H ANDBOOK OF MATERIA MEDICA, PHARMACY, AND THERAPEUTICS. POTTER. A N ew Series of Manuals FOR Medical Students. Price of each Book, Cloth, $3.00; Leather, $3.50. MIDWIFERY. By Alfred Lewis Galabin, m.a., m.d., Obstetric Physician to, and Lecturer on Midwifery and the Diseases of Women at, Guy’s Hospital, London, etc. 227 fine Engravings. 753 pages. PHYSIOLOGY. Second Edition. By Gerald F. Yeo, m.d., f.r.c.s., Professor of Physiology in Kings College, London. Revised. 743 pages. 301 carefully printed Illustrations. MATERIA MEDICA, PHARMACY, AND THERAPEUTICS, including the Physiological Action of Drugs, Special Therapeutics, Official and F.xtemporaneous Pharmacy, with numerous Tables, Form- ulae, Notes on Temperature, Clinical Thermometry, Poisons, Urinary Examinations and Patent Medicines. By Sam’l 0. L. Potter, m.a., m.d., Professor of Practice of Medicine, Cooper Medical College, San Francisco; Late A. A. Surgeon U. S. Army. 830 pages. CHILDREN. By J. F. Goodhart, m.d., Physician to the Evelina Hospital for Children; Assistant Physician, Guy’s Hospital, London. American Edition, Revised and Edited by Louis Starr, m.d., Clinical Professor of Diseases of Children in the Hospital of the University of Pennsylvania; Physician to the Children’s Hospital, Philadelphia. 50 Formulae, and Directions fjr preparing Artificial Human Milk, for the Artificial Digestion of Milk, etc. 738 pages. PRACTICAL THERAPEUTICS. Fourth Edition. With an Index of Diseases. By Ed. John Waking, m.d., f.r c.p. Rewritten and Re- vised. Edited by Dudley W. Buxton, Assistant to the Professor of Medicine, University College Hospital, London. 744 pages. MEDICAL JURISPRUDENCE AND TOXICOLOGY. By John J. Reese, m.d., Professor of Medical Jurisprudence and Toxicology, University of Pennsylvania, etc. 606 pages. ORGANIC CHEMISTRY. By Prof. Victor von Richter, Univer- sity of Breslau. Translated from Fourth German Edition by Edgar F. Smith, m.a., ph.d., Professor of Chemistry, Wittenberg College, Spring- field, O., formerly in the Laboratories of the University of Pennsylvania, etc. Illustrated. 710 pages. WINCKEL’S DISEASES OF WOMEN. By Parvin. A new Text-Book. By Dr. F. Winckel, Professor of Gynaecology, etc., Royal University7 of Munich. The Translation Edited by Theophilus Parvin, m.d., Professor of Obstetrics and Diseases of Women and Children, Jef- ferson Medical College, Philadelphia. 132 Engravings, most of which are new. 700 pages. *** Other Volumes in Preparation. A complete circular with illustrations and sample pages sent free, upon application. Price of each Book, Cloth, $3.00 j Leather, $3 50. P. BLAKISTON, SON & CO., Medical Publishers & Booksellers, 1012 Walnut Street, Philadelphia. HANDBOOK OF MATERIA MEDICA, PHARMACY, AND THERAPEUTICS, INCLUDING THE PHYSIOLOGICAL ACTION OF DRUGS, THE SPECIAL THERAPEUTICS OF DISEASE, OFFICIAL AND EXTEMPORANEOUS PHARMACY, AND MINUTE DIRECTIONS FOR PRESCRIPTION WRITING. BY u/ SAM'L O. L. POTTER, M.A., M.D., . ■\ /// PROFESSOR OF THE THEORY AND PRACTICE OF MEDICINE IN THE COOPER MEDICAL COLLEGE OF SAN FRANCISCO: AUTHOR OF “ QUIZ-COMPENDS ” OF ANATOMY AND MATERIA MEDICA, “AN INDEX OF COMPARATIVE THERAPEUTICS," AND “ A STUDY OF SPEECH AND ITS DEFECTS." LATE A. A. SURGEON, U. S. ARMY. PHILADELPHIA : P. BLAKISTON, SON & CO., 1012 Walnut Street. 1887. TO MY WIFE I DEDICATE MY FIRST LARGE BOOK, IN LOVING APPRECIATION OF THE PATIENCE WITH WHICH SHE HAS BORNE MY ABSORPTION IN THIS WORK DURING THE PAST TWO YEARS. Copyright, 1886, by P. Blakiston, Son & Co. PREFACE. The book, which this preface completes, has occupied the writer’s leisure hours during the past two years, and in a measure has grown out of some less pretentious volumes previously written by him. The continued favor shown by teachers and students, both in this country and in England, to his three manuals in the “ Quiz-Compend ” series for students, and particularly to the volume on Materia Medica and Therapeutics, has encouraged their author to hope that a hand-book from him on the same sub- ject, but embracing a wider scope, might meet with a correspond- ing degree of appreciation. The fact that quite a number of new manuals on Materia Medica have lately appeared, has not deterred him from entering the field, nor diminished his confi- dence in the approbation of his readers; but has rather seemed a proof that most of the older text-books on this branch of medi- cal knowledge are no longer satisfactory, even with the regular revisions which they undergo at stated periods. Hence he ex- pects for this hand-book a position, among the recent manuals of its class, as high as its merits and demerits may entitle it to re- ceive in the estimation of those for whose use it has been prepared. The author’s intention has been to produce a book, which would embrace in a single volume the Essentials of practical Materia Medica and Therapeutics, treating of each subject in as concise phraseology as possible consistent with the delineation of every important feature. He has also endeavored to formulate such minute and definite directions for the framing of Prescrip- tions, as might elucidate what to many is a very difficult problem. Furthermore, he has tried to present as much information, upon the subject of Pharmacy, as every physician should possess, in order to handle the implements of his profession with confidence, and to direct their use by others with pharmaceutical accuracy. PREFACE. The complete fulfilment of these aims would be realized if the book should take rank as a working companion to the advanced student and the junior practitioner; and be deemed by them a reliable guide through the forest of observations and experiments on drug actions and uses, which makes progress slow for the already over-burdened mind, when ploughing through the more exhaustive and exhausting text-books. Although this book is essentially a compilation, as all books of its class must be, there will be found in its pages much original matter derived from the writer’s own experience in professional life. The arrangement of the matter will be found to be in some respects unique. After full consideration of the many arrangements of the Materia Medica in vogue, a modified alpha- betical plan was adopted, by which the advantages of the alpha- betical order might be retained, while permitting the grouping together of agents which are closely related, physiologically and therapeutically, under the title of the principal member of the class—the chief, as it were, of that particular clan. Thus, under the title Amyl Nitris (Nitrite of Amyl), will be found men- tion also of the Nitrites of Ethyl, Sodium and Potassium, and their congener Nitro-Glycerin, all of which are closely allied to the first-named and to each other, in respect of their actions and uses. A very elaborate section on Drug Classification is placed at the end of the Materia Medica, in order to supplement such deficiencies in grouping as are inevitable in an alphabetical arrangement. In detailing the characteristics of an important drug, its physical properties and chemical constituents are first briefly enumerated, then its preparations are described in the official language of the pharmacopoeia, usually somewhat abbreviated; any important unofficial preparations being also noted, and all the compounds into which it enters enumerated. Next the phys- iological action is taken up, its characteristic features being first described ; then the actions resulting from an ordinary medicinal dose, next those produced by small doses continued, and finally those from a toxic dose. These are followed by a brief account of its antagonists, antidotes and incompatibles, if any; and a PREFACE. concise summary of its therapeutical applications closes the article;—the whole presenting, it is hoped, a clearly defined word-picture of the drug under consideration. Every article and preparation comprised in the last edition of the U. S. Phar- macopoeia is fully noticed, while all the prominent unofficial agents receive such mention as their respective importance seems to demand. The second part of the book is devoted to Pharmacy, and has been written from the standpoint of a conviction that many young practitioners would gladly dispense their own medicines, if provided with a few practical directions on the subject; thereby saving many a dollar from the drug store, preventing in their own practices at least the “renewals” which constitute so bad a feature of modern pharmaceutics, and gaining for themselves a practical acquaintance with their professional weapons which cannot but make them better physicians and more accurate pre- scribes. In this section of the book Prescription Writing re- ceives full consideration, and many standard formulae are given as samples of prescriptions of each kind in extemporaneous use. In the third part the subject of Special Therapeutics is treated of elaborately, and in the form of an alphabetically arranged Index to the treatment of diseases, as laid down by the most recent authorities. Every indication for the use of a drug is referred to its author by his initial, and to the most prominent articles are appended a few selected formulae, to serve as guides to the neophyte in prescribing. The Appendix contains numerous tables, comprising diagnostic hints, Latin terms and phrases, formulae for hypodermic use, metric equivalents, specific gravities and volumes, and obstetric memoranda; as also Notes on temperature in disease, the use of the clinical thermometer, the treatment of poisoning, and the examination of urine; also formulae representing the most noted patent medicines. The Index has received especial attention, from a conviction that if well made it is the best part of a good book. Every title, synonym and other reference of importance is included therein, double and treble entries being made in every instance which seemed to require such repetition. PREFACE. Nearly all the regular text-books have been laid under contri- bution in the preparation of the book, but especial use has been made of the works of Bartholow, Ringer, Wood, Phillips, Pif- fard, Waring and Brunton, in their latest editions; as well as of the writer’s verbatim notes of two courses of didactic and clini- cal lectures delivered by Professors Bartholow and Da Costa in the Jefferson Medical College and Hospital and in the auditorium of the Pennsylvania Hospital. On pages 514 and 515 will be found a full list of the authorities referred to by initials in the section on Special Therapeutics. The term “officinal,” as applied to drugs recognized by the pharmacopoeia has been discarded, the word “official” being used instead; for the simple reason that the idea to be conveyed is expressed more correctly by the latter term than by the former one. When none but official drugs «and preparations were kept in the officina or drug store, it was eminently proper to call them “officinal,” but inasmuch as this class does not nowadays con- stitute much over one-fourth part of the officinal stock, it is a wilful debasement of our professional weapons, as well as an inexcusable misnomer, to apply the shop-title to them any longer. SAM’L O. L. POTTER. San Francisco, December, 1886. TABLE OF CONTENTS. PAGE INTRODUCTION, 13 Materia Medica, . 13 Pharmacy, 13 Empirical Therapeutics, 14 Rational Therapeutics, 15 Administration of Medicines 16 Dosage of Medicines, 20 PART I.—MATERIA MEDICA AND THERAPEUTICS, . 17 Abrus to Zingiber, 17-398 Classification of Medicines, 399 Stimulants and Sedatives, 399 Agents acting chiefly on the Nervous System, 400 Agents acting on the Organs of Special Sense, 405 Agents acting on Respiration, 408 Agents acting on the Circulation, 410 Agents acting on the Digestive System, 412 Agents acting on Metabolism, 419 Agents acting on Excretion, 422 Agents acting on the Generative System, 426 Agents acting on the Cutaneous Surface, 429 Agents acting on Microbes, Ferments, etc., 431 Agents acting upon each other, 433 PART II.—PHARMACY AND PRESCRIPTION WRITING, 435 Constituents of Vegetable Drugs, 436 Official Operations, 437 Official Preparations, 448 Extemporaneous Pharmacy 464 TABLE OF CONTENTS. Weights and Measures, 465 Metric System, * 467 Approximate or Domestic Measures, 469 Specific Gravity and Specific Volume, 470 Prescriptions, 470 Analysis of a Prescription, 470 Principles of Combination, 473 Prescription Writing, ...... 474 Abbreviations, 475 Prescription Blanks, 475 Renewals, 476 Filling a Prescription, 478 Stock Solutions, 479 Rules for the Pharmaceutical Student, 480 Incompatibility, 480 Chemical Incompatibility, 480 Pharmaceutical Incompatibility, 483 Therapeutical Incompatibility, 4&4 Rules for Avoidance of Dangers, * 485 Extemporaneous Preparations and Formula, . ... 486 Excipients for Mixtures, . 488 Excipients for Emulsions, 490 Excipients for Pills, 497 PART III.—SPECIAL THERAPEUTICS, 514 References and Bibliography, 514 Abdominal Plethora to Yellow Fever, 515-748 APPENDIX, 749 Latin Terms, Phrases, etc., used in Prescriptions, . . . 749 Hypodermic Formulae, 760 Genitive Case-endings, 763 Verbs, Participles, Prepositions, etc., 764 Chlorodyne, Comparisons of Ten Formulae therefor, . 765 Patent Medicines, 766 The Treatment of Poisoning, 767 Tables of Differential Diagnosis, 773 Notes on Temperature in Disease, 780 Clinical Thermometry, 7^0 TABLE OF CONTENTS. Obstetrical Memoranda, 782 Signs of Piegnancy, 782 Signs of Labor, 782 Average Pelvic Diameters, 783 Development of the Foetus, 783 Diameters of the Foetal Skull at Term, 784 Asphyxia and Apncea 784 Clinical Examination of the Urine, 786 Ethics, the Hippocratic Oath, etc., 788 Notes on Some New Remedies, 790 Table of Specific Gravities and Specific Volumes, . . . 794 Table of Drops in, and Weights of, a Fluid-drachm of Various Liquids 795 Table for Converting Apothecaries’ Weights and Meas- ures into Grams, 796 INDEX, 797 ERRATA. Page 25, line 5 from bottom—for “ March ” read “ Marsh.” Page 33» line 8 from bottom—before the word “ alkaloids ” insert the word “ uncombined.” Page 35, line 12 from top—for “ Trinitro” read “Trinito.” Page 36, line 13 from bottom—after “Dose” insert “gr.” Page 70, line 20 from top—for “ Antimonii ” read “ Antimonium.” Page 71, line 7 from bottom—for “ read “ Page 96, line 12 from bottom—for “ lessens” read “increases.” Page 169, line 10 from top—for “ is” read “was.” Page 184, line 11 from bottom—for “membane” read “membrane.” Page 183, line 3 from top—for “ 5 per cent.” read “ 25 per cent.” Page 222, line 12 from bottom—for “ Hydrochoric” read “Hydrochloric.” Page 306, line 3 from bottom—change the sign 3 to 3;. Page 334, line 8 from top—after “ njjx—” insert the sign “ z.” Page 340, line 10 from top—strike out “ Caryophyllus (cloves).’’ Page 353, line 4 from top—“ Seneg& ” should be “ Senega.” Page 384, lines 5 and 6 from top—for “ Uva ” read “ Uvae.” Page 434, line 15 from bottom—for “Nitrate” read “Nitrite,” and after the word “ Curare ” insert the word “ Urethran.” Page 457, last line—for “acids” read “acid.” Page 458, line 1—for “ Olecium ” read “ Oleicum.” Page 460, line 11—for “ Resina ” read “ Resinae.” Page 460, line 21 from top—for “ Massi ” read “ Massa.” Page 469, last line—after the word “ classes” insert “ (See Appendix for a fuller Table).” Page 476, line 17 from top—after the words “ Non Kenovatum ” insert the words “ Non Repetatur, etc.” Page 481, line 6 from top—read “addition of fixed alkalies, their salts, or salts which.” Page 481, line 7 from top—before “alkalies” insert “fixed.” Page 481, line 14 from top—for “ emulsions” read “ emulsin.” Page 485, line 17 from top—for “ in emulsions” read “ Emulsin.” Page 485, line 23 from top—for “ is ” read “ are.” Page 506, line 2 from top—for “ Chartulas ” read “ Chartulm.” Page 560, line 15 from top—for “(H)” read “(R).” Page 744, line 26 from top—for “Creasote” read “ Creasoti.” Page 758, line 3 from top—for “ Septnna ” read “ Septim.” INTRODUCTION. Pharmacology, from ydppaxov, a drug, Xoyoq, a discourse, is a general term which properly includes all matters pertaining to the study of medicinal agents in the widest possible sense, embracing all of Materia Medica and Pharmacy, with so much of Therapeutics as relates to drugs. The term is however fre- quently employed in a more restricted sense, including only the physiological action of drugs ; a subject to which the title Pharmacodynamics is much more appropriately applied. Materia Medica is that branch of medical science which treats of the substances used as medicines, their origin, com- position, physical characteristics, chemical properties, modes of preparation and administration, physiological and toxicological actions. Pharmacodynamics, from (pdp/xaKov, a drug, Svva/us, power, is the proper title for that portion of the Materia Medica which relates to the physiological action of drugs, that is, the influence of drugs upon the healthy human body to modify its physiological activity. Toxicology is another subdivision, and includes the effects of drugs when administered in poisonous doses, together with the study of the drug-antago- nists for the most dangerous symptoms produced, and the appropriate chemi- cal antidotes. (See page 433.) Pharmacy is the art of preparing medicines for use and dispensing them on the order of the therapeutist. It includes a knowledge of the Materia Medica, an acquaintance with the theories and manipulations of chemistry, and an intimate practi- cal knowledge of many special operations peculiar to itself. Therapeutics, from dspaneuecv, to attend upon, includes all that relates to the science and art of healing ; and embraces the application, not only of medicines to the alleviation or cure of disease, but of all other agents which may aid in the accom- plishment of the same result. The operations of Nature herself, as well as of the substances described in the Materia Medica, INTRODUCTION. and those of all other remedial measures, as food, climate, clothing, heat, cold, electricity, etc., are all embraced in the term Thera- peutics, which may be divided into two grand divisions, viz. :— Natural Therapeutics, including the operations of the Vis Medicatrix Naturge,—the modes and processes of healing which occur independently of Art, for the spontaneous decline and cure of disease. There is no more com- pletely established fact in science than that the living organism is in itself adequate to the cure of all its curable disorders. This natural law enables the homoeopath to relate his sugar cures, aids the medical skeptic to hold to his infidelity, and helps all physicians out of more close places than most of them are willing to acknowledge before their clientele. This part of the sub- ject is not taught in the schools except in connection with pathology, and by the chair of Theory and Practice of Medicine. It is deserving of a special chair and of more systematic treatment than it receives. Applied Therapeutics embraces the application by Art of agents foreign to the living organism, for the purpose of aiding Nature to restore the body to a healthy condition. This division is the portion of the subject which is taught separately and systematically in the schools, and therefore is alone considered in the following pages. Other divisions of the general subject of Therapeutics employed in professional literature and conversation are those entitled “ Empirical ” and “ Rational Therapeutics.” Empirical Therapeutics is a term applied to the use of medi- cinal or other therapeutical agents for the sole reason that they have been tried previously with successful results in cases appa- rently identical with the one under treatment. By those who advocate this method it is styled the Therapeutics of Experience, and claimed to be an accumulation of means of combating dis- ease simply by observation and experiment, independently of physio-pathological reasoning (Hartshorne). It was necessarily the original method in Therapeutics, has conferred many rich gifts upon medical science, and has been advocated by many great physicians, its latest and ablest expounder being the eminent and lamented Niemeyer. The use of Opium to relieve pain,—that of Cinchona for malarial fevers,— of Colchicum in gout,—of Potassium Iodide in syphilis,—of the Bromides in epilepsy,—of Cod-liver Oil in phthisis,—are examples of the empirical use of remedies. But, after all has been said for it that can be said, the fact remains that it is essentially an unscientific method, a mere elaboration of the prevail- ing popular habit of recommending Mrs A. to use pepper tea, because it cured Mrs. B. of “ the very same trouble.” Permitted to reign supreme it would be destructive to all exactness in therapeutical progress. The so-called “ expe- rience ” of one observer is too often overbalanced by the experience of another equally competent and trustworthy ; and as few are encouraged to record their failures with remedies, there can be no scientific comparison of the failures with the reported successes.. P'or this reason empirical methods would tend to a minimum degree of accuracy in a science which, in the very nature of things, INTRODUCTION. can never be an exact one ;—though undoubtedly such methods will always prevail to some extent. Rational Therapeutics embraces the use of remedies for reasons based on a knowledge (i) of the pathological conditions present in the subject, and (2) of the physiological action of the agent employed. This method is the very antithesis of empiri- cism, and has been the leading idea in every revolt against em- pirical therapeutics in the past. Humoralism, Chemicism, Solid- ism, Stimulism, Galenism in the 2d century, Paracelcism in the 16th, and Hahnemannism in the 19th,—all originated in efforts to find a more rational system of administering medicines than the prevailing empiricism of the day. The illustrious Albrecht von Haller, the father of Physiology and the author of the doctrine of Irritability, was the real origi- nator of modern physiological therapeutics. In the preface to his Swiss Pharmacopoeia (circa A.D. 1755), occur the following remarkable directions: “ Nempe primum in corpore sano medela tentanda est, sine peregrina ulla miscela: odoreque et sapore ejus exploratis, exigua illius dosis ingerenda et ad omnes quae inde contingunt affectiones, quis pulsus, quis calor, quae respi- ratio, quaenam excretiones, attendendum. Inde adductum phenominorum in sano obviorum, transeas ad experimenta in corpore aegroto.” “ In the first place the remedy is to be tried on the healthy body, without any foreign substance mixed with it; having been examined as to its odor and taste, a small dose is to be taken, and the attention directed to all effects which thereupon occur ; such as upon the pulse, the temperature, the respiration, the excretions. Having thereby adduced their obvious phenomena in health, you may pass on to experiment upon the sick body Forty or more years after these rules were laid down ex ca- thedra by Haller, the central idea contained in them was incor- porated, as one of the main pillars, in a medical edifice then being erected in Germany. In the course of construction this pillar became so buried beneath a superstructure of palpable absurdities, that the medical profession, in its anxiety to steer clear of the whole mass, almost forgot the humble corner-stone, appropriated from the teachings of one of its own greatest chief- tains. While, however, the masses of the profession, blinded by its prejudices, turned away from everything which savored of drug-experimentation, a few in every country were quietly work- ing on the lines of the Hallerian dictum ; and as a result of their labors, the present generation has seen the development of an idea, announced 130 years ago, but now inspiring the minds of teachers and students all over the civilized world. Medical Col- leges are recognizing physiological drug experimentation as a INTRODUCTION. part of their regular curricula;—laboratories are fitted up in many of the schools with costly instruments of precision, for the more exact prosecution of this study ;—and under the direction of such men as Wood, Ringer, Murrell, Brunton, Bartholow, Hildebrandt, Liebermeister, Husemann, Schmiedeberg, etc., sys- tematic researches are being conducted upon the physiological action of every agent hitherto used in medicine. The alkaloids, and other component principles of vegetable drugs, are being subjected to the same rigid observation,—as also every new com- pound which chemistry gives to medicine. Journals, in every civilized country, teem with the results of these labors; and no medical student is permitted to pass the graduating ordeal until he has mastered the essential characteristics of the physiological action of the important medicaments. What has hitherto been the conviction of but a few, is daily growing into a fixed canon of professional belief, viz :—that physiological experimentation with drugs must be the basis of their therapeutical employment, and that all real advance towards the establishment of Thera- peutics as a science, must be made upon the course laid down by Haller. Still, in the words of Brown-Sequard, “Therapeutics will cease to be empirical, only when this last kind of knowledge shall be fully obtained.” ADMINISTRATION OF MEDICINES. Medicines may be introduced into the circulation by various routes, as the gastro-intestinal tract, the rectum, the respiratory tract, the veins and arteries, the subcutaneous cellular tissue, and the integument itself. The Gastro-intestinal Route is the one most frequently employed, being the most convenient. The remedies, after being swallowed, find their way into the current of the circula- tion, through the walls of the gastro-intestinal bloodvessels and the lacteals. When the stomach is empty and its mucous mem- brane healthy, crystalloidal substances in solution pass through the walls of its vessels with great rapidity. Colloidal substances (fats, albumen, gum, gelatin, etc.) require to be digested and emulsified before they can be absorbed. INTRODUCTION. The Rectum will absorb many substances applied in the form of Enemata or Suppositories. Those most suited to this route are the salts of the alkaloids in solution, especially those of Morphine, Atropine and Strychnine, the latter being absorbed more rapidly per rectum than by the stomach. Acid solutions, if not too frequently repeated, are also well administered by this channel. The Respiratory Tract admits of the rapid absorption of medicinal substances through its extensive blood-supply. The inhalation of vapors or atomized fluids, the insufflation of pow- ders into the nares, fauces, larynx, etc., and the use of a medi- cated nasal douche, are methods whereby this channel may be utilized. The Veins are only used as a route of medication in emer- gencies, where the other channels are not available, and where immediate action is necessary to the preservation of life, the operation being a highly dangerous one. The injection intra- venously of Saline Solutions in the collapse of cholera, diabetic coma, etc.,—Blood or Milk as a last resort in excessive hemor- rhage, epilepsy, uraemia, the collapse of cholera, etc.,—and a solution of Ammonia for the bites of venomous reptiles, Hydro- cyanic-acid poisoning, Opium narcosis, Chloroform asphyxia, etc., are the instances admitted in practice. Arterial Transfusion has also been performed successfully in a number of cases, and is considered safer than venous transfusion when a large quantity of fluid has to be introduced into the circulation. A special apparatus is employed for these purposes, known as Aveling’s Transfusion Syringe, but the ordinary Dieulafoy’s aspirator slightly modified, may be used with safety and convenience. The danger of the operation lies in the liability of air to introduction into the circulation, an occurrence which causes instant death in the human subject. The Hypodermic Method is the introduction of medicines into the organism by injecting them into the subcutaneous areolar tissue, from which they are quickly absorbed by the lymphatic and capillary vessels. The medicines must be in solution, of neutral reaction and freshly prepared, the usual menstruum being distilled water; though spring water filtered will answer just as well, and much better than distilled water which has been standing several days, and exposed from time to time to the air. The solu- tion is to be injected beneath the skin, by a hypodermic syringe, care being taken to avoid puncturing a vein. The most suitable localities for the injec- tion are the external aspect of the arms and thighs, the abdomen, the back, INTRODUCTION. and the calves of the legs. On the external aspect of the thigh, just in front of the great trochanter, there is an area of some two inches square, over which the insertion of a fine hypodermic needle is not felt, so barren is the skin in that region of sensitive nerve filaments. After nearly filling the syringe with the solution to be used, the needle should be screwed on tightly ; and with the instrument held in a vertical posi- tion, point uppermost, the excess of solution over the amount required should be ejected, thus expelling air bubbles and filling the needle itself. A portion of skin should be grasped by the thumb and forefinger at the site selected for the injection, into which the needle should then be quickly inserted until its point has passed beneath the skin, when the piston may be pressed down slowly, delivering the solution so gradually as to avoid rupturing the tissue. If the solutions are freshly prepared with clean water, the needles kept clean and sharp, and the injection be made beneath the skin 7iot into it, there will be no risk of producing abscesses with the agents ordinarily employed. Tablets for hypodermic use are prepared by the prominent manufacturers, each containing one dose. They may be readily dissolved in a teaspoon at the bedside, and are very convenient for the pocket, if put up in a case with a good hypodermic syringe, as may be obtained from Parke, Davis and Co., of Detroit. Their regular line of Hypodermic Tablets includes the agents named in the following list, put up in tubes of 25 each. List of Hypodei'inic Tablets. Aconitine (crystals), . . gr. Apormorphine Muriate, . gr. j1^. Atropine Sulphate, . . gr. Atropine Sulphate, . . gr. Cocaine Hydrochlorate, . gr. j. Conine Hydrobromate, . gr. f Colchicine, . . , gr. Corrosive Sub. and Urea, . gr. Digitalin (soluble), . . gr. T^. Gelsemine Muriate, . . gr. Hyoscine Hydrobromate, . gr. Hyoscyamine, . . . gr. -X. Morphine Sulphate, . . gr. Morphine Sulphate, . . gr. Morphine & Atropine, No. x Morphine Sulph., . . gr. 54- Atropine Sulph., . . gr. Morphine & Atropine, No. 2. Morphine Sulph., . . gr. 54- Atropine Sulph., . . gr. x£5. Picrotoxin, . . . gr. -5'^. Pilocarpine Hydrochlor., . gr. Jr. Pilocarpine Nitrate, . . gr. J. Physostigmine Sulph., . gr. jfa. Sodium Arseniate, . . gr. . Strychnine Sulphate, . . gr. . Strychnine Sulphate, . . gr. [For Formulae for Hypodermic Solutions, see Appendix, page 760.] Parenchymatous Injection is the delivery of a medicine deeply into the tissues, either to affect a muscle itself or to locally influence some important nerve-trunk. The principal agents used in this manner are Strychnine for palsied muscles, Chloroform for sciatic and other neuralgias, and Salts of Cocaine for local anaesthesia. The Skin is an active absorbent of crystalloidal substances when its epidermis or cuticle is removed. By this route there are four methods of introducing medicaments into the circula- INTRODUCTION. tion, viz.—the Enepidermic, Epidermic and Endermic Methods, and Inoculation. The Enepidermic Method consists in placing the medi- cine in simple contact with the epidermis, no friction being used to hasten its penetration. Chloroform and Oleic Acid solutions of the alkaloids pass by osmosis in this manner with comparative ease, but aqueous solutions act very slowly and alco- holic ones with great difficulty if at all. (See page 34.) The Epidermic Method consists in the use of friction to promote the passage of the medicament between the cells of the epidermis. Mercurial Ointment, Cod-liver Oil, and other fats, Oleates, etc., are used in this way for their local and systemic effects. The Endermic Method obviates the difficulty of absorption through the cuticle by removing the latter through the agency of a blister, and then powdering the medicament over the surface of the denuded derma. An ordinary cantharides-plaster, followed by a poultice to raise the blister, may be employed ; but a quicker method is to place upon the skin a piece of lint soaked in Stronger Water of Ammonia, covering it with a watch glass or a piece of oiled silk to prevent evaporation. The blister raises rapidly and should then be removed with scissors. Morphine, Atropine, Quinine and Strychnine, are the agents generally used in this manner, but the method is painful and unpopular. Inoculation is the introduction of medicinal agents through the scraped or punctured skin by an operation similar to that employed for vaccination. DOSAGE. DOSAGE OF MEDICINES. The Doses given throughout this book are for adults; for children the following rule (Young’s) will be found the most convenient. Add 12 to the age, and divide by the age, to get the denominator of a fraction, the numerator of which is 1. Thus, for a child two years old, ?+ia=7, and the dose is one-seventh of that for an adult. Of powerful narcotics scarcely more than one-half of this proportion should be used. Of mild cathartics, two or even three times the proportion may be employed. For Hypodermic Injection, the dose should be two-thirds or three-fourths of that used by the mouth; by rectum five- fourths of the same. Strychnine acts more actively when given per rectum than by the stomach. Conditions which modify the action of medicines, and there- fore affect their dosage, are—age, body-weight, temperament and idiosyncrasy, drug-habits, intervals between doses, time of admin- istration, condition of the stomach, temperature of the body, cumulative drug-action, mode and form of drug-administration, disease, climate, race, etc. Children bear Opiates badly (see page 278):—but on the other hand they stand comparatively large doses of several other drugs; such being Arsenic, Belladonna, Calomel, Ipecacuanha, Squill, Rhubarb, and several other purgatives. PART I. MATERIA MED1CA AND THERAPEUTICS. ABRUS, Jeriquity (Unofficial),—is the seed of Abrus pre- catorius, or Wild Liquorice, a plant of the nat. ord. Legumi- nosae, indigenous in India, but growing wild in most tropical countries. The seeds are small, hard, of a bright scarlet color, with a black spot around the hilum, and contain an alkaloid, some fixed oil, sugar, a principle resembling Glycyrrhizin, and A brie Acid, C12H24N30 ; but neither of these is believed to be the active principle. Preparation. Infusum Abri, Infusion of Jeriquity (Unofficial),—prepared by macerating three powdered seeds in of cold water for twelve hours, adding 3;ss of boiling w'ater, and filtering when cold. It should be used while fresh, as after two or three days it is worthless. Another formula contains gr. ix of Jeriquity to the with gr. iv of Boric Acid to prevent decomposition. Physiological Action and Therapeutics. Jeriquity seeds, when moistened with water, become highly poisonous. If applied to the conjunctiva, a severe inflammation is set up, with oedema and false membrane, ulceration of the cornea, and extension to the lids, face, neck and submaxillary glands. Inserted into a wound in cattle, they cause death in a few hours. The irritant action is believed to result from the presence in the seeds of some ferment, or perhaps great numbers of gonidia, which develop rapidly on a suitable tissue. The in- fusion, in a short time, swarms with bacteria. Jeriquity is used for the purpose of producing a purulent or croupous conjunctivitis, by which to destroy old granulations (trachoma) and pannus. A mild infusion is applied to the eye two or three times a day for two days, and followed by weak 18 ABSINTHIUM—ACACIA. solutions of Alum or Borax. This should be repeated after three weeks if necessary. An emulsion of the seeds in water is a useful application to unhealthy ulcers and lupus. ABSINTHIUM, Wormwood,—the leaves and tops of Artemisia Absinthium, a perennial garden herb of the nat. ord. Compositae, indigenous in Europe, but cultivated in the United States. The leaves are about 2 inches long, hoary, silky-pubes- cent, petiolate, pinnately two or three-cleft; heads numerous, with small, pale-yellow florets, odor aromatic, taste persistently bitter. It contains a volatile oil and a bitter principle, Ab- sinthin. Dose, gr. xx-xl, in infusion. There are no official preparations, except Vinum Aromaticum (see Alcohol), of which Absinthium constitutes one per cent. Absinthe, the French liqueur, is an alcoholic solution of the oil, containing also extracts of Anise, Marjoram, and Angelica. Its continued use produces various nervous symptoms, morning nausea and vomiting, also a tendency to epileptiform convulsions. Physiological Action and Therapeutics. The bitter constituent of Absinthium is stimulant to the di- gestive organs, but the oil is a narcotic poison, increases the car- diac action, and produces tremor, stupor, epileptiform convul- sions, involuntary evacuations, and stertorous breathing. It is but little used in medicine, and only as a stomachic tonic in dyspepsia. ACACIA, Gum Arabic,—is a gummyexudation from Acacia Verek, a small tree of the nat. ord. Leguminosse, indigenous in Africa—also from other species of Acacia. It occurs in sphe- roidal tears of various sizes, breaking with a glassy, sometimes iridescent fracture; insoluble in alcohol, but soluble in water, forming a thick and mucilaginous liquid. It consists of Arabia or Arabic Acid, CmHmOu, combined with calcium, potassium, and magnesium. Preparations. Mucilago Acacia,—has of Acacia 34, Water to 100 parts. It should not be prescribed with tinctures or spirits except in very small quantity. Dose, indefinite. Syrupus Acacias,—has of the Mucilage 25, Syrup 75. Should be freshly made. Dose, indefinite. Acacia enters into the composition of Mistura Amygdalae, Mistura Glycyr- rhizae Composita, Pul vis Cretae Compositus, Trochisci Cretae, Trochisci Cu- bebae, and Trochisci Glycyrrhizae et Opii. ACIDUM ACETICUM. 19 Physiological Action and Therapeutics. Gum Arabic has no activity except the negative one of a demul- cent, and is chiefly used in coughs, sore throats, catarrhal inflam- mation of the stomach and intestines, and irritant poisoning. It is much employed in pharmacy to suspend insoluble powders in mixtures, for which purpose the mucilage is generally used. ACIDUM ACETICUM, Acetic Acid,—is a liquid com- posed of 36 per cent, of absolute Acetic Acid, HC2H302, and 64 per cent, of water. It is a clear, colorless liquid, of a distinctly vinegar odor, a purely acid taste, and a strongly acid reaction; sp. gr. 1.048 at 590 F. ; miscible in all proportions with water and alcohol, and wholly volatilized by heat. It is prepared from wood by destructive distillation and purification. Acetic Acid is also official in two other degrees of concentration, viz.— Acidum Aceticum Glaciale, Glacial Acetic Acid, HCjH302,—is nearly or quite absolute Acetic Acid, solid below 590 F., above that temperature a colorless liquid of sp. gr. 1.056 to 1.058. Is strongly escharotic and only used locally. Acidum Aceticum Dilutum, Diluted Acetic Acid,—consists of Acetic Acid 17, Distilled Water 83 parts, contains 6 per cent, of absolute Acetic Acid, and has a sp. gr. of 1.0083. Dose, zj-ij. Acktum, Vinegar Unofficial),—is an impure diluted Acetic Acid, pro- duced by the acetous fermentation of any liquid susceptible of the vinous fermentation. Diluted Acetic Acid is used in the preparation of the four official Aceta (Vinegars). Physiological Action. Acetic Acid, like the other vegetable acids, in concentrated form is escharotic and produces gastro-enteritis if swallowed. In dilute form it acts as a refrigerant, diminishing thirst and allaying restlessness. It forms salts in the stomach, thus enters the blood, and is there oxidized, producing carbonic acid, and thereby increases the acidity of the urine. It is also diuretic. Long used, it causes emaciation and poverty of the blood, pro- ducing a general scorbutic condition. It is hemostatic and anthelmintic, and the vapor inhaled causes reflex contraction of the vessels and raises the blood-pressure. Therapeutics. The glacial acid is used as a caustic in many skin affections, as warts, condylomata, etc., and to destroy the parasite in ringworm and pityriasis. It has been employed locally in carcinoma, with 20 ACIDUM BORICUM. the view of dissolving the supposed cancer-cells. The dilute acid is used locally in superficial inflammations of the skin, and may be sponged over the body to check perspiration and reduce the surface temperature in fevers. It is often administered internally to reduce obesity, which it does by impairing digestion. Locally, it may be employed to arrest slight hemorrhages, as epistaxis; and is occasionally used by enema for the destruction of ascarides. ACIDUM BORICUM, Boric or Boracic Acid, H3Bo3, —is a weak acid occurring in transparent, colorless, six-sided plates, of unctuous touch, odorless, of a cooling and slightly bitter taste, soluble in 25 of water and in 15 of alcohol at 590 F., in 3 of boiling water and in 5 of boiling alcohol. It is produced from Borax by the action of Sulphuric Acid. Dose, gr. v-xx. There is only one official Borate, viz.— Sodii Boras, Borate of Sodium, Borax, Na2B4Or ioH20,— colorless, transparent prisms, of cooling and sweetish, afterwards alkaline taste and alkaline reaction, soluble in 16 of water at 590 F., and in 0.5 of boiling water; insoluble in alcohol. Oc- curs native in ancient lake beds in various parts of the world. Dose, gr. v-xl. Unofficial Preparations. Boro-glyceride,—is a solid chemical compound, prepared by heating together Boracic Acid and Glycerin. It is soluble in water, but is generally used in solution of equal parts of pure Glycerin and Boro-glyceride. It com- bines readily with Chrysarobin, Carbolic Acid, Atropine, and Morphine, and is used as a local application in eye-diseases and skin affections. Boracic Ointment,—has of Boracic Acid 1, White Wax 1, Paraffin 2, Almond Oil 2, thoroughly mixed together. Boracic Lotion,—is a saturated solution of the acid in water. Boracic Lint,—prepared by steeping lint in a boiling saturated solution and drying. It contains nearly one-half its weight of the acid. Magnesii Boro citras, Borocitrnte of Magnesium,—prepared extempora- neously thus,— B. Magnesii Carbonatis 3j, Acidi Citrici 39, Sodii Biborat. afij. Aquae Bullientis 5viij. A tablespoonful three or four times daily as a solvent of uric acid calculi. Potassii Tartra boras, Tartraborate of Potassium,—is a better solvent of uric acid calculi than the Magnesium salt, and is soluble in 2 parts of cold water. Prepared by heating together Boracic Acid 1, Potassii Bitartras 4, Water 10 parts. Dose, gr. xx, largely diluted with water, three or four times a day. Physiological Action and Therapeutics. Boracic Acid is an efficient antiseptic, disinfectant, and deo- dorant, arresting fermentation and putrefaction, and very de- structive to low organisms. A solution of 1 in 133 arrests the activity of bacteria. It is feebly acid and but slightly irritant, ACIDUM CARBOLICUM. 21 and is used as a surgical dressing for its antiseptic and unirritating qualities. Its lotion and ointment have been successfully em- ployed in ulcers, eczema, burns and scalds, pruritus ani, fetid perspiration, wounds, tinea tonsurans, and tinea circinata. The Borate of Sodium is antiseptic and disinfectant, as it also destroys low vegetable organisms. It removes the epidermis when locally applied, has power to increase uterine contraction, and aids the solution of Benzoic Acid. It is employed as a wash to remove the epidermis from the skin, and as a lotion in acne, freckles, chloasma, leucorrhoea, aphthae, etc., and to allay itching in urticaria, psoriasis, impetigo, and in pruritus pudendi, scroti et ani. It has been used internally in amenorrhoea, dysmenorrhcea, puerperal fever and puerperal convulsions, for its supposed spe- cific action on the uterus. Boro-glyceride in solution (i to 40) is also a powerful anti- septic, and is used as a lotion in purulent ophthalmia and in the treatment of wounds, also as a local application to diphtheritic membranes. It is an efficient preservative of milk and food against putrefactive changes, and is entirely harmless. An elegant cosmetic cream maybe made by dissolving Boracic Acid in Glycerin, and then incorporating it with White Wax and Almond Oil. ACIDUM CARBOLICUM, Carbolic Acid, Phenic Acid, Phenylic Alcohol, Phenol, C6H5HO,—is an alcoholic product of the distillation of coal-tar between the temperatures of 356° and 3740 F. It occurs in needle-shaped crystals of tarry odor and burning taste, is liquefied by about 5 per cent, of water, soluble in 20 of water at 590 F., and very soluble in alcohol,- ether, chloroform, glycerin, oils, etc. Peculiarities about Car- bolic Acid are that about 5 per cent, of water liquefies it, a further addition of water renders it turbid, until 2000 parts of water to 100 of the acid have been added, when a stable and clear solution is formed. One volume of liquefied Carbolic Acid containing 5 per cent, of water forms with one volume of Glycerin a clear mixture which is not rendered turbid by the addition of three volumes of water (absence of Creasote and Cresylic Acid). It does not redden blue litmus paper, but combines freely with alkalies and other salifiable bases, the products having an alkaline reaction and being decomposed by the feeblest acids (carbonic, etc.). Dose, gr. }(-). Acidum Carbolicum Crudum, Impure Carbolic Acid,—is obtained as above stated, but at a lower heat (338° to 3740 F.), 22 ACIDUM CARBOLICUM. and contains Carbolic, Xylic, and Cresylic Acids in varying pro- portions, together with other impurities. It is used as a disin- fectant. Preparations. Unguentum Acidi Carbolici,—strength io per cent., Ointment 90. Glyceritum Acini Carbolici (Unofficial),—Carbolic Acid 1, Glycerin 4. Aqua Acidi Carbolici (Unofficial),—has of the Glycerite gx to Aqua; Oj. Dose, 3j-gss. Carbolic Acid Gauze (Unofficial),—is medicated with Ac. Carbol. 1, Resin 5, Paraffin 7 parts. Carbolic Acid Plaster (Unofficial),—has of Carbolic Acid 25, Shellac 75, coated with Gutta-percha dissolved in Carbon Disulphide. Carbolic Acid Solutions, for antiseptic surgery, are— 5 per cent, in Water, as a spray or wash. 2 i/2 per cent, in Water, for sponges, hands, or as a lotion. 5 per cent, or less in Olive Oil, as a special dressing. Official Derivative Salts. Sodii Sulpho-Carbolas, Sulpho-carbolate of Sodium, NaC6TI5S04.2pI20, —prepared by dissolving Carbolic Acid I, in strong Sulphuric Acid 1, thus form- ing Sulpho-carbolic Acid, which is then neutralized with Carbonate of Sodium. Transparent, rhombic prisms, soluble in 5 of water at 590 F., less freely in alco- hol and glycerin. Dose, gr. x-xxx. Analogues. Creasotum, Creasote,—is a similar product, obtained from wood-tar, but by the action of Nitric Acid it is converted into Oxalic Acid chiefly, while by the same reagent Carbolic is converted into Picric Acid. Creasote does not coagulate albumen or collodion, Carbolic Acid does. Creasote is described under its own title. Resorcin (non-official), C6H602,—is also a phenol, obtained from certain resins by the action of fusing alkalies. [Described under its own title.] Physiological Action. Carbolic Acid is a powerful antiseptic and antiferment, being destructive to all low forms of life. It is a local anaesthetic and a superficial escharotic, coagulating albumen and also the blood when out of the body. Taken internally undiluted it produces violent gastritis, uivj of the pure acid having caused dangerous symptoms. It stimulates the cardiac inhibition, first slowing, then depressing, and finally paralyzing the heart. Respiration, at first increased, is soon depressed, the pupils are contracted, and both brain and spinal cord are directly affected ; stupor, coma, suspended reflexes, impaired motility and sensibility being pro- duced. It is rapidly absorbed and diffused, many fatal cases having occurred from its external use. It is partly oxidized in the blood, and partly eliminated by the lungs and kidneys, im- parting to the urine a peculiar olive-green or smoky color. ACIDUM CHROMICUM. 23 Locally applied Carbolic Acid produces on the skin or mucous membrane a white superficial eschar which succeeds to burning pain of short duration. Antidotes and Antagonists. Liquor Calcis Saccharatus, or the official Syrupus Calcis, given freely; or Sodium Sulphate to form the Sulpho-carbolate of Sodium, are the chemical antidotes. Vegetable demulcents (but no oils or glycerin) to protect the mucous surfaces. Atropine is a very complete physiological antagonist to the systemic symptoms, maintaining the heart and respiration until elimination occurs. Therapeutics. Carbolic Acid owes its prominence to its having been the principal agent used in the antiseptic method of treating wounds; but lately its employment in that connection has become much restricted, and many of the most prominent surgeons have aban- doned it altogether in favor of other germicides. For nausea and vomiting it is an excellent remedy in grain doses, and in many chronic pulmonary affections it is used with benefit by spray. It maybe employed locally in acute and chronic catarrhs, parasitic skin diseases, uterine and other ulcers, abscesses, boils, and carbuncles, endo-metritis, and perhaps in pulmonary phthisis. It has proven of temporary benefit in diabetes of hepatic origin. It has been injected parenchymatously (2 per cent, solution) in erysipelas, pleuro-pneumonia, intermittents, synovitis, lupus, chancroid, hydrocele, etc. The Sulpho-carbolates of Sodium, Potassium, Calcium, and Magnesium, have been employed advantageously in the septic diseases (as the exanthemata, diphtheria, puerperal fever), the object being to obtain the antiseptic and antipyretic actions of Carbolic Acid without its dangers. They may be used locally with good results in aphthae, tonsillitis, otorrhoea, gonorrhoea, and inflamed mucous membranes generally. ACIDUM CHROMICUM, Chromic Acid, Cr03is obtained by the action of Sulphuric Acid upon Potassium Chro- mate, and occurs in small crimson needle-shaped crystals, deli- quescent and very soluble in water. Brought in contact with alcohol mutual decomposition takes place. A similar result and perhaps sudden combustion results when it is placed in contact with other easily oxidizable substances, such as Glycerin, Spirit of Nitrous Ether, etc. It is not used internally. Potass11 Bichromas, Bichromate of Potassium, K2Cr207,—large, orange- red prisms of disagreeable, metallic taste and acid reaction, soluble in io of 24 ACIDUM CHROMICUM. water at 590 F., and in i| of boiling water, insoluble in alcohol. Used locally in aqueous solution (gr. v-gj to the %), and internally in doses of gr. in trituration. Physiological Action and Therapeutics. Chromic Acid is a powerful escharotic, penetrating deeply, but slow of action and not very painful. It coagulates albumen and parts readily with its oxygen, oxidizing organic matter and decomposing ammonia and sulphuretted hydrogen. It is there- fore an energetic disinfectant and deodorizer. When used as a caustic it is mixed with sufficient water to make a paste, which may be employed for the destruction of warts, hemorrhoids and other superficial growths, the neighboring parts being protected by cotton soaked in a strong alkaline solution. For syphilitic warts and condylomata, lupus, tinea tonsurans, etc., a solution of 100 grains to the 3 of distilled water is generally used. A solu- tion of 1 in 40 is an excellent and inexpensive antiseptic lotion for putrid sores and wounds, syphilitic affections of the tongue, mouth and throat, ozaena, leucorrhoea, and gonorrhoea. In ute- rine catarrh and hemorrhages a solution of 120 grains to the 3 has been injected into the uterine cavitywith good results. Bichromate of Potassium is a good antiseptic and an escha- rotic of milder action than the acid. In doses of 3ij-iv it has proved fatal to life in adults, with symptoms of gastro-enteritis, suppression of urine, and cardiac paralysis. It is chiefly employed as a local application in saturated solution to warts and venereal condylomata; and in dilute solution (gr. j-x to the 3) for catarrhal conditions of the nasal, buccal, or vaginal mucous mem- brane. Internally it has been employed with benefit in locomotor ataxia and in dyspepsia simulating gastric cancer; also in chronic gastric catarrh, the tongue having a thick yellow coat, in chronic diarrhoea from intestinal ulceration, and in chronic ulcers of the pharynx and mouth. It is a good remedy in syphilitic sore throat, local rheumatism of the fibrous tissues, periosteal and syphilitic rheumatism, and acute catarrh and influenza, chronic nasal catarrh, chronic laryngitis, and chronic catarrhal affections of the bronchial mucous membrane, especially when the expectoration is tough and stringy. It has also been used with some success in membranous croup and diphtheria. In pharmacy it is employed in the preparation of Chromic Acid and Valerianic Acid, and as a test solution. Most of the medical galvanic and faradic bat- teries are run by a mixture of this salt with Sulphuric Acid. Poisoning by it should be treated as directed for that by mineral acids. - . ...... ACIDUM FLUORICUM—ACIDUM GALLICUM. 25 ACIDUM FLUORICUM, Fluoric Acid,HF(Unofficial), —isastrongescharotic, acting deeply and leaving a dry and painful slough. The dilute acid (1 in 200) is prepared by acting on fluor spar by Sulphuric Acid, the resulting gas being dissolved in water. Its dose is xx-xxx, well diluted. T herapeutics'. Dilute Fluoric Acid has been successfully used as an internal remedy in goitre, and the gas has been inhaled with benefit in diphtheria and membranous croup. ACIDUM GALLICUM, Gallic Acid, HC7H505.H20,— is a nearly colorless solid in long needles or triclinic prisms, having a slightly acid and astringent taste, soluble in ioo of water and in 4*4 of alcohol at 590 F., and in 3 of boiling water. It is pre- pared from a paste of powdered galls (see Galla), by fermenting for six weeks, boiling and reboiling in water, filtering and crys- tallizing. According to some authorities the Tannic Acid of the galls is split up into Gallic Acid and glucose by fermentation ; but according to others the glucose is an impurity and the Tannic Acid is simply converted into two parts of Gallic Acid, CuHi0O,+ H1O=(HC7H5O5)2. Dose, gr. v-xv, in solution, pill, or powder. Acidum Pyrogallicum, Pyrogallic Acid, C6Hs(HO)s (unoffi- cial),—is obtained from Gallic or Tannic Acid by careful heating. Dose, gr. j-ij. Preparations. Unguentum Acidi Gallici,—is a 10 per cent, ointment, with a basis of Benzoinated Lard. Vegetable Astringents depend for their medicinal value upon the Gallic and Tannic Acids contained in them. Such are— Alnus, Alder Bark. Castanea, Chestnut Leaves. Catechu, Catechu. Diospyros, Persimmon. Galla, Nut Galls. Geranium, Cranesbill. Granatum, Pomegranate. Hamamelis, Witch Hazel. Haematoxylon, Logwood. Heuchera, Alum Root. Kino, Kino. Krameria, Rhatany. Myrica, Wax Myrtle. Nymphaea, Pond Idly. Quercus Alba, Oak Bark. Rosa Gallica, Red Rose. Rvjbus, Blackberry. Statice, March Rosemary. Physiological Action. Gallic Acid, and its congener Tannic Acid, are astringents, the former being the more feeble of the two. They differ in that Tannic Acid coagulates albumen and gelatin, while Gallic does 26 ACIDUM HYDROBROMICUM DILUTUM. not. Tannic Acid is converted by the organism into Gallic and Pyrogallic Acids, in which forms it is absorbed and excreted. According to some authorities the difference between Gallic and Tannic Acids is one of oxidation, according to others of hydra- tion ; the latter assuming Tannic Acid to be simply Gallic Acid Anhydride. They constringe the muscular tissue in the walls of the minute vessels, thus checking secretion and hemorrhages and cutting short local inflammations. Except in enormous doses they are harmless. [Compare Acidum Tannicum.] Pyrogallic Acid may act as an intense poison, having been absorbed from the surface with fatal results, preceded by vomiting and diarrhoea, rigors, and fever, black urine full of globulin, and disorganization of the blood-corpuscles. It has great affinity for oxygen and maybe used as an antiseptic and disinfectant in 1 to P/z per cent, solutions. Antagonists and Incompatibles. Mineral acids, alkalies, per-salts of iron, and salts of antimony, lead, and silver are chemically incompatible. Therapeutics. Gallic Acid is preferred to Tannic Acid when an astringent action is desired upon remote parts, as the lungs, kidneys, etc., which can only be reached through the circulation. In hematuria, distant passive hemorrhages, albuminuria, diabetes insipidus, bronchorrhoea, night-sweats, chronic diarrhoea, and chronic cystitis, it is a most useful remedy. Pyrogallic Acid has been used internally in two-grain doses for internal hemorrhages. As an ointment (3j_3j) it is next to Chrysarobin as an efficient palliative in psoriasis, and has been used with good results in lupus and epithelioma, being supposed to attack the diseased nodules only, leaving the adjacent skin uninjured. ACIDUM HYDROBROMICUM DILUTUM, Di- luted Hydrobromic Acid,—is composed of io per cent, of absolute Hydrobromic Acid (HBr), and 90 per cent, of water. It is a clear, colorless, atjd odorless liquid, of a pungent acid taste, produced by decomposing Potassium Bromide by Sulphuric Acid and distilling. Dose, n^xx-3ij. Physiological Action and Therapeutics. Hydrobromic Acid has identical action on the nervous system and circulation with that of the Bromides. Added to a mixture ACIDUM HYDROCHLORICUM. 27 of Quinine and water ij to each grain of Quinine) it will produce a clear solution. In hysteria, congestive headaches, neuralgia, and nervous exhaustion, Hydrobromic Acid has been found useful. Used as a solvent of Quinine it retards cinchonism, and prevents the headache resulting from the full action of Quinine and Iron. As a substitute for the Bromides of Sodium and Potassium it is highly recommended, being much less depressant. It has been especially recommended in tinnitus aurium. Fothergili uses it for coughs of reflex or spasmodic nature, also for simple continued fever where there is cerebral disturbance. ACIDUM HYDROCHLORICUM, Hydrochloric Acid, Muriatic Acid,—is a liquid composed of about 32 per cent, of absolute Hydrochloric Acid Gas, HC1, and 68 per cent, of water. It is colorless and fuming, of specific gravity 1.160, pungent odor, intensely acid reaction and taste, and is obtained by the action of Sulphuric Acid upon Sodium Chloride, the resulting gas being carried through water which dissolves it. It is sometimes used as a caustic. Its union with basic substances forms salts, called Hydrochlorates (Muriates), of which four are official, viz.: the Hydrochlorates of Apomorphine, Morphine, Pilocarpine, and Quinine, described under the titles of their respective bases. Preparations. Acidum Hydrochloricum Dilutum,—is a 10 per cent, solution of the absolute acid in water. Dose, nj; iij-x. Acidum Nitro-hydrochloricum,—see under Acidum Nitricum. Physiological Action of the Mineral Acids. The mineral acids (Hydrochloric, Sulphuric, Nitric, Nitro- hydrochloric, and Phosphoric) resemble each other in general action so closely that they may all be described in this place. The strong acids are escharotic, abstracting the water of the tissues, combining with the albumen and other bases, and de- stroying the protoplasm. They are very diffusible, redestroying the albumen after precipitating it (except Nitric Acid). Sulphuric and Phosphoric have a strong affinity for water, completely decomposing tissues to which they are applied, and are therefore the most powerfully escharotic. Nitric Acid does not readily redissolve the albumen precipitated by it, which thus forms a bar- rier against the deep action of the acid. Sulphuric Acid chars or carbonizes the tissues black, while Nitric and Hydrochloric tan them yellow. 28 ACIDUM HYDROCHLORICUM. The dilute acids produce a peculiar taste in the mouth and a sensation of roughness on the teeth. They stimulate the flow of saliva from the parotid and submaxillary glands, but have no action on the sympathetic saliva. They promote the alkaline intestinal secretions and excite the flow from ducts having an alkaline secretion (bile, etc.), but check that from those whose secretion is acid (gastric, etc.). Secretion generally is promoted by Nitric Acid, and lessened by Sulphuric, Hydrochloric acting between the other two. Given before meals, in small doses, they relieve acidity of the stomach by checking the production of the acid gastric juice. At first they aid digestion, being synergistic to the action of pepsin, but if continued they impair digestion by lessening the production of the gastric juiv. Tinctures of Aconite root vary greatly in strength. In Fleming’s Tincture 79 parts of aconite are used in preparing 100 of the tincture, in that of the Br. P. 16, the French 20, the German 10, while the Linimentum Aconiti (B. P.) is really a very strong tincture, of the strength of 1 to Probably the best and safest preparation for ordinary use is a 10 per cent, tincture, of which the maximum single dose for an adult is stated in the P. Ger. at ix, and the maximum daily dose at uj; xxxv. The best rule for the administration of aconite preparations is to give the minimum dose at intervals of 15 to 20 minutes, until the desired effect is pro- duced. Unofficial Preparations. Aconitina, Aconitine, C33H43N012,—a white, and usually amorphous solid, of alkaline reaction, soluble in i5oof cold and in 50 of hot water; much more soluble in alcohol and ether. Is difficult to obtain of constant strength, some samples being all but inert, others extremely active. As obtained in the shops it is usually a mixture of several alkaloids. The Aconitine crystalisee of Duquesnel, which, according to Squibb, is a nitrate of aconitine, is consid- ered to be the most active of those in the market. Dose, gr. - 5V Oleatum Aconitine,—is a 2 per cent, solution in Oleic Acid, for external use. Duquesnel’s crystals will not dissolve in Oleic Acid (Squibb). Napellina, Napelline,—is weaker than Aconitine, and has been used in doses of gr. |-f. It has lately been studied by Laborde, who claims for it most valuable hypnotic properties, and proposes to use it as a substitute for opium and chloral. St. Jacob’s Oil (a patent medicine),—is a weak Aconite Liniment, which also contains Ether, Alcohol, Turpentine, red coloring matter and water (Squibb). Physiological Action. Aconite is a powerful depressant of the heart, the respiration and the spinal system. It is also antipyretic, diaphoretic and diuretic. It paralyzes both the sensory and motor nerves—the sensory being affected first and from the periphery inwards, while the motor nerves are affected from the centres outwards. It re- laxes the inhibitory apparatus of the heart, and paralyzes the cardiac muscle and its contained ganglia, the respiratory centres, ACONITUM. 41 and the spinal cord in all its functions—sensory, reflex and motor; but does not affect the cerebrum. Its taste is bitter, acrid and pungent. Soon after the ingestion of even a small quantity, a sensation of numbness and a persistent tingling are felt in the tongue and lips. Full medicinal doses cause a sense of constriction in the fauces, irritation of the gas- trointestinal mucous membrane with increased secretion ; some- times nausea and vomiting, and severe pains in the joints and muscles; always more or less salivation, diaphoresis and diuresis; reduced respiratory power, cardiac rate and force; lowered arterial tension and temperature. A lethal dose produces great muscular weakness, dim sight, dilated (sometimes contracted) pupils; shallow, irregular, and labored respiration, slow and weak pulse, cold surface, clammy sweat, great anxiety, numbness and tingling in the extremities, lowered body-temperature (20 to 30), abolished sensation, im- paired reflexes and motility, and finally death from paralysis of the heart and respiration, with or without convulsions, conscious- ness being preserved until near the end, when C02 narcosis sets in. Aconite is rapidly diffused and slowly excreted, the effects of a full medicinal dose continuing for three or four hours. Applied externally, it paralyzes the sensory nerves of the part, producing its characteristic numbness and tingling. A ntagonists. Atropine, Morphine and Ammonia antagonize its effects on the heart and respiration. Digitalis counteracts its heart action and the relaxation of cardiac inhibition. In Aconite poisoning, the stomach should be evacuated, warmth applied to the extremities, stimulants administered, artificial respira- tion if necessary, and the recumbent posture strictly maintained. Therapeutics. Aconite antagonizes the fever process, and rightly used is therefore one of the most valuable drugs we possess. It has well been called the “ therapeutic lancet,” and is certainly responsible to a great extent for the disuse of venesection. Its power over the circulation, respiration and transpiration renders it of the greatest value in all affections characterized by high resisting pulse, dry hot skin, and elevated body-temperature. It is espe- cially useful in acute throat affections, the early stage of acute inflammations of the respiratory organs, catarrhal croup, acute pleuritis and peritonitis before the stage of effusion, simple and eruptive fevers, puerperal and surgical fevers, facial erysipelas, acute rheumatism, cardiac affections with overaction or hyper- trophy and without valvular lesion, diarrhoea and dysentery from 42 ADEPS—.ETHER. cold or exposure, menstrual Suppression from chill, and neuralgia of the 5th (externally and internally), it having a selective influ- ence on that nerve. It is also highly recommended in otitis, nervous palpitations, restlessness, and sick headache, as also in the acute stage of gonorrhoea. Aconite is best administered in small doses frequently repeated ; from half a drop to a drop of the tincture every fifteen minutes in a teaspoonful of water giving as a rule better results than a pro- portional quantity at longer intervals. Aconitine has been remarkably efficient in trigeminal neuralgia, and Napelline in the same affection, and as an hypnotic. ADEPS, Lard ,—is the prepared internal fat of the abdomen of Sus scrofa (Pig), purified by washing, melting and straining. A soft, white, unctuous solid, of bland taste and neutral reaction, entirely soluble in ether, benzin, and bisulphide of carbon ; com- posed of 38 per cent, of stearin and margarin, and 62 per cent, of olein. Lard forms 70 per cent, of Ceratum, and 80 per cent, of Unguentum, and enters into the composition of several of the official cerates. Preparations. Adeps Benzoinatus, Benzoinated Lard,—has 2 per cent, of Benzoin in powder incorporated by stirring. Oleum Adipis, Lard Oil,—is a fixed oil expressed from lard at a low tem- perature. Physiological A ction. The actions of the Oils and Fats will be described under Mor- rhile Oleum (which see). Therapeutics. Lard is only used as an ingredient of ointments and cerates. Lard Oil is used in making the Unguentum Hydrargyri Nitratis, but has been proposed as an inferior substitute for Cod-liver Oil in cases where the taste of the latter is particularly offensive. AETHER, Ether, Ethyl Oxide (CjH^O,—in its absolute form is not official, the strongest preparation containing 6 per cent, of alcohol and some water. Considered as a generic term, an ether is analogous to a salt, as an alcohol is to a metallic hy- drate. The particular ether officially so named is Ethyl Oxide, prepared from Ethyl Hydrate (Ethylic Alcohol) by a dehydrating agent with the aid of heat, and then purified by various processes. The agent used is Sulphuric Acid, hence this ether is improperly ATHER. 43 called “ Sulphuric Ether,” but the acid simply dehydrates the alcohol and remains in the retort, becoming constantly more diluted by the abstraction of water from the alcohol. Conse- quently H20 is the difference between Alcohol and Ether. (C2H80)2—H20 = (C2H5)20. The official ethers are the three following, viz.— .Father, Ether,—is a liquid composed of about 74 per cent, of Ethyl Oxide, and about 26 per cent, of Alcohol containing a little water; an inflammable, thin, very diffusive, clear and colorless liquid, having a burning, sweetish taste, and a neutral reaction, of sp. gr. about 0.750 at 590 F. Its vapor is heavier than air and forms therewith a highly explosive mixture. Ether is freely soluble in alcohol, chloroform, benzol, oils, and in 8 volumes of water at 590 F. It boils at the temperature of the body (98.6°), and is a solvent of oils, fats, resins, caoutchouc, gutta-percha, and many other substances. It has chiefly a phar- maceutical value. Fther Fortior, Stronger Ether,—is a liquid composed of about 94 per cent, pf Ethyl Oxide, and about 6 per cent, of Alcohol containing a little water. Sp. gr. not above 0.725 at 590 F. It is the preparation employed for anaesthetic use, and is generally though improperly called “Sulphuric Ether,” a term which belongs to Ethyl Sulphate (C4H10SO4). The dose of Fther Fortior for internal administration is in syrup. Fther Aceticus, Acetic Ether, Acetate of Ethyl, C,H5C2HsO, —is an inflammable liquid, transparent and colorless, of ethereal and acetous odor, soluble in alcohol, ether, chloroform, and 17 of water. Sp. gr. 0.889 to 0-897. Is a constituent of Sp. Odor- atus and Tr. Ferri Acetatis. Dose, ttj; x~3j. Hydrobromic Ether, Ethyl Bromide, C2H5Br (Unofficial),— is not inflammable. Dose, internally and hypodermically, itjt x~3j. Hydriodic Ether, Ethyl Iodide, C2H5I (Unofficial),—is a colorless liquid, non-inflammable, and insoluble in water. Dose, inhaled, ti£ xv. [For the chlorinated Ethers see under Chloroform.] Preparations. Oleum Athereum, Ethereal Oil,—is a volatile liquid, consisting of equal volumes of heavy Oil of Wine and Stronger Ether. Used to prepare the Spt. Atheris Comp., and as it occurs in commerce is usually a worthless preparation. Spiritus Atheris, Spirit of Ether,—has of Stronger Ether 30 parts, Alco- hol 70. Dose, Tijx-^j. Spiritus Aether is Compositus, Hoffman’s Anodyne,—contains Stronger Ether 30, Alcohol 67, Ethereal Oil 3 parts. Dose, njjv-^j. Spiritus Atheris Nitrosi, Spirit of Nitrous Ether, Sweet Spirit of Nitre, —is an alcoholic solution of Ethyl Nitrite, C2H5N02, containing 5 per cent, of 44 /ETHER. file crude ether. It turns acid with age, and should not be kept long. It is a constituent of Mist. Glycyrrhizse Co. (3 per cent.). Dose, Its in- compatibles are Potassic Iodide, Ferric Sulphate, Tr. Guaiaci, Tannic and Gallic Acids. Anasthetic Mixtures. Nussbaum’s has—Ether 3 parts, Chloroform 1, Alcohol 1. Vienna General Hospital uses—Ether 9, Chloroform 30, Alcohol 9. The “ Vienna Mixture,”—Ether 3, Chloroform 1. Committee of Medico-Chirurgical Society of London (1864) pro- posed—Ether 3, Chloroform 2, Alcohol 1. Physiological Action of Ether. Ether is anodyne, antispasmodic, diaphoretic and anthel- mintic ; a cardiac and cerebral stimulant, an anaesthetic, and a narcotic poison. Given internally, it stimulates the secretions of the stomach, salivary glands and pancreas. On the cerebrum and the motor and sensory nerves its action is similar to that of alcohol, but more prompt and less protracted. It is eliminated rapidly, chiefly by the lungs. Externally it is a powerful refrigerant and local anaesthetic; also rubefacient wheivubbed into the skin. Inhaled Ether produces at first faucial irritation, a sense of strangulation and cough; then a stage of excitement (cerebral intoxication), in which the face is flushed and the respiration and pulse are accelerated. A tetanic convulsive s’- >ge generally fol- lows, the face being cyanosed, the muscles rigid, and the respira- tion stertorous. This soon subsides, and complete insensibility is established, the muscles being then relaxed, the reflexes abolished, and the cerebral functions suspended, the lower centres in the medulla carrying on the processes of respiration and circula- tion. If the inhalation be continued, these also become paralyzed, death usually resulting from slow paralysis of respiration, the heart pulsating long after breathing has ceased. [Chloroform usually paralyzes the heart.] If the inhalation be discontinued before the lower centres are affected, the patient gradually emerges from the condition of insensibility, and, as the narcosis subsides, vomiting is usually experienced. Compared with Chloroform. Ether is less irritant than Chloroform to the mucous membranes when swallowed, but its vapor is more irritant to the air-passages. It is more of a general stimulant, and less depressant to the heart and circulation. It does not clot the blood. Its vapor is very inflammable, less pleasant to inhale, slower in action, has a longer stage of excitement, and a less profound narcosis, and causes a greater degree of vomiting. It is much less dangerous than .ETHER. 45 Chloroform, death from the inhalation of Ether occurring slowly and usually by paralysis of respiration—from Chloroform it is almost always sudden, and by paralysis of the heart. Ether has undoubtedly caused a number of deaths, besides several which occurred some hours after the anaesthesia. The reported cases of fatal Chloroform narcosis number about 500, those from Ether about 20. Modes of Dying from. Anesthetics. (1.) From sudden paralysis of the cardiac ganglia, early in the inhalation, by reflex action proceeding from some peripheral injury before complete anaesthe- sia is produced. Thus, in the extraction of teeth, a small quantity of Chloroform having been administered, the heart is enfeebled, and the cerebral hemispheres paralyzed, but not the basal or medullary ganglia. If at this stage the 5th nerve be irritated, by the intimate relation of its nucleus with that of the pneumogastric reflex inhibition may be transmitted over the latter, arresting the cardiac ganglia. The stage of incomplete anaesthesia is always a dangerous one in which to perform any operation. (2.) In the stage of rigidity, from tetanic fixation of the respiratory muscles, the blood backing up on the venous side, and the arresting of the heart’s action, respiration ceasing before the cardiac action is stopped. (3.) In the stage of complete relaxation, by paralysis of respiration; or by paralysis of the tongue, causing obstructed respiration. (4.) In the same stage, by paralysis of the motor ganglia of the heart. (5.) From depression of the functions by chloroform narcosis, and from shock,—and may occur in the anaesthetic state, or afterward. Contraindications for Anaesthesia are—fatty degeneration or dilatation of the heart, renal and pulmonary disease, enlarged tonsils, cerebral tumor, and chronic alcoholism—particularly the first and last named. Dangerous Symptoms should be met by withdrawing the vapor and inverting the patient head downwards, drawing the tongue forwards, and applying a cold douche to the face and chest. Atropine hypodermically is an agent of great value in combat- ing the cardiac failure,—artificial respiration and faradization of the respiratory muscles if breathing ceases. Amyl Nitrite by inhalation, or Ammonia hypodermically. Heat to the body and limbs. Notes on Other Anesthetics. A comparison of these agents in respect to their safety has been lately made by Dr. Richardson, who considers Methylic Ether to be the safest of all, and the others as follows: Safe are—Ethyl Bromide, Ethyl Chloride, Ether, Ethene (olefiant gas), Ethene Chloride, Methyl Bromide, Methyl Chloride, Methyl Ether, Methene Chloride, Methane (marsh gas), Nitrous Oxide. Of doubtful value are—Amylene, Amyl Chloride, Butyl Chloride, Ben- zene (benzol), Carbon Disulphide, Carbon Dioxide, Carbon Tetrachloride, Methyl Alcohol, Methylal, Spirits of Turpentine. 46 AETHER. Dangerous are—Amyl Hydride, Butyl Hydride, Carbon Monoxide, Ethyl Hydride. Chloroform and Ethene Dichloride are considered useful, but requiring care. Physiological Action of Other Ethers. Hydriodic Ether is an antispasmodic and a general stimu- lant ; also an anaesthetic if inhaled for a sufficiently long time. Its use as a medicinal agent is chiefly to bring the system rapidly under the influence of iodine. It increases appetite, stimulates the action of the heart, gives vivacity to the general feelings and activity to the intellect. Hydrobromic Ether has a not unpleasant odor, produces but little irritation of the air-passages, has very brief stages of excite- ment and rigidity, and but a short stage of insensibility, with prompt awakening and but little of the mental confusion and excitement consequent on the use of the other anaesthetics. It is not inflammable, acts quickly, and is a good local anaesthetic. Its actions in other respects correspond with those of Ether. Nitrous Ether is a mild diaphoretic, a diffusible stimulant, a carminative, and an efficient diuretic. On the blood it acts simi- larly to Amyl Nitrite, diminishing oxygenation, relaxing the peri- pheral vessels, accelerating the heart’s action, and thus lowering arterial tension. Relaxing the renal and cutaneous vessels, it is diuretic and diaphoretic. Acetic Ether has a pleasant odor and taste, forming agree- able combinations with other carminatives as a stimulant and antispasmodic. Therapeutics. When diluted with alcohol Ether mixes readily with water, and may be administered internally with advantage in indigestion of fats, and to aid the digestion of Cod-liver Oil. It is also given in hysteria to relieve the paroxysm and flatulence, and in hepatic colic from calculi, Ether with Turpentine (Durande’s solvent remedy), which acts only as an anodyne and antispas- modic, is considered by some as of great value. Subcutaneously Ether is used in the algid stage of cholera, sudden cardiac depression, neuralgia, and in the adynamia of hemmorrhage, pneumonia and the eruptive fevers. Local anaesthesia by the Ether-spray affords great relief in neuralgia of superficial nerves, lumbago, chorea, and spinal irrita- tion. In minor surgical operations it is a valuable method. As an Anaesthetic the vapor of Ether is less prompt than that of Chloroform, biit is equally efficient and much safer. It should AGARICUS ALBUS. 47 be inhaled in as concentrated a form as possible, and will then produce insensibility in from 5 to 10 minutes. If a light be in the room it should be high above the patient. A grate-fire or gas- stove in the vicinity is very dangerous. [Compare Chloroform.] Besides its surgical uses ether-ansesthesia is employed in neuralgia, cancer, tetanus, chorea, colic, delirium, puerperal mania and con- vulsions, infantile convulsions, hystero-epilepsy, epileptic seizures, laryngismus stridulus, whooping-cough, and asthma. The un- pleasant after-effects may be greatly modified if not entirely pre- vented by the previous administration of Morphine (gr. and Atropine (gr. Hs) subcutaneously. Hydrobromic Ether had a short period of popularity as an anaesthetic, but fell into disrepute after a few cases of death under its influence, which were probably not due to the agent used (Levis’ and Sims’ cases). Its action is less prolonged than that of Ether, but it has many advantages, requiring only 3j to 3ij rap- idly given, and being uninflammable. Its inhalation has been of especial value in hysteria, epilepsy, chorea and other spasmodic disorders. The Compound Spirit of Ether (Hoffman’s Anodyne) is an admirable agent in gastralgia, colic, flatulence, syncope, etc., also in the various manifestations of the hysterical paroxysm. In combination with the camphorated tincture of Opium it is often remarkably efficient in checking the diarrhoea of hot weather. Spirit of Nitrous Ether is used as a diaphoretic, a diuretic and a carminative; also in expectorant mixtures, as an antipyretic in febrile affections, and to relieve pain in angina pectoris, dys- menorrhoea and asthma. Hydrobromic Ether has been employed subcutaneously in place of Ether in the treatment of such spasmodic affections as whooping-cough, chorea, etc. Its place as an anaesthetic is not determined, having caused two deaths at the very outset of its career. Hydriodic Ether may be obtained in glass capsules con- taining five minims each, and is used by inhalation in chronic pulmonary disorders, cardiac dyspnoea, spasmodic affections of the bronchi and larynx, asthma, and in catarrhal laryngitis with dyspnoea. It is not employed as an anaesthetic. AGARICUS ALBUS, Purging Agaric (Unofficial),—is a fungus, occurring in large white spongy pieces, obtained from the European larch. It contains Agaricin, a crystalline sub- stance, and Agaric Acid; also from 40 to 70 per cent, of resins. 48 AGARICUS CHIRURGORUM AGARICUS MUSCARIUS. Physiological Action. The taste of Purging Agaric is first sweetish, then becoming very acrid and bitter. The powder inhaled causes violent sneezing, and taken internally in full doses it produces watery stools. Small doses check diarrhoea and dysentery, and diminish the secretions of the bronchi and mammae. Therapeutics. Agaricus Albus was formerly employed as a drastic purgative, in doses of gr. xxx to 3j- It has lately been used, with much success, in 15-grain doses of the powder, or 3 grains of the alco- holic extract, to check the night-sweats of phthisis. AGARICUS CHIRURGORUM, Surgeon’s Agaric (Unofficial),—is the interior portion of the fungus Polyporus fomentarius, which grows on the trunks of beeches, birches, and oaks in Europe. It is prepared for use by boiling in weak lye and beating with mallets, and then occurs in light, thin, yellowish- brown pieces, soft and pliable, without odor or taste.. It is almost pure cellulose. It was formerly used as a mechanical hemostatic, and for the purpose of moxa. When soaked in a strong solution of Potassium Nitrate or Potassium Chlorate and dried, it is very inflammable, and is then called Spunk. AGARICUS MUSCARIUS, Amanita Muscaria, Fly- Agaric (Unofficial),—is a poisonous mushroom, of a disagree- able odor and a burning, acrid taste, used in infusion with milk for poisoning flies, and used by the Tartars as an intoxicant. It contains an actively toxic alkaloid, Muscarine, C5H13N02, of syrupy consistence, odorless and tasteless, soluble in water and alcohol, and readily dissolved out by water and dilute acetic acid, so that a doubtful mushroom may be easily rendered innocuous. It may also be produced synthetically, but it is doubtful whether the article so prepared is as active as the natural product. Preparations. Muscarina, Muscarine (Unofficial),—Dose, gr. j-gr. ij. It may be used hypodermically in watery solution. Muscarine Nitras, Nitrate of Muscarine (Unofficial),—may be used hypo- dermically in doses of from gr. to gr. Physiological Action. Muscarine is a powerful respiratory and cardiac depressant, paralyzing the respiratory centre and arresting the heart in dias- AILANTHUS. 49 tole by paralyzing its motor ganglia while stimulating its inhibi- tory apparatus. It lowers the arterial tension, produces profound salivation, lachrymation and sweating, contracts the pulmonary vessels, causing intense dyspnoea, and increases the intestinal, hepatic and pancreatic secretions, but markedly diminishes the renal. It disturbs the gastro-intestinal tract, causing tetanic intestinal contractions, severe colic, vomiting and purging. It produces spasm of the accommodation, marked myosis and con- traction of the pupil when given internally, but dilates the pupil widely when locally applied. [Gelsemium does so also.] Under its action the body temperature is decidedly reduced, and the excre- tion of waste-products is lessened. It is eliminated unchanged by the kidneys. Agaricus acts as an intoxicant to the cerebrum, producing more vertigo and delirium than Alcohol, followed by profound sopor with lowered reflexes, perhaps coma and death. Antagonists. Atropine exactly opposes Muscarine, and rice versa ; no example of physio- logical antagonism being so complete in all particulars. When a frog’s heart is arrested by the topical action of a minute quantity of Muscarine, the appli- cation of a little Atropine will immediately paralyze the inhibition and restore the pulsations. An equally prompt antagonism runs through their entire spheres of action. Digitaline is to some extent antagonistic; so also is Eserine. Therapeutics. Muscarine has been as yet little used in medicine, but it will probably prove to be a valuable drug. It has been long used, with marked benefit, in the night-sweats of phthisis. A tincture of Agaricus has been found beneficial in ataxic typhus, chorea, and chilblains. Muscarine promises to be of great value in inflam- mations characterized by copious exudation, especially eye-in- flammations, catarrhal jaundice, recent hemorrhoids, acute bron- chitis, pulmonary hemorrhage, incipient pulmonary congestion, diabetes of both forms, and in constipation due to intestinal torpor and deficient secretion, accompanied by a torpid liver and difficult digestion of fats. In the latter affection it should be given in small doses, gr. jV, thrice daily. AILANTHUS, Tree of Heaven (Unofficial),—is the bark of Ailanthus glandulosa, a well-known shade tree, of the nat. ord. Simarubaceae, indigenous to China, but cultivated elsewhere. It contains an oleo-resin and a volatile oil, on which its properties probably depend. Dose, gr. x~3j. 50 ALCOHOL. Preparations. Extractum Ailanthus Fluidum (Unofficial),—Dose, trgx-^j. Tinctura Ailanthus (Unofficial),—Dose, itjjx-^ij. Physiological Action. Ailanthus is a decided nauseant, and a drastic purgative, caus- ing also vertigo, weakness, cold sweats, dull headache, pains in the back, numbness and tingling in the limbs. It paralyzes the cerebrum and spinal cord of animals, impairment of motility beginning in their hind extremities. The cardiac action, at first increased, soon slows, the pulse becoming small and weak, and the respiration depressed, death occurring from paralysis of res- piration. It is a good tseniafuge. Therapeutics. Ailanthus is used against tapeworm, a decoction of the fresh bark (3j ad or the oleo-resin in drachm doses, being very efficient. It has also been well employed in malignant scarlatina, with dark and partial eruption, insensibility, delirium, and other cerebral symptoms. ALCOHOL, —is a liquid composed of 91 per cent, by weight (94 per cent, by volume) of Ethyl Alcohol, C2H5HO, and 9 per cent, by weight (6 per cent, by volume) of water. Sp. gr. 0.820 at 6o° F., and 0.812 at 770 F. An inflammable, transparent, colorless, mobile and volatile liquid, of agreeable odor and burn- ing taste. Obtained by the distillation of fermented saccharine fluids. Used in making all the Tinctures and Spirits; also in some of the Liniments, Liquors and Mixtures. Preparations. Alcohol Dilutum, Diluted Alcohol,—consists of Alcohol and Distilled Water, equal parts of each. Sp. gr. 0.928 at 6o° F. Spiritus Frumenti, Whiskey,—obtained from the distillation of fermented grain, rye or corn (U. S.), barley (Scotch), and at least two years old. Sp. gr. 0.917 to 0.930. Has an alcoholic strength of 44 to 50 per cent, by weight; also Ethers developed by the action of acetic and butyric acids on the alcohol, and traces of Amylic Alcohol (fusil-oil) even in the best. Spiritus Vini Gallici, Brandy,—obtained from the distillation of fer- mented grapes, and at least four years old. Sp. gr. 0.925 to 0.941. Has an alcoholic strength of 39 to 47 per cent, by weight, and CEnanthic and other Ethers developed by age. Pale Brandy is colored by the cask, the dark has caramel to color it. Is often prepared artificially by adding to high wines Acetic or Nitric Ether, Caramel, and Logwood or Catechu for astringency. Spiritus Odoratus, Perfumed Spirit, Cologne-water,—prepared by adding ALCOHOL. 51 to 800 parts of Alcohol, Water 158, Acetic Ether 2, Oil of Bergamot 16, Oil of Lemon 8, Oil of Rosemary 8, Oil of Lavender Flowers 4, and Oil of Orange Flowers 4 parts. A perfume or ingredient of lotions. Vinum Album, White Wine,— should contain from 10 to 12 per cent, by weight of absolute alcohol, and is made by fermenting the unmodified juice of the grape, freed from seeds, stems and skins. Vinum Album Fortius, Stronger White Wine,—should contain 20 to 25 per cent, by weight of absolute alcohol, and is made by adding 1 part of Alcohol to 7 of Vinum Album. Is simply a formal recognition of the fact that the stronger sherries are artificially made. Used to prepare the official Vina (Wines). Vinum Rubrum, Red Wine,—should contain from 10 to 12 per cent, by weight of absolute alcohol, and is made by fermenting the juice of colored grapes in presence of their skins. Vinum Aromaticum, Aromatic Wine,—consists of Stronger White Wine 94 per cent., with Lavender, Origanum, Peppermint, Rosemary, Sage and Wormwood, of each 1 per cent. Unofficial Alcoholic Preparations. Rectified Spirit, sp. gr. 0.835,—^as 85 per cent, by weight of absolute alcohol, and no fusil oil. Is often spoken of as “ 56 over proof,” meaning that to reduce 100 volumes of it to the strength of proof spirit, requires 56 vol- umes of water. Proof Spirit, sp. gr. 0.920,—contains 49 per cent, by weight of absolute alcohol, with a peculiar oil and other foreign matters. Rum,—is obtained from the distillation of fermented molasses, and has about 42 per cent, by weight of alcohol. Gin,—has about the same alcoholic strength as rum, and approaches very nearly to the official Spiritus Juniperi Compositus. It is usually distilled from rye or barley, and flavored, in Holland, with juniper berries and hops, in England, often with oil of turpentine, various cheap aromatics, acetate of lead, sulphate of zinc, cayenne pepper, etc. Pure gin is slightly diuretic, from the oil of juniper contained in it. Vinum Portense, Port Wine,—is not a natural wine, spirit being added during the process of manufacture, and the alcoholic strength raised to 30 or 40 per cent. Vinum Xericum, Sherry Wine,—a dry, spirituous white wine, generally made to order by the dealers, and having from 20 to 35 per cent, of alcohol. Sparkling Wines, as Champagne, Hock, Catawba,—are more or less sweet, and charged with carbonic acid, being bottled before fermentation is completed and the grape-sugar all converted into alcohol. They contain 8 to 10 per cent, of absolute alcohol. Sweet Wines, as Burgundy, Tokay, Muscatel, Malaga, Angelica, Madeira, etc.,—are of low alcoholic strength, 6 to 7 per cent., unless fortified. Light Red Wines, as Claret, Red Rhine, Concord,—have 5 to 7 per cent, alcohol, tannic acid, grape coloring matter, etc. Dry Acid Wines, as Rhine and Moselle wines, California Hock, Ohio, and Kelley-Island Catawba,—in these fermentation is complete, and the alco- holic strength from 5 to 7 per cent. Bf.f.r, Ale, and Porter,—are fermented liquors, made from malted grain, with hops and other bitters added. Beer is made by slow fermentation, the yeast sinking; Ale by rapid fermentation, the yeast floating. Their alcoholic strength is from 2 to 3 per cent, in beer, to 4 to 6 per cent, in ale and porter, 52 ALCOHOL. —and they also contain malt extract, carbonic acid, lactic acid, various aro- matics, potassium and sodium salts, etc. Koumiss,—is obtained by the fermentation of milk, that of the mare being used in Tartary, where it is largely employed as a food. It contains from I to 3 per cent, of alcohol, sugar, lactic acid, casein, fat, salts, carbonic acid and ethers. Principal Alcohols. Ethylic Alcohol, Ethyl Hydrate, C2H60,—Grain-spirit. Methylic Alcohol, Methyl Hydrate, CH40,—Wood-spirit. Amylic Alcohol, Amyl Hydrate, C5H120,—Potato-spirit, Fusil Oil. Occurs also in the excessive distillation of fermented grain, after the ethylic alcohol has distilled over. Phenylic Alcohol, Phenol, Carbolic Acid, C6H60,—from coal-tar (see page 21). Composition, etc., of Alcohols. An Alcohol is a volatile organic compound, which contains no N, has a great affinity for water, and reacts with acids, forming H20 and ethers. Alco- hols are therefore analogous to the metallic hydrates, and Ethers to salts. They are obtained by distillation from the fermented product of grape-sugar, or some substance (as starch) easily converted into grape-sugar, which, in the presence of certain low vegetable organisms (as the yeast-plant), splits up into Alcohol and C02; and may be made synthetically by shaking Olefiant gas (C2H4) with strong Sulphuric Acid, then diluting and distilling. C2H4 + H.O = C2H60, Ethylic Alcohol. Absolute Ethylic Alcohol, which is only used for chemical testing, is made by shaking Rectified Spirit with Potassium Car- bonate, decanting, and distilling with slaked lime. Alcohol very slowly oxidized forms Aldehyde (C2H40), if less slowly, Acetic acid (C2H402), if quickly as in burning, C02 and H20, which are in all cases the ultimate products of its continued oxidation. Physiological Action. Alcohol is a cerebral excitant and depressant and a narcotic poison. It is anaesthetic, antiseptic, and antiparasitic, a mild counter-irritant, and it coagulates albumen by abstracting its water. It is very diffusible, and is partly oxidized by the organism, part being excreted unchanged. In small doses, Alcohol relaxes the vessels, stimulates the gastric glands, promotes appetite and digestion, lessens the elimination of waste-products (urea and C02), causes a subjective sensation of heat, and slightly raises the body temperature. It briefly stimulates the heart, prolonging its systole and reducing the length of the diastole, and increases the functional activity of all the organs. A portion is oxidized by the organism (about gjss in twenty-four hours), yielding force which is utilized as nervous, muscular and glandular power. The continued use of small or moderate doses congests the ALCOHOL. 53 stomach and liver, over-stimulating the gastric glands and the hepatic cells to the production of pathological secretions, causing gastric catarrh and morning-vomiting of mucus, and impairing digestion. By irritation it sets up hyperplasia of the submucous connective tissue (sclerosis), especially in the stomach, brain, kidneys and liver (cirrhosis); produces fatty degeneration (stea- tosis) of the blood, the arterial walls, and the various organs, and depresses the heart and the arterial tension. Epilepsy, paraplegia, amaurosis and insanity may result from the long-continued use of spirits, alcohol having an especial affinity for the nervous system. The malt liquors (beer, ale, etc.) are less prone than the spirituous to affect the brain, but are even more apt to set up fatty degen- eration of the liver and heart. In large doses Alcohol precipitates pepsin and destroys its activity as a ferment, arrests digestion, produces exhilaration, in- toxication, hallucinations, delirium, muscular incoordination, depression of the heart, lowered arterial tension and body tem- perature, abolished reflexes and coma. A toxic dose, after a very brief period of excitement, produces insensibility, stertorous breathing, dilated or contracted pupils, complete muscular resolution, and death by paralysis of the heart and respiration. Acute Alcoholism may be confounded with apoplexy, opium narcosis, concussion of the brain, and even acute pneumonia,— the differential diagnosis being impossible to make in the stage of deep coma. The pupils are not a trustworthy indication, as in alcoholism they may be either dilated or contracted. Alcohol is a food within narrow limits, 3jss per diem being the probable quantity which the adult organism can oxidize, more than this being probably poisonous, as it sets up structural changes in the various organs, and lowers the power of resistance to morbific influences. It has frequently caused an intractable form of phthisis. The very young and the very old stand more alcohol relatively than the adult. It has been proven to exist normally in the human organism. Treatment of Acute Alcoholism. The stomach should be evacuated, Ammonia by inhalation cautiously, warmth applied to the extremities, cold affusion to the head, faradism of the muscles of respiration. Milk, mucilaginous drinks, black coffee are useful afterwards. Lupuline as a substitute stimulant, Chloral (cautiously) to secure sleep, but is dangerous in old topers. Capsicum is excellent for the same purpose in 20- to 30-grain doses. Nutritious, digestible diet in fluid form and small quantity frequently repeated. 54 ALLIUM. Therapeutics. Though Alcohol is decidedly injurious in health, in disease it is a most useful agent. It is invaluable in diphtheria, poisoning by cardiac depressants and snake-venom, adynamic fevers and cardiac failure from any cause. It is an excellent dressing to wounds and bed-sores, may prevent colds from exposure by relax- ing the peripheral vessels and restoring the balance of the circu- lation, and in phthisis it does good if it promotes digestion and assimilation. In atonic indigestion of nervous and depressed subjects, cholera infantum, diarrhoea, etc., brandy is universally found to be beneficial. In the vomiting of yellow fever or of sea-sickness iced champagne is very efficient. In anaemia and chlorosis good red wines are almost indispensable, as also in convalescence from acute diseases, sudden and profuse hemor- rhage, and in many other morbid conditions. Koumiss is an excellent food and stimulant in feeble digestion, phthisis, chronic bronchitis, and in all adynamic states in which the effects of alcohol and nutrients are indicated. The stomach is very tolerant of koumiss even when it will bear nothing else, and as it increases the body nutrition remarkably it is of great value in the treatment of all the cachexiae. Each quart is esti- mated to contain 4 ounces of solid food, besides 1 to 3 per cent, of alcohol. ALLIUM, Garlic ,—is the bulb of Allium sativum, a plant of the nat. ord. Liliaceae, indigenous to Asia, but cultivated in Europe and America. It is sub-globular and compound, consist- ing of eight bulblets, covered by dry, membranous scales. Its odor is pungent and disagreeable and its taste is warm and acrid. It contains a Volatile Oil, which consists mainly of the Sulphide of Allyl (C3H5)2S, on which its qualities depend. Allied species are Allium Cepa, the Onion, and Allium Porrum, the Leek. Preparation. Syrupus Allii,—contains 15 per cent, of Garlic, Sugar 60, Dilute Acetic Acid 40 parts. Dose, according to age. Physiological Action and Therapeutics. Garlic, Leeks and Onions are stimulant to the digestion and to the nervous system, and are supposed to have a special influ- ence upon the bronchial secretion. Garlic is also thought to be emmenagogue and anthelmintic. It promotes diaphoresis and ALNUS—ALOE. 55 diuresis, and acts as a tonic and carminative. Many persons use it as a condiment. Large doses will often produce gastric irrita- tion, flatulence, hemorrhoids, headache and fever. In domestic practice it is frequently employed as an external application in the cutaneous eruptions of children, and as a poultice or liniment in infantile disorders of many kinds. Internally it is of real benefit in feeble digestion and flatulence, chronic catarrhal affec- tions of children, in nervous and spasmodic coughs and in ner- vous vomiting. ALN US, Alder-Bark (Unofficial),—is the bark of Alnus ser- mlata, the common American Alder, a small tree of the nat. ord. Betulaceae. It has similar properties to those of A. gluiinosa, the European Alder, and A. urcana, the Tag Alder, and contains a tannic acid, an oil and a resin. The bark and leaves are astrin- gent and bitter, and are chiefly used as gargles for the throat, as local applications to wounds and ulcers, and to restrain the secre- tion of milk. Dose of the powdered bark gr. x, in decoction or infusion, several times a day. The Tag Alder is highly recom- mended as a hemostatic. ALOE, Aloes ,—is the inspissated juice of the leaves of Aloe socotrina, a plant of the nat. ord. Liliaceae, inhabiting the island of Socotra and the eastern coast of Africa near the southern shore of the Red Sea. It has orange-colored flowers and resembles in appearance the American aloe or century-plant (Agave ameri- cana). It occurs in soft masses, hard exteriorly, of a yellowish- brown color, fragrant odor and bitter taste, soluble in alcohol and in boiling water, and containing a peculiar volatile oil, a resin and Soaloin, C1SH1607, a variety of the principle Aloin, which is common to all varieties of aloes,—also Aloetic and Chrysammic Acids. Dose, gr.j-v. Other varieties are Aloe Barbadensis, Barbadoes Aloes, from Aloe vulgaris; and Aloe Capensis, Cape Aloes, from Aloe ferox, the first of which is official in the Br. Phar. Preparations. Aloe Purificata, Purified Aloes,—prepared by heating with alcohol, straining and evaporating. Is almost entirely soluble in alcohol. Dose, gr. j-v. Extractum Aloes Aquosum,—prepared by mixing i with io parts of Boiling Distilled Water, standing 12 hours, decanting, straining and evapo- rating. Dose, gr. ss-v. 56 ALOE. Tinctura Aloes,—has of Aloes io, extract of Glycyrrhiza io, Diluted Alcohol to ioo parts. Dose, gss-ij. Tinctura Aloes et Myrrh^e,—Aloes io, Myrrh io, Alcohol to ioo parts. Dose, Vinum Aloes,—has of Aloes 6, Cardamom I, Ginger i, Stronger White Wine to ioo parts. Dose, j^j-iv. Pilulze Aloes,—each has of Aloes gr. ij with the same quantity of Soap. Pilule Aloes et Asafetid^e,—each contains gr. of each ingre- dient. Pilule Aloes et Ferri,—each pill contains gr. j each of Aloes, Sulphate of Iron and Aromatic Powder, with Confection of Rose. Pilulze Aloes et Mastiches, Lady Webster’s Pill,—each has of Aloes gr. ij, Mastic gr. ss, Red Rose gr. ss. Pilule Aloes et Myrrhs,—each contains of Aloes gr. ij, Myrrh gr. j, Aromatic Powder gr. ss, mixed with Syrup. Pulvis Aloes et Canell.e (Unofficial),—contains the powdered bark of Canella alba. Dose, gr. v-xx. Aloes is also a constituent of Pilulae Rhei Composite and Tinctura Ben- zoini Composita—(which see.) Physiological Action. Aloes is a tonic-astringent and resin-bearing purgative, an em- menagogue and an anthelmintic against the thread-worm. As a cathartic it acts chiefly on the lower half of the large intestine, in doses of gr. j-iv producing in about io hours copious soft evacu- ations with some griping pain. This effect is produced whether the drug be taken internally or absorbed from an exposed surface, so that it probably diffuses into the blood and is eliminated by the mucous membrane of the colon. It is a stomachic tonic in small doses, a stimulant of the hepatic functions, and an excitant of the pelvic circulation. It may cause abortion in the female and priapism in the male, and is said to have frequently produced hemorrhoids, which if existing it will certainly aggravate. Given to nursing mothers it imparts a purgative quality to their milk. Therapeutics. Aloes is chiefly used in combination with Iron, Myrrh, Nux- vomica, etc., for amenorrhcea and chronic constipation with atonic dyspepsia and hypochondriasis. It is curative in certain forms of hemorrhoids, especially those occurring after delivery and where the condition is not one of active pelvic congestion. It is also used internally and as an injection in gonorrhoea, and for simple atonic jaundice. It must be avoided in irritable rectum, hemorrhoids of active form, menorrhagia and pregnancy, unless given in small doses and with care. The Pil. Aloes et Ferri is perhaps the most generally useful agent in anaemia, amenorrhcea and constipation of girls at the period of puberty. ALTHAEA—ALUMEN. 57 ALTHAEA, Marsh-mallow,—is the peeled root of Althtza officinalis, a European plant of the nat. ord. Malvaceae, occurring in dry cylindrical pieces, of white color, without pith, of faintly aromatic odor and sweetish mucilaginous taste. It contains about 35 per cent, each of vegetable mucus and starch, with 2 percent, of Asparagin, also pectous matter, sugar, fixed oil, but no tannin. It is a constituent of Massa Hydrargyri and Pilulae Phosphori, and is much used as an excipient in extemporaneous phar- macy. Dose, indefinite. Preparation. Syrupus AltH/P.^e,—has of Althaea 4 per cent., and should be freshly made. Dose, indefinite. Physiological Action and Therapeutics. Althaea is one of the best mucilaginous drugs, but has no active medicinal properties. It is used in Europe to make pec- toral teas and syrups, and is extensively employed as a mucilagi- nous demulcent. The powdered root makes a good emollient poultice. In the German Pharmacopoeia a Compound Althaea Tea is official, which under the common name, “German Breast Tea,” is a popular demulcent drink in bronchial affections, coughs, colds, etc. Asparagin is an organic principle, occurring in large rhombic crystals, and found in many other plants, as in the shoots of asparagus, vetches, potatoes, liquorice, the sweet almond, the root of the locust, etc. It is considered a derivative of Succinic Acid, and has diuretic properties, besides being sedative to the circula- tion. It may be used in ascites, especially in children, in the anasarca of Bright’s disease, and in gout. Dose, gr. ij-iij, in water. ALUMEN, ALUM, Potassa-alum,—is the Sulphate of Potassium and Aluminium, K2A12(S04)4.24H20, which, when the 24 molecules of water are driven off, becomes Alumen Exsiccatum, Dried Alum, K2A12(S04)4. Alum occurs in large, octahedral crystals, or cubes, of sweetish astringent taste and acid reaction. It is soluble in io)4 parts of water at 590 F., and in 0.3 part of boiling water, but is insoluble in alcohol. The Ammonia-alum (Aluminii et Ammonii Sulphas) was formerly official, and is still sold and dispensed as “Alum.” Dose, gr. x-xx, as an emetic 3j for a child. 58 ALUMINIUM. Preparation. Alumen Exsiccatum, Dried Alum,—is a white, granular powder, slowly soluble in 20 parts of water at 590 F., and quickly soluble in 0.7 of boiling water. Dose, gr. x-xx. (See above.) Physiological Action. Alum is an astringent, coagulating albumen and stimulating muscular contraction. At first it excites the flow of saliva and then markedly diminishes it. It coagulates pepsin and arrests digestion, stops peristalsis, and usually causes constipation, though sometimes inducing diarrhoea. Although coagulating albumen, even in weak solution, it enters the blood, constricts the capillaries, arrests secretions, especially those of mucous sur- faces, and stops capillary hemorrhage. In teaspoonful doses Alum is an efficient and non-depressant emetic. In large doses it is a gastro-intestinal irritant, §j$4 of dried Alum having caused the death of an adult in 8 hours. Therapeutics. Alum is used locally as an astringent in chronic catarrhs, leu- chorrhoea, gonorrhoea, hemorrhoids, bed-sores, ulcers, relaxed throat, colliquative sweats, catarrhal ophthalmia and granular lids. The dried powder is escharotic, destroying granulations and warty growths, and is used by insufflation in chronic nasal catarrh. Internally it is beneficial in gastric catarrh, gastralgia, enteralgia, passive hemorrhages, lead colic and constipation. As an emetic it is employed in croup, and it is a good antidote in lead-poisoning. Alum is best administered alone, as it forms precipitates with a large number of drugs. ALUMINIUM,—This metal is not official, though of its salts two are, besides Alum. They are— Aluminii Hydras, Hydrate of Aluminium, Hydrated Alumina, Al2HOe,— is a white, light, amorphous, tasteless powder, insoluble in water or alcohol, but soluble in strong alkaline or acid solutions. Dose, gr. iij-xx, in powder or mixture. Aluminii Sulphas, Sulphate of Aluminium, A12(S04)3.i8H20,—is a white crystalline powder, soluble in 1.2 of water at 590 F., almost insoluble in alco- hol. Used locally. Physiological Action and Therapeutics. The Hydrate is a feebly astringent and desiccant powder, occasionally used in inflammatory skin affections as a local appli- cation, and internally in diarrhoea. AMMONIACUM—AMMONIUM. 59 The Sulphate is antiseptic and astringent. It has been used internally in diarrhoeas, but is chiefly employed in a 5 per cent, solution locally to ulcers, or in stronger solution (3iij ad £vi) in foul discharges from mucous surfaces. A saturated solution is a mild caustic, and may be used daily as a local application to enlarged tonsils, nasal polypi, ulceration of the os uteri, and various chronic enlargements. The Benzoinated Solution of Alumina is an unofficial preparation used for the same purposes. AMMONIACUM, Ammoniac,—is a gum-resin, obtained from Dorema Ammoniacum, a Persian plant of the nat. ord. Um- belliferse, occurring in yellowish-brown tears of peculiar odor, and bitter, acrid and nauseous taste. When triturated with water it readily yields a milk-white emulsion, and contains a Volatile Oil, which differs from that of Asafoetida in that it is neither sulphur- etted nor phosphoretted. It also contains resin, gum, gluten, etc. Dose, gr. x-xxx. Preparations. Mistura Ammoniaci,—is an emulsion with water of 4 per cent, strength, the resin being suspended by the contained gum. Dose, Emplastrum Ammoniaci,—Ammoniac 100 parts, digested with 140 of Dilute Acetic Acid until emulsionized, then strained and evaporated. Emplastrum Ammoniaci cum Hydrargyro,—Ammoniac 72, Mercury 18 per cent., and contains also Lead-plaster, Sulphur, Olive Oil, and Dilute Acetic Acid. Physiological Action and Therapeutics. Ammoniac is a stimulating expectorant and a laxative, and has a mildly irritant action on the skin. Its actions are similar to those of Asafoetida, but much less powerful. It is not much used, but may be employed with benefit in chronic bronchial affections, especially of the aged, the mixture with the Chloride or Car- bonate of Ammonium facilitating expectoration and lessening wheezing. It is also recommended in asthma, and in glandular enlargements and indolent swellings the plasters are employed as stimulating alteratives and resolvents. AMMONIUM, NH4,—is a hypothetical compound radical, which does not exist in the free state, but which in combination with acids forms salts which closely resemble those of the ele- ments Potassium and Sodium. Many of its salts are official, as well as the aqueous solutions of the gas Ammonia, NH3, which is produced during the putrefaction of all organisms and of many organic nitrogenous compounds existing in the air and in the 60 AMMONIUM. soil in the free state. The chief commercial source of Ammo- nium salts is the ammoniacal liquor from gas-works and bones. Preparations of A??imonia. Aqua Ammonia, Water of Ammonia,—is an aqueous solution of Ammo- nia, containing by weight of the gas. It is a colorless liquid, of pungent odor, acrid taste and strongly alkaline reaction. Sp. gr. 0.959 at 59° F- Dose, up well diluted. Aqua Ammonia Fortior, Stronger Water of Ammonia,—contains 28 per cent, by weight of the gas. Sp. gr. 0.900 at 590 F. Spiritus Ammonia,—is a 10 per cent, solution of the gas in alcohol. Sp. gr. about 0.810. Dose, upx-gj, diluted. Spiritus Ammonite Aromaticus,—contains Ammonium Carbonate, Aqua Ammonite, Oils of Lemon, Lavender, and Pimenta, Alcohol and Water. Used in the Tinct. Guaiaci Ammoniata and the Tinct. Valerianae Ammoniala. Dose, Linimentum Ammonite, Ammonia Liniment,—has of Aqua Ammoniae 30 parts, Cotton-seed Oil 70. Ammonium Salts and their Preparations. Liquor Ammonii Acetatis, Solution of the Acetate of Ammonium, Spirit of Mindererus,—is prepared by neutralizing Dilute Acetic Acid with Carbonate of Ammonium, and contains about per cent, of the Acetate. It should be freshly made. Used in Mistura Ferri et Ammonii Acetatis. Dose, Ammonii Benzoas, Benzoate of Ammonium, NH4C7H502,—in minute four- sided laminar crystals, soluble in 5 of water and 28 of alcohol at 590 F. Dose, gr. v-xv. Ammonii Bromidum, Bromide of Ammonium, NH4Br,—in prismatic crys- tals or as a granular salt, soluble in of water and 150 of alcohol at 590 F. Dose gr. x-gss, well diluted. Ammonii Carbonas, Carbonate of Ammonium, NII4UC03.NH4NII2C02, —occurs in white masses consisting of both the bicarbonate and carbonate, which on exposure to air becomes a white powder (acid carbonate). Soluble in 4 parts of water at 590 F. Dose, gr. v-x. Ammonii Chloridum, Chloride of Ammonium, Sal-ammoniac, HN4C1,—a white, crystalline powder, of saline taste, and slightly acid reaction ; soluble in 3 of water and very sparingly in alcohol. Dose, gr. j-xx. Trochisci Ammonii Chloridi, Troches of Chloride of Ammonium,—each contains 2 grains of the chloride. Ammonii Iodidum, Iodide of Ammonium, NIT4I,—a deliquescent, gran- ular, white salt, soluble in 1 of water and 9 of alcohol at 590 F. Dose, gr. ij-x. Ammonii Nitras, Nitrate of Ammonium, NH4N()3,—in colorless crystals or fused masses, soluble in 0.5 of water and 20 of alcohol at 590 F. Only used to prepare Nitrous Oxide Gas by heating to 365° F., for ansesthesia. Ammonii Phosphas, Phosphate of Ammonium (NH4)2HP04,—in colorless prisms, soluble in 4 of water, insoluble in alcohol. Dose, gr. v-xx. Ammonii Sulphas, Sulphate of Ammonium (NH4)aS04,—is only used for the preparation of other ammonium salts. Ammonii Valerianas, Valerianate of Ammonium, NII4C5IT902,—in white, quadrangular plates, deliquescent; very soluble in water and alcohol. Dose, gr. j-v. AMMONIUM. 61 Raspail’s Eau Sedatif (Unofficial),—consists of Aqua Ammoniae j|ij, Soiiii Chloridum 3ij, Spiritus Vini Camphorat. Aqua P'or local use. Physiological Action. The gas Ammonia is intensely alkaline and irritant to mucous membranes; inhaled producing spasmodic cough and a sense of suffocation. Its prolonged inhalation will induce violent inflam- mation of the air-passages and oedema of the glottis. It stimu- lates the nasal branch of the fifth nerve, exciting the vaso motor centre by reflex action, and thus raising the arterial tension. Applied to the skin and allowed to evaporate, it has a slight rube- facient effect, but if evaporation be prevented it penetrates the epidermis and has a powerfully vesicant action. The Aqua, swallowed undiluted, may cause death quickly by suffocation from the action of its vapor upon the air-passages; if not, it may excite gastro-enteritis accompanied by coma, differing in the latter respect from potassium or sodium poisoning. After absorp- tion it stimulates both the respiration and the circulation by direct action on their respective nerve-centres. Ammonia exists normally in the circulation, where it keeps the fibrin in solution and thus maintains the fluidity of the blood. It increases the glycogenic function of the liver, and is converted finally into urea. It is a powerful irritant to muscular tissue, causing tetanic contraction and subsequent rigor mortis when directly applied. Ammonium Salts all stimulate and finally paralyze the spinal cord, motor nerves and muscles, in animals, but the order and readiness of the action vary with the salt employed, some having a predominating influence on the cord, others on the motor nerves. In general they may be said to form a series, of which the members at one end stimulate the cord, and those at the other paralyze both the cord and the motor nerves. At the stimu- lant end are Ammonia and the Chloride; at the paralyzant end the Iodide; the Bromide, Phosphate and Sulphate lying between (Brunton). In medicinal doses they act on man as stimulating expectorants, in large quantity they injure the structure of the red blood-corpuscles, and if long-continued they produce rapid emaciation by impairing digestion and increasing tissue-waste. The Chloride has decided cholagogue powers, increases the excretion of urea, in 20-grain doses is purgative, and is consid- ered to have a selective action upon the gastric mucous membrane. The Carbonate is a powerful and very diffusible stimulant; when administered internally in moderate doses, it is probably decom- posed by the HC1 of the gastric juice, nascent ammonia being set free and absorbed. It stimulates the respiratory centre, acts as 62 ammonium. a stimulating expectorant, and in very small doses stimulates the secretion of the gastric juice. It is also emetic, and has been supposed to prevent iodism when administered conjointly with Iodide of Potassium. The Solution of the Acetate is an ac- tive diaphoretic if the body be warm, or a diuretic if it be cool. In wineglassful-doses it will counteract many of the immediate effects of alcohol. The Phosphate is diuretic, and is believed to decompose the insoluble Urate of Sodium in the blood, convert- ing it into the soluble salts Urate of Ammonium and Phosphate of Sodium, and thus promoting its elimination. The Benzoate is also diuretic, and like Benzoic Acid passes out of the system in the urine as Hippuric Acid. It acidifies the urine where there is phosphatic tendency of the same. The Nitrate and Sulphate are only used for the preparation of other salts, while the Iodide, Bromide and Valerianate correspond in action to that of their titular bases, and are described under their respective titles, Iodum, Bromum and Valeriana. Antagonists to Ammonia. When inhaled, give HC1 vapors by inhalation to form the chloride ; if taken in solution, give Vegetable Acids, and demulcents to protect the mucous surfaces. Its physiological antagonists are the cardiac sedatives, Aconite, Digitalis, Veratrum, etc. Therapeutics. The strong solution of Ammonia may be used as a rubefacient and vesicant, and its vapor, by cautious inhalation, in syncope and the results of shock. Locally, it is a good application to bites of the less venomous reptiles and to the stings of insects. The Carbonate is used internally in the eruptive fevers, delirium tremens, continued fevers, pneumonia, etc., where much depres- sion exists; as a stimulating expectorant in chronic bronchitis, in the broncho-pneumonia of children, and in cardiac asthma. It is highly recommended in scarlet fever in doses of 3 to 5 grains every one, two or three hours, all acid drinks or fruits being pro- hibited while it is being administered. With ten-minim doses of tincture of capsicum in an ounce of some bitter infusion it is exceedingly efficient, in 5-10-grain doses, for the sinking sensa- tions and craving for stimulants experienced by subjects of alco- holism. It may be used as an emetic in bronchitis, when the tubes are choked with mucus and the circulation of the patient is weak. It may also be employed by inhalation, and adminis- tered internally, for similar purposes as Liquor Ammonias. The Chloride has a high repute in catarrh of the stomach, with ano- rexia, bad taste in the mouth, flatulence, coated tongue, etc., in AMYGDALA. 63 short, the symptoms of so called “biliousness;” also, in chronic congestion of the liver, jaundice from catarrh of the bile-ducts, nervous and sick headaches, myalgia, amenorrhoea, muscular rheumatism, and neuralgia. In the latter affection it should be given in 30-grain doses several times a day. It is also efficient in bronchial catarrh without fever, and in chronic bronchitis when the secretion is scanty and tough. Locally, in solution, it has been well employed in inflammatory swellings, as sprains, inflamed joints, orchitis, etc., as a lotion ; also, to allay itching in prurigo, to remove ecchymoses and glandular enlargements. Eau Seda- tif is often a good local application in headaches. The Solution of the Acetate is especially beneficial in the exanthemata, influenza, coryza, anomalous febrile conditions of children, acidity and vomiting; also, in erysipelas when there is feeble circulation, cyanosis and delirium. It is frequently com- bined with Spirit of Nitrous Ether, as a diuretic and diaphoretic in febrile affections. The Phosphate is particularly applicable to gout and lithsemia, and is a very efficient cholagogue. The Benzoate is useful in cystitis with alkaline urine and phosphatic deposits, as it acidulates the urine, at the same time stimulating and disinfecting the mucous coat of the bladder. Aqua Ammonite has been administered by intra-venous injec- tion, with efficacy and safety, in sudden or threatened throm- bosis, cardiac paralysis from Chloroform, and in poisoning by Hydrocyanic Acid and other cardiac depressants. In the same manner, it has been employed, but unsuccessfully, in poisoning by the bite of venomous reptiles. Ten drops of the strong Liquor are diluted with three parts of water, and carefully injected into a vein, all air being rigorously excluded from entrance thereinto. The therapeutics of the Iodide, Bromide and Valerianate are enumerated under the titles Iodum, Bromum and Valeriana respectively. AMYGDALA, Almond,—the seeds of two varieties of Amygdalus communis (nat. ord. Rosacea), namely Amygdala amara and Amygdala dulcis, are official, together with several preparations, some prepared from one variety, some from another, while one is from either and one from both. An important point is the reaction between Amygdalin and Emulsin in the presence of water, producing Hydrocyanic Acid (see ante, page 29). Amyg- dalin, CjoHyjNOjj, is a crystalline glucoside, existing in Amygdala amara but not in Amydala dulcis; while the ferment Emulsin is common to both varieties. 64 AMYGDALA. Amygdala Amara, Bitter Almond,— is the seed of Amygdalus communis, var. amara, a tree of the nat. ord. Rosaceae, indigenous to Western Asia, but cultivated in many other parts of the world. The seed is lanceolate in shape, brownish in color, about an inch long, having a white, oily embryo of bitter taste, which, when triturated with water, emits an odor of Hydrocyanic Acid. Cul- tivated chiefly in Spain and the Balearic Islands. Amygdala Dulcis, Sweet Almond,—is the seed of Amygdalus communis, var. dulcis, a tree of the nat. ord. Rosaceae. The bitter and sweet almond trees are identical botanically, and the fruits and seeds of the two varieties resemble each other closely, only differing in taste and the presence of Amygdalin (see above"). The sweet almond is largely cultivated about Malaga and in Cali- fornia. Preparations. Aqua Amygdalae Amara;,—is a weak solution of the Oil of Bitter Almond in Distilled Water (i in 1000). Is only a flavored water. Dose, indefinite. Oleum Amygdala Amara,—is a volatile oil, of peculiar and aromatic odor, bitter, burning taste, and neutral reaction; soluble in 300 of water, but freely in alcohol and ether. Dose, in mixture. This essential oil, one of the products of the reaction between Amygdalin and Emulsin (see ante, p. 29), contains a varying quantity of Hydrocyanic Acid (3 to 14 per cent.), which may be removed by distillation with caustic potash. Nitrobenzol, or “Oil of Mirbane,” closely resembles the oil of bitter almond, and like it is used for flavoring. It contains no Hydrocyanic Acid, but is a dangerous poison, producing toxic effects when inhaled, even in small doses. Syrupus Amygdala,—has of Bitter Almond 3 percent., of Sweet Almond 10. Dose, indefinite. Mistura Amygdala,—made of Sweet Almond 6 per cent., with Acacia, Sugar and Water. A demulcent drink, used as a vehicle for cough mixtures. Dose, Oleum Amygdala Expressum,—is the fixed oil which is expressed from either Bitter or Sweet Almond. Used in Unguentum Aquae Rosas, and as a bland local application in skin affections. Physiological Action. The bitter and sweet varieties of the species Amygdalus com- munis differ in action only through the agency of the principle Amygdalin contained in the former. The Sweet Almond is de- mulcent and nutritive, while the fixed oil expressed from either variety is a bland application, having the same action as Olive Oil. The action of the Bitter Almond and its oil is due to the Hydrocyanic Acid contained in them (see ante, p. 29). Therapeutics. Expressed Oil of Almond is demulcent, and in doses of 5j-ij a mild laxative. It is used externally for excoriations, AMYL NITRIS. 65 chapped hands, and inflammatory skin affections, and is applied to the ear in earache. The cake remaining after the expression of the fixed oil from the sweet almond is ground into flour, and used in the form of biscuits for diabetics as a substitute for bread, as it contains no starch. The Oil of Bitter Almond is used as a flavoring agent, and may be employed locally or internally in lieu of Hydrocyanic Acid. The Syrup is somewhat sedative, but is generally used as a demulcent or for flavoring purposes. The Mixture is used in catarrhal affections and as a vehicle for cough-mixtures. The poisonous character of the Bitter Almond and its essential oil (Oleum Amygdalae Amarae) should be kept in mind. AMYL NITRIS, Nitrite of Amyl, C5HnN02,—is a clear, yellowish liquid, of ethereal and fruity odor, aromatic taste, and neutral or slightly acid reaction, extremely volatile, insoluble in water but freely soluble in alcohol, ether, chloroform and benzin. It is produced by the action of Nitric or Nitrous Acid upon Amylic Alcohol, and when impure may have Nitric or Hydro- cyanic Acid in it. Dose internally dissolved in alcohol,— by inhalation uiij-v; but larger doses are probably safe. Unofficial Analogue. Nitroglycerinum, Nitroglycerin, Glonoin, Trinitrate of Glyceryl, CjH5(N08)3,—is a clear, oily liquid, insoluble in water, but soluble in alcohol, ether, oils, etc., produced by the action of nitric and sulphuric acids upon gly- cerin. Is a dangerous explosive, and should not be kept in stronger solution than i per cent. Dose to -fa or more, according to susceptibility. Unofficial Preparations of Nitroglycerin. Tinctura Nitroglycerini,—a one per cent, solution in alcohol. Dose, 1Tty£-x. The strong tincture sold by the homoeopathic pharmaceutists and official in their American Pharmacopoeia is a ten per cent, solution, or ten times the strength of the above. It is an extremely dangerous preparation, both as an explosive and as a medicine. (See Amei-ican Homoeopathic Phar- macopoeia, 2d ed., Boericke & Tafel, 1883, page 235.) TabelLjE Nitroglycerini, B. P.—are tablets of chocolate, each contain- ing gr. of pure Nitroglycerin. Dose, j-ij. Other Nitrites. Sodii Nitris, Nitrite of Sodium, and Potassii Nitris, Nitrite of Potas- sium (both unofficial), are used as substitutes for Amyl Nitrite and Nitro- glycerin. The former is a white, granular powder, deliquescent, with a cool, saline taste, very soluble in water, is made by heating Sodium Nitrate, and has the formula NaNOa. Dose, gr. x/z~v, according to individual suscep- tibility. 66 AMYL NITRIS. Ethyl Nitrite, C2H5N02,—constitutes 5 per cent, of Spiritus Sheris Nitrosi. (See ante, page 43.) Physiological Action. Nitrite of Amyl and the other Nitrites agree closely in their general action, producing great vascular dilatation by para- lyzing either the sympathetic system, the vaso-motor centre or the muscular coat of the arterioles,—which, is yet undecided. They cause tumultuous action of the heart by relaxing its inhibi- tion ;—lowered respiration, from paralysis of the respiratory mus- cles and impairment of the ozonizing function of the blood ;— diminution of sensation, motility and reflexes;—a sense of heat, but lowered body-temperature; also throbbing pain in the head, beating carotids, quickened pulse, flushed face and vertigo. The effect of an ordinary inhalation of Amyl Nitrite on man is very transitory, excepting the headache, which may last several hours. Of the nitrites it is the most prompt but least enduring in action, and is best administered by inhalation. It causes sugar to appear in the urine and increases the quantity voided. Mixed with blood it forms methaemoglobin which is not so readily deoxi- dized as haemoglobin, and under its influence the blood in the body becomes of a dark chocolate color both in the arteries and in the veins. Nitroglycerin acts similarly, but less promptly, and its action is more enduring. Its headache is of intensely frontal character, and persists for hours after the other effects have passed off. It is more suitable for internal administration. Nitrite of Sodium is also slower in action than Amyl Nitrite, and does not cause so much throbbing headache as Nitroglycerin. It may be given in solution with water. The action of all these agents is probably due to the Nitrous Acid contained in them. Antagonists. Ergot, Belladonna, Strychnine, Brucine, Digitalis, Picrotoxin, and all other agents which increase the functional activity of the spinal cord and sympa- thetic are antagonistic, though by reason of their slower rate of diffusion the antagonism may not be always available. Stimulants, artificial respiration, the alternate cold and hot douche, with cold to the head, and Ergotin or Atropine subcutaneously, are the best means to be used in cases of poisoning by the Nitrites. Therapeutics. The inhalation of Amyl Nitrite is a useful palliative in angina pectoris, epilepsy, tetanus, and many of the respiratory neuroses, as spasmodic asthma, whooping-cough, laryngismus stridulus, etc. AMYLUM. 67 It is also indicated in migraine of the pale-face form, and in the cold stage of intermittents and pernicious remittents to prevent internal congestion,—also in convulsions of various kinds, in- cluding the puerperal. It has been sometimes used in threatened death from chloroform anaesthesia, and in poisoning by strychnine. Nitroglycerin has been used with benefit in neuralgic dys- menorrhcea, sea-sickness, and in chronic interstitial nephritis by redistributing to the kidneys their blood-supply cut off by de- generation of the renal ganglionic centres. It promptly relieves hiccough, migraine of spasmodic character, and has afforded immediate relief in neuralgia of the fifth. Its administration in angina pectoris, though not producing such prompt results as that of Amyl Nitrite, gives excellent and much more lasting effects. It is useful in the weak heart of the aged, or that from fatty degeneration, or when, as in Bright’s disease, the arterial tension is above normal. Nitrite of Sodium has been successfully employed in angina pectoris, hemicrania, and in asthma of purely bronchial and neu- rotic origin. It has also proved decidedly beneficial in the abnor- mally high arterial tension of chronic desquamative nephritis, especially when complicated with a weakened and dilated heart. AMYLUM, Starch, C6H10O5,—is the fecula of the seed of Triticum vulgare, common wheat, a plant of the nat. ord. Grami- naceae. Though wheat-starch is the official kind, any other might be properly used, as the starch occurring in barley, oats, arrow- root, sago and tapioca, all of which foods were official in the U. S. P. of 1870. The last three are entirely composed of starch ; wheat contains about 70 per cent., and rice 90 per cent. Starch is a carbo-hydrate, and occurs in distinct grains, forming irregular, angular masses, white, inodorous and tasteless, easily pulverized, of neutral reaction, and insoluble in alcohol, ether or cold water. Under the microscope the granules are seen to be lenticular in form and concentrically striated. When boiled with water it yields a whitish jelly of bluish tinge, which when cool gives a deep blue color with test-solution of iodine, the color disappearing on warming and returning on cooling. By boiling with dilute mineral acids starch is converted into glucose, dextrin being formed as an intermediate product. Hot concentrated nitric acid converts it into oxalic acid, but cold fuming nitric acid dissolves it, forming an explosive compound. Diastase, ptyalin and pancreatin convert it into glucose. [For Glycogen, Dextrin, Cellulose and other allied substances see the article Saccharum in the following pages.] 68 ANISUM—ANTHEMIS. Preparations. Amylum Iodatum, Iodized Starch,—has of Starch 95 parts, Iodine 5, tritu- rated with distilled water and dried. Used as a method of giving Iodine (see Iodum). Dose, —jjss. Glyceritum Amyli, Glycerite of Starch,—has of Starch 10 parts, Glycerin 90, triturated and heated to a transparent jelly. Used as a vehicle for exter- nal applications. Physiological Action and Therapeutics. Starch, though a nutritive of the first order, may be regarded as inert medicinally. It serves as a protective and absorbent if dusted over the skin, as a vehicle for enemata, and as an antidote in iodine-poisoning. Mixed with glue it makes an excellent stiff bandage for surgical purposes. ANISUM, Anise ,—is the fruit of Pimpinella Anisurn, a European plant of the nat. ord. Umbelliferge. It occurs in ovate bodies, jr inch long, hairy, of grayish color, aromatic odor, and sweet, spicy taste, resembling conium fruit in appearance. Dose, gr. x-xx. Preparations. Oleum Anisi,—is a volatile oil distilled from Anise or from Illicium ani- s a turn (the star-anise), and represents the medicinal qualities of the plant. That from Anise congeals at 50° to 590 F., and is soluble in an equal part of alcohol. That from Illicium congeals at about F. The oil is an in- gredient of Tinctura Opii Camphorata, Trochisci Glycyrrhizae et Opii, and of the two following preparations. Dose, Titj-v. Aqua Anisi,—has in 500 parts 1 of Oil of Anise mixed with distilled water by the aid of cotton. Dose, indefinite. Spiritus Anisi,—is a 10 per cent, solution of the oil in alcohol. Dose, Physiological Action and Therapeutics. The Volatile Oil is the active constituent of Anise. It has a slightly stimulant action on the heart and the digestive organs, and liquefies the bronchial secretion, being probably in part ex- creted by the bronchial mucous membrane. It is a favorite flavor- ing ingredient of cough-mixtures, and relieves slight intestinal colic and flatulence in children. In full doses it has a weak nar- cotic power. ANTHEMIS, Chamomile,—the flower-heads of Anthemis nobilis, a European perennial of the nat. ord. Compositse, col- lected from cultivated plants. Chamomile-flowers are subglobu- lar, about inch broad, having numerous white, three-toothed ANTIMONIUM. 69 florets on a conical, solid receptacle, a strong but agreeable odor, and an aromatic, bitter taste; and contain a volatile oil, a cam- phor and a bitter principle but no alkaloid. There are no official preparations. An infusion (5iv to Oj) may be given in doses of 3 Hi- Oleum Anthemidis, Chamomile Oil (Unofficial),—the volatile oil, is of a dark blue or green color, and is composed of various ethers, the Angelates and Valerianates of Butyl predominating. Dose, ni ij-x, on sugar. Physiological Action. Chamomile is a stomachic tonic. It improves the appetite and aids digestion by increasing the vascularity of the gastric mucous membrane. In large doses the warm infusion is emetic, and per- haps diaphoretic, though the latter action is chiefly due to the hot water. The oil is remarkably efficient in reducing reflex ex- citability in frogs, even after its excitation by Strychnine or Bru- cine. Therapeutics. Chamomile is popular in domestic practice. An infusion is used by nurses for many infantile complaints, and externally as a fomentation to relieve pain, as in colic, etc. The oil is very efficient in reflex cough, pulmonary catarrh, acute dyspepsia, diarrhoea of children, spasmodic asthma, whooping-cough, colic, and the spasmodic and pseudo-neuralgic affections of hysterical women. It should prove extremely useful in poisoning by Strych- nine from its power over reflex excitability. The Chamomile of the homoeopaths is the Matricaria Chamo- milla, or German Chamomile, official in the U. S. Pharmacopoeia as “Matricaria,” which see. ANTIMONIUM, Antimony, Sb.—Metallic Antimony is not official, nor is it used in medicine. It is represented, how- ever, by the following official salts and preparations, viz.: Compounds of Antimony and their Preparations. Antimonii et Potassii Tartras, Tartrate of Antimony and Potassium, Tartar Emetic, 2KSb0C4H406.H20,—small white crystals or a granular powder, of sweet, disagreeable metallic taste, soluble in 17 of water at 590 F., and in 3 of boiling water, insoluble in alcohol. Dose, gr. but after tolerance is established as high as gr. ij may be given. Is an ingredient of the two following, viz.; Vinum Antimonii, Wine of Antimony,—has of Tartar Emetic 4, Boiling Distilled Water 60, Stronger White Wine to 1000 parts. Contains about 2 70 ANTIMONIUM. grains of Tartar Emetic to the g, and is an ingredient of Mistura Glycyrrhizse Composita. Dose, as a febrifuge and expectorant, nt v-xv. Syrupus Compositus, Cox’s Hive Mixture, Hive Syrup (see under Scill^E),—contains about y grain of Tartar Emetic to the J, or more accu- rately 3 parts in 2000, with Squill, Senega, etc. Dose, HI v-'zi, cautiously in children. Antimonii Oxidum, Oxide of Antimony, Sb2C)3,—a heavy, gray powder, insoluble in water or alcohol, but readily and wholly soluble in Hydrochloric or Tartaric Acids. Dose, gr. j-iij. It constitutes of — PuLVis Antimonialis,—Antimonial or James’ Powder,—consists of the Oxide of Antimony 33 parts, with 67 of Calcium Phosphate. Dose, gr. iij-viij, every 3 hours as a diaphoretic, larger doses for emetic and cathartic effects. Antimonii Sulphidum, Sulphide of Antimony, Sb2S3,—is the native sul- phide, purified by lusion, and as nearly free from Arsenic as possible,—steel-gray masses, or a black, lustreless powder, insoluble in water or alcohol. Dose, gr- X-i- Antimonii Sulphidum Purificatum, Sb2S3,—is purified by maceration in Aq. Ammonise, washing and drying. Dose, gr. Antimonii Sulphuratum, Sulphurated Antimony,—is chiefly Sb2S3, with a very small amount of Sb203. A reddish-brown, odorless and tasteless powder, insoluble in water or alcohol. Is a constituent of Pil. Antimonii Composite Dose, gr. j-v. Pilulae Antimonii Composite, Plummer’s Pills,—each pill contains gr. x/2 each of Calomel and Sulphurated Antimony. Physiologica l Action. Tartar Emetic in its action represents the other official antimonial preparations, being a cardiac, arterial and general depressant, a protoplasmic poison, a systemic and local emetic, a specific gastro-intestinal irritant, an expectorant and a diapho- retic. Like Aconite, Arsenic, Hydrocyanic Acid and Potassium, it is destructive to protoplasm, destroying function in all nitro- genous tissue, and paralyzing the spinal cord, the motor nerves, the muscles and the sensory nerve terminations. It is especially depressant to the heart-muscle and the cardiac motor ganglia; it combines with the red blood-corpuscles, lessening their oxidizing power, lowering the blood-pressure and reducing the body-tem- perature. Its taste is styptic and one of its earliest effects is the production of constriction of the fauces. It promotes waste and rapid excretion of waste-products, carbonic acid and urea being especially increased. Being eliminated by all the excretory organs, including the skin, it excites follicular inflammation at the points of elimination ; resulting in an eruption which is pap- ular at first, then becomes vesicular, and finally pustular, the pustules being umbilicated, like those of variola. This same eruption is also produced by the application of the drug to the skin with friction. Aphthous ulcerations, extending from the antimonium. 71 mouth to the stomach, with salivation and painful deglutition, may also result from its continued use. In small doses Tartar Emetic stimulates secretion in the bronchial and salivary glands, the stomach, intestinal canal, liver and pancreas. In larger doses it excites nausea, vomiting and purging, with evacuations like the “rice-water discharges” of cholera, and great prostration of the vital powers. Toxic doses produce similar symptoms, besides epigastric pain, cyanosis, deli- rium, cramps, motor and sensory paralysis, suppression of urine and collapse,—much the same phenomena as observed in Asiatic cholera. The Sulphide occurs native, and is the source from which the other compounds are prepared. It seems to be inert medicinally. Sulphurated Antimony owes its efficacy to the small quantity of the Oxide contained in it, and as this is variable, the action of the preparation is uncertain. The Oxide has a similar action to that of Tartar Emetic, but being insoluble in water, it is of much less certain activity. Antidotes and Antagonists. Tannic Acid, or any substance containing it, is the antidote, forming the insoluble tannate. Opium, Alcohol, Ether, and other antispasmodics are physiological antagonists. Demulcent drinks should be freely administered to protect the mucous membranes. Alkalies and Salts of Lead decompose Tartar Emetic. Therapeutics. Tartar Emetic was formerly much employed as an antiphlo- gistic on account of its power to cut short acute inflammations of sthenic type, and its use was very much abused, so that it has now gone out of fashion as a remedy. The contra-stimulant treatment of pneumonia and other inflammatory diseases by large doses of this salt after tolerance was established, is only worthy of reference as an historical fact. The same may be said of its external use as a counter-irritant as well as of its employment as an emetic, in both of which capacities it is too severe, while its emesis is too tardy in action to be of any value in poisoning. It is, however, a very efficient agent in many grave affections, if used in small doses (gr. being highly recommended in acute inflammatory affections of the respiratory tract, especially pneumonia, broncho-pneumonia, acute oedema of the lungs, feverish and catarrhal colds, bronchitis, laryngitis and tonsillitis. In many respects it acts like Aconite in these and kindred affec- tions, producing copious diaphoresis, slowing the pulse and allay- ing restlessness. It is considered a good remedy in puerperal 72 ANTIPYRINA. peritonitis, mammitisand orchitis, in lumbago and other muscular rheumatisms, also in photophobia and in gastric indigestion after beer-drinking. In still smaller doses (gr. TJ5 hourly) it is par- ticularly efficient in catarrhal inflammations of the respiratory mucous membrane in children, accompanied by rattling breathing and much mucus, which is expelled with difficulty. Such cases often simulate asthma, the attacks being marked by cough, wheezing, and difficult respiration, also sibilant rales in the chest, and usually follow on severe colds or on measles. The Compound Syrup of Squill is commonly used as an expectorant and nauseant in the treatment of bronchitis and croup. The quantity of Tartar Emetic in it (gr. to the 3) should be remem- bered in administering it to children. (See Scilla.) The Oxide is chiefly employed in the form of James’ Powder (Pulvis Antimonialis) for its mild diaphoretic qualities. The Sulphide is not used in medicine. Sulphurated Antimony is very uncertain in action and is but little used. The Compound Pill of Antimony (Plummer’s Pill) was devised to obtain mercu- rial results without writing Hydrargyrum on a prescription. ANTIPYRINA, Antipyrine, Dimethyl-oxy-chinicine, C20H18N4O2 (Unofficial),—is an alkaloidal product of the destruc- tive distillation of Coal-tar (compare Chinolina), and prepared by a patented and complicated process. It may also be obtained synthetically by heating Methyl-oxy-chinicine with Phenyl-hy- dracine, and collecting the powder. It is a grayish or reddish- white crystalline powder, of slightly bitter taste, soluble freely in cold water, also but to a less degree in alcohol, chloroform and ether. It gives an intense red color with Ferric Chloride, and a beautiful green with Nitric Acid. Dose, for an adult gr. xxx every hour for two or three hours, for a child gr. jss for each year of age for three successive hourly doses, in sweetened peppermint water. If vomiting is produced, it may be dissolved in half its weight of water and injected subcutaneously. Physiological Action. Anti pyrin reduces the temperature 3 to 5 degrees in fevers, for several hours, slightly increases the blood-pressure, has no action on the respiration, but causes profuse sweating, which may however be prevented by a small dose of Atropine or Agaricine previously administered. It occasionally produces vomiting and a peculiar eruption on the skin, rarely slight collapse has been observed from it, but as yet no serious result has followed its use. APIOL. 73 Its antipyretic influence lasts from five to twenty hours, and the after-rise of temperature is not generally accompanied by rigor as is the rule with Kairine. It dilates the pupil, and is eliminated by the kidneys, appearing in the urine about three hours after its ingestion. It is a powerful antiseptic and disinfectant, and is said to have hemostatic qualities superior to those of Ergotine. Symptoms, occurring after its administration in health, are slight nausea, singing in the ears, and reduction of body temperature about of a degree. The fall in fever is usually from three to five degrees, but one instance of twelve degrees has been recorded. When administered with Kairine, the mixed drugs produced a greater fall of temperature with longer continuance than when an equal quantity of either was given alone. Therapeutics. Antipyrin is probably the most powerful and least unpleasant of the many organic compounds which possess antipyretic quali- ties. (See under the title Cinchona.) It has been used very extensively in every form of febrile disease, and often with the most strikingly beneficial results, the unpleasant effects being ob- served only in a few instances. It is especially useful in typhoid fever, phthisis, erysipelas and rheumatism, also in the febrile dis- eases of children and surgical fever. It is not so satisfactory in pneumonia or in pleurisy. In phthisis it may produce consid- erable depression, and in typhus fever it has caused serious col- lapse, but in the other affections noted it is an agent of great value, and almost free from danger. APIOL (Unofficial),—is a non-volatile, oily liquid, of acid reaction and pungent taste, soluble in alcohol, ether, chloroform, and in glacial acetic acid. It is extracted from the fruit of Petro- selinum sativum (Parsley), a biennial plant of the nat. ord. Um- belliferse, which also contains a gelatinous substance named Apiin, and a Volatile Oil which is by some considered to be the true emmenagogue principle of the plant. Apiol is probably a mixture of several substances, and as found in commerce is often an impure oleoresin. Dose, tr£iij-x in capsule two or three times a day; as an emmenagogue, Ttjjxv in one daily dose. Physiological Action and Therapeutics. In small doses Crrjjiij—v) Apiol is carminative, diuretic, dia- phoretic, expectorant, and stimulant to the circulation. In full doses (trjjxv) it is decidedly emmenagogue and feebly antiperi- odic, producing headache, tinnitus aurium, intoxication, giddi- 74 APOCYNUM—APOMORPHINA. ness, etc., its action generally resembling that of Quinine. Large doses (uixxx-3j) are decidedly narcotic. It has had some reputation in intermittents and in malarial neuralgise, but is most frequently employed in amenorrhoea and dysmenorrhoea, being of especial advantage in the amenorrhoea of anaemia, also when the menstrual discharge is fetid. It is becoming fashionable as a supposed abortifacient, but is useless for this purpose, and if freely used may produce decided nar- cotism, especially if the preparation employed should happen to be an active one. The capsules of Apiol put up in France and sold in this country over the counters of drug-stores to any appli- cant are generally inert; hence cases of poisoning by this drug are seldom observed. They are however an important source of revenue to the retailers, as, being “imported” preparations, they command a high price, which is readily paid by gullible women who wish to “ bring around their courses.” APOCYNUM, Canadian Hemp,—is the root of Apocynum cannabinum, an indigenous perennial plant of the nat. ord. Apo- cynacese, and inodorous but of bitter, disagreeable taste. It con- tains a peculiar active principle, Apocynin, also tannic and gallic acids, resin, wax, caoutchouc, etc. Dose of the powdered root, gr. v-xxx. A decoction to the pint) may be given in doses of 3j-ij thrice daily. Physiological Action and Therapeutics. Apocynum is powerfully emetic and cathartic in full doses, also diaphoretic, expectorant and sometimes actively diuretic. It lowers the pulse-rate, produces much nausea, and induces drowsiness. It should not be confounded with Indian or Amer- ican Hemp (Cannabis sativa), which have entirely different qualities. The only condition in which Apocynum has proven of much value is dropsy, especially the anasarca of Bright’s disease and ascites, in which 15-grain-doses are indicated. The active prin- ciple, Apocynin, is a good expectorant, in doses of gr. to gr. APOMORPHIN-ZE HYDROCHLORAS, C„H„NOs- HC1,—is the Hydrochlorate of an artificial alkaloid, Apomor- phine, prepared from Morphine or Codeine by the action of strong acids or zinc chloride. It occurs in minute, colorless crys- tals, odorless, of bitter taste, and neutral or faintly acid reac- tion; soluble in 7 of water and 50 of alcohol at 590 F., almost AQUA. 75 insoluble in ether or chloroform ; decomposed by boiling water or boiling alcohol. Dose, gr. to Jg hypodermically, gr. 11-g- to by the mouth. For young children, gr. g to should not be exceeded. Solutions should be fresh when used. Physiological Action. Apomorphine is a systemic emetic, acting directly on the vomiting centre, and is the quickest, most certain and least irri- tating of all emetics, acting in from five to twenty minutes with but moderate nausea. In large dose it is very depressant to the heart (gr. Jj having caused death in a weak adult by cardiac fail- ure), and produces paralysis of the motor and sensory nerves, delirium, convulsions, and depression of respiratory power. Small doses (gr. ) are expectorant Therapeutics. The Hydrochlorate is usually employed, and is the only official preparation. It is the best emetic to use in many cases of poi- soning, particularly when swallowing is difficult, but is useless in narcotic poisoning after narcosis has blunted the vagus centre. It is a very desirable agent in any case where time is of great importance. As an expectorant it is highly recommended but has not yet been much used. In catarrhs the of a grain every 3 hours will prove of great advantage, but it must be used with caution especially in young children who’bear this remedy very badly. AQUA, Water, H20,—is natural water in its purest attain- able state, a colorless, limpid liquid, devoid of odor or taste, of neutral reaction, and containing not more than i part of fixed impurities in 10,000 parts. Besides entering into the composition of most of the official extracts, fluid extracts, and many other phar- maceutical preparations, from it are prepared the 13 official Waters (Aquse), and also the official— Aqua Destillata, Distilled Water, H20,—1000 parts of water are distilled, the first 50 parts obtained being thrown away, 800 parts are preserved. It is as near chemically pure water as can be obtained. Nomenclature. Aqua Fluvialis, River-water. Aqua Pluvialis, Rain-water. Aqua Fontana, Spring or Well-water. Aqua Marina, Sea-water. Aqua Destillata, Distilled Water. Aqua Bulliens, Boiling Water. Aqua Fervens, Hot Water. Aqua Communis, Common Water. Balneum Maris, Warm-water Bath. Balneum Vaporis, Vapor Bath. 76 AQUA. Mineral Waters. Natural Water differs from Distilled in containing saline and other constituents in varying proportions,—from common water (Aq. Communis), in which they are so small in quantity as not to alter the taste, color, etc., up to the Sea-water, having per cent., and that of the Dead Sea with per cent. Spring waters, impregnated with foreign substances so as to have a de- cided taste and a marked action on the human system, are called Mitieral Waters, which may be subdivided into various groups, according to their prevailing constituents, as Carbonated, Alka- line, Saline, Sulphuretted, Silicious, etc. Full analyses of all the principal mineral waters of Europe and America are given in the United States Dispensatory, 15th edition, but a few of the most prominent will be mentioned here. Carbonated Mineral Waters. Selters, Nassau, Germany, 30 cubic inches Apollinaris, Nuenahr, Prussia, ... 47 “ Old Sweet Spring, West Virginia, . . 11 “ Sweet Chalybeate Spring, Virginia,. . 13 “ of C02 to the pint. These waters are cold, contain generally Carbonates of Calcium, Magnesium and Sodium (in some, Iron), which are held in solution by the excess of Car- bonic Acid, also Chlorides of Sodium and Potassium, Sulphates, Phosphates, etc. Ems, Germany. Salzbrunn, Germany. Gleickenberg, Austria. Vichy, France. Vais, France. Bladon Spring, Ala. Congress Spring, Cal. Seltzer Spring, Cal. Alkaline Mineral Waters. Perry Spring, Ills. St. Louis Spring, Mich. Buffalo Lithia Spring, Va. Hot Spring, Va. Warm Spring, Va. Berkeley Spring, Va. Bethesda Spring, Wis. Gettysburg Spring, Pa. These waters are generally cold, those of Vichy and Ems being warm. They contain a considerable amount of Sodium Carbonate, also Sodium Chlo- ride and Sulphate, and various other Chlorides, Carbonates and Sulphates, with Carbonic Acid gas in varying quantity. Vichy and Vais waters depend for their efficacy almost wholly on the quantity of Sodium Carbonate contained in them, which is for Vichy from 26 to 50 grains and for Vais about 60 grains to the pint. Saline Mineral Waters. Friedrichshall, Germany. Hunyadi Janos, Hungary. Baden-Baden, Germany. Wiesbaden, Germany. Carlsbad, Bohemia. Pullna, Bohemia. Seidlitz, Bohemia. Marienbad, Bohemia. Cheltenham, England. Kissengen, Bavaria. Reichenhall, Bavaria. Adelheidsquelle, Bavaria. Kreutznach, Prussia. Saratoga Springs, N. Y. Ballston, N. Y. Hot Springs, Arkansas. AQUA. 77 These waters are of more complex composition, the various waters of Sara- toga containing more than thirty constituent salts. Those usually present are the Sulphates and Carbonates of Sodium, Calcium, Magnesium, etc. (Mag- nesian waters'); Chlorides of Sodium, Potassium and Lithium (Chlorinated waters), Ferrous salts (Chalybeate waters), with Iodine, Bromine, Manganese salts, and Phosphates in some few. Carbonic Acid gas is present in all. Most of them are purgative, some are considered alterative, and many are warm (ioo°- 1600). The most powerful member of the saline group is Hunyadi Janos, which contains about 150 grains each of Magnesium and Sodium Sulphates to the pint, and is, therefore, effectively purgative. Nearly as strong is Piillna water, with 124 grains of Sodium Sulphate and 93 grains of Magnesium Sulphate to the pint. Friedrichshall is less powerful, but perhaps a better aperient water in doses of 6 to 10 fluid ounces. Marienbad contains no Magnesium Sulphate, but has 36 grains of Sodium Sulphate, 9 of Sodium Carbonate, 11 of Sodium Chloride, and a small quantity of Ferrous Carbonate to the pint; in transportation, however, it loses its Carbonic Acid and deposits the Iron. It is not aperient in ordinary doses. Carlsbad water contains 20 grains of Sodium Sulphate and 9 each of Sodium Carbonate and Chloride to the pint. The so-called “ Carlsbad Salt” is simply Sodium Sulphate with a trace of the Carbonate. Hartnack gives the following formula for its artificial preparation : Sodium Sulphate 100 parts, Sodium Bicarb. 80, Sodium Chloride 40; a des- sertspoonful in water as a mild saline purgative. These waters are imported into the United States in large quantities, and may be ordered through any druggist. Aix-la-Chapelle, Prussia. Bareges, S. France. Eux-Bonnes, S. France. Llandrindod, Wales. Uarrowgate, England. Sulphurous Mineral Waters. Blue Lick Spring, Ky. Sharon Spring, N. Y. Yellow Sulphur Spring, Va. White Sulphur Spring, W. Va. Salt Lake Warm Springs, Utah. These waters all contain Sulphuretted Hydrogen gas, also Carbonic Acid gas and Carbonates, Chlorides and Sulphates of Sodium, Potassium, Mag- nesium and Calcium; sometimes Carbonate and Oxide of Iron, Iodide and Bromide of Sodium. Silicious Mineral Waters. Hot Springs, Iceland. Geysers of Yellowstone Park. The constituents of these waters are chiefly alkaline Silicates. Water is an essential constituent of all the tissues of the body, forming from 0.2 per cent, of the enamel of the teeth to 77 per cent, of the ligaments. In the liquids of the organism it is con- tained in the proportions of 78 per cent, of the blood to 93 per cent, of the urine, and 99 per cent, of the tears. In moderate quantity it is necessary to digestion, but in large amount it weakens digestion by diluting the gastric juice. Ice-cold water, if freely used, suspends the action of the pepsin, depresses the Pnysiological Action. 78 AQUA. nerves of the stomach, and lowers its blood-supply. The free use of water internally produces increased cutaneous and renal excretion, and promotes the elimination of some of the products of tissue-change, as urea, phosphoric acid, etc. In some subjects it favort the deposition of fat. Cold Water applied externally, as by a bath (4o°-6o°F.), abstracts a portion of the body-heat, lowering the surface tem- perature and depressing the cutaneous nerves, producing spas- modic breathing and a quickened pulse. If the temperature of the water is not too low and the bodily vigor is good, reaction soon occurs, and the general effect is tonic to the muscular power, circulation and respiration. If this does not take place a secondary chill occurs, and serious depression may result. Warm Water (95°-ioo°F.) applied to the surface of the body, as by baths of water or steam, packing, etc., acts in the opposite manner at first, increasing the circulation in the skin, the rapidity of the pulse and respiration, and the body tempera- ture. Rapid tissue-change occurs, the waste products being eliminated chiefly by the skin and the pulmonary mucous mem- brane. If long-continued, precordial oppression, giddiness and muscular debility are experienced. Hot Water (iio°-ii2° F.) at first dilates the vessels of the part to which it is applied, and soon afterwards contracts them. It is a valuable means of relieving congestion and inflammation, and is a most effective hemostatic when the bleeding is from small vessels or of capillary character. Whether generally or locally applied it is one of the most reliable means of relieving spasm. Hot Vapor applied to the surface accelerates the circulation and produces profuse sweating. Its general action is similar to that of warm water. Mineral Waters taken internally act chiefly by virtue of the water, partly in accordance with the effects of their various constituents. As baths their action is doubtless entirely due to their temperature. Therapeutics of Water. Cold Water or Ice has many external applications of value in the treatment of disease. As a wet pack it is used in tonsillitis, diphtheria and croup. Cold baths are the most effective anti- pyretic in the high temperature of fevers, and the cold wet pack is used for the same purpose. Ice or cold water is applied to the head in acute cerebral congestion, and to the spine in chorea, etc. ; also locally in hemorrhoids, bubo, orchitis, and to the uterus in post-partum hemorrhage. Cold affusion to the body AQUA. 79 is employed as a preventive of spasmodic croup, as well as to lessen the tendency to taking cold. Hot Water externally, as fomentations, hot wet pack, baths, etc., is most effective in reducing local congestion and setting up resolution of local inflammation. Hot fomentations to the renal region are useful in functional inactivity of the kidneys. The hot spinal douche is used in affections of the spinal cord and meninges, and in the backache of women. The hot wet pack is highly esteemed in inflammations of the chest organs, and hot injections for chronic inflammation of the uterus. Hot water dressings for wounds are strongly recommended by many high surgical authorities. Vapor and Turkish baths are used as diaphoretics in advanced kidney disease, in acute and chronic rheumatism, mineral poisoning, and syphilis. Warm baths, with cold applications to the head, are esteemed as of value in infantile convulsions and chorea. Internally, water is chiefly of value as a diuretic, and if hot as a diaphoretic. A glass of cold water before breakfast daily is often an effective means of overcoming constipation, while the drinking of hot water an hour before each meal has been of great value to many dyspeptics. The value of the popular teas in chronic diseases is almost entirely due to the diluent, diuretic and diaphoretic actions of the hot water used. Therapeutics of the Mineral Waters. An undue value is placed by the laity and interested proprietors on the medicinal value of mineral waters, causing the various localities of the best advertised springs to become resorts for invalids and idlers from every civilized country. The benefit derived is in most instances due to the change of climate and scene, freedom from home cares and business worry, regularity of life and diet, drinking of water in quantity, and in many cases the substitution of water for alcoholic beverages. In order to get the worth of their money, people will gladly submit to rigid hygienic and dietetic restrictions at a watering-place which they would totally ignore at home. The same may be said of the treatment at the so-called “hydropathic” or “ water-cure” establishments. As a rule, those springs will prove of most value which are furthest removed from the patient’s residence, for “ dis- tance lends enchantment” in these matters as well as in many others. Invalids whose homes are in the vicinity of some won- der-working spring will not usually derive any benefit from its water, but will by that of another spring, similar in constituents, but located several hundred miles away. 80 ARGENTUM. The principal affections in which mineral waters are esteemed most highly are the following: dyspepsia, cirrhosis of the liver, gout, rheumatism, lithiasis, diabetes of hepatic origin, constipa- tion, strumous disorders, obesity, plethora of the pelvic organs, hypochondriasis, skin diseases, especially those depending on gastric derangement, phthisis, constitutional syphilis, metallic poisoning, etc., in all of which the influences above mentioned are especially efficacious, and are no doubt the chief factors in producing any benefit which may be attainable. The special therapeutics of mineral waters are to be found in this volume under the heads of their principal constituents, as Sodium Chloride, Sodium Sulphate, Magnesium Sulphate, etc., also in the therapeutical part of the work. Aperient and purgative waters are useful in many cases where a prejudice exists against purgative medicine, but none against the same agents in a natural water. The strong saline-aperient waters, as Carlsbad, Hunyadi, Friedrichshall, etc., have considerable re- pute in the treatment of the uric-acid diathesis and calculous affections. ARGENTUM, Silver, Ag,— is represented by the follow- ing four official salts, viz.— Compounds of Silver and their Preparations. Argenti Nitras, Nitrate of Silver, AgN03,—occurs in colorless rhombic crystals, of bitter caustic taste and neutral reaction, soluble in 0.8 of water and 26 of alcohol at 590 F. Is best given in pill or distilled water; never with tannin or a vegetalile extract, lest an explosive compound result. Dose, gr. £- yi,—if watched up to gr. j may be given. When melted with 4 per cent, of Hydrochloric Acid it makes — Argenti Nitras Fusus, Moulded Nitrate of Silver, Lunar Caustic,—for local use as a mild caustic and an astringent. Argenti Nitras Dilutus, Diluted Nitrate of Silver, Mitigated Stick,—is the same melted with an equal weight of Potassium Nitrate. Is used locally by ophthalmologists. Argenti Cyanidum, Cyanide of Silver, AgCN,—has no medicinal use except for the extemporaneous preparation of Hydrocyanic Acid. (See ante, page 29.) Argenti Iodidum, Iodide of Silver, Agl,—a greenish-yellow powder in- soluble in water or alcohol. Is used instead of the nitrate internally, as it is supposed not to discolor the skin. Dose, gr. in pill. Argenti Oxidum, Oxide of Silver, Ag20,—a brownish-black powder, nearly insoluble in water and insoluble in alcohol. It should not be triturated with readily oxidizable or combustible substances, and should not be brought into contact with ammonia. Dose, gr. in pill. Is not dangerous. All the silver salts should be protected from light in dark amber-colored vials. ARGENTUM. 