Solve in
                     Aqua, destill. Oj.
                Adde
                     Tinct. opii crocat. vel
                     Vini opii f 3j. ad f^ij.  M.
   Applied to frost-bites.                                    Trusen.

                 R.  Calcis chlorin. §ss.
                 Tere invicem et sensim affunde
                     Aq.  (seu Aq. rosae) Oj.
                 Et post clarificat. limpid, admisce
                     Mucil. acac. (seu sein. cydon.) ^ij.

   Applied, by means of linen rags, in  cases of burns.—    Trusen.

                 R.  Calcis chlorin. ^ij. ad ^iij.
                     Aqua. Oj.  Solve.

   To be  applied, by means of rags kept constantly wet, in cases of
hospital gangrene ; the mixture being shaken.        Rust $• Kluge.

                 R.  Calcis chlorin. 5iij.
                     Aqua, destillat. Oj.
             Solve et cola.

   Used as a lotion in cases of itch on the thighs, legs and arms, twice
or thrice  daily.  In general, six or eight days are sufficient to effect a
cure.                                                    Magendie.

   The  disinfecting  liquor of  Labarraque, Liqueur desinfectante  de
Labarraque, is made by adding ten parts of water to one part of chlo-
rinated lime, divided in a mortar; suffering the solution to settle, and
then filtering.
                  Collyrium  calcis  chlorinatae.
                     Collyrium of chlorinated lime.
                 R. Calcis chlorin. gr. iv. ad vj.
                      Vin. opii trjj x.
                      Mucilag. acac. f 3iss.
                     Aq. rosa. f 3*ij. M.  et filtra.

   To be dropped on the eye, in cases of catarrhal and scrofidous oph-
thalmia.                                                 Farvagnie.
             Injectio  calcis chlorinatae composita.
                 Compound injection of  chlorinated lime.
                 R.  Calcis chlorinat. gij.
                      Decoct, kramer. f^xiij.  M.
   Half an ounce of this to be injected  into the nose three or four times
a day,  in cases of  ozsena.                     Detmold,  of Hanover.

                  Cataplasma calcis chlorinatae.
                     Cataplasm of chlorinated lime.
                 R. Calcis chlorin.
                      Sodii chlorid. aa 3*ss.
                      Aquae destill.  Oss.
                      Farina, sem. lin. q. s. ut fiat cataplasma.

   Used in cases of scrofulous swelling of the joints.         Grafe. 
                       CANNABIS INDICA.                      175

               Unguentum calcis chlorinatae.
                   Ointment of chlorinated lime.
               R.  Calcis chlorin. gj.
                   Adipis ^j.  M. et fiat unguentum.

To be rubbed in, in cases of scrofulous swellings.          Cima.
               R.  Calcis chlorin. gss.
                   Adipis 3*j.  M. et f. unguent.
Used in goitre.                                        Werneck.
               R.  Adipis 3*j.
                   Sodae borat.
                   Calcis chlorin. aa 3j.  M. exactissime.
In cases of chilblains.                                   Trusen.
               R.  Sulphuris 3*iss.
                   Calcis chlorin. bene tritur. ^ij.
                   Adipis 3*x.  M.
In itch, morning and evening.                         Hospital.

               Linimentum calcis chlorinatae.
                   Liniment of chlorinated lime.
               R.  Calcis chlorin. gss.
           Tere in mortario vitreo et sensim affunde
                   Aq. rosa. (seu fontanae) f §j.
           Et post limpid, clarificat. admisce
                   01. amygd. fgj.
To be  applied by means of a pencil in cases of tinea capitis.
                                                        Trusen.
                    LII. CANNABIS INDICA.
Stn'onymes. Indian Hemp, Gunjah, Haschisch.
French. Chanvre Indien.
German. Hanf.
  Cannabis, which grows in India, and has been described by some
botanists under the name Cannabis Indica, does not appear to possess
any specific differences from the common hemp,  Cannabis sativa;  and
accordingly, by many botanists, they have been regarded as identical.1
  The term "Indian hemp " has long  been assigned, in the United
States, to Apocynum cannabinum:  this has given occasion in Europe,
and occasionally  in this  country,  to confusion in regard  to the  two
articles, which are very distinct in their natural and  medical charac-
ters.3
  The narcotic effects of cannabis have been long known to the peo-
ple of Southern Africa, South America, Turkey, Egypt, Asia Minor,
India, and the adjacent countries of the Malays, Burmese, and Siamese,
by whom it is  used in various forms to induce intoxication.   It is, like-
wise,  extensively employed in popular practice in various diseases.   In

  1 Rovle, Mat. Med. and Therap. Amer. edit. p. 551.  Philad. 1847, and Pereira, Ele-
ments of Materia Medica, 3d Amer. edit. ii. 334.  Philad. 1854.
  1 Farre, in Lond. Med. Gaz. May 5, 1843, p. 209. 
176                       CANNABIS INDICA.
Western Europe its use is unknown, and it is questionable, whether the
hemp of that region or of this country be possessed of the same pro-
perties.  Dr. O'Shaughnessy, of Calcutta, states, that the extraordinary
symptoms produced by the  oriental plant depend  upon a  resinous se-
cretion with which it abounds, and which seems to be wholly absent in
the European plant.   The absence of the resinous secretion, and con-
sequent want of narcotic power, he ascribes to difference of climate.
M. de Courtive1 has submitted to analysis cannabis  procured from Al-
giers, or from Indian  seeds reared in France.   He finds the active
principle to reside in resin, which he extracted by a complicated pro-
cess of maceration and the  action of alcohol.   From 9 to 10 parts  of
this resin—canneibine—were procured from 100  parts of the plant:
the Algerian article furnishing it in greater abundance; and he affirms,
that a grain  and  two-thirds, or  even half  the  quantity, produced  in
some temperaments an equal effect with half a dram of the  thick ex-
tract.   The  Cannabis  sativa of Italy furnished  an active but  much
weaker resin.  The  resin  obtained  by  M. de  Courtive  is of a  deep
greenish-brown colour, of an aromatic but nauseous odour, and of a hot,
acrid, and enduring taste.  It is soluble  in cold ether, alcohol, and vo-
latile oils; insoluble in water and dilute  alcohol.
   The Messrs. Smith, of Edinburgh, satisfied themselves that the resin
concentrates in itself the whole properties of the plant.   The following
is their mode of preparing  it.  Digest  bruised gunjah in successive
portions of warm  water until the expressed water comes  away colour-
less, and again for two days at a moderate  heat in  a solution of car-
bonate of soda, in the proportion of one  part of the  salt to two of gun-
jah.  Colouring matter, chlorophyll, and inert concrete oil, being thus
removed, express  and wash the residuum, dry it, and exhaust it by per-
colation with rectified spirit.  Agitate with the tincture  milk of lime,
containing an ounce of lime for every pound of gunjah; and, after fil-
tration, throw down the excess of lime with a little sulphuric acid.   Agi-
tate with the filtered liquor a little animal charcoal, which is afterwards
to be removed by  filtration.  Distil off most of the spirit: add to the
residual tincture twice its weight of water in a porcelain basin, and let
the remaining spirit evaporate gradually.  Lastly, wash the resin with
fresh water till it  comes away neither acid  nor bitter; and dry  it  in
thin layers.  Dry gunjah yields six or seven  per  cent, of it;  and its
strength as a narcotic corresponds with this proportion.2
   In certain seasons and in warm countries, a  resinous juice exudes,
and concretes on  the leaves, slender stems and  flowers of cannabis.
This  constitutes   the  churrus of Nipal  and Hindustan, and  in  it re-
sides the powers of all the preparations of hemp.  This resin —canna-
bine, haschischine3—is very soluble in alcohol  and ether;  partially
soluble in alkaline, but insoluble in acid, solutions.   When pure, it is
of a blackish-gray colour;  it is hard at 90° of Fahrenheit, but softens

  _i Bouchardat, Annuaire de Therapeutique, pour 1849, p. 52.  Paris, 1849: and Ran-
king s Half-yearly Abstract, viii.  214, Amer. edit. Philad. 1849.
    Chnstison, Dispensatory, Amer. edit. p. 973.  Philad. 1848
   3 Bouchardat, Annuaire de Therapeutique, pour 1850, p. 10 
CANNABIS INDICA.
177
at higher temperatures, and fuses readily.   It is soluble in the fixed,
and in several volatile, oils.   Its odour is fragrant and narcotic; taste
slightly warm, bitterish and acrid.  The dried hemp plant, which has
flowered, and from which  the  resin has not been  removed, is  called
Gunjah, Ganja or Haschisch.   It  is made into bundles of 21  plants
each.  These bundles are 2 feet in length, and 3 inches in diameter.1
It yields to alcohol twenty per  cent, of  resinous extract,  composed  of
the resin—churrus—and green  colouring matter.   The Gunjah is used
for  smoking.  The larger leaves and capsules, without the stalks, con-
stitute Sidhee, Subjec, Bhang  or  Bang, which is  used  to form with
water an intoxicating drink.  When the plant is distilled with a large
quantity of water, traces  of volatile  oil pass  over, and the distilled
liquor has the powerful narcotic odour  of  the plant.2
  The resin or alcoholic  extract  of  the dried tops of cannabis'has
been admitted into the Pharmacopoeia of the United States, under the
name extractum cannabis, Extract of hemp.  The Dublin has an ex-
tractum cannabis indic_e purificatum, which is the commercial ex-
tract, purified by treating it with alcohol, allowing the dregs to subside,
decanting the clear liquor,  and  evaporating, by means  of a water bath,
to the consistence of a soft extract.

                      EFFECTS ON THE ECONOMY.
   Cannabis Indica, raised  in India, appears to have the  greatest ac-
tivity.  Mr. Donovan made numerous  experiments with hemp cultivated
by himself, and was satisfied that domestic  hemp  is  destitute  of the
 principle "which  renders the Indian plant so desirable  an extract to
 the voluptuous people of  the East."
   The effects of this remedy would appear to have been well known to
 the Arabian and Persian physicians of both modern and ancient periods;
 but the first person,  who seems to have well tested its properties, was
 Dr. O'Shaughnessy.3  In his various  experiments, he  did not  observe
 the least indication  of pain, or any  degree of convulsive movement.
 They all, he affirms,  "led  to one  remarkable  result,—that while car-
 nivorous animals  and fish,  dogs, cats, swine, vultures,  crows, and adju-
 tants invariably and speedily exhibited the intoxicating influence of the
 drug, the graminivorous,—such as the horse, deer, monkey, goat, sheep,
 and cow,—experienced but trivial effects from any dose that was admi-
 nistered."   Encouraged  by these  results, he felt no  hesitation as to
 the perfect safety of giving the resin of  hemp an extensive  trial in
 cases in which its apparent powers promised the greatest degree of utility.
 The general effects observed on man  were  alleviation  of  pain  in  most
 cases, remarkable augmentation of the appetite, aphrodisia, and great
 mental cheerfulness.  The more violent effects were a peculiar form of
 delirium, and a cataleptic  state.

   1 Ballard and Garrod, Elements of Mat. Med. and Therap., p. 413.   Lond. 1845.
  ! For the history of the Haschisch, see Moreau, Louradour, and Bouchardat, in Bou-
 chardat, Annuaire pour 1847, p. 11.  Paris, 1847.  Also, on the varieties of intoxicating
 drugs prepared from the Cannabis, C.J. Mutter, Pharmaceut. Journ., Oct. 1854; and
 Amer. Journ. of Pharm. June, 1855, p. 360.
  8 On the Preparations of Indian Hemp, or Gunjah, (Cannabis Indica,) &c, Calcutta,
 1839; and Brit, and For. Med. Rev., July, 1840, p. 224.
        12 
178
CANNABIS INDICA.
   Under the influence of fourteen grains of the resinous extract taken
 at bed-time, Mr. Donovan1 awoke early  in the morning, with a rush of
 strange sensations through his head, accompanied by a crackling  and
singing noise, and a vibratory motion through the whole body.   These
gradually subsided, and whilst dozing off, he thought an explosion took
place in his head, followed by the same rushing noise  and vibration as
before, and afterwards by a strange metallic sound.  Various other
noises succeeded.  His sense of touch and feeling had gradually become
more and more  obtuse, until  at  length  he lost  all feeling, unless he
pinched himself  severely.   "The  effects," says  Mr. Donovan, "were
now at their height, and the consequences  were surprising.   I absolutely
lost the consciousness of having a body; and  my corporeal existence
appeared to be comprised within the head, and a small portion of  my
chest near the throat: in these spots I felt as  much alive  as ever,  but
all other parts were without feeling, and, to my perception,  annihilated.
My  intellect was not in the least  disturbed; memory was as good as
ever.  I  reasoned well enough; was  conscious of external objects as
in perfect health; but I had some notion that  if I gave way to sleep,
I should never wake  in this world; yet, strange to say, I felt perfectly
resigned to this sudden termination of existence."   Similar phenomena
have appeared in others from a much smaller dose.2
   On trying an alcoholic extract, sent to Dr. Christison3 by  Mr. Andrew
Robertson of Calcutta,4 for toothache, he  found, that about  four grains,
taken at three A. M., caused, in an hour, cessation of pain, a pleasant
numbness  in the  limbs, giddiness, a rapid succession  of unassociated
ideas, and impossibility to  follow a train of thought; frequent intervals
of sleep,  and slight increase in the force of the pulse.  Next morning
there was an  ordinary appetite,  much  torpidity, great  defect and
shortness of memory, extreme apparent protraction  of time, but  no
peculiarity of articulation or other effect, and these symptoms lasted
until two  P.  M., when  they entirely ceased in  a few minutes after
taking lemonade.
   The  results, however,  of different observers,  in   regard  to this
agent, are by no means in accordance.  Whilst  some believe  it  ca-
pable of  replacing   opium,  where the latter  disagrees,   others have
found it  fail where  opium had failed.   Dr. Lawrie, of Glasgow,5 has
reported  its effects in twenty-six  cases, from which he drew the fol-
lowing  conclusions.   First.  It seems to belong  to that class of nar-
cotics, which rapidly induce excitement  and intoxication, followed by
sleep—neither sound nor  refreshing.    Secondly. In  a  full dose, it
acts powerfully on the heart, causing  palpitation, and a rapid, weak,
intermittent  pulse; and on  the nervous  system,  producing delirium,
coma, convulsions and dilated pupils.  Thirdly. Its effects are generally
transitory.   In one  case,  however, the intoxication and  dilatation of
the  pupils lasted nearly forty-eight hours.   Fourthly. It is a very

  1 Dublin Journal of Med. Science, Jan. 1845.
  2 See the author's General Therapeutics and Mat. Med. 5th edit. i. 418. Philad. 1853.
  3 Op. cit. p. 973.
  * For an account of this extract, see Pharmaceutical Journal, cited in American Jour-
nal of Pharmacy, for August, 1847, p. 195.
__,« Lond. and Edinb. Monthly Journal of Medical  Science, Nov. 1844, p. 497 
CANNABIS INDICA.
179
uncertain agent;—in some cases producing the most violent and seemingly
dangerous symptoms; in others, being nearly inert.   Fifthly. It very
frequently causes vomiting, which, whether it occurs spontaneously, or
from  emetics,  very speedily relieves its  unpleasant,  and  perhaps
dangerous effects.   Sixthly. Applied around the eye, it does not dilate
the pupil.  Seventhly.  It exerted little influence on the few  patients
to whom it was given in the form of enema.  Eighthly. He does not
think it a valuable addition to our narcotic medicines.  In very few
cases did it act as an agreeable soporific and anodyne.  In none did it
succeed when opium had failed;  and in one case only was it preferred
to opium.  He does not think it  is to  be trusted  to.  Ninthly.  So far
from acting  generally as an  anodyne, its effect was so disagreeable,
that the majority of those who took it once, only did so a second time
on compulsion, and  this was the  more remarkable, as the patients on
whom he experimented belonged to a class to whom stimulants of all
kinds were familiar, and who would greedily swallow opium and  spirits
to  an unlimited amount.  Tenthly.  It  seemed useful in two cases  of
subacute rheumatism ; and, lastly, it caused an  immediate craving for
food, and, in a few, permanently increased  the appetite.
   Professor Miller,1 of Edinburgh, believes cannabis to be comparatively
valueless as an anodyne, as well as hypnotic, in ordinary circumstances.
Its virtue seems to him to consist in a power of controlling inordinate
muscular spasm.   This  it exhibited in a case  of traumatic tetanus
reported by him.   Many cases have been published, in which its anti-
 convulsive power was confirmed.   In opposition, however, to Professor
 Miller, Dr. Clendinning* has  no  hesitation in affirming, that its exhibi-
 tion has usually, and with remarkably few substantial exceptions, been
 followed by manifest effects as a soporific or hypnotic, in conciliating
 sleep;  as an anodyne, in lulling irritation; as an antispasmodic,  in
 checking cough and cramp; and as a nervine  stimulant, in removing
 languor and anxiety, and raising  the pulse and spirits; and these effects
 have been  observed by him in  both  acute  and chronic  affections, in
 young  and old, male and female.
    Dr.  Corrigan3 believes, that the action of cannabis is primarily  on
.the motor nerves;  its  influence he inclines to think being transmitted
 along these to the sensorium, and nerves of sensation.   Speaking  of
 its peculiar  advantages as  a sedative, he  affirms, that even in over-
 doses it does not  produce the dry tongue, or the derangement of the
 digestive organs, which occasionally follows the use of opium.  Its  ef-
 fects on different  persons, however, he remarks, are very  different.
 In the case of a lady who had long suffered from neuralgia of the face,
 neck, and head, twenty drops of the tincture caused temporary loss of
 power  in  almost all the muscles, followed  by  sleep;  while a  similar
 dose has been taken  by other  patients three  times daily, for weeks,
 with impunity and advantage.
    Dr.  Pereira4 experimented on some  specimens of gunjah and _Ni-
 palesc  churrus, which were sent to him by Dr. O'Shaughnessy.   He
   1 Ibid. Jan. 1845.
   2 Provincial  .led. and Surg. Journ. May 27,  1843, and Med. Chirurg. Trans, xxvi. 208.
   8 London Med. Times, cited in Med. Examiner for Sept.  1845.
   4 Elements of Mat. Med. 2d edit. ii. 1098.   London, 1842. 
180                     CANNABIS INDICA.

trie! them both on animals and man, and gave specimens of them to
medical friends; but their effects were found to be comparatively slight ;—
"whether,"—says Dr. Pereira,—"this be owing to the preparations
having undergone some deterioration in  their passage, or to the  com-
parative phlegmatic  temperament  of  the English, I know not.   My
experiments on  animals were made in the  lecture-room of the  Lon-
don Hospital before the students of the  Materia Medica class;  and
the trials on the human subject were made in the wards  of  the hos-
pital."
   Messrs. Ballard and Garrod1 state,  that when the dose was large,
they  observed the urine acquire an  odour something like that evolved
when the tincture is  mixed with water,  and in part like that of the
Tonquin bean.2
   Indian hemp was prescribed by Dr. O'Shaughnessy in various dis-
eases.  In rheumatism, acute and chronic,  the results were not very
satisfactory.  In  one case,  the most  marked  catalepsy  supervened
along with the usual intoxicating effects.  Heer,3 however, found the
tincture, given in the  dose of eight  drops, three times  a day, very ser-
viceable in acute rheumatism.  In a case of hydrophobia, Dr. O'Shaugh-
nessy observed the soothing influence of  the remedy to be very great;
but the disease terminated fatally.  In cholera, he considered its agency
to be "promising, and to deserve the attention of the practitioner;"
and since then  it has been  extolled in  that disease by MM. Aubert-
Roche, Chaniac, Willemin,4 Gastinel, Legroux5 and others.
   The testimony is strongest in regard  to its influence in traumatic
tetanus, of which Dr. O'Shaughnessy refers to fourteen  cases; of these,
nine  appear to have  recovered.6   It  is well remarked, however, by
Messrs. Ballard and  Garrod,7 that  it is  no  easy matter to  determine
the claims which a medicine holds forth  to control tetanus; and  that
we should be cautious of advancing statements in reference to the sub-
jugation of such a formidable disease unless on the most unexception-
able evidence.  " Tetanus has been  occasionally recovered  from under
a variety of treatment, and hence  the  disappearance of  it in a few
cases during the treatment by this drug must not be rashly used as a
decided  evidence of  its  curative capabilities.  Of  two cases lately
treated with it  in the University College hospital, one died, and the
other  recovered:  the former was  traumatic; the latter  idiopathic.
However, it  is  difficult to say how far it influenced the favourable ter-
mination ; inasmuch as full and repeated blood-letting and colchicum
were also employed."   This difficulty exists  in most of the reported
cases.  In but few has cannabis been given alone.   It is proper, too,
to add, that in the  hands of Mr. Stafford,8 Mr. Potter,9 and  Dr. Ba-
  1 Op. cit.
  2 For the experiments of M. Lieautaud and Brierre  de Boismont, and of M. E. de Chaniac,
see Bouchardat, Annuaire de Therapeutique, pour 1845, p. 29, Paris, 1845, and Ibid, pour
1846, p. 13. Also, Lieautaud, in Ranking's Abstract, p. 342, Amer. edit. New York, 1846.
  3 Bouchardat, Annuaire de Therap. pour 1855, p. 17.
  * Bouchardat, Annuaire de Therapeutique pour 1849, p. 51.
  6 Ibid, pour 1850, p. 10.
  « See cases by Ley, Lond. Lancet, April 1, 1843, and Isaac Heister, Bost. Med. and
Surg. Journal,  June 17, 1846, p. 394.                     t qp cit. p. 414.
  8 Lond. Med. Gaz., April  29, 1845.         9 Lond. Lancet, Jan. 11,  1845, p. 36. 
CANNABIS INDICA.
181
 bingtonl it failed, or, at the most, afforded only temporary relief, al-
 though the utmost care was taken to obtain the article in a state of
 purity.*  From the results of his cases, Dr. O'Shaughnessy concludes,
 that the resin of hemp,  given boldly and in large doses, is capable of
 arresting effectually the progress of that formidable disease, "and in
 a large proportion of cases, of effecting a perfect cure;"—and further;
 "that in hemp the profession has gained an anti-convulsive remedy of
 the greatest value."
   The commendations of Dr. O'Shaughnessy gave occasion to the em-
 ployment of cannabis by many practitioners.   Two cases  of  trismus
 nascentium have been published—one by Dr. P. C. Gaillard, the other by
 Dr. II. W. De Saussure,3 which recovered under the use of cannabis.
 Dr. Gaillard, however, exhibits a wise caution in making his  deductions,
 and remarks,—that time and farther experience must determine, whether
 we possess in cannabis an agent  capable of controlling the  disease, or
 whether these cases must be reckoned amongst those fortunate accidents
 or coincidences which too often  mislead us in estimating the value of
 therapeutical agents.  Dr. Jackson,4 in the Native Hospital at Calcutta,
 associated it with chloroform inhalations.   He  gave two grains every
 six hours, and repeated the inhalations every four hours; and affirms,
 that many more cases have recovered  from tjiis plan of treatment than
 from any other.  Mr. Ley prescribed it with advantage in various spas-
modic diseases,—chorea,  sciatica,  &c, which gave him the most perfect
 confidence in its  power  to produce relaxation  of the muscles,  heavy
 sleep; and, during its  action, abatement of pain;5 and Wolff5 and Ruh-
 baum,7 found it valuable in neuralgic  affections.  Mr. Lynch8 likewise
 prescribed it with success in a case of neuralgia above and  around the
 right orbit; and in an epidemic neuralgia of the head, but especially of the
jaw, which prevailed around Rathenow in the last quarter of the year
 1847, Ruhbaum9  found great benefit  from 16 to 20 drops of the tinc-
 ture of cannabis, which  contained about a grain  of  the alcoholic ex-
 tract.  It has also been given in mania with advantage, by M. Moreau.10
 Dr. Conolly, in  a clinical lecture upon mental disorders,  remarked,
 that he believed there was then very little of the genuine Indian hemp
 in Europe.   He thinks,  that if his observation of its  effects  in  the
 Hanwell Asylum be not  altogether erroneous, it must become an  im-
portant article of commerce.  After some careful trials of the tincture,
he feels justified in speaking well of it. It is chiefly useful, he thinks,
in chronic cases.  A dram and a half,  and sometimes two drams, have
frequently been given in chronic cases of  recurrent mania, and al-
though generally with good effects, sometimes without any whatever.11

  1 Ibid. Dec. 14, 1844, p. 352.
  2 Charlton, Retrospective Address, in Transactions of the Provincial Med. and Surg.
Association, xiv. 20.   Lond. 184(5.            3 Charleston Med. Journ.  Nov. 1853.
  4 Indian Annals, Oct. 1853, and Ranking's Abstract, xix. 59.
  6 Provincial Med. and Surg. Journ., Aug. 20,  1842.      6 Schmidt, Op. cit. s. 155.
  7 Schmidt's Jahrbiicher, u. s. w., No. 9, Jahrgang, 1848, S. 277.
  8 Provincial Med. and Surg. Journ., April 1,  1843.
  9 Schmidt's Jahrbiicher der gesammten Medicin. Jahrgang, 1848, No. 11; S. 155.
 10 Du Hachisch et de l'Ali.nation Mentale, Etudes  Psychologiques; Paris, 1845;—no-
ticed by Dr. Pliny Earle, in  Amer. Journ. of the Med. Sciences, April, 1846, p. 423.
 11 Amer. Journal, loc. cit. 
182
CANNABIS INDICA.
By Dr. Corrigan,  cannabis has been  administered with great success
in chorea, in the Richmond Hospital, Dublin.
  With such evidence in its favour, it is certainly important, that In-
dian hemp should  be subjected to a full and fair trial; and  even ad-
mitting that it may fall  short  of the character  given of it by Dr.
O'Shaughnessy and others, it can scarcely fail to be an important addi-
tion to our Materia Medica.
  Dr.  Churchhill1  speaks favourably of the powers of cannabis  in
checking uterine hemorrhagic discharges, from his own experience, as
well as from that  of others.  The largest  class of cases in  which he
found  it of the most unqualified benefit was of  menorrhagia, when
the discharge, although excessive, was fluid, and but little mixed with
clots, and when the uterus was not enlarged.   In many such cases, five
drops  of the tincture, three times a  day,  arrested  the flow in from
twenty-four to forty-eight hours.   In several cases of threatened abor-
tion, when employed sufficiently early, it succeeded  remarkably well.
He prescribed it, too, in three cases of cancer uteri, at a tolerably early
period, on account of continued draining  of blood; and he thought
temporary relief was afforded.   It appeared to him to exert an astrin-
gent power in hemorrhages from  mucous surfaces, and  to have a seda-
tive or anodyne effect.  The preparation he invariably used was Mr.
Donovan's tincture of the resin, with which he begins with the dose of
five drops, three times a day, increasing it,  in a few  cases,  to ten, but
seldom more.   The effects are very soon seen, generally in twenty-four
or forty-eight hours; often much sooner.  In some cases, indeed, the
effect was instantaneous.
   In consequence of Dr. Churchhill's belief, that cannabis possesses
powers similar to ergot in arresting hemorrhage from the uterus, Dr.
Simpson2 was induced to try, whether it is  possessed of any oxytocic
property:  accordingly,  he gave  it in several cases of tedious labour,
and he states that parturient action seemed to  be very markedly and
directly  increased  after its exhibition;  but, far  more  extensive and
careful experiments would be  required before a decided opinion could
be  attained in regard to its possessing such  powers, and their amount.
Since then, Dr. Alexander Christison3 has  tried the remedy  in nume-
rous cases, and infers, that it has a remarkable power in increasing the
force of uterine contraction during labour.  In none of the cases were
the ordinary physiological effects induced.   The obvious difference be-
tween  its action and that of ergot appeared  to him to  be,—First.  That
whilst  the effect of ergot does not occur for a  considerable time, that
of  hemp, if it is  to appear, comes on within two or  three  minutes.—
Secondly.   The action of ergot is of a lasting character; that of hemp
is confined to a few pains shortly after its administration: and, thirdly,
the action  of hemp is more energetic, and perhaps more certainly in-
duced  than that of ergot.  He has little doubt, consequently, that In-
dian hemp may prove of  essential service  in promoting uterine  con-

  1 Medical Times, May 12, 1849.
  2 Monthly Journal of Medical Science, July, 1850.
  8 Lond. Journ. of Med. Nov. 1851; and Amer. Journ. of the Med. Sciences, Jan. 1852, 
CANNABIS INDICA.
183
traction in tedious labour.  For this purpose, the extract may be given
in doses of one to  six  grains;  the  tincture in doses of ten to thirty
drops.  Less  than  thirty drops, however,  is of little service in pro-
moting uterine contractions.
   Encouraged by such results, Dr. John Grigor1 gave it in sixteen cases
of labour; in nine, without effect.  In seven, however, its oxytocic action
could not be doubted.
                     MODE OF ADMINISTRATION.
   The preparations used by Dr. O'Shaughnessy are the following:—
           Extractum cannabis  Indicse alcoholicum.
              Resinous or alcoholic extract of Indian hemp.
   This is prepared  by foiling the rich adhesive tops of the dried gun-
jah  in alcohol (.835) until all  the  resin is dissolved.  The tincture,
thus obtained, is evaporated to dryness in a vessel placed over a pot
of boiling water.   The  mode of  preparing the resin by the Messrs.
Smith, of Edinburgh, is given before.   The ordinary dose  of the ex-
tract is from two  to five grains; that of the pure resin of Messrs. Smith
appeared to them to be active in the dose of two-thirds of  a grain, al-
though made with old gunjah.2
   In hydrophobia the resin in soft pill, to the amount of ten or twenty
grains, is  directed  to  be chewed by the patient, and to be repeated
according to the  effect.
                   Tinctura cannabis Indicse.
                      Tincture of Indian hemp.
               R.  Extract, cannab. Indie, alcohol, gr. xxiv.
                    Alcohol, dilut. f Jj.
   Of this a dram is given in tetanus every half hour, until the parox--
ysms cease, or catalepsy is induced.   In cholera, ten drops, given every
half hour, were often found to check  the  vomiting  and purging, and
bring  back  warmth to  the surface.   Dr. O'Shaughnessy's experience
leads him to prefer small doses of the remedy in order to excite, rather
than narcotize, the  patient.
   The  Dublin College  has a tinctura cannabis  indic_e,  Tincture
of Indian Hemp, which is made of the purified extract |ss; dilute al-
cohol Oss (imperial measure.)   The dose equivalent to a grain of the
extract is twenty-two minims or about forty drops,  which is gradually
increased until its effects are manifested.
                   Haustus cannabis Indicse-
                       Draught of Indian hemp.
                 R. Tinct. cannab. Indie, in* xv.
                    Alcohol, rig xlv.  M. ut f. haustus.
                                                        Donovan.
  Mr. Donovan3  recommends that  the patient should either swallow
the whole of this  directly from the bottle, to avoid loss,—or pour it into
a little water,  and instantly swallow it.  If it be not taken instantly,
  1 Edinb. Monthly Journal of Med. Science, Aug. 1852, p. 124.
  J See, on all this subject, Bouchardat, Annuaire de Th.rapeutique, pour 1849, p. 51—
60.  Paris, 1849.
  * Op. cit. 
184
CARBO ANIMALIS.
the resin will  be precipitated, will  adhere to  the  vessel, and thus
escape being swallowed, which always happens when the prescriber
directs water to be mixed in  the draught by the apothecary;  and Mr.
Donovan says he has seen several  disappointments in consequence.
                     LIII. CARBO ANIMA'LIS.
 Stnoxtmes. Carbo Carnis, Caro Vitulina Tosta, Animal Charcoal.
 French.  Charbon Animal.
 German. Thierische Kohle, Fleischkohle, Thierkohle.
   Animal charcoal is  an ancient remedy, which has been revived
 amorigst  us.  The older physicians used several kinds,  and recom-
 mended them in various diseases, but without having any fixed principle;
 the  circumstances, indeed, that  suggested their  exhibition,  in many
 cases, are entirely unintelligible to us of the present day.   In the old
 Wirtemburg Pharmacopoeia,  we  find  the FJrinaceus  combustus, or
 "burnt hedgehog," as an antihydropic; the Sericum tostum, or "burnt
 silk," and the Hirundines combustce, or  "burnt swallows," as anti-
 epileptics; the Lepus combustus, or "burnt  hare,"  as  an antilithic;
 the Reguli usti, or " burnt wrens," advised in  nephritis and calculous
 affections: and the Talpce combustse, or  "burnt  moles,"  at  onetime
 much extolled in  erratic gout, lepra, scrofula,  ulcers and fistulae!  All
 have properly fallen,  however,  into  oblivion with  the   profession,
 although  there may yet be some who cling with  pertinacity to these
 relics of ancient  ignorance and superstition.  The  " cancer-remedy"
 of  Come, into the  composition of which burnt  shoe-soles  entered,
 appears to have kept up the employment of animal  charcoal; as well
 as the "burnt sponge," Spongia usta, in which, however, the charcoal
 is of but  little efficacy compared with the iodine  it  contains.  These
 were, perhaps, the only forms in which animal charcoal was used at the
 time when Weise, a  German physician, revived its employment;  and
 many physicians soon came forward to attest favourably in  regard to it.

                      METHOD OF PREPARING.
   The substance, most commonly met with under the  name of " animal
 charcoal," is obtained  by burning bones.   The residue, when reduced
 to powder,  is the well  known substance bone black or ivory  black
 This generally contains more  or less phosphate of lime, according to
the kind of  bone  from which it has been procured.   It  is directed in
the Pharmacopoeia of the United States to be  purified by  digestion in
 dilute muriatic acid, as  follows.—Take of animal charcoal, a pound;
muriatic acid and water, each  twelve fluidounces. Mix the  muriatic
acid with  the water, and gradually pour  it upon the charcoal; then
digest for  two days in a gentle heat, occasionally agitating.  Set aside,
and  pour off the supernatant liquor;  then wash the  charcoal with
repeated portions of water till no  traces of acid are perceptible: lastly,
dry it.1

 _ 1 For the mode of preparation on the large scale, see Pereira, The Elements of Mate-
ria Medica and Therapeutics, 3d Amer. edit.  i. 332.  Philad.  1852. 
CARBO ANIMALIS.
185
                     EFFECTS  ON THE ECONOMY.
   In the case of  a young  man of scrofulous diathesis, Weise saw  a
 tumour, of  the size of a hazelnut, and very painful, situate under  the
 nipple,  disappear  under'the use of  animal charcoal.  According to
 him, its efficacy is  strongly exerted on the uterus and mamma..  Rotha-
 mel and Hohnbaum extol it in dyspepsia and gastricism, as well as in
 cases ^ of diarrhoea.   In  obstinate  chronic  glandular  indurations,
 especially of the  mammary glands, Weise  affirms it  to  be a certain
 remedy: he, at the same  time, however, considers a regulated diet to
 be indispensable.   Scirrhus of the lips, he says,  also disappears under
 its use,  and even scirrhous goitre, when the charcoal is associated with
 burnt sponge.   On cartilaginous polypi, it is said to have  exerted a
 beneficial agency, and to  have diminished the  tendency of  mucous
 polypi to return after operation. Even open cancer, it is  asserted, has
 been healed by  it.1  On  these recommendations of Weise,  animal
 charcoal has been used by several  German physicians, especially by
 Wagner, Kopp, Pitschaft,  Radius,  Rothamel, Hesselbach,  Gumpert,
 Hohnbaum, Fricke, Michaelsen, and  Siebenhaar; and,  as a  general
 result of their observations, it would seem not to be devoid of therapeu-
 tical agency;  although  many  of the  experimenters failed  in noticing
 any sanative effect from it.  Fricke, for example, did not observe the
 least benefit in the very cases mentioned by Weise.  He gave  it, also,
 in the way of experiment, in several other cases,  but without detecting
 the slightest influence on  the organism.   Other physicians saw ad-
 vantages from  its  use in open cancer, but  these were only transient.
 On the  other hand, the experience of Wagner, Kopp, Michaelsen, and
 Rothamel would seem to show, that it was effectual in removing incipient
 scirrhus of  the mammce.  Kopp employed it successfully in scirrhous
 goitre, and  Pitschaft in a  case of what  he  terms struma varicosa.
 Radius  dispersed under its use  a considerable swelling of the submaxil-
 lary glands.  In scrofulous affections, especially in scrofulous indura-
 tions  of the glands, it is  said  to have proved useful  in the hands of
 Kopp, Rothamel, Speranza, Kuhn,  and others; but Baudelocque did
 not find it possess any therapeutical property.2   Pitschaft, in a delicate,
 strumous woman, who was suffering constantly under  ozcena, found it
 of eminent service  after other remedies had  failed.   Radius thought it
 aided the absorption of a disintegrated cataract, and  Siebenhaar saw
 good effects  from it in induration of the pancreas.  Riecke3 suggests,
 that farther trials  may show,  that it might be  used  in the place of
 iodine, which it appears to resemble  in  its action  on the economy,
 whilst it affects the organism less injuriously.  It is doubtful, however,
 whether the  properties of the two substances can  be regarded as at  all
 analogous, and whether  animal charcoal be possessed of  any other
properties than those usually ascribed to prepared charcoal—carbo ligni.

  1 Riecke, Die neuern Arzneimittel, v. s. w. S. 104.
  2 Dubois (d'Amiens,)  Trait, de Pathologie Gene'rale 2eme .dit. p. 206. Bruxelles, 1835.
  3 Op. cit. 
186
CARBONIS SESQUI-IODIDUM.
                     MODE OF  ADMINISTRATION.
   Carbo animalis is given in doses of from half a grain to three grains
twice a day—commonly in  the form of powder with sugar, or with
powdered liquorice root.   Weise advises it to be sprinkled on the hard
edges of cancerous ulcers, and Speranza extols an ointment  made of
charcoal, and oil, or simple  cerate, as a discutient in  scrofulous swell-
ings.
                    Pulvis  carbonis animalis.
                      Powder of animal charcoal.
                 R.  Carbon, animal, gr. ij.
                     Glycyrr. pulv. gr. v.
                P. pulvis.
   A powder to  be  given morning and evening in induration of the
mammse.                                              Michaelsen.
                 R.  Carbon, animal, gr. vi.
                     Spong. ust. gr. xij.
                     Glycyrrhiz. pulv. gss.
             M. f. pulv. in partes vi. aequales dividendus.
   A powder to be taken night and morning in scirrhous goitre.
                                                          Riecke.
                 R.  Carbon, animal, gr. iv.
                     Glycyrrh. pulv. 9_v.  M. et divide in part. viij.
   One of these to be taken dry, morning and evening, a little water
being drunk afterwards, in cases of scirrhous indurations of the mam-
ma.  After the  eight powders  have been taken, the  dose may be in-
creased gradually by half a grain, until it ultimately attains four grains.
At the same time, unirritating  and spare diet should  be inculcated.

                   Bolus carbonis  animalis.
                      Bolus of animal charcoal.
                 R.  Carbon, animal, gr. iij.
                     Ammon. muriat. pulv. 3j.
                     Ext. conii gr. ij.
                     ----glycyrrhiz. q. s. ut fiat bolus.
   One of these to be given three times a day;—in cases of swelling
and scirrhus of the prostate, and of the mucous membrane of the ure-
thra.                                                   Magendie.
               LIV. CARBO'NIS  SESQUI-IO'DIDUM.
Synonymes.  Carbonis Sesqui-ioduretum, Iodidum Carbonis, Ioduretum Carbonii, Car-
  bonei Ioduretum, Iodoformum, Iodoforma,  Carbonium  seu Carboneum Iodatum,
  Sesqui-iodide or Sesqui-ioduret of Carbon, Iodoform.
French. Iodure de Carbone, Iodoforme.
German. Iodkohlenstoff, Iodkohlenwasserstoff, Iodatherid, Formylsu-
  periodid.
  This preparation is made by mixing concentrated alcoholic solutions
of iodine and potassa until the former loses its colour.   A solutionis
obtained, from which the addition  of water throws down a yellow pre-
cipitate—the  sesqui-iodide of carbon,  which is soluble in alcohol and
ether,  but insoluble  in water.   The ethereal solution yields large yel- 
CARBONIS SESQUI-IODIDUM.
187
low crystals by slow evaporation.  It has a sweet taste, and a strong,
saffron-like  odour.   Mitscherlich1 considers the taste very disagreea-
ble.   M. Bouchardat  gives  the  following  form for  its  preparation.2
Take, of iodine, 100 parts; bicarbonate of potassa, 100 parts; water,
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 decoloree,)
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 solution 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 iodine
employed internally.
   Fifty grains,  given  by  Dr. Cogswell,3 to a strongly made terrier
dog, proved fatal; and, on dissection, the large vessels were found con-
gested ; the  inner membrane was closely corrugated, and the apices of
the rugae were of a rose-red  colour.   M. Bouchardat gives it in  the
form of pill, united with extractum  absinthii  in scrofulous affections,
and of lozenges.
   Iodoform has been recommended by llighini,4 mixed with starch  and
spread upon  paper, as  a disinfectant.   It  slowly escapes, and is said
to lessen smells, and to be also useful in phthisis.
   It has been employed as a local anaesthetic,—being kept upon the part
for a considerable time.5

              EFFECTS ON THE  ECONOMY  IN DISEASE.
   The dose  of iodoform is one grain three times a day.   Dr. Litch-
field6 used it with advantage  in five  cases of enlarged glands; in  two
of lepra, and  three of porrigo, in  the form of ointment composed of
5ss. of the powder to 5vj-  °f simple cerate.
                 Pulvis  carbonis  sesqui-iodidi.
         Powder of sesqui-iodide of carbon.   (Iodoform powder.)
       •         R.  Carbon, sesqui-iodid.
                    Elaeosacchar. vanill. aa £ij.
                    Sacchar. pulv. §ij.  M.
  Dose.—Fifteen grains, three times a day, in scrofula.
                                                     Bouchardat.1
  1 Trait, de Chimie, traduit par Valerius.
  2 Annuaire de Therap. pour 1844, p. 116.  Paris,  1844; and  Nouveau Formulaire
Magistral, p. 333.  Paris, 1845.
  3 Essay on Iodine, p. 122.  Edinb. 1837.
  4 Journal de Chim.  M.dic.  and Brit, and For. Med.  Rev. July, 1853, p. 281.
  * Bouchardat, Annuaire de Therap. pour 1855, p. 54.
  6 Lond. Med. Gaz., Aug. 1836.         7 Annuaire, &c, pour 1842, p. 129. 
188   CAUTERIZATIO ET CATHETERISMUS LARYNGIS ET TRACHEiE.


  LV. CAUTERIZATIO  ET CATHETERISM'US LARYN'GIS  ET
                           TRACHEA.

Synoxyme. Cauterization and Catheterism of the Larynx and Trachea.

  The "topical medication" of the air passages, so far as it consists
in the application of astringent and other medicines to the  lining mem-
brane of the upper part of the larynx, has been long employed in va-
rious affections of the lining membrane of the air tubes; but it is only
within the last few years, that any attempt has  been made to  intro-
duce an instrument impregnated with them through the opening of the
glottis into the trachea, and as far as the bifurcation of the bronchi;
nay, even, according to Dr. Horace Green, "in many instances into
the right or left bronchus, with as much ease and safety as the cathe-
ter is introduced into the bladder." l
   To the upper part of the larynx, above the rima glottidis,  solutions
of nitrate of silver were applied by Sir Charles Bell2 fifty years ago;
by M. Bretonneau,3 thirty years ago, and by MM. Trousseau and Bel-
loc about twenty years ago, as recorded in a work, which was a Prize Es-
say of the Royal Academy  of Medicine, of Paris, and a translation of
which, by Dr. J. A. Warder, of Cincinnati, was  published in the "Ame-
 rican Medical Library," of which the author  was editor.  The mode
 of application, by means of the sponge employed by them, was as fol-
 lows : * " When we wish to cauterize the pharynx, the base of the tongue
 and the top of the larynx at the same time, we take a whalebone, at
 least a line  and a  half thick, that it may not bend readily;  this is
 heated an inch or more from one end; and, when sufficiently softened,
 we  curve it at an angle of  forty-five degrees.    To this end we fasten
 a spherical piece  of sponge, six lines in diameter: the sponge is to be
 moistened with a solution of nitrate of silver;  the mouth opened and
 the tongue depressed with  the handle  of a crooked spoon.  When the
 isthmus of the gullet is  passed, there occurs an effort of deglutition,
 which elevates the larynx, and we seize  this opportunity to draw for-
 ward the sponge, which had been at  the entrance of the oesophagus.
 By this manoeuvre, we get at the glottis,  and then it is easy to express
 the  solution into  the larynx: the cough which  now occurs, favours the
 introduction of the caustic."—And they remark on  this  operation:—
 " One must have practised or seen these cauterizations performed to
 have an idea of their harmlessness, and of the  little  pain which results.
 We are much afraid of caustic, for it is exceedingly painful on the skin
 and mucous openings, although  scarcely felt  in the pharynx, larynx,
 or  neck of the uterus.  We must not confound the organic sensibility
 of the larynx, that sympathetically causes the cough, with the animal
 sensibility of the organ, which is extremely obtuse."
    Were any doubt remaining in regard  to the operation, as practised

   1 Lancet, Sept. 18, 1852.
   2 Surg. Observations, being a Quarterly Report of Cases of Surgery, p. 34. Lond. 1816.
   3 Des Inflammations Sp.ciales du Tissu Muqueuse, et en particulier de la Diphtherite,
  &c.  Paris, 1826.
   * A Practical Treatise on Laryngeal Phthisis, Chronic  Laryngitis and Diseases of the
  Voice, by A. Trousseau and H. Belloc, p. 125.  Philad. 1839. 
      CAUTERIZATIO ET CATHETERISMUS LARYNGIS ET TRACHEiE.   189

by MM. Trousseau and  Belloc—to whom has  been usually ascribed
the priority of having applied topical remedies to the larynx—it is set
at rest by a letter from Professor Trousseau to Dr. Green, in which he
says his endeavours were restricted  to expressing the caustic solution
into the cavity of the larynx: and he adds:—"the direct introduction
of the sponge, saturated with the solution, into the larynx,  and into
the bronchial  tubes, does not belong to me in any respect whatever;
and even  at the present time I content  myself with expressing  the
caustic at the  entrance of  the larynx, or with causing powders or va-
pours to be inhaled."1
   It would appear, also, that Mr. Vance, many years ago,  was in the
habit of employing topically a solution of nitrate of silver in the treat-
ment of laryngeal  diseases; and that he met with much success from
the  practice:2 but according to the testimony of medical men, who
knew his  mode of procedure, he never introduced  the solution  of the
nitrate below the glottis, but contented himself with sponging  the back
of the throat.
   The operation of introducing the sponge-probang through the rima
 glottidis has been conceived to be so dangerous that its practicability
has been  denied;  and when it has been apparently performed by Dr.
 Green,  the greatest  skepticism has been exhibited by distinguished
 observers  present, who, from the  little inconvenience  experienced,
 could scarcely believe that it had entered the trachea;  and presumed
 that it  rAust  have passed into the  oesophagus.   Professor Erichsen3
 indeed, affirms, " that it  is  utterly impossible to pass a whalebone, whe-
 ther curved or straight,  armed with a sponge, beyond, or even between
 the vocal cords."   In the language of science, and especially of bio-
 logical  science, the word "impossible" is rarely applicable; and cer-
 tainly ought not to be employed in a case like the present,  where no
 doubt ought to exist, that  such an instrument has been so passed.   In
 the presence of several intelligent physicians—one of them  an intimate
 friend of the Author, Dr.  John S. Davis, of the University of Virgi-
 nia—by means of a hollow tube introduced, to which a sponge was at-
 tached, air was  distinctly received into,  and expelled from, the lungs;
 every one present expressing himself "satisfied with the success of the
 experiments, as proving  the introduction of the instrument between and
 beyond the true vocal cords into the trachea of the patients;" and Dr.
 Green affirms, in allusion to the report of a discussion, which took place
 in the London Medical  Society on  " Topical  Medication in the Treat-
 ment of Diseases  of the  Pharyngo-Laryngeal Membrane,"—"I can
 assure the gentlemen of the Medical Society of London,  that I have
 succeeded in  passing an armed probang down to the bifurcation of the
 trachea, probably  over 500 times:  and this has been done in the pre-
 sence of  half that number of medical men,  all of  whom, if required,
 will give  their testimony to the fact."

   1 On the Employment  of Injections into the Bronchial Tubes, and into Tubercular
 Cavities of the Lungs, by Dr. Green, in Transactions of the State Medical Society of the
 State of New York, p.  238.  Albany, 1855.
   2 Dr. John Hastings, Treatise on Diseases of the Larynx and Trachea.  Introd., p. viii.
   ' The Science and  Art of Surgery, Amer. edit, by John H. Brinton,  M. D., p. 672.
 riiilad. 1854. 
190   CAUTERIZATIO ET CATHETERISMUS LARYNGIS ET TRACHEiE.
  The instrument has likewise been passed into the trachea by others,
as by Dr. Eben Watson,1 Prof. J. II. Bennett,2 Dr. Wagstaffe,3 Dr. S.
Scott Allison,4 &c.: and in this manner solutions of nitrate of silver
have been introduced in various diseases of the air passages.   It was
in the year 1840, that Dr. Green brought this method of treatment be-
fore the Medical Society of New York;  and  six  years afterwards he
published an ex professo treatise on the subject.5
  The instruments, employed in the operation, are—a tongue depres-
sor, with a bent handle; a whalebone probang, about 10 inches long,
having, at its extremity, a round piece of the finest sponge, about the
size of a gun or pistol bullet, sewn firmly to the extremity of the whale-
bone, which must not be cut in the form of  a bulb, but tapered as much
as is consistent with firmness.   The probang, according to Dr. Green,
ought  to  form the  arc  of  one  quarter of a circle, whose diameter is
four inches.   Dr. Eben Watson6 prefers one  not so much curved,—
"just such a bend as will enable the operator easily to avoid the tongue
and epiglottis, in endeavouring to touch the deeper parts."
  The method of introduction may be as follows:—The patient, being
seated in a good  light, the practitioner, standing on his right side,
must depress the tongue with the depressor held in his left.  Dr. Eben
Watson  believing, that,little or no aid  can be obtained from  sight,
does not  use the depressor.  He  thinks the only way to know that
the instrument enters the rima  glottidis is  to introduce the fore-finger
of the  left hand into the mouth of the patient, passing it over the root
of  the tongue, till its point comes in contact with the tip of  the epi-
glottis.   By maintaining the finger in this position, and passing the
sponge of the probang over it,  the  rima glottidis is  reached with per-
fect certainty.  When the depressor is used,  the  probang, held in the
right hand, and  the sponge saturated with the liquid to be employed,
is passed carefully  over  the upper  surface of the instrument, exactly
in the  median plane, until it is above, or immediately behind, the epi-
glottis.  The patient should now be told to inspire, and as he  does so,
the tongue should  be dragged slightly forwards with the depressor,
and the probang be thrust downwards and forwards by elevating the
right arm and bringing the hand almost in contact  with the patient's
face.^   The saturated sponge is thus rapidly thrust  through the rima
glottidis^the muscles of which  contract by reflex  action, so that a con-
striction is^ felt on withdrawing the instrument, and at the same time
the liquid is squeezed out of the sponge, and diffused over the laryn-
geal and tracheal mucous membrane.7
   For the success of the operation it is most important to accustom

  1  On the Topical Reduction of the Larynx in certain Diseases of the Respiratory and
Vocal Organs.  London, 1854.
  2 The Pathology and Treatment of Pulmonary Tuberculosis, p. 126, Edinb. 1853; or
Amer. edit.  Philad. 1854.
  3  On Diseases of the  Mucous Membrane of the Throat, and  their Treatment; and
Ranking'-; Abstract, xiv. 20G, Amer. edit.   Philad. 1852.
  * The Medication of the Larynx and Trachea.  London. 1853.
  5  A Treatise on Diseases of the Air-Passages, comprising an Inquiry into the History,
Pathology, Cause and  Treatment of those  Affections of the  Throat, called Bronchitis,
Chronic Laryngitis, Clergyman's Sore Throat, &c, by Horace Green. New York, 1846.
•  6 °P- Clt>                          7 Bennett, Op. cit. p.  139. 
      CAUTERIZATIO ET CATHETERISMUS LARYNGIS ET TRACHE_E.   191

the entrance of the larynx and the pharynx to the presence of the in-
strument in one or more preliminary trials.   This is strongly insisted
on by Dr. Green: for if the precaution be not attended to, the attempt
will, in all probability, be frustrated by spasm; and on no account must
the passage of the larynx be forced when spasm is present.
   The solutions of nitrate of silver employed are of various strengths,
from a scruple to a dram of  the crystallized salt to a  fluidounce of
distilled water.   They have been found  beneficial in acute laryngitis,
both  simple  and  diphtheritic,  in  chronic laryngitis and  in  bron-
chitis.   Many cases  of laryngeal  disease, which interfere  with  the
voice, and give occasion to much distress,  Dr. Green considers  to  be
owing to  obstruction,  tumefaction and ulceration of the mucous folli-
cles, which he denominates  "follicular disease  of the air passages:"
"and there can be no  doubt," as Dr. Bennett1 has remarked, "that
lesions of the pharynx and larynx ought to occupy the serious atten-
tion of the practitioner, in all cases of pulmonary diseases:" that, not
unfrequently, diseases, entirely seated  in  the larynx or pharynx, are
mistaken  for  pulmonary tuberculosis; that even when pulmonary tu-
berculosis exists, many of the urgent symptoms are not so much owing
to disease in the lung as to the  pharyngeal  and laryngeal complica-
tions; and  that a local treatment may not only remove  or alleviate
these complications, but that, in conjunction with  general remedies,
it tends, in a marked manner, to arrest  the pulmonary disease.2
   In every variety of aphonia, the application of the nitrate of silver
has been found advantageous.  "My experience," says Dr. Green,3
"is entirely in favour of the topical application of strong solutions of
crystallized  nitrate of  silver,  constitutional remedies being at  the
6ame time  employed, when indicated,  as  in other cases where  the
local disease is  complicated with  general derangement.  As auxi-
liaries to the topical  treatment, I have found  benefit  to be derived
from the preparations of iodine, chalybeates, and  other tonics, with
inhalation of creasote; but, alone, I have found them of no avail."
   In hooping cough, the topical treatment, above-mentioned, has been
found very beneficial.   When pursued with proper precautions,  and
with especial attention to diet and  regimen, in the experience of  Dr.
Eben Watson4 it shortened  the disease in  a remarkable manner,  and
rendered  it nearly as mild as ordinary catarrh:  "complications seldom
occur, and  the disease is thus stripped of its most formidable charac-
teristic;" and he gives the following results of treatment by himself,
and by M. Joubert.5                   ,
                                 Cured within Cured in 3   Resisted  Total.
                                  a fortnight,  to 4 weeks. Treatment.
        M. Joubert?s cases,             40       20      8      68
        Cases treated by Dr. Watson,      46       20      0      66

                                    8G       40      8     134
   Dr. Wacstaffe6 also confirms its good effects in this disease, as well
as in croup, in which  it was employed with advantage, in many cases,
   i Op. cit. p. 142.                       2 Eben Watson, Op. cit.
   8 Lancet May 13, p. 513, and Dr. Eben Watson, Op. cit.
   * Op. cit. and Ranking's Abstract, xx. 254, Amer. edit,  Philad. 1855.
  6 Bulletin de Therap. Janvier, 1852; Prov. Med. and Surg. Journ. May 26,1852. and
Amer. Journ. of the Med. Sciences, July, 1852, p. 223.                6 Loc. cit. 
192   CAUTERIZATIO ET CATHETERISMUS LARYNGIS ET TRACHEiE.

by the gentlemen already referred to,1 as well as by Dr. Homans 3 and
Dr. Chapman.3
  Equally good effects followed its employment in spasmodic asthma,
and  in  the, so called, stomach and hysterical cough, in the hands of
Dr. Watson and others.
  In the laryngismus of epilepsy, for which tracheotomy has been re-
commended by Dr. Marshall Hall, Dr. Brown Sequard4 had suggested
cauterization of the larynx; but had only experimented on animals.
Without, perhaps, being aware of those  experiments, Dr. Watson con-
sidered that great benefit might accrue from it, and that it might  an-
swer the same end as tracheotomy, and be free from  the objections
which apply to that operation; and  in corroboration of this  opinion, he
has related two cases occurring to himself, and  one to Dr. Horace
Green.
  Other substances besides the solution of nitrate of silver have been'
introduced by the sponge-probang.   Dr. Eben Watson  speaks favour-
ably of the hyposulphite of soda  and  silver, which has, he says,  "a
very soothing effect on the larynx, when  its lining membrane is irri-
tated by a vitiated, and, as is generally the  case, an  acid  secretion."
Dr. Scott Allison,5 who, in  cases of chronic hoarseness and  oedema,
uses the solution of nitrate of silver in weaker doses than Dr. Green—
gr. v. to the f ij.  of water—found  even it  too stimulating in acute
cases.   In several cases  of more  or less  acute laryngeal  attacks, ho
introduced the sponge soaked in olive oil, with the effect of relieving  the
dryness; and, in some cases, the voice was at once improved.   Glyce-
rin and mucilage were also  employed  by him, alone and  as vehicles
for the local application of morphia, atropia and conia; the first, in
the dose of one-eighth of a grain,  allayed irritation and cough;  the
second, in the dose  of one-thirtieth of  a  grain, appeared  useful in a
case of hysterical cough; and he suggests its employment in epilepsy.
  When Dr. Horace Green had satisfied himself, that he had succeeded
in introducing his elastic tube into the bronchial  divisions, it occurred
to him, that injections might be thrown through the tube into the lungs,
or directly into  the bronchi and their  terminations;  and, under  fa-
vourable circumstances,  even into a vomica or into tubercular excava-
tions: and he states that, in thirty-two cases, catheterism of the air
passages had been accomplished  by him in this manner.8   Since that
statement  was made, he has, he affirms, frequently employed  it, and
the success, which had attended the practice, had  served  to increase
his confidence in the measure as a therapeutical  agent.7  In an in-
teresting case, the particulars of which were related to the author by
Dr. Davis, of the University of Virginia, who accompanied the  patient,
Dr. Green, in the presence of Dr. Davis, and of several other physicians,
introduced "number 12  of Hutching's flexible tubes through the rima

  1 Observations on the Pathology of Croup, with Remarks on its Treatment by Topical
Medications, by Horace Green, M. D.
  2 Amer. Journ. of the Med. Sciences, April, 1854,  p. 346.
  s New York Journ. of Med., Mar. and July, 1854; and Ranking's Abstract, xxi. 50,
Amer. edit.  Philad. 1855.                i Medical Examiner, April, 1853.
  ' °P- Clt- .     ,               6 American Medical Monthly, Jan. 1855.
  1 Transactions of the State Medical Society, p. 245.  Albany, 1855. 
CETRARINA.
193
of the glottis, carrying it down to  the right bronchial division of the
trachea;'] and injected with a small glass syringe a dram and a half
of a solution of nitrate of silver, of the strength of thirty grains to the
ounce of water, "through the tube, into the lungs,"—an operation which
was performed without exciting any cough, except at the moment of
the introduction of the tube into the opening of the glottis: "nor did
any feeling of suffocation, or any irritation whatever, follow the intro-
duction of the solution into the chest.''   This operation was frequently ■
repeated; and,  under it, with the application of the solution by means
of the sponge-probang to the larynx and trachea, and a revellent in-
ternal treatment by the iodide of potassium, in combination with mi-
nute doses of iodide of mercury, the patient, in three weeks, was able
to return  and  resume his duties as a  teacher at the  University of
Virginia, which had been previously impracticable.
  There can be no doubt, that injections can be thrown into the bron-
chial tubes; but  it is difficult to suppose,  that they can  often reach
tuberculous excavations in such quantity as to exert any direct action
on the diseased surface.  In many cases of bronchitis, however, they
may prove beneficial; and for whatever advantage may have been, or
maybe, derived from the immediate application of medicinal agents to
the lining  membrane of the air passages below the rima glottidis,  the
credit must be mainly ascribed to Dr. Green.
                        LVI. CETRARI'NA.
 Synonymes. Cetrarinum, Cetrarium, Cetrarin, Cetrarine.
 French. Cetrarin.
 German. Cetrarin,  Moosbitter, Flechtenbitter der Islandischen
   Iuechte.

   This substance was extracted from Cetraria Islandica by M. Her-
 berger, a pharmacien at Kaiserslautern.1

                      METHOD 0E PREPARING.
   The coarse powder of cetraria is boiled for half an hour in four times
 its weight of alcohol at .883;  it is then left at  rest until vapours cease
 to be given off, to avoid the loss of the alcohol; when it is strained and
 pressed.   Three drams of muriatic acid, previously diluted with water,
 are now added to each pound of the moss; this  is mixed with from
 four times and a quarter to four  times and a  half its bulk of  water,
 and the mixture is left at rest for a night in a closed flask.   The next
 day, the  deep yellow fluid, which swims above  the copious deposit ob-
 tained, is poured off: this deposit is the impure cetrarin, the colour of
 which is more or less greenish.   It is now collected on a filter (chausse,)
 left to drain  as little as possible, and subjected to pressure.  To purify
it, it must be divided into small  fragments, and  washed, whilst still
moist, with alcohol  or  ether, which  deprives it of colour; it is then

                1 Buchner's Repertorium, B. viii. H. 1, 1837.
      13 
194
CETRARINA.
treated with two hundred times its weight of boiling alcohol, in which
the inorganic matter, that has  hitherto accompanied it, is scarcely so-
luble.   The  greater  part of  the cetrarin is gradually precipitated on
the cooling of the alcoholic solution.   The portion which still remains
in solution may be separated by the evaporation of the alcohol.
   One pound of cetraria, according  to  Messrs. Ballard and Garrod,1
yields about two drams and a half of cetrarin.
   Pure cetrarin is, at times, in the state of a white powder, resembling
magnesia; at others, in small globules united  in the form of arboriza-
tions, which  do not present—even under the microscope—any crystal-
line texture.  When gently compressed, it has a slight silky splendour.
It is neuter, light, unalterable  in the air, inodorous, and  has a very
intense, bitter taste,  especially in the alcoholic solution.   Its best sol-
vent is absolute alcohol, one hundred parts dissolving 1.70 of it at the
boiling temperature, but only 0.28 at 11° centig.  (58° Fahr.)  Alco-
hol at .830 dissolves 0.44 when boiling; 0.28 at £5° cent. (77° Fahr.,)
and only 0.04  at 14° cent. (58° Fahr.)   It is still less soluble in boil-
ing and in cold water, the essential oils, creasote, &c.  It is somewhat
more soluble in ether, but insoluble in the fixed oils.2

                EFFECTS  ON THE ECONOMY  IN DISEASE.
   Muller, of Kaiserslautern,3 details two cases in which he has adminis-
tered  cetrarin.   One of these  was a quartan, the other, a tertian in-
termittent.  The effects appeared to be exerted more slowly than those
of quinia, but it seemed to him not to affect the stomach as much. [?]
Its price must be considerably  less, as  M. Herberger succeeded in ob-
taining, from a pound of cetraria, 135  grains of very pure cetrarin.
It has also been prescribed successfully in intermittents, by Regatelli
and Von Lippich.4
   It has not been given, so far as the author knows, in this country.

                     MODE  OF  ADMINISTRATION.
   Muller gave it in the form of powder, according to the following pre-
scription :—
                 R.   Cetrarin.
                      Acacias aa. gr. ij.
                      Sacchar. 9ss.   M. et fiat pulvis.
   Dose.—One of  these every  two  hours, during the apyrexia.
   Bruck,5 suggests, that if dissolved in alcohol, its action may be in-
 comparably more potent, and that it may  more speedily arrest the pa-
 roxysm, of an intermittent than when given in powder.

   1 Elements of Mat. Med. and Therap. p. 365.  Lond. 1845.
   2 Journal de Pharmacie, xxiii. 505.   Paris, 1837; and Bulletin General de Th.rapeu-
 tique, No. 18,  Sept. 30, 1837.
   3 H. Bruck,  in Bulletin General de  Therapeutique, No. 17, 15 Sept., 1837.
   4 Aschenbrenner, Die neueren Arzneimittel, u. s. w. S. 71.  Erlangen, 1848.
   5 Op. cit. 
CHIMAPHILA.
195
                  LVII. CIIDIAPHTLA (EO'LIA.)
Synonymes. Chimaphila. vel Chimophila.  Umbellata. Folia, Chimaphilaa Corymbosae
  Folia, Pyrola, Pyrolae Umbellata. Folia, Winter Green, Umbellated Winter Green,
  Pipsissewa.
French.  Herbe a Pisser, Pyrole en Ombelle.
German. Die Blatter des holdenbluhtigen  Wintergruns, Wintergriin-
  blatter.
  This plant is not new to us;  but numerous trials have  been  made,
with it of late in Europe.   It is admitted into the Pharmacopoeia of
the United States, is a beautiful evergreen, and is indigenous in  the
northern parts of Europe, Asia, and America.   It belongs to the Na-
tural Family Ericineoe of Decandolle:  Pyrolaceae Lindley; Sexual
System, Decandria Monogynia.  A good description of it is given by
Barton.1
  The leaves  have a bitter-sweetish taste,  with some degree of astrin-
gency.   The taste of the stems and roots is, in addition, considerably
pungent.   Boiling water and alcohol extract the virtues of the plant.
The constituents, so  far as ascertained, are  bitter extractive, tannic
acid, resin, gum, lignin, and saline  matters.   The active principle has
not been determined.   It probably resides in the bitter extractive,—
the resin and  tannic acid, however, contributing to its effects.2

               EFFECTS ON THE ECONOMY IN DISEASE.
  The leaves  of Chimaphila were long used by the Indians of this con-
tinent, and from them the American physician was induced to employ
them.   The first regular treatise respecting the plant is said to have
been a thesis of Dr. Mitchell, published in the year 1803.3   In Canada,
it is said  to have been long used in diseases of the urinary passages,
especially calculus ; in dropsy, and in chronic gout and rheumatism;
its effects appearing to resemble—but not to exceed—those marvellously
ascribed to uva ursi.4   SomervilleJ and Barton extol it as an excellent
diuretic in different forms of dysuria, and  in dropsies, especially such
as succeed to  acute diseases; in nephralgia as a palliative, especially
when the paroxysms are occasioned by gravel which has accumulated
in the kidney; and even in  vesical calculus.  During its use, the appe-
tite has improved, and the digestive powers have augmented,—the pa-
tients often experiencing—immediately after it was taken—an agree-
able sensation in the stomach, and in the region of the kidneys.  Ra-
dius 6 found it especially serviceable in dropsy, gout, and rheumatism;
and  in inordinate activity of the secretory function of the mucous mem-
branes—chronic catarrh, phthisis pituitosa, &c.  According to him, it
is contraindicated where there is much fever, disposition to diarrhoea,
gastricism, and great debility of the stomach.   Heyfelder affirms, that
it appears to be advantageous  in the debility  of the digestive organs

  1 Medical Botany, i. 17; see, also, Art. Chimaphila, in Wood andBache's Dispensatory.
  2 Pereira's Elements of Materia  Medica, &c, 3d  Amer. edit. iii. 578.  Philad. 1854.
  s Barton's Collection, ii. 2.
  4 See the author's General  Therap. and Mat. Med. 5th edit. i. 340.  Philad. 1853.
  6 Medico-Chirurgical Transactions, v. 340.
  8 Auserlesene Heilformeln zum  Gebrauche fur  praktische Aerzte und Wundiirzte,
 . 8. w. S. 175.  Leipz. 1836. 
196
CHIMAPHILA.
 attendant upon dropsy, but its  diuretic effect  is not considerable or
 enduring,  so that it requires to be associated with more powerful
 agents.
   Experiments which have been made in the Burger-hospital, at Pesth,
 and which have been  collected by St. Rochus, and published by Win-
 disch, the director of the hospital, are extremely favourable to  the chi-
 maphila.   Within two years, nearly two hundred dropsical cases  are
 said to have been  radically cured by it.  Windisch recommends it
 most strongly to the attention of his colleagues; he asserts it to be one
 of the best diuretics we possess; that it does not impair digestion; mo-
 derately accelerates the circulation; gently encourages  the action of
 the  bowels,  and powerfully augments the urinary secretion; that the
 patients willingly take it, and that it induces no nausea.  It was ad-
 ministered with advantage in dropsies unaccompanied by fever, and not
 dependent upon organic mischief, upon "corruption of the humours or
 paralysis of  the  lymphatic textures."  In febrile conditions and  in-
 flammatory diatheses, it is said to have been always injurious, as well
 as when it was administered prior to the resolution of obstructions  re-
 maining after long  protracted intermittents;  but when  these  are  re-
 moved, and  no  excitement exists, more, according to Windisch, is to
 be expected  from it than from any other agent, and he strongly advises,
 that careful  trials should be made with it in the proper cases.   He ad-
 vises, also, that its use should be persevered in, in order that good  ef-
 fects may be derived from it.
   The  author  has frequently administered chimaphila in public and
 private practice, and has found it serviceable, where a tonico-diuretic
 was  indicated.   It is probably owing to its tonic properties, that it has
 been found occasionally serviceable in scrofula.

                     MODE OF ADMINISTRATION.
   Chimaphila is given either  in  infusion, or, what  is preferable, in
 decoction;  the dose in the day being from  half an ounce to an ounce
 of the drug.  Where it does not act sufficiently on the bowels,  Radius
 advises, that a few  senna leaves  should be added.   In  affections of
 the chest, he found the addition of the  spirit of nitric ether advanta-
 geous.  Generally, however, he gave it alone.   Windisch found a com-
 bination of it with tartrate of  antimony and potassa, sulphuret  of po-
 tassium, muriate of ammonia, squill, and, in very great weakness, cin-
 chona  and preparations of iron, serviceable.  Radius often adminis-
 tered, also, the aqueous or spirituous extract.

                     Decoctum chimaphilse.
                       Decoction of pipsissewa.
                 R.  Chimaphil. §j.
                     Aquas Oij.  (Oiss, Ph. U. S. and Lond.)
                 Coque ad colatur. Oj.
  To be used daily in dropsy.                          Somerville.
  Dr. Joy1 adds to this two drams of Liquor Potassa Carbonatis, and
directs four table-spoonfuls of the mixture to  be taken three times a

  1 Tweedie's Library of Medicine, 2d American edit. vol. iii. p. 692.  Philad. 1842. 
CHLORINIUM.
197
day.  He recommends it "in dropsy and chronic affections of the uri-
nary organs,'^—as if all these affections were identical or even analo-
gous pathological conditions!
                 R.   Chimaphil. gss. ad ^j.
                     Coque cum aqua, f §xij. ad reman, f ^vj.
                     Coctione finite adde
                     Spiritus frumenti (gin, malt spirit or whisky,) f ^ij.
                 Digere frigid e per horas vj. et cola.
  Dose.—Two  spoonfuls, to be taken four times a day, in dropsy and
gout.                                                    Radius.
                 R.   Chimaphil. gvj.
               Coque cum aq. f §xij. ad reman, f ^yj.
               Sub finem coctionis adde
                     Fol. sennas gij. et cola.
  Dose.—A spoonful to be taken every two hours.        Radius.

 _ A fermented decoction was  used by Dr. Parrish, in the Pennsylva-
nia Hospital, in cases of strumous disease, particularly white swelling
and similar affections of the joints.   According  to Dr. Carson,1 it
makes an agreeable  beverage.   A decoction or infusion is first formed
with half a pound of chimaphila leaves to a gallon of water:  a pound
of sugar or half a pint of molasses, half an ounce of powdered ginger,
and some yeast are  then added.   This mixture  is  placed in a tight
vessel, and kept in  a warm place, until fermentation is accomplished.
Instead of the  ginger, or, in addition to it, essence  of spruce may be
used.
  The dose is half a tumblerful three or four times daily.
                                                      J. Parrish.
                       LVIII. CHLORINIUM.
Stnonymes. Chlorinum, Chlorineum, Chlorum, Chlorine, Murigene, Acidum Muriati-
  cum Oxygenatum seu Marinum Dephlogisticatum, Spiritus Salis Marini Dephlogis-
  ticatus, Dephlogisticated Muriatic Acid, Oxygenated Muriatic Acid.
French. Chlore.
German. Chlor,  Chlorgas.

   Uncombined  chlorine is  employed medicinally not only in the gas-
eous but in the liquid state.  Each of these will be treated in succession.
The forms for evolving it in the gaseous state, as well as the gaseous
chlorine itself,  have had various names assigned  them  expressive of
their chemical  or medical  properties.  They have  been termed,  re-
spectively, Acidum muriaticum oxygenatum  ad contagia;  Fumiga-
tio muriatico-oxygenata ;  Fumigatio Guyton-Morveauniana; Pulvis
ad fumigationes muriaticus; Species pro vaporibus superoxydi mu-
riatici ; Suffitus oxymuriaticus:  S. chlorini; Alexiterium Chlor i-
cum, Fumigation de  Chlor, F.  de Guyton,  F. Guytonienne, F. Hy-
g Unique.

  1 Pereira's Elements of Mat. Med. and Therap., 2d Amer. edit. p. 391.  Phila. 1846. 
198
CHLORINIUM.
                       METHOD OF PREPARING.
   Chlorine is obtained  from chlorohydric or muriatic acid.   For this
purpose, one part of well pulverized peroxide of manganese, with five
or six parts of concentrated muriatic acid, is put into  a retort,  to
which heat is  applied, and the gas received over water.   Or, it may
be obtained from a mixture of one  part  of peroxide of manganese,
four parts of  kitchen salt, two parts of concentrated sulphuric acid,
and four parts  of water.
   Chlorine  is a greenish-yellow gas; of a peculiar, strong, disagree-
able,  stifling odour.   The  flame of a lighted  taper introduced into it
becomes at first pale, afterwards  red, and is ultimately extinguished.
It remains unchanged in  the  highest temperatures.  It  has a great
affinity for hydrogen, so that it abstracts this gas from every substance
that contains it, and forms with it chlorohydric acid. Hence it decom-
poses all the  gases that contain  hydrogen, and all organic colouring
matters, as well as—it is  conceived  by many—miasmata and conta-
gious matters.
                     EFFECTS ON  THE ECONOMY
   Chlorine, when diluted, and received into the lungs, occasions cough-
ing, and symptoms  of suffocation,  to which a protracted catarrh often
succeeds: not unfrequently, too, we observe in  those who are compelled
to be exposed  to it, bronchitis and  pneumonia.    Animals soon die
when they are immersed in it.1  In Mr. Broughton's experiments, mice
exposed to it fell dead in less than thirty seconds.   On  opening them,
the heart was found palpitating; the peristaltic motion of the intestinal
canal continued, and could be kept  up by irritating  it with a probe.
The vessels of the brain were collapsed.  The lungs were tinged with
the yellow colour of the gas, and the peculiar odour of chlorine was
perceptible throughout their structure.   Coagulation of the blood took
place as under ordinary circumstances.  A rabbit,  two or three weeks
old, was immersed in it, and died in less than half a minute.  On open-
ing the  thorax, the heart was found acting freely, and on puncturing
the aorta, the blood jetted  out forcibly to a considerable distance.  The
peristaltic motion of the bowels was also going on.   The vessels of the
brain were in a collapsed state.  The lungs were very much  distended,
tinged yellow, and,  when removed from the chest to a distance, emitted
the odour of chlorine.   The right ventricle of the heart was distended
with dark blood.   The  eyes were much  glazed in each  experiment.
"It has been generally thought,"  adds Mr. Broughton, "that chlorine
is incapable of passing  the epiglottis" [the glottis], "but from the
above observations it is evident that this gas enters the bronchial tubes
in the act of inspiration.   A portion  of it probably circulates through
the brain, suspending the cerebral functions without directly destroy-
ing the  action of the involuntary organs,—contractility remaining long
after the destruction of animal life, as is evinced by the activity of the
heart and of the intestinal canal."3
&   These very facts, however, seem to show,  that but little of the gas

         1 Christison on Poisons, Amer. edit. p. 152.  Philad. 1845.
         2 Journal of the Royal Institution, from Jan. to June, 1830. 
CHLORINIUM.
199
enters the lungs;  probably no more than what passes immediately pre-
ceding the closure of the glottis by the forcible contraction of the ary-
tenoids muscles.  When inhaled in a dilute state it is  absorbed; and,
according to Mr. Wallace, the urine acquires bleaching properties.  It
would appear, also, that, in manufactories, the chief consequences from
exposure to an atmosphere of it are  acidity, and other stomach com-
plaints, which the men generally remove by taking chalk:1 this fact
is confirmatory of the view, that acidity of the stomach is  usually, if
not always, dependent upon excess in the secretion of the gastric acids,
the most important of which is the  chlorohydric.   When chlorine i_-
inhaled, it is reasonable to suppose that more of this  acid may be se-
creted in the stomach.
   The irritating  effects of chlorine become less and less, where per-
sons  are exposed to the  fumes, and workmen  are  able  to carry on
their operations with impunity in  an atmosphere impregnated with it,
where one unaccustomed to such exposure could not remain with im-
punity for more than a few minutes.2

                     MODE OF ADMINISTRATION.
   1.  By inhalation.—In the way  of inhalation, chlorine gas is never
administered in a  state of purity, but always diluted with atmospheric
air; often, too, it is united with watery vapour.  Gannal affirms, that
the workmen in a  bleaching establishment, who suffered under diseases
of the chest, were visibly improved, and ascribed the  amelioration to
the inhalation of air containing it.  He, therefore,  instituted various
experiments on  consumptive individuals,  from  which good results, he
conceived, followed.   Sir James Murray3 also mentions, that a friend
of his had observed  similar effects  among  his workmen who were ex-
posed to the inhalation of watery  vapour  strongly impregnated with
chlorine.  The experiments, however, which were instituted at La Cha-
rite, in Paris, on this mode of treating phthisis, were by no means en-
couraging;  and the  same may be  said of  those at the Hotel Dieu of
that city, instituted by Rullier.*   In  many cases, indeed, the disease
appeared to be aggravated.  Bayle, likewise, thought the inhalation of
it generally unfavourable, although he asserts that he  cured a case of
tubercular phthisis with it.  Since then, it has  been recommended  by
Cottereau.   Professor Albers,5 of  Bonn, who administered  it repeat-
edly, and  carefully watched its effects, conceives, that it acts as a sti-
mulant when applied to the membrane, but that, when it gets into the
blood, its effects are  antiphlogistic; and he is  of opinion, that when
there is no haemoptysis or violent local irritation present, chlorine  in-
halations may be used in diseases of the lungs  and air-passages.  Its

  1 Pereira, Elements of Mat. Med. &c, 2d edit. i. 228, Lond. 1842; or 3d Amer. edit.
by Dr. Carson, i. 381.  Philad. 1852.
  2 Christison, A Treatise on Poisons, 1st Amer. edit. p. 616.  Philad. 1845.
  3 A Dissertation on the Influence of Heat, &c, Lond. 1829;  cited in the Dub. Journ.
of Medical Science, for March, 1839, p. 96.
  ♦Pereira, Op. cit. 3d Amer. edit. p. 382. Philad. 1852; and  E. J. Coxe, Practical
Treatise on Medical Inhalation, p. 83.  Philad. 1841; and  in Philad. Med. Exam. Nov.
1851, p. 705.
  * Hannoversch. Annalen. 1836; and Brit,  and For. Med. Rev. July, 1837, p. 215. 
200
CHLORINIUM.
 stimulant  effect  gradually diminishes, and, after a  time, the mucous
 surfaces of the lung become less sensible to its exciting influence.  In
 tubercles of the lung, chronic catarrh, chronic inflammation,  and ulce-
 ration of the bronchial mucous membrane, and in dilatation of the bron-
 chi, he found it of no service; and in most cases it could not be borne,
 in consequence of the irritation it induced;  but its operation was very
 salutary in pure ulceration of the lungs, or vomica.  It had always, how-
 ever, to be administered cautiously and experimentally.   Dr. Stokes
 always found chlorine inhalations prejudicial in phthisis, as  they pro-
 duced, in every case, increase of bronchial irritation, dyspepsia, and ar-
 rest of the pulmonary secretion.  In his trials of the remedy in gangrene
 of the lungs,1 he found it decidedly beneficial, correcting the foetor of
 the breath and expectoration, and, therefore, calculated to obviate not
 only the local but the constitutional symptoms.  Sir James Clark2 is
 of opinion, that the inhalation of chlorine has only produced relief in
 persons whose lungs have been diseased to a very limited extent.  Dr.
 A. T. Thomson3 considers it "the best topical expectorant, and the
 most salutary excitant to the mucous membrane of the lungs that has
 yet  been inhaled;" and Dr. Christison4 affirms, that he has tried the
 practice repeatedly; and although, like Dr. Elliotson, he has witnessed
 "such amelioration as he never saw before under the use of narcotics
 or any other means," he  has  not met with any instance where the
 amelioration was permanent.   Such, likewise, has been the experience
 of the  author.  Dr. Pancoast informed him, that a case of aphonia
 occurring in a young lady, in which  there was  but little voluntary
 power over the diaphragm,  was cured by the inhalation of  chlorine,
 after the galvanic plates and the electro-magnetic apparatus had been
 used in vain.  This case has since been published.'  The mode of ap-
 plication was as follows.   He took an ordinary tubulated glass retort,
 and a glass funnel, with filtering paper at the bottom.  In the bottom
 of the retort was placed a solution of chlorinated soda or chlorinated
 lime; and in the funnel a very dilute muriatic acid.   As this fell, drop
 by drop, into the retort, chlorine was gradually liberated and  breathed
 from the end of  the  instrument.   The inhalation was  continued for
 some minutes, and repeated two or three times a day.  Subsequently,
 Dr. Pancoast treated successfully, in the same manner, a medical prac-
 titioner, whose voice  had  been  lost for about  seven  months, and who
 had vainly employed the  ordinary means, and the  application of a
 strong solution of nitrate of silver by means of a sponge to the glottis.
 His voice began to improve after the first application of the chlorine;
 and, in  a week or ten days, it was restored to its natural strength.
   Chlorine may be inhaled from a common dish or inhaling apparatus,
by dropping  any of the acids on  a  mixture  of chlorinated lime, so
that the gas may be disengaged slowly; but the best method of  in-

  1 Dublin Hospital Reports, vol. v.
  2 Treatise on Tubercular Phthisis, p. 84,  Lond. 1834; also, Amer. edit. Phila. 1835.
  « Elements of Mat. Med. and Therap. 2d edit. Lond. 1835.
  * Dispensatory, p. 312.   Edinb. 1842.
  6 Transactions of the Amer. Med. Association, iii. 135.  Philad. 1852. 
CHLORINIUM.
201
haling it, as well as iodine, is that recommended  by Dr. Corrigan.1
He properly remarks, that, in order for inhalation to have a fair trial,
it is requisite, first,  That the apparatus should be simple  in its con-
struction, and^ easily kept in order.   Secondly, That it  should  be ca-
pable of keeping up a supply of vapour for any length  of time, and
that the evolution of the vapour should be steady and easily regulated.
Thirdly. That it should also furnish a sufficient supply of aqueous va-
pour to prevent  any irritation of  the larynx, or lining  membrane  of
the air-tubes;  and, fourthly, and most important of all, that its employ-
ment should entail neither trouble nor fatigue on the invalid.
                                  To fulfil these objects, Dr. Corrigan
                               advises the apparatus represented  in
                               the marginal figure.   It consists  of
                               a  light open iron-wire frame, about
                               eighteen inches high, at the bottom of
                               which is'a spirit-lamp, A: at the pro-
                               per height above it is an evaporating
                               porcelain dish, about six inches  in dia-
                               meter, B:  above this is  a glass globe,
                               C, with its neck downwards.   In the
                               neck of the globe  is a cork, D,  bored,
                               and through  the opening is drawn, mo-
                               derately tight, a short plug of  cotton
                               wick, such as is used in a spirit lamp:
                               in the glass globe at E,  opposite  the
                               neck, is drilled a pin-hole, to allow air
                               to pass in, according as the fluid within
   |!iftg^                    drops out through the neck.   To use
it, the porcelain dish is filled with  hot water,  the spirit lamp is lighted,
a nd as soon as the water in the dish has begun to  boil, the glass globe
  ontaining  chlorinated lime, (if this be the substance used,) is  placed
as in the illustration.   The rate, at which the fluid in the  globe shall
percolate the cotton wick and drop into the hot water beneath, is easily
regulated.   If it should not drop with sufficient rapidity, one or two of
the threads of cotton may be removed.  Should it drop too rapidly, this
is corrected by pressing in the cork more tightly, or introducing one
or two additional threads of wick.
   Eight ounces of a saturated solution of chlorinated lime maybe poured
into the  glass  globe;  and  into the water  of the  porcelain  dish, two
ounces of the  diluted sulphuric acid  of the  pharmacopoeia.  As  the
solution drops, the acid seizes on the lime,  and the chlorine is evolved
in connexion Avith aqueous vapour.2
   Chlorine is but little used in this form, and can  only be adapted for
cases in which the pathological condition of the bronchial mucous mem-
brane, or neighbouring parts, requires the exhibition of an excitant.3

  1 Dublin Journal of Medical Science, March, 1839, p. 94.
  2 London Medical Gazette, April  6, 1839, p. 49.
  * Toulmouche in Revue M.dicale, Avril,  1834.  See, on the various modes of inhala-
tion, Sir C. Scudamore, in Lond. Med. Gaz., Feb. 7, 1840, and E. J. Coxe,, Practical
Treatise on Inhalation.  Philad. 1S41.
 
202
CHLORINIUM.
In this way it may be occasionally serviceable in chronic bronchitis; but
its administration requires great caution.1   In cases of poisoning by
hydrocyanic acid, as well as by sulphuretted hydrogen, it is a most ef-
ficacious agent.   Chlorinated lime may be used for this purpose.
   2.  By Fumigation.—Fumigations of chlorine have been particularly
recommended by Dr. Wallace,  of Dublin.2   They appear to resemble,
in their action, the nitrous and nitro-muriatic acid baths, and have been
especially employed in liver diseases, unaccompanied by inflammation,
but in which there is a disturbance of the  biliary secretion.  Accord-
ing to Wallace, they are more certain than ablutions and baths of nitro-
muriatic acid, and have the advantage, that their  application subjects
the patient to less inconvenience.3   The good  effects of chlorine, in
such  cases, have likewise been  tested by Zeise,4 in his bathing estab-
lishment at Altona.   When chlorine is brought in contact with the skin,
in this way, it soon occasions a pricking sensation;  increase  of tran-
spiration ;  great afflux of fluids to the surface of the body, and some-
times 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  introduced the nitro-muriatic acid
to notice, about thirty-eight years ago, (1817,) that a solution of chlo-
rine 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 for-
mula has been introduced for the preparation of the Acidum Nitro-
muriaticum.   Take of  Nitric  acid,  f  §iv., Muriatic  acid, f ^viij.
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 he-
patic diseases with disordered secretion of the liver, but in several other
morbid conditions, as hypochondriasis,  cachexia, and in  all affections
in which a prolonged excitation of  the  skin, and a  restoration of its
suppressed or impaired functions are esteemed serviceable,—hence, in
old cases of syphilis, scrofula,  chronic catarrh and rheumatism.   Ge-
nerally, cathartics were combined with  the fumigations, and the evacu-
ations 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  which they can be prepared.5
   Injections of chlorine gas have been  employed for the  radical cure
of hydrocele by M. Deblois, of Tournay, and M. Deconde.6  The gas

  1 Archives G_ne"rales, Avril, 1834;  and a communication on the excellent effects of
chlorine vapour in catarrh, in Gazette Me"dicale de Paris.  June, 1838.
  2 Researches respecting the Medical  Powers of Chlorine, &c.  Lond.  1822.
  8 See on the Nitro-Muriatic Mixture, as a remedial agent, J. P. Mettauer, American
Journ. of the Med. Sciences, Feb. 1849, p. 291.
  * Nye Hygea udgived af  C. Otto, 1825,  and Hufeland und Osann's Journ. der prakt.
Heilkund. B. lxiii. St. 1.
  6 Green on Diseases of the Skin, American Library edit.  Philad. 1838.
  6 Bulletin Medical Beige, Janvier, 1836. 
CHLORINIUM.
203
is contained in a bladder, to which is attached a  pipe  and stop-cock
adapted to the cannula of the trocar, into which it is fixed after the
fluid is evacuated; the stop-cock is then turned, and the bladder pressed
so as to force the gas into the tunica vaginalis.   When this is distended
the pipe and bladder are removed, and the thumb is  placed  over the
mouth  of the trocar, so as to prevent the issue of the gas for the space
of two  minutes; it is then 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.1   As long ago as the year 1773, they were proposed for
these purposes; and were subsequently extensively used by Guyton de
Morveau: hence they have been called the u Guy Ionian," or " Guyton
Mor v eau fumigations.v  In fumigating the extensive  general peniten-
tiary 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 quan-
tities of the ingredients employed were  700 pounds  of common salt,
the same quantity of oxide  of manganese, and 1400 pounds  of sul-
phuric acid.2
   Whatever may be the virtues of chlorine fumigations as  an antibro-
mic or smell destroyer, experience would seem to have shown that they
are useless in  preventing the  spread  of zymotic diseases.  Possessed,
as all the  preparations of chlorine are, of potent antibromic virtues,
it was  natural to suppose, that they might equally destroy morbific mi-
asmata, and therefore be valuable preventives of cholera, and other
zymotic maladies.   In the  fever  of  the Niger, they  were fully tried
and  totally failed, and  there is no reason to believe that they are more
effective in other forms.  Some years ago, chlorine was employed at
the Small Pox Hospital, London, with the view of arresting erysipelas
in the  wards.3   The offensive smell was removed as usual, but the pro-
pagation of the disease appeared to be unaffected.  During the progress
of cholera on the continent  of Europe, in 1831  and 1832, extensive
trials were made with it, but without  any beneficial result.4  At a time
when the Cholera Hospital at Moscow, was filled with clouds of chlorine,5
the greatest number of  attendants was attacked; and similar facts were
noticed by distinguished observers in Berlin and elsewhere.6
   When chlorine is evolved in the manner above described, it is liable,

  J Link, Art. Chlor, in Encyclop'ad. Worterb. der Medicin. Wissenschaft. B. vii. S. 575.
Berlin, 1831.                                 2 Pereira, Op. cit. p. 228.
  5 Pereira, Op. cit. 3d Amer. edit. i. 381. Philad. 1852.
  * Dierbach, Die Neuesten Entdeckungen in der Materia Medica, i. 411, Heidelberg
und Leipzig, 1837.
  5 Albers, Lond. Med. Gazette, viii. 40.
  6 Gerardin and Gaimard, Du Cholera-Morbus, 3eme .dit. p. 110, Paris, 1833, and the
author, in Report of the Sub-Committee on Cleansing the city (Philad.,) p. 15. Phila. 1849. 
204
CHLORINII AQUA.
like all the acid gases, to the objection, that it is extremety irritating
when respired.  It cannot, therefore, be used  in  the  sleepyig apart-
ments of the sick,  although it may be  employed beneficially  after
they have been withdrawn, and the object is to disinfect the cham-
ber.  It ruins all polished surfaces, but this can be effectually 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.
                     LIX. CHLORINTI AQUA.
Synonymes. Aqua Chlorinii seu Chlorinei seu Chlorata seu Chlorinica seu Chlori sea
  Oxymuriatica seu Oxygenata Muriatica seu Oxygeno-Muriatica, Liquor Chlori seu
  Chlorinii seu Acidi Muriatici Oxygenati seu Alexiterius  Oxygenatus, Chlorum
  Liquidum, Solutio Chlorinii seu Alexiteria Oxygenata, Solution of Chlorine, Liquid
  Oxymuriatic Acid.
French. Chlore Liquide, Eau de Chlore.
German. Chlorwasser, Wasseriges Chlor, Chlorfliissigkeit, Dephlogis-
  tisirte oder  Oxydirte Salzsaure, Uebersaure Salzsaure, Oxydirt
  Salzsaures Wasser.

  This preparation is contained in many of the foreign pharmacopoeias.
It is in those of Austria and An vers; and in the Batavian, Bavarian,
Belgian, Danish, Dublin, Edinburgh,  Parisian, Finnish, Hanoverian,
Polish, Prussian and Swedish.1   It has been more extensively admi-
nistered on  the continent of Europe than in this country or in  Great
Britain.
                       METHOD OF PREPARING.
  The Prussian Pharmacopoeia  directs chlorine gas,  made after the
manner before described, to be passed into the bottles of a Woulfe's
apparatus filled with distilled  water, until two-thirds of the water are
displaced:  the bottles  are  corked  under water, and the water  is agi-
tated  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 chlorohydric 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 (commercial,) two
fluidrams; Red oxide of lead,  three hundred and fifty grains;  Water,
eight  fluidounces.   Triturate  the  chloride of sodium and oxide to-
gether ; put them  into the water contained in  a bottle with  a glass
stopper; add the acid, and agitate occasionally till the red oxide be-
comes  almost  white.   Allow the  insoluble matter to subside  before
using the liquid.
1 Pharmacop.e Universelle, i. 405. Pari., 1828. 
CHLORINII AQUA.
205
              EFFECTS ON THE ECONOMY IN  HEALTH.
  From  experiments made by Orfila1  on dogs, it appears, that con-
siderable doses of a moderately concentrated solution of chlorine prove
fatal by exciting, sooner or later, inflammation of the  stomach, accom-
panied with great languor; and when death takes place very rapidly,
signs of organic alteration are met with in the stomach. In its action
on the economy, chlorine is  closely allied to the acids,  and especially
to the 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 prostration.   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 antiphlogistics proper.
In the opinion of some of the German pathologists, it powerfully stimu-
lates the organic actions, especially the lymphatic and  glandular sys-
tems, moderating  inordinate  secretion.   Its antiseptic properties are
likewise considerable.  It would appear, however, that  the number of
observations has not been sufficiently great—although they  have been
by no means few—to allow of any comprehensive appreciation  of its
exact modus operandi on the human organism.2

              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 pre-
sent day, in some  countries, it is in common use. It is  not long since
Meurer maintained, that it is impossible to administer chlorine inter-
nally, and  that  in every case in which it was believed to have been
given, the article really taken  was chlorohydric or muriatic  acid; for,
owing to the affinity of chlorine  for  hydrogen, whenever any union
takes place between it and organic matters, the chlorine, he affirmed,
disappears, and  chlorohydric 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 experi-
ments 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, commit-
ted.  From Biirwald'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 differ-
ence is produced in the rapidity of the  decomposition.  In  a mixture
of aqua chlorinii, distilled water, and simple syrup, the  decomposition
takes place tardily; but if, in  place of syrup,  a mucilaginous juice be
substituted—for example, the syrupus  althaeoe—acids are speedily
formed; as well as when a decoction of althaea  is substituted for dis-
tilled water; whereas a mixture of decoction of salep, (gr. v. to water

       1 Toxicologic  Gen.rale, i. 141.
       2 Riecke, Die neuern Arzneimittel, v. s. w. S. 30.  Stuttgart, 1837. 
206
CHLORINII AQUA.
§j.), syrup, and aqua chlorini, in well-stopped bottles, remained unde-
composed about  twenty-four  hours.   In these experiments, however,
the persistence of the smell and taste of the chlorine exhibited, that
the whole of it had not been converted into chlorohydric acid.  In the
same manner as in the case of the decoction of marsh-mallows, the ad-
dition of infusum sennae and infusum Valerianae, as well as of the solutions
of extracts, and especially of liquorice, destroyed the smell of the aqua
chlorini instantaneously, even when the taste of chlorine could still be
detected.   When the solution was combined with remedial agents that
contained much  colouring matter, the decomposition  took place with
great rapidity.   From the results of these experiments, Barwald ad-
vises aqua chlorini to be given  in admixture with distilled water and
simple syrup,  as  in this way only can we be sure that the patient has
taken the  chlorine undecomposed.   Herzog lays it  down  as a rule,
that the  solution of chlorine should only  be mixed with  colourless
transparent substances—water, simple syrup, gum Arabic or decoc-
tion 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 recommended:—
   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.1 Dangerous
determinations to the head have  been, in this way, obviated, along with
the unpleasant complications which are apt  to be occasioned thereby.
Toel2 exhibited it in convulsions during  dentition which were accom-
panied  by too  great  activity of vessels;  and he affirms, that  he has
prescribed no remedy, which, in all respects, answered so well.
   Nervous fever, especially when tending to  the putrid character.   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 typhus  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 oppose 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 chlorinii in consider-
able doses;—in lighter cases, a  dram every two hours; and if  the dis-
order 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, and not unfrequently increases the abdominal

  1 Op. cit. S.  30.          2 Archiv. d. med. Erfahrung, Miirz und April, 1825. 
CHLORINII AQUA.
207
symptoms so palpably, that the physician is compelled to have recourse
to other agents.  Rieckex thinks, however, that it may be of essential
service in this  disease, which so frequently mocks  the best directed
efforts of  the practitioner; and he suggests, that farther experiments
are highly desirable, especially as those instituted by Trusen and others
are not free from objection, by reason  of their having associated sub-
stances with chlorine that quickly decompose it.
   Carbunculus malignus (Milzbrandkarbunkel.)—In the variety
of malignant anthrax caused by handling the skins of cattle, the internal
and external  use of chlorine has  been found of essential service by
Ettmuller, Herbst, Stumpf, and Hoffmann.  The benefit derived from
its use externally, in this and similar affections, induced Dr. Cramer 2
to try its  effects on bad furunculous swellings, the progress of which
was surprisingly expedited, and the extension of the ulceration much
limited compared with what occurs under the use of poultices; and such
was the experience of Brosius.3
   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 sanguiferous system,
—indicated by rapidity of pulse and inordinate evolution of heat, which
bear 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, supposed that it acted as specifically as
the bark in intermittent, or mercury in syphilis! and Trusen  asserts
that it may be advantageously used in cases where other remedies have
been found  ineffectual.  It is  especially recommended by Braun  and
Spiritus in malignant scarlatina.  Dr. Watson4 says, that from  several
distinct 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 misgivings 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.   Dr. Cramer saw great relief follow
its application to the neck, in a case of this disease in a child, in which
suffocation was  impending.   He kept  compresses well soaked  in it to
the part.   See Soda Chlorinata.
   In other febrile affections—small-pox, measles, rubeolse, &c.—it has
been prescribed with advantage; and Dr. Schneider5  strongly recom-

  1 Op. cit.  S. 33.
  2 Casper's AVochenschrlft, No. 8, cited in Brit, and Foreign Medico-Chirurg. Rev. July,
1850, p. 278.                      s Canstatt'.. Jahresbericht, 1851,  v. 73.
  4 Lectures on the Principles and Practice of Physic, 2d Amer. edit. p. 1024. Phila. 1845.
  5 Cramer, Op. cit. 
208
CHLORINII AQUA.
 mends it as a gargle in small-pox and angina.   He applies it diluted
 with water, and finds it exert a remarkable ectrotic effect over variola
 when affecting the tongue and  throat;  and over angina in general.
 In putrid dysentery, (faulige Ruhr,) it is extolled by Nysten and
 Kopp;  and in intermittent, by Kopp and Kretschmar.  Trusen re-
 commends 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 mem-
 brane of the digestive tube.  Other physicians have also derived equally
 favourable results from its administration in that malady.
   In gastromalacia, it has been  prescribed by Rhades, Blasius, and
 Winter,  but as Riecke,1—from whom this detail of the  experience 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.   In  ulceration of the throat with diphtheritis,  Mr.
 Blyth2 recommends the internal use of chlorine conjoined with quinia.
 He puts into a pint bottle eight grains of chlorate of potassa and one
 dram of chlorohydric acid.  A violent action ensues, during which the
 bottle is corked.   An ounce of water is then poured in, and the bottle
 is well shaken until the chlorine is partly absorbed.  Another ounce
 of water is then poured in, and so on  until the bottle is filled.  A weak
 solution  of chlorine is thus  prepared, of which, to a child, two tea-
 spoonfuls with a quarter of a grain of sulphate of quinia may be given
 every two or three hours.   The same treatment is useful in scarlatina
 anginosa and s. maligna.   Dr. Hamilton Roe3 had previously recom-
 mended a similar preparation  of chlorine in scarlatina.
   In erysipelas, especially  of children, it has been recommended by
 Kopp.
   In inflammation of the liver, favourable results were obtained from
 it in the Children's Hospital at St. Petersburg;  and  it exhibited, in
 these cases, the  analogy to calomel  in  its action, which has been
 pointed out by many observers.
   In hydrophobia, it has been used both internally and externally as
 a preventive, especially  by the Italian  physicians  Brera, Previtali,4
 Ghisaldoni, Agliati, Arrigoni, Narcisi, and Anelli,  whose experience
is in its favour.   Wendelstiidt  and Ruppius have likewise published
 favourably regarding it.  It is obvious, however, that much  fallacy
 may arise as to the precise agency of reputed preventives.  Every one,
for example, who may be bitten by a mad dog is not attacked with hy-
drophobia ; and, unless great caution  is  used, any article may be re-
garded as a  preventive.  This  is  the main reason why we have so
many preventives  of this and other diseases.
  Solution of chlorine has been advised by Ruppius and Mertzdorf in
dropsy,  especially such as supervenes on the acute exanthemata.

  1 Op- cit. S. 34.                    2 Med- Timeg and Gaz ? April) 1853
  3 Lancet, Mar. 1853, and Brit, and For. Med. Chir. Rev., July, 1853, p. 282.
  * Pratiche Osservazioni sulT Idrofobia, &c. Milan, 1820.  • 
CHLORINII AQUA.
209
  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 requires to be given  in
large doses, and to be exhibited for a considerable time.
  In many cases of chronic cutaneous affections with diminished plastic
energy, it has been used with success by Kopp.
  In noma or cancrum oris, and in foetor of the mouth, it has been
recommended internally as well as topically; and, according to  the ex-
periments of Persoz, Nonat, and others, it renders eminent service in
cases of poisoning by hydrocyanic  acid.
  Externally, it is used either  pure, diluted with water, or in combi-
nation with oil.   Godier affirms, that he cured strumous swellings of
the glands by a cerate of chlorine.  Eisenmann, Cullerier, and Blache
recommend it—at times pure, at others  diluted—in the way of  in-
jection, in gonorrhoea and leucorrhcea.   It is employed, also, in flabby,
putrid, and offensive  ulcers, in carbunculus malignus, and in  chronic
cutaneous affections—as tinea capitis, itch (Deimann,) herpes (Alibert,)
asthenic aphtha, &c.
  In large abscesses and in buboes, great advantage was derived by Dr.
Cramer1 from its  external  use.   The matter was at times absorbed,
and when this was not the case, the progress of the case was still very
favourably influenced.
  Lastly: ablution with a solution of chlorine, or of the chlorides, has
been advised as a preventive of venereal infection.  In cancerous 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  ex-
pect much from it.  Baths of  it are recommended by Wagner as  an
excellent means for preventing the plague.  Schonlein advises, that in
scarlatina the whole surface of the body should be washed with a mix-
ture of aqua chlorinii and water, which  he prefers to  ablution  with
 cold water.
   Finally, aqua chlorinii is occasionally sprinkled in the sick chamber,
to purify the atmosphere, during the prevalence of contagious or other
diseases.

                     MODE OF  ADMINISTRATION.
   As  already remarked, whenever aqua chlorinii is prescribed, its fa-
cility of decomposition must  be borne in mind.  It is, for this  rea-
son, best to prescribe it, for internal  administration, with water only,2
or at most with the addition of simple  syrup.   For external use,  wa-
ter alone should be  associated with it.   As to  the precise  mode in
which  chlorine is affected by fatty substances, we have as yet no ac-
curate  knowledge; it may be calculated, however, that  part under-
goes decomposition.   Such combinations  have, notwithstanding, been
found  useful.
   The solution should never be  prescribed in  quantity  larger than is
necessary for twenty-four hours,  as by frequently opening the vessel

  1  Op.  cit.
  2 Lepage, Journ. de Chimie M.d. cited in Encyclop. des Sciences M.d. Janv. 1842, p. 22.
        14 
210                       CHLOROFORMUM.

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 quantities may be given with-
out  inconvenience.   It is  scarcely necessary to  say that  the precise
dose must vary with the degree of concentration.

                      Unguentum chlorinii-

   Ointment of chlorine.   Unguentum oxygenatum ex tempore parandum.
                  R.  Aqua, chlorin. p. j.
                     Adipis p. viij.  M.
   Used in itch.                        Pharmacopoeia of Austria.

                  Linimentum  aquae  chlorinii.
                         Liniment of chlorine.
                 R.  Aquas chlorin. fgj.
                     Oleiolivffifgj.  M.

   Externally, in obstinate itch, tinea capitis, and herpes.
                                      Deimann, %•  G. A. Richter.
                 R.  Cera, albse gij.
             Leni calor. liquef. adde
                     01. amygdal. q. s.
             ut fiat linimentum cui refrig. adde
                     Aq. chlorin. f3iss.  M.

   Used externally in ulcers.                               Ludwig.

                  Gargarisma aquae chlorinii.

                          Gargle of chlorine.
                  R.  Tragac. pulv. gr. xij.
                     Aquae f 3.v.
                     Aqua, chlorin.
                     Syrup, aa. f §ss.  M.

   To be used  as  a  gargle in  ulceration and chronic inflammation of
the mouth and fauces.                                     Ratier.1
                      LX. CHLOROFORMUM.
Synonymes. Chloroforma, Chloroformyl, Carboneum Chloratum, Superchloridum For-
  mylicum, Chloroform, Terchloride of Formyl,—improperly called, by some, Chloric
  Ether,3 and Terchloride of Carbon.
French. Chloroforme.
German. Chloroform,  Formylsuperchlorid.

  This preparation, which was admitted into the supplement to the last
edition but one of this work, has acquired fresh interest, in consequence
of its introduction and extensive  employment  as  an anaesthetic in the
same cases  as sulphuric ether; which it has, indeed, in  the practice of
many, wholly supplanted.

  1 Formulaire Pratique des Hopitaux Civils de Paris, 3.me Edition.  Paris, 1827.
  2 Dierbach, Die  neuesten Entdeckungen in der Materia Medica, iii. 930, Heidelberg
and Leipzig, 1847. 
CHLOROFORMUM.
211
                      METHOD  OF PREPARING.
  Chloroform was discovered separately and about the same period by
Mr. Guthrie,1 M. Soubeiran,2 and Liebig.3
  The process admitted into the last edition of the Pharmacopoeia of
the United States, (1851,) is as follows.—Take of chlorinated lime, ten
pounds; water, three gallons and a half; alcohol, two pints.  Mix the
chlorinated lime, first with the water, and then with the alcohol, in a
distillatory vessel, having the  capacity of about six gallons.   Distil
with a brisk heat into a refrigerated receiver, and when the tempera-
ture  approaches 176°, withdraw the fire, in order that the distillation
may proceed by the heat received  solely from the reaction  of the
materials.   When  the  distillation  slackens,  hasten  it  by a fresh
application of heat,  and continue to distil until  the  liquid ceases to
come over with a sweet  taste.   Separate the heavier layer of liquid
in the receiver from the lighter, by decantation, and having washed it,
first  with water, and then with  a weak solution  of carbonate of soda,
agitate it thoroughly with  powdered chloride  of calcium, and distil
by means of a water bath, stopping the distillation when eleven-twelfths
of the liquid have come  over.  The residue, together with the  light
liquid of the first distillation, may be reserved for use in a  second ope-
ration.
  The most fragrant form is  obtained by the action  of  chlorinated
lime on alcohol.   Dr. Christison4 gives the following mode of preparing
the article, which  he and others have used so successfully  as an anaes-
thetic.  One pound avoirdupois  of bleaching powder, with three pounds
of water and three ounces of rectified  spirit, yields, by distillation in
a roomy vessel, about nine fluidrams of crude chloroform of the density
1.220.  After this,  the residuum begins suddenly to froth up.  The
crude  chloroform, which is  covered in the receiver  by a  stratum of
weak spirit, is purified by shaking with it half  its volume of sulphuric
acid, gradually added;  and  water and alcohol being thus removed, the
strong chloroform is freed of a little  sulphuric acid  by redistilling it
from milk of lime or baryta.  The product, which is pure  chloroform,
if the process  be well conducted, amounts to about half a fluidounce.
Dr.  Christison has not found  the quantity to  be increased,  as some
have represented,  by increasing the quantity of alcohol.
   Chloroform is  a   transparent, colourless  fluid varying in  specific
gravity according to the  process employed.  That of the Pharmacopoeia of
the United States is 1.40, of the  London, 1.48, and of the Dublin, 1.496.
It has a peculiar, fragrant,  ethereal odour, resembling that of  apples;
and an ethereal, slightly acrid, intensely sweet, taste.  It speedily evapo-
rates ; and boils at 140° Fahr.  It  is readily soluble  in alcohol and
ether, but only in 2000 parts of water.   It dissolves volatile oils, cam-
phor, caoutchouc,  wax,  and resins.   Its most frequent  adulteration is
with alcohol, and next with ether, which are detected by the reduction
of its  density, or by its  becoming  opaline when dropped  into water.

  1 Silliman's Journal, xxi. 64, Jan. 1832.
  2 Annales de Chimie et de Physique,  xlviii. 131.  Paris, 1831.
  s Ibid, xlix., 146.  Paris. 1S32.
  1 Dispensatory, Amer. edit, by R. E.  Griffith, p. 974.  Philad. 1848. 
212
CHLOROFORMUM.
   Dr. W.  Gregory1  ascribes the  injurious  effects  of the  chloro-
form in  ordinary use to the presence of certain volatile oily impuri-
ties, which must be removed before it can be safely employed.   These
oils contain chlorine, have a disagreeable smell, and, when inspired or
smelt, cause distressing headache and sickness.   The  test recommen-
ded  by Dr.  Gregory for these impurities  is to agitate the chloroform
with sulphuric acid, which should be quite colourless, pure, and of the
full density of 1.840 at least.   This, when agitated with impure chlo-
roform, becomes  yellow or brown, from its  action  on the oils, which
it chars and destroys.   Any change of colour is readily seen by the
contact with the colourless chloroform that floats above.  Pure chloro-
form gives no colour to  the acid.   Dr. Beatty2 accords with Dr. Gre-
gory in the belief, that we have thus in our power a very simple means
of testing and purifying chloroform before employing it.3

                     EFFECTS ON THE ECONOMY.
   The medical properties of chloroform are like those of sulphuric ether,
than which, when sufficiently diluted, it  possesses a  more agreeable
taste, so that it is  readily  taken even by  children.  Dr.  H. Harts-
horne4 experimented with it on himself and others  when in  health.
He  found  that seventy-five drops gave him a sensation  of  general
diminution  of consciousness and  sensorial capacity.   Sight, hearing,
and  touch were made less impressive; but no feeling of exhilaration or
perversion occurred: he was  drowsy:  the  pulse was not  at  all ac-
celerated;  it  was, indeed, two beats  slower in the minute;  and the
same effects were observed in two other medical  gentlemen, from two
or three times the quantity.   One  took  over two hundred drops.  He
became very heavy, and, in  a short  time, passed into a sound sleep.
In all of them, the influence had departed after an hour or two.  No
one  felt  as if he  had taken alcohol, and in none was the pulse in-
creased ; and  the  conclusion with  all of them was, that  it is  a direct
sedative to the encephalic nervous system,—a sedative narcotic.
   Chloroform has  been used  with advantage  in diseases  in which a
grateful  and  composing medicine is  indicated.   In  cases of cancer
it has been  given internally in the dose of two or three drops by Mr.
Tuson,5 and has produced  sleep and perfect  ease.   As a local applica-
tion  to the cancerous part its action was of a sedative character.  He
also  gave it with advantage  in uterine irritation or neuralgic affec-
tions of the uterus.   In such cases he prescribed it internally, but in
others, attended with obstinate discharge, it ought to be  injected as
welh  In obstinate vomiting, three drops have "at  once taken  effect;"
and  in such cases Mr. Tuson has found benefit from applying it to the
pit of the stomach.   In cancer of the pylorus,  "it  has proved most

  1 Monthly Journal of Med. Science, May, 1850, p. 414.
  2 The Dublin Quarterly Journal of Med. Science, August, 1850.
  3 See, on all this subject, Dr. Bache, Dispensatory of the United States, 10th edit. p.
844.  Edinb. 1854.
  4 Amer. Journ. of the Med.  Sciences, p. 353, Oct. 1848.
  3 Lond. Lancet, July 15,1843, p. 553, and The Structure and Functions of the Female
Breast, p. 410.  Lond. 1846. 
CHLOROFORMUM.
213
efficacious in preventing the return of the food, and in relieving the
pain and suffering of the patient."  In sloughing ulcers, he has used
it extensively, and he is not acquainted with a remedy more beneficial.
" In phagedana, there  cannot be a more useful local application; but
care should  be taken to apply it only to the sloughing parts. "  " In
fungoid  disease, the  application  of the chloride  of carbon has been
very remarkable."   Mixed with water, it  is said to form a very use-
ful gargle in foul ulcerated sore-throat, removing the fcetor, and giving
the ulcers a  healthy appearance.   It is also, according to Mr. Tuson,
of the greatest use in affections of the gums and teeth, "removing the
unpleasant  stinging pains produced by the exposure of some nervous
filament; and its use not only gives ease, but  removes any unpleasant
foetor  from the breath."   Such  is a picture—doubtless overdrawn by
Mr. Tuson—of the  efficacy of chloroform as a remedial agent.
   It has, moreover,  been given internally, in hysteria,1 neuralgia,2 chro-
nic vomiting from nervous causes,3 such as that which occurs in preg-
nancy, delirium tremens,4 maniacal delirium,5 in flatulent colic, and in
lead colic.6  In malignant cholera, according to Dr. Henry Hartshorne,7
it has  produced the most admirable effects, when combined with tinc-
ture of camphor and tincture of opium; as in the following form:—
                 R.  Chloroform, f gij.
                      Tinct. camphor.
                      ----opii. aa f ^iss.
                      01. cinnam. gtt. viij.
                      Alcohol, f 3iij.  M.
Dose, from five to thirty minims, given repeatedly,   He lays  stress on
the shortness of the intervals between the doses.  In violent rheumatic
or neuralgic pains,  its internal and external use has often proved most
serviceable in the hands of the author, and of others.8   Like other to-
pical applications, however, it has not  served any valuable purpose, in
his experience, in gout or acute rheumatism.
   In epileptic convulsions, in a child of a  year and a half old, benefit
appeared to  be produced by a five minim dose, suspended in mucilage,
after every fit, in the observation of Mr. 11. Bowe.9  It has been given
in cough, as an addition  to  pectoral mixtures; and by M. Delioux10
and M. Giraudet11 in intermittent fever ; by Dr. Gordon12 to  allay the
  1 Formby, Christison's Dispensatory, p. 975.  Philad. 1848.
  2 Mr.  Tuson,  Op. cit.; also, Wahu, Annuaire  de Medecine et de Chirurgie Pratiques
pour 1853, p. 15; H. Hartshorne, Amer. Journ. of the Med. Sciences, Oct. 1848, p. 353;
and Dr.  Wood, Dr. Hays, and Dr. John H. Rauch, Amer. Journal of the Med. Sciences,
July, 1851, p. 112.
  3 Dr. Inman,  Med. Times and Gazette, Mar. 5, 1853.
  4 Dr. Stephen Pratt, Amer. Journ. of the Med. Sciences,  Jan. 1852, p.  142; Mr.
Butcher and Dr. Neligan, Dublin Med. Press, cited in Ranking, xvi. 54, Amer. edit. Phila.
1853; and Dr. Letherman, U. S. A., Med. Examiner,  Jan. 1853, p. 33.
  1 Dublin Quarterly Journal, May, 1853.
  •Aran, Bulletin de Therapeutique, in Bouchardat, pour 1851, p. 31; and Brit, and
For. Medico-Chirurg. Rev. April, 1851;  and Union Med. Jan. 1855, and Amer. Journ.
of the Med. Sciences, July, 1855, p. 207.
  r Amer. Journ. of the Med. Sciences, Jan. 1854, p.  114.
  « Dr. J. Kirby, Dublin Med. Press, March 16, 1853.
  » Med. Times and Gazette, Sep. 24, 1853.
  10 Bouchardat, Annuaire de Therap. pour 1851, p. 31.      " Ibid, pour 1852, p. 66.
  12 Dublin Hospital Gaz. Feb., 1854, and Ranking, xix. 27. 
214
CHLOROFORMUM.
 insomnia and nervous  irritation of fever;  by Dr. Osborne1  to con-
 trol the depressing and  saddening feelings belonging to hypochondria-
 sis ;  and, united with camphor and valerian, it was  employed bene-
 ficially by Dr. C. J. Pope2 in a singular case of delirium and  violent
 spasms.
   Soon after its discovery, it was prescribed by the  Doctors Ives,3 of
 New Haven, in asthma* spasmodic cough, scarlatina, and atonic quinsy,
 —and with favourable results.
   As an external application, again, it has been used in open  cancer,
 sloughing ulcers,5 orchitis,6 neuralgia,7 and painful affections in gene-
 ral,8 neuralgic tooth-ache,9 lumbago,10painful pelvic tumours,11 and as a
 collutory in foetor oris.
   M. Venot,12 of Bordeaux, affirms, as the result of twelve months' ex-
 perience, that injections of chloroform are  of little avail in confirmed
 gonorrhoea;  but are possessed of a complete abortive power,  if em-
 ployed during the first week.    It  has also been used as an injection,
 by Professor Langenbeck13 of Berlin, for the radical cure of hydrocele:
 f 3j- or f 3_ss. is thrown in, and  after  allowing  it  to remain for  a
 short time in contact with the tunica vaginalis, it is allowed to escape.
 He has  been quite satisfied with  it in several cases.   United with po-
 tassii cyanuretum it has been used successfully in hemicrania and fa-
 cial neuralgia, in the form of ointment, by M. Cazenave, of Bourdeaux.14
   But its most interesting and important  application is as  an anaes-
 thetic agent  administered in the way of inhalation.   As long  ago as
 the year 1832 it was employed in this manner by Professor Ives,15 of
 New Haven, in a pulmonary affection attended with great debility and
 dyspnoea, which was effectually relieved by it; but no farther attention
 appears to have been paid to it until Professor Simpson,16 of  the Uni-
 versity  of Edinburgh, instituted trials with it,  and other anaesthetic
 agents, and  found it infinitely more efficacious than any.  In his first
 publication, after  having tried it on upwards  of fifty individuals, he
 detailed some striking cases of midwifery and surgical practice, in which
 it had been inhaled with the most satisfactory results.  The main ad-
 vantages which he conceived it to possess over sulphuric ether, were;—

  1 Dublin Quarterly Journ. Nov. 1853, and Ranking, xix. 51.
  2 Med. Examiner, Sept., 1853, p. 559.
  s Silliman's Journal, xxi. 406.
  * See also, H. A. Swasey, Philad. Med. Exam., Jan.  1852, p. 23.
  5 Mr. Hancock, Lancet, Feb. 12, 1853.
  6 Buisson, L'Union Medicale, No. 4, cited in Brit, and  Foreign Medico-Chirurg. Rev.
July, 1850; and Wahu, Annuaire de Med., &c., pour 1851, p. 73.
  * Ranking, Half-yearly Abstract, ix. 219, Amer. edit.  Philad. 1849.  Tuson, Op. cit.
 Hays and  Bond, Transactions of the College of Physicians of Philadelphia, vol. 2, No. 6;
 and Laroque, Bulletin de Therapeutique, Mars, 1849, p.  209.
  8 Dr. Channing, Amer. Journ. of the Med. Sciences, April, 1852, p. 353.
  9 Pigeolet, M.AVahu, Annuaire de Medecine, etde Chirurgie Pratiques, pour 1849, p. 247.
  w L'Union Medicale, 21 Oct.  1848.                      u ibid. 31 Octobre, 1848.
  12 Bull, de Th.rap. xi. 184; and Brit, and For. Med.  Chir. Rev. Oct. 1851, p.  550.
  "Dublin Hosp. Gaz. April  1, 1855, from Deutsche  Klinik; and in Amer. Journ.
of the  Med. Sciences, July, 1855, p. 224.
  11 Bouchardat Annuaire de The"rap. pour 1853, p. 94.
  15 Silliman's Journal, xxi. 406.
  « Account of a New Anaesthetic Agent as a Substitute for Sulphuric Ether in Surgery,
Edinb. 1847. 
CHLOROFORMUM.
215
that a much  less quantity is needed;  that  its action is much more ra-
pid and complete, and generally more persistent; its  inhalation more
agreeable and pleasant; and that being required in much less quantity,
it  is  more portable  and  transmissible  than sulphuric ether;—that
recovery is usually more speedy, leaving  fewer unpleasant feelings;
and that it does not excite irritation of the  bronchial tubes, is pleasant
to the taste, and does not leave a disagreeable  taint of the  breath.
   As soon as the discovery was promulgated by Dr. Simpson, the inha-
lation of chloroform was largely employed in all cases  in which the in-
halations  of  ether had  previously been directed.   Experiments were
made by  numerous observers,—by Dr. Simpson1 himself, Dr. Snow,2
M. Sedillot,3  Mr. Wakley, jun.,4 Mr. Gruby,5 MM. Dumeril and Demar-
quay, M.  Amussat,6 M. Gerdy,7 M. Jobert,8 Mr. F. Sibson,9 M. Coze,10
and others, to determine its physiological action; from all of which it
appears, that whilst chloroform is a much more potent agent than sul-
phuric ether, its  action as an anaesthetic is essentially  the same.   The
remarks,  consequently, which were  made upon  the  latter are  equally
appropriate to the article under consideration.  MM. Dumeril and De-
marquay  in their experiments on animals state,  that ether and chloro-
form are rapidly fatal,  when  inhaled in very large quantity.  _  Dogs
were destroyed  in thirty-five or forty-five minutes, and even in less
time, by chloroform.   When the inhalation of chloroform, like that of
ether, is  carried beyond a certain point,  it is  capable of producing
death; and if not to this extent, convulsions and  profound insensibility.
Certain persons  appear, too,  peculiarly susceptible to its influence, so
that disagreeable, and even dangerous phenomena may present them-
selves, when  least expected.   Many such cases have been recorded;—
the disagreeable effects  being chiefly,—vomiting, especially when the
inhalation has been used soon after eating;  headache, continuing for
several hours; hysteric or tetanic convulsions, and formidable depres-
sion of the heart's action.  The ordinary effects are described by Dr.
Christison11 as follows:—When inhaled in  the dose of  twenty or thirty
minims from a handkerchief, it speedily occasions whizzing and pulsa-
tion  in the head; a change in  the apparent colour of objects;  plea-
surable ideas and visions; loss  of  consciousness, or a semi-conscious
state, and either soft sleep, or tendency to laughter and jocularity, or
propensity to incoherent talking, or boisterous turbulence;  and when
this state passes  off, which happens in five or six minutes at most, there
is little or no recollection of what has passed, and no  remembrance of
pain, even although pain may have been  expressed.  These phenomena
closely resemble in nature and variety the effects of the inhalation of
nitrous oxide gas.  The effect on the  heart's  action is variable.   The
most frequent deviation, witnessed by Dr.  Christison, is, some increase

   1 Monthly Journal of Med. Science, Dec. 1847.
   2 Lancet  Feb. 12,1848, and May 13,1848.            3 Comptes rendus, p. 802.   ^
   * Lancet, loc. cit.                              " Bulletin des Academies
   « Comptes rendus, Nov. 29,1847.               .   1 Comptes rendus p. 803.
   8 Ibid p. 806. Also, Amer. Journ. of the Med. Sciences, July, 1848, p. 22/.
   » Lond. Med.  Gaz., Feb. 1818.
  10 Bouchardat, Annuaire do Th.rapeutique, pour 18o0, p.  38.
  » Dispensatory, Amer. edit, by R. E. Griffith, p. 975, Philad. 1848.  Also, a letter from
Dr. Christison to M. Dumas, in Bouchardat, Annuaire de Th.rapeutique, pour 1849, p. 76. 
216
CHLOROFORMUM.
in the frequency and diminution in the force of the pulse; but often
no distinct change takes place, and occasionally the pulse is strength-
ened.  When a dose of a fluidram or more is inhaled in the same man-
ner, the most frequent effect is the rapid induction of coma, with com-
plete relaxation of the muscles;  slow and often stertorous breathing;
upturning and fixing of the eyes, and total insensibility to agents which
cause, in ordinary circumstances, the  most acute suffering.  The pu-
pils  are variously affected, but always  contractile.   Frothing at the
mouth is not unusual.  Slight convulsive twitches of the face and limbs
are more rare.   The insensibility may begin in fifteen seconds, and is
rarely postponed  beyond two  minutes, if the chloroform be skilfully
applied.  It continues usually between five and ten minutes, but some-
times for two hours,  if the inhalation has been kept up  for some time
by renewing the chloroform on the handkerchief.   Sometimes quiet
sleep succeeds; more generally a drowsy, dreamy state, but not unfre-
quently rapid, complete consciousness and  activity.   In general, no
recollection is retained of any occurrence during the state of insensi-
bility.   For the most part,  there is no remarkable subsequent effect;
no lassitude; no headache; no sickness; no loss of appetite; but occa-
sionally there is a little weariness or sickness.
   Such is the statement of one who is partial to the administration of
chloroform.  He admits, however, that other results have been ob-
served, which he regards as anomalies, depending  upon  constitutional
peculiarities or imburities  in  the  article.   "I have witnessed," he
remarks, " violent tetanic spasm twice in the healthy state; and once
in delirium tremens, but without any ill  consequence: hysteric  agita-
tions, contortions, and screaming, have also been witnessed, but without
any ultimate harm;  and during both of these affections there has been
no recollection  afterwards of any uneasiness.   Sickness  and vomiting
have sometimes occurred, chiefly, according  to my observation, when
the remedy was used too  continuously  so  as  greatly to  obstruct the
breathing.   Relaxation  of the sphincters is  an  untoward accident,
which is not so frequent as might be  expected.  The  only really for-
midable affection is sinking of  the pulse,  as in the case  adverted to
above; and this seems a rare occurrence.  According to Mr. Skey,1
the records of St.  Bartholomew's  Hospital  point to its successful ad-
ministration in upwards of 9000 cases; "in not one of which, includ-
ing the aged and the young, the healthy, the  infirm, and the asthma-
tic, has its  employment left a stain on its character as  an innocuous
agent of good." "Under all circumstances," he adds, "its careful em-
ployment may be unhesitatingly resorted to in all cases excepting only
such as are marked by determination  to the brain of  an apoplectic
type; secondly, under circumstances of great and serious exhaustion
from loss of blood;  and thirdly, in  diseases of the heart.  In these
conditions of the system, it is perhaps better avoided."
  It is undoubted, however, that unpleasant and even alarming phe-
nomena have been produced by it in the experience of Mr. Beales,2

         1 Operative Surgery, Amer. edit. p. 31.  Philad. 1851.
         2 Lond. Med. Gaz., Dec. 24, 1847. 
CHLOROFORMUM.
217
Mr. R. Stewart,1 Mr. W. W. Gull,2 Dr. Mitchell,3 Dr. Nevins,4 Dr. Reed,5
Mr. Tomes, Dr. Webster,6 (insanity induced,)  Dr. John Snow,7 Dr. C.
II. Cragin,8 M. Miction,9 Delarue,10Mr. Stanley,11 and others; and fatal
cases ascribed  to its  deleterious agency have been  recorded by Mr.
Meggison,12 Dr. 11. Jamieson,13 Mr. Robinson,14 M. Gorre,15 Dr. Ander-
son,16  M.  Robert,17 R. 0. Johnston,18 M. Confevron,19 Dr. Farwell,20
Mr.  John  Harrison,21 Dr.  De Wolf,22 Dr. Snow,23 who  enumerates up
to that time eighteen deaths, and  others.24
   According to M. Gruby, during the  inspiration of  chloroform, the
arterial blood retains its florid hue, and if, under asphyxia, it  assumes
the dark venous character, the red colour is speedily restored; yet by
others25 a highly venous appearance of  the  blood issuing from the ar-
teries  has been noticed; and M. Robin26 ascribes the  anaesthesia in-
duced by  it and  ether to their preventing the  complete conversion  of
venous into arterial blood.27
   Like  ether,  chloroform is capable of inducing local  anaesthesia,28
by dipping the part in it,  or applying it externally by means of  lint,
—a fact,  which was noticed before it was employed as an  ansesthetie
in the way of inhalation,  and led to its use as  a local agent  by Mr.
Tuson and others.  Its influence in deadening the sensibility of a part


   i Lond. Med. Gaz., Jan.  1848.                            2 Ibid. Dec. 1847.
   3 Ibid. Jan., 1848, from  Dublin Med. Press.
   * London Med. Gazette, Mar. 1848.                  5  Lancet, April 29,  1848.
   6 London Med. Gazette, Jan. 1850, and Psychological Journal, April, 1850.
   ' Edinb. Med. and Surg. Journal, cited in Amer. Journal  of the Med. Sciences, July,
1850, p. 169.                          8 Med. Examiner, April,  1848, p. 223.
   8 Archives G.n.rales de M.decine, Juillet, 1850, p. 370.    Ibid. Sept. 1850, p. 105.
  10 Med. Times, Nov. 22,1851, and Amer. Journ. of the Med. Sciences, Jan. 1852, p. 255.
  11 Archives Gcn_rales de M6decine, Sept. 1850, p. 105.
  12 Med. Times, Feb. 5, 1848.                 13 Lond. Med. Gaz. Feb.  26, 1848.
  u Med. Times, cited in Ranking's Half-yearly Abstract, Amer. edit. viii. 220. Phila. 1848.
  15 Lancet,  July 4, 1848.  A  fatal  case, occurring in Cincinnati, in AVestern Lancet,
Mar. 1848; and another at Hyderabad in Scinde, in Ibid., July 22, 1848.       16 Ibid.
  « Cited in Medical Times, July 22, 1848.
  18 Provincial Medical and Surgical Journal,  July 20, 1848.
  19 Cited in Lancet, Nov. 17, 1849.
  20 Med.  Times, Dec. 13, 1851.
  21 Assoc. Med. Journ. Feb. 4, 1854, and Brit, and For. Med. Chir.  April, 1854, p. 581.
  22 Buffalo Med. Journ. Dec. 1853; and Amer. Journ. of the Med. Sciences, April, 1854,
p. 552.
  23 Med.  Times and Gazette, March 6, 1852.
  2i Lond. Med. Gazette, Jan. 1849.  See, on the injurious and fatal effects of chloroform,
J. C. Warren, Amer. Journ. of the Med. Sciences, April, 1849,  p. 379; and Effects of
Chloroform and of strong Chloric Ether, as Narcotic Agents, Boston, 1849; Dr. Snow and
others,  in Amer. Journ. of the Med. Sciences, July, 1849, pp. 274-278; also, a Discus-
sion  before  the Academy of Medicine of Paris  on the  action of Chloroform, by MM.
Malgaigne, Amussat, and  Gu6rin, cited in Med. Times, Nov. 25, and Dec. 2, 1848, and
Lancet, Feb. 2, 1849; and in Bouchardat, Annuaire de Therapeutique, pour 1849, p. 90.
Also, Dr.  Crisp, on the recorded deaths from Chloroform, in Lancet, June 4, 1853; seve-
ral cases referred to, in Brit, and For. Med. Chir. Jan. 1854, p. 290; one in University
Hospital, under Mr. Erichsen, in Med. Times and Gaz., Oct.  14,1855; one under Mr. Bir-
kett, in Brit, and For. Med. Chir. July, 1855, p. 278, and one in Lancet, Sept. 1, 1855, &c.
  25 Provincial Med. and Surg. Journ., Feb. 9, 1848; and London Med. Gaz.,.Nov. 1850.
  J<s Archives Gen.rales de M.decine, Fevrier, 1850, p. 238.
  J7 For the  cause and prevention of death by Chloroform,  see Drs.  T. Snow,  Crisp, and
others,  in Medical Times and Gaz., Mar. 1852, and Amer. Journ. of the Med. Sciences,
April, 1852, p. 556.
  28 Boston Med. and Surg. Journal, April, 1848. 
218
CHLOROFORMUM.
 has been recorded also by M. Gruby,1 Mr. Nunnely,2 Dr. Simpson,3
 Mr. Spry,4  M. Jules  Roux,5 Mr. Higginson,6 M. Aran,7 and others.
   No sooner  were  the anaesthetic  properties promulgated  by  Prof.
 Simpson than it was employed in all the cases in which the inhalation
 of ether had been prescribed.   It has been given in the various
   Neuroses.  In
   Tetanus,  successful  cases were recorded by Mr. Geo. Sloman,8 Mr.
 R. L. Baker,9  Dr. E. H. Clarke,10 Dr. Dusch,11 Dr. L. Woodworth,12 Dr.
 F. J. Lowes,13 Mr. Harding,14 Dr. Symes,15 Dr. Betton,16 and Dr. Thos. T.
 Russell.17 M. Forget18 and M. Jules Roux19 refer to seven cases of cure,
 against  six of want of  success.20   Dr. C. A. Worthington21 and Mr. R.
 C. H. Butcher22 have reported cases in which it afforded  great relief,
 but did  not  prevent the fatal termination.
   Dr. Jackson,23 from the results of treatment in the Native Hospital
 at Calcutta, shows  that great relief is afforded in tetanus  by the re-
 peated inhalation of chloroform, joined with the internal administration
 of extract of hemp  and aloes; and—in the latter stages—of quinia and
 generous diet;  and affirms that many more cases have  recovered from
 this treatment than from any other.  The cannabis was given in doses
 of two grains every six hours; and the inhalations were repeated every
 four hours.  It was likewise successful with Dr. Upshur2i in the tetanic
 spasms  induced in a  child three months old  by strychnia.  Fifteen
 drops were sprinkled on a towel folded in the  shape of a funnel and
 applied  over the mouth and nose.  In four minutes, the child was un-
 der its influence.   When consciousness returned, and  the spasms be-
 gan to reappear, it was again applied.  The child, in this way, was kept
 under its influence  for  four hours, when, the spasms being arrested, it
 was discontinued.   The quantity inhaled altogether was f 3ss.   In
   Infantile  convulsions, it was given by Prof. Simpson.25
   Hydrophobia.   One case of this almost intractable malady has been
  1 London Med. Gazette, Dec. 24, 1847.
  2 Provincial Medical and Surgical Journal, June 28, 1848.
  8 Monthly Journal of Med. Science, 1847-48, p. 451.
  * Provincial Medical and Surgical Journal, Aug. 28, 1848.
  5 Gazette des Hopitaux, 7 Nov.  1848.         6 Lond. Med. Gazette, Jan. 1849.
  T Archives G.n. de M.d., Fevr. 1851, p. 245.
  8 Provincial Med. and Surg. Journ. Sept. 5, 1849.
  9 Ibid.,  May  31, 1848, and Lancet, June 3, 1848.
  10 Amer. Journ.  of the Med. Sciences, July, 1849, p. 75.
  11 Henle und Pfeufer, Zeitsch, 1853, cited in Ranking, xvii. 68, 1853.
  12 New York Journal of Med. May, 1853.
  13 Med. Times and Gaz. May 21, 1853.                 " Lancet, Dec. 10, 1853.
  15 Dublin Hosp. Gaz. Feb. 1, 1854.      " Philad. Med. Examiner,  Nov. 1853, p. 680.
  17 Amer. Journ.  of the Med. Sciences, Jan. 1853, p. 266.
  18 Cited  in Canstatt und Eisenmann's Jahresbericht, u. s. w. im Jahre, 1849, v. 190,
Erlangen, 1850.
  19 Revue M.dico-Chirurg. Nov. 1848, cited in Bouchardat, Annuaire de Therapeutique
pour 1849, p. 101.
  20 Medical Times and Gazette, June 17, 1854.
  21 Provincial  Med. and Surg. Journ. April  19,  1848.  Similar cases have been re-
corded by Prof. Laurie, Glasgow Med. Journ. Jan. 1854, Dr. Chambers, Lancet, April 5,
1854, Mr.  C. de Morgan, Medical Times and Gazette, April 22, 1854, M. Panthel, Henle's
Zeitschnft, Bd. iv. Heft. 3, cited in Brit, and For. Med. Chirurg. Rev. Oct. 1854, p. 504.
  22 Dublin Medical Press, July 30, 1851.
  23 Indian Annals, Oct. 1853, and Rankings Abstract, xix.  59.
  2t Med. Examiner, June, 1853, p. 337.
  25 Edinb. Monthly Journ. of Med. Science, Jan. 1852, p. 39. 
CHLOROFORMUM.                        219
recorded in which it was successful; and others1 in which it greatly
relieved the intense suffering from the spasms; but, on the other hand,
in a case by Mr.  S. B. Denton2 it augmented them.   A case of hydro-
phobic  mania was treated happily with it by  Mr.  R.  Y. Ackerly;3
and one of presumed hydrophobia, under the care of Professor Jack-
son4 of Philadelphia, is reported as having been  cured by  it.   Dr.
Jackson inclines to the belief,  that the case was one of true hydropho-
bia ; but the published details  do not lead the author to  the same con-
clusion.   In
   Neuralgia  it was  prescribed  with advantage,  by Dr. Protheroe
Smith,  Mr. Sibson,5 Dr. D. Brainard,6 and  others;  and in
   Chorea, by Mr. Harris7 and Mr. Sibson.8
   In delirium tremens, by Dr. P. Smith; and  it was used with great
success  in  inducing sleep, by Dr. Joseph  Parrish9 and Dr. Whiting.10.
   Insanity.   Dr. M'Gavin11 and  Dr. E.  B. Moore12 found  it  an ex-
cellent  sedative and hypnotic;  and  in sick headache, Dr. P. Smith
prescribed it with advantage.   It was also  given with great benefit in
typhus, as a sedative and hypnotic, by Dr.  Fairbrother,13 in
   Asthma, by Mr. Chandler,14 Mr. Greenhalgh15 and Dr. Cragin;16 in
   Hooping cough, by Dr. Protheroe  Smith, Dr. Churchill17 and  Pro-
fessor Simpson;  in
   Angina Pectoris by M.  Carriere.18  In
   Obstinate  Hiccough.19   In
   Violent Spasmodic Cough, by M. Carriere.20   In
   Colic, by Dr. Protheroe Smith, and by Dr. Cragin.21   In
   Spasmodic  Obstruction of the Bowels,  by Dr. Cain.22   In
   Spasmodic  and Irritable  Stricture, by Mr. J. R. Mackenzie.23   In
   Retention of Urine, by the  same gentleman,  and  Professor Simp-
son.  In
   Nephritic Colic, by Drs. Bowditch and A. Stille.24 In
   Biliary  Calculus, by Dr.  P. Smith.  In

  1 Ranking's Half-yearly Abstract, &c, viii. 212, Amer. edit., Philad. 1848, and T. T.
Smiley, Med. Examiner, April, 1848, p. 223.  See,  Dublin Quarterly Journ. Feb. 1852.
Prov. Med. and Surg. Journ. Mar.  31, 1852, Transactions of the  Med. and Phys. Soc,
of Bombay, No. x.; and Ranking, xv. 224, Amer.  edit. Philad. 1852. Dr. Laurie and
Dr. Sandwith, Ibid. xvi. 56.  Philad. 1853.
  2 Prov.  Med. and Surg. Journ., Oct. 31, 1849.           8 Lancet, July 29, 1848.
  4 Transactions of the College of Physicians of Philadelphia, for January and April, 1849.
  6 London Med. Gazette, March 31, 1848.
  8 North-Western Med. and Surg. Journ. Sept. 1849.      T Lancet,  June 3, 1848.
  8 London Med. Gaz.  Feb. 4, 1848.      9 New Jersey Medical Reporter, July, 1848.
 10 Ohio Med. and Surg. Journ., March, 1849.  See, also, Zeitschrift fur die Gesammt.
Medicin. April, 1850. No. 4, S. 553.
 11 Report of Montrose Asylum, 1848, cited in Monthly Journ. of Med. Science, Oct. 1848.
 12 Boston Med. and Surg. Journal, April 4, 1849.
 13 Lancet, Jan. 28, 1848.     " Provinc. Med. and Surg. Journ. Jan. 29, 1848.
 15 Lancet, Dec. 4, 1847.       16 Medical Examiner. April, 1848, p. 227.
 17 Edinb. Monthly Journal, Aug. 1853, p. 180.
 18 Bull... de Th.rap.  i. 7; and Bouchardat, Annuaire pour 1853, p. 88.
 19 Bouchardat, Annuaire de Th.rap. pour 1853, p.  91.                  21 Op. cit.
 20 Medical Examiner, April, 1848, p. 227.
 2- Southern  Med. and Surg. Journ., and Med. Examiner, Nov. 1853.
 ** Edinb. Monthly Journal of Med. Science, Mar.  1852.
 2i Transactions of the College of Physicians of Philadelphia, vol. ii. No. 6. 
220
CHLOROFORMUxM.
   Tenesmus, the vapour has been thrown up with advantage by Mr.
Ehrenreich;x and in
   Pneumonia, it has been given by Wucherer, Baumgartner and Varren-
trapp2 and Stohandl.3
   Uterine  Affections it has been found efficacious, by Dr. S. L. Har-
dy,4—the vapour being directed on the part.  It  is  applied by  means
of an instrument consisting of a metallic chamber, from one end of which
a pipe with a valve  is  attached to the gum elastic bottle.   A sponge,
dipped in chloroform, is placed in the metallic chamber, and by press-
ing on  the elastic  bag the vapour is expelled through the pipe.  In
cases of carcinoma and simple  ulceration  of the os uteri, the plan
was found  to be very efficacious.  He also found it useful in pruritus
pudendi, sore nipples,  and other painful  affections  of the skin. Mr.
Aran5 has adapted  to  Dr. Hardy's  apparatus a hollow uterine  sound,
pierced at  the end by  two openings, which is passed into the cavity of
the uterus.  Through this chloroform vapour is injected to relieve ute-
rine pain.   Caution is advised not to inject too suddenly, lest the ute-
rus be distended; but, done  gradually, it is  said  that uterine pain is
relieved instantaneously.  In a  case of metritis  after delivery, pain
was completely  suspended; and,  on  a second injection, altogether  ar-
rested.   In a  case of chronic metritis with an irritable condition of
the uterus, two injections produced permanent amelioration.  In  a case
of retroflexion, in which the intra-uterine pessary could not be  borne,
after a few injections, the instrument could be retained several days at a
time; in two other  cases the effect was not so marked.  In one of  re-
troflexion  with  chronic inflammation, the injections,  at first,  caused
great pain, from being forced too rapidly, it was supposed;  but relief
followed.  In the other,  a case of obstinate  dysmenorrhoea with colics
and nervous phenomena, relief was but momentary, whilst the injection
of a few drops of laudanum  into the uterine cavity gave ease, which
lasted for  twenty-four hours.  More  recently, Dr. Hardy6 has  urged
the advantages  to be derived from the local application of the vapour
of chloroform in a variety of painful affections, as tetanus, neuralgia,
and gout; painful hemorrhoids, fyc; and  a successful case of neu-
ralgia thus treated  has been reported by Mr. John A. Baker.7
   M. Nelaton8 relates a case in which the  vapour  of chloroform, di-
rected by  Hardy's  apparatus, on an abscess in the axilla, produced
complete insensibility,  so that the entrance of the knife was not per-
ceived.
   It was prescribed in Amenorrhcea by Dr.  David H.  Gibson.9   In

  1 Preuss. Verein. Zeit. 29, 1853, and Ranking's Abstract, xix. 89.
  2 Henle and Pfeufer's Zeitschrift, N. S. i. 76, and Brit, and For. Med. Chir. April,
1852, p. 559.
,  3 Schmidt's Jahrbuch. No. 9, p. 295; and Brit, and For. Med. Chir. Rev. Oct. 1854, p. 5(14.
  4 Dublin Quarterly Journ. Nov. 1853, and  Ranking's Abstract, xix. 288. Amer.  edit.
Philad. 1854.
  5 Bullet, de Therap. Jan. 1855, and Brit, and For. Med. Chir. Rev. April. 1855, p.  573.
  « Dublin Med. Press, Nov. 15, 1854, and Feb. 21,  1855; and Ranking's Abstract,
Amer. edit. xxi. 120.  Philad. 1855.  Also, Mr. Butcher, Dublin Quarterly Journ., May,
1855, p. 304.                                                J
  ' Lancet, Sept. 1, 1855, and Med. News, Nov. 1855, p. 183.
  8 Gaz. des  Hopitaux, and Med. Times and Gaz., Mar. 4, 1854.
  » Philad. Med. Exam. p. 425, July, 1852. 
CHLOROFORMUM.
221
  Dysmenorrhoea by Dr. P. Smith, and by  Drs. J. 11. Bennett1'and
Dr. Withers.2  In
  Bronchitis, by Mr. Brown.3   In
  Cholera Morbus, it has been  employed successfully by Mr. Brady
and Mr. Plummer.4   And in
  Cholera, by Dr. James Hill, Dr. Ferguson,5 and Dr. A. Bournonville.6
With others, however, as  Dr. W. Robertson,7 it has only succeeded in
relieving the distressing cramps.  Lastly, in
  Feigned Diseases, it has been  used in the way of detection; but the
same objections apply to it as  to other anaesthetics.  See page (87.)
  In regard to the employment of the inhalation of chloroform as an
anaesthetic in surgical operations, the same remarks are  applicable as
were made on sulphuric ether.   Wherever a  powerful anaesthetic,  ano-
dyne and relaxant was needed,  chloroform has been had recourse to,
and the highest  testimonials have been  brought forward  in its favour
by the most distinguished surgeons of all countries.   On this side the
Atlantic, ether inhalation is, perhaps, more employed, and is generally
considered  safer; but there  are many who prefer chloroform.8  It
would  appear  that an antihemorrhagic influence is exerted by it in
 such cases;  and that  a smaller  amount  of  blood is lost during severe
 operations  by those  under its influence.   M.  Chassaignac9 remarks,
 that he has long  observed this.
   In obstetrical  practice, chloroform has  been  largely administered;
 and the same objections have  been urged against its employment in  a
 natural process,  as in the case of sulphuric ether.10  Since its first in-
 troduction by Dr. Simpson, it has been  extensively used in Edinburgh,
 to  subdue the sufferings  of childbearing; and it is impossible to extol
 any  agent more highly than it has been.  "Its  effect," saysj)r. Chris-
 tison,11 "is perfect, and may be maintained uninterruptedly for many
 hours, without influencing the frequency or force of  the uterine con-
 tractions, and without any eventual harm.   It is only when the deepest
 coma, with suffocative stertor,  is brought on, that the  uterine contrac-
 tions are apt to be  arrested  for a  time;—a property which may be
 taken advantage of to facilitate the operation of turning."
    From a careful and dispassionate inquiry into its effects in such cases,
 Dr.  Murphy12 is of  opinion, that  it does not interfere with the  par-
 turient action of the uterus, unless given  in large and unnecessary
 doses;—that it causes greater relaxation of the passages and perineum,
   1 Lancet, Feb. 19, 1848.           2 Western Journ. of Med. and Surg. Feb. 1849.
   s Lancet, Dec. 4, 1847.
   4 Lond. Med. Gaz. Sept. 16, 1848.      5 Dublin Med. Press, Nov. 8 and 18, 1848.
   B Medical Examiner, Aug., 1849.       7 Monthly Journal of Med. Science, Dec. 1848.
   8 On the value of Anaesthetics, and especially of Chloroform, in Surgery, see Surgical
 Experience of Chloroform, by James  Miller, F. R. S. E. Edinb. 1848, auu in Principles
 of Surgery, 3d Amer. edit, by F. W. Sargent, M. D., p. 699.  Philad. 1852.  Prof. Lizars,
 Med. Gazette, June 8, 1849, and the Reports of the Committees on  Surgery, in Transac-
 tions of the American Medical Association, vols. i. and iii.   Philad.  1848-50, and vol. iv.
 Philad. 1851.
   9 Moniteur des Hopitaux, Mars, 1853, and Dublin Quarterly Journal, May, 1853, and
 Ranking's Abstract, xviii. 134, 1854.
  1(1 See page 87, and Ranking's Half-yearly Abstract, vii. 252. American edition, Phila.
 1848, for the views of Drs. Ranking, Simpson, Roland, Tyler, Smith, and others; and
 Ibid. viii. 241.  Philad. 1849.        u Dispensatory, edit. cit. p. 976.  Philad. 1848.
   12 Chloroform in the Practice of Midwifery, cited in Ranking, loc. cit., and Monthly
 Journal of Medical Science, Dec. 1S49. 
222
CHLOROFORMUM.
 and a greater secretion from the mucous membrane  of the vagina;
 subdues nervous irritation, caused by severe  pain; restores nervous
 energy; secures the patient perfect repose for some hours after delive-
 ry,—and  that its injurious effects, when an ordinary dose is  given
 seem to be dependent  upon  constitutional peculiarities  or improper
 management.
    Its value in natural labour and operative midwifery has been deposed
 to  by numerous  observers;—by Mr. Brown,1  Dr.  Nevins,2 Messrs.
 Clifford, Fearn, Wilson, M. Richet,3  Dr. Protheroe Smith,4 and  by
 Drs.  Keith, Moir, Malcolm, Thompson, Purdie, Cumming, and nume-
 rous  others, cited by Dr. Simpson,5  as well  as by Dr. Denham,6 Dr.
 Henry  Bennett,7 Dr. Geo. N. Burwell,8  Dr. J. P. White,9  Dr. Chan-
 ning,10  Dr. C. H. Cragin,11 Dr. Lindsly,12  Dr. Beatty,13  Dr. Trask,11
 Mr. Canney,15 and others.  As  in the case of  ether, however, objec-
 tions have been made, by some, to its use in any case;  and  one of the
 strongest opponents  is  Dr. Robert Lee,  who,  in  a communication to
 the Royal Medical and  Chirurgical  Society, gave an account of seven-
 teen  cases  of parturition, in which it had  been inhaled with, he con-
 ceived,  injurious effects;  and,  in  the discussion on  its presentation, he
 expressed  himself in  the most  forcible terms against its  employment
 in obstetrics.16
    In labours complicated with puerperal convulsions,  good effects have
 resulted from  it  iri  the   practice  of  Mr.  W.  J. White,17 Mr. Fearn 18
 Mr.  Clifton,  Dr.  J. P.  White,19  Dr.  Channing,20  Dr. S.  N. Harris,21
 Dr. Harding,22 Dr. Keith,23 Mr. Bolton,24 Dr. Van  Buren,25 Macorio,28
 and others.27
   Professor Simpson,28 is of opinion, that it may prevent the superven-

   1 Lancet, Dec. 4, 1847.                  2 London Med. Gazette, March, 1848.
   3 Ranking's Half-yearly Abstract, vii. 255.  Philad. 1848.    * Lancet, Nov. 27,1847.
   5 Monthly Journal of Med.  Science, October, 1848; and  Ranking, Op. cit., viii. 242.
 Philad. 1849.                   6 DUDiin Quart. Journ. of Med. Science, Aug. 1849.
   7 Lond. Journ. of Med., March, 1850.
   8 Buffalo Med. Journal, Nov. 1848; and of the use of Chloroform in Midwifery, Buf-
 falo, 1853.                                     9 ibid. Sept. 1848.
  10 Dr. Parkman, Amer. Journ. of the Med. Sciences, July, 1849, p. 41.
  11 Medical Examiner, April, 1848, p. 228.
  12 Ibid. June, 1848, p. 340; and Report of the Committee of Obstetrics, Dr. Lindsly,
 Chairman, in Trans, of the Amer. Med. Association, i. 228, Philad.  1818, and Supple-
 ment, containing the favourable Testimony of Prof. Channing, Dr. E. J. Marsh, Dr. J. C.
 Bennett, Dr. M. B. Wright, Dr. Moultrie, Dr. Gross, Dr. Jas. Stewart, &c.; also, Report
 of the same Committee, Dr. Gilmnn, Chairman, in Transactions,  &c, ii. 241.  Phila. 1849.
  13 Dublin Quart. Journal of Med. Science, Aug. 1850, p. 341.
  14 Amer. Journal of the Med. Sciences, July, 1850, p. 341.
  15 Med. Times and Gazette, Sept. 18, 1852.
  16 An account of the discussion is contained in Lancet, Dec. 24 1853
  » Lancet, March, 1848.                is Lond. Medical Gazette, Feb. 11, 1848.
  19 Buffalo Med. Journal, Sept. 1848.
  20 A Treatise on Etherization in Childbirth, Boston, 1848.
  21 Charleston Med. Journal, Sept. 1848.
  22 Boston Med. and Surg. Journal, Feb. 21, 1849.
  23 Monthly Journal of Med. Science, August, 1850
  __ JfnCf' _,°?' ?9, 18?3-                  25 New York Med< Times,  April, 1853.
  2« Bouchardat, Annuaire de Th.rap.  pour 1855, p 49
  27 See, on all this subject, Chloroform, its properties and safety in Childbirth, by E. W.
Murphy, A M., M D.   Lond. 1855; and a Review of the same, by Dr. Churchill, in Brit.
and For. Medico-Chirurg. April, 1855, p. 364.
  28 Edinb. Monthly Journal of Med. Science, Oct. 1852 
CHLOROFORMUM.                       223
tion of puerperal mania.  He stated to the Edinburgh Obstetrical So-
ciety the particulars of three  cases, in which chloroform was used  in
persons, who, in former confinements,  had been affected with the dis-
ease.  In none of them did it recur.   One of them had borne several
children previously; and, after each labour had been  attacked with
puerperal mania, except the last, in which she  had used chloroform.
On the  other  hand, whilst Dr. Atthill1 is favourable to its use in par-
turition, from  his observation  in  the  Rotunda Hospital, Dublin, he
"feels forced to consider, that in labour-cases, when chloroform is used,
there is  great tendency to post partum hemorrhage."
   Dr. Ranking2 once remarked, that if he might judge from the tenor
of numerous private communications, there seemed to be  a growing in-
disposition,  in  England at least, to the employment of anaesthetics in
natural labour, although he was not  prepared to say,  that the trouble
attending the use of the agent had  not  something to do with the ob-
jection.   In instrumental and other forms  of complicated labour, he
believed they were still much employed by the leading accoucheurs of
England; whilst, in Scotland, the withholding of them, even in natural
labour, was  almost the exception.  At a subsequent period, however, he
has remarked, that it would seem, from what he had been able to gather
on the subject, " that the usefulness of anaesthetics is  freely admitted
even in England: while in Scotland, if we are correctly informed, the
use  of chloroform  in labour  is  the  rule  rather  than  the exception.3
Dr.  M'Clintock,4 however, has  published  a case, which  exhibits that
here, as  in other cases, the utmost  care and circumspection should  be
had in its employment; and  he stigmatizes  the 'most dangerous fal-
lacy,' which has led to  the idea, that the administration of chloroform
in parturient cases is 'almost, if not  entirely, free from danger.'   Dr.
Rigby is satisfied, that  a sufficient immunity from suffering may  be at-
tained without  annihilating consciousness, and advises, that not more
than ten or fifteen drops  should be used at a time—chloroform a la
Reine—by which the patient may have the sensations of pain much
mitigated, and, at the same time, be perfectly conscious  of its occur-
rence; and  a  similar view is  entertained by Professor  Lindsly,5 of
Washington, and by Professor T. E. Beatty,6 of Dublin.   It would ap-
pear, from the  observations of  Drs. Murphy and Beatty, that the first
effect of a good dose of  chloroform is to  arrest uterine action for a short
time, so  that if the pains be slow and feeble, they may be more cer-
tainly interfered with; and to obviate this result, Dr. Beatty7 associates
ergot with it, which he  has found to answer a valuable purpose.

                     MODE OF ADMINISTRATION.
  It is almost impossible not to believe  from the fatal cases which have
occurred elsewhere, and their  comparative absence, in Edinburgh for

  1 Dublin  Quarterly Journal, May, 1853.
  2 Half-yearly Abstract, &c, x. 260, Amer. edit.  Phila. 1850.
  5 Banking's Abstract, xvi. 298, Amer. edit.  Philad.  1853.
  4 Transactions of the College of Physicians of Ireland; and Med. Examiner, Sept. 1855,
p. 571.                           5 Medical Examiner, June, 1848, p. 340.
  6 Dublin  Quarterly Journ, of the Med. Science, Aug.  1850, p. 6.   For his subsequent
confirmatory experience, see Dublin .led. Press,  April 19, 1852.         7 Ibid. p. 8. 
224                       CHLOROFORMUM.
example, that there must be an essential difference between the article
as furnished  by different chemists.   One distinguished observer, Pro-
fessor Simpson, believes that the presence of aldehyde is the deleterious
admixture.   According  to Dr. Murphy,1 if rubbed on the hands, the
smell should  be fragrant, not pungent, like sulphuric ether.  If in-
spired, there is a sense of warmth in the mouth;  a  fruity flavour; no
pungency; if the strength of the vapour be sufficient, it will excite  a
slight cough; but if impure, the cough is irritating.
   The dose in which Mr. Tuson administers chloroform is from one to
four or five drops; but others go as high as a tea-spoonful, diluted with
water, or sugar and water, or mucilage.   Dr. Henry  Hartshorne2 af-
firms,  as the result of  his experience,  that a fluidram is not more
than equal, in hypnotic effect, to thirty or thirty-five drops of laudanum.
   In neuralgic  affections it appears to have  given the greatest relief
in the form of liniment, composed of linimentum saponis seu linimen-
tum camphora, f gij., chloroform, f 5j., to be carefully rubbed over
the affected part; or the chloroform may  be applied by means of a rag
wetted with it.
   As a wash, injection, and gargle, Mr. Tuson prescribed it diluted
with water, in the proportion of one or two drams to the pint; but as
an application to the sound skin, it is generally used undiluted—being
applied by means of  lint  or soft rags, covered with oiled  silk to pre-
vent evaporation.  When employed undiluted, it ought to be pure, as,
according to Mialhe and others, when it  contains absolute alcohol it
acquires caustic properties, and excoriates  the surface with which it is
made to come in contact.   Dr. Hayward,3 indeed, ascribes such pro-
perties  to the chloroform itself, and such has been  the experience of
the  author.
   The dose  for inhalation is a fluidram  at a time, which must be re-
newed in two minutes, if the desired effect be not induced.  According
to Dr. Christison,4 there seems to be no limit to  the safe repetition of
it.   Dr. Simpson has used eight fluidounces in thirteen hours, in a case
of labour.  The patient, he says, experiences least annoyance, and is
least apt to show a precursory stage of excitement, when a full dose is
used at once.  In the summer of  1854, the author had an  opportunity
of witnessing the exhibition of chloroform by that distinguished gentle-
man, and by others.   It was given with a degree of freedom that at
first excited  in  him alarm;  but  no evil  consequences followed in any
case.  Professor S. Jackson5 has related the case of a lady, labouring
under stricture of the upper portion of the rectum, with convulsions and
peculiar spasms, who, by gradually increasing the quantity as the effects
diminished, inhaled, in the course of an evening, two ounces; then two
ounces more, and another ounce  in the  course of the night—making
five ounces,  from 5 o'clock, P. m. until 10 o'clock the next morning.
Dr. Jackson, having been sent for in consequence of the mother's alarm

  1 Chloroform, its Properties and Safety in Childbirth. Lond. 1855.
  2 Amer. Journ. of the Med. Sciences, Jan. 1854, p. 113.
  3 Remarks on the Comparative Value of the different Anesthetic Agents.  Bost. 1850.
  4 Dispensatory, Amer. edit, by R. E. Griffith, p. 977. Philad. 1848.
  5 Transactions of the College of Physicians of Philadelphia, vol. ii.  No. 6. 
CHLOROFORMUM.
225
at the quantity of chloroform used, found her with a feeble  pulse, di-
minished temperature of  the  body, and considerable mental excite-
ment.   She remained cold and  nearly pulseless for forty-eight hours,
when the effects disappeared.   According to Dr. W. H. Byford,1 in
a case of severe neuralgic pain, thirty-six ounces were  used in  four-
teen days without any bad results.
  As in the case of the  inhalation of sulphuric ether, various forms of
apparatus have been invented for the inhalation of chloroform,  some
of which have been figured in another work.2  They are all, however,
admitted  to  be unnecessary.   A  small muslin or silk handkerchief,
twisted into a hollow cone, or into the form of a bird's nest, moistened
with chloroform, and held near the nose or mouth of the  patient, is
the arrangement adopted by  Dr. Simpson, and most operators.  In
this way, a due admixture of atmospheric air may be  insured, and  the
risk of apnoea avoided.  Almost all agree, that the breathing must be
attended to more perhaps than the  pulse.3  As soon  as the breathing
becomes stertorous, it must be  discontinued.4   When the effect pro-
duced is greater than is desired, the  patient should  be placed in  the
horizontal posture; cold air be fanned across the face, and cold water
be dashed or poured over  the  forehead and head.   Ammonia may be
inhaled; and, in more urgent cases, it has been advised, that the phy-
sician should blow  into the mouth of the patient for the purpose of arti-
ficial respiration, if no apparatus be at  hand.  It has been suggested,
too, that it would not be an idle provision to have an electro-magnetic
machine in operation.  As soon as  the  patient is able to  swallow,  sti-
mulants may be administered  internally; but under the  apprehension
that the respiration might otherwise be farther embarrassed,5 it has been
recommended that they should not be given until he has revived in some
measure.6
  Mr. Joseph Ewart7 details a case, in which the value of galvanism
was triumphantly  exhibited,  after  ordinary  remedies had been em-
ployed without effect, and the danger was becoming imminent. Shocks
were passed over the chest and top of the spine, at the origin and  in-
sertion  of the phrenic nerves, and continued foi 'two or three minutes.
In another case, the inhalation of oxygen was had recourse to by Dr.
Abrahams, of New York,8  with marked advantage.  MM.  Nelaton9 and
Denonvilliers found inversion of the body speedily remove the urgent

  1 Amer. Journ. of the Med. Sciences, Jan. 1852, p. 279.
  2 General Therapeutics and  Mat. Med. 5th edit. i. 422, 426.  Philad. 1853.
  3 ^Ir. R. E. Bickersteth, Edinb. Monthly Journ. Sept. 1853, or  Ranking's Abstract,
xviii. 136. Philad. 1854.
  4 Mr. Clendon, in Ranking"s  Abstract, xvi. 160, and Prof. Syme,  Lancet, Jan. 20,
1855, and Ranking, xxi. 118, Amer. edit. Philad. 1855.
  5 C. H. Cragin, Med.  Examiner, April, 1848, p. 227.
  • See, on the  rules for  administering Chloroform, Christison, Dispensatory, p. 977,
Robert, Bull. General de Therap. vol. 2,  1853, and Ranking's Abstract, xix. 116, Amer.
edit.  Philad. 1854.  Sedillot, in Bouchardat, Annuaire de Therap. pour 1852, p.  67;
Baudens,  Ibid, pour 1853, p. 93, and  Amer. Journ. of the Med. Sciences, Jan. 1854, p.
208; and for its administration in Midwifery, see Murphy, On Chloroform, its Properties
and Safety in Childbirth.  Loud. 1855:  and a Review of the same by Dr. Churchill, in
Brit. For. and Med. Chir. April, 1855, p. 368.       7 Lancet, July,  1831, 1852.
  e Canada Medical Journal, Jan., 1853.     9 Dublin Medical Press, April 20, 1853.
       15 
226
CHLOROFORMUM.
phenomena.   In each case, the face at once recovered its colour; the
interruption to respiration ceased, and the imminent danger passed away.
   Like the vapour of ether, that of chloroform has been administered
per anum by Pirogoff, Bromme, Korner, and  Seifert.1

                        Aqua chloroformi.
             Chloroform water.—French. Eau chloroformisec.
                 R.  Chloroform, gtt. xx.
                     Aq. destillat. f 3iij.  M.
                      Mistura chloroformi.
         Mixture of chloroform.—French. Potion de chloroforme,
                 R. Aq. chloroform, f. 3*iij.
                     Syrup, aurant. f gvj. M.
   Dose.—A  spoonful in neuralgia, asthma, &c.

                    Unguentum  chloroformi.
       Ointment of chloroform.—French.  Pommade de chloroforme.
                 R. Chloroform, f^ss. to 3j.
                    Adipis 3"j. M.
   In neuralgia, pruritus, &c.                        A. Cazenave.2

   Under the names concentrated chloric ether, and strong chlo-
ric ether, a compound of pure chloroform and nearly absolute alcohol,
composed of  one third of the former to two-thirds of the latter has been
employed by Dr. J. C.Warren3 and others; but Dr. Bache4 has properly
suggested that, as the name  chloric ether was originally applied by
Dr. T. Thomson to the "Dutch liquid," or "chloride of olefiant gas,"
it  would be well to abandon  the appellation for either  chloroform or
its union with alcohol.   Correct names,  as  he remarks, for the latter
combination would be either alcoholic solution of chloroform, or tinc-
ture of chloroform.
   By Dr. Warren, and others, this preparation has been regarded as
safer than  chloroform, and more agreeable  than sulphuric ether; but
if the unpleasant effects of chloroform be owing, as has been supposed by
some, to its not being pure, it is not easy to see how the chloric ether
can be safer than  chloroform.5  The preparation, sold in London and
elsewhere under the name "chloric ether,"  is  said to be a weak tinc-
ture of  chloroform, of variable quantity, containing at most but 16
or 18 per cent, of  chloroform, and at times not more than 5 or 6 per
cent.
 _  Dr.  Strong6 thought great  benefit resulted from the local applica-
tion of the  compound tincture of chloroform in a case of croup, which
was freely  applied, by means of cloths saturated with it, to the neck;
and the fauces and tonsils were wetted with  it  by means of a linen
swab.   The cloths were  remoistened, and applied  as soon as they be-

  1 Canstatt und Eisenmann's Jahresbericht. u. s. w. im Jahre,1849, v. 190, Erlangen, 1850.
  2 Memento du Praticien, p. 13.  Paris, 1852.
  8 Effects of Chloroform and of strong Chloric Ether, as narcoticfagents.  Boston, 1849.
  * The Dispensatory of the United States of America, 10th edit. p. 81!).  Phila. 1854.
  5 Hayward, Remarks on the Comparative Value of different Anaesthetic Agents.  Bos-
ton, 1850.                 6 Amer journ; of the Med> sciences> April, 1852, p. 372. 
CHLOROFORMUM.
227
came dry, and this course was persevered in through the day,  the ap-
plications and swabbing being attended to  perhaps as often as once
an hour.  The ordinary remedies, as an emetic, cathartic and diapho-
retic were, however, administered along with the local use of the tinc-
ture.
  The compound tincture of chloroform has likewise been used by Dr.
Strong in bubo, inflamed  glands of the  neck, paronychia, and deep-
seated inflammation of the hand; and, also, in inflamed and ulcerated
gums, and, so far, with most marked advantage.
  According to a Report  of the Standing Committee on Surgery  of
the American Medical  Association, of which Dr. Mussey was chair-
man,1 there are two kinds of chloric ether—the  chloric ether of com-
merce, consisting of one  part of  chloroform to fifteen of alcohol; the
other, more concentrated, composed of chloroform one part, and al-
cohol nine parts—the latter, the one employed for anaesthetic purposes.
It is a much weaker article than those above mentioned.   Cases of the
successful use of chloric ether, as an anaesthetic in surgical operations,
are given by Dr. Warren ;2 and Dr. Channing3 employed it successfully
in obstetric practice.  Dr. Hayward,4 however,  states that he cannot
divest himself of the belief, that chloric ether is  an unsafe anaesthetic,
when he considers that  it is simply chloroform diluted with alcohol.
"It is true," he remarks, "that  as far as we  know, no fatal effects
have hitherto followed its  inhalation; but it is also true, that it has  as
yet been used to a very  limited extent, and  in all the  cases in which
it has  been exhibited, that have come to my knowledge, it has  been
managed with great caution  and  judgment.   But I fear, that  if it be
used with the same freedom that sulphuric ether  is, we shall soon have
to record some very different results.   We cannot feel confident that
it will  always  be confided to  skilful hands  only, nor by any means
certain  that death, when  not  looked  for,  may  not follow its  exhibi-
tion."
  When it comes in contact with the unprotected skin, it acts upon  it
—Dr. Hayward says—in  the same manner as chloroform. He thinks,
too, that it is more  apt to induce disagreeable encephalic disorder
than ether.
  A compound ether has been employed, which consists of a solution
of chloroform in sulphuric ether.  It  was formed on the suggestion
that ether alone is too slow and uncertain,  whilst  chloroform itself  is
too rapid and hazardous in its effects; and hence, the union of the two,
it was conceived, might act more gradually and safely. .  Under its in-
fluence, amputations were performed by Dr. Cox at the Bellevue Hos-
pital with favourable results.5
  1 The Transactions of the Amer. Med. Association, iii. 323, Philad. 1850: and Amer.
Journ. of the Med. Sciences, April, 1849, p. 379.
  2 Op. cit. and Transactions of the Amer. Med. Association, iii. 385.
  8 A Treatise on Etherization in Childbirth, illustrated by five hundred and eighty-one
ca<cs, Boston, 1848; and Dr. S. Parkman, Amer. Journ. of the Med. Sciences, July,
lSI'.i. p. 42.
  * Remarks on the Comparative Value of the different Anaesthetic Agents. Boston, 1850.
  6 Channing, A Treatise on Etherization in Childbirth, p. 30. Boston, 1848.  See, also,
Robert and Cellaries, in Gaz. Med. de Paris, No. 96, 1854, cited in Amer. Journ. of the
Med. Sciences, April, 1855, p. 498. 
228
CHLOROFORM UM.
   Sulphuric ether, chloroform, chloric  ether, and compound ether
are the anaesthetics most frequently employed; and it may be interest-
ing to state the preference of different practitioners for one  or other
of them, as enumerated in the Report of the Standing Committee on
Surgery of the American Medical Association, of which  Dr. Mussey,
of Cincinnati,  was chairman.1  Dr. Hayward, of Boston, expresses a
strong preference  for sulphuric ether.   It was preferred, too, by Dr.
Horner, of Philadelphia.   Dr. J. C. Warren, and his son, Dr. John
Mason  Warren, Professor Knight, of Yale College,  and Dr. A. L.
Pierson, of Salem, Massachusetts, employ  chloric ether exclusively.
Dr. D. M. Reese, of the Bellevue Hospital, New York, uses a mixture
of one part of  chloroform with two parts of sulphuric ether, by weight;
and when the patient is less impressible, chloroform alone.   Dr. Pope,
of St. Louis, employs either chloroform alone  or in combination with
ether.  Dr. Brainard, of Chicago, uses pure ether, or three  parts of
ether to  one of chloroform.   Dr. Washington L. Atlee, two  parts of
ether to one of chloroform, liquid measure.   Dr. Howard, of Columbus,
Ohio; Dr. Twitchell, of New Hampshire; Dr. Eve, of  Augusta, Geor-
gia, now  of Nashville; Dr. Gross, of  Louisville, then  of New York;
Dr. Shipman of  Syracuse,  New York;  Dr. Hamilton,  of Buffalo,  and
Dr. Mussey, prefer chloroform; and the last gentleman remarks, that
were  he  to employ any other  anaesthetic than  simple chloroform, he
would select the mixture of it with ether—one measure to two, as  em-
ployed by Dr. Atlee; as from several trials he has made, he thinks the
pulse  is rather  better sustained than under chloroform  alone.
  It appears, then, that each of these anaesthetics has its advocates;
and, perhaps, under careful management, no decided preference need
exist.
  The vapours of sundry other substances—of chlorohydric and nitric
ethers, of chlorinated  chlorohydric ether (chlorinated  muriatic ether,
French, Ether  chlorhydrique chlore)2 of bisulphuret of carbon, of chlo-
ride of defiant gas, of benzin, aldehyde, light coal tar naphtha,3 &c,
&c, have been inhaled, and produced anaesthetic  effects  analogous to
those  of  ether and  chloroform, but they are not employed.4

  1 Transactions of the  Amer. Med. Association, iii. 323.  Philad. 1850.
  2 See, Chlorinated Anaesthetic Compounds, by Dr. Bache, in Dispensatorv of the United
States, 10th edit. p. 1313. Philad. 1854.
  3 Professor Simpson, Monthly Journal of Medical Science, April, 1848.  Bouchardat,
Annuaire  de Th.rapeutique, pour 1849, p. 107-111.  H. J.  Bigelow, Transactions of
the Amer. Med. Association, i. 197, Philad. 1848; and Report of the Committee on Sur-
gery, Dr. N. R. Smith, Chairman, Ibid. vol. ii. p. 213.  Phila. 1849,  Stanley, On Anes-
thesia and Anaesthetic Substances, in Trans, of Prov. Med. and Surg. Association, vol.
xvi. pt. 2, &c. &c.                                        &
  * Amer. Journ. of the Med. Sciences, April, 1849, p. 528.  Nunnely, Provincial Med.
and Surg. Journ. March 7, 1849. 
CHONDRUS.
229
                        LXI. CHONDRUS.
Syvoxtmes. Fucus  Crispus seu Irlandicus,  Lichen Carrageen, Chondrus  Crispus
  seu Polymorphus, Sphserococcus Crispus, Ulva Crispa, Irish Moss, Carrageen, Car-
  ragaheen or Corigeen Moss.
French.  Mousse d'Irlande, Mousse Perlee.
German. Krauser  Tang, Seetang, Carragaheenmoos, Irlandisch Moos,
  Irlandisch Perl-oder Seemoos, Geperltes Seemoos, Krauser Knor-
  peltang.
  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 first trials were made with it
in the  year  1833, by  Von  Grafe of  Berlin, and the results were given
to the world  in his  report for that  year1 of the Clinical, Surgical,
and  Ophthalmic  Institute, attached  to  the Frederick  William  Uni-
versity.
   Chondrus, which belongs  to  the  Natural  Family Algae, 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  abund-
antly,  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.2
   Irish  moss, when fresh, is of a purple-brown or purple-red  colour,
and  somewhat resembles  Iceland moss;  but  when dried, as we  meet
with it in  commerce, it is mostly yellowish or  dirty white, but inter-
mixed  with purplish-red particles, and resembles laminae of horn:  it
is crisped, translucent, and frequently contains 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.3
   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 per cent.,  and has  been
considered  to consist of pectin in  large proportion, and starch; but
Dr.  Pereira4 esteems it  a peculiar principle, and gives  it the  name
 Carrageenin.  It  is easy of digestion, is readily borne by weak and
irritable stomachs, and exerts 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.  Yon Griife obtained  from  nine ounces of milk, boiled with
  1 Bericht iiber das Klinische chir. augen'arzliche Institut. der k.  Friedr. Wilh. Univers.
fur d. J. 1833. Berl. 1834.
  2 Pereira, Elements of Materia Medica and Therapeutics, 3d Amer. edit. p. 57.  Phila.
1854.
  s E. Grafe in Art.  Fucus, Encyelop'ad. Worterb. der Medicinischen Wissenschaft. xiii.
8. i.  Berlin,  1835.
  4 Op.  cit. 
230
CHONDRUS.
half a dram of the moss, five ounces  of jelly; and  as  much  from a
dram and a half of the moss and  twelve  ounces of water.  The for-
mula, commonly used by him, is given below.  To this jelly  may be
added any dietetic or remedial agent, which may be considered indi-
cated in the particular case.1
   Chondrus was in the secondary list  of the Pharmacopoeia of the
United  States,—cetraria in the primary; but the assignment appeared
to be arbitrary, as one is perhaps  as valuable an agent  as the other,2
and accordingly, in the last edition, (1851) they have  been  both placed
on the primary  list.
                     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 digestive apparatus.
It is sometimes prescribed in diarrhoea, along with astringent or other
remedies.  The jelly has been advised 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 accompanied
by much emaciation, and in the prostration ensuing on serious diseases
and operations.   In similar affections it has been extolled  by Hufeland.3
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 well as in  erethism  of the  respiratory  and
digestive organs; and  Riecke4 remarks, that as  it makes  a  very
agreeable jelly, when boiled with milk, and with the addition of a little
of the aqua laurocerasi, it may do for cases where we must prescribe
"ut fecisse  aliquid videamur."  The truth is, that it can render no
more  service than other substances  that 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.
  A paste or confection is made of it, and sold in the shops, which is
used as  a demulcent to allay cough.

                     MODE OF ADMINISTRATION.
                        Decoctum chondri.
                       Decoction of Irish moss.
                   R.  Chondri (elect, et concis.) Jss.
                       Lact. recent, f §ix.
                       Coq. ad remanent, colatur. f 5jv.
                 Adde
                       Sacchar. ^ss. ad 3J.
                       Aq. amygdal. amar. concentr. 9j.
   To be taken in the course of the day.                Von Grafe.

  1 L. Feuchtwanger, in Philad. Journ. of Pharm. vi. 204.  Philad. 1833-4.
  2 The author's General Therapeutics and Mat. Med. 5th edit. i. 285. Philad. 1853.
  3 Hufeland und Osann's Journ. der practisch. Heilkund. B. 77, St. 5, s. 135.
  * Die neuern Arzneimittel.  Stuttgart, 1837, S. 235. 
                             CIMICIFUGA.                         231

                   R.  Chondr. (elect, et concis.) J^ss.
               Coq. cum aq. font, f ^xij. ad remanent, colat. f ^v.
                       Syrup, rubi idaei f §iss. ad f ^ij.
                       Aq. amygd. amar. concentr. 9j.  M.

  To be used through the day.  When employed as diet, Von Griife
allows from ten to  eighteen ounces  of the jelly in the day.

                   R.  Chondr. (elect, et concis.) gss.
                 Coque cum aq. font. q. s. ad reman, f ^yj.
                 Colatur. adde
                       Sodae phosphat. giss.
                       Syrup opiif 3ij.adf3iij.

  Dose.—A spoonful every two hours in cases of hsemoptysis, between
the attacks.                                                Clarus.
                   R.  Lactis f §xxiv.
                       Chondr. (elect, et concis.) 9_v.
                       Sacch. 5jj.
                       Cinnam. cont. 9j.
               Coque per minut. x. leni igne; filtr. et exprime.
                                                            Biral.
                   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.
                        LXII. CIMICIFUGA.
Synonymes. Cimicifuga  Racemosa seu Serpentaria, Actaea Racemosa, Macrotrys
  Racemosa, Black Snake-root, Cohosh, Bugbane, Cohort.
French. Actee, Herbe Saint Christophe.
German. Traubenformiges Christophskraut,  Schwarze  Klapperschlan-
  genwurzel.

   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, Ranunculaceae.  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.1

                     EFFECTS  ON THE ECONOMY.
   Cimicifuga belongs to the class of acro-narcotics.  Until recently, it
is  said to have been employed chiefly in domestic practice, as a remedy
in  rheumatism, dropsy, hysteria, and  in various affections of the  lungs,
especially such as resemble consumption.2   It is noticed here, however,
chiefly in consequence of the encomiums that have been  passed upon

 1 Journal of Philadelphia College of Pharmacy, vi. 20; and Dr. Wood, in Dispensatory
of the United States,  Art.  Cimicifuga.
 1 F. J. Garden, Amer. Med. Recorder, Oct.  1823. 
232
CIMICIFUGA.
it, 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.1   Dr. Wood2 also states,  that
he administered it in a case of  chorea, which rapidly recovered 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 connected with uterine disorder.
Dr. T. S. Kirkbride,3 has published some cases of success, obtained in
the same disease, from its administration, after free purging had been
employed.   In one  successful  case, in a  girl, nine years  old, whose
mental  faculties were much  disordered, and who had  lost nearly all
power over  both her left  extremities,—there being, at the same time,
irregularity of the bowels, 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 moderately 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. Beadle4  of New York treated a  case
successfully in  a  girl eighteen years of age.  There was considerable
gastric derangement, with suppression of the catamenia,  for nearly
five months, from pregnancy.   She was put upon  the use of cimicifuga,
five grains of the powder being given every three hours, and  no other
remedy except an occasional dose of sulphate of magnesia.   There was
little  improvement in her condition during  the day, for nearly a week,
after  which she improved rapidly and was well in three weeks.   The
medicine produced no sensible effect.
   Allusion has been made to  the employment of cimicifuga in popular
practice, in cases of rheumatism.  Like  other narcotico-acrids, when
pushed  so as to produce catharsis, and even slight narcosis, it  may
unquestionably be of service in acute forms of the disease.5  Dr. F. N.
Johnson has, at  different times, selected  more than twenty cases of
acute rheumatism, including the severest forms, and treated them  with
cimicifuga for the purpose of testing  its powers in that disease.   The
results were in the highest degree satisfactory, "every vestige of the
disease disappearing in from two to eight or ten days, without  inducing
any sensible evacuation,  or  leaving  behind  a single bad symptom."
These trials were repeated by Dr. Johnson, Dr. N. S. Davis, and others,
until  they had  no more doubt of the efficacy of cimicifuga in the early
stages of acute rheumatism than they had  of the power of vaccination
as a  preventive  of  variola!  Dr. Johnson found the most acute  and
  1 Amer. Journ. of the Med. Sciences, ix. 310.                 2 Op. citat.
  3 Amer. Journ. of the Med. Sciences, February, 1840, p. 289.
  * New York Journ. of Medicine and Surgery, July, 1840, p. 191.  Also, C. C. Hildreth,
Amer. Journ.  of the Med. Sciences, Jan.  1843, p. 61; and F. J. Garden, Ibid. p. 247.
  5 E. A. Anderson, and Alexander Vedder, in Amer. Med. Intelligencer, vol. ii. p. 296,
Philad. 1839.  Also, Boston Med. and Surg. Journal, Oct. 2, 1839, p. 126. 
CIMICIFUGA.
233
severe  cases yield to its influence not only more speedily, but more
perfectly, and with less  danger of metastasis to other organs, than to
any  other  form of  treatment.1   The  author has  always classed it
among sedatives;  and the observations of Dr. Davis are in favour of
this.
  In some  parts of the country, cimicifuga has become a very popular
remedy in coughs;  and Dr. E. G. Wheeler2 affirms, that he has found
it useful in several cases of severe and protracted cough; especially in
the  chronic cough or bronchitis of  old  people.  Dr. Wheeler  states
farther, that by some eminent physicians, it has been thought to be a
good substitute for ergot in parturition, being dissimilar, however, in
its mode of action,—relaxing the parts, and thereby rendering labour
short and easy.  This, however, requires  confirmation.
  It has been advised  by Dr. C. C.  Hildreth3  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 inflammations,  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 precision.4
  It has been affirmed, by Dr. E. M. Brundige,5 that over ophthalmia,
in its various stages  and degrees, but especially in its recent and acute
form, the cimicifuga has been found to exert  an influence so decisive
and prompt, as to  establish for it a claim of superiority over  every
other mode of treatment.  To secure this result, he says, a saturated
alcoholic tincture of the dried  root  is indispensable.   When the in-
flammation  is  confined  to one eye, a dram,  and twice the quantity
when both eyes are affected, is to be applied slowly and cautiously with a
camel's hair pencil, the eyelids being closed so as to prevent, as far as
possible, the entrance between them  of any of the liquid.  In recent,
and  not very  severe, cases one  application is sufficient;  but in njore
aggravated cases, it  should be repeated after two or three hours, and
occasionally may be required the next day.  Chronic cases may require
its daily use.  Dr. Brundige associates with it, in the last class of cases,
the ointment of iodide of  potassium; the tincture being applied first,
and  the ointment immediately after.  In  cases of unusual pain and ir-
ritability, the sulphate of morphia is added,—four or five grains to the
ounce of tincture.    Dr.  Brundige also records  a case  of neuralgia
successfully treated by a  dram dose of the tincture, given three or four
times a day, combined with its external use the same number of times.

 1 Report of the Committee  on Indigenous Botany, Dr. N. S. Davis, Chairman; in
Transactions of Amer. Med. Association, i. 353.  Philad. 1848.
 2 Boston Med. and Surg. Journal, Sept. 4, 18o9,  p. 65.
 8 Amer. Journ.  of the Med. Sciences, Oct. 1842, p. 288.
 4 The author's General  Therapeutics and Mat.  Med. 5th edit. ii. 208.  Philad. 1853.
 6 New York Med. Gaz., and  Philad. Med. Examiner, Dec, 1851, p.  809. 
234
CJNCHONIA.
                     MODE OF ADMINISTRATION.
  The dried root of  cimicifuga may be given in powder.   Dr. Kirk-
bride administered it in the dose of a tea-spoonful;  and Dr. Wheeler
in the dose of 5j. from three  to five times a day.   Dr. Davis recom-
mends it in  the dose  of from  thirty to sixty drops of the tincture, or
twenty grains of the powder, repeated every two hours "until its effects
are manifest."  It  is most commonly, however, given in the  form of
the
                      Decoctum cimicifugae.
                     Decoction of black snake-root.
                      R.  Cimicifug. contus. §j.
                  Coque paulisper in
                          Aquae Oj.
  Dose.—One or two fluidounces—two to four table-spoonfuls—several.
times a day.
                      Tinctura  cimicifugae.
                     Tincture of black snake-root.
                      R.  Cimicifug. contus. ,§iv.
                           Alcohol. (.835,) Oj.
  Dose.—Twenty drops three or four times a day.   An idea prevails,
that the stronger the alcohol the better is the preparation;  but this may
be questioned.
                       LXIII.  CINCHO'NIA.
Synonymes. Cinchonina, Cinchoninum, Cinchonin, Cinchonine.
French. Cinchonine.
German. Cinchonin.

  Although Duncan, of Edinburgh,  Reuss, of  Moscow, and Gomez,1
of Lisbon, had endeavoured to separate the active principle of the cin-
chonas, 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.2
  Cinchonia is commonly obtained from  the gray or pale varieties of
cinchona; the yellow furnishing the quinia, and the  red both cinchonia
and quinia.  It is an  alkaloid strikingly analogous to  quinia  in its
chemical and medical relations, but has not been 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 li-

  1 Richter's Specielle Therapie, B. x. S. 325, Berlin, 1828; and Magendie's Formulaire.
  2 Annales de Chimie et de Physique, xv. 289 and 337. 
CINCHONIA.
235
quid 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  alcohol; the alcoholic liquors are mixed, and the
cinchonia crystallizes  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 thus be  de-
feated.1
   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, washing, and treating
it, after  drying, with boiling alcohol.2
   Cinchona  is white, translucent,  crystallizing in needles; requiring,
for its solution, 700  parts of cold  water, according to Magendie; ac-
cording to others, 2500 parts of boiling water.  On account of its very
sparing solubility in water, it has but a slightly bitter taste.  In alcohol,
it is readily soluble, and the solution is extremely bitter, as well as the
salts formed by its union with acids, which resemble the salts of 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. .815:) it is not soluble  in ether.  It forms crys-
tals and tastes bitter.   The acetate, on the other hand, does not crys-
tallize; 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 wholly superseded
by quinia and its salts.   It has been regarded  as a weaker article, and
therefore given in larger doses.    Magendie and  Gittermann assert
that it has been found ineffective as an  antiperiodic.  Bally,3 Chomel,4
Mariana,5 Wutzer,6  and others, however, exhibited  it  successfully.7
Dufresne8 frequently prescribed it, and he assigns  it this claim to pre-
ference,  that it is almost tasteless, 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.9  He gave it in intermittents,  during the apyrexia, in the
quantity of from six to twenty grains,  and found it of marked use in
cases of gastralgia  with formation of acid,  which are so often met

  1  Magendie, Formulaire, &c.
  2  Pharmacop.e Universelle, i. 414, Paris,  1828.
  s  Nouv. Biblioth. Medicale, ix. 189.       4 Nouv. Journ. de Me"decine, Mars, 1821.
  5 Osservaz. sulla Pratica del Solfato de Cinconina,  &c.
  6  Rust und Casper's Krit. Repert. B. xxi. and Bulletin des Sciences Medic. Sept. 1827.
  7  Art. Cinchonine, in Merat and De Lens, Diet. De Mat. M.d.
  8  Biblioth.que Universelle, Mai, 1831, p. 89.
  •  Also, Ganz, in Bulletino delle Scienze Mediche di Bologna, Agosto et Settembre, 1836,
p. 121. 
236
CINCHONIA.
with in young females, and are not unfrequently associated with leu-
corrhcea, hypochondriasis, melancholy, &c.
  Owing  to  the recent high price of sulphate of quinia, further ex-
periments have  been made on the sulphate of cinchonia.   Dr. Wahu,1
in Algeria, was furnished by  M. Delondre,  the celebrated chemist,
with a quantity,  to  test its efficacy in  the  malarious  fevers there.
Since the year 1815, the price of the cinchona of Loxa, which yields
the cinchonia so  largely, has  been, in France, nearly three quarters
lower than that of the yellow bark; and  it became important to test
the relative powers of the two alkaloids.   The sulphate of cinchonia
was  entirely  successful  in  thirteen cases.   These  and  subsequent
trials2 induced  him to believe  that  quinia and cinchonia are identical,
as regards their curative powers in malarious  fevers—fievres paludeen-
nes—and that the latter very rarely produces  the deafness and  buzz-
ing in the ears, which are so frequent when the former is taken.
  Trials,  made  with  it at the Pennsylvania Hospital  by Dr. Pepper,3
confirm the favourable results  obtained by former observers, and have
led him to infer, that the sulphate of cinchonia proved  quite as effica-
cious as the  sulphate of quinia; and, occasionally, it appeared to be
even more prompt.  In all the cases, it was given in solution, with the
addition of a few drops of sulphuric acid.  Such, too, was the result of a
somewhat extensive observation of M. Hudellet,4 and of numerous trials
recently made with it in the Philadelphia Dispensary,  by Dr. George
Martin; and in the Northern Dispensary, by Dr. Alfred M. Sloane.4
   In  several cases  of  neuralgia and intermittent fever, which  fell
under Dr. Pepper's observation  in private practice, the  cinchonia suc-
ceeded after the failure of quinia in like  doses.    In two cases,  it
succeeded after the failure of  the sulphate of bebeeria.
   Mr. Edward Parrish6 states, that the average price of  the sulphate of
quinia is three  dollars an ounce; that of  the  sulphate of quinidia two
dollars and a half; whilst that of  sulphate of cinchonia is only one dollar.

                      MODE  OF ADMINISTRATION.
   The following formulae have been recommended.
                        Syrupus cinchoniae.
                          Syrup of cinchonia.
                   R. Cinchonia. sulphat. gr. xlviii.
                        Syrup Oj. M.
   Used in the same cases  as the Syrupus quinise; a  table-spoonful
for a dose.                                             Magendie.
                         Vinum cinchoniae.
                           Wine of cinchonia.
                    R.  Cinchoniae sulphat. gr. xviij.
                        Vini Maderens. Oij.   M.
                                                        Magendie.
  1 Jamain and Wahu, Annuaire de M.d. &c. pour 1854, p. 21.
  2 Ibid, pour 1855, p. 2.
  3 Amer. Journ. of the Med. Science3, Jan. 1853,  p. 16.
  * Rev. Med. Chir. de Paris, Jan. 1855, and Ranking's Abstract, Amer. edit. xxi. 33.
Philad. 1855.
  5 Dr. Robert P. Thomas. Quarterly Summary of the  Transactions of the College of
Physicians of Philad., from May 2, to Oct.  3, 1855, p. 430.
  8 An Introduction to Practical Pharmacy, p. 318.  Philad. 1856. 
CINCHONIA.
237
                          Tinctura cinchonie.
                   R.  Cinchoniae sulphat. gr. ix.
                       Alcohol (34° or s. g. -847,) f gj.  M.
                                                        Magendie.
  Magendie recommends, that this  tincture should be used for pre-
paring, extemporaneously, wine of  cinchonia, by  adding two  ounces
of the tincture to a pint of Madeira wine.

                          Boli  cinchoniae.
       Boluses of cinchonia.—Boli antifebriles.—Febrifuge boluses.
                   R.  Cinchoniae sulphat. gr. iij.
                       Micae panis,
                       Mellis,
                       Glycyrrhiz. aa. q. s. ut-fiat bolus.
  Dose.—One, every two hours.                            Brera.1
                        Mistura  cinchoniae.
                         Mixture of cinchonia.
                   R.  Cinchoniae sulphat. gr. vi. ad xlviij.
                       Potassa. acetat.
                       Saccr_ar. aa. 3ss.
               Solve in
                       Aquae anthemid.  ,5 vj.
  Dose.—A table-spoonful every two  hours, in intermittents.
                                                         Sundelin.
  Cinchonicine,  Cinchonicia.—By exposing any salt of cinchonia,
with certain precautions, to heat, M. Pasteur found, that the alkaloid
was  changed  into  another  alkaloid, isomeric  with itself, to which he
gave  the name cinchonicine;  and to the salt  of  quinia, similarly
treated,  quinicine.2   Ordinary sulphate of cinchonia^for example,
when subjected to heat,  enters into  fusion, and is  immediately de-
stroyed, furnishing a beautiful  red resinous matter, which is a product
of the changed cinchonicine.   But if  care  be taken to add to the sul-
phate  a little water  and sulphuric  acid, before  subjecting it  to the
action of heat, it remains fused, even  after the  expulsion of all the
water, at a  low temperature, and  it is sufficient  to retain  it  in this
state, at 120 to 130°, for three or four hours, to  have it wholly trans-
formed into sulphate of cinchonicine.
  Sulphate of cinchonicine has been  prescribed  by Professor Forget,
of Strasburg, as an anti-periodic.  It was  generally given by him in
solution,  in the  dose  of from  50  centigrammes (gr. vijj)  to one
gramme, (gr. xvss) taken in two doses morning and evening.   It was
found, that larger doses  than the  first mentioned usually produced
unpleasant symptoms,  and  generally  of gastro-enteric irritation,  in
this  respect differing from sulphate of quinia, which induces cerebral
disorder.
  Ten cases of intermittent fever are reported  by Professor Forget3

  1 Ricettario Clinico di Brera.  Padov. 1825.
  2 Journal de Pharmacie, 3_me s.rie xxiv. 161.  Paris, 1853 ; and Dr. Wood, Dispen-
satory of the United States of America, 10th  edit. p. 254, (note.)  Philad. 1854.
  ' Bouchardat, Annuaire de Therap. pour 1855, p. 170; and Jamain and Wahn, An-
nuaire de Med. et de Chirurg. pour 1855, p.  26. 
238
CODEIA.
with the following results.   Cinchonicine only broke up  the fever
readily in three cases; and, consequently, its action was more tardy
than that of the sulphate of quinia.   It  induces  gastric uneasiness,
even in a small  dose.   On  five occasions, the sulphate of quinia ex-
hibited its superiority over  the  cinchonicine.  Relapses  occurred at
least as often after the  cinchonicine as after the sulphate of quinia;
and, lastly, cinchonicine cures  intermittent fevers, like many other
remedies, but its efficacy cannot enter into a parallel with that of the
sulphate of quinia.
  Professor  Forget had not prescribed  it in enlargement  of the
spleen.   In one case  of acute rheumatism, of four days' duration, he
gave it in the quantity of 1  gramme (gr. xvss) in two doses, and raised
it to two grammes, when serious  gastric  disturbance  was  produced.
The rheumatism, however, completely disappeared in six days.
  For the iodide, and  other preparations, of  cinchonia, see  the corre-
sponding preparations  of  quinia.
                         LXIV.  CODEIA.
Synonymes. Codeina, Codeinum, Papaverinum, 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 twenty-five years, that the article, whose name is at the
head of this paragraph, had been  obtained from it.   It was discovered
by Robiquet in 1832,1 and as it has been exhibited as a therapeutical
agent, it requires notice.

                      METHOD  OF PREPARING.
  According to Winkler,2 this new alkaloid may be  prepared in  the
following manner.   Morphia is first thrown down from a solution of
opium, made in the  cold,  by means of  ammonia; the meconic acid is
precipitated by the chloride of calcium; for the removal of the colour-
ing matter, the fluid is then treated with the extract  or subacetate of
lead; and the extract of lead,  contained in the fluid poured off from
the precipitates, is  afterwards decomposed by sulphuric acid;  the
fluid,  separated from the sulphate of lead, is now treated with an ex-
cess of caustic alkali; the mixture is exposed  to  the air until  the
excess of free alkali has  attracted carbonic  acid from it:  it is then
agitated and digested with ether,  and left to evaporate spontaneously,
after which a  yellowish, highly transparent, but  not  crystalline com-
pound remains, which  forms with  muriatic acid a crystalline salt,  and
resembles exactly the  codeia of Robiquet.
  1 Journal de Pharmacie, xix. 91 and 162.  Paris. 1833.
  2 Buchner's Report, xlv. p. 459, and Journal de Pharmacie, xxi. 251. Paris, 1835. 
CODEIA.
239
Merck1 procures codeia in a very simple manner.  He treats morphia,
precipitated by soda, with cold alcohol; the spirituous tincture is care-
fully saturated with sulphuric acid; the alcohol drawn off, and the re-
sidue  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 mix-
ture  is then so saturated, that codeia crystallizes  from it in  a few
hours.   By evaporating the ether,  and treating the  residue with alco-
hol, the  codeia is obtained, by degrees, wholly pure,  and separated
from an oily matter, which is a great obstacle to crystallization.
   Codeia, according to Pelletier, consists of thirty-one parts  of car-
bon; forty parts  of  hydrogen;  five parts of oxygen, and two of nitro-
gen.  It is an alkaloid, soluble in water, alcohol and ether; but not
so in  alkaline  solutions.   It unites readily with  acids, and, with the
chlorohydric especially, forms  a salt, which crystallizes with great fa-
cility.   When the crystals of codeia are heated  on a plate of plati-
num, they  burn with  a flame without leaving any  residue.  Heated
in a tube,  they melt at  about  150° centigrade; and, if allowed  to
cool  immediately, form a  crystalline mass;  if,  however, the heat be
continued,  the  oleaginous  fluid rises along the  sides of the tube, ap-
pearing to  shun the  heat; but it does not volatilize.  When dissolved
in water, codeia  communicates to it decidedly  alkaline properties.
1000 parts of water at 60° Fahrenheit, dissolved 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 meted.  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 being soluble in ether, but  insoluble in a solution
of potassa;  in not  decomposing iodic acid,  nor  forming  a red com-
pound  Avith nitric acid; whilst it is not precipitated from the dilute so-
lution of its salts  by means of ammonia.2

                     EFFECTS on the economy.
   As morphia does not represent the whole of the activity of opium,
Robiquet concluded, that other substances might concur therewith, and
he conjectured  that  codeia might be one of them.  Under this idea,
Kunkel3 instituted experiments with it on rabbits and dogs, from which
he obtained  the following  results.   First.  Codeia  differs from mor-
phia in this—that it does  not, like  the latter, paralyze the lower ex-
tremities.  Secondly. It  appears  to  exert a  powerfully  excitant  ac-
tion.  It occasions convulsions of the limbs,  and muscles of the neck,
and when it produces death, this seems to be owing to its action on the

  1 Journal de Pharmacie, cited in American Journal of  Pharmacy, new series, i. 171.
Philad. 1835.
  2 Ballard and  Garrod, Elements of Mat. Med. and Therap. p. 169.  Lond. 1845.
  3 Journal de Chimie Medicale, ix. 223. 
240
CODEIA.
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 occa-
sions  inflammation of the tissues, with which it  comes in immediate
contact.   Its  action is more energetic, when introduced into the are-
olar membrane, than into the stomach.  It  seems, also, to exhibit a
special action on the urinary organs, for animals to which it is given
never evacuate their bladder as long as they are  under its  influence.
Tliirdly.  Codeia differs from the watery extract of opium, in not pa-
ralyzing the hinder extremities;  but it approximates it in this, that it
acts, as has been said, more powerfully when introduced into the are-
olar membrane than into the stomach, and accelerates respiration and
circulation.  Kunkel, however, remarks upon the results of his experi-
ments, that they demand repeated  trials for confirmation, as he was
only able to experiment with a very small quantity of the substance.
Robiquet observes that Kunkel's experiments have led to the 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.
  Barbier1 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  alkaloid  of
such strength that a table-spoonful of half an ounce contained one
grain of codeia.   In his  opinion, it exerts a  peculiar action  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 epigastric  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 syrup of codeia be adminis-
tered  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  complains of pain in the epigastric
region, beneath the lower extremity of the  sternum, and stretching to
the sides  and  back; and  if, with  these symptoms, there  is  combined
a feeling of heat, with indescribable anxiety, marked debility, paleness,
decided alteration of the features, a sense of painful traction sometimes
on one side, at others on the other, of the epigastric region,—with ten-
dency  to  syncope, frequent  sighing, despondency, and more  or less
sensibility to pressure on the epigastric 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 sto-
mach  were manifestly in a state  of degeneration.   A  common effect
of codeia is sleep; which  is  never  accompanied  by heaviness  of the
1 Gaz. Medicale, 8 Mars, 1834. 
CODEIA.
241
head, nor by determination of the blood to the brain.  When the per-
sons 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 vertebral portions of the centre of the nervous system.   In his ob-
servations 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  abdomi-
nal uneasiness, it left the others untouched,—a singular circumstance,
if true, but  requiring fresh observation before we can esteem it to be
established.   He remarks  further, that  almost all the patients who
were benefited  by codeia  had used laudanum unsuccessfully.  Codeia,
he adds, occasions no manifest change in the circulation and respira-
tion; it  does not disturb the  digestive function; seems merely to  di-
minish  the feeling of hunger, and occasions no constipation.   During
its use, itching of the surface is frequently experienced.  When ap-
plied to the skin, it induces no striking  phenomena.   When placed,
in the quantity of two grains, on a blistered surface, it excites a pain-
ful  sensation of burning, without any other  change,—the neuralgic
pains, for the removal of which it may have been thus employed, 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 grains, how-
 ever, 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, sti-
 mulation, 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 disagreeable sense of relaxation, with nausea,
 and often vomiting.   None of the experimenters felt the slightest in-
 clination to sleep, until after the feeling of relaxation.  Riecke1 thinks
 that these  experiments  confirm Kunkel's observation, that codeia loses
 its efficacy when combined with acids.
   In the year 1834,  M. Martin Solon, at one of the sittings of the Aca-
 demie Royale de Medecine, when the experiments of Barbier with  co-
 deia were the subject of  discussion, confirmed his views regarding its
 soporific property.  It  appeared to him to  allay the cough  of the con-
 sumptive.  He remarked, however, that he had not observed the effects
 on the ganglionic nervous system, which Barbier had witnessed.
   Magendie2 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 im-
 mediately thrown into profound sleep—readily broken, however, by
 any strong noise made  in the vicinity of the animal; but the interrup-
 tion was of brief duration,—sleep soon recurring.  This condition per-
 sisted for several hours without being accompanied by any unpleasant
 symptoms.   The effect was not the same with the muriate of codeia:  a

   'Die neuern Arzneimittel, u. s. w. S. 140.  Stuttgart,  1837.
   2 Formulairc pour la  Preparation ct l'Emploi de Plusieurs Nouveaux Mcdicnmens.
 Edit. Ome. Paris, 1836.
      16 
242
CODEIA.
single grain of this salt, introduced in the same manner into the  or-
ganism, suddenly induced deep sleep; but, after the animal had slept
five or six hours, it died.   Several similar experiments afforded a like
result.  Magendie  administered 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 confu-
sion succeeded the  next  day,  as is commonly the case with morphia.
As respects intensity of action, he compares one grain of codeia with
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, besides sleep, vertigo,
nausea, and even vomiting;  but this dose succeeded like a charm in
cases of neuralgia faciei and in sciatica, that had resisted the most va-
lued agents.1
   Dr. Miranda, of the Havana, has published2 the results of his ex-
perience with  codeia in what he calls powerful nervous irritations 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, night
and morning,  and gradually increased it to an ounce in the twenty-four
hours.  His success was so striking that he is induced to "regard the
discovery of codeia  to be fortunate for humanity, especially in climates
like that of the Havana, in which gastrites are so multiplied."
                         Syrupus codeiae.
                          Syrup of codeia.
   This  is directed by M.'Cap3 to be prepared in the following man-
ner :—
                  R.  Codeia. gr. xxiv.
                      Aquae  destillat. f ^iv.
                      Sacchar. ^viij.
   Reduce the  codeia to an impalpable powder in a glass or porcelain
mortar.  Triturate with one-third of the water, allow it to settle and
decant.  Treat the  residuum  with  another  third  of the water, and
again with the remainder.  Put the whole into a small matrass, covering
the opening with a piece  of  moistened parchment  perforated with a
pin-hole.   Heat  in  a water  bath until the codeia has entirely disap-
peared.  Remove the matrass  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 grains of  codeia.
   M.Levrat, aine,4 of Lyons, obtained excellent effects from the use
of the syrup in the "ataxic form" of typhoid fever.  He  gave it to
adults in the dose of two  drams, and of one dram to a child.
   Muriate of Codeia has been used in this city, but it has not been
found to possess any virtues  which the salts of morphia do not; whilst
its price has been enormous—as much, we are informed, as four dol-
lars the dram.

  i Gully's Translation of the 8th edit, of Magendie's Formulaire.  Lond.  1835.
  2 Journal de Pharmacie, xxiv. 145.  Paris, 1838.
  3 Journal de Pharmacie, xxiii. 418.  Paris', 1837.
  * Archives Gen.rales de M.decine, Mai, 1847 p. 112 
COLCHICUM.                       243
                        LXV. COL'CHICUM.
 Synonymes. Colchicum Autumnale, Meadow Saffron.
 French.  Colchique, Tue-Chien, Mort aux Chiens, Safran des Pres, Safran Batard,
   Yi.'illotte.
 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 Colchicaceoe: Melanthaceae (Lindley;) and to Sexual System
 Ilexandria Trigynia.  It is avoided by cattle ; and its active poisonous
 properties have been long known;  fatal cases, indeed, still occur every
 now and then  from its employment, not only in animals, but in con-
 sequence of  its too free use in the treatment of gout.   Reynolds, the
 inventor of the  wine of colchicum, commonly called " Reynolds's  Spe-
 cific," 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  tinc-
 ture, and died in forty-eight hours, after suffering much by vomiting,
 acute pain in the stomach, colic, purging, and delirium.1   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.  Considerable redness of the mucous
 coat of the stomach and small intestines was found.  In other cases, no
 morbid appearance has been detected.2
   A fatal case has been published by Dr. Blumhardt, from the papers
 of Dr. Neubrandt.  The patient, a man aged thirty-two, took, by mis-
 take, a decoction made of a large tablespoonful of the seeds to three
 pints of water.   He was soon afterwards attacked by vomiting, purging,
 and  died two days afterwards under symptoms of narcosis and endo-
 enteritis.   Another fatal case, which was caused by the leaves,3 is re-
 ferred to in the same journal;4 and, more recently, one, from the ad-
 ministration of  the  tincture, has been published by Professor A. T.
 Thomson.5
   Colchicum is not of  modern introduction.   It is the Sermodactyl
 of the ancients.   It had, however, almost wholly fallen into neglect,
 when its use was revived in Great Britain, in the first quarter of the  pre-
 sent  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, the Pharmacopoeias of the United States, Austria, Amsterdam,
 and Anvers, and in the Batavian, Belgic, Brunswick, Danish, Dublin,
 Edinburgh, Paris, Ferrara, Geneva, Hamburg, Hanoverian,  London,
 Lisbon,  Russian, Saxon, Spanish, Swedish, and AVirtemberg.
   Several chemists have  investigated the composition of the plant.

  1 Edinb. Med. and Surg. Journal, xiv. 262.
  2 Christison, on Poisons, 3d edit. p. 791.  Edinb. 1836.
  3 A case of over-dose of Colchicum,  by T. A. Henderson, in London Med.  Gaz., Aug.
17, I83!i. p. 763.
  4 Medicinisches Correspondenzblatt, 1840, and Encyclographie des Sciences Medicales,
Mai, 1840, p. 492.
  5 London and Edinb. Monthly Journal of Med. Science, June, 1843, p. 537. 
244
COLCHICUM.
Pelletier and Caventou believed, that  they had found veratria in it;
but, from the  examinations of Geige'r and Hesse, it appears that the
alkaloid, discovered by those gentlemen, was not veratria, but a peculiar
principle, colchicia or colchicine, which is found in every part of the
plant;  crystallizes in  slender  needles;  is  inodorous, and  of a very
bitter,  and, afterwards,  biting  taste.   Introduced into  the nose,  it
does not  occasion sneezing like veratria.  It has a feeble  alkaline
reaction ; but neutralizes acids completely, and forms with them crystal-
lizable  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, hiccough, violent pains
in the abdomen, vomiting, diarrhoea, and discharge of blood upwards
and downwards.
  By drying, the cormi lose somewhat of their efficacy.  Dr. Houlton1
recommends the following method to ensure their drying spontaneously
without being sliced.  They are to be stripped of their loose, dry coats,
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;  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 inodorous,
but of a very acrid taste.  Their action is like that  of the bulb, and
—some think—they are more equable in their effects.   To ensure this,
however, they must be  gathered wholly ripe, when they first become
entirely black.  They have been highly recommended by Dr. Williams
and others.
  The flowers are the mildest part of the plant.   They have been suc-
cessfully administered  by several English physicians.   Experiments
by Professor Schroff,2 of Vienna, have shown that the cormi of colchi-
cum have no activity, if ilug up in  May and August; and  that  they
possess  the greatest activity in October, at the time of flowering.

              EFFECTS ON  THE  ECONOMY IN  HEALTH.
  In its effects,  colchicum resembles digitalis in one thing, that it ren-
ders the pulse less frequent,3 according to  Thomson  and Willis; but,
in other respects,  Osann and  Riecke4 think it agrees more with squill.5
In  moderate  doses,  the different parts of the plant that have  been
mentioned act as  diaphoretics, diuretics, and  cathartics.  On the di-

  1 Pharmaceutical Transactions, July 1, 1844.
  2 Canstatt's Jahresbericht, 1851. v. 78.
  » Art, Colchicum, Encyc. Worterb. der Med. Wissensch. viii. 136.  Berlin, 1832.
  4 Op. cit. 142.
  5 See the author's General Therapeutics and Mat. Med. 5th edit. i. 325.  Phila. 1853. 
COLCHICUM.
245
gestive organs, they are conceived to produce less debilitating effects
than squill.
   Sir Everard Home ascribes much  of the griping and  nauseating
effect which sometimes follows the  use of the vinous and other tinc-
tures of colchicum that have not  been carefully filtered, to the sedi-
ment which forms in them, and which may be removed without injury
to the desired  effect  of the  medicine.1   Sir C. Scudamore,2 however,
found the sediment to be inert.   Several experiments were made with
colchicum on healthy individuals.  In the first case, one hundred and
sixty drops of the vinous tincture of the seeds were taken  in  twenty-
four hours, by a young man aged eighteen;—the first dose being fifty
drops, the last, sixty.  Seven copious  evacuations were produced, with
loss  of appetite and debility for twenty-four  hours.  In  the  second
case, a youth, seventeen years  old,  took one hundred and  seventy
drops in nine hours, in doses of seventy, sixty, and forty drops: nau-
sea and vomiting, and six copious evacuations  followed.   Third case;
a youth, aged fifteen, took  one hundred and  thirty drops in ten hours,
in four doses; the first of forty  drops, and  the  last three of thirty;
vomiting and  only one evacuation were  the result.  Fourth  case; a
youth, aged twelve, took sixty drops, in two doses, after an interval of
eight hours;  nine copious  watery evacuations were  produced.   Fifth
case; a youth aged seventeen, took forty drops at bed-time, thirty drops
next morning, and thirty drops seven hours after,—in all, one hundred
drops in nineteen  hours:  vomiting and faintness,  and five  copious
evacuations were the result.   The same boy afterwards  took  seventy
drops at one dose, which were followed by vomiting and headache, but
not by purging.  Sixth case; a  boy,  aged  ten, took eighty drops  in
twenty-four hours and a half, in four doses, of twenty, fifteen,  twenty-
five, and twenty drops: great sickness and vomiting, and nine  evacua-
tions resulted.
   Dr. John Aldridge3 states, that  he has seen three cases in which
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.
   The general opinion is, that  colchicum produces its  good effects,
mainly, by inducing a  considerable increase in the proportion of urea
and uric acid excreted; but the author has certainly not observed this
in his own  case.  "Chelius,"  says Dr. Garrod,4 "once made a state-
ment, that  in some cases  it  increases the amount of uric  acid in the
urine.  Dr. Graves made a somewhat opposite  assertion; for our own
part, we do not know, whether it decreases the uric acid in the urine
or not, although we are pretty certain, that it does  not increase it."

  1 Brande's Dictionary of Materia Medica, p. 189.  London, 1839.
  2 Treatise on Gout, 3d edit. p. 513.
  s Dublin Hospital Gazette, Oct. 1, 1845; and Amer. Journ. of the Med. Sciences, Jan.
184(1.  p. 215.
  * Brit, and For. Med. Chir. Rev. Oct. 1854, p. 338. 
246
COLCHICUM.
                EFFECTS ON THE ECONOMY IN DISEASE.
   The diseases  in which colchicum is recommended, are as follows:
   In gouty and rheumatic cases, it has been supposed to be  almost  a
specific.   Numerous practitioners  have testified to its valuable agency
in such affections; among these, may be named Mr. Want, Dr. Johnson,
Dr. Williams, Mr. Battley, Dr. Armstrong, Sir Everard Home, Sir 0.
Scudamore, Mr. Haden, Dr. Copland, Dr. Graves, Sir Henry Halford,
Dr. Wallis, Dr. Barlow,1 Mr. Wigan,2 Sir Henry Holland,3 Dr. Gairdner,4
Dr.  Seymour,5 and others  in  England; and Locher-Balber, Kahleis,
Gumpert, Plasse, Weber, Klokow,  Biermann, &c, in Germany.6   Col-
chicum is presumed to be the active ingredient of the celebrated  gout
remedy—Eau medicinale d'Husson7—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.
   Dr.  R. B. Todd8 considers colchicum to be chiefly applicable to the
sthenic form of gout, which occurs in robust constitutions, and in the
prime  of life, and that it is almost inadmissible in persons  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 admi-
nistration  of this remedy;  and Dr.  Seymour9 affirms, "that in gout,
especially  in gout originated from excess; in strong, violent, painful
gout, it may be  given not  only without fear, in moderation, but with
almost an absolute certainty of relief, without  any bad  effects either
immediately or remotely following its use."
   In acute rheumatism, as  well as in various inflammatory affections,
colchicum was proposed by the author's friend, Mr. Charles T. Haden,10
as an  excellent  sedative to reduce  excited organic action, which he
conceived it capable of effecting to such an extent, that  blood-letting
might  generally be rendered unnecessary in febrile and inflammatory
disorders;u yet, in the very cases  in which it was esteemed  so appro-
priate by Mr. Haden and by Carminati,12 it is regarded unadvisable by
others.  Thus, Riecke,13 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 em-
ployment within narrow limits, and to pretermit it when any consider-
able febrile condition existed.  Professor J. H. Bennett,14 of Edinburgh,

  1 Art.  Gout, in Cyclopaedia of Practical Medicine, Amer.  edit.  Philad. 1845.
  2 Lancet and Med. Gaz., June 30, 1838.
  3 Medical Notes and Reflections, 2d edit. p. 124.  Lond. 1840.
  4 On Gout,  its History, its Causes, and its Cure.   Lond. 1849.
  5 Thoughts on the Nature and Treatment of several severe Diseases of the Human
Body, i. 93.  Lond. 1847.
  6 Riecke, Op. cit, and Richter's Specielle Therapie, x. 180.  Berlin, 1828.
  7 See a history of this nostrum, in Pereira, and by Mr. Bushell in Lond. Pharm. Journ.
April, 1852,  and Philad. Med. Exam. July, 1852, p. 450.   Also, Dr. J. M. Maclagan,
Monthly Journ. of Med. Science, Jan. 1852, p. 14.
  8 Practical Remarks on Gout, Rheumatism, Fever, &c, p. 105. Lond. 1843.
  9 Op. cit. p. 93.
 10 Pract. Obs. on Colchicum Autumnale in Inflammatory Diseases. Lond. 1820.
? u Also, Dr. Lewins, in Edinb. Med. and Surg. Journ. for April, 1837, or in Brit, and
For. Med. Review, for Oct. 1837, p. 565.
 12 Memor. dell' Instituto del Regno Lombardo-Venet. 1819.        13 Op. cit. S. 43
 14 Edinb. Monthly Journ. of Med. Science, Dec. 1852. 
COLCHICUM.                       247
says, his observation has led him to the opinion, that in pure rheuma-
tism colchicum is of no advantage, although in gout it is invaluable.
  In the last edition  of  this work the author remarked, that he had
often  exhibited the different  preparations of colchicum in gout, and,
frequently, with decided advantage; but very often it had failed alto-
gether.   In his own person, it had never appeared to prevent or to
modify the paroxysm.   As elsewhere stated,1 his trials had then been
made  with the vinous tincture of the dried root only.  Since then,  he
has imported the vinum  colchici of the London Pharmacopoeia, made
at Apothecaries' Hall from the fresh root, and has taken it in a larger
dose.   At the  onset  of  a paroxysm, he  begins with 50 or 60 drops,
and afterwards takes 30 drops three times a day; and, in the course
of three or four days, he is generally able to go abroad, if urgent affairs
demand it.  To prevent  its acting on the bowels, he occasionally asso-
ciates with it a few drops of laudanum.   The author has never felt  in-
convenience from its use; and where the greatest benefit has apparently
been derived from it, he  has not  noticed any increased evacuation, or
any augmented  elimination by the urine.   In acute—and the same
may be said of chronic—rheumatism, its advantages have not been  by
any means clearly marked in the author's 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 acute rheumatism.   A severe case, under the author's care, yielded
rapidly to it when pushed to the extent of inducing 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 diminished.  By attending to these rules, Dr. Christi-
son2 affirms, that he has never had occasion to observe any unpleasant
effects from  its use, 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  eolic and diarrhoea,
on the one hand, or from frontal headache and giddiness, on the other.
The ill  success which some  practitioners  have encountered in  using
colchicum, he thinks, may have arisen from inattention to this  circum-
stance.
  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, 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 aliment-
ary  canal.3  Such, too, is the experience of M. Monneret,4 who found
that the powerful revulsion on the  bowels, caused by the tincture  in

  1 General Therap. and Mat. Med. 5th edit. ii. 201.  Philad.  1853.
  2 Dispensatory, p. 355. Edinb. 1842.
  s 8ee  Wood and Bache's Dispensatory, Art. Colchicum; and Lewins, Op. citat.
  4 Archives G.u.rales de Med. Mar. 1844, cited in Lond. Med. Gaz., May, 1844. 
248
COLCHICUM.
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. Wigan1 asserts, that he gives colchicum powder in rheumatic gout
in the dose of eight grains every hour, until "active vomiting, profuse
purging, or  abundant perspiration 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." Yet, Dr. Upshur2 has declared,
that, in  chronic rheumatism, he thinks he has sometimes derived great
benefit from it, but, in the acute  form, never.  He adds, it may be that
he has been "so unfortunate as  always to get hold of an inferior pre-
paration,"—a qualification which, however, applies equally to the re-
sults of his  experience in  the chronic form of the disease.
   Professor Forget,3 of Strasburg, affirms, that the alcoholic tincture of
the flowers is a good remedy in  acute articular rheumatism; but that
it  is without any manifestly  favourable action in chronic rheumatism
and in acute neuralgia.
   Mr. Anthony White,4 himself  a sufferer from gout, relies exclusively
on a combination of colchicum and calomel, according to the formula
given hereafter.  He is of opinion, that "the main object to be pur-
sued towards the effectual cure of the gouty paroxysm, by the removal
of its immediate cause, is the restoration of  the natural functions of
the liver, as indicated by  a copious discharge of bile through the bow-
els."   On  the other hand, Dr.  Gairdner5 maintains, that colchicum
never more effectually relieves the patient than when it  acts silently
and peacefully, without producing any evacuation whatever, or in any
way disturbing the patient's comfort and ease.   It  has  been demon-
strated, by Drs. Douglas Maclagan, Chelius and  Lewins, that it causes
a more  copious discharge  of  urea from the system, and Dr. Gairdner
found, in repeated investigations, that the increase of urea was attend-
ed by a great  diminution of  the urates in the urine.   It may, there-
fore, as suggested by Dr.  Pereira,6 prevent the formation of uric acid;
for, as  already remarked, it does not prevent its elimination.
   The vinous tincture of  the  seeds has been extolled  in the tetanus of
warm climates, by Dr. W. G. Smith,7 of Port-au-Prince.   He begins
with  5ss. and  increases  the  dose every  half hour, repeating it until
emesis or catharsis has been  produced.   It is then discontinued.
   In dropsy, colchicum was  used of  old  with good results; and it has
been employed in modern times.   Carminati gives  the details of a
case of dropsy supervening on  scarlatina, and Plasse, one of hydro-
thorax, 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 with advantage by  many physicians, and

   1 Lond. Med. Gaz. June 30, 1838.            2 Med. Examiner, Oct. 1850, p. 580.
   3 Bouchardat, Annuaire de Therap. pour 1855, p. 111.
   4 Lond. Med. Gaz., Aug. 18,  1848; and in Med. Examiner, Sept., 1852, p. 595.
   5 Op. cit.
   6 Elements  of Mat. Med. and Therap. 3d Amer. edit. ii. 176.  Philad. 1854.
   ' Amer. Journal of the Med.  Sciences, for Nov. 1835, p. 66. 
COLCHICUM.
249
especially by Drs. Armstrong1 and Hastings,2 and Dr. Pereira3 found
it of great service in humoral asthma and other chronic bronchial affec-
tions, especially when these complaints  were accompanied  with ana-
sarcous swellings.   By Drs. Eisenmann  and Ficinus,4 the vinum col-
chici has been given in gonorrhoea.  The latter prescribes from twenty-
five to  thirty drops three times a day, combined with  tinctura  opii,
low diet, the warm bath, &c.  These means were attended with unpre-
cedented success in  the treatment of gonorrhoea and other inflamma-
tory discharges  from the  urethra in the male, and from the vagina
and uterus in the female.
   By Ritton* it has been advised  as an extremely efficacious remedy in
leucorrhcea, in the dose of five grains of the powder three times a day ;
and in several spasmodic diseases it has been extolled by Raven.8   Tait7
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 col-
chici every three or four hours.   Mr. Fosbroke advises it in  ischuria;
Elliotson saw favourable effects from it  in obstinate prurigo; and M.
Bouchardat8 employed it in a case of urticaria in which  there was a
deficiency of urea and uric acid: "under its use" for fifteen days, the
quantity of these constituents was more than tripled.   Bullock  gave
it in erysipelas ; by  Chisholm and Baumbach9 it was exhibited success-
fully against tape-worm ; and Bauhin used it to  destroy pedicuii.  Dr.
Chapman10 states, that from ten drops of the tincture of the root re-
peated  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  rheu-
matic joints, in the  form of the tincture of the seeds or bulb.11  It has
been recommended by Mr. Wansborough in gout;12 two drams of the
tincture of the seeds being  added  to f giv. of  a  spirit  lotion.   It is
affirmed, however, that the local use of morphia had the same effect,13—
the part being bathed in hot water for a minute, and then lint applied,
spread  with simple  cerate, on which about three  grains of acetate of
morphia were distributed.
   Mr. Laycock14 has advised the tincture of the  root as  an external
application in rheumatism, alone or combined with tinctura camphor a.

   1 Pathology of Consumptive Diseases.  London,  1822.                  ,
   2 Inflammation of the Mucous Membrane of the Lungs.  Lond. 1821.
   8 Elements of Mat. Medica,  &c, ii. 947, London, 1842; or 3d Amer. edit, by Dr. Car-
son, ii. 178.  Philad. 1854.
   4 rasper's Wochenschrift, Aug. 26, 1848.             5 Lancet, Aug. 2, 1844.
   ^Lond. Med. and  Phys. Journ., Jan., 1817.
   7 Amer. Journ. of the  Med.  Sciences, May, 1838, p. 205.
   8 Annuaire de Th.rap. pour 1853, p. 141.
   9 Rust's Magazin, B. xxi. S. 270; and Osann, in Art. Colchicum, in Encyc. Wb'rterb.
der . ledicin. Wissenschaft. B. viii. S. 136.  Berlin, 1832.
  10 Lectures on the more Important Diseases of the Thoracic and Abdominal Viscera,
p. 2ii!l.   Philad. 1844.
  11 Diet, de Matiere Mi'dic. par MM. Moral and De Lens, ii. 361.
  12 Lancet. July 29, 1837.                           1S Ibid. Aug. 5, 1S37.
  14 Lond. Med. Gaz., March 16, 1S39, and June 8, 1839, p. 388. 
250
COLCHICUM.
It was used in the author's Clinic 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 officinal  prepara-
tions of this country and Great Britain are:—acetum colchici (United
States and London;) oxymel colchici (Dublin;) syrupus colchici (Edin-
burgh;) vinum colchici radicis  (United  States  and  London;)  and
extractum  colchici aceticum  (London;) than which, Sir Henry Hol-
land 1 affirms, he knows no preparation more certain in effect, or bet-
ter capable of fulfilling the peculiar purposes of the medicine.   These
are made from the bulb.
   The officinal preparations from  the seeds are  tinctura colchici se-
minis (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 recenter expresso, and such a preparation is  in the Pharma-
copoeia of Austria.2  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 was 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.  Copland3 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.
   A tincture of the flowers, Tinctura Florum  Colchici, maybe prepared
of dried colchicum flowers Sj.; diluted alcohol Oj.  Mr. T.  Spencer
Wells4 prefers the tincture of the flowers to any other preparation, as
less likely to  cause sickness, depression, or purging.   Such has, also,
been the  preference of Sir James  Clark.  The  dose appears to be
small, 10 minims from three to six times a day.  A single  drop is often
given by Mr. Wells with a grain of  iodide of potassium, three or four
times a day, and continued for several months  in gouty cases.   Pro-
fessor Forget,5  of  Strasburg, considers this tincture preferable to that
of the seeds in the treatment of acute  rheumatism.
  1 Medical Notes and Reflections, 2d edit., p. 153. Lond. 1840.
  2 Jourdan, Pharmacop.e Universelle, i. 436. Paris, 1828.
  3 Lond. Med. Rep. xviii. 541. Lond. 1823.
  4 Practical Observations on Gout. Lond. 1853.
  5 Bouchardat, Annuaire de Th.rap.  pour 1855, p. 111. 
                             COLCHICUM.                          251

                 Haustus  colchici  et magnesiae.