81 Physiological Action. Nitrate of Silver is a powerful astringent and a limited escharotic. Applied to the skin or mucous membrane it com- bines with the albumen of the tissue, excites superficial inflamma- tion, which is soon followed by an altered condition of the part, and stains the same black under the influence of light. The stains may be removed by washing with a strong solution of Po- tassium Cyanide. Given internally in small doses it increases secretion, stimulates the heart, promotes nutrition, and acts as a nerve tonic. Its continued use produces symptoms which are collectively termed Argyria, and are as follows : gastro-intestinal catarrh, tissue waste, uraemia, albuminuria, fatty degeneration of the heart, liver and kidneys, hemorrhages, fluidity of the blood, a slate-colored line along the margin of the gums, and a similar discoloration of the skin and mucous membranes, with centric impairment of the nervous system producing paralysis on a large scale, loss of codrdination power, convulsions, and finally death by paralysis of respiration. Large doses produce violent gastro- enteritis, also ulcer of the stomach from thrombosis of its veins, and destruction of the gastro-intestinal mucous membrane. The Iodide and Oxide are sometimes used to produce the same constitutional effects, they being supposed not to discolor the skin, but this has been found to be fallacious. The oxide is much the least irritant of the silver salts. Antagonists and Incompatibles. Common Salt freely used is the antidote, precipitating the insoluble chlo- ride of silver and acting as an emetic. The nitrate is exceedingly sensitive to organic material and light, which decompose it readily. Incompatibles are all the soluble chlorides (hence it should be used in distilled water), most of the mineral acids and their salts, alkalies and their carbonates, limewater and astringent infusions. A course of silver medication should be regulated by suspending the remedy after 5 or 6 weeks’ use, and then promoting elimination by purgatives, diu- retics and baths. To prevent the general discoloration Potassic Iodide should be given conjointly with the silver, and baths of Sodium Hyposulphite used frequently. Therapeutics. Locally the Nitrate is much used as a stimulant application, an astringent, a caustic, an alterative and an antiphlogistic. To ulcers and in throat affections the solid stick may be used, but solutions of various strengths from gr. j to gr. xl to the 3 are much better. The mildest solutions are employed in conjunc- tivitis (never over the cornea), the stronger in throat and mouth 82 ARNICA. affections, and the strongest in lupus, erysipelas and other skin diseases. A solution in Nitrous Ether (gr. xl to the 3) is said to abort superficial inflammations if applied early to the neigh- boring integument, and in erysipelas a solution of gr. xx to the 3 is often used over the inflamed surface and beyond, after careful washing and drying, in the hope of preventing the extension of the disease, which it will not do. The mucous membranes of the conjunctiva, fauces, larynx, urethra, bladder, uterus, vagina and rectum, have all been subjected to the local action of this salt. Internally the silver salts are used in dyspepsia with vomiting of yeasty fluid, chronic gastritis and gastric ulcer, dysentery of chronic type especially if rectal ulcer (the Nitrate internally and by enema), the diarrhoea of phthisis and typhoid fever (Nitrate with Opium), chronic spinal inflammations causing loco- motor ataxia or paraplegia, and epilepsy, in the latter affection the Nitrate having occasionally given good results. The Oxide has been used internally for gastric neuralgia, irri- tative dyspepsia, pyrosis, gastric and pulmonary hemorrhages, and menorrhagia. The Iodide is used to obtain the constitu- tional effects of silver, but has no advantage over the other preparations. ARNICA ,—is the plant Arnica Montana or Leopard’s Bane, a perennial of the nat. ord. Compositae, indigenous to the moun- tains of Northern Europe and Siberia, and said to have been also found in the mountains about the headwaters of the Missouri and Columbia rivers. It has large orange-yellow flowers, and a small, curved rhizome with several rootlets. Both the flowers and the root are official. Its most important constituent is Trimethy- lamine, C3H9N, an ammoniacal alkaloidal principle which is probably the active ingredient. It also contains Amicin, Inulin, Capronic and Caprylic Acids, tannin, mucilage, resins, and two essential oils, one of which exists in the flowers, the other in the root. Arnica; Flores, Arnica Flowers,—the flower-heads of Arnica Montana, large, yellow, having 14 to 16 strap-shaped florets in the ray, twice as long as the disk, which consists of numerous tubular florets. The odor is feebly aromatic, the taste bitter and acrid. Used in Tincture and Infusion. Arnica; Radix, Arnica Root,—the rhizome and rootlets of Arnica Montana, is about 2 inches long and yi to */& inch thick, externally brown and rough from leaf-scars; internally whitish, with a thick bark containing a circle of resin-cells and a large, ARNICA. 83 spongy pith. Odor somewhat aromatic, taste pungent, aromatic and bitter. Resembles Valerian, which is distinguished by its smell; Serpentaria, which has many contorted rootlets; and Vera- trum Viride, which has thicker rootlets. Dose, gr. v-xx. Preparations of the Flowers. Tinctura Arnica Florum,—20 per cent. Dose, Rlv-xxx. Infusum Arnica (Unofficial),—Arnica flowers 20 in 100 parts of water, is thought by many observers to be the best form for local use, as it does not excite dermatitis, probably from containing none of the Volatile Oil, or the insoluble principle Arnicin. Preparations of the Root. Extractum Arnica: Radios,—Dose, gr. j-iij. Extractum Arnica: Radios Fluidum,—Dose, iR v-xx. Tinctura Arnica: Radios,—10 per cent. Dose, Rl v-xxx. Emplastrum Arnica:,—contains Extract of Arnica Root 50 parts to 100 of Lead Plaster. Derivative. Trimethylamina, Trimethylamine, C3H9N (Unofficial),—is a thin, color- less, strongly alkaline liquid, boiling at 50° F„ and at ordinary temperatures is a colorless, inflammable gas. The Hydrochlorate is the most stable salt, crys- tallizing in white or colorless prisms, nearly odorless, of pungent taste, very deliquescent, and freely soluble in water and in alcohol. Dose, gr. ij-iij in syrup every 2 hours. Trimethylamine has been obtained from Arnica flowers and those of several other plants, from Ergot, Hops, Codeine, Cod-liver Oil, human urine, herring- pickle, and the residue left in making sugar from beets. It is sometimes incorrectly named Propylamine, a term also applied to an impure trimethyla- mine, but in reality an allied and isomeric compound. Physiological Action. Arnica is irritant, stimulant, depressant, antipyretic, diuretic and vulnerary. It irritates the gastrointestinal tract, and in some persons the local use of an alcoholic preparation of the flowers will excite erysipelatous inflammation of the skin, though those of the root have not been observed to do so. In small doses internally it increases the action of the heart, raises the arterial tension and stimulates the action of the skin and the kidneys. Large doses produce a transient excitement, followed by depres- sion of the circulation, respiration, and nerve-centres; head- ache, unconsciousness, and even convulsions being induced, the body-temperature lowered, the pupils dilated, and muscular paresis produced. A toxic dose paralyzes the nervous systems of animal and organic life, causing collapse and death. Trimethylamine is an active escharotic and a gastro-intestinal irritant. It lowers the rate and force of the heart, decreases the 84 ARSENIUM. body-temperature, and diminishes (though sometimes increases) the excretion of urea. The Hydrochlorate is a powerful anti- pyretic in doses of gr. ij every 3 hours. Therapeutics. Arnica is a popular remedy with those who patronize the so-called homceopathic school of practice, but, like many other agents which the homoeopathists claim to have given to medicine, it is a remedy much older than homoeopathy, and was investi- gated originally by regular physicians, notably by Van der Kolk in the sphere of mental affections. Externally, the tincture in water has a popular reputation in sprains, bruises, etc., though an infusion is better for local use. Ecchymosesare rapidly dispersed by its administration internally as well as externally; and, in internal bruises from shocks or con- cussions, its internal use has proven very efficacious. The aqueous preparation locally promotes the rapid union of cut surfaces. Internally, besides its value as noted above, Arnica is un- doubtedly effectively employed in typhus and typhoid fevers as a stimulant and antipyretic, also in delirium tremens, rheuma- tism and rheumatic gout, hemorrhages, epistaxis, hemoptysis, amaurosis, concussion of the brain, chronic dysentery, and par- alysis of the bladder. In idiopathic mania, after the first excitement has diminished, Arnica, in aqueous preparation internally, has given great satis- faction. It has often checked an exhausting diarrhoea after many other remedies have failed. Trimethylamine has been found useful in acute rheumatism and gout, relieving pain, reducing temperature, and diminishing the frequency of the pulse. In chronic rheumatism, as a liniment (1 to 3 of Glycerin), it is said to give relief equal to that pro- duced by any anodyne. It has also been used with benefit in chorea, moderating the spasmodic movements when not sus- pending them entirely. ARSENIUM, Arsenic, As.—The metal Arsenic is not used in medicine, but is represented by one of its Oxides, a salt of another Oxide, and the Iodide, which are official; together with four preparations of these compounds, or of their salts, viz.— Arsenic Compounds and their Preparations. AciDUM Arseniosum, Arsenious Acid, Arsenious Oxide, White Arsenic, As2Os,—is a heavy, white solid, occurring as an opaque powder, or in semi- ARSENIUM. 85 transparent masses having usually a striated appearance, soluble in 30 to 80 of water at 590 F., the solubility varying with its physical condition, also sol- uble in 15 of boiling water, in alkalies and their carbonates, hydrochloric acid and in glycerin. It is volatilized at 424.50 F., without melting, and when thrown on ignited charcoal it emits an alliaceous odor. Arsenious Acid is obtained by roasting native arsenides, and condensing the fumes in a long horizontal chimney. Dose, gr. -fo to T\j. Liquor Acidi Arseniosi,— is a 1 per cent, solution of Arsenious Acid in Hydrochloric Acid and Distilled Water. Dose, rri_ij—x. Liquor Potassii Arsenitis, Solution of Arsenite of Potassium, Fowlers Solution,— is prepared by boiling together Arsenious Acid 1, Bicarbonate of Potassium 1, and Distilled Water 10; then adding Compound Tincture of Lavender 3, and Distilled Water up to 100 parts. Dose, ttlij-x. Sodii Arsenias, Arseniate of Sodium, Na2HAs04.7H20,—is a salt of the second oxide, Arsenic Acid, As205. It is in colorless, prismatic crystals, of feebly alkaline taste and a faintly alkaline reaction, soluble in 4 of water at 59° F., very soluble in boiling water, hardly soluble in alcohol. Dose, gr. lVs ; of the dried salt, gr. Liquor Sodii Arseniatis, Solution of Arseniate of Sodium, Pearson’s Solution,—has of the Arseniate dried 1 part in 100 of Distilled Water. Dose, iTtij-xv. Arsenii Iodidum, Iodide of Arsenic, Asl3,—in glossy, orange-red, crystal- line masses or scales, gradually losing iodine by exposure to the air, soluble in 3.} of water and in 10 of alcohol at 50° F., is gradually decomposed by boiling water and by boiling alcohol, and is completely volatilized by heat. Dose, gr. Liquor Arsenii et PIydrargyri Iodidi, Solution of Iodide of Arsenic and Mercury, Donovan’s Solution,—has of Iodide of Arsenic 1, Red Iodide of Mercury 1, in 100 parts of Distilled Water. Dose, Tn.ij-x. Physiological Action. Arsenious Acid, when applied to the skin denuded of its epi- dermis, acts as a painful escharotic, producing violent inflamma- tion and resulting in a slough which forms a barrier to its ab- sorption. If applied in dilute solution over a large surface, it will be absorbed, and may produce the systemic effects to be de- scribed. In small doses it is a stomachic and general tonic, promoting the appetite and digestion, increasing the cardiac action, the re- spiratory power, and the intestinal secretions,—stimulating per- istalsis, exalting mental activity and the sexual appetite, and pro- ducing a fair skin and a rotund form. When tolerance of the drug is established, large doses are used with impunity, as by the arsenic-eaters of Styria, who can swallow at once as much as 5 grains with safety. They are careful, however, not to take any water into the stomach at the same time, so that the dose is slowly absorbed, and probably eliminated rapidly. Not all those who begin its use can acquire tolerance of it, but those who do so 86 ARSENIUM. seem to continue it without injury, and live to an old age, under- going great exertion without exhaustion, and being enabled to ascend steep mountains without difficulty of respiration. In full medicinal doses, continued for some time, it causes itch- ing and oedema of the eyelids, ptyalism, nausea and vomiting, diarrhoea or dysentery, epigastric pain and soreness, feeble and irritable heart, dyspnoea, disordered sensibility, herpes zoster, urticaria, eczema and other skin eruptions, jaundice and albumi- nuria. In large doses, it is a powerful irritant to the gastro-intestinal and bronchial mucous membranes. Toxic doses may produce either symptoms of gastro-enteritis, or those of profoundly nar- cotic character. In the first and most usual form of acute arsen- ical poisoning, there is burning pain in the throat and stomach extending over the abdomen, vomiting, thirst, bloody stools, strangury, suppressed, albuminous, or bloody urine, rapid and feeble heart, great anxiety, cold breath, finally exhaustion and collapse,—a group of symptoms much resembling cholera. Au- topsy shows erosions, ecchymoses, and softening of the gastro- intestinal mucous membrane, congestion of the lungs and bronchi, and fatty degeneration of the liver, kidneys and cardiac muscle. The poison is found in the urine, saliva, tears, sweat, etc., and may be detected even in the parenchymatous tissues. In the nervous form of poisoning by Arsenic, profound coma and insen- sibility come on suddenly without any gastro-intestinal symptoms. Arsenical preparations are generally classed as alteratives, but they are valuable tonics and antiseptics, and possess antiperiodic powers second only to those of Quinine. Chronic Arsenical Poisoning may occur from the inhalation of arsenical vapors or dust arising from wall-papers or other substances containing the poison. The quantity necessary to produce symptoms of poisoning when inhaled seems to be very small. The most prominent symptoms are, at first in- creased appetite, next colicky pains, mucous or dysenteric stools, irritation of the eyes, coryza, a short, dry cough, and a white and silvery tongue, all accompanied by great bodily prostration. To avoid arsenical poisoning during a course of the drug, full doses (njjx of Fowler’s Solution) should be used at the commence- ment, and always taken on a full stomach. The dose should then be steadily reduced. Susceptible persons often tolerate it better if a few drops of Tinctura Opii are administered with each dose. ARSENIUM. 87 Antidotes and Incompatibles. Poisoning by Arsenic is treated by prompt evacuation of the stomach, and washing it by means of the stomach-pump, then Magnesia, Chalk and Lime- water freely, or better still, the chemical antidote to Arsenic in solution, viz., the Hydrated Oxide of Iron, freshly precipitated and in a soft magma, in the proportion of gr. viij for each grain of the poison ingested. (See Ferri Oxidum Hydratum for the preparation of this antidote.) Oil or mucilagi- nous drinks should be given to protect the mucous membranes, and diluents, alkaline mineral waters or Iodide of Potassium to promote elimination. Di- alyzed Iron has been shown to be quite efficient as an antidote, and is more easily obtained than the hydrated oxide. It has rendered good service in many cases of poisoning from inhalation of arsenical fumes. Incompatibles are the salts of iron, magnesia and lime, and astringents. Therapeutics. Externally, Arsenic has been employed in the form of paste as a depilatory, and as an escharotic in cancers, but is excessively painful. Most of the secret “ cancer-cures ” have arsenious acid for their basis. Internally, it is used as a tonic and astringent to the intestinal canal, as a tonic and antispasmodic in nervous diseases, and for its action on tissue change. It is of especial value in irritative dyspepsia, gastralgia, pyrosis, gastric ulcer or cancer, regurgitation of food without nausea, diarrhoea coming on immediately after taking food, vomiting of drunkards and chronic alcoholism. It has proven of signal service in the com- mencement of phthisis, and in catarrhal pneumonia, probably by causing fatty degeneration of the exudation in the alveolar cavi- ties, thus breaking it up and quickening its absorption. It is often very serviceable in chronic bronchitis with copious expectoration, in acute catarrh, hay-fever, whooping-cough, asthma, chorea, epilepsy, angina pectoris and other spasmodic nervous disorders. In many forms of neuralgia, it often gives prompt and permanent relief, especially in cases due to malarial poisoning. As an anti- periodic, it has high rank, being, however, of particular value in chronic malarial poisoning, and as an adjunct to Quinine in the intervals between the paroxysms of intermittents. Amemia and chlorosis are remarkably benefited by it, and in rheumatic ar- thritis and chronic rheumatism it is sometimes of great service. In chronic scaly and papular skin-diseases, its value is very great, but it is not serviceable in acute forms, and the more chronic the cutaneous affection the more likely is it to be amenable to Ar- senic. Epithelioma may be retarded by small doses long con- tinued, and it has certainly been useful in delaying the progress of other cancers, particularly scirrhus of the stomach and uterine carcinoma. Hypodermically its solutions have been extremely 88 ASAFCETIDA. efficient in histrionic spasm, local chorea of the head and neck, obstinate cases of general chorea, and in lymphadenoma. ASAFCETIDA, Asafetida,—a gum-resin obtained by inci- sion from the living root of Ferula Narthex and Ferula Scorodosma, perennial herbs of the nat. ord. Umbelliferae, and natives of Persia and Afghanistan. It occurs in whitish tears embedded in grayish sticky mass, of alliaceous odor and taste, soluble in alcohol to at least 60 per cent., and triturated with water it yields a milk-white emulsion. Its principal constituent is a Sulphuretted Volatile Oil, consisting chiefly of Sulphide of Allyl, C6HipS ; it also contains a gum and a resin, with ferulaic, malic, acetic, formic and vale- rianic acids. Dose, gr. v-xx. Preparations. Tinctura Asafcetid^e,—strength 20 per cent. Dose, Mistura Asafcetid.®,—a watery emulsion of strength 4 per cent. Dose, EmplastruM Asafcetiive,—Asafetida 35, Lead Plaster 35, Galbanum 15, Yellow Wax 15, and Alcohol 120 parts. Pilule Asafcetid^e,—each has gr. iij with gr. j of Soap. Dose, j-iv. Pilule Aloes et AsafceTid^E,—each has gr. 1 of each ingredient. Pilulte Galbani Composite,—each has gr. of Asafetida, and gr. jss each of Galbanum and Myrrh, with syrup. Dose, j-iv pills. Mistura M agnesi/e et Dewees’ Carminative,—Magnesium Carbonate 5, Tinct. Asaf. 7, Tinct. Opii 1, Sugar 10, Aqua Dest. q. s. ad 100 parts. Dose, Spiritus Ammonite FcEtidus (Unofficial),—Asafetida Liquor Ammo- niae Fortior 2, Spirit 20 parts. Dose, gss-j. Physiological A ction. Asafetida is a powerful antispasmodic, a stimulant to the brain and nervous system, a stimulating expectorant, also tonic, laxa- tive, diuretic, diaphoretic, emmenagogue, aphrodisiac and anthel- mintic in action. Its odor and taste are extremely nauseous and persistent. In small doses continued it is said to cause impaired digestion, alliaceous eructations, acrid sensation in the fauces, gastralgia, flatulent distension, fetid flatulence, burning urination, diarrhoea and tenesmus. Full doses produce various nervous or hysterical phenomena, with nausea, vomiting and purging. The Volatile Oil diffuses into the blood and tissues, and is excreted in the urine, sweat, breath, etc. By its action the cir- culation is stimulated, the arterial tension raised, the power of the cardiac motor ganglia is increased and the inhibition relaxed. ASCLEPI AS ASPIDIUM. 89 Asafetida also stimulates the brain even to a very pleasant intoxi- cation, and produces a subjective sensation of warmth without any rise of body temperature. It stimulates the nervous system, the secretions and excretions, the menstrual flow and the sexual appetite. In Asia it is used as a condiment with food, and though at first it is extremely nauseous to most people, a taste for it may be readily acquired. Therapeutics. The disgust which is generally felt for this remedy makes its use very restricted, though a valuable medicine. The Mixture is extremely serviceable in the flatulent colic of infants, and as an enema in infantile convulsions. There is no better remedy in hysteria and hypochondriasis with indigestion and flatulence,—in constipation with amenorrhcea of anaemic subjects, due to ovarian and intestinal torpor,—in bronchial affections, cough of habit, chronic catarrhs, and flatulent indigestion. ASCLEPIAS, Pleurisy Root,—is the root of Asclepias tuberosa, a plant of the nat. ord. Asclepiadaceae and a native of the Eastern and Southern States. Two other species of Asclepias are used in medicine and were formerly official. There are no offi- cial preparations, but a fluid extract is in the market, the dose of which is about 5j every 4 hours. An infusion or decoction may be made in the proportion of of the powdered root to a quart of water, and given in teacupful doses every 2 or 3 hours. Physiological Action and Therapeutics. Asclepias contains two resins, a peculiar principle, tannic and gallic acids, albumen, pectin, gum, various salts and a volatile, odorous, fatty matter. It is emetic and cathartic in full doses, also diaphoretic and expectorant, as well as depressant to the action of the heart, and probably slightly sedative and astringent. It is a popular remedy in the Southern States for pleurisy (hence its common name), and has been used in medicine for catarrh, pneumonia, phthisis, diarrhoea, dysentery, rheumatism, gastralgia, and to promote the eruption in exanthematous fevers. It is undoubtedly a powerful diaphoretic. ASPIDIUM, —is the rhizome of Aspidium Filix-mas (Male Fern) and of Aspidium margitiale (Marginal Shield Fern), plants of the nat. ord. Filices, the former found in most parts of the world, the latter indigenous to N. America. It is 3 to 6 inches 90 AURANTIUM. long, thick, scaly, having fibro-vascular bundles within, arranged in an interrupted circle; odor slight but disagreeable, taste sweetish and bitter, astringent and nauseous. The active prin- ciple is Filicic Acid, CMH1806, which is extracted in the oleo-resin. It also contains a green, fatty oil, a volatile oil, resin, tannin, etc. Dose, 5ss-5jss in a single dose fasting, or in divided doses at short intervals, followed by a purgative. Preparation. Oleoresina Aspidii,—is an ethereal extract and deposits Filicic Acid on standing. It should be well shaken before being used. Dose, in capsules, repeated every 3 hours for 2 or 3 doses. Physiological Action and Therapeutics. Aspidium is an efficient vermicide against tape-worm, particu- larly the unarmed variety (Bothriocephalus latus). The oleo- resin is the best form in which to use it, the patient having fasted for the previous day, or only used a milk diet, 5j may then be given in 4 doses hour apart. This may be repeated the next morning and followed by three drops of croton oil in emulsion. This is one of many methods. Brayera (Kousso) may be com- bined with it advantageously. A formula for a mixed treatment by Aspidium, Pomegranate and Pumpkin-seed is given under the title Granatum. AURANTIUM, Orange, —occurs in two official varieties of fruit and flowers, viz.—those of Citrus vulgaris, the Bitter Orange, and Citrus Aurantium, the Sweet or Portugal Orange, both trees of the nat. ord. Aurantiacese, cultivated in almost all warm climates. Other varieties are described under Limon. The official titles are— Aurantii Amari Cortex, Bitter Orange Peel,—tlie rind of the fruit of Citrus vulgaris, characteristics well known. Con- tains a Volatile Oil isomeric with Oil of Turpentine, C10H16, and a bitter, crystalline principle, Hesperidin or Aurantiin. Aurantii Dulcis Cortex, Sweet Orange Peel,—is the rind of the fruit of Citrus Aurantium. It contains a Volatile Oil dif- fering from that of the bitter orange, and less of the bitter prin- ciple. Aurantii Flores, Orange Flowers,—the partly expanded fresh flowers of Citrus vulgaris a.ndCitrus Aurantium. They contain an aromatic Volatile Oil (the official Oleum Aurantii Florum) and a trace of bitter principle. AURUM. 91 Preparations. Extractum Aurantii Amari Fi.uidum,—Bitter Orange Peel ioo, Alco- hol and Water. Used as flavoring. Dose, Tinctura Aurantii Amari,—Bitter Orange Peel 20, Diluted Alcohol q. s. ad 100. A flavoring preparation. Dose, £j-ij. Tinctura Aurantii Dulcis,—Sweet Orange Peel 20, Diluted Alcohol q. s. ad 100. For flavoring. Dose, 3jj-ij. Syrupus Aurantii,—Sweet Orange Peel 5, Alcohol 5, Calcii Phosphas Praecip. 1, Sugar 60, Water q. s. ad 100. Flavoring. Oleum Aurantii Corticis,—a volatile oil, extracted by mechanical means from fresh orange peel. Is soluble in 2 of alcohol, and is an ingredient of Bay Rum (Sp. Myrcise). Dose, gtt. j-v. Elixir Aurantii, Simple Elixir,—Oil of Orange Peel 1, Sugar 100, Alco- hol and Water q. s. ad 300. An excipient for extracts and tinctures, designed to replace the unofficial elixirs. Spiritus Aurantii,—Oil of Orange Peel 6, Alcohol 94 parts. Dose,to be regulated by the quantity of alcohol desired.- Aqua Aurantii Florum, Recent Orange Flowers 40, Water 200 parts dis- tilled to 100 parts. Dose, indefinite. Oleum Aurantii Florum, Oil of Neroli,—a volatile oil, distilled from fresh orange flowers. Is the most important constituent of Cologne Water (Spt. Odoratus). Dose, gtt. j-v. Syrupus Aurantii Florum,—Orange-flower Water 35, Sugar 65. A delicate flavoring agent, but having to some persons an extremely sickish taste. Physiological Action and Therapeutics. Orange is aromatic and tonic, also more or less bitter, but has little action except a mild influence on the nervous system due to its volatile oil. Persons much exposed to its fumes are liable to cutaneous eruptions and various nervous disorders. The oil may produce violent colic and convulsions in children, one case being reported in which death resulted from eating the rind. Its use in medicine is confined to flavoring purposes, though the preparations of the Bhter Orange may be used as mild tonics and stimulants to the digestion, but they are usually combined with more energetic agents for these purposes. AURUM, Gold, Au,—is represented by but one official preparation. The Chloride is found in the shops, being much used by photographers; and triturations of the metal itself may be prepared according to the general formula therefor. Preparations. Auri et Sodii Chloridum,—is a mixture composed of equal parts of dry Chloride of Gold and Chloride of Sodium, AuC13-|- NaCl. An orange-col- ored powder, soluble in water. Dose, gr. Auri Chloridum (Unofficial),—occurs in needle-shaped prisms, of an 92 AZEDARACH. orange-yellow color, deliquescent, freely soluble in water. Dose, gr. - fa. Is best given in solution. Physiological Action. Locally used the Chloride of Gold is escharotic ; administered internally its action closely resembles that of the Bichloride of Mercury. In small doses, it promotes appetite and digestion, and stimulates the functions of the brain, producing marked mental exhilaration and a general sense of well-being. Continued, it induces aphrodisiac effects in both sexes, and in women in- creases the menstrual discharge. Full doses cause nausea and vomiting, glandular irritation, salivation without loosening of the teeth or sore gums, increased urinary discharge, sweat and fever (the auric fever); nutrition is impaired and rapid waste set up. A toxic dose produces effects similar to those from corrosive sub- limate, namely, violent gastro-enteritis, mental disturbance, priap- ism, tremor, convulsions and paralysis. Antagonists. Poisoning is treated by albumen (eggs) or flour, and evacuation of the stomach—just as in the case of Corrosive Sublimate. Therapeutics. Chloride of Gold is a useful remedy in irritative dyspepsia, gastro-duodenal catarrh, hypochondriasis, amenorrhoea, func- tional impotence, chronic metritis, habitual abortion, ovarian dropsy, vertigo and vertiginous sensations from disordered stomach. It is especially recommended in chronic albuminuria, hepatic sclerosis, granular and fibroid kidney, as it prevents hyper- plasia of connective tissue. In syphilis its utility is proven beyond doubt, particularly in the tertiary manifestations and syphiloma of the bones, in which it is fully as efficacious as the Bichloride of Mercury, with incomparably less inconvenience to the patient. AZEDARACH, —is the bark of the root of Melia Azedarach, or Pride of China, a handsome tree of the nat. ord. Meliaceae, indigenous to China and India, but naturalized in the Gulf States. It occurs in curved pieces or quills, which are almost inodorous and have a sweetish taste, afterwards becoming bitter and nau- seous. There are no official preparations, but a decoction of the fresh bark to Oj boiled to 0)4) may be used in tablespoonful doses. BALSAMUM PERUVIANUM. 93 Physiological A ction and Therapeutics. This drug is known to produce symptoms of narcotic poison- ing, as giddiness, dimness of sight, mental confusion, stertorous breathing, dilated pupils and stupor. Large doses are necessary to cause these effects, and some authorities question their occur- rence. It is, however, a gastro-intestinal irritant, producing vom- iting and purging, and an anthelmintic against the round-worm. Its active principle has not been isolated. It is only employed as an anthelmintic against lumbricoid worms, and as the fresh bark is difficult to obtain in any region where it does not grow, other agents will be more generally used. It is given to horses affected with “ bots.” BALSAMUM PERUVIANUM, Balsam of Peru—is a balsam obtained from Myroxylon Pereira, a Central American tree, of the nat. ord. Leguminosse. Occurs as a thick brown black liquid, its odor reminding of benzoin and vanilla, soluble in 5 of alcohol, almost insoluble in water which only extracts from it some Cinnamic Acid and Cinnamein. It is not a true balsam, as it contains no volatile oil. Composition is,—Cinnamein (Benzyl Cinnamate, C16Hu02) 60 per cent., Cinnamic Acid 6 percent., Resins 30 per cent.; also, Benzoic Acid, and other bodies. Dose, n^x—xxv, in emulsion. There are no official preparations. Physiological Action. The actions of Balsam of Peru are those of its several con- stituents, namely, antiseptic, disinfectant, stimulant to the circu- lation, and sedative to the nervous system; acting chiefly on the mucous membrane, it is tonic and expectorant, diuretic and dia- phoretic. In large doses, it causes gastralgia, nausea and vomit- ing, colic and diarrhoea. It closely resembles in physiological action its congeners Styraxand Benzoin. Therapeutics. Balsam of Peru is used locally in chronic skin-diseases of inflam- matory type and sore-nipples, to relieve itching, cleanse bed- sores, promote the healing of wounds and sores, and to kill the acarus scabiei, being considered by some authorities the best of all applications in itch. Internally, it is used as a stimulant and disinfectant expectorant in chronic bronchitis, asthma, etc., as well as in gonorrhoea, gleet, leucorrhcea, and other discharges from mucous membranes. Incorporated with Iodoform it par- tially covers the odor of that drug. 94 BALSAMUM TOLUTANUM—BAPTISIA. BALSAMUM TOLUTANUM, Balsam of Tolu,—is a balsam obtained from Myroxylon toluifera, a tree of the nat. ord. Leguminosae, native in Venezuela and New Granada. Its composi- tion and properties are similar to those of Balsamum Peruvianum, except that it is of lighter color, more agreeable odor, and con- tains a volatile oil, Tolene, in the proportion of about i per cent. Preparations. \ Tinctura Tolutana, Tincture of Tolu,—contains io per cent, of the balsam dissolved in 90 of alcohol. Dose, njjx-xxx. Syrupus Tolutanus, Syrup of Tolu,—has of the balsam 4 parts in 100 of sugar and water. Dose, gj-ij. Much used in cough-mixtures. Covers the taste of Chloral well. Physiological Action and Therapeutics. Balsam of Tolu has similar actions to those of Balsam of Peru, but being more agreeable in flavor it is used internally more than the latter. It is chiefly employed as a pleasant excipient in cough- mixtures, and is a constituent of the Compound Tincture of Benzoin. BAPTISIA, Wild Indigo (Unofficial),—is the root-bark of Baptisia tinctoria, a plant of the nat. ord. Leguminosse, native in North America, and contains an alkaloid and a resin, neither of which has been examined critically. The so-called Baptisin is an impure resinoid, obtained by precipitation from the alcoholic extract with water. Preparations. Extractum Baptisia, Extract of Baptisia (Unofficial). Dose, gr. j-x. Extractum Baptisias Fluidum (Unofficial). Dose, niij-xx. Tinctura Baptisia (Unofficial). Dose, fflv-xxx. Baptisin (Unofficial),—the resinoid. Dose, gr. j-v. Physiological Action. Baptisia has a bitter and acrid taste; in small doses it is laxa- tive, in large violently emeto-cathartic, and may excite severe gastro-intestinal inflammation. It is a decided stimulant of the liver, and increases the secretions of all the glandular appendages of the gastro-intestinal mucous membrane. It has considerable power as an antiseptic. Therapeutics. Baptisia has been used locally in decoction or cataplasm to obstinate and painful ulcers, in threatened or existing gangrene, BELLADONNA. 95 and gangrenous sores. Internally, it is a useful remedy in amen- orrhcea, typhoid and typhus fevers, variola, scarlatina, and epi- demic dysentery. In the common continued-fever, or in the first stage of typhoid, it will be found of great service in drop-doses of a fresh tincture, repeated every hour. BELLADONNA, Deadly Nightshade,—is an herba- ceous, perennial plant, of the nat. ord. Solanacese, having dark- purple, bell-shaped flowers, and glossy, purplish-black berries about the size of cherries. It is indigenous in the mountainous districts of Central and Southern Europe and Asia, and is cultivated in Europe and in the United States. It contains two alkaloids,— the official Atropine (see below), and Beliadonnine, the latter being considered by many authorities as identical with Hyoscy- amine, Daturine and Duboisine. These exist in the plant in com- bination with Malic Acid. The plant also contains the usual vegetable constituents, as albumen, gum, etc., and a coloring principle named Atrosin. The official titles are as follows: Belladonna Folia, Belladonna Leaves,—ovate and tapering, brownish-green above, grayish-green below, of slight odor and bitter, disagreeable taste. Stramonium leaves are more wrinkled, Hyoscyamus leaves are more hairy. Dose, gr. j gradually in- creased . Belladonna Radix, Belladonna Root,—cylindrical, tapering, wrinkled pieces, to i inch thick, nearly odorless, taste bitter and acrid. Dose, gr. j cautiously increased. Preparations of the Leaves. Extractum Belladonna Ai.coholicum,—Dose, gr. p$-%. Tinctura Belladonna,—15 per cent. Dose, 1Tlj-xxx. Unguf.ntum Belladonna,—has of the Alcoholic Extract 10, Diluted Alco- hol 6, Benzoinated Lard 84. Preparations of the Root. Abstractum Belladonna,—Dose, gr. Extractum Belladonna Fluidum,—Dose, "^Ij-v. Emplastrum Belladonna,—made with Resin Plaster. Linimentum Belladonna,—Fluid Extract 95, Camphor 5. Atropine and its Derivatives. Atropina, Atropine, CnH23N03,—in white, acicular crystals, odorless, of bitter taste and alkaline reaction; very soluble in alcohol and in chloroform, also in 600 of water at 590 F. Is decomposed by prolonged contact with caustic alkalies, and is resolvable into Tropin and Tropic Acid. Atropina Sulphas, Sulphate of Atropine (C17H23N03)2H;|S04,—a white 96 BELLADONNA. powder of bitter taste and neutral reaction, soluble in 0.4 of water and in 6.5 of alcohol at 590 F. Dose, gr. Homatropina, Homatropine, C16H21NOs (Unofficial),—is a derivative alka- loid obtained by the action of dilute HC1 on Amygdalate of Tropin. The Hydrobromate of Homatropine is used by ophthalmologists as a mydriatic, its effects passing off much sooner than those of Atropine. Homatropine slows the heart, Atropine quickening it. Tropeius (Unofficial),—is a result of the action of a mineral acid on Tropin. Physiological Action. Belladonna is an irritant narcotic, a mydriatic, an antispas- modic and an anodyne; in small doses a cardiac, respiratory and spinal stimulant—in large doses a paralyzer of the cardiac and respiratory centres, the spinal cord, the motor nerves and invol- untary muscles. It produces congestion and dryness of the mu- cous membrane of the throat, mouth, nose and larynx, and at first lessens the gastric and intestinal secretions but soon reproduces these in large quantity. The heart-rate is at first slowed, but soon becomes very rapid and vigorous, the pulse being doubled in rapidity; the arterial tension being at the same time raised, the circulation is greatly increased. This is accomplished by stimulation of the cardiac sympathetic, and paralysis of the pneu- mogastric, thus stimulating the accelerator apparatus while les- sening the inhibitory. [Digitalis increases both.] The vaso- motor ganglia are stimulated all over the body, but are afterwards paralyzed by over-stimulation, the heart weakens, the vessels relax, and the blood-pressure becomes greatly reduced. Com- plete motor paralysis follows, delirium, stupor, and finally death which usually occurs by asphyxia. The pupils are dilated by the local or systemic use of the drug, it stimulating the end-organs of the sympathetic and paralyzing those of the motor oculi, thus increasing the power of the radiat- ing iris fibres and lessening the action of its circular ones. Atro- pine locally also paralyzes accommodation and lessens the intra- ocular pressure. The least quantity of Atropine which will affect the pupil is stated at gr. tustht (Wood), gr. (Roosa), gr- iinftnr (E1y)> gr.nhr* (Trousseau), gr. (Loring), gr. tWij(Donders). The brain is congested by Belladonna, headache, vertigo, busy delirium, hallucinations, etc., being produced, the latter from a selective action on the cells of the gray matter. The spinal cord is stimulated from the 3d cervical to the xoth dorsal vertebra, resulting in complete motor paralysis, central and peripheral, power being lost first in the lower extremities. Sensation is also impaired somewhat, but the muscular irritability is not. Respi- BELLADONNA. 97 ration is increased and the body temperature elevated. Meta- morphosis is greatly promoted by the increased activity of the circulation. A diffused eruption of scarlet color, greatly resembling the eruption of scarlet fever, is often produced on the skin and fauces by Belladonna, with dysphagia and sore throat, and is sometimes followed by desquamation of the epidermis. It is due to capil- lary congestion caused by the greatly increased circulation. Belladonna is rapidly diffused and quickly eliminated particu- larly by the kidneys. The urine of an animal under the action of the drug will dilate the pupil of another animal. Herbivo- rous animals and birds are scarcely susceptible to it, and pigeons are not affected by it at all. Atropine has the same actions as above described, being the active principle of the plant. Belladonnine was long supposed to be inert, but has recently been shown to be identical with Hyoscyamine. It is a mydriatic when given internally, but not when used locally. Antagonists and Incompatibles. Opium is the physiological antagonist to the effects of Belladonna on the cerebrum, pupil, heart, respiration, arterial tension and kidneys. I’hysostig- mine, Aconite, Pilocarpine and Quinine are each antagonistic to some of its effects, Muscarine to most of them. In poisoning by this drug, Tannic Acid and emetics should be used, then Morphine, Physostigmine or Pilocarpine for the nervous disturbances. Caustic alkalies decompose Atropine and are therefore incompatible with the preparations of Belladonna. Therapeutics. Belladonna is one of the most valuable drugs in the Materia Medica, ranking with Aconite, Arsenic and Opium in efficacy and wide range of use. It is especially useful in the pain of in- flammation, particularly that of rheumatism, gout, neuralgia due to peripheral disturbance, sciatica, cancer and pelvic affections. In cerebral and spinal hyperaemia, congestive headaches, ence- phalitis, meningitis and myelitis it proves one of the very best remedies. In erysipelas of superficial and non-vesicular character and when cerebral, it is really curative locally and internally administered. Inflammations of the lungs, iris, bladder, kidneys and breasts, are all amenable to it. In constipation from atony of the bowels it is remarkably efficient, and in the enuresis of children it is equally so if used freely, io to 20 drops of the tinc- ture thrice daily. In recent cystitis from chill, spasm of the urethra, bladder and sphincter ani, typhus and typhoid fevers, acute nasal catarrh, sore throat with fever, inflammation, and 98 BENZINUM. swollen tonsils, many skin diseases, asthma and whooping-cough, epileptic and puerperal convulsions, spermatorrhoea and seminal losses, Belladonna is often a highly useful agent. Its local appli- cation is efficiently used in ulcers of the rectum, anal fissure, ab- scesses, boils, carbuncles, and other superficial inflammations. In scarlet fever it relieves many of the symptoms, and is especially indicated in this disease when the rash is imperfect, the pulse feeble and the condition one of adynamia. Its prophylactic power against scarlet fever is believed in by many of our best practi- tioners, though questioned by many others. Atropine is used in poisoning by Opium, Physostigma, and Prussic Acid ; in ptyalism from mercury, pregnancy, etc. ; in the sweats of phthisis, sudden cardiac failure, and by eye-surgeons to paralyze accommodation, dilate the pupil, contract the vessels, lessen pain, and diminish intraocular tension. In ©pium-poi- soning it should be given in very small doses and repeated for effect, as most of the unsuccessful cases of its use in this connec- tion were due to overdosing with the antagonist, superinducing belladonna-narcosis upon the opium-narcosis. In cases of heart- failure from Chloroform or Ether inhalation the hypodermic in- jection of Atropine has in the writer’s hands saved several lives when all other methods of resuscitation had failed. BENZINUM, Benzin, Petroleum Ether,—isapurified distillate from American petroleum, consisting of hydro-carbons, chiefly of the marsh-gas series, having a specific gravity from 0.670 to 0.675, and boiling at 1220 to 140° F. It is a transparent, color- less liquid, highly inflammable, very diffusive, insoluble in water, but soluble in alcohol, ether, etc. It should be distinguished from Benzol, which is called Benzene by English chemists. In pharmacy it has many uses, on account of its powers as a solvent for oils, fats, resins, caoutchouc and some alkaloids. Dose, gtt. v-x, on sugar or in mucilage. Physiological Action and Therapeutics. Benzin is reported to have caused death in one case from gas- tro-enteritis, but ordinarily it does not produce vomiting or diar- rhoea. It has been used with some success externally as a remedy for rheumatic pain, neuralgia, itch and prurigo ; and internally as a vermicide against tapeworm. Its chief value is that of a solvent in cleaning old clothing and in pharmaceutical operations. BENZOINUM. 99 BENZOINUM, Benzoin ,—is a balsamic resin obtained from Styrax Benzoin, a tree of the nat. ord. Styraceie, native in Sumatra and Siam, by incision of its bark. It occurs in agglutinated tears or a brown, mottled mass, is soluble in alcohol and solution of potassa, and is composed of Resins 80 per cent., Benzoic Acid io to 20 per cent., and a trace of Volatile Oil. Some varieties of benzoin yield also Cinnamic Acid. Preparations of Benzoin. Adeps Benzoinatus, Benzoinated Lard,—has of Benzoin 2 parts in ioo parts of Lard. Tinctura Benzoini, Tincture of Benzoin,—has of Benzoin 20 parts, Alco- hol q. s. ad 100. Dose, Tinctura Bf.nzoini Composita, Friar’s Balsam,—has of Benzoin 12, Aloes 2, Styrax 8, Balsam of Tolu 4, Alcohol q. s. ad 100 parts. Dose, ij- Preparations of Benzoic Acid. Acidum Benzoicum, Benzoic Acid, HC7H5021,—occurs in light, feathery plates and needles, and is obtained from Benzoin by sublimation. It is sol- uble in 500 of water, and in 3 of alcohol at 590 F., but its solubility in water is aided by Borax, one part of each being soluble in 100 parts. It is a con- stituent of Tinctura Opii Camphorata. Dose, gr. x-xxv, in wafers. Ammonii Benzoas, Benzoate of Ammonium,—is soluble in 5 parts of water and in 28 of alcohol. Dose, gr. v-xxx. Lithii Benzoas, Benzoate of Lithium,—soluble in 4 parts of water and in 12 of alcohol. Dose, gr. v-xxx. Sodii Benzoas, Benzoate of Sodium,—is efflorescent on exposure to air, soluble in 2 parts of water and in 45 of alcohol. Dose, gr. v-sjj. Physiological Action. Benzoin is decidedly antiseptic and disinfectant, and when used externally is somewhat stimulant to the vessels. Its actions are due to its Benzoic Acid, which taken internally produces slight epigastric heat, increases the pulse-rate, and stimulates the action of the skin, the salivary glands, and of the bronchial mu- cous membrane. It is chiefly excreted by the kidneys, in part as hippuric acid by combination with glycocoll, and in part un- changed. It renders the urine acid and increases its quantity. Benzoin is irritant to the fauces, and the powder inhaled excites sneezing and coughing. Therapeutics. Benzoin is principally used as a stimulant expectorant, espe- cially in the chronic bronchitis of the aged, and by atomization in laryngeal affections. It has also been used beneficially in chlo- rosis and some uterine disorders. The compound tincture is a 100 BERBERIS. good local application (1 to 4 of Glycerin) for sore nipples and chaps of the hands and lips. For use as a cosmetic, either tinct- ure is mixed with 20 parts of water, and employed to remove freckles and other skin eruptions. They are excellent applica- tions to foul smelling wounds, and form the basis of all the pro- prietary preparations sold for that purpose. Benzoic Acid and its salts are the only certain means we possess, by which to neutralize morbid alkalinity of the urine. In cystitis, with phosphatic deposits and alkaline urine, they are extremely valuable, acidulating the secretion, and stimulating and disinfecting the mucous surfaces involved. Phosphatic cal- culi are said to be dissolved by the long-continued use of Ammo- nium Benzoate. Benzoate of Sodium has been largely used as a substitute for the salicylates in the septic diseases, being equally antiseptic and antipyretic. Though slower in action, its effects are more per- manent, and it is capable of being used in larger doses (3'.HU daily). In diphtheria and scarlet fever it has been highly effi- cient, and in acute rheumatism, typhoid and the malarial fevers, it has rendered good service. In phthisis its use by inhalation to the extent of of the body-weight daily has seemed to be of value in some cases. It has also proven very efficient in whoop- ing-cough. Benzoate of Lithium is intended for use in gout and the uric acid diathesis, with the object of forming the very soluble urate of lithium in the system, as also on the theory that, as benzoic acid is converted into hippuric acid at the expense of nitrogenous material which would otherwise become uric acid, the latter pro- duct will be lessened. BERBERIS, Barberry (Unofficial),—is the root of several species of the nat. ord. Berberidaceae, the one generally used being the Berberis aquifolium, or Oregon grape, which grows on the Pacific slope of the United States. Its value is probably due to its alkaloid, Berberine, C20H17NO4, a yellow, crystalline body, soluble in hot water and alcohol, but not in ether, which is found also in several other plants, as Hydrastis, Coptis, Podophyllum Menispermum, Calumba, Xanthoxylum, etc. Preparations. Extractum Berberidis Fluidum (Unofficial),—Dose, n\v-xxx. Tinctura Berberidis (Unofficial),—i to 5. Dose, rrix-%j. Berberina, Berberine (Unofficial),—Dose, gr. j-x. Usually occurs in BERGAMII OLEUM BISMUTHUM. 101 commerce as “ Hydrastin,” which is a Muriate of Berberine, prepared from Hydrastis. Physiological Action and Therapeutics. Berberis is an astringent bitter, a tonic and stomachic in small doses, but in large doses it is cathartic, producing watery diarrhoea with abdominal pain. It is also believed to possess considerable alterative powers. Berberine has some antiseptic and antiperiodic value, and in large doses is a gastro-intestinal irritant. Berberis has been successfully used as a local application in conjunctivitis, and internally as a remedy for intermittent, remit- tent and typhoid fevers, diarrhoea and dyspepsia. As an alter- ative and tonic it has been found useful in syphilitic and stru- mous affections, and in pain, soreness and burning sensations along the biliary or urinary tracts with a tendency to gravel or gall-stones it will be found a useful remedy. The Muriate of Berberine is a useful injection in gonorrhoea, in which it acts by virtue of its antiseptic and astringent powers. BERGAMII OLEUM, Oil of Bergamot,—is a volatile oil, extracted from the rind of the fresh fruit of Citrus Bergamia, an orange-tree of the nat. ord. Aurantiaceae, native in Southern Europe. It is of greenish color, faintly acid, sp. gr. 0.87, and is soluble in alcohol, glacial acetic acid and liquor potassae. It contains several hydrocarbons of the formula C10H16, together with Bergaptene or Bergamot Camphor. It is an ingredient of Spiritus Odoratus, and is exclusively used as a perfume in the manufacture of toilet articles. BISMUTHUM, Bismuth, Bi,—is represented by three of its salts, and one combination of the Citrate with Aqua Ammonise. Preparations. Bismuthi Citras, Citrate of Bismuth, BiC6H507,—is a white, amorphous powder, odorless and tasteless, insoluble in water or alcohol, but soluble in water of ammonia. Used only for pharmaceutical purposes. Bismuthi et Ammonii Citras, Citrate of Bismuth and Ammonium,—is not proven to have any definite composition. Small, pearly scales, very sol- uble in water. Dose, gr. j-v. Bismuthi Subcarbonas, Subcarbonate of Bismuth (Bi0)2C03.H20,—is a white or yellowish-white powder, tasteless, insoluble in water or alcohol. Dose, gr. in powder or emulsion. Bismuthi Subnitras, Subnitrate of Bismuth, Bi0N03.H20,—a heavy, 102 BOLDUS. white powder, odorless and almost tasteless, slightly acid, insoluble in water or alcohol. Dose, gr. x-^j. Physiological Action. The action of the last two Bismuth salts is chiefly a local one, being sedative to the end-organs of the nerves, though a minute quantity passes into the blood and acts as a tonic, promoting con- structive metamorphosis by increasing the appetite and digestion. They are also feebly astringent, and produce constipation after a time, coloring the stools and tongue a dark clay color, from their conversion in part into the sulphide. Toxic effects when occurring are due to Arsenic, with which the commercial prepa- rations are usually contaminated. The Citrate of Bismuth and Ammonium, being soluble, is more rapid in action, more astringent and probably more irritant, though it is probably precipitated in the stomach by the hydro- chloric acid of the gastric juice. Therapeutics. The insoluble Bismuth salts are used internally in many forms of disordered digestion, gastralgia, vomiting and diarrhoea, espe- cially in children, but large doses are necessary for efficiency. The best vehicle for them is milk. Locally they are used with ad- vantage in acne rosacea, stomatitis, nursing sore mouth, eczema, intertrigo, ulcers, conjunctivitis, coryza, gonorrhoea, gleet and leucorrhoea. The Citrate is not used except for pharmaceutical purposes, and the Citrate of Bismuth and Ammonium is only serviceable in diarrhoea without irritation of the intestinal mucous membrane, but rather with relaxation thereof. BOLDUS, Boldo (Unofficial),—the leaves and stems of Peumus Boldus, an evergreen shrub of the nat. ord. Monimiaceae found in Chili. It contains a volatile oil and a bitter alkaloid, Boldine. A tincture is made (i to 5), of which the dose is ■ntv-viij, gradually increased, but large doses have a somewhat narcotic effect, besides causing vomiting and purging. Therapeutics. Boldo is used in anaemia, rheumatism, dyspepsia and general debility, also in catarrhal affections of the urinary passages, and as a substitute for Quinine. In France it is employed as a tonic, especially for cases with chronic torpor of the liver; and in South America it is much used in gonorrhoea and in chronic cystitis. BRAYERA—BROMUM. 103 BRAYERA, Kousso ,—is the female inflorescence of Bray- era anthelmintica, an Abyssinian tree of the nat. ord. Rosaceae. It occurs in bundles or rolls, of fragrant, tea like odor, and bitter, nauseous taste, and contains tannic acid, a volatile oil, and a crys- talline principle named Koussin, which by itself is apparently inert. Dose of Brayera, 5b_Sj- Preparations. Extractum Brayera Fluidum,—Dose, gij-Sj. Infusum Brayera,—6 per cent. Dose or more. Physiological Action and Therapeutics. Kousso has little or no effect except the nausea, vomiting, colic and slight diarrhoea produced by large doses. Its chief action is anthelmintic against both varieties of tape-worm, but it rarely expels the head of the parasite, and is very nauseous to the taste and difficult of retention by the stomach in the large doses ne- cessary to efficiency. 5'j 1:0 5J °f the flowers infused in %\v of boiling water is the usual dose, and should be taken on an empty stomach and followed by a castor-oil or saline purge after 3 or 4 hours. An emulsion of the official infusion with castor-oil, yolk of egg, a few drops of ether and oil of anise with 10 to 20 drops of Oleoresin of Male-fern, is more agreeable and efficient than the infusion alone. BROMUM, Bromine, Br,—is a dark, brownish-red, vola- tile liquid, evolving an irritant vapor of peculiar and suffocating odor. It is soluble in 33 of water at 590 F., very soluble in alcohol, ether, chloroform and carbon disulphide; is a non- metallic element found in sea-water, and in the mother-liquor of certain salt-works, usually in combination. It is only used by inhalation and as an escharotic. Bromides and their Preparations. Potassii Bromidum, Bromide of Potassium, KBr,— colorless, cubical crys- tals, soluble in 1.6 of water, and 200 of alcohol. Dose, gr. v-^j. Sod 11 Bromidum, Bromide of Sodium, NaBr,—colorless, monoclinic crys- tals, soluble in 1.2 of water, and 13 of alcohol. Dose, gr. v-^j. Lithii Bromidum, Bromide of Lithium, LiBr,—a white, granular, deli- quescent salt, very soluble in water and alcohol. Dose, gr. v-xx. Ammonii Bromidum, Bromide of Ammonium, NH4Br,—colorless, pris- matic crystals, soluble in 1.5 of water, and 150 of alcohol. Dose, gr. v-xx. Calcii Bromidum, Bromide of Calcium, CaBr2,—a white, granular, deli- quescent salt, very soluble in water and alcohol. Dose, gr. v-^j. Zinci Bromidum, Bromide of Zinc, ZnBr2,—a white, granular, deliques- cent powder, very soluble in water and alcohol. Dose, gr. y£-ij. 104 BROMUM. Syrupus Ferri Bromidi, Syrup of Bromide of Iron,—is a syrupy liquid containing 10 per cent, of Ferrous Bromide, FeBr.2, prepared by acting on Iron Wire 35 parts with Bromine 75, adding Sugar 600 and Water up to 1000 parts. A translucent, pale-green, odorless liquid of sweet, ferruginous taste and neu- tral reaction. Dose, £ss-j. [Hydrobromic Acid is described on page 26, Ethyl Bromide on page 43, and Camphora Monobromata under Camphora.] Physiological Action. Bromine is an active and very painful escharotic, a deodorant and an antiseptic, setting free ozone. Its vapor is highly irritant to the respiratory mucous membrane and the eyes, producing cough, hoarseness and dyspnoea. Internally, it is an active, cor- rosive poison, causing violent gastritis, depression and collapse. The Bromides are cerebral and spinal depressants, alteratives, antispasmodics and hypnotics. They have a disagreeable, saline taste, and are very diffusible, but slowly eliminated. They are decomposed in the blood, and reformed at the points of elimina- tion (fauces, bronchi, intestines, skin and kidneys), where they irritate the mucous membranes. Continued for some time, they produce severe gastric catarrh. They reduce the number of the respirations and the heart’s action and force, and, though dimin- ishing the calibre of the arterioles, they lower arterial tension. They produce somnolence by lessening the activity of the brain- cells,—diminish the sensibility of the peripheral nerves, causing anaesthesia of the skin and mucous membranes,—impair motility and the sexual function. They also cause pallor, emaciation, lowered body-temperature, acne on the face and upper extremi- ties, fetid breath, dysphagia, sluggish reflexes, defective coordi- nation, and, if long-continued, may even impair the mental fac- ulties, producing melancholia with suicidal tendency and periph- eral paralysis extending to the centres. The general result of their action is termed “ Bromism,” and this condition is heralded by the acne and lowered faucial sensibility. It is probably due to the sedative influence of these agents on the sympathetic ner- vous system, causing a general anaemia of the brain, spinal cord, sexual organs and skin. Potassium Bromide is the most paralyzant to the heart and muscles, and is the least hypnotic. It contains less bromine than the others, 66 per cent. Sodium Bromide is the least toxic, but the most hypnotic, and is most energetic in its action on the circulation. It contains 78 per cent, of bromine. Ammonium Bromide resembles the potassium salt in action, BROMUM. 105 except that it exerts less influence on the heart and muscular sys- tem, and is more stimulating. Lithium Bromide contains the most bromine, 92 per cent., and resembles the sodium salt in action. It has proved better than the others in some cases of epilepsy, and is by several au- thorities considered to be the best hypnotic of the series. Calcium Bromide is an efficient hypnotic, but otherwise much less active than the other salts. Zinc Bromide, in large doses, is violently irritant. It is sup- posed to combine the tonic effects of zinc with the sedative actions of the bromides. Ferrous Bromide is official only in the Syrup. It is supposed to combine the actions of iron and the bromides, and to produce the effects of a sedative chalybeate tonic. It is not an eligible chalybeate. Antagonists and Incompatibles. The physiological actions of the Bromides are antagonized by agents which stimulate the vaso-motor nerves, as Digitalis, Ergot, Belladonna, etc. Nitrous Ether is incompatible with the ammonium salt, and acids and metallic salts with all the Bromides. Therapeutics. The Bromides are used as sedatives to the nervous system, to lower reflex activity and excitement of the genital apparatus, and to produce sleep. They are contraindicated in anaemic condi- tions. The much-employed combination of the potassium salt with chloral is particularly unsafe where fatty or weak heart ex- ists, both drugs being active cardiac depressants. In convulsive and spasmodic affections the bromides are very efficient, and in epilepsy, especially when the seizures are diurnal, the sodium salt is used with great advantage over a long period, in sufficient quantity to maintain anaesthesia of the fauces. It requires occa- sional purgation to prevent its accumulation, and arsenic to com- bat the acne. In diabetes of nervous origin, the ammonium salt, long used, has proved curative by its sedative influence on the medulla; and in acute rheumatism it is an excellent alkali. In muscular rheumatism, rheumatic arthritis and myalgia, the lithium salt gives good results, and in tetanus and strychnine-poisoning the potassium salt, in large doses, is antagonistic. These agents are generally efficient in nervous erethism, insomnia with congestion, infantile colic, cholera infantum, vomiting of cerebral origin, cardiac irritability when not due to anaemia, delirium tremens, melancholia, whooping cough and other reflex coughs, seminal losses when plethora exists, and nymphomania. The potassium salt is, by some writers, considered almost specific in subinvolu- 106 BRYONIA. tion of the womb, and uterine hemorrhage not due to a mechan- ical cause. Bromine is not much used. Its vapor may be inhaled from hot water in acute coryza, hay-asthma, etc., and in chancre and hospital gangrene it is the best escharotic. In diphtheria and membranous croup, a solution of mviij to the 3, used internally, and inhalation of the vapor have been used successfully in the most severe cases. The Syrup of the Bromide of Iron has been reported by some observers as very efficient in chorea, and its usefulness as stren- uously denied by others. BRYONIA, Bryony, —is the root of Bryonia alba and of Bryonia dioica, European perennial plants of the nat. ord. Cucurbi- tacese. It occurs in transverse sections about 2 inches in diameter, having numerous small wood-bundles arranged in circles and projecting lines in the central portion, which is white or grayish. Its taste is acrid and bitter, but it is inodorous. The active prin- ciple is the glucoside Bryonin, which is intensely bitter, and soluble in water and in alcohol, but insoluble in ether. Dose, of the powdered root, gr. x-xxx. Preparations. Tinctura Bryonia, Tincture of Bryonia,—a 10 per cent, solution of the root in alcohol. Dose, n^v-^ss. Bryonin (Unofficial),—is a violent poison in doses of from 3 to 4 grains. Dose, as a drastic purgative, gr. *4 - lA- Physiological Action. Bryonia is a pure irritant, setting up local inflammation wher- ever applied, with febrile phenomena. It has a vesicant action on the skin, and is violently irritant to the serous and mucous mem- branes. Taken internally, it has caused fatal gastritis; introduced into the pleura, fatal pleuritis has resulted with fibrinous effusion. It has a specific determination to serous and synovial membranes, especially the pleurae, and is also irritant to muscular fibre, and to the bronchial mucous membrane, causing dry, continuous, shaking cough, with soreness behind the sternum. It produces cerebral congestion, with frontal headache, vertigo, and epistaxis; also, hepatic and renal congestion, burning pain and tenderness in the hepatic region with bilious disturbance amounting some- times to severe jaundice, vesical tenesmus, and depression of the ac- tion of the heart. It is a drastic purgative and a powerful diuretic. BUCHU. 107 Therapeutics. Bryonia is a very old medicine, its most ancient reputation having been in epilepsy, hysteria and mania, conditions in which it is now superseded by other agents. It is a most valuable drug in the second stage of serous inflammations, especially in pleurisy, pleuro-pneumonia, and pericarditis, after Aconite has reduced pyrexia, to limit the extent of the effusion and to promote its absorption. For this, small doses frequently repeated are required. Also, in rheumatic fever, after the swelling of the joints has been reduced by other means, Bryonia is extremely efficient for the pain and stiffness. It is one of the best remedies for a “ cold- on-the-chest,” with dry, shaking cough, soreness, or shooting pains. It has been used with success in common, continued, or “ gastric” fever, relapsing fever, congestive headaches increased by stooping, bilious headache with vomiting, gastralgia with pyrosis and soreness of the epigastrium, constipation, cholera infantum during dry, hot weather, congestion of the liver, croup, and threatened mammitis. Pains of shooting or tearing character, which are increased by movement, are often quickly relieved by this drug. In dropsies of various forms it is used as a drastic purgative and diuretic to remove the accumulated fluid. BUCHU ,—is the leaf of Barosma betulina, B. crenulata, and B. serratifolia, S. African shrubs, of the nat. ord. Rutaceae, each species having differently-shaped leaves, but all the leaves having crenated or serrated margins, and conspicuous oil-glands at the edges and on their under surface. They contain a Volatile Oil, which is probably the active principle, and gives them a peculiar and penetrating odor, resembling that of peppermint; also, Barosmin, a bitter extractive, and resin, gum, lignin, etc. Dose, of the leaves, gr. xv-xxx. Preparations. Extractum Buchu Fi.uidum,—Dose, - gj. Infusum Buchu (Unofficial),—gj to the pint. Dose, - ij. Physiological Action. Buchu in small doses causes a sense of heat in the stomach, which is gradually diffused over the body. It increases the pulse- rate, stimulates the appetite, and produces slight moisture of the skin. It increases the flow of urine, which becomes of darker color and strongly aromatic odor, and deposits a brownish sediment. 108 CADMIUM—CAFFEA. In large doses, it produces vomiting, purging, and strangury, with a burning sensation at the stomach. Therapeutics. Buchu is of especial value in chronic affections of the genito- urinary mucous membrane, on which the volatile oil acts topically, being eliminated by the kidneys. It is a very useful remedy in pyelitis, cystitis, and urethritis; also, in lithiasis, chronic bron- chitis, and affections of the prostate gland. It is recommended in atonic dyspepsia, chronic rheumatism, affections of the skin, and for dropsy, but it is not so actively diuretic as to be very efficient in the latter condition. The infusion makes an excellent vehicle for saline diuretics. CADMIUM, Cd (Unofficial).—This metal was official in the Pharmacopoeia of 1870, but is no longer so. In its physio- logical action it resembles both Antimony and Zinc, being escharotic, astringent, and a very depressant emetic. In over- doses, its salts act as irritant poisons, with cerebro-spinal symp- toms, such as coma and convulsions. It is never used internally. Its salts in general use are— Cadmii Sulphas (Unofficial),—transparent oblique prisms, efflorescent, and very soluble in water. Used externally in a solution of gr. ss - iv ad aq. destil., or as an ointment (1 to 40 of fresh lard). Cadmii Iodidum (Unofficial),—large, white, pearly crystals, soluble in water and alcohol. Used as an ointment, 1 to 8 of lard. Therapeutics. The Sulphate has been used almost exclusively as a stimulating astringent in gonorrhoea and diseases of the eye. Corneal opacities are absorbed under the use of a solution of gr. ij to the 3, and in gonorrhoea a mild injection (gr. ad 3j) is very beneficial. The ointment of the Iodide has been usefully em- ployed for enlarged glands, chronic joint affections, cutaneous diseases, nodes and chilblains. CAFFEA, Coffee,—the seed of Coffea Arabica, is officially represented only by its active principle, Caffeine. The coffee- plant is a small tree, of the nat. ord. Rubiaceae, 15 to 30 feet high, native of South Arabia and Abyssinia, but cultivated in various parts of the world. Its seeds contain Caffeine (partly free, partly as a tannate), tannic and caffeic acids, sugar, legumin, etc. By roasting them, part of the caffeic acid is converted into methyla- CAFFEA. 109 mine, the sugar is changed into caramel, and an empyreumatic oil is developed. Preparations. Caffeina, Caffeine, C8H10N4O2.H2O,—is a proximate principle of feebly alkaloidal power, existing in the seeds and leaves of Coffea Arabica, Camel- lia Thea, Paullinia sorbilis, and other plants (also made artificially), being identical with Theine and Guaranine, and containing more nitrogen than almost any other proximate vegetable principle. It occurs in colorless, flex- ible crystals, which are soluble in 75 of water and 35 of alcohol at 590 F. Dose, gr. j-v. Caffeine Citras (Unofficial),—Dose, gr. j-v. Extractum Viridis Fluidum (Squibb), Fluid Extract of Green Coffee (Unofficial),— is intended as a substitute for the Fluid Extract of Gua- rana. Dose, 3ss—ij. [Compare the title Guarana.] Physiological Action. Coffee is a cerebro-spinal stimulant, a stomachic tonic, and a laxative. It is decidedly diuretic, and somewhat antiperiodic and antiseptic. The green bean produces very different effects from those of the roasted one. It increases secretion, blunts sen- sation, exalts reflex excitability, increases mental activity, and produces insomnia and nervous restlessness. It first briefly stim- ulates the heart, and raises arterial tension, but soon depresses both. The wakefulness is preceded by a brief period of drowsi- ness. As a beverage, it assists digestion, promotes intestinal peristal- sis, allays the sense of fatigue and of hunger, lessens tissue-waste, and consequently the excretion of urea. Used to excess it dis- orders digestion, and causes functional disturbance of the nervous system, shown by headache, vertigo, mental confusion and pal- pitation of the heart. Caffeine is poisonous to the smaller animals, exalting reflex excitability by direct action on the spinal cord, and producing tetanus. In large doses it paralyzes both the cardiac muscle and its ganglia in dogs, and if given in sufficient quantity, would doubtless prove toxic to man. It is an efficient diuretic, and is excreted unchanged in the bile and urine. Comparison of the Stimulant Beverages, Coffee is more stimulating than Coca, and less sustaining. It is apt to cause severe palpitation of the heart, and may greatly disorder digestion. Tea (Camellia Thea) is the most refreshing and stimulating member of the group. Used to excess it affects the stability of the motor system, causing tremulousness of the limbs. It is apt to produce flatulent dyspepsia in those addicted to its use. Theine is identical with Caffeine. Coca (Erythroxylon Coca) is more sustaining, and less of a stimulant. It 110 CAJUPUTI OLEUM. also markedly lessens the sense of fatigue. Cocaine resembles Caffeine, but is not identical therewith. COCOA ( Thcobrotna Cacao) is more directly nutritious than any member of the group, containing a large quantity of fat (Oleum Theobromae), which, however, makes it difficult of digestion to many persons. Theobromine re- sembles Caffeine, but contains more nitrogen. MATfc {Ilex Paraguayensis) contains Caffeine, and is supposed to have effects intermediate between those of tea and coffee. Guarana (Paullinia sorbilis) is especially noted as a remedy for migraine. Its alkaloid, Guaranine, is identical with Caffeine. (Compare the title Guarana.) Therapeutics. Coffee and Caffeine are valuable as stimulants in many forms of nervous depression, and have proved especially efficient in head- aches of nervous or neuralgic type, gastric catarrh with periodical attacks of migraine, choleraic diarrhoea, cervico-brachial neural- gia, dropsies both cardiac and renal, hay fever, insomnia of chronic alcoholism, adynamic fevers as a stimulant in lieu of al- cohol, intermittents and spasmodic asthma. In lithsemia and gout, a tincture of the green bean has marked power as an elimi- nating agent. In opium-narcosis, strong black coffee is most efficacious in antagonizing the increasing torpor of the nerve- centres, and acts better than Caffeine. CAJUPUTI OLEUM, Oil of Cajuput, —is a volatile oil distilled from the leaves of Melaleuca Cajuputi, a tree of the nat. ord. Myrtaceae, native of the Molucca Islands. It is a bluish- green or colorless liquid, of camphoraceous odor, and neutral reaction. Specific gravity about 0.920, freely soluble in alcohol. It contains Cajuputol or Bihydrate of Cajuputene, which forms Yz of it, the other yi being another oil. Dose, uij-v. Physiological Action and Therapeutics. Cajuput Oil resembles Oil of Turpentine, and has similar ac- tions to those of the other volatile oils, being a stimulant carmi- native, somewhat diuretic and diaphoretic, antiseptic, parasiticide and anthelmintic. Externally used, it is irritant to the skin. Swallowed, it produces a sense of warmth in the stomach and accelerates the pulse. It is not much used internally, though it has been given with benefit in flatulent colic, dropsy, hysteria, chronic rheumatism, scrofula, syphilis, elephantiasis and other cutaneous disorders. Externally, as a strong, stimulating rubefacient, it is efficient in chilblains, muscular rheumatism and nervous headaches. CALAMUS—CALCIUM. 111 CALAMUS, Sweet Flag, —is the rhizome of Acorus Cala- mus, a plant of the nat. ord. Araceae, native in Europe and North America, having an aromatic odor and pungent taste. The un- peeled root should only be used, peeled or bleached calamus being almost inert. It contains a volatile oil and Aconn, which is a nitrogenous, bitter principle, also benzoic acid, starch, etc. Dose, indefinite. Preparation. Extractum Calami Fluidum,—is made with Alcohol as a menstruum. Dose, tu.xv-3j. Physiological Action and Therapeutics. Calamus is an aromatic bitter, and stomachic tonic, increasing the appetite and stimulating digestion. It is one of the constit- uents of the preparations termed “ bitters,” and is chewed as an appetizer. CALCIUM,Ca,—is the metal characteristic of Lime, Chalk and all calcareous substances, and though itself unofficial is represented by several official salts and preparations. Official Salts of Calcium. Calcii Carbonas Pr^eCipitatus, Precipitated Carbonate of Calcium, CaC03,—a fine, impalpable, white jpowder, odorless and tasteless, insoluble in water or alcohol, but soluble in mineral acids or acetic acid with efferves- cence. Creta (chalk) is the native carbonate of calcium (see below). Dose, gr. v-xx. Calx, Lime, Oxide of Calcium, CaO,—hard, white masses, gradually re- solving to a white powder in the air, odorless, of sharp, caustic taste and alka- line reaction, soluble in 750 of water and 1300 of boiling water, insoluble in alcohol. Not used internally except in solution. Is a constituent of l’otassa cum Calce. (See under Potassium.) Calcii Chloridum, Chloride of Calcium, CaCl2,—hard, colorless masses, deliquescent, of sharp, saline taste, soluble in of water and 8 of alcohol at 590 F. Dose, gr. x-xx in solution. Calcii Bromidum,—described under Bromides, ante page 103. Calcii Hypophosphis —described under Phosphorus. Calcii Phosphas Pr^ecipitatus,—described under Phosphorus. Calcii Sulphidum,—described under Sulphur. Preparations of the Carbonate. Creta Preparata, Prepared Chalk,—is native Carbonate of Calcium freed from most of its impurities by elutriation; a white, amorphous powder, odor- less and tasteless, insoluble in water or alcohol. Dose, gr. v-xx. Is a con- stituent of Hydrargyrum cum Creta, and also of the following: Pulvis Crf.t/f. Compositus, Compound Chalk Powder,—has of Prepared Chalk 30, Acacia 20, Sugar 50 parts. Dose, gr. v-^j. 112 CALCIUM. Mistura Cret>e, Chalk Mixture,—has of the preceding 20 parts, Cinna- mon Water 40, Water 40, rubbed together and made fresh as required. Dose, gss. • Trochisci Cret.e, Troches of Chalk,—each contains of Prepared Chalk 4 grains, Acacia 1, Sugar 6, with a little NutmCg. Dose, indefinite. Testa Preparata, Prepared Oyster-shell (Unofficial),—contains animal matter intimately mixed with the carbonate of calcium. Dose, gr. x-xx or more. Preparations of the Oxide. Liquor Calcis, Solution of Lime, Lime-water,—contains about 0.15 per cent, of Calcium Hydrate, Ca(HO)2. A clear, colorless liquid, of saline taste and alkaline reaction. Dose, Syrupus Calcis, Syrup of Lime, Saccharated Solution of Lime,—contains 5 per cent, of Lime, 30 of Sugar, the latter aiding the solvent power. Dose, gss-ij. Is the antidote to poisoning by carbolic or oxalic acid. Linimentum Calcis, Lime Liniment,—contains equal parts of Liquor Calcis and Cotton-seed Oil. Is nearly the same as the application known as “ Carron Oil.” Calx Chlorata,—described under Chlorine. Calx Sulphurata,—described under Sulphur. Potassa cum Calce,—described under Potassa. Preparations of the Phosphate and Hypophosphite. Syrupus Calcii Lactophosphatis, Syrupus Hypophosphitum, Syrupus Hypophosphitum cum Ferro, are described under Phosphorus. Physiological A ction. Lime before it assumes the condition of Hydrate is irritant and caustic, and if inhaled or swallowed may produce dangerous in- flammation. The preparations of Lime and Chalk are feebly alkaline and astringent; they neutralize the acid of the gastric juice and are sedative to the mucous membrane of the stomach. A small quantity of the oxide passes into the blood and promotes constructive metamorphosis,—but if used in large quantity or for a long time it will act in the opposite manner, producing waste. Calcium Chloride is a gastro-intestinal irritant, very diffus- ible and remarkably alterative, being apparently a powerful an- tagonist to the strumous diathesis. [The actions of the other salts of Calcium are described under the titles of their respective bases.] Antagonists and Incompatibles. The preparations of Lime and Chalk are incompatible with acids and metallic salts. In poisoning by Lime the antidote is a dilute vegetable acid, followed by demulcents or the fixed oils to protect the mucous membrane. CALENDULA. 113 Therapeutics. Lime may be used as a caustic and depilatory, but is better known as an agent for hastening decomposition which it does by its affinity for water, the resulting Hydrate absorbing many of the products. Chlorinated Lime is an excellent antiseptic and disinfectant, but as it owes its energy entirely to its chlorine it will be noted under that title. Lime-water is a favorite remedy for vomiting, especially in children, and is added to milk to in- crease its digestibility. It is also efficient for acid dyspepsia and mucous enteritis, as an antacid and astringent. Locally it is usefully employed as an enema against thread-worms, as a lotion in many mucous and purulent discharges, and in aphthae. The vapor of slaking lime or lime-water as spray are often very serviceable inhalations in diphtheria. Syrup of Lime contains more lime in solution than lime-water, and may be used instead of the latter where a diluent is not advisable. It is the antidote for poisoning by Carbolic or Oxalic Acid, while lime in any form (as wall-plaster) is a valuable antidote for poisoning by any mineral acid. Chalk-mixture is used in the diarrhoeas of children with sour- smelling, watery stools ; and may be conveniently prescribed in combination with other astringents. Lime Liniment is used on cotton or lint as a dressing for burns. Calcium Chloride has been advantageously employed in the various manifestations of the strumous diathesis. It sometimes resolves glandular enlargements, calcifies tubercular deposits, aids the cicatrization of ulcerating cavities, and has been curative in eczema and lupus. It is strongly recommended in chorea, phthi- sis and in the colliquative diarrhoea of strumous children. In solution externally as a fomentation it will hasten the maturation of boils. [The therapeutics of the other salts of Calcium are included under those of their respective bases.] CALENDULA, Marigold ,—is the fresh, flowering herb of Calendula officinalis, the common Garden Marigold, a plant of the nat. ord. Compositse, frequently cultivated for ornament. The tincture (20 per cent.) is also official, and is exclusively used as a local application to promote the healing process in wounds, ulcers, burns and other breaches of tissue. Extravagant views of its powers as a vulnerary are promulgated by the so-called “ ho- moeopathic surgeons,” and serve as one of their excuses for pro- fessing an exclusive position in the art of surgery. 114 CALUMBA—CAMBOGIA. CALUMBA, Columbo ,—is the root of Jateorrhiza Calumba, a plant of the nat. ord. Menispermaceae, native in southeastern Africa, but cultivated in the East Indian Islands. It occurs in nearly circular disks, having two or three interrupted circles of projecting wood-bundles, odor slight, taste mucilaginous, aro- matic and bitter. It contains the alkaloid Berberine (see under Berberis, ante, page 100), a bitter principle named Calumbin, also Calumbic Acid and Starch, but no Tannin. Dose, gr. v-xxx. Preparations. Extractum Calumba Fluidum,—Dose, in.v-xxx. Tinctura Calumb/e,—1 in 10. Dose, Jss-ij. Physiological Action. Calumba is the first in alphabetical order of the simple bitters, having no astringency or aroma, and its action, as herein de- scribed, will apply to the other members of that class (Quassia, Gentian, Cornus). It stimulates the nerves of taste, increases the flow of saliva, excites the flow of the gastric juice and the gastric circulation, thus increasing the appetite and promoting digestion, and so promoting the constructive metamorphosis. As it also increases the gastric mucus, its continued use will set up catarrh of the stomach, and interfere with digestion, though it is one of the least irritant of stomachic tonics. Therapeutics. As Calumba contains no Tannin, it may be administered with the salts of Iron, and is often prescribed with the sub-carbonate. It is useful in atonic dyspepsia with pain after eating, in the convalescent stage of disease to promote appetite and digestion, in diarrhoea and dysentery, vomiting, sea-sickness, cholera mor- bus and cholera infantum. An Infusion of Calumba with Ginger and Senna is effective in flatulence, and the same preparation is a good vehicle for the administration of acids and alkalies, tonics, aromatics and mild cathartics. Having little or no irritant quality, it is an excellent tonic in the hectic of phthisis. CAMBOGIA, Gamboge,—is a gum-resin, obtained from Garcinia Hanburii, a Siamese tree of the nat. ord. Guttiferae. It occurs in cylindrical pieces, of orange-red color, but yellow when powdered. Its taste is very acrid. It contains 73 per cent, of Gambogic Acid, a resinous substance, also 25 per cent. CAMPHORA. 115 of gum and 2 of water. It is partly soluble in alcohol and ether. The only official preparation is the Pil. Catharticse Co. (de- scribed under Colocynthis), each pill containing gr. of Gam- boge. Its dose, as a cathartic, is gr. ij-v,—as a diuretic, gr. j at short intervals. Physiological Action. Gamboge is an irritant purgative, decidedly diuretic, and its powder is sternutatory. Its catharsis is accompanied by vomiting and colic, and the stools produced are watery, but not so much so as generally believed. It has no cholagogue action. Full doses are liable to produce violent gastro-enteritis, and incautiously used (as in Morrison’s pills) it has frequently caused death. On the other hand, large doses have been given continuously in some cases, without producing any dangerous symptoms. Therapeutics. Gamboge was formerly much used as a hydragogue cathartic and diuretic in dropsies, but its irritant qualities have caused it to be superseded by other agents (elaterium, digitalis, etc.). However, for dysentery, especially when in young subjects, very small doses (gr. ) at short intervals, up to gr. in 24 hours, have proven to be remarkably efficacious. CAMPHORA, Camphor, C10HlgO,—is a stearopten (solid volatile oil), derived from Cinnamomum Camphora, a tree of the nat. ord. Lauracege, and purified by sublimation. Occurs in white, translucent, waxy masses, of penetrating odor and pun- gent taste, lighter than water, in which it is sparingly soluble (i to 1300), but dissolves readily in alcohol, ether, chloroform, benzin, oils, etc. The camphor-tree is indigenous in China, Japan, Formosa and other parts of eastern Asia. Borneo Cam- phor has the formula C10H18O, bears the same relation to Japanese Camphor as alcohol bears to aldehyde, and is heavier than water. Dose, gr. j-xx. Derivatives of Camphor are—Camphor-cymol, which is ob- tained by its distillation with zinc chloride,—Camphoric and Camphretic Acids, which result respectively from its lesser or greater oxidation. Preparations. Aqua Camphors, Camphor-water,—Camphor 8, Alcohol 16, Distilled Water q. s. ad 1000 parts. Used externally or as a vehicle. Dose, Spiritus Camphor/E, Spirit of Camphor,—Camphor 10, Alcohol 70, Water 20 parts. Dose, Rlv-xx. 116 CAMPHORA. Linimf.ntum Camphorte, Camphor Liniment,—Camphor 20, Cotton-seed Oil 80 parts. For external use. Ceratum Camphors, Camphor Cerate,—has of the Liniment 3, Olive Oil 12, Cerate 85 parts. Used for itching skin-affections. Camphora Monohromata, Monobromated Camphor, C10H15BrO,—color- less, prismatic needles or scales, of mild camphoraceous odor and taste, and neutral reaction, almost insoluble in water, slightly in glycerin, freely in alco- hol, ether, oils, etc. Dose, gr. j-x, in emulsion. Rubini’s Tincture of Camphor (Unofficial),—is a saturated solution in alcohol, of which the dose is from 4 to 20 drops. Raspail's “ Eau Sedatif ” (Unofficial),—contains Aq. Ammoniae Sodii Chloridum Camphorated Spirits of Wine 3iij, Water Oij. Used externally. Camphor is also an ingredient of Linimentum Saponis, Linimentum Sina- pis Compositum, and Tinctura Opii Camphorata. Physiological Action. Camphor is antispasmodic, anodyne, antiseptic, diaphoretic, a stimulant expectorant, a cerebral excitant, a gastro-intestinal irritant, and a rubefacient. It has an acrid, hot taste, and irri- tates the skin and mucous membranes, in quantity exciting severe gastric inflammation with all the effects of an irritant poison. In medicinal doses, it stimulates the vaso-motor system and the car- diac motor ganglia, and lessens the influence of the pneumogas- tric,—thus increasing the circulation and raising arterial tension. It also stimulates respiration and mental activity, even producing intoxication; promotes diaphoresis, allays pain, and increases the menstrual flow and the sexual appetite, but its continued use depresses the generative function. “ Camphora per nares castrat odore mares.” Large doses cause gastro-intestinal inflammation, depress the heart and lower arterial tension, diminish the reflex function of the spinal cord, produce coldness of the surface, insensibility, coma, convulsions and perhaps death. It is eliminated by the bronchial mucous membrane, skin and kidneys, and has often caused dysuria. Monobromated Camphor resembles the bromides in action, but is not identical therewith. In mammals it produces muscular weakness passing into paralysis, lowered temperature and respira- tion, stupor and death. In some cases its use by man has been followed by epileptiform convulsions. It is a nervous sedative and hypnotic, and a gastric irritant. Antagonists and Incompatibles» Arterial sedatives, coffee, cold, etc., antagonize its action. Water precipi- tates it from the alcoholic solution, alkalies and earthy salts precipitate even the small quantity which is soluble in water. CANNABIS. 117 * Therapeutics. Camphor was much used by the older physicians as an anti- spasmodic, and is yet greatly valued in China and Japan. It has a reputation for uncertainty of therapeutic action, but is usefully administered in cholera and choleraic diarrhoea, summer diarrhoea and that of infants, vomiting, gastralgia, cardiac depression, nervousness and nervous headache, nymphomania, capillary bron- chitis, typhoid and eruptive fevers, dysmenorrhoea, afterpains, chordee, strangury, and catarrhal colds. Locally it is effective in myalgia, lumbago, toothache, gangrene, and other conditions where counter-irritation or a local anodyne are required. A solution in ether has been found to be a beneficial application in erysipelas. Monobromated Camphor is used as a nerve sedative and hypnotic, but is not particularly efficient in this regard. It has been used with advantage in whooping-cough, neuralgia, chorea, hysteria, delirium tremens and epilepsy. Camphora Carbolata is a name given to a mixture of 2 parts of camphor with one each of carbolic acid and alcohol. This preparation, mixed with olive-oil, is a good non-irritating and antiseptic dressing for wounds and breaches of surface. Camphor-Chloral is a fluid obtained by triturating together equal parts of camphor and chloral hydrate. It has decided sol- vent powers, dissolving sulphate of morphine readily (gr. xx in 3ij), and many other salts of alkaloids. It is often a serviceable application in superficial neuralgia, and is said to allay spasmodic cough if painted over the larynx. Camphora Salicylata is obtained by heating together 11 parts of salicylic acid and 14 of camphor. An ointment prepared from this substance has been used with very satisfactory results in the treatment of phagedena, spreading syphilitic sores, epi- thelioma, lupus, etc. CANNABIS, Hemp ,—is Cannabissativa, the hemp-plant, a coarse, pubescent, somewhat viscid annual of the nat. ord. Urti- caceae, having an erect, branching stem 3 to 6 feet high, with alternate or opposite digitate leaves on long, weak petioles; and dioecious flowers, the staminate clusters being lax, drooping, leafless at the base ; the pistillate clusters erect and leafy at the base. It is indigenous to Asia, but is cultivated in most civilized countries for its textile bast-fibres and its oily fruit. The two official varieties are specifically identical with each other, differ- ing only in the degree of their action, that grown in India being 118 CANNABIS. the most powerful. They contain a resin named Cannabin, and a Volatile Oil, from the latter of which are obtained Cannabene, a light hydrocarbon, and Hydride of Cannabene, a crystalline body. Cannabis should not be confounded with the so-called “ Indian or Canadian Hemp,” Apocynum cannabinum (see ante, page 74). The official varieties of Cannabis are as follows: Cannabis Americana, American Cannabis,—is Cannabissativa, grown in the Southern United States and collected while flower- ing, having a stem about six feet long and rough, leaves petiolate and digitate, opposite below, alternate above, flowers dioecious, odor heavy, taste bitter and slightly acrid. No official prepara- tions. Cannabis Indica, Indian Cannabis, Indian Hemp,—the flow- ering tops of the female plant of Cannabis sativa, grown in the East Indies. Is about two inches long, branching, compressed and brittle, having a few digitate leaves with linear-lanceolate leaflets, and numerous bracts, each containing two small pistillate flowers, sometimes with the nearly ripe fruit, the whole agglutin- ated with a resinous exudation. Color brownish, odor peculiar and narcotic, taste slightly acrid. Preparations. Extractum Cannabis Indict,—Dose, gr. 14-j, if active. Extractum Cannabis Indicaj Fluidum,—an alcoholic preparation which in mixtures must be emulsified with Gum Acacia, otherwise the resin will separate and float to the top or adhere to the sides of the bottle. Dose, fflj-v. Tinctura Cannabis Indict,—strength 20 per cent. Dose, The above remark on mixtures containing the fluid extract applies also to the tinc- ture. Similar preparations of Cannabis Americana are prepared by the manu- facturers and may be used in larger quantities. The dosage of all prepara- tions of hemp is uncertain, as specimens of the plant vary very much in activity. The best rule is to begin with a small dose, gradually testing the activity of the drug and the susceptibility of the patient by carefully increased doses. Cannabin Tannate (Unofficial),—is a yellowish-brown permanent powder, insoluble in water and ether, slightly soluble in alcohol, having a not unpleasant odor and a bitterish, astringent taste. No formula has been published for it, but it is claimed to be the tannate of a glucoside by Merck of Darmstadt who placed it on the market. Dose, as a hypnotic gr. v-x. Preparations used in the East. Churrus is an impure resin, prepared by rubbing the leaves of the plant together and scraping off the adhering resin. Gunjah is the dried leaf and tops as sold in the bazaars for smoking pur- poses. Hashish, Bhang or Siddhi is a confection consisting of the leaves and cannabis. 119 small stalks coarsely broken and mixed with fruits and aromatics. It is em- ployed in the preparation of various electuaries and beverages, and is also smoked with or without tobacco. Physiological Action. Cannabis is an antispasmodic, analgesic, anaesthetic and nar- cotic, a cerebro-spinal stimulant and a powerful aphrodisiac. It increases intellectual and motor activity, stimulates the vaso- motor nerves raising arterial tension, depresses sensation, and strengthens the energy of the uterine muscular fibre, but has no power to initiate uterine contractions. In large doses it causes a pleasurable intoxication during which the peculiar traits of the individual are exalted, and the ideas follow each other so rapidly as to produce a sense of great prolongation of time, minutes seeming as if hours or even days. With this occurs increased sexual desire, great uterine activity, and sensations of double consciousness and enormous dimensions. The sight and hear- ing are exalted, pupils dilated, anaesthesia sets in, the reflexes are lowered by stimulation of inhibition (Setchenow’s centre?), and if the dose be a heavy one a cataleptic state is induced. Sleep or coma follows according to the size of the dose, but death has never been produced by this drug. After-effects are dullness, heaviness, vertigo, headache, and confused thought, anaesthesia of the skin, and marked diuresis,— but no nausea, no vital depression, no constipation. Repeated use of the drug causes mental weakness and impotence, the result of over-stimulation. A ravenous appetite is usually one of its effects. Antagonists and Incompatibles. Strychnine and faradism are antagonistic. Caustic alkalies are incompat- ible. In poisoning by it the stomach should be evacuated, stimulants given cautiously, and respiration maintained. The effects of a large dose last over 24 hours. Lemon-juice is said to antagonize its effects. Therapeutics. Cannabis was formerly much employed as an anodyne and hypnotic, also as an ansesthetic during surgical operations. It is now somewhat out of fashion. In migraine it is useful to prevent recurrence of the attack, and in neuralgia it is often very efficient. Uterine affections, as—chronic metritis, subinvolution, men- orrhagia, dysmenorrhoea, etc., are greatly benefited by its ano- dyne quality and its power over the uterine muscular fibre. It is the best hypnotic in delirium tremens, and in traumatic tetanus and paralysis agitans large doses will lower the reflex activity. Dysuria and retention of urine are often relieved by it, while in 120 CANTHARIS. spasm of the bladder and other painful affections of that organ it will be found a most efficient remedy. It is useful in functional impotence, especially if combined with Ergot and Nux-vomica. In gonorrhoea it lessens the discharge, relieves the inflammation, burning pain and restlessness, and allays chordee. The tincture of C. Americana is the most useful in this affection, being fully as efficient as Copaiba or Sandal Oil, and much more agreeable. It should, however, be prepared from the fresh plant, and be given in 3 to 5 drops doses 3 or 4 times daily after the subsidence of the acute symptoms. Full doses of the tincture of the Indian plant are extremely efficient in many cases of headache at the meno- pause, but should be used cautiously until the activity of the sample and the susceptibility of the patient are tested. Tannate of Cannabin is recommended as a powerful hyp- notic, not in any degree dangerous and neither disturbing the secretions nor leaving unpleasant after-effects. It has been used with benefit in acute mania. CANTHARIS, Cantharides, Spanish Flies,—is the dried beetle Cantharis vesicatoria, an insect of the nat. ord. Coleoptera, about an inch long, of a shining green color, the powder being grayish-brown, with green particles, odor very dis- agreeable. Contains Cantharidin, C10Hj.2O4, the active princi- ple,—also a greenish volatile oil and peculiar fatty bodies. Preparations. Tinctura Cantharidis,—strength 5 per cent. Dose, fflj-xx. Ceratum Cantharidis, Cantharides Cerate, Blistering Cerate,—Cantha- rides 35, Yellow Wax 20, Resin 20, Lard 25 parts. Ceratum Extracti Cantharidis,—Cantharides 30, Resin 15, Yellow Wax 35 parts, Lard 35 parts, Alcohol q. s. Charta Cantharidis,—Cantharides 1, Canada Turpentine 1, Olive Oil 4, Spermaceti 3, White Wax 8, Water 10 parts—spread on paper. Linimentum Cantharidis,—Cantharides 15, Oil of Turpentine q. s. ad 100. Emplastrum Picis cum Cantharide, Pitch Plaster with Cantharides, Warming Plaster,—Burgundy Pitch 92 parts, Ceratum Cantharidis 8 parts. Collodium cum Cantharide, Cantharidal Collodion,—Cantharides 60, Flexible Collodion 85, Commercial Chloroform q. s. Physiological Action. Cantharis applied to the skin is a rubefacient and vesicant, acting more slowly than mustard but much more severely. Inter- nally it is also irritant, causing heat of stomach, gastralgia, nausea, and vomiting, the circulation is stimulated, temperature CANTHARIS. 121 elevated, urine becomes scanty and irritating, is voided with diffi- culty and pain, and often contains blood and albumen. After- wards the pulse falls, temperature and arterial tension are lowered, and depression ensues. A toxic dose produces severe gastro- enteritis, abdominal tenderness, tenesmus, mucous or bloody stools, pain in the stomach and loins, dysphagia, ptyalism, stran- gury, priapism, hematuria, swollen genitals, abortion, muscular tremor, convulsions, coma and insensibility. Post-mortem shows evidences of violent metritis, gastro enteritis and general peri- tonitis. Cantharis is aphrodisiac by causing vascular turgescence of the genital apparatus, but only in doses which produce dan- gerous symptoms. It is only abortive in toxic dose. In small doses it is diuretic and emmenagogue. Counter-irritation by rubefacients or blisters acts on disease prob- ably through the nervous system. Its influence is explained by the theory that the peripheral extremities of the nerves supplying the skin of the part to which the agent is applied undergo some mole- cular change, which extends to the nerve centre and is thence radiated to centrifugal or trophic nerves, effecting various changes in nutrition and secretion over the areas to which they are dis- tributed. In addition to this method of action, neighboring parts are affected by direct extension of the inflammation pro- duced, and distant parts are also affected by absorption through the vesicated surface of agents having special affinities for certain organs. Blisters act primarily as a stimulant to the body generally as well as to the organs in its vicinity, but if permitted to remain long enough to produce large blebs, the result is a depression pro- portionate to the amount of serum abstracted, the serum contain- ing nearly as much albumen as the blood itself. Antagonists. There is no chemical or physiological antagonist to Cantharis. Evacuation of the stomach, mucilaginous drinks freely, Opium for the gastro-enteritis, are the best measures in poisoning by this agent. Therapeutics. As a counter-irritant and vesicant Cantharis is of great value in neuralgia if applied close to the emergence of the nerve from the spinal column, also in sciatica and neuritis, and in acute rheuma- tism around the affected joints. A blister at the nape of the neck controls many headaches, and one behind the ear will mod- ify inflammatory affections of the eye. In pleuritic effusions a succession of small blisters (flying-blisters) will promote absorp- 122 CAPSICUM. tion of the pleural contents, and a blister applied to the perineum will often cure a rebellious gleet. Though valuable as a thera- peutic measure in very many conditions, blistering is going out of fashion except in hospitals and among people who believe in heroic treatment. As an internal remedy Cantharis must be employed in very small doses (mj—iij of the tincture) in order to be efficient. When so used it is an admirable agent in acute desquamative ne- phritis after the active inflammation and fever have subsided, to reduce the albumen and blood in the urine. Drop-doses are par- ticularly useful in irritable bladder with frequent desire to mictu- rate, so often observed in women, also in the incontinence of the aged and of children, and in cystitis, gonorrhoea and gleet. The same dose thrice daily will generally abate chordee. In sperma- torrhoea, prostatorrhoea, scanty menstruation and menorrhagia in subjects of lax fibre and general want of tone it is often very serviceable. Cutaneous squamae and vesiculae are greatly im- proved by small doses frequently administered and gradually increased, and it is one of the best remedies for psoriasis. For alopecia areata it is of the utmost value as an external application, and the tincture, greatly diluted, is an ingredient of all the hair- renewers in common use. In pleurisy, after effusion has taken place, it will be found admirable in i to 2 drop doses every 2 or 3 hours, and in the after prostration of diphtheria it proves a serviceable stimulant. One of the best applications to burns or scalds is a cloth dipped in a lotion of the tincture one part to thirty or forty of water. The same lotion is an efficient applica- tion to vesicular erysipelas and herpes zoster CAPSICUM, Cayenne Pepper,—is the fruit of Capsicum fastigiatum, a plant of the nat. ord. Solanaceae native in tropical Africa and America. Occurs in small red pods, enclosing two cells containing flat, yellowish seed, and has a peculiar odor and an intensely hot taste. It contains Capsicin, which is a thick, red liquid, and is the active principle,—also a volatile alkaloid having the odor of Oonine. Dose of the powdered drug, gr. v-x. Preparations. Extractum Capsici Fluidum,— alcoholic. Dose, Tinctura Capsici,—5 per cent, strength. Dose, Ttlx-gj'. Oleorksina Capsici, prepared by ether. Dose, j-v. Emplastrum Capsici, Capsicum Plaster,—prepared from the oleoresin of capsicum and resin plaster. CARBO. 123 Physiological Action. Capsicum is irritant to the skin and mucous membranes. Exter- nally used for sufficient length of time it will produce vesication, internally in quantity it will excite gastritis. In medicinal doses it increases the saliva, excites a sensation of warmth in the stomach, promotes appetite and digestion, and produces more easy and copious alvine evacuations. It stimulates the action of the heart, is diaphoretic and diuretic, also decidedly aphrodisiac. It is a general stimulant to the nervous system, but in repeated doses produces a slight narcotic effect upon the brain. On the vascular system it acts like ergot, powerfully constringing the vessels by influencing the unstriped muscular fibre in their walls, either directly or through the vaso-motor nerves. Therapeutics. Capsicum is an excellent stomachic tonic in atonic dyspepsia and in that of chronic alcoholism with tremor and insomnia. In acute dipsomania and delirium tremens large doses are efficient in producing sleep and promoting appetite. It is the best sub- stitute for alcohol and opium in attempts to cure those habits. It is well used in intermittents, chiefly as an adjuvant to more active drugs,—in flatulent colic especially when occurring in hys- terical women and hypochondriacs,—also in low fevers and cholera as a stimulant. It gives good results in functional impo- tence, in spermatorrhoea from loss of tone, in chronic parenchy- matous nephritis to check the waste of albumen, and is beneficial in chronic cystitis and in prostatorrhoea. The tincture internally and a plaster externally over the loins are efficient in cases of renal congestion with habitual pain in the back and a trace of albumen in the urine. Locally the tincture diluted (5j to gviij) or the powder with honey, form excellent gargles for relaxed throat and its accom- panying cough, relaxed uvula, inflammatory sore throat, and the cynanche of scarlet fever, but they must be used with caution as such applications are sometimes very irritating. The Capsicum-plaster is a mild counter-irritant, of great value in lumbago and other muscular rheumatisms as a palliative appli- cation. CARBO, Carbon ,—exists in nature in many forms, of which two are official, namely the charcoals specified below. Carbo Animalis, Animal Charcoal,—prepared from bone, 124 CARBO. occurring in dull black fragments or powder, odorless and nearly tasteless, insoluble in water or alcohol. Carbo Ligni, Charcoal,—prepared from soft wood, is black, shining, brittle, inodorous, tasteless and insoluble. Preparations. Carbo Animai.is Purificatus, Purified Animal Charcoal,—the bone- phosphate and calcium carbonate being removed by digesting with Hydro- chloric acid and washing. Dose, gr. xx-^j. Carbonei Bi-sui.phidum, Bisulphide of Carbon, CS2,—is a clear, colorless, diffusive liquid, of strong, offensive odor, aromatic taste and neutral reaction ; soluble in alcohol, ether, chloroform and oils, insoluble in water; vaporizes at ordinary temperatures, and is highly inflammable. Dose, Rlss-j. Physiological A ction. Charcoal is an efficient deodorant and disinfectant, as it ab- sorbs and condenses many gaseous bodies and vapors. It is evacuated unchanged by the bowel and exerts no specific action on the body. Carbon Bisulphide is largely used in the arts, hence its effects are frequently observed. Persons exposed to its fumes are af- fected by headache, vertigo, overexcitement of the nervous sys- tem, emaciation, incoordination of movement, depression of all the special senses with impairment of sensation and motility and perhaps insanity. Inhaled directly, it excites violent coughing and produces anaesthesia characterized by great muscular rigidity. Being a powerful cardiac paralyzant, it is extremely dangerous as an anaesthetic. In 3-drop doses, it produces severe nausea and vomiting, with a sense of heat in the stomach and a weak and rapid action of the heart. It is a good solvent for Caoutchouc and many other substances. Therapeutics. Charcoal is used in pharmacy for decolorizing vegetable prin- ciples, removing alkaloids from infusions of plants, and making several preparations, asacidum sulphurosum, potassii iodidum, etc. Externally, it makes an efficient disinfectant, absorbent and deodorant application to cancerous discharges, foul ulcers and gangrenous wounds. Having no odor it is not open to the charge of substitution of one smell for another. A small quantity added to water will keep it sweet for a long time. It is an excellent dentifrice if finely powdered. Internally, it is used for the same purposes, namely, to absorb gases and offending products of indigestion. In flatulent dys- pepsia, gastralgia, pyrosis, diarrhoeas, nausea of pregnancy, epi- CARDAMOMUM CARDUUS. 125 demic cholera, and constipation, it has warm advocates. When used internally for any time, an occasional purgative should be given to prevent its accumulation in the intestines. It has been proposed as an antidote for several alkaloidal poisons on theo- retical grounds, but its efficacy in this respect is doubtful. Carbon Bisulphide has such a horribly offensive odor that it will never be used for any purpose for which another agent can be found. It relieves the pain of gastric cancer, and in y2-drop doses will alleviate nausea and vomiting, also gastralgia. Locally it has been used as a counter-irritant and a local anaesthetic, for deafness due to w’ant of nervous energy, in facial neuralgia and various local pains. CARDAMOMUM, Cardamom,—is the fruit of Elettaria Cardamomum, a plant of the nat. ord. Zingiberacese, cultivated in Malabar. Occurs as dried capsules, containing small, reddish- brown seeds, of warm, aromatic taste and agreeable odor. Con- tains about 4*4 per cent, of a Volatile Oil, C10H1S, isomeric with Oil of Turpentine, which oil is the active principle, also a fixed oil, coloring matter, etc. It is an ingredient of Pulvis Aromati- cus and of Extractum Aromaticum Fluidum (see under Cinna- momum), as well as of several compound preparations. Preparations. Tinctura Cardamomi,—15 per cent, strength. Dose, gj-ij. Tinctura Cardamomi Composita,—Cardamom 20, Cinnamon 20, Cara- way 10, Cochineal 5, Glycerin 60, Diluted Alcohol q. s. ad 1000. Dose, 3Hi- Infusum Cardamomi (Unofficial),—may be made in the strength of gj to 0]/2, and used in wineglassful doses. Physiological Action and Therapeutics. Cardamom is aromatic, carminative and stomachic, and is used as an agreeable flavoring for bitter mixtures in dyspepsia and other stomach affections. It is especially useful when combined with purgatives to check flatulence and griping, and it makes the best flavoring for saline solutions or mineral waters. CARDUUS (Unofficial),—the seeds of Carduus marianus, or St. Mary’s thistle, an annual European plant of the nat. ord. Com- posite. A decoction ad Oi) is the preparation usually em- ployed. It is an old remedy recently revived as a hemostatic, and reported as very efficient in hemoptysis, uterine hemor- 126 CARUM—CARYOPHYLLUS. rhage, melsena and amenorrhoea connected with derangement of the portal circulation. It has proved curative in congestion of the liver and simple jaundice, and in Germany it has long been popularly deemed efficacious in gall-stones, and liver affections generally. Dose, of the decoction, 3j-3ss>—of a tincture, Carduus Benedictus, the “blessed thistle,” also called Cnicus benedictus and Centaurea bene dicta, is another plant of the same order, formerly held in high esteem as a popular “ cure-all.” It contains Cnicin, an amorphous, bitter principle, which has been used as an antiperiodic in doses of gr. v-x, but generally pro- duces burning sensations and pharyngeal constriction, with nau- sea, vomiting, colic and diarrhoea. It acts chiefly as a bitter tonic, resembling Calumba and Taraxacum most closely. CARUM, Caraway,—is the fruit of Carum Carvi, a Euro- pean plant, of the nat. ord. Umbelliferge, and is of oblong shape, gth of an inch in length, separating into two parts, each having 5 ribs and 6 oil-tubes. Its odor and taste are aromatic and agreeable. The active principle is the Volatile Oil, which is also official. Caraway is an ingredient of Tinct. Cardamomi Com- posita. Preparations. Olf.um Cart,—is the volatile oil distilled from Caraway, and is resolvable into Caruen, C10H16, isomeric with Turpentine, and Caruol, C10IIuO, iso- meric with Thymol. It is an ingredient of Spiritus Juniperi Compositus. Dose, ntj-v. Infusum Cari (Unofficial),—3j-ij ad Oss. Dose, Physiological Action and Therapeutics. The Oil of Caraway is fatal to small animals, and in one case 3j produced cerebral congestion, delirium and rigors in man. The chief use of Caraway is as a flavoring agent, but it is efficient in the flatulent colic of children, and to prevent griping from the use of purgatives. * CARYOPHYLLUS, Cloves, —are the unexpanded flowers of Eugenia caryophyllata, a handsome evergreen tree of the nat. ord. Myrtacese, cultivated in the East and West Indian Islands. They are about long, of a dark-brown color, consist of a calyx-tube terminated by four teeth and surmounted by a glob- ular head formed by four petals which cover numerous, curved stamens and one style. They emit oil when scratched, have an CASCA BARK. 127 aromatic odor, and a pungent, spicy taste, and are contained in Tinctura Lavandulae Composita, Tinctura Rhei Aromatica and Vinum Opii. They contain a heavy Volatile Oil, which is official, —also Eugenin, C10H12O2, a crystalline body; Caryophyllin, C10Hl6O, a camphor; Caryophyllic Acid, and tannin, gum, etc. Preparations. Oleum Caryophyi.LI, Oil of Cloves,—a volatile oil distilled from Cloves, soluble in alcohol, and of sp. gr. 1.050. It consists of a light and a heavy oil, the latter containing Eugenol, C10H12O, a phenol-like compound, and Caryophyllin, C,0H16O, which yields as a product of its oxidation Caryophyl- linic Acid, C20H32Og. Dose of the oil, Blj-iv. Infusum Caryophylli (Unofficial),—may be made of strength I to 40, and used in doses of one to two fluid ounces. Physiological Action and Therapeutics. Cloves may be considered as a type of several agents yielding aromatic oils, which as a rule consist of terpenes with camphors, resins, fatty and other acids, etc., closely allied to phenol and benzoic acid, the balsams and gum-resins. Such are Orange, Lemon, Allspice, Cajuput, Caraway, Peppermint, etc. Their oils are antiseptic, locally anaesthetic, stimulant and irritant, anti- spasmodic, stomachic and carminative. Internally they increase circulation and temperature, promote digestion and nutrition (in quantity may cause inflammation), relieve pain and spasm, and are excreted by the kidneys, skin, liver and the bronchial mucous membrane, stimulating and disinfecting their routes through the organism. These agents are used to flavor pharmaceutical preparations, to correct the griping tendency of many purgatives, to correct flatulence, to relieve pains in the stomach and bowels, and to promote the flow of saliva and gastric juice. As external appli- cations they are efficiently employed for anaesthetic and counter- irritant purposes, to relieve pain in chronic rheumatism, myalgia, lumbago, superficial neuralgia, toothache, etc. The Oil of Cloves is an effective deodorizer for sponge-tents, a good application to a painful tooth, and is occasionally applied over the course of an aching nerve with relief to the pain. CASCA BARK, Sassy Bark, Ordeal Bark (Unofficial), —is the bark of Erythrophlceum Guinense, an African tree used by the negroes as an ordeal in trials for witchcraft. It contains a poisonous alkaloid, Erythrophleine, and when used in quantity produces nausea and vomiting, stricture across the brow, severe 128 CASCARA AMARGA—CASCARA SAGRADA—CASCARILLA. cephalalgia, narcosis and death. It is used as a remedy in Africa for intermittent fever, dysentery, diarrhoea and colic, and in England is considered to resemble Digitalis in action and uses. A tincture is made ad Oj) of which the dose is tux, or a watery Extract may be used in doses of gr. j. CASCARA AMARGA, Honduras Bark (Unofficial),— is the bark of a Mexican treeof the nat. ord. Simarubaceae, which has been used with apparent success as an alterative tonic and diuretic in syphilis and various chronic skin affections. The use of tobacco and alcohol seems to counteract its usefulness It is certainly a very powerful tonic and has been employed by com- petent observers with uniformly good results in syphilis and svphi- lodermata, chronic liver complaints, chronic eczema, chronic nasal catarrh and psoriasis. A Fluid Extract is on the market of which the dose is 3ss-j thrice daily. CASCARA SAGRADA, Chittem Bark, Sacred Bark (Unofficial),—is the bark of Rhamnus Purshiana, or California Buckthorn, a small tree of the nat. ord. Rhamnacege growing on the Pacific of the United States. It contains a Volatile Oil, a neutral crystalline substance, several Resins, with tannic, malic and oxalic acids. A Fluid Extract is on the market, of which the dose is 3ss—j, two or three times a day. It has been found very serviceable in the treatment of chronic constipation, given in gradually diminished doses. It produces large, soft and pain- less evacuations, and the bowels are said to act naturally and regularly after its disuse. Cascara Cordial is a trade preparation, intended as a remedy for constipation, dyspepsia and hemorrhoids, and as a pleasant excipient for nauseous and bitter drugs. A similar preparation may be made by combining the fluid extract with the official Elixir Aurantii in the proportion of 3j of which teaspoon- ful doses or more may be administered. Another species of the same genus, Rhamnus Frangula, is official under the title Frangula, which see. CASCARILLA, —is the bark of Croton Eluteria, a shrub or small treeof the nat. ord. Euphorbiaceae, growing in the Bahamas. It occurs in grayish-brown quills, having a warm, bitter taste, and a fragrant odor when burned. Contains Cascarillin a crystalline principle, two resinoid extracts, aromatic volatile oils, with CASSIA FISTULA CASTANEA. 129 tannic acid, etc. There are no official preparations, but an Infusion (1 to 10) or a Tincture (1 to xo) may be prepared and given in doses of 3j~3j- Physiological Action and Therapeutics. Cascarilla is an aromatic bitter. It increases appetite and digestion, the mucous secretion, the flow of saliva and gastric juice, stimulates the intestinal secretions, and acts as a mild astringent by the influence of its tannin. Large doses produce nausea, vomiting and diarrhoea, and in medicinal doses continued it will set up gastric catarrh and consequently indigestion. It has slight antiperiodic powers. It has been used with success in epidemic dysentery, flatulent dyspepsia, debility, chronic bronchitis, intermittents, and low nervous fevers. It is difficult to dispense, as the infusion decomposes quickly, and acids precipitate the resin from the tincture. CASSIA FISTULA, Purging Cassia,—is the fruit of Cassia Fistula, a tree of the nat. ord. Leguminosse, growing in tropical regions of Asia, Africa and America. It occurs in long, brown pods which are divided into numerous transverse cells, each containing a dark pulp in which is a glossy seed. No active principle has been isolated as yet. The pulp is the only valuable part of the drug. There are no official preparations, but it is one of the ingredients of Confectio Sennae. Cassia-pulp is laxative in doses of 3j-ij, and purgative in larger quantities, producing nausea, flatulence and griping. It is rarely prescribed alone, owing to its tendency to cause colic and flatu- lence. C AST AN E A, Chestnut,—the leaves of Castanea vesca, a stately tree of the nat. ord. Cupuliferae, and should be collected while green. Chestnut leaves are 5 to 10 inches long and about 2 broad, have a slight odor and somewhat of an astringent taste. They contain tannic and gallic acids, salts, gum, etc. Preparation. Extractum Castanet Fluidum,—Dose, Physiological Action and Therapeutics. This drug has not been studied as to its physiological actions, if it has any. It is classed among the vegetable astringents by 130 CATECHU—CAULOPHYLLUM. reason of its containing tannin. Its only reputation therapeuti- cally is as a remedy for whooping-cough, in which it is said to be very efficacious. An infusion or decoction of the leaves has been used in indefinite doses. CATECHU ,—is an extract prepared from the wood of Acacia Catechu, a tree of the nat. ord. Leguminosae, native of the East Indies. Occurs in irregular masses, dark-brown and brittle, nearly inodorous, but of astringent and sweetish taste, soluble in alcohol, and partly so in water. It contains Catechu- tannic Acid 50 per cent., and Catechuic Acid which is converted into the former by heat. Dose, gr. j~5ss. P7-eparations. Tinctura Catechu Composita,—contains Catechu 12, Cinnamon 8, Diluted Alcohol q. s. ad 100 parts. Dose, rq, x-^j. Trochisci Catechu,—each troche contains of Catechu 1 grain, mixed with Sugar, Tragacanth and Orange-flower water. Physiological Action and Therapeutics. Catechu is a powerful astringent, acting by virtue of its tannic acid. (See ante, page 38, for actions and in compatibles.) Its uses depend entirely on its astringency. In the diarrhoea of children the Tincture with Chalk-mixture is very serviceable, and with Opium it is efficient in dysentery. It is also used as a gargle and mouth-wash in relaxed conditions of the pharyngeal mucous membrane, as an injection in leucorrhoea, and to control passive hemorrhages, spongy gums, etc. CAULOPHYLLUM, Blue Cohosh,—is the rhizome and rootlets of Caulophyllum thalictroides, a plant of the nat. ord. Berberidaceae growing in Canada and the northern United States. Rhizome about 4 inches long, thick and bent, rootlets numerous and matted, taste sweetish, bitter and acrid. Contains Saponin a glucoside, and two resins. Dose, gr. v-xx. There are no official preparations. The eclectic preparation Caulophyllin is a resinous precipitate obtained by pouring an alcoholic extract into water. Physiological Action and Therapeutics. Caulophyllum is a new addition to the pharmacopoeia, and has not yet been made the subject of experimental work by reliable observers. It was much used by the aborigines of this CERA—CERII OXALAS. 131 country in all affections to which their women were peculiarly subject, and was known among them by the name “squaw-root.” It is said to produce intermittent contractions of the gravid uterus, to have diuretic, emmenagogue and antispasmodic powers; and is used as a remedy for deficient labor-pains, spamodic after- pains, spasmodic pains in the uterus at any time, spasmodic dvs- menorrhoea, and pains in other organs seemingly in sympathy with uterine affections. It has somewhat of a reputation in acute rheumatism of the hands and fingers, and as a preparative medi- cine for labor. CERA, Wax ,—is a mixture of Myricin, Cerotic Acid and Cerolein, is formed by the honey-bee, and exists in the pollen and leaves of many plants, particularly in Myrica cerifera, the wax myrtle. That produced by the bee is alone official. Cera Alba, White Wax,—is yellow wax bleached. Cera Flava, Yellow Wax,—is a peculiar concrete substance prepared by Apis mellifica, the honey-bee. It is a yellowish solid, of agreeable odor and faint, balsamic taste, melting at 145.40 to 1470 F., of sp. gr. 0.955-0.967, insoluble in water and almost so in cold alcohol, but soluble in 35 of ether, 11 of chloroform, boiling alcohol, fixed and volatile oils. Preparations. Ceratum, Cerate,—consists of White Wax 30, Lard 70. Unguentum, Ointment,—consists of Yellow Wax 20, Lard 80. Wax is also a constituent of the 7 compound Cerates, 5 of the 25 compound Ointments, and 8 of the 17 Plasters. Physiological Action and Therapeutics. Wax owes its value to its power of resistance to decomposition and to many chemical agents. Its fusibility at a moderate degree of heat, and its solidity at the temperature of the body, together with its unirritating quality, make it a valuable ingredient of the cerates and ointments to give them consistence. Ceratum and Unguentum may be used as simple protective applications. They form the bases of most of the compound preparations so named. CERII OXALAS, Oxalate of Cerium, Ce2(C204)g.9H20, —is a white, slightly granular powder, odorless and tasteless, insoluble in water or alcohol, but soluble in hydrochloric acid. Dose, gr. j-x, in pill. 132 CETACEUM CETRARIA. Physiological Action and Therapeutics. Oxalate of Cerium is a gastric sedative (like Bismuth), and is thought to have selective action as a sedative to the motor distri- bution of the pneumogastric nerve. It is considered to be par- ticularly useful in vomiting of reflex origin, especially in the vomiting of pregnancy, but it often fails, probably because not given in sufficient doses. To be effective at least 4 or 5 grains should be given 3 times a day to adults, and no results promised until after it has been used several days. It is also recommended in the vomiting of phthisis and bronchitis, cough with vomiting, gastralgia, chorea and diarrhoea. CETACEUM, Spermaceti,—is a peculiar, concrete, fatty substance obtained from Physeter macrocephalus, the sperm whale. Occurs in white, pearly masses, odorless, of bland taste, and neutral reaction, becoming rancid in the air, soluble in ether, chloroform, carbon bisulphide and boiling alcohol. Is a constit- uent of Unguentum Aquae Rosse, and Charta Cantharidis. Preparation. Ceratum Cetacei, Spermaceti Cerate,—consists of Spermaceti 10, White Wax 35, Olive Oil 55 parts. Physiological Action and Therapeutics. Spermaceti consists of Cetin or Palmitate of Cetyl with several other fats in small quantities. Its action is solely that of an emollient, and it is rarely used internally. The Cerate is used as a bland ointment in blisters, abrasions, and ulcers. CETRARIA, Iceland Moss,—is the lichen Cetraria islandica, found in northern latitudes. Occurs about 2 to 4 inches long, brown above, whitish beneath, taste mucilaginous and bitter. Contains Lichenin or lichen starch, which forms as a jelly when the plant is boiled in water;—also Cetraric Acid. Preparation. Decoctum Cetraria,—5 per cent, strength. Dose, Physiological Action and Therapeutics. Cetraria is nutrient, demulcent and feebly tonic. It has a popular reputation in pulmonary affections, and is of value in chronic catarrhs, chronic bronchitis, purulent discharges from CHAULMOOGRA OIL CHELIDONIUM CHENOPODIUM. 133 mucous surfaces generally, also in chronic diarrhoea and dysentery. CHAULMOOGRA OIL (Unofficial),—is a fixed oil ex- pressed from the seeds of Gynocardia odorata, an East Indian tree of the nat. ord. Bixaceae. It is nauseous and bulky, solid at 62.6° F., and soluble in alcohol, ether, chloroform, etc. Its active principle, Gynocardic Acid, is the best preparation for use, and may be given internally in doses of gr. ss-iij, or applied as an ointment, gr. xx ad 3j of Petrolatum. Dose of the oil, gtt. v-x, in capsules. Chaulmoogra Oil is credited with a few cures of leprosy, and several cases improved by its use both interally and externally. It is recommended as an external application in scaly eczema, psoriasis, syphilitic skin-diseases, chronic rheumatism, rheumatic arthritis and tabes mesenterica. CHELIDONIUM, Celandine,—is the plant Chelidonium majus, nat. ord. Papaveraceae, which grows in Europe and N. America about rocky places. It has a peculiar, unpleasant odor, and a pungent, acrid taste. Contains 2 alkaloids, Chelidonine, C19HnN303, and Chelerythrine, the latter being identical with Sanguinarine : also Chelidoxanthin, a yellow, crystalline substance, and Chelidonic Acid, supposed to be identical with Succinic Acid. Dose of the plant, gr. x-xxx,—of the fresh juice There are no official preparations. Physiological Action and Therapeutics. Chelidonium used externally is irritant, internally it is a drastic purgative but an unreliable one. It is also perhaps diu- retic, diaphoretic and expectorant. In overdoses it is considered poisonous. It is an old remedy for jaundice and liver affections, but has been obsolete for some time. The fresh juice is a popular application for warts and corns, and a tincture in whiskey is used in Indiana as a remedy for phthisis, the menstruum being proba- bly the most useful agent. It seems to be of real service in simple jaundice, whooping-cough, right-sided pneumonia with hepatic involvement, and the catarrhal pneumonia of children. CHENOPODIUM, American Wormseed,—is the fruit of Chenopodium ambrosioides, var. anthelminticum, a plant of the 134 CHIMAPHILA. nat. ord. Chenopodiaceae, indigenous in the United States. It is about -Jj inch in diameter, and contains a glossy, black seed, has a peculiar, terebinthinate odor, and a pungent, bitter taste. Its active principle is a Volatile Oil which is official. Preparation. Oleum Chenopodii,—a thin, colorless or yellowish liquid, of aromatic odor and pungent, bitter taste. Dose, "Ulv-xv. Physiological Action and Therapeutics. The Oil is the only preparation used and that rarely, its odor and taste being very disagreeable. It increases the cardiac rate, and promotes the secretions of the skin, bronchi and kidneys. It is an efficient anthelmintic against the round worm in doses of gtt. x three times a day for two days and followed by a cathartic. It seems to possess some tonic properties, and certainly is a dif- fusible stimulant. As such it has been used with benefit in cho- rea, hysteria, flatulent dyspepsia, and chronic malaria. CHIMAPHILA, Pipsissewa ,—the leaves of Chimaphila umbellata, or Prince’s Pine, an evergreen plant of the nat. ord. Ericaceae, indigenous in all parts of the United States. The leaves are about 2 inches long, serrate above, wedge-shaped towards the base, having an astringent and bitter taste. Con- tains Chimaphilin a yellow crystalline principle, Arbutin also crystalline but colorless, with tannic acid, etc. Preparations. Extractum Chimaphila? Fluidum,—Dose, .^ss—ij. Decoctum Chimaphila (Unofficial),—1 to 17. Dose, ifj-iij. Physiological Action and Therapeutics. Chimaphila is a tonic, astringent diuretic, belonging to the same group as Buchu, Uva Ursi, Pareira and Scoparius. It is probably the most active diuretic among them, stimulating all the excretory organs but especially the kidneys. It is an agree- able tonic, excites the appetite and promotes digestion. The fresh leaves, bruised and applied to the skin, are rubefacient and vesicant, showing the presence of some irritant principle. Chimaphila is a good diuretic in dropsy, and is efficient in several forms of chronic kidney disease with albuminuria, and in chronic catarrhal affections of the urinary passages, as hematuria, ischuria, dysuria and gonorrhoea. It is believed to check the CHINOLINA—CHIRATA. 135 secretion of uric acid, and should prove useful in gout and rheu- matism. Externally, it has been applied to ulcers and tumors with benefit. CHINOLINA,Chinoline, Leucoline,C9H7N(Unofficial), —is an alkaloidal derivative of Quinine or Cinchonine, obtained by their destructive distillation with Potassium Hydrate; also found as a constituent of coal-tar, and artificially prepared by heating Anilin or Nitrobenzol with Glycerin in the presence of a dehydrating agent. It is a colorless, oily liquid, strongly re- fractive, sp. gr. 1.081 at 50° F., boils at 460° F., without decom- position, turning dark on exposure to air, soluble in alcohol, ether, and carbon bisulphide, sparingly soluble in water. It com- bines with acids to form salts, which, except the tartrate, are very deliquescent. Preparation. Tartras,—a white, micaceous, crystalline powder, of pungent odor and sharp taste, stable in the air and soluble in water. Dose, gr. v-xx. Physiological Action and Therapeutics. Chinolineis a valuable antiseptic and antipyretic, being nearly as effective in this respect as Quinine, which it closely resembles in chemical character and physiological action. It is one of the most powerful antipyretics of all the substances which have been discovered in the search for an artificial quinine (Hydroqui- noine, Antipyrin, Pyrocatechin, Resorcin, Thallin, Kairine, etc.). Chinoline has a very disagreeable taste and smell, and is irritant in action, hence the tartrate is preferred for medicinal use. It has been extensively used as an antipyretic in pneumonia, typhus, diphtheria, typhoid and other fevers, with varying success. In diphtheria, a 5 per cent, solution in weak alcohol is painted on the affected surface with great benefit. The tartrate has been used beneficially in neuralgia and whooping-cough, and as an antiperiodic in intermittents. CHIRATA, Chiretta,—is the Indian plant Ophelia Chirata, nat. ord. Gentianaceae, occurring in bundles composed of all but the coarser woody stems. It is inodorous but intensely bitter, and contains Chiratin and Ophelic Acid, two amorphous, bitter principles, but no tannin. Dose of the powdered plant, gr. xv- XXX. 136 CHLORAL. Preparations. Extractum Chiratae Fluidum,—made with glycerin and diluted alco- hol. Dose, Trpxv-xxx. Tinctura Chiratve,—10 per cent. Dose, 3ss—ij. Physiological Action and Therapeutics. The action of this plant is that of a simple bitter, like its con- gener Gentian. It is an excellent tonic, in this respect rivalling Cinchona, and is used in India as a substitute for the latter. It is laxative and stomachic, diminishes flatulency and acidity, and is particularly serviceable in the dyspepsia of gouty subjects. As it contains no tannin, it may be administered with preparations of Iron. CHLORAL, Hydrate of Chloral, C2HC1;,0,H20,—is in- accurately named, the hydrate being the official preparation. Chloral, properly so-called, x^Trichloracetyl-hydride, C2HC130, an unstable, oily, colorless fluid, formed by the action of Chlorine upon Alcohol, whence its name Chlor-al. Its hydrate, the official Chloral, is a colorless, crystalline solid, which slowly evaporates on exposure to the air, of aromatic and acrid odor, bitter and caustic taste, and neutral reaction. It is freely soluble in water, alcohol, ether, glycerin, oils, etc., liquefies when mixed with camphor or carbolic acid, melts at 136° F. and is decomposed by alkalies into chloroform and a formate of the alkaline base. Its aqueous solution becomes acid, but the alcoholic solution re- mains neutral. Dose varies much with individual susceptibility and with the presence or absence of cardiac and pulmonary disease. Death has been caused in several instances by gr. xxx, in one case by gr. x, and in another gr. vijss produced alarming symptoms, all being adults. On the other hand several hundred grains have been ingested at one time without lethal effects, and where toler- ance has been established by habitual use, are frequently taken with- out poisonous symptoms. An average dose for a healthy adult is gr. xv, for a child gr. j for each year of age up to gr. vj. It is best given in Syrup of Tolu. When prescribed in combination with alcoholic preparations, Chloral Hy- drate is very apt to separate as an alcoholate, especially if the Bromides of Potassium or Sodium are used in the same mixture and if the solutions are at all concentrated. In this way great danger is incurred of giving a heavy overdose, as the alcoholate floats on the surface of the mixture. Physiological Action. Chloral is a powerful hypnotic, also an antispasmodic, an anti- ferment, a preventive of the coagulation of fibrin, indirectly an CHLORAL. 137 anaesthetic, and especially a depressant of the cerebral, medullary and spinal centres and of the cardiac muscle. It is more hypnotic than chloroform but less of an ansesthetic. Applied to the skin or mucous membranes a i per cent, solution (gr. v ad 3j) is anti- septic, but strong solutions are irritant and vesicant, may produce sloughing ulcers, and if taken internally may excite gastritis with nausea and vomiting. After a brief period of stimulation a medicinal dose depresses the heart and lowers arterial tension, diminishes oxidation and decreases the body temperature. On the brain cells it has a selec- tive action, producing a deep sopor very like normal sleep, from which the patient may be awakened, but immediately falls asleep again, and which is not followed by headache or depression. This effect is considered by some authorities to be the result of cerebral anaemia produced by the drug. In some persons, instead of sleep it causes headache, insomnia and delirious excitement. It is not an anodyne as it does not affect the conductivity of the sensory nerves, and does not interrupt the transmission of pain; but by overwhelming the centres it drowns the consciousness of pain, and is therefore only indirectly anaesthetic. A toxic dose produces profound narcotism, abolishment of reflexes and sensi- bility, complete muscular relaxation and a great fall of body tem- perature. Death may result in the chloral sleep from paralysis of the respiratory centre or the cardiac motor ganglia, or by sudden failure of the heart-muscle in cases of fatty degeneration or in old drunkards. The Chloral-habit produces a state of marked anaemia, its subject presenting a weak, irritable, often irregular heart, deranged hepatic functions, jaundice, bileless stools, perhaps purpura and sloughing of a finger from decreased blood-supply. Its votaries are on the border of insanity, excitable, uncontrollable in speech and action, talking in a silly manner and very volubly. Many cases of insanity have their origin in chloralism. On the blood its action is to increase the fluidity, crenate the red corpuscles, and to destroy the leucocytes if used in large quantity. It is rapidly diffused, and is excreted by the kidneys partly unchanged, but chiefly as urochloralic acid, producing some diuresis,—also by the skin, causing various eruptions if used for any lengthened period. It has been held that the blood, being an alkaline fluid, decomposes it, setting free chloroform, but there are many facts against this theory. Chloral and Atropine, though antagonistic in their action on the spinal cord, both produce motor paralysis, the former by 138 CHLORAL. paralyzing the cord, the latter by direct paralysis of the motor nerves. Antagonists and Incompatibles. Atropine antagonizes its cardiac, respiratory and spinal depression, and should be injected in small doses frequently repeated, until its effects are apparent. Morphine administered with Chloral antagonizes the tendency to cardiac failure, while synergistic to the hypnotism. While Chloral is the antagonist to Strychnine, opposing the spinal action of that drug, the reverse is only true to a very limited extent. Heat is a necessary application, to main- tain the body-temperature, and artificial respiration should be practiced if required. Ail alkalies are incompatible. Therapeutics. Chloral Hydrate is of great value as a hypnotic and antispas- modic, but must be cautiously used if at all in old alcoholics or persons with weak or fatty hearts, atheromatous vessels or advanced pulmonary disease. In combination with Potassic Bromide it is much used in asylum and general practice, and equally abused, both drugs being active cardiac poisons. It is highly serviceable in fevers, when high temperature exists with excitement, restless- ness and a sthenic condition, as it lowers temperature and pre- vents the coagulation of fibrin. In the algid stage .of cholera and in violent cases of cholera morbus it may be injected hypo- dermically in 15-grain doses with extraordinary efficacy. In seasickness small doses (gr. v) two or three times a day are gen- erally very efficient. In obstetrics it is used to relieve suffering, relax the os uteri, palliate convulsions and to relieve after-pains. For nocturnal epilepsy a full dose at bedtime is a useful palliative. In neuralgia it may be triturated with camphor and applied over the course of the affected nerve. Tetanus is best treated by chloral and potassic bromide. It is an excellent remedy for in- fantile convulsions and colic, chorea, spasmodic asthma, whoop- ing-cough, laryngismus stridulus, and the first stage of diphtheria, but not when the heart is weak. In acute mania and delirium tremens it is the best hypnotic, but has been too incautiously employed. In cancers and ulcers a 25 per cent, solution is a good antiseptic and anodyne application. In strychnine-poison- ing Chloral is the antagonist. It is generally given by the mouth in dilute solution with some simple elixir or cinnamon-water, but is well absorbed by the rectum. Its hypodermic administration is liable to result in great local irritation and even sloughing ulcers. The mixture of Chloral and Camphor is a good local applica- tion in superficial neuralgia, and may be painted over the larynx for spasmodic cough. It makes a good remedy for internal use CHLORAL BUTYLICUM CHLOROFORMUM. 139 in colic, cholera and cholera morbus, especially if combined with Morphine. CHLORAL BUTYLICUM, Butyl-chloral Hydrate, Croton-chloral, C4H.C130,H.20 (Unofficial),—is formed by the action of Chlorine upon Aldehyde, then adding to the Butyl- Chloral thus produced the necessary water. It occurs in crys- talline scales, insoluble in chloroform, sparingly soluble in water, but freely soluble in alcohol, hot water and glycerin. Dose gr. v-xx, in syrup or pill. But the best method is to give 5 grains every half-hour until 20 grains have been taken or relief afforded. Physiological Action and Therapeutics. Croton-chloral so far as is ascertained has an action parallel to that of Chloral Hydrate, but feebler and less certain. It is said to have a specific paralyzant power over the 5th nerve, and to have no paralyzant effect on the heart. It has been used with benefit in various neuralgiae, especially tic-douloureux, also in sciatica and dysmenorrhoea. All statements of the action and therapeutics of this drug are to be received with hesitation, as wide differences are reported by the best authorities. CHLOROFORMUM, Chloroform, CHC1;„—the Ter- chloride of Methyl, or the Chloride of Bichlorinated Methyl, is formed by the substitution of 3 atoms of Chlorine for 3 of Hy- drogen in Methyl Hydride (marsh-gas, CH4). In practice it is obtained from Ethylic Alcohol or Methylated Spirit by the action of Chlorinated Lime, or from Chloral by an alkaline hydrate, and is known chemically as Normal Chloroform. If prepared from Methylic Alcohol (wood-spirit) it is called Methylic Chloroform and is purified with great difficulty. The object of purification is to remove the chlorinated pyrogenous oil. Absolute Chloroform has a sp. gr. of 1.500, and decomposes easily in sunlight or dif- fused daylight, but when reduced to a sp. gr. of 1.485 to 1.490 by alcohol it will keep well. It is official in two forms, viz.— Chloroformum Venale, Commercial Chloroform,—is a liquid containing at least 98 per cent, of Chloroform, and having a sp. gr. not lower than 1.470. It contains sundry Hydrocarbons, free Chlorine, Aldehyde and Hydrochloric Acid, and is used only for external applications, or to make the purified article. It is a constituent of Linimentum Chloroformi. Chloroformum Purificatum, Purified Chloroform,—is a 140 CHLOROFORMUM. heavy, clear, colorless, diffusive liquid, of characteristic odor, sweet, burning taste and neutral reaction, soluble in 200 of water, freely so in alcohol or ether, also in oils, benzol or benzin. Sp. gr. 1.485 to 1.490 at 590 F., and contains to 1 per cent, of alcohol. Dose, internally, Tt£ij-xx, for inhalation about 3j> re- peated until the desired effect is produced. Preparations. Mistura Chloroformi,—contains of Purified Chloroform 8, Camphor 2 fresh Yolk of Egg 10, Water 80 parts. Dose, Shritus Chloroformi,—contains of Purified Chloroform 10, Alcohol 90 parts. Dose, nix-sq, well diluted. Linimentum Chloroformi,—Commercial Chloroform 40, Soap Liniment 60 parts. Linimentum Chloroformi Compositum (Unofficial),—Chloroform Jj, Oil of Turpentine 5;j, Tincture of Opium Tincture of Aconite 39. Chlorodyne (Unofficial),—a celebrated secret mixture, put forth by Dr. J. Collis Browne, of London, and since imitated by many others. It is sup- posed to contain Chloroform, Ether, Morphine, Cannabis Indica, Hydrocyanic Acid, Capsicum, etc., and is powerfully anodyne, antispasmodic and narcotic, and therefore highly dangerous in non professional hands. Dose, Tqx-xxx, according to the quantities of Morphine and Chloroform present, these being the active agents in the preparation. A comparison of the principal formulae which have been used in imitation of Browne’s Chlorodyne is given in the appendix, and will show the wide differences between them. A list of 25 formulae for Chlorodyne was published in the Therapeutic Gazette for Octo- ber, 1883. Anaesthetic Mixtures containing Chloroform,—see under /Ether, ante, page 44. Some Chlorinated Ancesthetic Compounds. Ethylene Bichloride, Dutch Liquid, Chloric Ether, C2H4CI2,—is a rapid and powerful anaesthetic, probably safer than Chloroform and less so than Ether. It always paralyzes the respiratory centre before the heart, so that its effects may be easily watched and controlled. This is the substance which Guthrie supposed he had obtained when he discovered chloroform. Ethylidene Chloride, Chlorinated Muriatic Ether, CH3,CHC12,—is a mixture of varying sp. gr., and is not inflammable. It closely resembles Chlo- roform both physically and physiologically, but is less depressant to the heart, consequently safer, and recovery from its effects is very prompt. Methylene Bichloride, Dichloro-methane, CII2C12,—is an effective an- aesthetic which it was supposed would displace Chloroform as being much safer. Dr. Richardson introduced it and Mr. Spencer Wells advocates its use, but though little used as compared with other anaesthetics several deaths have occurred from its employment. It kills by paralyzing the heart. Carbon Tetrachloride, CC14,—is less irritant than Chloroform, but far more dangerous to the heart. * Physiological Action. The action of Chloroform is similar to that of Ether (see ante, page 44) with several important differences, as follows: It is more CHLOROFORMUM. 141 irritant to the mucous membranes, and if swallowed undiluted it produces violent gastro-enteritis, which becomes apparent after the subsidence of the profound narcotism which at first follows its ingestion in quantity. A dose of gj internally will cause death. It is less of a stimulant than Ether, and more depressant to the heart and circulation. It clots blood outside the body, making a mass like sealing-wax. Inhaled for anaesthetic purposes it is considered much more dangerous than Ether from its direct paralyzant effect on the heart. Its vapor requires admixture with g6}4 per cent, of air to produce anaesthesia with safety according to the authorities on the subject. As compared with Ether its vapor is less irritant to the air-passages, uninflammable, more pleasant, more prompt in ac- tion, has a shorter stage of excitement and a more profound nar- cosis, and produces much less vomiting. Its mortality is greater, being i in 3000, against 1 in 16,000 for Ether, about 500 fatal cases being reported, none of which, however, were in obstetrical prac- tice. Death from Chloroform-inhalation is almost always sudden and by cardiac paralysis,—from Ether it is slow and usually by paralysis of respiration. [For modes of death from anaesthetic vapors, and the treatment of dangerous symptoms, see ante, page 45.] Antagonists. There is no chemical antidote. If swallowed, the stomach should be evacuated and the case treated as one of poisoning by an irritant. Amyl Ni- trite by inhalation, and Atropine hypodermically, to sustain the heart. Therapeutics. Chloroform is used for the same conditions as is Ether, and is much employed in liniments as a rubefacient and anodyne application, as in pruritus, rheumatic and neuralgic pains, etc. Internally it is advantageously administered in true cholera, in which it has been more efficacious than any other single remedy, in cholera morbus, vomiting, colic, dysmenorrhoea, hepatic colic, and other pains of internal and spasmodic character. In sciatica, tic-douloureux and other neuralgise of important nerves the deep injection of of pure Chloroform in the vicinity of the nerve is highly recommended, though it may cause dangerous local disturbance. The writer has, in several cases of severe supra-orbital neuralgia, injected two or three minims of Chloro- form into the vicinity of the supra-orbital nerve just above its foramen of exit, with the most gratifying results, though severe local pain and considerable swelling were experienced for several 142 CHLOROFORMUM. days. The vapor in small quantities inhaled from warm water is useful in many respiratory neuroses, as hay-fever, spasmodic asthma, reflex cough. As an Ancesthetic the use of Chloroform is decreasing every year in favor of Ether, except for young children and in obstet- rical practice. Its vapor being four times denser than air, and the rule for its effective use requiring fully 9 per cent, of air with it, its administration according to the orthodox fashion requires most careful management, and should never be attempted in any but the recumbent posture. An ounce of Brandy and a hypodermic injection of Morphine, gr. with Atropine, gr. g>ven 20 minutes before commencing the inhalation, are means of great utility in sustaining the heart and respiration, as well as in rendering the anaesthesia more profound. No opera- tion, especially on parts supplied by the fifth nerve, should be undertaken during partial chloroform anaesthesia, for the reasons given on page 45. Dr. Sayre of New York administers Chloroform in a manner which is calculated to strike terror to the heart of an emotional observer who is impressed by the orthodox rule of per cent, air with per cent, of the anaesthetic as the only safe propor- tion. Having been made familiar with the practice of Dr. Sayre through observance of the method employed by some of his pupils, the writer sought for more direct instructions from that distinguished surgeon, and received from him a letter from which the following paragraphs are extracted. “ I have employed no other method for more than twenty years, have used it in this manner in some thousands of cases without the least appearance of danger, and can therefore speak with confidence as to its safety. “ My plan is simply to anaesthetize the patient with the smallest amount of Chloroform possible; and as Oxygen is the antidote to the anaesthetic I ex- clude all air that is not impregnated svith the ancesthetic. “ In this manner a very few inspirations will produce immediate anaesthesia without the muscular struggling which always follows when pure air is ad- mitted with the chloroform. I always measure my dose with the same care as if I were administering Arsenic, Strychnine, Corrosive Sublimate, or any other potent agent; and then I know what I am doing. If by accident there should be some peculiarity about the patient, making him unduly susceptible, a few artificial respirations would soon remove the influence of the few drops which had been inhaled, and thus all danger can be avoided. Five, ten or twenty drops of Chloroform administered in this manner is all that is requisite to produce immediate and profound anaesthesia. I have explained my method hundreds of times at my clinical lectures in Bellevue Hospital, many of which have been published at different times in different medical journals by various persons who have made stenographic reports of my lectures. In the ‘ Trans- actions of the International Medical Congress,’ held in Philadelphia in 1876, CHLORUM. 143 is a verbatim report of my remarks on this subject made while I was perform- ing an exsection of the hip-joint in the hospital before the Congress.” I remain, yours truly, Lewis A. £ayre. The writer can add his testimony to that of the above letter respecting the thorough anaesthetic effect and freedom from un- pleasant symptoms observed in a large number of cases in which Chloroform was administered in the manner described under his observation during the past three years. As to the safety of this method over the ordinary way no conclusion can be reached without the results of many thousands of examples in the hands of many different observers. CHLORUM, Chlorine, Cl,—is a greenish-yellow gas hav- ing a suffocating odor and belonging to the group of Halogen elements, so named (from akq, the sea) because its most impor- tant members Chlorine, Bromine and Iodine are derived from the ocean, Chlorine being obtained from sea-salt, Bromine from sea- water, and Iodine from sea-weed. Chlorine itself is not official, but is represented in medicine by 2 Chlorates and 2 Chlorides (of Potassium, Sodium, etc.), which are described under the titles of their respective bases, also by the following preparations which furnish it. Preparations. Aqua Chlori, Chlorine Water,—is an aqueous solution of Chlorine, con- taining at least 0.4 per cent, of the gas ; and is prepared by heating together Black Oxide of Manganese 10 parts and Hydrochloric Acid 40 parts, then saturating 400 of distilled Water with the gas so obtained. It is a clear, green- ish-yellow liquid, of suffocating odor and disagreeable taste. Dose, 3j-£ss, well diluted, as a lotion or spray ; internally, nix-xx in water. Chlorine Water may be extemporaneously prepared by mixing in a mortar Chlorate of Potassium 40 grains and Hydrochloric Acid ounce, and add- ing a pint of distilled water by agitation during the evolution of the vapors. If done in a closed vessel danger may arise from the explosive gas, Cla04, which is liberated at the same time. It should be quickly bottled. Calx Chlorata, Chlorinated Lime, Chloride of Lime,—is a compound resulting from the action of Chlorine upon Calcium Hydrate, and containing at least 25 per cent, of available Chlorine. It is obtained by exposing slaked Lime to the action of Chlorine gas as long as the latter is absorbed, and should not be confounded with Chloride of Calcium (see ante, page in). It occurs as a whitish, dry powder or friable lumps, gradually decomposing in the air, of saline, disagreeable taste and a feeble Chlorine odor, partially soluble in water and in alcohol, and when dissolved in dilute Hydrochloric acid gives off Chlorine gas. Dose, gr. iij-vj in water; for external use a 1 to 3 per cent, solution. Liquor Calcis Chlorate, B. P., is a solution of 1 pound in 1 gallon of water. Liquor Sod/£ Chlorate, Solution of Chlorinated Soda, Labarraque’s 144 CHLORUM. Solution,—a pale-greenish liquid, of faint Chlorine odor, and alkaline taste and reaction; prepared by adding together watery solutions of Sodium Car- bonate ioo parts and Calx Chlorata 80, then adding Water up to 1000. Dose, TTLx-gj 20 parts of water. Physiological Action. Chlorine is actively irritant to the skin and mucous membranes. Locally applied it produces heat, burning and even vesication. Inhaled in any quantity it causes cough, sneezing and spasm of the glottis, also inflammation of the air-passages and of the lungs. It is the most powerful of all disinfectants and deodorants, also an antiseptic and antifermentive agent of the highest activity. Its power in all these respects is due to its affinity for hydrogen, decomposing all bodies in which hydrogen enters as a molecular constituent, forming chlorhydric acid and setting oxygen free in its nascent form (ozone). Used internally it has the same local action on the parts with which it comes in contact, and on reach- ing the stomach in dilute solution it is converted into hydro- chloric acid and chlorides, losing all further action on the body in its own character. Antidotes. Ammoniacal vapors inhaled after Chlorine form Ammonium Chloride. Ammonium Sulphide has a similar reaction, but should be inhaled in great moderation. Albumen is the antidote if Chlorine preparations have been taken into the stomach, and a little Aqua Ammonite, sufficiently diluted, may also be administered with advantage. Therapeutics. The chlorinated preparations are used as disinfectants and deodorizers of rooms, drains and discharges from the body. They are rarely used about the person or clothing of patients by reason of the irritation produced by them when inhaled, and their power to destroy the color of fabrics. In dilute solution they are well employed as local applications in aphthae, gangrene, scarlet fever and diphtheria, in which their principal action is to destroy fetor. The same may be said of their use in sloughing ulcers and gangrenous wounds, foul discharges, etc., as they are rarely employed about the person in sufficient strength to have any destructive effect on disease-germs. A strong solution of Chlorinated Soda is a good application to bites of serpents and insects, to prevent infection by the syphilitic poison, and to wash the hands after contact with infectious material. These preparations have been administered internally in septic diseases, low fevers, etc., but without producing any marked beneficial results. To disinfect unoccupied rooms all means of exit should be CHONDRUS CHRYSAROBINUM. 145 stopped up, then a pound of Chlorinated Lime sewed loosely in a strong canvas bag is immersed in a mixture of a pint and a half of common muriatic acid with pints of water, and left 24 hours. CHONDRUS, Irish Moss ,—consists of two sea-algse, Chondrus crispus and Chondrus mammilosus, dried -and bleached. Is horny, translucent, pale yellowish-white, swelling in water, of sea-weed odor and mucilaginous, saline taste. On boiling with 30 parts of water for ten minutes it yields a solution which gela- tinizes on cooling. It contains 90 per cent, of mucilage with traces of Iodine and Bromine, also 1 per cent, of Nitrogen. There are no official preparations. A jelly or blanc mange may be prepared by boiling in of water for an hour, strain- ing and adding Jiij of sugar while hot. Dose, indefinite. Physiological Action and Therapeutics. Irish Moss is a demulcent and nutrient substance of some slight value in bronchial and catarrhal affections. Having no starch in its composition it is not so valuable as Iceland moss (Cetraria) as an article of food for the sick. CHRYSAROBINUM, Chrysarobinis a mixture of proximate principles extracted from Goa-powder, a substance found in cavities formed by decay in the wood of the trunk of Andira Araroba, a Brazilian tree of the nat. ord. Leguminosae. It is commonly misnamed “ Chrysophanic Acid” (which is one of the constituents of Rheum)—though easily converted into that substance. Occurs as an orange-yellow powder, odorless and tasteless, nearly insoluble in water and alcohol, but readily soluble in ether, solutions of alkalies and sulphuric acid. Dose, gr. >$-gr. xx. Preparation. Unguentum Ciirysarobini,—Chrysarobin io, Benzoinated Lard 90 parts. Should be diluted for average use from 3 to 5 times. Physiological Action and Therapeutics. In 30-grain doses Chrysarobin is a gastro-intestinal irritant, producing large, watery, bilious stools, with repeated vomiting but not much nausea. Locally it produces diffuse dermatitis often followed by follicular and furuncular inflammation. It stains the skin a dark yellowish-brown color, which may be removed by a 146 CIMICIFUGA. weak solution of chlorinated lime. The use of this remedy is confined to superficial parasitic skin diseases of vegetable origin, and for psoriasis, in the latter affection it being the best remedy known. It maybe used in weak ointment locally, and internally in -grain doses. CIMICIFUGA, Black Snake-root, Black Cohosh,— is the rhizome and rootlets of Cimicifuga racemosa, a plant of the nat. ord. Ranunculaceae native in the United States. Rhizome horizontal, 2 inches long or more, about 1 inch thick, with nu- merous upright or curved branches. Rootlets numerous, con- taining a ligneous cord which branches into four or five rays. Contains a Volatile Oil when fresh, resin, tannic and gallic acids, also an acrid, crystallizable, neutral principle. Cimicifugin or Macrotin is an impure resin obtained by precipitation from a con- centrated tincture by the addition of water. The active principle has not been isolated. Preparations of the Fresh Root. Extractum Cimicifuga Fluidum,—alcoholic. Dose, nix-^j. Tinctura Cimicifuga,—20 per cent. Dose, gss-ij. Macrotin (Unofficial),—Dose, gr. y£-ij. Physiological Action. Cimicifuga is stomachic, antispasmodic, aphrodisiac, diapho- retic, diuretic and expectorant. Its taste is bitter and nauseous, resembling that of Opium. It acts on the heart and circulation similarly to Digitalis, and on unstriped muscular fibre like Ergot, but is much feebler in activity than either of these agents. Small doses stimulate digestion and secretion, the generative function and the menstrual flow, and especially the secretions of the bronchial mucous membrane and the kidneys. Full doses slow the heart while increasing its force, raise arterial tension and stimulate uterine contraction. Large doses dilate the pupils and produce dimness of vision, vertigo, intense headache, nausea, vomiting, and in some persons soporific and anodyne effects. Therapeutics. Cimicifuga closely resembles Digitalis in action, but it is safer, and should be more frequently used when the latter drug is indi- cated. In cardiac diseases it is very efficient, especially in weak or fatty heart where Digitalis would be dangerous. It is a good stomachic tonic particularly in the irritable dyspepsia of alco- CINCHONA. 147 holism. As an expectorant it is used in acute and chronic bron- chitis. It is a good nerve-tonic in delirium tremens, and in functional impotence it is remarkably efficient. In rheumatism of the localized muscular variety, as lumbago, torticollis, pleuro- dynia, intercostal rheumatism, etc., it is one of the most effica- cious remedies, having a strong affinity for the muscular system. Neuralgias of various kinds are benefited by it, particularly ova- rian neifralgia. Chorea about the age of puberty is one of the affections in which it is most efficient, and the same may be said of the hysterical form of this disease. Many uterine disorders are remarkably benefited by Cimici- fuga, such as amenorrhoea, neuralgic and congestive dysmenor- rhea, subinvolution, spinal irritation due to some obscure sympa- thetic or neuralgic affection of the womb, sympathetic pains and neuralgise arising from the so-called irritable womb, passive men- orrhagia, etc. In obstetrics it gives excellent results when used to initiate uterine contractions, check hemorrhage, allay afterpains and nervousness after delivery. In puerperal mania and periton- itis its good effects are frequently remarkable, and in puerperal hy- pochondriasis it is strongly recommended by very high authority. CINCHONA, Peruvian Bark. — The Cinchona tree belongs to the nat. ord. Rubiacese and is a native of the eastern slope of the Andes, but has been largely planted in India, Ceylon, Java and Burmah, with the result of improving the quinine-yielding value of many species by cultivation. In late years the test of appearance has given way to that of assay in judging of the various barks of commerce, and only those are official which yield 3 per cent, of total alkaloids of which at least 2 per cent, must be Quinine. Yellow bark contains most Qui- nine (as high as 9 per cent, having been obtained from one spe- cimen), pale bark contains most Cinchonine and least Quinine, while red bark contains these alkaloids in about equal propor- tions. The Columbian varieties afford the largest percentage of Cinchonidine. The principal varieties of the sub-order Cinchonese, the barks of which are found in commerce and used by manufacturers of the alkaloids, are— Cinchona Calisaya, Yellow Bark,—from Peru, Bolivia and India. Cinchona succiruba, Red Bark,—from Ecuador, Java and Ceylon. Cinchona Condaminea, Pale Bark,—from Ecuador and Peru. Cinchona Pitayensis, Pitaya Bark,—from New Granada. Cinchona micrantha, Gray Bark,—from Peru and Bolivia. 148 CINCHONA. Altogether there are some 31 species acknowleged by botanists, and the list is constantly increasing from the tendency of the different trees to hybridize. Several trees formerly acknowledged as Cinchonas are now placed in the genus Cascarilla, but their barks are to be found on the market. Cuprea bark is from trees of the genus Remijia, growing in Columbia; it contains Quinine and a peculiar alkaloid, Cinchonamine, but no Cinchonidine. Official Species. Cinchona,—is the bark of any species of Cinchona which contains at least 3 per cent, of its peculiar alkaloids, as deter- mined by assay according to a prescribed rule. Cinchona Flava, Yellow Cinchona, Calisaya Bark,—is the bark of Cin- chona Calisaya, containing at least 2 per cent of quinine. Occurs in tawny- yellow flat pieces or quills, ridged exteriorly, finely striated on inner surface, breaking with a transverse fracture showing numerous rigid fibres in bundles or radial rows. Cinchona Rubra, Red Cinchona,—the bark of C. succiruba, containing at least 2 per cent, of quinine. Occurs in brown-red quills and flat pieces of various sizes, with ridges and warts on outer surface, coarsely striated on inner surface. Bark may be administered in doses of gr. but it is never used now in substance, being too bulky and disagreeable. Compositio?i of Cinchona. The bark contains 21 natural alkaloids (of which 4 are official), 8 artificial alkaloids, 2 simple acids, 2 tannic acids, a resinoid and coloring-matter, as follows :— Quinine, G^H^NjOj,—a strong base, fluorescent, the most valuable of all the alkaloids; heated with glycerin to 3740 F., it is converted into the isomeric base Quitiicine. Quinidine, C20H24N2O2,—isomeric with Quinine, fluorescent, probably the most powerful as an antiperiodic, but existing in very small quantity. Cinchonine, C20H24N2O,—the least active of the official four, having about half the therapeutic power of Quinine. Not fluorescent. Cinchonidine, C.^H.^KjO,—isomeric with Cinchonine, not fluorescent, one of the most powerful of the alkaloids. Kinic and Kinovic Acids,—are combined in the bark with the alkaloids. The former is used to make a Kinate of Quinine, and the latter occurs in non- official pharmacy as Kinovate of Lime, an ingredient in Deloudre’s Extract, which is used in Europe and India for dysentery. Kino-tannic and Kinovo-tannic Acids,—give to bark its peculiar and powerful astringent qualities. They have not been fully studied. Kinovin,—is a bitter, amorphous resinoid, which is resolvable into Kinovic Acid and sugar. It is soluble in alcohol, but not in water. Cinchona Red,—a reddish-brown, insipid, inodorous substance. [The other alkaloids are of no interest medicinally.] CINCHONA. 149 Preparations of the Bark. Extractum Cinchona,—made from Yellow Cinchona. Dose, gr. j-v. Extractum Cinchona Fluidum,—from Yellow Cinchona. Dose, Tinctura Cinchona,—Yellow Cinchona, strength 20per cent. Dose, Tinctura Cinchona Composita,—made from Red Cinchona, strength 10 per cent. Contains Bitter Orange-peel 8, and Serpentaria 2 per cent. Dose, 3j-.?ss- Infusum Cinchona,—made from any official bark. Cinchona 6, Aromatic Sulphuric Acid 1, Water 93 parts. Is the only official infusion containing this acid. Dose, or more. Huxham’s Tincture of Bark, 1788 (Unofficial),—is still used. Red Cinchona Orange-peel 5iij, Serpentaria gr. lxxx, Spanish Saffron gr. clx, Cochineal gr. lxxx, Brandy £xl, digested for 4 days, expressed and filtered. Dose, 3ss-ij. Quinine and its Salts. Quinina, Quinine, C20H24N.2O2.3H2O,—a white, amorphous or minutely crystalline powder, of alkaline reaction and very bitter taste, soluble in 1600 of water and 6 of alcohol at 590 F., in 25 of ether, 5 of chloroform, and readily in dilute acids. Dose, gr. j-xx, or xl in special cases. Is insoluble in saliva. Quinine Sulphas, Sulphate of Quinine (C20H24N2O2)2.H2SO4.7H2O,—very light, snow-white, fragile crystals, of very bitter, persistent taste, soluble in 700 of water and 65 of alcohol at 590 F., in 30 of boiling water, 3 of boiling alcohol, also in acidulated water. Dose, gr. j-xx, or even gr. xl in special cases. Quinine Bisulphas, Bisulphate of Quinine, C20H24N2O2.H2SO4.7H2O,— clear, colorless, efflorescent crystals or small needles, of very bitter taste and strongly acid reaction, soluble in 10 of water with blue efflorescence, and in 32 of alcohol, at 590 F. Dose, gr. j-xxx, or even gr. lx in special cases. Quinine Hydrobromas, Hydrobromate of Quinine, C20H24N2O2HBr. 2H20,—colorless needles, of very bitter taste, soluble in 16 of wrater and in 3 of alcohol at 590 F., and in 1 of boiling water or alcohol. Is the best salt for hypodermic use, of water dissolving gr. iv, which may be injected every 4 hours without causing irritation. Dose, gr. j-xx. Quininve Hydrochloras, Muriate of Quinine, C2pH24N202HC1.2H20,— white needles in tufts, of very bitter taste, soluble in 34 of water and 3 of alcohol at 590 F., in 1 of boiling water or alcohol. Is used hypodermically. Dose, gr. j-xx. An excellent salt which should be more generally used ; 5 to 10 gr. doses are antipyretic. Quinine Valerianas, Valerianate of Quinine, H20, white, pearly crystals, of valerianic odor and bitter taste, soluble in 100 of water and in 5 of alcohol at 590 F. Dose, gr. j-iij. It is the only salt of Quinine supposed to be affected by the constituent acid. Quinine Hydrochloras Carbamidata, Carbamide Hydrochlorate of Quinine (Unofficial),—is a new compound salt of Quinine and Urea, soluble in equal parts of water and therefore admirably adapted for hypodermic ad- ministration in a 50 per cent, solution. It is almost unirritating to the tissues, and is given subcutaneously in doses of gr. j-iij. Chininum Amorphum Boricum, Amorphous Borate of Quinine (Unof- ficial),—is a new preparation, soluble in an equal quantity of water, and claimed by its introducers to be equally as satisfactory as any other Quinine salt, and much better borne by the stomach than any other one. It is also said to cause little or no congestion of the membrana tympani. 150 CINCHONA. Tinctura Pyrexialis, Warburg’s Tincture (Unofficial),—is a celebrated preparation, formerly secret, but published in 1875 by the originator, whose formula is as follows : R. Aloes soc. lb j; Rad. rhei (chinens), Sem. angelicae, Confec. Damocratis,* aa §iv; Rad. helenii (s. enulae), Croci sativi, Sem. foeni- culi, Cretae prep, aa Jij; Rad. gentianae, Rad. zedoariae, Pip. cubebse, Myr- rhae elect., Camphorae, Bolet. laricis, aa Digest the whole with 500 oz. of proof spirit in a water-bath for 12 hours, express, add Bisulphate of Quinine, dissolve by aid of a water-bath, cool and filter. Dose, 3j, in two doses 3 hours apart. Hager’s modification of the original formula is—R. Quininae sulph. part, j, Spt. camphorae part, ij, Elix. proprietatis (Tinct. aloes et myrrhae) part, xxij, Alcoholis part. xvj. The evidence published in favor of this preparation goes to show that its power does not wholly lie in the qui- nine, camphor, aloes or rhubarb, but in some of the aromatic plants contaihed in it. Other Official Alkaloids and their Preparations. Cinchonina, Cinchonine, C20H24N2O,—white, lustrous prisms or needles, of bitter after-taste, almost insoluble in water, readily so in dilute acids and in 110 of alcohol at 590 F. Dose, gr. j-xxx or more. Cinchonine Sulphas, Sulphate of Cinchonine (C20H24N2O )2H2S04. 2H20,—white, shining prisms, of very bitter taste, soluble in 70 of water and in 6 of alcohol at 590 F., and readily soluble in dilute acids. Dose, gr. v-xxx or more. Cinchonidine Sulphas, Sulphate of Cinchomdine (C20H24N2O)2H2SO4. 3H20,—white, silky crystals, of bitter taste, soluble in 100 of water end in 71 of alcohol at 590 F., freely soluble in acidulated water. Dose, gr. j-xx or more. Quinidine Sulphas, Sulphate of Quinidine (C20H24N'2O2)2H2SO4.2H2O,— white, silky needles, of bitter taste, soluble in 100 of water and in 8 of alcohol, readily in acidulated water, at 590 F. Dose, gr. j-xx or more. It is not so bitter as Quinine, is less expensive, and is a valuable antipyretic and anti- periodic. Chinoidinum, Chinoidin, Quinoidin,—a mixture of alkaloids, mostly amor- phous, obtained as a by-product in the manufacture of the cystallizable alka- loids from Cinchona. A black solid when cold, plastic when warmed, of bitter taste, almost insoluble in water, freely soluble in alcohol and in dilute acids. It contains the 4 alkaloids in amorphous condition, and has about *4 the therapeutic power of Quinine. Dose, gr. v-xxx or more. Non- Official Preparations. Quinquinina, or Quinetum,—is an Indian preparation containing the total alkaloids extracted from bark by acidulated water, then precipitated by soda and dried. In India it is called “ febrifuge.” Cinchonidine Sai.icylas, Salicylate of Cinchonidine,—has anti-malarial power only inferior to the salts of Quinine. Substitutes for Quinine. Chemists have for some time been searching for an artificial quinine made synthetically, and in the search have found a number of bodies, closely related to each other and to quinine, * For the formula for this ingredient see the article on Confections in the section on Extemporaneous Pharmacy, Part II. CINCHONA. 151 both in physiological action and in chemical composition. The most important of these are Antipyrine, Resorcin and Chino- line, which are respectively described utfder their own titles. The latter substance is obtained from the cinchona alkaloids and from coal-tar, and like the other two may be produced syntheti- cally. Others of the same class are as follows. Some Unofficial Antipyretics. Kairina, Kairine (Hydrochlorate of Oxy - ethyl - chinoline-hydride), CjflHj3NO.HCl.H2O,—is an artificial alkaloid prepared from Chinoline, be- longing to the phenol group of carbon compounds, and a powerful antipyretic in 8-grain doses hourly. It stains the urine a deep green, and has not proven toxic though 220 doses have been administered in one case. In some cases of typhus it has caused cyanosis and collapse. It produces profuse sweating and vomiting, and the subsequent rise of temperature after its antipyretic in- fluence has worn off is generally ushered in by a severe rigor. It is by many authorities considered to be the most certain, most powerful and most rapid antipyretic drug we possess, though this claim is now disputed by the advo- cates of Antipyrine. It occurs in white crystals, which are freely soluble in water, but is best given in wafer-paper or capsules. Dose, gr. iij-xxx. Kairolina, Kairoline (Sulphate of Tetra-hydromethyl-chinoline),—is anti- pyretic, but much less efficient than Kairine. Thallin (Parachinanisols),—is a very powerful antipyretic, in 4-grain doses causing a rapid fall of temperature, but its effects are not lasting, it is not so well borne as Antipyrin, it sometimes causes a very alarming tendency to collapse, and as it excites profuse sweating it leaves the patient consider- ably weakened. Hydroquinone (Di-hydroxyl-benzole), C6II602,—crystallizes in rhombic, colorless prisms which are slightly soluble in water, readily so in alcohol and in ether, and is obtained from Arbntin, a glucoside constituent of Uva Ursi and other Ericaceae. It is an efficient antipyretic, without injurious effects so far as observed, but its influence is only temporary. The action of this drug on animals is summarized in the N. Y Medical Record for August 15th, 1885, and its influence on pyrexia elucidated in the same journal for May 30th, 1885. Dose, as an antipyretic, gr. xv-xx, best given in alcohol. Gr. xl have been given without disagreeable effects. Pyrocatechin, Catechol, C6H602,—one of the acid constituents of coal-tar, also obtained from wood-tar and from kinic acid. It is a good antipyretic but much inferior to Quinine or Resorcin. Pheno-resorcin,—is a mixture of Carbolic Acid 67 with Resorcin 33 and Water 10, forming a liquid which mixes readily with water. It is supposed to combine the virtues of both its ingredients. Physiological Action. The action of Cinchona in sufficient dose is generally that of its alkaloid Quinine, except that bark is decidedly astringent, more of a gastric irritant, and by reason of its bulk its active prin- ciples are more slowly absorbed. In large doses (3ij) the pow- dered bark has produced flatulence and eructation, and in many well-authenticated instances has produced a well-marked febrile 152 CINCHONA. paroxysm, beginning with chill, then fever and headache, which gradually subsided in slight perspiration. So also, Quinine, while incapable of producing intermittent fever in a healthy person, will, if taken in large doses unnecessarily, throw the nervous system into high commotion, and if untimely used by a malarial subject may reproduce the paroxysm with greater or less severity. Cinchona is an astringent bitter and a stomachic tonic. At first it promotes appetite, digestion, the flow of saliva and of gastric juice ; long-continued it sets up a gastric catarrh, impeding digestion and causing constipation. Quinine is a bitter tonic, antiseptic, antiperiodic, antimias- matic and antipyretic, a diminisher of reflex action, a protoplas- mic poison, a cardiac depressant and perhaps an oxytocic. It is rapidly diffused and slowly excreted, being found in the urine in 15 minutes after its administration and for two or three days afterwards. Its action on the stomach is similar to that of cinchona. It arrests the movements of the white blood-corpuscles though in- creasing their number, and prevents acetification and decay of the blood. It is actively destructive of lowly organized life, a solution of 1 to 500 being fatal to infusoria and fungi, while one of double this strength prevents alcoholic fermentation and checks putrefac- tive decomposition. The heart and arterial tension are somewhat stimulated by small doses, but depressed by large ones (gr.xl-lxxx), which slow and enfeeble the pulse by direct action on the cardiac ganglia. The brain isrendered hyperaemic and exhilarated bysmall or moderate doses, but large ones produce a sense of fulness and constriction in the head, cerebral anaemia, pallor, tinnitus aurium, vertigo, staggering gait, amaurosis and deafness, great headache, dilated pupils, delirium, coma, and in animals convulsions. The eyes and ears are very rarely injured permanently. These symptoms col- lectively are termed Cinchonism. It reduces the size of the spleen when enlarged, and lowers the temperature of pyrexia, though it does not depress the body temperature in health. Large doses lower the reflex function of the spinal cord. In some subjects it pro- duces sexual excitement, in others cutaneous eruptions sometimes followed by desquamation. It lessens the excretion of uric acid, but not that of urea, and is a uterine stimulant in labor, but its power to initiate uterine contractions is a much debated question. Quinidine and Cinchonidine correspond in action with Qui- nine both qualitatively and quantitatively, the latter however producing less severe head symptoms. Cinchonine also corresponds in effect, but is much the least active of the four alkaloids. It is said to produce greater head- CINCHONA. 153 ache, and much precordial pain and muscular weakness, but to have little effect on sight or hearing. Antagonists and Incompatibles. Morphine antagonizes its cerebral action, Atropine its nervous, cardiac and antipyretic powers. Free Tannic Acid is incompatible with the Infusion of Cinchona. Iodine preparations, Alkalies, Alkaline Carbonates and Earths, are incompatible with solutions of the alkaloids, the first-named forming in- soluble compounds, the latter precipitating them. Therapeutics. Cinchona is used as a tonic and has many applications. The Infusion or Compound Tincture with a mineral acid is extremely serviceable in atonic dyspepsia, gastric catarrh of alcoholics, ady- namia, convalescence, asthma, chronic bronchitis, and generally in weak subjects of flabby flesh and perspiring skin. Quinine finds its principal field of action in the malarial dis- eases, over which its power is that of a specific. In intermittents, a ten-grain dose of the sulphate should be given in the sweating stage and again 5 hours before the expected time of the next par- oxysm. In the intervals Arsenic is better used, as Quinine will cause a daily exacerbation of temperature if long continued. In remittents 20- to 30-grain doses should be administered once or twice a day until the temperature is reduced to the normal point. In pernicious remittents large doses (gr. xxx to lx) are necessary to the safety of the patient. In chronic malarial poisoning Qui- nine has considerable power, but Chinoidin is more effective. Small doses of Quinine (gr. ij-iij per diem) are efficient as a prophylactic against malaria. As an antipyretic Quinine is used with the best results, espe- cially in typhus, typhoid, variola, pneumonia and acute rheuma- tism. Inflammations may, at their inception, be aborted by 15- or 20-grain doses, combined with Morphine, which in this respect is synergistic to Quinine. Acute tonsillitis and acute catarrh may sometimes be aborted by a full dose. In surgical fevers, pyaemia and exhausting suppurative conditions, also in septicaemia, hectic fever, and before surgical operations, Quinine is much employed. Neuralgias of malarial origin are amenable to it, as also neuralgia of the ophthalmic division of the fifth nerve. In eruptive fevers, especially scarlet fever, erysipelas and measles, it is advantageously administered throughout their course. In some skin diseases, particularly erythema nodosum, it is quite efficient, also in whoop- ing-cough and hay-fever. In the latter affection a solution of gr. vj to the % of the neutral hydrochlorate is a very useful local application. 154 CINNAMOMUM. Antipyresis has of late received considerable attention, par- ticularly in the German hospitals. The most certain and safe of all antipyretics is undoubtedly the cold bath, but it is not always the most practicable, especially in private practice. Internal antipyretics are therefore of great value, and of these the safest and best is Quinine, next in order being Antipyrine. Warburg’s Tincture has obtained a very high reputation in the hands of Indian army-surgeons in the treatment of remittent and other malarial fevers of the most malignant types, in mala- rial neuralgise, acute nervous exhaustion and sudden collapse without organic disease. The most pronounced testimony to its value is that of Dr. Maclean {Med. Times and Gazette, Nov., 1875), whose authority will not be questioned by the most cap- tious. He affirms that the influence of this combination to arrest an exacerbation of remittent fever is far more powerful than that of Quinine alone. The remedy has become much less of a favorite since its originator was induced to make public the secret of its composition. A dm in istration. The persistently bitter taste of Quinine and its salts is best obviated by administering them in pill-form, made with glycerin as an excipient, or by using liquorice, eriodyction or chocolate to cover the taste if given in solution or powder. For hypodermic use the best salt is the Hydrobromate, it being the most soluble,—gr. xij in of distilled water gives gr. j in The Carbamide Hydrochlorate is coming into favor for hypodermic administration by reason of its solubility and freedom from irritating qualities. CINNAMOMUM, Cinnamon ,—is the inner bark of the shoots of Cinnamomum Zeylanicum (Ceylon), or the bark of the shoots of several species of Cinnamomum (nat. ord. Lauraceae) grown in China (Cassia Bark). The former occurs in light, yel- lowish-brown quills, consisting of several pieces rolled together, each very thin, while the Chinese variety comes in single quills of irregular form and rougher texture. The taste is warm and aro- matic, and the odor very fragrant. The active principle is a Volatile Oil, and it also contains a resin, tannic and cinnamic acids. Dose, gr. x-xx. Preparations. Oleum Cinnamomi,—is the volatile oil, a yellowish-colored liquid of sp. gr. x.040 to 1.060, becomes dark by age, of slightly acid reaction. The oil of Chinese cinnamon is not so agreeable in odor or taste. Dose, gtt. j-v. Aqua Cinnamomi, Cinnamon-Water,—has of the oil 2 parts in 1000, perco- lated through cotton. Dose, indefinite. Spiritus Cinnamomi,—contains 10 per cent, of the oil. Dose, iqv-xxx. COCCUS—COLCHICUM. 155 Tinctura Cinnamomi,—contains io per cent, of the powdered bark. Dose, sjss-ij. Pui.vis Aromaticus, Aromatic Powder,—Cinnamon 35, Ginger 35, Car- damom 15, Nutmeg 15, rubbed together in fine powder. Dose, gr. x-xxx. Extractum Aromaticum Fluidum,—has of Aromatic Powder 100 grammes, Alcohol q. s. ad 100 cubic centimeters. Dose, Tqx-xxx. Physiological Action and Therapeutics. Cinnamon is an agreeable carminative, somewhat astringent and stimulant, and highly aromatic. The oil is not astringent but is a pleasant stimulant to the nervous and vascular systems, and is by some believed to exercise a specific action on the uterus, particularly as a hemostatic. The various preparations are in general use as flavoring excipi- ents, and the aqua is a pleasant vehicle for extemporaneous pre- scriptions. The bark and its preparations are used to check diarrhoea in combination with opium, chalk, or some vegetable infusion. The oil is a good stimulant in flatulence, paralysis of the tongue, cramp of the stomach, enteralgia, etc., and is some- times used to check nausea and vomiting. Cinnamon was for- merly used with success in uterine hemorrhage, generally in combination with sulphuric acid which of itself is an efficient uterine hemostatic. COCCUS, Cochineal,—is the dried female of Coccus cacti, an insect of the order Hemiptera, which feeds on the cactus plants of Mexico and Central America. Occurs in ovate, plano- convex form, of a purple-gray or purple-black color, yielding when crushed a dark-red powder, which contains Carminic Acid, or Carmine, the red coloring-matter, which is soluble in water and alcohol, but not in oils. Cochineal is an ingredient of Tinc- tura Cardamomi Composita, and is used in pharmacy solely as a coloring material. Therapeutics. The only therapeutic use of Cochineal is in whooping-cough and neuralgia, in which affections it is supposed to have consid- erable influence, especially in the former. Its dose to an infant is about gr. thrice daily. COLCHICUM, Meadow Saffron,—is the corm and seed of the Colchicum autumnale, a European plant of the nat. ord. Melanthaceae. It contains an alkaloid, Colchicine, C1TH19NO 5> 156 colchicum. which by the action of acids is converted into Colchiceine and a resin,—also tannic and gallic acids, resin, starch, sugar, etc. It is official in two forms, namely— Colchici Radix, Colchicum Root,—the corm, about i inch long, white internally, grooved on one side, inodorous, taste sweetish, bitter and acrid. Is less active than the seed. Dose, gr. ij-viij. Colchici Semen, Colchicum Seed,—about j inch thick, sub- globular, resembling black mustard seed l>ut larger, very hard and tough, inodorous, of bitter and acrid taste. Dose, gr. j-v. Preparations. Extractum Colchici Radicis,—made with Acetic Acid 35 parts to 100 of the root, and sufficient water. Dose, gr. Extractum Colchici Radicis Fluidum,—Dose, npj-x. Extractum Colchici Seminis Fluidum,—Dose, ntj-v. Vinum Colchici Radicis,—strength 40 per cent. Dose, rriv-xv. Vinum Colchici Seminis,—strength 15 per cent. Dose, ttlx-xxx. Tinctura Colchici,—from the seed, strength 15 per cent. Dose, mx-xxx. Colchicina, Colchicine, C17H19N05 (Unofficial),—a white or yellowish, amorphous powder, of saffron-like odor and bitter taste, soluble in water and in alcohol. Dose, gr. y£g~gV Is suitable for hypodermic injection. Physiological Action. Colchicum is emetic, diuretic and diaphoretic, a drastic pur- gative, a gastro-intestinal irritant and a cardiac depressant. In small doses it increases secretion, especially the urine and the sweat. In full doses its action is emeto-cathartic, producing profuse watery discharges, great nausea and extreme muscular feebleness. In large doses it is a powerful irritant of the gastro- intestinal tract, causing severe griping, choleraic discharges, lowered arterial tension and depression of the heart by reflex action over the distribution of the pneumogastric,—then great prostration, convulsions and collapse, death occurring from ex- haustion, with consciousness preserved until carbonic acid nar- cosis sets in. On the excretion of uric acid and urea its influence is very much disputed, but it probably increases the flow of bile, and certainly unloads the portal circulation. Antagonists and Incompatibles. Tannic Acid to retard absorption. Emetics and cathartics, also warm de- mulcent drinks freely. Morphine hypodermically to antagonize the cardiac depression, also Alcohol. Therapeutics. Colchicum is a specific palliative in gout of acute form, in which it should be given with an alkali, and kept short of emeto- COLOCYNTHIS. 157 catharsis. It does not prevent relapses, and its power in this disorder is weakened by repetition. In ascites from obstructive disease of the liver it is most effective, given in full doses to establish a profuse drain, with opium to sustain the heart. In acute cerebral congestion and in portal congestions it is well given as a drastic purgative. It is often used with marked suc- cess in acute rheumatism, but frequently fails, and in no case should it be continued long in this affection. It has been used with good results in the treatment of gonorrhoea and chordee. The alkaloid is probably the best preparation for general use, and is admittedly superior to the other preparations in acute gout. COLOCYNTHIS, Colocynth,—is the fruit of Citrullus Colocynthis, deprived of its rind. The plant is a native of Spain and Asiatic Turkey, and belongs to the nat. ord. Cucurbitacese, the fruit being of the size of a small orange, white, light, spongy, inodorous, very bitter, containing many flat, brown seeds which should be rejected before the pulp is used. Its active principle is Colocynthin, an amorphous but crystallizable bitter glucoside, readily soluble in water. It also contains Colocynthein, a resin, and Colocynthitin, which is & tasteless, crystalline powder, soluble in ether but not in water, and devoid of purgative action. Preparations. Extractum Colocynthidis,—alcoholic. Dose, gr. )/z-ij. Extractum Colocynthidis Compositum,—contains of the preceding 16 parts, Aloes 50, Cardamom 6, Resin of Scammony 14, Soap 14, Alcohol 10. Dose, gr. v-xx. Pilule Cathartics Composite, Compound Cathartic Pills,—each has of the preceding gr. 1.3, Abstract of Jalap gr. j, Calomel gr. j, Gamboge gr. Dose, j-iij pills. Laville’s Anti-Gout Remedy,—is a proprietary medicine prepared in France and purporting to be “ a mixture of prepared Kino-colocynthine.” The published formula is as follows: Active principle of Colocynth 2yz, Qui- nine and Cinchonine 5, Spanish Wine 800, Alcohol 100, Water to 1000 parts ; but there is good reason for believing that it contains Colchicine instead of Colocynthin. Physiological Action. Colocynth is classed among the tonic-astringent and resin- bearing purgatives. In moderate doses it increases peristalsis and the intestinal glandular secretions, producing bilious, watery evacuations with much colicky griping pain. Its purgative action is specific, and may be obtained by its application to the skin over the abdomen. In large doses it is a violent irritant of the gastro-intestinal tract, and has frequently produced fatal gastro- 158 CONIUM. enteritis. It is popularly supposed to be abortifacient, but this is only true of quantities sufficient to endanger life. It is an indirect diuretic. Therapeutics. Colocynth is too severe an agent to be administered alone for constipation, but it makes a useful factor in compound purgatives, as the compound cathartic pill. In cerebral congestion it may be used to produce rapid derivation, and in ascites to set up a profuse drain from the intestinal canal. In certain cases of chlo- rotic amenorrhoea it stimulates the pelvic nerves and vessels with excellent results. There seems to be abundant evidence that in very small doses (hIijV'tV °f a tincture) colocynth is an efficient remedy in colic, sciatica, ovarian and other neuralgise, as well as in the pain of glaucoma. These actions may be due to its two non-purgative principles, which may prove to possess powers not heretofore suspected, an example of which is seen in the recently- discovered cardiac influence of Convallaria, a drug until recently only known as a purgative and a diuretic. CONIUM, Hemlock, —is the full-grown fruit, gathered while green, of Conium maculatum, the spotted hemlock (nat. ord. Umbelliferge). It is smaller than anise-fruit, of a gray-green color, slight odor and taste, and contains 3 alkaloids, namely,— Conine, C8H)5N, liquid and volatile, Methyl-conine, C8HUNCH3, and Conhydrine, C8H17NO, solid and volatilizable;—also Coniic acid and a volatile oil. Paraconine is an artificial substance pro- duced by the reaction between Butyric Aldehyd and an alcoholic solution of Ammonia, and isomeric with Conine but not identical with it. The leaves of Conium are no longer official. Preparations. Abstractum Conii,—made from 200 parts of Conium, 6 of Dilute HC1 acid, Sugar of Milk and Alcohol to make 100 parts; each grain representing 2 grains of the powdered drug. Dose, gr. ss-iij. Extractum Conii Alcoholicum,—each grain represents a grain of the crude drug. Dose, gr. ij-v. Extractum Conii Fluidum,—of the same strength as the alcoholic ex- tract. Dose, nvij-v-xl. Tinctura Conii,—strength 15 per cent. Dose, iff x-sjj, beginning with the 10-minim dose and gradually increasing until physiological effects are mani- fest. Conina, Conine, C8H15N (Unofficial),—an oily, limpid, volatile liquid, of acrid taste, alkaline reaction, and an odor compared to that of the urine of mice. It is quickly decomposed by heat, and if exposed to the air soon be- comes inert. Dose, gr.or in minim-doses, iff yff-ij. Is too irritant 159 CONIUM. for hypodermic use, unless carefully neutralized by acetic acid. The Hydro- bromate in watery solution of gr. viij to the , of this is a good form for subcutaneous or stomachal administration, and may be given in doses of gr. yij to gr. j, as it is not actively toxic. All the preparations of Conium are uncertain in action, particularly the extract and abstract, as the active principle is very volatile. Any specimen must be carefully tested before deciding on its dosage. Physiological Action. The special action of Conium and Conine is the production of motor paralysis without loss of consciousness or sensation. It paralyzes the motor nerves, the action commencing at the peripheral end-organs and extending upwards, involving the nerve-trunks and finally the centres, but the muscular irritability remains unaffected. Methyl-conine acts similarly but reversely, affecting first the motor columns of the cord. The sensory nerves are not affected, but the general sensibility is, a feeling of numb- ness being experienced in the extremities. Gastric irritation is usually the first sensation produced by a full dose of Conium, nausea and vomiting being its symptoms. Then weakness of the legs, numbness and fatigue, drooping eye- lids, diplopia, slightly dilated pupils, vertigo, impaired utterance, slow and labored breathing, and if the dose be a lethal one, par- alysis of the voluntary muscles, those of the lower limbs being first affected, speech and vision are lost, and finally death occurs from paralysis of the muscles of respiration. The heart is not affected and the mind remains clear, but torpid and indifferent, until carbonic acid narcosis sets in. Muscular movement counteracts the effects of the drug to a very great extent. Conium is believed to have been the state poison of the Athe- nians, by the juice of which Socrates and Phocion died. Antagonists and Incompatibles. Nux Vomica and its alkaloids, Picrotoxin and other tetanizers are antag- onistic. Tannic acid and caustic alkalies are chemically incompatible. Therapeutics. Conium is especially indicated in diseases characterized by excessive motor activity. Large doses are required as some phys- iological action is necessary. Children bear it well, their constant activity preventing its full action. In chorea it palliates by de- pressing the motor nervous system. In acute mania and delirium tremens to quiet motor excitement and prevent exhaustion, it is remarkably efficient, especially when given conjointly with Mor- 160 CONVALLARIA MAJALIS. phine. When pain and spasm are present, it will prove a useful agent; and in tetanus, blepharospasm, asthma, whooping-cough, and other spasmodic affections it is frequently used with great benefit. The pain of cancer seems to be especially amenable to its influence when locally applied, and Conine-vapor is an ad- mirable palliative of the tickling cough of phthisis and the irrita- bility of the air-passages in acute bronchitis. In pneumonia and pleurisy the hypodermic use of Conine to afford the organs rest by inducing a paretic state of the respiratory muscles has been followed by a marked decrease in the temperature and pulse-rate. CONVALLARIA MAJALIS, Lily of the Valley (Un- official),—is a stemless perennial of the nat. ord. Liliaceae, in- digenous to Europe, Northern Asia, and the Southeastern portion of the United States. All parts of the plant are used, but the preparations vary in action according to the quantity of the Resin present, it being emeto-cathartic. Convallaria contains two glu- cosides, namely, Convallamarin, on which the cardiac action depends, and Convallarin, a crystalline, purgative principle, in- soluble in water;—also an acrid Resin which probably contains the latter glucoside. Preparations. Extractum Convallaria (Unofficial),—prepared from the flowers and stalks with of the leaves and root; is a black solid, freely soluble in water and alcohol. Dose, gr. v-xxx. Extractum Convallaria Fluidum (Unofficial),—as found in the shops is an alcoholic’preparation of the whole plant, and is likely to contain Con- vallarin, which is not present in aqueous preparations being insoluble in water. Dose, Infusum Convallaria (Unofficial),—prepared from the flowers, leaves and stems 25, in water 75. Dose, Convallamarinum, Convallamarin, C23H44012 (Unofficial), — an amor- phous, white, bitter powder, freely soluble in water and in alcohol, but insolu- ble in ether. Dose, gr. )^-ij. Physiological Action. Convallaria has long been known as a decided cathartic and a prompt and powerful diuretic, but its cardiac action has only lately excited attention, and it is now considered a close analogue of Digitalis, while free from the cumulative action which makes the latter drug so frequently a dangerous remedy. Preparations of the root have a powerful emeto-cathartic action, probably due to a preponderance of the resin. Those freed from this ingredient correspond in action with Convallamarin, stimu- late the appetite without impairing digestion, increase peristalsis COPAIBA. 161 without producing catharsis, slow the heart and raise the arterial tension, also slowing and deepening respiration. Lethal doses at first produce irregularity of the cardiac action and spasm of the respiratory muscles, high arterial tension and a very rapid pulse,— followed by lowered blood-pressure, very slow and deep breath- ing, and finally arrest of the heart in systole. Its mode of action is by direct stimulation of the pneumogastric, the motor and sensory nerves retain their irritability, the muscles preserve their contractility, and the cerebral functions and the pupil are un- affected. Convallarin is a drastic purgative in 3-grain doses. Con- vallamarin is an emetic even in small quantity, and the pow- dered root is sternutatory. Therapeutics. Convallaria is a heart-tonic like Digitalis, and is indicated in the same class of cases as is that drug, with the advantage that having no cumulative action it is not dangerous to the heart in medicinal doses, and does not disturb the stomach or the func- tions of the cerebro-spinal axis. In doses of gr. xv-xxv of the extract it slows the action of the heart and increases the force of its contractions, raises arterial tension, augments the force and volume of the respiration, and produces prompt diuresis without altering the composition of the urine. It is a most valuable remedy in mitral stenosis or insufficiency with venous stasis, dila- tation of the heart, palpitation, vehement cardiac action or dis- ordered rhythm, and in all valvular affections accompanied by dropsy and a weak heart. It has also been used with benefit in pneumonia, typhoid fever and renal dropsy. Its action is main- tained for several days after its use has been suspended. COPAIBA, Balsam of Copaiba,—is the oleoresin of Co- paifera Langsdorffii, and of other species of Copaifera, a S. Ameri- can tree of the nat. ord. Leguminosae, growing chiefly in the valley of the Amazon. It is a translucent, viscid liquid, of yel- low color, aromatic odor, acrid and bitter taste, not fluorescent, soluble in alcohol and benzol. Is not a balsam as it contains no cinnamic acid. Its constituents are a Volatile Oil and a Resin in about equal proportions, the latter containing nearly 99 percent, of Copaibic Acid. Dose, n^x-3j. 162 COPAIBA. Preparations. Oleum Copaiba, C10II16,—the volatile oil, a pale yellow liquid, of sp. gr. 0.890, of bitter taste and neutral reaction, soluble in an equal weight of alco- hol. Dose, Tiix-xv. Resina Copaiba:,—is the residue left after distilling off the volatile oil from Copaiba, a yellowish, brittle body, of acid reaction, soluble in alcohol, benzol or amylic alcohol. Consists mainly of Copaibic Acid, which is crys- tallizable, also 1 per cent, of a viscid resin. Dose, gr. j-v. Massa Copaiba;,—consists of Copaiba 94, fresh Magnesia 6 parts, mixed and set aside to concrete into a pilular mass. Dose, TTLx-^j. Mistura Copaibas Composita, Lafayette’s Mixture (Unofficial),—R. Co- paibae sjvij, Ol. Cubebaa Glyceriti Vitelli Triturate and add gradu- ally while triturating Syrupi Aq. Menth. Piperitse jpjss. Then add with con- stant stirring Liq. Potassae Tr. Cardamomi Co. Spt. Etheris Nitrosi jfss, Aq. Menthae Pip. q. s. ad !|viij. Dose, gj-^ss. Physiological Action. Copaiba is a stimulant diuretic, diaphoretic, expectorant, and a gastro-intestinal irritant. Its taste is bitter and nauseous. In the stomach it causes heat, unpleasant eructations, heaviness, fre- quently anorexia and diarrhoea, and if continued for any length of time gastro-intestinal catarrh and desquamative nephritis may result. The oil and resin diffuse into the blood and are excreted by the bronchial mucous membrane, skin and kidneys, produc- ing increased secretion at the points of elimination. The various secretions have the odor of the drug, especially the urine. In medium doses it increases the quantity of urine and its solid con- stituents, but large doses will cause scanty urine, containing al- bumen, casts and blood, with pain in the loins and other signs of renal congestion. On the skin it often produces itching and several forms of eruption. Therapeutics. Copaiba has been largely used in gonorrhoea after the acute symptoms have subsided, also in chronic cystitis, acute and chronic bronchitis, and in dropsies, particularly ascites. In all these affections it is a useful remedy, but its nauseous taste and irritant effects on the stomach are driving it out of fashion espe- cially in private practice. One eminent surgeon declares that not only is it useless in gonorrhoea but that it does more harm than good, often prolonging the disease beyond its natural limit. In psoriasis and urticaria, and in cutaneous affections character- ized by torpid peripheral circulation, this drug has been admin- istered internally with excellent results. In long-standing cys- titis in the female Copaiba has been injected into the bladder with CORIANDRUM—CORNUS—COTO. 163 great benefit. The resin is the most active ingredient, especially for diuretic purposes. CORIANDRUM, Coriander,—is the fruit of Coriandrum sativum, a European plant of the nat. ord. Umbelliferae. It is a minute, globular, brownish-yellow body, finely ribbed, of aro- matic odor and taste, and contains a volatile and a fixed oil. Dose, gr. x-xx. Preparation. Oleum Coriandri,—the volatile oil. Dose, tn.ij-v. Physiological Action and Therapeutics. Coriander is stimulant, aromatic and carminative. It is used almost wholly as a flavoring to other remedies, or as a corrective against the griping effects of certain purgatives. Its flavor covers the taste of Senna and Rhubarb, and it is an ingredient of the official Confectio Sennae. CORNUS, Dog-wood,—is the bark of the root of Cornus florida, a small tree of the nat. ord. Cornaceae, indigenous in the U. S. Occurs in reddish-brown, curved pieces of astringent, bitter taste, and contains a bitter principle named Cornin, which is crystallizable and soluble in water and alcohol; also a resin and tannic acid. Preparation. Extractum Cornus Fluidum,—Dose, Physiological Action and Therapeutics. Cornus is a simple bitter, having stomachic and other qualities similar to those of Calumba (which see). In addition it is pos- sessed of considerable antiperiodic power, and has a good deal of reputation in the Southern States as a remedy in malarial fever, the physicians of that section considering it as next to Quinine in efficiency. Heat destroys its active principle, consequently a decoction is a useless preparation. COTO, Coto Bark (Unofficial),—is the bark of some un- known tree growing in Bolivia, from whence it comes in brownish pieces of aromatic odor and acrid, bitter taste. It contains an acrid, bitter principle, of yellow color, crystalline and soluble in hot water and alcohol, named Cotoin, C22H1806; also Piperonylic 164 CREASOTUM. Acid, C8H604, and a volatile oil, resin, etc., but no tannin. Dose, gr. j-xv. Paracoto Bark, or False Coto,—is thicker than the true bark, has a fainter odor and taste, and is marked by whitish furrows on its surface. Its principle, Paracotoin, C19HJ206, has a strong simi- larity to Cotoin therapeutically, but is less active. Preparations. A fluid extract of the official strength is prepared, also a tincture (10 per cent.), which may be administered in doses of from TTtj_Xx. Cotoin is used in doses of gr. j-iv, and Paracotoin in somewhat larger quantities. Physiological Action and Therapeutics. The physiological action of Coto has not been studied, all that is known about it being that it is decidedly irritant to the skin rnd mucous membranes. After its internal administration the urine takes a dark-red color with Nitric Acid. Ferric Chloride blackens a dilute solution of Cotoin, but has no reaction with Paracotoin. The bark and both principles are highly recommended in diarrhoeas of various forms, especially those of phthisis, typhoid fever, and cholera. In Asiatic cholera Paracotoin has been used hypodermically in 3-grain doses writh success. Where there is any tendency to acute inflammation of the gastro-intestinal tract this agent must be used with caution. Small doses of the tincture (rrij-v) are said to be very effective in the diarrhoea of children. CREASOTUM, Creasote, —is a product of the distillation of wood-tar, chiefly consisting of the four phenols, Guiacol, Crea- sol, Methyl-creasol and Phlorol, in varying proportions. It is a nearly colorless, inflammable, oily liquid, of smoky odor, caustic taste and neutral reaction, soluble in 80 of water at 590 F., in 12 of boiling water, and in all proportions in alcohol, ether, chloroform and acetic acid. It does not coagulate albu- men or collodion, Carbolic Acid does. It was named from its remarkably preservative power over meat, xpeas, flesh, and (rwZw, I preserve. Much of the commercial Creasote is an impure Car- bolic Acid, or a heavy oil distilled from coal-tar and containing Carbolic and Cresylic Acids. Dose, mj-iij, well diluted. Preparation. Aqua Creasoti,—a 1 per cent, solution, containing 'fTlivI4ff in each fluid- ounce. Dose, 3j-iv. 165 CROCUS. Physiological Action and Therapeutics. Creasote is expectorant, astringent, antiseptic, styptic, eschar- otic, anaesthetic and narcotic. Its action is practically the same as that of Carbolic Acid (see ante, page 22), especially upon the heart, respiration and nervous system. It is eliminated by the kidneys and bronchial mucous membrane, which it stimulates being quite a good expectorant. It small doses it seems to have a selective sedative influence on the terminal nerve-filaments in the gastric mucous membrane. In large doses it is a powerful poison, resembling Carbolic Acid in its symptoms, except that its nervous effects are even more marked. It explodes when com- bined with Oxide of Silver in pill, unless previously diluted with an inert powder. Therapeutics. Being a very complex substance of varying composition Crea- sote as a therapeutic agent has been almost entirely supplanted by Carbolic Acid. It is used internally with success in reflex nausea and vomiting, as from sea-sickness, pregnancy, cholera, etc., also as an aseptic and expectorant in chronic basilar cavity, in which it seems to have greater efficacy than any other remedy. As an astringent it has been employed in intestinal hemorrhage, gonorrhoea and gleet, and generally in the same affections as Carbolic Acid. Externally it is a good application in eczema, pruritus, ulcers and scaly skin diseases, and it effectually relieves the pain of an exposed dental nerve if applied thereto. It is a good agent by inhalation in chronic bronchitis and gangrene of the lung. CROCUS, Saffron,—the stigmas of Crocussalivus, a plant of the nat. ord. Iridacese, cultivated in Europe, containing a vola- tile oil and coloring matter. Occurs as separate stigmas or three attached to the style, of orange-brown color, peculiar, aromatic odor, and bitter taste. So-called American Saffron is not Crocus but the flowers of Carthamus tinctorius. True Saffron is expen- sive, as it requires about 60,000 flowers to furnish one pound of the stigmas. Dose, gr. v-xx, in infusion. Preparations. Tinctura Croci,—10 per cent. Dose, Saffron Tea, so much used in domestic practice, is an infusion of Car- thamus tinctorius, or Safflower. 166 CUBEBA. Physiological A ction and Therapeutics. Crocus is a stimulant aromatic, having some antispasmodic and anodyne qualities. The hot infusion produces diaphoresis, prob- ably by virtue of the hot water alone. It is said to have caused death with narcotic symptoms. On the continent of Europe it is employed as a stimulant and emmenagogue, but in this country its only use is as a coloring agent. The miscalled Saffron Tea noted above is used in domestic practice for measles and other exanthemata. CUBEBA, Cubeb,- —is the unripe fruit of Cubeba officinalis, a plant of the nat. ord. Piperaceae, cultivated in Java. Occurs as a blackish-gray, wrinkled, globular body, about the size and shape of black pepper, of strong, spicy odor, and aromatic, pungent taste. Contains a Volatile Oil, which is official, an acrid resin composed in part of Cubebic Acid, also a fatty oil, gum, and Cubebin, which is an insoluble, neutral, odorless and tasteless body. The volatile oil may be separated into Cubebene a cam- phor, and Cubeben a liquid portion. The active principles are the volatile oil and the cubebic acid, both of which are contained in the oleoresin. Cubeb should be kept whole and not pulver- ized until wanted for use. Dose of the powdered drug, gr. x-3ij. Preparations. Extractum Cubeba? Fluidum,—alcoholic. Dose, rqv-xxx. Tinctura Cubeba,—io per cent. Dose, ntx-gnj. Oleoresina Cubeba,—extracted by ether. Dose, rrtv-xxx. Trochisci Cubebze,—each contains of the Oleoresin gr. y£, Oil of Sassa- fras gr. 0.15, Extract of Glycyrrhiza gr. iv, Acacia gr. ij, and Syrup of Tolu q. s. to form a mass. Dose, j-iij. Oleum CubebvE, C15H24,—is the volatile oil, a colorless or pale greenish- yellow liquid, of sp. gr. 0.920, warm, aromatic taste, odor of cubeb and a neutral reaction. Is soluble in an equal weight of alcohol. Dose, njv-xx. Physiological Action. Cubeb belongs to the pepper family, and like black pepper is an aromatic stomachic and a stimulant diuretic in small or medium doses, but large doses derange digestion and may act as a gastro-intestinal irritant. Its constituents are eliminated by the bronchial mucous membrane, the skin and the kidneys, stimulat- ing and disinfecting the genito-urinary passages, increasing the bronchial mucus, sweat and urine, and frequently causing an urti- carial or vesicular eruption. It increases the action of the heart CUPRUM. 167 and of the vascular system, stimulates the venereal appetite, and promotes the menstrual discharge. Therapeutics. Cubeb is particularly useful in affections of the bladder and urethra. It is used in the acute stage of gonorrhoea, chronic cystitis, prostatorrhcea and chronic bronchitis with excellent re- sults. The powder is a good application in hay-fever, chronic nasal catarrh and follicular pharyngitis, blown on to the mucous membrane by an insufflator. It may also be smoked in cigarettes with temporary relief in cases of acute nasal catarrh with “ stuffed ” nasal passages. In some subjects the continued use of cubeb produces nausea, hemorrhoids, hematuria and severe heacT ache. The troches are a useful preparation in chronic irritability of the fauces, pharynx and air-passages, and are much employed by singers and public speakers for their tonic effect on these parts and for the relief or prevention of hoarseness. CUPRUM, Copper, Cu,—is not official, but two of its salts are, namely the Acetate and the Sulphate. The metal itself is inert, but in combination it is actively poisonous. Copper has been found in the normal human blood in very minute quantity. Salts and Preparations of Copper. Cupri Acetas, Acetate of Copper, Cu(C2fI302)2.H20,—forms green, pris- matic crystals, efflorescent, of nauseous, metallic taste and acid reaction, soluble in 15 of water and 135 of alcohol at 590 F. Its aqueous solution is of a blue color. Dose, gr. Cupri Sulphas, Sulphate of Copper, CuS04-5H20,—blue, translucent crys- tals, efflorescent, of nauseous, metallic taste and acid reaction, very soluble in water, insoluble in alcohol. Its solution is blue by transmitted light, green by reflected light. Dose, as an emetic, gr. ij-v, every 10 or 15 minutes,—as a tonic, gr. \~y2. Solution of Potassio-Cupric Tartrate, Fehling’s Solution (Unofficial), used as a reagent for glucose, may be made as follows,—Dissolve 70 grains of Sulphate of Copper in 400 minims of Distilled Water. Also dissolve 488 grains of Rochelle Salt (Pot. et Sodii Tart.) in 1600 minims Solution of Soda (Liq. Sodse), sp. gr. 1.12. When required for use pour the copper solution into the other, and add distilled water to make 2720 minims {%$%)■ Cuprum Ammoniatum, Ammoniated Copper (Unofficial),—is made by triturating 3 parts of Ammonium Carbonate with 4 of Cupric Sulphate until effervescence has ceased, then drying. A deep azure-blue powder, of ammo- niacal odor, a styptic, metallic taste, and alkaline reaction, soluble in water. Dose, gr. Physiological Action. The salts of Copper are gastro-intestinal irritants, producing a metallic taste, nausea with greenish vomited matter, purging of 168 CUPRUM. blood and mucus, constricted fauces, depressed heart-action, hurried respiration and fever. Or, as with Arsenic, gastro- enteritis may not occur, but instead profound nervous symptoms, as headache, defective coordination, coma and convulsions. The symptoms of chronic poisoning are bronchial irritation and catarrh, gastro-intestinal catarrh, colic with diarrhoea [Lead produces colic with constipation], dysentery, nausea, emaciation, anaemia, salivation, and a green line (sulphide) along the margin of the gums in those who do not clean their teeth. The nervous symptoms above mentioned are also usually well marked. The liver becomes atrophied from irritation of its connective tissue and fatty degeneration of the hepatic cells. The lungs are con- gested, even pneumonic consolidation may be set up, the metal seeming to have a selective affinity for the parenchyma of these organs. These effects are often produced by the inhalation of cuprous fumes, and by eating acid fruits cooked in a copper vessel. Sulphate of Copper is a simple, irritant emetic, producing prompt and continued vomiting with but little nausea or depres- sion. In small doses it is a nerve-tonic and astringent to the gastro-intestinal tract. Externally applied in solution it is a useful stimulant and astringent to diseased mucous surfaces, and is mildly caustic if used in substance. The Acetate is possessed of the same general action as above described. Its local action is stimulant and escharotic. The impure acetate (verdigris) is a violent irritant poison. Ammoniated Copper has no special action other than above noted. Antagonists and Antidotes. Ferro-cyanide of Potassium is the antidote to Copper salts, but albumen or magnesia may be used. Any chemical antidote should be followed by prompt evacuation of the stomach, then Opium and demulcents for gastro- enteritis, and Potassium Iodide even to saturation of the system. Alkalies and their carbonates, lime-water, iodides, mineral salts except the sulphates, are all incompatible. Therapeutics. The Sulphate is a prompt and efficient emetic, and is so used in croup and narcotic poisoning. In phosphorus poisoning it forms a comparatively insoluble phosphide of copper besides pro- ducing emesis. Fifteen or twenty grains may be dissolved in %iv of water, and a teaspoon fill or more according to age given every ten minutes until vomiting is produced. In acute diarrhoea and chronic dysentery it is the best metallic astringent in doses of gr. to with Opium, and in gastro-intestinal catarrh it is CURARE. 169 equally efficient. Locally, it is used with benefit in throat affec- tions, gonorrhoea, granular lids and corneal ulcers, indolent granulations and chronic inflammations of mucous membranes. In most of these affections weak solutions (gr. £ to to the 5) are best, but in granular conjunctivitis the smooth crystal may be rubbed quickly over the surface once daily. In various nervous diseases, as epilepsy, chorea, hysteria, etc., the salts of copper are sometimes beneficial, the Ammoniated Copper being considered the most efficient preparation in these cases. In Germany a tincture of the Acetate is official and has been used successfully in the treatment of pneumonia. Ammo- niated Copper has lately been highly recommended for facial neuralgia, but requires pushing to the production of some physio- logical action. Ointments or lotions of the Acetate are useful applications in eczema, herpes, tinea sycosis, mentagra and herpes circinatus. Villate’s Solution has been successfully used as a local injection for the cure of caries. It is composed of Sulphate of Copper, Sulphate of Zinc of each 15 parts, Liquor Plumbi Subacetatis 30, Vinegar 200. The solution is thoroughly injected into the sinuses leading to the carious bone. CURARE, Woorara (Unofficial),—is a vegetable extract obtained from various members of the Strychnos family and from Paulinia curare and other plants. It is used in S. America as an arrow-poison under various names, as Caroval, Vao, etc. Its active principle is the crystallizable alkaloid Curarine, which con- tains no oxygen. The dose of Curare is gr. hypodermically,—of Curarine, gr. hypodermically, or gr. by the stomach, but as the samples vary greatly in activity they should first be tried on some inferior animal before being ad- ministered to man. Physiological Action. Curare is a paralyzer of the voluntary muscles, affecting them through the end-organs of the motor nerves. It does not at first act upon the brain or spinal cord, but if life be prolonged by arti- ficial respiration the cord, sensory nerves and even the muscular tissue all become affected. The heart, at first quickened, becomes depressed, and the blood-pressure is lowered, the eyelids droop, the eye-balls protrude, vision is disordered, intestinal peristalsis and sensibility to stimuli are greatly increased, and an artificial glycosuria (curare-diabetes) is set up. The limbs are paralyzed 170 CYDONIUM. first, death occurring by paralysis of respiration. The absorption of the drug by the stomach is very slow, as its active principle passes with difficulty through animal membranes, and its elimina- tion, which takes place by the kidneys, being more rapid and complete than that of any other agent, no marked effect may be produced when administered internally. When hypodermically injected its action is very prompt. The urine of a curarized ani- mal will poison another, and that of the second will paralyze a third. As compared with other motor depressants Curarine and Conine paralyze the end-organs of the motor nerves, Gelsemine and Methyl-conine paralyze the motor centres. Antagonists and Incompatibles. Strychnine, though from a member of the same family, is antagonistic as to the action on the heart and respiration. So also is Atropine. Artificial respiration is the most efficient antagonist, maintaining life until elimination occurs. Evacuation of the bladder repeatedly is important to prevent reab- sorption. The caustic alkalies destroy Curarine as they do all other alkaloids. Therapeutics. Curare is chiefly used for experimental purposes on the lower animals. It has an historical interest from its having been the means by which Bernard demonstrated the existence of muscular contractility as an essential endowment of that tissue. It has been used with some success in spasmodic nervous affections, particularly in tetanus, both idiopathic and traumatic, in hydro- phobia, chorea and epilepsy. It does not promise well as a therapeutic agent, but two undoubted cases of hydrophobia are reported by high authority as cured by this drug. CYDONIUM, Quince Seed,—is the seed of Cydonia vul- garis, a tree of the nat. ord. Rosaceae, native in Crete and Aus- tria, and cultivated elsewhere. The seeds are about % inch long, triangularly compressed, covered with a whitish epithelium, and in water they swell up forming a mucilaginous mass. The mucil- age is the only constituent of importance and is contained in the epithelial cells. It has been named Cydonin, and considered to be a compound of gum and cellulose. Preparation. Mucilago Cydonii,—prepared by macerating 2 parts of Cydonium in ioo of Distilled Water. Dose, indefinite. CYPRIPEDIUM DAMIANA. 171 Physiological Action and Therapeutics. Cydonium is of value for its mucilage, which is used as a bland, demulcent application in conjunctivitis, abrasions of the skin, fissures of the mucous membranes, and as a vehicle for injections in gonorrhoea. Internally it may be used as a soothing remedy for the throat, stomach or intestines. The preparation known as Bandoline, used as a hair-dressing, is identical with the mucilage of Cydonium. CYPRIPEDIUM, Ladies’ Slipper,—is the rhizome and rootlets of Cypripedium pubescens, and of C. parviflorum, the Moc- casin-plant, or American Valerian (nat. ord. Orchidaceie). Is dark or orange-brown in color, of strong, he.avy odor, and bitter pungent taste. It contains a volatile oil, a volatile acid, resins and tannin. Preparations. Extractum Cypripedii Fluidum,—Dose, uix-xxx. Cypripedin (Unofficial),—is an impure alcoholic extract. Dose, gr. ss-iij. Physiological Action and Therapeutics. Cypripedium is antispasmodic, tonic, stimulant and diaphoretic, possessing the same general properties as Valerian, whence one of its common names. It is a popular remedy in some parts of the U. S. for nervous hyperaesthesia unaccompanied by organic lesion, especially mor- bid sensibility of the eye. It is reported to have even cured epi- lepsy, and to be highly useful in neuralgia, hysteria, nervous headache and insomnia. DAMIAN A (Unofficial),—the leaves of Turnera aphrodis- iaca, a plant of the nat. ord. Turneracese, growing in Mexico and Lower California. Several varieties of so-called Daniiana are in the market, but the true leaf is of a light-green color, small, lanceolate, and dentate along the margin. It contains a volatile oil and a resin. Dose, 3j daily. Preparations. Extractum Damians (Unofficial),—Dose, gr. ij-x. Extractum Damians Fluidum (Unofficial),—Dose, ntx-^j. Physiological Action and Therapeutics. Damiana is said to be a powerful aphrodisiac in cases of sexual atony, but the published reports of its use since its introduction 172 DATURA TATULA—DIGITALIS. vary greatly as to its efficacy. It is probably a stimulant diuretic, a bitter tonic, and a purgative in sufficient doses. Besides its use as an aphrodisiac Damiana has been adminis- tered with benefit in some forms of cerebral exhaustion and general atony of the nervous system, also in sick headaches and in some few cases of paralysis. It forms the chief stock in trade of the numerous charlatans who fill the daily papers with advertisements of “ manhood-restorers.” DATURA TATULA (Unofficial), — is an indigenous plant of the nat. ord. Solanacese, resembling Stramonium very closely, with which it generally agrees in its physiological action and therapeutics. It is distinguished by its purple stem, purple flowers and anthers, and the darker green of its leaves. It prob- ably contains the alkaloid Daturine (see Stramonium),—and has been smoked in asthma, in a few cases giving continued relief when Stramonium had failed to render any service. DIGITALIS, Fox-glove ,—the leaves of Digitalis purpurea, nat. ord. Scrophulariaceae, collected from plants of the second year’s growth. Fox-glove grows wild in Europe, but is cultivated in the U. S., especially by the Shakers, and much of their product is of very poor quality. The leaves are 4 to 12 inches long, of dull-green color above, paler and reticulate on the under surface, of faint, tea-like odor, and nauseous, bitter taste. Its active prin- ciple has long been known as Digitalin, an amorphous substance, probably of complex constitution ; but in 1871 Nativelle obtained a crystalline principle to which he gave the same name and the formula C25Htt015. Schmiedeberg (1875) affirmed Roucher’s statement that the Digitalin of Nativelle is a mixture of Digitalin with Digitoxin, and states that true Digitalin is amorphous or granular. Schmiedeberg’s analysis of Digitalis gives the following list of principles contained in the plant, viz.—-(1) Digitoxin, the most active. (2) Digitonin, a substance allied to Saponin. (3) Digitalin. (4) Digitalein. The only points settled are that the Digitalin of the shops does not represent Digitalis, that the activity of the plant is due to more than one ingredient, and that the powdered leaves in wafer, pill, or infusion, are the best form for obtaining the action of the drug. Dose, gr. ss-iij. Preparations. Abstractum Digitalis,—strength 200 per cent. Dose, gr. Extractum Digitalis,—the leaves yield about 25 per cent, of extract. Dose, gr. ]/(,-l/z. DIGITALIS. 173 Extractum Digitalis Fluidum,—strength ioo per cent. Dose, -rrij-iij. Tinctura Digitalis,—strength 15 per cent. Dose, ffiv-gj. Infusum Digitalis,—strength iy£ per cent. Is flavored with Cinnamon, and contains 7 >4 per cent, of Alcohol. Is the best preparation when made from good foreign leaves. Dose, twice daily. Digitalinum, Digitalin (Unofficial), — complex, expensive and varies greatly in quality. Dose, gr. Physiological Action. Digitalis is a cardiac stimulant, an excito-motor, also emetic, diuretic, hemostatic, anaphrodisiac, and paralyzant. It irritates the mucous membranes, causing sneezing, severe gastric disturb- ance, nausea, vomiting, colic and purging, the discharges being of a grass-green color. It lowers temperature probably by lessen- ing the supply of blood to the tissues, produces headache, irregu- larity of cardiac action, vertigo, and an appearance of vibratory fringes of color around objects. It produces diuresis, probably by specific action on the Malpighian tufts, as well as by increasing the blood-pressure. The urea is at first increased, but in some cases is afterwards decidedly diminished. It lessens the venereal appetite, impairs the sexual function, and stimulates the muscular tissue of the uterus. The heart is slowed by Digitalis, but its force is at the same time increased. Medium doses stimulate the cardiac motor ganglia, the inhibitory apparatus and the vaso-motor centres, contracting the arterioles, thereby a great rise of arterial tension resulting. Full doses continued exhaust the irritability of the motor-ganglia and paralyze the cardiac muscle itself. The recumbent posture must be maintained when Digitalis is given for its cardiac effect, to prevent exhaustion of the motor-ganglia. Lethal doses lessen the reflexes by stimulation of Setchenow’s centre, and paralyze the muscles and the peripheral nerves, motor and sensory. Respiration, at first slowed, becomes rapid and feeble, cyanosis, coma and convulsions follow, death occurring by sudden paralysis of the heart, which is arrested in systole. Compared with Aconite, both it and Digitalis slow the heart, but otherwise their actions are antagonistic. Aconite relaxes inhi- bition and depresses the cardiac motor in- creases inhibition and stimulates the motor apparatus. Both drugs finally paralyze the cardiac ganglia, Aconite by direct depression, Digitalis by over-stimulation. Both depress the cardiac muscle. Under Aconite the heart is arrested in diastole, under Digitalis in systole. The arterial tension is lowered by Aconite, raised by Digitalis. Aconite acts quickly, Digitalis very slowly,—a fact 174 DIGITALIS. which makes the latter drug of little value in poisoning by the former. During the use of this drug for any length of time the motor apparatus of the heart is so nearly paralyzed by overstimulation that on suddenly assuming the erect position the cardiac energy may fail, more especially if the doses used are administered too closely together to admit of the elimination of one before the ingestion of the next. This is the explanation of the so-called cumulative action of Digitalis, which is not now recognized in the sense in which the term was formerly applied. Antidotes, Antagonists and Incompatibles. Tannic Acid is the chemical antidote, but as the tannate is not inert the stomach should be evacuated. Aconite is the best antagonist to the effects of large doses, Opium to those of its long-continued use. Saponin and Senegin are considered to be its most complete physiological antagonists. Incom- patibles are Cinchona, Sulphate of Iron, Tincture of the Chloride of Iron, and Acetate of Lead. Therapeutics. The chief use of Digitalis in disease is based on its property as a heart tonic. Its great sphere is in mitral disease, when the heart is rapid and feeble, it moderating pulmonary hyperaemia and engorgement by giving the auricle time to empty itself through the obstructed orifice. In aortic disease it gives relief when the compensatory hypertrophy has not set in, otherwise it is contra- indicated. It is particularly useful in dilatation of the right side of the heart with incompetence of the tricuspid. The rational symptoms which indicate its use are—rapid and feeble cardiac action, low arterial tension, cough, dyspnoea, pulsating jugulars, a dusky face, scanty and high-colored urine and general dropsy. In the irritable heart of soldiers Digitalis is frequently curative, and palpitation, cardiac failure, and venous engorgement are well treated by it. It should not be used in simple hypertrophy when compensatory, aortic stenosis with compensatory hyper- trophy, pericarditis or fatty heart, except temporarily for some special indication. It is a useful remedy in dropsy, both cardiac and renal, in the first stage of pneumonia and other inflamma- tions, in the early stage of scarlet fever and when the kidneys strike work in that disease, in exophthalmic goitre, congestive headaches, and hemicrania, in mania, delirium tremens and other congestive conditions of the brain. As a hemostatic it may be used in hemorrhage from a large surface, in the hemorrhagic diathesis, hemoptysis, and menorrhagia. As an antipyretic it has been much used in fevers, but a reaction is setting in against this DIOSCOREA DITA BARK DUBOISIA. 175 employment of so powerful a heart-depressant. In rheumatic fever it lowers the temperature, shortens the duration of the dis- ease, and is particularly indicated for any cardiac complications. In spermatorrhoea of the plethoric it may be well combined with Potassium Bromide, and when this affection is complicated with an atonic condition, shown by feeble erections, frequent emis- sions and cold feet and hands, it is a serviceable anaphrodisiac. Finally, Digitalis is said by high authority to be particularly adapted to blondes and persons of sanguine and indolent tem- perament. DIOSCOREA, Wild Yam, Colic-root (Unofficial),—is the rhizome of Dioscorea villosa, a creeping plant of the nat. ord. Dioscoracese, indigenous to the eastern U. S. It contains an acrid Resin, and is reported to be expectorant and diaphoretic in action, as well as stimulating to the intestinal canal, and in large doses to cause general neuralgic pains with erotic excitement. It is used with great success in bilious colic; and in the cramps of cholera morbus, spasmodic hiccough, dysmenorrhoea and noctur- nal emissions of sthenic type it is said to be very efficient. A powdered extract named Dioscorein is on the market, of which the dose is gr. j-iv. A fluid extract made according to the phar- macopceial rule may be administered in doses of bjjxv—xxx. DITA BARK (Unofficial),—is the bark of Alstonia scho- lars, a tree of the nat. ord. Apocynacese, growing in the Phi- lippine Islands. It contains two active alkaloids, Ditaine and Ditamine, the former of which has an action identical with that of Curare. The bark is considered tonic and antiperiodic, and is used in the East as a remedy for intermittents. It may be given in doses of 3j-iv> in powder or as fluid extract. DUBOISIA (Unofficial),—is the leaf of Duboisia myopo- roides, an Australian tree of the order Solanacese. It contains a poisonous alkaloid, Duboisine, which is believed to be identical with Hyoscyamine, and strongly resembles Atropine. Preparations. Extractum Duboisine (Unofficial),—Dose, gr. Tinctura Duboisia (Unofficial),—Dose, iRv-xx. Duboisine Sulphas (Langenberg’s), Unofficial,—Dose, gr. ry 0—55. 176 DULCAMARA. Physiological Action. The actions of Duboisia are in all respects similar to those of its congener, Belladonna, except that Duboisine is more soluble in water than Atropine, is less irritating to mucous membranes, and more prompt in mydriatic action, but its effects are of shorter duration. It is also less of a cerebral excitant and more of a calmative and hypnotic. On man its action is said by some authorities to be more powerful than that of Atropine, but less powerful on frogs. Antagonists and Incompatibles. These are the same as for Belladonna, for which see ante, page 97. Therapeutics. Duboisine has not been much used except by ophthalmologists who employ it as a mild mydriatic. Its advantages over Atro- pine in ocular therapeutics are its more rapid action in paralyzing accommodation and effecting mydriasis, the shorter duration of its effects and its slight irritation of the conjunctiva. It has been well employed in puerperal mania, and may be used in place of Atropine in many conditions, especially the night-sweats of phthisis, respiratory neuroses and cardiac failure. It is an efficient antagonist to Morphine. DULCAMARA, Bittersweet,—the young branches of Solatium Dulcamara, or Woody Night-shade, a shrub of the nat. ord. Solanaceae, growing in Europe and N. America. Occurs in short sections inch thick, covered with a pale green bark, of slight odor, and taste at first bitter, afterwards sweet. It contains the glucoside Dulcamarin, a peculiar principle named Picrogly- cion, and the alkaloid Solanine, which exists in the stems of other species of Solanum, viz.—A. tuberosum (potato), A. Lycopersicum (tomato), and S. nigrum (black nightshade). Solanine is of bitter taste, alkaline reaction, crystalline in minute prisms, soluble in 125 of boiling alcohol but very insoluble in water. It is a nar- cotic poison, but exists in very small quantity in the plant. Preparations. Extractum Dulcamarae Fluidum,—Dose, gj. Decoctum Dulcamara (Unofficial),—maybe made of the official 10 per cent, strength and given in doses of Jj-ij. Physiological Action. Dulcamara is but imperfectly understood. In overdoses it has produced nausea and vomiting, vertigo, convulsive muscular ELATERINUM. 177 movements, pruritus and erythematous eruptions on the skin, languid circulation with a dusky color of the face and hands. In children who have eaten the berries there have been observed signs of severe enteralgia, abdominal tenderness, nausea, thirst, heat in the throat and chest, great prostration,rapid pulse, quick and painful respiration. In very large doses it is a narcotic poi- son, causing paralysis by depression of the central nervous system, with lowered activity of the heart and respiration. It is believed by some authorities to be anaphrodisiac, diaphoretic and diuretic. Therapeutics. Dulcamara was formerly used in a variety of affections, as her- petic diseases, chronic rheumatism, gout, jaundice, etc. It is now chiefly employed in obstinate scaly skin diseases, as psoriasis and pityriasis, in which it is unquestionably serviceable. It is also serviceable in the diarrhoea of children when produced by exposure to cold and damp, in mania with strong venereal pro- pensities, chronic bronchitis and whooping-cough. As a diapho- retic it has been used with benefit in rheumatic and venereal dis- orders, and is often beneficial in nasal, pulmonary and vesical catarrhs. It is said to be particularly useful in affections of a rheumatic or catarrhal nature when caused by exposure to damp weather. ELATERINUM, Elaterin, C20H28O9,—is a neutral prin- ciple extracted from Elaterium, a substance deposited by the juice of the fruit of Ecballium Elaterium, or Squirting Cucumber, a cultivated European plant of the nat. ord. Cucurbitaceae. Elate- rium is no longer official by reason of its variable quality. Elate- rin occurs in small, colorless scales or prisms, of bitter taste and neutral reaction, insoluble in water, soluble in 125 of alcohol and in solutions of the alkalies. Dose, gr. 2V_T2- Preparation. Trituratio ELATERINl,—Elaterin 10, Sugar of Milk 90 parts, thoroughly mixed by trituration. Dose, gr. ss-j. Physiological Action and Therapeutics. Elaterin is the most powerful of the hydragogue cathartics, causing profuse, watery stools, and when given in large doses great prostration and gastro-intestinal irritation, nausea and vomiting. On the lower animals it does not produce purgation, 178 ERGOTA. but profoundly impresses the nervous system, causing irregular breathing, convulsions and death. Its chief use is to produce free watery discharges in ascites, anasarca, uraemia and cerebral disorders, but while the most effi- cient agent we possess for this purpose it must be used with great caution in the aged and feeble, as it is very depressant. ERGOTA, Ergot, Ergot of Rye, —is the sclerotium (com- pact mycelium or spawn, intermediate fibrous stage) of Claviceps purpurea (nat. ord. Fungi), growing within the flower and replac- ing the grain of Secale cereale, Rye (nat. ord. Graminaceae). It occurs in fusiform, curved, grain-like bodies, about an inch long, three-furrowed, obtuse at the ends, of purplish-black color, pecu- liar and heavy odor, and oily, disagreeable taste. It should be preserved in a dry place, and should not be kept longer than a year. Dose, gr. x~3j. Composition of Ergot. The composition of Ergot and the nomenclature of its sup- posed constituents is a subject upon which there exists a great diversity of opinion, and about which there is nothing settled. The following synopsis gives the views of the different persons who have examined into the matter. Wenzell (1864) named two alkaloids, Ecboline and Ergotine, which he claimed to be the active principles, and to be combined with Ergotic Acid, a volatile body yielding crystallizable salts. He also claimed the presence of Trimethylamine as a Phosphate. Tanret (1877) isolated a crystallized alkaloid, which he named Ergoti- nine, C35H40N4O6 (dose, gr. also a volatile camphoraceous substance. Dragendorff and his pupils (1875-1879) stated the active principles to be two in number, Sclerotinic Acid, a very powerful body, yellow-brown, amorphous, tasteless and well adapted for hypodermic use in doses of gr. and Scleromucin, a colloid substance, also quite active. Besides these they held that Ergot contained various coloring matters (Sclererythrin, Scle- roxanthin, etc.), also a non-drying Oil, a peculiar sugar (Mykose), a number of alkaloids (Trimethylamine, etc.), and other principles, all inert. Kobert (1885) announces that Ergot contains three active principles, viz., Ergotinic Acid, the chief constituent of Sclerotinic Acid, having no ecbolic action, but affecting the nervous system, the heart and the respiration;—Sphace- linic Acid, which is non-nitrogenous and soluble in alcohol, stimulates the vaso-motor centre and is the active agent in producing gangrenous ergotism ;— Cornutine, an alkaloid, produces convulsions and peristaltic contractions of the uterus, and is the active agent in causing convulsive ergotism. Tanret’s Ergotinine has been proven to have no action on the uterus. The Ergotin of Bonjean, Wiggers and Tanret is not a ERGOTA. 179 fixed compound, but a mixture. The Ecboline of Wiggers is also a mixture. Sclerotinic Acid is said by many authorities to act on the uterus, but this is positively denied by many others. It is probably a very uncertain preparation. For the Ergotin of commerce see below. Preparations. Extractum Fluidum,—prepared with diluted Hydrochloric Acid, Alcohol and Water. Dose, sjss-ij. Extractum Ergots, Extract of Ergot, commonly called Ergotin,—is prepared by evaporating 5 parts of the fluid extract at a temperature not above 1220 F. until reduced to 1 part. Dose, gr. ij-xx. Vinum Ergot^e,—strength 15 per cent. Dose, Is made by an improved method and is more reliable than that formerly official. Ergotin (Unofficial),—is the name of several watery extracts found on the market, and varying much in action both from each other and from the parent drug. That made by Squibb is about the same strength as the official extract, and represents the general powers of Ergot. It may be used hypodermically in doses of gr. v• The Ergotin of Bonjean is also an aqueous extract, but is very variable in quality and frequently inert. Wiggers’ Ergotin is insoluble in the ordinary menstrua, and inert on the vascular apparatus, but causes colic and gastro-enteritis. Physiological Action. Ergot is an excito-motor and a hemostatic, chiefly affecting the spinal cord, circulation, respiration, intestinal and uterine muscular fibres. Its principal actions are the production of an artificial anaemia, and tetanic contraction of unstriped muscular fibre. Its phenomena are divided into two sets, named respec- tively Acute and Chronic Ergotism, according as the drug is ad- ministered in large doses, or in small quantity for a considerable length of time. Acute Ergotism. In large doses Ergot acts as a gastroin- testinal irritant, causing nausea and vomiting, gastralgia, colic, thirst, difficult micturition and purging. It slows the heart, raises the arterial tension greatly, dilates the pupils and produces pallor, vertigo and frontal headache. Its action on the circulation is due to its inducing arterial anaemia, but whether this is done by contraction of the arterioles through direct action on their muscular fibres or by central stimulation of the vaso-motor system, or by producing active venous dilatation, thus draining the arte- rial system, is a much disputed question. It certainly stimulates the contraction of unstriped muscular fibre, especially affecting the sphincters and the uterus, causing continuous labor pains and tonic contraction of the sphincter vesicae, making micturition difficult if not impossible. It also produces cerebral and spinal anaemia, coldness of the surface, tetanic spasms and violent con- 180 ERGOTA. vulsions, but very large doses (several ounces) are necessary to such results. As much as §iij of the fluid extract has been given daily for a week or more, without producing any marked effect. Chronic Ergotism occurs in two forms, (i) the Convulsive, (2) the Gangrenous,—either usually excluding the other. The convulsions are tetanoid spasms of the flexor muscles, the uterus, the intestinal fibres, and the muscles of respiration, ending in coma and death by asphyxia. The gangrenous form begins with coldness and numbness of the limbs, formication of the skin all over the body, loss of sensibility and abolishment of the special senses, bullae of blood and ichor, followed by dry or moist gan- grene of the lower extremities, buttocks and other parts, epilep- tiform convulsions, coma and death. Autopsies show changes in the posterior columns of the cord, resulting probably from the spinal anaemia. Experiments with the various derivatives of Ergot show that no one of its constituents represents the power of the drug itself. Those which come nearest to it in action are the Ergotinine of Tanret and Sclerotinic Acid. Antagonists and Incompatibles. Amyl Nitrite, Aconite, Veratrum Viride, Tobacco and Lobelia antagonize its action on the circulation. Caustic alkalies and metallic salts are chemi- cally incompatible. Therapeutics. Ergot has a wide field of application. Its most familiar use is to promote uterine contraction in labor, but as the contractions produced by it are continuous instead of the natural intermittent ones, it is highly dangerous when there is any obstacle in front of the child, the probable results being rupture of the uterus, paralysis of the foetal heart, and severe laceration of the perineum. At the end of the second stage of labor is the time for its best employment, to promote firm uterine contraction, thereby guard- ing against post-partum hemorrhage, as well as to aid in the expulsion of the placenta. In many uterine affections, as chronic metritis, subinvolution, congestive dysmenorrhcea, menorrhagia, fibroids and polypi, it is well employed, producing firm contrac- tion of the womb and promoting absorption of inflammatory products. It is extremely useful in amenorrhoea due to plethora, and in the atonic form of spermatorrhoea. In conjunctivitis, gonorrhoea, and inflammations of mucous membranes generally, it.is of striking benefit, if used both locally and internally. It is also an excellent remedy in acute and chronic dysentery, chronic diarrhoea, atonic hemorrhages of arterial type, mania due to ERIGERON—ERIODYCTION. 181 cerebral hypercemia, headache and migraine of congestive form, myelitis, spinal congestion, cerebro-spinal meningitis, splenic enlargement, lax sphincters of rectum and bladder, and in incon- tinence of urine from paralysis of the sphincter vesicse. Hemor- rhoids are well treated by its local application, but here it should not be used internally as it promotes venous congestion. In aneurism it aids coagulation by slowing the blood-current, and in cardiac hypertrophy without valvular lesion it acts well by slowing the heart. In diabetes insipidus full doses of Ergot are often curative, and it has been used with benefit in diabetes mel- litus. Hypodermically, the aqueous extract dissolved in water and free from alcohol or any other irritating substance, is in many cases much more prompt in action than when given per orem, especially if injected near to the seat of the affection. This is particularly true in post-partum and other hemorrhages, prolapse of the rectum, chronic metritis and subinvolution of the womb, uterine fibroids, varicocele and varicose veins. When so ad- ministered it will frequently so contract the sphincter of the bladder as to produce retention of urine, and require the use of the catheter. ERIGERON, Fleabane (Unofficial),—is the flowering plant Erigeron canadense, a weed of the nat. ord. Compositse, growing in N. America. It contains a Volatile Oil, which is official, also tannic acid and a bitter extractive. Preparation. Oleum Erigerontis, Oil of Fleabane,—a pale yellow liquid, of sp. gr. about 0.850, becoming darker by age and exposure to air, of peculiar and per- sistent odor, pungent taste and neutral reaction, readily soluble in alcohol. Dose, utx-gss. Physiological Action and Therapeutics. Oil of Erigeron has the same action as Oil of Turpentine but is less irritant and less efficient. It has considerable reputation as a hemostatic, especially in menorrhagia and intestinal hemorrhage of passive form, as in typhoid fever. It is also used with benefit in diarrhoea and dysentery, and in hemoptysis without fever or other evidence of irritation it is a very valuable remedy. ERIODYCTION, Yerba Santa (Unofficial),—the leaves of Eriodyction glutinosum, a Californian shrub of the nat. ord. 182 ERYTHROXYLON. Hydrophyllaceae. They are from 2 to 4 inches long, shining- green as if varnished on the upper surface, white and hairy beneath, of fragrant odor, aromatic taste, and contain an acrid Resin and an aromatic Volatile Oil. Preparations. Extractum Eriodyctii Fluidum (Unofficial),—Dose, Rlxv-^j. Extractum Eriodyctii (Unofficial),—Dose, gr. ij-x. Physiological Action and Therapeutics. Eriodyction is expectorant, and covers the taste of Quinine in a remarkable manner. It is used with fair success in bronchial and laryngeal affections, and asthma. Combined in syrup with Grindelia it is very efficient for coughs. ERYTHROXYLON, Coca, Cuca,—the leaves of Ery- throxylon Coca, a small shrub of the nat. ord. Erythroxylaceae, indigenous to the mountains of Peru and Bolivia, and extensively cultivated in those and other S. American states. It has numerous purplish-brown branches; small, yellowish, 5-petalous flowers, and a scarlet-red, oblong fruit, containing a single seed. The leaf resembles a large tea-leaf, being 2 to 3 inches long, oval- shaped, obtuse at the apex, reticulate on both sides, with a promi- nent midrib, on either side of which is seen a curved line on the leaf from base to apex; odor tea-like, taste slightly bitter and aromatic. It contains a crystalline alkaloid Cocaine, C17H21N04, which when heated with HC1 is split up into Benzoic Acid, Me- thylic Alcohol and another alkaloid Ecgonine. Other constituents are a volatile, liquid alkaloid of herring-brine odor, alkaline reaction and burning taste, named Hygrine, an aromatic Oil, and Coca-tannic Acid. Coca should not be confounded with Cocoa, the seed of the chocolate-tree, Theobroma Cacao. Dose of the leaves, 3j-iv. Preparations. Extractum Erythroxyli Fluidum,—Dose, J^ss-ij. Leaves of good quality are so difficult to be obtained that Dr. Squibb, the well-known phar- maceutist, recently omitted the fluid extract from his trade-list, with the explan- ation that “ it is impossible to get Coca of proper quality for medical use.” Cocaina, Cocaine, C17H21N04 (Unofficial),—crystalline, colorless and of bitter taste, very soluble in ether, almost insoluble in water or alcohol, and of decided basic properties, combining with acids to form salts. It exists in the leaves in very small quantity, viz.—from 0.02 to 0.04 per cent. Dose, gr. yi- fl- Cocaine IIydrochloras, Hydrochlorate of Cocaine, C17H21N04C1 (Un- official),—more properly Chloride of Cocaine,—is used in aqueous solutions ERYTHROXYLON. 183 of 2 to 5 per cent, as a local ansesthetic to mucous surfaces or by subcutaneous injection. Dose, internally, gr. y£-ij. Oleas, Oleate of Cocaine (Unofficial),—a 5 per cent, solution of the alkaloid in Oleic Acid, for external use. Wines, Lozenges, Elixirs, Glyceroles, Pastes, etc., of Coca are being manu- factured and marketed in great variety. The Citrate and Salicylate of Cocaine are recent products of the laboratory and may be obtained in the shops. Physiological Action. Coca is an aromatic bitter tonic, a diuretic and a cerebral and nervous stimulant, though locally used one of the most efficient nerve sedatives. Small doses improve digestion, stimulate res- piration, increase the heart’s action after a brief depression, raise the arterial tension, and increase the excitability of the sensory nerves. It stimulates the brain by increasing its blood- supply, producing wakefulness, a sense of well-being, and a marked diminution of the senses of fatigue, hunger and thirst. Under its daily use a considerable amount of labor and want of sleep can be borne without suffering. Though diuretic, it lessens the quantity of urea eliminated by checking the processes of waste. Very large doses produce impaired coordination, hallucinations and delirium. Cocaine acts upon the lower animals similarly to Caffeine. It tetanizes frogs, and in large doses paralyzes their sensory nerves and the posterior columns of the spinal cord. It kills rabbits and dogs by paralysis of the respiratory centre. In proper doses it raises arterial tension by stimulating the vaso-motor centres and the cardiac motor system. On man its action resembles that of Cannabis Indica, having a primary stimulating action on the brain, and an after narcotic effect. A dose of 22 grains has been taken without causing any disturbance of the heart or mind, but producing colic, burning and dryness of the mouth, thirst, vom- iting, vertigo and feebleness. On the other hand an insufflation of 3 grains into the nostrils produced dizziness, sinking sensa- tions, dimness of vision, great debility, elevated temperature, dyspnoea, difficult articulation and deglutition, nausea but no vomiting, mind in a semi-comatose condition from which how- ever the patient was easily aroused. It resembles Caffeine in its action on the nerve-centres, and Atropine in its effect on the respiration, circulation, pupils, intestinal movements, salivary and sweat-glands. In full doses it causes intense and persistent nausea (but vomiting seems to be impossible), the flow of urine is largely increased, the sexual organs are stimulated, the action of the heart is increased and the respiration accelerated, the cap- illaries of the skin are contracted, producing pallor followed by 184 ERYTHROXYLON. profuse the mouth and throat become dry, the pupils are dilated, and all the reflexes are exaggerated. On the cere- brum the action is one of direct stimulation, the sense of fatigue disappears, ideas flow rapidly, speech is exalted, and sleep is banished. The lethal dose of Cocaine is not ascertained, but would undoubtedly be very large. In sufficient quantity it would probably induce epileptiform convulsions, terminating in death from exhaustion, or from'paralysis of respiration. Cocainism, or the Cocaine-habit, is now presenting itself to observation, several cases having been lately reported of persons addicted to its excessive use. Loss of digestive power, absolute insomnia, enfeeblement of the intellect, great emaciation, ascites, general marasmus, nausea, decay of the teeth, an excessively fetid breath, amblyopia, visual hallucinations and complete anor- exia form a consensus of symptoms which rival the worst effects of the opium-habit. Some observers report the most extraordi- nary mental changes resulting from Cocainism, and exceeding those produced by any other drug. The most intense selfishness, utter disregard of all social and domestic duties, the most debas- ing habits, complete destruction of all noble qualities, and a gen- eral condition of depravity are some of the results which are being charged to this drug. (See the recent case of Dr. Chas. D. Bradley, of Chicago, reported November 30, 1885, by the Associated Press; also article by Dr. Bauduy in College and Clinical Record, October 1885.) As a local anaesthetic to mucous surfaces Cocaine is very powerful over a limited area. Applied to the conjunctiva it causes profound but temporary anaesthesia of the superficial tissue, dilatation of the pupil, paralysis of accommodation, slight lach- rymation, and enlargement of the palpebral fissure. Applied to the tongue it destroys both taste and tactile sensibility so that salt cannot be distinguished from sugar, nor can the prick of a pin be felt. Used on the mucous membane of the nasal passages it rapidly depletes the venous sinuses and contracts the membrane firmly, causing local anaesthesia as well as loss of the sense of smell if applied high enough. Through the unbroken skin it does not act so promptly as on mucous membranes, but injected hypodermically in the vicinity of the muco-cutaneous junction it causes the same local anaesthesia throughout a small space. A number of cases have been reported tending To show that after the anaesthetic effect has passed away, a severe local congestion frequently arises, which in the eye may produce serious inflamma- tion. The use of Cocaine is for this reason generally condemned ERYTHROXYLON. 185 by ophthalmologists whenever the eyeball is to be incised or penetrated. Therapeutics. Coca-leaves are chewed by the Peruvians for the purpose of sustaining them during arduous labors and long journeys, and were so highly esteemed as to have been represented on the coat- of-arms of that nation, by whom they are used much as we do tea, coffee or tobacco. This example was imitated by Weston the pedestrian, who is said to have been detected chewing the coca-leaf during one of his protracted walks. Cocaine is a useful stimulant to the brain and the nervous system in many morbid con- ditions, particularly cerebral and spinal anaemia, neurasthenia, melancholia, hysterical and hypochondriacal insanity, and in pro- tracted mental depression with suicidal tendency. A case of insan- ity of 15 years’ duration in the person of a distinguished Roman Catholic prelate has just been reported as cured by Cocaine. It may be employed with benefit in wasting diseases to retard waste and to stimulate digestion, in convalescence from fevers and other acute maladies, and in migraine and neuralgia due to depression of the nervous system. It is very beneficial in the vomiting of preg- nancy, in stomatitis and gastralgia, and in functional impotence due to general atony of the system. The Morphine-habit is most effectively combated by the hypodermic administration of Cocaine, but care must be taken to conceal the identity of the agent used from the patient, lest the Cocaine-habit take the place of the origi- nal one, which would be a veritable illustration of “jumping from the frying-pan into the fire.’’ A wine of the leaves is found by singers and speakers to relieve hoarseness, to tense the vocal cords and improve the timbre of the voice. Coca-leaves may be smoked in cigars or cigarettes to obtain the exhilarating effects of the drug, and for the relief of hay-fever and many irritable throat affections. The Oleate of Cocaine is an efficient pallia- tive application to painful hemorrhoids, fissures of the anus, burns, boils, and irritable ulcers; also in pruritus pudendi et ani and skin diseases attended with intolerable itching. Hydrochlorate of Cocaine has recently achieved notoriety as a local anaesthetic, and promises to be of the greatest value in many operations on the eye and ear, nasal passages, uterus and urethra. A 2 to 4 per cent, solution is brushed lightly over the mucous surface or injected into the urethral canal, the applica- tion being repeated within 5 or 10 minutes if profound local anaesthesia is required. After about fifteen minutes any super- ficial operation may be performed without giving the slightest 186 EUCALYPTUS. pain. Its anaesthetic action is so entirely local and generally free from unpleasant after-effects that it is considered the most efficient and desirable agent of the kind which is known. It has been used in the same manner with decided benefit in congestion of the nasal passages from acute catarrh and hay-fever; and has been applied to the cervix uteri to relieve the first pains of labor, to the ear for tinnitus aurium, and by inhalation to strengthen the vocal chords, relieve hoarseness and cough, and to improve the quality of the voice. It is injected hypodermically around the prepuce to prevent pain during circumcision, into the vicinity of the supraorbital and infraorbital foramina to cut short neural- gia of those nerves, and into hemorrhoids previous to their liga- tion. It may be injected into the bladder before lithotrity, into the urethra before the passage of sounds or catheters or to relieve chordee, and it is an excellent application to the gums of teething infants. To be efficient it must reach the terminal filaments of the sensory nerves in sufficient concentration. EUCALYPTUS,—the leaves collected from rather old trees, of Eucalyptus globulus, or Blue Gum-tree (nat. ord. Myr- tacege), a native of Australia, now grown in California, Italy, etc. The leaves are 6 to 12 inches long, gray-green, lanceolately scythe-shaped, studded with oil-glands ; of camphoraceous odor and bitter, aromatic taste. They contain tannic acid, a resin, a fatty acid and a Volatile Oil. The latter consists of three different oils which distil over at different temperatures, the first product being named Eucalyptol, C12H20O, which by the action of Phos- phoric Acid is converted into Eucalyptene, a substance allied to Cymene, and Eucalyptolen. Preparations. Extractum Eucalypti Fluidum,—alcoholic. Dose, Ttlx-^j. Oleum Eucalypti,—the volatile oil, distilled from various species of Eu- calyptus, that from E. amygdalina being considered wanting in Eucalyptol. Dose, uiv-xxx in capsules or emulsion. Tinctura Eucalypti (Unofficial),—Dose, Physiological Action. The taste of Eucalyptus is warm, aromatic, bitter and cam- phoraceous. It increases the flow of saliva, the gastric juice and the intestinal secretions, and in small doses promotes appetite and digestion, increases the heart’s action and lowers arterial tension. In large doses it produces eructations, indigestion, EUCALYPTUS. 187 diarrhoea, nausea and vomiting, lowered temperature, great mus- cular weakness, and if continued will irritate and congest the kidneys, and induce a feverish state with symptoms of cerebral congestion, and great constitutional disturbance. Toxic doses are fatal by paralysis of respiration through direct action on the spinal cord. It is powerfully antiseptic, and destructive to low forms of life, a stimulating expectorant and an efficient diaphoretic. By some authorities it is believed to reduce the size of an enlarged spleen, and to possess anti-malarial properties by absorbing nox- ious germs as well as bv draining the soil of its water, and by its aseptic emanations purifying the atmosphere in its vicinity. It is largely cultivated in malarial districts for these properties, and is reported to have rendered habitable a portion of the deadly Roman Campagna. Eucalyptus is eliminated by the skin, bronchial mucous mem- brane and the kidneys, imparts its odor to the breath and the urine, and is more or less irritant at the points of its elimination. Therapeutics. Eucalyptus is an efficient stomachic in atonic dyspepsia, chronic gastric and intestinal catarrh, and in conditions of the intestinal canal which favor the development of worms. In chronic catarrhal conditions of the genito-urinary organs, the broncho- pulmonary mucous membrane, and especially the bladder, it is very useful, acting as a stimulant and disinfectant to the mucous membranes. It is equally beneficial in chronic bronchitis and bronchorrhoea, in cachectic states generally, and in convalescence from acute diseases. In hysteria, chorea and asthma it is bene- ficial, in the latter affection being advantageously smoked in cigarettes with Stramonium or Belladonna Leaves. In malaria as a reconstructant it is better than Quinine, and it has considerable utility in obstinate intermittents where it is desirable to stop the use of Cinchona preparations. As an antiseptic it is highly valued in dilute solution for application to ulcers, and as a substi- tute for Carbolic Acid on gauze in the antiseptic treatment of wounds. It is also used in dilute solution locally as a stimulating disinfectant in stomatitis and in the subacute stages of pharyngitis and tonsillitis. An aqueous preparation is highly recommended as a vehicle for alkaloids in solutions for hypodermic use, to pre- vent the development of the penicillium which rapidly destroys the alkaloid present. 188 EUONYMUS—EUPATORIUM. EUONYMUS, Wahoo, —is the bark of Euonymus atro- purpureus, a shrub of the nat. ord. Celastraceae, growing in the U. S. Occurs in quills or curved pieces, about inch thick, of ashy-gray color and acrid, sweetish taste. It contains an amorphous, bitter principle named Euonymin, also Resins, Euotiic Acid, and Asparagin, fixed oil, etc. Preparations. Extractum Euonymi,—Dose, gr. j-v. Euonymin (Unofficial),—the eclectic preparation, consists of the fixed oil and resin, and is given in doses of gr. ss-v. Physiological Action and Therapeutics. Euonymus is classed with Rhubarb, Jalap, Aloes, etc., as a tonic-astringent and resin-bearing purgative. It is said to be also diuretic and expectorant, and a very efficient cholagogue. Its cathartic action is similar to that of Rhubarb but milder. It has been employed with benefit in some cases of dropsy, also in habitual constipation, torpid liver, and pulmonary affections. In overdoses it will set up considerable gastro-intestinal irritation. EUPATORIUM, Thorough - wort, Boneset, — the leaves and flowering tops of Eupatoriuyn perfoliatum,an American plant of the nat. ord. Compositse, having lanceolate leaves, two united at the base, each 4 to 6 inches long, of weak, aromatic odor and bitter, astringent taste. It contains a neutral, bitter principle, named Eupatorin, tannic acid, a volatile oil etc. Preparation. Extracti Eupatorii Fluidum,—Dose, mx-gj. Physiological Action and Therapeutics. Boneset is a bitter tonic and efficient diaphoretic, also in full doses emetic and aperient. It has been supposed to have anti- periodic and tseniafuge powers. A warm infusion (Boneset tea) is a popular diaphoretic in remittent and typhoid fevers, and at the onset of an attack of acute catarrh or general cold. As a bitter tonic it may be used with advantage in dyspepsia and gen- eral debility. Its common name is derived from its supposed power to relieve the bone pains of dengue or the “break-bone fever.” Another variety of Eupatorium, E. purpureum, or Gravel-root, is reputed to have decided power over the uric acid diathesis. EUPHRASIA—FEL BOVIS FERRUM. 189 EUPHRASIA, Eye-bright,—is a small annual plant of the nat. ord. Strophulariacege, growing in Europe and the U. S., odorless, of astringent taste, and containing Euphrastic Acid, tannin, etc. It was formerly of great repute in various eye-affec- tions, and maybe of utility as a mild astringent in catarrhal con- junctivitis. Its chief value, however, is to abort an attack of acute nasal catarrh with lachrymation, for which purpose a few drops of the tincture every two hours is remarkably efficient. In hay-fever also it is of decided utility in mitigating the catarrhal symptoms, and in the acute coryza of measles it will be found an excellent remedy. A tincture (1 to 9) of the fresh plant should be used, and given in doses of inj-v. FEL BOVIS, Ox-gall,—the fresh gall or bile of Bos Taurus, is a dark-green, viscid liquid, of peculiar odor, bitter taste, and neutral or faintly alkaline reaction. Sp. gr. 1.018 to 1.028. It contains Glycocholate of Sodium, Taurocholate of Sodium, Cholesterin and coloring matter. Preparations. Fel Bovis Inspissatum, Inspissated Ox-gall,—100 parts of fresh Ox-gall evaporated to 15 parts, after straining. Dose, gr. v-xv. Fel Bovis Purificatum, Purified Ox-gall,—3 of Ox-gall and 1 of Alcohol evaporated to pilular consistence, after standing 24 hours, decanting, filtering, etc. Dose, gr. v-xv. Physiological Action and Therapeutics. Bile is tonic, antiseptic and purgative, it assists in the emulsifi- cation of fats, and stimulates the absorbent powers of the mucous membrane. In the stomach it neutralizes the gastric juice, pre- cipitating the pepsin, and is apt to cause nausea and vomiting. Recently it is found to act well in stimulating the resolution of hypertrophies when locally applied to the part, as the mammse, tonsils, pannus, etc. It is used as a laxative in constipation when the natural secretion of bile is deficient, but has no advan- tage over other purgatives. FERRUM, Iron, Fe,—is metallic Iron in the form of fine, bright and non-elastic wire. Ferrum Reductum, Reduced Iron,—consists of metallic Iron in fine powder, obtained by reducing the Sesquioxide by hydro- gen at a dull red heat. It is a very fine, gray-black, lustreless powder, odorless, tasteless, and insoluble in water or alcohol, but 190 FERRUM. soluble in dilute sulphuric acid with the evolution of nearly odor- less hydrogen gas. Dose, gr. j-v, after meals. Iron Compounds and their Preparations. Liquor Ferri Acetatis,—is an aqueous solution of Ferric Acetate, con- taining 33 per cent, of the anhydrous salt. A dark red-brown transparent liquid, of acetous odor, sweetish and faintly styptic taste, reaction slightly acid. Action,—stimulant, ferruginous, little if any astringency. Used to prepare the following tincture. Tinctura Ferri Acetatis,—has of the preceding 50 parts, Alcohol 30, Acetic Ether 20. A clear, dark red-brown liquid, of acetous odor, acidulous and slightly astringent taste, and slight acid reaction. Miscible with water in all proportions. Dose, Trtx-sjij. Syrupus Ferri Bromidi,—is a syrupy liquid containing 10 per cent, of Ferrous Bromide, FeBr2. A pale-green, odorless liquid, of sweet ferruginous taste and neutral reaction. Action,—a sedative chalybeate tonic, especially recommended in nervous disorders, and by Da Costa in chorea. Irritant in large doses. Dose, uiv-xxx. Ferri Carbonas Saccharatus,—has at least 15 per cent, of ferrous car- bonate. A greenish-gray powder, of sweetish taste at first, changing to ferru- ginous. Partially soluble in water, but soluble in dilute hydrochloric acid with evolution of C02. Action,—slightly stimulant to digestive tract. Dose, gr. ij-x with food. Massa Ferri Carbonatis, Vallet’s Mass,—Sulphate of Iron 100, Carbo- nate of Sodium no, Honey 38, Sugar 25, Syrup, Distilled Water, each q. s. ad 100 parts. Has 42 per cent, of ferrous carbonate. Action,—non-astrin- gent, unirritating, ferruginous tonic. Dose, gr. iij-v after food. Mistura Ferri Composita, Griffith’s Mixture,—Sulphate of Iron 6, Myrrh 18, Sugar 18, Carbonate of Potassium 8, Spirit of Lavender 50, Rose-water 900 parts. Is really a solution of the carbonate, with sulphate of potassium to suspend the iron salt. Is an excellent mixture, but disagreeable. Dose, 5ss. Pilule Ferri Composita, Griffith’s Pills,—Sulphate of Iron gr. Car- bonate of Sodium gr. Myrrh gr. jss, Syrup q. s. in each pill, answering in composition to the preceding. Dose, ij-vj. Ferri Chloridum, Perchloride of Iron, FeCl6.i2H20,—orange-yellow, deliquescent, crystalline pieces, of styptic taste and acid reaction, freely soluble in water, alcohol or ether. Action,—strongly astringent, hemostatic. Never used internally. Liquor Ferri Chloridi,—an aqueous solution of the preceding, contain- ing 37.8 per cent, of the anhydrous salt, with some free HC1 acid. Action,— strongly astringent and styptic. Rarely used internally. Dose, niij-x, well diluted. Tinctura Ferri Chloridi,—has of the preceding 35 parts in 65 of Alco- hol. A bright, brownish liquid, of ethereal odor, styptic taste and acid reaction. Is used in Mistura Ferri et Ammonii Acetatis. One of the best preparations of iron. Action,—ferruginous tonic. Dose, Ulv-xx, in water, syrup or glycerin. Ferri Citras, Fe2(C6H507)2.6H20,—garnet-red, transparent scales, slowly soluble in water, not in alcohol. Action,—mildly stimulant. Dose, gr. ij-v. Formed by evaporating the following: Liquor Ferri Citratis,—is an aqueous solution of the preceding, contain- ing about per cent, of the anhydrous salt. A dark-brown liquid, of FERRUM. 191 slightly ferruginous taste and acid reaction. Action,—as Ferri Citras. Dose, Titv-xv. Vinum Ferri Citratis,—made from the Citrate of Iron and Ammonium 4, Tincture of Sweet Orange-peel 12, Syrup 12, stronger White Wine 72 parts. An iron elixir. Dose, zj-ij. Ferri Hypophosphis, Fe2(H2P02)6, Ferric Hypophosphite,—a white or grayish-white powder, odorless, tasteless, -slightly soluble in water, freely so in HC1 acid or in a solution of sodium citrate. Action,— ferruginous tonic. Dose, gr. v-x. Ferri Iodidum Saccharatum,—a yellowish-white powder, very hygro- scopic, odorless, of sweetish, ferruginous taste, and slightly acid reaction, soluble in 7 of water at 590 F., insoluble in alcohol. Action,—ferruginous tonic. Dose, gr. v-xxv in pill or elixir. Pilule Ferri Iodidi,—made with Reduced Iron, Iodine, Licorice, Sugar, Acacia and Water, covered with a coating of Balsam of Tolu in Ether. “ Blancard’s Pills ” only differ from these by being covered with a coating of reduced iron to protect the interior from oxidation, but it also protects them from the solvent action of the gastric juice. Dose, 1 or 2 pills ter in die. Syrupus Ferri Iodidi,—is a syrupy liquid containing 10 per cent, of fer- rous iodide. A transparent, pale-green liquid, of sweet, ferruginous taste and neutral reaction. Action,—ferruginous tonic. Dose, ir^v-xxx. Ferri I.actas, Fe(C3H503)2.3H20, Ferrous Lactate, — pale, greenish- white, crystalline grains, soluble in 40 of water at 590 F., freely in citrate of so- dium, almost insoluble in alcohol. Action,—feebly ferruginous tonic. Dose, gr. j-iij in pill or syrup. Is a constituent of Syrupus Hypophosphitum cum Ferro. Liquor Ferri Nitratis, — is an aqueous solution of Ferric Nitrate, Fe2(N03)6, containing about 6 per cent, of the anhydrous salt. A transparent, amber-colored liquid, of acid, styptic taste, and acid reaction. Action,— medium as to irritation, astringent and hemostatic. Dose, nqv-xv, well diluted. Ferri Oxalas, Ferrous Oxalate, FeC204.H20, —a pale yellow, crystalline powder, very slightly soluble in water. Dose, gr. ij in pill. Ferri Oxidum Hydratum, Ferric Hydrate, Fe(HO)8,—is a brown-red magma wholly soluble in HC1 acid without effervescence. Should be freshly prepared from the Solution of Tersulphate of Iron 10 parts and Water of Ammonia 8 parts. Is the chemical antidote for Arsenic. Dose, a teaspoonful in water frequently repeated. The solutions should be kept ready for use. Ferri Oxidum Hydratum cum Magnesia,—is made by mixing when required for use (1) Solution of Tersulphate of Iron 1000 grains, Water 2000 grains. (2) Magnesia 150 grains, Water Sxxxij. This should be adminis- tered as directed under the preceding head. It is a more convenient and a more efficient antidote for Arsenic than the simple ferric hydrate, as the excess of the alkaline precipitant is non-irritant and is itself an antidote to arsenic. Emplastrum Ferri, Strengthening Plaster,—has of Hydrated Oxide of Iron, dried, 10 parts, Canada Turpentine 10, Burgundy Pitch 10, Lead Plas- ter 70. Trochisci Ferri,—each has of Hydrated Oxide of Iron, dried, gr. v, Vanilla gr. y Sugar, and Mucilage of Tragacanth. Dose, j-iij, ter die. Ferri Phosphas,—Bright-green, transparent scales, of acidulous, saline taste, soluble in water, not in alcohol. Used as an adjuvant to laxative pills to prevent the after reactionary constipation. Dose, gr. v-x. Made by reac- tion between the Citrate of Iron and the Phosphate of Sodium. Ferri Pyrophosphas,—Green, transparent scales, of acidulous taste, 192 FERRUM. soluble in water but not in alcohol. Is almost tasteless and unirritating, and non-constipative. Dose, gr. ij-v. Made by reaction between the Citrate of Iron and the Pyrophosphate of Sodium. Ferri Sulphas, Ferrous Sulphate, FeS04-7lI20,—large, pale bluish-green prisms, efflorescent, of saline, styptic taste, and acid reaction, soluble in 1.8 of water at 590 F., insoluble in alcohol. Is chiefly used to make the Dried Sulphate and other preparations. Ferri Sulphas Exsiccatus, Dried Ferrous Sulphate, FeS04.H20,—a grayish-white powder, nearly soluble in water, consisting of the preceding salt, heated gradually to 300° F., until it ceases to lose weight. The most astringent and irritating ferrous salt, but an excellent one in small doses. Is a constituent of Pil. Aloes et Ferri. Dose, gr. ss-ij in pill. Ferri Sulphas PRyECiPiTATUS, Precipitated Ferrous Sulphate, FeS04.7H20, —is the same salt as above described, precipitated by Alcohol from solution in dilute sulphuric acid. Dose, gr. ss-ij. Liquor Ferri Subsulphatis, Monsel’s Solution,—is an aqueous solution of Basic Ferric Sulphate, Fe40(S04)5, containing 43.7 per cent, of the salt. A dark reddish-brown, almost syrupy liquid, of very astringent but not caustic taste, and acid reaction, mixing with water or alcohol in all proportions with- out decomposition. Is but slightly irritating, and powerfully astringent, chiefly used locally as an astringent and hemostatic, but may be given internally in doses of TTtiij-x, well diluted. Liquor Ferri Tersulphatis,—is an aqueous solution of Normal Ferric Sulphate, Fe2(S04)3, containing 28.7 per cent, of the salt. Has the same properties as described for the preceding, but a less sp. gr. Is used to make other preparations of Iron. Ferri Valerianas, Fe2(C6H902)6,—a dark, tile-red, amorphous powder, of faint, valerianic odor, and mildly styptic taste, insoluble in cold water, de- composed by hot water, readily soluble in alcohol. Of doubtful value as a valerianate. Dose, gr. j-iij in pill. Preparations of Compound Iron Salts. Ferri et Ammonii Citras, Ammonio-ferric Citrate,—prepared from Solu- tion of Citrate of Iron 3 parts, Water of Ammonia 1, mixed and evaporated. Transparent, garnet-red scales, deliquescent, soluble readily in water, insoluble in alcohol. Dose, gr. ij-v. Ferri et Ammonii Sulphas, Ammonio-ferric Alum,—pale, violet crystals, efflorescent, of styptic taste and slightly acid reaction, soluble in 3 of water at 590 F., insoluble in alcohol. Is the least astringent of the sulphates of iron, but more so than any of the salts formed by vegetable acids. Dose, gr. iij-xv. Ferri et Ammonii Tartras, Ammonio-ferric Tartrate,—made from Liq. Ferri Tersulphatis 90, Tartaric Acid 60, Aq. Ammonise 72, Ammonium Car- bonate, Water q. s. Transparent, reddish-brown scales, slightly deliquescent, of sweetish and slightly ferruginous taste, very soluble in water, insoluble in alcohol. Contains an equivalent of about 25 per cent, of Ferric Oxide, and has but slight irritant qualities. Dose, gr. v-xx. Ferri et Potassii Tartras, Potassio-ferric Tartrate,—made from Liq. Ferri Tersulphatis 12, Potassii Bitart. 4, Aq. Destil. 32, Aq. Ammoniae, et Aquae q. s. Transparent, garnet-red scales, slightly deliquescent, of sweetish and slightly ferruginous taste, very soluble in water, insoluble in alcohol. Is the least disagreeable in taste of all the iron preparations, and contains a little FERRUM. 193 more ferric oxide than the preceding salt. Is but slightly astringent and is not constipating. Dose, gr. v-x. Ferri et Quinine Citras,—prepared from Ferri Citras 88, Quinine, dried, 12, Aq. Destil. q. s. ad ioo, mixed and evaporated. Thin, transparent, yel- lowish-brown scales, slowly deliquescent, of bitter taste, slowly soluble in water, slightly soluble in alcohol. Contains 12 per cent, of dry quinine. Action,—astringent and stimulant to the digestive tract. Dose, gr. iij-v. Liquor Ferri et Quinine Citratis,—made directly from Ferri et Am- monii Citras 65, Quinine, dried, 12, Ac. Citric. 28, Alcohol 30, Aq. Destil. q. s. ad 200. A greenish-brown liquid, of bitter taste and slightly acid reac- tion. Contains 6 per cent, of quinine. Is very slowly soluble and of doubtful value. Dose, it\_v-xv. Vinum Ferri Amarum, Bitter Wine of Iron,—has of the preceding 8 parts, Tinct. Aurantii Dulcis 12, Syrup 36, Stronger White Wine 44. May replace the various “ elixirs of iron and calisaya.” Dose, Ferri et Strychnine Citras,—Ferri et Ammonii Citras 98, Strychnin® 1, Ac* Citric. 1, Aq. Destil. 120, mixed and evaporated. Transparent, garnet- red scales, deliquescent, readily soluble in water, slightly so in alcohol. Con- tains I per cent, of Strychnine. Action,—astringent and stimulating. Dose, gr. |-nj. Syrupus Ferri, Quinine et Strychnine Phosphatum, Syrup of the Phosphates of Iron, Quinine and Strychnine. [Described under Phosphorus.] Syrupus Hypophosphitum cum Ferro, Syrup of Hypophosphites with Iron. [Described under Phosphorus.] Mistura Ferri et Ammonii Acetatis, Basham’s Mixture,—is properly a Liquor, and is prepared from Tr. Ferri Chloridi 2, Ac. Acet. Dil. 3, Liquor Ammonii Acet. 20, Elixir Aurantii 10, Syrup 15, Water 50 parts. An elegant and agreeable preparation, having some power as a diuretic and a diaphoretic. Dose, 3jij-v, well diluted. Unofficial Preparations of Iron. Ferrum Dialysatum, Dialysed Iron, — composition varies from Fe2Cl6. i2Fe203 to Fe2Cl6.95Fe203, and is a 10 per cent, solution of Ferric Oxychloride in water. Prepared by treating a solution of Chloride of Iron with Ammonia, ferric hydrate being precipitated, this being dissolved by agi- tation is placed in a dialyzer and suspended in water, which is renewed as long as it shows a trace of HC1 acid. It is a reddish-brown liquid, free from astringent, styptic taste, but is a very feeble chalybeate, incapable of absorp- tion except by change into a hydrated sesquioxide in the alimentary canal. Is used as a chalybeate, and as an antidote to Arsenic, but is not considered an eligible preparation. Dose, uix-xxx. Ferri Arsenias, Ferrous Arseniate, Fe3As2Og,—a green, tasteless powder, insoluble in water, soluble in HC1 acid. Its activity is due to the arsenic alone. Dose, gr. J. Syrupus Ferri et Manganesii Iodidi, Syrup of the Iodide of Iron and Manganese,—is a pale, straw-colored liquid, containing a little sulphate of potassium, and in each fluid 3; has 50 grains of the mixed iodides in the pro- portion of Iodide of Iron 3 parts, to l of Iodide of Manganese. Dose, xxx-^j. Syrupus Ferri et Manganesii Phosphatis, Syrup of the Phosphate of Iron and Manganese,—as used by Dr. Simpson of Edinburgh, contains in each 3 of syrup 2 grains of the Phosphate of Iron and 1 grain of Phosphate of Manganese. Dose, gj. 194 FERRUM. Mistura Ferri Aromatica,—Pale Bark 4, Calumba 2, Cloves 1, Iron wire 2, Tr. Cardamomi Co. 12, Tr. Aurantii Cort. 2, Aq. Menth. Pip. 50,— Macerate the first 4 in the last one for 3 days, filter, add the tinctures and make up to 50. Dose, Jjj-ij. Mistura Ferri Laxans,—Ferri Sulph. gr. ij, Magnesii Sulph. £j, Ac. Sulphurici Dil. TTliij, Spt. Chloroformi nlxx, Aq. Menth. Pip. ad Mistura Ferro-salina,—Magnesii Sulph. H-j, Potassii Bitart. 5|j, Ferri Sulph. Exsic. gr. x, Aquae quart j. Dose, a wineglassful. Notes on the Preparations. Oxides and Carbonates, including Ferrum Reductum, Ferri Carbonas Saccharatus, MisturaFerri Composita, Pil. Ferri Comp., Massa Ferri Carb., Ferri Oxidum Hydratum, Ferri Oxidum Hyd. cum Magnesia, and Mist. Ferri Aromatica,—possess the haema- tinic action of iron with but little astringency, and are therefore selected to restore the blood in anaemia, chlorosis and amenor- rhcea, with tendency to dyspepsia and constipation. The Hy- drated Oxides are only used as antidotes in arsenical poisoning. Ferrum Reductum is one of the best forms for internal use, but gives rise to sulphuretted or phosphoretted eructations which are very disagreeable. The Subcarbonate is little more than the Red Oxide, but in the Massa Ferri Carb. the oxidation is pre- vented by the sugar. Mineral Acid Salts and their preparations comprise the Sulphate in its 3 forms, the solutions of the Subsulphate and "Per- sulphate, the Phosphate, Pyrophosphate and Hypophosphite, the Chloride and its preparations and the Liquor Ferri Nitratis. They are characterized by their astringent and corrugating action, and are used locally especially as hemostatics, the Solution of the Subsulphate being preferred for topical use as it is powerfully styptic but not corrosive. The Tincture of the Chloride is one of the best preparations for internal use, and is most agreeable in the form of Creuse’s tasteless preparation, which is made as follows,—Liq. Ferri Chloridi 3j, Acidi Citrici 544 grains, Sodii Carb. xooo grains or q.s., Aquae Destil. 3j, Alcoholis q. s. Dis- solve the citric acid in the distilled water and heat to the boiling point, gradually adding sodium carbonate until the acid is sat- urated ; mix this with the iron solution and make up to £iv with alcohol. Of thejPhosphates the best is the Pyrophosphate, which is easily assimilated, readily soluble and entirely unirritating. Vegetable Acid Salts and their preparations comprise the Lactate, Citrate and its preparations, Oxalate, and the prepara- tions of the Acetate and the Tartrate. They are the least irritat- ing to the stomach but are also the least efficient as chalybeates. FERRUM. 195 They may be administered in white wines, or with alkalies and vegetable acids in effervescing mixtures. Other Compounds are those in which Iron is combined with bodies equally active, as the Syrup of the Bromide, the prepara- tions of the Iodide, those with Quinine, Strychnine, etc. Gen- erally these preparations are used for a two-fold purpose, namely to relieve anaemia and at the same time act upon the specific ailment on which the anaemia depends. Physiological Action. Metallic Iron is not inert, for in the stomach it acquires mo- lecular activity through its oxidation, setting hydrogen free. It is a normal constituent of the blood (i part to 230 of red cor- puscles), existing probably as an oxide in combination with haematin, which is not formed without it. It is also found in the bile, lymph, chyle, gastric juice, in the pigment of the eye, in the milk and the urine. Given medicinally in small doses it promotes appetite and digestion, and improves the quality of the blood, increasing the number of the red corpuscles. In the stomach all the salts of iron are converted into the Chloride and in the duodenum into an alkaline albuminate, entering the blood along the whole length of the alimentary canal. Large doses, or small ones long-continued are directly unfavorable to digestion, nausea and vomiting are produced by the soluble preparations, the per-salts are actively irritant, the Iodide, Chloride, Nitrate and Sulphate being active poisons, highly astringent, and act in- juriously on the teeth. Only a small portion of iron is absorbed, the rest being eliminated by the intestinal canal, blackening the faeces by conversion into a sulphide. Of the portion absorbed from the alimentary canal, only a small part reaches the systemic circulation and is eliminated by the kidneys, the greater part being excreted by the liver with the bile. Locally most of the iron salts are more or less constringing to the tissues and the mucous membranes, acting as hemostatics and astringents by virtue of their power to coagulate albumen, and acting injuriously on the teeth. The Tincture of the Chloride is considered diuretic. Incompatibles. Alkalies and their carbonates, acids, acidulous salts and vegetable astrin- gents are incompatible with most preparations of iron, the latter group being so by virtue of their tannic and gallic acids which form a deep blue-black precipitate (tannate of iron) with the per-salts. 196 FERRUM. Therapeutics. The chief indication for the internal administration of Iron is anaemia; when plethora exists it is contraindicated. It should always be given after meals, and occasionally suspended for a time, to avoid deranging the stomach. When appetite and diges- tion are promoted by Iron it will do the greatest amount of good, many authorities holding that the principal benefit derived from its use, even in anaemia, is due to its stimulating digestion and the primary assimilation. The Sulphate is here probably the most efficient salt and is well used in combination with aloes when there exists any intestinal torpor. In pseudo-leucocythaemia, chorea of anaemic girls at the age of puberty, epilepsy and neu- ralgia of the anaemic, amenorrhoea and other menstrual disorders of the same class of subjects, and in acute rheumatism of pale, cachectic persons, the chalybeates are generally very efficient remedies, especially the Tincture of the Chloride. The same preparation is extensively employed in erysipelas and diphtheria with good results. In albuminuria with chronic disease of the kidneys the Tinctures of the Chloride and of the Acetate are useful as chalybeate diuretics. In many cardiac diseases of the anaemic, fatty heart, weak heart, dilatation, mitral disease, etc., ferruginous preparations are often of signal advantage. In the syphilitic cachexia, chancroid, and sloughing phagedena, the Iodide gives good results, particularly when the subject is one of debilitated constitution. In the nocturnal incontinence of chil- dren the Syrup of the Iodide is one of the most efficient remedies. In all chronic affections of the respiratory organs, when hemor- rhage is not existing or threatened, the Phosphate of Iron, Quinine and Strychnine is used with much benefit. In passive hemorrhages, especially when due to anaemia, the Tincture of the Chloride is very effective, and in all active bleeding the Solution of the Subsulphate locally used is a prompt and efficient hemo- static. A weak solution of this preparation (3j ad used in the form of spray is the most serviceable astringent in obsti- nate epistaxis, and in hematemesis the same solution may be swallowed in small quantities at short intervals, In chronic diarrhoea and dysentery the Solution of the Nitrate is an efficient astringent, and a weak solution of the Chloride is used as a rectal injection against thread-worms. In arsenical poisoning the most effective antidote is the Hydrated Oxide, which forms with Arsenious Acid an almost insoluble compound. The solutions used in its preparation should be kept on hand and only mixed when wanted for use. FICUS FCENICULUM—FRANGULA. 197 FICUS, Fig ,—is the fleshy receptacle of Ficus Carica, bear- ing fruit upon its inner surface. The fig-tree is a member of the nat. ord. Urticaceae and a native of the shores of the Levant, but is cultivated in Southern Europe and in other warm countries. Figs contain about 62 per cent, of grape sugar, also gum, fat, etc., and are a constituent of the official Confectio Sennse. Physiological Action and Therapeutics. Figs are demulcent, laxative and nutritious. They are used in their fresh state as an aliment, but if eaten in quantity may pro- duce flatulence, enteralgia and diarrhoea. They are chiefly used as an article of diet in habitual constipation, but may be employed as an ingredient of demulcent decoctions, and locally as a poul- tice to gum-boils. FCENICULUM, Fennel,—is the fruit of Fceniculum vul- gare, a European cultivated plant of the nat. ord. Umbelliferse. It is l/i to Yi of an inch long, oblong, slightly curved, separable into 2 mericarps, and having 5 ribs, and several oil-tubes, odor and taste aromatic. It contains a volatile oil, united with a ter- pene, and is a constituent of Pulvis Glycyrrhizse Compositus. Preparations. Oleum Fceniculi,—the volatile oil, a light-yellow colored liquid, having the odor of fennel, a warm taste and neutral reaction, soluble in alcohol. It is an ingredient of Spiritus Juniperi Compositus. Dose, npij-v. Aqua Fceniculi,—contains 2 parts of the oil in 1000 of distilled water percolated through cotton. Dose, Jjss-^j. Physiological Action and Therapeutics. Fennel is an aromatic stomachic and a mild stimulant. It is chiefly used as an agreeable carminative in flatulence and colic, and as a corrigent to Senna, Rhubarb, and other disagreeable medicines. An infusion is often used as an enema to expel flatus in infants. FRANGULA, Buckthorn,—the bark, collected at least one year before being used, of Rhamnus Frangula, or Alder Buckthorn, a European shrub of the nat. ord. Rhamnacese. Occurs in quilled pieces inch thick, outer surface of gray- brown color, with numerous small warts. It contains several principles, of which the only important one is Frangulin, or 198 FUCHSIN—FUCUS VESICULOSUS. Rhamnoxanthin, a lemon-yellow, odorless and tasteless glucoside, insoluble in water and but sparingly so in alcohol or ether, and thought to be identical with Cathartin, the active principle of Senna. Another species of the genus Rhamnus is described under the title Cascara Sagrada, see ante, p. 128. Preparation. Extractum Frangula: Fluidum,—Dose, gss-ij. Physiological Action and Therapeutics. Frangula-bark when fresh is a violent irritant to the gastro- intestinal tract, producing vomiting, purging, and much pain. The old dried bark is a safe purgative without irritant qualities, and is much used in the constipation of pregnancy, and other conditions requiring purgation. The fluid extract is the best form for administration. FUCHSIN, Roseine, Magenta, Anilin Red (Unoffi- cial),—is the Hydrochlorate of Rosanilin, C20H10N3.HC1, occur- ring in brilliant, elongated crystals having a green lustre, readily soluble in water and therein making a bright red solution. Given internally it has produced salivation, vomiting, and diar- rhoea ; and when injected intravenously it has caused trembling, staggering, albuminuria and fatty degeneration of the kidneys, symptoms which are thought to be possibly due to the presence of Arsenic or Anilin as impurities. It imparts a magenta color to the urine, and is excreted by the kidneys, liver and salivary glands. It has been found to be very efficient in reducing albu- minuria, in many instances having entirely arrested it. It is best administered in pill with a vegetable extract as Licorice or Gen- tian, and in doses of gr. according to age. FUCUS VESICULOSUS, Bladder-wrack, Sea- wrack (Unofficial),—is a perennial plant of the nat. ord. Algae, growing on the shores of the Atlantic and Pacific Oceans as a sea-weed. It has a flat leaf, with a midrib throughout its length, and small spherical vesicles, filled with air, in the leaf. It con- tains mucilage and much Soda in saline combination, also Iodine, but less of the latter than other algae growing in deeper water. A decoction of the fresh plant is the best form for administration. Fucus Vesiculosus is one of a number of marine plants which GALBANUM— GALLA. 199 are used in various parts of the world as food for man and cattle and as manure. The species under consideration is considered alterative and tonic, and has been employed in goitre, glandular and joint enlargements and psoriasis, but especially to produce absorption of adipose tissue in the obese. An extract is sold under the title “Anti-fat.” GALBANUM ,—is a gum-resin obtained from Ferula galba- niflua, an Asiatic plant of the nat. ord. Umbelliferae, and proba- bly from other allied plants. It occurs in minute tears, aggluti- nated into a hard mass, of balsamic odor and acrid, bitter taste. It contains a Volatile Oil isomeric with Turpentine, a Gum, and a mixture of Resins which yield by dry distillation a blue oil and Umbelliferon, a tasteless substance in satiny crystals. Dose, gr. x-xx, in pill or emulsion. Preparations. Pilul/e Galbani Composite,—each pill contains of Galbanum iy£ grain, Myrrh grain, Asafetida yh, grain, and Syrup. Dose, ij—iij. Emplastrum Galbani,—Galbanum 16, Turpentine 2, Burgundy Pitch 6, and Lead-plaster 76 parts. Galbanum is also an ingredient of Emplastrum Asafoetidae. Physiological Action and Therapeutics. Galbanum is stimulant, expectorant and antispasmodic, acting much like Ammonia and Asafetida, and usually given with either of these substances. It is used in chronic bronchitis and catarrh of mucous membranes generally, in amenorrhcea and chronic rheumatism. The plaster is used as a stimulant application to indolent swellings. GALLA, Nutgall ,—is an excrescence on Quercus lusitanica, the Dyer’s Oak, a shrub of the nat. ord. Cupulifene, growing in Western Asia, and is caused by the puncture and deposited ova of the insect Cynips Gallce tinctorice. Galls are hard, globular bodies, from to inch in diameter, of blackish-gray color, tuberculated on the surface, having a central cavity, and an in- tensely astringent taste. They contain from 15 to 75 per cent, of Tannic Acid, about 5 per cent, of Gallic Acid, and other un- important constituents. Dose, gr. v-xv. Preparations. Tinctura Gall.*:,—strength 20 per cent. Dose, Unguentum Gall.e,—strength 10 per cent. 200 GAULTHERIA GELSEMIUM. Physiological Action and Therapeutics. The action of Nut-galls is powerfully astringent, due to the Tannic and Gallic Acids contained in them. Having no special action or use of their own, their qualities may be learned by con- sulting the articles Acidum Tannicum and Acidum Gallicum, ante, pages 37 and 25. GAULTHERIA, Wintergreen,—is the leaf of Gaulthe- ria procumbens, an American evergreen plant of the nat. ord. Ericaceae, having a peculiar flavor, a fragrant odor, and an aro- matic and astringent taste. Its active principle is the Volatile Oil, which is official. It also contains Tannic Acid, Arbutin, Ur- ion, Ericolin, etc. Preparations. Oleum Gaultheri.®, Oil of Wintergreen,—is the volatile oil, a liquid of peculiar and aromatic odor, sweetish, warm taste, and a slightly acid reaction. It is readily soluble in alcohol, and consists of Methyl Salicylate go per cent., and Gaultherilene, a hydrocarbon, to per cent. Dose, trtiij-x. Spiritus Gaultheria,—has of the oil 3 per cent., dissolved in 97 of alco- hol. Used for flavoring. Dose, Physiological Action. Gaultheria is stimulant and slightly astringent. Its chief value is as one of the sources of the oil named after it, which is also found in the sweet birch and many other plants, and, containing so large a proportion of Methyl Salicylate or Methylsalicylic Acid, is power- fully antiseptic and antipyretic. In large doses it is irritant to the stomach, in one case %j having caused death by violent gastritis. Therapeutics. Oil of Gaultheria is used successfully as a substitute for Sali- cylic Acid in many conditions, especially in rheumatic and gouty disorders. The plant has been used as an emmenagogue and a galactagogue, but its principal employment is in the form of the spirit as an agreeable flavoring agent. GELSEMIUM, Yellow Jasmine,—is the rhizome and rootlets of Gelsemiutn sempervirens, a climbing plant of the nat. ord. Loganiacese, with showy yellow flowers, which grows in the forests of the southern U. S. forming festoons from one tree to another. The rhizome is cylindrical, long, about an inch thick, of a light yellowish-brown color, an aromatic, heavy odor and a GELSEMIUM. 201 bitter taste. It contains a volatile oil, a resin and an alkaloid Gelsemine in combination with Gelsemic Acid. Dose, gr. ij-xx. Preparations. Extractum Gelsemii Fluidum,—alcoholic. Dose, rt|ij-xx. Tinctura Gelsemii,—strength 15 per cent. Dose, m_v-xxx. Gelsimina, Gelsimine, CnH19N02 (Unofficial),—an amorphous, colorless, inodorous, nearly insoluble solid, of intensely bitter taste, and strong basic properties, neutralizing the strongest acids and with them forming soluble salts. Dose, gr. Physiological Action. Gelsemium is a powerful motor-depressant, causing paralysis of motility and depression of sensibility by central action on the spinal cord. It is also antispasmodic and diaphoretic. In moderate doses it produces languor, slowing of the cardiac rate, enfeebled muscular action, impaired sensibility, drooped eyelids and dilated pupils, with some diaphoresis. In toxic dose, as a teaspoonsful of the fluid extract, it produces vertigo, diplopia, drooped eyelids and dilated pupils (paralysis of 3d nerve), labored respiration, slow and feeble heart, dropped jaw, staggering gait, extreme muscular weakness and almost complete anaesthesia, pro- fuse diaphoresis, loss of articulation, and death by asphyxia from paralysis of the muscles of respiration, consciousness being pre- served until CO, narcosis sets in. Convulsions occur in animals with backward movements, but not in man. Motion is affected before sensibility in warm-blooded animals, sensibility before motion in frogs. Gelsemium is not an arterial depressant, although it lowers the heart-rate, and is not irritant to the gastro-intestinal tract, but it produces a decided lowering of the body temperature. The effects of a moderate dose pass off in about three hours. Antagonists and Incompatibles. Morphine is the most complete antagonist, so are also Digitalis, Ammonia, Alcohol, and to some extent the tincture of Xanthoxylum fraxineum. Emetics, heat, faradization of the respiratory muscles and artificial respiration are measures of prime importance. The caustic alkalies and tannic acid are chemically incompatible. Therapeutics. Gelsemium is indicated in all conditions of exalted nerve function, and contra-indicated whenenever there is a weak heart. It is best used in cerebro-spinal meningitis, mania with great motor excitement and persistent insomnia, delirium tremens, many forms of sleeplessness, pneumonia and pleurisy if the heart be strong, coughs of convulsive and spasmodic character, neural- 202 GENTIANA. gia of the fifth nerve, remittent fever, after-pains, ovarian neu- ralgia, dysmenorrhoea, irritable bladder of women, and inconti- nence of urine from spasm of the vesical muscular fibres. In most of these affections the remedy must be pushed to the induc- ing of some physiological symptoms, but its action should not be carried beyond the production of drooped eyelids, diplopia and muscular debility. It has also been used with varying success in intercostal neuralgia, myalgia, sciatica, spasmodic asthma, sick headache, eczema, pruritus and tetanus. Its especial field how- ever is in remittent and typho-malarial fevers and cerebro-spinal meningitis. It is not suitable to low fevers and has not sufficient power as a cardiac depressant to be of much use in sthenic forms. GENTIANA, Gentian ,—is the root of Gentiana lutea, the Yellow Gentian, one of a numerous family of plants (nat. ord. Gentianaceae), which inhabit the mountainous districts of Europe. An American species, G. Catesbcei, Blue Gentian, is considered nearly equal in value to the official species. Gentian occurs in cylindrical pieces or longitudinal slices of the root, which is to i inch thick and several inches long, brown externally, yellowish-brown within, of faint, peculiar odor, and taste at first sweetish, afterwards persistently bitter. It contains an active, bitter glucoside, Gentopicrin or Gentianin, C20HS0O]2, which is crystalline and soluble in water, also an inert, amorphous body Gentianic or Gentesic Acid, gum, considerable sugar, and a trace of a volatile oil, but no tannin. Preparations. Extractum Gentians,—aqueous. Dose, gr. j-v. Extractum Gentians Fluidum,—Dose, Tinctura Gentians Composita,—Gentian 8, Bitter Orange Peel 4, Car- damom 2, Diluted Alcohol to 100. Dose, gss-ij. Unofficial Preparations. Infusum Gentians Compositum,—contains Gentian 10, Bitter Orange Peel 2y2, Coriander Alcohol 40, Water to 320. Dose, Mistura Gentians Alkalina,—Ac. Hydrocyan. Dil. rrtiij, Sodii Bicarb, gr. xv, Infusum Gentianas Co. to j|j. One dose. Mistura Gentians et Senn/e,—Infusum Sennae giij, Tr. Cardamomi Co. 3h Infusum Gentianae Co. sjvj. One dose. Physiological Action. Gentian is a simple bitter without astringency or aroma, its action corresponding to that of Calumba (see ante, page 114), but GERANIUM GLYCERINUM. 203 it is more apt to disagree with the stomach. In addition, like Cornus, a member of the same class, it has considerable repute as an antiperiodic and febrifuge. Therapeutics. Gentian has been considered a valuable tonic throughout all Europe from the earliest historical times. It is highly esteemed as a stomachic tonic in dyspepsia connected with a gouty diathesis, in hysteria, jaundice, and in convalescence from acute diseases and from malarial fever. The compound tincture is an excellent vehicle for cod-liver oil, and the now unofficial infusion is a good vehicle for the administration of chalybeates, mineral acids and neutral salts. The discoloration which iron salts make with gen- tian preparations is probably due to Gentesic Acid and not to tannin, as it contains none of the latter. GERANIUM, Cranesbill-root,—is the rhizome of the indigenous perennial Geraniutn maculatum (nat. ord. Gerania- cese). It is 2 or 3 inches long, horizontal, contorted and tuber- culated, with thin, fragile rootlets, inodorous, taste astringent. Its active constituents are tannic and gallic acids. Preparation. Extractum Geranii Fluidum,—Dose, "ntv-^j. Physiological Action and Therapeutics. Geranium is an efficient astringent, and its action corresponds with that of Tannic Acid (see ante, page 38). Having no un- pleasant taste it is a useful agent for infants and others having delicate stomachs, and is a very popular domestic remedy in many parts of the country. It is especially used in diarrhoeas, dysentery, cholera infantum, hemorrhages, relaxed conditions of mucous membranes, gleet and leucorrhoea. GLYCERINUM, Glycerin, —is a liquid obtained by the decomposition of fats or fixed oils, containing not less than 95 per cent, of absolute Glycerin, C3H5(HO)s, which exists in fats and fixed oils in combination with the fatty acids. Glycerin is clear and colorless, of syrupy consistence, hygroscopic, non- drying, odorless, of warm and very sweet taste, neutral reaction, sp. gr. 1.250, soluble in water and alcohol, but insoluble in ether, chloroform and fixed oils. 204 GLYCERINUM. It dissolves tannin, gallic acid, carbolic acid, salicylic acid, bromine, iodine, etc., and with the aid of heat metallic salts and oxides, alkaloids, etc. With strong Nitric Acid it forms Nitro-glycerin, and it reduces potassium perman- ganate, chromic acid and chlorinated lime with great violence. An impurity frequently present in it is Acrolein, formed by the use of too high a heat in its manufacture, and which is very acrid and poisonous. Glycerin is a con- stituent of Glyceritum Amyli, Glyceritum Vitelli, Pilulae Phosphori, Mucilago Tragacanthae, Massa Hydrargyri, and several extracts and fluid extracts. Dose, 3J-ij, diluted. Physiological Action. Glycerin is highly antiseptic, abstracts water from tissues with which it comes in contact, and unless pure isoften very irritating to the skin. It is freely absorbed by all surfaces, cutaneous and mucous, and is decomposed in the system passing out as formic and other acids. On the stomach it has no particular action, but in large quantities it is laxative and is said to cause the solu- tion of the red blood-corpuscles and hsemoglobinuria. The urine of persons using glycerin contains a body which acts like sugar in the copper and fermentation tests, but is not sugar. Glycerin is a good emollient and is considered nutritive by many authori- ties. Therapeutics. Glycerin has been used as a substitute for Cod-liver Oil in wasting diseases, but with little benefit. It has also been tried as a remedy in diabetes, but with unsatisfactory results so far as reported, except as a sweetening substitute for sugar in the dietary of those afflicted with that disease. It is said to be fatal to intes- tinal trichinae, and to be an efficient internal remedy in acne and flatulence. As a vehicle it is used for many drugs, and is a good ingredient of solutions for hypodermic use, promoting the solu- bility of many alkaloids and acting as an antiseptic. It is also employed to preserve and aid the action of the digestive fer- ments, Pepsin and Pancreatin, as well as to prevent the decompo- sition of vaccine lymph. Locally it is valuable in many cutaneous affections as an emol- lient and softening agent. In acute coryza it gives great relief if applied by a brush or as a spray to the nasal mucous membrane. It is used on cotton to the cervix uteri as a depleting agent, and mixed with an infusion of flaxseed as an enema to relieve tenes- mus in acute dysentery. With tincture of Benzoin it is an ex- cellent application to chapped hands or lips and fissured nipples. In the external auditory canal it is usefully employed to soften cerumen, diminish the secretion of pus, deplete the tissues, and keep the surface moist. [For other uses of Glycerin in combina- GLYCYRRHIZA. 205 ion see Glyceritum Vitelli, Glyceritum Amyli, and Glyceritum Acidi Tannici, under the titles of their respective bases.] GLYCYRRHIZA, Liquorice Root, —is the root of Gly- cyrrhiza glabra, a plant of the nat. ord. Leguminosse, native in southern Europe and Asia, but largely cultivated in many other parts. It occurs in long pieces, ] to i inch thick, longitudinally wrinkled, of a grayish-brown color externally, tawny-yellow in- ternally, pliable and tough, and of a somewhat acrid, sweet taste. It contains a yellow, amorphous glucoside, Glycyrrhizin, C24H3609, also Glycyrrhizic Acid, Asparagin, sugar, resin, gum, etc. Gly- cyrrhizin when boiled with dilute acids yields glucose and a very bitter substance named Glycyrretin. Preparations. Extractum Glycyrrhiza,—is the commercial extract of the root, occur- ring in glossy-black rolls, of sweet, peculiar taste. Not less than 60 per cent, of it should be soluble in cold water. Extractum Glycyrrhiza Purum,—made with Aqua Ammonia and Water, by percolation and evaporation to a pilular consistence. Dose, in- definite. Extractum Glycyrrhiza Fluidum,—made with Aqua Ammonia and diluted Alcohol. Dose, indefinite. Mistura Glycyrrhiza Composita, Brown Mixture,—-has of the Pure Extract 3 parts, Sugar 3, Acacia 3, Tr. Opii Camph. 12, Vinum Antimonii 6, Spt. zEtheris Nitrosi 3, and Water 70. Dose, gj-jfss. Pulvis Glycyrrhiza Compositus,—Senna 18, Glycyrrhiza 16, Fennel 8, Washed Sulphur 8, Sugar 50 parts. Dose, a teaspoonful. 1 ROCHlsci et Opii,—each has of Extract of Glycyrrhiza gr. ij, Extract of Opium gr. -fa, Acacia, Sugar and Oil of Anise. Dose, j-ij every hour. Glycyrrhizinum Ammoniatum, Ammoniated Glycyrrhizin,—the sweet principle of Liquorice rendered soluble and therefore tasteable by Ammonia, believed to be the form in which Glycyrrhizin exists in the root. Occurs in brownish-red scales, very sweet, and soluble in water or in alcohol. Dose, gr. v-xv. Physiological Action and Therapeutics. Liquorice is demulcent and mildly laxative. It has an agree- able taste, and increases the flow of saliva and mucus when slowly chewed or sucked, the increased secretions acting as emollients to the throat. It is used in many pharmaceutical preparations, covering the taste of Senna, Senega, Hyoscyamus, Turpentine, Chloride of Ammonium, bitter Sulphates, and to some degree the bitterness of Quinine. The powdered extract or root is used as an excipient in pills and troches. The Compound Mixture is an efficient expectorant, much employed in acute bronchitis and 206 GOSSYPIUM. catarrhal laryngitis, but owing its power over cough mainly to the Opium contained in it. The Compound Powder is a gentle laxative, of which Senna is the most active ingredient. The Troches are used for cough, but must be carefully prescribed to children as they contain gr. of Extract of Opium in each. GOSSYPIUM, Cotton,—is the hair of the seed of Gossyp- ium herbaceum, and of other species of Gossypium (nat. ord. Malvaceae), freed from adhering impurities and deprived of fatty matter. In this form it is known as Purified ox Absorbent Cottont is insoluble in water, alcohol or ether, but is soluble in an ammo- niacal solution of Cupric Sulphate. Cotton-fibre is familiar in appearance to every one, but when examined microscopically it shows as flattened, hollow and twisted bands, spirally striate, and slightly thickened at the edges. It is a modification of Cel- lulose, C12H10O10, and corresponds therewith in all its ordinary chemical properties. Preparations of the Cotton Plant. GossYpii Radicis Cortex, Cotton Root Bark,—thin bands or quilled pieces, brownish-yellow exteriorly, white interiorly, of slightly acrid and astringent taste. Dose, gr. xxx-^j. Extractum Gossypii Radicis Fluidum,—made with Glycerin and Alco- hol, by maceration and percolation. Dose, itlxxx-^j. Oleum Gossypii SeMinis, Cotton-seed Oil,—the fixed oil expressed from the seeds and purified. Is yellow, odorless, of bland taste and neutral reac- tion, soluble in ether, but slightly soluble in alcohol. Is introduced into the pharmacopoeia for the reason that it constitutes most of the “ Olive Oil ” sold in foreign-shaped bottles and under foreign appearing labels. It is directed to be used in the official Liniments of Ammonia, Lime, Camphor, and Sub- acetate of Lead. Pyroxylinum, Pyroxylin, Soluble Gun-cotton,—is official for the purpose of making Collodium. It is prepared by macerating Cotton in a mixture of Sulphuric and Nitric Acids, washing, draining and drying. Collodium, Collodion,—made by dissolving Pyroxylin 4, in Ether 70 and Alcohol 26 parts. Collodium Flexile, Flexible Collodion,—Collodion 92, Canada Turpen- tine 5, Castor Oil 3 parts. Collodium Stypticum, Styptic Collodion,—Collodion 55, Ether 20, Alco- hol 5, Tannic Acid 20 parts. Collodium cum Cantharide, Cantharidal Collodion,—Cantharides 60, Flexible Collodion 85, Chloroform q. s. Physiological Action. Cotton-root is believed to be an efficient emmenagogue and oxytocic by southern practitioners, also somewhat of a galacta- gogue, but experiments on pregnant animals have not confirmed GOSSYPIUM. 207 this view of its action. The Oil of the seed is very bland and may be applied to all the purposes for which Olive Oil is used. Cotton itself, when freed from oily matter, is remarkably absorb- ent of water, and is a good agent for excluding air from injured surfaces. Pyroxylin is highly inflammable, and explosive at 300° F. Collodion is also inflammable, and rapidly dries on exposure to the atmosphere by evaporation of its ether, leaving a transparent film of Pyroxylin on the surface to which it has been applied; which film, if the flexible collodion be used, does not contract on drying or readily crack, making it an excellent pro- tective application. Styptic Collodion is a solution of Tannin, and is an excellent hemostatic. Cantharidal Collodion is a convenient blistering agent, suitable for cases where the patient is inclined to remove a blister if applied in the ordinary way. Therapeutics, Absorbent Cotton is a valuable agent in surgical practice, being employed as an application in burns and scalds, erysipelas, articular rheumatism, etc., to exclude the atmosphere, allay pain, and when covered with oiled-silk or rubber cloth to keep up local perspiration. It may be carbolated, borated or salicylated by soaking in the respective solutions, and then used as an antiseptic dressing for wounds, ulcers, etc. It is employed by the pharma- cist in funnels to filter oils, and for the preparation of the official waters. Cotton-root Bark is much employed by the negroes of the southern states in decoction as a supposed abortifacient, oxytocic and emmenagogue. It is used in the south for intensifying uterine action in normal labor, in dysmenorrhoea and amenor- rhoea. A decoction of in a quart of water boiled to a pint is the favorite preparation, administered in wineglassful doses. Collodion is used as a protective covering for superficial burns, ulcers and wounds, slight cuts, cracked nipples, anal fissures, and erysipelas. For these affections the flexible collodion should be used, but where it is desirable to produce pressure on the part the ordinary form is best, as it contracts in drying with con- siderable force. This property makes it highly useful in drawing the edges of wounds together, bringing pressure on buboes, in- cipient boils, carbuncles, etc. Styptic Collodion has many uses as a hemostatic and pro- tective which will suggest themselves, and the Cantharidal form is a convenient epispastic for uneven surfaces, the therapeutics of which are detailed under Cantharis. (See ante, page 121.) 208 GRANATUM—GRINDELIA. GRANATUM, Pomegranate,—is the bark of the root of Punica Granatum, a small tree of the nat. ord. Granataceae, cul- tivated in sub-tropical countries. It occurs in thin quills of yellowish-gray color, warty or ridged on the external surface, inodorous, of astringent and slightly bitter taste. It contains Tannic and Punico-tannic Acids, Mannite and an active liquid alkaloid Pelletierine, C8H13NO, which is soluble in water, alcohol, ether, chloroform, etc., and has strong basic properties. There are no official preparations. Unofficial Preparations. , Extractum Granati Fluidum,—Dose, gss-jss. Dkcoctum Granati,—gxvij of bark from the fresh root in of boiling water, boiled down to and strained. Dose, every hour, preceded and followed in a few hours by a brisk cathartic. The decoction of the Br. Phar. is of I to 8 strength and is given in doses of Pelletierine Tannas, Tannate of Pelletierine,—Dose, gr. ss-j, taken fasting and followed in 15 minutes by a sharp purgative. Physiological Action and Therapeutics. Granatum and its alkaloid are taeniafuge, and very efficiently so, rarely failing to bring away the whole worm. The decoction is usually employed, but lately Pelletierine has been coming into fashion, a proprietary form being sold as “ Tanret’s Pelletierine ” in bottles containing one adult dose at three dollars each. The decoction, in full doses, causes nausea and vomiting, flatulence, purging, and sometimes cramps in the legs, giddiness, dimness of vision, general numbness of the limbs and increase of the quantity of urine. For the expulsion of tape-worm a mixed treatment by Pome- granate-root bark, Pumpkin seeds and Oleo-resin of Male-fern is preferred by many practitioners. The following formula has proved very efficient. R. Granati Aquae Ojss, boiled to 5vij; Pepinis §j, deprived of outer coats and beaten to a paste with finely-powdered sugar; Oleoresinae Aspidii, gr. xxx, made into emulsion with Acacia and the above decoction of Granatum, then added to the paste of Pepo, and flavored with Syrups up to 5ix, one-third of this to be taken in the morning after a light diet and a laxative on the previous day. If not successful the second and third portions may be taken at intervals of 3 hours. The worm should be passed sitting in a tepid sitz-bath to prevent the expelled portion tearing off the head by its weight. GRINDELIA,—the leaves and flowering tops of Grindelia robusta, an herbaceous Californian plant, of the nat. ord. Com- GUAIACUM. 209 positse, having a branched stem, lower leaves spatulate and taper- ing at the base, upper leaves oblong, pointed and have broad bases, flowers yellow, odor balsamic, taste pungently aromatic and bitter. It contains a resin, a volatile oil, and an alkaloid with basic properties. Preparation. Extractum Grindelia Fluidum,—Dose, nix-^j. Physiological Action. Grindelia is antispasmodic and a motor-depressant, inducing paralysis in small animals beginning in the hind extremities. It slightly slows the heart and respiration, and produces mydriasis and hypnotic effects if given in sufficient quantity, with reduced cutaneous sensibility and sluggish reflexes. It has a pungent taste, creates a sense of warmth in the stomach, and in small doses pro- motes appetite and digestion. It is eliminated by the pulmonary mucous membrane and the kidneys, and is markedly diuretic. Therapeutics. Grindelia has been used chiefly in spasmodic asthma, bronchitis and whooping-cough, which it greatly relieves. It is a useful remedy in spasmodic coughs, dyspnoea of various pulmonary and cardiac affections, hay-fever, and chronic cystitis. Locally it is highly efficient as a sedative lotion (1 part of the fluid extract to 10 of water) in poisoning by Rhus toxicodendron, and in skin diseases attended with itching and burning sensations. GUAIACUM, Lignum Vitae, —is official in two forms, Guaiaci Lignum, the heart-wood, and Guaiaci Resina, Guaiac, the resin of the wood of Guaiacum officinale, a large West Indian tree of the nat. ord. Zygophyllacese. The Resin is the important constituent, and itself consists of three resins, namely,— Guaia- conic Acid, C19H20O5, 70 per cent., Guaiac Acid, C6H803, resem- bling Benzoic Acid, and Guaiarec Acid, C20H26O4; also an indif- ferent resin. The wood also contains a yellow coloring matter, gum, etc. Guaiaci Lignum, Guaiacum Wood,—generally used in the form of raspings of greenish-brown color containing whitish particles, of resinous odor, taste slightly acrid. Is a constituent of Decoctum Sarsaparillae Compositum. Guaiaci Resina, Guaiac,—occurs in large masses of a greenish- brown or reddish-brown color, feebly aromatic, taste somewhat 210 GUARANA. acrid, fracture having a glassy lustre, insoluble in water, soluble in alcohol, ether, chloroform and alkaline fluids. Dose, gr. v-xxx, in wafer. Preparations. Tinctura Guaiaci,—Guaiac 20 per cent. Dose, iuv_3j> m mucilage or syrup, as the resin is precipitated by water. Tinctura Guaiaci Ammoniata,—Guaiac 20, Aromatic Spirit of Ammo- nia 80 parts. Dose, rriv-^ss. Physiological Action. Guaiac is diaphoretic, expectorant and alterative. Its taste is acrid and very disagreeable. Internally it is a local stimulant, producing salivation, an acrid sensation in the throat, warmth in the epigastrium, increase of the gastric and intestinal secre- tions and the flow of bile, and reflex stimulation of the heart. Its continued use causes gastric catarrh, and in large doses it is a gastro-intestinal irritant, causing vomiting, purging and severe congestive headache. Though a colloidal body it enters the blood, stimulates the liver and other excretory glands and the production of bronchial mucus, and causes increased circulation and diaphoresis. Sometimes it fails to act on the skin and then is markedly diuretic. Incompatibles. Mineral Acids and Spirit of Nitrous Ether are chemically incompatible with Guaiac preparations. Therapeutics. Guaiacum was first used as an antisyphilitic, being used in de- coction and in large quantity, with a spare diet and external warmth. It acquired a great reputation in this disease during the 16th century, but it is now abandoned for this purpose except as an ingredient of the Compound Decoction of Sarsaparilla. It is a very efficient remedy in tonsillitis, given in 3ss doses of the tincture in emulsion with mucilage or yolk of egg, to abate the inflammation and abort the disease. It has considerable reputa- tion in neuralgic dysmenorrhcea, amenorrhoea, chronic rheuma- tism, gout, lumbago and sciatica. The ammoniated tincture in water makes a cleanly and not very disagreeable gargle. GUAR AN A,—is a dried paste prepared from the crushed or ground seeds of Paullinia sorbilis, a climbing plant of the nat. ord. Sapindaceae, growing in Brazil. It occurs in brown cakes or sticks, having an odor of chocolate and a bitter, astrin- gent taste, partly soluble in water and in alcohol. It contains 25 GURJUN BALSAM GUTTA-PERCHA. 211 per cent, of tannic acid, gum, albumen, starch, and a greenish fixed oil, also an alkaloid Guaranine (5 per cent.), which is identical with Caffeine. The specimens of Guarana in the market are very untrustworthy, unequal in quality and expensive, it being a secret mixture prepared in Brazil. Hence it has been omitted from the list of Squibb’s preparations, and a fluid extract of green coffee substituted in its place. Preparation. Extractum Guarani FluidiM,—Dose, uix-^ij. Physiological Action and Therapeutics. Guarana has similar actions to those of Coffee, the active prim ciples of both plants being identical, both chemically and physio- logically. It is chiefly employed in the treatment of nervous sick-headache (migraine) administered in half-drachm doses of the fluid extract when the attack is developing. It has been used in the diarrhoea of phthisis, convalescence from acute diseases, and generally in conditions requiring tonic treatment. GURJUN BALSAM, Wood Oil, Balsamum Diptero* carpi (Unofficial),—is an oleoresin obtained from incisions in various trees of the genus Dipterocarpus, growing in India. It is thick, opaque and grayish-brown by reflected light, soluble in chloroform and partly so in alcohol, ether and volatile oils, odor balsamic, taste bitter. It contains from 40 to 70 per cent, of a Volatile Oil, a Resin and Gurjtlttic Acid. Dose, uix-Jij, in emulsion, or in capsules. Physiological Action and Therapeutics. The properties of this balsam are similar to those of Copaiba, but it is less disagreeable and less apt to upset the stomach, also less actively diuretic. It has been used with good success in leprosy, given internally in full doses and used locally at the same time. Mixed with 4 parts of Lime-water it is well applied in chronic eczema, lupus and psoriasis. GUTTA-PERCHA ,—is the concrete exudation of Isonan- dra Gutta, a large tree of the nat. ord. Sapotaceae, growing in the Malay peninsula and adjoining islands. Occurs in tough but somewhat flexible pieces, of grayish or yellowish color, plastic 212 H/EMATOXYLON. above 140° F., soft at 2120 F., insoluble in water or alcohol, soluble in chloroform, oil of turpentine, carbon bisulphide, benzin and benzol. It contains a hydrocarbon Gutta, C10Hl8 (80 per cent.), two Resins named Fluavil and Albau, also a volatile oil, salts, fat and coloring matter. Preparations. Liquor Gutta-Percha,—a solution of Gutta-Percha 9, Carbonate of Lead 10, in Chloroformum Venale 91 parts. Used as a protective application to eruptions and slight wounds, the evaporation of the menstruum leaving behind a thin adhesive and non-irritating pellicle. Traumaticine (Unofficial),—is the name given to a 10per cent, solution of Gutta-percha in Chloroform, which forms on drying a permanent, unirri- tating, adhesive, flexible and lion-contractile skin for the treatment of skin affections and slight wounds. It forms an excellent basis for the application of Chrysarobin to psoriasis. Uses. Gutta-Percha has neither physiological action nor therapeutics, being used for its physical qualities alone. In surgical practice it has several applications, making a good material for splints, as it can be softened in hot water and adapted to any surface while pliable. From it are manufactured pessaries, specula, stetho- scopes and other instruments. The solution may be used as a protective covering for excoriations and slight wounds, to prevent pitting in small-pox, and to paint over the line of suture after post-mortem examinations. H./EMATOXYLON, Log-wood,—is the heart-wood of Hcematoxylon campechianum, a tree of the nat. ord. Leguminosae, native of tropical America, but naturalized in the West Indies. It occurs in chips or powder of a dark brown-red color, often with a greenish lustre, of feeble and agreeable odor, taste sweet and astringent, and colors the saliva a dark pink when chewed. It contains tannic acid, and a sweet, crystalline coloring principle named Htzmatoxy/in, C10HuO6, which is colorless when pure, but turns red on exposure to light. Preparations. Extractum Hamatoxyli,—Dose, gr. v-xx. Decoctum Hamatoxyli (Unofficial),—strength i in 17. Dose, ij. Physiological Action and Therapeutics. Logwood is mildly astringent, its properties depending on the tannin contained in it. As it is devoid of irritating qualities it HAMAMELIS. 213 is well adapted to the diarrhoeas and hemorrhages of young chil- dren. It does not produce constipation nor disorder the bowels, but colons the urine and stools blood-red, and has caused phle- bitis. It has been used as an hemostatic in bleeding of the lungs, and hemorrhages from the uterus and intestines, and as an astrin- gent in leucorrhcea. HAMAMELIS, Witch-hazel,—the leaves, collected in autumn, of Hamamelis virginica, a shrub of the nat. ord. Hama- melacese, growing in the United States, having yellow flowers and oval-shaped leaves about 4 inches long, which are inodorous, but of a bitter and astringent taste. They contain about 8 per cent, of tannic acid, a bitter principle and probably some volatile mat- ters, but the chemistry of the plant has not been fully studied. Preparations. Extractum Hamamelidis Fluidum,—Dose, is the only official preparation, and is prepared from the leaves. Hamamelin (Unofficial),—is an uncertain extract of very indefinite com- position. Dose, gr. j-ij. Distilled Extracts, so-called, but really Waters distilled from the bark, are sold by various manufacturers, and are said by the vendors to contain the volatile principles of the plant. Pond's Extract is such a preparation, said to be made by distilling the bark with a very dilute alcohol, and is a proprie- tary medicine of uncertain composition. Physiological Action and Therapeutics. No trustworthy experimentation has yet been made with this drug. It is tonic, astringent, styptic and sedative, owing most of its properties to its tannin, but appears to possess some special influence over the venous circulation similar to that of Aconite on the arterial system. In full doses it may produce severe throb- bing pain in the head. It is used both internally and locally with great benefit in hemorrhoids, particularly those of the bleeding variety, varicose veins and ulcers, varicocele, venous congestions and threatening local inflammations. It is highly recommended in hemorrhages from the nose, stomach, lungs, rectum and kid- neys, threatened abortion, and externally for sprains and bruises, foul ulcers, the pruritus of eczema, leucorrhoea and gonorrhoea. An Ointment of Witch-hazel is found in the shops, and supposi- tories may be prepared extemporaneously by evaporating the fluid extract and incorporating the residue with cocoa-butter. 214 HEDEOMA—HELLEBORUS. HEDEOMA, Pennyroyal,—the leaves and tops of He- deoma pulegioides, a plant of the nat. ord. Labiatse, common to all parts of the U. S., having a four-sided, hairy stem, pale blue flowers, leaves y2 inch long, glandular on the under surface, odor strong and mint-like, taste pungent. Its only important con- stituent is the Volatile Oil, which is official. Preparations. Oleum Oil of Pennyroyal,—is the volatile oil, readily soluble in alcohol. Dose, TRij-x. Spiritus HedeoMj® (Unofficial),—contains 1 part of the oil in 9 of alcohol. Used externally or as spray. Physiological Action and Therapeutics. Hedeoma is a stimulant aromatic, also somewhat carminative and emmenagogue. Its odor is extremely repulsive to insects, especially fleas and mosquitoes. In warm infusion it is a popular remedy for amenorrhoea and flatulent colic. It may be used as a corrective with other medicines, and the spirit is well employed on the hands and face to keep away mosquitoes. The writer has known death by narcosis to result from an overdose of the oil taken to produce an abortion. HELLEBORUS, Hellebore (Unofficial),—the rhizome and rootlets of Helleborus niger (Black Hellebore) and Helleborus viridis (Green Hellebore), plants of the nat. ord. Ranunculaceae, natives of Europe. A third variety, Helleborus occidentalis, growing in Greece, is probably the true Hellebore of the ancients. The rhizome is x to 3 inches long, knotty, with transverse rings, of rancid odor when freshly bruised, and bitter, acrid taste. Its most important constituents are two glucosides, Helleborin and Heilebore'in, both crystalline and very poisonous. Preparations. Extractum Hellebori Nigri (Unofficial),—Dose, gr. j-x, cautiously. Extractum Hellibori Nigri Fluidum (Unofficial),—Dose, niij-xv. Heleeborin, C36H4206 (Unofficial), — crystalline, insoluble in water, soluble in alcohol and chloroform. Helleborein, C26H44015 (Unofficial),—crystalline, very soluble in water, slightly so in alcohol, insoluble in ether. Dose, gr. y'g-xV Physiological Action. Black Hellebore is a drastic, hydragogue cathartic, and an emmenagogue. In overdoses it is a violent gastro-intestinal irri- tant, producing vomiting, hypercatharsis, vertigo, cramps and HUMULUS. 