                  Draught of colchicum and magnesia.
                   R.  Vin.  rad. col chic. 9j.
                       Magnesia. Qss.
                       Mist, camphor, ^x.  M.
                 Fiat haustus.
   To be taken twice a day in gout.

                                                         Seymour.
                         Mistura  colchici.

              Mixture of colchicum.—Scudamore's mixture.
                   R- _ Magnes. sulphat. 3J. ad 3*ij.
                 Solve in
                       Aquas menth. crisp, f 3*x.
                 Adde
                       Acet. colchic. f sj. ad f Jiss.
                       Syrup, croc, f 3"j.
                       Magnes. 9viij.  M.
   To be well shaken.  Three tablespoonfuls 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.

                   Guttae colchici  compositae.
                     Compound drops of colchicum.
                   R. Extract, aconit. 9j. ad gss.
                 Solve in
                       Vin. colchic. sem. f 3"ss.  M.
Fifteen, twenty, thirty, or forty  drops to be given three times a day.
                                                            Weber.
                   R.  Tinctur. colchic. sem.
                       ------guaiac. aa. f ^iij.  M.
  Dose.—Thirty or forty drops three times a day in chronic rheuma-
tism.                                                      Blasms.
                   R.  Tinct. colchic. sem.
                      ------digit, aa. f^ij.
                      Sp. aether, nitric, f gss.  M.
  Dose.—Twenty drops,  on sugar.                    Dildenbrand.

                         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.
                                                           Rizton.
                   Pilulae colchici  compositae-

                    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.
                  R.  Ext. colchic. aeet.
                      Hydrarg. chlorid. mit.
                      Aloes, aa. gr. j.
                      Ipecac, pulv. gr. ij.  M.
  Dose.—One every four hours in gout.   Two or three are generally 
252                         COLLODION.

enough "to produce a considerable disgorgement of the liver."   This
is assisted by one or two doses of compound decoction of aloes.
                                                      A.  White.
              Linimentum colchici et  camphorae.
                 Liniment of colchicum and camphor.
                  R.  Tinctur. colchic. rad.
                      ------camphorae, aa.  partes aaquales.   M.
                                                       LaycocJc.
                        LXVI. COLLO'DION.
Stxoxtmes.—Collodium, Ethereal Solution of Gun Cotton.

  Professor Schonbein appears to have first shown the solubility of gun
cotton in sulphuric  ether.  He  states, that long  before  it was em-
ployed in this country, he  had recommended for surgical use a fluid,
which he termed " liquor constringens" and " ether glue; " and that
it had been employed in Switzerland  three  years previous to any no-
tice of it in America.1   Specimens of the solution were exhibited by
Dr. C. F. Jackson before the Boston Society for Medical Improvement,
in December, 1846, or January, 1847, to illustrate its  use as a bril-
liant varnish.   Soon afterwards, Dr. H. J. Bigelow2 prepared a bottle
of the solution according to Dr. Jackson's directions, and whilst em-
ploying it as a varnish, he accidentally smeared  it on a fresh wound of
the  finger.  The smarting that resulted drew his attention to the wound,
and he immediately endeavoured to rub it off, but it had dried almost
instantaneously, and remained on; the smarting soon ceased, and when
the  film was  removed, union had taken place.   Dr. Bigelow at  once
had  recourse to it  as a dressing for wounds, especially such as  it is
desirable to unite rapidly by the first intention.
  About the  same time a young medical student, Mr. George P. May-
nard,3 of Boston, exhibited a similar  liquid adhesive substance, which
he had introduced as  a substitute for the common adhesive plaster,
over which it seemed  to  possess many advantages,  and to be applica-
ble  to cases in which the latter is not;  and in a letter to Dr. John D.
Fisher, read before the Boston Society, Mr. Maynard4 stated, that he
had used the adhesive liquid,  and seen it used by his preceptor, Dr.
Whitney, in  more than one hundred cases of surgery,—some of  them
serious,—and in  all successfully.  Mr. Maynard appears to have first
used it  surgically in January, 1847:  and  it  was, in  consequence,
known for some time under the name of u Maynard's adhesive liquid;"
but, subsequently, it received  the name Collodion—from xoua, 'glue;'
—by which it is now known.

                      METHOD OF PREPARING.
  The formula generally adopted for the preparation of collodion is
that of M.  Mialhe.   The plan recommended by Mr. Maynard was to
  i Lancet, Mar. 17,1849.      2 Boston Medical and Surgical Journal, Mar. 22,1848.
  8 Amer. Journal of the Medical Sciences, April, 1848.
  * Boston Medical and Surgical Journal, Mar. 29, 1848. 
COLLODION.
253
treat  cotton with  nitric  and sulphuric acids; washing the substance
thoroughly, and afterwards dissolving it in pure sulphuric ether.  Several
French chemists, on repeating  the process, failed to procure the cotton
in a state in which it  could be  dissolved  by ether, when M. Mialhel
ascertained, after many trials,  that it was much more readily procured
by using a mixture of  nitrate of potassa and sulphuric acid.
   A process for its formation has been introduced into the last edition
of the Pharmacopoeia  of the United  States.  (1851.)  Take of  cotton,
freed  from  impurities,  and  finely carded,  gss, nitrate of potassa,
in powder,  Sx., sulphuric acid, f gviiiss., sether, Oiiss., cdcohol, f 5i.
Add the sulphuric acid to the nitrate of potassa in a Wedgewood mor-
tar, and triturate  them, until  uniformly mixed; then add  the cotton,
and by means of the pestle and a glass rod, imbue it thoroughly with the
mixture for four minutes.  Transfer  the cotton to a vessel  containino-
water, and wash it, in  successive portions, by agitation and pressure,
until the washings cease to have an  acid  taste, or to be precipitated
on the addition of chloride of  barium.  Having separated the fibres
by picking, dry the cotton with  a gentle heat, dissolve it by agitation
on the ether previously mixed  with the alcohol, and strain.
   Other modes of preparing it are given by Mr.  J. B. Edwards,2 and
by Messrs. Charles S.  Rand3 and  Edward Parrish.4  Gun  cotton will
also dissolve in equal parts of  ether and alcohol, and form as adhesive
a solution as that in  ether alone.   It of course dries  more slowly, and
whilst it may not  be  as well adapted for holding the edges of  incised
wounds together as  the latter, it  may be  preferable in  certain cases,
—as an application to abraded surfaces, for  example.  It should be
kept in closely-stopped bottles previously well dried.

                EFFECTS ON THE ECONOMY IN DISEASE.
   Collodion has  been used extensively by the surgeon as a retentive
 adhesive compound in all cases of solution  of continuity,—either ap-
plied directly to the part, by being brushed over it with a camel's hair
 pencil, or spread on strips of cotton.   On ulcers and abraded surfaces
—as in superficial burns—it acts as an excitant;  the ether evaporates,
 and a film is left, which protects  them against the irritating and de-
 siccative influence  of the air.5   It was suggested in burns by  Dr.  Payne,
 dentist, of Montreal;  and employed successfully by  Dr. Crawford6 of
 that  city, and  since  then its  utility  has  been confirmed  by others.7

   1 Lond. Med. Gazette, cited in Amer. Journ. of Pharmacy, Jan. 1819, p. 42.
   ' Lond. Pharmaceut. Journ. cited in Amer. Journ. of Pharmacy, July, 1849,  p. 233.
   * Amer. Journ. of Pharmacy, July, 1849, p. 209.
   4 Ibid. October, 1849, p. 289; and his Introduction  to Practical Pharmacy, p. 235.
 Philad. 1856.
   1 For a summary of the surgical and  other cases in which it had been until that lime
 employed, see Bigelow and  Maynard, Op. cit., and Lond. Journ. of Medicine, Feb., 1819;
or Banking's Half-Yearly Abstract, Amer.  edit. ix. 100. Philad. 1849.
   6 Brit. Amer. Journ., Aug. 1848.
   1 Lambert, Gazette Medicale de Lyon; cited in Bouchardat,  Annuaire  de Therapeu-
tique, pour 1850, p. 241; and Liman, in Casper's Wochenschrift, 27 Juli,  1850, cited in
 Keller und Tiedemann's Nord Amerikanischer Monatsbericht fiir Natur-und Heilkunde,
 8. 188, Nov. 1S50; Blumhardt, cited  in Edinb. Med. Journ. April, 1854, and Ranking's
 Abstract, xix. 105.  Philad. 1851; and Coste, Journ. de M.d. de Bordeaux, and in Jainain
and Wahu, Annuaire de Med. et de Chirurg. prat, pour 1855, p. 14.. 
254
COLLODION.
 M. Briquet1 used it successfully in a case of erysipelas of the abdomen;
 and Dr. J. W. Freer,2 of Illinois,  in an epidemic erysipelas, which pre-
 vailed there in the spring of 1839, applied it, by means of a feather,
 over the affected part.3
   M. Guersant employed with advantage, in a severe case of erysipe-
 las, an application consisting of  thirty parts of collodion to two parts
 of  castor oil.  The varnish was applied once on each of three  succes-
 sive days.   To avoid the inconvenience of the splitting and scaling off
 of  the  collodion, and  its exercising on  the inflamed parts  a degree of
 pressure, Avhich  some  might find  intolerable, M. Latour4  proposes to
 add to  the ordinary collodion a fifteenth part by weight of turpentine
 deprived of its volatile  part  by evaporation, and five or six drops of
 castor  oil to every  thirty  grammes (463  grains.)   The castor  oil is
 preferred to other oils, owing to  its being  more unctuous, and having
 less drying  quality.   M. Aran also applied collodion  successfully in
 erysipelas;5 and  Sprengler in the same affection, as well  as in impe-
 tigo, eczema, sore nipples, ulcers,  painful varices, &c.6
   Having observed the utility of the salts of iron in erysipelas, M.Aran,7
 to  facilitate their application, associated  them with collodion,—thus
 having a preparation, which combined a compressive  and an astringent
 agency.  It consisted of equal portions of collodion and Bestucheff's
 tincture, which is an ethereal tincture of perchloride of  iron.   Spread
 on the  skin, it forms a somewhat  thinner pellicle than  ordinary collo-
 dion, but is  much more supple and resisting, so that the limb can be
 moved  in any  direction, without the crackings which take  place when
 collodion is used alone.
   By Mr. Erasmus Wilson8 collodion was prescribed in various cutaneous
 diseases, and with advantage,—for example in chronic erythema of the
face, intertrigo, chapped nipples  and chapped hands; herpes labialis,
 h. prseputialis, and h. zoster ; lichen agr^us ; lupus non exedens, and
 I. exedens;  acne vulgaris,  and several affections of  the sebiparous or-
 gans.   In these  cases, it has  the same action  as in burns; and be-
 sides by its contraction, during the evaporation  of the solvent, pressure
 is exerted on the part which may be of essential  service.   As elsewhere
 remarked by the author,9 in cases of acne and follicular affections of
 the skin in  general, he has  seen advantage from it.10  Occasionally, it
 has induced an inflammatory condition of  the follicles, and at first
 seemed to aggravate the affection; but, subsequently, good has result-
 ed  from the  modified nutrition  induced.   As a protecting,  supporting
 and compressing agent, it  appears to have  been applied with  advan-

  1  Bulletin de Th.rapeutique, xxxviii., 322, and Brit, and For. Medico-Chirurg. July,
 1850, p. 275.
  3 North Western Medical and Surgical Journal, Jan., 1850.
  3  See, also, in favour of its use in erysipelas, Mr. Luke, in Ranking, xii. 24, Amer.
 edit., 1851, Drs. Piauchaud and Guersant, Ibid. xvi. 107, Amer. edit., 1853, and Christen,
 of Prague, Ibid. xvii. 100. Philad. 1853.             * Revue M6dicale, 1851, p. 462.
  6  Bouchardat, Annuaire de Therap. 1851, p. 263.
  6  Canstatt's Jahresbericht, 1821, 5 Bd.  S. T-i.
  1  Bulletin de  Th.rap. xliv. 370,  and Brit, and For. Med. Chir. Rev. July, 1853, p. 277.
  8  Lancet, Nov., 1848.
  3  General Therapeutics and Mat. Med. 5th edit. i. 540.  Philad. 1853.
  10  Also, Frank, in Canstatt, Op.  cit. 
COLLODION.
255
tage by M. Caballero1 over a large aneurismal tumour of the subcla-
vian artery; and Dr. Brainard2 used  it with advantage for the cure
of erectile tumours (navi) without operation;  and as a means of metho-
dical compression it was employed by  M. Alix3 in varix of the  lower
limbs, varicocele, and glandular and other tumours.  Dr. John Evans,4
disheartened by the general want of success in preventing suppuration
in mastitis, and  satisfied that the most  prominent indication of cure
is to overcome  the  freedom with which blood is sent into the mamma,
and by compression cause the absorption of the  effused  plasma, em-
ployed a coating of collodion to obtain the benefit of its contraction;
and he affirms, that in no case except one had the slightest suppura-
tion supervened.  In  every one, the relief was prompt, and no incon-
venience resulted in any, except  the slight smarting  caused by its ap-
plication.  Testimony is also  afforded in favour of this plan of  treat-
ment by Dr. Murphy.5  It has been employed, too, advantageously in
 orchitis  by M. Dechange, M. Costes,  and  M. Bonnafont.6  The last
 gentleman has spread  it over  the scrotum in fifty-six cases.  The ap-
 plication, he says, gives little, or at  most only transient pain, and the
 effect  on the disease  is described as marvellous.   On the  other hand,
 Velpeau and Ricord have found it injurious.  They have known  great
 pain caused  by it whilst the disease was not benefited.7  Dr. Claiborne8
 applies it in bubo when the local inflammation  is not violent.   When
 it is, he premises  leeching.   In a case of chordce, after all  the usual
 internal agents had been  tried in vain, M. Doringer,9 when  the penis
 had become relaxed by means of cold, covered  the organ with a thick
 layer  of collodion, which prevented  erection.   Next  day, however,
 when  the collodion was removed, the erection returned.
    Mr. Wilson, as well as others, found that the film left by the evapo-
 ration of the  solvent  is liable to crack from want  of  elasticity, and
 consequently to  peel  off,  a  defect  which is remedied by combining a
 certain  portion of oil with it: by  this means, the film  is sufficiently
  elastic to follow the motion of the part  to which it is applied, without
  separating into  flakes.  A farther improvement was considered to  be
  effected by giving  the solution  a flesh colour.  The coloured solution
  has been called  collodium tinctum.
    Professor Simpson10 employed collodion with perfect success in some
  cases of painful fissures at the base of the nipple.   Having brought to-
  gether the edges, he  applied  the collodion, which formed  a protection
  against all irritating  influences, and permitted the child to suck.  The
  healing process took place rapidly.   Equally good effects in cases of
  sore nipple were obtained by Mr. Brown.11  It has also been prescribed

    1 Wahu, Annuaire de Mi'decine et de Chirurgie pratiques, pour 1850, p. 215.
    : North Western Medical and Surgical Journal, Sept. 1849.
    3 Jamain and Wahu, Annuaire de M.'d. et de  Chirurg. pratiq. pour 1855, p. 144.
    ' North Western Med. and Surg. Journ. Sept. 1850.
    •Ibid, March,  1851.
    8 Jamain and Wahu, Annuaire de  Med. &c, pour 1.54, p. 226.
    1 Bull. Gen. de Therap. Juin, 1854, and Brit, and For. Med. Chir. Rev. Oct. 1854, p.
  563. Also, Ibid. Jan. 18/55, p. 283.
    s Stethoscope, March, 1853.
    9 R.'-vue M.d. Chir. xiii. 240, and Brit, and  For. Med. Chir. July, 1853, p. 2/9.
   10 Monthly Journal of Med. Science, July, 1849.          « Lancet, Dec. 24, 1848. 
256
COLLODION.
with advantage by Mr. Vetzler1  in  chilblains, even when  ulcerated.
The o-ood effects were almost instantaneous:  and not more  than three
or four repetitions were needed.
   In cases of ingrowing of the nails, M. Meynier2 presses down the
fleshy  portion, and pours  in between this  and the edge of  the nail  a
small quantity of  collodion, which soon solidifies, induces rapid cicatri-
zation of the ulceration; and, when the disease does not arise from an
abnormal shape of the nail, produces  a cure.  M. II. Larrey succeeded
in this way in four cases out of five.
   Dr.  T. R. Mitchell3 considers it superior in ulceration of the os  and
cervix uteri to nitrate of silver.   It forms an artificial covering  to the
ulcer,  and permits the healing process to go  on beneath.   In cases of
simple abrasion, three  applications have proved sufficient; in more ob-
stinate cases, he  has  employed  caustics first,  and  then covered the
eschar with collodion,  and has  in this way cured extensive ulcers in
half the time required by other methods.   He  has likewise found  it
beneficial in inflammation of the vagina without ulceration. In cases
of chancres, which have become clean, and are in process of reparation,
H. Lippert has seen the  cicatrization rapidly effected by the applica-
tion of collodion,  several times a day, by means of a camel's hair  pen-
cil.4
   In bleeding from  leech bites, the hemorrhage wTas restrained by Mr.
Tucker,* by compresses of lint dipped in  collodion, and it succeeded
also with Mr. R.  T.  Wylde.6   Dr. W. H. Ranking7 applied it advan-
tageously with the same view in the incisions made in cupping.  By
Dr. Muirhead8 it  was employed with great  benefit in bed sores: by
Dr. W. H. Ranking9 it has been suggested as a valuable  application
to the face for the purpose of excluding  the air, and preventing pit-
ting in variola; and by M. Aran10 it was found to be eminently suc-
cessful ; but Dr. Christen,11 of Prague, was not so fortunate. " In  mild
cases," he  says,  "from which the favourable results that have been
recorded have been derived,  its  use is  superfluous;  and in  severe
cases  with extensive eruption, from which our present conclusions have
been chiefly drawn, it is absolutely prejudicial and objectionable."  M.
Aran12 applied it with success to arrest herpes zoster.   As a stopping
for teeth, it was used by Mr. Ancell, and by Mr. J. Robinson,13 dentist;
 the latter of whom  affirms, that  he  has frequently applied collodion
in severe cases of toothache, arising  from exposure of the  nerve,  with
perfect success, where no persuasion could induce the  patient to  sub-
 mit to extraction.
   By M. Ilairion14  it has been employed to glue the eyelids together,
   1 Bouchardat, Annuaire de Therap. 1853, p. 208.
   2 Bull, de Th.rap.  xl.  186, and Brit, and For. Med. Chir. July, 1851, p. 269.
   8 Dublin Med. Press, Oct. 4, 1848; also, M.Aran, Bull. Gen. de Therap. June 15,16.33.
   4 Lancet, Dec. 9, 1848.
   5 Casper's Wochenschrift, 16 Febr., 1850, No. 7, cited in Keller und Tiedemann, Op.
 cit., Dec, 1850, p. 221.
   6 Lancet, Jan. 6, 1849.                          •" Ibid. January 13, 1849.
   8 Ibid. Jan. 27, 1849.                            9 Op. cit.
   10 Prov. Med. Journ., April 2, 1851; and Ranking, xiii. 86, Amer. edit. Phila. 1851.
   11 Ranking's Abstract,  xvii. 98, Amer. edit. Philad. 1853.
   12 Bouchardat, Annuaire de Th.rap. pour 1851, p. 263.     " Lancet, Dec.30, lei*-
   " L'Union  Medicale, Nov. 29 and 31, and  Brit, and  For. Medico-chirurg. Rev. July,
 1849. 
COLLODION.
257
where it has been desirable, as in keratitis, and conjunctivitis, to pro-
tect the inflamed surface from the contact of air, to prevent the move-
ments of the eyelids over it, or to retain topical applications in  con-
tact with it.   He usually applies it to the eyelids of one eye, and after-
wards, if both eyes are diseased,  to  the  other.  The  adhesion never
continues longer than forty-eight hours.  A  little space  may be  left
at the angle of the eye for the discharge from the inflamed surface to
escape.   In perverted states of the eyelids—as trichiasis, districhia-
sis, entropion, ectropion,  &c, the ease with which the  desired rectifi-
cation can be secured  renders it,  M. Hairion considers, a most valua-
ble palliative and even curative ao-ent.
   In pharmacy, collodion has been employed as a coating for pills
The pill is placed on the point of a needle and dipped  in the solution'
M. Durden1  employs  one of the specific gravity .810, and two immer-
sions are sufficient.  Pills of aloes and colocynth,  thus coated, can be
taken without the slightest  taste of those nauseous articles being per-
ceived.                                                       ° *
   M. Clarus2 has recommended two varieties of collodion, the first for
closing wounds, and the second especially for cutaneous eruptions in
which collodion is useful.   The  first, collodium terebinthinaturn,  com-
posed of a scruple  of  turpentine  dissolved in  an  ounce of collodion
forms a very tough and adhesive  fluid;  the  second, collodium ricina-
tum,  composed of a scruple  of castor  oil and an  ounce of collodion
forms a thin and soft solution, well adapted for the skin.
   Dr. Christopher  Fleming, of Dublin,3 with the view  of having a
rapid effect  from  certain  remedies, as well  as  of  circumscribing
their action, has employed  them combined  with  collodion.  Iodine
for example, he has used in this way with  the most  satisfactory re-
sults. A dram of iodine will dissolve readily in an ounce  of collodion.
Dr. Fleming prefers ten or twenty grains to  the  ounce, and even of
this strength it ought not to be indiscriminately applied.  Five grains
to the ounce  forms a highly stimulating application when  the skin is
very delicate; and in particular  stages of chronic suppuration, accord-
ing to Dr. Fleming, will be found'a most efficient remedy; and to the
vesicant  collodion the addition  of even a less quantity of iodine, im-
parts considerable  activity.   The use of iodized  collodion, he says,
will be found extremely manageable in very many  forms of tumours. '
   Dr. Fleming further remarks, that several of the alkaloids being
soluble in  ether, and,  therefore, in  collodion, may be  applied locally
through its agency.   Dr. Aldridge prepared  for him a  solution of
atropia in the chloroform solution of gutta percha.   The upper eyelid
was painted with some of the solution, and, in a very few minutes  the
pupil was manifestly dilated.
   The best mode of applying these remedies is with  a camel's  hair
brush, which should be rapidly passed over the part, as  a thick varnish
is very quickly formed.

  Cantharidal Collodion, Vesicant Collodion, Collodium vesicans

 1 Bouchardat, Annuaire de Therapeutique, pour 1850, p. 243.
 2 Schmidt's Jahrbuch, No. 8, S. 27, and Brit, and For. Med. Chir. for Oct., 1853, p. 558
   Dublin Hospital Gazette, June 15, 1855.                           ' p
      IT 
258
COLLODION.
seu cnntharidale; French, Collodium cantharidal.   Under this name,
a vesicating agent has been proposed by M. Ilisch,1 of St. Petersburg.
It is prepared by exhausting, by the method of displacement, a pound
of cantharides coarsely powdered, with a pound of sulphuric ether
and three ounces of acetic ether.   In this manner, a saturated solu-
tion of cantharides is obtained.  In two ounces of this solution twenty-
five grains of cotton powder are dissolved.   It may be preserved un-
changed in well-stopped bottles.2
   Mr. Charles S. Rand,3 of Philadelphia,  who has made many experi-
ments with this preparation, confirms the statements of M. Ilisch in its
favour.  Some improvements, he thinks, might be made in his formula.
The proportion of cantharides is unnecessarily large,—a tincture made
with double the amount of ether being  found to vesicate with equal
power.
   In  employing  M. Ilisch's  preparation,  it is sufficient to  paint the
part with a camel's hair pencil dipped in it; and if, after  desiccation,
which takes place in less than a minute, it appears  that the skin is not
entirely  covered, the operation must  be  repeated.  A more certain and
rapid action is obtained, if the part  be  covered  with a  little lard or
simple cerate.  No longer time is required  for the  blister to be pro-
duced than in the case of the Emplastrum cantharidis; and it has the
advantage of  not being disturbed by the  movements of the patient.
   According  to  Mr.  Rand, the contraction induced by it, as  in the
case of simple collodion, is a serious objection,—owing to its not only
causing pain in the sensitive vesicated surface, but retarding the neces-
sary action;  but the addition of Venice turpentine  to the amount of
about one  per cent, effectually obviates  this, " and renders the prepara-
tion perfect."  When the blister is formed, the film of collodion loosens,
and, curling at the edges, may, by a slight effort, be detached without
rupturing  the membrane beneath.   If it be  simply painted upon the
skin, and the ether be allowed to evaporate, vesication does  not take1
place  sooner than with the officinal plaster;  but  if immediately on its
application a piece  of oiled silk be bound upon the  part, and  suffered
to remain  an hour, so as to prevent rapid desiccation, a  blister will be
formed in  three hours, sometimes more quickly; and in  one instance
it formed in one hour.4
   The cantharidal collodion has been  frequently employed, and has
met with much favour.

   A  Solution  of Gutta Percha in Chloroform has been used in
the same  cases  as collodion.   Dr. Graves5 of Dublin recommends it
in various cutaneous  diseases, remarking, that when a saturated solu-
tion is spread by means of a camel's  hair  pencil over  the skin, the
 solvent  fluid rapidly evaporates, leaving a delicate and extremely thin

   1 Canstatt und Eisenmann's Jahresbericht  iiber die Fortschritte in der Heilkunde im
 Jahre 1819, V. 178.  Erlangen, 1850; and Pharmaceutical Journal, Mar. 1, 1850, cited
 in Amer. Journ. of  Pharmacy, July, 1850, p. '229.
   a Bouchardat, Annuaire de Therapeutique, pour 1850, p. 101.
   ' Amer. Journ. of Pharmacy, Jan., 1850, p. 20.              * Rand, Op. cit.
   1 Dublin Quarterly Journ., June, 1852.  See,  also, Robert, cited in Bouchardat, An-
 nuaire, pour 1851, p. 37. 
COMPRESSIO.                          259
pellicle of gutta  percha  adhering  firmly  to  the part.  The peculiar
toughness of the gutta percha prevents the pellicle from being brittle,
and, consequently, it is much less liable than collodion  to  crack and
fall off in small scales.  It has been much used in the Jefferson Medi-
cal College clinic, and with advantage.
   By Spengler and Rapp it has been  applied  in erysipelas,1 and  by
Dr. Stokes as an ectrotic  in small-pox, applied after the maturation of
the pustules.   Prior to this, it was  considered to be mischievous.   Me-
licher2usesit to cover scrofulous and indolent ulcers, and protect them
from the action of the air.
   Under the name  traumaticine, Dr. Eulenberg3 employed it success-
fully, painted on daily, in  a case of chronic eczema and one of psoriasis.
                        LXVII. COMPRES'SIO.
 Syxoxymes. Compression, Methodical Compression.
 German. Druck.
   This valuable method of modifying the condition of the capillary or
 intermediate system of  vessels, and, through it,  the function of nutri-
 tion, has become more extensively employed in the treatment of dis-
 ease.  As a sorbefacient, in various hypertrophies  and dropsies, ana-
 sarca, ascites,  ovarian dropsy,4  chronic hydrocephalus,5 &c, it has long
 been used wherever its agency was applicable, and its  effects have been
 decided.6  Of late years, it  has been  proposed  in inflammatory and
 other affections, in which it had been previously esteemed  inapplicable.
 Upwards of  twenty years ago, it was highly recommended in rheuma-
 tic affections, by Dr. William Balfour, of Edinburgh;7 and  numerous
 cases were brought forward by him, and by others, to attest its efficacy.
 Since  then,  it has  been advised by Guerin,8 in cases of phlegmon-
 ous erysipelas  of  the extremities;  by Velpeau,9  in severe burns, and
phlebitis, and in inflammation  of the  synovial apparatus ;10 and Mr.
 James Allan11 has related three cases of phlegmasia benefited by a  si-
 milar treatment—two were of erysipelas of the lower extremities, and
 one of the face.   In these, compression was of speedy and permanent

  1 N^ligan's Treatise on Diseases of the Skin, p. 310, Amer. edit.  Philad. 1852.
  3 Wien Zeitschrift, viii. 6;  and Brit,  and For.  Med. Chir. April, 1853, p. 575.
  ' Allgem. Med.  Centralzeitung, in Union Medicale,  Juin, 1854, and Brit, and For.
 Med. Chir. Oct. 1854. p. 561.
  ' Mr. Isaac Brown, London Lancet, May 9, 1844, and April 5, 1845.
  1 Hirsch, Casper's Wochenschrift. in Provincial Med. and Surg. Journ.  April 29, 1843.
F.ngelmann, in Gaz. Med. de Paris, Jan. 28, 1843, and Amer. Journ. of the Med. Sciences,
Oct. 1S43, p. 15^.
  8 Clinique Medicale de l'Hopital Neckar, p. 247, Paris, 1835;  or the author's transla-
tion in American Medical Library, first year. Also, the author's General Therapeutics,
p. :22S, Philad.  1836;  or his General Therap. and Mat. Med. 5th  edit.  ii. 301, Philad.
1853; and Morelli, Annali Universali di Medicin. Marzo, 1840, cited in Brit, and For.
Med. Rev. Jan. 1S4I,  p. 237.
  1 A new Mode of curing Rheumatism  and Sprains without Debilitating. Edinb. 1817.
  • Journ. Analyt. i. 90.
  •Ibid, and Bulletin General de Therapeutique, No. 16, Aout 30,  1836.
 10 frouv. Bib. M.d. Aout, 1826; and Merat and de Lens. Diet, de Mat. M.d., art. Com-
pression.                          n British Annals of Medicine, Jan. 27, 1837. 
260
COMPRESSIO.
benefit—the pain caused by it being very transient.  He states, more-
over, that he has found the bandage of very great service in removing
the pain and swelling of joints affected with  acute rheumatism, after
the more active degree of inflammation had passed away.
  In cases of external inflammation, compression acts probably in two
ways,—first, by diminishing the circulation in the intermediate system
of vessels concerned in the  pathological condition; and, secondly, by
restoring tone to the over-dilated vessels;  for it is in erysipelatous af-
fections, in which this form of hyperaemia more especially exists, that
it has been found of greatest advantage.   Numerous cases of  erysipe-
las  of the extremities have been treated by the  author by compression
and with great benefit.   He is constantly, also, in the habit of  employ-
ing compression, under the circumstances mentioned by Mr. Allan, in
arthritic affections attended with great effusion, and with the most  sa-
tisfactory results.
  From an observation of the good effects resulting from  compression
in analogous cases, it occurred to Dr. Fricke,1 of Hamburg, that it
might be employed with advantage in cases of orchitis or swelled tes-
ticle (hernia humoralis;) which is frequently very tedious,  and requires
means that are by no means easy of application.   He, accordingly, had
recourse to it, and the  result was 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 1803, it was
used at  the Pennsylvania Hospital, by Dr. Physick, and by Dr. Harts-
horne.2  Dr. Fricke is of opinion, that, generally speaking, compression
may be  employed in every kind of inflammatory engorgement of  the
testicle,  whatever may have been its cause, and at all stages of the dis-
ease.   In many cases, the pain was, at first, in some degree, increased;
and in some, especially when applied too tightly, it induced great suf-
fering ;  but this never continued long:—the  patient, in  a short time,
finding  himself so much relieved as to be  able  to leave  his bed and
walk about the room.   In many cases of recent origin, a  single appli-
cation 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 it two or three times.   Swelling of the spermatic cord, if not
very considerable, did not contra-indicate  its use; nor did other  co-
existent local affections, as buboes, ulcers, &c.   When a general febrile
state accompanied the orchitis, compression  was found to be the best
means for  removing it, where the vascular action was not too consider-
able ; although, in extremely rare cases, such a state was the  effect of
the compression itself.   When the pain was very severe, it was gene-
rally  owing to the compression having been too strong, and the same
was the case with certain signs of gastric derangement, that occasion-
ally supervened.  In these cases, it was necessary to suspend the re-
medy until the derangement was removed, by the use of an emetic, or
the application of a poultice to the stomach.  Such cases were, how-

  1 Zeitschrift fur die gesammt. Medicin. B. i. H. 1, Hamburg, 1836.  Also, Brit, and
For. Med. Rev. for July, 1836, p. 253.
  2 Amer. Journ. of the Med. Sciences, Jan. 1842, p. 258. 
COMPRESSIO.
261
ever, extremely  unfrequent.   The  good effects 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 unfavourable cases.   For
the purpose of compression, he employed sticking  plaster, made very
adhesive, but not of too irritating  materials,  and spread  on strips of
linen, of the breadth  of the thumb.   No preparatory  measures, as
leeches, cataplasms, &c, are  required.  In  slighter cases, the patient
may stand before the surgeon, leaning against the wall, or he may sit
on the edge of a bed or sofa, so  that  the  scrotum may hang freely
down.  If the scrotum and neighbouring parts are  much covered with
hair, it must be removed; but, generally speaking, this is unnecessary.
  The following  is the method adopted by Dr. Fricke for  applying
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 isolated 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, which must cover the former either in
part or altogether.  The first part of the process  must  be  carefully
done; the  strips  must compress the  cord closely; for this  purpose, the
cord must be  kept approximated to the skin, which must be tightly
stretched over it; otherwise, when  the  other extremity of the testicle
is compressed, the upper end will be apt to slip upwards through the
loose rings of adhesive plaster, which will not 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 compression will  be indicated, in most cases,  by the speedy
disappearance of the pain which had previously existed.  When  both
testicles 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 
262
COMPRESSIO.
the strapping has been attached, and walk about the room; and, where
the inflammation has not been great, he may even attend to light labour
out of doors.   When  the strapping becomes loose, it  may have to be
reapplied, but often one application is sufficient.
   In orchitis, caused by blows or pressure, compression is regarded by
Dr. Fricke as the best agent.   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 advantages which  he  considers this mode
of treating orchitis has over others, are: First. The speedy removal of
the  pain;  Secondly. The  quick cure 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,1  of Liege, 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 Parker2 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  another writer3 affirms,  that he  has
adopted the practice in many  cases, and can speak most unequivocally
in its praise.  It may be employed, he  remarks, in very acute forms;
and he has seen several instances, where the patients had not  lain in
bed an hour, " whilst under the ordinary antiphlogistic treatment they
would have been confined from ten days to a fortnight."—To  facilitate
the employment  of compression in  such cases, Mr. Hutchinson4  has
contrived a double bag, on the principle of the double night  cap with
the cavity of which a  tube  communicates.   The whole is constructed
of air-tight materials, and to the end of the tube, which is  long and
flexible, a small screw-cock is affixed.  The enlarged testicle having
been put into the involuted bag, the latter is kept in  place by means
of a riband  tied tightly round the  cord.  Air  is then blown through
the tube into  the cavity of  the bag, and compression of the gland is
effected, just as would be the case with the lungs, if air were forced
into  the pleural sac.   When filled as much  as the patient  can bear
comfortably, the screw-cock is closed,  and the air retained.
   Methodical compression  has  been  employed  with advantage in
mammary  abscess,  by  MM. Trousseau and Contour.5  They found it
frequently produce  a cure when used at the commencement of the in-

  1 Bulletin M.dicale Beige, Aout, 1838, p. 218.
  ' London Lancet, July 25, 1840, p.  640.  Also, J. Dixon, Lond. Lancet, Dec. 5,1810.
  * Brit, and For. Med.  Rev. Oct. 1840, p. 393.
  4 Med. Times and Gazette, Feb. 26, 1853.
  4 Journal des Connaissances Med. Chirurg. F.vrier, 1841. Also, J. Bell, Lond. Med.
Gaz., or Med. Intelligencer, Dec. 1841, p. 121. 
COMPRESSIO.
263
flammation; relieve  the  pain when suppuration was established; 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.1—A similar result was obtained by
M. Seutin2 by means of the starch bandage.
  M. Brachet, of Lyons,3 has reported four  cases of  spermatorrhoea
treated  by compression of the prostate  gland.   He states, that pressure
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, onanism 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 excretory 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. Batchelder4 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.
   Compression of the Arteries,  as  an antiphlogistic  agent, has been
revived  by Goyrand, Malapert, and others; the object being to prevent
the afflux  of blood to a part  labouring under  hyperaemia.   The origin
of this idea has been a  matter of controversy;5 but,  as  Dezeimeris6
has  remarked, it certainly is not due to  the  gentlemen who have en-
gaged in it.  Blaud compressed 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. Strohlin7 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 commencement of the paroxysm
always caused them  to cease in-a minute afterwards.
   Recently, Dr. Fleming8 of Cork has suggested compression of both
carotids, as a means of inducing sleep and anaesthesia, and he thinks
it may be found useful as a remedial agent in certain headaches, teta-
nus, asthma, and  other  spasmodic diseases,  and to prevent pain  in

  ' Also,  LittrS, Journal des Connaiss. Med. Chirurg., Janvier, 1841.
  * Wahu, Annuaire de M.decine, &c, pour 1852, p. 227.
  ' Medical Times, May 24, 1845.
  4 New York Medical and Surgical Reporter, cited in St. Louis Med. and Surg. Journ.,
June, 1846, p. 43.
  ' Gazette Medicale de Paris, No.  46,  18 Nov., 1837, and No. 47.         ' Ibid.
  ' Archives G.n.rales de M.decine, Mars, 1841.
  ' Brit, and For. Med. Chir. Rev.  April, 1855, p. 529. 
264
COMPRESSIO.
such small operations  as  the  extraction of a tooth, or the opening of
an abscess.   " Whether the compression can be continued, with safety,
sufficiently long to make  it available  in larger  operations, has  to be
ascertained."
  M. Allierx has published a case of intermittent neuralgia of the lobe
of the right ear,  cured by compression of the primitive carotid of the
same side:  half  an  hour  before  the  paroxysm, the compression was
exerted, with  interruptions of five minutes  every quarter of  an  hour.
He has, also, reported a case of neuralgia of the orbito-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 minutes every quarter of an  hour.   For the  pudic
neuralgia, the abdominal  aorta was compressed for the  space of  three
quarters of an hour: the neuralgia, in both instances, gradually ceased.
M. Dufresne2 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 disappear-
ance 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 compression 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 pos-
terior pain disappeared, and no return  of  either had taken place  ten
minutes afterwards.   The patient slept well and made no complaint of
pain in the morning.
   The employment of compression of the epigastrium to arrest hiccough
was recommended by  Bordeu, but it  had fallen  into oblivion.   It has
been revived, however, and was suggested  to M. Rostan3 by an  old
physician of  Paris, whose wife  was  subject  to attacks of  hysteria,
during which she suffered  from incessant hiccough, and in which he had
observed, that she  experienced  remarkable relief  from strong com-
pression on the  epigastrium with the hand.   Since then, M. Rostan
has employed it  in many cases of the same kind, and constantly with
good effect, whatever might have been the cause of the hiccough.  To
render the pressure constant, he has  employed  a pad with a truss-
spring as a substitute for  the hand; and M. Boyer4 has recorded three
cases  of painful  and obstinate hiccough instantly relieved by the same
means.
   Compression of the abdominal aorta has been revived by M. Baude-
locque,  and many others, with  the view of arresting  uterine hemor-
 rhage occurring in labour, as well as the  hemorrhage which follows
 wounds of the arteries of the inferior half of the body.5  In  a case of
   1 L'Experience, No. 16, 20 Jan. 1838.      * Ibid. No. cxxviii. Dec. 1839.
   ' La Lancette Francaise, 20 Fevr. 1847.     4 Revue M.dico-chirurg. Juillet, 1847.
   8 See an account of Baudelocque's views, by J. C. Christophers, in Lancet,  July 20,
 1839, p. 559. 
COMPRESSIO.
265
uterine hemorrhage, detailed by Dr. Ehrenreich,1 external compression
by the hand on the abdomen, which is  the  only way of acting on the
aorta when any obstacle exists to the  introduction of the hand into
the uterus, was tried without  success, owing to the thickness of the
abdominal parietes.   The  hemorrhage  was, however, completely con-
trolled by introducing the entire right hand into the uterus, and making
forcible pressure with the fingers in a conical  shape on the aorta im-
mediately above its bifurcation.   Many similar cases  have been pub-
lished and referred to by M. Piedagnel, in a memoir communicated to
the Societe Medicale d'Emulation, of Paris, on which an excellent re-
port was read by MM. Velpeau and Briere de Boismont, giving a his-
tory 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 ad-
vise that it should be associated with ergot.2
   The mode adopted  by M. Seutin3 for compressing the aorta in such
cases is as follows.   The woman is to be placed on a horizontal 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  disengaged for any other pur-
pose 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 behind and to the left of the uterus, nearly
on a level with the umbilicus.   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 fatigued by continued exertion, his hand may be compressed
by those of an assistant.
   Lastly: M. Allier4 employed compression of both carotids in a case
of  hydrophobia at the commencement of an attack; immediately, the
convulsion  ceased,  and  the patient became apparently exanimate.
The family were alarmed, and would not permit a repetition of the
experiment.   The case  ended fatally.
   In paroxysmal diseases,  the ratio medendi of compression is not the
same as in inflammatory diseases.  In the latter, the flow of blood to-
wards the inflamed part is prevented by the compression of the arte-
rial vessels proceeding to it; but when compression is exerted on the
vessels  in  neuralgia  and  congenerous diseases, the new impression
caused by the resulting irregularity in the circulation, and the modifi-
cation in the nervous functions induced thereby, break in upon the
morbid catenation like the  different agents that are classed under the
head of antispasmodics, of which class the author has elsewhere endea-
voured to show—what, by the way, is not now contested by any eminent
>; ' Medicinische Zeitung, No. xxxvii. 1839, and  British and Foreign Medical Review,
July, 1840, p. 274.
  2 La Lancette  Franeaise, 12 Mai, 1840.  See, also, Bonnet, cited in Wahu, Annuaire
de M d. et de Chir. prat, pour 1852, p. 271.
  1 Bullet, de l'Acad. M.d. Beige, cited in Ranking's Abstract, pt. 1, p. 180, Amer. edit.
Philad. 1845.                           4 L'Experience, No. xvi. 20 Janv., 1838. 
266   CONTRA-IRRITATIO.—AMMONIATED COUNTER-IRRITANTS.

therapeutist—that there are none which can be regarded in any other
light than as indirect agents.1
   In the treatment of aneurism, pressure early suggested itself as a
means of cure; but it was never extensively and methodically employed
until of late years.   Professor Erichsen2 assigns the merit of having
introduced it into modern surgery,  of having given it a definite place
in the art, and  of  having established  the true principles  on which it
acts incontestably to the Dublin  surgeons, amongst whom  the  names
of Hutton, Bellingham, Tufnell,  and Carte deserve especial mention.
For the last ten years  the medical  journals have teemed with the re-
cords of successful cases.
                   LXVIII. CONTRA-IRRITATIO.
Synonymes. 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;3  but to refer to
some  agents not mentioned in the  body of this work, to which atten-
tion has been revived,  or first directed, of late  years more especially.

                  AMMONIATED  COUNTER-IRRITANTS.
Gondret's ammoniacal ointment;  Granville's counter-irritants
  —Antidynous4 counter-irritants—Raspail's counter-irritant.
   Ammonia has long been used,  in  different  formulae, 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 sweet almonds, the mixture forms the Pommade ammoniacale of
Gondret, which  has  been used  for a long time  to excite a speedy re-
vulsion in cases  of chronic  affections  of the  brain,  incipient  cataract,
amaurosis, &c.,s as well  as  to cauterize the integuments  deeply.6  To
the advantages of this preparation, as well as of derivation in various
diseases,  M. Gondret has called the attention of practitioners in an ex
prqfesso treatise.7

  1 See the author's General Therapeutics, p. 380; or his General Therapeutics and Mat.
 Med.  5th edit. i. 434.  Philad. 1853.
  'The Science and Art of Surgery, p. 488.   Philad.  1854; and Miller's Principles of
Surgery, 3d Amer. edit, by F. W. Sargent, M.  D., p. 547.  Philad. 1852.
  'General Therapeutics, p. 333; or General Therapeutics and Mat. Med. ii. 230.
  4 A term coined by Dr. Granville.  It ought to be " Antodynous," from am," against,"
and oSuvn, "pain."  '
  * Bouchardat Annuaire de Therapeutique pour 1844, p. 215, Paris, 1844, and Lisfranc,
Ibid, pour 1845, Paris, 1845.
  * Considerations sur l'Emploi du Feu en M.decine, suivies de l'expose' d'un moyen epis-
 fastique propre a suppleer la cauterisation, et a  remplacer l'usage des cantharides. Paris,
 819;  and Nouv. Biblioth. Med. iii. 441, Paris, 1828.
  T Trait. Theprique et Pratique de la Derivation contre  les Affections les plus Com-
munes, en g.n.ral, telle que la Plethore, l'Inflammation, l'H.morrhagie, &c. Paris, 1837. 
       CONTRA-IRRITATIO.—AMMONIATED COUNTER-IRRITANTS.    267

  The formula, given above,  is  that of the French Codex;  but, ac-
cording to M. Trousseau,1 it  is  much  too hard  for  use, unless the
weather is warm.  He proposes two different formulae,—one  for sum-
mer, and the other for winter.   In the former, he  directs three parts
of lard, one of suet,  and four of liquor ammonise; in the  latter, equal
parts of lard, and liejuor ammonise.
  M. Gondret has communicated to M. Miquel a formula for his Pom-
made, which  differs  from that of the  Codex, and, according 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  am-
mpiia at 25°, 17 parts, stirring until it becomes cold.2
  Since the  appearance of M. Gondret's treatise, Dr. Granville3 has
published one on counter-irritation, which gave rise to much  attention
on both sides of the Atlantic,—partly  in  consequence of the strong
encomiums he passed on certain counter-irritant applications employed
by him; and still more in consequence of the mystery which  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 indivi-
dual  holding an elevated position  in  the ranks  of the profession,
naturally engendered.  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  for-
mulae 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 formulae from his friends, and always intended to
give them to  the world.4
  Dr. Granville describes two sorts of ammoniated lotions, of different
degrees of  power, which are prepared in the following manner: Each
kind of lotion consists of three  ingredients:—1st. The strongest liquor
of ammonia,  A.  2d. Distilled spirit of rosemary, B.  3d. Spirit of
camphor, C.   These are made  as follows:—
  A. The  Strongest Liquor of Ammonia.—Saturate a given quan-
tity 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 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 de-
scribed; its specific  gravity will then be about .872, and 100 parts of
it will contain thirty-three parts of real ammonia, according to Sir H.
Davy's tables.   This solution of ammonia  will, therefore, be more than
three times the strength of the liquor ammoniac of the then Pharmacopoeia
of London, 100 parts of which, at a specific gravity of .960, contained

  1 Journ. des Connaiss.  Med., cited  in  Medico-Chirurgical Review, July,  1840, and
Trousseau and Pidoux, Trait, de Therapeutique, &c. 3ome edit. i. 366.  Paris, 1847.
  'Bouchardat, Op. cit. 1815, 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, 1K!8; or Amer.  Med. Lib. edition.  Philad. 1838.
  4 Lond. Lancet, Oct. 27, 1838. 
 268   CONTRA-IRRITATIO.—AMMONIATED counter-irritants.

 only ten parts of real  ammonia.   Dr. Granville, therefore, called this
 " liquor ammoniae fortissimus."  The liquor  ammonise  fortior  of the
 last United  States' Pharmacopoeia  (1851,) which  is of  the specific
 gravity .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 covered vessel, and
 after  adding as  much water as will  just prevent  the empyreumatic
 smell, distil over seven pints.   The  Pharmacopoeias  of London and
 the United States direct the essential oil of rosemary to  be distilled
 with alcohol to form the spirit  of rosemary.   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, and filter.
   The three ingredients, thus  prepared, should be kept always  ready
 at hand, in well-stoppered  glass bottles,  so as to  be  able to make, ex-
 temporaneously, 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 prepared 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 fol-
 lows :—
                   R.  Liq.  amnion, fort. f^j.
                       Spirit, rosmarin.  f 3yj.
                       Tinct. camphor, f sjij. M.
                    Lotio  ammoniata  fortior-
                     Stronger ammoniated lotion.
   If the quantity desired be divided into  eight  parts, then the pro-
 portion of the ingredients will run  as  follows:—
 .  A—five-eighths.  B—two-eighths.  C—one-eighth, or as follows :—
                  R.  Liq.  ammon. fort, f ^x.
                       Spirit, rosmar. f §ss.
                       Tinct. camph. f 3ij.  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 for  Mixing the Ingredients.—A. and  B are gradually
 mixed together.   The mixture becomes opalescent and somewhat tur-
 bid,  and a peculiar, highly agreeable,  ethereal  smell  is given out, dif-
 ferent from the individual odour of either ingredient, although the ex-
 treme pungency of the ammonia is still discernible.   " I have strong
 reasons to believe," says Dr. Granville, "that, at this point of the ope-
ration, some particular change takes place, which imparts to the mix-
ture of  the two  ingredients some  of its valuable  peculiarities as a
 counter-irritant described in my work; but what  that change is, it is 
       CONTRA-IRRITATIO.—AMMONIATED COUNTER-IRRITANTS.    269

not my business to enter upon in this place:  suffice it to say, that in a
great number of experiments  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 for-
mer  case being found unequal to the production  of those complete re-
sults which I trust I have justly promised to the profession.  Ammo-
nia alone (however strong) will not  give rise to the effects I have de-
scribed, though it has often stopped internal pain, and produced small
blisters; but never has it succeeded in almost  immediately producing
a full vesication, as I have  seldom failed to  produce with the  two in-
gredients mixed together, particularly after the third ingredient had
been added."   Before, however, the third ingredient 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 va-
rious precautions here mentioned  may, upon  an emergency, be dis-
pensed with, when an immediate action is required, either to arrest
pain or relieve deep-seated  inflammation.  But for the more delicate
uses, particularly for  instantaneous vesication, Dr. Granville recom-
mends, that the preparations should be obtained in the manner spe-
cified.   The lotion must  always be kept in bottles with a glass stopper.
   M. Raspail1 has recommended the following lotion, the effects of
which, he says, are often instantaneous  in relieving intolerable head-
ache:—   "
                  R.  Liquor, ammon. p. 100.
                      Aquae destillat. p. 900.
                      Sodii chlorid. purif.  p. 20.
                      Camphor, p. 2.
                      Essent. rosar. q. s.
   The whole to be mixed cold.
   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, liquor ammonise is the main effective in-
gredient.  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 is 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 liquor ammoniae.
   The mode of applying these liquid counter-irritants is as in the case
of Oleum Sinapis—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
1 L'Experience, 24 Juillet, 1840. 
270    CONTRA-IRRITATIO.—AMMONIATED COUNTER-IRRITANTS.
 should be placed a thick towel, doubled several times, so that not only
 the evaporation of the lotion may be impeded, but the hand employed
 in pressing the application 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.1  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 alleviation of
 pain and spasm.   But, in order to excite the higher degrees of counter-
 irritation, 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,'
 when the diseased action has been prolonged for a considerable period,
 and in affections which belong to the neuralgic class, that rapid revul-
 sions  are productive of the most marked advantage.   When the disease
 is of  an acute character—as in the  different  phlegmasiae—revellents,
 which are  more prolonged 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
 vesication effected by them in the treatment  of many serious disorders;
 and affirms  that  they arrest  " nervous  and muscular pain almost
 immediately,  provided it  does not  depend on  structural  disease."3
 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.   This we say from observation; and it is a result to
 which just theory would lead.   The ammoniated  lotions are, however,
 devoid of the painful mental impression, which the dread of actual fire
 occasions;  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, which, 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 { j^Jj* } Tic Douloureux.
   2. Spasms      } .  .  ..   f Epilepsy.
   3. Convulsions    [ mcluding \ ^- Situs's Dance.
   .   _           J         (Hysterics.
   4. Cramp.

  1 Granville, Op. cit. Amer. edit. p. 39.
JitGTTot Tplra1P^t1i_SoP-34l; and General Therapeutics and Materia Medica, 5th
edit., „. 262.  Philad. 18o3.                      P      , Lancet) 0ct. 27, 1838. 
       CONTRA-IRRITATIO.—AMMONIATED COUNTER-IRRITANTS.    271

  5. Brow-ague.
  6. T'lanus or Lock-jaic.
  7. Highly acute toothache.
  S. Nervous headache.

B. Principally  affecting  the Muscles  and  Tendinous  Tissues.
  9. Rheum ut ism.
  10. Lumbago.
  11. Swelled and highly painful articulations.

           C  Principally affecting the  Circulation.
  12. Headache from fulness of blood in the head.
  13. Congestions and sudden attacks of blood in the head.
  14. Sore-throat.
  , - r, ,  • n__f a. of the trachea and bronchia,      )   m  _•
  1.. Early inflam-  &< of ^      &nd theJr mem^      I   Tending to
        Wm./.«    | c> Qf the hea^ and pericardiumi     | consumption.
D.  Diseases of a  mixed character.
               the heart.
               the stomach.
  16. Suppressed gout  j £ ^tinf
  17. Genuine gout.
  IS. Paralytic debility-
  's,.  Accidental,  Mechanical and  Cutaneous Derangements.
  19. Violent sprains.
  20. Pimples.
  21. Biles.
  21, liiugworm.

  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 ordinary internal  remedies
to assist  in, and complete  the cure.   Among the  exceptions  to  the
general rule of success, he  enumerates chronic tic douloureux; chronic
rheumatism of long standing; epilepsy dependent on organic mischief
in the 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 the number
that 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-irritant lotions.1
  In many of  the disorders,  referred to by Dr.  Granville in the table
given  above, the  ammoniated counter-irritants  have  been employed,
both in public  and private  in this country.   They have  been largely
used by the author, and their effect in nervous and spasmodic diseases,
in neuralgic and deep-seated rheumatic pains, has, at times, been very
striking.   Severe pains  have  yielded  rapidly,  as  described by Dr.
Granville; hyperscmise of  particular organs  have been diverted else-
where, especially after blood-letting and sedatives had been premised;
and, in short,  whenever revellents, sudden and rapid in their action,
» Op. cit. p. 29. 
272
CONTRA-IRRITATIO.—FIRING.
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 congenerous affections, and with equally satisfactory results.
There is one objection,  too, that applies to the use of these strong
lotions:—the sloughs and sores induced by them are often considerable,
and  remarkably difficult to  heal.   This,  it is true, may be partly
prevented, by being careful that  the  application is not too long con-
tinued; 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.

   Firing. Not long ago, Dr. Corrigan,1 of Dublin, strongly recom-
mended a mode of producing counter-irritation as an admirable remedy
in lumbago and  analogous affections  in other parts of the body.  It
consists in a species of "firing " performed by an iron instrument which
is very portable, and is formed of a thick  iron wire shank, about two
inches long, inserted in a small wooden handle, having on its extremity,
which is slightly curved, a disc or button of iron, a quarter of an inch
thick, and half an inch in  diameter, the whole instrument being only
six inches in length.   The face of the disc for application  is quite flat.
The  only other portion  of apparatus required is  a small  glass spirit
lamp, so small that it can be  carried  in the waistcoat pocket.  To use
the instrument, the lamp must be lighted, and the button held over the
flame, keeping the forefinger of the hand holding the instrument at the
distance of about half an inch from the button.  As soon as  the finger
 feels uncomfortably hot, the  instrument is ready for use, and the time
required for heating it to this degree is only about a quarter  of a minute.
 It is applied as quickly  as possible, the skin being tapped  successively
 at intervals of half  an inch  over the affected part as lightly and as
 rapidly as possible;  care being  taken to bring the flat surface of the
 disc in contact with the skin.   In this way, the process of firing a whole
 limb, or the loins, making about  one hundred applications, does not
 occupy a minute, and once heating the lamp suffices.   The iron is never
 rendered red hot; it is very little hotter  than boiling water, and an
 eschar is never made by it, and rarely a blister.   The pain produced
 by its application is so slight, that, according to Dr. Corrigan, some of
 the resident clinical clerks  in the hospital preferred  it, in their own
 cases, when suffering under local muscular rheumatism, to any other
 method  of  counter-irritation,—it being,  in  their opinion, the least
 troublesome, most rapid, least painful and most effectual.    In sprains
 of the muscles of the back and other  parts, and in sciatica, he has seen
 it render valuable service, as well as in neuralgia of the fifth pair, and
 in paralysis of the portio dura.   Even delicate females,  he says, will
 not object to its frequent repetition, when required.
    The  method of  Dr. Corrigan has  been extensively tried by  Dr.
 M'Cormack,2 who has reported very favourably in regard to its powers;
 by Mr. James  Dickinson,3 who  highly extols it in  the treatment of
 violent sprains of the back, and  by others.
   1 Dublin Hospital Gazette, March, 18 4fi.               Lancet, Jan. 5, 1847.
   ' Provincial Med. and Surg. Journ. Mar. 3, 1852. 
CORTEX ADSTRINGENS BRASILIENSIS.
273
        LXIX. CORTEX ADSTRIN'GEXS  BRASILIEN'SIS.
Synonymes.  Cortex Adstringens Brasiliensis  Verus, Cortex  Adstringens  Yerus,
  Astringent Bark of Brazil.
German. Adstringirende  Brasilianische Rinde.
  This bark was  introduced  into  Germany, in  the year  1818, by
Schimmelbusch, a  merchant, who carried  it from Brazil, where it had
long been used internally, as well as externally, as an excellent astrin-
gent.1  According  to Von Martius,2 it is  the bark of Acacia jurema,
but this is not certainly  determined.3   Oesterlen4 assigns it to mimosa
(acacia) cochliacarpa seu virginalis.   Merrem5 affirms, that the genuine
bark is in more or less flat pieces; at times, in half, or complete rolls,
from four to twelve inches long; from an inch to two inches and a half
broad, and  from one to four lines  thick; these  are more frequently
straight than crooked.   The bark may be separated into two parts; an
outer, which is  rough, and an inner rind, of a smooth, fibrous character:
the two are but loosely connected  together.  The outer bark  is of a
grayish-brown  colour, traversed by longitudinal and transverse furrows,
having, here and there, white and grayish-white crusty growths, covered
with a foliated lichen.   The inner  bark is of a dark-red brown on its
outer surface, and, after  the outer bark has been separated, is somewhat
smooth: on the inner side it is  of a bright 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 sepa-
rated 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, nor leave any arriere-gout.   It
has scarcely any smell.   In its chemical relations, it resembles rhatany.8
   Merrem, who made numerous experiments with the bark, affirms,
that, while  it possesses the properties of astringents in general, and to
 a high degree, it is rather sedative  than exciting; agrees with  the di-
gestive organs, and aids the peristaltic action.   He  employed it, first,
with  more  or  less success, in hemorrhage—in epistaxis, hsemoptysis,
 and metrorrhagia; and  Giinther7 found  it very efficacious in profuse
 menstruation arising from atony of the uterus.   Secondly;  in mucous
 discharges, as leucorrhcea, blennorrhcea, &c.   Thirdly; in inflammatory
 and exanthematous affections—as cynanche, urticaria, and in periodi-
 cal erysipelas  of the face.  Fourthly;  in nervous diseases, especially
 when associated with disturbance of the  menstrual  function, and leu-
 corrhoea: and, fifthly, in weakness  and catarrhs of the genital organs,
 bladder and rectum.   The Indians  consider, that the bark affects espe-
 cially the generative apparatus,  and, from the experiments of Merrem,

   1 Von Schlectendal, in Encyclop. Wb'rterb. der Medicin. Wissenschaft. B. viii. S. 538.
 Berlin, \&Z2.                                    a Reise, ii. 7.8.
   * Riecke, Die neuern Arzneimittel, S. 146.
   4 Handbuch der Heilmittellehre, S. 4.4.  Tubing. 1845.
   5 Ueber den Cortex adstringens Brasiliensis. Koln, 1828.
   ' See the analysis by Hofrath Trommsdorff, in  Brandes Archiv. B.  xxxiii. S. 260j
 and Dierbach, in Heidelberg.  Annalen, B. x. H. 3, S. 357.  Heidelb. 1834.
   1 In Harless Rein-Westphal. Jahrbuch, B. viii. St. 1, S. 72; and Brandes Archiv. Band.
 xi. S. 200.
     18 
274
CORYLUS ROSTRATA.
it would seem, that its agency is more particularly exerted in  cases of
leucorrhcea; and  in many after cinchona had been administered with-
out effect.1
                     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 dis-
charges unaccompanied  by disorder of the digestive functions; 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 Sviij.; and to this an ounce of syrup was added.   The dose was
from one to two spoonfuls every two hours.  Merrem also  prepared an
extract, and a tincture, in the same manner as these preparations
are made of  cinchona:  of the former, he took from one to two drams,
dissolved it  in six ounces of an aromatic water, and  added Sss. of
syrup.   Of the mixture, a spoonful was given every hour.
   Externally,  the decoction was  injected three  times a  day in leu-
corrhcea and blennorrhcea; or, in the former disease, a sponge imbued
with the decoction was introduced, and kept  there  for some  time.  It
has been applied, also, as an astringent to ulcers.

         Mistura corticis  Brasiliensis  adstringentis.
               Mixture of the astringent bark of Brazil.
                 R.   Decoct, cort. adstring. Brasil. f §vij.
                     Copaib. cum vitelli ovi q. s. subaet.
                     Tinct. ferri pomati, aa. f 3y-
                     Syrup, balsam, f^j.  M.
  Dose.—A  spoonful every two hours, in obstinate gonorrhoea and leu-
corrhcea.                                                Merrem.
                R.  Cort. adstring. Brasil. ^ss.
               Coque cum aquas fontan. q. s.
               Sub fin. coction. adde
                     Sabin. gss.
               Colatura. f Jviij. adde
                     Syrup, aurant. cort. f £j.
  Dose.—A  spoonful every hour in cancer of the uterus, and in the
hemorrhage thence arising.                               Merrem.
                  LXX. COR'YI^US ROSTRA'TA.
Synonyme. Beaked Hazel.

  Beaked hazel is a shrub two or three  feet high; Natural Order,
Amentacese; Suborder, Cupuliferae; Sexual System, Moncecia Poly-
andria,  which grows  in the  mountainous regions of North America.
The nut which it produces  is of an  ovate  shape, surrounded by a co-
        1 Osann, in Encyc. Worterbuch der Medicin. Wissensch. viii. 541. 
CREASOTUM.
275
riaceous 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.1

                     EFFECTS  ON THE ECONOMY.
   The short, stiff bristles  have been found to possess similar anthel-
mintic virtues with mucuna, and to be equal to it in all respects.   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 consistent
 vehicle, and in the same doses.
                      LXXI. CREASO'TUM.
synonymes. Creasoton, Creosoton, Creosotum, Kreosoton, Kreosotum, Oxyhydro-car-
  buretum ex Oleo Pyroxilico Paratum, Creosote, Creasote, Kreosote, Kreasote.
French. Creosote.
German. Kreosot.

  This substance was first discovered, several years ago, by Reichen-
bach, of Blansko, and is extensively employed as a therapeutical 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 accuracy 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 creasote forms  a valuable addition to the list of
our remedial agents.

                      METHOD  OF PREPARING.
  The process given by Koene,2 is esteemed one  of the  best for  pre-
paring 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—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 necessary 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

  1 Duhamel, Amer. Journal of Pharmacy, Jan. 1843.
  1 Annales de Chimie et de Physique, Juillet, 1835.  See Cormack on Creasote, p.
36, Lond. 1836; or the Amer. edit, in Amer. Med. Library:  also, Turner's Chemistry,
5th edit. p. 872, and Christison, Dispensatory, p. 374, Edinb. 1842. 
276
CREASOTUM.
the retort, where it unites with the naphthalin, forming a butyraceous
substance.  By applying a gentle heat, the mass drops into the recei-
ver.  The product is now allowed to remain in a  cool  place for some
hours, after which it is pressed.  The expressed  naphthalin still  con-
tains 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 car-
bonate 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 al-
lowed 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  separated.   It  is
again rectified;  and the  first  product, which  is chiefly water, being
rejected, the creasote comes over pure.   M. Koene recommends the
substance, thus prepared, to be  preserved in bottles covered with black
paper.
   A  protracted and complex process, like the above, necessarily makes
the drug expensive, especially as the quantity  obtained is  but small.
M. Koene procured by  it ten  drams from thirty-two ounces of tar.
M. Lemere, one  of the first  Parisian pharmaciens who  made pure
creasote, obtained from  eight hundred pounds of tar about six pounds
of creasote.
   Reichenbach generally prepared it from the tar of the beech by six
distillations; dissolving it afterwards in a  solution of  caustic  potassa
three times, and  setting it free successively by  sulphuric acid.1
   Creasote is  a colourless, transparent fluid.   Its  refractive power is
very  great,^ and in  angular glass vessels  it is beautifully iridescent.
Its odour  is penetrating, and  disagreeable, but  not offensive: many
compare it to that of  castor.  It adheres  to every thing, and is some-
what permanent.   Its taste at first is very burning and caustic to the
tongue;  but on admixture with the saliva, it becomes somewhat sweet-
ish.   It has an oleaginous feel,  and is  of  about the consistence of oil
of almonds.  Its specific gravity, at 68° Fahr., is  stated by Reichen-
bach to be 1.037;  but Dr. Christison2  affirms that he has never found
it lower than 1.065, or  higher than 1.067.  The fact is, of course,  of

  1 For an account of this and other products of the destructive distillation of vegeta.U
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  Zusatzen von Schweigger-
Seidel verm. Ausgabe. Leipz. 1835;" see, also, Annales de Chimie, liii. 325. Paris, 1833.
lor the process of  Giordano, see Annali di Medicina, Aprile, 1835, cited in Brit, and
For. Med  Rev. July, 1836, p. 283; for that of Calderini, Edinb. Med. and Surg. Journ.
t    ,_.;«' ««  for that of Gozzi> Journ-de Chimie M.d. and Amer. Journ. of Pharm..
Jan., 1839, p. 339.
  1 Dispensatory,  p. 374, Edinb. 1842. 
CREASOTUM.                        277
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 awhile, and  can be removed  by the
application of a heated body without  any residue.   It is a non-con-
ductor of electricity.   With water at  68°, it  unites in two different
proportions—one of the combinations consisting of 1^ 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
weaker.  A drop of creasote in  10,000  parts of water  produces a
marked impression on  the  tongue, and has a smoky smell.  Litmus
and turmeric paper are not in the least changed by it;  so that it has
neither an acid nor an alkaline reaction. At both poles of the galvanic
battery, it furnishes numerous and  striking combinations.  It  does
not possess  the property of the ordinary empyreumatic   oils,  of be-
coming yellow and inspissated.   It dissolves iodine, phosphorus, and
sulphur.   Acetic acid at 1.070, and alcohol, dissolve it in all propor-
tions, and with the latter it is often adulterated.1  Ether  and petroleum
likewise  combine with  it in all proportions.   With potassa, it forms
two or three combinations, one of which crystallizes.  Resins and re-
sinous bodies either decompose creasote, or it decomposes them.  With
balsams, fixed and volatile oils, camphor, and the vegetable alkaloids,
it unites readily.   It coagulates albumen, and its  antiseptic property
is most remarkable, whence its name, from xp*a., "flesh," and aa^u,
"I preserve,"—uw^p,  "-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 putrefaction.
Nay, when flesh has begun to be putrid, the process ceases after it has
been washed with creasote water; and if suffered to remain immersed
in it for an hour, it does not  subsequently putrefy.  There can be but
little  doubt, consequently, that  creasote is the main antiseptic  and
conservative principle of pyroligneous acid and tar water.   From the
experiments made  by Reichenbach to determine the exact  components
of the flesh on which the creasote acts, he arrived  at the following re-
sults.  It unites with the albumen of  the blood in the  flesh, which it
coagulates, and with the red particles, without  acting  on the  fleshy
fibre, which serves  merely as the frame-work for the coagulated mat-
ters ;  and it is well known that  dried albumen does not putrefy, but
becomes hard, brittle, and transparent.

              EFFECTS  ON THE  ECONOMY IN HEALTH.
  Reichenbach has properly remarked, that the  excessive burning
pain in the tongue, which creasote causes, must have at once suggested
it to be a poisonous substance.  It was soon found that plants, sprinkled
with creasote water, died; that fish placed in it were convulsed;  and
that small animals, as wasps and flies, died when touched with 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 appear-

   1 Journal de Chim. M.d. and Amer. Journal of Pharmacy, July, 1841, p. 112.
• 
278
CREASOTUM.
 ance, but without pain or inflammation.   In the course of a few days,
 the place becomes dry, and the cuticle desquamates.   When creasote
 is applied to a part where  the epidermis is  deficient, or to a wound,
 instantaneously  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 which creasote possesses of coagulating albumen; and, where
 Wood  is flowing, of  arresting it.   If the rapid disturbance which it
 excites, affects  important organs, death results sooner  or later, ac-
 cording to their  importance in the economy:  relief, however,  may be
 afforded by those  substances  that dissolve  coagulated  albumen, as
 caustic  alkalies, acetic  acid, &c.   It is probable,  however, that the
 poisonous properties result from its acrid character.
   To appreciate the physiological effects  of creasote experiments have
 been undertaken by many individuals.   Mignet gave a young dog,
 for eight days, an ounce a day of distilled water containing four drops
 of creasote, without  any effect.   When, however, 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 recovered its flesh.  To  another dog,  he  gave at once
 two drams in half an ounce of water, and immediately thereafter great
 prostration 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 vomiting of a milky
 matter, although the animal had taken nothing of the kind.   After
 two hours' suffering it died of convulsions.    The body  was immedi-
 ately opened: all the tissues, except 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 simi-
 lar phenomena, but more rapidly.   The  precise quantity of creasote
 used in this experiment is not stated.
  Simon, in his  experiments, found that  when ten drops  of creasote,
 diluted, were injected into a vein, scarcely any effect resulted.  Reiter
 and Muller, who  likewise made experiments  on animals, agree with
 Simon as to the result of injections of creasote into the veins; no spe-
 cial symptoms were induced  by it, but this appeared to  be owing to
 the blood being instantaneously coagulated by it, which not only pre-
vented the farther progress of the creasote, but  also of the blood; hence,
no evil consequences resulted;  and, it is probable, as Riecke has sug-
gested,1 that the weaker the solution of creasote, within certain limits
the greater may be its effect on the mass  of blood.

                 1 Die neuern Arzneimittel, u. s. w. S. 153.
• 
CREASOTUM.
279
   Cornell ani,1 an Italian physician, has also instituted a series of ex-
 periments with creasote  on lambs, rabbits, &c.  All these  animals
 bore small4doses of creasote—however unwillingly it might be taken—
 without any remarkable results, and without loss of appetite.   Laro-e
 doses, however, immediately occasioned general torpor, sudden incli-
 nation to pass the urine, paralysis—especially of the lower extremities
 —with or without convulsions, and frequently the ejection of a bloody
 foam.   When  the doses were large, and 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 al-
 low of death being ascribed to that circumstance. It followed, farther,
 from his experiments, that pure  creasote applied to a denuded nerve,
 or  injected only in small quantities into a vein, may occasion death
 suddenly; and  that the application of the creasote to extensive wounded
 surfaces  in the same animals may be ultimately followed by  fatal  con-
 sequences.   Where  a very large dose of  creasote was  administered,
 immediate death was produced without organic lesion.
   In  the trials made with it by Dr. Elliotson2 he found no action pro-
 duced 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 ap-
 pearance, 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 mixture  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 inter-
 nal and external diseases,  affirms, that he has never observed any caus-
 tic effect from it: from  which assertion, as Riecke has remarked,3 the
 only inference  to be deduced is, that he must  always  have applied it
 largely diluted.  Fremanger likewise asserts, that when pure creasote
 is applied to the epidermis, it does not destroy it; but merely  occasions
 more or  less redness  of the  skin.   When  applied  to  a  suppurating
 surface, it caused, instantaneously, the formation of a white pellicle,
 owing  to its coagulating the  albumen contained in the  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 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,

  1 Giornale delle Scienze Medico-Chirurgiche, No. 8, Fcbrajo, 1835 , cited in Brit, and
For. Med. Review, p. 265, Jan. 1836.
  2 Modico-Chirurg. Transac. vol. xix.   Lond. 1835.            s Op. cit. S. 154. 
280
CREASOTUM.
indeed, disposed to refer all its  efficacy to the action which it exerts
on albumen.
  Its long-continued  use often occasions  an inflammatory condition
which, as Dr. J. L. Da Luzx observes, has nothing in common 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 su-
pervened, and  the head was  covered by an  artificial eruption, which
induced, however, a  new action in the system of nutrition of the scalp,
and, after its subsidence, the  porrigo disappeared.
  Dr. Cormack, of Edinburgh, instituted various  experiments on the
lower  animals,  to  test  its physiological  effects.2   In three experi-
ments, 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 follow-
ing 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 instantaneously paralyzed.  In some instances, hurried and so-
norous respiration 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 it is injected 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 inconveni-
ence,—a circumstance which proves the importance of a thorough ad-
mixture 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 in-
jected into the arteries, and consequently distributed through the  sys-
tem of nutrition.
  When taken for  any length of time, the  urine acquires a blackish
hue, and, in some cases, creasote may be recognised  in it.3

               EFFECTS  ON THE ECONOMY  IN DISEASE.
   Creasote has been  administered in various diseases; the following
may  be esteemed a summary of the chief therapeutical experiments
made with it.
  Hemorrhage.—The discovery of creasote happened  at a time when
the Acqua Binelli enjoyed more confidence as  a styptic  than it does
now; and  the fancied probability, that the  nostrum was  indebted to
creasote for its properties, gave rise to many experiments with the lat-
ter in cases of hemorrhage.  One of the  first,  who instituted experi-
ments with it  on rabbits, was  Gr. 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

  1 Journal da Sociedade das Sciencas Medicas de Lisboa, torn. v.  Lisboa, 1837; reviewed
in Zeitschrift fiir die gesammte Medicin.   Oct. 1838, S. 224.
  J Op. cit. p. 66.                 3 Macleod, in Med. Gaz. xvi. 599, and xvii. 653. 
CREASOTUM.
281
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 in-
fluence of creasote, he found to  be of no  advantage, as  the  mass re-
mained soft and pulpy;  and the wound in the vessel would not  close,
but was immediately opened by the stream of blood.   Neither did he
esteem it  adapted for  arresting trifling hemorrhages; for, when very
much diluted, it was still too exciting to the injured parts, and greatly
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 favourable.   Mailer and Reiter,1
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 hemor-
rhage.  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 mi-
nutes 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 en-
tirely 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 wholly closed, having a navel-
like depression at the extremity, which disappeared when the vessel
was pressed upon, and  ultimately became conical.   Within the vessel
there was a conical coagulum, which could  be readily detached; and
for the space of a line, the artery  appeared inflamed through its coats.
In arteries that had been divided for  a longer time, the union was like-
wise complete; but there was this  difference, 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, Muller and Reiter were led to confirm the
haemastatic properties  of creasote, both when the  hemorrhage occurs
from veins and from arteries.  The arteries divided were  of consider-
able size, larger  than the radial artery of an adult male.  They con-

  1  Schmidt's Jahrbuch., cited in Encyclographie des Sciences Medicales, Mars, 1837.
See, also,  Burdach, Medicin. Zeitung. Jahrgang, 184t0, No. 31, and Lond. and Edinb.
Monthly Journal of Med. Science, May, 1842. 
282
CREASOTUM.
 sider pressure indispensable to occasion the creasote to act immediately
 on the artery; and the arrest of the hemorrhage, they ascribe, not alone
 to the coagulation of the blood, but to the contraction of the arteries.
 In parenchymatous hemorrhage, creasote water was generally suflicient;
 as well as in tolerably extensive wounds of the surface.   Horing, also,
 obtained satisfactory results from his experiments on animals.  He
 exposed, on an old cat, the crural artery and vein of the right side;
 made  a  small incision into the latter,  and pressed upon  it to stop the"
 copious  flow which ensued; he then applied over the wound, for two mi-
 nutes, a small compress of lint, wetted with a solution of creasote—two
 drops  to one hundred of water—and the bleeding ceased.  The artery
 was now opened,  and a  similar compress placed upon it with the same
 result.  Two days afterwards, a second experiment was made of the
 same kind, except that,  owing to the struggles of the animal, a larger
 opening was made into the crural artery.   In this case,  it was necessary
 to apply the compress for four minutes before the  hemorrhage  ceased.
 In another cat a large transverse incision  was made into the inner sur-
 face 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 mi-
 nutes, and the bleeding entirely ceased.  The like result was obtained in
 the case of an old  horse,  whose jugular  vein was opened.  But the crea-
 sote 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 in-
 stituted  on the human subject, which  testify, more or less, to the efficacy
 of creasote as a haemastatic.   Hahn applied it in some insignificant
 cases,  but saw no  better effect from 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 re-
 sisted other agents,—two plugs of lint,  dipped in a solution of creasote,
 being inserted in the  nostrils, after which  the hemorrhage soon ceased.
 Fichtdauer employed it with equally advantageous results in  violent
 bleeding from leech bites, after several haemastatics had  been used in
 vain;  and Heyfelder extols  it for arresting hemorrhage from large
 wounded surfaces.  Berthelot differs with Fremanger and Simon, who
 affirm that union by the first intention is prevented by  it.  The results
 of his  observation were opposite.   Miguet applied it successfully as a
 haemastatic in fresh wounds on man and animals.  Both pure creasote,
 and a  solution of  it were, however, unsuccessfully used by Bardili in
 hemorrhage from  the arteria tibialis postica, which he ascribed to the
 blood having lost its albumen, owing to the excessive discharge.   Reich
and Hauff found injections with creasote water useful  in hemorrhagic
 uteri.  In metrorrhagia in non-pregnant women, and in some cases
 of hemorrhage prior to delivery owing to placenta pravia, it was found
very useful by M. Arendt.1 He esteems it, indeed a  valuable ha.mastatic
whenever the bleeding proceeds from  small vessels,  and  especially those
of mucous membranes.  In some of  these cases, a more concentrated

    1 Froriep's Tagesbericht, and Brit, and For. Med. Chir. Rev. Oct. 1853, p.  558. 
CREASOTUM.
283
 mixture is required—as 10 to 20 drops to the ounce.   Schneider had
 a  case of hemorrhage  that had continued for seven hours in a  man
 eighty years old, 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.   Kohler1
 endeavoured to test the haemastatic operation upon himself.  He made
 an incision in his forearm an inch long, and three or four lines deep,
 to which he  applied creasote water.   A lancinating pain was felt in the
 wound, but no other sensible 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
 of 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
 Borne time; the edges of the wound were somewhat swollen and oedema-
 tous, 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 hemor-
 rhage by any of the usual means, and no particular vessel could be dis-
 covered 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 intro-
 duced into the wound, and pressed against the  bleeding parts for an
 instant or  two.   The hemorrhage was immediately arrested.   No par-
 ticular pain was experienced; no unpleasant symptoms occurred; thin
 eschars were thrown off, and the patient  recovered.2   J. L. da Luz3
 found it an excellent styptic in capillary hemorrhage ; but in hemor-
 rhage from great vessels it did not prevent a recurrence of the bleeding.
 In hsemoptysis,  its internal use has been  found beneficial.   Santini4
 prescribed  it in a desperate case  with complete  success, and with
 Schmalz it was  equally  effective; but  it was of little avail in Guitti'a
 hands.  In hamatemesis, it succeeded with Dr. Isaac Parrish of Phila-
 delphia,5 after the remedies generally employed in such cases  had
 failed to produce any  effect.  Dr. Wm. T.  Wragg,6 employed  it inter-
 nally with advantage  in a variety of  hemorrhages—as flooding after
 abortion; flooding  where there  was no pregnancy;  hemorrhage from
 the stomach and bowels;  hemorrhage from the bladder, and hcemoptysis;
 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 wo are  often embarrassed."  He extols it also
 as  a haemastatic in traumatic hemorrhage: and a case is given  by Drs.

 1 Xeue Wissenschaftlich. Annalen, r. s. w. B. i. II. 3, S. 285.  Berlin, 1835.
 8 Daser, Edinb. Medical and Surgical Journal, Oct.  1841.               s Op. cit.
 4 Gazetta Terapeutica di Verona, Mars, 1834; and American Journal of the Medical
Sciences, Feb. 1836,  p. 502.
 6 Medical Examiner, Aug. 10, 1839, p. 501.
 • Southern Journal of Medicine and Pharmacy, March, 1846, p. 128. 
284
CREASOTUM.
J. L. Lawrence Smith and S. D. Sinkler,1 in which a mixture of crea-
sote, "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, however, that when  the emulsion of creasote
is applied to the divided artery of the sheep, ^depends greatly, if not
altogether, upon the manner in which the lint is applied to the wound
in the  artery, whether the hemorrhage  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."
   Its effects as a  haemastatic  suggested it  to Dr.  E. W. Faulcon,2 of
North Carolina, as a remedy in a case of mercurial salivation,  in the
form of gargle made by half a dram of creasote to a pint of sage tea,
which was used every hour  during the first day.   The  effects were ex-
cellent.
   Burns.—Most used creasote with decided relief  in burns of the  se-
cond 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 for-
mation  of  a crust.  Guitti applied both creasote water and creasote
ointment with advantage in burns which had proceeded to profuse sup-
puration;  and Dr. Sutro3 strongly recommends an ointment of  crea-
sote, the  formula  for which  is given hereafter; and  advises it to  be
kept ready prepared under the name of 'burn ointment.'
   In profuse suppuration,  it  has  been  advised, on the  authority  of
Levrat  and Berthelot; but,  according to J. L. da Luz,4 it has  no
marked influence on the secretion of pus, and  is  therefore useless in
suppurating abscesses.   In otorrhcea it has been especially beneficial.
   Lesions of  the integuments.—According to Reichenbach, creasote
is of essential service in  the intertrigo of children, as well as in exco-
riations 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 ho-
mogeneous serous  fluid, but no pus.
   Horing  employed  creasote  water  with  advantage in sore nipples;
and creasote ointment has been recommended by Dr. Fife,5 in sprains
and contusions.
   In chilblains, whether ulcerated or not, Hahn8 used creasote washes
successfully;—the affection yielding in a few days; and Dr. Herndon7

  1 Ibid.  July, 1816, p. 403.               2 Medical Examiner, Nov. 1838, p. 656.
  s Medical Times, Jan. 4, 1845, p. 314.                     * Op. cit.
  5 Lond. Med. Gaz., April 7, 1838, p. 66.      6 Gazette Medicale de Paris, Dec. 1831
  » Amer. Med. Intelligencer, March 15, 1838, p, 425. 
CREASOTUM.
285
regards creasote  ointment as the best remedy in that affection with
which he is acquainted.  M. Devergie also extols an ointment of cre-
asote, subacetate of lead and opium in the proportions given hereafter.
   Ulcers.—Fissures  of the skin  and superficied ulcers,  according 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, especially of the leg, has been attested by
Levrat, Berthelot, Rossi, Hechenberger, and others; but  Guitti, Hey-
felder,  and Schmalz were  less satisfied with it.  A case of indolent
ulcer between the knee and ankle, accompanied with a good deal of in-
flammation, 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 of the limb, by means of  a bandage.1  Bresciani de Borsa2
considers it a ' sovereign remedy' for indolent and obstinate ulcers.   He
applies it in the form of a lotion, consisting of six  drops of creasote
to four ounces of water, gradually increasing the strength to  ten or
twenty drops.   Meister found the application of creasote water, in cases
of carious, scrofulous,  syphilitic, fistulous, and sanious  ulcers, to be
strikingly and almost uniformly advantageous.   Heyfelder,  likewise,
found it extraordinarily useful in scrofulous ulcers, and Dr. Cormack3
Btates that he had an opportunity of  seeing a case of the  kind treated
by Dr. Shortt, in the Royal Infirmary of Edinburgh,  where an exten-
sive scrofulous ulcer of the hip, after resisting a variety of treatment,
at  last yielded to creasote, and was ultimately completely cicatrized.
 On the other hand, Otto tried both pure creasote and the watery solution
in ulcers of various kinds, especially the scrofulous: the ulcers very gene-
rally put on, in the course  of twenty-four hours, a cleaner appearance;
still they did  not cicatrize;  on which account Otto prefers, in  old ul-
cerations at least, the  use of  a solution of chlorinated lime; for not-
withstanding  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 sup-
puration, local pains, loss of sleep, and slight febrile movements gene-
rally 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 scrofulous
 caries.  Among these may be  mentioned Hahn, Coster,  Ritgen, Fre-
 manger and Hauff.  In fistulous  ulcers—also of syphilitic  origin-
several physicians have employed it  beneficially.  Dr. Fife,4 of IScw-
 castle-upon-Tyne, found it useful  not merely in obstinate but in ma-
 lignant 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 poul-

  1 Boston Medical and Surgical Journal, July 3, 1839, p. 332.
  'Gazette des Hopitaux, Sept. 19, 1846; and Ranking's Half-yearly Abstract, January
to July, 1847. p. 199.
  s Op. cit. p! 106.                  4 Lond- Med- Gaz-> APrU 7» 1838> P" 65* 
286
CREASOTUM.
tices, was applied with advantage by Dr. Herndon,1 of Culpeper C. II.
Virginia.  In scurvy and in scorbutic ulcers, M. Coen2 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
Luz3 considers it an excellent cleansing remedy in  atonic ulcers, but
its prolonged use, he  thinks, retards cicatrization.   In hospital  gan-
grene, 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.  Ac-
cording to Reichenbach, two offensive affections of the  labia pudendi
—the consequences  of infiltration of blood—were cured  by it; and
Reich and Sir Francis Smith4 treated with success  cases  of cancrum
oris; and the former, one of scorbutic ulceration  of the  gums.  In
herpetic ulcers,  Horing and Berthelot  observed favourable effects  from
creasote water; and it has been found especially useful in carcinoma-
tous and syphilitic ulcers,  in which  it has  been  often employed.  In
cancer of the uterus, Wolff injected it, in two cases, into  the vagina.
In one, the pain was so great, that,  on the  ninth  day, after six pints
of creasote water had been used, it was  obliged  to be discontinued.
In the other case, the treatment was continued twenty-six  days, and
sixteen pints were used:  in it, also,  the pain was sensibly aggravated.
The secretion was not improved in  either  case, nor was  hemorrhage
prevented by it; for one of the patients died  immediately after an at-
tack of this kind: the other lingered  a long  time.   Heyfelder found
injections of creasote water, in conjunction with the extractum calen-
dulas, of no use in cancer uteri.  On the  other hand, in a case of su-
perficial ulceration of the os uteri, with copious discharge of a puriform
mucus, which had been treated unsuccessfully by other agents, for se-
veral months, Hahn found an injection of  creasote  water effectual in
fourteen days.  Tealiers has  likewise reported  a case of superficial
ulcerations around the os uteri, to which nitrate of silver had been ap-
plied 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  mix-
ture 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  last two 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

  1 Amer. Med. Intelligencer, March 15, 1838,  p. 425
  * Giornale per Servire, &c, di Venezia, 1836.
... J?urn- da Sociedade das Sciencas de Lisboa,  T. v. Lisboa, 1837; noticed in Zeitschrift
fur die gesammte Medicin, Oct. 1838, S. 224.
  * Dublin Journal of Med. Science, for May' 1837
  s Revue M6dicale, Fevrier, 1834.  For  similar cases, see Friese, in Berlin Medicin.
Zeitung, Nro. 13, 1837. 
CREASOTUM.
287
the teeth of that side except one, and which 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 Cormack1 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 lip, the cure of which,
he believes,  he accomplished by means of creasote.2  Garbiglietti cured
a fungous ulcer with caries of the fibula by creasote, but it is question-
able  whether the ulcer was carcinomatous; and Meisinger saw cancer
of the face improved by the use  of creasote ointment.
   It has been before remarked,  that Meisinger used creasote with ad-
vantage in syphilitic ulcers.   Hahn also applied creasote water in pri-
mary syphilitic sores ; the small, superficial ulcers healed soon; the larger
and deeper remained stationary.   In a phagedenic ulcerated bubo, the
spreading was arrested, but this was all.   According to Heyfelder,
creasote—probably  pure—excited, in  a case of primary  syphilitic
ulcer, in a plethoric individual, violent inflammation, and so much sen-
sibility, 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 sy-
philitic ulcers successfully with it, giving, however, at the same time,
the corrosive chloride of mercury inwardly.  Cltronic venereal ulcers
have in some  cases yielded  to  it, after they had resisted every other
kind of treatment.3  Dr. Biirkner, of Breslau,4 reports  a case, which,
after having  proved rebellious  to every kind of general and local
management that could be devised, at length  yielded to the application
of pure creasote  by means of a camel's hair  brush.   The  character
of the secreted pus  immediately improved; the wound began  to  heal
by granulations from the base; and, at  the end of four weeks, Dr.
Biirkner found his  patient quite well.   In 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,5 Fricke, and  Coen,e
also  found creasote efficacious in these cases.   The last gentleman but
one had the  most  frequent opportunities for observation; by him, crea-
sote, in a diluted  state,  was applied to the top of the condylomata 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 disappeared;  but when once they fell  off
they did not return.
   Gonorrhoea  and Leucorrhoea.—Most extols  creasote water as  a
remedy in gleet.   He applies  it  either in the  way of injection, or by

  1 Op. cit. p. 115.          2 Gazette M.dicale de Paris, F<_v. 1835.
  3 Cormack, Op. citat. p. 107; and in  Lond. and Edinb. Monthly Journal of Medical
Science, Oct. 1M2.  See, also, Kiinchel, in Bulletin Gcner. de  Th.rapeutique, p. 313.
Paris, 1S33.                   * Casper's Wochenschrift, Sept. 9, 1837, S. 583.
  6 Hufeland's  Journal, Jan.  1834, and Revue Medicale, Mai, 1834.
  6 Uiornale per Servire, &c, di Yenezia Aif. 1836. 
288
CREASOTUM.
  small tents wetted with it and introduced into the urethra.  In leucor-
  rhcea,  he  strongly recommends  both its  internal  and  external  use.
  Reich injected creasote  water in a case of gonorrhoea,  and in one of
  malignant leucorrhcea; yet its agency in  these cases wasdoubtful, as
  copaiba was given  at  the  same  time.   Hahn1 also used injections of
  creasote water in the second stage of gonorrhoea and in  gleet; but he
  did not think that the discharge ceased sooner under its agency than
  under the ordinary means; whilst, in some cases, the inflammation was
  even augmented.  In two cases of benign flluor albus, after many other
  remedies 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
  relief.   Mr. Arendt2  states, that he has generally been able to  cure
  ordinary cases of leucorrhcea in three or four days, by weak injections
   of creasote, two drops to the ounce  of water, repeated  twice or thrice
   a day.  Dr.  Elliotson3 gave it internally to a female labouring under
   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 minims, but
   no good resulted from it.   Dr. R. H. Allnatt4 has used creasote in-
   jections in gonorrhoea and in leucorrhcea with very satisfactory results.
   He proposes the remedy also for  cases  of gleet  occurring  in flabby
   leucophlegmatic males.   The formula for an injection  used by him is
   given hereafter.
      The author has administered it not unfrequently in Zeucorrhoea and
   other mucous discharges, and, when  persevered in, it has at  times
   appeared to be  of  decided  service.5   Dr. Robert  Dick,6 of  Glasgow,
   has called the attention of the profession to its use in the chronic stage
   of gonorrhoea, and in gleet.   He thinks its beneficial effects are more
   obvious  than those  of  copaiba.   He administered it  in doses of two
   drops with loaf sugar beaten into  a  syrup with water; and M. Em.
   Rousseau7 has  used it successfully in the acute stage of gonorrhoea in
   the proportion  of gr.  xvss. of creasote to half an ounce  of water.  The
   dose  of this  was three or four drops, from four to six times a day, in a
   wineglassful of sugared water; injecting, five or six  times a day, three
   drops in a glassful of decoction of marshmallow.
      Cutaneous affections.—Br. Fahnestock,8 of Pittsburgh, uses creasote
   in erysipelas, as a local remedy,  and so successfully, that, in a practice
   of many years, he has not  seen  a case that did  not  yield to it.  In
    every case of local erysipelas of the face or elsewhere,  he applies pure
    creasote, with  a camel's hair brush, over the whole   of the affected
    surface, and to some distance beyond the seat of inflammation; and,
    at the  same time, prescribes calomel, followed by  jalap  in sufficient
    quantity to  induce free catharsis.   In the  majority  of  cases, this is all
    that is needed.   In the phlegmonous form, it is necessary to repeat the

      1 Gazette M edicale de Paris, Dec. 1834.
      2 Froriep's Tagesbericht, No. 627, 1853, in Ranking's Abstract, xviii. 197.
      3 Lancet, for Dec, 1835, p. 435.           * London Lancet, Dec. 31, 1842, p. 5M-
      6 See, also, Coen, in Giornale  per Servire, &c, di  Venezia, 1836; and Dr. Wm- L
    Wragg, Southern  Journal of Medicine and Pharmacy, March, 1846, p. 128.
      6 Edinb. Med. and Surg. Journal, April,  1838, p.  602.
      i L'Abeille M.dicale, Avril, 1847, p. 96.
      8 American Journal of the Medical Sciences, July, 1848, p. 152. 
CREASOTUM.
289
application more frequently than in the simple, with the addition of a
bread and water cataplasm, applied nearly cold,  and well  sprinkled
with water strongly impregnated with creasote; or a cloth may be kept
constantly wet with  the  solution, especially when the face is the seat
of the affection.   The creasote  should cause the parts  to become white
immediately; and it is worthy of observation, that the  skin does not
remain in the least marked by  the application, no matter how  often it
is applied.  Reich treated a case of crusta lactea externally by crea-
sote, and internally by the  mild chloride, and the black sulphuret, of
mercury.   The result was favourable.   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 Coen1
extol the water and  the  ointment in  inveterate  itch.   J. L. Da Luz2
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 ad-
dition, general baths of warm water.  The eruption commonly disap-
peared very rapidly under this  management, but it speedily recurred,
unless general bathing was  used at the  same time.  It again yielded,
however, very readily to creasote water.  Grandjean, Reich, and Kohler,
also applied the water  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 com-
bined with them.   Even in herpes exedens, the external application
of  creasote was  found  effectual  by Ritgen, Grandjean, and  Rossi.
Wolff3 cured a case of ancient  impetigo in about eight weeks, by a so-
lution of  creasote (Creasot. f 3ss«j 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 day to day until the cure was
completed.   Dr. Herndon, of  Culpeper  C. H., Va., derived  much be-
nefit from the ointment in psoriasis.  In a case  of acne rosacea of se-
ven years' standing, accompanied with  headache, nervousness, thirst
in the morning and  acid eructations, for which the patient—a female
—was put under treatment for a month, without  success, Dr. Elliot-
son4 determined on trying creasote.   The advantage was soon mani-
fest, as in three days the eruption was evidently diminished.   At first,
she took two minims three times a day;  this was gradually augmented
to twenty minims,—the farther increase of the dose being prevented by
the supervention of giddiness  and tremors.   At the  end of seven

  1 Op. cit.
  2 Journal  da Sociedade das Sciencas Medicas de Lisboa, torn. v. Lisboa, 1837, noticed
in Zeitschrift far die gesammte Medicin. Oct. 1838, S. 224.
  3 Medicin. Zeitung, u. s. w. No. 30, 1834.           * Lancet, July 4, 1834, p. 459.
       19 
290
CREASOTUM.
 monHis, she was discharged;  the eruption being scarcely perceptible,
 and the dyspeptic symptoms entirely removed.  In a chronic pustular
 disease, not curable by antiphlogistics, the  same  gentleman observed
 better  effects  from  it than from any remedy previously prescribed.1
 Dr. Copland found a saturated  solution in water  answer well  as a lo-
 tion in porrigo favosa?  The author has  often used it in porrigo, both
 creasote water and creasote ointment, (see  the formulre 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  induced, that they had  to be  discontinued for a  time.
   In cases  of  chronic inflammation of the free edge  of the  eyelids,
cures were effected by Coster, and G.  T. Black;3 by the  former, from
the use, twice a day, of a dilute  solution  of creasote  {Crcasot.  gu xij.;
Aq, destillat. f Sij.) applied by  means of a camel's hair pencil.   The
cure was  complete in ten days.   The  formula for the lotion used by
Mr. Black is given afterwards.  An  ointment of it has also been found
of essential  service in various forms  of strumous ophthalmia, by Dr. C.
C. Hildreth, of Zanesville, Ohio.4  In chronic varicose ophthalmia, M.
Arendt5 found from one to three  drops of creasote  to  an ounce of
water a valuable collyrium; a little being dropped into the eye several
times daily.  In different kinds of ophthalmia, M. Sanson used creasote,
but never observed the disease to be modified by the treatment.6
   In cases of prolapsus vaginss,  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, omitting it only at the
time of menstruation.  It  excited  a burning sensation of  a few mi-
nutes'  duration.   At the  expiration of  the time  mentioned, the pro-
lapsus had strikingly diminished, and  the  great sensibility of the  pro-
lapsed parts had disappeared.   Owing, however, to the supervention of
irritation in the urinary bladder, it had to be discontinued, when there
was every prospect of ultimate success.
   Dr. Buttmann7 has given the case of an  old lady, upwards of  seventy
years of age, who had laboured  for several years under oedema  of both
legs, to such an  extent  as to  interfere  materially  with progression.
She experienced  lancinating pains in  both feet, and irregular pa-
roxysms of fever.    Many external and internal remedies  had been
used in vain, when, by way of experiment,  he applied cataplasms of
creasote,  soon after which the  swelling,  very much  to his astonish-
ment, gradually disappeared, and with it the febrile attacks.
   In toothache from carious teeth,  creasote has often been used, being
 applied to the hollow of the tooth by means of a pencil, or of cotton

   1 Medico-Chirurg. Transact, xix. 237.  Lond. 1835.
   2 Gully's edition of Magendie's Formulary, p. 204.  Lond. 1835.  See, also, Sir F.
 Smith, in Dublin Med. Journal for May, 1837,  and J. L. Da Luz, Op. cit.
   s London Lancet, Aug. 7, 1841.
  *■ Amer. Journ.  of the Med. Sciences, Oct. 1842, p. 364.
   5 Froriep's Tagesberichte, No. 627, and Brit, and For. Med. Chir. Oct., 1853, p. 558.
   6 Comptes Rendus des Seances de la Soci.te de M.decine, Stance du 7 Mars, 18:;4._
  7 Beitivgen zum Sanitats-Berichte des Frankfurter Regierungs-Bezirks: and Medicin.
 Zeitung, Dec. 7, 1836, S. 252. 
CREASOTUM.
291
imbued with it.   The testimony in its favour has been very great.  It
has been extolled by Coster, Reich, Hahn, Kneisel, Heyfelder, Fitch-
bauer, Hauff, Otto, Guitti, Kohler, Meisinger,1 and numerous others.
Some have advised a  collutory of creasote, but this is more disagree-
able,  whilst it is less  efficacious than  creasote  applied immediately to
the carious tooth.  It excites instantaneously acute pain and a consider-
able secretion of saliva.  The pain of toothache is often relieved by it,
but it generally recurs;  and perhaps the advantage derived from this
agent is not greater than from any of the stronger  essential oils.   As
a palliative it is very useful.  In rheumatic toothache, the  insertion of
a little cotton, imbued with creasote, in the  ear of the same side,  has
been  found  serviceable.2  Although, however, it  alleviates the pain
of toothache, it has been considered  to hasten the destruction of  the
tooth.3
  In deafness, apparently owing  to deficient  secretion from the ceru-
minous follicles, advantage has been found from its use, after  the  ear
had been syringed.   Perhaps  as  good a form as  any is  that recom-
mended by Mr.Curtis,4  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 prepara-
tion contra-indicated in  cases of otorrhcea attended by pain or inflam-
mation.  Dr. Partridge,5 who  has seen  many excellent  effects from
creasote in such cases, prefers  to commence with half a dram 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
the occasion may require, often using it as strong as one part to three
of oil.
  In  cases of navi, Dr. Thornton6 found it the most effectual of all ap-  '
plications.  He applies it two or three times daily, more or less diluted:
excoriation, ulceration, and gradual disappearance 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, hcematemesis and leucorrhcea.  In  the  following diseases,
it has been chiefly given internally:—
  Phthisis.—Reichenbach excited considerable expectations from its
use in phthisis,—pulmonary, laryngeal and bronchial; andas in so in-
tractable a disease  every suggestion is immediately and eagerly em-
braced, numerous trials  were instituted  with it, the  results of which
were by no means accordant.  Reich7 affirmed, that he gave  it both
in laryngeal  and tubercular phthisis with distinguished success.  In a
case, in which the disease appeared to be considerably advanced, the

  1 Medicin. Jahrbuch. des k. k. osterreich. Staates, B. xv. S. 553.  Wien, 1834.
  2 Riecke, Op. cit. S. 167.
  3 Cormack, Lond. and Edinb. Monthly Journ. of Med.  Oct. 1842.
  1 London Lancet, vol. i. p. 328, 1838-9; and Mr. Wright, Ibid. p. 580.
 6 Medical Examiner, May 30, 1840, p. 348.
 6 Northern Jourual of Medicine, Dec. 1844;  and Braithwaite's Retrospect, xi. 186,
Amer. edit. N. Y., 1845.
 7 Hufeland's Journ., Jan. 1834; and Revue M.d., Mai, 1834. 
292
CREASOTUM.
  offensive  expectoration was changed into one of a  tasteless, mucous
  character, although  the fever and  the night sweats experienced no
  modification.    Subsequently, haemoptysis  supervened, with violent
  fever; on which account the dose 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—im-
  proved so much, that he was led to believe she might be saved, although
  the cough still remained severe and frequent.   In another case, crea-
  sote 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  dimi-
  nished ; the pain in the side removed; the appetite, sleep and strength
  restored under its administration, but the result of the case was not
  known.   Levrat asserts, that he found it highly  useful  in chronic
  bronchitis, and in some kinds  of phthisis.  Hechenberger saw good ef-
  fects from the inhalation of creasote in the form of vapour in a case of
  "ulcerated lungs;" five, ten, or fifteen drops, according to the degree
  of tolerance of the lungs, being dropped into hot water in an appro-
  priate vessel, and the vapour  received through the tube of an inverted
  funnel.   He was of opinion, that this mode of exhibiting it prevented
  the  disagreeable  effects apt  to be induced by its internal use;  and
  farther experiments have confirmed his view.   On the other hand,
  Elliotson1 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 ten-
  dency to  their farther production, as well as where there  is much se-
  cretion from the bronchial mucous membrane.   Either no  advantage,
  or an injurious influence followed its use in phthisis by Rehfeld, Haupt,
  Treumann, Giinther, Schmalz, Meisinger, Otto, Kohler,2 and  others.
  The published experiments by Wolff, in the Charite,  at Berlin, cannot
  be esteemed more favourable.   It was tried in  eleven cases of tuber-
-  cular 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 ad-
  vantage, after it had been given  for fourteen  days.  In  one case, it
  had to be discontinued on the eleventh day, owing to the supervention
  of obstinate vomiting.  The case ultimately terminated  unfavourably.
  In six cases, the symptoms appeared to be aggravated, and the patients
  died soon afterwards.   In two, in which the disease  was in its second
  stage, death supervened unexpectedly early, on the fourth and seventh
  days of the treatment,—in one case, by suffocation;  in the other, by
  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 was not  mitigated;  nor the dyspnoea  diminished:  in four
                1 Medico-Chirurg.  Transact, xix. 221.  Lond. 1835.
                2 Hecker's neuern Wissenschaft. Annal. B. i. H. 3. 
CREASOTUM.
293
cases, on  the other hand, they were manifestly increased: once, epis-
taxis occurred, and twice haemoptysis.  From  the results of all his
trials, Wolff  is disposed to think, that  creasote  should  be banished
from our list of agents employed in phthisis;  both as respects the ra-
dical and the palliative treatment;1 but although they^may not sanction
us in placing much value on it in the treatment of phthisis, it may be
improper to ostracise it altogether,2 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  confirmed phthisis
where no  inflammatory complication was present,—the expectoration
and colliquative sweats  being diminished under its use ; and M. Petre-
quin,3 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 any thing approaching the radical cures de-
scribed by some.   He, indeed, gives the preference to tar water,  (see
Aqua Picis Liquid_e.)
  In bronchorrhoea, or in that state of the bronchial mucous membrane
which consists  in a profuse secretion without inflammation, the inha-
lation of creasote has been found of essential servipe.4  In the chronic
mucous affections of the lungs of  old people, it appears to have  been
especially useful.
  Rheumatism and Clout.—The success obtained by Reichs from tinc-
ture 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 at-
tacked with  lancinating pain in  the  right leg, for the removal  of
which the  ordinary remedies Avere employed in vain: it yielded to  the
use of creasote given for nine days.  He relates  another case of rheu-
matism, and  one  of atonic gout, in which  it was equally successful.
Marcus, of Hadersleben, recommends it in cases of rheumatism, un-
accompanied  by excitement of  the vascular  system, or  tendency  to
congestion  and febrile reaction.  It  is proper, however,  to observe
that he combined other agents with it, so that his experiments 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 improve-
ment.   Karsten  found  none of the advantages 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,
arrd plugging the ear with cotton dipped in  it.   It 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 crea-
sote water greatly alleviated the pain  of the joints in rheumatism and
atonic gout.
  In vomiting, not arising from  inflammation  or  other organic disease
of the stomach, Elliotson6 found creasote very efficacious.  In the vo-
  1 See, also, Kohler, in Rust's Magazin, B. xlvi.  and Amer. Journ. of the Med. Sciences,
Feb., 1837, p. 497.                            2 Riecke, Op. cit. S. 170.
  5 Gazette Medicale de Paris, Nov. 1836.
  ' Elliotson, in Med. Chirurg. Transact, xix. 221.  Lond. 1833.
  6 Hufeland's Journal, Jan. 1834, and Revue Med. Mai. 1834.
  • Medico-Chirurgical Transactions, vol. xix., or Lancet, Aug. 20, 1836. 
294                         CREASOTUM.
miting in pregnancy it has  been highly valuable.   If the  sickness
comes  on regularly after rising in the  morning, Dr. Cormack1 pre-
scribes  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.
He has also found it serviceable  in the sickness and  vomiting  fol-
lowing a drinking debauch.  Even  in Asiatic cholera and in sea-sick-
ness, it appeared to allay the vomiting.  In various affections  of the
stomach, as in cardialgia and gastrodynia, it may be useful.2  In vo-
miting from nervous excitability, it has been affirmed  to excel all  known
medicines.3   After Dr. Elliotson had recommended it, Dr. Shortt tried
it in about  a dozen cases, and found it equally successful, as did also
Dr. A. T. Thomson, of London, Dr. Bodington, of Erdington, in War-
wickshire, Dr. Christison,4 and  many  others.   Dr. John Walker, of
Glasgow, in a case published by him,5 does not appear to have been
equally fortunate; and with Dr.  Paris it entirely failed.6  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  previously  exist.7    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.  Elliotson, and by Mr. A. B. Maddock.8   It has been administered,
also, as an excitant  to relieve gastrodynia and flatulence, and where
hydrocyanic  acid and  creasote  have been  separately tried  unsuccess-
fully, Dr. Elliotson recommends that they should be combined.  Dr.
J. B. Wilmott9 has extolled its use in  injections in camp dysentery.
One was administered every night composed of a dram to twelve  ounces
of starch;  and  since  then it has  been  suggested  in the same form
by Dr. Flint10 in chronic dysentery.  Mr. Kesteven11 found it a  never-
failingfremedy in  diarrhoea, given in the manner mentioned hereafter;
and, when  severe pain was a concomitant, adding tinctura opii cam-
phorata; and with Dr. T. M. Woodson,12 of Tennessee, Mr. Kesteven's
method of treatment  was completely successful.   Dr. Cain,13  too, of
Charleston, found creasote more  beneficial in the ordinary diarrhaa

  1 Lond. and Edinb. Monthly Journal  of Med.  Science, Oct. 1842.
  2 Riecke, Op. cit. S. 172; and Arendt, Froriep's Tagesberichte, No. 627, and Brit, and
For.  Med. Chir. Rev. Oct. 1853, p. 558.       3 Cormack on Creasote, p.  133.
  * Dispensatory, p. 377.  Edinb. 1842.
  6 Lancet, Dec. 19, 1835, p. 447.  See, also, Taylor, Ibid. Aug. 15, 1835, and Macleod,
in Lond.  Med. Gazette, xvi. 598, and xvii. 653.
  6 Pharmacologia, 8th edit, append.   Lond. 1838.  See, also, Pereira, Elem.  of Mat.
Med. and Therap. 3d Amer. edit. p. 960.  Philad. 1854.
  7 Cormack,  Lond.  and Edinb. Monthly Journal of Med. Science, Oct. 1842.
  8 Amer. Journ. of the Med. Sciences, Feb. 1838, p. 496.
  9 London Medical Gazette, May 23, 1845, p. 162 ; and on the Use of Creasote  in Scor-
butic Camp Dysentery. Lond. 1855.
  10 Buffalo Med. Journal, and Med. Examiner, April, 1850, p. 252.
  11 London Med. Gaz., Feb. 7, 1851.
  12 Western Journ. of Med. and Surgery, April, 1852.
  13 Charleston Med. Journ. Feb., 1852. 
CREASOTUM.
295
of adults and children than  any article of the class of astringents,
mineral or vegetable; but in cholera morbus and  cholera infantum,
"its greatest triumph is exhibited."  He prescribed it, also, with benefit
in flatulent colic, and in the declining stage ofdysentery.  "In short,"
he adds, "I have found it serviceable  in all cases of derangement of
the secretions of the stomach and bowels, when  there exists  no phleg-
masial state of those organs."  When the secretions require correction,
he usually combines it with charcoal, prepared chalk, or  bi-carbonate
of soda.
   Several portions of tania having been observed to be discharged af-
ter 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  cas-
tor oil; or where the bowels were not freely opened, with half a drop
or a drop of croton oil.
   In diabetes mellitus, it was  first given by Berndt,1 and with striking
success.  One or two cases of the same kind  are related by Gadolin,
and one by Dr. Michalsky, of Kreuzburg;2 but Rehfeld used it without
advantage.   Dr. Elliotson agrees with Berndt  in the opinion,  that it
is sometimes of use in diabetes, and may even be greatly instrumental
in accomplishing a  cure.3
   Dr. Elliotson4 tried it in nervous diseases.   In some cases of  epi-
lepsy, the paroxysms appeared to be rendered less frequent and more
mild; but in the generality of cases, they returned with fresh violence.
In some, the remedy had no influence on the  disease, in others, it ap-
peared to aggravate it.  In neuralgia, great advantage was at times
derived from it,  although here, again, it was frequently of no service.5
A severe case of facial neuralgia, was  cured by Mr. Thomas Kelly,8
by three drops made into a  pill with crumb of bread, and given every
three hours.—Inoculation with a  mixture  consisting  of ten or fifteen
grains  of acetate of morphia  in  one dram of creasote, was  employed
with much advantage in the same disease by  Mr. Rynd.7   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 disap-
peared.  Dr. Elliotson  also observed good  effects from it in  hysteria,
where there  was no inflammatory complication, in spasmodic erethism
of the nervous system, and in palpitation:  and Dr. Herndon,8  of Vir-
ginia, 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 membrane, Dr. Elliotson9
found its inhalation often useful.
   In two  cases of chronic glanders,  the  same gentleman10  accom-
plished a cure in the course of a few weeks, by the  sedulous use of an
injection of a dilute solution of creasote (Creasot. gtt. j; Jlquse f Sj.)
thrown up the affected nostril; combining the treatment, in one of the
  1 Kleinert's Repertorium, Jan. 1835, and Lancet, July 18, 1835.
  2 Sanitiits-Bericht, in Edinb. Med.  Journ. July, 1855, p.  54.
  8 Medico-Chirurgical Transactions, xix. 132-135.  Lond. 1S35.          i Op. cit.
  4 Cormack, loc. cit.                     6 Dublin Medical Press, Sept. 13, 1849.
  7 Dublin Medical Press, March 12, 1845.
  8 Amer. Med. Intelligencer, March 15, 1838, p. 425.              9 Op. cit.
 10 Lancet, for June 29, 1833. 
296
CREASOTUM.
 cases with the  internal use of the remedy;  and a similar case of suc-
 cess is given in a more recent number of a British medical periodical.1

                      MODE OF ADMINISTRATION.
   The  dose  for internal use is one or two drops, given several times a
 day, in gum water.2  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 administered  in pill.   Externally, it is
 at times applied pure;  at others, diluted,—commonly with water, with
 or without the  addition of alcohol,—or in the form of ointment.   Car-
 minati3 affirms, that oil and mucilage, when  combined with it, render
 it milder, but that  vinegar increases its  action.  Dr. Cormack,4 how-
 ever, doubts the  assertion in regard  to  vinegar.   In three compara-
 tive experiments, which he made with  a view of testing the justice of
 Carminati's conclusion, there was no apparent difference in the activi-
 ty 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 diffusing
 a few drops of creasote through  water, or a mucilaginous liquid, in  an
 ordinary inhaling vessel, or in the mode  described under the head of
 Chlorine.5
                          Pilulae creasoti.
                           Pills of creasote.
                  R.  Creasoti trjjx.
                      Glycyrrhiz. pulv. gj.
                     Mucilag. acac. q. s. ut fiat massa
                 in  pilulas xx. dividenda.
   Dose.—Two  pills three times a day.  In neuralgia, atonic rheuma-
 tism, and chronic bronchitis.   The number of  pills may be gradually
 increased to eight or ten at a time.                            Joy.6
                  R. Creasot. gj.
                      Ext. glycyrrhiz.
                     Galban. aa. gss.
                     Althaea, pulv. gij.
                 Fiat massa in pilulas cxx. dividenda.
   Dose.—Six pills, four times a day.  In consumption.     Reich.
                 R.  Creasoti.
                     Ext. glycyrrhiz. aa. gj.
                     Altha..- pulv. 3ij.
                 Fiat mass, in pil. cxx. dividend.

   Dose.—Five  pills, morning and evening, in atonic gout.
                                                            Reich.
  1 Lancet, Jan. 20, 1839, p. 145.
  2 It may be well to remark, that the fluidram contains one hundred and fifty drops of
 creasote.            3 Op. cit.         * Op. citat. p. 88.        6 See page 201.
  6 Tweedie's Library of Medicine, v. 282.  London, 1840; or 2d American edit. vol. iii.
Philad. 1842.                               '     ' 
                             CREASOTUM.                         297

                        Haustus  creasoti.
                           Creasote draught.
                 R.  Creasot. tn/ i.
                     Aquae camphorae,
                     Infus. gentian, compos., aa. f 3vj.
                     Fiat haustus.  M.
  To check vomiting.
                 R.  Creasot. tn> i—v.
                     Sp. ammon. aromat. nj; xv.—f ^i.
                     Aqua, f 3j.—f 3 iss.  M.

  In diarrhoea.  One  draught was usually sufficient; a second dose
was  rarely required.                                     Kesteven.
                        Mistura creasoti;
                          Mixture of creasote.
                 R.  Creasot. gtt. v.
                     Mucilag. acaciae f 3"iij.
                     Syrup, althaeae f 3*j.  M.

  Dose.—A spoonful,  every three hours, in hcemoptysis.  Santini.

                Tinctura creasoti  pro gingivis.
                   Tincture of creasote for the gums.
                 R.  Creasot. f gj.
                     Alcohol, f %\}.  41.

  As much of this  is to be added to cold water as is necessary to give
it a piquant taste.   The teeth may be washed with it, and the mouth
rinsed.   Used in cases of fee tor of the mouth  from carious teeth, and
to limit the caries.                                        Buchner.
                 R.  Alcohol. (36° Beaume,) f giss.
                     Creasot. f gj.
                     Tinct. cocci f £vj.
                   « 01. mentha. gtt. xxxvj.
  Used for toothache ; 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. £ss.
                     Aqua, destillat. f^*v.  M.
  Used as a lotion  in impetigo sparsa and itch.             Wolff.
                 R.  Creasot. f 3j.
                     Acacias pulv. £j.
                     Aqua, f 3 viij.  M. et fiat emulsio.
  This is  "creasote emulsion," used as a haemastatic.
                                                 Smith $• Sinkler.
                   1 Journal de Chimie Me'd.  Avril, 1841. 
298                         CREASOTUM.

   The author has occasionally found a lotion composed of f 3ss. to Oj.
of water too irritating.
                 R.  Creasot. gtt. xij.
                     Aq. destillat. fgij. M.

   To be applied by means of a  camel's  hair pencil twice a day to in-
flamed eyelids.                                             Coster.
                 R.  Creasot. Ttt>  iij.
                     Tinct. lavand. compos. in^  xx.
                     Aquae destillat. f^ss.  M.
                                                      a. T. Black.
                 R.  Creasot. gtt. iv.
                     Aq. destillat. f 3*ij. M.
   In irritation of the gums.                           Fremanger.
                 R.  Creasot. f gss.
                     Acacias §iss.
                     Aquae camphor, f 5 x3s.  M.

   Used every two hours in cases of  aphthous ulceration of the mouth.
                                                        Magendie.
                 R.  Creasot. gtt. x.
                     Aceti f gij.
                     Aquae f 3*ij.  M.
   Used in cases of phagedenic ulceration,  and to chancres;  applied by
means  of a camel's hair pencil.                             Shortt.1

                       Unguentum creasoti.
                         Ointment of creasote.
                 R.  Cerati.
                     01. amygdal. aa. 3*j.
                      Creasot. gtt. xxx.  M.
   A dressing in scrofulous caries.                      Fremanger.

   The Unguentum Creasoti of  the London and -United States Phar-
macopoeias is  composed of half  a fluidram of creasote  to an  ounce of
lard;—that of the  Dublin  Pharmacopoeia,  (1850,)  of one  dram to
seven.
                Unguentum creasoti  compositum.
                     Compound ointment  of creasote.
                  R.  Creasot.                    •
                      Liq. plumb, subaeetat. aa. gtt. x.
                     Extract, opii gr. iss.
                      Adipis 3*j.  M.
   An application to chilblains.                          Devergie.
                  R.  Creasot. ^ss.
                      Carbon, animal, praeparat. 3j-
                      Alcohol, f ^iss.
                      Ung. cetacei 3" iss. M.
   A '•'■burn ointment."   This  maybe  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 chil-
 dren 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 increased.                  Sutro.

                        1 Cormack, Op. cit. p. 112. 
CUBEBA.
209
                     Linimentum creasoti.
                        Liniment of creasote.
                R.  Creasot. ptt. v.—xx.
                    01. oliv. f 3ss.  M.
  To be rubbed two or three times a day on the diseased parts in chro-
nic herpes.                                           Corneliani.
                       Injectio creasoti.
                        Injection of creasote.
                R.  Creasot. *% xx.
                    Liq. potass, f ijij.
                    Sacchar. gij.
              Tere in mortario, et adde gradatim.
                    Aquae f 3"viij.  M.
  The injection to be used three times a day, in gonorrhoea and leucor-
rhcea.                                             R. A. Allnatt.
                        LXXII. CUBE'BA.
Synoxymes. Cubebae, Piper Cubeba seu Cubebarum seu Caudatum, Cubebs.
French. Poivre a queue, Cubebe.
German. Cubeben,  Cubebenpfeffer,  Kubebenpfeffer,  Schwanzpfeffer,
  Schwindelkorner.
  Cubebs are the fruit of Piper cubeba, which grows in India, Java,
Guinea, &c.  Sexual System, Diandria Trigynia; Natural Order,
Piperaceee.  The corns of this plant have been long known in the shops;
and in the old Wirtemberg Pharmacopoeia they figure as calefacient,
inciting,  discutient,  antinervous, and carminative agents, which seem
to have a specific action in vertigo:  hence they obtained the  name
"Schwindelkorner" or "grains for vertigo." They had, however,
fallen into oblivion,  until they were reintroduced in modern times into
practice,  especially by the English physicians and surgeons.
  The shell of the dried berry has  a weak taste, but smells agreeably;
and the kernel has a bitter aromatic flavour, which is biting at first,
but afterwards cooling.   The corns were analyzed by Tromsdorff and
by Yauquelin,1 but the most recent analysis is by Monheim.2  He found
in 100 parts,—lignin 65;  extractive matter 6; cubebin (piperin) 4.5;
matter like wax, 3;  green volatile oil 2.5; yellow volatile oil 1.0; bal-
samic resin—which,  according to Yauquelin, is very  analogous to bal-
sam of copaiba—1.5; chloride of sodium 1.0, and 15.5 parts loss.  Cu-
bebin appeared to  Monheim  to be identical with piperin, but to be
united with an acrid soft resin.  The volatile oil may be  obtained sepa-
rately 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 considerations that apply  to
  1 M.moires du Mus.um, vi. 225.            a Journal de Pharmacie, xx. 403. 
300
CUBEBA.
copaiba are equally applicable to cubebs.   Although the revulsive ef-
fect induced  by both on the  kidneys may mitigate the  inflammatory
condition of  the lining  membrane of the urethra, which constitutes
gonorrhoea;   yet,  in  violent  inflammatory cases, and  in the  early
stages of ordinary cases, they may be injurious; and there are many
instances on record in which bad consequences appear to have resulted
from their improper administration.   Still, there are physicians  who
administer both  them and  the copaiba in every stage of the disease.
Of 50 patients, treated by Mr. Broughton1 by cubebs, 10 were cured
in from 2 to 7 days; 17 in  from 8 to 14;  18 in from 15 to 21; 1 on
the 55th day; and in 4 only was no success obtained.  In the chronic
stage of gonorrhoea, M. Ricord2 prescribes  cubebs in combination with
sesquioxide of iron; and in addition  the patient is directed to inject,
four times a day, a solution  composed of Aq. destillat. f gviij., Argent
nitrat. gr. ij.
   It has been affirmed, that different evils have ensued  from the use
of cubebs; which ought to suggest care in their administration;—for
example,—ardor urinae; fever; inflammation of the urethra, bladder,
and testicles; retention of  urine;  cutaneous eruptions, &c.3
   In the blennorrhcea of females, cubebs are equally extolled by many
practitioners, as  well as in leucorrhcea.41
   Spitta  found  them very  efficacious  in  old and obstinate cases of
coryza, when  given in the  form of lozenge:  they are  said, likewise,
to have been administered with advantage in defective audition, caused
by  a catarrhal affection of the  Eustachian tube.  Rosin found the
chewing  of cubebs very  serviceable in  aphonia.  They have  also
been prescribed successfully in chronic rheumatism.  Piil5 gave  them
with striking  advantage in intermittent fever ;  and  in India, they are
regarded to be aphrodisiac.6
   In involuntary micturition  or incontinence of  urine  at night, Dr.
Deiters7 extols the  effects of cubebs, given  in tolerably large doses
twice a day,  for from three  to eight weeks.  The same remedy is use-
ful in nocturnal emissions.
   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.8

                     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.
  1 Medico-Chirurgical Transactions, xii. 1.  Lond. 1822.
  2 La Lancette Francaise, No. 33.   Paris,  1838.
  8 Lond. Med. and Physical Journal, Mar. 1832, and M6rat and de Lens, Diet. Univers.
de Mati.re M.dicale, &c, art. Piper Cubeba.
  * Edinb. Med.  and Surg. Journal, xviii. 319.  Blundell, Diseases  of Women, p. 158,
Lond.;  or American Medical Library edition, Philad. 1840;  also,  Lisfranc by Pauly,
translated  by Lodge, p. 243, Boston, 1839; and Ricord, Practical Treatise on Venereal
Diseases, by Drummond, Amer. edit.  Philad. 1843.
  5 Recueil de M.d.  Chirurg. et Pharm. Militaire, xvi.
  6 Merat and De Lens, Art. cit.
  T Prag. Ver. Zeitung, 1853, p. 16,  and Brit, and For. Med. Chir. Oct. 1853, p. 561.
  8 Brande, Dictionary of Materia  Medica, p. 205.  Lond. 1839. 
CUBEBA.
301
Lozenges, boluses, and  electuaries,  are likewise prepared  of them;
and the London, Dublin, and  United  States  Pharmacopoeias  have a
Tinctura Cubeb_e [cubeb. Biv., alcohol, dilut. Oij. Dose, f 5j.—f 5ij.)
The distilled oil—Oleum Cubeb_e—which is officinal in the Pharma-
copoeias of the United States, Edinburgh, and Dublin, contains most
of the virtues of the cubebs, and  is much used by many practitioners
in gonorrhoea, in the dose of ten or twelve  drops, gradually increased,
in sugared water, emulsion, or in capsules.  In consequence  of the
disorder at times induced by cubebs in the  digestive  function, Yelpeau
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.1  To
attain the same  object, M. Dublanc, Jun., prepared an oleo-resinous ex-
tract, 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.2   He prepares  it by adding oil of cubebs
to the resinous extract, which is  prepared  by digesting the  cake left
after  the distillation of the oil in  alcohol,  and distilling off the spirit.
The process of Mr. Wm. Procter,  Jr.,  is considered to be a better one.
He exhausts  cubebs by ether, in a displacement apparatus, and sub-
mits the ethereal tincture to  distillation in a water bath.  The residual
ethereal  extract  of  cubebs contains all the volatile  oil, cubebin, and
resin, as well as most of the waxy matter, but none of the extractive.
One dram of it  is equal  to one ounce of cubebs.  It may  be adminis-
tered in the form of  emulsion, pills,  or capsules.   Dose,  from gr. v.
to 5ss.3  It has been admitted into the last edition of the Pharmaco-
poeia  of the United  States  (1851,) under  the name Extractum Cu-
beb_e Fluidum, Fluid Extract of Cubebs.
   The volatile oil is  sometimes  given in the dose of 10 or  12 drops,
suspended in water by the aid of sugar, or associated with oil of  co-
paiba.  Gelatinous  capsules of cubebs, containing  the oil, are  some-
times taken.
   M. Piorry4 has strongly recommended  an Infusion  of  Cubebs
(Cubeb. gj. Aquae Oij.) to be used six  or  eight times a day  as an in-
jection in urethritis  and vaginitis.
                   Pulvis cubebae compositus.
                      Compound powder of cubebs.
                 R.  Cubebae pulv. 3j.
                     Ergota? pulv. £ss.
                     Pulv. aromat.  £)ij.
                     Sacchari 3j.
             Divide in chartulas viij.
   Dose.—One, three or  four times a day, in gonorrhoea,  leucorrhcea,
gleet, prostatic and involuntary seminal discharges.         Ryan.5

  1 Archives G.ndrales de M.decine, xiii.  47.
  J Journ. de Chimie M.dicale, iii.  491, and Journ. de Pharmacie, xiv. 40.
  s Pereira, Elements of Mat.  Med. and Therap. 3d Amer. edit. ii. 356.   Philad. 18.4.
  4 Gazette des Hopitaux, Mai, 1842.
  6 Universal Pharmacopoeia, or a  Practical Formulary of Hospitals, both British ana
Foreign, by Michael Ryan,  M. D ., &c, 3d edit. p. 160.  Lond. 1839. 
302                            CUBEBA.

                  R.  Cubeb. pulv. gij.  "        ,..,.,..
                      Aluminis pulv. 3"ss.   M. et divide in chart, ix.

   One to be taken three times a day.                       Ricord.1

                        Electuarium cubebse.

                           Electuary of cubebs.
                  R.  Cubeb. pulv. §ss.
                      Mellis despum. q. s.
                Fiat electuarium.

   Dose.—A  tea-spoonful, three or four times  a day,  in catarrhus
vesicse, c.  urethrse, &c.                                       Radius.

                  R.  Copaib. givss.
              Subige cum
                      Vitello ovi unius et
              Adde
                      Cubeb. pulv. givss.
                       Confect.  rosae 3*ss.
              M. et fiat electuarium.
   Dose.—A tea-spoonful three or four times a day.           Vogt.

                   R. Copaib.
                       Cubeb. pulv. aa. 3ij.
                       Aluminis 3*i.
                      ' Extract, opii gr. v.  M.
    Dose.—A  dram night  and morning, in the pulp of a prune.  The
 quantity may be  rapidly increased to two drams morning and evening.

                   R.  Copaib. part. i.
                       Cubeb. pulv. part. xij.
                       Tinct. vanilla, q. s.   M.
    Dose.—5j. three times a day.                          Cazenave.'

                          Trochisci cubebae.
                            Lozenges of cubebs.
                         R.  Cubeb. pulv. ^ij.
                             Balsam, tolut. gr. vj.
                     Admisce
                             Syr. tolut.
                             Ext. glycyrr. aa. 3*j.
                Acaciae q. s. ut fiat massa in trochiscos pond. gr. x. sing, dividenda.
    Used in coryza.                                            Spitta.
                              Boli cubebae.
                             Boluses of cubebs.
                          R.  Copaib.
                              Acac. pulv. aa. ^ij-
                              Aquae flor. aurant. 9ij.
                     Terendo bene mixtis a.dde
                              Cubeb. pulv. ^ij.
                     Misce, et fiant boli No. vj.

    Dose.—One, three times  a day.                        Henschel

    M. Labelonye3 has  proposed the following  method for separating
  all  the principles of  cubebs  from  the ligneous  matter.—Cubebs re-

    1 Mathieu, Journal des Connaiss. M.d. Chirur. Juin, 1840.
    2 Bouchardat, Annuaire de Therapeutique, pour 1842, p. 44.  Paris, 1842.
    s Bulletin General de Th.rapeutique, cited in Amer. Journ. of Pharmacy, 2d series,
  vol.  2, p. 316.  Philad. 1837. 
CUBEBA.
303
duced 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 alco-
hol at 20° (.935,) which dissolves  the extractive principle,  and chlo-
ride 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 ac-
count of the contained volatile oils; the presence of which in all cases
interferes with complete desiccation.
   One part of this extract is conceived to be equal to five of the cubebs.
It can be readily mixed  with water by means of mucilage, and can be
administered in potions, injections, &c.
   The best form of exhibition, according to M. Labelonye, is in lozen-
ges, or in an emulsive syrup.
    Troschisci extracti  hydro-alcoholici aetherei cubebae-
        Lozenges of the ethereal hydro-alcoholic extract of cubebs.
                R. Extract, hydro-alcohol. __ther. cubeb. 3*viij.
                     Alcohol. Oij.
             Solve et adde
                     Sacchar. in pulv. ten. Ibj.
                     01. mentha. pip. gtt. xviij.

   Pour the mixture into flat vessels upon a stove,  and allow the alco-
hol to evaporate at  a moderate heat.  When the mass is completely de-
siccated, reduce it  to a  fine powder, and  add a  sufficient quantity of
mucilage of gum tragacanth to form lozenges—18,12, 9, or 6 grains
each.  Most persons, M. Labelonye says, can  swallow with facility
those weighing eighteen grains, and containing  six grains of the ex-
tract : ten of these  are equivalent to half an ounce of the powder.

     Syrupus extracti hydro-alcoholici  aetherei cubebae-
         Syrup ef  the ethereal hydro-alcoholic extract of cubebs.
                R. Ext. hydro-alcohol, aether, cubeb. 3"iij.
             Suspende ope mucilaginis in
                     Aq. mentha. pip. Oj.
             Adde
                  •   Sacchar. lbij.  M.
   Four ounces of this syrup contain two  drams of extract, equivalent
to ten of powdered  cubebs.
   Dose.—A tea-spoonful.
   M. Labelonye also  envelops the extract in sugar, as in the ordinary
sugar-plum.

   An extract of  cubebs has been recommended  to be  prepared as
follows:—Cubebs are  exhausted by repeated digestion in alcohol, which
readily takes up all the active principles  of the  pepper;  viz., a resin
resembling that  of  copaiba, and  a coloured resin, with an almost con-
crete essential volatile oil.    The alcohol  is distilled from those tine- 
304
DELPHINIA.
tures at a  temperature  so moderate  as not  to volatilize the essential
oil.   When the operation can be  carried no further 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 re-
sin, and preserve the extract of a uniform consistence.
   The ordinary dose of  this in blennorrhoea is  about fifteen  grains
three times a day.1
   Dr. Puche2 employs & fluid aqueous extract of cubebs; a, fluid alco-
holic  extract; a syrup of the alcoholic extract; a bolus of cubebs; and
one of cubebs, copaiba and turpentine.   The last he covers with a ge-
latinous mixture to obviate the unpleasant taste.
                        LXXIII. DELPHI'NIA.
Stxoxtmes. Delphinina, Delphininum, Delphininium, Delphium, Delphina, Delphia,
  Delphinine, Delphine.
German. Delphinin, DelpTiin.

  This alkaloid was  discovered in 1819, by MM. Feneulle and Las-
saigne,3 and, almost at the same time, by Brandes4 in the seeds of del-
phinium staphisagria, in which it is united with acetic acid.  As a the-
rapeutical 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 Magendie5  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 repeated; and the residues
are washed carefully and  digested in alcohol.   On evaporating the al-
coholic 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 unclean 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 dis-
tillation, dissolve the residuum in  muriatic acid, and boil with  mag-
nesia.
  The plan recommended by Couerbe, and  adopted by Turnbull,6 is to

  1 Judd, Medico-Botanical Transactions, vol. i. p. 4.   Lond. 1839.
  2 Journ. des  Connais.  M.dical. Aout, 1840; and Bouchardat, Nouveau Formulaire
Magistral, 3eme edit. p. 129.  Paris, 1845.
  3 Annales de Chimie, torn. xii. or Journal de Pharmacie, vi. 47 and 366.
  4 Sclrweigger's Journal der Chimie, xxv. 369.                 & Formulaire, &c.
  e On the Medical Properties of the Natural Order Ranunculacea., chap. 11. Lond. 1835. 
DELPHINIA.
305
evaporate a saturated tincture of the seeds to the consistence of a thin
extract, and then to treat it with water acidulated with sulphuric acid.
This solution, when filtered,  is to be precipitated by ammonia.  The
precipitate—after being freed from its  water—is to be taken up by al-
cohol, and again reduced to the consistence of an extract, which is like-
wise 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, staphysagrin and delphinia;
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  de-
void of smell; but, like veratria, when applied to the mucous  mem-
brane of the  nose, it occasions sneezing, along with an abundant se-
cretion of  mucus.  Its  taste is  at first bitter, and afterwards  acrid,
and it acts upon  animals in  the  same manner as—but more energeti-
cally than—the seeds from which it is prepared.  It is very sparingly
soluble in water, but yet in sufficient quantity to communicate a bitter
taste to the fluid.  In alcohol and ether it dissolves readily; and these
solutions have the property of 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 pos-
sessed 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,1 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 stomach of a dog, 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 sto-
mach was generally found injected.   In experiments made on dogs,
cats, and rabbits, by J. Leonides van Praag,2 asphyxia, as  a result of
paralysis of the heart, was among the principal phenomena.  Paralysis
of the nerves of motion, and, at a later period, of those  of the special
senses, and of secretion followed.   He thinks it causes death by para-
lyzing the  spinal cord.3
  From his administration of delphinia and its salts, Turnbull con-
cludes, 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
  1 Xouveau Journal de Me"d. x.; and Toxicologic G.n. i. 739.
  2 Archiv. fur  Pathol. Anat. v. s. w. Bd. vi. Heft. 3, p. 385, and Brit, and  For. Med.
Chir. Rev. July, 1854,  p. 246.                   3 Ibid. Oct., 1854, p. 545.
       20 
306
DIGITALINA.
each, without exciting vomiting; in this quantity, however, it  some-
times operates upon  the bowels, but causes very little irritation.   In
most instances, it acts as a diuretic, and occasions a considerable flow
of pale urine.   When  taken to the extent of a few grains, it induces
heat and tingling in various  parts of the body,  similar to those pro-
duced 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 diseases
as those of veratria, and they appear to  exert a similar action:  the
test  laid down by Turnbull, in the case of veratria, applies 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 fore-
head, the specimen ought not to be used, as no beneficial effect  would
ensue 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 de-
gree, unless the friction has been carried too far.  The  effects of del-
phinia differ from those of  veratria in being generally more powerful
and durable.
   The diseases in which delphinia  has been chiefly employed, like ve-
ratria, 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  foramen, the use of delphinia,
according to Turnbull, is to be preferred, 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 treatment of paralytic cases than veratria, but princi-
pally 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  recommended
for  veratria.   It may be used either in the form  of ointment or in
solution in alcohol;  and the proportions to be employed, in either
case, may vary from  ten to  thirty or more grains to the ounce, ac-
cording 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 continued  until the pungent sensation
produced by the rubbing exhibits itself.
                      LXXIY. DIGITALI'NA.
Stxontmes. Digitalin, Digitalia, Digitalinum, Digitaline.
I1 reach. Digitaline.
German. Digitalin.
  The active principle of digitalis was supposed to have been separated
by Le Royer, and by Lancelot;J yet these substances excited but little

  1 Pereira, Elements of  Mat. Med. and Therap., 3d Amer. edit. i. 437.  Philad. 1854;
and Art. Digitaline, in Merat and De Lens, Diet, de Mat. M.d. 
DIGITALINA.
307
attention either from the pharmacien or the physician.  Subsequently,
MM. llomolle  and Quevenne separated it, and  it has received much
notice, especially from M. Bouchardat,1 who has entered fully into its
pharmaceutical and remedial properties.

                      METHOD OF  PREPARING.
   The following formula is given by M. Bouchardat.2  One kilogramme
(about 2 lbs. 8 oz.) of dried  digitalis leaves of the year, coarsely pow-
dered and previously moistened, is  put into a displacement 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 immedi-
ately precipitated by a slight excess of subacetate of lead, and be thrown
upon a filter, when it will pass through, limpid and colourless.  A so-
lution 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 precipitated by tannic acid in excess, and the precipitate, col-
lected on a filter, is mjxed, while 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 exhausted
 by concentrated'alcohol, in  a displacement apparatus.  The alcoholic
 solution,  deprived of colour by means of  animal charcoal, 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 mammillated form.3
   .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.4
   Digitalin is a neutral product, not  an  alkaloid, as said by some;3
 having the appearance of  a white powder; a confused or amorphous
 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 communicate a decided bit-
 terness to two quarts of water.  When diffused in small quantity in
 the air, it causes violent sneezing.    It is  not susceptible of any  com-
 bination with acids or bases.
               EFFECTS ON  THE  ECONOMY  IN HEALTH.
   MM. Bouchardat and Sandras6  injected into the subcutaneous veina
 of the abdomen of a robust dog one tenth of a grain of impure  digi-
 talin, dissolved in a few drops of  alcohol, and  about two  fluidounces

   1 Annuaire de Therapeutique et de Mat. Med., &c, pour 1845, p. 60.  Paris, 1845.
   2 Op. cit. p. 09.
   8 See, farther, on the preparation, properties, &c, of this substance, Bouchardat,
 Annuaire de Therapeutique, pour 184(1, p. 89, Paris, 184G; and, for recent researches
 of MM. llomolle  and Quevenne, Sandras and Bataille, the Annuaire of M. Bouchardat,
 for 1850, p.  106. and  especially a monograph of  376 pages, by MM. Homolle  and
 Quevenne, in Archives de Physiologic de Therapeutique et d'Hygiene, Janv. 1854.
   * O.sterlen, Handbuch der Heilmittellehre, S. 769.  Tubingen, 1845.
   5 Bouchardat, Op.  cit. pour 1845, p. 60.             6 Bouchardat,  Op. cit p. 60. 
308
DIGITALINA.
of water.  Scarcely was the dog untied, when it made several attempts
to vomit;  walked in a straggling manner, like  an intoxicated indivi-
dual ; 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  exhi-
bited the greatest irregularity in their rhythm.   They were jerking
(brusques) and strong; several of them succeeding each other rapidly,
and  then  a manifest  interval occurred.   The  number of pulsations,
which in the normal  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
distended the principal veins.  There was no other appreciable disorder.
  In another dog, pure digitalin, furnished by MM. llomolle and Que-
venne, 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;  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 appreciable  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 conclude, from the whole of  their
experiments, that it is unquestionably an excessively active substance,
especially when pure.  It modifies in a singular manner the circula-
tion, and is capable of exciting intense  irritation of  the digestive or-
gans, when taken by the mouth.

              EFFECTS ON THE ECONOMY IN DISEASE.
  Having satisfied themselves as  to  the  energy and modus operandi
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. Bouchardat and
Sandras made pills, each of which  contained a demicentigramme (the
10th  part  of  a  French grain)  of digitalin.   These pills  they  gave
under their own eyes to patients to whom a retardation of the circula-
tion  might be useful, and  when there was  nothing dangerous to be ap-
prehended from the use of an agent capable of irritating  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 uri-
nary secretion.  When the toxical effects appeared, they were indicated
by disorders of the senses, disturbance of the head, distressing dreams,
and  hallucinations, which 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.
  M. Bouchardat1  subsequently records its beneficial administration in
a case of hypertrophy of the heart; and  adds, that he had frequently
prescribed it;  and that, from its safety, and the facility of regulating
the dose, (dosage,) he has always found it far preferable to the best pre-
                      1 Annuaire, pour 1851, p. 96. 
DIGITALINA.
309
parations of digitalis.  He has no  apprehensions from employing so
active a remedy, provided due care is taken.1
  Careful observations have been made in regard to its effects on dis-
ease by MM. Andral and Lemaistre,2 from which they conclude, that it
ought to be administered  in chronic diseases  of the  heart, when the
pulse is excited and the circulation  irregular, as " it has  the  property
of bringing the pulse back to its normal condition;"  and in cases of
dropsy, proceeding either  from disease of the heart or  from alteration
of the blood,—as in albuminuria,—" it facilitates diuresis, and thus re-
moves serous inflammations."  The form of granules appeared to them
the most simple for the administration of digitalin.
  On the other hand, Dr. Lange3  scarcely  ever observed diuresis
from its administration in  dropsy.   In one case of general renal  ana-
sarca, after eight days' use, there was, for forty-eight hours, some in-
crease  in the  flow of urine, but it disappeared.  In  three cases of
cardiac dropsy, the  heart's action was  lessened,—in  one, after  one-
sixtieth of a grain  doses every three hours; but there was no diuresis,
although  the specific, effects of the digitalin were evident.   In  two
other cases, there was no diuresis.
  In six cases of intermittent treated by digitalin, no cure was effected,
after eight to ten days' use.
  Cases are recorded by M. L. Corvisart and  M. Brughmans, and by
MM. Charrier and  llomolle,4 of benefit observed from it  in spermator-
rhea.   Influenced  by these cases,  M. Homolle5 has given it in  two
cases of  incontinence of urine, and with success.
  The investigations of M. Rayer,  as reported by M. Hervieux,6  have
led  him to  sum up the physiological effects of digitalin  as follows.
First.  In doses of the twenty-fourth  to the sixteenth  of a grain, it
renders the  circulation slower, and increases  the secretion  of urine.
Secondly. Doses of one-twelfth to one-eighth of  a grain may give rise
to serious disturbance of the nervous centres, and the digestive organs;
and, thirdly. Beyond an eighth of  a grain, intolerance always super-
venes,  and  death might ensue if this limit were overstepped, or if the
experiment  were continued too long.
  It would  appear  from  these  observations  that digitalin represents
digitalis in all its active properties, and that it  may be administered
in every morbid condition in which the plant has been found service-
able.7   Professor Christison8 states, that his experience  of its effects
has  been  highly satisfactory.  He  has used  it  expressly as a diuretic
only;  but  its   sedative virtues have  also  come  incidentally under
observation; and he considers  it quite evident, that it is a most  ener-
getic medicine  in both ways.  By employing it—as properly remarked
by  MM. Bouchardat and  Sandras—the  physician always knows ex-
actly the  quantity  of  the active principle which he administers.
  1 Ibid, pour  1852, p.  130.
  2 Union M.dicale, 1 and 4 Mai, 1852, cited in Bouchardat, Annuaire, 1853, p. 124.
  8 Deutsche Klin, and  Schmidt's Jahrbuch. No. 7, p. 26, and Brit, and For. Med. Chir.
Oct. 1854, p. 561.          * Union Med. Juillet, 1854.                 5 Ibid.
  6 Bouchardat, Annuaire de Th.rapeutique pour 1849, p. 149.
  * Strohl, Gazette .led de Strasbourg, Aout et  Octobre, 1849, and Archiv. Generates
de M.decine, Janv. 1850, p. 100.
  8 Monthly Journal of Med. Science, Jan.,  1855,  p. 2. 
310
DIGITALINA.
  When applied endermically, its action is so irritating  that  it can
scarcely be used in this manner.1

                     MODE  OF ADMINISTRATION.
  Comparative trials satisfied M. Bouchardat2 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.3

                        Pilulae  digitalinae.
                          Pills of digitalin.
                 R. Digitalin. gr. .7720 (5 centigrammes.)
                     Acacias pulv.
                     Mucilagin. acacias q. s. ut fiant pilulae xx.
  Dose.—1 to 4 daily in hypertrophy of the heart.      Bouchardat.
                        Granula  digitalinae.
                         Granules  of digitalin.
                 R. Digitalin. gr. 15.44 (1 gramme.)
                     Sacchar. 3*iss.  (50 grammes.)
  Make into one thousand granules like comfits.   Each of these con-
tains a milligramme (gr. .0154) of digitalin.
  Dose.—Four to  six in the 24 hours.        Homolle 8f Quevenne.
                        Syrupus  digitalinae.
                          Syrup of digitalin.
                 R. Digitalin. gr. iss. (10 centigrammes.)
                     Syrupi O  2f (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 Sc Quevenne.
                        Mistura  digitalinae-
                         Mixture of digitalin.
                 R. Digitalin. gr. .0770 (5 milligrammes.)
                     Aquas lactucae 3iiii (100 grammes.)
                     Syrup,  flor. aurant. gviss. (25 grammes.)
  Dissolve  the digitalin in a few  drops of alcohol; then  add the dis-
tilled water and the syrup.
  To be taken by  table-spoonfuls  in the 24 hours.
                                             Homolle 8f Quevenne.
                     Unguentum digitalinae.
                        Ointment  of digitalin.
                 R. Digitalin. gr. .770 (5 centigrammes.)
  Dissolve in a few drops of alcohol at 22°  (s.  g. .923;)  and incorpo-
rate in lard (axonge balsamique) 10 grammes (5iiss.)
  1 Bouchardat Annuaire, &c, pour  1816, p. 92.             2 Op. cit. p. 77.
  8 Bouchardat, Op. cit. p. 76;  and  Nouveau Formulaire Magistral, 3eme -dit. p. 237.
Paris, 1845. 
ELECTRO-MAGNETISMUS.
311
               ELECTRICITAS, see GALVANISMUS.

                LXXV.  ELEC'TRO-MAGNETIS'MUS.
Synonymes. Electro-magnetism, Magnetic Electricity.

  Electro-magnetism has been introduced amongst therapeutical agen-
cies as adapted for the same  cases  as  electricity and galvanism.  Va-
rious forms of apparatus have been designed; coil machines, and mag-
neto-electric machines:1  but, perhaps, as Dr. Pereira has  remarked,2
the most convenient, simple,  and powerful is the magneto-electric ma-
chine of Mr. E.  M. Clarke, of London;  which consists of a battery of
six curved permanent  magnets,  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 direc-
tors, 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 interposed  between the  directors,  a succession of shocks is
experienced.   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 in which voltaic
electricity  has  been deemed advisable.  Mr. E.  S. Clarke, who  ap-
plied 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-magnetic current  for many  successive days.
Next, in order of facility, came "rheumatic and sciatic cases; then cases
of deafness; after those, some varieties  of catamenial suppression.
  It also acted  readily  in  certain  curable forms  of  ameturosis;  then
in partial paralysis, and  with  greater  difficulty in  hemiplegia  than
in almost any other form."   Dr. Golding Bird4 and  Dr. Neligan
found electro-magnetism of immense advantage in many forms of pa-
ralysis; whilst in Dr. Bence Jones's6 trials of it, in the same disease, no
benefit was derived in the majority of the cases.  Dr. Wm. Davis7 found
it of great value in rheumatic paralysis, in a case of subacute articular
rheumatism, which had produced such changes in locomotive organs,
that the patient was unable  to walk or use her hands;  and Professor
Kubik8 bears equally favourable testimony to it in the same affections.
  In  an exprofesso  work  by  Professor  Froriep of Berlin,  he gives
cases of good  effects from electro-magnetism in "rheumatic effusions"
Bpread over the body,—acute, subacute,  and chronic;  in hemiplegia
  1 See the author's General Therapeutics and Mat. Med. 5th edit. i. 550.  Philad. 1853.
  2 Elements of Mat. Med. and Therap. 3d Amer. edit. i. 112.  Philad. 1852.
  8 Graves, System of  Clinical Medicine, p. 434. Dublin, 1843.
  4 London Lancet, June 13, 1846, p. 649.
  5 London and Edinburgh Monthly Journal of Med. Science, April, 1846.
  6 London Journal of  Medicine,  No. 2, 1849.
  1 Provincial Medical and Surgical Journal, Nov. 15, 1848.
  8 Prag. Vierteljahr.  v. 4, 1848; and Schmidt's  Jahrbiicher, u. s.  w. No. 2, p. 159.
Jahrgang, 1849. 
312
ELECTRO-MAGNETISMUS.
 rheumatica, rheumatic neuralgia, rheumatic facial palsy;  spasmodic
 contraction of the muscles of the face; writer's cramp;  rheumatic
 paralysis of the forearm, hip, muscles of the thigh and leg, Sfc.  He
 rarely employed any remedial agent along with it, being desirous of
 ascertaining, without the possibility of a doubt, its real effect.   Cur-
 rents were transmitted through the medium of sponges saturated with
 salt and water, and applied to the skin, or  by acupuncturation, when
 it was requisite to act energetically on parts deeply seated, by introdu-
 cing two needles of platinum in the course of a nerve.1
   An anomalous case belonging to the neuroses was laid before  the
 Sheffield Medical Society; a summary of which is given by Mr. Law.2
   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 impos-
 sible to swallow, and the sickness subsided:  after this, she had paraly-
 sis of the left side of the face, and of the right arm and leg.  Nothing
 could be introduced  into the  stomach except through 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 twice 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 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.   Paraly-
 sis occasionally terminates  favourably quite irrespectively of medical
 treatment, and the acknowledged obscurity in which the proximate
 cause, in the case under consideration was involved, demands especial
 caution in assigning  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, re-
 tarded the cure, and  that this was ultimately accomplished  by nature
 assisted by the  general treatment.  Until a series  of cases treated
 with  electro-magnetism, have  been contrasted with a parallel series
 treated without, it would be unphilosophical to pronounce a decided opi-
 nion 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 positive pole, as chance directed.
Now, Retter asserts, that the former diminishes, whilst the latter aug-
ments the powers of life; and J. D.  Humphreys, medical galvanist,

  1 On the Therapeutic Application of Electro-Magnetism in the Treatment of  Rheu-
matic and Paralytic Affections, by  Robert Froriep, &c, translated  by Richard  Moore
Lawrance, M. D., &c.  Lond. 1850.
  a Provincial Medical and Surgical Journal, May 15, 1814. 
ELECTRO-MAGNETISMUS.                   313
with Chas. Woodward and others, says, that the positive pole exerts a
salutary  influence,  by exhilarating  the spirits, and infusing feelings
of energy and strength; while the negative excites a sense of exhaus-
tion and of  irritation.   These writers  distinctly st_Cte, 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 re-
conciled 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 au-
thors 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 (Sheffield Medi-
cal,)  generally agreed with  Dr.  Shearman, in ascribing the cure to
electro-magnetism;  and that Dr. Abercrombie speaks rather favoura-
bly 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.  The same may be said of a case
of  hysterical convulsions,  which  occurred to Dr. Byrne,1 in a girl,
twelve years of age, who was aroused from each paroxysm by having
the poles of  an ordinary electro-magnetic battery  applied—the  one to
the occiput,  the other to the sacrum.
  Mr. Tuson2 has recorded observations of a very favourable character
in regard to the benefit of this agent in certain local neuralgic affec-
tions, the  consequence of injury;  and a case of aphonia, of four years'
standing,  in  a female, 79 years of age, is reported by Dr. F. K. Bai-
ley,3 as having been completely cured by it.
  Dr. Hays,4 who, as  remarked under Galvanismus, found galvanism
the most useful remedy  in certain cases of amaurosis which fell under
his  care,  employed electro-magnetism in several cases  in  Wills' Hos-
pital, and in a number in private practice, but without 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 interrupted currents, such as are induced by  the electro-
magnetic apparatus.  This is obviously a non sequitur, 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.
  1 Charleston Med. and Surg. Journ., and Ranking's Abstract, Jan. to July, 1849, p. 49.
  2 Medical Times, Feb. 24, 184'.'.
  8 Peninsular Journal of Med., Dec, 1853, and Amer. Journal of the Med. Sciences,
April, 1854, p.  555.
  4 American Journal of the Med. Sciences, Aug. 1840, p. 288. 
314                   electro-magnetismus.
  Dr. Kramer1 has employed the magneto-electric or electro-magnetic
current as a remedy for deafness and tinnitus aurium.   He found it
a decided excitant to the organ of hearing, its action being manifested
by convulsive twitchings, pains in the ear, momentary increase in the
hearing distance, and aggravation of the tinnitus, either at the  time
or afterwards; but it did not seem  to have any strengthening effect
on the nerves, and required  to be used with the greatest precaution,
and in the mildest manner.   The action was strongest when the cur-
rent was conveyed from the mouth of the Eustachian tube  to the ex-
ternal meatus of the affected ear, instead of from one auditory passage
to the other.
  Dr. Thomas Radford2 employed galvanism with great success in the
treatment of  cases of uterine hemorrhage, accidental or unavoidable,
accompanied by exhaustion, and occurring before, during, or after la-
bour.  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  obstacles  exist.3   He  also sug-
gests the probability of its proving valuable in originating uterine action
de novo in cases where it may be deemed necessary to induce prema-
ture labour;  and that it may be worthy of  trial in certain cases  of
menorrhagia  in the ungravid state, where, on  examination per vagi-
nam, 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 simul-
taneously 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 continued so as to meet
the  exigencies of the case.   More recently, Dr. Radford,4  in vindi-
cating his claim to having been the first to recommend and employ gal-
vanism as an  obstetric agent in Great Britain, gives the following list
of cases in which he considers it may be  employed:—1.  In tedious la-
bour, arising from uterine inertia. 2. In accidental hemorrhage, either
before or after the rupture of the membranes, and especially when ex-
haustion from loss of blood exists.   3. In placenta pravia, in which the
practice of detaching the placenta is adopted, and the vital powers are
greatly depressed.   4.  In internal flooding,  before  or during labour.
5. In post partum floodings.   6.  In hour glass or irregular contraction
of the uterus.  7. To originate de novo uterine action, or when it is de-
sired to induce premature labour.   8. In abortion, when the indications
show the necessity, or justify the  expulsion  of the  ovum;  and 9.  In
asphyxia in infants.

  1 Beitr'age zur Ohrenheilkunde, Berlin, 1845; and Brit, and For. Med. Review, July,
1847, p. 22.
  2 Provincial Medical and Surgical Journal, Sept. 18, 1844, p. 386; and Dublin Quart.
Journal, May, 1847.
  3 See a case by Mr. Clarke,  Dublin Hospital Gazette, March 1, 1845, and Braithwaite'a
Retrospect, January—June, 1846, p. 423.
  * Lancet, Nov. 25, 1853. 
ELECTRO-MAGNETISMUS.
315
  Successful cases are also related by Messrs. Thomas Dorrington,1 II.
Wilson,8 Mr. Cleveland,3 Haighton,4 and  others.
  In a case of amenorrhea, electro-magnetism was used with success
by Dr. Collins.5  He had applied the electro-magnetic machine in some
other  cases with the happiest effects; and was induced 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 po-
sitive  poles alternately to the spine and abdomen: the remedy was con-
tinued five days, from five to ten minutes each  day, when the catame-
nia were fully re-established.   Dr. Collins adds, that he has used it
with good effect in rheumatism.
  It has likewise been employed with success in amenorrhcea and dysme-
norrhoea, by Dr. Robert L. M'Donnell, of Montreal,6 and by Dr. Walkly,
of Mobile.7   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 protect 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 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 trochanter.
   Dr. Walkly8 thinks electro-magnetism as a parturifacient far pre-
ferable to ergot, for the reason, that the  pains induced by it are regu-
larly 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 succession of
shocks be passed for from three to five minutes.  Dr. R. Barnes,9 too,
in a long communication, endeavours to show the complete superiority
of galvanism over ergot in the management of labour characterized by
defective  uterine action.   He regards the ordinary electro-magnetic

  1 Provincial Med. and Surg. Journal, March 11 and 18,1846.      3 Ibid. Ap. 29,1846.
  1 Dr. G. Bird, Lectures on Electricity and Galvanism, in London Medical Gazette, June
11, 1847.                           * Dublin Quarterly Journal, Feb. 1832.
  6 London Lancet, Jan. 25, 1845, p. 91.
  6 British American Journal, cited in Ranking's Half-yearly Abstract, July to December,
1846, p. 170.
  7 New Orleans Med. and Surg. Journal, July, 1846,  p.  52.
  8 Op. cit.                            9 Lancet, Nov. 5 and 12, 1853. 
316
ELECTRO-MAGNETISMUS.
apparatus in use for medical purposes as the best form that can be em-
ployed.  He  has observed, that the uterine  contractions are always
provoked at the break and renewal of  the circuit.   Repeated shocks
act as  a far more effectual and  certain stimulus to uterine contraction
than a continued current.  He  does not consider it necessary to apply
one pole over the spine, and the other to the neck of the uterus.  He
has found it more convenient, and quite as effectual, to apply the disks
covered with  thin flannel moistened in water,—one  on each  side of
the abdomen over the uterus.
   The application of galvanism  to induce and increase  parturient
contractions of  the  uterus  has  often  been proposed.  It was sug-
gested by Herder1 in 1803, and by Dr. F. Ramsbotham in 1834,2 but
does not appear to have been employed by them.   Several trials were
instituted by Professor Simpson, of Edinburgh, with the view of ascer-
taining 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 fre-
quent  in their recurrence, but shorter in their duration during the ap-
plication  of galvanism;  in  five other  cases, it neither increased the
average frequency 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 entirely useless as
a stimulant  to the parturient action of the uterus."
   There can be no doubt, however from the mass of  testimony, much
of which has been collected by Dr. Channing,3 of Boston, that uterine
contractions may be excited by the powerful stimulation which inter-
rupted electro-magnetic currents are capable of inducing.
   In  the opinion of Dr. Golding Bird,4 electricity is  the only really
direct  emmenagogue with wdiich experience has furnished us.   "I do
not think," he  remarks, "I have ever known it  fail to excite men-
struation  when  the uterus is  capable  of  performing this  function."
"The  rule," he  adds, "for ensuring success in the great mass of cases
of amenorrhoea  is sufficiently  simple.   Improve the general health
by exercise  and tonics; remove  the accumulations often present in the
bowels by appropriate purgatives; and  then a few electrical shocks—
often a single one—will be sufficient to produce menstruation, and at
once to restore the previous deficient function."  As the author has
  1 Diagnostische Praktische Beitrage  zur Erweiterung der Geburtshulfe, Leipz. 1803,
cited by Professor Simpson, in Monthly Journal of Medical Science. July, 1846, p. 33,
and Obstetric Memoirs and Contributions, p. 375. Edinb. 1855.
  2 Simpson, Op. cit.
  3 Notes on the Medical Application of Electricity.  Boston, 1849.
  * Lond. Med. Gaz, June 11, 1847.
  B General Therapeutics and Mat. Med. 5th edit. i. 461.  Philad. 1853. 
ELECTRO-MAGNETISM US.
317
elsewhere* remarked, however, improvement of the  general health is
itself an efficient agency in the removal of amenorrhoea.  An admirable
mode of using it, according to Dr. Channing, is the hip-bath, in which
one of  the poles of the electro-magnetic or galvanic apparatus is im-
mersed near the organs to be especially acted upon: the other handle
is  applied in the course of the spine, or in the bath on the opposite
side of the body.   Dr. Tracy E.Waller1 recommends it as a valuable
agent in prolapsus uteri.
   An interesting case of poisoning by opium is recorded by Dr. Thomas
S. Page,2 of Valparaiso, in which electro-magnetism was  successfully
employed to cure the patient.  The breathing had become short and
hurried; the mouth widely extended, and jaw fallen; nothing seemed
capable of rousing him; the exhaustion was extreme; the pulse could
be felt feebly at the wrist, and was maintained  there, in  Dr. Page's
opinion, by the agitation which he had undergone.  Electro-magnetism
was now applied.   Whilst an assistant rapidly rotated  the wheel, Dr.
Page applied the balls at first to each side of the neck, and ran them
down behind  the clavicles.   The arms and body 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 the eyes opened, and  with a ghastly
 expression of countenance the head and body were thrown convulsively
 toward Dr. Page, and he groaned.   He now sank  back into his re-
 clining 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 out:—" 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 system prevents re-
 action and speedily  destroys life.  In all cases of  asphyxia he con-
 siders it will be useful, and believes that in very many instances  it
 might be  applied with the happiest effects in asphyxia  neonatorum.
    When  employed—as every form of electricity occasionally is—to
 modify the function of nutrition for the removal of morbid growths,
 or to promote the absorption of effused fluid, as in hydrocele ;3  mag-
 neto-electricity is  most commonly administered in the way of electro-
 puncture ; yet excellent  effects  are not unfrequently  induced by the
 employment of the  magneto-electric influence in the shape of shocks
 passed through the  part affected for a longer or shorter period.

   1 Medical Examiner, April, 1848, p. 238.
   "Amer. Journ. of the Medical Sciences, Aug. 1843, p. 301.
   8 Ogier, in Southern Journal of Medicine and Surgery, No. 3 ; and Frost, Charleston
 Med. Journal, July, 1848. 
318         ELECTRO-PUNCTURA AND GALVANO-PUNCTURA.
    LXXVI. ELECTRO-PUNCTURA,  GAL'VANO-PUNCTURA.
Synonymes. Electro-puncture, Electro-puncturation,  Galvano-punctura,  Galvano-
  puncture, Galvano-puncturation.          i
German. Electropunctur,  Galvanopunctur.
  Electro-puncture consists in a union of acupuncture with electricity.
The idea of the conjunction appears to  have  originated with Berlioz;
but Sarlandiere  was, doubtless, the  first who put  it in  practice, al-
though J. Cloquet has contested the priority with him,—a matter, by
the way, as in all such cases,  of extremely small moment.   The opera-
tion consists in  employing acupuncturation in the usual way, either
with a single needle,  or with  twTo or more; and making a  communica-
tion 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 ap-
pears to have  employed  electro-puncture with great  success; but he
restricts its use  to rheumatic or neuralgic  pains, uncomplicated with
organic mischief or  inflammation:  when such complications exist, he
advises that blood-letting and  general  antiphlogistics should be pre-
mised.1  Guersent  thinks it  better, in  all these cases,  to use  simple
acupuncturation, 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 which voluntary
motion and sensibility were destroyed, has been published.2  The pa-
tient 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.  Jobert3 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.  An-
other 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 chlorohydric acid, is  passed
through the eye of one of the needles,  and the end of the other con-
ducting wire is made  to touch.the opposite needle.  M. Jobert has used

  1 E. Grafe, art. Electro-punctura, in Encyclop'ad. Worterb. der Medicinisch. Wissensch.
x. 550.   Berlin. 1834.
  2 La Lancette Francaise, Dec. 20, 1836; cited in  Amer. Med. Intel., Oct. 16,1837, p. 20..
  3 Cited from L'Examinateur M.dicale, in  Lond. Med. Gaz., June 2, 1843, p. 35C. 
ELECTRO-PUNCTURA AND GALVANO-PUNCTURA.         319
in the beginning eight pairs of plates as a battery; afterwards, ten and
twelve pairs, and as high as eighteen;  and he asserts, that he has had
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 was felt for eight days; but it never exceeded a slight
pain,  and ceased of itself.   When the patient was irritable, only one
shock was given; but he has given two and even three shocks to  per-
sons whose sensibility was obtuse,  and who had been already subjected
to electro-puncture.  In general, he permitted  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 galvano-
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.  Magen-
die regards electro-puncture  as the remedy par excellence in the treat-
ment of  obstinate neuralgia.1  In rheumatism of the chronic form, it
has afforded almost instantaneous relief; and  M. Raciborski2 found it
 of essential advantage in cases of sprains.
   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 maxillary, making
 these communicate respectively with the poles  of a galvanic pile  of
 twelve pairs of plates, each six inches square.  Whenever the contact
 was made, the patient experienced a  painful commotion  in  the  course
 of the nerves, and at  the bottom of  the orbit; light became better ap-
 preciated, and  the pupil  contracted.  A  case has  been reported by
 Dr. Dacamina3  of palsy  of the  tongue, which was cured  by it.  In
 1813, an old woman was seized with  general paralysis of sensation and
 motion  in consequence of fright.   This  passed away,  except  as re-
 garded the arms, head and  tongue.    She was unable to articulate a
 word.  Twenty-three years afterwards, Dr. Dacamina had recourse  to
 galvano-puncture,—one pole of the apparatus being applied to the oc-
 cipital nerve by means of  a needle introduced into  the  neck, and the
 other to the tip of the tongue.   After  two  applications,  the patient
 could raise the organ; and after the third,  she could  reply to some
 questions intelligibly,  although with  difficulty.  After this, the  points
 of contact were  varied, and the electricity  wras applied to  different
 parts.  The patient gradually recovered her speech, and the other pal-
 sied parts were also cured.
   In cases of asphyxia, galvano-puncture has been proposed to  arouse

   1 Medico-Chirurg. Rev. July,  1841, p. 202;  see, also, Dr. Shuster, in Lond. and Edinb.
 Monthly Journ. of Med. Science, June, 1844, p. 510; and Dr. Cowan,  in Address before
 the l'rovincial Med. and Surg. Association, in Braithwaite's Retrospect, Amer. edit. xii.
 Sti.  N. Y. 1815.
   ' Cited in Southern Medical and Surgical Journal, July, 1846, p. 436.
   5 Psychological Journal, January, 1819. 
320         ELECTRO-PUNCTURA AND GALVANO-PUNCTURA.
the dormant energies.   The effect of electricity, in the different 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,1 and  others  have highly re-
commended  it;—the latter gentleman, on  the strength of numerous
experiments on animals.   As  the object, in these cases, is to arouse
the respiratory muscles to action, the electric shock  may  be passed
through the shoulders or the chest in any direction.  Neither  common
nor galvanic electricity is  possessed of much—if any—power to re-
store  the action of the involuntary 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, al-
though the voluntary muscles responded to  it energetically.   Besides,
were  the action of the heart reWcited by it, this could be but momen-
tary.   A necessary stimulating agency to that viscus  is distention by
the proper fluid, and unless the respiratory movements were restored,
and the conversion of venous into arterial blood effected, so that the lat-
ter 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 accom-
plished.2
   M. Leroy d'Etiolles3 has suggested galvano-puncture  in a manner
which, at the first  aspect, appears most  formidable;  but which is
really less so than it seems to  be, in consequence of the impunity with
which fine needles can be made to penetrate, as has been seen,4 even
the most important organs.   He  introduced an  acupuncture needle
on each side, between the eighth and ninth ribs, until it reached the
fibres of the diaphragm.   He then established a galvanic current be-
tween 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 accomplished.  He then interrupted  the circle,
when the diaphragm, urged  by the weight of the abdominal viscera, and,
aided by gentle 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 respi-
ration was  reinduced.   A  continuous current was likewise employed
in some cases;  but  the respiratory movements were irregular, and no-
thing 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.5   On different oc-

   1 Archives Generates de Medecine, torn. xii.
   2 Art. Asphyxia, by the author, in  the American Cyclopedia of Practical Medicine,
part x. p. 486, Sept. 1836; and in his Practice of Medicine, 3d edit. i. 475.  Philad. 1848.
   3 Magendie's Journal de Physiologie, torn. vii. torn. viii. and torn. ix.; also, Recherches
Exp.rimentales sur l'Asphyxie, Paris, 1829; and Bourgeois, Observations sur la Possibilite
du Retour a la Vie dans Plusieurs Cas d'Asphyxie.  Paris, 1829.
   * See art. Acupuncture, p.  71.                 5 j0Urnal de Physiologie, ix. 
ELECTRO-PUNCTURA AND GALVANO-PUNCTURA.         321
casions, M. Leroy asphyxied animals of the same kind, and apparently
of the same strength, and while those that were left to themselves pe-
rished, those that were  treated by galvanism recovered.  As an aid,
therefore, to pulmonary insufflation, and  an important one, galvanism
—combined  or not with  acupuncturation,—might be advantageously
employed in asphyxia, but, as has been  already remarked,  it  can
rarely be available.   Certainly,  no  time should  be lost in adopting
the other energetic and indispensable measures that are demanded.1
It has been  recommended, that as only a very small  apparatus is ne-
cessary,  batteries, consisting of a few plates, might be  kept wherever
there are station-houses for  the reception of persons in  a state of as-
phyxia.9   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.3
   In a paper read before the  French Academy of Sciences, in Janu-
ary, 1843, Dr. Shuster4 reported  the following conclusions as the re-
sult of his employment of electro-puncture in disease.  First, Electri-
city is only useful as a therapeutical agent when introduced into the
substance of the affected  organs by means of acupuncture.  Secondly,
 Galvanic electricity and the electro-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 successfully are:—First, hydrocele, ascites (idiopathic or symp-
 tomatic  of curable lesions,) hydrothorax and articular  dropsies.   Its
 use may be extended to chronic hydrocephalus, dropsy of the pericar-
 dium, and  the greater part of dropsical effusions.  Secondly, lipo-
 matous,  steatomatous,  atheromatous, melicerous, serous and synovial
 cysts.   Thirdly,  congestions and indurations, chiefly those of the lym-
 phatic glands, of the testicles and epididymis; indurations of the areolar
 tissue in the neighbourhood of certain 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 cancer-
 ous affections in  the  same  way.   Fourthly, goitre.  Fifthly, varicose
 dilatations,  especially when electro-puncture can be aided by rest and
 compression; and he  does  not despair  to employ it with^advantage
 in cases of aneurism and erectile tumours.   Sixthly, chronic rheuma-
 tism, neuralgia,  and certain nervous diseases.   Seventhly, paralytic
 affections in general,  but  especially those  of the retina, (amaurose
 est/unique,) and  of the muscles of the voice, (mutisme paralytique.)
    M. D. Tavignot5 gives the  case of a young girl, who was  affected
 with catarrhal conjunctivitis, with enormous chemosis, and infiltration
 of the cornea with lymph;  a central ulceration occurred, which finally

   1 See art. Asphyxia, Op. cit. p. 486.
   s Kay, in Edinburgh .led. and Surg. Journal, xxix., and in his work on Asphyxia.
 London, 1834.
   •' See Most, Art. Galvanismus, in Encycl.pad. der gesammten Medicin. und Chirurgisch.
 I'raxis, v. s. w. 2te Auflage.   Leipz. 1836.                       4 Gp. cit.
   b Bull,  de Therap. Juillet, 1854, p. 49, and Brit, and For.  Med. Chir. Rev. Oct. 18.4,
 p. 558.
        21 
322         ELECTRO-PUNCTURA AND GALVANO-PUNCTURA.
 ended in central albugo.   After simple acupuncture, to accustom the
 eye in some measure, electro-puncture was used, and after four appli-
 cations, of some minutes each, at least two-thirds of the exuded mat-
 ter was removed; but the pain was so severe at each application, that
 the  patient would not continue the remedy.
   M. Zenobi Pechioli1 has detailed a case of double hydrocele in which
 he employed electro-puncture.   Two needles were inserted, 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 dis-
 continued in consequence of the right testicle becoming painful.  Five
 minutes after the removal 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 cedematous.   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  openings made by the
 common mode of acupuncturation are  too small to allow the fluid to
 escape, and he thinks, that by passing a current of electricity through
 the hydrocele, the contained fluid is forced out  through the sac into
 the areolar tissue of the scrotum, whence it is removed by absorption.
   M. Petrequin,2 of Lyons, has applied electricity to the cure of aneu-
 rism in three cases.  Two of these he had lost sight of before  the in-
 fluence  of the treatment could  be  duly  appreciated.   In another
 case, of aneurism of the temporal artery, galvano-puncture was per-
 formed by the introduction  into the  tumour of  two sharp steel pins
 crossing each other at right  angles;  the heads of the pins were then
 placed in communication with the wires of a voltaic pile, and a shock,
 and a sharp pain were experienced, the pain increasing with the intensity
 of the electric action.   The  operation lasted ten minutes, and fifteen
 plates were employed.   The  pulsations  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 tume-
 faction nor pulsation could be detected in the spot where the aneurism
 had  existed.  M. Petrequin  lays down  the following  precepts, an ob-
 servance  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 tu-
 mour 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.   Successful cases of  its employ-
 ment in  aneurism are given  by Drs.  Bellingham, O'Shaughnessy,3

  1 Bulletino delle Scienze Medic, di Bologna, Sept. 1841; and Dublin Journal of Medical
 Sciences, November, 1842, p. 311.
  2 Amer. Journal of the Med. Sciences, Jan. 1846, p. 229; cited from Med. Times, Nov.
 15, 1845; and Revue Medicale, Nov. 1846, p. 340.
  3 Ranking's Half-yearly Abstract, January to July, 1847; Amer. edit. p. 196; and
Ibid. July to December, 1847, p. 203. 
EMETIA.
323
Abeille,1 Borelli,2 and others; but it has been unsuccessful in the hands
of Liston, Phillips, Nelaton,3 Eyre,4 Schuh,5 and others, and has been
unfavourably reported on by M. Gimelle,6 before the Academy of Me-
dicine of Paris, who is so impressed with the numerous  dangers and
the ill success of  it, that he desired the Academy to  pass  an  ab-
solute condemnation of it.   This was, however, regarded  as  too  ex-
treme a measure, since cases in which the ligature could nottbe em-
ployed,  or  had been so usually without  success, might sometimes be
benefited by this  procedure.
   In regard to the best mode of employing galvano-puncture in aneu-
rism and varicose  veins,  it would appear from M. Steinlein,? that
Baumgarten had  obtained the following results.  1. The negative pole
alone gives rise to no coagulation.   2.  The two poles,  used together,
produce but a very slow, feeble,  and incomplete  coagulation.   3. The
positive pole  alone produces coagulation  very rapidly, completely, and
infallibly. ^ These results were  verified  by M. Steinlein, whose mode
of performing galvano-puncture is as follows.   The needles are thrust
into the aneurysmal tumour, or  the varicose vein, and then connected
with the positive  pole; after which the negative pole is brought in con-
tact with a, platinum plate,  and placed on the skin  in  the vicinity of
the aneurism.  The  integument is moistened with a dilute acid or a
Baline solution.   Instead  of the platinum plate, a sponge, dipped in
a saline solution, may be used.
   There can be no doubt that electro-puncture  is capable of materi-
ally modifying the  nutrition of the part on which it is  practised, and
that it will, consequently, be found to exert power over morbid depo-
sitions, solid as well as fluid.
                       LXXVII. EMETTA.
 Svkoxymes. Emetina, Emeta, Emetinum, Emetium, Emetine.
 French.  Emetine, La Matiere Vomitive.
 German. Emetin, Brechstoff.

   In the year 1817, MM. Pelletier and Magendie,8 by a series of che-
 mical and physiological experiments, discovered, that the various kinds
 of ipecacuanha  are indebted  for their emetic properties to a peculiar
 substance to which they gave the name Emetine.   This substance pos-

  1 Annales de Therapeutique, Novembre, 1847; and Ranking, Op. cit. January to June,
 184S, p.  107.
  1 Schmidt's Jahrbiicher, Bd. lxiv., S. 75; and Canstatt und Eisenmann, Jahresbericht,
 »■ s. w. im Jahre, 1849, v. 145. Erlangen, 1850.
  1 Lancet, July 13, 1853.
  4 Medical Times and Gazette, Sept.  10, 1853.
  1 Prag. viert. Jahrschr. 1851; Dublin Quart. Journ. Nov. 1851, and Amer. Journ. of the
 Med. Sciences, Jan.  1852, p. 252.
  * Bulletin de 1' Academ. xv. 572-82; and M. Boinet, in Mem. de la Societe de Chirurgie,
m. 1852, p. 120, 1852; cited in Brit, and For. Med. Chir. Rev. Oct.  1852.
  ' Lancet, Feb. 18, 1854, and Amer. Journ. of the Med.  Sciences, April, 1854, p. 507.
  'Journal de Pharmacie, iii. 145; and Magendie, Formulaire pour la Preparation d«
Plusieurs Nouveaux M.dicamens, &c. 
324
EMETIA.
sesses 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,1 bear the same relation to  each
other as. moist sugar does to the white and crystallized.  Ipecacuanha,
derived from cephaelis ipecacuanha, contains the most emetia.
   Emetia has been received  into many of the Pharmacopoeias, as the
Parisian, Batavian, Hanoverian, &c.

                      METHOD OF  PREPARING.
   1.  Coloured Emetia.—Powdered ipecacuanha  is  digested in ether
at 60° (.720)  to  dissolve the fatty matter whence  it derives its  disa-
greeable odour, and which possesses no emetic virtue.  When the powder
yields nothing more to ether, it is exhausted by means of alcohol: the
alcohol is then evaporated in a water-bath, and the residue is dissolved
in cold water.  It thus loses some of the wax, and a little fatty matter,
which still  adhered to it;  it is then only necessary to mix it with car-
bonate 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 odorata, an active, alkaline, bitter and acrid
principle, similar  to emetia from ipecacuanha, which he denominates
emetine of the violet, indigenous emetine or violine.   According to Or-
fila, it possesses highly poisonous qualities.2
   2.  Pure  emetia—Cephaelinum, of Bischoff.—This  is obtained by
substituting calcined magnesia, for the carbonate used in the process
just described, in such quantity, that the acid existing in the liquid may
be neutralized, and that which is associated with the emetia be  sepa-
rated 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 eme-
tia obtained by the evaporation of the alcohol, must then be dissolved
in a dilute acid and treated with pure  animal charcoal.   After this
purification, the emetia must be precipitated by a  salifiable base.  The
waters  used  to wash  the magnesian precipitate still contain emetia,
which may be separated by a second series of operations.
   Coloured emetia appears in  the form of reddish brown, transparent
scales; is almost inodorous, and of a bitter,  but not nauseous 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 yellowish ap-
pearance ;  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

   1 Op. cit.                       2 Journal de  Pharmacie, Janvier, 1824. 
EMETIA.
325
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.

              EFFECTS  ON THE  ECONOMY IN HEALTH.
  According to Magendie,1 from half a grain to two or three grains
of coloured  emetia given to dogs  and cats, excited vomiting,  at times
followed by  long sleep.  In larger doses,—ten grains, for example,—
it occasioned, in dogs, repeated vomiting, after which  the animal fell
asleep, and  generally died  in  twenty-four hours.   On dissection, vio-
lent inflammation was found in  the lungs, and in the mucous membrane
of the stomach and bowels throughout their whole extent.  The effects
were the same when the 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 eco-
nomy.  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, however, been much used, except by Magendie himself.   M.  Ler-
minier, who  prescribed it, says that one or two grains of coloured eme-
tia are  equal in  strength  to from ten to twenty of ipecacuanha; but
that he observed no difference in their operation, and Dr. Domeier2 ap-
pears to have arrived  at the same conclusion.  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 frequently passed off in commerce, and occasion,
in consequence, considerable disappointment in the mind of the practi-
tioner.  The employment  of the active principle of  course  precludes
these inconveniences.3
  Prollius has frequently administered pure emetia, which he recom-
mends as a substitute for ipecacuanha, on the grounds above mentioned;
and he properly adds, that the  price is not a matter of so much moment
as it might seem to be, by reason of  the very small quantity required
to produce the desired effects.
  When made into an ointment with lard, and rubbed on the skin, it
produces a  great number  of small   painful pustules, which neither
suppurate  nor  leave  pits.  It may be used in all cases in. which the
unguentum  antimonii is needed; and where  it cannot be applied, as

  1 Op. citat.                   2 London Medical Gazette, Sept. 14, 1839, p. 229.
  8 Clinique Medicale, vol. i.  Paris, 1823. 
826
EMETIA.
 on the face.  It has been rubbed on the chest in diseases of the lungs,
 nervous palpitation, and rheumatic pains.1

                     MODE  OF ADMINISTRATION.
   To produce vomiting, three grains of coloured emetia may be dis-
 solved in any vehicle,  and  given in divided doses, at  short intervals.
 In several  cases, with Dr.  Domeier,2 one grain was amply sufficient.
 Of pure emetia, Magendie found, in  a man eighty-five years of age,
 one-sixteenth of  a grain enough to induce vomiting.  He  remarks,
 however, that the  man was  easily made  to vomit.   Prollius found the
 medium dose of pure 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 had he 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 emetia.  vomitoria.
                       Emetic mixture of emetia.
                 R.  Emet. colorat. gr. iv.
                     Infus. flor. aurant. f ^ij.
                     Syrup, flor. aurant. f^ ss.  M.
   Dose.—A  dessert-spoonful  every  half  hour,—to excite  vomiting.
 Any simple distilled water and syrup may be  substituted for those of
 orange flowers.                                         Magendie.
                   Pastilli emetiae  pectorales.
                      Pectoral lozenges of emetia.
                 R.  Emetia.  colorat. gr. xxxij.
                     Sacchar. ^iv.
               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.  Emetiaa  colorat. gr. xxxij.
                     Sacch. §ij.
                 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 emetiae purificatae vomitoria.
                   Emetic mixture of purified emetia.
                 R.  EmetiBe  purif.—in pauxil. acid. nitr. solut.—gr. j.
                     Infus. flor. tiliae f ^iij.
                     Syrup, althaea, f 3J.  M.
   Dose.—A dessert spoonful  to be given every quarter of an  hour,
until  vomiting is induced.

  1 Aschenbrenner, Die neueren Arzneimittel, v. s. w. S. 108.  Erlangen, 1848.
  »Op. citat.                                             & 
ERGOTA.
327
                        LXXVIII. ER'GOTA.
Syxonymes. Secale  Cornutum seu Luxurians  seu  Clavatum, Clavus  Secalinus,
  Calcar, Secalis Mater, Semina Monstrosa  Secalis Cerealis, Ustilago, Clavus Sihgi-
  nis, Spurred Rye, Corned Rye, The Spur, Ergot, Hornseed.         ^
French.  Seigle  Ergote, Ergot de  Seigle, Ble Cornu, Clou de Seigle, Mere de Seigle,
  Bled  Avorte, B. Farouche, Faux Seigle, Seigle Cornu ou Corrompu, S. &. Eperon,
  S. Ergotise, S. Ivre, S. Noir.
German. Mutterkorn, Gebarpulver, Afterkorn,  Schwarzkorn, Aetzrog-
  gen,  Hahnensporn.
   The effects which this substance is  capable of exerting on the uterus
are so well known  as  not to need  any lengthened description.   Its
employment in parturition having been revived in this  country, there
are but few who are ignorant of its reputed properties.   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" appearance1—is usually considered to  be the result  of  a
disease in rye, occurring most frequently when a hot summer succeeds
a rainy spring.2   Decandolle, however, regards it as a parasitic fungus,
which he  terms 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  Fungaceae, and  terms it Sper-
moedia clavus; and in the  last edition of the  London Pharmacopoeia,
it is referred to Acinula clavus of Fries;3 but, according to Lindley,
Fries  has no such plant in  any of his works;  and the  only  species of
Acinula  known,  Acinula candicans, is found  on the rotten leaves of
the  common alder, and among  melting snow;  its  organization  is of
another kind from that of the spermoedia; and Fries, who regards the
other  as  a morbid state of the grain  of certain grasses, regards acmula
as a true fungus.4  M. Debourge considers,  that  ergot is  an  animal
product of the telephorus family.   The insect deposits a  liquid ot its
own formation on a grain of rye, and produces the ergot;  whence  it
follows, 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.5                      .    .   .          •     +
   Mr  Smith6 and Mr. Quekett,' however, maintain that  ergot is not
a fungus, but a diseased state of the grain  occasioned by the growth

   SSr^hTEdUTed. and Surg. Journ., Jan. 1841.            » Syst. Mycol.
   < Brande'! D ctionary of the Materia Medica, p. 233. Lond. 1839   See  also, Venus,
GrundrTss  der Medicin Receptirkunst, v. s.  w. S. 347, Weimar, 1838; and the opinions
of SchreLr De Geer, Parmentier, Buffon, Von  Munchausen, Tessier, Zuckert, Rossig,
 Hube,  Aymen, Robert, Tillet, &c, in Wright Op. cit.                .„„„    ,  .
   5 Socils Sarantes, in Encyclographie des Sciences Medicales Avril, 1838; and  A.
Richard, Elements d'Histoire Xaturelle Medicale, 4eme edit  n. 13 Pj™ ^
   « Transactions of the Linnean Society  of London,  xvm. Pt. 3 p. 419.  Lond. 1840.
   t IbTd p  453, and London Lancet, June 22, 1839, p. 465.   See, also, au abridgment
 of a communication read by Mr. Quekett before the Linnean Society Dec. 4, 1838, with
illustrative wood-cuts, in American Journal  of Pharmacy, for ^ 1839,  P'• ^J- ™r
remarks on an insect met with in the diseased grain, see a paper by Mi. Muller, of Butler
 county, Pa., with comments by Dr. Carson, in Amer. Journal of Pharmacy for Jan. IS..>, 
328
ERGOTA.
of a fungus  not previously detected:  to  this fungus the latter gives
the name, Ergotsetia1 abortans  or Ergotsetia  abortifaciens.   By the
microscope, they discovered sporules, sporidia, or jointed bodies, which
appeared to be the reproductive  particles  of the fungus.2
  Mr. Francis  Bauer,3 who has made ergot  a  subject  of particular
study, and who, many 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  re-
cent observers, are the cause or the consequence  of the ergot:—be-
cause, first—every gramineous plant  is  equally infected with  that
minute filamentous fungus, yet very few of these plants produce ergots,
—amongst agricultural grains, the rye being the only one that is sub-
ject to the  disease; and  secondly, in autumn all decaying plants
are infected with  such  filamentous  fungi and  minute  sporidia.    M.
Bauer's investigations led him, however, to determine the ergot to be
a morbid condition 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 furrows, and
often irregularly cracked and fissured.   Externally, it is of a dingy-
purple  hue; internally, of a pale  grayish-red or grayish-white.   Its
odour is peculiar, fishy and nauseous;  taste obscurely acrid and dis-
agreeable.   Unless excluded from the air, it swells and  softens, ac-
quiring 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 ergot, 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.4  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. Rowle5 keeps a  small
piece of camphor in the stopper  bottle which contains the ergot.  This
soon  annihilates the whole race of insects, and  adds greatly to  the
certainty of the effect  of the  medicine.  The plan had been recom-
mended  before by Dr. Bright.6   It has been advised that the camphor
should  be mixed with the ergot, in the  proportion of a grain to a
scruple.7  Dr. R. J. Nunn,8 of  Savannah, puts  into an ounce bottle

  1 From ergota and ant*., "cause."
  2 See the views of Quekett, Zink, Corda and others on the fungus, to which Dr. Pereira
has given the  name  O'idium abortifaciens. ergot-mould, from  coov, "an egg," and n.o?,
"resemblance," in Pereira's Elements of Mat. Med. and Therap. 3d Amer. edit. ii. 133.
Philad. 1854.
  3 Transactions of the Linnean Society of London,  xviii. Pt. 3, p. 481.  Lond. 1840.
  4 Pereira, Elements of Mat. Med. and Therap. 3d Amer. edit. ii. 135.  Philad. 1854.
  0 London Lancet, Aug. 10,  1844.
  6 Edinb. Med. and Surg. Journal, No. 141, and Lond. Lancet, Aug. 24, 1844.
  7 Mr. Simpson, Lond. Lancet, Sept. 7, 1844.
  8 Amer. Journ. of Pharmacy, June, 1855, p. 310. 
ERGOTA.
329
in which the powder is to be kept a dram of a solution  of camphor in
the ether, consisting of 80 grains of camphor to the ounce of ether.
   It has been proposed to dip the dried ergot in a concentrated solu-
tion 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; keeping it after-
wards in a well-stopped bottle.1   M. V. Legrip2 has advised the fol-
lowing method for preserving it in good condition 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 hermetically.   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 preserva-
tion, of which he speaks from experience.3  Procure a choice specimen
of ergot;  reduce it to  powder;  have  in readiness a sufficient 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, Dr.
Wright remarks,4 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  clearly;  exhibiting a
pink blush interiorly;  unpunctured by insects; burning with a clear
jetting flame, and 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.5
   When examined by the microscope, the  internal  structure of ergot
is found to consist of  minute roundish cells,  many of which 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 believed by many
to owe its  origin.6
   Chemical analysis has thrown  no light on the cause of its proper-
ties.   According to that  of Vauquelin,7 it contains a colouring  matter
   1 M. Martin, Journ. de Chim. Med. Avril, 1841.
   2 Journal de Chimie Medicale, and Lond. and Edinb. Monthly Journ. of Med.  Science,
April, 1845.
   3 London Lancet, cited in Med. Examiner, Oct. 19, 1844,  p. 251.
   * Edinb. Med.  and Surg. Journ. Oct. 1839, p. 296.
   6 Bottcher and Kluge, cited by Christison, Dispensatory, p. 414.  Edinb. 1842.
   "Christison, Op. cit. p. 411.   Edinb. 1842.
   7 M.moir.  du Mus.um, iii. 198. Paris, 1817. 
330
ERGOTA.
of a yellowish hue; a white oily substance; a violet-colouring matter
insoluble in alcohol;  a free acid, which is in part phosphoric; a very
abundant vegeto-animal matter, which  is greatly disposed to putrefac-
tion, and furnishes much thick oil and  ammonia on distillation;  and a
small quantity of free ammonia, which may  be obtained at the tempe-
rature of boiling water.  A more  recent analysis has been made  by
Maas,1 of Hamburg.   He found it  contain gluten; ammonia or a pecu-
liar alkali; acetic  acid; a  violet-colouring  matter: resin;  fixed oil;
an alkaline acetate;  but neither starch, hydrocyanic acid,  narcotina,
nor phosphoric acid, which some had discovered in it.2  It has likewise
been analyzed by Bonvoisin, Pettenkofer, Winkler, Robert, Wiggers,3
Legrip,4 and others.   The analysis of Wiggers is very elaborate.  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's5  analysis furnished him with the following constituents and
their proportions in 100 parts of ergot;  thick white  oil, 31.00;  osma-
zome, 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 fungin.   He gives the  following process for preparing the OIL  OF
ergot.6  Digest  ergot in  liquor potassae, at a temperature of from
120° to 150°, until a perfect saponaceous  mixture is formed.  The
liquid must then be diluted with half its weight of water, be accurately
neutralized by sulphuric acid, and submitted to distillation from a salt-
water or oil bath.   The product is white, adhesive, and fatty-looking,
almost fi*e 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.7
This Dr. Wright  considers  to be the active matter of ergot; and  he
states—as the result of positive experiment—that it has the same effect
in inducing powerful uterine contractions as ergot  itself.

                    EFFECTS ON THE  ECONOMY.
  The effects produced on  the animal  economy by ergot, when eaten
as food, are extremely injurious: the aggregate of the symptoms  has
been termed Ergotism.  At times  they are limited to vertigo, spasms,
and convulsions, with  a peculiar tingling or formication  in the arms
and legs, which has given the affection  the name, among the Germans,
ofKriebelkrankheitor "creeping disease."   Most commonly, the

  1 Bulletin des Sciences M6dica.es de Ferussac, xix. 332; and M.rat and De Lens, Diet.
de Mat. Med. art. Ergot.
  2 For Mr. Battley's Analysis, see Lond. Med. Gaz., Feb. 1831, and for that of Wiggers,
Lancet, Nov.  10, 1832, cited from  Allgem. Med.  Zeitung.
  8 Wright, Edinb. Med. and Surg. Journal, Oct. 1839, p. 298.
  * Bouchardat, Annuaire de Therapeutique, pour 1845, p. 44.  Paris, 1845.
  5 Op. cit.                        6 Edinb. Med. and Surg. Journal, July, 1840.
  7 Duhamel, Amer. Journal of Pharmacy,  July, 1841, p. 95. 
ERGOTA.
331
 limbs waste away, lose sensation and the power of motion, and separate
 from the body by dry gangrene—constituting qangrenous erethism or
 mildew mortification.1  These, however, are the toxical, not the thera-
 peutical, effects  of the agent.2
   The extraordinary property,  ascribed to ergot, of assisting the par-
 turient efforts, has long been credited in Germany.   Its old German
 names, Mutterkorn  ("womb-grain") and Gebarpulver ["par-
 turient powder," pulvis ad partum,) are sufficient evidences of this no-
 tion ; but, for a  long  time, this was  rather a matter of popular than of
 scientific belief, although  the "pulvis parturientis" of the Marburg
 Pharmacopoeia consisted principally of ergot.3
   About fifty 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 distinguished indivi-
 duals, 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 disturbance 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,4 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 ex-
 periments and  observation, that  there is no " farther connexion be-
 tween these degenerate grains and the uterus, than the word  Mutter
 ('uterus') which is common  to both."  From his various and varied ex-
 periments, Dr. Jorg infers, that ergot, when given in small doses, pro-
 duces little  or no effect upon the functions; but that when fresh-dried
 in an oven  and administered in large doses, it oppresses the stomach,
 occasioning nausea, vomiting, colic,  liquid evacuations; destroys the
 appetite,  and injures  the digestive powers; these effects being  accom-
 panied  by a sense of weight  in the head, vertigo, cephalalgia, and by
 general torpor of the  system.   Under these circumstances, he thinks,
 it is not difficult  to understand, that the connexion between the foetus
 and the uterus may be  modified,  and abortion  take place.  The re-
 searches of  M. Arnal,5 satisfied him, that  the first action of ergot is on
 the intestinal canal, in the mucous membrane of which it produces an
 inflammation sui generis (?), and anatomical lesions, which remind the
 observer of those seen in typhoid fever;  whilst  the greater  part of

  1 See articles, Convulsio cerealis, and Ergotism, in the author's Medical Lexicon, 12th
 edit. Philad. 1855; also, his Therapeutics,  p. 272, Philad. 1836; or  his General Thera-
 peutics and Mat. Med. 5th edit.ii. 209, Philad. 1853; and a case of Kriebelkrankheit,
 induced by ergot, in Med. Times for July, 1847, recorded by Dr. R.  R. Nuttall.
  2 See Chris'tison on Poisons, 3d edit. chap. xl. Wright, Op. cit. p. 307, and Jan. 1840, p. 9.
  8 Wright, Op. cit. p. 22.  See, on the History of Ergot, Ramsbotham, Principles and
 Practice of Obstetric Medicine and Surgery; appendix, Amer. edit. Philad. 1855.
  * Dass der Gebrauch inner  Reizmittel zur Beforderung der Geburt des Kindes unno-
 thig, fruchtlos, und gesunden Frauen sogar  sch'adlich sei; v. s. w. S. 40, Zeit. 1833.  See,
 also, Pereira, Op. cit. p. 138, and Bonjean,  in Rapport de MM. Bussy, Pelletier, Dubail,
Fremy pere et  F. Boudet, in Journ. de Pharmacie, Fevrier, 1842, p.  175.
  5 See a ResumS, by M. Piorry, of the Memoire of M. Arnal, in Bouchardat, Annuaire
de Therapeutique pour 1849, p. 124. 
332
ERGOTA.
the phenomena, seen towards the termination of poisoning by it, resem-
ble many of those of the same malady.  The composition of the  blood
he found greatly altered.  It was rendered more diffluent; a portion of
its fibrin was removed; and, if long continued, it produced softening
of the  gums, and  pathological phenomena,  analogous  to those  of
scurvy.
  The author caused various experiments to be instituted with  ergot
in doses of half a dram, and a scruple of the powder, and in the form
of the oily matter referred to below.   These were made on both males
and females; and the general effects were those described by Dr. Jorg;
—when  the  dose was too large, nausea or vomiting often  resulting,
with signs of narcosis.   They were made, at  the author's  desire, by
Drs. Cottman and M'Kee, at the time resident physicians at the Phi-
ladelphia Hospital.1   A case of narcosis, produced by this drug in the
dose of thirty grains—administeKed 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 Ra-
leigh, North Carolina.2
  Dr. Hooker, of New Haven,3 found, 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,
that there remained at the  bottom of the vessel a small quantity of
thick heavy 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.  The light  oil was
found to be  possessed of  decidedly narcotic properties.  In two  ex-
perimental  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  ap-
petite, general languor and lassitude,  and rigidity and soreness of the
muscles;  those of the thighs and other parts of the lower extremities
being more particularly affected.   For three days, the pulse continued
below fifty, with a proportionate infrequency of respiration.4
  In the experiments made with this substance, by Dr. M'Kee,5  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 followed by sedation, and
in the larger doses by nausea,  also.  The sedative properties were

  1 Amer. Med. Intelligencer, Sept. 1, 1839, p. 161.  See, also, M. Cordier, in  Journ.
Gen.  de M.d. Avril, 1823, and C. T. De Gravina, in Annali Universali di Medicina,
Ottobre, 1839, and Brit,  and For. Med. Rev. Oct. 1840, p. 555.
  2 Amer. Med. Intelligencer, Oct. 15, 1839, p. 213.  See, also, Trousseau and Pidoux,
Trait, de Th.rap. i. 546, Paris, 1837.
  3 Boston Med. and Surg. Journal, x. 298, Boston, 1837.
  4 See Amer. Med.  Intelligencer, Dec. 15,  1837, p. 329.  A case has  been  published
by Dr. Myddleton Michel, of sudden death, which he  ascribes to ergot taken with  the
view of producing abortion in  one who, owing to her  having been previously afflicted
in two attacks, with well-marked opisthotonos and emprosthotonos and nervous depression
of the vital energies, was a fit subject for the occurrence of such fatal results.  It does
not, however, appear to the author as clearly as it does to the narrator of the case, that the
sudden—immediate—death, was owing to the toxical influence of the ergot.   Charleston
Med. Journal and Review for Sept. 1850
  5 Ibid. Sept. 1, 1839, p. 161. 
ERGOTA.
333
equally exhibited in experiments instituted on the healthy individual,
by Dr. Q. Gibbon,1 of Salem, New Jersey, with the decoction, extract,
and oil.   The experiments of Dr. De Gravina,2 led him to  infer that
ergot is a direct sedative, 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 digesting
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 dis-
solved in  two fluidounces  of ether.   Repeated  trials of this pre-
paration have been made by Mr. J. C. W.  Lever,3  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 unfrequently produce acro-nar-
cosis, he has not once seen these symptoms 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 half a dram dose
of the powdered drug.   Mr. Lever gave  it,  dropped upon sugar, in
doses varying from fifteen drops to thirty, and found that uterine ac-
tion commenced in twenty minutes or half an hour.
   Although  ergot is capable of producing the acro-narcotic effects de-
 scribed above,4 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 con-
tractions constant and almost unremitting; but there is no accompa-
nying disorder.   Cases are on record5 in which it  has appeared to
 induce rupture of the uterus, where the obstacles to  delivery were  in-
vincible.   It has been largely administered, and in no country, perhaps,
more than in this.   Practitioners of 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 expulsive properties by
which it acts upon the parturient uterus; but that it  is capable of pro-
 ducing  any effect upon the unimpregnated uterus, or upon the impreg-
nated, at any time except when parturition has commenced,  is denied
 by many.   It has been affirmed, indeed, that in the neighbourhood of
 Trois Croix, in France, there was, during the season of 1841, an  epi-

  1 Amer. Journ. of the Medical Sciences, Jan. 1844, p. 244.              2 Op. cit.
  5 London Medical Gazette, April 10, 1840, p. 108.
  4 Boujean, cited in Bouchardat, Annuaire de Th.rap.  pour 1843, p. 85.  Paris, 1843.
  5 Delmas, Journal de M.decine de Montpellier. and Journal de Pharmacie, Juin, 1842,
p. 546. 
834
ERGOTA.
Bootic abortion  amongst the  cows, which had produced much conster-
nation amongst  the farmers;  and that M. Bodin,1 director of the school
of agriculture, 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 ex-
periments  of Dr. Wright,2 and  of Dr. De Gravina,3 seem to exhibit
the singular  fact, that ergot  appears to have the power of prolonging
gestation in the guinea pig and rabbit,  when administered for a consi-
derable period!4  The result of all observations precludes the  belief,
that the increased parturient efforts resulting from its agency are pro-
duced  indirectly by violence done to the  constitution of the mother,
inasmuch as, in  most of the recorded cases of benefit accruing from its
administration, no such violence would appear to have been perpetrated.
Yet, admitting  the full power ascribed to 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 writer, who  places the dis-
covery of its powers in the same  rank with that of  the vaccine virus,
states, that he has administered it in 1500 cases!5
   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 ac-
crues to the offspring;6 either by the induction of asphyxia, or positive
death, owing to  the violence of the uterine contractions, or to  the dele-
terious agency of the drug on the foetus in  utero.7  Observations by
Dr. Hardy,8 of Dublin, show, that  it exerts a powerful sedative in-
fluence  on the action of the heart of both mother and foetus.  But even
were we to admit its prejudicial effect on the foetus 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.9
   Mr. Braithwaite10 affirms,  that in order that ergot should act perni-
ciously 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

  i Journal de M.d. et Chirurg.  Pratiq. Oct. 1841.       « Op. cit.       3 Op. cit.
  * Brit, and For. Med. Review, Oct. 1840, p. 556.
  5 Wardleworth, Essay on the Chemical, Botanical, Physical and Parturient Properties
of the Secale Cornutum.  London, 1840.
  6 Chevasse, in Transact, of the Provincial Med. and Surg. Association, iv.  306, Lond.
1836.  Huston, North American Med. and Surg. Journ., 1829: and Chatto, in London
Med. Gaz., July 13, 1839, p. 575; also, Reports of Med. Society of London, in Lancet,
Oct. 26, 1839, p. 168, and Wright, Edinb. Med. and Surg. Journal, Jan. 1840, p. 25.
  7 Mojon, in Gaz. M.d. de Paris, 19 Janv., 1839; and T. E. Beatty, Dublin Journal of
Med. Science, May, 1844, p. 218.
  8 Dublin Journal  of Medical Science; cited in Med. Examiner, for Jan. 1848,  p. 75.
  9 Avery, in Transact, of the Med.  Society of the State of New York, vol. iii. Pt. 2, p.
185, Albany, 1837.
  io Retrospect of Pract. Med. and Surg. vol. i. No. 1, p. 181, 3d edit.  London, 1842. 
ERGOTA.
335
cases, it  has been largely administered, and yet the child has  been
born alive.   Dr. James Patterson,1 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, now before  the author, by Professor Von Busch,2 of
Berlin, which contains a  reference to one hundred and seventy-five
oases, 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  loss 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 ergot,
and there was no  reasonable ground for such reference.
   A recent writer3 is disposed to think, that ergot, improperly admi-
nistered, produces puerperal convulsions as a remote effect,—and that
it gives  rise to  hour-glass  contraction, and  to a predisposition to hy-
drocephalus in  the  early stage of  infantile life!   The chief or only
cases in  which Dr. Catlett seems to think it  admissible are, when there
is serious hemorrhage,  owing to detachment of the placenta, accompa-
nied by deficient uterine  tone;  and in the latter stage of labour, in
checking hemorrhage from whatever cause.
   Dr.  Frank Ramsbotham,4 who regards ergot as capable  of exerting
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 although it may
bring  on labour without having recourse to any operation, yet that it
does not present a  more  likely, or indeed, so probable  a  means of
saving the infant as  the older  method of puncturing the membranes j
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.5
   Dr.  Paterson0 and Mr. Ilcane7 have directed ergot successfully in

  1 Lond. Med. Gaz., June 1,1839, p. 337.  See, on this subject, E. Warren, New England
Quarterly Journal of Medicine and Surgery, July, 1842, p. 10.
  a Die  gebiirtshulfliche Klinik  an der koniglichen Friedrich-Wilhelms-Universitat za
Berlin, in Neue Zeitschrift fur Geburtskunde, u. s. w. B. v.  H. i. S. 107.  Berlin, 1837.
  3 Catlett, Edinb. Med. and Surg. Journal, Jan. 1842.
  4 London Med. Gaz., June 15th, 1839, p.  420.  See, also, Ibid. June 28, 1834.
  5 See, on this subject, J. J. Kelso, in London Lancet, June 22, 1839, p. 462; and Du-
parcque, in Revue Medicale,  Mars, 1838.  An interesting report on Ergot  in its obstetri-
cal relations was made by M. Danyau,  to the Academie de M.decine of Paris, in answer
to a quesiion from the Prefect of the Seine, " What may be the influence of ergot on the
life of the child, and on the health of the mother?"  Bouchardat, Annuaire de Th.rap.
pour 1851, p. <i5.
  6 Lond. Med. Gaz., June 1, 1839, p.  332.   See, also, Ibid., Sept. 1838.
  T Ibid. Jan. 26, 1So9.  For various opinions on this subject, see Dr. Wright, in Edinb.
Wed. and Surg. Journal, Jan., 1840, p. 27. 
336
ERGOTA.
large doses with the view of inducing premature labour.   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 ute-
rine 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 ute-
rine contractions, it  was philosophical to employ it in  retention of the
placenta, in after-pains,1 and in cases of uterine  hemorrhage, and of
convulsions'1 in the  parturient  state,  accompanied  by atony of  the
uterus.3  In such  cases, means of more speedy action are needed;  but
still, cases might arise in which  its administration might be servicea-
ble, and several such, attesting the benefit rendered by it, have been
published.4  It has been strongly recommended, likewise, for the pre-
vention or removal of uterine hemorrhage, by Stearns,5 Dewees,6 Brad-
ley,7 Abraham,8 Kisch, Trousseau,9 T. E. Beatty,10 and others.  In a
case of copious hemorrhage from the uterus connected with polypus,
Mr. Moyle,11  administered two drams of the  tincture, which was  re-
peated at intervals, with the effect of inducing uterine contraction and
the expulsion of the polypus, "which equalled in size  two large pla-
centae."  He 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.12
   The employment  of ergot has been extended to amenorrhoea13 and
dysmenorrhoea, and to uterine hemorrhage in the unimpregnatedfe-
male,  and many cases have been published in confirmation of its being
possessed of decided virtues.14   It was thought, also, that it might be
serviceable,—and was found to be so by Bazzoni,15 Negri, Langlet,J6 and
others,—in le ucorr hoe a, and M. Lacowski17 has recommended it strongly
in this disease when combined with sulphate of quinia; and in gonor-
rhoea,19 dysentery,19 &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,™
  1 Hoffman, in Berl. Med. Zeitung, June 29, 1836; and Beatty, in Op. infra cit.
  2 Duparcque, Revue Med. Mars, 1838.             3 Von Busch, Op. cit. i. 105.
  * Camps, London Med. Gaz., Jan. 13, 1843.
  5 Philad. Journ.  of Med. and Phys. Science, v. 44.          6 System of Midwifery.
  7 Lancet, April 15, 1837.                               8 iDUL  April 22, 1837.
  9 Journal des Connoissances, 1839.
  10 Dublin Quarterly Journal of Med. Science, May, 1846, p.  322.
  11 Lond. and Edinb. Monthly Journ. of Med. Science, June, 1841.   12 Ibid. Aug. 1841.
  13 Enriotti, in Repertorio  Med.  Chirurg. del  Piemonte, cited in Journ. des  Connois-
sances, Mars, 1838.   Langlet, Bulletin Medical Beige, Juin, 1839, p. 125.  Dewees, Mid-
wifery, chap.  Amenorrhoea; Locock, Cyclop, of Practical Medicine, i. 70.  Nauche, Nou-
veau Diet, de Med. et Chirurg., art. Ergot; and Dr. Wright, in Edinb. Med. and Surg. Jour-
nal, Jan. 1840, p. 34. See, also, Churchill, (with whom it failed,) Diseases of Females, Amer.
Med. Library edit. p. 54. Philad. 1839; and G. Fyfe, Med. Gazette, June 18, 1841.
  14 G. Fyfe, Op. cit., and John Yale, Boston Med. and Surg. Journal, July 8,1816, p. 459.
  15 Annali Universali di Medicina, Feb. 1831; and Ryan, Medical Formulary, p. 264, 3d
edit.  London, 1839.                                    ]6 Op.  citat.
  17 Gaz. Hebdomad. Dec. 2, 1853, cited in Ranking's Abstract, xix. 177.
  18 Muller, in Rust's Magazin, B. xl. H. iii. and Amer. Journal of the Medical Sciences,
Feb. 1835, p. 527; Ryan, Op. cit., and Desruelles, Gazette des Hopitaux, 2 Juin, 1842.
  is Mojon, Op. cit.                            20 j0hn Yale, loc. cit. 
ERGOTA.
337
 hsemoptysis,  hsematemesis, hsematuria, £c.  In these last cases, it has
 not been so often employed.1  The author has frequently administered
 it in them, but has never had reason to believe that it exerted any effi-
 cacy ;  and such has been the case with  MM. Trousseau and Pidoux 2
 Dr. Pereira,3 and  others.4  The narcotic or sedative  property, how-
 ever, which it exhibits in certain cases and doses, and the sedative action
 which it exerts m others may render it, at times, serviceable in these
 affections, whatever may have been  the process of reasoning which led
 originally to its employment.5
   Nickels,6 having given it in a  case of paralytic retention of urini
 in the dose of five grains of the powder every hour, observed, after  a
 few doses, a marked diminution  in the frequency of the pulse;—so that
 in two hours, it fell twenty to twenty-four beats in the minute.  This
 induced him to prescribe ergot in pneumonia after bleeding, in the form
 of infusion or light decoction (3ij to fSiv,) and after the use of a few
 spoonfuls he found the diminution of pulse and other signs of  a seda-
 tive influence supervene.   He observed equally good effects from it in
 acute rheumatism.
   Where hysteria depends upon simple atony of the generative system ;
 or of the nervous and generative systems combined, Dr. Nardo7 found
 the internal administration of ergot  followed 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 secretion having been removed at the same time.
 In spermatorrhoea, too, dependent upon atony or excessive irritation
 of the genital organs, it has been useful in the dose of from three to
 five grains three times a day.8
  # Dr. Wright9 affirms, that when applied to an abraded surface, it gives
 rise to profuse sloughing.  He tried it on wounds nearly healed, and
 in less than twenty-four hours they  discharged purulent matter abun-
 dantly, which 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 mecha-
 nical manner, as was proved by  experiment.  Even in the form of in-
 fusion,  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

  1 Duparcque, Op. cit., and De Gravina, Annali Universali di Medicina, Ottobre 1839
  2 Traite de Therap. i. 546.   Paris, 1837.
  8 Elem. of Mat. Med. and Therap. ii. 142.  3d Am. edit. 1854.
  4 See the author's General Therap. and Mat. Med. 5th edit. ii. 209.  Philad. 1853.
  5 See some remarks on this subject, by the author, in his Amer. Med. Intel, vol i p 219
  6 Canstatt's Jahresbericht, 1850, 5 Bd. S. 147.
  7 Cited in Edinb. Med. and Surg. Journal, Jan. 1843, p. 223, and in Bouchardat An-
nuaire de Therapeutique pour 1843, p. 93.  Paris, 1843.
  8 Ibid, pour 1848, p. 80.  Paris, 1848.            » Op. cit. Jan.  1840, p. 20.
       oo 
338
ERGOTA.
the external jugular and the saphena major veins, and has never failed
to arrest the hemorrhage by an infusion  of ergot, although with arte-
ries 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 recommends it as a va-
luable means of preventing troublesome hemorrhage from smallvessels
in  the course of surgical operations; and, upon  the same principle,
believes  the injection of  a  similar solution into the uterus, in cases of
flooding, will be found to answer every practical end that can be desired.
The decoction has proved  to be  an equally efficacious  haemastatic in
the hands of others.1
   In a severe case of epistaxis, Dr. Wright2 arrested the hemorrhage 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  hemorrhage 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.
   Snuffed up the nose, powdered ergot was observed, by M. Cow-
perat,3 to have the  power of removing the  dilatation of the pupil
caused by belladonna.  Dr. J. F. M'Evers4 repeated the  experiment,
and found that it did not  cause  any change when  employed on the
same day with the belladonna; but, in every case, on the subsequent
morning, whilst the pupils  were still  largely dilated, the ergot had  a
marked  effect in a few minutes.   In a case of mydriasis he prescribed
it with success.
   Dr. Wright found the oil a valuable external  application in  cases of
local rheumatism.   In  three instances, it  was entirely successful.
The  affected part was well rubbed with it for a quarter  of an hour,
night and morning, until relief was obtained.  He states, farther, that
it is one  of  the most valuable remedies with which he is acquainted in
toothache, and has repeatedly known it subdue the pain when  creasote
had failed.   By M. Lisfranc,5 the powder was  employed in the dose
 of from  two to eight grains, in cases of hypertrophy  of the uterus of
various kinds, whenever reduction of the organ to a less  size  seemed
 to be the prominent indication;  and Dr. Perrine6 has published some
 cases of periodical disease, in which  it was  administered with ad-
 vantage  during the intervals; but  no farther results  appear  to have
 been elicited.
    M. Payan7 thinks it demonstrated, that  ergot is  primarily and  es-

   1 Wright, cited in Liston's Lectures, London Lancet, Aug. 31, 1844, p. 691.
   2 Edinb. Med. and Surg. Journ., July, 1840.       3 Lond. Med. Gaz., Sept., 1848.
   4 Dublin Quarterly Journal of Med. Science, November, 1848.
   5 Pauly's Lisfranc, translated by Lodge, p. 330.  Boston, 1839.
   6 Amer.  Journal  of the Med. Sciences, for Nov. 1833, p. 279.
   7 Revue Medicale, Fevrier et Mars, 1839; and Journ. de rharmacie, Juin, 1842, p. 545. 
ERGOTA.
339
sentially an excitant of 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  mar-
row to those organs through the nerves distributed to them.   He has
given the details of some cases of paraplegia, which seemed to be re-
lieved by it; an infusion of fifteen grains in water being given at first
in the course of the day, and the dose being gradually augmented.1
  M. Allier, fils,2 from  having  observed, as  he believed, contraction
of the fibres of the bladder under the administration of ergot, has re-
commended it highly in cases of retention of urine;  and feels himself
justified  in inferring, from the results of varied observation, that it is
capable of restoring to the bladder the contractility 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 para-
lysis 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 be long continued.   He
recommends, that it should be commenced in the quantity of a scruple
in the day, divided into six equal parts; that the dose should be after-
wards 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. Kingsley,3 of Roscrea.  Ten
grains were given  three times a day.  Similar testimony is  afforded
by  Dr. J. J.  Ross,4 of Cambusmore, Dr.  Houston,  of Dublin,  Dr.
Sainmont,5 and others.6
   It  has been recommended by Dr. Steinbeck,7 in  incontinence of
urine from  want  of power in  the sphincter of the  bladder.   It was
associated, however, with extract of belladonna, nux vomica, and phos-
phoric acid;  so that it is impossible to say what precise influence was
exerted by it.
   Lastly: in the Annates de la Societe de Medecine de Grand, M. Guer-
sant8  has published  two  cases in which  he administered  it  with
the greatest advantage to effect  the expulsion of fragments 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, when the patient  experienced
frequent desire to pass the urine, followed by pain in the hypogastric
region, pricking in the limbs, and slight derangement of vision. After
using the medicine for  five days, fragments of calculi were  passed,

  1 See, also, G6rard and P.trequin, Bulletin de Therapeutique, Mars, 1840; and Dr. R.
D. White, Dublin Med. Press, April, 1852.
  2 Journal des Connoissances M.dico-Chirurgicales, Nov. 1838.
  3 Dublin Medical Press, April 26, 1843.
  4 Lond. and Edinb. Monthly Journal of Med. Science, Jan. 1844, p. 43.
  6 Gazette des Hopitaux, Juillet, 1848, cited in Schmidt's Jahrbiicher, u. s. w. No. 7, S.
17.  Jahrgang 1819.
  6 Provincial  Med. and Surg.  Journ. April 24, 1844; and M. Passot, Gaz. M.d. de
Lyons, and Rev. Me"d. Chir. de Paris, Avril, 1853, and Amer. Journ. of the Med. Sciences,
Oct. 1853,  p. 488.
  7 Medicin. Zeitung, cited in Lond. Lancet, March 4, 1843.
  8 Journal de M.decine et de Chirurg.  Pratiq. Novembre, 1839. 
340
ERGOTA.
and, during twenty-four  hours, in three times the quantity that  had
been discharged during the whole previous  period subsequent to the
operation.
                     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,1 in-
deed, 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
surface; not  powdery;  of a  deep purple colour;  neither entirely
black, nor light brown;  have  a full strong odour;  break clearly, ex-
hibiting 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.2
   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.  By many, as by M. Arnal,3 it  is considered
more  active than  any  of  its preparations.   Professor  Von  Busch4
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 re-
quisite 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 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. Ryan5 says the maximum dose is a dram and a half;
but it, obviously, cannot be thus limited.
   Dr. Samuel Hardy, of Dublin,6 has observed, that it has always com-
menced its action within twenty-five 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 run-
 ning into one  another without  any appreciable  interval.   Professor
 Beatty, of Dublin, affirms that  when delivery was not effected within
 two hours from its exhibition, the child's life was generally lost;  and
 such is the result of the observations of Dr. Hardy.7  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.8
    Dr. Hooker, who considers, that the  ecbolic  and  the narcotic pro-

   i Formulary, p.  264.                                2 Allier,  Op. cit.
   3 Bouchardat, Annuaire de Th.rap. pour 1849, p. 124.      4 Op. cit. S. 106.
   5 Op. cit.                       6 Dublin Journal of Med. Science, May, 1845.
   1 Dublin Journ. of Med. Science, cited in Med. Examiner,  Jan. 1848, p. 76.
   6 Dublin Hospital Gazette, cited in Amer. Journ of the Medical Sciences, Jan. 1846,
 p. 244. 
ERGOTA.
341
perties of ergot  may be  separated, recommends, in these cases, the
clear infusion, which possesses, he conceives, the former property only.
The powder of course contains both.
  Dr. Bishop, of New Haven,1 asserts, that he has seen but once any
unpleasant effects from ergot, and then he gave it in powder; the  la-
bour was protracted and narcotism induced.   In New Haven it is the
general practice to  administer the infusion, and in that form it is con-
sidered safe and effective  in  parturition.  It is not easy, however, to
see how the fixed oil can be taken up by hot water.2   The infusion is
termed in France,  " The de Seigle noirci des  sages-femmes  Ameri-
cainesl "3   By some, as will  be seen hereafter, the sedative and other
properties of ergot have been affirmed to exist in the aqueous extract
or 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. Wright4 recommends the oil of ergot to be given in the  dose of
twenty to fifty drops in  tea, weak spirit and water,  some aromatic
water,  or made into an  emulsion with mucilage and syrup.  It would
seem to be the most advisable form of exhibition, as the 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  al-
cohol will not extract the active property, and Dr.Ryan5 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 necessary
to give ergot in larger doses.  Dr. Paterson6 gave it  in the form of
infusion, until the patient took six drams of the medicine.   The infu-
sion was likewise given by  Dr. F. Ramsbotham,7  and the quantity
which each of his patients took varied from two to twelve  drams.
   As a  parturifacient, Dr. W.  R. Gore8 has recommended the am-
moniacal solution of ergot, a formula for which is given hereafter.  This,
he says, contains all the  active principles in a convenient form, and
with increased efficacy, the ammonia causing the ergot to act more ra-
pidly, 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 ob-
servations of Dr. Cottman9  have  shown, however, that in  30 grain
doses its  sedative effects are more  marked, and it was given in this
dose by M. Gerard, and Dr. R.  D. White in paraplegia.  This, too,
was the dose in which it was administered by Dr. Hooker.  In such

  1 Amer. Med. Intel. Dec. 15, 1837, p. 330.
  2 See the author's General Therapeutics and Mat. Med. 5th edit. i. 469.  Philad. 1853
  8 Journal de Pharmacie, F.vrier, 1842, p. 177.
  4 Edinb. Med. and Surg. Journal,  July, 1840.
  6 Op. cit. p. 266.                     6 Lond. Med. Gaz., June 1, 1839, p. 333.
  7 Ibid. June 15, 1839,  p. 421.            8 Medical Times, Nov. 5, 1842.
  8 American Medical Intelligencer,  Sept. 1, 1839, p. 161. 
342
ERGOTA.
cases, the tincture, and the light oil described by him may also be pre-
scribed;—the latter, in the dose of ten to thirty drops.
                        Infusum ergotse.
                          Infusion of ergot.
                 R. Ergot. 3j.
                     Aqua, bullientis f 3iv.
             Infunde.
  Dose.—One-third, to  be repeated  every  15 or 20 minutes  in defi-
ciency of uterine contractions.
                 R.  Ergot, gss.
                     Aquae bullientis f 3 xxiv,
             Colaturae adde
                     Syrup, simpl. f 3j.
  Dose.—Tw0 ounces every three or four hours, to induce premature
labour.                                                 Paterson.
                 R. Ergot ^ss.
             Infunde per semihoram in
                     Aquae bullientis fgiss. et cola.
  This quantity to be  taken for a dose, and repeated every four hours.
                                                 F. Ramsbotham.
                 R.  Ergot. 3ss.
             Infunde in
                     Aquae bullient. f J iij.
             Cola et adde
                     Ergot, in pulv. gr. x.—gr. xv. M.
   This quantity sweetened with sugar to be 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. L. Hardy.
                 R.  Ergot, in pulv. crass, ^ij. (avoirdupois.)
                     Aquae bullient. §ix.
  Infuse for an hour in a covered vessel and strain.
  The product should measure about eight ounces.
                                  Dublin Pharmacopoeia of 1850.
                  Liquor  ergotae ammonia'calis.
                    Ammoniacal solution of ergot.
  Into half a pint of spiritus ammonise 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 mi-
nutes, 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  ergotae.
                          Decoction of ergot.
                 R. Ergot, gj.
                     Aquae Oijss.
             Coque ad Oij. et cola.
  Dose.—A table-spoonful every quarter of an hour. 
                               ERGOTA.                           343

                          Tinctura  ergotse.

                           Tincture of ergot.
                  R.  Ergotae in pulv. crass, 3*viij. (avoirdupois.)
                      Alcohol, dilut. Oij. (fgxl.)
   Macerate for fourteen days, and strain; express, and filter.

   Five fluidrams contain one dram of ergot.
                                   Dublin Pharmacopoeia of 1850.
                  R.  Ergot, 3*ijss.
                      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  ergotae.
            Syrup of ergot.—(Strop de C'alcar.—Desgranges.)
                  R.  Ergot, gr. xx.
                      Extract, opii. gr. f.
                      Syrup, f gviij.  M.

   Dose.—Two table-spoonfuls (one ounce) in cases of engorgement of
 the uterus.                                                Lisfranc.
                    Pulveres  ergotae  compositi.
     Compound powders of ergot.—(Antihemorrhagic powders.—Ryan.)
                  R.  Ergot. 3ss.
                      Pulv. aromat. ^ss.
                      Sacch. gss.
          M. et divide in chartulas x.
   Dose.—One, every hour or  every second or third hour, in active he-
 morrhage from any outlet.  In leucorrhcea and gleet, one may be given
 three or four times  a  day,  and should they fail the following  may be
 substituted.
                  R.  Ergot, pulv.  ^ij.
                      Cubeb. pulv. gj.
                      Pulv. aromat. gss.
                      Sacchar. gj-
                  M. et divide in chartulas viij.
   Dose.—One, three  or four times a day.                   Ryan.

                           Pilulae ergotae.
                            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 prostatic
or membranous portion of  the canal.                   Desruelles.

                          Vinum ergotae.
                            Wine of ergot.