215 convulsions, which may result fatally. Locally applied, the fresh root is violently irritant to the skin, producing inflammation and vesication. Helleborin is an active poison, acting on the tongue like Aconite, and on the nervous system as a narcotic, producing in animals paresis of motion and sensation, cerebral and spinal congestion, dilated pupils and death. It is less irritant than Helleboreiin to the mucous membranes. Helleborein is less actively toxic to animals, but is very irri- tant, producing conjunctivitis, sneezing, salivation, nausea, vomit- ing and purging. It affects the heart like Digitalis, small doses frequently repeated slowing its action, but large ones quicken it and then suddenly paralyze it through the pneumogastric nerve. Respiration is at first accelerated, then slowed and rendered labo- rious. Diuresis is a constant result, the kidneys and uterus are congested, gradual paralysis and severe convulsions follow, and death occurs by paralysis of the heart. Therapeutics. Black Hellebore is an old remedy, having been highly esteemed by the early physicians in insanity, dropsies, worms, cutaneous affections and amenorrhcea. It is at present gone out of fashion, but might be usefully employed in dropsies and as a revulsant in acute cerebral affections. Recently Helleborein has come into notice as a substitute for Digitalis in cardiac affections, as being of less bulk and more definite composition. Its action on the heart is obtained by doses much smaller than those neces- sary for its irritant effects on the gastro-intestinal canal. Its solu- bility in water and the freedom with which it can be used hypo- dermically are important qualities to recommend it. HUMULUS, Hops,—the strobiles (fruit-cones) of Hu- mulus Lupulus, a cultivated creeping plant of the nat. ord. Urti- cacese. They are ovate, i to inch long, and consist of a hairy, undulating axis and several membranous, greenish scales, odor aromatic, taste bitter, aromatic and slightly astringent. Its constituents are wax, resins (50 per cent.), tannin (5 per cent.), a liquid volatile alkaloid Lupuline, a Volatile Oil (2 per cent.) which consists in part of Valerol and Trimethyla7nine, and a crys- talline, bitter principle Lupuluiic Acid (11 per cent.). These, except tannin, are more abundant in the glandular powder of the strobiles, which is named Lupulin. A narcotic alkaloid, said to be almost as powerful as Morphine, has recently been discovered in the wild American hop, and named Hopeine. 216 HYDRANGEA. Preparations. Tinctura Humuli,—strength 20 per cent. Dose, gj-ij. Infusum Humuli (Unofficial),— to the pint. Dose, Lupulinum, Lupulin,—is the glandular powder separated from the stro- biles, of bright brownish-yellow color, aromatic and bitter taste. The Volatile Oil resides in the Lupulin grains, and contains Valerol, which is changed into Valerianic Acid by long exposure, giving a disagreeable odor to old hops. Dose, gr. v-xv. Extractum Lupulini Fluidum,—alcoholic. Dose, sjss-ij. Oleoresina Lupulini,—an ethereal extract. Dose, gr. ij-v. Tinctura Lupulini (Unofficial),—strength yfa. Dose, Physiological Actions. Humulus is a bitter tonic, a feeble hypnotic, and somewhat diaphoretic, astringent and anaphrodisiac. It increases the car- diac action and the cutaneous circulation. After slight cerebral excitement it produces calm and a soporific disposition, espe- cially if the solution administered be strongly alcoholic. The stomachic and tonic effects are due to the bitter principle, lupu- linic acid, and are found in bitter ale. The primary stimulant and secondary sedative effects are due to the volatile oil and are also possessed by ales and beer. Incompatibles. Mineral acids and metallic salts are chemically incompatible with prepara- tions of Hops. Therapeutics. Hops are used as a tonic and calmative in delirium tremens, in which a combination of the tincture with Tr. Capsici is very effi- cient and is an excellent substitute for alcohol. In dyspepsia of atonic form Humulus is an excellent stomachic tonic, and in nervous irritability the fluid extract of Lupulin may be used as a calmative and hypnotic, or the hop-pillow, which certainly exer- cises considerable influence, imaginary or otherwise. A poultice of hops is a favorite domestic application in inflammations and pain. Lupulin has been used with benefit in irritable bladder, alcoholism, and as an anaphrodisiac in the treatment of chordee, gonorrhoea, spermatorrhoea and other affections of the genito- urinary organs. HYDRANGEA (Unofficial),—is the root of Hydrangea arborescens, a plant of the nat. ord. Saxifragacese, growing in the southeastern U. S. It is a white, tough root, having a thin brown bark which peels off in spots, inodorous, taste insipid, HYDRARGYRUM. 217 afterwards pungent. It contains gum, albumen, starch, resin, and a ferrous salt, with other salts. Dose, 3ss~3'j> best in fluid extract. A decoction of the root may be used in doses of 3j-ij. Hydrangea has been long used by the Cherokee Indians in calculous affections, and reports of cases by competent observers show that it is of unquestionable utility in this class of disorders, promoting the removal of gravel from the bladder, and relieving pain during the passage of renal concretions through the ureters. Large doses produce vertigo, oppression of the chest, and con- siderable cerebral disturbance. HYDRARGYRUM, Mercury, Quicksilver, Hg,—is a shining, silver-white metal, fluid and slowly volatile at ordinary temperatures, solidifies at —40° F., boils at 662° F., volatilizes without residue, insoluble in ordinary solvents, wholly soluble in nitric acid, of sp. gr. 13.5, odorless and tasteless. Preparations of Alercury. Hydrargyrum cum Creta, Mercury with Chalk, Gray Powder,—has of Mercury 38, Sugar of Milk 12, Prepared Chalk 50, Ether and Alcohol, tritu- rated together to a uniform gray powder. Dose, gr. ss-x. Massa Hydrargyri, Blue Mass, Blue Pill,—contains of Mercury 33 parts, Liquorice 5, Althaea 25, Glycerin 3, Honey of Rose 34. Each grain contains gr. of Mercury. Dose, gr. ss-xx. Unguentum Hydrargyri, Mercurial Ointment, Blue Ointment,—Mercury 450, Lard 225, Suet 225, Compound Tincture of Benzoin 40, Old Mercurial Ointment 100 parts, triturated until globules of Mercury cease to be visible under a magnifying power of 10 diameters. Emplastrum Hydrargyri, Mercurial Plaster,—Mercury 30, Olive Oil 10, Resin 10, Lead Plaster 50 parts. Emplastrum Ammoniaci cum Hydrargyro,—see ante, page 59. Chlorides and their Preparations. Hydrargyri Chloridum Corrosivum, Corrosive Chloride of Mercury, Bichloride, Mercuric Chloride, Corrosive Sublimate, IIgCl2,—heavy colorless crystals, of acrid, metallic taste, acid reaction, soluble in 16 of water and 3 of alcohol at 590 F., in 2 of boiling water, 1.2 of boiling alcohol and in 4 of ether. Dose, gr. A- ... _ _ . .. Hydrargyri Chloridum Mite, Mdd Chloride of Mercury, Subchloride, Mercurous Chloride, Calomel, IIg2Cl2,—a heavy, white, impalpable powder, insoluble in water, alcohol or ether, odorless and tasteless. Is an ingredient of Pil. Antimonii Co. and Pil. Catharticse Co. Dose, gr. 2\-x. Hydrargyrum Ammoniatum, Ammoniated Mercury, White Precipitate, Mercur-ammonium Chloride, NH2HgCl,—is a white, insoluble powder, odor- less and tasteless. Only used externally. Unguentum Hydrargyri Ammoniati, White Precipitate Ointment,—Am- moniated Mercury 10, Benzoinated Lard 90 parts. 218 HYDRARGYRUM. Oxides and their Preparations. Hydrargyri Oxidum Flavum, Yellow Oxide of Mercury, Precipitated Oxide, HgO,—an orange-yellow, heavy, impalpable powder, odorless and tasteless, insoluble in water or alcohol, but wholly soluble in nitric or hydro- chloric acid. Used to prepare: Unguentum Hydrargyri Oxidi Flavi,—strength i to 9 of Ointment. Oleatum Hydrargyri,—Yellow Oxide 10, Oleic Acid 90. Hydrargyri Oxidum Ruhrum, Red Oxide of Mercury, HgO,—a heavy, orange-red crystalline powder, having the same properties as the yellow oxide, from which it differs only in being crystalline and not in such a minute state of subdivision. Dose, gr. -fa-Jxv Unguentum Hydrargyri Oxidi Rubri,—strength 1 to 9 of Ointment. Iodides and their Preparations. Hydrargyri Iodidum Rubrum, Red Iodide of Mercury, Biniodide, Mer- curic Iodide, Hgl2,—a scarlet-red, crystalline powder, almost insoluble in water, soluble in 130 of alcohol, in solution of iodide of potassium or of mer- curic chloride. Prepared by double decomposition between Iodide of Potas- sium 11 parts and Mercuric Chloride 9 parts. Dose, gr. 3^-^. Liquor Arsenii et Hydrargyri Iodidi, Solution of Iodide of Arsenic and Mercury, Donovan’s Solution,—see ante, page 85. Hydrargyri Iodidum Viride, Green Iodide of Mercury, Protiodide, Mercurous Iodide, Hg2T2,—a dull green or greenish-yellow powder, insoluble in alcohol or ether and almost so in water. Dose, gr. y^-J. Acid Combinations and their Preparations. Liquor Hydrargyri Nitratis, Solution of Mercuric Nitrate,—a liquid containing in solution about 50 per cent, of Mercuric Nitrate, Hg(NOs)2, with some free Nitric Acid. Prepared from the Red Oxide of Mercury 40, by Nitric Acid 45, and Distilled Water 15 parts. Used as a caustic. Unguentum Hydrargyri Nitratis, Citrine Ointment,—prepared by dis- solving Mercury 7, in Nitric Acid 17, and adding Lard Oil 76. Hydrargyri Subsulphas Flavus, Yellow Subsulphate of Mercury, Basic Mercuric Sulphate, Turpeth Mineral, Hg(Hg0)2S04,—a heavy, lemon-yellow powder, insoluble in water or alcohol, soluble in nitric acid and in 20 parts of hydrochloric acid without residue. Dose, as an emetic, gr. ij-v. Sulphide and Cyanide. Hydrargyri Sulphidum Rubrum, Red Mercuric Sulphide, Cinnabar, HgS,—Red, crystalline masses, or a fine, scarlet powder, insoluble in ordinary solvents, but soluble in nitro-hydrochloric acid with separation of sulphur. Used only for mercurial fumigation. Hydrargyri Cyanidum, Mercuric Cyanide, Hg(CN)2,—colorless, pris- matic crystals, of bitter, metallic taste, soluble in 12.8 of water and in 15 of alcohol at 590 F. Dose, gr. Triturations. These may be prepared according to the general formula under “ Tritui'a- tiones ” in the Pharmacopoeia, 10 parts of the substance to 90 of Sugar of Milk. Mercury itself or any of its salts may be so treated with excellent HYDRARGYRUM. 219 results, the particles being much finer and therefore more easily absorbed than if rubbed up with any other agent. Unofficial Preparations. Lotio Hydrargyri Flava, Yellow Wash,—prepared by adding Corrosive Sublimate gr. xviij to Lime-water 3jx, producing the yellow oxide, a favorite application for syphilitic sores. Lotio Hydrargyri Nigra, Black Wash,—prepared by adding Calomel gr. xxx, to Lime-water producing the black oxide, and used as an appli- cation to syphilitic sores. Unguentum Hydrargyri Nitratis Rubrum,—Red Ointment of Mer- curic Nitrate, Brown Citrine Ointment,—differs from the official ointment only in being made with Cod-liver Oil, which gives it a brown color, and a more agreeable odor. Physiological Action. Mercury is tonic, purgative, alterative, antiphlogistic and sorbe- facient, but not directly cholagogue. Some of its salts are corro- sive poisons, others are local caustics, all produce by long-con- tinued administration the peculiar cachexia termed Hydrargyrism. The metal itself is inert, but by combination with the acids and fluids of the body becomes active, and is easily absorbed in any form, passing into the blood from the skin, mucous membranes, lungs and stomach, in each case probably as an Oxyalbuminate of Mercury. Entering the stomach .in any form it is first con- verted into a double Chloride of Sodium and Mercury, then uniting with the albuminous juices to form a complex molecule of Mercury, Sodium, Chlorine and Albumen, which being soluble in an excess of sodium chloride or albumen, exists in solution, and is easily absorbed, being decomposed in the blood and changed to the oxyalbuminate. Entering the intestines a purga- tive action is soon set up, of more or less severity according to the preparation used, a small portion only is absorbed, the rest being converted into a Sulphide and excreted with the faeces, unless combined with opium which delays its progress through the intestines and permits of its greater absorption. In the blood its effects are tonic in small doses, but in quantity it indirectly produces impoverishment thereof, impairs the ozonizing function, diminishes the red corpuscles, and consequently disorders nutri- tion and deranges digestion. From the blood it enters the tissues, where it remains for an indefinite period, exerting a pe- culiar influence, termed “alterative” on all processes character- ized by growth of young cells, but not producing any definite anatomical changes either in the viscera or the nervous tissue, though in the latter a low form of inflammation arises, resulting in loss of coordination-power. It stimulates most of the glands 220 HYDRARGYRUM. of the body, especially the salivary glands and the pancreas, to the production of pathological secretions, and is excreted with com- parative slowness by all the secretory organs, being found in the saliva, sweat, milk, urine and bile. It tends to accumulate in the liver, while stimulating its cells, and is not cholagogue, though stimulating the flow of bile already secreted by reflex action on the bile-ducts due to its direct purgation of the duodenum. Its excretion is hastened and completed by the use of the iodide of potassium. In small doses administered for a short time the mercurial preparations are blood-tonics, improving its general condition, increasing the number of red corpuscles and the body weight. They soon begin to promote waste by stimulating the lymphatic system, and if the small doses are long continued or the quantity is increased, symptoms of mercurial poisoning begin to manifest themselves. The first symptoms of Hydrargyrism are fetid breath, swollen and spongy gums having a bluish line along their margins, stoma- titis, sore and loosened teeth, inflamed and tender salivary glands pouring out a peculiar, thin saliva of foul odor in large quantity, and a metallic taste in the mouth. Anorexia, diarrhoea and fever follow, also ulceration and in some cases even gangrene of the lips and tongue. If the use of the drug be continued nutrition will be greatly impaired through the extreme promotion of ret- rograde metamorphosis, and various nervous disturbances will follow, the effects being emaciation, pallor, oedema, ulcerated skin, erythematous, vesicular or pustular eruptions, headache, insomnia, neuralgia, tremor through paresis of the muscles of the head and extremities, epilepsy, coma and convulsions. In preg- nant women abortion will occur by reason of the impoverishment of the blood. Indeed, as Dr. Ringer said in the earlier editions of his Handbook of Therapeutics, the phenomena produced by mercury are singularly similar to those which will result from syphilis, and the serious symptoms known as secondary and ter- tiary syphilis can be produced both by syphilis and by mercury. The drug is probably a true vital antidote against the syphilitic virus, and is capable of bringing about a radical cure of the dis- ease, if introduced into the system in considerable quantity and its use protracted over a very long time, the action of the drug in all cases being kept short of ptyalism or any pronounced physio- logical effects. Salivation is most readily produced by Blue Mass, next by Calomel, and less easily by Gray Powder. Individuals differ greatly in their susceptibility to the action of mercury, some per- HYDRARGYRUM. 221 sons having been affected after a single moderate dose. Children are not easily salivated. Inhalation of mercurial vapors is apt to affect the nervous system most, its internal administration and that by inunction are more likely to produce salivation. The observations on the antiphlogistic and sorbefacient actions of Mercury are clinical rather than physiological, but it is gen- erally agreed that exhibited in inflammation mercurials antagonize the increase of the hsemic fibrin which is so constant an effect of the inflammatory process, and that in chronic diseases attended by the formation of semi-organized deposits, a mild mercurial course will almost insensibly remove the new-formed material. A not uncommon result of full doses of Blue Pill is an acute coryza of very severe character, which the writer has frequently observed to follow on neglect of the old-fashioned precaution to “ work off” the mercurial by a saline cathartic. The symptoms produced are those of a severe attack of influenza, epistaxis, con- junctivitis and obstinate muco-purulent discharge from the nasal passages being especially marked. Similar effects have been observed during physiological experiments with mercury on ani- mals by Overbeck and Bennett. Notes on the Action of the Preparations. Metallic Mercury is not used internally except in the finely- divided form obtained in Blue Pill and Gray Powder, which are capable of producing all the effects above described. Mercurial Ointment is the preparation generally used for inunction, a piece the size of a small nut being daily rubbed into the soft skin at the flexures of joints. The Oleate painted over the surface is a more cleanly method of making the same application. Both these preparations are efficient parasiticides. The Bichloride is the most actively toxic of the mercurial salts. It is probably the most active zymoticide and parasiticide, a solution of i part in 2000 being efficiently antiseptic for use as injections or dressings, and one of 1 to 250 being the usual strength for use against epizoa and parasitic skin affections. It is a very active gastro-intestinal irritant, in toxic dose producing nausea, retching and vomiting, a metallic taste, constriction of the fauces, burning pain in the stomach, suppression of urine, bloody diarrhoea, collapse and death often preceded by convul- sions. It affects specifically the lower bowel [Calomel preferring the upper intestine], and produces inflammation and ulceration of the rectum. It is, however, one of the most manageable and efficient of the mercurials when used in proper doses. The Subchloride (Calomel) is very insoluble and unirritating, 222 HYDRARGYRUM. tasteless, laxative in grain-doses, decomposed by the alkaline con- tents of the intestines, the Oxide of Mercury being formed, and acts especially on the excrementitious glandular appendages of the upper intestine, stimulating the liver by indirect reflex action as a duodenal purgative. In the presence of alkaline chlorides it is converted into the Bichloride, but not in sufficient quantity to render it dangerous in the gastro-intestinal canal. Externally applied it is very sedative to the mucous membranes and the skin. Ammoniated Mercury is an Ammonio-Chloride, and a useful stimulant and parasiticide when used locally in the form of oint- ment. The Iodides are actively poisonous, the Red being much the most irritant, in overdoses producing symptoms and results very similar to those caused by the Bichloride. The Cyanide is also actively poisonous. The Yellow Subsulphate is a prompt and usually harmless emetic, but has occasionally produced fatal re- sults by local irritant action. The Oxides are irritant, the Red being the most so, and are rarely used internally. The Acid Nitrate is a good escharotic, the pain caused by it being tran- sient though severe, and its caustic action being comparatively superficial. The Ointment of the Nitrate (Citrine Ointment) is more irritant than that of the Ammoniated Mercury, and gener- ally needs dilution. All these preparations may produce the constitutional effects of mercury, and their administration should be carefully watched for the first symptoms of mercurialization. Antidotes and Incompatibles. Albumen in some form, the white of one egg to gr. iv of the bichloride, forms the albuminate, which must be at once evacuated by emesis or the stomach-pump, as it is soluble in excess of albumen or in the alkaline con- tents of the intestines. The Chlorides are incompatible with very many agents, and the Bichloride should be administered in distilled water or pill by itself, being easily decom- posed. The combination of Calomel with Hydrochoric Acid or Chlorides is apt to produce Corrosive Sublimate. In the “ mixed treatment ” of syphilis, a mercurial is combined in solution with Iodide of Potassium, and the Red Iodide is the preparation usually selected, as the Bichloride is decomposed by the Potassic Iodide, Red Iodide of Mercury being precipitated. All trouble regarding incompatibility can be avoided by using sugar of milk triturations according to the general official formula. In this form, says Piffard, “ a larger proportion of the drug is utilized for specific purposes, while but a small amount remains to give rise to local irritation.” Therapeutics. Mercury is undoubtedly a specific in syphiliq but is not appli- cable to the tertiary form of that disease. It is best administered HYDRARGYRUM. 223 in very small doses carefully watched and stopped just short of ptyalism, but renewed and so continued for a long time. Fumiga- tion by Calomel volatilized by heat, or inunction by the Oleate or by Mercurial Ointment may be used when the stomach will not bear any mercurial. The hypodermic method is also used, employing a solution of the Bichloride gr. j each of glycerin and distilled water, of which the dose is mx once daily ; or the Albuminate in solution with Sodium Chloride. The Green Iodide in doses of gr. to thrice daily with Opium is the best preparation for internal use. Accuracy of diagnosis is an absolutely necessary preliminary to the administration of Mercury, for where there is no syphilitic virus to be antagonized the constitutional effects of mercurials will become manifest sooner and may do great harm in feeble subjects, besides the risk of mistaking them for the results of the disease supposed to be present. Tonsillitis, parotitis and other acute glandular inflammations of the throat and neck may often be rapidly cured by Calomel gr. or Gray Powder gr. 4 every two hours. In irritable stomach with obstinate vomiting the same small doses of Calomel every half hour are very efficient. The dysentery of adults with slimy and bloody stools is best treated by small doses (gr. of the Bichloride, and in the diarrhoea and dysentery (ileo-colitis) of infants Gray Powder gr. 4 or Calomel gr. will be found very effective. In gastric ulcer and in the first stage of hepatic cirrhosis, the Bichloride in doses of gr. to thrice daily is a good remedy. Typhoid fever is treated in Germany by daily doses of Calomel, gr. x, for three days as an antipyretic. Diph- theria is by many practitioners considered to be best antagonized by Calomel in large doses, and in this affection the Cyanide has many advocates, given in doses of gr. T^5—5V every hour, a weak solution being at the same time used as a gargle. Asiatic cholera is frequenly treated by small, repeated doses of Calomel with Opium from the start. Inflammations of sthenic character in the stage of exudation, especially when affecting serous membranes, are considered by many authorities to be best met by the free use of mercurials, but this treatment is fast going out of favor, excepting in cases of iritis, which, however, is very often of syphilitic causation, and pneumonia, which is frequently treated according to the best American authorities with sedative doses (gr. xv-xx) of Calomel. In the general condition known as “biliousness,” manifested by whitish or clay-colored stools, constipation, nausea, anorexia, coated tongue, slight jaundice, etc., mercurial purgatives have long been a routine remedy, but mild saline purgatives are by 224 HYDRASTIS. many authorities considered equally efficient. As an antiseptic to the gastro-enteric tract in many forms of stomach and intesti- nal disorders (dyspepsia septica), the administration of minute doses of the Yellow Oxide of Mercury will be found remarkably efficient. It is best used in trituration with sugar of milk, 1 to 1000, and in daily doses of gr. 5V By the use °f these small doses failing digestion and nutrition may almost certainly be improved. In membranous laryngitis or true croup the Subsulphate as an emetic is by many considered to have some specially beneficial influence. Locally, an ointment of Calomel 3j to 3j of Lard is an excellent antipruritic, and ointments of the Chlorides and Iodides are much used in skin diseases, particularly psoriasis, herpes, acne, and pityriasis. In parasitic affections a lotion of the Bichloride, gr. ij to %j of distilled water, or a 5 per cent. Oleate with }£t\\ part of Ether, are very efficient. The Oleate is a serviceable application to syphilitic indurations, but is not deemed advisable when ulceration exists. In conjunctivitis Calomel may be used as a sedative application, or still better an Ointment of the Yellow Oxide, gr. x to jfj of Vaseline, triturated to the utmost fineness before mixing. Goitre and enlarged spleen are often speedily reduced by rubbing into the skin covering them the Ointment of the Red Iodide somewhat diluted and applied before a hot fire or in the direct sunlight. The Acid Nitrate Solution is one of the best caustics for destroying chancroid and syphilitic warts and vegetations. Black and Yellow Wash are used as applica- tions to syphilitic erosions and ulcerated indurations. As an antiseptic injection or application to dressings a solution of the Bichloride, gr. vijss in a quart of hot water (JUViy)> is prob- ably the most efficient that can be used, and still weaker solutions (rdta) are sufficiently antiseptic for most purposes. HYDRASTIS, Golden Seal,—the rhizome and rootlets of Hydrastis canadensis, a small plant of the nat. ord. Ranunculacese growing in most parts of the U. S. The rhizome is i y2 inch long, rough, bent and branched, externally of a yellowish-gray color, internally a bright reddish-yellow, having numerous thin, brittle rootlets, a slight odor and a bitter taste. It contains an unnamed Resin and 3 alkaloids, Hydrastine, C22H23N06, white and crystalline, soluble in alcohol, ether, etc., Berberine, C20HnNO4, yellow crystals soluble in hot water and alcohol, but not in ether (see page 100), and Xanthopuccine, also yellow and crystalline. All these alkaloids unite with acids to form salts. HYDRASTIS. 225 Preparations. Extractum Hydrastis Fluidum,—Dose, iriv-xxx. Tinctura Hydrastis,—strength 20 per cent. Dose, £ss-ij. Hydrastin (Unofficial),—an impure extract precipitated by Hydrochloric Acid from the alcoholic solution, chiefly consisting of Muriate of Berberine. Dose, gr. ij-v. Physiological Action. Hydrastis is a simple bitter and a stomachic tonic. It pro- motes appetite and digestion and increases the secretions of the gastro-intestinal tract and the flow of bile, but if long used it will derange digestion and produce constipation. It is possessed of antiperiodic powers, and is a protoplasmic poison, arresting the movements of the white blood-corpuscles. By many observers it is also considered alterative to the mucous membranes, deob- struent to the glandular system, cholagogue, diuretic and anti- septic. The alkaloid Hydrastine produces effects on the nervous system somewhat similar to those caused by Quinine, but seems to be devoid of toxic power, large doses only producing a sense of warmth in the epigastric region, and noises of a rushing character in the ears. Incompatibles. Tannic Acid, Hydrochloric Acid and the Alkalies are chemically incom- patible with preparations of Hydrastis. Therapeutics. Hydrastis is chiefly used as a stomachic tonic, an antiperiodic, a mild laxative and an antiseptic. Its alkaloid (Hydrastine) and extract (Hydrastin) are ranked high in the treatment of inter- mittents and chronic malaria, though much less efficient than Quinine. It is an excellent remedy locally and internally in all forms of catarrh, especially that of the stomach, duodenum, gall- ducts, bladder, uterus and vagina. Internally it is efficient in many glandular swellings, in chronic constipation due to a slug- gish state of the liver or deficiency of the other intestinal secre- tions, in chronic dyspepsia, and as a substitute for alcohol in dipsomaniacs when a catarrhal state of the stomach has been in- duced. In gonorrhoea, gleet, and chronic nasal catarrh it is locally employed with much benefit, also in syphilitic affections of the mouth, throat and nares. As a local alterative and anti- septic application it is highly recommended for unhealthy ulcers and sores, cancerous ulcerations, mercurial and aphthous stoma- titis, rectal fissure, fistula and prolapse, internal and external hemorrhoids, cracks, fissures and abrasions of the nipples, erosion and ulceration of the cervix uteri, and in conjunctivitis with 226 HYDROCOTYLE—HYOSCYAMUS. muco-purulent discharge. In gonorrhoea a very efficient injection is an infusion of Hydrastis, 5j of the powdered root to |viij of boiling water, or the fluid extract diluted in the proportion of 3ss or 5j to the pint of water, but it should not be used until the acute stage has subsided. HYDROCOTYLE, Pennywort (Unofficial),—is the leaf of Hydrocotyle asiatica, a small plant of the nat. ord. Umbelli- ferse, a native of southern Africa and India. It contains a pecu- liar, oleaginous substance Vellarine, which has a bitter, persistent taste, and is thought to be the active principle. It has long been used in its native countries as an alterative to purify the blood, and has lately been found of great service in eczema, lupus, pso- riasis, syphilitic and scrofulous sores, and in leprosy. An ounce of the dried plant or leaves is given daily in infusion. It causes great itching over the whole body, ovarian pain in females, and urinary irritation. In one case in which the drug was being given for lupus of the hand a severe orchitis was set up without any other apparent cause. It certainly exerts a markedly special in- fluence on the genito-urinary tract. HYOSCYAMUS, Henbane,—the leaves, collected from plants of the second year’s growth, of Hyoscyamus niger, a bien- nial plant of the order Solanacege, growing in Europe and the northern U. S. The leaves are ovate, often io inches long and 4 broad, of grayish-green color, glandular-hairy, midrib promi- nent, odor heavy and narcotic, taste bitter and acrid. It con- tains an alkaloid Hyoscyamine, C17H23NOs, which is isomeric with Atropine and identical with Daturine and Duboisine, occurring as an oily liquid or in tufted crystals of silky lustre and yellow color, soluble in hot water, alcohol or ether. Another substance, Uyoscine, is by some authorities considered a derivative of Hyos- cyamine, by others a second alkaloid. It is semi-liquid, isomeric with Atropine, and yields Tropic Acid and Pseudotropine. Hyos- cyamus leaves also contain a fatty Oil and much Potassic Nitrate, while from their destructive distillation an empyreumatic Oil is obtained which is a powerful narcotic. Preparations. Abstractum Hyoscyami,—Dose, gr. iij-v. Extractum Hyoscyami Alcoiiolicum,—Dose, gr. j, when active. Extractum Hyoscyami Fluidum,—Dose, ruv-xx. HYOSCYAMUS. 227 Tinctura Hyoscyami,—strength 15 per cent. Dose, jj-iv; as a hypnotic is necessary. All the preparations of Hyoscyamus are uncertain in strength and in ac- tivity, so much so that the effective dose of the extract.(no longer official) ranged from 2 to 250 grains. Hyoscyamine Sulphas, Sulphate of Hyoscyamine (CnH23N03)2.H2S04, —occurs in small, yellow scales or crystals, which are deliquescent, of bitter taste, and very soluble in water and in alcohol. It varies much in purity of the base and consequently in activity. A grain of the commercial article, which was formerly very impure, has been given with impunity, but gr. of the pure alkaloid has produced violent poisoning. Dose, hypodermically, should not exceed gr. g*5; by the mouth gr. maybe given in urgent cases. Hyoscyamine of good quality is difficult to procure and is very expensive, while Duboisine is easily obtained in any quantity, so that if these alkaloids prove to be physiologically as well as chemically identical as is now claimed, the latter will be used to the exclusion of the former. Hyoscine Hydrobromas, Hydrobromate of Hyoscine (Unofficial),— Merck’s is the only reliable preparation on the market. Dose, hypoder- mically, gr. ; by the mouth gr. -fo-fo. Physiological Action. Hyoscyamus has similar action to that of Belladonna, Duboisia and Stramonium, except that it is the least powerful and irritant of the group, but the most calmative and hypnotic. The delirium produced by it is never furious and is without hypergemia, but is accompanied by insomnia. It is more stimulant to the vaso- motor system and to the cardiac accelerator apparatus than is Stramonium, but is less active on the pneumogastric. It has decidedly laxative and carminative effects on the intestines and a very marked sedative influence on the urinary passages. Hyoscyamine corresponds in action to the plant and its con- geners, being considered by many authorities as almost identical with Atropine, but less powerful. No death has directly resulted from it. Except in very large doses it is more an anodyne or anaesthetic than a narcotic or soporific. It is a mydriatic, ex- cites the cerebral functions and depresses the spinal. Many observers deny that it has any soporific influence. Hyoscine is a powerful hypnotic, lowers the pulse-rate and lessens the frequency of the respirations. It especially affects the motor tract of the spinal cord and the cerebral cortex, slightly depresses the heart, but paralyzes respiration. It is free from irritant qualities and may be used hypodermically. Its habitual use brings on muscular paralysis and delirium of violent charac- ter. It is coming into use as a hypnotic by alcoholics and ner- vous subjects, and will probably ere long be responsible for many deaths. As a mydriatic its reputation is doubtful, some observers claiming greater power for it in this respect than that of Atro- 228 ICHTHYOCOLLA. pine, while others say that mydriasis may follow its use but is not always produced by even large doses. Antagonists and Incompatibles. These are the same as for Belladonna (see ante page 97). Liquor Potassse though incompatible is frequently prescribed in combination with Hyoscyamus. All the fixed caustic alkalies decompose its alkaloid as also those of the allied plants. Therapeutics. Hyoscyamus is a valuable narcotic and is chiefly used as a hypnotic and anodyne when Opium is contraindicated, and for children. It is by far the best agent to use in acute mania with high motor excitement, obstinate insomnia and varied hallucina- tions. Chronic mania has been more benefited by it than by any other drug, and it is very efficient in insanity characterized by frequent delusions. In delirium tremens and the delirium of fevers it is an excellent hypnotic, and the monomania of hypo- chondriacs is alleviated and often cured by it. Whooping-cough, nervous coughs, and especially a dry, tickling night-cough, are greatly alleviated by full doses of Hyoscyamus. It is also efficient in colic of various forms, to palliate the trembling of paralysis agitans and mercurial tremor, and to relieve the pains and disor- dered coordination of locomotor ataxia. In constipation it is a good remedy, the extract being much employed in combination with other purgatives to render them more efficient and less drastic, but the quantity used is generally too small to be of any particular benefit. Tire tincture is an efficient remedy in irrita- bility of the bladder from any cause. Hyoscyamine may be used for the same purposes as Atropine, but being liable to considerable variation in purity and activity, it is not a popular agent with the profession. Hyoscine has been used in neuralgia, whooping-cough, in- somnia from cerebral excitement, delirium tremens, asthma and enteralgia, also in ophthalmic practice as a mydriatic. Doses of gr. tV are given by the stomach, gr. hypodermically. ICHTHYOCOLLA, Isinglassis the swimming-bladder of Acipenser Huso, and of other species of Acipenser (Sturgeon). It occurs in horny sheets, semi-transparent, iridescent, soluble in 24 parts of boiling water, forming on cooling a transparent jelly. It is the purest form of Gelatin known. IGNATIA. 229 Preparation. Emplastrum Court Plaster,—consists of Isinglass io, Gly- cerin i, Alcohol 40, Water and Tincture of Benzoin, spread on taffeta and allowed to dry. Physiological Action and Therapeutics. Isinglass is slightly nutritious, but has no advantage over any other form of gelatin. It is used for clarifying liquids, and in solution as a test for tannin. The plaster is a common protective application. IGNATIA, St. Ignatius’ Bean,—is the seed of Strychnos Ignatii, a small tree of the nat. ord. Loganiacese, native in the Phillipine Islands, and also called Ignatia Amara. The seed is about an inch long, ovate, irregularly angular, hard and horny, enclosing an irregular cavity containing an oblong embryo, in- odorous, taste very bitter. It contains the alkaloids Strychnine and Brucine, about i per cent, of each, for a description of which see the title Nux Vomica. Preparations. Abstractum Ignatiy,—Dose, gr. ss-j. Tinctura Ignatial,—strength io per cent. Dose, uiij-x. Physiological Action. Ignatia closely resembles Nux Vomica in action, a poisonous dose producing the same exaltation of the spinal functions, mus- cular writhing, tetanic spasms, and death by asphyxia through tetanic fixation of the respiratory muscles, but containing a greater quantity of Strychnine than the latter it is more powerful in the same dose. It especially exalts the susceptibility of the sensory neves, and of the nerves of special sense, for a time, but an opposite condition soon succeeds, manifested by numbness and torpor with great mental depression. It causes a feeling of constriction about the throat and a sensation of intense anguish at the pit of the stomach. Its antagonists and incompatibles are the same as for Nux Vomica. Therapeutics. Ignatia is recommended for hysteria, to control the general hyperaesthesia, insomnia, clavus hystericus, mental excitement or depression, aphonia, diseased appetite, convulsive crying or laugh- ing, etc. It will often remove the intercostal neuralgia of hys- 230 ILLICIUM—INULA. terical subjects and the sensation as of a ball rising to the throat (globus hystericus). Cerebro-spinal irritability is diminished by small doses though excited by large ones, Ignatia being probably the most efficient controller of functional phenomena of the cere- bro-spinal axis. In the convulsions of children from intestinal irritation without cerebral congestion, and in insomnia from ner- vous erethism, small doses of Ignatia are used with the happiest results. It is by many practitioners preferred to Nux Vomica as a stomachic tonic, and is useful in the treatment of dyspepsia, hypochondriasis and various nervous affections. ILLICIUM, Star Anise, —is the fruit of Illicium anisatum, an Asiatic shrub of the nat. ord. Magnoliacese, and is formed by 8 boat-shaped carpels arranged in a star-shaped whorl around a central axis which is the top of the stalk. Each carpel contains a single seed, flat, oval, glossy, and of a brownish-yellow color. It contains a Volatile Oil which is chemically and practically iden- tical with the Oil of Anise. Another species, Illicium religiosum, is very poisonous, causing vomiting, epileptiform convulsions, dilated pupils and cyanosed countenance. Its carpels are more woody, shrivelled and wrinkled, and end in a curved beak. Illi- cium is recognized officially as a source of the Oil of Anise, and has similar actions and uses to those of Anisum (see ante, page 68). INULA, Elecampane,—is the root of Inula Helenium, a plant of the nat. ord. Compositge, growing in Europe and N. America. It occurs in slices or sections, externally grayish-brown, internally white, fleshy and full of resin cells, of peculiar, aro- matic odor, pungent and bitter taste. It contains a volatile oil, a resin, a crystalline substance named Helenin, C6H80, and a peculiar principle resembling starch, Inulin, C„H]0O5, which is found in Arnica, Taraxacum and other plants. Having the same chemical composition as starch, Inulin differs from the latter in being colored yellow by iodine, and depositing from its solu- tion in hot water as the solution cools. It is contained in Ele- campane in large quantity, from 19 to 44 per cent., the latter in autumn. There are no official preparations, but a decoction (3ss to Oj) may be given in doses of 3j-ij. Dose of the powdered root, gr. xx—3j. Physiological Action and Therapeutics. Inula is a gentle stimulant to the secretory organs, and is said to be expectorant, diaphoretic and diuretic. In large doses it IODUM. 231 causes nausea and vomiting. It was formerly supposed to be emmenagogue and was much used in amenorrhcea. It is now chiefly employed as a domestic remedy in chronic bronchitis and dyspepsia, and to promote the eruption in exanthematous fevers. IODUM, Iodine, I, —-is a non-metallic element, existing in sea-weed, sea-water, some fresh waters and fresh-water plants, also in sponge, oysters, eggs, cod-liver oil, rock salt and several ores. It occurs in bluish-black rhombic plates, of metallic lustre, peculiar odor, acrid taste and neutral reaction, sparingly soluble in water (i in 7000), readily so in ether, and in 11 of alcohol at 590 F., also in a solution of potassic iodide or sodic chloride. It volatilizes slowly at ordinary temperatures, and produces a dark-blue color with gelatinized starch in a cold solution. Inter- nally it is generally administered in the form of an Iodide or as the Compound Solution of Iodine. Dose, gr. ss-j. Preparations of Iodine. TiNCTURA IoDI,—strength 8 per cent. Dose rrtj-v, but it is generally used as a local application or for injection into cavities. Liquor Iodi Compositus, Lugol’s Solution,—is a Solution of Iodine 5 and Iodide of Potassium 10 in Distilled Water 85 parts. Dose, mj-x, well diluted. Unguentum Iodi,—has of Iodine 4, Iodide of Potassium 1, Water 2,Ben- zoinated Lard 93 parts. Amyi.um Iodatum, Iodized Starch,—consists of Starch 95, Iodine 5, Dis- tilled Water q. s. ad 100 parts, triturated together, dried, amd rubbed to a fine powder. Intended to enable Iodine to be given without irritating the stomach. Dose, gj-gj. Iodized Phenol, Carbolate of Iodine (Unofficial),—a mixture of Iodine and crystallized Carbolic Acid in varying proportions, generally 1 of the former to 4 of the latter, for local use. Iodides and their Preparations. Ammonii Iodidum, NH4I,—a deliquescent, granular, white salt, soluble in I of water and in 9 of alcohol at 590 F. Dose, gr. ij-x. Potassii Iodidum, KI,—a colorless, deliquescent, crystalline salt, of saline and bitter taste, soluble in 0.8 of water and in 18 of alcohol at 590 F. Dose, -gr- v~3j- Unguentum Pot assn Iodidi,—has of the Iodide 12, Hyposulphite of Sodium 1, Boiling Water 6, Benzoinated Lard 81 parts. Sodii Iodidum, Nal,—deliquescent, minute crystals, soluble ino.6of water and in 1.8 of alcohol. Dose, gr. v-zij. Iodoformum, Iodoform, Iodide of Formyl,—small lemon-yellow crystals, of saffron-like and penetrating odor, unpleasant and iodine-like taste, sp.gr. 2000, soluble in 80 of alcohol at 59° F-, and in chloroform, ether, benzol, benzin, carbon bisulphide, fixed and volatile oils, not perceptibly soluble in water. Its solutions have a neutral reaction. To remove its odor without 232 IODUM. forming a compound the best agents are Thymol (gtt. ij ad Oil of Mir- bane (gtt. vj ad gr. xv), Oil of Bitter Almonds, or Oil of Rose (gtt. j ad 3]). Dose, gr. j-v. . . Unguentum Iodoformi,—Iodoform, finely pulverized, 10, Benzoinated Lard 90 parts, thoroughly mixed by trituration. Other Iodides and preparations thereof are—Argenti Iodidum, Arsenii Iodidum, Liquor Arsenii et Hydrargyri Iodidum, Hydrargyri Iodidum Ru- brum, Hydrargyri Iodidum Viride, Syrupus Ferri Iodidi, Pilulae Ferri Iodidi, Plumbi Iodidum, Sulphuris Iodidum and Zinci Iodidum. As these prepa- rations are allied in action and uses less to Iodine than to the other elements in their composition, they are described under other titles. (See Argentum, Hydrargyrum, etc.) The Iodide of Ethyl or Hydriodic Ether is described under Hither (see ante page 43.) Preparation of Hydriodic Acid. Syrupus Acidi Hydriodici,—contains 1 per cent, of absolute Hydriodic Acid, HI. Dose, 3j-iv, well diluted. Physiological A ction. Iodine is irritant to the mucous membranes and to the skin. Applied to the latter it stains a deep yellowish-brown color and combines with the albumen of the tissue, causing considerable pain and subsequent exfoliation of the epidermis. Vesication maybe quickly produced if the quantity used be large. Inhaled its vapor irritates the respiratory mucous membrane, producing sneezing, cough, dyspnoea, also pain in the chest and over the frontal sinuses. In the gastro-intestinal canal it is equally irri- tant, but is gradually converted into the iodide or iodate of sodium, in which form or as an albuminate it is absorbed into the blood. Iodine decomposes organic molecules, and in the presence of phosphoretted or sulphuretted gases it acts like chlorine but more feebly, uniting with their hydrogen and thus breaking up these noxious compounds it is disinfectant and deodorant. The Iodides of Sodium, Potassium, etc., are very diffusible and are as rapidly excreted; setting free nascent oxygen (Ozone) and Iodine at the points of their elimination, they are remotely irritant to the mucous membranes, setting up violent coryza, with soreness of the throat, acute conjunctivitis, profuse mucous dis- charges, headache and irritation of the kidneys and the skin. If used for any length of time they induce great waste and rapid elimination of waste products, causing anaemia, emaciation and mental depression. They combine with certain poisons in the sys- tem, particularly Lead, Mercury and the products of the syphilitic disease, hastening their elimination. Iodism is the term applied to the general condition produced by these agents, and comprises the symptoms above noted together with frontal headache, ptya- IODUM. 233 lism, a saline taste in the mouth, dysphagia, temporary impotence, and an acneform eruption on the face and limbs. Sometimes the eruption is furuncular or even purpuric. Copiously diluting these salts with water promotes their excretion and to a great extent prevents the development of these results. Iodoform contains from 94 to 97 per cent, of Iodine and naturally resembles the latter in action. Locally its action is anaesthetic and powerfully antiseptic. It is the best agent to pre- vent decomposition and to destroy the germs of putrefaction and of disease, but must be carefully employed, as when used in quantity on an extensive raw surface it has often produced fatal results with symptoms of narcotic poisoning. The first sign of its dangerous absorption is increase of temperature, which may reach 104° or more, then headache, quick and feeble pulse, marked anxiety and restlessness, and suddenly collapse and death may supervene. The quantities which have produced fatal results from local absorption have varied from 525 to 4500 grains. In small doses internally it is considered to be a tonic and alterative, wasting does not occur, but the body weight increases and the general condition improves. In these respects its action markedly differs from that of Iodine or the Iodides. Ethyl Iodide (see ante, pages 43 and 46) is used by inhala- tion to bring the system rapidly under the influence of Iodine. It is a good antispasmodic and general stimulant and a very slow antesthetic. Antagonists and Incompatibles. Restorative agents and vaso-motor tonics, Quinine, Digitalis, etc., are thera- peutically antagonistic. Starch is the antidote to free Iodine, but the stomach must be evacuated as the Iodide of Starch is not inactive. The mineral acids, metallic salts, ammonia and vegetable alkaloids are incompatible with Iodine, and if the Potassium salt be prescribed with Potassium Chlorate a poisonous compound will result. In chronic poisoning by the iodides a free salivary flow by chewing Pyrethrum root will hasten the elimination of the drug. Therapeutics of Iodine. The tincture or the compound solution are much employed locally as counterirritants and by injection into cavities as altera- tive applications, instances of which are their use in glandular tumors, hypertrophied tonsils, cervical and ovarian cysts, empy- ema, hydrocele, etc. In various skin diseases, as chloasma, lentigo, lupus, etc., the tincture or a glycerite is well applied, and in many splenic and hepatic disorders of chronic type the ointment or tincture is a favorite counterirritant application. In sores, ulcers, fissures, etc., the Iodide of Starch or a mixture of Iodo- 234 IODUM. form and Tannin, are strongly recommended, and the tincture is much used locally to promote absorption of the products of acute inflammations. In acute catarrh and hay-fever inhalations of iodine-vapor, or that from Iodized Phenol are very serviceable, and in the vomiting of pregnancy drop-doses of the tincture every hour are often efficient. The compound solution well diluted is given thrice daily in typhoid fever with good results in many cases, and in malarial fevers the same preparation combined with Carbolic Acid has remarkably curative power. In strumous conditions Iodine internally is much more efficient than any of the Iodides. Therapeutics of the Iodides. The Iodide of Potassium is the most frequently used, and is the form in which Iodine is generally administered internally. It is usually administered in simple solution or in the compound infusion or syrup of Sarsaparilla. Though its mode of action has never been explained satisfactorily, it is known by clinical experi- ence to counteract many pathological conditions, to promote the absorption of morbid products, and the elimination of several metallic poisons. It is almost of specific rank in tertiary syphilis and its results, as neuralgiae, paralyses from gummata, ulcerations, syphiloma of the internal viscera, lupus, chronic rheumatism and sciatica, in all of which when of syphilitic origin this iodide in large doses (50 to 150 grains daily) to saturation of the system will speedily cause improvement. So in mercurial poisoning and other chronic metallic toxaemiae, the best treatment is by rapid saturation with Potassic Iodide. The products left behind by pneumonia, pleurisy and pericarditis often yield to moderate doses (5 grains), which if used for a prolonged period seem to retard the changes of chronic nephritis. It is the best remedy for the early stage of hepatic cirrhosis, and acts as a most efficient expectorant in chronic bronchitis. Aneurisms are often cured by large doses (20 to 30 grains) of Potassic Iodide, the sac be- coming perfectly solid by fibrinous deposit. In acute catarrh and hay-fever, it is useful with Arsenic, the Iodized Phenol being at the same time used locally in weak solution. In tonsillitis and simple sore throat a weak solution (gr. ij-v ad 3j) is a good gargle, and in large doses it is often very efficient in spasmodic asthma when induced by bronchial catarrh. The Iodide of Ammonium in grain dose repeated frequently is an excellent remedy in acute catarrh, hay fever, duodenal catarrh and its accompanying jaundice, in chronic and capillary bron- chitis, and in catarrhal pneumonia to prevent caseation of the IPECACUANHA. 235 products. In the first stage of hepatic cirrhosis and in chronic malarial poisoning it is equally efficient administered in conjunc- tion with Arsenic. Being somewhat more irritating than the other iodides it is usually given in smaller quantity, but being less stable it is more energetic in action. The Iodide of Sodium may be used instead of the potassium salt, and the same may be said of the Syrup of Hydriodic Acid if freshly prepared. Hydriodic Acid is used as a substitute for Iodine and the Io- dides. As an alterative it is believed by some to possess all the powers of Iodine while it is much less offensive to the taste and the stomach. It has been used with benefit in asthma and bron- chitis. The acid itself is not now official, as it is liable to change by the development of free Iodine. Therapeutics of Iodoform. Iodoform is chiefly employed in local diseases as an antiseptic, anaesthetic and alterative agent. It may be dusted in fine powder over a wound or sore, or used in ethereal solution to saturate gauze or absorbent cotton. It is particularly useful as an applica- tion to sloughing and phagedenic ulcers, gunshot wounds, chan- croids, fistulae, sinuses and painful affections of the rectum or uterus. Internally it may be used as a general tonic and altera- tive in syphilis and other cachexise, also for neuralgia, and is fre- quently prescribed with Iron. Triturated with Tannin it forms a useful application to the cervix uteri in erosions and ulcerations thereof, or an Iodo-tannin may be prepared by saturating the Tincture of Iodine with Tannic Acid, and applied on a cotton tent to the uterine mucous membrane in many chronic affections of that organ. IPECACUANHA, Ipecac,—is the root of Cephaelis Ipe- cacuanha, a small shrubby plant of the nat. ord. Rubiaceae, grow- ing in Brazil. The root is of the thickness of a small quill and about 4 inches long, of dull gray-brown color, contorted and finely wrinkled, internally white, tough and ligneous ; odor slight but nauseous, taste acrid, bitter and nauseating. It contains starch, gum, a trace of volatile oil, a crystalline alkaloid, Emetine, C20H30NO5, and a glucoside named Ipecacuanhic Acid. Dose of the powdered root, as an expectorant gr. ss-ij, as an emetic gr. xv-xxx. 236 IPECACUANHA. Preparations. Extractum Ipecacuanha Fluidum,—Dose, irij-v. Syrupus Ipecacuanha,—strength 5 per cent. Dose, Vinum Ipecacuanha,—strength 7 per cent. Dose, rilj-^j. Trochisci Ipecacuanha,—each contains gr. of Ipecac. Trochisci Morphina et Ipecacuanha,—each contains of Morphine Sulphate gr. of Ipecac gr. with oil of Gaultheria, Sugar, etc. Pulvis Ipecacuanha et Opii, Dover’s Powder,—consists of Ipecac 10, Pulvis Opii 10, Sugar of Milk 80 parts. Dose, gr. ij-xv. Tinctura Ipecacuanha et Opii,—Deodorized Tincture of Opium 100 parts evaporated to 85, Fluid Extract of Ipecac 10, Alcohol q. s. ad 100. Dose, mv-xxx. Emetina, Emetine (Unofficial),—a crystalline alkaloid, white becoming yellow, odorless, bitter, nearly insoluble in water, but forming with acids salts which are readily soluble. Is powerfully poisonous in large doses. Dose as an expectorant, gr. ; as an emetic, gr. Physiological Action. Ipecac is nauseant, emetic, expectorant, cholagogue, diapho- retic, hemostatic, sternutatory and counterirritant. Applied to the skin it produces pustulation, used as snuff it excites violent sneezing and reflex mucous secretion, in some persons the smallest inhalation of the dust exciting an asthmatic paroxysm. Internally small doses (gr. }£-}{) act as a stomachic tonic and increase the gastric secretions; larger doses (gr. v-xx) are nauseant and emetic in from 20 minutes to half an hour, but the emesis pro- duced is not violent nor is it followed by much depression. If these doses are repeated a tolerance of the stomach to the drug becomes established and a cathartic action is produced, the stools having a peculiar bilious character. The circulation is only slightly affected by Ipecac, but it relaxes the skin and increases the broncho-pulmonary mucus, being diaphoretic and expecto- rant. In large doses it is decidedly irritant to the intestinal canal, but here also it is capable of the same tolerance as in the stomach. In poisonous doses it has frequently produced hemop- tysis and other hemorrhages. Emetine, the active principle, causes death in animals by par- alysis of the muscles of respiration, and the autopsies show evi- dences of gastro-intestinal irritation and hypenemic lungs with patches of hepatization. Antagonists and Incompatibles-. Narcotics generally antagonize the emetic action, so also do Bismuth, Car- bolic and Hydrocyanic Acids. The salts of Lead and Mercury, Vegetable Acids and astringent infusions are incompatible with Ipecac. IRIS. 237 Therapeutics. Ipecac is much used as an emetic, being safe, efficient and non- depressant, though slow of action. It is the best agent of the kind to relieve the stomach in acute indigestion and bilious sick- headache, and an ipecac-vomit is frequently very serviceable at the commencement of eruptive, continued and periodical fevers. The syrup is a favorite domestic emetic to cut short an attack of laryngismus stridulus, and it may be used beneficially in mem- branous croup and capillary bronchitis. Dysentery is a disease in which large doses of Ipecac (gr. xx every 4 hours) are used with great success, especially in the epi- demic form, and in the summer dysentery of teething children. Tolerance must be established to produce its curative action. In small doses (njjj of the wine) frequently repeated, it will relieve many kinds of vomiting, especially those of nervous origin, per- haps through a sedative action on the pneumogastric. As an antihemorrhagic it has been efficiently employed in post-partum hemorrhage, menorrhagia, epistaxis, hemoptysis, etc., and it is considered very useful in night coughs, acute catarrh and bron- chitis, spasmodic asthma and hay fever. In most of these affec- tions slightly nauseating doses must be used. IRIS, Blue Flag ,—is the rhizome and rootlets of Iris versi- color, an indigenous plant of the nat. ord. Iridacese, growing in moist meadows and on the borders of swamps, having large blue flowers and a horizontal rhizome, 2 to 4 inches long, with long rootlets, slight odor but an acrid, nauseous taste. It contains tannin, sugar, starch, gum, an acrid resin, fixed oil and traces of an alkaloid. Dose of the powdered root, gr. v-xx. Preparations. Extractum Iridis,—Dose.gr. j-v. Extractum Iridis Fluidum,—Dose, rn.v— Iridin or Irisin (Unofficial),—is a so-called resinoid found in the shops, of undetermined composition, but probably an oleoresin precipitated by water from an alcoholic preparation. Dose, gr. j-v. Physiological Action. Iris when fresh is actively purgative, emetic and diuretic, pro- ducing severe nausea and prostration. Iridin has been the subject of experimentation upon dogs, and is shown to be a powerful hepatic stimulant with considerable influence on the intestinal glands, being more purgative than Euonymin and less irritant 238 JALAPA. than Podophyllin. In very small doses it causes obstinate con- stipation by producing rectal inactivity. Therapeutics. Iris is very serviceable in duodenal catarrh with obstruction of the bile-ducts and consequent jaundice, also in malarial poison- ing, bilious remittents, and jaundice of malarial origin. It is used in many hepatic and intestinal disorders as a cholagogue and purgative of mild but efficient action, also as a diuretic in drop- sies. In small doses (nj>j of a tincture) it is strongly recom- mended in a peculiar blinding headache in the right supra-orbital region with nausea or vomiting, supposed to be of hepatic origin. JALAPA, Jalap ,—is the tuberous root of Exogonium purga, a Mexican plant of the nat. ord. Convolvulaceae. It is large, turnip-shaped, externally dark-brown and wrinkled, internally grayish-brown with numerous concentric circles composed of small resin-cells, odor slight, taste sweetish and acrid. It con- tains 15 to 20 per cent, of the officinal Resin, which is composed of two resins, Jalapin, soft, soluble in ether, and Convolvulin, C.HsoO,, which is hard, insoluble in ether, and the most active of the two. Preparations. Abstractum Jalaps,—is an ingredient of Pil. Cathartic* Compositse, gr. j in each. (See ante, page 157.) Dose, gr. j-v. Resina Jalap^e,—prepared by precipitation by water from a tincture. In- soluble in water, soluble in alcohol. Dose, gr. ij-v. Pulvis Jalaps Compositus,—Jalap 35, Potassium Bitartrate 65 parts, triturated together. Dose, gr. x-^j. Physiological Action. Jalap is an active cathartic, producing copious and watery stools, with considerable tormina and tenesmus, also sometimes nausea. It does not produce hemorrhoids, but does increase the secretions of the intestinal canal and the flow of bile. Its action is not due to any one of the contained principles, but all the active constituents are found in the resin. Compared with other agents of the same class its action most resembles that of Scam- mony. It is more drastic than Senna and less irritant than Gam- boge, but in overdoses may produce dangerous hypercatharsis. Convolvulin in sufficient dose is an active irritant poison, producing gastro-enteritis and narcotism. Its action as a purga- tive seems to be wholly lopal, as from its intravenous injection no JUGLANS. 239 catharsis results, yet it exerts little if any irritant action on the conjunctiva, nasal mucous membrane or skip. It is not eliminated in the urine or the faeces, and is therefore probably destroyed in the system by oxidation. Therapeutics. In olden bowel-moving times Jalap and Calomel were used together in doses of gr. x each (“ten and ten”), as a routine purgative prescription. Less ponderous doses are now considered equally efficient, and one grain of each agent with the same quantity of Extract of Hyoscyamus as a corrective may be used with advantage at the onset of fevers and inflammations. As the compound powder it is much employed to produce free watery evacuations in ascites and anasarca. Being nearly tasteless it is a useful cathartic for children, and may be administered in Syrup of Rhubarb (gr. ij-v in 3ss). As a vermifuge it is efficient as an adjunct to more powerful agents, and is employed with Calomel after Santonin for the expulsion of lumbrici. Jalap is contra- indicated in all inflammatory conditions of the intestinal mucous membrane, but in proper doses it is one of the most manageable and efficient cathartics. JUGLANS, Butternut,—is the inner bark of the root col- lected in autumn of Juglans cinerea, the Butternut or White Wal- nut, an indigenous forest tree of the nat. ord. Juglandacese. It occurs in flat or curved pieces, the outer surface smooth, dark- brown, mottled, and nearly free from corky remnants of the outer bark, odor feeble, taste bitter and acrid. It contains an orange-yellow, crystalline and acrid substance named Juglandic Acid ox Nucin, resembling Chrysophanic Acid, also some resin, volatile acid, etc., but neither tannin nor any alkaloid. Preparation. Extractum Juglandis,—Dose, gr. v-xx or more. Physiological Action and Therapeutics. Juglans is a mild cathartic operating without the production of pain or irritant symptoms. It is never used in substance, but the extract is a good laxative in doses of gr. v-x, and a purgative in larger doses. It has considerable reputation in dysentery and chronic constipation. 240 JUNIPERUS. JUNIPERUS, Juniper ,—is the fruit of Juniperus commu- nis, an evergreen shrub of the nat. ord. Coniferae, growing in Europe and N. America. The fruit or berry is dark-purple with a bluish-gray bloom, having a three-rayed furrow at the apex, internally pulpy, containing 3 triangular, bony seeds. It con- tains a Volatile Oil which is official and consists of terpenes and camphors in complex combination, also a non-crystallizable principle named Juniperin, and grape sugar, resin, formic, acetic and malic acids, etc. Preparations. Oleum Junipf.ri,—the volatile oil, a colorless or faintly greenish-yellow liquid, of sp. gr. about 0.870, of terebinthinate and sweetish taste, and the odor of juniper, soluble in 12 of alcohol. Dose, rn.v-xx. Spiritus Juniperi,—has of the oil 3 parts in 97 of alcohol. Dose, .^j-^j. Spiritus Juniperi Compositus,—approximates closely to the best grade of “ Gin” (see ante, page 51). It contains Oil of Juniper 10, Oil of Caraway 1, Oil of Fennel 1, Alcohol 3000, and Water sufficient to make 5000 parts. Dose, Ineusum Juniperi (Unofficial),—Juniper Berries Jjj in Oj of boiling water. Dose, .qss-ij. Oleum Cadini, Oil of Cade (Unofficial),—is a tar obtained by the destruc- tive distillation of Juniper wood, but is of uncertain purity. The official Oleum Picis Liquid* (Oil of Tar) is just as efficient for all purposes to which the Oil of Cade has been applied. Physiological Action. Juniper is a stomachic tonic, diaphoretic, diuretic and aphro- disiac. The oil is the active principle, and is readily diffused, exciting increased cardiac action, stimulating the renal functions and the action of the skin, and causing a subjective sense of heat throughout the system. It is eliminated chiefly by the kidneys, and may set up renal irritation, in large doses producing stran- gury, priapism, hematuria, suppression of the urine, and uraemic convulsions. It imparts a violet odor to the urine, and will pro- duce diuresis when inhaled. Therapeutics. The Oil of Juniper is used to flavor gin and to impart the diu- retic power popularly ascribed to that liquor. The medicinal use of the juniper preparations (spirit and compound spirit) is restricted to their employment as vehicles for less irritant diuretics. The oil acts therapeutically like the Oil of Turpentine, and may be used in chronic pyelitis and cystitis, prostatorrhoea, gleet, etc., but it is contraindicated in all cases where acute inflammation of the kidneys exists. Oil of Cade is used locally in chronic skin diseases as a stim- KAMALA—KAVA-KAVA. 241 ulant application. It is too active for acute eruptions, but has been used with benefit in chronic eczema and psoriasis. The official Oil of Tar (see Pix) is equally efficient. KAMALA, Rottlera,—the glands and hairs from the cap- sules of Mallotusphilippinensis, or Rottlera tinctoria, a small tree of the nat. ord. Euphorbiacese, growing in Abyssinia, Arabia, India, China, etc. It occurs as a granular, mobile, brick-red powder, inodorous and nearly tasteless, partly soluble in alcohol and ether. It contains several resins, one of which is named Rottlerin, CuH10O3, also tannin, starch, gum, red coloring mat- ter, etc. There are no official preparations. Dose, 3ss-iij. Physiological Action and Therapeutics. Kamala is anthelmintic and purgative, sometimes causing nau- sea and colic, seldom vomiting. It is used as a taeniafuge and to expel lumbrici and ascarides vermiculares. One or two drachms are given suspended in water, mucilage or syrup, and repeated in 4 hours if necessary. A tincture in xvj of alcohol) may be used in doses of 3j~3ss- In India it is used locally in scabies and other skin affections, and has been found of especial service in herpetic ringworm. As a remedy against tapeworm it is per- haps next after Male-fern in efficiency, and requires no prepara- tory treatment. KAVA-KAVA, Ava-Kava (Unofficial),—the root of Piper methysticum, a shrub of the nat. ord. Piperacese growing in South America and the South Sea Islands. The root is large, weighing from 2 to 20 pounds, fibrous, light and spongy, and contains a crystalline principle, Kavahin or Methysticin, which is analogous to Piperin, an acrid, greenish-yellow resin Kawin, which is prob- ably the active principle, also a Volatile Oil. Dose, 3ss-j> mace- rated in water, or the same quantity of a fluid extract. Physiological Action and Therapeutics. Kava is intoxicant, diuretic and motor-depressant. A beverage is prepared in the Sandwich Islands by chewing the root and then infusing it in water or cocoanut milk, which produces a drowsy intoxication with pleasant dreams often of erotic character, and followed by severe headache. A moderate dose is tonic and stimulant, lessening the sense of fatigue and sharpening the 242 KINO—KRAMERIA. mental faculties. It is highly recommended in gonorrhoea and gout, also in chronic gleet and obstinate cystitis. KINO ,—is the inspissated juice of Pterocarpus Marsupium, a tall tree of the nat. ord. Leguminosse, growing in India. It occurs in angular, brown-red pieces, shining and brittle, inodor- ous, taste astringent and sweetish, soluble in alcohol. It con- tains 75 per cent, of a variety of tannin named Kino-tannic Acid, C18H1808, which gives a greenish precipitate with persalts of iron, also a crystalline, neutral substance, Kinoin, C14H1206, and Kino- red, formed from Kino-tannic Acid by oxidation, besides gum, pectin, etc. There are several other varieties of Kino in the market, brought from S. America, Africa, Australia, etc., which are products of other trees than the official one. Preparations. Tinctura Kino,—strength 10 per cent. Dose, trix-gij. Pulvis Kino Compositus (Unofficial),—Kino 15, Opium 1, Cinnamon 4, (has of Opium 1 in 20). Dose, gr. v-xx. Physiological Action and Therapeutics. The action of Kino is the same as that of Tannic Acid, though less powerful (see ante, page 38), and may be used for the same purposes, both internally and locally. It is chiefly employed as an astringent gargle and as a constituent of diarrhoea-mixtures. KRAMERIA, Rhatany, is the root of Krameria triandra and Krameria tomentosa, shrubs of the nat. ord. Polygalacege, growing in S. America, the first-named in Peru and the latter in New Granada. It is about an inch thick, branched below, more or less knotty, covered with a brownish bark which is very astrin- gent ; and contains 20 to 45 per cent, of Rhatania-tannic Acid, CMHa4021, and Rhatanine, C10H13NO3, an alkaloid,—also wax, gum, etc. Preparations. Extractum Krameria,—aqueous. Dose, gr. v-x. Extractum Krameria Fluidum,—Dose, uxv-^ss. Tinctura Krameria,—20 per cent. Dose, -rqv-gj. Syrupus Krameria,—Fluid Extract 35, Syrup 65'. Dose, £ss-!|ss. Trochisci Krameria,—each troche contains gr. j of the extract, with Tragacanth, Sugar and Orange-Flower Water. KUMYSS. 243 Physiological Action and Therapeutics. Krameria possesses the same astringent qualities as Tannic Acid (see ante, page 38), and may be employed for the same purposes except as an antidote to Antimony. It has long had a high repu- tation as an injection for fissure of the anus, as a local application to spongy gums, and as a tonic for debilitated subjects. KUMYSS, Koomiss (Unofficial),—is an effervescing fer- mented liquor originally prepared by the Tartars from mares’ milk, but now imitated with cow’s milk by adding sugar of milk, fermenting in open tanks, skimming off the casein and butter, then bottling during active fermentation. Wolff’s formula for its preparation in small quantity is as follows,— Dissolve of grape sugar in of water. Dissolve gr. xx of Fleisch- mann’s compressed yeast or well-washed and pressed out brewer’s yeast of cow’s milk. Mix the two solutions in a quart champagne bottle, and till to within 2 inches of the top with good cow’s milk. Cork well, secure the cork with wire, keep it in a cellar or ice chest, maintaining a temperature of 50° F. or less, and agitate thrice daily. In three or four days it is ready for use, but should not be kept longer than four or five days. Draw it with a champagne tap. Kumyss contains Alcohol, 1.23 to 3.23 per cent., Carbonic Acid, 0.75 to 1.99, Lactic Acid, 0.25 to 2.92, Casein, 1.12 to 3.08, Sugar of Milk, 1.77 to 2.37, Fat, 1.05 to 2.05, Salts, 0.28 to 0.57 per cent., besides volatile, fragrant compounds. The further the fermentation is carried the more Alcohol and Car- bonic Acid will result and the less Sugar and Casein, while if carried on to a considerable degree Butyric, Succinic and Acetic Acids are produced. Physiological Action and Therapeutics. The taste of Kumyss is acidulous and peculiar. In large quan- tity it takes the place of food, each quart equalling four ouhces of solids. It is said to be a powerful diuretic especially in cold weather, and in warm weather to produce free diaphoresis. It is stimulating and tonic, increases the body nutrition and produces considerable somnolence. The stomach is very tolerant of it, and retains it when any other food will be rejected. It is easily assimilated and very nutritious. Kumyss is an invaluable article of diet in many wasting dis- eases, especially phthisis. It is also of great benefit in dyspepsia, the diarrhoea of children, convalescence from acute maladies, 244 LACTUCARIUM LAPPA. chronic affections of the kidneys, chronic bronchitis, and other cachexiae. In cases of feeble digestive power gj every hour is sufficient, but as its digestion and assimilation increase it may be given almost ad libitum, and when used with other food a half- pint may be taken after each meal. Kefir is the name of a fermented drink prepared from the milk of a cow or mare by the addition of a secret ferment. It is used by the natives of the Asiatic plains as a remedy for struma, anaemia, lung and stomach diseases, LACTUCARIUM, Lettuce, —is the concrete milk-juice of Lactuca virosa, or Acrid Lettuce, a biennial European plant, of the nat. ord. Compositae. It occurs in sections of cakes or irregular pieces showing the form of the vessel in which it hard- ened, externally reddish-brown, internally white or yellowish and of waxy lustre, odor heavy and narcotic, taste bitter, partly sol- uble in alcohol and in ether, and yielding a turbid mixture when triturated with water. Lactucarium is a mixture of several sub- stances, the most important being Lacttuerin, 42 per cent., a crystalline, tasteless body, resembling caoutchouc, insoluble in water and probably inert; Lactucin, 0.3 per cent., a neutral prin- ciple, crystallizing in pearly scales, insoluble in cold water, per- sistently bitter ; Lactucic Acid, bitter, amorphous, but crystallizes after long standing. Preparations. Extractum Lactucarii Fluidum,—Dose, fora child m.j-iij,for an adult v\x-3), according to the activity of the drug. Syrupus Lactucarii,—5 per cent. Dose, gj-^j. Physiological Action and Therapeutics. Lactucarium is feebly hypnotic, somewhat sedative and diuretic. It is supposed to act similarly to Opium, but very feebly and without depressing after-symptoms. Its preparations are very uncertain in activity, and are chiefly used as placebos, to allay cough and quiet nervous irritability. The syrup is a good vehicle for expectorants and antispasmodics. LAPPA, Burdock,—is the root of Lappa officinalis, the common Burdock, a coarse-looking biennial weed of the nat. ord. Compositae, found in waste places and along roadsides in Europe, Asia and N. America. Three varieties are recognized,—Lappa major, L. tomentosa and Z. minor, of which the first-named is LAVANDULA. 245 most frequently met with in this country. The root is about a foot long, an inch thick, has a feeble odor and a mucilaginous, bitterish taste, and contains a bitter principle, traces of a volatile oil, also inulin, resin, tannin, mucilage, sugar, etc. There are no official preparations. Dose, 3j-ij> in infusion, decoction or tincture. Dr. Squibb recommends a tincture of the seed, Ibj of ground seed to gall, j of whiskey, allowed to stand for 2 weeks before decanting, and used in doses of 3ij—iij before meals. Physiological Action and Therapeutics. Lappa promotes all the secretions and is considered aperient, diuretic and diaphoretic, without irritating qualities. In decoc- tion it has been a popular domestic remedy for many morbid conditions, especially rheumatism, gout, pulmonary catarrhs and chronic cutaneous affections. By several practitioners it is praised as an alterative in constitutional diseases, as syphilis and scrofula, also as an external application to swellings, hemorrhoids and chronic sores. A tincture of the seed has proved remarkably efficient as a stomachic tonic and has cured several cases of pso- riasis inveterata. (See Squjbb’s Ephemeris, vol. i., page 116.) LAVANDULA, Lavender,—the flowers of Lavandula vera, a small European shrub of the nat. ord. Labiatse, largely culti- vated in England. They have a bluish-gray tubular calyx, a violet-blue corolla, a fragrant odor, and an aromatic, camphora- ceous taste, and contain resin and tannin, also a Volatile Oil which is official. Lavender is a constituent of Vinum Aromaticum. Preparations. Oleum Lavandulae,—is a volatile oil distilled from the flowering tops or the whole herb. It is much coarser than the oil of lavender flowers and more stimulant. Dose, ifl-j-v. Oleum Lavandulae Florum,—is a volatile oil distilled from fresh Lav- ender, and having the fragrant odor of the flowers. Sp. gr. 0.890, soluble in alcohol and in acetic acid of 90 per cent. It is a constituent of Spiritus Odoratus. (See ante, page 50.) Dose, uij-v. Spiritus Lavandulae,—has of the Oil of Lavender Flowers 3 parts in 97 of Alcohol. A perfume and flavoring. Dose, Tinctura Lavandulae Composita,—an aromatic stimulant composed of Oil of Lavender 8, Oil of Rosemary 2, Cinnamon 18, Cloves 4, Nutmeg 10, Red Saunders 8, Alcohol 680, Water 270, Diluted Alcohol q. s. ad 1000 parts. Dose, 3ss-ij. Is a constituent of Liquor Potassii Arsenitis. Physiological Action and Therapeutics. Lavender is aromatic, stimulant and carminative, but is rarely used alone as a medicine. It is an agreeable flavoring and per- 246 LEPTANDRA—LICOPERDON GIGANTEUM—LIMON. fume, in the form of the official spirit, which is sold under the name of “Lavender-water,” after the addition of Oil of Berga- mot and Essence of Ambergris. The compound tincture, formerly called the compound spirit of Lavender, is a very agreeable com- pound of spices, and is much used as a remedy for gastralgia, nausea, flatulence, etc., and as an adjuvant or corrigent of other medicines. LEPTANDRA, Culver’s Root,—is the rhizome and rootlets of Leptandra virginica, an indigenous perennial plant of the nat. ord. Scrofulariaceae. The rhizome is horizontal, about 5 inches long and inch thick, bent and branched, with thin, wrinkled rootlets, inodorous, taste bitter and feebly acrid. It contains a glucoside named Leptandrin, which is probably the active principle, also Saponin, resin, tannin, etc. The Leptan- drin of the shops is an impure alcoholic extract. Preparations. Extractum Leptandras,—Dose, gr. j-iij. Extractum Leptandra Fluidum,—Dose, ttlxx-^j. Physiological Action and Therapeutics. Leptandra is tonic, laxative, and like other resin-bearing pur- gatives is decidedly cholagogue. The recent root is a violent cathartic, but in the dried state it is less active. It is indicated in duodenal indigestion and chronic constipation with insuffi- ciency of the biliary and intestinal secretions. LICOPERDON GIGANTEUM, Puff-Ball—is a com- mon fungus of the nat. ord. Trichogastres, found in hilly and wooded districts. The dust, which consists of the capillitium and spores, is a valuable hemostatic, and dusted over bleeding surfaces acts promptly in arresting hemorrhage. It has been pro- posed as a surgical dressing, but while useful in emergencies where other agents are unattainable, the fetor which results from its application to wounds will prevent its use becoming general for this purpose. It may prove of value as an internal hemostatic in hematemesis and the hemorrhage of typhoid fever. LIMON, Lemon ,—is the fruit of Citrus Limonum, a tree of the nat. ord. Aurantiaceae, native in Asia but cultivated in LIMON. 247 southern Europe and many other countries. It is official in the two forms described below. The Orange (Citrus vulgaris and C. Aurantium), the Citron ( Citrus me die a), and the Lime acris), all belong to the same genus as the Lemon (Citrus Limo- num). Limonis Cortex, Lemon Peel,—is the rind of the recent fruit, and contains a Volatile Oil, C10H16, which is official, and a bitter crystalline glucoside, Hesperidin, C22H26012, chiefly contained in the white portion of the rind. Limonis Succus, Lemon Juice,—is the freshly expressed juice of the ripe fruit, each lemon yielding from to i fluid ounce. It contains about 7 per cent, of free Citric Acid, besides Phos- phoric and Malic Acids, Citrates of Potassium and of other bases, etc. Dose, Acidum Citricum, Citric Acid, H3C6H507.H20,—is obtained from the juice of the Lemon or the Lime by adding chalk to form the Citrate of Calcium, which is then decomposed by dilute Sul- phuric Acid. It occurs in colorless, rhombic crystals which are very soluble in water. A solution of gr. xvij in §ssof water cor- responds to of fresh lemon-juice, and this quantity of either will neutralize of Potassium Bicarbonate gr. xxv, of Sodium Bicarbonate gr. xx, and of Ammonium Carbonate gr. xivss. Dose, gr. x-xxx. Citrates of Bismuth, Bismuth and Ammonium, Iron, Iron and Ammonium, Iron and Quinine, Iron and Strychnine, Lithium, Potassium, eight in all, are official. They are described under their respective bases, to which rather than to the acid their me- dicinal qualities are due. Preparations. Oleum Limonis, Oil of Lemon, C10H16,—is the volatile oil, isomeric with oil of turpentine, and extracted from fresh lemon peel by mechanical means. It is used for flavoring and is an ingredient of Spiritus Limonis, Spiritus Odoratus, and Spiritus Ammonise Aromaticus. Dose, Ttlj-v. Spiritus Limonis, Essence of Lemon,—prepared by macerating 6 parts of the oil and 4 of the peel in 90 of alcohol. Used for flavoring. Dose, accord- ing to the alcohol required to be given. Syrupus Limonis,—Lemon-juice 40, Lemon-peel 2, Sugar 60, Water q. s. ad 100 parts. Dose, indefinite. Syrupus Acidi Citrici,—Citric Acid 8, Water 8, Spirit of Lemon 4, Syrup 980 parts. Dose, indefinite. Physiological Action. Lemon-peel is bitter and probably tonic to the stomach, but is only used for flavoring purposes. Lemon-juice, on the other hand, is refrigerant and antiscorbutic, entering the blood as alkaline 248 LINUM. citrates, potassium salts and phosphoric acid, the citrates being therein partly oxidized into C02 and H20, while the potassium salts and phosphoric acid probably act upon the red corpuscles. Citric Acid has the same general action as Acetic and the other vegetable acids (see Acidum Aceticum, ante, page 19). It is wholly decomposed in the blood, and appears to be non-toxic in man, but used internally it may precipitate uric acid and thus promote the formation of calculi. Therapeutics. Lemon-juice is employed largely in the treatment and preven- tion of scurvy, in which disease it possesses powers of specific rank, but whether its action therein is due to the citric acid, the phosphoric acid or the salts of potassium is not known. Lime- juice is equally efficient but Citric Acid itself is not so. As refrigerants and diuretic mixtures in fevers, Lemon-juice and Citric Acid are much used, entering into the composition of lemonades, effervescing draughts, etc., to allay thirst and subdue restlessness, and to promote the action of the skin and the kid- neys. For acidity of the stomach they are efficient if given in small doses before meals, but the mineral acids are usually pre- ferred for this purpose. Long-continued they will impair diges- tion and impoverish the blood. Atheromatous degeneration of the vessels is said to be retarded by the daily use of lemon-juice, which is supposed to dissolve the excess of organic matter and to aid its excretion. Obesity may be reduced by using the juice of limes or lemons in large quantity, but it will be done at the ex- pense of the digestion. Lemon-juice has been found of service in acute rheumatism, probably through the alkalies which it con- veys into the blood. As a local application it has been found efficient in pruritus scroti, sunburn, and post-partum hemorrhage, and as a gargle in diphtheritic sore throat. LINUM, Flaxseed, Linseed,—is the seed of Linurn usi- tatissimum (flax), a cultivated annual plant of the nat. ord. Lina- cese. The seeds are small, flattened, oblong-ovate bodies, brown and glossy, inodorous, taste mucilaginous and bitter; and con- tain 15 per cent, of Mucilage in the epithelium, also 30 to 40 per cent, of Fixed Oil in the embryo. Ground Flaxseed should yield not less than 25 per cent, of the fixed oil. Preparations. Oleum Lini, Linseed Oil,—the fixed oil expressed from flaxseed without the use of heat. A yellow, oily liquid, of slight odor, bland taste, and neu- LITHIUM. 249 tral reaction, soluble in 5 of absolute alcohol and in of ether. Consists chiefly of the Glyceride of Linoleic Acid, C16H2g04, which having a powerful affinity for oxygen becomes resinoid on exposure to the air, making it a “ dry- ing oil.” Dose, Infusum Lini, Linseed Tea (Unofficial),—Flaxseed giij, Liquorice-root 3j, Boiling Water 3£x, infused for 4 hours and strained. Dose, indefinite. Carron Oil (Unofficial),—is made by emulsifying equal parts of Linseed Oil and Limewater. The official Linimentum Calcis is intended for the same purposes. Physiological Action and Therapeutics. Flaxseed is demulcent, emollient, expectorant and diuretic. The oil is laxative in a dose of gj, and in smaller doses is oxi- dized in the system and excreted as a resinoid body by the kidneys, which it stimulates slightly. The infusion contains the mucilaginous principle and a small portion of the oil, and is ad- vantageously used in inflammations of the mucous membrane of the throat, the gastro-intestinal tract and the urinary passages. It is an excellent demulcent in coughs of various kinds, and will be found very serviceable in cystitis, irritable bladder, renal colic, strangury, etc. The oil may be administered internally as a lax- ative but is usually given as an enema, and has considerable rep- utation as a remedy for hemorrhoids in doses of §ij twice daily. Externally it is a favorite application to burns when made into an emulsion with lime-water. The ground seed (flaxseed meal) is one of the best agents for use in poultices, and is universally employed for that purpose. LITHIUM, Li ,—is represented in the Pharmacopoeia by five of its salts, of which the Carbonate is but slightly soluble while the others are readily so. The low atomic weight of this metal (7) makes its saturating power greater than that of the other alkaline metals, hence the value of its salts in medicine. Salts of I.ithium. Lithii Bf.nzoas, Benzoate of Lithium, LiC7H502,—is classed with the Benzoates and described under Benzoic Acid. (See ante, page 99.) Lithii Bromidum, Bromide of Lithium, LiBr,—is classed with the Bro- mides and described under Bromine. (See ante, page 103.) Lithii Carbonas, Carbonate of Lithium, Li2C03,—a light, white powder, permanent in the air, odorless, of alkaline taste and reaction, soluble in 130 of water, insoluble in alcohol. Dose, gr. ij-xv. Lithii Citras, Citrate of Lithium, Li3C6H507,—a white, deliquescent powder, odorless, of faintly alkaline taste and neutral reaction, soluble in of water, slightly in alcohol. Dose, gr. v-xxx. Lithii Saucyi.as, Salicylate of Lithium, 2LiC7H503.II20,—is classed with the Salicylates and described under Salix. 250 LOBELIA. Physiological Action. The Lithium salts have strong alkaline qualities and act on the system in the same manner as other alkalies (see under Potas- sium). The high saturating power of this metal makes its salts more alkaline than those of Potassium, Sodium or Calcium, hence more efficient in alkalinizing the urine. The Urate of Lithium is the most soluble of the urates, hence the value of lithium salts in the uric acid diathesis. The Carbonate and Citrate are the salts referred to in this connection, the others partaking more of the qualities of their acid factors. Both these salts are antacid and strongly diuretic, the Carbonate being but slightly soluble is given in wafer or in carbonic acid water, and the Citrate in solution. The latter may be extemporaneously prepared by add- ing Citric Acid to an aqueous solution of the Carbonate, and in the organism is decomposed, the citric acid being oxidized and the carbonate formed. Many mineral waters contain small quan- tities of the carbonate, varying from a mere trace to o.ox grain to the pint, an amount so minute as to be practically inert in com- parison with the much greater quantities of potassium and sodium salts in the same waters. Therapeutics. The Carbonate and Citrate of Lithium are extensively used in gout and the lithaemic diathesis, for the purpose of holding the uric acid in solution as urate of lithium, and preventing its deposit in the tissues as urate of sodium which is less soluble. Their prolonged administration is so efficient in this affection that they have been credited with the power of dissolving uric acid calculi and called lithontriptics. They are also highly useful in the indigestion and rheumatism of obese subjects, and in irritable bladder from excess of acid in the urine. LOBELIA, Indian Tobacco,—the leaves and tops of Lobelia infiata (nat. ord. Lobeliaceae), collected after a portion of the capsules have become inflated. The plant is a common annual weed growing on roadsides throughout the United States, having pale-green, alternate leaves, a single, erect and very hairy stem, with hairy branches and small, pale-blue flowers, odor slight but irritating, taste at first mild, afterwards burning and acrid. It contains gum, "resin, fixed oil, wax, lignin, salts of lime, potassium and iron, a liquid alkaloid Lobeline, which is the narcotic principle of the plant, also Lobelic Acid, and an acrid substance named Lobelacrin. LOBELIA. 251 Preparations. Extractum Lobelias Fluidum,—Dose, nij-x. Tinctura Lobelia,—20 per cent. Dose, ntv-xxx. Acetum Lobeliae,—10 per cent. Dose, "tTLv-^j. Infusum Lobeliae (Unofficial),—to the pint. Dose, Lobelin (Unofficial),—an impure resinoid. Dose, gr. ss-j. Physiological Action. Lobelia has an acrid, nauseous taste, and a heavy, unpleas- ant odor. It is expectorant, diaphoretic, emetic, purgative, anti- spasmodic, motor-depressant and narcotic. It excites an abundant flow of saliva, much gastric mucus, profuse urination and sweat- ing, with nausea, vomiting and great depression. The heart’s action is enfeebled, and the blood-pressure, at first increased, soon falls ; muscular debility, reduced temperature and coma follow, and death occurs by paralysis of the respiratory apparatus. The drug produces paralysis of the motor nerve-trunks, the peri- pheral vagi, and probably the respiratory and vaso-motor centres also. It strongly resembles tobacco in its action, and is highly dangerous in full medicinal doses, having caused many deaths when administered therapeutically, the most important instance of its fatal results being the case of Ezra Lovett, Jr., who in 1809 was poisoned by Lobelia administered by the founder of the Thomsonian sect of medical practitioners. The responsible party escaped conviction on the plea that he gave the drug in ignorance of its qualities. Antidotes and Incompatibles. Tannic Acid to form the insoluble tannate. Strychnine, Picrotoxine and Thebaine antagonize its action on the nervous system;—the vaso-motor ex- citants, as Alcohol, Digitalis, Belladonna, Ergot, etc., antagonize its effects on the circulation. Caustic alkalies are incompatible, decomposing the alkaloid. Therapeutics. Lobelia was a favorite remedy with the Indians at the time of the first settlement of the United States, and was introduced into regular practice as an anti-asthmatic, after having served as the main stock-in-trade of the irregular practitioners for many years. Its principal therapeutic action is that of an antispas- modic, and in cautious hands it is extremely useful in paroxysmal spasmodic asthma, as well as in dry cough with constant tickling in the throat. As an enema in cases of strangulated hernia the infusion is much safer than Tobacco and fully as efficient, and may overcome the obstruction in intussusception, while the tinc- ture in 2-drop doses every hour will often relieve a case of im- 252 LYCOPODIUM—MAGNESIUM. pacted caecum. In constipation from atony and deficient secre- tion a 10-minim dose of the tincture at bed-time acts excellently, and in the poison-oak eczema the infusion is a good local applica- tion. As an emetic it is entirely too depressant for children’s use. LYCOPODIUM, —is a very mobile, pale-yellow, fine pow- der, consisting of the sporules or seeds of the Club-moss, Lyco- podium clavatum, and of other species of Lycopodium (nat. ord. Lycopodiacese). The plant is a native of Europe and the U. S., has a trailing stem several feet long, with smooth, deep-green, pointed leaves, flowers in terminal spikes, and yellow capsules which contain the seeds. Lycopodium is odorless, tasteless, floats on water which does not wet it, and burns quickly when thrown on a flame. It should be free from pine-pollen, starch, sand and other impurities, which are detected by means of the microscope, the seeds being about of an inch in diameter, four-sided and reticulated, with short projections on the edges. They contain about 47 per cent, of a bland, fixed oil. Physiological Actions and Therapeutics. The plant was formerly considered to be diuretic and anti- spasmodic, and was used in rheumatism, epilepsy and pulmonary and renal disorders. The powder is now employed quite exten- sively in pharmacy to facilitate the rolling of a pill-mass and to prevent adhesion of pills to each other. It makes an excellent absorbent and protective powder when dusted over an excoriated surface, as seen between the thighs of infants. By the homoeopathic practitioners Lycopodium is elevated to the rank of an active drug when triturated with sugar of milk sufficiently long to break up the seeds and liberate their oily con- tents. In their first centesimal trituration (T^T) it is said to have produced symptoms of high excitement of the circulation and irritation of the urinary organs, and they profess to use it with benefit in many affections of the mucous tracts, dyspepsia, pyrosis, flatulence* constipation, ileo-colitis of infants, hepatic congestion, aneurism, chronic affections of the lungs and bronchi, diphtheria, lithiasis, intertrigo, porrigo capitis, plica polonica and pruritus ani, in all of which as an internal remedy and in high attenuation. MAGNESIUM, Mg.—This metal is represented by its Oxide, Carbonate, Citrate, Sulphate and Sulphite, of which the Sulphate occurs native in sea-\Vater, caves* etc., the others being MAGNESIUM. 253 prepared from it. The first two are almost insoluble in water or alcohol. Its salts are either white or colorless, and those which are official are as follows,— Official Salts of Magnesium. Magnesia, Light Magnesia, Oxide of Magnesium, MgO,—made by heat- ing the light carbonate in a crucible to expel nearly all the carbonic acid. A white, light and very fine powder, almost insoluble in water, insoluble in alcohol, and gelatinizes wuth 15 of water after standing y2 hour, having be- come hydrated. Is a constituent of Pulvis Rhei Compositus, Massa Copaibas and Ferri Oxidum Hydratum cum Magnesia. Dose, gr. x-^j. Magnesia Ponderosa, Heavy Magnesia, Oxide of Magnesium, MgO,— is a white, dense and very fine powder, corresponding in other properties and reactions with Magnesia, except that it does not gelatinize with water. It is made by calcining the heavier variety of the carbonate, and is much slower in action than the light magnesia. Dose, gr. x-^j. Magnesii Carbonas, Carbonate of Magnesium, (MgC03)4Mg(H0)2.5H20, —light, friable masses, or powder, odorless and tasteless, insoluble in alcohol, almost insoluble in water. Dose, gr. x-^j. Magnesii Sulphas, Sulphate of Magnesium, Epsom Salt, MgS04.7H20, —colorless prisms or acicular needles, slowly efflorescent, odorless, of cool- ing, saline taste, and neutral reaction, very soluble in water, insoluble in alco- hol. Is a constituent of Infusum Sennrn Compositum. Dose, Magnesii Sulphis, Sulphite of Magnesium, MgS03.6H20,—a white, crys- talline powder, becoming oxidized on exposure to air, of sulphurous and slightly bitter taste, and neutral or slightly alkaline reaction, soluble in 20 of water, insoluble in alcohol. Dose, gr. x-xxx. Preparations. Magnesii Citras Granulatus, Granulated Citrate of Magnesium,—pre- pared from the Carbonate with Citric Acid, Sugar, Bicarbonate of Sodium, Alcohol and Distilled Water. A coarsely granular, white salt, deliquescent, of acidulous taste and acid reaction, soluble with copious effervescence in 2 of water, insoluble in alcohol. Dose, 3pj-!|j. Liquor Magnesii Citratis,—prepared from the Carbonate gr. 200, Citric Acid gr. 400, Syrup of Citric Acid gr. 1200, Potassium Bicarbonate gr. 30, Water q. s. ad Dose, repeated for catharsis. Trochisci Magnesii,—each troche contains of Magnesia gr. 3, Nutmeg gr. 0.15, with Sugar and Mucilage of Tragacanth. Dose, indefinite. Mistura Magnesia et AsafcetidA, Dewees’ Carminative,—contains of the Carbonate 5 per cent., Tincture of Asafcetida 7, Tincture of Opium I, Sugar 10, and Distilled Water 77. Dose, Used for flatulent colic and diarrhoea in infants. Physiological Action. Magnesia and the Carbonate of Magnesium are mildly laxa- tive and antacid, neutralizing free acids in the stomach and form- ing therewith laxative salts. If used in large quantity for any length of time it may become hydrated and produce intestinal concretions. The freshly-precipitated hydrate (see above, Mag- 254 MAGNOLIA. nesia) is an antidote to Arsenic in solution, but less effective than the Hydrated Sesquioxide of Iron, with which it is combined in the official Ferri Ox. Hydratum cum Magnesia. (See ante, page 191.) Magnesia may also be used in acid or phosphorus-poi- soning. The Citrate and Sulphate are saline cathartics, the latter being the most powerful, producing prompt and free watery dis- charges, with but little griping or irritation, but frequently a sense of coldness and depression. The purgative action is chiefly due to increase of the intestinal fluids by an outward osmosis from the vessels, and not from increase of the secretions of the glandular appendages. If the purgative action should not take place a diuretic one will result, but to secure the desired catharsis the drug should be administered in a considerable quantity of water. Sulphate of Magnesium is the principal aperient con- stituent of many of the popular laxative mineral waters, as Fried- richshall, Piillna, Hunyadi, etc. The Sulphite shares the actions and uses of the other sulphites, and is more properly considered with them. (See ante, page 36.) Therapeutics. Magnesia and the Carbonate are used as antacids and laxatives, in acidity, sick headache, flatulent colic, etc., and as antidotes in poisoning by acids, arsenic, phosphorus, mercuric and cupric salts. The Citrate is an agreeable laxative, cooling and accept- able to the stomach. The Sulphate is the most efficient of the saline cathartics and has a wide field of application. In acute inflammatory conditions, renal and cardiac dropsy, ascites from obstruction of the portal circulation, increased blood-pressure within the cranium, intestinal obstruction without acute inflam- mation, the constipation of lead poisoning, and habitual consti- pation from deficiency of the intestinal secretions, this agent will be found to be exceedingly serviceable. Acute dysentery is well treated by Magnesium Sulphate combined with diluted Sulphuric Acid, and followed by Opium and starch enemata. Bleeding from hemorrhoids and uterine hemorrhage are often relieved by the same combination when other agents fail. The ferro-saline mixture (see a?ite, page 194) is a very useful laxative" in'the con- stipation of anaemic women. The bitter taste of Epsom Salt is best covered by coffee. MAGNOLIA ,—is the bark of Magnolia glauc a (Sweet Bay, Swamp Sassafras), M. acuminata (Cucumber-tree), and M. tripe- MALTUM—MANACA. 255 tala (Umbrella-tree), all of which belong to the nat. ord. Mag- noliaceae, and are indigenous to the eastern and southern States. It occurs in quilled or curved pieces, of orange-brown color exter- nally, whitish or a pale-brown internally, taste astringent, pun- gent and bitter. It contains a crystalline principle named Mag- nolin, which is insoluble in water, but soluble in alcohol, ether, etc. Dose of the powdered bark, 3ss_j- There are no official preparations. Physiological Action and Therapeutics. Magnolia is an aromatic bitter tonic and diaphoretic, usefully employed in chronic rheumatism, remittent and intermittent fevers. In the latter affection it will arrest the paroxysms if used freely. MALTUM, Malt ,—is the seed of Hordeum distichum, Bar- ley (nat. ord. Graminacese), caused to enter the incipient stage of germination by artificial means and dried. The germination is allowed to go far enough to develop the maximum amount of Diastase, the peculiar ferment by which the starch of the grain is converted into Glucose. Malt is the source of beer, ale and whiskey, and is composed of the germinated, dead grains with their acrospires and radicles. It should be fresh, not darker in color than a pale amber, and of agreeable odor and sweet taste. Preparations. Extractum Malti,—a liquid of the consistence of thick honey, contain- ing all the soluble principles of malt in permanent form. It consists chiefly of diastase and glucose. Dose, Horlick’s Food (Unofficial),—is, like Mellin’s and many other foods for children, a granulated Extract of Malt. Hoff's Malt Extract is another such preparation, containing alcohol, and corresponding to a concentrated beer. Physiological Action and Therapeutics. Malt Extract is directly nutritive, containing good food ele- ments, and indirectly so from the presence of the ferment Dias- tase, which converts the starch of bread or other farinas into sugar. It is usefully employed in wasting diseases, and mixed with milk or oleaginous foods it aids their digestion and assimila- tion. It may be used to form a syrupy mixture with preparations of Iron or Cinchona. MANACA (Unofficial) ,—is the root of Franciscea uniflora, a shrub of the nat. ord. Scrophulariaceae, indigenous to Brazil, 256 MANGANUM. where it is known as Mercurio-vegetal, or Vegetable Mercury, a name applied by charlatans to a number of widely differing plants. Very little is known about Manaca, but it is extensively adver- tised as an unfailing remedy for subacute and chronic rheumatism. It is also considered purgative, diuretic, emmenagogue and anti- syphilitic, being official in the Brazilian Dispensatories, and no- ticed as follows in the Did. de Botan. Brazileira. “ This whole plant, but especially the root, excites powerfully the lymphatic system, eliminating morbid matter by the skin and kidneys. It is antisyphilitic; the interior bark is nauseating and stimulates the throat. In small doses it is resolvent; in larger purgative, diuretic and emmenagogue. In large doses it is an acrid poison.” A fluid extract is on the market, the average dose of which is nix three or four times daily. MANGANUM, Manganese, Mn.—This metal is repre- sented in the Pharmacopoeia by two of its salts, viz.—the native Black Oxide and the Sulphate, as follows,— Mangani Oxidum Nigrum, Black Oxide of Manganese, Dioxide of Man- ganese,—is native, crude Binoxide of Manganese, containing at least 66 per cent, of the pure Oxide, MnOa. A heavy, grayish-black powder, odorless and tasteless, insoluble in water or alcohol, giving off oxygen gas at a red heat, and if heated with hydrochloric acid it causes the evolution of chlorine gas. Is used in preparing Chlorine Water. Dose, gr. ij-x. Mangani Sulphas, Sulphate of Manganese, MnS04.4.H20,— colorless prisms, of slightly bitter and astringent taste, faintly acid reaction, very soluble in water, insoluble in alcohol. Dose, gr. ij-v. Preparations. Potassii PerManganas, Permanganate of Potassium, K2Mn2Og,—deep, purple-violet prisms, of sweet and astringent taste, neutral reaction, soluble in 20 of water with a scanty, brown residue, decomposed by alcohol. It should be kept in well-stoppered bottles, and should not be triturated nor combined in solution with organic or readily oxidizable substances. Dose, gr. ss-ij, in distilled water. Syrupus Mangani Iodidi, Syrup of the Iodide of Manganese (Unofficial), —contains about gj of the iodide in each g. Dose, mx-xxx. For formula see U. S. D>, page 1691. Syrupus Ferri et Mangani Iodidi, Syrup of the Iodide of Iron and Manganese (Unofficial),— each g contains gr. 50 of the mixed iodides in the proportion of 3 of the Iodide of Iron to 1 of that of Manganese. Dose, For formula see U. S. D., page 1692. Ferri et Mangani Carbonas Saccharatus, Saccharated Carbonate of Iron and Manganese (Unofficial),—is a tasteless, reddish-brown powder. Dose, gr. v-xx. For formula see U. S. D., page 1693. manganum. 257 Physiological Action. The salts of Manganese in small doses improve the appetite and the digestion and stimulate the action of the heart. Used in larger doses and for considerable length of time they lower the heart’s action, paralyze the muscular system especially the muscular coat of the arteries, causing progressive wasting, para- plegia, and acute fatty degeneration of the liver. They are gastro-intestinal irritants, and the Sulphate is emeto-cathartic and decidedly cholagogue. Manganese is closely associated with Iron in the blood, bile, etc., in the proportion of about i to 20. Permanganate of Potassium is an active oxidizer, containing as it does a large proportion of oxygen which it yields very readily in the form of ozone, and then becomes the binoxide of manganese. This property gives it the qualities of an antiseptic, a disinfectant and a deodorant. It is considered by some au- thorities to be an efficient emmenagogue. Used internally it must be instantly decomposed in the stomach, and probably is not absorbed in its own state. Therapeutics. The salts of Manganese are used by those practitioners who affect to see a manganese-anaemia in cachectic subjects, and they are always combined with ferric preparations. In gastrodynia and pyrosis the purified oxide is a good remedy in doses of io to 15 grains, and the same preparation is used as an ointment in many skin diseases. In jaundice of malarial origin or catarrh of the biliary passages the sulphate gives good results. Permanganate of Potassium is used as an antiseptic and oxidizing agent in diphtheria, scarlatina, septicaemia, erysipelas, etc., given internally and used locally at the same time. It is given with apparent benefit in dyspepsia, flatulence, lithaemia and obesity, and has often seemed to be of service in acute rheu- matism. In amenorrhoea it is reported to be very efficient, and has lately been used with success as a remedy for the bites of venomous serpents and for other animal poisons. Locally it is frequently employed (3j to the pint) to correct fetor in cancer, ulcers, caries, abscesses, ozaena, and in the proportion of gr. iv to the J it will destroy the odor of a foul breath or that of the fetid perspirations of the feet. It is used both as a test and as a corrigent for organic impurities in drinking-water. 258 MANGO—MANNA—MARRUBIUM. MANGO (Unofficial),—is the bark of Mangifera indica, an Indian tree of the nat. ord. Guttiferae. It is supposed to be an astringent with special tonic action upon mucous membranes. It is highly recommended by its vendors for nasal catarrh, hemor- rhages, and muco-purulent discharges from the intestines, uterus, vagina and bronchi. A fluid extract is sold, which may be used in doses of mx-5j. Mango-Fruit, or Mangosteen, is the fruit of Garcinia mangostana, nat. ord. Guttiferse, also from India. It is a powerful astringent, and is used for nasal catarrh, diarrhoeas, dysentery, leucorrhoea, etc. MANNA ,—is the concrete, saccharine exudation of Fraxinus Ornus, or Flowering Ash, a tree of the nat. ord. Oleaceae, grow- ing in Southern Europe. Manna is produced also by several other trees, and substances resembling it are exuded by many plants. The official Manna occurs in three-edged, flattish pieces, brownish-white and glutinous externally, white and crystalline internally, odor honey-like, taste sweet, slightly bitter and faintly acrid. It contains from 40 to 90 per cent, of Mannit, CfiHuOe, or Manna-sugar, which does not undergo vinous fermentation, and is chemically allied to the alcohols and to glycerin. Manna also contains glucose, mucilage, some acrid resin, and a small quantity of the fluorescent glucoside Fraxin, C16H]8O10. There are no official preparations, but Marina itself may be given in doses of 3j-ij. Physiological Action and Therapeutics. Manna is a mild laxative, with some tendency to produce flatu- lence and colic. It is usually combined with other purgatives, as Senna, Rhubarb, Magnesia, etc., to disguise the taste and increase the effect. It is a constituent of the official Infusum Sennae Com- positum. Manna may be eaten by children if of good quality, or may be readily dissolved in milk and so administered. MARRUBIUM, Horehound,—the leaves and tops of Marrubium vulgare, a plant of the nat. ord. Labiatae, native in Europe, but naturalized in America. It contains a bitter prin- ciple named Marrubiin, also a volatile oil, resin, tannin, lignin, etc. There are no official preparations. Dose, 5ss~b Physiological Action and Therapeutics. Horehound in large doses is laxative, diuretic and diaphoretic, and in ordinary dosage it is a gentle tonic and stomachic. It is MASTICHE—MATICO. 259 generally used in catarrhal states of the air-passages, over which it seems to have a soothing effect, and is much employed in con- fectionery as an ingredient in “ cough-drops.” MASTICHE, Mastic, —is a concrete, resinous exudation from Pistacia Lentiscus, a tree of the nat. ord. Terebinthaceae, growing in the island of Scio. It occurs in globular tears, cov- ered with a whitish dust, of weakly resinous odor and slightly terebinthinate taste. Alcohol dissolves about 90 per cent, includ- ing the resin Mastichic Acid, C.20H32O3, the remainder consisting of another resin Mastichin, which is soluble in ether and resem- bles copal. There are no official preparations, but Mastic is an ingredient of the official Pil. Aloes et Mastiches (see ante, page 56)- Physiological Action and Therapeutics. Mastic was formerly used for supposed properties analogous to those of other oleo-resins, but now its application is confined to dentistry, being employed as a temporary filling for carious teeth, a solution in ether being applied on cotton with moderate pressure, and remaining as a firm plug after evaporation of the solvent. M ATI CO,—the leaves of Artanthe elongata (Piper angusti- folium), a Peruvian shrub of the nat. ord. Piperacese. They are 4 to 6 inches long, and prominently venated on the under sur- face, the veins forming deep, angular meshes. Matico contains a crystallizable acid named Artanthic Acid, also resin, tannin, and a volatile oil. Its odor is aromatic, and its taste astringent, spicy and somewhat bitter. Preparations. Extractum Matico Fi.uidum,—Dose, Tinctura Matico,—io per cent. Dose, Physiological Action and Therapeutics. Matico is an aromatic tonic and stimulant, also aphrodisiac, vulnerary and hemostatic. It acts, like cubebs, on the urinary passages, and is an excellent alterative stimulant to mucous mem- branes. It has been used with considerable success in mucous catarrhs, as gonorrhoea, leucorrhoea, chronic cystitis, etc., also in epistaxis, hemorrhoids, menorrhagia, hemoptysis, hematemesis and other hemorrhages. The under surface of the leaf is so formed as to promote coagulation of blood if applied to a bleed- 260 MATRICARIA MEL. ing surface, and therefore it is a good local hemostatic for trivial cuts or wounds. MATRICARIA, German Chamomile,—the flower-heads of Matricaria Chamomilla, a European annual plant of the nat. ord. Compositse. They are small, yellow flowers, with white ray-florets, the receptacle being hollow, naked and conical, of strongly aromatic odor and bitter taste; and contain per cent, of a blue Volatile Oil (the color of which is due to Azulen), also a bitter extractive, tannin, etc. There are no official preparations, but the flowers may be eaten or a decoction or in- fusion used almost ad libitum. Physiological Action and Therapeutics. Matricaria is a mild tonic, in large doses emetic, anthelmintic and antispasmodic. It is much used in Germany, and in this country is a popular domestic remedy among German people, who use it in infusion as a diaphoretic, etc. This plant is the “Chamomilla” of the homoeopaths, who find in it remarkable power over morbid impressionability of the sensory and excito- motor nerves, and administer it in various pains, aggravated at night and by warmth, clonic spasms of pregnancy, irritability of teething-children, flatulent colic, etc. MEL, Honey,—is a saccharine secretion deposited in the honey-comb by Apis melliftca, the honey-bee; occurring as a pale-yellowish, syrupy liquid, gradually becoming crystalline and opaque, of peculiar and heavy odor, and a very sweet, faintly acrid taste. It is a strong aqueous solution of several sugars (cane and grape sugar, levulose), with wax-pollen, coloring and odorous matters, etc. The sugars, which may be resolved into Levulose and Dextrose, amount to 70 or 80 per cent. Honey is frequently adulterated with starch and artificial glucose, which may be detected by the official tests (see U. S. Phar.). Dose, in- definite. Preparations. Mel Despumatum, Clarified Honey,—is honey heated, skimmed and strained. It is an ingredient of Confectio Rosse, Mel Rosse, and Massa Ferri Carbonatis. Dose, indefinite. Mel Rosai, Honey of Rose,—Red Rose 8, Clarified Honey 92, Diluted Alcohol q. s. Dose, indefinite; generally used as a local application to the throat for its astringency and flavor, in combination with more active agents. MELISSA—MENISPERMUM. 261 Physiological Action and Therapeutics. Honey is emollient, nutritive and laxative, in some persons giving rise to pyrosis, flatulence and colic, and in others to an eruption of urticaria, but generally constituting an agreeable article of diet. It is sometimes actually poisonous from the pres- ence of toxic agents extracted by the bee from certain plants, in this country generally the Mountain Laurel (Kalmia Latifolia). Honey is chiefly used as an emollient in diseases of the throat, to relieve dryness, pain, cough and dysphagia. A mixture of Honey 8 parts to 1 each of Acetic Acid and Water is official in the Br. Phar. under the title Oxymel, and forms a pleasant addi- tion to gargles or a vehicle for expectorant medicines. Honey of Rose is somewhat astringent, and is used in gargles for the throat and in mouth-washes. MELISSA, Balm,—the leaves and tops of Melissa officina- lis, a European plant of the nat. ord. Labiatae, growing also in America. It has a perennial root, which annually gives forth several stems from i to 2 feet high, with leaves about two inches long, deeply serrate, hairy and glandular, and white or yellowish flowers in axillary whorls of four or five around half the stem. It contains gum, tannin, bitter extractive, and a fragrant essential oil in very small quantity (to per cent.). There are no official preparations. Physiological Action and Therapeutics. Balm has little or no action, except to flavor hot water for use as a beverage or a mild diaphoretic. MENISPERMUM, —is the rhizome and rootlets of Meni- spermum canadense, or Canadian Moonseed, a woody, climbing plant of the nat. ord. Menispermacese, native of the eastern U. S., having peltate three- to seven-lobed leaves, greenish-yellow flowers in small clusters, and a kidney-shaped fruit. The rhi- zome is several feet long, % inch thick, finely wrinkled, rootlets numerous, taste bitter. It contains starch, Berberine, and a white alkaloid which is soluble in alcohol and in ether. There are no official preparations. Dose, gr. v-xx, in infusion. Physiological Action and Therapeutics. Menispermum is reputed to have tonic properties, and is used in some of the Southern States in domestic practice as a substi- 262 MENTHA PIPERITA. tute for Sarsaparilla in scrofulous conditions. Little is known about it of a definite character. MENTHA PIPERITA, Peppermint,—the leaves and tops of Mentha piperita, a perennial herbaceous plant, of the nat. ord. Labiatse, native of Britain, but largely cultivated elsewhere. The leaves are about 2 inches long, ovate-lanceolate, sharply ser- rate, of aromatic odor, and pungent, cooling taste. They con- tain 1 to 1 per cent, of a Volatile Oil which is official, and a little tannin. Preparations. Oleum Piperita, Oil of Peppermint,—is the volatile oil dis- tilled from the fresh herb; a colorless or pale yellow fluid of sp. gr. about 0.900, having the odor of peppermint, a strongly aromatic taste followed by a cold sensation when air is drawn into the mouth. It consists of a liquid ter- pene, and a stearoptene named Menthol or Peppermint Camphor, C10H20O. Dose, ffl-j-v. Aqua Piperitve, Peppermint Water,—has of the oil 2 parts in 1000 of Distilled Water. Dose, indefinite. Spiritus Mentha Piperita, Essence of Peppermint,—is an alcoholic solution containing 10 per cent, of the Oil and 1 per cent, of the powdered herb. Is an ingredient of Mistura Rhei et Sodae. Dose, ttlx-xxx. Trochisci Menth on a full stomach, increased as assimilated. MORR.HU.iE OLEUM. 265 Unofficial Preparation. Glyconin Emulsion of Cod-liver Oil,—Ol. Morrhuae Glyceritum Vitelli Aromatic Spirit of Ammonia gj, Sherry Wine %ij, Diluted Phos- phoric Acid Essence of Bitter Almond (>jj of the Volatile Oil in Oss Alcohol) gij. The Cod-liver Oil is to be added to the Glyconin very slowly with brisk stirring, and the other ingredients added in the order named. Physiological Action. The action of Cod-liver Oil is that of any other fat, except that it is more easily assimilated than any member of the class. Fats in small quantity are necessary for the digestion of nitro- genous food, and form the molecular basis of the chyle, being prepared for absorption by the pancreatic juice and the bile, especially by the latter. Fat is an essential constituent of the products of tissue formation, whether physiological or pathologi- cal, and is the principal material concerned in the production of force. After oxidation it is excreted as carbonic acid and water. Locally applied fats reduce the body temperature. Cod-liver Oil is the most easily digestible of fats, penetrating animal membranes with comparative ease after being emulsified by the pancreatic and biliary secretions, hence entering the lacteal vessels readily and appearing to bring with it the oily and nitro- genous elements of the food. The result is facilitation of the digestive process, increase of the red blood-corpuscles and of the body-weight, and stimulation of healthy cell-formation through- out the tissues. The properties of this oil have been ascribed to its contained biliary constituents, Iodine, free Oleic Acid, etc., but no satisfactory explanation has yet been offered for the differ- ence between its action and that of other animal or vegetable oils. Therapeutics. The use of Cod-liver Oil is that of a nutrient wholly, this ac- tion being most marked in wasting diseases. In high febrile states or catarrhal conditions of the gastro-intestinal tract its use is contraindicated, but in phthisis a slight degree of fever will not interfere with its beneficial employment. It is found to be of most value in chronic forms of phthisis, chronic bronchitis and emphysema, chronic rheumatic disorders, atheroma of the arteries, strumous skin diseases and diarrhoea, syphilodermata, neuralgia, chorea and epilepsy. In many disorders referable to exhaustion or debility of the nervous centres it is of great value as a nerve tonic, and in convalescence from acute diseases it is of marked benefit. It should always be considered as a supplementary food, 266 MOSCHUS. and if its use endangers the appetite for other food it should be abandoned. The administration of this valuable agent is a serious matter, as many patients cannot overcome their repugnance to its taste and smell. Various emulsions are on the market, but they are objec- tionable because in no case do they conceal the taste, and the efficacy of the oil is seriously impaired by the processes used in their preparation. Moreover, the temptation is very great to employ an inferior grade of the oil or to adulterate it with other fish-oils in the manufacture of these preparations, and when the commercial spirit of gain is remembered one can never be sure of the quality of the oil so prepared. The oil itself is the best form for use, in small doses, say a teaspoonful thrice daily for an adult, after meals, in black coffee, beer or lemon-juice. The essential Oil of Eucalyptus in the proportion of 1 part to 100 of cod-liver oil will effectually extinguish the odor and taste to many persons. Alkaline stomachics given before meals, the oil after, and a teaspoonful of the “Liquor Pancreaticus” given half an hour afterwards, would be a good routine in most cases, the latter agent preventing the fishy eructations which often give so much trouble. Extemporaneous emulsions may be prepared with Glycerite of Yolk of Egg (see ante, page 265), White of Egg, Mucilage of Tragacanth, Extract of Malt, or any syrup, and flavored with Lemon, Cinnamon or Bitter Almond. The addi- tion of miv of Ether to each 3 of the oil promotes its digestion by stimulating the pancreatic secretion, and enables a patient to take it with whom it had previously disagreed. Inunction by Cod-liver Oil is a method of value in the wasting diseases of children. A tablespoonful may be rubbed into the skin of the abdomen twice a day, and covered with a flannel binder with oiled silk or mackintosh-cloth outside. It readily passes through the skin and is absorbed, producing valuable and lasting results. MOSCHUS, Musk ,—is the dried secretion from the pre- putial follicles of Moschus moschifenis (the Musk Deer), an ani- mal inhabiting the mountainous regions of Central Asia. It occurs in irregular, unctuous grains, of a reddish-brown color, peculiar and penetrating odor and bitterish taste, contained in oval sacs about 2 inches in diameter, membranous on one side, hairy on the other. About 10 per cent, is soluble in alcohol, 50 per cent, in water. Chinese Musk in the pods or sacs is the most valuable, but all varieties are much adulterated, the price of MYRCIiE OLEUM. 267 the drug being very high. The odor is destroyed by drying, but returns again on the addition of moisture. Trituration with Camphor or Hydrocyanic Acid also destroys it. The odorous principle has not been isolated, it is probably a product of de- composition which is constantly being formed. The constituents of Musk are a bitter resinous substance, ammonia, fat, choles- terin, etc. Dose, gr. ij-x. Preparation. Tinctura Moschi,—10 per cent. Dose, Physiological Action and Therapeutics. Musk is a very diffusible stimulant, acting directly on the nervous and circulatory systems, but without much energy. It is also an antispasmodic, and is used with benefit in general prostra- tion of the system with nervous agitation or irregular muscular action. It has been used with advantage in laryngismus stridulus, insomnia, the collapse of typhoid and typhus fevers, spasmodic affections of the stomach, obstinate hiccough and convulsions of children due to intestinal spasms. The pure Musk is very diffi- cult to obtain, and its high price makes it an extremely expensive medicine, so that it is seldom used except as a perfume. MYRCI./E OLEUM, Oil of Myrcia, Oil of Bay,— is a volatile oil distilled from the leaves of Myrcia acris, or Bay- berry, a tree of the nat. ord. Myrtaceae, native of the West Indian Islands. It is a dark-brown liquid, of aromatic odor, pungent taste, slightly acid reaction, and soluble in an equal weight of alcohol. Sp. gr. about 1.040. It contains a hydrocarbon and Eugenic Acid. Used as a perfume. Preparation. Spiritus Spirit of Myrciae, Bay Rum,—contains in 1800 parts Oil of Myrcia 16, Oil of Orange-peel 1, Oil of Pimento 1, Alcohol 1000, Water 782 parts, filtered through Carbonate of Magnesium. Used as a wash or perfume. Physiological Action and Therapeutics. The Oil of Bay is an agreeable perfume used to prepare bay- rum and in other cosmetic preparations. The spirit, known as “Bay-rum,” is used principally as a refreshing perfume, and is thought to relieve headache, faintness, etc., by application to the forehead or to the nostrils. 268 MYRISTICA. MYRISTICA, Nutmeg,—is the kernel of the seed of Myristica fragrans deprived of its testa. The nutmeg tree is cultivated extensively in the East and West India Islands, belongs to the nat. ord. Myristicaceae, and is a native of the Banda Islands in the Malayan Archipelago. The Nutmeg is about an inch long, oval or roundish-ovate, recticulately furrowed, inter- nally pale-brown or grayish-red with dark-brown veins, having a strongly aromatic odor and a somewhat bitter taste. It contains 4 to 9 per cent, of the official Volatile Oil, and 30 per cent, of a concrete oil, commonly called “ Oil of Mace,” which is a com- pound of fluid glycerides of Oleic and Butyric Acids, and the solid glyceride of Myrisiic Acid, some resin and volatile oil. Dose, gr. v-xx. Macis, Mace,—is the arillus or fleshy covering of the fruit of Myristica fragrans, the Nutmeg-tree. It occurs in narrow bands about an inch long, branched and lobed, of brownish-orange color, fragrant odor, warm and aromatic taste. It yields a fixed oil by pressure and a volatile oil by distillation, the latter being probably identical with Oil of Nutmeg. Preparations. Oleum Myristica, Oil of Nutmeg,—is the volatile oil, and consists chiefly of a terpene and an oxygenated oil Myristicol. It is colorless or pale- yellow, of hot, spicy taste and neutral reaction, and is soluble in alcohol. Dose, rtpj-v. Spiritus Myristica, Spirit or Essence of Nutmeg,—is a 3 per cent, solu- tion of the oil in alcohol. Dose, gj-ij. Nutmeg is an ingredient of Acetum Opii, Pulvis Aromaticus, Tr. Lavan- dulae Co., Syr. Rhei Aromat., Trochisci Cretae, Trochisci Magnesias and Trochisci Sodii Bicarbonatis. Physiological Action and Therapeutics. Nutmeg is an aromatic stomachic of agreeable flavor. In small doses it stimulates the production of gastric juice, and thus pro- motes digestion and increases appetite. It also relieves intestinal spasm and flatulence. In large doses it is powerfully narcotic, acting directly on the cerebrum, and producing stupor and de- lirium. It is used chiefly for flavoring purposes, and generally in substance, grated as required, but has been employed as a car- minative, anodyne and astringent in diarrhoeas and dysentery, as well as to relieve nausea and vomiting. The Volatile Oil is decidedly rubefacient when used externally, and has narcotic powers if used internally in sufficient quantity. It is occasionally employed as an external stimulant in paralysis and chronic rheu- matism. MYRRHA—NAPHTHALIN. 269 Mace is stimulant, carminative and aromatic. It is used solely as a spice or condiment. Dose, gr. v-xx. MYRRHA, Myrrh ,—is a gum resin obtained from Bal- samodendron Myrrha, an Arabian tree of the nat. ord. Bursera- ceae, collecting spontaneously upon the bark, and occurring in roundish tears, having a waxy fracture, a balsamic odor, and an acrid and bitter taste. Triturated with water it yields a brownish- yellow emulsion ; with alcohol it yields a brownish-yellow tincture which turns purple on the addition of nitric acid. It contains 60 per cent, of gum, 35 per cent, of Myrrhin a resin, and about 2 per cent, of an oxygenated ethereal oil Myrrhol, C10HuO. Dose, gr. x-xxx. Preparations. Tinctura Myrrhs,—20 per cent. Dose, th. x-xxx. Myrrh is also contained in Mist. Ferri Co., Pil. Aloes et Myrrhre, Pil. Ferri Co., Pil. Galbani Co., Pil. Rhei Co., and Tr. Aloes et Myrrhse. Physiological Action and Therapeutics. Myrrh in small doses stimulates the gastro-intestinal mucous membrane; in large doses it is an irritant thereunto, producing vomiting and purging. It quickens the action of the heart and diminishes the bronchial secretion. It is a uterine stimulant and emmenagogue, a- stimulant expectorant, and is thought to increase the number of leucocytes in the blood. Locally it is stimulant and disinfectant to mucous membranes and ulcerated surfaces. Myrrh is used internally in the various combinations noted above for anaemia and amenorrhoea, bronchial catarrh, etc. It has been supposed to diminish excessive secretion from the mucous surfaces of the uterus, vagina, bladder, and bronchi, and to have an especially beneficial influence on chronic pharyngitis. Lo- cally, the tincture has a good tonic action on diseased mucous surfaces, and is applied to spongy gums, relaxed throat, aphthous patches and unhealthy ulcers. The tincture diluted with water makes an excellent disinfectant and stimulant gargle in ulcerated sore-throat. Myrrh has long been used as an ingredient of den- tifrices. NAPHTHALIN, C10Hg (Unofficial),—is one of the many products of the distillation of coal-tar, occurring in white crystals, 270 NUX VOMICA. fusible at 176° F., and boiling at 4230 F., insoluble in water, but soluble in alcohol, ether, naphtha, and the oils. Dose, gr. v-5>s, in emulsion or syrup, and frequently repeated. Physiological Action and Therapeutics. Naphthalin is destructive to all low forms of life and hence is antiseptic in a high degree. Internally it is a stimulant expect )- rant of decided power. As an antiseptic it has been extensively used in the form of a fine powder applied to indolent ulcers, sloughing wounds, chancres, open cancers, also to fresh wounds and for disinfectant purposes in pus cavities. Internally it has been administered with decided benefit in impending suffocation accompanying the chronic pulmonary catarrh of the aged, in humoral asthma, verminous affections, and as an ointment in pso- riasis, lepra vulgaris, and other forms of scaly skin diseases. Applied as a paint to organic remains it effectually prevents the ravages of insects. NUX VOMICA ,—is the seed of Strychnos Nux-vomica, an East India tree of the nat. ord. Loganiacese, having white, fun- nel-shaped flowers, and a fruit about the size of an orange, with many seeds in a juicy pulp. The seeds are flattened and nearly circular, about one inch in diameter, ashy-gray in color, covered with short, satiny hairs, internally translucent, tough and horny, with a large cavity, inodorous, taste intensely bitter. It contains two alkaloids, Strychnine, 0.2 to 0.5 per cent., and Brucine, 0.1 to 1.0 percent., with a crystalline acid Igasuric or Strychnic Acid, and a yellow coloring matter, a concrete oil, gum, starch, wax, earthy phosphates, etc. A third alkaloid, Igasurine, is claimed to exist by some authorities and is denied by others. Preparations. Abstractum Nucis Vomica,—Dose, gr. gradually increased. Extractum Nucis Vomicae,—Dose, gr. y£-j. Extractum Nucis Vomica Fluidum,—Dose, itlj-v. Tinctura Nucis Vomicae,—20 per cent. Dose, uiv-xx. Strychnina, Strychnine, C21H22N202,—is an alkaloid prepared from Nux Vomica, Ignatia, and other plants of the order Loganiace®; crystalline, in- tensely bitter even in 1 to 700,000 solution, of alkaline reaction, soluble in 6 of chloroform, no of alcohol, 6700 of water, almost insoluble in ether. It is a constituent of Ferri et Strychnin® Citras, and of Syrupus Ferri, Quinin® et Strychnin® Phosphatum. Dose, gr. Strychnine Sulphas, Sulphate of Strychnine fC21H22^2<^2)2H2^h-7^2 — crystalline, efflorescent, odorless, of intensely bitter taste even in 1 to NUX VOMICA. 271 700,000 solution, neutral reaction, soluble in 10 of water and 60 of alcohol at 590 F. Dose, gr. Brucina, Brucine, CMH26N204 (Unofficial), — colorless prisms, pearly flakes, or masses, soluble in water, less so in alcohol; as compared with Strychnine it is less bitter, 12 times weaker and 3 time's slower physiologically. Is thought to be a compound of strychnine and resin, corresponding with the other alkaloid both physiologically and therapeutically. Is seldom used. Dose, gr. Physiological Action. The actions of Nux Vomica are those of its alkaloid Strychnine. In small doses, it acts as a bitter tonic, stimulates respiration, secretion, appetite and digestion, and sharpens the vision. It increases peristalsis, stimulates both the motor and the inhibitory apparatus of the heart, and raises the arterial tension by stimu- lating the vaso-motor centres, thus contracting the arterioles, though by full doses the arterioles are relaxed. By a full dose (Strychnine, gr. y the pupils are dilated, the limbs jerk, respi- ration becomes spasmodic and the lower jaw stiff, a sensation of cerebral tension, sudden shuddering and anxiety follow, the face wearing an unmeaning smile. A toxic dose (Strychnine gr. )4 for an adult) on an empty stomach quickly produces heightened reflexes; tonic spasms, especially of the extensor muscles, on the least irritation quickly succeed each other with intervals of re- pose, resulting after two or three hours at most in death by as- phyxia, from tetanic fixation of the muscles of respiration, con- sciousness being preserved until carbonic acid narcosis sets in. Strychnine exalts all the functions of the spinal cord,—reflex, motor, vaso-motor and sensory,—the latter being the least af- fected. It has a selective action on the large multipolar ganglia in the anterior columns, which it first stimulates and then para- lyzes by over-stimulation. A large dose destroys the spinal func- tions as by one blow. It does not affect the brain directly. The- baine, one of the alkaloids of Opium, is a powerful spinal exaltant and acts very similarly to Strychnine. From the spasms of tetanus those of Strychnine may be differ- entiated by their intermittency, the former being constant. More- over, the meaningless smile, the less marked trismus, the absence of a wound, and the rapid course of the symptoms, all point to the action of Nux vomica. The excretion of Strychnine takes place very slowly, and by the urinary, salivary and cutaneous channels. Rapidly absorbed but very slowly excreted, it accumulates in the system if even a small dose be frequently repeated. On the eye Strychnine has marked effects, augmenting the ex- 272 NUX VOMICA. citability of the retinal elements, increasing the sharpness of vision and enlarging the visual field. Antagonists and Incompatibles. The antidote is Tannic Acid, to form the very insoluble tannate, or a sol- uble salt of Iodine. Then emetics or the stomach-pump, followed by perfect quiet which is very important. Antagonists are Chloral, Tobacco, Chloro- form inhalations or Ether, and Potassium Bromide, the latter being almost too slow of action to be of much use in practice. Chamomile oil should antago- nize the reflex excitability. The bladder must be frequently evacuated to prevent re-absorption of the poison, and artificial respiration maintained as necessary. Incompatibles are Bromides, Chlorides and Iodides in the same solution, the Strychnine being precipitated as hydrobromate, hydriodate, etc. Therapeutics. Nux Vomica and its chief alkaloid are used as a stomachic tonic and as a respiratory, cardiac, muscular and nervous stimu- lant. As the quantity of Strychnine in Nux Vomica varies greatly, it is best to use the alkaloid when its physiological action is de- sired, as more definite dosage may thus be obtained. The tinct- ure in 5-drop doses is excellent in atonic dyspepsia and gastric catarrh, especially in drunkards, and in constipation from atony of the bowels it may be given in io-drop doses with good re- sults, not as a purgative but to increase peristalsis. The extract is much used in laxative pills for habitual constipation. In the vomiting of pregnancy the tincture is frequently an efficient remedy, and in the vomiting of phthisis Strychnine is the very best agent. Epidemic diarrhoeas and dysentery are well treated by Strychnine, and in anaemia and chlorosis it is invaluable, com- bined with Iron and Quinine. In neuralgiae, especially the vis- ceral, tetanus of the idiopathic type, cardiac failure from any cause, and in intermittents as an adjunct to Quinine, it is always a useful drug. Local paralyses of various forms are well treated by injecting Strychnine hypodermically into the affected muscles, and diphtheritic paralyses are almost invariably cured by it. Strychnine is an excellent remedy in hemiplegia when degenera- tion has not yet set in, and when the paralyzed muscles are com- pletely relaxed ; but is of no avail in recent cases, nor when the muscles have lost electrical contractility. In amaurosis from lead, tobacco or alcohol, it has proved remarkably useful, and in the dyspnoea of pulmonary affections it may be employed with benefit as a respiratory stimulant. Strychnine is a physiological antagonist to Chloral, Physostigmine and Morphine, and may be NYMPHALA ODORATA—OLIVAS OLEUM. 273 carefully administered in poisoning by these substances while the ordinary methods are also employed. In many eye diseases Strychnine is injected into the tissues about the temple with great benefit, especially in amblyopia due to functional disorder of the retina without lesions, and in atro- phy of the optic nerve. Used in the same manner it is highly recommended in infra-orbital neuralgia, and in other neuralgiae characterized by debility and anaemia. NYMPHjEA ODORATA, Sweet-scented Water- lily (Unofficial),—is a well-known American plant of the nat. ord. Nymphaeacese, the root of which is very bitter and highly astrin- gent, containing much Gallic and Tannic Acids, to which its actions and uses are due. A decoction of 3j to the pint may be used in doses of oss~j> °r a fluid extract in doses of 3ss~j* For the physiological actions and therapeutics of this vegetable astrin- gent see Tannic Acid, ante, page 38. OLIVAE OLEUM, Olive Oil, Sweet Oil, Salad Oil,— is a fixed oil expressed from the ripe fruit of Olea europcea, the Olive tree (nat. ord. Oleacese), which is cultivated in southern Europe, California and Australia. It is a pale-yellow or greenish- yellow, oily liquid, of nutty, oleaginous taste, and neutral re- action, sparingly soluble in alcohol but readily soluble in ether. Sp. gr. about 0.916. Olive Oil consists of 72 per cent, of Olein (a fluid oil) and 28 per cent, of Palmitin (a solid oil or stearoptene), which are compounds of the base Glyceryl, C3H5, with Oleic Acid, C19H3402, and Palmitic Acid, C17H3102, re- spectively. It is frequently adulterated with cheaper fixed oils, especially poppy oil, lard oil, and cotton-seed oil, quantities of the latter being exported every year to Italy, whence it is returned to us as Olive Oil under a French label. (See Gossypium, ante, page 206.) It is an ingredient of Ceratum Camphorse, Ceratum Cetacei, Emplastrum Plumbi and Unguentum Diachylon, and is the source of the official Soap. Dose, Physiological Action and Therapeutics. Externally used Olive Oil is a good protective from the air, and renders the skin soft and flexible. If rubbed into the integu- ment it is absorbed by the lymphatics and is directly nutritive in effect. Internally it is also nutritious and mildly laxative, and in quantity acts as a protective of the mucous membrane against acrid or poisonous substances. Like other oils it is partly emulsified, 274 OPIUM. partly saponified in the intestines, its glycerin being set free and its fatty acids combining with free alkalies to form soap, which with the emulsion forms the molecular basis of the chyle, enter- ing the blood through the lacteals and being finally oxidized into carbonic acid and water, though an excess will appear unchanged in the urine. Oils are therefore a food within certain limits, in- crease the fat of the tissues, furnish force, and save the waste of nitrogenous tissue, but are unable of themselves to support life. Therapeutics. Olive Oil possesses no very marked therapeutic power above any other bland oil or fat. It is a good laxative for infants ad- ministered internally, and may be used as an enema followed by warm water. Its chief employment is as a local application. Applied to burns and acute inflammations of the skin it is an ex- cellent protective, coating the surface and excluding the air; and as an ingredient of liniments it acts as a diluent for more active agents. It is used to facilitate friction over enlarged or stiff joints, and in the desquamative stage of scarlet fever is a very useful and grateful application. As an antidote in corrosive poi- soning it acts mechanically by protecting the mucous membrane of the stomach and preventing absorption. In pharmacy its bland, unirritating qualities have procured its common employ- ment as an ingredient of liniments, plasters, ointments and cerates, but the foreign article is so frequently adulterated with inferior oils that Cotton-seed Oil is now directed in its place in many official preparations. OPIUM ,—is the concrete, milky exudation, obtained in Asia Minor by incising the unripe capsules of the White Poppy, Pa- paver somniferum, an annual herb of the nat. ord. Papaveraceae, indigenous to Western Asia but cultivated extensively elsewhere. Its capsules are globular, two or three inches in diameter, and are crowned by a sessile, stellate stigma, which distinguishes them from Colocynth and Bael fruits. Opium occurs in irregular lumps or cakes, of dark-brown color, sharp, narcotic odor, and bitter taste; and in its normal, moist condition should yield not less than 9 per cent, of Morphine when assayed by the process official in the Pharmacopoeia. Composition of Opium. Opium contains 17 alkaloids, 2 neutral substances and 2 organic acids, together with sugar, gum, resin, pectin, extractives, odor- OPIUM. 275 ous principles, water and other constituents of plants. Its most important alkaloids are the following : Morphine, C17H19N03, 5 to 20 per cent,—the principal alkaloid, occur- ring in the drug in the form of the tribasic meconate. Its properties are ano- dyne, hypnotic and narcotic. From it by a process of dehydration by heat and hydrochloric acid is prepared the artificial alkaloid Apomorphine, a powerful emetic. (See ante, page 74.) Codeine, C18H21N03, 0.3 to 0.5 per cent.,—is calmative and when pure a not very active alkaloid, but is frequently contaminated with other alkaloids. Apomorphine may be prepared also from it. Narcotine, C22H23N07, 2 to 10 per cent.,—is antiperiodic and a tetanizer, but wholly devoid of narcotic properties. Thebaine or Paramorphine, C19H21N03, 0.15 to 0.20 per cent.,—is a power- ful spinal exaltant and tetanizer, resembling Strychnine in its action. Narceine, C23H29N09, 0.02 per cent.,—closely resembles Morphine-in action, but is probably more hypnotic, and is not followed by many of the disagreeable after-effects of Morphine. It is extremely difficult to obtain this alkaloid pure. Papaverine, C2lH21N04, i per cent.,—is reported inert on man by some observers, a narcotic and convulsant by others. Other Alkaloids at present acknowledged are—Cryptopine, Pseudomor- phine, Protopine, Hydrocotarnine, Laudanine, Codamine, Rhceadine, Meconi- dine, Laudanosine, Lanthopine and Gnoscopine. Many of them are probably to be regarded as derivatives from Morphine. Besides the above-named alkaloids the most important of the constituents of Opium are the following acids and neutral princi- ples,viz. : Acids are—Meconic Acid, C7II407, 4 per cent., and Lactic Acid, C3H603, per cent., which exist in combination with the alkaloids as meconates, bime- conates, etc. The second acid is generally called Thebolactic, but has been recently shown to be identical with lactic acid. Neutral Principles are—Meconin, C10H10O4, 0.01 per cent., white, crys- talline, neutral, but very acrid; Meconoiosin, C8H10O2, also crystalline, and Porphyroxiti, which is now said not to be a proximate principle but a very complex combination of several alkaloids. Smyrna, Turkey or Levant Opium is the best grade. Con- stantinople Opium is of uncertain quality, while of the other varieties in the market Egyptian, Persian and Indian samples are those most frequently met with. All varieties are more or less adulterated with fruits and leaves of other plants, starch, pitch, clay, wax, gum, liquorice, etc. Preparations of Opium. Pulvis Opii, Powdered Opium,—is Opium dried at a temperature not ex- ceeding 185° F., and reduced to a moderately fine powder. It should contain not less than 12 nor more than 16 per cent, of Morphine when assayed by the official process. Dose, gr. ss-iij,an average adult dose being about one grain. 276 OPIUM. Opium Denarcotisatum, Denarcotized Opium,—is powdered Opium freed from the constituents which are soluble in ether, namely—the odorous matters and Narcotine, which are supposed to cause the unpleasant after-effects of Opium. It should yield 14 per cent, of Morphine, and therefore is by no means “ denarcotized,” but is a good preparation, being a purified Opium having a fixed Morphine standard. Dose, gr. ss-iij, an average adult dose being about one grain. The proprietary article named Svapnia is a similar preparation. Extractum Opii,—an aqueous extract containing Glycerin to keep it soft, and freed from some disturbing principles which are insoluble in water. Dose, gf- X-j* . . . Pilule Opii,—each pill contains gr. j of powdered Opium with gr. % of Soap. Dose, j-iij. Tinctura Opii, Laudanum,—Opium-strength 10 per cent., average Mor- phine-strength gr. vj, equalling gr. vijss of the Sulphate to the Ttlxj (git. xxij) = gr. ] of Opium or gr. •/£ of Morphine Sulphate. Sixty minims yield on the average 120 drops. Dose, iffv-xx as per effect required. Tinctura Opii Deodorata, Deodorized Tincture of Opium,—an aqueous extract shaken with ether, which being separated the residue is dissolved in water, and enough alcohol is added to preserve it. An excellent liquid prepa- ration, being freed from all the noxious and useless ingredients soluble in alcohol and ether. McMunn's Elixir is a similar preparation, so also is a recent nostrum named Papine. Opium-strength 10 per cent., average Mor- phine-strength gr. vj to the flj|. Dose, as Tinct. Opii. Drops of this prepa- ration nearly equal minims. Vinum Opii, Wine of Opium, Sydenham’s Laudanum,—Opium-strength 10 per cent., with the aromatics Cinnamon and Cloves of each 1 per cent., in Stronger White Wine. A vinous tincture decreased somewhat in strength from the wine of 1870. Dose, as Tinct. Opii. Drops of this preparation are larger than those of the tincture. Acetum Opii, Vinegar of Opium, Black Drop,—Opium-strength 10 per cent., with Nutmeg and Sugar in Dilute Acetic Acid. Is now weaker than formerly, having the same strength and dose as Tinct. Opii. Tinctura Opii Camphorata, Camphorated Tincture, Paregoric,—has of Powdered Opium 4, Benzoic Acid 4, Camphor 4, Oil of Anise 4, Glycerin 40, Diluted Alcohol q. s. ad 1000 parts, contains nearly one grain of pow- dered Opium. Dose, for an infant gtt. v-xx, for an adult gj-iv. [Note.—According to the U. S. Pharmacopoeia of 1880 the official dried Opium should contain 12 to 16 per cent, of Morphine instead of 10 per cent, as required by the Pharmacopoeia of 1870. The liquid preparations, except Paregoric, are now directed to be of the uniform Opium-strength of 10 per cent, by weight, making the Wine less strong by 2 per cent., the Acetum fully y3 less in strength, and the other liquid preparations stronger by >4 in Mor- phine than formerly. So that if the full anodyne dose of Tincture or Deo- dorized Tincture be taken at 24 minims, equalling gr. % of Morphine Sulphate, the corresponding dose under the new system will be 16 minims.] Liquor Opii Compositus,Compound Solution of Opium (Squibb),Unoffi- cial,—has the same strength as the official tinctures, namely gr. vj of Morphine, equalling gr. vijss of the Sulphate to each fluidounce. rn.xvj == gr. % of Mor- phine Sulphate. Tinctura Opii Composita, Squibb’s Diarrhoea Mixture (Unofficial),—has of Tinct. Opii, Spt. Camphorae and Tinct. Capsici of each, Purified Chlo- roform Stronger Alcohol q. s. ad Each H3 or teaspoonful contains OPIUM. 277 about ioo drops or "nixij of each of the first three ingredients and TH-ivss or 18 drops of Chloroform. Dose, for infants gtt. j-x, for children gtt. x-xxx,for adults Emplastrum Opii,—Extract of Opium 6, Burgundy Pitch 18, Lead Plaster 76 parts. Pulvis Ipecacuanha et Opii, Dover’s Powder,—Ipecac 10, Powdered Opium 10, Sugar of Milk 80, triturated to a fine powder. Dose, gr. v-xv, ten grains equalling one grain each of Ipecac and Opium. Tinctura Ipecacuanha et Opii,—Deodorized Tincture of Opium 100 parts evaporated to 85, Fluid Extract of Ipecac 10, Diluted Alcohol q. s. ad ioo. Intended to represent Dover’s Powder in a liquid form. Dose, uiv-xv. Trochisci GlycyrrhizA et Opii,—each troche contains Extract of Opium gr. with Extract of Liquorice, Acacia, Sugar and Oil of Anise. Dose, j-iv. Alkaloids and their Preparations. Morphina, Morphine, C17H19N03.H/),—white, prismatic crystals or a crystalline powder, odorless, of bitter taste and alkaline reaction, almost in- soluble in water, soluble in 100 of alcohol. Its comparative insolubility makes the salts preferable for use, and as a very small proportion of acid neu- tralizes it, the dosage is about the same for the alkaloid and its salts, viz., gr. 55-gr. j. Gr. is about equal to one grain of Opium of medium Morphine-strength. [Compare Morphina Sulphas, below.] Morphina AcetAs, Acetate of Morphine,—a white, crystalline or amor- phous powder, of faintly acetous odor, bitter taste, neutral or faintly alkaline reaction, soluble when fresh in 12 of water and in 68 of alcohol at 590 F. Dose, gr. Morphina Hydrochloras, Hydrochlorate of Morphine,—white, feathery crystals of silky lustre, of bitter taste and neutral reaction, soluble in 24 of water and in 63 of alcohol at 590 F. Dose, gr. Morphina Sulphas, Sulphate of Morphine,—white, feathery, acicular crystals of silky lustre, of bitter taste and neutral reaction, soluble in 24 of water and in 702 of alcohol at 590 F., and in 0.75 of boiling water. Con- tains about 80 per cent, of Morphine. Dose, gr. jV-gr. j; being a small dose for an adult, a moderate one, Y-'/z a full dose, and a large one. Pulvis Morphina Compositus, Tully’s Powder,—has of Morphine Sul- phate 1 part to 20 each of Camphor, Liquorice and Calcium Carbonate. A similar preparation to Dover’s Powder minus the Ipecac. Dose, gr. v-xv, ten grains containing gr. of Morphine Sulphate. Trochisci Morphina et Ipecacuanha,—each troche contains gr. of Morphine Sulphate with about gr. of Ipecac, also Sugar, Oil of Gaultheria and Mucilage of Tragacanth. Dose, one every hour or so, cautiously with children. Liquor Morphina Sulphatis, Magendie’s Solution (Unofficial),—has gr. xvj of Morphine Sulphate in each fig, or gr. j in mxxx, or gr. % in hi vijss. Oleatum Morphina, Oleate of Morphine (Unofficial), — Morphine- strength 10 per cent, with Oleic Acid 90. For local use. Codeina, Codeine, C18H21N03.-H20,—white or yellowish-white, rhombic prisms, efflorescent in warm air, of bitter taste and alkaline reaction, soluble in 80 of water at 590 F. and in 17 of boiling water, very soluble in alcohol, chloroform and ether. This alkaloid is official. Dose, gr. ss-ij, but gr. i/£ has caused alarming symptoms in children. 278 OPIUM. Narcotin,*: Hydrochloras, Hydrochlorate of Narcotine (Unofficial),— Dose, gr. ij-x, as an antiperiodic. The Tincture of Opium is an ingredient of Mistura Magnesite et Asafoetidae, and the Camphorated Tincture is an ingredient of Mistura Glycyrrhizse Com- posita. (See ante, pages 253, 205.) Children bear Opium badly, and for them its proportionate dosage should be much below that for other agents. Morphine should not be given to children below 10 years of age, and never hypodermically to those beneath the age of 15. Opium given to a nursing mother will affect the child, being partly excreted in the milk. Reactions and Incompatibles. An aqueous or alcoholic preparation of Opium reddens litmus paper (free meconic acid);—gives a deep red color with Perchloride of Iron (meconic acid);—forms precipitates with Acetate and Subacetate of Lead, Nitrate of Silver, Zinc, Copper, and Arsenic (meconates, sulphates and coloring matter); —forms a precipitate with tincture of Galls or astringent preparations (tan- nates of morphine and codeine);—and becomes turbid with the fixed Alka- lies, Carbonates, Alkaline Earths, and Ammonia (precipitated morphine and narcotine). Tests for Morphine. Nitric Acid produces a blood-red, turning orange, then yellow, then disap- pearing. Test-solution of Ferric Chloride gives a blue color changing to green with excess of the reagent, and destroyed by free acids or alcohol, but not by alkalies. Iodic Acid liberates Iodine which may be tested by starch. Physiological Action. Opium is analgesic, hypnotic, antispasmodic, diaphoretic and narcotic. It first stimulates then depresses the cerebrum, heart and respiratory apparatus, and is classed among the cerebral depressants. In medium dose (gr. j) it arrests all the secretions except the milk and sweat, the latter being increased ; producing dryness of the mouth and throat, retarded digestion from stoppage of the gastric juice, and decided loss of appetite. The action of the heart is increased, arterial tension raised and. the pupils slightly contracted. The cerebral faculties are stimulated by increased blood-supply to a pleasant activity, ideas follow each other rapidly through the mind, and an exhilaration bordering on mild intoxi- cation is experienced, succeeded by a calm of variable length. Sleep generally follows, disturbed, however, by dreams, and after waking headache, malaise, constipation, digestive disturbance and some depression result. The conductivity of the nerves is not affected. Frequently the stage of mental activity is absent, but in persons habituated to the use of Opium it is usually well OPIUM. 279 marked. In some subjects a lengthened period of calm repose takes the place of sleep, in others neither calm nor sleep occurs, but the stimulant action of the drug prevails, the spinal func- tions as well as the cerebral are exalted, and great restlessness is the result. In full dose (gr. iij-v) the same symptoms are produced but in greater intensity; the stage of stimulation is much shorter, digestion is arrested, nausea and vomiting produced, also profuse diaphoresis. The conductivity of the nerves is more or less impaired, the heart and circulation depressed, oxidation being interfered with and the body-temperature lowered. The pupils are contracted by stimulation of the motor oculi through the basal ganglia, intense pruritus is produced especially at the nose, and often spasmodic retention of the urine. Profound sopor soon comes on, with irregular and slow respiration, but in some subjects this is replaced by coma-vigil and delirium. After- effects are nausea, depression, constipation, racking headache, vertigo, anorexia, nasal pruritus and fetid pathological secretions. A toxic dose produces cold and clammy sweat, very slow pulse, slow and stertorous respiration gradually becoming feeble and irregular, cyanosed face, abolished reflexes, coma gradually deep- ening, the pupils minutely contracted but dilating as the end approaches, and finally death by paralysis of the respiratory centre due to direct action on the medulla. Post-mortem shows only a wet brain, congested lungs, and engorgement of the venous trunks and of the right heart. The principal action of Opium is exerted upon the nervous system, first affecting the cerebral convolutions which are briefly stimulated and soon depressed,—next the perceptive and sensory centres in the higher brain are more or less blunted and the con- ductivity of the afferent nerves impaired,—soon the ganglia at the base of the brain are involved, evinced by the contraction of the pupils, vomiting, and slowing of respiration,—the cardiac, vascular and other centres are depressed but to a less degree than the respiratory and perceptive,—the gray matter of the cord, at first stimulated, as shown by the increase of reflex excitability, is also depressed, and locomotion becomes difficult, the motor nerves becoming paralyzed from the centre outwards, but muscular irritability is never lost. Death generally occurs by paralysis of the respiratory centre, rarely by sudden cardiac failure. Metabolism is greatly reduced in activity by Opium, the quan- tity of urea excreted being markedly lessened, and the biliary and glycogenic functions of the liver being affected, resulting in 280 OPIUM. whitish stools, perhaps jaundice, and certainly decided decrease of the sugar excreted by diabetics. The hypnotic action of Opium is now believed to be produced by a double influence, (i) on the vascular system causing anaemia of the brain, (2) on the cerebral cells, diminishing their activity and consequently lessening their demand for blood. Its constipating action is shown experimentally to be produced by stimulation of the inhibitory nerves of the intestines through the splanchnics. Morphine acts similarly to Opium in general, being the prin- cipal alkaloid therein, but when used alone its influence is not complicated with that of the convulsant alkaloids (Thebaine, Codeine, Narcotine), which must affect to a considerable degree the action of Opium. Consequently, as compared with the latter, Morphine acts more quickly, and for a shorter time, has less influence on the intestines and skin, is less constipating, less stimulant, less convulsant and less diaphoretic, but more sedative, more anodyne and hypnotic and produces more intense pruritus. Its excretion commences quickly but may not be completed for as much as 48 hours, and is effected by most of the secretions, especially by the urine. It is probably retained in the system when the action of the kidneys is defective, and hence when given in renal disease may accumulate with fatal results. Codeine exalts the spinal cord more than Morphine and affects the cerebrum less, producing muscular tremor in excess of the sedative action. It is anodyne and hypnotic with less general disturbance than produced by Morphine. It markedly reduces the amount of sugar excreted by diabetics, and has a special sedative influence on the pneumogastric nerve. Narcotine should be named Anarcotine, as it has little or no narcotic power. It is a convulsant in animals and an antiperiodic in man. Narceine is said by some observers to be remarkably hypnotic, and free from convulsant action,—by others equally deserving of credit it is considered almost inert. This alkaloid is difficult to obtain pure; hence the samples heretofore used have probably been contaminated with other alkaloids. Thebaine is a powerful convulsant, exalting the spinal cord almost like Strychnine and Brucine. It is not used medicinally. Fatal Doses. In a child one day old inj of Laudanum caused death. A me- dicinal dose given to a nursing mother proved fatal to the infant. A few drops of Paregoric have killed a child of nine months. OPIUM. 281 In the adult gr. yfc of Morphine in one case, and gr. iv of crude Opium in another, have proved fatal. Antagonists and Treatment of Poisoning. Atropine antagonizes the cerebral action of Morphine, also its action on the pupils, respiration, heart and arterial tension, but if given too freely will endanger the case by substituting Belladonna-narcosis for Opium-narcosis. Gr. T|ff hypodermically every 15 minutes for three doses, is generally suffi- cient. Caffeine is also physiologically antagonistic, and is generally used in the form of strong black coffee frequently administered. The chief indica- tions in Opium-poisoning are—to evacuate the stomach, maintain respiration and keep up the circulation. Faradization of the chest muscles, cold affusion, and artificial respiration are of great value, and evacuation of the bladder is important. Flagellation is a very dangerous procedure from the exhaustion which may be produced; strong faradic currents are much more efficient. Some of the cerebral effects of Opium, as vertigo and mental confusion, are removed by a full dose of Potassium Bromide, others are antagonized by Qui- nine, and the general intra-cranial effects of the drug are to some extent opposed by Digitalis and Tartar Emetic. Atropine may be advantageously combined with Morphine in solution for hypodermic injection, in the proportions of gr. to of the former to gr. % of the latter, preventing the sickness and depression and many other unpleasant after-effects of Morphine, while increasing its anodyne, hypnotic and antispasmodic powers. Therapeutics. The chief indications for the use of Opium are—(1) to relieve pain from any cause except acute inflammation of the brain,—(2) to produce sleep, particularly in the insomnia of low fevers with delirium, in which the combination of Morphine and Chloral is very efficient,—(3) to allay irritation in the various forms of acute nervous erethism,—(4) to check excessive secretion, as in diarrhoeas, dysentery, diabetes, ptyalism, etc.,—‘(5) to support the system in low fevers and other adynamic conditions, when sufficient food cannot be retained,—(6) as a sudorific, to produce sweating in coryza, etc. It is considered of especial value in any irritation of the stomach, bladder or bronchi, in severe vomiting, both forms of diabetes, gastralgia, colic and muscular spasm. In peritonitis and inflammations of other serous membranes, used freely even to narcotism it has often saved life. In cerebro-spinal meningitis it is the one remedy if given early, before exudation has set in. Cholera morbus and dysentery are efficiently treated by Morphine and Atropine hypodermically (gr. with gr. T^¥) after the ingesta have been removed by purging. In acute urae- mia its use in large doses is recommended by Loomis to control convulsions and promote diuresis, but here it is a dangerous agent. In muscular rheumatism and acute colds Dover’s powder as a diaphoretic, conjoined with hot drinks and foot-baths, is old 282 OPIUM. but excellent treatment. In delirium tremens, acute and chronic mania and melancholia, nervous prostration and the delirium of fevers Opium is probably the best hypnotic. Severe pain from any cause (except cerebritis) is relieved by Opium with an effi- ciency possessed by no other drug, as the pain of sciatica, neuralgia, lumbago, cancer, renal and hepatic colic from calculi, etc. Cough of harassing and frequent character with but little secretion is best treated by Opium, but when there is profuse expectoration it should not be used, as the lowering of excita- bility of the respiratory centre which it produces would in such a case be dangerous. In nearly all acute inflammations it is valu- able, especially where it becomes advisable to lock up the bowels. Its tranquillizing power over the circulation makes it invaluable in various forms of hemorrhage. Applications of the Various Preparations. Intense pain, as from the passage of calculi, is best met by hypodermic injection of Morphine Sulphate in full doses (gr. 1f- y2) with Atropine Sulphate (gr. Either the Solution of Morphine or the liquid preparations of Opium maybe given by the mouth in corresponding doses for the same purpose. Severe pain enables the system to resist the action of Opium, which in such cases should be repeated at short intervals for effect regardless of dosage. Superficial pain is often alleviated by the Plaster or by extem- poraneous liniments containing Laudanum or some other fluid preparation. It is, however, very doubtful whether such applica- tions are of direct value, as Morphine is not absorbed by the unbroken integument; but the Oleate of Morphine is said to be very penetrating. To produce sleep the most efficient preparations are the De- odorized Tincture, the Solution of Morphine, Pil. Opii and Dover’s Powder, in dose corresponding to the degree of insomnia and restlessness present. Cough is relieved by the two Trochisci, the Deodorized and Camphorated Tinctures, and by the Solution of Morphine in small doses with Syrup of Wild Cherry or Syrup of Tolu. Diaphoresis is best obtained by the use of Dover’s Powder in either of its three forms. Sedative action is obtained by different preparations for dif- ferent organs. The stomach is best affected by the Solution of Morphine in effervescing mixtures, the Extract in a small pill, or Morphine hypodermically over the epigastrium. The intestines may be influenced by Laudanum in a starch enema, or internally ORIGANUM. 283 by Dover’s Powder, Pulvis Opii,or Pil. Opii, especially the latter, with or without Calomel as an astringent when the bowel must be paralyzed, as in peritonitis, hernia, intussusception, etc. The rectum and other pelvic organs are promptly affected by a supposi- tory of the Extract of Opium, gr. % with gr. of the Extract of Belladonna. A dministration. Probably no drug in the Materia Medica is so useful as Opium, or has so wide a range of application. At the same time no drug requires such careful handling, by reason of the many in- fluences which modify its action and uses. As before pointed out, children are extremely susceptible to its narcotic action, and women are more easily affected by it than men. Many persons are found with idiosyncrasies in respect to Opium, some being easily narcotized, others being remarkably insusceptible to its action, and many suffer from a decided shock after its hypodermic administration, which may even produce alarming symptoms of collapse. In subjects of kidney disease it may accumulate and act more powerfully than expected, and generally it may be said to be contraindicated or to be used with great care in alcoholism, congestion of the brain, and disease of the respiratory organs, heart and kidneys. Morphine and Atropine are sufficiently antagonistic to each other to make their combination extremely valuable as a therapeutic measure, and their use as mutual antidotes in poisoning by either a most efficient procedure if employed with due precautions. When Morphine is given as a hypnotic or an anodyne, Atropine should always be administered at the same time in the proportion of gr. of the latter to gr. of the former. By this means the anodyne and hypnotic qualities of Morphine are increased, while the nausea and depression with the subsequent dyspepsia and constipation due to it are avoided. Moreover, as in the doses above-mentioned Atropine is a cardiac and respiratory stimulant, it will counteract the depressing tendency of Morphine on the heart and respiration in subjects who have undue suscepti- bility to its action. ORIGANUM, Wild Marjoram, —is the plant Origanum vulgare, a perennial herb of the nat. ord. Labiatae, native of Europe and America, having a stem branched above, petiolate leaves about an inch long and hairy beneath, pale purple flowers, aromatic, pungent and bitterish. It contains a Volatile Oil, some tannin, resin, and a bitter principle. The oil was formerly much used and was official, but it is now entirely superseded by the Oil of Thyme. Origanum is an ingredient of Vinum Aro- 284 PANCREATIN PAPAIN. maticum. There are no official preparations. Dose, 3j-’j> in infusion. Physiological Action and Therapeutics. Origanum is gently tonic, also carminative, stimulant and emmenagogue. It was formerly much ejnployed as a diaphoretic, etc., but is now rarely administered. PANCREATIN (Unofficial),—is the juice of the pancreas, and consists of four ferments: (x) Pancreatic Diastase, the amy- lolytic ferment, (2) Trypsin, the proteolytic ferment, (3) a fat- emulsifying and (4) a milk-curdling ferment. It is marketed in various forms, named Pancreatine, Pancreatic Emulsion, and Liquor Pancreaticus, of which the last-named is the most effi- cient preparation. Liquor Pancreaticus, Pancreatic Solution (Unofficial),—prepared by di- gesting a finely-chopped pig’s pancreas with 4 times its weight of dilute alco- hol. Is a nearly clear alcoholic solution, with little taste or smell. Dose, 3}~S ss. Physiological Action and Therapeutics. Pancreatic preparations are active digestives of proteid and amyloid foods, converting proteids into peptones, and emulsify- ing fats, in the presence of an alkaline solution (Pepsin requiring an acid one). Pancreatin is digested by Pepsin, and hence probably never passes into the duodenum in its own character. Trypsin affects albuminoids even in a slightly acid solution. Liquor Pancreaticus is used to partially digest (peptonize) milk, gruel, soups and other foods, before their administration in cases of great digestive debility. These peptonized foods may be ad- ministered per oretn vel rectum, and are valuable in intestinal dyspepsia, wasting diseases, and convalescence from acute affec- tions. A teaspoonful taken after the administration of Cod-liver Oil will prevent the disagreeable eructations which are so offen- sive to some patients, and will aid in the digestion of the oil. Trypsin, unlike Pepsin, will dissolve mucin, and like Pepsin it is inert towards nuclein, horny tissues and amyloid matter. Used as a spray on diphtheritic membrane it has proved a very efficient solvent. PAPAIN, Papaiva (Unofficial),—is a ferment obtained from the milky juice of Carica Papaya, a S. American fruit-tree of the nat. ord. Papayacese. It is soluble in water but net in PARALDEHYDE PAREIRA. 285 alcohol, and has active digestive powers. It softens and dissolves fibrin in liquids which may be either acid, or neutral, or slightly alkaline, in this respect differing greatly from Pepsin. It also acts at higher temperatures and more rapidly than Pepsin. It is a rapid solvent of false membranes and intestinal worms. It has been injected into tumors, dissolving the tissues in its vicinity, but with much pain and considerable febrile reaction. It is not used internally, as it is feared that it may digest the gastrointes- tinal mucous membrane as well as its contents. Papaw Milk is the milky juice of the fruit, coagulating into two parts, a pulpy mass and a liquid serum. When mixed with alcohol an amorphous powder is precipitated, which when dried forms Papain. PARALDEHYDE, C6H1203 (Unofficial),—is a polymeric modification of Aldehyde, fluid above 510 F., solidifying below that temperature, soluble in 8 of water. Dose, mxx-3ijss. It is powerfully hypnotic and diuretic, but has no diaphoretic action. It possesses many of the qualities of Chloral with none of its dangers, strengthening and slowing the heart, instead of weaken- ing it. A toxic dose paralyzes the medulla and the respiratory centre. As compared with Chloral its action is not so persistent and it requires more frequent repetition, but it is unquestionably safer. As a hypnotic it has been used with great benefit in fevers, rheumatism, acute mania, hysteria, and insomnia from various causes. The above-mentioned maximum dose has frequently been given without any ill-effect, and with no digestive or cere- bral disturbances afterwards. PAREIRA, Pareira Brava ,—is the root of Chondodendron tomentosum, a climbing, woody vine of the nat. ord. Menisperma- cege, with very large leaves and grape-like fruit, inhabiting Peru and Brazil. Occurs in sub-cylindrical, tortuous pieces, 4 to 6 inches long, dark brownish-gray externally, with transverse ridges, fissures and furrows; internally pale-brown, interior woody, po- rous, in concentric circles with medullary rays. It contains Pelosine or Cissampeline, an alkaloid identical with the Berberine of Nectandra and the Buxine of Buxus sempervirens (Boxwood). Several other Pareiras are on the market, that from the West Indies (Cissampelos Pareira) being the plant formerly official in the Br. Pharmacopoeia. 286 PEPO—PEPSINUM. Preparations. Extractum Pareirze Fluidum,—Dose, Infusum Pareira (Unofficial),—I in 17. Dose, gj-ij. Physiological Action and Therapeutics. Pareira is diuretic and laxative, stimulating peristalsis and the action of the kidneys. It is eliminated by the renal secretion, and passing over the mucous membrane of the genito-urinary tract, it acts thereon in a tonic and soothing manner, especially on the bladder. It is particularly useful in chronic cystitis, suppurative kidney diseases, gonorrhoea and gleet, but must be used internally, as when injected locally for gonorrhoea and cystitis it has not proved successful. Formerly Pareira was considered an efficient lithon- triptic, and in Brazil it is used as a cure for bites of poisonous serpents, being employed both internally and locally to the wound. PEPO, Pumpkin-seed,—is the seed of Cucurbita Pepo, or common Pumpkin (nat, ord. Cucurbitaceae), about inch long, white, flat, oval, inodorous, bland and oily. The active prin- ciple is a resin contained in the endopleuron or envelope imme- diately surrounding the embryo. It also contains an alkaloid Cucurbitine, a fixed oil, starch, sugar, etc. There are no official preparations. Dose, of the resin, gr. xv; of the seeds, gj-ij, beaten up in emulsion with sugar and water. Physiological Action and Therapeutics. Pumpkin-seed is an efficient agent for the removal of tape- worm (taeniafuge), and its use is not followed by unpleasant symptoms. The outer coat of the seed should be removed, and an emulsion then made by trituration with sugar and water. This, if taken on an empty stomach and followed by a brisk cathartic, will generally prove effective. Dr. Squibb maintains that the seeds should not be decorticated, but that husks and all should be swallowed. According to some observers the expressed oil is equally efficient in doses of 3ss repeated twice or three times, and followed by a cathartic. PEPSINUM, Pepsin,—is a hypothetical name for the di- gestive principle of the gastric juice, and as a definite body is unknown, the various preparations, official and unofficial, being PEPSINUM. 287 mere approximations, and vary much from each other. They are usually obtained from a solution prepared by digesting the mu- cous membrane scraped from the rennet-bags of sheep or the stomach of the pig in acidulated water for several days. The so- called “Pepsin” is then precipitated by Chloride of Sodium {Scheffer), Acetate of Lead (.Boudault), or by drying the pep- tones on glass plates {Beale). It may also be precipitated by alcohol. By Scheffer’s process it occurs as a tough, gray, leathery substance, partially soluble in water, one grain dissolving 3000 grains of albumen in a few days. Jensen’s “ Crystal Pepsin,” probably prepared after Beale’s method, is in yellowish, translu- cent scales, soluble in water, and reputed to be many times stronger than any other preparation yet obtained. Preparations. Tepsinum Saccharatum, Saccharated Pepsin,—is Pepsin obtained from the mucous membrane of the hog, and mixed with powdered Sugar of Milk. One part dissolved in 500 of water acidulated with 7y2 of Hydrochloric Acid, should digest at least 50 parts of hard-boiled egg-albumen in 5 or 6 hours at a temperature of ioo° to 104° F. Dose, gr. soon after meals. Liquor Pepsini, Liquid Pepsin,—contains of Saccharated Pepsin 40 parts, Plydrochloric Acid 12, Glycerin 400, Water q. s. ad 1000 parts. Dose, gij- iv, after meals. Lactopeptine (Unofficial),—claimed to contain Pepsin, Diastase or Ptya- lin, Pancreatin, Lactic and Hydrochloric Acids, and that will digest of albumen, fibrin, casein or gelatin, will emulsionize of cod-liver oil, and convert of starch into glucose. A proprietary preparation. Dose, gr. v-xv. Ingluvin (Unofficial),—is a preparation obtained from the gizzard of the domestic fowl, which owes its activity to no ferment corresponding to Pepsin, but to a peculiar bitter principle. Dose, gr. x-xxx. [Every manufacturer has his own preparation of Pepsin, and his peculiar name therefor, such as “ Liquid Pancreopepsine,” “ Lacto-peptine,” “ Gluco- pepsine,” “ Golden Scale Pepsin,” “ Peptogenic Milk Powder,” etc. They vary considerably in their properties, but all have the power in some degree of digesting albumen or fibrin.] Physiological Action. Pepsin is not a solvent but a ferment, and is a normal con- stituent of the gastric juice, converting albuminoids (casein, albu- men, fibrin, etc.) into peptones for assimilation, with the aid of the Lactic and Hydrochloric Acids associated with it. This it will do out of the body or in cavities as the rectum, if warmth, acidity and moisture be present. Pancreatin, on the other hand, is destroyed by acids and requires an alkaline medium in which to exercise its powers. As the food passes out of the stomach in 2 or 3 hours, Pepsin should be administered within, and Pancre- atin after that period to be effective. 288 PETROLATUM. Incompatibles. Alcohol destroys the activity of Pepsin. Alkalies and many mineral salts precipitate it. Therapeutics. Dyspepsia in its various forms is the malady for which Pepsin is chiefly employed, but it is also extremely useful in the apepsia of infants, gastralgia, anaemia, chlorosis, gastric ulcer and cancer, the diarrhoea of infants and the vomiting of pregnancy. It is added to nutritive enemata, the rectum not being a digestive or- gan, and is injected into the substance of morbid growths which are homologous to the tissues, particularly fatty tumors, for the purpose of arresting their growth and promoting their absorption. It has been injected into the bladder to break down a blood-clot, and has been suggested as an atomized inhalation in diphtheria and croup to digest the membrane without injuring the living tissues. Ingluvin is particularly useful against vomiting and has been found exceptionally efficient in the vomiting of pregnancy, given in 20-grain doses before meals. [Compare Pancreatin, ante, page 284.] PETROLATUM, Petroleum Ointment,—is a semi- solid substance, consisting of hydrocarbons, obtained from Petro- leum by distilling off the lighter portions and purifying the resi- due. It is a yellowish, fat-like mass, somewhat fluorescent, amorphous, odorless and tasteless, of neutral reaction, insoluble in water or alcohol, soluble in ether, chloroform, fixed and vola- tile oils, benzin, etc. Its melting point is from 104° F. to 1250 F., the first being the softer, and the second the firmer variety. Commercially, it is known as Cosmoline, Vaselme, etc., and is largely prepared from residuums or sediments deposited in tanks containing crude petroleum. Physiological Action and Therapeutics. Petrolatum is a valuable protective dressing, and an excellent basis for ointments, having no acridity and no liability to become rancid. It is readily miscible with many active agents, as the alkaloids, phenol compounds, etc., but it does not penetrate the skin as readily as animal fats and fixed oils. Uncombined, it forms an excellent bland application in all irritated conditions and injuries of the skin. PHOSPHORUS, PHOSPHITES AND PHOSPHATBS. 289 PHOSPHORUS, Phosphites and Phosphates,—are best studied together, as the supplying of the element Phosphorus to the body is the aim of the administration of these agents. Phosphorus, P,—is a non-metallic element obtained from bones, and occurs as a translucent, nearly colorless solid, of waxy lustre, and usually the consistence of beeswax, insoluble in water, soluble in 50 parts of any fatty oil, in 80 of absolute ether, 350 of absolute alcohol, and freely in carbon bisulphide. It has a disagreeable odor and taste, melts at in° F., is luminous in the dark, ignites in the air, and should' be kept under water in a cool place, protected from light. It usually contains Arsenic and sometimes Sulphur, the limits of which are fixed by the pharmacopceial tests. Dose, gr. t&u-tV thrice daily. . Preparations of Phosphorus. Pilule Phosphori, Pills of Phosphorus,—each contains gr. of Phos- phorus, dissolved in Chloroform, mixed with Althfea and Acacia in Glycerin and Water, and coated by shaking with a solution of Balsam of Tolu in Ether. Dose, j-v. Oleum Phosphoratum, Phosphorated Oil,—has of Phosphorus 1 part, Aether Fortior 9, Expressed Oil of Almond q. s. ad 100 parts. Dose, 'nlj-v, thrice daily. Acidum Phosphoricum and Acidum Phosphoricum Dilutum,—are described on page 34, ante. Tinctura I’hosphori (Thompson’s), Unofficial,—Phosphorus gr. j, Abso- lute Alcohol sjv, Glycerin 5jy2, Alcohol Spt. Menthas Piperitae, nqxl. Of this contains gr. fa of Phosphorus. Tinctura Phosphori (Bellevue Hospital), Unofficial,—Phosphorus gr. xxxij, Absolute Alcohol Essence of Vanilla i|j, Oil of Orange sjiij, Alcohol q. s. ad Of this gj contains gr. fa of Phosphorus. Zinci Phosphidum, Phosphide of Zinc, Zn,P2,—crystalline fragments or a gray-black powder, insoluble in water or alcohol, but completely soluble in hydrochloric or sulphuric acids with evolution of phosphoretted hydrogen. Is very irritant to the stomach. Dose, gr. - fa. Preparations of Phosphites. Calcii Hypophosphis, Hypophosphite of Calcium, Ca4(P02)3,—colorless prisms, or thin, pearly scales, of nauseous taste, soluble in 6.8 of water, insol- uble in alcohol. Is an ingredient of the Syrupus Hypophosphitum. Dose, gr. x-xxx. Ferri Hypophosphis, Ferric Hypophosphite, Fe2(H2P02B),—a white or grayish-white powder, odorless and tasteless, slightly soluble in water, freely so in hydrochloric acid or a solution of sodium citrate. Dose, gr. v-x. A ferruginous tonic. Potassii Hypophosphis, KH2P02,—white masses, or a white, granular powder, deliquescent, odorless, of saline taste and neutral reaction. Soluble in 0.6 of water and in 7.3 of alcohol at 590 F. Dose, gr. v-x. Sodii Hypophosphis, NaH2P02H20,—small plates, or a white, granular powder, deliquescent, odorless, of sweetish, saline taste and neutral reaction. Soluble in 1 of water and 30 of alcohol at 590 F. Dose, gr. v-x. 290 PHOSPHORUS, PHOSPHITES AND PHOSPHATES. Syrupus Hypophosphitum, Syrup of Hypophosphites,—has of the Cal- cium salt 35, of the Sodium and Potassium salts each 12, Citric Acid 1, Spirit of Lemon 2, Sugar 500, Water q. s. ad 1000 parts. Dose, gj-5j. Syrupus Hypophosphitum cum Ferro, Syrup of Hypophosphites with Iron,—has of the preceding 99 parts with 1 of the Lactate of Iron, dissolved by trituration. Dose, Preparations of Phosphates: Calcii Phosphas Pr/ecipitatus, Precipitated Phosphate of Calcium, Ca3(P04)2,—a light, white, amorphous powder, odorless and tasteless, insol- uble in water or in alcohol. Dose, gr. ij-x. Syrupus Calcii Lactophosphatis,—has of the preceding 22 parts, Lactic Acid 33, Orange-flower Water 80, Sugar 600, Hydrochloric Acid, Water of Ammonia, Water, aa q. s. ad 1000. The Phosphate of Calcium is dissolved by the acid, but does not enter into the chemical combination suggested by the title. Dose, —Jfj. Sodii Phosphas, Na2HP04. i2H20,—large, monoclinic prisms, efflcrrescent, of saline taste and alkaline reaction. Soluble in 6 of water at 590 F., insol- uble in alcohol. Dose, 3j —j. Sodii Pyrophosphas, Na4P207.ioH20,—colorless, monoclinic prisms, of saline taste and alkaline reaction. Soluble in 12 of water at 590 F., insoluble in alcohol. Dose, Syrupus Ferri, Quinine et Strychnine Phosphatum,—has of the Phosphate of Iron 133, Quinine 133, Strychnine 4, Phosphoric Acid 800, Sugar 6000, Distilled Water q. s. ad 10,000 parts. A powerful tonic. Dose, 3j — ij. Syrupus Phosphatum Compositus, Compound Syrup of Phosphates, Parrish’s Chemical Food (Unofficial),—has in each 3 Phosphate of Iron gr. 2)4> Phosphate of Calcium gr. j. Dose, 3)—ij. Ammonii Phosphas, Ferri Phosphas and Ferri Pyrophosphas are respectively described on pages 60 and 191. Physiological Action. Phosphorus in small doses stimulates the brain and circulation, the functions of the stomach and the genital organs, and the growth of bones. It aids digestion by irritating the end-organs of the gastric nerves, and produces eructations of Hydrogen Phos- phide. Its fumes cause necrosis of the upper or lower maxillae, especially in those whose teeth are decayed, but this may be prevented by the inhalation of fumes from old acid turpentine. In poisonous doses it is a powerful irritant of the gastro-intestinal tract, causing vomiting and purging with great depression of the vital forces. Reaching the blood as Phosphorus, it is partly oxidized at the expense of the oxygen of the red corpuscles, causes acute hemorrhages from fatty degeneration of the arterial walls, rapid steatosis of the stomach, liver and heart, with deep jaundice,—then delirium, convulsions, coma and death usually from gradual failure of the respiration and circulation. Acute yel- PHOSPHORUS, PHOSPHITES AND PHOSPHATES. 291 low atrophy of the liver resembles acute phosphorus-poisoning so much that it is generally impossible to distinguish between them. Its effect on metabolism is to increase the nitrogenous products, to diminish the excretion of carbonic acid, reduce the glycogen of the liver to almost nothing, and to raise the temperature. While generally increasing metabolism it so influences that pro- cess as to arrest it at the stage of conversion of proteids into urea and oil, instead of allowing it to proceed to the final oxida- tion of oil into carbonic acid and water, hence leading to fatty degeneration of epithelial, glandular and muscular protoplasm throughout the body. Phosphate of Calcium is an essential ingredient of all the tis- sues and fluids of the body, and forms more than 50 per cent, of the bones. Lactic and Hydrochloric acids dissolve it in small quantities. It increases the alkalinity of the blood as well as its power of holding Carbonic Acid, and diminishes the excretion of urea. Phosphate of Sodium acts on the blood and on the excretion of urea similarly to the calcium salt. It increases secretion gen- erally, especially of the bile, being an excellent cholagogue and thereby aiding in the digestion of fats. In ounce doses it is laxative. It is a normal constituent of the blood, and possesses the property of increasing the capacity of any fluid to hold Car- bonic Acid in solution. The Hypophosphites are generally tonic, and are supposed to constitute a safer form in which to administer Phosphorus than in the unoxidized state. They are probably converted into phos- phates in the stomach. Antidotes and Antagonists. Antidotes are hydrated magnesia, lime-water, powdered charcoal, sulphate of copper and old acid turpentine. Sulphate of Copper is the best emetic, forming a comparatively insoluble phosphide of copper; 3-grain doses should be given every 5 minutes in dilute solution until emesis occurs. Hydrated Magnesia as a quickly-acting purgative. Limewater or Charcoal to pre- vent the action on the tissues. Crude French Acid Turpentine is the best antidote, which may be given rapidly in an emulsion of gum. Opium to counteract the depression of the heart and system. TRANSFUSION has proved efficient where the blood is affected. No oils or fats should be used, as they dissolve Phosphorus and promote its absorption. Therapeutics. Phosphorus is chiefly used to promote the nutrition of osseous and nervous tissue. It is useful in chronic nervous exhaustion 292 PHYSOSTIGMA. when the nerve centres are implicated, in osteomalacia, rachitis and progressive locomotor ataxia. In threatened cerebral soft- ening it affects the nerve centres as no other drug does, and in paraplegia of myelitic origin from excessive venery it is often very efficient. Progressive pernicious anaemia has sometimes been arrested by Phosphorus in very small doses, while in impotence of functional character there is no remedy so effective. In wake- fulness of the aged and that due to cerebral anaemia small doses of the pill or tincture are sometimes remarkably beneficial. In certain skin diseases (acne, psoriasis, lupus), it is an excellent substitute for Arsenic. Neuralgia is often cured by Phosphorus, but large doses are necessary, at least gr. every 4 hours. Phosphate of Calcium and the Hypophosphites are used with benefit in all diseases of mal-nutrition, and where the repair or development of the bones is required. They are particularly useful in protracted suppuration, osteomalacia, rachitis, caries, scrofulosis, chronic phthisis, and in the anaemia and bone-soften- ing of lactation. The Hypophosphites are much employed in nervous and general debility and in chronic lung diseases, and are supposed to act in the same manner as free Phosphorus, but without irritation. They are probably converted into Phos- phates in the stomach, and hence may be expected to promote the growth and healing of bones, to stimulate the hepatic and intestinal secretions, and to affect the lymphatic glands and ade- noid tissue. The Compound Syrup of the Hypophosphites is an excellent remedy in acne indurata. Phosphate of Sodium in drachm-doses thrice daily for adults, gr. x-xx for children, is extremely useful as a laxative in condi- tions depending on catarrh of the bile-ducts and duodenum, as headache, jaundice, chalky stools, etc. Gall-stones may be pre- vented from forming by scruple or drachm doses before meals for months at a time. It is also an efficient agent in obesity, hepatic diabetes, incipient hepatic sclerosis, chronic infantile diarrhoea, cerebral debility, bilious sick headache, and the pasty, white stools of ill-conditioned children. Vichy-water contains this salt in the proportion of gr. to the pint, and is considered a valuable water in hepatic colic and kindred conditions. Finally for the condition of the system producing a crop of boils, Phos- phate of Sodium is probably the best remedy. PHYSOSTIGMA, Calabar Bean,—is the seed of Phy- sostigma venenosum (nat. ord. Leguminosse), a woody creeper of Calabar, West Africa, where it is used by the natives as an ordeal PHYSOSTIGMA. 293 for witches, etc., vomiting after its ingestion being held to estab- lish the innocence of the accused. It is about an inch long, irreg- ularly kidney-shaped, with two flat sides and a furrow along its convex margin ending in an aperture near one end. It contains an alkaloid, variously named Eserine, Physostigmine, and Cala- barine, C15H21N302, which is obtained as a crystalline, an amor- phous or a syrupy body. Some authorities apply names to different bodies, but acknowledge that they agree in physio- logical action, though not in physical qualities. Preparations. Extractum Physostigmatis,—an alcoholic extract, of which the dose is from gr. to gr. j. Tinctura Physostigmatis,—strength io per cent. Dose, -mv-xx. Physostigmine Salicylas, Salicylate of Physostigmine,—colorless, col- umnar crystals, of bitter taste and neutral reaction, soluble in 130 of water and in 12 of alcohol at 590 F. Dose, gr. Eserina, Eserine (Unofficial),—perhaps the same as Physostigmine,but is considered as representing the powers of the plant. Dose, gr. sV~tV Physiological Action. Physostigma is a direct spinal paralyzer, producing complete general paralysis, and abolished reflexes, but not affecting mus- cular irritability or the cerebral functions. It stimulates secre- tion, excites nausea and vomiting, salivation and diaphoresis, and is laxative by stimulating the muscular coat of the intestines to increased peristalsis as well as by increasing the intestinal secre- tions. It first lowers then raises arterial tension, increases the frequency of the heart-beat, but depresses the power of the cardiac muscle though not destroying it. It produces dyspnoea by a tetanic action on the respiratory muscles, causing carbonic acid narcosis and death by paralysis of respiration. It contracts the pupil (how, is disputed), and the ciliary muscle, producing marked myosis. It is eliminated chiefly by the kidneys, the urine of the animal affected poisoning another. Antagonists and Incompatibles. Atropine is antagonistic as to the effects on the respiration, heart and pupil. Chloral is also antagonistic and over a greater field of action, but to be effective must be administered before the ingestion of the Physostigma. The vegetable astringents, tannic acid and the caustic alkalies are chemically incompatible. Therapeutics. The applications of Physostigma are not many. It is efficient in constipation due to torpor of the bowels, in which condition it 294 PHYTOLACCA. is usually combined with Belladonna and Nux-vomica. In tetanus it has been used with advantage to diminish reflex excita- bility in grain-doses of the extract repeated every 2 hours and the dose modified according to the effect produced. Progressive paralysis of the insane is apparently retarded by it, and while antagonistic theoretically in atropine and strychnine poisoning, practically it is not of much value. Eserine is now used locally by ophthalmologists for many purposes in affections of the eye. In a solution of gr. ij to the % of water dropped into the eye, it is efficient in breaking up or preventing adhesions of the iris, diminishes intraocular tension, prevents suppuration after operations, contracts the pupil, dimin- ishing the entrance of light in photophobia, etc., and empties the vessels of the eye. It is very useful in keratitis, glaucoma, strumous ophthalmia, and neuralgia of the eye-ball. The salts of Eserine or Physostigmine in neutral solution may be used for these purposes, as well as to counteract the effects of Atropine on the pupil. Gelatin disks medicated with Eserine may be ob- tained in the shops, and are a convenient form in which to use the drug for ophthalmic purposes. PHYTOLACCA, Poke,—is official under two forms, the berry and the root of Phytolacca decandra, a plant of the nat. ord. Phytolaccacese, found in all parts of the United States. It contains a neutral principle Phytolaccin, and an acid Phytolaccic Acid, also tannin, starch, fixed oil, etc. There are no official preparations. Phytolaccae Bacca, Poke Berry,—dark-purple, depressed globular, about inch in diameter, composed of io carpels, each containing one black seed ; juice purplish-red, sweet and slightly acrid. Phytolaccae Radix, Poke Root,—large, conical, branched, fracture fibrous, wood-bundles in concentric circles, inodorous, sweetish and acrid. Dose, as emetic, gr. x-xxx,—as an alterative, gr. j-v. Preparations. Extractum Phytolaccae Fluidum (Unofficial),—Dose, niv-^j. Tinctura Phytolaccae (Unofficial),—Dose, Physiological A ction. Phytolacca is an emeto-cathartic, acting slowly but persistently, with great nausea and considerable depression. It lowers the rate of respiration and of cardiac action, and is a motor depres- PICROTOXINUM. 295 sant, paralyzing the spinal cord and the medulla, death occur- ring from paralysis of respiration, preceded by tetanic convulsions. Several cases of poisoning by this plant have occurred. Its action is antagonized by Alcohol, Ether, Opium, Digitalis, etc. Therapeutics. Alterative powers have been ascribed to Phytolacca, and com- petent observers have reported curative results from its use in malignant tumors, varicose and other ulcers, obstinate eczema, sycosis, favus and other skin affections, employing it both inter- nally and externally. It is a very serviceable remedy in chronic rheumatism, and given internally has undoubtedly cured cases of granular conjunctivitis. Mastitis is sometimes aborted and sup- puration of the breasts prevented by the use of the fluid extract internally while a solid extract is locally applied to the seat of the impending inflammation. In tonsillitis and diphtheritic sore throat, also in chronic follicular pharyngitis, it has been much used with good results, especially when there is high fever and pains in the head, back and limbs. In true adynamic diphtheria it will do little good. PICROTOXINUM, Picrotoxin, Picrotoxic Acid, c9h10o v—is a poisonous, neutral principle obtained from the seeds contained in the berries (Cocculus Indicus, Fish-berries), of Anamirta paniculata (Anamirta Cocculus, Menispermum Coc- culus), a climbing shrub of the nat. ord Menispermaceae, a native of the East Indies. The berries are somewhat kidney-shaped, of blackish-brown color, wrinkled, brittle, inodorous and nearly tasteless, except the shrivelled embryo which is bitter. They contain, besides Picrotoxin, a large quantity of fixed oil and other substances of less interest. In the shell are found Menis- pertnin an alkaline principle, Paramenispermin which is neutral and crystalline, and Hypopicrotoxic Acid. Picrotoxin occurs in colorless, flexible crystals, of prismatic form, bitter taste and neutral reaction, soluble in 150 of water and in 10 of alcohol at 590 F., also in acids and in alkaline solu- tions. Dose by the stomach, gr. cautiously. For hypo- dermic use a solution in water of gr. ij in 3j may be used, in doses of gr. of the principle, rriiv equalling gr. Unofficial Preparations of Cocculus. Tinctura Cocculi,—1 in 8. Dose, Tilij-xv. Extractum Cocculi Fluidum,—Dose, nij-iij. Planat’s Tincture of Cocculus,—1 in 4. Dose, uij-v. 296 PICROTOXINUM. Physiological Action. Picrotoxin is a cerebro-spinal exaltant, affecting especially the centres in the medulla oblongata, and in its action representing the combined actions of Belladonna and Nux-vomica. It stimu- lates all the secretions, especially the cutaneous, the salivary and intestinal; produces nausea and vomiting, and slows the heart and the respiration after transiently accelerating both. It causes muscular twitching, incoordination, stupor, delirium, epilepti- form convulsions, tonic spasms of the flexor muscles alternating with clonic ones, exalted reflexes and trembling,—then coma, in- sensibility and death by paralysis of the heart, which is arrested in diastole. The action of the drug is on the spasm and vagus centres in the medulla, and on Setchenow’s inhibitory centre, as well as on the cerebellum and spinal cord, paralyzing the first- named centres and stimulating the reflex centres in the cord. It is eliminated by all the excretory channels, chiefly by the kidneys. The spasms caused by Picrotoxin are choreic and chiefly affect the flexor muscles,—those from Strychnine are tetanic, affecting principally the extensors. The order, succession and character of the phenomena produced by Picrotoxin resemble in marked degree those of the epileptic paroxysm. Cocculus berries are used to stupefy fish, being thrown into ponds containing them. They are also employed to adulterate beer and porter in order to make these drinks more intoxicating. Antagonists. Chloral is antagonistic to its cerebral and spinal actions, but synergistic to its depressant power over the heart and the respiration. Acetic Acid gives relief in overdosing, and may have some antidotal power. Anesthetics antagonize its spasm-producing action. Therapeutics. Picrotoxin is used chiefly in nervous diseases. Epilepsy is amenable to it, especially when the attacks are nocturnal, and in anaemic cases and those attributable to onanism. Paralyses of several forms have been greatly benefited by it, especially par- alysis of the sphincters, hemiplegia from cold, glosso-labio-laryn- geal paralysis, and paralysis agitans. Chorea is well treated by it but requires full doses. It is remarkably efficient in control- ling the nightsweats of phthisis, and in flatulent colic, also in dyspepsia with flatulence and severe epigastric pain, and in vom- iting with giddiness, headache and intolerance of light and sound. Dysmenorrhoea is often benefited by Cocculus adminis- PILOCARPUS. 297 tered for two days before the period ; and leucorrhoea, when the discharge is sero-purulent with lumbar pains, is frequently con- trolled by it. Parasitic skin diseases are well treated by an oint- ment of Picrotoxin (gr. x to the 3), which will also kill pediculi, but it must be used cautiously and with special care to avoid an abraded surface. PILOCARPUS, Jaborandi, —the leaflets of Pilocarpus pennatifolius, a Brazilian plant of the nat. ord. Rutaceae. They are about 4 inches long, ovate-oblong, coriaceous, pellucid-punc- tate, mostly smooth, somewhat pungent and bitter. It contains two alkaloids,—Pilocarpine, CnH16N20.2, soft and viscous, slightly soluble in water but soluble in alcohol, ether and chloroform; Jaborine, isomeric with Pilocarpine, to which it is antagonistic in action; also a Volatile Oil and probably a peculiar acid. Preparations. Extractum Pilocarpi Fluidum,—Dose, lUv-^j. Pilocarpine Hydrochloras,—minute, white, deliquescent crystals, very soluble in water and in alcohol, almost insoluble in ether or chloroform. Dose, gr- V%~lA- Physiological Action. Jaborandi is a paralyzer of the vaso-motor system. It pro- duces prompt and profuse diaphoresis, the perspiration from a full dose amounting to ten or fifteen fluid ounces; also profuse salivation (§x to xxx), and much increase of the nasal, bronchial and lachrymal secretions, with sometimes a watery diarrhoea. Nausea is generally experienced and sometimes vomiting. The face is flushed, the action of the heart is first increased and after- wards lowered, the arterial tension is reduced and the tempera- ture falls from i° to 40. Drowsiness, pallor, chilliness and de- bility succeed and last several hours, the pupils are contracted and accommodation is impaired. The respiratory power is lowered, and apnoea may occur from increase of the bronchial mucus. The elimination of urea is increased greatly, but not the quantity of urine. The effects pass off usually in from 3 to 6 hours. The drug is rapidly diffused and is eliminated by the skin and the salivary glands. Children are less affected than adults by proportionate doses. Uterine contractions are reported by several observers as having been initiated by Jaborandi, but according to others it frequently fails to produce this effect. Pilocarpine is the principle to which the foregoing actions are due, but Jaborine, though chemically identical, is perfectly 298 PILOCARPUS, antagonistic thereto in its effects on the heart, pupils, lungs and salivary glands, acting precisely like Atropine on these organs. The difference is probably due to a different molecular arrange- ment. Antagonists and Incompatibles. Atropine is the antagonist to Pilocarpine in dose of gr. for gr. £ of the latter. The antagonism between these two alkaloids extends over the whole range of their action, and is the most complete known to physiological exper- imentation. Caustic alkalies, the persalts of Iron and salts of the metals generally, are chemically incompatible. Therapeutics. Jaborandi is used with great benefit in dropsies, especially the renal form, also in eclampsia of renal origin, in uraemia, pleuritis, meningitis and other inflammations of serous membranes, but it is contraindicated when from any cause there is weak heart. In diabetes insipidus it reduces the quantity of urine remarkably, relieving the kidneys by throwing the work on the skin. In the acute and chronic forms of Bright’s disease it has been used with great advantage, but being so depressant it must be employed with great caution in this disorder. For alopecia it is the most efficient remedy known, stimulating the skin and improving the color and condition of the hair. In agalactia it stimulates the secretion of the milk, and it often gives prompt relief in parotitis. Ptyalism is frequently relieved by minute doses of Pilocarpine (gr. which acting on the same gland antagonizes the morbid action ; and similar doses used thrice daily will check profuse perspiration. The hypodermic use of Pilocarpine will arrest a paroxysm of spasmodic asthma, and is equally efficient in hic- cough. Atropine-poisoning is best combated by the use of Pilo- carpine hypodermically. Ophthalmologists employ Pilocarpine with most excellent re- sults in the amblyopia of alcoholism and that from the abuse of tobacco, in detachment of the retina, chronic iritis, keratitis, glaucoma, hemorrhage into the vitreous, atrophic choroiditis, white atrophy, to promote resolution and absorption in inflam- matory conditions with exudation, and instead of Eserine as a myositic. Erysipelas and diphtheria are diseases in which Pilocarpine has recently proved very efficient, but its depressant action on the heart and respiration must not be lost sight of. In the writer’s experience the fluid extract is one of the best agents for break- ing up a common cold. It may be given in doses of uix-3j, PIMENTA—PIPER. 299 according to age, at bedtime. Children bear the drug well in respect to all its physiological actions. PIMENTA, Allspice, —is the nearly ripe fruit of Eugenia Pimenta, a West Indian tree of the nat. ord. Myrtacese. The berries are nearly globular, about inch in diameter, crowned with the remnants of the calyx, two-celled, each cell containing one reniform seed, odor and taste pungent and aromatic. They contain a Volatile Oil which is official, a green fixed oil, fat, tannin, gum, resin, etc. Dose, gr. x-xl. Oleum Pimento, the volatile oil, colorless or pale-yellow, of aromatic odor, pungent taste and slightly acid reaction. Is a constituent of Bay Rum (Spt. Myrcise). Dose, TrUj-vj. Physiological Action and Therapeutics. Allspice is a warm, aromatic stimulant, very useful as a condi- ment, improving digestion by increasing the vascularity of the gastric mucous membrane, and by stimulating the salivary secre- tion. The Oil is an agreeable remedy for flatulence, nausea and intestinal colic, and is used to prevent the griping of purgatives and to cover the taste of nauseous medicines. PIPER, Pepper, Black Pepper,—is the unripe fruit of Piper nigrum, or Pepper-vine, a perennial plant of the nat. ord. Piperaceae, growing in India, Siam, Java, Borneo, etc. It is about yfc inch in diameter, of globular shape, reticulately wrinkled, aromatic, of pungent, spicy taste, and contains an alkaloid, Piperine, which is official, also a green, acrid, concrete oil, a balsamic volatile oil, starch, lignin, gum, extractive, etc. Dose, gr. v-xx. Preparations. Oleoresina Piperis, Oleoresin of Pepper,—contains almost all the volatile oil and acrid resin extracted by ether, with little of the Piperine. Dose, mX-j- Piperina, Piperine, C17H19N03,—a proximate principle of feeble alkaloidal power, prepared from Pepper, and occurring also in other plants of the natural order Piperaceae. Occurs in colorless or pale-yellowish prisms, of neutral reaction, almost insoluble in water, slightly so in ether, but soluble in 30 of alcohol at 590 F. Dose, gr. j-x. Physiological Action and Therapeutics. Pepper when applied to the skin acts as an irritant; internally its effects are similar to those of other aromatics, being a warm 300 PISCIDIA. carminative and stimulant, increasing slightly the action of the heart, stimulating the kidneys somewhat, and toning up the mucous membrane of the urinary and intestinal passages, by which channels it is eliminated. It has been thought to possess antiperiodic powers, and was formerly much employed in inter- mittents. Its chief medical use is to correct flatulence, and to excite the action of the stomach, being very commonly taken as a condiment with food. It is occasionally employed in gleet, but more extensively in hemorrhoids and other diseases of the rectum. Its active constituents are the concrete oil or resin and the vola- tile oil, the alkaloid having very slight action on the system, except as an antiperiodic and antipyretic, qualities which it cer- tainly possesses. PISCIDIA, Jamaica Dogwood (Unofficial),—is the bark of the root of Piscidia erythrina, a tree of the nat. ord. Legu- minosse, growing in the West Indies. It occurs as a tough, fibrous bark, externally blackish, internally greenish, of a heavy, narcotic odor, and a bitter, acrid and astringent taste, containing a yel- lowish, resinoid substance named Piscidin. Its active principle has not yet been isolated. A fluid extract is on the market, of which the dose is 3ss—j, carefully increased. Physiological Action. Piscidia has a narcotic effect on many animals, and has been used in Jamaica for many years to stupefy fish that they may be easily taken. It produces muscular relaxation, incoordination of movement, lowered sensibility, increased action of the heart and increase of the arterial tension by stimulation of the vaso-motor centre. Soon, however, the heart is weakened, vascular tension falls, and a tetanoid state results from stimulation of the spinal cord, with reduced reflex action. On the brain its effects resemble those of Opium, causing deep sleep without any unpleasant after results. It relieves pain in less degree, however, than Opium does, but its hypnotic action is greater. It also relieves cough and spasm, produces diaphoresis and salivation, and dilates the pupils. From toxic doses death occurs by asphyxia. In man it probably causes the same effects but in decidedly less marked degree. Therapeutics. Jamaica Dogwood is used chiefly as a general nervous sedative. Its hypnotic and anodyne powers are somewhat uncertain, but PIX. 301 have in many cases been very decided. It is useful in whooping- cough and spasm, and has proved almost specific in many cases of neuralgia, while in others it has caused great gastric distress without the least anodyne effect. PIX, Pitch ,—is a resinous exudation from the stem of cer- tain trees of the genera Finns (Pines) and Abies (Firs and Spruces) ; and may also be obtained by the evaporation of wood- tar. [See Pix Liquida below.] The following varieties are offi- cial, viz. : Pix Burgundica, Burgundy Pitch,—the prepared, resinous exudation of Abies excelsa or Norway Spruce (nat. ord. Coni- ferae), a native of Europe and Northern Asia. Occurs in hard, brittle, opaque or translucent mass, with a shining, conchoidal fracture, reddish-brown color, aromatic and somewhat empyreu- matic, not bitter, almost entirely soluble in glacial acetic acid. It is very fusible, and at the body-heat it softens and becomes adhesive. Used for plasters. Pix Canadensis, Canada or Hemlock Pitch,—the prepared resinous exudation of Abies canadensis (nat. ord. Coniferge), the Hemlock Spruce of the U. S. and Canada. Its properties are much the same as those of the preceding. Pix Liquida, Tar,—is an empyreumatic oleo-resin obtained by the destructive distillation of the wood of Pinus palustris and other species of Pinus (nat. ord. Coniferse). Is thick, viscid, semi-fluid, blackish-brown, of acid reaction, terebinthinate odor, and sharp, empyreumatic taste, slightly soluble in water, soluble in alcohol, oils, and in solution of potassa or of soda. By dis- tillation it yields an acid liquor named Pyroligneous Acid and an empyreumatic oil called Oil of Tar (see Ol. Picis Liquids, be- low), the residue being pitch. Its granular appearance is due to crystals of Pyrocatechin, C6H4(OH)2, which occur either in the Pyroligneous Acid or in the tarry mixture. Dose, 5j-'j daily, in ten-grain doses. Preparations. Oleum Picis Liquids, Oil of Tar,—a volatile oil distilled from Tar. Dark, reddish-brown (almost colorless when fresh), of tarry odor and taste and acid reaction, readily soluble in alcohol. Contains a great variety of compounds, including Hydrocarbons, Phenols, Paraffin, etc., among the phenols being Creasote and Carbolic Acid. Is used locally and as an atomized inhalation. Syrupus Picis Liquid.*, Syrup of Tar,—has of Tar 6 per cent., and is a sweetened Tar-water. Dose, ppj-^ss. Unuuentum Picis Liquid*, Tar Ointment,—contains equal parts of Tar and Suet. 302 PIX. Emplastrum Picis Burgundy Pitch Plaster,—has of Bur- gundy Pitch go, Yellow Wax io parts. Emplastrum Picis Canadensis, Canada Pitch Plaster,—has of Canada Pitch 90, Yellow Wax 10 parts. Emplastrum Picis cum Cantharide, Warming Plaster,—has of Bur- gundy Pitch 92, Cerate of Cantharides 8 parts. Infusum Picis Liquids, Tar Water (Unofficial),—made by shaking Tar 1 with Water 4 frequently during 24 hours, decanting and filtering. Is stim- ulant and diuretic. Dose, Oj-ij daily. VlNUM Picis Liquids, Wine of Tar (Unofficial),—Tar jfxvj, Glycerin, White Wine, Honey, aa ,lfviij, Acetic Acid Boiling Water Ovj, shaken together and digested in a close vessel for two hours at 15°° to 1600, then macerated for a few days, frequently shaken, strained and filtered. Oleum Pini SYlVestris, Oil of Scotch Fir (Unofficial),—a colorless, fra- grant oil, distilled from the leaves of Pinus sylvestris, resembling Turpentine in action. Used by inhalation to Oj of boiling water), or locally. Physiological Action and Therapeutics. Pitch is a gentle rubefacient when applied to the skin, but in some constitutions the Burgundy variety causes a vesicular and pustular inflammation if used extensively. It is generally em- ployed as a basis for plasters, and is of benefit in lumbago, rheumatism, chronic pleurisy, painful joints, superficial neuralgias, etc., protecting the part from variations of temperature, and perhaps by the gentle pressure exercised stimulating the lym- phatics and promoting absorption. It is supposed to have a special influence on the rectum, and in pill with Tar has been employed as a remedy for hemorrhoids. In applying adhesive plasters the hair should first be shaved off, and when about to be removed the plaster should be warmed, and a little Oil of Turpen- tine inserted between its edge and the skin. Canada Pitch is too soft for plasters, but is employed for the same purposes as the preceding. A volatile oil obtained from the same tree (Oil of Spruce, Oil of Hemlock) has been used for abortifacient purposes, endangering the life of the subject. Tar is a complex mixture of resins and hydrocarbons, contain- ing Creasote and Carbolic Acid which give to it irritant qualities. Internally it is expectorant and produces gastro intestinal irrita- tion, sometimes severe headache, giddiness and febrile*phenom- ena. It is eliminated by the kidneys chiefly, which it stimulates, and may cause their congestion and increased diuresis. Exter- nally it is a decided stimulant to the skin, often giving rise to considerable irritation and pain. It is also antiseptic, and in most of its effects it resembles the turpentines. Tar is used as a local application in chronic scaly skin dis- eases, especially psoriasis and chronic eczema. As an atomized PLANTAGO—PLUMBUM. 303 inhalation it is of decided benefit in bronchitis, pharyngitis, laryngitis and winter cough. Internally it may be employed with advantage in these affections, in hemorrhoids, bronchial catarrh, and phthisis. The best preparation for internal admin- istration is the syrup, which is a sweetened tar-water, the sugar forming with the Tar a soluble compound. PLANT AGO, Plantain (Unofficial),—is the leaf of Plan- tago major,and. Plantago lanceolata (nat. ord. Plantaginaceae), the common “Ribbed Grass.” The pounded leaves applied as a paste, or the dry leaf powdered, are actively hemostatic, stopping hemorrhages speedily. Among the ancients it had a good repu- tation as a remedy for toothache and earache, which still adheres to it in Switzerland and many other parts of Europe. In many other painful affections it is extremely efficient, especially in mastitis, rhus-poisoning, erysipelas, burns, scalds, wounds and bruises. A poultice of the leaves may be applied to the affected part, and an infusion administered internally. A fluid extract is sold in the shops, of which the dose is uiv-xv. PLUMBUM, Lead, Pb,—is not official, but several of its salts are, namely,—the Acetate, Carbonate, Iodide, Nitrate and Oxide, of which the Acetate is the only one administered inter- nally, the solutions of the Subacetate are the only liquid prepara- tions, the Oxide (Litharge) is used as Emplastrum Plumbi, the Nitrate is used as a local stimulant or escharotic, the Iodide as an ointment for absorbent purposes, and the Carbonate as an astrin- gent locally to inflamed surfaces. The metal occurs in nature chiefly as a Sulphide named Galena, also as an Oxide rarely, and in various saline combinations. Official Salts of Lead. Plumbi Acetas, Acetate of Lead, Sugar of Lead, Pb(C2H302)2.3H20,— colorless, shining, prismatic crystals or scales, efflorescent, of faintly acetous odor and acid reaction, and a sweetish, astringent and metallic taste. Soluble in 1.8 of water and in 8 of alcohol at 590 F., in 0.5 of boiling water and in 1 of boiling alcohol. Dose, gr. ss-v. Plumbi Carbonas, Carbonate of Lead, White Lead, (PbC03)2Pb(HO)2,— a heavy, white, opaque powder, odorless, tasteless and insoluble in water or alcohol, but soluble with effervescence in dilute nitric acid. Used locally as ointment, powder, or white paint. Plumbi Iodidum, Iodide of Lead, Pbl2,—a heavy, bright citron-yellow powder, odorless and tasteless, fusible and volatilizable by heat, soluble in 304 PLUMBUM. about 2000 of water at 590 F., and in about 200 of boiling water. Used ex- ternally as an ointment. May be given internally in doses of gr. twice daily. Pi.UMBi Nitras, Nitrate of Lead, Pb(N03)2,—colorless, opaque, octahedral crystals, odorless, of sweetish, astringent and metallic taste and acid reaction, soluble in 2 of water at 590 F., almost insoluble in alcohol. Used locally as an astringent and deodorizer in solutions up to 1 per cent., also as an escha- rotic and a disinfectant. Plumbi Oxidum, Oxide of Lead, Litharge, PbO,—a heavy, yellowish or reddish yellow powder, odorless, tasteless and insoluble in water or alcohol, but almost wholly soluble with slight effervescence in dilute nitric acid. When heated in contact with charcoal it is reduced to metallic lead. Used as Lead-Plaster and sometimes with oil as an external application. Preparations. Liquor Plumbi Subacetatis, Solution of Subacetate of Lead, Goulard’s Extract,—an aqueous solution containing about 25 per cent, of the salt, pre- pared from Acetate of Lead 170, Oxide of Lead 120, and Distilled Water q.s. ad 1000 parts. It is a clear, colorless liquid, of sweetish, astringent taste and alkaline reaction, of sp. gr. 1.228, and when added to a solution of acacia it produces a dense, white precipitate. Used locally as an astringent and cool- ing lotion, diluted usually with an equal quantity of water. Liquor Plumbi Subacetatis Dilutus,—Lead-water,—has of the preced- ing 3 parts to 97 of Distilled Water. Used locally as a mild astringent and cooling lotion. Linimentum Plumbi Subacetatis,—contains of Liquor Plumbi Subace- tatis 40 parts to 60 of Cotton-seed Oil. Used as an anodyne application for itching, etc. Ceratum Plumbi Subacetatis, Goulard’s Cerate,—has of the same solu- tion 20 parts with 80 of Camphor Cerate, freshly prepared, as it becomes rancid easily. Used as an astringent and protective application. Emplastrum Plumbi, Lead-plaster, Diachylon Plaster,—Oxide of Lead 32, Olive Oil 60, rubbed together and boiled with 10 parts of water. Is white, pliable and tenacious, free from greasiness or stickiness, and should be entirely soluble in warm oil of turpentine. A good protective in abrasions and bed- sores, and the basis of many other plasters. Unguentum Diachylon, Diachylon Ointment,—has of Lead Plaster 60, Olive Oil 39, Oil of Lavender 1. Used locally in eczema and other cutaneous disorders. Unguentum Plumbi Carbonatis,—has of the Carbonate in very fine pow- der 10, Benzoinated Lard go. Used as a dressing for burns. Unguentum Plumbi Iodidi,—has of the Iodide in very fine powder 10, Benzoinated Lard 90. Used locally to promote absorption of glandular tumors. Oleatum Plumbi, Oleate of Lead (Unofficial),—a 20 per cent, solution of Oxide of Lead in Oleic Acid. A soft, yellowish ointment, for local use. Physiological Actions. Lead-salts are all more or less poisonous, but metallic Lead is inert until converted into a soluble salt by the acids of the stomach. The Acetate in large doses is emetic, so that acute PLUMBUM. 305 lead-poisoning is rare. Its chief phenomena are intense gastro- intestinal irritation, vomiting, paralysis, coma and collapse. Chronic lead-poisoning (plumbism) has its principal sources in pure water conveyed by leaden pipes, the use of hair-dyes, handling of printing-type, working in the smelting of lead ores, etc. It produces loss of appetite, emaciation, pallor and consti- pation, followed by slowing of the heart’s action, and accompa- nied by violent colic (enteralgia), muscular impairment evinced by paralysis of the extensor muscles of the forearm (drop-wrist), impaired sensibility and albuminuria. Occasionally aphonia, vertigo, gastralgia, headache, stupor and convulsions are mani- fested. Rheumatism without fever or tenderness in the joints, which however are red and swollen, is a frequent symptom. A blue line (sulphide) is seen along the margin of the gums in those who do not clean their teeth. Neuralgic troubles may arise, and amaurosis often occurs from impairment of the optic nerve. The metal becomes deposited in the affected muscles and other tissues, and probably acts by impairing the isolating power of the nerve- fibres, thus enfeebling the nerve-currents. It also produces con- traction of the smaller vessels, and may affect any muscles of the body, also the brain, producing delirium, coma and convulsions. Abortion is a frequent result, either through an influence on the muscular tissue of the uterus, or from a toxic action on the foetus. Death may occur from extension of the paresis to the muscles of respiration, from gradual impairment of nutrition, or from con- vulsions and coma, a form of disease known as Lead-encepha- lopathy. Astringency is the chief quality of the lead salts; they lessen secretion, contract muscular tissue and then destroy its contrac- tile power, slow both the heart and the respiration, and in time destroy the red blood-corpuscles. Lead enters the blood as an albuminate, in which form also it is retained by the tissues. It is slowly excreted by the liver, kidneys, skin and mammary glands.. That which escapes by the bile is reabsorbed by the bowel, is again excreted by the intestinal glands, escaping with the faeces as a sulphide. It lessens the excretion of uric acid. Antidotes and Incompatibles. In acute poisoning, as by the Acetate, the antidotes are Sulphate of Sodium or of Magnesium, and Phosphate of Sodium. The stomach should be evacu- ated, and albuminous drinks and Opium given to allay irritation. Chronic poisoning is best treated by Iodides to saturation of the system. Sulphurated Potassa baths (%j or more in water) are also very useful. Incompatibles are mineral acids and salts, vegetable acids, alkalies, vegetable astringents, 306 PLUMBUM. Iodide of Potassium, albuminous solutions, Opium, and all natural waters containing lime, sulphates, carbonates, and Carbonic Acid. Therapeutics. Lead salts are chiefly used as astringents and hemostatics. The solution of the Subacetate diluted with 4 parts of glycerin and water is locally employed in many skin-diseases, especially in eczema, lichen, impetigo and erythema; also in catarrhal dis- charges of muco-purulent character from the ear, vagina and the urethra, particularly in gonorrhoea and leucorrhoea. Inflamma- tions of external parts are constantly treated by the lotion of “ Lead water and Laudanum ” (Liquor Plumbi Subacetatis Dilutus 7 parts to 1 of Tinctura Opii). Though the constituents of this lotion are chemically incompatible, it is a valuable sedative and astringent. The Acetate, in 5-grain doses every 3 hours, is an efficient internal styptic in various hemorrhages, particularly in hemoptysis, hematemesis and gastric ulcer, lowering the action of the heart and constringing the vessels. Its astringent action is well manifested in bronchorrhcea and other pulmonary affec- tions with excessive secretion. It is well used in diarrhoeas, gr. ij with gr. j of pulverized Opium in choleraic diarrhoea, and smaller doses for the summer complaint of children. In caseous pneu- monia the Acetate is highly recommended as the best remedial agent, combined with Opium and Digitalis; and in cardiac hyper- trophy it may be often used to lower the action of the heart. It is also serviceable in whooping-cough with profuse bronchial secretion, and in humid asthma. Carbonate of Lead is only used externally to protect irritated surfaces, as erythema, erysipelas, intertrigo, etc., in which it may be dusted over the surface if unbroken. The official ointment, or white paint mixed with linseed oil, is an excellent application to burns or scalds, but if applied on the broken cuticle it may prove rapidly poisonous. The Iodide is employed externally as an ointment to enlarged lymphatic glands and enlarged spleen, also to chronic eczema and psoriasis. It has been used internally to reduce a malarial spleen. The Nitrate is an efficient application to fissured nipples, gr. x to §j of glycerin. In powder, dusted over unhealthy granula- tions, and sanious ulcers resulting from onychia, it gives prompt relief after a brief period of pain. It is said to have cured cases of epithelioma when used in the same manner. In solution (gr. x to the 3) it is a most efficient deodorizer against the fetor from gangrenous sores, ozrnna and other offensive discharges. Phar- maceutically it is used in the preparation of the Iodide. PODOPHYLLUM. 307 The Oxide is used in the preparation of plasters, most of the other salts of lead, and Digitalin. It is not employed internally, but may be used as an external application mixed with sweet oil in superficial burns, but care should be taken that it is only applied to the unbroken skin. PODOPHYLLUM, May Apple,—is the rhizome and rootlets of Podophyllum, peltatum (Mandrake), an herbaceous per- ennial of the nat. ord. Berberidacese, growing in the woodlands of Canada and the U. S., having a pale-green stem about a foot high, with a single white flower at its summit. The rhizome is horizontal, inch thick, consisting of joints about 2 inches long, of orange-brown color externally, white and mealy internally, inodorous, taste bitter and acrid. Its active principle is a Resin which is official, and is a compound of several resins. It prob- ably contains the alkaloid Berberine, which is also found in Ber- beris, Hydrastis and several other plants. Dose, gr. v-xx. Preparations. Abstractum Podophylli,—Dose, gr. yf-j. Extractum Podophylli,—Dose, gr. v-x. Extract™ Podophylli Fluidum,—Dose, rrtj-xxx. Resina Podophylli, Podophyllin,—is precipitated from a concentrated tincture by acidulated water. Soluble in alkaline liquids and partly so in ether. Contains Podophyllotoxin, Picropodophyllin, Podophyllinic and Proto- caleckuic Acids. Dose, gr. j, in pill. Physiological Action and Therapeutics. Podophyllum is a tonic-astringent and resin-bearing purgative, having an action similar to that of Jalap but slower like Calomel, taking 6 to 10 hours to produce its cathartic effect. It increases the intestinal secretions and the flow of bile, causing copious watery stools, with considerable griping pain and some nausea. The powder is irritant to the respiratory passages and the skin. Resina Podophylli is an excellent purgative in cases of habitual constipation or portal congestion, and is a useful chola- gogue. Laxative effects are produced by small doses (gr. but grain-doses are necessary for its full action. It should be combined with Hyoscyamus, Belladonna or Cannabis Indica, in order to counteract its griping tendency. It is an efficient de- rivative in cases of catarrhal or malarial jaundice, and is recom- mended in very small doses for prolapse of the rectum, remittent fevers of children, dyspepsia, hepatic derangement, bilious vomit- 308 POLYGONUM HYDROPIPEROIDES PONGAMIA. ing and headache, and in the vomiting and diarrhoea of gastro- enteritis. POLYGONUM HYDROPIPEROIDES,Water-pep- per, Smart-weed (Unofficial),—is a plant of the nat. ord. Polygonaceae, indigenous to the U. S., having narrow, lanceo- lated leaves and slender spikes of whitish flowers. It contains Tannin and an active principle, PtMygonic Acid, which is green, crystallizable, insoluble in water, but soluble in alcohol, ether, and chloroform. Preparations. Extractum Polygoni Fluidum (Unofficial),—Dose, ffi-x-sjj. Extractum Polygoni (Unofficial),—Dose, gr. j-v. Physiological Action and Therapeutics. Smart-weed has a pungent, acrid taste, producing a sensation of heat in the stomach, and a peculiar tingling throughout the system. It stimulates the action of the heart, raises the arterial tension, increases the warmth of the surface, promotes the cuta- neous, bronchial and renal secretions and the menstrual flow. It is an efficient diuretic, emmenagogue and aphrodisiac. The juice applied to the skin excites inflammation and vesication. Amenorrhoea from functional inactivity of the uterine system is remarkably benefited by this remedy in 3ss doses of the fluid extract four times daily for a week before the expected period. It has considerable influence over functional impotence, but pro- duces aching pains in the hips and loins, and a sense of weight and fulness within the pelvis. It has also been used with bene- fit in diarrhoea, dysentery, gravel, and locally in mercurial sali- vation and the sore mouth of nursing women. PONGAMIA, Kurung Oil (Unofficial),—is a yellow oil expressed from the seeds of Pongamia glabra, an Indian tree of the nat. ord. Leguminosae. It has been used for many years in India for skin affections, and in professional hands has proven an excellent application in pityriasis versicolor, rubbed in twice daily. It promises to be a valuable remedy in parasitic diseases of the skin, is not irritating and does not discolor the surface to which it is applied. POTASSIUM. 309 POTASSIUM, Kalium, K ,—is represented by a number of official salts, which are colorless or white, sometimes anhy- drous, and generally readily soluble in water. The metal itself is not official. The chief source of its salts is the ash remaining after the combustion of plants or trees, which contains the Car- bonate, from which most of the others are prepared. There are also two subsidiary sources, viz.—the Nitrate, which is found native ; and the Bitartrate, which, under the name of Crude Tar- tar or Argol, is deposited during the fermentation of wine. It is distinguished from all other bases (except Magnesium, Sodium and Ammonium) by not being precipitated by Ammonium Sul- phide or Ammonium Carbonate. It is positively known by the violet color it imparts to flame, by its very sparing solubility when converted into the Bitartrate, and by its precipitation by Platinum Perchloride. Potassium Compounds and their Preparations. Potassa, Potassium Hydrate, Caustic Potash, KHO,—a very deliquescent, white, hard and dry solid, of very acrid and caustic taste and strongly alka- line reaction, soluble in 0.5 of water and in 2 of alcohol. It is a powerful and deeply-acting escharotic, and should be kept in well-stoppered bottles made of hard glass. Potassa cum Calce, Potassa with Lime, Vienna Paste,—a grayish-white, deliquescent powder, consisting of equal parts of Potassa and Lime rubbed together. A milder and more manageable caustic than the preceding. Liquor Potassa, Solution of Potassa,—contains about 5 per cent, of Po- tassium Hydrate, and is prepared by dissolving 90 parts of Potassium Bicar- bonate in 400 of Distilled Water, 40 of Lime in the same quantity of Distilled Water, boiling, mixing the solutions gradually, again boiling, and when cold adding Water up to 1000 parts, straining, settling, and decanting the clear solution. Or, by dissolving 56 of Potassa in 944 of Distilled Water. Is a clear, colorless, odorless liquid of acrid and caustic taste, and strongly alka- line reaction. Dose, well diluted with water. Potassii Acetas, Acetate of Potassium, KC2H302,—a white, satiny, crys- talline mass, or a granular powder, very deliquescent, odorless, of pungent, saline taste, and a neutral or faintly alkaline reaction, soluble in 0.4 of water and in 2.5 of alcohol at 590 F. Dose, gr. v-^j. Potassii Carbonas, Carbonate of Potassium, (K2C03l2.3lI20,—a white, crystalline or granular powder, very deliquescent, odorless, of alkaline taste and reaction, soluble in 1 of water at 590 F., insoluble in alcohol. Is a con- stituent of Unguentum Sulphuris Alkalinum. Dose, gr. ij-xx. Potassii Bicarbonas, Bicarbonate of Potassium, KHC03,—colorless prisms of saline and alkaline taste and alkaline reaction, soluble in 3.2 of water at 590 F., decomposed by boiling water, almost insoluble in alcohol. Dose, gr. v-xxx. Potassii Chloras, Chlorate of Potassium, KC102,—colorless prisms or plates, of pearly lustre, of cooling, saline taste and neutral reaction, soluble in 16.5 of water at 590 F. and in 2 of boiling water; slightly soluble in alcohol. It should not be triturated with readily oxidizable or combustible substances. Dose, gr. v-xx. [See page 314.] 310 POTASSIUM. Trochisci Potassxi Chloratis,—each troche contains gr. v of Potassium Chlorate, with Sugar, Tragacanth and Spirit of Lemon. Dose, j-iij, slowly dissolved in the mouth. Potassn Citras, Citrate of Potassium, K3C6H507.H2Q,—a white, granu- lar, deliquescent powder, of cooling, alkaline taste, and a neutral or faintly alkaline reaction, soluble in 0.6 of water at 590 F., slightly soluble in alcohol. Dose, gr. x-xxx. Liquor Potassii Citratis,—contains about 9 per cent, of the salt, with some free Citric Acid and Carbonic Acid gas. Prepared by dissolving 6 of Citric Acid and 8 of Potassium Bicarbonate each in 40 of water, filtering and adding to the filters in each case enough water to bring to 50 parts, then mix- ing the two solutions. Dose, Mistura Potassii Citratis, Neutral Mixture,—Lemon-juice, fresh and strained, 100, Bicarbonate of Potassium about 10 parts or enough to neutralize the Lemon-juice. Should be freshly made. Dose, Potassii Nitras, Nitrate of Potassium, Saltpetre, Nitre, KN03,—colorless, transparent prisms or a crystalline powder, of pungent, cooling and saline taste and neutral reaction ; soluble in 4 of water at 590 F. and in 0.4 of boil- ing water; almost insoluble in alcohol. Is a constituent of Argenti Nitras Dilutus. Dose, gr. v-xx, well diluted. Charta Potassii Nitratis, Nitrate of Potassium Paper,—is unsized paper immersed in a solution of 20 parts of the salt in 80 of distilled water, and dried. Used for inhalation, the fumes from the burning paper being inhaled in asthma. Potassii Sulphas, Sulphate of Potassium, K2S04,—colorless, hard, rhom- bic prisms, of sharp, saline and bitter taste and neutral reaction, soluble in 9 of water at 590 F., and in 4 of boiling water, insoluble in alcohol. Dose, gr. well diluted. Potassii Tartras, Tartrate of Potassium (K2C4H406)2.H20,—small, trans- parent crystals, or a white powder, somewhat deliquescent, of saline, bitter taste, and neutral reaction, soluble in 0.7 of water, almost insoluble in alco- hol. Dose, gr. xx-^ss. Potassii Bitartras, Bitartrate of Potassium, Acid Tartrate of Potash, Creamor Tartar, Cream of Tartar, KHC4H406,—colorless rhombic crystals, or a white, gritty powder, of acidulous taste and acid reaction; soluble in 210 of water at 590 F., and in 15 of boiling water, very slightly soluble in alcohol. Is a constituent of Pulvis Jalapse Compositus. Dose, gr. xx-^ss. Potassii et Sodii Tartras, Tartrate of Potassium and Sodium, Rochelle Salt, KNaC4H4Og.4H20,—colorless, rhombic crystals, or a white powder, of cooling and slightly saline and bitter taste, and neutral reaction; soluble in 2.5 of water at 590 F., very soluble in boiling water, almost insoluble in alcohol. Is a constituent of the following preparation. Dose, 3ss-j. Pulvis Effervescens Compositus, Compound Effervescing Powder, Seid- litz Powder,—each has of the preceding salt 120 grains, of Sodium Bicar- bonate 40 grains, mixed in one paper; and of Tartaric Acid 35 grains in another paper. Dose, 1 or 2 pair, dissolved separately in water and the solu- tions poured together. Potassii Silicas, Silicate of Potassium, Soluble Glass, K2Si03 (Unofficial), —is used in solution of a syrupy consistence for the preparation of immovable dressings for fractured limbs, etc. (See under Silicates.) [The Arsenite of Potassium is described under Arsenic, page 85;— the Bromide under Bromum, page 103 ;—the Bichromate under Acidum Chromicum, page 23;—the Iodide under Iodum, page 231 the Cyanide POTASSIUM. 311 and Ferrocyanidf, under Acidum Hydrocyanicum, page 29;—the Hypo- phosphite under Phosphorus, page 289;—the Permanganate under Man- ganum, page 256;—the Sulphite under Acidum Sulphurosum, page 36 ;— the Nitrite under Amyl Nitris, page 65;—and Sulphurated Potassa under Sulphur.] Physiological A ction. Caustic Potash, like other caustic alkalies,, destroys the tissues by combining with their water, dissolving the albumen and saponifying the fats, and converting the tissue to which it is applied into a moist, gray slough, with considerable surrounding inflammation. Internally it acts as a powerful corrosive poison, destroying the mucous membrane of the parts with which it comes in contact, and giving rise to intense pain, diarrhoea, con- vulsions and delirium. Unless speedily rejected or neutralized it causes death from inflammation of the larynx, the gastro-intestinal lesions, or after some time from stricture of the oesophagus. Liquor containing over 5 per cent, of the pure Potash, possesses in a degree the same caustic properties, and should never be administered undiluted. It neutralizes the acids in the stomach, and in the blood exists chiefly as the Carbonate, being eliminated with the urine which it renders alkaline. If its use be continued too long it impairs the blood, and renders the sub- ject anaemic. Potassium Salts in large doses are cardiac poisons, muscular paralyzers, poisonous to protoplasm, especially nerve-tissue, and destructive to the ozonizing function of the blood. They increase the saliva, promote oxidation and stimulate retrograde metamorphosis; and are therefore waste-producers. In small doses on an empty stomach they promote the formation of acid gastric juice by favoring the outward osmosis of its constitu- ents from the blood ; in larger doses they act chemically on the stomach contents, neutralizing its free acids, and disordering digestion. The Bicarbonate, given on an empty stomach, enters the blood unchanged, meets the neutral phosphate of sodium and is decomposed, acid phosphate of sodium being formed, which renders the urine more acid. On a full stomach it is decomposed by the acids of the gastric juice, increases the alkalinity of the blood and makes the urine less acid. The Salts of Potassium with Vegetable Acids (Acetate, Citrate, Tartrate, etc.) enter the blood in their own form, are there converted into alkaline carbonates in which form they are eliminated, forming free carbonic acid, alkalinizing the blood and the urine, and are diuretics, increasing the urinary water and solids, but decreasing the uric acid by causing increased oxidation. The Mineral 312 POTASSIUM. Salts (Nitrate, Chlorate, etc.) are not decomposed in the blood but are eliminated in their own form, the Nitrate being a most active diuretic, the Chlorate irritating the kidneys, depressing the heart, causing albuminuria, and impairing the ozonizing function of the blood. In large doses these salts decompose the red blood-corpuscles and paralyze the motor ganglia of the heart. The Chlorate does not part with its oxygen in the system, as generally believed. The Sulphate is chiefly purga- tive in its action, but acts harshly, and in overdoses has caused death. [The action of the remaining Potassium salts is described under the titles of their acid and other constituents, to which their effects are chiefly referable.] Antagonists and Incompatibles. Poisoning by caustic alkalies is treated by the dilute Vegetable Acids, as vinegar, cider, lemon-juice;—then demulcent drinks and oils to protect the mucous membrane, and the usual measures to support vitality. The alkalies and their carbonates are incompatible with the acids and also with metallic salts, and the caustic alkalies decompose most of the alkaloids. Therapeutics. Caustic Potash is used locally to destroy morbid or cica- tricial tissue, to cauterize the wounds resulting from bites of animals or stings of insects, to form issues or to open deep-seated abscesses, and to destroy chancres, malignant pustules, ngevi, warts, etc. Its action is deep and severe, and it is best employed in the form of Potassa cum Calce, which is far more manageable. Liquor Potassa; is used internally as a free alkali to neutralize excess of acid in the stomach, blood and secretions, as an anti- lithic in the uric acid diathesis, also for acne, boils, and obesity. Locally it is employed to soften the nail in in-growing toe-nail, and diluted to relieve pruritus and remove scales in various skin- diseases. In small doses with a vegetable bitter tonic before meals it acts well in atonic dyspepsia, increasing the flow of the gastric juice by direct stimulation of the gastric mucous mem- brane. If given after meals in acid dyspepsia large doses are necessary for temporary alleviation by neutralizing the food acids. These remarks concerning acidity and dyspepsia apply equally well to the Bicarbonate, which is used for the same purpose, and while possessing all the virtues of the potassium salts, is'without any corrosive or irritant action. It is also useful in simple gas- tralgia or cardialgia; and in cystitis, gonorrhoea, etc., where there is acid urine, it renders the urine less irritating and soothes the inflamed surfaces. Acute and chronic rheumatism and rheu- POTASSIUM. 313 matoid arthritis are much benefited by an alkaline treatment in patients of sufficient bodily vigor to stand its lowering effects. The Bicarbonate is also used to alkalinize the blood and secre- tions in lithiemia, jaundice, many cutaneous eruptions, and in diabetes; also locally as a lotion for fetid perspiration of the feet and axillae, acne and acute eczema. The Carbonate is diuretic, antacid and antilithic, but is seldom used internally, being too irritant, and the Bicarbonate having all its virtues without its objectionable qualities. Locally a solution (3j to the §) is said to be effectual as a remedy for pruritus vulvae, and one of half the above strength is used in freckles, sunburn and tan of the epi- dermis, in moist eczema and the itching of urticaria. The Acetate, Citrate and Tartrate are good purgatives in doses of 3ij to 3>v> and in smaller doses are much employed as alkalinizers of the blood and urine, diuretics, etc. Of these vegetable potassium salts the Acetate is the most certain diuretic, the Bitartrate is the most active cathartic, while the Citrate is the most reliable diaphoretic and the best agent to use to alkalinize the urine for any length of time, it having the least injurious effect on the blood or on the digestion. In lithsemia these salts are given to promote oxidation, and by keeping the urine alka- line they may reduce small calculi of the uric acid variety. In acute rheumatism and fevers they act as antacids in the blood, as febrifuges by promoting diaphoresis, and as sedatives to the general nervous system. As an agreeable laxative no preparation surpasses the Bitartrate in 2 to 4 drachm doses made into a paste with orange marmalade or any other conserve. It is also used in Infusion of Juniper as a diuretic in general cardiac dropsy, and without the Juniper in acute desquamative nephritis. Potassium Chlorate is much employed locally in solution (3ss to the as a deodorizer and detergent wash in inflamed, ulcerated and aphthous conditions of the mouth. On unhealthy mucous membranes generally it exercises an alterative action for the better, but if too long used it will keep up a state of chronic irritation. In mercurial salivation it is of great benefit, and in dilute solution (gr. x to the £) it is an efficient application to un- healthy sores and ulcers, as a wash for foul sinuses or cavities, and as an injection in chronic affections of the bladder. The powdered salt may be applied to aphthae, and dusted over epithelioma will alter the action, diminish the pain, check the growth and pro- mote cicatrization. Internally this salt has been administered in the mistaken idea that it parts with its oxygen in the system, but it is now shown that it is excreted unchanged. Setting up congestion and irritation of the kidneys it is highly dangerous 314 PRINOS. in large doses or if used for any length of time, but is constantly administered in diphtheria, chronic bronchitis, purpura, hema- turia, ovarian tumor, pseudo-membranous laryngitis, scarlatina, typhoid fever, chronic cystitis, etc. When used internally it should be given in small doses (gr. xx in 24 hours for an infant, gr. xxx in 24 hours for a child of 2 to 4 years, and 3jss f°r an adult in the same time), and the action of the heart and the kidneys should be carefully watched. It should never be prescribed with the Iodide of Potassium lest the poisonous Iodate be formed. Strong acids and acid sulphates decompose it, and it forms explosive compounds with easily oxidizable substances as Sugar, Sulphur, Tannin, Sodium or Potassium Hypophosphites, Catechu, Glycerin, etc. Potassium Nitrate has been much employed as a refrigerant diaphoretic and diuretic in febrile and inflammatory affections, especially in inflammation of the trachea and bronchi, pneu- monia and rheumatism, but its action is uncertain and it is now giving place in these disorders to more efficient agents. The fumes of burning nitre paper (Charta Potassii Nitratis) are a useful inhalation in some forms of spasmodic asthma. Potassium Sulphate is used in teaspoonful doses in water as an hepatic stimulant and a mild cathartic, increasing the secre- tions of the intestinal glandular apparatus. Its action is some- times harsh, and death has resulted from overdoses. The Tartrate of Potassium and Sodium, or Rochelle Salt, is the chief aperient agent in Seidlitz Powders. In doses of it is a gentle and cooling laxative, and in drachm doses fre- quently repeated it is used to render the urine alkaline, and as an anti-lithic. [The uses of the other Potassium Salts are described as noted on page 312.] PRINOS, Black Alder,—is the bark of Prinos verticillatus or Winter-berry, a shrub of the nat. ord. Aquifoliacese, indig- enous in Canada and the U. S., having small, white flowers, and a globose, six-seeded, bright-red berry, which grows in clusters and is persistent all winter. The bark occurs in thin, slender fragments, of a brownish-ash color externally, and a pale-green or yellow internally; taste bitter and slightly astringent. It contains an amorphous, yellow and bitter principle, also tannin, sugar, starch, wax, resin, etc. There are no official preparations, but the bark may be given in substance in doses of 3ss, or a decoction (5ij in Oiij boiled to a quart) in doses of i—ij- 315 PRUNUM—PRUNUS VIRGINIANA. Physiological Action and Therapeutics. Black Alder is astringent and tonic, and has been used in intermittent fever, diarrhoea, and chronic cutaneous diseases. In the latter class of disorders it may be applied locally. PRUNUM, Prune,—is the fruit of Prunus doniestica, the Plum tree (nat. ord. Rosacese), indigenous to Western Asia, but cultivated in most countries of temperate climate. The dried fruit (Prune) is oblong, shrivelled, of blackish-blue color, having an almond-shaped seed. Prunes contain sugar, pectin, albumen, malic acid and salts. They are a constituent of Confectio Sennae. Physiological Action and Therapeutics. Prunes are laxative and nutritious, and are freely used as a food and sweetmeat, but in excess may give rise to flatulent'colic from the indigestibility of their skins. Stewed Prunes is an excellent dish for constipation in children, and may be made more effec- tive by the addition of a little Senna. PRUNUS VIRGINIANA, Wild Cherry—is the bark of Prunus serotina, or Wild Cherry, a large forest tree of the nat. ord. Rosacese, growing in Canada and the U. S. The bark should be collected in autumn from the large branches only, and comes in curved pieces Ta5 inch or more thick, of greenish or yellowish-brown color externally, and astringent, aromatic and bitter taste. On maceration in water it develops a distinct odor of bitter-almonds. It contains tannin, gallic acid, resin, starch, etc., also Amygdalin and Etmilsin, which by their mutual reaction in the presence of water, produce Hydrocyanic Acid and a Vola- tile Oil resembling that of Bitter Almond. [See ante, Amygdala, page 63, and Acidum Hydrocyanicum, page 29.] Dose of the powdered bark, 5ss_j- Preparations. Extractum Pruni Virginians Fluidum,—Dose, Infusum Pruni Virginians,— 4 per cent. Dose, Should be made with cold water. Syrupus Pruni Virginians,—12 per cent. Dose, £j-iv. Physiological Action. Wild Cherry is an aromatic bitter tonic, increases appetite, aiding digestion, and thus promoting constructive metamorphosis. 316 PULSATILLA. The presence of a volatile oil gives it a local stimulating action on the alimentary canal in common with Serpentaria, Cascarilla and other members of the same class. Hydrocyanic Acid being yielded by it in the presence of cold water, results in imparting a sedative action to its preparations, calming irritation and dimin- ishing nervous excitability. Very large doses reduce the action of the heart. Therapeutics. The preparations of Wild Cherry are used in catarrhal condi- tions of the bronchial mucous membrane, in the hectic of phthisis and scrofula, palpitation of the heart, and debilitated stomach, a collection of symptoms often observed in consumptive subjects, to whom it is a very useful palliative. Cough is supposed to be especially amenable to its influence, and hence it has become a matter of daily routine to prescribe the syrup as an ingredient of cough-mixtures. The infusion is an excellent stomachic tonic, and may be administered with great benefit in dyspepsia and in convalescence from acute disease. PULSATILLA, Pasque-flower, Meadow Anemone, —is the herb, collected soon after flowering, of Anemone Pulsa- tilla and Anemone pratensis (Pulsatilla nigricans), and of Anemone patens (Pulsatilla Nuttalliana), small herbal plants of the same natural order (Ranunculaceae) to which Aconite belongs. The first-named species inhabit Europe and Siberia, and have large, purple flowers; the last-named is an inhabitant of the United States, and sometimes has whitish-colored flowers ; all are inodor- ous and very acrid. Pulsatilla contains a very acrid yellow oil, which in the presence of water is gradually changed to Anemonin, Ci5H1206, a volatile, crystallizable, camphoraceoqs principle, sol- uble in chloroform, nearly insoluble in ether or water; and Ane- monic Acid, C15Hu07, a white, crystalline, tasteless powder, which may be formed also by the action of alkalies on Anemonin. There are no official preparations, but a tincture may be made according to the pharmacopoeial directions for Tincturse Herbarum Recentium (i in 2), of which the dose is The imported homoeopathic tincture has equal parts of the expressed juice and alcohol, and is generally a very good preparation. Anemoninum, Anemonin (Unofficial),—the active principle. Dose, gr. ij in pill. Physiological Action. Pulsatilla is a local irritant, the fresh juice producing numbness and tingling in the part to which it is applied, and may excite vio- PULSATILLA. 317 lent inflammation of the skin with vesicular or pustular eruption, and if swallowed severe irritation of the gastro-intestinal mucous membrane. On the tongue it produces symptoms like those from Aconite, viz.—tingling and burning, followed by numbness. In- ternally it lowers the heart and arterial tension, reduces respira- tion and temperature, dilates the pupils, produces nausea and vomiting, diaphoresis and diuresis, and paralyzes motion and sensibility. Stupor, coma and convulsions may be caused by a toxic dose. Most of these effects have been observed on rabbits. The active principle (Anemonin) is volatile, hence the herb must be fresh to be suitable for medicinal use. Antagonists and Incompatibles. Alcohol, Opium and Digitalis are the physiological antagonists. Incom- patibles are the caustic alkalies, Tannic Acid and the metallic salts. Therapeutics. Pulsatilla is a very efficient remedy if a fresh preparation be employed. It was highly praised by Storck for amenorrhoea, corneal opacities, cataract, paralyses, rheumatism, old ulcers, constitutional syphilis and scaly skin diseases. On the generative organs it seems to have a specific action, and is an excellent remedy in functional amenorrhoea, dysmenorrhoea, menstrual suppression from fright or chill, leucorrhoeal discharges with back- pains and nervous depression. Epididymitis and orchitis are often controlled and even dissipated by very small doses (ttitV- every 2 hours. It quickly relieves dyspepsia or subacute gastritis, with white coated tongue, no taste or a greasy sensation in the palate, nausea, flatulence, heartburn, etc. Many acute inflammations of mucous surfaces with mucous or muco-purulent discharges, as coryza, otitis (externa and interna), rhinitis, bron- chitis, conjunctivitis, etc., are greatly benefited by 5 to io-drop doses every 4 hours and locally 5j—’j °f the tincture to water as a lotion. A similar use of this remedy has proven of great benefit in many cutaneous affections, especially eczematous erup- tions, syphilides, and ulcers of indolent character. It is also said to be efficiently employed in acute cerebral and spinal me- ningitis, subacute rheumatism of the small joints, rheumatic gout, chronic vesical and nasal catarrhs, gastro-enteric symptoms of remittent fever and measles, ophthalmia neonatorum, strumous ophthalmia with profuse but bland discharge, acute and subacute inflammations of the middle ear, and in left-sided clavus, hemi- crania and inframammary pain. An extract of the root has proved efficient against tapeworm. 318 PYRETHRUM. Coughs which are loose by day but dry and tickling on lying down at night are greatly benefited by Pulsatilla, and Anemonin in doses of gr. y2-j has been found extremely useful in whooping- cough and other coughs of irritative character. PYRETHRUM, Pellitory,—is the root of Anacyclus Py- rethrum, a plant of the nat. ord. Compositge, native of Northern Africa, but cultivated in Europe. The root is 2 to 4 inches long, y2 inch thick, annulate above, wrinkled below, externally a dark grayish-brown, internally brownish-white; the bark thick, con- taining two circles of resin-cells surrounding slender wood- bundles and medullary rays ; inodorous, pungent and acrid. It contains an alkaloid Pyrethrine, also inulin, tannin, mucilage, etc., with a brown Resin and two fixed oils. Dose, as a mastica- tory, 5ss-j. Pyrethrum Roseum, Persian Pellitory (Unofficial),—is indige- nous to Western Asia, and resembles Chamomile in appearance. The flower-heads are used in powder to kill insects, 4 grains kill- ing a fly in a vial in 2 or 3 minutes. Preparation. Tinctura Pyrethrt,—20 per cent. Not used internally. Physiological Action. Pellitory is an irritant sialogogue. When chewed it causes a pricking sensation in the tongue and fauces with heat, acridity, pungency and a copious flow of saliva and buccal mucus. Large doses may cause bloody diarrhoea, tetanoid spasms, accelerated pulse, and profound stupor. Applied to the skin it acts as a ru- befacient, the powder inhaled as a sternutatory. It stimulates the local nerves and vessels of the mouth and salivary glands by direct irritant action, but soon depresses the nerves and blunts their sensibility. Therapeutics. Pellitory is chewed as a masticatory and sialogogue in paraly- sis of the tongue, rheumatic and neuralgic affections of the head and face, and pain from carious teeth. Its powder has been rec- ommended as a sternutatory in chronic catarrh of the frontal sinuses. As a gargle or lotion (3iij to Oj) it is very useful for relaxed uvula and as a mouth-wash. When used for toothache a few drops of the tincture should be inserted into the cavity on cotton wool. Used as a sialogogue it is an efficient agent to se- QUASSIA. 319 cure the rapid elimination of Iodine from the system in chronic poisoning thereby. QUASSIA ,—is the wood of Picroena excelsa, a large tree of the nat. ord. Simarubaceae, indigenous to Jamaica and other West Indian islands. Surinam Quassia, used in Europe, is the wood of Quassia amara. Both varieties, as met with in the shops, are in the form of chips or raspings, of a yellowish-white color, inodorous but of intensely bitter taste. The wood is also turned into cups, which are sold under the name of quassia- or bitter-cups. It contains a bitter principle, Quassin, C31H4209, which is crystalline, soluble in hot alcohol and in chloroform, slowly in cold water, faster in alkaline or acidulated water. Dose of the powdered wood, gr. xx-xxx. Preparations. Extractum Quassia,—aqueous. Dose, gr. j-iij. Extractum Quassia Fluidum,—Dose, Tinctura Quassia,—strength io per cent. Dose, niv-^j. Infusum Quassia (Unofficial),—made with cold water %x, Quassia-chips sjj, macerated for y2 hour and strained. Or water poured into a quassia-cup and left standing will give a good infusion. Dose, 3j—iij. Physiological Action. Quassia is a simple bitter, having no flavor, but is intensely bitter and less agreeable than either Gentian or Chiretta. It is fatal to flies and fish, and makes an excellent anthelmintic enema against the thread-worm. A concentrated preparation is poison- ous to rabbits and dogs, and has produced very alarming narcotic symptoms in a four-year-old child. As usually administered its action is that of a bitter stomachic tonic, as described under Calumba (see ante, page 114). Therapeutics. The preparations of Quassia contain no tannin and hence may be prescribed with salts of Iron. It is chiefly employed in atonic dyspepsia with pain after eating, and vomiting or regurgitation of food, also in atonic diarrhoea depending on indigestion or an irritable condition of the intestinal mucous membrane. It is useful in convalescence to promote the appetite and digestion, and with Sodium Bicarbonate in gastric vertigo. As an enema the strong infusion is an effective remedy for ascarides of the 320 QUEBRACHO. rectum. It has been used as a feeble antiperiodic, and in hys- teria its repulsiveness is an aid to its medicinal action. QUEBRACHO (Unofficial),—is the bark of Aspidosperma Quebracho, a. large evergreen tree of the nat. ord. Apocynacese, growing in Chili and the Argentine Republic. The name is one given in S. America to any very hard wood (quebrar hacho, to break the axe), and the particular tree above named is known as Quebracho bianco, from the white color of its wood. It contains several alkaloids, no one of which represents the action of the bark itself; the most important being Aspidospermine, C22H30N2O2, and (2«^ras,fo«^,C21H26N203. Several false Quebrachos are found on the market, that most frequently seen being the bark of Lox- opterygiuni Lorentzu, or Quebracho Colorado, an Argentine tree of the order Terebinthaceae. Preparations. Tinctura Quebracho (Unofficial),—20 per cent. Dose, gj-gss. Extractum Quebracho Fluidum (Unofficial;,—Dose, rriv-^j. Vinum Quebracho (Unofficial),—Quebracho 1, Alcohol 2, White Wine 16 parts. Dose, Extractum Quebracho (Unofficial),—Dose, gr. ij-viij. Physiological Action. Quebracho is a bitter tonic of disagreeable taste, promoting appetite and increasing digestion. It lowers the action of the heart, reduces arterial tension, and slows respiration, also de- creasing the sensation of need of air after active exercise. In large doses it causes severe salivation, nausea, vomiting, vertigo and headache. In animals it paralyzes the motor nervous system and lowers the reflexes, producing great dyspnoea and finally death apparently from asphyxia. Aspidospermine is actively poisonous to the respiratory appa- ratus and circulation in both cold- and warm-blooded animals, in the former the respiration being chiefly affected, in the latter the motor ganglia of the heart. Lowered temperature, dyspnoea, stupor and convulsions occur before death. Therapeutics. Quebracho has long been used in Chili as an antiperiodic, a stomachic tonic, and a remedy for dyspnoea. In the latter con- dition it is reported to be remarkably palliative, especially when due to emphysema, uraemic and spasmodic asthma, spasmodic QUERCUS ALBA—QUILLAIA. 321 cough and chronic bronchitis. It is not efficient in dyspnoea from organic disease of the heart, nor in that of aged subjects of atheroma. Aspidospermine has been used as an antipyretic, also in car- diac neuroses and in asthma. Its salts are freely soluble in water, but the alkaloid itself is only soluble in oils and fats, 6 to 8 parts being readily incorporated with 100 of cod-liver oil by the aid of heat. Its average dose is gr. j-ij. QUERCUS ALBA, White Oak,—is the bark of Quercus alba, the White-oak tree (nat. ord. Capuliferse), and occurs in nearly flat pieces deprived of the corky layer, of pale-brown color, tan-like odor, and strongly astringent taste; or as a coarse, fibrous powder, which does not tinge the saliva yellow. It con- tains a variety of Tannin named Quercitannic Acid, C.28H„4012, also Pectin and a bitter principle Quercin, but no Gallic Acid. There are no official preparations, but a decoction (3j ad Oj) may be used in doses of Jss-j. Quercus Tinctoria, Black Oak Bark,—was formerly official. It contains a coloring principle Quercitrin, which stains the saliva yellow when the bark is chewed, also Quercitannic Acid, etc. Quercus Lusitanica is the source of Galls (see ante, Galla, page 199). Physiological Action and Therapeutics. Oak-bark is astringent and tonic, but is seldom used internally. Its action and uses are those of Tannic Acid (see ante, page 38). The decoction is much used in country practice as a cheap astrin- gent application or injection in leucorrhoea, prolapsus ani, hemor- rhoids, etc., and as a gargle in faucial inflammation and prolapsed uvula. It has also been used as an injection into dropsical cysts, and as a lotion for flabby ulcers and suppurating wounds. The powdered bark as a poultice has proved an excellent application in gangrene, and in finely pulverized state it is a useful ingredi- ent of tooth-powders. A concentrated fluid extract is used in the Heaton-Warren operation for the radical cure of hernia, by injection into the tissues around the margin of the ring, with the object of exciting inflammation and occlusion of the opening. QUILLAIA, Soap-Bark,—is the inner bark of Quillaia Saponaria, a tree of the nat. ord. Rosacese, indigenous to Peru and Chili. It occurs in large, flat pieces, about \ inch thick, of a brownish-white color externally, very acrid and sternutatory, but 322 RESINA. inodorous. It contains Calcium Sulphate crystals, starch, and the glucoside Saponin, C32H54018, a white, amorphous, sternuta- tory powder, soluble in water and in dilute alcohol. There are no official preparations, but a tincture may be prepared by ex- hausting one part of the bark with sufficient dilute alcohol to make 5 parts of tincture. Physiological Action and Therapeutics. Quillaia in powder is sternutatory and causes the water in which it is macerated to froth, making emulsions of oils, and being used instead of soap for washing purposes in various affec- tions of the skin, and to stimulate the growth of the hair in alo- pecia. Its properties are due to the glucoside Saponin, which is found also in Senega and in a number of other plants, and is a violent irritant of the respiratory passages, a local anaesthetic, an antipyretic, a powerful paralyzant of the heart and respiration, and a poison to the voluntary muscles. It has not been made use of in practical medicine. A decoction of the bark (5 to 200) has been employed in doses of 3j~i) according to age, as a substitute for Senega in the treat- ment of diseases of the respiratory organs where a pleasant expectorant is indicated. Its expectorant properties are well established, and children take it readily. It does not provoke diarrhoea or vomiting, and has a sweetish, agreeable taste. RESINA, Resin, Rosin, Colophony, cao, —is the residue left after distilling off the volatile oil from Turpentine. It is a transparent, amber-colored substance, of sp. gr. 1.070 to 1.080, hard and brittle, with a glossy and shallow conchoidal fracture, and a faintly terebinthinate odor and taste, soluble in alcohol, ether, fixed or volatile oils, and in its own weight of oil of turpentine. Chemically it is considered as the Anhydride of Abietic Acid, into which acid it is converted by agita- tion with warm diluted alcohol. Silvic, Pinic and Pahnaric Acids are decomposition products, not constituents of the resin as formerly taught. Other official resins are Resina Copaiba, Resina Jalaps, Resina Podophylli and Resina Scammonii, which are severally described under the titles of the plants form- ing their respective sources. Preparations. Ckratum Resina, Resin Cerate, Basilicon Ointment,—consists of Resin 35, Yellow Wax 15, and Lard 50 parts. It forms 65 per cent, of Turpentine Liniment, and is a constituent of Savine Cerate. RESORCINUM. 323 Emplastrum Resina, Resin Plaster, Adhesive Plaster,—consists of Resin 14, Lead Plaster 80, Yellow Wax 6 parts. Is the common adhesive plaster of surgery, and an ingredient of the official Arnica, Belladonna and Capsicum Plasters. Resin itself is an ingredient of Mercurial Plaster, Cantharides Cerate, and Cerate of the Extract of Cantharides. Physiological Action and Therapeutics. Resin gives consistence and adhesiveness to plasters and cerates, and generally acts as a mild local stimulant, but the writer has seen persons with so susceptible a skin that the ordinary adhesive plaster would produce on them a high degree of cutaneous irrita- tion. It is never employed internally, but in chronic bronchial catarrh the fumes from boiling resin are inhaled with considerable advantage. Resin Cerate is one of the most commonly used applications to promote the healing of indolent ulcers, blistered surfaces, burns, scalds, chilblains, etc. RESORCINUM, Resorcin, C6H4(HO)2 (Unofficial)—is a diatomic phenol, isometric with Pyrocatechin axuMfydroquinone (see ante, page 151), obtained by fusing certain resins with a caustic alkali, but best prepared by fusing Potassium Benzol- disulphonate with Caustic Potassa, the salt being decomposed into Potassium Sulphite and Resorcin. It crystallizes in color- less, rhombic prisms or plates of neutral reaction, odorless, and of sweetish, acrid taste, soluble in of water, also in alcohol, ether, etc. Dose, gr. v-xv;—as an antipyretic 3j, not repeated for several hours, or gr. v every 2 hours. Physiological Action. Resorcin is closely allied to Carbolic Acid, but possesses the advantage over the latter in that it is odorless, more soluble and almost non-irritant. It is equally powerful as an antiseptic and antiferment, arresting decomposition and destroying low organ- isms. Injected beneath the integument in solution it produces very little irritation, and never causes inflammation or abscess. Vesication results from its application to the mucous membrane. Internally a 30- to 60-grain dose causes a sense of heat, discomfort and oppression, followed by profuse perspiration and languor; if fever be present the temperature of the body is lowered several degrees, but rises again after a rigor in from 2 to 4 hours. Larger doses (150 grains) have produced deafness, dizziness, sali- vation, confused vision, vertigo, unconscfousnes, general clonic 324 RHEUM. convulsions, and tetanic rigidity of the muscles of the neck, with no decline of temperature in feverless subjects. Toxic doses (gr. xv to each of weight) cause in animals trembling succeeded by epileptiform convulsions, which increase in severity and then decline, the respiration is quickened and enfeebled, the heart’s action becomes rapid, weak, and irregular, and death results from paralysis of respiration, the drug paralyzing the motor tracts in the spinal cord, but not affecting the general sensibility. It is eliminated chiefly by the urine, which it colors a bluish-violet hue, and with great rapidity, about one hour serving for its excretion. The best test for its presence is the solution of the Perchloride of Iron, which produces with it a dark-violet, almost black color. Antagonists. Atropine and other cardiac and respiratory stimulants, cerebral excitants and agents which raise the arterial tension are physiologically antagonistic. Therapeutics. Resorcin is employed as an antipyretic and antiseptic, being preferred to Carbolic Acid for internal and subcutaneous use. A 3 per cent, solution gives good results in stomach complaints, as gastralgia, gastric catarrh, gastric ulcer, fermentative indigestion, etc. It has given great satisfaction to some observers in intermit- tent fevers and malarial diseases generally, while others have been much disappointed with its action therein. As an antipyretic it has been used in erysipelas, puerperal fever, septicaemia and diphtheria, and in the latter disease it has been employed locally in crystals with decided benefit. A 2 per cent, solution has given great satisfaction as a local antiseptic application to wounds, parasitic skin diseases, cystitis, gonorrhoea, anthrax, and syphilitic sores of unhealthy character. As spray a similar solu- tion is well applied to catarrhal or ulcerative affections of the respiratory passages. As a caustic it may be applied in undiluted form to chancres, papillomata, carbuncles, etc. A saturated ethereal solution is a good application where the caustic action of the drug is required. RHEUM, Rhubarb,—is the root of Rheum officinale, a perennial plant of the nat. ord. Polygonaceae, a native of Thibet, and of other undetermined species of Rheum, many of which are cultivated in Europe and America, their leaf-stalks being used as a fruit. The commonly accepted medicinal Rhubarb is the Chinese variety, and is imported from Shanghai and Canton. It RHEUM. 325 occurs in cylindrical or conical segments, sometimes flattened and bored with a hole, of a dirty-brown-yellow color externally, internally marbled with fine waving lines, of peculiar odor, gritty between the teeth, and of a bitter astringent taste. It imparts its virtues to water and alcohol, and contains several substances of greater or lesser activity, the least important being Phceoretin, CS2H32Ou, the rhubarb-resin,—Erythroretin, and Chry- sophan, the latter of which is split by acids into Sugar and Chrysophanic Acid. (See ante, Chrysarobinum, page 145). It also contains Rheo-tannic Acid, CS2H52028, Rheumic Acid, C40H32O18, and probably a principle which is identical with Ca- thartic Acid (see Senna), on which its purgative activity may depend. Dose of Rhubarb as a stomachic, gr. j-v;—as a purga- tive, gr. x-xx. Preparations. Extractum Rhei,—Dose, gr. x-xv. Extractum Rhei Fluidum,—Dose, Pilulhj Rhei,—composed of Rhubarb 3, Soap 1; each pill containing gr. iij of powdered Rhubarb. Dose, j-iij. Pilulhj Rhei Composite,—each contains of Rhubarb gr. ij, Aloes gr. \l/z, Myrrh gr. j, Oil of Peppermint gr. . Dose, ij-iv. A safe and efficient laxative. Tinctura Rhei,—has of Rhubarb 12, Cardamom 2, with diluted Alcohol to 100 parts. Dose, Tinctura Rhei Aromatica,—has of Rhubarb 20, Cinnamon 4, Cloves 4, Nutmeg 2, Diluted Alcohol to 100 parts. Dose, Tinctura Rhei Dulcis,—has of Rhubarb 8, Licorice 4, Anise 4, Carda- mom 1, Diluted Alcohol to 100 parts. Dose, f^ss-^ij. Syrupus Rhei,—has of Rhubarb 90, Cinnamon 18, Potassium Carbonate 6, Sugar 600, Water to 1000 parts. Or, it may be made extemporaneously thus: —Fluid Extract giij, Simple Syrup Jjxxix. Dose for an infant gj > f°r older children Syrupus Rhei Aromaticus,—has of the Aromatic Tincture 10, Syrup 90 parts. Dose, as the Syrup. Vinum Rhei,—has of Rhubarb 10, Calamus 1, Stronger White Wine to 100 parts. Dose, 3_j-?ss. Pulvis Rhei Compositus,—has of Rhubarb 25, Magnesia 65, Ginger 10. Dose, a teaspoonful. Mistura Rhei et Sod^e,—Sodium Bicarbonate 30, Fluid Extract of Rhu- barb 30, Spirit of Peppermint 30, Water to 1000 parts. Dose, Physiological Action. Rhubarb is classed among the tonic-astringent and resin-bear- ing purgatives, which increase the secretions of the glandular appendages of the intestinal canal, and stimulate the muscular layer of the bowel. In small doses (gr. j-v) its action is that of a stomachic and intestinal astringent, the influence of the 326 RHINACANTHUS. bitter principle and the rheo-tannic acid probably predominating. In larger doses (gr. xxx-lx),its cathartic action prevails, produc- ing in 6 to 8 hours copious yellow, pultaceous stools, with some griping and considerable hepatic stimulation. After the cathartic principle is expelled, the astringent quality of its tannin asserts itself and constipation is likely to result. The yellow color of the stools is partly due to the rhubarb pigment and partly to excess of bile, the drug having marked cholagogue properties, in all probability due to its resin, Phaeoretin. Its pigment stains the milk, urine and sweat, the milk acquiring a bitter taste and purgative properties. The cathartic action of Rhubarb may be obtained from its application locally to ulcers, by being rubbed into the moist skin, or applied to the abdomen as a poultice. Therapeutics. Rhubarb is highly esteemed as a cathartic for children, from the mildness of its action, as, though occasionally producing quite severe griping, it never inflames the gastro-enteric mucous mem- brane. Its tonic and astringent action following its catharsis makes it a valuable agent in diarrhoeas due to. the presence of irritating matter in the bowel, and to correct atonic indigestion accompanied by diarrhoea. For hemorrhoids with constipation its gentle action makes it peculiarly suitable, its astringent after- effect being entirely overcome by 2 to 4 drachm doses of olive oil nightly. It may be combined with a mercurial or with Bicarbo- nate of Sodium, the latter being supposed to overcome its astrin- gent action and to disguise its taste in some degree. In small doses the tincture is a very efficient stomachic tonic, improving appetite, increasing the flow of the gastric juice, assisting diges- tion, and promoting the action of the liver without producing any cathartic results. The preparations most in use for children are the Aromatic Syrup and the Mistura Rhei et Sodte. RHINACANTHUS (Unofficial),—the leaves and root of Rhinacanthus communis, a shrub of the nat. ord. Acanthaceae, in- digenous to India and China. The root contains a quinone-like body named Rhinacanthin, C14H1804, which forms with alkalies intensely red compounds which are decomposed by benzin. It is known in China as Hong-Pang-Chong, and is employed as a local remedy for ringworm and parasitic skin diseases, the leaves being bruised and mixed with lime-juice. Used internally a tincture of the root has some reputation as a feeble tonic and RHUS AROMATICA RHUS GLABRA. 327 antiperiodic. The same preparation is applied locally in chronic eczema, tinea and psoriasis. RHUS AROMATIC A, Sweet Sumach (Unofficial),— is an indigenous shrub of the nat. ord. Terebinthaceae, growing about 5 feet high, and having yellow flowers in spikes. The root-bark contains a volatile oil, several resins, fat, tannin, etc. A fluid extract is prepared from the bark of the root according to the general pharmacopoeial rule, and may be given in doses of ttix-xxx, every 2 or 3 hours. Physiological Action and Therapeutics. Rhus Aromatica has astringent properties, and seems to pos- sess a selective action upon the urinary tract. Its action is not yet clearly made out. Therapeutically it has been used with advantage in cystitis, night-sweats, hematuria, menorrhagia, dia- betes insipidus, diarrhoea and dysentery. As a remedy for incon- tinence of urine in children it has attracted considerable atten- tion, having been extremely efficient in doses of -nixv of a good fluid extract four times daily, administered in glycerin and wa- ter, or any other suitable excipient. It is reported to be equally effective in hysterical enuresis of adults, but larger doses (tiixx- xxx several times a day) are required. Diabetes insipidus is remarkably benefited by its continued use, and even in diabetes mellitus its employment has occasionally seemed to have been followed by curative results. RHUS GLABRA, Smooth Sumach,—is the fruit of Rhus glabra, an indigenous shrub of the nat. ord. Terebinthacese, growing in rocky and barren soil to a height of 8 to 12 feet. The berries are about | inch in diameter, subglobular, densely hairy, of crimson color and acidulous taste, but inodorous. The leaves and bark have an astringent and bitter taste, and are also used medicinally. It contains tannin, coloring matter, potassium and calcium malates. Preparation. Extractum RhoIs Glabra Fluidum,—Dose, jj-ij. Physiological Action and Therapeutics. Sumach-berries form a useful acidulous and astringent drink or gargle in catarrhal pharyngitis, stomatitis, aphthae, etc. An in- 328 RHUS TOXICODENDRON. fusion (3j to the pint) may be used, or the official fluid extract as a wash and dressing for ulcers and wounds. Internally they are useful remedies for mild catarrhal affections of the stomach and bowels. RHUS TOXICODENDRON, Poison Sumach,—is the fresh leaf of Rhus Toxicodendron, the Poison Oak, and of Rhus radicans, the Poison Ivy, shrubs of the nat. ord. Terebinthaceae, indigenous to Canada and the greater part of the United States east of the Rocky Mountains. The climbing plant (R. radicans) is not a distinct species, but a variety of the erect form, both when wounded exuding a poisonous, acjid, milky juice which turns dark on exposure. The leaves are trifoliate, on petioles 4 or 5 inches long, the lateral leaflets sessile, entire and glabrous in R. radicans (or variously notched, toothed or lobed, downy beneath, in R. Tox.), inodorous, astringent and acrid. They may be confounded with the leaves of the hop-tree, Ptelea trifoliata, which are quite similar in appearance, but all its leaflets are ses- sile. The poisonous principle of the plant is Toxicodendric Acid, which is volatile, and also exists in Rhus venenata or Swamp sumach, Rhuspumila, and Rhus diversiloba, the former of which is probably the most poisonous of the four species. Dose of the leaves is generally placed at gr. j-iv, but if old and dry they will generally prove to be inert. There are no official preparations. Preparations. Tinctura RhoIs Toxicodendri (Unofficial),—may be prepared accord- ing to the formula of the Pharmacopoeia for Tincturae Herbarum Recentium (Tinctures of Fresh Herbs), one part of the fresh leaves to two of Alcohol. Dose, Tn.xV-71Up Extractum RhoTs Toxicodendri,—has been used in France in large doses. It is probably inert. Physiological Action. The effects of Rhus Toxicodendron upon the skin are familiar to all who have suffered from contact with poison-oak or ivy. Some persons are so susceptible to the poison that the exhalations from the plant will produce on them its characteristic action. Others are apparently insusceptible to its influence, and can with impunity rub the juice into their skin, or even chew its leaves. The action of the plant when locally applied is that of a cuta- neous irritant, causing redness and swelling of the affected parts, with a vesicular eruption and intolerable itching, which may RHUS TOXICODENDRON. 329 spread rapidly over the surface of the body and extend to the mucous membranes, producing conjunctivitis, redness and tume- faction of the mouth and throat, thirst, cough, nausea and vomit- ing, vertigo, stupefaction, etc. Colicky pains are experienced in the abdomen, are worse at night and are aggravated by food or drink. Diarrhoea may occur, with tenesmus and bloody stools, also diuresis, bloody urine, or even complete retention. Fever with delirium is frequently present, and may be typhoid in character, or intermittent with profuse perspiration. Pains of rheumatoid type are experienced throughout the body, but par- ticularly in the joints and lumbar region, apparently intensified by rest and heat. The fibrous structures are evidently the seat of its selective action, and a sensation of numbness in the lower extremities is frequently experienced. Similar phenomena attend its internal administration, but fatal results have not followed in any case of poisoning recorded. The effects of the poison usually last from ten to fifteen days, and are then followed by desquama- tion of the epidermis. Antidotes. Grindelia Robusta is the best local application in cases of Rhus poison- ing, but a solution of Mercuric Chloride is also a very serviceable lotion, and Lime-water with Linseed-oil, solution of Plumbum Acetate, solution of Chlorinated Soda, and Alum-curd are all very useful. Rest, low diet and laxatives are appropriate, and Opium or strong black coffee to relieve the irritability of the nervous system. Therapeutics. Rhus Toxicodendron was used medicinally by Dufresnoy in France and by Alderson in England about the close of the eighteenth century. The attention of the former was attracted to it by the accidental poisoning of a student who was afflicted with chronic eczema, which disappeared on the subsidence of the Rhus symptoms. It is a favorite remedy with the so-called homoeopathists, who ascribe to it extraordinary virtues in acute cutaneous affections df vesicular type, subacute and chronic rheu- matism, vesicular erysipelas and typhoid fever. Among regular authorities it meets with very little favor as a remedial agent, but Dr. Phillips recommends it strongly in rheumatic affections of the fibrous tissues, erythema and erysipelas, eczema, herpes zoster and pemphigus. Dr. Piffard corroborates these opinions of its therapeutical value, and states that when rheumatic pain is “worse at night” prompt relief maybe expected from Rhus. It was used by Dufresnoy in paralyses with a certain degree of success, and Eberle reports a case of paralysis in which it proved curative. 330 RICINI OLEUM. It is admitted by many observers to be a useful remedy in paralytic affections of the lower extremities depending on a rheumatic dia- thesis, or resulting from exposure to cold and wet. As an exter- nal application it is efficacious in sprains and other affections of ligaments and tendons, also to extensive but superficial burns, stings of insects and chilblains. For these affections a lotion of about 3ss of the strong tincture to a pint of water is usually em- ployed. RICINI OLEUM, Castor Oil,—is a fixed oil expressed from the seeds of Ricinus communis, a tree of the nat. ord. Euphorbiacege, indigenous to India, but extensively cultivated in the United States, where it is an annual plant about 5 or 6 feet high, bearing ovate seeds, smooth and shiny, of gray color marbled with brownish spots and stripes, three contained in a pod. The oil is an almost colorless, transparent, viscid liquid, of faint odor, bland or slightly acrid taste, neutral reaction, sp. gr. 0.950 to 0.970, soluble in an equal weight of alcohol, and con- gealing at about 0.40 F. It consists mainly of Ricinoleic Acid, Ci8H3403, combined with glycerin, but palmitin, stearin, choles- terin, and probably a resin and an alkaloid also occur in small quantities. Dose, 5)-%). It is contained in Collodium Flexile (3 per cent.) and in Linimentum Sinapis Co. (15 per cent.). Physiological Action. Used externally pure Castor Oil is perfectly bland. Internally administered it is non-irritant until it reaches the duodenum, where it is decomposed by the pancreatic juice, setting free the Ricinoleic Acid, which produces purgation by a mildly irritant action on the bowel, stimulating the intestinal glands and mus- cular coat, but not the liver. It is a simple purgative, acting in four to six hours, producing one or more liquid stools without pain or tenesmus, and followed by a sedative effect on the intes- tines. The leaves are believed to possess galactagogue properties when locally applied as a poultice to the breasts. Ricinoleic Acid enters the blood and the tissues, and is excreted with the various secretions of the body, imparting its purgative qualities to the milk of the nursing mother. Therapeutics. Castor Oil is the best of simple purgatives, and is used where a free evacuation of the bowels is alone indicated, or when only ROSA CENTIFOLIA. 331 a laxative action is desired, as in the constipation of typhoid fever, in pregnancy and post-partum conditions, diarrhoea from the presence of irritating matter in the bowels, and after opera- tions on the abdominal or pelvic organs. It is often used as a purgative for children, also for the aged and infirm. Infants bear a larger relative dose than adults, probably from their ability to digest a larger quantity of what is taken. It is employed with great benefit as a laxative in irritation or inflammation of the bowels, in hemorrhoids, inflammatory or spasmodic affections of the genito-urinary organs, nephritis or cystitis, gonorrhoea, cal- culi, and stricture of the urethra and rectum. In cases of dys- entery io to 20 drops of Laudanum may be added to each dose to counteract the pain, tenesmus and exhaustion resulting from the frequency of the passages. If much depression exists, as shown by lowered arterial tension and a dry, glazed tongue, 5 drops of Turpentine should also be added. Castor Oil is much used in the puerperal state and greatly abused. There is considerable evidence in support of the charge that it induces hemorrhoids by congesting the rectal vessels. Its purgative action is milder in proportion to th<2 purity of the sample employed. Externally, the pure oil is employed as a local sedative and protective, as in neutralizing the effects of lime upon the conjunctiva. The leaves of the castor-oil plant are used to promote the secre* tion of milk. They may be applied to the breast in poultice, and a decoction or fluid extract given internally at the same time. Administration. The nauseous smell is best concealed by the Essential Oil of Bitter Almonds. Emulsions are not a success. Capsules containing the requisite dose are easily obtained. In the absence of these the best way to administer a dose of oil is to smear the sides of a clean wineglass with very thick cream, then to pour in the oil, covering it with a little more cream. A teaspoonful of cream being then taken into the patient’s mouth, he is directed to bolt the dose at one gulp. Some prefer it floated on orange-juice, strong coffee, gruel or wine. ROSA CENTIFOLIA, Pale Rose,—the petals of Rosa centifolia, the Cabbage Rose, a well-known cultivated shrub of the nat. ord. Rosace®. They are of pink color, fragrant odor, sweetish taste changing to slightly bitter and faintly astringent. The odor is due to a minute quantity of a Volatile Oil (Oil of Rose), besides which, the petals contain tannin, fat, resin, sugar, etc. If it is desired to keep Pale Rose fresh for any length of time, it 332 ROSA DAMASCENA ROSA GALLICA. should be mixed with half its weight of Sodium Chloride, pressed into a jar and kept, well closed, in a cool place. Preparations. Aqua Rosze, Rose-water,—Pale Rose 40, Water 200 parts, mixed and dis- tilled by steam to 100 parts. Dose, indefinite. Unguentum AqUjE RoSjE, Cold Cream,—has of Expressed Oil of Almond 50 parts, Spermaceti 10, White Wax 10, Rose-water 30. If Glycerin and Benzoic Acid were added, it would keep better and be much more efficient as an emollient and protective. Pale Rose is also an ingredient of the Compound Syrup of Sarsaparilla. Physiological Action and Therapeutics. Pale Rose is only used fot odoriferous and flavoring purposes. Rose-water has no strictly medicinal properties, but is an agree- able excipient for lotions, urethral injections and collyria. The ointment, commonly termed “ cold cream,” is an agreeable emol- lient and protective in chapped hands and other superficial skin affections. ROSA DAMASCENA, —is not official, but is the source of the official Oil of Rose. It is largely cultivated in Roumelia on the southern slope of the Balkan Mountains, from whence almost all of the product is supplied to commerce. Oleum Ros.®, Oil of Rose, Attar of Rose,—is a volatile oil distilled from the fresh flowers of Rosa damascena. It is a pale-yellowish, transparent liquid, having a strong odor of rose, a sweetish taste and a slightly acid reaction, but slightly soluble in alcohol, of sp. gr. about 0.860. Slowly cooled to 50° F. it congeals to a transparent solid, interspersed with slender, iridescent, scale-like crystals. Rapidly cooled to 540 F., it congeals to a solid mass of feathery scales or plates. It consists of an aromatic oxygenated elaeopten and an odor- less solid stearopten (rose-camphor) being very expensive it is much adul- terated with other volatile oils. It is used chiefly for perfuming cosmetic preparations, ointments and lotions. ROSA GALLICA, Red Rose,—the petals of Rosa gallic a (nat. ord. Rosaceae), collected before expanding. They occur in small cones of roseate odor, and a bitter, slightly acid and dis- tinctly astringent taste, and contain an aromatic oil, tannic and gallic acids, quercitrin, coloring matter, salts, etc. Preparations. Extractum Fluidum,—Dose, flv-^ij. Confectio Rosae,—has of Red Rose 8 parts, Sugar 64, Honey 12, Rose- water 16. A basis for pills. ROSMARINUS RUBUS. 333 Mel RoSj'E, Honey of Rose,—has of Red Rose 8, Honey 92, Diluted Al- cohol to 100 parts. For local use. Syrupus Ros^e,—has of the Fluid Extract of Rose 10 in Syrup 90. Dose, 3j-ij, for flavoring. Red Rose is also an ingredient of Pilulse Aloes et Mastiches. Physiological Action and Therapeutics. Rosa Gallica is classed among the astringents as it contains an appreciable amount of Tannic and Gallic Acids. A compound infusion, containing sugar and dilute Sulphuric Acid, was for- merly official, and is used as an agreeable gargle for the throat and mouth in inflamed and ulcerated conditions. The chief uses of the rose preparations, however, are as vehicles for other agents, or to impart flavor and odor to extemporaneous prescriptions. ROSMARINUS, Rosemary ,—the leaves of Rosmarinus officinalis, a shrub of the nat. ord. Labiatse, cultivated in gardens for the sake of its large pale-blue flowers. The leaves are pun- gently aromatic and somewhat camphoraceous, containing, besides the official volatile oil, a little tannin, resin and a bitter principle. They constitute one per cent, of the ingredients of Vinum Aro- maticum (see ante, page 51). Oleum Rosmarini,—is the volatile oil distilled from Rosemary, a colorless or yellowish liquid, of sp. gr. about 0.900, having the characteristic odor of the plant, a camphoraceous taste, and is readily soluble in alcohol. It con- sists of a terpene, isomeric with Turpentine, Cj0H16, and a body allied to Cam- phor. It is an ingredient of Linimentum Saponis, Spiritus Odoratus and Tinctura Lavandulae Composita. Dose, Tj-v. Physiological Action and Therapeutics. Rosemary was formerly considered emmenagogue, galacta- gogue and diuretic, but is now never employed in substance. Its oil is somewhat stimulant and carminative, and in excessive quan- tity has caused death. It is chiefly employed an external stimulant in liniments and lotions, especially to the scalp in alo- pecia, where it is supposed to increase the blood-supply to the hair-bulbs, and is usually combined with cantharides. Inhaled it reduces the body temperature and gives the urine a violaceous odor. RUBUS, Blackberry-bark,—is the bark of the root of Rubus villosus, the common Blackberry, Rubus canadensis, the 334 RUBUS IDALUS RUMEX. Dewberry, and Rubus trivialis, the Bush Blackberry of the Southern States, all of the nat. ord. Rosaceae. It occurs in thin, tough, flexible bands, blackish-gray externally, pale brown inter- nally, inodorous, strongly astringent and of somewhat bitter taste. It contains over io per cent, of Tannin. Dose, gr. xv- XXX. Preparations. Extractum Rubi Fluidum,—Dose, mx-j. Syrupus Rubi has of the Fluid Extract 20 parts, Syrup 80. Dose, %j-%j. Syrupus Rubi Aromaticus (Unofficial),—contains the root-bark, cinna- mon, cloves and mace. Each has gr. xxx of the drug. Physiological Action and Therapeutics. Blackberry-bark derives its virtues from its tannin, It is strongly astringent, and may be used in decoction, wine or the above-named official preparations. It is highly esteemed in summer and infantile diarrhoeas. RUBUS ID./EUS, Raspberry,—is the fruit of Rubus idceus, the Raspberry bush, Rubus occidentalis, the Thimbleberry, or Rubus strigosus, the wild Red Raspberry, all of the nat. ord. Rosaceae. It contains sugar, malic and citric acids, proteids, pectin, etc., also a Volatile Oil consisting of compound ethers, to which the odor is due. Its sole use in medicine is to prepare a pleasantly flavored syrup. Preparation. SyRUPUS Rubi Id.*I, Raspberry Syrup,—has of Raspberries and Sugar any convenient quantity, boiled (but not in tinned vessels) and strained. Dose, ad libitum. It has a bright-red color, a fruity, agreeable odor, a pleasant, acidu- lous taste and an acid reaction. It has no special medicinal virtues, but forms an agreeable flavoring for mixtures, and mixed with water a pleasant drink in febrile conditions. The leaves of the wild Red Raspberry (Rubus strignsus) are considerably astringent, and in infusion, gj to the pint, are a popular domestic remedy for diarrhoeas. RUMEX, Yellow Dock ,—is the root of Rumex crispus, and of other species of Rumex, plants of the nat. ord. Polygona- ceae, growing as common weeds along roadsides. Several species of Rumex have sour leaves, and are popularly called Sorrel to dis- tinguish them from the others which are called Dock. The official root is 8 to 12 inches long, y2 inch thick, somewhat fusiform and RUTA. 335 fleshy, annulate above, deeply wrinkled below, externally rusty- brown, internally whitish, with fine medullary rays; fracture short, odor slight, taste bitter and astringent. It contains tannin, mucilage, starch, calcium oxalate, and two principles named Rumicin and Lapathin, which are shown to be identical with Chrysophanic Acid. (See ante, page 325). Its constituents are nearly identical with those of Rhubarb. Dose, gr. xv-3j. Prep a rations. Extractum Rumicis Fluidum,—Dose -nqxv-gj. Decoctum Rumicis (Unofficial), of the fresh root, or of the dry root to Oj of water. Dose, Physiological Action and Therapeutics. Rumex is astringent, tonic and laxative. It has also been considered alterative and anti-scorbutic. It has been employed chiefly in chronic cutaneous disorders, glandular swellings, and other symptoms of the strumous diathesis. It seems to possess a selective action on the mucous membrane of the larynx, and in many cases of laryngeal irritation with catarrhal symptoms, dry, violent cough, and a sense of soreness behind the sternum, it will give prompt relief. RUTA, Rue ,—is the source of the official Oil of Rue, which is distilled from the leaves of Ruta graveolens, an herbaceous perennial of the nat. ord. Rutacese, growing wild throughout South- ern Europe, and frequently cultivated in gardens for its yellowish flowers. The fresh leaves only should be used, and as drying impairs their qualities the oil is generally employed. OLeum Rut as, Oil of Rue,—the volatile oil distilled from Ruta graveolens ; a colorless, or greenish-yellow liquid, of disagreeable but aromatic odor, pun- gent acrid taste and neutral reaction, sp. gr. about 0.880, soluble in an equal weight of alcohol. Dose, ttlj-v, in mucilage. Physiological Action. Rue is an active irritant, locally a rubefacient, the oil producing heat, inflammation and vesication. In the ordinary dose it causes a sensation of heat in the stomach and skin, increases the action of the heart, and stimulates the bronchial, cutaneous and renal secretions, the odor of the oil being distinctly perceptible in the breath, sweat and urine. After toxic doses of the oil violent gastro-enteritis results, with extreme prostration, convulsions, 336 SABINA. strangury and suppression of the urine. Abortion may be pro- duced by large doses, but with great danger to life. Rue is an efficient emmenagogue, and in men aphrodisiac; it is also con- sidered antispasmodic and carminative. Therapeutics. The Oil of Rue is employed internally in amenorrhoea, hys- teria, convulsions and flatulence. As an emmenagogue it is very efficient when the condition is one of functional inactivity of the uterus and ovaries. It has been well used in menorrhagia from debility and after abortion. A decoction of the fresh leaves is often employed by injection against ascarides, and internally to remove lumbricoid worms. Externally the same preparation has been applied to the chest in chronic bronchitis, also in various scaly eruptions and glandular enlargements. Used as an aborti- facient it has frequently caused death, preceded by symptoms of narcotic and irritant poisoning. SABINA, Savine,—the tops of Juniperus Sabina, a small, evergreen shrub of the nat. ord. Coniferse, growing in Northern Europe, Asia and America. It closely resembles Red Cedar (Juniperus virginiana), but is distinguished from the latter by its smaller size and by its larger fruit. It occurs in short, thin branchlets, having oveo-lanceolate leaves in four rows; of pecu- liar, terebinthinate odor, and nauseous, bitter, resinous taste. It contains a Volatile Oil (which is official), also tannin, resin, extractive matters, chlorophyll, etc. Dose, gr. v-x. Preparations. Extractum Sabina Fluidum,—Dose, uiv-xv. Ceratum Sabina,—has of the Fluid Extract 25, Resin Cerate 90 parts, melted and cooled. Oleum Sabina,—a volatile oil distilled from Savine existing in the fresh tops in the proportion of per cent., and in the berries 10 per cent. It is a colorless, or yellowish liquid, isomeric with oil of turpentine, C10H16, having a peculiar, terebinthinate odor, a pungent camphoraceous taste, and neutral reaction, of sp. gr. about 0.910 and soluble in an equal weight of alcohol. Dose, uij-v. Physiological Action. Externally the action of Savine resembles that of Turpentine, except that it is more irritant, the oil producing vesication if applied sufficiently long. Internally a full medicinal dose causes heat sensations, nauseous eructations, flatulence, increased car- SACCHARUM. 337 diac action, stimulation of the cutaneous, bronchial and renal secretions, irritation of the kidneys, hypertemia of the ovaries and uterus and increased menstrual activity. In large doses it pro- duces hematuria, dysuria, and intense gastro-enteritis, with vio- lent vomiting and purging. It may originate uterine contrac- tions in the pregnant female, but its abortifacient effect can only be produced by a quantity sufficient to endanger life. The oil diffuses into the blood and is excreted by the various excretory channels. Therapeutics. As an emmenagogue Savine is highly esteemed by many author- ities, Dr. Phillips considering it “one of the most certain and powerful” agents of this class, “with the additional advantage that it can be given with perfect freedom from risk of doing harm.” So irritant an agent, however, requires the exercise of great caution in its use. It has been found extremely efficient in dysmenorrhcea when not due to mechanical causes; also, in menorrhagia and hemorrhage after abortion. In chronic gout and the joint affections of chronic rheumatism, it was formerly much employed. Externally the cerate is used to prolong the discharge from blisters, setons or issues, and to stimulate the healing of indolent ulcers. For these purposes it is considered safer than Cantharides, as its prolonged employment does not bring on strangury or vesical irritation. As a caustic it is effi- cient for the destruction of warts and other excrescences, and the moistened powder is used as a paste on venereal condylomata, in combination with burnt alum or cupric subacetate. The oil is the most efficient preparation for internal administration. SACCHARUM, Sugar, Cane-Sugar, C12H22Ou,—is the refined sugar of Saccharum officinarum, or Sugar-cane, a perennial plant of the nat. ord. Graminacese, indigenous to India and ad- joining countries, but cultivated in tropical regions throughout the world. This sugar is also present in several grasses (as Zea Mays, maize, Sorghum saccharatum, etc.), in the juice of various trees (maple, birch, palm, etc.), and in many roots, particularly Beta vulgaris, the sugar-beet, which contains 12 per cent. Cane-sugar occurs in white, dry, hard, crystalline granules, permanent in the air, odorless, of purely sweet taste and neutral reaction, soluble in 0.5 of water and in 175 of alcohol at 590 F., in 0.2 of boiling water and in 28 of boiling alcohol, insoluble in ether. The aqueous solution, saturated at 590 F., has the sp. gr. 1.345, and is miscible with alcohol in all proportions. Its freedom from Grape-sugar (glucose) and from more than a slight quantity of 338 SACCHARUM. Inverted Sugar (glucose plus levulose) is ascertained by dissolving I gram in io c.c. of boiling water, then mixing with the solution 4 or 5 drops of test- solution of Silver Nitrate and about 2 c.c. of Aqua Ammonioe, and quickly heating to boiling, when not more than a slight coloration, but no black pre- cipitate should appear after standing at rest for 5 minutes. Other Sugars. Saccharum Lactis, Sugar of Milk, Lactose, C12H220u.H20,—described on page 339. Glucose, Dextrose, Grape-sugar, Starch-sugar, C^H12Oe, or hydrated C6H1206.H20 (Unofficial), also known as liver-sugar, diabetic sugar,—.forms yellowish nodules or crystals, very soluble in water and in alcohol, has a sweet taste, less marked than that of cane sugar, may be obtained artificially from cane sugar or from starch, by boiling with a dilute mineral acid, or by the action of Diastase, a vegetable ferment formed during the germination of grain. Boiling solutions of the alkalies convert it into a brown substance (melassic acid). Levulose, Fruit-sugar, C6H1206 (Unofficial),—frequently found with grape- sugar in fruits, also in honey. Inosit, Phaseo-mannit, G6H1206.2H20 (Unofficial),—exists in the juice of some meats, in asparagus, etc. Is very sweet, but does not undergo alcoholic fermentation. Allied Substances. Theriaca, Treacle, Sugar-house Molasses (Unofficial),—is the uncrystal- lizable residue of the process for refining sugar,—a thick, brown, ferment- able syrup, very sweet, and of sp. gr. about 1.40. It is official in the B. P., and is used in making up some of the official pills of that pharmacopoeia. Amylum, Starch, C6H10O5,—wffien boiled with dilute mineral acids or when subjected to the action of diastase, ptyalin or pancreatin, starch is converted into glucose. (See ante, article Amylum, page 67.) Cellulose, C6H10O5 (Unofficial),—forms the basis of all vegetable fibre, and is isomeric with starch. It exists almost pure in cotton and in Swedish filter paper. Pyroxylin (see ante, page 206), or gun-cotton, is dinitro-cellulose. Glycogen (Unofficial),—closely resembles starch in its properties, being converted into glucose by the same agents which so act on starch. It exists in the liver of all animals. Dextrin (Unofficial),—is produced by the action of dilute acids on starch, and is an intermediate product in the conversion of starch into glucose. It is a transparent, brittle solid, looking like gum, soluble in water and dilute alco- hol, is not fermentable, nor is it colored by Iodine. Preparations. Sugar is an ingredient of Pil. Ferri Carbonatis, Pil. Ferri Iodidi, Ferri Car- bonas Saccharatus, Mistura Ferri Composita, Pulvis Cretae Compositus, Pulvis Glycyrrhizae Compositus, and the Troches, Syrups, Compound Syrups, etc. Physiological Action and Therapeutics. Sugar is employed in pharmacy and therapeutics chiefly as a vehicle, a corrigent, a preservative and an antiseptic. Svruos SACCHARUM LACTIS—SALIX. 339 protect the active ingredients against putrefaction, but not always against fermentation. They also protect certain ferruginous prepa- rations against oxidation. As an ingredient in troches, powders and extemporaneous mixtures sugar is used to cover the taste or to make insoluble substances more easily miscible with water. It increases the solubility of Lime in water. As a food it possesses well-known properties, being a nutrient to adipose tissue and a respiratory fuel. SACCHARUM LACTIS, Sugar of Milk, Lactose, —is one of the constituents of the milk of mam- mals, and is officially described as a peculiar, crystalline sugar obtained from the whey of cow’s milk by evaporation and purified by re-crystallization. Occurs in white, hard, crystalline masses, yielding a gritty, white powder, odorless, permanent in the air, of faintly sweet taste and neutral reaction, soluble in 7 of water at 590 F. and in 1 of boiling water, insoluble in alcohol, ether or chloroform. On adding to a solution of sugar of milk in an equal weight of boiling water some solution of soda, the liquid turns brownish, and on further addition of test-solution of Cupric Sulphate a brick-red precipitate separates. Sugar of Milk is the least soluble of all sugars in water and is insoluble in alcohol. It enters into alcoholic fermentation with difficulty. In the presence of decomposing albuminous matter and under certain other influences, it under- goes the lactic fermentation, which results in the formation of Lactic Acid, Carbon Dioxide and Alcohol. It readily reacts with the reduction tests. Preparations and Uses. Sugar of Milk is used in the Triturations, also in the Abstracts, Dover’s Powder, Denarcotized Opium, etc., as a diluent. Being much harder than cane-sugar it is considered a valuable excipient for powders requiring fine trituration and the minute subdivision of their medicinal constituent. It is less sweet than cane-sugar, and being less apt to ferment in the stomach and bowels is better than the latter for use with infants’ food. SALIX, Willow ,—is the bark of Salix alba, the common White Willow, and of other species of Salix, trees of the nat. ord. Salicaceae. It occurs in fragments or quills, inodorous, bitter or astringent, and contains a large proportion of tannin, besides resin, gum, wax, lignin, etc., and the characteristic constituent 340 SALIX. Salicin, which is official. Dose of the bark, gr. x-3j, or more, in infusion. Preparations. Salicinum, Salicin, C1SH1807,—a neutral principle prepared from the bark of Salix Helix and of other species of Salix. White, shiny, silky crystals, odorless, of very bitter taste and neutral reaction;—soluble in 28 of water and in 30 of alcohol at 590 F., in 0.7 of boiling water and in 2 of boiling alcohol; insoluble in ether or chloroform. Salicin is a glucoside, consisting of Saligenin and glucose, and is found in Carbolic Acid, Gaultheria (winter- green), Caryophyllus (clove), as well as the willow-barks, and is contained in Oleum Caryophylli and in Oleum Gaultherise. Dose, gr. xx-^ij. Acidum Salicylicum. Salicylic Acid, HC7H5Og,—a derivative of Salicin, largely produced synthetically by acting on carbolic acid with sodic and car- bonic anhydrides, but the natural acid is the most efficient. Occurs in fine, white, needle-shaped crystals, of sweetish-acrid taste and acid reaction, soluble in 450 of water and in 2of alcohol at 590 F. ; 100 parts may be dissolved in 100 of water by the aid of 8 parts of Borax. Dose, gr. v-gj. Sodii Salicylas, Salicylate of Sodium, 2NaC7H-0g.H20,—is soluble in 1 parts of water. Dose, gr. v-^j. Lithii Salicylas, Salicylate of Lithium, 2LiC7H5Og.H20,—is very soluble in water or alcohol. Dose, gr. v-%). PhysostigmiNj'e Salicylas,—is described under Physostigma, ante, page 293. Physiological Actions. Willow-bark is highly astringent and antiperiodic and feebly tonic, but is never employed medicinally, owing to its bulk. Salicin is a bitter tonic, an antiferment, antiseptic, and is highly destructive to low organisms. It has slight antiperiodic power and is feebly antipyretic. It prevents the reaction between Amygdalin and Emulsin (see page 29), and also that of Ptyalin, etc., on Starch (see page 67). It seems to be devoid of toxic power on man, and is mainly excreted as Salicylic, Salicyluric and Salicylous acids, being first changed in the bowel into Saligenin and Glucose. Salicin is well borne by the stomach. Salicylic Acid has properties similar to the above, but is much more energetic in its action, being a powerful antipyretic and antiseptic. It is also anhydrotic, checking local perspiration when locally applied. Inhaled it causes irritation of the respira- tory passages, producing sneezing and cough. In small doses it stimulates the stomach, heart and respiration, but moderate quan- tities derange the stomach, causing nausea and vomiting, while large doses depress the heart’s action and the respiration after a primary excitation of both, lower the arterial tension, relax the vessels, produce free perspiration, and reduce the temperature in fever. It causes vertigo, dilated pupils, tinnitus aurium, a sensa- tion of tension in the frontal cerebrum, delirium, and may pro- SALVIA. 341 duce bed-sores from depression of the circulation, but does not affect the peripheral nerves as to either motion or sensation. In the blood it is first changed to Salicylate of Sodium, but a por- tion is again set free and uniting with glycocoll forms Salicyluric Acid (HC9H8N04), coloring the urine green. It is slowly ex- creted through the secretions generally, especially in the urine, sweat, saliva and bile. It stimulates the kidneys, at the same time disinfecting them and increasing the acidity of the urine, but may so irritate the kidneys as to produce albuminuria and hematuria. Salicylate of Sodium is identical in action with the acid from which it is formed, as the latter is converted into the former before reaching the tissues. Internally used it is less irritating than the acid, and is remarkably antipyretic in 15-grain doses given 4 or 5 times in the 24 hours; but it has no antiseptic or disinfectant properties unless so combined with a mineral acid as to liberate the Salicylic Acid. It produces free diaphoresis. Therapeutics. Salicin and its derivatives are chiefly used in acute rheumatism, to lower temperature, relieve pain, and reduce articular swelling. They are most suitable to strong, vigorous patients, and if not promptly efficient they should be abandoned. The acid is much used as an antipyretic in fevers, especially those of septi- caemic character. It is a useful local application in gangrenous wounds, eczema of the hands or feet, cancer, burns, and in fetid perspirations, in the last affection being used in solution with borax. Salicylate of Sodium is more soluble than the acid and less irritant to the stomach, while in doses about 50 per cent, larger it is equally efficient. Salicylate of Lithium is also non-irritant and is supposed to act towards uric acid in the same manner as the other salts of this metal. It is expected to be of especial value in acute rheu- matism and rheumatic gout. SALVIA, Sage ,—the leaves of Salvia officinalis, the com- mon garden sage, a perennial plant of the nat. ord. Labiatse, native in Southern Europe, but cultivated in our gardens for its strong, fragrant odor. The leaves are about 2 inches long, finely crenulate, grayish-green, thick and wrinkled ; soft, hairy and glandular beneath, of aromatic odor and bitterish, astringent 342 SAMBUCUS—SANGUINARIA. taste. They contain tannin, resin, etc., and a volatile oil which consists of Salviol (C10H16O), camphor and terpenes. Sage is a constituent of Vinum Aromaticum. There are no official prepa- rations. Dose of the powdered leaves, gr. xx-xxx, in infusion. Physiological Action and Therapeutics. Sage is aromatic, stimulant, tonic, astringent, and a vulnerary. It was highly esteemed in ancient times, and even yet is popular as a domestic cure-all with many people. In an infusion it may be used as a beverage in febrile conditions and to check the night-sweats of phthisis. Like other members of the same class it has a slight influence over enteralgia and flatulence. It makes a good astringent and stimulating gargle. SAMBUCUS, Elder,—the flowers of Sambucus canadensis, the common elder, a shrub of the nat. ord. Caprifoliaceae, from 6 to io feet high, having small white flowers disposed in loose cymes of five divisions, the cream-colored corolla being whorl- shaped with five stamens on the tube. The berries are small, globular, and when ripe of a deep purple color. The plant con- tains a small quantity of a volatile oil, also a resin and valerianic acid. The common elder of Europe (S. nigra) is more of a tree, and is official in the B. P. There are no official preparations. Dose, gr. xxx-Jj, in hot infusion. Physiological Action and Therapeutics. Elder-flowers are stimulant and diaphoretic, also perhaps diu- retic in some degree. The berries are diaphoretic and laxative, while the inner bark is a hydragogue cathartic and in large doses emetic. Formerly the inspissated juice of the berries was employed as an alterative in rheumatism and syphilis, but at present the flowers are used only for flavoring purposes. Elder-flower Water (Aqua Sambuci, B. P.) is a nice vehicle for dbllyria and lotions. SANGUINARIA, Blood-root,—is the rhizome, collected in autumn, of Sanguinaria canadensis, a perennial plant of the nat. ord. Papaveracese, which grows abundantly throughout the U. S., being one of the earliest and most beautiful of the spring flowers. It has a single white flower on an erect stalk, the petals often tinged with rose or purple. Leaf reniform, smooth, deeply lobed, yellowish-green above, paler beneath, and strongly SANGUINARIA. 343 marked with orange-colored veins. The rhizome is about 2 inches long and fths inch thick, cylindrical, horizontal, wrinkled, red- dish-brown, fracture short, waxy, with numerous small red resin- cells, bark thin, odor slight, taste very bitter and acrid. It con- tains 3 alkaloids,—Sanguinarine, CnH15N04, which is probably identical with Chelerythrine (see Chelidonium), Porphyroxine, and Puccine, combined with Chelidonic and Sanguinarinic Acids, —also resin, gum, albumen, sugar, etc. The salts of its alkaloids are of brilliant red and wange colors and are all soluble in Water. Dose of the powdered root as expectorant, gr. j-v; as emetic, gr. x-xx, best given in pill. Preparations* Extr'actum Sanguinari/E Fluidum,—Dose, irij-v as expectorant and stimulant; rr\x-lx as emetic, cautiously. Tinctura Sanguinarias,—strength 15 per cent. Dose, as expectorant, TTlv-gj, as emetic 5jj-iij. Acetum Sanguinarias,—has of Sanguinaria 10, in Diluted Acetic Acid 90. Dose, rn_x-xxx ; as an emetic, jpj-^ss. Sanguinarina, Sanguinarine, C17H15N04 (Unofficial),—is the chief alka- loid and probably the active principle of the plant. Dose as an expectorant, gr. ; as an emetic, gr. repeated in 10 minutes will produce vomiting after the second or third dose. Physiological Action. Sanguinaria is sternutatory, sialogogue, expectorant and em- menagogue, a systemic emetic, a cardiac paralyzer, a violent irri- tant, an acro-narcotic and an alterative. Its taste is bitter and acrid. It causes violent sneezing when inhaled, increases secre- tion by irritating the secretory organs as it is eliminated, and in full doses produces salivation, catharsis and vomiting with great depression. Overdoses are violently irritant, the heart’s action being at first increased, together with the arterial tension, then markedly depressed, and finally paralyzed by stimulation of its inhibition. The reflexes are lowered by paralysis of the spinal centres, muscular contractility impaired, the pupils dilated, tem- perature lowered, cold sweats, great thirst and collapse supervene, and death occurs by paralysis of the cardiac and respiratory centres, often preceded by convulsions. Locally used, Sanguin- aria is a feeble escharotic. Antagonists and Incompatibles. Opium, Amyl Nitrite, Atropine, etc., to antagonize the depression of the circulation and the local irritant action. Incompatibles are alkalies, tannin, and most of the metallic salts. Therapeutis. As a tonic to the stomach and a stimulant to the liver Sanguin- aria or its active principle is well employed in small doses (gtt. 344 SANTALUM ALBUM. iij of the tincture or gr. of the alkaloid) for atonic dyspepsia, duodenal catarrh and catarrh of the biliary ducts with jaundice. Respiratory affections are often remarkably amenable to its influ- ence, particularly chronic nasal catarrh, asthma and acute bron- chitis. In these affections expectorant doses are the best, namely gtt. x of the tincture, and in the former the powder locally as a sternutatory. A docoction is a very efficient gargle in the sore- throat of scarlet fever. Sanguinaria is a very serviceable remedy in chronic bronchitis and in amenorrhoeaof functional character, also in functional impotence from irritability of the organs, with daily losses and relaxation of the genitalia. By many practitioners it is considered a specific emetic in croup, but others look upon it with disfavor as too uncertain and harsh in its action. It has been thought to have alterative properties, and hence is frequently used with Stillingia and other plants in the treatment of strumous and syphilitic affections. In pneumonia of typhoid type and in pleuro-pneumonia it has undoubtedly been of great service in many cases. Locally, the powdered root is well employed as an application to foul ulcers and fungous granulations, and by insufflation to nasal polypi, and for chronic hypertrophy of the nasal mucous membrane. Sanguinarine has been used with good results in pneumonia, bronchitis and atonic dyspepsia. Doses of gr. to £ are expec- torant without irritating the stomach; and still smaller doses (gr. to j are stimulating to the gastric and intestinal secre- tions. SANTALUM ALBUM, White Sandalwood,—is the source of the official Oil of Santal (see below), but is not itself official. It is a tree of the nat. ord. Santalacese, having its habitat in India but now nearly exterminated there;—Santalum citrinum, the yellow sandalwood, from the Sandwich and Feejee Islands, is more commonly met with in commerce. Preparations. Oleum Santali, Oil of Santal, Oil of Sandalwood,—a volatile oil distilled from the wood of Santalum album; a pale-yellow liquid, of sp. gr. about 0.945, soluble in alcohol, of peculiar and aromatic odor, pungent taste and acid reaction. Dose, Rlx-xxx, in emulsion or capsule. Extractum Santali Fluidum (Unofficial),—made with alcohol as a menstruum. Dose, SANTALUM RUBRUM—SANTONICA. 345 Physiological Action and Therapeutics. Sandalwood is a very agreeable perfume. The Oil is astringent to mucous membranes, producing dryness of the fauces, thirst, colic, and a sense of fulness in the renal regions. In concen- trated form it is a local irritant, but the effects of large doses have not been studied. It is extensively used in chronic bron- chitis and in gonorrhoea, forming the contents of proprietary capsules which are sold for the cure of the latter disease in all drug stores. As found in the shops it is extensively adulterated with Oil of Cedar, and hence is a very unreliable remedy. SANTALUM RUBRUM, Red Saunders,—is the wood of Pterocarpus santalinus, a tree of the nat. ord. Leguminosae, native in India. It comes as a dark reddish-brown, heavy, coarse wood, in chips or as a coarse powder, nearly inodorous and taste- less, not imparting any red color to water when macerated in it, but coloring alcohol, ether and alkaline solutions a bright red. The wood has no medicinal properties and is employed solely for the purpose of coloring alcoholic preparations. It is a constituent of Tinctura Lavandulae Compositus. SANTONICA, Levant Wormseed, — the unexpanded flowerheads of Artemisia maritima, var. Stechmanniana, a small, perennial plant of the nat. ord. Compositse, which grows in Asia Minor, Turkestan, etc., and contains a volatile oil and the pecu- liar, crystalline principle Santonin, (see below). Flowerheads about inch long, pale greenish-brown, smooth, resembling seeds in appearance, but consisting of imbricated involucral scales with a green midrib, enclosing 4 or 5 tubular florets ; odor strong and peculiar, somewhat camphoraceous, taste aromatic and bitter. Dose, gr. x-lx. Prepa rations. Santoninum, Santonin, C15H1803,—the neutral principle prepared from Sanlonica. Occurs in colorless, prismatic crystals, turning yellow on expo- sure to light, odorless, of bitter after-taste, and neutral reaction, nearly in- soluble in cold water, but soluble in 250 of boiling water, in 40 of alcohol, 3 of boiling alcohol, 160 of ether, 4 of chloroform, also in solutions of the alkalies. Dose, gr. for a child, gr.j-v for an adult, not repeated too soon as the action of the drug is slow. Sodii Santoninas, Santoninate of Sodium, 2NaC15H)904.7H20,—colorless, rhombic crystals, turning yellow on exposure to light, slightly efflorescent, of saline taste and slightly alkaline reaction, soluble in 3 of water and in 12 of 346 SAPO. alcohol at 590 F., in 0.5 of boiling water and in 3.4 of boiling alcohol. Dose, gr. ij-x, as per age. Trochisci Sodii Santoninatis,—each troche contains of the preceding gr. j, with sugar, tragacanth and orange-flower water. Dose, ij-x, as per age. Trochisci Santonini (Unofficial),—each troche contains gr. ss of San- tonin. Dose, j-v, as per age. Santonin and its preparations are sensitive to light and should be kept in amber-colored bottles tightly corked. Physiological Action. Santonin is anthelmintic to the round-worm (Ascaris lumbri- coides), also but in less degree to the thread-worm (Oxyuris ver- micularis). It is taken into the blood as Santoninate of Sodium, and affects the cerebral faculties and the vision, objects appearing at first blue, green or red, then yellow (chromatopsia). Large doses disturb the consciousness of the patient, produce a sort of intoxication, tremors, weakness, with enfeebled respiration and slowing of the pulse, coldness of the surface, vomiting, sweating, mydriasis, convulsions and death from failure of respiration. A dose of 2 grains is said to have proved fatal to a feeble child of five years old. It is excreted by the kidneys, coloring the urine if acid a greenish-yellow, if alkaline a reddish-purple, and pro- duces considerable enuresis. Santoninate of Sodium acts similarly, but being more soluble it is more rapidly absorbed and eliminated, and does not produce the constitutional symptoms of the drug in so marked a degree. Therapeutics. As an anthelmintic Santonin is the most certain agent against the round-worm, and is best administered in powder with Calomel at bedtime after a day of fasting, a Senna-draught or a dose of Castor Oil being used the following morning. It also acts fairly well in suppository against the thread-worm, but is inoperative against tape-worm. Some observers consider that it is more promptly efficient when given in Castor Oil, and that the oil lessens the risk of evil after-effects. It has also been prescribed with great benefit for nocturnal incontinence of urine, and for certain eye affections, particularly amaurosis from atrophic or inflammatory changes in the retina and optic nerve. SAPO, Soap,—is soap prepared from Soda and Olive Oil; a white solid, hard yet easily cut when fresh, of slight, peculiar odor free from rancidity, a disagreeable, alkaline taste, and an SAPO. 347 alkaline reaction, readily soluble in water and in alcohol. It is well represented by the best “white Castile soap.” Sapo Viridis, Green Soap,—is soap prepared from Potassa and fixed oils; a soft, greenish-yellow, unctuous jelly, having a peculiar odor and an alkaline reaction, soluble in water and in alcohol, does not impart an oily stain to paper. Incinerated it yields an ash which is very deliquescent. Green Soap is a bad name for it, as its color is usually brown. Saponification is a process of double decomposition between a fat (stear- ate, palmitate or oleate of glyceryl) and an alkali, in which glycerin and the metallic salt of the fatty acid are formed. The glycerin, not being saponi- fiable, is set free, but the fatty acid (stearic, palmitic or oleic) unites \vith the salifiable base to form soaps, which are therefore mixed stearates, oleates and palmitates of various bases. Nearly all soaps are oleates or palmitates (or both) of sodium or potassium (or both). Hard soaps are soda soaps, soft soaps are potassium soaps. [Compare the articles Oleum Oliva, Adeps, Aciclum Oleicum, Glycerinum, etc.] Insoluble Soaps are combinations of the oily acids with earths and metallic oxides. Two of them are official, viz.,—the Soap of the Monoxide of Lead (Emplastrum Plumbi) and the Soap of Lime (Linimentum Calcis). Unofficial Soaps. Sapo MolLIS, Soft Soap,—official in the Br. Phar., is made with Olive Oil and Potash, the solution of the alkali being present in excess. It is often adulterated with starch. Sapo Animalis, Curd Soap,—official in the Br. Phar.,—is made with Soda and a purified animal fat, consisting chiefly of Stearin. Used in pills and suppositories. Sapo Medicatus,—official in the Fr. Codex,—is a Soda soap prepared from expressed Almond Oil. Preparations. Emplastrum Saponis, Soap Plaster,—has of Soap to parts, Lead Plaster 90, Water q. s. Linimentum Saponis, Soap Liniment,—has of Soap 10 parts, Camphor 5, Oil of Rosemary 1, Alcohol 70, Wrater q. s. ad 100 parts. Opodeldoc is a similar preparation. Tinctura Saponis Viridis,—has of Green Soap 65 parts, Oil of Lavender 2, Alcohol q. s. ad 100 parts. For external use. Soap is also an ingredient of Chloroform Liniment and several of the offi- cial pills. Physiological Action and Therapeutics. Soap is a laxative, antacid and antilithic; externally it is a stimulating discutient, and is used for cleansing the skin, remov- ing fatty substances and softening the epidermis, but if too long 348 SARSAPARILLA. applied it may prove decidedly irritant. It is a good antidote in poisoning by acids, and should be administered freely in such cases until more energetic alkalies can be obtained. In aqueous solution it makes a useful enema for constipation, or a plug of soap may be inserted into the rectum. Green Soap is a powerful detergent stimulant and is much employed in skin diseases, especially eczema rubrum, in which the tincture is well rubbed on, the diseased skin well washed and then covered with a bland ointment. The tincture is the most elegant form for use, and may be diluted with three parts of alco- hol for shampooing the scalp. The Liniment is used with friction in sprains, bruises and stiff joints, being a little more stimulating than Camphor-liniment. It makes a good basis for extemporaneous liniment prescriptions. SARSAPARILLA ,—is the root of Smilax officinalis, Smilax tnedica, and of other undetermined species of S?nilax, plants of the nat. ord. Smilaceae, growing in Mexico, Central America, Brazil, etc. There are six commercial varieties on the market, which are generally put up in differently formed bundles. The roots are about as thick as a goose-quill, reddish-brown, several feet in length, covered with rootlets and folded in bundles about 18 inches long, taste mucilaginous, bitter and acrid. It contains starch, resin, oxalate of calcium, an essential oil, and an acrid neutral principle named Parillin or Smi/acin, which when acted on by dilute sulphuric acid affords another principle, Parigenin. Preparations. Extractum Sarsaparilla Fluidum,—Dose, gjss-^j. Ext. Sarsaparilla Compositum Fluidum,—contains Sarsaparilla 75, Glycyrrhiza 12, Sassafras bark 10, Mezereum 3, Glycerin 10, Water and Alco- hol up to 100. Dose, gss-gj. Syrupus Sarsaparilla Compositus,—Sarsaparilla 150, Guaiacum wood 20, Pale Rose 12, Glycyrrhiza 12, Senna 12, Sassafras 6, Anise 6, Gaultheria 6, Sugar 600, Alcohol and Water up to 1000 parts. Dose, A good vehicle for Potassium Iodide. Decoctum Sarsaparilla Compositum,—Sarsaparilla 10, Sassafras 2, Guaiacum Wood 2, Glycyrrhiza 2, Mezereum 1, Water q. s. ad 100 parts. Dose, » Syrup of Sarsaparilla (Unofficial),—so much used in flavoring soda- water, is a mixture of the oils of sassafras and gaultheria. Physiological Action and Therapeutics. Those who believe that Sarsaparilla has any action ascribe to it properties as a diuretic, diaphoretic, tonic and alterative. So far careful physiological experiments with the drug and its prin- SASSAFRAS. 349 ciple have given negative results. It has been used as a so-called “blood-purifier” in scrofula, chronic abscesses, necrosis, old ulcers, many cutaneous diseases, etc., but is generally combined with other agents of undoubted activity. The compound decoc- tion is considered a good agent in tertiary syphilis, especially in debilitated subjects; while the other preparations are commonly employed as vehicles for Iodide of Potassium and Bichloride of Mercury in syphilis of any form. Whenever used, the compound decoction will give .the best results, the hot water and its other constituents being each of medicinal value. SASSAFRAS ,—is the root-bark of Sassafras officinalis, a tree of the nat. ord. Lauracese, growing throughout the U. S., and occurs in irregular fragments of a bright, rust-brown color, strongly fragrant, taste sweetish, aromatic and somewhat astrin- gent. The volatile oil is official. Sassafras Medulla, Sassafras Pith,—is the pith of the tree described above. Occurs in slender, cylindrical pieces, often curved or coiled, light, spongy, white, inodorous, insipid. Mace- rated in water it forms a mucilaginous liquid which is not pre- cipitated on the addition of alcohol. Preparations. Mucilago Sassafras Medulla,—has of the pith 2 parts in 100 of water. Dose, indefinite. Oleum Sassafras,—is a volatile oil distilled from Sassafras,—a colorless or yellowish liquid, having the odor of Sassafras, a warm, aromatic taste and a neutral reaction, readily soluble in alcohol. Sp. gr. about 1.090. Treated with cold nitric acid it becomes of a dark-red color, and is finally converted into a red resin. Dose, lUj-iv. Infusum Sassafras (Unofficial),—a popular “tea” which may be drank ad libitum. Sassafras is a constituent of the three compound Sarsaparilla preparations. Physiological Action and Therapeutics. Sassafras is a stimulant diaphoretic when used in quantity of the hot infusion. It enjoys a popular reputation as a “ blood- purifier,” and has a destructive influence on infusoria. It is employed chiefly in combination with Sarsaparilla and Guaiacum in cutaneous disorders and rheumatic and syphilitic affections. The mucilage of the pith is an excellent demulcent drink in acute gastritis or enteritis, or in poisoning by irritant or corrosive agents. It may also be used in extemporaneous prescriptions to 350 SCAMMONIUM—SCILLA. hold insoluble substances in suspension and for flavoring purposes. The oil is chiefly used for flavoring in mixtures and confec- tionery. The syrup popularly known as “Sarsaparilla” is com- posed of Oil of Sassafras and Oil of Gaultheria. SCAMMONIUM, Scammony,—is a resinous exudation from the root of Convolvulus Scarnmonia, a plant of the nat. ord. Convolvulacese, growing chiefly in Syria and Asia Minor. It occurs in irregular, angular pieces or circular cakes, of a greenish- gray or blackish color, a peculiar, cheese-like odor, and a slightly acrid taste ; easily triturated into a dirty-gray powder, and with water yields a smooth, greenish emulsion. It contains about 80 per cent, of Resin, with gum, sugar, starch, etc. The active principle, Jalapin, is probably identical with the Convolvulin of Jalap, and is contained in the root, the resin, etc. Dose, gr. v-x. Preparations. Resina ScaMMONII, Resin of Scammony,—is wholly soluble in ether. Dose, gr. iij-viij. Extractum Colocynthidis Compositum,—(see ante, page 157) contains 14 per cent, of Resin of Scammony, and is an ingredient of the Compound Cathartic Pill. Physiological Action and Therapeutics. Scammony is an active cathartic, stimulating the liver and the intestinal glands, and causing free purgation in a few hours, with considerable griping. Its solution in the bile is necessary to its action, and it combines with the soda in that secretion. Though quite drastic in action it is somewhat uncertain as a purgative and is generally employed in combination with similarly acting agents. It is anthelmintic against the tapeworm, and in over- doses produces a high degree of irritation. It is used as a drastic purgative for children with Calomel or Potassium Sulphate, when an active cathartic is indicated. In the same way it is the appropriate agent on the principle of deri- vation in dropsies and cerebral affections, also in torpid states of the intestines with much slimy intestinal mucus; but it is contra- indicated in cases attended by irritability of the stomach and bowels. SCILLA, Squill ,—is the sliced bulb of Urginea Scilla, or Scilla maritima, a perennial plant of the nat. ord. Liliacese, grow- ing on the shores of the Mediterranean. It comes in narrow SCILLA. 