                 R.  Ergot, contus. 3ij-
                     Vini albi Oj.

  Macerate for 14 days, shaking occasionally; then express, and filter
through paper.
  Dose.—f 5j- to f 3y.   To a woman in  labour f  3y.—f 3"j«
                                             Pharm.  U.  S. 1851. 
344
ERGOTA.
                      *  Injectio ergotae.
                          Injection of ergot.
                 R.  Ergotae 3*ss.
                     Aq. bullient. Oss.
   Used in cases  of erythemoid vaginitis and urethritis.
                                                      Desruelles.
                       Extractum  ergotae.
Extraet of ergot.—Ergotin.—{Ergotine ou Extrait hemostatique, of Bonjean.)
  Powdered  ergot is exhausted by water, by the process of displace-
ment, 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 separated 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, which 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 solution is brought directly to a half syrupy state,
and is  treated by alcohol as  mentioned above, to obtain from it the
extract, which, procured  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 ex-
tract.
  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 con-
siders  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 produces in the  most frightful (foudroy-
antes)  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 er-
gotin is also  the obstetrical principle, we have only to  treat powdered
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, with-
out any disagreeable taste or poisonous  influence,  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.1
  Dr.  Sachero,2 Professor of clinical  medicine in the University of
Turin, prepared two extracts of ergot, the one aqueous, and the other
  1 Bouchardat, Annuaire de Therap. pour 1843, p. 88, and Ibid, pour 1844, p. 21.
  2 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. 
ERGOTA.
345
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 hemor-
rhage; 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 hyposthenic, that of the oily or poisonous principle."
  Dr. Ebersx found  ergotin of very marked advantage in uterine he-
morrhage.  He employed it "with the most perfect success" in those
forms that are attendant upon cancer of the uterus, and which so greatly
exhaust the patient's strength, and  lead rapidly to death.  These he
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 uterine hemorrhage occurring at different periods
of life, in youth,  and especially at the critical period, he has found  it
of equal advantage.
   It is proper to remark,  that Drs. J. Lawrence Smith and S. D. Sink-
ler infer, from the results of a trial of ergotin on the divided carotid
of a sheep, that 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 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."2   Such, also, is the  opinion of M.Velpeau,3 and  of M.
Bouchardat,4 the  latter of whom  had done  much to disseminate the
views of  M. Bonjean.   He  has concluded, that the facts adduced by
M. Bonjean, in " support of his discovery, are very far from presenting
the characters of demonstration."   "As regards the  success  on ani-
mals," he remarks, "it is well known how plastic their tissues are, and
with what ease they are repaired after serious injuries;  and as respects
the effects of ergotin on wounds  in  individuals of the human species,
those that have been hitherto published may be attributed, with proba-
bility, to the circumstances that were associated with the application of
the remedy almost as much as to the action of the remedy itself."5

                    Mistura  extracti ergotae.  '
            Mixture of extract of ergot.—(Potion d'ergotine.)
                 R. Extracti ergotae gr. xv.
                    Aquae f 3iij.
                    Syrup, flor. aurant. seu limonis f 3*j.  M.
  Dose.—A table-spoonful every quarter of an hour in cases of hemor-

  1 London Medical Gazette, Nov. 1845.
  2 Southern Journal of Medicine and Pharmacy, July, 1846, p. 406.
  3 Comptes rendus, 6 Juillet, 1846.
  * Annuaire de Therapeutique, &c, pour 1847, p. 49. Paris, 1847.
  i Annuaire, &c, pour 1848, p. 81.  Paris, 1848. 
346                    EUPHORBIA LATHYRIS.

rhage, or of inertia of the uterus.   In very violent cases of hemorrhage
the quantity of ergota must be increased, and the doses be given more
frequently.                                              Bonjean.
                    Syrupus  extracti ergotae.
             Syrup of extract of ergot.—(Sirop d'ergotine.)
                 R.  Extract, ergot. 3iiss.
           Solve in
                     Aq. flor. aurant. seu
                     Aq. rosa3 f 3\j.
                     Syrupi f 3*xvj.
                 Coque syrupum et adde solutum.
  Doge.—Two to four  table-spoonfuls a day, more or less, according
to the urgency of the case.                              Bonjean.
                     Pilulae extracti  ergotae.
             Pills of extract of ergot.—(Pilules d'ergotine.)
                 R.  Extract, ergotae 3j-
                     Glycyrrhiz. pulv. q. s. ut fiat pil.  1.
  Dose.—Six to  ten  in the day.                          Bonjean.
                LXXIX. EUPHOR'BIA LATH'YRIS.
Synonymes. Cataputia Minor, Lathyris, Tithymalus Latifolius, Caper Spurge, Garden
  Spurge, Mole Plant.
French. Epurge, Catapuce.
German. Kleines Springkraut,  Purgirkorner-Euphorbie.
  The  oil of  spurge—Oleum Euphorbi_e  Lathyridis—has been
recently recommended  in medicine.  Although the euphorbia 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.1
  The oil obtained from  the seeds  resembles oleum ricini  in  colour,
but is less dense.   It has no odour when newly prepared, and no per-
ceptible  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 occasioning 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 advantageously substituted for castor oil, espe-
cially for children.  After him, it was employed by  M. Grimaud,  and
subsequently by M. Bally,2 who carried the  dose  as far as ten drops;
and by M. Martin Solon,3 at the Hotel-Dieu of Paris, who used it with

  1 Scattergood, in Philad. Journ. of Pharmacy, iv. 124, Philad. 1833.  See, also, Journ.
de Chimie M.d. ii. 178.          2 Journal Universel des Sciences Medicales, xli. 264.
  3 Bullet. G.neral de Th.rapeutique, Aout, 1848. 
FERRI  PRiEPARATA.
347
excellent effects as a hydragogue cathartic in various  diseases, in the
dose of from 23 to 46  grains—or one and a half to three grammes.
Louis Frank1 has suggested its  employment in cases of tcenia, hyste-
ralgia, ascites, &c.
  It would appear, from the remarks of Mr. Scattergood, that the oil
obtained from the beans grown  in this country, does not  possess the
mild qualities ascribed  to the European article.   Six, eight, ten, and
twelve drops were given to several individuals as a cathartic; and al-
though 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.
  Pichonnier2 has proposed the  following formula for a cathartic mix-
ture.
                    Mistura olei  euphorbiae.
                     Mixture of oil of euphorbia.
                 R.  Olei euphorb. lathyr. gtt. viij.
                    Acac. pulv. ;5j.
                    Sacchar. 3*ij.
                    Aqu33 destillat. f3*iij. M.
                  LXXX.  FERRI PRiEPARA'TA.
Synonymes. Preparations of Iron.
French. Les Preparations de Fer.
German. Eisenpraparate.
  Metallic Iron has long been employed in the cases in which chaly-
beates in general are indicated.  The French Codex directs it  to be
formed into an impalpable powder prepared by porphyrizing bright and
clear  iron filings without water.  Of late years, it has  been proposed
by  M. Quevenne to  reduce the  sesquioxide  by means of hydrogen,
which is done by passing a stream of the gas over  the oxide contained
in an  iron or porcelain tube heated  to low redness.  The iron, thus
prepared,  Ferri pulvis—Le fer reduit  par Ihydrogene  sometimes
called  Quevenne s Iron,—must be kept in a dry, well stopped, bottle,
on account of  its great liability to oxidation.   Mr. Wm. Procter pre-
pares  it by placing precipitated carbonate of iron on  layers of  iron-
gauze in a tube of wrought iron; passing a stream of hydrogen through
it heated to a  dull red;  maintaining this  for some hours, and keeping
up a small current of gas till cool.3
  Ferri pulvis has been received  into the  last editions of the pharma-
copoeia of Dublin (1850) and of the United States (1851.) MM. Mique-

  1 Journ. de Pharm. xi. 273: and M.rat and De Lens, Diet, de  Mat. M6d. iii. 183.
Paris, 1831.
  2 Journ de Chimie M.dicale. Paris, 1827.
  8 R. E. Griffith,  Universal Formulary, &c, p. 199.  Philad. 1850. 
348
FERRI ARSENIAS.
lard and Quevenne combine it with sugar and chocolate, and form it
into granules and pills.1   M. Quevenne considers it, of all the insoluble
preparations, the most easily assimilated.2  M. Raciborski3 has strongly
recommended it in ansemic and, especially, in chlorotic cases: and it
is a favourite chalybeate with  the author's colleague, Professor Meigs.4
M. Coste5 considers it superior  to other ferruginous preparations  in
engorgement of the spleen succeeding to intermittent fevers.  The ordi-
nary dose is about two grains  three times a  day in the  form of pill
made with sugar and gum.  It has not appeared to the  author to  pos-
sess any marked advantage over the carbonate or sesquioxide.
                   LXXXI. FERRI ARSE'NIAS.
Synonymes. Ferrum Arseniatum seu Arsenicicum Oxydulatum, Arseniate of Iron,
  Arseniate of Protoxide of Iron.
French. Arseniate de Fer.
German. Arsensaures Eisenoxydul, Arseniksaures  Eisenoxydul.
  This preparation has  been recommended  by Mr. Carmichael,6 who
often applied  it externally in cases of cancerous ulcers.  Naturally,
it presents itself in small, clear, bluish-green crystals, of a regular oc-
tahedral shape, and is called scorodite.   Artificially, it  is formed  by
double decomposition, by adding a  solution of sulphate of iron to one
of arseniate of soda.   It is  precipitated in the form of a dirty green
powder.
                     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 ap-
plication—which was at one time so much celebrated—called " Plun-
kefs caustic."  He allows, however, that the greatest caution should
be observed in its use.   Of late, he has employed a compound of arse-
niate 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.   It has also been administered internally in
cancerous affections and lepra, by Cazenave.  Biett7 recommends it in
lupus, elephantiasis, psoriasis,  chronic  eczema and lichen, and  M.
Duchesne Duparc8 feels authorized, from numerous  facts  accurately
observed, in concluding, that a daily dose of a fifth of a grain, uninter-
  1 Trousseau and Pidoux, Trait, de Th.rapeutique et de Matiere M.dicale, i. 2.  Paris,
1847.
  2 Archives de Physiologie, de Th.rapeutique et d'Hygiene, par M. Bouchardat, No. 2,
October, 1854, which contains an elaborate memoir, of 356 pages, on the physiological
and therapeutical action of the chalybeates, by M. Quevenne.
  3 De la Puberte", &c.  Paris, 1844.
  * Females and their Diseases, p. 371.  Philad. 1848.
  5 Journ. Med. de Bourdeaux, cited in Bouchardat, Annuaire de Therap. pour 1853, p. 246.
  6 An Essay on the Effects of the Carbonate and other Preparations of Iron upon Can-
cer, 2d edit. Dublin, 1809.
  7 Aschenbrenner, Die neueren Arzneimittel, S. 131.  Erlangen, 1848.
  8 Gaz. des Hopitaux, 25 Juillet,1854, and Bouchardat, Ann. de Th.rap. pour 1855, p. 225. 
                        FERRI BROMIDUM.                       349

ruptedly repeated  during the necessary  time,  is competent, in the
adult, to effect the cure of an herpetic or squamous affection', however
extensive or long-established.

                     MODE  OF ADMINISTRATION.
  Arseniate of iron may be applied externally in the  form  of  oint-
ment, composed of  from 9j. to 3ss. to from Sss. to gj. of lard; or
the  compound, just mentioned, may  be applied in the following man-
ner:—
           "Unguentum  ferri  arseniatis compositum'.
                Compound ointment of arseniate of iron.
                R.   Ferri arseniat.  gss.
                     ----phosphat. sjij.
                     Cerat. cetacei ^vi. M.

  This ointment must be spread on  lint and applied to the ulcer.
                                          Carmichael $ Werneck.
  Werneck  gives it  the preference  over all the usual arsenical pre-
parations.  The dose is  from Jgth to J^th of a grain, made  into a
pill.
  The following formula may be used in cancerous  and  other affec-
tions.
              Pilulae ferri arseniatis compositae.
                 Compound pills of arseniate of iron.
                R.   Ferri arseniat.  gr. iij.
                     Extract, gentian.  £Jj.
                     Glycyrrhiz. pulv.  gij.
                     Syrup, cujusvis q. s. ut fiat
                massa, in pilulas xlviii. dividenda.
  Dose.—One, three times a day.
                  LXXXII. FERRI BRO'MIDUM.
Svnonymes. Ferrum Bromatum seu Perbromatum, Brometum Ferricum, Bromated
  Iron, Bromide of Iron;—in solution, Hydrobromate of Iron, Ferri Hydrobromas,
  Ferrum Hydrobromicum Oxydatum.
French. Bromure de Fer.
German.  Bromeisen, Eisenbromid, Bromwasserstoffsaures 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.1

  1 Magendie, Formulaire pour la Preparation, &c, dePlusieurs Nouveaux Medicamens,
derniere edit. 
350                     FERRICARBURETUM.

     EFFECTS ON THE  ECONOMY, AND MODE  OF  ADMINISTRATION.
  Magendie has prescribed it  successfully in cases in which the pre-
parations of bromine have been indicated.   (See Brominium, p. 153.)
He recommends the following formula.
                      Pilulae  ferri bromidi.
                       Pills of bromide of iron.
                 R. Ferri bromid. pulv. gr. xij.
                    Confect. rosae gr. xviij.
                    Acacias pulv. gr. xij.
                 Fiat massa in pilulas xx. dividenda.
  Dose.—Two, morning and evening.                  Magendie.
                 R. Ferri bromid. 3j.
                    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.
                LXXXIII. FERRI  CARBURETUM.
Synonymes. Ferrum Carburetum seu Carbonatum seu Supercarburetum; Carburetum
  Ferri Nativum, Graphites, Plumbago, Plumbum Nigrum, Carbo Mineralis, Cerussa
  Nigra, Black Lead, Carburet of Iron, Graphite.
French. Carbure de Fer, Graphite, Crayon noir, Plombagine.
German. Kohlenstoffeisen,  Graphit,  Reissblei,  Mineralische Kohle.
  This well-known substance  was formerly considered to be  slightly
astringent  and  desiccative.   By Weinhold,1  it  has  been  advised
strongly  in certain cutaneous  affections;  but, although it has been re-
ceived into various pharmacopoeias of continental Europe, as the An-
twerp, Bavarian, Brunswick,  Spanish,  Parisian,  Finnish,  Prussian,
Saxon, and Swedish, it has never been recognised  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 purification,
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 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 pro-

      1 Der Graphit als ein neu  entdecktes Mittel gegen Flechten.  Leipz. 1809. 
FERRICARBURETUM.
351
tracted 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  resnlts
of his  observations, he published  a monograph in which he  recom-
mended it to physicians in these diseases.   He employed  it  as well
internally as externally.   The urine, he asserts, after its administra-
tion, commonly began  to  make a  deposit, and this  continued until
some  change  in the cutaneous affection announced  its approaching
cure.   In cases of complication of herpes with other affections, Wein-
hold combined it with other remedies;—in syphilitic eruptions, adding
corrosive sublimate, &c.
   The efficacy of graphite in herpetic and  other cutaneous  affections
has also been  attested by many other respectable physicians, as Horn,
Heim, Ruggieri, Brera,  Bernstein, Hildenbrand,  Richter, Hufeland,
Marc,1 &c.  This circumstance  gave occasion to its admission into the
Prussian Pharmacopoeia; yet it has not the confidence of physicians,
even in those  countries into  the pharmacopoeias of which it has been
received, and  is consequently but little prescribed.   Its  use in chronic
cutaneous diseases is said to have been suggested by the circumstance,
that in Venice the makers of crayons are  speedily cured of any such
affections  under which they may labour.2

                     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  augmented, accord-
ing 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 5y» to 5vj»  of the graphite to an  ounce of the con-
stituent.
                     Pulvis ferri  carbureti.
                f    Powder of carburet of iron.
                 R.  Ferri carburet.
                     Sacch. aa. gss.  M.
             Divide in partes aequal. vi.
   Dose.—One, every two hours, in lichen leproidcs.
                                                Von  Hildenbrand.   ]
                  Electuarium  ferri carbureti.
                     Electuary of carburet of iron.
                 R.  Ferri carburet. 5SS-
                     Mellis despumat. ^ij.  M.
             Fiat electuarium.
   Dose.—A coffee-spoonful,  morning and evening.      Weinhold.

  1 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, Journal 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. Wissensch. x. 434.
Berlin, 1834.
  a Merat and De Lens, in Diet, de Mat. Med., art. Carbone. 
352
FERRI CITRAS.
Brera.
                   Pilulae  ferri carbureti.
                    Pills of carburet of iron.
              R.  Ferri carburet.
                   Extract, dulcamar. aa jj.
           M. et fiant pilulae pond. gr. ij.  sing.
Dose.—Six, three times a day.                         Marker.
              R.  Ferri carburet, ^ij.
                   Zinci oxid. gss.
                   Adipis 3"j. M.

              Unguentum  ferri carbureti-
                   Ointment of carburet of iron.
              R.  Ferri carburet.
                   Sulphur, aa. Sfij.
                   Adipis q.  s. ut fiat unguentum.

              Emplastrum  ferri  carbureti.
                   Plaster of carburet of iron.
              R.  Ferri carburet, ^ij.
                   Emplast.  sapon. giv.
           Misce intime.
                                                     Weinhold.
                    LXXXIV.  FERRI CITRAS.
Synonymes. Ferrum Citricum, Citras Ferricus, Citrate of Iron.
French. Citrate de Fer.
German. Citronsaures Eisenoxydul,  Citronensaures Eisenoxyd.
  Two citrates of iron have  been proposed, of late years, by M. Be-
rap—the one  the  sesquicitrate  or citrate of  the sesquioxide
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. Duhamel,2 is  pre-
pared as  follows:—Take of citric acid, crystallized, Siij. or three parts;
hydrated  oxide of iron,  §ij. or two parts;  distilled water, §xij. or
twelve parts.  If the moist hydrate be used, about §vj. 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.3    The solution  is
filtered,  and the filter washed with distilled water  sufficient to ob-
tain   twelve 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

  1 Journ.  de Chimie M.dicale; cited in Amer. Journ. of Pharm., April, 1841, p. 72.
  2 Amer.  Journ. of Pharmacy, Oct. 1842, p. 225.
  8 W. Procter, cited in Dispensatory of the United States, 8th edit., p. 1246.  Phila. 1848. 
ferri citras.
353
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 cha-
lybeate salts, the least unpleasant to the taste.  A formula for its pre-
paration has been received into the last edition of  the pharmacopoeia
of the  United State:., under the name Ferri Citras.
   Citrate of protoxide of iron is  prepared by M. Beral,1 by treating
iron filings with citric  acid  previously dissolved in distilled water.
It has  a strongly marked chalybeate taste.
   Mr.  Edward Parrish2 makes a syrup of citrate of iron as  follows.
He first prepares a moist protocarbonate of iron, by mixing together
solutions  of sulphate of iron  and carbonate  of soda, precisely as di-
rected  for Vallet's ferruginous mass, and washing with sweetened wa-
ter.  This is then dissolved by means of a slight excess of citric acid
in water, and  is evaporated  to  dryness.  A greenish, deliquescent,
freely  soluble, uncrystallizable salt results, the taste of which is ferru-
ginous, but not very unpleasant.   To make the syrup, one ounce, Troy,
of this salt is dissolved in five fluidounces of simple syrup.  The  solu-
tion is easily effected, and forms  a  dark greenish-brown liquid.  The
dose is from thirty drops to a tea-spoonful.  The syrup  of citrate of
iron of Beral is a saccharine  solution of the citrates of  ammonia and
sesquioxide of iron.
   Citrate of sesqui-oxide  of iron is a somewhat 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; soluble, and
the solution does not change its green colour by exposure  to air.

   Ammonio-citrate of Iron, Ferri Ammonio-citras, Citrate of iron
and ammonia, Ammonise ferro-citras, A. ferrico-citras, Ferri et am-
monise citras, Ferrum citricum cum ammoniaco, Ferrum ammoniaco-
citricum ; German, EisenoxydmitAmmoniak,is prepared by neu-
tralizing the excess of acid in preparing the nitrate of the sesquioxide
by ammonia, and evaporating as before.3  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 ammo-
nia, the sodio-citrate, and the potassio-citrate of iron, are formed,
which greatly resemble the ammonio-citrate.4  The ammonio-citrate—
Ferri ammonio-citras—is officinal in the last Dublin Pharmacopoeia.5
   A citrate of magnetic oxide of iron is prepared  by combining
 the magnetic oxide with  citric acid.
               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
  1 Amer. Journ. of Tharm., April, 1841, p. 72.
  2 Amer. Journ. of Pharmacy, October,  1848, p. 649.
  3 For forms of preparation see Redwood, in his edition of  Gray's Supplement to the
Pharmacopoeias, 2d edit.,  London, 1848.
  * Ballard and Garrod, Elements of Mat. Med. and Therap.  p. 389.   London, 1845.
  6 The Pharmacopoeia of the King and Queen's College of Physicians in Ireland, 1850,
p. 43.   Dublin, 1850.
       23 
354
FERRI CITRAS.
 has used the citrate  largely, and is much pleased with it.   It  is un-
 questionably 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 quantity
 of ten grains three times a day.  The citrates are not decomposed by
 alkalies, and hence may be given with them if desirable.  The ammo-
 nio-citrate, according to Messrs. Ballard and Garrod, is the most used,
 and may be conveniently administered  in  porter, which conceals its
 taste, without its own flavour being impaired.
   It has long been administered  in wine, of which the following are
 two forms;—the first from the Hamburg, and the latter from the Wir-
 temburg, Pharmacopoeia.
                Vinum ferri citratis aromaticum.
                   Aromatic wine of citrate of iron.
                 R.  Ferri limatur. 3*j.
                     Limon. succ. 3*iij.
             Macera per noctem et adde
                     Gentian. 3*ss.
                     Cinnam. gij.
                     Vini f 3*xvj.
   Dose.—Of the decanted wine, f $ss. to f $ij' and more.  This pre-
 paration, or one analogous to  it, is  said to be prescribed by certain
 physicians of this country—of  Charleston, for example.1

  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 suf-
 ficient digestion, express and filter.   This preparation is  called, in
 the Wirtemburg Pharmacopoeia, Tinctura Ferri Aurantiaca seu Tinc-
 tura Martis cum Vino Malvatico et Pomis  JLurantiis.2  According to
 Mr. Gore,3 it possesses the most agreeable odour and taste of any me-
 dicinal compound ever introduced into practice.   It is aromatic, car-
 minative, and tonic;  and he adds, that he has no doubt it will  super-
 sede the preparations in general  use, when once  it has been  fairly
 tried.  In  strumous habits;  in  passive uterine  hemorrhage; in ana-
 sarca from  general  debility; in chlorosis; in malignant  disease, in
 which iron has  been extolled; 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 chalybeata effervescens.
                     Effervescing chalybeate water.
                 R.   Aquae Oiss.
                     Ferri citrat. sice. 9j.
                     Acid, citric. 9_v.
                     Sodae bicarb. 9 v.
  1 Duhamel, loc. cit.       2 Jourdan Pharmacop.e Universelle, i. 545.   Paris, 1828.
  s Dublin Medical Press, April 29, 1840. 
FERRI ET MAGNESLE CITRAS.
355
    Add first the citrate of iron and citric acid, then the bicarbonate of
  soda, corking  the bottle at once, and securing the  cork.1  This  is  a
  delicate, but active, chalybeate.  It may be formed,  also, conveniently
  and agreeably, by dissolving 5 to 10 grains of the citrate in f gvj. of
  the mineral water of the shops, and  flavouring with syrup  of orange
 peel.   It is said, however, to be apt to excite unpleasant eructations.2
  It has been called "Chalybeate Champagne."

    A citrate of ^ iron^ and magnesia, Ferri et  Magnesle  Citras, is
  prepared  by dissolving hydrated oxide  of iron in a solution of citric
  acid, saturating the liquid with carbonate of magnesia, and evaporating
  to dryness.3   The salt presents itself in the form of  brown brilliant
  scales, of a sweetish and feebly inky and not disagreeable  taste.   It
  is perfectly soluble in water, and has the advantage over  the  ferro-
  citrate of ammonia, that it is not deliquescent, so that  it can be given
  in powder.  Moreover, it does not induce constipation, like most of
  the salts of iron.   The  dose is from 4  to 15 grains in  solution.   It
  may also be given in powder or pill.
               Syrupus  ferri et magnesiae  citratis.
                 Syrup of citrate of iron and magnesia.
                  R. Ferri et magnes. citrat. p. x.
              Solve in
                     Aq. flor. aurant. p. xx.
                     Syrup, p. cc.   M.
                                                  Van den  Corput.
                Pulvis ferri  et magnesiae  citratis.
 Powder of citrate of iron and magnesia.—(Saccharure de citrate de fer et
                             de magnesie.)
                  R.  Ferri et magnes. citrat. p. v.
                     Sacchar. pulv. p. xl.
                     Canellae albas p. v.  M.
   Dose.—Fifteen grains.                         Van den  Corput.
             Troschisci ferri  et magnesiae citratis.
                Lozenges  of citrate of iron and magnesia.
                  R.  Ferri et magnes. citrat. p. v.
                     Sacchar. pulv. p. xl.
                     Vanill. sacchar. (Saccharure de vanille.)  p. 2.
                     Mucilag. Tragacanth. p. v.  M.
   Each lozenge to contain fifteen grains.          Van  den Corput.

   M. Beral has likewise introduced a Citrate of Protoxide of Iron and
 Quinia,  Ferri et Quini_e Citras, Ferrum et  Chininum  Citricum;
 German, Citronensaures  Eisenchinin;  which  is  formed by the
 union of four parts of citrate of iron with one part of  citrate  of quinia
 in solution,  and evaporating.
   Citrate of iron and quinia may be given in the form  of pill,  wherever

  1 Bullet, de Th.rap. cited in Provincial Med. and Surg. Journal,  Dec. 10, 1842.
  2 Pereira, Elements of Mat. Med. and Therap. 3d Amer. edit. i. 749.  Philad. 1852.
  3 Van den Corput, cited in Bouchardat,  Annuaire  de Therap.  pour 1850, p. 186. The
formula of Van den Corput, with remarks by Mr.  Wm. Procter, Jr., is given in Amer.
Journ. of Pharmacy, October, 1850, p. 314. 
356
FERRI FERROCYANURETUM.
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, which may be given either in  pills or solution.1
             LXXXV.  FERRI  FERROCYANURE'TUM.
 Synonymes. Ferri Cyanidum seu Cyanuretum seu Borussias seu Sesquicyanidum seu
   Ferrosesquicyanidum seu Percyanidum seu Ferrocyanas, Ferrum Cyanogenatum
   seu Cyanuretum seu Zootieum seu Borussicum seu Hydrocyanicum seu Oxydula-
   tum Hydrocyanicum, Caeruleum Borussicum seu Beroliniense, Prussiate or Cyanide
   or Cyanuret of Iron, Prussian Blue, Berlin Blue.
 French. Trito-hydro-ferro-cyanate de  Fer; Deutoxicyanure de Fer Hydrate, Tritohy-
   drocyanate Ferrure de Fer, Prussiate de Potasse et de Fer, Bleu de Prusse.
 German. Cyaneisen, Blaustoffeisen, Blausaures Eisenoxydul, Eisenblau-
   saures  Eisenoxyd, Blausaures Eisen, Eisencyanurcyanid, Berliner
   Blau, PariserBlau.
   In commerce, this preparation, with us, bears  the name of " Prus-
 sian blue," but in Germany it is called " lJariser Blau."  It is  not in
 a state of purity, and, consequently, that which the apothecary prepares
 is best adapted for  internal use.

                       METHOD OF PREPARING.
   The following  form  for the  preparation of  "pure Prussian blue,"
 is admitted into the last edition of the Pharmacopoeia of the United
 States:—Take  of sulphate of iron, Siv.;  sulphuric  acid, f 3hiss.:
 nitric acid, f $vi., or  a sufficient quantity;  ferrocyanuret of potas-
 sium, Sivss.;  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 ferrocyanuret 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.2
   Ferrocyanuret of iron is of a beautiful deep blue colour, and devoid
 of odour and  taste.   It is decomposed by heat, and is insoluble in
 water, alcohol, ether, oils and dilute acids.   Potassa and soda decom-
 pose 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 animals, but
 observed no action from it.  It has been given, however,  and not with-
 out success, in several diseases; and  Dr. L. W. Sachs, who has not un-
frequently administered it, considers it one of the most important chaly-
beates with which we are acquainted.  He thinks, it probable, that the

  1 See on the preparation of this article, Dr.  E. R. Squibb, U. S. N.  in  Amer. Journ. of
Pharm., June, 1855, p. 294.
  2 Pharmacopoeia of the United States, p. 134.  Philad. 1851. 
FERRI FERROCYANURETUM.
357
hydrocyanic acid has not much agency; yet it certainly seems to differ
from all the other preparations of iron.  It has been especially recom-
mended in epilepsy by Kirckhoff,1 of Ghent; and more recently by M.
Faivre  d'Esnans.2  In  very obstinate cases, not dependent  upon or-
ganic mischief, Kirckhoff succeeded entirely with it:  with the 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 Gergeres confirm its efficacy
in epilepsy.  M. Faivre d'Esnans used the following  formula:—
                 R.  Ferri ferrocyanuret. gr. xv.
                     Ext. valerian, gr. xlv.
                 M. et divide in pil. xxiv.

   One pill to be taken three times a day, at an interval of six hours,
and each pill to be followed by a wineglassful of infusion of valerian.
   It has also been administered by Dr. Zollickoffer3 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 assafcetida, nitrate of silver,
and subcarbonate of iron had been given in vain.  In intermittent fever,
Dr. Zollickoffer4 found  it so efficacious, that he even gave it the prefer-
ence over cinchona:  and his experience has been confirmed by that of
Eberle,s Hosack,6  J. E. Craighead,7 Hasse,8 and others.  Wutzer, in
Germany, also exhibited it successfully; and  Stosch  gave it advan-
tageously, in combination with cinchona  and rhubarb, in  a case of ob-
stinate intermittent.   Sachs likewise tried it frequently, but as often
without, as with, success.   When it has proved  efficacious in  intermit-
tents, 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 effi-
cacious, when four doses of two grains each were taken;  and  Riecke9
affirms, that his father  obtained essential service from it in the leuco-
phlegmatic conditions resulting from intermittent fever.  Zollickoffer
extols the ferrocyanuret also in remittent fever; and there may be
periods when it may be  administered with benefit; but it is not often
used.   He recommends  it, likewise, in dysentery10 when the inflamma-
tory condition has passed away, either spontaneously or  under the ef-
forts of art; and Sachs remarks, that in  atonic conditions of the intes-
tinal  canal, which supervene on  dysentery, it may doubtless  be of
great  service.   Gergeres administered it successfully in  chronic diar-
rhoea.   L. W. Sachs enters into a long theoretical disquisition on the

  1 Journal de Chimie Medicale, iii. 285. See, also, Journ. des Connais. M_d. Chirur.
Aout, 1841; or Encycl. des Sciences, Med. Sept. 1841, p. 468.
  2 Journal de Mt'decine et de Chirurgie Pratiques, and Amer. Journ. of the Med. Sciences,
July, 1850, p. 202.
  3 Medical Examiner, May 16, 1840, p. 314.
  4 American Medical Recorder, v. 540.           5 Materia Medica, 2d edit. i. 233.
  6 New York Medical and Physical Journal, 1823.
  7 American Medical Intelligencer, May, 1842, p. 230.
  8 Aschenbrenner, Die neueren Arzneimittel, u. s. w. S. 122. Erlangen, 1848.
  B Op. citat. S. 217.              10 Chapman's Philadelphia Journal, Aug. 1823. 
358
FERRI FERROCYANURETUM.
precise action of the remedy, in which there is much that is specula-
tive.   He used it, he says, with success, in many cases which it would
be difficult to classify under any formal nosology; their common bond,
however,  was, that they were dependent upon "nervous disorders, es-
pecially of the plastic functions 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 ser-
viceable.   He gave  it in  not  less than two grain doses, which  were
gradually augmented to six, three times a day.  Dr. Moll saw decidedly
good effects from  its use in a case of immoderate menstruation from
atony of  the  uterus, with  general  elevation of  nervous excitability,
after he had employed the remedies, commonly recommended, unsuc-
cessfully.   He found it also extremely beneficial in children of a stru-
mous habit, and of great torpor. Stosch found it serviceable in a case
of scrofula,  in which haematosis was  imperfectly  accomplished;  and
Dr.  Bridges1 obtained great advantage  from  it  in a  case of severe
and protracted facial neuralgia.
  It has been also recommended as probably more effective than  any
other remedy in  inveterate cases of ascarides in the rectum.  With
this view, five grains  of the salt may be rubbed  up in two ounces of
warm water or mucilage of gum  Arabic, and be thrown up into the rec-
tum, to be retained there "until the next regular defecation."   This
must  be repeated daily, gradually increasing the quantity of the cya-
nuret, until perfect and permanent relief is afforded.2
  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 using it in
that form.
                     MODE OF  ADMINISTRATION.
                  Pulvis  ferri ferrocyanureti.
                   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. ..quales dividendus.
  Dose.—A powder,  every two  hours, in epilepsy.  Von Hildenbrand.
                 R.   Ferri ferrocyan.
                     Guaiac. pulv. aa. 3j.
                 Misce et divide in chartulas xij.
  Dose.—One, three times a day.—Employed successfully  in  inter-
mittents?

       1 Wood and Bache's Dispensatory, art. Ferri Ferrocyanuretum.
       2 American Journal of the Med. Sciences, Jan. 1847, p. 247.
       3 Ellis's Formulary, 10th edit.  p. 156.  Philad. 1854. 
                           FERRI IODIDUM.                        359

                  Pilulae ferri ferrocyanureti.
                     Pills of ferrocyanuret of iron.
                 R.  Ammoniac.
                     Rhei
                     Ext. taraxac. aa. 3j.
                     Ferri ferrocyan.  gr. xviij. ad xxxvj.
                 M. et fiat massa in pilulas Ix. dividenda.
  Dose.—Four to six, twice a day, in disorder of the ganglionic sys-
tem. [?]                            ,      L.  W.  Sachs, $> Radius.
               Unguentum ferri ferrocyanureti.
                   Ointment of ferrocyanuret of iron.
                 R.  Ferri ferrocyan.  3J.
                     Unguent, cetacei 3j.  M. et fiat unguentum.
                     LXXXVI. FERRI IO'DIDUM.
 Synonymes. Ferri Ioduretum, Ferrum Iodatum,  Iodated Iron, Iodide or Ioduret,
   Protoioduret, Protoiodide or Protiodide of Iron.
 French. Iodure de Fer, Protoiodure de Fer.
 German. Iodeisen.

 In Solution, Ferri Hydriodas, Ferrum Hydriodatum seu Hydroiodicum Oxydulatum,
   Hydriodated Iron, Hydriodate of Iron, Hydriodate of Protoxide of Iron.
 French.  Hydriodate de Fer.
 German, fiydroiodsaures  Eisenoxydul, Iodeisen,  Iodwasserstoffsaures
   Eisenoxydul, Eiseniodiir.
    Although attention  had been directed, several years ago, to this pre-
 paration, it was  not  much  used, until Prof. A. T. Thomson,1 of  the
 London University, recommended it strongly in a special monograph
 several years since.  It has  been received  into different Pharmaco-
 poeias.
                       METHOD OF PREPARING.
   The  form for the preparation  of the solid iodide, recommended  in
 the Pharmacopoeia of  the United States, is  the  following:—Take  of
 iodine,  gij., iron filings, Si-, distilled water, a pint and a half.  Mix
 the iodine with a pint of the distilled water in a porcelain  or glass ves-
 sel, and gradually add the iron filings, stirring constantly.  Heat the
 mixture gently until the liquid acquires 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.2
   A plan  proposed by Mr. Durand,3  of Philadelphia, after one  by
 MM. Baup and Caillot,4 for preparing  the solution of the protiodide
 of iron  (hydriodate of  protoxide of iron) is  the  following:—Take of
 iodine,  3x., iron filings, perfectly pure  and  unoxidized, 5v., distilled
 water, oxiiss.   Put the iodine into a porcelain capsule, with  one half

 1 Some  Observations on the Preparation and Medicinal Employment of the Ioduret
and Hydriodate of Iron, 8vo. p. 64.   Lond. 1834.
 ' Pharm. of the  United States, p. 135.  Philad. 1851.
 8 Philad. Journ. of Pharmacy, iv. 287.  Philad. 1833.            < Ibid, i 201. 
360
FERRI IODIDUM.
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, which
gradually deepens to  a dark red.   When  the whole of the iron has
been added, the capsule is put in a sand bath, or over the flame of a
spirit lamp, and heated slowly;  continuing to stir the liquid.  An io-
duretted hydriodate of iron is first produced, which, under the action
of heat,  soon passes to the state of a simple hydriodate.  This  point
is indicated by the entire discoloration of the solution.  In  this state
it is filtered: and  the dregs and filter  are carefully washed with the
remaining half of the distilled water, previously heated to the boiling
point.  In this manner, a solution forming twelve  and  a half fluid-
ounces is afforded,  one ounce  of which represents one dram of iodide
of iron.
   The solution, which is at first colourless, acquires a deep red colour
by standing,  and precipitates some oxide of iron; by which it  is re-
duced 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 quan-
tity 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,1 but which M. Dupasquier has recently
rediscovered.2
   The iodide of iron is obtained by evaporating to dryness the filtered
solution, taking care, towards the end, to stir incessantly with an iron
spatula,  and  to detach the salt from the  bottom of the capsule as it
forms.   The heat must be managed most carefully, diminishing it gra-
dually, 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 comparatively inert  as a medi-
cinal agent; whilst the free iodine extricated during its oxidation, ac-
cording to Dr. Thomson, alters altogether  the virtues of  the medicine.
This partial  decomposition of the iodide is rendered  immediately ap-
parent on dissolving  it  in twenty times its weight of distilled water,
and filtering:  instead  of a permanent, clear, very pale greenish-yellow,
we obtain an ochre-coloured,  completely 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 ap-
parently similar.   Even when the iodide has been carefully prepared,
it often contains a little free  iodine; but,  according to Thomson,- it is
              1 Squire, Annals of Philosophy, May, 1836, p. 79.
              2 Journal de Pharmacie, Mars, 1842, p. 224. 
FERRI IODIDUM.
361
chiefly owing to the carelessness of assistants and apprentices in com-
pounding  prescriptions, by frequently exposing  the  iodide to the air,
that its properties,  and, consequently, its medicinal powers, are im-
paired : 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 de-
scribed, it will  keep without changing its  characters; but as it is usu-
ally made by dissolving the  iodide in distilled water, it requires to be
rendered neutral by the following means:—Introduce  into  a flask the
solution of any given strength,  and place  in it two or three doubles of
clean and soft  iron wire, sufficiently long to 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, however long it may be preserved, provided
it be  kept in a blackened 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 being thus obtained, by the
immediate conversion of a newly formed iodide into the hydriodate of
the protoxide, no subsequent change takes place so long as the solution
is kept secluded from the light.   The best proportions, according to Dr.
Thomson, for forming the medicinal solution, are three 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 particularly if it contain any earthy or saline carbo-
nates, decomposition instantly  takes place, iodine is extricated,  and  a
carbonate of iron, which rapidly passes into the state of a peroxide of
the 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 pro-
tective agency as it does on  the protocarbonate.1
   With this view, the following formula for the Liquor Ferri Iodidi
or  Solution of Iodide of Iron, has  been introduced into the Phar-
macopoeia of the United States.   Take of iodine Sij. _ iron filings
Sj. sugar in  powder gxij. distilled water a sufficient  quantity. Mix the
iodine with five  fluidounces  of  distilled water  in a  porcelain or glass
vessel, and  gradually add the  iron filings, stirring constantly.   Heat
the mixture gently until  all  the iodine is  dissolved,  or until the liquid
acquires a light  greenish colour.  Then filter the solution into  a glass
bottle containing the sugar, and after it has passed, pour distilled water
gradually upon the filter, until the filtered liquor, including the sugar,
measures f 3xx.  Lastly, shake the bottle until the sugar is dissolved,
and keep it closely stopped.
   Similar preparations are  contained  in  the London and  Edinburgh
pharmacopoeias, under the name of syrup of iodide of iron;  of which
various formulae have been given from time to  time.2

  1 W. Procter, American Journal of Pharmacy, for July, 1840, p. 13;  and Ibid, for
January, 1841, p. 323.
  2 Frederking, Repertor fur die Pharmacie, 1830, cited in Amer. Journ. Med. Sciences, 
 362                       FERRI IODIDUM.

   When iodide  of iron is carefully prepared, it  is of an iron-gray
 colour, foliated texture, brittle, and exhibits a crystalline arrangement
 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 decomposed—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, therefore,
 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 stimulate moderately the digestive canal
 through its entire length;  for it  opens the  bowels; and, whilst it pro-
 duces the black  colour  of the alvine discharges, characteristic of all
 the  preparations  of iron,  it corrects their foetor.   When  it does  not
 affect the bowels, it 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 increased.   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 headache.  These
 symptoms were relieved by a copious evacuation, which was perfectly
 black.   Two hours after taking the medicine, a large  quantity of urine
 was discharged; which, on being tested, displayed the presence  of both
 iodine and iron.   The experiments on animals, made by Dr. Cogswell,1
 induced  him to infer:—1.  That it 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 coagulation.2

               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 augmented

Feb. 1840, p. 499; Dupasquier, Journ. de Pharm. Mars, 1841, p. 116, and Mars, 1842,
p. 225; F. Boudet, Ibid. Sept. 1841, p. 335; Beral, Journ. de Chim. Med. cited  in Amer.
Journ. of Pharmacy, April, 1811, p. 74; A. T. Thomson, Lond. Pharmac. Transactions,
Aug. 1841, and Leistner, Journ.  de Pharmacie, Fevrier, 1849, p. 122.
  1 Essay on Iodine, p. 132.  Edinburgh, 1837.
  2 Magendie, Lecons sur le Sang, &c.; or translation in the Lancet,  Jan. 26, 1839. 
FERRI IODIDUM.
363
activity of the capillary or intermediate  system, with a tonic effect,
might  be indicated,  and particularly in scrofulous affections, tabes
mesenterica,  chlorosis, incipient scirrhus, rickets, amenorrhoea, bron-
chocele, atonic dyspepsia,—indeed in all cases accompanied by debility.
In such affections, he  conceives the iodide will act more efficiently than
any of  the other preparations of iron.  In secondary syphilis,  it may
be combined, he suggests, with iodide of potassium; and in incipient
cancer, its efficacy is aided by the administration of arsenic at the same
time.  ' Dr. Thomson has found it serviceable in atonic gastric dyspepsia,
when combined with bicarbonate of potassa, and taken at the moment
of admixture, in the  dose of  from three to eight grains or  more.1   A
great advantage it possesses is  its ready solubility,  owing to which it
can enter the circulatory system with facility, and modify the condition
of the  fluids.  In chronic  scrofulous cases, it  produces all the good
effects of the preparations of iron,  without any of the concomitant and
subsequent  symptoms that  are  so  apt to supervene, especially in  im-
pressible  individuals.  Where  the case is  accompanied by vascular
erethism, or fulness, it must be reduced  before the iodide can be es-
teemed appropriate.   In chlorosis, occurring in  strumous habits, it has
been  found most serviceable.   Dr. Ashwell2 prescribed it with  success
in such cases, in association with colomba or gentian, according to the
formula given hereafter.   Its  efficacy in cancer  is elucidated  by  Dr.
Thomson, by the details of a case of scirrhous mamma, which, after
protracted and fruitless treatment  by other agents—as by other prepa-
rations of iron combined with conium—ultimately yielded to a combi-
nation of iodide of iron and  conium.  Some cases are also detailed in
which it was very effective in removing old syphilitic affections, espe-
cially of the skin.  M. Baumes,3 who employed the iodide with  the
most satisfactory results in  old and obstinate syphilitic ulcers especially
 when the patient was feeble and scrofulous, gave it in the form of  pill
 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 witn
 the cicatrization of  the sores,  the improvement of  the  general health
 was most remarkable.                         ....    ,,   .  -,•-,
   Prior to the publication  of Thomson, Pierqum had given the iodide
 in cases of leucorrhcea and amenorrhoea', and Eager4 had recommend-
 ed it in scrofula.  Ricord5 found the very best effects from its inter-
 nal use in cases where tonics required to be combined with antisypni-
 litic  remedies, especially where any scrofulous vice (lymphatisme)  con-
 stituted a complication.  He administered it, likewise, with great suc-
 cess, to remove  the consequences of syphilis ; and found it advantage-
 ous in atonic ulcers  of the  legs and in spreading ulcers of the throat,
 which had  been  aggravated  or  had not yielded  to mercury ^Ihe
 strength of M. Ricord's solution was half a dram of the iodide  to 3viij.

   i London Dispensatory, and Brande's Dictionary of Mat. Med. p. 25S!.  Lond.  1889.
 See, also, Solon! in Diet, de Med. et de Chirurg. Pratiq. art. lode; and Ashwell, m Guy s
 Hospital Reports, pt. i. 128; and p.. in. 555.                              ,
   2 A Practical Treatise on the Diseases Peculiar to Women, Amer. edit. p. 32. Phila. l«4o.
   s Medico-Chirurgical Rev., Oct. 1840.                       ,,8 v<Unh  1837
   * Dublin Journ. of Med. Science,  1834;  also, Cogswell on Iodine, p. 138. Edmb. 1M7.
   1 J. J. L. Rattier, in La Lancette Francaise,  4 Fev., 1837. 
361
FERRI IODIDUM.
of water, given, we presume, in the twenty-four  hours.   M. Ricord'
also uses it in the form of injection in cases of blennorrhoea : wherever,
indeed, tonic  astringent  injections  are needed, the iodide, in his opi-
nion, should occupy the first rank.   Its use, he thinks, can  only be con-
traindicated 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, Magendie2 prescribed it in the form of injection  (f 5h to Oij.
of water,) several times a day in a case of severe  uterine  hemorrhage.
The hemorrhage ceased.
  A case of confirmed  diabetes3 was treated in the H&tel-Dieu of Pa-
ris  by the  iodide given in the  form of pill, each pill  containing five
grains.   Four pills were taken in the twenty-four hours.  In this case,
the iodide  must have been efficacious, for the usual animal diet recom-
mended in such cases  had  failed previously to do good, until the  io-
dide was associated with  it.
  It has likewise afforded apparent benefit in cases of tubercular phthi-
sis, and in the  mass of  such cases is as well adapted for modifying
the morbid action  of the system of nutrition, so deeply implicated in
that fatal malady,  as any other agent, with the exception, perhaps, of
cod liver oil.   The syrup is the  best preparation.   Champouillon, how-
ever, affirms, that he had prescribed it in eighty-four cases of phthisis,
but in  none had he seen any advantage from it.  On the contrary, even
when given with circumspection, it often excited cough and  disagreeable
salivation; irritated  the  digestive organs,  and caused  either vomiting
or diarrhoea.4
  Dr.  C. J. B. Williams5 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. Phillips6 prefers  it in scrofula to any of the preparations of
iodine.  The minimum dose was a  grain 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. In one, it excited pytalism.
About once a week he gave  an aperient or cathartic.  In cases of scrofu-
lous ulceration, as  a consequence of abscess, or from other causes, he
employed,  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 on lint.

  1 J. J. L. Rattier, Ibid. 16  Fev., 1837; see, also, Revue Medicale,  Janvier, 1838, cited
in Amer. Med. Intel., Sept.  15, 1838.
  2 Op. cit.
  3 Cited in Provincial Med. and Surg. Journal, Nov. 5, 1842.   The results obtained in
the  Hotel-Dieu are referred to in London  Lancet, July 8, 1843, p. 517; see, also, M.
Boissiere, Gazette MeU de Paris, 24 Dec, 1842, and  Amer. Journ. of the Med. Sciences,
April, 1843, p. 454.
  * Bouchardat, Annuaire de Therap. pour 1852, p. 280.
  B Medical Times, May 24, 1815, p. 133.
  6 Lond. Med. Gaz., Jan. 10,  1840; see, also, Scrofula; its Nature, Causes, &c, by B.
Phillips, F. R. S., Amer. edit. p.  248.  Philad. 1846. 
FERRI IODIDUM.
365
  Staussx gives the  case  of  a young female affected with ascites, hy-
drothorax and anasarca, who had been tapped  for the  ascites, had
taken gratiola and lactuca virosa without any benefit, and was cured
by a mixture of tinctura ferri iodid., tinct. cort. aur ant. aa.  5ij., and
aq. flor. aurantior. Sij-. of which  a spoonful was given four times  a
day.  Under this, the status hydropicus disappeared.
  The author has frequently given this remedy in public and private
practice, and  has  considered it especially adapted  for  those cases in
which there  appears  to be  torpor  in  the system  of nutrition, as in as-
thenic dropsy, old visceral engorgements, and indeed of hypertrophy of
any kind, accompanied by deficient action in the system of nutrition.
In oligemia, where there is paucity of red corpuscles 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 inspissating it.   Hence, in all  cases of
scorbutic, hydropic and other dyscrasies, 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 is 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.
                 R.  Ferri sulphat. £j.
                     Potass, iodid. 9iv.
                     Tragacanth. pulv. gr. x.
                     Sacchar. pulv.  3«s.

  Beat them with syrup, so as to form a mass to be divided into forty
pills.   It should  be made when  wanted  for immediate use.  When
freshly made, each pill contains a little more than a grain and a half
of iodide of iron.                     Pharmacopoeia V. S. (1851.)
  Pills of iodide of iron may also be prepared in the following manner,
according to a formula communicated by Mr. Robert Leslie, of Glas-
gow, to Dr. Christison of Edinburgh.2   Take  of iodine, 127 grains;
iron wire, of about the thickness  of a  thin quill, half an ounce;  dis-
tilled 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 mi-
nutes.   Pour  the liquid upon two  drams of finely powdered loaf sugar
in a little water,  and triturate immediately and briskly for a few mi-
nutes ; add gradually a mixture of the  following powders:—liquorice
powder, half an ounce;  powder of gum Arabic, a  dram and a half;

  1 Casper, Wochenschrift, No. 24, and Canstatt und Eisemann's Jahresbericht uber die
Fortsehritte in  der Heilkunde im Jahre  1848, v. 135.
  2 Pharmaceut. Transact.,  Aug. 1, 1844,  p. 79. 
366                       FERRI IODIDUM.
Pierquin.3
flour, a dram.   Divide the mass into 144 pills.   Each pill will contain
about a grain of iodide of iron.

   The Pills of Blancard, Pilules d'lodure de Fer de Blancard, Pilules
de  Blancard,  are made  by enveloping pills  formed  of protiodide,
honey,  liquorice, and marshmallow  powder, with a layer  of finely
divided iron, reduced from its oxides by means of hydrogen, in which
they are rolled, and varnished with a thin coat  of resin.1   Dr. D. F.
Wright,  of Memphis, makes  a pill  extemporaneously from reduced
iron, protected by honey and an excess of iron.2

                       Vinum  ferri iodidi,
                       Wine of iodide of iron.
                 R.  Ferri iodidi 3*ss.
                     Vin Burdigalens. Oj.  M.

  Dose.—A tea-spoonful, morning and evening.

                      Tinctura ferri iodidi.
                       Tincture of  iodide of iron.
                 R.  Ferri iodidi ^ij.
                     Alcoholis,
                     Aqua?, aa. f 3*ij.  M.
  Dose.—A tea-spoonful, morning and evening.

                 Mistura ferri iodidi  composita.
                  Compound mixture of iodide of iron.
                 R.  Ferri iodidi gr.  xvj.
                     Tinct. colomb. seu
                     ------gentian., comp. f 3*j.
                     Aqua, destillat. f^vij.   M.
  Dose.—Two table-spoonfuls two or three times a day.


                      Trochisci ferri iodidi.
                      Lozenges of iodide of iron.
                 R.  Ferri iodidi gss.
                     Croci pulv. gij.
                     Sacchar. 3*iv.
               M. fiant trochisci No. 120.
  Dose.—Six to ten, daily.
Pierquin.
Ashwell,
P
lerqum.
Solutio  ferri  iodidi.
     Solution of iodide of iron.—(French, Eau d'Hydriodate de Fer.)
                 R.  Ferri iodidi §ss.
                     Aqua. Oij. M.
  Added to enemata, lotions, and injections.
                 R.  Ferri iodidi 3*ss. ad gij.
                     Aquae destillat. Oj.  M.

  To be added  to a  general bath in  cases  of  leucorrhcea, amenor-
rhoea, &c.          ,

  1 Bouchardat, Annuaire de Therap. pour 1851, pp. 198 and 200.
  2 American Journal of Pharmacy, Jan. 1854, p. 6; and The Dispensatory of the United
States of America, 10th edit. p. 1005. Philad. 1854.
  3 Journal de Chimie Medicale, p. 310, Mai, 1831. 
FERRI LACTAS.                       367
                     Injectio ferri  iodidi.
                      Injection of iodide of iron.
                 R.  Ferri iodid. gr. iij.
                     Aqua, destillat. f 3" vi.  M.
  The quantity may be increased to nine grains to the ounce of water,
care being taken to avoid irritation.
  Used in gonorrhoea.                                    Ricord.1
                   Unguentum ferri  iodidi.
                      Ointment of iodide of iron.
                 R.  Ferri iodidi giss.
                     Adipis 3*j.  M. ut fiat unguentum.
  A piece, the size of a hazelnut, to  be rubbed, morning and eve-
ning, on  the  inner part of the  thigh,  in  cases of leucorrhcea and
amenorrhoea.
                    LXXXVII. FERRI  LaCTAS.
 Synonymes. Ferrum Lacticum, Lactas Ferrosus, Lactate of Iron, Lactate of Protox-
  ide of Iron.
 French. Lactate de Fer.
 German. Milchsaures  Eisenoxyd,  Milchsaures Eisenoxydul.

   This preparation was recommended  by MM. Gelis and Conte, in-
 ternes at La Charite, in Paris, and was favourably reported upon by
 M. Bouillaud, in the name of a committee, consisting of  MM. Bally,
 Fouquier, and Bouillaud.2

                      METHOD OF  PREPARING.
   MM. Gelis and Conte prepared lactate of iron by treating pure iron
filings with  lactic acid diluted with water.   M. Louradour3 extracts
 lactic acid from whey, which he collects from the  dairies in the neigh-
 bourhood of Paris, where much cheese  is  made.   The whey, exposed
 a Ions: time to fermentation  under the influence of an  elevated  tern-
     o                                                 ...
 perature, becomes charged with a large quantity of lactic acid.   It  is
 evaporated to one-third or one-fourth of its volume, decanted  and fil-
 tered; 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  concen-
 trated to a syrupy consistence.   It is now diluted with  alcohol, which
 precipitates the lactine and the salts.   The solution, on  being filtered,
 and the alcohol distilled  off,  yields  pure  lactic  acid.   Lactate of
 protoxide of iron is prepared by digesting in a sand-bath, at a low

  1 A Practical Treatise on Venereal Diseases, translated by Drummond, Amer. edit.  p.
 237, 249.  Philad. 1843.
  2 Journal de Pharmacie, cited in Amer. Journ. of Pharmacy, July, 1840, p. 121.  See,
alsn, Beral, Journ. de Chimie Medicale, cited in Amer. Journ. of Pharm. April, 1841,  p.
74; and Gelis and Cont_, in Bouchardat, Annuaire de Therapeutique, pour 1848, p. 166.
Paris, 18 48.
 3 Bulletin General de  Therapeutique, Mars, 1840. 
368
FERRI LACTAS.
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 cooling, 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 air.   The
salt  presents  itself under  the  form  of crystalline plates, which are
very  white, and but slightly alterable.   It is  sparingly  soluble in
water;  reddens litmus paper, and possesses the ferruginous taste in a
tolerable degree.   When dissolved in water, it  attracts  oxygen, and
quickly becomes yellow.
  The  sparing  solubility of  the  lactate has permitted M. Louradour
to simplify still more his process, by omitting the purification of lactic
acid  by alcohol, and treating it immediately with 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 effloresced
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 crystalline plates, which do
not readily admit of fraud.1

                     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 protocarbonate  to its
becoming lactate  of iron  in the stomach, by uniting with the  lactic
acid, which has been presumed—but, in the  author's opinion, errone-
ously—to be one of  the healthy gastric acids.   This idea led them to
administer lactate  of iron ready formed.   In chlorosis the remedy has
been given by MM. Fouquier, Bally, Beau, Rayer,  Nonat, Andral,
Bouillaud, Gerdy, Franz, and others, who have collected a great number
of cases, which show its success in that disease.2  M. Bouillaud3 made
trial of it in  twenty-one  cases, fourteen  of which  were  treated at
La Charit6.   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
of anaemia.  The dose was carried to six, eight, ten, twelve, and fifteen
lozenges, each  containing about five centigrammes of  the salt (gr. f)
in the twenty-four hours.  It was well borne, and  always sensibly in-
creased the appetite; but, as Mialhe4 and Pereira5 remark, there seems
to be no evidence of its superiority over the citrate or tartrate of iron.

  1 Journ. de Pharmacie and Amer. Journ. of Pharmacy, Oct.  1840, p. 230.  Wohler's
process is given by Christison, Dispensatory, Amer. edit, by P.. E. Griffith, p. 978. Phila.
1848.  F. Roder's  process, which resembles it, is given in Dierbach, Die neuesten Ent
deckungen in der Mat. Med. 3er Band. 2te Abth. S. 856.  Heidelb. und Leipz. 1847. See,
also, on this subject, Dispensatory of the United States, 10th edit. p. 1353. Phila. 1854.
  2 Bulletin General de Th.rapeutique, Mars, 1840; also, La Lancette Francaise, cited
in London Lancet, Feb. 8, 1840, p. 707.
  3 Encyclographie des  Sciences Medicales, Mars, 1840, p. 226; Acad.mie Royale de
M.decine de Paris, Seance du 4 Fevrier, 1840.
  4 Trait, de l'Art. de Formuler, p. 184.  Paris, 1845.
  5 Elements of Mat. Med. and Therap. 3d Amer. edit. i. 748.  Philad. 1852. 
FERRI LACTAS.
369
  Dr. Brainard,1 of Chicago, having found by experimenting with a
solution of lactate of iron, that, when  injected  into a vessel, it pro-
duced thickening of the coats, and obliteration  of the  channels,  ap-
plied  this knowledge  to the  treatment of vascular tumours, and  has
succeeded in  removing them by puncturing the  tumour with an  in-
filtrating cannula, and injecting  through it a solution of the lactate in
the proportion of 8 grains of the salt to f 3j. of distilled water,—well
filtered.'
  He was, at  one time, disposed to think, that  the lactate  of iron was
possessed  of more  influence  over cancer than  any known medicine;
but subsequent observation has  shown  him, that, although  it is pos-
sessed of power to check  it, it  does not wholly cure it.  To  modify
the condition of the solids and fluids  as much as possible, Dr. Brainard
injected it, in one case, into the  blood vessels, in  the  dose of from
f 3ij.  to f Siiss. of a solution composed of eight  grains  of the lactate
to a fluidounce of distilled  water.  The  case  got well; and  no incon-
venience was caused by the injection.2

                    MODE  OF ADMINISTRATION.
  MM. Gelis  and  Conte form  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 twenty-four
hours; and M. Bouillaud never gives more than twenty.
  The following formulae have been proposed by M. Cap:3

                    Trochisci  ferri  lactatis.
                      Lozenges of lactate of iron.
                R. Ferri lactat. gvij. gr. 43 (30 grammes.)
                     Sacchar. 3*xiss. (360 grammes.)
                     Mucilag. acaciae q. s.
  Make into lozenges, each weighing gr. x. (65 centigrammes) which
will contain gr. f ( 5 centigrammes) of the salt.

                      Syrupus  ferri lactatis.
                       Syrup of lactate of iron.
                R. Ferri lactat. ^i- (4 grammes.)
                     Aquae destillat. bullient. 5~viss. (200 grammes.)
                     Sacchar. alb. 3*xiij. (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.
                      Pilulae ferri lactatis.
                       Pills of lactate of iron.
                R.  Ferri lactat.
                     Althaea, pulv. aa. gr. xvss. (1 gramme.)
                     Mellis q. s. ut fiant pil. xx.
  1 London Lancet, Aug. 20, 1853.
  1 Amer. Journ. of the Med. Sciences, April, 1852, p. 561.
  1 Journal de Pharmacie, and Amer. Journ. of Pharmacy, Oct. 1840, p 228. 
370
FERRI NITRAS.
  Chalybeate bread has been administered in one of the largest hospi-
tals of Paris to chlorotic patients, and with the best  effects.  From
four to five grains of lactate of iron may be mixed with  every three
and a half ounces of bread, without giving  it any unpleasant taste or
injuring its quality.1
                    LXXXVIII. FERRI NITRAS.
Synonymes. Ferri  Pernitras, Ferrum  Nitratum seu Nitricum Oxydatum, Nitras
  Ferri, Nitras Ferricus, Nitrate of Iron, Pernitrate of Iron.
French. Nitrate de Fer.
German.  Salpetersaures Eisenoxyd.
                 LIQUOR FERRI PERSESQUINITRA'TIS.
Synonymes. Liquor seu Solutio Nitratis seu Pernitratis Ferri, Liquor Ferri Nitrici
  Oxydati, Solution of Persesquinitrate of Iron, Solution of Nitrate of Iron.

                      METHOD OF PREPARING.
   This  preparation, which has  been introduced of late years into prac-
tice, 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 increase the whole solution to thirty ounces.
When the process is finished—which takes some hours—the liquid has
a red  colour, so dark, that when  viewed  by  reflected light  it seems
almost  black.
   Three  ounces of nitric acid  of the usual  strength (1.4) generally
dissolve an  ounce of iron,  so that when the process is completed, a por-
tion of the metal remains  undissolved.  The solution then consists en-
tirely  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  gradu-
ally converted into  pernitrate and protonitrate of iron.   The first of
these is insoluble, and renders the liquid turbid; and the latter, which
remains dissolved, has not  the medicinal properties that render the per-
sesquinitrate valuable.  When the solution contains nothing but nitric
acid and peroxide of iron, it slowly undergoes decomposition on stand-
ing, so  that, at the end of a few weeks, the whole liquid begins to become
turbid.   The addition of some muriatic acid prevents this decomposition,
and the quantity sufficient for this purpose is too small to affect the
medicinal powers of  the  persesquinitrate.   The solution, when pro-
perly prepared,  is of  a  beautiful dark red colour, when  viewed with
1 Provincial Medical and Surgical Journal, June, 1841. 
FERRI NITRAS.
371
transmitted light.  Its taste is very astringent, and not at all caus-
tic.1
   A formula, since given by Mr. Kerr, is the following.   Take of iron
wire, (No.  17,) one ounce;  nitric acid, three fluidounces; water, fifty-
seven ounces; muriatic acid, a dram.  Mix the nitric acid with fifteen
ounces of water in an earthen vessel capable of holding three or four
times the quantity.  Put into this the iron wire broken into a number
of pieces: cover the vessel lightly.   In eight or twelve hours, the solu-
tion must be poured off, and the remainder of  the water, with the mu-
riatic acid, be added.
   The formula admitted into the last edition of the Pharmacopoeia of
the United  States (1851) is the following.   Take of iron wire, cut in
pieces, Sj;  nitric acid  (s. g. 1.42) f giij; distilled  water, a sufficient
quantity.  Mix the acid with a pint of the distilled water; add the iron,
and agitate occasionally, until gas ceases to be disengaged;  then filter
the solution, and add to it sufficient distilled water to make it measure
f Sxxx.
                     EFFECTS ON THE ECONOMY.
   This preparation greatly  resembles solution of chloride of  iron in its
medicinal properties.   Mr. Kerr considers, that to an astringent power
it unites that  of diminishing the irritability and  tenderness of the
mucous  membranes with which  it comes in  contact; and he has
called attention to it as a  remedy in cholera.2  In chronic diarrhoea
an experience of eighteen years has proved its great value; but he has
not found it serviceable where ulceration of the bowels is present; and,
therefore, he thinks it  not applicable in  the  diarrhoea of phthisis.
Kopp administered it with the greatest success in many cases  of chronic
diarrhoea, 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 accom-
plished, the remedy was gradually diminished, until it was left off
altogether.3  Dr. Graves4 speaks in equally high terms of the perses-
quinitrate 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 diarrhoea
and other affections of the mucous membranes accompanied by dis-
charges.5  In chronic diarrhoea, depending mainly on an excess in the
sensibility of the organic nerves which supply the digestive tube, Dr.
Adam rarely orders less than fifteen drops at the commencement, and
after a few days' employment of the remedy, he increases the quantity
to twenty, twenty-five,  and thirty drops.   In leucorrhcea, occurring in

  1 Kerr, in Amer. Journ. of the Medical Sciences for May, 1832, cited from the Edinb.
Med. and Surg. Journal.
  1 Monthly Journal of Med. Science, Jan. 1848.
  8 See, also, Twining on the  Diseases of India, i. 217.  Calcutta, 1835.
  4 Clinical Lectures,  Amer. Med. Library edition, p. 128.  Philad. 1838.
  6 Amer. Journal of the Med. Sciences, May, 1839, p. 61. 
872
FERRI OXIDUM HYDRATUM.
such  as are  pale, exsanguious, feeble, and languid, the internal, con-
joined 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 aph-
thous sores;  and he affirms that its application has afforded relief in
toothache-  Dr.  J. W. Williams1 employed it successfully in the diar-
rhoea and intestinal hemorrhage of typhoid fever.
  Mr. Kerr gave it in a case of urticaria, which yielded speedily, after
having resisted other remedies.  He found it also potent  in allaying
hiccough.  Subsequently,2 he pointed out its utility in the treatment
of intermittent fever, thus  administered.  Ten  grains  of  sulphate of
quinia are to be given in divided doses before the expected paroxysm,
combined with a tea-spoonful of the solution of the persesquinitrate.
This will  probably prevent the paroxysm; and  the subsequent treat-
ment may consist of the iron  uncombinecl.
  It is, doubtless, a powerful astringent, but it is questionable whether
it possesses any advantage over the tincture of chloride of iron.
             LXXXIX. FERRI OXTDUM HYDRATUM.
Synonymes. Ferri Sesquioxidum Hydratum, Ferrugo, Hydras Ferricus, Ferrum Oxy-
  datum Hydratum, F. 0. Hydricum, Oxidum Ferri seu Ferricum 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 E'isenoxyd.
  Hydrated oxide of iron has been introduced into practice as an an-
tidote to white arsenic.  Dr. Bunsen,  of Gottingen, had already made
frequent experiments with it, which satisfied him, that it was an effi-
cacious agent; but, along with Dr. Berthold,3 he subjected it to fresh
trials.  The results of their investigations were  published, and since
then it has received 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 the dose of oxygen  by
treating it with nitric acid, and precipitate the oxide by  adding pure
ammonia in excess,—washing the precipitate.   In order not  to  de-
prive the precipitate  of its water, and to diminish its  loose  state of
aggregation as little as possible,  it is not filtered, but is put aside  for
a few days, until the  precipitate is wholly deposited, after which the
supernatant fluid is poured off.  It is then kept in well-stopped vessels.
  Riecke4 has added the formula for pharmaciens,  which is recom-
mended by Von Specz:—

  1 Boston Med. and Surg. Journal,  April 7, 1841.
  2 Edinb. Monthly Journal, Oct. 1851, p. 336.
  3 Das Eisenoxydhydrat ein Gegengift der arsenigen S'aure.  Gotting. 1834.
  1 Die neuern Arzneimittel, S. 227.  Stuttgart, 1837. 
FERRI OXIDUM HYDRATUM.
373
  R.  Vitrioli ferri puri crystallizati libram; teratur in pulv. subtiliss. et detur in
vas. porcellan. aut murrhinum impositum balneo arenas; dein adde acidi nitrici con-
cent rati lbss.; terantur ope baculi vitrei usque dum massa resolvitur in pultem; nunc,
igne animato, massae pultaceae calidae affunde sensim terendo, sensim acid, nitric, con-
centrat. q. s. donee  nullum  amplius evolvatur gas nitrosum.  Massa tunc  leni igne
evaporetur ad siccitatem et solvatur demum in aq. destill. q. s.; solutioni filtratae in-
stilletur ammoniae puree q. s. donee praecipitatio cesset; stent nunc per horam unam
alteramve et liquor limpidus _. sedimento bruneo decantetur;  massae residua, fundum
petenti adfunde aq. destillat. lbiij. et agitentur; nunc filtra, et praacipitatum  in filtro
aq. destill. q.  s. edulcora donee aqua insipida defiuat.  Prsecipitatum bene  edulcora-
tum in umbra  siccatum convertat. in pulv. subtilissim. qui servetur vase vitreo bene
clauso.1
   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  developed, and deutoxide
of nitrogen,  which  is transformed by the  atmospheric 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 exhibit  an alkaline reaction.  The
precipitate, thus formed, is the hydrated  oxide of iron,  which is col-
lected on the filter,  and washed with boiling  water until it is tasteless,
and ceases  to exhibit any alkaline characters.
   The mode of preparation recommended  by Majesty 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.2
He asserted, that it was subjected to practice by Mr. Durand,  an able
pharmacien of Philadelphia, who obtained a  perfect result,  with a sa-
tisfactory economy of material.   Take of sulphuric acid, (67° Baum6,)
8 oz. or 16 parts; iron wire, 8 oz.  or 16 parts; nitric acid, (49° Baume,)
5h oz. or 11 parts; water of ammonia, as much as is sufficient; water, a
gallon and  a half or 384 parts.  Mix the sulphuric acid with the 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 preci-
pitate 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. William Procter, Junr.,3 show, that
  1 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 concen-
trated nitric acid; stir them with a glass rod until the mass is resolved into a soft paste;
then—the  fire being raised—pour  gradually on the hot pultaceous mass concentrated
nitric acid, until no more nitrous gas is evolved.  Let the mass be evaporated by a gentle
heat to dryness, and at last be dissolved in a sufficient quantity of distilled water. Into
the filtered 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
the residuary  mass remaining at the bottom,  pour three pounds of distilled water, and
shake  them together; filter and wash the precipitate on the filter with distilled water,
until  the water is tasteless.  The well-washed precipitate dried in the shade forms a
Bubtle powder, which may be kept in a well closed vessel."
  2 American  Journal of Pharmacy, vol. vi. No. 1, April, 1840.
  »Ibid. April, 1842, p.  37. 
374
FERRI OXIDUM HYDRATUM.
even when kept under water its power of  neutralizing 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 re-
lative proportion of the oxide, 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 directed in the United
States Pharmacopoeia, should be kept in every shop as a source for ob-
taining the peroxide;  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 rea-
sons 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.1
   The form for this preparation admitted into the edition of the Phar-
macopoeia of the United States (1842,) is the following: Take of sul-
phate of iron, Siv.;  sulphuric acid, f 3iijss.;  nitric acid, f 3vj., or a
sufficient quantity; solution of ammonia, a sufficient quantity; water,
Oij.   Dissolve  the sulphate in  the water, and, having added the sul-
phuric acid, boil  the  solution;  then  add the nitric acid in small por-
tions, boiling the liquid for a minute or two after each addition, until the
acid ceases to  produce 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
precipitate with chloride  of barium, and keep it in close  bottles with
water sufficient to cover it.2

                    EFFECTS  ON  THE ECONOMY.
   If a solution of arsenious acid be decomposed by freshly  precipitated
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  oxyhydrate, which contains
at least ten or twelve parts of oxide of iron. Yet, even where a smaller
quantity is employed, the arsenious acid  is almost  wholly separated,
as a stream of 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 portions to the  precipitating agent, the reaction is still slighter.
If a few drops of ammonia be added to water in which the oxyhydrate
of iron is suspended, and the mixture be digested with finely powdered
arsenious acid, an insoluble arsenite of iron is formed; a circumstance,
which would  encourage the belief—even had it not been sanctioned by
experience—that freshly prepared oxyhydrate of iron may serve as an

       1 Procter, loc. citat.
       2 Pharmacopoeia of the United States, p. 137.  Philad. 1851. 
FERRI OXIDUM HYDRATUM.
375
antidote to arsenic; the union between it and arsenious acid forming—
as has been seen—an  insoluble compound, devoid of  all poisonous in-
fluence on the economy, and  only exciting gastric oppression when
given in large doses.
  Accurate microscopical investigation, in experiments on animals that
had taken arsenious.acid in the solid form mixed with the oxyhydrate,
exhibited to the discoverer of the antidote, that under the influence of
animal heat and the peristaltic motion, it had become completely con-
verted into subarseniate of protoxide of iron, and thus rendered inno-
cuous.  Such was the  result of the  observations of  Boulet,1  Orfila,
Chevallier, Lassaigne, Soubeiran and Miquel,2 Nonat,  Borelli and De-
maria,3 Lesueur,  Boulay, fils,*  Monod,5 Von  Specs,  Mackenzie,6 D.
Maclagan,7 and others.8  On the other hand, the experiments of Brett,9
Reginald Orton,10 and Cramer, were unfavourable; but Messrs. Bun-
sen 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, prepared  according to their  formula, which is necessary to
neutralize that quantity of the poison.11
  Messrs. Bunsen and Berthold, from the results they have obtained,
recommend the oxyhydrate  as the chief antidote in all cases of poison-
ing 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, sub
stances 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 substances 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 receiving  only a small quantity of the antidote.
But, whether vomiting 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  given afterwards 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  unchanged.   With  the  same view, the

  1 Gaz. M.d. de Paris, 1834.         2 Bullet. General de The"rap. Dec. 1834.
  » Br. and For. Med. Rev. April,  1836, p. 594.
  * Journal Hebdom.  des Progres des Sciences M<.dic. 14 Mars, 1835.
  5 Gazette Medicale, 22 Aout, 1835, and Annales d'Hygiene, &c. xiv. 135.
  6 London Lancet, April 4, 1840.      7 Edinb. Med. and Surg. Journal, July, 1840.
  8 T. R. Beck, Amer. Journ. of the Medical Sciences, July, 1841, p. 90.
  9 London Medical Gazette, xv. 220.                    10 Lancet,  Nov. 8, 1834.
 11 See, also, Maclagan, op. cit. 
376
FERRI OXIDUM HYDRATUM.
oxyhydrate may be  thrown up  in  the way of clyster, whenever it is
presumable that the compound, formed by the oxyhydrate  and the
arsenic, has reached the lower portion  of the  bowels.   To aid this,
cathartics  may  be administered.   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 parts of
hydrated oxide of iron are more than sufficient  to convert one part of
arsenious acid into the 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 necessary, 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 re-action 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 symptoms
is obtained.1
  Mr. J. Haidlen2 has found, experimentally, that to thoroughly pre-
cipitate one part of arsenious  acid within five  minutes by the hydra-
ted peroxide, twenty-two parts of the latter are needed.   On account
of this property of the hydrated oxide, a mixture of hydrated peroxide
of iron and magnesia has  been  advised,—that is, a mixture of a solu-
tion of persulphate of iron, which  yields from seventeen to eighteen
per cent, of the hydrated peroxide,  dried at 212° Fahr. with excess of
caustic magnesia.   In the Wurtemburg Pharmacopoeia  a mixture of
perchloride of iron with excess of magnesia is directed.
  From experiments instituted by M. Schroff3  he inferred, that hy-
drate of  magnesia and hydrated oxide of iron  are both  capable, to a
certain  extent, of mitigating the poisonous effects of arsenious  acid;
and hydrate of magnesia is certainly the more efficacious of  the two.
M.  Schuckhardt considers the  hydrate  of magnesia a  certain anti-
dote.
  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

  1 T. R. Beck, Amer. Journ.  of Med. Sciences, July, 1841, p. 95.
  2 Chem. Gazette, May 1, 1852, cited by Dr. T. R. Beck, in Amer. Journ. of the Med.
Sciences, July, 1852, p. 274.
  3 Pharmaceutical  Journ. July, 1853, and Amer. Journ. of the Med.  Sciences. April,
1854, p. 537. 
FERRI OXIDUM HYDRATUM.
377
reject the poison by vomiting; but if the poison be retained in the
stomach by a ligature passed round the oesophagus, it exerts its ac-
customed deleterious effects.1  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.2
  It would  appear,  that cases  have occurred, in which  this antidote
has saved  the lives of some who might have been destroyed without its
agency.  Buzorini3  had a case in  which about  thirty-five  grains of
arsenic  had  been swallowed,  and  where it was successful, 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  ordinary means.  In another case,
which was also treated by the antidote at a late period, marked allevia-
tion of the suffering was induced.  Three cases are related by Majeste,
two by Bineau,4 one by Bcnoist, and one by Geoffroy5 of Paris, which
were treated successfully in the same manner.  The subject of the last
was a  hair-dresser,  thirty-five years  of age, who, in a  paroxysm of
delirium 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, experienced scarcely
any uneasiness.   A  successful case has, also, been related by Mr. John
Robson, house-surgeon to the Warrington Dispensary.6
  Dr. Richard H. Thomas, of Baltimore,7 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 tum-
bler 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 which  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 pa-
tient 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

  1 MM. Miquel and Soubeiran, Bullet. General de Therap. Dec. 1834.  See, on this
subject, Dr. Joseph E. Muse, in Amer. Med. Intelligencer, for April 2, 1838.
  » Robert B. Hall, in Amer. Med. Intelligencer, for Sept. 15, 1838, p. 181.
  3 La Lancette Francaise, Nov. 17, 1835.
  4 Journal des Connaissances M6dico-Chirurgicales, Nov. 1835.
  6 Journal  de M6d. et de Chirurg. Pratiq.  Sept. 1835; and Brit, and For. Med. Rev.,
April, 1836, p. 572.
  6 Lond. Med. Gaz. Nov. 5, 1836.
  ' Amer. Med. Intelligencer, for July 16, 1838, p. 167. 
378
FERRI OXIDUM HYDRATUM.
covered with sugar.   The prompt relief which followed the exhibition
of the peroxide is also confirmatory of the impression that the poison
was really taken."
  A case has been published by M. Deville,1 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,2 the sub-
ject of which took at eight o'clock, p. m.  about half an ounce  of  ar-
senic, after which he vomited incessantly, and did not take the hydra-
ted oxide until three  p. m. on the  day following.   He  got well; and
the vomiting appeared  to be  relieved by it.   Since  then,  several
cases of the successful exhibition of the hydrated oxide have been pub-
lished;  one by M. Ansroul,  of Brussels;3 seven by Puchelt,4 of Hei-
delberg ; one by Dr. Macdonald;5 one by Dr. Chilton; ° and one by Dr.
Murray,7 of India.  Drs. Smiley and Wallace,8  of Philadelphia, admi-
nistered it to a family of eight persons.   Death followed in two cases.
The antidote could not be retained, but was rejected immediately.  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 de-
finite quantity of  water, in order that it may be always at hand, so as
to be administered without delay;  and  the recommendation  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 important element in the treat-
ment of every case in which arsenic  has been taken.
  A commission of the Acad6mie  Royale de Medecine,9 composed 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—should be suspended  in twenty-four ounces
of water, and a good glassful of the mixture be taken  every ten mi-
nutes.    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 pure hydrated oxide, Von Specs10 employed  substances
in which the peroxide is known to  exist in considerable  quantity, and

  1 Revue Medicale Franc, et Etrangere, Sept. 1838 ; see, also, Br. and For. Med. Rev.
and Johnston's Med.-Chir. Rev. for April, 1839 ; and Amer. Journ. of the Med. Sciences,
May, 1839, p. 243.
  2 Medical Examiner, April 18, 1840, p. 251.
  8 Annales de la Societ. de Medecine de Gand, Avril, 1840, and Encyclographie des
Sciences Medicales, Mai, 1840, p. 494.
  * Heidelberg Medicinisch. Annal. B. v.;  and Encyclographie des Sciences Medicales,
Mai, 1840.
  6 New York Journ. of Med. and Surg. iii. 205.                 « Ibid. p. 54.
  7 Calcutta Med. Journ., Dec. 1837, and Amer. Journ. of the Med. Sciences, Feb. 1839,
p. 503.                                 a Philad. Med. Examiner, iii. 679.
  9 Revue M.dicale, Mai et Juin, 1839.
 10 Med. Jahrbiicher des k. k. o. St. B. xix. S. 621.  Wien, 1836; Ibid. B. xx. S. 149.
Wien, 1836 and Brit, and For. Med. Rev. July, 1837, p. 237. 
FERRI PR0T0CARB0NAS.
379
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  ad-
vantage of being readily procurable.
  A case has been published by M. Batilliat,1 which induced him to
infer, that  the hydrated oxide, dried in the air, is as efficacious as
that which is kept moist.   It certainly would seem, that the  dry hy-
drated oxide — the Ferri  Subcarbonas  of the Pharmacopoeia of  the
United  States,—possesses  the  power  to a considerable   extent, of
neutralizing arsenious acid;2 and hence  it  ought  to be used in the
absence of the moist and fresh preparation.  The  latter, however, as
already remarked, may be obtained in a condition fit for use in ten or
fifteen minutes,  by using a solution of the persulphate of iron.3   The
experiments of M. Guibert4 would seem to show, that the subcarbonate
of iron,  as ordinarily  prepared, is about three  times  less active in
neutralizing 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,5 in which the
hydrated oxide was administered as an antidote  to Scheele's green—
Arseniate  of Copper.  A boy, three years  of age, poisoned himself
by licking a shell covered with the poison.   Half an hour afterwards,
 he became pale: violent vomiting  soon came on, with  diarrhoea,  pam
 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 ceased, and the next  day all the symptoms
 had disappeared.
                 XC. 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  London  Pharmacopoeia—to " sesquioxide  ol
iron."  The protocarbonate readily absorbs oxygen, and, consequently,
becomes  converted into the  sesquioxide;  and  this is an objection
commonly urged  both against the Mistura Ferri Composita and  the
Pilulae Ferri Compositae of the Pharmacopoeias.  M. Vallet  has dis-
covered a method of obviating the objection, which consists in mixing
the protocarbonate with saccharine matter.

  » Journ. de Chimie Medicale, Janvier, 1840.              2 T.B. Beck,  loc. citat
  » W. Procter, Jun., Amer. Journ. of Pharmacy, April, 1842, p. 3/, and the Report of
the Committee of the College of Pharmacy, on his paper, Ibid. p. 39
  * Bullet.  General de Th.rap., Dec. 1841, and Amer. Journ. of the Med. Sciences, Oct.

 "6 Journal des Connaissances M.dico-Chirurg. Mars, 1840, and Archives de  M.decine,
F.vrier, 1842; cited in Journal de Pharmacie, Mars, 1842, p. 269. 
380
FERRI PROTOCARBONAS.
                      METHOD  OF PREPARING.
   The following method is given by Mr. Procter,1 as a simplification
of M. Vallet's  process.  Take of protosulphate of iron,  (pure,) six-
teen  parts;  carbonate of  soda,  (crystallized,)  nineteen  parts;  pure
honey, nine parts;  syrup, a sufficient quantity.  Dissolve the sulphate
in half a  gallon of water, at the temperature of 180°  Fahrenheit,
and the carbonate of soda in  a like quantity;  to  each of these solu-
tions  add four ounces  of syrup; and then mix them in a jar, which
should afterwards  be  entirely filled with  sweetened water  and the
access of air be prevented.   After the precipitate has subsided, de-
cant  the supernatant  fluid, and wash it with sweetened water in the
jar, until deprived of the adhering sulphate of  soda.  After the car-
bonate is thus  purified, throw the precipitate on a flannel cloth; ex-
press 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 process of Mr. Procter, has been
introduced into the Pharmacopoeia of the  United States.

                    Pilulae  ferri carbonatis.
         Pills of carbonate of iron.—( Vallet's Ferruginous Pills.)

   Take of sulphate of iron, Sviii.; carbonate of soda, %x.;  clarified
honey, giii.; sugar in  powder, 5ij.; boiling water, Oij.   Dissolve the
sulphate of iron and  carbonate of soda, each in a pint of the water,
a fluidounce of syrup having been previously added to each pint; then
mix the two solutions when cold, in a bottle just large enough to con-
tain 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 water,  sweeten 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 flan-
nel cloth to drain, and afterwards express as  much  of the water  as
possible;  then  immediately mix the precipitate  with the honey and
sugar, and, by means of  a water-bath, evaporate the  mixture, con-
stantly stirring, until  it is  so far concentrated  as to have a pilular
consistence on  cooling.
   A formula for the Ferri Carbonas Saccharatum, Ferri Carbonas
cum Saccharo, is in the London, Dublin, and Edinburgh Pharmacopoeias,
On the continent of Europe the preparation is known under the name
of Klauer's Ferrum Carbonicum Saccharatum.2  It is in the Pharma-
copoeia of Baden.3
   When prepared in this manner, the protocarbonate has  a dark olive
colour, strong ferruginous taste, contains about 30 per cent,  of protoxide
of iron,  and, if carefully  prepared,  dissolves wholly and directly  in
acids.

  1 Amer.  Journ. of Pharmacy, Jan. 1839, p. 272.
  s Pereira, Elements of Materia  Medica, &c, 3d Amer. edit. i. 727. Philad. 1853.
  1 Oesterlen, Handbuch der Heilmittellehre, S. 457. Tiibinfe. 1845. 
FERRI protocarbonas.
381
                    EFFECTS on  the  economy.
  The pills of M. Vallet have been  prescribed in most of the diseases
in which  chalybeates in general are considered  to be indicated;  and
especially in chlorosis  and amenorrhoea.1   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.   This
can only  be decided  therapeutically; and as yet the  trials have  been
insufficient.  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 protocarbonate 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.2  The author  has  never witnessed  such effects from its admi-
nistration.
                    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.  They may be given to
the extent of eight or ten pills daily, and be continued for weeks, if
necessary.
  A medicine, which greatly resembles the Piluloe Ferri Compositae 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 preparation of his pills is as follows:—Take of
gum tragacanth, in  powder, six  grains;  water, one dram.  Macerate
in a glass or porcelain mortar, until a thick mucilage  is formed;  and
if it be desired to prevent the 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, of carbonate of potassa, half an ounce.  Beat
until the mass, which soon becomes of a yellowish-green colour, passes
to a deep green, and assumes a soft  consistence.   Divide into 48 pills
or boluses; which M. Blaud  considers sufficient for the cure of a chlo-
rotic patient.3  M. Guibourt substitutes the bicarbonate of potassa for
the simple carbonate or sub-carbonate; and he gives as reasons: First, the
avoidance of a very alkaline salt, an excess of which may prove prejudicial

  1 Soubeiran, Rapport sur les nouvelles pilules ferrugineuses de M. Yallet, in Bulletin
G.n6ral de Therapeutique, Mai, 1838, cited in Amer. Journ. of Pharm., x. 244.   See
also, Berthemot, in Bull. G.n.ral de Therapeut. Juillet, 1839.
  2 Christison, Dispensatory, p. 426. Edinb. 1842.
  s Revue M6dicale, Mars, 1832, Dec. 1838. 
382
FERRI PROTOCARBONAS.
 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
 astringent.   His form is the following:—Take  of pure  crystallized
 sulphate of iron, crystallized bicarbonate of potassa, each four drams;
 powdered gum Arabic,  one  dram;  powdered marshmallows, half a
 dram.  Mix and divide into ninety-six pills.1
   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.2   Blaud,3 however, maintains
 properly, that the  virtue  of  medicines cannot  be appreciated from
 chemical experiments: "It  is," he  remarks, "to therapeutical trials,
 and not to chemical experiments that we must have recourse, to learn
 accurately the medical properties of any agent.   What  signifies it to
 practitioners that my pills contain little or no protoxide of iron, provided
 they cure chlorosis?"  To prove that they do possess this power, Blaud
 adduces a long list of cases in which  a cure was  obtained in three or
 four weeks.   To prevent, however, the change to which the chemists
 object,  but  which  Blaud appears rather  to  regard  with  favour,  M.
 Adorne has  suggested the  addition  of sugar, and the pulvis althaeas
 according to the following  form:—Take of sulphate of iron, recently
 prepared, according to the  method of Bonsdorff,  which is  a pure  sul-
 phate;  carbonate of potassa,  or, what  is  better, carbonate of soda;
powdered root of marshmallow and sugar, each, half  an ounce; muci-
 lage 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 correct the disagreeable odour.4  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 which 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 give 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,5 by employing  pure crystallized
 sulphate of  iron, 100 grammes;6  pure  carbonate  of  potassa,  100
grammes; white honey, 50 grammes; from which he obtained  130
grammes of  a deep green mass, very ductile, 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,7 who considers Blaud's pills

  1 Pharmacop.e Raisonne, i. 383; and Amer. Journ.  of Pharm. April, 1839, p. 61.
  2 Soubeiran, Bull. General de Therap. Mai, 1838.                       3 Ibid.
  1 Bull. M.dical du Midi, Janvier, 1839; and Encyclographie des Sciences M.dicales,
Mars, 1839.
  5 Journal de Pharmacie, Mars, 1841, p. 153.
  6 A gramme is gr. 15.434 Troy.
 J1 Southern Med. and Surg. Journal, July, 1846. 
FERRI PR0T0CARB0NAS.
383
to be a capital remedy in chlorosis, the best he has ever used, recom-
mends 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 afterwards,
three, daily.
  Mr. Donovan1 recommends the protocarbonate  of iron to be  admi-
nistered in the following manner, for extemporaneous use:—blue sul-
phate 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,2 of Dublin, has advised the following mode of ex-
hibiting the precipitated carbonate:—Take  one dram of bicarbonate
of soda, dissolved in four ounces of spring water, 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  the  quan-
tity of carbonate of iron formed is not considerable, yet it  is in such
a state of minute  subdivision, and combined with a solution of chlo-
ride of sodium  equally  minute—"the  saline most  congenial  to the
system of red-blooded animals, as it renders the hematosine active and
vivifying,"—that, thus given, he always found it answer the object of a
chalybeate much better than the large doses of from  one to two  drams
of the subcarbonate.   If ulceration existed, it  was very generally im-
proved ; and he has seen many cases of lupus attacking  the face cured
by its joint internal and external use.   He formerly thought the phos-
phate of iron, administered internally, possessed superior advantages
to the  carbonate;  but now thinks the carbonate given during the pre-
cipitation answers every purpose of a chalybeate, without causing any
derangement of stomach.  Dr. Stegmann3 has recommended the car-
bonate in the treatment  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 even more than, the number of years in a 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.  Similar
testimony  is said to have  been afforded by Ghisholme,4 and  it has
been strongly advised by R. Froriep,5 who gives it in the same doses
in which it  is prescribed in chlorosis, and has succeeded in removing
the disease  in two weeks, or,  at the farthest, in six.

  1 Dublin Journal of Medical Science, March, 1840, p. 159.
  2 Dublin Medical Press, March 4, 1840.
  3 Horn's Archiv. 1835, Juli and August, S. 651; and Medicin. Correspondenz Blatt,
cited in Gazette Medicale de Paris, 20 Juin, 1838.
  * Trousseau and Pidous, Trait, de Therapeutique, &c, 3me _dit. i. 26.  Paris, 1847.
  6 Tagesberichte, Mars, 1850, No. 48; and Keller and Tiedemann's Nordamerikanischer
Monatsberichte fur Xatur und Heilkunde, Sept. 1850, S. 104. 
384
FERRI SUBCARBONAS.
                   XCI. FERRI SUBCAR'BONAS.
Synonymes.  F. Carbonas seu  Carbonas Pracipitatus, Ferrum Carbonatum Pnvcipi-
  tatum seu Carbonicum Oxydnlatuin, Oxydum Ferri Fuscum, Ferri Oxydum Ru-
  brum seu Sesquioxidum, Deuto-Carbonas Ferri Fuscus, Crocus Martis  Aperiens,
  Subcarbonate of Iron, Sesquioxide of Iron, Peroxide of Iron.
French. Sous carbonate de Fer, Safran de Mars Aperitif.
German. Kohlensaures  Eisenoxydul, Kohlensaures  Eisen, Kohlen-
  saures Eisenoxyd,  Braunes Eisenoxyd.
  This preparation, which is officinal in the British, United States and
other Pharmacopoeias, is formed by  adding a solution of carbonate of
soda to a solution of sulphate of iron: the precipitate is the subcarbo-
nate, or—as it is now called in the London Pharmacopoeia—the sesqui-
oxide of iron, which must be washed with water, and dried.

                     EFFECTS ON THE ECONOMY.
  Subcarbonate of iron possesses the properties of chalybeates  in ge-
neral, and has been highly recommended as a tonic, wherever  such re-
medies are indicated.   It is  introduced here  mainly on  account of
the favour which  it has received as  a remedy for neuralgia.  Nearly
forty years ago, its use was strongly advised in  cancer and carcinoma-
tous ulcerations of the uterus, by Mr. Carmichael,1 and, subsequently,
by  Rust, Volker, and  Kopp;  as well as  in a  case  of lupus of the
ala  nasi, by Key:2 but,  in  similar  cases, it proved unsuccessful in
the hands of Clarke, El.  Von Siebold, Meissner, Richter,  and others.3
In chronic nervous diseases of a spasmodic nature,  and especially in
tic douloureux of the face, it was  first highly extolled by Dr. Ben-
jamin Hutchinson, about thirty-five  years ago,4  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,5 Stewart Crawford,6 R.  Macleod,7 Mr.  J.  E.
Beale,8 and many others,  and its efficacy is now almost universally ad-
mitted.  Dr. Rowland9 had often witnessed the most happy results from
its exhibition, even after  various powerful medicines  had been tried in
vain.  Dr. Elliotson10 published several cases, in which it had been effi-
cacious in large doses; and he remarks, that true chronic neuralgia, not
arising from cold, and coming on in a violent, stabbing, plunging form
aggravated by the least shake of the patient, and by touching the sur-
face, is best treated by subcarbonate of iron.   He observes, however,
in a subsequent  publication,11 that he does not recollect  that he ever
cured the disease, but in almost every case improved it, and caused

  1 An Essay on the Effects of the Carbonate and other Preparations of Iron upon Can-
cer, 2d edit.  Dublin, 1809.                       2 Lancet, xiv. 92.
  3 Osann, in Encyclopad. Worterb. der Medicinisch. Wissensch.  x. 424. Berlin, 1834.
  4 Cases  of Tic Douloureux successfully treated.  Lond. 1820.
  5 Medical and Physical Journal, Feb. 1823.
  6 Ibid.                i  Ibid. June, 1823.                8 ibid. Sept. 1823.
  9 Treatise on Neuralgia, by Richard Rowland, M.  D., p.  84. Lond. 1838; or the re-
print in the author's Amer. Med. Library.
  10 Medico-Chirurgical Transactions, xv. 161.
  " Principles and Practice of Medicine, &c, by John Elliotson, M. D.; with Notes, &c.
by Nathaniel Ropers, M. D. p. 507.  Lond. 1S39. 
FERRI SUBCARBONAS.
385
it to disappear for a time.  In  one of the severest cases of neuralo-ia
under the form of hemicrania, which the author ever witnessed, and
which had rendered the patient's life miserable for years, the subcar-
bonate, 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 exhibition of the remedy,—with
the surface pale and cool; the pulse small; complaining much of de-
bility, and  yet suffering under  the most intense headache, which  the
least light and noise rendered almost intolerable; yet, after she had per-
severed in the use of the remedy for a month, in large doses, the symp-
toms gradually disappeared, and she has since remained entirely well.
It need scarcely be said, that where plethora  exists, or febrile irrita-
tion supervenes,  it must be removed;  the subcarbonate rarely, how-
ever, disagrees with the  stomach, and where  it does, the inconveni-
ences are removed by the addition of an aromatic, or the administra-
tion 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. Elliotson1 affirms, that he has had—he should suppose—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 some
time ago, M. Gimon,2 physician at Thouars, published two cases eluci-
dative 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 sulphate 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 gradually diminishing the  dose.  In the second case, the same dose
was prescribed  in the first instance; and it was ultimately carried to
six drams,  with complete success.
   The great efficacy of this preparation—as of every tonic—in diseases
that are  paroxysmal, appears to consist in the  new impression 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 5ss.

  1 Op. cit. p. 515.      s Journ. des Connaissances Medico-Chirurgicales, Mai, 1837.
       25 
 386                     FERRI SUBCARBONAS.

 to 5ij>j 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
 formulae  have  been recommended.1

                    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.
                     Valerianae pulv. ^ss.
                     Syrup, zingib. q. s.
             Fiat bolus.

                   Pilulae ferri subcarbonatis.
                     Pills  of subcarbonate of iron.
                  R.  Ferri  subcarb.
                     Extract, anthemid. aa. %ss.
      Misce et divide in pilulas xij.; quarum sumat binas ter quotidie.
                  R.  Ferri subcarb. 3j-
                     Pilul. aloes cum myrrhS. gss.
      Misce et divide in pilulas xviij.; dua. bis terve indies sumenda..

        Pilulae  ferri subcarbonatis  et hydrargyri.
               Pills of subcarbonate of iron and mercury.
                  R.  Ferri subcarbonat. 3j«
                     Hydrargyr. ^ij.
                     Confect. rosa. 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. Collier2 recommends
it as especially eligible for  the strumous, the irritable, and for reduced
ansemic 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.

             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.

       1 Brande, Dictionary of the Materia Medica, p. 248. Lond. 1839.
       2 From the second edition of the London Pharmacopoeia. 
                        FERRI VALERIANAS.                     387


                     XCII.  FERRI TANNAS.
Synonymes. Ferrum Tannicum.
French. Tannate de Fer, Tannate de Peroxide de Fer.
German.  Gerbesaures  Eisenoxyd.
  Tannate of iron has been recently employed internally in diseases
in which chalybeates  are indicated.

                     METHOD OF PREPARING.
  To a boiling solution of 90 parts of pure tannic acid add gradually
440 parts  of subcarbonate of iron prepared from pure sulphate of iron
and carbonate of soda dried  at a moderate heat.  Agitate the solution
until the effervescence ceases.   Evaporate at 176° Fahr., in a porce-
lain vessel, until it becomes thick; and spread it on glass or  porcelain
to dry in  a stove at  95° Fahr.  It  is usually  obtained, however, by
adding  a solution of  a  salt of sesquioxide of iron, as the persulphate,
to a decoction of nut-galls.  The result is a tanno-gallate of iron, as in
common ink.
  Tannate of iron is of a blue colour, tasteless, and insoluble in water.
It is  possessed of tonic and astringent properties; and has been highly
extolled in chlorosis  by Benedetti,1  and  been  used wherever chaly-
beates, especially astringent chalybeates, are  indicated;  but  it  does
not appear to possess  any special virtues.  As an external  application
in herpes  circinnatus or ringworm, ink has been long a popular  re-
medy.
                     MODE OF ADMINISTRATION.
  The dose of tannate of iron is from 10 grains to half a dram in the
day,  given in  syrup or in the pilular form.

                   Syrupus  ferri tannatis.
                      Syrup of tannate of iron.
                R.   Syrup. gxij.
                    ------aceti ^iv.
                     Ferri oxidi magnetici citrat. ^ijss.
                     Ext. gallae -_j. M.
  This preparation was first proposed by MM. Trousseau and Pidoux,2
and as the iron, they remark, "is in the state of ferrosoferric tannate,
and associated with an acid, it is soluble, sapid, and susceptible of use-
ful applications."
                   XCIII.  FERRI VALERIA'NAS.
 Synonymes. Ferrum Valerianicum, Valerianate of Iron, Valerianate of Sesquioxide
  of Iron.
 French. Valerianate de Fer.
 German. Baldriansaures Eisenoxyd.
  This salt may be formed,  according to Ruspini,3 by putting clear iron
filings into a wedgewood mortar, adding gradually an equal weight of

  1 Bouchardat, Annuaire de Th.rapeutique, pour 1847, p. 186.  Paris, 1847.
  3 Traite de Therapeutique et de  Mat. M.dicale, 3eme .dit. i. 7.   Paris, 1847.
  1 Bouchardat, Annuaire de Therapeutique pour 1847, p. 54. 
388
FILIX MAS.
valerianic  acid, and stirring  continually.  In an hour, add  distilled
water; pour the whole into a flask; warm gently, and filter.   The sur-
face exposed  to  the air becomes covered with a crystalline  layer  of
valerianate of iron.   Collect this on a filter, and repeat the process as
long as crystals are formed.   It is a dark, brick-red, loose, amorphous
powder, of feeble taste and smell of valerianic acid.   It is insoluble in
water.1   It has been given in the form of pill, in the dose of from two
to four grains in  hysterical symptoms complicating chlorosis.   The salt
is officinal in the last Dublin Pharmacopoeia,2 in which it is directed to
be made by a double decomposition between the  tersulphate of sesqui-
oxide of iron and valerianate of soda.
                        XCIV. FILIX Mis.
Synonymes. Filix, Nephrodium seu Aspidium seu Athyrium seu Polypodium seu
  Polystichum Filix Mas, Lastr__a Filix Mas, Male Fern, Male Shield Fern.
French. Fougere Male.
German. Farrenkraut, Johanniswurzel, Mannlicher  Farrenkraut, Far-
  renkrautmannlein, Mannlicher Nierenfarrn, Bandwurmwaldfarrn,
  Mannleinwurmtiipfelfarrn.
  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 the time of Dioscorides indeed—as an an-
thelmintic;  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.4   It is noticed here on account of the proposition  of Peschier,5
of Geneva, to administer the ethereal extract, which has since been
carried into effect, and  apparently with the best results.6  It possesses
the advantage of 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 sulphuric 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 obtained, which possesses
the repulsive odour  of  the plant,  and has an acrid taste.

  1 Aschenbrenner, Die neueren Arzneimittel und Arzneibereitungsformen, S. 132.  Er-
langen, 1848.
  2 The Pharmacopoeia of the King and Queen's College of Physicians in Ireland, 1850,
p. 166.  Dublin, 1850.
  3 Merat and De Lens, Diet, de Mat. Med. art. Polypodium.
  * For the various forms in which it has been given as an anthelmintic against tenia,
as well as for the  methods  of Von Beck, Herrenschwand, Matthieu, Measeed, Nuffer,
Odier, and Wawruch: see Linke, Vollst'andiges Recept-Taschenbuch, u. s. w. i. 232.
Leipzig, 1840.
  5 Nouvelle Biblioth.que M.dicale, Sept. 1828, p. 151, and Biblioth. Univer. 324, 1826.
  6 Rayer, Annal. de The"rap. Mai, 1847, and Schmidt's Jahrbucher, u. s. w. No. 5, p.
162.   Jahrgang, 1848. 
FILIX MAS.
389
   In Germany, the extract is generally prepared according to the for-
 mula of the Prussian Pharmacopoeia, which is as follows:—Take an
 ounce of the powdered root; and pour thereon eight ounces of the sul-
 phuric 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-saccharine mat-
 ter, green and red  colouring matter, and a  semi-resinous substance.1
 By some it is called oleum  filicis  maris.   The  active  constituents
 of the fern are highly concentrated  in  it; and as the result of nume-
 rous trials, it was found,  that  from eighteen to twenty grains, given
 at night, and the same quantity  in the morning, fasting, destroyed
 taenia; so that, on the  administration of a cathartic,  the  parasite was
 discharged—often in the form  of  a  ball.  Not unfrequently,  indeed,
 it was voided before the cathartic was  given.2
   In Germany, this new  preparation  has been chiefly recommended
 by Hufeland, who maintained,  that in rapidity, certainty,  and gen-
 tleness of  action, it exceeds  all known means, and many  other physi-
 cians have testified to the accuracy of this opinion.  Radius3 who fre-
 quently prescribed it/says  he  never gave it without bringing away
 large pieces  of the worm, but frequently the  head remained behind.4
 Peschier had found it to be  successful in one hundred and fifty cases
 when he wrote;5  Ullersberger had used  it in  sixty cases,  and a medi-
 cal friend  of  his  in two  hundred cases, with invariable success.  It is
 affirmed to have proved  more successful in cases of Bothriocephalus la-
 tus than of Taenia solium;  and a part of the  discrepancy of results
 amongst observers has  been ascribed  to this circumstance.   For ex-
 ample,  it has not been  found as effective in  the treatment  of taenia
 at Paris;  and the taenia most common  there  is Taenia solium.6
   Buchner7 thought, that  the  extract might  be  prepared with  alco-
 hol, but many physicians have objected to  this  menstruum—that it
 does not dissolve the fixed oil.
   The male fern is preferred by M. Rouzel8 to  the bark of pomegranate
 root in  the treatment of taenia;  and by Drs. Christison,9 and  Albers,10

   1 The proximate constituents of the root are given by H. Bock, in Chem.  Gaz. Oct. 1851,
 and Amer. Journ. of Pharm. Jan. 1852, p. 64.
  'l For successful cases of the administration of the oil, by Dr. Gull and Mr.  Molley, see
 Lancet, Aug. 14th and 21st, 1852, and for a discussion of its value as an anthelmintic,
 see Edinb. Monthly Journal of Med. Science, June 1852; cited in Ranking,  xvi. 94. Amer.
 Edit. Philad.  1853.                8 Auserlesene Heilformeln, u. s. w. Leipz. 1836.
  * See, also, Ebers, in Hufeland und Osann's Journal, lxvi. St. 1, S. 43, and Gazette
 de Sant., Sept. 25, 1828.                    6 Merat and De Lens,  loc. cit.
  6 Christison, Dispensatory, p. 451.  Edinb. 1842.
  7 Repertorium fiir  Pharm. xxiii. 433, and xxvii. 337, and Funk, in Medicin.  Zeitung.
 17 Mai, 1837, S. 102.   .
  8 Revue M.dicale,  Oct. 1840.  See,  also, M. Wawruch, Oesterreich. Med. Jahrbuch.
cited in Encycl. des  Sciences Med. Nov. 1841, p. 264; Brit, and For. Med. Rev. Oct,
1844; and M. Daumerie, Archives de la Med. Beige, Sept. 1841, p. 5.
  9 Edinb. Monthly Journal, July 1853,  p. 47.
 10 Casper's Wochenschrift, 1850, No. 30 and 31: cited in Canstatt's Jahresbericht, 1850,
5 Bd. S. 148. 
390
FUCUS amylaceus.
and J. Hughes Bennett,1 it is placed above all other remedies.  " My
experience,"  Dr. Christison remarks, "of  the male shield-fern, corre-
sponds precisely with the much more extended observations of M. Pes-
chier, at Geneva more  than a quarter of a century ago. _ I am per-
suaded, therefore, that it is easy, with a few simple precautions, to ob-
tain from a common indigenous plant a more efficacious and less disa-
greeable anthelmintic for the  expulsion of taenia than from either the
Abyssinian kousso, the Continental pomegranate, or American Tur-
pentine."  "It is surprising," he adds, "that Peschier's observations,
made on a very large scale indeed, have attracted  so little attention
in Britain until the late  notice  in the Edinburgh  Monthly Journal.
I can only say this has not been for want of a strong recommendation
on my part, both in my lectures, constantly, since 1833, and also in my
Dispensatory, when first published in 1842."   The dose given was gr.
xviij.—xxiv.  and one was sufficient.
  The article Filix mas has been in every edition  of the "New Re-
medies," the first of which was published in 1839.
                     MODE OF ADMINISTRATION.
  The extract is commonly given in the form of pill: an emulsion does
not answer, because the active constituents are apt to be enveloped
and masked in this form.   In Geneva, it is now frequently 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.2  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;3 and a decoc-
tion (one ounce of the rhizoma to a pint of water) has been occasion-
ally prescribed.
                       Mel filicis maris.
                        Honey of male fern.
                 R.  Ext. asther. filicis maris £ss.
                     Mel. rosae ^ss.  M.
  Half of this  to be taken on  going to bed; the other half early in the
morning fasting.
                   XCV. FUCUS AMYLACEUS.
Synonymes- Plocaria Candida, Gracilaria seu Sphaerococcus seu Gigartina seu
  Fucus Lichenoides, Ceylon Moss, Marine Moss, Jaffna Moss, Edible Moss.
  The attention of physicians has  been directed to this vegetable by
Messrs. Sigmond and Farre,4 and by Dr. O'Shaughnessy, of Calcutta.5
Like chondrus, (p. 229,) it belongs to the Natural Order Algae, and
was first introduced, some years ago, into England from India.   As
met with in  commerce, it is white, filiform, and fibrous, and has  the

  1 Monthly Journ. of Med. Science, Feb. 1855, p. 107.
  2 Hufeland und Osann's Journal, lxiv. St. 1, S. 133.
  3 London Lancet for 1834-5, ii. 597.           * The Ceylon Moss.  Lond. 1840.
  5 Medico-Botan. Transactions, vol. i. pt. iv. p. 184. 
FUCUS AMYLACEUS.
391
 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,
 15;  wax, a trace; ligneous fibre, 18; gum, 4; sulphate of soda, and
 chloride of sodium, 6.50; sulphate and  phosphate of lime, 1; iron, a
 trace; loss, 1:—Total, 100.   When boiled in water, a liquid results,
 which gelatinizes  on cooling.  It has also been examined chemically
 by Guibourt, Wonneberg and Kreyssig, Bley  and Riegel.1

                     EFFECTS ON THE ECONOMY.
   The  medical properties of  fucus amylaceus are similar to those of
 chondrus.  The decoction  is  an  agreeable, light, nutritious 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-
 Bpoonful 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 another 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 gradu-
 ally 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 boil-
 ing ; taking care, that after the second boiling  it rests for some minutes
 by the fire-side, with some hot charcoal 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
 to the eye, although its  quality may be  the same.  When  clear, and
 of a lemon colour,  it may be 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.   Blanc-
 manger and Italian cream can be made with it without isinglass; but
 in such case the jelly  must be made much stronger before 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 pronounced by all the medical facul-

  1 Cited in Pereira, Elements of Mat. Med. and Therap. 3d Amer. edit. ii. 55. Lond. 1854 
392                          FULIGO.
ty of Calcutta to be unequalled for its delicate and nutritious qualities,
and has been  especially and highly recommended for the use of the
sick.   When all other nourishment has failed, this has proved success-
ful; and Dr. O'Shaughnessy says he has no doubt, that when the ar-
ticle 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 six-
teen years.1
                          XCVI. FULFGO.
Synonymes. Fuligo Splendens seu Fornacum seu Ligni, Soot, Woodsoot.
French. Suie.
German. Russ, Glanzruss, Spiegelruss, Kaminruss,  Ofenruss.
   The discovery of creasote, and its extensive application to the treat-
ment 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 exciting diaphoretic agent
in cachexia' of every kind, in chronic rheumatism, cutaneous affections
and especially in the evil results of their sudden repercussion; in glan-
dular indurations, rickets, exostoses, &c.   It has also been employed,
as a domestic remedy, in colic, and in the simple and dysenteric diar-
rhoea, and cholera of  children.  Several modern recommendations—
as by Schiitte and Weisenberg—remained  unheeded until the  atten-
tion of physicians was drawn  to it, especially by Blaud.2   He is of
opinion, that the costly—and by no means  easily prepared—creasote
may be wholly replaced by soot.   Both are products of  the  dry  dis-
tillation 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 nauseously
empyreumatic, more or less bitter, and acrid, saline  taste.

                    EFFECTS ON  THE ECONOMY.
  Blaud3 has exhibited soot in  different diseases, especially in the form
of ointment, or in decoction, with excellent and rapid effects, in herpes,
itch, tinea, gutta rosea, and pruritus vulvae ; and he asserts, that he
even healed cancer of the breast by frequent ablutions with a tepid de-
coction 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  also cured a scabby eruption of the
mucous membrane of the nose by an ointment of it.  In  diphtheritis
he used, in two cases,  a decoction, as  a mouth-wash, with the best ef-
fects.   In confirmation of Blaud's remarks, Voisin  asserts, that  he
cured a case of cancer of the face by soot  ointment.

  1 Braithwaite's Retrospect of Pract. Med. and Surg. No. 1, Jan. to June, 1840,  3d edit.
p. 70.  Lond. 1812; and Sigmond and Farre on the Ceylon Moss.  Lond. 1840.
  2 Revue M.dicale, Juin, 1834, et Janvier, 1835, and E. Grafe, in Grafe und Walther's
Journal, xxiii. 310.  Berlin, 1835.
  * Journal des Connaissances M.dico-Chirurg., Mai, 1834. 
FULIGO.
393
  Dr. J. R. Marinus1 has found it very efficacious in chronic eruptions
(dartres,) and in tinea;  and his observations have been  confirmed by
MM. Nobele2 and Le Montagnier.3  M.  Nobele's  conclusions are,—
1. That it cannot be applied, with  any expectation of  success, until
the crusts have been removed, and the irritation of the parts has been
diminished  by means of emollient applications.   2. That the gray
layer, left by it  on the skin, whether it be used in  the  form  of oint-
ment 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,4 has employed a  decoction of soot with
great advantage in a case of severe burn in  which the patient  was
suffering from the profuse discharge.   A handful  of soot was boiled
in eight pounds of water, until the fluid was  reduced to two pounds.
Lint was then soaked in it and applied to the granulating surface.
  Carron du Villardss advises a collyrium prepared from soot in cases
of strumous ophthalmia.  He infuses  two ounces in boiling water, fil-
ters 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 colly-
rium, 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
accustomed to it, Carron du Villards advises,  that  the eye should be
excited to a more lively  action by means of the combination of soot
and tincture of opium given below.   It is, he says, an energetic agent,
and may be applied by means of a pencil to  granulations on  the  cor-
nea.  He likewise recommends a decoction of soot as an injection in
discharges, which are the consequence  of  chronic inflammation of the
vagina.
  M. Andre Gibrin6 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  pint  of water.   The decoction was  filtered

  1 Bulletin Medical Beige, Nov. 1838, p. 289.  For farther testimony in its favour, see
London Lancet, Nov. 25,1843.
  a Annales de la Societe de Medecine de Gand, Gazette M.dicale, or Encyclographie
des Sciences M.dicales,  Mars,  1840, p. 540.
  s Bullet. Gcner. de Therap. Nov. 1840, or Encycl. des Sciences Med., Fev. 1841, p. 299.
  4 Journal de Med. et Chirurg. Pratiq. Juin, 1841, and Amer. Journal of the Medical
Sciences, Jan. 1842,  p. 231.
  'Gazette Medicale, Janvier, 1831; see, also, Baudelocque, on its Use in Scrofuloua
Ophthalmia, in Bulletin G.n.ral de Th.rapeutique.   Mars, 1834.
  8 Bulletin de 1'Academie, 15  Mars,  1837. 
394
FULIGO.
through paper, and injected into the bladder twice a day.  The good
effects supervened so closely on the administration of the remedy, that
there could be no doubt as to the cause.   The pain ceased, and the
patient obtained sleep, to which he had been for some time a stranger.
The urine  gradually became clear, and recovered its natural appear-
ance.
   To these remarks may be added, that, according to Schutte, anoint-
ment composed of two parts of fresh butter or hog's lard,  and one part
of soot—is a popular and efficacious remedy on the  Rhine for cases of
porrigo, itch, and  herpes;  not more than a dram  being rubbed in at
a time.  Weisenberg ascribes to the soot a protective  power against
contagious affections of the skin, and  recommends,  especially, lotions
of soot water,—partly, as a preventive agent,  and partly as a thera-
peutical application in itch.
   Employed as an injection,  an infusion  of soot was  found by Dr.
Hewson, of Philadelphia, an efficacious  remedy in ascarides vermi-
formes.1
   But  soot has not been used,  of late, externally only; its internal
use, in the form of the old  " tincture of soot," has been  revived.   This
was long known under the name of "soot 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 fuliginis.
            Mixture of soot.—(Tinctura Fuliginis Clauderi.)
                R. Fulig. |ss.
                     Potassa. carbonat. ^iss.
                     Ammoniae carb. gij.
                    Aq. sambuc. f ^ix.
      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 name
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 decanting.  Of this, a small
wine glassful is taken three or four times a day.

                        Lotio  fuliginis.
                           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 syphi-
litic ulcers.                                              Blaud.
         1 United States Dispensatory, 10th edit. p. 1392.  Philad. 1854. 
                            FULIGOKALI.                         395

                     Unguentum fuliginis.
                           Ointment of soot.
                 R.  Fulig.
                     Adipis aa. ^ss.
                     Extract, belladon. gj.  M. exacte.
  To be spread upon lint or tents in case  of  cancer.        Blaud.

                 R.  Adipis,
                     Fulig. aa. ^ij.
     Coque leni igne per horas vj.

  As a dressing in cases of tinea and of foul ulcers.        Blaud.
                 R.  Fulig.
                     Cinchon. flav. aa. ^ss.
                     Carbon, pulv.
                     Sulph. aa. ^j.
                     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^ii.
                     Caryoph. 35.
                     Aq. cinnam. f ^viij.
                     Alcoholis f ^iv.
     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. £vj.
                     Adipis giv.  M.
  Applied in cases of tinea.   It is the Pommade contre la teigne, of
Bories.1
                     Cataplasma fuliginis.
                          Cataplasm of soot.
                 R.  Fulig. Sij. _
                     Albi ovi vj.
     Tere  simul.
  As a dressing for herpes and tinea.   It is the Pommade resolutive
of Sainte  Marie.2
                      XCVII. FULIGO'KALI.
Stnonyme.  German. Russkali.

  This new remedy called from fuligo, 'soot,' and kali, 'potassa,' has
been introduced as an analogous preparation to anthrakokali (p. 95.)3

                      METHOD OF  PREPARING.
  Fuligokali  is prepared  as follows:—Take of potassa,  20  parts;
shining  soot,  in powder,  100 parts;  water, a sufficient  quantity.
Boil for an hour;  suffer the.decoction to  cool;  dilute with water  so

  1 Formulaire de Montpellier.  Montpellier, 1822.
  2 Nouveau Formulaire M.dicale et Pharmaceutique.  Paris et Lyon, 1820.
  8 Journal des Connaiss. M.d. Chir. and Encyclogr. des Sciences M.d. Juillet, 1842, p. 9. 
396
GALEOPSIS GRANDIFLORA.
that filtration may be better accomplished; filter, evaporate, and dry,
in order to obtain the fuligokali in scales or powder; and enclose 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.  Dis-
solve the  sulphur and potassa in a little water;  then add the fuligo-
kali ; 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 lat-
ter mode, in various chronic cutaneous diseases.   An  ointment may
be made of either the simple or the sulphuretted article, by  mixing
one or two parts with thirty of lard.   M. Gibert ascribes to these oint-
ments resolvent, detergent and slightly excitant virtues.1
   Mr. E. Wilson2 thinks it probable, that both anthrakokali and fuligo-
kali owe  much  of  their therapeutic value to the alkali  which forms
their basis.   He has employed  fuligokali in  several  cases, and espe-
cially in psoriasis palmaris, and with better success than he  has ob-
tained by the usual remedies.  The  preparation referred  to  on the
last page but  one,  as having been used in Philadelphia  under the
names of medical lye, &c,  may  be regarded  as a weak solution of fu-
ligokali.3
              XCVIII. GALEOPSIS  GRANDIFLO'RA.
Syxoxymes. Galeopsis Ochroleuca seu Prostrata seu Villosa seu Segetum seu An-
  gustifolia seu Dubia, Herba Sideritidis.
German. Grossbluthiger Holzahn, Grossblumige Hanfnessel, Gelbe
  Grossbliithige Hundsnessel,  Katzermaul.
  This plant, which belongs to Natural Family Labiatae, Sexual
System Didynamia Gymnospermia, grows in the western part of Ger-
many, in sandy corn-fields.4

                    EFFECTS ON THE ECONOMY.
  The fresh  plant has a peculiar, feeble, balsamic smell, and a some-
what  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 "Blanken-
heimer Tea," (Blankenheimer Thee,) or "Lieber's pectoral and
phthisical  herbs,"  (Liebersche  Brust  oder  Auszehrungs-
krauter,) and enjoyed great repute.   In the Ardennes also, parti-
cularly in the district of Malmedy, it  has  been long  employed as a

  1 See, also, Duhamel, Amer. Journ. of Pharmacy, Jan. 1843, p. 284, and Deschamps,
in Bouchardat, Annuaire de Therapeutique, pour 1843, p. 153.  Paris, 1843.
  2 A Practical and Theoretical Treatise on the Diagnosis, Pathology and Treatment of
Diseases of the Skin, p. 397. Lond. 1842; or Amer. edit. Philad. 1843.
  3 Duhamel, Op. cit.
  * Von Schlechtendal, in Encyclop'dd. Worterb der Medicin. Wissenschaft. xiii. 115.
Berlin, 1835. 
GALEOPSIS GRANDIFLORA.
397
popular remedy.   In the year 1828, Lejeune1 directed attention to
its therapeutical importance.  According to his observation, it is very
useful  in diseases of the  mucous membrane of the  respiratory and di-
gestive organs, and especially in chronic pulmonary catarrh, even when
it  exists to such a degree  as to merit the  name  Phthisis  mucosa
(Schleimschwindsucht.)   In actual phthisis,  the affection seemed
to him to be diminished by it; the hectic being moderated, the expec-
toration 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 which a milk
diet was appropriate, the  decoction was made with an equal quantity
of milk.  Wesener2 found it advantageous in phthisis mucosa and chro-
nic pulmonary catarrh.   Giinther, who  had many opportunities for ob-
serving the action of the remedy, affirms  that the Lieberschen
Krauter  not unfrequently produces some amelioration in phthisis,
especially in scrofulous phthisis, but he  never saw any actual recovery
therefrom.  It seemed to him  to moderate the colliquative sweats,  and
to facilitate and diminish the expectoration.  In  one case especially,
of scrofulous phthisis in the last stage, it appeared  to be of essential
service, and to prolong life;  and from all his observations he is  dis-
posed  to infer, that if it be not the sole or the main  remedy to be  em-
ployed in every stage of  phthisis, it  may be used with  advantage
throughout the disease as a supporting  agent.
   Riecke3 asserts, that he has seen many cases in which the Lieber-
schen Krauter were of great service in thoracic affections threatening
phthisis.   In one case, which promised to terminate unfavourably in a
short time, owing to the complication of violent hsemoptysis with hectic
fever,  and in which an experienced physician  had exhausted every ef-
fort 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 difficulty.  On the other hand, Richter affirms,
 that in two cases in  which he administered the galeopsis, no benefit re-
 sulted 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,4 is not yet sufficient to enable them to lay down
 any positive rules as to the exact indications  and counter-indications
 that must  regulate its employment.   It is probably  of no farther ser-
 vice than as a  mild  bitter; and its place may be supplied, perhaps ad-
 vantageously, by many of the tonics that are  admitted into  the lists of
 our remedial agents.  Geiger5 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, so-
 luble in ether;  and  a brownish  matter, insoluble therein; phosphate

   1 Annales Generates des Sciences Physiques, p. 331, Sept. 1820.
   1 Hufeland und Osann's Journ.  der Pract. Heilk. 1823, 1824.
   1 Die neuern Arzneimittel, u. s. w. S. 241.  Stuttgart, 1837.         * Ibid.
   5 Magaz. fur Pharmacie, ix. 134. 
398                        GALVANISMUS.

and malate of lime;  salts of potassa;  muco-saccharine matter and fe-
cula,  and 65.882 of ligneous matter.
                     MODE  OF ADMINISTRATION.
             Decoctum galeopsidis  grandiflorae.
                 R.  Galeopsid. grandifl. summitat. ,§j.
              Coque in aquas Oj. per minut. xv. et cola.
   To be used in the  twenty-four hours.                   Wesener.
                 R.  Galeop. grandifl. summitat.
                     Althaea, aa. ^j.
                     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 produced
by the softening of pulmonary tubercles.—Radius.1

   Galeopsis versicolor, and  galeopsis  villosa, which have  also
been examined  by Geiger,2  appear to be  possessed of the same virtues
as galeopsis grandijlora?
                     XCIX.  GALVANIS'MUS.
Synonymes. Electricitas Animalis seu Galvanica seu Metallica, Irritamentum Metal-
  lorum seu Metallicum, Galvanism, Voltaism, Galvanic Electricity.
French. Galvanisme.
German. Galvanismus,  Volta'sche Electricitat.
   The ordinary effects of common and galvanic electricity and of elec-
tro-magnetism  are  so well known as to require  but little comment.
They are decidedly excitant;  and, like all  excitants, when applied to
a part of the frame, are counter-irritant or revellent.  All have been
employed  in paralysis,—general  and local,—amaurosis, deafness and
dumbness4 of recent duration, asthma, rheumatism, neuralgia, amenor-
rhoea,5 chorea, hysteria,6 incontinence of urine,7  sprains,8 &c.   The ef-
fect, however, which galvanism exerts on the contractility of the mus-
cular fibre, and the great  similarity in its  agency to the nervous in-
fluence,9 has led to its employment more frequently in the various ner-
vous  and  spasmodic  diseases  referred  to, and  in others belonging  to
the same class.10  Resting on his views of the absolute identity between
the nervous and galvanic fluids,11 Dr.  Wilson Philip employed it in many
diseases, and especially in asthma. In a paper read by him before the

  1 Auserlesene Heilformeln, u. s. w. S. 274.  Leipz. 1836.
  2 Allgem. Med. Annalen, S. 1141.   1825.
  3 Richter's Specielle Therapie,  B. x. S. 397.  Berlin, 1828.
  * See a case of aphonia cured by galvanism, in London Lancet, May 27, 1843.
  6 G. Bird, Guy's Hospital Reports, April, 1841, p. 84.
  6 Dr. Gull, Guy's  Hospital Reports, viii. pt. 2.  Lond. 1852, and Ranking's Abstract,
xvii. 219.  Philad.  1853.
  7 Froriep, cited in Edinb. Med. and Surg. Journ., 1844, p. 491.
  8 Raciborski, Gaz. M.d. Chirurg., and Med. Chir. Rev. April, 1846.
  9 See the author's Human Physiology, 7th edit. i. 118.  Philad. 1850.
 io Pereira, Elements of Mat. Med., 2d edit., p. 42.   Lond., 1842; or 3d Amer. edit.,
Philad. 1852.  See, also, the author's General Therapeutics and Mat.  Med. 5th edit.,
i. 553.  Philad. 1853.
 « Experimental Inquiry into the Laws of the Vital Functions.  London, 1817. 
GALVANISMUS.                       399
Royal Society of London, in  January, 1816, he details some experi-
ments, which he made on rabbits.   The eighth pair or pneumogastric
nerves were divided by incisions made in the neck.  After the opera-
tion, the parsley, which the animals had eaten, remained unchanged in
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 closely in contact with the
Bkin 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 killed and the parsley was found digested.
   The removal of dyspnoea, in these  cases, led Dr. Philip to  employ
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 em-
ployed varied from ten to twenty-five  pairs of plates.   Since then, gal-
vanism has been repeatedly used in such cases, and  at times with mani-
fest relief.  Commonly, however, the plates, described hereafter,  are em-
ployed for  this purpose.  The disease, in the majority of cases, appears
to be  dependent upon erethism of  the pneumogastric nerves;  all the
phenomena indicating 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 observe
spasms or ordinary cramp relieved,  or paroxysmal diseases warded off,
by agents that  are capable of  suddenly impressing some part of the
nervous system.
   Not long after these  researches of Dr. Philip, galvanism was em-
ployed satisfactorily by  Mr. Mansford1 in a  congenerous disease—
epilepsy—and his plan was afterwards—although tardily—extended to
some  other paroxysmal disorders.  The mode of application  recom-
mended by  him 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  at-
tached 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  attached, until it arrives  opposite the groin
of  the side  on which  we desire to employ it; it then passes  down the
inside  of the thigh, and is fastened to the  zinc plate in the same man-
ner as to the silver one.   The apparatus, contrived in this way,  is thus
1 Researches into the Nature and Causes of Epilepsy, &c.  Bath, 1819. 
400                       GALVANISMUS.            «

applied.   A  small  piece  of  sponge,  moistened in water, and  corre-
sponding 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 plaster passed through
the shank on its back; another above, and  another below  it.   If these
be properly placed, and the wire which passes down the  back  be  al-
lowed sufficient room, that it  may not drag, the plate will not be  moved
from its position by any ordinary motion of the body.   The zinc plate
is fastened in the same manner, but in place of the second layer of
sponge, a piece  of muscle answering in size to the zinc plate is inter-
posed; that is, a small piece of moistened  sponge being first fitted to
the exposed surface below the knee, the piece of  muscle moistened, or
—what has  been found  equally  effectual  and  less inconvenient—a
piece of moistened flannel1 follows, and on this the  plate of zinc.
  The apparatus, thus arranged, will continue, according to Mr. Mans-
ford, 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 security of a permanent action,  and
for the additional comfort of the patient."
   The adoption of this plan of treatment  in cases of  tic douloureux;
the confidence reposed by Laennec in the use of plates on the  breast
and back in angina pectoris, and  similar  neuralgic affections of the
chest; and the communications of Drs. Thomas 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 Chapman2—"triumphantly direct-
ed" 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
any marked benefit was experienced.3 About the same period, this mode
of applying  galvanism was  recommended   by Dr. Miller,4 formerly of
Washington  University, Baltimore, and a  case of paraplegia and  an-
other  of  general paralysis were  published by him, in which  it was
found efficacious.   A similar arrangement, employed for the purposes
of counter-irritation, has  been described by Dr. Golding  Bird5 under
the title of the  "electric  moxa."   It was long ago observed by Hum-
boldt, and afterwards by Grapengiesser, that when a simple  galvanic
arc was applied to a blistered surface, the  part  opposed  to the most
oxidizable metal was more irritated than  that to which  the  negative
plate was applied.   In adopting such an arc in the  treatment of para-
lysis, Dr. Bird was  struck with the remarkable  effects produced, and
such a combination of its results induced him to propose the following

  1 Dr. Chapman says soft buckskin or parchment;—American Journal of the Medical
 Sciences, Aug.  1834, p. 311.                     2 Qp. citat. p. 311.
  3 Dr. Harris,  in American Journal of the Med. Sciences, Aug.  1834, p. 384.
  * Ibid. p. 321.                     5 Lond. Med. Gazette, June, 1847. 
GALVANISMUS.
401
ready mode of establishing a discharge from the surface of the body.
Two small  blisters, the size of a shilling, are applied to any part, one
a few inches below the other.  When the cuticle is raised, it must be
snipped, and to the one whence a permanent discharge is  required, a
piece of zinc foil must be applied; and to the other a piece of  silver.
They are then connected  by a copper wire, and covered with a com-
mon water-dressing and oiled silk.  If the zinc plate be raised in a
few hours,  the surface of the skin will  look white, as if rubbed over
with nitrate of silver.   In forty-eight hours, a decided eschar will ap-
pear, which, if the plates are still kept on, will  begin to separate at
the edges in four or five  days.   A common poultice may now be ap-
plied, and a healthy sore, freely discharging pus, will be left.
   Confirmation of the advantage to be  derived  from  this method of
applying galvanism has been afforded by Mr. Wells,1 who recorded the
results of his treatment in  the Civil Hospital at  Corfu.   The cases, in
which its efficacy was tested, were thirty of ulcers; five of fistulce, five of
fungous growths;  and five of nervous disorders.  More recently2 Mr.
Wells has afforded fresh evidence of the efficacy of the method, as well
as of Pulvermacher's chain, in similar cases.  If the former be used, the
silver plate is placed over  the  ulcer, the zinc plate on the  moistened
skin  at some  little distance.   Granulations form very rapidly.  The
plates or chain are kept constantly applied.  Mr. Hinton3 does not
give so favourable an account as Mr. Wells of the action of the gal-
vanic plates.   The scar left by the slough, he says, has a very uneven
surface, and would not be borne in many cases.
   With the view of employing galvanism in such a  manner that con-
tinued currents  may be generated by  the  contact  of metals,  and  a
large quantity of  electricity be obtained  at a low tension, Professor
RScamier has devised what he calls "galvanic cataplasms," consisting
of filings of copper  and  zinc enveloped  in cotton wool.   He  subse-
quently devised a more convenient form of application, which may
be worn day and night, without inconvenience, although, in ordinary
cases, it is  only applied at  night.   The  attention of the  Medical So-
ciety of London was drawn to it  at  their meeting, May  31, 1851, by
Dr. Tilt,4 and  Dr.  Ruschenberger, U. S.,5 has recorded a case of bed-
sore successfully treated by it.
   The effect of galvanism on the uterus has been referred to  under
Electro-Magnetismus.
   M. Matteucci6 from his researches, is induced  to think that paraly-
sis 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 transmitted 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,

  1 Lond. Med. Gazette, May 26,  1848.     2 Med. Times and Gazette, July 23, 1853.
  8 Ibid.. July, 1848, and Ranking's Half-yearly Abstract,  July to Dec. 1848.  Amer.
edit. p. 216.
  * Lond. Med. Gaz. June, 1851, and Amer. Journ. of the Med. Sciences, Oct. 1851, p. 477.
  5 Philad. Med. Examiner, Jan.  1852, p.  25.       6 Med. Chirurg. Rev. April, 1845.
       26 
402
GALVANISMUS.
after a certain interval it recovers its  excitability.   But it has been
ascertained by M. Matteucci, that the excitability 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  at short  intervals, tetanic  contractions are
excited; and if the' experiment 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 eases of paralysis, the nerves of the
affected limb are in a condition similar to that produced by the con-
tinued 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 direction.
Hence, to cure the paralysis, the current should be passed in a con-
trary direction to that which has produced it.  In a paralysis of mo-
tion, 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 will 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 sen-
sibility 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 intensity which should vary with the degree  of
the malady, and continue its passage for two or three  minutes at  in-
tervals of  some seconds.   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."
   A case of paralysis of  the bladder is reported by Dr. W. Frazer1 of
Montreal, which was cured by galvanism.   A silver catheter was intro-
duced into the bladder, and a female catheter into  the rectum; the
former was made to rest on the fundus of the organ, and the latter on
the recto-vesical parietes.   They were then put in connexion  with the
poles of an electro-galvanic machine, which was set,  at first, in gentle
action, and then a pretty  strong current was kept up for ten  minutes,
which produced powerful  contractions tending to expel the catheter.
   Dr. William Cumming2 has employed  electro-galvanism with advan-
tage in constipation and  in certain irregularities of the functions of
the bowels.   The agent is applied by means of Kemp's (of Edinburgh)
machine for a quarter of  an hour daily, the intensity being increased
from time to time, and the stream of electricity transmitted through the
part continuously without jerk  or shock.  The same plan is recommend-

   1 Montreal Monthly Journal,  Sept. 1853.      2 Lond. Med. Gaz., Dec. 7, 1849. 
GALVANISMUS.
403
ed by Dr. Laycock1  for the treatment of cerebral hysteria and moral
insanity in women, the electro-galvanism being perseveringly and sys-
tematically applied to the abdominal and pelvic regions in combination
with other means.
  It is  affirmed that Dr. Krusell,2 of St. Petersburgh,  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 com-
menced  between  the 4th of July and the 11th of September, 1844,
inclusive, twenty-one were free from all appearance 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,3 was unquestionably galvanism.
This was evinced not only in the improvement which followed its appli-
cation, but in the "more striking fact," that the patient  saw  better
whilst subjected to the galvanic action. Dr. Hays found a Cruikshank's
battery of fifty pairs of plates three inches square—when  in full activity
—too powerful for the purpose, so that only  one-half or two-thirds of
the plates were usually employed.   The connexion was made by means
of leaden wire  conductors, to one end of which was soldered a  slip of
copper, and to the other a hemisphere of brass, the flat surface of which
was filed into grooves crossing at right angles, so as to form a number
of sharp points.  Over these were tied thin discs of sponge, which were
kept moist with a solution of common salt, and when it was considered
desirable to introduce  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 bat-
tery was not wanted, instead of putting the slips in the  extreme cells,
they were placed in cells more or less remote, according to the power
required; and the force was easily regulated.  The galvanic current may
be made to pass from the mastoid process to the superciliary ridge.
   Dr. Hays  expresses his persuasion, that galvanism,  properly em-
ployed, 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 galvanism may be  employed with
advantage, but they are not so numerous as was at one  time  believed.
The author has used the plates extensively—in neuralgic  cases espe-
cially—but has not experienced so much success as to induce him to
advise them frequently, under the inconveniences that necessarily ac-
company their employment.
   The ordinary modes of applying galvanism are referred to in ano-
ther work.4  An  apparatus has been devised by Mr. Coad, of Phila-

  ' Medical Times, July 20, 1850.
  3 Journ. fur Chirurg. und Augenheilknnde, von Walther und Ammon. Bd. v. S. 29:
and Lond. Med. Gaz. June 5, 1846, p. 1015.
  s American Journal of the Medical Sciences, Aug. 1840, p. 288.
  4 General Therapeutics and Materia Medica, 5th edit. i. 552.  Philad. 1853. 
404
GALVANISMUS.
 delphia, which  enables  galvanism to be communicated either continu-
 ously, or in  an interrupted manner, and the dose to be regulated ac-
 cording to the  wishes of  the practitioner.   It is  convenient, and well
 adapted for all cases in which it may be deemed advisable to apply
 galvanism.1
   M. Duchenne,2 of Boulogne, has published a long memoire on what
 he terms a new method  of galvanization, Galvanisation localisie.   He
 states, that if the skin and the excitors (excitateurs)—as he terms me-
 tallic bodies communicating with  the poles  of a  galvanic  apparatus,
 which are placed on parts to be galvanized—are perfectly dry, and the
 epidermis of considerable thickness, the  two electric currents are re-
 composed at the surface of the epidermis, without traversing the der-
 ma ;  and cause sparks and a peculiar crepitation without physiological
 phenomena.  But if we  place on  the skin one excitor  moist and the
 other dry, the  individual  experiences, in  the point where the second
 excitor had developed only physiological effects, a  superficial sensation
 evidently cutaneous.  This is owing  to the contrary electricities being
 recomposed in  the point  of the dry epidermis, but after having tra-
 versed the skin by the  moist excitor.  Again,  if we moisten very
 slightly the skin where the epidermis  is very thick in the points on which
 the metallic excitors are placed, a  superficial sensation is experienced,
 stronger than the  preceding, without sparks or crepitation.   Here the
 electric recomposition takes place in the substance of the skin.  Lastly,
 if the skin and excitors are very moist, neither sparks, crepitation nor
 sensation of burning  is experienced, but very variable phenomena
 of contractility or sensibility present themselves,  according as we act
 on a muscle or a fasciculus  of muscular fibres;  on a  nerve or a bony sur-
 face.  In the last case,  an acute pain of  a very peculiar  character is
 experienced; and consequently great care ought to be had not to place
 moist excitors  over  bony  surfaces.   M. Duchenne infers from these
 phenomena, that the electric power may be arrested at will in the skin;
 and that, without any incision or  puncture, it may be  traversed, and
 the action of electricity be limited to the organs which it  covers, to
 the nerves, muscles and even the bones.

   Some years ago, Professor Von Hildenbrand, of Pavia,3 recommend-
 ed, in cases of frontal neuralgia an  anodyne metallic ox galvanic brush,
 which appears to have been as effectual  in his hands as the galvanic
 plates in those of Dr. Harris.   It consists of a bundle of metallic wires
 not thicker than common knitting-needles, firmly tied together by wire
 of the same material, so as to form a  cylinder of about four or  five
 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 common salt; and, according to Von Hildenbrand, it
 at times produces relief  so instantaneously, that it appears to the pa-
tient  to act like  a  charm.   In his  first  experiments, he  employed
brushes constructed of two kinds of metal,—for instance, of silver and
copper wire, copper and  zinc wire, or zinc  and brass wire, the indivi-

 1 Art. Galvanism, in Cyclop, of Practical Med. Amer. edit, by the author.  Phila. 1845.
 3 Archives Generates de Medecine, Juillet, 1850, p. 257, and  Aout,  1850, p. 420.
 J Edinburgh Medical and Surgical Journal, April,  1833. 
GALVANISMUS.
405
dual wires being mutually commingled;  but he subsequently ascertained,
that bundles of wires  of  one and the same metal produced an effect
scarcely less  speedy, and  that solid metallic  bodies act  in a  similar
manner, but in a much feebler degree.  The nature  of the metal, he
thinks, occasions no difference.
   It is not probable, that, in these cases, galvanism is the agency con-
cerned.  Like the metallic  tractors of Perkins, the effect is probably
induced by the new nervous impression made through the excited ima-
gination of the patient.
   It has been proposed to introduce into the  rectum, in cases of con-
stipation,  a kind of galvanic  suppository,  made  of two metals—zinc
and copper—and various forms of instruments have  been devised  by
the prolific imaginations of the inventors; those intended for the rectum
simply were doubtless of advantage, at times, by virtue of the excita-
tion they induced  in  the nerves of the mucous  membrane.  Others,
shaped somewhat like a bassoon—and  so arranged as to have one me-
tal in the  mouth and the other in the  rectum connected together  by
metal—did not appear to act differently  from those of the  simpler
form.  Both  have  gone into  disuse, and if  their efficacy on the frame
has not been well  marked, they have  not  failed  to administer to the
pockets of the inventors.

   Animal Magnetism, Mesmerism,  Neurogamia,  Biogamia, Biomag-
netismus,  Zoomagnetismus,  Tellurismus, Exoneurism, as it has been
termed—exerts  an  anodyne  influence  in probably the  same manner.
In highly impressible persons, more or less prolonged impressions made
upon the  senses—as by the  operator  looking steadfastly in the  eyes
of the  patient, holding the  thumbs or  hands at the  same time,  or
making passes in front of the patient—will induce an hysteric or hys-
teroid condition, in which the patient may fall into what is called "mag-
netic sleep," of a very sound,  and at times cataleptic character.  Du-
ring the existence of this sleep, the patient may be  insensible to cer-
tain irritants, and  yet  extremely alive to others, so that operations—
as the extraction of teeth, and even some of a more serious character
—may be  performed without eliciting the ordinary evidences of feeling.
In cases of delirium tremens, accompanied by watchfulness, in which
the whole nervous system is  extremely impressible, sleep may be  at
times induced by the employment of this agency, which had resisted
the ordinary anodynes.1
   The Galvanic Cautery has been  used with benefit by Mr. Ellis,2 in
cases of induration of the os  and cervix uteri; in  ulceration of the os
uteri, and  in prolapsus of the uterus and of the anterior wall of the vagi-
na; and by Mr. Richard Steele3 in the treatment of hemorrhoids.  Mr.
Marshall4 has also obtained excellent results in cases of prolapsus, and
in vesico-vaginal fistulse,  from cauterization with a  wire heated by
galvanism.  In prolapsus, a series of eschars  are  made by the same

      1 Dr. Vedder, American Medical Intelligencer, Feb. 1, 1839, p. 331.
      2 Lancet, Nov. 26, 1853.
      3 Assoc. Med. Journ., and New York Journ. of Med., July, 1854.
      * Med. Times and Gazette, July 2, 1853. 
406
GLYCERINA.
means in the mucous membrane of the vagina; and after cicatrization
the passage is greatly contracted.   Mr.  Hilton1 has removed by it
a ncevus, of the flat kind, situated  in front  of the ear of a child ten
months old.
                   C.  GENTIA'NA CHIRAYI'TA.
Synonymes. Henricea Pharmacearcha, Swertia Chirayita, Agathotes Chirayta, Chi-
  retta, Chirayita, Chirayta.
  Gentiana chirayita is a native of the northern part of India, whence
it is imported into England, tied  up in bundles.  It  has been long in
use there.
                    EFFECTS ON  THE ECONOMY.
  The herb and root—Chiretta, of the Edinburgh Pharmacopoeia—are
intensely bitter, and  produce on  the  economy the  ordinary effects of
the pure  bitters.   They strikingly resemble  gentian, and  are  em-
ployed in India in  dyspepsia, and  as an antiperiodic  in intermittents?
The plant has  been  highly extolled  by Drs.  Currie,  Sigmond,  and
others.  These gentlemen consider that the secretion from the liver im-
proves under its use; and the latter advises it not only in torpor of
the digestive function, but he prefers it to sarsaparilla where the latter
is considered to be indicated; as after large quantities of mercury have
been taken, or where profuse salivation has  been induced.   Dr. Jack-
son, formerly of Calcutta, informed Dr. Christison, that he found it of-
ten have the effect of  restoring the healthy alvine evacuations in cos-
tive habits; and he adds, that frequent trials made in Edinburgh con-
firm all that has been  said by the  practitioners  of Bengal as to its effi-
cacy as a  tonic and  stomachic.3   It  has also  been advised in atonic
leucorrhcea.
                    MODE  OF ADMINISTRATION.
  Chiretta  yields  its virtues to alcohol and water.  The  Edinburgh
and Dublin Pharmacopoeias have  an  Infusum  Chirett_e.   (Chirettse
Bss. Aq. Bullient. Oj.) Dose, f Sj. to  f Sij.  A Tincture—Tinctura
Chirett_e is  officinal  in  the  Dublin  Pharmacopoeia.   It is  made by
macerating five ounces of chiretta, for fourteen days, in two pints of di-
luted  alcohol.   Dose, a teaspoonful.   The dose of  the powder is  one
scruple.4
                         CI.  GLYCERI'NA.
Syxoxymes. Glycerinum, Glycerine, Glycerin:—improperly cited as Glycyrrhine,5
  Hydrate of Oxide of Glyceryl.
French. Glycerine.
German. Glyzerin, Glycerylo'xyd,  Oelsuss,  Scheel'sches  Suss.

   This substance forms a base to the oleic, stearic, and margaric acids
of the fat oils and  tallow, and is separated when these acids are made

  1 Lancet, and Philad. Med. Exam., Mar. 1852, p. 197.
  ' J. Johnson, Influence of Tropical Climates, 3d edit. p. 58.
  3 Dispensatory, Amer. edit. p. 364. Philad. 1849.
  * See "Note upon Gentiana Chirayita," by Dr. Carson, in Amer. Journ. of Pharmacy,
new series, vol.  vi. No. 1, Apl. 1843, p. 20.
  6 Braithwaite's Retrospect, iiii. 306, Amer. edit  New York, 1846. 
GLYCERINA.
407
to combine with an alkali, or any metallic oxide in the saponification
of the oils.
                      method of  preparing.
   Glycerin is obtained by heating  together olive or  other suitable oil,
oxide of lead, and water, as  in the manufacture of  the common lead
plaster: an  insoluble salt of lead is formed, and the glycerin remains
in the aqueous liquid.   This is treated with sulphohydric acid; digest-
ed with animal  charcoal; filtered, and  evaporated in vacuo at the
temperature of the air.
   The following is the  officinal formula in the  Pharmacopoeia of the
United  States (1851.)  Take  of lead plaster recently prepared and
yet fluid, and boiling water, each a gallon.  Mix them, stir briskly for fif-
teen minutes; then allow them to  cool, and pour  off the supernatant
liquid.  Evaporate this until it has the specific gravity 1.15; and pass
a  current  of  sulphohydric acid slowly through it until a black precipi-
tate  is no longer produced.   Filter and  boil until the sulphohydric
acid is driven off.  Lastly, evaporate the  liquid until it ceases to lose
weight.
   In a pure state, glycerin  forms a  nearly colourless and very viscid
liquid; s.  g. 1.27.  It has an intensely sweet taste, and mixes with wa-
ter and alcohol in all proportions;  but is insoluble in ether.1

                    EFFECTS ON THE ECONOMY.
   Glycerin was  introduced  by  Mr. Startin,2 as  a new  remedy for
the cure of certain cutaneous diseases; and its usefulness is presumed
to be most probably dependent  upon its property of resisting evapo-
ration  even at  a considerable temperature.   Mr. Startin  affirms, that
a  common plate wetted with it  may be kept in an oven,  side by side
with a joint  of meat,  till the meat is  cooked,  without  any  sensible
diminution in the quantity of the liquid.  Hence, when applied to the
skin it remains moist, forming a coating or varnish, which is not dis-
tinguishable from the  ordinary secretion of the  part.  A lotion com-
posed of half an ounce to ten fluidounces of water  effectually prevents
the skin from becoming dry.   When  employed in  its pure  state, it
makes the part  stiff and  uncomfortable;  and  consequently answers
best  diluted.   It is also added with advantage to  poultices, and even
to baths.  Mr. Startin  speaks of  its use chiefly in psoriasis, pityriasis,
lepra, and ichthyosis,  in  all which  diseases he describes it  as pro-
ducing excellent palliative  effects;  and in  such cases the author has
employed  it with marked  advantage.  It keeps the part moist, and
prevents the formation of scabs.
   It is probable, that glycerin might be used with  much advantage  in
burns, and wherever it is desirable to prevent the desiccative influence
of the air  from irritating an exposed surface.
   In consequence of the publication, by Mr. Yearsley,3 of some cases
of deafness, in which the tympanum had been perforated by ulceration,
having been astonishingly benefited by the insertion of wetted cotton

  1 Graham's Elements of Chemistry, Amer. edit., by Dr. Bridges, p. 596. Phila. 1843,
and Fownes's Elementary Chemistry, Amer. edit, by the same,  p. 399.   Philad. 1845.
  2 .led. Times, Feb. 8, 1846.
  8 Lancet, July 1, 1848. 
408
GLYCERINA.
 into the meatus, Dr. Turnbullx and  Mr. Thomas H. Wakely,2 under
 the idea that  the benefit resulted from the moisture and not from the
 cotton, thought of glycerin as an agent, which would retain its moisture
 and lubricate the auditory canal.   Mr. Wakley accordingly used it in
 three  hundred cases, and in  a number of them the power of hearing
 was restored.   "Contrary," he says, "to what might have been anti-
 cipated, the use of the remedy was successful in persons in whom the
 deafness had been of many years'  duration—one, for example, thirty
 years; and also in cases where the existence of the malady could  be
 traced to the eruptive fevers of  childhood.  In  instances of deafness
 caused by inflammation, followed first by suppuration, and then by a
 horny dry condition of  the auditory canal, the application of glycerin
 has been attended with signal advantage.  Equally marked and pecu-
 liar is the  success when it is used in  cases where there is a partial  or
 total absence of ceruminous secretion.   In many instances of deafness
 belonging to these classes of  cases, the  employment of glycerin has
 been followed by a perfect restoration of the power of hearing. In other
 examples of deafness, where the membrana tympani had evidently be-
 come thickened and hardened, and an examination with the speculum
 denoted a whitish or pearly appearance, the use of the glycerin was
 followed by strikingly beneficial and gratifying effects.   It is evident,
 therefore, that the application of glycerin is equally admissible, whether
 the tympanum [membrana tympani,]  be in a sound  state, or whether
 it has  been destroyed by ulceration."
   Dr.  Paterson,3  of Edinburgh, obtained some improvement in  one  of
 three cases in which he  used it.
   The benefits to be derived  from  glycerin in such  cases have been
 greatly exaggerated.  There may be cases where advantage may be de-
 rived from keeping the meatus  and  external layer of  the membrana
 tympani moist; but the cases, as Mr. Wilde4 has remarked, are compara-
 tively rare.  It is singular, that a cure for deafness arising from an aper-
 ture in the membrana tympani has been found, it is said, in pressing
 a portion of wool or raw cotton, moistened with some fluid,  as glycerin,
 into the bottom of the meatus.  Mr. Yearsleys first observed this, and
 his experience is confirmed by that of Mr. Wilde.6
   Recently, Dr. Crawcour7 has recommended it internally.  He says,
he has employed it in all cases in which he formerly used cod liver oil;
and with better effect; for he found it to possess all the remedial vir-
tues of the oil, without disordering  the digestive function   In phthisis
 and scrofulosis, he had used it with marked success.

                    MODE OF ADMINISTRATION.
  Dr.  Crawcour prescribes it internally in the dose of from one dram to
three drams in an ounce of water, three times a day.  " In from one to

  1 Lond. Med. Gazette, June 1, 1849, p. 962.
  2 Lancet, cited in Med. Examiner, Sept. 1849, p. 561.
  3 Monthly Retrospect, Aug. 1840; cited in Amer. Journal of the Med. Sciences, Oct.
1849, p. 461.     * Pract. Observations on Aural Surgery, Amer. ed. p. 51, Phil. 1853.
  5 Med. Times, April 12, 1851, p. 412.                   6 op. cit. p. 296.
  T New Orleans Medical News and Hospital Gazette, in Amer. Journal of Pharm., May,
1855, p. 230. 
                              GLYCERINA.                         409

 ten drams it, in a short period, relieves the cough, improves the diges-
 tive powers, arid increases the deposition of fat.

                      Linimentum  glycerinae.
                         Liniment of glycerin.
                 R.   Glycerin, f £j.
                      Tragacanth. pulv. ^ij. ad ^ss.
                      Liquor, calcis f ^iv.
                      Aq. ros. f ^ iij -  M.

   As a liniment or embrocation in prurigo, lichen, strophulus, lepra,
 psoriasis, pruritus, &c.                                    Startin.
                         Lotio glycerinae.
                          Lotion of glycerin.
                 R.  Glycerin, f ^ss.
                      Acid, nitric, dilut. f gss. ad f gj.
                      Bismuth, subnit. 3ss.
                      Tinct. digital, f 3j.
                      Aq. ^osaa f ^viiss.  M.
   As a lotion; to be  used by dabbing the part for chapped nipples, or
 hands, fissures of the lips, irritation of the skin of any kind, as after
 shaving, exposure to  the sun,  in pityriasis, &c.             Startin.

                 R.  Glycerin, f ^ss.
                     Sodae borat. gss. ad 3j.
                     Aq. ros. ^fviiss. M.

   To be used by dabbing the affected part in alopecia following fevers;
 in dryness or want of action of the scalp, thinness of the hair, &c.
                                                           Startin.
                 R.  Glycerin, f ^ss.
                     Sp. ammon. aromat. f ^j.
                     Tinct. cantharid. f 3j. ad f gij.
                     Aq. rosmarin. f ^vij.  M.

  As a lotion to be used with a wet hair-brush once or  twice  a day in
rheumatism or gout, neuralgic pains, sprains, bruises, stiffness, &c.

                     Embrocatio glycerinae.
                       Embrocation of glycerin.
                 R.   Glycerin, f gss.
                     Lin. sapon. comp. f jfiss.
                     Ext. belladon. gj.  M.

  As an embrocation; to be used twice a day in the ordinary manner.
                                                          Startin.
                     Unguentum glycerinae.
                        Ointment of glycerin.
                 R.   Glycerin, f j.
                     Cetacei^ss.
                     Cera, albas gj.
                     01. amygdal. f £ij.  M.
  Used in chaps of the hands and lips, excoriations, &c. J. H. Ecky.1


                1 Amer. Journ. of Pharm., Jan. 1853, p. 27. 
410                         GRANATUM.


                        CII. GRANATUM.
Synonymes. Punica Granatum, Malogranatum, Pomegranate.
French. Grenadier, Balaustier.
German. Granatbaum, Granatapfelbaum, Apfelgranate.
  Punica Granatum  appears to be a  native of the northern coast of
Africa, whence it  was transported to Italy at the time of the Cartha-
ginian wars.   It is  now cultivated in all civilized regions, where the
climate  is sufficiently warm to allow the fruit to ripen.  It belongs to
the Natural Family Myrtaceae,  and, in the Sexual System, to Ico-
sandria Monogynia.
  All the parts of the plant contain more or less tannic  acid.   The
bark of the root is externally of a yellowish-gray or ash colour; inter-
nally yellow, and  has an  astringent taste.   According to  Latour de
Trie,1 it  contains  wax, chlorophyll, a  considerable  quantity of resin,
gallic acid, tannic  acid, fatty matter, and a peculiar matter called Gre-
nadin;  in German,  Granatin.
  Grenadin,  in its pure state, is of a white colour;  inodorous, and of
a sweetish taste,—so much so, indeed, that according  to Magendie, it
might be presumed to be a variety of sugar, except that it differs from
ordinary sugar in  being devoid of the property of fermenting.   Ac-
cording to the degree of its purity, it  crystallizes in  grains, tufts or
stars.  When thrown on red hot  coals, it  consumes without any resi-
duum, and smells like burnt bread.  It is  fusible, and by a moderate
heat may be  almost wholly sublimed.   It neither reacts as an acid nor
an alkali, and is readily soluble in water.  Cold alcohol dissolves only
traces of it, but boiling alcohol dissolves it readily: a  property which
is to be taken advantage of in the formation of crystals.  In ether  it
is insoluble.  Nitric acid, with the assistance of heat, converts it into
oxalic acid.  An ounce of the bark yields six grains of grenadin; but
it is not settled, whether it contains the whole of  the  medical  proper-
ties of the bark.   Cenedella,2 from whom we have the most recent ana-
lysis of  the bark of the pomegranate root,  also found the grenadin dis-
covered by Latour.  This substance is readily prepared.  The bark in
powder is treated  with ether, and  afterwards with boiling alcohol, and
the fluid is evaporated to the  consistence of a soft extract.  By treating
this extract with water, grenadin  is dissolved  without difficulty, and
it may be purified  by suffering it  to crystallize frequently from alco-
hol.
                    effects on  the economy.
  The therapeutical  properties of the different parts of the pomegra-
nate tree were known to the writers of antiquity.   They employed not
only the bark of  the root as a  remedial agent, but also  the  flowers,
(Flores Balaustiorum, Balaustes,  Balaustia, Balaustine Flowers,) the
whole fruit, (Poma  Granati, Malogranata, Granata, Mala Punica,
Pomegranate:  Fr. Grenades,) the rind of the fruit (Malicorium, Mali-

  1 Journal de Pharmacie, Fev. 1828, p. 109.
  2 Giornale de Farmacia, Agosto, 1831,  p. 55.  See, also, Journal de Pharmacie, ix.
219; x. 352; and xvii. 503;  and Dierbach, in Heidelberg Klin. Annalen, B. x. H. 3, S.
365.  Heidelb. 1834. 
GRANATUM.
411
 chorium, Malacorium,) and the seeds.  Dioscorides, Pliny, Celsus and
 Marcellus  Empiricus speak of the employment of the bark of the root
 in tsenia.1   In more modern times, Punica granatum had been greatly
 neglected, although the juice of the fruit was recommended by Frederick
 Iloffmann against worms in children.  In India, it has been  long held
 in great estimation as a remedy in tapeworm; and its efficacy having
 been noticed by some English physicians, it was  recommended to the
 attention of Europeans, especially by Buchanan,2 Fleming  and Bre-
 ton.3  About the same time, a monograph was published by  Gomez, a
 Portuguese physician, which appears to have had considerable influence
 in  extending the reputation of the remedy, especially  in  Germany,
 where the  monograph was translated into  the Journal  of Gerson and
 Julius.4  Gomez directs two ounces of the fresh rind of  the root to be
 boiled in a pint and a half  of water down to a pint; and of this de-
 coction two or three spoonfuls to be taken for a dose;  the first,  early
 in the morning, fasting, and then  every  half hour until the whole  is
 used.  The efficacy of this  preparation he  tested in fourteen cases,
 from which it appeared, that the worm could not withstand  its action
 more than forty-eight hours.   He  found  it  exert most  efficacy  when
 portions of the worm were perceptible in the evacuations, a period when
 the patient generally suffers most  inconvenience.   If the exit of the
 worm did not take  place on the first day after the use of the agent,
 the decoction was continued on the second day, when the  worm was ge-
 nerally discharged.   Did this not happen, however, a farther continu-
 ance of the remedy was of  no avail; and  he thought it better to inter-
 mit it until the appearance  of fresh portions of the worm in  the eva-
 cuations.   Gomez also administers the dried rind  in pills.  If the dose
 be too large, or the appropriate dose be too frequently repeated, nau-
 sea, vomiting and diarrhoea at times supervene: should this be the case,
 the proper course is obvious.
  In countries where the fresh rind can be  obtained, Gomez  advises,
 that it should be used; in colder countries, the dried rind, which is ob-
 tained from more southern  regions, will have to  be employed.   Ac-
 cording to  Breton, the latter acts  more powerfully.  The  dried rind
 loses  more  than half its weight, and two ounces of it may be  esteemed
 equal to  three of the fresh.
  The strong testimony adduced in its favour by Gomez gave occasion
 to numerous trials with it  in  England, France, Germany, and Italy,
 which were generally attended with favourable results.  Such testimony
 has been afforded  by Boiti, Marchese,  Calabro, Majoli, Chevallier,
 Deslandes,  Merat,5 Pichonnier, Mandrux, Claret,  Bayle, Delaporte,
 Gendrin, Grimaud, Chapotin, Bourgeoise, Ilousson, Goupil,  Ferrus,
 Wolff, Kostler, Meisinger,  Berthold,  Schmidt, Muller,6  and  others.7

  1 Mt'rat and De Lens, Diet, de Mat. M.dical. art.  Punica Granatum.
  2 Edinb. Med. and Surg. Journal, iii. 22, 1827.
  8 Medico-Chirurg. Transact, xi.  31.
  * Magazin, u. s. w. vi. 427, and Journal Compl.mentaire des Sciences Medicales, xvi.
24, 1823.
  6 Du Taenia, &c, et de sa Cure radicate par l'Ecorce de la Racine de Grenadier. Paris,
1832; and Merat and De Lens, Op. cit.; and in Supplement au Diet. vol. 7, Paris, 1846.
  • Hannov. Annal., vii. 1847; cited in Schmidt's Jahrbiicher, No. 8, S. 161. Jahrgang
1S4N.                   ' Riecke, Die neuern Arzneimittel, S. 247. 
412
GRANATUM.
On the other hand, Keibel1 complains of its uncertainty;  and in the
Polyclinical Institute of the University of Berlin, it was given without
advantage;  but Osann, in his report of that institution, is disposed to
refer the want  of success  to some imperfection in the  rind  employed,
which, he remarks, is found to vary greatly in its character, as met with
in the shop  of  the apothecary.  It  would appear,  also, that it is not
unfrequently mixed with the rind of the root of the  Box tree and Guel-
der rose.
   To introduce more  precision on this  matter, Wolff recommends that
the druggists should  purchase the  bark  of the root  of  the  genuine
East India,  or, at all  events,  the Portuguese tree.   Boiti2 advises that
the root should be obtained from mountainous regions, where the tree
grows wild; that it should be taken only from young trees, and that it
should not be more than an inch thick; that it should  be  carefully se-
parated from the woody portion, and be collected in the spring of the
year, when the tree has most sap, and  be dried in the shade.  Cheval-
lier3  also advises, that only the rind of the root of the wild tree
should be used.   Gendrin, Montault,  and Pichonnier  affirm, that the
fresh rind was  alone certain in its  operation;  the  dry frequently dis-
appointing them.  According to Breton, the rind of the trunk is  to be
preferred to that  of the  root, because it preserves its virtues longer.
Chevallier recommends, before the decoction of the pomegranate tree
bark is administered, that a gentle  cathartic of castor  oil with lemon
juice should be premised.   This may be taken the evening before, the
patient fasting during the following day.   He directs  the  DECOCTION
to be made of two ounces  of the rind macerated for twenty-four hours
in two pints of water, and  then  boiled  until a pint  of the  strained
liquor remains.  This must be divided into three portions, which are
taken  in  half  hourly doses.   The  first  and second doses  with many
persons excite vomiting, but this need  not prevent  the  administration
of the third, as it rarely produces the same effect.  This quantity of
the decoction commonly occasions three or four evacuations, preceded
by slight colic  pains; at other times, but  one evacuation is produced,
with which the worm is usually expelled.  The period  that elapses be-
tween  the administration  of the last dose of the remedy and the com-
mencement of  its operation is from a quarter of an hour  to  a whole
hour,—rarely longer.
   Merck4 states  that, when properly administered,   it  never  fails.
The mode he recommends is  the  following.—Whenever a patient has
evacuated portions of taenia, he must take, on the same day, or the
next, a decoction of two  ounces  of the fresh  bark in a  pint and a
half of water,  reduced to a pint, in three doses, leaving an  interval
of half an hour between  each dose.  The worm will be evacuated at
the utmost in twenty-four hours, and no relapse need be feared.  Want
of success, he affirms, is  owing  to  the fact that  sometimes  the dry
bark is employed; and sometimes it is adulterated with  other kinds
of bark; or that it is taken too long after the portions of taenia have

  1 Rust's Magazin, xvi. St. 3, S. 566.               J Revue Encyclop. xxxii. 234.
  8 Journal de  Chimie M.dicale, i. 378, 1825.
  4 Revue Medicale, cited in Medical Times, Jan. 11,  1845, p. 323. 
GRANATUM.
413
been expelled;  or because the dose was  too weak, or  combined with
purgatives, &c.   Where  this  bark is  used,  a purgative is not neces-
sary.   Filix mas, on the other hand, requires a cathartic.
   Cenedella advises, that the bark of  the root  should be macerated
before boiling; that the decoction should be made in earthen, not in
metallic, vessels; and that it should be filtered or strained whilst hot,
—different constituents, which are probably efficacious, being deposited
as the liquor cools.
   According to M. Constant, the decoction is commonly prepared in
France in the following manner:—The rind of  the fresh root—ox the
bruised root dried—is macerated through the night in  from a pint
and a half to a quart of water; the liquor is then boiled to one half;
strained;  and, in the morning, a third part is  taken lukewarm, fast-
ing, and repeated every three hours until the whole has been adminis-
tered.  The  quantity of the rind, used for  the decoction, is, in  the
case of the adult, gj.;  of children, from six to fifteen years old, 5vj.;
and of those under six years of age, gss.  At times, however, it  has
been  administered  in much  larger doses.  A girl, twenty-four years
of age, had  suffered  from tsenia from  her infancy, and  had  fre-
quently passed fragments of worms in  her evacuations.  She  took
two ounces of the  bruised bark of the  pomegranate root, boiled in
two pounds of water, at thrice, with half an hour's interval between
the doses, but without effect.  The dose was now increased  to three
ounces, and two tapeworms were expelled; so that, in two days, and
without any abdominal disturbance, the patient took the decoction of
five ounces of the bark of the root.1
   To ensure the proper action of the decoction, it  must be given as
directed above, without the addition of sugar or syrup, which  changes
its  properties.  During  its operation,  the  patient  should drink  no-
thing except when the  tormina  are  urgent,  and then a little  of any
aromatized water, without sugar, may be  taken.  The remedy should
be given only on  days  in which portions of taenia  are evacuated, or
on the following morning;  and  the  alimentary canal should  be free
from  every evidence  of inflammatory  irritation.   By some, as  by
Latour de Trie and Ferrus, an infusion  of the  rind has been found
serviceable; and  Deslandes  recommends an Extractum spirituosum,
and an Extractum aquosum corticis radicis granati.
   MM. Ferrus, Berthold, Goupil,  and others, have published cases in
which, along with the  expulsion  of tsenia, various  neuroses  were re-
moved under the  use of the rind, and accordingly it has been thought
that it might be usefully employed in such affections where no  tsenia
exists; in epilepsy and hysteria, for example.

                      METHOD OF PREPARING.
              Decoctum granati radicis  corticis.
                 Decoction of pomegranate root bark.
                 R.  Granati radicis corticis £,'\).
                    Aqua? Oij.
             Boil to a pint and a half.
  1 Forget, in Gazette des Hopitaux, 19 Fevrier, 1839, and London Medical Gazette,
April 20, 1839. 
414
GUACO.
  Dose.—*ij. every half hour.  Three or four doses are usually suffi-
cient to expel the worm.1   The formula given by Dr. Ainslie,2 directs
the decoction to  be prepared with 5ij. of the fresh bark, boiled  in
a pint  and  a  half of water, until only three quarters  of a pint re-
main.
        Electuarium extracti  granati  radicis corticis.
             Electuary of extract of pomegranate root bark.
                 R.  Extract, alcohol, granat. rad. cort. ^vj.
                     Aquae florum  .ilise,*
                     Sucei limon. aa. f ^iij.
                     Tragac. q.  s. ut fiat electuarium.
  Dose.—One-half, from half  hour to half hour.        Beslandes.

           Mistura extracti  granati radicis  corticis.
              Mixture of extract of pomegranate root bark.
                 R.  Extract, alcohol, granat. rad. cort. 3vj.
                     Aquae menthae,
                     ----flor. tilise,
                     Succ. limon. aa. f §ij. M.
   To be divided  into  four  parts, one of which may be taken every
quarter of an hour.                                    Beslandes.
                          cm. GUACO.
Synonymes. Huaco, Eupatorium Huaco.
  It would appear, that owing to some extracts in the "Allgemeine
Z eitung," the attention of the German physicians had been directed
to this article  as an important agent in the cure  of  epidemic cholera;
and various testimonials have been brought forward in its favour, which,
as Riecke4 properly suggests, may  not be confirmed by farther experi-
ence ; and yet the circumstance may have led to the introduction of a
valuable article into the catalogue of medicinal agents.
  Many species of the genus  Eupatorium, and  of the  kindred genus
Mikania,—which has been recently separated from  it,—belonging to
the Natural  Family Compositae (Synantherese, sub-division Corymbi-
ferae,) and in the Sexual System,  to Syngenesia iEqualis, have  been
prized in various parts of America, particularly in cases of bites of ser-
pents.  This is especially the case with Eupatorium ayapana (E. tri-
plinerve.)  According to Von Martius, a quantity of the bruised leaver
is applied to the scarified wound, and  the  application of fresh leaves
is renewed, over and over again, until the patient  is freed from the
dangerous symptoms, and especially from the  violent suffering.  At
the same time, a few spoonfuls of the expressed juice are administered
every now and then.  The Mikania  opifera (Eupatorium crenatum,)
—in Brazil termed  Erva da cobra—and the Eupatorium saturejce-
folium  (Mikania saturejcefolia,)  also belong to many Synantherese,

           1 Jourdan's Pharmacop.e Universelle, i. 638.  Paris, 1828.
           2 Materia Indica, ii. 175.  London, 1826.
           3 Any simple aromatic water may be substituted for this.
           4 Die neuern Arzneimittel, v. s. w. S. 250.  Stuttgart, 1837 
GUACO.                           415
which, in South America, are reputed specifics against the bites of ser-
pents.   The most important species appears to be that called in Peru
Guaco or Huaco, which is held there in high consideration, as well as
in New Grenada, and Venezuela, not only in these cases, but  in the
prevention  of hydrophobia.1  This is presumed  to  be the Mikania
guaco of Humboldt.  Dr. Hancock, however, affirms, that the names
Guaco and Bejuco de Guaco were given—in the parts of America where
he sojourned—to different species of Aristolochia.
   Guaco was made  known, forty or fifty years ago, by Mutis,2 who re-
fers to its effects in cases of the bites of serpents.

                     EFFECTS ON THE ECONOMY.
   Of the efficacy of the guaco in Indian cholera, M. E.  de Chaniac,
Officier de Sanfe" in the French navy, and Dr. Chabert, physician to the
military hospital in Mexico, have published the results of their experi-
ence.  When the brig Adonis, on her voyage  from Havana to Mexico,
in the year 1833, arrived at Vera Cruz, some of her crew were attacked
with cholera, which prevailed at the time in Mexico.   Of all the reme-
dies employed, the guaco was found most beneficial; its effects, indeed,
were so wonderful, that it was regarded almost as a specific.   Its action
is chiefly exerted on the heart and the circulation, which it renders more
energetic.   All the patients to whom it was exhibited in the commence-
ment of the disease were saved, and even of  those in  whom  the  cho-
lera had already reached a certain stage, the greater part were saved,
as soon as  a free and complete reaction was established.   Dr. Chabert,
who first administered guaco in  cholera,  as well as in yellow fever, ob-
serves on its use in the former disease;—In simple cases, a small tea-
cupful of a warm decoction was  given every half hour, until a general
diaphoresis and proper warmth of surface supervened, which was kept
up for some days, when  the remedy was gradually discontinued.   To
allay the thirst, the decoction was given, diluted with two-thirds, or
half, water.  In dangerous cases of cholera algida, with coldness, loss
of pulse, &c, a spoonful of the tincture was  mixed with six or eight
spoonfuls of water,  and, every quarter of an  hour, a  spoonful  of this
mixture was given  alternately with  a small  cupful of the decoction.
When the pulse returned, the warmth became restored and the  per-
spiration re-established,  the tincture  was omitted, and the  decoction
continued alone at  longer intervals.   In the majority of cases, after
the cessation of the cholera symptoms,  pain was experienced in  the
epigastrium, with burning thirst, which yielded when the decoction was
diluted with half or two-thirds water.   When the decoction  could  not
be retained by the  stomach, it was  given in clyster.   Blood-letting,
general and local, was employed along with other  external means, but
nothing was given internally except the guaco.   To make the decoc-
tion ;—two drams of the stalks, and half a  dram of the leaves, were
boiled in two pints of the water, down to one.  The tincture was pre-
pared like other tinctures.
  1 See Trof. W. R. Johnson, in Silliman's Journal, xxiv. 272 and 388, New Haven, 1833;
and Ibid, xxvii. 171, New Haven, 1835;  also, Dr. Hancock, in  Quarterly Journal  of
Science, &c, from January to June, 1830, p. 333.
  * Virey, in Bulletin de la Soci-t6 de Pharmacie, vi. 241; and Riecke, Op. cit. 251. 
416
HIPPOCASTANUM.
   In consequence of the communications of Chabert and De Chaniac,
as well as of the parallel drawn by Harless1 between the cholera and
the effects of the bites of serpents, Professor Beckers of Munich re-
commended that experiments should be made with guaco;  and it was
accordingly tried at Munich, but not with as favourable results as had
been expected.  Romerio asserts that  it was given in the stadium as-
phycticum in the form of infusion, made  of half an ounce of the
stalks, but with uncertain results.   It  appeared to combine the effects
of valerian  and  ipecacuanha, yet  it excited less vomiting than the
latter.    The  tincture seemed  to  render greater  service.  It was
given in the  dose of a coffee-spoonful  every half hour;  and, subse-
quently,  every hour, and every two hours.   It would appear, that in
the district of Prague, its administration was  attended with very fa-
vourable consequences.2   To account for  the different results,  it is
affirmed, that different drugs are  met with in commerce  under the
name guaco.  Riecke says, that M.  Jobst  had sent him  two kinds,
which were  evidently from different plants: the  one variety was ob-
tained  from Hamburg and Bordeaux; the other, from Paris:  descrip-
tions of these are given by Riecke.  The truth, probably, is, that this,
like most of the cholera specifics which have  been brought  forward, is
efficacious in certain cases of the disease, but that its agency has been
egregiously exaggerated.
               CIV. HIPPOCAS'TANUM (CORTEX.)
Synonymes. _Esculus Hippocastanum, Castanea Equina seu Pavina, Horse Chestnut,
  Buck Eye (the Bark.)
French. Marronier, Marronier d'lnde.
German. Rosskastanie,  Pferdekastanie, Rosskeste, Pferdekeste.
  The tree whence  this  bark is  derived  is iEsculus Hippocastanum,
or Horse Chestnut—of the Natural Family Hippocastanese; Sexual
System, Heptandria Monogynia—which is wild on  the mountains of
Asia Minor and Persia, and grows in this country as well as in Europe.
The bark has  a very astringent  taste; is somewhat bitter, and con-
tains a great deal of tannic acid.   Canzoneri thinks he discovered  a
peculiar principle in it, which he calls aesculine, but the existence of
this is contested.
                    EFFECTS ON THE  ECONOMY.
  _ The Cortex Hippocastani has long been  advised as  an astringent, but
without receiving much attention.3   In modern times, it has been pro-
posed by Zaijnichelli, Hufeland, Voigtel,  and others, as the best sub-
stitute for cinchona.  These  recommendations have caused  the bark
to be more  frequently administered in Europe, by which  means it
has been discovered to accord almost entirely in its effects with that
of the willow:  the  latter, however, appears to be more effective, and
to agree better with the digestive organs.  In  the wars of Napoleon,
when bark was very scarce, it was much employed.  Hufeland and

  1 Die Indische Cholera, v. s.  w. Braunschweig, 1831.      2 Riecke, Op. cit. S. 256.
  3 Merat and De Lens,  art. _Esculus Hippocastanum. 
HIPPOCASTANUM.
417
Voigtel recommended  it especially in intermittents.  Sinogowitz1 ad-
vises that it should  be given  after the  removal  of intermittents by
quinia, to prevent a relapse;  and, also,  in  combination with diuretic
agents, in the cases of dropsy which often succeed to that disease.
Krugelstein found it  always extremely  efficacious in atonic gout, and
in removing the  weakness  of the digestive apparatus that remains
after  attacks  of  gout.  The Austrian,  Brunswick, Danish,  Russian,
and Saxon Pharmacopoeias2 have an  aqueous extract  of*the  bark,
which Voigtel  administered  with good results in  intermittent fever,
and often found  serviceable in chronic  discharges from  the mucous
membranes. It agrees better with the stomach than the powder or the
decoction.   Externally, the  decoction  has been advised as a  good
astringent.
                     MODE OF ADMINISTRATION.
           Pulvis corticis hippocastani compositus.
               Compound powder of horse chestnut bark.
                 Pulvis China. Pactitius.
                 Factitious powder of baric.
                 R.  Hippocast. cort.
                      Salic, cort.
                     Gentian rubr. cort.
                      Calam.
                      Caryophyll. aa. ^\].
             Misce et fiat pulvis.
   Hufeland3  affirms,  that this powder is an adequate substitute for
 cinchona in three cases out of four.
                          Hufeland, and Prussian Pharmacopoeia.

                 Decoctum corticis hippocastani.
                    Decoction of horse  chestnut bark.
                 R.   Cort. hippocastan. 3*iss.
      Coque cum aqua3 f gxviij. ad. reman, colat. f fix.; cui refrigerat. adde
                      Spir. aether, sulph. f 3j.—^ij.
                      Syr. cort. aurant. f^j.  M.
   To be used during the apyrexia.                        Voigtel.

                  Decoctum chinse  factitiae-
                      Decoction of factitious baric.
                 R.   Salic, cort. pulv. crass.
                      Hippocast. cort. aa. 3*ss.
                      Calam.
                      Caryophyll. aa. gij.
              Coque cum aq. fontan. f 3*xvi. ad reman, colat. f fviij.
                                         Prussian Pharmacopoeia.

               Decoctum  hippocastani  acidum.
                    Acid decoction of horse chestnut.
                 R.  Hippocast. cort. pulv.  3yj.
               Coque  cum
                      Acid, sulphur, dilut. f 3j-
                      Aqua, f §x.
              ad. colat. f 3yj.
   Used  in the after treatment of intermittents.—Sinogowitz.

               1 Rust's  Magazin, B. xxix. H. i. p. 84.
               2 Pharmacop.e Universelle, ii. 14.  Paris,  1828.
               8 Armenpharmacopoe 4te Ausgab.  Berl. 1825.
     27 
418
HYDRARGYRI BROMIDUM.
           Electuarium  corticis  hippocastani.
                   Electuary of horse chestnut bark.
                R.  Hippocast. cort. pulv. 3*ss.
                    Calam. gss.
                    Roob. juniperi fiij.  M. ut fiat electuarium.
  A tea-spoonful to be taken every hour, or every two hours, in drop-
sies supervening on intermittent fever.—Sinogowitz.
                 HYDRAR'GYRI PRiEPARA'TA.
Synonymes. Preparations of Mercury.
French. Les Preparations de Mercure.
German. Quecksilberpraparate.

               CV. HYDRAR'GYRI BRO'MIDUM.
Synonymes. Hydrargyrum Bromatum, Brometum Hydrargyrosum seu Hydrargyri,
  Bromuretum Mercurii, Bromide of Mercury.
German. Bromquecksilber, Quecksilberbromur,  Quecksilberbromid.
  Mercury unites with bromine in more than one proportion.  A solu-
tion of bromide of potassium produces with a solution of nitrate of pro-
toxide of mercury a white curdy precipitate, which resembles calomel;
and appears to be a bromide of quicksilver, answering  to the proto-
iodide  (Hydrargyrum  Bromatum,  Hydrargyri  Protobromidum;
German, Quecksilberbromur, Bromquecksilber, Protobro-
miiredesQuecksilbers.)   On the other hand, the bromide, which
is formed by the  direct  union of bromine with mercury, corresponds
probably to the red iodide.   A white substance results, which can be
sublimed by heat, is soluble in water, alcohol, and especially in ether;
is coloured red or yellow by the alkalies,  and exhibits considerable re-
semblance  to corrosive sublimate;—(Hydrargyri perbromas seu bibro-
mas, Hydrargyrum perbromatum seu bibromatum seu perbromidum
seu deutobromidum seu bibromidum, Beutobromuretum mercurii, Bro-
metum  hydrargyricum;  German,  Quecksilber-deuto-bromiir,
Bromquecksilber   in  maximum,   Doppel tbr o mqueck-
silber.)
                     EFFECTS ON THE  ECONOMY.
   The effects of these preparations on the sound and diseased organism
are not well known.  They have,  however, been employed by some
physicians.  The protobromide strongly resembles calomel in its pro-
perties.  In the dose  of one  or two grains, it produces no effect in
health, even when taken fasting.  In a higher dose—four or five grains,
and upwards—it purges moderately, augmenting, at the same time, the
secretion of urine.  When used in primary syphilitic affections, in the
way of friction on the gums, or internally in pill, it removes them like
calomel; but it does not seem to affect the mouth as speedily or as se-
verely.1
1 Bulletin General de Th.rapeutique, No. 14, 30 Juillet, 1837. 
HYDRARGYRICYANURETUM.
419
  The DEUTOBROMiDEor bibromide resembles the bichloride of mercury
in its  action,—producing, in too strong a dose, vomiting and purging,
with colic and cramp of the stomach; affecting the mouth, and exciting
violent salivation.1  Werneck, of Austria, has administered it frequently
in syphilis.   In recent cases, he prescribed it in the  form of pill, be-
ginning with one-twentieth of a grain.  This dose he increases by one-
twelfth every two days,—the chancres being covered  at the same time
with compresses, wetted with  a solution formed of six grains of the same
substance to a pint of distilled water.  After a few days' treatment he
remarked that the sores assumed a better appearance;  and from twenty
to thirty days were sufficient to effect their entire  cicatrization.  The
total  quantity of the bromide administered was about five grains;  it
was rarely necessary to carry it as high as  ten or  twelve grains.  It
has been believed,  that deutobromide of mercury is  less liable to act
on the salivary glands than  the corrosive chloride, and to affect  less
severely the stomach and chest.2
  Desorgues has recommended the second (?) preparation as a prophy-
lactic and curative agent in syphilis.  It was  doubtless, also—Riecke
suggests—the second preparation which was administered with excellent
effects by Prieger in porrigo favosa of an  obstinate character.  He
terms the preparation bromas mercurii; but the true bromate is proba-
bly insoluble in ether.3  The first of the following formulse is  recom-
mended by Prieger.

             Guttse  hydrargyri  deutobromidi.
                  Drops of deutobromide of mercury.
      R. Bromatis mercurii, (vel potius hydrargyri perbromidi,) gr. vj.
  Solve in
                   _Ether. sulphuric, f^iij.   M.
  Dose.—Ten  to  twenty drops, according to the age of the patient,
daily, in water.
                R. Hydrargyr. deutobromid. gr. j.
                    _Ether. sulphuric, f^j.   M.
  Dose.—Ten  to  twenty drops, in barley water, a  short time after
taking dinner;—in syphilis.                 Werneck and Prieger.
              CVI.  HYDRAR'GYRI CYANURE'TUM.
Synonymes. Hydrargyri Cyanidum seu Percyanidum seu Bicyanidum seu Prussias
  seu Borussias, Hydrargyrum Cyanogenatum seu Cyanatum seu Cyanicum seu Bo-
  russicum seu Zooticum seu Hydrocyanicum, Cyanuretum seu Cyanetum Hydrar-
  gyri, Mercurius Hydrocyanicus,  Cyanidum Mercurii, Cyanide, Percyanide or Bicy-
  anide, Prussiate or Hydrocyanate of Mercury.
French. Cyanure ou Hydrocyanate ou Prussiate de Mercure.
German.  Cyanquecksilber,  Blaustoffquecksilber,  Blausaures  Queck-
  silberoxyd, Quecksilbercyanid.
  This mercurial  preparation is  contained in the  Pharmacopoeia of
the  United States, as it was  formerly in that of London.

  1 Glover, Edinb. Med. and Surg.  Journ., Oct. 1842.                2 Ibid.
  •Die neuern Arzneimittel, S. 261.  Stuttgart,' 1837, & 2te Auflage, S. 371.  Stutt-
gart, 1840. 
420
HYDRARGYRICYANURETUM.
                       METHOD OF PREPARING.
   According to Proust and  Gay-Lussac, two parts of good and finely
powdered Prussian blue  must be boiled with one part of deutoxide of
mercury and eight parts of water, until the mixture acquires a bright
yellowish tint.   It is then filtered, and the filtered liquor, which is the
hydrocyanate of deuxtoxide of mercury,—containing, however, some
iron—is digested or boiled  with  an  excess  of deutoxide of mercury,
whereby the oxide of iron  is completely precipitated.   As, however,
the hydrocyanate is combined with an excess of oxide  of mercury, this
must be saturated with free hydrocyanic acid, and the solution be eva-
porated to induce crystallization.  In this mode the cyanuret is formed.
   The formula of the Pharmacopoeia of the United States is the same
as that  adopted in the Codex Medicamentarius of Paris, which was re-
commended by Berzelius.  It is  as  follows:—Take  of red  oxide of
mercury, three ounces, or a sufficient  quantity; ferrocyanuret of iron,
four ounces; distilled water, three pints.   Put the ferrocyanuret of
iron, and three ounces of the  oxide  of mercury, previously powdered
and thoroughly mixed  together,  into a glass vessel;  and  pour  upon
them two pints of the distilled water.   Then boil the mixture, stirring
constantly, and if, at the  end of half  an hour, the blue colour remains,
add small portions of the oxide of mercury, continuing the ebullition
until the  mixture becomes  of a  yellowish colour; after which  filter
through paper.   Wash  the residue in a pint of the distilled water, and
filter  as before.   Mix  the solutions, and evaporate by the fire till  a
pellicle  appears; then set the liquor aside that crystals may  form.  To
purify the  crystals, dissolve them in distilled water; filter; evaporate
the solution, and set it aside to crystallize.1   Dr. Christison2  does not
approve of this preparation.   He regards it as a " needless incumbrance
of the London and Dublin  Pharmacopoeias."  "It was introduced,"
he  remarks, "into the  latter, as  the source of the hydrocyanic acid;
which may now be obtained more cheaply, and equally well,  from
other materials."  Since then, it has been expunged from both of them.
   Schrader directs it to be prepared  by mixing a solution of red oxide
of mercury with hydrocyanic acid, filtering  and evaporating.3
   Cyanuret of mercury forms white, opake, four-sided prisms;  is in-
odorous, and its taste is extremely disagreeable and metallic.  It is de-
composed by heat; is readily soluble in water, and becomes converted
thereby into hydrocyanate of mercury.   It is insoluble in alcohol.  It
contains,  at times, ferrocyanuret of potassium, proceeding from the
Prussian blue,  with which it has been prepared.4

                     EFFECTS ON THE  ECONOMY.
   According to Coullon,  the poisonous action of this salt  is  as rapid
as that  of hydrocyanic acid.   A  fatal  case  has been  published.5  In
  i Pharm. of the United States, p. 118.  Philad.,  1842, and p.  146.  Philad., 1851;
see, also, Mr. Ellis, in Journal of the Philadelphia College of Pharmacy, vi. 24. Philad.,
1834-5.                            2 Dispensatory, p. 519.  Edinb. 1842.
  3 See a new process for its preparation, by  MM. Chevallier and Deleschamps, in
Journ. de Chimie Medicale, Janv. 1830.               * Orfila, Toxicologic, i. 331.
  * Thibert, cited by T. R. Beck, in Amer. Journ. of the Med. Sciences, April, 1842, p.
490. 
HYDRARGYRICYANURETUM.
421
 the dose of from two to five grains, Ittner found it  produce on doo-s
 only signs of indisposition, tremors, &C.1   It is one of the substances
 which Magendie,2 in his experiments, found to promote the coagula-
 tion of the blood.
   Parent,3 who frequently used this preparation, prefers it greatly to
 corrosive sublimate, in consequence of its greater solubility, and  the
 capability of more readily affecting the  organism by it.   According
 to his  experience, syphilis yields more  readily under its  use, than
 under that of any other of the mercurials.   He did not observe pains
 in the  abdomen accompanying its protracted employment, which he
 so frequently witnessed when the corrosive chloride was taken.   An-
 other advantage which it possesses is, that it is not so readily decom-
 posed.   No  salt, no alkali—not even  caustic  alkali—disturbs  it;
 neither  do substances  that contain  nitrogen  or  gallic  acid, which
 speedily  convert  the  corrosive  chloride into calomel.   Moreover,
 cyanuret of mercury appears to act on the animal textures differently
 from the corrosive  chloride.   When the  latter is placed  in  contact
 with flesh, it becomes quickly changed, in part, into  calomel; whilst
 the cyanuret preserves  the flesh  equally well, without  being decom-
 posed.   The hydrocyanic  acid appears  to play no important  part in
 the action of  the  remedy.   According to Olivier's experiments,4 the
 cyanuret, like  the  corrosive chloride, acts as  a powerful excitant to
 the  tissues to  which it is applied.   He saw a  man  destroyed  by
 inflammation of the intestines, who had taken twenty-three  grains
 of it.
   Cyanuret of mercury was first,  perhaps, recommended in Italy, by
 Brera, and in Spain.  Mendoza especially made many trials with  it,
 from which he  was induced to conclude, that it is  the best agent we
 possess in venereal affections—an opinion in which he was joined by
 several of his  professional brethren in  Malaga.   He advises,  that
 laudanum should be added to it,  on account of its liability to excite
 vomiting.  When too large  doses were administered, or when the  pa-
 tient was unusually impressible, he found  that the nervous system  be-
 came  especially disordered—as  indicated  by syncope, oppression,
 anxiety, and convulsions.   Chaussier, likewise, as well as Thaer  and
 Horn,  proposed the cyanuret as a remedial agent at  an early period.
 On the  other hand, AVendt, Cullerier and  Plisson complain of its little
 efficacy; whence it has been inferred that the preparations must differ.3
   Neumann6 advises it in  chronic inflammation of the  lungs,  of  the
 membranous  organs  of the chest  and  abdomen, and of the ovaries.
 In particular cases, its use  has to be soon pretermitted, in consequence
 of its powerful action on the salivary glands, even in  small doses—as
 one-eighth  of a grain, three times a day.   In  other  cases, it  can be

  1 Merat and De Lens, Diet, de Mat. Med. art. Cyanogene.
  2 Lecons sur le Sang; and Translation in Lond. Lancet, Jan. 20th, 1839, p. 636.
  5 Journ. de Chimie Medicate, viii. 473.
  4 Journ. de Chimie M.dicale, i. 289; see, also, Letheby, Lond. Med. Gaz., Jan. 9,  and
Feb. 14 and 17, 1815.
  6 Riecke, Die neuern Arzneimittel, u. s. w. S. 204.   Stuttgart, 1837, and 2te Auflage,
S. 370. Stuttgart, 1840.
  • Hufeland and Osann's Journal, lv. 66. 
422
HYDRARGYRICYANURETUM.
continued  long without  the  supervention of any unpleasant  conse-
quences.   In the Charite, at  Berlin, it was used with advantage in a
case of obstinate cephalalgia, the origin of which was syphilitic.   Biett
has employed it externally—in the form of the ointment given below—
in humid tetter, accompanied with  inflammation  and itching.   Parent
recommends  it to be  applied in chancre;  Brera uses it in solution, as
a gargle, in  syphilitic  ulcerations of  the fauces, and Mr. Wormaldx
has employed a saturated solution  as an  application to syphilitic  ul-
cerations, abrasions, &c, of the tongue, with more satisfactory results
than from  any remedy he had previously used.   The solution is painted
over the affected part;  care being  taken that none is swallowed.  Dr.
Strohl2 cures chancres  even when complicated,  usually within twelve
days, with  an ointment composed  of two  grains of the cyanuret to a
dram of lard.  The ointment is spread upon a piece of lint of the size
of the sore:  the dressing  is apt to be painful at first, and it must be
taken  off occasionally, after it has been  on for an hour  or two, and
be applied  in a  weaker form.   The pain is said  to be most violent in
half an  hour or an hour, and  frequently ceases  in two or three hours.
When the  chancre is extensive and painful, after the  ointment has
been on  for from four to ten hours, according to the sensibility of the
patient,  it  is dressed with mercurial ointment or opium cerate.  By
Carron du Villards it was used in the form of ointment in scrofulous
conjunctivitis;  and  by Desmarres in the blepharitis glandulosa of
scrofulous  individuals:  and Fischer and Diihrsen observed good effects
from the use of an ointment composed of it in  the hydrocephalus of
children.3
   Such is  the chief testimony recorded in  favour of the medical action
of the cyanuret of mercury.   Dr. Christison4 thinks, that "the few
trials hitherto made of its effects in disease scarcely justify its intro-
duction as  a remedy."  Although,  however, it has been but little used
in Great Britain, many trials have been made with it, on the continent
of Europe more especially, and recently, M. Desmartis5 of Bordeaux,
after careful comparison, has come  to the conclusion, that it is superior
to all  other  preparations  of mercury,  especially in syphilis.  He has
employed it, too, with benefit in iritis.

                     MODE OF ADMINISTRATION.
   Cyanuret  of mercury may be given  in  pills or in solution.   Horn
prescribed it in powder, but this form is  less  appropriate.  The dose
is from  one  sixteenth of a grain to a grain, several times a day.  As
a gargle, half a grain to  a grain may be  dissolved in f Sj- of water;
as an ointment, from one and a half to two grains may be united with
5j. of lard.   Chaussier used it in friction on  the soles of the feet, in
the same way as the  corrosive  chloride.
  1 Medical Times and Gazette, July, 1855.
  * Oesterreich, Med. Wochenschrift,  and Lond. Med. Gaz., Nov. 1842.  Gaz. M.d. de
Strasbourg, Nos. 15, 17; or Encycl. des Sciences Med. Sept. 1841, p. 525.
  3 Aschenbrenner, Die neueren Arzneimittel, u. s. w. S. 147.  Erlangen, 1848.
  * Dispensatory, p. 519.  Edinb. 1842.
  6 Dublin Hospital Gazette, April 1, 1855, and Amer. Journ. of the Med. Sciences, July,
1855, p. 186. 
                    HYDRARGYRICYANURETUM.                 423

               Liquor hydrargyri  cyanureti.
                (Liqueur antisyphilitique de Chaussier.)
                R.  Hydrargyri cyanur. gr. viij.
                    Aqua, destillat. Oj.

  Each ounce contains half a grain of the cyanuret.
                                         Chaussier1 and Parent.
                R.  Hydrarg. cyanuret. 9ss.
             Solve in
                    Aq. destillat. Oj.
             Adde
                    Tinctura. opii fgj.  M.

  Dose.—Morning  and  evening, a spoonful, in a decoction of sarsa-
parilla or barley.                            Mendoza and Parent.

               Pilulae hydrargyri  cyanureti.
                    Pills of cyanuret of mercury.
                R.  Hydrarg. cyanuret. gr. v.
                    Opii 9ss.
                    Mica, panis 3>
                    Mellis q. s. ut fiant pilula. xcyj.

  Dose.—One to four, three times a day.                  Parent.

            Gargarisma hydrargyri cyanureti.
                    Gargle of cyanuret of mercury.
                R.  Hydrarg. cyanur. 9ss.
                    Decoct, ten. sem. lini, (vel. rad. althaea.,) Oj.
             M. et fiat gargarisma.
     R.  Hydrarg. cyanur. Qss.
        Decoct, hordei Oj.
        Mellis rosa. 3j.  M. et fiat gargarisma.

Unguentum hydrargyri cyanureti

      Ointment of cyanuret of mercury.
    R.  Hydrarg. cyanur. gr. xij.
        Adipis §j.  M. ut fiat unguentum.
Parent.
Brera.
Brera.
               R.  Hydrarg. cyanur. gr. xvj.
                   Adipis gj.
                   01. limonis gtt. xv. M.
From half a dram to a dram, to be rubbed in, in cases of tetter.
                                                         Biett.

1 Rattier, Formulaire Pratique des Hopitaux Civils de Paris, 3.me _dit.  Paris, 1823 
424
HYDRARGYRI IODIDUM.
                 CVII. HYDRAR'GYRI IO'DIDUM.
 Synonymes. Hydrargyri Proto-iodidum seu Proto-ioduretum  seu Subiodidum, Hy-
  drargyrum Iodatum  flavum, Iodidum seu Ioduretum Hydrargyrosum, Hydrargy-
  rum Iodidulatum seu Subiodatum seu Iodatum, (in contradistinction to the Perio-
  datum,) Iodidum seu Iodetum Hydrargyrosum, Proto-ioduretum Mercurii, Protio-
  dide, Proto-iodide, Proto-ioduret or Subiodide of Mercury.
 French. Proto-iodure de Mercure.
 German. Gelbes oder einfach  Iodquecksilber,  Gelbes Quecksilber-
  iodid,  Protoiodiir des Quecksilbers,  Quecksilberiodidul,  Quecksil-
  beriodiir, Iodquecksilber in minimum des Iods.

                       METHOD  OF PREPARING.1
   In the United States Pharmacopoeia, iodide of mercury is prepared
 by rubbing together an ounce  of mercury and five drams  of iodine,
 adding gradually as much alcohol as may be  sufficient until globules
 are no longer  visible.   The powder is  dried  immediately by a gentle
 heat, access of light being excluded;  and it is kept in a well-stopped
 vessel.2
   Iodide of mercury has a  greenish-yellow  colour, and is  insoluble
 in water, alcohol, or solution of chloride of sodium, but is soluble in
 ether.  It is  a preparation holding a  similar  relation to iodine  and
 mercury, that the mild chloride holds to chlorine and mercury.

                     EFFECTS  ON  THE  ECONOMY.
   This preparation has been less used than the red  iodide to be de-
 scribed next.   Tunnermann remarks, as the results  of his experience,
 that its action in respect to the  mercury is  analogous to that of the
 mild  chloride,  except that it appears to excite more the lymphatic  and
 glandular systems.   When given in  conjunction with a generous ani-
 mal diet, he found  it very efficacious in a case of scrophulosis, where
 colliquative sweats  had appeared; and in a  second case, also, it ren-
 dered essential service.  In one  of the cases, he gave it  internally in
 the dose  of from one-twelfth to  half a grain, three times  a day; in
 the other, of from half a grain to a grain.   He directed it  also to be
 rubbed, in the form of ointment,  on tumefied glands of the neck.   Pel-
 letan found it  serviceable in the cure of obstinate glandular  swellings,
 when used in  the form of ointment in  combination with morphia, as
 well as in obstruction of the liver.  Biett recommends an ointment of
the iodide in  the treatment  of chronic  venereal ulcers, the cicatriza-
 tion of which it expedited; Lugol3 advises it in phagedenic scrofulous
ulcers, which present a syphilitic aspect; and Poiret4 recommends it
 strongly in psoriasis; the  patient using, at the same time, simple alka-
 line or water  baths  alternately.   According to the  experience of Ri-

  1 For a process by M. Boutigny, see Bulletin General de Therapeutique, and Amer.
Journ.  of Pharmacy, 2d  vol. 2d series, p. 326.  Philad. 1837, and United  States Dis-
pensatory, 10th edit. p. 1037.  Philad. 1854.
  2 Pharm. of the  United States, p. 147.   Philad. 1851.
  3 Essays on the  Effects of Iodine in Scrofulous  Diseases, &c., by O'Shaughnessy, p.
 170.   Lond. 1831.
  4 Gazette des Hopitaux, 20 Juillet, 1837; see, also, Bulletin General de Therapeutique,
Juillet, 1837; and  C. A.  Porter, in Amer. Journ.  of the Med. Sciences, Nov. 1839, p. 68. 
                        HYDRARGYRI IODIDUM.                     425

 cord1 in the syphilitic affections of children, especially of a cutaneous
 character, it is to be preferred to other forms of mercurial,  and is not
 apt to be followed by the bad effects, which, in adults, often supervene
 on the use  of other preparations.2

                      MODE OF ADMINISTRATION.
   On account of its insolubility it is given only in the form  of powder
 or pill, to the  extent of from  a grain, gradually carried to three or
 four grains, twice  or  thrice  a day.  Externally, it is applied, for the
 same reasons, in the form of ointment only.

                   Pilulae hydrargyri  iodidi.
                       Pills of iodide of mercury.
                 R.  Hydrarg. iodidi £j.
                      Confect. rosa? caninas giij.
                      Zingiberis pulv. £j.  M.

   Dose.—From five to ten grains.              London Pharmac.

            Pilulae hydrargyri iodidi compositae.
                  Compound pills of iodide of mercury.
                 R.  Hydrarg. iodid. gr. vj.
                      Extract, opii gr. iv.
                      Lactucarii gr. xxiv.
                      Ext. guaiac. gr. xlviij.
              M. Fiant pilula. xlviij.

   Dose.—For a child, half a year  old, one pill; for older children, two,
 three or  four.   In  the syphilis of children.                 Ricord.

                 R.  Hydrarg. iodid. gr. j.
                      Ext. junip. gr. xij.
                      Glycyrrhiz. pulv. q. s.
             Divide in pil. viij.

   Dose.—At first, two,  morning  and evening: afterwards, three  or
 four.                                         Magendie and Biett.
                 R.  Hydrargyri iodid. ^ij.
                      Guaiac. pulv. gj.
                      Thridac. gss.   M. et divide in pil. xlviij.

   Dose.—One a day in scrofula, syphilis, $c.               Biett?

                 Pulveres  hydrargyri iodidi-
                    Powders of iodide of mercury.
                 R.  Hydrarg. iodid. gr. i. iv., vj.. vel viij.
                     Magnes. 3j.  _
             M. et divide in pulv. xij.

   Dose.—A powder, three times a day.

  'La Lancette Francaise, No. 65, 1834.
  s Cogswell's Essay on Iodine, p. 158.  Edinb. 1837.  See, also, Ricord, Practical Trea-
tise on Venereal Diseases, translated by Drummond, Philad. 1843, and  Hocken's Com-
parative Value of the Different Preparations of Mercury and Iodine, &c. &c. in Edinb.
Med. and Surg. Journ.  April, 1844.
  • Duhamel, Amer. Journ. of Pharm. July, 1841, p. 105. 
426
HYDRARGYRI IODIDUM RUBRUM.
               Unguentum hydrargyri iodidi.
                    Ointment of iodide of mercury.
                 R.  Hydrargyr. iodid. ^j.
                     Cera, albae Jjij.
                     Adipis Jvj.  M.
                                                    Lond. Pharm.
                 R.  Hydrarg. iodid. gr. vj.
                     Morphias acetat. gr. viij.
                     Adipis :fj.  M.
  In obstinate glandular swellings.                      Pelletan.

                 R.  Hydrarg. iodid. 9j.
                     Adipis ^iss.1  M.
  In old venereal ulcers.                      Magendie and Biett.

                 R.  Hydrarg. iodid. ^ij.; (vel iij. vel iv.)
                     Adipis |ij.  M.
  As a dressing to phagedenic and scrofulous ulcers.        Lugol.

  When this salve  is first prepared, it is of a canary-yellow, sometimes
of a greenish  colour.  By time, it becomes of an orange hue, when it
must be  thrown aside, as owing to the  formation of  the red iodide, it
becomes as corrosive as  the ointment of the corrosive chloride.
                 R.  Hydrarg. iodid. £j.
                     Adipis |jj.  M.

  To  be rubbed morning and evening on the parts affected.   Poiret.*

                 R.  Hydrarg. iodid. gj.
                     Sapon. medicin. gss.
                     Aqua. rosa. ^ij.
                     Unguent, rosa? 3yj.   M.
  This ointment is said not to turn rancid so rapidly as the  common
ointment.                                                  Riecke.
           CVIII. HYDRAR'GYRI IO'DIDUM RUBRUM.
Synoxymes. Hydrargyri Deuto-iodidum seu Deuto-Ioduretum seu  Periodidum seu
  Biniodidum, Hydrargyrum Iodatum Rubrum seu Bi-iodatum seu Periodatum, Iodi-
  dum seu Iodetum Hydrargyricum, Deuto-ioduretum  Mercurii, Red Iodide, Deuti-
  odide, Biniodide or Periodide of Mercury.
French. Deuto-Iodure ou Bi-iodure ou Periodure de Mercure.
German.  Rothes Iodquecksilber, Iodquecksilber  in  Maximum, Queck-
  silber-iodid, IJeuto-Iodur  des  Quecksilbers, Doppelt  Iodquecksil-
  ber, Quecksilberdeutiodiir.

                       METHOD OF PREPARING.
 ^ The process of  the Pharmacopoeia of the United States consists in
dissolving an ounce of corrosive  chloride of mercury in  a pint and  a
half of distilled water;  and ten drams of iodide of potassium, in half
a pint of distilled water.   The solutions are then mixed, and the pre-
cipitate is collected on a filter, washed with distilled water, dried with
a moderate heat, and kept in  a well-stopped bottle.3

  1 Tiinnermann uses only gss.
  8 Bouchardat, Annuaire pour 1844, p. 140.   Paris, 1844.
  8 Pharmacopoeia of the United States, 1851, p. 147. 
HYDRARGYRI IODIDUM RUBRUM.
427
   Red iodide of mercury is  a beautiful  vermilion-coloured  powder,
which, when  moderately heated, becomes yellow, but, when exposed to
the air, is gradually restored to red,  and is volatilized.   When volati-
lized, it crystallizes in beautiful rhomboidal leaves, which, at a higher
temperature, are of a golden-yellow hue; but  at the ordinary tempera-
ture of a shining red.   It is insoluble in water;  but soluble in alcohol
and ether; and in solutions of iodide of potassium, and chloride of so-
dium.   It contains 250 parts of mercury,  and 312 of iodine.

                    EFFECTS  ON  THE ECONOMY.
   This preparation,  which was introduced into practice by the French
physicians, has been particularly recommended in syphilis complicated
with scrofula.   Biett  found  it very efficacious in  scrofulo-venereal
ulcers, in syphilitic  swellings  of the lymphatic glands, and in invete-
rate itch.  He  administered  it also internally, dissolved in alcohol
or ether, in scrofulous  affections complicated with syphilis, and with
advantage.   In  its effects, it  resembles the  corrosive chloride,  whilst
the iodide resembles the mild  chloride.  Rayer,1 indeed, considers the
red iodide more  active than the corrosive  chloride.   Paillard  found it
very efficacious in chronic cutaneous  eruptions.  He dipped a camel's
hair pencil in a weak solution of it  in ether, and pencilled the parts
with it three  or four times a day.   In this way, he cured several squa-
mous, tuberculous, and other eruptions.   It scarcely excited any pain.
As, however, this  mode of  applying it  often failed, he  employed 5j.
mixed with Sj- of oil of almonds in the same manner. If the  corrosive
action was considerable, a sense of heat soon arose in the part,  which
gradually terminated in burning pain.   The  neighbouring parts were
also hot, painful, and tumefied; and, in the course of an hour, an ef-
fusion of serum took place; but in four or five hours the pain always
disappeared.   If applied  on the cheeks  or lips, salivation at times en-
sued suddenly.  Scabs  formed, which fell off in a few days,  and  ex-
posed a  red  surface much disposed to cicatrize.  When  frequently
used, symptoms occurred, which were probably the consequences of its
being absorbed,—namely, fever, colic, diarrhoea, and dysentery.  Bres-
chet2 applied it,  in the form of ointment, with great  success, in a case
of obstinate ulceration at the angle of the eye, presumed to be carcino-
matous.  Blasius advises  it internally and externally in lupus,  and it
has been recommended highly by Dr. J. W.  Schmidt, Junr.,  of New
York,3 in cases of the same affection,  and especially in the dartre vene-
rienne.   Both the iodide and red iodide  were  given internally.  These
cases, as well as  syphilitic sore throat of long  standing, which had been
previously treated by mercury without success, Dr. Schmidt found to
yield invariably to a pill of a quarter  of a  grain of the iodide, and
a grain of extractum conii, given night and  morning, and afterwards
three times daily.  After using these  pills for  from four to eight weeks,
he substitutes the solution of  iodide  of potassium,—changing,  in the

  1 Treatise on Skin Diseases, by Dr. Willis, p. 79. See, also, Puche, Journal des Con-
naissances M .dicales, Oct. et Nov. 1838, and Janvier, 1839.
  2 Lugol's Essays on Iodine, by O'Shaughnessy, p. 204.
  8 American Journal of the Medical Sciences, Feb. 1840, p. 301. 
428
HYDRARGYRI IODIDUM RUBRUM.
first place, the action of the parts by cauterizing the throat with the
solid argenti nitras.  Dr. Schmidt has not found it necessary to carry the
iodide so far as to touch the mouth, but should it accidentally do so, he
stops the mercury, and goes on with the iodide of potassium.  Tiinncr-
mann used it with advantage, in the form of ointment, for the removal
of furuncular inflammation of the glands of the neck.   Riecke,1  like-
wise, employed it, with great success, as a discutient, (gr. xvj. to Sj of
lard,) in a case of ganglion in  the region of the knee, from which vio-
lent pain proceeded along the  nerves when it was pressed upon—and
in two cases of goitre.  Whenever it has to be applied over an exten-
sive surface, as in the disease  last  mentioned, it has generally to be
discontinued soon, in consequence of the supervention of inflammation
of the cutaneous surface.  In the form of a weak ointment—composed
of  red  iodide  gr. ij., cerate 9ij., almond oil 9j.—it has been used in
opacity of the cornea.2  A strong ointment of it, made of equal parts
of the red iodide and lard, is highly extolled in lupus, by M. Cazenave.3
It  is applied, by means  of  a  camel's hair pencil, every six or eight
days;  but as  it  causes much  jpain, it is  better to apply it only to a
small part at a time.  He considers it adapted not only for the tuber-
culous  lupus, but for the  lupus with hypertrophy, and even the ery-
thematous lupus, erytheme centrifuge of Biett.   Cod liver oil is given
internally.
   Kopp has published some favourable cases of the therapeutical appli-
cation of the red iodide.  The ointment, given below, he found very
efficacious in luxuriant, chronic, scrofulous, and  syphilitic sores, as
well as in condylomata, and venereal blotches.    No less useful did he
find it  in many  other skin  diseases, and  particularly in herpes.  In
one case, in which he administered it in the last  affection, he found a
co-existent goitre, which had been there for several years, almost wholly
disappear; and he,  consequently,  afterwards  prescribed it frequently
for the  latter  affection.  He also  used it, with excellent effect, in oph-
thalmia tarsi; and,  where  there was a disposition to the formation
of  hordeolum, a little of the  second ointment, the form for which is
given hereafter, was applied.at bed  time  to the edges of the eyelid.
Lastly, he advises friction with the first ointment in chronic rheumatic
pains, and in cases of induration of the glands, especially of the liver.
After the friction has been continued for some time, an eruption occa-
sionally appears.
  Both the  iodide and red iodide, in the form of ointment, have been
found, by Dr. Moj'sisovics,4 of Vienna, exceedingly useful in promoting
absorption.   The strength of the ointment  of the iodide, recommended
by  him, is gr. x. to  3ij« °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 $j- to Sj of simple ointment.   This ointment
spread upon leather vesicates; and the cuticle separates in the form of

  1 Die neuern Arzneimittel, u. s. w. S. 270.
  a Grafe und Walther's Journ. fur Chirurg. Bd. xiii., cited by Pereira, Elements of Ma-
teria Medica, 3d Amer. edit., i. 815, Philad. 1852.
  » Annates des Maladies de la Peau, cited in Bouchardat, Annuaire de Th.rap. pour
1852, p. 175.
  4 Darstellung einer sicheren und schnellen Heilmethode der Syphilis durch Iodpra-
parate, Wien, 1845: and Brit, and For. Med. Rev., April, 1845, p. 516. 
HYDRARGYRI IODIDUM RUBRUM.
429
a crust.  Its efficacy has been great in bronchocele:  according to M.
Moj'sisovics, on  the falling off of  the dried cuticle, the size has been
found to be sensibly diminished.  No preparation of iodide, 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 an enormous size with it, and at the first appli-
cation all the  threatenings  of suffocation  or  apoplexy—where they
existed—ceased.   Condylomata about the anus and perineum, or even
within the rectum and vagina, were cured by this  ointment; and unless
they were very extensive and indurated,  a  single application—which
is very painful—combined with the internal use of iodine, has been
found sufficient.
   The author has frequently administered the red iodide in  public and
in private practice, and in cases where an active modifier of the system
of nutrition appeared  to be needed, and where  a combination of re-
medies so  potent as mercury and  iodine suggested itself.  In chronic
glandular enlargements, especially of the liver and spleen, and in ha-
bits where the  use of mercury was not contra-indicated, both the red
iodide and  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 powder or
pill, or dissolved in  alcohol or ether, in the dose of  one-sixteenth to
one-fourth of a  grain, gradually increased daily.   Externally, it is ap-
plied  in the  form of ointment.

              Pilulae hydrargyri  iodidi rubri.
                    Pills of red iodide of mercury.
                R.  Hydrarg. iodid. rubr. in syrup, commun.
             pauxill. terendo bene distribuend. gr. v.
                    Micas panis alb.
                    Sacch. pulv. aa. q. s. ut fiant pilula. Ix.
   Dose.—Two, morning and evening, drinking afterwards a cupful of
oatmeal gruel.   The dose to  be raised  gradually.          Blasius.

             Tinctura hydrargyri iodidi rubri.
                  Tincture of red iodide of mercury.
                R.  Hydrarg. iodid. rubr. 9j.
                    Alcohol 36° (.837) fgiss.  M.
   Dose.—Ten to twenty drops, in a glass of distilled water.
                                            Magendie and Biett.

      Syrupus hydrargyri iodidi rubri  compositus.
               Compound syrup of red iodide of mercury.
                R.  Hydrarg. iodid. rubr. gram. i. (gr. 15.434 Troy.)
                    Potass, iodid. gram. 50.
                    Aqua?, gram. 50.
      Dissolve, filter through paper, and add
                    Syrup. (30° when cold,) gram. 2400.
   A table-spoonful of this syrup is a dose.  It represents, provided it 
430                     HYDRARGYRI NITRAS.

holds 25 grammes of the syrup, a centigramme of red iodide of mer-
cury, and 50 centigrammes of iodide of potassium.          Gibert.1

    JEther  sulphuricus cum  hydrargyri iodido rubro.
               Sulphuric ether with red iodide of mercury.
                 R.  Hydrarg. iodid. rubr. 9j.
                     iEther. sulph. f^iss.  M.
   Administered like the last.                  Magendie and Biett.

           Unguentum  hydrargyri iodidi rubri.
                   Ointment of red iodide of mercury.
                 R.  Hydrarg. iodid. rubr. in pulv. subtiliss. gr. vj.
                     Adipis 9vj.  M.                     Kopp.

                 R.  Hydrarg. iodid. rubr. in pulv. subtilissim. gr. \ to \.
                     Adipis 3ij.
                     Ceraa albse gr. ij.
      M. fiat unguentum.
   For an eye-salve.                                        Kopp.
                 R.  Hydrargyri iodid. rubr. gr. xv.
                     Adipis £ss.
      M. exactissime.  Fiat unguent.
   As a dressing in lupus.                                Blasius.

                 R.  Hydrarg. iodid. rubr. gr. xv.
                     Adipis ^ij.
                     01. bergamot. gtt. x. M.
   To be rubbed on the parts in  chronic cutaneous affections.
                                                            Biett.
                 R.  Hydrarg. iodid. rubr. 9j.
                     Adipis Jjiss.  M.
   To be spread on lint in old venereal  ulcerations.           Biett.

   The unguentum hydrargyri biniodidi of the London College is pre-
pared like the ung. hydrarg. iodidi.
                   CIX. HYDRAR'GYRI  NITRAS.
Synonymes.  Hydrargyrum  Nitratum.
French. Nitrate ou Azotate de Mereure.
German. Salpetersaures  Quecksilber.

  There are two  nitrates of mercury employed in medicine:
                  I. HYDRARGYRI PROTONITRAS.
Syxonymes.  Hydrargyrum Nitricum Oxydulatum, Mercurius Nitrosus Frigore para-
  tus, Nitras Hydrargyrosus, Protonitrate of Mercury, Neutral Nitrate of Suboxide of
  Mercury.
French. Protonitrate de Mereure.
German.  Salpetersaures Quecksilberoxydul, Kaltbereitetes Salpeter-
  saures Quecksilber.
                        METHOD  OF PREPARING.

  This salt is formed by digesting excess  of mercury in cold dilute ni-
tric acid, until short prismatic crystals are formed.  It is soluble with-

                 1 Journ. de Pharmacie, Oct. 1841, p. 634. 
HYDRARGYRI NITRAS.
431
out decomposition in a  small quantity of water; but in much water
its crystals  are decomposed  into a yellow powder—bibasic nitrate of
suboxide of mercury, and  an acid liquor, which contains a soluble su-
pernitrate.
                     EFFECTS ON THE ECONOMY.
  The effects of protonitrate of mercury, according to  Dr. Pereira,1
may  be considered  intermediate between those of calomel and corro-
sive sublimate; and he considers it  probable, that  after its  ingestion
it becomes converted into calomel by the action of the alkaline chlo-
rides in the alimentary canal;  and Mialhe2  states, that  if atmosphe-
ric oxygen and an excess of alkaline chloride be present, a portion of
corrosive  sublimate  is formed.  Sundelin3 employs  it in all cases in
which  the corrosive  chloride  is used, and especially in  the different
forms of chronic syphilis; and Cazenave extols it as an excellent an-
tisyphilitic.   It is not  often given, however, internally.   Externally,
it  has been used by  Biett and others  in  chronic cutaneous diseases in
the form of ointment.

                     MODE OF ADMINISTRATION.
   The dose of the  protonitrate of mercury is from  one-sixteenth to
one-eighth of a grain in the form of pill, made with extract of liquor-
ice.   Sundelin gave it in the dose of from one-eighth of  a grain  to a
grain.
              Liquor  hydrargyri  protonitratis.
Solution of protonitrate of mercury. (Liq. Hydrarg. Nitrici, Ph. Boruss. 1847.)
                 R.  Hydrargyri protonitrat. ^j.
                     Aquae destillat. § viij.
                     Acid, nitric, ^iiiss.
  Mix the acid and water before the protonitrate is added; filter, and add water, if
necessary, to make the liquor of the sp. gr. 1.100.  Preserve it carefully in a stopped
vessel.
   Dose, three drops.
              Pilulae  hydrargyri protonitratis.
                    Pills of protonitrate of mercury.
                 R.  Hydrarg. protonitrat. gr. vj.
               Solve in aquae destillat. pauxillo; et adde
                     Succ. glycyrrhiz. pulv.
                     Rad. althaea, pulv. sing. gj.
                 M. et fiant pilulae xcvj.
   Dose.—Two pills twice a day.                         Sundelin.

           Unguentum  hydrargyri protonitratis.
                  Ointment of protonitrate of mercury.
                 R. Hydrarg. protonitrat. gr. xv.
                     Adipis 5J.  M.
   In chronic cutaneous diseases.               Biett and Cazenave.

  1 Elements of Mat. Med. and Therap. 3d Amer. edit. i. 817.  Lond. 1852.
  2 Traite" de l'Art de Formuler, p. 72. Paris, 1845.
  3 Horn's Archiv., Jahrgang. 1827, St. 1, p. 164; and Dierbach, Die neuesten Entdec-
kungeu in der Mat. Med. 3er Band, lste Abth. S. 302.  Heidelb. und Leipz. 1845. 
432
HYDRARGYRI NITRAS.
                  II. HYDRARGYRI DEUTONITRAS.
Synonymes. Hydrargyri Pernitras seu Dipernitras seu Supernitras, Hydrargyrum Ni-
  tricum Oxvdatum, Mercurius Nitrosus calide paratus, Nitras Hydrargyricus, Deu-
  tonitrate, Pernitrate, Dipernitrate or Supernitrate of Mercury.
French. Deuto-nitrate ou Dipernitrate de Mereure.
German. Salpetersaures Quecksilberoxyd, Heissbereitetes  Salpeter-
  saures Quecksilberoxyd.

                       METHOD OF  PREPARING.
  A solution of this salt is formed by boiling mercury in strong nitric
acid until the liquid, when diluted with water, ceases to yield a white
precipitate  (calomel)  on the addition of a solution of common salt.
By evaporating, crystals are formed.

                      EFFECTS ON THE ECONOMY.
  This salt is more acrid and caustic than the protonitrate.  It is con-
sidered to be converted into corrosive sublimate by the alkaline chlo-
rides with which it comes in contact in  the intestinal  canal; and  the
action of the two  substances, may, therefore, be regarded as  the same.
It is scarcely ever administered internally; but when so, the  dose may
be  one-sixteenth  of a grain.   It is often, however, used externally,
and especially in  the form  of Liquor Hydrargyri  Supernitratis
seu Pernitratis, Nitras Hydrargyricus Acido Nitrico Solutus, Solu-
tion of Supernitrate of Mercury, Liquid Acid Beutonitrate of Mer-
cury, Acid Nitrate of Mercury: French, Beutonitrate Acide de Mer-
eure Liquide, Nitrate Acide de  Mereure;  which  is made,  according
to  the Parisian  Codex, by dissolving  100  parts  by weight of mer-
cury in 200 parts by weight of nitric acid, sp. gr. 1.321, and  evapo-
rating the solution to 225 parts.1
   The following formula for the preparation  of the Hydrargyri Per-
nitratis Liquor is given in the last Dublin Pharmacopoeia.2  Take of
pure  mercury, S\j- (avoirdupois;)  pure  nitric  acid, Siss; distilled
water, Siss.  In  the acid, first  diluted with the  water, dissolve the
mercury, with the application of heat, and evaporate  the solution to
the bulk of two ounces and  a half.  It is chiefly as a caustic that  this
solution has been used, as by Biett, Petrequin,3 and others, in  lupus;
and, by the French surgeons especially, for the purpose of cauterizing
the ulcerated cervix uteri.41  Biett applies it  to  the extent  of  a five-
franc  piece, by  means  of  a camel's hair  pencil; and  then  applies
lint  dipped in  the  solution  to the cauterized surface.   The parts
immediately  become  white,  and  a yellowish  eschar  forms,  which
apparently adheres  strongly  to  them, but gradually separates.5  By
 Chardon it has  been employed successfully as an injection in gonor-

  1 Trousseau and Pidoux, Trait, de Th.rap. et de Mat. M.d. 3e  .dit. i. 185.  Paris, 1847.
  2 The Pharmacopoeia of the King and Queen's College of Physicians, 1850, p. 89.  Dub-
 lin, 1850.
  3 Revue M.dicale, Paris, 1848, and Brit, and For.  Medico-Chirurg. Review, April,
 1849, p. 538.
  * J. H. Bennett, A Practical Treatise on Inflammation, Ulceration and Induration of
 the Neck of the Uterus, Amer. edit. p. 106.  Philad. 1847.
   s Dierbacb, Op. cit. S. 304. 
HYDRARGYRI NITRAS.
433
  rhoea, a few drops being added to a glassful of water, and thrown up
  four  times a day.1   By Devergie it was  applied beneficially in tinea
  favosa ; and  by Camus in freckles.   Godard used it successfully in
  herpes scrophulosus exedens; and in various obstinate cancerous ulcers,
  and other chronic cutaneous affections, it has been prescribed with good
  results; and Godemer2 has strongly advised it as a cauterizing agent
  to the pharynx in cases which require such applications.  He employs
  a solution of one part of the acid nitrate to four or five of water, and
  applies it, by means of a camel's-hair pencil, passed once over the part,
  and gargling immediately afterwards.
    At the Hospital for Cutaneous Diseases in London, the acid nitrate
  is used as a very convenient form of caustic.  Its formula is hydrarg.,
  Sj.; acid, nitric, (s. g. 1.50) Sij.; dissolve.  In carbuncle, Mr. Startin^
  paints it freely on a central spot  of about the size  of a shilling.  An
  eschar is produced, from beneath which the core  escapes.  In acne,
  whether suppurated or not, a very minute  drop, placed by a finely-
  pointed glass  brush on the apex of an indolent tubercle, causes  its
  disappearance.  In large boils,  the same  treatment is effectual.   In
  lupus, where there are indolent  tubercles and indurated patches, not
  actually ulcerated, he finds  it one of the most efficient and convenient
  forms of caustic.  In many cases of  sloughing  or unhealthy ulcers-,
  Mr. Startin  has  employed  it with  advantage; and the  rapidity with
  which the surface granulates afterwards,  he says, is often surprising.
  In moles, nsevi, &c, he  has employed it with satisfactory results.
   M. Venot,* surgeon of the Venereal Hospital at  Bordeaux, has ob-
 tained the  best results from the employment of  an ointment  of the
 nitro-tannate of  mercury in indolent  syphilitic tertiary ulcers.   The
 form he employs is the following.

                 R.  Adipis ^j.
                     Acid, tannic, gr. lxxv.
                     Hydrarg. nitrat. acid. gtt. 12.  M.

   Constitutional effects are said to have supervened on its local employ-
 ment.   Bveschet saw salivation  induced  by a single  application of  it
 to the neck of  the uterus. *   To prevent  this, the part may be washed
 well after it has been touched.
   The well-known Unguentum Hydrargyri Nitratis, Citrine Oint-
 ment, of the Pharmacopoeia of the United States, is formed of the deu-
 tonitrate of mercury.

  1 Froriep's Notizen, B. 28, No. 3, p. 46, cited by Dierbach.
  2 Journal de Medecine de la Cote d'Or, Mai, 1847, cited in Bouchardat, Annuiire de
 Therapeutique, pour 1848, p. 184.
  3 Med. Times and Gazette, Jan. 6, 1855.
  4 Revue Th.rapeutique du Midi: and Journal de Pharmacie, Seme s.rie, xxiv. .63.
Paris, 1853.
  5 Op. cit. p.  191.

       28 
434
HYDRARGYRI ET ARSENICI IODIDUM.
          CX. HYDRAR'GYRI ET ARSENTCI IO'DIDUM.
 Synonymes. Arsenici et  Hydrargyri Iodidum, Hydriodas  Arsenici et Hydra.gvri,
  Iodide or Hydriodate of Mercury and Arsenic, I )ouble Iodide of Arsenic and i\_er-
  cury, Iodo-arsenite of Mercury, Donovan's Solution.
  Mr. Donovan1 has  proposed this new  compound, which he  regards
as more  efficacious than either the iodide of mercury or the iodide of
arsenic.
                       METHOD OF PREPARING.
   Triturate  6.08 grains of  finely levigated 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 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 hydri-
odic  acid, prepared by the  acidification 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 exactly that measure
with distilled water.   Finally, filter.2
   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 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 mercury.   The  quantity of water is
such, that each  dram  by measure of the solution  will contain exactly
one-eighth of a  grain  of arsenious  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.
  On repeating Mr. Donovan's process, M. Soubeiran3 found, that a
portion of arsenic remained undissolved, and he therefore proposed the
following mode of preparation: Take of teriodide of arsenic, gr. xxxv.;
biniodide of mercury,  gr. xxxv.;  boiling distilled water, f Sviij.   Tri-
turate until dissolved,  and filter; and, if necessary, add sufficient water
to make Sviij. of the solution.  A similar formula has been recommended
by Mr. Procter,4 of Philadelphia, who employs 36 grains of the  terio-
dide  of arsenic, and 34 grains of  the  biniodide to  Sviij. of water.
  Of the preparation above described, which Mr. Donovan calls liquor
hydriodatis arsenici et hydrargyri, (liquor arsenici et hydrargyri iodidi
seu  hydrargyri iodo-arsenilis,) each  dram  by measure  consists—he
considers—of water, one dram; arsenious acid, one-eighth of a grain;
peroxide of mercury, one-fourth of a grain; iodine, converted into hy-
driodic acid,  about three-fourths of a grain.  The colour of the solution
  1 Dublin Journal of Medical Science, Nov. 1839, p. 281.
  2 Donovan, Dublin Journal, Nov.  1842, p. 171.
  3 Journal de Pharmacie, xxvii. 744.  Paris, 1841.
  4 American Journal of Pharmacy, June, 1847, p. 93.   A form for the preparation of
the Arsenici et Hydrargyri Hydriodatis Liquor has been introduced into the last edition of
the Dublin Pharmacopoeia,  1850. 
HYDRARGYRI ET ARSENICI IODIDUM.
435
is yellow, with a pale  tinge of green: its taste is slightly styptic.  It
is incompatible with tincture of opium, or with sulphate, muriate, or
acetate of morphia.
  The test of the perfection of the preparation, according to Mr. Dono-
van,1 is, that the whole of the iodine, arsenic and mercury shall disap-
pear, 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 sufficiently long continued.
  A Liquor Arsenici et Hydrargyri Iodidi has been admitted into
the last edition of the  Pharmacopoeia of the United States (1851.)  It
is directed to be prepared as follows:—Take  of iodide of arsenic, red
iodide of mercury, each gr. xxxv.; distilled water, Oj.   Rub the iodides
with half a fluidounce of the water; and when they have dissolved, add
the remainder  of  the water, heat to the boiling point and filter.

                  effects  on the E.0N0MY.
  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 countrymen 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.2  Mr.
Colles administered it in two extreme cases of scrofulous ulceration in
the adult with  some benefit; Dr. Croker gave  it internally, and applied
it externally, with complete success, in a case of psoriasis guttata ; Dr.
Graves treated with it a very inveterate case  of psoriasis with decided
advantage; Dr. Irvine completely cured by it  a most virulent case of the
same affection; Mr. Cusack found, that venereal eruptions yielded ra-
pidly 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 increased 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 numerous
others  from the practice of Dr. Charles O'Reilly, Sir Henry Marsh,
Dr. Robert J.  Hickson, Dr. J. D. White, Mr. Richard Jones, Dr. Big-
ger, Mr. O'Ferrall, Dr. Ferguson, Dr.  Osbrey, Dr. W.  T.  Hamilton,
Dr. Graves, Dr. Kirby,  Mr. Gabriel Stokes,  and  Dr. C. P. Croker,
which led him  to infer, that the diseases in which the preparation has
been found of  most service are the various forms of psoriasis, impetigo,
porrigo, lepra, venereal eruptions—both papular and scaly, pityriasis,
sycosis, ephelis, lupus, sibbens,  and some uterine diseases.3  In several
of the  cases, slight ptyalism was induced.

  1 Dublin Journal, Sept. 1840, p. 106.     2 Dublin Medical Press, Jan. 18, 1840.
  3 Dublin Journal of Medical Science, Nov. 1842, p. 199, and Erichsen, London Medi-
cal Gazette, May 12, 1843, p. 238, and May 19, 1843, p. 241. 
436
HYDRARGYRI ET ARSENICI IODIDUM.
   Dr. Isaac E. Taylor, of New York,1 prescribed this  preparation in
 a number of cutaneous diseases;  and he  testifies,  that it produces a
 more marked and prompt effect than the various  remedies usually re-
 sorted to in lupus, rupia, psoriasis, secondary syphilis, &c.  It is also
 spoken of in high  terms by Dr. Gerald Osbrey,2 in inveterate  psoria-
 sis, lichen urticatus, and scrofulous ophthalmia.

                     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. Donovan3
 recommends the following form:—

     Mistura  liquoris arsenici  et hydrargyri iodidi.
          Mixture of solution of iodide of arsenic and  mercury.
                 R.  Liq. arsenic, et hydrarg. iodid. f 3ij-
                     Aquae destillat. f 3-iiss.
                     Syrup, zingib. f S;ss.  M.
             Divide in haustus iv.
   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 in-
 gredients by the use of a metallic spoon, as a measure,—the  general
 way in which doses of medicine are administered.   When applied  ex-
 ternally in cutaneous affections, it may be diluted with  an  equal por-
 tion of  water, or farther—should  a weaker lotion be  indicated.  Mr.
 Donovan states, that the employment of this preparation was  rapidly
 extending, as shown by the  fact,  that within two  years and  a half,
 about three hundred pints of it had 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, lodure double
 de mereure et de morphine, has been recommended by M. Bouchardat.3
 It is obtained by treating in boiling  alcohol, a  mixture of  equal parts
 of red iodide of mercury, and iodhydrate  or hydriodate of morpliia.
 On cooling,  crystallized grains are deposited of a double  compound,
 having a white, slightly yellowish 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, which
may be given once a day in the form of pill in constitutional syphilis;
gradually increasing the dose, especially  in syphilitic pains  of  the
bones.
  1 American Journal of the Medical Sciences, April, 1843, p.  319.
  2 Dublin Journal of Medical Science, July, 1842.
  * Ibid. Nov. 1839, p. 282.                     * Ibid. Nov. 1842, p. 199.
  5 Nouveau Formulaire Magistral, p.  303.  Paris, 1845. 
INDIGUM.
437
                          CXI. INDIGUM.
 Synonymes. Indicum, Indicus Color, Pigmentum Indieum, Indigo.
 French. Indigo.
 German. Indig.
   This well-known colouring material is obtained from several species
 of the genus Indigofera (I. tinctoria, L anil, I.  disperma, 1. argentea,
 and  I. hirsuta,) belonging to the Natural Family Leguminosre, and,
 in the Linnsean System, to Diadelphia Decandria.   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 which 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,  and
 argillaceous and  siliceous earth.  With hydrogen,  pure indigo forms
 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  twenty years that
 attention has been paid to it in  Europe.  Prof. Von Stahly,1 of Ofen,
 appears to have first employed it with success in various spasmodic dis-
 eases, especially in epilepsy.   To these cases Lenhossek alludes, in de-
 tailing certain  trials which  he himself had  made with  it.  In  1833,
 Grossheim2 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 al-
 most every remedial agent.   They 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  period, terminated
 in a  comatose state, from  which  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, touch-
ing the remedial properties of indigo, in the  Charite at Berlin, the re-
sults  of which have  been  given by  Roth.3   In most of the cases, it
excited  nausea, and  even  vomiting,  preceded 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

          1 Hecker's Neue Annalen, B. i. H. 1.  Berlin, 1835.
          2 Medicinischc Zeitung, No. 51, 1833.
          8 Hecker's Neue Annalen,  B. i.  Heft. 1.  Berlin, 1835. 
438
INDIGUM.
its place.   All the patients did not vomit, and many escaped the diar-
rhoea.   When  once  diarrhoea occurred, however, it commonly persist-
ed as long as the indigo was used.   The  evacuations were seldom en-
tirely fluid, but usually semifluid, and of a dark  bluish-black colour.
While the vomiting and purging continued,  more  or less uneasiness
was experienced in the digestive apparatus.   The vomiting and diar-
rhoea were frequently accompanied by pains in the stomach and bow-
els, which were commonly slight, but occasionally  so violent that it
had to be discontinued.   In every patient at the  Charit6, the urine
was of a dark violet hue.  Von Stahly affirmed, that the perspiration
was coloured blue, but this Roth never observed.  He remarked, more-
over,  that after its use 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 it, were at first
more  frequently attacked with spasms than prior to the  use of the re-
medy.  In the beginning, the attacks of the disease were, in all cases,
stronger, but of less duration, than previous 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 expi-
ration of  this time, all the epileptic  symptoms were diminished in in-
tensity and duration, until the last attacks were mere premonitions.
   The number of epileptic cases, treated by it, which Roth had an op-
portunity of observing in the Charite,  was twenty-six;  of these  nine
were  cured, eleven improved, and six remained.
   Dr. Ideler,1  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,2 which of  themselves might have  induced
epilepsy.
   Dr. Strahl,3 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's dance.  In  four  cases of hysteria, it ex-
cited violent nephralgia, and in one of the cases, only after the affec-
tion of the kidney was removed  was the patient cured.   It acted, how-
ever, markedly on the uterus; in two cases spasmodic affections,  com-
plicated 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
Charite, a dark violet hue was  constantly noticed.
   Favourable cases are  also  detailed by Drs. Mankiewicz of Nackel,4

  1 Medicinische Zeitung, No. vi. cited in Lancet, June 6, 1835.
  2 Op. cit. S. 276, and 2te Auflage, S. 389.   Stuttgart, 1840.
  * Hecker's Neue Wissenschaft. Annalen, 1836; cited in Edinb. Med. and Surg. Journ.
1837.                        * Medicin. Zeitung, 31 Mai, 1837, S. 109. 
INJHGUM.
439
and Hohnhorst, of Frankfort.1  M. Podreca2 found it especially effi-
cacious when associated with assafcetida and castor.
  M. Noble,  of Versailles,3 administered it  in three  cases, in which
the disease had continued for four, twelve and twenty years respect-
ively.  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  considered 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 in-
duced,  which ceased, however, as soon as the indigo was discontinued,
or the  dose reduced 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 favourable to
it.  In none  of the epileptics to whom he gave it was  there any thing
more than a slight amelioration.  In the Hospice d'Hommes Incurables
of the  Faubourg St. Martin, trials were 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 its exhibition 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 sus-
tained, 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 discon-
tinued  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,4 one of the senior resident physicians at
the Philadelphia Hospital, published the  results  of some trials  made
with it, which, so far as they go, confirm its antiparoxysmal power.
Two  of the  seven  cases reported were  apparently cured, two ame-
liorated,  and  three  without any  decisive results—the  medicine  not
having been continued  perhaps for a  sufficient  length of time.  In
these cases, it was commenced in the dose of 3j., which was usually
doubled daily until  the  patient  took SijJ daily,  which quantity was
persevered in for some weeks.  In some of the cases, the faeces, urine,
and perspiration were all coloured blue.
  In other trials, instituted in the  same  charity, with indigo, the re-
sults were not as favourable.5  It is obvious, indeed,  that  a  wide  dif-
  1 Ibid. S. 110, and Medicin. Zeitung des Yereins fur Heilkunde in Preussen, 1837,
No. 22.
  2 Bouchardat, Annuaire de Therapeutique, pour 1843, p. 69.  Paris, 1843.
  3 Bulletin G.neral de Therapeutique, 1836.
  * American Medical Intelligencer for July 15,  1839, p. 122.
  B William II. M'Kee, in American Med. Intelligencer, Sept. 16, 1839, p. 177. 
440
INDIGUM-
ference  must exist amongst cases of epilepsy,, and that where  the
organic  modifications are considerable, as indicated 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 di-
minished under its use.  Where  the cerebral  affection  is  slight, and
more functional than organic, like artemisia and other remedies  ex-
tolled in epilepsy, it may be useful.   Its main efficacy, perhaps—as
has been said of the Ferri Subcarbonas (p. 385,)—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. Pereira1 states, that he has tried it in a  considerable number of
epileptic cases at the London Hospital, but without deriving the least
benefit from it.

                    MODE  OF ADMINISTRATION.
  As indigo is extremely light, the powder is  too  bulky for adminis-
tration :  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 pulvis aromaticus, or 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 following formulae were  generally
employed:—
                         Pulvis  indigi.
                       '• Powder of indigo.
                R. Indig. in pulv. subtilissim. £ss.
                    Pulv. aromat. gr. v.   M. et fiat pulvis.
  A powder to be given four times a day.

                  Pilulae  indigi compositae.
            Compound pills of indigo.—(Antiepileptic Pills.')
                R. Indig. gr. lxxv.
                    Assafoetid. gr. xv.
                    Castor, gr. vij.  M.
             et divide in pilulas xx.
  One to be given every hour.                          Podreca.

                     Electuarium indigi.
                        Electuary of indigo.
                R.  Indig. pulv. aquas guttis nonnullis subact. gij.—^ss.
 >                   Pulv. aromat. ^ss.
                    Syr. simpl. fgj.
             M. et fiat electuarium.
  To  be  used in the course of the day.                      Ideler.

         1 Elements of Mat. Med. &c, 3d Amer. edit. p.  860, Thilad. 1854. 
INJECTIONES IN TUBAM EUSTACHIANAM.
441
CXH. INJECTIONES AERIS, _ETHERIS VAPORIS, &c. IN TUBAM
                       EUSTACHIANAM.
Synonyme. Injections of Air, Vapour of Ether, &c., into the Eustachian Tube.
  An important improvement in the understanding and  treatment of
diseases of the ear has resulted from the attention that has been paid
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  dis-
eases of the  ear, and, as a consequence, they have furnished largely
to empiricism; so that an  exclusive aurist has been, too often, per-
haps, esteemed synonymous with an exclusive empiric.  Now, that the
physiology of the outer and middle ear is better understood, their pa-
thological relations are no longer environed with the same difficulties.
The  attention of the surgeon has to be first  directed to the meatus
externus, and if  he discovers any obstacle,—as hardened cerumen,—
which prevents  the vibration of a sonorous body from reaching the
membrana tympani, such obstacle  must be removed.  Should no de-
fect 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 any defect—organic or functional—be seated there.
Such are the main subjects  of investigation in cases of deafness;  al-
though 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 accumulation of mucus in  the
tympanic cavities.  In the former case, catheterism is  demanded; in
the latter, injections of air, in addition.
  For the purpose of  catheterism, various instruments have been  em-
ployed.  The catheter of Itard is a conical silver tube, curved at the
extremity, with a slight enlargement to  prevent laceration of the mem-
brane.   Kramer's instrument is a modification of that  of Itard;  the
curve is more gradual, and the enlarged or button point is  omitted.
It is  made of silver, six inches long, and is of  a calibre varying from
the size of a small crow-quill to  that of a large goose-quill.   The ex-
                  Catheter of Itard, (Reduced one-half.)
tremity 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 with
the lateral situation of the mouth of the Eustachian tube.  It is nearly 
442
INJECTIONES IN TUBAM EUSTACHIANAM.
of the same calibre throughout 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 added 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.1  When it is requisite to sound the
Eustachian tube, a piece of catgut may be passed through the instrument.
   The catheter recommended by Mr. Pilcher2 admits of being passed
farther into the tube, and has a more gradual curve.  Deleau3 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
Eustachian tube being above  the level of the floor of the nose: in this
way the tube enters, and is readily felt  by the operator to have done
so. The instrument is then carried onwards, until its farther progress
is prevented by the 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 mem-
brane may be lacerated, and pain will certainly be produced.4  When
Mr. Pilcher's catheter is fairly introduced, it will remain without sup-
port,  an advantage it possesses—in the opinion of its proposer—over
those of Itard and Kramer, which require a frontal bandage to retain
them  in situ.  Itard's bandage is represented in the next figure.  It
Frontal Bandage of Itard.
consists of a middle piece made of metal, bent so as to fit the arch of the
forehead, and slightly padded within;  to this are attached two straps,
which fasten with a buckle.  To the centre of the middle piece, a pair
of forceps are  attached, which  move  in a ball and socket joint, and
the blades of which are  brought together by a screw.  The bandage is
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 position.  Through the catheter thus in-
troduced, aurists were in the habit of sending lukewarm water through

  1 Kramer, Diseases of the Ear, chap. 2, Amer. Med. Library edit. Philad. 1838.
  2 A Treatise on the Structure, Economy and Diseases of the Ear, p. 304.  London, 1838.
  3 Op. cit. p. 305.                                   * Op. cit. p. 305. 
INJECTIONES IN TUBAM EUSTACHIANAM.
443
the Eustachian tube into the cavity of the tympanum;x but owing  to
certain objections that apply to the employment of fluids, Deleau2 sug-
gested the air douche, or injections of air for the purpose of  clearing
the cavity; and this is regarded by Kramer3 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,  10J  inches
  high, made of molten brass;  the
  diameter of its calibre is 4 J inches,
  and it is fastened at b with strong
  screws, on  a  strong oaken  stand
  of the height of an ordinary stool.
  Within the cylinder c b is a  pump
  barrel of wrought brass screwed
  into it, which measures 10 J inches
  in height, and 2 } inches in diame-
  ter, rising, at  cl a, 3 inches  out of
  the cylinder,  so that the whole
  machine a . 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 (/. There is a second valve in
  the bottom of the pump barrel,
  through which the  air is  forced
  into the interior of the cylinder.
                                              Air-press of Kramer.
   Mr. Wilde4 considers Kramer's press to be by far the best, and most
easily managed.  He  uses, however, a pump, which is figured in the
accompanying illustration.   It may not, he says, be  so easily managed
  1 See some cases of deafness relieved in this way, by John H. Dix, in Boston Medical
and Surgical Journal, Sept. 25, 1839, p.  105.
  2 Sur le Cath.terisme de la Trompe d'Eustache, &c.  Paris, 1828; Itard, in Mem. de
l'Acadi'm. Royale  de  Medecine, Tom. v. Fasc. 4.  Paris, 1836;  and Translation in
Medical and Surgical Monographs, vol. i. p. 75,  of Amer. Med. Library, p. 86.  Philad.
1838.                                             3 Op. citat. p. 164.
  * Practical Observations on Aural Surgery, &c., Amer.  edit. p. 77.   Philad. 1853.
 
444            INJECTIONES IN TUBAM EUSTACHIANAM.
 as that of Kramer, in which the piston rod is worked by a long lever;
 but it possesses the advantage of having the receiver quickly, and more
 effectually, charged.  The instrument is fourteen inches high, exclusive
 of the piston rod, and four and a half in diameter.   The cylinder of
 the force pump, which rises above the surrounding receiver, and passes
 into it for about two-thirds of its depth, is provided with valves  through
 which the air is accumulated in the latter to the required extent.  Gene-
 rally six  or seven strokes of the piston are sufficient for this purpose.
   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. Pilcher1 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 de-
 clare his  conviction,  that the ceremony and inconvenience of the  air-
 press may be dispensed with.   He recommends, that the operator should
 merely steady the instrument with  his left  hand, whilst he uses  the
 syringe with his right.   By this  means, any fluid  or  gas injected
 through  the  catheter may be brought into  contact with  the  mucous
 membrane, and thus  stimulate the  nerves of the cavity.   Nor is the
 air-press entirely devoid of  danger.   Inflammation and even suppura-
 tion is sometimes caused by the air douche.  This occurred, in seven
 cases, to M. Itard; and Mr. Henry Savage2 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 Eusta-
 chian tube, immediately  on  removing  the  instrument from  the nostril
 the patient fell back in  the chair, and never spoke afterwards.3   The
 sudden shock to the  nervous system was probably the  cause of death;
 and it has been suggested, that, to  avoid too great a degree of pres-
 sure,  the nozzle of the tube of the air-press should be held,  during the
 operation, so loosely in the dilated end of the catheter, that there may
 be room for air to regurgitate;4 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  im-
 portance of care, is the fact, that the mucous membrane may  be rup-
 tured, and serious emphysematous tumefaction be occasioned.
   It  is proper to observe, that the results of 258  cases, treated by
 Itard,5 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  ex-
ploring obstructions of the tympanum by the crepitation which often

  1 Op. cit. p. 307.
  2 Lond. Med. Gaz. for July 20, 1839, p. 616.  M. Lynch, in Lancet, Aug. 3, 1839, p.
683, and Ibid. p. 690; and Joseph Williams, Treatise on the Ear; including its Anatomy,
Physiology and Pathology, &c, p. 242.   Lond. 1840.
  3 Lond. Med.'Gazette, July 6, 1839, p. 538.
: * British and Foreign Medical Review, July, 1839, p. 95.            & Op. citat. 
INJECTIONES IN TUBAM EUSTACHIANAM.
445
accompanies them,  douches of air  can afford  no certain index;  and
secondly, that as a  mechanical agent for deterging or evacuating ob-
structing matters, they can only dislodge and force them together; and,
consequently, that both in the first and second point of view, douches
of air do not deserve the confidence of the profession.
   The vapour of acetic ether has been injected into the middle ear
in cases of nervous  deafness, of which Kramer1 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 vapourized.   The
ether is, however, decomposed in this manner,  so that it is not ethere-
ous 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 vapourize 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  incon-
venience he proposes  to remedy in the
erethitic form of nervous deafness, in
the following way:—A large glass flask
—represented in the  accompanying fi-
gure—holding about ten quarts, is firmly
and closely stopped  with a cork through
which are  passed two  brass tubes, each
provided with a cock; one of these tubes
is connected  above with a  funnel  for
dropping in the fluid, and the other with
an air-tight tube to  conduct the vapour
generated  and enclosed within the flask,
into the cavity of the tympanum.  When
the apparatus is to be used, the cork  is
to be firmly fixed into  the  neck of the
flask, with two tubes attached, and the
cocks  closed; the  proper quantity of
ether is then to be poured into the fun-
nel, and forced into the flask by a gen-
tle 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.
Vapour Apparatus of Itard.
 1 See. on this subject, T. Wharton Jones, in London Med. Gaz., August 3, 10, 17, and
24; 1^39. 
446
INJECTIONES IN TUBAM EUSTACHIANAM.
  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 unnecessary to make use of warm water to pour into the
flask, as the ordinary temperature of the room is sufficient to vapourize
the ether.
  In  the torpid form of nervous deafness, this  method of procedure
does not answer, owing  to the necessity for greater  excitation than it
is capable of effecting.   In such a case, a modification of the appara-
tus 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 conse-
quence the temperature  of  the vapour generated never  remains for a
moment the same,  but varies extremely: immediately  after the inser-
tion of the red-hot saucer, the vapour issues burning hot into the ear,
Vapour Apparatus of Kramer.
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 bell-glass of the apparatus rests, a thin metal plate is  sub-
stituted,  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 apparatus, 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 individual is to be benefited
by the plan in either form of deafness—an improvement ought to be
perceptible.
  This course of treatment, aided, occasionally, by attention to  the
state of the system, has,  in Kramer's hands, been attended with satis- 
INJECTIONES IN TUBAM EUSTACHIANAM.
447
factory results, and has been adopted with advantage by others, with
a more or less modified apparatus.1  In a more recent work, however,2
he states,  that his mode of treating nervous deaf ness is essentially the
same as that previously described by him—the introduction of stimu-
lating vapours into the cavity of the tympanum; but, instead of the
vapour of acetic ether, which he formerly recommended, but which, of
late years, he had found too stimulating, and therefore not so well borne,
he now advises the vapour of Aqua  assafcetidae simplex, of musk, of
Aqua amygdal. amar. sine spiritu parata, and the like;—and, as else-
where remarked, after all the revival that has taken  place  in regard
to aural medicine and surgery, chiefly through the writings of Deleau,
Itard, Kramer and others, it would seem that but little permanent be-
nefit has resulted from the new methods of treatment;  unless where
there has  been partial obstruction of the Eustachian tube; and  then
perhaps the most valuable agent is the elastic gum catheter of M. Deleau,
which the patient can be readily taught  to pass into  the tube  through
the nose,  and if the outer extremity be  bent down  and  inserted into
the mouth, the  middle ear can be inflated by the  patient's breath.
Temporary improvement in hearing follows the insufflation, and  as a
palliative method, where nervous deafness exists, it may be serviceable.
"Every honest surgeon must, however, express his disappointment in
the methods that were so strongly urged some years  ago;  and  admit
that the benefit derived from them in nervous deafness has  been ex-
ceedingly limited; yet the mercenary and unprincipled have reaped a
rich harvest from the noise which they created, by acting upon the cre-
dulity of  the public."3
   A case of  the successful application of  the  acetic  ether in erethitic
deafness was published by Dr. Bolton, of  Richmond, Virginia.4  The
hearing distance was  amazingly improved by it, and the success far
exceeded  the operator's  most  sanguine expectations.   The vapour
certainly  proves, at  times, too  irritating,  or occasions  results by  no
means to  be desired.   The author was applied to in one case in conse-
quence of inflammation having  supervened in the mucous  membrane,
which subsequently extended, in the erysipelatous form, over the cutane-
ous surface.   It yielded to appropriate treatment.
   On the whole, then, the treatment  of  deafness by injection is by no
means so  effective as was at one time supposed.5

  1 Pilcher, Op. cit. p. 318.  See some observations on  this subject, with two  by no
means satisfactory cases, by T. Wharton Jones, in Lond. Med. Gaz. for Aug. 31, and
Sept. 7, 1839.
  2 Beitrage zur Ohrenheilkunde, Berlin, 1845, and Brit, and For. Med. Review, July,
1847, p. 39.
  s The author's Practice of Medicine, 3d edit. ii.  345.  Philad. 1848.
  4 Amer. Med. Intelligencer, April 1, 1839, p. 1.
  r> See, on all this subject, Wilde, Practical Observations on Aural Surgery, Amer. edit.
p. 75.  Philad. 1852. 
448
IODINIUM.
                         CXIII. IODINIUM.
 Synonymes. Iodinum, Iodium, Iodum, Iodina, Iodine.
 French. lode.
 German. Iod.
   Iodine was accidentally discovered, in the year 1812, by Courtois, a
 maufacturer of saltpetre at  Paris, but it was chiefly through the labours
 of Gay-Lussac and Sir Humphry Davy,1 that the chemical relations of
 this elementary body were  appreciated.   The discoverer 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 Coindet2 that experiments might be made with
 it in goitre:  from these he obtained such striking results, that its repu-
 tation soon spread abroad, and it was employed in various other diseases,
 —often with the most marked advantage.  By experience, too, the in-
 jurious effects which it is considered by many capable of inducing were
 appreciated, so that  it could be administered more satisfactorily than
 at an earlier period.
   By the continued investigations of  the chemist, iodine was found to
 be more  largely distributed than was at  first imagined.  It was dis-
 covered 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.3   It
 is  manufactured  in large quantity, in  Scotland, from the  kelp of the
 Hebrides  and Orkney Islands.4   According to Dr. Traill, the greatest
 quantity is produced  by kelp made from driftweed, which is in a great
 measure composed of Laminaria digitata, and Himanthalia lorea;—
 cutweed, which consists of Fucus vesicidosus and F. serratus, yielding
much less of it.   One hundred tons of Caithness kelp afford, according to
the experience  of one manufacturer, one thousand pounds of iodine, or
about a 224th  part.5   It is  always prepared  on the  large scale, and
hence it is placed in  the Materia Medica list of the Pharmacopoeia of
the United States.

 1 Annates  de Chimie, torn, lxxxviii. xc. andxci., and Philos. Transact. 1814 and 1815.
 2 Bibliotheque Universelle, Juillet, 1820, p. 190.
 3 For the method employed by Soubeiran, see Journal de Pharmacie, Janvier, 1837 ;
and for that by Barruel, see Bussy, Ibid.
 * Christison, Dispensatory, Amer. edit. p. 591.  Philad. 1848.
 6 Christison, loc. cit. 
IODINIUM.
449
  Iodine is solid at the ordinary temperature;  of  a foliated  appear-
ance, and metallic  lustre; of a grayish or bluish-black colour similar
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
4.940 at 02°  of Fahrenheit.   Its smell is similar to that  of chlorine,
with which it accords in its property of destroying vegetable  colours.
It possesses,  in a high degree, electro-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
(tojSrji, 'blue.')  It is soluble in ether and in alcohol; forms  an acid
both with oxygen and  hydrogen, and enters into numerous chemical
combinations.1
  In consequence of its high price, iodine is very liable to adultera-
tion;  and  it is said, that coal,  black lead,  oxide of  manganese, and
charcoal have  been added to it; but neither Dr. Christison2  nor Dr.
Pereira3 has met with  any of  these  impurities, which would remain
behind when heat was  applied, and admit, therefore, of easy detection.
Water is the chief adulterant, and its unusual  presence may be sus-
pected if the iodine adheres to the sides  of  the bottle  in  which it is
kept.  Dr. Christison states, that until within the eighteen  months be-
fore 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 investigations
of Gay-Lussac, Magendie4 instituted a series of experiments  in order
to appreciate its action on the animal organism.  It was injected into
the veins without  any apparent  effect.   Several dogs  were made to
swallow  it; they vomited, but it exerted no farther influence.  He
himself swallowed a coffee-spoonful of the tincture, and perceived  no
other result  than a disagreeable taste, which continued  for several
hours, but gradually  disappeared.   In  larger  doses, however, the
effects were markedly injurious.  Orfila,5 likewise, instituted several
experiments on dogs, from which he concludes:—that, introduced into
the stomach in moderate quantity, it acts  as a gentle stimulant, but
may excite vomiting:—that  in the dose of  a dram, it has almost  al-
ways killed the animal in four or five days,  when the oesophagus had
been tied to prevent vomiting, and that in the 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 causes death when given in the dose of one or two drams, the
animal rejecting it by repeated  vomiting; that it does not destroy life

  1 See, on Iodine and its Combinations, Duhamel, in  Philad. Journ. of Pharmacy, vi.
101.  Philad. 1823-4; and Dorvault, Iodognosie, Paris, 1850.
  - Dispensatory, p. 553.  Edinb. 1842.
  3 Elements of Mat. Med. and Therap. 3d Amer. edit. i. 395.   Philad. 1852.
  4 Formulaire pour la Preparation, &c, de Plusieurs  Nouveaux M'odicamens.
  6 Toxicologic, i. 556.
       29 
450
IODINIUM.
when applied externally, and that it must be classed amongst  the ir-
ritant poisons.   Dr. Cogswell,1—in repeating one  of Orfila's  experi-
ments, 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  introduced a
scruple  of  iodine  into the  areolar  tissue of the  thigh of an adult
rabbit, through a small opening made in the skin.   The animal mani-
fested 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  pus was  found  distending the  cavity of the  wound,
from which the  iodine had  entirely disappeared.   Dr. Cogswell pro-
perly suggests,  however,  the possibility, that the irritation of a large
abscess  might have been  the sole origin of the animal's unhealthy ap-
pearance.
  To discover  the effects which it induces on  man, Orfila took  two
grains fasting.   An extremely disagreeable taste, with some nausea,
was  the only  consequence.  On the  next  day, early,  he  took four
grains, when he immediately experienced a sense of constriction  and
heat in  the throat, which continued for a quarter of an hour, and 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, eruc-
tation, increased flow of  saliva, and pain at the pit  of the  stomach:
ten minutes afterwards 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.  All 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,2  of Glasgow, exhibited, within  eighty days, nine hundred
and fifty-three  grains of iodine in  the form  of tincture, the doses
having  been so proportioned, that, towards  the last, the patient—a
girl—did not seem to  be in any way particularly affected; and  Dr.
Buchanan3 gave half an ounce  of iodide of potassium within twelve
hours, without  any unpleasant  results, diluents being largely taken
at the same time.   See Potassii Iodidum.
   It has been  conceived that, when iodine proves mischievous, it is
owing to its being in a free  state, and that it then  operates as a  cor-

  » Experimental Essay on Iodine and its Compounds, p. 21.  Edinb.  1837.
  2 Lond. Med. Repository, for 1822.
  3 Lond. Med. Gazette, July, 1836.  See, also, Fuster, in Bullet. G.n.ral de Th.rap.
F.vr. 1837, and Sept. 1837. 
IODINIUM.
451
rosive poison.   The tincture  and the ioduretted iodides are esteemed
objectionable on this account.1   It  does not appear, that the vapours
of iodine exert any injurious  effect  on  the workmen  concerned  in its
preparation.2
  From  experiments, instituted by Jorg3  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 excites, also,
the different glands in the cavity of the mouth and stomach, the pan-
creas, 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 it  enters into the blood,  and, in
this way, doubtless produces  its modifications on the  system of nutri-
tion.   Two drams  of iodide  of starch,  according to  Dr. Buchanan,4
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 crassamen-
tum 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
in the joint, and upwards of  twelve ounces  of synovia were drawn off
by a cupping-glass.  The synovia 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 tapping him some hours after he had taken the last dose,
more than  thirty ounces of  serum were  drawn off, containing  a large
quantity of iodine.5
   Dr.  Gairdner6 observed the  action of iodine  on the human body
when administered in particular doses,  and pointed out the disadvan-
tages attendant upon its  improvident use.   The most striking incon-
veniences were induced in  the digestive organs: it excited diarrhoea,
and, at times, obstinate constipation; gastrodynia and violent vomiting,
especially  when food was received into  the stomach.   The emaciation
occasioned by  it, Iodo-phthisie, is, according to some, a striking phe-
nomenon, and may attain an incredible extent; yet it is proper to re-
mark, that Lugol,7 in his frequent employment of it in scrofula, never
observed this  result: he  affirms, indeed, that emaciated patients  be-
came 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 employment,—results which  have been confirmed
by  others,8 and which would, therefore,  seem to show that this, as well

  1 Brande's  Dictionary of the Materia Medica, p. 323.   Lond. 1839. See, also,. Mialhe,.
Chimie appliqu.e a la Physiologie et a la Th.rapeutique, p. 225.  Paris, 1856.
  2 A. Chevallier, Annates d'Hygiene Publiq. &c, Avril, 1842.
  3 Materialen zu einer kiinft. Heilmittellehre, v. s. w. i. 473.  1824.        * Op. cit.
  6 Brande, Op. citat. p. 321.   Lond. 1839.   See, also, Cantu, in  Journal de Chimie
M.dicale, ii.  291 and 394; and Bennerscheidt, Ibid. iv. 383.
  • Essay on  the Effects of Iodine, &c.  Lond. 1824; also, Lebert, in Bouchardat, An-
nuaire de Th.rap. pour 1855, p. 228.
  7 Memoire  sur l'Emploi de l'lode dans les Maladies  Scrofuleuses. Paris, 1829; and
Observations  on the Effects of Iodine, p. 17, Johnson's translation.  Lond. 1824.
  8 B. Phillips, London Med. Gaz., January  10, 1840;  and Scrofula, its Nature, Causes,
&a, Amer. edit.   Philad. 1846. 
452
IODINIUM.
 as  some of the other unpleasant  effects  ascribed to iodine, may have
 been owing to ah incautious use of the article.
   In addition to the above phenomena, Dr. Gairdner noticed anxiety,
 depression of spirits, and other symptoms similar  to those of hypo-
 chondriasis ; obscurity of vision; hardness of hearing; palpitations; and
 tremors  of the limbs, particularly of the hands, which last symptom
 indicated the full effect of iodine on the constitution.   He  found,
 however, that the  remedy was  extremely variable in its  effects;  and
 that it might frequently be given in large doses, for a long time, with-
 out  disadvantage; whilst, at other times, the  unpleasant symptoms
 supervened rapidly, indicating that much must depend upon the pecu-
 liar  impressibility  of the  individual.   Coindet,1 who, as already re-
 marked,  first  used iodine as a therapeutical agent, speaks of many of
 the above-mentioned phenomena as resulting from its administration:
 these he  considers  evidences of the saturation of the organism, as the
 effect on the mouth is an index of the  same thing in  the case of mer-
 cury.  It appears, however, to be never necessary, in the administra-
 tion of iodine, to induce saturation of the organism, in order that the
 full sanative influence of the remedy shall be elicited.   On the con-
 trary, it  seems to be advisable to avoid such saturation:  and, accord-
 ingly, whenever there are the slightest  indications of  it, the  dose
 should be diminished, or it should be discontinued  for a  time; after
 which—according to the results of numerous cases—its curative agency,
 when it is resumed, is exerted afresh,  and  more decidedly.  Several
 physicians, indeed, advise that frequent intermissions should be made
in the use of the agent, in order that its action may be more certain.
  According to the observations of Coindet and Formey,2 iodine, ad-
 ministered internally, occasions  increase of appetite;  but no influence
 is perceptible on the condition of the bowels and urinary 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,3 vio-
 lent colic, which readily yielded to  gum water  and laudanum.   Ras-
pail,  however, under analogous circumstances, experienced no  other
inconvenience than a disagreeable taste in the back part of the mouth.
According to Lugol, the vapour, disengaged from tincture of  iodine
poured into the water of a bath, is  liable to induce a state of " iodic
 intoxication," and  even  of cerebral congestion.  He affirms, that it
exerted a powerful diuretic  influence on all his patients,  the urinary
secretion  being  so  much augmented, that many of  them,  contrary to
their usual habit, were compelled to rise from bed several times in the
night to  discharge  their urine.  In upwards of a third, it had  a ca-
thartic effect, producing  six or seven evacuations in the day, and oc-
casionally tormina.  In  several, ptyalism ensued.   Others, and espe-
cially 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,4 at the Hopital

  1 Biblioth.que Universelle, Mars, Avril, Mai, et Septembre, 1821.
  2 See, also, Ricord, Op. cit.                 3 Journ. Gi;ner. de Med. ciii. 336.
  * Bull, de Therap. Sept. 1842; cited at length in Provin. Med. Journ. March 18, 1843. 
IODINIUM.
453
des V6neriens of Paris, whilst under its influence, passed daily from
forty to fifty litres  or quarts of urine, drinking, however, in  an equi-
valent ratio.   This enormous secretion 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,1 who used the tincture of iodine, found it occasionally
produce sickness of the stomach, and M. Delisser affirms, that, in two
months, he gave one  thousand and nineteen grains of the iodide to  a
female affected with cancer of  the mamma,—the  doses, at certain pe-
riods, amounting to  thirty grains in  twenty-four hours.   The conse-
quences 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. Ricord2 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 idiosyn-
crasies, 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 not often observed such results  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 com-
monly gave the tincture, whilst the former prescribed the solution  of
water, with a little chloride of sodium.  Lugol observes,  that the ap-
petite of his patients was very much increased by it.  Eager, who like-
wise administered the watery solution, rarely observed diarrhoea  and
emaciation; in general, indeed, the appetite  and  nutrition  improved
under  it.  At times,  ulceration took place in the mouth, whereby the
breath assumed  a mercurial foetor; and salivation has been observed
from it, according  to Manson,3 Winslow,4 Ely,5  Mackall,6 Sir F.  W.
Smith,7 and others; but Riecke8  suggests, that this, perhaps, only  oc-
curred in those who,  along with  the use of iodine internally, had em-
ployed iodide of mercury externally; and on what appears to the
author to be very inadequate evidence,9 Dr. Wm. Budd, of the Bristol
Royal  Infirmary, has  hazarded the hypothesis, that wherever salivation
has seemed to be produced by it, mercury may have been given even
months before, and become fixed  in the system; but, under the solvent
influence of the iodide of potassium, has become liberated, and caused
the ptyalism.  Ricord, however,10 affirms, that  salivation  is a common
effect;  and that, at  times, the quantity of saliva  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 ptya-
lism  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 cedematous and irrita-
  1 Med. Researches on the Effects of Iodine.  Lond. 1825.           2 Op. cit.
  3 Op. citat, p. 61.          4 Lond. Med. Gaz. for 1836, p. 401.      » Ibid. p. 480.
  6 Medico-Chirurg. Rev. Jan. 1836.
  7 Dublin Journal of Med. Science, July, 1840, and Jan. 1841.
  8 Die neuern Arzneimittel, u. s. w. S. 282.
  9 General Therap. and Mat. Med. 5th edit. ii. 324. Philad. 1853.      w Op. cit 
454
IODINIUM.
ble; but  no inflammation or ulceration is perceptible as in mercurial
ptyalism; neither, according to him, is the breath tainted, nor are the
salivary glands the seat of any tumefaction.
   On the genital organs, Eager found iodine act as an excitant; it aug-
mented the activity of  the uterus, and rendered  the catamenia more
abundant; it is asserted, too, to have increased the sexual appetite, but
this is questionable: during its use, indeed, the testes in men, and the
mammae in women, have been observed to disappear:1 but this, as will
be seen hereafter, is certainly not a common occurrence.2   It has been
imagined, also, to cause  sterility.  Two  cases are detailed  by  Dr.
Robert H. Rivers,3 in  which barrenness succeeded its administration.
Magendie, on giving it as an emmenagogue to a young lady of unsus-
pected virtue, brought on  abortion.4  Krimer several times observed,
even when the tincture was given in small doses,  considerable metror-
rhagia, epistaxis, haemoptysis,  obstinate diarrhoea,  leucorrhcea, &c,
supervene under its  use.   Dr. J. B. Biddle5 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.
Jahn6 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 glandiform bodies,—
the mesenteric glands, suprarenal capsules, &c.—and the areolar tissue
appeared  to exist in smaller quantity.   In the case of a  female, who
died from the excessive  use of the  tincture, Zinck7 found  the  bowels
inflated with gas; in some parts, highly inflamed;  in  others, exhibiting
an approach to sphacelation,  both within and without: the inner mem-
brane of the stomach displayed redness, growing deeper from the car-
diac towards the pyloric orifice, where the organ  looked as if it had
undergone corrosion;  the liver  was large and reddened;  and there
was ecchymosis of the spleen.   Dr. Christison8 is of opinion, that iodine
is capable of inflaming the latter organ.
  Mr. Langston Parker,9 who has seen many cases of what he consi-
ders the prolonged and  excessive use of the preparations of iodine in
constitutional syphilis, and principally of the iodides of potassium and
iron, points out, as an effect, hypertrophy  of the tongue, which is ten-
der and  covered with lobes or nodes, and fissured by deep cracks.
This condition he has seen so  frequently in  persons who  have taken
  1 Christison, Treatise on  Poisons, p. 180; Cogswell on Iodine, p. 47.   Edinb. 1837.
  2 Pereira, in Lond. Med.  Gaz. vol. xvii.   Diet, de Mat. Med. par Merat and De Lens,
art. lode.            3 Amer. Journ. of the Med. Sciences, Aug. 1831, p. 546.
  * Formulary, Gully's edit. p. 105.
  5 Philad. Med. Examiner, Jan. 29, 1842, p. 65.  See, also,  R. Coates,  Ibid;  J. C. L.
Carson, New York Med. Gaz. Dec. 1, 1841, p. 333, and the Report of a Conversation on
the Occasional Injurious Effects of Iodine, at the London University College Med. Society,
in Med. Examiner, Jan. 15, 1842, p. 48.
  6 Archiv. fiir Medicin. Erfahrung,  i. 342, 1829; and Journal  Complement, du Diet, des
Sciences M.dicales, xxxv. 362.
  7 Journ. Complem. du Diet, des Sciences Medicates, xviii. 231.
  8 Treatise on Poisons.
  9 Prov. Med. and Surg. Journ. Feb. 4, 1852, and Amer. Journ. of the Med. Sciences,
Oct. 1852, p. 495. 
                            IODINIUM.                         455

the iodide of potassium for  long periods, that he considers it a pure
chronic  glossitis produced by the iodide.   The  author has, however,
met with such appearances  of the tongue where no iodide  has  been
taken.
  Professor J. K. Mitchellx  affirms, that he has not  unfrequently wit-
nessed very distressing effects not only from an extravagant quantity,
but from the too prolonged  use  of even moderate portions of iodine.
As regards iodide  of potassium—he  properly remarks—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 seldom
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 iodine disease, iodosis,  iodinia or iodism,
cachexie iodee, 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.  Dr. D. R. Phillips,2 U. S. N., in a letter to the author, has
referred tetanic symptoms to the administration of iodide of potassium
in too concentrated a form.   He had given it in a case of rheumatism,
to a  sailor, in the dose of eight  grains, three times a day; and, about
the same time, the author attended  one of his own pupils for singular
epileptiform  attacks, which  might  have  been owing, he  conceived,
to iodide of potassium.  The iodide was discontinued in both cases, and
the patients entirely recovered.  Cases, too, are related in which its use
seemed to have been followed by fatal results;3 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 oedema  and infiltration of the adjacent subcu-
taneous areolar tissue, described by M. Ricord.4 In  this inflammation,
he says, there is little or no tendency to suppuration, and it is a phe-
nomenon which most usually appears only at the commencement of  a
course of iodide of potassium, and rarely recurs; but it is important to
avoid mistaking it for venereal or  gonorrhceal ophthalmia, to which
it appears to bear some analogy.  A somewhat similar affection, under
the use of the iodine, he observes, sometimes extends to the mucous mem-
brane 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. Williams5 recommends that
the patient should eat a piece of bread or biscuit after each dose: " the
starch of this, combining with the  free iodine, removes its injurious pro-
perty."
   To avoid evil consequences, Wutzer advises that iodine should be

  1 Medical Examiner, Aug. 1846, p. 460.        J Med. Exam., May, 1853, p. 294.
  3 Sir B. Brodie, Lancet, March 30, 1839.        * Op. cit.
  B The  Library of Practical Medicine, arranged and edited by Alexander Tweedie.^
Practical Medicine, vol. iii. p.  124, art.  Pleurisy, by Williams.  Lond. 1840. 
456
IODINIUM.
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 children, attention
should be paid to observe, whether, after the medicine has been taken,
the temperature of the  skin becomes more  elevated; the pulse quicker,
and whether there  is 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 benefi-
cial 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 practi-
tioner and patient are  apt to become dissatisfied, unless the  remedy
exhibits its  action more speedily.  When  it acts beneficially, the ap-
petite is augmented, or is not  deteriorated; digestion improves, so that
the patient  is able  to take more food, and experiences less inconveni-
ence therefrom; the secretion of the bile is increased, and the evacua-
tions  are more copious and of a yellow 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 sufficient
index.
   To remove the symptoms of  iodine disease, general or local blood-
letting has been employed; with warm bathing; the use of milk ;  emul-
sions  of gum Arabic, and the  like; rigid diet and rest.  The prepara-
tions  of hydrocyanic  acid have also been given with advantage in the
palpitation,  tremors,  and other  nervous  symptoms that  sometimes fol-
low its use.
  Precaution is requisite in the case  of  impressible, and also,—it has
been conceived,—of robust persons,1 to avoid the supervention of hy-
persemia.    It is  advisable, too, during its administration, to let the
diet be sparing, and devoid of all heating qualities.  Kolley2 remarks,
that it occasionally exerts a most unfavourable influence on the ner-
vous 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 tinc-
ture;  these  pains, at times, ending in violent  spasms.  Such persons
exhibit  the  impressibility, even under very minute doses, by fidgeti-
ness 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 inebriation3 succeed, with violent cephalalgia,
spasms, tremors of the  limbs,  paralysis,4 prostration, spasms, deprava-
tion of  vision,  and disposition to  lamentation and distress.   Some of

  i Riecke, Op. cit. S. 284.                2 Journal Comptementaire, xvii. 307.
  3 Giddiness was observed  by Manson, (Researches on  the Effects of Iodine, p. 61.
Lond. 1825;) Ashwell,  (Guy's  Hospital Reports, i.  136;) and Lugol, (Essays  on the
Effects of Iodine in Scrofulous Diseases, O'Shaughnessy's translation, p. 73. Lond. 1831.)
  * Sir B. Brodie, Lancet, 1832; Manson, Op. citat.;  and Sir A. Cooper, Lancet, ii. 147. 
IODINIUM.
457
 these nervous symptoms the author has occasionally noticed, when the
 dose of iodine has been rapidly augmented.  Where the person is lia-
 ble to gastric uneasiness, caution is requisite in the use of the remedy,
 as it  not unfrequently  occasions  dyspepsia and violent gastrodynia'
 All febrile and purely inflammatory diseases, according to Kolley, for-
 bid its use.
    Dr. Andrew Buchanan1 affirms,  that  he has never witnessed any
 of the unpleasant symptoms  that have been ascribed to iodine.   He
 asserts, that  he has never seen its use  "followed  by wasting of the
 testicles  or mammae, by palpitations, faintness,  excessive debility, hur-
 ried  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 characterizing
 the supposed affection, termed iodism.  As regards the wasting of the
 mammae  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, al-
 though they are said to be frequent in  Switzerland.2  The author's
 own experience  accords  with  that of  those gentlemen.  He has  pre-
 scribed, and seen it prescribed, largely, both in public  and in private;
 yet no such results have ever  supervened.  In the Philadelphia  Hos-
 pital,  great attention was paid to the condition of the testes, in seve-
 ral cases in which it was administered, yet no case of atrophy occurred.3
 M. Cullerier,4 however, who has had much experience with iodine and its
 various preparations, lays down the proposition, that it seems to exert
 a more direct action on the mammae and  testes  when it is given to an
 individual in health, than when the constitution is  deteriorated;  but
 this is opposed to ten years' hospital experience of Dr. T. H. Silvester,5
 who did not meet with  "a single  proof of the opinion that atrophy or
 absorption of the  glandular system,  in  its normal condition, arises
 from the  use of iodine in any  form.
   Dr.  J. Adair  Lawrie,6 of  Glasgow, has  advanced the opinion, that
 the iodides of potassium and starch exert a poisonous influence  on the
 mucous membrane  of the air passages, not as direct irritants, but in-
 directly 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 mammae and testes,  hectic and the
 other symptoms described under the term iodosis.

  1 Lond. Med. Gazette, July 2, 1836.
  3 Pereira,  Elements of Mat. Med. and Therap. 3d Amer. edit. i. 397.  Philad. 1852.
  8 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 Dis-
eases and External Injuries, &c, Lond. 1839.  Reprinted  in American Med. Library,
1839—40.
 * Memoires de la Soci.t. de Chirurgie de Paris, Tom. i. Fascic. 1  & 2, Paris, 1847; cited
in British and Foreign Medico-Chirurgical Review, Jan. 1818, p.  129.
 * Prov. Med. and Surg. Journ. Sept. 1, 1852, and Amer. Journ. of the Med. Sciences,
Jan. 1853, p. 196.
 6 London Medical Gazette, July 3, 1840, p. 590. 
458
IODINIUM.
                EFFECTS ON THE ECONOMY IN DISEASE.
  Iodine exhibits itself as a  most efficacious remedy  in  a variety of
diseases, in which it is desirable to modify the condition of the function
of nutrition.   It doubtless has often had effects ascribed to it to which
it was in no way entitled;  and not the least singular has been recorded
by*  M. Delfraysse,1 who, at a sitting of the Academie des Sciences
of Paris, reported cases, both in animals and in the human female, in
which "ioduretted preparations, administered in the latter  period of
gestation, arrested the  development of the foetus," and  hence, that
they must be valuable  agents, when  narrowness of the  pelvis would
render the expulsion  of a  foetus of the ordinary size dangerous or im-
practicable !
  In referring to the use  of  iodine in the following diseases,  the re-
marks apply not only to pure  iodine, but to the iodides of the metals of
the alkalies,  especially  the iodide and ioduretted iodide of potassium;
the medical properties of which accord with those of iodine.
  Bronchocele.—The very first experiments made with iodine were on
goitre.  Coindet recommended it strongly in that  affection, and For-
mey2 first introduced it into Germany.   Coindet gave, in the first
instance, the tincture internally; and he remarked, that about  a week
after the commencement of its use, the skin over the goitre generally
became less tense, the substance of the tumour felt  softer, without the
tumefaction having abated; the particular portions of the gland  became
more distinct, separated from each other, and less and less hard, until
gradually a diminution  was perceptible.   Frequently, the goitre  dis-
appeared completely, in the space of from six to ten weeks, under the
continued use of the remedy.   At an after period, he employed iodine
externally, in which form of administration the evil consequences some-
times induced by it are less to be  apprehended; and  often combined
its internal and external administration.
  The efficacy of iodine in bronchocele has received the  most ample
confirmation.   Cases have been published by Hufeland, Grafe, Baup,
Helling, Zeigler, Vollmer, Reiss,  Paulitsky, Hirsch,  Ulrich, Jager,
Barchewitz, Meissner, Vogel, Wutzer,  Seiler,  Ficinus, Nieustaclt, Hoff-
man,  De  Carro, J. Reid, Manson, Elliotson, Lugol, Bardsley,3 Cop-
land,4 and numerous  others.5   Mr.  Bramley, whilst  in Nepal, amongst
the Himalaya mountains, and under unfavourable circumstances, cured
fifty-seven out of one hundred and sixteen cases, and brought thirty-
four more into a fair way towards ultimate recovery.6  The author
has administered it in a great many cases of soft goitre, and in every
one the disease was removed.   In two  it recurred, but the  hypertrophy
was again dispersed under the use  of the remedy.7  It has been  re-.

  1 Archives Generates de Medecine.  Juin, 1850, p. 232.
  2 Bemerk. iiber den Kropf. u. s. w. Berlin, 1820; and Hufeland's Journal, B. Ii. St. 4,
S. 91.           3 Hospital Facts and Observations, p. 121.   Lond. 1830.
  * Diet, of Pract. Medicine, i. 270.
  6 Richter's Specielle Therapie. Berlin, 1828, S. 214; Dictionnaire de Mati.re  Medicate,
&c, par MM. Merat and De Lens, art. lode; and Osann, art. Iod, in Encyclopiid. Wor-
terb. der Med. Wissensch. Bd. xix. S. 17.  Berlin, 1838.
  6 Christison, Dispensatory, p. 556.  Edinb. 1842.
  ' See the author's Practice of Medicine, 3d edit. ii. 455.   Philad. 1848. 
IODINIUM.
459
commended by some, that its exhibition should be preceded by bleed-
ing; and as the  abstraction of blood  facilitates absorption, bleeding
may be advisable; and more especially where but little, if any, effect
Beems to be induced by it, after  it  has been  administered for some
time.  Reid advises, that we should commence with its  external  ad-
ministration ;  and, at a later period, conjoin this with the internal.
  Although cases have been  published, in which iodine has  not  an-
swered the purpose of  the prescriber, there can be no question that it
is  the  most  efficacious agent in goitre in the lists of the Materia
Medica; but  when the tumour has  acquired a cartilaginous hardness,
although it may  be diminished under  the use of the remedy, it  can
rarely, or never, be wholly removed.  Under such circumstances, how-
ever, every other remedy would be found equally fruitless.
  It is worthy  of recollection,  that  burnt sponge, which contains
iodine, was long celebrated  for  its powers over goitre, before iodine
was discovered;  and the same was the fact in regard to  certain brine
springs, as that  of Salzhausen, which also contain iodine.
  Glandular affections.—Besides the affections of the thyroid gland,
there are others  of different true glandular bodies, in which iodine ex-
hibits itself efficacious.   Jahn used friction with it, with advantage, in
induration of the liver, Wutzer gave it  in  two cases of induration of
the spleen, but no precise  deductions could  be  made as to  individual
efficacy, owing  to  its having been combined with other remedies.
Milligan1 relates three cases of enlargement of the liver or spleen in
children, in which he gave the tincture with success, after mercurials
had been used ineffectually.  In several cases of chronic disease of the
liver attended with jaundice, Dr. Abercrombie2 found an ointment com-
posed of 3ss. of iodine, and an  ounce of lard, of great benefit.  M.
Eusebe de Salle3 and Jahn  employed it with  success in enlargement
of the testes;  Riecke,4 too, found it of essential  service in a case of
great induration and enlargement of the testicle, which, in the opinion
of several physicians, would require an operation; and Jahn in a case
of strumous  induration of  the submaxillary gland, and in one of tu-
mefaction of the  prostate, the consequence of mismanaged gonorrhoea.
Krimer employed it  beneficially in cases of tumefaction  and  indura-
tion of the mesenteric glands: and Cerchari5 found  an ointment, com-
posed of a scruple of iodine and  an ounce  of unguentum rosatum,
very efficacious in the cure of enlarged tonsils.   He  applied it to  the
tonsils, morning  and evening, by means of a small brush; and he
asserts, that under its use the tonsils will, in two  months, be restored
to their natural  dimensions.   Inflammation must  be subdued before
the ointment can be had recourse to.   Sir B. Brodie6 has used it suc-
cessfully in similar cases; the enlarged  tonsils  being touched  every
day with a camel's hair pencil dipped in the tincture.  Delfiz7 details

  1 Cogswell, Op. cit. p. 83; see, also, Casey, New York Journal of Medicine, Oct. 1840,
p. 324; and Christison, Dispensatory, p. 557.  Edinb. 11S42.
  2 On the Stomach, Edinb. 1828; or Amer. edit, Philad. 1830.
  3 Journal Complement, xix. 193, and Journal Universel, xi. S4S.
  4 Die neuern Arzneimittel, v. s. w. S. 286.
  6 Amer. Journ. of Pharm. 2d series, ii. 83.  Philad. 1837.
  B Lancet, March 30, 1839, p. 38.      7 Froriep's Notizen, B. xiii. H. 5, S. 33. 
460
IODINIUM.
a case of hypertrophy of the mammve, which resulted favourably;  and
in hypertrophy  of the thymus gland, iodine baths have been advised
by Dr. Fingerhuth.   In induration of the female  mammoe, not of a
malignant  nature, Riecke1 found it  frequently of  essential  service;
and Dr. Pereira2 states, that in the chronic mammary tumour, described
by Sir Astley Cooper, he has  seen it afford great relief, allaying pain,
and keeping the disease in check.  In Bubo, painting over the surface
with the tincture of iodine, or with a solution composed of a scruple
of iodine,  two scruples  of iodide  of  potassium, and a fluidounce of
water, has been of great service.   The effect of the latter application,
according to Mr. Langston Parker,3 "is  almost magical."  Mr. Staf-
ford i affirms, that he has employed it in nearly all cases of  enlarge-
ment of glands, excepting those  from malignant  diseases, and  has
found it of  the greatest service: "indeed, its  use, in some instances,
has been attended  by almost a miraculous  effect, so rapidly has the
swelling been reduced."  In  active scrofulous swellings of the lym-
phatic glands  of the neck, Dr. Wm. B. Diver5 has  applied a plaster
made of iodin. p. i.;  balsam Canadens. p. iij.; picis abietis, p. iij.   The
iodine is triturated with the balsam; the pitch is melted with  a  gentle
heat, and when about to cool, the whole  is mixed  and spread upon
kid for immediate use.   He prefers this plaster whenever the  extreme
sensitiveness of the parts precludes the employment of inunction.
   Scrofula.—Soon  after the  introduction of iodine, it was used exter-
nally in scrofulous affections;  and at an early  period was prescribed
by Gordon, Sir A. Halliday,6 and others, especially combined with mer-
cury.  Their observations were confirmed by Magendie,  Baup,7 Sab-
lairoles,8 Baron, Brera, Manson, and others.  Wutzer used it in many
cases of scrofula,  and  found it especially useful in the  lymphatic
(pastosen) form.   In  irritable cases, he was  cautious of  employing
it, as  well as  in hyperaemic conditions; and he found, that  when aggra-
vation of the symptoms  occurred, some concealed inflammatory dispo-
sition was the cause.   Lugol9 has contributed to the more extensive
employment  of it in  scrofula, and has  especially  recommended the
watery solution internally, and baths externally.   The fortunate results
of his trials, in the Hopital  St. Louis, were corroborated  by a com-
mittee appointed for the purpose by the Royal  Academy  of Sciences.
It afforded eminent  service in the different forms of scrofula; but in
scrofulous caries it merely induced improvement, never  entire cicatri-
zation.   Lugol regards it as the most efficacious remedy we possess in
scrofula.  Eager,10 in speaking of Lugol's method of managing scrofula,
properly lays great  stress on the accompanying regimen—nutritious
diet, cleanliness, bathing and exercise in the open air—which he regards
  1 Op. cit. s. 292.
  2 Elements of Mat. Med. and Therap. 2d edit. i. 224. London, 1842; or 3d Amer. edit.
i. 402.  Philad. 1852.
  3 Provincial Med. and Surg. Journ. April 1, 1843.
  * Essay on the Prostate Gland, noticed in Brit, and For. Med. Review, Oct. 1840, p. 529.
  6 Med. Examiner, Sept. 1845, p. 529.
  6 Lond. Med.  Repos. Sept. 1821.            7 Biblioth.que Universelle, Dec. 1821.
  8 Bulletin des Sciences Medicates,  Fev. 1824.
  9 Essay on the Effects of Iodine, &c, p. 48; and Researches on Scrofulous Diseases,
translated by A. S. Doane. New York, 1844.
 10 Dublin Journal of Medical Science, July, 1834, p. 344. 
IODINIUM.
461
as indispensable to a fortunate issue.   He prefers the watery solution
internally to all other remedies.   Lugol and Eager unite, with the in-
ternal use of iodine, the external in the form of ointment, or solution:
for example, in fistulae they employ it as an injection.   To excite ulcers
to cicatrization, after appropriate pressure and injections have failed,
Eager recommends,  that the skin, which has separated at the margins
of the ulcers from the subjacent parts, should be destroyed by caustic
or removed by the knife, but that this should not be practised until the
scrofulous tendency  has been somewhat got under.   As a caustic, he
directs calcis viv. 5vj., potass. 5v., to  be  made into a paste with alco-
hol,  and to be applied a few lines thick:  it destroys the skin in about
five  minutes.
   According to the same  observer, iodine has exhibited its efficacy
in various cases of periostitis, scrofulous swellings  of the joints,
and  necrosis.  In scrofulous ophthalmia, it  was less beneficial.  It
will  be  seen hereafter, however, that  in  the  last affection, the appli-
cation of the tincture to the eyelids has been  beneficial.  In scrofu-
lous discharges from the nose and ear, iodine injections were commonly
of service.  Baudelocque1 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 Parrish2 found the iodide of potas-
sium serviceable in certain diseases of  the eye, which had  a constitu-
tional origin, or were closely allied to a scrofulous or cachectic condi-
tion  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 com-
pound 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 charac-
ter,  were removed by its use.  Wutzer has likewise offered 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 pre-
served.   In various scrofulous affections, the tincture was given by Dr.
Kuhne3 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 advantage than the  ointment;   the
alcohol  readily evaporating and leaving  the  iodine  on the  skin; for
which reason he recommends, that the  tincture  should be applied re-
peatedly by  means of a camel's hair pencil.  Commonly, in every form
of cachexia  especially, it is necessary that iodine, or  its preparations,
should be given for a considerable time.   The disease is often chronic,

  1 Etudes sur la Maladie Scrofuleuse.  Paris, 1834; and  London Lancet, May 25,  1839,
p. 35il; see, also, Cogswell on Iodine, p. 75; and Lisfranc, Annates de Therap., citfid in
Med.  Times, Jan. 11. 1845.            *' Med. Examiner, Ap. 16, 1842, p. 241.
  3 Medicinische Zeitung, No. 34, Aug. 24, 1836.  Berlin. 
462
IODINIUM.
and a chronic system of medication is demanded.   Occasionally, how-
ever, it would appear to have acted speedily.  Professor J. K. Mitchelll
relates the case of  a man who had an enormous  tumefaction  of the
thyroid gland, and of the lymphatic glands of the neck, accompanied
by severe dyspnoea, and difficult  deglutition, threatening dissolution.
"We proposed then," says Dr. Mitchell, "to try iodine, a remedy in
which neither of us," Dr. Mitchell and a skilful surgeon, "had much
direct knowledge.  Within a  single day, the patient breathed  better,
and became thoroughly convinced of approaching 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."
  In combination  with  calomel, iodine  appeared to  Drs. Bennett,
Wiltshire,2 and Malin,3 to have the power of controlling scrofulous in-
flammation and its effects.
   Tubercles.—The reputed efficacy of iodine  in  scrofulous affections
gave  rise to the belief that it  might be serviceable in tubercles.  Brera
and  Calloway administered it frequently in mesenteric tubercles with
success, and the  observations  of Krimer, referred to above, correspond
with theirs.   It has also been given  with advantage  in cases of pul-
monary 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.4  Similar examples  are  detailed by Jahn, Wal-
dack, and others; and it has been recommended, in conjunction with
decoction of cimicifuga, by Dr. C. C. Hildreth,5 of Zanesville, Ohio; but
the evidence adduced by  him  is not strong.
  Berton affirms, that  he 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,6 and  Sir  C.  Scudamore.7   The addition of a
little tincture of conium was found by the latter gentleman to  be
beneficial in subduing the irritating qualities  of the  gas. _  His first
formula was  the following:—£. iodin.  gr. viij., pot ass. iodid.,  gr. iij.,
alcohol.  Sss., aquae destillat., gvss. 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.  Subsequently, Sir Charles published the
results  of his farther observation with this remedy, of which he had as
high an opinion as ever.  He had somewhat modified his formula, how-

  1 Med. Examiner, Aug. 1846, p. 46.       2 Medical Times, July and August, 1847.
  » Schmidt's Jahrbiicher, u. s. w. No. 2, S. 164.  Jahrgang, 1849.
  * Formulary—the author's edition, p. 37.  Lond. 1824.
  5 American Journ. of the Med. Sciences, Oct. 1842, p. 280.
  6 On Temperature, Aliment, &c,  1829.
  i Cases Illustrative of the Efficacy of various Medicines administered by Inhalation in
Pulmonary Consumption, 2d edit. London; and Lond. Med. Gaz. Feb. 17,  1838, p. 804. 
IODINIUM.
463
ever;1 and recommended the following:—R. iodin. pur., potass, iodid.
aa. gr-  vj., aquae  destillat. Sv.  5vj.,  alcoholis, 3ij. M.   He prefers
to add the conium at the  time  of mixing the iodine solution  with
the water, and recommends that it should be a saturated tincture, pre-
pared with genuine dried leaves.   In the commencement of the treat-
ment, 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 "sooth-
ing,^ 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-j an(i 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, however, 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 contain-
ing water of a rather higher  temperature  than 120°.  The  feelings
of the patient will be a great guide as to the strength of the inhaling
mixture  in any particular case.  A reviewer in the British and Fo-
reign Medical Review2 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 remedy in bronchitis.   It  is  true, however, he
adds, that the relief has often been as great from the simple aqueous
as from the medicated inhalation.  The author's  own experience has
not been favourable to it,3 and Dr. Pereira4 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 201.)5
It has  been dreaded, because, in some instances, troublesome irritation
of the larynx  has followed its use; but  Dr. Corrigan6  considers, that
this  injurious effect has resulted from  the defective  means -of inhala-
tion  previously employed.   Used in the manner  he has recommended
under  the article referred to above—gradual in its evaporation, and
ultimately combined with a large portion of aqueous  vapour—it  is, he
says, positively free from any injurious irritative  effects.  The vapour
he found to diminish most remarkably the profuse and wasting puru-
lent  expectoration  of phthisis.  The effects of  iodine, thus used, on
the  digestive function, were also very gratifying.   In all the cases in
which he employed it, the  appetite and  state of the intestinal  canal

  1 Lond. Med. Gaz. Feb. 7, 1840, p. 750.  See, also, E. J. Coxe, Practical Treatise on
Medical Inhalation, pp. 51-85.  Phila. 1841,  and in Philad. Med. Exam. Nov. 1851,  p. 765.
  1 April, 1838, p. 606.        3 Practice of Medicine, 3d edit. i. 416.  Philad. 1848.
  4 Elements of the Materia Medica, 3d Amer. edit. ii. 402.  Philad. 1852.
  6 See, also, .Ether Hydriodicus, at the end of this article.
  6 Dublin Journal of Medical Science, for March,  1839, p. 103. 
464
IODINIUM.
were improved.   It  acted as a useful tonic to the  digestive organs,
without any of the irritation which its internal use, in  the ordinary
form, at times produces.  It likewise greatly alleviated the cough, so
that the patient was enabled to obtain 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 con-
stitutes 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 pa-
tient 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 medicated 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 round three  of the sides.   The rate of evaporation, which ge-
nerally 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 tinc-
ture 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 sufficient 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 ulcera-
tion, 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.
  In a paper,  read before the Academie Imperiale de Medecine, of
Paris,  M. Piorry1 bears strong testimony to the value of iodine inhala-
tions in phthisis, in the following conclusions:—1st. The inhalation of
the vapour and tincture of iodine is  useful in the cure of phthisis.—2dly.
In many  cases, such inhalation is followed  by a diminution in the ex-
tent of the  indurated parts surrounding tuberculous deposits, and an
amelioration in the general symptoms.—3dly. It is probable that tuber-
cle itself  disappears under  the influence of iodine inhalations.—4thly.
Inhalations of the tincture  of iodine may promote the cure of tubercu-
lous cavities, &c, and 5thly.  Iodide of potassium administered internally
and frictions with diluted tincture  of iodine over adherent portions of
the lung are also of great utility.
   The  opinion of M. Louis  is very unfavourable to any ultimate bene-
fit from iodine in phthisis.  "I have given it," he says, "either in the

  1 Comptes rendus, Jan. 24, 1854, or Archives Generates de M.decine, Mars, 1854, p
361, and Ranking's Abstract, xx.  70. 
IODINIUM.
465
city or in  the hospital to more than sixty persons in the most varied
stages or degrees of phthisis; and  in no  case, and  I  say so with as-
tonishment, have I observed any improvement that could be ascribed
to this new agent."1
  Fontana, however,  affirms, that he has observed decided advantage
from it in  a case of phthisis mucosa, when given in the form of syrup,
and combined with the external application  of the ointment of tartar-
ized  antimony.   Duverney  has  communicated some cases, which ap-
peared 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 demonstration.  The
author has frequently administered it, in various forms, in pulmonary
tubercles,  but, it must be confessed, not with that  decided advantage,
which the well known  eutrophic 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  Riecke2 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 Hiiser  as corroborative of his opinion.  A woman,  fifty years old,
was  affected with anchylosis spuria, for which an ointment  of iodine
was  recommended; but it had not been employed more than  three
weeks, and  not more than a dram  of 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  anything more than a coincidence.
   Mr. Leigh3 directs the patient to  apply a sufficient quantity of 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 potas-
 sium has been highly recommended by Dr. George L. Upshur,4 of Nor-
 folk, Va., on the strength of several observed cases.  The indications for
 its use he has found  to be the following:—First, In cases of pneumo-
 nia 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 treatment, and the suppurative stage  is just beginning.
 " This  stage is easily recognised by 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

   1 Bouchardat, Annuaire de Th.rap. pour 1852, p. 280.
   1 Die neuern Arzneimittel, u. s. w. S. 289; see, also,  Giinther, in Harless's Neue Jahrb.
 B. xii. St. 3, S. 161.
   5 London Medical Gazette, May, 1841.
   * Med. Examiner, June 29, 1844, p. 145: and June, 1845, p. 323.
        30 
466
IODINIUM.
been found very beneficial by Dr.W. S. Oke,1 Dr. Casey,2 and others.
Dr.  Casey gave it in upwards of five and twenty cases, and  in  no in-
stance, where a fair trial was made, did it  fail "to afford unequivocal
and  decided relief."   The dose varies  from two to five  grains three
times a day.  Dr. W. A. M'Murry3 has used iodide of potassium with
great advantage, in hooping-cough. He employs, however, a compound
formula.
                 R.  Potass, iodid. gr. vj.; Mucilag. acac ^vij.
                     Syrup. Senega., §ij.; Tinct. lobel. Jj.  M.
    Dose.—For a child two years old, a tea-spoonful four times a day.

   In chronic engorgements of the larynx, iodine was used in  two cases
by Trousseau and Belloq;4 once without success, but the  second  time
with marked advantage;  and in tubercles of the liver it  has been re-
garded worthy of special consideration.5 In a case of membranous croup
in a boy 2| years old, who recovered, the iodide of potassium was pre-
scribed by Dr. J. D. Griscom,6 in doses of two grains and a half every
three hours, under the  idea, that it  might  modify the disposition to
pseudo-membranous deposit.
   In chronic or catarrhal  laryngitis7 with  aphonia, the application of
a strong alcoholic  solution of iodine to the external  throat  has been
found a most successful counter-irritant.
   Bropsy.—Owing to its powerful eutrophic agency, many trials have
been made with iodine in cases of dropsy.8   Drs. Bradfield and Bards-
ley exhibited it frequently with success in hydrothorax and ascites; and
Dr.  Kissam, in a case of dropsy, dependent probably upon induration
of the liver.  Dr. Coster9 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., aquse f Sj-; aided by an ointment
composed of fifteen grains of iodine, with double the quantity of iodide
of potassium, to an ounce of lard.   This is to be placed inside the
thighs  after removing the cuticle by a blister.   The arm-pits  and soles
of the feet were also rubbed with the ointment.  The same plan is re-
commended by Dr. Osborne.10   Jahn,  also, regards iodine as an ex-
tremely valuable antihydropic.11   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, which he met with,
—even in the new-born,—united with mercury or extract of  conium;
and  in every case which was not of too chronic a character, it exhibited

  1 Prov. Med. Journ. April and May, 1844.     2 Boston Med. and Surg. Journ. 1845.
  8 Saint Louis Medical and Surgical Journal, March and April, 1848.
  *■ Trait. Pratique de la Phthisie Laryngee, p. 371.  Paris, 1837; and translation by
Dr. Warder, Am. Med. Library ed. p. 145. Phil. 1839.      & Riecke, Op.  cit. S. 290.
  6 Summary of Trans, of the College of Physicians of Phila. vol. i., p. 68, New Series.
Phila. 1853.                         7 Med. Times and Gaz. Nov. 12, 1853.
  8 Wm. Stokes, in Amer. Journ. of .led. Sciences, May, 1834,  p. 543, from Lond.  Med.
and Surg. Journal.                           9 Journal de Pharmacie, 1834.
 10 On the Nature and Treatment of Dropsical Diseases, 2d edit. p. 48.   Lond. 1837; or
Amer. Med. Library edit.  Philad. 1838.
 11 Elliotson,  in Lancet, 1830-31.   See, also, P. Spalding, in Boston Med. and Surg.
Journal, Dec. 25, 1839, p. 314. 
IODINIUM.
467
 its sanative powers.   The only unfavourable effects induced by it were
 a temporary disappearance of the testicle, in some cases; and a humid
 cutaneous eruption of the  scrotum.  He also found iodine  extremely
 useful in hydrothorax and ascites; and especially in cases  of  dropsy
 that succeeded to exanthematous  diseases,—and 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—q,b well chronic as acute—especially when the latter  form
 had attained its  full  development,—that is, when the inflammatory
 stage was over, and the accumulation of fluid was the prominent con-
 dition.  In these cases, he commonly used iodine in the  form of iodide
 of potassium made into an ointment, and rubbed on the head.   Fre-
 quently, however, 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 stomach too
 violently.1  Dr. Reiser,2 of Wurtemberg, likewise advocates the use of
 iodide of  potassium, m large doses, in cases of acute hydrocephalus or
 tubercular meningitis, where the  ordinary remedies  have failed, para-
 lysis has occurred, and death appears to be impending; and three suc-
 cessful cases have been recorded by Mr. C. Fluder.3   The  ordinary
 means had been employed in vain, when he suggested a trial of  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 recorded  by Dr. John Christie.4  The child
 was eight years old, and before  Dr. Christie saw him had been ill a
 week.  He had 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; there were frequent automatic movements  of the
 left  arm and leg, and  the  pulse  was rapid  and  weak.  Dr. Christie
 determined to  make a trial  of iodine in a  mode mentioned  by Drs.
 Evanson and Maunsell,5 and 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 mer-
 cury.  Good effects, in a similar  case, resulted from the internal  use
 of iodide of potassium  in the practice of  Dr. Barbour, of  St. Louis;6
 and of Dr. J. D. Guerard of Beaufort, S. C, from the internal and ex-
 ternal  use of the  iodide;7 and  Dr. Malin8 prescribed a combination
 of iodine and calomel in oedema meningum and hydrocephalus acutus.
 with advantage.

  Riecke. Op. cit. S. 291.
  2 Hufeland's Journal, for April, 1841, S. 84; and Lond. and Edinb. Monthly Journ. of'
Medical Science. See K. G. Zimmermann, Zeitschrift fur die gesammte Medicin Aue:
Ls42, S.  418.
  » Lond. Med. Gaz. Sept. 30, 1842.
  4 Lond. and Edinb. Monthly Journal, March,  1843.       * On Diseases of Children.
  6 Boston Medical and Surgical Journal, Jan. 1846.
 ' Amer. Journal of the Med. Sciences, Jan. 1851, p. 109.
 6 Schmidt's Jahrbiicher, u. s. w. No. 2, S. 164.  Jahrgang,  1849. 
468
IODINIUM.
  M. Ricord1 employed iodine with success in five cases of hydrocele;
—the tincture being diluted with distilled water, and applied by means
of compresses wetted with it, in  which the  scrotum was enveloped.
He used it of four different strengths—3j-> 3\j-> 3iij-> and 5vj. of the
tincture, to f giij. of water.
  In hygroma or dropsy  of the bursse mucosse  of the joints, an oint-
ment of iodide of potassium (3ij-? ad adipis gj.) has been successfully
used  by M. Reynaud.2  The  limb is kept at rest,  and morning and
evening, or three times a day, friction is  made with  this quantity of
ointment;  after which the knee—the  joint commonly  affected—is
covered with a large flaxseed  poultice.  From  some trials made with
iodide of lead, there was reason to  believe it more efficacious than iodide
of potassium.    The treatment was generally successful in about a fort-
night.
  Intermittent  Fever. In obstinate intermittents, which had  resisted
quinia and other antiperiodics, M. Seguin3 found the tincture of iodine
a very valuable  and effective  remedy.  He prescribed  it in doses of
thirty drops in a little sweetened water, gradually increasing the quan-
tity to forty, fifty, and even sixty drops.  Three doses  were given in
the apyrexia.   He did not find it  equally effectual in recent cases.
   Typhus and  Typhoid Fever.  Dr. Morrison4 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 disposition to dark fetid
discharges from the bowels;  by a weak and compressible pulse;  and
by the  ordinary signs of depraved secretions, vitiated  fluids, and de-
bility.   The dose which  he 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 typhoid fever is reported by Dr. C. B.Voigt,5 in which
iodide of potassium was apparently beneficial, and M. Aran6 has used
small doses of tincture of iodine, with benefit, in an epidemic  fever in
Paris.  Under  its use, the tongue became moistened, the abdominal
pain and purging abated almost  immediately,  and without the super-
vention of nausea, vomiting,  or any unpleasant symptom.  The dose
was five grains  repeated, according to circumstances, from three to six
times in the twenty-four  hours.
    Variola. Iodine has  been successfully employed in  variola to pre-
vent pitting.  Dr. Crawford,7 of Montreal, tried the comparative merits
of tincture of iodine and nitrate of silver, and gives the preference to
the former.   He found  the  application " very manageable and very
bearable."   Recently8 he has published his further experience, which
has been so favourable, that he conceives he would not be  doing justice
and his duty to his patient, if he omitted to  apply the remedy on any

  1 Journ. des Connaissances Med. Chirurg., Janvier, 1833.
   2 Cabissol, in Bulletin General de Th.rapeutique, Fev. 1838.
  8 Journal des Connaissances  Medicates  Pratiques, Dec. 1846, and Amer. Journ. of the
 Medical  Sciences, July, 1847, p. 223.         * Dublin Medical Press, Oct. 21, 1840.
   5 Medical Examiner, Dec. 1845, p. 715.
   « Bull, de Th.rap. xliv. 272,  and Br. and For. Med. Chir., July, 1853, p. 280.
   ' Montreal Medical Gazette,  April 1, 1844.
   8 Montreal Med.  Chronicle, Nov. 1853, and Med.  Exam., Dec. 1853, p. 771. 
IODINIUM.                         469
future occasion.   Dr. Crawford has always commenced at the earliest
day of the eruption, and  continued the application  daily for a week.
Dr. Jackson,1 formerly of Northumberland, Pa., now of Philadelphia,
informed 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  abor-
tion at the time was considered to be complete.   There were, however,
some slight pits to be seen  afterwards, but they were  very incon-
siderable compared with those on the other arm.  Dr. Sargent stated
to Dr. Jackson, that he had subsequently used  iodine on one side of
the face in 25 cases: the swelling, 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 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 ectrotic
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.
Subsequently, Dr.  Sargent2 instituted other experiments with it.  It
was painted over one half the face only, in order that  the appearance
of the surface, thus protected, might be fairly compared with that of
the other side.   Having  been tested in this manner in a great many
cases, of which thirty were carefully noted, the  effects were found to
be as follows:—The side of the face which was covered with the  tinc-
ture was  comparatively little  swollen; the eruption was flattened, so
as to be scarcely higher than the  surface,  whilst on the other side the
vesicles first,  and subsequently the pustules, were full and  swollen;
there was much less heat and soreness in the protected  side than in
the other, and much less tenderness when this side was touched.  When
pits were left on the unprotected  side of the  face after the disengage-
ment of the scabs,  and the healing of  the little  ulcers thus  exposed,
those on  the protected  side were  found to be less numerous and per-
haps less deep; but in no instance could Dr. Sargent certainly affirm
that pitting was entirely prevented by the  iodine, in  cases  in which
there were pits on  the opposite surface.
  Dr. Schreiber3 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:

  1 Medical Examiner,  August, 1846, p. 464.
  2 American Journal of the Medical Sciences, April, 1849, p. 373.
  s Northern Journ. of Med., July, 1844, and Braithwaite's Retrospect, x. 187.   New
York, 1845. 
470
IODINIUM.
                  R.  Potass, iodid. gr. viij.
                      Tinct. iodin. gtt. xvi.
                      Aquas f ^ij.  M.
   A teaspoonful of this was given night and morning.  Dr. Schreiber
 invites practitioners to a farther investigation of the anti-variolous 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 affirmed: that in cases of suppressed measles and scarla-
 tina, it will frequently induce a healthy reaction under the most despe-
 rate circumstances.   One or two grains of iodide of potassium—accord-
 ing to the age of the  patient—when 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 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 Biseases.—As to the efficacy of iodine in these diseases, tes-
 timony  is somewhat discordant.   Drs. Manson2 and Elliotson3 found
 it useful in paralysis,  but Dr.  Bardsley failed with it.  Chorea was re-
 moved by Gibney,4 Bardsley, Manson, Oke,5 and Muller;6 and Frank-
 lin,7 by very large doses, relieved a case of epilepsy.   Dr. Bennett8
 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 beneficial in neuralgia.9  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.
 Mitchell10 gave seven  grains of iodide of potassium three  times  a day,
 which speedily relieved, and within six weeks completely cured, the pa-
 tient, after arsenic, mercury, and most of the narcotics had been pre-
 scribed in vain.  An equally beneficial and speedy effect was produced
 in a case of protracted erratic pains.
   Like many other agents, iodide of potassium  has been  proposed as
 a prophylactic in cholera.  In  this relation, it has been recommended
 by M. Marchandier.  M.  Bouchardat,11 however, knew a case of cholera
 supervene in a person who was at the time under its use.
  It has also been used therapeutically, on  theoretical considerations,
 by Dr. Buchanan.   Under the idea, that iodine never passes out of the
system by way of the  intestines, he thought the serous discharge might
  1 London Lancet, Jan. 21, 1843, p. 632.
  2 Op. cit.         s Lancet, 1830-31.             * Ibid. 1827-8,  p. 54.
  5 Provincial Med. and Surg. Journal, April and May, 1844.
  6 Gazette Med. de Paris, No. 19, cited by Gorup-Besanez, in Canstatt und Eisenmann's
Jahresbericht iiber die Fortschritte in der Heilkunde im Jahre 1848, S. 135.
  7 Lancet, 1836, and Cogswell, op. cit. p. 24. See,  also,  Scott, Provincial Med. and
Surg. Journ., April 3, 1844, p. 9.           8 London Lancet, Dec. 21, 1839.
  9 Crawford, Montreal Med. Gaz. April 1, 1844.
 10 Medical Examiner, Aug. 1846, p.  460.
 11 Annuaire de Therapeutique, pour 1850, p. 196. 
IODINIUM.
471
 be arrested by  impregnating the blood freely with it.   Accordingly,
 he gave from nine to sixteen grains, in the form of iodide of starch, in
 the course of twenty-four hours; and, he thought, with good effects, as
 did his medical  friends who adopted the same plan.   Opium, however,
 was given with  it.
   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.
   Lead Poisoning and Mercurial Poisoning.  M. Melsens,1 from nume-
 rous investigations infers, that iodide of potassium has  the  power of
 dissolving mercury and lead, and some other compounds, and that the
 presence of organic matter does not prevent these  changes; but the
 power is very much more limited in regard to lead.  It dissolves metallic
 mercury, and all the  mercurial  compounds, which can possibly occur
 in the living body.   He is of opinion,  that the iodide acts curatively,
 in these  cases,  by  dissolving the fixed union existing  between the
 metal and the  organic tissues, and  by forming a  soluble  compound,
 which passes off by the kidneys, owing to its diuretic  properties.  M.
 Melsens suggests, that other alkaline, earthy or metallic iodides, or even
 bromides or chlorides, might answer the same  purpose.   In this way,
 it is supposed, common salt may have acted  as a prophylactic with per-
 sons who use much with their food, as they have seemed to be less
 liable to mercurial and saturnine affections than they who use little salt.
   The primary effect of the iodide of potassium, in  cases of mercurial
 and  lead poisoning, was  to  aggravate all the phenomena, by setting
 free—as it seemed—the metal united with the tissues; thus forming an
 active compound, which, however, was speedily thrown out of the sys-
 tem.  It must be given largely in such cases:  fifty or sixty grains a
 day.  Upwards  of three thousand grains have  been  needed to effect a
 cure.
   Dr. Wm. Budd2 has witnessed effects similar to those  described by
 Melsens;  and Dr. Parker3 has  published a case of saturnine para-
 lysis, in which the iodide  appeared, from observation, to cause the eli-
 mination of lead in the urine.
   Dr. Goolden4 records a case of lead paralysis, successfully treated by
 the iodide and galvanism.  During the treatment, the urine  was exa-
 mined for lead; but although it was believed,  that  lead  was  present,
 the examination was not  entirely decisive.   Dr. J.R.Nicholson5 has
 related a case of the same disease treated by the same remedies.   The
 urine was examined for lead before treatment, but none was detected;
 but during treatment it passed off  abundantly in  that excretion; and
 Dr. Corson6 has  recorded  several cases testing the value  of the iodide
 as an antidote to the injurious effects of mercury, which are corrobora-
 tive of the experiments of Melsens.

  1 See Melsens' Paper, translated by Dr. William Budd, in Brit, and  For. Med. Chir.
Rev., for Jan. 1853,  p. 201.                    2 Ibid., p.  202.
  8 Brit, and For. Med. Chir. Rev. April, 1853, p. 522.
  * Lancet, Dec. 1853.                        a Lancet, Jan. 1854.
  6 New York Journal of Med., Sept. 1853. 
472
IODINIUM.
  In twenty-three cases of saturnine disease, including colic, neuralgia,
arthralgia, wrist drop, and general paralysis, the iodide of potassium was
prescribed by Dr. Swett1 of New York, as recommended by Melsens.
Sixteen cases were cured; three so far relieved as to be  able to resume
their  occupations, and  four were gradually improving at the time the
report was made.  In thirteen cases,  the urine was subjected  to che-
mical analysis, and lead was found in it; and, in no case was it detected
before the administration of the remedy.   M. Malherbe2 has given it in
some cases of lead poisoning with  great  benefit; and Dr. Biddle3 re-
ported a case to  the  College of  Physicians of Philadelphia, in which
there were the actual signs of lead  poisoning, and  in which a gradual
and permanent amelioration took place, under the use of five grains of
iodide of potassium, given three times a day, but no appearance of lead
could be detected in the urine by the sulphuretted hydrogen  test.
   Chronic Biseases.—Cases of  dry scaly tetter were treated by Tiin-
nermann with an ointment 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.  Magendie,
Gimelle, and Jeffray4 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 tissues.  The  author has  often em-
ployed them in these cases with success;  and like testimony has been
afforded by  MM. Biett, Gimelle, Kolley, Locher-Balber, Kennedy,5
and others.  Brehme succeeded in  removing, rapidly and completely,
a case of inveterate porrigo favosa,  and ophthalmia thereon dependent,
by an ointment  of iodine.  Dr. G. Billingslea, of Alabama, asserts,"
that for twelve years he had used the tincture  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 highly
extolled by Drs. Graves, and J. J.  Ross.7  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

  1 New York Med.  Times,  Feb., 1854; and Amer. Jour, of the Med. Sciences, July.
1854, p. 286.
  2 Gaz. des Hopitaux, 21 Dec. 1854, and Amer. Journ. of the Med. Sciences, July, 1855.
p. 208.                                                     i   J»    i
  3 Quarterly Summary of the Transactions of the College of Physicians of Philadelphia,
from May 2, to Oct.  3, 1855, p. 421.  See, also, a discussion on the question, Can Iodine
revive Mercury latent in the system? in Ibid, from Mar. 7 to April 4, 1855, p. 409.
  4 Cogswell, op. cit. p. 80.           = London Med. Gazette, May 8, 1840, p. 260.
  6 American Medical Intelligencer, May, 1839, p.  34.
  ' London and Edinb. Monthly Journ.  of Med. Science, Sept. 1842, p. 292. 
IODINIUM.
473
stick.   If 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  constantly
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. Barosch1 cured an
inveterate dartrous eruption, affecting the perinseum 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 cicatrization taken place.  It is  recommended  to be applied not
only to the  ulcerated portion, but to the  parts around.2   Some in-
veterate cases yielded to the use of iodide of potassium, given  in large
doses, by M. Maisonneuve.3
   A case of elephantiasis,  or enormous enlargement of the  leg, had
been recorded by M. Cazenave,4 which Avas cured by iodine, associated
with other remedies.  The  patient—a woman—was ordered a strong
decoction  of guaiac and mezereon;  the leg was carefully bandaged
from the toes, and every other day the bandages  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 dimensions.   M. Cazenave states, that he has met with several
similar cases, which have been all more or less benefited, and some even
cured by this plan of treatment.
   Mr. Ogier Ward5 cures itch by a simple lotion of iodide of potassium,
a single washing with which, in some instances, completely eradicated
the disease.   To ensure complete success, he applies 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, according to the delicacy of  the cutane-
ous  surface.
   Amenorrhoea.—According to Coindet, iodine is a powerful emmena-
gogue, and the possession of this property has likewise  been   ascribed
to it by Brera,6 who frequently administered it successfully in  amenor-
rhoea ; and Formey, Nieustadt, and Ash well7 confirm their observations.
Sablairoles cured three cases by frictions with iodine ointment on the
breast, conjoined  with %e internal use of iodine.   It  was necessary,
however,  to give it in large doses, and for a long time.   Dr. Aldridge,8

   1 G-sterreich. Medicinisch. Wochensch. cited in Provincial Med. and Surg. Journal,
April 29, 1843, p. 99.
   2 Pereira, Elements of Mat. Med. and Therap. 3d Amer. edit. i. 403.  Philad. 1852.
   8 Bulletin Gen.de Therapeutique, Jan. 1849; and Canstatt und Eisenmann's Jahresbe-
richt, u. s. w. im Jahre  1849, V.  159.  Erlangen, 1850.
   4 1,'Expcrience, Oct. 19, 1843, and Edinb. Med. and Surg. Journal, April, 1844.
   6 Lond. Med. Gazette, April 3,  1846, p. 008.           6 Saggio Clinico sull' Iodio.
   7 Guy's Hospital Reports, No. 1.  Lond. 1836, and Cogswell, op. cit., p. 43.
   8 Dublin Hospital Gazette, Oct. 1, 1845. 
474
IODINIUM.
of Dublin, states, that benefit may be expected from its use, when the
absence of the catamenia is dependent upon uterine irritation, Avhether
from exposure to cold, mental  emotion or other  causes, and  accom-
panied by pain  in the  loins, headache, palpitation, &c.   Locher-Bal-
ber1 and Golis found iodine of value,  at times, in those troublesome
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 respiratory organs,—such as
dry cough, or cough accompanied by bloody sputa.
  Begeneration 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 degeneration of the ova-
ries, which gave rise to two tumours, each the size of the head;  and
Messrs. Thetford,2 Klaproth,3 Jewel,4 and Ashwell5 were equally suc-
cessful.  Baron employed it beneficially  in a case of dropsy of the
ovarium.
  In hypertrophy of the ventricles of the  heart, Magendie  recom-
mended it long ago.
  In scirrhus of the uterus, mammse, &c, it has been advised by Heun,
Klaproth, Kennemann, Von dem Busch,6  Ullmann, Hill, Benaben, Ma-
gendie, Hammer, Elwert, Wagner,7 Copland,8  Zimmermann;9 and from
their recorded observations, it  would seem, that great efficacy ought
to be ascribed to it, both Avhen internally and externally administered.
A case is published by Dr. Thetford,10  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 likewise reported by Dr. Ashwell,11 which were removed
by it, with occasional depletion, and regulated diet.   It was given in-
ternally, and at the same time applied externally in the  form of oint-
ment,  (iodin. gr. xv., potass, iodid. J^ij., ung.  cetacei gss.,) of which
a piece of  the size of a nutmeg was  introduced  into  the vagina  and
rubbed into the  cervix  uteri for ten or  twelve minutes  every night.
The average time required for the removal of these tumours was from
eight to  sixteen  weeks.  In congestion, erosion or ulceration of the
cervix uteri, Dr. Churchill12 found iodine, used according to the  for-
mula given hereafter, the best application of  all that he  has tried.
He usually commences with a single application of nitric acid, or the
acid nitrate of mercury, and then, after a few days, paints  the entire
cervix with iodine, which he repeats once or  twice a  week.  The ap-
plication occasions no pain unless the orifice o£ the vagina  should be
touched.   Jahn extols it much in incipient scYrrhus  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

  1 Hecker's Litter. Annal. i. 275; and Cogswell on Iodine, p.  77.
  2 Transactions of the Dublin College of Physicians, v.  510.   Dublin, 1828.
  3 Revue Medicate, Mars, 1824.           * Op. cit.
  5 Guy's Hospital Reports, vol. i.          «  Hufeland's Jour. B. Ix. St. 2, S. 81.
  ' Revue M.dicale, Juin, 1833.           8 Diet, of Pract. Med., art.  Cancer.
  9 Journal de Pharmacie, Juin, 1842, p. 598.
  10 Trans, of the King and Queen's College of Physicians of Ireland, vol. v.
  11 Op. cit.                              " Medical Times, May 19, 1849. 
IODINIUM.
475
 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 Tviistedt employed it successfully in stricture of the urethra, su-
 pervening on badly managed gonorrhoea.  In a  case of scirrhous tu-
 mour, of large size, seated in the neck,  and protruding into the isth-
 mus faucium, which was attended by a prolonged ceaseless pain of an
 aching and depressing character, Professor J. K. Mitchell1 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."
   Leucorrhcea and Gonorrhoea.—A Parisian physician  made the ob-
 servation, that during the employment  of iodine in goitre, obstinate
 and protracted leucorrhcea disappeared:  this induced him to try the
 remedy  in the latter disease, and he found it efficacious.   Goden and
 Broglio, likewise, observed  it useful  in  malignant  flluor albus;  and
 Benaben, Richond,2 De  Salle, Caswall,3 and Broglio, in gonorrhoea.
 The last two individuals gave it especially 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.  M. Boinet4 speaks highly of  the effect of  tincture of iodine,
 when applied to the mucous membrane of the vagina  in the gonorrhoea
 of Avomen.  A single application Avas, at times, sufficient.  At the same
'time a solution of  equal  parts of the tincture and Avater was  injected
 into the urethra, but was  not permitted to  enter the bladder.  He
 has had  recourse to the  local application of iodine  in inflammations
 and ulcerations of other mucous  membranes, and with great  success.
 In chronic fluor albus, it Avas used by Muller5  with marked benefit.
 A young female had  long  suffered under this affection, which had re-
 duced  her strength, and  did not yield to any of the means that had
 been employed, when  the ointment of iodide  of potassium Avas rubbed
 —morning  and evening—on the inner surface of the  thighs.   After
 this plan had been  continued for  four Aveeks, the disease  entirely
 ceased.  MM. Gimelle and JeAvell are also Sdvocates for it.6   M. Ri-
 cord,7  however—who  considers  that  the genito-urinary organs are
 amongst those that are most susceptible  of the action of iodide of po-
 tassium—says, that he has been able to trace the fresh access of blen-
 norrhoeas ineffectually got rid  of previously, or the exasperation of
those actually existing, so frequently to  its  use, that he regards the
existence or recent presence of a blennorrhcea as  its temporary contra-
indication.   "Perhaps, hoAvever," he adds, (on  the  principle similia
  1 Medical Examiner, Aug. 1846, p. 462.
  2 Archives G.n.rales de M.decine, vol. iv.          3 Lond. Med. Gazette for 1834.
  * Union Medicate, Sept. 1853, and Brit,  and For.  Med. Chir. April, 1854, p. 586; also,
Iodotherapie ou de l'Emploi Med. Chirurg. de l'lode et de ses Composes et particuli.re-
ment des Injections Iodees.  Paris, 1855,  noticed in Dublin  Quart. Journal of Medical
Science, Nov. 1855, p. 434.
  8 Wochenschrift fiir die gesammte Heilkunde, No. 40,  S. 633, Oct. 1836.
  6 Revue M.dicale, vii. 249; and Practical Observations on Leucorrhcea, &c, by Geo.
Jewell, p. 80.  Lond. 1830.  See, also, Solon, in Nouv. Diet, de Med. et Chirurg., art.
lode.                 7 L'Experience, cited in Lancet, Jan. 28, 1843. 
476
IODINIUM.
similibus probably,) "advantage  maybe 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 leucorrhcea.   He dissolves a  dram of  iodine  in  tAvelve fluid-
ounces of alcohol;  and adds about forty fluidounces of water.   About
a fluidounce of  this  is  thrown into the vagina as an injection; Avhich
is repeated every day, or every other day, according to the excitement
it occasions.  Dr. Thomas T. Russell1 affirms, that he has found no re-
medy equal to  injections  of iodine in this  obstinate, and, in many
cases, intractable disease."  He  employs  them, varying  in strength
from one to four grains of iodine, with double the quantity of iodide
of potassium to an ounce of water; once or twice a day, or once every
second or third  day, as occasion may require.  As an internal remedy,
iodine proved of little or no  \Talue.
  In  chronic dysentery, it  has been  employed in injections by M.
Delioux.2  He forms the injection  of from 150 to 200 grains of tincture
of iodine;  15 to 30 grains of  iodide  of  potassium, and 6 to 7 ounces
of water.   An  emollient  injection was first administered to clear the
intestine, and then  the iodine injection, which  thus acted  immediately
on  the mucous  membrane.  Dr. Eimer,3 had before recommended the
use of iodine injections in  acute dysentery.
   In  discharges from the nose,  iodine, in the form of iodide of potas-
sium, has been used  with advantage by Dr. Elliotson4  and  by Mr.
George Fayrer,5—given internally, as well as employed  in the form
of injection (9j. ad aquce f giv.)
   In  secondary syphilis,  iodine  has  been recommended by  Tyrrel,
Saville,  De  Salle, Schlesier,8 Dietrich,7 A. Cade,8 Acton,9  and nume-
rous others;—especially when the disease is complicated with scrofula,
and the  effects  of mercurials.   Wallace10 has  likewise communicated
some  fortunate  results from  the administration of iodide of potassium
in secondary syphilis, and  Ebers,11 Ricord,12 Yon Haselberg,13 Cullerier
and others haAre confirmed his observations.  Benecke14 has employed
iodide of potassium, with  the best effects,  in every form of syphilis—
primary, secondary and tertiary.  Mr. Bullockl5 has reported the par-
                        *
  1 Amer. Journ. of the Med. Sciences, April, 1854, p. 398.
  2 Presse M.d. Beige, 1853, Dublin Med. Press, July 15,1853; and Ranking's Abstract,
xviii. 97.
  3 Henle's Zeitschrift, x. 238, and Brit, and For. Med. Chir. April, 1852, p. 560.
  4 Lancet, Feb. 10, 1838, p. 725.   /               6 Ibid. Feb. 24, p. 786.
  6 Casper's Wochenschrift, Feb. 4, 1837, S. 78.
  ' Journ. des Chirurg. und Augenheilkunde, von Grafe und Walther, and Encyclog. des
Sciences M.d. Jan. 1841, p. 165.
  8 Bull. Gen. de Therap. Mai, 1841, and Encycl. des Sciences Mud. Aout, 1811, p. 319.
  9 London Lancet, Jan. 31, 1846.
  10 Treatise on the Venereal Disease.   Lond. 1833.
  11 Medicinische Zeitung, Oct. 5, 1836, S. 201 and 207.
  12 J. J. L. Rattier, La Lancette Francaise, No. 34, 19 Mars, 1839.  Gazette des Hopi-
taux, Mars, 1839, and Langston Parker's  Modern Treatment of Syphilitic Diseases, &c,
&c. Amer.  Med. Library edit. p. 77.  Philad. 1840.
  13 Medicinische Zeitung, No. 48 and 49.  Berlin, 1837.
  14 Schmidt's Jahrbiicher der in-und-auslandischen gesammten Medicin, Jahrgang, 1848,
No. 8, S.  185.
  15 Edinb. Med. and Surg. Journal, Jan.  2, 1837.  See, also, Cogswell on Iodine, p. 80,
Laycock, London Med. Gaz. March 2, 1839, p. 821;  and  Lisfranc, in Med. Times, Jan.
 11, 1845. 
IODINIUM.
477
ticulars of eleven cases of secondary syphilitic diseases, of a formi-
dable character, relieved by iodide of potassium given internallv  in
doses of eight  grains, three times a day, in camphor mixture.   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 tubercular erup-
tions.   The period of cure was from one to two months.   Mr. Mayol
has described it as efficacious in certain disorders, which are the con-
sequences 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; and M. Michel2 gave it with great advantage for the
removal of tertiary  symptoms, in the dose of four grains  in the day,
dissolved in an ounce of tar water.
   Iodide of potassium has been used with much success by M. Ricord,3
in deep-seated  syphilitic tubercles.  Before  the tubercles have become
inflamed or softened, whilst they are still indurated, he has constantly
succeeded in dispersing them by iodide of potassium, with small doses
of iodide of mercury.   Yery commonly, however, he employs iodide
of potassium alone; and when the tubercles have become ulcerated,  he
still relies upon it as his  principal  remedy.   M. Ricord4 considers  its
results  to be most happy in the tertiary forms of syphilis, in which  he
regards it as the great remedy.   He employs it in gradually increas-
ing doses,  commencing with ten grains dissolved in three fluidounces
of distilled 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  ra-
 pidity.   By the same plan Jagerschmits5 treated successfully two cases
 of constitutional syphilis, after the mercurial treatment had failed.  In
 one of  the cases, the iodide of potassium Avas given with the iodide of
 mercury;  in the other, the iodide of potassium alone.
   From an examinination into the  comparatiAre value of the  different
 preparations of mercury and iodine, and the best modes of administer-
 ing them, Dr.  Hocken6 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
   1 London Med. Gaz. xi. 249.  See, also, A Treatise on Syphilis, by Herbert Mayo,
 F. R. S.  Lond. 1840.
   2 Bouchardat, Annuaire de Th.rapeutique pour 1848, p. 193. Paris, 1848.
   * Langston Parker, op. cit. p. 77.
   4 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. F.vrier, 1841, p. 359, and M. Seguin, Bull. G.n.
 de Th.rap. Dec. 1*41.
   5 Bulletin de Therapeutique, Janv. 1849; and Canstatt und Eisenman's Jahresbericht,
 u. s. w.  im Jahre 1849,  v. 159.  Erlangen, 1850.
   6 Edinb. Med. and Surg. Journal, April, 1844, p. 325. 
478
IODINIUM.
of some severe cases of pustular 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 valuable 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 pre-
senting both secondary and tertiary phenomena;  and that the only form
of iodine, safely applicable 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.
   Nocturnal pains in the bones, and diseases of the bones and periosteum
have likewise been particularly  benefited  by the iodide:1 the  latter,
when localized for  a longer or  shorter  period,  have yielded sooner
when blisters have  been applied over the affected parts.  Mr. A. Ure2
reports a case of periostitis of the left ulna, of two months' standing,
Avhich, after leeching, blistering, &c, had  been employed,  was cured
by two grains of iodide of potassium given  tAvice 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.  Keate3  to be beneficial in
enlarged prostate;  and  iodide of potassium was administered success-
fully in the same disease by Dr. Casey.4  In enlargements of the third
lobe  of the prostate  Mr. R. A. Stafford,5 has recommended it to  be
applied, by charging a  bougie  at its point with iodine, or iodide of po-
tassium, 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  potas-
sium into contact with it, and, by drawing the bougie gently backwards
and  forwards, 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 a dram of unguentum
cetacei, and increasing  it as the patient 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.

  1 Wm. B. Casey, in New York Journal of Medicine and  Surgery, October, 1840, p.
320; and J. M. Ferrall, Lond. Med. Gazette, April 18,1840, W. S.  Oke, Provincial Med.
and Surg. Journ. April  24, 1844; and Henry Hartshorne, Amer. Journ. of the Medical
Sciences, Jan., 1849, p. 47.       2 London Medical Gazette, March 21, 1845, p. 785.
  3 Lancet, for 1832-3,  p. 672.
  4 New York Journal of Medicine, Oct. 1840,  p. 324.
  5 Brit, and For. Med. Rev. Oct. 1840, p. 529, being a notice of  Mr. Stafford's Essay
on the Prostate Gland. 
IODINIUM.
i
479
   In different forms of rheumatism, iodine has been given with success
 by Dr. Clendinning,1 in the Mary-le-bone Hospital, and a series of cases
 in which it was employed has been published by him.   Sir B. Brodie2
 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  internally and  externally, have  been pub-
 lished by Dr. Mackey,3 Mr.Wardleworth,4 and M. Bouyer.5  Dr. Cowane
 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 leech-
 ing 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 rheu-
 matism 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 combination has been highly  extolled by Dr.
 Graves in sciatica and lumbago;7 by M. Izarie8 in  the former affec-
 tion; and by Dr. Heygate9 in chronic rheumatism, secondary syphilis,
 &c.10  When rheumatism assumes the  chronic form, or if there should
 exist a strumous or syphilitic taint, no remedy, according to Dr. George
 L. Upshur,11 will be found equal to the iodide of potassium, of which
 he usually prescribes five grains four times a day in hop tea, the bow-
 els in the mean time, being opened every day by the  black draught or
 other cathartic.   He has rarely seen the  most obstinate  cases resist
 this  treatment.   Dr. Basham,12 however, lays down the questionable
 rule, that iodide  of  potassium  is  only useful in those  cases of rheu-
 matism, in which the patient  has, at some former period,  been mer-
 curialized.  The idea was probably suggested to Dr. Basham by the ob-
 servations of Melsens, before referred to (page 471;) but if can scarcely
 explain the results of the numerous observations of benefit from the
 salt  in  chronic  rheumatism.    In gout, too, it has  been  prescribed.
 Jahn found it extremely effective in dispersing gouty  tophi;  and  its
 efficacy has been ascribed to its power  of  dissolving urate of soda, a
 great constituent of gouty depositions.  It would appear, however, from
 actual experiments by Dr. Garrod, that  the power of  the iodide in disr-
 solving  gouty concretions is no  greater than that  possessed by other
 salts.13  Yalentin observed, that when  iodine* was given  in a case of
 goitre complicated with gout, the tumefaction of the joints  and the de-
 positions gradually disappeared.   Adopting the hint, he gave  it in se-
 veral  cases of gout,  with the effect of always mitigating the  disease,
  1 London Med. Gazette, May, 1835.                    2 Lancet for 1832-3.
  5 Ibid. March 2, 1839,  p. 830.                        4 Ibid. March 30, 1839.
  8 Gazette M.d. de Paris, No. 32,  1840; see, also, Davies, Op. cit. p. 317,  and Crawford,
 Montreal Medical Gazette, April 1, 1844.
  •Prov. Med. and Surg. Journ. May 27, 1843.
  ' Dublin Journ. of Med. Science, Nov. 1840, and M. Ebrard, Journ. de  Med. et Chi-
rurgie Pratiques, Nov. 1845, and Amer. Journ. of the Medical Sciences, July, 1846, p. 225.
  8 Revue Med. Chir. de Paris, Mai, 1832, and Ranking, xvi. 71, Amer. edit. Phila. 1853.
  "London Lancet, Mar. 6, 1841; see, also, E. D. Connor, American Medical Intelli-
gencer, Dec. 1, 1840,  p. 257.
 10 See, also, W. S. Oke, Provincial Med. and Surg. Journ. May 1, 1844, p. 54.
 11 Medical Examiner, Oct. 1850, p. 581.
 12 Lancet, Nov. 19 and 26, 1853.
 13 Brit, and For. Med. Chir. Oct., 1854, p. 389. 
480
IODINIUM.
and, at times,  of  completely curing it.   Gendrin used iodine not only
in chronic gouty swellings with success, but also in acute caxcx.  Ebers
likewise  confirms  the efficacy of iodine in gout; and Mr. T.  Spencer
Wells,1 says he has given the iodide of potassium very extensively for
thirteen years, in  almost all forms of gout except during the acute at-
tack, and in almost every case with the most encouraging results.   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.   Similar  cases have also been
given by Treusen  and Blasius.   The latter gentleman2 also applied ex-
ternally with success, a  tincture composed of iodine, 9j.; iodide of po-
tassium, 5ss.; alcohol, f Sj-; in three cases of ununited fracture.  The
fracture  became  consolidated after three  or  four weeks' pencilling.
Painting  the  affected surface with it, even in acute rheumatism, has
been found useful.3   In various rheumatic affections of the joints, espe-
cially of  the chronic kind, Dr. R. B. Todd4 has employed "with un-
questionable benefit," 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; yet  Dr. Gros, of Wesser-
ling,5  affirms,  that before he recently recommended the tincture of
iodine, it had  never been employed in chronic rheumatic affections of
the  joints!  In adiposis,1^'on  Grafe6 prescribed  it, and not Avithout
advantage.  The  case was accompanied by great voracity and sense
of suffocation.   Bleeding and cathartics were  premised.  In stomacace
or a scorbutic  state  of the gums, the  use of iodine  has  been  recom-
mended  by Friedrich, as well as in mercurial  salivation, by Klugc,
Knod,7 Klose,8 Graves,9 Asmus,10 and  others;  yet its efficacy appears
to be somewhat doubtful in the last affection.  Heyfelder found it of
no value in three  cases.   Dr. Norman Cheevers,11 however, strongly re-
commends a  gargle  containing from  two  to  five drams of the com-
pound tincture of iodine to eight ounces of water.   Dr. H. D. Holt12

   1 Practical Observations on Gout and its Complications, &c.  Lond. 1854.
   2 Med. Zeitung, 1851, No. 39; and Brit, and For. Med. Rev. April, 1852, p.  551.
   3 Cowan, Provincial Med. and Surg.  Journal, May 27, 1843.
   4 Lond. and Edinb.  Monthly Journal of Med. Science, Dec. 1843, p. 1084; and Craw-
ford, Montreal Med. Gazette, April 1, 1844.
   5 These de Strasbourg,  in Archives Generates de M.decine, F.vr. 1850, p. 214.
   6 Walther und Grafe's Journal fur Chirurgie, B. ix. St. 3, S. 367.
   ' Gazette des Hopitaux, July, 1837.
   8 Medicinische Zeitung, No. 34, 1836.  See, also, Amer. Journ. of the Med. Sciences,
 Feb. 1834, p. 533.                     s Dublin Journ. Med. Science, Jan. 1834.
  10 Casper's Wochenschrift fur die gesammte Heilkunde, No. 45, 1838, and  Encyclo-
 graphie des Sciences  Medicales, Juillet, 1839.
  11 Indian Annals of Med. Science, April, 1854;  and Brit, and  For. Med. Chir. Rev.
 Oct., 1854, p. 564.
  12 New York Journal of Medicine, May, 1848. 
IODINIUM.
481
found, that every case of  nurses'  sore mouth, which he  treated with
five grain  doses of iodide of potassium three  times  a day, yielded
Avithin forty-eight hours.   In a case  of stricture of the oesophagus, it
was given with much benefit by Dr. Cumming, of NeAvYork.1  A bou-
gie had been previously used, but without advantage.  An adventitious
membrane Avas  brought up in scales soon after commencing the iodine.
For two or three weeks, the medicine was laid aside, but it was  neces-
sary to resume it.   In affections of the mucous membrane of the mid-
dle ear, it has been  used by Dr. Manson, and also by Mr. T. Wharton
Jones;2 by the former with advantage; by the latter  without  any
marked effect.   Dr. Manson likewise succeeded in curing chronic da-
cryocystitis by  it; and M. Lopez3  employed  iodide of potassium with
advantage, internally, along with vesication  on  the temples, in cata-
ract.   The treatment was persevered in for five or six months, and in
three cases out of four, it was productive of great benefit.
   In cases of hydrocele,  M. Yelpeau4  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.5   Injection
by iodine, he considers, possesses an incontestable advantage over others,
because it causes no inflammation  or sloughing, should it escape  into
the areolar tissue of the scrotum; and because, from the investigations
of M.  Hutin, it is ascertained that the cure is effected without obli-
teration of the sac of the tunica vaginalis.6   He applies collodion over
the scrotum on the third  or fourth day after the usual  operation  and
iodine injection.  The secondary inflammation  and  engorgement are
much lessened.   In the next  case he treats, he intends  to apply the
collodion immediately after the operation.7
   Mr. J. R. Martin,8 of India, appears,  however, to have anticipated M.
Yelpeau in this application of the remedy.   Up to the time of the pre-
sentation of his paper to the Medical  and Physical Society of Calcutta,
(January, 1835,) he had used'it successfully in upAvards of ninety cases,
and subsequently he communicated to  the  Medical and Physical So-
ciety  of Calcutta the results  of his after experience.   The number
treated since March, 1832, at the Native Hospital, was seven hundred
and seventy-seven: of these, seven hundred  and sixty-six had a solution
of tincture of iodine injected.
   In order to ascertain whether it was by mere stimulation that the
cure by the tincture was  obtained, Mr. Martin  treated ten cases with
a common urethra-syringeful of undiluted port wine, and one with di-
luted tinctura lyttae, in the same proportion as that of iodine,—f 5lj*t0
water f 5vj.  Of this, two drams were  injected and retained; the pain
during twenty-four hours was excessive, and the inflammation, although

  1 New York Journal of Medicine and Surgery,  No. 2, Oct. 1839, p. 451.
  »,Lond. Med. Gaz. Aug. 17, 1839, p. 754, and Amer. Med. Intel. Nov.  1, 1839, p. 233.
  3 Bull. Gen. de Therap. 1854,  ii. 89.
  4 Archives Generates de M.decine, Jan. 1837; La Presse Medicate, Mai, 1837.  See,
also, Amer. Med. Intelligencer, July 15, 1837, p. 138; and Oct. 16, p. 263.
  6 Bouchardat, Annuaire de Therapeutique pour 1844, p. 338.  Paris,  1844.
  6 Gaz. des  Hopitaux, 11 Fev., 1854; and Med. Times and Gaz., Mar.  4, 1854.
  7 Union M.d. Juillet, 1854, and Brit, and For. Med. Chir. Rev. Oct. 1854, p. 562.
  8 Amer. Journal of the Medical Sciences, Nov. 1837, p. 238.
       31 
482
IODINIUM.
not proportionate to the pain, was much longer in subsiding than Avhen
the tincture of iodine solution was used:  this was also remarkably ap-
parent in the cases  treated with undiluted  port wine.   Of seven hun-
dred and sixty-six cases it does not appear that more than four failed.1
  For hydroceles containing from six to  thirty ounces  of fluid, two
drams of the solution of tincture of iodine are sufficient; for those con-
taining 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.2   The cure is effected
much sooner by iodine; and if any infiltration takes place, it is readily
absorbed.  Highly  favourable results have also been obtained  by MM.
Oppenheim3 and Fricke,4 and by Mr. Bransby Cooper,5 and M. Speng-
ler,6 and  the  method  has been largely employed in this  country with
equal advantage.7   Two successful cases  are reported  by Dr. Stewart.8
  Encouraged by the success, which attended the use of iodine injections
in hydrocele, M. Yelpeau9 has  adopted  a  similar mode of treatment
for various kinds of serous cysts, enlarged  bur see, &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 inflames, though never greatly, and it ultimately
shrivels and disappears.   Since then he has used the injection success-
fully  in five cases of goitre, which is often formed of cysts filled with a
thin  serous  or a blackish fluid.   In hydrarthrosis, the operation  ap-
peared to him to be more formidable.   He practised it in two cases;
one recovered; the other did not.10   The  plan has been employed by
M. Bonnet,11 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. Bonnet's cases, the acute ar-
thritis which supervened subsided within a  few days, and was never fol-
lowed by suppuration.   Since then, M. Yelpeau12 has expressed himself

  1 Quarterly Journal of the Calcutta Med. and Physical Society, for Jan. 1837; and
American Journal of the Medical Sciences, for Feb. 1839, p. 485.
  2 Dujat, in Gazette M.dicale de Paris, Sept. 1838.
  3 Zeitschrift fur die gesammte Medicin. Aug. 1838, S. 389.         4 Ibid. S. 405.
  5 Medico-Chirurg. Rev. Apl.  1841, p. 541.
  6 Prager, Viertel-Jahresschr. Bd. i. S. 159, cited in Canstatt's Jahresbericht, 1852, v. 104.
  7 A. C. Post, New York Journal of Medicine, April, 1840, p. 369, and G. W. Norris,
Amer. Journ. of the Med.  Sciences,  Feb.  1839, p.  299.
  8 India Journal of Medicine, May, 1836.
  9 Bulletin General de Therapeutique, Nov. 1841.
  10Recherches sur les Cavites Closes, &c, pp. 112—165, and Bourchardat, Annuaire de
Therapeutique pour 1843, p. 256.   Paris, 1843.
  11 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 had until then been employed in hydrarthrosis.
  12 Gazette des Hopitaux, and Brit, and For. Med. Chirurg.  Rev. July, 1850, p. 268. 
IODINIUM.
483
 more decidedly in regard to the beneficial effects of this plan; and he
 states that at least fifty cases treated by different surgeons are now on
 record, in none  of which  were any alarming symptoms  developed.
 Dangerous and fatal consequences  had resulted, according to him, in
 certain cases, from the joint having been laid  widely open, and  ir-
 ritating fluids several times thrown in, whilst in the modern operation
 the smallest  possible trocar is employed, and  in the majority of cases
 a single injection is sufficient.  He is now of opinion, that there is not
 more danger in  injecting a joint than the tunica vaginalis.   Still more
 recently, he  has stated, that his subsequent experience is entirely con-
 firmative of the views formerly expressed.   In more than one hundred
 cases, the joints have  been  punctured and injected with iodine, and
 none of the  patients appear to have had any unfavourable symptoms.
 M. Velpeau has seen his  patients long after the operation, and, in all,
 the movements of the joints were preserved.1
   M. Yelpeau likewise tried the effect  of iodine injections into the sac
 of a reducible hernia, and repeated the experiment in two other cases;
 but the difficulty of reaching  the sac with certainty, and the unsatis-
 factory results obtained in these three cases, have  been  regarded  as
 serious objections to the practice.   The plan was used by  Professor
 Pancoast, who has, likewise, employed  the tincture of cantharides for
 the material of the injection.  He states2 that he had used it eleven
 years before the date of publication of his work.  He injected  from
 half a dram to a dram of Lugol's solution.   Dr. H. J. Bigelow3 has also
 injected the tincture of iodine in such cases with safety and advantage.
 He uses  a minute  silver syringe terminating in  a fine tube, Avhich
 carries, at its point, a perforated trocar, serving, at once, to  make the
 puncture and deliver the injection.  With this, tAventy-five drops of the
 tincture of iodine were deposited at the ring through a puncture in the
 skin made with a tenotomy  knife.   More recently,  M. Jobert4 has
 presented to  the Academie Imperiale de Medecine the history of three
 cases of inguinal  hernia, which were radically cured by injecting tinc-
 ture of iodine into the hernial  sac; and a few drops of a highly concen-
 trated solution of perchloride of iron were successfully injected by MM.
 Pravaz and Deslongchamps.5
  M. Arelpeau6  was disposed  to go even farther, and, as he considered
 it to be proved by his experiments, that the tincture of iodine does not
 induce either suppuration or  gangrene when  thrown into serous cavi-
 ties, he suggested whether we might  not hope that certain varieties of
 spina  bifida, hydropericardium, hydrothorax and  ascites may respect-
 ively  find an efficacious  remedy in this kind of"medication?   "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, I  think, to

  1 Presse M.dicale Beige, cited in Dublin Med. Press, Jan. 5, 1853.
  1 Operative Surgery, Philad. 1846.      3 Boston Med. and Surg. Journ. Dec, 1850.
  4 Gazette des Hopitaux, Aug. 10, 1854; Med. Times and Gaz. Sept. 1854; and Amer.
Journ. of the Med. Sciences, Jan., 1855, p. 241.
  6 Schmidt's Jahrbuch. Bd. 78, S. 71, and Ranking, xvii. 251, Amer. edit.  Philad. 1853.
  6 Bouchardat, Annuaire de Th.rapeutique pour 1844, p. 132.  Paris, 1844. 
484
IODINIUM.
justify fresh trials in this direction.  I may add, that the iodine injec-
tion has succeeded with me in purely liquid hsematocele as well as in
hydrocele."   A case of spina bifida has, indeed, been treated success-
fully by Dr. Brainard,1 Avith injections of iodine.  The patient, a girl,
thirteen years of age, had a tumour at the top of the  sacrum,  nine
inches in circumference and about three in length, with thin walls.  She
had been paralytic in the  lower limbs, but within three years had ac-
quired a partial use of them.   Through a small puncture, a solution
of a grain of iodide of potassium with half  a grain of iodine in a flui-
dram of water, was thrown  into  the  sac;  compresses and a bandage
were applied to prevent the escape of the fluid; and methodical com-
pression by a  bandage was  exerted  on the tumour.   A month after-
wards the injection was repeated, of half the strength of the first, and
in about a fortnight the fluid in the sac was in  great  part absorbed.
A spring truss Avas  now applied, and the  fluid became entirely ab-
sorbed.  Since then, he  has treated three cases, all associated  with
hydrocephalus, and therefore  incurable.  He  is  of opinion that the
disease is  generally  curable by this  plan  of treatment, and  that,
compared with every known method, it  is "safe and efficient."   He
advises that, at the commencement, not more than the thirty-second
part of a grain of iodine, and three times as much  iodide of potas-
sium, dissolved in distilled water, should be used.  As long as it pro-
duces moderate inflammation, the quantity should not be increased.
Collodion is  subsequently applied and reapplied as long as the tumour
continues to decrease; and when it  ceases  to  decrease, or increases,
'the injection is repeated.2
   M. Chassaignac3 protests against  the common practice of aban-
doning such cases as hopeless; for although many of them are attended
with such organic alterations as to render a cure impracticable; others
are  under more  favourable  conditions;  and he relates the case  of a
child, five months old, in Avhich a radical cure was  effected by iodine
injections.
   A case of ovarian  dropsy was  published  by Dr. Benjamin A. Alli-
son,4 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  con-
trolled.5  They subsided, however, in a few days, and  she continued
improving.   The  discharge  rapidly increased until it  almost entirely
ceased."
   Professor  Simpson,6 of Edinburgh, has injected  dropsical ovarian
cysts with tincture of iodine in seven or eight  cases.   He has usually

  1 Illinois and Indiana Med. and Surg. Journal, Jan. 1848.
  2 North-Western Med. and Surg. Journal, July, 1850.
  s Bull, de Therap., xlv. 163.
  1 Medical Examiner, June, 1846, p. 336; and August, 1847, p. 459.
  6 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 Medical Times, Feb. 7,
1846, p.  363.
  6 Edinb. Monthly Journ. p. 467, May, 1854, and for his  further experience, Ibid. Dec.
1854, p. 565. 
IODINIUM.
485
 thrown in two or  three  ounces; and  while he considers the method
 perfectly safe, it has by no means proved  always as successful  as in
 hydrocele in preventing a reaccumulation of the  fluid;  for, in several
 instances, the effusion into the  sac seems to have gone on as rapidly
 as after a simple tapping without iodine injection.  In two or three of
 the  cases, obliteration of  the  tapped  cyst appeared  to have taken
 place.
   M. DuplayMias  published a case in which  an ovarian tumour was
 tapped: 16J litres  (35 pints) of fluid were drawn off, and 250 grammes
 (about Sviij.) of a solution consisting of water, 100 parts; alcohol, 50;
 iodine, 5, and  iodide of potassium, 5,  were thrown into the cyst, and
 then, by pressure, made to issue again through the cannula.  Some
 Bharp pain and fever followed;  but, in  three days, every unfavourable
 symptom disappeared, and the patient recovered.
   A similar  plan has been used successfully in some cases of hydro-
 thorax and ascites.2
   In a case of empyema after paracentesis, Dr. Suytgaerens, of Puers,
 repeatedly injected the pleura with an iodine solution, and the patient
 recovered.  Successful cases have also been published by M. Aran.3
 M. Tessier4 recommends that the whole of the fluid shall not be drawn
 off before injecting.
   In a case of ascites, M. Dieulafoy, of Toulouse, 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 employed about six weeks  afterwards:  after this
 the  ascites disappeared.5  Another case is related6 in  which a  cure
 was  effected in the  same manner.  The patient,—a child, seven years
 of age,—had been tapped several  times, but the abdomen had always
 become filled again, and he was  in an  almost hopeless state when
 this  course was resorted  to.  The case was one of asthenic  dropsy,
 without any  apparent  complication of disease of the heart or other
 viscus;  and M. Leriche,  of Lyons, has published two  cases in AAThich
 a single injection,  after  the complete evacuation  of  the fluid,  was
 sufficient  for the cure.   M.  Boinet presented a memoir before  the
 Sociite de Chirurgie, in  which he enumerated eighteen  cases,  from
 various sources, wherein  different  substances, as  gases,  water, iodine,
 &c,  were injected.   Fifteen of these  were successful, and only one
 died; iodine  seeming to be the  preferable material for the injection.
 M. Morel, reporting upon this  paper,  pronounced an almost unquali-

  1 Archives Generates de Med. Fev. 1853.
  2 Rul-Oges, of Antwerp, cited by Thirion, in Gazette  Medicale de Paris, 10, 1849; and
in Schmidt's Jahrbiicher, u. s. w. No. 11, S. 169.  Jahrgang, 1849. See, also, Ranking's
Abstract, xiv. 214.  Amer. edit. Philad., 1852.  Costes, Gaz. Med. de  Paris, Oct. 29,
1853; and Ranking, xix. 89.  Philad. 1854.
  3 Union Medicate, 98 to 103, Paris, 1853, or Archives Gener. de Med. Oct. 1853, p. 491.
  4 Bull, de Therap. 1854, and Ranking, xx. 90, Philad. 1855.
  6 British and Foreign  Medical Review, July, 1846, p. 78.
  6 Gazette Medicale de Paris, 4 Mars, 18-18. 
486
IODINIUM.
 fied  opinion in favour of the  practice;  but " MM. Yidal,  Gosselin,
 Robert and others, protested  against  drawing  any such hasty con-
 clusions from cases the history of which had been imperfectly given,
 and  have to be confronted with others  in which  a fatal termination
 has resulted, an example of which has recently occurred in Paris."1
   Dr.  Brainard states,2 that in December,  1845, he  threAv into the
 peritoneal cavity fifteen grains  of iodide  of potassium dissolved in one
 fluidounce of distilled water, after he had evacuated the fluid of asci-
 tes by  tapping.  Acute smarting pain followed, which subsided in a
 few minutes without any subsequent evidence of inflammation.  The
 patient returned home, and  Dr. Brainard  lost sight of him.   In ano-
 ther  case, Dr. Hagemann injected the cavity twice without the super-
 vention of inflammation.  In the winter of 1850, Dr. Brainard injected
 the  abdomen  of a patient affected with  anasarca, as well as ascites,
 from cardiac disease, with four  grains of iodine, and eight of iodide of
 potassium in solution, without drawing off the fluid.  The injection was
 followed by no signs of inflammation, but the fluid in the peritoneum was
 absorbed, and a great amelioration of the symptoms folloAved.  Dr. Brai-
 nard refers to cases treated in a similar manner by Dr. M'Clure, of Dun-
 dee, Illinois, and by Professor Mussey, with similar results; whence he
 concludes, it may be considered an established fact, that injections of
 this kind may be made, with  suitable care, without danger of producing
 inflammation.3
   M. Teissier4 relates three  cases of ascites treated by injections, com-
 posed of from 60  to 70 grains of iodide of potassium,  from 7 to 10
 drams  of tincture of iodine, and six ounces of water.   The iodine was
 rapidly absorbed, and  excreted by the  kidneys.  In the case of an
 hydatid cyst of the liver, M. Jobert de Lamballe  introduced a large
 trocar for  the purpose of injecting iodine, which  he allowed to remain
 in the wound.   M. Aran5 uses capillary tubes, and  relates the particu-
 lars of  a case, in which, after ten successive punctures, he injected a
 fluid, composed of tincture of iodine f gij., distilled water f §ij., iodide
 of potassium 5iss.   No pain ensued;  and the cyst, which contained
 thirty-two ounces of reddish fluid, slowly contracted.   A second case
 is also  given.
   In the Parisian  hospitals, iodine injections are  used freely  in the
 treatment of chronic abscesses ;6 and although the reports are generally
 favourable, one case, of a fatal result, has been recorded by M. Robert.7
  1 British and Foreign Medico-Chirurgical Review, July, 1850, p. 270, and  L'Union
 M.dicale, Nos. 17, 18, 19, and 20.
  2 North-Western Medical and Surgical Journal, July, 1850; and Amer. Journal of the
 Med. Sciences, Oct. 1850, p. 560.
  3 See, also, M. Ore, in Bullet, de Th.rap. Sept. 1852, and Brit, and For.  Med. Chir.
 Rev. April, 1853, p. 569.
  * Gazette des Hopitaux, 1852, p. 120,  and Brit, and For. Med. Chir. Rev. April, 1853,
 p. 569.
  5 Revue Me"d. Chirurg. de Paris, 8eme ann.e, torn. xvi. and Brit, and For. Med. Chir.
 Rev. for  Jan. 1855, p. 280.
  6 Med.  Times and Gaz. March 27, 1852, and Ranking's Abstract, xv. 269, Amer. edit.
Philad., 1852. See, also, Spengler,  cited in Canstatt's Jahresbericht, 1852, v. 104; and
Bouchut,  cited in Brit, and For. Med. Chir. Rev., Jan. 1855,  p. 280.
  7 Gaz. des Hopitaux, No. 49, cited in Brit, and For. Med. Chir., July, 1853, p. 280. 
IODINIUM.
487
It was that of  a large abscess supposed to be dependent upon disease
of the spine. After evacuating the pus, an iodine injection was thrown
in; but, soon after, constitutional irritation was set up, and the  man
sank in thirty-six hours.   The only cause of death that could be
discovered was the infiltration of the areolar tissue of  the  thigh  with
a mixture of the  pus and the iodine.  M. Robert  thinks  this  miodit
have been prevented, by making a direct, instead of an oblique, opening
into the abscess.   Great constitutional disturbance also resulted from
its injection, by M. Nelaton, in a case of psoas abscess.1
   Iodine is said by  Coindet and. Formey to have  been efficacious in
cases of impotence; and  Mr. Key2 regards it as one of the most effi-
cacious remedies we possess in checking or  controlling the ulcerative
process,—the most  active phagedenic ulcers often  yielding in  a sur-
prising manner to its influence, and  assuming  a healthy, granulating
appearance.  M. Lisfranc3 employed 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 was prescribed in  doses  of a scru-
ple daily, which was subsequently increased  to six  grains every six
hours.
   Dr.  John Davies4 has published at length the results of his experi-
ence with the local application  of  iodine—especially the tincture—in
various diseases.   In erysipelas, no matter Avhere  present  or of what
description, he found  the tincture,  " painted"  over the part with  a
camel's hair brush, preferable to  leeches, lotions,  incisions, scarifica-
tions, or caustic.5  Mr. Wm. Reeves6 uses in these cases the compound
iodine  ointment; and Dr. Durkee7 recommends the local  application
of the  ethereal tincture, in  quantities of 20  to 30 drops, poured on the
parts and immediately spread over the surface with  a brush.  The skin
is to be made nearly black with the iodine.   In phlegmon, where pain and
throbbing only exist, one  application of the tincture of the full strength
has 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 areolar membrane,
after phlegmonous  erysipelas of the loAver 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. A large sanguineous cyst of the thyroid body was successfully

  1 Journ. de Chim. M.d. i. 1854, cited in Brit, and For. Med. Chir., Jan. 1855, p. 280.
  1 Medico-Chirurgical Transactions, vol. xix.
  3 Cited in London Lancet, Jan. 7, 1843.
  1 Practical Remarks on the Use of Iodine Locally Applied, &c, &c. London, 1839: or
Amer. Med. Library, 1839-40.
  5 See,  also, Burns, in Philad. Medical Examiner, Nov. 6,1841; Dr. Crawford, Montreal
Med. Gaz., April 1, 1844, and Mr. Hugh Norris, Med. Times and Gaz. Dec. 11, 1832.
  « London Lancet Oct,  22, 1842, p. 119.
  7 Amer. Journ. of the Med. Sciences, July,  1854, p. 108. 
488
IODINIUM.
 treated by Mr. Holmes Coote1 by puncture, and injection of tincture of
 iodine.  It became developed in a healthy young married woman shortly
 after her first confinement.  It was thrice punctured.   Sixteen ounces
 of  colourless blood first flowed out, which separated into a firmish yel-
 low clot and serum;  afterwards it was of  a pale  red  hue,  and  much
 less in quantity.   An ounce and a  half of an injection composed  of
 compound tincture   of iodine f 5j; water f §v. was  then  thrown  in
 through a trocar.   The patient recovered.   In the case of a large cyst
 of  the thyroid, Mr.  Lawrence also  succeeded  in  effecting  a  cure by
 repeated injections of  small quantities  of the compound tincture  of
 iodine.  M. Nelaton cured a biliary fistula by the same method.
   In acute inflammation of the joints, it was,  in  Dr.  Davies's experi-
 ence, more  efficacious  than any of the  ordinary local  applications.
 Over the knee—if the skin be delicate—it may be applied at first  about
 half strength, and be increased gradually  as required.   When the hip
 is affected, the strong tincture must be  painted all round  the upper
 part of the thigh and groin.   In these cases, Dr. Davies prefers leech-
 ing the joint,  and then using the iodine as  the  bleeding ceases.   Mr.
 William Reeves2 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 dis-
 covered ;  and if an abscess should form, its extent will be limited.
   Dr. II. C. Stewart3 records that in several cases of mastitis the iodine
 ointment, spread upon  linen, and applied  to the breast, prevented,  in
 his opinion, the supervention of mammary abscess.
   In gout, Dr. Davies found the application of iodine cut short the attack;
 and in anomalous pains of the joints, supposed to be gouty or  rheu-
 matic, its effect has been marked.  In these cases, Dr. 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 exten-
 sively 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,  when
 the enlargement is of old standing,  an iodine lotion—composed of 32
 grains of iodide  of potassium, dissolved in a  fluidounce of  distilled
 water, to which eight grains of iodine are  added—is preferred to the
 tincture by Dr. Davies;—a rag being wetted in it three or four  times
 a day, and laid round the joint, and the  strength  of the lotion being
 determined by the discretion of the attendant.  In inflammation  of
 the absorbents, the strong tincture, applied along the track of the ves-
 sels, is generally sufficient to subdue the affection.   Employed in an-
 thrax, before or after incisions, it dispels  the  inflammation, and ena-
 bles the parts to  cast off the dead areolar tissue, and form  granula-
tions.  It is equally applicable to boils and buboes,—cutting short the
progress of the latter;  or, if used after  suppuration, limiting  the ex-
tent of the abscess.   The  suppurative  process in  cases of  abscesses
being well established, and the acute inflammation of surrounding parts

  1 Medical Times and Gazette, Nov. 4, 1854.                   2 Op. cit.
  3 Med. Exam.,  May, 1853,  p. 292. 
IODINIUM.
489
repressed by cataplasms, M. Borelli,1 of Turin, after opening the ab-
scess in its most depending part, and evacuating the contents as far as
practicable, introduces the nozzle of a small syringe through the aper-
ture, and throws in pure tincture of iodine with some force, allowing
it to remain in, when the pain is not too great, about half a minute.
He noAv waits three or four days, to see whether  the plastic effusion
into the cavity will effect its occlusion, which is rarely the case,  unless
the abscess is very small, and the engorgement of the surrounding tis-
sues slight.   The  injection will require, therefore,  repetition every two
or three days, according to the amount of reaction produced, and, when
this is in excess, emollient cataplasms  are required.  M.  Borelli has
never seen any ill effect, local or general,  from this mode of using the
iodine.   He reports, also,  cases of ranula, which yielded to the  iodine
injection, after simple puncture had repeatedly failed.2
   Injected into fistulce in ano, iodine was found to be an  excellent
remedy by Mr. Charles Clay, and by M.  Boinet,3 the latter of  whom
has related many cases to show its value, and is of opinion that  it
ought ahvays to be tried  before having recourse to the  knife.   The
ordinary injection is composed of half a dram of iodine, fifteen  grains
of iodide of potassium,  and two fluidounces  of water:—a stronger, of
a dram of iodine,  fifteen grains of iodide  of potassium, and about an
ounce and  a  quarter of water.  One or tAvo  teaspoonfuls of either of
these solutions is injected  by  means  of a  glass  syringe—a  finger
having been  previously placed on  the opening in the rectum, if  such
an opening exists, to confine the injection,  whilst, at the same time,
precautions are taken to prevent it from floAving from the outer open-
ing for at least five or six minutes.  The  operation  may be repeated
if necessary.
   In lupus, or noli me tangere,  the strong tincture  laid upon the ul-
cerated surface has cured  the disease Avithout the use of internal re-
medies.  In  malignant ulcers of the tongue  and tonsils, the  tincture,
of  full strength, brushed all over the parts, arrested the  affection, no
matter how threatening.  The only internal remedy Avas the ioduretted
solution,—in  doses of ten drops twice a day, in water. ^ 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 be repeated in tAvelve  hours, unless the morbid sen-
sation has  ceased.  Where this has been  done prior to_ suppuration, it
never fails, according to  Dr. Davies, to  subdue the disease.   Should
matter have been  formed,  a free incision  must be made, and  the  tinc-
ture be applied over the finger or hand, if SAVollen.   In chilblains, the
tincture, of full strength, is to be applied over the part  affected, and
beyond the boundary of the surrounding inflammation.  This must be
  1 Omodei, Annali, exxviii. 79—154, and British  and Foreign Med. Chir. Rev. July,
1850, p. 269.
  2 Gazz. Sarda. ii. 1854, cited in Brit, and For. Med. Chir. Rev. Jan. 1855, p. 280.
  3 Gaz. Med. de Paris, Dec. 24 and 31, 1853; and Ranking's Abstract, xix. 146, also,
Iodotherapie  ou de l'Emploi Med. Chirurg. de l'lode et de ses Composes et particu-
li.rement  de. Injections Iod.es, Paris,  1855.  Noticed in Dublin Quart. Journ. Med.
Science, Nov. 1855, p. 434. 
490
IODINIUM.
repeated daily for some time, and the affected parts should be immersed
every night in water as hot as can be  borne.   When the ulceration
looks healthy, and the skin around has lost its livid colour, the strength
of the tincture may be reduced.   After each application,  the sore, if
any, should  be dressed with some stimulating  ointment.   In  cases
where  the  inflammation spreads along  the foot  or leg, the affected
parts must be  painted with the strong tincture.   Mr. James Hender-
son x has likewise  found a compound  preparation of  iodine  useful in
chilblains.   The form is given hereafter.   Three applications have ge-
nerally been sufficient.   Dr. Wilson2 has found the Unguentum lodinii
Compositum  of the London Pharmacopoeia "almost a specific," as far
as a merely local application can be considered in such a light.
  In lacerated, contused, and punctured wounds, the tincture was found
by Dr. Davies to be preferable to every plan of local treatment.  When
the accident was one of simple laceration—after the blood  or dirt had
been wiped away,  every point of the surface of the wound Avas touched
over with the tincture, generally of the  full strength,  and the applica-
tion 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 Avas found to be united,  and  the  rest granu-
lating.  The granulations, 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 Dr.
Davies every day or two to the surface: this  quickly occasions the
absorption 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 ap-
plied, is used with the same  success  it  exerts in local  diseases,  and
injuries attended with inflammation.  In such cases,  it should be  al-
lowed  to insinuate itself freely into the Avound, 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 Dr. Davies to be eminently success-
ful in ulcers.   Several cases of chancre yielded sooner than  to the or-
dinary 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 tincture, of full strength, must
be applied to the surface and surrounding skin.   After being allowed
to remain some time, the ulcer must be covered with  simple  ointment
in preference to a poultice.   The application  must be repeated  daily
till the sore becomes clean  and healthy, when the granulations may
be touched with the diluted tincture  every two or three days.  Under

           1 London Lancet, April 18, 1840.
           3 Med. Times, and Edinb. Med. Journ. July, 1855, p. 52. 
IODINIUM.
491
this plan, the cavity of the ulcer  fills up rapidly.   Mr. Fergusonx has
published a most obstinate case of old ulcers, which were cured by the
use of the corrosive chloride of mercury internally, and the  tincture
of iodine externally.   M. Ricord2 considers the tincture to be the very
best topical application in phagedenic chancres, and Dr. Samuel Jack-
son, of Philadelphia, (formerly of Northumberland, Pa.,) has found  it
an admirable remedy in the irritable ulcer with inflamed surface  and
erysipelatoid margins.   It soon  films  the  surface, and with  this the
whole inflammation disappears.   A little lunar caustic then  disposes
the ulcers to granulate.   In hospital gangrene, the  tincture of iodine
has been used, with  excellent effects, by M. Nelaton.3  The  effect  is
very prompt, the granulations assuming a good  appearance  by the
third day, when they are dressed with chloride of sodium.   It is said
to cause less pain than lemon-juice, which is the usual application in
the French hospitals.
   In snake bites, as in those of the rattlesnake, viper, and copperhead,
in both man and animals, the tincture of iodine was first successfully
used by Dr. Whitmire4 with the effect of putting an entire stop to the
swelling and pain in from twelve to sixteen  hours.   He  paints the
bitten part and the whole SAvelling with three or four coats of the tinc-
ture twice daily,  and  should the  swelling  extend,  which it  almost al-
ways does after the first  application, if made soon  after the infliction
of the wound, he repeats it.
   Under the idea that diffuse inflammation is, in many cases, the re-
sult of a specific poison received into the fluids of the body,  Dr.
Brainard5 throws into the areolar tissue of the affected part, a solution
of iodide of potassium—10 grains to the f §ss. of Avater—by means of
an infiltrating syringe; but he has not adduced much  reason in favour
of his  hypothesis, or sufficient evidence of the success  of the practice.
Dr. John W. Green and himself6  have likewise found, that solutions of
iodine destroy the poisonous properties of  the curare poison, as  Dr.
Brainard had observed in the case of the poison of venomous serpents.7
He regards  a solution of iodine  and iodide of potassium,  in  the pro-
portion of ten grains of  the former, and  thirty of the  latter, to an
ounce  of distilled Avater, "Avithin  certain limits," as an antidote to the
venom of the rattlesnake.   When the poison is inserted deeply, or has
been  absorbed, the solution must be infiltrated into the tissues;  and
this can be performed without causing loss  of substance, or  producing
either eschar or suppuration.
   In several cases of poisoning from contact with Rhus toxicodendron,
Rhus  radicans, and  Rhus vernix,  Dr. T. Smith,8 of Cincinnati, pre-
scribed the tincture of iodine as a  local application with the best effects.
  1 London Lancet, Nov. 13, 1841.  See, also, Lisfranc, in Med. Times, Jan. 11, 1845.
  3 Bulletin General de Therapeuticpae, 15 et 18 Fevrier, 1841.
  3 Gaz. des Hopitaux, 1850, No. 86, and Brit, and For. Med. Chir. Rev. April, 1851, p. 549.
  4 North-western Medical and Surgical Journal, Dec. 1848, and Jan. 1849, p. 396.
  6 Amer. Journ. of the Med. Sciences, April, 1852, p. 563.
  6 Archives Generates de Med. 1854, p.  493.  See, also,  M. Alvaro Reynoso, Archives
Gener. de Med. Aout, 1854, p. 237.
  7 Essay on a New Method of Treating Serpent Bite and other Poisoned AVounds. Chi-
cago, 1854. See, also, Dr. Green, in New York Med.  Gaz. July, 1855.
  8 Western Lancet, May, 1851. 
492
IODINIUM.
   Besides these  affections, the tincture has been employed with good
effect in gouty and rheumatic swellings of the small joints from thick-
ening  of their ligaments, fistulous openings, malignant warts  or ad-
ventitious excrescences, ganglions,  the stinging  of wasps, diseases of
the spine, ununited fractures, orchitis, inflamed urethra and chordee,
inflammation of the bursse, chronic ophthalmia, granidations of the eye-
lids1 and opacities of the cornea,2 (being much  diluted,) in  strumous
ophthalmia, when applied to the outside  of the eyelids,3 in ulcerations
of the  tonsils  and fauces, specific  or non-specific,4 and  in  dissection
wounds.   The strength of the remedy,  in the several cases, must de-
pend upon the judgment of the practitioner.5   It has also been used as
a counter-irritant in many internal affections.  Painting the trachea and
larynx with a  strong tincture of iodine  has  been found  beneficial by
Mr. E. Copeman6 in inflammation  of the  air passages.  Dr. Willige7
extols it highly in cases of croup;  and  in bowel complaints,  an  iodine
liniment, in the proportion of a scruple  to the ounce of  olive oil, has
been employed most advantageously by Mr. M'Diarmid.8   He directed
the entire surface of the abdomen to be smeared over with it, and the
operation to be repeated as soon as the liniment is absorbed, and the
skin has again become dry and colourless,  or almost so.  In  the acute
form of diarrhoea of infants, in which the surface of the abdomen feels
hot and dry,  somewhat tender and full, with great irritability of the
boAvels, and frequent watery  evacuations, changeable in colour, and
offensive, Avith general febrile phenomena, an almost magical effect Avas
produced by the liniment in a few hours.
   Iodine has  been  employed  by M. Reiniger9 to remove sparks of iron
from the  cornea.  A small particle of steel struck the eye of a cutler,
whilst at AATork, and fixed itself in the substance of the  cornea, from
which  it Avas found impossible  to remove  it either by the forceps  or the
needle.   It soon excited inflammation, and after eight days the eye
Avas still red, hot and painful, and  the patient complained of a  prick-
ing 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 Avhich
AA*ould  not injure the eye.   A weak solution of iodine and iodide of
potassium was  therefore used as a collyrium, and its very first applica-
tion sensibly deadened  the lustre of the spark of steel.   By its con-
tinued use, the steel was rendered soluble, and gradually removed.
   Lastly: two cases of  nsevi have been recorded by Dr.  S. Edwards,10
in which the iodine  paint was employed with entire success: the surface

  1 Fromont, cited in Wahu, Annuaire de Medecine,  &c. pour 1849, p.  246.
  2 See, Lohsse, Medicinisch. Zeitung, Mar. 3, 1841;  and Brit, and For. Med. Rev. July,
1841, p. 238; and W. S.  Helmuth, Med. Examiner, Sept. 11, 1841, p. 583.
  3 Furnivall, Lancet, Dec. 10, 1842, p. 405.
  4 J. J. Loss, Lond. and Edinb. Monthly Journ. of Med. Science, Sept. 1842, p. 792.
  5 Provincial Medical and Surgical Journal, August 12, 1843.
  6 British and Foreign Medical Review, Oct. 1839, p. 523.  See, also, Langan, London
Lancet, June 27, 1810, p. 484.
  7 Schmidt's Jahrbiicher, No. 7, 1847; and Lond. Med. Gaz. Jan. 1848.
  8 British Amer. Journal of  Med. Sciences, Nov.  1S46.
  9 Journal de Pharmacie et de Chimie, Juin, 1845.
  10 Med. Times and Gazette,  June 2, 1855. 
IODINIUM.
493
being gently painted over with a camel's hair pencil every alternate
day, leaving it off for three or four days, when the skin was very irri-
table and rough.   Success was complete in both cases.

  With regard to the relative value of the preparations of iodine, Dr.
A. Buchanan1 is inclined to place them in the following order:—Iodide
of starch, hydriodic acid (iodine,) and iodide of potassium; although
he admits that the superiority he ascribes to the first is perhaps owing to
his having prescribed it most 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 converted in the stomach into hydriodic acid.
  Mr. B. Phillips2 prefers the iodide of iron in all cases.
  M. Moj'sissovics, of Yienna,3 considers iodide of potassium and the
iodides of mercury to  be decidedly  the  most valuable preparations,
when pure; but  they are often,  he  affirms, given in prescriptions with
matters that decompose them.
   In the Glasgow Infirmary, they are in the habit of preparing a li-
quid hydriodic acid, by dissolving three hundred  and  thirty grains
of iodide of potassium  in f Siss. 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 5ij«4
Each dram of this liquid acid contains five grains of iodine.  The  acid,
thus prepared, is, however, very liable to change, and is necessarily va-
riable  in its effects.5  To prevent its decomposition it  has been recently
proposed to make it, immediately Avhen formed, into  syrup.6
   From his researches on the effects of  the various preparations of
iodine, Dr. CogSAvell7 infers, 1.  That iodine  and iodide  of  potassium
 act  very much in the  same way, but that there  is  still  a  difference,
not merely in point of power,  but of  specific properties.   2.  That,
whatever be the  proper action of the iodide of sulphur, its facility of
 decomposition gives it a resemblance to  iodine.  3. That the iodides
 of  carbon, so far as examined, have an action peculiar to themselves;
and, 4. That in those metallic iodides which Avere submitted to exami-
nation, the preponderance of poAver is on the side of the metals.

                      MODE OF  ADMINISTRATION.
   Iodine is not easily given internally in substance—in the form of
pill or poAvder;  neither are these forms to be recommended.  Coindet
preferred it in the form of tincture; and this is one of the most common
modes in which it  is  administered.  When, hoAvever, the  tincture  is
taken with water, a great part of the iodine is thrown down, and, it has

  1 Medical Gazette, July 2, 1836.
  2 London Medical  Gazette, Jan. 10, 1840.
  5 Oesterreich. Med. Jahrbuch., and Encyclog. des Sciences Med. Avril, 1841, p. 8.
  4 Buchanan, op. cit.
  5 Guibourt, in Revue M.dicale, Aout, 1837; and Bull. Gen. de  Th.rap. Sept. 1837.
  6 Mr. James Murdoch, in Lond. Pharm. Journ. Aug. 1, 1855, and Amer. Journ. of
Pharmacy, Sept.  1855, p. 410.
  ' Essay on Iodine, p. 106.  Edinb. 1837. 
494
IODINIUM.
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,  however, that, in the  generality of
cases, when iodine has disagreed, it has been in the form of tincture.1
For this reason, it has been given more, of late years, in watery solution;
and to promote the solution, iodide of potassium is added; or a little chlo-
ride of sodium, according to Lugol's prescription. An ethereal solution
is also prescribed; and Mr. Curling2 has published a case in which, in im-
peded respiration from bronchocele, it produced  great mitigation of the
symptoms after the common solutions of iodine, combined with its internal
use, had failed. It caused great pain. Mr. Curling has also used it with
great benefit as a counter-irritant in inflamed joints.
   Externally, iodine is applied in the form of tincture, ointment, or
watery solution, or in baths, or fumigations.   Frictions with iodine
readily occasion considerable irritation of the  skin, which  commonly
soon passes away when the  friction  is suspended for a time.   After
bathing a part, painful rubefaction of the skin  often ensues, which is
usually followed by perspiration and sleep.  M. Hannon3 has sugges-
ted, that when iodine is  to  be applied to a local tumour—goitre for
example—it should be placed between two layers of cotton wool, sewed
in a bag, and  tied directly over  the  part.   The vapour of  iodine ra-
pidly penetrates the bag, and stains both  the skin and the  linen,—to
prevent which, a thin sheet of gutta percha or oiled silk, may be placed
over the bag.  Applied in  this way, iodine rapidly enters the system,
and may  be detected in the excretions.  M. Eichmann4 has recorded
a case in  which the vapour of iodine, disengaged in this manner, re-
moAred a case of mammary enlargement.
   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,5 the  most effectual  method of employing
iodine externally is the endermic, in the form of an ioduretted ointment,
to the cutis vera, after the epidermis has  been removed by a blister.
The plan is not, however, often used.   It has been proposed recently
to apply it in the form of iodized collodion, as mentioned elsewhere.6
   Under  the idea that the \rirtues of cod  liver  oil might be owing to
the small quantity of  iodine it contains, rather  than to the  fatty mat-
ter, which—as has been elsewhere  shown—is  probably not the case,
iodine has been added to olive or almond oil, and the results have  not
appeared to the author to be less favourable than when cod liver oil has
been given.   Such a  preparation—iodized or iodined oil—has super-
seded—it seems—the other forms of iodine at the Yal-de-Grace, in Paris.
M. Marchal (de Calvi7) found, that  in  this  way far larger doses of
iodine can be administered without irritating the stomach.   The trials
made by him with the iodized oil have been very satisfactory in their
results, the progress of the cure of buboes and other glandular enlarge-

  1 See page 451.               * Med. Times and Gazette, Nov. 12, 1853.
  3 Presse Med. cited in Med. Times and Gaz. Sept. 4, 1852.
  4 Gaz. des Hopitaux, 19 Dec. 1854, and Amer. Journ. July, 1855, p. 224.
  s Elements of Mat. Med. and Therap. 2d edit. p. 242.  Lond. 1842.     6 Page 257.
  T Gazette  des Hopitaux, Fevrier, 1848.  See a Report to the Academie de Medecine
of Paris on Iodined Oil, by M. Guibourt, in Bull, de 1'Academie, xvi. 1141-57, and Brit.
and For. Med. Chir. Rev. Jan. 1852, p. 276. 
                             IODINIUM.                         '495

ments having been much expedited.  M. Ricord, too, exhibited it with
benefit in tertiary syphilis, caries syphilitica ; and M. Marchal directs
the iodine, as wanted, to  be dissolved in fresh almond oil, in the pro-
portion of  one part  to fifteen.  The minimum  dose  is a grain of the
iodine.
  The following are some  of the forms  in which pure iodine is admi-
nistered internally and externally:—

                        Tinctura  iodinii.
            Tincture of iodine.—Tinctura seu Alcohol lodii.
                 R.   Iodinii gr. xlviij.
             Solve in
                     Alcohol. 35° (s. g. .842) gj.

  Dose.—Ten  drops in some mucilaginous or saccharine fluid, or in
wine and water.                            Coindet and Magendie.

  The tinctura iodinii 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 5x. of alcohol form a  saturated solution.  Based
on this fact, the following formula has been  given, which does not seem,
however, to possess any advantages over the simple tincture.

                 R.   Iodin. ^ij.
                     Alcohol. 5j.
                     Spirit, lavand. comp. gij.

  Dose.—Five to ten drops, twice a day, gradually increasing it.1

       Tinctura Iodinii Composita.  See Potassii Iodidum.

                    Tinctura  setherea iodinii.
Ethereal tincture of iodine.—Tinctura iodii cvtherea.—French. Ether iodure.
                 R.   _Ether. sulphuric, f ji.
                     Iodin. gr. iv.  M.

  Dose.—Eight or ten drops, two or three times a day.   Magendie.

         Pulvis iodinii cum hydrargyri chlorido mite.

                    Powder of iodine and calomel.
                 R.   Hydrarg. chlorid. mit. gr.  viij.
                     Iodin. gr. j.
                     Saochari albi gr. lxxx. M.
           et divide in partes xij.

  One to be taken every four hours, to control scrofulous inflammation
and its effects.                              Bennett and Wiltshire.

          Decoctum cinchonae  cum  tinctura  iodinii.

              Decoction of cinchona with tincture of iodine.
                 R.  Decoct, cinchon. fgx.
                     Tinct. iodin. gtt. xc.   M.

  Dose.—Two spoonfuls, three times a day, in scrofulous ulcers.
                                                              Rey.

         1 Ellis's Medical Formulary, 8th edit. p. 113.  Philad. 1846. 
496                           iodinium.

                         Mistura iodinii.
                          Mixture of iodine.
                 R.  Iodin. gr. v.
                     Alcohol, f 3ij.
             Solve et adde
                     Aq. cinnam. f giiss.
                     Syrup, simpl. f giss.  M.
   To be taken in twenty-four hours,  in dram doses.

                         Syrupus iodinii.
                           Syrup of iodine.
                 R.  Tinct. iodin. gr. vj.
                     Syrup, simpl. i'gij.  M.                   Henry.
Liquor iodinii. (Lcgol's	■■)
Solution of iodine.—French. Boisson iode'e.	
(1. For internal use.)	
A. B.	C.
R. Iodin. Sr-i.. gr* %:. Sodii chlorid. gr. xij. gr. xij. Aqua, destill. Oj. Oj.	gr-j-.. gr. xij. Oj-Solve.
(2. For external use.)	
A. B.	C.
R. Iodin. gr. ij. gr. iij. Aq.. destillat. Oj. Oj.	gr. iv. Oj-Solve.
  Lugol gives formulae for the solution of the three different strengths
above.
       Liquor Iodinii Compositus.  See Potassii Iodidum.

                           Lotio  iodinii.
                          Lotion of iodine.
                 R.  Tinct. iodin. f ^ss.
                     Ferri iodid. gr. xij.
                     Antim. chlorid. §ss.  M.
  Used for corns.   To be applied by means of a camel's hair pencil,
after the corns have been well pared.            James Henderson.
                 R.  Iodin. 3j.
                     Potass, iodid. gij.
                     Aq. destillat.
                     Alcohol, aa. §ij.  M.
  As a local application in congestion and ulceration of the os uteri.
                                                        Churchill.
                       Gargarisma iodinii.
                           Gargle of iodine.
                 R.  Tinct. iodin. f^j.—^ij.
                      ----opii f 3i>
                     Aquae f ^vj.  M.
   To be used three or  four times a day.                J. J. Ross.

                        Unguentum iodinii.
 Ointment of iodine.— Unguentum Iodatum.—French,  Pommade  d'Tode.—
                         German, lodsalbe.
                 R.  Iodin. gr. iij.
                     Adipis Jij.  M. 
IODINIUM.
497
  The Unguentum Iodinii of the Pharmacopoeia of the United States,
(1851,) is made as follows:—
                R.  Iodin. gr. xx.
                    Potass, iodid. gr. iv.
                    Aqua. tn? vi.
                    Adipis |j.
  Rub the  iodine  and iodide with the water, and then with the lard,
until they are thoroughly mixed.

  Unguentum Iodinii Compositum, see Potassii Iodidum.
                      Linimentum iodinii.
                         Liniment of iodine.
                R.  Linim. sapon. f §j.
                    Tinct. iodin. f3j.  M.
                                                       Manson.
                      Cataplasma iodinii,
                         Cataplasm of iodine.
                R.  Tinct. iodin. f ^ss.
                    Lin. pulv. gj.^ _
                    A vena, farin. 5iij.
                    Aqua, destillat. q. s. ut fiat cataplasma.
  Used as  a  cataplasm in scrofulous tumours, and goitre.

  Iodide of Ammonium,  Io'didum seu Iodure''turn Ammo''nii, Ammo-
nium Iodatum seu Hydroiodicum, Hydriodas Ammonias, Hydriodate
of Ammonia, Ioduret of Ammonium ; German, Iodammoniu m—is
formed by  saturating liquid hydriodic acid with caustic ammonia and
evaporating the solution.  It crystallizes Avith difficulty, and is deliques-
cent.   It was introduced into medical practice by M.  Biett, of Paris,
as a valuable  therapeutical agent in certain diseases of the skin.  Seve-
ral  successful cases of its employment in lepra and psoriasis, by M.
Biett, are given by Dr. Pennock,1 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, Io'didum seu Iodure'turn Am'yli, Amylum Ioda-
tum; French, Iodure d'Amidon;  German,  Iodstdrkmehl,  Iod-
stdrke, Stiirkmehl-oder-Satzmehliodilr, has been extolled by
Dr. Andrew Buchanan,2 of GlasgOAV; and M. Quesneville3 and M. Droste4
regard it as  the best  form for administering  iodine.  It is  prepared
of iodine,  gr. xxiv.; starch,  in fine  powder, Sj-  The iodine is first
triturated with a  little water,  and the starch is gradually added, the
trituration  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.
  1 Amer.  Journ. of the Med. Sciences, Feb.  1835, p. 374.
  1 Lond. Med.  Gaz. July 2, 1836; see, also, Soubeiran, Revue Medicale, Aout, 1837.
  8 Bouchardat, Annuaire de Th.rap. pour 1851, p. 262.
  * Canstatt's Jahresbericht, 1851, 6 Bd. S. 73.
       32 
498
IODINIUM.
   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.  Pro-
fessor Forget, of Strasburg, has published the case of a youth, seven-
teen  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.1  Pauli2 thought it inert;
but it is proper  to state, that Dr. Laurie, of Glasgow,3 was of opinion,
that 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.   It has been proposed by M. Burguet4 to cover the abdomen in
a case of ascites with a thick layer of iodide of starch, made of about
9j. of iodine, to twelve ounces of starch.   He  found the iodine ab-
sorbed, and the  dropsical effusion disappear.

   Iodie Acid, Ac"idum Iod'icum; French, Acide  Iodique; German,
Iodsdure.  This  is obtained by boiling iodine with nitric acid; or
by decomposing iodate  of baryta by dilute sulphuric  acid.   It is  a
white, transparent solid, slightly deliquescent, and very  soluble in
water.  It  was  proposed in  medicine by Mr. Monks,5 of Norwood,
England, who gives it in combination with sulphate  of quinia, rendered
soluble by sulphuric acid, as a tonic, excitant and eutrophic in  hoarse-
ness consequent on catarrh,  in scrofula, incipient phthisis, chronic in-
flammation,  syphilis, &c.  Unlike iodide of potassium, it can be given
in combination with sulphuric  or nitric acid without  suffering  decom-
position.
   The dose for  children, from seven to fourteen years of age, is three
grains; for adults, from three to six grains, or more.   Its general ef-
fects on the system are those of iodine.0

   Iodide  of Chlorideof  Mercury, lod'idum  Hydrar'gyri Chlo'ridi,
Hydrargyrum Iodatum cum Chlorido Mercurii;  French, Iodhydrar-
gyrite de  Chlorure Mercureux;  German, lod-Chlor-Quecksil-
ber.  This  preparation, discovered by M. Boutigny,7 is made by the
reaction of iodine on mild chloride of mercury, (calomel.)  Two iodides
may be prepared in this manner—the iodide and the biniodide.  The
iodide is prepared of one equivalent of iodine, and one of  chloride of
mercury.   The  calomel is coarsely powdered, put into a matrass, (ma-
tras d'essayeur,) heating gently, and  agitating it, until  it begins to
sublime: the iodine is then added in small portions.
   The combination  is effected with noise, without  any sensible loss of
iodine.
   The biniodide is  prepared of one equivalent of iodine, and one of
the mild chloride of mercury.   It may be run in cylinders like nitrate
of silver.
   The effects of both these preparations are those of violent irritants.

   1 Gazette des Hopitaux, 19 F.v., 1839.
   2 Aschenbrenner, Die neueren Arzneimittel,  u. s. w. S. 22, Erlangen, 1848.
   3 Lond. Med. Gazette, July 3, 1840, p. 590.
   * Journal de Med. et de Chirurgie Pratiques, and Annuaire de Th.rapeutique pour
1848, p. 194.                            5 Medical Times, Oct. 3, 1846.
   6 Pereira, The Elements of Materia Medica  and Therapeutics, 3d Amer. edit. i. 406.
Philad. 1852.          ' Bouchardat, Annuaire de Th.rapeutique, pour 1848, p. 186. 
IODINIUM.
499
The biniodide especially is a most powerful  caustic.  They are said[
to have been used as secret remedies, in France, in obstinate scrofu-
lous affections of the glands.  The  iodide has  been given internally
in the same cases: the biniodide has only been used  externally, like
nitrate of silver,  in scrofulous and certain syphilitic ulcerations.  M.
Rochard2 employs the iodide in scrofula, in the form of ointment—
one part of the salt to twenty of lard, varying  the proportion accord-
ing to the  sensibility of the  individual.   Of this ointment  he uses a
piece, of the size of a pea, which he applies  lightly, and arrests it,  if
too great pain and irritation supervene.  In  this Avay he has  found
nutrition modified  locally and generally.   He  rubs  it  on  the tumefac-
tion, applies it lightly to  ulcers, or rubs it in  the axillae, the inner part
of the  thigh, or on the back or chest.

               Pilulae iodidi hydrargyri  chloridi.
                 Pills of iodide of chloride of  mercury.
                 R.  Iodid. hydrarg. chlorid. gr. v.
                     Acacias pulv. gr. xvj.
                     Mica? panis gij.
                     Aq. flor. aurant. q. s. ut fiant pil. 100.     Boutiqny.

             Unguentum iodidi hydrargyri  chloridi.
                Ointment of iodide of chloride of mercury.
                   ( Unguen turn contra scrophulosin.)
                 R.  Iodid. hydrarg. chlorid- gr. xv.
                     Adipis |ij.  M.                       Boutigny.
                                                       ij
   _Ether Hydriod'icus, Hydriodic  or  Iodhydric Ether, Iodide of
Ethyle;  French, Ether  iodhydrique.   This  is  obtained  by gradually
and cautiously mixing five parts of alcohol,  ten of iodine, and one of
phosphorus, and  distilling.  The phosphorus is converted into phos-
phorous acid by  the oxygen  of  the alcohol,  and the liberated ethyle
unites  with the iodine.  It is a colourless, non-inflammable liquid, in-
soluble in water,  of a penetrating ethereal odour, and a pungent taste.
Its specific gravity is 1.92;  and boiling point 158° Fahr.3
   Hydriodic ether has been  strongly recommended by M. Huette,4 in
the way of inhalation, practised in the following manner.  One or two
grammes of the  ether  are placed, by means of a  graduated pipette,
in a small bottle  with a ground  stopper.   This is then covered with a
thick stratum of water, which forms  a kind of movable stopper, (ob-
turateur) to moderate evaporation.   The opening of the  bottle is then
held to one of the nostrils to  inhale  the air above the liquid, so that
the ethereal vapour, when it reaches the lungs,  is mixed with a proper
proportion  of atmospheric  air.  To  accelerate the evaporation, it is
only necessary to incline  the bottle a little, which occasions the water
to collect together, and leave  the greater part of  the ether exposed.
The heat of the  hand may be employed with the same object; fifteen
  1 Aschenbrenner, Die neueren Arzneimittel und Arzneibereitungsformen, S. 150.  Er-
langen, 1850.
  8 Bouchardat, op.  cit. p. 188.
  s Amer. Journ. of Pharm. xxiii. 156, and Dispensatory of the United States, 10th edit.
p. 1342.  Philad. 1854.
  * Gazette Medicale, and Bouchardat, Annuaire de Therap. pour 1851, p. 212. 
500
JUGLANS REGIA.
or twenty inspirations are sufficient to impregnate the whole economy
with iodine.   The  first  effects, according to M. Huette, are those of
ether,—antispasmodic; and these are followed by the phenomena Avhich
result from the use of iodine, and indicate a general increase of the
organic actions.  He regards it as an excellent method for bringing the
system under the influence of iodine; whilst it enables the quantity of
iodine to be regulated according to the effect desired to be  produced
by the therapeutist.
  M. Coffin  affirms, that he  arrested the progress of crude tubercles
in two cases by this agent.1

  An Ethereal or Chloroform Tincture of Iodine has been sug-
gested in the way of inhalation; a little iodide  of potassium  being
added to prevent precipitation on adding it to any aqueous fluid.2

  The other preparations of iodine are described  in different parts of
this volume.
                    CXIV. JUGLANS RE'GIA.
Synonymes. Walnut Tree.
French. Noyer.
German. Wallnussbaum, Baumnuss, Konigswallnuss,  Nnssbaum, Wal-
  sche Nuss.
   The walnut tree, Sexual System, Monoecia Polyandria; Natural
Order, Terebinthacese or Juglandese, is a native of Persia, whence it
was carried to Greece, Italy, France, &c.

                     EFFECTS ON THE ECONOMY.
   The leaves of the walnut which had  been previously recommended
by Jurine of Geneva, and Borson of Chambery, have been highly ex-
tolled by M. Negrier3 as superior to all other antiscrofulous remedies.
He prescribed  them to 56 patients  affected with different  forms of
scrofula.  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 en-
cephalitis, and  the  fourth of double pneumonia.   The extract of the
leaves, which may be ranked in the class  of  slightly aromatic  bit-
ters, M. Negrier found to be almost constantly efficacious in scrofu-
lous 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, di-
gestion and circulation, and, according to M. Negrier, communicate
remarkable  energy to  all  the functions; and he is disposed to think
that they have  a special action on the lymphatic  system.  In a sub-

  1 Trousseau and Reveil, Trait, de l'Art de Formuler, p. 148.  Paris, 1851.
  2 E. Parrish, An  Introduction to Practical Pharmacy, p. 479.  Philad.  1856.
  8 Archiv. General, de M.decine, Avril et Mai, 1841, Fevr. 1844; Fevr. 1850, p. 173,
and Avril, 1850, p.  447.  The last two memoirs have been given at length in the Edinb.
Med. and Surg. Journ. for October, 1850, p. 271  to 318. 
JUGLANS REGIA.
501
 sequent essay* he arrives at the following corollaries.  First. Scrofulous
 affections are, in general, radically cured by the preparations of the
 leaves of the walnut.  Secondly. Their action on the economy is suffi-
 ciently constant to enable us to reckon upon the cure of the majority of
 patients treated by them.  Thirdly. Their action is slow, unobjection-
 able and durable.  Fourthly.  The first effects of the treatment on the
 economy are general; its local influence  comes afterwards.   Fifthly.
 Scrofulous affections of the skin, mucous membranes, lymphatics and
 lymphatic ganglions are cured as easily, promptly and certainly as by
 any other known agent.   Sixthly. Affections of the osseous, cartilagi-
 nous, and ligamentous systems, whose essence is a scrofulous vice, are
 at times radically cured by the preparations of the leaves of the walnut
 alone.  Lymphatic subjects always experience good effects from them;
 the profound modifications which they experience often cause the cure
 of caries of the bones and their appendages.  The same affections of the
 bones in dry nervous subjects  are  not  sensibly modified by  the treat-
 ment.   Liver oil is then preferable, associated with infusions of the
 leaves or fruit of the walnut, (the green shell,)—and seventhly, scrofu-
 lous inflammations of the eyes are certainly and speedily cured by a
 treatment, the basis of which is the preparations of the leaves of the
 walnut.
   Favourable reports of the action of the walnut leaves in scrofula are
 quoted  by M. Negrier from Nasse, of Bonn, M. J. Kreutzwald, and
 Borgiali.   They  have likewise been given  successfully  by Mirault,
 Jurine and Hauser in the same affection; and have been recommend-
 ed  in helminthiasis, otorrhcea, filuor albus, scrophulosis, chronic  bron-
 chitis, cutaneous diseases,  as impetigo, tinea capitis, herpes, and chronic
 eczema, by Kreutzwald, Nasse and Hauser; and in the after treatment
 (Nachbehandlung) of cachectic conditions,—scrofula,gout, syphi-
 lis, mercurial cachexia, &c.2

                    MODE OF  ADMINISTRATION.
   The preparations used by M. Negrier are the following:—

                     Infusum juglandis regise.
                      Infusion of walnut leaves.
  This infusion is made by throwing  a large pugillus (pincee) of the
 cut leaves into eight ounces of boiling water.  It is SAveetened with
 sugar or with  the syrup mentioned below.   Two or three  cups were
 prescribed daily,  and sometimes as many as five.

                 Decoctum juglandis  regiae.
                      Decoction of walnut leaves.
  The decoction  may be  made by boiling,  for ten or fifteen minutes,
 a small  manipulus  (poignee) of the leaves in Oijss (un kilogramme)
 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.

  1 Archives, &c, Avril, 1850, p. 466.  Also, Bouchardat, Annuaire de Th.rap. pour
1851, p. 00.
  1 Aschenbrenner, Die neueren Arzneimittel, v. s. w. S. 159.  Erlangen, 1848. 
502
JUGLANS REGIA.
It has,  also, been used as a partial  and general  bath;  and as an in-
jection into fistulous  openings.

                 Extract urn juglandis regiae.
                      Extract of walnut leaves.
   This extract is prepared by the method of displacement.

                  Syrupus  juglandis regiae-
                       Syrup of walnut leaves.
   This 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 tAVO ounces.
The ordinary dose for the last is from eight to ten  drams.

              Pilulae extracti juglandis regiae.
                   Pills of extract of walnut leaves.
   Each of  these may  be made of three grains of the extract rendered
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 dis-
eased part, he has employed the following ointment:

           Unguentum  extracti juglandis regiae.
                 Ointment of extract  of walnut leaves.
                 R.   Extract, juglandis regia. ^i.
                     Adipis J5X-
                     01. bergamot. mj iij.  M.
   The friction must be gentle, and for about a quarter of an hour, twice
a  day.
                  Vinum juglandis  regiae.
                       Wine of walnut leaves.
   M. Negrier  directs this to be prepared by macerating from an ounce
and a half  to  two ounces of the  fresh leaves, or ten to twelve walnuts
covered with their drupes, cut in fragments,  in a  quart  of  Malaga or
Lunel wine.   In winter, it may be prepared of from half  an ounce to
five drams of the  extract to the quart of wine.
   The dose is a spoonful or more, after eating, night and morning.
   M. Negrier  properly  remarks, that in all  such  deeply rooted affec-
tions, it may be necessary to  persevere  in the remedy for some time;
as not only have the effects of the  disease to be combated,  but a pro-
found modification to  be induced in the  constitution  of the individual.1
   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  leucorrhcea by  M. Vidal,2 and  the fresh leaves or

  1 Archiv. General, de Medecine, Mai, 1841.
  2 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.
503
fresh bark have been employed topically by M. Pomayrol and M. Bru-
guier1 in  cases  of pustule maligne, the phlyctense having been first
opened, and the cuticle removed.
                       CXV. LACTUCARIUM.
 Synoxymes. Lettuce Opium, Thridace.
 German. Lattigopium,  Lattigmilchsaft, Lattigbitter.
   The  ancient Greek and Roman  physicians were well  aware of the
 hypnotic property of  the  common garden lettuce (lactuca sativa,) the
 milky juice of Avhich 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.2  Dr. Duncan, Senr., of Edinburgh,
 subsequently paid particular attention to the subject, and recommended
 it as  a remedy in phthisis, in place of opium.3   The  properties of the
 juice have also been investigated by M. Frangois,4 a French physician.

                       METHOD OF PREPARING.
   There are three kinds of lactucarium.  The first and  best, but the
 most costly, is  obtained  from incisions  made into the stalks, whence
 the juice exudes, which is subsequently dried in the air.  This prepara-
 tion 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;5 and  the third variety is prepared
 in the  same  manner as any common extract, from all  parts of the
 plant.  This is the  Thridace of some.   It is unworthy of confidence.
   The first is the strongest and most uniform, and therefore to be pre-
 ferred.
   Chemical examination shows that lactucarium contains neither mor
 phia  nor  narcotina, as had been supposed.   It has been examined by
 M. Aubergier,6 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. Au-
 bergier  regards the  crystalline matter as the  active principle of the lac-
 tucarium.7   M. Quevenne8 also analyzed it, and  found it to  contain a
 bitter principle, soluble in water and in alcohol, insoluble in ether, and
  1 Bouchardat, Annuaire de Therap. pour 1854, p. 39.
  2 Wood and Bache's Dispensatory, 10th edit. p. 441.  Philad. 1854.
  3 Observations on Consumption, 2d edit.  Edinb. 1816.
  4 Archiv. General, de Medecine, 1825.  Journal Univer. xl. 254, and xli. 147.  See,
also, Fischer, in Rust's Magazin. B. liii. Heft. 1.
  6 Riecke, Die neuern Arzneimittel, S. 313; und 2te Auflage, S. 473.  Stuttgart, 1840.
See, also, M .rat and De Lens, Diet, de Mat. Med. art. Lactuca Sativa.
  6 Journ. de Pharm. Jan. 1842, p. 78.
  7 Bouchardat, Annuaire de Th.rapeutique pour 1813,  p. 14. Paris, 1843.
  8 A. Richard, Elements d'Histoire Naturelle M.dicale, 4eme _dit., iii. 94,  Paris, 1849. 
504
LACTUCARIUM.
 not precipitable by the salts of lead; albumen;  caoutchouc; wax; a
 vegetable acid, (lactucic;) chloride of calcium; phosphate of lime;  po-
 tassa; gum, and acetic acid.

                     EFFECTS ON  THE ECONOMY.
   To  investigate these, Rothamel1  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 indescribable feeling
 of  lightness over the whole body, without  any narcotic symptoms or
 modification of the pulse: from six to eight grains increased  this sen-
 sation,  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  dulness, vertigo, considerable  dilatation  of the pupils,
 yawning and stretching, slow pulse, disturbed sleep, general prostration;
 the tongue coated with mucus; disagreeable taste; loss  of appetite;
 pains in the shoulders and bones,  and uncertain gait; all which symp-
 toms were  speedily removed by a few drops of acetic ether, or a glass
 of Rhenish Avine.  Coffee was much less  efficacious.
  Lactucarium has been extolled by numerous physicians  as equally
 effective with  opium, whilst it is  not—they  assert—followed  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,2 of
 Berlin,  in  catarrhal ophthalmia,  and a  solution in the proportion of
 four grains to the ounce, has been advised in  acute inflammation of
 the conjunctiva, by Guibert.3
  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;4 and such would seem to have been the
 general results of extensive trials made with it by others.5

                     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.   Exter-
nally, it has been applied in plaster or ointment.
                      Mistura  lactucarii.
                       Mixture of lactucarium.
                 R.  Lactucar. 9j.
                     Mucilag. acac. q. s. ad subactionem.
                 Perfecte unitis adfunde
                     Aq.fgvj.
                     Syrup, rub. idaei f §ss.  M.
  1 Ferussac's Bulletin des Sciences Medicales, xxii.  Paris, 1830.
  2 Berliner Medicin. Central-Zeitung, Nov. 2,  1838.
  * Froriep's  Notizen, Bd. xxi. S. 320, and Osann, art. Lactuca, Encyclopad. Worterb.
 der Medicinischen Wissenschaften, xx. 697. Berlin, 1839.
  4 General Therapeutics and Mat. Med. 5th edit.  i. 414. Philad. 1853.
  5 Bouchardat, Op. cit. p. 26, and M. Homolle, in Bouchardat's Annuaire, &c, pour
1845, p. 27.  Paris, 1845. 
MAGNES.
505
  Dose.—Two spoonfuls, every two hours, in spasmodic cough, sleep-
lessness and hysteria.                           Von Hildenbrand.
                 R.  Acid, boracic. ^ij.
                     Lactucarii 9j.
             Solve in
                     Aq. destillat. f ,fvj.
                     Syrup, papav. f§ss.  M.
  Dose.—A small spoonful—in cases of "spastic haemoptysis."
                                                       Rothamel.
                     Collyrium  lactucarii.
                      Eye-wash of lactucarium.
                 R.  Lactucar. gr. iij.
                     Aq. destillat. f giij •
                     Mucilag. cydon. gtt. xx.  M.                 Rau.

  M. Aubergier1 considers the alcoholic extract to be the best form of
preparation.   The lactucarium is twice successively digested 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 Siss.  to  f gij. in  the twenty-four  hours, in
cases of bronchitis or phthisis.
                         CXVI.  MAGNES.
 Synonymes. Magnetes, Magnet.
 French. Aimant, Pierre d'Aimant.
 German. Magnet,  Magnetstein.
   The natural magnet was employed of old both externally and in-
 ternally, and in the most diversified forms and affections.2  The arti-
 ficial magnet has been used within the last century only.   It is gene-
 rally on  the diseased part, or  around it, that it  is applied, and the
 application is made for a longer or shorter time according to circum-
 stances—being at  times  drawn along the nerves of the affected part;
 at others applied in a more prolonged manner.
   It has been affirmed,3 that magnets of 10 pounds supporting  power,
 when drawn along  the body downward, without contact, produce cer-
 tain sensations in a certain, or rather uncertain, proportion of  human
 beings.  Occasionally, in twenty persons three or four sensitive indi-
 viduals are found;  and in  one  case, of twenty-two females,_ examined
 by Von Reichenbach,  eighteen were sensitive.   The sensation  is said
 to be rather unpleasant  than agreeable, and is like an aura, in some
  1 Bouchardat. Annuaire,  &c, pour 1845, and Ibid,  pour 1855, p. 15.
  2 Art. Aimant, in Diet. Univers,  de Mati.re Medicale, par M.rat and De Lens.
  8 Abstract of Researches on Magnetism and certain  allied Subjects, &c, by Baron Von
 Reichenbach:  translated by W. Gregory; or notice of the same in the Bulletin of Med.
Science.  Philad. July, 1846, p. 217. 
506
MAGNES.
cases warm, in others cool;  or it may be a pricking, or a sensation of
the creeping of insects on the skin; and at times headache rapidly super-
venes.  These effects, it is  said, occur when 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 often  in those  whose  health, al-
though good, is  not so vigorous, and in nervous persons.   Children are
often found to be sensitive.  Persons affected with spasmodic diseases
—epilepsy, catalepsy, chorea, paralysis and hysteria—are especially
sensitive,  and lunatics and somnambulists, he says, are uniformly  so.1
  It is, then, on the nervous system that the magnet  exerts its efficacy.
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,2 com-
missioners of  the  Societe Royale de Medecine,  appointed to  examine
into the  matter.  In  cases  of  spasms, palpitations, convulsions, epi-
lepsy, tremors, cramps, neuralgia, rheumatism, &c, the only agent
employed was  the magnet, and  it was wholly successful.  These  gen-
tlemen were disposed to infer, that  the magnet exerts an incontestable
magnetic  action on the nervous system, to which, in part at least, the
curative agency must  be ascribed, and their conclusions were thought
to be corroborated by cases  observed by MM. Alibert, Cayol, Chomel,
Recamiey, &c.  The celebrated Laennec,3 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 mag-
netized  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 applica-
tion 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 Lon-
don, by the success said to have been obtained in the treatment of  neu-
ralgia, toothache, and other affections of the nerves, by the application
of the ordinary magnet,  or "mineral magnet" as it was termed by Dr.
Blundell who  employed  it.4   It  would seem, too, that owing to a  con-
siderable  demand for  loadstone, the conductors of the Bulletino delle
Scienze Mediche,5 of Bologna,  were led to make inquiries  concerning
the uses to which it was 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 certain efficacy.  He  immediately procured a piece of loadstone,
  1 See, on all this curious subject, Baron Charles Von Reichenbach, Physico-physiologi-
cal Researches on the Dynamics of Magnetism, Electricity,  Heat, Light, Crystallization,
and Chemism in their relation to Vital Force,—translated, &c. by John Ashburner, M.D.
London, 1851.
  2 Mum. de la Societe" Royale de M.decine de Paris, pour 1776, p. 531, and  Thouret,
art. Aimant, in Encyclop.d. Method., Partie Medicale, i. 421.   Paris, 1786;  also Du-
mont. in Bouchardat, Annuaire de  Therapeutique pour 1843, p. 79.  Paris, 1843.
  3  Traits de l'Auscultation Mediate, 2de _dit. torn. ii.
  4 See Lancet for 1833,  cited in Amer.  Journ. of the Med.  Sciences, Nov. 1833, p. 247.
  5 Marzo et Aprile, 1835; cited in Brit, and For. Medical Review, July, 1836, p. 246. 
MAGNESI2E CITRAS.
507
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 inva-
riably 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 presently 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 magnet re-
peatedly in nervous diseases, in  persons of highly impressible  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,1 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 his 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 Electri-
city,  see Electro-Magnetismus.
                   CXVII.  MAGNE'SIJE CITRAS.
 Synonymes. Citrate of Magnesia.
 French. Citrate de Magnesie.
 German. Citronensaures Magnesia oder Bittererde.

   This preparation has been introduced as an agreeable cathartic, by
 M. Roge Delabarre.2
                       METHOD OF PREPARING.
   Citrate of magnesia may be prepared by saturating a solution  of
 citric acid with  either  magnesia or carbonette of magnesia.   Dr. Pe-
 reira3 finds that 9j. of the crystallized acid of commerce saturates
 about fourteen grains of either light or hea\ry carbonate of magnesia.
 Another mode of preparing it is by double decomposition from sulphate
 of magnesia and citrate of soda.
  Neutral citrate of magnesia is a white, pulverulent, insipid salt, and
 when aided  by the addition of a slight excess of the acid, is soluble  in
 water.  The solution has an acid taste, and has not the disagreeable
 bitter taste  of the magnesian salts.  It is a mild  laxative, in the dose
 of from an ounce to ten drams.
  It is, hoAvever, in solution, and in the effervescing state, that  it is

  1 Gaz. des Hopitaux, 14 Juin, 1842; and Brit, and For. Med. Rev. Oct., 1842, p. 557.
  2 Journal de Pharmacie, Juin, 1817, Bouchardat, Annnuaire de  Therap. pour 1848,
p. 118; and Amer. Journ. of Pharmacy, August, 1847, p. 218.
  3 Elements of Materia Medica and Therapeutics, 2d edit. i. 619.  Lond. 1849. 
508
MAGNESIiE CITRAS.
best known and preferred.   Four drams of citric acid and three and a
half drams of carbonate of magnesia, dissolved in a sufficiency of water,
yield rather more than an ounce of solid citrate of magnesia.
  Dr. Pereira gives the following formulae for, first, the simple solution,
acidulated with citric acid and flavoured with syrup of orange  peel,
called magnesian lemonade; and, secondly, the effervescing solution,
called effervescing magnesian lemonade.

                  1.  Liquor magnesiae  citratis.
                    Solution of citrate of magnesia.
                 R.  Acid citric, £ss.
                     Magnes. carb. 9j.
                     Syrup, aurant. gij.
                     Aq. destillat. ^ij.  M.
           2- Liquor magnesiae  citratis  effervescens.
               Effervescing solution of citrate of magnesia.
                 R.  Acid citric, gss.
                     Aquas destillat. 3J.
                     Syrup, aurant. gi).  M".
  To be taken with f 3x. of Dinneford's  solution of bicarbonate of mag-
nesia in a state of effenTescence.
  Various modes of preparing the  effervescing solution of the citrate
have been  proposed  by MM. Roge Delabarre, Bardet, Massignon,
Garot, Marchand, Duclou, Dorvault, V. Gamier, Maury, Cadet Gasse-
court, and others.1   Mr. Edward Parrish,2 of Philadelphia, prepares
it by forming a slightly acid citrate of magnesia—about an ounce and
a half of the salt to a pint of water—which is introduced into ordinary
Saratoga water bottles, containing the requisite quantity of lemon syrup,
until nearly full, and the remaining space is filled with moist, recently
prepared, carbonate of magnesia, immediately after which the bottles
are well corked.   On mixing the contents of the bottle, the carbonate
of magnesia is decomposed by the free  citric acid in the solution, and
the evolved carbonic acid is retained by the close  cork, and  absorbed
by the liquid.
  The last edition of the Pharmacopoeia of the United States (1851)
contains a formula, which is essentially that of M. Rabourdin.3  It is
as follows:—Take of carbonate of magnesia 3v., citric acid 3viiss., syrup
of citric acid Sij; water, a sufficient quantity.   Dissolve the acid in four
fluidounces of water,  and add to the solution four  drams of the carbo-
nate of magnesia, previously rubbed with three fluidounces  of water.
When  the reaction has  ceased, filter the solution into a strong  glass
bottle, of the capacity of twelve fluidounces, into which the syrup of
citric acid has  been  previously introduced.   Rub the  remaining car-
bonate of magnesia Avith two fluidounces of water, and pour the mixture
into the bottle, which must then be tightly corked, and secured with
twine.  Lastly, shake the mixture occasionally, until it becomes trans-
parent.
  1 Bouchardat, Annuaire de Th.rap. pour 1848, p. 118, 123, and Ibid, pour 1849, p.
188, 189, 192, 193 and 194.
  2 Amer. Journal of Pharmacy, Nov. 1847, p. 264.
  8 Amer. Journ. of Pharmacy, July, 1848, p. 254. 
MANNITA.
509
  This mixture does not bear  keeping—a white crystalline precipitate
being deposited, which was found by Mr. Procter to consist of one
equivalent of citric acid, three of magnesia, and fourteen of water.
  The dose is from a half to a whole bottle.   It is certainly an agree-
able laxative,  and  is much employed.
                       CXVIII. MANNI'TA.
 Synonymes. Mannitum, Saccharum Manna., 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 consti-
 tutes the chief ingredient of manna.   Its presence is not confined, how-
 ever, 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.1
                     METHOD OF PREPARING.
   Mannite is commonly procured from manna.  Manna in  lachrymis,
 as it is obtained in commerce,  is treated with  boiling alcohol, filtered,
 and suffered to crystallize:  by rest and refrigeration, mannite is  pre-
 cipitated in small, beautiful, white needles.   The  manna in tears  con-
 sists almost wholly of mannite.  Common manna, on the other hand, con-
 tains 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 selected.
   Should the administration of mannite  as a remedial agent  become
 more common, it may be worth the trouble to inquire, whether it might
 not be advantageous to prepare it from the vegetable juices above men-
 tioned.
   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 crystallizes on cooling.  When more
 strongly heated, it burns,  and is decomposed like sugar.  From its al-
 coholic solutions it separates on cooling, in Avhite, silky, shining, needle-
 shaped crystals, collected in  stelliform roundish  masses.  When mannite
 is  dissolved  in an equal weight  of boiling water, and the fluid is evapo-
 rated 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, mannite consists
of 40.0228 of carbon, 7.6234 of hydrogen, and 52.3537 of oxygen.
          1 Art. Mannite, in M6rat and De Lens, Diet, de Mat. M.d. 
510
MATIAS.
   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,1 mannite may be advantageously substituted
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, Magendie  always  found the
catharsis too active: for this reason he considers it to be the best dose
for the adult.  He recommends, that  a syrup should be prepared from
it, and that this should be prescribed  both as a cathartic for children
at the breast, and as an addition to other articles in cases of pulmonary
catarrh.   M. Solon has likevvise 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  occasioned
by obstinate  constipation its use was followed by the  best effects.   In
the last case, the inflammation  completely disappeared, and the consti-
pation yielded  without  any other  agency.  It was found, likewise, of
essential service in convalescence from bronchitis and pneumonia.  Only
in two cases of females—the one  labouring under ascites—the other
under phlegmatia dolens,  did mannite fail to have any aperient effect.
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 cathartic potions.  He assigns it the
preference over manna and castor oil; first, because it has an agree-
able saccharine taste, and secondly, because it is always  equally good;
whilst those substances are often deteriorated, and on that account un-
certain in their effects.   It appeared to  him to be peculiarly adapted
for cases in which it  was desirable  to evacuate the  intestines with as
little  excitation as possible.
   Magendie, in his lectures on  the blood, classes mannite amongst the
substances that promote the coagulation  of that  fluid.2
                         CXIX. MATIAS.
Synonymes. Malambo, Melambo.
  A paper on the Matias bark was read before  the  Medical Section
of the British Association for the  Advancement of  Science, at their
meeting  in  1840, by Dr. Mackay.   The  plant, from which the bark
was  obtained, grows in great  abundance  in  South America; but its
botanical characters have not been  given.   From what Dr. Mackay
  1 Formulaire, &c, dern. e'dit.
  2 Lec^ns sur le Sang, &c. &c.  Translation in Lond. Lancet for Jan. 26,1839, p. 636. 
MATICO.
511
heard, it would seem to belong to the genus Wintersonia.   It contains
an intensely bitteY extractive matter, and yields, on distillation, two
distinct essential oils, Avhich differ in specific gravity, and are soluble
in alcohol and ether; and but very sparingly so in water.  The princi-
pal characteristic substance derived from it was a bitter resinous mat-
ter.  No alkaloid  was discovered in it.  Mr. Ure1 considers it to be
identical with malambo, 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, though somewhat fibrous;  of a brown colour, and
covered with an ash-coloured  tuberculated epidermis.
  Malambo bark was analyzed by Cadet, and afterwards by Vauque-
lin, 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 cinchonas.2

                    EFFECTS  ON THE  ECONOMY.
   In its native country, matias bark is extensively used as a substitute
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 accompanied by loss
of appetite, which it quickly  restored.   In phthisis, where tonics were
admissible, it supported the strength and prevented rapid sinking.  In
dropsy, it was found to be a valuable adjunct to diuretics; and, in in-
termittents, to deserve its native reputation of being a good substitute
for cinchona.
   The virtues ascribed to it by Dr. Mackay are confirmed by Dr. Neu-
bigging, who has used  it extensively.3   Mr. Ure has often administered
it with  good  effect as a substitute for cinchona.   In scrofulous  oph-
thalmia, after having removed feculent accumulations from the bow-
els, he has known an infusion, made Avith tAvo drams of the  bark  to a
pint of water, cause a speedy and complete removal  of the inflamma-
tion  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."
                          CXX. MATI'CO.
Synonymes. Piper Angustifolium seu Elongatum, Stepheusia seu Artanthe Elongata,
  Matico Plant, Soldier's Weed or Herb.
Spanish. Yerba del Soldado.
  The name of this plant is said to have been derived from a Spanish
soldier called  Matico, who, lying desperately wounded,  and bleeding

  1 Pharmaceutical Journal, vol. iii. No. 4, p. 170.
  2 Annales de Chimie, xcvi. 113: and Journ. de Pharmacie, ii. 172.  See, also, Merat
and De Lens, Diet, de  Mat. M.d. &c, art. Malambo.
  3 Lond. Athemeum,  Oct. 1840; and Amer. Journ. Med. Sciences, Jan. 1841, p. 209. 
512
MATICO.
 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, held in
 1827, Mr. Frost brought a specimen of this plant before their notice;
 which appeared to  him  to  be a species of pepper.1   A specimen of
 Matico leaves was brought from Peru to the United States, in 1834, by
 Dr. Ruschenberger, of the United States  Navy, who has since received
 other specimens from Lima,  with a portion of  which he has  kindly fa-
 voured the author.  The leaves  are considered to be  those of  Piper
 angustifolium, of Ruiz and Pavon;2 but Dr. Ruschenberger observes, that
 the properties of the plant, so far as we can judge from the imperfect
 dried specimens, differ somewhat from those of 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 herbaceous
 and jointed; but the specimens are so much broken, as to render it diffi-
 cult, if not impracticable, to form  an  accurate idea of  the plant.   It
 has been introduced of late years into Great Britain, and, according to
 Messrs. Ballard and Garrod,3 promises to maintain the reputation it
 has enjoyed in South America as a most powerful styptic.  It is in the
 last  edition of the Dublin Pharmacopoeia, and is referred to Artanthe
 elongata.
   Dr. Carson4 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 astringent taste; and the smell and taste
 of their infusion in water very much resemble those of the tea pre-
 pared by the country people  in Ireland from the leaves  of the indige-
 nous Salvia verbenaea.   Dr. J. H. Scrivener, in a letter to Dr. Rus-
 chenberger, dated Lima, April 30,1845, says, that matico grows abund-
 antly 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, broAvn, 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 un-
knoAvn.   Their discovery is attributed to a soldier, who was wounded
 on the 9th of  December,  1824, at the  battle of Ayacucho.5
  The specimens examined by the author  had no marked sensible pro-
 perties.

  1 London Medical and Physical Journal, and North American Medical  and Surgical
Journal, iv. 419.  Philad. 1827.
  2 Persoon, i. 32, Cramer's edit, cited by Jeffreys in Transactions of the Provincial Med.
 and Surg. Association, xi. 351.  Lond. 1843.
  3 Elements of Mat. Med. and Therap. p. 411.  Lond. 1845.
  4 Elements of Mat. Med. and Therap., 3d Amer. edit. ii. 357.  Philad. 1854.
  5 Ruschenberger. 
MATICO.
513
  When analyzed by Mr. Clay, of Liverpool,1 matico seemed to have
gallic acid in its composition ; but from the experiments of Dr. Hodges,
he concluded, that besides the ordinary constituents of leaves, it con-
tains a soft, dark-green resin, some aromatic volatile oil, and a bitter
principle, to which 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 improper mode of preparation.  Dr. Ruschenberger, how-
ever, affirms, that the oil is heavier than a  saturated solution  of com-
mon salt.2
                     EFFECTS ON  THE ECONOMY.
   Matico, under the name Yerba 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 sup-
ply 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 infusion of the plant is used as a Avash
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 haema-
static, it is said to be given as a diuretic.3   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
to the under surface of a small piece of  matico leaf.
   In one case,  Dr.  Ruschenberger employed the leaves  to arrest he-
morrhage 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 a molar 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 ar-
teria ad cutem  abdominis, which bled freely.  He directed that an at-
tempt should be made to arrest the hemorrhage by lint  and  pressure.
After a trial of ten minutes, Avhich totally failed, he  directed moist-
ened matico leaA'es to be applied.   The assistant reported, in  a  few
moments, that the matico exerted  no influence, and  proposed to secure
the bleeding \Tessel by ligature.   Dr. Ruschenberger now visited the
patient, Avho had lost six or eight ounces of blood, and was still bleed-
ing.   Coarsely powdering some matico leaves in the palm of his hand,

  1 Jeffreys, op. cit. p. 332.                2 Med. Exam., July, 1846, p.  401.
  5 Jeffreys, Lond. Lancet, Jan. 5, 1839, p. 567.
       33 
514
MATICO.
he formed the mass into a paste with cold water.   He then removed a
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  immedi-
ately sponged clean:  the hemorrhage ceased instantly, and not a  sin-
gle drop of blood flowed afterwards.   No pressure was used, nor dress-
ing applied.   On the first application, which 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 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 per-
fectly satisfied, that there  need be no difficulty in arresting hemorrhage
from leech-bites where  matico  can be  obtained.   Mr. Edward Young1
has also found it a Araluable  agent in  arresting the bleeding  in  such
cases.
   When first introduced into  England, it was  found by Dr. Jeffreys2
to possess the power of  controlling obstinate accidental hemorrhages;
such as arose from leech-bites, the removal of naevi, incisions, &c, Avhen
the under side of the leaf was applied to  the bleeding surface.  Testi-
mony of its  haemastatic powers  Avas also furnished by Dr. Kendrick,3
Dr. Monroe,4 Dr. Scott, Mr. Hamilton,5 and others.
   The stump of an arm, amputated near the shoulder, bled to a danger-
ous amount from the Avhole surface.   Pressure  having failed, a paste
was made by moistening powdered matico, which was spread over the
part.  It acted as an artificial coagulum, and checked the flow of blood,
which did not subsequently recur.  The only other remedy would have
been to tie the subclavian  artery.6
   Possessed apparently of powers as a styptic, it was soon administered
internally in cases Avhere  astringents  appeared to  be indicated.   By
Dr. Jeffreys and others, it was  found to be valuable in gonorrhoea, leu-
corrhcea, menorrhagia, hemorrhoids, catarrhus  vesicae, &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 followed  by  a serous or muco-puru-
lent discharge.  The usual treatment had been unsuccessful; when a
wine-glassful of infusion of matico was given four times daily; and in
ten days she recovered from all severe symptoms.  In another case of
discharge of blood from the bowels, with scarcely any feculent matter
in the  evacuations, 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.

  1 Dublin Hospital Gaz., cited in Braithwaite's Retrospect, xii. 179, Amer. edit.  New
York, 1845.
  2 London Lancet, Jan. 5, 1839, p. 567.               3 Jeffreys, op. cit. p. 357.
  4 Provincial Med. and Surg. Journal, June 18, 1842, p.  209,  and London  and Edin-
burgh Monthly Journal of Medical Science, Aug. 1842, p.  737.
  6 Monthly Journal of Med. Science, for Nov. 1846;  and Amer. Journal of the Med.
Sciences, Jan. 1847, p. 142.
  8 H. Hartshorne, Amer. Journ. of the Med. Sciences, Jan. 1850, p. 112. 
MATICO.                           515
 In melcena, occurring in the course of adynamic fever, Dr. Watmouo-h1
 found a combination of it  Avith senna particularly beneficial.  Two
 drams of each were infused in a pint of water;  and a wine-glassful of
 the infusion was given frequently.
   Dr. Hunter Lane2 found the infusion and tincture very serviceable
 in similar  cases.   In chronic diarrhoea it did not  prove of very emi-
 nent  service, but as an injection in leucorrhcea,  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 menorrhagia, and in  the
 varicose and ulcerated condition of the rectum for  which Dr. Houston
 proposes the topical application  of nitric acid.3   (See Acidum Nitri-
 cum.)  Mr. Butler4 used  the matico infusion internally, and by injec-
 tion,  with the best results, in two cases of uterine hemorrhage accom-
 panying abortion.   Mr. Edward Young5 also found great benefit from
 it in  leucorrhcea, in the form of injection, made by boiling  an ounce
 of the leaves  in a pint of Avater for  ten minutes; and he considers it
 unsurpassed as an external application  in hemorrhoids, when made into
 an ointment with opium, according to the form given hereafter, and
 applied night and morning.
   Dr. Ruschenberger used the tincture advantageously  in  a  case of
 hosmatemesis, after other plans of  treatment had been resorted to in-
 effectually.   In several cases of gonorrhoea,  its impression Avas very
 slight,   lie does  not think  it equal to cubebs.  He  used the syrup
 in teaspoonful doses,*Avith decided advantage, in leucorrhcea  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.
   M. Modonini6 states that he has employed matico in about one hun-
 dred and tAventy cases of intestinal discharges, and  especially in atonic
 diarrhoea, and Avith excellent and  speedy effect.  It was given in  the
 dose  of from eighteen grains to a dram in the day.
   From the whole of the testimony, then,  there is  encouragement to
 expect  beneficial  results  from matico.   The difficulty,  however,  of
 establishing the action of styptics is  considerable, as is sufficiently  ex-
 emplified in the history of the Acqua Binelli  and the Acqua Brocchieri.
 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 haemastatic
 reputation.   This is probably the history of the employment of chloride
 of sodium to check the flow of blood  in haemoptysis.   Doubtless,  how-
 ever,  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 hemastatic 'Waters' referred to.
  1 Provincial Medical Journal, March 10, 1847.
  2 Lond. Med. Gazette, Oct. 6, 1843, p.  9.
  3 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.
  * London Lancet, Jan. 18, 1845.                         5 Op. cit.
  6 Bulletino delle Scienze  Med. xx. 63, cited in Brit, and For. Med. Chir., July, 1852,
p. 275. 
516                           MATICO.

  M. Velpeau applied the powdered leaves to various ulcers, but found
them without any beneficial action, whilst they occasioned considerable
pain; and M. Merat was quite unsuccessful in the treatment by them
of a wound subject  to frequent hemorrhage, which, instead, of dimi-
nishing, appeared rather to be augmented.1

                     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 first three forms; and also in
ointment.  In  epistaxis, the  powdered herb, used  as snuff,  has been
found a convenient mode of application.2

                Infusum  piperis angustifolii.
                         Infusion of matico.
                 R. Piper, angustifol. fol. ^j.
                     Aquae bullientis Oj.

  Infuse for two hours.   Dose, two table-spoonfuls twice or thrice  a
day, or oftener.                                         Jeffreys.
                         Infusum  matico.
                 R. Piper, angustifol. fol. concis. §ss. (avoirdupois.)
                     Aqua, bullientis Oss. (f 3x.)
             Infunde per horam et cola.
  The product should measure about eight ounces.
                                  Bublin Pharmacopoeia of 1850.

               Decoctum piperis  angustifolii.
                         Decoction of matico.
                 R. Piperis angustifol. §j.
                     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. ,5iij.
                    Alcohol, dilut. Oj.
      Digest for fourteen days, and filter.
  Dose, from 30 to 60 drops in water.                    Jeffreys.
  The Dublin Pharmacopoeia of 1850 has a Tinctura Matico, formed
of Sviij., avoirdupois, of matico leaves, in coarse powder,  to a quart
(f Sxl.) of proof spirit.

                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.

       1 Bouchardat Annuaire de Th.rap. pour 1851, p. 58.
       2 Jeffreys, Provincial Med. and Surg. Journal, June 12, 1844, p.  161. 
                           MONESIA.                          517

            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. 3iij.
                   Opii pulv. gr. iij.
                  Adipis %i.  M.
Applied, night and morning, in hemorrhoids.            Young.
                         CXXI. MONESIA.
   This vegetable substance has been imported into Europe, from South
 America, within the last sixteen years, and, in consequence of the trials
 that have been made with it, by the French practitioners  more espe-
 cially, it was introduced in the year 1840 into this country.  It is im-
 ported 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.1  They are com-
 posed of an extract, prepared in South America  from  the bark of a
 tree.   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  ex-
 tract 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  experi-
 ments of his medical and pharmaceutical countrymen.2  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 spe-
 cimens of the  bark of the tree, from Avhich he procured an extract pre-
 senting all the characters of that preAriously sent to him, and identical
 in composition.   This bark is said by  M. Derosne ,to be called by some
 travellers goharem, and,  by others, buranhem and guaranhem;  and
 the naturalists, who have examined it  there, think  that the tree which
 furnished it is a chrysophyllum—chrysophyllum buranhem seu glycy-
phlteum.3 It is smooth and grayish, like that of the  plane tree; but with
 this difference, that it is much thicker; its fracture is imbricated, and
its SAveet taste contrasts singularly Avith 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

  1 Martin Saint-Ange, Gazette M.dicale de Paris, 19 Oct., 1839.
  2 Bernard Derosne, Notice sur le Monesia.  Paris,  1839; Sigmond, Lond. Lancet,
1840; and A. Richard, Elements d'Histoire Naturelle M.dicale,  4eme _dit. iii. 3. Paris,
1849.
  s See a  translation of a communication by M. Saint-Ange, in American Journal of
Pharmacy, July, 1840, and in Amer. Med. Intel. March, 1840, p. 363. 
518
MONESIA.
 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 separate
 principles :—chlorophyll; vegetable Avax; fatty and crystallizable mat-
 ter; glycyrrhizin;  an acrid and slightly bitter matter;  a little tannic
 acid;  an organic acid, not studied; a red colouring matter, analogous
 to that of cinchona;  phosphates of lime and  magnesia; and salts  of
 lime, with an organic acid.1  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 betAveen the
 imported extract and that prepared from the bark.
   An analysis by M. Persoz,2 Professor  at the Academie des Sciences
 of Paris, gave the following  as  the constituents of the extract:—tan-
 nic  acid, rendering iron blue, 52; gum or mucilage, 10; sweet matter,
 36; loss, 2.
   It has been  suggested, that the  bark  of the  tree which  furnishes
 monesia is  the same with that of quillaia  saponaria of Chili.  Nei-
 ther the bark  nor the  extract would seem, however, to be  identical,
 although in certain respects  they resemble each other: moreover, the
 analysis of quillaia  Avas made by MM. Henry,  fils, and Bourtron-Char-
 lard, and  if monesia and quillaia were the same, the identity could
 not  have failed to be detected by these able chemical analysts.3

                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 ope-
 ration on the digestive passages, and accelerates in a remarkable man-
 ner  the  action of the stomach.   If the dose be  pushed to a dram or
 more in the day,  and it be continued for fifteen or twenty  days, the
 appetite increases, but a feeling of  heat is experienced in the epigas-
 tric  region; and tenesmus and obstinate constipation  may likeAvise su-
 pervene.4   Its  action is manifestly 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 bronchorrhoea,  it has been suc-
 cessfully employed by Alquie, Daynac, Manec,  and others,—sometimes

  1 Bernard Derosne, and 0. Henry, in Notice sur le Monesia, par B. Derosne; and in
Tableau Synoptique, &c, du Mon.sia, par M. Saint-Ange.   See, also, Saint-Ange, in op.
cit., and MM.  Bernard Derosne, 0. Henry, and J. F. Payen, in Journal de Pharmacie,
Janvier, 1841, p. 20.
  2 Forget, Bulletin General, de Therapeutique, Avril,  1839.
  8 See, on this subject, Drs. Chaloner and Ruschenberger, in Amer. Med.  Intel. Sept.
15, 1840, p. 184-187.  Merat and De Lens, art. Quillaia; and the analysis of Quillaia,
by Bourtron-Charlard, and Henry, fils, in Journal de Pharmacie, xiv. 247; and in Amer.
Journ. of Pharmacy, for  Oct. 1840, p. 210, with remarks by Dr. Carson.
  4 Martin Saint-Ange, op. cit. 
MONESIA.
519
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 hsemoptysis, according to Alquie.   On phthisis, it of course
exerted no direct efficacy; but 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,1 where the debility was so great that syncope was induced
on the least movement of  the body, the extract Avas given in pills in
the dose of  sixteen grains in the course of  the day, Avith the best ef-
fect.  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 diarrhoea, especially
when owing to improper diet, and several fortunate results have been
published by M. Adrien ;2 and by Dr. Q. Gibbon, of Salem, N. J.,3 and
a pupil  of the author, (1851,)  Mr. J. Hendley Kennon, informs  him,
that his father, Dr. II. C. Kennon,  of  Greene county, Alabama, and
himself, have employed  it successfully in some very obstinate cases.
Even in the colliquative diarrhoea of phthisis it has acted beneficially.
B. Derosne  affirms, that surprising results have followed its adminis-
tration in the diarrhoea 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. Nancrede4 gave it
successfully in a case  of diarrhoea of long standing, and  Dr. Burns
in two cases of chronic diarrhoea succeeding to  cholera infantum.  In
leucorrhcea, the efficacy of monesia, as of every  other astringent, is less
marked than in  diarrhoea.   Where the internal treatment is alone em-
ployed, the astringent has probably to pass into the mass of blood, and
in this manner to act upon the parts  concerned, Avhilst in every form of
chronic enteritis, it can come into immediate contact with the seat of the
disease.  Injections of monesia have  accordingly been more advantage-
ous in leucorrhcea.   M. Barron, after having employed all the  ordi-
nary means in a case of inflammation of the vagina, had recourse to
them, and arrested the discharge.   M. Payen  gives a  case in which,
when 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
Avhich monesia has  been given, it is  said  to have succeeded in mode-
rating or  suppressing the flow  more perfectly  than  any other agent.
It has been given,  with  excellent effects in these cases by MM. Day-
nac,  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. Chaloner6 administered the extract in the

  1 Bernard Derosne, Notice sur le Mon.sia, p. 7.
  2 Journ. des Connaiss. M.d. Chirurg. Nov. 1840.
  s American Medical Library, Jan. 1842, p.  143.
  « Medical Examiner, April 4, 1840, p. 215.      5 Ibid. Aug. 15, 1840, p. 517.
  •Ibid. July 11,1840, p. 441. 
520
MONESIA.
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
taken, benefit was experienced, and the  patient was directed to take
three more,—one every two hours.  The cure was complete.   It  is
proper to add, that perfect rest and cold drinks Avere used at the same
time;  and the same may be said of a successful  case reported by Dr.
Burns.1   In blennorrhoea, it has exerted but little action when admi-
nistered by the stomach; but when injected into the urethra it effected
a cure in half the cases, and diminished the amount of the discharge in
the other  half.2   In a case of well marked scorbutus, with petechia
of the inferior extremities, soft and bleeding gums, and frequent epis-
taxis, which  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 con-
taining 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 ex-
cellent 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, excellent
effects were obtained from it by MM. Baron and  Martin Saint-Ange.
M. Manec used it with benefit in an obstinate  serpiginous ulcer of
long duration.  M. Monod cured a phagedenic ulcer by it,  which had
resisted the use of nitrate of mercury and  the  arsenical paste.  M.
Payen Avas 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 stomatitis,3 one of a gangrenous character; and in cases
of fissure  of  the anus, the result of inflammation from hemorrhoids.
Tavo 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 dentist, has employed
it in cases of caries of the teeth, the progress  of which it appeared to
him to retard, and, when  united  with opium, it seemed to assuage the
pain more  than when  the  latter  was given singly.   He recommends
the use of the tincture  to maintain a good state of the gums.4
   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 derived from it as an
astringent.5  Still, it is not much used.

                    MODE OF ADMINISTRATION.
   Monesia is generally given  in pills in the dose of from twelve to
forty grains a day;—the medium dose, in the twenty-four hours being

  1 Medical Examiner, August 15, p. 517.
  2 Martin Saint-Ange, Op.  cit.                a See, also, J. G. Nancrede, Op. cit.
  4 Bernard Derosne,  Notice sur le Monesia, &c, &c.
  » Sigmond, Op. cit.  See, also, Forget, Bulletin Gen.ral de Therapeutique, Avril, 1839. 
MORPHIA.
521
fifteen to twenty grains, taken  at twice or thrice.   M. Martin Saint-
Ange has given it to the extent of forty-five grains a day.
  The syrup,  which  contains  six grains  of extract to the  ounce,
is given less frequently.   It is esteemed to  be less  active than  the
pure extract, and is preferred only in the case of infants.
  The Hydro-alcoholic Tincture, which  contains thirty-two grains
to the ounce, has been most  commonly used in injections, in  the pro-
portion 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, powdered
monesia; and at others again,  the acrid  matter itself referred to in
the  analysis.
                      MORPHIA ET EJUS  SALES.
 Synonymes. Morphia and its Salts.
 French.  Morphine et Sels de Morphine.
 German. Morphin und Morphinsalze.

                         CXXII.  MOR'PHIA.
 Synonymks. Morphina, Morphinum, Morphium, Morpheum, Morphine, Papaverine.1
 German. Morphin, Mohnstoff, Opiumalkaloid.
   The  discovery of this  principle is ascribed  to Seguin and SertUr-
 ner, who were engaged in the  chemical analysis of opium upwards 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 process of Hot tot is greatly followed  in  France.   It is a modi-
 fication of that used by Sertiirner, and similar to that  adopted in  the
 Pharmacopoeia of the United States, which is essentially the same with
 that of Dr. Edward Staples, published in the Journal of the Philadelphia
 College of Pharmacy.2   By it morphia is separated from opium by suc-
 cessive  macerations in distilled water until the  salt of morphia is  ex-
 tracted.  The fluid of the maceration is then mixed and filtered; and
 alcohol  and solution of ammonia are added,  by which the meconate or
 other salt of morphia is decomposed; the alcohol dissolving the colouring
 matter as soon as it is separated  by the ammonia, and the  morphia it-
 self being precipitated in a pure state.3
   Tilloy, Petit, and others, have obtained morphia on the  large  scale
 from domestic opium.4
  1 Jahn's Handworterbuch der Chimie, B. iii. S. 150.
  2 Vol. i. p. 15: For Robiquet's process, see Annales de Chimie, &c, v. 276; for Faure's
process, see Journal of the Philadelphia College of Pharmacy, ii. 71.  Philad. 1831: for
Mohr's process, Journal de Pharmacie, cited in American Journal of  Pharmacy, April,
1M1, p. 60.  See, also, Dispensatory of the United States, 10th edit.,  p. 1080.  Philad.
1854.                  s Pharmacopoeia of the United States, p. 173.  Philad. 1851.
 * Art. Morphine, in Merat and De Lens, Diet, de Mat. Mod. 
522
MORPHIA.
   The crystals are completely white, translucent, almost  transparent,
and slightly opaline; and are wholly inodorous.  In the form of poAv-
der, 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, ac-
cording  to  Choulant, dissolves  one eighty-second part; according to
Jahn, only  one four-hundredth;  and, according to Bally,1 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 ap-
pear to be rectangular 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 sys-
tem like opium, but  does not  exert  the same  agency on the vascular
system.  Magendie2  asserts, that it  possesses all the advantages of
opium without any of its  disadvantages.   Bally3 took especial pains
to investigate the effects of morphia  on the organism, 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  opportunity 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 who have expe-
rienced an  apoplectic  attack  previously.   Bally found,  moreover—
which does not accord with the author's 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 extremities;  but  no  delirium supervened,
and the intellectual faculties 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 trouble-
some tremours.   He found the pupils contracted under its  use  when
larger doses were given, which is  opposed to the ordinary effect of nar-
cotic agents.   Not unfrequently, when  morphia was continued, the
soothing and soporific effect  was  preceded, for some days, by restless-
ness, and loss of sleep.  Very often it excited headache.   On the vas-
cular system it did not  act as an excitant—neither rendering the pulse
quicker, more frequent, nor tenser. The opposite effect seemed, indeed,

  1 M.moires de 1'Academie Royale de Medecine, i.  99.
  2 Formulaire pour la Preparation, &c. de plusieurs nouveaux M.dicamens.
  * Revue M.dicale, F6v. 1824; and Mem. de  la Societ. Royale de Medecine, i. 142. 
MORPHIA.
523
 to be induced.  It has no action, Bally affirms, as an emmenagogue;
 produces no diaphoresis—which 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 Avhole
 surface of the body or topically; in the latter case, the sensation being
 chiefly felt in the  face, neck, loins or genitals.  At times, the itching
 is associated with  an  eruption of conical wheals  or bumps, Avhich 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 none on the mouth,
 pharynx, or oesophagus, except that ptyalism has been observed to re-
 sult 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, which is a  forerunner of  its effects on the stomach.  The
 appetite is not diminished, except when its emetic properties are deve-
 loped 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 which, at times, diarrhoea
 supervenes.   Very frequently, also, colic is induced 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.1
   The author's own view of its  action—when  no idiosyncrasy inter-
 feres 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 Dr. Blake.2  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 pres-
 sure of the arterial system.
   As in the case of opium, the system may, under excessive  pain or
 long continued use, be so  habituated to its action as to bear very large
 doses.   Mr. Lingen,3 of Hereford, has published a case in which a fe-
 male, under a painful affection, took scruple, and, according to her own
 report, half dram  doses of  the acetate; and Mr. Teevan,4 of London,
 one of a gentleman, labouring under a disease of the  spinal  cord, at-
 tended 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.
  In a case of malignant disease of the abdomen, the diagnosis  of
 which was impracticable and the pains intense, the quantity of acetate
 of morphia given almost surpasses belief.   An apothecary supplied an
 account of the quantity furnished by him; but, besides this, more was ob-
 tained several times elsewhere, and various other forms of medicine con-
 taining opium were ordered.  Commencing with two grains in  Febru-
ary, 1849, the quantity was gradually increased so as to bring it to 14
grains for May; 50 for June,  60 for October;  and 136 for December,

  1 Richter's Specielle Therapie, 2te Auflage, S. 358.  Berlin, 1828.
  2 Edinb. Medical and Surgical Journal, April, 1839. p. 344.
  1 London Lancet, Jan. 26, 1839, p. 680.      * Ibid, for February 9, 1839, p. 738. 
524                         MORPHIA.

making a total of 454  grains  from  February to December.  Com-
mencing with 192 grains for January 1850, it reached 648  in March,
being 21 grains per diem; and 936 in May—thus averaging  30-j grains
per diem;  and the highest quantity ever taken in one  day—namely
52 grains—Avas during this month.  After this, the quantity Avas dimi-
nished again to 648 in June, 216 in September, and 288 in December
—making a total of 5175 grains or 10 ounces, six drams  and fifteen
grains, Apothecaries' weight, for 1850.  During four months  of 1851
the amounts taken continued much the same, being 75(5  grains.  The
entire quantity taken during 25 months was 6385 grains, or lib. 1 oz.
2 drams and 25 grains.1

               EFFECTS  ON THE ECONOMY IN DISEASE.
  Morphia may often be administered advantageously, not only Avhere
opium is indicated, but, it is thought, where it disagrees.  Riecke2 re-
marks, that where diaphoresis is  needed, it  cannot supplant opium;
but in this we apprehend he is mistaken, at least in febrile and inflam-
matory  diseases.   In such cases, the author has observed a  sedative
dose of  opium succeed in restoring the cutaneous transpiration more
effectually than any other agent, by allaying the  pathological condition
on which the suppression of perspiration 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 preparations 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, Avhere  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 experi-
menters, asserts, that he  has  found it equally efficacious with its salts.
As, however, this result is doubtless owing to the existence  of acid  in
the  stomach,  and, consequently, is liable to uncertainty, 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 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 beneath the  epidermis,
and be allowed to remain there a few seconds, the following effects, ac-
cording to M. Lafargue, are  observed:—About  a minute and a half
after the operation, a small pimple appears, 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 somewhat deeper than that of the  skin;  it is hard;  the are-
ola  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

  1 Dr. Crede, Casper's Wochenschrift, 1851, No. 45, cited in Brit, and For. Med. Chir.
April, 1852, p. 561.
  2 Die neuern Arzneimittel, u. s. w. S. 327. 
MORPHIA.
525
 deA'elopment, after which they gradually disappear.  The general ef-
 fects, Avhich  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 considers that  the  inocula-
 tion of morphia may supersede the use  of  blisters  and ammoniacal
 plasters, and that it deserves employment more particularly Avhere 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.1
   The experiments of M. Lafargue Avere repeated by M. Martin Solon,
 with nearly the same results.2
   M. Jaques of Anvers,3 and Castiglioni,4 an  Italian physician, also
 reeommend inoculation with  morphia—the  sulphate—in neuralgia.
 In one case,  the former made about forty punctures  over the seat  of
 pain.  The same  plan was used  in sciatica,—the  inoculations being
 made the whole length of the sciatic nerve.   Poultices  are useful  in
 subduing the irritation produced by the  punctures.   The latter em-
 ploys the acetate  in a  similar manner.   He uses  a  solution  of three
 grains of the salt in half an ounce of distilled water, and makes nume-
 rous punctures in  the course of the affected nerve.   Dr. A. T.  Thom-
 son5 has drawn the following  conclusions in regard to  the utility  of
 the endermic use of the salts of morphia in certain articular affections.
 First, In painful  swollen, and  contracted joints, depending on rheu-
 matism, or other causes, the topical application of  muriate  or acetate
 of morphia to a blistered surface  over the affected  joint is capable  of
 reducing the  swelling, abating pain, and restoring  the motion  of the
 joint.  Secondly, These 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 discon-
 tinued.   Mr. Rhynd,6 too, has found the  inoculation  of  morphia tri-
 umphantly successful in rebellious cases of neuralgia.  He associates
 the acetate of morphia, hoAvever,  with creasote;  in the  proportion  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, which was very slight, had  ceased.   In another case—
of sciatic neuralgia—the fluid was introduced by one puncture behind
the trochanter, and  another half way down the thigh.   The man was
  1 Rev. Med. Chirurg. ii. 163. Gibbon, American Medical Intelligencer, July, 1841, p. 1.
  2 Bulletin de PAcademie Royale de Medecine, Nos. 1 and 7, 1836-7.
  * Bouchardat,  Annuaire de Therapeutique, pour 1844,  p. 24.
  * Provincial Medical  and Surgical Journal, July 3, 1844, p. 208.
  5 London and Edinburgh Monthly Journal of Medical Science, Oct. 1845, p. 774.
  8 Dublin Medical Press, March 12, 1845. 
526
MORPHIA.
instantly relieved from pain.  Should the pain return, the fluid must
be again introduced.1
   In painful  local nervous affections, Dr. Alexander Wood2 has in-
troduced solutions of morphia, into  the areolar tissue, as  near as pos-
sible to the  affected nerve, by means of  a small  perforating syringe,
such as is used for  injecting aneurisms with perchloride of iron; and
has narrated nine cases  in which he employed this  method with per-
fect safety;  and in some with complete—in  others with partial—suc-
cess.
   M. Ebrard,  of Bourg,3 has employed, with signal success in the cure
of toothache, the muriate of morphia, by  friction on the  gum of the
pained part.   These frictions  are  made in  the following  manner.
The patient  takes upon the moistened extremity of his fingers 13 mil-
ligrammes,—about one-fifth of a grain, Troy,—of the salt, and applies
it for tAvo 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 dissolved, he must allow the  saliva to
be  in contact with the gum for five or ten minutes.  He may after-
wards swallow the saliAra.   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 treatment
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,
hoAvever, that great caution should be used in employing tnis  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 has 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 inoculation.

                       Haustus morphiae.
               Draught of morphia.—r(Potio narcotica.)
                 R.  Morphia, gr. \.
                     Syrup, papav. f gj.
                     Aq. destillat. fgj.  M.
  To be taken at  bed-time.

                        Enema morphiae.
                Injection of morphia.—(Injectio leniens.)
                 R.  Morphias gr. ij.
                     01. amygdal.
                     — lilior aa ^ss.  M.