351 segments about two inches long, of yellowish-white or reddish color, slightly translucent, inodorous, mucilaginous, bitter and acrid to the taste. Its active principle has not yet been definitely isolated, but it is probably the acrid, bitter glucoside Scillitin. Other principles have been obtained and named Scillipicrin, Scil- litoxin and Scil/in, also Sinistrin, a peculiar carbohydrate or mucilage, and the usual constituents of plants. Dose, in powder, gr- j-iij. Preparations. Extractum Scilla: Fluidum,—Dose, ni j-v. Tinctura Scilla:,—15 per cent. Dose, up v-xxx. Acetum Scill^e,—10 per cent. Dose, ui x-sjj. Syrupus ScilLjE,—has of the Acetum 40 parts with Sugar 60 and Water. Dose, Syrupus Compositus,—has of Squill 120, Senega 120, Tartar Emetic 3, Sugar 1200, Calcium Phosphate 9, Diluted Alcohol and Water up to 2000 parts. Is known as Coxe’s Hive Mixture, and each fluid ounce con- tains about gr. of Tartar Emetic. Dose, Tti for children, the lat- ter being an emetic dose; as an expectorant for adults nt xx-xxx. Physiological Action. In small doses Squill is expectorant, in larger doses emetic and diuretic, and in overdoses it is a violent irritant poison, producing nausea, vomiting, purging, gastro-enteritis, strangury, bloody urine, perhaps suppression of urine, paralysis and convulsions, with death by paralysis of the heart in systole. Medicinal doses slow the heart, making the pulse stronger and slower, and increase the flow of urine (like Digitalis). Its active constituents diffuse into the blood, and its systemic effects follow on its application to the skin and seem to be exerted upon the mucous membrane of the secretory organs, especially affecting the bronchial, gastro- intestinal and genito-urinary. Therapeutics'. Squill is employed in medicine for its expectorant and diuretic effects. It is especially applicable in cardiac dropsy, combined with Digitalis or the saline diuretics, and in chronic bronchitis associated with Ipecac or Ammonia, Asafoetida, Benzoin, etc. It is also used in croup, but is usually combined in this affection with some other emetic, as Tartar Emetic in the Compound Syrup, a mixture which may produce very depressing effects and should be used with caution. In whooping-cough and other irritant coughs with tickling sensations in the throat the Syrup or Vinegar of Squill is often of great service. The actions and uses of Squill should be studied in connection with those of Digitalis and Ipecacuanha. 352 SCOPARIUS—SCUTELLARIA. SCOPARIUS, Broom,—the tops of Sarothamnus Scoparius, or Broom-plant, a common garden shrub of the nat. ord. Legu- minosae, having small, downy leaves and numerous large golden- yellow flowers. It occurs in thin, flexible twigs, usually free from leaves, nearly smooth, tough, of a peculiar odor when bruised and a disagreeably bitter taste. It contains Scoparin, C21H22Oio, a neutral, crystallizable principle; and Sparteine, C1#H26N2, a volatile, liquid alkaloid, having no oxygen, but pos- sessing very decided basic qualities and being highly poisonous. There are no official preparations, but a decoction may be pre- pared in the proportion of gj to the pint, and administered in doses of 3j every three hours until its diuretic effect is produced. Physiological Action and Therapeutics. Broom is diuretic and laxative, in large doses cathartic and emetic. It is classed with Buchu, Uva ursi, Pareira, Pipsissewa, etc., all being tonic, astringent diuretics. The alkaloid Spar- teine is a powerful narcotic, but exists in the plant in such small quantity that its share in the action thereof is not determin- able. Broom-tops are a favorite remedy for dropsies of cardiac origin, and for the general anasarca of chronic kidney disease, but are inadmissible in acute renal affections or where there is pulmonary congestion or inflammation. SCUTELLARIA, Skull-cap, —is the plant Scutellaria lat- eriflora, an indigenous, perennial herb of the nat. ord. Labiatae, growing in moist places and along ditches; having small, pale- blue flowers disposed in long, leafy racemes, of slight odor and bitterish taste. It contains a little volatile oil, traces of a bitter principle, besides fat, tannin, sugar, etc. Preparation. Extractum Scutellaria Fluidum,—Dose, gss-ij. Physiological Action and Therapeutics. Scutellaria produces no very obvious effects when taken inter- nally. By some practitioners it is said to have tonic, nervine and antispasmodic powers, and it has been used in domestic prac- tice to calm the nervous system in diseases characterized by rest- lessness, tremors, spasms, twitching of the muscles, hyperaesthesia, etc., as chorea, delirium tremens, nervous exhaustion from fatigue or over-excitement, hydrophobia, hysteria and epilepsy. The SENEGA. 353 Scutellarin of the Eclectics is not a proximate principle, but an extract precipitated by alum from a concentrated aqueous tincture. It is given in dose of from one to four grains. SENEGA, —is the root of Polygala Senega, an indigenous, perennial plant of the nat. ord. Polygalacese, having small, white flowers in a close spike at the summit of the stem. The root is about 4 inches long, with a knotty crown and tortuous, spreading branches, thick bark inclosing a porous, yellowish wood ;■ odor slight but unpleasant, taste at first sweetish, afterwards acrid. Its principal constituent is the glucoside Senegin, C32H54018, which is identical with Saponin, and closely allied to Digitonin. It is a white, amorphous powder, readily soluble in alcohol and hot water, forming a soapy emulsion when mixed with boiling water, and decomposed by HC1 into sugar and Sapogenin, C14H2202. Preparations. Abstractum Senega,—Dose, gr. v-x. Extractum Senega Fluidum,—Dose, uix-xx. Syrupus Senega,—has of the fluid extract 160, Aqua Ammonise 4, Sugar 600, Water to 1000 parts. Dose, s^j-ij. Syrupus Scilla: Compositus,—contains 6 per cent, of Senega. (See page 351.) Dose for children, niv-^j; for adults as an expectorant, nixx-^ss. Physiological Action. Senega is a stimulating expectorant, a diuretic and a diapho- retic. It causes irritation of the throat, with some salivation and gastro-intestinal irritation, an inclination to cough, increased bronchial secretion, and perhaps some diuresis and diaphoresis. Inhaled as a snuff it is very irritant to the mucous membrane of the nose, causing cough, sneezing and nasal catarrh. Senegin is violently irritant and a powerful depressant to the heart, vessels, nervous and muscular systems. It is excreted by the bronchial mucous membrane, the kidneys and the skin, all of which it stim- ulates and in large quantity irritates. Therapeutics. The use of Senega is chiefly that of a stimulating expectorant in chronic bronchitis, the second stage of acute bronchitis, ty- phoid pneumonia, asthma, croup, and as a diuretic in dropsy due to renal disease. It removes the tightness and oppression expe- rienced in subacute chest affections, relieves the cough and rap- idly promotes expectoration. When the mucus is tough and 354 SENNA. scanty this remedy is of no value. It has been used with great benefit in amenorrhoea, given in saturated decoction for two weeks before the expected period. In chronic rheumatism and in rheumatic paralysis its stimulating and diaphoretic powers have been of great value. Senegin has been successfully used in 2- grain doses as a remedy for uterine hemorrhage. SENNA,—the leaflets of Cassia acutifolia (Alexandria Senna), and of Cassia elongata (Indian Senna), shrubs of the nat. ord. Leguminosae, growing in Egypt and India. The leaflets are from i to 2 inches long, lanceolate, brittle, dull green, of peculiar odor, and nauseous, bitter taste. They contain an amorphous glucoside, Cathartic Acid, C180H192N2SO82, which forms salts with bases and may be decomposed into glucose and Cathartogenic Acid. Other constituents are Sennapicrin and Sennacrol, both glucosides;—Catharto-mannite, a peculiar unfermentable sugar; also a coloring matter allied to Chrysarobin (see page 145), and various vegetable salts. Preparations. Extractum Senna Fluidum,—Dose, Syrupus Senna,—has of Senna 33 parts, Sugar 60, Alcohol 4, Oil of Coriander and Water to xoo parts. Dose, Jjss-ij. Confectio Senna,—has of Senna 10,' Coriander 6, Cassia Fistula 16, Tamarind 10, Prune 7, Fig 12, Sugar 50, Water 60 parts. Is sold under the titles “ Tamar-Indien,” “Tropical Fruit Laxative,” etc. Dose, gj-ij. Infusum Senna Compositum, Black Draught,—has of Senna 6, Manna 12, Magnesium Sulphate 12, Fennel 2, Water 100 parts. Dose, Pulvis Glycyrrhiza Compositus (see ante, page 205),—contains 18 per cent, of Senna. Dose, gr. xx-^j. Syrupus Sarsaparilla Compositus (see ante, page 348),—contains 12 per 1000 of Senna. Dose, Physiological Action. Senna is a very efficient and safe cathartic, producing, when taken internally, copious yellow stools in about 4 hours, with considerable griping and flatulence, which may, however, be les- sened by combining it with carminatives. Its action is chiefly expended on the small intestine, and it increases both peristalsis and secretion. It has no irritant qualities in ordinary medicinal doses, and does not produce hypercatharsis, nor leave constipa- tion as an after result. Its infusion injected into the veins causes both vomiting and purging; and in large doses per orem it pro- duces nausea, vomiting, flatulence, excited pulse, drastic purga- tion with severe tenesmus, but its effects are never poisonous. It SERPENTARIA. 355 may produce hemorrhoids and increase the menstrual flow in women. Given to a nursing mother her milk will acquire purga- tive powers. In some very susceptible persons the odor of the leaves or of the infusion will cause an evacuation of the bowels. Its odor and taste are particularly disagreeable, especially when administered in infusion. Therapeutics. Senna would probably take rank as our best and safest cathartic but for the nauseousness of its smell and taste. It is a favorite laxative in England for children, and is used with great benefit in habitual constipation or where prompt evacuation of the bowels is required. In hemorrhoids and anal fissures it is employed to produce soft and easy motions. It should never be used where fever exists, nor in any such conditions as hemorrhage or inflam- mation of the intestinal mucous membrane, hemorrhoids, menor- rhagia, aboHipn, etc. The least disagreeable of its preparations are the Confection of Senna and the Compound Liqourice Powder. SERPENTARIA, Virginia Snake-root,—is the rhizome and rootlets of Aristolochia Serpentaria and of Aristolochia reticu- lata, indigenous herbaceous plants of the nat. ord. Aristolo- chiacese, growing in rich, shady woods, with purple flowers arising from joints near the root. The rhizome is about an inch long, thin and bent, having on the upper side short stem-rem- nants, on the lower side numerous thin, branching rootlets; odor and taste are aromatic and camphoraceous. It contains a volatile oil, a camphor-resin and a bitter principle named Aristolochine, which is soluble in both alcohol and water. All its preparations should be made from the fresh root, as it deteriorates by keeping. Preparations. Extractum Serpentaria Fluidum,—Dose, rrtx-xxx. Tinctura Serpentaria,—io per cent. Dose, zss-ij. Tinctura Cinchona Composita,—has 2 parts of Serpentaria in 100. (See ante, page 149). Dose, 5jj-ij. Physiological Action. Serpentaria is a stimulant expectorant and tonic, also a cardiac stimulant, a diaphoretic, diuretic, emmenagogue, aphrodisiac, and somewhat of an antiperiodic. Its taste is warm and pungent, its odor characteristic. Small doses promote appetite and diges- tion, increase the bronchial and intestinal secretions, the action 356 SESAMI OLEUM—SEVUM. of the heart, the cutaneous circulation and the surface tempera- ture, and produce considerable mental exhilaration. Large doses are irritant, causing nausea and vomiting, vertigo and headache, colic, borborygmi, rectal tenesmus, flatulent distention and fre- quent but not watery stools. The irritant action seems to produce gas rather than fluid. Pruritus ani and hemorrhoids are occa- sionally caused by its use. Therapeutics. Serpentaria is chiefly employed as a vehicle for other stimulant drugs, but has many uses of its own. In bronchial affections it is extremely valuable as a stimulating expectorant. In typhoid pneumonia it is a good vehicle for carbonate of ammonium, and in the exanthemata is extremely useful when much depression exists. It is indicated in typhoid conditions generally, and in the amenorrhoea of anaemia and chlorosis it is an efficient em- menagogue in many cases. It will often restore the waning sexual power in functional impotence, while in bilious vomiting it fre- quently checks the nausea and settles the stomach. It is used as a vehicle for Cinchona in remittent fever. In diphtheria, scar- latina, etc., the infusion forms an excellent gargle. Its diapho- retic and diuretic properties, though slight, are sometimes of avail in chronic rheumatism. SESAMI OLEUM, Oil of Sesamum, Benne Oil,—is a fixed oil expressed from the seeds of Sesamum indicum, or Benne plant (nat. ord, Pedaliaceae), which is a native of India, but is cultivated in the southern portions of the U. S. It is a yellowish or yellow, oily liquid, inodorous or nearly so, having a bland, nut-like taste and a neutral reaction. It is a bland fixed oil, very similar in its properties to olive oil, and may be used for the same purposes. It is rich in Olein (76 per cent.) and keeps better than olive oil. It is chiefly employed as a hair-oil. SEVUM, Suet,—is the internal fat of the abdomen of Ovis Aries (the Sheep), purified by melting and straining. It should be kept in well-closed vessels and not used after it has become rancid, as it will on exposure to air. It is a white, smooth, solid fat, of bland taste and neutral reaction, soluble in 24 of boiling alcohol, 60 of ether, and slowly in 2 of benzin. It consists chiefly of Stearin, but also has Palmitin and Olein, and is a constituent SILICATES—SINAPIS. 357 of Unguentum Hydrargyri and Unguentum Picis Liquidse. It is a harder fat than lard and more liable to turn rancid. It is used in ointments and liniments to give them greater consistency, but may be applied alone as a dressing to ulcers. In physiological action and therapeutics it follows the other oils and fats (see ante, pages 265, 273). SILICATES of Sodium (Na2Si03) of Potassium (K2Si03), and of Magnesium (2Mg03Si02) are used in medicine and sur- gery, a solution of the Silicate of Sodium being official. Liquor Sodii Silicatis, Soluble Glass Solution,—is a semi- transparent, colorless or yellowish, viscid liquid, odorless, ofsharp saline and alkaline taste and alkaline reaction, of sp. gr. 1.300 to 1.400. A small quantity should not produce any caustic effect when applied to the skin. It usually contains about 20 percent, of Silica and 10 per cent, of Soda, and is used on bandages to make immovable dressings, being lighter than plaster-of-Paris and stronger than starch. Liquor Potassii Silicatis (Unofficial),—also known as Soluble Glass Solution,—is used for immovable dressings in the same manner as the preced- ing. A mixture of 2 parts of this solution with one of the soda salt solution is said to set more quickly and firmly than either solution separately. Diluted (1 to 4) the solution of the Potassium Silicate has been applied locally in ery- sipelas, gonorrhoea, cystitis, vaginitis, etc., as an antiseptic, and with good results. Magnesii Silicas Hydratus, Hydrated Silicate of Magnesium, Meer- schaum, 2Mg0,3Si02-j-2H20 (Unofficial),—a mineral used for the manufac- ture of smoking-pipes, and employed in France as a substitute for Bismuth Suhnitrate in obstinate choleraic diarrhoea, to protect the intestinal mucous membrane or as an absorbent. It is given in fine powder and in doses of gj- iv per diem. SINAPIS, Mustard ,—is official under the two following titles, but all the pharmacopoeial preparations are made from Black Mustard only. Sinapis Alba, White Mustard,—the seed of Sinapis Atfra, an annual plant of the nat. ord. Cruciferae, cultivated in our gar- dens. It has yellow flowers in racemes, and ribbed pods with a long, ensiform beak. The seeds are about inch in diameter, yellowish, hard, almost globular with a circular hilum ; embryo oily, with a curved radicle and two cotyledons, one folded over the other; inodorous, taste pungent and acrid. 358 SINAPIS. White Mustard contains Myrosin, a ferment, and Sinalbin, a crystalline substance, which reacting on each other in the presence of water produce Sulpho-cyanate of Acrinyl, a rubefacient principle allied to the volatile oil of black mustard. It also contains Sinapine, an alkaloid, Erucic or Brassic Acid, and a bland, fixed oil, all three contained also in Black Mustard. Sinapis Nigra, Black Mustard,—is the seed of Sinapis nigra, an annual plant of the nat. ord. Cruciferae, native of Europe but naturalized in the U. S. It has small, yellow flowers standing closely together on peduncles at the ends of the branches, also smooth, erect pods with a short beak. The seeds are about one- half the size of those from white mustard, black and hard, almost globular with a circular hilum ; embryo as in Sinapis Alba; in- odorous when dry, but when moist of a pungent, irritating odor; taste pungent and acrid. Black Mustard contains Myrosin, a ferment, and Sinigrin (Potassium My- ronate), which reacting on each other in the presence of water produce the Sulpho-cyanide of Allyl, or Volatile Oil of Mustard. It also contains Sina- pine, an alkaloid, Erucic or Brassic Acid, and a bland, fixed oil; all three of which are contained also in White Mustard. Commercial Flour of Mustard (Unofficial),—is a mixture of white and black mustard seeds ground to a fine powder. It may be employed in lieu of either variety. Dose, as emetic, 3ij-iv, Preparations. Oleum Sinapis Volatile, Sulpho-cyanide of Allyl, C4H5NS,—a colorless or pale yellow liquid, of very pungent and acrid odor and taste and neutral reaction, sp. gr. 1.017 to 1.021, almost insoluble in water but freely soluble in alcohol and ether. Dose, Charta Sinapis, Mustard Paper,—consists of Black Mustard, the fixed oil removed by percolation with Benzin, mixed with Solution of Gutta-Percha and spread on paper. Each square inch should contaiq about gr. vj of Mus- tard. For local use. Linimentum Sinapis Compositum,—has of the Volatile Oil 3, Extract of Mezereum 2, Camphor 6, Castor Oil 15, Alcohol to 100 parts. For local use. Physiological Action. Locally used, Mustard is rubefacient, counter-irritant, and a nervous stimulant, causing heat, redness and severe burning pain. Its prolonged application produces vesication by inducing local inflammation. Internally it is a local emetic in full doses, in smaller a condiment and carminative. Its irritant effect on the gastric mucous membrane is much less powerful than on the skin. Therapeutics. Mustard is commonly used as a local application to relieve local pain, to stimulate the viscera, and to produce counter-irri- SODIUM. 359 tation. These objects find their application in muscular rheu- matism, neuralgia, colic, gastralgia, inflammation of the throat, larynx, bronchi, lungs, pleurae and pericardium, also as a deriva- tive in headache, cerebral congestion, and suppressed menstrua- tion. It may also be used as a stimulant to the heart, vascular system and respiratory apparatus. When action of a mild char- acter is desired it may be diluted with flaxseed or flour. Internally it may be employed as an emetic in indigestion or narcotic poisoning. Its use as a condiment is familiar, acting by stimulation of the gastric mucous membrane. In overdoses it may excite severe gastritis. White mustard seed, unground, has been used as a laxative, as it produces no irritation. The Oil is one of the most irritant of the volatile oils, producing severe gastro-enteritis. It is used chiefly as an ingredient of stimu- lating liniments, but may be employed internally in small doses. SODIUM, Natrium, Na.,—This metal is not official, but is represented by a number of official salts, which are generally colorless or white, and with very few exceptions are readily soluble in water. Some of them are found native, as the Chloride (in sea-water, salt lakes, salt mines),—the Nitrate (in Peruvian deserts, etc.) and the Borate (in lakes of Persia, California, etc.). The Carbonate is found in the ashes of marine plants. From the Chloride is prepared the Sulphate, from this the Carbonate, and from the latter most of the other salts are prepared. All sodium salts impart a yellow color to flame, which should not appear more than transiently red when observed through a blue glass, which cuts off the yellow rays but allows the violet ones of Potassium to be seen. Sodium. Compounds and their Preparations. Soda, Sodium Hydrate, Caustic Soda, NaHO,—a white, hard, opaque solid, deliquescent in moist air, efflorescent in dry air, odorless, of intensely acrid and caustic taste and strongly alkaline reaction, soluble in 1.7 of water at 590 F., and in 0.8 of boiling water, very soluble in alcohol. Is a powerful caustic but milder than Potassa, and should be kept in well-stoppered bottles made of hard glass. Liquor Solution of Soda,—contains about 5 per cent, of the hydrate, and is prepared by dissolving 180 parts of Sodium Carbonate in 400 of boiling Distilled Water, also 60 of Lime in the same quantity of Distilled Water, boiling, mixing the solutions gradually, again boiling and when cold adding water up to 1000 parts, straining, settling, and then removing the clear solution. Or, by dissolving 56 of Soda in 944 of Distilled Water. It is a clear, colorless liquid, odorless, of acrid and caustic taste and strongly alkaline reaction. Dose, well diluted with water. 360 SODIUM. Sodii Acetas, Acetate of Sodium, NaC2H302.3H20,—large, transparent prisms, efflorescent in dry air, odorless, of saline, bitter taste, and a neutral or faintly alkaline reaction, soluble in 3 of water and in 30 of alcohol at 590 F., in 1 of boiling water and in 2 of boiling alcohol. Dose, gr. xx-^j. Sodii Carbonas, Carbonate of Sodium, Na2C03.ioH20,—large, colorless crystals, rapidly efflorescent, with a harsh alkaline taste and strongly alkaline reaction; very soluble in water, insoluble in alcohol. By heat it undergoes aqueous fusion and then dries up, losing 63 per cent, of its weight. Of it 20 grains will neutralize 9.7 grains of Citric Acid, or grains of Tartaric Acid. Dose, gr. v-xxx. Sodii Carbonas Exsiccatus, Dried Carbonate of Sodium,—is the Car- bonate 200 parts dried at a heat of 1130 F., until it is converted into a white powder weighing 100 parts. Is chiefly used for pharmaceutical purposes. Sodii Bicarbonas, Bicarbonate of Sodium, NaHCOs,—an opaque, white powder, permanent in the air, odorless, of cooling, saline taste, and a slightly alkaline reaction; soluble in 12 of water at 590 F., insoluble in alcohol, decomposed by hot water. It is distinguished from the Carbonate by its solution in cold water giving a white and not a colored precipitate with solution of per- chloride of mercury. Of it 20 grains neutralize 16.7 grains of Citric Acid, or 17.8grains of Tartaric Acid. It is a constituent of MisturaRheiet Sodse (see page 325) and of Pulvis Effervescens Compositus (see page 3101. Dose, gr. x-^j. Sodii Bicarbonas Venalis, Commercial Bicarbonate of Sodium,—should contain 95 per cent, of the pure bicarbonate, which it resembles in appearance and properties. It is employed solely for external applications. Trochisci Sodii Bicarbonatis,—each troche contains of the Bicarbonate 3 grains, with Sugar, Nutmeg and Mucilage of Tragacanth. Dose, as of the bicarbonate. Sodii Chloras, Chlorate of Sodium, NaC103,—colorless, transparent tetra- hedrons of the regular system, permanent in dry air, odorless; of cooling, saline taste and neutral reaction, soluble in 1.1 of water and in 40 of alcohol at 590 F. also in 0.5 of boiling water and in 43 of boiling alcohol. When heated it melts and then gives off a portion of its oxygen, leaving a residue of sodium chloride. Should be kept in well-stoppered bottles, and should not be triturated with readily oxidizable or combustible substances. Dose, gr. v-xx. Sodii Chloridum, Chloride of Sodium, Common Salt, NaCl,—white, hard, cubical crystals or a crystalline powder, permanent in the air, odorless, of a purely saline taste and neutral reaction; soluble in 2.8 of water at 590 F., and in 2.5 of boiling water. Almost insoluble in alcohol. Dose, gr. x-gj. Sodii Nitras, Nitrate of Sodium, Cubic Nitre, Chili Nitre, Chili Saltpetre, NaN03,—colorless, transparent crystals, slightly deliquescent, odorless, of cooling, saline and bitter taste, and neutral reaction; soluble in 1.3 of water at 590 F., and in 0.6 of boiling water, scarcely soluble in cold alcohol. Dose, gj-ij. Sodii Sulphas, Sulphate of Sodium, Glauber’s Salt, Na2S04.ioH20,— large, colorless, transparent, monoclinic prisms, rapidly efflorescent in air; of cooling, saline taste and neutral reaction; soluble in 2.8 of water at 590 F., in 0.25 of water at 91.40 F., and in 0.4 of boiling water, insoluble in alcohol. Dose, gr. v-xx; as purgative §ss-j, or a third of a teaspoonful in a large glass of water. Sodii Ethylas, Ethylate of Sodium, Caustic Alcohol, C2H5NaO, (Unof- ficial),—is a white powder, often having a brownish tinge, dissolving in water with a hissing sound. Upon contact with the smallest quantity of water or 361 SODIUM. moist living tissue it splits into alcohol and caustic soda. An alcoholic solu- tion is made by dissolving sodium in absolute alcohol, and is used as a caustic. Chloroform decomposes it at once into ether and chloride of sodium. It should be kept in a cool place as it is liable to explode. The Arseniate of Sodium is described under Arsenic, page 85 ;—the Benzoate under Benzoin, page 99;—the Borate under Ac. Boricum, page 20;—the Bromide under Bromum, page 103;—the Solution of Chlori- nated Soda under Chlorum. page 143;—the Iodide under Iodum, page 231;—the Hypophosphite, Phosphate and Pyrophosphate under Phos- phorus, page 289;—the Salicylate under Salicin, page 340;—the San- toninate and its Troches under Santonica, page 345;—the Sulphite, Bisulphite and PIyposulphite under Acidum Sulphurosum, page 36; and the Sulpho-carbolate under Carbolic Acid, page 22. Physiological Action. The action of the Sodium salts is similar to that of the Potas- sium salts, except that the former are feebler as alkalies, are not so depressant, and are not so poisonous to the cardiac muscle or the nerves. They are diffused more slowly, are neither absorbed nor excreted so readily, and have not so marked a diuretic action. Locally applied in large doses to muscular and nervous tissue they are paralyzant, but *not so powerfully as potassium salts. XJrate of Sodium is not soluble like the urates of lithium or potas- sium, being therefore much less readily excreted, and forming the masses called “chalk-stones” in gouty subjects. Soda is a less active escharotic than potash, having less affinity for water. Liquor renders the blood and secretions more alkaline, but does not alter nutrition to the extent that liquor potassse does. The Acetate is converted into the Carbonate in the blood, and is a less active diuretic than the corresponding potassium salt. The Carbonate is chiefly used in the preparation of the other salts. • The Bicarbonate is slightly irritant, stimulates the secre- tion of gastric juice, acts as an antacid and will increase the alka- linity of the blood. The Chloride is a most important food. It exists normally in the blood, where it keeps the fibrin and albumen in solution, and plays an important part in tissue change. In inflammation, being thus needed, it accumulates at the seat of the morbid action, disappearing from the urine; its reappearance therein being a sign of improvement. A solution of 0.65 part to 100 of water does not destroy animal tissues like water alone, and may be mixed with blood without destroying the corpuscles, though strong solutions are intensely irritating. Internally used in quantity it is emetic and hemostatic. As an enema it is des- tructive to ascarides. Nitrate of Sodium is a mild cathartic, and in solution is a solvent of false membranes. The Sulphate is generally cathartic 362 SODIUM. in action, though in small doses and with little water it may be passed off by the kidneys. It is mixed with the Bicarbonate to imitate the salts obtained by evaporation of Carlsbad water. The Ethylate is an antiseptic, and a powerful but almost painless caustic. [The actions of the other Sodium salts are respectively de- scribed under the titles of their other constituents, to which their effects are mainly referable.] Antagonists and Incompatibles. Poisoning by caustic alkalies is treated by the dilute Vegetable Acids, as vinegar, cider, lemon-juice; then demulcent drinks and oils to protect the mucous membrane, and the usual vital supporters. The alkalies and their carbonates are incompatible with the acids and also with metallic salts, and the caustic alkalies decompose most alkaloids. Therapeutics. The Sodium salts treated of in this article are not much used internally, the corresponding Potassium salts being preferred, especially when it is desired to alkalinize the urine or to promote oxidation. In the alkaline treatment *of stomach affections the Sodium salts are the most efficient, especially the Bicarbonate before meals or on an empty stomach to increase the secretion of the gastric juice. This same salt is used in diabetes to lessen the amount of sugar, in frontal headache with constipation, the pain being seated at the junction of the forehead with the hairy scalp, —also as a wash (gr. ij ad 3j) in itching skin-affections arid as a lotion in burns and eczema. The Chloride is used internally as an antidote in poisoning by Nitrate of Silver and as an emetic, and will often relieve hemoptysis. In bilious diarrhoea it is em- ployed in doses of gr. x~3j, thrice daily. Locally in baths, it is a good stimulant to the skin, and in solution (J/2 to i per cent.) to wash wounds in place of water, to cleanse the nasal cavities, or to destroy ascarides, in which case it is given by enema of the strength of two tablespoonfuls to the pint. The Carbonate may be used in dilute solution locally to prevent itching, but is chiefly employed in the preparation of the other salts. The Sulphate is a good purgative, either alone or with the Bicarbonate in imitation of Carlsbad Salts, for bilious disorders, gouty affections, chronic constipation, obesity and diabetes mellitus. The Chlorate has similar uses to those of the Potassium Chlorate, but being more soluble can be used in stronger solutions, but this is of doubtful benefit for internal use as it has all of the irritating power on the kidneys and destructive action on the blood possessed by the other salt. (See ante, page 312). The Nitrate is employed as a mild SPIGELIA STAPHISAGRIA. 363 cathartic, and in solution by atomization to destroy the false membrane in croup. The Ethylate has been of service as a caustic in cancer, lupus and naevi, for the latter affection being painted over the growth with a glass rod. Caustic Soda is a better caustic than Potassa as it has less affinity for water and hence does not destroy the tissues so deeply, nor has it the same tendency to run over adjacent part*. [The therapeutics of the other Sodium Compounds are de- scribed as noted on page 361.] SPIGELIA, Pink-root,—is the rhizome and rootlets of Spigelia marilandica, the Carolina Pink, an herbaceous perennial of the nat. ord. Loganiacese, native of the southern states; hav- ing large, showy flowers, scarlet or crimson externally, yellow within. The rhizome is 2 inches long, inch thick, horizontal, bent and branched ; having cup-shaped scars above and numer- ous thin rootlets below. It contains a bitter principle and a volatile oil, also tannin, wax, resin, lignin and salts. Dose, 3j-ij for an adult, gr. x-xx for a child of 3 years. Preparations. Extractum Spigeliae Fluidum,—Dose for an adult, gj-ij; for a child of 3 years, rrtx-xx. Infusum Spigelia Compositum, Worm Tea (Unofficial),—has of Spigelia 15, Senna 10, Fennel 10, Manna 30, Water, 500. Dose, Physiological Action and Therapeittics. Spigelia is anthelmintic against the round worm (Ascaris lum- bricoides), and is in popular use as a vermifuge, administered usually with Senna. In large doses it is an uncertain cathartic, and may produce quite serious symptoms, as vertigo, dimness of vision, dilated pupils, spasms and even convulsions. These effects are most apt to occur when the drug fails to produce pur- gation, hence it is usually administered with an active cathartic. STAPHISAGRIA, Stavesacre,—is the seed of Delphi- nium Staphisagria, an annual or biennial plant of the nat. ord. Ranunculaceae, a native of Europe, having bluish or purple flowers, in terminal racemes; and seeds in straight, oblong cap- sules. The seeds contain an alkaloid Delphinine, probably 3 other alkaloids, a bitter principle, a volatile and a fixed oil, etc. There are no official preparations. 364 STILLINGIA. Preparations. Unguentum Staphisagria (Unofficial),—contains of the powdered seeds 1 part with 2 each of olive oil and lard. Delpiiinina, Delphinine, C22H35N06 (Unofficial),—is.the active alkaloid, and exists in the fatty oil which is extracted by ether. Dose, gr. Physiological Actions. Stavesacre is a violent emetic and cathartic, also parasiticide. The alkaloid is irritant to the skin if locally used, producing tingling, burning, and inflammation. Internally, it lowers the activity of the heart and respiration and produces a most pro- found adynamia, and may prove fatal from paralysis of the spinal cord and asphyxia. In many respects its alkaloid resembles Aconitine and Veratrine. Therapeutics. The ointment is often employed as a parasiticide against pedi- culi and the acarus scabies. The fixed oil is probably equally effective. Delphinine has been used internally in asthma, rheu- matism and neuralgia, and in the latter affection is well employed as an ointment (gr. xx to 3j), applied over the course of painful superficial nerves. It has been suggested as an antipyretic and for dropsy. A tincture or fluid extract is a very efficient applica- tion against pediculi. STILLINGIA, Queen’s Root,—is the root of Stillingia syl- vatica, or Queen’s Delight, an indigenous, perennial plant of the nat. ord. Euphorbiaceae, with yellow flowers on a spike, and a large, thick and woody root, of peculiar and unpleasant odor, and an acrid, pungent, bitter taste. It contains a resin and a volatile oil, but its active principle has not yet been isolated. The fresh root should be used in making the preparations, as those from the dried root are almost inactive. Dose of the pow- dered root, gr. x-3j. Preparations. Extractum Stillingia Fluidum,—Dose, Tinctura Stillingia (Unofficial),—Dose, Decoctum Stillingia (Unofficial),—ad Oj. Dose, Syrupus Stillingia Compositus (Unofficial),—is composed of Stillingia, Corydalis, Iris, Chimaphila, Coriander, Xanthoxylum, Sambucus, Sugar, Water and Alcohol. For the formula, see U. S. Disp., page 1363. Physiological Action. Stillingia in large doses is emetic and cathartic, in smaller doses it is expectorant, diaphoretic, diuretic, sialogogue and STRAMONIUM. 365 cholagogue, possessing the various properties which are con- sidered “alterative.” Its taste is acrid and pungent, and it in- creases the action of the heart, skin, kidneys, and bronchial mucous membrane; and the gastric, hepatic, intestinal and sali- vary secretions. Full doses often excite epigastric pain, nausea and vomiting. Therapeutics. Stillingia is much employed with Sarsaparilla and similar act- ing drugs as an alterative in syphilitic affections, particularly in chronic cases of the tertiary form, in which the system is greatly reduced by the abuse of mercurials and iodides. In these cases it possesses considerable power and frequently cures. It is also valuable in strumous affections, in ascites due to hepatic changes, portal congestions with jaundice following malaria, habitual con- stipation, hemorrhoids from hepatic obstruction, and intermit- tents. In the latter affection the fluid extract with Quinine or Arsenic is a very useful combination. A strong decoction is said to ward off an impending paroxysm of ague. STRAMONIUM, Thornapple. —The plant Datura Stra- monium, Jamestown Weed or Thornapple (nat. ord. Solanacese), is official in two forms, the leaves and the seed. It is an annual, of rank and vigorous growth, having a green stem with large white flowers, and numerous seeds in a large, fleshy, four-celled capsule, open at the summit. It grows wild in Southern Russia and the middle United States, and contains an alkaloid, Datu- rine, which is generally considered identical with Atropine both physiologically and chemically,—also malic acid, albumen, gum, resin, etc. Stramonii Folia,— the leaves of Datura Stramonium, are about 6 inches long, smooth, petiolate, ovate, pointed, unequal at the base, coarsely toothed, of bitter and nauseous taste. Dose, gr. ij-xx. Stramonii Semen,—the seed of Datura Stramonium, is about yi inch long, reniform, flattened, pitted and wrinkled, the testa blackish and hard, enclosing a curved embryo embedded in a whitish, oily albumen ; of unpleasant odor when bruised and an oily, bitter taste. Dose, gr. j. The official preparations are all made from the seed. Preparations. Extractum Stramonii,—Dose, gr. l/e-l/2- Extractum Stramonii Fluidum,—Dose, nxj-v. Tinctura Stramonii,—io per cent. Dose, rrx v-xxx. 366 STYRAX. UngOentum Stramonii,—has of the Extract io, Water 5, Benzoinated Lard 85 parts. Baturina, Daturine, C17Hs3N03 (Unofficial),—is the alkaloid found in all parts of the plant, also in Datura Tatula. It is a Tropate of Tropin, isomeric and identical with Atropine. Dose gr., Physiological Action. The action of Stramonium is similar to that of Belladonna in almost every particular, except that Stramonium is more powerful and chiefly influences the sympathetic nervous system, not affect- ing the motor or sensory nerves. It excites a greater degree of car- diac irregularity and a more furious delirium, and seems to have a special affinity for the generative apparatus, being decidedly aphrodisiac in full doses. [Compare Belladonna, ante, page 96.] As previously stated the alkaloids Atropine, Daturine, Hyoscy- amine, and Duboisine are chemically alike and almost identical physiologically. They all produce dilatation of the pupil, increase the cardiac action, the pulse and respiration rate, and cause deli- rium. Poisoning by one of them is indistinguishable from that by another. Antagonists and Incompatibles. These are the same as for Belladonna. Poisoning by Stramonium is not uncommon as children may eat the seeds, which should be evacuated by an emetic. If physiological symptoms follow Opium must be exhibited as the antagonist, but cautiously lest opium-narcosis be substituted. Therapeutics. Stramonium is chiefly used as an antispasmodic and to relieve pain. In asthma the leaves are smoked with advantage at the com- mencement of a paroxysm, the smoke being drawn into the lungs. In other spasmodic affections, as hepatic colic, laryngeal cough, chorea and stammering it is very beneficial. In dysmenorrhoea and neuralgia it is used in combination with Opium and Hyoscy- amus, and in tic douloureux and sciatica it is often very efficient. In nymphomania with great mental depression it is often very effective, and in mania of furious character, particularly the puer- peral form with suicidal tendency, it is highly serviceable in 10-20 minim doses of the tincture every 3 or 4 hours. The ointment is much used in irritable ulcers, and as an anodyne application in painful hemorrhoids and certain cutaneous diseases. STYRAX, Storax ,—is a balsam prepared from the inner bark of Liquidambar orienialis, the Oriental Sweet-gum, a tree of the nat. ord. Hamamelaceae, growing in Asia Minor. It is semi- liquid, sticky, opaque and gray-colored, of agreeable odor and SUCCINUM. 367 balsamic taste, completely soluble (except accidental impurities) in an equal weight of warm alcohol. It consists of a volatile oil named Styrol, C8H8,—a crystalline solid Styracin, which is a cinna- mate of cinnamic ether,—two peculiar resins, one hard, the other soft,—and Cinnamic Acid, C9H902, a colorless, odorless, crystal- line body, closely allied to Benzoic Acid, excreted in the urine partly as Hippuric Acid, and occurs also in the Balsams of Peru and Tolu. Dose of Storax, gr. v-xx. Preparation. Tinctura Benzoini Composita, Friar’s Balsam,—contains 8 per cent, of Storax. (See ante, page 99.) Dose, gss-ij. Physiological Action and Therapeutics. Storax is a stimulant expectorant, an antiseptic and a disin- fectant, acting both locally and remotely, like Benzoin and the Balsams of Tolu and Peru. It is used with benefit in chronic bronchitis and other affections of the respiratory organs, also in chronic catarrhs of the genito-urinary passages, in gonorrhoea and in amenorrhoea. Externally it is employed in ointment as a detergent for foul ulcers, and as a parasiticide for scabies and phthiriasis. SUCCINUM, Amber,—the source of the official Oil of Amber, is a fossil resin, occurring in alluvial deposits, chiefly in Prussia, Bohemia and Courland. It is usually associated with lignite, sometimes encloses insects and parts of vegetables, and consists of a volatile oil, a yellow resin, another resin, succinic acid and a bituminous principle. Its source is thought to be an extinct coniferous tree, the Pinites succinifer, of which amber represents the exudation. Preparation. Oleum Succini, Oil of Amber,—is a volatile oil obtained by the destructive distillation of Amber, and purified by subsequent rectification;—a colorless or pale yellow, thin liquid, of sp. gr. about 0.920, of empyreumatic and balsamic odor, a warm, acrid taste, and a neutral or faintly acid reaction, and readily soluble in alcohol. Dose, gtt. v-x. Physiological Action and Therapeutics. Oil of Amber is stimulant, antispasmodic and diuretic, when used internally. Externally it is irritant and rubefacient. It has been employed with benefit in epilepsy, hysteria, convulsions, amenorrhcea, whooping-cough, etc. As a liniment it is often used in chronic rheumatism, and has been applied along the spine in 368 SULPHUR AND SULPHIDES. infantile convulsions, mixed with an equal part of laudanum and diluted with olive oil or brandy. SULPHUR, and SULPHIDES.—The non-metallic element Sulphur, S, is a brittle solid of a pale yellow color, per- manent in the air, of crystalline texture and susceptible of several allotropic states, which are for the most part induced by heat. It is obtained native in several volcanic districts, or from the native Sulphides of Iron and Copper (iron and copper pyrites) by roasting, as it sublimes at about 238° F. It is official in three forms, viz. : Sulphur Sublimatum, Sublimed Sulphur, S,—is prepared from crude Sulphur by sublimation and condensation. It is a fine citron-yellow powder, of faintly acid taste and acid reaction, insoluble in water or alcohol. Ignited it burns with a blue flame, forming sulphurous acid gas, and leaving no residue or only a trace. Dose, gr. x-xx-lx. Sulphur Lotum, Washed Sulphur, S,—prepared by digesting sublimed Sulphur with dilute Water of Ammonia, thoroughly washing with water and passing through a No. 30 sieve. In this process the Ammonia dissolves out any Sulphide of Arsenic which may be present and neutralizes any Sulphurous or Sulphuric Acid. [For solubility and dose see S. below.] Sulphur Prsecipitatum, Precipitated Sulphur, Lac Sul- phuris, Milk of Sulphur, S,—prepared by boiling sublimed Sul- phur with slaked lime and water, thus forming the Sulphide and Hyposulphite of Calcium. These are then decomposed by HC1, and Sulphur is precipitated as a very fine powder which is next washed until the washings are tasteless, and it is dried with a gentle heat. The result is a very fine, yellowish-white, amor- phous powder, odorless and almost tasteless, insoluble in water or alcohol, but completely soluble in disulphide of carbon or a boiling solution of soda. By heat it is completely volatilized. Dose, gr. x~3j. Preparations of Sulphur. Unguentum Sulphuris,—has of Sublimed Sulphur 30, Benzoinated Lard 70 parts, rubbed together. Unguentum Sulphuris Alkalinum,—has of Washed Sulphur Zo, Potas- sium Carbonate 10, Water 5, Benzoinated Lard 65 parts, thoroughly rubbed together. Pulvis Glycyrrhiz.® Compositus (see ante, page 205) contains 8 per cent, of Sulphur Lotum; and Emplastrum Ammoniaci cum Hydrargyro (see ante, page 59) contains 1 per 1000 of Sulphur Sublimatum. Sulphuric Acid is described under Acidum Sulphuricum, ante, page 35 ; Sulphurous Acid and the Sulphites under Acidum Sulphurosum, ante, page 36. The Sulphates are noted under the titles of their respective bases. SULPHUR AND SULPHIDES. 369 Sulphides and their Preparations. Calcii Sulphidum, Sulphide of Calcium, CaS (Unofficial),—is the prepa- ration named “ Hepar Sulphuris, Liver of Sulphur,” by the homoeopathists, who prepare it by mixing equal parts of powdered oyster-shell and sublimed sulphur, and heating at a white heat in a crucible hermetically closed. It is a constituent of the following official compound, viz.: Calx Sulphurata, Sulphurated Lime,—is commonly misnamed Sulphide of Calcium. It is a mixture of Calcium Sulphide and Calcium Sulphate, CaS-|-CaS04, in varying proportions, but containing not less than 36 per cent, of the former, and is prepared by heating together in a closed crucible Pow- dered Lime 100 parts and Precipitated Sulphur 90 parts, at a low red heat for one hour. The result, rubbed to powder, is grayish-white, of offensive taste and alkaline reaction, very slightly soluble in water, insoluble in alcohol. Dose, gr. TV4- Potassa Sulphurata, Sulphurated Potassa,—formerly called Hepar Sul- phuris,—is a mixture of Potassium Trisulphide with small quantities of Potas- sium Hyposulphite and Sulphate, formed by heating together 1 part of Sub- limed Sulphur with 2 of Potassium Carbonate, until melted. Of a liver-brown color gradually changing with age to greenish- or brownish-yellow, of dis- agreeable odor, alkaline and repulsive taste and alkaline reaction. Soluble in 2 of water, excepting a small residue, partly soluble in alcohol. Dose, gr. ij-x, in pill or solution. Sulphuris Iodidum, Iodide of Sulphur, Iodine Disulphide, I2S2,—is pre- pared by fusing together Washed Sulphur 1 part, and Iodine 4. It is a grayish-black crystalline solid, having the odor of iodine, an acrid taste and a faintly acid reaction, insoluble in water, but very soluble in disulphide of carbon and in about 60 of glycerin. Alcohol and ether dissolve out the iodine, leaving the sulphur. Only used as ointment, gr. xxx to the §. Hydrogen Sulphide, Sulphuretted Hydrogen, H2S (Unofficial),—is used only as a test. It is a colorless gas having the smell of rotten eggs, prepared by the action of dilute Sulphuric Acid on Sulphide of Iron, the gas being passed into water a solution is obtained. It precipitates most of the metals from acid solutions as sulphides, that with Arsenic being yellow; with Anti- mony, orange; with Cadmium, yellow; with Copper, Lead, Mercury and Silver,black ; with Bismuth, brown; with Gold and Platinum, brownish-black. Bisulphide of Carbon is described under Carbo, ante, page 124; Sul- phide of Antimony and Sulphurated Antimony under Antimonium, ante, page 70. Physiological Action. Sulphur is a mild laxative and a diaphoretic. In contact with living protoplasm it enters into combination and produces either sulphuretted hydrogen or sulphurous acid ; taken into the intestinal canal a large portion passes out unchanged, some of it being converted by the alkaline bile into sulphuretted hydrogen and sulphides. The former is excreted by the lungs, giving to the breath the smell of rotten eggs, and by the skin, discoloring silver articles carried about the person by forming a sulphide of silver. The Sulphides are partly absorbed into the blood, and are excreted in the urine, chiefly as sulphates, and in the feces 370 SULPHUR AND SULPHIDES. which they blacken and render soft. Given in full doses they are irritant to the stomach and intestines, extremely nauseous to the taste and smell, increase the secretions of the intestinal glands, and peristaltic, action, and if used for any length of time they impair the blood, causing anaemia, emaciation, tremor and great debility. Sulphuretted Hydrogen is very destructive to plant life, and in animals it destroys* the tissue functions, decomposing the blood and paralyzing the nervous and the muscular systems. The symptoms of poisoning are those of asphyxia; muscular tremors occur and are followed by convulsions and death. This gas is often found in cesspools in large quantities, but in one case poisoning occurred from its excessive formation in the intestines and subsequent absorption into the blood. Calx Sulphurata and Potassa Sulphurata act like the sul- phides as local irritants and in large doses as irritant poisons, producing narcotic symptoms and convulsions. In small doses they act like sulphur and are supposed by many observers to have a peculiar influence on suppuration to limit or prevent it if given in small doses frequently repeated. The Iodide is believed to possess some of the properties of both its elements. It is doubtful whether it is a distinct chemi- cal compound or merely a physical mixture. As a parasiticide it is very efficient, and has been found remarkably alterative in many local affections of chronic character, but may prove very irritant to the skin if improperly prepared. [The actions of Sulphuric Acid, Sulphurous Acid and the> Sul- phites are respectively described on pages 35 and 36, ante.'] Antagonists and Incompatibles. Solutions of the Sulphides are decomposed by the mineral acids and by so- lutions of metallic salts. Antidotes are Chlorine-water, Chlorides of Sodium and Potassium, Sulphate of Iron, etc. Poisoning by Sulphuretted Hydrogen is best treated by artificial respiration. Therapeutics. Sulphur is chiefly used as a laxative when pultaceous rather than liquid stools are required, as in hemorrhoids, anal fissure, or constipation. Scabies has long been treated by its local and internal use, but sulphur alone does not kill the itch insect. The older sulphur ointments were made with sublimed sulphur and probably contained a considerable amount of sulphurous acid on which their parasiticide property depended. The recent oint- ments, made with purified sulphur, all contain an alkaline ingre- dient and develop sulphides which are powerful insect poisons. SUMBUL—TABACUM. 371 Sulphur fumigations are practically applications of volatile sul- phurous acid, while most of the sulphur baths and mineral waters are solutions of sulphuretted hydrogen or of the alkaline sulphides. They are of value in lead poisoning to favor the elimination of that metal, in chronic constipation, chronic rheumatism and sci- atica, and many skin diseases especially chronic psoriasis, eczema, pityriasis and prurigo. The Ointment and the Alkaline Oint- ment are both used in scabies. The Iodide has been used internally in scrofula, glanders and cutaneous disorders, but it is chiefly employed as an ointment in lupus and parasitic skin diseases, especially herpes circinatus. Calx Sulphurata is extremely efficient as an internal remedy in crops of boils, scrofulous sores, glandular enlargements, acne, etc., and will prevent or limit suppuration. For these purposes it must be used in small doses (gr. frequently repeated. Potassa Sulphurata is only used externally as baths or oint- ment in skin diseases and mucous discharges, also in chronic rheumatism. SUMBUL, —is the root of Ferula Sumbul, a very large plant of the nat. ord. Umbellifene, which grows to the height of 8 feet in the mountains of northern Asia. The root occurs in trans- verse segments of a strong and musk-like odor and a bitter, bal- samic taste, and contains Angelic Acid, C.H802, Valerianic Acid, C5H10O2, also a volatile oil, two balsamic resins, a bitter substance, etc. Dose, gr. xxx-5j or more in infusion, decoction, etc. Preparation. Tinctura Sumbul, io per cent. Dose, v. Physiological Action and Therapeutics. Sumbul is an efficient nerve tonic, having qualities closely re- sembling musk and valerian. It is used by the Russian physicians in very many morbid conditions, and seems to be a favorite rem- edy in that country for almost any disease. It is probably of some value in hysteria and other nervous derangements in deli- cate females, and may be used as a substitute for musk in typhoid conditions and fevers, asthma, delirium tremens and perhaps in epilepsy. TABACUM, Tobacco,—the commercial, dried leaves of Nicotiana Tabacum, an annual plant of the nat. ord. Solanacese, 372 TABACUM. native of tropical America, but cultivated in several parts of the world, especially in Cuba and Virginia. The leaves are large, as long as 20 inches, mottled-brown, ovate or lanceolate, glan- dular-hairy ; having a heavy, peculiar odor, and a nauseous, bitter and acrid taste. It contains a very powerful and poisonous fluid alkaloid named Nicotine, C10HUN2, also a concrete, camphora- ceous,volatile oil, Nicotianin, besides alkaline salts (nitrates, phos- phates), and other less important substances. Its combustion gives rise to several empyreumatic products, of which Pyridin, C5H5N, and its compounds are the chief, having somewhat the same action as Nicotine, but of less severity. Besides these pro- ducts, tobacco-smoke contains Creasote, Hydrocyanic and Hy- drosulphurous acids, etc., but little or no Nicotine. Unofficial Preparations. Enema Tabaci,—gr. xx infused in Boiling Water, and administered as one enema. Vinum Tabaci,— to the pint. Dose, niv-gj. Oleum Tabaci,—is an empyreumatic product, obtained by distillation at a temperature above that of boiling water, and a most virulent poison. Nicotina, Nicotine, C10HmN2,—the alkaloid and active principle ; a col- orless, oily-looking fluid, having the odor of tobacco and an acrid taste ; readily soluble in water, and forming soluble salts with acids. Dose, trt^- in strychnine-poisoning, up to Ulij in 2 hours. [Other Liquid Alkaloids besides Nicotine are—Coniine, Muscarine, Spar- teine, Lobeline and Lupuline.] Physiological Action. Tobacco is a very depressant nauseant, an emetic by irritant as well as systemic action, and an antispasmodic; also sternuta- tory, diuretic, diaphoretic, cathartic, sedative and narcotic. It paralyses the motor nervous system, its action commencing at the periphery and extending to the spinal cord. It increases the salivary and intestinal secretions, and produces diuresis, tremor, clonic spasms and a tetanic stage followed by paresis. It contracts the pupils, depresses the heart, lowers arterial tension, reduces body-temperature, and causes profuse sweating, cold and clammy skin, collapse and death usually by paralysis of respiration, some- times by paralysis of the heart. It does not impair the muscular irritability, nor does it act upon the cerebrum directly. Its em- pyreumatic products act similarly but less powerfully. Fatal re- sults have followed on the inhalation of its vapor into the lungs. Nicotine is almost as rapidly fatal as Prussic Acid, death hav- ing occurred from a toxic dose in three minutes, with no symp- toms except a wild stare and a deep sigh. 'l'he continued use of Tobacco in excess by smoking or chew- TAMARINDUS. 373 ing produces granular inflammation of the fauces and pharynx, atrophy of the retina, dyspepsia, lowered sexual power, nervous depression, and occasionally angina pectoris. Used by the young it hinders the development of the higher nerve centres, and im- pairs the body nutrition by interfering with the processes of digestion and assimilation. Strychnine is the true physiological antagonist to Nicotine (or Tobacco) and vice versa. Alcohol, Ammonia, Ergot, Digitalis, Belladonna, etc., antagonize its action on the circulation. In poisoning by Tobacco the means resorted to are evacuation of the stomach, Tannin, Iodides, and artificial respiration. A curious synergism has been observed by the author between Opium and Tobacco. If a person, habituated to the use of the latter, either by smoking or chewing, begins to use Morphine, the smallest quantity of To bacco will make him sick, the symptoms being those experienced by a novice in its use. Therapeutics. Tobacco is now but little used in medicine; the dangers at- tending its employment either internally or externally have caused it to be superseded by less violently acting agents. The chief indications for its use are to relax spasm and to relieve local pain. It may be employed with advantage in habitual constipation, for the dyspnoea of spasmodic asthma and emphysema, and in nym- phomania and chordee. Intestinal affections like impaction of the caecum, intussusception and strangulated hernia may be overcome by a tobacco-enema to relax spasm, but it is a dangerous expe- dient. In dropsy, especially the renal form, it makes a very efficient diuretic. In tetanus there is no more effective remedy than minim-doses of the alkaloid every two hours by the stomach, or friij by the rectum, or better still the wine in io-minim doses repeated for effect. Strychnine-poisoning is best met by minute doses of Nicotine (gr. 2>¥) hypodermically, as a physiological antagonist. The use of Tobacco in moderation, when under excessive ex- ertion, aids in supporting the system and lessening the sense of fatigue. Smokers rarely suffer from constipation, but generally experience an immediate laxative result from their morning cigar. TAMARINDUS, Tamarind,—is the preserved pulp of the fruit of Tamarindus indica, a large tree of the nat. ord. Leguminosge, native in the East and West Indies. It occurs as a reddish-brown, sweet-acid and pulpy mass, containing strong, branching fibres and brown, quadrangular seeds, each enclosed in a tough membrane. It contains citric, tartaric and malic acids, sugar, gum, potassium bitartrate, etc. 374 TANACETUM TARAXACUM. Preparation. Confectio (see ante, page 354),— contains Tamarind to the amount of 10 per cent. Dose, gj-ij. Physiological Action and Therapeutics. Tamarind is a laxative and refrigerant fruit. In infusion it may be used by convalescents as a pleasant acidulous drink, or the pulp may be boiled with milk as a whey for the same pur- pose. As a laxative it is usually prescribed in connection with other agents having the same action. TANACETUM, Tansy, —the leaves and tops of Tanace- tum vulgare, a perennial, herbaceous plant of the nat. ord. Com- positae, having yellow flowers in dense terminal corymbs, indige- nous in Europe, but cultivated in our gardens, and growing wild in roads and old fields. It contains a volatile oil, a bitter prin- ciple named Tanacetin, a tannic acid, etc. There are no official preparations, but a fluid extract may be prepared according to the general rule and administered in doses of Titx-3j. The dose of the volatile oil (Oleum Tanaceti) is i to 3 drops. An infu- sion (Tansy Tea) may be made in the proportion of 3j to the pint, and used in doses of Jj-ij. Physiological Action and Therapeutics. Tansy is emmenagogue, diuretic and anthelmintic, an aromatic bitter and an irritant narcotic. Fatal results have frequently followed upon overdoses of the oil (^ss—j), or strong decoctions, preceded by clonic spasms, disturbed respiration and cessation of the heart’s action. It is a useful remedy in amenorrhoea, but is in popular repute as an abortifacient, a virtue which it does not possess except in quantity dangerous to life. TARAXACUM, Dandelion, —is the root, gathered in autumn, of Taraxacum Dens-leo?iis, an herbaceous plant of the nat. ord. Compositae, with a perennial fusiform root, long, sinuate- toothed or runcinate leaves, and slender peduncles, each bearing a single head of yellow flowers. All parts of the plant contain a bitter, milky juice, exuding from any break or wound. Its con- stituents are a bitter amorphous principle named Taraxacin, a crystalline principle Taraxacerin, with potassium and calcium salts, inulin, and resinoid bodies, etc. The French name for the plant is “Pissenlit.” TEREBINTHINA. 375 Preparations. Extractum Taraxaci,—Dose, gr. v-xxx. Extractum Taraxaci Fluidum,—Dose, Physiological Action and Therapeutics. Taraxacum is a bitter tonic, a diuretic and an aperient. It has been supposed to act especially on the liver, and is chiefly used in dyspepsia with hepatic torpor. As found in the shops it is usually inert. The extract is probably only of value as an excipient for pills. TEREBINTHINA, Turpentine, —means a vegetable exudation, liquid or concrete, which consists of resin combined with a peculiar essential oil named Oil of Turpentine, and gener- ally procured from various species of pine, fir, or larch. Two of the many turpentines are official, viz.: Terebinthina, Turpentine,—a concrete oleoresin obtained from Pinus australis, the Yellow Pine, and from other species of Pinus, nat. ord. Coniferse. Occurs in tough, yellowish masses, brittle when cold, crummy-crystalline interiorly, of terebinthinate odor and taste. Dose, gr. v-xxx as a stimulant, antispasmodic or diuretic ; 3iHv as an anthelmintic. Terebinthina Canadensis, Canada Turpentine, Balsam of Fir,—a liquid oleoresin obtained from Abies balsamea, the Silver Fir, or Balm of Gilead, a tree of the nat. ord. Coniferse. A yel- lowish, transparent, viscid liquid, of agreeable, terebinthinate odor, and a bitterish and slightly acrid taste, slowly drying on exposure, forming a transparent mass; completely soluble in ether, chloroform or benzol. Dose, gr. x-xxx. Preparations. Oleum Terebinthina, Oil of Turpentine, C10H16,—a volatile oil, distilled from Turpentine; a thin, colorless liquid, of characteristic odor and taste; sp. gr. 0.855 t0 0.870, soluble in 6 of alcohol. Bromine and powdered Iodine act violently on it, and when brought into contact with a mixture of Nitric and Sulphuric Acids, it takes fire. Commonly called “ Spirits of Turpentine.” Consists of a mixture of several hydrocarbons. Dose, tit v-xv as a stimulant or diuretic in emulsion 3 to 6 times daily; as a cathartic or anthelmintic or more, combined with other cathartics. A little Glycerin and Oil of Gaulthe- ria with each dose will disguise the taste. Linimentum Terebinthina,—Resin Cerate 65, Oil of Turpentine 35 parts, thoroughly mixed. Linimentum Cantharidis (see ante, page 120),—Oil of Turpentine 85, Cantharides 15 parts. Unofficial Turpentines. Ciiian Turpentine,—from the Pistacece Terebinthus, a small larch tree 376 TEREBINTHINA. growing in the islands of Chio and Cyprus; a thick, tenacious, greenish-yel- low liquid, concreting on exposure to the air into a translucent solid. Dose, gr. iij-v in emulsion. Venice Turpentine,—procured in Switzerland from the I.arix Europcea or European Larcha viscid liquid of the consistence of honey, does not con- crete on exposure, and is entirely soluble in alcohol. The Venice Turpentine of commerce is usually prepared by dissolving Rosin in Oil of Turpentine. Physiological Action. Turpentines are stimulant, diuretic, anthelmintic, and hemo- static ; in large doses laxative and irritant, and externally used are rubefacient and antiseptic. Their virtues depend entirely on the volatile oil. Oil of Turpentine in small doses causes a sense of heat at the epigastrium, burning in the mouth, and by reflex action saliva- tion. In moderate doses it at first stimulates the vaso-motor nervous system, afterwards paralyzing these centres, thus causing a rise and then a fall of the arterial tension. It lowers the functions of the brain, spinal cord and medulla in the order stated, causing diminution of voluntary movement and reflex action, dilatation of the vessels, lowered blood-pressure, and slowed respiration, the latter often becoming spasmodic. The pulse is sometimes slowed, sometimes quickened. Large doses produce gastro-enteritis, with vomiting and diarrhoea, suppression of urine, pain in the lumbar regions, burning in the urethra, hematuria, and strangury. The muscular power is diminished, codrdination impaired, and a state of intoxication induced. Toxic doses cause complete muscular relaxation, profound insensibility, with abolished reflexes, dilated pupils, cyanosed face, labored and stertorous breathing and death by paralysis of respiration. It is excreted by the various organs of excretion, all of which are highly irritated, the kidneys suffering particularly. Its vapor inhaled produces nasal and renal irritation, frontal headache, and frequently strangury and hematuria. Locally to the skin it is rubefacient, and even vesicant if applied for any length of time or if evaporation be prevented. Turpentine-oil when exposed to the air readily absorbs oxygen in the form of ozone, which it retains tenaciously. This Ozo- nized Oil of Turpentine is an antidote to Phosphorus, pre- venting the formation of phosphoric acid, and converting the phosphorus into an insoluble substance resembling spermaceti. Worn about the neck in an open vial it is believed to prevent necrosis of the jaw and steatosis of the organs in workmen ex- posed to phosphorus-fumes. It is also supposed to dissolve gall- stones. THEOBROMA OLEUM. 377 Antagonists. In cases of poisoning the stomach should be emptied, anodynes and demul- cents administered, elimination favored, and special symptoms met as they arise. Therapeutics. The Oil of Turpentine is employed externally as a rubefacient and counter-irritant in many conditions producing pain and in- flammation. Cloths wrung out of hot water and then sprinkled with the oil (turpentine-stupes), are useful applications in sciatica and other neuralgiae, lumbago, chronic rheumatism, chronic bronchitis, peritonitis with tympanites, pleurisy, renal colie, etc. It is one of the most efficient agents in hospital gangrene applied in full strength to the part affected. The liniment is in con- stant use for sprains, neuralgia, and other slight local affections. Internally it is best employed in ulceration and hemorrhage of the intestines and in hemorrhages of a passive character from other organs. Active bleeding with a plethoric condition and he- maturia are states in which it is contraindicated. It is often used with Ether (i to 3) in biliary and flatulent colic,-as an anodyne and antispasmodic. As a vermifuge against tape-worm it must be employed in large doses with Castor oil to promote its rapid passage through the intestinal canal. The French acid oil, which is old and contains ozone, is used in phosphorus poisoning. It is well employed as a stimulant to the heart and vaso-motor system in puerperal fever, yellow fever, traumatic erysipelas, pneumonia, capillary bronchitis, etc. It is also useful in chronic bronchial catarrh, chronic cystitis, subacute gonorrhoea and similar affections of the mucous surfaces generally. Inhalations of the vapor or atomized oil are extremely bene- ficial in chronic affections of the larynx and bronchi. The pure vapor is too irritating for inhalation, but it may be diluted with steam from a steam atomizer. Chian Turpentine is one of the many remedies which have been used for cancer. Terebene is a substance which is prepared by the action of Sulphuric Acid on Oil of Turpentine. It is a disinfectant with a very agreeable balsamic odor. Mixed with Thymol and Car- bolic Acid in equal parts, it is used as an inhalation (3ss to the pint of hot water) in phthisis. THEOBROMINE OLEUM, Oil of Theobroma, Cacao- butter,—is a fixed oil expressed from the seed of Theobroma Cacao, the Chocolate-tree, nat. ord. Sterculiaceae, growing in 378 THUJA. Mexico, the West Indies and South America. The oil is a yel- lowish-white solid, of faint odor, bland taste and neutral reaction, and melting at 86° to 950 F. The seeds are oval, about the size of almonds, and consist of shells and kernels, in both of which is found the alkaloid Theobromine C7H8N402, which closely resembles Caffeine, the latter being its methyl derivative. Chocolate is prepared by roasting the seeds, removing the shells, then crushing or grind- ing the kernels to a smooth paste, which is cast in molds. Cacao-butter consists chiefly of Stearin with a little Olein. Its action is demulcent, and it does not become rancid on expo- sure to the air. Its chief use is as a basis for making suppositories. A cerate is prepared by melting together Cacao-butter 35, White Wax 35, Oil of Almond 30, adding a drop of Oil of Rose and coloring, with a minute quantity of Carmine previously triturated with a drop of Water of Ammonia. This is known as Red Lip- salve. Theobromine has the same action and uses as Caffeine. (See ante, page 109.) THUJA, Arbor Vitae, —the fresh tops of Tfiuja occidentals, a tree of the nat. ord. Coniferae, commonly though incorrectly called White Cedar, and growing in swampy ground in Canada and the northern U. S. Its twigs are flattish and two-edged, with scale-like leaves appressed and closely imbricate in four rows, rhombic-ovate, obtusely pointed, having a roundish gland upon the back; of a balsamic, somewhat terebinthinate odor, and a pungently aromatic, camphoraceous and bitter taste. They con- tain a volatile oil, tannin, wax, resin, etc. ; also Pinipicrin, CmH18Ou, a bitter principle, and Thujin, C20H22O12, a yellow, astringent and crystallizable coloring principle, which is separ- able into glucose and Thujetin, CuHu08. Preparations. There are none official. The dose of a saturated, fresh tincture or fluid extract is gj 3-6 times daily. The Volatile Oil may be given in doses of mj-v. Physiological Action. Thuja resembles Savine in action very closely. It is a stimu- lant, irritant, astringent, aroma'tic, diuretic and emmenagogue. The oil is a gastro-intestinal irritant, and produces epileptiform convulsions in warm-blooded animals, and paralysis in cold- blooded ones. It causes rhythmical contraction and dilatation of THYMI OLEUM. 379 the vessels, lowers the temperature, and is anthelmintic. Thuja is indirectly an abortifacient when given in doses sufficient to cause violent gastro-enteritis, and is reported to have produced an acute urethritis, resembling gonorrhoea. Therapeutics. Thuja in decoction has been usefully employed in coughs, rheu- matic and arthritic pains, dropsy and amenorrhoea. It has also been given with benefit in intermittent fever and as an alterative blennorrhetic in chronic catarrh and bronchorrhoea. It is highly praised by Dr. Phillips for the cure of warts with narrow base and pendulous body, a strong tincture being applied locally and given internally at the same time in 5-minim doses twice daily. Dr.Pif- fard speaks strongly in its favor as a valuable agent for non-syphi- litic warts (condylomata acuminata) of the penis and vulva, for papillomatous growths in general, and for gleets dependent on granular urethritis. It has been used in chronic gonorrhoea and prostatitis with asserted success, and is said to have cured epithe- lioma. The oil has been employed as a vermifuge. THYMI OLEUM, Oil of Thyme, —is a volatile oil dis- tilled from Thymus vulgaris, Garden Thyme, a common shrub of the nat. ord. Labiatae, indigenous in France but cultivated in our gardens. The oil is a pale yellow or colorless, thin liquid, having a strong odor of thyme, a warm, pungent and afterward cooling taste, and a neutral reaction, of sp. gr. about 0.880, and readily soluble in alcohol. It consists of two portions, the more volatile being a mixture of the hydrocarbons Cymene and Thy- mene, the less volatile being chiefly Thymol, which is official. Thymol, C10H]3HO,—is a stearoptene contained in Oil of Thyme and in the volatile oils of several other plants. It occurs in large, colorless, hexagonal crystals, of aromatic odor, pungent taste and neutral reaction ; soluble in 1200 of water, 900 of boil- ing water, and in 1 of alcohol at 590 F., freely in fats and oils, solutions of chloral and alkalies, ether, chloroform, etc. It liquefies with camphor. Dose, gr. ss-ij. Unofficial Preparations. Thymol Solution,—for antiseptic spray, 1 in 1000. Thymol Gauze,—contains 1 per cent, of Thymol. Thymol Ointments,—vary from 5 to 30 grains to the 5. Thymol Inhalation,—Thymol gr. xx, Alcoholis ziij, Magnesium Car- bonate gr. x, Water to A teaspoonful to a pint of water at 150° F. for each inhalation. 380 TIGLII OLEUM. Physiological Action. Oil of Thyme has the same properties as the oils of other mints, and containing a large quantity of Thymol it is similar to the latter in action. Thymol in its action stands between Carbolic Acid and Oil of Turpentine. Like the former it is a powerful antiseptic and dis- infectant. It is a local irritant and anaesthetic to the skin and mucous membranes, paralyzing the end-organs of the sensory nerves. When absorbed it paralyzes the nerve-centres in the spinal cord and in the medulla, lessening reflex action, slowing respiration, lowering the temperature and the arterial tension, and in poisonous doses causing weakness, coma and death. In- ternally administered in doses of 20 to 30 grains per diem it produces a sensation of epigastric heat, sweating, singing in the ears, deafness, a sense of constriction in the forehead, and in- crease of the urinary discharge, which assumes a dark, greenish hue. It is eliminated by the respiratory and urinary organs which it irritates considerably during the process of its excre- tion. As an antiseptic it is much more powerful and permanent than Carbolic Acid and much less poisonous. Therapeutics. Thymol is chiefly employed in lieu of Carbolic Acid as an antiseptic for dressing wounds ; as a gargle, spray or inhalation in laryngitis and diphtheria; as an ointment in ringworm, ec- zema and psoriasis, and as an injection in ozaena. A solution of 1 part in xooo is the strength usually employed. Internally it has been used with success in diphtheria, typhoid fever, diabetes, phthisis and vesical catarrh. Its fragrant odor renders it a very agreeable antiseptic application for ulcerated conditions of the mouth and fauces, but makes it very attractive to flies; which fact, together with its high price, will prevent it becoming a fa- vorite in hospital practice. TIGLII OLEUM, Croton Oil,—is a fixed oil expressed from the seed of Croton Tigliutn, a small tree of the nat. ord. Euphorbiaceae, a native of India. The oil is of a pale or brown- ish-yellow color, somewhat viscid and slightly fluorescent, of fatty odor, acrid taste and slightly acid reaction ; sp. gr. 0.940 to 0.955, soluble in 60 of alcohol, freely in ether, chloroform, or carbon disulphide. Its composition is very complex and has not been thoroughly made out, but it is known to contain the gly- TONGA. 381 cerides of several fatty acids, also a peculiar acid named Tiglinic Acid, C5H802, which is isomeric with Angelic Acid. Dose of the oil, in pill, emulsion or tincture. Physiological Action. Externally Croton Oil is highly irritant, producing a pustular eruption which heals by scabbing and may leave unsightly cica- trices. Internally it is a powerful drastic cathartic, producing in one or two hours copious watery stools, in overdoses causing great congestion of the intestinal canal and perhaps death from gastro-enteritis. Vomiting usually occurs after large doses, so that the irritant hyper-catharsis is not always observed. It is absorbed into the blood, and produces glandular hypersemia as well as direct inflammation of the intestinal mucous membrane, together with increased peristaltic action. Its cathartic power is increased by the addition of an alkali, and is manifested, though in less degree, when applied to the integument. Therapeutics. Croton Oil is used as a hydragogue cathartic when a speedy and complete evacuation of the bowels, diminution of arterial pres- sure and prompt derivative action are desired, as in apoplexy, impaction of the intestines, dropsy, lead constipation, paralysis, etc. It is contraindicated where there is debility, organic ob- struction, and inflammatory conditions of the stomach and bowels. The smallness of the dose makes it a very easily administered and manageable purgative. A considerable fraction of a drop is absorbed by a pellet of sugar, and may be given thus in repeated doses until the desired effect is obtained. It has been used as a vermifuge against tapeworm. Externally it is used as a counter-irritant in ovaritis, bronchi- tis, pleurisy, rheumatism, neuralgia, glandular swellings, and in laryngeal and pulmonary diseases. The Linimentum Crotonis of the British Pharmacopoeia contains i part of the oil in each of Alcohol and Oil of Cajuput, and is a useful pustulant preparation, being more manageable than the oil itself. TONGA (Unofficial) ,—is a mixed drug said to be obtained from the Fiji Islands, consisting of thin barks, root fibres and leaves tied into long bundles. The fibrous material is believed to be derived from Rhaphidophora vitiensis, a creeping plant of the nat. ord. Aracese, containing starch, potassium chloride and 382 TRAGACANTHA TRITICUM. a volatile alkaloid Tongine. The barky portion is referred to Pretnna tatiensis, a shrub or tree of the nat. ord. Verbenaceae, and contains a little volatile oil, sugar, pectin, etc. A fluid extract is prepared by Parke, Davis & Co. of Detroit, and may be given in doses of nucxx-3j thrice daily. Tonga was introduced by Drs. Ringer and Murrell as a remedy for neuralgia in 1880, stating that they had used it with gratify- ing results. Since then reports have differed considerably in regard to its efficacy, and from the fact that Dr. Ringer does not mention it in the last edition of his Handbook of Therapeutics, it may be inferred that his further experience with it has not borne out the claims first made. TRAGACANTHA, Tragacanth, —is a gummy exudation from Astragalus gu7twiifer and from other species of Astragalus, shrubs of the nat. ord. Leguminosse, growing chiefly in the mountainous regions of Asia Minor and Persia. It occurs in shell-like, curved or contorted bands, translucent, faintly yellow- ish, horn-like, tough, swelling with water to a gelatinous mass, which is tinged blue by test-solutfon of iodine, and consists of a mixture of Arabin, or gum-arabic, which is soluble in water, and Bassorin, a gum which is insoluble in water but swells up in it, also a little starch. Preparation. Mucilago Tragacanthje,—Tragacanth 6, Glycerin 18, water to ioo parts* Dose, or more. Physiological Action and Therapeutics. Tragacanth is demulcent, but in large quantities it may cause indigestion. It is chiefly employed to suspend resins and heavy powders in emulsion. The mucilage may be used as a vehicle for active agents in gargles for pharyngitis, and to cause cohesion in the preparation of pills, troches, etc. It is a constituent of 13 of the 16 official troches, and is a better agent than acacia for making emulsions of cod-liver oil. TRITICUM, Couch-grass, —is the rhizome, gathered in the spring and deprived of its rootlets, of Triticum repens, the Couch-grass, a perennial plant of the nat. ord. Graminacege, abounding in meadows and cultivated grounds, where it ranks as a weed, though of the same genus as wheat. The rhizome is very long, but as met with in the shops is cut into two sections about ULMUS—UVA URSI. 383 fths inch in length and inch thick, creeping, smooth, hollow in the centre, of straw color, and sweet taste. It contains much sugar and a gum-like principle Triticin. Dose, 3j~3j> in infusion or decoction. Preparation. Extractum Tritici Fluidum,—Dose, well diluted. Physiological Action and Therapeutics. Couch-grass is demulcent, emollient and a feeble diuretic. It is chiefly used in cystitis and irritable bladder. The infusion is a popular fever-drink in Europe, and has had of old a consid- erable reputation in dysuria. ULMUS, Elm, Slippery Elm,—is the inner bark of Ulrnus fulva, an indigenous tree of the nat. ord. Urticacese, and occurs in flat pieces of various sizes, having a slight, peculiar odor and a mucilaginous, insipid taste. It contains a large quan- tity of mucilage which it readily parts with to water. Preparation. Mucilago Ulmi,—Elm 6, Boiling Water ioo parts, macerated for two hours and strained. Dose, ad libitum. Physiological Action and Therapeutics. Slippery-elm bark is demulcent, slightly astringent and some- what tonic. It is used internally in diarrhoea, dysentery and affections of the urinary passages, and externally in the form of poultice as an emollient application in cases of inflammation. It is also employed in the dilatation of fistulse, strictures and the os uteri. UVA URSI, Bearberry,—the leaves of Arctostaphylos Uva- ursi, a low, evergreen shrub, of the nat. ord. Ericaceae, inhabit- ing the northern latitudes and high mountains of Europe, Asia and America. The leaves are small, obovate, nearly sessile, shining, reticulated beneath, of a faint but hay-like odor, and a strongly astringent taste. They contain Tannic and Gallic Acids and 3 principles, viz.—Arbutin, C24H32Ou, a bitter glucoside, neutral, crystalline, soluble in warm water and resolvable into glucose and Hydroquinone, C6HgOa;—Ericolin, C34H6fl02, bitter and amorphous;—Ursone, C20H34O2, resinous, neutral, crystalline 384 VALERIANA. and tasteless. The Californian Manzanita (Arctostaphylos glauca) is an allied plant and also contains Arbutjn and Tannin. Dose of the powdered leaves, gr. x~3j in infusion or decoction. Preparations. Extractum Uva-ursi Fluidum,—Dose, nix-gj. Infusum Uva-ursi (Unofficial), Dose, Arbutinum, Arbutin (Unofficial),—Dose, gr. iij-v. Physiological Action and Therapeutis. Uva-ursi is astringent, tonic and feebly diuretic. Used in large quantity it produces vomiting and purging, and is alleged to, have oxytocic power. Arbutin is an efficient diuretic, and is decomposed in the body, yielding Hydroquinone which is ex- creted by the kidneys as Hydroquinone-sulphuric Acid. This is non-toxic, imparts a brown color with antiseptic and slightly irritant qualities to the urine. Bear-berry was formerly used in all calculous affections and chronic disorders of the urinary passages. It has some reputa- tion as an antilithic, and is no doubt useful in gravel, chronic nephritis, cystitis, urethritis, and kindred diseases. It relieves incontinence of urine, dysuria and strangury, and has proved serviceable even in uterine hemorrhages. Arbutin has been successfully employed in cardiac dropsy as a diuretic, also in urethritis. VALERIANA, Valerian ,—is the rhizome and rootlets of Valeriana officinalis, a large, herbaceous plant of the nat. ord. Valerianacese, having small, white, or rose-colored flowers, and opposite pinnate leaves on an erect, round and channelled stem. The plant is a native of Europe but is cultivated in Vermont and New York. The root is perennial, its rhizome about an inch long, upright, truncate at both ends, internally whitish or pale- brownish with a narrow circle of white wood under the thin bark. Odor peculiar, taste camphoraceous and bitter. It contains a complex Volatile Oil, from which are developed by oxidation Valerene, C,0H16, which is a terpene, Valerol or Baldrian Cam- phor, C12H20O, and Valerianic Acid, C5H10O2, which occurs also in many other plants and in cod-liver oil. The Valerianic Acid of pharmacy is obtained as a product of the oxidation of Amylic Alcohol, and from it are formed the various Valerianates. It is, however, not identical with the natural acid. Dose of the pow- dered root, gr. x-xxx. VALERIANA. 385 Preparations of Valerian. Abstractum Valerians,—Dose, gr. v-xx. Extractum Valerianae Fluidum,—Dose, Rlx-xxx. Tinctura Valerians,—Strength 20 per cent. Dose, 3ss—ij. Tinctura Valerians Ammoniata,—Valerian 20, Aromatic Spirit of Ammonia to 100 parts. Dose, j^ss-ij. Oleum Valerianae,—the volatile oil, sp. gr. about 0.950, a greenish or yellowish, thin liquid, having the odor of valerian, an aromatic taste and a slightly acid reaction, readily soluble in alcohol. Dose, TTlij-v. The Oil is by far the best preparation for use, as the tinctures are extremely nauseous and the fluid extract is too bulky. The taste is best covered by Cinnamon. Preparations of the Valerianic Acid. Ammonii Valerianas, Valerianate of Ammonium, NH4C5H902,—de- scribed on page 60. Dose, gr. ij-x. Ferri Valerianas, Valerianate of Iron, Fes(C5H902’)6, — described on page 192. Dose, gr. j-iij. Quininae Valerianas, Valerianate of Quinine, N202'CjHjqO 2.H20, —described on page 149. Dose, gr. j-iij. Zinci Valerianas, Valerianate of Zinc, Zn(C5H0O2)2.H2O—described on page 395. Dose, gr. J^-iij. The Valerianates are made with the acid produced from Amylic Alcohol, and do not represent the action of the plant, but rather that of the bases from which they are prepared. Physiological Action. Valerian is antispasmodic, and a gentle stimulant to the ner- vous and circulatory systems. It is sedative to reflex excitability, antagonizing the action of Strychnine, Brucine, Thebaine, etc., and is laxative, diaphoretic and anthelmintic. Its taste and odor are very disagreeable, but cats are extrava- gantly fond of it. In these animals it greatly excites the sexual appetite, probably from a resemblance between its odor and theirs when under venereal excitement. After a time it pro- duces in them violent spasms and convulsions. In full doses it increases the action of the heart and raises the temperature, in most persons producing exhilaration (in some, slight mental disturbance), with formication of the hands and feet. Long used it induces a condition of low melancholy and hysterical depression. Large doses cause hiccough, diarrhoea, nausea and vomiting, frequent micturition with tenesmus of the bladder and lithates in the urine, mental disturbance even to de- lirium, reduced motility and sensibility, and lessened reflex ex- citability. The oil in large doses is paralyzant to the brain and the spinal cord, lowers the blood-pressure and slows the pulse. The Valerianates follow their bases in general action, but are supposed to combine therewith some of the sedative qualities of the acid. 386 VANILLA. Therapeutics. Valerian was formerly much used in epilepsy, but it was proba- bly only useful in the hysterical form of that disease (hystero- epilepsy). It is a valuable remedy in all forms of hysteria, espe- cially when occurring in young and delicate women. It is also useful in flatulence of infants and in that of hypochondriacal and hysterical subjects, and in coughs of nervous type, whooping- cough, diabetes insipidus, convulsions due to worms and in de- lirium with vital depression. In the coma of typhus fever the oil proved remarkably efficient in a series of 135 cases out of 172 treated by it. Valerianate of Ammonium is used in the same class of disor- ders as is Valerian. It is often a good remedy for nervous head- ache, administered in 10-grain doses and in an elixir. Valerianate of Zinc has been supposed to combine the anti- spasmodic power of valerian with the nerve-tonic effect of a zinc salt. It has been used in chorea, epilepsy and neuralgia, fre- quently with considerable success. The Valerianates of Iron and Quinine are used as the salts of their respective bases. VANILLA ,—is the fruit of Vanillaplanifolia, a perennial, climbing plant of the nat. ord. Orchidacese, a native of the West Indies and tropical America, but cultivated in Java, etc. It has dark green, tough leaves, pale greenish-yellow sessile flowers, and long pods (6 to io inches), wrinkled, warty, one-celled, contain- ing a blackish-brown pulp with numerous small seeds and acicular crystals, of peculiar and fragrant odor and taste. Its character- istic odorous principle is Vanillin, or the methyl-ether of proto- catechuic aldehyd, which oxidizes slowly in damp air to Vanillic Acid, and may be resolved into methyl chloride and protocate- chuic acid. Vanillin may be made synthetically from Coniferin or from Eugenol. Dose, indefinite. Preparations. Tinctura Vanilla,—io per cent. Dose, a few drops according to the strength of flavor desired. Trochisci Ferri,—contains about per cent, of Vanilla. Physiological Action and Therapeutics. Vanilla is an aromatic stimulant, with considerable influence on the nervous system. It is chiefly employed as a perfume and VERATRUM VIRIDE. 387 for flavoring purposes, but has been used in hysteria and low fevers. VERATRUM VIRIDE, American Hellebore,—is the rhizome and rootlets of Veratru??i viride, or Indian Poke, Poke- root, Swamp Hellebore, an indigenous plant of the nat. ord. Melanthaceae, having a solid, round stem, furnished with bright green leaves, and terminating in a panicle of greenish-yellow flowers. The root is perennial, upright, externally blackish-gray, internally grayish-white, 2 to 3 inches long, with numerous, shrivelled rootlets, inodorous but sternutatory when powdered, taste bitter and very acrid. It contains several alkaloids, Jer- vine, Fseudo-jervine, Cevadine, C32H49N09, a very little Rubijervine, C26H43N02, and traces of Veratrine, C37H53NOu, and Veratralbine, C28H43N05. Veratroidine, formerly regarded as one of its alkaloids, is now thought to be Rubijervine and Resin. Veratrum Viride also contains Gallic Acid and Sugar. Allied Plants. Veratrum Album, White Hellebore,—is a native of the moun- tainous regions of continental Europe, and so closely resembles V. Viride in appearance and characteristics that it may be con- sidered a variety of the same plant. The rhizome was official in the U. S. P. 1870. It contains the alkaloids Jervine, Pseudo- jervine, Rubijervine, traces of Cevadine, and another powerful alkaloid Veratralbine, C^H^NOj. Veratrum Sabadilla, Cevadilla, Asagrsea officinalis,—is a bulbous plant of the nat. ord. Melanthaceae, indigenous in Mexico and Central America. It contains the alkaloids Cevadine (formerly called Veratrine), Cevadilline and Veratrine, with Veratric and Sabadillic or Cevadic Acids. It is the source of the official Vera- trine (see below). The seeds are official in the Br. Phar. under the title Sabadilla. Preparations. Extractum Veratri Viridis Fluidum,—Dose, nij-iv. Tinctura Veratri Viridis,—50 per cent. Dose, Tlij-x. Veratrina, Veratrine,—is an alkaloid or mixture of alkaloids prepared from the seeds of Asagrcea officinalis (see above). A white, or grayish-white, amorphous powder, highly irritant to the nostrils, of very acrid taste, pro- ducing tingling and numbness of the tongue and constriction of the fauces; slightly soluble in cold water, soluble in 3 of alcohol at 590 F., in 6 of ether, 2 of chloroform, 96 of glycerin and in 56 of olive oil. Dose, gr. fa- TU- 388 VERATRUM VIRIDE. Unguentum VERATRlNiE,—Veratrine 4, Alcohol 6, Benzoinated Lard 96 parts. For local use. Oleatum VeratriNjE,—Veratrine 2, Oleic Acid 98 parts. For local use. Physiological A ction. Veratrum Viride is a powerful depressant to the heart and a paralyzant of the spinal cord, acting similarly to Aconite in this respect, but differing therefrom in affecting respiration to a much less extent, in being a systemic emeto-cathartic (due to its Rubi- jervine), in paralyzing the motor nervous system centrally, im- pairing the reflexes but not sensation, and in having little or no action as a diaphoretic or diuretic. It produces great depression, but is seldom fatal in its results; when it causes death it does so by paralyzing the heart. In small doses it reduces the force of the pulse without at first affecting the rate, which afterwards however becomes very slow and the pulse soft and compressible, rising on the least exertion to be very rapid and feeble. Muscular weakness and frequently nausea and vomiting accompany the depression of the circulation. By large doses these symptoms are very much increased, the pulse becomes extremely rapid and almost imperceptible, the skin cold and clammy, constant vomiting, great weakness, giddiness, lost vision and partial unconsciousness ensue. Jervine represents in part the depressant action of the plant on the circulation and the central nervous system. It has no action on the vagus, and but little on the voluntary muscles or on the motor nerves, but it irritates the motor centres in the brain, causing convulsions, and slows the heart by direct action on the cardiac muscle or its motor ganglia. It kills by asphyxia, respi- ration ceasing before the heart stops. Veratroidine, which is probably Rubijervine plus a poisonous resin, also slows the respiration and the pulse, but differs from Jervine in always causing emeto-catharsis, and in producing less violent convulsions. It stimulates the vagus centre and paralyses the vagus terminations, also increasing the excitability of the vaso-motor centre. Veratrine is an intensely acrid and irritant powder, consist- ing probably of several alkaloids. It causes violent sneezing, a burning sensation in the respiratory passages and free salivation. It affects the heart and circulation similarly to the other Veratrige, and seems in addition to be a direct poison to muscular tissue, causing violent convulsions before the muscular paralysis sets in. Veratrum Album contains a very powerful alkaloid Veratral- bine, and perhaps also an irritant poisonous resin. Its general VERBASCUM. 389 action is similar to that of the official plant, but it is much more irritant to the gastro-intestinal mucous membrane, causing violent vomiting and purging, intense abdominal and oesophageal pain, greatly reduced pulse and temperature, collapse and death from cardiac and respiratory paralysis. Antagonists and Incompatibles. Alcohol, Opium, Belladonna and Ammonia counteract the cardiac depres- sion. Morphine and Atropine should be administered hypodermically, or Laudanum internally with alcoholic stimulants, the recumbent position should be enforced, and dry heat applied to the body. Caustic alkalies are incom- patible, as they decompose the alkaloids. Therapeutics. Veratrum Viride is inferior to Aconite in most of the fevers and inflammations, by reason of its lacking power over excretion. It renders good service, however, in the early stages of many parenchymatous and serous inflammations when occurring in sthenic subjects, especially in pneumonia. It is highly esteemed in puerperal fever and in many cardiac disorders, as simple hy- pertrophy, irritable heart, etc. It has been used with remarkably good results in many cases of acute mania and puerperal convul- sions, and it is of service in aneurism to depress the circulation to the lowest point, but in this case the recumbent position must be strictly observed in order to secure safety. It should always be administered in small doses and its effects carefully watched. Veratrttm Album is the “Hellebore” of the ancient physi- cians, and was much used by them as a derivative in insanity. It is rarely used at present except by the homoeopathists, who give it in the cold stage of cholera, in colic, in the vomiting and purging of summer diarrhoea, in whooping-cough and asthma. Veratrine is chiefly used externally. The ointment or oleate may be used with benefit in many cases of superficial neuralgia, myalgia and headaches, a small quantity being rubbed in over the seat of the pain. It may be absorbed through an abrasion of the cuticle and give rise to dangerous symptoms. Internally it has been employed as a cardiac sedative in fevers and inflam- mation, also in acute articular rheumatism, dropsies, dysmenor- rhoea and various nervous affections, but its uncertainty of action and the dangerous depression which it may produce have caused it to lose favor as an internal remedy. VERBASCUM, Mullein (Unofficial),—the leaves of Ver~ bascum Thaspus, the Mullein-weed, a common plant of the nat. 390 VIBURNUM. ord. Scrophulariaceae, having large woolly leaves and yellow flowers in dense spikes. Its chief constituent is mucilage, though the flowers contain an essential oil in very small proportion. An infusion of §iv of fresh leaves to the pint of milk is the form in which it has generally been given; this quantity to be taken thrice daily. Physiological Action and Therapeutics. Mullein is emollient and demulcent, perhaps also slightly ano- dyne. It has long been a popular Irish remedy in pulmonary affections, as under its use the weight steadily increases in phthisis and other wasting disorders, while expectoration is rendered more easy, cough is palliated and the general condition improved. It is also recommended in cystitis, irritable bladder, and diarrhoea, and is employed as an enema in dysentery and as a poultice for hemorrhoids. The dried leaves may be smoked with benefit in aphonia from laryngeal irritation. VIBURNUM, Black Haw,—is the bark of Viburnumpru- nifolium, an indigenous shrub or small tree of the nat. ord. Capri- foliacese, having sharply serrulate leaves, and small, white flowers in terminal cymes. The bark occurs in glossy, purplish-brown, thin pieces or quills covered with scattered warts and minute black dots; inner surface whitish and smooth, inodorous, some- what astringent and bitter. It contains tannic, oxalic, citric and malic acids, sulphates and chlorides; also two resins, one of which is named Viburnin, and Viburnic Acid, which is identical with Valerianic Acid. Preparation. Extractum Viburni Fluidum,—Dose, gss-ij. Physiological Action and Therapeutics. Viburnum is considered to possess nervine, antispasmodic, astringent, diuretic and tonic properties, and to be especially useful in preventing abortion in the nervous diseases of preg- nancy, and in dysmenorrhoea. It may be administered with cannabis indica, morphine, nerve-sedatives or simple aromatics. No exact observations have been made regarding its action, and its therapeutical claims are denied by many who have used it. It often excites nausea and vomiting. Viburnum Opulus, Cramp-bark, Cranberry-tree,—another shrub of the same genus, is highly valued by many practitioners as a remedy in uterine and other abdominal pains, but is not VIOLA TRICOLOR—VISCUM. 391 official. The so-called “ Viburnum Compound of Dr. Hayden,” is stated by its manufacturers to consist of “ the active principles of the Viburnum Opulus, Dioscorea Villosa, Scutellaria Lateri- flora, and a combination of aromatics, prepared by a process peculiar to ourselves.” This they call publishing the formula of the preparation. VIOLA TRICOLOR, Pansy,—is the wild-grown, flower- ing herb of Viola tricolor, the Heart’s-ease Pansy, a plant of the nat. ord. Violaceae, native in Europe, but naturalized in the southern U. S. It has an angular and nearly smooth stem; leaves alternate, petiolate, ovate or oblong and crenate; flowers with an obtuse spur and variegated petals, inodorous, taste somewhat bitter and acrid. It contains an active alkaloid Violine, allied in many respects to Emetine, and poisonous. There are no official preparations. Dose, gr. x~3j, in decoction. Physiological Action and Therapeutics. Viola is mucilaginous, emollient, expectorant and slightly laxa- tive. Its active principle is emeto-cathartic, but exists in very small quantity in the plant. A decoction of the fresh herb in milk, with a poultice of the same was formerly highly recom- mended in crusta lactea and impetigo. It is used with benefit in some forms of eczema, especially in that of the head and face, and has had some reputation in bronchitis and constitutional syphilis. VISCUM, Mistletoe (Unofficial),—occurs in two species (i) Viscutn album, the European Mistletoe, a small, parasitic, evergreen shrub, of the nat. ord. Loranthacese, growing chiefly on deciduous-leaved trees, and (2) Viscum fiavescens, the Ameri- can species, growing on oaks, elms, etc. They contain mucilage, starch, fixed oil, resin, salts, etc., and Viscin, or Bird-lime, which occurs also in Ilex aquifolium, Gentiana lutea and other plants. Dose, gr. x~3j in decoction, or tn.v-xxxof a ten per cent, tincture. Physiological Action and Therapeutics. The berries of the mistletoes have produced emeto-catharsis, with great thirst, tenesmus, bloody stools, convulsions and even death in young children. The leaves and twigs have been used in epilepsy, hysteria, chorea, asthma and other nervous affections. 392 VITELLUS—XANTHOXYLUM. The American plant is asserted to possess qualities similar to those of Digitalis, and to incite uterine contractions. It has been used in cardiac affections, dropsies, uterine hemorrhages and amenor- rhoea, also as an abortifacient. VITELLUS, Yolk of Egg,—-is the yolk of the egg of the domestic fowl, Gallus Bankiva, var. domesticus. It is a viscid, reddish-yellow, opaque liquid, of bland taste, alkaline reaction, odorless, and may be regarded as a dense emulsion of oil sus- pended in water by means of albumen. It is coagulated by heat or by alcohol and contains Vitellin, which is a proteid related to casein, Cholesterin and Albumin, besides fat, inorganic salts, sugar, etc. Preparation. Glyceritum Vitelli, Glycerite of Yolk of Egg, Glyconin,—consists of Vitellus 45, Glycerin 55 parts rubbed together until thoroughly mixed. Physiological Action and Therapeutics. Yolk of Egg is highly nutritive and forms a useful article of diet in exhausted conditions of the system, but its chief use in medicine is for emulsionizing oils and camphors. The Glycer- ite has the consistence of honey and forms an opaque emulsion with water. It is a very good vehicle for cod-liver oil (see ante, page 265), and an excellent protective application for burns, ery- sipelas, fissure of the nipples and many cutaneous disorders. It is also used as a cosmetic, and may be employed as an aliment. XANTHOXYLUM, Prickly Ash,—is the bark of Xan- thoxylum fraxineum, the northern species, and of Xanthoxylum carolinianum, the southern species of an indigenous shrub of the nat. ord. Rutaceae, having small, greenish flowers, alternate un- equally pinnate leaves, leaflets punctate with pellucid dots, stems and leafstalks armed with prickles. The bark of both species comes in curved or quilled fragments, of a brownish-gray color externally with whitish patches, and minute black dots, faintly furrowed, inodorous, bitter and pungent. That of X. fraxineum is about inch thick, has several two-edged spines each inch long, the bark of X. carolinianum is twice as thick as the other and is marked by many conical, corky projections, and by stout brown spines, arising from corky bases. It contains a volatile oil, a fixed oil, resin, gum, coloring matter and an alkaloid, ZEA MAYS. 393 Xanthoxyline, which is identical with Berberine (see ante, page ioo.) Dose, of the powdered bark, gr. x-xxx. Preparations. Extractum Xanthoxyli Fluidum,—Dose, Decoctum Xanthoxyli (Unofficial),—to the quart. Dose, a pint dur- ing 24 hours in divided doses. Physiological Action. Xanthoxylum is a stimulant and aromatic bitter, a local and systemic sialogogue, diaphoretic, diuretic and emmenagogue. Its taste is aromatic, soon becoming acrid and bitter and causing profuse salivation, tingling in the tongue and increased secretion from stomach, intestines, liver and pancreas. It also increases the cardiac action and raises the arterial tension, and is classed among the vegetable alteratives, with Mezereum, Guaiac, Stillin- gia, etc. Therapeutics. Xanthoxylum has a high reputation in chronic rheumatism, myalgia, lumbago and similar disorders, also in jaundice from catarrh of the bile-ducts, in dropsies, chronic pharyngitis and constitutional syphilis. In old cases of pharyngitis, the mucous membrane being glazed and dry, the decoction should be used as a gargle and mx-xxx of the fluid extract taken internally thrice daily. The bark, used as a masticatory, is a popular rem- edy for toothache, and has been frequently successful in paraly- sis of the tongue. ZEA MAYS, Maize, Indian Corn.—This well-known species of the nat. ord. Graminacege, though itself unofficial, is the source of two drugs one of which is official, viz.— Ustilago, Corn Smut,—Ustilago Maydis, nat. ord. Fungi, grown upon the stems, the pistils and the male inflorescence (tassel) of Zea Mays. It occurs in irregular, globular masses, sometimes 6 inches thick, and consisting of a blackish membrane, inclosing numerous globular, minute spores, their surfaces covered with echinulate warts. Its odor and taste are unpleasant, and it contains fixed oil, resin, pectin, gluten, sugar, an acid resembling the Sclerotic Acid of Ergot, and a volatile principle called Secaline, which is supposed to be identical with Trimethylamine. Preparation. Extractum Ustilaginis Fluidum (Unofficial),—may be made according to the general rule. Dose, ffi-xv-^j. 394 ZINCUM. Stigmata Maydis, Stigmata of Maize, Corn Silk (Unoffi- cial),—should be gathered when the tassel has well shed its pollen. Its active principle is said to be Maizenic Acid. Preparation. Extractum Stigmatarum Maydis Fluidum (Unofficial),—made by the general rule for fluid extracts. Dose, gj-ij. Physiological Action and Therapeutics. The properties of Ustilago, so far as examined, resemble those of Ergot and Nux-vomica combined. It is a spinal excitant, exalts sensibility and reflex action, producing tonic convulsions on the least irritation of the skin. It slows the heart by stimu- lation of the pneumogastric, dilates the pupil, causes muscular paresis, and death by tetanus of the respiratory muscles or by exhaustion. Experiments on its reputed oxytocic action have not substantiated the claims made for it in this respect, though it is said to have produced abortion in cows and other animals, after they had eaten the diseased grain. As a therapeutic agent Ustilago has been very little used, and when employed it has been as a substitute for Ergot. Stigmata Maydis is a certain but mild diuretic when given in full doses at short intervals. It is by some observers considered demulcent and anodyne, and is generally believed to have a specific or alterative influence over many disorders of the genito- urinary passages and the urinary bladder. It has been used with considerable success in incontinence of urine, uric and phos- phatic gravel, gout, rheumatism, urethritis, pyelitis, acute and chronic cystitis, cardiac dropsy and obstructive valvular disease of the heart. ZINCUM, Zinc, Zn,—is metallic Zinc, in the form of thin sheets, or irregular, granulated pieces, and is a bluish-white metal, having the sp. gr. 6.9. It occurs native as a Sulphide (Blende), as a Carbonate and a Silicate (Calamine), as a Red Oxide (Zincite), and as a mixture of Zinc Oxide with Oxide of Iron and Manga- nese (Franklinite). Zinc is soluble in the weakest acids, and therefore should never be used for culinary vessels. Its salts are all more or less active poisons. Metallic Zinc is not employed as a medicine. Zinc Compounds and their Preparations. Zinci Acetas, Acetate of Zinc, Zn(C2H320)2.3H20,—soft, white, mica- ceous or pearly, six-sided tablets or scales, somewhat efflorescent in dry air, ZINCUM. 395 of faintly acetous odor, sharp metallic taste and a slightly acid reaction; soluble in 3 of water and in 30 of alcohol at 590 F., in of boiling water and in 3 of boiling alcohol. Used locally as an astringent in solution of gr. j or ij to £j, or internally in doses of gr. J^-ij. Zinci Carbonas Prajcipitatus, Precipitated Carbonate of Zinc, (ZnCOs)2.- 3Zn(HO)2,—a white, impalpable powder, permanent in the air, odorless and tasteless, insoluble in water or alcohol, but soluble in acids with copious effer- vescence. When strongly heated it loses water and carbonic acid gas, leaving a residue of oxide of zinc. Used locally as a protective. Zinci ChloridUm, Chloride of Zinc, ZnCl2,—a white, crystalline powder, deliquescent, odorless, of caustic, saline, and metallic taste and acid reaction, very soluble in water and in alcohol, forming a clear or only faintly opalescent solution. Tonic and escharotic. For internal use a solution in Spirit of Ether is the most convenient form, of the strength of of which from 4 to 8 drops may be given twice daily. Strength of injections and collyria, gr. j-ij ad |j. Liquor Zinci Chloridi,—an aqueous solution of Zinc Chloride containing about 50 per cent, of the salt. A clear, colorless, odorless liquid, of a very astringent, sweetish taste and an acid reaction. A powerful disinfectant for sinks, drains, etc. Used also as an injection in gonorrhoea, leucorrhoea, etc., in dilute solution, to 1 per cent. Burnett's Disinfecting Fluid is similar to the above but slightly stronger. Zinci Iodidum, Iodide of Zinc, Znl2,—a white, granular powder, very deliquescent, odorless, of sharp, saline and metallic taste and acid reaction, very soluble in water and in alcohol. Dose, gr. ss-ij in syrup. Zinci OxidUm, Oxide of Zinc, ZnO,—a soft, pale-yellowish powder, per- manent in the air, odorless and tasteless, insoluble in water or alcohol, but soluble in acids without effervescence. Dose, gr. j-x, in pill. UnguentuM Zinci Oxidi,—strength 20 per cent., made with Benzoinated Lard, thoroughly mixed. Zinci Sulphas, Sulphate of Zinc, ZnS04-7H20,—small colorless prisms or acicular needles, slowly efflorescing in dry air, odorless, of sharp, saline, nau- seous and metallic taste and acid reaction, soluble in 0.6 of water, insoluble in alcohol. Dose, as emetic, gr. x-xxx,—as a tonic and astringent, gr. in pill. For Villate's Solution, see ante, page 169. Zinci Valerianas, Valerianate of Zinc, Zn(CBH902)2.H20,—soft, white, pearly scales, of sweet and styptic taste and acid reaction; soluble in 100 of water and in 40 of alcohol at 590 F. Dose, gr. in pill. [The Bromide of Zinc is described under Bromum, see page 103, and the Phosphide under Phosphorus, on page 289.] Physiological Action and Therapeutics. Zinc Salts are astringents, but milder ones than the salts of Lead. Its soluble compounds (the Chloride, Iodide, Sulphate and Acetate) are corrosive poisons, causing violent gastro- enteritis, and in some cases profound nervous depression. The Chloride is a very powerful and painful escharotic or rather mummifier of the tissues, having great affinity for water, coagu- lating albumen and shrivelling the vessels. It is a very active disinfectant. The Sulphate is also escharotic and a specific 396 ZINCUM. emetic, acting promptly by direct irritation of the stomach, and without much depression or after-nausea. In small doses it is tonic and astringent, in larger it would be a severe irritant but for its causing prompt emesis. The Acetate resembles the sulphate in action. The Oxide used externally is a mild, soothing astrin- gent ; used internally it enters the blood as a lactate or chloride, and acts as a mild astringent and as a nervous sedative. Being almost insoluble in the stomach, it has but feeble diffusive power and consequently but slight activity. The Carbonate resembles the Oxide in action. The Iodide locally is a powerful escharotic and has been supposed to possess some alterative powers when given internally in addition to its astringent qualities as a zinc salt. The Valerianate acts as a nervous sedative, but its prop- erties are in all probability due to its base and not to the acid combined with it. Continued use of zinc salts produces symptoms similar to those of chronic lead-poisoning, but of much less gravity. They manifest much less tendency to accumulate in the system than other metallic salts, and are excreted much more rapidly. Elimi- nation takes place chiefly by the liver and intestinal glands. [The actions of the Bromide and Phosphide are described respectively on pages 105 and 290.] Antidotes and Incompatibles. lime-water, mucilaginous drinks, soap, tannic acid, milk, Potassium and Sodium Carbonates if given early, are the antidotes in poisoning by the salts of zinc. Incompatibles are—lime-water, alkalies and their carbonates, nitrate of silver, and vegetable astringents. Acetate of Lead produces double de- composition with zinc salts, but it is often used in solution with the sulphate as an injection. Therapeutics. Zinc salts are chiefly employed in weak solution as mild astrin- gent applications in catarrhs of mucous membranes, such as con- junctivitis, gonorrhoea, etc., and as unguents and lotions in skin- diseases, particularly eczema, impetigo, herpes and erythema. The Chloride is made into a paste with flour and glycerin for the destruction of lupus, epithelioma and other morbid growths, and for opening abscesses in locations where puncture or incision might be dangerous. The cuticle, if unbroken, should be re- moved by strong water of ammonia before the paste is applied, as it will not act through the epidermic tissue. It is a commonly used disinfectant and deodorant, and in weak solution (niiij-v of the Liquor to Jj of water) makes a good lotion for putrid ulcers, and still weaker (gr. j-ij to the pint), is an excellent injection ZINGIBER. 397 for gonorrhoea. The Iodide is not employed as an escharotic, nor has it ever been a favorite remedy for internal use. It is chiefly employed in solution as an application to enlarged tonsils, and as an ointment (i part to 8 of lard) for the reduction of glandular enlargements. The Sulphate is used locally as an astringent to mucous surfaces generally, internally as an emetic in narcotic poisoning and croup, and in small doses as a tonic and antispasmodic in convulsive diseases, as chorea, hysteria, epilepsy, angina pectoris, asthma, etc. In diarrhoeas and dysen- tery it is a good astringent, and is frequently combined with Opium and Ipecac. The Acetate is used for the same purposes as the Sulphate, but is usually preferred for collyria. The Oxide may be used as a dusting powder in intertrigo, and as an oint- ment in eczema and excoriated surfaces generally. In combina- tion with Bismuth and Pepsin it is an excellent remedy for the summer diarrhoea of children, and with Aromatic Powder and Morphine it is very efficient in gastralgia. It is a good remedy in 3-grain doses for the night-sweats of phthisis, and has been successfully employed in epilepsy and neuralgia, in whooping- cough, hysteria, nervous headache and in bronchorrhoea to check the profuse secretion. It is much employed as an ingredient of cosmetics. The Carbonate is by some preferred to the oxide for local use in skin diseases. Calamine Ointment, which is a mix- ture of the impure carbonate (calamine) with the oxide and an unguent basis, was until recently a-favorite application as a sooth- ing protective to abrasions and inflammations of the integument. The Valerianate has been used in chorea, epilepsy, neuralgia and various anomalous nervous affections, such as the nervous headache of hysterical women, nervous coughs and aphonia due to uterine and ovarian irritation. [The Bromide and Phosphide are used entirely with reference to their respective non-metallic bases, under which titles their therapeutics are described.] ZINGIBER, Ginger, —is the rhizome of Zingiber officinale, a plant of the nat. ord. Zingiberaceae, having dingy-yellow flowers on a leafless flower-stalk, and long, lanceolate leaves on a separate stem. The plant is a native of Hindostan, but is culti- vated in Jamaica, Sierra Leone, etc. The rhizome is about -f inch broad, flattish, on one side lobed or clavately branched, of a pale-buff color, striate, agreeably aromatic and of a warm, pun- gent taste. It breaks with a mealy, fibrous fracture showing 398 ZINGIBER. numerous small resin-cells and fibro-vascular bundles. It con- tains an aromatic volatile oil and a resin. Preparations. Extractum Zingiberis Fluidum,—Dose, uix-^ss. Tinctura Zingiberis,—20 per cent. Dose, mxx-^ij. Syrupus Zingiberis,—has of the fluid extract 2 per cent, in sugar and water. Dose, gss-ij. Trochisci Zingiberis,—each troche contains of the tincture 2 grains, with Tragacanth, Sugar and Syrup of Ginger. Oleoresina Zingiberis,—contains all the virtues of the root, and is ex- tracted by ether. Dose, well diluted. Ginger is also a constituent of Pulvis Aromaticus, Pulvis Rhei Compositus and Vinum Aloes. Physiological Action and Therapeutics. Ginger is sialogogue when chewed, sternutatory when inhaled, and externally a rubefacient. Internally it is a grateful stimulant and carminative, produces a sensation of wafmth at the epigas- trium and promotes the expulsion of flatus. It is employed as a carminative in colic, as a masticatory to increase the secretion of saliva and in relaxed conditions of the throat, also internally in atonic dyspepsia, to relieve flatulence, and as an adjunct to pur- gative agents to correct their griping properties. The syrup is in common use as a flavoring and adjuvant in prescriptions. . CLASSIFICATION OF MEDICINES. In the present state of knowledge respecting the actions and uses of medicinal agents, no really scientific classification of* these substances is possible. Some writers have adopted a system based on the natural relations of the various articles to each other, while many classify them according to their effects on the human system, and others make no attempt at arrangement but treat of them in alphabetical order. The latter method has been followed in this work, from a conviction that every medi- cine should first be studied as an individual, both with respect to its physiological actions and its therapeutical applications. When the student has thus made himself familiar with the characteristic features of each article of the Materia Medica, he may begin, by comparing one with another, to seek acquaintance with their more delicate lights and shades. Some system of classification then becomes imperative as an aid to the memory, and as the titles of the groups to which the various agents belong in any physiological classification are also used to express their actions and uses, the following synopsis is inserted as an appropriate addendum to the section on Materia Medica and Therapeutics. Stimulants and Sedatives. These are general terms employed in various classifications with very little discrimination. Stimulant (stimulus, a goad),—is a term which is used in various senses as applied to medicinal agents. Alcoholic preparations, which are true narcotics, are commonly termed “stimulants,” and the same expression is employed to designate any agent which excites the organic action of a part of the economy. Diffusible Stimulants are those which have a prompt but transient effect, such as Alcohol, Ammonia, Camphor, etc. Spinal Stimulants exalt the func- tions of the cord, as Strychnine, I’icrotoxin, Ergot, Atropine, Phosphorus. 400 AGENTS ACTING ON THE NERVOUS SYSTEM. Cardiac Stimulants increase the action of the heart, as Alcohol, Atropine and Morphine in small doses, Strychnine, etc., also Squill, Convallaria, Cimi- cifuga and Digitalis, which slow but strengthen the cardiac action. Vaso-motor Stimulants, as Alcohol, Chloroform, Ether, Ammonia, Strychnine, Digitalis and Squill, acting on the vaso-motor centre; and the Nitrites, Belladonna, Electricity, Volatile Oils, etc., acting as local dilators of the vascular system. Cerebral Stimulants as Alcohol, Opium, Belladonna, Caffeine, Cocaine, Theine, Cannabis, Chloroform, Ether, Tobacco, etc. Renal Stimulants, as the diuretic group. Stomachic Stimulants, as the Aromatics, Volatile Oils, Vegetable Bitters, Mineral Acids, Nux Vomica, Mustard, Capsicum, etc. Hepatic Stimulants, as Nitro-muriatic and Nitric Acids, and the cholagogue purgatives Podophyllum, Jalap, Leptandra, Euonymin, Iridin, etc. Intestinal Stimulants, as Mercurials, Elaterium, Colocynth, Jalap, Scammony, Podo- phyllum, etc., which affect the glandular apparatus,—and Belladonna, Phy- sostigma, Nux Vomica, Rhubarb, Senna, Aloes, Frangula, Cascara, etc., which chiefly affect the muscular fibres and the intestinal nerves. Cutaneous Stimu- lants, as the diaphoretic group, and the rubefacients Mustard, Capsicum, Tur- pentine, Ammonia, etc. All stimulation reacts into depression, and most of the agents which stimulate the nerve centres at first soon depress and finally paralyze them. Sedatives (sedo, to allay),—are agents which exert a soothing influence on the system by lessening functional activity, depressing motility and diminishing pain. General Sedatives include the narcotics and anaesthetics. I.ocal Sedatives include Aconite, Opium, Ice, etc. Pulmonary Sedatives, as Hydrocyanic Acid, Veratrine, and the nauseants and emetics. Spinal Sedatives, as Phy- sostigma, Gelsemium, Potassium Bromide. Stomachic Sedatives include Ar- senic, Bismuth, Nitrate of Silver, Bicarbonate of Sodium. Vascular Seda- tives, as Digitalis, Tobacco, Aconite, Veratrum, and the emetics. Nervous Sedatives, among which are Potassium Bromide, Tobacco, Lobelia, and the group of spinal depressants. • Agents Acting Chiefly on the Nervous System. Motor-Excitants are agents which increase the functional activity of the spinal cord and the motor apparatus, producing disturbances of motility, heightened reflex excitability, and tetanic convulsions when given in large doses, their ultimate effect being motor paralysis from over-stimulation. The most important members of this class are Nux Vomica and Ignatia, with their alkaloids Strychnine and Brucine, also Thebaine, the tetanizing alkaloid of Opium. It also includes Morphine and Atropine, which, though at first sedative, when given in large doses produce convulsions. The respi- ratory centre in the medulla is stimulated by Strychnine, Atropine, Ammonia, and small doses of Alcohol, Ether and Chloroform. The motor convolutions in the brain are stimulated by Alcohol in moderate doses, as also for a brief period by Ether and Chloroform. AGENTS ACTING ON THE NERVOUS SYSTEM. 401 The end-organs of the motor nerves are stimulated by the local use of Electricity, Strychnine and friction; and are irritated by the internal admin- istration of Aconitine, Nicotine, Camphor, Pilocarpine and Pyridine. Other members of this class are embraced in the following list. Nux Vomica. Ignatia. Strychnine. Brucine. Thebaine. Morphine.* Atropine.* Alcohol.j- Ether.f Chloroform.| Ammonia. Absinthe. Buxine. Calabarine. Ergot. Ustilago. Gossypium. Picrotoxin. Aconitine. Nicotine. Camphor. Digitalis. Convallaria. Cimicifuga. Pilocarpine. Pyridine. Rhus Toxicoden. Electricity. Motor-Depressants lower the functional activity of the spinal cord and motor apparatus, and in large doses paralyze them. Some act indirectly by reducing the spinal circulation, as Digitalis, Aconite and large doses of Quinine; others by a directly paralyzant action on the centres. The principal mem- bers of this class may be enumerated as follows, viz.— Opium, Morphine. Gelsemium. Muscarine. Pulsatilla. Grindelia. Phytolacca. Physostigma. Belladonna. Stramonium. Hyoscyamus. Pilocarpus. Quebracho. Camphor. Aconite. Tobacco. Lobelia. Curare. Conium. Chloral. Ergot (at last). Arnica. Ailanthus. Veratrum. Alcohol.* Ether* Chloroform.* Bromides. Potassium. Lithium. Zinc. Prussic Acid. Potass. Cyanide. Amyl Nitrite. Sodium Nitrite. Methyl Strychnine. Ethyl Strychnine. Methyl Thebaine. Methyl Veratrine. Methyl Conine. Other Methyl Compounds. Ammonium Cyanide. Ammonium Iodide. Ethyl Ammonium Chloride. Amyl Ammonium Chloride. Amyl Ammonium Iodide. Amyl Ammonium Sulphate. Other Compound Ammonias. Galvanism. The motor centres in the medulla are powerfully depressed by Opium, Mor- phine, Aconite, Conium, Chloral, Physostigma, and large doses of Alcohol, Ether and Chloroform. The three last named are also paralyzers of the motor convolutions in the brain, arresting all voluntary movements when administered in sufficient quantity. The anterior cornua of the cord are greatly depressed by Physostigma and other agents, and the motor nerves by Conium, Methyl-Strychnine, etc., both actions resulting in paralysis ’of the limbs. Curare, even in small doses, paralyzes the end-organs of the motor nerves, and Belladonna, the compound Ammonias, Methyl compounds, etc., exercise a similar but less powerful influence. Galvanism is also an effective local depressant of motor activity. Local Stimulants increase common sensibility to the extent of producing pain, chiefly by direct action upon the end-organs * In large doses. f In small doses. 402 AGENTS ACTING ON THE NERVOUS SYSTEM. of the sensory nerves in the skin, though some act probably by stimulating the local circulation, as in inflammation. The prin- cipal members of this group are— Faradism. Heat. Cold. Alcohol. Ether. Chloroform. Carbolic Acid. Creasote. Mineral Acids. Ammonia. Volatile Oils. Acrid Essential Oils. Metallic Salts. Veratrine (at first). Cantharis (at first). Local Anaesthetics and Anodynes (,' to carry off),—are agents which increase the secretion and flow of saliva and buccal mucus, either by reflex action from the local irritation produced when anything is taken into the mouth, or by stimulating the glands during their elimination. The principal sialogogues are divided into two classes, the first (topical) acting by reflex stimulation, the second (general) acting through their systemic influence on the glands or their secretory nerves. They are as follows :— Topical Sialogognes. Acids and Alkalies. Ether, Chloroform, etc. Mustard, Ginger. Pyrethrum, Mezereon. Tobacco, Cubebs. Capsicum, Rhubarb. General Sialogognes. Pilocarpus (Jaborandi). Muscarine. Physostigma. Mercurials. Iodides, and Ipecac. Antimonials. Antisialics (am, against, alalov, saliva),—are remedies which diminish the secretions of the salivary glands. Atropine is the principal agent of this group, acting by paralyzing the termina- tions of the nerves of secretion. Physostigrna counteracts this paralysis, but in large doses acts as an antisialic by lessening the blood supply to the glands. Opium diminishes the reflex excita- bility of the reflex centre and also diminishes the secretion. Others acting locally are— Borax. Potassium Chlorate. Soda. Lime. Lithia. Magnesia. Insipid or nauseous articles of food or medicine. Refrigerants (refrigero, to cool),—are remedies which allay thirst and impart a sensation of coolness. They include the Vegetable Acids, the Mineral Acids (greatly diluted), Ice, Water, Effervescing drinks, Fruit juices, and many diaphoretics. Gastric Tonics or Stomachics,—are agents which increase the appetite and promote gastric digestion. They include a num- ber of substances, dietetic and medicinal, some acting by stim- ulation of the production of gastric juice, others by stimulating the local circulation, and several by exciting the activity of the nervo-muscular apparatus of the stomach. The first indication is met by the use of dilute alkaline solutions before meals,—the second by administering any of the pungent carminatives, as the Aromatic Oils, Pepper, Mustard, etc., or by Alcohol and Ether in small doses, or by the Aromatic Bitters, as Gentian, Orange, etc., or the simple bitters, as Calumba; —while the third desideratum is secured by the use of such agents as Nux Vomica, Hydrastis, Arsenic, the dilute Mineral Acids, and the Volatile 414 AGENTS ACTING ON THE DIGESTIVE SYSTEM. Oils. Adjuvants to gastric digestion are the various digestion-ferments, Pepsin, Ingluvin and dilute HCl Acid, which may be used to supplement the gastric juice when deficient in quantity or quality. Acids,—considered therapeutically and physiologically, are medicines which in concentrated form act usually as caustics, and when given in medicinal doses internally check the secretions of organs producing acid secretions with which they come in con- tact, and increase those of organs producing alkaline secretions. Thus a dilute acid given before meals will check the production of the acid gastric juice, but will stimulate that of the alkaline pancreatic juice. The chief members of this group are the following, which should be given in very dilute form :— Acidum Aceticum. Acidum Citricum. Acidum Benzoicum. Acidum Hydrochloricum. Acidum Nitricum. Acidum Phosphoricum. Acidum Sulphuricum. Acidum Nitro-hydrochloricum. Ant-acids or Alkalies,—from the.same stand-point, are remedies which neutralize acids, check alkaline secretions and stimulate acid secretions, when in contact with the ducts of the organs producing them. Thus a dilute alkali given before meals will stimulate the production o'f the acid gastric juice, and if applied to the mouth of the pancreatic duct will check the secre- tion of the alkaline pancreatic juice. The principal articles which belong to this group are the following, which should always be administered in dilute solution Liquor Potassse, Liquor Sodae. Carbonates and Bicarbonates of Potassium, Sodium, Lithium, Magnesium and Am- monium. Calcined Magnesia (Magnesia). Lime-water, Chalk. Aromatic Spirit of Ammonia. Potassium Acetate. Potassium Citrate. Potassium Tartrate. Potassium Bitartrate. Sodium Acetate. Sodium Citrate. Lithium Citrate. The substances in the first list are direct antacids, lessening the acidity in the stomach, and many of them also acting as remote antacids, lessening the acidity of the urine, as Potash and Soda, and their Carbonates and Bicarbo- nates. Ammonia and its Carbonates after absorption are eliminated as urea, and do not lessen the acidity of the urine. The salts in the second list are remote antacids, do not lessen acidity in the stomach, but do that of the urine, being oxidized in the blood and excreted as Carbonates. Emetics (Zulu), to vomit),—are agents which produce vomit- ing. They may be subdivided into two groups, (i) Local Emetics, or those which act by irritating the end-organs of the gastric, AGENTS ACTING ON THE DIGESTIVE SYSTEM. 415 pharyngeal or oesophageal nerves, and (2) •General or Systemic Emetics, which act through the medium of the circulation. Both these classes produce the emetic action by irritation of the vom- iting centre in the medulla, the first by reflex, the second by direct stimulation. The principal emetics are the following named:— Local Emetics. Alum, Mustard, Salt. Ammonium Carbonate. Zinc and Copper Sulphates. Subsulphate of Mercury. Tepid Water, in quantity. Vegetable Bitters, as Quassia, in strong infusions. General Emetics. Ipecacuanha. Emetine. Apomorphine. Tartar Emetic. Veratrine. Seneca. Squill. Tartar Emetic, Ipecacuanha and probably Apcrmorphine, act locally as well as systemically, for if injected subcutaneously they are excreted by the stomach in part, thus irritating the gastric nerves as well as the vomiting centre. Pilocarpus is a local emetic, and Digitalis and its congeners, also Muscarine, are systemic emetics, but none of these agents are used medicin- ally for that purpose. Opium, Morphine and Codeine usually produce emesis as one of their after-effects. Anti-emetics,—are agents which diminish nausea and vomit- ing, either through a local sedative action upon the end-organs of the gastric nerves, or by reducing the irritability of the vom- iting centre in the medulla. The most efficient of the local sedatives is Ice, swallowed in small pieces. Astringents are very useful when there is congestion of the gastric mucous membrane, as in the vomiting of alcoholism and phthisis, where Silver Nitrate and Alum are respectively effective. The most important anti- emetics are the following, viz. :— Local Gastric Sedatives. General Sedatives. Opium. Morphine. Prussic Acid. Bromides. Chloral. Nitro-glycerin. Food. Alcohol. Amyl Nitrite. Alcohol. Alum. Arsenic. Belladonna. Bismuth. Carbonic Acid. Cerium Oxalate. Chloroform. Carbolic Acid. Creasote. Ether. Ice. Opium. Prussic Acid. Silver Nitrate. Calomel Ipecac Hot Water. small doses. Vomiting being set up by irritation of many afferent nerves from various regions of the body, or by impulses from the brain excited through impres- sions on the nerves of special sense, the measures for combating it are very diversified. (Compare the title Vomiting in Part III.) Gastric Pain is best treated by such local sedatives as Bismuth, Hydrocy- anic Acid, or small doses of Morphine, Arsenic and Belladonna. 416 AGENTS ACTING O'N THE DIGESTIVE SYSTEM. Carminatives (carmino, to soothe),—aid the expulsion of gas from the stomach and intestines, by increasing peristalsis, stimu- lating the circulation, and relaxing the cardiac and pyloric orifices of the stomach. They also act as diffusible stimulants, both of the bodily and mental faculties. The principal carmina- tives belong to the aromatic oils, alcohols or ethers, and are embraced in the following list:— Asafetida. Capsicum. Cardamom. Chloroform. Ether. Fennel. Ginger. Horse-radish. Mace. Mustard. Pepper. Spirits. Oil of Anise. Oil of Cajuput. Oil of Caraway. Oil of Cinnamon. Oil of Cloves. Oil of Coriander. Oil of Eucalyptus. Oil of Fennel. Oil of Peppermint. Oil of Spearmint. Oil of Nutmeg. Oil of Pimento. Oil of Valerian. Camp hor. Serpentaria. Cathartics or Purgatives (xadaipu>, purgo, to cleanse),— are agents which increase or hasten the intestinal evacuations. According to their respective degrees and direction of action they are subdivided into several groups, as follows :— Laxatives (laxo, to loose), or Aperients (aperio, to open),— include those which excite moderate peristalsis, and produce soft- ened motions without irritation. Sulphur is the typical laxative. Simple Purgatives,—increase peristalsis actively, and stimulate the secretions of the intestinal glands, producing one or more copious and semifluid motions with some irritation and griping. Senna is the type of this group. Drastic Purgatives {ppaw, to act),—act still more intensely, producing violent peristalsis and watery stools, with much grip- ing pain, tenesmus and borborygmi. They irritate the intestinal mucous membrane, cause exosmosis of serum from its vessels, and in large dose set up inflammation and symptoms of irritant poisoning. Jalap is a typical drastic. Saline Purgatives,—consist of the neutral salts of metals of the alkalies or alkaline earths. They stimulate the glands, increase peristalsis, promote osmosis and cause free watery evacuations. Magnesium Sulphate is a typical saline. Hydragogue Purgatives (j'Aiop, water, ayo>, to bring away),— include the most active of the drastic and saline groups, those which remove a large quantity of water from the vessels. Ela- terium is a typical hydragogue. Cholagogue Purgatives {yy'/p, bile, aym, to bring away),—are those agents which stimulate the flow of bile and produce free AGENTS ACTING ON THE DIGESTIVE SYSTEM. 417 purgation at the same time, the stools being green-colored, or “ bilious,” and liquid. Podophyllin is the type of this group. The principal Cathartics are the following named :— Laxatives. Sulphur. Magnesia. Cassia. Manna. Figs. Prunes. Tamarinds. Honey. Olive Oil. Cascara Sagrada. Physostigma. Ergot. Belladonna. Stramonium. Hyoscyamus, Soap. Almond Oil. Taraxacum. Glycerin. Oatmeal. Bran Biscuit. Brown Bread. Simple Purgatives. Senna. Aloes. Rhubarb. Castor Oil. Rhamnus Frangula. Ox-gall. Calomel. Drastics. Jalap. Colocynth. Elaterium. Scammony. Gamboge. Croton Oil. Small doses of drastics, salines or cholagogues. Saline Purgatives. Magnesium Sulphate. Magnesium Citrate. Potassium Sulphate. Potassium Tartrate. Potassium Bitartrate. Sodium Sulphate. Sodium Phosphate. Sodium Chloride. Pot. et Sodium Tartrate. Manganese Sulphate. Hydragogues. Elaterium. Gamboge. Potas. Bitartrate. Croton Oil. Salines in large doses. Cholagogues. Mercurials. Aloes. Rhubarb. Euonymin. Podophyllin. Iridin. Intestinal Astringents, contract the walls of the intestinal vessels, diminishing the exudation therefrom, and lessening the fluidity of the faecal discharges. The more powerful members of this group have also a constringing action on the intestinal mucous membrane. The principal agents of this class are the following :— Astringents. Phosphoric Acid. Nitric Acid. Sulphuric Acid. Acetic Acid. Acetate of Lead. Nitrate of Silver. Constringents. Tannic Acid. Vegetable Astringents. Alum. Oxide of Zinc. Sulphate of Copper. Persalts of Iron. • Diluted. Hepatic Stimulants and Cholagogues bile, ayw, to bring away),—are two groups of agents acting upon the biliary secretion, the first-named increasing the functional activity of the liver and the amount of bile formed, the second removing the bile from the duodenum and preventing its reabsorption into the portal circulation. Some hepatic stimulants are also chola- gogues, others are not, while cholagogues proper generally act as 418 AGENTS ACTING ON THE DIGESTIVE SYSTEM. hepatic stimulants by carrying off the bile and so indirectly urging the liver to secrete more. The discovery of the entero- hepatic circulation of bile has cleared up many of the discrepan- cies formerly existing with regard to the action of drugs upon this gland and its secretion. The following list includes the principal drugs belonging to both groups:— Aloes. Podophyllin. Mercuric Chloride. Sodium Benzoate. Phosphate. Salicylate. Nitro-hydrochloric Acid. Euonymin. Iridin. I’hytolaccin. Sanguinarin. Antimony. Arsenic. Ipecacuanha. Colchicin. Colocynth. Rhubarb. Hepatic Stimulants. Potassium Sulphate. Sodium Sulphate. Bicarbonate. Ammonium Benzoate. Chloride. Nitric Acid (dilute). Benzoic Acid. Baptisin. Hydrastin. Juglandin. Leptandrin. Jalapin. Scammony. Guaiac. Sarsaparilla. Physostigma. Rochelle Salt. Cholagogues. Aloes. Podophyllin. Mercurous Chloride. Pil. Hydrargyri. Mercury with Chalk. Sodium Phosphate. Sulphate. Potassium Sulphate. Colchicum. Colocynth. Rhubarb. Arsenic. Euonymin. Scammony. Baptisin. Jalapin. Iridin. Those in the first column are the most powerful of the stimulant group, the second column including the less efficient agents. To secure the best chola- gogue effect it is advisable to combine an hepatic stimulant with an intestinal stimulant which shall produce increased secretion from the intestinal mucous membrane and excite peristalsis. The Glycogenic Function of the liver, and the production of urea are stimulated by the following-named drugs:— Lncreasing Glycogen. Nitrite of Amyl. Sodium Bicarbonate. Nitro-hydrochloric Acid. Increasing Urea. Arsenic. Iron. Antimony. Phosphorus. Ammonium Chloride. Hepatic Depressants are agents which lower the functional activity of the liver, reducing the quantity of bile secreted, and lessening the production of glycogen and urea. They are as follows, viz.:— Lessening Bile. Opium. Morphine. Many Purgatives. Acetate of Lead. Quinine (?). Alcohol (?). Diminishing Glycogen. Opium. Morphine. Codeine. Phosphorus. Arsenic. Antimony. Lessening Urea. Opium. Morphine. Colchicum. Alcohol. Quinine. AGENTS ACTING ON METABOLISM. 419 Many purgatives act as hepatic depressants and diminish the secretion of bile by lowering the blood-pressure in the liver, and by carrying off the ma- terials from which bile might be formed. Pancreatic Stimulation may be obtained by the adminis- tration of Ether, or by Galvanism of the gland itself. It is depressed by Atropine and by inducing nausea and vomiting. Anthelmintics (dm', against, iXfuvs, a worm),—are agents which destroy (vermicides) or cause the expulsion (vermifuges) of intestinal worms. The chief vermifuges are Castor Oil, Jalap and Scammony, while the*vermicides may be enumerated as fol- lows, viz.:— Thread Worms. (Oxyuris Vermicular is!) Alum. Sulphate of Iron. Lime-water. Quassia. Eucalyptol. Sodium Chloride. Tannin. Veg. Astringents. Round Worms. (Ascaris Lumbricoides.) Santonica. Santonin. Spigelia. Chenopodium. Azedarach. Tapeworms. (Tcenice, etc.) Filix Mas. Kamala. Kousso. Granatum. Pelletierine. Pepo. Turpentine. Chloroform. Senna. Calomel. _ with the above. The substances enumerated in the first column are all used locally by enema. Adjuncts to these remedies are such agents as prevent the excessive secretion of intestinal mucus, which affords a nidus for the worms. Such are Bitter Tonics and preparations of Iron, also Ammonium Chloride and Sodium Chloride. Agents Acting on Metabolism. Restoratives,—are agents which promote constructive meta- morphosis, including the Foods, Haematics, and Tonics, as well as many agents called Stimulants in other classifications. Foods,—are substances which, when introduced into the body, supply material to renew some structure or to maintain some vital process; being distinguished from medicines in that the latter modify some vital action but supply no material to sustain such. ' The food of man is derived from all three of the kingdoms of nature, viz., the mineral, vegetable and animal, and includes many substances treated of in the Materia Medica, as Oils and Fats, Sugar, Starch, Gum, Alcohol, Bev- erages like Coffee and Tea, Water, Phosphate of Lime, Chloride of Sodium, etc. Hcetnatics (al[ia, the blood),—are medicines which augment the quantity of haematin in the blood, and thus restore the quality 420 AGENTS ACTING ON METABOLISM. of that tissue by enriching its red corpuscles. They consist chiefly of Iron and Manganese and their compounds. Tonics (t6vo<;, tension),—are agents which improve the tone of the tissues on which they have specific action, restoring energy and strength to debilitated subjects, by a scarcely perceptible stimulation of all the vital functions, their effects being apparent in an increased vigor of the entire system. The chief tonics are enumerated in the foregoing lists under the heads of the organs or tissues particularly affected by them. (Compare the titles Stimulants, Respiratory Stimulants, Cardiac Tonics, Vascular Tonics, Gastric Tonics, etc.) The most typical medicinal agents which* impart a general sense of tone and strength are Strychnine, Quinine, Iron, and Vegetable Bitters. Those especially acting upon the stomach are Arsenic, Bismuth, Cinchona, Hydrastis and Nux Vomica,—on the spinal cord and general circulation, Strychnine,— on the heart, Digitalis, Squill, Convallaria and Cimicifuga,—on the nervous system, Phosphorus, Quinine and the Valerianates,—on muscular tissue, Tan- nin,—on the blood, Iron, Manganese, Cod-liver Oil, and other fats. Alteratives,—are certain remedies which alter the course of morbid conditions in some way not yet understood, perhaps by promoting metabolism. They certainly modify the nutritive processes and thereby cure many diseases of chronic type. Mer- cury and Iodine are the most prominent agents of this class, the former being endowed with the power of breaking up newly de- posited fibrin, and disorganizing syphilitic deposits, while the latter acts energetically upon the lymphatic system and promotes absorption. Arsenic also is almost specific in many chronic skin affections, and has remarkable power over chronic pulmonary consolidations, probably producing fatty degeneration and soft- ening of the effusion, so that it may be absorbed or expectorated. The principal alteratives are:— Arsenic. Antimony. Aurum. Mezereum. Sulphur. Sulphides. Mercury. Colchicum. Guaiacum. Sanguinaria. Xanthoxylum. Calcium Chloride. Iodine. Iodides. Stillingia. Sarsaparilla. Cod-liver Oil. Phosphorus. Certain therapeutists of laboratory type have, of late years, seen fit to de- nounce the term Alterative as “ a cloak for ignorance,” but have never been able to present a better designation for a class of agents whose effects are among the most thoroughly established of chemical facts. Resolvents or Discutients (resolvo, to unbind, discutio, to dissipate),—are agents which promote the absorption of inflam- matory products or other materials of morbid origin, apparently AGENTS ACTING ON METABOLISM. 421 by stimulation of the lymphatic system. They include Mercury, Arsenic, Iodine and Cadmium, as well as such local measures as Poulticing and Counter-irritation. The Destructive Metamorphosis of the body is promoted by a number of agents, most of which are classed as Alteratives or Astringents, and the most important of which are the follow- ing-named :— Alkalies. Vegetable Acids. Metals and their salts. Colchicum. Sulphides and Iodides. Sarsaparilla. Stillingta. Xanthoxylum. On the other hand, Metabolism may be diminished by many substances, the following-named being the chief ones,— Tannic and Gallic Acids, and substances containing them. Alcohol. Glycerin. Oils and Fats. Salicin. Salicylates. Quinine. Resorcin. Chinoline. Kairine. Antipyretics (am", against, nuperds, fever),—are agents or measures which reduce the body-temperature when abnormally high. This may be done by two principal methods, and the agents doing either accomplish the result by different actions, as follows, viz.— By Lessening the Production of Heat, by 1. Diminishing tissue-change. 2. Reducing the circulation. or by Promoting the Loss of Heat, by 3. Dilating cutaneous vessels, and producing increased radiation. 4. Producing perspiration, and its evaporation. 5. Abstracting heat from the body. The following list contains nearly all the antipyretics, the number following each referring to its proper method of action, as enumerated above :— Quinine.1 Quinidine.1 Cinchonine.1 Cinchonidine.1 Berberine.1 Benzoic Acid.1 Carbolic Acid.1 Picric Acid.1 Salicin.1 Salicylic Acid.1 Sodium Salicylate.1,4 Quinine Salicylate.1 Methyl Salicylate.1 (Oil of Gaultheria.) Trirnethylamine.2 Chinoline.1 Resorcin.1 Kairine.1, 4 Kairoline. 4,4 Antipyrine. *,4 Hydroquinone.1 Thallin.1,4 Pyrocatechin.1 Pheno-resorcin.1 Camphor.1 Eucalyptol.1 Thymol.1 Other Essential Oils.1 Alcohol1,3 Digitalis.2 Aconite.2 Antimonials.2,4 Veratrine.2 Colchicum.2 Leeching.2 Cupping.2 Blistering.2 Poulticing.2 Nitrous Ether.5,4 Dover’s Powder.4 Cold Bath.5 Cold Drinks.5 Ice to Surface.5 Cold Sponging.5 Wet Packing.5 422 AGENTS ACTING' UPON EXCRETION Purgation and Venesection produce antipyretic results, but their mode of action is doubtful (Brunton). For the action of some unofficial antipyretics, see page 151. Antiphlogistics (dm, against, (phyw, to burn),—are measures and medicines which are supposed to have some specific power in reducing inflammation. The term is becoming obsolete, but frequent references are seen yet to the influence of Mercury and Opium in inflamrnations of serous membranes, Antimony and Aconite in inflammations of the respiratory tract and organs, and to the power of Veratrum Viride over puerperal metritis. The chief antiphlogistics are the following: — Aconite. Veratrum Viride. Tartar Emetic. Mercury. Opium. Digitalis. Ergot. Ipecacuanha. Potassium Nitrate. Rest, recumbent position. Venesection. Local Depletion. Purgation. Counter-irritation. Cold. Antiperiodics are remedies which affect certain periodical febrile diseases, lessening the severity of their paroxysms or pre- venting their return. They act probably by arresting the devel- opment in the blood of successive crops of pathogenic organisms, upon which the disorders are supposed to depend. The principal antiperiodics are: Cinchona Bark and its Alkaloids. Bebeeru Bark and its Alkaloid. Salicin, Salicylic Acid, Salicylates. Arsenic. Eucalyptol. Iodine. Agents Acting upon Excretion. Diuretics (dioupnurination),—are remedies which increase the renal secretion. They may act in several ways, namely: — 1. By raising the general blood-pressure by contraction of efferent vessels or vessels in other regions of the body. 2. By dilating the renal arteries and increasing the renal blood-supply, raising the pressure in the glomeruli. 3. By stimulating the secreting nerves or cells of the kidney. 4. By simply washing out the kidneys, as by Water in quantity. The following list contains the most important agents of this class, which are usually subdivided into the two groups indicated by the sub-titles. The numbers refer to the action of the drug in the above synopsis: AGENTS ACTING UPON EXCRETION. 423 Refrigerant Diuretics. Potassium Acetate.3 Potassium Bitartrate.3 Potassium Citrate.3 Potassium Chlorate.3 Potassium Nitrate.3 Sodium Acetate.3 Sodium Chloride.3 Digitalis.1,2 Erythrophloeum.1 Caffeine.3 Broom.3 Squill.1,2 Nitrites.2 Colchicum.3 Strychnine.1 Stigmata Maidis.1,2 Stimulant Diuretics. Alcohol.2 . Cantharides.3 Turpentine.3 Juniper.3 Savine.3 Copaiba.3 Cubebs.3 Pepper.3 Matico.3 Kava.3 Guaiac.3 Parsley.3 Taraxacum.3 Jaborandi.3 Dulcamara.3 Bryonia.3 Gin.2 Carrot.3 Fennel.3 Mustard.3 Asparagus.8 Uva Ursi.3 Buchu.3 Sarsaparilla.3 Pareira.3 Chimaphila.8 Santonica.3 Lobelia.3 Aconite.8 Tobacco.1,3 Volatile Oils.3 Oleo-resins.3 Diuretics are employed for the following purposes, namely, (i) to remove the excess of fluid in dropsies,—(2) to hasten the elimination of waste products and other poisonous substances from the blood,—(3) to dilute the urine. In— Cardiac Dropsy,—or other dropsies .due to venous congestion, the best diuretics are those which act on the general vascular system, as Digitalis, Squill, etc. Dropsy from Renal Disease,—Broom, Nitrous Ether, Oil of Juniper, Digi- talis and Squill are the most reliable diuretics in the order named. Hepatic Dropsy,—Copaiba is considered especially suitable. In this and the previous form a little Pil. Hydrargyri occasionally often aids the diuretic action of other agents. To Eliminate Solids,—Potassium Nitrate and Bitartrate, Turpentine, Ju- niper, Caffeine, etc., are the most efficient. [Compare Antilithics.] To Dilute the Urine,—Water is the best diuretic, and the most efficient form is Distilled Water acidified with Carbonic Acid Gas. Renal Depressants,—are such agents as directly diminish the activity of the renal cells and lessen or suspend the secretion of urine. Morphine, Quinine and Ergot act in this way through the circulation, and Digitalis, instead of acting as a diuretic, may arrest the renal circulation by stimulating the vaso-motor centre and thus contracting the vessels stopping.the secretion altogether (Brunton). Alkalinizers of the Urine,—are agents which produce an alkaline reaction to the urine when taken internally. They in- clude the alkalies, particularly Potassium and Lithium salts, but excepting Ammonia, which is broken up in the organism. Sodium salts, being excreted partly by the bile and the bronchial mucus, and partly locked up in the system as the neutral chloride, while the Urate of Sodium is insoluble, are not as efficient in this re- 424 AGENTS ACTING UPON EXCRETION. gard as are other alkalies. Fruits, milk and fish also act in the same manner by means of the salts which they convey into the economy. Acidifiers of the Urine,—are Benzoic and Salicylic Acids, and Vegetable Acids in excess, also excess of proteids, sugar and starch in the food, and certain wines and spirits. The Mineral Acids have little or no influence on the acidity of the urine, being excreted as neutral sulphates, chlorides, phosphates, etc. Vesical Sedatives,—are substances which lessen irritability of the bladder, relieving pain and decreasing the desire to mic- turate. Opium, Belladonna, Hyoscyamus, Stigmata Maidis, Cannabis, etc., lessen the irritability of the nerves, Carbonate of Lime that due to the presence of calculi,—and mucilaginous drinks, such as Barley-water or Linseed tea, also astringents like Buchu, Uva Ursi, Pareira, etc., diminish the irritation due to chronic cystitis, and antiseptics as Copaiba and Cubebs, also act in like manner. Vesical Tonics,—increase the contractile power of the mus- cular fibres in the wall of the bladder. Cantharides, Potassium Bromide, Strychnine and Belladonna are the most prominent members of this class. Urinary Sedatives and Astringents,—act upon the whole extent of the genito-urinary mucous membrane through the con- tact of the urine charged with them when administered internally. Some, of the members of this class may be administered locally, as to the urethral and vesical mucous membranes, which are acces- sible to local medication. Instances of the application of these agents are in the use of Potassium and Lithium Salts to diminish the acidity of the secretion,—Cubebs, Copaiba and Sandal-wood Oil as antiseptics and astringents,—and urethral injections of Alum, Acetates of Zinc and Lead, Boracic Acid, Chloral and Zinc Chlo- rides, etc., for a similar purpose. Copaiba is one of the most efficient agents for rendering the urine antiseptic, and should be more employed in cystitis and urethritis than it is. Oil of Eucalyptus is nearly as efficient, and Stigmata Maidis (Corn Silk), in tincture, is beginning to be well thought of for a gen- eral alterative influence on the urinary tract. Antilithics or Lithontriptics (am', against, M6oq, a stone, rptfw, to wear down),—are agents supposed to prevent the forma- AGENTS ACTING UPON EXCRETION. 425 tion of concretions in the excretory passages (antilithics), or to dissolve them when formed (lithontriptics). The terms are gen- erally restricted to remedies affecting the urinary calculi, but those directed against the biliary form are included in this ar- rangement for the sake of consistent classification. The chief agents coming under this title are— Biliary Calculi. Ether and Turpentine. (Durande’s Solvent.) Sodium Bicarbonate. Sodium Salicylate. Sodium Phosphate. Castile Soap. Alkaline Waters, especially Vichy. Uric Acid or Urates. Distilled Water. Alkalies, Potash or Lithia. Potassium Salts. Lithium Salts. Potassium Tartraborate. Magnesium Citroborate. Oxalate of Calcium. Dilute Nitro-Hydrochloric Acid. Pkosphatic Calculi. Ammonium Benzoate. Benzoic Acid. Dilute Nitric Acid. There is probably little or no solvent value to the agents recommended for biliary calculi. In the case of Uric Acid the administration of Potash or Lithia is based on their combining with the acid forming the calculus, and forming Urate of Potassium or Lithium, which salts are more soluble than the Uric Acid itself. Diluents (diluo, to dilute),—are agents which dilute the ex- cretory fluids after their absorption and enable the latter to hold more sfolid material in suspension. Water is the one true diluent, whatever form it may be disguised in, as teas, weak fluid foods, acid drinks, etc. Diaphoretics and Sudorifics (Siapopiw, to carry through; sudor, sweat, facio, to make),—are remedies which increase the action of the skin and promote the secretion of sweat. When they act energetically, so that the perspiration stands in beads upon the surface they are known as Sudorifics. They may be subdivided into the following groups, viz.— 1. Simple Diaphoretics, which enter the circulation and are eliminated by the sudoriferous glands, which they stimulate to increased action. 2. Nauseating Diaphoretics, which produce relaxation and the dilatation of the superficial capillaries. 3. Refrigerant Diaphoretics, which reduce the circulation, at the same time acting directly on the sweat centres in the spinal cord and medulla. The principal diaphoretics are enumerated as follows, the figures referring to their supposed mode of action as indicated above, viz. 426 AGENTS ACTING ON THE GENERATIVE SYSTEM. Jaborandi.*,3 Pilocarpine.1,® Salicylic Acid.1 Salicylates.1 Ipecacuanha.2 Tartar Emetic.2 Sulphur.1 Opium.2,® Camphor.1 Tobacco.2,® Ether.2,® Alcohol.2,® . Nitrous Ether.2,3 Ammonium Acetate.1 Ammonium Citrate.1 Dover’s Powder.2 Aconite.® Veratrum Viride.® Potassium Salts.® Mezereon.1 Lobelia.2,® Sarsaparilla.1 Guaiacum.1 Serpentaria.1 Sassafras.1 Senega.1 Vapor Bath.2 Turkish Bath.2 Wet Pack.2 Warm Drinks.2 Anhidrotics (&v, without, Idpux;, sweat),—are agents which check perspiration. They may act— 1. By depressing the action of the sweat-glands. 2. By depressing the excitability of the sweat-centres. 3. By reducing the circulation in the skin. The most important agents of this class are the following- named, the figures indicating their mode of action as above ar- ranged, viz.:— Belladonna.1 Atropine.1 Hyoscyamus.1 Stramonium.1 Muscarine.2 Agaricus Albus.2 Acids, locally.® Jaborandi. Pilocarpine. Nux Vomica. Strychnine. Ergot.3 Quinine ? Picrotoxin. Dover’s Powder. Opium.2 Zinc Salts.® Local Cold.® Strychnine, Atropine, Dover’s Powder, Jaborandi, Picrotoxin and Zinc Salts, are all respiratory stimulants, and very efficient against the sweating of phthisis, though most of them are classed as diaphoretics. This is explained on the theory of accumulation of Carbonic Acid in the blood by depressed respiration caused by severe coughing, this stimulating the sweat centres, and being opposed by agents which stimulate the respiratory centre. Agents Acting on the Generative System. Aphrodisiacs A h h Calomel, %, 1, 2, 3, 5. Calomel 2, Opium 1. Camphor Monobromated, 2, 3, 5. Cathartic Comp. (Ui S. P.) and Imp’vd. Cerium Oxalate, 2. Cinchona Alkaloids (Mixed). Cinchonine Sulphate, 2, 3, 4, 5. Cinchonidine Sulphate, 2, 3, 4, 5. Codeine, y. Digitaline, Extract of Cannabis Indica, y. Extract of Ignatia Amara, y, yz. Extract of Nux Vomica, y, y.. Ferrum (Quevenne’s), 1, 2. Ferrum Arseniate, )/&,%. Proto-carb., 3, 5. Lactate, 1. Pyrophosphate, 2. and Quinine Citrate, 2, 3, 5. Hydrargyrum, 1, 3, 5. Chlor. Corros., y^. Iod. Rub., yJj. Proto-Iodide, T\j, J, £. Ipecac, et Opii, 2, 3, 5. Morphine Sulphate, , f, £, }, £. Opium Deodorized, 1. Opium y, and Lead Acetate 1 y. Pepsin Sacch., 2, 5. Podophyllin, T\, %, y, y, 1, 2. Potassium Bromide, 5, 10. Chlorate, 5. Iodide, 5. Nitrate, 5. Permanganate, y, 1, 2. Quinine Bisulphate, ]/z, 1, 2,3, 4, 5. Salicylate, 2. —- Sulphate, yz, 1, 2, 3, 4, 5. Quinquinine, 2, 3. Rhubarb, 3. Rhei Co. (U. S. P.). Rhei 2, et Magnesiae 2. Salicin, 5. Santonin, 1. Santonin 1, et Calomel 1. Sodium Bicarbonate, 5. Salicylate, 3, 5. Strychnine, yfo, fo up to . Zinc Phosphide, y up to The following prescriptions represent the composition of a few unofficial pills in general use. A complete pill formulary is easily obtained, being published annually by each of the principal manufacturers. Pills of Iron. R. Ferri Reducti, . . gr. 1. Mannae, . . . gr. xv. Glucosi, q. s. Fiat massa, et div. in pil. xxv. Sig.—One after each meal. Astringent Pill, R. Plumbi Acetatis, . . gr. xvj. Pulv. Camphorae, . . gr. xij. Pulv. Opii, . . . gr. iij. Bismuthi Subcarb., . gr. xij. Ext. Gentianse, q. s. Fiat massa, et div. in pil. xij. Sig.—One thrice daily. Emmenagogue Pill ( Otto). R. Ferri Sulph. Exsic., . gr. xlviij. Pulv. Aloes, . . gr. xij. Terebinthinae, . . gr. xxxij. 01. Terebinth., . . ntx. Fiat massa, et div. in pil. xxx. Sig.—Two, three times a day. Astringent Pill. R. Argenti Nitratis, . gr. xx. Pulv. Cretae (Gallicae), gr. lxxx. Petrolati, q. s. Fiat massa et div. in pil. xl. EXTEMPORANEOUS PREPARATIONS. 503 Hooper's Female Pills. R. Pulv. Aloes Socot., . gr. xlviij. Ferri Sulph. Exsic., . gr. xxiv. Ext. Hellebori Nig., Pulv. Myrrhae, Saponis, . . aa gr. xij. Pulv. Canellae Alb., Pulv. Zingiberis, aa gr. vj. Aquae vel Syrupi, q. s. • Fiat massa, et div. in pil., quisque pondo gr. ijss. Sig.—One to three at a dose. Cholagogue Pills (Squibb). R. Resinae Podophylli, . gr. vj. Ext. Belladon. Alcohol., gr. iij. Pulv. Capsici, Pulv. Sacch. Lactis, aagr. xxiv. Pulv. Acaciae, . . gr. vj. Glycerini, Syrupi, q. s. Fiat massa, et div. in pil. xxiv. Sig.—One or two as required. Aperient Pills. R. Pulv. Aloes Socot., . gr. xxiv. Pulv. Rhei, . . gr. xlviij. Hydrarg. Chlor. Mitis, gr. iv. Ant. et Potas. Tart., . gr. ij. Fiat massa, et div. in pil. xxiv. Sig.—One or two as needed. Tonic Pill for Women. R. Strychninae Sulph., Ac. Arseniosi, . aa gr. j. Ext. Belladonnae, . gr. v. Quininae Sulph., . gr. xxxv. Massae Ferri Carb., . gr. xc. Fiat massa, et div. in pil. xxxv. Sig.—One three times daily. Anti-bilious Pills. R. Pulv. Scammonii, Pulv. Aloes Socot., Pulv. Gambogiae, Hydrarg. Chlor. Mitis, Potass. Bitart., . . aa gr. xx. Ext. Taraxaci, q. s. Fiat massa, et div. in pil. xx. Anaphrodisiac and Sedative. R. Camphorae,. . . gr. xxx. Lupulini, . . . gr. xx. Fiat massa, et div. in pil. xx. Sig.—One thrice daily. Gelatin Capsules are to be obtained from the drug stores of various sizes from o to io. They are a convenient means of ad- ministering oils or nauseous solids, and when filled may be swal- lowed as easily as a large pill. By some of the manufacturers Soluble Elastic Capsules are prepared, each containing an ordi- nary dose of such medicines as Castor Oil, Cod-liver Oil, etc. The largest of these capsules makes a bolus which may be swal- lowed with a little effort, as it is quite compressible and changes its shape to suit the calibre of the passage. The ordinary cap- sules are easily filled by the aid of a paper funnel, and the end of a pen-holder as a packer; but simple devices {capsule-fillers') may be obtained for the purpose of facilitating the operation. R. Pulv. Opii, . . . gr. x. Pulv. Camphorae, . . gr. xx Sacch Alb., q. s. Trit., et fiant capsulse x. Sig.—One at bedtime for chordee: repeat in two hours if necessary. R. Copaibae,.... Oleo-resinse Cubebae, . sjss. M., et Rant capsulse xij. . Sig.—Two capsules three times daily, soon after meals, for gonor- rhcea. 504 EXTEMPORANEOUS PREPARATIONS. Troches (Trochisci),—also named Tablets, Pastilles, Loz- enges, etc., and Compressed Pills, are not readily compounded at the dispensing counter, but may be obtained in all first-class shops, being prepared in great variety by the manufacturers. Be- sides the official Troches (see ante, page 461), those named in the following list are generally for sale:— Troches (Lozenges). Alum, gr. ij. Alum gr. iy, Catechu gr. ij. Ammonium Chloride gr. ij, and Cu- bebs gr. j. Ammon. Chlor. gr. ij, Liquorice gr. viij. Benzoic Acid, gr. y. Borax, gr. iij. Bismuth, gr. ij, and Charcoal, gr. v. Bronchial,—Ol.-res. Cubebs, gr. Tolu, gr. 1, 01. Sassafras, gr. and Ext. of Liquorice, gr. vij. Brown Mixture. Carbolic Acid, gr. j. Ginger and Sodium Bicarb. Guaiac., gr. ij. Kino, gr. ij. Lettuce, gr. j. Lime-juice. Logwood, gr. ij. Magnesia, gr. iij. Pellitory, gr. j. Pepsin, gr. iij, Charcoal, gr. iij, Magnesia, gr. ij, and Ginger, gr- j- Potassium Bitartrate, gr. iij. Potassium Citrate, gr. iij. Santonin, gr. y, and Calomel, gr. y2. Compressed Tablets. Ammonium Chloride, gr. iij. Charcoal, gr. x. Cocaine Hydrochlorate. Dover’s Powder. Mercury, Yellow Oxide, gr. 54 TS- Pepsin and Pancreatin. Potassium Bicarb., gr. v. Potassium Chlorate, gr. v. Potas. Chlorate and Borax, aa gr. 2Y*- Potas. Chi. and Ammon. Chloride. Spencer’s Chloramine Pastilles. Sodium Bicarb., gr. iv., Ammon Carb., gr. y, 01. Menth. Pip., gtt. 54- Sodium Salicylate, gr. iij. Antiseptic. Hydrarg. Chlor. Corr., gr. vijss. Fehling’s Test for grape-sugar in the urine. Hypodermic Tablets. Morphine Sulphate, gr. to L Morph. Sulph. and Atropine Sulph. Atropine Sulphate, gr. jfo-sV Strychnine Sulphate, gr. Apomorphine Muriate, gr. , y Pilocarpine Muriate, gr. -£$-%■ (And several others.) Confections (Confectiones), and Electuaries (Electuaria), —are very seldom prescribed, and therefore can have but little place in extemporaneous pharmacy. They are medicinal powders, etc., beaten up with sugar, honey or molasses, to the consistence of a thick paste, and are administered with a spoon like preserved fruits. The two official confections are described on page 461, and a few old formulae for similar preparations are given below as pharmaceutical curios. The first is a meritorious prescrip- tion. EXTEMPORANEOUS PREPARATIONS. 505 Electuary for Piles. R. Potassi Bitartratis, Potassii Nitratis, Pulv. Jalapae, . . aa Confectio Sennce, . . Syrupi Zingiberis, q. s. M. Fiat electuarium. Sig.—A piece the size of a marble to be taken thrice daily. The Chelsea Pensioner. R. Sulphuris Loti, . . . ,^ij. Potassii Bitart., . . • §}■ Pulv. Rhei, . . . gij. Guaiaci Resinse, . . Zj. Mellis Despum., . . ftj. Myristicam Pulv., . . j. M. Fiat electuarium. Sig.—A tablespoonful twice daily, as a laxative. Confectio Damocratis. [An ingredient of Warburg’s Tincture.] This preparation was official in the London Pharmacopceia of 1745. It contained 1 grain of Opium in and consisted of 45 ingredients, as fol- lows, viz.: Cinnamon, 14 parts; Myrrh, II parts;—White Agaric, Spikenard, Ginger, Spanish Saffron, Treacle, Mustard Seed, Frankincense and Chian Turpentine, of each 10 parts;—Camel’s Hay, Costus Arabacus, Zedoary, In- dian leaf, Mace, French Lavender, Long Pepper, Seeds of Harwort, Juice of ripe Cistus, strained Storax, Opponex, strained Galbanum, Balsam of Gilead, Oil of Nutmeg, Russian Castor, of each 8 parts;—WaterGermunder, Balsam- tree Fruit, Cubeb, White Pepper, Seeds of Cretian Carrot, Poley Mont, strained Bdellium, of each 7 parts;—Gentian-root, Celtic Hard, Leaves of Dittany of Crete, Red Rose, Seeds of Macedonium, Parsley, Sweet Fennel Seed, Seeds of Lesser Cardamom, Gum Arabic, Opium, of each 5 parts;— Sweet Flag, Wild Valerian, Anise-seed, Sagapenum, of each 3 parts; Spig- rul, St. John’s Wort, Juice of Acacia, Catechu, Dried Bellies of Skunk, of each parts;—the roots finely powdered and the whole mixed thoroughly into a paste with Clarified Honey. Powders (Pulveres),—as prepared extemporaneously are generally compound, and may be mixed on a slab with a spatula, but a much better method of mixing them is by trituration in a mortar. The latter should always be employed except in the case of substances which may explode if so treated, as Potasssium Chlorate with oxidizable substances. (See ante, page 482.) The Diluent best employed in powders is Sugar of Milk, on account of its hardness, its density and its comparative insolubility. A coloring agent, as Carmine in minute quantity, is a useful ingre- dient, enabling the eye to judge of the degree of mixing and subdivision obtained. Powders containing soluble salts, extracts, volatile oils, camphor, or any other hygroscopic or volatile sub- stances, should be dispensed in waxed paper. For ordinary powders the plain white paper of the drug-stores will answer, but a better paper for small powders is one having a high surface finish and made very thin, as the white glazed French demy. Powders are often ordered in Wafers (Cachets), to be swallowed 506 EXTEMPORANEOUS PREPARATIONS. without unfolding. The division of powders into the number of papers (Chartulas) ordered, and folding them neatly, requires a considerable amount of practice. A small machine is used over which the ends of the papers are bent, in order to have them of the proper size for the box in which they are usually dispensed. If they are to be put into an envelope less exactness of folding is required, and the mechanical contrivance may be dispensed with. Substances suitable to administration in the form of powders are those which are insoluble, those which would be chemically incompatible in fluid form, and certain pulverizable extracts. Those which are unsuited to this form are such as have a very nauseous taste or odor, substances of which the dose is large, those which are deliquescent, efflorescent or very volatile, and those which liquefy on mixing. A list of deliquescent and efflorescent salts is found on page 500, while the following named, though dry alone, become moist when triturated together, viz.:— Sodium Sulphate and Potassium Carbonate. Zinc Sulphate and Lead Acetate. Camphor and Chloral Plydrate. Many substances cannot be powdered without the intervention of another body: thus Opium requires a hard substance like Sugar of Milk or Potassium Sulphate, Camphor requires a minute quan- tity of Alcohol, Myrrh needs Sugar or Gum, etc. Substances, as the alkaloids and their salts, which are very active and are used in very small doses, require some inert substance to give them bulk enough for division and handling. Sugar of milk will be found the best agent for this purpose. Prescriptions may order the ingredients for a single powder, with directions to dispense a certain number of the same composition; or they may give the quantities for the whole number of powders ordered, with instruc- tions to divide into a certain number. The dispenser should carefully scan the prescription in order to avoid the multipli- cation of quantities where division is intended. The official powders are enumerated on page 462; and the following formulae will serve to illustrate those generally prescribed. Astringent Powder for Infants. U. Plumbi Acetatis, . . gr. ij. Pulveris Opii, . . gr. ss. Camphone, . . . gr. j. Sacchari Lactis, . . gr. iij. Trit., et div. in chartulas xij. Sig.—One every 2 or 3 hours in diarrhoea of infants. For an adult the above represents one dose. Bismuth and Soda. R. Bismuthi Subnitratis, Sodii Bicarb., . aa Pulv. Zingiberis, . . gr. xl. M., et div. in chartulas xij. Sig.—One after each meal. Corrective in dyspepsia, acne and eczema. EXTEMPORANEOUS PREPARATIONS. 507 Gastric Sedative. R. Bismuthi Subnitratis, . . Pulveris Rhei, Pulveris Aromat., . . aa gss. M., et div. in chartulas vj. Sig.—One before each meal. Antipruritic Powder. 1$. Pulveris Camphorse, . . Zinci Oxidi, . . . giv. Pulv. Amyli, . . . M., et fiat pul vis. Sig.—Use locally as a dusting pow- der to relieve itching. Catarrh Powder. R. Bismuthi Subnitratis, . Jpij. Pulv. Acacise, . . . £j. Pulv. Talc., . . . gij. Morphinae Muriatis,. . • gr. j. M. Sig.—Use by insufflation. Laxative Powder. R. Hydrarg. Chlor. Mitis, . gr x. Sacchari Lactis, . . gr. xx. M., et fiant pulv. x. Sig.—One powder twice daily. Compressed Pills are really powders which have been com- pressed into pill shape by machinery. A little pressure from the blade of a spatula will restore them to powder form. (See ante, page 501.) Triturations (Triturationes),—are powders containing mi- nute doses of very active agents diluted with Sugar of Milk, and possessing a definite relation between the active ingredient and the diluent, namely i in io, according to the general formula of the U. S. Pharmacopoeia, which, as well as the one official tritu- ration, is described on page 462. Sugar of Milk is employed as the diluent because of its hardness and its comparative insolu- bility. The first of these qualities secures the fine comminution of the active ingredient whereby the action of the medicine is increased and better distributed. Its insolubility makes it the best diluent for powders or triturations administered from a spoon or glass with fluid, as is so often done, for unlike cane sugar it is not readily dissolved and does not leave the active substance behind on the surface of the utensil. Triturations are excellent forms for the administration of powerful alkaloids, which may thus be divided with great accuracy into the minute quantities required. Mercury and its salts are especially adapted to this method of preparation, being more uniformly divided and hence more active than when administered in any other form. Tritu- rations of mercury with sugar were commonly used in England a hundred years ago, and triturations of many substances were employed by the Arabian physicians of the 13th century. But the subsequent adoption of these preparations by the homceopa- thists produced such a prejudice against them in the ranks of the regular profession that until recently any one using them stood in danger of being stigmatized as a homoeopath. Their recent recog- 508 EXTEMPORANEOUS PREPARATIONS. nition by the U. S. Pharmacopoeia under their proper title does away with any such implication, though it is much to be regretted that the compilers of the last revision of the British Pharmacopoeia should have shown their fear of a name by continuing the title “ Pulvis Elaterini Compositus” to designate a preparation which in every respect is a trituration. The preparations of Pepsin daily prescribed by physicians all over the country are really sugar - of-milk triturations of that ferment, and not pure Pepsin as many suppose. Prof. H. G. Pififard, Med. Dept. Univ. of the City of New York, in his treatise on the Materia Medica and Thera- peutics of the Skin (N. Y., 1881), after detailing several micro- scopical examinations of pills and triturations, uses the following language: “ It is to be expected, therefore, that the protoiodide trituration will prove, ceteris paribus, more active than the pill, and such we have found it Io- dides of Mercury .... Since we have used the triturations, however, in preference to the ordinary pills, patients more rarely complain of disagreeable sensations. We have been enabled to materially reduce the size of the dose in order to obtain the desired effect. In other words, a larger proportion of the drug is utilized for specific purposes, while but a small amount remains to give rise to local irritation I have nothing to add to this, except that I continue to use triturations of Mercury and other substances with increasing satisfaction. Besides those mentioned I employ Calomel, Cyanide of Mer- cury, Black Oxide of Mercury and Corrosive Sublimate in this form.” The following examples will illustrate the mode in which Trit- urations may be prescribed :— R. Hydrarg. Oxidi Flavi, . gr. ss. Sacchari Lactis, . . gr. 1. Trit., et div. in chartulas xxiv. Sig.—One twice daily. R. Morphinse Sulph., . gr. j. Sacchari Lactis, . . gr. xvj. Trit. et div. in chartulas viij. Sig.—One every six hours. R. Hydrarg. Chi or. Mitis, . gr. x. Sacchari Lactis, q. s. Trit., et div. in chartulas x, Sig.—One powder daily. R. Acidi Arseniosi, . . gr. ss. Sacch. Lactis, . . gr. xl. Trit., et div. in chartulas xx. Sig.—One powder thrice daily. Suppositories (Suppositoria),—are small, conical, medicated bodies intended for introduction into the rectum, uterus, or urethra (bougies), occasionally into the vagina. No official sup- positories are enumerated, but a general formula is prescribed by the pharmacopoeia for their preparation (see ante, page 462). The basis is usually Cacao-butter, but for those intended for the ure- thra or uterus a mixture of Gelatin and Glycerin is considered the best excipient, being firmer and more plastic than cacao- EXTEMPORANEOUS PREPARATIONS. 509 butter, and more easily handled. Hollow cones of cacao-butter, or some composition resembling it, are kept in the shops, and will be used by the average druggist in filling prescriptions for rectal suppositories unless prohibited, as they save him consid- erable labor; the active drug being simply placed in the centre of the cone which is then sealed with a plug fitting in its base. These contrivances are by no means so efficient as the regular suppository, in which the medicinal agent is thoroughly incor- porated with the excipient, for the former smear the rectum with a quantity of melted grease before the active portion of the prep- aration is permitted to come into contact with its walls. The agents used in suppositories are chiefly extracts and alkaloids; some few powders, and a few metallic salts are occasionally em- ployed. Those for the adult rectum should contain from 15 to 30 grains of the excipient, for the vagina a drachm of cacao-butter is the average quantity. Those for the uterus and urethra are made of cylindrical instead of conical form, and about the di- ameter of a No. 9 catheter. The methods of compounding suppositories are two, viz.:—that by the use of moulds (the official method), and that by hand. The former process is described on page 462, but many prefer the hand method, which is as follows: The medicament is mixed with finely shaved Cacao-butter by the aid of a spatula on aboard or tile lightly dusted with Lycopodium or Starch. After a smooth and uniform mixture is thus obtained, the mass may be rolled into cylindrical form, cut into the required sizes and with the spatula given the proper shape. When dispensed, they should be placed in a powder-box, between layers of cotton. Bougies or Pencils, as urethral and uterine suppositories are often termed, may be prepared by melting together White Gela- tin 3, Glycerin 1, and Distilled Water 1 part by weight, then adding the medicament, and drawing the mass into a glass tube previously oiled inside. When cold the bougie may be pushed out and cut into suitable lengths. The Br. Pharmacopoeia describes 8 official suppositories, as fol- lows, viz.— Suppositoria Acidi Carbolici cum Sapone,—Carbolic Acid, 12 grains; Curd Soap, in powder, 180 grains; Glycerin of Starch, 40 grains ; to make 12 sup- positories, each containing x grain of Carbolic Acid. Suppositoria Acidi Tannici,—Tannic Acid, 36 grains ; Oil of Theobroma, 144 grains; to make 12 suppositories, each containing 3 grains of Tannic Acid. Suppositoria Acidi Tannici cum Sapone,—Tannic Acid, 36 grains; Glycerin of Starch, 30 grains; Curd Soap, in powder, 100 grains; Starch in powder q. s.; to make 12 suppositories, each containing 3 grains of Tannic Acid. 510 EXTEMPORANEOUS PREPARATIONS. Suppositoria Hydrargyri,—Mercurial Ointment, 60 grains; Oil of Theo- broma, 120 grains; to make 12 suppositories, each containing 5 grains of Mercurial Ointment. Suppositoria Iodoformi,—Iodoform, 36 grains; Oil of Theobroma, 144 grains; to make 12 suppositories, each containing 3 grains of Iodoform. Suppositoria Morphines,—Morphine Hydrochlorate, 6 grains; Oil of Theo- broma, 174 grains; to make 12 suppositories, each containing grain of the Morphine salt. Suppositoria Morphines cum Sapone,—Morphine Hydrochlorate, 6 grains; Glycerin of Starch, 30 grains; Curd Soap, in powder, 100 grains; Starch, q. s. to make 12 suppositories, each containing grain of the Morphine salt. Suppositoria Plumbi Composita,—Acetate of Lead, 36 grains; Opium, in powder, 12 grains; Oil of Theobroma, 132 grains; to make 12 suppositories, each containing 3 grains of Lead Acetate and 1 grain of Opium. Suppositories and Bougies may be prescribed in the manner illustrated by the following formulae: Anodyne Suppository. R. Ext. Opii, . . . gr. vj. Ext. Belladonnae, . . gr. ss. Ext. Hyoscyami, . . gr. ij. Olei Theobromae, q. s. M. Fiant suppositoria vj. Sig.—One into the rectum morning and night. IVade’s Bougies. R. Iodoformi, . . . gj. Bismuthi Subnitrat., . gj. Chloralis, . . . gr. viij. Morphinae Sulphat., . gr. iij. Ol. Rosae, . . . upx. Gelatini, et Glycerini, q. s. M. Fiant bougia xij. Sig.—One into urethra thrice daily. Anthelmintic. R. Santonini, . . . gr. xij. Olei Theobromae, . • 3j- M. Fiant suppositoria vj. Sig.—One into the rectum as di- rected. Bougie for Gleet. R. Zinci Sulphatis, . . gr. vj. Ac. Carbolici, . . npiij. Pulv. Hydrastis, . . gr. xij. Ext. Belladonnse, . . gr. xij. Gelatini, et Glycerini, q. s. M. Fiant bougia xij. Sig.—One into urethra night and morning. Quinine Suppository. R. Quininse Sulphatis, . . gr. v. Olei Theobromae, . . gr. x. Fiat suppositorium unum, mitte tales sex. Ointments (Unguenta) and Cerates (Cerata),—are fre- quently ordered on extemporaneous formulae, though the 34 official preparations of these classes (see ante, pages 462, 463) would seem to give the physician a sufficiently wide field of selection. The basis used is usually either the official Ceratum or Unguentum, but Petrolatum, Lard, Lead Plaster with a fixed oil, etc., may be used. Lard is probably the best basis for all ointments, as it softens the skin better than any other similar substance. Its dis- advantage is that it soon becomes rancid, so that preparations made with it must be quickly used. Cerates only differ from EXTEMPORANEOUS PREPARATIONS. 511 ointments in their firmer consistence, melting at tempera- tures above 104° F., while the latter melt below the ordi- nary temperature of the body. Oleates are described fully on Page 34. The process of compounding an ointment or a cerate is suffi- ciently simple, being generally a mere matter of triturating the ingredients together in a mortar, or of their incorporation on a slab by means of a spatula. Rarely will melting be required in the compounding of extemporaneous ointments. When extracts, powders or gritty substances are ordered, the ingredients should be first pulverized into a fine powder, then triturated with a small quantity of the basis into a smooth, impalpable paste; the remainder of the basis being added gradually, until the whole is thoroughly incorporated. A warm mortar may be required for hard extracts. Soluble salts should be triturated with a little water before adding the excipient. Camphor needs a little alcohol to enable it to be pulverized; and Iodine should be rubbed to a fine powder, then a little alcohol added and finally the excipient by degrees. Iodide of Sulphur requires persevering work with a small portion of olive oil. Borax should be triturated with glycerin and Red Oxide of Mercury with distilled water. A bone or horn spatula should be used for all ointments, as steel or iron blades will injure many substances, particularly alkaloids, free acids, tannin or iodine, and several of the mercurial salts. Volatile substances should be added last, and quickly worked in, so that their evaporation may be as slight as possible. Ointments are dispensed usually in amber-colored glass pots with wooden or metallic covers, or in porcelain jars called Galli- pots. In hospital and dispensary practice the common chip pill- box is used, but soon becomes excessively dirty and disagreeable to handle. Ung. Iodoformi Compos. R. Iodoformi, . . . sjj. Ol. Anisi, . . . TRxx. Ol. Rosae, Ol. Ylang-ylang, . aa "fRv. Ung. Aquae Rosae, . • §)■ M. Fiat unguentum. Sig.—Ointment. Unguentum Anti-pruriticum. R. Camphorae, Chloralis Hydrat., . aa gj. Tere una ad liquorem, dein adde cum tritu— Unguenti Aquae Rosae, . M. Fiat unguentum. Sig.—Ointment. Plasters (Emplastra),—are rarely prepared extemporaneously, the official and many other ones being produced on a large scale by the manufacturers, and kept in stock by all druggists. As a consequence the compounding and spreading of a plaster by the 512 EXTEMPORANEOUS PREPARATIONS. pharmaceutist has become a lost art. The official plasters are enumerated and described on page 464, and may be ordered by prescription in the manner illustrated below. Blisters may be produced by the application of any preparation of Cantharides sufficiently strong for the purpose. Either of the official Cerates of Cantharides (see page 120), may be spread on Adhesive Plaster (Emplastrum Resinae), making a blistering plaster; or Cantharidal Collodion (see page 120), may be painted over the surface. Plasters are usually ordered by the square inch, but a model of the shape and size may be drawn on paper, and the plaster be directed to conform thereto, as in the first of the following pre- scriptions. Two of the official Papers (Chartae) are practically plasters, viz.—Charta Cantharidis and Charta Sinapis. Emplastrum Vesicatorium. R. Cerati Cantharidis, q. s. Extende supra Emplastrum Resin® hujus form® et magnitudinis. Sig.—Blistering Plaster, to be ap- plied over the region of the heart. Counter-irritant and Anodyne. R. Chart® Sinapis, Emplas. Belladonn®, aa, 3//x6//. Sig.—Apply the mustard paper first, to be followed by the plaster when the surface has been well reddened. Poultices (Cataplasmata),—are usually prepared at the resi- dence of the patient, the ingredients only being ordered from the druggist. They are generally employed as a means of applying heat and moisture to a certain part of the body, but are sometimes medicated with anodyne, counter-irritant or disinfectant agents. Poultices are not official in the U. S. Pharmacopoeia, but are in the British, the following list including all so recognized. . Cataplasma Carbonis,—Wood Charcoal i, Crumb of Bread 4, Linseed Meal .3, Boiling Water 20 parts. Cataplasma Conii,—Hemlock-juice I, evaporated to half its volume, Lin- seed Meal 4, Boiling Water 10 parts. Cataplasma Fermenti,—Beer Yeast 3, Wheaten Flour 7, Water at ioo° F., 3 parts. Cataplasma Lini,—Linseed Meal 2, Boiling Water 5 parts, mixed with constant stirring. Cataplasma Sinapis,—Mustard, Linseed Meal, Boiling Water and Water, of each a sufficiency. Cataplasma Sodee Chlorinates,—Solution of Chlorinated Soda 1, Linseed Meal 2, Boiling Water 4 parts. Paints (Pigmenta),—are preparations for external use, which cannot be classed with the preceding. They are generally pre- scribed in skin-diseases, for use over inflamed joints, or for appli- cation to the throat with a camel’s-hair brush. GASEOUS PREPARATIONS. 513 R. Tinct. Iodi, . . . 5j. ALtheris Fort., . . . giij. Tinct. Aconiti,. . . gss. Ext. Belladon. FI., . . giv. Morph. Sulph., . . gr. ij. Iodi, .... gjss. M. et fiat pigmentum. Sig.—Paint 4 or 5 coats freely over the inflamed and painful parts. R. Alcoholis, Saponis Viridis, Olei Cadini, . . aa gj. M. et fiat pigmentum. Sig.—Paint over the part. R. Olei Tiglii,. . . . gj. Aitheris Fort., . . . gij. Tinct. Iodi, . . . gv. M. Sig.—Paint on once in 3 days. GASEOUS PREPARATIONS. Vapors (Vapores) and Inhalations (Inhalationes),—are medicines in the form of a vapor, a gas or an atomized spray, to be inhaled by the patient for their local action on the respiratory tract. The well-known steam-atomizer is the agent by which most of these preparations are administered, though many sub- stances may be inhaled from the surface of hot-water, from a sponge in a bottle surrounded by a hot cloth, or from a heated shovel. They are prescribed in the usual manner, as follows : — Stimulant Inhalation, R. Olei Cubebae, . . . gij. Magnesii Carbonat., . . gj. Aquae, .... §iij- M. Sig.—A teaspoonful in a pint of water at 150° F., for each inhala- tion. Carbolized Inhalation. R. Acidi Carbolici, . . tqxlviij. Aquae, q. s. , . ad M. Sig,—Use one-half in the cup of a steam-atomizer for each inhala- tion. Oil of Pine. R. Ol. Pini Sylvestris, . . gij. Magnesii Carb., . . gi. Aquae, .... Jiij. M. Sig.—A teaspoonful on a pint of hot water for each inhalation. Tar and Turpentine. R, 01. Picis Liquidae, Ol. Terebinth., . . aa lij. M. Sig.—Pour slowly on a hot shovel in the sick-room, keeping the vapor Confined therein. The official Charta Potassii Nitratis, Nitre-paper (see ante, page 464), is a preparation intended for use as an inhalation, its vapors while burning being taken into the lungs. PART III. SPECIAL THERAPEUTICS. Applied Therapeutics may be studied either with the various therapeutic agents as the objects of chief consideration, as in the first part of this work; or with the different diseases and morbid conditions forming the objects of study in respect to their modification and treatment by medicines. In the following pages the latter method is followed, the therapeutics of each affec- tion being exhibited in the form of an Analytical Index to the recognized text-books of the day. Every indication for the use of a drug, or statement regarding its value, is followed by the initial (in parentheses) of its author: these references enabling the book to be used as an index to the authorities, for more strict differentiation between indicated remedies,—while the brief an- alyses given include enough to make each section a complete synopsis of the most advanced therapeutics of the disease forming its title. The principal authors to whom references are made, and the various initials indicating them, are comprised in the following list. References and Bibliography. (A.) Aitken.—The Science and Practice of Medicine, 7th edition, revised, Philadelphia, 1885. (Ag.) Agtiezv.—The Principles and Practice of Surgery, Philadelphia, 1878, 3 vols. (B.) Bartkolow.—Materia Medica and Therapeutics, 5th edition, New York, 1884. (Br.) Brunton.—Pharmacology, Therapeutics and Materia Medica, Phila- delphia, 1885. (C.) Carter.—A Practical Treatise on Diseases of the Eye, edited by Green, Philadelphia, 1880. (Cl.) Clarke.—A Manual of the Practice of Surgery, New York, 1881. (D.) Druitt.—A Manual of Modern Surgery, 12th edition, London, 1882. (E.) Emmet.—Principles and Practice of Gynaecology, 3d edition, Phila- delphia, 1884. ABDOMINAL PLETHORA. 515 (El.) Ellis.—A Practical Manual of Diseases of Children, 3d edition, London, 1883. (F.) Fothergill.—The Practitioner’s Handbook of Treatment, 2d edition, London, 1884. (G.) Goodell.—Lessons in Gynaecology, Philadelphia, 1882. (H.) Hamilton.—Nervous Diseases, their Description and Treatment, 2d edition, Philadelphia, 1881. (L.) Leishman.—A System of Midwifery, 3d edition, Philadelphia, 1S84. (M. & P.) Meigs and Pepper.—A Practical Treatise on Diseases of Chil- dren, 7th edition, Philadelphia, 1882. (N.) Niemeyer.—A Text-book of Practical Medicine, 9th edition, New York, 1884. (P.) Phillips.—Materia Medica and Therapeutics, revised edition, Phila- delphia and London, 1886. (Pf.) Piffard.—Materia Medica and Therapeutics of the Skin, N. Y. 1881. Editor of Phillips’s Materia Medica and Therapeutics, Vegetable Kingdom, 1879. (R.) Ringer.—A Handbook of Therapeutics, 1 ith edition, New York, 1886. (Ros.) Rosenthal.—A Treatise on Diseases of the Nervous System, New York, 1884. (S.) Stilli.—Therapeutics and Materia Medica, 4th edition, Philadelphia) 1880. (St.) Sturgis.—The Student’s Handbook of Venereal Diseases New York, 1883. (T.) Tanner.—An Index of Diseases ahd their Treatment, 2d edition, Philadelphia, 1882, (Tr.) Trousseau and Pidoux.—A Treatise on Therapeutics, 9th edition, New York, 1880. - (Tt.) Tail.—Diseases of Women, by Lawson Talt, New York, 1879. (W.) Wood, H. C.—Therapeutics, Materia Medica ahd Toxicology, 6th edition, Philadelphia, 1886; (Wa.) Waring.—Practical Therapeutics, 4th edition, edited by Buxton, Philadelphia and London, 1886. Besides the above named, occasional references are made to other works by the same authors. References will also be found, with names in full, to Anstie, Brown-Sequard, Clymer, Cohen, Da Costa, Fordyce-Barker, Gross, Hammond, Hilton, Lister, Mitchell, Nelaton, Noyes, Nussbaum, Ricord, Roosa, Simpson, Thomas, and others. When a statement is not followed by any reference it is to be understood as coming from the writer of this book. Abdominal Plethora. Cathartics. The saline aild hydragogue cathartics are of value in conges- tion of the portal circulation (B.). Saline Mineral Watei's, especially the purgative saline waters, as Vichy and Saratoga, in plethora of the abdominal viscera (B.). Grape-cure has helped many cases, particularly those of he- patic engorgement and sluggish portal circulation; is best used after a pre- liminary course of powerful mineral waters (P.). Aliment is very important. A dry diet is particularly indicated in cases of dyspepsia and hepatic en- largement due to excessive beer-drinking. Avoid much bread, also salted or twice-cooked meats, rich sauces, solid vegetables especially cucumbers, soups and fruit. Biscuits, fresh meat, lemons, fish, fowl and game, may be used. [Compare Hepatic Congestion, Obesity. ] 516 ABORTION—ABSCESS. R. Potassii Bicarbonatis, Sodii Sulphatis, . . an Dissolve in 1)4 pint of Water, and add Acidi Tartarici (cryst.) . gij. Cork quickly and firmly. to be taken thrice daily. Prescriptions. R. Resinse Podophylli, . gr. vj. Ext. Colocynthidis Co., . gr. xij. Ext. Belladonnae, . . gr. iij. Fiat massa, et div. in pil. no. xij. Sig.—One pill every night. Abortion. Opium, cautiously in threatened abortion, is often very valuable (Wa.);— the tincture, Tqxx-xxx by rectum (Parvin);—Opium to check uterine action and Ergot to restrain hemorrhage (B.). Ergot, small tonic doses give excel- lent results in threatened abortion (P.). Tannin, combined with Opium and Ipecac. (Wa.). Cimicifuga, to prevent miscarriage when uterus is irritable and prolapsed (R.). Savine, the dried powder of the leaves, gr. xv-xx, thrice daily, one of the most powerful remedies against the hemorrhage indicative of approaching abortion (Wa.);—the tincture in doses of 5 to 10 drops, every )/2 to 3 hours, useful against the hemorrhage (P.). Aurum Chloride, to avert the tendency to habitual abortion (B.). Iron, with Potassium Chlorate, throughout the pregnancy, when fatty degeneration the cause of habitual abortion (Mc- Lane). Tamponade of the cervix uteri, with cotton or sponge, dipped in vinegar or glycerin, when abortion is inevitable and it is desirable to hasten it and re- strain hemorrhage. Empty uterus thoroughly with the finger, placenta-forceps liable to do harm (Barker). Abortifacients, see pages 207 and 428. Quinine and Ergotin, of each gr. ij in pill every 3 hours, the routine abortifacient of many irregular practitioners. Only by the production of such violent irritation of the abdominal and pelvic organs as generally endangers life, can the pregnant uterus be stimulated to expel its contents (P.). The abortifacient effect of Savine and other drugs cannot be obtained unless by the administration of a quantity sufficient to endanger life (B.). Prescriptions. R. Ext. Ergotse Fluidi, . . gv. Tinct. Opii Deodorat., . Syrupi Limonis, . . M. Sig.—A teaspoonful thrice daily. R. Acidi Tannici, . . gr. xv. Pulv. Ipecacuanhse, . gr. xij. Extractii Opii, . . gr. iij. Ft. pil. xij. Sig.—One every six hours. Abscess. Poultices, to check or to assist in maturation, may be smeared with Bella- donna or Opium (R.). Belladonna, as plaster to subdue (B.); painted around areola (Wa.); internally often successful in aborting (R.). Sulphide of Cal- cium, half-grain doses frequently repeated, to abort abscess or to hasten forma- tion of pus (B.); gr. every hour or two, gives striking results in healing large abscesses (R.). Phosphate of Calcium, in large abscesses (R.). Mercury and Morphine, the Oleate locally, diminishes induration due to old abscesses and prevents the formation of new ones (R.). Carbolic Acid, a weak solution as injection after evacuation, also as a dressing (Lister). Silver Nitrate, a strong solution in Nitrous Ether if applied early to adjacent surface will check inflam- mation (B.). Blisters or Iodine, as counterirritants around or adjacent to seat of disease (R.). Potassium to the pint of water, to correct fetor ACIDITY. 517 (B.). Iodine, the tincture injected after opening large abscesses (R.); especially in scrofulous abscess (Wa.). Salicylic or Boracic Acid, as dressings (B.). Sar- saparilla, a very useful remedy in chronic abscess with profuse discharge (P.). Cod-liver Oil, improves and lessens discharge from scrofulous abscesses (Wa.). Surgical. Opening necessary in all deep abscesses, or when on face, near anus, mammary, or if danger of its opening into an internal cavity. Open with grooved director and forceps (Hilton). Never open a deep abscess with a plunge. Drainage-tube may be required, also irrigation of the cavity and pressure (Agnew). Weaning of child necessary in chronic mammary abscess (Gross). Psoas abscess may result from strain or laceration of muscle, as by heavy lifting, effort to recover balance when skating, etc., as well as from spinal disease. Symptoms often obscure and simulating those of chronic ma- laria. Early opening by lumbar incision necessary; then tonics, good food, and daily irrigation of the cavity with an antiseptic solution. [Compare Sup- puration, Carbuncle.] Prescriptions. R. Syrupi Ferri, Quininse et Strychninse Phosphatum, Sig.—A teaspoonful in water thrice daily. To repair waste from suppura- tion. R. Quininise Sulph., . . gj. Ferri Pyrophosphatis, . gj. Strychninse Sulph., . . gr. j, Ac. Phosphor. Dil.,. . Syrupi Zingiberis, . 5ij. Aquae, q. s. . . ad M. ft. mistura. Sig.—A teaspoon- ful thrice daily. R. Syrupi Hypophosphitum, . Sig.—A dessertspoonful thrice daily. Acidity. Acids, Hydrochloric or Phosphoric before meals; acid wine, a genuine Rhine wine best; Sulphurous Acid nqv-xxx well diluted; for acid fermenta- tion of starchy foods (R.); acids after meals for alkaline pyrosis (R.). Tan- nic Acid, useful in pill,gr iv. with nqj of glycerin (B.). Carbolic Acid, often arrests eructations (B.). Alkalies, after meals for immediate relief, effects only temporary, bicarbonate best (R.); frequent use of alkalies enhances the mischief (B.). Nux Vomica, gtt. ij-iij of tincture before meals, excellent in small doses (B.) ; especially in acidity of pregnancy (R.), Pulsatilla, gtt. v of tincture every 4 hours in acid dyspepsia (P.). Silver Oxide, extremely useful (B.). Manganese Oxide, gr. x-xx of the purified black oxide relieves (B.). Kino, a favorite remedy (B.). Ipecacuanha, in acidity of pregnancy (R.h Mercury, gr. ss of gray powder ter in die, when acidity with clayey stools (R.). Bismuth gives excellent results, combined with Opium or Mor- phine, sometimes with Magnesia (R.). Diet. Use lemon-juice, aerated or old bread, plain biscuits. Avoid new bread, pastry and vegetables. Prescriptions. R. Bismuthi Subnitrat., , Acidi Carbolici, . . gr. ij-v. Mucil. Acaciae, . . %j. Aq. Menth. Pip.,. . M. Sig.—A Thblespoonful 3 or 4 times daily for adults. R. Sodii Bicarb., . . Spt. Ammonise Aromat., . %i). Tinct. Zingiberis, . . gj. Infus. Gentianse Co. (U. S. P., 1870), q. s. ad M. Sig.—A tablespoonful or two. 518 ACNE. Acne. Alkalies, internally yield the best results in a number of cases (Bulkley); alkaline lotions for cases with seborrhoea (B.). Borax, a weak solution in rose-water of great benefit locally in acne simplex (Wa.). Po- tassium Bromide, in moderate doses has proved curative in some obstinate cases (R.). Sulphur, internally and as a lotion. In severe forms an ointment of the iodide or hypochlorite, ad (R.). Belladonna locally, is of some service, checking the abundant secretion from the sebaceous follicles (R.). Arsenic, in old cases, especially in acne indurata, but often disappoints. Given with bromides it prevents the bromic acne (R.). Phosphorus, is an excellent substitute for arsenic (B.); the compound syrup of the hypophosphites in acne indurata (R.). Mercury, in lotion is much employed (B.); a weak lotion of the bichloride to the face two or three times daily (R.). The iodo-chloride (gr. v-xv ad %) as irritant application (Fox); or ointments containing the bichloride or biniodide may be employed instead of the green soap applica- tion (Pf.). Glycerin, internally, has been used with success (B.). Berberis, nqv of a fresh tincture thrice daily for the acne of girls at puberty. Bromide of Arsenic is adapted to the majority of cases of acne vulgaris (Pf.). Calcium Sulphide is indicated in cases characterized by a tendency to pustulation (Pf.). Bismuth, locally as a cosmetic (B.). Magnesium Sulphate, as a purgative daily before breakfast, in cases of acne vulgaris depending on derangement of stomach and bowels (Duhring); the skit, finely triturated, is an excellent dusting-powder for cases of acne rosacea. Water, hot sponging for 15 or 20 minutes several times a day, followed by glycerite of starch to allay irrita- tion (R.); the local use of very hot water is of the greatest benefit in all in- flammatory forms of acne (Bulkley). Puncturing each papule with a lancet point, followed by very hot water, and ointments of sulphur iodide, ammoni- ated mercury, etc., diluted (Pf.). Ergot is well used in acne rosacea and other forms of acne; a good fluid extract with glycerin and water, giving 3ss internally per diem (B.). Diet and Hygiene, require careful attention (B.); powerful tonics are often required (Bulkley). Sapo Viridis, as an active irri- tant in subacute cases, applied every night as long as bearable, then emollients until irritation subsides, when the green soap should be removed (Pf.). [Com- pare Seborrhcea.] Prescriptions. EL Potassii Acetatis, . . !|ss—j. Tinct. Nucis Vomicae, . xij. Ext. Rumicis Fluidi, . Misce. Sig.—A teaspoonful, largely diluted, half an hour before meals. EL Sulphuris, . . . xj. Glycerini, . . . ?j. Aquae Rosae, . . . gvij. M. Sig.—Lotion. EL Potassii Acetatis, . . Sj. Spt. Etheris Nitrosi, . gjss. Ac. Acetici Dil., . . %j. Ext. Taraxaci FI., . . §ij. Misce. Sig.—A teaspoonful, well diluted, on an empty stomach. EL Hydrarg. Chlor. Corr., . gr. x. Alcoholis, q. s. Aquae Destil., . . . M. Fiat. sol. Sig.—A teaspoonful in pint of water as a lotion, twice daily. Addison’s disease—adynamia. 519 R. Magnesii Sulphatis, . Ferri Sulphatis, . . gr. xvj. Acidi Sulphurici, . . sjij. Aquse, . . q. s. ad j§viij. M. Sig.—A tablespoonful in a glass of water before breakfast. R. Liq. Potassse, . . . £j. Aquse Rosse, . . ad £iv. M. Sig.—Apply with a soft sponge twice daily. R. Bismuthi Subnit., . . 3). Ung. Hydr. Ammoniat., . Zij. Ung. Aq. Rosse,. . ad 3jj. M. et fiat unguentum. R. Potassii Acetatis, . . Tinct. Nucis Vom., . gij. Infusi Quassiae, vel Tinct. Cinchonae Co., ad M. Sig.—Teaspoonful in water after meals, as an antacid tonic. R. Hydrarg. Iodo-chlor., . g. v-xv. Adipis, . . • • Fiat unguentum. An irritating ap- plication, requiring care. Addison’s Disease. Arsenic, with cod-liver oil, gives the best results (Da Costa). Iron, and other tonics are useful, especially a combination of the chloride, glycerin and chloroform (Greenhow). Phosphorus, has seemed to exert a beneficial in- fluence (Wilks). Treatment must be symptomatic, and is of little use, the disease being always fatal (H.). Prescriptions. R. Tinct. Ferri Chloridi, . 2j. Spt. Chloroformi, . . 5j. Glycerini, . . . M. Sig.—A dessertspoonful in wa- ter thrice daily. R. Quininse Sulph., . . gj. Ferri Reducti, . . gjss. Ac. Arseniosi, Strych. Sulph., . aa gr. iij. Confect. Rosae, q. s. M. et div. in pilulas lx. Adynamia. Cinchona or Quinine, with arsenic, for pale, badly-fed town-dwellers (R.); as a general tonic when flesh flabby, skin perspiring (P.). Arsenic, for swelled feet of old or weakly persons, and breathlessness from weak heart (R.); tonic ip continued doses of gr. to (Wa.). Nux Vomica, in adynamia of drunk- ards. R. Tinct. Capsici £vj; Tinct. Nucis Vom. ; gtt. xx in water every four hours (B.). Lime Salts, the phosphate, when from prolonged town-life or overwork, gr. j, with grain j each of Phosphate of Iron and Carbonate of Lime, for a dose (R.); Hypophosphites, of Lime or Soda, in nervous or general debility (R.). Iron, promotes appetite and digestion; gr. j-iij of the Sul- phate, or the official iron and aloes pill, or with manganese (B.); anaemic subjects (R.). Hydrastine, as substitute for Quinine, to promote appetite and digestion and improve assimilation (B.). Digitalis or Eucalyptus, in debility with weak heart-action (B.). Bitters, especially Calumbaand Gentian, useful for a short time (B.). Sanguinaria, when stomach needs stimulation (P.). Sar- saparilla, broken-down, syphilitic constitutions (P.). Alcohol, is of great value, but has been abused; hurtful when it increases temperature and pulse, dryness of tongue, etc. (B.); a wine with much ether in debility of old age, especially where sleeplessness, indigestion and stomach cramps (R.). Ali- 520 AFTER-PAINS—AGALACTIA—ALBUMINURIA. ment, sugar and saccharine fruits, vegetables, oil, milk, cod-liver oil, wine of good body and strength (B.). Porteror rum-and-milk for town-living women (R.). Sea-bathing is useful in chronic illness, with much debility (R.). Turk- ish Baths, when debility is caused by the tropics, but caution necessary. When town dwellers become stout and flabby, are easily tired, suffer from a lack of energy and from mental depression, a course of baths is beneficial (R.). [Com- pare An/emia, Convalescence.] Tonic Prescriptions. R. Quininse Sulph., . . gr. xxx. Ac. Sulph. Dil., q. s. Tinct. Ferri Chlor., . gij. Aquae, . . ad 3 ij. M. Sig.—A teaspoonful thrice daily. R. Quininse Sulph., . . 3 j. Strychninse Sulph., . „ gr. j. Tr. Ferri Chloridi, . . Zv. Ac. Phosph. Dil,, . . ’zj). Syr. Limonis, . . ad M. Sig.—A teaspoonful in water thrice daily, in nervous debility. R. Tinct. Ferri Chlor., . . 5jiv. Ac. Phosphor. Dil., . . gvi. Sp. Limonis, . . . 5tij. Syrupi, . . q. s, ad gvj. M. Sig.—A dessertspoonful in wa- ter after each meal. R Ac. Arseniosi, . , gr. j. Quininse Sulph., , gr. xl. Ferri et Pot. Tart., . gr. lxxx, M. Fiant pil. no. xl. Sig.—One after each meal. After-pains. Opium, more certain in action than any other remedy (Wa.); Morphine and Atropine (gr. \ and gr. T combined (B.), hypodermically (Wa.). Belladonna, as ointment, much used in France (L.). Camphor, gr. x with gr. morphine, an effective remedy (B.); in of mucilage, tablespoonful doses every hour or two (Wa.), Chloral, will stop the pains, but large doses, gr, xx-xl, are necessary (R.). Chloroform, the linimentum chloroformi with linim. Saponis applied on flannel to the abdomen (Barker). Qui- nine, gr. v-x night and morning, with the above chloroform liniment locally, in neuralgic after-pains which do not yield to opiates, the uterus being tender on pressure (Barker). Gelsemium, suspends them, large doses (npxx) neces- sary (B.). Cimicifuga, relieves the pains, and allays general nervous excite- ment (P.). Ergot, is better than cimicifuga (R.). Poultices, warm, over the hypogastrium, with soothing injections into the vagina (L.). Agalactia. Ricinis Cotnmunis, gr. v of extract, or gj-ij of strong decoction, daily in water; also the leaves, or an infusion, locally to mamma (T.). Gossypium, an emul- sion of the seeds has repute in India, as a galactagogue. A wineglass of the decoction every 20 or 30 minutes (P.). Pilocarpus, remarkably increases the secretions (B.). Tea, a good black tea promotes the milk-supply. [Com- pare Lactation.] Albuminuria* Aconite, in incipient, high body temperature (R.). Lead, diminishes the albumen (R.). Turpentine, gtt. ss-j, every 2 to 4 hours, or one to two drop ALCOHOLISM. 521 doses night and morning, of great value in chronic albuminuria without marked symptoms of Bright’s disease (P.). Gallic Acid, the most efficient agent in the acute form to restrain loss of albumen (B. P.). See Aitken’s formula below. Cannabis Indica, is indicated when bloody urine (R.). Chimaphila, has unquestioned power over albuminuria (P.). Cantharis, Tty every three hours, of the tincture, after the subsidence of acute symptoms, especially when bloody urine (R.). Fuchsine, in doses of gr. j-iij, completely arrested albu- minuria in many cases with oedema (Bouchut). Alkalies, the citrates and acetates as diuretics (R.); the Buffalo Lithia Water of Virginia, is highly recommended. Nitro-glycerin, Tty of a one per cent, solution to dilatatfhe peripheral vessels, relieving the heart and lessening the renal congestion (B.). Turkish Baths, benefit by relieving the kidneys of work (R.). Milk-cure, with buttermilk, has proved very efficient in many cases (B.). Chalybeate Waters, especially those having purgative qualities, are beneficial (B.). [Com- pare Bright’s Disease.] Prescriptions. R. Acidi Gallici, . . . gj-ij. Ac. Sulphurici Dil., . Tinct. Lupuli,. . . 3). Infusi Lupuli, . . ad M. Sig.—Tablesp. thrice daily. (A it hen.) R. Mist. Ferri et Ammonii Ace- tatis (U. S. P.), . . 3;yj. Sig.—Teasp. to a tablesp. according to age, well diluted, thrice daily. [Basham.) Alcoholism. Arsenic, for distressing vomiting, one drop of liquor arsenicalis before breakfast (R.). Capsicum, in dyspepsia of chronic alcoholism, and to induce sleep; also as a substitute for the alcohol. Gr. x, with honey (B.). With bromide or arsenic and bitters to assist in overcoming habit, by removing the distress at pit of the stomach. The tinct. in io-minim doses should be taken shortly before meals, or whenever there is depression or craving for alcohol. It obviates the morning vomiting, and promotes appetite and digestion (R.). Ammonia, a full dose of the spirit will often sober a drunkard speedily (R.);—a few drops of liquor ammonite, diluted, have prompt action (S.);— 3) of the aromatic spirit with capsicum, see formula below. Quinine, espe- cially the cinchona rubra, for gastric catarrh of drunkards (B.); gr. ij-vj daily to raise the nervous tone (P.). Nux Vomica, for after stomachal disorders (B.); in tremor of chronic alcoholism, of much value (P.). Bromides, 3} every 4-6 hours in the “ horrors ” (B.). Phosphorus, in chronic alcoholism, recommended by Anstie (R.). Opium, cautiously, if at all (B.);—Morphine with tonics before meals for pain, nausea and want of appetite (R.). Cocaine, has been pronounced of great benefit, restoring appetite, inducing sleep and promoting digestion, while it soothes the brain and induces a feeling of con- tentment and calm (R.). Cimicifuga, is said to be useful in the treatment of the drunkard’s stomach (R.). Chloral, is very successful, gr. xv-xx, but must be cautiously used with old worn-out drunkards (B.). Picrotoxin, small doses for the tremor, gr. fa repeated (B.). Lupulin, is the best substitute for alco- holic stimulants, and extremely serviceable in delirium tremens (B.). Zinc Oxide, is very useful in chronic alcoholism, to diminish the craving, to relieve the gastric catarrh and lessen the tremor (B.). Acute Alcoholic Poisoning requires an emetic or the stomach-pump, cold douche to the head and breast, 522 ALOPECIA. warmth to the feet and limbs. Artificial respiration may be required. Milk, mucilaginous drinks, and black coffee, are the principal remedies. A milk diet often creates a disgust for alcohol. [Compare Delirium Tremens and Vomiting.] Prescriptions. R. Tinct. Capsici, . . . S^ss. Potass. Bromidi, . . (^ss. Vel Liq. Potass. Arsenit., . -npl. * Vel Tinct. Nucis Vom., . Spt. Ammonise Aromat., . Syr. Tolutani, . . ad £vj. M. Fiat mistura. Sig.—A dessert- spoonful in water four or five times daily. R. Zinci Oxidi, . . . Piperinse, . . . gr. xx. M. Fiant pil. no. xx. Sig.—One pill thrice daily. R. Ext. Lupulini FI., . . gj. Ext. Aromatici FI., ] Tinct. Capsici, . >- . aa, gvj. Mucil. Acaciae, . ) Aquae Menth. Viridis, . ad Fiat emulsio. Sig.—A teaspoonful or two as required. R. Tinct. Nucis Vom., . . gj. Tinct. Gentiana; Co., . Spt. Limonis, . . . myj. Spt. Chloroformi, . . Aqua;, . . q. s .ad M. Sig.—One-sixth to be taken 3 or 4 times daily, for insomnia. R. Tinct. Gentianse Co., . Tinct. Calumbge Co., . gij. Tinct. Nucis Vom., . trtlxxx. M. Sig.—A dessertsp. before each meal, for rum-stomachs. (Loomis.) Alopecia. Cantharides tincture, I part to 8 of castor oil, well rubbed into roots of hair, night and morning (Wa.). Arsenic, ntv of liq. arsenic, ter die, exercises a more or less powerful influence (Wa.). Nitric Acid, with olive oil, makes a serviceable liniment (Wa.). Pilocarpine, has a decided influence on the growth of the hair (B.). Glycerin, in combination with the above remedies (Wa.). Sulphur Iodide, has been found very effectual, used internally and externally (Wa.). Frequent shaving may often save the hair in alopecia after illness. Use clean brushes with long bristles, and brush against the natural lay of the hair. [Compare Tinea.] Prescriptions. R. 01. Amygdalae Expres., Aq. Ammoniae, . aa ,fj. Ol. Rosmarini, . . gij. Alcoholis, . . . -^ij. Aquae Destillat., . . Mellis Despumat., . ad M. Sig.—Lotion for the hair. ( Wilson.) R. Tinct. Cantharidis, . . Tinct. Capsici, . . trpxx. Glycerini, . . 3ss. Spt. Odorat., . . ad M. Sig.—Hair tonic. (Gross.) R. Pilocarpin. Hydrochlorat., gr. j. Aquae Destillat., . . 5;j. M. Sig.—Ten to thirty drops twice daily, according to age, to improve the growth of the hair. [Bart ho low.) R. Tinct. Macis, . . . zjss. Olei Olivae, . . ad §ij. M. Sig. —Lotion for baldness. (Jiebra.) AMAUROSIS AND AMBLYOPIA—AMENORRHCEA. 523 Amaurosis and Amblyopia. Arnica, has long been a popular remedy for amaurosis in Germany. Man- noir employed it with much success (P., Wa.). Rue, in minim doses night and morning, for dimness of vision from functional amaurotic condition. ElgS.- jaki says it produces dimness of vision, and in smaller doses improves the eye- sight (P.). Strychnine, may cure, in functional amaurosis from lead, tobacco and alcohol (B.). Gr. fa hypodermically (Nagel). Hypodermically in tobacco and traumatic amaurosis, and in progressive nerve atrophy not dependent on inter-cranial disease (R.). Guaiac, is advised for cases of amaurosis occurring in persons of a rheumatic diathesis (Wa.). Santonin, has given very satisfactory results in amaurosis (Wa.). Veratrine, as lotion brushed over eyelids, brows and temples once a day, is often useful, but should not be permitted to touch the conjunctiva, or great pain will result. See formula below (Wa.). Potassium Iodide, in amblyopia from lead-poisohing (Wa.). Seton, a small seton in the temple, kept open for a long period, has been found effectual when other remedies failed (Wa.). Amaurosis and Amblyopia are names formerly much used to denote the various conditions of blindness, before ocular diagnosis became as exact as it now is. Amblyopia is still used to designate certain impairments of vision not accounted for by any organic changes visible (Roosa). R. Veratrin®, . . , gr. x. yEtheris gij. Alcoholis, . , • M. Sig.—Use with a brush once a day over eyelids, eyebrows and tem- ples. Prescriptions. R. Strychnin® Sulphatis, . gr. j. Alcoholis, w . . Aqu® Destillat®, w ad M. Fiat solutio. Sig—A teaspoon- ful thrice daily before meals, when not used hypodermically. Amenorrhoea. Aconite, sudden suppression from cold or wet feet (B., R., P.). Pulsatilla, in sudden suppression, also aconite (B.); often of the greatest value in func- tional form (P.). Iron, when from an®mia, the most frequent cause. Small doses preferred. Solution of acetate, or ferri et ammonii citras (gr. ij), or ferri et strychnin® citras (gr. j), also chalybeate waters. Caution.—Careful diag- nosis before giving iron (B.). Aloes, when dependent on an®mia (B.); at the periods, with hot pediluvia, friction, etc. (R., P.). Potassium Perman- ganate, gr. j thrice dally increased to gr. ij, is the best of all remedies fbr bringing back the menses, having specific action on the uterine tissue (R.);— excellent in amenorrhoea from cold feet, and is by far the best emmenagogue. In pill it may explode; best in capsule with powdered elm or liquorice (Par- vin). Apiol, when from functional inactivity. First give iron for the blood; next aloetic purgatives, then apiol (gr. xv) just preceding the period ; or a daily dose for a week, or several days before (B.). The best emmenagogue next to Potass. Permang. (Parvin). Senega, a saturated decoction of the root, to extent of a pint in 24 hours, during preceding two weeks, advantageous (P.). Polygonum, has given excellent results when used in doses four times daily for a week (B.). Cimicifuga, has been recommended (R.); is of very great value (Pi). Arsenic, combined with iron, when from functional inac- tivity of ovaries (B.). Aurum Salts, from torpor of ovaries (B.). Ignatia, in suppression of hysteria (P.). Cinnamon, causes a flow of blood to the 524 ANAEMIA. womb (Goodell). Nux Vomica, small doses of the extract, of benefit in some obstinate cases (Wa.), Silver Nitrate, in substance lightly to the os uteri, at time of expected discharge (Wa.). Colocynth, in chlorotic amenorrhoea (P.). Ergot, has cured when due to plethora (B.); when anaemia after use of iron (R.); in chlorotic (P.); ny every ]/2 hour for 5 or 6 hours the day before and that of the expected flow, is very efficient when the cessation is not due to anaemia (A. A. Smith). Senecio Aureus, seems to have a well-founded reputation. Rue, in functional inactivity. Ol. rutae, rry-v (B., P.). San- guinaria, functional amenorrhoea, in absence of plethora (B., P.). Savine, general atony. Extractum sabinae fl., ntv-x (B., R., P.), Serpentaria, with anaemia or chlorosis (B.). Ammonium Chloride, for headache (R.). Sitz- baths, hot, for six days before period; mustard may be added at period. Often effectual in sudden suppression (B.). Spinal-ice-bag, to lower dorsal and lumbar vertebrae; or cold sponging useful (R.). Electricity, in atony of uterus and ovaries (B.). [Compare Anemia, Chlorosis.] Prescriptions. R. Olei Sabinae, . . . Olei Rutae, . . . 7,). Tinct. Polygon. Hydropip., Jj. Ol. Amygdalae Expres., Mucil. Acaciae, Aquae Menthae Pip., . aa Fiat mistura. Sig.—A teaspoonful two or three times daily. (Bartkolow.) R. Tinct. Ferri Chloridi, . giij. Tinct. Cantharidis, . . gj. Tinct. Guaiaci Ammon., . Tinct. Aloes, . ■* . . Syrupi, . . q. s. ad Fiat mistura. Sig.—A tablespoon- ful thrice daily, in simple atonic amen- orrhcea. (//. C. Wood. Dewees.) R. Extr. Aloe Aquosi, . . gj. Ferri Sulph. Exsic., . . t^ij. Asafoetidae, . . . Fiant pilulae ioo. Sig.—One pill after each meal, gradually increased to three. (Goodell.) R. Quininae Sulphat., . £jss. Extr. Nucis Vom., . gr. xij. Olei Sabinae, . . Aloes Socotrin., . . gr. viij. Cantharidis, . . gr. xxiv. Fiant pilulae xlviij. Sig.—One pill thrice daily. Anaemia. Nux Vomica, stimulates blood-making organs, and is used as an adjunct to restorative remedies (B.). Iron, its chief value is to improve digestion; also furnishes hsematin to the blood. The most astringent preparation is the best, and should be used after meals. Also chalybeate waters (B.). Some stom- achs, with irritable mucous membrane, require bland preparations. A pale, flabby tongue indicates large doses of the perchloride or sulphate (R.). Arsenic, as adjunct to iron, and where iron cannot be borne, or fails (B.). Quinine, for badly-fed town dwellers (R.). • Hypophosphites, are useful, but should not be given with iron, cod-liver oil, or stimulants (R.). Phosphate of Calciu7n, in anaemia of growing persons, and of women weakened by rapid child-bearing or excessive menstruation (R.). Lacto-phosphate of Calcium, for nursing mothers, or in waste from suppuration (B.j. Acids, added to A3NLEMIA. 525 purgative salts as tonics to the mucous membrane (R.). Pepsin, is recom- mended by Hollmann (B.). Manganese, alone not of much use; is best combined with iron (B.). Is not, like iron, found in the faeces, nor does it cause constipation (Wa.). Galvanization, as aid to remedies (B.). Cold Sponging, needs great caution, or may lower tone by minute degrees (R.). Diet and Hygiene, of prime importance. Nourishing, digestible food, in as large quantities as can be assimilated—milk, eggs, animal broths; afterwards, fish, poultry, game, mutton, etc. Moderate daily out-of-door exercise, in pure air, is indispensable. Bathing, especially sea-bathing, aids restoration. Wines, often useful. Red wines are the best. R. Tinct. Ferri Chloridi, . giv. Ac. Phosphorici Dil., . gvj. Spt. Limonis, . . . !jij. Syrupi, . . q. s. ad %'/)■ Misce. Sig.—A dessertspoonful in water after meals. To the above may be added gij of the Liquor Strych- ninae Hydrochloratis of the B. P. (Goodell.) Tonic Prescriptions. R. Quininae Sulphatis, . gr. xx. Ferri Sulph. Exsic., . gr. xl. Strychninae Sulph., . gr. ss. Fiant pilulae xx. Sig.—One pill thrice daily. (Bartholow.) R. Ferri Sulph. Exsiccat., Potass. Carbonatis, . aa Syrupi, q. s. Fiant pilulse no. xlviij. Sig.—One pill after each meal, gradually in- creased to three. (Blaud.) R. Hydrarg. Chlor. Corr., gr. j—ij Liq. Arsenici Chlor., . gj. Tinct. Ferri Chlor., . . giv. Ac. Hydrochlor. Dil., . ,^iv. Syrupi, .... giij. Aquae, . . q. s. ad t^vj. Misce. Sig.—A dessertspoonful in a wineglassful of water after each meal, as an alterative tonic. (A. H. Smith.') R. Acidi Arseniosi, . . gr. j. Quininae Sulphat., . gj. Ferri et Potass. Tart., . gij. M. Ft. pil. no. xxx. Sig.—One pill after each meal. R. Tinct. Nucis Vom., . . Tinct. Cinchonae, . ad M. Sig.—A teaspoonful after each meal. R. Pil. Ferri Comp. (U. S.), . xlviij; Sig.—One jto three after meals. R. Pil. Ferri Iodidi (U. S.), . xlviij. Sig.—One to three after meals. R. Tinct. Ferri Chloridi, . sjiij. Potassii Chloratis, . • 3)- Liq. Strychninse (B. P.), . Sjj. Syr. Simplicis, . . z*v* Aquae Cinnamomi, . ad giv. Misce. Sig.—One or two tea- spoonsful after each meal. R. Massse Ferri Carbonat., . jj. Acidi Arseniosi, . . gr. j. Quininae Sulphatis, . gr. xl. Fiat massa, et div*. in pilulas xl. Sig.—One or two thrice daily. 526 ANAESTHESIA ANEURISM. Anaesthesia. Morphine, subcutaneously before inhalation, diminishes the danger, and lessens the after-pain if an operation is to be performed (Nussbaumj; Mor- phine gr. and Atropine gr. T|5, hypodermically, after emergence from an- aesthesia, will relieve the nausea and vomiting. A preliminary injection of Morphine lessens the stage of rigidity and spasm, enables a smaller quantity of the anaesthetic to be used with fpll effect, prolongs the stage of insensibility, prevents shock, and antagonizes the cardiac and respiratory depression (B.). Atropine, is decidedly the best antagonist to the respiratory paralysis of Ether, and should be given hypodermically (gr. 5) as soon as alarming symptoms manifest themselves (Amidon). The writer of this book has saved at least four subjects of chloroform-narcosis by the hypodermic use of Atro- pine after both heart and respiration had apparently failed. Alcohol, of whiskey or brandy, before inhalation, to sustain the heart and prolong nar- cosis (B.). [Compare pages 45 and 142, ante, for the general subject of Anesthesia, and page 402, for a list of Local Anesthetics.] Aneqrism. Potassium Iodide, in large doses (gr. 3 or 4 times a day, gives great relief, and has cured (B.); combined with recumbent position and re- stricted diet (R.). Veratrum Viride, aids surgical expedients ; also in large internal aneurisms, with absolute recumbence and a little Opium to relieve pain, vomiting to be avoided (B.). Ergot, with recumbent position; favors coagulation of the blood in sac (B.); Ergotin (P.). Gallic Acid and Iron, internally, have cured cases of aortic aneurism (Speer), Chloroform, inhala- tion, great dyspnoea (R.). Plumbic Acetate, a valuable auxiliary to the more important items of rest, diet, and mechanical appliances, gr. iij-v ter die (Wa.); its use limited to the sacculated form (S.). Electrolysis, galvano-puncture in deep aneurisms; not very successful (B.). The object sought is the coagu- lation of blood within the aneurismal sac. Cures have not been attained by this treatment, but in many it has produced great amelioration of the most distressing symptoms (Petit). Aliment, milk regimen, for denutrition (B.); a low diet, with absolute rest; Ergotin and Iodide of Potass, for deep aneu- risms beyond reach of surgical treatment (B.). Rest, in recumbent posture, and light, unstimulating diet, are primary and essential elements in treatment of aneurisms. Surgical Treatment includes ligation of the vessels, also pressure by a tourniquet or hags of shot, the operator’s fingers, etc., applied to the main artery above the tumor. Prescriptions. R. Potassii Iodidi, , . 2;j. Tinct. Veratri Viridis, . gjss. Tr. Cinchonae Co., . . 5j. Tr. Cardamomi Co., . Sjss. Tr. Gentianse Co., . . gss. Syrupi Simplicis, Alcoholis, . . aa 5iv. Aquae, . . q. s. ad ijxvj. Misce. Sig.—ifss thrice daily. Each dose has gr. xv of Pot. Iod; R. Acidi Gallici, , . tjj. Ext. Ergotse, . , gr. xx. Digitalis, . . . gr. xx. Fiat massa, et div. in pil. xx, Sig.—One every two hours. R. Plumbi Acetatis, . gr. xxxvj. Extracti Opii, . gr. iv. Confectjonis Rosse, q, s. Ft. pil. xij. Ope every four hours. ANGINA PECTORIS—ANUS, FISSURED—APHONIA. 527 Angina Pectoris. Aconite, believed by Gubler to be appropriate, and by Fleming to have been curative in many severe cases resisting other remedies (P.). In cardiac disease its action is uncertain (Br.). Arsenic, lessens or prevents paroxysms, if used in the intervals (B., R., Anstie). Amyl Nitrite, as inhalation, affords signal relief (R., B.); unsafe in advanced degeneration of cerebral vessels and fatty degeneration of heart (B.); gives great relief during paroxysms (Br.). Nitrite of Sodium, is less rapid in action than Nitrite of Amyl, but is more efficient in preventing return of symptoms (Br.). Laurocerasus, as anodyne (P.). Strychnine, in the milder forms; very small doses, gr. to (P.). Glonoinum, doses of have been used with success (Pf., R.). Chamomile, in pseudo-spasms of hysterical persons (P.). Ether aborts a mild attack (B.); Sulphuric Ether, in nervous form; a spoonful immediately on .commencement of attack will greatly mitigate it (Anstie). Phosphorus, often serviceable (R.). Morphine, hypodermically, especially in cardiac dyspnoea; strengthens the heart (R.). Turpentine, applications, hot, over chest, to mitigate severity of the paroxysms, especially in the aged (Wa.), Quinine, when intermittent (Wa.) or when any malarial taint (Br.). Brandy, in frequent small doses, with hot bran poultice over heart, and warmth to ex- tremities. Anus, Fissured. Hydrastis, locally, promotes healing (B.). Rhatany, as injection, night and mQrning, after enema in the morning to move the bowels (Pf., Tr.). Iodoform, improves, and relieves pain (B.). lodo-tannin, well applied, effec- tive (B.). Belladonna, locally, of great service for painful spasms of sphinc- ter (P.). Opium, with gall-ointment for fissures of anus; mild purgatives should be simultaneously employed (R.). Sulphur, as a mild purgative, to cause soft motions (R.). Tannin, introduced on a tent, night and morning, with great advantage (Wa.). Collodion, as protective covering (P.). Potassic Bromide, with 5 parts glycerin, as local application (R.). Castor Oil, as a mild purgative (R.) ; to keep motions soft (Br.). Sur- gical Means, the most efficient; forcible dilatation of sphincter, or partial division in severe cases, through the mucous membrane, and a few fibres of sphincter. Prescriptions. R. Tinct. Kramerise, . . gj. Ext. Kramerise, . . Xi). Aquse, . . ad M. Sig.—One-fourth as injection, night and morning, after using enema. R. Sulphuris, . . . 3jj. Pulveris Aromat., . . sjij. Confec. Rosse, . . . gij. Misce. Sig.—One-third to be taken at bedtime as a laxative. Aphonia. Ignatia, in hysterical women (P.). Atropine, in hysterical aphonia, and for fatigue of vocal chords, gr. to morning and evening (B.). Nitric Acid, tilv-x of the dilute acid, for hoarseness of singers, in fatigue of vocal chords, and when stomachal (B.). Benzoin, the tincture by inhalation in laryngeal catarrh (Br.). Oil of Rue, as inhalation in chronic catarrh (Br.). Nitrate of Uraniu?n, as spray in very chronic catarrh (Br.). Alum, gr. x-gj aq., as spray, in chronic coughs and hoarseness (R.). Borax, a piece the size 528 APHTHAL—APOPLEXY. of a pea allowed to dissolve in the mouth (R.). Glycerin of Tannin, locally* in chronic inflammation of the throat (R.). Sulphurous Acid, by inhalation, spray or fumigation, in clergyman’s aphonia (R.). Ipecacuanha, wine, as spray, when congestion of vocal chords (R.); in laryngeal catarrh (Br.). Am- monium Chloride, vapor inhaled, of great value in catarrhal aphonia (Wa.). Turkish Bath, at commencement of a feverish cold (R.); in acute laryngeal catarrh (Br.). Galvanism, localized, the best means for hysterical aphonia. R. Liq. Ammoniae, . . . Sj. 1 Aquae, . . . . gj. M. Sig.—A teaspoonful in a pint of hot water for each inhalation. Prescriptions. R. Acidi Nitrici Dil., . . zij. Tinct. Calumbae, . . $j. Aquae, ... ad M. Sig.—A dessertsp. in a winegl. of water thrice daily. Aphthae. Potassium Chlorate, the best remedy. Solution of gr. x to the as wash, alone or with borax (Br.), and gr. x to xx by the stomach (B.). Borax, with honey, or as glycerin of borax, frequently used (R.); crystals allowed to dis- solve in the mouth (W.). Sulphurous Acid, as solution, strong or diluted, locally (R.); dilute as spray (B.). Mineral Acids, formerly much used (B.). Mercury. Hydr. cum creta in small doses to remove the indigestion on which aphthae often depends (Br.), borax being used locally, when aphthae exist in the mouth (Wa.). Copper Sulphate, a weak solution painted over mucous membrane (R.). Potassium Iodide, gr. j-v-ijj aquae, locally (B.). Salicylic Acid, one part (dissolved in alcohol) to 250 of water (R.). Quinine, gr. j every 2 or 3 hours, in infants (B.), especially when consequent on diarrhoea (Br.). Coptis, the infusion has repute in New England (B.). Bismuth, freely to parts (B.); as a local application (Br.). Glycerin, will sometimes cure (R.). Rhubarb, the compound powder of rhubarb, to remove indigestion (Br.); —is highly useful in small doses (Wa.). R. Ac. Sulphurosi, . . . Aquse, ... ad gij. M. Sig.—Mouth-wash, or use as a spray. Prescriptions. R. Pulv. Rhei Co., . . . tpj. Sacch. Lactis, q. s. Triturat. et div. in pulv. xij. Sig.— One thrice daily. Apoplexy. Aconite, full strong pulse; hot, dry skin, plethoric cases. The best remedy (P.);—to lower blood-pressure and prevent further hemorrhage, where the pulse is strong and the arterial tension high (Br.). Elaterium, as a purga- tive; a large dose (gr. ij) in suppository with soap, or as an injection into large bowel (P-). Croton Oil as purgative, a drop may be put on the back of the tongue (Br.);—trt % or each hour (R.). Colocynth, as a derivative purga- tive (Br.); appears to act well (P.). Cold Water, often harmful, though fre- quently used. Injurious when face pale, surface cool, circulation depressed (B.). Electricity. Very mild galvanic currents to promote absorption. Caution necessary, especially if much headache and vertigo (B.). Diet and Hygiene, of great importance in patients subject to apoplexy. Avoid stimulating food and drink (especially beer), overeating, excitement, haste, APPETITE—ASCITES. 529 exposure to hot sun, heated rooms, etc. At no subsequent period should a full animal diet or the use of undiluted wines be indulged in (A.). Diagnosis. Should be carefully differentiated from drunkenness, with which it is often confounded. [Compare Cerebral Congestion.] R. Tinct. Aconiti, . . . n^x. Aquae Cinnamomi, . ad M. Sig.—A teaspf. every hour for 2 hours, then every half-hour. Prescriptions. R. Ext. Colocynthidis Co., . gr. xx. Olei Tiglii, . . . ntij. Fiat massa, et div. in pil. iv. Sig.—One pill as required, until free purgation ensues. Appetite. Ignatia, will correct diseased appetite (P.); especially in hysterical sub- jects (Br.). Anthemis, will stimulate the appetite. Bitters, to stimulate the appetite (R.). Food should be savory and well cooked. Habits require examining into, when lost appetite complained of. Fluorides of Sodium or Potassium will produce almost total anorexia, and may be employed with advantage in bulimia (Da Costa). [Compare Dyspepsia.] Prescriptions. R. Gentianse, Quassiae, Cinnamomi, . . . aa tjij. Sig.—Put into a pint of boiling water and when cold, strain; take a winegl. thrice daily as an appe- tizer. R. Anthemidis, Quassiae, . . . aa Jjj. Sig.—Put in a pint of boiling water, and when cold strain; take a winegl. thrice daily before meals as an appe- tizer. Ascites. Digitalis, of the greatest service, except where aortic regurgitation and cardiac hypertrophy (P.); fresh infusion best (R.);—its action increased by combination with squill and pil. hydrargyri (Br.). Arsenic, when from feeble heart, and in old age (B.). Apocynum Can., an active diuretic (P.). Copaiba, excellent in hepatic dropsy (Br.). Jaborandi, has given good results (B.). Stillingia, in ascites due to hepatic changes (B.). Jalap, the compound powder, with podophyllum, the most generally approved hydragogue purga- tive (B.). Elaterium, to produce free watery evacuations. Cautiously in debilitated subjects. Contraindicated when gastro-intestinal irritation or inflammation. Is depressant (B*). Milk-diet, successful; an ancient practice ; causes profuse alvine and urinary discharges (B.);—sometimes very useful when the kidney action is inadequate (Br.). [Compare Dropsy.] Prescriptions. R. Resinae Copaibae, . . giij. Alcoholis, . . . gv. Spt. Chloroformi, . . %j. Mucil. Acacise, . . ±ij. Aquae, . . q. s. ad M. Sig*—A tablesp. thrice daily. R. Hydrarg. Chlor. Mitis, Pulv. Digitalis, Pulv. Scillae, . . aa gr. vj. Fiat massa, et div. in pil. vj. Sig.—One pill thrice daily, in as- cites from hepatic changes. 530 ASTHENOPIA— ASTHMA. Asthenopia. The proper glasses; cold douche; rest of eyes. Atropine, systematically instilled, to prevent strain, and control spasm of the accommodation (C.). [Compare Myopia.] Asthma. Aconite, in spasmodic (P.); often averts the attack, if given at commence- ment; useful also in the asthma following coryza and sneezing in children (R.). Ipecacuanha, the wine as spray to the fauces, sometimes useful in severe bronchial asthma, but not of much service in genuine asthma (R.); nauseating and emetic doses in spasmodic form (B.). Lobelia, gtt. x of tincture every hour during paroxysm ; Ttlx ter die, with additional doses at night, in bronchitic asthma when worse at night. Cautiously if heart disease (R.). Often gives permanent relief (B.). Arsenic, as cigarettes as well as by internal adminis- tration (B.). One drop of liquor arsenicalis ter die, in attacks from bronchitis, local irritation, etc., allied to hay fever (R.). Belladonna, relieves paroxysm when expectoration abundant, skin cool and moist (B.). Internally in large doses, also in cigarettes (Br.). Atropine hypodermically is more efficient, gr. -Jq at bedtime to abort morning paroxysm (B.). Large doses required, but very satisfactory (R-). Was much valued by Dr. Salter and M. S6e (P-). Potassium Iodide, when from acute bronchial catarrh, gr. xv-xx each 2, 3, or 4 hours. [See Bromides.] (B., R.) Nux Vomica, in nervous subjects (B.); in spasmodic asthma, often of great benefit (P.). Chloral, may arrest paroxysm (B., R.). Chloroform, inhaled from warm water. Anaesthetics relieve, but increasing doses required, leading to habit (B., R.). Ether, full dose, may abort a mild attack (B.). Amyl Nitrite, inhaled, quickly checks spasmodic asthma (B., R.). Antimony, in an affection of children like asthma. Dissolve a grain of tartar-emetic in half a pint of water, and give a teaspoonful of this every hour for the first hour, then hourly. If vomiting induced, lessen the dose (R.). Coffee, a small cup of very strong coffee often useful in a paroxysm (R.). Asthmatics should not use it as a beverage (P.). Stramonium, twenty grains of the dried leaves or ten of the powdered root may be smoked. Datura tatula sometimes better. Stramonium preparations often bad. Asthmatics advised to grow the drug themselves (R.). Grindelia, gives relief in spasmodic form (B.); three grains of extract thrice daily to prevent attacks, or Wlxx-xxx of liquid extract every half-hour or hourly from onset of paroxysm (R.). Ethyl Iodide, very valuable in spasmodic form, and lessens liability to subsequent attacks. Ttlv-xx thrice daily by inhalation (B.). Cannabis Indica, has been useful (R.). Sulphurous Acid, by inhalation, spray, or fumigation (R.). Morphine, hypodermically, quickly cuts short a paroxysm (B.); in some cases morphine will induce a paroxysm (R.). Apomorphine, gr. hypodermically, has been found effective; or gr. every 3 or 4 hours in camphor water, with or without morphine or ipecacuanha. Tobacco, smoking sometimes relieves (R.,P.). Asa- fast ida, has been recommended (R.); palliative only (P.). Colchicum, in gouty subjects (R.). Bromides, relieve, but soon lose effect (B., R.), Eucalyptus, smoked with stramonium, belladonna, tobacco (B.). Quinine, after acute symptoms subside, as antipyretic to succeeding fever and restorative tonic (B.). Potassium Nitrate, the inhalation of fumes of burnt nitre paper will sometimes avert a paroxysm. Different methods of preparation useful for different cases (R.). Oxygen, when no hearfdisease (R.). Silver Nitrate, sometimes injected into trachea (R.). Chamomile Oil,has been found very serviceable (P.). San- guinaria, is very useful in humid asthma, and occasionally so in the spasmodic ASTIGMATISM. 531 form (B.). Galvanism of pneumogastric often relieves; pole beneath mas- toid process; — pole to epigastrium. Faradism of no use (B.). Prophylaxis, avoidance of exciting causes, especially indigestible food, wet, damp, and sud- den changes of temperature. Attention to the stomach will do most for many asthmatic patients. An important point is to take the heaviest meal early in the day, and very little solid food after 2 p.m. Shower-bath and out-of-door exercise, not, however, to a fatiguing extent (R.). Prescriptions. R. Ext. Grindelise, . . Ext. Lobelise FI., . . g'l). Ext. Belladonnse FI., . gj. Potassii Iodidi, . . gii). Glycerini, . . . M. Sig.—A tablesp. as required.. (Bartholow.) Arsenical Cigarettes. R. Sodii Arseniatis, , . zss-j. Aquae Destillatse, . • 3i- Moisten unsized white paper, and roll into cigarettes, each containing gr. % to gr. j of the salt. Two or three of these to be inhaled daily. {Bartholow.) R. Tinct. Sanguinarise, Tinct. Lobeliae, Ammonii Iodidi, . aa g). Syr. Tolutani, . . . £vj. M. Sig.—A teasp. every 2, 3 or 4 hours, in humid asthma. (B.) Belladonna, etc., Cigarettes. R. Belladonnse Fol., . . g). Stramonii Fol., Hyoscyami, . , aa jss. Extracti Opii, . . gr. iij. Aquae Lauro-cerasi, q. s. Dissolve the opium in the water, and moisten the leaves therewith. When dry, roll into twelve cigarettes. Smoke two to four daily. ( Trousseau.) R. Tinct. Lobelise, . . gj. Ammonii Iodidi, . . g\). Ammonii Bromidi, . . gi\). Syrupi Tolutani, . . gi). M. Sig.'—A teasp. every I, 2, 3 or 4 hours. (B.) R. Chart. Potass. Nitratis, . i. Burn in a close room and inhale the fumes. R. Ammonii Bromidi, , gr. clx. Ammonii Chloridi, . gr. xc. Tinct. Lobelise, . . Spt. Etheris Comp., . 5j. Syrupi Acacise, . ad M. Sig.—A dessertsp. in water, every hour or two, for the paroxysm. (Pepper.) R. Spt. Etheris Compos., Liq. Morph. Sulph. (gr-jadgj), . aa %j. M. Sig.—A teasp. every half-hour or hour in the paroxysm. R. Potassi Bromidi, . . ?j. Potassii Iodidi, . . sss. Aquse Cinnamomi, . . M. Sig.—A teasp. in water every half-hour or hour. (B.) R. Spt. Etheris Comp., . . !|j. Tinct. Belladonnse, . . g). M. Sig.—A teasp. ter in die. Astigmatism. Atropine, a weak solution to aid examination of eye by dilating pupil, and paralyzing accommodation (B.). Duboisine, as substitute for atropine, has 532 ATHEROMA ATROPHY—BALANITIS—BED-SORES. more rapid action, with shorter duration of effects, and less conjunctival irri- tation. Glasses, of suitable form, cylindrical in simple astigmatism, bi-cylin- drical in mixed astigmatism. Pray’s Test Letters, to determine degree and direction of the defect (C.). Atheroma. Phosphorus, in minute doses, for atheroma, with cod-liver oil (B.). Ar- senic, often of great value in atheroma, especially where imperfect action of kidneys (Br.); indicated when there are puffy eyes, drowsiness, intellectual torpor (B.). Quinine, gr. iij-x daily, in atheroma, with advantage (B.). Am- monium Bromide, in atheroma, to promote absorption of deposit (Wa.). Digi- talis, may be useful in general capillary atheroma; cautiously! (W.) Cod- liver Oil, with phosphates, hypophosphites, or the lacto-phosphate of lime, in combination (B.). [Compare Aneurism.] Atrophy. Cod-liver Oil, has proved beneficial (Wa.). Olive Oil, by inunction, every 12, 6, or 4 hours, successfully employed (Wa.). Arsenic, has had re- markable success in muscular atrophy (Tr.). Electricity, in progressive muscular atrophy, the induced current very strong at first, then weaker as improvement; interrupted currents from vertebral column and plexuses to nerves of affected muscles; in more extended forms, the constant current to the nerves, the induced to the muscles (Ros.). Massage, removes the waste products and restores the muscular power (Br.). [Compare Emaciation, Lo- comotor Ataxia.] Balanitis. Mercury, Hydr. Chlor. Corr. gr. j to aquae calcis, as lotion, if not much inflammation (Br.). Oil, on linen, to inflamed part, beneath foreskin, which must be again drawn forward; strict cleanliness. Astringent Lotions, Alum, Sulphate of Zinc, with warm water injections (Br.). Lime-water, the best lotion if much inflammation (D.). Tannin, in alcohol, equal parts, as dress- ing after washing with a weak solution of common salt. Carbolic Acid, a 5 per cent, solution, on cotton rag after washing, thrice daily, is generally suffi- cient. [Compare Phimosis, Gonorrhcea.] Bed-sores. Alcohol, Brandy, or eau-de-cologne, to harden skin of parts exposed to pres- sure (R.); as wash to parts threatened (B.). Glycerin, or glycerin-cream, rubbed over the parts exposed to pressure, after washing, morning and evening, is one of the best preventives (R.). Alum, j|ss, whites of four eggs, Tinct. Cam- phorse !|ij, an excellent application (B.). Charcoal, sprinkled over the black slough, which is then covered with poultice (R.). Galvanic Couplet, of zinc and silver, connected by a copper wire; one element on sore, the other on adjacent part (B.). Silver Nitrate, a solution (gr. xx-5j) to be painted on threatened but unbroken skin, as soon as it becomes red, will prevent sores ; if Nitrous Ether solution be used, 5 grs. to the oz. is enough (R.). Lodoform, dusted over sores (R.). Linen, air-dried better than that which is ironed or mangled, by reason of its greater softness. BILIOUSNESS—BLADDER, IRRITABLE. 533 Biliousness. Podophyllum, acts as a cathartic (B.); corrects deficient secretion of bile, especially in children and infants; gr. to tJq, every 6 hours, to correct white or clayey stools; also in general hepatic derangement (P.). Aconite, in occa- sional doses, improves the effect of Podophyllum (R.). Mercurial Cathartics, act only as purgatives, Calomel gr. j-x, or Pil. Hydrarg. gr. v-x; Mercury restricted as purgative to cases where there is excess or deficiency of bile (B.). Frequent small doses of gray powder for deficiency (R.) ; Calomel gr. iij, fol- lowed by xij each of Rochelle and Epsom Salts, when the tongue is heavily coated and furred (Gross). Yellow Oxide of Mercury, in doses of gr. to in trituration with sugar of milk, exceedingly efficient in many disordered con- ditions of the alimentary canal and its appendages (Schaffer). Bryonia, is worthy of commendation in the ordinary bilious headache with vomiting, and in general hepatic derangement known as sluggish liver (P.). Hydrastis, gtt. v-xv fl. ext. daily before meals, when with chronic gastric catarrh and dyspepsia (B.). Mineral Acids, before meals, Hydrochloric Acid and Pepsin after meals, in atonic dyspepsia (B.). Stillingia, when deficient biliary secre- tion (B.); may be used in place of Mercury (Br.). Ammoniutn Iodide, gr. j-iij in water each 2, 3, or 4 hours, when catarrh of duodenum and biliary ducts (B.). Ammonium Chloride, is much employed in Germany for hepatic de- rangements, and with good success. Euonymus, is considered very efficient by many practitioners in cases of hepatic dyspepsia, or “ billious attacks,” so called. Manganese, gouty subjects. Rhubarb, as a cholagogue, Aloes, with constipation. Angostura, is suitable to worst forms of bilious fevers (P.). Ca- lumba, is of benefit in many forms (P.). Alkalies, and their laxative salts, when bilious state, with uric acid diathesis (B.). Milk-cure, in obstinate cases; buttermilk or skimmed milk often agrees best (B.). [Compare Dys- pepsia, Hepatic Congestion, Duodenal Catarrh.] Prescriptions. R. Ext. Stillingise FI., . . gv. Tinct. Aloes, . . . gij. Tinct. Nucis Vom., . . gj. M. Sig.—Twenty drops in water thrice daily. (B.) R. Hydrarg. Oxidi Flavi, . gr.j. Sacch. Lactis, q. s. Triturat. et div. in chart, xlviij. Sig.15—One powder dry on the tongue twice daily. R. Ext. Euonymi, . . Jjss. Ext. Hyoscyami, . . gr. xv. Ext. Gentianse, . . gr. vj. Fiat massa, et div. in pil. xij. Sig.—One pill every other day. R. Massse Hydrargyri, Ext. Colocynthidis Co., aa gr. iij. M. et div. in pil. ij. Sig.—Take at once, and follow in a few hours with a saline cathartic. Bladder, Irritable. Belladonna, in nocturnal incontinence, due to relaxation of sphincter, or irritable mucous membrane (B.); gtt. v-xx of tinct. every 3 or 4 hours give gradual but sure relief (P.). Cantharis, in women, without acute inflamma- tion (B.) ; on coughing (R.). Benzoic Acid, when from enlarged prostate, removes fetor of urine; also renders phosphatic or alkaline urine acid (P.). Ammonium Benzoate, may be used instead of Benzoic Acid (Br.). Cubebs, 534 BLADDER, PARALYSIS OF—BLEPHARITIS—BOILS. is often successful in women, but Cantharides generally better (Br.); is of especial value when vesical catarrh present (P.). Aqua-puncture, strange to Say, has been used with considerable success (B.). Cannabis Indica, in spasm of the bladder, and in irritable conditions of that organ is generally useful. Eucalyptol, is often very efficient, but frequently fails, rn_ij on sugar two or three times a day. [Compare CVstItis, DYsuria, Enuresis, LlTHi- Asis, Calculi, Urinary Disorders ] Bladder, Paralysis of. Cannabis Indica, in retention from spinal disease (R.). Ergot, in para- lytic dysuria, especially when sensation of bladder being only partially emp- tied (P.) ; when incontinence from paralytic sphincter, and in paralysis from overdistension (B., Wa.). Arnica, has proved curative (P.). Strychnine, gr. E to useful (B.). Cantharides, often given with excellent effect, when bladder atonic (Wa.). Galvanism, may greatly benefit (B.); electro mag- netic current from the bladder to the spine, of great use (Wa.). Blepharitis. Pulsatilla, internally and externally (P., B.). Mercury, after detaching crusts, rub in brown citrine ointment (B.); should be diluted with vaseline or simple ointment (Br.). Tannin, powdered, or tannic acid solution, gr. j-x to the (B.). Alum, after acute symptoms subside (B.); a solution, gr. aquae, every % or hour, an excellent application (R.). Hydrastis, as lotion, very serviceable (P.). Bismuth, equal parts of the subnitrate and glycerin to the inflamed surface, in ciliary and glandular blepharitis (Wa.). Ergot, the fluid extract locally, gives excellent results (B.). Prescriptions» R. Aluminis, . . . gr. x. Aquae Rosae, . . . !|ij. M. Sig. — Lotion for the eve- lids. (B.) R. Unguent. Hydrarg. Nitrat., pjj. Vaselinae Albse, . . giij. M. Sig.—Ointment for the margins of the eyelids. Boils. Belladonna, as plaster, to subdue inflammation, or Use lint wetted with Atro- pine gr. iv, Aquae Rosae (B.); with Glycerin locally, to allay pain; inter- nally often successful (R., Wa.). Sulphides, in small doses (gr. to J of Calx Sulphurata) every hour or two, or Sulphurous Mineral Waters will abort or mature, and aid to expel pus ( B., R.); of no use in the boils of diabetes (R.). Aromatic Sulphuric Acid, for the tendency, gtt. x-xv, in plenty of water thrice daily. Silver Nitrate, gr. v-T)j-2;j of nitrous ether, painted over adjacent part, to abort; specific if used early (B„ R.). Arsenic, long-con- tinued, for succession of boils (B.); to lessen tendency to recurrence (Br.). Opium, a thick extract locally (R ). Camphorated Alcohol, smeared over boils in the earliest stage, then, when skin dry, smear with camphorated oil, to abort (R.). Sodium Phosphate, the best remedy for the systemic condition which produces boils (B.). Carbolic Acid, undiluted, on a thread passed through centre of boil while recent, will abort it. Counter-irritation, by blis- ters or Iodine around the boil (R.). Collodion, at papular or pustular stage BONE, DISEASES OF—BRIGHT’S DISEASE, ACUTE. 535 (R.). Poultices, to assist maturation and allay pain, may be smeared over with Belladonna or Opium (R.). [Compare Acne, Carbuncle.] R. Cal£is Sulphurat., . . gr. iij. Sacch. Lactis, q. s. Triturat. et div. in chartas Xxx. Sig.—One powder every 2 hours. Prescriptions. R. Ac. Sulph. Aromat., . , ;^vj. Aquse, ... ad 5iv. M. Sig.—A teasp. in a winegh of water 3 or 4 times daily. Bone, Diseases of. Iodine, in scrofulous affections of bones, should be used locally, with the iodide of iron or cod-liver oil internally, nutritious diet, wine, out-door exer- cise (Wa.). Cod-liver Oil, in scrofulous affections, may be relied on if perse- veringly used, and accompanied by good hygienic conditions (Wa.). [Com- pare Caries, Exostosis, Nodes, Periostitis, Rachitis, Spina Bifida, etc.] Breath, Fetid. Potass. Permang., gr. aqure rosse, as awash for the mouth (B.). Chlo- rine, as solution of chlorinated lime, to remove fetor (B.). Carbolic Acid, a dilute solution, as wash for mouth (W.l. Camphor, is used as a corrective (R.). Look for bad teeth, disordered digestion; in very offensive cases, gan- grenous lungs; cleanliness of teeth and mouth are essential. R. Calcis Chlorat., . , giij. Aquse Destillatse, Alcoholis, . . aa jij. Olei Rosse, . . . Tipiv. M. Sig.—A teasp. in a glassful of water, as a lotion for the mouth. (B.) Prescriptions. R. Acidi Salicylici, . . %]. Liq. Ammonii Acet., . Glycerini, . . . 5j. Aquse, q. s. . . ad gvj. M. Sig.—A tablesp. every six hours, (Robinson.) Bright’s Disease, Acute^ Aconite, should be given immediately on the appearance of the nephritis in scarlatina (R.) ; as a diuretic, advocated (P.). Cantharis, after subsidence of the acute stage, one-minim dose every 3 hours will stop the hematuria (R„ B.). Digitalis, (infusion the best remedy in renal dropsy from acute desquamative nephritis (B.); only diuretic as long as dropsy lasts (R.). Can- nabis Indica, as diuretic; is especially useful when bloody urine (R.). Eu- calyptus, sometimes effective ; cautiously, or it will aggravate symptoms (B.). Hyoscyamusfm irritable kidneys (P.); maybe substituted for Belladonna (Wa.). Jaborandi, is much used (Da Costa); large doses very depressant to the heart, but ntv-x of the fluid extract every half-hour or hour will pro- duce sweating. It may be combined with tinct. of Digitalis (A. A. Smith); or the Nitrate of Pilocarpine, to excite skin when symptoms urgent, gr. to £ for adult (B.). Turpentine, in drop or half-drop doses every 2 to 4 hours, controls the dropsy in a remarkable manner (P.); hot turpentine epithems are serviceable, but may increase the action of the kidneys (Wa.). Belladontia, has often proved useful (P.); may be used with benefit (Wa.). Jalap, the compound powder is the most generally useful purgative, used in the early 536 bright’s DISEASE, CHRONIC. morning, to produce free watery evacuations, when uraemic symptoms super- vene (B.). Gallic Acid, checks albuminuria (B.). [See Albuminuria, for formula.] Juniper, as diuretic; often aggravates (P.). Poultices, large, of linseed meal, made light and soft as possible, beneficial (Wa.). Cupping, in lumbar region, ameliorates acute desq. nephritis, and congestion of the kid- ney (B.); cupping, or leeches over the loins, with opiates freely, diluents, and demulcents, with rest and an antiphlogistic regimen, often suffice (Wa.). Va- por-bath or Warm Pack; to increase the action of the skin (B.). Diluents, as milk, and cream-of-tartar in solution, should be used freely to relieve the congestion and remove obstructions from the tubules (B.). Iron, after the acute symptoms have subsided, as a tonic, the most suitable preparation being Basham’s mixture, the now official Mist. Ferri et Ammonii Acetatis, in doses thrice daily (Da Costa). [Compare Albuminuria, Hematuria, Uraemia.] R. Potassii Acetatis, . . £ijss. Infusi Digitalis, . . Infusi Juniperi, . . giij. M. Sig.—A tablesp. every 2 to 4 hours as a diuretic. Prescriptions. R. Mist. Ferri et Ammonii Ace- tatis, .... Sig.—A tablesp. thrice daily, as soon as hematuria disappears. R. Ext. Pilocarpi FI., . . Vini Ipecac., . . . :jjss. Mucil. Acacise, . . Aq. Cinnamomi, . ad M. Sig.—A teasp. every four hours until free diaphoresis. R. Pulv. Jalapse Comp., . . giv. Div. in chartulas no. iv. Sig.—One in water before break- fast. Bright’s Disease, Chronic. Milk-cure, has been very successful; skim-milk alone for some time, then gradual addition of other diet (B.). Water, in large draughts, as diuretic, when excretion of solids is deficient (Br.); hot fomentations to lumbar region (B.). Lead, diminishes the albumen (R.). Gallic Acid, to lessen the albu- minuria. See under Albuminuria for formula (A.). Hydrastis, lessens ex- cretion of albumen (B.). Potassium Bitartrate, to prevent dangerous accu- mulations in cellular tissue or important cavities, also to draw off effete mat- ters ; care must be used, as it is a brisk purgative and is weakening (R.); in form of “ cream-of-tartar lemonade,” an agreeable diuretic (B.). Jalap, the compound powder occasionally, as derivative cathartic, to relieve the kidneys (Da Costa). Nitro-glycerin,~t dilate peripheral vessels, relieves the heart and the renal congestion, and diminishes albumen (B.). Tartrates, ex- cellent diuretics (R.). Cod-liver Oil, is very useful (R.). Baths, warm and Turkish, when uraemic symptoms and dropsy; discretion needful, as baths may weaken (R.). Cannabis Bidica, as diuretic when bloody urine (R.). Turpentine, sometimes given in very small doses as a diuretic, and to check hematuria (R.) ; half-drop or drop doses every 2 to 4 hours very successful in dropsy with albuminous urine depending on non-desquamative disease of the kidneys. Jaborandi, in uraemia is very satisfactory (B.) ; large doses very depressant to the heart (A. A. Smith); of the fluid extract ter in die if the urine decreases much (Da Costa). Iron, to improve digestion and correct anaemia; the tinct. of the chloride or tinct. ferri acetatis preferred (B.); in 537 BRONCHIECTASIS—BRONCHITIS, ACUTE. chronic tubular nephritis with cardiac hypertrophy the mist, ferri et ammonii acetatis, gss ter in die, with an occasional vapor-bath (Da Costa). Chimaphila, has power over various forms of nephritic disease, especially when albumi- nuria present (P.). Eucalyptus, in chronic desquamative nephritis, cautiously used will cause improvement (B.). Elaterium. for the dropsy, as a derivative cathartic; must be cautiously used (R.). Bromides, are useful in the convul- sions (R.). See Uremia. Potassium Iodide, has improved some cases, which were possibly due to syphilis (R.). Aurum, the chloride in pill, gr. tit to ~io ter d*e> persistently, in the chronic interstitial nephritis, to arrest hyperplasia of the connective tissue ; may be combined with Arsenic, which has a similar influence (B.). Mercuric Chloride, acts in the same manner, gr. bis die (Da Costa). Pood, should be nourishing, particularly suitable are milk, eggs and rare beef (Da Costa). Buffalo Lithia Water, of Virginia, has many advocates. [Compare Dropsy, Uremia.] Prescriptions. R. Strychninae Sulphatis, . gr. ft. Tinct. Ferri Chloridi, . Acidi Acetici, . . Curagoae, . . . 5j. Liq. Ammonii Acetat., ad Jvj. M. Sig.—A tablesp. every 6 hours, followed by a glass of water. For the anaemia. (Compare those under Bright’s Disease, Acute.) R. Tinct. Nitro-glycerini, . £j. Sig.—One drop, gradually increased to five, four times daily on sugar. (B.) R. Auri et Sodii Chlor., . gr. jss. Aquae Destillatae,. . Solve. Sig.—A teasp. ter in die. Bronchiectasis. Quinine, the most useful remedy as a tonic (B.). Phosphates, are undoubt- edly useful, so also are the Hypophosphites (B.). Chlorine in solution as a stimulant and deodorizer, or as inhalation to lessen fetor (Br.). Palliation of the cough and expectoration, with care of the general health of the patient, is all that can be accomplished. [Compare Emphysema.] Bronchitis, Acute. Aconite, gtt. ss-j every hour (B.); in catarrh and bronchitis of measles (R.). Tartar Emetic, first stage, gr. to especially if cough is violent (B.);— gr. j to a quart of water, a teasp. of this every hour for the wheezing and cough of slight bronchitis in children (A. A. Smith);—gr. to every 2 or 3 hours (R.). Ipecacuanha, as wine, when expectoration profuse, and difficult to expel (R.); dry stage (P.); see below, Opium. Lobelia, as expectorant (B.); for paroxysmal dyspnoea (R.). Sanguinaria, after subsidence of acute symptoms, as expectorant (B.); very successful (P.). Quinine, to reduce temperature (R.). Colchictim, useful when gouty diathesis (P.). Ammo- nium Carbonate, expectoration profuse, and condition low (R.). Opium. Morphine and quinine combined,or Dover’s powder, to abort an attack; also with expectorants to allay cough (B.). Frequent and violent coughs, without obstructed oxidation; also to check excessive secretion (R.). As sudorific very useful, grs. x of Dover’s powder (P.). Carbolic Acid, as spray, a 5 per cent, solution with steam atomizer, prompt and efficient. Apomorphine, the hydrochlorate in doses of gr. A every 3 hours, the best of all expectorants. 538 BRONCHITIS, CAPILLARY. Cimicifuga, an excellent expectorant, and useful when acute symptoms have subsided (B.). Nitric Acid, rt\y of dilute acid relieve (B.). Asafoetida or Ammoniacum, the last best, in bronchitis with wheezing of old people (R.). Cubebs, very useful, especially when secretion copious and system relaxed (P.). Copaiba, after subsidence of the fever, the most serviceable expectorant, but nauseous (B.). Counter-irritants, mustard as poultice (large), with lin* seed or oatmeal, or both, very useful (R.). Iron, Lead, Zinc Oxide, to check profuse secretion (R.). Heat, to chest by linseed poultice, of great service. Diet should be light and in liquid form. Temperature of atmosphere in room about 8o° F., and the air moistened by steam. [Compare Cough.] Prescriptions. R. Antim. et Pot. Tart., . gr. ij. Liq. Ammonii Acet., . Spt. Etheris Nitrosi, . %j. Tinct. Aconiti, . . £ss. Syr. Simplicis, . ad 3vi. M. Sig.—A teasp. every 2 or 3 hours. In first stage. R. Ext. Cimicifugae FI.,. . Tinct. Opii Deodorat., . 3j. Syr. Tolutani, . . ad M. Sig.—A teasp. every 4 hours. (B.) R. Tinct. Sanguinariae, Tinct. Lobeliae, . . aa £j. Vini Ipecac., . . . sjij. Syrupi Tolutani, . . M. Sig.—A teasp. every 3 hours. (B.) R. Tinct. Aconiti, . . iitviij. Aquae Cinnamomi, . • §j- M. Sig.—A teasp. every x/z hour for 2 hours, then every hour. In acute inflammatory form. R. Apormorph. Hydrochlor., gr. x/t. Ac. Hydrochlor. Dil., . '•h.iij. Syrupi Senegae, . . Aquae Destillat., . . £}. M. Sig.—A teasp. every 2 hours. For a child of 3 years as expectorant. Should be put up in a blue bottle. R. Vini Ipecac., . . . gij. Liq. Potassii Citratis, . £iv. Tinct. Opii Camphorat., Syr. Acaciae, . . aa §j. M. Sig.—Tablesp. ter die. In first stage of ordinary acute bronchitis. [Da Costa.) R. Ext. Eriodyctii FI., . . gvi. Ext. Senegae FI., . . Z\v. Syr. Pruni Virginian., . 31J. Aquae, q. s. . . ad 3iv. M. Sig.—Teasp. every 3 hours. Bronchitis, Capillary. Ipecacuanha, as emetic, preferred to tartar emetic in capillary bronchitis of very young or very old (B.); as wine, when expectoration profuse and diffi- cult to expel (R.). In very young infants should be used in place of antimony (M. & P.). Squill, as expectorant, may be used with benefit (Wa.). Anti- mony, sulphurated, gr. in combination with Dover’s powder, every 2 or 3 hours, when the temperature very high, and pulse full and strong. Must be stopped as soon as nausea and vomiting begin (M. & P.). Lobelia, for par- oxysmal dyspnoea (R.). Ammonium Carbonate, when expectoration profuse and strength diminishing; in severe bronchitis or broncho-pneumonia of chil- BRONCHITIS, CHRONIC. 539 dren, especially when prostrate and livid (R.); has probably a specific action on the diseased tissue and its products (Clymer). Ammonium Iodide, in small, rapid doses, often gives great relief to the catarrhal process (Da Costa); often gives the most astonishing relief (B.). Ammonium Muriate, gr. ij every 2 hours, either alone or with potassic chlorate (Clymer). Serpentaria, in capillary bronchitis of children gives excellent results (B.). Turpentine, one of the best stimulants when vital powers are depressed and peripheral circula- tion feeble (B.). Camphor, to allay cough and promote expectoration (B.). Hydrocyanic Acid, for cough and tendency to spasm. Hydrarg. Subsulph. effective as emetic (B.). Mustard, as poultice or bath, useful (R.);—the most important part of the treatment (M. & P.). Poultices, to encircle the whole chest in children (R.). A jacket of cotton-wool around the chest. Steam, by inhalation, may be impregnated with sedatives, or with carbolic acid;—is of great importance (M. & P.). Quinine, in that form of capillary bronchitis occurring in tropical climates, and where marked debility (M. & P.). Stimu- lants, are often necessary, especially in the suffocative form, and where marked prostration (M. & P.). Emetics, ate necessary when suffocative symptoms become prominent. [Compare Cough.] Prescriptions. R. Ext. Serpentariae FI., . Ammonii Carb., . . 2ij. Syr. Tolutani, . . . M. Sig.—A teasp. every 2, 3, or 4 hours. (B.) R. Liq. Ammonii Acet., . !|ss. Syr. Ipecac., . . -3). Liq. Morp. Sulph. (gr. j ad • • Syr. Acacise, . . . 5|j. Aquae, . . . . 3jss. M. Sig.—A teasp. every 2 hours for a child 2 years old. When surface pale and expression languid, skin cool. (M. & P.) R. Quininse Sulph., . . gr. vj. Ac. Sulph. Dll., . . ttfxij. Syr. Simplicis, . . 3;ss. Aquae, .... :fijss. M. Sig.—A teasp. every 2 hours to child of 2 or 3 years; older Children require more quinine. (M. & P.) R. Amrtionii Iodidi, . . gj-ij. Ammonii Carb., . . Syr. Glycyrrhizae, . . 5ij. Syr. Tolutani, . . M. Sig.—A teasp. every 2 or 3 hours. Bronchitis, Chronic. Antimony, when expectoration copious and difficult to expel (R.). Arsenic, where emphysema, in cigarettes (B.). [See ante, Asthma, for formula.] Sulphur, gr. v-x, in severe cases, with abundant discharge, especially where constitutional debility (R-). Sulphurous Acid Gas, inhalations, or the acid in form of spray, sometimes beneficial (B., R.). Lobelia, for paroxysmal dys- pnoea (R.). Ammonium Chloride, combined with stimulating expectorants, such as Serpentaria, Sanguinaria, or Eucalyptus (B.);—when secretion is thick and abundant, may be applied by an atomizer (R.). Carbolic Arid, as inhala- tion of spray, I part to loo of water; may be combined with tincture iodine (B., R.). A 5 per cent, solution in steam atomizer as inhalation. Hydrastis, fluid extract, locally and internally (B.) ; of great value internally and exter- nally in chronic coryza (P.)- Senega, especially in the aged (R.). Iodine, by inhalation, sometimes used (R.);—the Iodides, especially the iodide of ammo- 540 BRONCHITIS, CHRONIC. nium, are very serviceable in combination with expectorants (B.). Colchicum, in gouty subjects (R.). Balsams of Peru, and Tolu, when copious secretion of pus (R.). Ammonia, inhalation, to lessen expectoration (R.). Oleum Anthemidis,'va pulmonary catarrh with excessive secretion and difficult expec- toration, a very useful remedy, Ttlij-iv (P.). Ammoniacum, the mistura, with chloride or carbonate of ammonium, efficient in the bronchitis of old people, with wheezing and abundant secretion (R.). [See Bronchorrhcea, for form- ula.] Benzoin, zj of the compound tincture to boiling water, as inhalation; eases cough and lessens expectoration (R.). Sometimes used by atomization (B.). Phosphates, for the resulting cachexia (B.). Phosphate of lime (R. 1. Serpentaria, as stimulant. Alum, powdered, dusted over surface (B.). Silver Nitrate, locally (gr. on sponge probang (B.). Camphor, to allay cough and promote expectoration (B.). Sumbul, has decided efficacy (P.). Opium, with expectorants, to allay cough (B.). When frequent and violent cough, without any signs of obstructed oxidation; also to check excessive secretion (R.). Codeine, gr. *4 every 3 to 6 hours, when other opiates are not well borne (P.). Ethyl Iodide, by inhalation, is very valuable by reason of its local influence Tltv-xx thrice daily (B.). Grindelia, an excellent expectorant, and especially when cough is troublesome (B.). Strychnine, as a respiratory stimulant and to check the reflex vomiting (B.). The syrup of the phosphates of iron, quinine and strychnine. Squill, in chronic forms with tenacious sputa, but not when fever or acute inflammation (R.). Tar, diminishes the secre- tion and allays the cough (P.); gr. ij in pill every 3 or 4 hours in chronic paroxysmal winter cough (R.). Digitalis, when interstitial pneumonia and general anasarca (B.). Eucalyptus, valuable in chronic cases of broncho- pulmonary catarrh (B.). Gallic Acid, useful in some forms of chronic broncho- pulmonary catarrh (B.). Iron, with free expectoration, mistura ferri com- posita ; or better, the phosphate of iron, quinine, and strychnine (B.). To check profuse bronchial secretion (R.). Myrtol, in fetid bronchitis, of great value (Gubler). Copaiba, when purulent secretion (R.);—for profuse secretion, the best of all expectorants, but nauseous (B.). Cubebs, when profuse expectora- tion, has similar remedial influence (B.). [See Bronchorrhcea, for formula;.] Koomiss-cure, possesess great value (B.). Cod-liver Oil, a teaspoonful ter die after meals, of great service, if continued (B.); to control expectoration (R.). Poultices, made large, of hot linseed meal to cover the chest, when congestion of lungs. Olive Oil, inunctions to chest, has soothing and strengthening effects. Diet, nutritious, and stimulants necessary when great prostration. Koomiss is an excellent article of diet. [Compare Cough, Emphysema.] Prescriptions. R. Ext. Eucalypti FI., . . §j. Ammonii Chloridi, . . gij. Ext. Glycyrrhizse, . . zij. Syrupi Tolutani, . . j|iij. M. Sig.—A teasp. 4 to 6 times daily. R. Ammonii Carbonat., . gr. xl. Infusi Serpentarise, . . s-iv. M. Sig.—A tablesp. every 3 hours. R. Ammonii Chloridi, . . ziij. Syrupi Picis Liquidse, . M. Sig.—Tablesp. 4 times daily. R. Ext. Eucalypti FI., . . Syr. Acacise, . . . £j. Aq. Menth. Piperitce, . t|iij. M. Sig.—A teasp. every 3 hours. R. Ammonii Chloridi, . . Syrupi Tolutani, Syr. Pruni Virg., . aa ,^ij. M. Sig.—Teasp. 3 or 4 times daily. BRONCHORRHCEA—BRUISES. 541 R. Tinct. Sanguinarise, . gj. Ammonii Chloridi, . . gj. Syrupi Tolutani, . . zij. Spt. Etheris Nitrosi, . Jss. Aquae, .... 3 iijss. M. Sig.—Tablesp. p. r. n. R. Syrupi Scillae, . . . gss. Tinct. Opii Camph., . . tjij. Ammoniaci, . . . gss. Syrupi Tolutani, . . gx. M. Sig.—A teasp. p. r. n. Bronchorrhcea. Ammoniurn Iodide, often improves the condition, especially if used with arsenic (B.). Oil of Eucalyptus, of great utility (B.); rqij ter die on sugar, or see formulae above. Sulphurous Acid Gas, as inhalations, or the sulphurous acid as spray, sometimes improve (B.). Lead Acetate, as astringent, to re- strain secretion (B ). Petroleum, crude, in capsules, has been administered with rapid amelioration as the result (Blache). Grindelia, an efficient rem- edy (B.). Iodine, as liniment, over front and back of chest (R.). Spinal Ice-bag, to restrain excessive secretion (R.). Quinine, and the Phosphates, also Cod-liver Oil, as restoratives (Wa.). Copaiba, the most serviceable ex- pectorant, but nauseous (B.); when copious secretion of pus (R.). Cubebs, has remedial effect in chronic bronchial affections with profuse expectoration (B.). Asafetida, is of great benefit (B.). Turpentine, an excellent remedy when fetid expectoration; maybe used internally (Tv) or by inhalation from atomizer. Carbolic Acid, internally, Tj, and by spray (gr. v ad gj aquae), olten of great utility (Da Costa). Benzoin, by inhalation, for its local in- fluence. Myrtol, is largely eliminated by the lungs, and is a most valuable agent in bronchorrhcea and fetid bronchitis, acting, as a stimulant and anti- septic (Gubler); dose Ttlij in capsules (Br.). [Compare Cough.] Prescriptions. R. Copaibae, Syrupi Tolutani, . aa 5ss. * Spt. Etheris Nitrosi, . . ?j. Aquae Menth. Pip., . . i$ij. M. Sig.—A teasp. every 4 hours. R. Ammonii Chloridi, . . £j. Mist. Asafoetidae, . . t^iv. Misce. Sig.—Tablesp. as required. R. Potassii Iodidi, . . gj. Ac. Nitrici Dil., . . giij. Tinct. Belladonnae, . . £j. Ac. Salicylici, . . . gj- Aquae Camphorae, . ad M. Sig.—Dessertsp. in water 3 or 4 times daily, for fetid bronchitis. R. Copaibae, Bals. Tolutan., Pulv. Acaciae, . . aa t^ss. Ac. Sulph. Aromat., . . zss. Aquae Destillat., . . gvi. M. Sig.—Tablesp. bis vel ter in die. Bruises. Arnica, the infusion very useful as an external application for bruises and cuts; also an excellent internal remedy for internal bruises, shake, falls, blows, or shock ; mv-x every 2 or 3 hours (P.); in bruises, sprains, etc. (Wa,). Aconite, the liniment locally to painful sprains and bruises (Wa.). Capsicum, a strong tinct. applied with gum, said to act like a charm on discolored bruises (R.). Sulphurous Acid, a solution, constantly applied (R.). Oil of Bay, as 542 BUBO—BUNION—BURNS AND SCALDS. stimulating liniment (P.). Opium, the tincture with linimentum saponis (gj to 3j) diligently rubbed in two or three times a day, affords great relief (Wa.). Bubo. Mercury, necessary in the indurated buboes diagnostic of syphilis (Ricord): the powder of calomel locally applied for indolent buboes refusing to heal after opening (H.). Nitric Acid, indolent and broken bubo (R.). Sulphides, are less useful in maturating than in the case of ordinary boils or abscesses (R.); to check suppuration (St.). Iodoform, locally, has proved useful (Wa.). Iodine, applied to produce vesication around a bubo, relieves inflammation (R.); freely every day, with rest and compression, to cause absorption (St.). Silver Nitrate, lightly to surface,to stimulate indolent buboes (Wa.). Potas- sio-tartrate of Iron, 30 parts to 250 aquse destil., three tablesp. daily ; also as lotion to sore (Ricord) ; phagedena (St.). Tartar Emetic, gr. j every two hours reduces inflammation in many cases (Wa.). Ice, greatly relieves (B.). Surgical.—Open freely with a bistoury when suppurating; if pus is virulent, the open bubo is a chancroid, and must be treated as such (Keyes). Pressure, by compressed sponge under a spica bandage, or a shot-bag, the best local treatment for indolent bubo (Keyes); in all cases cleanliness, rest in recum- bent posture, emollient poultices. Diet, should be generous, with cod-liver oil, in phagedenic bubo. The treatment of Syphilitic Bubo is that of gen- eral syphilis, local measures are useless, and no treatment called for until a general eruption appears (Keyes). [Compare Chancroid, Syphilis.] Bunion. • Iodine paint, or Emplastrum Hydrargyri, for indolent form, thick but not tender (D.). Rest, fomentations, and anti-arthritic remedies for thickened bunion; burst it by pressure if recent and sac thin (D.). [Compare Bursitis.] Burns and Scalds. Carbolic Acid, 1 part to 30 of lin. calcis, or 1 part to 6 of olive oil; the latter speedily relieves pain, and promotes healing without suppuration (Wa.); 1 part to 10 of olive oil, applied on layers of cotton batting, the best application for burns of all degrees. Boracic Acid, a saturated watery solu- tion, used with great success by Lister (B.). Lead Carbonate, white lead paint, an excellent application to burns of small extent (B.). Salicylic Acid, ol. olivae is an efficient local application (B.). Collodion, flexible, to burns of first degree (B., R., P.). Phytolacca, relieves pain (B.). Lime, as lime-water and oil, equal parts (R.); or lime-water with linseed oil, a favorite application (P.). Rhus Toxicoden., externally 3 to the pint, in superficial but extensive burns (P.). Cantharis, the tincture diluted with 40 parts of water and applied on rags, is a most excellent application. Sodium Carbonate, in solution as lotion, immediately relieves pain and promotes rapid healing. Tur- pentine, in dangerous cases, where great constitutional depression (P.); as wash to severe burns, then locally basilicon ointment mixed with turpentine (B.). Cotton-wool, to allay pain and exclude air (P.). Warm Bath, immerse for some days (R.); exclusion of air the main indication (H.). BURSITIS—CACHEXIAE. 543 Prescriptions. Lime and Linseed. R. Olei Lini, . . . Aquae Calcis, . . . M. Sig.—Apply on sheet lint, and cover with oiled silk. R. Iodoformi, . . . Cetacei,. . . -Eh Ext. Conii Alcohol., . gr xl. Acidi Carbolici, . . gtt. x. M. Sig.—Spread on lint and cover the parts therewith. R. Sodii Carbonatis, . . Aquse, .... Oiij. M. Sig.—Apply freely for 3 days on old cloths or lint. R. Pulv. Carbonis Ligni, . Sig.—To be dusted thickly over the burned parts. Bursitis. Iodine, painted on outside, after removal of fluid with aspirator (D.): after blistering (Wa.). Blisters, in rheumatic enlargement of bursae, are almost indispensable for a rapid cure (Wa.). Fomentations, with rest, to relieve pain and swelling. If unavailing, a crucial incision into the bursa, care being taken not to open the capsule of the knee (D.). Excision, when chronic, tumor hard, resisting other measures (C.). Cachexise. Lime, the phosphate, in scrofulous affections and anaemia (Wa.); in phthisis, and affections marked by mal-nutrition (B.). Iron, in splenic, syphilitic, and strumous, and especially in all anaemic states ; also in the malarial and phthis- ical ; chalybeate waters (B.). The ammonio-citrate the best tonic in the ca- chexia of gastric ulcers, especially in chlorotic females (Wa.). Arsenic, a prompt remedy in the malarial cachexia; also in cancerous of real value (Wa.). Hydrastine, in paludal and splenic cachexise, stands in high esteem (B.). Nitric Acid, is adapted to the cachexia following acute disease or in- temperance ; also as alterative after long courses of mercury (Wa.). Potas- sium Iodide, in constitutional syphilis, and resulting affections of bones and skin (Wa.). Mercury, in the syphilitic; but its utility much questioned (Wa.). Aurum, in cancerous, mercurial, and syphilitic cachexise, especially when bones, glands, and oculo-nasal mucous membrane affected. Phosphates, in bone diseases, wasting, bronchitic, leucorrhceic, etc. (B.). Arnica, in very developed cachexise, has excitant action on nervous system (Wa.). Euca- lyptus, a serviceable tonic and stimulant in cachectic states generally (B.). Manganese, the syrup of the iodide of iron and manganese in ansemic, syphilitic, strumous, malarial, cancerous, etc. (B.). Grape-cure, often modifies most happily many conditions (P.). Air, in good condition, an important element (B.). Water, the Turkish bath and wet pack as aids to remedial action, in plumbic, mercurial and paludal (B.). Oils and Fats, to promote constructive metamorphosis in many cachexise, especially cod-liver oil (B.); the latter a most valuable remedy in scrofula, phthisis, atrophy, tubercular and jaii cachexise, ansemia, etc. (Wa.). Alassage, has been productive of re- markable results in many forms of cachexise (B.). Aliment, of prime im- portance (B.). [Compare the various titles, Anemia, Scrofula, Syphilis, etc., and the formulae for tonics, on pages 520 and 525, anie.~\ 544 CALCULI,, BILIARY—CALCULI, RENAL AND VESICAL. Calculi, Biliary. Chloroform, is supposed by some to act as a solvent in 20- to 60 drop doses every 3 or 4 hours; it cannot act as a solvent, but undoubtedly affords some relief (B.); as an inhalation it may be used to relieve the pain of the parox- ysm (Br.). Ether and Turpentine, equal parts of each, gj once daily for a year, is Durande’s solvent remedy; is not solvent, and as an anodyne inferior to morphine or chloral (B.). Morphine, gr. % with Atropine gr. hypo- dermically, the best anodyne for the pain and vomiting during the paroxysm (Br.). Chloral, sometimes relieves the pain (R.). Counter-irritants, z.s mus- tard poultices to relieve the pain during the paroxysm (Br.). Olive Oil, at night, followed next morning by 3 or 4 seidlitz powders an hour apart, efficient in facilitating the expulsion of accumulated gall-stones. Nitro-muriatic Acid, as bath, found useful in India to relieve the pain and promote expulsion of the calculus, of the acid to a gallon of water (Scott). Sodium Phos- phate, in 3 doses before each meal for several months, to prevent recurrence (B.); should be given in plenty of water (Br.). Succinate of the Peroxide of Iron, hydrated, contains a large proportion of nascent oxygen, and is given in teaspoonful doses after meals for several months, and resumed at intervals afterwards, to prevent reformation of the calculi (Buckler). Diet, is impor- tant; withhold all starches, sugars and fats, also malt liquors and spirits ; mod- erate exercise out of doors, lean meats, eggs, fish, fruits and succulent veg- etables to be used freely. Mineral Waters, the alkaline are useful, especially Vichy, which is deemed of great benefit. [Compare Colic, Jaundice.] Prescriptions. R. Succinat. Hydrat. Ferri Peroxidi, . . . 5jss. Aquae, .... M. Sig.—Teasp. after each meal for several months. R, Spt. Etheris Comp., . £ij. Liquor. Magendie, . TRxxx. Syr. Zingiberis, . ad j|j. M. Sig.—Teasp. doses, an hour apart, until pain is relieved. Calculi, Renal and Vesical. Alkalies, especially potassium salts, if long continued will effect solution of uric acid calculi (R.); sodium salts should not be used (B.). Potassium Citrate, in large doses for bloody urine containing uric acid crystals (R.); the citrate and carbonate of potassium are the most desirable solvents for uric acid gravel (Sir H. Thompson). Potassium Tartra-borate, if long used, is very efficient as a solvent for uric acid calculi (B.). Potassium salts are much more efficient than those of Lithium as solvents for uric acid (Prof. Rogers). Alka- line Mineral Waters, those rich in potassium preferred, especially Vichy (B.). Ammoniu?n Benzoate, long-continued will dissolve phosphatic calculi (B.). Magnesium Boro-citrate, is a good solvent of uric acid calculi (Madsen). Lithium Citrate, to promote oxidation (Da Costa). Hydrangea, in decoc- tion, used by the Cherokees in all calculous affections with uniform success (Butler). Lead Acetate, gr. to the p, of distilled water, injected into the bladder to prevent formation of phosphatic calculi, or a solution of Dilute HCl And, Tilij-iij to the £ (Sir H. Thompson). Nitric Acid, very dilute, as injec- tion for phosphatic calculi (R.); gtt. j to the ;j, as injection into bladder in chronic cystitis and phosphatic deposits (B.). Cotton-root, in decoction, as a CANCER. 545 demulcent for strangury and gravel (P.). Castor Oil, of value as a purgative (P.). Calumba, to relieve the vomiting (P.). Counter-irritants, as mustard- poultices, or turpentine stupes, to relieve pain of the paroxysm (R.). Ances- thetics, for the same purpose (B.). Morphine, hypodermically, as an anodyne and to relieve the vomiting (B.). Hot Fomentations, to alleviate spasm and pain while calculus is passing. Diet. Restrict the use of sugar in any form or combination, also fats and alcoholic beverages. Fresh, green vegetables may be used freely, also skimmed milk or buttermilk. Mineral waters, pre- ferably Vichy, Friedrichshalle and Carlsbad. Frequent abstinence from animal food. Lemon-juice and soft water in large draughts, are useful. Surgical Measures. Lithotomy or Lithotrity for removal of stone from bladder. Solvents are of no use except for a very small calculus, and even then a considerable time must be occupied in the process. No operation in surgery more certainly safe, rapid and successful than lithotrity (Sir H. Thompson). [Compare Colic, Lithiasis, Oxaluria, etc.] Prescriptions. Magnesium Boro-citrate. R. Magnesii Carbonat., . £j. Sodii Biborat., Acidi Citrici, . aa Aquse Bullientis, . . M. Sig.—Tablesp. 3 or 4 times daily. (B.) Potassium Tartra-borate. R. Potassii Bitartratis, . partes iv. Ac. Borici, . . partem j. Aquae, . . . partes x. By heating the above together, the salt is obtained as a white powder, of which gr. xx in a large draught of water 3 or 4 times daily. Cancer. Arsenic, in cancer of stomach, diminishes pain and checks vomiting; also in scirrhus of stomach and epithelioma; is believed to retard the growth of uterine cancer (B.). Arsenious acid, pure or with starch, as a caustic; enough should be used to set up active inflammation (R.). Belladonna, locally and internally (triv-x), of great benefit as palliative in severe pains of cancer (P.). Conium, as poultice, and internally to relieve pain (R.). Is particularly appli- cable to pain of cancer (P.). As palliative (Wa.). Hydrastis, has a renewed interest (Pf.). Carbolic Acid, undiluted, to sore, and injected beneath it, limits and retards (B.); pure, as anaesthetic, before applying caustics; with glycerin, as application to fetid cancers (R.). Mercuric Chloride, in small doses, long- continued, will retard the growth of gastric cancer (Da Costa). Citric Acid, aquae, useful in allaying pain of cancerous ulcerations (Wa.). Acetic Acid, 1 to 3 aquae; ttlxxx injected into the tumors,has been used with varying success (Wa.). Chloral, in gr. x doses, 3 times a day, has relieved most severe pain of cancer (R.). Chloroform, as vapor to raw surface (R.). Hyos- cyamus, bruised leaves, locally (P.). Bismuth, relieves pain and vomiting of gastric cancer (B.). Glycerin of Tannin, with glycerin of carbolic acid, checks discharge and stench of uterine cancer (R.). Carbonic Acid, injected up va- gina in cancer of uterus, to relieve pain (R.). Iodoform, applied to diseased surface, relieves pain and removes fetid odor (B., P.). Resorcin, 15 parts to 20 of Vaseline as an ointment twice daily after washing with a solution of pot. permanganate has successfully stopped epithelioma (Antonio). Potassium Chlorate, in impalpable powder, dusted on epithelioma, said to be curative (B.). Pepsin, injections into tumor (B.). Salicylic Acid, pure, applied in 546 CANCRUM ORIS—CARBUNCLE. powder (B.). Zinc Chloride, the most efficient and safe escharotic. Parts j— ij-v flour, or -‘caustic arrows” inserted at base of tumor (B.). Potassa Fusa, as escharotic (B.). Opium, to cancerous sores. Morphine, dissolved in gly- cerin and spread on lint, very useful where there is much pain. Opium is also used in cancer of the stomach (R.). Codeine (gr. TJ5 to a good hypnotic (P.). Zinc Sulphate, dusted over, dry. An excellent caustic. Remove the eschar by poultice (B.). Bromine, for destruction of uterine cancer, is preferred by some (B.). Chromic Acid, a powerful escharotic (B ). Iron and Manga- nese, the syrup of the iodide, for resulting cachectic state (B.). Poultices of starch, applied cold (R.); or poultices of bread, sprinkled with charcoal or freshly ground coffee, as deodorizers to open cancers. Warm Enemata, to relieve pain and straining in intestinal cancer (R.). Prescriptions. R. Bismuthi Subnit., . . gij. Morphinae Sulph , . . gr. j. Fiant pulv. vj. Sig.—One thrice daily in milk, when gastric pain and vomiting. (B.) R. Acidi Arseniosi, 1 . . gij. Mucil. Acaciae, . . . As paste on cancerous sore, followed after 2 or 3 days by bread poultices until slough separates. Cancrum Oris. Arsenic, in medicinal doses (R.). Nitric Acid, to surface (R.); strong nitric acid the best caustic for worse forms of the disease (Wa.). Potassic Chlorate, gr. xx-xl in 24 hours, has been strongly recommended (D.). Qui- nine, made into a syrup, or as enema, to support the strength (Wa.). [Com- pare Aphthae, Stomatitis.] Carbuncle. Belladonna, with glycerin, as local application to relieve pain (R., P., Wa.). AiJimonium Acetate, to support the system (Cezard). Carbolic Acid, on lint, with glycerin or oil, into discharging sinuses (R.); or hypodermically into the sloughing tissues. Iodine, to produce vesication around carbuncle; reduces inflammation (R.); part j of tincture to iij aquae, locally, has most striking effect (Wa.); maybe used with benefit internally or hypodermically (Cezard). Calcium Sulphide, gr. hourly, or every two hours, of great service (R.). Opium, a thick extract, locally (R.). Potassium Chlorate, highly recom- mended, also Quinine and Iron, freely to support the system and counteract the carbuncular poison. Poultices, the inflamed surface having been pre- viously smeared with belladonna and glycerin (R.). Long-continued poul- ticing thought to create tendency to a fresh crop. Strapping, with plaster, concentrically from border inwards, leaving the centre free, will sometimes arrest extension (R.). Collodion, as protective covering (P.); as zone around base, leaving the centre exposed (Wa.). Collodium cum cantharide in a broad zone painted around the carbuncle, to relieve the tension (Ag.). Ice, or Ice-bags or iced-water on cloths in early stage, changing to warm fomenta- tions as soon as suppuration has begun (Hebra). Galbanum and Opium as plaster to relieve pain, the separation of the core then proceeding painlessly (Hill). Crucial Incisions are not so frequently made now as formerly ; they relieve tension, but often give rise to severe hemorrhage. Diet should be very supporting, and stimulants may be used freely when the patient is debilitated. CARIES—CATALEPSY—CATARACT. 547 Saline purges occasionally (Hill). Cauterization, with fuming nitric or carbolic acid, on top of a free, crucial incision, followed by dressing with carbolized oil, is the course to pursue in malignant pustule. Caustic Potash, applied before an opening occurs, or small pieces inserted into openings made by scalpel, to cause the rapid separation of the slough. The resulting ulcer should be treated on general principles. [Compare Boils.] Prescriptions. R. Calcis Sulphurat., . . gr. iij. Sacchari Lactis, . . q. s. Triturat. et div. in chart, xxx. Sig.—One powder every 2 houts, to be taken dry on the tongue. R. Tinct. Ferri Chloridi, . £j. Potass. Chlorat., . . ziij. Liq. Ammonii Acetat., . Syrupi et Aquae, . q. s., ad j|viij. M. Sig.—Dessertsp. every 2 hours. Cariesi Aurum, in syphiloma of bones (B ). Calcium Chloride, where strumous cachexia (B.)-. Phosphoric Acid, with 8 parts water, locally applied, has been of benefit (Wa.). Phosphates, best is syrup of lacto-phosphate of lime, or Parrish’s phos. (B., R.). Villate's Solution, to dissolve the carious bone, has cured many cases (B.); see formula below. Sarsaparilla, a very useful medi- cine (P.). Iodine, locally, with iron or cod-liver oil internally (Wa.); See Bone. Potassic Iodide, in syphilitic caries, holds the first place (Wa.). Cod- liver Oil, to promote constructive metamorphosis (B., R.). Mechanical Con- trivances, necessary in most cases ; Sayre’s plaster jacket, Agnew’s jacket of leather and steel, Taylor’s apparatus, etc., are used in spinal caries to separate the diseased bones, and extend the spinal cblumh. [Compare NecRosis.] Vill'ate's Solution. R. Cupri Sulphat., Zinci Sulphat., aa partes xv. Liq. Plumbi Subacetat., p. xxx. Aceti, . . . . p. tc. To be injected through the sinuses. Prescriptions. R. Syrupi Calcii Lacto-phos- phatis (U. S. P.), . i Sig.—A dessertsp. to a tablesp. 3 or 4 times daily. Catalepsy. Turpentine, in enemas, and embrocations along the spine, affords the best chance of stopping the paroxysms (Wa.). Treatment must be essentially tonic and restorative (H.). No constant line can be stated (A.); external stimulation to arouse consciousness, by Ammonia, cold douches, Faradism, etc. Apomorphine, gr. to T\j, in the paroxysm; with the onset of nausea, consciousness returns and spasm ceases; in the intervals between the attacks the treatment should be that of hysteria (Gowers). Cataract. Phosphorus, with oil, by frictions to the forehead, and instillation of the same into the eye, may cause absorption of the lens or capsule (Wa.). Co- deine, in diabetic cases (Br.). Sodium Sulphate, a solution suggested as in- 548 CATARRH, ACUTE NASAL. jeetion into anterior chamber, in hope to dissolve the nebula (Wa.). Gal- vanism, has been successfully employed in incipient stage (Wa.). Mydri- atics, Atropine, Duboisine, etc., to secure full dilatation of pupil, as a means of ascertaining when the operation should be made, which is when the cataract is mature, there being no vision even with dilated pupil (Wa.). Diet and Regimen, may do much to retard degeneration of the lens, in cases due to diabetes, or malassimilation in gouty or rheumatic persons (C.). Iridectomy, made early and effectually may postpone the progress of lenticular opacity, if due to increased intraocular tension (C.). In partial cataracts, which have become stationary, iridectomy for artificial pupil may be done to expose clear portion of lens (Roosa). Medicine accomplishes nothing except to improve general health and so delay the progress of the opacity. Removal may be performed by one of several operations (Roosa). Catarrh, Acute Nasal. Aconite, in severe coryza with much chilliness, aching limbs, hot and dry skin, and quick pulse; also in catarrhs of children and that accompanying measles (R.); in acute coryza (P.) ; with Belladonna in ordinary colds with sore throat and high fever (B.); in doses of 1Tl every )4 hour, very useful fur a commencing cold in the head (A. A. Smith). Belladonna, in acute nasal catarrh with profuse watery secretion, tp. v of tincture, then Ttf j each hour (B.). Nux Vomica, has great effect upon a dry cold in the head (P.). Euphrasia. is of decided utility in coryza (P.). Pulsatilla, a warm lotion, in aquae, syringed into the nasal passages in subacute coryza with muco- purulent secretion (P.); acts similarly to Aconite, but is contraindicated if much gastric or intestinal irritation exists (B.). Iodine, by inhalation in daily attacks with itching nose (R ) ; 5jij of the tincture with 5jj of carbolic acid inhaled from a sponge in the bottom of a wide-mouthed bottle placed in hot water (B.). Iodides, are unquestionably serviceable, their action being local and substitutive; Ammonium Iodide, gr. j every two hours, the best mode of using them (B.). Sodium Iodide, gr. x ter die, with Pil. Ferri Iodidi, in ca- tarrhs of specific origin (B.). Potassium Iodide, gr. x at bedtime at the on- set, to cut short an acute cold in the head; also useful in chronic colds (R.). Quinine and Morphine, gr. x with gr. >4, at incipiency, will often abort (B.). Opium, at night, if taken early, will often abort an attack of coryza; a glass of hot grog assists its action (R.); Dover’s powder, in a full dose at the onset may abort (B.). Codeine, is useful in common colds, as a palliative (B.). Ammonia, maybe inhaled in the early stage (R.). Potassium Chlorate, 8 or io lozenges a day will abort many a cold (R.). Camphor, as inhalation, the spirit in form of vapor (R.); with Opium and ammonium carbonate as powder (see formula below), to break up or modify a cold (Beard). Tartar Emetic, gr. s to in the first stage (B.); in acute catarrh of children often accompanied by vomiting and diarrhoea (R.). Arsenic, when sneezing, itch- ing of nostrils, frontal headache (R.); as cigarettes (B.); see under Asthma, for formula. Veratrum Viride, if arsenic fails (R.). Ipecacuanha, for acute nasal and bronchial catarrh, and ordinary colds in children (B ). Cimicifuga, when headache, stiff muscles, dull aches, bone-pains, etc. (R.); an excellent expectorant (B.) ; rheumatic colds, neuralgic pains in jaws (P.). Jaborandi, the fluid extract in doses of rrtx to xxx, every half-hour until profuse dia- phoresis sets in, is one of the best modes of aborting a cold. Cocaine, a 4 or 5 per cent, solution locally as spray, to empty the engorged venous sinuses of CATARRH, CHRONIC NASAL. 549 the nasal mucous membrane, by their contraction, which it induces. The fluid extract of Erythroxylon diluted with water is equally efficient if enough be used (Cohen). Cubeb, or Ammonium Chloride, in the dry, congestive stage of a cold in the head; Cubeb cigarettes may be smoked as a temporary palliative with great relief. Sulphurous Acid, in coryza, by inhalation, spray or fumigation, is very efficient (R.). Oil Inunctions, daily to the whole body, in cases of undue susceptibility to taking cold, will prevent the frequency of the attacks (B.). Baths, a warm foot-bath before going to bed; Turkish bath, at onset in coryza, may prove abortive; also useful later on. Cold sponge bath, in cases of extreme susceptibility, supplemented by occasional Turkish baths (R.). [Compare Cough, Hay-fever, Influenza.] R. Camphorae, . . . gr. 1. Athens, . . . q. s. Dissolve to creamy consist- ence, then add— Ammonii Carbonat., . gr. xl. Pulv. Opii, . . . gr. x. Divide into thirty papers. One or two powders, according to age, twice or thrice daily. [Beard.) Prescriptions. R. Codeinae, . . . gr. ij. Syrupi Tolutam, Syr. Scillae Comp.,. aa §j. M. Sig.—Teasp. occasionally for a common cold. (B.) R. Tinct. Aconiti,. . . th. x. Tinct. Belladonnse, . . £ss. Syrupi Zingiberis, . ad 5ij. M. Sig.—Half to one teasp. accord- ing to age, every hour. R. Acidi Carbolici,. . gr. lxxx. Alcoholis, . . . Aq. Ammonise, . . Tqlxxx. Aquae, . . . M. Sig.—A few drops as an inhala- tion from a cone of blotting-paper [Brand.) Ferried s Snuff. R. Morph. Hydrochlor., . gr. ij. Bismuthi Subnit., . . gvj. Pulv. Acaciae, . . J^ij. M. Sig.—Use as snuff, to j4 the above in 24 hours. Catarrh, Chronic Nasal. Sanguinaria, the tincture in io-drop doses thrice daily, or gr. of the alkaloid, internally, and the powder in small quantity locally to the mucous membrane, is successful treatment for chronic nasal catarrh (B.). Hydrastis, is of value in chronic coryza, also in ulceration of the septum or any other part of the nasal fossse, gtt. v of the tincture thrice daily internally, and to ijviij of water locally with syringe (P.). Pulsatilla, is excellent in subacute inflammation of nasal passages, with offensive muco-purulent discharge. ad 5iv of water, as wash (P.). Potassium Bichromate, is an excellent local application in a solution of gr. j-x to giv water (B.). Iodoform and Tannin, 1 of the former to 2 or 3 of the latter, carefully triturated, and applied by an insufflator every other day only, is the very best of all applications (B.). Sodium Chloride or Phosphate, a teasp. to the pint of warm water as cleansing solution, or the Bicarbonate in the same proportion. A sea-water gargle in the naso-pharyngeal space, has been used with success (Mosler). Wei de Meyer’s Catarrh Cure is simply bicarbonate of sodium and a little pink coloring matter (Robinson). Potassium Permanganate, gr. j-x to the pint of warm water, as a deodorant solution when necessary. Ammonia, by inhala- 550 CATARRH, CHRONIC NASAL. tion.when painful inflammation of nasal mucous membrane and frontal bones (R.). Carbolic Acid, a. I per cent, solution as spray, or inhalations of the vapor with that of iodine from a bottle in hot water, or vaporized by the warmth of the hand (B.). Salicylic Acid, in weak solution, 1 to 500 of water, as a disinfectant and astringent injection, used wilh a retro-pharyngeal syringe, and followed by applications of powdered Calomel, through a speculum, upon the ulcerated parts of the mucous membrane (Massei). Cubebs, finely pow- dered and blown into the nares by an insufflator (B.); have proven very useful (P.) ; may be smoked, and administered internally in teasp, doses (Wa.); in freshly ground powder, as a confection (see below for formula), very efficient in follicular disease of the naso-pharyngeal space (Robinson). Ammonia- cum, in the same condition, very small doses, gr. j—iij, with ipecac, or carbonate of ammonium, will greatly lessen the amount of secretion (Robinson). Bismuth, in powder, with gum acaciae, as in Ferrier’s snuff (see above for formula), or with tannin, calomel, iodoform, etc., used by insufflation, daily (Robinson). Aurum Chloride, in mercurialized and syphilitic subjects, with offensive discharge, depressed spirits, and soreness of the nasal bones. Iodides, of iron and sodium, in catarrh of specific origin (B.). Silver Nitrate, in pow- der, as alterative application, gr. x-xv to the 5 of menstruum, is often a useful adjunct to treatment, used once every 4 or 5 days (Robinson). Cod-liver Oil, should be used in strumous subjects (R.). Alum, in powder, dusted over the affected surface, is a useful application (B.). Eucalyptus, has been employed with benefit (Wa.). Bromine, the. vapor may greatly benefit, but must be used with caution (B.). Senega has been found serviceable (Wa.). Douche is dangerous, being likely to cause extension of the catarrh to the Eustachian tube and the middle ear. It has been very generally abandoned. Sprays by hand-ball atomizers, or compressed-air apparatus, of warm watery solutions, vaseline, etc., are used with considerable success (Cohen). The Hank’s atomizing tubes, with a 2-ball rubber syringe, are very serviceable for office use, and for the application of Rumbold’s hot. vaseline spray. (See formula below.) Sulphur Waters, internally, of great benefit in follicular disease. (Robinson.) [Compare Oz/ena.] R. Acidi Carbolici, , . ffl.x. Glycerini, . , . 3'i- Vaselinae, . . . jfij. M. Sig.—Warm and use as a spray every 4 hours. [Rumbold'.) Prescriptions. R. Acidi Carbolici, , , n^xl. Sodii Boratis, Sodii Bicarbonat., . da gij. Glycerini, . . . Aquae, . . q. s. ad Jvnj. M. Sig.—Use daily as spray. [Dobell.) R. Pulv. Argenti Nitrat., . gr. vijt Pulv. Acaciae, . • 3)- Bismuthi Subnitrat., . Triturat. Sig.—Apply with insuf- flator once in 4 or 5 days. [Robinson.) R. Sodii Boro-benzoatis, , ?j. Ext. Hydrastis FI., , , )$j. Glycerini, . . . gj. Ac. Carbolici, . . . Aquae Camphorae, . . ?vj. Aquae, . . q. s. £xij. M. Sig.—Use with syringe or atom- izer thrice daily. (Cha?nberlain.) R. Bismuthi Subcarb , . gvj. Morph. Muriatis, . . gr. ij. Pulv. Amyli, . . . gij. Triturat. Sig.—Burness’ modifica- tion of Ferrier’s snufif. CEREBRAL ANAEMIA—CEREBRAL CONGESTION. 551 R. Bismuthi Subcarb., Pulv. Acaciae, . aa gss. Zinci Sulphat., . . gr. x. Morph. Sulphat., . . gr. ij. M. Sig.—Snuff, to be used thrice daily. [Sajous.) R. Sodii Salicylatis, . . g;ij. Sodii Boratis, . . . ziij. Glycerini, . . . tss. Aquae, . . q. s. ad$\). M. Sig.—Of this put a dessert- spoonful into a pint of warm water, and snuff it from the hollow of the hand thrice daily. (Sajous.) R. Pulv. Cubebse, . . 3ij. Syr. Aurantii, . . iiij. Aq. Menth. Pip., . . ?ij. Aquae, . . q. s. ad^viij. Ft. mistura. Sig.—A teaspoonful every 3 or 4 hours. (Robinson.) R. Sodii Iodidi, . . . 3ss. Syrupi Picis Liq., . . gvj. M. Sig.—Dessertsp. thrice daily with Pil. Ferri Iodidi (U. S.) one thrice daily, in chronic nasal catarrh of specific origin. (B.) Cerebral Anaemia. Iron, the tincture of the chloride, or mild chalybeate waters, in chronic cases from general anaemia (B.). Amyl Nitrite, in vaso-motor spasm; affords relief in sudden attack (B.). Chloral, in small doses, with stimulants, warm baths (Ros.). Camphor, or other cerebral excitants, as asafoetida, valerian, serpentaria (B.). The mono-bromide of camphor in one to five grain doses (Hammond). Glonoinum, TT\j of I per cent, solution (P.). Phosphorus, sup- plies the needed material for healthy brain-action (B.). Strychnine, stimu- lates the circulation generally; as a tonic with iron preparations. Galvanism, a mild current transversely through the head, gives excellent results in the confusion of mind, vertigo, etc., due to imperfect nutrition of the brain from atheroma of the cerebral vessels (B.). Arsenic, is highly efficient in some hypochondriacal cases (B.). Aurum, is of great utility in vertigo, melan- cholia, etc., when due to or accompanied by cerebral anaemia (B.). [Com- pare Insomnia.] Cerebral Concussion. Arnica, when from a fall, cannot be too highly spoken of (P.). Warmth, to extremities, rest, expectant treatment, will suffice in mild cases (Ag.). The indications are: (i) to recover from insensibility and collapse; (2) to prevent inflammation; (3) to restore impaired faculties (D.). Stimulants, or Venesec- tion, cannot be too strongly reprobated (Ag.). Cerebral Congestion. Aconite, in active form, renders important service (B.). Is much the best remedy in this condition (P.). Belladonna, one of the best remedies in all hyperaemic conditions of the brain or spinal cord (P.). Gelsemium, tt\v of the fluid extract every 2 hours, very useful (B.). Bromides, are very useful (B.); must be used in full doses. Colocynth, as counter-irritant, appears to act well (P.). Cathartics, lessen blood-pressure (B.). Colchicum, in plethoric subjects (B.). Galvanism, of brain and cervical sympathetics (B.). Chloral, when tem- perature high (B.). Arsenic, sluggish venous circulation, torpor (B.). Hydrocyanic Acid, Tixij—v of Scheele’s dilute acid (B.) Venesection, will CEREBRAL SOFTENING—CHANCRE—CHANCROID. 552 prevent injury to brain. Not to be adopted as a matter of course. It is con- traindicated when anaemia, aortic valvular disease, or in cases commencing with syncope (A.). Water, cold douche to head, feet in warm water: ice and hot water alternately to head and nape of neck, often more effective than ice alone (B.). Hot water to head on flannels: mustard and hot-water packing, for 20 to 30 minutes, around legs, when active congestion. Protect bowels well (R.)i Diet, should be low, but not too low, until all fear of relapse past. Full animal diet should be avoided, also undiluted wines (A.). [Compare Apo- plexy, Coma.] Cerebral Softening. Vensection, and antiphlogistic treatment generally, most beneficial in red softening, result of inflammation. Require wise discretion, and should be used early. Not to be thought of in the yellow form, from want of nutrition : where restoratives and food, perhaps wine (A.). Phosphorus, in threatened softening of the brain; is the only drug which affects the nerve-centres (W.). Chancre. Mercury, small doses steadily, ptyalism must not be induced. Black-wash (calomel gr. viij, aq. calcis 3jj), or yellow-wash (hydr. chlor. corr. gr. j, aq. calcis on lint, to erosions and ulcerated indurations (B.). Calomel alone as dry dressing. Internal use of mercury best postponed until secondary symptoms appear (St.). Carbolic Acid, as wet dressing, gr. ij of crystals to Jjiv aquae ter die (St.). Iodofortn, heads the list of dry dressings; with lyco- podium, equal parts, or 1 to 2 zinci oxidi; 2 to 1 hydr. chlor. mite (St.). Hy- drogen Peroxide, said to destroy the specific character. Wash lesion ter die, and apply lint soaked in it (R.). Caustics, should never be used unless chan- cre attacked by phagedena (St.). Caustic Alkalies, to hard edges (R.). Bro- mine, Chromic Acid, best escharotics (B.). Dressings, are effective as far as the local trouble is concerned in the majority of cases; sometimes a piece of lint on the erosion will suffice. Never cauterize an initial lesion unless it is attacked by phagedena (St.). Cleanliness, of great importance; tepid water locally frequently suffices for the outward treatment of infecting chancre. [Compare Syphilis.] Chancroid. Mercury, the acid nitrate one of the best caustics; apply with a glass rod (B.). Nitric Acid, fuming, as caustic (B., R.); gj to viij aquae is an excel- lent dressing (St.). Carbolic Acid, injected into sore (B.); to Oj aquae locally in phagedena (St.). Ferri et Potas. Tartras, the “born enemy of phagedena” (Ricord) ; Jj to aquae, internally, teasp. doses thrice daily; also locally (St ). Ferric Iodide, in sloughing phagedena, or simple c. in de- bilitated constitutions (B.). Iodoform, powdered and dusted over the sore, allays pain, changes morbid action, and is antiseptic (B„ R.) ; I part to 2 of lycopodium, or one of tannic acid; as stimulant and alterative (St.). Does no good except to relieve pain (Gross). Potassium Chlorate, in impalpable powder, is better than iodoform (B). Chloral, gr. iij ad gj aquae, the best local application to relieve pain (Gross). Caustics, in severe cases; the white iron, strong sulphuric acid, pure nitric acid, pure carbolic acid, are ef- fective in the order named (St.). [Compare Bubo.] CHAPPED HANDS AND LIPS—CHILBLAINS. 553 Chapped Hands and Lips. Sulphurous Acid, as solution, or by fumigation, will speedily cure (R.). Glycerin, diluted, or better still, glycerin of starch, or with the quantity of eau de cologne (R.). Benzoin, the comp, tinct., I part to 4 of glycerin; an admirable application (P.). Hydrastis, on compress, as lotion (P.). Collodion, is usefully employed (P.). Carbolic Acid, I to 2 of glycerin, locally ; one ap- plication is generally sufficient. Unguentum Aquce Rosce alone, is often efficient; may be combined with oxide of zinc. Prescriptions. R. Resinae, . . . . Cerae Albse, . . . _^ij. Adipis, . . . . Zinci Oxidi, . . . 2fvij. R. Cetacei, . . . 3). Glycerini, . . . sjij. Cerae Albas, . . . gr. xv. Ol. Amygd. Amarae, . Ttliij. Chest-pains. Belladonna, as ointment, when tenderness is in skin (pleurodynia) (R.). Iodine, oint ; pain in muscles (myalgia) of chest, they being tender on pres- sure, while the skin may be pinched without pain (R.). Strychnine, affords relief in functional irritability of the nervous system, manifested by wander- ing neuralgic pains (B.). Arnica, for a “ stitch ” in the side. Bryonia, when painful catching of breath. Citnicifuga, for intercostal rheumatism and pains under the breasts in women. Chicken-pox. Aconite, is of great value (B.). Water, hot and cold baths and packs are of great utility; cold, if hyperpyrexia; cold compress if sore-throat; hot or warm pack when free diaphoresis required (B.). Treatment, precautionary only required. Avoid exposure to cold and wet; maintain the action of skin and bowels (H.). Acetate of Ammonium, in diaphoretic and antifebrile mix- ture. See Fever, Simple, for formula. Inunction, with camphorated oil, or thin starch, to relieve itching and allay inflammation (P.). Chilblains. Arnica, a useful application (Wa.). Iodine, ointment, the best application (R.). Carbolic Acid, an efficient application is an ointment of carbolic acid and iodine (B). Benzoin, the tincture in glycerin, applied after thorough wash- ing in soap and water and drying, the best application. Sulphurous Acid, an efficient application; each of water and glycerin (B.); as solution or fumigation (R ). Balsam of Peru, in ointment for broken chilblains (R.). Capsicum, tinct. painted over unbroken chilblains (R.). Cajuput Oil, applied locally (R.) Turpentine, as wash, then apply basilicon ointment mixed with turpentine (B.). R. Acidi Carbolici, . . 5jj. Tinct. Iodi, . . . gij. Ac. Tannici, . . . zij. Cerati Simplicis, . . M. Sig.—Ointment. (B.) Prescriptions. R. Tinct. Benzoini, . . gij. Olei Lini, . . . giv. Cerse Flavae, . . • 3‘j- Glycerini, . . . q. s. M. Sig.—Ointment. {Reveil.) 554 CHLOROSIS—CHOKING CHOLERA ASIATICA. Chlorosis. Iron, combined with arsenic or strychnine. Occasional purgation and ac- tive exercise. Also chalybeate waters for blood deficiencies (B., R.); is not a specific in chlorosis, and acts best in the purest types (Tr.); the iodide, when much torpor of the system, is often speedily efficacious (Wa.). Arsenic, if iron fails, or disagrees (B.). Ergot, in chlorotic amenorrhcea (P.). Man- ganese, the saccharated carbonate of manganese and iron (B.). Nux Vomica, stimulates the bloodmaking organs, and may be combined with iron. A very generally useful preparation is the syrup or elixir of iron, quinine and strych- nine (B.). Cocculus Indicus, with amenorrhcea and exhausting leucorrhcea (P.). Hypophosphites, of lime or sodium (R-). Benzoin, has been used with advantage (P.). Pepsin, benefits, especially where digestive derangement (B.). Oils and Fats, as inunctions after baths, of great benefit (B.). Gal- vanization, central; will aid the action of the remedies (B.). [Compare Anaemia, Amenorrhcea.] R. Ferri Arseniatis, . . gr. ij. Extracti Cinchonae, . gr. xij. Fiant pil. xij. Sig.—One after each meal. (B.) Prescriptions. R. Pulv. Aloes. Socot., . gr. v. Ferri Sulph. Exsiccat., gr. xv. 01. Tanaceti vel Ol. Sabinae, . . gtt. xxx. Myrrhse, Croci, Cantharidis, . aa gr. xxx. Ft. pil. lx. Sig.—Two thrice daily, gradually increased to four. {Wallace.) R. Ferri Sulph. Exsiccat., . gr. xl. Quininae Sulphatis, . gr. xx. Strychninae Sulphat., . gr ss. Ft. pil. xx. Sig.—One thrice daily. Choking. Potassic Bromide, benefits a curious affection, sometimes found in children, who from their birth can swallow solids with ease but choke at drinks (B.). Oil of Cajuput, in one case of persistent “ choking ” sensation in the throat, a few doses removed the symptoms which had lasted several weeks (Hale). Cholera Asiatica. Camphor, a drop or two of the saturated tincture, or v-x drops of the spirits with a little opium every half-hour (B.); gtt. iv-vj of strong spirits every ten minutes until symptoms abate, then hourly (R). Arsenic, in epidemic chol- era: some cases of arsenic poisoning not distinguishable from cholera (B.); for the vomiting and in collapse (R.). Copper salts have been given (R.). Turpentine, TT].x-xx every two hours promises to be a remedy of value (Wa.). Chloral, as injection, the most efficient treatment, especially when morphine and atropine are given coincidently (B.). Chloroform,a few drops frequently repeated, or x-xxx drops of chlorodyne, of great value (B.). Opium, to i gr. morph, hypodermically in preliminary diarrhoea (B., P.); Y% to gr. of the greatest value, even in collapse (R.); dangerous if kidney complications exist (P.). Lead, the acetate in early stages (R ). Carbolic Acid, with iodine, has given good results (B.). Sulphuric Acid, the aromatic, with opium, is very effective (B.); two parts of the former with one of laudanum, of this 5 to 30 drops as per age, is one of the best prophylacdcs (McClellan). Strych- CHOLERA INFANTUM. 555 nine, as prophylactic during the preliminary diarrhoea, and in epidemic when nearing collapse (B.). Alcohol, small doses of iced brandy for vomiting (B.). Spinal Ice-bag, for cramps (R.). Saline Injections, into the veins, have been successful in the collapse (B.). Transfusion, of milk, in collapse (B.). Absolute Pest, recumbent posture, no food, ice ad libitum ; enemata of warm milk; fresh air, friction and heat to abdomen, legs and feet; stimulants worse than useless. R. Chloralis Hydrat., . . giij. Morphinse Sulph., . . gr. iv. Aquae Laurocerasi,. . 5j. M. Sig.—Fifteen to twenty drops as injection hypodermically. (B.) Prescriptions. R. Acidi Carbolici, . . gr. iv. Tinct. Iodi, . . gtt. xvj. Aq. Menth. Pip.,. . M. Sig.—A tablesp. every hour or oftener. (B.) R. Chloroformi, . . . Tinct. Opii, Spt. Camphorse, Tinct. Capsici, . aa 3VSS* Alcoholis, . . • 3b M. Sig.—30 to 60 drops in water. (Squibb's Cholera Mixture.) R. Acidi Carbolici, . . gr. viij. Bismuthi Subnit.,. . sjij. Mucil. Acacise, Aqua: Laurocerasi, aa ijj. M. Sig.—Teasp. every hour or two for vomiting and diarrhoea. Cholera Infantum. Ipecacuanha, greenish stools with mucus and often blood (B.). Arsenic, for vomiting and collapse (R.). Mercury, gr. «/£ of gray powder hourly of great service in infantile cholera with incessant sickness, profuse almost con- tinuous diarrhoea, offensive and nearly colorless stools. A starch injection, with a minute quantity of laudanum, assists the gray powder, and should be given in urgent cases (R.). Zinc Oxide, with bismuth and pepsin, is very useful (B.). Camphor, 3)-%iv of milk, very serviceable (B.); an admirable remedy for summer and choleraic diarrhoea (R.). Opium, generally necessary. Ene- mata of starch and laudanum (see above under Mercury). Alorphine, hypo- dermically, in doses of gr. to -fo according to age, the latter dose for a child of one year, with 5 or 6 drops of ether, to be repeated in an hour, the most efficient treatment (E. Smith). Copper Sulphate, often very successful (B.), Carbolic Acid, with Bismuth, may arrest the disorder promptly (Br V Lead Acetate, is one of the most useful astringents in this complaint (Br.). Potassium Bromide, when due to nervous irritation or cerebral congestion (B.). Silver Nitrate, is beneficial after the acute symptoms have passed (B.). Caffeine, when due to nervous irritation (R.) Coto Bark, the tinct. gtt. j-iij is highly recommended by Rohrer for choleraic diarrhoeas of children. Alcohol, in grave cases, with tendency to collapse, gtt. x-xx of brandy with milk every 30 to 60 minutes. Diet. Farinaceous food a common cause. Cow’s milk with sacch. lactis §j to aquse-bul., or cold milk with lime-water (R.) ; milk, animal broths; no starches or fats (B.). Drinks, as water, weak tea, etc., freely, to keep vessels filled and prevent paralysis of the heart (Meinert). Spice Poultice, to abdomen, composed of cloves, ginger and cinnamon, mixed with brandy or whiskey. Mustard Bath, in stage of collapse, with mustard over the heart, and ether hypodermically (Smith). 556 CHOLERA SIMPLEX—CHORDEE. Prescriptions. R. Acidi Carbolici, . . gr. iv. Bismuthi Subnit., . . zij. Mucil. Acaciae, . . 5j. Aquae Menth. Pip., . ]§iij. M. Sig.—Teasp. every 2, 3, or 4 hours. (B.) R. Cupri Sulphat., . . gr. j. Tinct Opii I)eod., . gtt. viij. Aquae Destil., . . j$iv. M. Sig.—Teasp. every 2, 3, or 4 hours for a child of one to two years old. (B.) R. Acidi Carbolici, . gr. xxiv. Spt. Vini Gallici, . gtt. xxiv. Aquae Menth. Pip., . (fjss. Mucil. Acaciae, . . gvj. Syr. Papaveris, . . zvj. Tinct. Opii Deod., . gtt. x. M, Sig.—A teasp. every 2 hours. R. Plumbi Acetat., . . gr. xxiv. Pulv. Opii, . . gr. xij. Pulv. Camphorae, . £ss. Sacch. Lactis, . . q. s. Triturat. et div. in chart, xij. Sig.—One every hour. (B.) R. Hydrarg. Chlor. Mitis, gr. y Bismuthi Subnitrat., . gr. ij-v. In powder every half-hour for the vomiting and purging. R. Hydrarg. Chlor. Mitis, gr. J. Plumbi Acetatis, . gr. |. Opii, . . . gr.|toTV Ft. pulv. no. j. Repeat every half- hour or hour for the acute gastric. symptoms. Cholera Simplex. Camphor, an admirable remedy (R., B.). Veratrum Album, for the vom- iting (R.). Copper Salts, have been given (R.). Arsenic, for vomiting; also for collapse in latter stages (R.). Chloral, by injection, the most efficient treatment (B.). [See C. Asiatica for formula.] For the cramps Chloral j|j, in Lin. Saponis 5iv-vj, applied with friction to the abdomen (Da Costa). Carbolic Acid, with bismuth, very effective (B.). [See above, C. Infantum.] Lead, the acetate, in early stages (R.). Opium, gr. morphine, hypo- dermically ; very useful (B.). Gr. i/jj, y, or yz opii, every 2, 4, or 6 hours, in early stage (P.). Calumba, as anti-emetic, of great value (P-). Ipecacuanha, has been used with much advantage (Wa.). Sutnbul, said to have proved successful (P.). Alustard, as an emetic in collapse, to stimulate a failing heart (P.). Cajtiput Oil, much used in India for choleraic affections (P.). Alcohol. Iced brandy in small doses for vomiting (B.). The value of stimu- lants justly doubted; if given, should be largely diluted (Wa.). [Compare Cholera Asiatica and Infantum, above.] Chordee. Aconite, gtt. j hourly, will relieve (R., P.). Belladonna, combined with cam- phor or opium, gives the best results of remedies administered internally (St). Camphor, 5jj doses of the spirit will relieve (R.). Cantharis, gtt. j ter die, will prevent (B., R.). Cannabis Indica or Cannabis Saliva (P.). Lupulin, valuable (P.); said to prevent (B.). Morphine, hypodermically, the one sure remedy; should be injected into the perineum at bedtime (St.). Diet should CHOREA—CHOROIDITIS. 557 be plain, even low, no stimulants; copious draughts of barley-water or lin- seed tea. R. Liq. Morph. (Magendie), . £iv. Atropinae Sulphat., . . gr. j. Acidi Acetici, . . . q. s. Aquae Destillat., . ad Jj. M. Sig.—TTLv-viij hypodermically at bedtime. (St.) Prescriptions. R. Pulv. Opii, . . . gr. xij. Pulv. Camphorse, . gr. xxiv. Sacch. Alb., . . q. s. Fiant capsulae xij. Sig.—One at bedtime, to be repeated in 2 hours if required. (St.) Chorea. Cinticifuga, in cases due to menstrual derangement, is very useful (B., P.); when rheumatic history (R.); a very valuable remedy (P.). Strychnine, in doses gradually increasing to toxic (Tr.); minute doses (gr. -fo to ?'5) have been of much use when from fright or commencing puberty (B.); Arsenic, large doses required, Tiqv ter die, when non-anaemic (B.); very successful in uncomplicated cases (R.). Zinc, the Sulphate has similar action to Arsenic, but is inferior (B.). In large and increasing doses it is very useful (R.). Iron, large doses of the Subcarbonate in anaemic cases, about the time of puberty (B.). Chalybeate waters often relieve or cure. Arsenic generally better, unless anaemia coexists (R.). Hyoscyamine, gr. ter die, gradually in- creased, has cured cases which resisted all other remedies (Da Costa). The mydriatics are very suitable in nervous, delicate children. Copper. Cupr. Ammoniatum has been used successfully (B.). Veratrum Viride, has been employed (R.). Cocculus, picrotoxine, large doses (B., P.). Conium, in large doses, to quiet muscular agitation (B.); is only palliative (R.); evidence con- tradictory as to its value (P.). Valerian, said to restrain the movements (R.). Useful when from worms (P.). Chloral, contributes to a cure by inducing quiet sleep (B., R.). Chloroform, inhalations, often of great service in severe cases (R.). Morphine, with Chloral, hypodermically in large doses, for severe cases (Tr.); when the movements prevent sleep (R.). Physostigma, is recommended (R.);—of doubtful benefit (B.). Musk, has been given (R.). Cod-liver Oil, in low nutrition (B., R.). Water. Cold affusion to head and spine, and cold baths, important (B.); not to be used if rheumatism, fever, or pain in joints. Tepid water first (R.). Galvanism, the constant current, used by Benedict in twenty cases, all recovering. Galvanic chain around neck and down the back. R. Tinct. Ferri Chloridi, . !|j. Liq. Acidi Arseniosi,. . sjij. Syr. Limonis, . . . 3SS. Syr. Simplicis, Aquae, . . aa q. s. ad Jiv. M. Sig.—Half a teaspoonful thrice daily, after meals, gradually increased, and effects carefully watched. Prescriptions. R. Chloralis Hydrat., . . Tinct. Hyoscyami, . . 3). Syr. Limonis, . . . ,5j. Aquae Cinnamomi, . . M. Sig.—A teasp. 3 or 4 times daily, according to age. Choroiditis. Mercury, as in iritis ; cannot be borne to the same extent as in latter dis- ease (A.). Opiates, necessary externally and internally to overcome pain 558 CLIMACTERIC DISORDERS—COLIC, INTESTINAL. (A.). Treatment, is generally the same as in corresponding forms of iritis, but when atrophic spots appear on the choroid, no treatment can repair the damage (A.). Rest of eyes and protection from light by blue glasses. In suppurative form (panophthalmitis) use Atropine in strong solution, with ice compresses and leeches in early stage. Paracentesis repeatedly to relieve ten- sion and give exit to pus. Canthoplasty of outer canthus to relieve the pres- sure of the lids (Roosa). Climacteric Disorders. Aconite, for nervous palpitations, and restlessness or “ fidgetsgtt. j hourly (R.). Cimicifuga, for distressing headache (R.). Nitrite of Amyl, in small doses when the “heats” predominate, followed by cold, clammy, pale skin (R.). Ergot, for the flooding, gr. ij of Squibb's extract in fresh pill every hour until relieved. Cannabis Indica may be well combined with it. Cannabis Inciica, is used in the headaches of the menopause with uniformly good results. [See Headache, for formula.] Nux Vomica, Opium, and Belladonna, when symptoms described under Iron are limited to head and face (R.). Iron, for flutterings of the heart, with fullness of head, heat and weight on the vertex, frequent flushings, and hot and cold perspirations. Large doses of Sesqui- chloride ter die (R.). Amtftonia, Raspail’s sedative lotion to painful part of head, in headaches (R.). Potassium Bromide, for despondency, with sleep- lessness and irritability, often also with heats, flushings, perspirations (R.). Physostigma, the extract, gr. every hour for 7 or 8 doses for flatulence and a sensation of fluttering at the pit of the stomach (A. A. Smith). Cam- phor, for drowsiness and headache. Eau-de-cologne saturated with camphor rubbed to head (R.). Zinc Valerianate, hysterical symptoms (R.). Change of air and scene, where other treatment only partially successful (R.). Warm Bath, to promote free perspiration, go0 to 950 Fah. for an hour once a week, will obviate many of the symptoms (R.). [Compare Metrorrhagia.] Coccyodynia. Chloroform, injected as deeply as possible about seat of greatest pain (B.). Electricity, has cured one severe case of 12 years’ standing, and helped others. Surgical treatment the only resource in rebellious and painful cases (Ros.). Nolt extirpated the coccyx; Simpson performed subcutaneous section of muscles and ligaments. Goodell removes the bone, after first treating the case as a local expression of a general neurosis. Coldness. Strychnine, for cold hands and feet (R.). Cold Baths, with friction to the skin, nightly for cold feet (R.). Spinal Ice-bag, is often efficiently employed in general coldness of the surface, and persistent coldness of the hands and feet (R.). Colic, Intestinal. Nux Vomica, quickly subdues abdominal cramps and spasms (P.). Bella- donna, especially in children (R.). Chamomile Oil, rrtiv-vj, in colicky attacks of hysterical women (P.). Cocculus, of great value, especially during pregnancy (P.). Chloral, sometimes relieves (R.). Chloroform, effective in COLIC, LEAD. 559 flatulent colic; also useful in hepatic and saturnine (B.). Often used combined with Opium (D.). Potassium Bromide, in a peculiar form in young children (R.). Given in anise or peppermint water is of greater efficacy for the colic of infants than the opium preparations in general use, and perfectly safe (B.). Asafcetida, no better remedy in flatulent colic of infants. Teasp. doses of the mistura asafcetidae (B.) Morphine, gr. y&-% hypodermically, repeated in 15 minutes, gives more relief than any other remedy, in all forms of colic (B.). Frequent small doses (R., P.). Arsenic, will cure in a surprising manner when enteralgia is idiopathic (B.). Essential Oils, especially those of Cloves and Cinnamon (R.), Anise, Cardamom, etc. Oil of Rue in flatulent colic of children (P.). Alagnesia, the carbonate with Opium and Asafetida, as in Dewees’s Carminative, now official as Mistura Magnesise et Asafoetidse,the dose being tffxx for an infant of 2 to 4 weeks old. Tobacco, as enema; dangerous! (B.); as clyster, or by stomach (R.). Ammonia, in spasm of intestinal canal and in colic of children or infants from bad feeding (R.). Lime Water, for young children who eject milk in lumpy masses, with colic and flatulence (R.). Water. Hot fomentations to ease pain (R.). A copious enema of warm water often gives immediate relief. R. Spiritus Chloroformi, Tinct. Cardamomi Co., . aa M. Sig.—Teasp. in water every hour. (B.) Prescriptions. R. Ext. Gentianae, Pulv. Rhei, . . . aa Ft. pil. xx. Sig.—One or two thrice daily for tendency to colic. R. Atropinae Sulph., . . gr. j. Zinci Sulphatis, . . gr. xxx. Aquae Destil., . . M. Sig.—3 to 5 drops 2 or 3 times daily. (B.) R. Pulv. Camphorae, Pulv. Capsici, Pulv Zingiberis, . aa gr. ij. Ft. pil. xij. Sig.—One as required. Colic, Lead. Alum, singularly is the best remedy (B.) ; gr. x hourly (R.) ; converts the poisonous salt of lead in the system into a comparatively innocuous sulphate; daily with iUxl-1 Tinct. Opii, and an occasional dose of castor or croton oil to procure one or two motions daily (Wa.). Opium, gives more relief than any other remedy, gr. to of morphine hypodermically (B.); gr. ij -iv of opium, with a moderate dose of castor oil (P.). Sulphuric Acid, diluted well, as a prophylactic, and is useful in the treatment of the disease (B.); con- sidered remarkably efficient when used in association with repeated sulphur baths (Wa.). Calomel, a full dose, with or without opium, followed in a few hours by castor oil and a turpentine enema, often affords speedy and marked relief (Wa.). Tobacco, may control, but is dangerous (B.). Croton Oil, in half-drop doses, with sufficient opium to relieve the pain, repeated every 3 or 4 hours until free evacuations are produced; proves effectual when other rem- edies fail (Wa.). Magnesium Sulphate, for the constipation, and to remove the poison from the system; should be combined with Iodide of Potassium, Zj of the former given ter in die and about two hours after gr. v-x of the iodide. This treatment dissolves the lead in the tissues, causes its elimination by the intestinal mucus, renders it insoluble after it has entered the intestinal canal, and quickly removes it from the body (Br.). [Compare the treatment of Lead-poisoning, ante, page 305.] 560 CONJUNCTIVITIS, CATARRHAL. Prescriptions. R. Aluminis, . . . sjij. Ac. Sulph. Dil., . . zj. Syr. Limonis, . . . Sj. Aquae, .... M. Sig.—Tablesp. every hour or two for colic. (B.) R. Magnesii Sulphatis, . . Ac. Sulph. Dil., . . p,). Aquae, . M. Sig.—Tablesp. every 3 hours (B.); or thrice daily, each time pre- ceded by a 5 to 10 grain dose of Po- tassium Iodide. (Br.) Colic, Renal and Hepatic. Ether, inhaled in paroxysms of hepatic colic (R.). Chloroform, inhalation in renal and biliary colic, inferior only to morphia injection, superior to opium, warm baths, etc.; two or three administrations may be required (R.). [See also Colic, Intestinal.] Counter-irritation, flying blisters for renal colic (R.). Opium, small doses with spt. chloroformi, every five or ten minutes until the pain gives way, or morphia hypoderm. (H.). Turpentine, has been given with benefit in biliary colic (R.). Dioscorea, is used successfully in so-called bilious colic, ttlxv-xxx of the fluid extract. Water, warm baths to ease the pain (R.). Aliment. Withhold all starches and fats. Alkaline mineral waters are useful (B.). [Compare Calculi.] Coma. Blisters, in a comatose condition, large blisters or mustard poultices should be applied in quick succession to different parts of the body—chest, abdomen, thighs and calves; often very valuable in the critical condition near the end of an acute illness (R.). Cold Douche, for stupor of drunkenness or of opium poisoning. May have to be repeated if relapses occur. It should be kept up for a long time if pulse and breathing improve, or no worse (R.). Croton Oil, as purgative, til or every hour (R.). Potassium Bitartrate, as purgative when blood is poisoned (R.). Mustard, as poultice to the feet and ankles in the coma of narcotic poisoning (P.). Exercise. In coma from poisoning the patient should be persistently walked about. [Compare Cere- bral Congestion, Uremia, and the treatment of Narcotic Poisoning, ante, page 281.] Condylomata. Nitric Acid, to Oj aquae, as wash, frequently used (B„ R.). Thuja, locally a strong tinct. with gtt. v in water, night and morning, internally, for warts with narrow base and pendulous body. Warts about anus or pudenda of either sex, whether syphilitic or not, often rapidly cured by Thuja (P.). In non-syphilitic warts of penis or vulva, I have employed it with satisfaction (Pf.). Mercury, Calomel dusted over, after washing with a solution of chlo- rinated soda (Ricord, R., B.); the nitrate locally ora 20 per cent, oleate (R.). Zinc, the chloride, iodide or nitrate as local applications (R.). Ar- senic, arsenious acid as a caustic (R.). Carbolic Acid, as a mild escharotic (B.). Chromic Acid, gr. c-Jj aquae dest.; a good local application (B.). [Com- pare Syphilis, Warts.] Conjunctivitis, Catarrhal. Zinc, a weak solution of the sulphate or acetate as astringent collyrium (B.); gr. ij ad aquae destil. as mild astringent lotion every few hours, CONJUNCTIVITIS, CATARRHAL. 561 with ice locally in the earlier stage (Roosa). Borate of Sodium, gr. v. ad aquae dest. a good and mild astringent for ordinary cases. Boric Acid, gr. vj ad gj each of aq. camph. and aq. destil., as collyrium (Fox). Boro-gly- ceride, jss ad of aq. camph. and aq. dest. a very efficient application. See ante, page 20. Carbolic Acid, a 5 per cent, solution applied every two hours by spray of steam atomizer, which dilutes it one-half, an extremely efficient application, relieving the pain and contracting the vessels. Cocaine, the hy- drochlorate in 3 to 5 per cent, solution or oleate, applied to the palpebral conjunctiva, is a very efficient palliative, especially where much pain and pho- tophobia (Roller). Alum, potassa alum after acute symptoms subside (Br.); gr. iij-v ad aq. destil. brushed over the conjunctiva tw'ice daily. Pulsa- tilla, of tincture to aquse as wash several times daily, also rnj-x internally every 3 or 4 hours (P.). Opium, the wine dropped into the eye relieves pain and improves the condition of the conjunctiva (R.); Morphine, gr. j-ij ad i|j, is often used in collyria with zinc salts or alum. Mercury, Calomel dusted over the palpebral conjunctiva, in severe cases; should be finely levigated and dusted from a camel’s-hair brush (B.); the oleate of mercury and morphine to the outside of the lids in palpebral conjunctivitis (R.); the red oxide as ointment, gr. x ad vaseline (Bader); the yellow oxide, gr. viij-x ad vaseline (Seely). Cadmium, as collyrium, gr. ij of the sulphate to J;j aqua; rosse (B.). Tannin, in glycerin, ad 5jj, every second day in chronic catarrhal conjunctivitis, presenting diffused injection of vessels with oedema (Hansell). Silver Nitrate, solutions of strength gr. j-iv ad gj applied by physician to conjunctiva (R.); should not be given to patient. Zinc and copper salts are preferred (B.). Copper, the sulphate crystal in chronic cases where great swelling or hypertrophy of the papillary layer. Is too irritating to be entrusted to the patient. Lead salts should never be used lest deposits occur in slight abrasions or ulcerations of the cornea. Sulphates, of zinc, copper and iron with alum, aa gr. j to of aq. destil. as collyrium, extremely efficient; in severe cases may be used in saturated solu- tion by the physician (Holmes). Castor Oil, a drop placed in the eye often allays the pain and photophobia caused by an irritant (R.). Belladonna, lo- cally and internally (B.); Atropine in strong solution, gr. iv to §j, is one of the best local applications where mydriasis is not objectionable. Euphrasia, as a mild astringent (P.). Blisters, behind the ears in bad cases (R.). Ergot, the fluid extract locally gives excellent results in acute conjunctivitis (B.). Staphisagria, especially in tarsal ophthalmia (P.). Colchicum, when gouty diathesis (A ). Spigelia, in rheumatic form (P.). Prescriptions. R. Zinci Sulphatis, . . gr. ij. Morphinae Sulph., . . gr. ij. Atropime Sulph., . . gr. ss. Aquae Rosae, . . • M. Sig.—Eye-water. (B.) R. Hydrarg. Oxidi Rub., . gr. x. Atropinae Sulph., . . gr. j. Vaselini, . . • §)■ M. Sig.—A minute portion as an ointment for the eye. {Bader.) R. Liq. Plumbi Subacetat., . Aquae Destillatae, . . giij. M. Sig.—For; local use. To be brushed over conjunctiva of everted lids by the surgeon and washed off with water. (Buller ) R . Ung. Hydrarg. Nitrat., . gr. xx. Cocainae Hydrochlorat., gr. v. Vaselini Albi, . %i). Use a fresh ointment, triturate thoroughly, and label “ Ointment for the eye.” 562 CONJUNCTIVITIS, PHLYCTENULAR. Conjunctivitis, Diphtheritic. Zinc Chloride, gr. ij-iv ad %j, as collyrium, has succeeded admirably (Wa.). Atropine, locally, throughout the disease. Treatment not very effectual (Roosa); is, for severe cases, powerless; cornea sure to be attacked, and liable to slough (Noyes). Boric Acid, 4 per cent, solution, as antiseptic, the best application, with Quinine, internally in full doses (Noyes). Iron, the pyrophosphate for children, gj in 3;iij of simple syrup, of which a teasp. thrice daily after meals, with quinine in 1 to 3-grain doses thrice daily, and good food (Derby). Cold by compresses, as in purulent ophthalmia, in early stages. Silver Nitrate, in solution locally, a 10-grain solution or the mitigated stick in the second stage. Tannin, gr. xx to the J; of glycerin, later on, applied every day, with hot water lotions if corneal complications. Conjunctivitis, Gonorrhoeal. Zinc Chloride, gr. j-ij ad 2j aquae, as collyrium, with marked benefit (Wa.). Silver Nitrate, a 2-gr. to the solution, after syringing out the eye with warm water, followed by ice compresses, in hope to abort the attack, if seen early (Roosa). Cold, by ice or wet compresses, essential in the early stage (C.). Atropine, may be used from the beginning, as corneal complications begin very early. Treatment, generally the same as for Purulent Conjuncti- vitis. Isolation and cleanliness are of prime importance. Conjunctivitis, Granular. Silver Nitrate, the diluted stick (see page 80) applied lightly and quickly (C.); strong solutions to granular lids, gr. xx ad cautiously when corneal ulcers exist (B.); mild solutions better, gr. v ad daily in the papillary form ; in miliary trachoma it should not be stronger than gr. ij ad gj (Noyes). Applications lose their effect after a time and should be changed (Roosa). Copper Sulphate, the solid crystal lightly touched to the membrane once a day, the favorite astringent and caustic in all forms of trachoma (Roosa); when membrane torpid to other stimulation and when lymphoid substance is predominant. As ointment gr. v-x ad vaseline, when for use bv patient (Noyes). Alum, a smooth crystal is a useful daily application (Noyes). Tannin, gr. x-xxx ad glycerini £), an application to change to from others (Roosa). Bismuth is one of the numerous applications in chronic conjuncti- vitis and granular lids (B.). Phytolacca internally, is undoubtedly efficient in granular conjunctivitis (W.). Jeriquity, to excite substitutive inflammation. See ante, page 17. Atropine, gr. ij ad aquae, thrice daily, is often advisable, where moderate irritation and haziness of the cornea (Noyes). Hygiefiic Meas- ures of great value. Protection by blue or smoked glasses. Rest of eyes, best secured by using atropine collyria. Hot or cold water as local bath fre- quently. Tobacco must be avoided, also all locations contaminated by impure air. Canthoplasty of outer commissure when lids press on globe. Conjunctivitis, Phlyctenular. Mercury. Calomel finely levigated and dusted from a camel’s-hair pencil over the membrane in phlyctenular ophthalmia, an excellent local applica- CONJUNCTIVITIS, PURULENT. 