  1 See a similar case by Dr. Charles Brackett, in North-western Med. and Surg. Journ.
Sept. 1851.
  2 Monthly Journ. of Med. Feb. 1855, p. 183.
  * Gaz. des Hopitaux, cited in Amer. Journ.  of the Med. Sciences, July, 1846, p. 220. 
                         MORPHIiE ACETAS.                      527

  To allay pain in the ear, the suffering in acute hlennorrhagia, and
the tenesmus in hemorrhoids, &c.                          Brera}

                    Linimentum morphiae.
                        Liniment of morphia.
                 R. Morphia, gr. iij.
             Solve in
                     01. amygdal. fgi.—f 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.2
                  cxxin. morthle: ace'tas.
Synonymes. Morphinae Acetas, Morphium Aceticum, Acetas Morphii, Acetas Mor-
  phicus, Acetate of Morphia.
French. Acetate de Morphine.
German. Essigsaures  Morphium, Morphiumacetat.

                      METHOD OF PREPARING.
   Acetate of morphia may be obtained by mixing morphia freed from
narcotina by boiling  Avith  ether, acetic acid and distilled  water in an
appropriate vessel, gradually evaporating  to the consistence of syrup
in a water  bath;  drying the acetate with a gentle heat, and rubbing
it to powder.3  This  mode of preparation is required, owing to the dif-
ficulty of obtaining the acetate crystallized, in consequence of  its ex-
treme deliquescence.   Crystallized acetate of morphia may, however,
be prepared  by dissolving  morphia  in  alcohol, saturating with acetic
acid, filtering the solution, and evaporating gradually in a vessel co-
vered over with thin  rag.   The acetate crystallizes in an  arborescent
manner on the sides  of the vessel.
   Acetate of morphia is one of the  substances, which, in the experi-
ments of Magendie,4 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,5 of the Hospital St. John, Turin,
according to a form  given  beloAV.   When the  pains  are  relieved,  or
sleep is about to commence, the intervals between  the doses are in-
creased,  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 Aveeks, if necessary.  Mr. Braithwaite6 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 Avithout any other bad effects  than severe sickness, which was

  1 Ricettario Clinico.  Padova, 1825.
  2 C. G. Lincke, Vollst'andiges Recept-Taschenbuch, tt. s. w. ii. 288. Leipz. 1841.
  3 Pharmacopoeia of the United States, p.  174.  Philada. 1851.
  * Lecons sur le Sang, &c, and translation in London Lancet, Jan. 26, 1839, p. 636.
  1 Repertorio Medico-chirurgico del Piemonte, in British and Foreign Medical Review,
Jan. 1840, p. 252.
  6 Retrospect of Practical Medicine and Surgery, vol. i. Jan. to July, 1840, 3d edit. p.
15.  London, 1842. 
528
MORPHIiE ACETAS.
easily abated by creasote or excitants—as the spiritus ammonias aro-
maticus.  He prescribes one-fourth or one-sixth of a grain every hour
or two,  in severe cases, until the system is completely under its influ-
ence, and then keeps up its effects  by smaller, and less frequently re-
peated,  doses.   It is  questionable, hoAvever, whether the acetate be
superior to  opium.   M. Gerard, of  AA'ignon, 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, however, the resources of art had been long
postponed, the effects of the remedy were less marked;  the vomiting
and the other symptoms 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 serous symptoms were removed, and
he omitted it as soon  as the spasms  and the diarrhoea  and vomiting
had ceased,  or  as soon as reaction ensued.
  In the treatment  of  chronic gastralgia,  M.Valleix1 derived the
greatest benefit from the employment of small doses of  the acetate.
Its use in that  disease is not new, but he  modifies the usual mode of
its administration.   Instead of  giving it before a meal, he prescribes
it after, and in this way has relieved cases that had resisted all other
treatment.  He orders a grain of the acetate to be dissolved in thirty
drams of  distilled water and nine  drams of  syrup, and directs a tea-
spoonful to be taken immediately after each meal.  Under the use of
these small  doses, the bowels, instead of  being very constipated, are
better regulated.
  Acetate of morphia has  been much used endermically, in the  dis-
eases 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 has  been sometimes very large.  In a  case of hydrophobic,
reported by Dr. Burne,2 of London, ten grains at a time were sprinkled
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.3  A case of  traumatic tetanus has been published,
which was cured by the internal and endermic use of the acetate.4

                    MODE  OF  ADMINISTRATION.
  The dose of acetate of  morphia is from an eighth of a grain  to a
quarter or more.  Its strength  does not vary materially from that of
pure morphia.

  1 Revue Medico-Chirurgicale, ii. 100, in Brit, and For. Med. Chir. Review, Jan. 1848,
p. 275.                               2 Lond. Medical Gazette, April 14,  1838.
  8 A. T.  Thomson, in London Lancet, for Jan. 19, 1839, p. 632.
  * L. Piquot, Journ. des Connais. Med. Chirurg.  Dec. 1840. 
                          MORPHIiE ACETAS.                      529

                   Liquor morphiae  acetatis.
                    Solution of acetate of morphia.
                 R.  Morphias acetat. gr. xvj.
                     Acid, acetic, f £ij.
                     Aquae destillat. f -Jvj.  M.
   This formula was proposed by the  authorl as a substitute  for  the
 "gouttes calmantes" of Magendie,2 which  permit the  deposition of the
 morphia when kept for a short time.  The dose is from six to twenty-
 four drops.
                 R.  Morphiae acetat. gr. xvj.
                     Acid, acetic, gtt. iij. vel iv.
                     Alcohol, f 3j.
                     Aquae destillat. fgj.  Fiat solutio.       Magendie.

                  Mistura morphiae acetatis.
                    Mixture of acetate of morphia.
                 R.  Morphias acetat. gr. i.
                     Syrup, acaciae f ^i.
                     Aquae destillat. f ^iv.  M.
   Dose.—A spoonful every hour in arthritis and nervous affections,
 until the pains are removed.                               Cristin.

                  Syrupus morphiae acetatis.
                     Syrup of acetate of morphia.
                 R.  Morphiae 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 syru-
 pus  papaveris.   It has  the advantage of  being always  of uniform
 strength.                                               Magendie.

   It has been suggested,3 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.   Hildenbrand re-
 commends the following ointment to be rubbed on the pubes  in cancer
 of the uterus:—
                Unguentum morphiae  acetatis.
                    Ointment of acetate of morphia.
                 R.  Morphia, acetat. gr. iv.
                     Ung. hydrarg. ciner.
                     ----simpl. aa. gij. M\
   A piece, the size of a pea, to be  rubbed on twice daily.

  1 Formulary, &c, translated from Magendie, by C. T. Haden, 2d edition, by Robley
Dunglison, M. D., p. 14.  Lond. 1824.  Amer. edit.,  Philad.  1825.
  2 Formulary, &c.
  ' Duhrtnel, Amer. Journ. of Pharmacy, for Oct. 1840, p. 187.
       34 
530
MORPHI_E MURIAS.
  A solution  of acetate  of morphia, which  he terms liquor opii, has
been proposed by Mr. Houlton.1   He  prepares it as follows:—Take
two  ounces and a half of the best  Turkey  opium; thirty-tAvo fluid-
ounces of Beaufoys acid, of the strength of pickling vinegar: mace-
rate with a gentle heat  for  six days, frequently shaking the Aressel;
then filter, and evaporate the fluid to  the  consistence of the extracts
of the pharmacopoeia, finishing the  evaporation  by the spontaneous
method.   This  Mr. Houlton  employs  under the name extractum opii
aceticum.  To the above  extract he adds, alcohol, five fluidounces; dis-
tilled water, thirty-five  fluidounces; macerating  for  eight  days, and
filtering.
  This liquor opii is about the strength of the  tinctura opii in seda-
tive 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.
                CXXIV. MOR'PHLE HYDRI'ODAS.
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 intro-
duced  of late years.   It is prepared  by mixing a solution of acid sul-
phate  of morphia, with a solution of ioduretted iodide of potassium,
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 appeared from
the few trials  made  of it  by M. Bouchardat,2 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.
                   CXXV. MOR'PHLE MU'RIAS.
Synonymes. Morphine. Murias seu Hydrochloras, Morphiae Hydrochloras, Morphium
  Muriaticum, Murias seu Chlorhydras Morphicus, Hydrochloras Morphicus, Murias
  Morphii, Muriate of Morphia, Hydrochlorate of Morphia or Morphine.
French. Hydrochlorate ou Muriate de Morphine.
German. Salzsaures Morphium, Hydrochlorsaures Morphium.
                      METHOD OF PREPARING.
  According to the Pharmacopoeia of the United States, muriate of
morphia is prepared as follows:—Take of morphia in powder, §i.; dis-

  1 Lond. Medical Gazette, Aug. 12,  1837.   See, also, Buchner, pere, in Journal de
Pharmacie, Fevrier, 1842, p. 48.
  2 Nouveau Formulaire Magistral, p. 70.  Paris, 1845. 
M0RPHI_E SULPHAS.
531
tilled water Oss.; muriatic  acid, a sufficient quantity.   Mix the mor-
phia with the water; then carefully drop in  the acid, constantly stir-
ring till  the morphia is saturated and dissolved.  Evaporate the solu-
tion by means of a water bath, so that it may crystallize  on cooling.
Dry "the crystals on bibulous paper.1
[' 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
morphia.
  The following  preparations are directed in the Edinburgh Pharma-
copoeia.
                      Trochisci morphiae.
                           Morphia lozenges.
                 R.  Morphiae muriat. 9i.
                     Tinct.  tolut. f ^ss.
                     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.2  Each lozenge contains about one-fourth of a grain
of muriate of morphia.  Dr. Pereira3 states, that the morphia lozenges
of the shops usually contain one twenty-fourth of a grain of the mu-
riate.  It is a good mode of  employing  morphia with the view of al-
laying cough.
            Trochisci morphiae  et ipecacuanhae.
                  Morphia and ipecacuanha lozenges.
                 R.  Morphiae muriat. ^i.
                     Ipecac, in pulv. subtil. &■
                     Tinct.  tolut. f ^ss.
                     Sacchar. ^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.
                  CXXVI.  MOR'PHI_E  SULPHAS.
Synonymes.  Morphinae Sulphas, Morphium Sulphuricum, Sulphas Morphii seu Mor-
  phicus, Sulphate of Morphia or Morphine.
French. Sulfate de Morphine.
German. Schwefelsaures Morphium, Morphiumsulphat.

                      METHOD OF PREPARING.
  Morphia is dissolved in dilute sulphuric acid.   The solution is then

  1 For Wm. Gregory's mode of preparing the muriate, see Edinb. Med. and Surg. Journ.
for April, 1831; or Philad. Journal of Pharmacy, iii. 124.  See, also, M. Robertson, in
Edinb. Med. and Surg. Journal, for April, 1832; and A. T. Thomson, Lond. Pharmaceut.
Journ. and Transact., or Amer. Journal of Pharmacy, July, 1842, p. 154.
  2 Christison, Dispensatory, p. 643.  Edinb. 1842.
  ' Elements of Mat. Med. and Therap. ii. 1782.  Lond. 1842; or 3d American edition,
by Dr. Carson, ii. 1067. Philad. 1854. 
532
M0RPHL33 SULPHAS.
evaporated by heat, and suffered to crystallize, which it does in silken
tufts, or snow-Avhite feathery crystals that are wholly soluble in water.

                    EFFECTS  ON THE ECONOMY.
  The general effects  of  sulphate  of morphia on  the economy in
health and disease resemble those of the acetate, to which it is  per-
haps to be preferred on account  of its  greater uniformity.  There  is
an advantage, 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, Magendie1 found that the sulphate
of morphia—unlike the acetate and the muriate—opposed the coagu-
lation of that fluid.
  A syrupus morphiae sulphatis, a liquor morphias  sulphatis,  and an
unguentum morphias sulphatis, may be formed in the same manner as
with acetate of morphia.  The  common form for the solution of sul-
phate of morphia is the following: it is that of the Pharmacopoeia of
the United States; and it is to.be regretted, that the strength is not the
same as that of the Liquor Morphias Acetatis.

                 Liquor  morphiae  sulphatis.
                   Solution of sulphate of morphia.
                 R.  Morphiae sulph. gr. viii.
                     Aquae destillat. Oss.   Fiat solutio.
  Dose.—A tea-spoonful (which is considered to be equivalent to about
twelve or fourteen drops of laudanum,) to be repeated as occasion may
require.
        Lotio  morphiae sulphatis et sodae boratis.
            Lotion of sulphate of morphia and borate of soda.
                 R.  Morphiae sulphat. gr. vj.
                     Sodae borat. ^ss.
                     Aquae rosae f 3viij. M.
  To  be  applied thrice a day to  the  affected parts by means  of  a
piece of sponge, or a piece of linen, in pruritus vulvae, taking  the pre-
caution first to wash  the surface with tepid water and soap, and to dry
them before applying the lotion.                          Meigs.2
  Citrate of Morphia is occasionally used;  but it possesses no ad-
vantage  over the preparations described above.   Many years ago,
Dr. Porter, of Bristol, recommended a liquor morphiae  citratis 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.3  Magendie
recommends  the substitution of the  following process:

  1 Lecons sur lc Sang, &c., or translation in London Lancet, January 26, 1839.
  2 A Treatise on the Diseases and Special Hygiene of Females, by Colombat de l'lsere,
translated by C. D. Meigs, p. 272.   Philad. 1845.
  * Pharmacologia, 4th American from the 7th London edit.  By J. B. Beck, p. 439.
New York, 1831. 
M0RPHUE SULPHAS.
533
              R.  Morphiae pur. gr. xvj.
                  Acid, citric, crystallis. gr. viij.
                  Aquae destillat. f 3*j.
                  Tinct. cocci,  q. s.   Fiat solutio.
Dose.—Six to tAventy-four drops in the twenty-four hours.
  Tartrate of  Morphia was suggested by Mr. Haden1 as a substi-
tute 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.
   Bimeconate of Morphia was  brought before the  notice of  the
 profession by Mr. Squire.2   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 re-
 action due to meconic acid and morphia.  It is an acid salt; for meconic
 acid is tribasic; and in the bimeconate of morphia, there are two equi-
 valents of morphia, and  one equivalent of water to each equivalent of
 acid.3
   Impressed with the idea, that the combination of the active principle
 of  opium, as prepared by nature, would  prove more beneficial  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 possible; 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. ^ 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 headache
 or other discomfort;  and that it repeatedly answered, in the most sa-
 tisfactory manner, where opium had disagreed, and succeeded in some
 cases where other salts of morphia—the  acetate and the  muriate—had
 failed to give relief.   Equally strong testimony in its favour is afforded
 by Dr. A. T. Thomson, who details  three cases—one of neuralgic pain
 of the left side of the face; another of wakefulness, Avithout any appa-
 rent cause, and a third of anomalous pain of the hip and thigh, all bene-
 fited strikingly by its use.

  A preparation termed M'Munn's Elixir of Opium has been intro-
 duced  into American  practice with many testimonials  in  its favour;
 but the formula for  its preparation is kept secret;  and, therefore, it
 merits  no  farther notice  here.

  1 Translation of Magendie's Formulary, 2d edit.  By Robley Dunglison, M. D., p. 19.
Lond. 1824.                          2 Lond. Med. Gaz. Mar. 9, 1839.
  1 Ballard and Garrod, Elements of Mat. Med. and Therap. p. 406.  Lond. 1845. 
534
MOXA.
   M. Bouchardat1 speaks of a double muriate of morphia and co-
deia ;  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, [?] Avhere  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.
                          CXXVII. MOXA.
 Synonyme. Moxiburium.
   By the term  moxa, the  Chinese and Japanese designate a cottony
 substance, which they prepare by beating the dried leaves of Artemisia
 Chinensis, a kind of Mugwort.   Dr. Lindley,  however, states, that it
 is made from A. Moxa.2   With this down they form a cone, which is
 placed upon the  part intended to be cauterized, 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  in-
 troduced through the agency of a Dutch physician3 who had resided in
 India.  It fell again, however, into disuse, until attention was redirected
 to it, during the last century, by Pouteau4 and Dujardin, and, at  the
 commencement of this century, by Percy and Laurent,5 and others.6

                       METHOD OF PREPARING.
   Various  agents haAre  been used  by different people, in  "moxibus-
 tion,"—for so the mode  of cauterization has been termed,  which con-
 sists in placing some combustible substance on a part of the body, and
 suffering it to burn down.   From the earliest ages, the Nomades em-
 ployed the fat wool of their flocks, as well as certain spongy substances
 growing upon oaks,7 or springing from the hazel:8 the Indian, the pith
 of the reed,9 and flax or hemp impregnated, with some combustible ma-
 terial;10 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;u the Egyptians, the Arracanese, and several
 oriental nations, cotton;12 the Ostiaks13 and the Laplanders,14 the agaric

  1 Nouveau Formulaire Magistral, p. 70. Paris, 1845.          * Flor. Med. 463.
  3 Ten Rhyne, Medit. de Veteri Medicin.; Dissert, de Arthritide, Lugd. Bat. 1672;  and
 Ksempfer's History of Japan, translated by Scheuchzer, vol. ii.  append, sect. iv. Lond.
 1728.                               * Melanges de Chirurgie, p. 49.
  5 Dictionnaire des  Sciences Medicates, art. Moxibustion.
  6 See, for a history of the Moxa, the author's translation of Baron Larrey's Memoir on
 the Use of the Moxa. Lond. 1822.              i Hippoc. lib. de Affect, cap. xxx.
  8 Paulus _Eginet. lib. vi. cap. 49.
  9 Kaem^fer, vol. ii. app. sect. iv. p. 36.     10 Bontius, De Medicina Indorum, p.  32.
 11 Percy, in Pyrotechnie Chirurgicale Pratique, p. 12.
 12 Prosper. Alpin. de Medicina _Egyptorum, lib. iii. cap. 12.
 13 Voyages de M. Pallas, iv. 68.
 14 Acerbi, Travels  through Sweden, Finland, and Lapland, ii. 291; and Linnaeus, in
Lachesia Lapponica,  translated by Sir James Smith, i. 274. 
MOXA.
535
 of  the birch;  and the aborigines  of  this continent, rotten and  dried
 wood.  Hippocrates1 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—
 which is known to be an  agaric prepared for the purpose; and it is not
 uncommonly employed in our hospitals,—a small disc or cylinder being
 placed on  the part,  and set fire to.  It has been  generally used in the
 French  hospitals.2  The match used  by artillerists was  recommended
 by Percy,3 after Bontius:4 it is composed  of hemp steeped in a solution
 of nitre.   He likewise  proposed the pith of the sun-flower—helianthus
 annuus—recommending that the stalk should be cut into cylinders of
 the desired length, the bark being left on; so that, when ignited, it may
 burn in the centre and be held with the hand.5  This he called moxa
 de voleurs.6  These  moxas, called Percy's moxas, prepared by Robinet,
 are found  in the London shops.  They consist of pith, rolled in cotton
 and enveloped  in muslin.7
   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.  Larrey advises,  that
 it should have the shape of a truncated cone—the form usually adopted
 —and be about an inch long.   Commonly, the cylinder is shorter than
 this; six or eight lines—as, when above six lines high, the combustion
 is not felt—and about  four or five lines broad.  The moxas employed
 by Dr. Sadler,8 of St. Petersburg,  are about half  an inch in diameter;
 and three-quarters of an inch in height.  They are composed of a nu-
 cleus formed of the  pith of  the sun-flower, wrapped in layers of cotton
 of various  thickness, and  surrounded Avith  an external envelope of thin
 muslin; 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 accommodate  them to the shape
 of the moxa; and Avhen 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, Larrey9 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. Leney10 soaks  a

  1 De Affect, cap. viii.      2 Bulletin General de Therapeutique, Juillet, 1840.
  3 Op. cit. p. 77.  Paris, 1811.                 4 Op. cit. p. 32.  Paris, 1645.
  6 Art. Moxibustion, in Diet, des Sciences Medicales.
  6 Merat and De Lens, Diet, de Mat. M£d. art. Moxa.
  » Pereira, Elements of Mat. Med. 2d edit. p. 1352.   Lond. 1842; or 3d Amer. edit, by
Dr. Carson, ii. 595.  Philad. 1854.
  8 Zeitschrift fur die gesammte Medicin. B. iii. H. ii. & iii.; and British and For. Med. Re-
view, July, 1837, p. 217.
  9 The author's translation  of his Essay on the Moxa, p. 5.
 10 Lond. Med. Gaz. July 15, 1842. 
586
MOXA.
piece of lint in a  strong solution  of nitrate of potassa, dries it, and
cuts off pieces of the size of the thumb nail, which he fastens with thin
adhesive plaster over the seat  of pain;  sets fire  to the opposite  ex-
tremity, and then applies the blow-pipe.  The pain during the process
is very severe, but he affirms, that the Irish prefer it greatly to the ap-
plication of a blister.  Professor Grafe1 employs moxas made of Avafera
dipped in a mixture of three parts of oil of turpentine, and one part
of sulphuric ether.  Before applying this inflammable  matter to  the
skin, it is necessary to 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.2 This
he admits to be equally successful with the one he proposes, and which
has been  already described (p. 266,) in forming  a rapid  vesication:
"but it is, at the same time, so complicated, and  attended by such in-
tense pain," that, in practice, he says, it will not  bear comparison with
the preparations which he recommends.  A piece  of linen or paper,
being cut of the requisite size,  is immersed in spirit of wine, or brandy.
It is then laid  on the part to be blistered, care being taken, that  the
moisture from the paper or linen does not wet the surrounding surface.
The flame of a lighted taper is applied  quickly over the surface, so as
to produce a general ignition, which is exceedingly rapid.   At the con-
clusion of  this  operation, the cuticle is found detached  from the true
skin beneath.  In  cases of convulsions, the region of the spine  has
been treated in this manner, and with good effects.3
   Dr. Osborne, of Dublin,4 avails himself of the high temperature pro-
duced by lime in  the act  of slacking, 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.  Water is
then dropped on the lime, and mixed with it.   In about two  minutes,
it SAvells, and becomes dry; and,  at the same time, a degree of heat is
produced,  which—according  to  some  experiments—may amount to
500° Fah.  He 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 unac-
companied by  the  emission of sparks or smoke, which frightens the
patient.   When the quantity of lime used is smaller than that men-
tioned above, or if it  be not kept on long, an  appearance results, re-
sembling that produced by acetic acid; and a thick crust is formed,
which separates as the new skin is perfected beneath.  But if the quan-
tity 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

  1 La Lancette Francaise, 26 Jan. 1839.
  2 Counter-irritation, its Principles and Practice, Amer. Med. Library edit., p. 21, and
p. 42.  Philad. 1838.
  3 C. J. Edwards, in Provincial Med. and Surg.  Journal,  Jan. 1842.
  4 Dublin Journal of Medical Science, Jan.  1842. 
MOXA.
537
the upper part of the  rectum and sigmoid flexure of the colon; in
which all  the  symptoms  of internal ulceration disappeared after the
application of a lime moxa, of about the size of  a crown, over the re-
gion of the sigmoid flexure.  In a case of incipient softening of tu-
bercles; and in another apparently of purulent infiltration after pneu-
monia, its effect in arresting the ulcerative process was most decided.
In a case  of hip-joint disease, in which there was great pain, and con-
sequent loss of sleep, the patient 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 obtained.   The  size of  the ulcer formed' by it is always much
larger than that of the lime applied.  When the lime is prepared from
calcareous spar, the heat, produced on  the addition of water, is sudden
and intense, and the pain is proportionably urgent.   For ordinary pur-
poses, 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  rubefaction,
vesication, or the formation of an eschar.   Where  it is desirable to pro-
duce the first result only, the cylinder  of cotton may be removed when
the pain becomes somewhat severe;  or the burning  material  maybe
held close to the  surface, and he moved  gradually along  it.  In  this
manner, a counter-irritant effect may be exerted along the  spine or any
extensive surface.  Any burning substance—a lighted coal, for example
—will answer  for this purpose.  When vesication is needed, it must be
kept on longer; and if it be desirable  to produce an eschar, the moxa
may have  to remain on until  it is  wholly  consumed.  Larrey,1 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.  Larrey
says the sloughing can be prevented by the application of liquid  am-
monia2 to  the  burnt surface,  after  the moxa has been removed.   This
will do when the disorganization is partial; but we know, from experi-
ence, that it often fails.

               EFFECTS  ON THE ECONOMY IN  DISEASE.
  Moxa—in its different forms—is doubtless a most  valuable agent,
when 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  potential, in that of moxa an
actual cauterant.  The moxa must  be regarded  as one of our most
valuable revellents.
1 Op. citat. p. 5.
2 Ibid. p. 9. 
538
NARCOTINA.
                      CXXVIII. NARCOTI'NA.
Synonymes. Narcotinum, Narcotin, Narcotine, Opiane, Matter or Salt of Derosne.
French. Matiere ou Sel de Derosne; Sel Essentiel d'Opium.
German. Narkotin, Opian, Derosne'sches Opiumsalz.
   In regard to the precise properties of this substance,  which is one
of the immediate principles of opium, and has attracted the attention
of many chemists and therapeutists, much  uncertainty exists.   It
seems, that it has not hitherto been found except in opium.

                       METHOD OF PREPARING.
   It  is  commonly obtained,  either from crude extract of  opium, by
means of ether, which only dissolves  the narcotina, and consequently
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  residue is twice  treated with
boiling acetic acid at 2° or 3°; it is precipitated by ammonia, and the
washed  precipitate is  purified by treating  it Avith hot alcohol at 40°,
and  a little animal charcoal; the liquid is then 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; so-
luble with the aid of heat in alcohol, and in the volatile  and  fixed oils;
very soluble  in ether,  which distinguishes it from morphia;  very solu-
ble also in cold acetic acid,  whence it is precipitated 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 ana-
logous, in some  respects, to the crystallizable resins or  sub-resins of
M. Bonastre.1
  Narcotina is generally reckoned amongst the vegetable  alkaloids;
but  by some it is considered to be neuter.2   Dr. Christison3 states,
that  "opium contains no fewer  than  seven  crystalline principles;—
morphia, codeia, and  paramorphia, narcotin, narcein, porphyroxin and
meconin, of which the first three are alkaline and the others neutral."
  Dr. O'Shaughnessy4 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 opi-
um is exhausted of its soluble parts.  The  solution is then decanted,
and the insoluble portion pressed.   To the alcoholic solution 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, composed of narcotina,  meconate of
ammonia, and resin.   This is Avashed with water, which dissolves the
meconate of ammonia, and afterwards with a quart of water and a dram

  1 Merat and De Lens, Diet, de Mat. M.d. art. Narcotine.
  2 Christison, Dispensatory, Amer. edit. p. 702.   Philad. 1848.
  3 Ibid. p. 701.
  * Calcutta Quarterly Journal, and Lond. Lancet, July 20, 1839, p. 606. 
NARCOTINA.
539
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 rosy colour, and brittle vitreous texture.  It is  very  soluble in dis-
tilled water and spirit; 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 observers.1  According
to Magendie,2 morphia is the anodyne principle of opium, and narco-
tina the  exciting.  When a grain of  narcotina dissolved in oil was
given to a dog, it produced a state of stupor, Avhich superficial observers
might readily confound with sleep; but it differed evidently from sleep;
the animal's eyes Avere open; the respiration Avas not deep, as in sleep,
and it was impossible to arouse it from its sluggish condition.  Death
generally took place in tAventy-four hours.   When combined Avith acetic
acid, it produced  quite  different effects.   Animals could bear a dose
of even twenty-four grains Avithout dying, and, Avhilst under its influ-
ence, they were agitated by convulsions like those which camphor in-
duces—exhibiting the  same signs of fright, the  same  backAvard mo-
tions, foaming at the mouth, convulsions of the jaws, &c.  When mor-
phia and narcotina were both given at the same time, the different ef-
fects of each occurred together.  A grain  of morphia, for  example,
#nd a grain of narcotina,  dissolved in  acetic acid, were placed in the
pleura of a dog.  The animal soon became  droAVsy, 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 stimu-
lating effects of the narcotina and the anodyne effects of the  morphia.
At  length, however, the  animal slept soundly,  being probably, Magen-
die 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—has
entertained, it appears, 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 different modus
operandi from opium, without, however, our being  able to regard it as
the exciting principle.3
  Owing to all these uncertainties connected with it, narcotina is little,
if at all, employed in medicine.  It would seem, however, that the ex-
citing properties of opium do not appertain exclusively to it: for,  as
has  been elsewhere remarked,  there are many persons who are as dis-
agreeably affected by morphia alone as they are by opium, which con-
tains both morphia and narcotina.
  The salts of narcotina—the muriate and the sulphate—have been
employed successfully as antiperiodics, especially in intermittents,4 and
  1 Ibid, and Diet, des Sciences M.dicales, xxxiv. 298.
  2 Formulaire pour la Preparation, &c, de plusieurs nouveaux Mt'dicamens.
  1 Merat and De Lens, op.  cit., and Orfila, Toxicologic Generate, ii. 69.
  » Roots, London Lancet, Sept. 1832, and T. W. Jeston, ibid. Oct. 6,  1832, p. 4^ 
540
NUX VOMICA.
Dr. O'Shaughnessy1 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.   He remarks farther, that, besides the
sixty cases recorded, more than one hundred ague  patients had been
treated by his pupils  and  acquaintances Avith  perfect success by the
remedy.
                     CXXIX. NUX VOMICA.
Synonymes. Vomic Nut, Poison Nut, Bachelor's Buttons.
French. Noix Vomique.
German. Krahenaugen, Brechnuss.
             EXTRACTUM NUCIS VOMICAE  ALCOHOLICUM.
Synonymes. Extractum Nucis Vomicae  Resinosum seu Nucis Vomicae Spirituosum,
  Spirituous, Resinous or Alcoholic Extract of Nux Vomica.
French. Extrait Alcoolique de Noix Vomique.
German. G-eistiges Extrakt der Krahenaugen.
  In the year 1809, Magendie discovered that  one entire class of ve-
getables—the bitter strychnos—has the power of exciting the spinal
marrow, without  implicating, except indirectly, the functions of the
brain.2  Since then, many have confirmed the observations of Magen-
die, and have attended especially  to  its  agency in various  diseases.
The  preparation of the strychnos  most used, if we except 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 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 evapo-
rating in appropriate dishes, as in making the dry extract of bark.
  The Extractum Nucis Vomicae 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 displacement, 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 consistence.3

                     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 con-

  1 India Journal of Medical Science, Sept.  and Nov. 1838; and British and For. Med.
Rev., No. xv. for July, 1839, p. 263.
  2 Examen de TAction de quelques V.getaux sur la Moe'lle Epinifere. Paris, 1809; and
Formulaire, &c.
  ' Pharmacopoeia of the United States, p. 123. Philad. 1851. 
NUX VOMICA.
541
siderable size, by inducing paroxysms of tetanus, which, by their con-
tinuance, arrest respiration  sufficiently long to  induce complete  as-
phyxia.  When the dose is much stronger, the animal appears to  die
entirely from  the  action of the  nux vomica on the nervous  system.1
If an  animal be touched whilst under the action of the substance, it
experiences a commotion similar to that of a strong electric shock, and
this takes place each time the contact is renewed.  On dissection, no
morbid appearances exist which  can account for death.   When intro-
duced  into the  frog's stomach, Dr. Lombard,2  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, tumultuous and intermitting; always diminished
in frequency.   Applied to the  heart  itself, it slightly stimulated it,
rendering  the pulsations  more  energetic  and frequent, whence Dr.
Lombard concludes, that 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 de-
scribed by Magendie,  and if the dose be sufficiently large, death
speedily follows with the same  symptoms.3  In those that are affected
with paralysis, the  effect is also the same;  but, what is singular, it is
particularly manifested  in the paralyzed parts by tetanic conATulsions,
and a feeling of creeping, which indicate the operation of the remedy;
 and a local perspiration is also  often observed to break out  on some
 parts  of the  body.  When  administered in cases of hemiplegia,  the
 contrast between the two sides of the body is rendered 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 dif-
 ference even between the two sides of the tongue, a decidedly bitter
 taste being occasionally perceived 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 pa-
 tient is sometimes thrown out of bed by the violence of the contractions.
 When given in very small doses, it has no perceptible effects immedi-
 ately, and some days elapse before its  advantageous or noxious  pro-
 perties can be appreciated.
   According to Magendie,4 the extract may be given  in all diseases
 that are attended with debility, general or local, and in paralysis of
 all kinds, general or partial.   He himself observed excellent  effects
 from  it in debility of the genital organs, incontinence of urine, &c.
 He also used it with  advantage in several cases of partial atrophy of
 the upper and lower  extremities.  As regards  its administration in
 cases of paralysis succeeding to apoplexy, he  remarks, that  it should
   1 S.galas, in Journal de Physiologie, par Magendie, Oct. 1822.
   2 Gazette  Medicale de Paris, 18 Oct., 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.
 See also, A. S. Taylor on Poisons, Amer. edit., by R. E. Griffith, p. 620.  Philad. 1848.
   * Formulaire pour la Preparation, &c, de plusieurs nouveaux Me"dicamens, &c. 
542
NUX VOMICA.
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 ex-
pected only when  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  alcoholic
extract of nux vomica in various forms of paralysis has been confirmed
by many observers.   Even  before  Magendie had employed it, Fou-
quier1 had given it in several cases, with the most satisfactory results.
Since then, we have  the testimony of Chauffart,2 Gendron,3 Perrussel,
Recamier,  Mauricet, Baxter,4 Galli,  Hauff, Wenneis, Burkard, Petre-
quin,5  Gellie,6 Debreyne,7 and numerous others  in  its favour.  The
author's  own experience with it in cases of hemiplegia has not been
limited;  yet although he has succeeded  in inducing tetanic movements
in the limb, he has not been  satisfied  that much advantage was  de-
rived from it;8  and in some  cases, it  appeared to induce serious  en-
cephalic  excitement.   After effusion has occurred into the encephalon,
time is required 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 affirms that he did not see any good effect from it; and,
with the  exception of two cases,  did not notice the slightest action, al-
though 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 Avhich a change seemed to be induced
there Avas 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 great
value of  strychnia—its active principle—which is not liable to so much
uncertainty.9   Dr. Christison,10 however, affirms, that " there seems no
particular reason why the powder and extract  should have been dis-
placed by  the principle strychnia; for their effects  are  precisely the
same; and the principle is not only troublesome to  prepare,  but like-
wise, 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 pictonum, amaurosis,11 palsy
of the rectum, &c, both  the alcoholic extract of nux vomica and its
active  principle  have been used Avith good effect.   (See Strychnia.)

  1 Bulletin de la Facult. de Medecine, &c, vol. v. 1818.
  2 Journ.  Gener. de Med. Oct. 1824.               * Ibid. Nov. 1829.
  4 New York Medical Repos. vol. viii.
  5 Gazette M.dicale de Paris, 27 Oct. and 3 Nov., 1838, and Bulletin General de Th.-
rapeutique, Mars, 1840.              6 La Lancette Francaise, 29 Aout, 1837.
  7 Braithwaite's Retrospect, Amer. edit. x. 26.  New York, 1845; and Med. and Chir.
Rev.  Oct. 1844, p. 384-396.
  8 See the author's Practice of Medicine, 3d edit. ii. 167.  Philad. 1848. Also, Chauf-
fart in op.  cit.
  » Richter's Specielle Therapie, v. s. w. B. x. S. 352.  Berlin, 1828.
 10 Dispensatory, p. 658.   Edinb. 1842.
 " Petrequin and Miquel, in Bulletin General de Therapeutique, Juillet, 1838.  De-
freyne, op. cit. 
NUX VOMICA.
543
M. Barez1 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, three-fourths
of a grain of the aqueous extract of nux vomica are  added.  A spoon-
ful  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 used with great caution.
  It has been given with good results by M. Duclos,2 in impotence and
spermatorrhoea.  He divides  seventy-five  grains of the alcoholic ex-
tract into one hundred pills.   During  five days, he gives one  every
night; then, for five  days more, one,  morning and night; for five days
more, two, night and morning;  and for  five days more, two at morning
and three at night, until four are taken night and morning.  The lini-
ment, for which a formula is given hereafter, rubbed on the loins, and
on  the inside of the thighs,  is a useful auxiliary.
  Dr.  Cerchiari3 treated two cases of incontinence of urine successfully
with the extract.   The first was that of a girl, nineteen years of age
—who, from her infancy, had passed her urine involuntarily every night
in her sleep.  She Avas  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 floAved in-
voluntarily, day and night, after  her first delivery.   As there was  no
fistulous opening to  account for the involuntary discharge, and it ap-
peared to arise from weakness of the  neck of the  bladder, in conse-
quence of the contusion by the head of the child, the extract was  ad-
ministered in the same doses as in the preceding 6ase, and in fifteen
days the cure was complete.   Mondiere, in cases  of  incontinence  of
urine,  dependent upon  atony, prescribed it advantageously in  associa-
tion with black oxide of iron ;4 and M. Petrequin 5 found, that local anaes-
thesia 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,*5 and
Mr. Pidduck,7 found it useful  in neuralgia, the former in neuralgia
faciei  especially.   Vogt gave  it—not without advantage—in gastral-
gia, and Legrand in gastralgia and gastro-enteralgia;* Hildenbrand,
in epilepsy;  by the Russian and Polish physicians it was administered
advantageously in choleric diarrhoea, and by many it has been strongly

  1  Journ. de Med. July, 1845, and Edinb. Med.  and Surg. Journal, July, 1846, p. 256.
  2  Bulletin de Therap. xxxvi. 529-33; cited in Brit, and For. Med. Chir. Oct. 1849, p.
564, and in Bouchardat, Annuaire de Therapeutique, pour 1850, p. 24.
  3  Gazette MTdicale, 14 Avril, 183S.
  4  Bouchardat, Annuaire de Th.rap. pour 1841, p. 8.  Paris, 1841.
  B  Bulletin General de Therapeutique, Mars, 1840.
  6  Med. Chir.  Review, from Edinb. Med. and Surg. Journal, Oct. 1843.
  7  London Med. Gazette, Aug. 7, 1840.
  8  Bouchardat, Annuaire de Th.rap. pour 1854, p.  18. 
544
NUX VOMICA.
advised in chronic diarrhoea and dysentery,1 as well as in dyspepsia, in
the varieties termed pyrosis and gastrodynia, especially when they ap-
peared  to proceed  from morbid irritability of the nerves of the sto-
mach,2 as in the vomiting of the pregnant female?   The addition of
a small portion of the extract  has been suggested by M. Boult as a re-
markably powerful adjuvant to cathartics.   He generally prescribes it
in pill, according to the formula given hereafter;  and Dr. Ranking4
affirms, that he has been in the habit of combining strychnia Avith  an
aperient extract, with considerable advantage, in habitual constipation.
Two cases of obstinate constipation are recorded by M. Ossieurs,5 which,
after having resisted other means, yielded at once to nux vomica.  And
at the  City Hospital for diseases of the chest in London, Drs. Peacock
and Andrew Clark6 are in the  habit of frequently resorting to it for
this purpose.
   Mr. C. F. Gream7 employed it, at the suggestion of Mr. Hammerston,
of St.  George's Hospital, London, in the cure of hay fever—summer
bronchitis, with the best effects.   He gave the tinctura nucis vomicae of
the Dublin Pharmacopoeia in doses of ten drops, gradually increased
to twenty, three times a day; at the same time applying to the lining
membrane of  the nostrils, as  high up  as possible, an ointment  com-
posed of a  dram and a half of Goulard's extract, two  ounces of sper-
maceti cerate, and a few  drops  of oil of bergamot.   (See the  article
Strychnia.)
   M. Tessier8 recommends nux-vomica in asthenic dropsy,  in the dose
of a quarter to a half a grain in the day of the alcoholic extract.

                     MODE OF ADMINISTRATION.
   The best form for exhibiting the alcoholic extract of nux vomica, ac-
cording 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 augmented until the re-
quired effect is induced.   It may then be discontinued, to  avoid  acci-
dents.   It is better, he thinks, to give the pills in the evening, as night
is  the most  favourable time  for observing the phenomena we are desi-
rous of inducing.   It is sometimes necessary to  increase the  dose  to
twenty or thirty grains, before the tetanic effects supervene, but  com-
monly  from four to six grains  are sufficient.  Esquirol  saw  two  cases,
in one  of which death took place after eighteen grains; in the other,
after five:  the stomach and  bowels were found inflamed.   Dr. Elliot-
son began with half a grain of a well prepared extract, and increased

  1 Most's Encyclopadie, 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 ; Hufeland, in Bally, Bulletin General de Therapeutique.  F.v. 1838;
and Nevins, Lond. Med. Gaz., Dec. 15, 1848.
  2 Mellor, in Med. Gaz., March 4, 1837, p. 850. H. S. Melcombe, Ibid. March 25,1837,
p. 964; and M. Huss, in Zeitschrift fiir die gesammte Medicin.   May, 1837, p. 393, and
Amer. Med. Intelligencer, Aug.  1, p. 162.
  3 Kroyher, Annuaire de Th.rap. pour 1842, par Bouchardat, p. 39.  Paris, 1842.
  * Half-Yearly Abstract, &c, from July to December, 1848, p. 215.
  * Med. Times, May 26, 1849.            « Med. Times and Gazette, Nov. 10, 1855.
  7 Lancet, June 8, 1850.
  8 Bouchardat, Annuaire de Th&rap. pour 1852, p. 63. 
NUX VOMICA.
545
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  recom-
mence with the small doses, and to increase them gradually 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.  Petrequin1  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 Tinc-
tura Nucis Vomicae, T. Strychnos,  T. Nucum Vomicarum, 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. Petrequin2 also employs  a tincture of  nux vomica, which he  pre-
pares with four  ounces of the powder and a quart of brandy.  This is
used altogether externally as an embrocation  to, and around,  palsied
parts.  The tinctura nucis  vomicae, of the Pharmacopoeia  of the
United States, is made of two ounces of rasped  nux vomica to eight
ounces of rectified spirit, (alcohol.)  Dose  from five to twenty  drops.

             Tinctura nucis vomicae  composita-
                   Compound tincture of nux vomica.
                 R.  Extract, nuc. vomic. alcohol, gr. xxv.
                     Camphorae £j.
                     Tinct. pyrethrifgj.  M.
   Dose.—Twenty drops, four times a day,  with arnica tea, in cases of
paralysis.                                                  Vogt.
                 R. Tinct. nucis vomica.,
                      ----cantharid.
                     Napth. phosphorate 9ij.  M.

   Dose.—Thirty drops, three or four times a day, with arnica  tea,  in
the paralysis of torpid subjects.                             Vogt.

                    Mistura nucis vomicae.
                       Mixture of nux vomica.
                 R. Extract, nuc. vomic. alcohol, gr. ij.—iv.—vj.
                     Mucilag. acac. f ^ss.
                     Aqua, melissa. f ^yj.  M.
   Dose.—Tavo spoonfuls, every two hours,  in epilepsy.
                                                     Hildenbrand.

   A similar form  is recommended by Richter4  in  dysentery.  Two
table-spoonfuls every two hours.

  1 Op. cit.                                           2 Op. cit.
  3 Naphtha phosphorata, JEther sulphuricus phosphoratus, is made by dissolving twenty-
eight grains of phosphorus in four ounces of rectified ether.
  4 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.
35 
546
NUX VOMICA.
                  R.  Tinct. nucis vomica? gtt. ij.
                      Aqua, lauroceras. gj-  M\
   Dose.—Ten drops every morning  and evening in the vomiting of
pregnancy.                                              Kroyhcr.
                       Pilulae nucis vomicae.
                         Pills of nux vomica.
                  R.  Ext. nuc. vomic. alcohol. 9j.
                      Ext. glycyrrhiz. 9vij.
              Misce et fiant pilula. lxxx.
   Dose.—Two to six, two or three times a day, in paralysis.
               Pilulae nucis vomicae  ferruginosae.
                    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.
                 Pilulae  nucis  vomicae  et  quiniae.
                    Pills of nux vomica and quinia.
                  R.  Ext. nucis vomicae gr. xij.
                      Quiniae sulphat.
                      Ext. hyoscyam. aa. gr. xxiv.  M.
                       et fiant pil. xxiv.
   Two to be taken an hour before meals, in gleet.     Ch. Johnson.

                  Pilulae nucis vomicae et aloes.
                     Pills of nux vomica and aloes.
                  R.  Nucis vomicae gr. ss.
                      Aloes
                      Ext. rhei aa. gr. f. M.
                       et f. pilula.
   Dose.—One at bed time as  a  cathartic.   To  increase its cholagogue
power, a grain of calomel may be added.                     Boult.
                     Pulveres  nucis vomicae.
                       Powders of nux vomica.
                  R.  Ext. nucis vomicae 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.
                      Acacia..
                      Sacchar. aa. gr. xij. M. et fiat pulvis.
   Dose.—One of these  poAvders  to  be repeated according to circum-
stances during the twenty-four hours, in diarrhoea and  dysentery.
                                                        Hufeland.
            Linimentum nucis  vomicae compositum.
                   Compound liniment of nux vomica.
                  R.  Tinct. nucis vomicae
                      ----arnicae seu
                      ----melissae aa. partes lx.
                      ----lytta. part. xv.  M. 
OLEUM MORRHUJE.
547
  To be rubbed on the loins and inside of the thighs in impotence and
spermatorrhoea.                                           Buclos.
                   Embrocatio nucis vomicae.
                     Embrocation of nux vomica.
                 R.  Tinct. nucis vomicae f^j.
                     Liquor, ammon. fgij.  M.
  To be rubbed on the paralyzed limbs, and on the surface, in cholera.
See Strychnia, and  its preparations.

  The seed of Strychnos Ignatii, Ignatia  amara—a tree inhabiting
the Philippine Islands—have the same virtues as nux vomica.   They
are the St. Ignatius's Beans, Fabse Sancti Ignatii, of .the shops, and
are remarkable for the large quantity of strychnia they contain; yielding
about 1.2 per cent,  of the alkaloid.  An extract of them is prescribed,
which has been thought to differ from that of nux vomica in its effects
on the economy.  It is probable, however,—Dr. Garrod,1 indeed, affirms
there can be no doubt,—that the difference is in degree only, strychnia
being the active ingredient.
                  CXXX. O'LETJM MOR'RHLl/E.
 Svnoxa-mks. Oleum Jecoris seu Jecinoris Aselli, 0. Jecoris Morrhua., Cod-liver Oil,
  Cod Oil.
 French. Huile de Morue, Hnile de Foie de Morue.
 German. Stockfischleberthran,  Bergerthran, Gichtthran, Leberthran,
  Kabliauthran.
  The animal fat,  which appears under  this name in commerce, is ob-
 tained from  several  of the fishes belonging to the genus Gadus, order
 Malacopterygii thoracici, but especially  from the codfish, (Gadus mor-
 rhua;) the Dorse or Borsch (Gadus callarias, Morrhua Americana;^)
 the Coalfish,  (Gadus Carbonarius;) the  Burbot, (Gadus  lota, or Lota
 vulgaris;)  the Pollock,  Gadus  Pollachius;  the Ling,  Lota molva,
 and the Torsk, Brosmius vulgaris.   There  is reason to believe, too,
 that, on the  American coast, it is obtained, also, from the Hake, Gadus
 Merluccius; and the Haddock, Gadus ^Fglifinus.  At Antwerp, it is said
 by M. Gouzee2 to be prepared from the liver of a species of Ray—the
 Raja Pastinaca—and of the Skate.  The disagreeable 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. Beitis; Skate-liver oil—German, Ro-
 chenleberthran.   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.3
  Several \rarieties of the oil  are met with in commerce, which differ
 from each other by their brighter or darker hue, and by  their greater

  1 The Essentials of the Materia Medica, p. 190.  Lond.  1855.
  2 Bullet. Med. Beige, Janvier, 1838.
  s Edinb. Med. and Surg. Journal, Oct.  1842, p. 504, and Gobley, Archiv.  General, de
M.d., Mai, 1842, p. 111.   See an excellent report on  this Oil, by M. Homolle, in Bou-
chardat, Annuaire de Therap. pour 1854, p. 96. 
548
OLEUM MORRHUJE.
or less transparency.  The clearest sort is admitted, into the shops of
continental Europe especially, under the name Oleum jecoris aselli al-
bum 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.1
   An interesting communication on cod-liver oil, and  its  manufacture
on the northeastern coast of this country, has been published by Mr. Vim.
Procter, jr.,2 and one on its manufacture  in  Newfoundland by Dr. 11.
Robinson.3
                       METHOD  OF  PREPARING.
   According to Riecke,4 the oil is obtained by exposing to the sun the
livers  of  the fish above  mentioned, cut  in  slices, and  collecting the
fixed oil  that  runs out.   That which is  first obtained resembles fine
olive or poppy oil, and is  called "yellow cod-liver oil"—Oleum jecoris
aselli flavum, (German, Hellbl anker Leberthran.)  If  the livers
are  running gradually to putrefaction,  the oil becomes of  a chest-
nut  brown  colour—Oleum jecoris  aselli subfuscoflavum—(German,
Braunkblanker  Thran:)  and, again, after the oil  has been ob-
tained by the  above methods, some can  still be  procured by boiling
the livers, which constitutes the Oleum jecoris aselli fus cum;5 but be-
tween the finest pale-yellow or almost colourless oil, and the dark-brown
cod-oil used by curriers, there is an  almost infinite variety of shades, so
that no absolute difference can be founded on colour only.6   At New-
haven, near Edinburgh, the fishermen simply boil the livers in an iron
pot, and then filter the oil through a towel containing a little sand.7
   Mr. Donovan8 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 un-
derneath.   Oil and some water will  run through; after twenty-four
hours, separate the former by decantation, and filter through paper.9
   The properties of cod-liver oil are said  to be different in the different

  1 Taufflied in Gazette M.dicale de Paris, 12 Aout, 1837.
  2 Amer. Journ.  of Pharmacy, April, 1851, p.  97.
  3 Ibid, xxviii.: see, also, Mr. E. Parrish, An Introduction to Practical Pharmacy, p. 278.
Philad. 1855.
  * Die neuern Arzneimittel, v. s. w. S. 351, and 2te Auflage, S. 538.   Stuttgart, 1840.
  6 For the analysis of the yellow and brown varieties, by Marder, see Riecke, op. cit.
2te Auflage, S. 541.  Stuttgart, 1840;  or Pereira,  op.  cit.  p.  1865; and De Jongh, The
Three Kinds of Cod-liver Oil, by E. Carey, Amer. edition, p. 79.  Philad. 1849.
  6 Pereira, Pharmaceutical Journal, Feb. 1819.   See, also, a full account of the dif-
ferent kinds of fish oils in Dierbach, Die neuesten Entdeckungen in der Materia Medica,
3er Band. 2te Abth. S. 1292.  Heidelb. und Leipz.  1847; and L. J. De Jongh, Cod-liver
Oil, cause of its frequent Inefficacy, and means of removing the same; with remarks upon
the superiority of the Light Brown over the Pale Oil; directions for its use, &c.  New
York, 1855.
  7 Prof. J. H. Bennet, Treatise on the Oleum Jecoris Aselli.  Lond. 1841.
  8 Dublin Journal of Medical Science, July, 1840,  p. 363. See, also, for a full account
of the article, Mr. Donovan, ibid. Sept. 1845.
  8 On the different methods of obtaining it, see Homolle, in op. cit., p. 99. 
OLEUM MORRHU-E.
549
varieties met with in commerce.  The colour varies from a bright yel-
low 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 em-
pyreumatic bitter, and resembles train oil; is somewhat acrid, and re-
mains for a  time on the tongue; that of  the clearer oil is much less
disagreeable.   Litmus paper is feebly reddened by the  clear, consi-
derably 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 ob-
servations of Mr. Donovan,1 to be owing to the  comparative freshness,
or the contrary, of the oil, or  of the livers from which it has been  pre-
pared.
   To test its purity, Mr. Hockin2 mixes, on a porcelain slab, four parts
of  the oil and one of  strong sulphuric acid.  If it be  genuine, a  rich
violet hue is produced, which in a  few minutes passes gradually  to a
dirty brown.   This characteristic,  he says, is  not possessed by  any
other oil, either animal  or vegetable.  From the  researches, however,
of Dr. Pereira,3 it would  appear, that although  sulphuric acid is a test
for liver oils, probably owing to  the  presence  in  them of one  of the
constituents of bile, it does not distinguish one liver oil from  another,
neither  does it distinguish good cod-liver oil from bad; for it produces
its characteristic  reaction both with common  brown cod-oil and with
the finest and palest qualities; but it  serves to distinguish oil procured
from  the liver from oil  obtained from other parts of the animal.   In
commerce it is said to be extensively adulterated with other fish oils;
scarcely a tenth—it is believed—of  what is sold under  that name is
genuine, being either  refined whale or sea elephant oil.4
   According to Messrs. Gouzee and Gmelin, the brightest oil  ought to
be employed internally;  but MM. Trousseau and. Pidouxs 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,6 Delcour7 and
others.   M. Champouillon8 agrees with De Jongh, that the black and
brown varieties have a more uniform  and rapid  action than the yellow.
On the  other  hand, Dr. J. C. B. Williams9 prefers the pale oil, as free
from  taste and smell as it can be procured.  To obtain this he advises,
that the livers of  the  fish should be obtained as fresh  as possible, the
pale plump livers being preferred.   These should be beaten into a pulp,

  1 Op. cit. Sept. 1845.
  2 Pharmaceutical Journal, Sept. 16, 1848; cited in Ranking's Half-yearly Abstract,
July to December, 1848, Amer. edit.  p. 213.
  3 Pharmaceutical Journal, 1848.
  * Report of the Committee on adulterated drugs, Dr. Huston chairman, in Transac-
tions of the Amer. Med. Association, vol. iii.   Philad. 1850.
  5 Traitd de Therapeutique, &c, 2de partie, p. 111.
  6 Medicinisch.  Zeitung, No. 26, July, 1835.
  7 Bulletin M.dical Beige, Juin, 1841, p. 249.
  •See Bouchardat, Annuaire de Th.rap. pour 1852, p. 276; also, Duclos, Bull, de Th.-
rap. xxxviii. 490, and Brit, and For.  Med. Chir. Oct. 1850, p. 553.
  * London Journal of Medicine, Jan.1849. 
550
OLEUM MORRHUiE.
mixed with water at 120°, and filtered.   After standing, the oil must
be decanted, cooled to 50°, and again filtered.   The process is to  be
performed quickly,  and in close vessels.
  The oil  prepared by Mr. Donovan's process is of a pale-yellow co-
lour; its smell is Aveak, and resembles that of a cod boiled for the table
when in excellent  condition.  Its taste is bland, by  no  means disa-
greeable, and totally devoid of rancidity.  It is very liquid.   Its spe-
cific gravity, in  Mr. Donovan's trials, was 0.934, although in all the
published tables  of specific gravities it is stated  to be 0.923.x  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 pounds of liver,  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 possible, the least putrescency being injurious;  and, '■].
The heat at which the separation  of the oil is effected must not exceed
192°.   This pale oil is the only kind that Mr. Donovan2 has supplied
so abundantly to the  profession  for  many years; and its  efficacy, he
says, has been in many cases most surprising.
  Dr. Pereira3 states, that  among  the  London  dealers, he had then
met with but one kind of  cod-liver  oil.   Its  colour was of  a chestnut
brown,  and  its  odour  like  that of  boiled cod's-liver.  " This is  the
cod-oil of  commerce—the oleum jecoris  aselli fuscum of continental
pharmacologists.  It is extensively used by curriers in dressing leather."
  From  an analysis  by De Jongh * it appears  to consist of a peculiar
principle—gaduin;  oleic and margaric acids, with glycerin; butyric and
acetic acids; various biliary principles, as fellinic, cholic and bilifelli-
nic acids, and bilifulvin; a peculiar  substance soluble in alcohol; a  pe-
culiar substance  insoluble in water, alcohol or ether;  iodine, chlorine
and  traces of bromine; phosphoric and  sulphuric acids;  phosphorus,
lime, magnesia,  soda and iron.
  Much of the oil used in this country is prepared in Boston.5

                     EFFECTS  ON  THE ECONOMY.
  Cod-liver oil  has  long been used as a popular remedy in northern
Germany,  especially in Westphalia—as  well as in Holland and Eng-
land ; it fell, however, into disuse in the  British isles, but in Germany
it has maintained its character to the present day.   In England, it ap-
pears to have been  first recommended by Percival,6 and in Germany
by Schenck.7  In Percival's time, it was so largely employed in Man-
chester, in the Hospital of that tOAvn, that nearly  a hogshead of it was
consumed annually.    When administered internally, it excites a disa-
greeable taste in the  mouth, and nausea.   Yet  patients soon become
accustomed to it; and children frequently take it without repugnance.
  1 Donovan, op. cit.
  2 Op. cit., and also, On the varieties of Cod-liver Oil, in Dubl. Med. Press, Oct. 22,1851;
and Amer. Journ. of the  Med. Sciences, Jan., 1852, p. 223.
  3 Elements of Mat. Med., and Therap. 3d Amer. edit. ii. 1146.  Philad. 1854.
  * Op. cit, p. 25.
  s Dispensatory of the United States, 8th edition, p. 1209.   Philad. 1849.
  6 Essays, Medical,  Philosophical and Experimental.  Warrington, 1790.  Vol. ii.
  i Hufeland's Journal, 1822 and 1826. 
OLEUM MORRHUiE.
551
 When the  nausea is once overcome, the oil  does not oppress the sto-
 mach, except when the organ is embarrassed, or  the digestive  powers
 are greatly enfeebled.   Nor does it s^eem to destroy the appetite by
 continued use.   Yet many persons, especially adults—less so children
 —reject it immediately.   It  is necessary for the digestive powers to
 be energetic when it has to be given for any length of time.   To those
 whose digestive organs are very irritable, Kopp recommends that Bor-
 deaux wine should be taken after it.
    Cod-liver oil has no manifest effect on any  of the secretions, except
 occasionally on  the urinary and cutaneous depurations; and  on the
 healthy organism it appears  to  excite no marked  change.  In  stru-
 mous affections, however, its favourable influence is said  to be striking,
 as well as in rhachitic, rheumatic, and gouty disorders.   In such cases,
 it  is said,  by the German Avriters, to  excite  powerfully the reproduc-
 tive or nutritive functions, when administered for a proper length of
 time.1  The favourable  effects are, in general, not rapidly exhibited;
 and  to produce a cure, according  to  Kopp, the  remedy must be per-
 sisted 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 efficacy might be owing to its containing the
 latter; and some  chemical investigations  made  by  him in the  year
 1836 confirmed the suggestion.2  The quantity  is extremely small,
 but—Kopp supposes—like iron chalybeate  waters,  as  the iodine is
 cominingled naturally Avith the oil, it may  exert a much greater effect
 than if it were added artificially in the like quantity.   This is the
 opinion also of Dr. J. H. Bennet,3  but Delcour4 and Panck5 think it
 very problematical.  Experiments by L. Gmelin6 seemed to shoAv, that
 the genuine oil contains  iodine, whilst  the spurious does not.   Iodine
 has likewise been detected in it by Hausmann, Bley, Brandes, Spring-
 miihl,7 and  W. Stein,8 and by MM. Chevalier  and Gobley.9  Herber-
 ger10 found both iodine and bromine in it, and analyses  made  by De
 Jongh11 showed, that the light-brown oil contained the largest quantity
 of  iodine.
   Owing to skate-liver oil appearing to be more efficacious therapeuti-
 cally than  cod-liver oil, MM. Girardin and Priesser  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 valu-
 able substitute for the more nauseous  article  in use.12  On the other

  1 Riecke, Die neuern Arzneimittel, S. 352, und 2te Auflage, S. 542.  Stuttgart, 1840;
 also Klencke, cited in Brit, and For. Med. Review, Oct. 1842, p. 443.
  2 Hufeland und Osann's Journal, 1836; Annalen der Pharmacie, xxi. und xxii.; and
 Bulletin General de Therapeutique, No. xx. 30 Oct., 1837.
  s Treatise on the Oleum Jecoris Aselli or Cod Liver Oil, &c. &c.   Lond. 1841.
  4 Bulletin M6dical Beige, Juin, 1841, p. 254.
  5 Zeitschrift fur die gesammte Medicin, July, 1842,  p. 282.
  c Bulletin General de Tin rapeutique, Mai, 1840.
  7 Riecke, op. cit. 2te Auflage, S. 541.  Stuttgart, 1840.
  8 Journal fur praktische Chemie, B. xxi., or Journal de Pharmacie, F.v. 1841, p. 94.
  9 Cited in Amer. Journ. of Pharm. April, 1852, p. 171.
 10 Pereira, op. cit. 2d Amer. edit. p. 805.  Philad. 1846.
 11 The Three Kinds of Cod-liver Oil, &c, edited by E.  Carey, Amer. edit. p. 79.  Philad.
1849.                                          '           *
 12 Edinb. Med. and Surg. Journ. Oct. 1842, p. 504. 
552
OLEUM MORRHU_E.
 hand, Mr. Donovan1 is of opinion, that every known fact impugns the
 notion that the curative principle is iodine.  In the first place, he says,
 many patients who have  been cured by the oil Avere 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 io-
 dine  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, 0.102: others gave still less.   Thirdly.  " The tendency
 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 impression of iodine, al-
 though the oil was eminently successful  as a medicine, and its  colour
 contra-indicated the presence  of free iodine.
   Dr. J. C. B. Williams,2 does not esteem  it necessary to discuss  the
 question whether the oil owes its efficacy to the iodine  contained in it.
 "To  suppose," he says,  "that the  minute proportion of this  ingre-
 dient could be the curative agent, would savour  of the absurdities of
 homoeopathy;  and, besides, most of the "patients had taken iodine in
 one form or other previously to taking the oil."3
   Again, it has been affirmed, that equally beneficial effects have fol-
 loAved the use of oil that contained no  iodine.  The author has  for
 many years stated to his  clinical classes, that such had been the result
 of his observation, and that vegetable oils had appeared to him to exert
 a similar action; and cases have been published  confirming  this view
 of*  the subject.4   Testimony has also been afforded in favour  of the
 good  effects of other animal oils;s and the author  has elsewhere stated,6
 that in the winter clinic of the Jefferson Medical College, he  is in the
 habit of prescribing, what, for convenience, he terms oleum cetaceum,—
 common  sperm oil purified by animal charcoal,—and has had no reason
 for placing its  virtues in  an inferior rank to those of oleum morrhua..
 Dr. C. R. Hall and Dr. Theophilus Thompson7  have  substituted the
 oleum bubulum, neat's  foot oil, with good effect for  cod-liver  oil in
 scrofula, especially where the  latter does not agree with the stomach.8
 M.  Bretonneau9  regards  common  train  oil  to be  equally efficacious.
 In a report (1849,) of the  Hospital for Consumption  and Diseases of the
 Chest, at Brompton, which is highly favourable to the use of  cod-liver
 oil, it is stated, that other animal oils, not  derived from the liver, and
 vegetable oils, were  tried; but the experiments thus far made there
 had not shown them to possess the  same powers: they had not, how-
 ever,  been sufficiently often repeated to warrant  decided conclusions.
  During  the  summer of 1854, the author had an opportunity of vi-
siting the hospital in question, when he learned, that they had arrived
at results  somewhat more definite.  They,  also, use whale  oil,  and
have  an  oleum cetaceum; but they do  not  think  it  as  good  as the
  1 Op. cit. Sept. 1845.                2 London Journal  of  Medicine, Jan.  1849.
  3 See Pereira, Pharmaceutical Journal, 1848.
  * Dr. P. M. Duncan and Mr. Nunn, London Medical Gazette, Feb. 1850.
  6 See Drs. Bagot and Stapleton, in Dublin  Medical Press, March 6, 1850.
  6 General Therapeutics and Mat. Med. 5th edit. ii. 337.  Philad.  1853.
  7 Clinical Lectures on Pulmonary Consumption, Amer. edit. Philad.  1854.
  8 Amer. Journal  of the Med. Sciences, Oct. 1852, p. 498.
  9 Bulletin de Therapeutique, cited in Medical Examiner, Sept. 1847, p. 579. 
OLEUM MORRHUiE.
553
 oleum morrhuae.   Indeed, the second in virtue is considered  to be co-
 coa-nut  oil—coco-olein; next  to  it, neat's  foot  oil; and then, oleum
 cetaceum, showing, so far as  observation in that hospital goes—and
 it is confirmative of the author's  own  experience—that  it is not ne-
 cessary for the oil  to be either ioduretted  or animal.1   Still, if it be
 admitted, that there is no specific influence  exerted by the oleum mor-
 rhuse over phthisis, the accumulated results of observation can by no
 means justify the inference of Dr. Swett,2 that " cod-liver oil, the pre-
 sent popular remedy for consumption,  is destined to be forgotten."
   Dr. Theophilus  Thompson3 found, as Dr. Franz Simon had' done,
 that during the administration of cod-liver oil to phthisical  patients,
 the blood became richer in red corpuscles.
   The author has elsewhere remarked,4 that the effect which  cod-liver
 oil induces  upon the system of nutrition, when cachexia exists, is simi-
 lar to that  of eutrophics in general.  It doubtless furnishes a modified
 chyle, and  of consequence a modified blood.  This induces a new ac-
 tion in the  tissues which it laves,—acting in these respects, like sugar,
 both dietetically and therapeutically; and probably its main action, as
 maintained by M. Taufflied, Dr. Bennett5 and M. Bouchardat,6 is that
 of a fatty  aliment.  Dr. Williams  thinks " there is  much reason to
 believe that it proves serviceable by supplying the fat molecules, which
 appear to be essential to healthy nutrition in forming the nuclei of the
 primary cells: thus supplying a fat,  which is capable of being readily
 absorbed and converted into a better plasma, as well as  more readily
 conveyed by the blood to the vicinity  of the  tubercular  deposits, the
 absorption of which it favours by dissolving the  irregularly concreted
 fat of which the masses are partly composed."
   The following results of the use of cod-liver oil in the medical ward
 of the Pennsylvania Hospital, during six  months,  reported by  Dr.
 Levick, one of the  resident  physicians, have  been published by  Dr.
 Gerhard.7  First. The light  coloured oil can be taken without difficulty
 by patients who have steadily rejected the brown  oil.   Secondly. A
 few of the patients  took it without any thing to disguise its taste.   Its
 nauseating  properties are corrected  by its administration  with milk;
 but its taste is most  effectually disguised by the froth of porter.   Third-
 ly. As a general rule it was  taken  before  meals;  but in four cases
 Avhere it  was not tolerated before meals, it was readily taken after them.
 Fourthly. Patients have increased in flesh, weight and strength, under
 its use:  the cough and expectoration have diminished, and with some

  1 Med. Times and Gaz. June 10, 1854, cited in Amer. Journ. of the Med. Sciences, Oct.
 1854, p. 509.
  2 A Treatise on Diseases of the Chest.  New York, 1852.
  3 Med. Times and Gaz., June 10, 1854, and Amer. Journ. of the Med. Sciences, Oct.
 1854, p. 509.
  * General Therapeutics and Materia Medica, 5th edit. ii. 337.  Philad. 1853.
  B Edinb.  Monthly Journal of Med. Science, Jan. 1852, p. 59, and April, 1853, p.  372;
and The Pathology and Treatment of Pulmonary Tuberculosis, p.  63.   Edinb. 1853, or
Amer. edit. Philad. 1854.
  6 Annuaire de Th.rapeutique pour 1849, p. 253.
  7 The Diagnosis, Pathology, and Treatment of Diseases of the Chest, 3d edit. p. 241.
Philad. 1850.  Also, Notes of Cases of Phthisis Pulmonalis, treated in the Pennsylvania
Hospital, with Remarks on  Cod-liver Oil and its uses in Tubercular  Disease, by Dr.
Levick, in  American Journal of the Medical Sciences, Jan. 1851, p. 21. 
554
OLEUM MORRHUiE.
hectic and  rigors have wholly disappeared.  Six were so much bene-
fited as to leave the  hospital, and resume their former occupations.  A
patient, who entered the hospital Avith cough, copious purulent expecto-
ration, extreme emaciation, inability  to leave  his  bed, and witli the
physical signs of a cavity under the left clavicle, after six months' use
of the oil, left the hospital weighing 140 pounds, Avith little or no cough,
no hectic nor rigors, and with an almost entire  absence of expectora-
tion ; and the physical signs had  greatly  diminished.   Fifthly. The
improvement of the physical signs was not coincident with that of the
general  symptoms.    Sixthly.  In those cases  which terminated fa-
tally, the appetite, nutrition and strength appeared for a  time  to be
decidedly increased: life appeared to  be temporarily protracted; but
for a few weeks immediately preceding dissolution the remedy seemed
to have entirely lost its value; and lastly,  To be  of decided perma-
nent  benefit, its use must  be steadily persevered  in,  even after the
most  striking symptoms of the disease have in a great measure disap-
peared.
  In a discussion before the College of Physicians of Philadelphia,1 Dr.
Wood stated that he had, in his "Practice of Medicine," affirmed that
the only effect he had observed from the cod-liver oil was th,e produc-
tion of nausea.   He ascribed  this  to  his not having persevered  suffi-
ciently long with it.  He  had subsequently employed it largely and
perseveringly in hospital, as well as in private practice; and "most as-
suredly he had never met with any one remedy,  or  combination of re-
medies, which had proved so efficacious as this in pulmonary phthisis."
Drs. Condie and Hays had  not seen such  good  effects from it in that
disease.  At a subsequent meeting of  the  College, Dr. Wood, on  what
appear to the  author to be insufficient data, was  disposed to infer, that
a diminished mortality from phthisis Avhich appeared to exist, judging
from the reports on meteorology and epidemics  made to  the College,
was owing to the efficacy of the oil in the treatment of pulmonary con-
sumption, and that probably one in every eight  cases had been cured
by it with the anticipation of a still larger proportion hereafter.2
  As respects the administration of cod-liver oil in disease, it has  been
employed—especially in Germany—as a remedy in
  Rheumatism, in which its reputation has been favourable.  In the
year 1782, it was highly recommended in chronic rheumatism by Dr.
J. Percival,3 and in 1807 by Dr. Bardsley,4 who  states, that it was in
high repute in Lancashire.   In the year 1835, Brefeld wrote a mono-
graph on it, in which, resting upon numerous indigenous  and foreign
experiments, he maintained it to be a  remedy of great and specific ef-
ficacy in every form of chronic rheumatism; and, since then, his testi-
mony has been  corroborated  by that  of Spiritus,5  Moning,6 Schutte,7

  1 Quarterly Summary of the Transact, of the Philad. Coll. of  Phys., vol. 1, No. 2, p.
73, new Series.  Philad.  1853.
  2 Ibid. vol. 2, No. 4, new Series, Philad.
  8 Lond. Med. Journ. iii. 393.
  * Reports from Hospital Practice, p. 18.  Lond. 1807.
  5 Rust's Magazin, Band. xvi. 566.                      6 td.(L
  'Horn's Archiv. 1824, (July and August.) 
OLEUM MORRHU_E.
555
 Wesener,1  Osberghaus,2 Gunther,3  Yolkmann,4  Kopp,  Rust,5 Moll,8
 Panck, W. 0. Chalk,7  and Bradshaw.8  By many, its  use  has  like-
 wise  been advised in gouty affections; but Brefeld esteems it ineffec-
 tual in actual gout; and Taufflied9 affirms, that it is  of no avail in
 gouty arthritis.
   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  per-
 manently  affected,—as in  the  different forms of rickets, arthrocace,
 spina ventosa, and caries scrofulosa:10 and  Kreebel11 is of opinion,
 that its efficacy is most marked in scrofulous  affections of the bones
 and in atrophia infantum.   Next to these, it has been extolled in af-
 fections of the chyliferous vessels and internal glands, especially when
 they  present themselves under the  chronic form  of atrophy.   In af-
 fections 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
 lymphatic 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 Avell as
 in external glandular swellings of a scrofulous character, it was espe-
 cially useful.   The slighter forms of scrofulous eruptions disappeared
 without any unpleasant sequelae, by simply smearing them with oil; the
 more  obstinate forms, by the simultaneous use of appropriate internal
 agents, of Avhich Brefeld prefers aethiops antimonialis to all others. Scro-
 fulous inflammation of the eyes disappeared frequently and rapidly by
 simply smearing the eyelids with the oil.12  Where, in the case of scro-
 fulous ophthalmia, there is inflammation of the eyelid with photopho-
 bia, Brefeld recommends, that the free edges of the eyelid should be
 anointed with pure cod-liver oil.   Cunier advises it  in association  with
 the extract of belladonna, one part of the latter to two of the former.
 Introduced between the eyelids  by means of a camel's hair pencil, it
 acts, he says, beneficially on scrofulous ulcers of the cornea, and hastens
 in a remarkable manner the absorption of the  opacities  of that mem-
 brane.  In the interciliary ulcerations, it is likeAvise very useful.   In
 such cases, as well as in opacities of the cornea; folloAving vascular pan-
 nus;  in cellular pannus, atonic  ulcerations, &c, Cunier found an oint-
 ment, the formula for which is given hereafter, very useful.13  Mr. Wilde,
 of Dublin,14 states, that in cases of pannus and  long continued chronic
 ophthalmia attended Avith granular lids, &c, where the  constitutional
 powers had fallen below par, as shown  by diminution in volume, and in-

  1 Hufeland's Journal, 1824, Heft. 1. (May.)   2 Ibid. 1825, Heft. iii. (September.)
  3 Ibid. 1824, Heft. ii. (August.)             * Ibid.
  6 Rust's Magazin. xx.  563.      6 Richter's Specielle Therapie, x. 468. Berl. 1828.
  7 Lond. .led. Gaz. Dec. 29, 1843, p. 414.
  8 Provincial Medical and Surgical Journal, Dec. 31, 1845, p. 753.
  9 Gaz. Mod. Nov. 9, 1839.
 10 Sourzac, Journ. de Med. et Chir. Prat., Mars, 1842, p.  110.
 11 Schmidt's Jahrbiicher, u.  s. w. No. 9, S. 287.  Jahrgang 1849.
 »2 Piffard, Bullet. General de Th6rap. Mai, 1840.
 13 Journal fur Kinderkrankheiten, cited from Annales d'Oculistique, Mai, 1845, and in
Braithwaite's Retrospect, xii. 234, Amer. edit.   New York, 1816.
 14 Donovan, Dublin Journal, &c, Sept. 1845. 
556
OLEUM MORRHUiE.
creased quickness of pulse, pallor of countenance, coldness of the extre-
mities, a clammy condition of skin during the day, and heat, and rest-
lessness 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.
  Dr. Hays has employed the oil extensively in the Wills' Hospital of
Philadelphia, and in private practice in scrofulous ophthalmia;  gra-
nular lids; scrofulous enlargement  of the external glands;  hip disease
and the various forms of external scrofula with the  best effects.   He
had employed the oil in  from two hundred to two hundred and fifty
cases of scrofulous ophthalmia  and granular lids, and in most of the
cases the  benefit was very striking.   In such cases, Dr. Condie, also,
had seen much advantage from it.1
  Kopp extols  it  in  scrofula  and rickets, both when  internally and
externally exhibited.   Numerous trials with  it by other physicians—
as by Schenck, Schiitte, Von  dem  Busch,  Gumpert, Fehr,  Rbsch,
Schmidt,  Knod  von  Helmenstreit, Heineken,  Munzenthaler, Beck-
haus,  Spitta,  Giinther,  Roy,  Gouzee,2  Taufflied,3 Jungken,4  W.  0.
Chalk,5 Daumerie,6 and others,  confirm its great efficacy in scrofulous
and rachitic affections.7  Schenck,3 indeed, esteems  it as certain  a re-
medy in scrofula and rickets as  cinchona is in intermittent fever!   In
the Pennsylvania Hospital, in scrofulosis, when there was no reason to
suspect the existence of  pulmonary tubercles, the  improvement in the
patient's health was very decided.9
  The  efficacy of the  oil in scrofula suggested its  administration in
cases of—
   Tubercles;—and, accordingly, it was  prescribed by Hankel, whose
experiments led him to advise a further trial of it.   Riecke10 refers to
a case of the kind, confirming Hankel's observations, which occurred
to Dr. Pagenstecher,  of Elberfeld; and Richter,  of Wiesbaden, Pro-
fessor Alexander of Utrecht, and Haser, of Jena,11 seem to have expe-
rienced equally satisfactory results.  M. Taufflied,12 hoAvever, considers
its  action  to be doubtful or null  in  scrofulous phthisis when at  all
advanced.   Both Kopp and Brefeld recommend it  highly in phthisis
pulmonalis of strumous origin, occurring especially  in youth;  and
Ray613 speaks in the highest terms of its efficacy in chronic inflamma-
tion of the lungs and  stomach.

  1 Quart. Summary of the Trans, of the Phila. College of Phys., vol. 1, No. 2, p. 71,
new Series.  Philad. 1853.
  2 Bulletin Medical Beige, Janvier, 1838, p. 6.
  3 Gazette M.dicale de Paris, 12 Aout, 1837; and 9 Nov., 1839.
  * Lond. Med. Gaz. April  20, 1839, p. 126.                        5 Op. cit.
  8 Journ. de Brux., Fevr.  et Mars, 1847, and Schmidt's Jahrbiicher, u. s. w. No. 5, S.
161.   Jahrgang 1849.
  T Riecke, op. cit. S. 356, und 2te Auflage, S. 542.  Stuttgart, 1840; also, Taufflied, in
Gaz. Medicale de Paris, Nov. 1839.
  8 Hufeland's Journal der Praktisch. Heilkunde, Mars, 1833.
  9 Levick, in Gerhard, op. cit. p. 242.                        10 Op.  cit. S. 356.
 « Hufeland's Journal, B.  lrxxvi. 1838.         " Gazette Medicale, 9 Nov. 1839.  '
 13 Annales de la Societ6 des Sciences, Nat. de Bruges,  in Encyclographie des Sciences
Medicales, Mars, 1840, p. 100; and Sept. 1840, p. 10. 
OLEUM MORRHUiE.
557
   Of late years, great attention has been given to it as a remedy in
 tuberculous cachexia; and the testimony in favour of it has been over-
 whelming   At the present day, there is no single article of the Ma-
 teria Medica so fashionable;  and hence  it has been  employed too in-
 discriminately.  Of those who have recently given the strongest evi-
 dence in  favour  of its great  efficacy in phthisis, may be mentioned,
 Drs. Madden  Blakiston,2 Ranking,' Trumbull/ J. P. Bramwell,5 Wood,
 lheophilus Ihompson, Walshe,6 and others already cited.
   M. Champouillon,7 after considerable experience, infers that the oil
 has the property of arresting or modifying the progress of incipient pul-
 monary tuberculosis, of curing catarrhal bronchitis, and, at least for the
 time,phthisis in a more advanced state; but the last is a very rare result.
   Dr. J. C. B. Williams8 prescribed it in above  400 cases of tubercu-
 losis of the lung in its different stages, and of these  he kept notes of
 204.  Of this number the oil  disagreed and was discontinued in only
 9.   In 19 it appeared to do no good, whilst in the large proportion of
 206 out of 234, itsuse was followed by marked and  unequivocal im-
 provement,—such  improvement varying from a temporary retardation
 of the progress of  the disease, up to a more or less complete restora-
 tion to apparent health.   He  found the most striking advantage from
 the oil  m  the third stage  of phthisis, even when far  advanced, where
 not  only the lung was excavated, but the  body was  rapidly wasting,
 with copious purulent expectoration, night sweats,  colliquative diarrhoea,
 &c.   Of the power of the oil  in this stage of the disease he quotes
 several decided cases.   The total number amounted to 62, in  34 of
 which the  improvement was known to have continued up to a recent
 period.  Eleven,  after temporary improvement, relapsed,  and termi-
 nated fatally.
   From the report of the physicians of the Hospital for Consumption
 and Diseases of  the Chest at  Brompton for 1849, it appears that 542
 cases were treated with it.  In about  62  per  cent, the symptoms im-
 proved;  in 18 per cent, the disease was arrested; and in 19 per cent.
 it Avent on unchecked.
   It has, likewise, been found  by Mr. Caleb Rose,9  and by Dr. Given,10
 to be of marked advantage in  gaol cachexia, which may perhaps be re-
 garded as  incipient scrofulosis.
  As one  of the  terminations of  diabetes is by phthisis, Dr. Bence
 Jones,11 for this reason, as well  as  on  account of the emaciation, was
 led to prescribe cod-liver oil.  Under its use the patients gained weight;
 but the disease was not arrested.   One of his patients took, in five
 weeks, eight pints,  fourteen and a half ounces.
  1 Lond. Med. Gazette, Sept. 17, 1847.
  2 Practical  Observations on certain Diseases of the Chest, Lond. 1848.  Amer. edit.
 Philad. 1848.
  3 Half-yearly Abstract, &c, from July to Dec. 1848.  Amer.  edit. p. 213.
  4 Lond. Journ. of Med. Feb. 1850, and Amer. Journ. of the Med. Sciences, July, 1850,
P- 182.          a Edinb. Monthly Journ. of Med. Science, Feb. 1851, p. 131.
  6__ A Practical Treatise on Diseases of the Lungs and Heart, Amer. edit., p. 358. Philad.
 1851.                   7 Bouchardat, Annuaire de Th.rap. pour 1852, p. 275.
  8 London Journal of Medicine, Jan.  1849.
  9 Provincial Med. and Surg. Journ.  Nov. 27, 1850.
 10 Amer. Journ. of the Med. Sciences, Oct  1851, p. 484.
 11 Med. Times and Gazette, Feb. 4, 1854. 
558
OLEUM MORRHUiE.
   In nursing sore-mouth, stomatitis nutricum, it has proved efficacious
in the hands of Dr. John Evans,1 and of Dr. Byford.2
   Chronic cutaneous  diseases.—In these affections, cod-liver  oil has
been given with advantage by Richter;  and it is suggested, 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 Avere made through a period of three years;
they are, therefore, highly deserving 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 administered daily to adults;—that it must be continued for
a long time, as the first traces of a favourable impression are generally
someAvhat late in  presenting themselves,—commonly four weeks, and,
in very obstinate cases, later;—so that usually from six to twelve Aveeks
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, invete-
rate itch, and tendency to the formation of boils.    Kopp's experiments
agree with those of Richter, as to the internal use of the  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, and in porrigo.
   A case of ichthyosis, in a girl thirteen years  of age, which was of
long standing, was cured by Dr. Banks,3 by the internal and external
use of the oil.   She was ordered  a generous diet, and  to take a des-
sert-spoonful  of the oil  three  times  a day.  She had a  vapour bath
every night, and, on coming out  of the bath the whole body was rubbed
with the oil, and a flannel dress was  kept constantly next the skin.
This plan was sedulously folloAved for three months, and was attended
with the gradual removal of the  disease, and the most  extraordinary
improvement in the general appearance of the patient.
   A severe  case of  lupus in a young female was  successfully treated
by M.  Gibert4 Avith 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 externally with success, after
iodine  had been used in the same manner without effect.    The treat-
ment was, however, continued for more than a year.  But the strongest
testimony in its favour in lupus is given by M. Emery.5   In a severe
case, Avhich  had  resisted  other  remedies, he gave it in large  doses—
from a pint  to a pint and a half in the  day.  In two  months a cure
was effected.   He subsequently employed it in a great number of cases,
commencing every one with one  hundred grammes—nearly 25 drams
—and  quickly increasing it to fifteen or twenty ounces in the day.  If
vomiting  supervened, its  use was suspended for a fevv days, and then

  1 North-western Medical and  Surgical Journal, April, 1851.
  2 Amer. Journ. of the Med. Sciences, April, 1853,-p. 398.
  3 Dublin Quarterly Journal, Aug. 1851.        4 Bullet, de l'Academie, Nov. 1844.
  6 Revue M.'d. Chirurgical, Aout, 1848, and Ranking's Half-yearly Abstract, July to
Dec. 1848, p. 77. 
OLEUM MORRHUiE.
559
 re-commenced as  before.   Sixty-four cases were treated in this man-
 ner, the majority of which received essential benefit, and twenty-four
 were completely cured.   M. Devergie1 is of opinion, that  M. Emery
 has over-estimated the beneficial effects of the oil in lupus, and pro-
 perly regards it as a great error to depend upon any one agent for the
 cure of diseases, especially of the skin, which may be single  or compli-
 cated, and yet bear the same name.   It would seem, however, from the
 observations  of  Dr. Begbie,2 in the Parisian hospitals, that the most
 successful constitutional remedy with M. Devergie is this oil.   M. Caze-
 nave highly extols it combined Avith the external use of a strong oint-
 ment of the red  iodide of mercury.3
   In some  troublesome affections of the skin, especially of  the hands,
 conjoining the characters of impetigo, with erysipelatous redness and
 swelling, and inducing  the  most  severe  suffering, Dr. Marshall Hall4
 speedily succeeded in restoring  the  textures to  a healthy  condition by
 the external use of 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 of great benefit  in eczema, and other diseases
 inducing excoriation and fissures of the skin.5
   Dr. A. K. David6 found its external use very serviceable  in various
 cutaneous affections,  ringworm  of  the scalp,  scalled head, psoriasis
 inveterata, &c.   He has also applied it in two cases of erysipelas with
 benefit.   Dr. Arnoldi, of  Montreal,  had used it in burns, and  also in
 chilblains with advantage.
   Sir H. Marsh,7 being of opinion that many of the cutaneous  affec-
 tions are strumous, treats them with oleum morrhuae; and he  consi-
 ders the cases to which it  is especially applicable, to be those in Avhich
 the general health is impaired, and  emaciation  is in progress;  but  to
 produce  good effects, it must be given in full doses, and be long  perse-
 vered in.  The author, regarding chronic cutaneous diseases to  be ca-
 chectic, or cell  diseases, has long treated  them in this  manner, and
 often with great success.
   Carron du Villards8 extols  cod-liver oil in  opacities of the cornea,
 whether resulting from slight  ulcerations, or from  inter-lamellar effu-
 sion.   It is only applicable after the inflammation has  disappeared.
 A drop or tAvo of the  oil is then  placed on the  cornea with a camel's
 hair pencil.   Sometimes, even the white oil is too stimulating: it is then
 necessary to dilute it  Avith oil.of SAveet almonds: in other  cases, the
 white oil is not sufficiently stimulating, and the brown must be used.
   In cases of tumours of the mammas in young females  Kopp  found
 the oil useful, when administered for some time,  conjoined with the ap-
 plication of leeches to the affected part.
   In the Charite, at Berlin, the oil was  given with advantage in cox-

  1 Bulletin de Th.rapeutique, xxxv. 466, and British and Foreign Med.  Chirurg. Rev.,
April, 1849, p. 538.
  2 Lancet, May 3, 1851.
  3 Bull. Gen. de Therap. 1854, p. 530, cited  in Br. and For. Med. Chir. Rev. Oct. 1854,
p. 563.
  * Lond. Med. Gaz.  Sept. 1832.               5 w. 0. Chalk, op. cit.
  6 Canada Med. Journ., May, 1852.             * Dublin Medical Press, Aug. 1850.
  8 Bullet.  G.n.r. de Th.rap. 30 Oct., 1835. 
560
OLEUM MORRHUiE.
 arthrocace, in doses of  four ounces every morning;—the mouth beino-
 rinsed afterwards with peppermint tea, followed by a cupful of this tea°
 or of coffee;  and in neuralgia it has been given with advantage by m!
 Durrant.1
   Kopp affirms, that he cured a case of chorea by it, which had su-
 pervened on  an attack of gout.
   M. Cazin2  has used the oil with success in worms, in the cases of two
 females, one  of whom passed  twelve  ascarides lumbricoides, the same
 day on which she had  taken, in the morning, three tablespoonfuls,  at
 intervals of an hour.
   It has been highly recommended by Schcepf Merel3 in laryngismus
 stridulus to correct the faulty constitution, and give a healthy impulse
 to the vegetative forces.  To a child, from two to four months of age, he
 gives, in the course of the day, from two to four tea-spoonfuls.  A child
 of six months can  take two tablespoonfuls in the day.   Where the oil
 cannot be borne, he uses it endermically, rubbing in from 5ss. to gj.
 along the spine every evening.
   In  the London  City Hospital for Diseases of  the Chest, the use of
 the oil is generally combined with tonics.   The favourite  tonics are
 the sulphates of quinia and iron, or the  sesquichloride of iron.5   The
 latter is extensively prescribed with the mineral  acids  in infusion of
 quassia.  In  cases of lupus and cutaneous struma, the oil is combined
 with mercury, and  also in the treatment of chronic diseases of the joint.
   Lastly;—Dr. Day4 states, that he has used cod-liver oil extensively
 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;
 and that it produces effects of which no other known remedy is capable."

                     MODE OF ADMINISTRATION.
   The dose of cod-liver  oil for an adult is from half a spoonful to three
 spoonfuls two  or three times a day.   Dr.Williams begins, in adults, with
 a tea-spoonful, gradually increasing to a table-spoonful; and he advises
 it to be taken  about an hour and a half after each meal. The author has
 always been in the  habit of directing it to be  given midway between
 breakfast and dinner, and between dinner and supper; the first dose be-
 ing taken in the morning on rising; so that three doses are taken in the
 day.   He begins with  a dessert-spoonful.  Its unpleasant taste can
 scarcely be annihilated by admixture with other agents; for which rea-
 son, many prefer to  give it in the pure state, taking afterwards some pep-
 permint lozenges.  It is also  recommended to be given in coffee, hot
 milk, froth of  porter, syrup of sarsaparilla, or lemon juice, or in the form
 of emulsion, or in thin flaxseed tea flavoured with lemon peel: or, as is
 often done in  the case of castor oil, floating on some aromatic water, as
 peppermint, first rinsing the mouth with some of the water; and M. Fre-
  1 Assoc. Med. Journ., and Bouchardat, Annuaire de Therap. pour 1855, p. 149.
  2 Journal de M.d. et Chirurg., cited from Dublin Quarterly Journal, May, 1850, in
 Ranking, ___.. 81,  Amer. ed.  Phila. 1851.        3 Edinb. Monthly Jour. Nov., 1850.
  o7nep°rt °n Materia  Medica, &c, in Ranking's Abstract of the Med. Sciences, pt. 2,
p. 340, Amer. edit.  New York, 1846.        ' Med. Times and Gaz., May 13, 1854. 
OLEUM MORRHU.E.
561
dericq : states, that a simple and effectual means is to masticate a mor-
sel of dried orange peel just before and just after SAvallowing the dose.
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. Ure2 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 im-
mersed  entire in boiling water, to Avhich a sufficient quantity of salt has
been  added to raise  the boiling point to about  220° Fahr.  The sud-
den application of this high temperature coagulates the albumen 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 very objectionable, until he contrived this plan, which answered
extremely  well.   It Avould appear, from the observations of Dr. Staple-
ton,3  that amongst the Norwegian fishermen the liver of the cod has
been found peculiarly efficacious in rheumatism.
   It has been said, that cod-liver oil, given in over doses, or  in parti-
cular cases, has a very manifest tendency to produce haemoptysis.  It
would require repeated and careful  observation  to establish this, and
the testimony in its favour can scarely be esteemed sufficient.4
                      Mistura olei morrhuae.
                        Mixture of cod-liver oil.
                  R.  01. morrhu.- f §ss.
                     Liquor potassae gtt. xl.
                     Aq. menth. pip. f ^ss.   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. morrhu.. f §j.
                      Liq. potass, carb. f gij.
                      01. calami gtt. iij.
                      Syrup, cort. aurant. f 51.  M.
   Dose.—One or two  tea-spoonfuls, morning and evening, in  cases of
rickets.                                                       Fehr.
                  R.  01. morrhua.
                      Syrup, cort. aurant.
                      Aquas anisi, aa. f 5J.
                      01. calam. aromat. gtt. iij.  M.
   Dose.—A  spoonful, morning, noon,  and  night, in gouty  swellings,
rickets, $c.                           ,                     Rosch.
                      Emulsio olei morrhuae.
                       Emulsion of cod-liver oil.
                  R.  01. morrhu.- alb.
                      Vin. Hungaric. (vel Malag.) aa. f 31V.
                      Acaciae ,§j.
                Fiat emulsio, cui adde
                      Syrup, cort. aurant. f 5J.
                      Eiseosacchar. menth. pip. f 3ij.s
  1 Revue Med. Chirurg.  v. 114; and Brit, and For. Medico-Chirurg. Rev. July, 1849,
p. 299.                      2 Pharmaceutical Journal, Nov. 1, 1842, p. 361.
  a Dublin Medical Press, Mar. 6, 1850.
  * Laucet, Mar. 24, 1855, and Amer. Journ. of the Med. Sciences, July, 1855, p. 190.
  s The elaosaccharum or oleosaccharum mentha? piperita! is officinal in the Pharmacopoeias
        86 
562
OLEUM MORRHUiE.
   Dose,—Two tablespoonfuls, two or three  times a day; shaking the
 mixture.                                                  Brefeld.
                        Sapo olei morrhuae.
                          Soap of cod-liver oil.
                  R.  01. morrhua. part. cxx.
                      Sod. caust. part. xvj.
                      Aquae part. iv.  M.
   To be giA^en in the form  of pill;  or made  into a kind of opodeldoch
 with an equal quantity of alcohol.                      Beschamps.1
                      Syrupus  olei  morrhuae.
                         Syrup of cod-liver oil.
                  R.  01. morrhuae f§viij.
                      Acac.  pulv. 3" v.
                      Aqua,  f 3*xij.
                      Syrup, commun. f 3*iv.
                      Sacchar. 3 xxiv.
    Make an emulsion of the first four ingredients; dissolve the sugar at a moderate
   heat; clarify, and add
                      Aq. flor. aurant. f 3"ij.                   Buchu.2

                    Unguentum  olei morrhuae.
                        Ointment of cod-liver oil.
                  R.  Olei morrhuae f ^i.
                      Hydrarg. oxid. rubr. gr. iv.
                      Cerat.  9ij.  M.                          Cunier.

                    Linimentum  olei  morrhuae.
                        Liniment of cod-liver oil.
                  R.  01. morrhuae f 3*ss.
                      Plumbi acetat. gij.
                  Vitell.  ovor. (seu adipis,) giij. M.
   For external use in cases of ulcers, fistulce, &c.          Brefeld.

   Cod  liver-oil olein.  Under the idea, that the only constituent of
cod-liver oil, which is available for nutrition,  is the olein, Mr. Arthur
Leared3 administered it in  the pure form,  obtained by subjecting the
oil to a Ioav temperature, and separating  the olein  by pressure from
the semi-solid  mass produced in this manner.  It is a very liquid and,
at  ordinary temperatures,  a very transparent  fluid;  and agrees in
colour with  the oil from Avhich it is prepared.  Mr. Leared states,—in
the absence  hoAvever of  an exact analysis,—that olein contains a larger
proportion of iodine and bromine than the  oil: but it has been already
remarked, that the  efficacy  of the oil  is  probably independent of those
substances.   Gaduin, too,  he remarks,  may  be administered in  larger
proportions in  the olein  than in the oil itself, as, according to De Jongh,
it adheres to the olein when the margarin is  separated.   The observa-
tions of Mr. Leared can, however,  only  be regarded in the light of con-
jectural suggestions, which  require to be tested clinically.
of Austria, Denmark, Hanover, Oldenburg,  Prussia, &c.  It is made by triturating
eight drops of the essential oil of peppermint with an ounce of sugar.
  1 Aschenbrenner, Die neueren Arzneimittel, u. s. w. S. 135.  Erlangen, 1848.
  2 Journal de  Pharmacie, Sept. 1837.
  2 Med. Times and Gazette, July 21, 1855. 
OLEUM SINAPIS.
563
                   • CXXXI. O'LEUM SINAPIS.
Synonymes. Oleum _Ethereum seu Volatile Seminum Sinapis, Oil of Mustard Seed.
French. Huile Volatile de Moutard.
German. AHherischea  Senfol.
   This preparation has been 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.1

                      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, advises, that the seed should be macerated with cold
water for several hours before the distillation is commenced.  It would
seem, too, that  acids, alcohol, &c, exercise  the same influence in pre-
venting the separation of the  oil.

               EFFECTS ON THE ECONOMY IN  HEALTH.
   Volatile oil of mustard is of a yellowish-white colour.  It exhales
so strong a  smell of mustard,  that the attempt to  test its odour instan-
taneously excites a violent pungent sensation in the nose, and tears in
the eyes.   Its  acridity is so great, that  its  application 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 mustard, 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 are
soon lost; and the  strength  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 ad-
visable 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 modes of external administration may be one of two—according
to the sensibility of the skin,  and the effect  it may be desirable to in-
duce.  It may consist either in rubbing the liquid on a part of the sur-
face, or in applying strips of  linen wetted with it.   The first method
is advisable Avhere the skin  is delicate—as  in the case of  women and
children,  and in those whose  healthy sensibility has not been  dimi-
1 Schmidt's Jahrbucher, 1837. 
564
OLEUM SINAPIS.
 nished—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, Avhich disappears in  the  course of a
 few hours at the farthest.   The  augmented sensibility, produced by
 friction with  the solution of  the oil, continues generally for a  longer
 period; and, consequently,  if a fresh application be needed at a short
 interval—say in from four  to six hours—it must be made on the neigh-
 bouring 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 sensible, as
 well as for morbid cases in which the healthy sensibility has been  de-
 pressed.  The size and shape of the strips must be determined by  cir-
 cumstances.  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 appli-
 cation be 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 method 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, behind the ears, or on  the
 neck.
   The oleum sinapis is  indicated wherever a counter-irritant or local
 excitant is demanded.  Riecke1 advises  it in chronic  cases unaccom-
 panied by fever, as well as in light febrile affections, where a gentle ex-
 citant may  be needed; and in such fevers as are conjoined  with a tor-
 pid state  of the system, and which require the use of excitants.  He re-
 gards  its  powerfully excitant action as constituting it a most useful ar-
 ticle in our  lists of  antagonizing or derivative, as well  as  of  excitant
 agents. ^  In the first relation, Wolff employed it with advantage both
 in  sub-inflammatory diseases, and  in nervous affections not of an in-
 flammatory character—as in subacute rheumatism of the joints, aponeu-
 roses and muscles,  and  in  chronic rheumatism of those parts, Avhere
 blisters would be serviceable; and  for which it may be substituted with
 advantage, in  consequence of its not being attended with  the incon-
 veniences occasionally produced by the  latter on the urinary  organs.
 He employed it, likewise, in rheumatic neuralgia, otalgia,  odontalgia,
prosopalgia,^ and ischias,—blood-letting  being prescribed or not,  ac-
 cording 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 pctralysis, in the sequelae of protracted

    1 Die neuern Arzneimittel, S. 341; und 2te Auflage, S. 519. Stuttgart, 1840. 
                           OLEUM TIGLII.                       565

rheumatism, and in neuralgia which was probably the result of exsu-
dation 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, that 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 secre-
tion  Avas largely augmented  by  it.1   Kuhn2 indeed, exhibited it with
signal benefit in a case  of  atonic  dropsy,  the  sequel of intermittent
fever.
   The oleum sinapis has been received into  the  Hamburg Pharma-
copoeia.
                    CXXXII. O'LEUM TIG'LII.
Syxonymes. Oleum Crotonis seu Seminis Crotonis, Croton Oil.
Freneh. 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 Monoecia  Monadelphia, and to the Natural Fa-
mily Euphorbiaceae—are characterized by their acrid  drastic proper-
ties—which, indeed, belong to the whole family.  These  seeds were
carried by the Dutch to Europe, tAvo centuries ago, and were  admitted
into  the  old Pharmacopoeias under the names  Grana  Tiglii,  G. Tilii,
G. Moluccae, &c, being prescribed as a drastic cathartic, but  owing to
their too violent operation, which frequently  induced  unpleasant re-
sults, they fell subsequently into entire disuse.  The oil of  croton was
also  introduced into Europe about the same period, and was occasion-
ally  used internally.    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 employment was
reintroduced into  Europe; and, in a short time, it acquired so much
repute as an active cathartic, that  it was received into various pharma-
copoeias.3
   Croton oil is a thickish fluid,  of a  honey-yellow colour, has a dis-
agreeable smell, and a very acrid  burning taste, so that it  excites in-
flammation of the tongue and fauces.  It is a fixed oil, having a very acrid
matter associated  with it, which  appears  to possess acid  qualities—
crotonic acid.   In  ether and turpentine it is wholly soluble; in alcohol,
partially so.  It is  imported chiefly from Madras, but partly from Bom-
bay,  and is prepared like castor  oil, being strained, however, instead

  1 Riecke, op. cit. S. 343, and 2te Auflage, S. 520.   Stuttgart, 1840.
  2 Medicinische Zeitung, No. 38,  Sept. 21, 1836, S. 191.
  3 Recherches sur les Propri.t.s Mcdicinales et l'Emploi de l'Huile du Croton Tiglium,
&c.  Paris, 1824. 
566
OLEUM TIGLII.
 of being boiled.  It is likewise expressed  in  England.1  About fifty
per cent, may be obtained in this Avaj;  and ten per cent, more may be
removed by the solvent action of sulphuric ether, which is afterwards
 expelled by a gentle heat.2  Being an  expensive article and readily
 adulterated, it is often  found impure and comparatively inert.   The
 adulteration  generally consists in mixing  it with a large proportion
 either of olive oil, or of oil of almonds.3
   According to Dr. Pereira, two  kinds  are found in the London mar-
 ket,—one imported from India and Ceylon; the other, expressed in
 London, which differ somewhat from each other.

                     EFFECTS ON THE ECONOMY.
   Croton oil holds a distinguished place amongst cathartics, inasmuch
 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 commonly 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  ca-
thartics, 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 Avhere the dose has  been large, but without inter-
fering 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 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, therefore, it
need scarcely be said, its use during inflammation of the canal, is con-
traindicated.   It does not appear to affect  any other secretory organs
than those of the bowels,  although some physicians 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 anthelmintic,
especially in  cases of tape-worm, by Poccinotti,  and others, and with
success.4
 ^ It has been recommended in dropsy by Dr. Geo. Fife5 as possessing
one very decided advantage over elaterium; viz.:—that even when its
extreme action is manifested, "it  is not  followed  by  the depression in-
separable from the effective action of the  latter; but that where the

 1 Pereira, Elements of Mat. Med. and Therap. 3d Amer. edit. ii. 367.  Philad. 1854.
 2 Christison, Dispensatory, Edinb. 1842.
 * Report of the Committee on Adulterated Drugs,  Dr. Huston, Chairman, in Trans-
actions of the American Medical Association, vol. iii.  Philad. 1850.
 * Richter, Specielle Therapie, B. x. S. 248.  Berlin, 1828.
 5 Provincial Med. and Surg. Journ. Sept. 25, 1844,  p. 397. 
OLEUM TIGLII.
567
greatest vis inertise 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-irritant,
and at  times to induce a cathartic  effect; but in this respect it is un-
certain.1
   Rubbed on the surface in small quantity, it induces inflammation  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, papulae or pimples appear over a wider extent, which
are transformed into pustules, and are surrounded by a red base  or
areola.   When the pustules are discrete, they dry up more rapidly than
when they run together;  and in the latter case they commonly form
scabs.  Friction 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 erup-
tion 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 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 local 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,2 Elliotson, Hutchin-
son,3  Short, Landsberg, Romberg,  and others, in the following affec-
tions :—in chronic inflammations, and  such  as have a tendency to ex-
sudation; in  chronic  rheumatic, and gouty diseases, in aphonia* and
chronic hoarseness,5 in phthisical affections, especially  in  incipient
phthisis;  and  in  the  neuroses—as spasmodic asthma, hooping-cough,
paralysis,6 &c.   Giinther7  advises them as almost specific in rheumatic
odontalgia and in otalgia.
   In  neuralgia faciei, the cause of which is considered by Sir Charles
Bell8 to be seated primarily in the intestinal canal, and remotely  in
the fifth pair of nerves, croton oil has been recommended as a superior

  1 See a case of ileus cured in this manner, by Dr. Susewind, in Casper's Wochenschrift
fur die gesammte Heilkunde, June 24, 1837, S. 404.
  2 Gazette Medicale, Jan. 1832,  and Archives Generales, Aout, 1833.
  * London Lancet, May, 1833, and Sauer, in Medicin. Zeitung, Aug. 10, 1836, S. 1.8,
cited in Amer. Med. Intel. Nov. 1, 1837,  p.  286.
  * Romberg, in Wochenschrift fiir die gesammte Heilkunde, 1835.
  B Sauer, op. cit.
  6 Boileau, (Paralysis of the Facial Nerve,) Bulletin Medical du Midi.  Avril, 1839.
  » Berliner Medicin. Central-Zeitung, Nov. 19, 1838.
  8 Practical Essays.  Edinb. 1841, p. 101.  Also, Allnatt on Tic Douloureux, London,
1841. 
568
OLEUM TIGLII.
purgative, and this, as well as other forms of neuralgia,1 would seem to
have been removed by it,—doubtless 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.  The same remark
applies to its employment as a purgative in acute rheumatism by Dr.
Geo. L. Upshur, of Norfolk, Virginia,2 who is disposed to believe "that
the efficacy  of Croton oil does not depend  entirely upon its cathartic
properties.   It  possesses—he  thinks—a power over the disease be-
yond  these, and apparently not dependent upon them; for other ca-
thartics, which act as powerfully and as promptly, producing similar
watery stools, do not bring a like amount of relief to the patient.   "I
do not say," he  adds, "that it  is a specific, for I am not a believer in
the doctrine of specifics in medicine: that doctrine has put more stumb-
ling-blocks in the way of medical progress than all  the open  quackery
of the past half century.   I merely desire  to  state, that after a fair
trial, in a number of cases accurately observed, where there was scarcely
a possibility of  falling into error,  I  believe that the croton  oil is the
best single  remedy in the treatment of acute rheumatism;  and I am
thoroughly convinced, that  it is as justly entitled to the term specific
in this disease, as is  quinine in miasmatic fever."  Yet  the  cases re-
ported by Dr. Upshur, in which other favourite anti-arthritic remedies
—as colchicum and sulphate of quinia—were also  prescribed, are far
from impressing the author as strongly as they do him.   Mr. Hancock3
is of opinion, that the cause most productive  of sciatica is irritation of
the nerves within the  pelvis, either from  loaded colon or caecum, or from
tumours formed within the cavity, and  acting  mechanically upon the
nerve.   A loaded colon, he thinks, is the most common cause;  and
" this may be a reason,  why sciatica is  most commonly seated in the
left thigh." [?]  The plan of treatment, he advises, is to thoroughly
purge the patient with small doses of croton oil, combined with blue
pill, hyoscyamus and compound extract  of colocynth; and, at the  same
time, to give three grain doses of sulphate of quinia, three times daily.
Local  applications he speaks  of as  injurious  rather than  beneficial.
The cases, reported by Mr. Hancock, yielded to the  treatment; but the
sulphate of quinia, had probably, at least, as much  agency in the cure
as the croton oil.
   In the only case of genuine tic  in which  Dr. Christison tried it, no
benefit whatever was  derived.  In delirium tremens  it has been ad-
vised by Dr. Prankerd4 as an  efficacious remedy,  in which  disease it
acts, he conceives, as a  direct  sedative to the nervous system.   The
testimony is, however, inadequate  to establish  the position: and but
little reliance ought therefore to be reposed in  it.
   Dr. Stark5 recommends, that a drop of croton  oil with  colocynth
should be given every hour in cholera, until a full evacuation of bilious
matter is procured.   Diluted sulphuric acid,  is sometimes  employed
simultaneously to check the vomiting.
  1 J. Cochrane, Lond. and Edinb. Monthly Journ. of Med. Science, July, 1841; J. A.
Ea^ton, London Lancet, Jan. 29, 1841; and Newbigging, Edinb. Med. and Surg.  Journ.
Jan. 1841, and Amer. Journ. of the Med. Sciences, Jan. 1841, p. 209.
  2 Medical Examiner, Oct. 1850, p. 580.           a Lancet, March 4 and 11, 1854.
  * Prov. Med. and Surg. Journ. April 29, 1846.      5 Lancet, Sep. 1854. 
OLEUM TIGLII.
569
  Croton oil has likeAvise been used as a direct excitant.   CampanelliJ
gives a case of paralysis  of the upper eyelid, Avhich was  promptly re-
lieved by the application  of four drops to the affected lid, and to the
eyebrow.   It has  been employed also, as proposed by M. Lafargue,2
by Mr. A.  Ure,3 in the way of inoculation for the removal of a ncevus
or erectile tumour, at the inner angle of the right upper eyelid.   Se-
veral minute punctures were made, with a cataract needle besmeared
with oil, over the  surface of the naevus.   These gave rise to  redness
and  swelling,  Avhich 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 vaccina-
ting.
                     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 neces-
sary.   The dose is  rarely carried higher, except in desperate cases,
and  in mental affections, for which it  is peculiarly appropriate.  It
may be prescribed either in the form of emulsion or of pill.   Hahne-
mann 4 and Hufeland  recommended it  as a substitute 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 externally 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 preAdously with flannel, or  to  apply first a  rubefacient, especially
when it is desirable to produce 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
liniment.5
                       Pilulse olei tiglii.
                        Pills of croton oil.
                 R.  Olei tiglii gtt. iv.
                     Micae panis q. s. ut fiant pilulas viij.
  Dose.—One,  or two, or more.
                 R.  Olei tiglii gtt. v.
                     Saponis,
                     Acaciae pulv. aa. 9j.
                 Misce et fiant pilulae xx.
  Dose.—One to  three.                                  Sundelin.

  1 Annali Universali di Medicina, July, 1835.
  2 Cited in Provincial Med. and Surg. Journal, Feb. 17, 1844, p. 393.
  5 London Med. Gaz., March 21,1845, p. 786.
  4 Apotheker Lexicon, B. ii. Abth. 1, S. 203.
  6 See the Author's Gen. Therap. and Mat. Med. 5th edit. ii. 276.  Philad. 1853. 
570                         OLEUM TIGLII.

                  R.  Olei tiglii gtt. ii.
                      Micse panis
                  vel
                      Saponis J}j.
                  M. et divide in pilulas viij.
   Dose.—One to four.

                   Pilulae  olei tiglii  compositae.
                       Compound pills of croton oil.
                  R.  Olei tiglii gtt. x.
                      Ext. colocynth. comp. gi.
                      01. mentha. piper, gtt. viij.  M.
                  et fiant pil. xviii.
   Two for a dose—to be repeated at short intervals, in cases of obsti-
nate constipation.
                        Haustus olei tiglii.
                          Draught of croton oil.
                  R.  Tinct. ol. tiglii f^ss.
                      Syrup.
                      Mucil. acacias, aa f gij-
                      Aquae destill. f 5 ss.  Fiat haustus.
   After  swallowing  a little milk, this draught  must  be taken very
quickly, and be washed down Avith the same diluent.—Nimmo.

                       Emulsio  olei  tiglii.
                         Emulsion of croton oil.
                  R.  Olei tiglii gtt. iij.
                      Olei amygdal. f ^ss.
                      Acac. pulv. gij.
                  Misce sensim terendo cum
                      Syrup, flor. aurant. f 5J.
                      Aq. anthemid. f 3 v.  M.
   Dose.—A spoonful every two hours until  it operates—shaking  the
vial.                                                        Phobus.1
                  R.  Olei tiglii gtt. i.—ij.
                      ----anthemid. gtt. ij.
                  Terendo misce cum
                      Mucilag. acaciae
                      Syrup, amygdal. aa f 53s.  M.
   Dose.—A tea-spoonful every two hours—shaking the vial.
                                                          Lockstddt.
                       Mistura olei tiglii.
                          Mixture of croton oil.
                  R.  Olei tiglii gtt. ii.
                      Mucilag. acac. f gij.
                      Aqua, f 3j.   M.
   Dose.—A fourth part, every two hours, until the  desired effect is
induced.
                Mistura  olei  tiglii  saponacea.
                    Saponaceous mixture of croton oil.
                  R.  Olei tiglii gtt. viij.
                      Potassae gr. vj.
                      Aquae destillat. f<j>ij.   M.

         1 Handbuch der Arzneiverordnungslehre, Th. ii.   Berlin, 1836. 
                            OLEUM TIGLII.                         571

  This is a substitute for the Sapo  Olei Tiglii, which  is  troublesome
in the preparation.
  Dose.—Three to  six drops.1
                 R.  01. tiglii gtt. ij.
                      Sacchar. gij.
                      Acaciae pulv. gss.
                      Tinct. card, f gss.
                      Aquas destillat. f ^x.  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. 3j.
                      Mucilag. acaciae q. s. ut fiant
                 trochisci non torrendi  No. viij.

   Dose.—One every two hours, until the desired effect is  induced.
                                                             Seiler2
                          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 in-

 duced.
                  R.  Olei tiglii
                      Liq. potassae aa. f 5ss.
     Mix  intimately by agitation.
                  R.  Soluti hujusce tn> xxx.
                      Aquae rosae f ^i.  M.
   To be rubbed on the part night and morning, or even three times a
 day, until the peculiar eruption is induced.            James Allen.3

   The Linimentum Crotonis of the Dublin Pharmacopoeia4 consists
 of one part of  croton oil to seven of oil of turpentine.

  Embrocatio  olei  tiglii cum  antimonii et potassae tartrate.
      Embrocation of croton oil with tartrate of antimony and potassa.
                  R.  01. tiglii trjj xx.
                       Antim. et potass, tartrat. 9j.
                       Liq. potassae f £i.
                       Aquaef^vij.  M.
   Used to keep up a mild rash upon the skin.              Morris.

   1 Ellis's Medical Formulary, 10th edit. p. 55.  Philad. 1854.       _
   2 Hufeland's Journal, B. lix. St. 4, S. _:.■_; and Rust's Magazin, B. xvm. St. 2, 8. o. _.
   8 Provincial Medical and Surgical Journal, Oct. 28, 1843, p. lo.            ,  ..,.
   « The Pharmacopoeia of the King and Queen's College of Physicians in Ireland, 18o0,
 pM7.  Dublin, 1850. 
572
PAULLINIA.
                     Unguentum  olei tiglii.
                        Ointment of croton oil.
                 R.  Olei tiglii trjj x.—xxx.
                     Adipis ^ss.  M.
  A little of this to be rubbed  on the part so as to excite the peculiar
eruption.
                     Emplastrum olei tiglii.
              Plaster of croton oil.—Sparadrap de croton.
  M. Bouchardat melts, over a very gentle fire, four parts  of  diachy-
lon plaster; and when it is in a semi-fluid state, he  mixes with it one
part of croton oil.   This he spreads upon linen, so as to  form an ad-
hesive and irritating plaster.
  M. Caventou prefers the following  form, as he considers the degree
of heat employed in the process of  M. Bouchardat may interfere with
the powers of the 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 must be incorporated.1

  A stronger plaster is  also  advised  by M. Bouchardat.2   He  melts
over a gentle fire eight parts of diachylon plaster, and when it is semi-
fluid mixes it with twenty  parts  of  croton oil.  The resulting plaster
must be spread  thickly on  muslin.   It produces 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 de-
sirable.

  Pope3 recommends a tinctura  granorum tiglii or tincture  of
the seeds, to be made of two ounces of  the seeds from which the rinds
haAre been carefully removed, to one ounce of alcohol.   This 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 material enough to  act
powerfully and certainly.
                      CXXXIII. PAULLINTA
Synonymes. Guarana, Guarana Pasta, Pasta Seminum Paullinia?.
French. Pate ou Extrait de Guarana ou Paullinia.
German. Guarana-Samenteig.
  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 considera-
ble  excitant  powers.   M.  Gavrelle presented a specimen of it  to  the

  1 Bulletin General de Th.rapeutique, Mars, 1812, or Journ. de Pharm. Avril, 1842,
p. 453.
  2 Annuaire de Therapeutique, &c, pour 1844, p. 210.  Paris, 1844.
  ' Medico-Chirurgical Transactions, vol. xiii. p. 1. 
PAULLINIA.
573
Societe de Medecine of Paris, as well as a new alkaloid, guaranine, which
had been separated from it by two chemists of Paris.   Both paullinia
and the alkali are very bitter.   The latter is considered to be identical
with Caffein.1 M. Gavrelle states, that paullinia is obtained from Paul-
linia sorbilis; Guarana officinalis ; Family, Sapindacese.   M. de Chas-
tetus 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 sub-
stance possessing the chemical properties of caffein.

               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 diarrhoea and dysentery;
 and in the  same affections, it  has been administered,  in France, by M.
 Lallemand.  As a tonic, M.  Gavrelle has employed  it successfully in
 chlorosis,  tedious convalescence, paralysis, the colliquative  diarrhoea
 of phthisis, and hemicrania.
   According to Von Martius, an extract is prepared  in  Brazil  from
 Paullinia sorbilis, which is known there under the  name  of Guarand,
 and is administered in similar pathological cases.2   It is probably the
 same substance.                                 t         .
   A  full  account  of the properties of this article  is given by Air.
 Ritchie.3
                      MODE OF  ADMINISTRATION.
    The  dose of guarana, in  powder, is  5j. given  three  or four  times
 daily.  M. Gavrelle has  given  formulae for  Lozenges, Syrup,  Pills,
 Powder, Tincture,  and Ointment of paullinia.4

                         Trochisci paulliniae.
                          Lozenges of paidlinia.
                   R. Paullinia. gvss.
                      Sacchar. (vanilla, odorisat.)  Ibiss.
      Make into lozenges each containing ten grains.
                          Syrupus paulliniae.
                           Syrup of  paullin ia.
                   R.  Paullin. giiss.
                       Syrup. Oij.
    Half a fluidounce may be given  in the 24 hours.

                          Pilulae paulliniae.
                          Pills of paullinia'.
                   R.  Paullin. q. s.        #
      To be  made into pills, each containing a grain and a halt.

    ! See SfGwana in Diet. Univers. de  Mat. Med. par Merat et De Lens, torn, ii p.
  865.^1^1^8; Journ. de  Pharmacie, cited in Ame, Journ. of Pharmacy, Jam
  1841,  p. 340; Dechastetus, Journ.  de Pharm. Aout, 1840, J. J. J™* **£ >"?
  Schlechtendal Encyclopad. Worterb.  der Medicin. Wissenschaft  xxvi 433   Beilin, l»4l,
  afd A. R^frdEE^ments d'Histoire Naturelle^M.dicale ttmeglxt g^)^™*
    3 Edinb. Monthly Journ. of Med.  Science, May, 1852, p. 46o.  it  is cited
  Journ. of the Med. Sciences, Oct. 1852, p. 496.                           _
    « Journal de Chimie M.d. cited  in Amer. Journ. of Pharmacy, Oct. 1840, p. J08. 
574                         PHLORIDZINA.

                        Pulveres  paulliniae.
                         Powders of paidlinia.
                 R.  Paullin. in pulv. gi.
                     Sacchar. aromatisat. ^ss.  M.
For a  dose.
     Tinctura paullinia..
       Tincture oj paullinia.
R.  Paullin. gi.
    Alcohol. (22°) Oi. M.
   Unguentum paulliniae.
       Ointment of paullinia.
R.  Paullin. £ij.
    Adipis gij.  M.
                    CXXXIV. PHLORIDZFNA.i
Synonymes. Phloridzinum, Phloiorrhizinum, Phlorrhizinum, Phloiorrhyzinum, Phlor-
  rhizin, Phloridzia, Phloridzine, Phlorizin, Phloridzin.
German. Phloridzin,  Phloiorrhizin,
  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 discoverer
(1834  or 1835.)—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  wa-
ter.  On uniting the two decoctions,  and permitting them to stand for
twenty-four hours, a deposition of phloridzine, in granular crystals, takes
place.   These are to be treated with distilled water and animal char-
coal, to purify them.  An additional quantity is obtained by evaporating
the mother waters  to one-fifth.   At  this degree of  concentration, all
the phloridzine  is deposited.   This method affords about one  part  in
three hundred.   Another  plan yields five per cent.  It consists in di-
gesting 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.2
  Phloridzine crystallizes in silky spicula of a dead-white colour when
in masses, or in long slender  prisms or tables when crystallized 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. 1.429.3
  1 From <t\ooc, inner bark,  and gtta, root.
  2 Journal de Pharmacie, xxii. 78, cited in  Amer. Journ. of Pharmacy, vol. ii. new
series, p. 240.  Also, M. Boullier, in Gazette M.dicale de Paris, 17 Juin, 1837, and
Marchand, Journ. de Chim.  Med. Avril, 1841.
  3 For some elaborate chemical researches on Phloridzine, see M. J. S. Stass, Annalcs
de Chimie et de Physique, Dec. 1838. 
PIPERINA.
575
               EFFECTS  ON THE ECONOMY IN DISEASE.
  M. de Koninck found, that from ten to fourteen grains, given for a
dose Avith  a dram of sugar, produced the most marked effect in inter-
mittent fever, where sulphate of quinia had failed.1  In four cases re-
ported by Van Mons,2 of Bruxelles, the disease was  arrested by the
first sixteen grains: other cases required sixteen grains a few hours be-
fore the first paroxysm; tweh-e grains before the second; six before the
third;  and four before the fourth.   Five successful  cases are likewise
given by M. Mathysen,3 lllve interne at the Hospital St. Pierre, Brux-
elles; and M. Lebaudy4 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. Leonhard5 is satisfied, from his various  trials, that  phloridzine 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 lave-
ment*.    The  paroxysm returned, but was less violent.  In two days
afterwards, the same quantity was administered in the same manner,
and the fever -did not recur.
                       CXXXV.  PIPElirNA.
Synonymes. Piperinum, Piperium, Piperine, Piperin.
French. Piperin.
German. Piperin, Pfefferstoff.
  This substance was  discovered  by M. Oerstadt, in the year 1819, in
black pepper, Piper nigrum.6  It is found, also, in Piper longum, and
it has been presumed to be the same, or an analogous principle, with
the eubebin of Piper cubeba.   It has been affirmed, that it exists only
in black, and not in white pepper; but this is an error.   Dr. Christi-
son7 invariably obtained it from the latter in larger quantity than from
the former, and more  easily, because  it is combined with less resin.
M. Ocrsttidt 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.8

  » Also. Prince Louis Lucien Bonaparte, in Bouchardat, Annuaire de Th.rapeutique
pour 1S43, p. 203.  Paris, 1843.
  2 Bulletin Medical Beige, Mai, 1836.

  * Journafdes Connaisa. Med. Chirurg.  cited in Braithwaite's Retrospect of Medicine
and Suro-erv No 5, p. 129, Lond. 1842, where it is termed erroneously Phloridrine, and
whence ft is copied into the Amer. Journ. of the Med. Sciences, and the Amer. Journ. of
Pharmacy, for Jan. 1843, under the name Fhlondine.
  * Eucy.l'ographie des Sciences Medicales, Mai, 1838.          _
  6 Journ. de Physique, No. 2, 1820, and Gazette de Sant., 2d Mai, 1820.
  ' Dispensatory, p. 698.  Edinb. 1842.               #
  s Examen Chimique du Poivre, par J. Pelletier, 8vo. Pans. 
576
PIPERINA.
                       METHOD OF PREPARING.
   Let two  pounds  of black pepper, bruised, be digested, at a gentle
heat, in three pounds  of alcohol at 36° (.837.)   This mixture must af-
terwards be raised to ebullition, then suffered to remain  at rest, and
grow cold;  Avhen 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 precipitate, of a deep
gray colour, is throAvn  down, which is composed in a great measure of
fatty matter.   The  deposit being separated, crystals may be collected
on the filter and sides of the A^essel.   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-
scribed by M. Pelletier.  He has likewise procured it by the folloAving
method:—After having exhausted pepper by alcohol, and evaporated
the  alcoholic  tinctures, a fatty or resinous matter is  obtained:  this
must be subjected to the action of boiling water, which 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,  Avhich may be purified by solution in alcohol and ether,
and  by repeated crystallization.   The alcoholic mother waters, left to
themselves,  will furnish  fresh crystals.  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: 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;1 but
Dr. Christison2 states,  that the very whitest crystals he was  able to
obtain were as acrid as those  which are  brownish, and they  emitted
an intensely irritating vapour  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 someAvhat
more so  in hot.   In  respect  to its solubility in alcohol, testimony is
discordant.  According to Magendie, it  dissolves very readily therein;
according 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;—which shows that it is not an alkaloid, as
the discoverer conceived.  With acids it forms no intimate chemical
combinations; acetic acid, indeed, dissolves it in considerable quan-
tity ; it is, however,  in great part, precipitated by water,  and  by eva-
poration the whole of  the acid escapes.   It is related to the resins.

                    EFFECTS  ON  THE ECONOMY.
d Piperin has been  exhibited  chiefly by the Italian physicians for the
cure  of intermittent fever.   Its employment was doubtless suggested

  1 Dispensatory  of the United States  of America, 4th edit. p. 512.  Philad. 1839.
  3 Op. cit. p.  697. 
PIPERINA.
577
by the use of pepper-corns as a popular remedy in that disease.   Ac-
cording to Riecke,1 the antiperiodic virtue of pepper is exhibited 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,2 who  treated  many cases of intermittent Avith piperin, con-
siders  it 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, Bertini, Gordini, Torelli,  and
others.   According  to Brandolini,  from forty to  fifty grains are ge-
nerally 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  doses, the fever was generally arrested.
Gordini affirms, that relapses occurred less frequently after the use of
piperin than after that of the sulphate of quinia.   On the other hand,
in the hospital at Turin, Christin  was disappointed in it, and  such
seems  to have been the result of the trials made by Chiappa.3  In the
year 1823, he administered  it in ten or twelve cases, but Avas unable
to detect any great  antiperiodic property;  not  more  than a fourth
part of the sick experienced  benefit, Avhilst on the others  cinchona
acted like a charm.   In general, a burning sensation was experienced
in the  stomach after taking it, as Avell 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 intermittents, 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 perspiration, especially  on the upper lip.   Blom is, hoAvever,
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
opinion, 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, Avith
great success, by Dr. Hartte,4 Port of Spain, West  Indies.  He pre-
scribed it  as  soon as the  SAveating stage was  established,  until  18
grains  had been taken, and, on the folloAving day,  when the  intermis-
sion was complete, he directed the  same quantity every three hours.

 1 Die neuern Arzneimittel, S. 361; und 2te Auflage, S. 522.  Stuttgart, 1840.
 2 .Nuove Esperienze, &c. Milan, 1823, 8vo.; and Annali Universali di Medicina, xxvii.
161, and xxviii. 22.
 * Riecke, Op. cit. S. 361; und 2te Auflage, S. 553.  Stuttgart, 1840.
 1 Edinb. Medical and Surgical Journal, Jan. 1841, p. 98.
       37 
578                    PLATINI PRiEPARATA.

It succeeded, in every case, in checking the paroxysm, and as soon as
this Avas accomplished he gave, for some days, pills composed of pilulae
hydrargyri, piperin, and  sulphate of quinia, the formula for which is
given below.
   In inflammatory intermittents, as well  as in those with gastric com-
plications, piperin is to be avoided.
   Magendie suggests that it should "be given in blennorrhoea, in place
of cubebs.
                   METHOD OF ADMINISTRATION.
                       Pilulae  piperinae.
                          Pills of piperin.
                 R.  Piperin. gr. xij.
                     Extract, gentian, q. s. ut fiant pilulae xij.
   Dose.—One every  hour, during the apyrexia of fever.

                 Pilulae piperinae  compositae.
                      Compound pills of piperin.
                 R.  Pil. hydrarg. gr. i.
                     Piperin. gr. ij.
                     Quinia; sulphat. gr. ij.
                     Syrup, q. s. ut fiat pilula.
   One to be taken morning, noon, and night.              Hartte.
               CXXXVI.  PLATTNI PR_EPARA'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 medicine.
Experimental researches were undertaken by M. F. Hofer,1 in regard
to their employment  as physiological and  therapeutical  agents;  and
the following were the main results.  Experiments were made on rab-
bits, dogs, and on himself, with  the view of discovering the physiologi-
cal action of the perchloride of platinum or chloroplatinic acid,  of the
chloroplatinate of sodium or the double chloride of platinum and sodi-
um;  of the  chloroplatinate of potassium,  and  the chloroplatinate of
ammonium.   He  found—First. That  the  chlorides of platinum are
poisonous,—the perchloride in the dose of  15 grains;  the chloroplati-
nate of sodium in that of 5SS»   Secondly.  The chlorides of platinum
are less poisonous than the chloride of gold, and  corrosive sublimate.
Tldrdly. The perchloride of  platinum, in concentrated solution, pro-
duces 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 nervous centre, and through it exerts
a special alterative action  on the fluids of the economy.  Fourthly.

  1 Gazette M.dicale de Paris, No. 48, 1840; or Journ. de Pharmacie, Avril, 1841, p. 213. 
PLATINI BICHLORIDUM.
579
The chloroplatinate of sodium produces no local irritation on the skin.
Taken internally, it does not react on the  nervous centres in as mani-
fest a manner as the simple perchloride.  It more especially increases
the urinary secretion.  Fifthly. The perchloride of platinum is a very
efficacious  remedy in  the  treatment of syphilitic diseases,  and espe-
cially in those that  have been of long duration, and are  inveterate.
Sixthly. The  chloroplatinate of sodium is more proper for the treat-
ment  of recent  syphilitic  diseases.  It is also very efficacious in  the
treatment of rheumatic  affections.   Seventhly. Platinum  ought to be
ranked in the class of alterative remedies, by the side of gold, iodine,
and arsenic.  It  differs from mercury in  previously inducing excite-
ment, whilst its administration is not followed by any of the disagree-
able consequences induced by mercury.   Eighthly, and lastly. Platinum
is preferable, as an alterative, to mercury and gold.
  The preparations of platinum have been used by others in syphilitic
affections with success, but the observations of Fricke were unfavour-
able to them.   By Cullerier they were given in gonorrhoea and leucor-
rhcea.
  Mr. Tuson1 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 consultation,  he fully
expected some most striking results from it, but that he  had been
disappointed on every occasion where it had been prescribed.   Still, it
was his intention to watch carefully its effects on some future oppor-
tunity.   From what he had seen, he had  little faith in its use, either
as a local application or as an internal remedy.
  The preparations of platinum have been  prescribed by Duttenhofer
and Prevost in scirrhus of the stomach; and by the latter in epilepsy.2
They  are, however, but little employed at the present  day.
              CXXXVII.  PLATINI BICHLORIDUM.
Synonymes. Platini Perchloridum, Platina Muriatica, Platinum Bichloratum, Chlo-
  ridum Platina., Bichloride or Perchloride or Chloride of Platinum.
French. Bichlorure ou Perchlorure de Platine.
German. Chlorplatin,  Platinchlorid, Salzsaures Platmoxyd.

   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 decomposed; and the protochlo-
ride, or even reduced platinum,  be the  result.
   Bichloride of platinum in  concentrated solution or m the solid state
is  of a deep red  colour.  It is very deliquescc.it, very soluble in water,
and soluble also in alcohol.

  i The Structure and Functions of the Female Brenst, p. 428   Lond. 1846.
  'Dierbach, Die neuesten Eutdeckungen in der Materia Medica, 2er Band. S. 11t6.
Heidelberg und Leipzig, 1843; and  Aschenbrenner, Die neueren Arzneimittel, u. s. w. to.
226. Erlangen, 1848. 
580                    SODII CHLOROPLATINAS.

                Mistura platini perchloridi.

         Mixture of perchloride of platinum.—Pot ion plat inique.
                 R.  Platin. perchlorid. sice. gr. iss.
                     Mucilag. acac.
                     Aquas aa. f 3iij.

  To be taken by table-spoonfuls in the course of the  24 hours.

                 Pilulae platini perchloridi.

          Pills of perchloride of platinum.—Pilules platiniques.
                 R.  Platin. perchlorid. gr. viij.
                     Guaiac. resin, gj-
                     Glycyrrhiz. pulv. q. s. ut fiant pil. xx.
  Dose—One, two, three, or four, morning  and evening.

               Unguentum platini  perchloridi.

        Ointment of perchloride of platinum.—Pommade platiniqw;.
                R.  Platin. perchlorid. gr. xv.
                     Extract, belladon. ^ss.
                     Adipis 3*i.
  To be applied to indolent ulcers.
             CXXXVIII. SODII CHLOROPLATINAS.
Synonymes. Platina  Muriatica Natronata, Chloroplatinate of Sodium, Double Chlo-
  ride of Platinum and Sodium.
French. Chloroplatinate de Sodium, Chlorure Double de Platine et de Sodium.
German. Chloroplatinnatrium, Natriumplatinchlorid.

  The chloroplatinate of  sodium  is prepared by dissolving bichloride
of platinum and very pure chloride of sodium in proper proportions in
water, evaporating and crystallizing.   It is soluble in water and in al-
cohol, and crystallizes in beautiful transparent  prisms of an intensely
yellow colour.

               Mistura  sodii chloroplatinatis.
 Mixture of chloroplatinate of sodium.—Potion de chloroplatinate de sodium.
                 R.  Platin. perchlorid. gr. v.
                     Sodii chlorid. pur. gr. viij.
                      Mucilag. acac.
                      Aquae aa. f 3iij.
  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. crystallis. 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. 
PLUMBI IODIDUM.
581
                   CXXXIX. PLUMBI  IO'DIDUM.
Synonymes. Plumbi loduretum seu Iodatum seu Hydriodas seu Hydroiodas seu
  Iodhydras, Plumbum Iodatum seu Hydroiodicum, Iodide or Ioduret of Lead.
French. Iodure de Plomb, Iodure Plombique.
German.  Bleiiodid, Iodblei, Bleiiodur,  Einfach Iodblei,  Hydroiod-
  saures oder  Iodwasserstoffsaures Blei.

                       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 ace-
tate of  lead.   In the Pharmacopoeia of  the  United  States, into the
last edition of which (1851) it was  admitted,  it is directed to be pre-
pared by the  double  decomposition  of iodide  of potassium and nitrate
of lead, according to  the following form:—Take of nitrate of lead and
iodide  of potassium, each £iv.:  distilled water, a sufficient quantity.
With the aid of heat dissolve the nitrate in a  pint and  a half, and the
iodide of potassium in half a pint, of distilled  water, and mix  the solu-
tions.   Having allowed the  insoluble  matter to subside, pour off the
supernatant liquid; wash the precipitate with distilled  water, and dry
it with a gentle heat.
  Iodide of lead is of a bright yellow colour.  According to Soubeiran,1
it is soluble in 1235 parts of cold water;  and is somewhat more soluble
in boiling water, which, on cooling, deposits the  iodide in minute, shining,
yellow,  crystalline scales.   Riecke2 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.3  M. Paton4 administered twelve grains of it  to a cat  of mode-
rate size.  In four hours  the animal did not appear to  experience any
inconvenience; twelve more grains  were then given; in twelve hours,
the animal became uneasy, and constantly refused 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 dissec-
tion Avas 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  decolorized  by charcoal, but no  effect was induced by the tests
for  lead.  The matter  remaining on the filter was digested  in dilute
nitric acid: the  solution  was filtered, and a  precipitate obtained on

  1 Trait, de Pharmacie, cited in Dispensatory of the United States of America, 10th edit.
p. 1128.  Philad. 1854.
  1 Die neuern Arzneimittel, u. s. w. 2te Auflage, S. 563.   Stuttgart, 1840.
  ' Eager, Dublin Journal for 1834.
  4 British Annals of Medicine, Mar. 3, 1837. 
582
PLUMBI IODIDUM.
 pouring  in a  solution of chromate of potassa.   The liquid was evapo-
 rated ; 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 in-
 testines,  and admitting of detection by the method described.   When
 given  internally, in  the dose  of a quarter  or  half a  grain, Velpeau
 thought,  that it occasioned, in one instance, irritation in the alimentary
 canal; but Dr.  O'Shaughnessy thinks, that this result must have been
 owing  to idiosyncrasy, as ten-grain doses can  be borne with  perfect
 impunity.  The experiments of  Dr. Cogswell*  show, that it is by no
 means  an active agent, and that its physiological operations do not cor-
 respond with  its therapeutical effects; as, in continued doses, it pro-
 duced 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.   Velpeau2
 treated three cases of enlarged glands with very gratifying success, al-
 though the patients had used frictions with other preparations of iodine
 ineffectually.   Similar good effects were observed by Guersent, Roots,
 Cottereau, Baudelocque, Delisle,  and others.3  Dr. Pereira,4 howeArer,
 used it in two cases of  enlarged cervical glands without benefit.  Dr.
 Christisons  has seen  it repeatedly useful to appearance  in obstinate
 ulcers, especially when " consecutive to mercurio-syphilitic  eruptions
 in strumous habits."   The dose is three, four, or more grains.   Bally
 has given 30  grains at a dose.

                     Pilulae plumbi iodidi.
                        Pills of iodide of lead.
                 R. Plumbi iodid. gr. iv.
                      Confect. ros33 gj.  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.                                        Cottereau and Joy.6

                  Unguentum  plumbi iodidi.
                       Ointment  of iodide of lead.
                 R. Plumbi iodid. 3*j.
                     Adipis 3~viij.  M.
   Applied to  scrofulous  and other indolent swellings  in the form  of
 friction.7

  1 Essay on Iodine, p. 142.  Edinb. 1837.
  * Lugol, Essays on Iodine, &c, by O'Shaughnessy, p. 206.
  1 Riecke, Nachtrage zu ersten Auflage der neuern Arzneimittel, S. 78. Stuttgart, 1840,
and Aschenbrenner, Die neueren Arzneimittel u. s. w. S. 229, Erlang.  1848.
  * The Elements of Mat. Med. and Therap. 3d Amer. edit. i. 706.  Philad. 1852.
  5 Dispensatory, p. 712. Edinb. 1843.
  6 Tweedie's Library of Medicine, v. 35)0.  Lond. 1840, or 2d American edit. vol. iii.
Philad. 1842.
  7 Trousseau and Pidoux, Trait, de Th.rapeutique, &c, 3.me .dit. i.  142. Paris, 1842- 
PLUMBI TANNAS.
583
                  Pessarium  plumbi iodidi.
                      Pessary of iodide of lead.
                 R.  Plumbi iodid. 9j.
                     Cera, flavae 9 v.
                     Adipis 3yj.   M.
  Make into a pessary of the size of  a walnut.   Used as a discutient
in uterine affections.                                    Simmon 1
                      CXL.  PLUMBI TANNAS.
 Synonymes. Plumbum Tannicum seu 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 water, until,
 when strained, four ounces remain; add acetate of lead as long as any
 precipitate falls;  filter the liquor through bibulous paper, and dry the
 precipitate remaining on the paper to the consistence of a thin oint-
 ment."
                    EFFECTS ON  THE  ECONOMY.
   Autenrieth2 has strongly recommended tannate of lead in cases of pa-
 ratrimma ad decubitum, or sores produced by lying, and its advantages
 have been confirmed  by others;  and Dr. Tott has advised it in cases
 of decubitus gangrsenosus, or sloughing sores produced by lying.3  In
 one case, in which it appeared to be inefficacious,  he took two drams of
 the dried precipitate, mixed it with an ounce of  unguentum rosatum,
 and used this unguentum plumbico-tannicum with success.   M. Os-
 sieur has spoken highly, of it in the same  affection.
   As a means of  preventing chapped nipples  it has been highly ex-
 tolled by M. Leon.4   He advises  every pregnant woman,  who has rea-
 son to fear this painful affection, to apply the following ointment, during
 the month preceding  delivery, over the nipple once a day, washing it
 previously with warm  water.  Should the ointment be  too irritant, the
 oil of roses may be left out, as  it is only employed to "aromatize" it.
   When  combined with  adhesive  plaster it preArents  the eczematous
 eruptions and vesications, apt to be produced in irritable  skins by the
 ordinary strapping, as employed in the treatment of wounds and ulcers.5
                Unguentum plumbi tannatis.
                     Ointment of  tannate of lead.
                 R.  Plumbi tannat. £j.
                     Cerat. 3j.
                     01. ros. gtt.  ij.  M.                       Leon.

  1 Edinb. Monthly Journ. of Med. Science, June, 1848, p. 886; and Obstetric Memoirs
and Contributions of James Y. Simpson, M. D., &c, &c, p. 98. Edinb.  1855.
  2 British Annals of Medicine, June 2, 1837; and Journ. de Chim. M.d., Mars, 1837.
  3 Griife und Walther's Journal  der  Chirurgie, B. xxiv. S. 676.  Berlin, 1836; and
Gazette M.dicale, Jan. 1837.
  * Gazette  Medicale, cited in Abeille M.dicale, 1 Octobre, 1848, p. 217.
  6 Herpin, in Med. Times and Gazette, April 7, 1855. 
584
POTASSiE CHLORAS.
                    CXLI.  POTAS'S^E CHLORAS.
 Synonymes. Kali Chloricum seu Oxychloricum seu Chlorinicum seu Oxymuriaticum
  seu Muriaticum Hyper-oxygenatum, Chloras Kalicus Depuratus seu Potassicus,
  Alcali Vegetabile Salito-dephlogisticatum, Chloruretum Potassae Oxidatum, Haloi-
  dum Oxygenatum, Murias Potassae Hyper-oxygenatum seu Oxygenatum, Oxygeno-
  ehloruretum Potassii, Potassae Euchloras, Chlorate of Potassa, Chlorate of Protox-
  ide of Potassium, Oxymuriate or Hyperoxymuriate of Potassa.
 French. Chlorate de Potasse.
 German. Chlorsaures Kali, Oxydirt oder Hyperoxygenirt Salzsaures
  Kali.
                       METHOD  OF PREPARING.
   In the chemical manufactories, chlorate of  potassa  is usually pre-
 pared 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 for medical use, should be purified by recrystallization.1
 It is to be observed, that when  the adequate quantity of chlorine gas
 is not employed in the preparation, the resulting  compound is analo-
 gous to chlorinated soda and chlorinated lime, and in action it  agrees
 rather with those preparations than with true chlorate of potassa.  This
 may tend to explain the discrepancy in the experience of different phy-
 sicians.
   Chlorate of potassa crystallizes in AA'hite leaA'es having the splendour
 of mother-of-pearl, or in  four or six-sided tables having a specific gra-
 vity of 1.989.   It is permanent in the air, and has a cool, saline, disa-
 greeable  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 potassium remains.  When beaten
 forcibly in a mortar, it crackles, and emits light and sparks.   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.2  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 liquefying or
resolvent  (fluidisirende) property is moderated, 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 de-
stroyed : the mode in which it is exerted, he thinks, is probably changed.
By  such a union, a medicine  has been  supposed to be  formed, which
acts chiefly on the nervous  system, and which is capable of mitigating
and perhaps of removing any morbid erethism therein, with hyperaesthe-
sia thereby induced.

  1 For various forms of preparation pee Pereira, Elements of  Materia Medica and The-
rapeutics, 3d Amer. edit. i. 484.  Philad.  1852.
  * Riecke, Die neuern Arzneimittel, S. 300, und 2te Auflage, S. 451.  Stuttgart, 1840. 
POTASSiE CHLORAS.
585
   Such is the opinion of certain- therapeutists.  Others  imagine, that
it is capable of purifying the mass of blood in consequence of the chlo-
rine it contains; but a salt of chloric acid is not possessed of the same
properties  as chlorine;  and, accordingly, Avhen the author has found
occasion to  administer  it, he  has never witnessed any  of the  effects
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.1  The saline poAvder, a formula for which
is given below, which was considered by Dr. Stevens to be so useful in
many febrile affections,  is affirmed  by Mr. Braithwaite2  to have been
very beneficial in typhous  cases, marked by dry, 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 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 function of  nutrition as
an excellent alterative, chlorate  of potassa has been  recommended in
chronic cutaneous diseases in general, as well as in hepatic and  syphi-
litic affections.  It has also  been occasionally administered in chronic
asthenia.
   Kohler3  employed it in several cases of  tubercular  phthisis, and
notwithstanding the general  results of his experiments were unfavour-
able, he thinks it ought to be admitted into the number of those
remedies that are  useful in phthisis, although  its stimulating 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 lungs, or  tendency to  haemoptysis.   Dr.  Chris-
tison4 states, that  he has tried the effects of seven-grain  doses three
times a day in phthisis, but could not observe  any physiological or
therapeutical action whatever.
   M. Sacquet5 has given it  in five  cases of acute rheumatism,  in the
quantity of  from 150 to 170 grains in the tAventy-four hours, and, at
times, more  largely.  The mean  duration of the disease, after the com-
mencement  of treatment, was twelve days.
   Sachs, in accordance with the views before mentioned in regard to
its antineuropathic properties, has advised it in cases of prosopalgia.
He affirms,  that, in a great many instances, it afforded essential  relief.
Chisholm  appears to have been one of the earliest to prescribe it in
neuralgia faciei; and, after him, Herber, and subsequently, B.  Schaf-
fer, Jos. Frank, Meyer, and others, employed it both as a curative and
palliative agent in that disease.  It has likewise been advised in obsti-
nate rheumatism of the nervous kind by Knod von Helmenstreit;  and
Eyr has extolled it in ulceration of the mouth after violent salivation.
   In cancrum oris and phagedcena  of the cheek, both  of which Dr.
Henry Hunt0 regards  as identical, varying only in the degree of se-
  1 See Stevens on the Blood, p. 296.  London, 1832;  and Pereira, Elements of Mat.
Med. and Therap. 3d Amer. edit. i.  486.   Philad. 1852.
  2 Retrospect of Practical Medicine and Surgery, July to December, 1840, p. 275.
  ' Rust's Magazin, B. xlvi.               * Dispensatory, p. 739.  Edinb.  1842.
  1 Rev. Med. Chir. de Paris, Aout, 1S54, and Brit, and For. Med. Chir. Rev. Oct. 1854,
p. 564.
  • Lond. Med. Gaz. April 7,1843, p. 76, and Medico-Chirurgical Transactions, xxvi. 142. 
586
POTASSiE CHLORAS.
 verity, and proceeding from a  cachectic condition of the system, he
 has found chlorate of potassa, freely given, folloAved by the best results,
 —the beneficial influence of  the  salt being generally apparent Avithin
 48 hours after its first administration; and  it seldom 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  age  of the child, in twelve hours.  It appears
 to have been employed successfully in the same affection in Romberg's
 Poliklinik, in  Berlin.  For children, some  years old, eighteen  grains
 were dissolved in three ounces of water, Avith half an ounce of syrup;
 and of this mixture a table-spoonful was given three times a day.   A
 few days were sufficient for the cure.1
   Dr. Watson2 affirms, that  he  has been in the  habit of directing a
 solution of chlorate  of potassa  in water (potass, chlor. 5j. aq. Oj.) as
 a drink for patients in scarlet fever, and in the typhoid forms of con-
 tinued fever;  a practice which was  suggested to him by Dr. Hunt,
 who informed Dr. Watson that he had long employed it with advantage.
 Under the use of  a pint  or a pint and a half of  the solution daily, he
 noticed, in many instances, a speedy improvement of the tongue, which,
 from being furred, or brown  or  dry, became cleaner  and  moist.   Dr.
 Scruggs,  of Germantown, Te.,3 extols it both as an internal remedy
 and a collutory in  the  erysipelatous  inflammation of the  mouth and
fauces, which occurs in the ' black tongue' of the Western States; and
 Mr. J. Allison4 speaks highly of it as an internal remedy in cases of
 mercurial salivation.   He cautions the practitioner, however, to watch
 its  effects;  for if  its exhibition, he  says, be  not  discontinued at  the
 proper time, a  state  of the system may be induced characterized by
 the phenomena of true  inflammation.
  It has been recently  used with much success in two  severe cases by
 Mr. Hutchinson, of the Metropolitan Free Hospital.5   In one case, in
 which the lips, cheek and gums became much swollen, the breath fetid,
 and there were large ulcerated surfaces on the inside  of both cheeks,
 fifteen grains of the chlorate were given thrice a  day in an ounce of
 water, no other treatment being adopted.  On the next day there was
 marked improvement;  on the third day all foetor had disappeared, and
 the ulcers were nearly  healed;  and  at  the  expiration of a week  the
 mouth was, in  every respect, perfectly well.   In the  second case,  the
 disease was of  a milder form, but the benefit was not less marked.
  Dr. J. H. Babington6 used  it  successfully in an epidemic ulcerative
 stomatitis, which occurred in the Coleraine Union Workhouse in 1849.
 The treatment consisted  of a  mild aperient, and the administration of
 the chlorate, dissolved in water, sweetened with syrup, in doses of four
 grains every fourth  hour; the mouth being  also  well washed with a
 weak solution of chlorinated soda. They all recovered in about six days.

  1 Mittheilungen  des badischen arzlichen Vereins.  Karlsruhe, Nr. 5, Marz 13, 1850;
 cited in Nordamerikanischer Monatsbericht fur Natur und Heilkunde, Dec. 1,1850, S.  216.
  2 Lectures on the Principles and Practice of Physic, 2d Amer. edit. p. 1024. Phila. 1845.
  3 Medical Examiner, for April, 1849.
  * London Med. Gaz., cited in  Amer. Journ. of the Med. Sciences, for Jan. 1847, p.  169.
  6 Medical Times and Gazette, Nov. 10, 1855.
  6 Dublin Quarterly Journal, Feb., 1853. 
POTASSiE CHLORAS.
587
  It is affirmed, that in the Middlesex Hospital a lotion of the chlorate
of potassa has been much and successfully used by Mr. Moore,1 and, at
his suggestion, by several of his colleagues, as a dressing to unhealthy
ulcers.  The strength has been from 5ij. to 5i>j- to the pint of water.
It is freely applied on lint.

                     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 quantity.   It may
be administered either in the form of powder or of solution.
  It would appear, as Dr. Pereira2 has  properly remarked, that most
of the uses of this salt have  been founded on certain views of chemical
pathology,  some of Avhich are now considered untenable.   It passes
through the kidneys  unchanged, and consequently 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,3 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 and Dublin Pharmacopoeias, and has been in-
troduced into the last edition of that of the United States, (1851.)
          Pulvis potassae chloratis  compositus.
    Compound powder of chlorate of potassa.—([Stevens's saline powder.)
                 R.  Potassa. chlorat. gr. viij.
                     Sodii chlorid. gr. xx.
                     Sodas bicarbonat. gr. xxx. M.
  One of  these to be given every tAvo or  three hours in  low febrile
cases.                                                    Stevens.
                  Liquor potassse  chloratis.
Solution of chlorate of potassa.—Solutio muriatispotassae oxygenati, Liquor
                          ad ulcera atonica.
                 R.  Potassa. chlorat. 3j.
                     Aqua, destillat. f 3xij. M.
  To be applied to indolent ulcers, by means  of lint, or of a  camel's
hair pencil, dipped in it, to excite the tissues.—Swedidur.4
                   Potus 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.                      Swedidur.
                 Mistura potassae  chloratis.
                    Mixture of chlorate of potassa.
                 R.  Potassae chlorat. sjiss.
                    Aquae destill. f 3*iv.
             Solve.
  Dose.—A  spoonful every two hours.           Von Helmenstreit.
  1 Med. Times and Gazette, and Med. Examiner, April, 1855, p. 249. „
  1 Elements of Mat. Med. and Therap. 3d Amer. edit. i. 486.  Philad. 1852.
  ' Dispensatory, p. 738.  Edinb. 1842.
  * Pharm. Med. Pract., Bruxelles, 1817, 2d edit. 
588                     POTASSII BROMIDUM.

  Eyr dissolves twenty-five grains of the chlorate in  four fluidounces
of distilled water, and administers a spoonful three times a day.
                 R.  Potass, chlorat. 3j.
                     Syrup. altha.a3 f 3*j.
                     Aquae destill. f 3*iv.  M.
  Dose.—A  table-spoonful four times a day.               Kohler.
                 CXLII. POTAS'SII BRO'MIDUM.
Synonymes.  Kalium Bromatum, Bromuretum Potassicum, Brometum  Kalii, Brome-
  tum seu Bromuretum Potassii, Bromide of Potassium.  In solution, Potassae Hy-
  drobromas, Kali Hydrobromieum, Bromhydras Potassae, Hydrobromate of Potassa.
French. Bromure de Potassium.
German. Bromkalium,  Kaliumbromid,   Kaliumbromur,  Bromwasser-
  stoffsaures oder  Hydrobromsaures Kali.

                      METHOD  OF PREPARING.
  According to Liebig,  this preparation can be readily made  by dis-
solving bromine in alcohol, and adding potassa until the spirit begins
to change colour, then evaporating and heating to redness.   In a former
London Pharmacopoeia,—and the process  of that of the United States
(1851) is essentially the same,—it is directed to be made by  adding first
an ounce of iron filings, and afterwards two ounces of bromine, to a pint
and a half of distilled water.  The mixture is set  aside for half an hour,
and frequently stirred with a spatula; a gentle  heat is  then applied,
and when a greenish colour is produced, two ounces and a dram of car-
bonate of potassa,  dissolved in a pint and a half of water,  are  poured
in.   What remains is filtered and washed with two pints  of boiling dis-
tilled water, and again filtered.   The mixed solutions are then evapo-
rated, that crystals may form.
  Liebig says it crystallizes in four-sided shining tables;  but according
to Ballard1 commonly in cubes, and at times in long rectangular paral-
lelopipedons.   It has a pungent taste  like  that  of  common salt, but
more  acrid; and is devoid of odour.  By heat, it crepitates, and melts
into a red-hot flux, without experiencing change.  It is  more  soluble
in hot than in cold water; producing, during its  solution, evident  cold,
and becoming converted into hydrobromate of potassa.  It is also solu-
ble 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 certainty and intensity.2  From  a dram and  a half to two
drams is needed to  kill a dog.   The  animal appears to suffer;  is  rest-
less,  and gradually  falls  into a state of  prostration.   In smaller  doses
it appears to act powerfully on the human  stomach.  The bromide, like

  1 Annales de Chimie, torn, xxxii.
  s Bouchardat, Annuaire de Th.rapeutique pour 1847, p. 237. Paris, 1847, and Ibid.
pour 1851, p. 217. 
POTASSII BROMIDUM.
589
bromine, seems first to have been applied to therapeutical purposes by
Pourche.1  Two cases of  scrofulous tumours are reported by him to
have been removed by friction with an ointment composed thereof, and
a cataplasm sprinkled with an aqueous solution.  In a third patient,
chronic otorrhoea 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.
   Magendie2 employed the preparations of bromine in scrofula, in ame-
norrhoea, 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 malignant tetter, and with good suc-
cess; and Dr. Williams3  in cases of enlarged spleen.   The last gentle-
man suggests, that it possesses unusual, if  not specific (?)  powers in
the cure of diseases of the spleen."  It was oAving to these results that
the bromide was introduced into the London Pharmacopoeia of 1836 ;4
but it has been left out of the last edition.   Dr. Williams also gaAre it
with success  in a case of  ascites.
   The Ioav price of the bromide compared with that  of the iodide of
potassium, induced M. Ricord to substitute it in the treatment of se-
condary syphilitic  affections.   He  gave it in the  same dose.   The
therapeutical effects  were found to be identical,  but induced more
slowly.  The results  of the experience of others  have, hoAvever, been
less satisfactory.  Dr. Egan,  from extensive observation, has  satisfied
himself,—first,  that the iodide of potassium exerts, in the majority of
instances  of secondary and tertiary  syphilis,  an instantaneous, de-
cided,  and always  beneficial action, contrasted Avith the bromide, the
effects of Avhich are slow, unsatisfactory, and frequently unsuccessful.
And, secondly,  that the iodide seems to act  favourably not only upon
the disease for  which it is prescribed, but  also  upon the constitution
in general, increasing the appetite and improving the powers of diges-
tion, thereby enabling the patient to gain flesh when under  its influ-
ence;  Avhilst the bromide not unfrequently produces nausea, impairs
the appetite, and  deranges the  digestive  organs;  and, lastly,  that
every form of secondary  and tertiary syphilis,  with  the  exception of
iritis, is amenable  to  the  action of the iodide, whilst  that of  the  bro-
mide is extremely  circumscribed.
   Similar vieAvs to  those  of Dr. Egan are maintained by Drs. Staple-
ton and Greoghegan.5
   By M. Huette6 it has been recommended as an antaphrodisiac, inpria-
pism, nymphomania,  and spermatorrhoea.   He affirms, too, that it exerts
an extremely curious local anaesthetic action, producing from the second

,  1 Journ. de Chimie M.dicale,  iv. 594.  Also, Bulletin General de Therapeutique, No.
14, 30 Juillet, 1837.
  2 Formulaire,  ed. cit.                          s Elements of Medicine, i. 338.
  1 Pereira, Elements of Mat. Med. and Therap. 3rd Amer. edit. i. 497. Philad.  1852,
and Brande's Diet, of Mat. Med. p. 126. Lond.  1839.
  4 Dublin Medical Press, May 19, 1847; Amer. Journal  of the Med. Sciences,  July,
1847, p. 206.
  • Gaz. Med. de Paris, xxiii., and Wahu, Annuaire de Med. et de Chir. pour 1851, p. 53. 
590
POTASSII CYANURETUM.
day of its administration, so  complete a state of insensibility of  the
fauces, that the posterior part of the pharynx may be touched, and
the  uvula titillated without nausea or vomiting being excited.   M.
Thielmann1 has, likewise, recommended it as an excellent  remedy in
satyriasis, in the frequent and painful erections during gonorrhoea, in
spermatorrhoea, and in nymphomania.  He gives it  in doses of from
tA\'0  to  three grains every tvyo or three hours;  at  the same time en-
joining a mixed vegetable and milk diet, and forbidding all acid sub-
stances;  and Prof. Trousseau2 esteems it to be of  certain and effica-
cious action.
                     MODE  OF  ADMINISTRATION.
                   Liquor potassii  bromidi.
                   Solution of bromide of potassium.
                 R.  Potassii bromidi gr. vi.—viij.—x.
                     Aquae lactuca. f 3~iij.
                     Syrup altha.a3 f %'\.  M.
  To be given in the course of twenty-four hours, in table-spoonfuls.
                                                       Magendie.
                Unguentum potassii bromidi.
                   Ointment of bromide of potassium.
                 R.  Potass, bromid. gr. xxxiv.
                     Adipis |j.  M.
  From half a dram to a dram to be rubbed on scrofulous swellings.
                                                       Magendie.
  M. Pourche employs 5j- of  the bromide to the ounce of lard.

        Unguentum potassii  bromidi  compositum.
              Compound ointment of bromide of potassium.
                 R.  Brominii gr. vi. ad xij.
                     Potassii bromid. gr. xxiv.
                     Adipis. gj.  M.                      Magendie.
                CXLIII. POTAS'SII CYANURETUM.
Synonymes. Potassii Cyanidum, Kali Hydrocyanicum seu Cyanogenatum seu Cyana-
  tum seu Borussicum, Kalium Cyanogenatum, Cyanuretum seu Cyanidum Potassi-
  cum  seu  Kalii, Cyanidum seu Cyanetum Kalii. Hydrocyanas seu Cyanhydras
  Potassa. seu Kalicus, Cyanide or Cyanuret of Potassium.
French. Cyanure de Potassium.
German. Cyankalium,  Blaustoffkalium, Kaliumcyanur, Kaliumcyanid,
  Hydrocyansaures Kali,  Cyanwasserstoffsaures Kali,  Blausaures
  Kali.
  This preparation was proposed by MM. Robiquet and Villerme,3 as
a substitute for hydrocyanic acid; than which it is, in their opinion*
far more certain in its effects.

  1 Med. Zeit. Russl. i. 1854, and Amer. Journ. of the Med. Sciences, April, 1855, p. 511.
  2 Journ. de M.d. et  de  Chirurg. Pratiq. Dec. 1854, and Monthly Journ. of  Medical
Science,  Mar. 1855.
  s Bulletin de la Societe Medicale d'Emulation, Juillet, 1823.  Also, James Hamilton
and Thos. G. Mackenzie, in Maryland Med. and Surg. Journ., April, 1840, p. 201. 
POTASSII CYANURETUM.
591
                      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 com-
monly prepared after  the process  of Robiquet, by exposing to long
continued heat the ferrocyanuret of potassium.  The cyanuret of iron is
completely decomposed, and that of potassium remains.  The residuum,
after this strong  calcination, constitutes 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 po-
tassium dissolves, and  is  transformed into  hydrocyanate of potassa.
When  the  process has been well conducted, the solution is perfectly
colourless, and retains no portion of iron.
  M. Chevallier1  prepares the salt by calcining the ferrocyanuret of po-
tassium, 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,2 recommend the
following process as most convenient and simple:—Expose—say—four
ounces of the dried ferrocyanuret of  potassium in a  common Hessian
crucible to a red heat, until nitrogen ceases to pass over;  (this generally
takes from  one and a half to two hours;) then, breaking the crucible,
powder the black mass quickly, and add—say—sixteen fluidounces of
alcohol, stirring the mixture repeatedly until it acquires the temperature
of about 150° Fahr.; then filter, and evaporate by a sand or water bath,
regulated so as to be below the boiling point of alcohol; for if heated
above this temperature, oil of  wine is formed, which is  gradually de-
composed during  the process,  and carbon is deposited, Avhich 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 Pharma-
copoeia of the  United  States.   Take  of ferrocyanuret of potassium,
dried,  Sviij.;  carbonate  of potassa, dried,  5iij«   Mix  the salts in-
timately, and  throw the mixture  into a deep iron crucible, previously
heated to redness;  maintain the  temperature till effervescence ceases,
and  the  fused mass concretes, of  a  pure white colour, upon a warm
glass rod dipped into it; then pour  out the  liquid carefully into a shal-
low dish to solidify, stopping  before  the salt becomes contaminated
with the precipitated iron.  Break up the mass Avhile  yet warm, and
preserve it  in  well stopped bottles.
  Cyanuret of potassium, thus  prepared, is in white opaque, amorphous
masses;  having a sharp,  somewhat alkaline, bitter almond taste, and
an alkaline  reaction.  It is  deliquescent;  very soluble  in water, and
sparingly so in alcohol.3
  All acids decompose it, even the carbonic: hence the solution, when

  1 Journ.  de Chimie  Medicale, and Journ. of Philad. College of Pharmacy, 1832.
  2 Op. cit. p. 203.
  3 The Pharmacopoeia of the United States of America, p. 200, Philad. 1851.
*> 
592
POTASSII CYANURETUM.
exposed to the air, emits the smell of hydrocyanic acid; and carbonate
of potassa is formed, in the place of the hydrocyanate of potassa.

                    EFFECTS  ON THE ECONOMY.
   MM. Robiquet and Yillerme performed some experiments on animals
in the  presence of Magendie.1  A tenth of a grain destroyed a male
linnet in a minute; less than a grain killed a guinea-pig in two or three
minutes: a small drop of the hydrocyanate of potassa, containing only
the hundredth part of a grain of the cyanuret  in solution, caused a
linnet to drop down dead in half a minute.   Half a dram, containing
five grains of the cyanuret, killed 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.2  Dr. Letheby3 states, as the result of his experiments on ani-
mals, 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 dis-
solved in eight times its weight of distilled water, when it becomes
transformed into hydrocyanate of potassa.   To this solution he gives
the name medicinal hydrocyanate of potassa, and advises that it should
be taken under the same circumstances,  and in  the same doses, as the
medicinal hydrocyanic acid, (see pages 44 and 53.)   He farther sug-
gests, that to render  it wholly independent of the action of  the small
portion of alkali contained in the cyanuret, a few drops of some vege-
table 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, gradually
increased to  a grain  and more.  M. Bally gave  it to  fifty-two indivi-
duals labouring  under different diseases:  it produced  no  effect  on
thirty-five; and, on the others, the result was neither constant nor sa-
lutary, so that he is not inclined to  place more reliance  upon the cy-
anuret than upon hydrocyanic acid.
   By M. Lombard,4  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 Avatery solution  is in the strength of  from  one to four  grains to
the ounce of  water; and the ointment is composed of from two to four
grains of the cyanuret to an  ounce of lard.   The aqueous solution,
however, is considered by Dr. Lombard to be the most prompt  in its
effects.   He  regards  the cyanuret to be contraindicated where the ner-
vous affection is complicated 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 with acute pains,
poultices, moistened with the solution, gave great relief.   Dr. Lombard,
indeed, affirms, that the soothing properties of the cyanuret are supe-
rior 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.
   1 Formulaire  pour la Preparation, &c, de plusieurs Nouveaux Mcdicamens, &c.
   1 See Christison on Poisons, first Amer edit. p. 593.   Philad. 1845.
   1 London Medical Gazette, Jan. 9,  and Feb. 4 and 17,  1845.
   * Gazette des Hopitaux, and Lond. Med. Gaz., Sept. 1831. 
POTASSII CYANURETUM.
593
  In a case of acute rheumatism attacking the articulations of a chlo-
rotic young female, M. Malherbe,1 after leeching, applied compresses
over the joints affected, moistened with a solution of the cyanuret—ten
grains to the ounce  of distilled water.  In forty-eight hours,  the pain
ceased.    It  is probable, however, that  much of the good effect was
owing to  the  compression.  MM. Trousseau  and Rullier2 also recom-
mend the cyanuret, in the proportion of four grains to an ounce of wa-
ter, as a local application in various forms  of neuralgia.   In the  quan-
tity of nine grains to eight ounces of water, it is employed by M. Caze-
nave,3 as a lotion in pruritus ani et vulvae, and in the form of oint-
ment, associated Avith chloroform, in hemicrania and facial neuralgia.4
   M. Andral5 employed it with  complete  success in a case of intense
cephalalgia,  which, for ten months, had resisted the most powerful re-
medies, as bleeding, a seton in the neck,  blisters and  sinapisms.   It
was given 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. Guthrie6 states, that a solution of the cyanuret, (potass.
 cyanur. gr. vj.;  aqu&e f gj.,)  applied by drops,  every other day, is an
 admirable remedy.  It is also equally effective in removing  the stain
 made by iodine on  the skin.

                      MODE OF  ADMINISTRATION.

                  Mistura  potassii  cyanureti.
   Mixture of cyanuret of potassium.—Mixture of hydrocyanate of potassa.
                      (Pectoral mixture of Magendie.)
                  R.  Potass, hydrocyan. med. f^i.
                      Aqua, destillat. Oj.
                      Sacchar. 3*iss. M.
    Dose.—About five drams (a table-spoonful,) night and morning.

                             (Pectoral potion.)
                  R.  Potass, hydrocyan. med. gtt. xv.
                      Infus. heder. terrestr. f 3*ij.
                      Syrup, alth33.3 f^j.  M.
    Dose.—Five grammes (a tea-spoonful,) every three hours.
                                                         Magendie.
                  R.  Potass, cyanur. gr. J.
                      Syrup, alth-3.3 f 3J.
                       Aquas lactucae f 3ij.  M.
    Dose.—Five drams  (a table-spoonful,) every two hours.
                                                          Magendie.

   1 Journal des Connaissances Medico-Chirurgicales.
   2 Lond.  Med. and Surg. Journ. Dec.  15, 1832 ; cited in Amer. Journal of the Medical
  Sciences, May, 1833, p. 238.
   s Ranking's Half-Yearly Abstract, July to Dec. 1846, p. 198.
   * Bouchardat, Annuaire de Therap. pour 1853, p. 94.
   6 Gazette Medicale, Jan. 1832.
   6 Cited in Amer. Journ. of the Med.  Sciences, Oct. 1844, p. 517.
         38 
 594                    POTASSII CYANURETUM.

                  R.  Tinct. castor.
                      Moschi,
                      Potassse nitrat. aa. gr. iv.
                      Potassii cyanuret. gr. ij.
                      Aqua3 flor. tilise seu
                      ----cinnamon, f 3*viij.
   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 OL
   This syrup must be  added to pectoral draughts,  and may be substi-
 tuted for other syrups, in appropriate cases.

                  Pilulae potassii cyanureti.
                     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.1

                   Lotio potassii cyanureti.
                   Lotion of cyanuret of potassium.
                 R.  Potass,  cyanuret. gr. xij.
                     Mist, amygdal. f 3"vj.   M.

   To be  used in  lichen, and other chronic  eruptions  attended with
 much itching.                                              Louis.
                 R.  Potass,  cyanuret. gr. vj.
             Solve in
                     Aqu_3 destillat. f 3*j.  M.

   Compresses to be wetted with it, and  applied in  cases of neuralgia
faciei, hemicrania, &c.           Recamier, Trousseau, Blouquier."
2
            Unguentum potassii cyanureti.
                Ointment of cyanuret of potassium.
              R.  Potass, cyanur. gr. ij.—iv.
                  Adipis 3"i.  M.

The size of a hazelnut to be rubbed in, in cases of neuralgia.
                                                     Lombard.

   Unguentum  potassii cyanureti et  chloroformi.

         Ointment  of cyanuret of potassium and chloroform.
              R.  Potass, cyanur. part. x.
                  Chloroform, part xij.
                  . Adipis part lx.  M.

To be applied in hemicrania and facial neuralgia.
                                        Cazenave, of Bordeaux.

     1 Ryan's Formulary, 3d edit. p. 392.  Lond.  1839.
     2 Lincke, Vollst'andiges Recept-Taschenbuch, ii. 91.  Leipz. 1841. 
                   POTASSII HYDRARGYRO-IODIDUM.               595


          CXLIV.  POTAS'SII  HYDRAR'GYRO-IO' DIDUM.
Syxoxymes. Potassii lodo-Hydrargyras, Hydrargyrum Biiodatum cum Kalio lodato,
  Kali Iodatum Hydrargyratum, Kalium Hydriodatum Hydrargyratum, Iodo-Hy-
  drargyrate of Potassium, Iodhydrargyrate of Ioduret of Potassium, Hydrargyro-
  iodide of Potassium,  Hydrargyro-biniodide of Potassium, Dihydrargyro-biniodide of
  Potassium.
French. Iodhydrargyrate de Potassium.
German.  Quecksilberiodidkalium.
  Dr. A. Channing,1 who has highly extolled this preparation in various
diseases, affirms, that this, with other new salts, was discovered by Bons-
dorff, of the University of Finland, in  1826; and it is a fact well known
to the chemist, that iodine, chlorine, &c, enter into combinations so as
to form both  acids and bases.  By experiment, Dr. Channing ascer-
tained,  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  combi-
nation 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 administration, 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 potassium with eleven  grains
of the iodide of mercury, may be used as containing twenty grains of
the hydrargyro-iodide  of potassium.
  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 excess of iodide of mercury;
for the saturated solution of eight  grains of  iodide of potassium will
dissolve, and enter  into combination with, more than thirteen grains of
iodide of mercury, forming  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 equivalent of
bichloride or of pernitrate of mercury in a solution of  four equivalents
of iodide of potassium, evaporating to dryness, and  dissolving 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, which may be detected by its  insolubility in strong al-
cohol.2
                     EFFECTS  ON  THE  ECONOMY.
  These are similar to those of the iodides of mercury, but, according
to Dr. Channing, in a  less degree.   The hydrargyro-iodide is not, how-
ever, much employed,  experience  seeming  to have shown, that it pos-
sesses no essential,  if, indeed, any advantages over those preparations.
It has been highly  extolled by Dr. Charles C. Hildreth,3 of Zanesville,
Ohio, in several diseases in which a combination of iodine and mercury

       1 American Journal of the Medical Sciences, Feb, 1834, p.  388.
       - Ambrose Smith, American Journal of Pharmacy, Jan. 1841, p. 271.
       3 American Journal of the Medical Sciences, Aug. 1840, p. 314. 
596
POTASSII HYDRARGYRO-IODIDUM.
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
enlargement of the spleen,  amenorrhoea, dysmenorrhoea, leucorrhcea,
dropsy, and glandular enlargements of  a  scrofulous  character.  In
these last cases, he  combines the internal use with the  external, ac-
cording to the form of  ointment given below.
   Puche1 has recommended  it as not being so subject  to produce sali-
vation  or pains in the bones, as the other combinations of mercury and
iodine.
                     MODE OF  ADMINISTRATION.

            Mistura  potassii hydrargyro-iodidi.
               Mixture of hydrargyro-iodide of potassium.
                 R.  Hydrarg. iodid. rubr. gr. iv.
                     Potassii iodid. ^ j.
                     Aquas destillat. f3j.  M.
   Dose.—Five drops, three times a day.                Channing.
                 R.  Hydrargyri iodid. rubr.
                     Potassii iodid. aa. gr. iv.
                     Aqu.3 f 3L   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.2
                 R.  Hydrarg. iodid. rubr. gr. viij.
                     Potassii iodid. gr. viij.
                     Aquas destillat. f 3*viij.  M.
   Dose.—f 5ij« to f Sij- in twenty-four hours.               Puche.
           Tinctura  potassii hydrargyro-iodidi.
               Tincture of hydrargyro-iodide of potassium.
                 R.  Potass, hydrargyro-iodid. gr. j.
                     Alcohol, dilut. f 3"j.  M.
   Dose.—Ten drops, three times a day.                 Channing.

             Pilulse 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 pilulas 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. Qij.
                     Adipis 3*j.
   To be applied to tumours, two or three times a day.  Should it
prove too irritating, the proportion of lard must be increased.
                                                        Hildreih.
  1 Journal des Connaissances  Medicales, Oct., Nov. 1838, Janvier, 1839; and Annales
de Chimie, Oct. 1838.
  2 Ambrose Smith, American Journal of Pharmacy, Jan. 1841, p. 270. 
POTASSII IODIDUM.
597
                   CXLV. POTAS'SII IO'DIDUM.
Synonymes. Kalium Iodatum, Iodidum Kalii, Kali Hydroiodinicum, K. Hydroiodi-
  cum, Hydroiodas  Kalicus  seu Lixiviae, loduretum Potassicum, Iodhydras Kalicus
  seu Potassa', Potassii loduretum, Iodide or Ioduret of Potassium.  In solution—
  Potass* Hydriodas, Potassii Proto-hydriodas seu Protoxidi Hydriodas, Hydroiodas
  Kalicus seu Lixiviae, Iodhydras Kalicus seu Potassre, Hydriodate of Potassa.
French. Hydriodate de Potasse, Iodure de Potassium.
German.  Iodkalium, Iodwasserstoffsaures  Kali, Kaliumiodur,  Iodin-
  wasserstoff Kali, Hydriodsaures  oder  Hydriodinsaures Kali, Ka-
  lihydroiodat.
                      METHOD  OF PREPARING.
   The process of Dr. Turner is, to take any  quantity of  solution of
caustic potassa, and  to  add to  it gradually, at a gentle heat, iodine
sufficient to neutralize the alkali; then  evaporating to dryness, calci-
ning strongly, dissolving in  water, and  crystallizing.   Dr.  William
Gregory1 suggested an  improvement  on this process, which has been
regarded as one of the simplest.2  He adds iodine to a hot solution of
potassa until the fluid assumes a yellowish-brown colour; then evapo-
rates, 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,—shaking the vessel
each time.  The  liquor is then  heated  until it loses its  colour, is fil-
tered, and the substance on  the filter is washed with boiling water,
until the liquid is tasteless; the liquor and the various liquids used in
the washings,  are united, and  the  whole is  heated  in a  sand bath.
When the temperature approaches that of ebullition, enough of a solu-
tion 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 completely exhausted.   All the  liquors are then
united, tested by reddened litmus paper, and if there be any excess of
base, a little hydriodic acid is added.   It is then evaporated in a sand
bath, until  a slight  pellicle forms;  the fire is  now discontinued, and
the salt is suffered to crystallize.   Lastly, the crystals are washed with
a little water, and dried.3
   The following  formula has  been introduced into  the last edition of
the Pharmacopoeia of the United  States.  Take of potassa, gvj.; iodine
in powder,  Sxvj.; charcoal, in fine  powder, gij.; boiling water Oiij.
Dissolve the potassa in  the  water; add  the  iodine  gradually,  stirring
after each addition until the solution becomes colourless,  and continue
the additions until the liquid  remains slightly coloured from excess of
iodine.   Evaporate the  solution to dryness, stirring in  the charcoal
towards the close, so  that it may be intimately mixed with the dried

  1 Edinb. Med. and Surg. Journ. xxxvi. 369, for Oct. 1831.
  1 Cogswell on Iodine, p. 85.
  1 Jourdan's Pharmacop.e Universelle, i. 662.  Taris, 1828;  also the London Phar-
macopoeia, and Brande's Dictionary of Materia Medica, p. 317.   Lond. 1839.   This is
essentially the process of the Pharmacopoeia of the United States (1842.) 
598
POTASSII IODIDUM.
salt.  Rub this to powder, and heat it  to dull redness in an iron cru-
cible, maintaining that temperature for fifteen minutes; then, after it
has cooled, dissolve  out the saline  matter Avith pure water, filter the
solution, evaporate,  and set aside to crystallize.  An additional quan-
tity of crystals may be obtained from the residual liquid by evapora-
ting, and crystallizing as before.
   Iodide of potassium is in white or transparent crystals.   These are
readily fused, and are volatilized at a red heat.   They do not decom-
pose, 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 potassium
with carbonate of potassa is exceedingly common, as it can with diffi-
culty be  avoided  in  the manufacture of the salt;  but Dr. Christison1
affirms, that he has  examined specimens, where the carbonate, Avith 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 administered?"  It is sometimes adulterated,
too, with nitrate of potassa, and the chlorides of potassium and sodium.2

                     EFFECTS  ON THE ECONOMY.
   As respects the action of iodide of potassium, and its administration
in disease, it is scarcely necessary to do more than refer to what has
been said under the head of iodine.   On the whole, its effects appear
to accord with  those of iodine; at least  no difference 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.3  For ex-
ternal 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  formulae contain  both one  and  the  other.  As re-
marked  under  iodine, it is now administered in very large doses in a
multitude of diseases 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 Sss., 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
  1 Edinb.  Med. and  Surg.  Journal, April, 1838; and Dispensatory, p. 253.  Edinb.
1842; also, Pereira, Elements of Mat. Med. and Therap. 3d edit. i. 489.  Lond. 1852;
or 2d Amer. edit, by Carson.  Philad. 1846.
  2 Report of the Committee on adulterated drugs, Dr. Huston, chairman, in Transac-
tions of the Amer. Med.  Assoc, iii., 291.  Philad. 1850.
  * Riecke, Die neuern Arzneimittel, u. s. w. S. 306.  Also, Cogswell on Iodine, p. 96, 
POTASSII IODIDUM.
599
found  deeply  impregnated with  iodine.1   On the  other hand,  Dr.
Lawrie, of Glasgow,2 considers it very uncertain, and at times dange-
rous, although he  esteems it  by far the best of the  recent remedies,
and prescribes it more frequently than any other medicine;  and  Mr.
Mayo3 affirms that no medicine, where it does good, produces amend-
ment, in constitutional  syphilis, so  speedily as it.   Lugol and  others
appear to have used it  mainly as  a solvent to iodine, and Lugol  con-
siders it inferior to the latter as a  therapeutical agent; but no chemical
or other prepossession can set aside the testimony just cited; or  that
of such observers as  Ricord,4 C. J. B. Williams,5 Joy, and  a host of
others.   In the author's hands, it  has appeared to afford as much bene-
fit as any of the preparations of  iodine, and  M. Dorvault5 regards it
as embodying  all the excellencies of iodine without  its defects.  For
the testimony in regard to its beneficial and injurious effects, see Io-
dine, page 449.
   M. Melsens7 found that it could be  taken in large quantities without
any ill effects.   He himself took daily, for two  months, a dose vary-
ing from 5ss. to  3iss without  pain or  disorder of any kind.   The salt
was found to pass rapidly, and almost exclusively, through the  kidneys.
   According to the experiments of  Magendie,8 iodide of potassium is
one of the substances that promote  the coagulation of the blood.

                     MODE OF ADMINISTRATION.

                    Liquor potassii iodidi.
                    Solution of iodide  of potassium.
        Potio resolvens ex Iodio; Solution de Coindet;  Coindet'_ Solution.
                 R.  Potassii iodidi  gr. xxxvj.
                      Aquee destillat. f 3*j.  Solve.

   Dose.—The same as that of the tincture of  iodine.
                                            Coindet and Magendie.
                 R.  Potassii iodidi £j.
                      Aquas destillat. f 3*j.  Solve.
   Hose.—Fifteen drops three  times  a day, gradually increased  to forty-
five, in cases of  ovarian dropsy,—frictions with iodine ointment being
used at the same time.                                    Elliotson.

  1 London Medical Gazette, July 2,  1836.
  * Ibid. July 3, 1840,  p. 591.
  8 A Treatise on Syphilis, by Herbert Mayo, F. R. S.  Lond. 1840.
  4 Practical Treatise on Venereal Diseases, translated by Drummond, Amer. edit. Philad.
1843.  Parker, Modern Treatment of Syphilitic Diseases, Amer. Med. Lib. edit. p. 77,
Philad. 1840; and Bulletin General de Therap. Juillet, 1840.
  5 Lectures on the Physiology and Diseases of the Chest, Bell's Medical Library edit.
p. 246.  Philad. 1839.
  6 Iodognosie ou Monographie  Chimique M.dicale et Pharmaceutique des Iodiques en
general, et en particulier de I'lode et de I'lodide de Potassium.  Paris, 1850; cited in
Brit, and Foreign Med. Review, Jan. 1851, p. 92.
  T Brit, and Foreign Med. Chir. Jan. 9 and  April, 1853.
  s Lecons sur le Sang; and translation in Lancet, for Jan. 26, 1839, p. 636. 
600
POTASSII IODIDUM.
             Liquor potassii iodidi  compositus.
               Compound solution of iodide of potassium.
                           (ImgoVs Solution.)
                 R.  Iodin. 9j.
                     Potassii iodid. 9ij.
                     Aq. destillat. f 3*vij.   Solve.
  Dr. Bache1 remarks, that "in the original it is seven ounces, but from
the context of the author, this is evidently a misprint for seven drams."
It is  proper, however, to observe, that many of the  successful  cases
were treated by the weaker solution, six drams of which contain only
^ 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.         Lugol.
  Lugol has a solution of three strengths for internal use :
                                 I.          II.        III.
          R.  Iodin.             gr. f.       gr. i.      gr. IJ.
              Potass, iodid.      gr. iss.      gr. ii.       gr. iiss.
              Aq. destillat.      f^viij.      f ^viij.     f^viij.
  Dose.—Two-thirds daily, at first;  afterwards, the whole.
  Lugol recommends this three-fold 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 hos-
pitals but one  solution, which might be  prescribed in varied  doses.
                  R.   Iodin. gr. v.
                      Potass, iodid. gr. x.
                      Aquaa destillat. f 3*xx.  M.
   Dose.—f 3y. to f $vj.                  London Pharmacopoeia.

                  Liquor iodinii compositus.
                      Compound solution of iodine.
                            (LugoVs Solution.)
                  R.   Iodin. £vj.
                      Potass, iodid. 3*iss.
                      Aqu_3 destillat. Oj.
    Dissolve the iodine and iodide of potassium in the water.
   Dose.—Ten to twenty drops, three times a day.
                                             Pharm.  United States.
                  R.  Potassii iodid.
                      Iodin. aa. gr. 78. (5 gram.)
                      Alcohol, at 90° C. ^xiij. (50 gr.)
                      Aquas destillat. 3"iij.  (100 gr.)
    Rub the iodine and iodide of potassium  in  a mortar with a little  of the water.
 Add the alcohol  and the remainder of the water.
   This has been proposed as a substitute for the  mixture  of tincture
 of iodine and  water, used by M. Velpeau, with  so  much success, in the
 surgical treatment of dropsies.2                          Guibourt.
   The compound solutions are much preferred to the simple iodine, or

   1 Dispensatory of the United States, 4th edit. p.  374.  Philad. 1839.
   2 Bouchardat, Annuaire de Therapeutique pour 1847, p. 244.  Paris, 1847. 
POTASSII IODIDUM.
601
iodide of potassium by many,  and especially by Mr. Lloydx of St. Bar-
tholomew's Hospital, London.

                 Tinctura  iodinii composita.
                     Compound tincture of iodine.
                 R.  Iodin. 3J.
                     Potass, iodid. 3*ij.
                     Alcohol.  Oij.  M.
   Dose.—Ten minims.                      Lond. Pharmacopoeia.

   The Pharmacopoeia of the United States adopts the same quantities;
but the pint Imperial measure contains about one-fourth more than the
pharmacopoeial pint of the United States.
                            (Iodine paint.)
                 R.  Iodin. gr. lxiv.
                     Potass, iodid. gr. xxx.
                     Alcohol, f gj.  M.
   Applied in  rheumatic affections of the joints, by painting the parts
freely with a  camel's hair pencil.          King's College Hospital.

   The iodine  paint has been  advised as a  counter-irritant in all forms
of chronic inflammation, and it has  been supposed, that the  reason
why it appears so superior to other applications is to  be found in the
fact, that the iodine is capable of being absorbed, and may thus act bene-'
ficially in two modes.2
            Mistura  potassii  iodidi composita.
               Compound mixture of iodide of potassium.
                 R. Iodin. gr. ss.
                     Potass, iodid. ^ss.
                     Syrup, papav. f 3*ss.
                     Aq. destillat. Oss.
   Dose.—Two table-spoonfuls, three times a day, in cases of complica-
tion of syphilis with scrofula.                              Tyrrel.
                 R. Iodin. gr. iss.
                      Potassii  iodid. gr. iij.
              Solve in
                      Aquae menth. pip. f 3*iv.
   Dose.—A spoonful two or  three times  a  day;—to children, a  tea-
spoonful.  In cases of cancrum oris; also,  in  dropsy, gleet, and  leu-
corrhcea.   On renewing the prescription, the dose of the iodine may
be increased  one-half,  and of the  iodide one grain, each time.
                                             Coster and Freidrich.
                 R. Potass, iodid. giv.
                      Syrup, althaeas f 3"j.
                      ----menth. pip. f-jij.
                      Aquae lactucae f 3*viij.
   Dose.—A spoonful, morning and evening,  in a little water,  increasing
the dose to two spoonfuls.  In cases of hypertrophy of the ventricles
of the heart.                                            Magendie.
                  R.  Potass, iodid. giv.
                      Tinct. digit, f 3j- ad f £ij.
                      Syr. althaeas f 3*iss.
                      Aq. lactuc. f 3viij.
                      — flor. naph. f ^ij. M.

   1 Lond. Med. Gaz. Jan. 6,  1853.        2 Med.  Times and Gazette, April 8, 1854. 
602                     POTASSII IODIDUM.

   Dose.—Morning and evening, a spoonful in a little water.  In hy-
pertrophy of the ventricles of the heart with quickening of the heart's
action.                                                  Magendie.
                 R. Quassiae,
                     Gentian, aa. gj.
                     Aquae bullient. f 3*xvj.
               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.
                     Pilulse  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. s.
              Fiant pilulae clxxx.

Dose.—Six, two or three times a day, in scrofula, goitre, &c.
                                                             Vogt.
               Unguentum  iodinii compositum.
           Compound ointment of iodine.—Ioduretted ointment.
                 R. Iodin. gss.
                     Potass, iodid. gj.
                     Alcohol, f 3j.
                    _ Adipis 3"ij.
    Rub the iodine and iodide with the alcohol, and mix with the lard.
                                  Pharm. Lond. and United States.

                 Unguentum  potassii  iodidi.
                     Ointment of iodide of potassium.
                 R. Potass, iodid. gss.
                     Adipis 3*iss.   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 in-
ternal use of iodine in some form.                       Magendie.

                 R. Potass, iodid. J}j.
                      Adipis 3*ss.  M.
   The  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  5j-  to 3iss. 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. 3*j. 
                        POTASSII IODIDUM.                     603

  Or,
                 R.  Potass, iodid.
                    Sodae carbon, depur. sice. aa. gss.
                    Ung. rosat. 31 v. 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,1  of  Edinburgh, having found  it impracti-
cable to make a neat ointment of  iodide of potassium by the ordinary
method, have recommended the following.  Dissolve the requisite quan-
tity of the iodide in  its own weight of  distilled or some perfumed
water, and then mix thoroughly in a mortar with the proper quantity
of lard.  The two will incorporate perfectly with a very little heating,
and form a smooth ointment.

                 R.  Potass, iodid. gss.
                    Ext. opii ^ss.
                    Curat,  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. J}iv.
                    Adipis 3*ij.  M.
  In scrofulous  ophthalmia,  ulcers, fyc.                    Lugol.

                 R.  Iodin. gr. xv.
                    Potass, iodid. gj.
                    Tinct. opii f gij.
                    Adipis 3"ij.   M.

  In painful scrofulous  ulcers, white swellings, Sec.        Lugol.

          Unguentum potassii  iodidi et  hydrargyri.

             Ointment of iodide of potassium and mercury.
                 R.  Potassii iodid. gr. xij.—xv.
                    Ung. hydrarg. ciner. 3*ss.  M.
  In herpes exedens.                                     Blasius.

          Unguentum potassii iodidi anodynum.
  Anodyne ointment of iodide of potassium.—(Pommade iodee calmante.)
                 R.  Potass, iodid. gr. xv.
                    Morphiae  muriat. gss.
                    Adipis gx.   M.
  Applied to painful tumours of the mammae, night and morning.
                                                        Chomel.

        Emplastrum  potassii iodidi  compositum.

               Compound plaster of iodide of potassium.
                 R.  Iodin.
                    Potass, iodid. aa. 9ss ad 9j.
                    Emplastr. hydrarg. seu
                    -------saponis. gij.   M.
  Applied in syphilitic and gouty swellings of the bones.   Ebers.

     1 London and Edinburgh Monthly Journal of Medical Science, Oct., 1841. 
604
POTASSII IODIDUM.
                Linimentum potassii iodidi.

         Liniment of iodide of potassium.—(Baume hydriodate.)

                 R.  Potassii iodid. gj.
                     Alcohol. (20°) f 3* iv.  M.

                 R.  Sapon. ex oleo animal, confect. giss.
                     Alcohol. (20°) fgiv.  M.

  Mix these two solutions together;  aromatize Avith a small quantity
of oil of lavender,  and before the mixture congeals pour it  into wide-
mouthed vials.1  This liniment has been much used at Lausanne under
the name Gelee pour le goitre.

                      L\niment conire les engelures.
                 R.  Potassii iodid. gj.
                     Tinct. camphorae
                     Yin. cinchon. aa. f gij.
                     Tinct. opii fgj.  M.

  This liniment is applied, night  and morning, by means of a com-
press,  over chilblains that are not ulcerated.               Marcel.2

              Lotio  potassii  iodidi composita.
                Compound lotion of iodide of potassium.
                 R.  Iodin. gr. i. ad ij.
                     Potassii iodid. gr. ij. ad gr. iv.
              Solve in
                     Aquae destillat. f 3viij.

  This solution was commonly used by Lugol externally, injected under
the eyelids in strumous ophthalmia, fistulce, &c.             Lugol.

                 R.  Iodin. gss.
                     Potassii iodidi gj.
              Solve in
                     Aq. destillat. gvj.

  This "rubefacient solution of iodine," may be used two  or  three
times a week, when the last prescription loses its effect, or when it  is
desirable to stimulate more actively. It is also added to baths—three
or  four  ounces to an  ordinary bath—as  well as to  poultices, being
mixed with 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 employs it chiefly
when  the skin on the edges of ulcers  is greatly hypertrophied, red,
and fungous, as well as in phagedenic ox spreading tetters.   It may be
applied  two  or three times a week, or daily, should the case require it.
                                                            Lugol.

P'F. Boudet, Journal de Pharmacie, Avril, 1842, p. 335; and  Duhamel, in Amer.
Journal of Pharmacy, July, 1842, p. 102.
  2 Bouchardat, Annuaire de Th.rap. pour 1852, p. 185. 
QUINIA.
605
          Collyrium potassii  iodidi compositum.
              Compound collyrium of iodide of potassium.
                R.  Iodin. gr. ss. ad gr. i.
                     Potassii iodid. Qss.
             Solve in
                    Aq. rosa. f giij.  M.
  To be applied, four  times a day, in cases of scrofulous ophthalmia,
with ulceration of the conjunctiva and cornea.           Magendie.

  So'dii Iod'idum, Iodide of Sodium.   Dr. Daveri1 of Bologna, pre-
fers the iodide of sodium to the iodide of potassium, which, he says, is
much less disagreeable and better borne;  and has succeeded where the
iodide  of potassium had failed.  He commences  by giving daily in
constitutional syphilis, in three equal doses, a scruple of the salt dis-
solved in three ounces of distilled water, increasing the strength of the
solution every two or three days by six grains.   Some patients have,
in this way, been able to take more than  two drams a day without suf-
fering  the slightest inconvenience.  Professor Gamberini,2 from an ex-
perience of one hundred and sixteen cases, confirms the favourable opi-
nion of it  given above; he  began with 5j-  in the day, and gradually
increased the dose to 3\j«
                     QUINIA ET EJUS SALES.
Synontme. Quinia and its Salts.

                         CXLVI. QUINIA.
Synona'Mes. Quinina, Quina, Quininum, Quinium, Chininum, Chininium, Chinium,
  Kinium, Sal Essentiale Corticis Peruviani.
French. Quinine, Kinine.
German. Chinin, Quinin, Chinastoff.
  Quinia is a most important gift from modern analytical chemistry
to medicine.  About thirty-five years have  elapsed since the discovery
of this substance, and, by general consent, it is 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 investiga-
tions of other chemists, as to the composition of the cinchona barks—
belongs to Pelletier and Caventou, (1820,3) and so rapidly and exten-
sively was its efficacy promulgated, that in  the year 1826, in two labo-
ratories in Paris for  the  preparation  of quinia, fifty-nine thousand
ounces of the sulphate—the form best known and most frequently pre-
scribed—were prepared.   For this discovery, the Royal Academy of
Sciences of Paris awarded MM. Pelletier and Caventou the Monthyon
prize of ten thousand francs.
  It would appear, from the observations of Henry fils and Plisson, that
cinchonia and quinia exist in cinchona bark in combination with kinic

  1 Corr. Sci. de Roma, No.  35, 1852; Chemist, Dec. 1852, and Ranking's Abstract,
Amer. edit. xvii. 145. Philad. 1853.
  » Bull, delle Sc. Med. xxi. 253, cited in Brit, and For. Med. Chir. April 1853, p. 574.
  5 Annales de Chimie et de Physique, xv. 28'J and 337. 
606
QUINIA.
 acid and also with  cinchonic  red, which is an insoluble red colouring
 matter.1
   Quinia is obtained from yellow bark by a similar process to the one
 described for the separation of cinchonia.2  In  the pure state, it is of
 a white colour, and commonly appears in the form  of powder; it crys-
 tallizes, however, in  silky, shining tufted needles.  In both cases, it
 contains  from  three to four per cent, of Avater.  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 por-
 tion being precipitated on cooling.  It requires  a much larger propor-
 tion, of cold water to dissolve it.  In alcohol it is far more soluble than
 in water.   It  is, likeAvise, soluble in ether,  and somewhat so in  oils.
 It exhibits  an  alkaline reaction,—restoring the colour of reddened lit-
 mus paper, and neutralizing acids.
   Impure quinia (quinine brute) is  prepared by treating cinchona with
 muriatic acid, lime and  alcohol, as in  the  preparation of sulphate of
 quinia:  but instead of acidulating  the alcoholic liquor, it is distilled
 without this addition.  The product is a plastic mass, of firm consist-
 ence, Avhich is  formed of a mixture of quinia, cinchonia, and fatty and
 colouring matters.  It is not sensibly  bitter.   500  grammes, or about
 11 ounces,  of good Calisaya bark, yield  nearly  16  grammes or about
 four drams of  quinine brute.3
   The observations of Piorry and Lavollee4 and of Quevenne,5 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.
   The effects of quinia will be spoken of at length under the head of
 SULPHATE of QUINIA, with Avhich it seems to accord  entirely in medi-
 cinal agency.   Several physicians, who have  experimented  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 pure  quinia, because it possesses, he
 thinks, equal efficacy, is  cheaper, easier taken, and better borne than
 the sulphate.   He  advises, that after each dose  an acidulous drink
 should  be given, to render its solution  in  the  stomach more rapid.
 Wutzer7 and Harles8 have also recommended the  more frequent  use
 of pure quinia; and M. Bouchardat9 states that he has often adminis-

  1 Journ. de Pharmacie, xiii. 269 and 369, and Pereira, Elem. of Mat. Med. and Therap.
3d Amer. edit, by  Dr. Carson, ii. 670.  Philad.  1854.
  2 See p. 234.
  3 Trousseau and Pidoux, Trail, de Th.rapeutique, &c,  i.  298. Paris, 1847.
  4 Gazette M.dicale, 1836, p.  73.
  5 L'Experience,  Juillet, 1838.
  6 Riecke, Die neuern  Arzneimittel, S. 118.  Also, Bally, in  Magendie's  Journal de
Physiologie, ii. 236.                       7 isiSj p. 441, 1829.
  8 Heidelberg Klinisch. Annalen, B.  v. H. 4, 573.
  9 Nouveau Formulaire Magistral, 3d .dition, p. 264.  Paris, 1845. 
QUINIiE ACETAS.
607
tercd impure quinia, and has been satisfied with the excellent effects it
produces  in a small dose.  It is likewise highly extolled by M. Trous-
seau,1 who thinks it more active than  the sulphate; and, owing to  its
being insoluble in  the saliva, and almost devoid of taste, he prefers it
in the diseases  of children.   He esteems it, indeed, the most useful
of the preparations of cinchona.
   After the administration  of  quinia and its salts, quinia may be de-
tected in the blood and in the excrements.2   It may be given either in
the form of powder or pill,  or in alcoholic solution.   The dose of im-
pure quinia is from 10  to 30 grains.

                        Tinctura  quinise.
                          Tincture of quinia.
                 R.  Quiniae 9j.
             Solve in
                     Alcohol, f gss.
   Dose.—Twenty to forty drops every two hours.          Wutzer.
                 R.  Quiniae impur. gvijf (30 gram.)
                     Alcohol.
                     Aq. destillat. aa. gxjj (350 gram.)
             Misce et cola.
   Two  spoonfuls of this solution are  considered to  represent fifteen
grains of  sulphate of quinia.  In this dose it  has  been administered in
many cases of hypertrophy  of the spleen; and it is affirmed, the spleen
diminished under its use with greater rapidity than under that of the
sulphate of quinia.3                                        Piorry.
   For some observations on amorphous  quinia, see  the appendix to
the SALTS OF QUINIA.
                      CXLVII. QUI'NIzF  ACETAS.
Synonymes. Quininae Acetas, Chinium Aceticum, Chininum Aceticum, Acetas Chinii
  seu Chinini seu Chinicus seu Quinicus, Acetas Quiniae seu Quinae seu Quinini seu
  Quinii seu Kinini, Quina Acetica, Acetate of Quinia or of Quinine.
French.  Acetate de Quinine.
German. Essigsaures  Chinin.
   This preparation is not much  employed.   It is made by saturating
quinia Avith pure  acetic  acid  diluted Avith water, and evaporating  the
neutral solution, by gentle heat,  to crystallization.   It appears in  the
form of very delicate, needle-shaped, snow-white, satiny, and  shining
crystals; tastes very  bitter; and is with difficulty  soluble in cold water,
but readily so in hot.
  Wutzer and Sundelin4 assert, that it acts like the other salts of quinia,
but merits no preference.

  1 Cited in British and Foreign Medical Review, Oct. 1842, p. 560.
  2 Landerer, Chem. Gazette, i. 147.
  5 Bouchardat, Annuaire de Th6rapeutique, pour 1847, p. 179.  Paris, 1847.
  1 Isis, p. 441, 1829; also, Heidelb.  Klinisch. Annal. B. v. H. 4, 575. 
608
QUINLE ARSENIS.
                  CXLVIII. QUI'NLE ARSENIAS.
Syxoxymes. Quininae seu Quinae Arsenias, Chininum Arsenicosum seu Arsenicicum,
  Arseniate of Quinia or of Quina or of Quinine.
French. Arseniate de Quinine.
German. Arseniksaures Chinin.

                      METHOD OF PREPARING.
   To obtain the salt, dissolve  half an ounce of sulphate of quinia in
barley water, and  precipitate by liquid ammonia, which will produce
upwards of two drams and a half of very pure quinia when washed and
dried.  Dissolve 46 grains of arsenic acid in about three ounces of dis-
tilled water.   The quinia is insoluble in water, but under the influence
of arsenic acid and ebullition it becomes soluble.  A combination takes
place, and, on cooling, crystals of arseniate of quinia are formed.  The
crystals are then dissolved  in distilled water, and  recrystallized by
evaporation, in order to obtain the salt pure, and free from any excess
of acid.
   Well prepared  arseniate of quinia is a white, light, salt, crystallized
in silky, brilliant needles.   It is soluble in water; but in greater  pro-
portion in boiling water than in cold; it is soluble in weak alcohol; dis-
solving less readily in alcohol.  It is insoluble in ether.1

                      EFFECTS ON THE ECONOMY.
   Arseniate of quinia has been employed by M. Bourieres in obstinate
intermittents,  in the dose of from three quarters of a grain to a grain
and a half in the 24 hours.  M. Bodin2 has instituted some trials to de-
termine the relative value of this salt and of arsenious acid.   He did
not exceed from one to two-fifths of a grain of the arseniate for a dose,
taken at  once or in tAvo doses; and could detect no superiority of action
in  this salt of quinia,  whilst it had  the inconvenience of being exces-
sively bitter.   He infers, therefore, that, so far, arsenious acid ought to
have the  preference.
   It may be given in solution in distilled water, to which a little simple
syrup may be added.
                   CXLIX. QUI'NIiE AR'SENIS.
Syxoxymes.  Quiniae Di-arsenis, Arsenite of Quinia.
French. Bi-arsenite de Quinine.

  This salt has been lately proposed by Dr. Kingdon.3

                       METHOD OF PREPARING.
  Dissolve sixty-four grains of arsenious acid, and  thirty-two grains
of subcarbonate of potassa, in four ounces  of  distilled water, by boil-
ing it for about half an hour, and making the  quantity four ounces by
the addition of water; so that each dram  may contain two grains of

  1 Journal de Chimie M.dicale, xi. 283.
  2 Bouchardat, Annuaire de Therapeutique pour 1846, p. 208.  Paris, 1846.
  3 Provincial Medical and Surgical Journal, August  25,  1847. 
QUINI.E CITRAS.
609
arsenic.   To  five drams of this solution  add .avo  scruples  of  disul-
phate of quinia,  previously  dissolved in  boiling distilled water.  A
white curdy precipitate  is immediately formed,  which  is  the  di-ar-
senite.   This  is poured on a filter and dried.   It is uncrystallizable,
and insoluble  in water, but soluble in alcohol.

                     EFFECTS  ON  THE ECONOMY.
   Arsenite of quinia has been highly extolled by Dr. Kingdon as a
eutrophic in chronic cutaneous affections especially;  and he has  no
doubt that it would be equally efficacious in ague and the  various forms
of neuralgia.  It possesses the medicinal qualities of both a mineral and
a vegetable tonic; and when the system has become habituated to either
one or the  other, the former  action is kept up by its  administration,
whilst, at the same time, a new one is introduced into the system.
   The dose is one-third of a grain twice a day, and gradually three and
four times a day,  in the form of pill or powder, mixed with a little su-
gar or gum.
                      CL.  QUI'NHE CITRAS.
Synonymes.  Quininae seu Quiuini seu Quiniae seu Quinae seu Quinii seu Chinini seu
  Kinini Citras, Citras  Chinii seu Chinicus seu  Quinicus, Chinium seu Chininum
  Citricum, Quina Citrica, Citrate of Quinia, of Quina, or of Quinine.
French.  Citrate de Quinine.
German. Zitronsaures Chinin, Citronsaures  Chinin, C itronen saures
  Chiuin.
                      METHOD OF  PREPARING.
  This preparation  is formed  like  the acetate, from an aqueous  solu-
tion of citric acid, and pure quinia;  or by the decomposition of a hot
solution of sulphate of quinia, by means of an acid citrate of soda.1  It
forms needle-shaped prisms, of a Avhite  colour, which are by no means
readily soluble in water.

                     EFFECTS ON THE ECONOMY.
  The acetate  and the citrate of quinia  have been highly esteemed;
and are  considered  to be  adapted for those excitable  persons with
Avhom the sulphate does not' seem to agree.   The citrate has been pre-
scribed by many Italian physicians, and  found to be very efficacious.2
The author is not aware  that it is  ever prescribed in this country.
Magendie  considers it, when it contains  an  excess  of  acid, advisable
for those cases where the union of a tonic with an antiseptic property
is indicated.  He considers,  that the following syrup may be substituted,
in  certain  cases,  for  the syrupus  antiscorbuticus,  which  is directed
by the Codex Medicamentarius of  Paris  to be prepared in the follow-
ing manner:—Take of the fresh leaves of cochlearia, ivater trefoil, cress,
horse-radish, and bitter oranges cut, of each one pound; cinnamon, an
ounce and a half, white wine, four pints.  Macerate for two days in  a
tin  cucurbit, covered Avith a well luted capital.  Distil, in a sand-bath,
 1 Guleani, in Annali Universali di Medicina.  Luglio, 1832; and  Heidelb. Klinisch.
Annal. B. x. H. i. S. 34.   Heidelb. 1834.
 a Beraudi, in Bulletin General de Therapeutique,  Nov.  1840.
       39 
610
QUINIJE FERROCYANAS.
a pint of fluid; to which add two pounds of white sugar and make into
a syrup.   Pass through a cloth, without  straining, what  remains in
the cucurbit; let the liquor rest; decant; and boil to the consistence of
syrup, with two pounds of white sugar.  When  cold, clarify, and mix
with the other.
                   Syrupus quiniae  citratis.
                       Syrup of citrate of quinia.
                 R.  Syrup. Oi.
                     Quiniae citrat. acid. gr. xxxvj.  M.
   Dose.—Two  spoonfuls in the twenty-four hours.

   A citrate of quinia and iron  is referred to elseAvhere, (p. 355.)
                  CLI. QUI'NIiE  FERROCYANAS.
Synonymes. Quininae Ferrocyanas, Chinium Ferrocyanogenatum seu Ferrohydrocy-
  anicum, Ferrocyanas Chinii, &c., Ferrocyanate or Hydrocyanoferrate of Quinia, of
  Quina, or of Quinine.
French. Ferrocyanate de Quinine.
German. Eisenblausaures Chinin.

                       METHOD OF PREPARING.
  This is obtained by the decomposition of sulphate of quinia, by means
of a solution of ferrocyanuret  of potassium;  after Avhich  the impure
salt is treated with warm alcohol, and the clear solution is evaporated.1
It forms needle-shaped, confused crystals, of a greenish-yellow colour,
and very bitter taste, recalling  that of hydrocyanic acid.  It dissolves
readily in alcohol, not so in water; and is decomposed by hot water.

                     EFFECTS  ON  THE  ECONOMY.
  In  this combination, the antifebrile properties of the quinia are said
to be even superior to  those of  the other preparations; yet the  remedy
has>not got into much  use.   It has been employed mainly by a few of
the French practitioners.   Cerioli2 and Zaccharelli, Italian physicians,
speak in high terms of its  efficacy in periodical diseases, even Avhere
the sulphate has failed. Cerioli gave it in the dose of from two  to eight
grains in  the  day.  Gouzee3 details the history of three cases  com-
pletely cured by the administration of a single grain, half an hour be-
fore the paroxysm; and Dr. H. V. Wooten,4 of Alabama, affirms, that
he has prescribed it  in about fifty cases, and has found it, when  pure,
" act  uniformly without those unpleasant  effects which generally arise
from  the use of the sulphate; " and in cases  in Avhich there is febrile
excitement or  inflammation he uses  it altogether; and, he adds, with

  1 See Bertozzi's method, in Journal de Pharmacie, xix. 45, and  Philada. Journal of
Pharmacy, vol. ii. new series, p. 82.  Philad. 1837.  Also, Donovan, in Dublin Journ.
of Med. Science, July, 1840, p. 440.
  * Annali Universali de Medicina, Luglio, 1832, and Archives Generates de_M.decine,
Dec. 1832.
  3 Observateur Medical Beige, Jan. 1834.
  * Southern Medical and Surgical Journal for April, 1846. 
                        QUINLE HYDRIODAS.                     611

full confidence, in all cases where he wishes to exert  "a sedative and
alterative or regulating power upon the nervous system."

                     MODE OF ADMINISTRATION.
  The following formulae have been recommended:

               Haustus quiniae ferrocyanatis.
                  Draught of ferrocyanate of quinia.
                 R.  Quiniae ferrocyanat. gr. iv.
                     Alcohol, f gj.
             Solve et adde
                     Aquae camphor, f gvij.  M.
               et fiat haustus.
  To be taken as occasion may require, first shaking the vial.
                                                       Bonovan.1
                Pilulae quiniae ferrocyanatis.
                    Pills of ferrocyanate of quinia.
                 R.  Quiniae ferrocyanat. gr. xxiv.
                     Mucilag.  acaciae q. s.
               ut fiat massa in pilulas xij. dividenda.
  Two for a dose.                                       Bonovan.
                    CLII. QUI'NLE HYDRTODAS.
Synonymes. Chininum Hydroiodicum, Hydriodate or Iodhydrate of Quinia, of Quina,
  or of Q uinine; called also loduretum seu Iodidum Quiniae, Ioduret or Iodide of Quinia,
  of Quina, or of Quinine.
French. Hydriodate ou Iodhydrate de Quinine, Iodure de Quinine.
German. Iodwasserstoffsaures Chinin.
   Hydriodate of  quinia  may be formed  by precipitating sulphate of
quinia by means of iodide of potassium.   The precipitate is of a yel-
Ioav colour, soluble in alcohol,  and crystallizes from  this solution in
quadrangular prisms.2
   Dr. Kingdon3 employs an  "iodide " and a "biniodide of quinia."
The former is made by dissolving equal weights of sulphate of quinia
and iodide of potassium in boiling distilled water, and" allowing  the
mixture to cool, when beautiful fasciculi of needle-shaped crystals  are
deposited, which  are insoluble in  cold Avater, but soluble in alcohol.
The latter is made by mixing twice the weight of iodide of potassium
with sulphate of quinia in  boiling distilled water, evaporating to  one-
third in a sand-bath, and  alloAving the residue to cool,—when  a resinous
substance is deposited, of a light  straw colour, which by exposure to
the air,  becomes  darker, and  of  a greenish hue, not  crystallizable,
sparingly soluble in cold  water, readily soluble in alcohol, and then not
precipitated Avhen mixed Avith water.   He has given  this preparation
in several  cases of  scrofulous  enlargement of the glands,  with very
great benefit.   In the case of a child between three and four years of
age, when the glands of  the neck were in a state of suppuration, half
  1 Op. citat.
  2 Journal de Chimie Medicale, Mars, 1836.         s Med. Times, July 29, 1843. 
612
QUINI2E HYDRIODAS.
a grain  was given twice a  day,  and at the  end of six months  the
swellings were wholly removed, and the general health much improved.
M.  Paura,1 Professor of chemistry, in Naples, has proposed the ioduret
of quinia as an antiperiodic, in intermittents, Avhich had resisted the
ordinary antiperiodics under the influence of a scrofulous constitution.
It was used successfully by Dr. Giuseppe Manfredonia, of Naples, in
doses of  from eight to sixteen grains daily; and its curative powers
were rapidly manifested in the most obstinate cases.
  Prof. A. T. Thomson prepared an "iodide  of  quinia," and  an
"iodide of cinchonia;" the former made by triturating together, in
a mortar, 164.55 grains of pure quinia, and 126.3 of  iodine; the latter
being added to the former until the whole is intimately mixed, and then
boiling the mixture in a moderate quantity of  distilled water at first,
adding more by degrees, until  as much is added as will give one grain
of the iodide for each fluidram of the solution.   During the boiling, a
deep brown resinoid substance is formed, apparently insoluble in water,
which subsides to the bottom when the solution cools.  This substance
is brittle, tasteless, inodorous, and affords no indication of the presence
of either iodine  or  quinia.  It  is  partially soluble in boiling alcohol.
Dr. Thomson was not able to ascertain its nature.  It shows, however,
by the appropriate tests, that it contains both iodine  and quinia.
  Iodide of cinchonia is prepared in the same manner, taking 156.55
grains of the alkaloid.   The  quantity of the  resinoid matter  is less
than in the case of iodide of quinia; but it closely resembles it in  its
physical  characters, insolubility in  water, and  solubility  in alcohol.
The solution is nearly inodorous, and has the bitter taste of cinchona.
It answers to the same tests  as the iodide of quinia.
  Dr. Thomson had  not  crystallized either of the saltsvnor does  he
seem to have administered them.  He thinks the tonic influence of the
quinia or cinchona may prevent iodism.2

  An  Iodide of  Iodhydrate of Quinia,  French,  Iodure a"Iodhy-
drate de Quinine, is prepared by pouring into an acid solution of qui-
nia, a solution of  iodide of iron,  containing a slight excess of iodine.
The precipitate which forms is treated with boiling alcohol.  The liquor
is filtered, and,  on cooling, the iodide of iodhydrate of  quinia is  de-
posited, which is in beautiful scales of a deep  greenish  colour.   It is
insoluble in water, and soluble  in alcohol; possesses the properties both
of quinia and iodine, and has been employed with much success in re-
bellious intermittents.
  All these preparations are well  adapted for diseases in which iodine
and a tonic are indicated, and hence may be given with success in many
cases of  scrofulous and other cachexice.

  Under the name Hydriodate  of Iron and  Quinia, Mr. Battley3
has introduced a new article into  the lists of  the  materia medica, in
which the iron exists in the form of a protosalt.   The  iodine also, being

  1 Gazetta Medica  Italiana; and Edinb. Med. Journ. July, 1855, p. 54.
  2 Pharmaceutical  Journal, March, 1845, Ranking's Abstract, Amer. edit. i. 349. New
York, 1845.                       s London Med. Gazette,  May 12, 1848. 
QUINLE LACTAS.
613
in the state of hydriodic acid, acts—it is conceived—more mildly than
the tincture and its other compounds.   The preparation is a syrup,
sugar being required to prevent the conversion of the protosalt of iron
into a persalt.   The proportions are such, that each fluidram contains
a grain  and a half of quinia, a grain  of iron, and a grain of iodine as
hydriodic acid.  The dose is from twenty to thirty drops.
                      CLIII. QUI'NI_E LACTAS.
 Synonymes. Quinae Lactas, Chininum Lacticum, Lactate of Quinia, of Quina, or of
   Quinine.
 French. Lactate de Quinine.
 German. Milchsaures  Chinin.

   By saturating lactic acid with quinia, and subjecting the solution to
 spontaneous evaporation in a flat vessel,  groups of silky needles of the
 lactate are obtained,  which are more flattened than those of  the sul-
 phate.
   Lactate of quinia does not  crystallize  as readily as the sulphate and
 valerianate,  and it is more soluble than either of those salts.
   Prince Louis Lucien Bonaparte, Beraudi and Bouchardat have found
 the lactate possessed of great energy, and M. Conte has proposed  to
 replace the sulphate by it.1

                      MODE OF ADMINISTRATION.

                    Pilulae  quiniae  lactatis.
                       Pills of lactate of quinia.
                 R.  Quiniae lactat. gss.
                     Extract, jump. q. s. ut fiant pil. xx.

   Dose.—Two to six in the day in intermittents.—Bouchardat.

                   Mistura  quiniae  lactatis.
                      Mixture of lactate of quinia.
                 R.  Quiniae-lactat. gr. vii.
                     Aq. menth. f gv.
                     Syrup, caryophyll. f 3 i.
                     Aquae f 3*iiiss.  M.

   Dose.—One-third.   The whole to be  taken during the interval  in
pernicious intermittents.                              Bouchardat.

                   Syrupus  quiniae  lactatis.
                       Syrup of lactate of quinia.
                 R.  Quiniae lactat. gr. xv.
           Solve in
                     Aquae fgj.
               adde
                     Sacchar. gij.  Solve.

  Dose.—A coffee-spoonful in the  intermittents of children.
                                                     Bouchardat.

       1 Bouchardat, Nouveau Formulaire Magistral, p. 264.  Paris, 1845. 
614
QUINIiE NITRAS.
                     CLIV. QUI'NI_E  MU'RIAS.
Synonymes. Quininae Murias, Chininum Muriaticum seu Salitum sen Hydrochloricum,
  Hydrochloras seu Murias Chinii seu Chinicus seu Quinicus, Chlorhydras Quinicus,
  Muriate of Quinia, of Quina, or of Quinine.
French. Muriate ou Hydrochlorate de Quinine.
German. Salzsaures Chinin, Hydrochlorsaures  Chinin.
   Perhaps, next to the sulphate of quinia, this salt has most frequently
been employed  in practice.

                       METHOD OF  PREPARING.
   It is obtained by dissolving pure quinia in dilute muriatic acid, or
by the decomposition of sulphate of quinia dissolved  in warm  water,
by means of a  solution of  chloride of barium, which is added so long
as a white precipitate is thrown down: the hot mixture is then filtered;
the precipitate washed, and the clear fluid evaporated,  by a gentle heat,
to crystallization, so long as crystals shoot on cooling:  these are col-
lected, washed in cold water, and purified by repeated  crystallization.
It forms fine, needle-shaped, white, silky crystals,  of a mother-of-pearl
lustre; and does not dissolve readily in water, but more  so  than the
sulphate.
                     EFFECTS ON THE ECONOMY.
   In this respect, the muriate agrees with the sulphate of quinia, and
by those of weak digestive powers is borne better.  Spielman1 assert3
that it is a more speedy and effectual remedy in intermittent fever than
the sulphate, and is more  soluble.  It is,  however,  more expensive.
The dose is generally considered  to be the same  as  that of the sul-
phate.   It is better given in  solution than in  powder.    Spielman rates
the dose  at from half a  grain to a grain.
                      CLV. QUFNIiE NI'TRAS.
Synonymes. Quinine. Nitras, Chinium seu Chininum Nitricum, Nitras Cninii, &c.
  Nitrate of Quinia, of Quina, or of Quinine.
French. Nitrate de Quinine.
German. Salpetersaures  Chinin.

                      METHOD OF PREPARING.
   This salt is obtained like the muriate, by the addition of nitric acid
to quinia;  or by the decomposition of  nitrate  of baryta by  sulphate
of quinia.  It  is, at first, a fluid, oil-like  mass, which gradually be-
comes solid.  In union with water it forms crystals.   It dissolves with
difficulty  in water, but readily in alcohol.

  1 Allgemein. Medicinisch. Zeitung, cited in Journal des Connaiss. M.dic. Fev. 1836:
also, Dierbach, in Heidelb. Klinisch. Annal. B. x. H. i. S. 33.  Heidelb. 1834. 
QUINLE SULPHAS.
615
                   CLVI. QUI'NI_E PHOSPHAS.
Synonymes. Quininae  Phosphas,  Chinium seu Chininum Phosphoricum, Phosphas
  Chinii seu Chinini, Phosphate of Quinia, of Quina or of Quinine.
French. Phosphate de  Quinine.
German. Phosphorsaures Chinin.

                       METHOD OF PREPARING.
  In mode of preparation, it accords with the preceding forms; dilute
phosphoric acid being added to quinia, or phosphate of baryta to sul-
phate of quinia1  It appears in the form of needle-shaped  prisms, of
a mother-of-pearl lustre, which, like the muriate of quinia, are readily
soluble in water and alcohol.  Harles,2  however, affirms, that in the
neutral condition it dissolves, with difficulty, in water.
  The phosphate is regarded by some to  stand  next to the sulphate in
medicinal efficacy.
                    CLVII. QUI'NL/E SULPHAS.
Synonymes. Quinin-3 Sulphas, Quinae Disulphas seu Sulphas, Chinium seu Chininum
  Sulphuricum, Sulphas Chinii seu Quinicus, Sulphate, Disulphate, or Subsulphate of
  Quinia, of Quina or of Quinine.
French. Sulfate de Quinine.
German. Schwefelsaures  Chinin, Chininsulphat.
   This preparation of quinia is by far the most frequently administered.
It is in fine, silky, flexible needles, and at times in rectangular columns.
Its taste is extremely bitter, and resembles that of yellow bark.   Ex-
posed  to a moderate heat, it loses its crystalline form, in consequence
of the escape of its water of crystallization.   It is only slightly solu-
ble in  cold water, requiring 740  parts at the ordinary temperature, and
30 parts of boiling water for its solution.   In alcohol, it is very solu-
ble,  but only  slightly so in ether.   With sulphuric  acid, it  forms a
super-sulphate, which is much more soluble in water  than the neutral
salt, and hence  a few drops of  dilute sulphuric  acid are usually  added
to mixtures of sulphate  of  quinia.

                      METHOD  OF PREPARING.
   This salt is generally  prepared on a large scale in the chemical labo-
ratories.   A formula was admitted,  however, into  the Pharmacopoeia
of the United States (1830,) which was  taken from the process  of M.
Henry, Junr.,3 for which he received a prize from the Academie Roy-
ale des Sciences, of Paris.   It is as follows:—Take of yellow bark, in
powder, a pound; lime,  in  powder,  four ounces; sulphuric acid, alco-
hol,  animal charcoal,  distilled water, each a sufficient quantity.   Boil
the bark for half an hour with eight pints of distilled water, acidulated
with a fluidounce of tho  sulphuric acid.  Strain  the decoction through
linen:  then boil  the residue with the same quantity of acidulated water,
  1 Winkler,  in Biichner's Repert. and Philad. Journ. of Pharmacy, new series, vol. ii.
p. 12.  Philada.  1837.
  3 Heidelb. Klinisch. Annal.  B. x. H. i. S. 36. Heidelb. 1834; and Journal de Chimie
M.dicale, 1837.               s Journal de Pharmacie, vii. 296, Juillet, 1821. 
616
QUINI_E SULPHAS.
and filter as before.  Mix the filtered  liquors, and gradually add the
lime, stirring constantly.   Wash the precipitate with distilled Avater,
and, having dried it, digest in alcohol with a moderate heat.   Pour off
the tincture, and repeat the digestion several times, till the alcohol  is
no longer rendered bitter.   Mix the tincture, and distil  over the alco-
hol, till a brown viscid liquid remains in  the retort.   Upon  this  sub-
stance, removed from the retort, pour as much sulphuric acid, largely
diluted with water, as may be sufficient for its perfect saturation.  Then
add the animal charcoal, and having evaporated the liquor sufficiently,
filter while  hot, and set  it aside to crystallize.   In  the  last edition,
(1842 and 1851) the form has been modified as follows:—Take  of yel-
low bark, in coarse powder, ftnv.; muriatic acid, f giij.; lime, in powder,
gv.;  water, five gallons; sulphuric acid, alcohol, animal  charcoal, of
each a sufficient quantity.   Boil  the  bark  in one-third of the Avater
mixed Avith one-third of the muriatic  acid, and  strain through linen.
Boil the residue twice successively with the same quantity of Avater and
acid as before, and strain.   Mix the decoction, and while the liquor is
hot, gradually add the lime, previously mixed with two pints  of water,
stirring constantly, until the quinia is completely precipitated.   Wash
the precipitate with  distilled water,  and,  having  pressed  and dried it,
digest in boiling alcohol.  Pour off the liquor, and repeat the digestion
several times, until the alcohol is no longer rendered bitter.  Mix the
liquors, and distil off the alcohol, until a brown viscid mass remains.
Upon this substance, removed from the vessel, pour about half  a  gal-
lon of distilled water, and having heated the mixture to  the  boiling
point, add as much sulphuric acid as may be necessary to dissolve the
impure alkali. Then add  an ounce and  a half of animal charcoal,
boil for two minutes, filter the liquor while hot, and set it aside to crys-
tallize.  Should the liquor, before filtration, be entirely neutral, acidu-
late it very slightly  with sulphuric  acid: should it, on  the  contrary,
change the  colour of litmus paper to a bright  red, add  more animal
charcoal.    Separate the crystals from the liquor, dissolve them in boil-
ing Avater slightly acidulated with sulphuric acid; add a little animal
charcoal, filter and set aside to crystallize:  wrap the crystals in bibu-
lous paper, and dry them with a gentle heat.  The mother waters may
be made to  yield an  additional quantity of sulphate of quinia by preci-
pitating the quinia with  solution of ammonia, and treating the preci-
pitated alkali with water, sulphuric acid, and animal charcoal as before.1
  It results from the calculation of  Pelletier and Caventou, that from
a quintal of cinchona, two pounds, one dram and thirty  grains  of sul-
phate  of  quinia  may be obtained,  which  makes tAvo drams, sixty-six
grains and  a sixth  per  pound, or  thirteen  grains and tAvo-sixths per
ounce; and as the sulphate is composed of  nine parts and nine-tenths
of sulphuric acid to ninety and a tenth of quinia, it follows that if the
dose  of cinchona in substance  be two drams, we should administer to
the patient three grains and nine thirty-secondths of a grain of sulphate
of quinia;  not taking into account a small quantity of  sulphate of
cinchonia, which may be mixed with it.   Four grains of the salt are
1 Pharm. of the United States, p. 206.  Philad. 1851. 
QUINL33 SULPHAS.
617
consequently, more  than an equivalent for  the dose of the  cinchona
often prescribed  in substance.   Those practitioners,  therefore, who
prescribe thirty-six or seventy-tAvo grains of the sulphate, give the re-
presentative of about twenty-seven drams of cinchona in the former case,
and fifty-four in the latter.1
  Sulphate of quinia is liable to be adulterated—for example, by man-
nite, which is similar in external appearance, but—as elsewhere shown
—is destitute of  all its properties.   This adulteration can be readily
detected by means of pure alcohol, which dissolves the quinia alone, but
leaves the mannite untouched, which is freely soluble in water, and  is
known by its characteristic  sweet taste.  It is also adulterated with
gypsum, the  presence of  which may likewise be  detected by alcohol,
Avhich does not dissolve it.2
  Some idea of  the immense  consumption may be formed when it  is
stated, that from 40,000  to  50,000 ounces of sulphate of quinia were
probably made during the year 1845, in Philadelphia.
  The sulphate of quinia of commerce  is said to be not unfrequently
adulterated with salicin.   If the proportion of  the salicin be one-half,
or even one-fourth, M. Pelletier3 states, that  the fraud may be de-
tected by the addition of concentrated sulphuric acid, which produces
with salicin a characteristic red colour.   But if no more than one-tenth
of salicin be mixed Avith the sulphate,  the  red  colour is not developed
by the addition of sulphuric acid.   In order to detect the presence  of
salicin in this or  a  still less proportion, the salicin must  be separated.
For this purpose, take three or four grains of  the suspected sulphate
of quinia, and pour on it about six times its weight of  concentrated
sulphuric acid, Avhich dissolves the  salt, and if salicin be present forms
a solution of a brown colour, like sulphuric acid soiled by some vegetable
matter.   To this some distilled water must be carefully and gradually
added,  until a white precipitate appears.  This  will probably be salicin,
which will not dissolve in a  moderately dilute acid solution of sulphate
of  quinia.   Filter the liquid,  and  collect  the  precipitate on a watch-
glass, and it will now produce, upon the addition of concentrated sul-
phuric  acid, the bright  red colour characteristic of  salicin.   If too
much water  be added,  the precipitate will dissolve, and only a loose
gelatinous precipitate will form, very difficult to separate.*
   One evidence of the value of this discovery of the sulphate of quinia,
has been mentioned by the author elsewhere.5   He was informed a few
years ago, that although  the best cinchona bark  could not  be purchased,
at the time,  in  Philadelphia, for less than  one  dollar and thirty-seven
cents per pound, and in powder for less than one  dollar and fifty cents,
—cinchona powder, so called, might be  obtained for ten cents a pound!
This consisted of the false and other barks, with the cinchona or true
barks;  and generally, perhaps, not a particle of the latter could be de-
tected in it.   Yet the appearance of the true and the spurious powder

  1 Jourdan, Pharmacop.e Universelle, ii.  375.   Paris, 1828.
  2 A'allet & Dubail, Journal de Pharmacie, Janvier, 1840.
  s Journ. de Chimie Medicale, cited in London Lancet, Jan.  11, 1845.
  * Sec,  on the means of knowing its purity, Bouchardat, Annuaire  de Th.rap. pour
1855  p. 162.       i Practice of Medicine, 3d edit.  ii. 424.  Philad. 1848. 
618
QUINLE SULPHAS.
 was so nearly alike, that no difference could be discovered, even by an
 experienced  eye.    From July  1848 to  April 1841),  inclusive,  Dr.
 Bailey,1 inspector of  drugs at the port of New York, rejected 34,000
 pounds of spurious and Avorthless cinchona barks, which contained none,
 or but a trace, of the alkaloids of the true barks;  and he affirms, that
 the cost of these barks, delivered  in that market, was, at the time, about
 six cents a pound, whilst the genuine cost eighty cents!

                      EFFECTS  ON THE  ECONOMY.
   The effects of the  preparations of quinia on  the  healthy organism
 haAre not been much investigated.  Recently, hoAvever, a valuable mo-
 nograph on the subject  has been published by M. Briquet.2   Accord-
 ing to Caventou, they produce a general excitement, similar to that
 caused by  coffee, and Wittmann  affirms, that the sulphate induces an
 excitement similar  to that of a  paroxysm of fever.   Hirschel,3 too,
 asserts, that  in a child, four years of age, to whom  the  sulphate was
 given in a  case of intermittent, a general chilliness of some minutes'
 duration supervened immediately on taking the remedy,  succeeded, in
 the course  of half an  hour, by general heat, and this again by a gentle
 perspiration,  in all  respects resembling a mild  attack  of fever.  The
 excitant action of the salts of  quinia formed by the vegetable acids is
 said to be less striking.
   Sulphate of quinia, in  large doses, appears, in  some cases, to pos-
 sess narcotic  properties.   It has  even proved fatal, when given in ex-
 cessive doses,  and Dr. Baldwin,4  of Alabama, from all he can gather,
 is disposed to think, that from fifty to eighty grains of a pure article,
 given in solution at one dose, will produce death nine times out of ten,
 in healthy adults, and that occasionally smaller doses will  have  the
 same  result.   "How far," he  adds,  "its operation  may be modified
 by morbid  action is a matter for  consideration at the bed-side."   M.
 Recamier5 ordered  a man in the  Hotel Dieu, affected with acute
 rheumatism, 48 grains of the sulphate in 12 powders—one to be taken
■ every hour.  The next day, 72 grains were ordered,—six to be taken
 every hour; but after the eighth  dose, the patient was suddenly seized
 with violent agitation, followed by furious delirium, and  died in a few
 hours.   On examination, evidences of  severe inflammation [?] of the
 cerebral membranes were discovered.  An analogous case, in which very
 dangerous symptoms supervened  on the administration of four scruples
 of the sulphate in twelve hours,  occurred about the  same time in the
 wards  of M. Husson.6  It has often, however, been  administered in
 considerable quantity without  the supervention of any disagreeable re-
 sults.   Bally7 gave it to the extent  of  110 grains in  the day without

   1 Report on the practical Operation of the Law relating to the Importation of adulterated
 and spurious  Drugs, Medicines, &c.  New York, 1849.
   2 Trait. Therapeutique  du Quinquina  et de ses Preparations; and Bouchardat, An-
 nuaire de Therap. pour 1854, p.  134.
   * Hufeland's Journal, B. lxi. St. 6, S. 140.
   * American Journal of the Medical Sciences, April, 1847, p. 307.
   6 Bouchardat,  Annuaire de Therapeutique, &c. pour 1843, p. 170.  Paris, 1843.
   8 Gazette des Hopitaux,  8 Decembre, 1842.
   T Revue Medicale, v. 244, Juillet, 1821. 
QUINIiE SULPHAS.
619
 any inconvenience.   Dr. Thomas Fearn,1 who administered it largely,
 regards it to be more  narcotic  than sedative,—usually, he thinks, sti-
 mulating in small doses, but in large  doses the stimulant effects not
 being obvious, but rather the reverse;  and such appears to be the view
 of Dr. A. Flint.2  Dr. Alex. Robertson3 regards it as a stimulant, more
 gradual and permanent in its  action than,  but in other respects  simi-
 lar to, the alcoholic stimulants.
   It is affirmed, that when administered for some days in large doses,
 the pulse became  greatly retarded, fell below fifty in the minute, and
 great debility was experienced.4 This  decisive  sedative action has been
 observed  by the author5 over  and over again, when the  sulphate  of
 quinia  has been given in free  doses;  but Dr.  George Mendenhall,6 of
 Cincinnati, affirms, from experiments  made upon  himself, that in all
 cases the  pulse was increased  in fulness and  hardness, even when it
 decreased in frequency.   "When ten  grains, and also twenty grains
 were taken, the ringing in the ears was very great, with some consider-
 able deafness  for several hours;  also a general feeling of the body,
 Buch as would  be excited by riding  in a  railroad car."   M. Favier
 took, in twelve days, two hundred and eighty grains of the  sulphate,
 commencing with six grains, and doubling  the dose every three  days.
 The first three doses produced  no  other effect  than an evident diminu-
 tion in the number of the pulsations,  and a degree of activity in the
 nutritive functions: the three following, which were of twelve grains, still
 acted on the pulse, the force and frequency of which were diminished.
 From time to time, ringing in the ears supervened, with frequent hun-
 ger.  The subsequent doses acted still more  in reducing  the activity
 of the circulation, and caused disorder of the mind, somnolency, tinni-
 tus aurium, and so much debility, that M. Favier was  almost unable to
 stand;  and  after he had discontinued  the  experiment, he did not re-
 cover his muscular strength for six or eight days.7
   When Mr. Scott,8 a medical  gentleman  and a martyr to dyspepsia,
 took quinia in  very large doses, under the idea that his malady was in-
 termittent neuralgia, he  found several singular  phenomena induced
 thereby.   He was directed to commence with  two  grains  three times
 a day, until he arrived at twenty grains  for a dose,—that is, a dram

  1 Transylvania Journal of Medicine, October, November and  December, 1836, p. 798;
 and American Medical Intelligencer, June 15, 1837, p. 109.
  2 American Journal of the Medical Sciences, Oct. 1841,  p. 277.
  1 Edinb. Monthly Journ. of Med Science, Feb. 1852, p.  189.
  * Bouchardat, op. cit. p. 170.  Also, on its sedative properties, J. W. Malone, Amer.
 Jour,  of the Medical Sciences, Oct. 1843, p. 376;  Boling, Ibid. July, 1844, p. 89;
 Legroux, Journ. de Med. in Encyclog. Med. Avril, 1845; Ranking's Half-yearly Abstract,
 i. 218.  New York, 1845;  J. Bell, in Stokes's and Bell's  Lectures on the  Theory and
 Practice  of Physic, 3d edition, ii. 638.  Philad. 1845; A. N. Bell, Medical Examiner,
 May, 1846, p. 283; M'Cormick, New  Orleans  Medical Journal, September, 1845; J.
 Harrison, Ibid. Nov. 1845.  Also, on this subject, Dickson, Southern Jour,  of Medicine
 and Pharmacy, January, 1846; T. D. Mitchell, New Orleans Medical and Surgical
Journal, July, 1846, p. 25;   Briquet, Annuaire de Therapeutique pour 1849, p. 205;
Op. cit., and Annuaire, pour 1854, p. 139; G. L. Upshur, Medical Examiner, March, 1847,
p. 143 ; and Prof. J. H. Bennett, in Edin. Monthly Journ. and Med. Science, June, 1852.
  5 Medical Examiner, April, 1845, p.  638, and his General Therapeutics and Materia
Medica, 5th edit. ii. 89.  Philad. 1853.
  6 American Journal of the Medical Sciences, July, 1846, p. 79.
  T Bouchardat, Annuaire de Therapeutique pour 1850, p. 172.
  8 London Medical and Physical Journal,  March, 1833. 
620
QUINIiE SULPHAS.
a day.  Until the doses were increased to fourteen  or sixteen grains,
he did not experience  any peculiar effects, but now began to feel heat
of skin, dryness of mouth and fauces, and obstinate constipation.  He
likeAvise lost the power of naming substantives; was obliged for a long
while to consider what familiar  things Avere  called, and was  unable to
cast up a line of six  or eight figures  correctly.  His  perceptions of
quantity Avere likewise  impaired, so that in prescriptions he Avrote ounces
for drams, drams for  grains, &c, &c.   He  still, however, persevered
with the quinia, until  he took 9j. four times  a day;  but he was unable
to continue these large doses long, the untoward symptoms augmenting,
so that he was often  unable to  stand, and  fell several  times in the
street.
   Very similar results to those observed by Mr. Scott, and  especially
as regards the inability of utterance—which, in their cases, was com-
plete—are recorded by M. Menage,1 and Mr. G. 0. Heming.2  Cases
of deafness caused by large doses have  been detailed by Dr. Joseph
Williams, of London,3 Mr. C. R. Bre'e,4 of Stow-market, England; M.
Fr. Lugeol, of Havanna,5 and Prof. Giacomoni ;6 and cases of blindness,
induced by large doses, are recorded by Dr. John M'Lean,7 and Dr.
Wm. Alex. Thorn.8
   MM. Trousseau and Pidoux9 refer to the case of a soldier who took
48 grains of  the sulphate for the cure of spasmodic  asthma,  which re-
turned daily at a certain hour.  Four hours afterwards, he experienced
buzzing in the ears, diminished sensibility, giddiness, and violent vomit-
ing.  Seven hours after taking it, he was blind and deaf, delirious, in-
capable of walking by reason of  the giddiness,  and vomited bile copi-
ously.  He was, in fact, in a state of intoxication.  The symptoms gra-
dually subsided.   Usually, the action of the sulphate does not extend
beyond twenty-four hours, and its maximum effects are experienced
two  or three hours after taking it.10
   In impressible individuals, the  sulphate and  the  muriate—even in
moderate  doses—not  unfrequently induce a sense of anxiety, restless-
ness, vertigo, confusion, depravation of vision, tinnitus aurium, and, in
many cases, transient deafness—cinchonism, quinism, quininism, ine-
briation quinique of Bretonneau—all of which symptoms appear to
be of a neuropathic character;  and, it has  been affirmed, occur more
frequently in females, especially those who are pregnant or suckling—
and in persons of slender and delicate conformation.11 In certain cases,
quinia and its salts seem to have caused ptyalism—the saliva being in-
odorous, and the teeth firm; and, when calomel  has  been given along
with it, it has been conceived that ptyalism has ensued sooner than  it
otherwise might have  done.

  1 Gazette M.dicale de Paris, 25 Avril, 1840.
  2 London Lancet; and Medical Examiner, July 18, 1840, p. 468.
  s London Lancet, July 25, 1840,  p. 639.               * Ibid. August 22, p. 786.
  6 Bullet. Gen. de Th.rap. Mars,  1842.
  6 Annali di Medicin. Feb. 1841, and Journal de Pharmacie, Sept. 1842, p. 209.
  7 Illinois and Indiana Medical and Surgical Journal,  Dec. 1846.
  8 Medical Examiner, April. 1847, p. 217.        9  Trait, de Therapeutique, ii. 217.
  10 Trollier, in Bouchardat, Annuaire de Therapeutique pour 1847, p. 176.   Paris, 1847.
  11 Riecke,  Die neuern Arzneimittel, S. 120. 
QUINI/E SULPHAS.
621
  M. Melier,1 in conjunction with M. Magendie, has investigated the
toxical  properties of  quinia.   They found, in animals, congestion of
the lungs and deficient coagulability of the blood.  These were the prin-
cipal post  mortem phenomena.   Its action was much  more energetic
when given fasting, and in acid solution.  Its absorption and elimina-
tion  were rapid.
  The most striking agency of quinia and its salts is in cases of perio-
dical diseases of all kinds; and especially in intermittent fever;  they
have now, indeed, almost wholly taken the place of the cinchona, over
which they possess many points of preference.  In the first place, their
bulk is much less; they therefore do not oppress the stomach so much,
whilst the impression of the cinchona  on that organ not unfrequently
interferes with its antipyretic properties.  In malignant fevers, too, it
is often impossible to introduce the requisite quantity of cinchona into
the organism to prevent the succeeding paroxysm, and the life of the
patient is  consequently placed in danger.   In this case, sulphate of
quinia is invaluable, possessing, as it does, the antiperiodic virtues of cin-
chona in such a concentrated state, that but a small quantity is required
to produce equal efficacy with a large quantity of powdered cinchona. In
such cases, indeed, the latter is apt  to disagree with, or be rejected by
the  stomach, before its full influence can be exerted.   In those perni-
cious fevers, that occur especially in Italy and Holland, sulphate of
quinia has  supported life in innumerable  cases where cinchona, in sub-
stance, might  have failed, and has thereby  best exhibited its sanative
agency.2  In such cases quinia is administered without regard to com-
plications, which, in less urgent  cases, might be alloAved  to  interfere
with its administration.  Another advantage ascribed to quinia is, that
in cases of paroxysmal fevers, in which the attacks follow each other
so closely that the second commences before the first has terminated,
it may be given  during the paroxysm,—a time at Avhich cinchona would
be apt to occasion oppression of the stomach and vomiting.
  A salutary change has occurred in the treatment of southern fevers,
and .indeed of yellow  fever, by the  liberal  administration of sulphate
of quinia, which is now regarded by many southern  practitioners as
"the Samson article of  the Materia Medica," in place of calomel, on
which the  epithet was  previously lavished.  In the  congestive fever of
the Western States, Dr. Charles Parry3 found the sulphate of quinia
" the remedy;" and such has been the result of the experience of others.4
Great success  has followed the use of sulphate of quinia, in doses of
from a scruple to a dram in yellow fever, in the practice of Drs. Hunt,
Beattie, Farrel, Mackay, Dr. Harrison of New Orleans,5 Dr. John B.
Porter,6 U. S. A., and others;7 but Dr. W. A. Van Buren, U. S. A., never
witnessed any decided and permanent good  effects from it; and in the
  1 Mem. de l'Acad.mie Royale de Medecine, torn. x.  Paris,  1843.
  1 Repertorio Med. Chirurg, por l'anno 1822, Torino. No. 12; Med. Chirurg. Zeitung,
B. ii.  S. 137, 1823;  and Richter's Specielle Therapie, B.  x. S. 326.  Berlin, 1828.
  s American Journal of the Med. Sciences, July, 1843, p. 32.  Also, C. E. Lavender,
American Journal of the Med. Sciences, July, 1848, p. 51.
  ' Tuck, New Orleans Med. and Surg. Journ., cited in Med. Examiner, Dec. 1845, p. 749.
  B Transact,  of the Amer. Med. Association for 1848, p. 79.
  6 Amer. Journ. of the Med. Sciences, Oct. 1853, p.  319.
  7 Medical Examiner, Oct. 19, and Oct. 26, 1839. 
622
QUINLE SULPHAS.
hands of others it has failed signally.   Dr. Porter thinks, that twenty
grains is near  the maximum dose.   In the epidemic at New Orleans,
in 1853, it was by no means as successful.  At the commencement of
the epidemic, it is affirmed,1 the advocates of large doses of the sulphate
of quinia soon found, that although the febrile symptoms gradually gave
way under its use, it failed to effect a cure.  "As the epidemic progressed,
and its type and characteristics became better known, few, as far as we
can learn, ventured  to give large and repeated doses of this salt, except
in particular instances.  In our previous epidemic of yellow fever, the
quinia practice succeeded best; but  it is generally conceded, as far as
we could ascertain, that this season it failed, in a majority of cases, to
sustain its previous high reputation as a powerful curative agent."
   In the remittents  of  the  South  and West it has been an  admirable
remedy in the practice  of Drs. J. B.  Porter,2 Wm. M. Boling,3 Wm.  A.
Van Buren,4 Prof. Dugas,5 Dr. R. L. Scruggs,6 and others.7  Dr. T. D.
Mitchell,8 indeed, lays  down the position, that all fevers "possess one
common property, which confessedly under the control of  the sulphate
of quinia in the case of common ague and fever, is not less so in typhoid,
typhus, congestive,  yelloAv, and it may be all the fevers named in the
books;" and he assumes the position "plainly and boldly," that "there
is but one feature or element in either of the fevers named,  that is es-
sential to its pathology, and that feature or property, or element bows
before the potent sway of the sulphate of quinia, and for this reason
only we cure the patient."!  M. Guerard9 employs it at the commence-
ment of  all febrile affections.   " Whenever a person  is attacked  with
typhoid fever,  variola, or any other acute febrile affection, which is at-
tended at the  onset with encephalic disturbance threatening a severe
form,—as delirium  with  aberration  of the senses, particularly of the
sense of sight, which is  most appreciable by the physician, he prescribes,
before every thing,  two grammes  or  about 31 grains  of the sulphate of
quinia, to be taken by spoonfuls through the twenty-four hours.   This
dose has to  be  given the next  day, and at  times also on the day fol-
lowing."  The encephalic symptoms,  he  affirms, are immediately»dis-
sipated; the pulse becomes  regular, and  the  disease assumes a  mild
character.   He states,  also, that he  has used it  successfully in tinnitus
aurium not accompanied  by febrile phenomena and dependent upon
cerebral congestion.
   Dr. Robert Dundas10 believes, that  the remittent and  intermittent
fevers  of the tropics are identical with the continued fever of England,
—maintains, indeed "the essential identity of fever in all countries."
  1 The Editor, in New Orleans Medical and  Surg. Journ. for Sept. 1853.
  2 American Journal of the Medical Sciences, Oct. 1845, p. 296.
  * Ibid.  July, 1846, p. 18.         i Cited in Medical Examiner, Feb. 1846, p. 139.
  5 Southern Med. and Surg. Journal, cited in Med. Examiner, for Feb. 1847, p. 107.
  6 Med. Examiner, Dec. 1848, p. 716.
  7 See a discussion on the powers of quinia in remittent fevers in Med. Examiner, Feb.
1850, p. 78.
  8 Western Lancet, cited in Med. Examiner, June, 1845, p. 386.  Also, New Orleans
Med. and Surg. Journ. July, 1846, p. 22.
  9 Bouchardat, Annuaire de Th6rapeutique  pour 1849, p.  212.
  10 Medical Times, Oct.  4, 1851; and Sketches of Brazil, &c. Lond. 1852; and Ranking's
Abstract, xv. 208, Amer. edit. Philad. 1852. 
QUINIiE SULPHAS.
623
With this conviction he treats the  latter with large doses of the sul-
phate of quinia—ten or twelve grains, repeated at intervals not exceed-
ing tAvo hours; and he cites Mr. Eddowes, house surgeon of the Liver-
pool Fever Hospital,  who  found this  treatment cut the fever short,
or,  at least, prevent the accession  of the more formidable symptoms;
and also Dr. Gee.1  Favourable testimony is also borne to the practice
by  Dr. Stevenson, Mr. Glassbrook, Mr. Lester, Dr. Graves of  Dublin,
Dr. Richard Kelly, Mr. T. B. Gildersleeves, Mr. J. Ogden Fletcher,3
and others.3  Dr. J. Hughes  Bennett,  however, adopted the treatment
in eight  cases of typhus without satisfactory results.4  In one case, in-
deed, it aggravated the cerebral symptoms.  Dr. A. White Barclay was
not more successful;s nor were Dr. Christison, Dr. Robertson,6 and Dr.
John Douglas.7
   Dr. Scruggs holds it to be  a most  important fact connected with the
use of the sulphate of quinia, "that it should never be given upon a
rising fever,—that is, until the fever  has attained  its climax, or has
been arrested by the  use of the lancet or other  remedial  agents, and
has a downward  tendency.   Then, although the pulse may have mount-
ed up to  one hundred  and  forty beats to the minute, and have de-
clined only ten  beats, quinine  may be  given in large and  repeated
doses, combined  Avith  ipecacuanha, not only with safety, but with the
most decidedly  beneficial  results."   On the other hand, Dr. R.  S.
Holmes8 affirms, that  as a remedy for periodicity quinia is to be given
regardless of any existing state  of inflammation.
   In the typhoid fever of  children  it was found serviceable by  MM.
Rilliet and Barthez.9   Trials of the remedy have likewise been made
at  the Hopital Cochin in Paris,  by M. Blache, in the  typhoid fever of
adults,  the results  of which were favourable.  The cases,  however,
Avere not numerous, and  in certain of  them  other  remedies Avere pre-
scribed  either before or in  conjunction with  the  sulphate of quinia.
Aftenvards, some of  the patients of M. Husson at the same hospital
Avere subjected  to  the same  mode of treatment, and  the results were
published by M. Laurent.10   The dose of the medicine usually pre-
scribed Avas three quarters  of a grain  every hour:  at times, the dose
Avas larger, and  given less frequently; and, in several  instances, two
drams and more Avere given in the twenty-four hours for several days
together.   In thirteen cases no other remedy was administered, but
although the patients recovered, the  results did not  show any  great
superiority over other modes of management.  In no instance  were
the phenomena arrested by the quinia.   Of  ten patients, who had the
disease mildly, all  recovered but  one, whose death  Avas attributed by
M. Laurent to the quinia.   Of three patients, labouring under the dis-
  1 See  the  statistical results of  the experience of  Dr. Gee, and Mr.  Eddowes, in
Lancet, July 2, 1853.                   2 Med. Times and Gazette, April 23, 1853.
   3 Ranking xvi. 26, Amer. edit. Philad.  1853.
  4 Monthly Journal of Med. Science, April, 1852.
   5 Med. Times and Gazette, Jan. 8, 1853.  Dr. Dundas, from an analysis of Dr. Barclay's
cases, draws inferences  more favourable to  cinchonism.—Ibid. Jan. 29, 1853.  An
abstract is given in  Ranking, xvii. 23.  Amer.  edit. Philad. 1853.
   6 Monthly Journal, July, 1852, p. 90.        7 Charleston Med. Journal, Sept. 1852.
   8 Amer. Journ. of the Medical  Sciences, Oct. 1846, p. 304.
   9 Archiv. Gen.ral de Med. Juin,  1841.                 10 Ibid., Sept. 1842. 
624
QUINI.E SULPHAS.
ease in a severe form, one only recovered; and he was for a time in
great danger from intestinal hemorrhage.   The report of M. Laurent
is not very favourable to the beneficial effects of the sulphate of quinia
in typhoid fever.  By Dr. A. N. Bell,1 it  has been given in the  same
disease, with  the effect of reducing  the  frequency of the pulse, but
without appearing to affect in the least the duration of the malady.
  It has been prescribed by M. Leudet,2 in large doses as a preven-
tive of puerperal fever; and Dr. W. M. Doling,3 of Alabama, has ad-
duced Avhat  he esteems reasons for the belief, that it is "peculiarly"
applicable to the treatment of the inflammatory affections of malari-
ous districts,—and this he considers is owing to the combination Avith
its  antiphlogistic properties of a power to  control the  periodicity of
morbid action.  "As an antiphlogistic remedy in elevated and healthy
localities," he remarks, "it will probably  never supersede  the lancet,
antimonials, &c, though it may in many cases be brought to their aid;
but in malarious regions,  ere long, it will  generally be looked upon as
the safest and most manageable contra-stimulant we possess, and, at
the same time, one sufficiently powerful, while other agents of the  same
class will only be used to fulfil some casual indication or as adjuvants
to this the poAverful remedy."
  It is scarcely necessary, however, to say that quinia and its prepa-
rations are  not universally admissible.  The stomach is occasionally
so irritable  as not to retain it.   In  such cases, it is true, it may be
given in the form of enema.   In remittents, too, that  are accompanied
with hypersemia of important organs, such  hyperaeuiia must be removed
before it can exert its wonted efficacy.  "Those," says Prof. Dickson,4
"deceive  themselves who regard  quinine  as a universal  and infallible
febrifuge even in malarious fevers."
  Like bark and its various preparations, quinia has been used as a
prophylactic in malarious regions.   For this purpose, the amorphous
quinia in wine, in the proportion of four grains to an ounce, has been
recommended  by Dr. Bryson, R. N.,s who gives the results of the ex-
perience of  many medical officers on the African station.
  Sulphate of quinia has likewise been found advantageous in  large
doses—twelve to thirty grains and more daily—in engorgement of the
spleen, consequent on intermittent fever;6 and M. Levy7 has seen the
dropsical effusions,  that not unfrequently  supervene on neglected  cases
of  the same disease, yield readily to the sulphate in full doses.8  In a
memoir presented to the Academy of Sciences of Paris, by M. Piorry,
a few years ago, he laid  down the  astounding opinion, that  sulphate
of quinia, dissolved in a small quantity of sulphuric acid and adminis-
tered in moderate doses, acted  so rapidly on the spleen,  that in the
course of 40 seconds a notable diminution in the size  of the organ took

  1  Med. Examiner, May, 1846, p. 282.
  2  L'Union Medicale,  8 Avril, 1848; and Wahu,  Annuaire de  Medecine, &c, pour
1849, p. 299.        3 Amer. Journ. of the Medical Sciences, July, 1844, p. 110.
  4  Southern Journal of Medicine and Pharmacy, Jan. 1846.
  6  Med. Times and Gaz. Jan. 6, 1854.
  6  For the opinions of Bally, Nona., and Piorry on this  subject, see Medico-Chirurg.
Rev. July, 1840, from La Lancette Francaise.                        ' Op. cit.
  8  Bulletin General de Th.rapeutique, 30 Nov., 1837, and Levy, Gazette  Med. No. xxii. 
QUINLE SULPHAS.
625
place.   As might have been presumed, there would  seem to be some
source of fallacy in his observations; and M. Gouraud1 has boldly main-
tained, as the result of accurate inquiry into the phenomena, that the
disappearance of dulness in the splenic region under such circumstances
is dependent upon the ingestion of fluid with the sulphate of quinia,
which produces  a  development of gas, rather than upon the action of
the sulphate of quinia; and M. Gouraud's observations have been con-
firmed by M. Valleix.2
  Its use has  been recommended in asthma by Dr. B. R. Hogan,3 who
gave it in doses of from two to  eight grains, repeated in an hour, if
relief did not follow.   He also affirms,  that in  the  forming stage of
croup, in the case of a child, two years old, two grains of the sulphate,
and a snuff plaster on the chest warded  off the attack.  It has been
administered successfully in the same disease by M. Puis4 in the form
of  lavement in  the  dose of  60 centi-grammes—gr.  9J—in  the day.
Where there was a malarious complication, it Avas more  decidedly effi-
cacious.
  In hiccough, when at all periodical, M. Mondiere has found the dis-
ease promptly and decisively cured by the free use of quinia, after it
had resisted every other mode of treatment.  He has  also used it with
good results in  many cases of severe cardialgia.   In a case of trau-
matic tetanus  it was  administered  along with sulphate  of morphia in
large sedative doses,with much success, by Dr. Bishop;5 and in  marsh
cachexy—cachexie paludeenne—it was found, by M.  Duclos, most ad-
vantageous.   In these cases,  it is associated  with chalybeates by Pro-
fessor Trousseau.6
  Sulphate of quinia, like  cinchona,  has  been given  largely in  acute'
rheumatism—a  disease which is peculiar,  and in  the  author's  view,
largely neuropathic.7   Some years ago, M. Briquet announced that he
had cured acute articular rheumatism, accompanied with violent pain,
swelling, redness,  fever, &c, in  two  or three days, with sulphate  of
quinia, in doses of about a dram and a half daily.  In such cases, and
especially in the subacute form, the author has prescribed from twenty
to thirty grains  in  the twenty-four  hours with marked advantage.
Its  antiperiodic ATirtues are clear, and instead of its  acting as an ex-
citant it  produces sedative effects.8  In obstinate cases, a combination
with opium—three or four grains in the tAventy-four hours—proved
most decidedly salutary.   Given after the use of the  lancet, in  highly
inflammatory cases, or after poAverful purgation Avith  croton oil, it has
been productive  of the happiest effects in the  hands of Dr. Geo. L. Up-
shur,9 of Norfolk,  Va.

  1 Cited in Medical Examiner, Sept. 1815, p.  577.
  a Monthly Journ. of Med. Science, July, 1847, and Med. Examiner, Nov. 1847, p. 697.
  3 American Medical Intelligencer, Feb. 1842, p. 153.
  4 Bouchardat, op.  cit. p. 214.
  5 New York Journal of Medicine, Sept. 1847.
  8 Bouchardat, Annuaire, &c. pour 1849, p. 215.
  7 Practice of Medicine, 3d edit. ii. 611.  Philad. 1848;—and Med. Examiner, Sept.
1845, p. 538.
  8 See Legroux,  Journal de Med. in Encyclographie Med., Avril,  1845, and Ranking's
Half-yearly Abstract, Amer. edit. i. 218.  New York, 1845.
 9 Med. Examiner, Oct. 1850, p. 581.
    40 
626
QUINLE SULPHAS.
  Dr. Muntendam1  infers, from his experience in twenty-two cases,
that sulphate of quinia, given along with acetate of morphia, or even
alone, is capable  of prolonging life in many  cases  of phthisis; and
may even effect a cure where tubercular deposition has just commenced,
especially in married women and children.   He believes, indeed, that
in very many—but not in all—cases of phthisis it should be ranked as
one of the best remedies.
  In scrofulous or phlyctenular ophthalmia, it has been extolled  by
Von Ammon;  and Mackenzie2 remarks, that after a trial of many in-
ternal remedies in  that disease, he has found  none  so useful as  the
sulphate of quinia.   It  exercises, he says, a remarkable  power over
the constitutional disorder which attends this ophthalmia, and, thereby,
over the local complaint.   He gives it generally in the dose of a grain
three times  a day: to very young children half a  grain; and to ado-
lescents  or adults, two grains.   He finds it act best in solution.
  Some  years ago, M. Gueneau de Mussy,3 in the name of a committee,
made a report on different papers that had been forwarded to the French
Academy, on the treatment of acute rheumatism by large doses of sul-
phate of quinia.   The committee concluded, that it should not be given
in the high  doses of four to six scruples, advised by M. Briquet; and
they affirmed, that the same therapeutic effects may be obtained from
ordinary doses.  The sulphate of quinia plan of treatment is followed
by MM.  Andral, Monneret, Legroux, and Professor Trousseau,4 at  the
Hopital Necker, and is recommended by M. Vinet.5
  United with  opium, it was found of great service  in two cases of pro-
bably incipient hip disease, by Dr. Nelson Nivison6 of New York.  In
the wards of M. Legroux, Dr. Wickham7 found several cases of urti-
caria, complicated with severe  pain of the joints, yield readily to qui-
nia,—a  remedy, he observes,  also useful  in simple urticaria, which
exhibits  the same fugacious character as rheumatism.  It was from its
analogy to neuralgia, that M. Cazenave recommended arsenic in urticaria.
  It has been  strongly advised  by many of the French practitioners
as a prophylactic  against  cholera;  but  the observations  made at  the
Hopital  Cochin, in Paris, were by no means favourable to those preten-
sions.8  At Rangoon, according to Mr. Taylor,9 large and repeated doses
were given, but not  with any very encouraging success.   In  the sum-
mer  of 1849, a few cases, treated with large doses,  were more satisfac-
tory in  their results.   Dr. F. W. Sargent10 states, that of seventeen
cases, treated in this way, in the stage of collapse, thirteen recovered;
—a  greater amount of success than from any other method.
  1 Nederlandsch.  Lancet, in Jamain  and Wahu,  Annuaire de  Med. &c, pour 1855; p.
116, and Amer. Journal of the Med. Sciences, April,  1855, p. 511.
  2 A Practical Treatise on Diseases of the Eye, Amer. edit, by Dr. A. Hewson, p. 483,
Philad. 1855.                        » Med. Examiner, July 8, 1843, p. 156.
  * Trousseau and Pidoux, Trait, de Therapeutique, &c, 3eme _dit. ii. 322.  Paris, 1847;
Also, Med. Examiner, May, 1848, p. 330.
  8 Union M.dicale, No. 43; and British and Foreign Med. Chirurg., July, 1848, p.  259.
  6 New York Journ. of Med. May, 1854.
  7 Rev. M.d. Chir. viii. 260, cited in Brit, and For. Med. Chir. Jan. 1852, p. 275.
  8 Bouchardat, Annuaire de Th.rapeutique pour 1850, p.  196.
  9 Indian Annals, cited  in Ranking's Abstract, xx. 203, Amer. edit. Philad. 1855.
  10 Philad. Med. Exam. Sept. 1854, p. 529. 
QUINI.B SULPHAS.
627
   Grafe and othersx have likewise reported favourably in regard to it
 as a cholera preventive.
   In large  doses, it has been prescribed with  speedy and good effect
 by M. Piorry2 in certain cases of insanity, in those especially in which
 the disease has seemed  to have  been connected with  certain changes
 of the functions of the  organs of sense, especially of hearing;  and in
 the case of hypochondriasis with  certain abdominal sensations.   Pe-
 riodicity is  a  characteristic in  many of these cases, and hence  the
 utility of quinia.
   Besides their antiperiodic property, the salts of quinia are generally
 considered  to  possess a tonic virtue that adapts them for  numerous
 cases in which that  class  of remedies  is indicated.   Yet  there  are
 many who  think that cinchona is  better calculated for such  cases
 than  quinia, and who administer the  latter to  prevent the paroxysms
 of an intermittent, but have recourse to  cinchona when they are desi-
 rous of fortifying the system to prevent a relapse.   There are cases, too,
 which resist quinia and its preparations, and which subsequently yield
 to cinchona in substance; but  this  may be  owing to the quantity of
 lignin, or woody matter in the bark in  substance aiding the quinia of
 the cinchona in  producing that  new impression  on the nerves of  the
 stomach, which is necessary to break in upon the paroxysmal catena-
 tion.   In its  antiseptic virtues,  also, sulphate of  quinia is inferior to
 cinchona.   It  has been doubted, indeed, whether it has any such vir-
 tues.   Professor J. H. Bennett,3 of Edinburgh,  doubts, also, whether it
 has any tonic virtue; and he affirms, that of one  thing he is satisfied,
 that it is far inferior  in tonic properties to many metallic and  other
 vegetable drugs; "and consequently," he adds, "a medicine  with such
 known valuable  antiperiodic  properties, the  supply of which, also, is
 yearly diminishing, should  not be wasted in  endeavouring to produce
 effects so very  doubtful  as the tonic virtues which have been ascribed
 to it."
  M. Delvaux,4 having observed the frequency with which worms are
 discharged during the use of the sulphate of quinia, employed it as an
 anthelmintic, and has collected more than forty cases in which ascari-
 des lumbricoides were discharged under its influence.  Lavements com-
 posed of it expel the oxyures vermiculares from the rectum.   From three
 to six grains were given in the twenty-four hours to children of from
 two to ten years of age, gradually diminishing the dose when the  object
 has been effected. The lavements may contain from four to six grains.
  Lastly:  there is an  advantage possessed by sulphate of  quinia,—
 that in irritable or impressible persons it may be exhibited endermi-
 cally, and  thus no disorder be induced  in the digestive  actions.  It
 need scarcely be said, that cinchona is not well adapted for this mode
 of administration.
  1 Canstatt's Jahresbericht, 1850, 5 Bd. S. 152.
  2 Gazette des Hopitaux, No. 86;  and British and Foreign Med. Chirurg. Review, Oct.
 1848, p. 554.
  3 Edinb. Monthly Journ. of Med. Science, June, 1852.
  4 Gazette des Hopitaux,  No. 58, and the Medical News for  September, 1855, p. 149.
Also, Amer. Journ. of the  Med. Sciences, Oct. 1855, p. 507. 
628
QUINLE SULPHAS.
                      MODE OF ADMINISTRATION.
   Sulphate of quinia may be given  internally in the form of  powder
 or pill, and in solution in water, alcohol, or syrup.  The average dose,
 in the  twenty-four hours of  apyrexia, is from four to ten grains; yet
 it has been given frequently to a much greater extent.   As in the case
 of cinchona, it has also been  advised, that a large dose should be given
 immediately before the expected  paroxysm, so  as to render the fre-
 quent administration during the apyrexia unnecessary:  this dose need
 not be  so great as the combined doses would  amount to, so that there
 may  be economy in the plan.   Dupasquier, Elliotson,1 the  author, and
 many others,2 have found this  course eminently successful; but  some
 object to it.   In  ordinary intermittents, the  author is in the habit of
 administering the sulphate in the form of the mistura quinise sulphatis,
 given hereafter.  As the antiperiodic virtues of the remedy  are exerted
 through the nervous system, he considers it advisable to impress not
 only  the nerves of the stomach  but those of gustation, which cannot be
 effected by the pilular form.   Half the mixture—or five grains of the
 sulphate—is  given about an hour before the paroxysm, and  the re-
 mainder half an hour afterwards; and if signs of the paroxysm appear
 notwithstanding, he directs fifty or sixty drops  of the tincture of opium
 to be given.  This course rarely fails.3   The  advantages of the  solu-
 tion over the pilular form have been  confirmed by the observations of
 M. Briquet.4   He  considers it more active by one-half.
   In the intermittents of India, from a scruple to half a dram is given
 a short time before the paroxysm; and testimony has been afforded by
 Dr. Corbyn,5 in regard to its efficacy when  administered immediately
 after the sweating  stage; and Dr. Murchison6 says, that  one large dose
 —usually a scruple—administered during the sweating stage, is the most
 effectual plan for checking the paroxysms at once.  Drs. Pfeuffer and
 Meyer7 found a single ten grain dose, given five or ten hours before the
 expected paroxysm, with  ten grains of sugar, a nutritious diet of meat
 and beer, with ferruginous preparations, sufficient to arrest the majority
 of intermittents.
   A case of severe remittent has been detailed by Dr. Thomas Fearn,8
 in which he gave at one dose, three tea-spoonfuls—weighing thirty-tAvo
 grains.   At the end of  an hour,  there Avas a  diminution in the fre-
 quency  of the pulse—"the invariable effect of large doses of quinia,
 when its operation  is favourable."   The dose Avas  repeated,  and at the
 end of  another hour it was again  given, making  ninety-six grains in
two hours.   Dr. Fearn remarks, that his  usual practice in remittent
fever  had been to  give three doses of twenty grains each, with an in-
 terval of an hour between.

  1 Medico-Chirurgical Transactions, xii. 543.  Lond. 1824.
  2 Thomas Stratton, R. N., Edinb. .led. and Surg. Journal, April, 1844.
  3 See the author's Practice of Medicine, 3d edit. ii. 424, Philad. 1848.
  4 Bouchardat, Annuaire de Th.rapeutique pour 1849, p. 211.
  5 Indian Annals of Med. Science, No. 1, Oct. 1853, and Ranking's Abstract, xix. 25.
  6 Edinb. Med. and Surg. Journ. Jan.  and April, 1855, and  Ranking, Op. cit. xxi. 31.
Amer.  edit. 1855.
  7 Casper's Wochenschrift, 1851, No. 27, cited in Brit, and For. Med. Chir. Rev. Jan.
1852, p. 276.                                                 s Op. cit. 
QUINL83 SULPHAS.                         629
  Of late years, it has been the practice with many physicians to ad-
minister  it in very large  doses—gr. xx.  to gr. xl.—in ordinary inter-
mittent fever;1 and  there may be cases in Avhich after  the disease
has resisted the usual doses, it may yield to these;  but the author has
not met with many.   It has been stated, indeed, that M. Piorry, who
was formerly an advocate for  large doses of the sulphate in intermit-
tents, now affirms, that he obtains the same results from doses of fif-
teen grains,  as he did  from those of seventy and ninety.2  Dr. Upshur,3
of Norfolk,  gives it in doses of three or five grains, every two hours,
commencing as soon as there is the slightest diminution in the hot stage,
and  continuing it until the patient complains of noises  in  the ears.
He found that, when administered in large doses in the hot stage,  so
far from exciting  the circulation, it acted as  a decided sedative—the
pulse, in every instance, being lessened in force and frequency under
its influence.4  A medical friend of Dr. Dickson,5 of Charleston, as-
sured him that in Alabama, he had administered "thirty grains  of a
solution  of  sulphate  of quinia,  every hour  for  seventeen successive
hours," and he  states that he  had heard authentically of a western
physician, "who emptied into the stomach of a patient labouring under
bilious remittent, an ounce bottle in one night."   Even  larger  doses
than these are recorded.  Dr. B. Rush Mitchell,6 in a case of congestive
fever, gave thirty grains every half hour, until 240 grains were taken
in about four hours;  and the  patient recovered.   Generally, between
the paroxysm several doses are administered; and according to the
particular case, the efficacy of the salt of quinia is attempted to be in-
creased by the addition of antimonals, laxatives, carminatives, &c, and
—in pernicious or malignant intermittents  especially—of  opium  or
morphia.  A recent writer7 affirms, that full doses of quinia and opium,
given in  the midst of the cold stage, will  be found both safe and effica-
cious. " The series of morbid phenomena, by which  a paroxysm is cha-
racterized, is broken up; and the germ of morbid action appears to  be
extinguished.   The  dose should be from 20 to 25  grains of the sul-
phate, and from two  to four grains of opium in combination.
  By many, a combination of  quinia with moderate doses  of cinchona
is highly recommended.   Chapman advises its union with piperin: a
combination with the alcoholic extract of cinchona  has also been pre-
scribed.
  MM. Galamini8 and Bartella9 propose to unite sulphate of quinia with
tartaric acid, in equal parts, in the treatment of intermittent;  and the
latter affirms that he  has successfully treated, altogether,  two hundred
and eight cases in this way, one hundred and ninety-six being simple
intermittents, and twelve pernicious fevers.   M. Bastille,10 too, consi-

  1 A. Flint, in American Journal of the Medical Sciences, Oct. 1841, p. 278.
  2 Philad. Med. Examiner, Feb. 4, 1843, p. 24.        * Ibid. Feb. 1846, p. 89.
  4 Medical Examiner, March, 1847, p. 146.                5 Dickson, loc. cit.
  8 New Orleans .Med. and Surg. Journal, July, 1846, p.  20.
  7 Southern Journal of Med. and Physiological  Science, May, 1853, and Ranking's
Abstract, xviii. 20.
  8 Bullet, dele Sc. Med. xxi. 99, and Brit, and For. Med. Rev. April, 1853, p. 569.
  » Bullet, de Therap. xlv. 49.
 10 Gazette des Hopitaux, No. 87, and Brit, and For. Medico-Chir. Rev. Oct. 18u3, p. .-.9. 
630
QUINliE SULPHAS.
ders the combination more active than the simple sulphate; as a gene-
ral rule, he found half the  quantity of the  sulphate, so combined, to
be  sufficient;  but in the pernicious fevers of Italy large doses were
required.
   Mr. Sherwin,1 of  Hull, affirms, that a piece of apple, cheAved for  a
moment, immediately annihilates the bitter taste left by it; and such
is  the author's  experience.  MM.  Des Vouves, Dorvault,  Quevenne
and Bouchardat2 state, that an  infusion of roasted coffee masks  the
bitterness so completely, that children—not  the  most docile—take it
without repugnance.  M. Thelu3 has found, that an infusion of black
tea, which possesses the same astringent principles as coffee,  has  the
like effect.  Perhaps the tannic acid contained in  them  is the  active
agent;  inasmuch  as  Dr.  Richard H. Thomas,4  of Baltimore, noticed
that the addition of two grains of the acid to ten of the sulphate of
quinia in  a mixture deprived it of its bitterness.
   M. Piorry5  recommends,  that  a piece of chocolate  should  be half
masticated, and retained between the cheeks and the teeth.   The qui-
nia draught must then be rapidly swallowed, when the  mastication of
the chocolate  must be completed, and it must be swallowed.  The taste,
it  is said, is scarcely perceived.
   Dr. W. H. Edwards6 says, that it may be taken without tasting its
bitterness, by putting it in powder, in the middle of  a tablespoonful of
thick mucilage of slippery elm, so that it may not touch the spoon, and
immediately swallowing it.   If the  quinia be dextrously enveloped in
the mucilage,  the patient is unconscious of having  taken a bitter dose.
   It is stated,7  that quinia, given in infusion of  senna, is more effica-
cious as a tonic, notwithstanding the cathartic nature of  the mixture,
than almost double the quantity given in pill.
   Sulphate of quinia may be used in the way of enema, and endermi-
cally, when the condition of the stomach  forbids its internal  employ-
ment.  As an enema, three times the ordinary dose, or  more, may be
mixed with starch, and be thrown up a short time before the paroxysm,
or at the  inception of the same.   In this way it has been found effica-
cious.8
   In administering the sulphate or  muriate  of quinia  endermically, a
space on  the surface of the body is deprived of its cuticle by means of
a  blister, and on this denuded portion the agent is applied, either  in
the form  of powder or of ointment.   To testify in regard to  the effi-
cacy of this mode of administering  the salts of quinia, many observers
have come forward,—Lesieur, Lembert,  Martin, Wesche, Lehmann,
Reilingh,  Stratingh, Lieber, G. Lane  Corbin,9 and others.  From four
to eight grains  may be placed on the  denuded part once or oftener  in

   1 Lond. Med. Gaz. April 1, 1837.
   2 Annuaire de Therapeutique pour  1848, p. 153.  Paris,  1848.
   ' Bouchardat,  op. cit. p. 157.
   4 American Journal of the Medical  Sciences, April, 1850, p. 541.
   5 Bullet,  de l'Acad. xvii. 329, and Brit, and For. Med. Chir. July, 1852, p. 276.
   6 Annals of Pharmacy, and Amer. Journ.  of Pharmacy, Jan. 1855, p. 21.
   7 Lond. Lancet, Nov. 4, 1843.
   8 Richter, Op. cit. S. 331.  Berlin. Medicin. Zeitung, Jan. 4, 1837.
   9 American Medical Intelligencer, Aug. 1841, p. 26. 
QUINI-E SULPHAS.
631
the day.   Dr. Lieber,  of Berlin, seems  to  have prescribed the salt
most frequently in this way: he mentions, that of sixty cases, in which
he employed it,  only eight or ten were unsuccessful;  and there was
reason to believe, that in these the internal administration of sulphate
of quinia would have failed also.  In the case of adults, he applies  a
blister in the evening—of the size of a  dollar—over  the  epigastric
region; in  the morning, during  the apyrexia, the  blister is  cut;  the
cuticle removed, and five or six grains—in children two grains—of the
sulphate are sprinkled over the  denuded  surface.  The whole is then
covered with adhesive plaster, which must extend to the  breadth of  a
finger over the edges of the blistered part.  The sprinkling of the sul-
phate always occasions a violent burning sensation, but if it be applied
in the form of ointment,  this evil is avoided, or at least diminished.
The pain, however, speedily disappears.   Some  hours after the appli-
cation, oppression is felt in the stomach, with a desire to vomit, without,
however, vomiting actually supervening;  borborygmi, or uneasiness in
the bowels, and frequently fluid dejections, with augmented  secretion
of saliva, which, in some cases, continues for several  days.   In  the
course of from twelve to twenty-four hours after the application, a very
bitter taste is usually perceived over the whole tongue, similar to that
of quinia; and if the application has been  made sufficiently long before
the anticipated paroxysm, it may be  entirely prevented, or  rendered
much milder.  After the  effect has been produced, the  adhesive plas-
ter may be kept applied for  some days, and, if the sore is not healed,
it may be dressed with simple applications.   In  only two cases did Dr.
Lieber observe any extensive or offensive suppuration; and both cases
healed under simple dressings with dry lint.  At times, the  blistered
surface is made much more extensive, and the quantity of the sulphate
of quinia much larger.   Dr. Wooten,1 for example, does not apply less
than two drams in the case of an adult, when the endermic use of the
remedy is required, which, of course, is not  often.  In a case related
by Dr. Corbin2 of intermittent of eighteen months'1  duration which
had resisted various measures, a blister was applied to each extremity,
and one over the epigastrium, an hour  before the expected paroxysm;
and to the exposed cutis, an ointment,  composed of five  drams of the
sulphate to four ounces of simple cerate.   The whole of this was spread
on cloths, and laid on the blistered surfaces  eight hours after the blis-
ters had been applied; and the dressings were not disturbed until the
parts were healed.   The cure was complete.   It is affirmed by M. Mar-
tin Solon,3 that when sulphate of quinia has been applied endermically
in no case could it be detected in the urine.
   Rubbing  quinia or its salts on  the  gums has, likewise, been occa-
sionally recommended, as well as frictions with  the^ alcoholic solution,
or with an, ointment, on these as well as  other portions of the  surface
of the body—the thighs, groin, and pit  of  the  stomach;4 and it has
been advised in cases of intermittent cephalalgia, and in iralgia, to be

  1 Southern Medical and Surgical Journal, July, 1846, p. 414.        * Op. cit.
  ' Cited in Medical Examiner, Nov. 1845, p. 695.
  4 Schuster, cited in American Journal, May, 1832, p. 242 ; and Antonini, Journal des
Connaissances, &c, Oct. 1838. 
632
QUINLE SULPHAS.
 snuffed up the nostrils.1  M. Ducros2 makes the strange assertion, that
 doses of about three quarters of a grain, dissolved in sulphuric ether,
 and applied with friction to the  lining membrane of the mouth—"par
 la  mithode buccale"—cause a stronger and  more rapid  action than
 half a dram given by the  stomach or rectum;  and that they are not
 liable  to  induce quininism.   This  rapidity of action he regards as
 peculiarly important in malignant intermittents.  " Sulphate of quinia,
 administered in pills or enema, requires five or six hours for its action,
 [?] but when administered by friction in the mouth, half an hour be-
 fore the third paroxysm, which is often fatal, reaction  has time to
 take place."
  Dr. Guastamocchia3 has  succeeded in arresting intermittents by dis-
 solving eight grains of sulphate  of quinia in half an ounce of alcohol,
 rubbing it, in two doses, with an interval of a quarter of  an hour be-
 tAveen them, along the spine.   This should be done at the beginning
 of  the cold stage.   It very often prevented a recurrence  of the  pa-
 roxysm.
                  Mistura  quiniae sulphatis.
                    Mixture of sulphate of quinia.
                 R.  Quinia. sulphat. gr. x.
                     Acid, sulph. dil. gtt. viij.
                     Aqua.  vel.
                     Aqua,  cinnam. f ^iiss.
                     Syrup, f^ij.  M.
  Dose.—One-half  to be taken an hour, and  the other half, half an
 hour before the  expected paroxysm of an intermittent, or the whole to
 be taken in divided  doses during the apyrexia.
                  Syrupus quinise  sulphatis.
                     Syrup of sulphate of quinia.
                 R.  Quinise sulphat. gr. xvj.
                     Syrup, f 3viij.  M.
  Dose.—A spoonful.                                  Magendie.
           Syrupus  quiniae  sulphatis compositus-
                 Compound  syrup of sulphate of quinia.
                 R.  Quinia. sulphat. gr. xvj.
                     Acid, sulphur, dilut. gtt. v.
                     Syrup, limonis f ^viij.  M.
  Dose.—Same as the last.
                    Mel quiniae sulphatis.
             Honey of sulphate of quinia.—Micl de quinine.
                 R.  Quinia. sulphat. gr. viij. (50 cent.)
                     Acid, sulphur, aromat. gj.
                     Mel purificat. § iss.  M.
  Dose.—A tea-spoonful in the intermittents of children.   It is gene-
rally taken  without  repugnance.                          Petzold.4

  1 B. St. Hilaire, in Gazette M.dicale de Paris, 26 Mars, 1836.
  Comptes Rendus, cited in Western Lancet, July, 1846, p. 138; and Bouchardat,
Annuaire de Th.rapeutique pour 1847, p. 179.  Paris, 1847.
  8 II Filiatre Sebezio, Agosto, 1841, and British and  Foreign Medical Review, Jan.
1843, p. 236.         4 Annuaire de Th.rap., &c,  pour 1847, p. 178.   Paris, 1847. 
                         QUINIiE SULPHAS.                      633

                 Tinctura  quiniae  sulphatis.

                    Tincture of sulphate of quinia.
                 R.  Quiniae sulph. gr. vj.
           Solve in
                    Alcohol. 34° (.847) f gj.
  Dose.—f 3j- or f $ij. immediately before  an attack of intermittent.
                                                      Magendie.
              Guttae quiniae sulphatis et opii.
                Drops of sulphate of quinia and opium.
                 R.  Quinia. sulphat. (seu  acetat.) gr. xij.
           Solve in
                    Alcohol, (seu sp. aather. sulph. comp.) f gss.
               adde  Tinct. opii gtt. xij.

  Dose.—Morning and evening, twenty  drops, in the summer fevers
of Europe.                                              Schmidt.
                 Pulveres  quiniae  sulphatis.
                   Powders of sulphate of quinia.
                 R.  Quiniae sulphat. gr. iij. ad xij.
                    Sacchar. gij.
           Misce et fiat pulvis in partes vj. aequales dividendus.
  Dose.—A powder, morning and  evening, in nervous debility, and in
intermittents.
  Radiusx advises, that the powders should be taken in coffee, by which
means the bitter taste  is almost wholly counteracted.

     Pulveres  quiniae  sulphatis et sodae carbonatis.

          Powders of sulphate of quinia and carbonate of soda.
                 R.  Quinia. sulphat. gr. j.—ij.
                    Soda,  carbonat. gr. iv.—v.
                    Sacch. 9j.
             Misce et fiat pulvis.
  D0Se.—A poAvder, morning and evening,  in scrofulous  ophthalmia.
                                                    Von Ammon.

Pulveres quiniae sulphatis et  antimonii et potassae tartratis.

   Powders of sulphate of quinia and tartrate of antimony and potassa.
                 R.  Quinia. sulphat. gr. x.
                    Antim. et potass, tartrat. gr. iij.
                    Sacchar. gr. xxiij.
             Misce exacte, et divide in partes sex  aequales.

  Dose.—One, every two  hours, during  the apyrexia, in  cases of ob-
stinate intermittents.                                        Gola.

            Pulveres quiniae  sulphatis  et opii.
               Powders of sulphate of quinia  and opium.
                 R.  Opii puri gr. j.
                    Quiniae sulph. gr. iij.
                    Sacchar.
                    Acac. aa. gr. vj. M. et fiat pulvis.
  To be  taken a short time before the paroxysm in malignant inter-
mittents.                                              Neumann.

            i Auserlesene Heilformeln, v. s.  w. S. 186.  Leip. 1836.
            2 Annali Univers. di Medicina, torn. 35. 
631                       QUINLE SULPHAS.


    Pulveres quiniae  sulphatis et  morphiae sulphatis.
         Powders of sulphate of quinia and sulphate of morphia.
                 R.  Quinia. sulph. gr. ij. ad vj.
                     Morphiae sulph. gr. ss. ad j.
             Divide in dos. iv.                            Magendie.

           Pulveres  quiniae  sulphatis compositi.

               Compound powders of sulphate of quinia.
                 R.  Quiniae sulph. gr. j.
                     Cinchon. pulv. gr. xv.
                     Rhei pulv.
                     Oleosacchar. menth. aa. gr. v.
             Misce et fiat pulvis.
   Eight of these to be given in  cases of intermittent fever.
                                                       Neumann.
                 R.  Quiniae sulph. gr. \.
                     Chocolat. gr. vij.
                     Sacchar. lact. gr. ij.
             Misce.  Fiat pulvis tertiis omnibus horis sumendus.
   In debility of the stomach.                                Kopp.

                   Pilulae  quiniae sulphatis.
                       Pills of sulphate of quinia.
                 R.  Quinia- sulphat. gr. v.—xij.
                     Ext. glycyrrhiz. 3j.
             Misce et fiant pilula. xij.
   To be given according to prescription in nervous diseases.
                                                          Radius.

   A form for  pilulje quini_e sulphatis is in the Pharmacopoeia of
 the  United States, (1851.)
                 R.  Quiniae sulphat. gj.
                     Acaciae in pulv. gij*
                     Mellis q. s.
   Mix together the sulphate of quinia and the gum;  then beat them
 with the syrup so as to form a mass, to be divided  into four hundred
 and eighty pills.   Mr.  Edward Parrish1 suggests powdered tragacanth
 in place of powdered gum Arabic—one grain to 12 of the sulphate,—
 water being the excipient.   The  pills, according to this  formula, are
 much smaller.
   Each pill contains a grain of the sulphate.

            Pilulae quiniae sulphatis compositae.'

                  Compound pills of sulphate of quinia.
                  R.  Quiniae sulphat. gr. x.—xv.
                     Acid, phosphoric, sice. ^ij.
                      Althaeas (vel rhei,) pulv. Qiv.
                      Ext. centaur, minor, vel gentian, ^ij.
              Misce et fiant pilulae lx.
   Dose.—Three to six pills, two or three times a day, in  cases of ner-
 vous debility with disposition to hemorrhage,—as after abortion.
                                                           Radius.

                1 Amer. Journ. of Pharm., July, 1853, p. 292. 
                         QUINLE sulphas.                      635

                R.  Quinia. sulphat. gr. xv.
                    Cinnam. pulv. ^.ss.
                    Extract, cinchona, q. s. ut fiant pilulae xxx.
  Dose.—Four pills every two to four  hours.            Henschel.
                R.  Quiniae sulphat. gr. xij.
                    Extract, trifol. 9j.
                    Calam. pulv. q. s.
             Fiant pilulas xij.
  Dose.—One or two every two hours.              Hildenbrand.
       Pulvis sternutatorius  ex quiniae sulphate.
              Sternutatory powder of sulphate of quinia.
                R.  Quiniae sulphat. gr. xv.
                    Tabaci sternutator. com. gj.  M.
  To be snuffed up the nostrils  in the course of five or six days, in
cases of intermittent headache.
                R.  Quiniae sulphat. gr. vj.
                    Sacchar. pulv. gj.
                    Irid. rad. pulv. £iss.  M.
  Small pinches of this to be snuffed up the nose at night.
                                                   B. St. Hilaire.
                Unguentum quiniae sulphatis.
                    Ointment of sulphate of quinia.
           *     R.  Quiniae sulphat. gj.
                    Alcohol. (38° ad 40°) q. s. (gij.)
                    Acid, sulphuric, q. s. (gtt. lxxx.)
                    Adipis giv.  M.
  Half an ounce  at  a time  to be rubbed on the groins in malignant
intermittents.  It may be likewise placed in the axillae.  Antonini.
  An ointment composed of 3j- of sulphate of quinia and By- of lard
bas been rubbed with success into the  axilla in cases of ague in chil-
dren.1
                         Vinum quiniae.
                           Wine of quinia.
                R.  Quiniae sulphat. gr. xij.
                    Vin. Mader. Oij.
  Wine of quinia may, also, be made extemporaneously, by  adding
two ounces of the tincture to a pint  bottle of wine.
                CLVIII. QUI'NLE VALERIAS AS.
Synonymes. Chininum Valerianicum, Valerianate of Quinia, of Quina, or of Quinine.
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  saturated by
a concentrated solution of  quinia in  alcohol  at 36°  (s. g. .847;) and
                     i Lond. Med.  Gaz. April 3, 1840. 
636
QUINLE VALERIANAS.
the valerianate of quinia thus formed is subjected to spontaneous eva-
poration.1  Or, it may be made by adding freshly precipitated quinia
to a hot solution of valerianic acid, and then crystallizing.   The crys-
tals are in thin, colourless rhomboidal plates, of a mother of pearl lus-
tre, 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.2
   Another method of preparing it is the following.   Into an alcoholic
and concentrated solution of quinia a slight excess of valerianic acid
is poured; the whole  is then  suspended in twice its bulk of  distilled
water;  and the mixture is carefully stirred, and subjected to evapora-
tion in  a stove at a  temperature not exceeding 50°.   When the evapo-
ration of the alcohol has  taken place, the valerianate presents itself in
the form of beautiful  crystals, sometimes isolated;  at others grouped
together.  It may also be prepared by double decomposition, by mix-
ing sulphate of quinia with chloride of calcium, or chloride of barium,
—both being dissolved in weak alcohol.3  The Dublin College prepare
it by the double decomposition of muriate of quinia and valerianate
of soda.4
                     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 occasionally
follow the use  of  sulphate of quinia.    Since  then, the salt has been
employed by different observers.  M. Devay,5 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.  Castiglioni6 gave
it in eighteen cases of intermittent or remittent  fever:  in fifteen it ef-
fected a cure, and in three it produced only temporary  relief.   In two
of the last cases the sulphate 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  maxi-
mum  thirty-five;  the  medium  quantity about ten grains and a half.
The minimum time required for the cure was two days; the maximum
eight days, and the mean three days and a half.   The high  price, how-
ever,  of the salt, will necessarily prevent it from being  much used.

                     MODE OF  ADMINISTRATION.
  Valerianate  of quinia being easily decomposed,  it is best to exhibit
it in  the most simple  form.  M. Devay dissolves 30  centigrammes,
(about gr. 4J,)  in 632 grammes, (about  f 5iij-,) of  gum  water; and di-
rects  it to be taken at three times, in  cases of rebellious fevers.   It

  1 Bouchardat, Nouveau Formulaire Magistral, p. 263.  Paris, 1845.
  2 Ballard and Garrod, Elements of Materia Medica and Therapeutics, p. 409.  Lond.
1845.  Also, Galvani, cited in Med. Examiner, April, 1846, p. 249.
  s Gazette M.dicale de Paris, cited in Provincial Med. and Surg. Jour. Dec. 24,1844;
and Bouchardat, Annuaire de Th.rapeutique pour 1845, p.  136.
  * The Pharmacopoeia of the King and Queen's College of Physicians in Ireland, 1850,
p. 167.   Dublin, 1850.
  8 Journal de Pharmacie, cited in Pharmaceutical Journal, March, 1845.
  6 Bouchardat, op. cit. p. 138. 
QUINLE ET CINCHONIiE TANNAS.
637
may also be  given in pills, and as  it dissolves  readily  in  oil, one
gramme (gr. 15.43,) may be dissolved in 60 grammes (about  Sij-,) of
olive oil, to form a liniment, which may be rubbed over the region of
the spleen.   When administered in the form of enema, 5 decigrammes
(gr. 7.7,) may be dissolved in 200 grammes (f gviss.,) of water.
            CLIX. QLTNLE ET CINCHO'NL_E TANNAS.
 Synoxtmes. Chininum  Tannicum, Tannas Chinii seu Cinchonicus seu  Quinicus,
   Tannate of Quinia and Cinchona.
 German. Gerbstoffsiiures  Chinin,  Gerbesaures oder Tanninsaurea
   Chinin.
   Dr. Ottox has drawn the attention of physicians to the efficacy of the
 .annates of  quinia and cinchonia, as recommended by Dr. Ronander,
 Secretary to the  SAvedish Medical Association.  He  regards them as
 the most  active  ingredients  of 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 useful in typhus, and in states of general weak-
 ness 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.2  Tannate  of  quinia has  been  found suc-
 cessful in typic or intermittent neuralgia, where sulphate of quinia
 had failed,3 as Avell  as in  the  night sweats of qyhthisis,  and in other
 diseases attended with sweating, in which  it was given by M. Delioux,4
 in doses of six to eight grains daily.   Pure tannin appeared, in some
 cases, to be  even  more powerful than the tannate of quinia.
   M. Bouvier,5 in the  name of a committee  to whom was  referred a
 paper by M. Barreswil on the therapeutical properties of the tannate
 of quinia, thinks it possesses an antiperiodic power, equal, but not su-
 perior to, that of the sulphate of quinia.  It has the disadvantage, how-
 ever, as all amorphous salts, of being very liable to adulteration.   M.
 Bourgogne,6 has recently brought it forward, both as a prophylactic and
 curative agent  in cholera.  Oesterlen,7  however,  considers  it a  su-
 perfluous preparation.  It is, as  before remarked, a  cheaper remedy
 than the sulphate.  Dr. Castiglioni8 found it had to be given in much
 larger doses than quinia; but it is much less expensive.
   It Avas elsewhere stated, (p. 628,) that the addition of tannic acid to
 sulphate of quinia, was found by Dr. Richard  H. Thomas, to deprive
 the latter of its bitterness.

  1 Dublin Journal of Medical Science, Sept. 1836.
  2 Revue Medicale. Mai,  1837, and Amer. Med. Intelligencer, Oct. 16,  1837, p. 270.
  ' Hauff, cited  in Northern Journal of Medicine, Dec. 1835, from Oesterlen's Jahrbuch,
and in Braithwaite's Retrospect, Jan.—June, 1846.
  4 L'Union Medicale, Avril, 1853, and Brit, and For. Med. Chir. July,  1853, p. 281.
  6 Amer. Journ. of the Med. Sciences, April, 1852,  p. 501. See, also, Lefevre, in Ar-
chives G.n.rales de Med  Nov., 1851, p. 355, and M. Bouvier, Ibid. Mars, 1852, p. 356.
  6 Pouchardat, Annuaire de Th.rap. pour 1855, p. 176.
  7 llandbuch der Heilmittellchre, S. 442.  Tubing.  1845.
  8 Schmidt's Jahrbuch, 1853, is., and Brit, and  For. Med. Rev. April,1854, p.  586. 
638
QUINL33 ET CINCHONIiE TANNAS.
                   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 anti-periodic power, and on that account
 has been much used by the Dutch physicians.   Two grains of  this re-
 siduum are said to act as well as one grain of quinia.   Truessink ad-
 duces  a  series  of observations of different  physicians, all of which
 confirm this, and he cites the experience of American physicians with
 the  residuum.   According to Dr.  Chapman,1 a grain of this may be
 given every two  hours during the apyrexia, in the form  of pill.   Stra-
 thing ascribes its efficacy to the quinia still  contained in it.  In Italy,
 several physicians have found the mother waters or  lees after the pre-
 paration of quinia, when  boiled to the consistence of syrup, very effi-
 cacious in intermittents; and Roux recommends it  highly in practice
 amongst the poor.  Buchner advises the lees, evaporated to dryness—
 which he terms Chininum Resino-sulphuricum—to  be introduced as a
 cheap, and, at the same time, efficacious preparation  of cinchona, which
 may be used in charitable institutions, rubbed  up with sugar as  a pow-
 der, or dissolved in alcohol, in place of sulphate  of quinia.  These ex-
 periments and propositions, as  Riecke2 observes, merit more considera-
 tion than they have yet received; for quinia, notwithstanding its price
 is much less than formerly, is yet so dear, that its administration  does
 not adapt it well for eleemosynary institutions, whilst the residue, which
 possesses valuable properties, is generally thrown  away, and  in this
 manner the price of quinia is enhanced.   An extract—which, accord-
 ing  to M. Wahu,3 has  been prepared by M.  Delondre, contains  all the
 active parts of the cinchona, to the exclusion of the inert, and is called
 by him Quinium—is highly extolled by M. Wahu as a tonic  in cases
 of marsh, scrofulous and scorbutic cachexise.
   Sertiirner4 thought he discovered, besides quinia and cinchonia, other
 alkaloids  of cinchona, especially one which he called Chinioidine, Chi-
 noidine or Quinoidine, and which excelled, he considered, in medicinal
 properties, all the other preparations of cinchona.  Henry and  Delon-
 dre—the French  chemists—affirmed, that chinioidine is  nothing more
 than quinia, cinchonia, and a peculiar yellow resinous matter, intimately
 adherent to the alkaloids, and rendering them uncrystallizable.  It ap-
 peared, also, from the experiments of different physicians with the pre-
 sumed new alkaloid,  that it essentially resembled the  preparations
 already mentioned in its medical properties.5   A resina  chinse praspa-
 rata is recommended by Plagge, which is prepared  from the  mother
 waters or lees  of quinia, by means of precipitation by  a carbonated
 alkali, extraction by alcohol, and removal of the alcoholic liquor by
 distillation.  It,  likewise, is said to possess markedly curative  powers
 in intermittents.
  1 Elements of Therapeutics, 6th edit. ii. 292.  Philad. 1831.
  2 Die neuern Arzneimittel, u. s. w. S. 130.
  s Jamain and Wahu, Annuaire de M.d. et de Chirurg. Prat, pour 1855, p. 81.
  * Hufeland's Journal, Jan. 1829.
  8 Radius,  Auserlesene Heilformeln, S. 191.  Leipz. 1836, and  Lincke, Vollstandiges
Recept-Taschenbuch, i. 455, Leipz. 1840. 
QUINLE ET CINCHONLE TANNAS.
639
  The Pharmacopoeia of  the United States  of 1830  gave a  formula
under the title Quinle  Sulphas  Impurus, which consisted  in eva-
porating the liquor poured off the crystals of sulphate of quinia to the
consistence of a pilular mass.   This has been known for years in Phila-
delphia under the name Extract of Quinia, and its active ingredients
appear to be sulphate of  quinia and  sulphate of cinchonia, which are
prevented from crystallizing by a  peculiar  resinoid  substance united
with them.   Dr. Wood1  asserted,  that  he  had seldom found inter-
mittents resist twenty-four grains of the impure  sulphate, given be-
tween  the paroxysms; although a larger quantity might be employed
with safety and greater  certainty of success;  and Bertini2 has con-
sidered these residual extracts after the preparation of sulphate of
quinia to be highly efficacious in masked intermittents, as well as in
those cases of relapse in which the salts of quinia,  from long use, have
become powerless.   He remarked, moreover, that  intermittents cured
by this agent were  less liable to  relapse.  These preparations, how-
ever, become important from  the investigations of Liebig, which show
that their active principle is really quinia, amorphous  quinia;—that
the substance in fact described by  Sertilrner, Henry,  and Delondre is
simply the alkaloid quinia in an amorphous or uncrystalline state, and
bearing the same relation to quinia, that uncrystallizable sugar does to
cane sugar.   "The testimony of  Dr. Serturner,  and of Henry and
Delondre, on the therapeutic effects of their alkaloid," says a recent
writer3—"becomes  therefore a matter of some interest, as Liebig tells
us a large quantity has probably  accumulated, and,  if so, it may be
obtained at a far cheaper rate than the price  sulphate  of quinia now
bears in the market.4 This  amorphous quinia was advertised in the
English journals, as a most efficacious and cheap antiperiodic.
   Dr. Harting5 has employed quinoidine with alcohol  and sulphuric
ether in intermittent fever, and, from twelve years' experience, consi-
ders it to be superior to common quinia.
   Dr. Lewis Slusser6 extols it highly as an antiperiodic, but, owing to
the numerous articles he  combined with it, it is impracticable to assign,
with any accuracy,  the precise agency of the quinoidine.  The ingre-
dients of his  pills were, in  addition to it,—tartaric acid, red cinchona
bark, powdered cascarilla,  powdered valerian, extract of quassia, ex-
tract of gentian, and mucilage of gum Arabic.
   Dr. Da Costa,? of Philadelphia, has published the results of upwards
of fifty cases of intermittent fever treated with the quinoidine, the.the-
rapeutical effects of which,  he thinks, so  far as he  has observed them,
are very nearly those of the ordinary sulphate of quinia.  In doses two-
thirds larger than those of  the latter, he succeeded perfectly in check-
ing  the disease, and in no case were there observed  any  signs of qui-
nism.   In a few instances  it succeeded  where quinia had been given

  1 Wood and Bache's Dispensatory, 4th edit., p. 1032. Philad. 1839.
  2 Bouchardat, Annuaire de Therap. pour 1847, p. 184.   Paris, 1847.
  s London Lancet, May 28, 1846.
  * London Medical Gazette, June 26,1846, p. 1117, and Bouchardat, op. cit. pour 1848,
p. 159.
  5 Schmidt's Jahrbuch, 1853,  ix., and Brit, and For. Med. Chir. April, 1854, p. 586.
  « Philad. Med. Exam.  April, 1851, p. 232.
  i Med. Exam. May, 1855, p. 295. 
640                QUINIiE ET CINCHONIiE TANNAS.
with a satisfactory result.   The average dose  required  to arrest the
chill in an adult, appeared to be about twenty grains, six of which, as
a general rule, Avere given shortly before the expected paroxysm, whilst
the remainder was taken during the intermission.  Dr. Da Costa states
his conviction, that whilst the antiperiodic virtues of quinoidine are cer-
tainly not inferior to those of the  sulphate of quinia, or  sulphate of
cinchonia, "it is preferable to  those from  the absence of bitter taste;
from its being less liable to affect the  head or the stomach of  the pa-
tient, and from its comparatively low price, which was, at the time, one
seventh of that of the sulphate of quinia."

   Quinid'ia, Quinidina, Quinidine, Chinidine, Chinidin, Cinchotin;
a distinct alkaloid of Peruvian bark, has  been recently subjected to
therapeutical examination.  It is found in many of the genuine cin-
chona barks, especially in  c. lancifolia, c. ovata, c. cordifolia, and c.
amygdalifolia;x and is obtained from them  by the same process as that
by which quinia is procured  from the barks which yield  it; but as its
sulphate is more soluble than the sulphate of quinia, it  is left in the
mother waters.  To obtain it pure, it  must be  repeatedly  crystallized
from its alcoholic  solution, to deprive it of a greenish-yellow resinous
substance, and  then  be shaken Avith  ether,  to  remove any adherent
quinia.
   Quinidia is found to  abound  in the cheaper kinds of New Granada
barks,—the  Bogota cinchona, which contains but little  quinia, and a
great amount of quinidia, being largely used  in England for obtaining
it; hence its cost is less than that of quinia.
   The salts of quinidia are, for the most  part, more soluble in water
than those of quinia.  The sulphate, quinidi_e sulphas, in appearance,
closely resembles  the  sulphate  of quinia.  It  is  much  more soluble,
however, in water and in alcohol.
   Sulphate of quinidia was prescribed by Dr. Pepper,2 in five cases
of intermittent, in the  dose  of  two grains  every hour, in anticipation
of the chill.   Except in one case, it had to be repeated a second time
before the fever was fully arrested; but in no case was its farther use
needed.   Ten  grains was the largest amount given in  any one day;
and as he had generally, under apparently similar circumstances, been
compelled to give fifteen grains of the sulphate  of quinia or of cincho-
nia, he was disposed to believe that it was  more active  than either of
these alkaloids.
   Dr. Upshur3 states, that he  gave the sulphate a very fair trial in the
treatment of intermittents, and he records the results in thirty cases,
twenty of which occurred in private,  and the  remainder in  hospital
practice, which, as he remarks, are sufficient to show that quinidia  is
undoubtedly  an agent of considerable efficacy in  the treatment of these
diseases.   He is not prepared, however, to  agree with Dr. Pepper, that
it is more active than quinia or cinchonia.  A large majority of his
cases required from fifteen  to  thirty grains  to arrest the paroxysm,

  1 Pereira, Elements of Mat. Med. and Therap. 3d Amer. edit. ii. 673.  Philad. 1854.
See, also, Wood and Bache, Dispensatory, 10th edit. p. 253.  Philad. 1854.
  2 Med. Exam. Sept: 1854, p. 523.              »Ibid. Dec, 1854, p. 740. 
SALICINA.
641
whilst in several, after the fairest trial, the disease did not yield until
quinia had been resorted to.  Dr. Upshur had treated a few cases of
remittent fever and of the  graver forms of miasmatic fever, with sul-
phate of quinidia.   The results were exceedingly satisfactory, and he
has no hesitation in saying that, as an "anti-miasmatic," it holds, in
his confidence, the  next  place to sulphate of quinia.
   In the Philadelphia Hospital, one hundred  and eighty cases of in-
termittent were treated; the results of  which are given  in a tabular
form by Dr. J. S. Dorsey Cullen.1   In one hundred and twenty-nine
of these the chill was arrested by fifteen grains of the  sulphate of qui-
nidia, and there was no  return.  On the day, however, after the ar-
rest of the chill, each patient was put upon the use of a compound in-
fusion  of cinchona and  iron, and "kept  steadily" under it, and "in
this way a decided antiperiodic influence kept up." " Upon the whole,"
says Dr. Cullen, "so well convinced is the writer of the merits of sul-
phate of quinidia, that with him it has entirely superseded the salt of
quinia;  being, he believes, quite as efficient in the treatment of inter-
mittent fever, whilst its price, about one-third less than that of sulphate
of quinia, renders  it  especially desirable for large hospitals, among
the poor in private practice, and with all who are influenced by consi-
derations of economy."
   Dr. C. B. Guthrie2 has reported thirteen cases of intermittent treated
by it.   Of these, nine were cured;  two did not  return, and  the result
was unknown, but Dr. Guthrie  thinks a  cure was accomplished.  In
two cases it failed, and the disease  yielded to sulphate of quinia.   No
unpleasant encephalic phenomena, like those that sometimes attend the
use of the sulphate of quinia, were  induced, although  the remedy was
 given, in some instances, in larger doses than the sulphate of quinia
 usually is.

    For  Quinicine  see Cinchonicine.
                         CLX.  SALICINA.
Synonymes. Salicinum, Saiicinium, 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 cin-
chona 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 practitioners.   This  discovery,
if not  made, was perfected by Leroux,3  an apothecary at  Vitry, in
France, Avho first obtained salicin in a pure state in 1828, after it had
been procured in an impure form by some German and Italian chemists.l

  1 Amer. Journ. of the Med. Sciences, Jan., 1855. p. 81.
  J Memphis Medical Recorder, Sept. 1855, and Medical News, Nov. 1855, p. 179.
  » Annales de Chimie, &c. xliii., and Journal de Chimie Medicale, torn. vi.
  4 Dictionnaire de Mat. Med. par M«.rat & De Lens,  art. Salicine.
     41 
642
SALICINA.
 It is prepared, by preference, from Salix helix, but is found  likewise
 in the barks of other willows—Salix alba, S. vitellina, S. purpurea,  S.
 Lambertiana, S. pentandra, S. polyandra, S. fragilis, S. viminalis, &c,
 and  in  the leaves and barks  of  several varieties of poplar, Populus
 tremula, P. tremuloides,1 P. alba, and P. Graeca.2

                       METHOD OF  PREPARING.
   According  to  the method  of  Leroux, three pounds of  dried and
 powdered willow bark (salix helix) are boiled for three-quarters of an
 hour in fifteen pounds of water, to which four ounces  of carbonate  of
 potassa have been added.  To the cold decoction are added two pounds
 of liquid subacetate of lead.   The mixture is permitted to settle, filtered,
 treated with sulphuric acid, and  the remaining lead is precipitated by
 a stream of sulphuretted hydrogen gas.  The excess of acid is neutral-
 ized by carbonate of lime:  the mixture is again filtered, and the fluid
 inspissated and neutralized by dilute sulphuric 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.
   Braconnot3 obtains it by adding subacetate of lead to a decoction  of
 the bark, precipitating the excess of lead by sulphuric acid, evaporating
 the  colourless liquid that  remains, adding near the end of the  process
 a little  animal charcoal previously washed, and filtering  the liquor
 while hot.   Salicin is deposited, on cooling, in a crystalline form.4
   The  following plan was advised by Messrs. Fisher  and Tyson,  of
 Baltimore.5   Willow  bark  is  boiled with caustic lime in water; the
 decoction 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 evaporated, yields crystals of
 salicin, which may be  purified by  washing 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 resemblance 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 ad-
 mixture with sulphuric acid it acquires a  beautiful red colour.7

  1 See L. Turnbull,  on  Populus Tremuloides, White Poplar or American Aspen,  in
American Journal of Pharmacy, Jan. 1843, p. 275.
  2 Riecke,  Die neuern Arzneimittel, S. 365, und 2te Auflage, 572.  Stuttgart, 1840.
  3 Journal de Chimie Medicale, Janvier, 1831.
  4 For Peschier's method, see  Annales de  Chimie, vol. xliv., and Amer. Journ. Med.
Sciences, May, 1831, p. 256.
  5 Journal of the Philadelphia College of Pharmacy, iii. 214.
  6 Pelouze and Jules Gay Lussac, in Annales de Chimie, vol. xliv.
  7 For an elaborate account of the chemical relations of salicin, see M. R. Piria, Annales
de Chimie et de Physique, Noverubre, 1838. 
SALICINA.
643
                     EFFECTS ON THE ECONOMY.
  The well known effects of the bark of the willows gave occasion to
the immediate employment of  salicin in cases of intermittent fever.
Miquel1 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 antiperiodic agents, although it re-
quires larger doses than quinia.   Soon afterwards it was given by other
physicians—by Husson and Bally, Girardin, Magendie, Andral, Blain-
court, Graff,  Linz,  Stegmayer, Amelung, Stam,  Van Sneek, Blom,
Grafe, Von dem  Busch, Krombholz, Pleischl, and others.  The senti-
ments respecting its value are discrepant; some classing it far beneath
quinia, whilst others assign it even a  higher position.   Its  general
properties are certainly analogous to those of quinia; but it in no respect
merits a preference,2 not even in  the article of price: for, although an
equal Aveight of salicin may cost less, it requires so much more to produce
the same effect, that the cost is perhaps equal.  Still,  as M. Pleischl,3
of 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.
   From all the testimony brought forward, M. Richard* is of opinion,
that Ave may conclude; first, that salicin possesses antiperiodic virtues;
secondly,  that its efficacy is in an inverse ratio with  the duration of
the fever; thirdly, that when its febrifuge virtues are not realized after
the fourth dose, it is well to abandon its use, as it will probably prove
inefficacious; fourthly, that in intermittents of the tertian type it cures
nine cases in ten; and in those of the quotidian  type five and a half
times in ten;  fifthly, that  the  quantity necessary for  the cure of an
intermittent is two or three times greater than that of sulphate of qui-
nia; sixthly, that it  ought not to be prescribed in pernicious intermit-
tents, the second or third paroxysms of which may be fatal; seventhly,
that it has  never been rejected by the stomach; and has  never in-
creased diarrhoea, nor "exasperated the sensibility of the stomach/'
and hence it should  be employed in  preference to the sulphate of qui-
nia in intermittents  complicated  with gastric or  intestinal irritation;
eighthly and lastly, that it has appeared to diminish, in a marked man-
ner, the circulation during the  apyrexia, even when it did not prevent
*he  paroxysm;  and  during convalescence, aa hen  the paroxysms had
ceased, the  pulse has frequently fallen thirty beats in a minute.
   Comparative trials with salicin and sulphate of quinia have been di-
rected by the able head of the medical department of the army, Dr.
Lawson,  so  that  Ave  may be  enabled to learn their relative  value as
antiperiodics.  Such an examination was made by Dr. E.  D. Fenner,5
of New  Orleans, who  arrived  at the conclusion that  "the  average
amount of quinia required to  cure 20 cases of intermittent fever, and
  1 Gazette Medicale de Paris, Janv. 1830: also, Annales de Chimie, xliii. and xliv.
  2 Richelot, in Archives Generales de M 'decine, Sepr. 1833; also, Dierbach, in Heidelb.
Klinisch. Annal. B. x. H. 1, S. 62.  Heidelb. 1834.
  s Medicinisch.  Jahrbiicher des k. k. o. Staat. 1835; and Brit, and For. Med. Rev. for
April, 1836, p. 576.                                      .
  * Elements d'Histoire Naturelle M.dicale, 4eme _dit. i. 232.  Pans, 1849.
  5 New Orleans Med. and Surg. Journ. Nov. 1845. 
644
SALICINA.
costing twenty-five cents, is fully three times as efficacious as the ave-
rage amount of salicin required in a like number of cases, and costing
seventy-five cents."  Dr. Fenner's report bears the stamp of accurate
and impartial observation and induction; and it is certainly far from
according with the statement of Bertini1 and others, who  consider that
salicin is wholly inert in the treatment of periodical fevers.

                     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 intermission:  in
the febres larvatse 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 salicin; but ten required  afterwards
the sulphate of quinia.   He considers it preferable to sulphate of qui-
nia in intermittents that are  accompanied by irritation of'the prima.
viae: he never saw it rejected or produce vomiting;  and in cases of
manifest irritation of the  digestive tube, it was borne perfectly well.2
  Salicin is generally given  in intermittents in the  form of powder.
In other affections, to obtain its  antiperiodic or tonic agency, one or
two grains may be given four or  five times a day—gradually augment-
ing the dose.   In cases of asthenia of the digestive  organs, Yon dem
Busch prescribes a powder of salicin and sugar with the addition of
cinnamon; and lozenges of salicin, sugar, gum Arabic, and oil of pep-
permint.  In cases of copious secretion from the mucous membranes,
especially in chronic bronchitis and leucorrhcea, he  directs salicin, to
be combined with a decoction of polygala amara, or of lichen islandi-
cus.  In  intermittents,  Stegmayer advises  it  to be associated  with
small doses of tartrate of antimony and potassa.
                        Pilulae salicinae.
                           Pills of salicin.
                 R.  Salicin.
                     Ext. gentian, aa. gr, xxiv.
                     Glycyr.h. pulv. q. S.
             ut fiant pilulae xij.                             Vavasseur.

                      Pulveres  salicinae.
                          Powders of salicin.
                 R.  Salicin. gr. xij.
                     Sacch. yij. Misce
             et fiat pulvis in partes iv. a.quales dividendus.
  Dose.—One, three times a day.                     Krombholz.
                Pulveres salicinae compositi.
                     Compound powders of salicin.
                 R.  Salicin. gr. xv.
                     Antim. et potas3. tartrat. gr. j.  .
                     Sacchar. 9_iss.  Misce
             et fiat pulvis in partes x. aequales dividendus.
  Dose.—A powder, every two hours.                  Stegmayer.
  1 Bouchardat, Annuaire de Th.rapeutique pour 1847, p. 184.  Paris, 1847.
  2 Archives Medicales de Strasbourg, and Gazette Medicale de Paris, 25 Fev., 1837. 
SAPO MOLLIS.
645
                    Mistura  salicinae.
                       Mixture of salicin.
              R.  Polygal. amar. rad. 3yj.
            Coque cum aquas f 3* xij. ad remanent, f 3viij.
            Colaturae adde
                  Salicin. gr. viij. ad x.  M.
Dose.—One or two spoonfuls every two hours.
                                            Von dem Busch.
                      CLXI. SAPO MOLLIS.
Syxoxymes.  Sapo Viridis seu Niger seu Kalicus seu Domesticus Mollis seu ex Olivae
  Oleo et Potassa Confectus, Kali Elainicum.
French. Savon Noir, Savon Mou, Savon _. base de Potasse.
German. Schmierseife,  Grttne  Schmierseife, Kaufliche Kaliseife,
  Schwarze Seife,  Oelsaures Kali.
   Under this name a soap is used, which is formed by a union of oil
with potassa.  It is  the  "sapo ex  oleo et  potassd confectus" of the
London Pharmacopoeia, which has of late years been brought forward
in Germany as a remedial agent in  cases of itch1 and 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.   The
whole body, with the  exception of the head, face, and genital organs,
is then besmeared with it, and the application is repeated, morning and
evening, for six days.  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  on those  parts which are affected
with the eruption or itching.  On the  eighth day the patient takes a
bath of tepid soap and water; and the body and bed linen, which have
not been shifted during the cure, may now be changed for cleaner.  In
dry and warm seasons, the patient is able to leave the infirmary on the
tenth day,  cured; but in moist and cold, not until the twelfth or four-
teenth.   The cur.e of the eruption is generally effected in seven days,
—that ia by fourteen rubbings.  During the period of treatment, he
must remain in bed, avoid exposure to draughts of air, and reside in a
chamber, whose temperature is  from 73° to 77°  of Fahrenheit.  On
account of  the strong smell of soap, not more than ten patients ought
to be allowed to occupy the same room.  Full diet may be allowed.
   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
  1 Pfeuffer, Beobachtungen liber die Kriitze und ihre Behandlung  durch die Schmier-
oder grime Seife.  Bamberg, 1S33. 
646
SODA CHLORINATA.
takes place freely;  the sleep, which may have  been disturbed for a
night or two, recurs; the skin  desquamates, and the patient does not
find his strength  in the least exhausted.  Should the inflammation  of
the  skin occur earlier than  the sixth rubbing, the friction must be
pretermitted.   Pfeuffer, however, never observed this to be the case.
   In scrofulous  syphilitic  dyserasies, the  friction  may  have to be
repeated once more, and  the patient have to remain from two to four
weeks in  the institution.   It  very generally happens that this  plan
excites inflammation of the skin and desquamation of the cuticle: when
this is not the case, no change  whatever is produced in the eruption.
   In order to mitigate the distressing feeling of burning produced by
the rubbing, one  part of flowers of  sulphur may be added to two parts
of the soft soap.
   In 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 decoction of the woods should be taken.   This
mode of treatment,  according  to  him, is  contraindicated by febrile
conditions, especially of the synochal kind; by acute cutaneous affec-
tions; pulmonary and abdominal catarrhs;  pulmonary and abdominal
phthisis; chronic  headache; and hereditary or acquired tendency to
epilepsy.   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 treatment  by sulphur,
which is greatly  used, on this very ground, in many of the eleemosy-
nary establishments of Germany at this time.1
   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  soap in scabies;  and  by Sicherer,  Seyffer,
Cless, and others, all of whom agree as to its excellence: they regard
it as one of the best  methods of treatment in use.  Soft soap forms an
ingredient in many of the officinal and  other itch ointments.2
                  CLXII. SODA CHLORINATA.
Syxoxymes. Sodae  Chloridum seu Chloruretum  seu Hypochloris seu  Oxymurias,
  Chloruretum Oxidi Sodii, Natrum Chloratum seu Chloricum seu Oxymuriaticum,
  Chlorinated Soda, Chloride, Hypochlorite,  Chloruret, Chlorite or 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 Berthollet under

  1 Yezin, Ueber die Kratze und ihre Behandlung nach der Englischen Methode.  Os-
nabruck, 1836.  Also, Amer. Med. Intelligencer, Aug. 15, 1839, p. 158.
  2 Riecke, Die neuern Arzneimittel, u. s. w. 2te Auflage, S. 584.  Stuttgart, 1840. 
SODA CHLORINATA.
647
 the common name Eau de Javelle or 'bleaching liquor;' and it has of
 late generally received the name  of Liqueur de Labarraque or Labar-
 raque'. Soda Bisinfecting Liquid.

                       METHOD OF PREPARING.
   Labarraque1 recommended  it to be  prepared directly by passing a
 current of chlorine gas into a  solution of carbonate of soda.  The fol-
 lowing is the formula in the last London Pharmacopoeia for the Liquor
 sodae Chlorinata., Liquor  Sodse Chloridi  seu  Sodse  Oxymuriatiese
 seu Chloreti seu Chlorureti Natri seu  Sodse, Natrum Chloratum  Li-
 quidum, Liquor seu Aqua Natri Oxymuriatici seu Natri Chlorati,
 Hypochloris  Sodicus  Aqud   Solutus;  German,  Oxydirt  salz-
 saures Natronwasser, Chlorsodaflussigkeit ox Labarraque s
 Disinfecting  Liquid.   "Take of carbonate of soda, a pound;  dis-
 tilled  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 Pharmacopoeia  of  the United
 States—"Take of chlorinated lime, 33bj.;  carbonate of soda,  Bbij.;
 water, a gallon and a half.  Dissolve the carbonate  of soda  in  three
 pints of the water, with 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 mixture  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, Avhich produce
 the original liquid when re-dissolved.  When the  solution is exposed
 to the air, and allowed  to  evaporate  spontaneously, it gives out chlo-
 rine, and yields crystals of carbonate of soda.2

                     EFFECTS  ON  THE ECONOMY.
   In its general remedial  agency, chlorinated  soda resembles chlori-
 nated lime,  and has been administered  both internally and externally
 in the same cases.  It is preferred 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,  however, that he has carefully prepared and tried the two  chlo-

  1 Gazette de  Sante, 25 Avril, 1826.
  2 Faraday, Quarterly Journal of Science, N. S. ii. 84, cited by Brande, Dictionary of
the Materia Medica, p. 508.  Lond. 1839. 
648
SODA CHLORINATA.
rides, and gives a decided preference to the chloride of soda.   Labar-
raque, likewise, preferred  it as an  antiseptic, on the ground, that by
the process  of disinfection it becomes chloride of sodium, Avhich 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 conditions—moisture—necessary for the putrefactive process.
Hence, he thinks, whilst chloride of lime will serve  equally well for
simple disinfection, chloride of soda is to be preferred where we Avish
at the same time to prevent a renewal of putrefaction.1
   By Bouillaud, Chomel and others, chlorinated soda has been given,
with  advantage, in typhous fevers; and by  Kretschmar,2  Lalesque,
Colson, and Gouzee,3 in intermittents.4  Ten cases are reported 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 pa-
roxysms abated, but it was thought necessary to have recourse to sul-
phate of quinia; in two others, no effect was produced, and in one, the
disease was aggravated.   Gouzee infers, that these cases prove the fe-
brifuge properties of chlorinated soda to be less marked than those of
sulphate of quinia, and, therefore, that it ought not to be trusted to,
except in slighter  cases,  and where the patients are  easily  suscep-
tible of  the effects of medicine,—as  women  and  children.   In like
manner, it has been found useful in scrofulous affections, and in short,
in the various diseases in which chlorinated lime has proved servicea-
ble.  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 cham-
bers.
   When applied externally, it is rarely used  pure  or  diluted  with so
little as  one half water, except in  cases  of asphyxia, and  gangrene,
and for dressing old ulcers, &c.  Most commonly it is diluted with ten
or thirty parts of Avater, and in this strength is  applied to ulcers  of
-various kinds, burns,  cutaneous diseases, &c.  When used as a  disin-
fecting agent, it is generally diluted with  ten, twenty  or thirty times
its weight of water.5

   1 Pereira, Elements of Mat. Med. 3d Amer. edit. i. 542.  Philad. 1852.
   2 Venus, Grundriss der Medicin. Receptirkunst, S. 67.  Weimar, 1838.
   s Revue Medicale, Fev. 1836.
   * Riecke, Die neuern Arzneimittel, S. 334, und 2te Auflage, S. 511.  Stuttgart, 1840.
   5 Pay an, Revue M.dicale, Aout, 1839. 
SPIRITUS PYRO-ACETICUS.
649
               CLXIII. SPIRITUS PYRO-ACETICUS.
Syxoxymes. JEther Pyro-acetieus seu Lignosus, Pyro-acetic Spirit, Pyro-acetic Ether,
  Acetone, Mesitic Alcohol, Bihydrate of Mesitylene:  called,  also, Naphtha, and
  Vv ood Naphtha.
French. Acetone, Esprit Pyro-acetique.
German. Essiggeist,  Mesitalkohol, Essigalkohol.
  There has been some confusion amongst therapeutists in regard to
the article meant by naphtha or wood naphtha, which Dr. John Hast-
ings1 brought forward of late years as an important remedy in  tuber-
cular phthisis.   The term naphtha, according to Dr. Pereira,2 had been
applied, but erroneously, to pyroxylic, or, as  he  writes it,  pyroxilic
spirit; and it is this article naphtha, which, according to Messrs. Bal-
lard and  Garrod,3 was given by Dr. Hastings.  In  this they are in
error; and the confusion has probably arisen from Dr. Hastings having
also given the erroneous name  "naphtha"  to  the pyro-acetic  spirit,
Avhich 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 quicklime 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 diameter, being adapted
to the mouth by a cork so as to form a distillatory apparatus.   The jar
is supported on the mouth of a  small furnace, by which the lower part
only is heated to redness, and the vapours are conducted into a Liebig's
condenser.  The product is repeatedly redistilled from quick-lime, until
its boiling point is constant at  1320.4
  It is a colourless, volatile, inflammable liquid, having a peculiar pe-
netrating odour, and  a  pungent taste  like that of peppermint.  Its
specific gravity is 0.792.  As found in the shops, its density is gene-
rally not lower than 0.820.   It is miscible with water, ether  and alco-
hol in all proportions.  If,  when mixed with water, it becomes turbid,
it has not been freed from empyreumatic oil.

                    EFFECTS ON THE  ECONOMY.
  Dr.  Hastingss states, that the reason why he was induced to deviate
from the line of medical treatment of phthisis, Avhich has so universally,
and for so long a period, been  in vogue, and to admit 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.   "I was led," he says, "to the conclusion, from a careful  sur-
vey of the chemical  analysis of tubercle made by Th6nard, that it was
defective, inasmuch  as the  composition of the animal matter, which
amounted to upAvards of 98 parts out of 100, had not been investigated.
From the greasy nature of  tubercle in its crude  state, there did not

  1 Pulmonary Consumption successfully treated with Naphtha.  Lond. 1843.
  2 Elements of Mat. Med. and Therap. 3d Amer. edit. ii. 939.  Philad. 1854.
  s Elements of Mat. Med. and Therap. p. 391.  Lond. 1845.
  * l'.ache, Dispensatory of the United States, 10th edit. p.  1385.  Philad. 1854.
  6 Op. cit. 
650                  SPIRITUS PYRO-ACETICUS.
 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 loss of fat, so remarkable in the
 earlier stages of consumption, I determined to employ those compound
 agents, rich in carbon and hydrogen, which had not  been previously
 used  in medicine; not with the idea that they would make up the de-
 ficiency  which the system had sustained  in the progress of the disease,
 but that such a change would, by that means, be introduced  into the
 constitution as would act on  the forces of the  organism, at the  point
 of departure from health, whether that took place in the stomach, blood
 or elsewhere; that change tending to such an affinity  in the  elements
 within the  body,  that the carbon, hydrogen, oxygen and nitrogen, in-
 stead of assisting in the formation  of  products which  threaten  life,
 would tend to develop those  materials only which are required for the
 preservation  of health and the prolongation of existence."
   Thirty-six  cases, presenting  all the phenomena of tubercular phthi-
 sis, are stated by him to have been cured by the pyro-acetic  spirit—
 the cough,  expectoration, sweats, &c, disappearing for the most  part
 within a few weeks, and the  physical  signs indicative of structural
 lesions disappearing soon after.  The statements of Dr. Hastings were
 very properly doubted by the best observers; but still it was  deemed
 advisable to give the remedy a fair trial, and the  result has been far
 from  confirming them.   In the  author's experience no good has resulted
 from  its  use except what follows the employment of ordinary  excitant
 expectorants, as creasote.  Testimony in its favour from others has not,
 howeArer, been wanting.   Mr. D. Wilson1  narrates cases which appeared
 to exhibit all the functional and physical phenomena  of phthisis, and
 were  cured or relieved by it.
   In  enumerating the cases in which  he recommends the use of " naph-
 tha," Dr. Hastings2 observes, that the less complicated phthisis may
 be with other  affections, the more suitable is it for  treatment by this
 agent.  When the pulse is at the ordinary standard  or thereabouts;
 when the hectic is slight; laryngeal and  peritoneal disease absent; the
 functions of the stomach and bowels  not much impaired; the constitu-
 tional disturbance inconsiderable, and the physical signs denoting only
 a slight deposit of tubercles in  one lung; the prognosis is  favourable,
 and a speedy recovery may be  anticipated.  In many cases, this mild
 character of the disease is never witnessed, howsoever early they  may
 be seen: for want of close observation, too, this  period frequently es-
 capes notice;  hence, success depends upon an early and correct  dia-
gnosis.   If naphtha be given in acute phthisis, when the cough is very
 harassing, with slight frothy expectoration; respirations 30 to 40 per
 minute; pulse 120 to 140; hot  skin; profuse night sweats; great thirst;
 appetite deficient  or altogether wanting;  and the physical signs de-
 noting an extensive  deposition of tubercles in both lungs, it  will be
 found, he says, injurious rather than  beneficial.  If it be employed  in
 chronic phthisis co-existing with  disease  in other organs, its  value  is
 diminished in proportion to the extent of the complications, and their

  1 London Lancet, June 3d, 1834, p. 344, and Nov. 25, 1843, p. 250.      2 Op. cit. 
SPIRITUS PYRO-ACETICUS.                   651
vitiating influence on the constitutional powers; and if it be persevered
with in certain cases in Avhich improvement had followed its use, after
the appearance of intercurrent pneumonia, bronchitis, or  pleurisy, it
will do great mischief.   Many such cases,  says Dr. Hastings, give way
to a short course of treatment with antimony, digitalis, &c, and then
the pyro-acetic spirit may be again employed with the greatest advan-
tage.    Where haemoptysis is present,  or where it has recently existed,
it is generally contra-indicated.  When phthisis is complicated with
dyspepsia, little or no benefit will accrue from its use, until the latter af-
fection is removed; yet Dr. Hughes  Bennett1 ascribes all  its agency
in phthisis to its power of calming the irritability of the stomach, Avhich
occurs often in the disease, and for which, according to his experience,
naphtha is the  best  remedy.   Dr. Hastings states farther, that the
disease is not amenable to the plan  of treatment when the patients
are in crowded hospitals, or in other  situations where  the  atmosphere
is impure.
   If doubt may be entertained in regard to the efficacy of pyro-acetic
spirit in phthisis, there would seem to be none, that in  cases of chronic
bronchitis resembling phthisis it has produced, and may be expected to
produce, benefit.  Mr. Procter2 has related a case, in which, after acute
bronchitis,  difficulty  of breathing, cough, with well marked  purulent
expectoration, and nocturnal perspiration  existed, Avith great emacia-
tion and occasional hsemoptysis.  A mixture Avas  prescribed  of pyro-
acetic spirit f Sj.; liquor opii sedativus f 5y.; of Avhich the patient took
fifteen drops three times  a day in  a little  water.   The  medicine was
continued for about two months, when the patient reported himself well.
In the Report of the Hospital  for Consumption  and  Diseases of the
Chest, (Lond. 1849,) it is  stated, that in some cases of bronchitis with
profuse secretion it seemed useful, but it was not otherwise  productive
of benefit, and often proved hurtful.3  It is in chronic bronchial affec-
tions that the pyro-acetic spirit will probably be glmost wholly employed,
provided it retains its place in the catalogue of the materia medica;
and hence it has been classed  elsewhere by the author Avith  creasote,
the balsams, &c, amongst excitant expectorants.4
   M. Lavirotte,  of Lyons, and Dr. David W. Yandell5 have recom-
mended it in diarrhoea.   In 23 cases—16  of diarrhoea,  and 7 of dy-
sentery—the results were favourable.   Dr. Yandell gives it in the dose
of twenty drops at intervals of three hours.
   Dr.  Hastings6 has  also extolled  it highly in gout, and in acute and
chronic rheumatism.   "For upwards  of twelve months," he  says, "I
have employed pyro-acetic spirit in these affections, and my treatment
has been attended Avith a  success  quite extraordinary, far exceeding
the results usually obtained by colchicum,  &c."   His overstrained eu-
logies, however,  of  its effect in phthisis will render the profession slow
to credit this assertion.
  1 On  Cod-liver Oil. Edinb. 1848.      2 Lond. Med. Gazette, Nov. 17, 1813, p. 213.
  s British and Foreign Medico-chirurg. Rev. for April, 1850, p. 321.  Also, the similar
sentiments of Dr. Theophilus Thomson, Dr. Golding  Bird, and others, in Lancet, Jan. »
15, 1848.       4 General Therapeutics and  Mat. Med., 5th ed. i. 270.  Phila. 1853.
  6 Western Journal of Medicine and Surgery,  Sept. 1849.
  6 Cited in Amer. Journ.  of Pharmacy, New Series, xiii. 66.  Philad. 1847. 
652                         STRYCHNIA.
                     MODE OF ADMINISTRATION.
  The dose in which Dr. Hastings generally administers the pyro-acetic
spirit is from ten to twenty drops three times a day in a small quantity
of water.   After the second  or  third day he augments the dose by
about one-fourth, regulating its increase or decrease according to the
absence or presence of nausea, vomiting, or any other untoward symp-
tom  resulting from its use.   As  the  disease advances  he raises the
dose to 40 and even 50 drops, and administers it  four times instead of
three times a day.
                    STRYCHNIA ET EJUS SALES.
  Syxoxyme. Strychnia and its salts.

                         CLXIV. STRYCHNIA.
  Syxoxymes. Strychnium, Strychninum, Strychna, Strychnine, Vauqueline.
  French. Strychnine.
  German. Strychnin,  Krahenaugenstoff,  Krahenaugenbitter.
     This alkaloid was discovered  by Pelletier and Caventou1  in  nux
  vomica, St. Ignatius's bean, upas tieute, and in the wood of strychnos
  colubrina; and experiment has shown, that these substances  are in-
  debted for their medicinal properties  to  it.2   In them, strychnia is
  found associated with another  principle analogous to it in its properties
  —brucia.3  In  St. Ignatius's bean, there  is less  brucia  than in  nux
  vomica, so that it is best adapted for the preparation  of strychnia; but
  it is  not as easily obtained,  and  consequently nux  vomica is  almost
  always used.
                        METHOD OF  PREPARING.
     According  to one form  of  preparation,  liquid subacetate of lead is
  added to a solution of the alcoholic extract of nux  vomica in water,
  until  a precipitate is no longer thrown down; the foreign matters being
  thus precipitated,  the strychnia remains in solution with a proportion
  of colouring matter, and sometimes an excess of acetate of lead.  The
  lead is now separated by sulphuretted hydrogen; and the fluid is filtered
  and boiled with magnesia, which unites with the acetic acid, and preci-
  pitates the  strychnia.  The precipitate is next washed in cold water,
  and redissolved in alcohol  to  separate it from the excess of  magnesia,
  and by evaporating the alcohol, the strychnia is obtained.  If it be not
  perfectly white, it  must be dissolved in acetic, or hydrochloric acid,
  and be reprecipitated by means of magnesia.
     The mode of preparation recommended  in the Pharmacopoeia of the
  United States (1851) is a3 follows—Take of nux vomica, rasped, Ibiv.;
  lime,  in poAvder, gvj.; muriatic acid, f Siij«; alcohol, dilute sulphuric acid,
  solution  of ammonia, purified animal charcoal, water, each a sufficient
  quantity.  Digest the nux vomica in two gallons of water, acidulated with
  a fluidounce of the muriatic acid, for twenty-four hours; then boil for two
» hours, and strain with expression through a strong linen rag.  Boil the

     1 Annales de Chimie, torn. viii. ix.  and x.
     2 Magendie, Annales de Chimie, x. 176.  1819.              s See page 155. 
STRYCHNIA.
653
residuum twice successively in the same quantity of acidulated water,
each time straining  as before.  Mix the decoctions, and evaporate to
theconsistence of thin syrup; then add the lime previously mixed with
a pint of  water, and boil for  ten  minutes, frequently stirring.   Pour
the mixture into a double linen bag, and, having washed the precipitate
well with water, press, dry, and powder it.  Treat the powder repeatedly
with boiling  alcohol until deprived of  its bitterness;  mix the liquors;
and distil off the alcohol by means of a water bath.  Mix the residue
with water, and, having applied heat, drop in sufficient diluted sulphuric
acid to neutralize and dissolve the strychnia; then add purified animal
charcoal, boil for a few minutes, filter, evaporate and crystallize.   Dis-
solve the  crystals in water, and  add sufficient solution  of ammonia to
precipitate the  strychnia.   Lastly,  dry the*  precipitate  on bibulous
paper.1   As  thus prepared, it is in the form of a white powder.
   Strychnia, obtained  by crystallization from an  alcoholic solution,
which has been  diluted Avith a small quantity of water, and  left to it-
self, appears under the form of microscopic crystals, constituting four-
sided prisms, terminated by pyramids with four flattened or depressed
faces.  When crystallized rapidly, it is white and  granular, is  insup-
portably bitter to  the taste, and  leaves an after taste  similar to that
caused by certain metallic salts;  it has no smell, and is not changed
by exposure  to the air;  is neither fusible nor volatile;  for, when sub-
jected to  the action of heat, it does  not fuse, until the moment of its
decomposition and carbonization, and it is decomposed by a degree of
heat  inferior to that which destroys most vegetable substances.   When
exposed to  the  naked fire, it swells, becomes black, and yields  an
empyreumatic oil,  a little water, acetic acid, carbonic acid and car-
buretted hydrogen.   Distilled with oxide of copper, it gives out  much
carbonic  acid, and only  slight traces of nitrogen.   It  is composed of
oxygen, hydrogen, carbon and nitrogen.   Although  strychnia has so
strong a  taste, it is scarcely soluble in water.  At  50° Fahr., 6667
parts of water dissolve but  one  of it; boiling water dissolves a little
more than double, so that it may be said to  be soluble in 2500 parts
of boiling water.   It is remarkable, however, that  a solution made in
the cold, and containing therefore only $■£$^th part of its weight, may
be diluted one  hundred times, and still retain a very decidedly  bitter
taste.  It is  more soluble in strong alcohol, little so in weak, and not
much so in ether or fixed oils, although they acquire a bitter taste from
it.  On the other hand,  it  is very readily soluble in  volatile oils, and
the hot  saturated  solution,  on cooling, deposits  crystals.   It  has  an
alkaline reaction and forms, with acids, salts which are mostly crystal-
lizable, and  insupportably  bitter, and are more  soluble  than pure
strychnia.2
   Strychnia, being sold at a high price, is liable to adulteration.  A
respectable druggist of Philadelphia informed the  author, that one of
his customers was offered strychnia by another house at a price  consi-
derably lower than what he had to pay for it when purchased even in
large quantities from respectable sources.   He bought an eighth of an
             ' Pharm.  of the United States, p. 216.  Philad. 1851.
             2 Magendie's Formulaire, &c. 
654                         STRYCHNIA.

ounce of it at the rate of five dollars the  ounce; when pure strychnia
could not be offered at less than nine dollars per ounce.  Some of this
was tested, when it Avas found to  consist of equal parts  of flour or
starch, and pure strychnia.

          EFFECTS ON  THE  ANIMAL ECONOMY IN HEALTH.
   The effects of strychnia on man and animals resemble, on the whole,
those of the spirituous extract of nux vomica, except that they are more
intense.   According to Magendie, one-eighth of a grain is sufficient to
kill a strong dog.  Pope, who made  experiments on dogs,  found that
one-tAvelfth  of a grain was enough to paralyze the lower  limbs of a
small dog in four or five minutes, and in half an hour to kill it.  Chris-
tison1 considers strychnia the strongest poison after hydrocyanic acid.
He injected a solution of a third of a grain in alcohol into the thorax of
a wild boar, and in ten minutes the  animal died.  A dog was destroyed
by one-sixth of a grain  in tAvo minutes; and he believes, that the same
effect Avould be induced on man by half a grain introduced into a Avound.
Lembert2 observed similar results from placing a grain in the thorax
of a small dog, and from three grains  introduced into the areolar tissue
of a larger animal, on which tetanic spasms were induced in the thoracic
muscles.  Dr. Blake3 injected a grain  of strychnia, dissolved in a small
quantity of acetic acid, into the veins of a dog.  The first effect of the
poison was to induce  general convulsions  in about thirty seconds after
its  injection, the action of the heart being at the same time rendered
irregular, which Dr. Blake presumes was owing to the convulsive struggles
of the animal.   All external  signs of life ceased in about a  minute and
a half after the  injection of the poison, but the heart still continued to
beat.  He found that when strychnia was introduced  into the circula-
tion in so small a quantity as not to produce any general symptoms, it
did not appear to exert the least influence on  the heart.
   That the action of strychnia is  analogous to that of nux  vomica  has
been proved by  the experiments of Segalas,4 Andral,5 Bardsley,8 Red-
lich, Sandras, Liiders, Hennemann, and numerous others.7   It affects
especially the vesicular matter of the spinal marrow, the reflex system
of Dr. M. Hall,—less strikingly  the  brain:  small doses, according to
some,8  excite the ganglionic  system;  larger, the spinal  marrow; con-
sequently it has been imagined, that it  might be an efficacious remedy
in nervous diseases, which are dependent upon spasmodic  disorder of
the ganglionic system, or upon diminished sensibility and torpor of the
nerves of motion.9
   The observations of Cartoni led him to  infer, first, that strychnia
  1 Treatise on Poisons, 3d edit. Edinb. 1836; and Dispensatory, p. 895.  Edinb. 1842.
  2 Essai sur la Methode Endermique.  Paris, 1828, 8vo.
  3 Edinb. Med. and Surg. Journal, April, 1839, p.  338.
  4 Magendie's Journal de Physiologie, ii. 4.            5 T^id. Juillet, 1823.
  6 Hospital Facts and Observations, Illustrative of the  Efficacy of Strychnia, Brucia,
&c.  Lond. 1830.
  7 Petrequin, Gazette Medicale de Paris, No. 44, Nov. 1838.
  8 Stumpf. art. Strychnos, Encyclopad. Worterb. der Medicin. Wissensch. xxxii.  480.
Berlin, 1844.
  9 See, on  this subject, Pickford, of Heidelberg, cited from Gazette Med. de Paris, 5
Juin, 1844, in Amer. Journal of the Med. Sciences, July, 1844, p. 201. 
STRYCHNIA.
655
has a special  elective action on the nerves of motion in general, and
chiefly on  those  which are concerned  in  the  movements of the iris:
secondly, that its action is diametrically opposed to that of substances,
which  occasion^ and  keep up,  abnormous  dilatation of the pupil;  and
lastly, that "it is a precious and efficacious agent in certain diseases of
the eyeball, which depend upon vital and  organico-vital  modifications
of the system of ciliary nerves."1
   The following- are the effects observed by Oppler from the internal
use of nitrate of strychnia:—a sensation of warmth and itching in the
epigastrium;  eructation; nausea; vertigo; slight excitement like that
of intoxication; great vividness,  with  more or less confusion of mind;
dull pain over the eyes; spots before the same;  dilatation of the pupils;
diplopia;  tinnitus aurium; difficult articulation and deglutition;  slight
trismus; sense of formication in  the paralyzed parts, Avith convulsive
motions or  twitchings, at times,  in them;  at others, over the whole body,
similar to electric shocks; tremors of the muscles; occasionally, violent
spasms; tetanus; asthma;  palpitations; febrile heat;  general  sweat-
ing ; prostration; pale or livid countenance; pulse sometimes full and
frequent,—at others, small and contracted; great sensibility over the
whole  body;  involuntary laughter,  succeeded  always  by difficulty of
breathing  and convulsions.  The sleep was generally interrupted by
convulsions;  the secretion of urine scanty,  and  occasionally suppressed.
These symptoms came on gradually, and disappeared in the same man-
ner, when the dose was moderate, in the course of some hours.  Large
doses, he says, induce death by a sudden shock to the nervous system;
smaller doses when continued for a long time, may destroy by causing
apoplexy,  of which he saw many  examples in his experiments on ani-
mals.2
   Dr. Blumhardt3 has recorded a case of poisoning by strychnia, which
occurred to him in Stuttgart.   He Avas called to a  young man, seven-
teen years  old, Avho had swallowed two scruples of strychnia after din-
ner.  A short time afterwards, experiencing great restlessness, he re-
pented of what he had done, and immediately took four grains of tartar
emetic,  which excited considerable vomiting.    When the  physician
arrived, about, a quarter of an hour after the strychnia had been taken,
he found the patient on  his back in bed, with  his head throAvn  back,
rigid and incapable of motion, but with a  constant inclination to turn
towards the right side.   He could only  move  the upper  limbs freely.
The countenance  Avas pale and haggard;  the temperature of the skin
natural, and the pulse quick and contracted.    Consciousness remained
unaffected; the speech Avas rendered difficult  by an occasional contrac-
tion of the  muscles that move the lower jaw; but it could not properly
be said to  be  interrupted: deglutition was unaffected.   The trismus,
however, became more and  more  frequent  and violent, and the respi-
ration thereby unequal and suspended; the pulse was small, suppressed,
and quick.   The remedies—employed  to save  him—as tincture  of io-
dine and acetate of morphia, Avere  of no avail.  With the periodical

  1 Bouchardat, Annuaire de Therapeutique, &c. pour 1847, p. 38.  Paris, 1847.
  2 Also, Tanquerel des Planches, Essai sur la Paralysie de Plomb.  Paris, 1834.
  • Medicinisch. Correspondenz-Blatt, in Encyclog. des Sciences M.dicales, Sept. 1837. 
656
STRYCHNIA.
trismus was now associated spasmodic agitation of the whole body, to
which—after a  short  interval—succeeded opisthotonos  with violent
symptoms of suffocation; the trismus attained the highest degree, and
the upper extremities were deprived of the influence of volition.  With
the increase of the general tonic spasm, the respiration was always more
difficult and oppressed, and for a time wholly ceased; the pulsation of
the heart and arteries became irregular, less distinct, and at length
imperceptible.   In  this condition, the skin acquired a bluish appear-
ance ;  the countenance was puffed and of a violent hue; the lips dark-
blue, the neck swollen, the eyes protruded, fixed and  directed towards
the right side; the pupils enlarged and immovable, and the conjunctiAra
injected.   At this  period, the patient was  entirely unconscious;  but
from this condition  he  awoke once, and all the symptoms became miti-
gated ; during this remission, the muscles influenced by the spinal mar-
row remained cramped, except the upper  extremities, which  could be
moved voluntarily.   In a quarter of an  hour, the  tetanic attack re-
turned in its violence, with intense commotion of the Avhole body; this
ended  in  asphyxia, from Avhich he again  recovered  to consciousness.
The same thing happened in a third attack.  In the fourth, he suc-
cumbed under the power of the  poison.  The whole scene,  from  the
taking of the poison to the occurrence of death, lasted an  hour and a
half.
   During the last attack, as doubt existed whether he was really dead,
the median vein of the left  arm, which was turgid, was opened, and
after the vessel was emptied of its thick, black blood, which resembled
that of an animal, several bubbles of air, from the size of a pea to that
of a small cherry, were  forced out  by pressure.   The dissection was
made twenty hours ,after death.  In spite of the elevated summer heat,
there were no signs of  putrefaction.   The whole of the  body was un-
commonly rigid.  The muscles of the back were of a  brownish-red
colour, almost like that of smoked meat.  On opening the spinal canal,
a considerable quantity of thick,  dark-coloured blood, like that of an
animal, flowed out.   The plexus venosi spindles were turgid with  the
same kind of blood, as well  as the vessels of the pia mater.  Under
this membrane, especially in the cervical portion, some  watery fluid
was effused.  The  upper portions  of the  spinal marrow were soft,
pappy in some  places, but lower  down  it became gradually harder.
Within the cavity of the cranium, the same turgid condition of vessels
existed; all the veins of the dura mater  appeared as if injected;  the
veins of the pia mater were likewise  engorged; and the whole mass of
the brain indicated an unusual supply of blood,  so  that  the cortical
substance appeared  quite blue.  The cerebellum was softer than usual.
In the cavities of the abdomen and thorax, a striking poverty of blood
was perceptible.  The heart  was  shrunken and empty, as well as  the
large vessels of the  thorax.   The stomach Avas full of solid food, which
appeared to have undergone no change; its blood-vessels contained a
considerable quantity of blood, and the mucous coat exhibited marked
redness over its whole-surface; but  this Avas especially concentrated
about the cardia and the fundus; the small intestine was likewise red-
der than natural, as is commonly the  case  in those who have  died 
STRYCHNIA.
657
whilst digestion was going on.   The liver  was tolerably supplied with
blood; the gall-bladder empty.1
  When strychnia is  used endermically,  as is  not  unfrequently the
case, the course of the phenomena is somewhat different.  G. H. Rich-
ter  employed it in  this way in many cases of hemiplegia, in  one of
which it occasioned  symptoms  of actual poisoning.   When the  dose
exceeded a quarter of a grain, a feeling arose in the part to which it was
applied as if needles were run into the skin; this  gradually spread over
the whole limb; the temperature of the body was augmented; the pulse
was quickened, full and hard; the breathing constrained; pain was ex-
perienced in the same side of the head;  the secretion of urine was in-
creased, and a general perspiration broke out, which persisted for
about an hour, after which the pricking  of the surface, and the excite-
ment of the vessels ceased.   To these  symptoms—and  seldom later
than two  hours after the application of the agent—convulsive move-
ments succeeded in the paralyzed limbs like those induced by electricity,
which augmented in violence and in frequency with the increase of the
dose,—being strongest and most severe during the night, at which time
the limbs were moved involuntarily.  When awake, a feeling of  stiffness
was experienced in  all the limbs, which passed off when they were used.
On digestion, defecation, and  the appetite, the  nitrate  of  strychnia
seldom  exerted any influence.  Only in  one case—in which no effects
were  induced on the  nervous  system, when the dose was gradually
carried to  three  grains—was  obstinate  constipation induced.   In
general, when it was begun with in the dose of one-eighth of a grain,
and on  the next day one-fourth was given, on the third day one-half,
and afterwards the dose was increased daily by one-fourth of a grain,
until one and a quarter were taken,—the  following unpleasant symp-
toms  supervened.   The patient  experienced twitchings  earlier than
before, and first in the paralyzed limbs.   As these became, from minute
to  minute, more violent, a penetrating  pain was felt in the  occiput,
with vertigo and tinnitus aurium.   The  twitchings now extended over
the affected  arm, and, subsequently, to  the sound side, whereupon the
vertigo  and  headache  increased,  and insensibility, with  difficult and
stertorous breathing, ensued.   The pulse now became very full, hard,
slow,  and intermitting; the countenance  bluish-red and  turgid;  the
paralyzed lower extremities of a marbled  blue;  the pupils very much
dilated, and  the mouth open,—the  convulsions  being occasionally so
strong as to toss him to and fro on the bed.  When  these phenomena
declared themselves, Richter removed the dressing from the  surface,
which appeared inflamed, and still contained a quantity of strychnia that
had not been absorbed; the parts were then washed and sprinkled imme-
diately—according to Lembert's and Lesieur's recommendation—with
two grains of acetate of morphia; the face  was washed with cold water,
the soles of  the feet were brushed, and other excitants administered.2

  1 For other cases, see Christison on Poisons, 1st Amer. edit. p. 685.  Philad. 1845;
and  James Wilson, London and Edinburgh Monthly Journal of Medical Science, Dec,
1845, cited at length in  Amer. Journal of the Med. Sciences, April, 1846, p. 528;  and
Taylor, On Poisons, Amer. edit, by R. E. Griffith, p. 622.  Philad. 1848.
  2 See some Experiments relative to the action of  Strychnia on the Nervous System, by
       42 
658
STRYCHNIA.
   Dr. Christison1 considers, that strychnia is not a cumulative poison;
 yet the author has seen one or two cases which would favour the con-
 trary opinion,2 and Dr. F. A.  Gebhard,3 of Moscow, under view of the
 dangerous effects it often induces, thinks that some other remedy should
 be sought for, even in those  cases in Avhich it  has been found advan-
 tageous.   The continued employment of strychnia in small  doses, or
 its administration in larger, appears to him to cause,  in some  unknown
 manner, such  a  change  in  the blood  as to result unexpectedly and
 suddenly in  a powerful  reaction in  the nervous system, marked by
 convulsions,  tetanus, exhaustion, paralysis and death.  Dr.  Gebhard
 proposes,  as  a substitute, one of the most  energetic articles of  the
 materia medica—veratria.
   Morphia appears to be the  most powerful antidote: under its use
 the dangerous symptoms rapidly disappear; consciousness returns; the
 patient sleeps for some  hours, and a  general perspiration breaks out,
 after which he awakes with a  feeling of dulness, and with  stiffness of
 the  limbs, which  soon,  however, vanish.  In respect  to  the topical
 application of strychnia by the endermic method, A. L. Richter4 re-
 marks, that the preparations of strychnia produce much more  powerful
 local effects than those of morphia; they maintain the  abraded portions
 of the skin in an inflamed state; promote suppuration more than mor-
 phia, and  occasion  violent itching  and burning, with a feeling  as if
 needles were run into the skin.  Artus recommends, from his investiga-
 tions, pure baryta (Aetzbaryt) as an antidote.  It  forms an inso-
 luble precipitate Avith  strychnia, and he esteems it to be more certain
 than the tinctures of iodine and bromine recommended by Donne,*  the
 chloride of barium,  or the infusions of tar and galls  recommended by
 Raspail.6
   The  effects, referred  to above, were chiefly obtained from the  ad-
 ministration  of the nitrate, but they may be esteemed applicable to all
 the preparations  of strychnia,  as we know nothing of any difference in
 their action.   It is probable, however, that the salts of strychnia, owing
 to their greater solubility, may have more action than strychnia itself,
 although  the  muriatic and acetic, or lactic, acid, the first  of which is
 always present in the stomach, it might be  presumed, would readily
 unite with it.
               EFFECTS ON THE ECONOMY IN DISEASE.
   The following remarks apply equally to pure  strychnia, and its salts,
 and to  the alcoholic extract of nux vomica, (see page 540,)  which is
 preferred by some.7   It has been administered  in
  Paralysis, especially in that arising from the action of lead, in which
 Bally, Lembert, Bardsley, Andral, Rayer, Tanquerel8 and others have
 H. Stannius, in Miiller's Archiv. Heft. ii. 1831, and Brit, and For. Med. Review, for
 Jan., 1838, p. 221.                  i Dispensatory, p. 895. Edinb. 1842.
  2 Pereira, Elements of Mat. Med. and Therap. 3d Amer. edit. ii. 548. Phila.  1854.
  3 Zeitschrift fur Therapie, v. s. w. Freiburg, Dec, 1844, No. 3, and Amer. Journal of
 the Medical Sciences, Jan.,  1846, p. 202.
  * Die Endermatische Methode, u. s.  w.  Berlin, 1835.
  5 Journal de Chimie Me"d. v. 494.  Paris, 1829.
  6 Nouveau Systeme de Chimie Organique.  Paris, 1833.
  7 Petrequin, Bulletin General de Th6rapeutique, Mars, 1840.
i 8 Gazette Medicale pour 1835, p. 383. 
STRYCHNIA.
659
employed it beneficially.  Drs. Swett and Buckley,1 of New York, gave
it in the dose of -^th of a grain three times a day in colica pictonum,
and this, it is affirmed, has become the settled practice in the New York
Hospital.  They consider the disease  to be  consequent upon paralysis
of the intestines, which strychnia, by its action on the nerves, relieves.
In paraplegia and hemiplegia it has been prescribed by Lesieur, G. H.
Richter, Romberg,  Bardsley,  Bally,  Lafaye,  Oesterlen,  Reinhardt,
Heyfelder, Faye,  Mart, Schaible, Raciborski,  A. T. Thomson,2 Gel-
lie,3 Petrequin,4 Toulmouche,5 Badeley,6 and numerous others.7   From
the results of their observations it would seem, that  strychnia is most
efficacious in paraplegia;  less so in hemiplegia, although it  is said to
have been given with advantage in the latter affection; but  its  admi-
nistration in hemiplegia requires special circumspection, particularly
when the paralysis has  succeeded to apoplexy.8
  The results of the observations of M. Toulmouche  induce him  to be-
lieve, that strychnia will only succeed in paralysis or other  affections
"that proceed from some lesion  of spinal innervation, occasioned  by
excessive masturbation or indulgence in venereal pleasures, by the abuse
of spirituous or narcotic  liquors, by the action  of the  emanations of
lead," &c.;  and that it is never successful in paralysis which is  owing
to an inflammatory condition of the brain or spinal  marrow.   He is
of opinion that strychnia has a directly excitant effect upon the  spinal
marrow, and secondarily on  the organs that  receive their nerves from
it.  Romberg affirms that, as a general rule, in cases of paralysis de-
pendent upon disease of the central organs of the nervous system, he
has never seen any striking effect from the endermic use of  strychnia,
and that great care is needed lest it should react injuriously on the  brain.
He considers it especially adapted for cases of paralysis that are  de-
pendent upon some affection of the spinal marrow  induced by mecha-
nical concussion; as well  as  for the local paralysis  that succeeds  to
rheumatism, suppressed exanthems, &c.
  In paralysis of the upper eyelid, it has been employed successfully
by  M. Saint Martin,  in  the way of  inoculation, as proposed by M.
Lafargue  in the case  of morphia  (page 524,) two centigrammes—
from one-fourth to one-third of a grain—of  the  sulphate being  intro-
duced into twelve small punctures around the  orbit.  The  operation
was continued for six days,  with complete success.9   The same result,
as shown hereafter, has followed its use by inoculation  in amaurosis.
  Dr. Favell10 contends, that the forms of paralysis most likely to be
benefited by it are those dependent upon cold, poisons, and certain mo-
lecular changes in the brain  and nerves, altogether  inappreciable by
post mortem examination.   He  considers,  that the most  dangerous
symptoms resulting from an  over dose are generally caused by the in-

  1 New York Times, Aug., 1853.               2 Lond. Med.  Gaz. April, 1831.
  3 La Lancette Francaise, 29 Aout, 1837.        * Op. citat.
  6 Gazette Med. de Paris, No. 5, 1841.      6 Lond. Med. Gaz. July 12, 1846, p. 496.
  1 Petrequin, Gazette M.dicale, Nov., 1838; and l'Expenence, Oct. 1843.
  8 See Bally, Considerations sur la Strychnine, &c, in Bulletin General de Therapeu-
tique, Fev. 1838.
  9 Bouchardat, Annuaire de Th.rapeutique pour 1849, p. 70.
 10 Provincial Medical and Surgical Journal, Dec. 31, 1845. 
660
STRYCHNIA.
fluence of the drug on the nerves distributed to the heart.   Dr. Benton,
of Illinois,1 affirms, that he has employed it with the happiest results
in some forms of  coma attending fevers in  malarious districts.   The
phenomenon occurred in remittent fever, and seemed wholly independ-
ent of organic lesion;—the secretions being natural, the tongue  and
skin moist, and all the symptoms improving, excepting those referable
to the encephalon.   In  such cases, strychnia in  doses  of one-twelfth
of a grain, every six hours, afforded relief in from 24 to 48 hours.
   Dr. Pereira2 has seen it very serviceable  in  that  shaking or trem-
bling action of the muscles, which is produced by habitual intoxication.
G. H. Richter  cured a case of aphonia by it, and Dr. P. H.  Clarke,3
of West Tennessee, considers, that it not only proved beneficial in loss
of voice caused by relaxation of the muscles  of the larynx, but in
chronic bronchitis.   In asthma, it has been prescribed with advantage*
in very minute doses, by M. Homolle.4  It has  been much used inter-
nally, and successfully, in amblyopia and amaurosis,  by Short, Liston,5
Guthrie, Middlemore,6  Henderson, Furnari,7 Mart, Petrequin,8 Duster-
burg,9 Debreyne,10 and  others.   Mr. Tyrrell and   Mr.  Lawrence,11
however, affirm that they have found it inefficacious in amaurosis.   In
these cases, it is generally used endermically on the temporal region.
Dr. Stevenson12 derived benefit from it—when  applied in  this Avay—
in cases of amaurosis of many years' duration.   Half a grain Avas re-
peated twiee a  day until tremors of the limbs were produced.   He em-
ployed it in the same manner in  other  cases of  local paralysis.   In
cases of amaurosis, Henderson advises, in addition,  that a solution of
strychnia should be dropped  into the  eye; and it has  likewise  been
used in the  form  of inoculation, in  the manner  described hereafter.
It has been given successfully in paralysis of the bladder by Schaible,
Bally, Hennemann, Behrend,13 and others, and  in the way of injection
by M. Lecleuse;14 and in paralysis of the facial nerve, by Drs. O'Brien,15
Beales,16 and Joslin.17 In two cases of paralysis  of the rectum in elderly
people,  accompanying  a disordered  state of the bowels, the author
found the best effects from the endermic use of strychnia—in the quan-
tity of a quarter of a grain, night and morning, to a blistered  surface
on the sacrum.   In high grades of paraplegia,  the internal use of the
remedy is to be preferred, but in general the endermic administration
is more advisable.   In paralysis of the limbs, a spot is selected in the
vicinity of the spinal marrow.
  1 Bullet, of Med.  Science.                       2 Med. Gazette,  vol. xix.
  3 Illinois and Indiana Med. and Surg. Journal, April and May,  1847.
  * Bouchardat, Annuaire de The"rap. pour 1854, p. 17.
  5 Lond. Med. Gaz. v. 541 and 575.
  6 Midland Medical and Surgical Reporter, May and August, 1831.
  7 Bouchardat, Annuaire de Th.rapeutique, pour 1841, p. 8.  Paris, 1841.
  8 Bulletin General de Therapeutique, Juillet, 1838.
  9 Cited in London Medical Gazette, August 5, 1842, p. 733.
  10 Noticed in Medico-Chirurg. Review, Oct. 1844.
  11 A Treatise on Diseases of the  Eye, Amer. edit, by Hays, p. 589.  Philad. 1854.
  12 Transactions of the Medical and Physical Society of Calcutta, vol. v.
  « Medicin. Zeitung, Sept. 1837, S. 190.
  14 Bouchardat, Annuaire de Th.rap. pour 1851, p. 27.
  l* Med. Chirurg. Review, and L'Experience, Nov. 1838.
  16 New York Journal of Medicine and Surgery, July, 1839, p. 201.
  n Amer. Journal of the Medical Sciences, Oct. 1842, p. 322. 
STRYCHNIA.
661
  Strychnia is  likewise  given in other affections.  Very favourable
reports have been made,  as to its efficacy in irregular gout, by Wendt,
who rubs on the affected  parts an ointment composed of a grain and a
half of nitrate of strychnia to two drams of lard;  and in
  Neuralgia.  Mart found it beneficial  in tic douloureux and in ner-
vous headache; Magnus in a  case of neuralgia of the arm; and several
successful cases have been published by  Dr. Pidduck.1  The sulphate
of strychnia, in doses of one-twelfth of  a  grain, two or  three times a
day, occasionally combined with sedatives  and quinia, has been highly
recommended by Dr. John Waters.2
   Traumatic Tetanus. In this disease it has  been extolled by Luders,
and a case, occurring in a negro girl, which terminated favourably under
its use, in the dose of one-twelfth of a grain every two hours, has been
reported by Dr. P. M. Kollock.3
   In  hysteria, hypochondriasis, and dyspepsia* it has  been advised
by Schmidtmann, and  Basedow, but morphia appears to render more
essential service.
   In  chorea, Romberg and  Professor Trousseau,5 Dr. A.  Ross,6 Dr.
Griscom,7 Prof.  Forget,8  M. Chevandier,9 Dr.  B. R. Hogan,10 saw good
effects from it.  Professor Trousseau administers a syrup of the sulphate
during or  after meals, in cautiously increased  doses  until convulsive
movements take place.   These are to be kept up for about eight days,
when, by diminishing the dose, a mere  muscular stiffness  should be
maintained for a similar  period, and the remedy be persevered in for
eight  or ten  days  after all irregular movements  have ceased.   Eight
cases  are  cited  in proof of his  assertions;  but  Dr. Cowan11  doubts
whether success should justify the employment of a remedy so difficult
to regulate, especially in  cases which seldom  resist ordinary and well
known treatment.   The experience of Professor Trousseau is confirmed
by that of M. Rougier.12   More recently, M. Trousseau13 has published
his mode of administering this powerful article.  This consists  in em-
ploying very small doses, increasing them  by  regular gradations, until
slight tetanic rigidity is  produced; then suspending  the medicine  or
continuing  the last dose^ but never increasing it beyond that point.
He states, that an  itching of the skin and  scalp generally precedes the
rigidity, and that  the masseter muscle is first  affected.   Hence he
advises, that the child should be frequently asked whether  it has any

  i London Medical Gazette, Aug. 7. 1840, p. 759.
  2 Cowan's Address, Trans, of the Provincial Med. and Surg. Assoc, p. 62.  Lond. 1845.
  8 Southern Med. and Surgical Journal, Oct. 1847.
  * Melcombe, in London Medical Gazette, for March 4,  1837, p. 850.
  5 Journal de Medecine de Beau,  Juin et Juillet, 1844, and Trait, de Therapeutique,
&c, i.  798.  Paris, 1847. Also, Union Medicale, Juin, 1849, and Ranking's Half-yearly
Abstract, July to Dec, 1849.  Amer edit. p. 41.
  6 London Lancet, June 7, 1845, p. 636.
  7 American Journal of the Med. Sciences, April, 1846, p. 471.
  6 Jamain et Wahu, Annuaire de Medecine, &c. pour 1853, p. 62.
  9 Ibid. p. 70, and Union Medicale, Mai, 1852.
  10 New Orleans Med. and Surg. Journal, Sept. 1846.
  11 Retrospective Address, in Transactions of the Provincial Medical and Surgical Asso-
ciation, xiii.  58. Lond. 1845.
  12 American Journal of the  Medical Sciences, Oct., 1844, and Medical Times, Aug.,
31 1844.                      1S Revue Medico-chirurgicale, Janv. 1850. 
662
STRYCHNIA.
difficulty in opening the mouth, and thus the earliest  toxical effects
may be recognised.
   M. Moynierx has published a paper, giving the results of treatment
according to Professor Trousseau's plan, in forty-three cases, of which
thirty-two were girls and eleven boys.  The average  date at which a
cure was effected was the thirty-third day in the case of the girls, and
seventy-four days in that of the boys.
   In retention of urine from loss of power after parturition, Dr. Cory2
administered a sixteenth of a grain of strychnia three  times a day, with
apparent advantage;  and it was given, with good results, in a case of
retention  of urine following scarlatina, by Dr.  Geo. L. Upshur, of
Norfolk, Va.3
   It has likewise  been advised in epilepsy4 and  catalepsy.   In a suc-
cessful case related by Dr. Weyland, nitrate of strychnia was taken in
such  quantity as to produce the peculiar  tetanic effects of  strychnia.
   Dr. Marshall Hall5 expects much benefit from the acetate of strych-
nia, in a tonic, not in  a stimulant dose, not only in epileptic cases, but
wherever there is nervous exhaustion, the result  of mental harass, or
sexual excess.  The formula he advises  is given under Strychni_e
Acetas.  From many trials he is led  to propose  the  fiftieth part of a
grain, three times  a day, as  the proper dose as a tonic.  Dr. Harris8
reports six cases treated successfully by it.
   Fricke has administered it successfully in—
   Syphilitic Osteocopi.  It has also been given with benefit  in cases of
   Dysentery  and  Biarrhoea, by Bardsley, Recamier,  Geddings  and
others.7  Dr. A. P. Merrill8 has employed it successfully  in the latter
disease and in choleraic diarrhoea.   It has been used also endermically
in cholera—two or three  grains being applied to  the  blistered surface
on the nape of the neck.   By MM. Dreyfus, Grimaud d'Angers and
Potton it was given internally in the same affection to allay vomiting,
—a quarter to a half a grain being  added to three ounces of water,
and prescribed in the dose  of a  spoonful every hour.9  Dr. Ryan10
asserts, that he has repeatedly known a few of the pills—the formula
for which is given  below—check a profuse diarrhoea with rice-coloured
evacuations, and even when  the  extremities were blue, in malignant
cholera.  In the same disease Mr. C. E. Jenkins11 gives a pill of one-
eighteenth of a grain every quarter of an hour, washing it  down with
copious draughts of cold water.  He finds the first three  or four pills
probably ejected, but the subsequent doses  are retained, and  their good
effect is speedily perceived.
   Of late, much discussion  has  occurred in Paris in relation to the

  1 Archiv. Gen. de M.d. July, 1854.       2 Medico-Chirurgical Review, July, 1839.
  s Medical Examiner, April, 1847, p. 213.
  * Brofferio, in Repertorio Medico-Chir. di Torino, 1825, and Revue Medicale, iv. 488.
Paris, 1825;  and Weyland, Wochenschrift fur die gesammte Heilkunde, cited in Encyc.
des Sciences M.d. Janv., 1851, p. 65.
  5 Threatenings of Apoplexy, p. 63, cited in Ranking, xiii. 38, Amer. edit. Phila. 1851.
  6 New York Medical  Times, April, 1855.
  * North American Archives, No. 2, Nov., 1834.
  8 Memphis Medical Recorder, and Atlanta Medical and Surgical Journ. Nov. 1855, p. 181.
  9 Merat and De Lens, Diet, de Mat. M.d. art. Strychnine.
 10 Formulary, 3d edit. p. 335.  Lond. 1839.        n London Lancet, Sept. 2, 1848. 
STRYCHNIA.
663
 powers  of strychnia in cholera.   M. Abeille,1 without any adequate
 foundation, affirmed it to be as certain in its action in that disease as
 quinia is in intermittent.  He gave the sulphate of strychnia in doses
 of one-third of a grain in two ounces of water four  times a day;  and
 each time applied from thirty to forty leeches, according to the strength
 of the individual, on the base of the thorax.  In consequence of these
 statements, strychnia  was employed by many physicians, not one of
 whom, after extensive experience with it, was able  to perceive the least
 benefit in bad cases.   It is  stated,  moreover, by the  editor of the Bul-
 letin Generale de Therapeutique, that he himself went to  the Hopital
 de Roule, where M. Abeille practises, and found that none of the phy-
 sicians there, in whose charge the cholera patients were, had the slightest
 faith in the practice.  A report was  also read to the Academie de Me-
 decine by M. Girardin on the  documents  submitted  by M. Abeille, in
 which his statements were shown to be without support, even from his
 own  evidence.2 _ Professor  Frazer,3 of Montreal, highly extols minute
 doses of strychnia as a general stimulant for sustaining the vital powers
 on the eve of their failure, and for restoring  them to  functional action,
 when that is all but  suspended by the supervention of collapse.   The
 dose he gives is the Jgth of a grain, every quarter of an hour,  or every
 five or ten minutes, in severe cases, until reaction is  established.   Dr.
 A. P. Merrill4 speaks highly of it in the dose of ^th to y^th of a grain,
 in diarrhoea, whether constituting the early stage of cholera or  not.   In
 Bevere cases, it may be necessary to repeat the dose every hour or two,
 the danger of cumulation being borne in mind.
   On the other hand, Dr. Ranking5  combined it with an aperient extract
 with advantage in  habitual constipation; and M.  Homolle6 relates
 three cases in which he found milligramme —gr. .0154—doses, repeated
 every hour, completely efficacious, after various other means had been
 used in vain, in relieving urgent symptoms of internal strangulation.
   It has proved beneficial in nervous vomiting and gastralgia, in the
 former of which  two teaspoonfuls of  a  solution of 5 centigrammes—
 gr. |,—in 100 grammes—Siij i-—of water, are given every quarter of
 an hour.   M. Debout has seen the  vomiting arrested after the fourth
 or fifth dose.   In gastralgia he gives  the same dose night and morning
 only.7
   In gleet, unaccompanied  by stricture, Dr.  C. Johnson8 has found
 good effects  from an injection of strychnia, according to the formula
 given hereafter.
   Biabetes.  Careful experiments, made  by Dr. Frick,9 of Baltimore, in
 a case of this disease, showed that  strychnia had  much  the greatest
 control over the quantity of  sugar passed in the urine and faeces.  The
  1 Bull. Gen. de Th.rap. Aout, 1854, and Archives Gen. de M.d. Aout,  1854, p.  234,
and Sept., 1854, p. 359.
  2 Brit, and For. Med. Chir. Rev. Oct., 1854, p. 559.
  3 Medical Chronicle, Sept., 1854, or Amer. Jour, of the Med. Sciences, Oct. 1854, p.  523.
  * Op. cit.
  6 L'Union M.dicale, No. 138-139,  1848, and Brit, and For. Med. Chir. Rev. April, 1849,
p. 639.                                               6 Ibid.
  7 Bouchardat, Annuaire de Therapeutique pour 1849,  p. 71.
  8 American Journal of the Medical Sciences, April, 1850, p. 541.
  9 Amer. Journ. of the Med. Sciences, p. 71, July, 1852. 
664
STRYCHNIA.
patient was kept under its influence for various periods, amounting, in
all, to  four months.   Under doses of one-twentieth of a grain, the
amount was diminished to less than one-half;  and under one-sixth of
a grain to less than one-fourth.
  Amenorrhoea.   Of twelve cases of suppressed menstruation, treated
by  Dr. Bardsley, ten  were cured, and two  relieved.  Dr. Churchill1
also had  two cases, in which the  cure by it was complete and perma-
nent.   Lastly. From its efficacy in analogous affections of the digestive
mucous membrane, Dr. Stokes2 thinks there is good reason to  hope
that it may prove useful in bronchitis.   It has been employed, indeed,
in all the cases in which the alcoholic extract of nux vomica has  been
found of service, than which it is of course to be more relied upon, in
consequence of its greater uniformity,—nux vomica itself being often
found unequal.
  Intermittent Fever.  This powerful agent has  been recommended
in this disease by Dr. S. E. M'Kinley,3 of Tennessee, who states, that
no remedy acts "with more certainty, as a permanent cure, if persist-
ed in for two  or  more weeks."   He gives from one-sixteenth to one-
eighth of a grain every three hours, gradually augmenting the dose,
"until, in some  cases, one  grain  may be given three or four times a
day, and without any toxical symptoms arising whatever."
  M. Grimaud4 has also recommended the sulphate of strychnia as an
antiperiodic in intermittent.
  It need scarcely be said that so potent an article must be adminis-
tered with the greatest caution, and the  cases  must be rare in which
it need be had recourse to to such an extent as to cause apprehension
of the unpleasant results  that appear to be produced at times by its
cumulating in the system.
  In  very obstinate  cases, Dr.  Keller,5 of Philadelphia, prescribes
the extract of nux  vomica in combination with arsenic, sulphate of
quinia and extract of quassia.

                     MODE OF ADMINISTRATION.
  Pure strychnia is best exhibited internally,  in the form of pill or in
spirituous solution; but if  a little acid, especially the acetic,  be added
to it, it may be given in watery solution, as in this way a salt of strych-
nia may  be formed  extemporaneously.   The  dose is  from one-six-
teenth to  one-eighth  of a grain,  which  may  be gradually 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 circum-
stance should arise to cause its discontinuance, it ought not to be re-
commenced in doses as large as the  last, but with small doses, as at
the beginning.  In the endermic application of the remedy, we sprinkle,
twice a day, a quarter of  a grain  on the denuded  surface, and slowly
increase the quantity to half a grain or more, should this be necessary.
  1 Outlines of the Principal Diseases of Females, American Med. Library edit. p. 54.
Philad.  1839.
  2 Treatise on Diseases of the Chest, p. 125. Dublin, 1837, or Amer. Med. Library
edit. Philad. 1838.                  » Medical Examiner, July, 1850,  p. 382.
  * Bouchardat, Annuaire de Th.rap. pour 1852, p. 160.
  B Nord Amerikanischer Monatsbericht fur Natur und Heilkunde, Sept. 1,1850, S. 103. 
STRYCHNIA.
665
If the larger doses  do not act more beneficially, it will be advisable
to discontinue it for a few days—after which  the smaller  doses  may
.gain  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 be-
coming covered with a layer of coagulable lymph, in consequence of
which the strychnia is unable to make its appropriate impression.   This
layer of lymph 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 preferable to increase
the dose of strychnia than to place so much  insoluble and irritating
powder on the sensitive  surface.
   It has also been introduced by inoculation  in the neighbourhood of
the eye in cases of amaurosis.2   A grain of the sulphate 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; and 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  tAvo days, the inoculations were repeated, and the num-
ber of punctures increased to eighteen.  The  patient now became
sensible of a  slight haziness.   After five successive inoculations, carried
to the length of thirty punctures,  the patient  began to distinguish ob-
jects; 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, inoculations were had recourse to  in the neighbourhood  of the
other  eye.   After the  lapse of two months, the patient was perfectly
restored.
                        Pilulae strychniae.
                          Pills of strychnia.
                  R. Strychnia, pur. gr. ij.
                     Confect. rosse s;ss.
                  Divide in pilulas xxiv.

    Dose.—One  to two, morning and evening.            Magendie.

                  R. Strychnia, gr. j.
                      Confect. ros. ^ss.
                     Glycyrrhiz. pulv. ^ss.
                  Divide  in pilulas xij.
    Dose.—One, night and morning.  The quantity may be increased
to four or five daily.                                       Ryan.

   » Bulletin General de Therapeutique, Mars, 1840.
   2 Yerlegh, Gazetta Medica di Milano, April, 1844, and London and Edinburgh Monthly
 Journal of Medical Science, Aug. 1844, p. 713. 
666                         STRYCHNIA.

                 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 strychniae.
                 R.  Strychnia, pur. gr. iij.
                     Alcohol 36° (.837) fgj.  M.
   Dose.—Six  to twenty-four drops, twice or thrice a day.
                                                       Magendie.
                      Mistura strychniae.
               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 strychniae.

                        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 amauro-
sis.                                                   Henderson.
                      Injectio strychniae.

                        Injection of strychnia.

                 R.  Strychnia, gr. ij.
                     Acid, nitric, fort. gtt. iv.
                     Aquas f gij.  M.

   A dram to be injected three times a day in  gleet.
                                             Christopher Johnson.

                    Unguentum strychniae.

                         Ointment of strychnia.

                 R.  Strychnia, gr. xvj.
                     Adipis gj.  M.

   Used in friction on paralyzed parts.                   Sandras.1

   It may be well to dissolve the strychnia,  before admixture, in a little
alcohol.
                    Linimentum strychniae.

                        Liniment of strychnia.

                R.   Strychnia, 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.

       1 Bouchardat, Nouveau Formulaire Magistral, p. 113.  Paris, 1845. 
STRYCHNLE IODAS.
667
                  CLXV. STRYCH'NLE ACETAS.
Synonymes.  Strychnia. Acetas, Strychnium  seu  Strychninum Aceticum, Acetas
  Strychnii seu Strychnicus, Acetate of Strychnia or Strychnine.
Grman. Essigsaures Strychnin,  Strychninacetat.
  In addition to the acetate, formed extemporaneously, as mentioned
under Strychnia, the proper acetate of strychnia has been administered,
especially by Luders and 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 diffi-
culty.   Even  when diluted 40,000 times, its solution occasions  a sense
of bitterness on the tongue.
  The following formulae have been given by the physicians cited.

                  Guttae  strychniae acetatis.
                    Drops of acetate of strychnia.
                 R. Strychniae acet. gr. iij.
                    Alcohol, fgj.
                    Aq. cinnam. f gvij.  M.
  Dose.—Five drops, twice a day, gradually increasing the dose.
                                                         Lilders.
                 R. Strychnia, acet. gr. j.
                    Acid, acetic, tnj xx.
                    Alcoholis f gij.
                    Aquae f gvj. M.
  Dose.—Ten drops three times a day.            Marshall Hall.
                Tinctura strychniae 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.
                  CLXYI.  STR,YCH'NI_E I'ODAS.
Syxonymes.  Strychnin..  Iodas,  Strychnina Iodata, Strychnium seu Strychninum
  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 strych-
nia: in a moment, the mass swells up, absorbs water, becomes thicker,
and at times very consistent.   It is now treated with boiling  alcohol,
filtered, and left  to spontaneous evaporation.   In this way, beautiful
crystals of iodide of  strychnia  are  obtained.   The iodic acid, proper
for  this preparation,  is procured according to  Geiger, in the folloAving
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 con-
sistence  of a  thin syrup, and is  exposed to the air for spontaneous
evaporation. 
668
STRYCHNIiE IODAS.
  Iodate of strychnia may likewise be formed by double decomposition,
by mixing a  soluble iodate, as  iodate of soda, Avith a solution of sul-
phate or muriate of strychnia.   The iodate of strychnia is precipitated,
which may be treated with boiling alcohol, and crystallized as  above
directed.
  The iodide is of a white colour, and crystallizes in beautiful pris-
matic needles:  it  is but slightly soluble in cold water, but more so in
boiling 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  destroy a
strong dog with tetanic symptoms.  It  acts  likewise powerfully  on
the diseased  organism.  I gave  it to several persons with a success
which far exceeded my expectations.   It  proved effectual in some old
paraplegic affections, which had been esteemed incurable, and after  all
the usual remedies had been 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 twenty-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 strychniae s'eu strychnicus;
Germ.  lodwasserstoffsdures  Strychnin, Iodwasserstoff
Strychnin, might be advantageously introduced into medicine.   It
is prepared by mixing a solution of iodide of potassium with a concen-
trated solution  of  acetate of strychnia: a white  crystalline powder is
precipitated, which  is soluble  in alcohol, 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 d'Iodhy-
drate 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 light chest-
nut hue, which is  dried and treated with boiling  alcohol.  On cooling,
the alcohol suffers crystals of ioduretted 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 Avhen slightly acidulated.
  M. Bouchardat1 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 re-
covered.   He  thinks  the  advantage  it  possesses over strychnia is in
being less poisonous  and  more persistent.   It is always identical in
composition, and  easy to obtain pure.
   The dose  is  a centigramme  (about a sixth of a grain) a day, gra-
dually increasing  it.
             1 Nouveau Formulaire Magistral, p. 114.  Paris, 1845. 
STRYCHNLE NITRAS.
669
  A double iodide OF zinc AND strychnia has also been prepared,
which, according to M. Bouchardat, is a well defined salt, crystallizing
regularly in beautiful needles of a brilliant  white colour.  It is com-
posed 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 pre-
pared by digesting for several days, in kot water, the iodide of iodhy-
drate of strychnia and zinc;  the  boiling liquid is  filtered, and, on
cooling,  the salt crystallizes.   M.  Bouchardat1 thinks it may replace
strychnia with advantage,—being more manageable; and he suggests,
that it may be a valuable agent in many serious neuroses, and especially
in epilepsy.
                 CLXVII. STRYCH'NI_E NITRAS.
Synonymes. Strychnin.. Nitras,  Strychnium seu Strychninum 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.2  It has been received into the Prussian Pharmacopoeia,
(Landespharmakopoe,) where it is directed to be prepared in the
following manner:
                      METHOD OF PREPARING.
  On eight  pounds of nux vomica, sixteen pounds of spirit of wine
(Kornbranntwein) are poured, and the liquid is distilled to one-
half.  The nux vomica is then freed from the liquor by filtering, is dried,
and reduced to coarse powder.   This is digested two or  three times,
with a sufficient quantity of the spirit, and after digestion it is strained.
The tinctures are then subjected to distillation, and what remains is
evaporated along with the fluid that remained after the boiling: to this
acetate of lead, dissolved in a sufficient quantity of distilled water, is
added so long as a precipitate falls.  The fluid, separated as much  as
possible from the precipitate, 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 suffered to stand three days, when  the  de-
posit  is separated by the aid  of the  filter, washed, and  dried.  This,
after  having been rubbed to powder, is digested two or three times in
alcohol, and the tinctures are subjected to distillation, until only a few
ounces remain.  The strychnia, which, on cooling, appears in the re-
tort 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 neutralized by a proper quantity of di-
lute nitric acid.  The filtered fluid is evaporated by a gentle  heat so
as to allow the formation of crystals.  It may, also, be  made by sa-
turating warm diluted nitric acid with strychnia; filtering, concen-
trating, and crystallizing.  These crystals are needle-shaped, colourless,

  2 Stumpf, art. Strychnos, Encyclopad. Worterb. der Medicin. rfossensch. xxxii. 484.
Berlin, 1844. 
670
SULPHURIS CARBURETUM.
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 when the internal administration  has been more
limited in  its results.   The experiments  instituted  by  Dr.  Stannius,
and others, and referred to in a former page, were with nitrate of strych-
nia.
  Magendie found, in his experiments, that  this salt completely pre-
vented the coagulation of the blood.1
                CLXVIII. STRYCH'NLE SULPHAS.
Synonymes. Strychnin.. Sulphas, Strychnium seu Strychninum Sulphuricum, Sulphas
  Strychnii 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 sulphuric  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 transparent cubes; when acid, in needles.
Its taste is extraordinarily bitter.  It is decomposed by every soluble
salifiable base.
  Sulphate of strychnia is much used by M. Trousseau, (see page 661.)
He prescribes it in the form of

                Syrupus strychniae  sulphatis.
    Syrup of sulphate of strychnia.—{\Sirop de strychnine.—Trousseau.)
                 R.  Strychniae sulphat. gr. 3.85 (25 cent.)
                     Syrup. Oj. (500 grammes.)  M.         Trousseau.
              CLXIX. SULTHURIS CARBURETUM.
Synonymes. Sulphuretum Carbonii  seu Carbonei, Carbonium seu Carboneum Sul-
  phuratum, Alcohol Sulphuris, Bisulphuretum Carbonii, Carbonii Bisulphuretum,
  Sulfidum Carbonii, Sulphuret of Carbon, Bisulphuret of Carbon, Sulphide of Carbon,
  Carburet of Sulphur, Alcohol of Sulphur.
French.  Sulfure de Carbon, Carbure de Soufre, Soufre Carbure, Alcool de Soufre.
German. SchweTelalkohol,  Schwefelkohlenstoff,  Fliissiger  Kohlen-
  schwefel, Kohlensulfurid.
  Carburet of sulphur or sulphuret of carbon was discovered by Lam-
padius in the year 1796.   It is a transparent and colourless fluid  at
the ordinary temperature;  has a very penetrating and  disagreeable

     i Lecons sur le Sang; or translation in Lond. Lancet, Jan. 26, 1839, p. 637. 
SULPHURIS CARBURETUM.
671
odour; and a taste cooling at first, but afterwards burning, acrid, and
somewhat aromatic.  Its specific gravity is 1.272.   It  boils  at 106°
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 the fixed and volatile oils.  Water
separates it immediately from those  solutions.   It  unites intimately
with the  alkalies; but,  of the acids, aqua regia—which is a mixture
of the nitric and muriatic acids—alone  lays  hold of it.  It  dissolves
potassa, camphor, sulphur, and phosphorus.  Lampadius, in the first
instance, regarded sulphuret of carbon as a compound of sulphur and
hydrogen; it is now, however, decided, that it consists of sulphur and
carbon,—according to Vauquelin, in the proportion  of  85 or 86 to 15
or 14; according to Berzelius and Marcet, of 84.84 to 15.16.

                      METHOD  OF PREPARING.
   Carburet of  sulphur  is obtained by passing  the vapour of sulphur
over  red hot charcoal, and condensing  the vapour of the  bisulphuret
either in a receiver cooled to 32° Fahr., or in ice cold water.1
   It 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.
   Dr. Snow2 diffused its vapour through air, and noticed the  effects on
mice.  He concludes that a single  deep inspiration of air  saturated
with  it, at  a summer temperature, would produce instant death.  It
did not  cause  muscular  relaxation before dissolution; but tremulous
convulsions continued until the last.   They supervened, or were threat-
ened, almost as  soon as complete insensibility to external impressions
was established.
   Carburet of  sulphur holds  a place amongst the transient or diffusible
stimulants.3  Its most marked effects are said to consist in its " exciting
the function of cutaneous transpiration to copious sweating; increasing
the secretion of urine, elevating the temperature of the body, quickening
the pulse, and  causing congestions towards the head  and those parts of
the body whose vitality may have been already somewhat augmented."4
Its most striking agency is exhibited in  the more active exercise of  the
functions of the skin.   According to Mansfeld,  it acts likewise 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.
   United  with phosphorus, it  has been recommended by M. Mandl
and by M. Aran,5 in severe  typhoid fever, where the debility was ur-
gent, in  the dose of three to five capsules a day,  which were  prepared,
by M.Mandl, of phosphorus, five centigrammes, (gr. £ troy;)  sulphu-

  1 Pereira, Elements of Mat. Med. and Therap. 3d Amer. edit. i. 376. Philad. 1852.
  2 London'Med. Gazette, June 23, 1848.
  * Wutzer, Journ. de Chimie Med., and Amer. Journ. Med. Sciences, Nov., 1831, p.  215.
  4 Riecke, Die neuern Arzneimittel, S. 109, und 2te Auflage, S. 166. Stuttgart, 1840.
  * Bouchardat, Annuaire de Th.rap. pour 1854, p. 43. 
672
SULPHURIS CARBURETUM.
ret of carbon, twenty drops; oil, eighteen grammes, (5ivss.;) magnesia,
as much  as is  sufficient for fifty pills, which are to be covered with ge-
latin.  Each capsule is estimated to contain a milligramme (gr. .0154)
of phosphorus, and the third of a drop of the sulphuret of carbon.
  The discoverer of the carburet of sulphur first recommended it as a
remedial agent.1  He particularly advised it, both internally and ex-
ternally, in rheumatic and gouty affections.   In Freiburg, a mixture
of one part of camphor, two of carburet of sulphur, and four of alcohol,
is a very common external application 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 unaccompanied by fever, or where  the  fever  is slight, it
exceeds every other remedy of the class.   Dr. Otto,2 of Copenhagen,
prescribes four drops of a mixture composed of one part  of carburet 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 Avith 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 gentle-
men found no advantage from it.   On the other  hand, in trials at the
Berlin Charite, 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.3
  Mansfeld, also, employed it in cases of after-pains, rubbing it,  with-
out admixture, on the abdomen;  and he  affirms,  that good effects re-
sulted from it, even when ergot had failed.  In  hysteric fainting, the
same gentleman  found it useful  when internally exhibited.  Lampa-
dius likewise  recommended it in fainting,  as  well  as  in asphyxia.
Krimer found it extremely efficacious in asphyxia from  carbonic acid,
but he frequently thought  it necessary to premise blood-letting. In
this way he treated eleven cases, and only one—in which apoplexy had
already supervened—terminated fatally.  The same physician  exhi-
bited it in some cases of drunkenness, attended with loss of conscious-
ness, and found its effects very beneficial.   He gave  it with great ad-
vantage once in a case of goitre ; and, in incarcerated hernia, no agent,
he says, facilitates so much the taxis as the cold produced by dropping
carburet of sulphur on the tumour.4  Lampadius  found, that slight
burns were instantaneously cured by it.  Dr. Turnbull affirms, that the
vapour of this substance was useful in cases  of indurated lymphatic
glands, and for the removal of deafness, dependent upon want of ner-
vous 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, imbibed by a piece of  sponge.   In the case of indurated
lymphatic glands, the part is first well moistened with water.  When the
vapour is applied to the ear, the bottle, the neck of which must be small
  1 Lampadius, in Bulletin des Sciences M.dicales de Ferussac, xi. 315.
  2 Annales de Chimie Medicale, and American Journal of the Medical Sciences, for
Nov., 1836, p. 222.
  3 G. Simon, art. Schwefelkohlenstoff, Encyclopad. Worterb. der  Medicinisch. Wissen-
schaft. xxxi. 270.  Berlin, 1843.
  * Journal de Pharmacie, and American Journal of Pharmacy, ix. 264. 
SULPHURIS CARBURETUM.
673
to fit the meatus, is held close to the organ, until considerable warmth
is induced.1  Clarus recommends it in hypertrophy of the coats of the
stomach, and in contraction of the oesophagus—when administered ac-
cording to the formula given below.   Every thing, indeed, says Riecke,
encourages its farther trial as  a remedial agent.2  It has been em-
ployed recently by Dr. Simpson,3 of Edinburgh, as an ansesthetic.   By
one or two to whom it was exhibited, it was declared to be more plea-
sant than chloroform; but in several it produced disagreeable  encepha-
lic disorder.  Its effects as an anaesthetic were powerful, and very ra-
pid, but difficult of regulation;  and its deranging influence continued
for some  time  after  it Avas exhibited.  Dr. Simpson  employed it in
obstetrical cases, when the same objections were found to  apply  to it.

                     MODE OF ADMINISTRATION.
   Carburet of  sulphur may be given  internally  in doses of from  one
drop to four, every five  or ten minutes, in cases of fainting and as-
phyxia; but where such a rapid analeptic agency is not  demanded, it
may be given  every two or  three hours.  It  may be  administered
dropped on sugar or  in a spoonful  of sugared  water or  barley water.
Clarus thinks it is best given in cow's milk.
   Externally, it is either applied pure, when a rapid development of
cold is needed—as in cases of  burns and incarcerated  hernia—or  dis-
solved in  alcohol or oil.
                  Guttae  sulphuris carbureti.
                     Drops of carburet of sulphur.
                 R.  Sulphur, carbur. f gij.
                     _Ether. 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 sulphuris carbureti.
                    Mixture of carburet of  sulphur.
                 R.  Sulphur, carbur. 9j.
                     Lact. vac .in. f gvj.
                     Sacch. gij.  M.
   Dose.—A table-spoonful, four  times  a day, or oftener.  Clarus.
              Embrocatio  sulphuris carbureti.
                  Embrocation of carburet of sulphur.
                 R.  Sulphur, carbur. gss.
                     Olei amygd. dulc. gj. M.
   To be rubbed in, in cases of old gouty nodes.  Mansfeld and Otto.4

  i Pharm. Journ. and Trans, ii. 35_2.      2 Die neuern Arzneimittel, v. s. vr. S. 110.
  'Pharmaceutical Journal, vii. 517.           ,-,,-.    .  i  iqq.    o^q
  * Bibliothek for Loeger, 1833, and Brit, and For. Med. Review, July, 1836, p. ZbA.
       43 
674                     SULPHURIS IODIDUM.

                 R.  Sulphur, carbur. f gij.
                     01. oliv. seu
                     Linim. ammon. camphor, f gij.  M.
  To be rubbed in, in cases of rheumatism.               Wutzer.
                 R.  Camphor, gij.
             Solve in
                     Sulphur, carbur. f gss.
             Adde
                     Alcohol, fgj.  M.
  To be used in friction, in  cases of rheumatism, and especially in
rheumatic odontalgia.                                 Lampadius.
                 CLXX. SULPH'URIS IO'DIDUM.
Synonymes.  Sulphuris loduretum, Sulphur Iodatum seu Ioduratum, Ioduret or Iodide
  of Sulphur.
French. Soufre Iodure, Iodure de Soufre.
German. Iodschwefel,  Iodinschwefel,  Schwefeliodur.

                      METHOD OF PREPARING.
  The following form for its preparation was  introduced  into the
edition of the Pharmacopoeia of the United  States for 1842:—Take
of iodine, %vf.; sulphur, 5j.   Rub the iodine and sulphur together in
a glass, porcelain, or marble mortar, until they are thoroughly mixed.
Put the mixture into a matrass; close the orifice  loosely, and apply a
gentle heat so as to darken the  mass without melting it.   When the
colour has  become uniformly dark  throughout,  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, aljow  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 dis-
eases 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, which had  resisted every other remedy, were
cured in four or five  months by iodide of sulphur alone.   To prevent
relapses, Biett advises that the frictions  should be  continued  after the
eruptions have scaled off.   He found it equally efficacious  in the lepra
vulgaris of Willan; and in acne—the gutta rosacea of Alibert—when
the inflammation of the skin had passed away.  Even acne indurata
was often  completely cured  by it.1  He found it also beneficial in in-
veterate porrigo of the scalp.2   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
areolar membrane.  In old standing lepra, Rayer3 prefers  it for ex-

 ^ 1 Rayer, Traits Th.orique et Pratique des Maladies de la Peau; and Copland, Dic-
tionary of Practical Medicine, art. AcDe.
  2 Cazenave et Schedel, Maladies de la Peau, p. 219;  and Cogswell on Iodine, p. 120.
Edinb. 1837.                   3 Diseases of the Skin, p. 634. 
SULPHURIS IODIDUM.
675
ternal  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.Volmar1 it has been used, with great success, in herpes pustu-
losus labialis.   It is likewise extolled by Lugol as a very active thera-
peutical agent. ^  Cless affirms, that in chronic squamous affections of
the skin, especially in psoriasis, he has employed it with  advantage,
but he was not able to  cure lepra vulgaris with  it.   It has been strongly
recommended in tinea capitis,  in  the proportion  of ten grains of the
iodide to  an ounce of lard.  A writer in an English  periodical2 af-
firms,  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 in-
creased 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 with a liniment composed
of iodid. sulphur 3ss-, ol. oliv., Sj-  In porrigo decalvans  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,3
too, has extolled it highly.  He affirms, that although it does  not  seem
to have so much poAver over lepra  and psoriasis as over porrigo, it has
succeeded more frequently than any agent he  has  tried, with the ex-
ception of blistering  by cantharides.  The author has certainly ob-
tained far more satisfactory results from  the  use of iodide of sulphur
in  chronic  cutaneous diseases  in  general, and especially  in porrigo,
eczema, and psoriasis, than from any other external agent;  and such
is the result of the observations of M. Escolar.4
   The iodide  has been given internally in the form of pill in inveterate
cases of eczema5—each pill containing about three quarters of a grain.
   The inhalation of the vapour of this substance has  been employed
in  humoral asthma by  Dr. Copland,6 with  temporary benefit;  and
fumigations of iodine and sulphur have been used advantageously in
certain atonic ulcers and chronic cutaneous diseases.1   With this view,
 the sulphur and iodine may be  combined extemporaneously,—say four
 parts  of iodine to one part of sulphur.

                      MODE OF ADMINISTRATION.
                 Unguentum sulphuris iodidi.
                     Ointment of iodide of sulphur.
                  R.  Sulphur, iodid. 9j—gss.
                      Adipis gj.   M. et fiat unguentum.  Biett.—Rayer.

  1 Die neuesten Entdeckung. in d. Mat. Med.; cited by Pereira, Elements of Mat. Med.
 3d Amer. edit. i. 407.  Philad. 1852.
  2 London Medical Gazette,  for Sept. 9, 1837, p.  879.  See, also, Cazenave, cited
in American Journal of the Med. Sciences, Oct. 1841, p. 460.
  3 London and  Edinburgh Monthly Journal of Medical Science, Dec, 1841; also, J. J.
Ross, Ibid. Sept., 1842, p. 792.
  4 Bouchardat,  Annuaire  de Th.rapeutique pour 1848, p. 196.  Paris, 1848.
  5 Devergie, Gaz. des Hopitaux, and Bouchardat, Annuaire de Therap. pour 1853, p. 305.
  6 Diet, of Practical Medicine, art. Asthma.          T London Lancet, vol. i. J S38. 
676
UREA.
  The Unguentum Sulphuris Iodidi of the Pharmacopoeias of Lon-
don and the United States, is formed of iodide of sulphur 5ss.; lard, 5j.
                          CLXXI. UREA.
Synonymes. Ureum, Uricum, Nephrine, Nephrin.
French. Uree, Extrait Savonneux de 1'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 Vauquelin, Berzelius,
Proust, and Liebig more especially.1

                      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  pre-
cipitated.   On dissohdng this in cold water, and decomposing by car-
bonate of potassa, reducing it almost to dryness, and treating the residue
by alcohol at  40°,  which  takes up the urea, crystals may be  obtained
by evaporation, which  may subsequently be procured colourless  by the
agency of animal charcoal.
  M. Henry,2 who  was not satisfied with the  scanty  product yielded
by this process, recommends  the  following:—Add to fresh  urine a
slight excess of subacetate of lead ; a precipitate is thus formed, which
consists of oxide of  lead united to the various acids of the urine, together
with the mucus, and a great part  of the animal matter;  the decanted
liquor is then  treated  with sulphuric acid in slight excess to  separate
the lead, and, afterwards, in  the  progress  of  the  evaporation, to de-
compose the salts 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 Avhole has become a clear syrup, pass it through  linen of
close texture,  and then reduce it one-third by evaporation.   On cool-
ing,  the liquid 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
with a very small quantity of carbonate of soda, with the view of sepa-
rating any remaining  acetate of lime, and  then digested in alcohol of
38°  to 40°.  The alcoholic solution being filtered,  and the alcohol
separated by  distillation,  the  urea remains, which  may be crystallized
afresh from water, if necessary.3
   Urea, thus  obtained, is in silky  or prismatic  needles, is very soluble,
and of a cooling taste.

  1 Annales de Chimie et de Physique, x.  369, and M.rat and De Lens, art. Ur.e.
  2 Journal de Pharmacie, xi. 161.  Paris, 1829.
  3 Manual of Materia  Medica and Pharmacy; by H. M. Edwards and P. Vavasseur, p.
231.  Philad.  1829. 
UREA.
677
  When obtained from urine, the most convenient  process, according
to Dr. Bache,1  is that proposed by Dr. Gregory, Avhich  consists in
saturating  concentrated urine with  oxalic  acid, dissolving  in  water
the oxalate of urea formed, decolorizing the solution with animal char-
coal, digesting it with carbonate of lime, separating  the  precipitated
oxalate of lime by filtration, and concentrating the  filtered liquor that
crystals may form.
  The following improved  method of preparation  has been  proposed
by Prof. Liebig.2  Twenty-eight parts of ferrocyanuret of potassium
perfectly dried are mixed with fourteen parts of peroxide of manganese,
both being reduced to as fine a powder as possible;  the mixture is then
heated on  an iron plate, not  in a crucible, over a coal fire to a feeble
red heat.   At  this temperature it inflames, and  is  gradually  extin-
guished.  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 sulphate 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 con-
centrated washings afforded by the ferrocyanuret of potassium; to dis-
solve in the last washings, in the cold, the  sulphate of ammonia, and
to mix  them with the first.  Commonly, an abundant precipitate of
sulphate of potassa  forms immediately.   The  supernatant  liquid is
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  decanted
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, and it  has  been  so  prescribed  by him and by  M. Segalas.
Fouquier employed it, also, but unsuccessfully, in diabetes?  Laennec
used  it with  advantage in a case of dropsy.   Dr.  Tanner4 employed
it in the same disease, and found it efficient.   In  no case did it give
rise to any unpleasant symptoms.  The  ordinary dose, given by him,
was ten grains every six hours, dissolved in water flavoured with syrup.
Diluents were freely allowed to  promote  its operation.  Professor
  1 Dispensatory of the United States, 10th edit. p. 1402.  Philad. 1854.
  2 Annalen der Chimie und Pharmacie,  B. xxxviii.; and Journal de Pharmacie, Aout,
1841, p. 502.                                          , .      ,  t. -  ,
  3 Journal de Physiol, de Magendie, ii.  344, and Magendie, Formulaire pour la 1 repa-
ration, &c, de Plu.ieurs Nouveaux Medicamens.
  * Med. Times and Gaz. May 8, 1852. 
678
VERATRIA.
Mauthner,1 of Vienna, has, likewise, employed both urea and the ni-
trate, in dropsy, and recommends that farther trials shall  be  made  <
with it.  In two cases reported by Mr. Kingdon,2  he found that Ni-
trate of Urea,—Nitras Urese, Urea Nitrica; French Nitrate d' Uree;
German, Salpetersaures Harnstoff,—acted as a very poAverful
diuretic; reducing, in a comparatively short time, anasarcousswellings
of some standing, when  ordinary diuretics had failed.   In the first
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 be-
came copious, and the  swelling disappeared.   In the second case, a
grain and  a half of the nitrate were given alone three times a day.
The like success attended this case: in ten days the anasarca had dis-
appeared.   Urea was also  prescribed  by M. Piorry in albuminuria?
  According to Prof. Fee,4 urea is received into the lists of the Ma-
teria Medica in the  Batavian Pharmacopoeia, and in some others less
knoAvn.  It has also been admitted into the French Pharmacopoeia.

                     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.
                      CLXXII. VERATRIA.
Synonymes. Veratrina, Veratrinum, Veratrium, Veratrine.
French. Veratrine.
German. Veratrin,  Niesswurzstoff.

  This alkaloid, which was discovered in 1819, by MM. Pelletier and
Caventou,5 and almost at the same  time by Meissner,6 is  commonly
prepared from the seeds of veratrum sabadilla—Sabadilla or Cevadilla
of the Pharmacopoeia of the United States.  It is contained in several
of the plants belonging to the family Colchicaceae.

                      METHOD  OF PREPARING.
  Cevadilla is repeatedly treated with boiling alcohol.   The tinctures,
filtered when almost boiling, allow whitish flakes of wax to be deposit-
ed on cooling;  the dissolved matters, brought to the consistence 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 liquid, a  new and  very abundant yellow

  1 Bouchardat, Annuaire de Th.rap. pour 1855,  p. 108.
 . 2 London Lancet, Sept. 7, 1844, p. 729.
  3 Aschenbrenner, Die neueren Arzneimittel, S. 268.  Erlangen, 1848.
  * Cours. d'Hist. Naturelle Pharm.  ii. 764; cited in Merat and De Lens, Diet, de Mat.
Med. art. Uree.                      5 Annales de Chimie et de Physique, xiv. 69.
  6 Gilbert's Annalen der Physik, lxv. 335. 
VERATRIA.
679
precipitate is thrown down, which can be separated  by means of the
filter.   The liquor, noAv nearly colourless, contains, besides other sub-
stances, acetate of lead, which had been added in excess; this is sepa-
rated by means of a stream of sulphuretted hydrogen; the liquor is
then filtered, and concentrated by evaporation;  treated by magnesia,
and again filtered.  The magnesian precipitate  is digested  in boiling
alcohol, and  on evaporating the alcoholic liquors, a  pulverulent, ex-
tremely 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 into the alco-
holic  solutions, it is obtained in the form of a very white and perfectly
inodorous powder.1
   Veratria has been received into the Pharmacopoeia of the United
States.2  In it, it is directed to be prepared as follows:—Take of  ce-
vadilla, bruised, two pounds; alcohol, three gallons; diluted sulphuric
acid,  solution of ammonia,  purified  animal  charcoal, magnesia, each
a  sufficient  quantity.   Boil the cevadilla in  a gallon of the alcohol, in
a  retort with 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 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 frequently;
then  express and wash what  remains.   Repeat the expression and
washing two or  three  times, andj having  dried  the residue, digest it
with a gentle heat several times in  alcohol,  and strain after each di-
gestion.   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 drop in as  much solution of am-
monia as may be necessary  to precipitate the veratria.   Lastly, sepa-
rate and dry the precipitate.
   The folloAving 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 decom-
poses 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 sul-
phuric 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  vera-
tria is precipitated.3

  1 Magendie, Formulaire pour la Preparation, &c, de plusieurs nouveaux Medicamens.
  2 Pharm. of the United States, p. 274.  Philad. 1851.  For Righini's method of ob-
taining what M. Soubeiran calls "medicinal veratrine" see Journal de Pharmacie, Oct. 1837.
  3 Pereira  Elements of Mat. Med. and Therap. 2d edit. ii. 961, London.  For what is 
680
VERATRIA.
  Veratria—commercial or medicinal veratria—as prepared by the
last process, is pulverulent, of a grayish-white colour, inodorous, and
of a bitter acrid taste, causing a sensation of tingling with numbness
in the tongue.   It is scarcely at all soluble in cold Avater; but boiling
water dissolves one thousandth part of its weight, and becomes sensi-
bly 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, Avhich, on evaporation, present the
appearance of gum.   The  sulphate alone affords rudiments of crystals
Avhen 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  sub-
stances into its elements, and  gives rise to a yellow detonating mat-
ter.
  Veratria has an alkaline reaction.   When exposed to heat, it lique-
fies at a temperature of 122° Fahrenheit, and has a waxy appearance.
On  cooling, it forms a translucent mass, having the appearance of am-
ber.  When distilled on  the  naked fire, it swells  up,  is  decomposed,
forms Avater, much oil, and leaves behind a bulky coal.
  According to Couerbe,1 when prepared in  the modes  above  men-
tioned, it still contains .several  other substances, sabadillina, veratria,
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:
                                                Sabadillina,   which
                   • n  ,  , T      ,          crystallizes on cooling.
                 yields to boiling water   ■< n  -A   .   „     _  .   , %.
                                             '  Resin of veratria, lelt
                                              in the cold solution.
                                               Veratria,  soluble  in
                                              ether.
                                               Gum resin of veratria,
                                              insoluble  in  ether, but
                                              soluble in alcohol.
Commercial
  veratria.
insoluble in boiling water
   On account of its very high price, and want of well defined external
characters, the veratria of the shops is said to be very subject to adul-
teration ;  and there would not seem  to be any good criterion for ascer-
taining its degree of purity.2
   Simon, an apothecary of Berlin, has affirmed, that he has found two
alkaloids  in veratrum album;  one of which possesses the property of
being precipitated from its solution in  acetic or phosphoric acid by sul-
phuric acid and its salts, like baryta;  hence he has given it the  name
harytin?

considered a less complicated and less troublesome process, see Mr. James Beatson in
Amer. Journ. of Pharm., Jan., 1854, p. 5.
  1 Annales de Chimie et de Physique, ii. 308.
  2 Christison, Dispensatory, p. 806.  Edinb. 1842.  See, as  regards its  adulteration
with lime, Versmann, cited in Med. Examiner,  Oct. 1845, p. 626.
  3 Pharmaceut. Centralblatt, 1837, p. 191, and Medicinische Annalen, B.iv. H. i.; S. 9.
Heidelb. 1838. 
VERATRIA.
681
                EFFECTS  ON THE ANIMAL  ECONOMY.
  Regarding the effects  of veratria on  animals, Magendie1  has the
following remarks:—A very small quantity of the acetate placed in
the nostrils of a dog, instantly excited violent sneezing, which continued
for a long time.  One or  two grains, placed in the mouth, immediately
occasioned profuse ptyalism.  When a small quantity was introduced
into any part of the  intestinal canal, and the body was opened to notice
its effects, the intestine was observed to be  much indurated, and to re-
lax and contract alternately for a certain length of time.  The part
of the mucous membrane with which the  veratria is made  to  come in
contact is inflamed; the irritation spreads, and vomiting and  purging
are excited.  In much stronger doses, the  circulation is  accelerated,
as well as the respiration; and  tetanus supervenes, soon  followed by
death.  The effects  are still more rapid, if  one or two grains be thrown
into the cavity of  the pleura, or tunica vaginalis.  In  less  than ten
minutes death  occurs, preceded  by tetanic  convulsions.    The  same
quantity, thrown into  the jugular  vein, induced tetanus and death in
a few seconds.   Dissection showed, that, even  in this  case, the vera-
tria had acted on the intestinal canal, the mucous membrane of which
was found injected.   The lungs, also, exhibited traces of inflammation
and engorgement.
   Veratria, in  large doses, would, doubtless, exhibit  the  same effects
on the human organism.   The  taste is very acrid, but  without bitter-
ness:  it excites a copious flow of saliva, even when  a  small  quantity
only has been introduced into the mouth.  Although it has no smell,
it must not be brought too close to the nose,  when in  the state of pow-
der, as it  occasions, even in very minute  quantity, violent  sneezing,
which may prove  dangerous.   A quarter  of a grain immediately in-
duces  copious  evacuations, and a someAvhat  larger dose more or less
violent vomiting.
   The experiments of MM. Ernest Faivre and Camille Leblanc2 exhi-
bit that it exerts three distinct actions on the animal organism, accord-
ing to the greater or less dose in Avhich it is given.  The first is clearly
shown -on the digestive tube; the second on the  organs of circulation
and  respiration, and  the third on the nervous system  and muscles of
animal life. Careful experiments with the view of  testing its action,
have  been  recently made by Van Praag.3  When a minute portion
was placed  on  the tongue, it was observed to  be bitter;  and it occa-
sioned a persistent scraping  sensation in  the throat.   It produced tick-
ling in the nose, and sneezing for a Avhole hour after the application of
a like quantity  to the Schneiderian membrane.  When  applied to the
skin, it caused a peculiar pricking sensation, with a feeling of cold m
the part.   A dilute  watery solution of acetate, applied to  the umbilical
region, produced,  almost immediately, intolerable pain, as if  the part

  1 Journal de Physiologie Experiment, i. 56; and Formulaire pour la Preparation, &c,
de Plusieurs Nouveaux M.dicamens.
  2 Bouchardat, Annuaire  de  Thfirnp. pour 1855, p. 112; and  Comptes Rendus des
Seances et Mem. de la Sociote  de Biologie, Ann.e 1854, p. 143.  Paris, 185->.
  3 Association Medical Journal, Aug. 17, 1855, from Virschow's Archiv. cited in Amer.
Journ. of the Med. Sciences, Oct. 1855, p. 488. 
682
VERATRIA.
were pierced with red hot needles.  On the lower animals, Van Praag
believes that it operates  much like delphinia.   The respiration and
circulation are loAvered; the muscles lose their tone, and the irritability
of many of the nerves, especially the cutaneous, is much reduced.  On
the other hand, even very small doses induce vomiting and often diar-
rhoea,  although the latter  more frequently arises  only after larger
doses.   The secretion of urine is not remarkably affected;  but that of
saliva is greatly increased.  The stage of irritation is  marked by ac-
celerated respiration and pulse; tonic and clonic muscular spasm; and
increased  nervous irritability.  He believes  the  tetanic stiffening of
the limbs, passing into a dancing movement,  to be peculiar  to poison-
ing by this alkaloid.  Death arises from paralysis of the spinal cord.
   According to Turnbull, who has immoderately extolled this remedy,
its effect is very different, according as it is exhibited internally or ex-
ternally.  Externally, it may be  applied for weeks and months, with-
out the supervention of any of the effects that succeed its internal ad-
ministration.  Exhibited  in this way, it diminishes internal nervous
excitement; assuages pain,  but does not act on  the intestinal canal.
In dropsical cases, it is stated to be one of  the greatest promoters of
the urinary secretion that we possess.  The part  of the skin on which
it is rubbed, either in solution or ointment, even when the friction  has
been continued for  a  long  time, exhibits  no evidence of  irritation;
when,  however, the dose  has attained a certain extent, the patients
feel a considerable degree of heat, and a kind of pricking sensation in
the rubbed part, whence it may be concluded that the article is active,
pure and genuine:  under more prolonged use, this feeling of warmth
and pricking extends over the surface of the whole body;  and, in some
cases,  involuntary twitchings have been observed in the muscles of the
mouth and eyelids.  These  symptoms, however, pass off, when the fric-
tions are discontinued for a day or  two.  Only in a few cases, accord-
ing  to Turnbull, was any eruption induced  by its  application.  The
endermic  use of the remedy always, however, excited so much irritation
as to prevent its repetition.
   Thus much for Turnbull:—His  views and experience have  by no
means been confirmed by the generality of observers.  The external
application  of veratria cannot  always be used without  local irritation
ensuing.  An English physician, labouring  under  rheumatism of the
arm, rubbed upon it an ointment composed of twenty grains of veratria
to an  ounce of lard; and, immediately afterwards, so much pain Avas
induced in the part, that he Avas obliged  to take  opium to obtain rest;
an eczematous eruption subsequently appeared  on the arm, but the
rheumatism remained.  Ebers  applied it endermically, but witnessed
nothing more than  a violent burning in the part, such as is  commonly
the  case  with  other agents.   He  frequently observed the  pricking
sensation mentioned by Turnbull, and it was often to  such  an extent
as to be almost insupportable.   According  to the trials of  Ebers, its
diuretic effect was not restricted  to dropsy, but was usually evinced in
other diseases.  The sensorium appears never to  have been implicated,
but when  applied in small doses over the pit of the stomach, it produced
striking effects on the spinal marrow, and the nerves connected there- 
VERATRIA.
683
with,—as the  nerves of the thorax  and abdomen:  violent pain was
experienced, which spread through the whole extent  of the nerves dis-
tributed to  the parietes of the abdomen, with a sense of traction along
the spinal marrow, twitchings, great  anxiety, orthopncea, nausea and
vomiting, and a feeling which the patient was unable to describe, except
that it was  almost intolerable.
   When given internally, veratria speedily caused  nausea, retching,
vertigo, and complete loss  of appetite; so that Ebers soon abandoned
its internal  use, and, like Turnbull, gave the preference to the external.
   Owing to its presumed effects on the nervous system,  and especially
on the spinal marrow, and the nerves connected with it, it was suggested
in nervous diseases—particularly in neuralgia, prosopalgia, and ischias
—in which  it is said to have been most efficacious, by Turnbull, Ebers,1
Bruck, Suffert,2 Professor S. Jackson,3 Cunier,4 Calve,5 F. A. Gebhard,6
and others.  In  no class of diseases, according to  the first of these
Avriters, have the beneficial effects of the ointment of veratria exhibited
themselves  more  strikingly, and  by no  other remedy  has the same
amount of relief been induced in so short a time.    Even in tic doulou-
reux, a single  friction is said to have  been sufficient to remove the dis-
ease without relapse.  Two circumstances chiefly  have here to be borne
in mind,—first, the extent of the pain, for when  it  is not concentrated
on a point,  but spreads along the branches  of the nerves, the  cure is
easier, and  a weaker ointment is needed;  and, secondly, the  duration
of the affection.   In long protracted cases, a complete cure is far more
difficult, and can, in general, be effected only after a long period.  The
paroxysms,  however, may be relieved by an ointment  composed of from
twenty to forty grains  to an ounce of lard.   In  this case, it  must be
strongly rubbed in, so as to excite itching,—care being taken, however,
that the ointment does not  touch the conjunctiva, as the  smallest quan-
tity of veratria would induce violent  inflammation.   In  many  cases of
prosopalgia M. Lafargue7  introduced it by inoculation with singularly
good  effects.   The plan he pursues is  nearly  the same as that for vacci-
nation.   Several punctures are made with the point of a lancet charged
with a saturated solution of the alkaloid.  Each puncture becomes at
once the seat of a sharp pain, which is usually compared  by the patient
to a  continued deep pricking with the point of  a needle.  This un-
pleasant sensation lasts for from five to fifteen minutes, and then gradu-
ally subsides;  and with it the red areola that has  formed around the
punctured spot.   M. Lafargue recommends, that in severe cases the
inoculation should be repeated morning and eATening;  and that as many
as ten or twelve punctures  should be made  at a time.  He has used

  1 Casper's Wochenschrift. 1837, No. 47.
  2 Berlin, Medicin. Centralzeitung, 1837, p. 673, and  Heidelberg. Medicin.  Annal. B.
iv. H. 1, S.  11.
  3 American Journal of Pharmacy, vol. iii. new series,  p. 186.   Philad. 1838.
  * Bulletin Medical Beige, Dec, 1837, and Bullet. General de Th.rap. Dec, 1838. See,
also, Forcke, Physiologisch-therapeutische Untersuchungen iiber das Veratria,  Hannov.
1837; cited in  Bib. Gon.rale, Encyclog. des Sciences Medicales, Aout, 1838.
  5 Cited in Braithwaite's Retrospect, x. 24; Amer. edit. New York, 1845.
  6 Zeitschrift  fur Therapie  und  Pharmacodynamik, Freiburg,  Dec,  1844; and Amer.
Journ. of the Med. Sciences, Jan., Ibid, p. 203.
  i Cited in Edinb. Med. and Surg. Journal, Oct. 1843. 
684                         VERATRIA.
the same method with decidedly good effects, in several cases of partial
paralysis.
  Ebers, likewise, found advantage from its use in  chorea, hypochon-
driasis and hysteria; and Turnbull, and F. A. Gebhard,1 in paralysis.
Both Ebers and Turnbull extol it in rheumatism and gout, in relation
to which Ebers remarks, that it has appeared to him more efficacious
when the  nervous system, or some nervous branches  were predomi-
nantly affected, and when the gastric  affection  was  entirely removed.
In the cases treated Avith it,  relief  was sooner obtained, and the cure
was more speedy and complete, than when other agents were employed;
the secretion of urine was augmented; restlessness  disappeared; and
sleep returned, without any evidence of narcosis.   As  regards  acute
rheumatism,  Turnbull remarks, that veratria is not to be preferred  to
antiphlogistics; in these cases, a Aveaker ointment must be used (ten
grains to the ounce:) in chronic cases, the quantity may be  carried
much higher;  and—especially Avhen extensive organic changes have
superA'ened in the parts—it must be continued  for a great length  of
time.  In lumbago, ischias and rheumatism of the chest, not more than
one or two rubbings Avere generally necessary.
  M. Piedagnel2 affirms, that he succeeded in curing acute articular
rheumatism by it, in seven or eight days.   He gives it in pills, each
containing about one-thirteenth of a grain.  Of these, one is taken the
first day, two the second, three the third, &c, up to  the sixth day.   It
Was  rarely necessary to  give seven pills.   The dose is gradually dis-
continued.    M. Trousseau appears to have been equally successful.
Siniilar benefit in rheumatism was obtained by M. D.  Fabre, M. Ma-
rotte and Prof. Trousseau.3
  M. Aran prescribed it in six cases of pneumonia, and,  he thought,
with evident benefit4 in pills,  each of which contained five milligrammes
(gr. .0770) or one-nineteenth; one  was given  every two, three, four,
five or six hours, according to circumstances.   He also gave it with ad-
vantage in other inflammatory affections, in  typhoid fever and acute
rheumatism.   The pulse fell in an  extraordinary manner; the  number
of respirations  diminished, and its  action on  the nervous system was
marked by extreme  debility, prostration, pallor, &c.  In a subsequent
communication,5 he states that veratria ought to be  employed in cases
of acute rheumatism complicated with endocarditis  or pericarditis.
  In gout, according to Turnbull, it may be exhibited  both internally
and externally; in the former mode of administration, he compares  its
efficacy with  that of colchicum: the latter has been recommended  by
Sir.  C. Scudamore.  It was  likewise found, by  Bardsley,6 very advan-
tageous in  chronic rheumatism.   In cases of severe  local suffering the
ointment composed of veratria and opium, the form for which is given
hereafter, has afforded marked relief.  In  two epidemics  of hooping

  1 Op. cit.
  2 Union M.dicale, 2 Avril, 1853, and Bouchardat, Annuaire de Th.rap. pour 1853, p.  49,
and Ibid., pour 1854, p. 57.
  3 Bouchardat, Ibid. p. 60 and 61, or Union M.dicale, Avril, 1853.
  4 Union Medicale, Sept., 1853, and Brit, and For. Med. Chir. Rev. April, 1854, p. 588.
  5 Bouchardat, Ibid, pour 1855, p. 122.
  6 Hospital Facts and Observations, illustrative of the Efficacy of  Strychnia, Brucia,
Veratria, Iodine, &c. Lond. 1830. 
VERATRIA.
685
cough, Dr. F. A. Gebhard1 found that great benefit was experienced,
where the second  stage was  of protracted  duration, from  rubbing it
over the vertebrae of the neck and upper part of the back.  Dr. Bush-
nan  has strongly recommended the ointment in dysmenorrhoea, which
he supposes may be  frequently owing to perversion of  the nervous  ac-
tion of the lower portion of the spinal marrow; and in certain spasmo-
dic affections of the larynx, presumed by Dr. Tunstall2 to be con-
nected with a morbid condition of the superior portion  of  the  spinal
marrow, it is asserted to have been efficacious.   It has also been used
in amaurosis, the ointment being rubbed on the temples and forehead,
for a few minutes, once or twice in  twenty-four hours.   The friction
should be continued until it causes redness, heat, and stinging.  Messrs.
Lawrence3 and  Tyrrel, however, affirm, that it is wholly inefficacious.
   Veratria would seem to have been most efficacious in cases of dropsy.
"Unadulterated veratria," says Ebers, "acts often on the urinary  se-
cretion with magical powers, and it may seem fabulous, when I state,
that friction with a very weak ointment two or three times in the twenty-
four hours  on the inner part of the thigh, or the back, epigastric region,
or around the navel, has excited such a copious secretion  of urine, that
the patient, under its long continuance, began to  feel weak; and  the
anasarca, and even the dropsical accumulation in the abdomen, in- a
short time  almost disappeared—circumstances  which indicate the cau-
tion that ought to be observed in apportioning  the dose, when we  are
satisfied of the goodness of the article."   lie  properly remarks, how-
ever, that veratria, by augmenting the secretion of urine, may not  re-
move the dropsy;  still, by occasioning  the absorption of the fluid, it
allows the physician to examine as to the existence of organic mischief.
Ebers gave it in many of the lighter hydropic cases which follow in-
termittents and other forms of fever, and often with  great and rapid
success; likewise, in twenty-four more  serious  cases, fifteen of which
recovered,  and one  experienced  relief: eight  very complicated cases
terminated fatally, and in four of these diuresis occurred; in four not.
Dr. F. A. Gebhard4 found more marked effects  from it in dropsies con-
sequent upon  long and  exhausting disease; and  particularly in cases
which supervene on a severe typhoid  epidemic,  Avhich  he  witnessed.
Fricker5 likewise obtained very good effects from the use of an oint-
ment of it in dropsy; but, on the  other hand, Spiith found it of no
avail.
   Turnbull observed, from the internal use of veratria, as well as from
its application to the pit of the stomach, a diminution  in the frequency
and force  of the pulsations  of  the  heart;  and, in  cases where they
were more excited than  natural, restoration of a  regular circulation.
He exhibited it, consequently, in heart diseases, especially in those of
gouty and rheumatic diathesis, in simple nervous and gouty palpita-
tion, and as a diuretic in  organic heart diseases, in which it frequently
seemed  to  afford relief.
  1 Op. cit.                 2 Provincial Med. and Surg. Journal, Aug. 14, 1841.
  3 A Treatise on the Diseases of the Eye, Amer. ed. by Dr. Hays, p. 519. Phila. 1843.
  4 Op. cit.
  5 AViirtemb. Medic. Correspondenzblatt, B. vi. S. 157 and 341; and Heidelb. Medicin.
Annal. B. iv. H. i. S. 15. 
686
VERATRIA.
  Dr. J. B. Klingner1 found it eminently useful in tumefactions and
stiffness of joints remaining after sprains, luxations, and other injuries,
as Avell as Avhen synovial membranes are tliickened and  ulcerated, and
partial anchylosis is established.   Indolent and scrofulous  ulcers as-
sume a healthy action, and cicatrize under its employment.   He com-
monly uses the A-eratria in the form of ointment, in the proportion of
five to ten grains to the ounce of lard,—the veratria being first dissolved
in a little spirits of Avine, or tincture of  capsicum, of which about  the
size of a small bean is rubbed into  the affected  part  Avith  the bare
hand, gently and steadily shampooing it for a  quarter of an hour.   He
finds its application valuable in cases of scrofulous deposits around
the joints,—the ointment of  veratria being used at night, and a tinc-
ture, composed of concentrated tincture of capsicum, with twenty grains
of  veratria to the fluidounce, rubbed in on the following  morning.
The plan requires to be continued for  some time.   Dr.  Klingner also
found it of the  greatest  efficacy  in  hydrops  articuli,  effusions from
sprains and dislocations, and chronic inflammation of the bursse and
tendons; but it could only be used with safety and benefit, when no ac-
tive inflammation was present.
   From  its observed physiological  action, Van Praag2 suggests that
veratria might be serviceable in febrile diseases, which are associated
with augmented muscular tonicity, and,  on account of its sedative ef-
fect on the pulse and respiration, in pneumonia, pleurisy, and inflam-
matory affections of the heart.
   The observation of Turnbull—that the external  application of ve-
ratria, in chronic  rheumatism  with swellings  of the  joints, caused
them to disappear—induced him to try it in glandular  swellings: he
found, that in goitre,  swellings  of the mammary glands unaccom-
panied  with  pain,  buboes, and  scrofulous  tumours of  various parts,
even in cases in which iodine had failed, it rendered essential service.
It has, according to him, the  advantage, that the skin is not subse-
quently irritated by it, and when, after the  rubbing, the  superfluous
ointment is washed off with soap and water, the affected  parts can soon
afterwards be exposed to the air.   Of an ointment formed of ten grains
of veratria to half  an ounce  of  lard, a piece, about the size of a nut,
is rubbed in for ten minutes twice a day, and every week  the strength
of the ointment is increased.
   Magendie3  recommends, that  veratria should be given, also, as  a
drastic cathartic, especially where a  speedy  action on  the bowels is
needed.   Prescribed with this view, it has been found effective in se-
veral aged persons, in whom  a collection of excrement  had formed in
the large intestine.   Turnbull advises it  in the  dose of half a  grain
—in the opposite  condition of the bowels—diarrhoea—a disease,  in
which, it  is well known, our ordinary cathartics often  prove service-
able.
  It would appear, as before remarked, that veratria is an article which
is frequently adulterated.  Such, at least, is the opinion of many prac-

  1 Glasgow Medical Journal, Jan. 1854, cited in  Amer. Journ. of the  Med. Sciences,
July, 1854, p. 226.
  2 Virchow's Archiv. Bd. vii. Heft. 2, and Brit, and For. Med. Chir. Rev. July, 1855, p. 236.
  1 Formulaire pour la Preparation, &c, de plusieurs nouveaux M<jdicamens. 
VERATRIA.
687
titioners, and in this way they account for the  dis§ordance amongst
observers as to its  virtues.1   The  article with which Ebers made his
first trials was obtained from the French laboratories; and it exhibited
the whole power of this heroic agent: on employing, however, a new
preparation,  he found the latter entirely useless;  whilst from another
he derived all the benefit  obtained from  the  first.  The observations
of Ebers would induce us to make farther trials with it; but the author
must confess  that his experience, thus far, has by no means confirmed
the eulogiums of Turnbull; and this, he thinks, is the general sentiment
of the profession.2   It has often been used externally by him as well as
by other American physicians, but it has almost always fallen short of
the mark.   It is difficult, indeed, to know what reliance is to be placed
on any of the  assertions of Dr. Turnbull, whose  course has been so erratic.
Some years ago he remarked, "Feeling satisfied that I had  in my pos-
session means decidedly effective in promoting absorption through the
medium of the nerves, and knowing that deafness often arose from the
Eustachian tube being obstructed by enlarged tonsil glands, I  applied
veratria externally over these glands, and found it frequently  succeed
in  removing their enlargement and restoring the hearing."  The " elec-
tro-stimulation," as he terms it, was found to be so efficacious [!] in re-
moving deafness, produced  in the manner described, .that  he  was  in-
 duced to employ it in the case of deaf mutes; and it was soon adver-
 tised in the newspapers that he had cured several of them.   It need
 scarcely be said that all this was as fabulous  as the reports of  cures of
 other affections, which have attended him in  his, progress from  town to
 town in the  United States and elsewhere.3

                     MODE OF ADMINISTRATION.
    Veratria  may be given either  in pill or in spirituous solution;  the
 dose being from one-twelfth to one-sixth of a  grain several times a day.
 Externally, it is best administered in the form of ointment, or ender-
 mically.
                         Liquor  veratrise.
                          Solution  of veratria.
                  R.  Veratria. gr. j.
                      Aq. destillat. f gij.  M.
    A dessert-spoonful to be taken in one or two ounces of sugared water,
 in cases of tic douloureux.                             Magendie.

                         Pilulae  veratriae.
                            Pills  of veratria.
                   R. Veratria. gr. ss.
                      Acacia. 9j.
                      Syrup, acac. q. s. ut fiant pilulffi vj.
   1 Ebers; and Riecke, Die neuern Arzneimittel, u. s. w. S. 407, and 2te Auflage, S. 641.
 Stuttgart,'1840.                                  .      ,. ,  _..     „_,
   2 Gully's translation of Magendie's Formulary; and Joy, in Tweedie s Library ot Me-
 dicine, v. 289.  Lond. 1840; or 2d Amer. edit.  Philad. 1842.  See, on the preparation,
 employment, action, and medicinal virtues of veratria, Ebers, in Hufeland's Journal,
 B. lxxxvi. 1838.                                                  1C_Q
   3 Wilde, Practical Observations on Aural Surgery, Amer.  edit. p. 55.  Philaa. ISO-. 
688                           VERATRIA.

  Dose.—One piil, to be repeated two or three times a day, according
to circumstances.                                        Magendie.
                 R. Veratria.  gr. j.
                      Glycyrr. pulv. gr. xii.
                     Ext. hyoscyam. gr. vj.
                 M. fiant pilulas xij.
  Dose.—One, three times a  day.                         Turnbull.

                       Tinctura  veratriae.

                          Tincture of veratria.
                 R. Veratriae  gr. iv.1
                      Alcohol, fjj. M.
  Dose.—Ten, fifteen, twenty, to twenty-five drops in a glass of water.
Given in dropsy.                                        Magendie.

  Magendie recommends  that the tincture should also  be used exter-
nally, in cases of dropsy or gout.

                     Linimentum veratriae.
                         Liniment of veratria.
                 R. Veratriae  gr. viij.
                Solve in
                      Alcohol.
                      Tinct. sapon. camphorat. aa f gss.  M.

                           Huile de  Veratrine.
                 R. Veratriae  gr. xvss. (1 gram.)
                     •Olei jecoris aselli 3viss. (25 gram.")  M.

  Used in the form of friction in inveterate neuralgia.2
                                                       Jourdain.
                     Unguentum veratriae.
                         Ointment of veratria.
                 R. Veratria.  gr. v. x. vel xx.
                     Adipis gi.
                Misce intime.
  For external use.   The size of a hazel-nut to be carefully rubbed in,
morning and evening, or oftener, for from  five to  fifteen minutes.
                                                       Turnbull.
                 R. Veratriae  9j.
              Tere cum
                     01. olivae  3j.
              Et adde
                     Unguent, cetacei ^vij. Misce.

                 Unguentum veratriae et opii.
                    Ointment of veratria and opium.
                 R. Veratriae  ^ss-
                      Opii pulv. 3i-
                      Adipis giss.  M.
  To be rubbed on the part in severe bodily suffering from rheumatism.
  The  uncertainty in  the action of  the ointment of veratria having

  1 In the Pharmacopee Universelle of Jourdan, (ii. 643,) there is the serious error of
directing giv. in the preparation of this tincture, in place of four grains!
  2 Bouchardat, Annuaire de Th.rapeutique, &c. pour 1847, p. 36.  Paris, 1847. 
ZINCI CHLORIDUM.
689
attracted the attention of M. Sauvan,1 he found, by accident, that the
difference did not proceed from the veratria, but from the fatty matter
employed.   With fresh pure lard, the ointment was of bad quality;
whilst with bad or rancid lard, a satisfactory ointment was obtained. f

   Sulphate  of Veratria— Veratrise Sulphas—possesses the  same
virtues  as veratria.   Magendie gives the following form for internal
administration;—
                  Solutio  veratriae  sulphatis.
                    Solution of sulphate of veratria.
                 R.  Veratriae sulphat. gr. j.
                     Aquae destillat. f gij.  Misce.
   Dose.—f 5j- to f %iv.  in a mixture.   The  preparation has been
suggested as a substitute for the Eau me'dicinale d'Husson.
                 CLXXIII.  ZINCI CHLO'BIDUM.
Stnoxtmes. Zinci Chloruretum, Zincum Chloratum seu Muriaticum Oxydatum seu
  Salitum, Chloruretum Zincicum seu Zinci, Chloretum Zinci seu Zincicum, Butyrum
  Zinci, Murias Zinci seu Zincicus, Chloride, Chloruret, Hydrochlorate, Muriate, or
  Butter of Zinc.
German. Zinckchlorid, Salzsaures oder Chlorwasserstoffsaures  Zink,
  Salzsaures  Zinkoxyd,  Chlorzink,  Zinkchloriir, Zinkbutter.

                     METHOD OF PREPARING.
  Chloride of zinc results,—when to any given quantity of pure mu-
riatic acid, pure oxide of zinc is added, by the aid of gentle heat, until
no more is  dissolved:  the solution is then filtered, and evaporated in a
porcelain dish to dryness; whereby a jelly-like—and by high drying,
firm white,  and by careless drying, light brownish—substance, remains,
of an austere, sourish, metallic taste, which must be rubbed to powder,
and preserved in a closely-stopped vessel.   In the last editions of the
Pharmacopoeia of the United States (1842 and 1851,) it is directed to
be prepared  as follows:—Take of zinc, in small  pieces, giiss.;  nitric
acid,  prepared chalk, each  5h 5 muriatic  acid, a sufficient  quantity.
To  the zinc, in  a glass or  porcelain vessel,  add gradually sufficient
muriatic acid to  dissolve it;  then strain; add  the nitric acid,  and
evaporate to  dryness.  Dissolve the dry mass in water, add the chalk,
and, having allowed the  mixture to stand for twenty-four hours, filter,
and again evaporate to dryness.
  Chloride of zinc is very  deliquescent in  the air,  forming butter of
zinc (butyrum zinci,  German, Zinkbutter.)  It is very soluble in
water, alcohol, and ether.

                    EFFECTS ON  THE ECONOMY.
  Chloride of zinc has been exhibited both internally and externally,
but chiefly in the latter mode, especially in this country.  Papenguth2
  1 Ibid, pour 1843, p. 43.  Paris, 1843.      2 Nouveau Journal de M.decine, 1819.
       44 
690
ZINCI CHLORIDUM.
 found a  very dilute solution, applied in the form of lotion, useful in
 flabby scrofulous ulcerations;  and in sinuous  ulcers, in  the form of
 injection.  It has been especially recommended as a caustic that does
 not exert any disagreeable influence, like corrosive sublimate, arsenic,
 or potassa fusa;—neither causing violent  pain in the affected  parts,
 nor any kind of irritative fever;  nor disordering the digestive organs,
 as some of the articles just mentioned.   Hancke, indeed,  advises, that
 arsenic  should be  entirely banished from  therapeutics  as a caustic
 agent, and that  chloride of  zinc should be substituted for  it.  He em-
 ployed it with success in old atonic ulcerations of the feet, in  the strength
 of two grains to the fluidounce of distilled  water: with this he wetted
 lint, and applied it two or three times a day.   With like success,  he
 used it  in  old syphilitic ulcers, with extremely morbid surfaces and
 secretions:  the  chloride  destroyed  the  degenerate formations, and
 effected cicatrization.   In scrofulous  and malignant herpetic ulcers,  he
 prescribed a concentrated solution; in pityriasis he used it as a  wash,
 and in wounds and  ulcerations ivith fungous formations, he applied it
 in a concentrated state:  in phagedenic ulcers of the face,  it effected a
 more certain  cure  than the method of  Cosme,—the chloride  being
 strewed, a line thick, in a dry state, over the whole surface  of the  ulcer,
 the edges surrounded  with adhesive plaster, and a plaster placed over
 the chloride of zinc, with compresses and an appropriate bandage.   In
 nsevi materni, angiectasis, &c, he applied  it in the  same manner,  as
 Avell as  in  the pustule maligne,  (Milzbrandkarbunkel.)   Mr.
 Carmichael1 states,  however, that  he has used it in several  instances,
 and has come to  the conclusion, that,  although not so objectionable  as
 the arsenious acid, on account of the poisonous nature of the latter, it
 excites  as much  pain and  inflammation,2 without destroying, to the
 same extent, the carcinomatous substance.
   M. Bonnet,3 of Lyons, reports  the  cure of  subclavian aneurism by
 successive applications of  the paste of chloride   of zinc, which,  pene-
 trating by imbibition  into the deeper parts of  the  tumour, produced
 complete coagulation of the blood, the clot coming away with the eschar
 without any hemorrhage.  The application was successful,  also, in a
 case of aneurism by anastomosis.
   A case of phagedenic ulcer of the septum  narium, which  had resisted
 all the topical  applications made to it—corrosive chloride  of mercury,
 arsenious acid, red oxide of  mercury, sulphuric  acid, nitric  acid, &c,
 was treated by Dr. Zwerina  of Vienna, with a solution of chloride  of
 zinc,—a  grain and a half of the salt  to an ounce of distilled water,—
 Avith entire success.   The scabs being removed,  the sore was pencilled
 over several times a day with the solution.   At the end of  a  fortnight,
 a healthy granulating surface was found beneath the thick crust, which
now covered the sore,  and this being  removed from  time to  time, and
 the solution reapplied, at the end of five weeks  the cicatrix was per-
fect and  the patient well.4

  1 Dublin Medical Press, March 4 1840.
  2 Vogt, Pharmakodynamik, i. 363, 2te Auflage; cited by  Pereira, Elements of Mat.
 Med. i. 682, 2d edit.   Lond. 1842, or 3d Amer. edit. i. 685.   Philad. 1852.
  3 Medical Times and Gazette, July 23, 1853.
  i Cited in Lond. and Edinb. Monthly Journal of Medical Science, July, 1843, p. 650. 
ZINCI CHLORIDUM.
691
   The chloride has also  been prescribed internally in  cases of cance-
 rous ulcerations, and with apparent  benefit.   Mr.  Tusonx gives cases
 in which its internal and external use combined was productive of great
 advantage.  He gave half a grain of the chloride every morning after
 breakfast in a wine-glassful of carraway water.
   By Mr. Guthrie, chloride of zinc has been used in necrosis to pene-
 trate the hardened case of new bone.   It  attacks the animal tissue of
 the  bone, destroys it, and thus causes the  earthy matter to soften and
 become detached.   The sequestrum is by this means exposed with little
 pain or  disturbance of* the part, and  may be  dealt with according to
 circumstances.2  Mr. Callaway,3 of Guy's Hospital, London, employed it
 with considerable success in  the cure of cutaneous and subcutaneous
 nsevi materni.   It was directed to be rubbed on the part until the skin
 became  slightly discoloured,  and  to  be repeated  at intervals.   Mr.
 Alexander Ure and Mr. Liston,4 found it  extremely useful in  the  va-
 rieties of erosive ulcers called lupus, Avhich were often speedily checked,
 and the  disease permanently cured by the  local use of it.   They  ap-
 plied it in a paste, made with one part of the chloride and two or three
 parts of the  anhydrous sulphate of lime—a modification of Canquoin's
 formula  (see below,) recommended  some years ago.5  One or two  ap-
 plications  of the paste  were generally sufficient to produce a proper
 eschar, and AA'hen this was  detached,  the sore was  treated with water
 dressing.8   A  case is related by Dr. Davidson,7 of malignant ulcer
 under the left  ear, which was cured by the unmixed chloride of zinc,
 applied repeatedly until the ulcer assumed a healthy character.  Hancke
 used it likewise for  the formation of issues, which it  established  in
 from six to eight hours; and, lastly, to excite  rubefaction  on the sur-
 face, either applied in the form of solution of the chloride  in water or
 wine, or mixed with oil or  lard into  an ointment, and  rubbed on  the
 skin: in  this way, a gritty kind of eruption of a scarlet hue is induced,
 which is said to have afforded relief in paralysis of the limbs.
   Chloride of  zinc is a favourite remedy of Professor Syme, of Edin-
 burgh, in rebellious pseudo-malignant ulcerations on the surface of  the
 body, and was, also, much employed by Professor  Liston.  Dr. Peddie,
 and Professor  Simpson have applied it, with advantage, instead of  po-
 tassa fusa, in ulcerations of the os and cervix uteri.  For this purpose
 the latter gentleman had it run into  moulds,  so as  to be formed into
 round sticks, like those of nitrate of silver or potassa fusa.8
   Wendt, Vogt, and Canquoin haA'e  highly extolled the chloride as a
 caustic, and it  has been  largely employed  by the physicians and sur-
 geons of this continent, especially  in  the  Philadelphia  Hospital, and

  1 London Lancet, Jan. 13, 1844, p. 502,  and Tuson on the Female Breast, p. 399.
 Lond. 1846.
  2 James, Retrospective Address before the Provincial Medical Association, in the Trans-
 actions of the Association.  Lond. 1840.    3 Brit. Annals of Medicine, May 19, 1837.
  4 London Lancet, Sept. 21, 1844, p. 775.  5 London Med. Gazette, Dec. 19, 1835.
  6 Lond. Med. Gaz., Dec. 3, 1836.  See a case of noli me tangere of the nostril, and one
 of phagedenic ulcer of the arm, cured, in London Lancet, cited in Boston Med. and Surg.
 Journ., Nov. 4, 1840, p. 215.
  7 Edinb. Med. and Surg. Journal, Jan., 1838.
  8 Edinb. Monthly Journal, July, 1851, p. 82, and Obstetric Memoirs and Contributions,
p. 100.  Edinb. 1855. 
692
ZINCI CHLORIDUM.
Pennsylvania Hospital, in similar cases to those  mentioned  aboAre.
Dr. Davidson1 is of opinion, that it is only superior  to  many other
caustics in cases  where the destruction  of a  considerable thickness of
texture is required, or where the removal of an excrescence by a caus-
tic is preferred by the patient to the knife: the nitrate  of silver seems,
he considers, to be superior in promoting a sound action, when the un-
healthy surface or stratum of the ulcer  is superficial.
   Hancke2 has used the chloride internally,  with  advantage, in cases
of epilepsy, as well  as  in St. Vitus s dance; and  has prescribed it,
united with hydrocyanic acid, in prosopalgia.   Hufeland, also, extols
a solution of it in all those neuroses in which the oxide  of zinc is indi-
cated, and especially in such patients as are not readily impressible.3
By Dr. Stanelli,4 when liquefied by exposure to the air,  it is considered
an excellent remedy in toothache.  By means of a camel's hair pencil,
a small quantity  is applied to the cavity of the tooth, and in the space
of a few minutes, the most acute sufferings are said to be appeased.
Before using it, it is indispensable  to surround the tooth carefully with
cotton wadding,  and when it has  been  applied,  to  fill  the cavity Avell
with the cotton.   The mouth is finally washed with a little warm Avater.
   M. Gaudriot5  considers, that when  properly diluted, it has great
effect in curing simple blennorrhcea of  the urethra, and vagina.   To
remove the disease readily in men, it is generally sufficient to use the
injection given below thrice a day for  two or three days.  The  first
injections are almost always followed by more or less SAvelling  of  the
glands, but this does not  prevent their  continuance. In women, four
or six of the suppositories mentioned below are  sufficient to produce a
cure.  The  first  generally occasions SAvelling, with  more or less heat
of the vulva;  but these symptoms soon  disappear.
   Several years  since, a patent was obtained by Sir William Burnett
for a process, discovered by him, for preserving timber, canvass, &c,
from dry rot, mildew, &c.   The  preserving substance is chloride of zinc
in solution.   It  was entirely effectual.   Since  then the solution  has
been employed as a disinfectant of dead bodies, and the testimonials
of Messrs. Bowman, Sharpey, and W. V. PettigreAv, have been publicly
given in its favour.6  Mr.  Pettigrew, in a letter to Sir  William, dated
March 24,1846, says, " I  have now used extensively your preparation
for the preservation of animal matter,  and find that it succeeds most
completely.   From  the 3d to the  28th  of February, I lectured upon
the superior extremity.  The arm, when received, was green in colour,
and highly offensive.  I injected the arteries with the  fluid, mixed in
the  proportion of one  pound of chloride of zinc to three gallons of
water, and  as the dissection proceeded, the surface of the limb  was
sponged about every alternate  day with  the solution.  It was perfectly
restored to its former fresh condition.   I have also placed various por-

   1 Op. cit. and American Journal of the Medical Sciences, May, 1839, p. 238.
  2 Rust's Magazine, xxii. 373;  and Journal de Pharmacie, xvi.  549.
   1 See M .rat and De Lens, art. Zinc (chlorure de.)
  * Cited in London Medical Gazette, Feb. 16, 1844, p.  672.
  5 Journ. des Connaissances Med. Sept. 1840;  and  Brit, and For. Med. Rev., April,
1841, p. 527.
   6 London Medical Gazette, cited in Medical Examiner, June, 1846, p. 374. 
ZINCI CHLORIDUM.
693
tions of the body in the solution, and they at present remain quite free
from putrefaction.   All our subjects are now injected with the fluid,
immediately they arrive; and I do not hesitate to say, that our dissect-
ing room is more free from unpleasant  odour than any room of the kind
in the metropolis, and the great advantage this fluid possesses over all
others we have as yet tried is,—that it has no effect upon the knives.
I cannot but consider it one of the  greatest boons conferred upon the
profession.  Dissection may be carried on in the hottest weather, with-
out the  slightest injury to the breath,  or offence from smell."
   The  value of chloride of  zinc as  an antiseptic has been fully esta-
blished  in the dissecting  rooms of  Philadelphia  and  elsewhere; but
there is no reason for believing that it is a disinfectant in the sense of
destroying contagious or  other morbific miasmata.  It is an excellent
antibromic, but as it does not give off any antiseptic vapour, its action
is restricted to the substances with which it is brought into immediate
contact.  Dr. Stratton,1 however, is disposed  to believe, that it  acted
as a true disinfectant by destroying miasmata in the Quebec Marine
and Emigrant Hospital, of which he  had charge in the autumn of 1847.
 He found, that one ounce of the strong fluid was  sufficient for every
ten persons.  This strong fluid, known under  the name of Sir William
 "Burnett's Bisinfecting  and Antiseptic Fluid," contains 25 grains of
 zinc in  every fluidram; and in using it one pint  is  mixed with five
 gallons  of water.2   He removes the disagreeable odour in hospital
 wards full of typhus and  dysentery  cases, by waving flannel cloths wet
 with a  dilute  fluid—one part to 40 of water—two  or three times a day,
 for a few minutes at a time, and by sprinkling some of it on the floor.
 " Next to perfect ventilation," he says, "I would place the useof Bur-
 nett's solution of the chloride of zinc.   On many occasions, as in badly
 constructed  buildings, in  cold weather, and  on board ship in  stormy
 weather, ventilation is impracticable, and recourse must be had to some
 other means of improving the quality of the air, and it appears to me,
 that the chloride of zinc  solution is  much superior to all the other arti-
 ficial methods of doing so, including Ledoyen's solution of the nitrate
 of lead."  (See Plumbi Nitras.)
   Dr.  Stratton saw  a case of lupus, in which the "Burnett fluid" was
 as effectual  as, and  more convenient  than, the solid  chloride of zinc.
 The fluid diluted—one to 130 parts  of water—was found very beneficial
 as an  application to chronic and scrofulous  ulcers by Dr. Allan, Mr.
 Erasmus Wilson, and others;  and in  mercurial sore throat by Mr.
 Flynn.  In the proportion  of one part to sixty  or  eighty of water—it
 is said  to be  an excellent lotion in  erysipelas, and  a valuable lotion or
 bath in psora, prurigo, pruritus, and other cutaneous diseases.   When
 introduced of the full strength on the point of a pen into the cavity of
 a tooth, it has proved serviceable in some cases  of  toothache.   Diluted
 with one hundred and forty parts of  water, it removes the fcetor from
 gangrenous frost-bites.  Dr. Stratton has no doubt, that it will be found
 a good remedy, when diluted with one hundred and forty parts of water
i Edinb. Med. and Surgical Journal, Oct., 1848, p. 287.
2 Pharmaceutical Journal vii., 60 and 107, Lond. 1847. 
 694                      ZINCI CHLORIDUM.

 as an injection in fetid otorrhoea; and as a  gargle in some throat dis-
 eases.   It has also been used as an injection in gonorrhoea.   The ac-
 tion of the diluted fluid on cancerous  and other sores, is like that of
 other antiseptics; it removes the foetor, and  induces a new action in
 the part of the system of nutrition implicated in the ulceration.

                     MODE OF ADMINISTRATION.

                       Guttae zinci chloridi.
                        Drops of chloride of zinc.
                              JEiher Zinci.
                  R.  Zinci chlorid. gr. j.
                      Sp. aether, muriat. seu sulphuric, f 3y.  Solve.
   Dose.—Five drops,  every four hours, in a little  sugared water; gra-
 dually increasing  the  dose to ten drops, in chorea, epilepsy, prosopal-
 gia, &c.                                    Hufeland and Hanke.1
                       Lotio zinci chloridi.
                       Lotion of chloride of zinc.
                  R. Zinci chlorid. gr. viij.
                      Ext. aloes aquos. 9ij.
                     Aquas destillat. f ^iv.  Solve.
   Applied to the dressings, in cases of  atonic scrofulous ulcers.
                                                              Vogt.
   Or, the aloes may be omitted.
                    Injectio zinci chloridi.
                      Injection of chloride of zinc.
                 R.  Zinci chlorid. liquid.2  gtt. xxiv.—xxxvi.
                      Aquae destillat. f 5jiv.
   Filter  through  paper.    A small quantity of this to be  injected
 about an inch  along the urethra, two or three times a day.
                                                         Gaudriot.
                Suppositorium zinci chloridi.
                     Suppository of chloride of  zinc.
                 R.  Zinci chlorid. liquid, gtt. v.
                     Morphias sulphat. gr. ss.
   Mix  with three drams of the following paste;
                 R.  Mucilag. tragacanth. p. vj.
                     Sacchar. pulv. p. iij.
                     Amyli pulv. p. ix.
   One of these must be introduced every  day, or every other  day.
                                                         Gaudriot.
   Chloride of  zinc may be applied as a caustic, by means  of  a moist-
ened hair pencil, either alone or mixed with an  equal portion  of oxide
of zinc, or  sulphate of lime, or according  to the following forms:—

  1 Lincke, Vollstandiges Recept-Taschenbuch. v. s. w. ii. 780.   Leipz. 1841.
  3 "Liquid chloride of zinc consists of a concentrated solution of pure zinc in  pure chlo-
rohydric  acid."—Lincke, loc. cit. 
         ZINCI CYANURETUM.

     Pasta  zinci  chloridi.
       Paste of chloride of zinc.
Pate de Canquoin.— CanquoiiCs caustic paste.
                   A.    B.   C.
  R.  Zinci chlorid.  p. i.    i.    i.
     Farina, tritici  p. iv.   iij.   ij.
     Aquae fontan.1 q. s. ut fiat pasta.

  R.  Zinci chlorid. p.j.
     Farinae tritici p. iss.
     Antimonii chloridi p. ss.
     Aq. font. q. «. ut fiat pasta.
695
                 CLXXIV. ZINCI CYANURETUM.
Syxoxymes. Zinci Cyanidum, Zincum Cyanogenatum seu Cyanatum seu Borussicum
  seu Zooticum seu Hydrocyanicum seu Hydrocyanicum sine Ferro, Cyanetum seu
  Cyanuretum  Zincicum seu Zinci sine Ferro, Cyanetum Zinci, Prussias seu Hydro-
  cyanas seu Cyanhydras Zinci seu Zincicus, Hydrocyanate, Prussiate, or Cyanuret
  of Zinc.
French. Cyanure de Zinc.
German. Cyanzink, Blausaures  Zink  oder Zinkoxyd, Blaustoffzink,
  Zinkcyaniir.

  This preparation was used in Germany for a long time  before the
process was made known.2

                      METHOD OF PREPARING.

  According to Kunze, it is directed in the Leipzic shops  to  be  pre-
pared  as follows:3—Any quantity of pure sulphate of zinc is dissolved
in ten  times as much distilled water; the fluid is then filtered,  and de-
composed by a solution  of cyanuret of potassium, or cyanuret of cal-
cium, added  by drops so long as a precipitate is formed.   This preci-
pitate, which consists of cyanuret  of zinc, must  be carefully  washed,
dried, and preserved  in  a glass jar, from which the entrance of light is
prevented.*
  It is admitted into the Parisian " Codex."
  Cyanuret of zinc has the appearance of a white, tasteless  powder,
which  is insoluble in water and  alcohol, but dissolves in  the  stronger
acids, with the disengagement of hydrocyanic acid.  Well prepared
and rubbed, it has a strong odour of hydrocyanic acid, and when moist-
ened, or exposed to heat, it gives off hydrocyanic acid.  ^
  As to its  medicinal  effects, and mode of administration, they are
analogous to those of the following  preparation: they are therefore
given together.

  1 To each ounce of the chloride of zinc twenty-four to thirty drops of water may be

* " Magendie, Formulaire pour la Preparation, &c. de plusieurs nouveaux M.dicamens, &c.
  8 Riecke, Die neuern Arzneimittel, u. s. w. S. 410.  Stuttgart, 1837.
  « For  _!.' Pelletier's method, see Magendie, Formulaire, &c. 
696
ZINCI FERROCYANURETUM.
             CLXXV.  ZINCI FERROCYANURETUM.
Syxoxymes.  Zinci FerroCyanidum seu Ferrohydrocyanas, Cyanetum seu Cyanuretum
  Zinci et Ferri seu Ferrosozincicum, Cyanuretum Ferrozincicum, Zincum Ferrohy-
  drocyanicum seu Ferroborussicum seu Ferrocyanogenatum seu Ferrocyanatum,
  Prussias Zinci et Ferri, Hydrocyanas Zinci Ferruginosus, Ferrohydrocyanas Zinci,
  Ferrocyanuret. Ferro-hydrocyanate or Ferrocyanate of Zinc.
German. Eisenblausaures  Zink, Blausaures Eisenzink, Eisenhaltiges
  Blausaures  Zink, Blausaures  Eisenoxydul-Zinkoxyd,  Zinkeisen-
  cyanur, Eisenzinkcyaniir,  Cyaneisenzink.

                      METHOD OF PREPARING.
  According to  Schindler,1 this preparation is best made by the mutual
decomposition of  boiling hot  solutions  of eighty-three parts of sul-
phate of zinc, and sixty parts of ferrocyanuret of potassium.  If the
sulphate of zinc be not entirely free from iron, the salt will have a
bluish lustre, which, after long washing with lime water, becomes of a
reddish hue.  If the bluish colour be manifested, some more sulphate
of zinc must be added, and  it must  be digested until  the  precipitate
appears entirely white.
  Ferrocyanuret  of zinc  forms  a white, insoluble, almost inodorous
powder, Avhich is  somewhat  soluble in the stronger acids, without ex-
haling a smell of hydrocyanic acid in the cold; but,  by boiling, hydro-
cyanic acid is slowly disengaged.

                    EFFECTS  ON THE ECONOMY.
 f Hufeland recommends the cyanuret,  or perhaps, the ferrocyanuret
of zinc in nervous  diseases.   According to him, from one to four grains
may be given for  a dose, two or three times a day, without  any inju-
rious effects;—the only inconvenience being, at  times, slight nausea,
but no diarrhoea, or disposition to  obstructions, and no narcotic symp-
toms.   In cardialgia,  it afforded, in his hands, essential service, as
well as in some cases of epilepsy and in paralysis.   Henning,2 likewise
found it useful in cramp  of  the stomach, hysteria, and spasmodic dis-
eases of children induced by worms.  In  epileptic attacks from teething,
he also gave it with advantage;  the dose being from half a grain to a
grain, three or  four times a day.  Clarus gave cyanuret  of zinc in
epilepsy, but  he observed no  other result than less frequent  and less
severe attacks.   Pohl saw no very decided effect from it in the dose of
from one-fourth to half a grain.   In the Berlin Polyclinic Institute,
advantage accrued from  it in two cases of St. Vitus's dance;  i. was
begun with in the dose of one-third of a grain twice a day, which was
gradually raised to fourteen  grains a day.  Klokow gave the cyanuret
of zinc—which Riecke suggests3 was the  cyanuret of zinc and potassium,
(Cyanzinkcyankalium,) in spasmodic affections,—beginning at
first with one-tenth of a grain,—as larger doses occasioned colic, diar-
rhoea, and vomiting—and, when the patient became accustomed to it,
gradually augmenting  the dose  to half a grain.  Success, he affirms,

  1 Riecke, op. cit. S. 411, und 2te Auflage, S. 646.  Stuttgart, 1840.
  2 Hufeland's Journal, 1823.                             a Op. cit. S. 413. 
ZINCI FERROCYANURETUM.
697
followed its administration.1   Muhrbeck gave it in violent periodical
cephalalgia in the region of the left frontal sinus with  great benefit.
He began with one-twelfth of a  grain, and gradually raised the dose
to a grain  and a half.   Muller and Gunther confirm the reports of its
efficacy in  St. Vitus s dance: the first gave daily a grain;  the latter,
from half  a grain to a  grain, four times a day.  Kopp, who distin-
guishes the two  preparations from each other, instituted experiments
Avith both.   He used the ferrocyanuret of zinc with advantage in cramp
of the stomach, general  nervous  disorder,  nervous debility, neuralgia,
nervous headache, and nocturnal pains in the bones.  He gave it in
the form of powder, with sugar of milk,  every two hours, or four times
a day, in  doses of one-twelfth to one-eighth of a  grain, gradually in-
creasing them.  According to his observations, it occasions, with many
 persons, obstructions, but does not disorder the stomach.   Kopp found
 the cyanuret still more efficacious in the same disorders.  Impressible
 patients, who suffered under unusual sensibility of the abdomen, took
 four powders  daily, of one-sixteenth of  a grain each, with  marked
 benefit.  In one case of neuralgia, in a man, he raised the dose very
 gradually  to half a grain,  four times  a  day.   When,  however, this
 quantity was exceeded, and  the patient  took five-eighths  of  a  grain
 four times a day, hyperemia occurred in  the  head, with constipation.
 In two cases of chorea of one side of the body, the ferrocyanuret had
 no  effect whatever.  Riecke2 asserts that his father used it several
 times with advantage in scirrhus of the pylorus.
    The cyanuret was applied externally, by Von Ammon, in scrofulous
 and incipient rheumatic inflammation of the eyes, as well as  in catarrhal
  inflammation of  the eyelids: he prescribed it  suspended by means  of
  gum Arabic in a mixture of cherry-laurel water  and laudanum.   M.
  Carrier3 believes, that  preparations  of hydrocyanic acid have great
  efficacy in healing  ulcers of the cornea, and causing  the absorption of
  opacities.   The compound which he prefers is one part of cyanuret of
  zinc to tw.enty-five of lard.
                      MODE  OF  ADMINISTRATION.
    On account of the insolubility of both the cyanuret and ferrocya-
  nuret, they are best given in pill or powder.
    The common  dose of the cyanuret is  from one-sixteenth to  one
  twelfth of a  grain several times a  day, gradually increasing it to a
  quarter of a grain: of  the ferrocyanuret, the  dose is from one to tour
  grains, two or three  times  a day.  Riecke4 advises—to prevent con-
  fusion—that when these articles are ordered, they should be respec-
  tively denominated Zincum hydrocyanicum  sine ferro  and Zmcum
  ferro-hydrocyanicum.
                     Pilulae zinci cyanureti.
                        Pills of cyanuret of zinc.
                   R. Zinci  cyanur. gr. xv.
                       Ext. glvcyrrh. ^ij.
                 Misce et fiant pilulae lx.
    » Hufeland und Osann's Journal B.lxx St. 2             2 Op.cit at. S.414.
    » Cited in Provincial Med. and Surg. Journal, Feb. 10, 1844, p. rf/8.
    ' Op. citat. 
698                        ZINCI IODIDUM.

  Dose.—One,  morning, noon, and night, gradually increasing the
quantity.                                                  Kopp.
                 R.  Zinci cyanuret. gr. vj.
                     Magnesia, gr. iv.
                     Cinnam. pulv. gr. iij. Misce.
  This dose to be repeated every four hours, in  nervous affections of
the stomach, especially in cases of cramp.           .      Henning.

                Mistura zinci  ferrocyanureti.
                   Mixture of ferrocyanuret of zinc.
                 R.  Zinci ferrocyanur. gr. iv.
                     Aquae destillat. f ^ij.  M.
  Dose.—A fourth part, four times  a day, in chorea.      Lincke.1

              Pulveres zinci ferrocyanureti.
                   Powders of ferrocyanuret of zinc.
                 R.  Zinci ferrocyanur. gr. ij.—viij.
                     Sacchar. gj.  M. et divide in part. vj.
  Dose.—One to be given every two hours in cardialgia.
                                               Von  Hildenbrand.
                Pilulas zinci ferrocyanureti.
                    Pills of ferrocyanuret of zinc.
                 R.  Zinci ferrocyanuret. gr. xv.
                     Valerian, pulv. gss.
                     Extract, valerian, q. s. ut fiant pil. Ix.
  Dose.—One, morning and evening, in chorea.
                                      Rosensteil and  Heckenroth?
                    CLXXVI. ZINCI IO'DIDUM.
Synonymes. Zincum Iodatum, Zinci loduretum, Iodetum Zinci seu Zincicum, Proto-
  ioduretum Zinci, Iodide or Ioduret of Zinc.
German. Iodzink, Zinkiodur.
  This preparation is made by boiling together iodine and zinc in ato-
mic proportions, or rather with an  excess of zinc, in a flask of  water,
to dryness, and subliming the residue.  Iodide of zinc is thus procured
in beautiful, colourless, prismatic  crystals.3   It  is very deliquescent,
and cannot easily be retained in  the solid form.  When heated in open
vessels, it is resolved into iodine and  oxide of zinc.  It is very liable
to undergo spontaneous decomposition,  and, to  prevent this, Dr. A.
T. Thomson proposed that a  syrup should  be made of it, on the same
plan as the syrup of iodide of iron.

                     EFFECTS ON THE  ECONOMY.
  Iodide of zinc has a caustic taste,  and when applied to a denuded
surface gives rise to considerable smarting.   Dr. Ure4 recommends an
ointment, formed  of a  dram to  an ounce  of lard, in cases where the

  1 Vollstandiges Recept-Taschenbuch, ii. 778, Leipz. 1841.         2 Lincke, op. cit.
  ' Annales de Chimie, xci.           * Dictionary of Chemistry, 2d edition, p. 516. 
ZINCI VALERIANAS.
699
external use of iodide of  potassium is indicated.   Proutet advises  it
as a collyrium in  scrofulous ophthalmia, of the strength of fifteen
grains  to six fluidounces of distilled water; and it has been employed
to form an astringent injection, in the proportion of one or two grains
to an ounce of water, in gonorrhoea.  Dr. J. J. Ross1 used a solution
of from 10 to 30 grains to the fluidounce of water, with much advan-
tage, in enlarged tonsils.   It was  applied  by means of a sponge tied
to a  quill.  After the use of the solution for  some time, he applied the
iodide, rendered liquid by deliquescence, by means of a camel's hair
brush.
  Numerous trials  have been made with it  internally in Guy's  Hos-
pital, by Dr. Barlow.2  It  was given in the form of syrup.   It is consi-
dered by him to be especially indicated in cases in which the zinc alone
might be too stimulating,  and in those in which it is desirable to  have
the effects of both  constituents.   It  had been chiefly used  in chorea,
strumous cachexia,  and in some forms of hysteria.   In a case of severe
strumous  superficial lupus, it had been continued for many months,
in full  doses and with great apparent benefit.

  A double iodide of zinc and morphia; French, Iodure double de
zinc  et de morphine, is described by M. Bouchardat.3   It is obtained
by boiling a gramme (gr.  15.44,) of iodide of iodhydrate  of  morphia,
with 59 grammes (nearly  f Sij.) of water, and 10 grammes (Siiss.) of
zinc, after they have acted upon each other for some days.  The  boil-
ing liquor is filtered; and  a salt is obtained, which crystallizes readily
in needles arranged in beautiful radiated  groups.   The salt is the io-
dide  of zinc and morphia, which is  very soluble in water and in alcohol.
The  compound is considered to combine the properties of morphia and
the salts of zinc.  M. Bouchardat  has prescribed it as an anodyne and
anti-spasmodic.   He makes about a grain and a half into eight pills, of
which he gives one or two in the day in gastralgia " and other nervous
affections."
  For  the Double  Iodide of Zinc and Strychnia, see  Strychnia.

  Tannate of Zinc has been used with great good effects by M. Al-
quie,4 in the proportion of one part to  one hundred  of water, as an
injection, night and morning, in gonorrhoea, after the acute symptoms
had subsided.
                 CLXXVII.  ZINCI VALERIA'NAS.
Synonymes. Zincum Valerianicum, Valerianate of Zinc.
French. Valerianate de Zinc.
German. Valeriansaures Zinkoxyd,  Baldriansaures Zink.
  This salt was first proposed  by Prince  Louis Lucien  Bonaparte.
It has been  much used by the Italian physicians, and has been more
recently introduced into medical practice in France and elsewhere.
  1 Cited in United States Dispensatory, 6th edition, p. 1349.  Philad. 1854.
  2 Med. Times and Gazette, Nov. 12, 1853.
  8 Nouveau Formulaire Magistral,  p. 70.   Paris, 1845.
  1 Bull, de The"rap."xliv. 277, and Brit, and For. Med. Chir., July, 1853, p. 281. 
700
ZINCI VALERIANAS.
                       METHOD  OF PREPARING.
  Valerianate of zinc is prepared by saturating valerianic acid  with
the carbonate, or, still better, Avith  perfectly pure oxide, of zinc re-
cently precipitated.  The action is assisted by heat; and the hot  solu-
tion is filtered, and allowed to crystallize in a gently heated sandbath.1
It may also be prepared by double decomposition from valerianate of
baryta and sulphate of zinc2—or, after  the formula of  the Dublin
college, by the double decomposition of valerianate of soda  and sul-
phate  of  zinc?
   The crystals form  light pearly plates of a  brilliant white colour.
Cold water dissolves one-fiftieth of its weight of the salt, and boiling
water one-fortieth.  It is scarcely soluble in ether.   One hundred parts
of boiling alcohol dissolve six parts.4   On these points, hoAvever, che-
mists are not in  exact accordance.

                     EFFECTS ON THE  ECONOMY.
   The "physiological effects" of the valerianate of zinc, according to
M. Devay,5 are scarcely more marked than those of valerian or of zinc
taken separately.   A dose of 15 centigrammes (gr. 2.316) which would
be sufficient to check a paroxysm of neuralgia, and to moderate an at-
tack of violent hemicrania, produces on the healthy economy only slight
headache, transient giddiness, and  slight depravation of hearing.  It
has been  chiefly prescribed in facial neuralgia and hemicrania, which
have  resisted the ordinary antispasmodics  and  antiperiodics, and M.
Devay, in such cases, has found it  eminently successful.  Four  cases
of obstinate neuralgia are recorded  by Mr. Joseph Bell,6 which yielded
to this remedy after the failure of other powerful agents.   He gave it
in half-grain doses  every six hours.  It has  also  been prescribed in
other neuroses,—nervous headache, for example,—by Boccacini and Hei-
berg.7 In epilepsy, M. Devay prescribed it, but had not given  it for
a sufficiently long period to be able to deduce any thing positive in re-
gard to its action.  M. Cerulli8 gave it in three cases of supra-orbitar
and infra-orbitar neuralgia.   It proved successful in doses of a  grain
and a half daily, taken at the moment of the accession of the paroxysm.
Its effect does not seem, however, to have been  energetic;  for, in one
case,  the cure was not complete under thirty days; in  another under
forty, and in a third under fifty.   Dr. C. W. Parsons9 says it is found
most beneficial in facial neuralgia, not presenting a regular periodical

   1 See a note on the preparation of the valerianate of zinc, by AVm. Procter, Jr., in the
American Journal of Pharmacy, April, 1845; and Bouchardat, Annuaire de Therap. &c.
pour 1845, p. 95.  Paris, 1845.
   2 Bouchardat, op. cit. p. 87.  Paris, 1845; and Nouveau  Formulaire Magistral, p.
 107.  Paris, 1845.
   3 The Pharmacopoeia of the King and Queen's College of Physicians in Ireland, 1850,
p. 169.  Dublin, 1850.
   i Journal de Pharmacie, Aout, 1844; Chemical Gazette, Nov. 1, 1844; and Lond. and
Edinb. Monthly Journ. of Med. Science, Jan., 1845.
   5 Gazette Medicale de Paris, 29 Juin, 1844.
   6 Ranking's Half-Yearly Abstract, January to June, 1846, p. 173.
   T Aschenbrenner, Die neueren Arzneimittel, u. s. w. S. 281, Erlangen, 1848.
   8 Gazette Medicale de Paris, Jan., 1844.
   9 Amer.  Journal of the Med. Sciences, Oct., 1854, p. 440. 
ZINCI VALERIANAS.
701
type,  and not connected with rheumatism or syphilis.   In three cases,
its good effectswere obvious, after many other powerful remedies had
failed.  He is in the habit of administering three quarters of a grain
in pill two or three times a day.
  It has been suggested,  however,  that  notwithstanding its reputed
brilliant success, it may be questioned, whether it be in reality a more
efficacious remedy than the ordinary salts  of zinc, and whether much
of its success amongst a certain class be  not in a great degree attri-
butable to the rarity,  and the high price of the drug.1  That  such  is
the case, Dr.  Johnson says, is to a certain extent proved by the obser-
vations of Dr. Fario,  an  Italian physician, cited and commented on in
a French periodical.2   Dr. Fario has employed it externally in certain
affections of the eye,  as  blennorrhcea of  the eyelids, ulcers, or recent
spots on the cornea, as well as in cases  of chronic conjunctivitis, in
which a mild astringent and  sedative agent  is indicated.3

                     MODE OF ADMINISTRATION.
   The dose of valerianate of  zinc prescribed by M. Devay was 10 centi-
grammes (gr. 1.54) in the day; but  there  is no reason, he says, why it
should not be carried  much higher—to 40 centigrammes (gr. 6.17) for
example.   The  Italian physicians, who would seem to have obtained
the most success from its administration,  do not, however, give it in a
larger dose than a grain  and a half.    It is best administered in the pi-
lular form.   For external use, as a collyrium, from two to four grains
may be dissolved in two  ounces of distilled water.
           Pilulse zinci valerianatis compositae.
                 Compound pills of valerianate of zinc.
                 R.   Zinci valerianat.
                      Extract, cinchon.
                      ------gentian, aa gr. xv,
                      -------belladonnas gr. iss.
              M. Fiant pilulaj x.
   Dose.—One, night  and morning,  in continued neuralgia.
                                                       E. Seguin.4
                 R.   Zinci valerianat.
                      Quinia. valerianat. aa. gr. viij.
                      Extract, gentian.
                      ------cinchon.  aa gr. xv.
                      -----— belladonnse gr. iss.
              M. Fiant pilula.  x.
Dose.—One, night and morning  in  continued  neuralgia, with  parox-
ysmal exacerbations.                                   E-  Seguin.
                 R.   Zinci valerianat.  gr. v.
                      Ext. hyoscyam. gr. iiss.
                      ----opii. gr. \\.
                      Confect. ros. q. s.
                 M.   Fiant pilula. vi.                      .
   Doset—Two  or three a day, in neuralgia of the 5th pair.
                                                         Tournie}
  1 Dr. Geo. Johnson, in Ranking, op. cit. p. 348.
  2 Gazette M.dicale de Paris, Jan., 1844.           3 Aechenbrenner, op. cit. b. -bZ.
  4 Bouchardat, Annuaire  de Th.rap. pour 1851, p. 43.
  5 Bouchardat, Ibid, pour 1852, p. 87. 
SUPPLEMENT.
   CLXXVIII. Ac"idum  Carbazot'icum,  Carbazotic, Carbonitric or Pic-
 ric Acid, Welter's Bitter: French, Acide Carbazotique;  German, Carbazot-
 sdure, Kohlenstickstoffsdure,  Pikrinsdure.   This acid is  frequently
 formed by the action of concentrated nitric acid on animal and vegetable sub-
 stances; for  example, by treating salicin with nitric acid, a  crystallization of
 the pure acid occurs.   By the decomposition of silk by nitric acid, it is pro-
 duced in even greater quantity.  It is commonly, however, obtained by boiling
 nitric acid on indigo.1  The process recommended by Liebig is to boil ten parts
 of  diluted nitric acid  on one of indigo ; adding  to  the liquid, when cold, a
 quantity of potassa.   The potassa combines with the carbazotic acid, and forms
 carbazotate of potassa; which, in its turn,  is decomposed by the addition of
 another acid, by  which the  carbazotie is set at liberty, and deposited in yellow
 shining plates or prisms.
   It  is devoid of smell; of a bitter  taste;  is slightly  soluble in  cold, but
 greatly so in hot water, and is readily dissolved by alcohol and by  ether.  It
 unites with salifiable bases.
   Carbazotic acid and the  carbazotates, according to Dr. T.  Moffatt,3 may be
 ranked, therapeutically, with tonics and astringents.  In a case of  continued
fever, complicated with subacute peritonitis and tympanitis, which had pro-
 ceeded to the stage in which tonics and stimulants  are indicated, he  prescribed
 grain doses three times a day.   The woman recovered  just  as if quinia had
 been  administered.   In a case of anosmia, which was recovering under the use
 of quinia and iron, he  suspended these, and  gave  carbazotate of ammonia in
 grain doses three  times a day.   She lost ground on this treatment, and again im-
 proved on returning to the quinia and chalybeate. A case of scarlatina maligna,
 in which the acid and  wine  were  administered, terminated fatally.  One of
 chronic eczema got well under its use.  Dr. Moffatt prescribed the carbazotate
 of iron in combination with  extract of conium, in grain doses three times a
 day, in two cases of cephalalgia, one of them of long standing. Both cases
 soon improved; one got quite well, and the other,  of long standing, was very
 much better.   In both  cases quinia and iron in combination with the same ex-
 tract; and in the case of  long standing, sulphate of zinc and strychnia had
 been  taken without relief.
  Dr. Moffatt records the notes of two cases in which the carbazotate of ammo-
 nia was eminently successful.  One of them was of diarrhoea after continued
 fever; grain doses of the carbazotate and of gallic acid, with one-sixth of a grain
 of opium, were given three  times a day, with the best effects.   The other was
 one of diarrhoea, of eighteen months' standing.  A similar treatment proved
 entirely successful.   In both cases, the ordinary astringent remedies bad been
 given in vain.

  1 Lehmann, Lehrbuch der Physiologischen Chemie, ler Band. S. 193.  Leipzig,  1850,
 or Amer. edit,  of Dr. Day's Translation, by Dr. R, E. Rogers, i. 172.   Philad. 1855.
  2 Association Medical Journal, Aug. 10, 1855, and Amer. Journ. of the Med.  Sciences,
 Oct. 1855, p. 490. 
SUPPLEMENT.—ACIDUM NITRICUM.
703
  A singular effect appears, however, to have resulted in  one half the cases in
which Dr. Moffatt prescribed  carbazotic acid and the carbazotates.   The  skin
and conjunctiva became yellow.  The patients were, indeed, completely jaun-
diced; and Dr.  Moffatt believes the yellowness was owing to the colouring  mat-
ter of the remedies having tinged the serum of the blood.   The tinge  of the
skin and conjunctiva so perfectly  resembled  jaundice, "that the keenest ob-
server would be deceived; and I believe"—says Dr. Moffatt—" that if the fact
were generally  known, there would be jaundiced  impostors and malingerers
without end."   It is important to bear in mind these curious  phenomena, in
the trials that may be made with this remedy.

  CLXXIX.   Ac"idum Chro'mictjm, Chromic  acid, Peroxide of Chromi-
um : French, Acide chromique;  German,  Chromsdure.  Chromic acid,
nearly pure, may be obtained by  the following process.   One hundred mea-
sures of a cold saturated  solution  of bichromate of potassa are mixed with one
hundred and fifty measures of oil of vitriol, and the whole  is suffered to  cool.
The chromic acid crystallizes in brilliant crimson-red prisms.  The mother liquor
is poured off, and the crystals are placed to drain upon a tile  closely covered
by a glass or bell jar.1  They are of a ruby-red colour, prismatic and deliques-
cent, of  a sour, acrid, and metallic taste, and soluble in  water,—the solution
being constantly reduced by contact with organic matter.
  It is in consequence of chromic acid being a powerful oxygenizing  agent,
—yielding half its oxygen readily to organic substances, and being reduced to
sesquioxide,—that  Dr. TJre,3 M.  Heller,3 and others, have employed it as  an
escharotic.  It  is, Dr. Ure says, exceedingly convenient of application, as it con-
sists'of a thick crystalline pap, which, when rightly managed,  does not spread
beyond the  prescribed limits; and its erodent  operation terminates with  its
passing into the state of inert pulverulent sesquioxide.  In a case of external
hemorrhoids, the acid was applied twice at an interval of two days.  It  caused
acute burning pain both times, destruction to a considerable amount of the dis-
eased texture, consolidation of the remainder, and permanent relief.   The trou-
blesome sores produced on the hands and arms of dyers, who use bichromate of
potassa, are ascribed by Dr. Ducatel,4 of Baltimore, to the action of the free
chromic  acid.

  CLXXX.  Ac"lDUM  Ni'tricum, Nitric Acid; French, Acide  Nitrique;
German,  Sal pet ers a ur c.   Nitric  acid  of the  specific gravity,  1.500,
destroys  instantaneously the vitality of the surface to which it is applied.  The
depth of the slough  which is  to follow may be regulated, in some  degree,  by
the quantity of acid laid on the part; and its extent, laterally, may be confined
with sufficient precision to the limits of its first application, by instantly  smear-
ing the whole over with  olive oil,  which neutralizes its further corrosive  pow-
ers by combining  and forming with it a new, but no longer  corrosive,  com-
pound.   The separation  of  the slough,  after the  application  of nitric  acid,
leaves a healthy, suppurating surface,  which contracts and heals  over  very
quickly.
  Such is the testimony of the late Dr. Houston, of Dublin,5 in regard to the
action of nitric acid  as an escharotic.  He has proposed  it as  such  in certain
forms of hemorrhoidal affections, and especially in that which  he terms  " vas-

  1 Warrington, Proceedings of Chera. Soc. i. 18, cited in Fownes, Elementary Chemistry,
Amer. edit°p. 245.   Philad. 1845.
  * London Medical Gazette, March 21, 1845, p.787.
  8 Bouchardat,  Annuaire de Therap. pour 1853, p. 283.
  * Manual of Practical Toxicology.   Baltimore, 1833.
  5 Dublin Journal of Medical Science, March, 1843. 
704
SUPPLEMENT.—ACIDUM NITRICUM.
cular tumour," and which he regards as an affection of the mucous and sub-
mucous tissue exclusively, having usually  for its  basis a knuckle or bunch of
varicose veins; but it may also be a distinct and independent  growth,  the  re-
sult  of some  other irritation in the region, but giving rise ultimately to the
formation of a varicose condition of the part.  In such cases, he has found the
application of nitric acid,  s. g.  1.500, of  eminent service.   It combines,  he
affirms, all the advantages possessed by excision or  ligature,  without any of
the disadvantages.  He directs  the application to be  made  in the following
manner :—Let the patient strain as in the  night chair, so  as to bring  the  tu-
mours fully into view : and while they  are so down let him  either lean over the
back of a chair, or lie down in a bent posture, on the side on which the disease
exists, with the nates over the edge of the bed.  Let a piece of wood, cut into
the shape of a dressing-case spatula, be dipped  in the acid;  and  then, with
as much of the acid adhering to it as it will carry without dripping, let it be
rubbed on  the tumour to the desired extent.   The dueeffect of the acid on the
part is shown by its becoming of a grayish white  colour.   If a superficial
slough be all that is required, a single  application  may be enough; if  a  more
deep one, then two or three applications may be required;  and if a still  more
deep one, two or three applications of  the  wood  dipped in  the acid may  be
made in quick succession, which, being finished, the part may be well smeared
over with olive oil.  The  prolapsed parts should then be pushed back within
the sphincter, the patient  put to bed,  and  an opiate administered.   The pain
is sharp and burning at first, but it goes off in two or three hours, and does
not return again in the same  form.  In no case has he heard of serious conse-
quences from the use of the remedy; and the symptoms usually following its ap-
plication are so mild as not absolutely to require confinement to bed more than
a few hours.  On the third or fourth day, Dr. Houston recommends that a  ca-
thartic draught should be given;  when the  bowels  will be found to yield to the
medicine, generally without either pain or prolapsus of the  rectum.   In a sub-
sequent communication,1 he urges, that the only  case  which the  nitric acid
will serve is the internal bleeding pile;—"that  soft,  red,  strawberrydike ele-
vation of the mucous membrane," for  which he uses the  term " vascular  tu-
mour."
   The safety and efficacy of this mode of practice  have been confirmed by the
testimony of Mr. Cusack,  of Dublin.
   Cases have been recorded, in which the acid was successfully applied by Mr.
Henry Lee* and Mr. Henry Smith,3 in hemorrhoids, connected with a relaxed
state of the mucous membrane; and Dr. Cooke* found it exceedingly useful in
external piles.  A dossil of lint was dipped in the acid and pressed upon  the
tumour.   For fifteen  or twenty minutes the pain was unusually severe.   Six
cases are given, in most of which the condition of the parts after the application
could not be ascertained, as the patients got rapidly well. In one case, abscess,
close to the sphincter, supervened, but it ultimately healed.  A large prolapsus
of the rectumwas successfully treated by nitric acid, by Dr. Christopher Fleming.8
   The internal use of nitric acid has been  highly extolled in hooping cough
and asthma, by  Dr. Arnoldi.6  In  the former disease he  administered it, di-
luted with water, as strong as lemon juice, and  sweetened.   He has given to
a child two years  of age, as  much as a dram and a  half  of  concentrated ni-

   1 Ibid. Sept. 1844, p. 32.      2 Pathological  and Surgical Observations, Lond. 1854.
   5 Med. Times and Gazette, Aug., 19, 1854.
   * Med. Times and Gazette, April, 1853.
   8 Dublin Med. Pres., April 25, 1855, and Amer. Journ. of the Med. Sciences, July,
1855, p. 233.
   « Canada Med. Journ., June, 1852, and Amer. Journ. of the Med. Sciences, July, 1852, 
SUPPLEMENT.—APIOLUM.
705
trie acid in this form per diem, and has never known the disease resist its use
beyond  three weeks.  He adds, that he could cite a hundred instances of suc-
cessful results.
  Dr. Gibb1 adopts the treatment of Dr. Arnoldi; and extravagantly remarks,
that in its effects upon the disease, and in whatever way administered, nitric
acid "not only arrests the paroxysms, and removes the hoop, but shortens the
disease almost as effectually as quinia does intermittent fever."
  Dr. Hopkins3 employed the acid successfully  in five cases of asthma;  and
Dr. Arnoldi3 affirms, that its use has proved, not  only in his own practice, but
in that of others who have adopted it,—" truly marvellous!"
  These overstrained eulogies throw doubts on the efficacy of the nitric acid in
diseases for which such a host of remedies have been almost  as highly extolled,
only to  lead, too often, to disappointment.

  CLXXXI.   Adanso'nia Digita'ta, Baobab  Tree.   The bark of this tree
is a native of Senegal; of the Natural Order, Bombacece: Sexual Sys-
tem, Monadelphia  Polyandria.   It has  been brought forward  as a valuable
antiperiodic by Duchassaing, who thinks it a fit substitute for cinchona.  It is
mucilaginous, and has  scarcely any taste or smell.  It is recommended by M.
Duchassaing in decoction; half an ounce of the bark being boiled in a pint of
water until the liquid is reduced to two-thirds.  From the quantity of mucilage
it contains, it is apt to undergo decomposition.  This may  be  prevented by
adding a small quantity of sulphuric acid,  which precipitates the mucilage, or
by  the addition of spirit.   In a great many cases in which it was  prescribed
by  him, it rendered eminent service."   Its employment was suggested by the
negroes, who make  constant use of it in the marsh fevers of the  country.  M.
SaiDt-Pierre5 has prescribed it in the last two years, in a locality in Burgundy,
where intermittents  are endemic.  He was only  able, however, to give it in
seven cases, owing  to his not  being possessed of a sufficient quantity of the
remedy; but they all terminated favourably.  According to him, "the taste of
the decoction is in no respect disagreeable, and its action is unaccompaniedby
any of the inconveniences that may follow the action of the sulphate  of quinia."

   CLXXXII. Apio'lum, Apiol.   This preparation has attracted much  at-
tention  in France as a substitute for the sulphate of quinia.  At a concours,
opened  by the Societe de Pharmacie  of  Paris, a memoir  on  this substance
was regarded as the  most important of any that were presented.8  It is an im-
mediate principle obtained from apium petroselinum, common parsley, by treat-
ing the  seed with alcohol at 70 to 80° Cent., (158 to 176° Fahr.)  The pow-
der is put into a displacement apparatus, and when it is sufficiently  exhausted,
the united liquors are deprived of colour by filtration through washed animal
charcoal.  They are then distilled in  a water  bath, so  as to draw  over about
three quarters of the alcohol.  The residue is treated with ether or chloroform,
which are separated  by a second distillation.  It  is then placed  in  a  stove, to
remove  all traces of these menstrua.   Lastly, the product is mixed,  by tritu-
ration, with an eighth part of its weight of litharge, and left to deposit for for-
ty-eight hours, after which it is filtered once more through a light  stratum of
charcoal, when the apiol passes perfectly pure and colourless.
  Apiol, thus obtained, has the appearance of a yellowish, oily liquid, stain-

  1  A Treatise on Hooping Cough, its Complications, &c.  London, 1854.
  * Amer. Journ. of the Med. Sciences, Oct. 1850, p. 549.             " Loc. cit.
  4  Pharmaceutical Journal, cited in American Journal of Pharmacy, Oct. 1848, p. 328.
  1  Archives Generates de Medecine, Aout, 1850, p. 535.
  8  Bouchardat, Annuaire de Th.rap. &c.,pour 1853, p. 227.
        45 
706
APIS MELLIFICA.
 ing paper like fatty bodies, without  the spot being removable by heat.   Its
 odour is special  and tenacious, slightly recalling that  of the  powdered  seed,
 but differing from that of the essential oil; and its taste is piquant, and acrid.
 It is soluble in alcohol of various strengths; in ether, and iu chloroform in all
 proportions.
   When apiol is given  in the dose of a  gramme (gr. 15.43,) it produces ;i
 slightly excitant effect;  and in larger  doses, from 2 to 4  grammes (gr. 80.8G
 to gr. 61.72,)  a true intoxication—ivresse aploliquc,—which  is comparable to
 that caused by quinia.
   In the intermittents of Europe, apiol has succeeded in 86 cases out of  100.
 It has not been so fortunate in  the fevers of  hot countries: and MM. Joret
 and Homolle1  conclude, as the result of all observations, that it cannot be em-
 ployed with the same advantage  as the sulphate of quinia, in the intermittents
 of torrid regions; but may very well be substituted for it in those of Europe.
   Apiol has also been given in intermittent neuralgia  and in the sweating oj
 phthisis: and  MM.  Joret and Homolle ascribe to it emmenagogue properties.
   The common dose, in the case of a quotidian, five or six hours before the
 paroxysm, and in that of a tertian, on  the day of apyrexia, is a gramme (gr.
 15.43,) in syrup, or in gelatin capsules.

   CLXXXIII.  Apis Mellip'ica, A. Domestica, Bee, Honey Bee; French,
 Abeille mellifique, A. Domestique; German, Biene,  Honig-Biene.  The
 bee  appears to  have  been employed in medicine in the  middle  ages in cases of
 alopecia.   It was dried or grilled  and reduced to powder;2 and in this form
 was mixed in the dose of half a dram,  with extract of juniper,  and extolled as
 an excellent diuretic.   "No  one ventures at the  present day,"  says M. H.
 Cloquet,3 " to propose such a remedial agent; for, although the Materia Medica
 has  still need of an  extensive  reform,  both in its  agents and  language, it  no
 longer admits  such absurdities; and scarcely dare we add, that the distilled
 water of bees has been also recommended, and in the same cases,—that an in-
 fusion of them  in diuretic wine or in cenogala was all-powerful  in dropsy and
 calculous affections, and cured ischuria; that the  remains  of those found dead
 in honey strengthened the eyes and the ears, and were applied with success  in
 cancerous ulcers of the lips.   All these follies  and a thousand others which
 Pliny and Galen first published, have  been repeated by Houillier, Alexander
 Benedictine, and a crowd of other authors of the middle age of medicine,  who
 have given  us  their reveries  in  the place  of theories founded  on experience,
 and  have contributed to  perpetuate errors rather than  dissipate them.   The
 belief that the prolonged use of those insects might produce sterility; that  by
 immediately crushing them upon a wound all its  consequences might be  ob-
 viated, and that they were capable of inciting to love, was not less ridiculous."4
   Yet the  employment of the bee as  a therapeutical agent has been revived.
 Dr. F._ H. Gordon,5 of Wilson County, Tennessee, affirms that he succeeded in
 removing the strangury, which was a common attendant on an epidemic me-
 tritis by an infusion  of the bee, made as follows :—"Sweep forty to sixty bees
into  a pan of water, so as to make them manageable: put the whole into a tea-
 cup : pour one  gill  of boiling  water on them, and  cover the cup securely.
 When it has remained twenty minutes, pour off the infusion, and let the  pa-
 tient take the whole at a draught."   This remedy,  he asserts, relieved  the
  1 Bouchardat, Ibid, pour 1855, p. 181.
  1 Schroder! Dilucidati Zoologia; and the second volume of the works of Ettmuller, fol.
Latin, p. 304.  Lyons, 1690; cited in Faune des Medecins, par H. Cloquet, i. 93.  Paris,
 3822-                                                'Op. cit.
  * See, also, Merat and De Lens, art. Abeille, Diet, de Mat. Med. et de Th.rap.
  6 Western Journal of Medicine and  Surgery, Nov.,  1845, p. 392. 
                     SUPPLEMENT.—CADMII SULPHAS.                707

 strangury in from two to fifteen minutes with great certainty.  He refers to other
 practitioners  who  have "given the remedy numerous fair trials," and,  so far
 as he has learned,  all estimate it highly.   He has tried it repeatedly in  reten-
 tion of urine from  inflammation of  the bladder, and from the effects of can-
 tharides, and found it to be more prompt and certain than any other remedy;
 and he says,  "there can be no question  that  'bee tea'  will prove a valuable
 accession to our Materia Medica.  How far it may be found  useful in ischuria
 and dysuria from every variety of cause remains to be tested; and its known
 value affords abundant encouragement for further investigation."   Dr. Gordon
 affirms that it was introduced into medicine some years ago  by an old woman
 in the habitual  practice  of midwifery, in the County of Smith, Tennessee; but
 it is  doubtless one of those cases in which a remedy formerly in use has been
 abandoned by the profession, but retained by the people.
   Since the publication of Dr.  Gordon's communication, the  infusion has been
 used by others.  Dr. Flint,  of Buffalo,1 states, that  it had been tried in that
 city  with immediate relief, in a case in which the introduction of the catheter
 had been attempted  without success ;  and that it  was subsequently repeated
 daily, with the  same results, until the occasion for its administration  ceased.
   Dr. Gordon considers the infusion to act as a narcotic; and that its proper-
, ties are probably owing  to the virus ejected Avith the sting.  The tea, when re-
 cently made,  has a smell identical with that of the incensed  bee,  and is then
 efficacious ; but if the infusion  be permitted to stand and  cool,  and especially
 to remain uncovered, the  characteristic odour and taste disappear, and it  is
 correspondingly inefficient.  Hence, he infers,  the virus is  volatile, and re-
 quires care to prevent its escape.  " Whether,"  he adds,  " this A'aluable virus
 may  not be collected and concentrated, or combined  with some  chemical ele-
 ment, so as to render it  portable  and convenient,  is a matter of  interest, and
 well worth the attention of the chemist."

   CLXXXIV.   Bisaiu'thi Valeria'nas, Bismuthum   Valerianicum, Ger-
 man, Valerians aures Wismut h—is formed by mixing a neutral solu-
 tion of nitrate of bismuth with valerianate of soda,  washing the precipitate
 with  water, and drying  with  a gentle heat.  It forms a white powder, which
 is insoluble in water; and has been recommended byRighini2 in gastrodynia,
 chronic gastralgia, and  especially in  neuralgia and nervous palpitation.'
   The dose is from half a grain to two grains, three or four times  a day,  in the
 form  of powder or pill.

   CLXXXV. Cadmi'i  Sulphas, SuljJias Melini seu Klaprothii, Cadmium
 seu Klaprothium seu Mdinum Sulplmricum,  Sidphas  Cadmicus, Sulphate
 of Cadmium; French, Sulfate dc Cadmium; German, Schwefelsiiures
 Cadmium,  Sc hwefelsiiures Klaprothium,  is obtained bydissolving
 carbonate of cadmium in dilute sulphuric acid, and eA*aporating the neutral li-
 quid so that it may crystallize.   The crystals are colourless, rectangular prisms,
 which effloresce in the air, and are readily soluble in water.
   Sulphate of cadmium, which was referred to in a former edition of this work/
 has been almost exclusively prescribed of late in different  diseases of the eyes-
 Rosenbaum,1 Kopp,5  Griife, Ansiaux, Radius,6 and  others,7  employed it suc-

   1 Buffalo Journal, cited in New York Journal of Medicine, Sept., 1846, p. 2G5.
   2 Aschenbrenner, Die neueren Arzneimittel, u. s. w. S. 51.  Erlangen,  1848.
   'Third edit, preface, p. iv., Philada. 1841.
   * Merat and De Lens. Dictionnaire Universel de Mat. Mt'd. i. 320.   Bruxelles, 1838.
   6 Dierbach, Die neuesten  Entdeckungen in der Mat Aled. i. 541.  Heidelb. und  Leipz.
1S37.                            e Auserlesene He'lformeln,  S. 123.   Leipz. 1S36.
   7 Riecke, Nachtriige  zur ersten Auflage tier neuern Arzneimittel,  S.  27, Muttgart, 
708                    SUPPLEMENT.—CAFFEINA.
cessfully in specks of the cornea.   In chronic ophthalmia, accompanied by a
scrofulous, syphilitic, or other dyscrasia, it was used with advantage by Daynac
and Giordano; and by Lincke,1 it was  prescribed as  an injection in torpid
chronic inflammation and blennorrhea of the meatus  auditorius, membrana
tympani and middle ear, being thrown both  into the meatus  and the Eusta-
chian tube.
  It has  been recommended by Grimaud,2 as a substitute for the corrosive
chloride of mercury in syphilis;  and has been given with apparent success in
rheumatism and gout.   He likewise  prescribes it as an  emetic, and  employs
it in place of the tartrate of  antimony and  potassa in pneumonia.  It is said
also to possess antiseptic properties.
  The  Nitrate oe Cadmium, in the  dose of &th of  a grain  dissolved in
warm  water,  according  to  M. Souteyron,8 induces  vomiting  and  purging;
and the experience of Professor Simpson4  induced  him  to  compare  the pre-
parations  of cadmium—as regarded their action on the economy,—to those of
antimony.
  Sulphate of cadmium does  not appear to differ materially in its medicinal pro-
perties from sulphate of zinc.
  To form a collyrium, from one to eight grains may be dissolved in an ounce
of water.   As an eye ointment, Radius used it in the quantity of from one to
two grains to 9-V.  or 2j. of lard.   As an injection in  otorrhcea, Lincke em-
ployed it  in the strength of from 9j.  to 3ss. in giv. of infusion of roses.

  CLXXXVI.  Caffei'na,  Caffein,  Cafein;  French, Cafeine; German,
Coffein,  Kaffein,  Coffeinum.   This weak alkaloid  is obtained from the
seed  of coffee—Coffea Arabica; and is identical with  thein, obtained from
tea, and with guaranin obtained from  guarana—Paullinia sorbilis.5   It may
be procured by exhausting bruised coffee by two successive portions of boiling
water, uniting the infusions; adding acetate of  lead  to precipitate the prin-
ciples,  which  accompany the caffein;   filtering,  decomposing the  excess of
aeetate of lead in the filtered liquor by sulphuretted hydrogen;'concentrating
by evaporation, and neutralizing with  ammonia.   The caffein  is deposited
in crystals upon cooling, and may be purified by redissolving in water, treat-
ing with  animal charcoal, and evaporating.6  Another method is to  precipi-
tate from a decoction of  coffee or tea the gallic acid and other substances  by
.acetate <of lead; filtering, evaporating to dryness, and, after having mixed sand
 with the  mass, subliming, as in the preparation of benzoic acid.7
   Caffein is crystallizable in long silky needles; is fusible, volatile, and soluble
 in water, alcohol, and ether.   Mulder gave a grain of  caffein  to a rabbit; the
 animal ate but little the next day, and aborted the  day after.  According  to
 Lehmann,* in  doses of from two to ten grains, it causes  violent excitement  of
 the  vascular and nervous systems, palpitations of the heart, extraordinary
 frequency, irregularity,  and often intermission  of pulse; oppression of  the
 chest, pains in the head, confusion of the senses, tinnitus aurium, scintillations

 1840;  Asehenbrenne., Die  neueren Arzneimittel, v. s. w. S. 54.  Erlangen, 1848;  and
 Pereira, The Elements of Mat.  Med. and Therap. 3d Amer. edit. i. 687.   Philad. 1852.
   1 Vollstandiges Recept-Taschenbuch, i. 311.  Leipz.  1840.
   * Lond. Med. Gaz. Api. 1851, in Canstatt's Jahresbericht,  1851, v.  74.
   * Comptes rendus, xxxii. cited in Canstatt's Jahresbericht, 1851, v. 74.
   * Monthly Journ. of Med. Science, Dec. 1854, p. 564.
   5 See page 573.
   « Dispensatory of the United States, 10th  edit. p. 1318.  Philad. 1854.
   7 Bouchardat, Annuaire de Th.rap., &c, pour 1853, p. 109.
   * Lehrbuch der Physiologischen Chemie, 1, 143.  Leipzig, 1850, or Amer. edit, by Dr.
 E. E. Rogers, p. 130.  Philad.  1855. 
SUPPLEMENT.—CALCIS PHOSPHAS.
709
before the eyes, sleeplessness, erections, and delirium;  and, in all cases, there
was an increase in the amount of urea  secreted.   Phobus doubts, whether the
caffein is of the importance that has  been assigned to it;  but Von Falck,1
from much observation, ascribes to  it  a highly powerful and even poisonous
action, which can, in no respect, be  ascribed to the infusion of roasted coffee;
and he refers to experiments by Albers, of Bonn, who produced tetanic phe-
nomena in a frog by the  citrate;  and  similar  effects  were induced by insert-
ing, in another frog, a solution of the citrate under the skin of the thigh.
   Various salts of caffein have been prescribed by M. Van den Corput,2 as the
citrate, the  lactate,  the violate, and the  muriate.  Of  these,  the citrate of
caffein—Caffeince citras, Caffeina citrica,  Caffeinum cifricum—has been most
employed.   It is very soluble in water, and is  made by saturating pure caffein
by a solution of citric acid, and evaporating;  or it may be made  by exhaust-
ing crude coffee with  a  very weak  solution of citric  acid, shaking the liquor
with an equal volume of  ether, decanting, and leaving  it to crystallize after
concentration.  M. Hannon3 extols the citrate  in idiopathic hemicrania.  Ten
grains are made into as many pills,  one of which  is to be taken every hour for
some time before the paroxysm.   The  dose is gradually increased until  relief
is obtained;  and, in one case, as much as half a dram was taken.  He gives
formulae for pills, syrup, mixture, pommade, lavement, &c, of the citrate.
Eulenberg* speaks highly of the effect of caffein in hemicrania in doses of  a
grain and a half every two or three hours.  He has also employed the citrate.
On account of the expensiveness of  caffein he has used—and with good effect
—the extract of coffee, four grains of which are equal to one grain of caffein.

   CLXXXVII. Calcis Phosphas, Calcaria phosphor ica, Phosphas ealcicus;
French,  Phosphate  de Chaux;  German, Phosphors a. ure  Kalk; Phos-
phate of Lime.  Phosphate  of lime,  in  the  form of Cornu ustum  or  burnt
hartshorn, was brought forward long ago, on chemical considerations, as a remedy
 in mollities ossium and rickets; owing  to the deficiency of earthy matter in  the
bones in such cases.  The error, however, consisted in  referring the malady
to a deficient supply of bone earth, whilst  the real fault was in the assimilating
power of the cells.  It had almost fallen into disuse, when it was again pre-
scribed,  owing to the view of Beneke,5 that it is  indispensable for cell forma-
tion in both plants and  animals, and his consequent recommendation of its
employment in scrofulous and other cachectic  affections.
   On chemical and physiological  reasons it was suggested  in tuberculosis by
Dr. S. Kneeland, Jr.,8 of Boston, who observes, that there  is a singular  co-
incidence, to say the least, between this remedy and the product which has been
generally considered as nature's attempt to cure  by a chemical transformation
 of tubercle.   He gives no cases, however.
   It was employed by Dr. Stone, of  New Orleans, in  cases of scrofulous ul-
ceration, phthisis, &c, with considerable  advantage—it was conceived.7   Dr.
 Wood,8 however, remarks,  that in the  reported cases of  benefit  from the phos-

   1 Canstatt's Jahresbericht im Jahre 1853, S. 152. Wiirzburg, 1854.
   2 Bull, de Therap. xxxviii. 498, and Rev. M.d. Chir. vii.  350, in British and Foreign
 Med.  Chirurg. Rev., Oct. 1850, p. 557.
   8 Presse M<_dicale Beige, in Bouchardat, Ibid, pour 1851, p.  47, and Supplement aux
Formulaires publics jusqu'a ce Jour, p. 13. Paris, 1852.
   * Allgem. Med. Central Zeitung, and L'Union Medicale, Juin, 1854, in Brit, and For.
 Med. Chir. Rev.  Oct.  1854, p. 561.
   5 Der Phosphors'aure Kalk in Physiologischer und  Therapeutischer Beziehung; and Zur
Physiologie und  Pathologie des Phosphorsauren und Oxalsauren Kalkes, in Canstatf s
Jahresbericht, 1^50, v. 138.     6 Amer. Journ. of the Med. Sciences, July, 1852, p.  117.
   7 St. Louis Mod. and Surg. Journal, x. 38.
   1 Dispensatory of the  United States, 10th edit. p. 917. Philad. 1855. 
710
SUPPLEMENT.—CARBONIS TRICHLORIDUM.
 phate of lime, it  had generally been  given  in  connexion with codliver oil or
 tonics; to which—as he rationally infers—any benefit experienced is more truly
 ascribable than to the phosphate.   The author has certainly seen  it most pro-
 fusely administered, and in a vast variety of cases, but he has had no sufficient
 evidence to show,  that it was more efficacious than so much saw-dust; and since
 this was written he has seen it stated,1  that in the Bethany Hospital of Berlin it
 has been used, as recommended by Beneke, in cases of atrophy in children, in
 scrofulous affections, caries of the joints, suppurating lymphatic glands, spina,
 vcntosa, &..,  Avithout the slightest improvement.   It is affirmed, indeed, that
 in every instance  there was an increase of the affection. (?)  The dose in which
 it was given was from two to four grains, three times a-day, and it was continued
 uninterruptedly for eight weeks.
   M. Moures* has affirmed,  that  in the French  towns the food is so deficient
 in phosphate  of lime, that nurses' milk has, consequently, the same defect; that
 the infant, as well as the foetus, suffers from the "deprivation of this element so
 indispensable to its development and life;" and hence one of the causes of the
 number of still-born children and of the mortality of infancy.  He therefore
 recommends the administration of phosphate of lime, and has  given it  to nur-
 sing women, with benefit, to the amount of 3hj- in the day.  His conclusions
 are, however, evidently deduced  from insufficient observations, and would re-
 quire very careful and unprejudiced investigation to establish them.
   The ordinary dose of  the  phosphate of lime is  from ten to thirty  grains.
 It may be given with food, and especially with milk, with which, according toKu-
 chenmeister3  it forms a soluble combination.  It probably dissolves in the gas-
 tric acids.

   CLXXXVIII.   Carbo'nis  Trichlo'ridum, Carbonis  Sesquichloridum,
 Carboneum Trichloratum, Trichlorctum  Carbonei,  Carbonicum  Chloratum,
 Terchloride or Scsquichloride of  Carbon; French,  Trichlorure ou Sesquichlo-
 rure de Carbon; German, Dreifach C hlorkohlens toff, Ko hlenstoff-
 trichlorid, is formed by the action of chlorine or chlorohydric ether, under
 the influence of sunlight.   It is in needle-shaped crystals, pul verizable, colourless
 or white; tasteless, and of a peculiar camphoraceous  aromatic odour.  It is very
 sparingly soluble in  water; soluble in  alcohol, and still more so in ether; and
 dissolves  in fixed and volatile oils.   It may be obtained, likewise, by the action
 of chlorine on Dutch liquid or chloride of oh fiant gas.
   Terchloride of carbon  has  been employed by  Dr. King  with advantage  in
 cholera morbus, and it is affirmed by Dr. Jones Lamprey,4 that it was originally
 used as a remedy in the treatment of cholera by a physician of Calcutta.   It
 had  been also prescribed, in  1843, in London, as 'an  excitant  and antiseptic.
 Mr. Tuson had found it effectual in  correcting  the fcetor of foul ulcers.5  M.
 Troschel,  chief physician to a cholera hospital in Berlin,  having read the  ob-
 servations of Dr. King, determined upon submitting it to  trial  in cholera, and
 he was encouraged to this course by the results  of experiments made by the
 Russian physicians in St. Petersburg.   The substance  being, at first, of high
 price, and obtainable only in small quantity, M. Troschel administered it in the
 moderate  dose of about four grains, repeating it  every half hour, or every tAvo
or three hours, according to circumstances ; and he  affirms, that in many cases
he succeeded  in breaking and shortening the asphyxial period, and establish-

   1 Schmidt's Jahrbuch, cited in Med. Exam. Oct. 1855, p. 590.
  2 Comptes  Rendus de l'Acadi'in. Janvier, 1854, and Ranking's Abstract, Amer. edit,,
 xx. 17.  Philad. 1855.  Also, Bouchardat, who reports on the Memoir in  his Annuaire
 de Therap. pour 1854, p. 292.
  3 Schmidt's Jahrbuch, 1854, vi. 298, and Brit, and For. Med. Chir. Oct. 1854, p. 563.
  * Medical Times, Jan. 6, 1849.                5 Medical Times, Dec. 2, 1848. 
SUPPLEMENT.—COAGULUM.
711
ing reaction.1  M. Manget also appears to  have found it of great advantage
under the same circumstances; and he had numerous opportunities for testing
its efficacy as physician  to the Bureau  de  Bienfaisance  of the fifth arron-
dissement of Paris, Avhere cholera made great ravages.   He gave it in the same
dose, in a spoonful of syrup of gum.  M. Manget regards it as one of the most
powerful diaphoretics we possess.2
   Like many other  anticholeric . remedies, its merits have  doubtless been
greatly exaggerated.

   CLXXXIX.  Ce'rium, Cererium.   This  metal is never found isolated.   It
is usually combined with two other  metals—lanthanium or  lantanium, and
didymium.   In  the complex  process of separating the cerium from these me-
tals, oxalic acid, or rather oxalate of ammonia, is  employed in the last stage;
and in the markets cerium is most  readily procured in the fornTof an oxalate
of the protoxide.3                                    ,                    .
   Professor Simpson, who has prescribed the salts of  cerium, considers their
principal  therapeutical action  to be sedative  and tonic,  like the pharmaceutical
oxide and salts  of silver and  bismuth.  He employed cerium, in the first  in-
 stance, in cases of  general chronic intestinal eruption—a peculiar and  in-
 tractable  form of disease for  which  arsenic and nitrate of  silver were gene-
 rally prescribed;  and where  they had failed  cerium was tried  with marked
 advantage.   In irritable dyspepsia with gastrodynia and pyrosis;  and in
 chronic vomiting,  its administration  was attended with satisfactory results;
 and in the vomiting of pregnancy prompt relief was afforded.*  More recently,
 Professor Simpson5 has stated, that he had employed cerium pretty extensively
 in the treatment  of  chronic  intestinal eruptions, and, occasionally, with  the
 most marked good effect when all other forms of medication had faded.  In his
 own practice and  in that of others, he has seen the preparations of cerium suc-
 ceed, at once, in allaying irritable and obstinate vomiting after all other means
 had failed.   Sometimes, like all remedies, it has not succeeded m relieving the
 sickness and vomiting of pregnancy;  but, far  more frequently  he  has found
 its employment accompanied by directly beneficial results, and  he has had
 repeated  occasions to see it immediately and  perfectly successful m some in-
 stances  "where the usual succession of  medicines—prussic acid, naphtha,
 opium, bismuth,  ice, &c. had been  previously,  and persevermgly tried in
vain.
  Professor Simpson employs the oxalate in the form of small pills and in the
dose of  one or two  grains/or a  solution of  the nitrate in water m the same
proportionate doses.

  CXC   Coag'ulum, Rennet, Runnet; French, Cailledait; German, Laab;
and Cerevis'i_eFerme*t'UM, Fei-mentum, Spuma Ccrevisicc; French, Levurc;
GermanriIefen,Bierhefen.   Both those substances  have been recently
bight'forward/on chemical considerations, for the treatment of diabetes
melUtus   Dr. Gray, of Glasgow,0 is of opinion that the disease consists in the
pToc s  of digestion being arrested at the conversion of other organic pnncjples
FnTsTar, which  cannot  be oxidated in the lungs, and  is, therefore, elimi-
nated bTthl kidneys j  and he argues, that as rennet converts sugar into lactic
"7outyof the econ^niy, it may  So so within it likewise;  and if such conver-
sion should  take place in  diabetes, the disease would be  brought to an end,

                                 2 Annuaire de Therapeutique pour 1850, p. 50.
  • ObtfcSric Memoirs and Contributions of J. Y. Simpson, M. D., &c p. 318  Edinb^l85_.
  . EinlTJournal of Med. Science, Dec  1854  p. 564        • Op. cit. p. 313.
  ■ Monthly Journal of Medical Science,  Jan., 18.3, p. 30. 
712
SUPPLEMENT.—COAGULUM.
"if Liebig be right in his opinion, that lactic acid is one of the principles of the
organic world, which can  support respiration by becoming oxidated in the
lungs."   On these theoretical considerations, Dr. Gray prescribed a teaspoonful
of rennet  three times a day, in a case in which medicines of various kinds had
been  of little use.   In eight  days, the quantity of urine was diminished,
and the density reduced from 1045 to 1025; and it contained lactic acid, but
only a trace of sugar.  In 25 days, the quantity passed was sixty-four ounces,
the density 1022.5, and the sugar gone.  The cure appeared to be complete.
   Such an announcement drew immediate attention to rennet in the treatment
of this intractable malady.  Dr. Robertson1 employed it, and heard of  its em-
ployment  in several cases ; from the results of which he infers, that the remedy
is not applicable  in all cases and circumstances.  Successful cases are, also, re-
corded by Dr. Fearnside;a and by Dr. Nelson,3 who esteems it valuable by acting
as a substitute for the morbid deficiency of the natural gastric juice; thus allow-
ing time for other remedial agents to be employed, " which may be considered
counteractive of the disease, whatever that may be thought to be."
   Dr. Robertso'n  considers it necessary, that the rennet  should be recently
prepared;  and that a teaspoonful  should be capable  of coagulating a pint of
milk in five minutes; as it not unfrequently happens, that, by  being kept for
some time, it loses power.   Its quality  should, therefore, on all occasions be
tested with milk  before being used as a medicine.

   The results of  Dr. Gray's experience with  rennet suggested  to Dr. Wood4
the employment  of yeast in  diabetes, which  he thought  might be beneficial
by causing a decomposition  of the sugar in the stomach  " such as it  is well
known to  occasion out of the body, resulting in the production of acetic acid."
Under the impression, that  in a  case,  which he reported to  the College of
Physicians, the primary disease probably resided in the stomach, and that the
diabetic sugar was generated  there, he  determined to try the effects of yeast,
a teaspoonful of which was given three  times a day, immediately before meals.
Soon after the commencement of the treatment, the quantity of urine, of sugar
contained  in it, and its density became  greatly diminished; and there was no
cause apparent to which the result could be ascribed except the yeast.   This
case was reported at the meeting of the college on the first of December, 1852.
At a subsequent  meeting, held  on the fifth of January, 1853,  Dr. Wood5 re-
ported, that no farther improvement  had occurred.  The yeast had been per-
severed with, except for  a short period  during which  rennet was substituted,
without any appreciable effect;  there had, indeed, been rather a falling back.
The patient, however, was better than when first subjected to treatment.  The
quantity of urine was diminished one  half, and its specific gravity was  con-
siderably  less.
   The author is not disposed  to expect much benefit from these or any other
articles, brought forward on hypothetical chemical considerations.  The history
of therapeutics exhibits, that neither in diabetes nor in any other disease of
assimilation have they sustained their first reputation.   For a time, a new im-
pression may be made on  the diseased cell agency which is concerned in  such
affections,—for diabetes appears to him  to be profoundly seated in the whole
system of  nutrition; but the good effects are apt to be temporary, and the dis-
ease, in almost all cases, proceeds  not the less certainly to a fatal termination.

  1 Ibid, and Ranking's Abstract, xvii. Amer. edit. p. 237.   Philad. 1853.
  2 Edinb. Monthly Journ. of Med. Science, Mar. 1854, and Ranking, xix. 95. Phila.  1854.
  * Lancet, Jan. 20, 1855, and Ranking, xxi. 81.   Philad. 1855.
  * Summary of the Transactions of the College of  Physicians of Philad. vol. 1. New
Series, p. 390.  Philad. 1853.
  5 Ibid. p. 412, or Amer. Journ. of the Med. Sciences, April, 1853, p.  559. 
 kJ.*.r_.;'.               SUPPLEMENT.—CONGELATIO.                   713

   CXCI. Conqela'tio, Congelation; German, Erfrieren, Gefrie ren.
   Of  late years, the  application of refrigerating mixtures  has been brought
 forward, and urged upon the attention of the profession, by Dr. James Arnott1
 as  a  means of inducing local anaesthesia by congelation,  and it has been fa-
 vourably reported upon by many observers.   Dr. Arnott employed,  at first, a
 freezing mixture in a small pig's bladder.  The bladder containing tepid water
 was placed so as to cover the portion of skin  to be rendered insensible: the ice
 was then gradually dropped in; and, last of all, the salt, so as  to bring  the
 temperature considerably below the freezing  point.
   Mr. Nunn *Temoved several excrescences  depending from the labia minora,
 and surrounding the clitoris, some of them of the size  of a fig, with but little
 pain or hemorrhage, after having applied wedge-shaped pieces of ice to the neck
 of the larger growths until they became blanched.   To show the advantage of
 the ice, he removed one without its use:—the pain was excessive.
   Dr. W. A. Berry,3 of Washington city, describes the plan adopted by M. Vel-
 peau, which was first  made use of in M. Velpeau's wards in the summer of
 1851  by one of his internes.  It was  employed to  remove the  nails of the
 fingers and toes.4  Anaesthesia was induced  by the mixture of ice and salt in
 five or six minutes.  It continued for two or three minutes; "and might have
 done  so for a longer period,  had  the contact  of  the mixture  been prolonged."
 No inconvenience resulted from it.   Once only it was followed by oedema.5
   Favourable testimony is  borne to its anaesthetic effects,  especially during
 minor operations, by Dr. Thomas Wood,6 of  Cincinnati; and by Dr. Snow, of
 London, who remarks, that the only means, yet possessed, of producing complete
 local  anaesthesia is that of refrigeration as proposed  by Dr. Arnott.   When a
 part is cooled  by the  application of a  refrigerating  mixture, it becomes—as
 the author has witnessed—of the colour of parchment, as hard as  suet,  and
 perfectly insensible.
   In  applying  the ice and salt, Dr.  Arnott7 now uses a  piece  of gauze,
 formed, for convenience, into a small net or bag.   The  common frigorific mix-
 ture of ice and  salt, he finds generally possesses a sufficient frigorific power;
 if not, saltpetre or an ammoniacal salt may be added.8  He has shown, that the
 temperature  of a part may be reduced  to many  degrees  below  zero; sensa-
 tion may become completely nullified;  and  circulation  partially arrested for
 a considerable time, without subsequent ill effects.  Dr. Arnott is not, however,
 satisfied with this.  Entertaining so exalted an  opinion of  the anaesthetic
 powers of congelation, he is disposed to substitute it altogether for chloroform,
 in  consequence of the accidents, that have  occasionally attended the use of
 the latter agent.9   It is not probable, however, that it will  be employed  ex-
 cept in minor operations: and, in this country,  it has not attracted much  at-
 tention.  Several cases, too,  have been  recorded in which the patients felt:

  1  Lancet, July 22, 1848, p. 98.            2 Lancet, August 31,  1850.
  3  Med. Examiner, Sept., 1852, p. 585.
  * Mr. Butcher, (case of evulsion of the nail of the middle finger,) Dublin Quart. Journ.
 May, 1855, p. 305.
  5  Union M.dicale, and Bouchardat, Annuaire de  Therap. pour 1851, p. 130.
  6 Western Lancet, April, 1854, and Amer. Journ. of the Med. Sciences, July, 1854, p. 287.
  '  Med. Times and  Gazette, Nov. 11, 1854, and  Ranking's Abstract, xxi. 124, Amer.
 edit.  Philad. 1855.
  8 For various Frigorific Mixtures, see the Author's Dictionary, art. Frigorific, 12th edit.
 Philad. 1855.
  9 Med. Times and Gazette, July 1, Aug. and Sept. 30,  1854, and Ranking's Abstract,
xx.  112, Amer. edit.   Philad. 1855.   Also, The Question considered, Is it justifiable to
administer Chloroform in  Surgical Operations, after its having already proved fatal in
upwards of fifty cases, when pain can be safely prevented, without loss of consciousness,
by momentary benumbing cold?  By James Arnott, M. D.  Lond. 1854. 
714                     SUPPLEMENT.—CONIA.
and "whether from a too timorous use  of the means, or some other cause, the
success was not so complete as could have been desired."'
   Dr. Arnott has been equally sanguine in regard to the good effects of con-
gelation in external inflammation, of which it is—he says—"a certain, speedy,
safe, and agreeable remedy." 3  Wounds produced by surgical operations appeared
to him to  heal invariably more speedily after the use of congelation, than under
the usual circumstances.   Its observed effects, indeed, in preventing inflamma-
tion led to its use as a remedy in the same condition.   Cases of successful re-
sults are recorded by him of its employment in erysipelas.  Two cases of can-
cer are also related by him in  which  congelation appeared to be of marked be-
nefit.   It has not been  much  used in such cases, in this country;  but appears
to be worthy of attention.   Whilst in Edinburgh,  in the autumn of 1854, the
author saw ice  and salt applied in inflammations of the surface; and he found,
that confidence was placed in  it in such cases, and as a modifier of nutritive
action, by more than one observer of eminence.

   CXCII.  Coni'a,  Coniinum,  Conicinum,  Cicutinum,  Coneine,  Conine,
 Conicine,  Ciculine ; French,  Coneine ; German, C o n i i n.   The  active prin-
ciple of conium or hemlock was discovered and carefully examined by Geiger,
in 1831;  but it had not attracted much attention from therapeutists.   It is
most easily obtained, according to Dr. Christison,3 by  cautiously distilling from
a muriate of lime bath, a mixture of strong solution of potassa, with the alco-
holic extract of the unripe fruit.   The alkaloid passes over with the water, and
floats upon it like an oil.  It  contains some water, which may be removed by
chloride of calcium, and also  a little ammonia, which is separated by keeping
it for a few hours in vacuo.   It is a colourless, oleaginous fluid, of an intense
peculiar, suffocating odour ; and an extremely acrid, benumbing taste;  is spa-
ringly soluble in water; very soluble in alcohol and ether, and in fixed and vo-
latile oils.   It is a most energetic poison, appearing to act on the nervous cen-
tres—the spinal  cord particularly—like hemlock, but unlike strychnia, which
irritates the spinal marrow, and induces  violent and permanent spasms of the
muscles.4   A few drops kill a  small animal in a few minutes—the effects being
gradual paralysis, slight convulsive tremors, and death from suspension of the
respiration, without any apparent  alteration in the  blood, or depression of the
heart's action.   The salts  of  conia, from  being more soluble, are even more
energetic  than it.5
   When conia  is administered in  medicinal doses,  it acts as a sedative on the
nervous centres; and may cause  incoherence and  even delirium; the move-
ments are enfeebled, and paralysis  may succeed; the  pulsations of the  heart
are less strong and less  frequent, and the respiratory  organs feel the influence
of this state of nervous stupor.  According to Nega,6 the  phenomena that in-
dicate the narcotic influence succeed  each other in the  following order :—fee-
bleness, paralysis of the voluntary muscles, anaesthesia, general indisposition,
vomiting, paralysis of the stomach, diminished frequency and force of the pul-
sations of the heart, stupor, vertigo and syncope.
   The diseases in which Nega employed it with benefit were,—hypercesthesia,

  1 Ranking, Op. cit. p. 114; and Monthly Journal of Med. Science,  May, 1854, p. 5G1.
  2 Medical Gazette, Mar. 2, 1849, and Ranking's Abstract, ix. 17.  Philad. 1849.
  ' Dispensatory, Amer. edit, by  R. E. Griffith, p. 410.  Philad.  1848.
  4 Richard, Elements d'Histoire  Naturelle M.dicale, iii. 184.  Paris, 1849.
  5 Christison, op. cit.;  and A Treatise on Poisons, Amer. edit. p. 055.  Philad. 1845.
See, also, for various modes of preparing Conia, and its effects in disease, Bouchardat,
Annuaire de Th.rap. pour 1853,  p. 56-73.
  6 Zeitschrift firr Klinische Medicin. H.  1.   Bre.lau, 1850, and Archives G.n.rales de
Med. Juin, 1850, p. 224. 
SUPPLEMENT—CONIA.
715
neuralgia and spasmodic  affections.—Ho instances particularly, hypercesthesia
of the fifth and tenth pairs of nerves, and the accidents resulting from them,
otalgia,, odontalgia, tic douloureux of the face, photophobia, and spasms of the
cydids, for which it had been recommended by Fronmiiller, and has since been
given by Spengler;1 in sthenic nervous affections of the larynx; brachial, intercos-
tal, and particularly sciatic neuralgia;  and, in short, all diseases in which pain
is a symptom, or a complication of any gravity; and it is affirmed that, like conium,
it renders ulcers of a malignant nature less painful, and of a better appearance;
aids in the resolution of scrofulous tumours, and prolongs the first stage of the
development of tubercles; and he  found it of  service in hooping cough.  In
intermittent fever, it produced little or  no result,  and this was the experience
of Rculing and Fr. Salzer.2  Such, however, was not the result of the observa-
tions of Wertheim,3 of Vienna, who appears to have obtained excellent effects
from it in that disease, when  the pulse was full and hard, indicating an inflam-
matory state.   On the other hand, when it was feeble and accelerated, and the
fever was asthenic, he prescribed leukolein,  described hereafter.
   In scrofulous intolerance of light, it was  found  by Dr. Mauthner* to be of
great benefit where  no inflammatory symptoms  were  present.   It was applied
twice or thrice daily in the form of oil, composed of conia, half a grain; oil
of sweet almonds, a dram, by means of a common camel's hair pencil.   Dr.
 Mauthner says the  most obstinate cases may be  cured in this way, in from
eight to fourteen days.
   Dr.  Spengler5 extols it in hooping cough—placing it, indeed, above  all re-
 medies ; and is of  opinion, that it may be of  great service in intermittents,
 especially in such as have resisted  quinia.
   Conia may be given  either in watery, alcoholic or ethereal solution, or united
 with  dilute acids.   Wertheim always  prescribed it  in watery solution,—one
sixty-fourth or one-thirty-secondth  to one-sixteenth of a grain, in six ounces of
 distilled water, of which  two spoonfuls, (cuillerees n louche,) were given every
 two hours.  Fronmiiller dissolved  three or  four drops in a scruple of alcohol;
 and added half an ounce of distilled water.   Of this, from fifteen to thirty drops
 were given three times a  day.  It has also been  used endermically—in the dose
 of two drops, mixed with acetic acid—and in enemata, to the extent of three
 drops.6
   Of  late, Mr. Murawjeff,7 a  Russian  physician, has recorded the following
 diseases in which its external use has been found beneficial.   In chronic cuta-
 neous diseases it allays irritation, and favours the cure; and in eczema,psoriasis,
 acne, lichen, psora, prurigo and favus he has been  successful  with  it.   In
 toothache, a  drop allays  the pain more speedily and effectually than even chlo-
 roform.   In neuralgia and syphilitic pains of the bones, it proved not a mere
 palliative, but effected a  radical cure.   It is beneficial in synovitis, and allays
 the pain of incised and gunshot wounds.  In scrofulous and rheumatic inflam-
 mation of the eyes,  it speedily diminishes the severity  of  the symptoms, and
 relieves the pain in scrofulous and cancerous ulcers.  His method of employ-
 ing it is as follows.  In  cutaneous diseases, an  ointment is used composed  of
 from 12 to 24 drops of conia to gj. of simple  ointment  or cold cream.   The

   1 Cited by Von Gorup-Besanez, in Canstatt und Eisenmann's Jahresbericht, u.  s. w.
 imJahre 1849, v. 171.  Erlang. 1850.
   2 Deutsche Klinik, No. 41, in Canstatt's Jahresbericht, 1853, b. l»o-
   8 Archives Gem-rales de Mi'd.  loc. cit.;  Gazette Medicale de Paris, 1849, p.  /48, and
Bouchardat, Annuaire de Th.rapeutique pour 1850, p. 177.
   4 Journal fur Kinderkr. Heft 1, 2, 1854,  cited in Ranking's Abstract, xxi. 198.   Am.
 ed  Phila 1855.                      B Union M.d., in Bouchardat, op. cit.
   « Aschenbrenner, Die neueren Arzneimittel, u. s. w. S. 89.   Erlangen,  1848.
   i Med. Zeit. Russ.  in Dublin Hosp.  Gaz., April 15, 1855, and Am. Journ. of the Med.
 Sciences, July, 1855, p. 187. 
716
SUPPLEMENT.—COTYLEDON UMBILICUS'.
diseased parts having been first rubbed with soft flannel, the ointment is applied
to them, and they are then covered with oiled silk  and a bandage.   In n eu-
ralgia, he first washes  the part  affected with  alcohol, and then applies to it
three or four drops of pure cpnia, covering it afterwards with oiled silk and a
bandage.  In cancer, he mixes the alkaloid with mucilage, and applies it to
the diseased  surface with the finger previously covered with a glove.   For a
collyrium he adds a third of a drop to f gvj. of distilled water, and  f.^ij. of  de-
coctum cydonii; and, when employed as an enema, he adds two or three drops
to starch emulsion.

  CXCIII.   Cottle'don Umbili'cus,   Cotyledon Umbilicus  Veneris, Na-
vclwort, Venus's Navelwort; French, Nombril  de  Venus; Family,  Crassu-
laceae; Sexual System, Pcntandria Pentagynia.   This plant, which grows in
Europe on old walls and rocks, has been  long used in medicine,  but was al-
most unknown to practitioners of the present day,  when its employment was
revived in a new direction.  The leaves are emollient,  and have  been  applied
externally to hemorrhoids, and to inflamed parts.  Of late, the inspissated juice
has been brought forward to swell  the uncertain crowd of anti-epileptic reme-
dies, by Mr.  Salter1 and Dr. Bullar.   " Encore un remede contre I'epilepsie!"
exclaims M. Bouchardat.2  The juice was first used with  advantage ;  and  af-
terwards an extract was prepared from it, which exerted the same  effects. Dr.
Bullar3 urges its protracted use.    He has prescribed it in a considerable num-
ber of cases—several of which were of a very  hopeless kind,—and in all there
was a marked diminution in the violence  and frequency  of the attacks.  In
many cases he thought it was " certainly " nervo-tonic,—the improved nervous
tone being shoAvn by quieter sleep, fewer dreams,  better spirits, more ability
to take exercise, and  a consciousness of general  improvement.   He is not
aware that it has any other action  on the body.
  From the proceedings of  the  Boston Society4 for Medical Improvement, it
appears that Dr. S. L. Abbott found it successful in one case, in the dose of
five grains, night and morning, for eight months.  Dr. H. 0. Stone, also, re-
ported favourably as to its action in two cases; and Dr. Sieveking5 infers,
from  cases,  which he has puiblished, that  "some encouragement" is given
for its further employment.  "
  Dr. Graves6 thought  it capable of materially aiding in the cure  of  certain
varieties of the disease.   It appears, however,  to have failed in three out of six
cases, and to have only partially succeeded in a fourth.   On  the  other hand,
Dr. Grieve 7  is  decidedly unfavourable to its  employment.   He prescribed it
in six cases without the slightest evidence of its having exercised any bene-
ficial  effects whatever on  any of his patients; and he adds—" so that I  am
constrained to regard the navelwort as a  useless weed, to be ranked with  the
mistletoe  of the oak, lady's  smock,  biting  stone  crop,  and other frivolous
things; not to speak of the warm blood  of the gladiator just slain, the dung
of birds, the hoof of quadrupeds, and other delicacies of a by-gone age."   Dr.
Ranking8 states that as far as his  own experience goes, it is utterly worthless
as an anti-epileptic.
  The juice  is obtained by bruising the leaves and leaf-stalks in a mortar,  and
expressing it from the bruised mass through a cloth.  One tea-spoonful of this is

  1 Med. Gaz., March 2,1849.         2 Annuaire de Th.rapeutique pour 1850, p. 59.
  * Provincial Med. and Surg. Journ. May 23, 1849.
  4 American Journal of the Med. Sciences, Jan. 1853, p. 84.
  5 Med. Times and Gazette, Dec. 2, 1854, and Ranking's Abstract, Amer. edit. xxi. 4 .
Philad. 1855.
  6 Dublin Quarterly Journal, Nov.  1852.       'Lancet, Oct., 1852.
  8 Med. Times and Gazette, April 1,  1854. 
SUPPLEMENT.—CUCURBITA PEPO.
717
given twice a day.  Of the extract, Dr. Bullar has prescribed five grains twice,
and occasionally, thrice, a day.
  As in the case of artemisia,1 it is to be feared, that the virtues of cotyle-
don  umbilicus have  been exaggerated.  Dr. Ranking2  is  properly of opi-
nion, "that the cases given in  illustration  are too few in number to be worthy
of much confidence; and he  is " disposed to  agree  with  Dr. Marshall Hall,
that there is no  'medicine especially adapted to the cure of epilepsy; and that
the only rational treatment  consists  in a judicious employment of hygienic
measures, including diet, exercise,'" &c.   It was not necessary to affiliate this
view on  Dr. Hall, as most intelligent practitioners had  arrived at the same
conclusion, and  not a few had promulgated it to the world.  In a note  from
the author's  friend, Dr. Francis G. Smith, dated Philadelphia, Jan. 9, 1851,
he states that he had used the extract in  two cases,—the  one, that of a female
approaching puberty; the other,  that of a young man twenty-five or twenty-six
 years of age ; but  in  neither case was the slightest benefit perceptible :—the
 young lady, indeed, became worse  when  taking it;  "for  whilst there was no
 diminution in  the frequency or severity of  the paroxysms, she became  de-
 sponding in the highest degree—in this last respect the case resembling some
 reported by the English practitioners."   Dr.  Smith gave the extract in doses
 of five grains, three times a day.   The author has never  used it.

   CXCIV.  Cucur'bita Pepo, Pepo vulgaris, Pumpkin ; French, Potiron,
  Citronille, Pepon, Courge;  German, Gemeiner  Garten-Ku rbis, Feld-
  Kiirbis, Mandel-Kiirbis, Pepone.  MM. Merat  and De Lens3 state,
  that Dr.  Hoarau had informed them, that the seeds of one of the cucurbitaceaa
  with edible fruit, and a variety of the pumpkin of Europe,  were given in  the
  Isle of France with  unvaried success in cases of taenia^  In the  year  1820,
  M. Mongeny, a physician of Cuba, discovered, by accident,  the good effects  of
  the fresh pumpkin in the form of paste, in the morning fasting,—in the quantity
  of  90  grammes (about 3'j- f)  followed by 180 grammes  of honey in three
  doses; the first an hour afterwards,  and the two  others at similar intervals.
  In six or eight hours, he says, the worm was always expelled; and often when
  other anthelmintics  had failed.  The  same results were  obtained  by MM.
  Brunet and Lamothe.  The paste of the seeds is, however, employed at Bor-
  deaux in the dose of 45 grammes with as much sugar.*  The seeds have, also,
  been used  successfully  by  Teschemacher, Dr. J.  S. Jones of Boston,'and
  others;  and Dr. Wood' states  that a very striking case had been related  to
  him, on the  best authority, in which they had " proved  immediately and com-
  pletely successful, after  the vain employment of  all  other known remedies
  Euroucrh a course of  several years."  Mr. Soule prefers  the V> est India seeds,
  taken°in the dose of about two  ounces in the morning fasting, and followed m
   an hour or two, by a fluidounce of castor oil.
     Two  cases are reported  by Dr. Leasure,8 of New Castle, Pennsylvania, m
  which an infusion of a pint of the bruised seed in three pints of boiling water,


    * TheMf-yearly Abstract of the Medical Sciences, No. D,  from Jan. to June, 1849;
   Amer. edit. p. 200.                                  ..    1co„
    » Diet Univers. de  Mat. Med. &c, n. 66.   Edit, de Bruxelles  18.8
     * It isa curious example of the "similia  similibus curantur," that the epithet cucurbt-
   ^u. was gTven of old to tapeworm, owing to the rings being  supposed to resemble the
   seeds of the cucurbita.
     » Bouchardat, Annuaire de Therap. pour 1853, p. 301.              901
     « Mr Richard Soule, in Boston Med. and Surg. Journ. Oct. 8, 1851, p. Ml.
     ^ Disi.ensatorv of the United States, 10th edit. p. 1323.   Philad. 1K>4.
     » Amer  Joum. of the Med. Sciences,  July, 1854,  p. 286; and July, 1855, p. 269. 
718                 SUPPLEMENT.—FEL BOVINUM.
left over night, and the whole taken the next day, the patient fasting  in  the
meantime, was successful in expelling ta_nia.
   The seeds contain a  large quantity of fixed oil, and  in  Anjou, in France,
the pumpkin is cultivated less  on account of its  fruit, which is given  to  the
hogs, than of the seeds, of which the oil—called, there, Huile de Terre—is used
as an aliment and for combustion.1  It is probably in the oil that the  taenia-
fuge property resides.   An emulsion, formed  by rubbing  up the seeds with
water and sugar, has  been entirely  successful.   A  case is recorded by Dr.
Henry S. Patterson,2 in which the patient, having fasted for a  day, took, in
the morning, two ounces of the kernels of  pumpkin seeds powdered,  with two
tablespoonfuls of white sugar and half a pint of boiling water.  An hour and a
half afterwards, he took an ounce of oleum ricini,  and, in an hour afterwards,
discharged about eight yards of tapeworm with  the  head.  In  many  other
cases, the remedy, thus administered, was successful.  Dr. Patterson3 then
determine'! to give the expressed  oil; and he has reported a case, in  which
it was prescribed with the happiest result.   The patient, having fasted for
twenty-four hours, f 3ss. of the oil was  given  in  the morning, and  in  about
two hours f gss. more.    In two hours after this f gj. of castor oil was  given,
which purged freely, bringing away a considerable quantity of the worm.
   CXCV.  Fel  Bovi'num, Fel  Bovis, Fel  tauri, Bilis taurina, Ox gall,
Ox bile;  French, Bile  ou Fielde Bceuf; German, Ochsengalle,  Rinds-
gal le.   Ox-gall  is by  no means of modern introduction.   It, as well as the
bile of many other animals, has been employed in medicine  in all ages;4 but,
as its administration appears to have been somewhat revived, it may be worthy
of a  passing notice.  It has long entered into many  officinal pharmacopoeias
and  formularies  of the continent of Europe; and has  been regarded as a
stomachic and anthelmintic.   Fel tauri inspissatum, Extractum Bills seu Fellis,
is referred by Jourdan5  to no fewer than seventeen pharmacopoeias;  and the
Globuli carmiuitavi seu Pilulce bilis are in the pharmacopoeias of Manheim and
Wirtemberg.
   Ox-gall is  a greenish yellow fluid, more or less thick and viscid, of a pe-
culiar, nauseous smell, and a bitter, disagreeable taste.  The chemical cha-
racters of bile, respecting which, as Simon6 has remarked, there is no subject
in the whole domain of animal chemistry that is more perplexing and intricate,
have been given—so far as known—in another work.7   Its uses in theeconomy
have been inquired into in the same.8  The author has there remarked, that
as to  the mode in which the biliary fluid acts on the chyme, we have not much
more than conjecture to guide us; and  that it is more than doubtful, whether
it has the property of soliciting the peristaltic action of the  intestines, so as to
produce the evacuation of their contents.   It was natural, however, that it
should be regarded as a plausible remedy for cases in which  a deficiency  of bile
is presumed to exist, although  it may be by no  means  easy to discriminate
them ; and that therefore it should be given in cases of intestinal torpor, which
have so often been hypothetically regarded  as dependent  upon a deficiency of
secretion from the liver.   Its bitterness, and alkalinity, too, suggested its em-
ployment as a tonic, and antacid.
  Of late years, ox-gall has been strongly advised in various diseases, and often
on very loose physiological and pathological notions.9   Jaundice,  it is known,

  1 Merat and De Lens, op. cit.               2 Medical Examiner, Oct.  1852,  p. 631.
  3 Ibid. Oct. 1853, p. 630.
  * H. Cloquet, Faune des Modecins, ii. 365.   Paris, 1822; and C. Clay, cited in Medico-
Chirur. Rev. July, 1842, p. 279.       5 Pharmacopee Universelle, i. 208. Paris, 1:28.
  6 Animal Chemistry, Sydenham Society's edition, i. 49.  Lond. 1845.
  1 Human Physiology, 7th edit ii. 318.  Philada. 1850.          8 Vol. i. p. 611.
  9 Lincke, Vollstiindiges Recep.-Taschenbuch,  i. 594.   Leipz.  1840. 
SUPPLEMENT.—FEL BOVINUM.
719
 when not owing to organic disease of the biliary  apparatus, generally termi-
'nates spontaneously in health.   Dr. Johnson 1 ascribes the cure of several cases
 to inspissated ox-gall given in the dose  of five grains, gradually increased to
 ten, three times a day; and he explains the action of the  remedy on the prin-
 ciple, that ox-bile  is the  best, substitute which can  be  found  for the human
 secretion;  as if jaundice necessarily consisted in a  deficient secretion of that
 fluid!
   Many years ago, ox-gall was employed by Dr. Copland,2 who speaks highly
 of its therapeutical properties, both when given in clysters, and when combined
 with aloes, taraxacum, soap, extract of gentian, &c, in restoring the healthy
 functions of the bowels, and  digestive organs generally.   One of ihe strongest
 advocates for its use is Dr. Charles Clay/ of Manchester.   He was first led to
 test its powers to relieve pain in cancer, from noticing the fact that Dr. Pea-
 cock, of Darlington, had observed, when the system was  impregnated with bile
 in cancerous affections, that the pain was remarkably relieved. (?)   In a case of
 cancei-ous ulcer, that had destroyed a greater portion of the nostrils, he ordered,
 as a forlorn hope, a mixture composed  of inspissated ox-gall, two  drams; oil
 of caraway, ten  minims; carbonate of magnesia, enough to form a mass,—to
 be divided into thirty-six pills.  Of these, two were given three  times a day.
 Marked relief was afforded after the pills had been  taken for one day; and in
 four the pain had ceased.   He states,  that before giving it in  this case, the
 evacuations were peculiarly white; and the bowels very much constipated, with
 acid eructations.   Dr. Clay, likewise, refers to  its beneficial influence in  dys-
 pepsia.  In all the cases  reported by him, he considered " deficiency in quality
 or  quantity of bilious secretion was the prominent and  prevailing  accompani-
 ment," and he regards the ox-gall to be "not a  cathartic,"  but "a direct sol-
 vent to the accumulated  hardened faecal mass,  the consequence of deficiency
 of quality  or quantity of bile in the alimentary canal!"
    Dr.  Clay observed also, that inspissated  gall has a remarkable tendency to
  counteract the constipating effects of opium.  He recommends it, moreover, in
 all cases of atrophy, whether of children or of adults.  In  acidity of the stomach
 in children, he says, it affords "most decided, effectual, and immediate relief."
 Its action on the system,  is not,  as before remarked, cathartic, but is a mere
 solvent of  the material contained within the intestinal canal, producing no ex-
 citement to propel, but facilitating excretion by liquidizing the  mass.  It is
 also, he says, tonic;  and in children, to a moderate extent, diuretic; but le_s
  bo in the adult.
    The views of Dr.  Clay are, in the main,  concurred in by Dr. R. H. Allnatt,*
  especially  those in regard to the use of ox-gall  in constipation and its effects in
 obviating the constipating tendency of opium.  The latter gentleman» gave it
 in a case of constipation during pregnancy, in the form  of  enema, which suc-
 ceeded in relieving the bowels, after warm  water enemata had  failed.   A dram
 of inspissated ox-gall was dissolved in about a pint  of warm water.   The relief
 was instantaneous :—a mass of scybala being  expelled, which had evidently
  lain impacted  in the colon.  Dr. Chapman,6 also, found it beneficial as "a  laxa-
  tive"  in constipation.
 .  It has  been advised in diabetes mellitus, and was prescribed  by M.  Bou-
 chardat/ not only to aid digestion, but to facilitate the action of the bowels.

   1 London Lancet, Dec. 19, 1840, p. 447.
   2 Art. Constipation  in Diet,  of Practical Medicine.
   8 Op. cit. cited in l.raithwaite's Retrospect, vi. 94. Lond. 184].
   <■ London Lancet, June 7, 1845, p. 635;  and  Lond. Med. Gaz. June 20, 184-., p. o43.
   * London Medical Gazette,  Feb. 6,1846, p, 253.
   « Lectures on the more important Diseases of the  Thoracic and Abdominal Viscera  p.
  301.   Philad. 1844.                      '  Annuaire de Th.rap. pour 18)1, p. 104. 
720        SUPPLEMENT.—INSPISSATED BILE OF THE SWINE.

  The preparation used  by Dr. Clay and Dr.  Allnatt  is  simply the recent
gall of the ox slowly evaporated to the consistence of an extract—the Fel tauri
■inspissatum, Extractum  Bilis seu Fell is ; French, Extra! t de Bile ou de Fiel;
German, Eingedickten Galle.  This may  be made into pills.   One
gall-bladder of a moderate-sized ox, according to Dr.  Clay, will afford as much
extract as will make one hundred  four grain pills, and it  is an article both
cheap and easy to procure.
  Dr. Lane1 desiccates the gall and makes it into  pills.  To desiccate  it,  he
allows it to remain  at the same temperature used in  forming the  inspissated
article, until there remains a dry, bright green, friable, purulent, slightly aro-
matic mass, in which state the substance loses  none of its  medicinal  virtues.
Its  deliquescent character is nearly lost.  It can be easily preserved in closely
stopped bottles, and is readily made into pills, particularly with any spirituous
fluid or essential oil.   M. Blancha has tried both the inspissated and the de-
siccated ox-gall, and very decidedly deposes in favour of the latter as the more
efficacious, and less nauseous.  The pills, too, he says, do not run together as
when made of the inspissated article.
  As an addition to simple clysters it has  been recommended to weak, ema-
ciated, nervous individuals, who are  subject to pains in the bowels.3
  The dose of ox-gall is £ss.  to ^i. in the day, made into pills.

  CXCVI.  Inspissated Bile op the Swine, Bilis Porcina, has been used
in the same cases as  the bile  of the ox, by Dr. Mettauer,* of Virginia, who
thinks its employment as a therapeutical agent original with him.   It has, how-
ever, been long used in medicine,—so long ago as the time of Pliny,5 who  ex-
tolled it in diseases of the spleen.  " At the present day," says M. H. Cloquet,8
" it is, we may say, out of use, and will never, probably, resume  any share of
favour."   It is said  to  contain neither picromel nor any nitrogenized mat-
ter ; but in addition to several salts is formed principally of resin  and soda.  It
differs, consequently,  considerably from the bile of man,  and that  of the ox:
yet, according to Dr. Mettauer, it seems to be adapted for cases of diseases  in
which the biliary  secretion is defective.   " We were induced to resort to it at
first," he says, "in the low depressing states of continued fever, with the design
of acting especially  on the gastro-intestinal mucous membrane, which, we be-
lieved, became disorganized in  such cases in a great measure from the want of
the biliary influences, and in these cases it always acted with decided benefit.
It served to substitute the action  of the bile.   Simply heating the bile over a
sand-bath until it became dry and pulverizable,  was our mode of preparing it.
It is a valuable agent in dyspepsia  and in many  chronic affections attended
with defective biliary secretion.   In chlorosis,  amenorrhoea,  some forms of
dysmenorrhoea, and constipation, we  have also employed it with decided ad-
vantage.   Dr. Mettauer  gave it with  benefit  in  the adynamic stage of fever
above referred to—two or three grains of the inspissated, or more properly de-
siccated,  bile, being associated with one of ipecacuanha, and two of carbonate of
potassa.   "This compound," he says, "seemed to act with decided effect, as a
supporting and secerning remedy upon the mucous membrane of the stomach
and intestines, and  as a diaphoretic at the same time."   It was  especially va-
luable in cases attended with a denuded raw tongue, which always becomes
more healthy after its administration.   In such  a combination, however, it is
obviously impracticable to test  the precise agency of the bile.

  1 London Lancet, July 5, 1845, p. 27.
  2 Cited in Braithwaite's Retrospect, xii. 93, Amer. edit. New York, 1846.
  3 Ann. Therap. Juin,1848 ; and Schmidt's Jahrbiicher, v. s. w. No. 5, S.  160. Jahrgang,
1849.
  4  Amer. Jour, of the Med. Sciences, July, 1843, p. 52.      » Hist. Nat. xxviii. 13.
  •  Faune des M.decins, ii. 377. Paris, 1822.  Also, M.rat and DeLens, Diet, de Mat. M.d.
&c.,art. Sua. 
SUPPLEMENT.—FERRI CHLORIDUM.
721
    CXCVII. Ferri et Alu'min_e Sulphas, Sulphate of Iron and Alumina.
  This salt has been introduced by Sir James Murray,1 of Dublin, as a valuable
  addition to the class of astringent remedies.   The bisulphate of iron and alu-
  mina—as he terms it—is readily  made  by treating bicarbonated solution of
  soft iron and carbonated solution of pure washed alumina with sulphuric acid
  after separating the arsenic and  other  ingredients,  which are too often found
  in the vitriolic acid of commerce.
    Sir James considers this salt to  be a superior astringent in the treatment of
  chronic diarrhoea, dysentery and cholera morbus; leucorrhcea, and the colliqua-
  tive diarrhoea and sweats  of  the consumptive.  It  is  also a valuable  anthel-
  mintic ; destroying the parasites, and  correcting the  morbid condition of the
  alimentary canal, which favours their generation.   Occasional cathartics are
  needed during its administration as an anthelmintic.   Applied externally, it is
  a powerful styptic, and may  be  used in epistaxis,  and in hemorrhage from
  leech bites.  It has been found, too, an excellent gargle  in  relaxation of  the
  uvula and  fauces, in the cynanche of scarlatina; and in diphtheritis.  It
  forms, likewise, a good collyrium; abates salivation, and improves the appear-
  ance, and corrects the foetor  of foul or flabby ideers.   Injections of the salt
  are good astringents in excessive hemorrhage from outlets with which they can
  be made to come in  contact.
     The dose is from five to ten grains in any  aromatic water, or in  molasses.

     CXCVIII.  FERRI Chlo'ridtj.I, F. Sesquichloridum, Ferrum Muriaticum
   Oxydatum seu Muriaticum  seu Pcrmuriaticum seu Muriaticum Rubrum  seu
   Perchloratum; French, Tritochlorure ou Perchlorure de Fer; German, Salz-
   saures   Eisenoxyd, Rothes   salzsaures  Eisen,  Eisenchlorid;
   Chloride, Sesquichloride or Perchloride of Iron. This salt of iron is obtained
   for medicinal purposes, by dissolving sesquioxide of iron in chlorohydric acid.
   It is rarely used, except in the form of the tincture of chloride of iron—Tinc-
   tura Ferri Chloridi—which is officinal in the pharmacopoeia of the United
   States, and in those of various European colleges.   Its properties, as a power-
   ful astringent, are well known; and it has been lately brought forward with
   the  highest encomiums by Mr.  Bell and Dr. Charles  Bell3 of Edinburgh, as
   an internal agent in  the  treatment of  erysipelas.  These gentlemen  affirm,
   that it not only removes the disease in a  short time,  but renders the patient
   less susceptible to its return.  In this  chalybeate treatment,  they consider it
   necessary to bring the system rapidly under  its influence.  It was found to be
\  effectual in idiopathic erysipelas,  as well as in the traumatic form, and in  the
   erysipelas of infants.  Dr.  Ranking3 has recorded a successful  case of  the
   idiopathic form in which  the remedy was  given in the dose  of forty minims
   in water, every three hours.  The improvement was "marvellous."  Dr. Geo.
   W.  Balfour4 had treated twenty cases with  it, and he believes that we have
   now a certain and unfailing remedy, whether the erysipelas be infantile or
   adult,  idiopathic or traumatic.   He gives from ten to  twenty minims every
   two hours, beginning with a cathartic, which is repeated occasionally.
     The evidence afforded in favour of the tincture, from the experience of the
   London  hospitals, is  said to  be  very strong.5
     Owing  to its  good  effects in  erysipelas,  and in anasarca  supervening on
   scarlatina, Dr. Byrd,6 of  Savannah, prescribed it  in scarlatina; and m more

     1 Dublin Medical Press, Mar. 14, 1849.
     2 Edinb. Monthly Journal of  Med. Science, June and July, 1851.
     * Provinc. Med.  and Surg. Journ. July 21, 1852, and Ranking's Abstract, Amer. edit.
   xvi.  108.   Phila.  1853.                  * Edinb. Monthly Journal, May, 1853.
     6 Lond.  Med. Times and Gazette, Nov. 12, 1853.
     6 North-Western Medical and Surgical Journal,  May, 1854.
          46 
122
SUPPLEMENT.—FERRI CHLORIDUM.
than twenty cases, his most sanguine hopes  were realized;  "but it unfortu-
nately happens"—says Dr. Ranking1—"that he did not trust to the steel ex-
clusively, so that no opinion can be formed from  the  reports of these cases.
This much, however, may be  said,  that  there  is  an  a priori probability in
favour of the soundness of  the practice, which ought to lead to a  repetition of
the trial."
   Of late, a concentrated  solution of perchloride  of  iron in water has been
brought  forward for  the radical cure of aneurism.   In the year  185:!, M.
Rayer3 communicated to the  Academie an extract of  a letter from  M. Lalle-
mand, giving an account of experiments  made by M.  Pravaz, of Lyons, on a
new means of coagulating blood in  arteries, which consisted in injecting a few
drops of a solution of perchloride of  iron at  the maximum of concentration.
This was accomplished by means of a fine trocar of gold or platinum, the point
of which was introduced very obliquely through the parietes of the artery by a
rotatory  or kind of drill movement (inouvement de vrillc.)   To this trocar, a
syringe was adjusted, the piston  of which moved by means of a screw, so that
the liquid could be injected steadily, and the quantity be accurately estimated.
The flow of blood in the artery was, at the time of injection, arrested  by means
of pressure above and below.   A few drops were  sufficient—three  or four in
the sheep; six or eight in the horse—to form a solid and resisting clot.
   The experiments  of  M. Pravaz  had only been made on  animals.8  Soon,
however, a case was reported by M. Raoul Deslongchamps of  an  aneurism of
the supra-orbital artery, which  was  treated  with success by it; one  by M.
Niepce of popliteal aneurism ; another, by M. Serre, of varicose aneurism of
the  elbow;* one by Mr. Wm.  Adams of traumatic  aneurism of  the poste-
rior tibial; and M. Lallemand,  at  the meeting of the Academie des Sciences
observed, that the success, which  had already attended the method of M.
Pravaz,  confirmed him in his opinion of its  superiority over all others.  He
was firmly persuaded, that the method of injection would produce as complete
a revolution  in the treatment of aneurism as lithotrity had  produced  in the
treatment  of calculous diseases.  " The first  instruments used in  the latter
operation"—he remarks—"were complicated and imperfect; and, for a long
time, successful cases were  mingled with severe  accidents and numerous re-
verses;  but now lithotrity is not what it was at its commencement.   It will
no doubt one day be the same with the method of M. Pravaz."
   On the other hand, unsuccessful cases have been recorded :—one by M. Vel-
peau of false aneurism at the  bend  of the arm ; one by M. Lenoir of popliteal
aneurism; one by Mr. Soule  of femoral aneurism; and another of  traumatic
aneurism of the posterior tibial; one by M. Alquie of traumatic aneurism of
the ulnar; one by M. Dufour, of carotid aneurism ; and one by M. Jobert.  A
case of varicose aneurism at the bend of the elbow was subsequently recorded
by M. Jobert.5  Two injections were  practised.  The first produced no decided
result;  the second occasioned serious local and constitutional  symptoms, which
subsided, and  the aneurism was cured.   M. Jobert thinks, that the  practice
ought not to be adopted when there are any signs of inflammation or degene-
ration in the sac.

   1 Abstract, xx. 28.  Philad. 1855.
   2 Bouchardat, Annuaire de Therap. pour 1853, p. 213.
   ' For other experiments on animals by  MM. Goubaux and Girald.s, see Comptes Ren-
dus des Seances et Memoires  de  la Societe de Biologie, Ann.e 1854, p. 50.  Paris, 1855,
and Med. Times and Gaz. July 1, 1854,  and Ranking's Abstract, xx. 106.  Philad. 1855,
from Gazette des Hopitaux.
   * Archiv. Generales de Med. Juin, 1853; Rev. Med. Chir. Aout, 1853, and Ranking's
Abstract, Amer. edit., xviii. 120.  Philad. 1854.
  * Comptes Rendus, Juin, 1854, and Ranking's Abstract, Amer. edit. xx. 196. Phila. 1855. 
SUPPLEMENT.—FRAXINUS.
723
  M.  Malgaigne1 is an  opponent of the method.  In  a communication  by
him, he  states,  that of  eleven  cases, then  reported, four had died; all had
had severe symptoms, and  two were  successful;  and he concludes " with  re-
gard to aneurisms, although the possibility of curing them by the injection of
perchloride of iron be placed beyond doubt, the successful cases are so rare,
obtained at the price of  so many accidents, and  counterbalanced by so many
reverses, and even  by deaths, that at present, I think, no  prudent surgeon
could expose his patient to the results  of  such a  disastrous mode of treat-
ment."
  M. Follin, in  a case of varicose veins of the leg, caused obliteration of the
saphena  by the  injection of  the perchloride; and M. Degranges reports  six
cases  of  the  same kind, in five  of  which the veins were obliterated without
any particular accident;  in the sixth, however, inflammation supervened, and
the patient died.3  Mr. Cooper Forster4 has  succeeded in two cases of ncevus,
and several others are in  progress.   The perchloride produced coagulation with
little or no inflammation.  There was some increase of size in the tumours,
and a hard clot  was formed, which was slowly absorbed, leaving the vascular
tissue of the naevus quite obliterated.
  The perchloride has, likewise, been employed by M. Remilly,5 to arrest  the
hemorrhage, which so  frequently accompanies cancer of the neck of the uterus.
He administers it in injections, of the strength of 15 parts of the perehloride
to 250 parts of water,—the quantity usually required being  about five drams
English.
   M. Lusanna6  has published a case of aneurism of the external  maxillary
artery, successfully treated by an injection of a solution of the acetate of per-
oxide  of iron, which, according  to M. Ruspini, is more efficacious and less
irritating than other coagulants.  The case was reported to the Academie  des
Sciences, of Paris.

   CXCIX.   Fraxinus,  F.  excelsior, French  Frene; German,  Asche,
Esche.  Common  European Ash.   The  bark  of this tree, of  the  order
Oleacea., Sexual System, Polygamia Dicecia, is bitter and astringent; and was,
at one time, employed in the treatment of intermittent fever.   Helwig, indeed,
regarded it as  eminently febrifuge,  and called it, in consequence, the  "cin-
chona of Europe."7  It had fallen, however, into complete disuse, and is  not
even referred to in many of the modern works on  the  Materia Medica; but,
of late,  the leaves have been strongly recommended in  gout and rheumatism,
as they had formerly been as an antidote to serpent  bites, and in the treatment
of scrofula.   As  M. Bouchardat8 has remarked—" multa renascentur quce
jam cecidere."   Since their introduction  into notice in January, 1841, by
Rademacher,  they  had  enjoyed some  reputation  in gout and  rheumatism,
but were not much known elsewhere, when M. Larue9 prescribed them in per-
manent and almost general rheumatic gout, in the case  of his mother, in  the
year  1840, and with complete success.  Since that time, he has given them

  1 For the M.moire of M. Malgaigne, see Jamain and Wahu, Annuaire de .led. et de
Chir. Prat, pour 1854, p. 131.
  2 For a history of the evidence for and  against the method up to that time, see Assoc.
Med.  Journ. Dec. 9, 1853, or Amer. Journ. of the Med. Sciences, April, 1854, p. 501.
  3 Edinb. Monthly Journ. of Med. Science, Dec. 1853, and Jan., 1854.
  * Lancet, Dec. 24, 1853.
  5 Bullet, de Th.rap. 1854, and Med.  Times and Gazette, Feb. 25, 1854, and Ranking,
xix. 185.
  6 Gaz. Hebdom. de Paris, 25 F.v. 1854, and Ranking's Abstract, xix. 110. Phila. 1854.
  7 Chaumeton Art, Frene, Diet, des Sciences Medicales, xvii. 5.  Paris, 1816.
  8 Annuaire de Therap. pour 1853, p. 115.
  9 Journ. des Connois. .led. Chirurg., and Bouchardat, p. 106. 
724
SUPPLEMENT.—HiEMOSPASIA.
repeatedly and in every form of gout and rheumatism—acute, chronic, ambu-
lant, vague or fixed, and, most commonly, with entire success.  By MM. Pouget
and Peyraud,  Fraxinus is esteemed as a " true specific " in those diseases, more
valuable than  colchicum, because it has  not  the inconveniences  which follow
the use of that drug; and they affirm, as the result of a sustained observation,
that,  generally,  at the end of  four  or five days, and  at  times sooner, the
pain,  redness and swelling sensibly diminish; if, as most commonly happens,
they have not already  disappeared.
  Similar testimony  is afforded by M.  Mouchon.1   The mode  of administra-
tion is  minutely detailed by MM. Pouget and Peyraud.   Each dose  of the
powder of one gramme (gr. xvss.) is infused for three hours, in two cupfuls  of
boiling water.   The  infusion may then  be strained and sweetened.   In a case
of acute gout, and especially at  the commencement  of  the  attack, two doses
ought to be  infused in three cups of water, one of which may be taken at night
on going to  bed; another in the morning, in bed or on rising, and the third
in the middle  of the day,  between the  meals.  The treatment must be con-
tinued for eight  days after the disappearance of the symptoms,  in the quan-
tity of a single dose of the powder to two cups of infusion.   In  chronic gout,
it will be sufficient to give  two cups of infusion in the day—one in the even-
ing, and the other in the morning; but  the treatment must be continued for
a longer time.2
  Under the  direction of  Dr. Hillairet, M. Collas has, for many years, pre-
pared an extract of the green leaves of the ash, which, in the dose of from 20
to 50 centigrammes (gr. iij. to gr. viiss.), removed, with tolerable rapidity, an
attack of recent  gout.   Its internal use was aided by the application of an
alcoholic solution of  the extract to the affected part.3

  CC. H_emospa'sia; French, Hemospasie.   This is a mode  of  revulsion
which has been strongly urged of late years by  M. Junod,  for his essays on
which he has  twice  received the  Monthyon prize.   It has been properly de-
scribed as a  means for producing a powerful derivation of the blood from one
part of the body, by  removing the atmospheric pressure  from a large extent of
surface, as from  one  or both extremities.  It is,  as the author has expressed it
elsewhere,4 dry cupping on a large scale.
  An air pump bath has been employed, in which the atmospheric pressure  is
diminished over  a greater or less surface of the body, and the application of va-
pour has been associated with  this,  constituting the air pump  vapour bath,
which has been  used in gout, paralysis and  other  affections.   In 1S32, Sir
James Murray5 gave a description of an apparatus for abstracting part of the
atmospheric pressure from almost the entire surface of the body.   For the pur-
pose of insulating the patient'sbody from the external air, a small oval bath of
tin, zinc, or copper, was employed by him,—its lip  furnished  with a groove
to contain luting for connecting the lid  or cover.  In this  lid is an aperture
to pass over  the  patient's head,  and around this opening is fitted a margin of
air-tight cloth, which applies itself so as to embrace the top of the chest and the
back of the  neck.  The patient sits upon a seat, with his head uncovered, the
body and limbs only being  enclosed.   When the bath is thus adjusted it is to
be partially  rarified, either  by the  condensation of a little hot air or steam, or
by a few strokes of a suction pump.6
  1 Bouchardat, Ibid, pour 1854, p.  72.
  2 See on the therapeutic properties  of the bark, leaves, seeds, and root of the com-
mon ash, Assoc. Med. Journal, Jan. 7, 1853, and  Amer. Journ. of the  Med. Sciences,
April,  1853, p. 492.          3 Bouchardat, Annuaire pour 1853, p. 120.
  * General Therapeutics and  Mat. Med. 5th edit. ii. 207.   Philad. 1853.
  5 London Medical and Surgical Journal, July 14, 1842.
  6 Observations on the Medical and Surgical Agency of the Air-pump, p. 41. Dub. 1836. 
SUPPLEMENT.—HJEM03PASIA.
725
   At a meeting of the  south-western  branch of the Provincial  Medical and
 Surgical Association held  at  Plymouth in 1844,  Dr. Marsden1  exhibited M.
 Junod's apparatus for exhausting the  air over a large surface, or for his " Sys-
 tem of Dry Cupping," as it has been  termed.  It is made of copper,  in  the
 shape of a boot, and is applied as  one, having an India  rubber tip to tie around
 the thigh, and render it air-tight.   The air is then exhausted with a syringe.
 By the application of this apparatus, the leg  may be distended  to double its
 ordinary size :  the pulse is at first quickened, but is gradually reduced  both in
 frequency and strength, and even syncope may supervene.  Very little pain
 attends the operation.  After the removal of the apparatus, the blood  gradu-
 ally returns to its course,  and in a couple of hours the swelling of the leg sub-
 sides.   Experience has proved that sixty operations on the same leg, with one
 or two days of interval, may be attended with no injurious effects on the  ner-
 vous system.   Dr. Marsden described  an  establishment under the superinten-
 dence of M. Bonnard, of  Paris, entirely devoted to the application of this in-
 strument.   He referred to the success which had attended its employment by
 M. Cerise, and detailed the histories of several cases in which he had  himself
 witnessed beneficial results,—as of amaurosis, deafness, sore  throat, chlorosis,
 amenorrhoea, croup, phthisis, &c.  In 1835, M.  Magendie greatly  extolled  it
 in cases in which it is important to attract the blood from the  internal parts
 towards the surface of the body without causing any loss of the vital fluid;—and
 its effects certainly entitle it to great attention.  It has  been objected, that when
 the apparatus  is removed  a violent reaction  will ensue, and the  blood  be  pro-
 pelled with greater force  than ever to  the seat of the  disease;  but the results
 of experience  do not confirm this;  "for as the hsemospastic  injection  or  ple-
 thora takes place chiefly  in the capillary vessels,  the turgescence induced by it
 is found to subside very  slowly and gradually."%
    M. Junod3 exhibited  his. apparatus before  the Edinburgh Medico-Chirur-
  gical Society  in  May, 1853; and  remarked, that by  means of one, modified
 so as to be adapted to the shape of the lower limb, he had  been able to dis-
 place six  or eight  pounds of blood  at a time with perfect success;  and  to
 effect, by hsemospasia, the circulation to  an extent equal to that of a general
 or local bleedina;, whilst " it was not  spoliative in its effects."
    Dr. ArogeD found, when the apparatus was used on the leg, the effect was
 much the°same as that of venesection ; and he  considers it preferable to the
  latter in  the  great number of cases, which exhibit  the  phenomena of  local
 congestion, or inflammation in non-plethoric, or in oligaemic persons.  The dis-
 appearance of redness and swelling in hyperaemic and inflammatory affections
 of  external parts—as in ophthalmia  and erysipelas  of the face—was otten
 striking   In pneumonia, its good effects were  very  marked ;  and it is espe-
' cially recommended by him in internal hemorrhage, and in organic diseases
  of the heart.                                             .     , .   , ,-, ,
    In Belgium, this powerful revellent appears to be so much used in  ophthal-
  mic  medicine, that M. Warlomont5  was  surprised, on theoccasion of a visit
  to  Eno-land, to find  no use made of  it there for  combating  the  congestion
  so  ofte°n  noticed after the  operation  for cataract.    Whenever a person has
  been operated on, and manifests the least  tendency  to reaction, Junod a ex-
  hausting boot is immediately applied.  It is renewed  two or three times daily
  and sometimes oftener-frequently inducing syncope, whilst the loss  of blood
  is avoided.  M. Warlomont strongly recommends it  not only  in  sucn cases,

    1 Provincial  Mod. and Surg. Journal, July 10, 1844 p. 224
    » Gazette Medicale, cited in Med.  Chir. Rev. Jan. 1844, p.-81.
    ' Edinb. Monthly Journ.  of Med.  Science, July, 18o3, p. bi.
    * lllustrirte Med. Zeitung, 1852,  No. 1.           „ ,  ...  -    n. .„„ _ ^aa
    5 Annales d'Oculistique, xxxiv. 12, and  Brit, and For. Med.  Chir. Rev.  Oct. 1855, p. o44. 
726
SUPPLEMENT.—HiEMOSTASIS.
 but in many others in which powerful revulsion is indicated,—in cases of con-
 gestive amaurosis,lox example.
   The effects of hromospasia resemble those of hgemostasis; the diminished pres-
 sure, induced over a greater or less surface, must not only affect the circulation,
 but induce a new action in the nervous system, and hence  act as an energetic
 revellent.

   CCI.  HiEMOs'TASis; French, Hemostase, Hemostasie; Germ. Stockung
 des  Blutes in den G e f a s s e n, has been long used to signify "stagna-
 tion of blood," and also  any agency which  arrests the flow of blood;  but it
 has been applied by Dr. Thos. Buckler, of Baltimore,1 to a  particular mode of
 arresting the flow of blood in the superficial vessels, which  he brings forward
 as a novel therapeutical agency.
   It  has been long the custom at the commencement  of the cold stage  of in-
 termittents to apply ligatures—as the tourniquet,2—to the extremities; and
 this unquestionably has appeared,  in many cases,  to give occasion to a subse-
 quent, mild, hot stage, and abridged duration of the whole paroxysm.   As to
 the mode in which the ligature of vessels acts under such circumstances, there
 has been difference of sentiment.  By some, as by  Dr. Kellie, it has been sup-
 posed, that the  obstruction to the circulation in the veins of the extremities
 causes an accumulation of blood in these vessels, and a consequent increase in
 the action  of the heart; but the true modus operandi is probably that suggested
 by Dr. Mackintosh;3  the tourniquet or ligature, by confining the blood in the
 extremities, "prevents so much, at least, of the congestion in internal organs;"
 and in this manner exerts an analogous effect to the withdrawal  of the same
 quantity of fluid from the vessels.  A case described by Sir Geo.  Lefevre, and
 referred to elsewhere,4—in which a disposition to syncope in the erect attitude,
 appeared to be owing to varicose veins of the lower extremities  robbing the
 brain  of its usual quantity of blood, and which was prevented by  the applica-
 tion of appropriate bandages,—is confirmatory of this view of the subject.
   Dr. Buckler applies his ligatures upon one or more of the extremities, ac-
 cording  to the effect which he desires to induce.   If a  bandage,  he remarks,
 be applied around a limb sufficiently tight to arrest completely the venous cir-
 culation, and at the same time allow the arteries to pulsate, the blood within
 the distended vein is cut off, as it were, from the general circulation ; a deple-
 tory effect is in this manner induced, and if the arrest  of  the venous circula-
 tion  be  practised on all  the extremities  at once, the skin becomes relaxed;
 the force of action of the heart and arteries is weakened; and if the ligatures
 be applied when the heart and arteries have been deprived of a portion of their
 ordinary amount of blood, owing either to anaemia  or  to bleeding, so that the
 vessels are partially empty, it is found, according to Dr. Buckler, that the ex-
 halants of the skin pour out the most copious  perspiration,—that  the  patient
. complains  of a feeling of lightness in  the  head; of weakness  and sickness of
 the stomach; and if the carotids be  pressed upon, they arc found to be scarcely
 pulsating,  and all the phenomena of syncope supervene.
   An agent possessed of such powers at once  suggested itself as  a valuable
 remedy in the phlegmasia^ more especially; and it has been so urged upon the
 attention of the profession by Dr. Buckler.  He considers it capable of exert-
 ing, under  given conditions, a more powerful control over the  circulation than

   1 Maryland Medical and Surgical Journal, March, 1843, p. 265.
   2 Kellie, Annals of Medicine, vols. i. and ii.
   3 Principles of Pathology and Practice  of Physic, 2d Amer. edit, by Morton, i. 155.
 Philad. 1837.
   * The author's General Therapeutics and Mat. Med. 5th edit. ii. 186.   Philad. 1853. 
             SUPPLEMENT.—HYDRARGYRI ET QUINLffi, ETC.         727
        (
the lancet, antimony, or digitalis,—controlling the action cf the heart, with-
out exhausting the vital forces, or giving rise to any other inconvenience.
   Many cases are brought forward by Dr. Buckler, in elucidation of the bene-
ficial action of haemostasia, and its power of sedation.  He suggests, also, ano-
ther application of it—bandaging the extremities, from the fimrers to the toes,
in cases where an individual has lost so much blood, that there is only enough
left in his system to supply the organs essential to life—the heart,  brain, and
lungs,—and to the extremities of a uremic females in protracted labour, where,
owing to the pressure of the uterus on the iliac veins,  so much is cut off from
the central circulation, as to deprive the brain of its normal supply, and thus
render the pains weak, feeble and inefficient.

   CCII. Htjra Brasilien'sis, Assaeou, Assacii or  Ussach, is a  poisonous
tree of Brazil, belonging to  the family Euphorbiaceae,  the juice of which, and
the decoction of its bark, cannot be  employed without danger, in a high dose.
The juice is anthelmintic, and at Santarem, in Brazil, the bark is given in
elephantiasis, and at Para, the natives regard it as a  specific in  lepra.  The
physicians of Brazil administer the extract of assaeou in pills, in the dose of
a sixth of a grain to a grain in the day, gradually augmenting it still farther.
They have also prescribed it as a drink in the form of infusion—a scruple of
the bark to a quart (pinte) of water; and in baths.  When given in too large
a dose it excites vomiting.
   Hebra,1 of Vienna, has prescribed the decoction (f^iss. to f §vj.) with suc-
cess in cases of chronic cutaneous diseases, especially psoriasis.
   The bark—Casca de Assacii—is hard, thick, of a grayish colour, and ino-
dorous : the epidermis is covered with a lichen of the genus  Lecanora.2  It
had not been subjected to investigation until of late, when having been taken
by a leper to Saint-Marie-de Belem,  Para, it was examined by a commission of
medical men appointed  by the authorities of the country, who reported upon
it favourably as a remedy in  lepra.   The  results were communicated by Dr.
Malcher, through the French consul  at Saint-Marie-de  Belem, to the Academie
de  Medecine, of Paris;  to  which body M.  Gibert  reported, that  the active
properties of assaeou, and its marked effects on the solids and fluids, and espe-
cially on the diseased skin,  and the acrid  emetic and cathartic  properties  it
possesses, prove it to be a powerful  remedy, and encourage hopes  that it has
the remedial powers ascribed to it by the Brazilians.
   M. Bouchardat3 is of opinion, that if introduced into the pharmacies, it may
render great service to therapeutics.

   CCIII. Hydrar'gyri et Qui'ni_e  Protochlo'ridtjm.  A combination of
mild chloride of mercury and quinia, has  been prepared by Mr. M'Dermott,
which bas been found beneficial in  some obstinate  skin diseases that had re-
sisted other remedies.   The bichloride employed in the combination is said to
perform the part of an acid,—the  alkaloid  quinia  forms the base; hence  a
double salt, a protochloride of mercury and quinia, is obtained—not mechani-
cally, but chemically combined.  On subjecting it to the  strictest analysis, no
trace of the bichloride could be detected.4   Several  cases are reported by Mr.
Hamilton, which had  been treated  at the Bichmond Hospital, Dublin.  A
grain  of the protochloride was given three  times a day.   In a case of lupus
superflcialis of the arm of a labourer, aged forty, a rather profuse salivation
set in when twenty-one  grains had been taken.  A great improvement, how-

  1 Canstatt's Jahresbericht, 1850, 5 Bd. S. 150, and Ibid. 1851, v. 89.
  2 Merat and Gibert, Journal de Pharmacie, xiv.  422.
  ' Annuaire de Therapeutique pour 1849, p. 71;  and Ibid, pour 1850, p. 26.
  4 Dublin Medical Press, No. 275. 
728
SUPPLEMENT.—INUNCTIO.
ever, had occurred in the local disease.   The  medicine was omitted for a few
days, and then reaimed in the dose of a grain night and  morning.  He was
cured,—nothing but a simple dressing having  been applied to the ulcers.   The
disease had exhsted twelve months before the treatment was commenced.

  CCIV. Ibe'ris  Ama'ra, Bitter  Candytuft;  French, Passcragc; of the
Family Cruciferas, is found plentifully in the  gardens of Great Britain, where
it is cultivated for  its brilliant milk-white flowers.  According to Dr. Silvester,1
it was known to the ancients, and is mentioned  by Pliny, Aetius, Paulus of
__Egina, and  Oribasius, by whom it  is extolled as an excellent  internal and
external remedy in  various diseases.  It  may admit, however, of question,
whether the  chapter in Aetius, headed  "De  Iberide  sive Cardamine qua. et
Lepidium vocatur,"2 refers to the plant in question.  Mr. Adams regards the
Lepidium of Paulus to be Lepidium latifolium or Pepperwort.
  The leaves,  stem  and  root of Iberis  amara, appear to  possess similar pro-
perties ; but  from  convenience and  greater relative strength, the  seeds were
chiefly employed.  Dr. Williams, of St. Thomas's  Hospital, London, appears
to have brought to light  the properties of the plant, in a course of therapeu-
tical researches at that  hospital.   He  observed its good  effects in asthma,
bronchitis,  dropsy, and more  especially in hypertrophy of the  heart.  It did
not seem to diminish the velocity of  the heart's action  like digitalis,  but  con-
trolled the violence and sharp action of the organ, and softened the pulse: hence
its great value in  hypertrophy with  dropsy.   Dr. Silvester had  prescribed it
for  ten years in numerous cases of the diseases above mentioned, "always with
some benefit, and sometimes with almost magical efficacy."  Its properties ap-
peared to him to be analogous to those of digitalis and belladonna.  It occasion-
ally caused sickness, giddiness or diarrhoea; but its control over the abnormous
action of the heart was equally evinced, whether these effects were present or
absent.
  Iberis amara was prescribed in powder in the dose of from one to  three
grains, generally mixed with bitartrate of potassa, which concealed the nause-
ous taste, and secured a perfect trituration and division of  the tough seed.

  CCV. Inunc'xio, Inunction;  French, Inonction;  German,  Einschmie-
rung, Fetteinreibung. A few years ago,  M. Schneemann3 strongly recom-
mended that the patient, in cases of scarlatina, should be rubbed, every morn-
ing and evening, over the whole  body, with a piece of bacon, in such a man-
ner, that, with the  exception of the face and  hairy scalp, a covering of fat
should be every where applied.   It alleviates, he says, or  arrests the dry brit-
tleness of the skin, and the tormenting itching;  keeps the skin in  a condition
to perform its important functions, which are  greatly interfered with by the
diseased condition that exists  until a new covering is prepared for the surface ;
promotes, in this way, the oxidation of the blood;[?] shortens the  period of des-
quamation, and protects against  the sequelae of the  disease.   Such are the
grounds on which inunction  was advised by Schneemann; and his sugges-
tions were followed  by Mauthner,4 the founder of the Children's  Hospital at
Vienna, who obtained great success in scarlatina from inunction of the whole
surface with lard, and was convinced, that  desquamation  takes  place  more
readily, and  that  there is less risk of  consecutive  anasarca.  It appeared to

  1 Provincial Medical and Surgical Journal, July  28, 1847.
  2 The Seven Books  of Paulus  _Egineta, translated,  &c, by Francis Adams.  Syden-
ham Soc. edit. iii. 212.  Lond. 1847.
  3 Lond. Journ. of Med., Sept. 1850, and Ranking's Abstract of the Med. Sciences, xii.
26, Amer. edit.  Philad. 1851.
  * E.v. Med. Chir. Janv. 1849,  and Ranking, ix. 27.   Philad. 1849. 
SUPPLEMENT.—INUNCTIO.
729
him, also, that the process prevented the spread of  the disease in  the family,
if  it were  used as a prophylactic.   Mr. Wm. Taylor,1 too, strenuously advo-
cates the  great  advantages to be derived, in all types of fever, in scarlatina,
meashs, &c, by the free inunction of the surface with an ointment, consisting
of equal portions of lard and suet.   It reduces, he  says, the force and fre-
quency of  the pulse, and, when employed early, wards off the typhoid condi-
tion.   The dryness and brownness of the tongue disappear with the saturation
of the skin;  the patient generally falls into a  sound sleep, delirium subsides,
" and,  in fact, all the symptoms  improve with a steadiness and  rapidity not
seen in other methods of treating fever."
   Ebers,2 of  Berlin, speaks favourably of the  treatment from  actual  experi-
ence.   Dr. Walz 3 employed the frictions after Schnecmann's  method in  343
cases of measles; 57 of which were severe.   All were cured very speedily.
In 30 of these cases, the patients were tuberculous, and the progress  of the
phthisis was arrested; and Dr. Evans,* of Chicago, has treated measles success-
fully by the same method.  In a number of cases the relief was uniform  and
prompt.
   Dr.  Caspar Morris5 is by no means in favour of it, especially as first  recom-
mended by Schneemann, although he says it is " highly lauded by some of his
professional friends."   He thinks whatever benefit  may accrue from it can be
ascribed only to the  soothing influence of the unctuous application to the skin.
It is difficult,  indeed, to see how it can operate in any other manner.   Judi-
ciously employed it may be a useful adjuvant in a disease, which is apt, however,
to run its course without being materially influenced by medicine; and whose
tendency, in mild epidemics, is to terminate in health.
   Inunction with fat has  been recently urged,  on high authority, as a remedy
in scrofulous and tubercxdous cachexia.  Professor Simpson,6 from evidence
collected from various  parts of Scotland, concludes, that children and young
persons employed in wool factories, in which large quantities of oil are used
daily, are  unusually exempt from scrofulous  diseases, and  from pulmonary
consumption.   He considers  the  immunity to  be owing to the oily particles,
which,  floating  in the atmosphere,  or attached to the raw material, enter
the system by the  lungs or  skin, and has prescribed  inunction—as he in-
formed the author—most beneficially in the  way of prophylaxis, as well as of
curative treatment.   Dr. Theophilus Thompson,7 too, remarks in his Lettso-
mian lecture on  the  treatment of pulmonary phthisis, that  if hereditary ten-
dency  to the  disease exists in any family, it is of great importance to  antici-
pate the " pulmonary era," and to introduce oleaginous medicines at an early
period.  The  practice of  daily inunction with  preparations  of  neat's  foot oil
or coco-olein  might,  he  conceives, prove of peculiar  efficacy.8
   Dr.  Baur9 has reported the great success in  certain cachexia?, which has fol-
lowed the use of friction of the whole surface of the body night and morning
with a sponge imbibed with tepid oil, the  patient being kept in bed wrapped
in a blanket for two hours afterwards.  The first effect  is  copious  sweating ;
and a secondary result is  soothing—as manifested  by the production of tran-

  1 New and Successful Treatment of Febrile and other Diseases, through the medium
of the cutaneous surface, Lond. 1850, and Ranking,  op. cit. xii. 104.
  2 Revue Med. Chir. Aout,  1851, and Ranking, Op. cit. xiv. 190.  Philad. 18<>2.
  s Schmidt's Jahrbuch, April, 1853, and Brit, and  For. Med. Chir. July, 1853, p. 282.
  4 North Western Med. and Surg. Journ. Nov. 1850.
  * Med. Examiner, July, 1851, p. 424.
  6 Monthly Journ. of Med.  Science, April, 1853, p. 37G,  and October, 1853, p. 31b.
  T Lancet, Aug. 5, 1854.
  8 See Oleum  Morrhu..;  and J. H. Bennett, The Pathology and Treatment of Pulmo-
nary Tuberculosis, p. 65.  Edinb. 185:?, or Amer. edit.  Philad. 1854.
  9 Rev. Med. Chir. 1855, in Med. Times and Gazette, Sept. 8, 1855. 
730
SUPPLEMENT.—LITHIiE CARBONAS.
quil sleep.   He noticed, too, increased secretion from the kidneys and liver.
Dr. Baur esteems these frictions to be  possessed of almost " specific " proper-
ties in diseases of scrofulous origin—as tabes mesenterica and glandular swell-
ings.   He believes, also, that they are valuable auxiliaries in scrofulous hydro-
cephalus, and  that they may even prove curative in phthisis, if steadily perse-
vered in.

   CCVI.  Leukolei'num, Chinoleinum, Leukol, Leucoleine, Leukoleine, Leu-
colein, Chinoleine, Chinolein,  Chinolin.   This substance has not been found
ready formed in nature.   A. Hoffmann obtained it as the  product of the dry
distillation of  coal, mixed with picolin, anilin, and other substances,  in mine-
ral tar.  Subsequently, it was procured by Gerhardt and Bromier,  by heating
quinia, cinchonia, and strychnia with as concentrated a ley of potassa as could
be made.   In whatsoever  manner obtained, it is  heavier  than water; of an
oleaginous consistence; and, in the state of  purity, is completely colourless,
and limpid as water.   Its specific gravity is 1.081; and it is slightly soluble
in water, and miscible in all  proportions  with  alcohol, ether, and  essential
oils.1  Wertheim  prescribed it internally in combination  with sulphuric acid
—the pure leucolein being dissolved in a very small quantity of pure sulphu-
ric acid.  Externally, he applied a solution  of pure leucolein in  a small quan-
tity of alcohol, diluted with a considerable quantity of water.   The most evi-
dent effect produced by leucolein is on the pulse, which, like conia, it depresses.
Wertheim affirms, however, that conia acts  in this manner when the pulse  is
full and hard; and when  the fever has a sthenic character;—leucolein on the
contrary, when the pulse  is feeble and  accelerated, and the fever assumes an
asthenic character.2
   Like conia,  it has  been given in intermittents  as a substitute for the sul-
phate of quinia; but observations thus far made are inadequate to fix its thera-
peutical value.3

   CCVII. LiTn'l_E Car'bonas, Lithium Carbonicum, Carbonate of Lithia;
French, Carbonate  de Lithine;  German,  Kohlensaures  Lithon oder
L i t h i o n.  This substance has been found  in various mineral waters, as those
of Toplitz, Franzensbad, Marienbad, Karlsbad,  some  of  which  have proved
serviceable in calculous affections.   This fact suggested to Mr. Ure,4 as it had
done to Lipowitz, to investigate the solvent  powers of carbonate of lithia with
reference to lithic or uric acid and its compounds,  at the ordinary temperature
of the human body ; and he found that its solvent power is more than double
that of carbonate of potassa or borate of soda, and about eight times that  of bi-
carbonate of soda, which is the active ingredient in the Vichy water.   An ex-
periment was made on a human urinary calculus, composed of uric acid with
alternate layers of oxalate  of lime.   It  was allowed to stand for four hours  in
two  ounces of the natural Vichy water, from the Hopital  spring, which con-
tained  three grains  and  a half of carbonate of soda ; when it was  found  to
have parted with two-tenths of a grain of uric acid; whilst a portion of the same
calculus, placed under precisely similar circumstances, at the same time, in a so-
lution of gr. 1.6 of carbonate of lithia to two ounces of distilled water, afford-
ed nine-tenths of a grain of uric acid;  thus demonstrating  its superior sol-
vent agency.   Mr. Ure is of opinion, that of all the various menstrua hitherto
recommended, none  appears to promise more favourably than the  carbonate of
lithia, from the promptitude and energy with which, in dilute solution,  it  at-

   1 Fownes, Elementary Chemistry, 3d Amer. edit, by R. Bridges, p. 437.  Philad. 1850.
   2 Bouchardat, Annuaire de Therapeutique pour 1850,  p. 177.
  s See Conia, p. 714.
   * Pharmaceutical Journal,  iii. 2, and Medical Examiner, Oct. 28, 1843, p. 250. 
SUPPLEMENT.—LUPULINA.                  731
tacks calculi of the uri* acid description; and he adds, " If by means of injec-
tion we can reduce a stone at the rate of a grain or more an hour, we shall not
merely diminish the positive bulk  of the calculus, but  farther loosen  its co-
hesion, disintegrate it, so to speak,  causing it to crumble down  and be washed
away in_the stream of the urine."
  The extreme scarcity of the  carbonate of lithia has prevented it from being
much employed in practice.  It may be obtained by adding a strong solution of
carbonate of ammonia to a solution of either sulphate of lithia or chloride  of
lithium; or by decomposing sulphate of lith in by acetate of baryta, and calcining
the acetate of lithia formed, which  is thus converted into the carbonate.  As
usually met with, it is a white powder, like carbonate of magnesia; has a slightly
alkaline taste; and is soluble both  in hot and cold water,  but  insoluble in al-
cohol.   About 100 parts of cold water dissolve one part.
  It has been suggested as an internal remedy in lithuria;1 and, according  to
Aschenbrenner,2 may be given  in the dose of from five to ten grains in the
day.

  CCVIII. Lupuli'na,  Lupulinum,  Lupulin, Lupulinic  glands; French,
Lupuline; German, Hopfenmehl, Hopfenstaub.  Of this substance,
presumed to possess all the virtues  ascribed to the hop, the author has spoken
in another work.3  As a bitter tonic he has made favourable mention of  it, but
as a hypnotic both it and hops  have disappointed him.   It is introduced here,
however, in consequence of its having been brought forward in a new relation.
Some years ago,  Dr. Wm. Byrd Page4  introduced it to a limited  extent  into
the Blockley Hospital as a preventive of nocturnal erections in  different forms
of acute venereal disease.   It was  successful in  the prevention of chordee;
and by preventing erection in acute gonorrhoa, it  exercised  a soothing in-
fluence on the inflamed urethra, and facilitated the operation of curative agents ;
relieved the troublesome perineal pain in chronic gonorrhoea, and during the
treatment of stricture by the  bougie  prevented the  occurrence of erections
during treatment of chancres of the male organ, which interfere so much with
the process of cure;  and after  the  operation for phimosis, had an excellent
effect in the same manner.  In  spermatorrhoea it prevented  the occurrence of
nocturnal emissions so long as the patient was freely under its influence.  Dr.
Page refers to Dr. F. G. Smith, and Dr.  Edward  Hartshorne,  in confirmation
of its antaphrodisiacal virtues. The dose he prescribes is from five to ten grains,
to be repeated as occasion may  require.   The latter dose rarely requires a re-
petition during  the night.   It  has been used in the same cases by M. Zam-
baco;5 and with great success;  and, as a tonic, he has prescribed it with  advan-
tage in strumous affections.   M. Debout  extols it highly  in spermatorrhoea;
inferring, from the results of one case, however, " that doubt can no longer  be
permitted in regard to the action of lupulin." 6
  M. Bouchardat gives formula) for the preparation of a tincture, an alcoholic
extract, a syrup, a saccharure, a gclee, and an ointment, of lupulin.   The lat-
ter, he says, is slightly excitant from the odorous resinous principle which it
contains.7
  Lupulin may be  given in powder or pill.  It causes no  headache,  con-
stipation, nervousness, or any other unpleasant  consequence.

  1 Pereira, Elements of Mat. Med. and Therap.  3d edit. p. 571.  Lond. 1849.
  2 Die neueren Arzneimittel, u. s.  -w. S. 178.   Erlangen, 1848.
  8 General Therapeutics and Mat. Med. 5th edit. i. 416.  Philad. 1853.
  * Medical Examiner, May, 1849,  p. 284.
  5 Bull. Gen.ral  die  Therap. 30 Aout, 1854, and Amer. Journ.  of the Med. Sciences,
April, 1855, p. 512.
  e Bouchardat, Annuaire de Tlu'rap. pour 1855, p. 63.             ' Ibid. p.  i 3. 
732             SUPPLEMENT.—MANGANESII SULPHAS.
   CCIX.  Mangane'sii Sulphas,  Manganum  Sulphuricum  Oxydulatum,
 Sulphas Manganesii seu Manganosus, Sulphate of manganese ;  French, Sid.
fate  de manganese;  German,  Schwefelsiiures  Manganoxydul.
 The salts of manganese have been employed chiefly as external remedies in cu-
 taneous diseases; but they have almost fallen into disuse.   " The sulpjiate  of
 manganese"—say MM. Merat  and  de Lens,1 "appears to  have been used
 externally, under the form of ointment, in the treatment of cutaneous diseases ;
 but on this head, as on the whole therapeutical history of the preparations  of
 the metal in question," [manganese,]  "we may say, that we have many more
 assertions than  proofs;  many more  chimerical views, based  upon the large
 quantity of oxygen,  which the oxide of manganese is supposed  to be able  to
 furnish to the living economy, than well  observed facts or truly practical de-
 ductions."
   By the Germans,  this salt—which  may be obtained  by dissolving carbonate
 of manganese in diluted sulphuric acid, filtering and evaporating the solution
 so as to yield crystals—has been given internally in syphilitic affections, and in
 chronic cutaneous diseases, in the dose of two or three grains [!] in watery so-
 lution.   It has  been used also externally in itch, in the form of ointment, made
 of a dram of the salt to an ounce of fresh, unsalted butter—a piece of the size
 of  a bean being rubbed on the affected part four times a day.2  Dr. A. Ure,3
 who has proposed many articles as therapeutical agents on chemical  considera-
 tions chiefly, but few of which  will probably stand the test  of accurate thera-
 peutical observation, has recommended the sulphate of manganese as a chola-
 gogue cathartic.  If a dram, he says, be dissolved in about half a pint of water,
 and swallowed before breakfast, it will generally occasion after the* lapse of an
 hour or so, one or more liquid evacuations.   With the view of testing whether
 bile was thus discharged to any amount, a portion of loose feculent matter was
 digested with strong alcohol, in order to separate the mucus, and thrown upon
 a filter; a limpid, olive-coloured solution was  obtained, which, after evapora-
 tion in  a water bath to  the  consistence of honey, yielded, on  the addition  of
 boiling chlorohydric acid, a notable quantity of biliary resin, together  with  a
 little fatty matter,—affording unequivocal proof of the excretion of bile.  He
 does  not show,  however, that the quantity was greater than  when other or no
 agents were administered; but he infers, that the salt is " essentially cholagogue
 in  the strict sense of the word."  Its action is said to be  prompt and soon
 over; and it is recommended by Dr.  Ure as a valuable  cathartic in gout,  in
 which he says there is generally a deficient action of the liver. [?]
   The communication of Dr. Ure attracted  the attention of Dr. Gooldens* to
 this salt, who instituted some trials to test its virtues.   When taken upon  an
 empty stomach, in the dose of one or two drams, he found it invariably induced
 vomiting in less than three hours, generally within one  hour, and the matter
 vomited consisted of a very  large quantity of yellow bile.   After a meal, the
 same effect took place, but not invariably.   It very rarely acted as a cathartic
 alone;  and after it  had been given for several days, he was often  obliged to
 have recourse to other cathartics.  After the first dose, it  seldom acts as  an
 emetic.  The evacuations, which are sometimes  dark-coloured, soon become
 yellow and loaded with  healthy bile; but if it be continued for four or five
 days, they become lighter, and ultimately show a total  absence of bile; "ap-
 pearing like jaundiced stools  of the colour of parchment; but there is no jaun-
 dice  either in the skin or urine.   If  the  medicine be discontinued, the yellow
 colour of the stools returns."

   1 Diet, de Mat. Med. &c, art.  Manganese.
   2 Kapp, in Hufeland's Journal der Pract. Heilkunde. Bd. xix. St. 1, S.  176; and Bd. x.
 St. 4, S. 178; cited by Osann, in Encyclopitd. Worterb.  der Medicin. Wissenschaft. xxii.
 358.  Berlin, 1840.                 3 Lond. ^ed. Gazette, Nov. 8, 1844, p. 190.
   * London Medical Gazette, Feb. 14, 1845, p. 646. 
SUPPLEMENT.—MANGANESII SALES.
733
  The dose, according to Dr. Thomson,1 may be from half an ounce to an
ounce, as  a cathartic;  but Dr. Ure has always found a much smaller quantity
suffice.^ Like other saline cathartics, it acts most efficiently when dissolved in
a considerable quantity of water.

  Of late, the  preparations of manganese, ferro-manganic preparations, have
been brought forward by M. Hannon,2and M. Petrequin, either as adjuvants
—or succedanea to the preparations of iron.  As a  succedaneum for iron the per-
oxide  of  manganese  had  been employed by M. Gendrin;  and M. Gintrac3
has related a case  of ascites, where oedema, with  great splenic enlargement
formed the sequela1 of intermittent fever, in  which a grain and a half [!] of the
sulphate, given  twice  daily in the form of pill, produced a complete cure.   It
would appear, too, that  a formulary, printed at  Leipzig, in 1847, under  the
title " Vade mecum Clinicum," by Dr. J. Kovasy, contains formulae for the  em-
ployment  of the oxide  of manganese  in chlorosis and  amenorrhaa, and ac-
cording to 31. Ducoux, the mineral  waters of Cransac,  which are well known
to be efficacious in anaemia,  chlorosis, &c, contain a considerable  amount of
sulphate of magnesia and sulphate of iron.   M. Hannon  has recommended
manganese most extravagantly as an almost infallible specific (?) in  anosmia,
whatever may be its origin.   M. Petrequin more judiciously suggests it  as a
succedaneum for iron in chlorosis, where the latter fails or loses  its  influence;
or where the disease removed by iron  returns.  It would seem, however, that
in only one of the four cases published by him was  the salt of manganese, the
subcarbonate, used alone; in the other three, the  manganese was associated
with iron.4 •
   Dr. S. T. Speer5 has published the following  formula, for the preparation
of a Saccharine  carbonate of iron and manganese, which he considers
to  be preferable to every other chalybeate ; and  which  is wholly free from
inky flavour.  Take  of  finely powdered sulphate of iron, ^iij. and  jj.; car-
bonate of soda, %v.;  sulphate of manganese gi. and 9j.;  white sugar ^iiss.
Dissolve each of the  three first  mentioned  ingredients  in a pint and a half of
water; mix well the solutions;  collect the  precipitate on a cloth ;  filter ;  and
immediately wash  with  cold water;  squeeze out as much of the water as
possible, and, without delay, triturate  with the sugar  previously reduced to
fine powder.  Dry at a heat  of about 120° Fahr.   The dose is  five grains, to
be  gradually increased to 9j. three times  a  day—given  with  the  meals, or
immediately after.6
   Permanganate of potassa, Ilypermanganate of potassa, was brought
forward by Mr. Sampson,7 on hypothetical  considerations, when seeking for
some remedy which should give out oxygen on being taken into the stomach,
with the  view  of  assisting"the imperfect  action  of the  digestive  and  assi-
milative functions  in  diabetes mellitus;  and he states, that  when  given in

  1 Chemistry of Inorganic Bodies, ii. 587, cited by Dr. Ure.
  2 Etudes  sur la Manganese, &c,  Bruxelles, 1849; cited in Canstatt und Eisenmann's
Jahresbericht, u.  s. w. im Jahre 1849, S.  102.  Erlang. 1850.  Also, Bouchardat, An-
nuaire de  Therap. pour 1853, p. 249.  See, on some pharmaceutical  preparations of
manganese, W. Procter, Jr., in Amer. Journal of Pharmacy, Oct. 1850, p. 297.
  3 Union Med. lxix. 1853, and Edinb. Monthly Journal of Med. Science, Jan. 1854, p. 62.
  < Gazette Medicale de Paris, Sept. 1849, and Archives Generates de Med. Janvier, 1850,
p. 97.  See, also,  Ranking's Abstract, xvi. 35, Amer. edit.   Philad. 1853, in which there
are  also, some formula, for the joint administration of manganese and iron by M. Burin-
Dubuisson- and M. Petrequin, in London Journ. Med.  Aug. 1852, cited in Amer. Journ.
of the Med. Sciences, Oct. 1852, p. 492. M. Burin-Dubuisson's formula) are in the same
Journal, p. 494, and in  Bouchardat, Ibid. p. 259.
  a Med Times and Gaz. Dec.  10,  1853.                                _
  6 See Mr W W. D. Liverniore's remarks on some of the salts of manganese, m Amer.
Journ. of Pharm. Jan. 1852, p. 9.                7 Lancet, Jan. 8, 1853. 
734
SUPPLEMENT.—NAPHTHALINA.
the dose of from two grains to five in  solution, three times a day, it had  a
marked  effect  in reducing the quantity of urine, in cases of obstinate dys-
pepsia, and in diabetes.  In a case of the latter disease, the urine fell from ten
to twelve pints in the day to its natural quantity; but it still contained sugar.
The hypothetical idea entertained was, that the  permanganate might supply
the stomach with an increased amount of oxygen, by which the metamorpho-
sis of the farinaceous material might be  hastened forward to a higher state of
oxidation than that of sugar;  but, as Dr. Basham1 has properly  remarked—
we must not overlook the fact, that a prominent error in the digestive process
of the diabetic patient is, the premature and rapid conversion  of the fecula of
food into sugar :  " it is hasty and imperfect—not tedious or protracted."
   Still, the permanganate was tried by Dr. Basham in two cases; and during
its administration—he says—the amount of sugar  excreted greatly increased,
although that of  the urine became somewhat less, and the thirst  appeared to
be alleviated.  No  inconvenience  accompanied its use.  Ten grain doses were
taken without any unpleasant effects on the digestive organs.   It was thought,
indeed, that some benefit accrued from it, as the fulness  and eructations, in
one case, seemed relieved;  but,  during its administration, the  ratio of the
sugar steadily augmented.   This  occurred  equally in both cases ; " so that,"
says Dr. Basham, " there was scarcely room for  a doubt, that the increased
amount of  oxygen  supplied to the food by the permanganate of potassa  facili-
tated the formation of sugar, and did not, as hypothetically inferred, advance
the chemical conversion of the glucose  into the stage of acid metamorphosis.
   Dr. Bence Jones 2 has, also, tried it without any success.   The permanga-
nate has, therefore, to share the  same fate  as so  many  other articles of the
materia medica, which  have been brought forward, of late years more espe-
cially, on faulty hypothetical considerations ; and has probably already fallen
into merited neglect.
   The salt may be prepared by  taking  equal  parts  of  very  finely powdered
peroxide of manganese and chlorate of potassa, mixing them with rather more
than one part of  hydrate of potassa dissolved in a  little water, and  exposing
the whole, after evaporation to dryness, to a temperature just short of ignition.
The mass is treated with hot water; the insoluble oxide separated  by decan-
tation, and the deep purple liquid concentrated by heat until crystals form
upon its surface.  It is then left  to cool.   The crystals  have a  dark purple
colour, and are not very soluble in cold water.3

   CCX.  Naphthalan A, Naphthalinum, Naphthalen, Naphthalin; French,
Napthaline; German, Naphthalin.  In the distillation of coal-tar, when
the last portion of the volatile oily product is collected apart, and left to stand, a
quantity of solid crystalline matter separates, which is principally  composed of
naphthalin.  This  substance forms large, colourless, transparent, brilliant, crys-
talline plates, which exhale a faint and peculiar odour, compared to that of the
narcissus.   It is  insoluble in cold water, but soluble in it to a  slight degree at
a  boiling temperature.   Alcohol and ether dissolve it  readily.*
   When applied to the tongue, naphthalin causes a peculiar hot and pricking
sensation, which extends down the throat and bronchial tubes, exciting a spasm
of the latter, and ultimately  inducing cough  "of a  kind very efficacious in
clearing the air cells and canals of accumulations of mucus.  It is, therefore, a
remedy highly suitable in the asthmatic coughs of old people, and  others, who,
from debility,  are  unable to expel  the matters which clog the pulmonary
membrane."5

   1 Lancet, Jan. 21 and 28, 1854.     2 Med. Times and Gazette, Feb. 4, 1854.
   3 Fownes's Chemistry, 3d Amer. edit. p. 254.  Philad. 1850.
   4 Bouchardat,  Annuaire de Therapeutique pour 1844, p. 46.  Paris, 1844.
   B London Lancet, July 8, 1843, p. 515. 
SUPPLEMENT.—OLEUM CADINUM.                735
  According to M. Rossignon,1 naphthalin possesses many of the physical and
medical properties of camphor; for which  it may be substituted.  With weak
alcohol it forms a tincture, which has all the properties of camphorated spirit
at one half the price.
  .d. I.inory,2 of the Hopital Saint Louis, Paris, had his attention directed to
the different products of tar as remedial agents in  skin diseases, from the suc-
cessful employment of tar in these diseases, and  its unpleasant odour.  Of
these the concrete naphthalin  appeared to him to  be the best.  He employed
it in 14 cases.  In two, one of psoriasis gyrata, and another of lepra vulgaris,
it failed; but in li_ it proved more serviceable: of these, two were lepra vul-
garis, and ten psoriasis.
  The dose is from 8 to 30 grains,  given in emulsion or syrup, and repeated
pro re natch   M. Dupasquier employs a looch,  a  syrup, and  lozenges.  The
ointment of M. Emory consists of two parts of  naphthalin  to  30 parts  of
lard.3

   CCXI. Nic'coli Sales, Salts of Nickel; French,  Sets de Nickel; Ger-
man, Nickelsalze.  Professor Simpson,4 of  Edinburgh, has experimented
with  nickel to discover  its therapeutical properties.  He  employed the sul-
phate, believing, that, as in the case of the metals already known, the use of
one of its salts would sufficiently indicate  the  general  medical action of the
metal.
   Sulphate of Nickel appeared to him  to be a gentle mineral tonic.  He
generally used it in doses of  half a grain, or a grain, repeated  thrice daily,
and gave it in the form of either simple  solution or of  pill.   In large doses,
like sulphate of zinc or  sulphate of  copper, it is  liable to cause nausea and
vomiting, especially if given on an empty stomach.   He generally requested
it to  be taken half an hour or an hour after meals.
   Dr. Simpson  is of opinion, that nickel, manganese, and  iron greatly re-
semble  each other therapeutically, and might be  used indiscriminately in
many cases.   Yet they differ in some respects.  For  example,  in  one most
interesting case, the sulphate of nickel removed  a  severe form of periodic
headache, which had previously resisted iron in many different forms, and all
other kinds of treatment.
   In chlorosis and amenorrhoea, in which iron is  so  eminently beneficial, Dr.
Simpson has seen nickel apparently serviceable under the same circumstances.
In the latter end of the year 1854, he gave it in a case of amenorrhoea  of ten
years' duration, which had commenced at the age of twenty-two.  At the same
time, an intra-uterine  bougie was introduced, and left for  some time  in the
cavity of the uterus.  In the  course of three  or  four weeks menstruation  re-
turned,  and  has recurred regularly from  that  time.   He properly remarks,
however, that in such a case it is difficult to say how far the  result was attri-
butable  to the local  means used; and what  share the nickel  had  in  the  re-
storation of the patient's health.

   CCXII. Oleum CAD'mvs^Juniperi oleum empyreumaticum; French, Huile
deCadeow.de Genevrier; German, Brenzliches  Waehholder-Oel,  Cade-
Oel.  This oil is obtained by the combustion of the wood of  Juniperus phoe-
nicea and J. oxycedrus;  French,  Cade Oxycedre.   A sort of liquid  tar  re-
sults which is of a blackish colour, fetid, and has  been employed  in France by

   i Bouchardat, op. cit. pour 1843, p. 64. Paris, 1843.
   a Cited in London and Edinburgh Monthly Journal of Med. Science, Jan.  1«4_, j>. W.
   3 Bouchardat, op. cit., and Nouveau Formulaire Magistral, p. 122.   Paris, 1845.
   * Monthly Journal of Med. Science,  Aug. 1852, p. 135, and Obstetric Memoirs and
Contributions, p. 296.  Edinb. 1655. 
736
SUPPLEMENT.—PISCIDIA ERYTHRINA.
farriers in the itch and ulcers of horses, as well as in the itch of sheep.   It
would appear, however, that the oil of turpentine has been very generally sub-
stituted for it, and has received the name of huile. de cade.1   The true oil has
been long employed in  toothache, and M. Serres 2 states, that he has seen the
most excruciating pain  relieved by the introduction of a drop into the cavity
of a carious  tooth.  It is also a popular domestic remedy in cases of worms,
in the dose of from 20  drops to a dessert spoonful, according to the age of the
child.  It is rubbed,  too, on the upper lip, the interior of the nostrils, temples
and neck, in order that it may enter the lungs with the air of inspiration.
   It has been long prescribed by Alibert and Cartheuser as an  anti-scrofulous
and antiscorbutic remedy, given internally; and was employed with advantage
in  chronic ophthalmia by Van   Wij;  and by Rosenstein  in  scabies  and
eczema.3
   M. Serres  has  revived  its use in  scabies,  and  now employs  it  altoge-
ther in that  disease; three or four frictions with it being generally sufficient
in recent cases.   It is affirmed, too, by him, that various cutaneous affections,
—eczematous, papular,  lichenoid, &c.—are cured by its application every other
day.   A pellicle appears to be formed by it, which falls off on the ninth or
tenth  day, leaving the  diseased surface healed or in the way of cure.  It
is in scrofulous ophthalmia, however, that  M. Serres has observed the best
effects—in obstinate cases that bad resisted other means.  In  infants, he ap-
plies it on the forehead, temples or cheeks, and on  the outer surface of the
eyedids; and at times  he  adds the introduction of a drop  into each nostril.
He has used it too with advantage in  tinea, otorrheca, pruritus ani, &c.4  It
effectually  destroys, according to M. Sully, the parasites which infest the hairy
scalp in tinea; and he  affirms, that it occasionally cures  this loathsome and
obstinate disease almost miraculously.
   As a remedy in chronic cutaneous diseases it has been extolled also by M.
Devergie,5 who has found it most successful, however, in eczema, both  in  the
simple and impetiginous form.  In squamous affections and in lupus he  has
also used it; but beyond this, he thinks, "there is uncertainty or deception."
   M. Sully6 prescribes the following ointment in tinea:
                   R.  Olei cadin. ^iss.
                       Essent. anis. gtt. v.
                       Adipis ^ij.  M.
   M. Bazin7 applies the pure oil in psoriasis and lichen, mixed, in  different
proportions, with oil of  sweet almonds;  or, what he thinks is better, in cases
of eczema, impetigo, kc. with lard.  He gives  it, also, internally, beginning
with a few drops, and gradually raising the dose to half a dram in the day.
This, he says, will of itself frequently remove the disease.

   CCXIII. Piscid'ia Erythri'na, Jamaica Dogwood. Dr. Hamilton,8 during
a visit to  the Antilles,  was  struck with the powerfully narcotic effects pro-
duced on fish by the bark of the root of this tree.  Inferring that it might be
useful as a medicine, he prepared a tincture, made by macerating the bark of
the roots, gathered during the period of inflorescence, and before the appear-
ance of the leaves, in four times "its weight by measure" of rectified spirit for

  1 Merat and De Lens,  Diet. Univ. de Mat. Med. ii. 489.  Bruxelles, 1838.
  2 Bouchardat, Annuaire de Th.rapeutique pour 1847, p. 65.
  3 Aschenbrenner, Die neueren Arzneimittel, u. s. w. S. 102.   Erlangen, 1848
  * Bouchardat, Annuaire de Therapeutique pour 1849, p. 122; and Begbie, Lancet, April

  5 Bouchardat, Annuaire de Therap. pour 1850, p. 65.     6 i^a, pour igi0  p 109
  7 Ibid, pour 1851, p. 55,  and  Ibid, pour 1852, p. 102.
  8 Pharmaceutical Journal, Aug. 1, 1844, and Med. Chir. Rev. Oct. 1814 
                     SUPPLEMENT.—PLUMBI NITRAS.                 tot

24 hours, and filtering.  Of this mixture be  took, when much afflicted with
toothache, a fluidram in a tumblerful of cold water, drank it off, and watched
its effects, which were anodyne and hypnotic; and on awaking from sleep, his
pain bad wholly disappeared.   He subsequently used it as a topical application
to carious teeth, introducing it on  a dossil of cotton into the diseased  cavity;
and  after a  single  application, he  never heard of a return of pain  in  that
tooth.
   The formula for Dr. Hamilton's tincture is one ounce of the bark  to  four
fluidounces of alcohol.   Dose, f gj.  and less, in a glass of water.

   CCXIV.   Plumbi Ciilo'kidum,  Chloride of Lead; French, Chlorure  de
Plomb; German, Chlorblei, Hornblei.   Chloride of lead is formed when
oxide of lead is digested in muriatic acid.  It also  falls  as a white  precipi-
tate when a  salt of lead is added  to any soluble  chloride.  In the  London
Pharmacopoeia it is  directed to be formed as follows:—Take of acetate of lead,
19 ounces;  boiling  distilled water,  three  pints,  (imperial measure;)  chloride
of sodium, six ounces.  Dissolve  separately the acetate of lead and  chloride
of sodium—the former in three pints of distilled water, the latter in one  pint.
Mix the solutions; wash the precipitate, after it has become cool, with  distilled
water, and dry it.   The chloride crystallizes in long, flattened acicular crystals
which are anhydrous.  Its solubility in  water is variously stated.  Generally,
 it is said to dissolve in 135 times its weight of cold water, and to be more solu-
 ble in hot.1   By the London College, it is  said  to be soluble  in 30  parts  of
 water at 60°, and in 22  parts at  212°.2  It was admitted  into the  London
 Pharmacopoeia as one of  the substances employed in the  preparation of the
 muriate of morphia.
   Mr. Tuson,3 has employed chloride of lead in cancerous ulcerations, both  in
 the form of  lotion and ointment, with some success.   As a lotion, it is of use,
 he  says, in  producing a healthy  surface of the sore, removing fcetor, and re-
 lieving pain; and when the ulcer has not been extensive, it has healed under
 its application.  In "painful neuralgic tumours" it proved very beneficial in
 relieving the pain.   When applied  to any great extent by rubbing it  over  the
 part in the form of  ointment, it has produced a numbness of the arm; and from
 the observations which Mr. Tuson made, on watching the effect of the appli-
 cation, he was induced to think, that the pain was removed by  paralyzing  the
 nerves of the adjacent parts.   From what he has seen of the effect of the re-
 medy he is inclined to believe, that combined with  other applications and as-
 sisted by internal treatment it may be of very considerable service in certain
 cancerous affections.

    CCXV.  Plumbi Nitras, Plumbum Nitricum, Nitras Plumbicus, Nitrum
  Saturnlnum, Nitrate of Lead; French, Nitrate ou Azotate de Plomb;  German,
 SalpetersiiuresBleioxyd.  This  salt is officinal with the Edinburgh col-
 lege; and is directed to be prepared as follows:—Take of litharge, gvss., di-
 luted nitric  acid, a pint.   Dissolve the  acid to saturation  with the  aid of a
 gentle heat.   Filter, and set the  liquid aside to crystallize.  Concentrate  the
 residual liquor to obtain more crystals.   It forms beautiful tetraedral and oc-
 taedral crystals nearly opake, white, and of adamantine lustre, which are per-
 manent in the  air,  and soluble  in somewhat more than four parts of water.*

   i Graham's Elements of Chemistry, Amer. edit. p. 409.  Philad. 1843; Fownes's Ele-
 mentary Chemistry, American edit. p.  242.   Philad. 1845.
   2 The Dispensatory of the United States of America, by Wood and Bache, 6th edit. p.
 1075.  Philad. 1845.                                                     _
   3 London Lancet, Jan. 13, 1844, p. 502; and The Structure and Functions  of the Fe-
 male Breast  p. 426.   Lond. 1846.
   * Christison, Dispensatory, Amer.  edit, by R. E. Griffith, p. 739.  Philad. 1848.
         47 
738
SUPPLEMENT.—PLUMBI NITRAS.
   Hitherto, nitrate of lead has not been much used in  Great Britain or this
 country, in medical practice; and it was introduced into the Edinburgh Phar-
 macopoeia merely as the best salt  of lead from which to prepare the iodide.  It
 has the same constitutional and local action as the other soluble  salts of lead.
 The property, however, which it possesses, of coagulating albumen, and of de-
 composing  the  compounds of chlorine  and the sulphohydrates, renders it  a
 valuable antibromic;  and it has been prescribed as an excitant  antiseptic to
 wounds.  In 1773, it was in use  as an antiepileptic, and was especially recom-
 mended by Osterdyk-Schacht and Gessner.1  Dr.Pereira2 states that in active
 hccmoptysis he has  sometimes  prescribed a pill of sugar of lead and opium, and
 a mixture containing nitric acid.   Nitrate of lead would  thus be formed in
 the stomach.  With this combination, he has succeeded  in getting the system
 under the influence of lead, in a much shorter time than by the sugar of lead
 only.
   Its main use, until of late, has been as an application to wounds, ulcers, can-
 cerous affections, chronic cutaneous diseases, chaps, &c.   According to Arolz, it
 is the active constituent of a secret remedy by Liebert, of Paris,  for cracked
 nipples?   Yolz employed it with  advantage in these and similar  cases, in the
 quantity of ten grains to the ounce of water.
   The circumstance of interest, connected with the nitrate of lead, owing to
 which it is  introduced here, is, that it is the admitted basis of " Ledoyen''_ dis-
 infecting fluid," which obtained so  much celebrity a few years ago, that the
 British government directed experiments to be instituted with it for disinfect-
 ing the subjects  of spreading diseases, as well  as  infected localities.  It is a
 solution of  one dram of nitrate of lead in a fluidounce of water; and it cer-
 tainly destroys the  unpleasant odour of  animal and vegetable substances that
 are evolving sulphuretted hydrogen and  hydro-sulphate of ammonia; but there
 is no evidence that it has any destructive power over the emanations that give
 occasion to  disease.4  Dr. Stratton5 is of opinion, from observation of the ef-
 fects of the two fluids, that the Ledoyen is inferior to the Burnett fluid.6  He
 affirms, too, that it is liable to  exert a depressing influence when applied to the
 body, or used in the room in  cases  of  typhus; and two cases of lead  colic,
 arising from its application to ulcers, have been recorded.7
   Mr. Ogier Ward8 extols it  highly as an antibromic  and  excitant antiseptic,
 in ulcers of the legs when in a sloughy and indolent condition; as in injection
 in cases accompanied by fetid discharges; in  gleety discharges,  and in those
 of cancer uteri.  "In short," he remarks, "it is as extensively useful as the
 acetate of lead, while it is superior to that preparation by its disinfecting pro-
 perty."   It proved highly advantageous, too, in inveterate cutaneous  affections.
   By Lemaitre  de  Rabodanges nitrate  of lead  has been employed both as a
 destroyer  of putrid  odours, and for the preservation of  animal substances,—
 of the dead body, for example,9 as in embalming;  yet its antiseptic power has
 been denied.10   The commission, consisting of Dr. Southwood Smith, Mr. Toyn-
 bee and Mr. Grainger, to whom,  in  connexion with the discoverer, the fluid

  1 Dierbach, Die neuesten Entdeckungen in der Mat. Med. 3er Band, lste Abtheil. S.
 610.   Heidelb. und Leipz. 1845.
  2 Elements of Mat.  Med. and Therap. 3d Amer. edit. i. 707.  Philad. 1852.
  s Dierbach, op. cit. 2er Band, S. 1224.  Heidelb.  und  Leipzig, 1843.
  * British Amer. Journ. of Med. and Phys. Sciences, December, 1847, and the author's
 General Therapeutics and Mat. Med.  5th edit. ii. 397.  Philad. 1853.
  5 Edinb.  Med. and Surg. Journal, Oct. 1848, p. 293.            « See  page 693.
  7 Brit. Amer. Journal, March, 1848.
  8 Prov. Med. and Surg. Journ.  Oct. 15, 1851, and Amer. Journ. of the Med. Sciences,
Oct. 1852,  p. 492.                                       9 pereira, op. cit.
 10 Academie des  Sciences, 8 Juin, 1846; cited by Pereira; and Aschenbrenner, Die
neueren Arzneimittel, u. s. w. S. 230.   Erlangen, 1848. 
SUPPLEMENT.—POTASSJE NITRAS.
739
was submitted for examination by Lord Morpeth, reported  that  it does not
possess  any peculiar power in preserving the dead body from decomposition,
whilst they admit its efficacy as an antibromic.1

                        Lotio plumbi nitratis.
                         Lotion of nitrate of lead.
                   R.  Plumbi carb. 9j.
                       Acid. nitr. dil. q. s. ad solvendum.
                       Aqua, destillat. Oj.  M.
  The lotion to be freely used two or three times daily.       Ogier Ward.

  CCXVI.  Potass'_E NlTRAS, Nitrate f>f Potassa, Nitre; French, Nitrate de
Potasse; German, Salpetersaures Kali.   This salt is noticed  here in con-
sequence of the revival of its use in large doses, within the last twenty years.
As a general rule, nitrate of potassa is a  dangerous and rapid irritant poison in
the dose of an ounce; yet there are cases in which this, and even a larger quantity,
has been borne with impunity,2 especially when dissolved in a large quantity of
water.
   As long ago as the year 1764, Dr. Brocklesby,  a  celebrated British  army
physician, urged  the value of this salt in large doses, in acute rheumatism,—
as much as ten drams being  given during the day and  night.  The practice
was followed by others,—and, in 1833, Messrs.  Gendrin and Martin Solon re-
vived it in Paris.   Sixteen cases are recorded, the average period of treatment
of which was eight days.   The mean quantity given in one day, was an ounce
in three quarts of water—the total average  quantity,  eleven ounces.   They
recommend, that it should be begun in the quantity of two drams and a half
to a quart of fluid.
   Twelve  successful cases  are also recorded by M. Aran.3   The  mean dose
was thirty-six grains in three  pints of fluid, and  the  average total quantity
374 grains.   The mean  duration of  the  disease was also eight  days;4 and
such  was the result  of the recorded  experience  of  Dr. Richard  Rowland;5
which  seemed, also,  to show, that the benefit   was  the more  striking in
proportion to the activity of  the attack.   The dose, with  him, never exceeded
half  an ounce; and it was sometimes  limited to three  drams daily, dissolved
in a pint of water.   No injurious consequences followed its use ;  neither  was
there any complaint  made of it as a disagreeable remedy, nor of  any kind of
inconvenience attending its use.
   Dr. Henry Bennet, who was clinical clerk and house  physician under M.
Gendrin,  at La  Pitie,  states, that for nearly three years,  which he  spent
there, all  the  cases of acute  rheumatism which  came  into the  wards were
treated with nitre, in doses varying from six to twelve, and sixteen drams in
the twenty-four hours, according to the age, sex, or constitution of the patient;
so that Dr. Bennet thinks he must have seen treated at La Pitie,  in this man-
ner, at  least  seventy or eighty persons.  The  salt was  always  administered
dissolved in a large quantity of barley water, sweetened with sugar—the pro-
portion being  about  half an ounce to a pint and a half or two pints of fluid.
This  was the  only beverage  allowed the patient.   The secretions of the skin
and kidneys were generally augmented, and  sometimes  those of the intestinal
canal;  but the principal action of the nitrate appeared to  be sedative, the
pulse generally falling rapidly, both as  regarded frequency and strength—or,

  1 Amer. Journal of Pharmacy, November, 1847, p.  269.
  2 Christison,  Treatise on Poisons, Amer. edit. p. 189.   Philad. 1845.
  s Journal des Connaissances Medico-Chirurg. 1841, or  Gazette Medicale, Mars, 1841.
  « Cowan,  Provincial Med. and Surg. Journ. May 20, 1843, p.  144.
  * Lancet,  Feb. 11, 1854. 
740
SUPPLEMENT.—SANICULA MARILANDICA.
 in other words, the salt seemed to act as a contrastimulant.  Neither M. Gen-
 drin, nor M. Martin Solon, nor Dr. Bennet, observed any renal  inflammation
 induced by it, as had been stated by some.   Dr. Bennet1 states, that he has
 not only administered an ounce or more of nitre in the twenty-four hours, for
 many days consecutively in acute rheumatism, but also in puerperal fever and
 other inflammatory diseases, with, he thinks, marked benefit, and without ob-
 serving any toxical phenomena;  and in a subsequent communication2 he asks,
 whether nitre, thus administered, may not prove a valuable sedative in febrile
 and inflammatory diseases.  In chronic rheumatism he found it of little avail.
 Dr. W. R. Basham3 gave it in acute rheumatism in the  quantity of one, two
 and three  ounces, largely diluted—in two quarts of water—in the twenty-four
 hours.
   The testimonies in favour of large doses of nitrate of potassa in acute rheu-
 matism are certainly not few; but, as the author has remarked elsewhere,4 it must
 be borne  in mind, that the disease is self-limited  in many instances, or, in
 other words, appears to run a definite course, greatly uninfluenced by medicine.
 The action of sedation,  ascribed to it, may result indirectly from its revellent
 operation on the stomach; but farther observations are needed to establish the
 fact of such action, before we attempt to explain the modus operandi.      .
   It may be proper to add, that Dr. Young,5 of Chester, Pa., has found  thai
 nitrate of  potassa, given  in ten  grain doses, every three hours, to the adult,
 had an excellent effect in incontinence of urine.  It succeeded in several cases,
 in which the tincture of  cantharides had failed.  To a boy between nine and
 ten years of age, "who rarely in his life had escaped wetting the bed one or
 more nights in the week," Dr. Young ordered ten grains three times a day for
 a  week.   During this time he escaped.   It was now omitted for three days,
 and then directed to be given four days in  the week, omitting it three.   It was
 thus continued five weeks, when  it was entirely abandoned.  The boy had no
 incontinence from the  time of taking the nitre, nor whilst he was under Dr.
 Young's notice for more than a year after.   Dr. Young supposes, that the
 modus operandi of the nitre in these cases may consist in increasing the  irri-
 tating properties of the urine, so as to make it more stimulating to the bladder
 or its sphincter.   If so, he suggests, whether other preparations of potassa and
 soda may not succeed, in  cases in which the nitrate  fails.  M. Delcour, how-
 ever, who  speaks favourably of the nitrate, as  recommended by Dr.  Young,
 thinks it  acts  rather by diminishing the  excitation  of the bladder.6  Here,
 again, farther experience is desirable.
   The fumes  produced  by the deflagration  of nitrate of potassa with paper
 have been  inhaled with advantage in asthma.  For this purpose bibulous paper
 may be dipped in a saturated solution of nitre, and afterwards  dried: in  thia
 way is obtained what is called touch paper.   The fumes may be inhaled either
 by setting fire to the paper on  a plate, or rolled up and placed in a candlestick,
 and  permitting the fumes to escape into the room; or by smoking the paper
 in a tobacco pipe.  The  beneficial effects are generally experienced in ten or
 fifteen minutes.7

   CCXVII.  Sanic'ula Mariland'ica,  Sanicle, Maryland Sanicle, Black
 Snakeroot; French, Sanicle du Maryland.  This plant—of the umbelliferous

  1 London Lancet, Feb. 10, 1844, p. 638.          2 Ibid. June 15, 1844, p. 374.
  3 Proceedings of  the Royal Medical and Chirurgical Society, Nov. 14,  1848; cited in
Amer. Journ. of the Med. Sciences, Jan.  1849, p 184.
  * General  Therapeutics and Mat. Med. 5th edit. ii. 224.   Philad. 1853.
  5 American Journal of the Medical Sciences, April, 1843, p. 371.
  « Journal  de Medecine de Bruxelles, cited in Medical Times, Jan. 4, 1845,  p. 303.
  ' Lond. Med. Gazette, Sept. 4, 1846, p. 431; and Pereira, Elements of Mat. Med. and
Therap. 3d Amer. edit. i. 505.  Philad. 1852. 
SUPPLEMENT.—SANTONINUM.
741
family—is indigenous, and common in woods  and copses.1  Dr. Stephen W.
Williams2 says, "it  is supposed to be  astringent, partially tonic and diuretic,
and it has been used with success  in dropsy;  and in decoction in dysentery,
leucorrhceji, and  hemorrhages.   It is  also pulmonary  and balsamic."  The
Indians—it is affirmed—and, after their example, physicians of the country,
employed it, "in  syphilis and diseases of the lungs."3  It is introduced here,
however, in consequence of its having  been highly recommended by J. B. Za-
briskii4—[in some of the French works  metamorphosed into  Labriski,]—in
cases  of chorea.  The root is fibrous, aromatic, and possesses the active matter
of the plant.  Dilute alcohol extracts the active principle in some degree; but
the best form of administering it, according to Dr. Zabriskii, is the powder of
the dried  root.   He regards  it  as  highly tonic; and  states, that  it is  used in
popular practice as a favourite remedy  in intermittent fever.
   In  chorea he gives it to children eight or ten years of age in the dose of half
a dram three times a day.

   CCXVIII. SANTONl'NUM, Santonina,  Santoninium, Santoninc, Santonin,
 Cinin; German,  Wurmsamenstoff.  Santonin  was first  separated from
European worm seed, the product of various species of Artemisia,  by Kohler of
Diisseldorf,  in the year 1830.5  It may be procured by treating wormsccd with hy-
drate of lime and alcohol,  evaporating the tincture to  one quarter, filtering the
residue  to  separate  the  resin, and  treating it, while hot, with  concentrated
acetic acid.   The santonin is deposited in crystals as  the liquor cools.
   It  is in  brilliant, colourless,  or yellowish  rhombic, flat prisms, devoid of
smell; and  of  a feeble bitterish taste when kept  long in the mouth; scarcely
soluble in cold  water, and but little so in hot;  but readily so in alcohol, ether
and in volatile  and fixed oils.6   A  beautiful  specimen of it was  presented to
the author by Messrs. Powers and  Weightman  of this city, who have prepared
it for a great many years past.
   The trials of Mayer of TubingenT in twenty-four cases of worms, as well as
those of Alms  and Callond,8 Cazin,9 and others in  Europe and this country,
have  shown it to be an effective vermifuge.   In the  experiments of Kiichen-
meister10 with various anthelmintics, santonin, mixed  with castor oil, appeared
to be most destructive to the ascarides lumbricoides, or long round worms; and
he advises, that it should be prescribed in the proportion of from two to five
grains to the ounce—a teaspoonful being given at intervals until the effect is
induced;  and,  along with  this, he  recommends salt and mustard, with onions
and garlic to be added to the diet of the patient.  The dose for  children under
four  years,  is from two to four grains; above   twelve years, five or six grains
in powder.  In an overdose it may give rise to unpleasant symptoms.   Spen-
gler u gives  the case of a boy, four years old, who had often taken doses of a
grain and a  half;  and who, subsequently, took  double the quantity, which was
followed by gastric oppression, colic and vomiting, with several evacuations in

  1 Gray's  Manual of the Botany of the Northern United States, p. 156.  Boston and
Cambridge, 1848.
  2 Report on the Indigenous Medical Botany of Massachusetts, in Transactions of Amer.
Med  Association, ii. 871.  Philad. 18-19.
  s M.rat and De bens Diet. Universel de Mat. Med. iv. 142.   Bruxelles, 1838.
  * \tuer Journ. of the Med. Sciences, Oct. 1.1), p. 374.
  6 Riecke Die neuern Arzneimittel, Nachtrag zur ersten Auflage, S. 79. Stuttgart, 1840.
  8 Aschen'brenner, Die neuereu Arzneimittel, v. s. w. S. 241.  Erlangen, 1848.
  1 Uiecke op. cit.                           8 Aschenbrenner, op. cit.
  9 Journ. de M>d. et de Chirurg. cited in Dublin Quart. Journ. May, 1850, and Ranking,
xii 81  \nier edit.  Philad. 1851.
 io Froriep's  Tigesberichte, cited in Banking's Abstract, xvii.  234, Amer. ed. Phila. 1853.
 " Bouchardat, Annuaire de Th.rap. pour  1852, p.  218. 
742
SUPPLEMENT.—SIMABA CEDRON.
which were found a number of ascarides.  These were followed by great pros-
tration, cold sweats, embarrassedt respiration,  dilated  pupils, and convulsive
movements of the extremities;  from which, however, he recovered.
   Santonin has also been prescribed as  an antiperiodic in intermittent fever
in the dose of four or five grains a day—continued for several days.1

   CCXIX. Sima'ba Cedron, Ccdron.   The seed of this  tree, of the natural
family Simurabaceae, which grows in New Granada and  Central America, are
of a  concavo-convex shape;  about an inch long;  of a  light  yellowish colour,
and intensely bitter taste ; supposed to be  owing to quassin.2  M. Lewy* ob-
tained from  the residuum after treatment by ether, by means of alcohol, a
neutral substance in the crystallized state, which  he  looks  upon as the active
principle of cedron, and has called cedrin.  It is slightly soluble in cold water,
but dissolves with  sufficient readiness in boiling water, and  in  alcohol.  Its
taste is bitter, and  resembles that of strychnia, than  which  it is  even more
persistent.
   The natives of the country ascribe great  efficacy to the  cedron against the
bites of serpents, and in the treatment of hydrophobia, and intermittent fever,
giving it  in the form of powder in  the dose of  five  grains.  In an elevated
dose,  it acts as a virulent poison.  The scrapings  of the fruit are administered
in a wineglassful of spirits or warm water, at  the same  time, that the wound
is washed  in an infusion,  and covered with the  scrapings  secured by a ban-
dage.   The dose is  repeated every two hours,  until relief is  obtained, and, to
quench the attendant thirst,  a weak infusion of the cedron  is given.
   Several cases  of  snake bites are  related  in which the cedron proved bene-
ficial, where other means had failed.*
   It is more especially, however, to its  anti-periodic virtues, that attention has
been recently paid.  In some parts of New Granada, it is the only remedy em-
ployed against ague.   In some trials made with it in Paris,  M. Rayer5 found
it to be effective in such cases.  It appeared to him, that the  dose of the powder,
generally  applicable, was from eight to fifteen grains.   M. Bertin6 speaks well
of it;  but the observations of  M. Lelut, made to the Academie de Medecine,
are not favourable  to it as a febrifuge.   Dr. P. Smith, of San Francisco, em-
ployed the scrapings successfully as a substitute for quinia  in the treatment of
malarious fevers.
   In a monograph on the  cedron, Dr. Purple,7 of New York, states, that Dr.
Magrath of Kingston, Jamaica, had  used it extensively in  the treatment of
intermittent,  and also of yellow fever.   In the latter disease,  he regarded it as
useless as quinia or any other remedy to arrest the disease in most of the cases
in the hospital, although it was thought, that the skin of those who were taking
it, was less dark or congested, than that of  those who  were  not.  His mode of
giving it in intermittent fever is in powder, or in pills, in  ten  grain doses every
three  hours, for  24 or 36 hours; and it had the effect of  arresting the disease.
He almost always gave it in the apyrexia, and it usually prevented a second
paroxysm, if it  failed with the first.   Dr. Purple himself  publishes five cases

  1 Bouchardat, Annuaire de Th.rap.  pour 1851, p. 147.
  2 Garrod, The Essentials of Mat. Med. &c, p. 128.  Lond. 1855.
  5 Bouchardat, Annuaire de Therap. pour 1852, p.  163.
  4 Dr. Cazentre, Amer. Journ. of the Med. Sciences, Jan. 1851, p. 202, and M. Herran,
in Bouchardat, Annuaire de Therap. pour 1851, p. 60.
  5 Bouchardat, Ibid. p. 164.
  6 Ibid, pour 1853, p. 226.
  i Observations on  some  of the Remedial Properties of the Simaba Cedron, and on its
employment in Intermittent Fever, p. 9. New York, 1854, and in  New York Journal of
Medicine, Sept. 1854. 
SUPPLEMENT.—SOD_E HYPOSULPHIS.
743
to corroborate the valuable anti-periodic properties of  the cedron ;  and states,
that he had subsequently treated six other cases with  it exclusively, and with
these  results:—in four  the cure was prompt and  permanent;  one  case passed
from  his observation before the result was known; and the remaining one was
still under observation, having resisted emetics, quinia and bebeeria before  he
was consulted.
  As the result of all his observations on the use of  cedron in intermittents
more  especially, Dr. Purple feels himself entitled  to  conclude—that it pos-
sesses decided antiperiodic virtues; that it  is less likely than quinia to pro-
duce  encephalic or neuropathic phenomena;  and that  it may, in  large doses,
often repeated, produce  griping  and even diarrhoea; but these conditions are
readily controlled by appropriate remedies;  that as a remedy in intermittent
it possesses properties in many respects equal to quinia; and in most cases is
equally adapted  to remove it; and that it  possesses  marked  tonic properties
and merits a  prominent place in the  materia medica.  To Dr. Wood1 it ap-
pears to be closely analogous  to quassia  with which  it is botanically allied.
Of its value  in  other diseases, observations  have not been sufficiently nume-
rous  to permit any judgment to  be formed.


   CCXX. Sod_e Hypostjlph'is, Hyposulphite of Soda; French, Ilyposulfite
 de Sonde.  There are several modes of preparing this salt, which is  largely
 used for photographic purposes.   One of the best is  to form  neutral  sulphite
 of soda, by passing a stream of  well washed sulphurous acid gas into a strong
 solution of carbonate of soda, and then to digest the  solution with sulphur at
 a gentle heat for several days.   By careful evaporation at a moderate tempera-
 ture, the salt is obtained in large and regular crystals, which are very soluble
 in  water.2
    It is said to have been  administered with constant  success by physicians of
 Paris, who are the most versed in the treatment of cutaneous diseases.  It was
 first  employed by MM. Chaussier, and Biett, under  the name sulfite  sulfure
 de sonde,  but it had fallen into neglect when its  use was revived by M. Ques-
 neville, and the results have been "entirely conformable  to  those  obtained  by
  JIM. Chaussier and Biett.  It is highly extolled by them in chronic cutaneous,
  and  in scrofulous affections, and is said to be a most efficacious auxiliary to ex-
  ternal sulphurous preparations.3
    Dr. R. Neale* gave it with advantage in an obstinate case of yeasty vomiting,
  in which were numerous sarcince ventriculi.  The  dose was 10 to  15 grains
  three times a day, in  half a fluidounce of infusion  of quassia.  It has like-
  wise been given as an antiphlogistic in acute rheumatism by Dr. J. H. Warren,0
  who ascribes to it powerful diuretic virtues.
    The best mode of exhibiting it is in syrup, the formula for which is as follows:
  —Hyposulphite of soda, 45  grammes,  (about 3xiss.;) Distilled M ater,  22o
  grammes, (about f 3viij.;) Sugar, in coarse powder, 1000 grammes, (about
  _bij.)   Dissolve the hyposulphite in the distilled water when  cold;  and form
  into a syrup at the ordinary temperature.
    Thirty parts of the syrup contain one part of the  hyposulphite,   l^rom oU
  to 125 grammes, (one ounce to four,) may be given  in the twenty-four hours.

    i Dispensatory of the United States, 10th edit. p. 1311.  Philad. 1854.
    -  French Codex for 1839, and Fownes's Elementary Chemistry, p. 198.   Philad. 184o.
    3  Abeille Medicale, 1844, p. 210, and Juin, 1845, p. 151.
    * Braithwaite's Retrospect, xxviii. 131.
    b  Boston Med. and Surg. Journal, cited in Southern Journ. of the Med. and Phys.
  Sciences, May and July. 1855, p. 288. 
744
SUPPLEMENT.—SODiE PHOSPHAS.
                   R.  Soda, hyposulph. gxiss. (15 grammes.)
                       Aq. destillat. f ^viij. (255 grammes.)   ,
                       Sacchar. in pulv. crass. Oij. (1000 grammes.)
                   fiat syrupus.
                                                       Emilc  Mouchon.1

   CCXXI. SoD_£ ET ARGEN'TI IlYPOSULPH'lS, Hyposulphite of S>>da  and
 Silver; French, Hyposulfite de Srmde et d'Argent.  This salt is formed by pouring
 a solution of hyposulphite of soda over oxide of silver recently precipitated by
potassa, until the oxide is entirely dissolved.  By evaporation, minute crystals
 are furnished, which are dried in a mild heat sheltered from light.   The salt
 is insoluble in alcohol  and  very soluble in water, the  solution  being more
 slowly decomposed by light than that of  the nitrate.  Kept from the light its
 transparency may be preserved indefinitely.  When pure, it does  not discolour
 the epidermis or linen.
   The hyposulphite of soda and silver is less astringent and irritating than the
 nitrate, and may often be advantageously substituted for it.   It has been found
 by M. Delioux2 especially useful in urethral discharges;—solutions of one or
 two parts to thirty of water exciting less irritation than solutions of the nitrate
 of silver of  half the strength.   M. Delioux generally, however, uses it of the
 strength of from one half to one part to one hundred parts of water.
   Dr. Eben Watson found  a solution of this salt to  have a very soothing
 effect on the larynx when applied in the way of topical medication.

  CCXXII. Sod_e Phosphas, Phosphate rf Soda; French, Phosphate de Sonde;
 German, Phosphorsiiures Natron.   This salt has been long known under
 the name of " tasteless purging salt,"  and a formula for its preparation is given
in the Pharmacopoeia of the United States.  It has been  urged as a remedy in
 lithuria, under similar views to  those that suggested the  employment  of phos-
phate of ammonia.  If sufficiently diluted, according  to  Dr. Golding  Bird,3 it
is sure to enter the circulation, and be excreted by the kidneys, thus  furnish-
 ing to the urine an energetic solvent of uric acid, as  Liebig has shown it to be.
It is true, he says, that this indication  can generally be  fulfilled  by the pure
alkalies and their carbonates; "  but they too often exert the injurious effect of
materially interfering with the digestive organs, and thus directly affecting the
integrity of those functions most intimately connected wdth the production of
the morbid  deposit."   The phosphate of soda, according  to  Dr. Bird, may be
given in doses of  9j. to ^ss. thrice a day in broth or gruel, without any other
apparent effect than that of slightly relaxing the bowels, and the urine  becomes
charged with the salt.   We may thus, he  says, hope to obtain  uric acid in so-
lution, and  gain time for the  enjoyment of those  remedies which are  best
adapted for the treatment of  the uric acid diathesis;  " for it  must never be
forgotten, that in merely giving a remedy to hold a urinary deposit dissolved,
we are merely treating an effect  and not  a cause.'*'  Dr. Bird states, that he
"has administered the salt in two very chronic cases of  uric acid gravel, and in
one with the effect of rapidly causing a disappearance of the deposit.    The
triple salt, ammonio-phosphate of soda,  he thinks, might perhaps be a more
active remedy than the simple  phosphate, but its disagreeable flavour consti-
tutes one objection to its employment.   Dr. Buckler suggests the  phosphate of
ammonia in preference to the phosphate of soda; the urate of  soda formed by

  i Journal de Pharmacie du Midi,  cited in Abeille Medicale, Septembre, 1845, p.  237,
and B iuchardat. Annuaire de Tin rap. pour  1852, p. 113.
  2 Bulletin de Thirapeutique, xiiii. 28'J, 401, and Brit, and For. Med. Chir. Rev. April,
1853, p. 567.
  3 London Medical Gazette, Aug.  23, 1844, p.  689; and  Urinary Deposits, &c, 2d
Amer. edit.   Philad. 1851. 
SUPPLEMENT.—SODII CHLORIDUM.
745
  the latter in the blood being insoluble; whilst, when phosphate of ammonia  is
  given, " a double reaction and decomposition take place, and two new salts are
  formed, both of which are readily soluble and  capable of being evolved.":—
  (See Ammonia. Phosphas.)

     CCXXIII.  Sodii  Chlo'ridt_m, Sodjr, Murias, Natrum Muriaticum,  Chlo-
  retum Natrii, (Jhlnrnatrlum, Sal Cu/inare; French, Chlorure de Sodium, Sel
   Communowde Cuisine ou Marin; German, Salzsaures Natrum, Kiiphen-
  salz,  Koch salz.  Salt has been highly recommended by many physicians,  of
  late years, for the cure of intermittent fcrcr.   As a domestic remedy, in such
  cases, it would appear to have been already employed.  In a memoir, addressed
  to the Academie de Medecine of Paris, M. Scelle-Mondezert* affirmed, that  in
  the dose of from fifteen to thirty grammes (gss. to J,].), it had constantly suc-
  ceeded.   M. Piorry,  who was appointed by the Academy to examine the me-
  moir, employed it in  seven cases of intermittent;  and not only prevented the
   paroxysm, but found, that the spleen diminished  in size more rapidly than  if
   he had given  the sulphate of  quinia;  and, accordingly,  he  reported most fa-
  vourably in regard to it as an antiperiodic, and as  a cheap substitute for that
  salt.3  Dr. W. P. Lattimore4 witnessed many of the experiments of 31. Piorry,
   and affirms, that in the great majority,  the fever yielded  as  readily as to the
   salts of quinia.   M.  Piorry's method was to give half an ounce of the chloride
   during the apyrexia,  in  a cup of  thin soup, fasting.  "It usually agrees with
   the stomach perfectly well; but, in  some few cases, we  have seen  it excite
   vomiting and  diarrhoea."  Three doses were commonly sufficient for the cure,
   the first two taken on successive  days, and the third  after the interval of a
   day.
     Dr. Lattimore observed seven  cases under the care of M. Piorry cured, and
   three in which  it failed.   In two of these  last, the sulphate of  quinia was
   given  successfully in  one, and not in the other.  In the third it was not  tried.
     Encouraged by these favourable statements, Dr. Derrick5  prescribed it  in
   intermittent, and records two cases in corroboration of the success said to have
'   been obtained from  it.   Dr. J.  C Hutchison6 has,  also, related  twenty-two
   cases in which it was prescribed.   The  dose varied from eight to twelve drams
   during the apyrexia.   Mucilage  of elm was the vehicle, which sufficiently dis-
   guised the salt.   Dr. Hutchison concludes from his own  experience, that
   although inferior to cinchona and its preparations, it forms a very good substi-
   tute for them in intermittent fever, having failed to produce a speedy suspen-
   sion of the paroxysms in 31.8 per cent,  of the  cases only; that it may be pre-
  ferable to quinia where the latter disagrees, or has lost its effect, as well as  on
   the score of economy; moreover, it is always at hand; and he affirms, that it
   has been found more energetic in curing  ague than any of  the vegetable  or
  mineral tonics except bark.   According, however, to M. Michel Levi,7 it has
  been employed in the military hospitals  by MM. Colette, Cazalas and Herbin,
  and in a few cases with advantage; but it acted by no means speedily.  Both
  he and M. Grisolls objected to its introduction into the army; where the dis-
  ease is apt  to be more difficult  of cure than  in  the  simple  intermittents of
  Paris.   M. Ancelon,8 too, affirms, that  common  salt only cures marsh fevers

     1 American Journal of the Medical Sciences, Jan.  1846, p. 120.
     2 Annuaire de M;':d. et de Chir. pour 1851, par A. Wahu, p. 57, and Bouchardat, An-
  nuaire de Therap. pour 1851, p. 149.
     s Jamain and Wahu,  Annuaire, &c, pour 18o3, p. 1.
     4 Amer. Journal of the Med.  Sciences, July, 1852, p. 101.
     6 North Western Med. and Surg. Journ. Sept. 1851, and Med. Exam.  April, 1854, p. 241.
     e New York Journal  of Med.  Mar. 1854.
     i Annuaire de Th.rapeutique de Bouchardat, pour 1853, p. 245.      8 Ibid. p. 245. 
746
SUPPLEMENT.—SUCCUS LIMONIS.
in exceptional cases, where any other  perturbating agent would succeed;  and
that sulphate of quinia continues to be the only "specific"  that can be op-
posed to every form of marsh fever.

   CCXXIV.  Succus Limo'nis, Lemon juice; French, Sue de Limon; Ger-
man, Citro n ens aft.  This familiar article has been brought forward by Dr.
Owen Rees on chemical considerations, to  swell  the  catalogue  of undoubted
cures of acute rheumatism.1  Dr. Rees first had recourse  to it  in  rheumatic
gout, from a belief that the vegetable acids—probably owing to  the  excessive
quantity of oxygen entering  into their  composition—contribute  to effect the
transformation of the tissues generally,  and because lemon juice was the most
palatable form in which such class of remedies  could be  applied.  Moreover,
it appeared to him probable,  that the supercitrate contained in the juice, al-
though  in small quantity,  was a form of alkaline  salt likely to contribute to
the alkalinity of the blood in its transformations; as  the examination of the
urine shows that  such organic compounds become converted into carbonates;
but the recent examinations  of Mr. Whytt2 exhibit  that  an ounce  of lemon
juice does not, at the utmost, contain two  grains of  citrate of po"tassa.   Dr.
Rees seems to regard retained uric acid as the materies morbi in rheumatism;
and thinks that the citric  acid of the lemon juice yields oxygen, which, with
the elements of water, converts uric acid into urea and carbonic acid;—an hy-
pothesis which is by no means admitted.3
   Dr. Bence Jones, indeed, found, from experiments made on a healthy person,
that lemon juice, in twelve ounce doses daily, causes temporarily an excessive
acidity of the urine and a  deposit of free uric acid,—acting, therefore, as a free
acid on the urine, and not at all resembling in  its effects those produced by
citrate of potassa and other vegetable acid  salts.   When  taken pure, without
water, no strong or diuretic action was observable, and  the  pulse  presented
nothing remarkable in force or frequency.   In St. George's  Hospital, he found
free uric acid in the urine, twelve hours after it had been  passed, in every case
in which  large doses of lemon juice were  given; and hence, he remarks, in
chronic rheumatism and gout it should be administered with care, lest red sand
or uric  acid calculus should be induced.
   In his earliest  communication, Dr. Rees4 reported several prominent cases
of cure; and stated that the early relief from pain was such, that had any one
unacquainted with the remedy in use watched the progress of the  cases, they
would almost inevitably have concluded that sedatives had been resorted to.
Subsequently, he published a pamphlet,5 in which he gives eight cases illus-
trative  of the practice.   The forms of rheumatic disease in  which the greatest
benefit was derived were acute rheumatism and rheumatic gout.   In pure gout,
with highly inflammatory symptoms,  more advantage was obtained than in the
chronic forms of the disease.   In doses of half an ounce  to an ounce, three
times a day, it appeared to exert a marked sedative influence on the circulation.
In the  cases of rheumatism related by Dr. Rees, the urine was never rendered
alkaline by the use of lemon juice;  and in  one case, in which it was alkaline
before treatment, it became acid after the juice was employed.   Dr. Ranking6
speaks  favourably of the  article; and others have afforded  similar testimony.'
   1 See  Cimicifuga, page 232.
   2 Dr.  Bence Jones in Med. Times and Gazette, 21 Oct. 1854, p. 408.
   s British and Foreign Medico-Chirurgical Review, Oct. 1849, p.  530.
   4 London Medical Gazette, Jan.  26, 1849.
   5 The Treatment of Rheumatic Diseases by Lemon Juice, with Illustrative Cases, from
Hospital Practice.   Lond. 1849.
   6 The Half-yearly Abstract of the Med. Sciences, No. 11, Jan. to July, 1850.  Amer./
edit. p.  19; and No. 12, July to  Dec. 1850, p. 33; Amer. edit.  Philad. 1851.
   7 Lond. Med. Gazette, June 15,  1849, and Mr.  D. Dalrymple, Lancet, Sept. 1850. 
SUPPLEMENT.—SUMBULI RADIX.
747
  Dr. Hector Peltier,1 of Montreal, affirms, that no remedy has given him as   -
much satisfaction.
  More recently, Dr. Rees,2 in referring to his recommendation of the remedy,
has stated, that  although  he considers it as an antidote to the true rheumatic
diathesis,  he  has found it  useless in gonorrhceal and syphilitic rheumatism,
in the rheumatic pains of Bright's disease, and in those connected with  non-
gonorrhceal purulent discharges.
   In a discussion  at the  Boston Society  for Medical  Improvement,  three
speakers stated, that they had given it without  effect in rheumatism.   One
gentleman had seen no  results produced in many cases, whilst, in some, benefit
was observed.   One gentleman—on the other hand—had seen decided  advan-
tage from it in  three or four cases.3   Prof. J. II. Bennet4 gave it freely in
four cases, in not one of which did it seem to control or alleviate the  disease.
The  experience of Dr. Pepper,5 in the  Pennsylvania  Hospital, in fourteen
cases of rheumatism, and of Dr. Cummins,6 of  Wheeling, Virginia, in  three
cases, were favourable  to the remedy; but  we cannot accord with the latter
 gentleman, in his  overstrained eulogy  of it as " by far the best medicine  that
 has ever  been promulgated in that disease, and Dr. Rees, for his discovery and
 the promulgation  of  it, is  deserving of  the highest esteem of  the profession,
 and the lasting gratitude of  his race" !   When grievously affected with  what
 was considered, by others, to be gout in the  muscles of the neck, but which
 the sufferer himself—the  author of this  work—regarded  as rheumatic in its
 character—lemon  juice was freely taken, for twenty-four  hours, without any
 apparent result.  At the end of this  time, however, a most violent and une-
 quivocal  attack of gout supervened in the lower extremities.
    Additional evidence, therefore, is needed, before this article—which  every
 gouty individual is, from experience,  afraid of—can be  regarded as an appro-
 priate, or even  an admissible remedial agent in arthritic  affections.   As  Mr.
 Dalrymple, however, has remarked, " should it stand the test of time and hos-
 pital practice, and we be able to avoid either half poisoning our patients with
 colchicum, stupifying  them with opium, or enervating them with mercury, a
 great boon will be conferred on the suffering multitudes  of this variable cli-
 mate,"—(that of England.)

    CCXXV.   Sum'buli Radix, Sumbul Root, Jata.mansia; German,  Sum-
 bulwurzel,  M o s ch us  wur zel, Spicanard.  A  root introduced into
  notice of late years—the mother plant undetermined, but presumed to belong
 to the Umbelliferae Family, and allied to Archangelica officinalis.7   Accord-
  in" to Erdmann  and Von Ledebour, and the  English botanist,  Mr  Robert
  Brown,  it comes from Bucharia;  whilst Guibourt says  it is obtained from Si-
  beria 8  It appears in  commerce either  uncut or in slices  from one to  lour (
  inches in diameter, and from half an inch to two inches thick; having a strong,
  musky odour, and a strong, bitter,  calamus-like taste.  Two varieties are met
  with in  En-dish commerce—the Russian and the Indian, which come respec-
  tively through Russia and Bombay—the latter being of closer texture, firmer,
  denser,  and^of a more reddish hue than  the former.9
    i Montreal Monthly Journal, Aug. 1853.       2 London Lancet, June 11, 1853.
    s Amer Journ. of the Med.  Sciences, July, 1854, p. 83.
    4 Edinb. Monthly Journ. of  Med. Science, April, 1853, p. 353.       ,„...,   , .
    5 Quarterly Summary  of the  Transaction, of the College of Physicians of Philad. vol. i.

    °6 Amer Journ.  of the Med. Sciences, Oct. 1852, p. 402.
    7 Whenbrenncr, Die neueren Arzneimittel, tr. s. w. S. 2.6.  Erlangen, 1848.
    s Dierbach Die neuesten Entdeckungen in der Materia Medica, 3er Band, _te Abth.

   S-^reir "^nts tS^S and  Therap. 3d Amer. edit. p. 1185.  Philad. 1854. 
748
SUPPLEMENT.—SUMBULI RADIX.
   When examined by Reinsch, it was found to contain an odorous ethereal oil,
 which did  not  smell of musk;  a colourless balsam, and two peculiar acids,
 (Sumbulamsaure and S umbulolsaure; ) aromatic resin, bitter princi-
 ple, &c.   According to Schnitzlein and A. Frickinger,1 a soft resin oozes from
 the wood and concretes, which possesses the characteristic smell of the root in
 a high degree, and has  a taste between that of musk and calamus.  It is solu-
 ble in alcohol, and is in great part thrown down in a milky form  by the  addi-
 tion of water.
   Sumbul is said  to have been used in dropsy and  atropliy; but, of late, it
 has been brought forward in Germany  as a gentle excitant of the nervous sys-
 tem, and through it of all the organic actions.   Thielmann prescribed it in the
 nervous  stadium of typhoid fever; and  in chorea, delirium tremens? flatulence
 of the stomach as a consequence of tonic spasms, in anasthcsia of the nerves of
 the bladder, enuresis, ischuria renalis spastica, diarrhoea and cholera morbus;
 and he suggests that it may be found a valuable  prophylactic  and  curative
 agent in cholera.   He  prescribed it also in a case of violent vomiting in  the
 convalescent stage of typhus; in diabetes insipidus; and in tubercular phthisis;
 and it seemed to him to improve the condition of a patient in the last period
 of profuse suppuration  from caries with hectic fever.   In  1853, he informed
 Drs. Wood and  Bache3 that he depended mainly upon it in the treatment of
 delirium tremens;  "having found it superior in its composing influence over
 that complaint  even to opium."   It has been prescribed, indeed, in the  most
 heterogeneous cases;4 and there is too much reason to  believe, that effects have
 been assigned to it to which it is little or not at all entitled.   It was given  by
 Dupuis,5of Mainz, in cardialgia, colic, disordered digestion in pregnancy, and
 in convalescence; and Von Kicter,6 of Kasan, prescribed it generally with ad-
 vantage  in cholera typhus and in the later  periods of cholera.   A few years
 ago it was introduced into England  by Dr. Granville, of London, with a title
 to his essay on it, which is sufficient to  cast distrust on his  testimony,—" The
 Sumbul; a  new Asiatic  remedy of great  power against nervous disorders,
 spasms of the stomach, cramp, hysterical affections, paralysis of the limbs and
 epilepsy ; with  an account of its physical, chemical and medicinal characters,
 and specific [?]  property of checking the  progress of collapse-cholera, as first
 ascertained in Russia"!   In this, Dr. Granville gives a history of the  article,
 and of its various applications to the treatment of disease.7  " We  do not find,"
 says Dr.  Ranking,8 "that  Dr. Granville's  observations have  been confirmed.
 Should there be anything in the medicine, it will doubtless soon be known."
  It has been given as an antispasmodic in epilepsy, by Dr. Todd,9 but the  re-
 sults have not been published.
  It is prescribed in powder, in  the  dose of half a scruple and more,  several
 times a day ; in  infusion—half an ounce of the root to  six ounces of water—
 —dose, a tablespoonful.—In decoction, in water or hock, half an  ounce of the
 root to eight ounces of water or wine, boiled down to  six ounces—dose, a  ta-
blespoonful ; and in infuso-decoctum—half an ounce of the root being infused

  1 Dierbach, Die  neuesten Entdeckungen in der Materia Medica, 3er Band, 2te Abth.
S. 1156.
  2 Meinhard, Schmidt's Jahr. lxx.  172, cited in  Brit, and  For. Med. Chir. Rev., Jan.
 1852, p. 275.
  3 Dispensatory of the United States of America, 10th edit.  p. 1395.  Philad. 1854.
  4 Aschenbrenner, Ibid. S. 257.
  5 Schmidt's Jahrbucher,  Jahrgang 1849, S. 294.                       6 ibid.
  1 A full notice of Dr. Granville's pamphlet is  contained  in Edinburgh Medical  and
Surgical Journal for Oct. 1850, p. 459.
  s The Half-yearly Abstract of the Medical Sciences, No. 12, July to December, 1850,
Amer. edit. p. 184. Philad. 1851.
  9 Cited from London Lancet, in Med. Examiner, July, 1850, p. 437. 
SUPPLEMENT.—TELLURIUM.
749
in five ounces of boiling water;  digested for a quarter of an hour in a closed
vessel; strained; and the residue boiled for a quarter of an hour in sufficient
water to leave three ounces.   The  strained liquors must then be mixed, and
given like the infusion  and decoction.  A tincture of it is  also prepared, like
the tinctura Valeriana.;  dose—fifteen  to twenty-five drops; and an extract, the
dose ot which is from five to ten grains.1

   CCXXVI.  Tellu'rium;  French, Tellure;  German, Tellur.  M. Han-
senJ made some experiments with the  view of testing the action of the salts
of tellurium on  the animal economy.  About eight grains of tellurous acid
were given to a  dog of medium size in a piece of meat; and the same quantity
the next day.  The breath of the animal gave off  the smell of tellurium, and
these were the only phenomena observed.   On  the third day, eleven grains of
the acid  tellurite or potassa were given in  solution.   At  the end of a
minute, the breath  had  a marked odour;  the animal  vomited, and  its excre-
ments were of a black colour.  On the  fourth day, eleven grains of the same
salt were injected into the stomach, and similar phenomena followed.  After
an injection of  the salt into the jugular vein, convulsions supervened,  with
alvine discharges, and the animal died in a few minutes;—the body, when
opened, exhaling the strong alliaceous  odour of tellurium; and many of the
organs being coloured of a blue black, owing to the deposition of  minute black
points seen distinctly with the microscope.
   M. Hansen took himself, for several days, small doses of the  acid tellurite
of potassa,—half a  grain the first four days; three quarters of a grain the two
following; and  a grain  and a quarter on the seventh  day.  During the first
days, he remarked no other phenomena than slight  somnolence, and a little
increase of appetite;  but after the last dose, nausea supervened, with a sense
of oppression in the cardiac region *and copious salivation.  The tongue be-
came clammy and foul,  and the appetite disappeared.  These  symptoms con-
tinued for a fortnight.   The most  curious phenomenon was the foetor of the
breath.   The alliaceous odour of tellurium was observed a few minutes after
taking the first dose;  became  very strong and disagreeable  in the  course  of
the experiments, and was not gone until the expiration of  seven weeks.   M.
Hansen thinks it is owing to a volatile  organic combination analogous to tel-
lurethyle; and he states, that M. Wohler—the celebrated chemist—observed
an alliaceous smell  about himself the  whole time he  was occupied in his re-
searches on tellurethyle.
  Similar trials were made with the salts of tellurium by Professor Simpson,
of Edinburgh.   The odour was, however, so disagreeable and persistent as  to
interfere with their  farther employment.

  1 Aschenbrenner, loc. cit.
  2 Annal. der Chemie und Pharm. Bd. lxxxvi. and Journal de Pharmacie, 3eme s.rie,
xxiv. 238.   Paris, 1853. 
\ 
INDEX   OF  REMEDIES.
 Abeille  mellifiqie, 706.
 Acetas chinicus, 007.
   morphicus, 527.
   morphii, 527.
   quinicus, 607.
   strychnicus,  667.
 Acetone,  640.
 Acetum ligneum, 33.
   lignoruni empyreumaticum, 33.
   pyrolignosum, 33.
 AcicL acetic, empyreumatic, 33.
   auric, 138.
   benzoic, 36.
   carbazotic, 702.
   chromic, 703.
   cyanhydric, 43.
   gallic, 39.
   hydriodic, liquid, 493.
   hydrocyanic, 43.
            medicinal, 43, 44.
   iodic, 498.
   lactic, 55.
   muriatic, dephlogisticated, 197.
           oxygenated, 197.
   nitric, 703.
   nitro-muriatic,  202.
   of milk, 55.
   oxymuriatic,  liquid, 204.
   picric, 702.
   prussic, 43.
   pyroligneous, 33.
   pyrolignic, 33.
   tannic,  57.
   tellurous, 749.
 Acide hydrocyanique, 43.
   benzoique, 36.
   carbazotique, 702.
   chromique, 703.
   gallique, 39.
   iodique, 498.
   lactique, 55.
   nitrique, 703.
   prussique, 43.
   pyro-ac.tique, 33.
   pyroligneux,  33.
   pyrolignique, 33.
   tannique, 57.
Acidum aceticum empyreumaticum, 33.
   benzoicum, 36.
            per sublimationem,  36.
 Acidum benzoylicum, 36.
   borussicum, 43.
   cahincicum, 159.
   caincre, 159.
   carbazoticum, 702.
   chromicum, 703.
   gallicum, 39.
   hydrocyanicum, 43.
   iodicum, 498.
   lacteum, 55.
   lacticum, 55.
   lactis,  55.
   ligni pyro-oleosum, 33.
   marinum dephlogisticatum, 197.
   muriaticum oxygenatum, 197.
   muriaticum oxygenatum  ad  contagia,
         197.
   nitricum, 703.
   prussicum, 43.
   pyro-aceticum, 33.
   pyrolignosum, 33.
   pyroxylicum, 33.
   quercitannicum, 57.
   tannicum, 57.
   zooticum, 43.
   zootinicum, 43.
Aconite,  extract  of,  alcoholic, 68.
   extract of, ammoniated, 68.
Aconitia, 63.
Aconitine, 63.
Aconitium, 63.
Acqua balsamica arteriale, 97.
      Binelli, 97.
      Brocchieri, 99.
      Monterossi, 98.
Actrea racemosa, 231.
Act.e, 231.
Acupuncturation, 69.
Acupuncture, 69.
Adansonia digitata,  705.
Adstringirende Brazilische Binde, 273.
iEsculin,  416.
-Esculus  hippocastanum, 416.
.Ether, 77.
  chloricus, 226.
  hydrocyanicus, 76.
  hydriodicus, 499.
  lignosus,  649.
  prussicus, 76.
  pyro-aceticus, 649. 
V
752
INDEX OF REMEDIES.
iEther sulphuricus, 77.
  sulphuricus phosphoratus, 545.
  vitriolicus, 77.
iEtherizatio,  77.
Aetzroggen, 327.
Afterkorn, 327.
Agaric blanc, 147.
  white, 147.
Agaricus albus, 147.
Agathosma crenatum, 157.
Agathotes chirayita, 406.
Aimant, 505.
Air-douches into the Eustachian tube,. 441.
Akonitin, 63.
Akupunktur, 69.      ^L
Alaunerde, reine, 115.
Alcali vegetabile  salito-dephlogisticatum,
         584.
Alcohol, mesitic, 649.
  sulphuris, 670.
Alcool de soufre, 670.
Alexiterium chloricum, 197.
Almond, bitter, water of, 95.
Alumina, acetate of, 89.
  pure,  115.
  salts of, 89.
  sulphate of, 89.
Aluminas sales, 89.
Alumine factice, 115.
  sels d', 89.
Aluminii oxidum, 115.
Aluminium, chloride of, 89.
Ammonia, arseniate of, 117.
  benzoate of, 39.
  hydriodate of, 497.
  phosphate of, 91.
Ammoniae arsenias, 117.
  ferro-citras, 353.
  phosphas, 91.
Ammoniak arseniksaures, 117.
Ammoniaque, arseniate d', 117.
  phosphate d', 91.
Ammoniated counter-irritants, 267.
Ammonii iodidum, 497.
Ammonium arsenicum, 117.
  arseniksiiures,  117.
  hydroiodicum, 497.
  iodatum,  497.
  iodide of, 497.
  phosphors'aures,  91.
Amyli iodidum, 497.
Amylum iodatum, 497.
Anthrakokali, 95.
  sulphuretted, 95.
Apfelgranate, 410.
Apiol, 705.
Apiolum, 705.
Apis domestica, 706.
  mellifica, 706.
Aqua amygdalarum concentrata, 95.
                   amar arum, 95.
   arsenicalis Pearsonii, 118.
   balsamica arterialis, 97.
   Binellii, 97.
   Brocchierii, 99.
   chlorinii, 204.
Aqua lauro-cerasi, 90.
  natri oxymuriatici, 647.
  oxygenata muriatica,  204.
  oxygeno-muriatica,  204.
  oxymuriatiea, 204.
  picis liquid.., 104.
Argent, chlorure d\ 108.
  et d'ammoniaque chlorure d', 109.
  cyanure d', 110.
  iodure d',  111.
  oxide d', 112.
  preparations  d',  106.
Argenti chloridum, 108.
  chloruretum,  108.
  cyanidum,  110.
  cyanuretum,  110.
  et ammoniaci chloruretum, 109.
  et ammoniae chloridum, 109.
  ioduretuni, 111.
  iodidum, 111.
  muriatico-ammoniati liquor, 110.
  oxidum, 112.
  praeparata, 106.
Argentum chloratum, 108.
  cyanogenatum, 110.
  divisum, 114.
  hydrocyanicum, 110.
  iodatum, 111.
  limatum,  114.
  muriaticum,  108.
  muriaticum ammoniatum, 109.
  oxydatum, 112.
  salitum, 108.
Argil, pure, 115.
Argilla pura, 115.
Armoise commune, 121.
Arnica, 116.
  montana, 116.
  plauensis,  116.
Arnique, 116.
Arsenias ammonise, 117.
  potassae acidus, 348.
Arseniate of soda, 118.
Arsenic, hydriodate of,  119.
  iodide of, 119.
  and mercury, double iodide of, 434.
  iodure de, li9.
  teriodide  of,  119.
 Arsenici hydriodas, 119.
   et hydrargyri hydriodas, 434.
   et hydrargyri iodidum, 434.
   iodidum,  119.
   ioduretum,  119.
   teriodidum,  119.
 Arsenicum iodatum, 119.
 Arsenikiodiir,  119.
 Arsenite of potassa, 118.
 Artanthe elongata, 511.
 Artemisia vulgaris, 121.
   extractum resinosum, 123.
 Asche, 723.
 Ash, European common, 723.
 Aspidium filix mas, 388.
 Assaeou, 727.
 Athyrium filix mas, 388.
 Atropia, 125. 
INDEX OF REMEDIES.
753
Atropin, 125.
Atropina, 125.
Atropine, 125.
Atropinum, 125.
Atropium, 125.
Auri chloretum, 132.
  chloretum cum chloreto natri, 134.
  chloridum, 132.
  chloruretum, 132.
  cyanidum,  136.
  cyanuretum, 136.
  et sodii chloridum, 134.
  et sodii chloruretum, 134.
  et sodii perchloruretum, 134.
  iodidum, 137.
  ioduretum, 137.
  murias, 132.
  nitromurias, 137.
  oxidum, 138.
  peroxidum, 138.
  praeparata, 128.
  pulvis, 138.
  terchloridum, 132.
   tercyanidum, 136.
   teroxidum, 138.
 Auric ]acid, 138.
 Aurico-natricum murias, 134.
 Aurif-res compos.s, 128.
 Auro-terchloride of sodium, 134.
 Aurum chloratum,  132.
   chloratum natronatum, 134.
   cyanatuin, 136.
   cyanicum, 136.
   cyanogenatum, 136.
   hydrocyanicum,  136.
   iodatum, 137.
   limatum, 138.
   metallicum, 138.
   muriaticum, 132.
   muriaticum natronatum, 134.
   nitro-muriaticum, 137.
   oxydatum, 138.
   oxydulatum muriaticum, 132.
   salitum, 132.
   sesquichloratum natronatum, 134.

 Bachelor's buttons, 540.
 Balaustier, 410.
 Ballota lanata, 140.
 Ballota wollige, 140.
 Ballota cotonneuse, 140.
 Bandwurmwaldfarrn,  388.
 Bang, 177.
 Banksia Abyssinica, 148.
 Baobab, 705.
 Barii iodati hydras, 141.
   iodidum, 141.
 Barium iodatum, 141.
   iodide of, 141.
 Bark, resinous constituents ot, t>.».
   astringent, of Brazil,  273.
 Barosma crenata,  157.
 Baryt hydriodsliurer,  141.
 Baryta hydriodica, 141.
   hvdriodate of, 141.
          48
Baryta, hydriodas, 141.
Barytin, 680.
Barytium iodatum, 141.
BaryumiodUr,  141.
Baumnuss, 509.
Bebeeria, 142.
Bebeerin, 142.
Bebeerina, 142.
Bebeerine,  142.
Bee, 706.
Beifusswurzel,* 121.
  extract,  123.
  gemeiner, 121.
Benzoeblumen, 36.
Benzoes'aure, 36.
Benzoyls'aure, 36.
Berberin, 145.
Berberina, 145.
Berberine, 145.
Berberinum, 145.
Berberisgelb,  145.
Bergerthran, 547.
Berliner Blau, 356.
B.toine  des Savoyards,  116.
Biberina, 142.
Biene, 706.
 Bierhefen, 711.
Bignonenbaum,  147.
 Bignonia catalpa,  147.
 Bile, ox, 718.
 Bile, swine, 720.
 Bilis porcina, 720.
 Bilis taurina, 718.
 Binellisches Wasser, 97.
 Biogamia, 405.
 Biomagnetismus, 405.
 Bismuth, valerianate of, 707.
 Bismuthi valerianas,  707.
 Bismuthum valerianicum, 707.
 Bitter almonds,  water of, 95.
   oil of, 96.
   Welter's, 702.
 Bittererde citronensaures, 507.
 Bittermandelwasser,  95.
 Blankenheimer  Thee, 396.
 Blau, Berliner,  356.
   Pariser, 356.
 Blaud's Pills, 381.
 Blausaure, 43.
 Blaustoffeisen,  356.
 Blaustoffgold, 136.
 Blaustoffkalium, 699.
 Blaustoffquecksilber, 419.
 Blaustoffsilber,  110.
 Blaustoffzink, 696.
 Bl. cornu, 327.
 Bled avort., 327.
   farouche, 327.
 Blei hydriodsaures, 581.
   iodiir, 581.
   iodwasserstoffsau.es, 581.
 j Bleichpulver, 165.
 Bleiiodid, 581.
 j Bleioxyd, salpetersaures, 737.
 [ Bleitannat, 583. 
754
INDEX OF REMEDIES.
 Bleu de  Prusse, 356.
 Blue, Berlin,  356.
    Prussian, 356.
 Boccho,  157.
 Bocchoe, 157.
 Bole, Armenian, 115.
 Boletus albus, 147.
    laricis, 147.
    purgans, 147.
 Boocho,  147.
 Brayera  anthelmintica, 148.
 Brechnuss, 540.
 Brechstoff,  323.
 Brom, 151.
 Brome, 151.
 Bromeisen, 349.
 Brometum  ferricum, 349.
    hydrargyrosum, 418.
 Bromin,  151.
 Bromina, 151.
 Bromine, 151.
   chloride  of,  154.
 Bromincum, 151.
 Brominii  chloridum, 154.
 Brominium, 151.
 Brominum,  151.
 Bromium, 151.
 Bromkalium, 588.
 Bromquecksilber, 418.
         doppelt, 418.
         in maximum, 418.
 Bromum, 151.
 Bromwasserstoffsliures kali, 588.
 Brucia, 155.
 Brucin, 155.
 Bruciha,  155.
 Brucine, 155.
 Buccubliitter,  157.
 Buchu,  157.
 Buckeye,  416.
 Buckhu, 157.
 Bugbane,  231.
 Buranhem, 517.
 Butyrum zinci,  689.

 Cabotz, 148.
 Cade Oel,  735.
 Cadmii sulphas, 707.
 Cadmium, nitrate of,  708.
  sulphuricum, 707.
  schwefelsiiures, 707.
  sulphate of, 707.
Caeruleum Beroliniense, 356.
  Borussicum,  356.
Cafein, 708.
Caffein,  708.
Oaffeina, 708.
Cahincae radix,  159.
Caille-lait, 711.
Cainano. radix,  159.
Cainca root, 159.
Caincae acidum, 160.
  radix, 159.
Caincawurzel, 159.
Calcar, 327.
Calcaria chlorata, 165.
 Calcaria chloretum, 165.
    chlorica, 105.
    phosphorica, 709.
 Calcaria. chlorum,  165.
 Calcii bichloruretum, 165.
    oxy chloruretum, 165.
    oxydi  chloruretum, 165.
    proto-chloruretum, 165.
 Calcis bichloruretum, 165.
    chloridum,  165.
    hypochloris,  165.
    oxymurias, 165.
    phosphas, 709.
 Calcium, oxide de, chlorure d', 165.
    protoxichlorure de, 165.
 Calendula Alpina, 116.
    officinalis, 162.
   sativa, 162.
 Calendulin, 162.
 Caltha  alpina, 116.
   sativa, 162.
 Calx chlorinata, 165.
   oxymuriatica, 165.
 Candytuft, bitter, 728.
 Caninanae radix, 159.
 Caniraminum, 155.
 Caniramium, 155.
 Cannabin, 176.
 Cannabis Indica, 175.
 Caper spurge, 346.
 Carbazotsaure, 702.
 Carbo animalis, 184.
   carnis, 184.
   mineralis, 350.
 Carbon,  sesqui-chloride of, 710.
   sesqui-iodide of, 186.
   sesqui-ioduret of, 186.
   terchloride of, 210, 710.
   trichloratum, 710.
   chloratum, 210.
 Carboneum sulphuratum, 070.
   chloratum, 210.
   trichloratum, 710.
Carbonicum chloratum,  710.
Carbonii bisulphuretum, 670.
   sulphuretum, 670.
   sulfidum, 670.
Carbonis sesqui-chloridum, 710.
   sesqui-iodidum, 186.
   sesqui-ioduretum, 186.
   trichloridum, 710.
Carbonium iodatum,  186.
Caro vitulina tosta. 184.
Carrageen moss, 229.
Carrageenin, 229.
Carragheen moss, 229.
Castanea equina, 416.
  pavina, 416.
Catalpa,  147.
  arborea,  147.
  arborescens, 147.
  cordifolia, 117.
  tree, 147.
Catapuce, 346.
Cataputia minor, 346.
Catawba tree,  147.
Catheterism of the Air-tubes, 188. 
INDEX OF  REMEDIES.
< 00
Catheterism of the Eustachian tube, 441.
Cauterizatio et Catheterismus Laryngis et
         Tracheae, 188.
Cauterization of the Air-passages, 138.
Cautery, galvanic, 405.
Cedron, 742.
Cephaelinum, 323.
Cererium, 711.
Cerevisiae fermentum, 711.
Cerium,  711.
Cerussa nigra, 350.
Cetrarin, 193.
Cetrarina, 193.
Cetrarine, 193.
Cetrarinum, 193.
Chanvre  Indien, 175.
Charbon  animal,  184.
Charcoal, animal, 181.
Chaux, chlorate de, 165.
  chlorure de, 165.
  muriate suroxigeno ou  oxig.ne- de,  165.
  oxichlorure de, 105.
  oximuriate de,  165.
  phosphate de, 709.
  souschlorate  de, 165.
Chestnut, horse, 416.
Chimaphila, 195.
Chimophila, 195.
Chinastoff, 605.
Chinicus citras, 609.
  hydrochloricus, 611.
Chinidine, 640.
Chinii acetas, 607.
  citras, 609.
  ferrocyanas, 610.
  hydrochloras, 614.
  murias, 614.
  nitras, 614.
  phosphas, 615.
  sulphas, 615.
  tannas, 637.
Chinin, 605.
  arseniksaures, 608.
  citronensaures, 609.
  citronsaures, 609.
  eisenblausaures, 610.
  essigsaures,  607.
  gerbesaures, 637.
  gerbstoffsaures, 637.
  hydrochlorsaures, 614.
  iodwasserstoffsaures, 611.
  milchsaures, 613.
  phosphorsaures, 615.
  salpetersaures,  614.
  salzsaures, 614.
  schwefelsaures, 615.
  sulphat, 615.
  tanninsaures, 637.
  valeriansaures, 635.
  zitronsaures, 609.
Chinini acetas, 607.
  citras,  609.
  phosphas,  615.
Chininum, 605.
  aceticum, 607.        ,  .
  arsenicosum seu arsenicicum, 60S.
  citricum, C09.
Chininum hydriodicum, 611.
  lacticum,  G13.
  muriaticum, 614.
  resino-sulphuricum, 638.
  salitum, 614.
  sulphuricum, 615.
  tannicum, 637.
  valerianicum, 635.
Chininium, 605.
Chiniodine, 03S.
Chinium, 605.
  aceticum, 607.
  citricum, 609.
  ferro-cyanogenatum, 610.
  ferro-hydrocyanicum, 610.
  hydrochloricum, 614.
  muriaticum, 611.
  nitricum, 614.
  phosphoricum, 615.
  salitum, 614.
  sulphuricum, 615.
  tannicum, 637.
Chinoidine, 638.
Chinolein, 730.
Chiococca. radix, 159.
Chirayita, 406.
Chiretta, 406.
Chlor, 197.
Chloras kalicus depuratus, 584.
  potassicus, 584.
Chlorblei, 737.
Chlorcalciumoxyd, 165.
Chlore, 197.
  eau de, 204.
  liquide,204.
Chloretum auri, 132.
                cum chloreto natrii, 134.
  calcaria.,  165.
  zinci, 688.
Chlorfllissigkeit, 204.
Chlorgas, 3 97.
Chlorgold, 132.
           natrium,  134.
          natronium, 134.
Chlorhydras morphicus, 530.
  quinicus, 614.
Chlori aqua, 204.
  liquor, 201.
Chloride of bromine, 154.
  of soda, 646.
  of zinc, OS:).
Chlorine, 197.
  solution of, 204.
Chlorineum,  197.
Chlorini aqua, 204.
Chlorinium, 197.
Chlorinum, 197.
Chlorkalk, 165.
Chlorkohlenstoff, dreifach, 710.
Chlornatrium, 745.
Chlornatron, 646.
Chlornatrum, 616.
Chloroform, 210.
  solution of gutta percha, 258.
Chloroformyl, 210.
Chloroplatinatrium, 580.
Chlorplatin, 579. 
75G
INDEX OF REMEDIES.
Chlorsilber, 108.
Chlorsodafliissigkeit, 647.
Chlorum, 197.
  calcariae, 165.
  liquidum, 204.
Chloruretum zincicum, 689.
Chlorwasser, 204.
Chlor, wasseriges, 204.
Chlorzink,  689.
Chondrus, 229.
  crispus, 229.
  polymorphus, 229.
Christophskraut, traubenformiges, 231.
Chromium, peroxide of, 703.
Chromsliure, 703.
Chrysanthemum, 162.
Churrus, 176.
Cicutinum,714.
Cimicifuga, 231.
Cinchonia,  234.
  iodide of, 611.
Cinchonicine, 237.
  sulphate  of, 237.
Cinchonin,  234.
Cinchonine, 234.
Cinchoninum, 234.
Cinchotin,  640.
Cinin, 741.
Citras chinicus, 609.
  ferricus,  352.
  quinicus, 609.
Citronensaft, 746.
Citronelle, 717.
Clavus secalinus, 327.
  siliginis, 327.
Clou de seigle, 327.
Coagulum,  711.
Codeia, 238.
Codeine, 238.
Codeinum, 238.
Cod-liver oil, 547.
Cod-liver olein, 547.
Coffein, 707.
Cohort, 231.
Cohosh, 231.
Colchicia, 244.
Colchicum, 243.
  autumnale, 243.
Colchique, 243.
Collodion,  252.
  cantharidal, 257.
   iodized,  257.
  vesicant, 257.
Collodium, 252.
  ricinatum, 257.
   terebinthinatum, 257.
   tinctum, 255.
   vesicans, 257.
 Compressio, 259.
 Compression, 259.
   of arteries, 263.
   methodical, 259.
 Conein, 714.
 Congelation, 713.
 Conia, 714.
 Conicinum, 714.
 Contra-irritation, 266.
Contre-irritation, 266.
Corrigeen moss, 2.!).
Cortex adstringens Braziliensis, 2
Corylus rostrata, 271.
Cosso, 148.
Coso, 148.
Cotyledon umbilicus, 716.
Cotz, 148.
Counter-action, 266.
Counter-irritant, Granville's, 267.
              ammoniated, 267.
              antidynous, 267.
              Gondret's, 266.
              Granville's, 267.
              Raspail's, 269.
Counter-irritation, 266.
Courge, 717.
Cousso, 148.
Crayon noir, 350.
Creasote, 275.
Creosoton, 275.
Creosotum, 275.
Crocus martis aperiens, 384.
Croton oil, 565.
Crusadinha raiz,  159.
Cubeba, 299.
Cubebenpfeffer, 299.
Cubebin, 299, 575.
Cubebs, 299.
Cucurbita pepo, 717.
Cusso, 148.
Cyanather, 76.
Cyaneisen, 356.
Cyaneisenzink, 696.    ;
Cyangold, 136.
Cyanhydras kalicus, 590.
  zincicus, 695.
Cyankalium, 590.
Cyanquecksilber, 419.
Cyansilber, 110.
Cyanuretum auricum, 136.
  ferrozincicum, 696.
  potassicum, 590.
  zincicum, 695.
Cyanwasserstoffather, 76.
Cyanwasserstoffsaure, 43.
Cyanzink, 694.

Del. hia, 304.
Delphin, 304.
Delphina, 304.
Delphinia, 304.
Delphinine, 304.
Delphium, 304.
Derosn'esches Opiumsalz, 538.
Digitalia, 306.
Digitalin, 306.
Digitalina, 306.
Digitaline, 306.
Digitalinum,  306.
Diosma, 157.
Diosmin, 158.
Dogwood, Jamaica, 736.
 Donovan's solution, 434.
 Doppelt bromquecksilber, 418.
 Doronic d'Allemagne, 116.
 Doronicum Germanicum, 116. 
INDEX OF REMEDIES.
757
Doronicum plantaginis folio, 116.
Drops, fever, Warburg's, 145.
Druck,259.
Duftstrauchblatter, 157.

Eau d'amandes ameres, 95.
  de Binelli, 97.
  de Brocchieri, 99.
  de chlore, 204.
  de goudron, 101.
  de javelle, 647.
  de Pagliari, 103.
  hemastatique de Tisserand, 103.
  medicinale d'Husson, 246.
  styptique de Brocchieri, 99.
Einschmierung, 728.
Eisenblausliures, 356.
Eisenbromid, 349.
Eisenchinin, citronensaures, 355.
Eisenchlorid, 721.
Eisencyaniircyanid, 356.
Eiseniodiir, 359.
Eisen, kohlensaures, 380, 384.
  salzsaures,  rothes, 721.
Eisenoxyd, blausaures, 356.
  baldriansaures, 387.   '
  braunes, 381.
  bromwasserstoffsliures, 349.
  citronensaures, 352.
  eisenblausaures, 356.
  gerbesaures, 387.
  iodwasserstoffsliures, 359.
  kohlensaures, 379, 384.
  milchsaures, 367.
  unit ammoniak, 353.
  salpetersaures, 370.
   salzsaures, 721.
  wasscrhaltiges, 372.
 Eisenoxydhydrat, 372.
Eisenoxydul arsensaures, 348.
  arseniksaures, 348.
  blausaures, 356.
  citronsaures, 352.
  hydriodsaures, 359.
  iodwasserstoffsaures, 359.
  kohlensaures, 380, 384.
  milchsaures, 367.
Eisenpraparate, 347.
Eisenzink, blausaures, 696.
Eisenzinkcyaniir, 696.
Electricitas.  See Galvanismus.
   animalis, 398.
  galvanica seu metallica, 398.
Electricity, galvanic, 398.
  magnetic, 311.
Electro-magnetismus, 311.
Electropunctura, 318.
Electropuncturation, 318.
Elixir of opium, M'Munn's, 533.
Emeta, 323.
Emetia, 323.
Emetina, 323.
Emetine of the  violet, 323.
  indigenous, 323.
Emetium, 323.
Epurge, 346.
Erfrieren, 713.
Ergot, 327.
Ergot, oil of, 341.
Ergota, 327.
Ergotin, 314.
Esche, 723.
Esprit pyroace"tique, 649.
Essigalkohol, 649.
Essiggeist, 649.
Ether, acetic, injections of, into the Eusta-
         chian tube, 445.
  chloric, 210.
          strong, 226.
  compound, 227.
  hydriodic, 499.
  hydrocyanic, 76.
  iodhydric, 499.
  prussic, 76.
  pyroacetic, 649.
  sulphuric, 77.
  sulphurique, 771
Etherine, hydrocyanate of, 76.
Etherization, 77.
Ethyle, cyanuret of, 76.
  iodide of, 499.
Eupatorium huaco, 410.
Euphorbia lathyris, 346.
Euphorbie, purgirkorner, 346.
Exoneurism, 405.
Extract, alcoholic, of nux vomica, 540.
  of ergot, 344.
Extractum ergotae, 344.
  filis maris, 388.
  nucis vomicae alcoholicum, 540.
  opii aceticum, 530.
  resinosum radicis artemisiae, 123.
Extrait alcoholique de noix vomique, 540.
  de  guarana, 572.
  hemastatique  de Bonjean, 344.
  savonneux de Purine, 676.
Extrakt geistiges der Krahenaugen, 540.

Fallkraut, 116.
Farrenkraut, 388.
   mannlein,'388.
   mannliches, 388.
Fel bovinum, 718.
   bovis, 718.
   tauri, 718.
Feldkiirbis, 715.
Fer, arseniate de, 348.
   bromure de, 349.
   carbure de, 350.
   citrate de, 352.
   cyanure de, 356.
   deutoxicyanure de, hydrate", 356.
   hydrate, deutocyanure de, 336.
   hydriodate de, 359.
   iodure de, 359.
   lactate de, 367.
   nitrate de, 370.
   perchlorure de, 721.
   preparations de, 347.
   protocarbonate de, 379.
   protoiodure de, 359.
   reduit par hydrogene, 347.
   souscarbonate de, 384.
   tannate de, 387. 
758
INDEX OF REMEDIES.
Fer, tritochlorure de, 721.
  tritohydrocyanate ferrure de, 356.
  tritohydroferrocyanate de, 356.
  valerianate de, 387.
Fermentum, 711.
Fern, male,  388.
  shield, male, 388.
Ferri  et alumim. sulphas, 721.
  ammonio-citras, 353.
  et ammoniae citras, 353.
  arsenias, 348.
  borussias, 336.
  bromidum, 349.
  carbonas, 379, 384.
          prcecipitatus, 384.
          saccharatum, 380.
  carburetum, 350.
             nativum, 350.
  chloridum, 721.
  citras, 352.
  cyanuretum, 356.
  deuto-carbonas fuscus, 384.
  ferrocyanuretum, 356.
  ferro-sesquicyanidum, 356.
  hydriodas, 359.
  hydrobromas, 349.
  iodidum, 35!).
  ioduretum, 359.
  lactas, 367.
  et magnesias citras, 355.
  nitras, 370.
  nitratis liquor, 370.
  nitrici oxydati liquor, 370.
  oxydi ferrocyanas, 356.
  oxydulatum hydrocyanicum, 356.
  oxydum fuscum, 384.
          hydratum, 372.
          rubrum, 384.
  perchloratum, 721.
  percyanidum, 356.
  pernitras, 370.
  persesquinitratis liquor, 370.
  prseparata, 347.
  protocarbonas,  379.
  prussias, 356.
  pulvis, 347.
  et quiniae citras, 355.
  sesquichloridum, 721.
  sesquicyanidum, 356.
  sesquioxidum hydratum, 372.
  sesquioxydum, 372, 384.
  subcarbonas, 384.
  tannas, 387.
  valerianas, 387.
Ferro-manganic preparations, 723.
Ferrugo, 372.
Ferrum ammoniaco-citricum, 353.
  arseniatum, 348.
  arsenicum oxydulatum, 348.
  borussicum, 356.
  bromatum, 349.
  carbonatum, 350.
              praecipitatum, 384.
  carbonicum oxydulatum, 384.
             saccharatum, 380.
  carburetum, 350.
Ferrum citricum, 352.
  citricum, cum ammoniaco, 353.
  cyanogenatum, 356.
  cyanuretum, 356.
  et chininum citricum, 355.
  hydriodatum, 359.
  hydrobromicum oxydatum, 349.
  hydrocyanicum, 356.
  hydroiodicum oxydulatum, 359.
  iodatum, 359.
  lacticum, 307.
  muriaticum, 721.
              oxydatum, 721.
              rubrum, 721.
  nitratum, 370.
  nitricum oxydatum, 370.
  oxydatum hydratum, 372.
  oxydulatum hydrocyanicum, 356.
  oxydum hydricum, 372.
  perbromatum, 349.
  permuriaticum, 721.
  supercarburetum, 350.
  tannicum, 387.
  valerianicum, 387.
  zooticum, 356.
Fetteinreibung, 728.
Fiel de Boeuf, 718.
Filix mas, 388.
Firing, 272.
Flechtenbitter der Isllindisch.n Flechte, 193.
Fleischkohle, 184.
Flores Benzoes, 36.
Flores Benzoini, 36.
Flores Cosso, 148.
Flowers of Benjamin, 36.
Formyl, terchloride of, 210.
Formylsuperchlorid, 210.
Formylsuperiodid,  186.
Foug.re male, 388.
Fraxinus, 723.
Frene, 723.
Fucus amylaceus, 390.
  crispus, 229.
  Irlandicus, 229.
  lichenoides, 390.
Fuligo, 392.
  fornacum, 392.
  ligni, 392.
  splendens, 392.
Fuligokali, 95, 395.
Fumigatio muriatico-oxygenata, 197.
Fumigation de chlor, 197.
  de Guyton, 197.
  Guytonienne, 197.
  hygi.nique, 197.
Fumigations, Guyton-Morveau, 197.
Fungus of the larch, 147.
  laricis, 147.

Galeopsis angtjstifolia, 396.
  dubia, 396.
  grandiflora, 396.
  ochroleuca, 396.
  prostrata, 396.
  segetum, 396.
  versicolor, 398. 
INDEX OF  REMEDIES.
759
Galeopsis villosa, 398.
Gall, ox, 718.
  swine, 720.
Gallussliure, 39.
Galvanic brush, 404.
  plates, 399.
  suppository,  405.
Galvanisation localis.e, 404.
Galvanism, 398.
Galvanopuncture, 318.
Garten-Kurbis, gemeiner, 717.
Geblirpulver, 327.
Gfcfrieren, 717.
Gegenreizung, 266.
Gentiana chirayita, 406.
Gerbestoff, 57.
Gerbestoffblei,  583.
Gerbsliure, 57.
Gichtthran, 547.
Gigartina lichenoides, 390.
Glanzruss, 392.
Glycerin,  406.
Glycerina, 406.
Glyceryle, hydrate of oxide of, 406.
Glyceryloxyd, 406.
Glyzerin,  406.
Goharem, 517.
Gold and soda, hydrochlorate of, 134.
               muriate of, 134.
  and sodium, chloride of, 134.
  chlorid, 132.
  chloride of,  132.
  cyanid, 136.
  cyanide of, 136.
  cyanuret of,  136.
  iodid, 137.
  iodide of, 137.
  iodur, 137.
  ioduret of,  137.
  krystalle, 132.
  metallic, 138.
  metallisches, 138.
  muriate of, 132.
  natrium-chlorid, 134.
  natrum-chlorid, 134.
  natrum, salzaures,  134.
  nitro-muriate of, 137.
  oxide of, 138.
  oxyd, 138.
        blausaures, 136.
        hydrochlorsaures, 132.
  oxydirtes, 138.
  oxydiil, salzsaures,  132.
  oxynatrium,  salzsaures, 134.
  peroxide of, 138.
  prliparate,  128.
  preparations of, 128.
  pulver, 138.
  salpetersalzsliures,  137.
  salz, Figuier's, 134.
  salzsaures, 132.
  siiure, 138.
  sodahaltiges, salzsaures, 134.
  terchloride of,  132.
  tercyanide of, 136.
Gondret's counter-irritants, 266.
Gosso, 148.
Gracilaria lichenoides, 390.
Granatapfelbaum, 410.
Granatbaum, 410.
Granatillol, 565.
Granatin, 410, 510.
Granatum, 410.
Granville's counter-irritants, 267.
Graphites 350.
Grenadier,  410.
Grenadin, 410, 510.
Guaco, 414.
Guarana, 572.
Guarana-samenteig, 572.
Guncotton, ethereal solution of, 252.
Gunjah, 175.
Gutta percha, solution of in chloroform, 288.

Habbi, 148.
Hachisch, 175.
Haemospasia, 724.
H__mostasis, 726.
Hagenia Abyssinica, 118.
Hahnensporn, 327.
Haloidum oxygenatum, 584.
Hanf, 175.
Hanfnessel grossblumigte, 396.
Harnstoff, 676.
  salpetersaures, 678.
Haschisch, 175.
Haschischine, 176.
Hazel, beaked, 274.
Hefen, 711.
Hemospasie, 724.
Hemostasie, 726.
Hemp, Indian, 175.
Henricea pharmacearcha, 406.
Herba sideritidis, 396.
Herbe a pisser, 195.
  St.  Christophe, 231.
Herbstblume, 243.
Herbstzeitlose, 243.
Hippocastanum, 416.
Hohlzahns, grossbliithige, 396.
Holzessig, 33.
Holzessigsliure, 33.
Holzsaure,' 33.
  brenzliche oder brandige, 33.
Honeybee,  706.
Honigbiene, 706.
Hopfenmehl, 731.
Hopfenstaub, 731.
Hornblei, 737.
Hornseed, 327.
Hornsilber, 108.
Horse chestnut, 416.
Huaco, 414.
Huile de foi de poisson,  547.
  de cade, 735.
  de genevrier, 735.
  de morue, 547.
  de pignon d'Inde, 565.
  volatile de moutarde,  563.
Hundsnessel, gelbe oder grossbliithige, 396.
Hura Braziliensis,  727.
Hydrargyri bibromatum, 418. 
760
INDEX OF REMEDIES.
Hydrargyri bibromidum, 418.
  bicyanidum, 419.
  biiodatum,  426.
  biniodidum, 426.
  borussias, 419.
  bromidum,  418.
  cyanetum, 419.
  cyanidum, 419.
  cyanuretum, 419.
  deuto-bromidum, 418.
  deuto-ioduretum, 426.
  deutonitras, 432.
  dipernitras, 432.
  et arsenici iodidum, 434.
  et quini.. proto-chloridum, 727.
  hydrocyanas, 419.
  iodidulatum, 424.
  iodidum, 424.
        rubrum, 426.
  nitras, 430.
  perbromidum, 418.
  percyanidum, 419.
  periodidum, 426.
  pernitras, 432.
  pernitratis liquor, 432.
  praeparata, 418.
  protobromidum, 418.
  proto-iodidum, 424.
  proto-ioduretum, 424.
  protonitras, 430.
  prussias, 419.
  subiodidum, 424.
  supernitras, 432.
 Hydrargyrum biiodatum, 426.
                    cum kalio iodato, 595.
  biniodidum, 426.
  borussicum, 419.
  bromatum, 418.
  cyanatum, 419.
  cyanogenatum, 419.
  hydrocyanicum, 419.
  iodatum, 419.
          cum chlorido mercurii, 498.
          fiavum, 419.
          rubrum, 426.
  iodidulatum, 424.
  nitratum, 430.
  nitricum oxydatum, 432.
           oxydulatum, 430.
  perbromatum, 418.
  periodatum, 426.
  subiodatum, 424.
  zooticum, 419.
 Hydras ferricus, 372.
 Hydriodas kalicus, 597.
   ammoniae, 497.
   lixiviae, 597.
   strychnicus, 668.
 Hydriodate of ammonia, 497.
   of potassa,  597.
 Hydriodic acid, liquid, 493.
 Hydrochloras morphicus,  530.
   chinicus, 614.
 Hydrocyanas kalicus, 590.
   zincicus, 695.
 Hydrocyan'ather, 76.
Hydrocyanate of etherine, 76.
Hydrocyanic ether, 76.
Hydrocyans'aure, 43.
Hydroiodas kalicus, 597.
  lixiviae, 597.
Hypochloris sodicus aqua solutus, 647.
Iberis amara, 728.
Indicum, 437.
Indicus colour, 437.
Indig, 437.
Indigo, 437.
Indigum, 437.
Infusum picis liquid.., 104.
             empyreumatic.. liquidae, 104.
Injections of air, &c., into the Eustachian
  tube, 441^
Inonction, 728.
Inunction, 728.
Iod, 448.
Iodammonium, 497.
Iodarsen,  119.
Iodarsenik, 119.
Iodas strychnicus, 667.
Iod'atherid, 186.
Iodbaryum, 141.
Iodblei, 581.
Iodchlorquecksilber, 498.
lode,  448.
Iodeisen, 359.
Iodetum  hydrargyricum, 426.
Iodgold, 137.
Iodhydrargyrosum, 424.
Iodhydras kalicus seu potassae, 597.
           strychnicus, 668.
lodhydrargyrite de chlorure mercureux, 498,
Iodic  acid, 498.
Iodide of ammonium, 497.
  of arsenic, 119.
  of carbon, 186.
  of chloride of mercury, 498.
  of ethyle, 499.
  of iron, 359.
  of potassium, 597.
  of quinia, 611.
  of silver, 111.
  of starch, 497.
  of sulphur, 674.
  of zinc, 698.
Iodidum hydrargyricum, 426.
  hydrargyrosum, 424.
Iodine, 448.
  ethereal tincture of, 500.
  chloroform tincture of, 500.
Iodinium, 448.
Iodinschwefel, 674.
Iodium,  448.
Iodkalium, 597.
Iodkohlenstoff, 186.
Iodkohlenwasserstoff, 186.
 Iodoforma, 186.
Iodoformum, 186.
 Iodohydrargyrate of potassium, 595.
   of ioduret of potassium, 595.
 Iodquecksilber doppelt, 426.
   gelbes, 424. 
INDEX OF REMEDIES.
761
Iodquecksilber in maximum, 426.
  in minimum des iods, 424.
  rothes, 426.
Iods'iure, 498.
Iodsehwefel, 674.
Iodsilber, 111.
Iodstlirke, 497.
Iodstarkmehl, 497.
Iodum, 448.
Iodure d'amidon, 497.
  d'arsenic, 119.
  de carbon, 186.
  de fer, 359.
  de potassium, 597.
  de quinine, 611.
  de soufre, 674.
  double de mereure et de morphine, 43(
  plombique, 581.
loduretum hydrargyrosum, 424.
  potassicum, 597.
Iodzink, 698.
Iron, ammonio-citrate of, 353.
  and alumina, sulphate of, 721.
  and magnesia, citrate of, 355.
  anil  manganese, saccharine  carbonate
     733.
  and quinia,  citrate of, 355.
  arseniate of, 348.
  bromated or bromide of,  349.
  carbonate of, 379.
  carburet of, 350.
  chloride of, 721.
  citrate of, 352.
           magnetic oxide of, 353.
  cyanide of, 356.
  cyanuret of, 356.
  hydriodate of, 359.
  hydrobromate of, 349.
  hydro-oxide of, 372:
  iodated, 359.
  iodide of,  359.
  ioduret of, 359.
  lactate of, 367.
  nitrate of, 370.
            solution of, 370.
  oxide of, hydrated, 372.
  oxyhydrate of, 372.
  perchloride of, 721.
  peroxide of, 384.
             acetate of, 723.
              hydrated, 372.
  pernitrate of, 370.
  persesquinitrate of, solution  of, 370.
  potassio-citrate of, 353.
  preparations of, 347.
  proto-carbonate of, 379.
  proto-iodide of, 359.
  proto-ioduret of, 359.
  protoxide of, hydriodate of, 359.
              lactate of, 367.
  prussiate of, 356.
  Quevenne's, 347.
  sesquichloride of, 721.
  sesquioxide of, 384.
                hydrated, 372.
  sodio-citrate of, 353.
     49
   ; Iron, subcarbonate of, 384.
      tannate of, 387.
      tritoxide of,  hydrated, 372.
      valerianate of, 387.
    Irritamentum  metallonim seu metallicum,
      398.

    Jatamaxsia, 747.
    Johanniswurzel,  388.
    Juglans regia,  500.

    Kabliautiirax,  517.
    Kaffein, 708.
    Kahinca. radix, 159.
    Kali blausaures. 590.
      borussicum,  590.
!.     bromwasserstoffsliures, 388.
      chloricum, 5S4.
      chlorinicum, 5*1.
      chlorsiiures, 584.
      cyanatum, 590.
      cyanogenatum, 590.
      cyanwasserstoffsau.es,  590.
      elaiiiicum, 615.
of, i   hydriodicum, 597.
      hydriodsilures, 597.
      hydrobromicum, 5H8.
      hydrobromsliures, 5*8.
      hydrocyanicum, 590.
      hydroiodat,  597.
      hydroiodinicum, 597.
      hyperoxygenirt salzsliures, 584.
      iodinwasserstoffsliures,  597.
      iodwasserstoffsliures, 597.
      iodatum hydrargyratum, 595.
      muriaticum  hyperoxygenatum, 584.
      dlsaures, 645.
      oxychloricum, 584.
      oxydirt salzsaures, 646.
      oxymuriaticum, 584.
      salpetersaures, 739.
    Kalii bromhydras. 5*-8.
      bromuretum, 588.
      cyanetum, 590.
      cyanidum, 590.
      cyanuretum, 590.
      iodidum, 597.
    Kaliseife, 645.
    Kalium bromatum, 588.
      bromid, 588.
      bromiir, 588.
      cyanid, 590.
      cyanogenatum, 590.
      cyanur, 590.
      hydriodatum hydrargyratum, 595.
      iodatum, 597.
      iodiir, 597.
    Kalk,  chlorigsiiure, 165.
      oxydirt salzsaures, 165.
      phosphorsliure, 709.
    Kalkchlorid, 105.
    Kaminruss, 392.
    Kaniramin, 155.
    Katalpa, 147.
    Katzermaul, 396.
    Kinine, 605. 
762
INDEX OF  REMEDIES.
Kinini acetas, 607.
  citras, 609.
Kininum. 605.
Kinium,  605.
Klapperschlangenwurzel, 231.
Klaprothii sulphas, 707.
Klaprothium schwefelsiiures,  707.
Knorpeltang, krauser, 229.
Kochsalz, 715.
Kodein, 238.
Kohle mineralische, 350.
  thierische, 184.
Kohlenschwefel, fliissiger, 670.
Kohlenstickstoffsliure, 702.
Kohlen.toffeisen, 350.
Kohlenstofftrichlorid, 710.
Kohlensulfurid, 670.
Koiiigswallnuss, 500.
Koso, 148.
Ko.so, 148.
Kousso,  148.
Krahenaugen, 540.
  bitter, 652.
  geistiges, extrakt der, 540.
Krahenaugenstoff, 652.
Krauser Tang,  229.
Kreasot, 275.
Kreasote, 275.
Kreasoton, 275.
Kreasotum, 275.
Kreosote, 275.
Krotonol, 565.
Kubebenpfeffer, 299.
Kubebin, 299.
Kuchensalz, 745.
Kuso, 148.
Kwoso, 148.

Laab, 711.
Labarraque's disinfecting liquid, 174, 647.
Lactas ferrosus, 367.
Lactucarium, 503.
Lastraea filix mas, 383.
Lathyris, 346.
Lattichopium, 503.
Lattigbitter, 503.
Lattigmilchsaft, 503.
Lead, black, 350.
  chloride of, 737.
  iodide of, 581.
  ioduret of, 581.
  nitrate of, 737.
  tannate of, 583.
Leberthran, 547.
Lemonade, magnesian, 507.
Lemonjuice, 746.
Leonurus lanata, 140.
Leopard's bane, 116.
Lerschenschwamm, 147.
Letheon, 77.
Lettuce opium, 503.
Leucolein,  730.
Leukol, 730.
Leukoleinum, 730.
Levure,  711.
Liebersche Brust oder Auszehrungskriiuter,
     396.
Lichen carrageen, 229.
Lime, chloride of, 165.
  chlorinated, 165.
  chlorite of, 165.
  chloruret of, 165.
  hypochlorite of, 165.
  oxymuriate of, 165.
  phosphate of, 709.
Limon, sue de, 746.
Liqueur desinfectante de Labarraque, 174,
  647.
Liquid, adhesive, Maynard's, 252.
  disinfecting, Labarraque's, 174, 647.
Liquor acidi muriatici oxygenati, 204.
  alexiterius oxygenatus, 204.
  argenti muriatico-ammoniata,  110.
  chlori, 204.
  disinfecting, of Labarraque, 174.
  ferri iodidi, 361.
  ferri nitratis, 370.
  ferri nitrici oxydati, 370.
  ferri persesquinitratis, 370.
  hydrargyri et arsenici iodidi,  434.
  hydrargyri pernitratis, 432.
  hydrargyri supernitratis, 432.
  hydriodatis arsenici et hydrargyri, 43 _.
  morphiae citratis, 532.
  natri chloreti, 647.
  opii sedativus, 533.
  sodae chloridi, 647.
       chlorinatae, 647.
 Lithanthrakokali, 95.
 Lithia, carbonate of, 730.
 Lithiae carbonas, 730.
 Lithine,  carbonate de, 730.
 Lithion kohlensaures, 730.
 Lithium kohlensaures, 730.
 Lithon kohlensaures, 730.
 Lupulin, 731.

 Macrotrys racemosa, 231.
 Magnes, 505.
 Magnesia and iron, citrate of, 355.
 Magnesia,  citrate of, 507.
  citronensaures, 507.
 Magnesiae  citras, 507.
 Magnesian lemonade, 507.
 Magnesie,  citrate de,  507.
 Magnet, 505.
 Magnetes,  505.
 Magnetic electricity, 311.
 Magnetism, animal, 405.
 Magnetstein, 505.
 Malambo,  510.
 Malogranatum, 410.
 Mandel Kiirbis,  717.
 Manganese, salts of, 732.
  sulphate of, 732.
 Manganese and iron, saccharine carbonate
  of, 733.
 Manganesii sulphas, 732.
 Manganoxydul, schwefelsaures,  732.
 Manganum sulphuricum oxydulatum, 732,
 Manna, sugar of, 509.
 Mannastoff, 509.
 Mannazucker, 509. 
INDEX OF  REMEDIES.
Mannite, 509.
Mannitum, 509,
Mannleinwurmtiipfelfarrn, 388.
Marigold, garden, 162.
  single, 162.
Marnmier, 416.
  d'lnde, 416.
Materia scytodephica, 57.
Matias, 510.
Matico, 511.
Matiere de Derosne, 538.
  vomitive, 323.
Matter of Derosne, 538.
Meadow saffron, 243.
Melambo, 510.
Melini sulphas, 707.
Mereure, azotate de,  439.
  biodure de. 426.
  bromure de, 418.
  cyanure de, 419.
  deuto-iodure de, 426.
  deuto-nitrate de, 432.
  dipernitrate de, 432.
  hydrocyanate de, 419.
  nitrate acide de, 432.
  nitrate de, 430.
  periodure de, 426.
  preparations  de, 418.
  protoiodure de, 424.
  protonitrate de, 430.
  prussiate de, 419.
Mercurii bromuretum, 418.
  cyanidum, 419.
  deuto-iodu-retum, 426.
  protobromuretum, 418.
  protoioduretum, 424.
Mercurius hydrocyanicus, 419.
  nitrosus calide  paratus, 432.
  frigore paratus, 430.
Mercury  and arsenic, hydriodate of, 434.
  iodide of, 434.
  and morphia, iodide of, double, 436.
  and quinia, protochloride of, 727.
  bicyanide of,  419.
  biniodide of,  426.
  bromide of, 418.
  cyanide of, 419.
  deutoiodide of,  426.
  deutonitrate of, 432.
  dipernitrate of, 432.
  hydrocj'anate of, 419.
  iodide of, 42 1.
           red, 426.
           chloride of, 493.
  iodoarsenite of, 434.
  nitrate of, acid, 432.
            suboxide of, 430.
  percynnide of, 419.
  periodide of, 426.
  preparations of, 418.
  protoiodide of, 424.
  protd-ioduret of, 424.
  protonitrate of,  430.
  prussiate of, 419.
  suliii'dide of, 424.
  superuitrate of, 432.
               solution of, 432.
 Mere de Seigle, 327.
 Mesitalkohol, 649.
 Mesitylene, bihydrate of, 649.
 Mesmerism, 405.
 Milchsaure, 55.
 Mixture, Scudamore's, 251.
 Mohnstoff, 521.
 Moleplant, 346.
 Monesia, 517.
 Monesin, 51*.
 Moosbitter, 193.
 Moos, carragheen, 229.
   Irlandisch, 229.
 Morphei acetas, 527.
 Morpheum, 521.
 Morphia, 521.
   acetate of, 527.
   and codeia, muriate of, 534.
   bimeconate of, 533.
   citrate of, 532.
   hydriodate of, 530.
   hydrochlorate of, 530.
   iodhydrate of, 530.
   iodide of iodhydrate of, 530.
   ioduret of, 530.
   muriate of, 530.
   salts of, 521.
   sulphate of, 531.
   tartrate of, 533.
 Morphiae acetas, 527.
   hydriodas, 530.
   hydrochloras, 530.
   sulphas, 531.
 Morphii  murias, 530.
   sulphas, 531.
 Morphin, 521.
   essigsiiures, 527.
   iodwasserstoffsliures, 530.
   salzsaures, 530.
   schwefelsiiures, 531..
 Morphina, 521.
 Morphin.- acetas, 527.
   bimeconas, 533.
   hydrochloras, 530.
   murias, 530.
   sulphas, 531.
   tartras, 533.
 Morphine, 521.
   acetate of, 527.
   and zinc, double iodide of,  699.
   bimeconate of, 533.
   citrate of, 530.
   et codeine, double muriate de, 534.
   hydriodate de, 530.
   hydrochlorate de, 530.
   iodhydrate de, 530.
   muriate of, 530.
   sels de, 521.
   sulphate of, 531.
   tartrate of, 533.
Morphinsalze, 521.
Morphinum. 521.
Morphium, 521.
  acetat, 527.
  aceticum, 527.
  essigsiiures. 527. 
764
INDEX OF REMEDIES.
Morphium, hydrochlorsliurcs, 530.
  muriaticum, 530.
  salzsaures, 530.
  schwefelsiiures, 531.
  sulphat, 531.
  sulphuricum, 531.
Mort aux chiens, 243.
Moschuswurzel,  747.
Moss, carrageen, 229.
  Ceylon, 390.
  corrigeen, 229.
  edible, 390.
  Irish, 229.
  Jaffna, 390.
  marine, 390.
Mousse d'Irlande, 229.
  perlee, 229.
Moxa, 534.
Moxiburium, 534.
Moxibustion, 534.
Mugwort, 121.
Murias aurico-natricum, 134.
  morphicus, 530.
  zincicu«, 689.
Murid, 151.
Muride, 151.
Murigene, 197.
Murin, 151.
Murine, 151.
Mutterkorn, 327.
 Nitras hydrargyricus, 432.
                 acido nitrico solutus, 432.
   hydrargyrosus, 430.
   plumbicus, 737.
   strychnicus,  669.
 Nitre, 739.
 Nitro-muriatic mixture, 202.
 Nitrum saturninum, 737.
 Noix vomique, 540.
   extrait alcoolique de, 540.
 Nombril de Venus, 716.
 Noyer, 500.
 Nussbaum, 500.
 Nux vomica, 540.
   alcoholic extract of, 540.

 Ochsengalle, 718.
 Oelsiiss, 406.
 Ofenruss, 392.
 Oil of bitter almonds, 95.
   cod, 547.
   codliver, 547.
   croton, 565.
   of ergot, 341.
   iodized, 494.
   of mustard seed, 563.
 Oleum __thereum florum arnicae, 117.
   aethereum seminum sinapis, 563.
   cadinum, 735.
   crotonis, 565.
   euphorbiae lathyridis, 346.
   jecoris  aselli, 517.
j   juniperi empyreumaticum, 735.
'   morrhuae, 547.
   ricini officinale, 569.
   seminis crotonis, 565.
   sinapis, 563.
   tiglii, 565.
   vitrioli dulce, 77.
   volatile seminum sinapis, 563.
 Opiane, 538.
 Opiumalkaloid, 521.
   lettuce, 503.
 Opiumsalz, Derosne'sches, 538.
 Or, chlorure d', 132.
   cyanure d', 136.
   divis., 138.
   oxide d', 138.
   et de sodium chlorure d',  131.
   et soude, hydrochlorate d', 134.
   muriate d', 134.
   m6tallique, 138.
   muriate d', 132.
   nitromuriate d', 137.
   oxide d', 138.
   preparations  d', 128.
   protoiodure d', 137.
 Oxidum ferricum hydratum, 372.
 Oxydirt-salzsliures natronwasser, 647.
 Oxyhydrocarburetum  ex  oleo  pyroxilico
    paratum, 275.

 Panacea lafsorum, 116.
 Papaverine, 521.
 Papaverinum, 238.
 Pariser blau, 356.
 Passerage, 728.
 Pasta seminum paulliniae, 572.
N.-delsticii, 69.
Naphtha, 649.
  phosphorata, 545.
  sulphuric.., 77.
  vitriol, 77.
  wood, 649.
Naphthalin, 734.
Naphthaline, 734.
Narcotina, 538.
  muriate of, 533.
Narda celtica altera,  119.
Narkotin, 538.
Natrium-gold-chlorid, 13 4.
Natrium-platin-chlorid, 580.
Natron phosphorsaures, 744.
Natronwasser, oxydirt salzsaures, 647.
Natrum chloratum, 646.
  chloricum, 646.
  chlorsiiures, 646.
  muriaticum, 745.
  oxydirt oder hyperoxygenirt salzsaures,
    646.
  salzsaures, 745.
  oxymuriaticum,  646.
Navelwort, 716.
Nephrine, 676.
Nephrodium filix mas, 388.
Neurogamia, 405.
Niccoli, sales, 735.
Nickel, salts of, 735.
  sels de, 735.
Nickelsalze, 735.
Nierenfarm, mannlicher, 338.
Niesswurzstoff, 678.
Nitras  ferricus, 370. 
                             INDEX

P.'.te de guarana, 572.
Paullinia, 572.
Pepo vulgaris, 717.
Pepon, 717.
Pepone, 717.
Perlmoos Irlandisch, 229.
Pfefferstoff, 575.
Pferdekastanie, 416.
Pferdekeste, 416.
Phloiorrhizina, 571.
Phloridzin, 574.
Phosphas calcicus, 709.
Pierre d'aimant, 505.
Pigmentum indicum, 437.
I'ikrinsiiure, 702.
Pills of Blancard, 360.
  Blaud's, 381.
  ferruginous, of Vallet,  380.
Pdules de Blancard, 306.
  d'iodure de fer de Blancard, 366.
Piper angustifoliurn, 511.
  caudatum, 29J.
  cubeba, 299.
  elongatum, 511.
Piperin, 299, 575.
Piperina, 575.
Pipsissewa, 1 95.
Piscidia erythrina, 736.
Platina, bichloride of,  579.
  muriatica, 579.
            natronata, 580.
  perchloride of, 579.
  preparations of, 578.
1'latinae  chloridum, 579.
Platinchlorid, 579.
Platine,  bichlorure  de, 579.
  et sodium, chlorure double de, 580.
  perchlorure de, 579.
  preparations de, 578.
Platini bichloridum, 579.
  perchloridum/ 579.
  praeparata, 578.
Platinoxyd, salzsaures, 579.
Platinpriiparate, 578.
Platinum, 578.
  bichloratum, 579.
  bichloride of, 579.
  chloride of, 579.
  perchloride of, 579.
  and  sodium, double chloride of, 580.
Plocaria Candida, 390.
Plomb, azotate de,  737.
  chlorure  de, 737.
  iodure de, 581.
  nitrate de, 737.
  tannate de, 583.
Plombagine, 350.
Plumbago, 350.
Plumbi  ch'oridum, 737.
  hydriodas, 5S1.
  hydroiodicum, 581.
  iodatum,  581.
   odhydras, 581.
  iodidum, 5*1.
  ioduretum, 3*1.
  nitras, 737.
  tannas, 583.
OF  REMEDIES.                         765

    Plumbum nigrum, 350.
      nitricum, 737.
      scytodepsicum, 583.
      tannicum, 5*3.
    Poison nut, 540.
    Pnivre a queue,  299.
    Polypodium filix mas, 388.
    Polyporus officinalis, 147.
    Polystichum filix mas, 388.
    Pomegranate,  410.
    Potassa, arsenite of, 118.
      chlorate of,  584.
      hydriodate of, 597.
      hydrobromate of, 5S8.
      hydrocyanate  of, 590.
      liypermanganate of, 733.
      hyperoxymuriate of, 584.
      nitrate of, 739.
      oxymuriate  of, 584.
      permanganate of, 733.
      tellurite of,  acid, 749.
    Potasso. bromhydras, 588.
      chloras. 5*4.
      cyanhydras, 590.
      euchloras, 584.
      hydriodas, 597.
      hydrobromas,  588.
      hydrocyanas,  590.
      murias hyperoxygenntum, 584.
             oxygenatum, 584.
      nitras, 739.
    Potas-e, broinure de, 588.
      chlorate de, 584.
      et de fer, prussiate de, 356.
      hydriodate de, 597.
      iodure de, 597.
      nitrate de, 739.
    Potassii bromidum, 588.
      bromuretum,  5*8.
      cyanidum, 590.
      cyanuretum, 590.
      hydrargyro-iodidum,  595.
      iodidum, 597.
      iodohydrargyras', 595.
      ioduretum, 597.
      oxygeno-chloruretum, 584.
      proto-hydriodas, 597.
      protoxidi hydriodas. 597.
    Potassium, bromide of,  588.
    j  bromure de, 588.
      cyanide of, 590.
      cyanuret of, 590.
      dihydrargyro-biniodide of,  595.
      hydrargyro-iodide of, 595.
      iodide of, 597.
      iodohydrargyrate of, 595.
      ioduret of, 597.
                 iodohydrargyrate of, 595.
      protoxide of, chlorate of, 584.
    Potio picea, 104.
    Potiron, 717.
    l'oudre de blanchement, 165.
      de Tennant, 165.
    i Powder, bleaching, Tennant's, 165.
    Preta raiz. 159.
    I Pr.us-is.he Sliure, 43. 
766
INDEX OF REMEDIES.
 Principium adstringens, 57.
   scytodephicum, 57.
 Prussiate de potasse et de fer,  358.
 Pseudoangusturinum,  155.
 Ptarmica montana, 116.
 Pulvis ad fumigationes muriaticas, 197.
   auri, 138.
   ferri, 347.
 Pumpkin, 717.
 Punica granatum, 410.
 Purgirkorner-Euphorbie, 346.
 Pyrola umbellata, 195.
   corymbosa, 195.
 Pyrole en ombelle, 195.

 Quecksilber, blausaures, 419.
   bromid, 418.
   bromiir, 418.
   cyanid, 419.
   deuto-bromiir, 418.
   deuto-iodiir, 426.
   deuto-iodiir des, 426.
   iodid, 424, 426.
        gelbes, 424.
   iodidkalium, 595.
   iodidul, 424.
   iodiir, 424.
   oxyd, blausaures, 419.
   oxydul, salpetersaures, 430.
   praparate, 418.
   proto-bromiire des, 418.
   proto-iodur des, 424.
   salpetersaures, kaltbereitetes, 430.
                 heissbereitetes, 431.
 Quillaia, 518.
 Quina, 605, see Quinia.
   acetica, 607.
   citrica, 609.
 Quinia, 605.
 Quinia. acetas, 607.
   arsenias, 608.
   arsenis, 608.
   citrab, 609.
  diarsenis, 608.
  disulphas, 615.
   et cinchoniae tannas, 637.
  ferrocyanas, 610.
  hydriodas, 611.
  iodidum, 611.
  lactas, 613.
  murias, 614.
  nitras, 614.
  phosphas, 615.
  subsulphas, 615.
  sulphas, 615.
          impurus, 639.
  valerianas, 635.
Quinicine, 237.
Quinidia, 640.
Quinidine, 640.
Quinin, 605.
Quinina, see Quinine.
Quinine, 605.
  acetate of, 607.
  amorphous, 63').
  arseniate of, 608.
  arsenite of, 608.
 Quinine, biarsenite de, 608.
   brute, 606.
   citrate of, 609.
   disulphate  of, 615.
   extract of, 639.
   ferrocyanuret of, 610.
   hydriodate of, 611.
   iodide of, 611.
            iodhydrate of, 612.
   lactate of, 613.
   muriate of, 614.
   nitrate of, 614.
   phosphate of, 615.
   subsulphate of,  615.
   sulphate of, 615.
   valerianate of, 635.
   and cinchonine, tannate of, 637.
   and iron, hydriodate of, 012.
 Quininum, 6i(5.
 Quiniodine, 638.
 Quinium, 605.

 Raiz crusadinha, 159.
   preta, 159.
 Reissblei, 350.
 Rennet, 711.
 Resina chinae praeparata, 638.
 Rindsgalle, 718.
 Ringelblume, 162.
 Rochenleberthran, 547.
 Rosscastanien, 416. "
 Rosskeste, 416.
 Runnet, 711.
 Russ, 392.
 Russkali, 395.
 Rye, corned, 327.
   spurred, 327.

 Sabadillina, 678.
 Saccharum mannae, 509.
 Safran blitard, 243.
   de mars aperitif, 3S4.
   des pros, 243.
   wilder, 243.
 Saffron, meadow, 243.
 Saint Christophe, herbe, 231.
 Sal culinare, 745.
   essentiale corticis Peruviani, 605.
 Salicina, 641.
 Salicinum, 641.
 Salpeters'aure, 703.
 Salt of Derosne, 538.
 Salzsaure,  dephlogistisirte oder  oxydirte,
   204.
 Salzsaures silberammonium, 109.
 Sanicula Marilandica, 740.
 Sanicle, 740.
   Maryland, 740.
 Santoninum, 741.
 Sapo domesticus mollis, 645.
j   ex oleo et potassa confectus, 645.
   elainicus, 615.
   kalicus, 645.
   mollis, 645.
   niger, 645.
   viridis, 645.
 Satzmehliodiir, 497. 
INDEX OF REMEDIES.
767
Sauerdornbitter, 145.
Savon a base de potasse, 645.
  moii, 615.
  noir, 645.
Scheel'sches siiss, 406.
Schmierseife, 615.
  gr'iine, 645.
Schwanzpfeffer, 299.
Schwarzkorn, 327.
Schwefellither, 77.
Schwefelalcohol, 670.
Schwefeliodur, 674.
Schwefelkohlenstoff, 670.
Schwererde, iodwasserstoffsaure, 141.
Schwindelkorner, 299.
Scorodite, 348.
Seudamore's mixture, 251.
Secale clavatum, 327.
   cornutum, 327.
   luxurians,  327.
Secalis  cerealis, semina monstrosa, 327.
   mater, 327.
Seemoos, Irlandisch, 229.
   geperltes, 229.
Seetang, 229.
Seife, kali, 645.
   schwarz, 645.
Seigle cornu ou corrompu, 327.
   a fperon, 327.
   ivn', 327.
   noir, 327.
   ergot'', 327.
   faux, 327.
 Sel  commun, 715.
   de Cuisine, 745.
   de Derosne, 538.
   de Gregory, 538.
   essentiel d'opium, 538.
   marin, 745.
 Senfol litherisches, 563.
 Serpentaria, cimicifuga, 231.
 Sfrpentariae  Braziliensis radix, 159.
 Sidhee, 177.
 Silberammonium, salzsaures, 109.
   chloriir, 108.
   iodiir, 111.
 Silber oxyd, cyansaures, 110.
   oxydirtes,  112.
   praparate, 106.
   salmi'ak, 109.
   salzsaures, 108.
   zertheiltes, 114.
 Silver, ammonio-chloride of, 109.
   chloride of, 108.
   chloruret  of, 108.
   cyanide of,  110.
   cyanuret of, 110.
   iodide of,- 111.
   ioduret of, 111.
   metallic, 114.
   muriate of, 108.
   and ammonia,  chloride of,  109.
                  chloruret of, 109.
   preparations of,  106.
 Simaba cedron, 742.
 Sinapis  oleum, 563,
 Sipeerine, 143.
Snake root,  black, 231, 740.
Soap, soft,  645.
Soda and Silver, hyposulphite of, 114, 744.
Soda, arseniate of, 118.
  chlorinata, 646.
  chloruret  of, 646.
  chlorite of, 646.
  hypochlorite of, 646.
  hyposulphite of, 743.
  phosphate of, 744.
Sodae et argenti hyposulphis, 114, 744.
  chloridum, 646.
  chloruretum, 646.
  hyposulphis, 743.
  murias, 745.
  oxymurias, 646.
  phosphas, 744.
Sodii auri-terchloridum, 134.
  chloridum, 745.
  chloroplatinas, 580.
  iodidum,  605.
  oxidi chloruretum, 646.
Sodium, auro-terchloride of, 134.
  chloride of, 745.
  chloroplatinate of, 580.
  chlorure de, 745.
  chlorure d'oxide de, 646.
  iodide of, 605.
Soldier's weed, 511.
Solutio alexiteria oxygenata, 204.
  chlorinii, 204.
  ferri nitratis, 370.
Solution of chlorine, 204.
  Coindet's, 599.
  of gun cotton, ethereal, 252.
  de Pearson, 118.
  Donovan's, 434.
  Fowler's, 118.
  Lugol's, 496, 600.
  of nitrate of iron,  370.
  of persesquinitrate of iron, 370.
Soot, 392.
Souci, 162.
  ordinaire, 162.
Soude, chlorure de, 646.
  hyposulfite de, 743.
  phosphate de, 744.
  sulfite sulfure de, 743.
Soufre, carbure de, 670.
  iodure, 674.
Species pro vaporibus superoxydi muriatici,
     197.
Sphaerococcus crispus, 229.
   lichenoides, 390.
Spicanard,  747.
Spiegelruss, 392.
 Spinnblume, 243.
Spirit, pyro-acetic, 649.
 Spiritus pyro-aceticus, 649.
   salis marini dephlogisticatus, 197.
 Sponsa solis, 162.
 Springkraut, kleines, 346.
 Spuma cerevisiae, 711.
 Spur,  the, 327.
 Spurge, caper, 346.
   garden, 316.
 Starch, iodide of, 497. 
768
INDEX OF  REMEDIES.
 Starkmehliodiir, 497.
 Steinkohlenkali, 95.
 Stephensia  elongata, 511.
 Stinkstoff, 151.
 Stockfischleberthran, 547.
 Stockung des Blutes in der Geflissen, 726.
 Strychna, 632.
 Strychnia, 632.
   acetate of, 667.
   hydriodate of, 667.
   iodate of, 667.
   iodide of iodhydrate of, 6G8.
   nitrate of, 069.
   sulphate of, 670.
   and zinc, double iodide of, 669.
 Strychnin, 652.
   acetat, 667.
   essigsaures, 667.
   iodsaures, 067.
   iodwasserstoffsaures, 668.
   nitrat, 669.
   salpetersaures, 669.
   schwefelsaures, 670.
   sulphat, 670.
 Strychnine, see Strychnia.
 Strychninum, 652.
   aceticum, 667.
   iodicum,  667.
   nitricum. 669.
   sulphuricum, 670.
 Strychnium, 632.
 Styptique de Brocchieri, 99.
 Subjee, 177.
 Sue de limon, 746.
 Succus limonis, 746.
 Suffitus chlorinii, 197.
   oxymuriaticus, 197.
 Silie, 392.
 Sulfidum carbonii, 670.
 Sulphas cadmicus, 707.
   manganosus, 732.
   morphicus, 531.
   quinicus,  615.
 Sulphur, iodide of, 674.
 Sulphuris carburetum, 670.
   iodidum, 674.
   ioduretum, 674.
 Sumbuli radix, 747.
 Sumbul root, 747.
 Sumbulwurzel, 747.
 Superchloridum formylicum, 210.
 Swertia chirayita, 406.

 Tabac de Montague, 116.
   des Savoyards, 116.
   des Vosges, 116.
 Tang, krauser, 229.
 Tannas cinchonicus seu quinicus, 637.
 Tannic acid, 57.
 Tannicum, 57.
 Tannin, 57.
 Tanninum, 57.
Tar water, 104.
Tellur, 749.
 Tellurismus, 405.
Tellurium, 749.
Tellurous acid, 749.
 Terra aluminis, 115.
   aluminosa pura, 115.
   argillacea pura, 115.
   bolaris, 115.
   sigillata, 115.
 The  de  seigle  noirci  des  sages-femmes
   Am.ricaines, 341.
 Theerwasser, 104.
 Thierkohle, 184.
 Thonerde, gereinigte,  115.
   reine, 115.
 Thonerdensalze, 89.
 Thridace, 503.
 Tithymalus latifolius,  346.
 Todtenblume, 162.
 Traumaticine, 258.
 Tue-chien, 213.

 Ulva crispa, 229.
 Urea, 676.
   nitrica, 67S.
 Ureae nitras, 678.
 Uree, 676.
   nitrate de, 678.
 Uricum, 676.
 Ussacu, 727.
 Ustilago, 327.

 Vallet's ferruginous pills, 380.
 Vauquelin, 652.
 Venus's Navelwort, 716.
 Veratria, 678.
   sulphate of, 6.9.
 Veratrin, 678.
 Veratrina, 678.
 Veratrium, 678.
 Verrucaria,  162.
 Vieillotte, 243.
 Vinaigre de bois, 33.
 Violine, 323.
 Volta'sche Electricit'at, 398.
 Voltaism, 398.
 Vomicina, 155.
 Vomic nut, 540.

 Wachiiolder-oel, brexzliches,  735.
 AVallnussbaum, 500.
 Walnut tree, 500.
 Walschennuss, 500.
Wasser, Binellische?, 97.
  Brocchierisches, 99.
  oxydirt, salzsaures, 204.
  Water, Binelli, 97.
  of bitter almonds, 95.
  Brocchieri, 99.
  tar, 104.
Weed, soldier's, 511.
Weidenbitter, 641.
 Weidenstoff, 641.
Wiesensafran, 243.
Winter green, 195.
 Wintergriin, 195.
  holdenbliithigen,  195.
Wismuth, valeriansaures,  707.
 Wohlverlei,  116.
  blumenol, 117. 
§
INDEX OF REMEDIES.
Wohlverleiol, 117.
Wolfstrapp, wolliger, 140.
Woodsoot, 392.
Wurmsamenstoff, 741
Yeast, 711.
Verba del Soldada, 511.
Zeitlose, 243.
Zinc and morphia, double iodide of, 698.
  and strychnia, double iodide of, 669.
  butter of, 689.
  chloride of, 689.
  cyanuret of, 695.
  ferrocyanuret of, 696.
  ferrohydrocyanate of, 696.
  hydrochlorate of, 689.
  hydrocyanate of, 695.
  iodide of, 698.
  muriate of, 689.
  prussiate of, 696.
  tannate of, 698.
Zinci butyrum, 689.
  chloridum, 689.
  chloruretum, 689.
  cyanhydras,  695.
  cyanidum, 695.
  cyanuretum, 695.
  ferrocyanuretum, 696.
  ferrohydrocyanas, 696.
  iodidum,  698.
 Zinci, ioduretum, 698.
   murias, 6*9.
   valerianas, 699.
 Zincum borussicum, 695.
   chloratum, 689.
   cyanogenatum, 695.
   ferrohydrocyanicum, 696.
   hydrocyanicum, 695.
   iodatum, 698.
   muriaticum oxydatum, 689.
   salitum,  689.
   valerianicum, 699.
   zooticum,
 Zink, baldriansaures, 699.
 Zinkbutter, 689.
 Zinkchlorid, 689.
 Zinkchloriir, 689.
 Zink, chlorwasserstoffsaures, 6*9.
 Zinkcyaniir, 695.
 Zinkeisenblausaures, 696.
 Zinkeisencyaniir, 696.
 Zinkiodiir, 698.
 Zinkoxyd, eisenoxydul, blausaures
  salzsaures, 689.
  valeriansaures, 699.
Zinkoxydul, blausaures, 695.
Zink, salzsaures, 689.
Zoomagnetismus, 405.
THE END. 
 
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rate descriptions of the various forms of venereal
disease, and especially the methods of treatment h
proposes, are worthy of the highest encomium.  In
these  respects it is better adapted for the assistance
of the every-day practitioner than any other with
which we are acquainted.  In variety  of methods i rj0<j „f many expeim
proposed, in minuteness of direction, guided by care-  aubject—the whole carefully digested by the aid of
lul discrimination of varying forms and comphca  t^e author's  extt
tions, we write down the book as unsurpassed.  It
is a work which should be in the possession of every
practitioner.— Chicago Med. Journal. Nov.  1861.
        The whole work presents a complete history of
       venereal diseases, comprising much interesting and
       valuable material that has been spread through med-
       ical journals within the last twenty years—the pe-
       riod of many experiments and investigations on the
      , subject—the whole carefully digested by the aid of
plica  | the author's extensive  personal experience, and
  The foregoing admirable volume comes to us, em-
bracing the whole subject of syphilology, resolving
many a doubt, correcting and confirming many an
entertained opinion, and in our estimation the best,
completest, fullest monogi aph on this subject in our
language.   As far as the author's labors themselves
are concerned, we feel it a duty to say that he has
not only exhausted his subject, but he has presented
to us, without the slightest hyperbole, the best di-
gested treatise on these diseases in our language
He has carried its literature down to the present
moment, and  has achieved  his  task in a manner
which cannot but redound  to his credit.—British
American Journal, Oct. 1861.
   We believe this treatise will come to be regarded
as high authority in this branch of medical practice,
and we cordially commend it to the favorable notice
of our brethren in the profession. For our own part,
we candidly confess that we have  received ii.any
new iotas from its perusal, as well as modified many
views which we have long, and, as we  now think.
 erroneously entertained  on  the subject ot syphilis.
offered to the profession in an admirable form.  Its
completeness is secured by good plates, which  are
especially full in the anatomy of the genital organs.
We have examined it with great satisfaction,  and
congratulate the medical profession in America on
the nationality of a work that may fairly be .ailed
original.—Berkshire Med. Journal, Dec. 1661.
  One thing, however, we are impelled to say,  that
we have met with no-other book on syphilis, in the
English language, which  gave so full, clear,  and
impartial views of the important subjects on wnich
it treats.  We cannot, however, refrain from ex-
pressing our satisfaction with the full and perspicu-
ous manner in which the subject has been presented,
and the careful attention to minute details, so  use-
ful—not to say indispensable—in a practical ireatise.
In conclusion, if we may be pardoned the use of a
phrase now become stereotyped, but which we  here
employ in all seriousness  and sincerity, we do not
hesitate to express the opinion that Dr. Bumstead's
Treatise on Venereal Diseases is a " work without
 which no medical library will hereafter be consi-
dered complete.?'—Boston Med. and  Surg. Journal,
 Sept. 5, 1861.
                              BARCLAY  (A. W.), M. D.,
                        Assistant Physician to St. George's Hospital, &c.
A MANUAL OF MEDICAL  DIAGNOSIS;  being an Analysis of  the  Signs
  and Symptoms of Disease.   Third American  from the second  and  revised London  edition.  In




^JZ^llnce to the el ner  in^he pro ecution of his studies, and to the practitioner who requires


foJ immed?ate?y turning to any  class of symptoms, or any variety of disease.
              '           .      , •  __:_i___.__    \xt_ h«n» Hip .nlnme Will
  The task of composing such a work is neither an
easy nor a light one; but Dr. Barclay has Performed
it in a manner which meets our most unqualified
approbation. He is no mere theorist; he knows his
work thoroughly, and in attempting to Perform it,
has not exceeded his powera.-Brttish Med. Journal.

  We venture to predict that the work will be;  de-
servedly popular, and soon become, like Watson e
Practice, anP.ndispensable neeeeeity to the practi-
tioner.—N. A. Med. Journal.
  An inestimable work  of reference for the young
practitioner iid student.-Nashville Med. Journal^.
  We hope the volume will have an extensive cir-
culation, not among students of medicine only, but
practitioners also. They will never regret a faith-
ful study of itspages.—CincinnatiLancet.
  An important acquisition  to medical litertture.
It is a work of high  merit, both from the vast im-
portance of the subject upon which it treats, and
also from the real aDility displayed in ■*»  elabora-
tion  In conclusion, let us bespeak for this volume
that attention of every student of our art which  it
so richly deserves - that place in every medical
library  which it can so well adorn.- Peninsular
Medical Journal.
                            HARTLETT (EL.ISHA), M. D.
mn*  utotohv   DIAGNOSIS,  AND TREATMENT  OF  THE  FEVERS
THE  HISTORY,  »\AWN "J1"'  and revised edition.  By Alonzo Clark , M. D., Prof.
  OF THE UNITED STATES^  £ nf ^^  y. College of Physicians and Surgeons, &c.   In
  of Pathology and P^^S^, extra cloth. °Price $4 00.
  one octavo volume, of six nunareu F°*        ------_
                             BROWN  (ISAAC  BAKER),
                         «„r.eon-Accoucheur to St. Mary's Hospital, to.
           t,  m-PAW   OF  WOMEN ADMITTING OF  SURGICAL TREAT-
ON  SOMEDIS^                                                 $l60.
  MENT.  With n       himself a high reputa-  and merit the  careful  attention  of every surgeon-
  Mr. Brown has earnedw^t of Bundry diseases  accoucheur.—Association Journal.
tion in the °Pe^|^ femaies are peculiarly subject.    We hav_ n0 heBitation in recommending this book
and injuriestownlfhigwork that it is an important  to tie CHretu) attention of all surgeons who make
\V? can truly say  n    literature   The operative      { complaint. • partof theirstudy and practice.
Bddlt.-Son- and contrivances which Mr. Brown de-  l_Dubiin ^afUfij, Journal.
"eK exhibit much practical sagacity and skill, | 
6
LEA & BLANCHARD'.  MEDICAL
 BRANDE (WM. T.) D. C. L.,  and  ALFRED  S. TAYLOR, M. D., F. R. S.
       Of her Majesty's Mint, &c.              Professor of Chemistry and Medical Jurisprudence in
                                                             Guy's Hospital.

CHEMISTRY.   In one handsome 8vo. volume of 696 pages, extra  cloth.   $4 25.

  " Having been engaged  in teaching Chemistry in this Metropolis^ the one for a period of forty,
and the oiher for a period of thirty years, it has appeared to us that, in spite of the number of books
already existing, there was room  for an additional volume, which should be especially adapted for
the use of studenls.  In preparing such a volume tor the  press, we have endeavored to bear in
mind, that the student in the present day has  much to learn, and but a short time at his disposal for
the acquisition of this learning."—Authors' Preface.
  In reprinting this volume, its passage through the press has been  superintended by a competent
chemist, who has sedulously  endeavored to secure  the accuracy so necessary  in a work of this
nature.  No notes or additions have been introduced, but the publishers have been favored by the
authors with some corrections and revisions of the first twenty-one chapters, which have  been duly
inserted.
  In so progressive a science as Chemistry, the latest work always has the advantage of presenting
the subject as modified by the results of the latest investigations and discoveries.  That this advan-
tage has been made the  most of, and that the work possesses superior attractions arising from  its
clearness, simplicity of style, and lucid arrangement, are manifested by the unanimous testimony
of the English medical press.
  It needs no great sagacity to foretell that this book
will be, literally, the Handbook in Chemistry of the
student and practitioner.  For clearness of language,
accuracy of description, extent of information, and
freedom from pedantry and mysticism of modern
chemistry, no other text-book comes into competition
with it. The result is a work which for fulness of
matter, for lucidity of arrangement, for clearness of
style, is as yet without a rival.   And long will it be
without a rival.  For, although with the necessary
advance of chemical knowledge addenda will be re-
quired, there will be little to take away.  The funda-
mental excellences of the book will remain, preserv-
ing it for years to come, what it now is, the best guide
to the study of Chemistry yet given to the world.—
London Lancet, Dec. 20, 1862.
  Most assuredly, time has not abated one whit of the
fluency, the vigor, and the clearness with which they
not only have composed the work before us, but have,
so to say, cleared  the ground for it, by hitting  right
and left at the affectation, mysticism, and obscurity
which pervade some late chemical  treatises.  Thus
conceived, and worked out in the most sturdy, com-
mon sense method, this book gives, in the clearest and
most summary method possible, all the facts and doc-
trines of chemistry, with more especial reference to
the wants of the medical student.—London Medical
Times and Gazette, Nov. 29, 1862.
  If we are not very much mistaken, this book will
occupy a place which none has hitherto held among
chemists ; for, by avoiding the errors of previous au-
thors, we have a work which, for its  size, is certainly
the most perfect of  any  in  the English  language.
There are several points to be noted in this volume
which separate it widely from any of its compeers—
its wide application, not to the medical student only,
nor to the student in chemistry merely, but to every
branch of science, art, or commerce which is in any
way connected with the domain of chemistry.—Lon-
donMed. Review, Feb. 1863.
                       BARWELL (RICHARD,)  F« R. C. S.,
                         Assistant Surgeon Charing Cross Hospital, &c.
A TREATISE ON  DISEASES  OP  THE  JOINTS.   Illustrated with engrav-
  ings on wood.  In one very handsome octavo volume, of about 500 pages, extra  cloth; $3 00.
  At the outset we may state that the work is
worthy of much praise, and bears evidence of much
thoughtful and careful inquiry, and here and there
of no slight originality.  We have already carried
this notice further than we intended to do,  but not
to the extent the work deserves.  "We can only add,
that the perusal of it has afforded us great pleasure.
The author has evidently worked very hard at his
subject, and his investigations into the Physiology
and Pathology of Joints have been carried on in a
manner which  entitles him to be listened  to with
attention and respect. We must not omit to men-
tion the very admirable plates with which  the vo-
lume is enriched.  We seldom meet with such strik-
ing and faithful delineations of disease.—London
Med. Times and Gazette, Feb. 9, 1861.
  This volume will be welcomed, as  the record of
much honest research and careful investigation into
the nature and treatment of a most important class
of disorders.  We cannot conclude this notice of a
valuable and useful book without calling attention
to the amount of bona fide work it contains. It is no
slight matter for a volume to show labojious inves-
tigation, and at the same time original thought, on
the part of its author, whom we may congratulate
on the successful completion of his arduous task.—
London Lancet, March 9,1861.
             CARPENTER (WILLIAM B.),  M. D.,  F. R. S., J_c,
           Examiner in Physiology and Comparative Anatomy in the University of London.

THE MICROSCOPE  AND ITS  REVELATIONS.    With  an Appendix  con-
  taining the Applications of the Microscope to Clinical Medicine, &c.  By F. G. Smith, M. D.
  Illustrated by four hundred and thirty-four beautiful engravings on wood.  In one large and very
  handsome octavo volume, of 724 pages, extra cloth, $5 25.     ♦
  The great importance of the microscope as a means of diagnosis, and the number of  microsco-
pists who are also physicians, have induced the American publishers, with the author's approval, to
add an Appendix, carefully prepared by Professor Smith, on  the applications of the instrument to
clinical medicine, together  with an  account of American  Microscopes, their modifications and
accessories.  This portion of the work is  illustrated with nearly one hundred wood-cuts, and, it is
hoped, will adapt the volume more particularly to the use of the American student.
  Those who are acquainted with Dr.  Carpenter's
previous writings on Animal and Vegetable Physio-
logy, will fully understand how vast a store of know-
ledge he is able to bring to bear upon so comprehen
sive a subject as the revelations of the microscope j
and even those who have no previous acquaintance
with the construction or uses  of this instrument,
will find abundance of information conveyed in clear
_nd simple language.—Med.  Times  and Gazette.
  The additions by Prof. Smith give it a positive
claim upon the profession, for which we doubt not
he will receive their sincere thanks.  Indeed, we
know not where the student  of medicine will find
such a complete and satisfactory collection of micro-
scopic facts bearing upon physiology and practical
medicine as is contained in Prof. Smith's appendix;
and this of itself, it seems to us, is fully worth the
cost of  the volume.—Louisville  Medical Review. 
AND  SCIENTIFIC  PUBLICATIONS.
7
                CARPENTER (WILLIAM B.),  M.  D., F. R. S.,
          Examiner in Physiology and Comparative Anatomy in the University of London.

PRINCIPLES  OF  HUMAN PHYSIOLOGY; with  their chief applications  to
  Psychology, Pathology, Therapeutics, Hygiene, and Forensic Medicine. A new American, from
  the last and revised London edition.  With nearly three hundred illustrations.  Edited, with addi-
  tions, by Francis Gurney Smith, M. D., Professor of the Institutes of Medicine in the Pennsyl-
  vania Medical College, &c.  In one very large and beautiful octavo volume, of about nine hundred
  large pages, handsomely printed, extra cloth, $5 25.

  For upwards of thirteen  years Dr. Carpenter'si  To eulogize this great work would be superfluous.
work has been considered by the profession gene-  We should observe, however, that in this  edition
rally, both in this country and England, as the most! the author has remodelled a large  portion of  tha
valuable compendium on the  subject  of physiology j former, and the editor has added much matter of in-
in our language. This distinction it owes to the high  terest, especially in  the form of illustrations.  We
attainments and unwearied industry of its accom-  may confidently recommend it as the most complete
plished author.  The present edition (which, like the  work on Human Physiology in our language.—
last American one, was prepared by the authoT him-  Southern Med. and Surg. Journal.
self), is the result of such extensive revision, that it    The most complete work on the science in our
                                              language.—Am. Med. Journal.
                                                The most complete work now extant in our lan-
                                              guage.—N. O. Med. Register.
                                                The best text-book in the language on this -ex-
                                              tensive subject.—London Med. Times.
                                                A complete cyclopaedia of this branch of science.
                                              —N. Y. Med. Times.
                                                The profession of this country, and perhaps also
                                               of Europe, have anxiously and for some time awaited
                                               the announcement of this new edition of Carpenter's
                                               Human Physiology.  His former editions have for
                                               many years been almost the only text-book on Phy-
                                               siology in all our medical schools, and its circula-
                                               tion among the profession has been unsurpassed by
                                               any work in any department of medical science.
                                                It is quite unnecessary for us to speak of this
                                               work as its merits would justify.  The mere an-
                                               nouncement of its appearance will afford the highest
                                               pleasure to every student of Physiology, while it!
                                               perusal will be of infinite service in advancing
                                               physiological science.—Ohio Med.andSurg. Jour*
may almost be considered a new work.  We need
hardly say, in concluding thisbrief notice, that while
the work is indispensable to every student of medi-
cine in this country, it will amply repay th^practi-
tioner for its perusal by the interest and value, of its
contents.—Boston Med. and Surg. Journal.

  This is a standard work—the text-book used by all
medical students who read the  English language.
it has passed through several editions in order to
keep pace with the rapidly growing science of Phy-
siology.  Nothing need be said in its praise, for its
merits are universally known ; we  have nothing to
say of its  defects, for they only appear where the
Bcience of which it treats is incomplete.—Western
Lancet.
   The most complete exposition of physiology which
any language can  at present give.—Brit, and For.
 Med.-Chirurg. Review.

   The greatest, the most reliable, and the best book
 on the  subject  which we know of in the English
 language.—Stethoscop*.
                                 BY THE SAME AUTHOR.

ELEMENTS  (OR MANUAL)  OF  PHYSIOLOGY, INCLUDING  PHYSIO-
  LOGICAL ANATOMY. Second American, from a new and revised London edition.  With
  one hundred and ninety illustrations.   In one very handsome octavo volume, leather,  pp. 566.
  $4 00.
  In publishing the first edition of this work, its title was altered from that of the London volume,
by the substitution of the word » Elements" for that of « Manual," and with the author's sanction
the title of "Elements" is still retained as being more  expressive of the scope of the treatise.

                                  BY THE  SAME AUTHOR.

PRINCIPLES OF COMPARATIVE PHYSIOLOGY.   New American, from
  the Fourth and Revised London edition. In one large and handsome octavo volume, with over
  three hundred beautiful illustrations,  pp. 752.   Extra cloth, $5 00.
  This book should not only be read but thoroughly
studied by every member of the profession.  None
are  too wise or old, to be benefited thereby. But
especially to the younger class would we cordially
commend it as best fitted of any work in the English
language to qualify them for the reception and coin-
prehension of those truths which are daily being de-
veloped in physiology .—Qledieal Counsellor.
  Without pretending to it, it is an encyclopedia of
the subject, accurate and complete in all respects—
a truthful reflection of the advanced state at which
the  science has now  arrived.—Dublin Quarterly
Journal of Medical Science.
  A truly magnificent work—in itself a perfect phy-
siological study.—Ranking's Abstract.
  This work stands without its Jfellow.  It iii one
few men in Europe could have undertaken; it is one
no man, we believe, could have brought to so suc-
cessful an  issue as Dr. Carpenter.  It required for
its production a physiologist at once deeply read in
the labors  of others, capable of taking a general.
critical, and unprejudiced view of those labors, and
of combining the varied, heterogeneous materials at
his disposal,  so as to form an harmonious whole.
We feel that this abstract can give the reader a very
imperfect idea of the fulness of this work, and no
idea of its unity, of the admirable manner in which
material has  been brought, from the most various
Bources, to conduce to its completeness, of the lucid-
ity of the reasoning it contains,  or of the  clearness
of language in which the whole is clothed.  Not the
profession  only, but the scientific world at large,
must feel deeply indebted to Dr. Carpenter for this
great work.  It must, indeed, add  largely even to
his high reputation.—Medical Times.
                           BY the same author.   (Preparing.)

m^PTPTFS  OF  GENERAL  PHYSIOLOGY,  INCLUDING  ORGANIC
PRi?SEf{rJ AND HISTOLOGY.  With a General Sketch of the Vegetable and Animal
  Km d^m   In on\ large and very handsome octavo volume, with several hundred illustrations.

                                  BY THE SAME AUTHOR.

 a PRIZE ESSAY ON THE USE OF ALCOHOLIC LIQUORS IN HEALTH
  AND DISEASE.  New edition, with  a  Preface by D. F. Condie, M. D., and explanations of
  fcSific words   In one neat 12mo. rolume, extra cloth,  pp. 178.  60 cents. 
8
LEA  & BLANCHARD'S  MEDICAL
                           CONDIE (D. F.), M. D.,  __c.

A PRACTICAL  TREATISE ON THE  DISEASES  OF CHILDREN.  Fifth
  edition, revised and augmented.  In one large volume, 8vo., extra cloth, of over 750 pages. S4 00.
  In presenting a new and revised edition ot this favorite work, the publishers have only to state
that the author has endeavored to render it in every respect  "a complete and faithful exposition of
the pathology and therapeutics of the maladies incident to the  earlier stages of existence—a  full
and exact account of the diseases of infancy and childhood."  To accomplish this he has subjected
the whole work to a  careful and thorough revision, rewriting a considerable portion, and adding
several new chapters. In this manner it is hoped that any deficiencies which may have previously
existed have been supplied, that the recent labors of practitioners  and observers have been  tho-
roughly incorporated, and that in every point the work will be found to maintain the high reputation
it has enjoyed as a complete and thoroughly practical book of relerence in infantile affections.
  A  few notices of previous editions are subjoined
  Dr. Condie's scholarship, acumen; industry, and
practical sense are manifested in this, as in all his
numerous contributions to science.—Dr. Holmes's
Report to the American Medical Association.
  Taken as a whole, in our judgment, Dr. Condie's
Treatise is  the one from the perusal of which the
practitioner in this country will rise with .the great-
est satisfaction.—Western Journal of Medicine and
Surgery.
  One of the best works upon the Diseases of Chil-
dren in the English language.—Western Lancet.
  We feel assured from actual experience that no
physician's library can be complete without a copy
of this work.—N. Y. Journal  of Medicine.
  A veritable pasdiatric encyclopaedia, and an honor
to American medical literature.—Ohio Medical and
Surgical Journal.
  We feel persuaded that the American medical pro-
fession will soon regard it not only as a very good,
but as the very best "Practical Treatise on the
Diseases of Children."—American Medical Journal
  In the department of infantile therapeutics, the
work of Dr. Condie is considered one of the best
which has been published in  the English language.
—The Stethoscope.
  We  pronounced the first edition to be the best
work  on the diseases of Children in  the English
language, and, notwithstanding all that has been
published, we still regard it in that light.—Medical
Examiner.            .
  The value of works by native authors on the dis-
 eases which the physician is called upon to combat,
 will be appreciated by all; and the work of Dr. Con-
 die has gained for itself the character of a safe guide
 for students, and a useful work for consultation by
 those engaged in practice.—JV. Y. Med Times.
  This is the fourth edition of this deservedly popu-
 lar treatise.  During the interval since the last edi-
 tion, it has been subjected to a thorough revision
 by the author;  and all new observations  in the
 pathology  and therapeutics of children have been
 included in the present volume.  As we said btfore,
 we do not know of a better book on diseases of chil-
 dren, and to a  large part of its recommendations we
 yield an unhesitating concurrence.—Buffalo Med.
 Journal.
  Perhaps the  most full and complete work now be-
 fore the profession of the United States; indeed, wa
 may say in the English language. It is vastly supe-
 rior to most of its predecessors.—Transylvania Med.
Journal
            CHRISTISON  (ROBERT), M. D., V. P. R. S. E., «tc

A DISPENSATORY;  or.  Commentary  on  the Pharmacopoeias of Great Britain
  and the United States; comprising the Natural History, Description, Chemistry, Pharmacy, Ac-
  tions, Uses, and Doses of the Articles of the Materia Medica.  Second edition, revised and im-
  proved, with a Supplement containing the most important New Remedies.  With copious Addi-
  tions, and two hundred and thirteen large wood-engravings.  By R. Eglesfeld Griffith, M. D.
  In one very large and handsome octavo volume, extra cloth, of over 1000 pages.  $3 50.
                       COOPER (BRANSBY  B.), F. R. S.
LECTURES  QN  THE PRINCIPLES  AND  PRACTICE  OF  SURGERY.
  In one very large octavo volume, extra cloth, of 750 pages  $2 00.
COOPER ON THE ANATOMY AND DISEASES
  OF THE BREAST, with twenty-five Miscellane-
  ous and Surgical Papers.  One large volume, im-
  perial 8vo., extra cloth, with 252 figures, on 36
  plates.  $3 00.
COOPER  ON  THE  STRUCTURE AND DIS-
  EASES  OF  THE  TESTIS, AND  ON THE
  THYMUS GLAND. One vol. imperial8vo., ex-
  tra cloth, with 177 figures on 29 plates,  $2 50.
CLYMER ON FEVERS; THEIR DIAGNOSIS,
  PATHOLOGY, AND  TREATMENT.  In ono
  octavo volume, leather, of 600 pages.  $1 75.
COLOMBAT DE L'ISERE  ON THE DISEASES
  OF FEMALES,  and on the special Hygiene of
  their Sex.  Translated, with many Notes and Ad-
  ditions, by C. D.  Meigs? M.D.  Second edition,
  revised and improved.   In one  large volume, oc-
  tavo, leather, with numerous wood-cuts.  pp. 720.
  83 75.
                           CARSON  (JOSEPH),  M. D.,
           Professor of Materia Medica and Pharmacy in the University of Pennsylvania.

SYNOPSIS OF  THE  COURSE OF LECTURES ON MATERIA MEDICA
  AND PHARMACY, delivered in the University of Penn.ylvania  Wiih three Lectures on
  the Modus Operandi-of Medicines.  Third edition, revised.  In  one handsome octavo volume.
  $2 50.

                          CURLING  (T.  B.), F.R.S.,
             Surgeon to  the London Hospital, President of the Hunterian Society, &o.

A PRACTICAL TREATISE ON  DISEASES OF THE TESTIS, SPERMA-
  TIC  CORD, AND SCROTUM.  Second American, from the second and enlarged English edi-
  Hon.   In one handsome octavo volume, extra cloth, with numerous illustrations, pp. 420. $2 00 
AND  SCIENTIFIC  PUBLICATIONS.
9
               CHURCHILL  (FLEETWOOD), M. D.,  M. R. I. A.
ON THE THEORY AND  PRACTICE OF  MIDWIFERY.   Anew American
  from the fourth revised and enlarged London edition.  With Notes and Additions, by D. Francis
  Condie, M. D., author of a  "Practical Treatise on the Diseases of Children," tec   With 194
  illustrations.  In one very handsome octavo volume, of nearly 700 large pages, extra cloth, $4 00.

  This work has been so long an established favorite, both as a text-book for the learner and as a
reliable aid in consultation for  the practitioner, that in presenting a new edition it is only necessary
to call attention to the very extended improvements which it has received. Having had the benefit
of two revisions by the author since the last American reprint, it has been materially enlarged, and
Dr. Churchill's well-known  conscientious industry is a guarantee  that every portion  has been tho-
roughly brought up with the latest results of  European investigation in all departments of the sci-
ence and art of obstetrics.   The recent date of the last Dublin edition has not left much ot novelty
for the American editor to introduce, but he has endeavored to insert whatever has since  appeared,
together with such matters as  his experience  has shown him would  be desirable for the American
student, including a large number of illustrations.   Wilh the sanction of the author he has added
in the form of an appendix,  some chapters from a little  "Manual for  Midwives and Nurses," re-
cently issued by Dr. Churchill, believing that  the details  there presented can hardly fail to prove of
advantage to the junior practitioner.  Tne  result of all these additions is  that the work  now con-
tains fully one-half more matter than the last American edition, with nearly one-half more illus-
trations, so that notwithstanding the use of a smaller type, the volume contains almost two hundred
pages more than before.
   No effort has been spared to secure an improvement  in the mechanical execution of  the work
equal to that which the text has received, and the volume is confidently presented as one of the
handsomest that has thus far  been laid before the American profession;  while the very low price
at which it is offered should secure for it a place in every lecture-room and on every office table.
  A better book in which to learn these important
points wc have not met than Dr. Churchill's.  Every
page of it is full of instruction; the opinion of all
writers of authority is given on questions of diffi-
culty, as well as  the directions and advice  of the
.learned autuor himself, to which he adds the result
of statistical inquiry, putting statistics in their pro
per place and giving them their due weight,  and no
more.  We have never read a book more free from
professional jealousy than Dr. Churchill's.  It ap-
pears to be written with the true design of a book on
medicine, viz: to give all that is known on the sub-
ject of which he treats, both theoretically and prac-
tically, and to advance such opinions of his own as
he believes will benefit medical  science, and insure
the safety of the patient.  We have said  enough to
convey to the profession that this book of Dr. Cnur-
chill's is admirably suited for a book  of reference
for the practitioner, as well as  a text-book  for the
student, and we  hope  it may be  extensively pur-
chased amongst  our  readers. . To them we most
strongly  recommend  it. — Dublin Medical  Press

  To bestow praise on a book that has received such
marked approbation would be superfluous. We need
only say, therefore, that if the  first edition was
thought worthy  of a favorable reception  by  the
medical public, we can confidently affirm that this
will be found much more so.  The lecturer,  the
practitioner, and the student, may all have recourse
to its pages, and  derive from their perusal much in-
terest and instruction in everything relating to theo-
retical and practical midwifery.—Dublin Quarterly
Journal of Medical Science.
  A work of very great merit,  and such as we can
eonfidently recommend to the study of every obste-
tric practitioner.—London Medical Gazette.
  Few treatises will be found  better  adapted as s
text-book for the student, or as a manual  for th<
frequent consultation of the young practitioner.-
American Medical Journal.
  Were we reduced to the necessity of having but
>»« work  on midwifery, and permitted to choose,
we would unhesitatingly take Churchill.— Western
Med. and Surg. Journal.
  It  is impossible to conceive a more useful  and
;legant manual  than Dr. Churchill's  Practice of
VEidwifery.—Provincial Medical Journal.
  Certainly, in our opinion, the very best work on
he subject  which exists.—iV. Y. Annalist.
  No work holds a higher position, or  is more de-
serving of being placed in the hands of the tyro,
the advanced student, or the practitioner.—Medical
Examiner.
  Previous editions  have been received with mark-
ed favor, and they deserved it; but this, reprinted.
from a very late Dublin edition, carefully revised
and brought up by the author to  the present time,
does pr.sent an unusually accurate and able expo-
sition of every important particular embraced in
the department of midwifery. *  *   The clearness,
directness, and precision of its teachings, together
with the great amount of statistical  research which
its text exhibits, have served to place it already in
the foremost rank of works in this department of re-
medial science.—N. O. Med. and Surg.  Journal.
   In our opinion, it forms one of the best if not t e
very best text-book and epitome of obstetric scienca
which we at present possess in the English lan-
guage.—Monthly Journal of Medical Science.
   The clearness and precision of style in which it is
written, and the greatamountof statistical researeh
which it contains, have served to place it in the first
rank of works in this departmentof medical science.
— N. Y. Journal of Medicine.
   This is certainly the most perfect system extant.
 [t is the  best adapted for the  purposes of a text-
 )Ook, and that which he whose necessities confine
 Slim to one book, should  select in preference to all
 )thers.—Southern Medical and Surgical Journal.
                         BY the same author.  (Lately Published.)

ON THE  DISEASES OF INFANTS  AND  CHILDREN.   Second  American
  Edition, revised and enlarged by the author  Edited, with Notes, by W. V. Keating, M. D.  In
  one large and handsome volume, extra cloth, of over 700 pages.  $4 00.
  In nrenaring this work a second time for the  American profession, the author has spared  no
labor in Jivinl it a very thorough revision, introducing several new chapters, and rewriting others,
wKleevery portion of the voh.me has  been subjected  to a severe scrutiny.  The efforts of the
American editor have been directed to  supplying such information relative to matters  peculiar
fo th s  coun rv as might have escaped the attention of the author and the  whole may, there-
for, be safely pronounced one of the most complete works on the subj  -
'?!?_ D_3I!JLPn   __„ «„ alteration in the  size of the page, these vei
to this country  a
fore, be safely pr

Ea^SoXted wnho^nnduiy increasing the size ofthe work.
By an alteration
   ect accessible to the Ame-
very extensive additions have
BY THE SAME AUTHOR.
ASSAYS ON THE  PUERPERAL FEVER, AND OTHER DISEASES  PF-
  r-TTT IAR TO WOMEN   Selected from the writingsof British Authors previous to the close of
  the Ei*htc-enth Century.  In one neat octavo volume, extra cloth, of about 450 pages.  $2 50. 
10
LEA  fl. BLANCHARD1.  MEDICAL
           CHURCHILL  (FLEETWOOD),  M.  D., M. R. I.  A.,  «tc.
ON THE DISEASES OF  WOMEN;  including those of Pregnancy  and  Child-
  bed. A new American edition, revised by the Author. With Notes and Additions, by D  Fran-
  cis Condie, M. D., author of " A Practical Treatise on the Diseases of Children."  With nume-
  rous illustrations.  In one large and handsome octavo volume, extra cloth, of 768 pages.  $4 00.
  This edition of Dr. Churchill's very popular treatise may almost  be termed a new work, so
thoroughly has he revised  it in every pdrtion.  It will be found greatly enlarged,  and  completely
brought up to  the most recent condition of  the subject, while the very handsome series of  illustra-
tions introduced,  representing such pathological conditions as can be accurately portrayed, present
a novel feature, and afford valuable  assistance to the young practitioner.  Such additions as ap-
peared desirable  for the American  student have been made by the  editor, Dr. Condie,  while a
matked improvement in the mechanical execution keeps pace with the advance in all other respects
which the volume has undergone, while the price has been kept at the former very moderate rate.
                                              extent that Dr. Churchill does.  His, indeed, is th«
                                              only thorough treatise we  know of on the  subject;
                                              and it may be commended  to practitioners and stu-
                                              dents as a masterpiece in its particular department.
                                              —Thi Western Journal of Medicine and Surgery.
                                                As a comprehensive  manual for students,  or a
                                              work of reference for practitioners, it surpasses any
                                              other that has ever issued  on the same subject from
                                              the British press.—Dublin Quart. Journal.
  It comprises, unquestionably, one of the most ex-
act and comprehensive expositions  of the present
state of medical knowledge in respect to the diseases
of women that has yet been published.—Am. Journ.
Med. Sciences.
  This work is the most reliable which we possess
on this subject; and is deservedly popular with the
profession.—Charleston Med. Journal, July, 1857.
  We know of no author who deserves that appro-
bation, on "the diseases of females," to the same
                             DICKSON (S.  H.), M. D.,
           Professor of Practice of Medicine in the Jefferson Medical College, Philadelphia.

ELEMENTS OF MEDICINE;  a Compendious  View  of Pathology and Thera-
  peutics, or the History and Treatment of Diseases.  Second edition, revised.  In one large and
  handsome octavo volume. of 750 pages, extra cloth.  $3 75.
  The steady demand which has so soon exhausted the first edition of this work, sufficiently shows
 that the author was not mistaken in supposing that a volume of this character was needed—an-
 elementary manual of practice, which should present the leading principles of medicine with the
 practical results, in a condensed and perspicuous  manner.  Disencumbered of unnecessary detail
 and fruitless speculations, it embodies what is  most requisite for the student to learn, and at the
 same time what the active practitioner wants when obliged, in the daily calls of his profession,  to
 refresh his  memory on  special points.  The clear and attractive  style of the author renders the
 whole easy of  comprehension, while his long experience gives to his teachings an authority every-
 where acknowledged.   Few physicians, indeed, have had wider opportunities foevobservation and
 experience, and few, perhaps, have used them  to better purpose   As the result of a long life de-
. voted to study  and practice, the present edition, revised and brought up to the date  of publication,
 will doubtless  maintain the reputation already acquired as a condensed and convenient American
 text-book on the Practice of Medicine. .
                     DRUITT (ROBERT),  M. R. C. S.>  &c.
THE PRINCIPLES  AND PRACTICE  OF  MODERN SURGERY.   A new
  and revised American from the eighth enlarged and improved London edition.  Illustrated with
  four hundred and thirty-two wood-engravings.  In one very handsomely printed octavo volume
  of nearly 700 large pages, extra cloth, $4 00.
  A work which like  Druitt's Surgery h«s for so many years maintained the position of a lead-
 ing favorite with all classes of the profession, needs no special recommendation to attract attention
 to a revised edition.  It is only necessary to state  that the auihor has spared no pains to keep the
 work up to its well earned reputation of presenting in a small and convenient compass the latest
 condition of every department of surgery, considered both as a science and as an art; and that the
 services of a competent American editor have been employed to introduce whatever novelties may
 have escaped the  author's attention, or may prove of service to the American practitioner.  As
 several editions  have  appeared in London since the issue of the last American reprint, the volume
 has had the benefit of repeated revisions by the author, resulting in a very thorough alteration and
 improvement.  The extent of these additions  may be estimated from the fact that it now contains
 about one-third  more matter than the  previous American edition, and  that notwithstanding the
 adoption of a smaller type, the pages have been increased by about one hundred, while nearly two
 hundred and fifty wood-cuts have been added to the former list of illustrations.
  A marked improvement will also be perceived in the mechanical and artistical execution of the
 work, which, printed  in the best style, on new type, and fine paper, leaves little to be desired as
 regards external finish; while  at the very low price affixed  it will be found one of the  cheapest
 volumes accessible to  the profession.
  This popular volume, now a most comprehensive
work on surgery, has undergone many corrections,
improvements, and additions, and the principles and
the practice of the art have been brought down to
the latest record and observation. Of the operations
in surgery ii is impossible to speak too highly. The
descriptions are so clear and concise, and the illus-
trations so accurate and numerous, that the student
can have no difficulty, with instrument in hand, and
book by his side, over the dead body, in obtaining
a proper knowledge and sufficient tact in this much
neglected department of medical education.—British
and Foreign Medico-Chirurg. Review, Jan. 1S60
  In the present edition  the author has entirely re-
written many of the chapters, and has incorporated
the various improvements and  additions in modern
surgery.  On  carefully going  over it, we find  that
nothing of real practical importance has been omit-
ted ;  it presents a faithful epitome of everything re-
lating t) surgery up to the present hour.  It  is de-
servedly a popular manual,  both with  the student
and practitioner.—London Lancet, Nov. 19,1859.

  In closing this brief notice, we recommend as cor-
diallv as ever this most useful and comprehensive
hand-book.   It must prove a vaBt assistance, not
only  to the student of surgery, but also to the busy
practitioner wht may not have the leisure to devote
himself to the study of more lengthy volumes.__
London Med. Times and Gazette,  Oct 22, 1859.

  In  a word, this eighth edition of Dr  Druitt's
Manual of Surgery is all that  the surgical student
or practitioner could desire. — Dublin Quarterly
Journal of Med. Sciences, Nov. 1859. 
AND SCIENTIFIC  PUBLICATIONS.
11
                            DALTON, JR.  (J. C), M.  D.
                 Professor of Physiology in the College of Physicians, New York.

A TREATISE ON  HUMAN  PEIYSIOLOG-Y, designed for the use of Students
  and  Practitioners of Medicine.  Third edition, revised, with nearly three hundred illustrations
  on wood.  In one very beautiful octavo volume, of 700 pages, extra cloth, $5 00.   (Just Ready,
  18.4.)

  The rapid demand for another edition of this work sufficiently shows that the author has suc-
ceeded in his efforts  to produce a text-book of standard and permanent value, embodying within
a moderate  compass all that is definitely and positively known within the domain of Human
Physiology.  His high reputation as an original observer and investigator, is a guarantee  thai in
again revising it he has  introduced whatever is necessary to render it thoroughly on a level with
the advanced science of the day, and this has been accomplished without unduly increasing  the
size of the volume.
  No exertion has been spared to maintain the high standard of typographical execution which has
rendered this work admittedly one of the handsomest volumes as yet produced in this country.
  It will be seen, therefore, that Dr. Dalton's best! own original views and experiments, together with
efforts have been directed towards  perfecting  his  a desire to supply what he considered some deficien-
work.  The additions are marked by the same fea-  cies in the first edition, have already made the pre-
tures which characterize the remainder of the vol- I sent one a necessity, and it will no doubt be even
ume, and render it by far the most desirable text- j more eagerly sought for than the first.  That it is
book on physiology to place in the hands of  the  not merely a reprint, will be seen from the author's
student which, so  far as we are aware,  exists in  statement of the following principal additions and
the English language, or perhaps in any other. We
therefore have no hesitation in recommending Dr.
Dalton's book for the classes for which it is intend-
ed, satisfied as we are that it is better adapted to
their use  than any other work of the kind to which
they have access.—American Journal of the Med.
Sciences, April, 1861.

  It is, therefore, no disparagement to the many
books upon physiology, most excellent in their day,
to say that Dalton's is the only one that gives us the
Bcience as  it was known to the best philosophers
throughout the world, at the beginning  of the cur-
rent year.  It states in comprehensive but concise
diction, the facts established by experiment,  or
other method of demonstration, and details, in  an
understandable manner, how it is done, but abstains
from the discussion of unsettled or theoretical points.
Herein it is unique;  and these  characteristics ren
der it a text-book without a rival, for those who
desire to  study physiological science as it is known
to its most successful cultivators.  And it is physi-
ology thus presented that lies at the foundation of
correct pathological  knowledge; and this in turn is
the basis  of rational therapeutics; so that patholo-
gy, in fact, becomes of prime importance in the
proper discharge of our every-day practical duties.
—Cincinnati Lancet, May, 1861.

  Dr. Dalton needs no word of praise from us. He
is universally recognized as among the first, if not
the very first, of American physiologists now living.
The first edition of his admirable work appeared but
two years since, and the advance of science, his
alterations which he has made.  The present, like
the first edition, is printed in the highest style of the
printer's art, and the illustrations are truly admira-
ble tor their clearness in expressing exactly what
their author intended.—Boston Medical and Surgi-
cal Journal, March 28, 1861.

  It is unnecessary to give a detail of the additions;
suffice it to say, that they are numerous and import-
ant,  and  such as  will render the work still more
valuable and acceptable to the profession as a learn-
ed and original treatise on this all-important branch
of medicine.  All  that was said in  commendation
of the getting up of the first edition, and the superior
style of the illustrations apply with equal force to
this.  No better work on physiology can be placed
in the hand of the  student.—St. Louis Medical and
Surgical Journal, May, 1861.
  These additions, while tes'.ifying to the learning
and industry of the author, render the book exceed-
ingly useful, as the most complete expose of a sci-
ence, of which Dr. Dalton is doubtless the ablest
representative on this side of the Atlantic.—New
Orleans Med. Times, May, 1861.
  A second edition of this deservedly popular work
having been called for  in  the short space of two
years, the author  has supplied deficiencies, which
existed in the former volume, and has thus more
completely fulfilled his design of presenting to the
profession a reliable and precise text- book, and one
which we consider the best outline  on  the subject
of which it treats, in any language.—N. American
Medico-Chirurg. Review, May, 1861.
           DUNGLISON,  FORBES,  TWEEDIE, AND  CONOLLY.

THE CYCLOPAEDIA OF PRACTICAL  MEDICINE: comprising Treatises on
  the Nature and Treatment of Diseases, Materia Medica, and Therapeutics, Diseases of Women
  and ChUdren, Medical Jurisprudence, &c. &c.   In four large super-royal  octavo volumes, of
  3254 doublecWumned pages, strongly and handsomely bound, with raised bands.  $14 00.
  *  * This work contains no less than four hundred and eighteen distinct treatises, contributed by
.ix*£eiJhS                               a comPlete  l^rary of reference for  the country
practitioner.
  The most complete work on Practical Medicine
•xtant;  or, at least, in  our  langwge.-Buffalo
Medical and Surgical Journal.

  For reference, it is above all price to every prac-
titioner.— Western Lancet.
  One of the most valuable medical publications of
theday-as a work of reference it is invaluable—
Western Journal of Medicine and Surgery.

  It has been to us, both as learner and teacher, a
wo^eadyandfreq^treferenc^onein^ich
  The editors are practitioners of established repu-
tation, and the lisl of contributors embraces many
of the most eminent professorsand teachers of Lon-
don, Edinburgh, Dublin, and Glasgow.  It is, in-
deed, the great merit ol this work thatth-principal
articles have been furnished by practitioners who
have not only devoted especial attention to the dis-
eases about which they have written, but have
also enjoyed opportunitiet  for an extensive practi-
cal  acquaintance with them and whose reputation
carries the assurance of their competency justly to
appreciate the opinions or  others, while it stamps
.u ..:-,....- H -_t.•;.- _. ...i +V hitrh an.timlailthnritv __
    . r      , . „„h fronnpnt reference, one in wiii.ii . <*_ i" *.*.__!.». ■...- .|.»_.».-.. ~, ~----, ......--- ~-—_■-
^^"Vn-M^h medicine Uexhibited in the most  their own doctrines witl high and just authority.-
modern  English medicine is  "'""' .               American Medical Journal.
idvantageous light.—Medical Examiner.          i ■*  ___


DEWEES'S COMPREHENSIVE SYSTEM OF
  MIDWIFERY.  Illustrated by occasional cases
  andi many engravings.  Twelfth edition, with the
  author^ast improvements and  corrections  In
  oneoctavovolume, extra cloth, of 600 pages #3 50.
DEWEES'S TREATISE ON THE PHYSICAL
 AND MEDICAL TREATMENT OF CHILD
 REN.  The last edition.  In one volume, octavo,
 extra cloth, 548 pages.  $. 80
DEVVEF.svS TREATISE  ON  THE  DISEASES
 OF FEMALES.  Tenth edition.  In one volume,
 octavo extra cloth, 532 pages, with plates. $3 08. 
12
LEA  &  BLANCHARD'S  MEDICAL
                         DUNGLISON  (ROBLEY),  M.D.,
          Professor of Institutes of Medicine in the Jefferson Medical College, Philadelphia

      ENLARGED  AND REVISED EDITION OF  1865—:Just Ready.)

MEDICAL  LEXICON;  a Dictionary of  Medical Science,  containing a  concise
  Explanation of the various Subjects and Terms of  Anatomy, Physiology, Pathology, Hygiene,
  Therapeutics  Pharmacology, Pharmacy, Surgery, Obstetrics, Medical Jurisprudence, and Den-
  tistry.  Notices of Climate and of Mineral Waters; Formulae for Officinal, Empirical, and Dietetic
  Preparations; with the Accentuation and Etymology of ihe Terms, and the French and other
  Synonymes; so as to constitute a French as  well  as  English Medical Lexicon.   Thoroughly
  revised  and very greatly modified and augmented,   in one very large and handsome royal
  octavo volume, of 1048 double-columned pages, in small type; strongly done up in extra cloth,
  $b 00; leather, raised bands, $6 75
                               Preface to the New Edition.
  " The author has again been required to subject  his Medical  Lexicon to a thorough revision.
The progress of Medical Science,  and the  consequent introduction of new subjects and terms,
demanded  this; and he  has embraced the occasion to render more complete the etymology and
accentuation of the terms.  On no previous revision ha« so much time and labor been expended by
him.  Some idea may be formed of this, from  the fact.'that although the page has been augmented
in all its dimensions, not fewer than between sixty and seventy pages have been added.
  "As the author has remarked on former occasions, it has ever been his ardent wish  to make the
work a satisfactory and  desirable—if not indispensable—lexicon, in which the inquirer may search,
without disappointment, for every term that has been legitimated in thenomenclatu eof ihe science;
and he confidently presents this edition as having more claims on the attention of the  praciitioner
and student than its predecessors.
  "Once more the author gladly seizes the opportunity afforded him to express hisgrateful acknow-
ledgments for the vast amount of favor which has been extended to the Dictionary."
    January, 1S65.
  The object of the author from the outset has not been to  make the work a mere lexicon or dic-
tionary of  terms, but to afford, under each a condensed view of its various medical relations, and
thus to render the work  an epitome of the existing condition of medical science.  Starting with
this view,  the immense demand whicn has existed for the work has enabled him, in repeated re-
visions,  to  augment its completeness and usefulness, until at length it has attained the position of
arecognized and standard authority wherever the language is spo.en.   This has onlybeen accom-
plished by  the earnest  determination to bring each  successive edition  thoroughly on  a level with
the most advanced condition of contemporary medical science, and  on no previous occasion  has
this demanded a more patient and laborious effort than in rendering the present edition fully equal
to the wants of the student of the present day, and in no previous editions hasthe amount of rew
matter introduced been sn large.  While, therefore, the  reader who merely desires a vocabulary
explaining the terms in common use can satisfy himself w'tb the smaller works, such as Hoblyn's,
the student and practitioner who wish a work  to which they can at all times refer with  unfailing
confidence for all which it is the province of such a book to supply, must still, as heretofore, keep
the latest edition of " Dunglison's Dictionary" within  reach.
   The mechanical execution of this edition will  be  found greatly superior to that of previous im-
pressions.   By enlarging the size of the volume to a royal octavo, and by the employment of a small
but clear type on extra fine paper, the additions have been incorporated  without materially increas-
ing the bulk of the volume, and ihe matter of  two or three ordinary octavos has been compressed
into the space of one not unhandy for consultation and reference.
   A few notices of the  previous edition are subjoined.
  This worlt, the appearance of the fifteenth edition
of  which it has become  our duty and  pleasure  to
announce,is perhaps the most stupendous monument
 of  labor  and erudition in medica! literature.  One
would hardly suppose after constant use of the pre
ceding editions, where we have never failed to find
a sufficiently full explanation of ever) medical term,
that in this edition " about six  thousand subjects
and terms have been added," with a careful revision
and correction of the entire work.  It is only neees-
Bary to announce the advent of this edition to make
it occupy the place of the preceding one on the table
of every medical man, as it is withoutdoubt the best
and most comprehensive work of the kind which has
ever appeared.—Buffalo Med. Journ., Jan. 1858.
  The work is a  monument  of patient research,
skilful judgment, and vast physical labor, that will
perpetuate the name of  the author more  effectually'
than any possible device of stone  or metal.  Dr.
Dunglison deserves the thanks not only of the Ame-
rican profession, but of the whole medical world.—
North Am. Medico-Chir. Review, Jan. 1858.
  A Medical Dictionary better adapted for the wants
of the profession than any other with which we are
acquainted, and of a character which places it far
above comparison and  competition.—Am. Journ.
Med. Sciences, Jan. 1858.
  We need only say, that the addition of 6,000 new
terms, with their accompanying definitions, may be
Baid to constitute a new work, by itself.   We have
examined the Dictionary attentively, and are most
happy to pronounce it unrivalled of.its kind.  The
erudition displayed, and the extraordinary industry
which must have been demanded, in its preparation
and perfection, redound  to the lasting credit of its
author, and have furnished us with a volume indis-
pensable at the present day,to all who would  find
themselves au niveau with the  highest standards of
medical information.—Boston Medical and Surgical
Journal, Dec. 31, 1857.
  Good lexicons and encyclopedic works generally,
ire the most labor-saving contrivances which lite-
rary men enjoy; and the labor which is required to
produce them in the perfect manner of this example
 . something appalling to contemplate. The author
tells us in  his preface that he has added  about six
thousand terms and subjects to this edition, which,
before, was considered universally as the  best work
of the kind in any language__Silliman's Journal,
March, 1858.
  A complete and thorough exponent of medical
terminology, without rival or possibility of rivalry.
—Nashville Journ. of Med. and Surg., Jan. 1858.
  It is universally acknowledged, we believe,  that
this work is incomparably the  best  and most com-
plete  Medical  Lexicon  in the English  language.
Comment and commendation are unnecessary, as no
one at the present day thinks of purchasing any other
Medical Dictionarj than this— St. Louis Med. and
Surg. Journ., Jan 1858.
  It is the  foundation stone of a good medical libra-
ry, and should always be included in the first list of
books purchased by the medical student.— Am. Med.
Monthly, Jan. 1858.
  It is scarcely necessary to remark that  any medi-
cal library wanting a copy of Dunsrlison's Lexicon
must be imperfect.—Cin. Lancet, Jan. 1858.
  The present edition we may safely say he s no equal
in the world—Peninsular Med. Journal  Jan. 1859. 
AND SCIENTIFIC  PUBLICATIONS.                  13
                         DUNGLISON (ROBLEY),  M.D.,
          Professor of Institutes of Medicine in the Jefferson Medical College, Philadelphia

HUMAN   PHYSIOLOGY.   Eighth  edition.    Thoroughly revised  and  exten-
  sively modified and enlarged, with five hundred and thirty-two illustrations   In two large and
  Handsomely printed octavo volumes, extra cloth, of about 1500 pages.  $7 00.

  In revising this work for its eighth appearance, the author has spared no labor to render it worthy
a continiian-e  of the very great favor which has been extended to it by the profession.  The whole
contents have  been rearranged, and to a greal extent remodelled; the investigations which of late
years have been so numerous and so important,  have been  carefully examined and incorporated,
and the work  in every respect has been brought up to a level with  the present state of the subject.
  he object of  the author  has been to render it a concise but comprehensive treatise, containing the
whole body of physiological science, to which the student and man of science can at all times refer
with the certainty of finding whatever they are in search of, fully presented in all its aspects; and
on no former edition has  the author bestowed more labor to secure this result.
  We believe that it can truly be said, no more com-
plete repertory of facts upon the subject treated,
can anywhere be found.  The author has, moreover,
that enviable tact at description and that facility
and ease of expression which render him peculiarly
acceptable to the casual,  or the studious reader.
This faculty, so requisite in  setting  forth  many
graver and less attractive subjects, lends additional
charms to one always fascinating.—Boston Med.
und Surg. Journal.

  The most complete and  satisfactory system of
Physiology in the English  language.—Amer. Med.
Journal.
  The best  work of the kind in the English lan-
guage.—Silliman's Journal.
  The present edition the author has made a pcifc.t
mirror of the science as it is at the present  hour.
As a work upon physiology proper, the science of
the functions performed by the body, the student wil 1
find it  all he wishes.—Nashville Journ. of Med.
  Thathe has succeeded, mostadmirably succeeded
in his purpose, is apparent from  the appearance of
an eighth edition. It is now the great encyclopaedia
on the subject,  and worthy of a place in every phy-
sician's library.—Western Lancet.
                          BY THE SAME  AUTHOR.   (A «_ __ edition.)

GENERAL  THERAPEUTICS  AND  MATERIA  MEDICA;  adapted  for a
  Medical Text-book.  With Indexes of Remedies and of Diseases and their Remedies.   Sixth
  Edition, revised and improved.  With one hundred and ninety-three illustrations.  In two large
  and handsomely printed octavo vols., extra cloth, of about 1100 pages. $6 50.
  In announcing a new edition of Dr. Dunglison's
General Therapeutics and Materia Medica, we have
no words of commendation to bestow upon a work
whose merits have been heretofore so often and so
justly extolled.  It must not be supposed, however,
that the present is a mere reprint of the previous
edition: the character  of the author for laborious
research, judicious analysis, and clearness of  ex-
pression, is fully sustained by the numerous addi-
tions he has made to  the work, and the careful re-
vision to which he has subjected the whole.—N. A.
Medico-Chir. Review, Jan. 1858.
  The work will, we have little doubt, be bought
and read by the majority of medical studentsj its
size, arrangement, and reliability recommend it to
all;  no  one, we  venture to predict, will study it
without profit, and there are few to whom it  will
not be in some measure useful as a work of refer-
ence.  The young practitioner, more especially, will
find the copious indexes appended to this eduion of
great assistance in the selection and preparation of
suitable  formulae.—Charleston Med. Journ.and Re-
view, Jan. 1858.
                        BY the same author.  (A new Edition.)

NEW REMEDIES, WITH FORMULAE FOR THEIR PREPARATION AND
  ADMINISTRATION.  Seventh edition, with extensive Additions.  In one very large octavo
  volume, extra cloth, of 770 pages.   $4 CO.
  One of the most useful of the author's works.—
Southern Medical and Surgical Journal.
  This elaborate  and  useful  volume  should  be
found in every medical library, for as a book of re-
ference, for physicians, it is  unsurpassed  by any
other work in existence, and  the double index for
diseases and  for remedies, will be found greatly to
•nhanceits value.—New York Med. Gazette.
  The great learning of the author, and his remark-
able industry in pushing his  researches into every
source whence information is derivable,have enabled
him to throw together an extensive mass of facts
and statements, accompanied by full reference to
authorities; which  last feature renders the work
practically valuable to investigators who desire to
examine the original papers.—The American Journal
of Pharmacy.
                            ELLIS  (BENJAMIN), M.D.

THE  MEDICAL FORMULARY:  being a Collection  of Prescriptions,  derived
  from the writings and practice of many of the most eminent physicians of America and Europe.
  Together with the usual Dietetic Preparations and Antidotes for Poisons.   To which  is added
  an Appendix on the Endermic use of Medicines, and on the use of Ether and Chloroform.   The
  whole accompanied with a few brief Pharmaceutic and Medical Observations.  Eleventh edition,
  carefullv revised and much extended by Robert P. Thomas, M. D., Professor of Materia Me-
  dica in the Philadelphia College of Pharmacy.  In one volume, 8vo., of about 3.0 pages.  $2 75.
  (Just Issued.)
  On no previous edition of this work has there  been so complete aud thorough a revision   The
extensive change's in the new United States Pharmacopoeia have necessitated corresponding alter-
ations" in the Formulary,  to  conform  to that national standard, while the progress made in the
materia medica and the arts of prescribing and dispensing during the last ten years have been care-
fullv noted and incorporated throughout.  It is therefore presented as not only wonhy a continuance
of the favor so long enjoyed, but as  more valuable than ever to the practitioner and pharmaceutist.
Those who possess  previous editions will find the additional matter of sufficient importance to
warrant their adding the present to their libraries. 
14
LEA  & BLANCHARD'S  MEDICAL
                                 ERICHSEN (JOHN),
                     Professor of Surgery in University College, London, toe.

THE SCIENCE AND ART OF SURGERY; being a Treatise on Surqioal
  Injuries, Diseases, and Operations. New and improved American, from the second enlarged
  and carefully revised London edition.   Illustrated with over four hundred engravings on wood.
  In  one large and handsome octavo volume, of one thousand closely printed pages, extra cloth,
  $6 00.
  The very distinguished favor with which this work has been received on both sides of the Atlan-
tic has stimulated the author to render it even more worthy of the position which it has so rapidly
attained  as a standard authority.   Every portion has been  carefully  revised,  numerous additions
have  been made, and the most watchful  care has been exercised to render it a complete exponent
of the most advanced condition of surgical science.   In this manner the work has been enlarged by
about a hundred pages, while the series of engravings has been increased by more than a hundred,
rendering it one of the most thoroughly illustrated volumes before the profession.   The additions of
the author having rendered unnecessary most of the notes of the former American editor, but little
has been  added in this country; some  few notes and occasional illustrations have, however, been
introduced to elucidate American modes of practice.
                                             excellent contribution to  surgery, as probably the
                                             best single volume  now extant on the subject, and
                                             with great pleasure we add it  to our text-books.—
                                             Nashville Journal of Medicine and Surgery.
                                               Prof. Erichsen's work, for its size, has not been
  It is, in our humble judgment, decidedly the best
 book of the kind in the English language. Strange
 that just such books are notoftener produced by pub-
 lic  teachers of surgery  in this country and Great
 Britain. Indeed, it is a matter of great astonishment.
 but no less true than astonishing, that of the many
 works on surgery republished in this country within
 the last fifteen or twenty years  as text-books for
 medical students, this is the only one that even ap-
 proximates to the fulfilment of the peculiar wants of
 youngmen justentennguponthe study ofthisbranch
 of the profession.— Western Jour, of Med. and Surgery.

  Its value is greatly enhanced by  a very copious
 well-arranged index.  We regard this as one of the
 most valuable contributions to modern surgery. To
one entering his novitiate of practice, we regard it
the most serviceable guide which he can consult.  He
will find a fulness of detailleadinghim through every
step of the operation, and not deserting him until the
final issue of the case is decided.—Sethoscope.
  Embracing, as will be perceived, the whole surg]
cal domain, and each division of itself almost com
plete and perfect, each chapterfull and explicit, eacl
subject faithfully exhibited, we can only express ou;
estimate of it in the aggregate. We consider  it ar.
surpassed; his nine hundred and eight pages, pro-
fusely illustrated, are rich in physiological, patholo-
gical, and operative suggestions, doctrines, details;
and processes; and will prove a reliable resource
for information, both to physician and surgeon, in the
hour of peril.—N  0. Med. and Surg Journal
  We may say, after a careful perusal of some of
the chapters, and a more hasty examination of the
remainder, that it must raise the character of the
author, and reflect great credit upon the college to
which he is professor, and we can cordially recom-
mend it  as a  work of  reference  both to students
and piactitioners.—Med. Times and Gazette. '
  We do not hesitate to say that the volume before
us gives a very admirable practical view of the sci-
ence and art ot Surgery of the present day, and  we
have no doubt that it will be highly valued as a
surgical guide as well by  the surgeon as by the
student  of surgery. — Edinburgh Med. and Su-g.
Journal.
FISKE  FUND PRIZE  ESSAYS. — THE EF-I   Edward Warren, M.D., of Edenton.N. C. To-
  FECTS  OF  CLIMATE ON TUBERCULOUS    getherinoneneat 8vo. volume, extra cloth. »\ 00.
  DISEASE. By Edwin Lee, M.R.C.S , London, | FRICK ON RENAL AFFECTIONS;  their Diag-
  and THE INFLUENCE OF PREGNANCY ON I   npsis and Pathology.  With illustrations.  Ona
  THE DEVELOPMENT OF TUBERCLES  By    volume, royal 12mo., extra cloth.  75 cents.
                       FERGUSSON  (WILLIAM), F. Ft. S.,
                     Professor of Surgery  in King's College, London, &c.

A  SYSTEM  OF PRACTICAL SURGERY.   Fourth American, from the third
  and enlarged London edition.  In one large and beautifully printed octavo volume, of about 710
  pages, with. 393 handsome illustrations, leather.  $3 50.
                        FOWNES (GEORGE), PH.  D., Sec.

 A MANUAL  OF  ELEMENTARY CHEMISTRY;  Theoretical and Practical.
   With one hundred and ninety-seven illustrations.  Edited by Robert Bridges, M. D.  In one
   large royal 12mo. volume, of 600 pages, extra cloth, $2 00.
   The death of the author having placed the editorial care  of this work in the practised hands ol
 Drs. Bence Jones and A. W. Hoffman, everything has been done in its revision which experience
 could suggest to keep it on a level with the  rapid advance of chemical science.  The additions
 requisite to this purpose have necessitated an enlargement of the page, notwithstanding which the
 work has been increased by about fifty pages.   At the same time every care  has been  used to
 maintain its distinctive character as a condensed manual for the student, divested of all unnecessary
 detail or mere theoretical speculation.  The additions have, of course, been mainly in the depart-
 ment of Organic Chemistry, which has made such'rapid  progress within the last few years, but
 yet equal attention has been bestowed on the other branches of the subject—Chemical Physics and
 Inorganic Chemistry—to present all investigations and discoveries of importance, and to keep up
 the reputation of the volume as a  complete manual of the whole science, admirably adapted for the
 learner. By the use of a small but exceedingly clear type the matter of a large octavo is compressed
 within the convenient and portable limits of a moderate  sized duodecimo, and at the very low price
 affixed, it is offered as one of the cheapest volumes before the profession.
  Dr. Fownes'excellent work has been universally    Ti^ work of  Dr.  Fownes has long been before
 recognized everywhereinhis own and thisoountry,  the public, and its merits have been fully appreci-
 as the best elementary treatise on chemistry in the  ated as the  best text-book  on chemistry now in
 English tongue, and is very generally adopted, we  existence. We do not, of course, place it in a rank
 believe, as the standard text-book in all < ur colleges,  superior to the works of Brande, Graham, Turner
both literary and scientific—Charleston Med Journ.  Gregory, or  Gmelin, but we  say that, as a work
and Review                                    for students, it is preferable to any of them.—Lon-
                                              don Journal of Medicine. 
AND  SCIENTIFIC  PUBLICATIONS.
15
                             FLINT (AUSTIN), M.  D.,
   Professor of the Principles and Practice of Medicine in Bellevue Ho_p. Med. College, Xew York.

TTTE  PRINCIPLES  AND  PRACTICE OF  MEDIC TNT..    For  the use of
  Practitioners and Students.   In one large and handsome  octavo volume.  (Preparing.)
  The want has for some time been felt in this country of a volume which, within a moderate
compass, should give a clear and connected view of general and special pathology and therapeutics
in their most modern aspect.  Re -ent researches have modified  many opinions which were formerly
universally received on important  points both of theory and practice, and these changes nave per-
haps as vet scarcely received the attention due to them in  the works accessible to the profession.
The author's reputation as a teacher is a guarantee that ihe present volume will be fully up to the
most advanced state of the science of the dav, while  his long and varied experience a* a practi-
tioner will insure that in all practical details his work will  be a sound and  trustworthy guide.
                                  BY THE SAME AUTHOR.

PHYSICAL EXPLORATION AND DIAGNOSIS  OF DISEASES  AFFECT
  ING THE  RESPIRATORY ORGANS.  Second edition.  In one large and handsome octavo
  volume, extrt cloth.   (Preparing.)

                           by the same author.  (Now Ready.)

A PRACTICAL TREATISE ON THE DIAGNOSIS, PATHOLOGY, AND
  TREATMENT  OF DISEASES OF THE  HEART.  In one neat octavo volume, of about
  500 pages, extra cloth.  $3 25.
  We do no* know that Dr. Flint has written any-
thing which is not first rate; but this, his latest con-
tribution to medical literature, in our opinion, sur-
passes all the  others. The work is most comprehen-
sive in its scope, and most sound in the views it enun-
ciates.  The descriptions are clear and methodical;
the statements are substantiated by facts, and are
made with such simplicity and sincerity, that with-
out them they would carry conviction. The style
is admirably  clear, direct, and free from dryness.
With Dr. Walshe's excellent treatise before us, we
have no hesitation in saying that Dr. Flint's book is
the best work on the heart in the English language.
—Boston Med. and  Surg. Journal.
                          GRAHAM  (THOMAS), F. R. S.

THE  ELEMENTS  OF  INORGANIC  CHEMISTRY, including the Applica-
  tions of the Science in the Arts. New and much enlarged edition, by Henry Watts and Robert
  Bridges, M. D.  Complete in one large and handsome octavo volume, ot over 800 very large
  pages, with two hundred and thirty-two wood-cuts, extra cloth.  $5 00.
  **.£ Part II., completing the work from p. 431 to end, with Index, Title Matter, &c, may be
had separate, cloth backs and paper sides.  Price $3 00.
  From Prof. E. N. Horsford, Harvard College.
  It has, in its earlier and less perfect editions, been
familiar to me, and the excellence of its plan and
the clearness and completeness of its discussions,
have long been my admiration.
  No reader of English works on this science can
afTord to be without this edition of Prof. Graham's
Elements.—Silliman's Journal, March, 1858.
 From Prof. Wolcott Gibbs, N. Y. Free Academy
 The work is an admirable one in all respects, and
its republication here cannot fail to exert a positive
influence upon the progress of science in this country.
                     GRIFFITH  (ROBERT  E.), M. D., «tc.

A UNIVERSAL  FORMULARY, containing the methods of Preparing and Ad-
  ministering Officinal and other Medicines.  The whole adapted to Physicians and Pharmaceu-
  tists.  Second Edition, thoroughly revised, with numerous additions, by Robert P. Thomas,
  M. D., Professor of Materia Medica in the Philadelphia College of Pharmacy.  In one large and
  handsome octavo volume, extra cloth, of 650 pages, double columns.  $3 75.
  It was a work requiring much perseverance, and  vision and ample additions of  Dr Thomas, and is
                    ■  ■           r~- *u~ *•==•*  now, we believe, one of the mosi complete works
                                             of its kind in any language.  The additions amount
                                             lo aboutseventy pages, and no effort has been spared
                                             to include in them all the recent improvements.  A
                                             work of this kind appears to us  indispensable to the
                                             physician, and tjiere is none we can more cordiallv
                                             recommend.— N. V. Journal of Medicin*.
when published was looked upon as by far the best
work of its kind that had issued from the American
press.  Prof Thomas has certainly "improved" as
well as added to this Formulary, and has rendered it
additionally deserving of the confidence of pharma-
ceutists and physicians.—Am. Journalof Pharmacy.
  We are happy to announce a new and improved
edition of this, one of the most valuable and useful
works that have emanated from an American pen
It would do credit to any country, and will be found
of daily usefulness to practitioners of medicine, it is
better adapted to their purposes than the d.spensato-
tits—Southern Med. and Surg. Journal.
  Itisoneofthe most useful books  a country practi
timer can possiblv have.—Medical Chron>rU
  This is a work of six hundred and fifty one pages
embracing all on the subject of Preparing and adm
nistenng medicines that can be desired b> the physi
Cian and pharmaceutist.- Western Lancet.
  The amountof useful, every-day mauer.fcri prac
licing physician, is really immense.-Boston Med
and Surg. Journal.
  This edition has been greatly improved by the re
  Pre-eminent among the best and most useful com-
pilations of the present day will be found the work
before us, which can have been produced only at a
very great cost of thought and labor.  A short de-
scription will suffice to .how that we do not put too
high an estimate on this work   We are not coeni-
zant of the existence of a parallel work.  Its value
will be apparent lo our readers from toe sketch of
its contents above given.  We strongly recommenl
it to all who are engaged either in practical medi-
cine, or more exclusively with its literature.—Lond.
Med. Gazette.

  A very useful work, and a most complete compen-
dium on the subject of materia medica.  We know
of no work in our language, or any other, so com-
preheniive in all its details.—London Lancet. 
16                   LEA  &  BLANCHARD'S  MEDICAL
                           GROSS (SAMUEL D.),  M. D.,
             Professor of Surgery in the Jefferson Medical College of Philadelphia, Sea.

                               Enlarged Edition.  Now Ready.

A  SYSTEM  OF SURGERY: Pathological, Diagnostic, Therapeutic, and Opera-
  tive.   Illustrated by over Thirteen Hundred Engravings. Third edition, much enlarged and
  carefully revised   In two  large and beautifully printed royal octavo volumes,  of 2200 pages;
  leather.   $15 00.  (Now Ready.)

  The  exhaustion within  five years of two large editions  of so elaborate and  comprehensive
 a work as this  is the best evidence that the author was  not mistaken  in his estimate  of the
 want which existed of a  complete American System of Surgery, presenting the science in all it.
 necessary details and in all its branches.  That he has succeeded in the attempt to supply this want
 is shown not only by the  rapid sale of the work, but also by the very favorable manner in which it
 has been received by the  organs of the profession in this country and in Europe, and by the fact that
 a translation is now preparing in Holland—a mark of appreciation not often bestowed on any scien-
 tific work so extended in  size.
   The  author has not been insensible to the kindness thus bestowed upon his labors, and in revising
 the work for a third edition he has spared no pains to render it worthy of the favor with which it
 has been received.  Every portion has been subjected to close examination and revision ;  any defi-
 ciencies apparent have been supplied, and the results of recent progress in the science and art of
 surgery have been everywhere introduced;  while the series  of illustrations has been still further
 enlarged,  rendering it one of  the most thoroughly illustrated works ever laid before the profession.
 To accommodate these very  extensive additions, the form of the work has been altered to a royal
 octavo, so that notwithstanding the increase in the matter and value of the book, its size wi 1 be found
 more convenient than before.   Every care has been taken in the printing to render the typographical
 execution unexceptionable, and it is confidently expected to prove a work in every  way worthy of
 a place in even the most limited library of the practitioner or student.
  Has Dr. Gross satisfactorily fulfilled this object?
A careful perusal of his volumes enables us to give
an answer in the affirmative. Not only has he given
to the reader an elaborate and well-written account
of his osvn vast experience, but he has not failed to
embody in his pages the opinions and practice of
Burgeons in this and other countries of Europe.  The
result has been a work of such completeness, that it
has no superior in the systematic treatises on sur-
gery which have emanated from English or Conti-
nental authors.  It has been justly  objected  that
these have been far from complete in many essential
particulars, many of them having been deficient in
some of the most important points which should
characterize such works  • Some of them have been
elaborate—too  elaborate—with respect  to certain
diseases, while they have merely glanced at, or
given an unsatisfactory account of, others equally
important to the  surgeon.  Dr. Gross has avoided
this error, and has produced the most complete work
that has yet issued from the press on the science and
practice of surgery.  It is not, strictly speaking, a
Dictionary of Surgery, but it gives to the reader all
the information that he may require for his treatment
of surgical diseases.  Having said so much, it might
appear superfluous to add another word ; but it is
only due to Dr. Gross to state that he has embraced
the opportunity of transferring to his pages a vast
number ol engravings from English  and other au-
thors, illustrative ot the pathology and treatment of
surgical diseases. To these are added several hun-
dred original wood-cuts. The work altogether com-
 mends itself to the attention of Britibh surgeons,
from whom  it cannot fail to meet with extensive
patronage.—London Lancet, Sept. 1, 1860.

   Of Dr.  Gross's treatise on Surgery we can say
no more than that it is the most elaborate and com
plete work on this branch of the healing art which
 has ever  been published in any country. A sys-
 tematic work, it admits of no analytical review;
 but, did our space permit, we should  gladly give
 some extracts from it, to enable our readers to judge
 of the classical style of the author, and the exhaust-
 ing way in which each subject is treated.—Dublin
 Quarterly Journal of Med. Science.
   The  work is so superior to its  predecessors in
 matteT and extent, as well as in illustrations and
 style of publication, that we can honestly recom-
 mend it as the best work of  the kind to be taken
 home by the young practitioner.—Am. Med. Tourn.
   With pleasure we  record the completion  of this
 long-anticipated  work.  The reputation which the
 author has for many  years sustained, both as a cur-
 geon and as a writer, had prepared  us to expect a
 treatise of great excellence and originality; but we
confess we were by no means prepared for the work
which is before us—the most complete treatise upon
surgery ever published; either in this or any othir
country, and  we  might, perhaps, safelv say, the
most original.  There is no subject belonging pro-
perly to surgery which has not  received from the
author a due share of uttention.  Dr. Grots has sup-
plied a want in surgical literature which has long
been felt by practitioners; he has furnished us with
a complete practical treatise upon surgery in all its
departments  As Anriericins, we are proud of the
achievement; as surgeons, we are most sincerely
thankful to him for his extraordnary labors in our
behalf.—N. Y. Review and Buffalo Med Journal.
  The  great merit of the work may be stated as
follows. It presents surgical science as it exists
at the latest date, with all its improvements;  and
it discusses every topic  in  due  proportion.  No-
thing is omitted, nothing is in excess.—Chicago
Med. Examiner, May, I860.
  We cannot close this brief notice  of Dr. Gross's
most valuable and excellent compendium of Sur-
geiy without again  drawing attention to it, as we
did in our notice of his first edition, as an evidence
of the progress our American brethren are making
towards establishing a literature of their own.—
Dublin Quarterly Journal, Feb. 1863.
   It has been characterized by the  representative
press  and by individual surgeons  of the  highest
eminence,  both at home  and abroad, as " the best
systematic work  on surgery ever published in the
 English language;" and  that the profession  at
 large have given substantial proofs  of their agree-
 ment to this verdict, is sufficiently evident from the
 fact that translations into European languages have
 been called for, and that so shortly after ifs first
 appearance,  and at  a time most unfavorable  to
 literary "enterprise," the Philadelphia puolishers
 have found it pay to issue a " second edition, much
 enlarged  and carefully revised."—American  Med.
 Monthly, May, 186-
   We are much gratified to  be able to  announce a
 new edition of this Cyclopaedia of Surgtry.   Con-
 sidering the large size of the work and its  expen-
 Biveness, the extremely rapid  sale and exhaustion
 of an entire edition, not only proves the value of
 the work, and its adaptation  to the wants of the
 profession, but  it speaks well for the  intelligence
 of American surgeons.—American Medical Times,
 May, 1862.
   A valuable and even necessary addition to every
 Burgical library.—Chicago Med. Journ., Dec  1859.
   A system of surgery which we think unrivalled
 iu our language.—British American Journal,
                                    BY THE SAME AUTHOR.

A  PRACTICAL TREATISE  ON  FOREIGN  BODIES  IN THE  AIR-PAS-
  SAGES.  In one handsome octavo volume, extra cloth, with illustrations,  pp. 468.   $2 75. 
AND  SCIENTIFIC  PUBLICATIONS                   17
                            GROSS (SAMUEL D.), M. D.
             Professor of Surgery in the Jefferson Medical College of Philadelphia, &c.

ELEMENTS OF PATHOLOGICAL ANATOMY.  Third  edition, thoroughly
  revised and greatly improved.  In one large and very handsome octavo volume, with about three
  hundred  and fifty beautiful illustrations, of which a large number  are from original drawings,
  extra cloth.  $4 00.

  The very rapid advances in the Science of Pathological Anatomy during the last few years have
rendered essential a thorough modification of this work, with a view of making it a correct expo-
nent of the present state of the subject.   The very careful manner in which this task has been
executed, and the amount of alteration which it has  undergone, have enabled the author to say that
" with the  many changes and improvements now introduced, the work may be regarded almost as
a new treatise," while the efforts of the author have been seconded as regards  the  mechanical
execution of the volume, rendering it one of the handsomest productions of the American press.
BY THE SAME AUTHOR.
A  PRACTICAL  TREATISE  ON   THE   DISEASES,  INJURIES,  AND
  MALFORMATIONS OF THE URINARY BLADDER, THE PROSTATE GLAND, AND
  THE URETHRA.  Second Edition, revised and much enlarged, with one hundred and eighty-
  four illustrations.  In one large and very handsome octavo volume, of over nine hundred pages,
  extra cloth, $4 00.
  Philosophical in its design, methodical in its ar-
rangement, ample and sound in its practical details,
it may in truth be said to leave scarcely anything to
be desired on so important a subject.—Boston Med.
and Surg Journal.
  Whoever will peruse the vast amount of valuable
practical information it contains, will, we think,
agree with us, that there is no work in the English
language which can  make any just pretensions to
be its equal.—N. Y. Journal of Medicine.
  A volume replete with truths and principles of the
utmost value in the investigation of these diseases.—
American Medical Journal.
                             GRAY (HENRY),  F. R. S.,
                   Lecturer on Anatomy at St. George's Hospital, London, tea.

ANATOMY, DESCRIPTIVE AND  SURGICAL.    The Drawings by  H.  V.
  Carter, M. D., late Demonstrator on Anatomy at St. George's Hospital; the Dissections jointly
  by the Author and Dr. Carter.  Second American, from  th_  second  revised and improved
  London edition.  In one magnificent imperial octavo volume, of over 800 pages, with 358 large
  and elaborate engravings  on wood.   Price in extra cloth, $7 00; leather, raised bands, $8 00.
  The/ speedy exhaustion of a large edition of this work is sufficient evidence that its plan and exe-
cution "have been found to present superior practical advantages in facilitating the study of Anato-
my  In presenting it  to the  profession  a second time, the author has availed himself of the oppor-
tunity'to supply any deficiencies which experience in its use had shown to exist, and to correct
any errors  of detail, to which the first edition of a scientific work on so extensive and complicated
a science is liable.  These improvements have resulted in some  increase in the size of the volurne,
whileHwenty-six new wood-cuts have  been  added to  the  beautiful series of illustrations which
fornrsosdistinctive a feature of the work.  The American edition has been passed through the press
underlie supervision of a competent professional man, Who has taken every care to  render it in
all respects accurate,  andiit  is now presented, without any increase of price, as  fitted to maintain
and extend the popularity which it has everywhere acquired
  With little trouble, the busy practitioner whose
knowledge of anatomy may have become obscured by
want of practice, may  now resuscitate his former
anatomical lore, and be ready for any emergency.
It is to this class of individuals, and not to the stu-
dent alone, that this work will ultimately tend to
be of most incalculable advantage, and we feel sat-
isfied that the library of the medical man will soon
be considered incomplete  in which a copy of this
work does  not exist.- Madras Quarterly Journal
of Med. Science, July,  1861.
  This edition is much improved and enlarged, and
contains several new illustrations by Dr. Westma-
cott.  The  volume is a complete companion to  the
dissecting-room, and saves the necessity of the stu
,i_-. „™J_-_;„n. _ vnriPtv of" Manuals."—The Lon
dent possessing a variety of" Manuals
don Lancet, Feb. 9, 1861.
  The work before us is one entitled to the highest
praise, and we accordingly welcome jt.as a valu-
able addition  to medicaf literature.  Intermediate
in fulness of detail  between the treatisesi of S.iar-
poy and of Wilson, its characteristic merit lies in
.hi number and excellence of the engravings it
contains.  Most of these  are original, ofmaeh
larger than ordinary size, ^d admirably executed_
The various parts  are also lettered  after the plan
adopted in Holden's Osteology   U would Jbeaiffi-
cult to over-estimate the ".vantage! on^wd^ttaw
mode of pictorial illustration.  Bones, •'«»««»■>
Tuscles bloodvessels, and nerves are each in turn
 gu^d 'and marked with their appropriate^ names■;
thus enabl ing the student to c< mprehend, at a glance.
figured, and marked


S&.i^'Se^JoS^i^cou.mend the I  Journ. Med. Sci., July, 18,9.
work of Mr. Gray to the attention of the medical
profession, feeling certain that, it should be regarded
as one of the most valuable contributions ever made
to educational literature.—N. Y. Monthly Review.
Dec. 1859.

  In this view, we regard the work of Mr. Gray as
far  better adapted  to the wants of the profession,
and especially of the student, than any treatise on
inatomy yet published in this country. It is destined,
we  believe, to supersede ill others, both as a manual
jf dissections, and a standard of reference to the
student  of general or  relative anatomy. — N. Y.
journal of Medicine, Nov. 1859.

  In our judgment, the mode of illustration adopted
in the present volums cannot but present many ad-
vantages to the student of anatomy.  To the zealous
disciple of Vesalius,  earnestly desirous of real  im-
provement, the book will certainly be of imm.nse
value; but, at the  same time, we must also confess
that to  those simply desirous of "cramming" it
will be an  undoubted godsend.  The peculiar value
of Mr. Gray's mode of illustration is nowhere more
markedly evident than  in the chapter on osteology,
and especially in those portions which treat  of the
bones of the head  and  of their development.  The
study of these parts isthus made one of comparative
ease, if not of positive pleasure; and those bugbears
of the student, the  temporal and sphenoid bones, are
shorn of half their  terrors.   It is, in our estimation,
an admirable and complete text-book for the student,
and a useful work  of reference for the practinoner;
its  pictorial character forming a novel element, to
                                   ded.—Am.
plica 
IS                   LEA  &  BLANCHARD'3  MEDICAL
GIBSON'S INSTITUTES AND PRACTICE OF
  SURGERY.  Eighth edition" improved and al-
  tered. With thirty-fourplates. In twohandsome
  octavo volumes, containing about 1,000 pages,
  leather, raised bandt.  $6 50.
GARDNER'S MEDICAL  CHEMISTRY, for the
  use of Students and the Profession. In one royal
  12mo. vol., cloth, pp. 396, with wood-cuts.  81.
GLUGE'S ATLAS OF PATHOLOGICAL HIS-
  TOLOGY  Translated, with Notes and Addi-
  tions  by Joseph Leidy, M. D.  In one volume.
  very large imperial quarto, extra cloth, wit. 32.
  copper- plate figures, plain and colored, $4 00.
HUGHES' INTRODUCTION  TO  THE  PRAC-
 TICE  OF AUSCULTATION  AND  OTHER
 MODES OF PHYSICAL DIAGNOSIS IN DIS-
 EASES OF THE LUNGS AND HEART   Se-
 cond edition   1 vol. royal 12mo., ex. cloth, pp.
 304  81 00.

HOLLAND'S  MEDICAL NOTES AND  RE-
 FLECTIONS.  From the third  London edition.
 In  one handsome octavo volume, extra cloth.
 »3 50.
HORNER'S SPECIAL  ANATOMY AND HIS-
 TOLOGY. Eighth edition.  Extensively revised
 and modified.  In two large octavo volumes, ex-
 tra cloth, of more than 1000pages, with over 309
 illustrations.  $6 00.
                           HILLIER (THOMAS),  M. D.,
 Physician to the Skin Department of University College Hospital; Physician to the Hospital for Sick
                                     Children, &c. &c.
HAND ROOK  OF  SKIN  DTSE \SES,  FOR  STUDENTS  AND  PRACTI-
  TIONERS.   In one neat royal 12mo. volume, of about 300 pages, with two plates; extra cloth,
  price $2 25.  (Now Ready.)
                               From the Author's Preface.
  " My object has been to furnish to students and practitioners a trustworthy, practical, and com-
pendious  treatise,  which shall comprise the greater part of what has long been known of cutaneous
diseases,  and of what has been more recently brought to light by English, French, and German
dermatologists, as well as to embody the most important results of my own experience in reference
to these diseases "
  The author's position  both  as a lecturer, wrter, and practitioner in this department of med'eine,
is a guarantee of his ability to accomplish  his object in presenting a condensed and convenient
manual, which shall comprise all that the general practitioner requires for his guidance.
  A text book well adapted to the student, and the information contained in it. shows the author to be au
niveau with the scientific medicine of the day —London Lancet, Feb  25, 1865.

                        HAMILTON  (FRANK  H.),  M. D.,
                    Professor of Surgery in the Long Island College Hospital.
A  PRACTICAL  TREATISE ON FRACTURES  AND  DISLOCATIONS.
  Second edition, revised and improved.  In one large and handsome octavo volume, of over 750
  pages, with nearly 300 illustrations, extra cloth, 85 00.
  The early demand for a new edition of  this work shows that it has been successful in securing
the confidence of the profession as a standard authority for consultation and reference on its import-
ant and difficult subject.  In again  passing it  through the press, the author has taken the opportu-
nity to revise it carefully, and introduce whatever improvements have been  suggested by further
experience and observation   An additional  chapter  on Gun-shot Fractures will be found to adapt
it still more  fully to the exigencies of the  time.
  Among th e many good workers at surgery of whom
America may nowboast not the least is FrankHast-
ings Hamilton; and the volume before us is (we say
it with a pang of wounded patriotism) the best and
handiest book on the subject in  the Eiglish lan-
guage.  It is in vain to attempt a review of it;
nearly as vain to seek for any sins, either of com-
mission or omission.  We have  seen no work on
practical surgery which we would sooner recom-
mend  to our brother surgeons, especially those of
" the services," cr those whose practice lies in dis-
tricts  where a man has necessarily to  rt-ly on his
own unaided resources.  The practitioner will find
in it directions for nearly every possible ac.ident,
easily found and comprehended; and much pleasant
reading for him to muse over in the after con.idera-
tion of his cases.—Edinburgh Med. Journ Feb  1861.
  This is a valuable contribution to the surgery of
most important affections,and is the more welcome,
inasmuch as at the present time we do  not possess
a single complete treatise on Fractures and Dislo-
cations in the English language. It has remained for
our American brother toproduce a complete treatise
upon the subject, and bring together in a convenient
form those alterations and improvements that  have
been made from time to time in the treatment of these
affections.  One great and valuable, feature in the
work before us is the fact that it comprises all the
Improvements introduced into the practice of both
English and American surgery, and though far from
omitting mention of our continental neighbors, the
author by no means encourages the notion—but too
prevalent in some quarters—that  nothing is good
unless  imported from France or  Germany.  The
latter half of the work is devoted  to the considera-
tion of the various dislocations and their appropri-
ate treatment, and its merit is fully equal to that of
the preceding portion__The London Lancet,May 5,
I860.
  It is emphatically the book upon the subjects of
which it  treats, and we  cannot doubt that it will
continue so to be for an  indefinite period of time.
When we say, however, that we believe it will at
once take its place as the best book for consultation
by the practitioner; and that it will form the most
complete, available, and reliable guide in emergen-
cies of every nature connected with its subjects; and
also that the student of surgery may make it his text-
book with entire confidence, and with pleasure also,
from its agreeable and easy style—we think our own
opinion may be gathered as to  its value.— Boston
Medical and Surgical Journal, March 1, 1860.
                            HODGE (HUGH  L.),  M. D.,
Professor of Midwifery and the Diseases of Women and Children in the University of Pennsylvania, Sea.
ON  DISEASES  PECULIAR  TO  WOMEN, including Displacements of the
  Uterus.  With original  illustrations.  In one beautifully printed octavo volume, of nearly 500
  pages, extra cloth.  $3 .0.
  This contribution towards the elucidation of the
pathology and  treatment of  some of the diseases
peculiar to women, cannot fail to meet with a favor
able reception  from  the medical profession.  The
character of the particular maladies of which the
work before us treats; their frequency, variety, and
obscuilty; the amount of malaise and even of actual
suffering by  which they are invariably attended;
their obstinacy, the difficulty with which they are
overcome, and  tleir disposition again and again to

  The illustrations, which are all original, are drawn to a uniform scale of one-half the natural size.
recur—these, taken in connection with the entire
competency of the author to render a correct ac-
count of their nature, their causes, and their appro-
priate management—his ample experience, his ma-
tured judgment, and his perfect, conscientiousness__
invest this publication with an interest and value to
which few of the medical treatises of a recent date
can lay a stronger, if, perchance, an equal claim__
Am. Journ. Med. Sciences, Jan. 1861. 
AND  SCIENTIFIC  PUBLICATIONS.
19
                           HODGE  (HUGH  L.),  M. D.,
                  Late Professor of Midwifery, &c, in the University of Pennsylvania.
PRINCIPLES AND  PRACTICE  OF OBSTETRICS.   In one large quarto
  volume of over 550 pages, with one hundred and fifty-eight figures on ihirty-two beautifully exe-
  cuted lithographic plates, and numerous wood-cuts in the text.  $ 14 00.  (Now Ready.)
  This work  embodying the results of an extensive practice for more than forty years, cannot fail
to prove of the utmost value to all who are engaged  in this department of medicine.  The author's
position as one of ,he  highest authorities on the subject in this country is well known, and the fruit
of his ripe experience and long observation, carefully  matured and elaborated, must serve as an
invaluable text-book for ihe student and an unfailing counsel for the practitioner  in the emergencies
which so frequently arise in obstetric practice.
  The illustrations form a novel feature  in  the work.  The  lithographic plates are all original,
and to insure their absolute accuracy they have all been copied from photographs taken expressly
tor the purpose.  In ordinary obstetrical plates, the positions of the fcetus are represented by dia-
grams or sections of the patient, which are  of course  purely imaginary, and their correctness is
scarcely more than a matter of chance with the artist. Their beauty as pictures is thereby increased
without corresponding utility to the student, as in practice he must for the most part depend for  his
diagnosis upon the relative positions of the foetal skull and the pelvic bones of the mother.  It is,
therefore, desirable that the points upon which he is in future to rely,  should form the basis of  his
instruction, and consequently in the preparation of these illustrations the skeleton has  alone been
used, and the  aid of photography invoked,  by  which  a serie> of representations has been secured of
the strictest and most rigid accuracy.  It is easy to recognize the value thus added to the very full
details on the  subject of the Mechanism of Labour with which the work abounds
  It may  be added I hat no pains or expense have been spared to render the mechanical execution of
the volume worthy in every respect of the character and value of the teachings  it contains.
                           HABERSHON (S. O.),  M.  D.,
   Assistant Physician to and Lecturer on Materia Medica and Therapeutics at Guy's Hospital, &c.
PATHOLOGICAL  AND   PRACTICAL OBSERVATIONS  ON  DISEASES
  OF  THE  ALIMENTARY CANAL, OESOPHAGUS, STOMACH, C/ECUM,  AND INTES-
  TINES.  With illustrations on wood.  In one handsome octavo volume of 312 page., extra
  cloth   $2 -5.
                        HOBLYN  (RICHARD D.), M.  D.

A DICTIONARY  OF  THE  TERMS USED  IN  MEDICINE  AND  THE
  COLLATERAL SCIENCES.  A new American edition.  Revised, with numerous Additions,
  by Isaac Hays, M. D., editor of the" American Journal of the Medical Sciences."  In one large
  royal l2mo. volume, cloth, of over 500 double columned pages.  $1 50.
   To both practitioner and student, we recommend
  this dictionary as being convenient in size, accurate
  in definition, and sufficiently full and complete for
  ordinary consultation —Charleston Med. Journ.
   We know of no dictionary better arranged and
\ adapted.  Itisnotencumbered with theobsoleteterms
  of a bygone age, but it contains all that are now in
use; embracing every department of medical science
down to the very latest date.—Western Lancet.
  Hoblyn's Dictionary has long been a favorite with
us.  It is the best book of definitions we have, and
ought always to be  upon  the student's table.—
Southern Med. and Surg. Journal.
                        JONES (T.  WHARTON), F. R. S.,
          Professor of Ophthalmic Medicine and Surgery in University College, London, Sec.
 THE  PRINCIPLES  AND PRACTICE  OF  OPHTHALMIC  MEDICINE
  AND SURGERY.  With one hundred and seventeen illustrations.  Third and revised Ameri-
  can, with additions from the second London edition.  In  one handsome octavo volume, extra
  cloth, of 455 pages.  $. 00.
  Seven years having elapsed since the appearance of the last edition of this standard work, very
 considerable additions have been found necessary to adapt it thoroughly to the advance of ophthal-
 mic science  The introduction of the ophthalmoscope has resulted in adding greatly to our know-
 ledge of the pathology of the  diseases of the eye, particularly of its more deeply seated tissues, and
 corresponding improvements in medical treatment and operative procedures  have been introduced.
 All these matters the editor has endeavoured to add, bearing in mind the character of the volume as a
 condensed anH practical manual  To accommodate this unavoidable increase in the size of the work,
 its form has been changed from a duodecimo to an octavo, and it is presented as worthy a continu-
 ance of the favour which has been bestowed on former editions.
  A  complete series  of " test-types" for  examining the accommodating power of the eye, will be
 found an important and useful addition.

 JONES (C.  HANDFIELD), F.R.S., &. EDWARD  H.  SIEVEKING,  M.D.,
               Assistant Physicians and Lecturers in St. Mary's Hospital, London.
 A MANUAL  OF  PATHOLOGICAL  ANATOMY.   First American Edition,
  Revised   With three hundred and ninety-seven  handsome wood engravings.  In one large and
  beautiful octavo volume of nearly 750 pages, extra cloth.  S3 50.
  As a concise text-book, containing, in a condensed | obliged to glean fromagreat number of monographs.
form a comp'ete outline of what  is  known  in the  and thefield was soextensivethatbutfewcultivated
domain of Pathological Anatomy, it  is perhaps the  it with any degree of success. As  a simple work
                                           <*  of reference, therefore, it is of great value  to the
                                             student of pathological anatomy, and should be in
                                             .very physician's library.—Western Lancet.
.est work in the Knglish language. Its great merit
consists in its completeness and brevity, and in this
rrsnect it supplies a great desideratum in our lite-
rature  Heretofore  the  student of pathology was 
20
LEA  &  BLANCHARD'S MEDICAL
                   KIRKES (WILLIAM  SENHOUSE),  M.D.,
               Demonstrator of Morbid Anatomy at St. Bartholomew's Hospital, See.

A  MANUAL  OF   PHYSIOLOGY.    A new  American, from the  third and
  improved London edition.  With two hundred illustrations.  In one large and handsome royal
  12mo. volume, extra cloth,  pp. 586. $2 00.
  This is a new and very much improved edition of
Dr. Kirkes' well-known Handbook of Physiology.
It combines conciseness with completeness, and is,
therefore, admirably adapted for consultation by the
busy practitioner.—Dublin Quarterly Journal.
  One of the very best handbooks  of Physiology we
possess—presenting just such an  outline of the sci-
ence as  the student requires during his attendance
upon a course of lectures, or for reference whilsl
preparing for examination.— Am. Medical Journal
  Its excellence is in its compactness, its clearness,
KNAPP'S TECHNOLOGY; or, Chemistry applied
  to the Arts and to Manufactures.  Edited by Dr.
  Ronalds, Dr. Richardson,  and  Prof. W. R.
  Johnson.  In two handsome 8vo. vols, extra cloth,
  with about 500 wood engravings.  $6 00.
 From Professor S. H. Dickson, Charleston, S. C.,
              September 18, 1855.
  A monument of intelligent and well applied re-
search, alme>st without example.  It is, indeed, in
itself, a large library, and is destined to constitute
the special resort as a book of reference, in the
subject of which it treats, to all future time.
  We have not time at present, engaged as we are,
by day and by night, in the work of combating this
very disease, now prevailing in our city, to do more
than give this cursory notice of what we consider
as undoubtedly the most able and erudite medical
publication our country has  yet produced   But in
view of the startling fact, that this, the most malig-
  We know of no better companion for the student I
during the hours spent in the lecture room, or to re-
fresh, at a glance, his memory of the various topics |
f and its carefully cited authorities.  It is the mo3t
.  convenient of text-books. Thesegentlemen, Messrs.
,  Kirkes and Paget, have the gift of telling us what
;  we want to know, without thinking it  necessary
  to tell us all they know.—Boston Med.  and Surg.
  Journal.

    For the student beginning  this study, and the
;  practitioner who has but leisure to refresh his
1  memory, this book is invaluable, as it contains all
  that it is  important to know.—Charleston  Med.
,  Journal.
LAYCOCK'S  LECTURES  ON  THE  PRINCI-
  PLES AND  METHODS OF MEDICAL OB-
  SERVATION AND RESEARCH.  For the Use
  of Advanced  Students and  Junior Practitioners.
  In one royal 12mo. volume, extra cloth. Price91.
nant and unmanageable disease of modern  times,
has for several years been prevailing in our country
to a greater extent than ever before; that it is no
longer confined to either large or small cities, but
penetrates  country villages, plantations, and farm-
houses; that it is treated with scarcely better suc-
cess now than thirty or forty years ago; that there
is vast mischief done by ignorant pretenders to know-
ledge in regard to the disease, and in view of the pro-
bability that a majority of southern physicians will
be called upon to treat the disease, we trust that this
able and comprehensive treatise will be very gene-
rally read in the south.—Memphis Med. Recorder.
I crammed into his head by the various professors to
 whom he is compelled to listen.— Western Lancet,
| May, 1857.        .                           '
                         LALLEMAND  AND  WILSON.

A  PRACTICAL  TREATISE   ON   THE   CAUSES,  SYMPTOMS,  AND
  TREATMENT OF  SPERMATORRHOEA.  By M. Lallemand.  Translated and edited  by
  Henry J McDougall.  Third American edition.  To which is added-----ON DISEASES
  OF THE VESICUL_£ SEMINALES; and their associated organs*  With  special refer-
  ence to the Morbid Secretion* of the Prostatic and Urethral Mucous Membrane.  By Marris
  Wilson, M. D.   In one neat octavo volume, of about 400 pp., extra cloth. $2 50.
                           LA ROCHE (R.),  M. D., &.c.

YELLOW  FEVER, considered in  its  Historical, Pathological,  Etiological, and
  Therapeutical Relations.  Including a Sketch of the Disease as it has occurred in  Philadelphia
  from 1699 to 1854, with an examination of the connections between it and the fevers known under
  the same name  in other parts of temperate as well as in tropical  regions   In  two large  and
  handsome octavo volumes of nearly 1500 pages, extra cloth.  $7 00.
                                   BY THE SAME AUTHOR.

PNEUMONIA; its Supposed Connection, Pathological and Etiological, with Au-
  tumnal Fevers, including an Inquiry into the Existence and Morbid Agency of Malaria.  In one
  handsome octavo volume, extra cloth, of 500 pages.  $3 00.
                              LUDLOW (J. L.),  M. D.

A  MANUAL OF  EXAMINATIONS  upon  Anatomy,  Physiology,  Surgery,
  Practice of Medicine, Obstetrics, Materia Medica, Chemistry, Pharmacy, and Therapeutics.   To
  which is added a Medical Formulary.  Third edition, thoroughly revised and greatly extended
  and enlarged.   With 370 illustrations.   In one handsome royal 12mo. volume, ot 816 large
  page.-, extra cloth, $3 00. 
AND  SCIENTIFIC PUBLICATIONS.
21
                                LEHMANN  (C.  G.)
PHYSIOLOGICAL  CHEMISTRY.   Translated  from  the  second edition by
  George E. Day, M. D., F. R. S., fee, edited by R. E. Rogers, M. D., Profes>or of Chemistry
  in the  Medical Department of the  University of Pennsylvania, with illustrations selected trom
  Funke's Atlas of Physiological Chemistry, and an Appendix of plates.  Complete in two large
  and handsome octavo volumes, extra cloth, containing 1200 pages, with nearly two hundred illus-
  trations.   $6 00.
  The work of Lehmann  stands unrivalled as the I   The most important contribution as yet made to
moBt comprehensive book of reference and informa-I Physiological Chemistry.—Am. Journal Med. Set-
tion extant on every branch of the subject on which I tnces, Jan. 1856.
it treats.—Edinburgh Journal of Medical  Science. \

                                   BY THE SAME AUTHOR.
MANUAL OF  CHEMICAL  PHYSIOLOGY.    Translated from  the German,
  with Notes and Additions, by J. Cheston Morris, M. D., with an Introductory Essay on Vital
  Force, by Professor Samuel Jackson, M. D., of the  University of Pennsylvania.   With illus-
  trations on wood.   In  one very handsome octavo volume, extra cloth, of 336 pages.  $2 25.
                        LYONS (ROBERT  D.), K. C. C,
                Late Pathologist in-chief to the British Army in the Crimea, &c.

A TREATISE ON  FEVER; or, selections from a course of Lectures on Fever.
  Being part of a course of Theory and Practice of Medicine.  In one neat octavo volume, of 362
  pages, extra cloth;  $2 25.  (Just Issued.)
  This is an admirable work upon the most remark-
able and most important class of diseases to which
mankind are liable.—Med. Journ. of N. Carolina.
May, 1861.
  We have great  pleasure in  recommending Dr.
Lyons' work on Fever to the attention of the pro-
fession.  It is a work which cannot fail to enhance
the author's previous well-earned reputation, as a
diligent, careful, and accurate observer.—British
Med. Journal, March 2, 1861.
                          MEIGS (CHARLES D.), M.D.,
         Lately Professor of Obstetrics, &c. in the Jefferson Medical College, Philadelphia.
OBSTETRICS •  THE SCIENCE AND THE  ART.   Fourth edition, revised
  and improved.   With one hundred and twenty-nine illustrations. In one beautifully printed octavo
  volume, of seven hundred and  thirty large pages, extra cloth, $4 .0.

                              From the Author's Preface.
  « [n this edition I have endeavored to amend the work by changes in its form ;  bj careful cor-
potions of manv expressions, and by a few omissions and some additions as to  he text.
  "The StuT.itywul find  ha  I havlrecast the article on Placenta Previa  which I was led to do
out I my desire Z notice certain new modes  of treatment which I regarded as not only ill founded
as to the nhilosoohv of our department, but dangerous to the peop e.
  « I  chanS ffie form of my work by dividing it into paragraphs  or sections, numbered from 1
,,, q«j I  t hn, " hi to ore lent to the reader a common-place book of the whole vol ume  Such a table
s^uVt^^                   «* -tu'to a s,udent whiie  auending puhbhc ,ehcture
   _     i,  rwt,  hnLmnved so extensive a  reputation and has been received with such general
  A work which  has enjoyed so^^ive    P        bored  assidl]0lisly to embody in  his new
favor, requires  only the **»"™™neceYsary to render it fully on a level with the  most advanced
edition whatever  has been found  nece^aryto           ^  ^ & ^.^ ^  of       we

tie epi&K is the°refore to be  hoped that the volume  will be found worthy a continuance of
the confidence reposed in previous editions.

                            BY  the same  author.  (Just Issued.)
woman- HER  DISEASES  AND THEIR  REMEDIES.   A Series  of  Lee-
*E2. t his Sa?  Fourth tid Improved edition.  In one large  and beautifully printed octave
   volume, extra cloth, of over 700 pages
$4 50
  In other respects, in our estimation, too much can-
not be said in praise of this work.  It abounds wth
beautiful passages, and for conciseness fo'origin
ality, and for all that is commendable in a wojkon
the diseases of females, it is not excel ed, and pro
bably not equalled in the English language.  On the
whole, we know of no wor. on the diseases of wo-
men  which we  can so  cordially commend  to the
,™u_en?and practitioneras the one beforeus.-OAt.
Med. and Surg. Journal.
  The body of the hook is worthy of .attentive con-
sideration? and  is evidently the  preiduc ion of. a
clever, thoughtful, »^  ■agaciou" P^Mcian^ ur





rureical Review.                  ,    .   __


of an acute and experienced mind. There is a terse
ness and at the  same time an accuracy in his de-
Stion of symptoms, and in the rules for diagnosis,
which cannot fail to recommend the volume to the
attention of the reader.—Ranking's Abstract.

  It contains a vast amount of practical knowledge,
oy one who has accurately observed and retained
the experience of many years.—Dublin Quarterly
Journal.
  Full of important matter, conveyed in a ready and
agreeable manner.—St.Louis Med. and Surg. Jour.

  There is an off-hand fervor, a glow, and a warm-
heartedness infecting the eff _rt of Dr. Meigs, which
ls entirely captivating, and which absolutely hur-
ries the reader through from beginning to end.   Be-
sides, the  book  teems with solid  instruction, and
it shows  the very highest evidence of ability, viz.,
the clearness  with which the information is  pre-
sented.  We know of no better test of one's under-
standing a subject than the evidence of the power
jf lucidly explaining it.   The most elementary, as
well as the obscurest subjects, under the pencil of
Prof. Meigs, are isolated and made to stand out in
such bold relief, as to produce distinct impressions
upon  the  mind  and  memory of the  reader. — The
Charleston Med. Journal, 
22                   LEA & BLANCHARD'S   MEDICAL
                          MEIGS (CHARLES D.)  M. D.,
           Lately Professor of Obstetrics, &c, in Jefferson Medical College, Philadelphia.

ON  THE   NATURE,   SIGNS,   AND   TREATMENT  OF  CHILDBED
  FEVER.  In a Series of Letters addressed to the Students of his Class.  In one  handsome
  octavo volume, extra cloth, of 365 pages.  $2 00.
  The instructive  and interesting author of this I lectable book. *  *  *  This treatise upon child-
work, whose previous labors have placed his Coun-  bed fevers will have  an extensive sale, being des-
trymen under deep and abiding obligations, again  tined, as it deserves, to find a place in the library
challenges their admiration in the fresh and vigor-  of every practitioner who scorns tolag in the rear.—
ous, attractive and racy pages before us. It is a de- ' Nashville Journal of Medicine and Surgery.
                       MACLISE  (JOSEPH), SURGEON.

SURGICAL ANATOMY.   Forming one volume, very large imperial  quarto
  With sixty-eight large and splendid Plates, drawn in the best style and beautifully colored.  Con-
  taining one hundred and  ninety Figures, many of them the size of life.   Together with copious
  and explanatory letter-press.  Strongly and handsomely bound  in extra cloth, being one of the
  cheapest and best executed Surgical works as yet issued in this country.  $13 00.

   Gentlemen preparing for service in the field  or hospital  will find these plates

of the highest practical value, either for consultation in emergencies or to refresh

their recollection  of the dissecting room.

  %* The size of this work prevents its transmission through the  post-office as a whole, but those
who desire to have copies  forwarded by mail, can receive them in five parts, done up in  stout
wrappers.  Price $11 00.
                                               A work which has no parallel in point of accu-
                                              racy and cheapness in the English language.—N. Y.
                                              Journal of Medicine.
                                               We are extremely gratified  to announce to ths
                                              profession the completion of this truly magnificent
                                              work, which, as a whole, certainly  stands  unri-
                                              valled, both for  accuracy  of drawing, beauty of
                                              coloring, and all the requisite explanations of th«
                                              subject  in  hand.—The New Orleans Medical and
                                              Surgical Journal.

                                               This is by far the ablest work on Surgical Ana-
                                              tomy that  has come under our observation. Wl
                                              know of no other work that would justify a stu-
                                              dent, in any degree, for  neglect of actual dissec-
                                              tion.  In those sudden emergencies that so often
                                              arise, and which require the instantaneous command
                                              of minute anatomical knowledge, a work of this kind
                                              keeps the details of the dissecting-room perpetually
                                              fresh in the memory.—The Western Journal of Medi-
                                              cine and Surgery.
  One of the greatest artistic  triumphs of the age
in Surgical Anatomy.—British American Medical
Journal.
  No practitioner whose means will admit should
fail to possess it.—Ranking's Abstract.
  Too  much cannot be said in its praise; indeed,
we have not language to do it justice.—Ohio Medi-
tal and Surgical Journal.
  The  most accurately engraved  and beautifully
colored plates we have ever seen  in an American
book—one of the best and cheapest surgical  works
ever published.—Buffalo Medical Journal.
  It is very rare that so elegantly  printed, so well
illustrated,  and so useful  a work,  is offered at so
moderate a price__Charleston Medical Journal.
  Its plates can boast a superiority which  places
them almost beyond the reach of competition .—Medi-
cal Examiner.
  Country practitioners will find these plates of im-
mense value.—N. Y. Medical Gazette.
                            MILLER (HENRY), M. D.,
     Professor of Obstetrics and Diseases of Women and Children in the University of Louisville.

PRINCIPLES AND  PRACTICE OF OBSTETRICS, &c.;  including the Treat-
  ment of Chronic Inflammation of the  Cervix and Body of the  Uterus considered  as a frequent
  cause of Abortion.   With about one hundred illustrations on wood.   In one very handsome oc-
  tavo volume, of over 600 pages, extra cloth.  $3 75.
  We congratulate the author that the task is done.
We cemgratulate him that he has given to the medi-
cal public a work which will secure for  him a high
and permanent position among the standard autho
rities on the principles and practice of obstetrics.
Congratulations are not less due to the medical pro-
fession of this country, on the acquisition of a trea-
tise embodying the results of the studies, reflections,
and experience of Prof. Miller.—Buffalo Medical
Journal.
  In fact, thisvolumemust take its place among the
standard systematic treatises on obstetrics; a posi-
tion to which its merits justly entitle it.—The Cin-
cinnati Lancet and Observer.
  A most respectable and valuable addition to our
home medical literature, and  one reflecting credit
alike on the author and the institution to which he
is attached.  The student will find in this work a
most useful guide to his studies; the  country prac-
titioner, rusty in his reading, can obtain from its
pages a fair resume of the modern literature of the
science; and we hope to see this American produc-
tion generally consulted by the  profession.—Vm.
Med. Journal.
                            MACKENZIE  (W.),  M.D.,
                .Surgeon Oculist in Scotland in ordinary to Her Majesty, Sec. Sec.

A PRACTICAL  TREATISE  ON  DISEASES   AND  INJURIES OF  THE
  EYE.  To which is prefixed an Anatomical  Introduction explanatory of a Horizontal Section of
  the  Human Eyeball, by Thomas Wharton Jones, F. R. S.  From the Fourth Revised and En-
  larged London Edition.  With Notes and Additions by Addinell Hewson,  M. D., Surgeon to
  Wills Hospital, &c. &c.  In one very large and handsome octavo volume, extra cloth, with plates
  „„J--------„----„ —._   $6 go.                                                   v
  and numerous wood-cuts
  The treatise of Dr. Mackenzie indisputably holds
the firstplace, and forms, in respect of learning and
research, an Encyclopaedia unequalled  in extent by
my other work of the kind, either English or foreign.
—Dixon on Diseases of the Eye.
  We consider it the duty of every one who has the
love of his profession and the welfare of his patient
at heart, to make himself familiar with this the most
complete work in the English language upon the dis-
eases of the eye__Med. Times and Gazette, 
AND SCIENTIFIC  PUBLICATIONS
23
                          MILLER (JAMES),  F. R. S. E.,
                     Professor of Surgery in the University of Edinburgh, *c.

PRINCIPLES OF SURGERY.   Fourth American, from  the third  and  revised
  Edinburgh edition.  In one large and very beautiful volume, extra cloth, of 700 pages, with
  two hundred and forty illustrations on wood.  $3 75.
                                 BY THE SAMB AUTHOR.

THE  PRACTICE  OF  SURGERY.   Fourth American from  the last  Edin-
  burgh edition.  Revised by the American editor.  Illustrated by three hundred and sixtv-four
  engravings on wood.   In one large octavo volume, extra cloth, of nearly 700 pages.   $3 75.

  No encomium of ours could add to the popularity
of Miller's Surgery.  Its reputation in this country
ia unsurpassed by that of any other work, and, when
taken  in connection with the author's Principles of
Surgery, constitutes  a whole, without reference to
which no conscientious surgeon would be willing to
practice his art.— Southern Med.andSurg. Journal
  It is seldom that two volumes have ever made so
profound  an impression in so short a time as the
"Principles"  and the  "Practice" of Surgery by
Mr. Miller—or so richly merited the reputation they
have acquired.  The author is an  eminently sensi-
ble, practical, and well-informed man, who knows
exactly what he is talking about and exactly how to
talk it.— Kentucky Medical Recorder.
  By the almost unanimous voice of the profession,
his works, both on  the principles and practice of
surgery have been assigned the highest rank.  If we
were limited to but one work on surgery, that one
should be Miller's, as we regard it as superior to all
others.—St. Louis Med. and Surg. Journal.

  The author has in this and his " Principles," pre-
sented to the profession one of the most complete and
reliable  systems of Surgery extant.  His style of
writing is original, impressive, and engaging, ener-
getic, concise, and lucid.  Few have the faculty of
condensing so much in small space, and at the same
time so persistently holding theattention. Whether
as a text-book for students or a book of reference
for practitioners, it cannot be too strongly recom-
mended.—Southern Journal of Med. and Physical
Sciences.
    MORLAND  (W. W.),  M. D.
Fellow of the Massachusetts Medical Society, &c.
DISEASES OF THE URINARY ORGANS; a Compendium of their Diagnosis,
  1>„* U^vl.^n... nnA T1....™.-" ~_ +   1ir;*Vi i Itn-t.. .t ir.na   Tn .\nt* lapcr** onH  hflll Hurting  rtptavn vol limft. of
  Pathology, and Treatment.   With illustrations
  about 600 pages, extra cloth.  $3 50.

  Taken as a whole, we can recommend Dr. Mor-
land's compendium as a very desirable addition to
the library of  every medical  or surgical practi-
tioner.— Brit and For. Med.-Chir. Rev., April, 1859
  Every medical practitioner whose attention  has
been to any extent attracted towards the class of
diseases to which  this treatise relates, must have
often and sorely experienced the want of some full,
yet concise recent compendium to which he  could
  -  -- /    -   i                      ._     -
  In one large and handsome octavo volume, ol


refer. This desideratum has been supplied by Dr
Morland, and it has been ably done.  He has placed
before us  a full,  judicious, and  reliable digest.
Each subject is treated with sufficient minuteness,
yet in a succinct, narrational style, such as to render
the woric one of great interest, and one which will
prove in the highest degree  useful to the general
practitioner.—N. Y. Journ. of Medicine,
                                   BY THE SAME AUTHOR.

THE MORBID  EFFECTS OF  THE  RETENTION  IN  THE  BLOOD OF
  THE  ELEMENTS OF THE URINARY" SECRETION.  Being the Dissertation to which the
  Fiske Fund Prize was awarded, July 11, 1861.  In one  small octavo volume, S3 pages, extra
  cloth.  75 cents.
              MONTGOMERY (W.  F.),  M. D.,  M. R. I. A.,  Sec,
        Professor of Midwifery in the King and Queen's College of Physicians in Ireland, See.

AN EXPOSITION OF THE SIGNS  AND SYMPTOMS OF PREGNANCY.
  With some other Papers on Subjects connected with Midwifery.  From the second and enlarged
  English edition. With two exquisite colored  plates,  and numerous wood-cuts.   In one very
  handsome octavo volume, extra cloth, of nearly 600 pages.   $3 75.
  A book unusually rich in practical suggestions—
Am. Journal Med. Sciences, Jan. 1857.
  These several  subjects so  interesting in them-
selves, and so important, every one  of them, *o the
most delicate and precious of social relations  con-
trolling often the honor and ^"t'C peace o fa
family! the legitimacy of offspring, or the life of its
parent are a I. treated with an elegance  f d ct on,
fulness of illustrations, acutenessand justice of na-
sonine unparalleled in obstetrics, and unsurpassed in
meSe  The reader's interest can never flag, so
fresh, and vigorous, and classical is our author's
style; and one forgets, in the renewed charm of
■wery page, that it, and every line, and every word
has been weighed and reweighed  through years of
preparation;  that this is of all others the book of
Obstetric Law, on each of its several topics; on all
points connected with pregnancy,  to be everywhere
received as a manual  of special jurisprudence, at
once announcing fact, affording argument, establish-
ing precedent, and governing alike the juryman, ad-
vocate, and judge. — N. A. Med.-Chir. Review.
„..,vc,,e msPFNNATORV  AND  THERA-
M^^1aEI|eEmNembrancer. ^VS
  Practical Formula contained in the three Bntisii
  Pharmaeopa.Ias   Edited, with the addition of the
  Formula, of the U. S. Pharmacopee'», bY R.  E.
  Sr.vvith.M.D   1 12mo.vol.ex.cl.,300pp. 75c.
MALGAIGNE'S OPERATIVE SURGERY, based
  on Normal and Pathological Anatomy.  Trans-
  lated from the French by Frederick Brittan,
  A. B.,M.D. Withnumerousillustrationsonwood.
  In one handsome octavo volume, extra cloth, of
  nearly six hundred pages. $2 50. 
24                  LEA &  BLANCHARD'S  MEDICAL
                              NEILL (JOHN), M. D.,
                        Surgeon to the Pennsylvania Hospital,Sec.; and

                      FRANCIS  GURNEY  SMITH,  M. D.,
             Professor of Institutes of Medicine in the Pennsylvania Medical College.

AN ANALYTICAL  COMPENDIUM   OF  THE   VARIOUS  BRANCHES
  OF MEDICAL SCIENCE; for the Use and Examination of Students.  A new edition, revised
  and improved.  In one very large and  handsomely printed royal 12mo. volume, of about one
  thousand pages, with 374 wood-cut., extra cloth, $3"75.  Strongly bound in leather, with raised
  bands.  $4 50.
  This  work is again presented as eminently worthy of  the favor with which it has  hitherto
been received.  As a book for daily reference by the student requiring a guide to his more elaborate
text-books, as a manual for preceptors desiring to stimulate their students by frequent and accurate
examination, or as a source from which the practitioners of older date may easily and cheaply acquire
a knowledge of the changes and improvement in professional science, its reputation is permanently
established.
  The best work  of the  kind with which we are
acquainted.—Med. Examiner.
  Having made free use of this volume in our ex-
aminations of  pupils, we can speak from experi-
ence in recommending it  as an admirable compend
for students, and as especially useful to preceptors
who examine their pupils. It will save the teacher
much  labor by enabling him  readily to recall all of
the  points upon which his  pupils should  be ex-
amined. A work of this sort should be in the hands
of every one who takes pupils into his office with a
view of examining them;  and this is unquestionably
the bestof its class.—Transylvania Med. Journal

  In the rapid course of lectures, where  work for
the students is heavy, and review necessary for an
examination, a compend  is not only valuable, but
it is almost a sine qua non.  The one before us is,
in most of the divisions, the most unexceptionable
of all books of the kind that we know of.  The
newest and soundest doctrines and the latest im-
provements and discoveries are explicitly,  though
eoncisely, laid before the student.  There is a class
to whom we very sincerely commend this cheap book
as worth its weight in silver—that class is the gradu-
ates in medicine of more than ten years' standing.
who  have not studied medicine since.  They will
perhaps find out from it that the science is not exactly
now what it was when they left it off.—The Stetht-
scope.
               NELIGAN (J.  MOORE), M. D.,  M.  R. I. A., «tc.

ATLAS  OF  CUTANEOUS DISEASES.   In one beautiful quarto volume, extra
  cloth, with splendid colored plates, presenting nearly one hundred elaborate representations of
  disease.   $5 50.
  This beautiful volume is intended as a complete and accurate  representation of  all the varieties
of Diseases of the Skin.  While it can be consulted in conjunction with any work on Practice, it has
especial reference to the author's " Treatise on Diseases of the Skin,"  so favorably received by the
profession some years since.  The publishers feel justified in saying that few more beautifully exe-
cuted plates have ever been presented to the profession of this country.
                                             give, at a coup d'ceil, the remarkable peculiarities
                                             of each individual variety.  And while thus the dis-
                                             ease is rendered more definable, there is yet no loss
  Neligan's Atlas of Cutaneous Diseases supplies a
long existent desideratum much felt by the largest
class of our profession.  It presents, in quarto size,
16 plates, each containing from 3 to 6 figures, and
forming in all a total of 90 distinct representations
of the different species of skin affections, grouped
together in genera or families.  The illustrations
have been taken from nature, and have been copied
with such fidelity that they present a striking picture
of life; in which the reduced scale aptly serves to
of proportion incurred by the necessary concentra-
tion. Each figure is highly colored, and so truthful
has  the artist been that the most fastidious observer
could not justly take exception to the correctness of
the  execution of the pictures under his scrutiny.—
Montreal Med. Chronicle.
BY THE SAME AUTHOR.
A  PRACTICAL  TREATISE  ON  DISEASES OF THE  SKIN.   Fourth
  American edition.  In one neat royal 12mo. volume, extra cloth, of 334 pages.  $1  50,
OWEN  ON THE  DIFFERENT FORMS OF I
  THE SKELETON, AND OF  THE TEETH.]
One vol. royal 12mo., extra cloth  with numerous
illustrations. SI 25
                        PI RRIE (WILLIAM), F. R. S. E.,
                      Professor of Surgery in the University of Aberdeen.
THE   PRINCIPLES AND  PRACTICE  OF SURGERY.   Edited by John
  Neill, M. D., Professor of Surgery in the Penna. Medical College, Surgeon tothe Pennsylvania
  Hospital, &c. In one very handsome 8vo. volume, extra cloth, of 780 pages, with 316 illustrations.
  $3 75.
  We know of no other surgical work of a reason-
able size, wherein there is so much theory and prac-
tice, or where subjects are more soundly or clearly
taught.—The Stethoscope.
  Prof. Pirrie, in the work before  us, has elabo-
rately discussed the principles of surgery, and a
safe and effectual practice predicated upon them.
Perhaps no work upon this subject heretofore issued
is so full upon the science of the art of surgery.—
Nashville Journal of Medicine and Surgery.
                             PARKER (LANGSTON),
                        Surgeon to the Queen's Hospital, Birmingham.

THE  MODERN  TREATMENT OF SYPHILITIC DISEASES, BOTH  PRI-
  MARY AND SECONDARY; comprising the Treatment of Constitutional and Confirmed Syphi-
  lis, by a safe and successful method.  With numerous Cases, Formulas, and Clinical Observa-
  tions. From the Third and entirely rewritten  London edition   In one neat octavo volume
  extra cloth, of 316 pages.  $2 50.                                                        ' 
AND SCIENTIFIC  PUBLICATIONS.                  25
                                PARRISH (EDWARD),
 _  m-r.T-1 » mTo?TofesROr of Materia Medica in the Philadelphia College of Pharmacy.
A TREATISE  ON  PHARMACY.   Designed  as a Text-book  for the  Student,
  and as a Guide for the Physician and Pharmaceutist.  With many Formulae and Prescriptions.
  Ihird  edition, greatly improved.  In one handsome octavo volume, of 850 pages, with several
  hundred Illustration;-, extra cloth.  $5 00.  (Just Ready.)
  Though for some time out  of print, ihe  appearance of a new edition of this work has been de-
 ayed for the purpose of embodying in it  the results of  the new U. S. Pharmacopoeia.  The pub-
lication of this latter has enabled the author to complete  his revision in the most thorough manner.
Those who have been waiting for the work may therefore rely on obtaining a volume completely
on a level with the most advanced condition of pharmaceutical science.
  The favor with which  the  work has thus far been received shows that the  author was not mis-
taken in his estimate of the want of a  treatise which should serve  as a practical text-book for all
engaged  in preparing and dispensing medicines.  Such a guide was indispensable not only to the
educated pharmaceutist, but  also to that large class of practitioners throughout the country wfio
are obliged to compound their own  prescriptions, and who during their collegiate course have no
opportunity of obtaining a  practical familiarity wilh the necessary processes and manipulations.
The rapid exhaustion of two  large editions is evidence that the author has succeeded in thoroughly
carrying out his object.  Since the  appearance of the last edition, much has  been done to perfect
the science ;  the new Pharmacopoeia has  introduced many changes to which the profession must
conform ; and the  author has labored assiduously to embody in his work all that physicians and
pharmaceutists can ask.for in such a volume.  The new matter alone will thus be found worth
more than the very moderate cost of the work to those who have been using the previous editions.
  All that we can say of it is that to the practising
physician, and  especially the country physician,
who is generally his own apothecary, there is hard-
ly any boon that might not better be dispensed with.
It is at the same time a dispensatory and a pharma
cy.—Louisville Review.
  A careful examination of this work enables us to
speak of it in the highest terms, as being the best
treatise on practical pharmacy with which we are
acquainted, and an invaluable vade-mecum, not only
to the  apothecary and to those  practitioners who
are accustomed to prepare their own medicines, but
to every medical man and medical student.—Boston
Med. and Surg. Journal.
  This is  altogether one of the most useful books
we have seen.  It is just what we have long felt to
be needed by apothecaries, students, and practition-
ers of medicine, most of whom in this country have
to put up  their own  prescriptions.   It bears, upon
every  page, the impress of practical knowledge.
conveyed  in a plain common sense manner,  und
adapted to the comprehension of all who may read
it__Southern  Med. and Surg. Journal.
  That Edward Parrish, in writing a  book upon
practical Pharmacy some few years ago—one emi-
nently original  and  unique—did the medical  and
pharmaceutical professions a great and valuable ser-
vice, no one, we think, who has had access to its
pages will deny; doubly welcome, then, is this new
edition, containing the added results of his recent
and rich experience as an  observer, teacher, and
practic tl operator in the pharmaceutical laboratory.
The excellent plan of the first is more thoroughly,
—Peninsular Med. Journal, Jan. 1860.
  Of course, all apothecaries who have not already
a copy of the first edition will procure one of this;
it is, therefore, to physicians residing in  the country
and in small towns, who cannot avail themselves of
the skill  of  an educated pharmaceutist, that  we
would  especially commend  this work.  In it they
will  find all  that they  desire to know, and  should
know, but very little of which they do really .now
in reference to  this important collateral branch of
their profession; for it is a well established fact,
that, in the education of physicians, while the sci-
ence of medicine  is generally well taught, very
little attention is paid to the art of preparing them
for use, and we know not how this defect can be so
well remedied as by procuring and consulting  Dr.
Pairish's excellent work.—St. Louis Med. Journal,
Jan.1860.

  We know of no work on the subject which would
be more indispensable  to the physician or student
desiring information on the subjectof which it treats.
Wilh Griffith's " Medic.il Formulary" and this, the
practising physician would  be supplied with nearly
or quite all the most useful infornation on the sub-
ject.—Charleston Med. J our. and Review, Jan. 1860.
                              PEASLEE  (E. R.),  M. D.,
         Professor of Physiology and General Pathology in the New York Medical College.
HUMAN  HiSTOLOGr-., in its relations to Anatomy, Physiology, and Pathology j
  for the use of Medical Students.   With four hundred and thirty-four illustrations.  In one hand-
  some octavo volume, extra cloth, of over 600 pages.  $3 75.
  It embraces a library upon the topics discussed
within itself, and is just what the teacherand learner
need.  We have not only the whole subject of His-
tology , interesting in itself, ably and fully discussed,
but what is ot infinitely greater interest to the stu-
dent, because of greater practical value, are its re-
lations to Anatomy, Physiology, and Pathology,
which are here fully and satisfactorily set forth.—
Nashville Journ. of Med. andSurgery.
  We would recommend it as containing a summary
of all that is known of the important subjects which
it treats; of all that is in the great works of Simon
and Lehmann, and the organic chemists in general.
Master this one volume, and you  know all that is
known of the great fundamental principles of medi-
cine, and we have no hesitation in saying that it
is an honor to the American medical profession.__
St.Louis Msd.andSurg^ Journal.
                          ROKITANSKY
    Curator of the Imperial Pathological Museum,
A  MANUAL   OF  PATHOLOGICAL
  bound in two, extra cloth, of about 1200 pages.
  king, C. H. Moore, and G. E. Day.   $7 00.
  The profession is too well acquainted with the re-
putation of Rokitansky's work to need »»'"■«-
_nce that this is one of the most profound, thorough
and valuable  books  ever issued from the medical
press   It is sui generis, and has no ■t"da«i «f corn
parison. It is only necessary to announce that it
issued in a form as cheap as  is compatible with its
(CARL),  M. D.,
and Professor at the University of Vienna, &c.
  AN ATOM Y.   Pour  volumes,  octavo.
  Translated by W. E. Swaine, Edward Sieve-

 size and preservation, and  its sale  follows as a
 matter of course.  No library can be called com-
 plete without it.—Buffalo Med. Journal.
  An attempt to give our readers any adequate idea
 of  the vast  amount of instruction accumulated in
 these volumes, would be feeble and  hopeless__
 Western Lancet.
l.BU.u ill a. i.»«» —« —---_

ROYLE'-S  MATERIA  MEDICA  AND  THERAPEUTICS;  including  the
  Pr^oarations ot the Pharmacopoeias of Lon. .n, Edinburgh, Dublin, and of the United States
  With many new medicines.  Edited by Joseih Carson, M. D.  With ninety-eight illustration.'
  In one large octavo volume, extra cloth, of-bout 700 pages.  $3  00. 
26
LEA  &  BLANCHARD'S  MEDICAL
                          RIGBY  (EDWARD), M.D.,
                    Senior Physician to the General Lying-in Hospital, Sec.

A  SYSTEM  OF  MIDWIFERY.   With  Notes and  Additional Illustrations.
  Second American Edit^pn. One volume octavo, extra cloth, 422 pages. $2 50.
                                BY  THE SAME AUTHOR.

ON THE CONSTITUTIONAL  TREATMENT OF  FEMALE DISEASES.
  In one neat royal 12mo. volume, extra cloth, of about 250 pages.  $1 00.
                    RAMSBOTHAM  (FRANCIS H.),  M.D.

THE  PRINCIPLES  AND PRACTICE  OF OBSTETRIC MEDICINE AND
  SURGERY, in reference to the Process of Parturition.  A new and enlarged edition, thoroughly
  revised by the Author.  WithAdditionsby W. V. Keating,M. D., Professor of Obstetrics, &c, in
  the Jefferson Medical College, Philadelphia.  In one large and handsome imperial octavo volume,
  of 650 pages, strongly bound in leather, with raised bands; with sixty-four beautiful Plates, and
  numerous Wood-cuts in the text, containing in all nearly 200 large and beautiful figures. $7 00.

                         From Prof. Hodge, of the University of Pa.
  To the American public, it is most valuable, from its intrinsic undoubted excellence, and as being
the best authorized exponent of British Midwifery.  Its circulation will, I trust, beextensive throughout
our country.
  It is unnecessary to say anything in regard to the
utility of this work. It is already appreciated in our
country for the value of the matter, the clearness of
its style, and the fulness of its illustrations. To the
physician's library it is indispensable, while to the
student as a text-book, from which to extract the
material for laying the foundation of an education on
obstetrical  science, it has no superior.—Ohio Med.
and Surg. Journal.
  The publishers have secured its success by the
truly elegant style in which they have brought it
out, excelling themselves in its production, espe-
cially in its plates.  It is dedicated to Prof. Meigs,
and has the  emphatic endorsement of Prof. Hodge,
as the best  exponent of British Midwifery.  We
know of no text-book which deserves in all respects
to be more highly recommended to students, and we
could wish to see it in the handsof every practitioner,
for they will find it invaluable for reference.—Med.
Gazette.
                               RICORD  (P.),  M. D.
A TREATISE ON THE VENEREAL DISEASE.   By John Hunter, F. R. 8.
  With copious Additions, by Ph Ricord, M.D. Translated and Edited, with Notes, by Freeman
  J. Btjmstead, M.D., Lecturer on Venereal at the College of Physicians and Surgeons, New York.
  Second edition, revised, containing a resume of Ricord's Recent Lectures on Chancre.  In
  one handsome octavo volume, extra cloth, of 550 pages, with eight plates. $4 00.
                                BY THE SAME AUTHOR.

RICORD'S LETTERS ON SYPHILIS.  Translated by W. P. Lattimore, M. D-
  In one neat octavo volume, of 270 pages, extra cloth.  $2 00.
   SMITH  (HENRY H.), M. D., AND  HORNER (Wl LLI AM  E.), M. D.
AN  ANATOMICAL ATLAS, illustrative of the Structure of the Human Body.
  In  one volume, large imperial octavo, extra cloth, with about six hundred and fifty beautiful
  figures.  $4 50.
  The plan of this Atlas, which renders it so pe-
culiarly convenient for the student, and its superb
artistical execution, have been already pointed out.
We must congratulate the student upon the comple-
tion of this Atlas, as it is the most convenient work
of the kind that has yet appeared ; and we must add.
the very beautiful manner in which it is " got up''
is so creditable to.the country as to be flattering
to our national pride—American Medical Journal.
                  SMITH (EDWARD),  M.D., LL.D., F.R.S.
    Assistant Physician to the Hospital for Consumption and Diseases of the Chest, Brompton, &c.

CONSUMPTION;  ITS EARLY  AND  REMEDIABLE  STAGES.   In one
  neat octavo volume of 254 pages, extra cloth.  $2 25.  (Now Ready.)
  One-half of Dr. Smith's work is devoted to the i than to drugs in the treatment of the disease.  In
treatment of Tuberculosis. We find in this portion | taking leave of the work, we would express the
of the work no occasion to^join issue with the au- j hope that the author will furnish occasions for the
thor j but, on the contrary, much which we would  renewal of our intercourse as  a reader, if not as a
commend to the reader's attention. Dr. Smith at- I reviewer.—Am. Med. Journal, Jan. 1863.
taches far greater importance to hygienic measures I
      SHARPEY  (WILLIAM), M. D.,  JONES  QUAIN,  M. D., AND
                       RICHARD QUAIN,  F. R. S., &c.

HUMAN ANATOMY.   Revised, with Notes and Additions, by Joseph Leidt
  M. D., Professor of Anatomy in the University of Pennsylvania.   Complete in two large octav(
  volumes, extra cloth, of about thirteen hundred pages.  With over 500 illustrations.  $6 00.
SOLLY ON THE HUMAN BRAIN; its Structure.
  Physiology, and Diseases.  From the Second ana
  much enlarged London edition.  In  one  octavo
  volume, extra cloth, of 500 pages, with 120 wood-
  cuts. $_ 50.
SKEY'S OPERATIVE SURGERY.  In one very
  handsome octavo volume, extra cloth, of over 65
  pages, with about one hundred wood-cuts. $3 25
SIMON'^ GENERAL PATHOLOGY, as condnc
  ive to the  Establishment of Rational Principle
  for the prevention and Cure of Disease   In  on
  octavo volume, extra cloth, of 212 pages. SI 25 
AND SCIENTIFIC  PUBLICATIONS.
27
                             STILLE  (ALFRED),  M.D.,
          Professor of the Theory and Practice of Medicine in the University of Pennsylvania.

THERAPEUTICS AND  MATERIA MEDICA;  a Systematic Treatise on  the
  Action and Uses of Medicinal Agents, including their Description and History.  Second Edition,
  revised and enlarged.  In two large and handsome octavo volumes, extra cloth.  $10 00.  (Now
  Ready.)

  This work is designed especially for the student and practitioner of medicine, and treats the various
articles of the Materia Medica from the point of view of the bedside, and not of the shop or of the
lecture-room.   While thus endeavoring to give all practical  information likely to be useful with
respect to the employment of special remedies  in special affections, and  the results to be anticipated
from their administration, a copious Index of Diseases and their Remedies renders the work emi-
nently fitted for reference'by showing at a glance the different means which have  been employed,
and enabling the practitioner to extend his resources in difficult ca.es with ail that the experience
of the profession has suggested.
  The speedy demand for another edition of this work shows that it has acceptably filled an acknow-
ledged want   No exertion of the author has been wanting to render it worthy a continuance of the
favor with which it has been  received, while  an alteration in the typographical arrangement has
accommodated the additions without increasing unduly the size of the volumes.
                                               tioned, Still.. His great work on et Materia Medi-
                                               ca and Therapeutics," published last year, in two
                                               octavo volumes,  of some sixteen hundred pages,
                                               while it embodies the results of the labor of others
                                               up to the time of publication, is enriched with a
                                               great amount of  original observation and research.
  Rarely, indeed, have we had  submitted to us a
work on medicine so ponderous in its dimensions
as that now before us, and yet so fascinating in its
contents.  It is, therefore, with a peculiar gratifi-
cation that we recognize in Dr. Still,  the posses-
sion of many of those more distinguished qualifica-
tions which entitle him to approbation, and which
justify him in  coming before his medical brethren
as an  instructor.   A comprehensive  knowledge,
tested by a sound and penetrating judgment, joined
to a love of progress —which a discriminating spirit
of inquiry has tempered so as to accept nothing new
because it is new, and abandon nothing old because
it is old, but which estimates either accord ing to its
relations to a just logic and experience—manifests
itself everywhere, and gives to the guidance of the
author all  'he assurance of safety which the diffi-
culties of his subject can allow.  In conclusion, we
earnestly advise our readers to ascertain  for them-
selves, by a study of Dr. Stille's volumes, the great
value and interest of the stores of knowledge they
present.  We  have pleasure  in referring rather  to
the ample treasury of undoubted truths, the real and
assured conquest of medicine, accumulated by Dr.
Stille in his pages; and commend the sum of his la-
bors to the attention of our readers, as alike honor-
able to our science, and  creditable to the zeal, the
candor, and the judgment of him who has garnered
the whole so carefully.—Edinburgh Med. Journal.
  The most recent authority is the one  last men-
We would draw attention, by the way, to the very
convenient mode in which the Index is arranged in
this work. There is first an " Index of Remedies;'
next an "Index of Diseases and their Remedies."
Such an arrangement of the Indices, in our opinion,
greatly enhances the practical value of books of this
kind.  In tedious, obstinate cases of disease, where
we have to try one remedy after another until our
stock is pretty nearly exhausted, and we are almost
driven to our wit's end, such  an index as the second
of the two  just mentioned, is precisely what  we
want.—London Med. Timesand Gazette, April, 1861.
  We think this work will do much to obviate  the
reluctance to a thorough investigation of this branch
of scientific study, for in the  wide range of medical
literature treasured in the English tongue, we shall
hardly find a work written in  a style more clear and
simple, conveying forcibly the facts taught, and yet
free from turgidity and redundancy.  There is a fas-
cination in  its pages that will insure to it a wide
popularity and attentive perusal, and a degree of
usefulness not often attained  through the influence
of a single work.
                              SIMPSON  (J.  Y.), M. D.,
                Professor of Midwifery, &c, in the University of Edinburgh, &c.

CLINICAL  LECTURES  ON  THE   DISEASES  OF  WOMEN.   With  nu-
  merous illustrations.  In one handsome octavo volume, of over 500 pages, extra cloth, $4 00.
  This valuable work having passed through the columns of " The Medical News and Library"
for I860 18.1  and 1862, is now completed, and may be had separate in one handsome volume.
  The nrinciDal topics embraced in the Lectures are Vesico-Vaginal Fistula, Cancer of the Uterus,
Treatment of Carcmoma by Caustics, Dysmenorrhoea, Amenorrhoea,  Closures, Contractions, &c,
of. hevSina  Vulvitis,  Causes of Death after Surgical Operations, Surgical Fever, Phlegmasia
nolens Coccvodinia, Pelvic Cellulitis, Pelvic Haematoma, Spurious Pregnancy, Ovarian Dropsy,
Ovariotom^CraSocla.tn, Diseases of the Fallopian Tubes, Puerperal Mania, Sub-Involution and

S^inS_?B0of min^S           important topics-many of which receive little attention
inVvl ^ZZl text-hooks—elucidated with the extensive experience and readiness of resource for
rttC2Sil?«?» distinguished, there are few practitioners who will  not find in its
Wes matter of the utmost importance in the treatment of obscure and difficult cases.


                              SALTER (H.  H.),  M. D.

ASTHMA-  its  Pathology, Causes,  Consequences, and Treatment.   In one  vol.
  8vo  extra cloth    (Just Issued.)   $2 50.
     '   .    ...  ci^r'R work which is devoted  and this we shall little regret, if, by our silence,
  The portion ot SJ r. oauei _vv .   tereB[and value,  we should induceour readers to possess themselves
to treatment, is ot great practical nil               of the book itself; a book which, without uoubt.de-
It would be necessary to ^liow u  j    i^j ^^  serves t0 be rani£ed among the most valuable of re-
in his remarks, not only on/n , " nf of th'edisease,  cent contributions to the medical literature of this
on the dietetic and hygienic treaimeuiu             country.-Ranking's Abstract, Jan., 1S61.
                               SLADE  (D.  D.), M.  D.
riTPTTTTTFRIA •  its Nature and Treatment, with an account of  the History of
  ftf Prevalence in Various  countries.  Second and  revised edition.  In one  neat royal 12mo.
  volume, extra cloth.  $125.  (Now Beady.) 
28                  LEA  &  BLANCHARD'S  MEDICAL
                            SARGENT (F. W.), M. D.
ON BANDAGING  AND OTHER  OPERATIONS OF MINOR  SURGERY.
  New edition, wilh an additional chapter on Military Surgery.  One handsome royal 12mo. vol.,
  of nearly 400 page:-, with 184 wood cuts.   Extra cloth, $1 75.
  The value of this work as a handy and convenient manual for surgeons engaged in active duty, has
induced the publishers to render it more complete for those purposes by the addition of a chapter
on gun-shot wounds and oiher  matters peculiar to military surgery.   In its present form, there-
fore, it will be found a very cheap and  convenient vade-mecum  for consultation and reierence in
the daily exigencies of military as well as civil practice.
                                              The instruction given upon the subject  of Ban-
                                            daging, is alone of great value, and while the author
                                            modestly proposes to instruct the students of medi-
                                            cine, >md the younger physicians, we will  say that
                                            experienced physicians will, obtain many exceed-
 • We consider that no better book could be placed
in the hands of an hospital dresser, or theyoung sur-
geon, whose education in this respect has not been
perfected  VVt most cordially commend this volume
as one which the medical student should most close
ly study, to perfect himself in  these minor surgical
operations in which neatness and dexterity are so
much itquirtd, and on which a great portion of his
reputation as a future surgeon must evidently rest.
Arid to the surgeon in practice it must prove itself
a valuable volume, as instructive on many points
  hich he  may have forgotten.—British American
  ■ urnal, May, 1862.
ingly valuable suggestions by its perusal.  It will
be found one of the mo.t satisfactory manuals for re-
ference in the field, or hospital yet published;  thor-
oughly adapted to the wants  of Military surgeons,
and at the same time equally useful for ready and
convenient reference by surgeons everywhere.—
Buffalo Med. and Surg. Journal, June, 1862.
                          SMITH (W.  TYLER), M. D.,
                       Physician Accoucheur to St. Mary's Hospital, Sec.
ON  PARTURITION,  AND   THE  PRINCIPLES  AND  PRACTICE  OF
  OBSTETRICS.  In one royal 12mo. volume, extra cloth, of 400 pages.   $1 50.
                                 BY THE SAME AUTHOR.
A PRACTICAL  TREATISE  ON  THE PATHOLOGY AND TREATMENT
  OF  LEUCORRHCEA   With numerous illustrations.  In  one  very handsome octavo volume,
  extra cloth, of about 250 pages.  $2  00

                            TANNER  (T.  H.),  M. D.,
                          Physician to the Hospital for Women, Sec.

A MANUAL OF CLINICAL  MEDICINE  AND PHYSICAL  DIAGNOSIS.
  To  which  is  added  The Code of Ethics ol the  American  Medical Association.  Third
  American Edition.  In one neat volume, small 12mo., extra cloth.  (Preparing.)

                    TAYLOR (ALFRED  S.),  M. D., F. R. S.,
               Lecturer on Medical Jurisprudence and Chemistry in Guy's Hospital.
MEDICAL JURISPRUDENCE.   Fifth American, from the seventh improved
  an<H enlarged London edition. With Notes and References to American Decisions, by Edward
  Hartshorne, M. D. In one large 8vo. volume, extra cloth,  of over 700 pages.  $3 75.
  This standard work having had the advantage of two revisions at the hands of the aulhor since
the appearance of the last American edition, will  be found thoroughly revised and brought up com-
pletely to the present state of the science.   As a work of authority, it must therefore maintain its
position, both as a text-book for the student, and a compendious treatise to which the practitioner
can at all times refer in cases of doubt or difficulty.
                                             American and British legal medicine.  It should be
  No work upon the subject can be put into the
hands of students either of law or medicine which
will engage them more closely or profitably j  and
none could be offered to the busy practitioner of
either calling, for the purpose of casual  or hasty
reference, that would be more likely toafford the aid
desired.  We therefore recommend it as the best and
Bafest manual for daily use.—American Journal oj
Medical Sciences.
  It is uot excess of praise to say that the volumt
in the possession of every physician, as the subject
is one of great and increasing importance to the
public as well as to the profession.—Si. Louis Med.
and Surg. Journal.

  This work of Dr. Taylor's is generally acknow-
ledged to be one of the ablest extant on the subject
of medical jurisprudence.  It is certainly one of the
most attractive boiiks that we have met with ; sup-
plying so much both  to interest and instruct, that
we do not hesitate to affirm that after  having once
commenced its perusal, lew could be prevailed upon
to desist before completing it.  In the  last London
edition, all the newly observed and accurately re-
corded facts have been inserted, including much
that is recent of Chemical, Micro, copicul,. and Pa-
thological research, besidt s papers on numerous
subjects  never before published__Charleston  Med.
before us is the very best treatise exlant on Medical
Jurisprudence.  In saying this, we do not wish tc
be understood as detracting from  the merits of tht
excellent works  of Beck, Ryan, Traill, Guy, and
others; but in interest and value  we think it, must
be conceded that Taylor is superior to anything that
has preceded it.—TV. W. Medical and Surg. Journal  j
  It is at once comprehensive and eminently prac-
tical, and by universal consent stands at the head of I Journal and Review.
                                 B_  THE SAME AUTHOR.
ON POISONS, IN  RELATION  TO  MEDICAL  JURISPRUDENCE  AND
  MEDICINE.   Second American, from a second and revised London edition.  In one large
  octavo volume, of 755 pages, extra cloth.  $4 50.
  Mr. Taylor's position as the leading medical jurist of England, has conferred on him extraordi-
nary advantages in acquiring experience on these subjects, nearly all cases of moment being
referred to him for examination,  as an expert  whose testimony  is generally accepted as final.
The results of his labors, therefore, as gathered together in this volume, carefully weighed  and
suied, and presented in  the clear and intelligible style for which  he i» noted, may be received
as an  acknowledged authority, and  as a guide  to be followed with implicit confidence.
                         BY THE SAME AUTHOR AND WM.  BRANDS.
CHEMISTRY.   In  one volume i>vo.  See "Brande," p. 6. 
AND  SCIENTIFIC PUBLICATIONS.
29
                TODD (ROBERT BE NT LEY), M. D., F. R. S.,
                    Professor of Physiology in King's College, London; and
                         WILLIAM  BOWMAN, F.R. S.,
                     Demonstrator of Anatomy in King's College, London.
THE PHYSIOLOGICAL ANATOMY AN i) PHrSIOLOGrV OF MAN.  With
  about three hundred large and beautiful illustrations  on wood.   Complete in one large  octavo
 ■ volume, of y50 pages, extra cloth.   Price $4 75.
  It is more concise than Carpenter's Principles, and
more modern than the accessible edition of Mailer's
Elements; its details are brief, but sumcierjt; itt
descriptions vivid; its illustrations exact and oopi-
ous; and its language terse and perspicuous.
Charleston Med. Journal.
  A magnificent contribution to British medicine,
and the American physician who shall fail to peruse
it, will have failed to read one of the most instruc-
tive books of the uineieenth century.—N. O. Med.
%nd Surg. Journal.
                      TODD (R.  B.)  M. D., F.  R. S., &c.
CLINICAL  LECTURES  ON  CERTAIN  DISEASES  OF  THE  URINARY
  ORGANS AND ON  DROPSIES.  In one octavo volume, 284 pages, extra cloth.  $2 50.
                                 BY THE SAME AUTHOR.
CLINICAL  LECTURES  ON CERTAIN  ACUTE DISEASES.    In one  neat
  octavo volume, of 320 pages, extra clotn.  $- 50.
                         TOYNBEE (JOSEPH),  F. R. S.,
               Aural Surgeon to, and Lecturer on Surgery at, St. Mary's Hospital.
A PRACTICAL  TREATISE  ON  DISEASES  OF  THE  EAR;  their Diag-
  nosis, Pathology, and Treatment.  Illustrated with one  hundred  engravings on wood.  In one
  very handsome octavo volume, extra cloth, $4 00
  The work is a model of its kind, and every page
and paragraph of it are worthy of the most thorough
study.  Considered all in all—as an original work,
well written, philosophically elaborated, and happi-
ly illustrated with cases and drawings—it is by far
the ablest monograph that has ever appeared on the
anatomy and diseases of the ear. and one of the most
valuable contributions to the art and science of sur-
gery in the nineteenth century.—iV. Amer. Medico-
Chirurg Review, Sept. 1860.
  We are speaking within the limits of modest ac-
knowledgment,  and with a sincere and unbiassed
judgment, when we affirm that as a treatise on Aural
Surgery, it is without a rival in our language or any
other.—Charleston Med Journ  and Rev., Sept. 1860.
  The work of Mr. Toynbee is undoubtedly, upon
the whole, the most valuable production of the kind
in any language.  The author has long ueen known
by his numerous monographs  upon subjects con-
nected with diseases of the ear, and is now regarded
as the highest authority on most points in his de-
partment  of science.  Mr. Toynbee's work, a. we
have already said, is undoubtedly the most reliable
guide for the study of  the diseases of the ear in any
language, and should be in the library of every phy-
sician.— Chicago Med. Journal, July, 1860.
                   WILLIAMS (C.  J. B.),  M.D.,  F. R. S.,
                Professor of Clinical Medicine in University College, London, Sea.

PRINCIPLES  OF MEDICINE.   An Elementaly View  of the  Causes, Nature,
  Treatment, Diagnosis, and Prognosis of Disease;  with  brief remarks on Hygienics, or the pre-
  servation of health.  A new American, from the third and revised London edition,  lnoneoctavo
  volume, extra cloth, of about 500 pages.  $3 50.   (Now Ready.)

                              WHAT  TO  OBSERVE
AT   THE  BEDSIDE  AND   AFTER   DEATH,  IN  MEDICAL  CASES.
  Published under the authority of the London Society for Medical Observation.   A new American,
  from the second and revised London edition.  In one very handsome volume, royal 12mo., extra
  cloth.  $1 00.
  To the observer who prefers accuracy to blunders I   One of the finest aids to a young practitioner w.
and precision to carelessness, this little book is in- have ever seen— Peninsular Journal of Medicin*.
valuable.—N. H. Journal of Medicine.         ^J_________

                            WALSHE (W.  H.)s  M. D.,
       Professor of the Principles and Practice of Medicine  in University College, London, &c.

A PRACTICAL  TREATISE ON DISEASES OF THE  LUNGS; including
  tv,^.  Prin. inle* of Phv*ical Diagnosis.  Third American, from the  third revised and much en-
  Lfflon edition.  In one°vol. octavo, of 4.8 pages extra cloth   .3 00.
  The „re«ent edition has been  carefully revised and much enlarged, and may be said in the main
to be  rewritten.   Descriptions of several diseases, previously omitted, are now introduced; an
effort  hasbeen made to bring tne  description of anatomical characters to the level of the wants of
.henracUcaTphysician; and the  diagnosis and prognosis of  each complaint are more completely
considered1  The  sections  on Treatment and the Appendix  have, especially, been largely ex-
tended.—Author's Preface.
                                 BY THE SAME  AUTHOR.

 a PRACTICAL  TREATISE ON  THE  DISEASES OF THE  HEART  AND
  nxtv Tt VESSELS including the Principles of Physical Diagnosis   Third American, from the
  third revised and much enlarged London edition.  In one handsome octavo volume of 420  pages,
  extra, cloth-  $3 00.
  The present edition has been carefully revised ; much new matter has been added, and the entire
work  in a measure remodelled.  Numerous facts and discissions, more or le>s completely novel,
Zm\be found in the description of the principles of physical d.agnos.s; but the chief additions have
^1 n made in the practical portions of the book,  beveral  affections, of which little or no account
h d been °-iven in the previous editions, are now treated of in detail.—Author's Preface. 
30                   LEA &  BLANCHARD'S  MEDICAL
LECTURES   ON
                          New and much enlarged edition.
                       WATSON (THOMAS),  M. D.,  tc,
                        Late Physician to the Middlesex  Hospital, &c.
                       THE  PRINCIPLES   AND  PRACTICE  OF  PHYSIC.
             t King's  College, London.  A new American,  from the  last revised and enlarged
  English edition, with Additions, by D. Francis Condie, M. D., author of " A Practical Treatise
  on the Diseases of Children," &c.  With one hundred and eighty.five illustrations on wood.  In
  one very large and handsome volume, imperial octavo, of over  1200  closely printed pages in
  small type; extra cloth, $6 00;  strongly bound in leather, with raised bands, $7 00.
  That the high  reputation of this work might be fully maintained, the author has subjected it to a
thorough revision;  every portion has been examined with the aid of the most recent researches
in pathology, and the  results of modern investigations in both theoretical and practical subjects
have been carefully weighed  and  embodied throughout its pages.  The watchful scrutiny of the
editor has likewise introduced whatever possesses immediate importance to the American physician
in relation to diseases  incident to our climate which are little known in England, as well as those
points in which experience here has led to different modes of practice ; and he has also added largely
to the series of illustrations, believing that in this manner valuable  assistance may be conveyed to
the student in elucidating the text.  The work will, therefore, be found  thoroughly on a level with
the most advanced state of medical science on both sides of the Atlantic.
   The additions  which the work has  received are shown by the fact that notwithstanding an en-
largement in the size of the page, more than two hundred additional pages have been necessary
to accommodate the two large volumes of the London  edition (which sells at ten dollars), within
the compass of  a single volume, and in its present form  it contains the matter  of at least three
ordinary octavos.   Believing it to be a work which should lie on the table of every physician, and
be in the hands of every student, the publishers have put it  at a price within the reach of all, making
it one of the cheapest books as yet presented to the American profession, Awhile  at the same time
the beauty of its mechanical execution renders it an exceedingly attractive volume.
   The fourth edition now appears, so carefully re-
vised, as to add considerably to the value of a book
already acknowledged,  wherever the English lan-
guage is read, to  be beyond all  comparison the best
systematic work  on the  Principles and Practice of
Physic in the whole range of medical literature.
Every lecture contains proof of the extreme anxiety
of the author to keep pace wi th the advancing know-
ledge of  the day   One scarcely knows  whether
to admire most the pure, simple, forcible English—
the vast amount of  useful practical  information
condensed into the Lectures—or the manly, kind-
hearted, unassuming character of the lecturer shin-
ing through his work.—Lond.  Med. Times.
   Thus these admirable Volumes come before the
profession in their.fourth edition, abounding in those
distinguished attributes of  moderation, judgment,
erudite cultivation, clearness, and eloquence, with
which they  were from the first invest ed, but yet
richer  than before in the results of more prolonged
observation, and in the able appreciation  of the
latest advances in pathology and medicine by one
of the  most profound medical thinkers of the day.—
London Lancet.
  The lecturer's skill, his wisdom, his learning,are
equalled by the ease of his graceful diction, his elo-
quence, and the far higher qualities of candor, of
courtesy, of modesty, and of generous appreciation
of merit in others.—N. A. Med.-Chir Review.
  Watson's unrivalled,  perhaps  unapproachable
work on Practice—the copious additions made to
which (the fourth edition) have given it all the no-
velty and much of the interest of a new  book.—
Charleston Med. Journal.
  Lecturers, practitioners, and students of medicine
will equally hail the reappearance of the work of
Dr. Watson in the form of anew—a fourth—edition.
We merely do justice to our own feelings, and, we
are sure, of the whole profession, if we thank him
for  having, in the trouble and turmoil of a large
practice, made leisure to supply the hiatus caused
by  the exhaustion of the third edition.   For Dr.
Watson has not merely caused the lectures to be
reprinted, but scattered through the whole work we
find additions or alterations which prove  that the
author has in every way sought to bring up his teach-
ing to the level of ihe most recent acquisitions in
science.—Brit, and For. Medico-Chir.Review.
                           New and much enlarged edition.
                         WILSON (ERASMUS),  F. R. S.
A SYSTEM  OF  HUMAN  ANATOMY,  General and  Special.   A new and re-
  vised American, from the last and enlarged English Edition. Edited by W. H. Gobrecht, M. D.,
  Professor of Anatomy in the Pennsylvania Medical College, &c.  Illustrated with three hundred
  and ninety-seven engravings on wood.  In one large and exquisitely printed octavo volume, of
  over 600 large pages; extra cloth, $4 00.
  The publishers trust that the well earned reputation so long enjoyed by this work will be more
than maintained by the present edition.  Besides a very thorough revision by the author, it has been
most carefully examined by the editor, and the efforts  of both have been directed to introducing
everything which increased experience in its use has suggested as desirable to render it a complete
text-book for those seeking to obtain or to renew an acquaintance with Human Anatomy.   The
amount of additions which it  has thus received may be estimated from the fact that the present
edition contains over one-fourth more matter than the last, rendering a smaller type and an enlarged
page requisite to keep the volume within a convenient size.  The editor has exercised the utmost
caution to  obtain entire accuracy in the text, and  has largely  increased  the number  of illustra-
tions, of  which there are  about one hundred and fifty more in this edition than in the last, thus
bringing distinctly before the eye of the student everything of interest or importance.
  It may be recommended  to the student as no less
distinguished by its accuracy and clearness of de-
scription than by its typographical elegance.  The
wood-cuts are exquisite.—Brit, and For. Medical
Review.

  An elegant edition of one of the most useful and
accurate systems of anatomical science which has
been issued from the press  The illustrations are
really beautiful.  In its style the work is extremely
concise and intelligible. No one can possibly take
up this volume without being struck with the great
beauty of its mechanical execution, and the clear-
ness of the descriptions which it contains is equally
evident.  Let students, by all means examine the
claims of this work on their notice, before they pur-
chase a text-book of the vitally important science
which this volume so fully and easily unfolds.—
Lancet.
  We regard it as the best system now extant for
students.—Western Lancet.
  It therefore receives our highestcommendation.__
Southern Med. and Surg. Journal. 
AND SCIENTIFIC  PUBLICATIONS.                  31
                          WILSON (ERASMUS),  F.  R.  S.

ON DISEASES  OF THE  SKIN.   Fifth  American,  from the  Fifth  enlarged
  London edition.  In one handsome octavo volume, of nearly 700 large  pages, with illustrations
  on wood, extra cloth   $4.0.       ■

•  Thls ?laf.S!lclJ1 work, which for twenty years has occupied the position  of the leading authority
in the English language on its important subject, has just received a thorough revision at the hands
ot the author, and is now presented as embodying the results _>f the latest investigations and expe-
rience on all matters connected with disea>es of the skin.   The increase in the size of the work
shows the  industry of the author, and his determination that it shall maintain the position which it
has acquired as thoroughly on a level with the most advanced condition of medical science.
  A few notices of the last edition are  appended.

  The writings of Wilson, upon diseases of the skin,
are by far  the  most scientific and practical that
have ever been presented to the medical world  on
this subject.  The present edition isa great improve-
ment on all its predecessors.  To dwell upon all the
great merits and high claims of the work before us,
seriatim, would indeed be an agreeable service; it
would be a mental homage which we could  freely
offer, but we should thus occupy an undue amount
of space in this Journal.  We will, however, look
at some of the  more salient points with which it
abounds,and which make itincompura.ry superior to
all other treatises on the subject of dermatology. No
mere speculative views are allowed a place in this
volume, which, withoutadoubt will, for a very long
period, be acknowledged as the chief standard work
on dermatology.  The principles of an enlightened
and rational therapeia are introduced on every ap-
propriate occasion.—Am. Jour. Med Science.
  When the first edition of this work  appeared;
about fourteen years ago, Mr- Erasmus Wilson had
already  given some years to the study of Diseases
of the Skin, and he then expressed his intention of
devoting his future life  to  the elucidation of this
branch of Medical Science.  In the present edition
Mr. Wilson presents us with the results of his ma-
tured experience, and we have now before us not
merely a reprint of his former publications, but  an
entirely new and rewritten volume. Thus, the whole
history of the diseases affecting the skin, whether
they originate in that structure or are the mere mani-
festations  of derangement  of internal  organs, is
brought under notice, and the book includes a mass
of information which is spread over a great part of
the domain of Medical and Surgical Pathology. We
can safely  recommend it to the profession as the
best work on the subject now in existence in the En-
glish language.—London Med. Times and Gazette.
  No matter what other treatises may be in the libra-
ry of the medical attendant, he needs the clear and
suggestive  counsels of Wilson, who is thoroughly
posted up on all subjects connected with cutaneous
pathology.  We have, it is very true, other valuable
works on the maladies that invade the skin; but,
compared with the volume under consideration, they
are certainly to be regarded as inferior lights in guid-
ing the judgment of the medical man.—Boston Med.
and Surg. Journal, Oct. 1857.
  The author adopts a simple and entertaining style.
He strives to clear away the complications of his
subject, and has thus produced a book tilled with a
vast  amount of information, in a form  so agreeable
as to make it pleasant reading, even to the uninitiated.
More especially does it deserve our praise because of
its beautiful and complete atlas, which the American
publishers have successfully imitated from the origi-
nal plates.  We pronounce them by far  the best imi-
tations of nature yet published in our country. With
the text-book and atlas at hand, the diagnosis is ren-'
dered easy and accurate, and the practitioner feels
himself safe in his treatment.  We will add that this
work, although it must have been very expensive to
the publishers, is not high priced.  There is  no rea-
son, then, to prevent every physician from obtaining
a work of such importance, and one which will save
him both labor and perplexity.— Va. Med. Journal.
  As a practical guide to the classification, diagnosis,
and treatment of the diseases of the skin, the book is
complete.  We know nothing, considered in this  as-
pect, better in our language; it is a  safe authority on
all the ordinary matters which, in this  range of dis-
eases, engage the practitioner's attention, and pos-
sesses the  high quality — unknown, we believe, to
every older manual, of being on a level with science's
high-water mark; a sound book of practice.—London
Med. Times.
                                     ALSO, NOW READY,

A  SERIES  OF PLATES ILLUSTRATING  WILSON  ON  DISEASES  OF
  THE SKIN; consisting of twenty beautifully executed plates, of which thirteen are exquisitely
  colored, presenting the Normal Anatomy and Pathology of the Skin, and containing accurate re-
  presentations of about one hundred varieties of disease, most of them the size of nature.  Price
  in cloth.  $5 50.

  In beauty of drawing and accuracy and  finish of coloring these plates will be found equal to
anything of the kind as yet issued in this country.  The value of the new edition is enhanced  by
an additional colored plate.

                                                 We have already expressed our high appreciation
                                               of Mr. Wilson's treatise on Diseases of the Skin.
                                               The  plates are comprised  in a  separate volume,
                                               which we counsel all those who possess the text to
                                               purchase.  It is a beautiful specimen of color print-
                                               ing, and the representations of the various forms of
                                               skin disease are as faithful as is possible in plates
                                               of the size.—Boston Med. and Surg. Journal, April
                                               8, 1858.
  The plates by which this edition is accompanied
leave nothing to be desired, so far as excellence of
delineation and perfect accuracy of illustration are
concerned.—Medico-Chirurgical Review.
  Of these platesit isimpossible to speak too highly.
The representations of the various forms of cutane-
ous disease are singularly accurate, and  the color-
ing exceeds almost anything we have met with.—
British and Foreign Medical Review.
  Also the TEXT  and PLATES done up in one handsome volume, extra cloth, price $9 50.

                                    BY THE SAME AUTHOR.

THE  DISSECTOR'S  MANUAL;  or,  Practical and  Surgical Anatomy.   Third
  American  from the last revised and enlarged English edition.   Modified and rearranged, by
  William Hunt, M. D.,  Demonstrator of Anatomy in the University of  Pennsylvania.  In one
  Large and handsome royal 12mo. volume, extra cloth, of 582 pages, with 154illustrations.  $2 00.

                                   BY THE SAME  AUTHOR.

HEALTHY  SKIN;  A Popular Treatise on the  Skin and Hair, their Preserva-
  tion and  Management.   Second American, from the fourth London edition.  One neat volume,
  royal 12mo., extra cloth, of about 300 pages, with numerous illustrations.  $1 00. 
32         LEA  &  BLANCHARD'S  MEDICAL  PUBLICATIONS.
                 WINSLOW (FORBES),  M.D.,  D. C. L.,  &,c.

ON OBSCURE DISEASES  OF THE BRAIN AND  DISORDERS OF  THE
  MIND; their incipient Symptoms, Pathology, Diagnosis, Treatment, and Prophylaxis.  Second
  American,  from the  third and revised English edition. ' In one  handsome octavo volume, of
  nearly 600 pages, extra cloth.  (Preparing.)

  We close this brief and necessarily very imperfect
notice of Dr. Winslow's great and classical work,
by expressing our conviction that it is long since so
important and beautifully written a volume has is-
sued from the  British medical press.—Dublin Med.
Press, July 25, I860.
  We honestly believe this to be the best book of the
BeasoD.— Hanking's Abstract, July, 1860.
  The 'after portion of Dr. Winslow's work is ex-
clusively devoted to the consideration of Cerebral
Pathology.  It completely exhausts the subject, in
the same manner as the previous seventeen chapters
relating to morbid psychical phenomena left nothing
unnoticed in reference to the mental symptoms pre-
monitory of cerebral disease.  It is impossible to
overrate the benefits likely to result from a general
perusal of Dr. Winslow's valuaole and deeply in-
teresting work.—London Lancet, June 23, 1860.

  It contains an immense mass of information.—
Brit, and For. Med.-Chir. Review, Oct. lb.O.
                            WEST (CHARLES),  M. D.,
Accoucheur to and Lecturer on Midwifery at St. Bartholomew's Hospital, Physician to the Hospital for
                                    Sick Children, &c.

LECTURES  ON  THE  DISEASES OF WOMEN.  Second American, from the
  second London  edition.  In  one handsome octavo volume, extra cloth, of about 500 pages;
  price $3 25.

*%.* Gentlemen who received the first portion, as issued in the "Medical News and Library," can
  now complete their copies by procuring Part II, being page 309 to end, with Index, Title matter,
t &c, 8vo., cloth, price $1  25.
  We mustnow conclude this hastily written sketch
with the confident assurance to our readers that the
work will well repay perusal.  The conscientious,
painstaking, practical physician isapparent on every
page.—N. Y. Journal of Medicine.
  We know of no treatise of the kind so complete
and yet so compact.—Chicago Med. Jour.

  A fairer, more honest, more earnest, and more re-
liable investigator of the many  diseases of women
and children is not to be found in any country.—
Southern Med. and Surg. Journal.

  We have to say of it,  briefly and decidedly, that
it is the  best work on the subject  in any language j
and that it stamps Dr. West as the facile princeps
of British obstetric authors.—Edinb. Med. Journ.
  We gladly recommend his Lectures as in the high-
est degree instructive to all who are interested in
obstetric practice.—London Lancet.
  Happy in his simplicity of manner, and moderate
in his expression of opinion, the author is a sound
reasoner and a good  practitioner, and his book is
worthy of the handsome garb in which it has ap-
peared.— Virginia Med. Journal.

  We must take leave of Dr. West's very useful
work, with our  commendation of the clearness of
its style, and the incustry and sobriety of judgment
of which it gives evidence.—London Med Times.

  Sound judgment and good sense pervade every
chapter of the book.  From its perusal we have de-
rived unmixed satisfaction.—Dublin Q-uart. Journ.
BY THE SAME AUTHOR.
LECTURES  ON  THE   DISEASES  OF  INFANCY AND  CHILDHOOD.
  Third American,  from the fourth enlarged and improved London edition.  In one handsome
  octavo volume, extra cloth, of about six hundred and fifty pages.  $3 25.
  The three former editions of the work now before
us have placed the author in the foremost rank of
those physicians who have devoted special attention
to the diseases of early life  We attempt no ana-
lysis of this edition, but may refer the reader to some
of the chapters to which the largest additions have
been made—those on Diphtheria, Disorders of the
Mind, and Idiocy, for instance—as a proot that the
work is really a new edition; not a mere reprint.
In its prei ent shape it, will be found of the greatest
possible service in the every-day practice of nine-
tenths of the profession.—Med. Times and Gazette,
London, Dec. 10,1859.
  All things considered, this book of Dr. West is
by far the best treatise in our language upon such
modifications of morbid  action and disease as are
witnessed when we have to deal with infancy and
childhood.  It is true that it confines itself to such
disorders as come within the province of the phy-
sician, and even with respect to these it is unequal
as regards mihutentss of consideration, and  some
diseases it omits to notice altogether.  But those
Who know anything  of  the present  condition  of
paediatrics will readily admit that it would be next
to impossible to effect more, or effect it better, thaD
the accoucheur of St. Bartholomew's has done in a
single volume.  The lecture (XVI.) upon Disorders
of the Mind in children is an admirable specimen of
the value ol the later  information conve>ed in  the
Lectures  of  Dr. Charles  West.—London Lancet,
Oct. 22, 1859.
  Since the appearance of the first edition, about
eleven years ago, the experience Of  the author has
doubled; so that, whereas the lectures at first were
founded on six hundred observations, and one hun-
dred and eighty dissections made among nearly four-
teen thousand children, they now embody the results
of nine hundred observations, and two hundred and
eighty-eight post-mortem examinations made among
nearly  thirty thousand children, who, during  the
past twenty  years, have been under his care.—
British Med. Journal, Oct. 1, 1859.
BY THE SAME AUTHOR.
AN ENQUIRY INTO THE PATHOLOGICAL IMPORTANCE OF ULCER-
  ATION OF THE OS UTERI.  In one neat octavo volume, extra cloth.  $1 25. 
 
 
 
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