563 tion ; which should never be used when iodine is being taken. In more obsti- nate cases a small bit of Pagenstecker’s ointment, the size of a pin-head (Hydrarg. Ox. Flav. gr. j—iij, Vaselini, afj), placed between the lids (Noyes). Ergot, the fluid extract, applied undiluted, gives excellent results in the phlyctenular ophthalmia of children (B.). Antimony. Tartar emetic gr. fa to fa 3 or 4 times daily in strumous ophthalmia, with sharp purgation at the outset (R.). Belladonna, or Atropine, locally in strumous ophthalmia, of great service in relieving pain; constitutional treatment also required (Wa.). Arsenic, invaluable in inveterate cases of strumous ophthalmia, especially when complicated with cutaneous eruptions (Wa.). Tannin, finely powdered and dusted over the everted lid, gives remarkably good results in this and other forms of conjunctivitis, causing very little pain and no inflammatory reac- tion (B.). Carbonic Acid Gas, applied to the eye is said to relieve the pain and photophobia of strumous ophthalmia (R-). Hydrastis, as lotion, is serv- iceable when meibomian follicles are implicated, causing adhesion of lids in the morning (P.). Eserine. locally, to reduce the pupil and shut out the light (P.). Iodine, is employed locally in strumous ophthalmia, for its alter- ative stimulation (W.). Zinc Chloride, gr. ij-iv ad as collyrium, has suc- ceeded admirably in pustular ophthalmia (Wa.). Zinc Sulphate, gr. j-iv ad 5j, is very serviceable; the addition of liquor plumbi improves its efficacy (Wa.). Rhubarb, the mistura rhei et sodse where much disturbance of diges- tion present. Tonics, may be given later, preparations of Cinchona and Iron. Cod-liver Oil, in strumous subjects, tends to remove the manifestations of the disease (R.). Conjunctivitis, Purulent. Alum, gr. ij ad 5j aquse, a sufficient astringent application in ophthalmia neonatorum (Roosa); gr. viij ad gj aquae, applied every fa or fa2 hour in the purulent ophthalmia of children, its success depending on the frequency of the application (R.). Copper Sulphate, gr. j ad gj aqtlse Camph. as collyrium in purulent ophthalmia of infants (Wa.). Silver Nitrate, gt. iij-x ad %j aquse destil. rarely so strong as gf. x,once daily applied by brush to everted lids in purulent ophthalmia of infants (Noyes); solution gr. fa ad twice daily under lids (Meigs)—by many it is considered needless and injurious (Roosa). Boric Acid, a 4 per cent, solution, as antiseptic, is all that is neces- sary in mild cases; in others it is the proper fluid fot cleansing the eye (Noyes). Atropine, when the cotnea becomes invaded, and shows haziness, a solution gr. ij ad j|j, must be instilled every 3 hours (R.). Cold, by ice or wet compresses, essential in the early stage of acute purulent ophthalmia (C.). Cleanliness, a matter of great importance. As the discharge is infectious the patient should be isolated and care taken to prevent inoculation of the other eye therewith. Prescriptions. R . Sodii Boratis, . . gr. xij. Zinci Sulphatis, . . gr. j. Aquae Camph., . . Aquae Destillat., . . j|j. M. Sig.—Apply to lids 2 or 3 times daily in oph. neonatorum, with solution of Silver Nitrate, gr. fa ad 5j injected under lids twice daily. (Meigs.) R. Sodii Boratis, , . . gr. iij. Aquae Rosse, Aquae, . . . aa §j. M. Sig.—Apply beneath lids three or four times daily after cleansing. R. Atropinse Sulph., . . gr. j. Glycerini p;ss, Aquae, . 31J. M. Sig.—Two drops into the eye. 564 CONSTIPATION. Constipation. Nux Vomica, gtt. j-ij of tincture bis vel ter in die (R ); gtt. v-x in a glass of cold water before breakfast and dinner, often overcomes the most obstinate constipation (P.); especially useful when great fecal accumulations from torpor of bowel (B.). Sulphtir, gr. x with confection senna?, olten succeeds after other remedies fail (R.). Sulphurous mineral waters (B.); or sulphates in purgative waters; frequent small doses (R.). Podophyllum, the most gen- erally used cathartic when deficient secretion (B.). Gr. T*2 to *4 night and morning, when constipation with nervous and bilious headaches (P.). Senna, as in the pulvis glycyrrhizae compos. U. S., which may be taken in doses of a teasp. to a tablesp. as required, and kept up for months (Godell). Mercury, Calomel or gray powder as cathartic (R.). Hydrastis, very valuable, when constipation referable to a sluggish liver (P.). Magnesium, the bi-carbonate, a useful and mild aperient (R.). Alum, cheap and serviceable laxative (B.). Jpecacuanha, gr. j every morning, fasting, when great torpor of bowels (R ). Coccuius, flatus, hard, lumpy motions (P.). Turpentine, in purely atonic constipation, with gaseous distension of colon, has triumphed when all other remedies failed (P.). Physostigma, very effective in intestinal torpor (B.). Stillingia, iqx of fluid extract in habitual constipation (B.). Castor Oil, a mild, efficient cathartic (B.). Ammonium Chloride, in the so-called bilious state, with constipation (B.). Arsenic, small doses (TTpij) of Fowler’s solution often overcome constipation (R.). Belladonna, gr. ]/2 of the extract at night, in habitual constipation (B.); gr. ]/(,-% once a day, especially when dyspepsia (R.). Acts directly on the bowel as a stimulant (P.). Croton Oil, the most efficient cathartic, when simple impaction without inflammation. Gtt. j-ij (B.); when evacuation of blackened feces (R.). Cascara Sagrada, the fluid extract in doses of gj, produces large, soft evacuations without griping, and leaves behind it a laxative influence. Frangula, in similar doses, is equally efficient, but if from a fresh bark may produce griping. Cathartics, especially confectio sennae, pil. rhei compos., pil. aloes, the comp, cathartic pill, as well as those above (B.). Purgation as usually practiced denounced by editor of the lancet, October i, 1870. Saline Waters, are useful (B.). Pullna, Friedrichshall, or Hunyadi; the first two with milk, are good for chil- dren (R.). Enemata, of soap-suds and salt, or a pint of cold water (B.); or turpentine, castor oil, aa j§ss,to Oss-j of gruel (P.). The habitual use of warm enemata increases torpor of the bowels (R.). Tamar-Indien, a favorite mild aperient, is proprietary, and supposed to contain cocculus, Glauber’s salts, etc. Aliment, important in habitual constipation; corn bread, cracked wheat, oatmeal, bread of unbolted flour, fruits, green corn, tomatoes, and celery. ]/2 dozen each of almonds and raisins daily. A glass of cold water before break- fast may overcome habitual constipation (B.). An orange or a smoke after breakfast (R;). Tobacco habitues rarely suffer from constipation. [Compare Intestinal Obstruction;] Prescriptions. R. Ext. Colocyhth Co j . gr. xij. Ext Belladonnae, , . gr. ij. Ext. Gentianae, . . gr. vj. Olti Cari, . . . gtt. iij. Ft. pil. vj. Sig;—One pill at bed- time. (Goodell.) Castor Oil Emulsion. R. Ol. Ricini, Glycerini, . . aa gj. Tinct. Aurantii, . . rqxx. Tinct. Senegse, , . rrtv. Aq. Cinnamomi, . ad M. ft. emulsio. Sig.—One dose. CONVALESCENCE CONVULSIONS, INFANTILE. 565 R. Podophylli Resinae, . gr. ij. Quinine Sulphatis, Ext. Aloes Aquosi, aa gr. viij. Fellis Bovini, . . gr. xvj. Ft. pil. no. xvj. Sig.—One or two at bedtime. (Goodell.) R. Aloes Socot., . . gr. xij. Extracti Bellad., . gr iij. Saponis, . . . q. s Ft. pil. no. xxiv. Sig.—One or two as required. (Wallace.) R. Ext. Cascarge Sag. FI., . £j. Ext. Belladonnse FI., . Tinct. Nucis Vom., . . Syrupi et Aquae, . aa ad jiv. M. Sig.—Teasp. thrice daily in ob- stinate constipation. (Clarke.) R. Aloes Socot., . , gr. vij. Rhei Pulv., . . gr. xxiv. Ext. Belladon., . . gr. j. M. Ft. pil. no. xij. Sig.—One or two pills as required. (Da Costa.) Convalescence. Lime, as lime-water, or the carbonate, in convalescence from serious dis- eases (R.). Quinine or Hydrastine, to promote digestion and appetite (B.). Fats, especially cod-liver oil (R.). Alcohol, before or during meals (R.). Koumiss, possesses great value (B.). Bitters, especially gentian and calumba (B); the latter especially when stomach weak (R.). Eucalyptus, a serviceable tonic (B.), Coca, of the fluid extract as a dose (B.). Guarana, gr. xv- may be given (B.). Opium, as laudanum, injected per rectum, for insomnia of convalescents ;R.). valuable in many cases (R.). Diet, requires the most careful attention ; the prevalent error of giving food of difficult diges- tion too early must be guarded against, especially in intestinal or gastric dis- orders. The strictest moderation should be enjoined. The symptoms must be watched closely, and Combated by appropriate medication. [Compare Adynamia for Tonic Prescriptions.] Convulsions* General Directions.—In all Cases, horizontal posture, fresh air, loosen the clothing; insert a plug of soft wood; ora cork, between the teeth, to prevent biting the tongue; sprinkle the face and chest with Cold water. Epileptic.— The general directions above will usually suffice. [See also Epilepsy.] Hysterical.— The diagnostic peculiarities are: pupils not dilated,but are sensi- tive to light; nb wounding of tongue; face not livid; pulse usually normal. [See also Hysteria.] Infantile.—Administer some anti-spasmodic, as Ether, alone or combined with Musk or Belladonna; then search for any mechanical cause, as a pin in the dress, etc. Lance gums, if dentition the cause (A ). [See Convulsions, Infantile.] Urtsmic.—[See Uremia; Puerperal Convulsions.] Convulsions, Infantile. Belladonna, is of the highest value in certain congestive forms, as in fits due to the irritation of teething, or those referable to whooping-cough (P.). Ignatia, is efficient in convulsions of children from intestinal irritation, no cerebral congestion being present (P.). Valerian, has been successfully used 566 CORNEAL OPACITIES. when from worms, to which parasites it is fatal (P-). Potassium Bromide, in all forms of convulsions in children (R.); children bear it in large doses, gr. v thrice daily or oftener for a child a year old in convulsions from teeth- ing (Br.). Chloral, in large doses, gr. v, by mouth or rectum (Br.); best used as a suppository rather than by liquid injection, and often very useful (R.). It gives better results than any other agent. Chloroform inhalations of great service (R.); useful in all forms (B.); should be used to arrest the convulsion and prevent recurrence (A. A. Smith). Alcohol, has remarkable power in arresting convulsions of dentition; small doses of wine or brandy (Wa.). Asafetida, in the convulsions of teething, a small portion in enema, appears to mitigate them (Wa.). Opium, efficient, but dangerous in young children. Veratrum Viride, has been employed successfully (R.). Amyl Nitrite, gtt. v. with gr. of morphine used in one case as a last resort, after five hours convulsions in a child of 18 months, which resulted in producing quiet sleep (Engel). Hot Baths, are important, with cold affusions or ice to the head (B.). Spinal Ice-bag, may be very efficient (R.). Prescriptions. R. Chloralis Hydratis, . gr v. Lactis, . . . • %)■ M. Sig.—As rectal injection. Or the dose may be made into a supposi- tory with cacao-butter and inserted well up into the rectum. R. Sodii Bromidi, Chloralis Hydratis, Sodii Bicarb., . aa gr. viij. Aquae, .... fp. M. Sig.—A teaspoonful every hour to a child under four months old. Corneal Opacities. Cadmium, is said to promote their absorption; gr. ij of the sulphate to 2j of rose-water as collyrium (R., Wa.). Mercury, Calomel by insufflation, or the red iodide gr. ij, cerate gr. xl, oil gtt. xx, as ointment, successfully used (Wa.); weak solutions of the bichloride, or ointments of the oxides, gr. ad !|j, as remedies among many others to hasten their absorption in recent cases (Arlt). Oils, eel-liver and cod-liver oils, ox-gall, juniper oil, oil of turpentine combined with olive oil, and others, dropped into the eye once or twice daily for the same purpose (Arlt). Opium, the wine at first, then in- sufflations of calomel and red precipitate or yellow oxide of mercury oint- ment, most frequently used by me in recent cases (Arlt). Potassium Iodide, as ointment with carbonate of potassium after cod-liver oil or oil of turpen- tine with olive oil, in cases of longer standing (Arlt). Silver Nitrate, gr. v-x ad aquae, as lotion (C.). Iodine, internally and as Collyria, has been efficacious, especially in strumous cases (Wa.). Sodium Chloride, gr. x ad aquae destil.,of which injected subconjunctivally, to hasten disappear- ance of turbidity (C.). Operative Measures, only in case of incrustations, as of lead and lime, situated superficially, by removal of epithelium and ante- rior elastic layer. Deeper interference may lead to suppurative keratitis. Ex- cision of opaque cornea and transplanting of one from an animal’s or a re- cently enucleated human eye (keratoplasty), has always failed. Artificial pupil by iridectomy, for central opacities which are unremovable. Tattooing to relieve deformity of disfiguring leucomata (Arlt). Pannus and leucoma are best let alone (D.). Stenopaic Spectacles, for semitransparent opacities in pupillary region (Donders). [Compare Keratitis.] CORNS—COUGH. 567 Corns. Silver Nitrate solid, after soaking and paring (Wa.); the best application for soft corns, and very irritable ones (D.). Acetic Acid, strong, to remove corns (Wa.). Mercury, corrosive sublimate in alcoholic solution locally to remove corns (Wa.). Iodine, gr. xl, ad Jj alcoholis, locally (Wa.). Poultices are useful; or a plaster of soft material with hole in centre (D.). Water, hot and cold, alternately applied to inflamed corns. Keep a corn thin by frequent washing and paring. In performing the latter operation, the knife should work downwards to the apex of the corn, so as to remove pressure from its centre. R. Acidi Salicylici, . gr. xv. Extract. Cannabis Ind., gr. vijss. Alcoholis, 90°, . . TRxv. zEtheris, 62°, . . Tttxxxvij. Collodii Flexilis, . trUxxv. Prescription. Mix, and keep in closely-corked vial. Paint the corn every other day for a week, then it can be easily squeezed out, (Vigier.) Cough. Opium., in some form, is much used in cough-mixtures; morphine and gly- cerin to fauces (B.); moderate doses only are useful in irritative affections of the air-psssages, to allay irritation and hypersecretion, but it may do even fatal mischief in cases where secretion is copious and expulsory power feeble (P.); opiates inadmissible when with copious expectoration there is any in- dication of bronchial congestion (Wa.); very useful in violent and frequent cough with little rhonchus and no signs of obstructed oxidation; also, wrhen cough is due to red, inflamed and ulcerated throat; opium or morphine given so as to cling for some time in contact with the pharyngeal structures (R.). Codeine is often efficient in cough when morphine cannot be borne (Br.). Aconite, irritable, tickling throat-cough; short, dry cough of asthmatics, with anxious look, full, strong pulse (P.). Belladonna, often useful. No indica- tions (R.). Internally and externally as plaster to the chest, very serviceable in spasmodic and nervous coughs (Wa.). Hyoscyamus, very useful in spas- modic, tickling night coughs (P.). Hydrocyanic Acid, for nervous, irritable cough, and cough of phthisis and mother’s sympathetic cough (B.); no more certain palliative for simple nervous cough due to irritable state of the system (Still6) ; a valuable adjunct to ordinary remedies in cough of phthisis (Wa.). Prunus Virginiana, has some influence due to its hydrocyanic acid; is much used in cough-mixtures (B., P.). Laurocerasus, used as substitute for hydro- cyanic acid in spasmodic coughs (B.). Conium, supposed to be useful (R.); is very useful in spasmodic cough (Wa.). Ipecacuanha, the fl. ext. for trouble- some night-cough (B ); in obstinate winter-cough, with wheezing, the wine as spray to fauces efficacious (R.); in coughs of childhood ipecac is one of the most generally serviceable expectorants we can use (Wa.). Lobelia, dry cough, continued tickling sensation, even in sleep (P.). Sanguinaria, com- bined with hyoscyamus, in nervous, spasmodic cough (P.). Senega, as a stimu- lant expectorant in the cough of chronic bronchitis and subacute chest affec- tions. Gelsemium, excessive irritability of the respiratory centre (R.) ; often remarkably relieves convulsive or spasmodic, reflex, nervous coughs (B.). Pulsatilla, as anemonine, gr. and gr. doses, very useful in irritative cough, 568 COUGH. asthma, whooping-cough (P.) Iodine, by inhalation for children in hoarse, hollow cough, wheezing (R.j. Alum, internally in spasmodic cough, gr. x to aq. as spray, in chronic cough (R.). Potassium Bromide, serviceable in various reflex coughs (uterine, renal, etc.), and in cough of phthisis occasion- ally ameliorative as a gargle (B.). Cubebs, of the tinct. in half-glass of linseed tea thrice daily, often cures like a charm the coughs of chronic ca- tarrh, of emphysema, or acute catarrh, or following an attack of influenza (R.). Asafoetida, Garrod ascribes its value to the sulphur oil in it (P.). Very ser- viceable in after-cough from habit, and in mother’s sympathetic whooping- cough (B.). Carbolic Acid, as spray, a 5 per cent, solution in a steam atom- izer will often prevent as well as cure a cough from cold. Valerian, in asth- matical and hysterical coughs (P.). Chloroform, with morphine and molasses in paroxysmal dry cough. Maybe painted on throat also (R.); in irritable reflex cough the vapor of a teaspoonful of the spirit may be inhaled from the surface of hot water and repeated every five minutes lor four or five times (B.). Chloral, in convulsive coughs, ameliorates symptoms after hypnotic effect (Wa.). Camphor, equal parts of camphor and chloral triturated together are said to allay spasmodic cough when painted over larynx (B.). Glycerin of Tannin, applied to throat when chronically inflamed and so pro- ducing cough; often the case with children (R.). Grindelia, useful in cough of habit and spasmodic cough (B.). Squill, in catarrhal cough, should not be employed until active inflammation has subsided (Wa.) ; the syrup or vinegar of squill is the best preparation for cough with tickling in the throat (P.). Cod-liver Oil, in chronic coughs (R., Wa.). Lactucarium, the syrup as vehicle in cough-mixtures (B.). Chamomile Oil, gtt. ij-viij, in coughs due to heightened reflex irritability, especially in hysterical women (P.). Pix, Tar- water, in winter cough, especially when paroxysmal (R.). Allays the cough of bronchitis and phthisis (P.). Emplastrum Picis, as rubefacient and counter- irritant in chronic coughs (Wa.). The frequency and violence of nervous coughs may be controlled by a determined effort of the patient’s will. [Com- pare Bronchitis, Pertussis, Phthisis.] Prescriptions for Cough Mixtures. Adults. R. Spiritus Etheris Nitrosi, . gij. Vini Ipecac., . . . ifss. Tinct. Opii Deodorat., . %j. Syrupi Tolutani, . ad ,3 ij. M. Sig.—sA teaspoonful twice or thrice daily. (Bowditch.) Children. R. Mist. Glycyrrh. Co., . . Syr. Pruni Virginian., Syr. Tolutan., . . aa M. Sig.—Half teaspoonful 3 or 4 times daily for infants, teasp. doses at 1 to 2 years, larger doses for older children. (Potter.) R. Liq. Morph. (Magendie), . gj. Syr. Scillse Comp., Syr. Tolutani, . . aa Syr. Ipecac., Spt. Lavand. Co., . aa ifss. Spt. Limonis, . . . gj. Syr. Pruni Virgin., . ad M. Sig.—A teasp. as required. Each dose has of Morph, gr. f. R . Tinct. Opii Deodorat., Vini Antimonii, . aa gss. Ext. Valerianae FI., Syr. Simplicis,. . aagij. Aquae, .... M. Sig.—A teasp. every hour or two until cough controlled. For those 4 years and upwards. (Meigs Pepper.) COXALGIA—CROUP. 569 Coxalgia. Barium Chloride, in considerable doses (gr. j-ij) persevered in for a month, thought to be a most valuable remedy in scrofulous diseases of joints (Wa.). Sulphuric Acid, ad adipis, as ointment, persevered in, has resulted in great benefit. A powerful irritant (Wa.). Counter-irritation, by blisters around the hip, with perfect rest in the straight posture, cod-liver oil, etc. (D.). Iodide of Iron, in scrofulous disease of the joints, with cod-liver oil and nu- tritious diet (Wa.). Iodoform, very successfully used by many continental practitioners in scrofulous diseases of the joints (Wa.). Cod-liver Oil, the remedy on which most reliance is to be placed (R.). [Compare Abscess, Caries, Suppuration, Synovitis.] Croup, Catarrhal. Aconite, valuable (R., Wa.); has been employed with the best results (P.); from gtt. ]/2 to j every half-hour, until an impression is made on the fever- movement, then every hour or two (B.). Hot Water, applications beneath the chin and along the whole course of the larynx (Wa.). Hot fomentations or turpentine stupe to throat (El.); hot bath (95°-io2°) in the paroxysm a good method (M. & P.). Potassium Bromide, locally, a solution by atomization has proven highly efficient in spasmodic croup (Wa.). Lobelia, has been used with occasional success (P.). Ipecacuanha, the syrup or fluid extract as an emetic at the outset (El.); is a slower emetic than tartar emetic (P.); the syrup to vomiting during the paroxysm, and ntv-x every 2 or 3 hours next day (M. & P.). [Compare Laryngismus Stridulus.] Prescriptions. R. Potassii Citratis, . . gj. Syr. Ipecac., . . gij. Tr. Opii Deodorat., . gtt. xij. Syr. Simplicis, . . zij. Aquae, .... M. Sig.—Teasp. every two hours at 2 years of age. In severe form of spasmodic laryngitis. (A/. &• P.) R. Tinct. Belladon., . . gtt. iv. Tinct. Opii Camph., . gtt. 1. Pulv. Aluminis, . . gr vj. Syr. Acaciae, . . . 3ss. Aquae, .... !$jss. M. Sig.—Teasp. every 2 or 3 hours at 6 months old when cough frequent and harassing. (Mdr5 P.) Croup, Membranous. Mercury, a remedy of established value, gr. ss-j of calomel, with gr. of ipecac, according to age, every 2 hours, with local and other general measures, especially the use of a hot (70°-75°) and moist atmosphere (Wa.). The sub- sulphate, given early, is the best emetic, gr. iij-v.; calomel is strongly urged as a laryngeal sedative and aplastic agent, allaying laryngeal spasm and preventing formation of membrane (B.). Alum, one of the best emetics in this disease, a teasp. in honey or syrup, repeated every 10 or 15 minutes until it operates (M. & P.); a very useful and non-depressant emetic (B.). Sanguinaria, by many considered specific, is undoubtedly the best emetic for this disease (P.); is too harsh and too uncertain in action (B.). Tartar Emetic, as an emetic, has established value in croup (Wa.). Is injurious; too depressant (B.). Potassium Chlorate, as alkali, after emetics, the most reliable internal remedy, gr. ij-iij every 2 hours to a child of 4 years (M. & P.). Chloride of Iron, may 570 CYANOSIS—CYSTITIS, ACUTE. be combined with the preceding, in doses of 3-5 drops of the tincture, at the same age (M. & P.). Emetics, besides the above: Copper Sulphate, in small frequent doses (R.); Ipecacuanha, inferior to mercury (B.). In severe cases, vomiting should be caused 3 or 4 times a day, and should be commenced early (R.). Apomorphine, effective, but highly dangerous (B.). Senega, is considered a valuable auxiliary (P.)> has been employed (R.). Quinine, in full doses is highly useful (B.). Sulphurous Acid, as spray, hourly or more frequently (R.). Tannin, a 5 per cent, spray, several times a day for 15 or 20 minutes (R.). Lactic Acid, as solvent of membrane (B.). Lodine, the tinc- ture, externally, affords great relief, and tends to prevent formation of false membranes (Wa.). Water.—Warm bath, hot fomentations or compress to throat. Watery vapor in room. Steam inhalations, with a few drops of Iodine or Bromine. Diet.—Water only in small quantities during attack. Supporting diet may be required afterwards. Lime-water, by vaporization, or inhalations of the vapor of slaking lime for a few minutes in every hour, or some other alkaline solution during the whole treatment (M. & P.). Tracheotomy, fully justifiable, per cent., recovered, out of 1024 operations; should be done when paroxysms become very frequent, and dyspnoea is rather persistent than paroxysmal (M. & P.). [Compare Laryngitis, Diphtheria.] Prescriptions. R . Pulv. Sanguinarise, . gr. xx. Pulv. Ipecac., . . gr. v. Syr. Ipecac., . . M. Sig.—A teasp. every hour until emesis, then *4 teasp. every hour. (P.) R. Acidi Lactici,. . . Aq. Destillat., . . 3X. M. Sig.—To be used as a spray, or applied by a mop. {London Throat Hospital.) Cyanosis. Amyl Nitrite, by inhalation, often gives marked relief (P.). Quebracho, in that from asthmatic attacks of consumptives, lessened the cyanosis or entirely relieved it (Rohrer). Leeching is of service, in a manner not easily under- stood (P.). Treatment must depend on the nature of the lesion or disease giving rise to the cyanotic condition (A.). Cystitis, Acute. Belladonna, is a good remedy in almost every form of vesical irritation (G.); when the vesical mucous membrane is irritable (B.); very useful in recent catarrh from chill, with pain (P.). Cantharis, in large doses causes inflammation of the urinary tract, but gtt. j of the tincture every hour will often relieve vesical catarrh (A. A. Smith); in small doses continued, very efficient (B.); gtt. j-v of the tincture thrice daily, when bladder is irritable, its sphincter weak, and pain along the urethra (P.) ; may be employed in cystitis with ben- efit (R.); the best remedy in small doses for acute cystitis. Aconite, for febrile symptoms (R., P.). Quitline, often useful for acute symptoms (B.). Iodoform, in suppository for painful cystitis (R.). Opium, a rectal injection of starch and laudanum will subdue pain and prevent the frequent micturition (R.); opium is dangerous if kidneys are diseased (P.). Alkalies, the citrates and bicarbonates if urine is highly acid; stop when it becomes alkaline (R.). Liquor potassse in barley-water or in a docoction of Triticum repens, preferred CYSTITIS, CHRONIC. 571 to all other alkalies; urine must be maintained at a neutral or very slightly acid reaction (Thompson). Cannabis Indica, an excellent anodyne in all bladder cases, having specific effect on that organ. Rest in horizontal posture, mucilaginous drinks, hot fomentations and hip-baths, from ioo° to iio°, laxa- tives for the bowels, light food. Milk-diet often necessary, especially in chil- dren. [Compare Bladder Irritable, Calculus, Dysuria, Enuresis, Hematuria.! R . Atropinse Sulphatis, . gr. j. Acidi Acetici, . . gtt. xx. Alcoholis, Aquae, . . . aa M. Sig.—Four drops in a winegl. of water before each meal. (G.) Prescriptions. R. Pulv. Opii, . . . gr. xij. Camphorse, . . . gr. xxx. Ext. Belladon., . . gr. iij. Ol. Theobrom., q. s. M. et div. in supposit. no. vj. Sig.—One at bed-time. Cystitis, Chronic. Benzoic Acid, and the benzoates, in chronic cystitis from any cause, when urine is alkaline (B.); has some balsamic character, and is useful in some cases of chronic'Cystitis: gr. xxiv at least in the day, in pills made with gly- cerin (Thompson). Alkalies, when urine is acid; the liquor potassae, with hyoscyamus as an anodyne, preferred notwithstanding its chemical incompati- bility, to control painful and frequent micturition (Thompson); bicarbonates or citrates better, as the strong reaction of liq. potassae unfits it to be given in doses sufficiently large to affect in any great degree the reaction of the urine (R.). Triticum, is very efficient as an internal remedy, of the rhizome boiled in a quart of water until reduced to a pint, this strained to be taken in four doses in the 24 hours (Thompson); a very useful remedy (Pancoast). Buchu, is probably the most efficient of the urino-genital remedies, the fluid extract in doses of (B.); the best drug in chronic cystitis, especially when the catarrh implicates the ureters or the kidneys themselves, producing considerable muco-purulent discharge (P.). Uva Ursi, is decidedly effective (P.); is less so than Buchu (B.). Stigmata Maydis, an infusion, ad Oj, wineglassful every 3 or 4 hours, has been used internally with considerable success (Dessein). Pareira, considered superior to Uva-Ursi (Brodie); often very successful (P.). Chimaphila, is often very efficient, but is more actively diuretic than the preceding named remedies (B.); by many practitioners it is considered the best remedy for chronic cystitis. Copaiba, is very useful by virtue of its local action on the mucous membrane, but objctionable for its nauseous taste and resulting gastric disturbance (B.). Cubeb, is often useful, from its stimulating effect (P.). Turpentine, has been useful in many cases (R., P.); when cystitis due to urethral inflammation or prostatic disease (B.l. Juniper, the oil is indicated under the same conditions as is turpentine (B.). Eucalyptus, there is no more efficient remedy in chronic cystitis than this (B.); the oxygenated oil of Merck is best in doses of 3 drops on sugar every 6 or 8 hours. Salicylic Acid, in large doses, either internally or by injection into the bladder, is most efficient (B.); the acid or salicylates often useful to prevent decomposition (P.). Carbolic Acid and sulpho-carbolates to preserve the urine sweet (R.). Sulphites will accomplish the same object (B.). Silver Nitrate, by intra-vesical injection, gr. j ad !|iv to begin with, increased grad- ually to gr. ad gj at most (Thompson). Stronger solutions are advocated 572 CYSTS. by Professor Richardson of New Orleans, and Professor Gardner of McGill College, Montreal. In the writer’s experience a 5 per cent, solution, used as a vesical wash, has been promptly efficient in curing many cases which resisted other treatment for months. It sometimes produces serious symptoms, and it is therefore well to have a neutralizing solution of sodium chloride on hand for use if required. Other Injections which may be used to wash out the bladder, are—Lead Acetate, gr. j to of warm water, once daily; Nitric Acid, dilute, ttlj-ij to the 3jj of water; Tannic Acid, gr. j to ; Borax, in .!|ij of glycerin and j|ij of water, of which to of warm water for one injec- tion ; Quinine, gr. j-ij to the of water, with a drop of acetic acid. All injec- tions must be used with great care, not more than j|ij forced in at once, and that very slowly. Use flexible catheter, warm solutions, and a rubber injecting- bottle with long nozzle and stop-cock (Thompson). Washing the bladder is of great value |R.). Evacuation of the urine, some of which is often retained in the bladder, is a matter of great importance. Ergotin, hypodermically, increases the contractile power of the bladder, and enables it to empty itself more perfectly (Langenbeck). [Compare Bladder Irritable, Calculus, Dysuria, Enuresis, Hematuria.] Prescriptions. R. Uva-Ursae Fol., Pareirae Radicis, . aa Sig.—Boil in 3 pints of water, until reduced to a quart, then strain, and take 1 or 2 winegl. 3 or 4 times daily. (Thompson.) R. Quininae Sulphatis, . sjss. Acaciae, . . . £ij. Morphinae Sulphatis, . gr. jss. Aquae, . . q. s. ad j^iij. M. Sig.—A tablesp. to ounces of warm water, which inject in 3 parts, daily. R. Ext. Tritici Fluidi, . . 3jij. Syr. Amygdalae, . . . 3ij. M. Sig.—A dessertsp. in water 5 or 6 times daily. [Pancoast.) R. Sodii Boratis, . . Glycerini, Aquae, aa jfij. M. Sig.—Tablesp. in four ounces of warm water as an injection. R. Ol. Terebinth., . . Camphorae, . . . gr. xv. Ext. Hyoscyami, . . gr. ss. Fiat massa. Sig.—Take a piece the size of a cherry-stone morning and evening. (Ckauvel.) R. Argenti Nitratis, . . gr. vij. Aquae Destillat., . . t^iijss. M. Sig.—Injection every third or fourth day after washing the bladder out w ith warm water. (Ricord.) Cysts. Iodine, injection very effective in cysts of neck, and sometimes in unilocular ovarian (B.); after tapping Silver Nitrate, gtt. v-x of solution, ij as injection, will cure alter settingup inflammation B.). Galvano-puncture, will permanently occlude cysts of neck ( B.). Aurum Chloride, may sometimes cure ovaiian dropsy (B.). Remedies internally have all been proved worth- less (E.). DEAFNESS DELIRIUM—DELIRIUM TREMENS. 573 Deafness. Quinine, cures some forms, and often causes deafness (Brown-Sequard). Glycerin, for dryness of meatus; also to form a film to ruptured tympanum (R.); either alone or in combination with olive oil (f\); elfects are temporary (Wa.). Tannin, the glycerite as application for throat deafness (R., Wa.). Colchicum, when from gout in ear (A.). Cantharides, as ointment; gr. xxx ad gj adipis, below and behind the ear bis die, with alterative mercurial treat- ment, in deafness from thickened tympanum (Wa.). Gargles, in throat-deaf- ness, are of great value ; potassium nitrate, borax, etc., in sthenic; tincture of capsicum added in nervous forms; hydrargyrum perchloride, when from sec- ondary syphilis (Wa.). Water, washing in warm water, in deafness from gen- eral debility (Toynbee). Faradization, of the ear in nervous deafness, in which slight results only to be expected from the treatment (R.). Demands the utmost caution (Wa.). Collodion, contractile, applied to the membrana tympani, in deafness from relaxation of the membrane, has exerted a perma- nently beneficial influence, even in cases of long standing (Wa.). Turpentine, gtt. xl in glycerin, a few drops into the meatus, in deafness depending on deficient secretion of cerumen, results in much benefit (Wa.). Morphine, gr. ss sprinkled on surface behind the ear denuded by a small blister, has proved curative in chronic deafness, after all other remedies had failed (Wa.). Delirium. Belladonna, delirium of typhus and other fevers (R.) ; severe forms of de- lirium (P.). Hyoscyamus, delirium of typhus; mild, less inflammatory form, hallucinations, nervous excitement, little cerebral congestion (P). Stramo- nium, in wild and furious delirium of puerperal mania, with general restless- ness and suicidal or destructive tendency (Wa.); no drug deserving of more confidence in the greater number of maniacal cases (Cullen). Opium, in traumatic delirium, as a rectal injection, combined with tartar emetic in fevers, or, better still, morphine hypoder. Laudanum in low, muttering de- lirium (R.l; is regarded with suspicion (P.). Cannabis Indica, the extract, in doses of gr. 'n nocturnal delirium occurring in softening of the brain (Wa.). Potassium Bromide, in delirium resembling delirium tremens (R.). Camphor Motiobromide, useful in rambling delirium (Wa.). Camphor, in 20-gr. doses, every 2 or 3 hours, especially in low muttering delirium (R.). Chloral, in violent delirium of fevers (R.). Antimony, delirium of fevers (R.). [See Fevers.] Water, the cold douche in maniacal delirium; place patient in warm bath during application (R.). [Compare Cerebral Con- gestion, Fever, Mania.] Delirium Tremens. Belladonna, of proven efficacy when congestion of the brain (P.); useful for the insomnia when coma vigil, cold surface, cyanosis (B.). Stramonium can do all that Bell, can do, and is more powerful (Tr.). Hyoscyamus, in some forms admirable (P.). Opium, cautiously, if at all (B.); as rectal in- jection, hypodermically, or with spirits. If patient strong, delirium boisterous, and pulse full, add Tartar Emetic or Aconite (R-). Bromides, in the “hor- rors” preceding the delirium, gj every 4 to 6 hours. Are of less value in the delirium and in subsequent attacks (B., R.). Ammonium Bromide has 574 DEMENTIA AND INSANITY. been used with very good results (Wa.). Chloral, at outset (R.); very suc- cessful, but dangerous to old drunkards, or when heart disease exists (B.). If long continued to produce sleep chloral will produce a condition of in- somnia. Chloroform, inhalations to procure sleep (R.). Anaesthetics dan- gerous (B.). Cannabis Indica, gr. ss-j of extract, one of the least dangerous and most useful hypnotics (P.). Tartar Emetic, as hypnotic (B.); combined with opium to control mania and insomnia (R.). Capsicum, to induce sleep in early stages, gr. xx-xxx in a bolus with honey, repeated after three hours (R.). In 20-30-gr. doses has remarkable success (P.). The tincture in doses every three hours of great benefit (Wa.). Nux Vomica, or Strychnine, should be more freely used than it is in alcoholism, and in delirium tremens may be used hypodermically almost to the commencement of tetanic action (Luton). Arnica, the tincture is exceptionally serviceable in cases where there is depression (B.). Coffee, often exceedingly useful (P.). Digitalis, of tinct. repeated in 4 to 6 hours (R.); a tablesp. of the infusion every 4 hours in pale subjects, anaemia of brain, with effusion and oedema (B.) has cured many cases promptly without producing any unfavorable symptoms. Its safety and efficacy are alike questionable (Wa.). Cimicifuga, an excellent tonic for the nervous system, very successful (P.). Quinine, with a mineral acid to restore digestion, in the “ horrors,” and in adynamic states (B.); gr. j two or three times daily as a tonic, the best to produce nervous tranquillity (Anstie). Sumbul, very efficient for insomnia (P.). Zinc Phosphide, gr. jss daily, in divided doses, for many weeks, is used with decided benefit. Zinc Oxide, is of essential benefit as a nerve tonic and sedative, gr. ij—viij, twice daily, gradually increased to the higher dose named (Wa.). Lupulin, the tinct. or oleo-resin, useful in mild cases as stomachic tonic and cerebral seda- tive (B.). Ammonium Carbonate* when anaemia of brain and feeble heart- action (B.). Conium, combined with opium, useful (P.). Alcohol, of un- doubted use where failure of stomach to appropriate food (B.). Water, about 6o° with ice to head, to reduce temperature in the hyperpyrexia (B., R.). Treatment, should tend to nourishment, and establishing of digestion (B.). Concentrated liquid nourishment, with moderate use of stimulants (H.). Diet and Hygiene. The immediate source of danger is exhaustion, hence ani- malized and nutritious, digestible diet in fluid form, small quantities frequently repeated ; beef-tea, soups, yolk of eggs, warm milk, cocoa, cayenne pepper or stimulants in soups; coffee, to still nervous excitement; hot baths and wet pack to eliminate the poison. A quiet dark room, sleep a necessity, often in- duced by Belladonna. [Compare Alcoholism.] Prescriptions. R. Tinct. Capsici, Ext. Lupulini FL, . aa 5j. Mucil. Acaciae, . . 5ss. Aquae Cinnamomi, . . 5jss. M. Sig.—Dessertsp. as required for the wakefulness and excitement which precedes an attack. R. Chloralis Hydrat., . . £vj. Ext. Conii FL, . . . giij. Ext. Hyoscyami FL, . Mucil. Acaciae, * . . arij. Aquae Menth. Virid., ad M. Sig.—Teaspoonful in water after each meal. Dementia and Insanity. Moral or Mental Treatment in recent times, is confided in greatly. With correct management from the start, nearly all cases of insanity unattended by DEMENTIA PARALYTICA—DENGUE. 575 paralysis or physical decay may be cured (Savage) This can be best admin- istered in a well-conducted asylum or hospital for the insane, where security and the prospect of recovery will be better than in the best home. The total abolition of any one plan of treatment in favor of another would be a great mistake. More than half of first attacks of insanity are recovered from under good management, which is best attained under the direction of persons trained in this specialty (H.). Recently, efforts have been made at the im- provement of the insane condition by requiring them to attend school daily, with remarkably good results. Tonics and Hypnotics, should be used in cases requiring them. Pood, of good quality is at the basis of treatment. Opium, mor- phine the best form, especially for melancholics, climacteric and senile cases, which improve under its use; is hurtful in mania. Chloral does as much harm as good, is best suited to wildly maniacal and erotic patients. Potassium Bro- mide, is almost discarded, except for epileptic cases. Conium, is useful, spar- ingly, for noisy patients, so also is Hyoscyamine. Colckicitm, for gouty cases, which are numerous. Cure the gout and you may cure the insanity. Shower- bath, suitable for cases due to self-abuse, and the wet pack in the mania of hystero-epilepsy. Stimulants rank high, next to quiet and absence from home. Koumiss, a good food in hysterical dyspepsia and anorexia, being easily di- gested and preventing waste (Dr. Savage, Bethlehem Asylum). [Compare Delirium, Hypochondriasis, Mania, Melancholia.] Dementia Paralytica. Physostigma, has seemed to retard the progress of the disease in some few cases (B.). Paraldehyde, in I or 2 drachm doses as a calmative and hypnotic is as efficient as chloral and without danger (B.). Tonics, may be used, though treatment is only palliative. Lacto-phosphate of Calcium, Cod-liver Oil, etc. No remedies have hitherto been of any avail (B.). Dengue. Emetics and Purgatives are indicated at the outset, also free diaphoresis. Treatment is entirely symptomatic. Quinine, in five-grain doses every four or five hours for the fever (Da Costa); should be given more for its tonic than for its antiperiodic effects (Fayrer). Opium, in some form for the pains and nocturnal restlessness. Salicylic Acid or salicylates for the pains in joints and muscles. Carbolic Acid, as lotion, a 5 per cent, solution, for the itching, or camphorated oil. Belladonna confers great relief in this disease, mx-xv of the tincture may be given every hour for two or three doses (Fayrer). Aconite, with salines and nitric ether, during the pyrexia, which may go so high that cold sponging or the cold bath may be required. Bitter Tonics, as gentian and calumba, with quinine and a mineral acid or strychnine during convales- cence. R. Tinct. Colchici Sem., . s;ij. Spt. Athens Nitrosi, . Potassii Nitratis, . . gr. xl. Aquae, ... ad M. Sig.—Tablesp. well diluted every hour or two until profuse dia- phoresis occurs. For relief of the violent pains. Prescriptions. R. Tinct. Aconiti, . . Ttlxvj. Morph. Acetatis, . . gr. ij. Spt. Nitrosi, . ziv. Liq. Ammon. Acetat., . Aquae Camphorse, . ad %iv. M. Sig.—Teasp. to dessertsp. ac- cording to age, every hour for three hours, then every two hours. 576 DENTITION—DIABETES. Dentition. Belladonna, in convulsions of dentition rarely fails to relieve (P.). Hyos- cyamus, to alleviate pain and subdue irritation; better than opium for children (P.). Chamomilla, mj of the tincture every % hour, an excellent sedative for children (A. A. Smith). Potassium Bromide, for irritability and convul- sions in teething (R.). Dulcamara, the infusion, in diarrhoea of dentition quickly checks symptoms (P.). Calumba, excellent for the accompanying vomiting and diarrhoea (P.). Hypophosphites, of lime or sodium, as a general tonic, are highly recommended (R.). Rhubarb, with soda, internally for the aphthae, with perfect cleanliness of the mouth and a wash of Borax or Potas- sium Chlorate in glycerin, gr. x ad gj (E. Smith). Castor Oil, for the diarrhoea of dentition to clear out the bowels, then a mixture of Chalk and Catechu, or Oxide of Zinc, gr. j to the dose, with gtt. j of Laudanum if required to reduce peristalsis (E. Smith). Lancing the Gums to relieve tension when gum is actually swollen: should not be indulged in indiscriminately. Prescriptions. R. Potassii Bromidi, . . 5jj. Olei Anisi, . . . ntij. Mucil. Acaciae, Aq. Menth. Pip., . aa 5j. M. Sig.—Teasp. every half-hour until relieved. (B.) R. Sodii Bromidi, Sodii Bicarbonat, Chloralis, . . aa gr. xx. Aq. Menth. Viridis, . ,^jss. Syr. Zingiberis, . . M. Sig.—Half-teasp. to dessertsp. according to age. Diabetes Insipidus. Opium, large doses necessary, gr. vj-xij a day (B.); combined with gallic acid the most generally useful remedy (W.). Ergot has cured many cases, the fluid extract in doses of gss-j thrice daily (Da Costa); one of the most efficient remedies (B.); is the most useful remedy (R.). Iron and Strych- nine are very useful for tonic effects (Da C.). Valerian restrains the flow of urine but does not cure (B.). Muscarine has been used with apparent suc- cess (R.). Potassium Iodide is curative in many cases of syphilitic origin (B.). Alum has produced good results (B.). Jaborandi, used successfully to reduce the quantity of urine (B.). Valerian, large, increasing doses (R.). Krameria. lessens quantity of urine (P.). Diet, a dry diet beneficial (B.). Prescriptions. R. Ext. Ergotae FI., . . Sig.—Half-teasp. thrice daily, grad- ually increased to a dessertspoonful. R. Acidi Gallici, . . . giij. Div. in chartulas xij. Sig.—One thrice daily. Diabetes Mellitus. Phosphoric Acid, largely diluted, assuages the inordinate thirst. In one case it seemed to act as a curative agent (Wa.). Arsenic, when from faulty DIARRHOEA. 577 assimilation, in diabetes of hepatic origin, and in thin subjects (B.). Opium, in large doses (gr. vj-xij a day), ameliorative. Codeine, is especially service- able (B.). Abates thirst and controls appetite (R.). Its value much disputed (P.); is of great value in many cases (W.). Codeine gr. one °f the best remedies (Da Costa). Sodium Salicylate has cured when all other drugs have failed (R.); gr. x-xv in compound spirit of lavender and water, thrice daily, is my favorite remedy (Da Costa). Ergot is one of the useful drugs (Da C.): decreases the quantity of sugar and the volume of urine. Potassium Bromide, gr. xx ter die, cured two cases in six weeks (Begbie, R.); useless (Da C.). Krameria lessens quantity of urine (P.). Phosphates, to avert failure of nutrition (B.). Glycerin has produced good results (B.). Used in place of sugar (W.). Aurum Chloride is one of the promising remedies (B.). Uranium Nitrate, gr. i-iij, thrice daily has caused decided improvement in several cases (Hughes). Alkalies are used on theoretical grounds, but have not produced much benefit. One case apparently cured by the diligent use of Ammonium Carbonate (B.); are serviceable (Da Costa). Alkaline min- eral waters for diabetes of hepatic origin and in obese subjects, are extremely useful (B.). Salines, a warm solution of phosphate and chloride of sodium, by intravenous injection, in diabetic coma, produced astonishing results in one case (B.). Aloin, for the accompanying constipation (Da C.). Nux Vomica, or Strychnine, is generally beneficial. Calcium Lactophosphate benefits the thin nervous type of diabetes remarkably (B.). Aliment. All saccharine and farinaceous foods forbidden. Use fats, animal food, and gluten or almond bread. Milk-cure, buttermilk best, to be the only food until cessation of symp- toms. Alkaline Waters, when of hepatic origin and in obese subjects. Tepid drinks in the intense thirst (B.). Diet and Hygiene are of the utmost im- portance. Avoid amylaceous food, and everything containing sugar, especially ordinary bread. Use fresh, nutritious animal food, with bread of bran or almonds. Warm baths, warm climate, flannel underclothing. Milk-cure, by skimmed milk, very successful, 6 to io pints daily. No other food for six weeks, then animal food alone. Caution,—the urine of patients taking sali- cylic acid gives the reaction of sugar with Trommer’s test (R.). Prescriptions. R . Liq. Potassii Arsenitis, . gjss. Tinct. Opii Deodorat., . sjv. Syrupi Zingiberis, . . Aquae Cinnamomi, . ad :§iv. M. Sig.—Teasp. thrice daily. R. Codeine, . . . gr. viij. Syrupi, et Aquae, . . t^ij. M. Sig.—Half-teasp. thrice daily, gradually increased up to two tea- spoonfuls. (Pavy.) Diarrhoea. Aconite, when from chill, high fever, cutting abdominal pains (P.). Mer- cury. Calomel for infantile diarrhoea (ileo-colitis), gr. to yfj every half- hour (B.). The bichloride, gr. j in aquae, a teasp. frequently in acute or chronic diarrhoea of adults or children with slimy, bloody stools, pain and straining. Gr. >4 of gray powder hourly, or gr. of corrosive sublimate every two or three hours (R.); gr. j of the bichloride to the quart of water, of this a teasp. every hour in mucous diarrhoea (A. A. Smith). Camphor, in 578 DIARRHCEA. summer diarrhoea and the preliminary diarrhoea of Cholera Asiatica (B.); when from effluvia of drains or exposure to cold (R.); useful in many forms (P.). Ipecacuanha, in summer diarrhoea and dysentery of children with greenish stools (B.); hourly drop-doses of the wine especially if vomiting (R.); when from nervous irritation, especially young children (P.). Dul- camara, in diarrhoea of children from damp, or with dentition (P.). Pulsa- tilla, dyspeptic diarrhoea, mucous discharges, active piles (P.). Quinine, in periodic diarrhoea, with dysentery and jaundice (B.). Veratrum Album, in the vomiting and purging of summer diarrhoea (R.). Podophyllum, in chronic, with high-colored motions and cutting pains, also, in morning diar- rhoea (R.). Gr. to with occasional doses of aconite, for vomiting and diarrhoea of gastro-enteritis and prolapse of rectum (P.). Chamomile, an infusion in summer diarrhoea of adults, or in that of dentition (R.). The oil in diarrhoea of children, especially from worms (P.). Arsenic, for evacua- tion of undigested food (B.); gtt. j of liq. arsen. before meals when diarrhoea excited by food; also in chronic and membranous forms (R.). Nux Vomica, a very useful adjunct to other remedies (B.); often of much service in epi- demic diarrhoea (P.). Sulphuric Acid, in summer and choleraic diarrhoea. Small doses in chronic form and in the straining diarrhoea of children (R.). Iron, sol. of pernitrate in army diarrhoea (B.). Lime Carbonate, in later stages, as chalk mixture in diarrhoea of typhoid or phthisis (R ). Zinc Salts, very efficient in summer diarrhoea of children (B.). Rhubarb, in early stages to get rid of irritant, afterwards to check the diarrhoea (R.); when torrefied it has no purgative power, but its astringency is retained. (See page 440.) Rumex, in morning diarrhoea (R.). Arnica checks exhausting diarrhoea with great certainty (P.). Silver Nitrate, in diarrhoea of children. White, pasty and offensive stools. Combined'with opium the most effective remedy for that of phthisis or typhoid (B.). Mineral Acids, in painless, watery stools, light color and alkaline (B.). Alkalies, mistura cretae in sour-smelling stools (B.). Sodium, potassium or magnesium bicarbonates when acid canal (R.). Lead Acetate is excellent in all forms (B.) ; with opium as an injection (R.), Bismuth is effective, requires large doses. Gr. xxx-lx every three or four hours ; is especially indicated when desire for stool is felt immediately after eating (B.). Gr. j hourly with milk, sometimes with gr. >4 gray various forms of infantile diarrhoea (R.). Opium, commonly used, but is best in watery evacuations, combined with mineral acids or acetate of lead (B.), As injection with starch in severe cases (R.). Calumba, when not inflamma- tory (B.). Coto Bark, the fluid ext. or Cotoin is one of the new remedies for atonic diarrhoea. Purgatives, Saline, a teasp. of Epsom salts (magnes. sulph.) in a wineglass of water every three hours when intestinal inflam’n (B.). Cop- per Sulphate, the most effective astringent in chronic diarrhoea and that of phthisis (B.). Ergot, in persistent chronic diarrhoea (B.). Iodine, one or two drops of tinct. in diarrhoea from atony of mucous membrane (B.). I'annic Acid, very useful in profuse and chronic diarrhoea. Stille advises tannic acid and milk diet for chronic diarrhoea and dysentery (B.). Diet. Cool or cold, light, bland food. Gruel, rice, arrow-root, whey, barley-water, in recent cases. In chronic cases the most digestible but nutritious food, as fresh fish, game, raw eggs, rice, mucilaginous drinks. Miik-and-lime-water or soda-water very useful. Also raw meat pulp. Avoid beef, pork, veal, and much starchy food. [Compare Dysentery, Cholera.] DIARRHOEA—DIPHTH ERI A. 579 Prescriptions. R. Bismuthi Subnit., . ij. Pepsini Saccharat., . £ss. Zinci Oxidi, . . gr. vj-xij. Trit. et div. in chartulas xij. Sig.—One every four hours in sum- mer diarrhoea of children. R. Tinct. Opii Deod., . . gj. Tinct. Calumbae, . ad^i). M. Sig.—Teasp. in a winegl. of water before meals. R. Cupri Sulphat., . . gr.j. Morph. Sulphat., . gr. ij. Quininae Sulph.,. . gr. xxiv. Fiant pil. no. xij. Sig.—One pill thrice daily. R. Zinci Sulphatis, Pulv. Opii, Pulv. Ipecac., . . aa gr. xij. M. Fiant pil. no. xij. Sig.—One 3 or 4 times daily in chronic diarrhoea of adults. R . Zinci Oxidi, . . gr. xvij. Sodii Bicarb., . . gr. viij. M. et div. in chartulas iv. Sig.—One every 6 hours. R. Tinct. Opii Camph., Tinct. Catechu, . aa Mist. Cretae, . . . M. Sig.—A teasp. four or five times daily for children. R. Plumbi Acetat., . . gr. xx. Pulv. Opii, . . . gr. x. Fiat massa, et div. in pil, x. Sig.—One twice daily. R. Tinct. Opii Camph., Syr. Rhei Aromat., . aa Sss. Aquae Calcis, . . ad M. Sig.—A teasp. for children. R. Ac. Nitrici Diluti, . . Tinct. Camphorae, Tinct. Opii, . . aa 5jj. Syr. Zingiberis, . , 2iv. Aq. Menthse Pip., . ad M. Sig.—Tablesp. doses to be used after a cathartic. (Hope's Mixture modified by Thompson.) R. Sodii Bromidi, . . Mucil. Acacise, Aquae Purse, . aa q.s. ad M. Sig.—Teasp. every three hours in the diarrhoea of dentition, for child less than a year old. (A. A. Smith.) R. Spt. ZEtheris Co., Tinct. Opii Camph., . aa 3j. Syr. Simplicis, . . . Jij. M. Sig.—Dessertsp. after each movement. Diphtheria. Belladonna, an excellent remedy; if given early will abort the exudation and later is useful to sustain the heart (B.); especially when throat and ton- sils acutely inflamed and much swollen (R.). Corrosive Sublimate, gr. every 2 or 3 hours, has given me most success, with Thymol or Boric Acid gargle; and Potassium Chlorate, Iron and Quinine together, where the mem- brane is not spreading (Da Costa). Merc. Cyanide, in solution of gr. to the of which a teasp. every hour day and night to older children and 580 DIPHTHERIA. adults, with a gargle of the same solution (Sellden); gr. according to age every hour or two (Erichsen). Calomel is next in importance to quinine and iron, has proved successful in cases where other means failed, gr. ]/%~y every 3 hours, with a little Dover’s powder (Da Costa). Chlorine-Water, tablesp. doses internally and as gargle, highly efficient. Calomel, checks plastic exu- dation; its use limited to children of good constitutions, with sthenic symp- toms. Gr. yz to j every 2 or 3 hours with or without Dover’s powder (gr. j) or ipecac, (gr. j) till bowels become relaxed, with greenish stools (Wa.). Gr. v repeated boldly every hour to for a child of 3 years, until the stools appear like polyps in water-troughs, gelatinous, and of a bright, dark-green hue. Then a dose of castor oil if salivation is feared (Reiter’s Monograph, 1878). Calcium Chlorate, solution locally as lotion for the mouth. Consid- ered almost specific by some ; its chief utility is in removing fetor; may influ- ence germs (R., B.). Potassium Chlorate, grain-doses every y2 hour (A. A. Smith); is more largely used than any remedy, both internally and locally (B.); in full doses with Liq. Cinchonae, seems to be of service in some cases (Wa.). Pilocarpine, used in 80 cases without a single death ; produces free salivary discharge but is depressant to the heart (Guttmann); many opinions for and against it. Is decidedly injurious in adynamic cases (B.). Quinine in tonic doses recommended from my experience (Da C.); when headache with high temperature, vomiting, and symptoms of septic poisoning, then in full doses (Wa.); is most useful after serious symptoms have abated, then with Iron and a mineral acid (Mackenzie). Carbolic Acid, in spray, locally to the fauces, to remove fetor and destroy disease-germs (B.). As caustic, the concentrated acid in glycerin on a mop or brush (W.). With iodine to prevent systemic infection (B.). Arsenic, in medicinal doses, when sloughing of throat, or ma- lignant diph. (R.). Salicylic Acid, locally and internally (gr. x) has produced good results (B.). Sulphurous Acid Gas, recommended by a royal commis- sion in Victoria, as a means of arresting the disease. Crude sulphur burned in the room, all apertures being closed (R.). Sodium Sulphite, p,j-gj aquae, locally, an easily managed application (B.); an injection for nares in nasal diphtheria (Da C.). See formula below. Sodium Benzoate, is highly effi- cient, 75 to 100 grains daily, according to age, also used locally (B ). Sodium Sulpho-Carbolate,h&?> been found useful in lieu of carbolic acid (Wa.). Lime Water, dissolves false membrane. The vapors of slacking lime inhaled ; or better, lime-water by atomizer to back of fauces while patient respires deeply (W.). Ferric Chloride, as solution painted on or applied by spray to the throat (R.). Of no advantage locally, internally may serve by supporting the or- ganism (B.); the tinct. of the chloride, gtt. xx every 2 or 3 hours; or better the perchloride, gr. y2 to j every 2 hours in syrup and water, is easier to take and doesn’t hurt the throat (Da C.). Strychnine, hypodermically, for the sub- sequent paralysis (R.). Tartaric Acid, locally, converts membrane into a gela- tinous mass, easily expelled (Vidal). Thymol, gr. xx to the § of water, with a little glycerin, is the best gargle; may need weakening (Da C.). Boracic Acid in solution, is next best as gargle (Da C.). Alum and Sulphur, equal parts, powdered and blown into the throat at moment of deep inspiration, as often as asphyxia is threatened, has been found efficient (Jones). Trypsin, is a good solvent of the false membrane. Chinolin, a 5 per cent, solution painted over the affected parts with great advantage (Seifert); the tartrate in 10-grain doses internally (B ). Bromine, the vapor by inhalation, is useful (Wa.); a solution in distilled water, of which gtt. j-iij every ]/2 hour in a teasp. of sweetened water, using a glass spoon; and a saucer full of bromine water in the room, renewed every 12 hours, has seemed to be extremely effi- DIPHTHERIA. 581 cient in a number of cases. Iodine, as inhalation frequently (see formula below): with use the solution maybe increased to ijss at each inhalation (R.). Potassium Permanganate, gr. l/2 in distilled water, internally, and also used locally, is of undoubted benefit (B.): is credited with brilliant results even in malignant cases. Sanguinaria, the best emetic, and by many is considered specific in this disease (P.). See formula below. Lactic Acid, to Jx of distilled water, as gargle, on mop or by spray, to dissolve membrane (B.). Tannin, a 5 per cent, solution, as spray (R.). Alcohol, is probably as good a local antiseptic as any: diluted with equal parts of water, by hand-ball atomizer every hour. Cubebs, are very efficient in the catarrhal forms of diphtheria (B. Robinson): the freshly ground berries in large doses in early stages of the disease, a very successful treatment (Trideau). Water. Ice in the mouth, and the wet pack to the throat are extremely serviceable (B.). Ice sucked, especially at commencement, and continued until the disease declines (R.). Ice packed in bladders or thin india-rubber bags, to the throat (W.). Aliment. Good foods, wines or brandy necessary from the start to maintain the patient’s strength (R.). A teasp. of glycerin every 3 or 4 hours, plenty of good soup and wine, nutritive enemata, are necessary to sustain system. Moist inhalations. Temp, of room 68° Fah. Removal from the house wherein attacked is advisable. Ice very grateful to the patient. Stimulation, freely, the essential part of the treatment; infants are not injuriously affected by even teasp. doses of whiskey every )/2 hour. Stimulate for effect and not by dose; those cases do best which are stimulated freely and early (Da C.). There is more danger from giving too little alcohol than from too much. A three-year old child can comfortably take from v of Cognac, or gr. xv of Musk or Camphor, or gr. of Ammonium Carbonate in 24 hours. In the septic form especially, the intoxicating action of alcohol is out of the question. Young children with general sepsis began to improve when their of brandy were increased to daily (Jacobi). Tracheotomy, only in extremis (R.): is not successful in this disease, though very much so in membranous croup (Da C.). Prescriptions. R . Tinct. Ferri Chloridi, Syrupi Tolutani, . aa 5j. Liq. Potassii Citratis, . M. Sig.—Teasp. to dessertsp. ac- cording to age, every 3 hours. 3=tri.x. (Anderson.) R. Acidi Lactici, vel Tartarici, . . gijss. Glycerini, . . . giv. Aq. Menth. Pip., . . 3vij. M. Sig.—Locally to patches every 3 hours. R. Hydrarg. Chlor. Corros., gr. j, may be added to the above formula, which should then be given in teasp. doses. R. Thymol, . . . . ZJ- Glycerini,.... xj. Aquae, .... 3 >ij. M. Sig.—Gargle. (Da Costa.) R. Potassii Chloratis, . . gr. xl. Syrupi Simplicis, calid., . Solve, et adde— Ac. Sulphur. Aromat., Tinct. Ferri Chloridi, aa %). M. Sig.—Teasp. doses for adults, every 2 to 4 hours, reduced as im- provement advances, but kept up throughout disease. R. Sodii Sulphit., . . • 3jij. Glycerini, .... .^ij- Aquae, . . q. s. ad M. Sig.—Nasal injection. [Da Costa.) 582 DROPSY. R . Tinct. Ferri Chloridi, Potassii Chloratis, . ail ijss. Glycerini, . . . 7,\). Aqua:, . . q. s. ad i^viij. M. Sig.—Gargle, every 3 hours. R. Tinct. Ferri Chloridi, . Glycerini, Aq. Destil., aa §j. M. Sig.—Teasp. of this and the next R. alternately every y hour. R. Potassii Chloratis, . .' £ss. Glycerini, . . . j^ss. Aquae Calcis, . . . t^ijss. M. Sig.—Teasp. of this and the preceding R. alternately every y2 hour. R. Iodi, . . . . gr. iv. Potassii Iodidi, . . gr. iv. Alcoholis, . . . Aquae, ... ad M. Sig.—Teasp. on boiling water as inhalation. ( Waring-Curran.) R. Pilocarpinae Muriatis, gr. Pepsini, . . . gr. x-xx. Acidi Hydrochlor., . gtt. ij. Aquae Destill., . . ,^viij. M. Sig.—Teasp. every hour for a child. R. Bromi, . . . . gr. j. Potass. Iodidi, . . . Aquae, .... j$j. M. Sig.—Inhale from a cone, as solvent of membrane. R. Pulv. Potass. Chlorat., . Ac. Hydrochlor., . . sjij. Mix in a strong pint bottle, cork until effervescence ceases. Add of Water, 3j at a time, shaking at each time. Cork tightly. Paint the bottle. Sig.—Chlorine-water. A tablesp. or two to be taken frequently, accord- ing to age. R. Acidi Carbolici, . . rr\xv. Aquae Calcis, . . . t^vj. M. Sig.—Spray. To be used with a hand-ball atomizer several times daily, for 5 minutes each time. R. Ac. Tartarici, . . . t^i. Glycerini, . . . .^jss. Aquae Menth. Pip., . ad $iv. M. Sig.—Gargle frequently. ( Vidal.) R. Pulv. Sanguinariae, , gr. xx. Pulv. Ipecac., . . gr. v. Syrupi Ipecac., . . M. Sig.—Teasp. every y hour until vomiting; afterwards, yz teasp. every hour. (Phillips.) R. Ac. Salicylici, Sodii Boratis, . . aa gij. Ac. Carbolici, . . . .^j. Aquae Siv. M. Sig.—Use as gargle or wash. Dropsy. Arsenic, in dropsy from feebleness of heart, and in old age (B.); swelled feet from debility (R.). Digitalis, one of the best remedies, esp. in renal dropsy from acute desquamative nephritis. The infusion in doses of (B.). The fresh infusion best for heart disease, esp. when tricuspid regurgitation (R.). Induces striking effects in cardiac dropsy, when scanty urine and venous en- gorgement. Has high rank as a diuretic (P.). Apocynum Cannabinum, actively diuretic (P.). Bryonia, as a drastic purgative and diuretic, care necessary as it depresses the heart. The infusion best (P.). Hellebore, the tinct. in doses of gtt. v-xv, every 2 or 3 hours, very successful in dropsical DROPSY. 583 effusions, especially in general anasarca after scarlatina (P.). Senega, as a diuretic when dependent on kidney disease; has been praised (P.). Chima- phila, is useful as diuretic in renal dropsy esp. when with loss of appetite and debility (P); maybe substituted for Scoparius (B.). Juniper, largely used as a diuretic in cardiac and renal dropsy (B.) ; esteemed in post-scarlatinal dropsy (R.). Iron, purgative chalybeate waters (B.); the Mistura Ferri et Ammonii Acetatis (Basham’s Mixture), in anaemic dropsy (Da C.). Pilocarpus, very valuable in renal dropsy when secretion of urine is much reduced or sup- pressed (B.). Jalap, the compound jalap powder, gr. xv-xx, with £iij of potas. bitart, and a little ginger, early in the morning, 2 or 3 times a week; nohydra- gogue superior, in dropsy from Bright’s disease (Wa.). Turpentine, controls dropsy with albuminous urine, from non-desq. renal disease. Gtt. ss every 2 to 4 hours (P.). Colchicum, as a hydragogue in hepatic and cardiac dropsy when patient is vigorous, also in post-scarlatinal dropsy (B.). Scoparius, esteemed by English physicians (B.); is most useful in cardiac dropsy. Cullen found it the most certain diuretic. Diluents should be freely used with it (P.). Squill, in cardiac dropsy ; cautiously if from kidney-disease. If anaemic add iron (B„ R.). Taraxacum, is occasionally used as a diuretic, with limited utility (B.). Copaiba, gives good results, especially in Ascites, which see for formula (B.). Potassium Bitartrate and Acetate, are very certain as diuretics when largely diluted with water. “ Cream-of-tartar lemonade.” Indicated in desquamative nephritis, and general dropsy from valvular disease of the heart (B., R.). Elaterium, of unquestionable value as derivative in many passive forms of dropsy; though many fear it (P.). Acupuncture, or better still, incisions from Y to an inch long, one over each external malleolus gen- erally sufficient. A hot sponge, moist with weak carbolic acid solution kept to incisions (R.). Aliment, dry diet is of advantage in dropsy of serous cavi- ties IB.). Diet. Should be light in acute dropsies; in chronic, nourishing. Water not injurious but beneficial as drink. Warm baths, Hollands gin in small doses, tapping, for alleviation in incurable cases. A moderately warm, dry atmosphere. Skim-milk diet said to be of very great value in renal dropsy. [Compare Ascites, Hydrocele, Hydrocephalus, Hydrothorax, etc.j R. Vini Colchici Seminis, . Sss. Liq. Ammonii Acetat., . Infusi Petroselini, . . gv. M. Sig.—Teasp. every 4 hours. An excellent diuretic, esp. adapted to dropsy of scarlatina. (B.) Prescriptions. R. Aceti Scillse, . . . .^ss. Infusi Digitalis, . ad M. Sig.—A tablesp. 2 or 3 times daily. R. Potassii Acetatis, . . gvss. Spt. Etheris Nitrosi, . ,^ij. Aquae, . . q. s. a*/i$viij. M. Sig.—Tablesp. every 3 or 4 hours. R. Elaterii, . . . . gr. j. Spt. Etheris Nitrosi,. . Tinct. Scillse, Tinct. Colchici, . aa 3ss. Syr. Simplicis, . . . %j. M. Sig.—Teasp. 3 or 4 times daily, in hepatic and cardiac dropsy in sthenic subjects. R. Potassii Bitartrat., . . 3;j. Ext. Taraxaci, . . £ss. Decocti Taraxaci, . . Sjviij. M. Sig.—]/z winegl. twice or thrice daily. 584 DUODENAL CATARRH—DYSENTERY. R. Pulv. Scillae, Pulv. Digitalis, . Potassii Nitratis, . . gj. M. Fiat massa, et div. in pil. xxx. Sig.—One pill thrice daily. R. Mist. Ferri et Ammonii Acetatis (U. S. P.), . 3vj. Sig.—Teasp. or two three or four times daily. [Basham's Mixt.) Duodenal Catarrh. Sodium Phosphate, gj four times daily, extremely efficient in catarrhal con- ditions of the duodenum and bile-ducts, resulting in jaundice, hepatic colic, etc. (B.). Vichy Water, in similar conditions, probably owes its efficacy to the phosphate of sodium contained in it (B.). Potassium Bichromate, in doses of gr. two or three times a day, is an excellent remedy in so-called duo- denal dyspepsia, manifested by a bitter taste, coated tongue, pale stools, vom- iting of glairy fluid and dull pain in right hypochondrium. Arsenic, has been used with success in jaundice from catarrh of bile-ducts after duodenal ca- tarrh (B.). Podophyllum, in catarrhal and malarial duodenitis. Nitro-muriatic Acid, in mucous duodenitis; also as bath to right hypochondrium j), temp, of bath 96° (B.). Aliment. No starches or fats; milk, eggs, oysters, beef-broth, broiled or raw beefsteak, whitefish (B.). Diet should be exclu- sively animal, in order to let the stomach deal with it. [Compare Jaundice, Biliousness.] Dysentery. Aconite, fever and cutting pains (P.). Mercury, in minute doses for the ileo-colitis of children. Gr. to of calomel or hydrargyrum cum creta every half hour (B.). Gr. of the bichloride hourly or every 2 hours, in acute or chronic dysentery if stools are slimy or bloody (R.). Ipecacuanha, is par excellence the remedy for acute dysentery of the ordinary type; large doses, gr. xxv-xxx (P.); gr. xv in milk (B.). Valuable in acute or epidemic, also in summer dysentery of children, with greenish stools, mucus and blood. Gr. ii-v every 2 hours in milk (B.). Dysenteric diarrhoea of children, especially with vomiting, will often yield to hourly drop doses of ipecacuanha wine (R.). Hamamelis, when the discharges contain much blood (R.). Nux Vomica, in epidemic dysentery (P.) ; prune-juice stools, much gas, vital depression (B.). Arsenic, Fowler’s solution gtt. ij with gtt. v of opium often benefits (B.). Quinine, when periodic (B.); in malarial subjects is as successful as ipecacu- anha in dysentery of the ordinary type (P.). Gamboge, gr. in 24 hours, exceedingly valuable, especially in young persons (P.). Castor Oil, as a mild cathartic, is very’ valuable in appropriate cases (Wa.); gtt. v every hour, in water with sugar and gum, is excellent for dysenteric diarrhoea of children (A. A. Smith). Arnica, when vital powers are greatly depressed, is highly extolled (Wa.). Saline Purgatives, Epsom salts the best treatment for acute dysentery, especially when fever, pain, tenesmus and stools of mucus and blood (B.). Silver Nitrate, in pill, gr. %-), with opium, in acute dysentery after subsidence of acute symptoms. Also as enema beyond the sigmoid flexure (gr. x-xx ad Oj aquae). Also as escharotic through speculum to ulcer of rectum (B.). Opium, as enema, with starch and milk, after canal is emptied by salines. Indispensable in chronic dysentery (B.). P'or the purging (R.). A remedy of great value, and applicable to every stage and every form of the disease, allaying pain and vascular excitement, moderating peristalsis, promoting the cutaneous secretion. Is inferior to ipecac, in acute dysentery, and is most valuable in the DYSENTERY. 585 chronic form (Wa.). Glycerin, with infusion of flaxseed (1 to 4', to allay tenesmus (B.). Lead Acetate, as enemata in acute and chronic dysentery, to allay tenesmus (B.); with ipecac, and opium in pill, for acute form, see formula (Da C.). Sulphuric Acid, with saline purgatives (B.). Copper Sul- phate, useful in acute dysentery ; in chronic the most valuable astringent (B.). Gr. x-xx ad Oj aquae (R.). Ergot, in chronic, after acute; and also in the acute form (R.). Grape-cure, is used successfully in the chronic form (P.). Iron Pernitrate, sometimes in chronic (army) dysentery (B.). Cahiniba, is of great value in chronic, with ulceration of colon (P.). Injections of muci- laginous enemata (as flaxseed) are of great value (R.). Diet is of prime importance (B.). Avoid animal food and stimulants. Liquid foods best; all cold (R.). [Compare Diarrhoea, Enteritis.] Prescriptions. R. Plumbi Acetat., . . gr. xxiv. Ipecacuanhae, . . gr. iij. Pulv. Opii, . . • gr. iij. Fiant pil. no. xij. Sig.—One every 2 hours until blood ceases, then at longer intervals. (Da Costa.) R. Magnesii Sulph., . . 5 viij. Ac. Sulph. Dil., . . tss. Aquae, .... gvtij. M. Sig.—Tablesp. in a winegl. of water every hour or two until it ope- rates. (B.) R. Ext. Ergotae FI., . . Tinct. Opii Deodor., . M. Sig.—Teasp. thrice daily. (Andrew.) R. Plumbi Acetat., . . gr. iv. Morph. Acetat., . . gr. ss. Aq. Fervid., . . %j. M. Sig.—Enema to allay tenesmus. R . Ferri Subsulphatis, . gr. xl. Pulv. Opii, . . . gr. xx. Fiant pil. no. xx. Sig.—One thrice daily. Chronic dysentery. R. Morphinae Sulph., . gr. ij. Strychninae Sulph., . gr. Ac. Sulphurici Dil., . ?ss. Aquae Camphorae, . M. Sig.—Teasp. well diluted, every hour or two. In epidemic dysentery with prune-juice stools and marked depression. R. Ergotini, . . . gr. xx. Ext. Nucis Vom., . . gr. v. Ext. Opii, . . . gr. x. Fiant pil. no. xx. Sig. — One every 6 hours. (Etng.) R. Bismuthi Subnit., . gij. Spt. Ammon. Aromat., %). Tinct. Opii, . . gtt. xvj. Syrupi Simplicis, . ,5ss. Misturse Cretee, . . .fjss. M. Sig.—Dessertsp. to child over one year; tablesp. or more to an adult, every 2 or 3 hours, after emptying bowels by a laxative. R. Liq. Ferri Nitratis, Ac. Nitrici Dil., . aa ,^ss. Syr. Zingiberis, . . 5j. Aquae, . . q. s. ad 3iij. M. Sig.—Teasp. thrice daily for child of 2 years. Tonic to follow palliative treatment. (Starr.) 586 DYSMENORRHCEA. Dysmenorrhcea. Pulsatilla, in the functional form, is of much benefit when discharge is scanty or profuse, black and clotted; should be persevered in for 2 months or more (P.); gtt. ij every hour is most effective when the affection is not of membranous, obstructive or neuralgic character (A. A. Smith). Belladonna, in neuralgic or spasmodic forms, dark and fetid discharge, crampy pains and cold chills, a suppository or mild injection, together with internal administra- tion, will relieve (P.); in neuralgic dysmenorrhcea it will permanently relieve (B.). Aconite, a valuable remedy when commenced early (P.); for the con- gestive form in plethoric subjects (B.). Cimicifuga, relieves the pain in conges- tive variety, and is decidedly useful (P.); is said to be very efficient (R.); is valuable (Wa.), Opium, necessary when pain is very severe; one hypodermic of morphine at each period is often sufficient (Wa.). Codeine, when morphine is not well borne, has given very complete satisfaction in several cases; gr. morning and evening (Oliver). Gelsemium, relieves pain in the neuralgic form, ttlv-x of the fluid extract every 2 hours (B.). Chloroform, as the liniment on a flannel wrung out of hot water, or by inhalation as anaesthetic when pains very severe ; sometimes exerts a permanent influence (Wa.). Ergot, given when the molimen begins, is useful in the congestive form (B.). Amyl Nitrite, may be inhaled with benefit in the neuralgic variety, especially in chlorotic girls (Wa ). Sodium Borate, in the membranous form, has been used with great benefit combined with ext. belladonna: (Wa.). Ammonium Acetate, has remarkable power over many forms of dysmenorrhcea. The liq. ammonii acetatis, in j|ss doses, with gr. of ipecac., every 2 or 3 hours, to keep up the action of the skin until the flow is well established (E.). Camphor, is my favorite remedy, gr. x in mucilage and cinnamon-water; repeat the dose in an hour or two if necessary (Dewees). Guaiacum, is very useful (P.); drachm doses of the ammoniated tincture in the neuralgic or rheumatic forms (B ). Caulophyllum, is by many considered the best curative remedy for spasmodic dysmenorrhcea, if given in the intervals. Viburnum Opulus', the fluid extract, in half-drachm doses, has considerable reputation in some sections for uterine pains of various kinds, and is useful in the spasmodic variety of this affection ; may be used in combination with cannabis indica (Thomas). Arsenic, gtt. iij-x of Fowler’s sol. with gtt. x of tinct. digitalis, ter die between the periods, gives excellent results (Athill); indicated when copious membranous discharge from bowels and uterus (R ). Cannabis Indica, is very useful as a palliative in painful menstruation (B.); gr. ss-j thrice daily to relieve the pain (R.). Nux Vomica, in neuralgic form. Syrup or elixir of iron, quinine, and strychnine (B.). Apiol, neuralgic form (B.); as emmenagogue, night and morning, for several days near the period (Wa.). Electricity, in neuralgic, a galvanic cur- rent; in congestive, inverse current (B.). Croton-Chloral, in neuralgic form (R.). Iron, if depending on amemia (B.). [See Amenorrhcea for formula.] Cajuput Oil, said to relieve the pains (R.). Rue and Sumbul, are reported useful (P.). Emetic of ipecac., with warm covering in bed, feet in hot water, hot ginger tea, liquor ammonii acetat. If pain very severe, a suppository of morphine and belladonna per rectum; best to avoid anodynes (E ). Ac- cessories, spinal ice-bag, when scanty discharge; when menorrhagic, hot water spinal-bag. Sitz baths, either hot or cold, or cold alone, during intervals. DYSPEPSIA. 587 Prescriptions. R . Ext. Belladonna,. . gr. iv. Ext. Stramonii, Ext Hyoscyami, aa gr. v. Quininae Sulphatis, . gr. xl. Fiant pil. no. xx. Sig.—One pill thrice daily. Neuralgic dysmenor- rhoea. R . Ext. Ergotae Fluidi, . Tinct. Gelsemii, . . Tinct. Aconiti, . . Tq.xvj. M. Sig.—Teasp. every 2, 3 or 4 hours. In congestive dysmenorrheea. R. Ext. Opii, . . . gr. v. Ext. Cannabis Ind., Ext. Hyoscyami, . aa gr. x. Camphorae, . . . gr. xxv. M. Fiant pil. no. x. Sig.—One pill 2 or 3 times daily. [MeLane.) R . Ext. Cannabis Ind. Fl., . £jss. Ext. Viburni Op. Fl., . Mucil. Acacias, . . Aq. Cinnamomi, . ad M. Sig.—Dessertsp. every 4 to 6 hours. Dyspepsia. Nux Vomica, gtt. v-x ter in die before meals as stomachic tonic (B.); when flatulence, weight on head and heartburn (R.). Often of the highest possible value in simple atonic form, or in the dyspepsia of drunkards (P.). Arsenic, drop doses of P'owler’s solution before meals in irritative dyspepsia (B.); also when diarrhoea is excited by food (R.). Bryonia, in dyspepsia of liver origin, “bilious” headache with vomiting (P.). Charcoal, when flatulence; nux vomica in 5~TTi doses, before meals, better (R.). Merctiry, gray powder gr.j, 3 or 4 times a day, when dyspepsia during chronic disease or convalescence. If constipated, calomel gr. ss with extract hyoscy. gr. itj in pill for 3 nights (R.). The yellow oxide, in doses of gr. for dyspepsia septica and kindred disorders of the alimentary canal; remarkably efficient in Austrian navy (Schaffer). Ipecacuanha, Ttlv-x of the wine most valuable in atonic and chronic catarrhal dyspepsia (P.); constipation, depression, food “like a heavy weight” (R.). Hydrastis, gtt. v-xv of the tincture before meals, a good stomachic tonic (B.); in chronic dyspepsia, sluggish liver (P.). Pulsatilla, a good rem- edy when depression with fear of death, white-coated tongue, little or greasy taste, nausea, flatulency, heartburn; gtt. v in water every 4 hours (P.). Cin- chona, with mineral acids in atonic dyspepsia (P.). Quinine, especially for town-dwellers and elderly people; checks excessive fermentation in aliment- ary canal (R., P.). Chamomile, Ttlij of oil, very useful in atonic dyspepsia (P.). Ignatia, useful in nervous dyspepsia (P.). Taraxacum, certainly does good in simple atonic dyspepsia (P.). Belladonna, gr. >4 to }£ of the extract, once a day when there is constipation (R.). Bismuth, mixed with vegetable charcoal in flatulent dyspepsia (R.); gr. x with same quantity of calcined magnesia, in chronic gastric catarrh, where rliet cannot be regulated (Rose). Manganese, gr. x-xv of the black oxide in gastrodynia and pyrosis (B.). Sanguinaria, gtt. ij-v of tincture or gr. of alkaloid, in atonic dyspepsia promotes secretion and increases the appetite (B.). Silver Oxide, doses with same quan- tity of ext. hyoscyami before meals in nervous dyspepsia (B.). Xanthoxylin, as stomachic tonic, sy fl. ext. in atonic dyspepsia (B.). Simple Bitters, calumba best, quassia or gentian or infusions of them as vehicles for acids and alkalies (B.). Calumba easily tolerated when stomach weak (R.). Gentian as stom- achic and tonic very useful in atonic dyspepsia, and that of gouty subjects. The tinct. in some aromatic water, or in combination with alkalies and seda- 588 DYSPEPSIA. tives (Wa.) Pepsin, very beneficial. Scheffer’s or Beale’s saccharated pepsin with hydrochloric acid. Ingluvin also promotes digestion (B.). Mineral Acids. Hydrochloric or lactic with pepsin after meals in atonic dyspepsia. Hydrochloric after meals for acid pyrosis. Nitro-muriatic for dyspepsia with mental despondency, oxalate of lime in urine, offensive gas, sallow complexion (B., R.); Phosphoric, dilute, very efficient before meals (Da C.). Sulphurous Acid, well diluted, for acid pyrosis (B.). Alkaline Mineral IVaters, before meals in atonic dyspepsia, and highly useful in the dyspepsia of obese subjects (B.). Alkalies, shortly before a meal increase the ga-tric juice, and are usually better than acids in atonic dyspepsia. Sodium bicarbonate is the best (R.); a full dose (gr. xl-lx), in dyspeptic attacks, with flatulence, etc., usually affords speedy relief (Wa.). Cascara Sagrada, in all cases of dys- pepsia, associated with a torpid liver and constipation; small doses at first, gradually increased (Wa.). Chloroform, gtt. xv-xx in sweetened water, when rapid fermentation of food and evolution of gas soon after eating; is promply efficient in giving relief (Willis). Aloes, combined with other agents, where habitual constipation accompanies dyspepsia (R.t; especially indicated in duodenal dyspepsia, gr. ij-iv with ipecac, gr. j-ij, two or three times a week (Wa.). Water. A dry diet will entirely relieve the ice-water dyspepsia, or that due to excessive beer-drinking (B.); half a tumbler of cold water ]/2 hour before breakfast acts to some people as a purgative and removes many dys- peptic symptoms, but flatulent dyspepsia is often traceable to excessive water drinking at meals, especially that of iced beverages (R.). Hot Water, ]/2 a pint to a pint at 110°-I50° F. an hour before each meal and )/2 an hour before going to bed, each draught sipped slowly during 15-30 minutes. As a cure lor dyspepsia this is an old and efficient practice (Wa.). Milk-cure, has suc- ceeded admirably (B.); fresh buttermdk a most excellent article for dyspep- tics, as also is koomiss. Alcohol, in any form,especially good wines, are useful in the atonic dyspepsia of sedentary livers (B.); when loss of appetite and of digestive power from fatigue, a glass of wine or brandy-and-water before eating is very appropriate; useful also in indigestion of town dwellers, or during con- valescence from acute disease (R.). Diet. Avoid tea and hot beverages, over-cooked food, over-feeding and iced-water; masticate all food well, eat slowly, small quantities and frequently. Active out-of-door habits should be cultivated, and all articles of food known to disagree should be strictly avoided. [Compare Acidity, Biliousness, Flatulence, Gastralgia, Pyrosis.] R. Hydrarg. Chlor. Mitis, . gr. ss-j. Sodii Bicarbonat., . gr. xx. Pulv. Aromat., . . gj. Trit. et div. in chartulas x. Sig.— One powder every 2 hours. For irri- tability of the stomach. (Hughes.) Prescriptions. R. Tinct. Nucis Vom., . . £jss. Ac. Hydrochlorici Dil., . £ijss. Glycerini, . . • 5J- Aquas Lauro-cerasi,. . M. Sig.—Dessertsp. before meals, to improve appetite and digestion. R . Sodii Bisulphitis, . . !|j. Tinct. Calumbae, . . gss. Aq. Menth. Pip., . ad £ij. M. Sig.—Teasp. 2 or 3 times daily, as an antifermentative. R. Bismuthi Subnit., . . gjss. Pepsi ni, . . . • 3) • Strych. Sulph., . . gr. j. Tinct. Cardam. Co., ad p,iv. M. Sig.—Teasp. thrice daily in water. For bilious dyspepsia, DYSPHAGIA—DYSPNfFA. 589 R. Tinct. Capsici, . . ttlxvj. Tinct. Nucis Vom., . tpj. Tinct. Gentianae Co., ad’ip), M. Sig.—A teasp. in water thrice daily, with gr. A Aloin at bedtime, avoiding a starchy diet. For aggra- vated dyspepsia with constipation. (I) a Costa.) R. Creasoti, . . . rqviij. Bism. Subcarb, . . Glycerini, Aq. Menth. Pip., . aa Jjj. M. Sig.—To be well shaken. A teasp. every 3, 4 or 6 hours, for pain in stomach and wind. (B.) R . Sodii Bicarb., . . . ;jij. Spt. Ammon. Arofnat., . zij. Tinct Zingib., . . gj. Infusi Gentianae Co., U. S. P. 1870, q. s. ad £viij. M. Sig.—Teasp. or two thrice daily. P'or acid dyspepsia. R. Ac. Hydrochlorici Dil., . 3[j. Tinct. Capsici, . . gss. Tinct. Calumbae, . . Vini Pepsini, . ad 3iv. M. Sig.—Dessertsp. after meals. In atonic dyspepsia. (Pancoast.) R. Pepsini (Jensen), . . Ac. Tartarici, . . . gr. v. Glycerini, . . . 5jss. Vini Xerici, . . ad fiviij. M. Sig.—Teasp. after meals. R. Rhei, Gentianae, et Carda- momi, contus., . aa Xij. Spt. Vini Gallici, . . 5ij Aquae, .... 3V). Macera per horas 48, cola, et adde— Tinct. Nucis Vom., . 5jj. Potassii Carbonat., . £j. M. Sig.—Tablesp. in water thrice daily, before meals. R. Tinct. Gentianae Co., . Sig.—Teasp. in water thrice daily. Dysphagia. Cocaine, the hydrochlorate in solution, 20 per cent., as spray or by swab, relieves the dysphagia of phthisical laryhgitis (P.). Cajnput Oil, in nervous dysphagia, used in India with considerable success (P.). Potassium Bromide, for congenital dysphagia of liquids in children, when no diphtheria or mal- formation (R.); in hysterical dysphagia (Wa.): benefits a curious affection sometimes seen in children, who from their birth can swallow solids with ease but choke at liquids (R.). Sprays of ammonium bromide, chlorine water, or other sedative agents in warm solution, for the dysphagia depending on specific disease of the larynx (Muirhead). Galvanism, in the vicinity of the oesophagus will speedily remove hysterical dysphagia (Muirhead). Tonics, as strychnine, iron and quinine, for post-diphtheritic dysphagia. Iced Fluids, slowly swallowed, will often remove spasmodic dysphagia (Wa.). Dyspnoea. Morphine, hypodermically, the most efficient agent in relieving dyspnoea from cardiac clbease, or any other form; but if albumen in the urine it must be withheld (Allbutt). Grindelia, of great service in dyspnoea with cough, occurring in emphysema (W.). Citnicifuga, has often relieved most distress- ing cases from cardiac disease (P-). Spigelta Anthelmia, produces and often 590 DYSURIA—ECCHYMOSIS—ECTHYMA. relieves it when with palpitations (P.). Valerian, proved useful when ner- vous (P. )• Prunus Virginiana, has proved very efficacious in cardiac dysp- noea (P.). Amyl Nitrite, serviceable in cardiac dyspnoea and other forms (Wa.). Asafcetida, in combination with other antispasmodics, often very beneficial in the dyspnoea of chronic bronchitis (Wa.). Chloroform, a few whiffs give temporary relief in the cough and dyspnoea of phthisis and bron- chitis (Wa.), Iodide of Ethyl, by inhalation, is very serviceable in many forms (See). Dyspnoea is a symptom, and may be referable to cardiac, pul- monary, pharyngeal, laryngeal or tracheal disease (T.). [Compare Asthma, Bronchitis, Croup, Emphysema, Phthisis, etc.] Dysuria. Canfharis, gtt. j (sometimes v) of tinct. ter die, for frequent micturition with pain (R.). Irritable bladder, vesical tenesmus (B.). Cannabis Indica, relieves dysuria (R.); when bloody urine (P.); an excellent anodynein painful affections of the bladder, having specific action on that organ. Belladonna and Hyoscyamus have similar sedative effects in vesical and urethral irritation (P.). Linseed, as infusion, is often a valuable adjunct (P.). Opium, in suppository, combined with hyoscyamus, gr. ij with gr. x, an excellent palliative (P.); an enema of laudanum or morphine hypodermically to relieve the strangury caused by blisters (B.). Camphor, is said to relieve strangury (R.). Chimaphila, has undoubted power (P.). Squill often produces the best effects, especially a combination of the acetum with spt. etheris nitrosi, equal parts, of which jss in Jij anise water, every hour or oftener (Wa.). Gelsemium, a useful remedy (B.). Ergot, in paralytic dysuria, with sensation of bladder being imperfectly emptied (P.). Alkalies, the citrates, when dysuria from uric acid crystals in young male children (R.). Nitrous Ether. Spt. etheris nitrosi 3j-jss in any convenient vehicle, a popular and efficacious remedy (Wa.). Diluent Drinks, freely, especially a decoction of uva ursi, or of cotton-root (P.). [Compare Vesicai. Sedatives, page 424, also, Bladder, Irritable, page 533, and Cystitis, page 570.] Ecchymosis. Arnica, rapidly disperses, if administered shortly after injury, rrtv-x in water every two or three hours (P.). Alcohol, diluted more or less, accord- ing to the amount of irritation present, is a good lotion (P.). Hamamelis, the tincture diluted with 5 to 8 parts of water, as lotion when much discoloration. Ammonium Chloride, in solution, as lotion on lint, or with bread or linseed to form a poultice, in ecchymosis of the eyelids (Wa.). [Compare Bruises, Purpura.] Ecthyma. Quinine, cures, though in many subjects will cause it (B.); malnutrition (R.). Lead, the liquor plumbi subacet. gj ad Oj aquae, a soothing applica- tion (Wa.). Zinc Oxide, the glycerite, with a little camphor, an excellent application (Wa.). Cod-liver Oil, internally and locally (B.). Grape-cure, orten happily modifies (P.). Borax, a solution in rose or elder-flower water (Wa.). Chlorinated Lime, a solution as a lotion (Wilson). Chrysarobin, internally, half-grain doses, in water or pill, given with good results (Stoc- quart). ECTROPIUM AND ENTROPIUM—ECZEMA. 591 Ectropium and Entropium. Silver Nitrate, freely to the exposed surface, in ectropium of lower lid due to hypertrophy of conjunctiva after inflammation (C.). Collodion, suc- cessfully used in entropium to restore position of the lid by its contraction. Should be concentrated (Wa.). Faradization, in paralytic ectropium (C.). Operative Measures, of great variety, are in use, Arlt’s being the best for bad cases in the upper lid (Roosa). Epilation of lashes gives temporary relief in entropium. Eczema. Mercury, as black and yellow wash in early vesicular and pustular condi- tions. Mercurial ointments are the most efficient of the local applications, especially those of white precipitate, nitrate, mild chloride, and black oxide. Ointments of the biniodide or bichloride as irritating application in chronic indolent form (Pf.). Brown citrine ointment nightly in eczema of the mar- gin of the eyelids after detaching scales (B.); very useful when eczema on hairy parts of face, often is best mixed with a tar oint. (R.). Arsenic, Tn.v of Fowler’s solution thrice daily on a full stomach, gradually diminishing the dose for chronic type (B.); especially in eczema of vulva, anus and scrotum (R.). Small doses for acute, full doses for chronic form; the urine to be closely watched and the drug discontinued on the least sign of renal irrita- tion (Pf.). Arseniate of Sodium, hypodermically into an eczematous patch, to change the indolent form into an active one (Pf.). Rhus Tox., externally and internally, when burning and itching, quickly subdues in some cases (P.); in chronifc form with rheumatism, worse at night-time; also in acute cases if given at the very beginning, nijgj of a good tincture enough dose to begin with (Pf.). Phosphorus, of undoubted service in eczema of long standing, probably acts as a hepatic stimulant, gr. to in oil, or reliable pill (Pf.). Viola Tricolor, an infusion the best form, with purgative doses of senna for a few days, then alone, in eczema of the head and face; gives prompt results (good or bad), often aggravating, which, though good in chronic forms, must be avoided in acute types (Pf.). Calcium Sulphide, gr. in acute and chronic cases of pustular character, the impetigo of old writers; small doses in acute form, larger ones in chronic cases (Pf.). Sul- phur, internally and sulphides as baths, but not in the acute stage (R.); solu- tion of potassium sulphide in water locally (B.). Liquor Potassce, or a stronger solution of potash, to infiltrated patch of chronic eczema, before attempting to heal it (Pf.). Croton Tiglium, the seeds bruised in alcohol, as liniment (Wa.); the oil as basis of stimulating applications in the chronic form (Pf.). Glycerite of Tannin, locally (R.). Potassium Iodide, is often efficient where a syphilitic history or inheritance can be traced. Salicylic Acid, locally, in eczema of hands and feet has been very successful (B.). Bella- donna, gr. of extract with gr. iij of quinine sulphate thrice daily in eczema of the hand, with bismuth subcarbonate as a dusting powder (B.). Zinc Salts, the oxide and carbonate as dusting powders, or the sulphate, etc., in astrin- gent ointments (Bulkley). Buckwheat Flour, one of the best dressings, a limb may be enveloped in a bag filled with the flour (Bulkley). Tar, inter- nally, the pix liquida in doses of gr. ij-v thrice daily, when arsenic fails to relieve or is contraindicated; locally in third stage when redness, dryness and scaling. Oleum Cadini, when genuine, is the best form of tar, mixed with simple ointment ad £). Oh Rusci or Pix Liquida may be used (Pf.). 592 ECZEMA. Conium, the tincture may be added to one of the ointments for the pruritus, which is usually very obstinate. So also Stramonium or crude Petroleum (Pf.). Hamamelis, locally as antipruritic, and in chronic eczema marked by decided venous retardation (Pf.) Benzoin, to allay itching, the compound tincture painted on the skin (R.). Lead, soluble salts as lotions when much inflammation and discharge (R.); also in early vesicular and pustular con- ditions. Diachylon ointment comes next in efficiency to mercurial ointments (Pf.). Zinc, the oxide and carbonate as dusting powders (R.); the sulphate with alum, glycerin and rose-water, an excellent lotion (B.); the oxide is not curative, but as a protective is the best ointment when freshly and well made, for use over a large surface (Pf.). Lime-water, as sedative application and to check discharge: after inflammation is subdued, lime-water and glyc- erin (R.). Carbolic Acid, externally and internally in chronic forms (B.); is analogous to tar, and suitable to the same types of the affection as the latter is given for (Pf.). Phytolacca has cured obstinate cases (B.). Graphite, in ointment, 1 to 10, or with some inert powder, as lycopodium or precipi- tated phosphate of calcium, in fissured eczema, especially that of the hands and behind ears (Pf.). Bismuth, the subnitrate or subcarbonate locally (R ). Anacaraium Orientate (oil of Cashew), as ointment in patches of indolent chronic eczema (Pf.). Iris Versicolor, in chronic eczema of gouty patients invaluable as a hepatic stimulant, tt]_v-x of tincture from the fresh root twice daily (P.). Glycerin, locally at night when caustic lotions have been used (R.). Electricity has cured obstinate cases (B.). Milk-cure,'when acid indi- gestion present (B.). Water, locally is injurious, unless its sp. gr. approaches that of the blood serum. Rosewater with a little glycerin and sodium chloride when ablution necessary in second stage, that of exudation and crusting (Pf.). Soaps, petroleum, cade or carbolic (R.); sapo viridis, to soften up infiltrated patches of chronic form, instead of the potash solutions mentioned above (Pf.). Diet should be largely vegetable, especially those which are eaten raw. Cod-liver oil as a supplemental article of diet. Chaulmoogra Oil, in old cases is often of great benefit, as ointment. The oil 1 part to 2 or more of vaseline (Wa.). Oil of Cajuput, put up by mistake of druggist for oil of cade made a remarkable cure in a case which had resisted treatment for some time (Claiborne). Internal. R. Violae Tricolor, . . Ij. Sennae, .... M. Fiant chartulae no. iv. Sig.—Make an infusion with hot water from each paper, and take every night. (Piffard.) Prescriptions. Local. R. Ung. Zinci Oxidi, . . 5ss. Ung. Plumbi Subacet., . !|ss. Chloralis, Camphorae, aa gr. xv. M. Sig.—Use as oint. 2 or 3 times daily after bathing with warm water. For local use in general eczema. (Gross.) R. 01. Morrhuae, . . . Vitellum Ovi, . . no.j. Liq. Sodii Arseniat., . gj. Syrupi, . . . . zij. Aquae, .... jfiv. M. Sig.—Half-teasp. thrice daily for chronic eczema in children. {Doyon.) $. Olei Cadini, . . . Zinci Oxidi, . . . gss-j. Ung. Aquae Rosae, . gj. M. Sig.—Ointment, antipruritic and mildly astringent. {Bulkley.) ELEPHANTIASIS—EMACIATION. 593 Internal. R. Picis Liquidse, Pulv. Sem. Anisi, . aa gijss. Magnesise Calcin., q. s. M. Ft. pil. no. c. Sig.—Two to ten pills daily. (Miguet.) Local. R. Aluminis, . . . gr. xx. Zinci Sulphat., . . gr. x. Glycerini, . . , Aquae Rosae, . . M. Sig.—Lotion. (B.) R. Vini Ferri Amari, . . Syrupi Tolutani, . . Liq. Potass. Arsenit., . x). Aquae Anethi, . . M. Sig.—Teasp. to dessertsp. thrice daily. (Wilson.) R. Liq. Plumbi Subacet., . Sj. Glycerini, . . . ?ss. Aq. Laurocerasi, . . M. Sig.—Lotion, when there is much weeping. (B.) R. Ol. Cadini, . . . gss. Glycerini, . . • kj Ung. Diachylon, . . M. Ft. unguentum. In squamous eczema with thickened skin. {Fox.) R. Ferri et Ammon. Citrat., %). Potassii Citratis, . . Liq. Potassii Arsenit., . gj-ij. Tinct. Nucis Vom., . xij. Tinct. Cinchon. Comp., ad giv. M. Sig.—Teasp. in water, after meals, as tonic and alterative. {Bulkley.) R. Hydrarg. Ammoniat., . gr. xv. Glyceriti Amyli, . . gj. M. Ft. unguentum. (Muller.) Elephantiasis. Anacardium Orientale (Oil of Cashew), has been much lauded. Investi- gation established that much of its success was due to hygienic measures and use of fresh meat as food (P.). Arsenic, with 5 or 6 times the quantity of black pepper, in esteem in India (Wa.). Sarsaparilla, as tonic and alterative, valuable (P.). Gurjun (Wood Oil), as ointment and emulsion, has been used with success in alleviating the disease, by Dr. Dougall, Port Blair, Andaman Islands. The ulcers of 24 lepers healed thereby. Ferri Arsenias, gr. I daily, is used with success (Wa.). Mercury, the oint. of the red iodide, diluted 1 to 10, or gr. j of the salt to gv of unguentum, gives very good results (Wa.). Diet. Nutritious food, cleanliness, baths, will do much to prevent the mani- festations of the disease (R.). Chaulmoogra Oil, see page 133, is credited with a few cures and many cases improved. The oil is mixed with Psoralea corylifolia as a liniment, and also used internally (Wa.). Hodng-Nan, is con- sidered of utility by a number of writers on leprosy, and is given in combina- tion with Alum I, Realgar 2 or 1, and the drug 2 parts, the whole being made into 3-grain pills, one pill daily being given at first and gradually increased (Pf.). Argenti Nitras, is said to act as a tonic and alterative, and to control leprosy for a limited period (Pf.). Emaciation. Calcium Phosphate, is especially useful in chronic wasting disease (R.). Arsenic, is used by cattle-breeders to fatten oxen, etc., quickly (Tr.). Iodine, 594 EMPHYSEMA OF THE LUNGS. improves the appetite and digestion, and gives strength and plumpness to the body (Wa.). Cinchona, in small doses improves the appetite, and the general tone (Wa.). Iron Salts, cause marked gain in flesh and color (Wa.); re- markably promote the appetite and digestion (B.). Cod-liver Oil, internally and externally with friction, often very effective in the mal-nutrition and ma- rasmus of children (P.). Olive Oil, by friction, daily inunctions are of value in many wasting diseases (P.). Pepsin, to promote digestion of food (P.). [Compare Tabes Mesenterica.] Emissions and Erections. Belladonna, when emissions, genitalia relaxed, atonic state (B.): in gradu- ally increasing doses produces good results, even in extreme cases of emis- sions (Wa.). Camphor, fails as often as it succeeds(P.). Potassium Bromide, exercises special influence as a sedative in irritable states of the genito-urinary organs (Wa.). Cimicifuga, as tonic to the nervous system, removes irritation and melancholy, procures sound and refreshing sleep (Wa., P.). Lupulin, useful to check emissions (P.); gr. v-x, or xv, to keep penis at rest (Wa.). Ruta, in small doses to limit discharge (P.). Chloral, at bed-time, repeated every night until the habit is broken off (Wa.). Iron, the tincture of the chloride in g doses at bed-time, sometimes conquers nocturnal emissions (Wa.). [Compare Anaphrodisiacs, page 427, also Chordee, Spermator- RHCEA.] Emphysema of the Lungs. Morphine, gr. £, and Atropine, gr. T^ff, hypodermically for the asthmatic attacks : no remedy so efficient. The disease being incurable, treatment must be chiefly palliative (B.). Potassium Iodide, in full doses alone, or combined with the bromide, affords most relief next to morphine (B.). Strychnine, is a valuable respiratory stimulant; useful where there is constant dyspnoea with prolonged expiration (Wa.). Stramonium, the leaves smoked for the asthma and dyspnoea before retiring, will often give a good night’s rest (Wa.). Am- monium Iodide, with arsenic, for the bronchitis, with copaiba, turpentine or eucalyptol, continued for some time (B.). Digitalis, ox hydragogue cathartics as pulvis jalapae comp, for the dropsy (Da C.). Arsenic, when connected with recession of a rash is esp. useful (R.). Long-continued it ameliorates (B.). Lobelia, allays the dyspnoea which accompanies capillary bronchitis in em- physema (R.). Senega, often acts beneficially (P.). Cod-liver Oil, continued for a long time (R.). Hypophosphites, are useful (B.). Chalybeates, the phos- phate of iron, quinine and strychnine (B.). Grindelia, for asthmatic breathing and bronchitis (B.).; of great service (Wa.). Chloral, for the short breath in such patients brought on by catching cold. If obstructed circulation, cau- tion required (R.). Bleeding and Purging, have been used with great success in many emphysematous conditions (R.). Compressed Air, the only scientific remedy yet brought forward for this disease; affords much relief which is sometimes permanent (B.); the apparatus of Waldenberg is the best for this purpose. [Compare Asthma, Bronchitis, Dyspncea.] EMPYEMA—ENDOCARDITIS—ENDOMETRITIS. 595 Prescriptions. &. Potassii Iodidi, . . Strychninae Sulph., . . gr. j. Liq. Potassii Arsenit., . ,"ijss. Aquae Laurocerasi, . ad t^iv. M. Sig.—'Teasp. 4 times daily. For relief of dyspnoea, toning the car- diac action, removing the bronchial catarrh, and preventing the progress of the affection. {Hughes.) R. Potassii Chlorat., . . gjss Tinct. Belladon., . . gjss. Ext. Pruni Virgin. Fluidi, Tinct. Cinchonae Comp., aa j|ij. M. Sig.—A dessertsp. 4 times a day. Where chronic bronchitis and anorexia. Dry cups also to chest night and morning. {Da Costa.) Empyema, Carbolic Acid, a weak solution to be injected after evacuating the pus (R.). Carbolate of Iodine, has been injected with benefit (B.). Iodine, in solution to be injected after tapping (R.).; the undiluted tincture may be thrown in without risk and with great benefit; or the compound solution to aquae, as wash for the cavity to prevent reformation of pus (B.). Chlorine- Water, or solution of Quinine, to wash out the cavity (R.). Salicylic Acid, in solution, answers well for the same purpose (P.). Ammonium Acetate. The official mistura ferri et ammonii acetatis, with quinine and stimulants, if the affection shows a tendency to linger (Da Costa). Endocarditis. Aconite, should be given early in all inflammations of serous membranes (P., Wa.); gtt. Yi or less, frequently (R ). Spigelia Anthetmia, useful in rheu- matic endocarditis (P.). Bryonia, fully equals any remedy that exists to limit the effusion and promote its absorption (P.). Opium, in inflammations of serous membranes (B.). Digitalis, to control the circulation, especially where irregular heart action (Da C.). Veratrum Vinde, has been used with re- markable effect on the pulse (Wa.). Blistering, of all local remedies the most serviceable, when effusion has taken place (Wa.). Alkalies, as potassium or ammonium carbonate, freely until urine is alkaline, to prevent permanent changes about the valves or orifices (Da C.). Potassium Iodide, to promote absorption of the exuded lymph. Quinine, at the onset, may check the in- flammation (B.). Salicylic Acid, is useful in the rheumatic form (P.). Rest for some days after active signs have abated, with agents to lower the blood- pressure within the heart and vessels (Fothergill). Leeching, in the acute in- flammation is to be recommended if done early, later is useless. Use cups if no leeches are at hand (Da Costa). Poultices, give great relief and are of decided benefit (Da C.). Stimulants, as ammonium carbonate, etc., freely, if signs of oppressed circulation appear (Da C.). Iron, the tincture of the chloride with alkalies, if pyaemic symptoms are manifested (Da C.). [Compare Pericarditis.] Endometritis. Carbolic Acid, undiluted, on cotton-wrapped probe; no better method of treating uterine catarrh (B.). Iodine, the most valuable of all local remedies (E.); Churchill’s tincture (Iod. gr. 75, Pot. Iod. gr. 90, Alcohol one of the most useful applications to the endometrium (Mund6). Iodized Phenol (Iod. j, Ac. Carbol. iv), on cotton-wound probes, applied to the uterine cavity, 596 ENEMATA. has given the best results of any agent used for 8 years past (Battey). Chro- mic Acid, as caustic, when slough is required; should only be used after dila- tation of cervical canal, and at the patient’s house (Munde); a solution of gr. xv to 5jj of hot water applied with success to the uterine cavity for catarrh (Wooster). Nitric Acid, fuming, to uterine cavity through intra-uterine speculum (Atthill); is considered by many the one agent for all forms of intra- uterine medication. Is efficient and comparatively safe, but produces too much cicatricial tissue (Mundfe). Iodoform, as suppository in rectum (B.); in pencils to uterine canal. Iodo-tannin, locally in chronic cases (B.). Ergot, or better Ergotine, gr. j, subcutaneously, for the train of uterine disorders depending on passive congestion of the organ (P.). See Hysteria for formula. Gly- cerin, as a local application introduced by Sims, is of great value; esp. as vehicle for impure carbolic acid, iodine, on cotton, or oakum (E.). Hot Water injections in large quantity about the os uteri, are of great value (E.); as usually made are of no value, must be applied by special syringe, in the dorsal recumbent posture with elevated hips, at a temperature of ioo° to 120° F. twice daily for at least 20 minutes each time, and persevered in for months and years (Munde). [Compare Uterine Congestion and Hypertrophy.] Prescriptions. R. Potassii Iodidi, Potassii Bromidi, . aa gr. xx. Tinct. Iodi, . . . jss. Aquae, .... M. For hypodermic injection into cervix, in chronic cervical metritis. (Bennett.) R. Ergotini, . . . gr. xx. Tinct. Iodi, . . . zj Glycerini, . . ad £j. M. Sig.—Apply twice daily with camel’s-hair brush, in cervical me- tritis. (Dabney.) Enemata. Enemata, for an infant, j|ss-j ; child 2 to 5 years, ; 5 to 15 years, j|vj-Oj; adult, Oj-1 quart. A simple domestic enema consists of soapsuds with a little common salt, or a pint of cold water (B.). Simple warm water or gruel sometimes; or, to one or the other of these add soap, turpentine or castor oil, with soap or gruel to suspend the two latter. Very cold water may be used without inconvenience. Starch, boiled or raw, of cream consistence, temperature ioo°, with a few drops of tinct. opii, in extreme cases of choleraic diarrhoea,or that of phthisis, or typhoid feverfR.). Nutrient Enemata, should contain materials for artificial digestion, as the rectum is not an organ of diges- tion, and to secure rapid osmosis should have an acid reaction. A suitable formula is appended below. Inject slowly and not frequently, five times in twenty-four hours should be the maximum. Defibrinated blood has also been used as a rectal injection with good results, being completely absorbed (B.). Should not exceed three or four ounces of bland material, injected slowly, aiter ascertaining that the rectum is not filled with faeces (R.). [Compare Ene- mata, ante, page 494.] Prescriptions. Nutrient Enema. R. Infusi Carnis (Beef-tea), . j|iv. Acidi Hydrochlorici, . iqx. Glyceriti Pepsini (Scheffer), gij. If rectum irritable add io to 20 drops of Laudanum. Enema Ricini et Terebinth. R. Ol. Ricini, . . . 5jss. Ol. Terebinth., . . Ovum, .... no. j- Decocti Hordei, vel Aq. Fervid., . . • ,fxiv ENTERITIS—ENURESIS. 597 Enteritis. Opium., to the point of tolerance, is the remedy, the deodorized tincture in io-drop doses every second or third hour, according to age (Da Costa); of great value to control inflammation and quiet the intestines (B.); proves of signal use (Wa.). Aconite, of great utility in acute inflammation with high temperature, sthenic condition, resisting pulse (R., P.). Arsenic, surprisingly curative ; small doses, with opium (B.). Podophyllum, with occasional doses of aconite, will often allay the vomiting and diarrhcea (P.). Ricinus Communis, is employed with great advantage (P.). Turpentine, stupes, hot, over seat of disease, are of manifest advantage (Wa.). Skim-milk, is of the highest value as sole diet in acute inflammation of digestive organs (B.). Water, cold and hot, principally cold, or ice, of unquestionable advantage (B.) Poultices, linseed, large and hot (Wa.); may be used or not, as the patient feels benefit from them or otherwise (Da C.). Water, hot fomentations constantly, fol- lowed by a wet compress. Perfect quiet in bed. Ice or cold water freely swallowed. No food until inflammation subsides, then beef-tea, milk, gum- water, etc., the very mildest and most bland diet for four or five days (Da C.). [Compare Diarrhcea, Dysentery, Cholera, Peritonitis, Typhlitis.] Enuresis. Belladonna, no single remedy so uniformly successful. Children require large doses. A solution of atropine, best, gr. to (B.). The best remedy for children, gtt. x-xx of the tinct. three times a day. If unsuccess- ful, and no worms or other irritation exist try strychnine, cantharides, turpen- tine, santonin or galvanism (R.). Small doses are useless (P.). Santonin, in over doses produces incontinence of urine in children, but curiously will sometimes stay the habit, even when not dependent on worms, and in cases where belladonna fails (R.); in the enuresis from worms (P.). Cantharides, one or two drops of the tinct. three or four times a day in middle-aged women or the aged, even when due to paralysis; sometimes also in children, but for them belladonna is generally better (R.). Chloral Hydrate, enuresis in chil- dren (R.); three-grain doses thrice daily for infantile incontinence (Da C.). Strychnine, may succeed when above remedies fail (B.); sometimes useful for old people with paralysis of bladder, also for children (R. P.). Buchu, often successful in chronic enuresis (P.). Turpentine, small doses sometimes remove the trouble (B.). Lupulin, said to be useful; Herzfelder used it with advantage. Rhus Aromatica, has proven curative in 75 per cent, of cases treated with it, and of great benefit in the other 25 per cent. The fluid ex- tract, rtix-xv four times daily in glycerin and water (Stein). Scutellaria, re- markably efficient in many instances, 3 doses of the fluid extract thrice daily for a child of 12 years old. Potassium Nitrate, has been recommended for children (R.). Potassium Bromide, succeeds in some cases (Wa.). Collodion, painted to form a cap over end of prepuce (R.). Ergot, when from paralytic state of sphincter (B.); said to be useful (R.). Iron Iodide, the syrup tti.xv- xx, well diluted with water, ter die, in pale, delicate, strumous children (B.); sometimes useful even when no worms (R.). Habits. Children to be taught to retain water as long as possible during the day; little salt to be eaten ; ab- stinence from fluids not necessary; bland fluids diminish acridity of the urine. Stopping meat from the diet has cured several cases permanently, after all remedies had been tried without success. 598 EPIDIDYMITIS—EPILEPSY. Prescriptions. R. Strychninse Sulph., . gr. j. Pulv. Cantharidis, . . gr. ij. Morphinse Sulph., . . gr. jss. P'erri Reducti, . . gr. xx. Ft. pil. no. xl. Sig.—One thrice daily to a child of 10 years. (Gross.) R. Tinct. Ferri Chloridi, . gij. Ext. Ergotse Fluidi, . %v. Spt. Chloroformi, . . srij. Tinct. Quassise, . ad M. Sig.—A teasp. in a winegl. of water thrice daily, for children. Epididymitis. Aconite, alternately with Pulsatilla, the latter in very small doses, a few drops of tinct. in a glass of water, a teasp. every 2 or 3 hours produces the happiest effects (Pf„ St.). Belladonna, the extract, 5jj-ij ad of glycerin and water, on lint, applied to the inflamed testicle (Bumstead). Tobacco, with lin- seed meal, as poultice, cautiously P.). Mercury and Morphine, locally, a 20 per cent, oleate by inunction, in cases of syphilitic origin (R.). Silver Ni- trate, ad aq. destil. freely applied to the scrotum will sometimes abort an epididymitis (Wa.). Strapping and suspensory bandage to support the tes- ticle, and rest in the recumbent posture from the beginning, with a saline cathartic to clear the bowels, are all measures of great importance (Bum- stead). Compare Orchitis. Epilepsy. Amyl Nitrite, inhaled at the beginning of the aura will prevent an attack (B.); or -trpij-v in mucilage, when fits are very frequent (R.). Nitro-glycerin, -rrpT-lff, slower in action than amyl nitrite, but more enduring (Pf.). Ignatia, convulsions unattended with cerebral congestion (P.). Par excellence the controller of functional phenomena of the cerebro-spinal axis (Pf.). Bella- donna, in petit mal and nocturnal epilepsy, in pale anaemic subjects, should be given for a year or more (B., Tr.); extr. and leaves £ of each in pill, every day at same hour, one additional pill every month (Tr.). Useful, especially when from fright (P.). Atropine better, drop-doses of a 1 per cent, solution of the neutral sulphate in white brandy (Tr.). Arsenic, in epileptiform ver- tigo from stomach disorder (B.); sometimes useful (R.). Chlorofortn, by inhalation during paroxysm and also in interval (Wa,); is of high value es- pecially in cases of an hysterical character (Brown-S6quard). Chloral, the most suitable remedy for the nocturnal variety, in full doses at bed-time (B.). Cannabis Indica, has given good results; is suitable for petit mal, the noc- turnal variety, and with strychnine, belladonna, or picrotoxin, for cases char- acterized by anaemia and depression (B.). Quinine, when of malarial origin (P); often useful in intermittent epilepsy (Ros.). Silver Nitrate is not without efficacy, and was formerly much used, but the danger of staining the skin has caused its disuse, especially as better agents have been found (Wa.). Picrotoxin, anaemic subjects, attacks occurring at night, fa to fa of a grain hypoderm., or fa to by stomach (B.). Benefits cases resulting from onan- ism (P.). Copper Salts, may be useful in cases originating from stomach, formerly much used (B.); the nitrate or oxide often given with benefit (R.). Strychnine, idiopathic epilepsy, injurious in symptomatic. Benefits when bromide of potassium fails. Cerebral anaemia ; nocturnal epilepsy (S., Pf.); if bromides fail and case is anaemic, give Strychnine, gr. fa ter die, and push it (B.i. Sodium Bromide, gr. xx ter die, will arrest epilepsy without produc- ing the cerebral symptoms of bromism (Clymer). Potassium Bromide, gr. EPISTAXIS. 599 xl ter die before meals, double dose at bed-time, for two or more years after all epileptic indications have ceased. Is generally useful, especially in day- time seizures and grand mal of sexual origin; also for infantile convulsions (B.); especially in convulsive form, but often powerless (R.). Digitalis, rqx of the tincture, with gr. xx of potas. brom. thrice daily, in cases complicated with cardiac dilatation (Gowers). Lithium Bromide, gss daily, acts in some cases after pot. brom. has failed, and is generally efficient in about one-half the dose of the latter salt (S. Weir Mitchell). Nickel Bromide, gr. v thrice daily, is remarkably efficient in the epilepsy occurring at the menstrual epoch, and those which have withstood the action of the other bromides (Da Costa). Ferrum Bromide will often cure cases in weak and anaemic subjects; also with potassium bromide to combat the anaemia and depression produced by the latter (B.). Zinc Oxide, probably useful only in cases originating from the stomach. Much said for and against it (B., R.). Turpentine, has long been used, when due to reflex impression of intestinal parasites (B.). Conium, not equal to the bromides (B.); not of much value (P.). Valerian, has been used with some advantage (R.). Bryonia, has an ancient reputation (P.), Rue, may benefit when seminal emissions (P.). Ancesthetics, are rarely called for (W.). Fats and Oils, especially cod-liver oil when faulty assimilation exists (B.). Galvanism, only in idiopathic epilepsy (B.). Meat Diet, in many cases must be prohibited entirely (B.). [Compare Convulsions.] R. Potassii Bromidi, . . 5ss. Sodii Bromidi, . . Liq. Potas. Arsenitis, . gss. Ext. Conii FI., . . nil. Aquae Cinnamomi, . . Sij. Infus. Gentian. Co., ad 3viij. M. Sig.—Tablesp. two hours after each meal. Prescriptions. R. Potassii Bromidi, Sodii Bromidi, Ammonii Bromidi, . aa Potassii Iodidi, Ammonii Iodidi, . aa gjss. Ammonii Carbonat., . zj. Tinct. Calumbae, . . ±jss. Aquae, . . q. s. ad gviij. M. Sig.—A teasp. and a half before each meal, and three teasp. at bed- time. {Brown-Slquard.) R. Potassii Bromidi, , . j|j. Ferri Bromidi, . . gr. iv. Aquae, . . . . 5ij. Syrupi Simplicis, . . M. Sig.—Tablesp. twice daily. R. Potassii Bromidi, Ammonii Brom., . aa 3ij. Ext. Ergotse FI., . . Sj. Aq. Cinnamomi, . ad^viij. M. Sig.—Dessertsp. in water thrice daily. When maniacal excitement and danger of cerebral hemorrhage. {Smith.) R. Strychninse Sulphatis, . gr.j. Acidi Sulph. Dil., . . nix. Aquae Destill., . . . l|iv. M. Sig.—Teasp. after each meal, gradually increased to a dessertsp. Epistaxis. Aconite, has been used with the best results (P.); small frequent doses quickly check epistaxis in children and plethoric people (R.). Arnica, is of great service when from mechanical violence (P.). Belladonna, when of congestive origin (P.). Ipecacuanha, has been highly praised (R.); acts upon the vessels (B.); gr. j-ij every quarter hour until nausea is felt, but vomiting 600 ERUPTIONS—ERYSIPELAS. need not be excited (Wa,). Hamamelis, venous hemorrhage (Pf., R.). Er- got, of fresh powdered ergot, or sjj-gij of flu. ext. every half-hour or hour, necessary in urgent cases (B.). Alum, injected or snuffed up in powder (R.). Iron Spray, in obstinate cases liq. ferri subsulph. aqua; by spray or injection. The tinct. of the chloride also useful (B.); diluted £ij in Svj injected into the nostrils is often effectual (Wa.). Tannin, finely pow- dered, blown into the nostrils through a quill (Wa.); a strong solution, gij ad by nasal syringe (B.). Turpentine, may be given internally with advan- tage (Wa.); especially in debilitated conditions (B.). Lead Acetate, gr. ij-iv with opium gr. ss-j, proves signally useful (Wa.). Vinegar, on lint intro- duced into the nostrils, sometimes highly efficient (Wa.). Digitalis, is of un- doubted benefit (B.); the infusion best (R.). 7ransfusion, when death from exhaustion is apparently imminent (B.). Facial Artery, compression of (R.). Sundry. Keep head elevated and cool; warm the feet and hands by plung- ing into hot water; apply ice over the nose; resort at once to the tampon, if bleeding becomes alarming. [Compare Hemorrhage, for formula?.] Eruptions, The following-named drugs produce the eruptions indicated respectively after each, viz.—Aconite—vesicular exanthemata. Arsenic—erythema and papules, vesicles and pustules. Belladonna—as Quinine. Bromide of Potas- sium—papules, pustules, deep tubercles with ecchymoses, ulcers, pemphigus. Cinchona—as Quinine. Carbolic Acid—erythema. Chloral—erythema, itching, desquamation, eczema, purpura and petechia. Copaiba and Cubebs— pemphigus, erythema, eczema. Cod-liver Oil—acne. Digitalis—erythema after long using. Iodide of Potassium—papules, vesicles, pustules, eczema, ecthyma, ecchymoses and purpura. Mercury—erythema, eczema. Opium and Morphine—erythema, papular eruption with marked desquamation and itching. Phosphorus—purpura. Quinine—erythema scarlatina, papular ery- thema, hemorrhagic purpura, pemphigus and prurigo. Rhus Toxicodendron (and other varieties of Sumach)—vesicles, perhaps pustules, with redness, swelling, and intolerable itching. Salicylic Acid—purpura, pemphigus, vesi- cular angina. Santonin—pemphigus, vesicles. Stramonium—as Quinine. Strychnine—as Quinine. Turpentine—as Copaiba. Erysipelas. Pilocarpine, to abort the disease, very efficient if used early, gr. hypo- dermically, or fluid extract of Jaborandi internally: when free diaphoresis occurs, the temperature and pulse fall to normal, and the disease is checked. Not suitable to debilitated cases, or those having a weak heart (Da Costa). Aconite, a favorite remedy with Liston, if used at beginning, when fever high (Wa.); no more useful agent in idiopathic erysipelas, especially facial, and cases of sthenic type (B.); at onset, often cuts the attack short; is very useful in the erysipelas following vaccination (R.); very valuable in sthenic cases (P.); especially so in traumatic erysipelas (Tr.). Belladonna, Tqv of tincture in water every hour for five or six doses, also locally; has astonishing power in superficial and non-vesicular forms, also when erysipelas attacks the brain, and in the phlegmonous type(P.); for similar indications as noted under Aconite, also when adynamia; if much fever, combine it with digitalis or aconite; when much depression, give it with quinine; gr. of the extract with gr. ij of quininse sulph. every 3 or 4 hours (B.); the extract with glycerin, 601 ERYSIPELAS. equal parts, spread thickly over the surface (Quain); should be used both internally and externally, and may be combined with aconite (R.). Iron, Tincture of the Chloride, the nearest to a specific yet discovered ; the remedy of most service, any man being decidedly to blame who neglects its use ; requires decided doses, gtt. xl every 4 hours (Da Costa); treatment by it very general, but questionable (B.); should be given with shorter intervals than 4 hours (R.); is very successful in this disease (P.); ten-drop doses every hour, or rrtxl every 4 hours (Quain). Is also used locally with much success, being painted over the surface in full strength. Quinine, may be given with the iron; also alone if thoracic complications, wherein iron might be contra-indi- cated (Da Costa); if pulse soft and tremulous, or very rapid, low muttering delirium (D.); a combination of quinine and tincture of the chloride of iron offers special advantages (Wa.); in the more severe cases to sustain the vital powers, and prevent cerebral embolism; but large doses, gr. v-xx every 4 hours, are alone of any use (B.). Ammonium Carbonate, when feeble circulation, cyanosis and delirium ; also when any signs of embolism appear (B.); highly useful in debilitated subjects (Wa.); after free purgation the continued use of this salt is all that is needed in most cases (Sir T. Watson). Potassium Iodide, with agents to secure free action of the bowels, skin and kidneys, the only effi- cient treatment in erysipelas ambulans, in which iron and quinine are useless (Da C.). Antipyrin, is particularly efficient when hyperpyrexia (Ernst). Rhus Tox., a very useful remedy in the vesicular form (P.). Tartar Emetic, in doses °f gr. frequently repeated, renders incontestable service (B.). Calomel and Jalap, as purgative at onset, followed in 4 or 5 hours by magnesium sulphate, ,|ss (Da C.). Chloral, is an admirable adjunct to give sleep at night (Da C.). Turpentine, as a stimulant in traumatic erysipelas, more generally serviceable than alcohol (B.). Local Applications. Silver Nitrate, by Higginbotham’s method in trau- matic form; gr. lxxx of the brittle stick dissolved in Jjiv of water and painted 2 or 3 times over inflamed surface and beyond, after careful washing and dry- ing (R.); no agent more useful in subduing external inflammation. Iodine, painted over affected and neighboring surface, to prevent spreading (R.). Iodized Collodion, very successful as a local application, see formula below. Collodion, a thick coating relieves (B.). Digitalis, an infusion locally is of much service applied as a lotion (R.). Sulphurous Acid, and glycerin, equal parts, or a solution of Sodium Bisulphite (Dewar). Zinc, Benzoated, as ointment, or the unguentum zinci oxidi, anything to exclude the air, and whichever one is most agreeable to the patient (Da C.). Bismuth, the ointment of the oleate, a very certain application to allay itching and burning, lessen pain, etc. (Shoe- maker). Oil, by inunction, is very grateful in simple erysipelas (B.). Oil of Turpentine, painted over surface is said to be remarkably efficient. Vaseline, lard, or mercurial ointment, diluted, ’£) to of vaseline; the simplest applica- tions are the best (B.). Carbolic Acid, one part, with 8 to 14 parts of oleic acid, locally by inunction for 3 to 4 minutes every hour, all around the edge of the diseased part until it ceases to spread (Jacobi). Cotton Wool, sprinkled with flour or a mixture of starch and zinc oxide, is a good application (B.). Earth, clean yellow clay, free from grit or sand, and powdered, applied directly to the skin in the form of a smooth paste, made by mixing it with water, the best of all applications, having properties of antiseptic, antiphlo- gistic, antipyretic and antimorbific nature (Hewson). Tracheotomy, promptly if oedema of glottis occurs, the operation giving time for inflammation to subside (Da C.). Incisions may be necessary in traumatic erysipelas, when limb is greatly swollen and inflamed ; also in the 602 ERYTHEMA. phlegmonous variety (Da C.). Diet, a milk-diet is generally suitable; should be light but nutritious (R.); feed the patient well (Da Costa). [Compare Phlegmon.] R. Quininae Sulphatis, . sjss. Ext. Belladonnae, . . gr. ijss. Ft. pil. no. xx. Sig.—Two pills every 4 hours, where much depres- sion. (B.) Prescriptions. For Local Use. R. /Etheris, Alcoholis, . . aa Pyroxylini, . . . gj. Solve, et adde— Ammonii Iod., . . gr. xl. Cadmii Iod., Cadmii Brom., . aa gr. xx. M. Sig.—For local use with a camel’s hair pencil. If the cadmium salts are not to be had use gj Amm. Iod., and gr. xx Pot. or Amm. Bro- mide. (Humphreys.) R. Quininae Sulphatis, . gj. Ac. Sulphurici Dil., q. s. Aquae, . . . . 5ij. Tincturae Ferri Chlor., . 3SS. Spt. Chloroformi, . . Zvj. Glycerini, . q. s. ad gw. M. Sig.—A teasp. in water every two hours. {Loomis.) R. Plumbi Acetatis, Ammonii Garb., . aa g). Aquae Rosae, . . . 3viij. Ft. lotio. Sig.—Apply on lint, to allay irritation. {Peart.) R. Tinct. Ferri Chloridi, . ?j. Syrupi Tolutani, . . 3j. Liq. Potassii Citratis, . 3iv. M. Sig.—Teasp. to tablesp. accord- ing to age every 3 hours, gj = trx, gi) — Tri.xx, 3ss = fflxl. {Anderson.) R. Acid. Carbol., Alcoholis, . . aa £ij. Ol. Terebinth., . . £iv. Tinct. Iodi, . . . gij. Glycerini, . . . gx. M. Sig.—Brush over surface every 2 hours, and cover with a thin layer of wadding. R. Tinct. Ferri Chlor., . gij-iij. Glycerini, Aquae, . aa gj. M. Sig.—Teasp. every 2 hours for children. (Gibney.) Erythema. Belladonna, useful in cases resisting ordinary treatment (B.). Quinine, the most valued remedy in erythema nodosum (B.). Rhus Toxicodendron, a val- uable remedy (P.). Zinc Sulphate, as lotion, with alum and glycerin. See Eczema, for formula; or the Acetate in ointment, see below. Bismuth, dusted over erythema about genitals of infants soothes pain and promotes healing (B.). Mineral Acids, nitric and nitro-hydrochloric, have been advantageously used when from imperfect digestion (B.). Dusting Powders, of starch, lycopodium or buckwheat flour are very useful. Prescriptions. R. Plumbi Carbonatis, Bismuthi Subnit., . aa g). Sodii Bicarbonat., . . Zss. Ung. Zinci Oxidi Benz., . Ft. unguentum. Sig.—Local use. R. Zinci Acetatis, . . gr. ij. Aquae Rosae, . . . gj. Ung. Aquae Rosae, . • oj- M. Sig.—Ointment. EXHAUSTION EYE-DISEASES. 603 Exhaustion. Arnica, a few drops internally for aching of the muscles (R.); in nerve prostration with general aching from over-fatigue (P.). Phosphorus, for physical or mental exhaustion ; also in depression from over-work (R.). Cal- cium Phosphate, combined with Calcium Carbonate and Phosphate of Iron, gr. j of each for a dose (R.). Potassium Bromide, when insomnia, bad dreams and irritability (R.b Opium, gtt. j of laudanum with 2 or 3 of the tinctura nucis vomicae, 3 or 4 times a day, for symptoms of exhaustion with headaches, flushing and dyspepsia (R.). Ammonia, internally ; its influence is but brief (R.). Coffee or Tea, in hot or cold climates (R.). Castor, is serviceable, but seldom used (P.). Musk, benefits all forms of nerve-exhaustion (P.). Cimi- cifuga, for headache from over-study or excessive fatigue (R.). Alcohol, of value in all conditions of fatigue (P.). Coca, lessens the sense of fatigue under exertion, relieves thirst, and obviates the effects of a too rarefied atmosphere; is suitable for weakly subjects easily fatigued, and to convalescents (P.). Co- caine, has been used successfully in exhaustion from sunstroke, loss of blood, and diarrhoea (P;). Wet Sheet, dripping, cold, as a restorative, and to prevent aching of muscles (R.). Sea Bathing, is also valuable (R.). Habits, change of occupation better than absolute rest. [Compare Adynamia, Conval- escence, Insomnia, Myalgia.] Exophthalmos. Belladonna, mv of tincture hourly, of great service (R.); results recorded from its use are very remarkable, but Digitalis will usually answer better (P.). Duboi- sine, gr. y1Tof the sulphate 2 or 3 times daily, has produced remarkable results in one case (Hunt). Opium, may be of use in some cases (P.). Digitalis, to raise the arterial tension and slow the heart, decidedly ameliorative in young subjects (B.). To tranquillize the heart is the main indication. Iron, with Digitalis, seems to do more good than any other medicines (Da Costa). Chaly- beate Waters, are beneficial (B.). Convallaria, ameliorates the painful palpi- tation (Wa.). Galvanism, of the cervical sympathetic and pneumogastric, and eyes and thyroid gland, is decidedly curative in uncomplicated cases (B.). Exostosis. Potassium Iodide, may promote absorption when recent; also friction with ointment of Mercury or Iodine (D.). Aconite, was used by Storck (P.). Mer- cury, a moderate course of mercurials may be effectual, when exostoses due to a blow or from syphilis (D.). Exostoses of clavicles in children almost always disappear themselves (D.). Excision if required (MacCormac). Eye-Diseases. Belladonna, locally and internally in iritis, conjunctivitis and other inflam- mations. Atropine, in iritis, locally; hypodermically, in glaucoma (R.); the best application in inflammatory conditions generally. Euphrasia, had an extended reputation in Germany, is a mild astringent, and of service in catar- rhal conjunctivitis (P.). Pulsatilla, as lotion in inflammations and ophthalmic cases (P.). Santonin, gives good results in inflammatory and atrophic condi- tions of the retina and optic nerve, and in the stage of effusion of many other 604 EYELIDS—FACE. inflammations (Wa.). Ruta, minim doses, night and morning, in dimness of vision depending on functional amaurotic condition, produces good results (P.). Physostigma, topically, to contract pupils; to reduce excessive atro- pinization. Stimulates the third nerve (P.). Strychnine, hypodermically in muscular asthenopia, amblyopia, amaurosis, and in progressive nerve-atrophy not dependent on intercranial diseases (R.). Increases the sensibilty of the eye, the field of vision becoming extended, and the vision more acute (Br.). Ergot, useful in many eye affections, especially disturbances of accommoda- tion, acute and chronic inflammations, and the blepharitis and pustular con- junctivitis of children (Wa.). Is myotic. Pilocarpus, is used with great benefit in many eye-affections, particularly amblyopia from alcohol and tobacco, detachment of the retina, chronic iritis, keratitis, hemorrhage into the vitreous, glaucoma, muscae, atrophic choroiditis, hemorrhages of the retina, white atrophy of the optic nerves, and inflammatory affections with effusion and exudation to promote resolution and absorption (Wecker). Cocaine, as a local anaesthetic in ophthalmic surgery, a 4 per cent, solution, by instillation, some- times injection required, as into the muscles for squint operation. Is mydri- atic, and in rare cases panophthalmitis has resulted after operations under cocaine (R.). Chloroform, vapor, close to a photophobic eye, relieves (R.). Oleate of Mercury and Rlorphine, outside the eye in palpebral conjunctivitis, and stye ; also in syphilitic iritis (R.). Silver Nitrate, Copper and Zinc Salts, are much used (B.). [See Conjunctivitis, etc. Compare Mydriatics, Myotics, etc., page 406; also in this section the titles Amaurosis, Asthen- opia, Cataract, Conjunctivitis, Corneal Opacities, Glaucoma, Iritis, Keratitis, Myopia, Ophthalmia, Photophobia, Retina, Strabismus, etc.] Eyelids. Calomel, locally, or brown citrine ointment, as application in many diseases (B.). Mercury and Morphine, the 20 per cent, ointment with lard, outside lid, for stye (R.). Pulsatilla, internally, and externally as wash, in ophthalmic cases and inflammations; the so-called “stye” may often be aborted by this treatment (P.). Cadmium, much esteemed as collyrium, gr. ij of sulphate to aquae rosae (R.). Zinc and Copper Sulphates, are esteemed applications (B.). [See Conjunctivitis for formulae.] Ergot, an aqueous infusion, as a collyrium, in ptosis and paralysis of the eyelids (Wa.). Tannin, a strong solution (1 to 3 aquae), locally; or a weaker solution (1 to 20, 30 or 50 aquae), is much employed. Also used in pomade, or as fine powder (Wa.). Vera- trine, in solution, brushed over lids once daily in painful spasmodic contraction of the orbicularis (Wa.). Ammonium Chloride, in solution as lotion, for ecchymosis of eyelids, vulgarly known as “ black eye.” [See Ecchymosis, Blepharitis, Conjunctivitis, Ptosis, Ectropium, etc.] Face. Amyl Nitrite, TTtyj to }4, in 30 times its volume of spirits, for flushing of face, or sensation of flushing, with cold feet and hands, and great prostration, chiefly in women at change of life (R.). Curare, effective in facial spasm, when other remedies failed (P.). Blisters, behind the ear, in facial palsy, followed by warm covering to part (H.). Strychnine, has improved some cases of facial palsy (P.). [Compare Neuralgia, Odontalgia, Tic-Doulou- reux.] FALSE PAINS—FEET—FEVER. 605 False Pains. Tartar Emetic, combined with small doses of opium, together with external fomentations, where evidence of congestion (L.). Opiates, to allay uterine irritation, after rectifying any derangement of bowels (L.). Opium, is valuable, having specific action on uterine muscular fibres, relaxing some, stimulating others (Wa.). Feet. Arsenic, swelled feet of old or weak persons ( R.); oedema of feet and ankles in the old, from feebleness of the heart (B.). Lead, as ointment of equal parts of emplastrum plumbi and linseed oil spread on linen, and wrapped round the feet when they sweat—to be renewed every third day for nine days (R.). Potassium Permanganate, gr. as wash, will remove fetor of feet (B.); temporarily discolors the skin. Boracic Acid, in strong solution, is used with good results. Chloral, I in 50 of water, as bath, effi- cient. Sodium Bicarbonate, a solution freely applied will remove fetor (B:). Belladonna, will check fetid secretions (R.). Salicylic Acid, in solution with borax, the most agreeable and efficient deodorant for fetid perspirations (B.). gjss-iij with of dried alum, in powder, applied freely to foot after washing and drying. Acid, salicylic. 3, magnesium silicate 87, is the composition of the powder used in the German army for sweating of the feet. Ice, to the spine, or heat and cold alternately, to equalize the circulation, has been strongly advocated (Wa.). Stockings, should be changed every day, and if dipped in a strong solution of boracic acid and dried will effectually check fetid perspirations. Cold Foot-Bath, and drying with friction, for cold feet (Ri). R. Ac. Salicylici, . . gr. xv. Amyli, . » . . gr. cl. Talci, .... M. et trit. Sig.—Locally for sweat- ing feet. (Kohnhorn.) Prescriptions. R. Ac. Borici (pulv.), . . Vaselini, . . . . M. Sig.—Ointment for bromidrosis. (Championniere.) Fever. [See also the titles of the various fevers, in their respective alphabetical order.] Aconite, has the highest value in the eruptive fevers, also in all hyperpy- rexise (B.). Always indicated in early stage of simple inflammatory fevers, pneumonia, and in most acute congestions (P.). Has marvellous power over sthenic fevers. Thermometer should go hand in hand with Aconite (R.). Veratrum Viride, possesses considerable power as an antipyretic; useful in rheumatism, pneumonia (P.); in delirium ferox of fevers it is of value (B.). Strongly recommended in both sthenic and asthenic fevers (R.). Belladonna, in the eruptive fevers, especially scarlatina (B.). In typhus, with delirium, insomnia, painful sensitiveness to light and sound. In all hypersemic states of brain and spinal cord (P.). Is prophylactic often against scarlet fever (P., Pf.). In delirium; also excellent in typhus (R.). Gelsemium, in remittent and typho-malarial, of real benefit. Is antipyretic (B.). In bilious remittent, of value (Pf.). Arsenic, in prostrating acute fevers to strengthen pulse and invigorate patient. Except quinine, no drug subdues intermittents so well (R.). In malarial, especially typho-malarial, it is of grext value (B.). Ctn- 606 FEVER. chona. Quinine in the eruptive, and all malarial, remittent, and intermittent; as apyretic, less effective and more dangerous than cold baths. Useless in typhus and typhoid, except for hyperpyrexia (B.). Is anti-miasmatic, antiseptic, and antiphlogistic; of great value in intermittent, septicsemic, and hectic fevers (P.). Large doses at night to reduce temperature in typhoid and other fevers strongly urged in Germany. Cinchonine best as prophylactic against ague (R.). Antipyrine, the type and the best of the new series of synthetical anti- pyretics, which includes kairine, chinoline, thallin, etc. (see pp. 72, 135, 151); is antipyretic and diaphoretic, moderates the intensity of the febrile movement, and is especially indicated in self-limited diseases with persistent hyperpyrexia, especially pneumonia, typhoid, etc. Kairine, is an efficient antipyretic, but profusely .diaphoretic, also a cardiac and nerve depressant of great power, and highly dangerous in pneumonia, and other fevers where the heart is weak. It often produces nausea and vomiting with headache and tinnitus aurium (P.). Resorcin, has been given in acute rheumatism, typhoid, typhus, pneumonia, erysipelas, etc.,as an antipyretic; like Kairine, however, its action in lowering temperature is transient as compared with quinine or salicylic acid (P.); may be used hypodermically as it is not irritant (B.). Sali- cylic Acid, or salicylate of sodium, nearly equal to quinine as antipyretic. Very useful in all forms with high temperature and in intermittents. Especially in septicaemia, pyaemia, erysipelas, and surgical fevers (B., R.). Digitalis, the German antipyretic. Very useful in scarlet fever, rheumatic, and pneumonia (B.); especially in typhoid (R.). Cimicifuga, as substitute for digitalis, but less effective; good in hectic (B.). Hydrastine, intermittents, typhoid with copious sweats (P.). Arnica, is antipyretic, full doses in sthenic cases, small (rn.v of tincture) in asthenic. Large and small doses produce different results (B.). In rheumatic and typhoid is highly extolled (P.). Camphor, subdues reflex excitability; praised as stimulant in adynamic fevers (P.). In adynamic fevers and where there is delirium (R.). Mercury, large doses of calomel, the German “ specific” treatment of typhoid (B.). Small doses in typhoid at com- mencement; has marked effect on tonsils in scarlatina (R.). Rhus Tox., in rheumatic fever after aconite, and in scarlatina with typhoid symptoms, is invaluable (P.). Opium, much less used than formerly. Useful in delirium, and with quinine in remittents and intermittents (B.). For fevers characterized by prostration, insomnia and delirium, noisy or muttering, with picking of bed-clothes and twitching of the muscles; in such cases opium, judiciously given, may save an almost hopeless case (R ). Morphine, hypodermically, the best form in febrile diseases, being less disturbing to the stomach and digestive power (P.). Turpentine, in typhoid, puerperal, and yellow, as a stimulant to vaso-motor nervous system (njx-gss) (B.); as enema (ttl30-6o in starch mucilage with rtyx of liq opii if pain) invaluable when in typhoid hemorrhage occurs with tympanitis (P., R.). Tartar Emetic, minute doses (gr. T*ff) frequently repeated, and with opium, are of great value in many acute febrile diseases (B.); as a diaphoretic; in ague; in large doses to abort spe- cific fevers (R.). Muriatic Acid, very useful in all forms, especially in typhoid and the exanthemata; relieving dryness of the mouth and fauces, increases digestion, and restrains the diarrhoea (B.). Acid Drinks, such as raspberry vinegar, citric acid, etc., very grateful and useful (R., B.); two sliced limes or lemons, with l|ij of sugar, in Oj of boiling water, cooled and strained, make an agreeable refrigerant beverage (Wa.). Baptisia, useful in common con- tinued fever, or in the first stage of typhoid; drop doses of a fresh tincture every hour. Eucalyptus, has given varied results in malarial fevers, some observers praising it very highly (P.). Valerian, has done much good in fevers 607 FEVER, SIMPLE—FISTULA. of a nervous character (P.). Sumbul, is used in Russia for low fevers of a typhoid type (P.). Cocculus, for tympanitis of typhoid (P.). Ammonium Acetate, as a diaphoretic, and in simple forms, as catarrhal; the Carbonate in scarlet fever and measles (R.). Purgation, by castor oil, sulphate of mag- nesium, etc., before exhaustion (R.). Mustard Bath, on recession of rash in eruptive fevers (R.). Aliment, milk and beef-tea alternately, every 3 hours. Milk only, in fevers and inflammations of the digestive tract (B.). Alcohol, in low conditions is useful when causes improvement in symptoms, which may become worse (B., R.). Coffee better than alcohol (P ). Water, is a valuable adjunct to remedies in the treatment of fevers. Warm baths, the wet pack, hot and cold compresses, fomentations, moist inhalations, etc., have great value [see various fever titles] : a most important agent. Cold baths or cold wet pack to reduce temperature (B.); cold affusion, baths, packing, ice, and ice-bag; hot affusion and sponging, all of great value in every form (R.). Fever, Simple. Aconite, in small repeated doses, the best remedy for febricula, etc. f B.); in ordinary febrile conditions, if given early, will abate fever and induce free perspiration; may be administered in conjunction with any other remedy in- dicated (R.). Veratrum Viride, in small doses, as antipyretic (P., R.). Hy- oscyamtis or Belladonna, very useful in febricula, especially for head-symp- toms and constipation (P.). Gelsemium, with remittent or bilious symptoms (P., B.). Arsenic, if typho-malarial symptoms (B.). Antipyrine, in hourly doses of gr. iv or less, in the simple continued fever of children, as antipyretic. Even infants bear it well (Penzoldtb Hydrochloric Acid, in the continued fever of childhood, has a beneficial influence (West). Valerian, when ner- vous excitability (P.). Lemon-juice, as “ lemonade,” or with bicarbonate of potass., as mild diaphoretic and diuretic (P.). Pomegranate juice is very grateful if mixed with sugar or honey (P.). Bromides, gr. ss-j every quarter- hour are excellent for the febrile disturbances of children (A. A. Smith). Baths, warm, in simple fevers of children (R.). Aliment, milk and beef-tea alternately every three hours, the most useful (B.). Prescriptions. R. Ac. Hydrochlor. Dil., . Spt. /Etheris Co., . . gjss. Syr. Rosae, . . . tss. Aquae Camph., . adppv. M. Sig.—Teasp. to tablesp., ac- cording to age, every 6 hours. (Modified from West.) R. Potassii Acetatis, . • 3'j- Spt. AStheris Nitrosi, . tpv. Syr. Simplicis, . . Sj. Liq. Ammonii Acetatis, . 5ij. Aquae Camphorae, . ad ifviij. M. Sig.—Teasp. to tablesp. doses, according to age. Diaphoretic and anti-febrile. Fistula. Piper Nigrum, the confection, as a gentle stimulant in anal fistula (P.). Iodine, by injection, sometimes curative, but generally fails (Wa.). San- guinaria, as injection, has cured (P.). Capsicum, the weak infusion, a use- ful stimulant in fistulous ulcerations (P.). Surgical. Division of sphincter in anal fistula, by knife or ligature, the best treatment (D.). In fistula lach- rymalis, dilatation of passage by probing the canaliculus, or slitting the can- 608 FLATULENCE—FLUSHING-HEATS—FOREIGN BODIES. aliculus up (D.). In vesico-vaginal, or recto-vaginal, surgical methods best. Diet should be nourishing and digestible; fresh air and general good hygienic conditions are necessary (R.). Flatulence. Nux Vomica will remove flatulence and intestinal indigestion (B.); when constipation, heart-burn, weight on head (R.). Charcoal, gr. v or x, soon after or just before meals (R.); mixed with bismuth (R.). Chloroform, pure, in drop doses, benefits (R.). Carbolic Acid, when no acidity present (R.). Turpentine, gtt. iij-v on sugar, will quickly relieve (B.). Asafoetida or Va- lerian, quickly relieves the flatulence of hypochondriasis (B., P.). Asaf. gj of tinct. to 0)4 water, give 5jj; useful for children (R.). Sodium Sulpho- carbolate, gr. xxx after eating, will be found very serviceable (R.). Phos- phoric Acid, dilute, is often promptly alleviative. Anise, the oil, also Ether, or any other member of the Carminative group (see page 416 ), will promote the expulsion of gas from the stomach and intestines. Mercury, when with clayey stools (R.). Calumba, an effective remedy for flatulent disposition is an infusion of j|ss each of calumba and ginger, gj of senna, hot water Oj, a wineglassful ter die (B., P.). Potassium Permang., in flatulence attendant on obesity (B.). Physostigma, flatulence of women at climacteric (B.). Sul- phurous Acid, in 5 to 10 minim doses, when due to fermentation (R.). Diet. Abstain from sugar, starchy food and tea; eat little, slowly and regularly; as a general rule abstain from alcoholic drinks and vegetables, especially cab- bage. Pepsin [or Ingluvin\ after meals, to promote digestion (R.). [Com- pare Colic, Dyspepsia.] R. Tinct. Nucis Vomicse, Tinct. Physostigmatis, Tinct. Belladonnse, . aa xj. M. Sig.—Fifteen drops twice daily, in a little water. (B.) Prescriptions. R. Gummi Camphorse, Pulv. Zingiberis, Pulv. Capsici, . . aa gr. j. Ft. pil. no. vj. Sig.—One pill as required for gastric and intestinal flatulence. Flushing-heats. Nux Vomica, TrUj of the tinct. with minim doses of laudanum in hysterical flushings of the middle-aged, with flatulence, weight on head and perspira- tions (R.). Nitrite of Amyl, to £ in thirty times its volume of rectified spirits. Effective for flushing of face, or sensation of flushing, followed by coldness, with cold feet and hands and great prostration, occurring at climac- teric chiefly (R.). Potassium Bromide, at climacteric, with mental depression (R.). Zinc Valerianate, or Valerian, flushings at the climacteric (R.). Eu- calyptol, for the flushings, palpitations and flatulence incident to the change of life (R.). Foreign Bodies. In the Eye,—Remove by bathing, or wiping towards the lower inner corner with a soft, moistened handkerchief, or a bent bristle, the two ends being held in the fingers. Use tepid solution of vinegar (gss-5j) for removing lime, tepid water for powder. Then apply a weak zinc or alum collyrium, or instil 609 FRACTURES AND DISLOCATIONS—FRECKLES. a solution of Atropine, gr ij to the 5, or Cocaine, 4 per cent. In the Ear,— Examine carefully with speculum before removal; first syringe with warm water, or a drop of sweet oil to drive out insects, before using forceps; apply equal parts of laudanum and olive oil, a few drops on cotton, if much pain. In the Nose,—A current of tepid salt water, forced up one nostril, may force down the body through the other, if the mouth be held open. In the Larynx or Pharynx,—if water can be swallowed, the obstruction is in the trachea. Never push a body down. Remove by curved forceps or blunt hook. It passed into the stomach use solid diet to imbed the article. If all fail and the case be urgent, resort to catheterism or tracheotomy. In the Flesh,—re- move at once by forceps, or sponge and water. Fractures and Dislocations. Arnica, is excellent to neutralize the ill effects of mechanical injuries, tqv-x in a wineglassful of water every 2 or 3 hours. When used after amputations, it certainly has the power of promoting the rapid union of the surfaces. The infusion is better than an alcoholic preparation for external use (P.). Aconite, quickly and repeatedly if feverish symptoms ensue (P.). Iodine, int. and frictions, occasionally useful in ununited fractures (Wa.). Calcium Phosphate, promotes formation of callus (Wa.). Opium, useless in surgical fever, and may do harm (Cl.) ; for nervousness or muscular spasms after dressing, gr. of morphine hypodermically as anodyne (Ag.). Benzoin, the tincture on lint, as a dressing for compound fractures and other severe injuries, leads to rapid and satisfactory healing (Bryant). Carbolic Acid, 1 to 20 or 1 to 40 solutions, for irrigation and dressings in compound fractures, obviates pyaemia and most of the other preventible causes of death (P.). Leadwater and Laudanum, on lint, or a Calendula lotion to the part, after reduction of the injury, with mor- phine hypodermically and perfect quiescence. Diet, should be very simple for a week or ten days. [Compare Wounds.] Freckles. Iodine, the tincture or glycerite, locally (B.). Liquor Potasses, ttj to 3ij Aquae Rosae, as a lotion (Todd). Benzoin, the compound tincture with water, as cosmetic to remove freckles (P.). Sodium Borate, a saturated solution of borax is a safe and often efficient lotion to remove freckles (B.). Lime-water and olive oil, equal parts, with a little liq. ammoniae, as liniment (Wa.). Po- tassium Carbonate, makes a good lotion for freckles, sunburn and tan (B.). Mercury, the bichloride, with alcohol and glycerin, as a lotion, has been found effective. Donovan’s solution, ni>xx to of Water, and |j every three hours, has been found highly successful (Wa.). Prescriptions. R. Potassii Carbonatis, . 3iij. Sodii Chloridi, . . gij. Aquae Aurantii Flor., . 3jij. Aquae Rosae, . . . 3viij. M. Sig.—Face-wash. (B.) R. Hydrarg. Chlor. Corr., . gr. vj. Ac. Hydrochlor. Dil., . gj. Alcoholis, Aq. Rosae, aa Glycerini, %j, Aquae, ad %viij. M. Sig.—Apply at night,and wash off in the morning. 610 GANGRENE GASTRALGIA AND GASTRODYNIA. Gangrene. Salicylic Acid, pure, in powder locally, to destroy fetor and change the character of the morbid action (B.). Carbolic Acid, acts in the same way (B.); a I per cent, solution as lotion in gangrenous ulcers (Wa.). Sodium Sulphite, in solution, i to 5 or 10 of water, as lotion or applied on compresses, to destroy odor, soothe pain and establish healthy action (Wa.). Ammonium Chloride, in solution as bath and fomentations, very successful in one case of senile gangrene (Wa.). Cinchona, or better, quinine, or the hydrochlorate, often proved of value (P.); generally decoction of cinchona best(Wa.). Tur- pentine, locally, after removal of gangrenous part, a most efficient application (B.); by stomach and inhalation from hot water in gangrene of lungs; the oil locally in dry and chronic gangrene (P.). Sanguinaria, has been recom- mended (P.). Oxygen, as gaseous bath in senile gangrene (R.). Charcoal, as poultice, value doubtful (R.). Citric Acid, lemon-juice dropped into wound, which is then covered with lint steeped in a solution of chlorine. Very effec- tive for hospital gangrene, in Parisian hospitals [Lancet, October, 1879]. Per~ chloride of Iron, locally, is considered superior to the mineral acids (Wa.). Ni- tric Acid, strong, applied carefully until the ulcer is converted into a firm, dry mass (Wa.); is probably the best escharotic, next to bromine, for gan- grenous destruction (B.). Bro/nine, is the best escharotic for hospital gan- grene (B.). Chromic Acid, is a very efficient caustic, penetrating deeply with but little pain (B.). Opium, to soothe the pain, and diminish restlessness and irritability (Wa.). Gastralgia and Gastrodynia. Opium, in some form necessary to relieve the pain in severe cases (Da Costa). Morphine, is of great value (P.); subcutaneously in epigastrium very efficient, or in small doses with bismuth and milk before meals (R.). Bella- donna, is useful in painful affections of the stomach (R.). Atropine, often relieves promptly, and is excellent in neuralgic pain of the abdominal vis- cera (P.). Nux Vomica, an excellent stomachic, gt. v-x of tincture before meals (B.); gtt. j-ij every 2 hours in many forms of gastric derangement (R.). Strychnine, hypodermically for gastralgia and gastrodynia (R.); in very small doses, gr. two or three times daily, a very successful remedy (P.). Arsenic, sometimes dissipates the pain surprisingly (B.); a drop of liquor arsenicalis before food in irritative dyspepsia and gastralgia with heart- burn (R.). Bismuth, when gastralgia due to irritation of mucous membrane, acts well alone, but is most efficient when given with aromatic powder and a little morphine (R.); or a combination of bismuth and arsenic in more chronic cases (B.); subcarbonate is especially adapted to gastralgia with la- borious digestion and putrid or acid eructations (Wa.). Manganese, the black oxide in gastrodynia and pyrosis (R.). Zinc Oxide, an excellent remedy when gastralgia after food, gr. v-x with aromatic powder and morphine, before meals (B.). Silver AStrate, in solution to check the pain of many stomachal disorders (R.); a pill of gr. ss, with extr. hyoscyami gr. ij-iv(Wa.). Hydro- cyanic Acid, often cures rapidly when gastralgia from nervous derangement (B.); may check vomiting as well as relieve pain (R.); cherry-laurel water a useful form (P.). Nitro-hydrochloric Acid, gtt. ij-iij of the dilute acid, is ser- viceable (Da Costa). Hither, a few drops of sulphuric ether or the com- pound spirit Tqx-xx, often relieves quickly (B.). Chloroform, Ttlij-v on sugar, often relieves (B.). Chloral, sometimes relieves pain in gastralgia (R.). Pul- GASTRIC DILATATION. 611 satilla, is efficient in many cases of painful dyspepsia, with coated tongue, headache and nervous depression (P.). Pepsin, when gastrodynia from indi- gestion (P.). Creasote, checks pain after food (R.l. Allan, often affords re- lief (B.). Ergot, of value in visceral neuralgise (P.). Alkalies, for pain in stomach, liquor potassse generally employed (R.). Quinine, in cases showing periodicity, and those of neuralgic type (P.). Sodium Salicylate, for gastralgia with fermentation (R.) Nitroglycerin allays the pain speedily (B.). Car- bonic Acid Water, in painful and irritable conditions; may be mixed with milk (R.). Milk-cure, very efficacious in obstinate cases (B.). Galvanism of the pneumogastric, and locally to the organ itself (B.). Aquapuncture has given extraordinary relief (B.). Diet is of the greatest importance. Food should be easily digestible, varied and plainly cooked. Sedentary livers should refrain from much animal food. Meals should be regular and frequent, eating little at a time, and that very slowly. Alcoholic beverages do harm as a rule, but may benefit particular cases. Eating should be done in as agreeable a frame of mind as possible, and the patient should rest for a time after a meal. [Compare Acidity, Dyspepsia, Neuralgia.] R. Morphinae Sulph., . . gr. j. Ac. Carbolici, . . . gss. Aq. Menth. Pip., . ad £iv. M. Sig.—Teasp. thrice daily. (Da Costa.) Prescriptions. R. Ac. Hydrocy. Dil., . . gij. Aq. Laurocefasi, , ad ppv. M. Sig.—Teasp. every 4 hours. R. Atropinae Sulph., . . gr. j. Zinci Sulph., . . . gss. Aquae Destill.,. . . Aj. M. Sig.—3 to 5 drops two or three times daily. (B.) R. Bismuthi Subnit., , . sjij. Aq. Hydrocy. Dil., . . gss. Mucil. Acacise, Aq. Menth. Pip., . aa %ij. M. Sig.—Tablesp. thrice daily. R. Bismuthi Subnit., Magnesii Carb., . aa gr- xvj. Ac. Hydrocy. Dil., . nix. Aquae, . ; ,^iv. M. Sig.—Dessertsp. for a child of 3 years in flatulent gastrodynia and gastralgia. R. Pepsini, . . > * gj. Ac. Hydrochlor. Dil., . gss. Glycerini, , . . .jjss. Aq. Cinnam., . . * ,^ijss. M. et filtra. Sig.—Tablespoonful doses for slow and feeble digestion. Gastric Dilatation. Carbolic Acid, internally to allay fermentation, with an occasional washing by the stomach pump (Da Costa), Strychnine, hypodermically or by the mouth, or NuxVomica, the best remedy, conjointly with washing of the sto- mach and a strict diet (Da C.). Bismuth, with magnesia or soda, or lime- water frequently, for the acidity, which is one of the most distressing symp- toms (Fenwick). Diet, should be free from all starch and sugar, and from vegetables of any kind (Fenwick), Milk not advisable, as much fluid will further diiate the organ ; solids better, as small quantities ol dry, stale bread, or gluten bread, and underdone meat (Da Costa). 612 GASTRITIS. Gastritis, Acute. Mercury, calomel in broken doses, with ice, frequently swallowed, for the idiopathic form, which is occasionally seen and cannot be distinguished from that due to irritant poisons (Da Costa). Bismuth, subnitrate or subcarbonate in full doses after the more acute symptoms have abated (Da C.). Morphine, hypodermically for pain (B.)» Ice, internally and externally, gives great relief (R.). Aliment should be given per rectum; no food, except milk and lime-water, being admitted to the stomach for some time (Da C.). Antidotes, in cases of irritant poisoning, as alkalies to neutralize acids, dialyzed iron or the hydrated sesquioxide for arsenic, turpentine for phosphorus, etc. [See page 434, antel\ Then oil, albumen or milk, to protect the mucous mem- brane, stimulants, opium, ammonia, etc., to antagonize the depression of the vital powers. Gastritis, Chronic. Arsenic, sometimes surprisingly curative; for the vomiting gtt. j-ij of Fowler’s Solution before meals (B.). Pulsatilla, in subacute gastritis of phlegmatic temperaments, white tongue, heartburn, nausea, flatulency, little or no taste (P.). Hydrastis, gtt. v-xv of tincture or fluid extract, daily before meals, especially for gastric catarrh of acute alcoholism (B.). Nux Vomica, gtt. j of tincture every 5 or 10 minutes for 8 or 10 doses in acute gastric catarrh, with headache or sick-headache; also drop or 2-drop doses every 2 hours or oftener, when chronic gastric catarrh in the course of chronic disease (R.). Cinchona, to promote healthy state of mucous membrane, the infusion best with mineral acids, or quinine; the red bark in gastric catarrh of drunkards (B .). Alkalies, either shortly before meals, to stimulate production of gastric juice; or some hours after, to neutralize the acids of decomposition (Da C.). Pepsin, gr. v immediately after a meal, to assist digestion (Da C.). Podophyl- lum, in small doses at night, to act on upper bowel. Purgation as a method of treatment stands at the head (Da Costa). Ipecac., in small doses may prove highly useful, upv-x of the wine (P.); for the nausea and vomiting (R., B.). Tannic Acid, in 4-grain doses with a drop of glycerin to make a pill (B.). Hydrocyanic Acid, is much used(R.); in subacute gastritis it often proves useful given in an ordinary effervescing draught (Wa.). Silver Nitrate, in or doses, with opium if pain, or preferably belladonna, is extremely useful (Da C.); to check pain and vomiting (R.), Silver Oxide, is nearly as good as the nitrate, and not liable to produce staining (Da C.). Opium or Morphine, to quell pain in chronic gastritis from alcoholic excess (R.). Euca- lyptus, a most useful stomachic, not to be used in inflammatory states (B.); is used with benefit (R.). Mercury, the yellow oxide, in doses of gr. _so’ *n chronic form. [See under Dyspepsia.] Calumba, and other bitters are use- ful (B.). Ammonium Chloride, in high repute in Germany (B.). Caffeine, especially when associated with migraine (B.). Bismuth, is very useful in chronic gastritis, especially that of drunkards, and the chronic gastric catarrh of children with vomiting (R.); invaluable for its sedative, alterative and astringent action; 10-15-grain doses several hours after meals (Da C.). Lead Acetate, in chronic gastritis with gastralgia and pyrosis, may be combined with morphine beneficially (B.). Alum, when vomiting of glairy mucus (B.). Ali- ment, such as will be digested in the small intestines; requires careful atten- tion. The milk-cure has been very effective in bad cases; malt liquors are harmful (B.). Mineral waters of purgative type, to keep the portal system drained. Exercise is not beneficial; better live quietly, and occasionally 613 GASTRIC ULCER. spend a day or two in bed (Da C.). Kumyss very agreeable, and tolerant to stomach; the milk-cure and buttermilk have been very efficacious. The farinaceous vegetables, rice, tapioca, arrowroot, aerated bread. [Compare Dyspepsia, Gastraegia.] R. Sodii Bicarbonat., i gr. lxxx. Spt. Chloroformi, . sjjss. Tinct. Gentianse, . 5ss. Infusi Rhei, . . 5iv. Aq. Menth. Pip.,q. s. ad M. Sig.—A tablesp. or two before each meal. In chronic gastric catarrh, with flatulence. Prescriptions. R. Sodii Bicarbonat., . . t^jss. Tinct. Aurantii Cort., . Infusi Calumbae, q. S: ad iij. M. Sig.—Two tablesp, before each meal. In chronic gastric catarrh. R. Aluminis, . . . gij. Ext. Gentianse, < . sjss. M. Ft. pil. no. xxx. Sig.—Two twice daily. R. Argenti Oxidi, . . gr. xij. Ext. Belladonnse, . gr. iij. Olei Caryophylli, . gtt. xx. M. Ft. pil. no. xxiv. Sig.—One pill twice daily. {Da Costa.) R. Magnesii Sulphatis, . gj-ij. Sodii et Potassii Tart., . gss-j. Ac. Tartarici,. . . gr. xx. Sig.—Dissolve in a glass of water, and drink, an hour before breakfast. Gastric Ulcer. Arsenic, Fowler’s solution in drop doses lessens the pain and relieves the vomiting remarkably (B.); has given relief when commonly-used reme- dies failed (R.) ; gives good results when used in very small doses (Da Costa). Bismuth, relieves pain and vomiting, and contributes to the cure (B;). [See under Gastralgia for formulae.] Silver Nitrate, in solution, to check pain and relieve the vomiting (R.); is next in value to bismuth, promoting cicatrization and easing the pain (B.). Silver Oxide is equally effi- cient, and is not liable to produce staining (Da C.). Atropine often happily relieves the pain and vomiting, even when given in very small quantity (Bt). Morphine, for the pain and vomiting (R.); in full doses if perforation occurs, to localize peritonitis until adhesions take place (DaC.). Ergotin, j to water x, of which gtt. xv hypodermically several times a day for the hemorrhage. Gallic Acid, in 5-grain pill every hour for hemorrhage. Lead Acetate, is sedative and hemostatic; gr. ss-ij in pill with opium, very useful to check hemorrhage and allay pain (R.). Turpentine, 5 to 10 drops frequently repeated in hemorrhage (R.). Charcoal is said to ease the pain by preventing formation of acid products (R.). Mercury. Corrosive sublimate an effective remedy; gr. thrice daily before meals (B.). Pepsin, by facilitating digestion, is useful (B.). Iron, for the anaemia: the lactate or ammonio-citrate if stomach irritable (Da C.). Ice-bag, to the epigastrium, for pain and vomit- ing, etc. (R.). Nutrient Enemata,X.o rest the stomach. [See under EnematA for formula.] Brandy may be added, also laudanum, gtt. x-xx, if the rectum is irritable (B.). Milk-cure, has succeeded admirably (B.); a strictly skimmed milk diet with lime-water, 2 parts of milk to 1 of aqua calcis (Da C.). Diet, should be of unirritating character, which, with cold or hot compresses to the epigastrium, leaves little room for medicine. In bad cases nourish per rectum, 614 GLANDERS AND FARCY—GLANDULAR ENLARGEMENTS. so as to give the stomach complete rest. In any case such food as is chiefly digested in the small intestine, e.g., farinaceous vegetables, rice, arrow- root, etc. A nice change from milk diet is a warmed pancreas, chopped up with rare meat, being nutritious and well relished (Da C.). Rest in bed for several months is imperative (Da C.). Defibrinated Blood, by injection into rectum, in doses of from (A; PI. Smith). [Compare Hematemesis.] Prescriptions. R. Argenti Oxidi, Ext. Hyoscyami, . aa gr. x. Ft. pil. no. xx. Sig.—One pill thrice daily before meals. R. Argenti Nitratis, . . gr. v. Ext. Opii, . . gr. iij. Ft. pil. no. xx. Sig.—One pill thrice daily. R. Bismuthi Subcarb., . giij. Morphinse Sulph., . gr. j—ij. Pulv. Aromat., . • 3b Ft. pulv. no. xij. Sig.—One powder in milk before each meal. R. Argenti Oxidi, . . gr. v. vel Zinci Oxidi, . . £ss. Morphinse Sulph.,. . gr. j—ij. Ft. pil. no. x. Sig.—One pill thrice daily, before meals. Glanders and Farcy. Ammonium Carbonate, in water, hourly, as concentrated as can be swal- lowed, followed by an opiate, and preceded by an emetic of ipecac, and an incision into each of Wharton’s ducts; proved successful in a case of acute glanders (Wa.). Carbolic Acid, and the Sulphites, as sodium sulphite, are most worthy of trial. Creasote, or Carbolic Acid, in glycerin, locally (Wa.); or dilute chlorinated soda, and lime-water. Escharotics, to destroy the affected spot, if inoculation occurs. Iodine, internally, also Arsenic and Strychnine, have been recommended. Quinine in large doses, and Chlo- ride of Iron, may be useful. No drug yet tried has any marked specific effect on the disease (Durham). Glandular Enlargements. Iodine and Iodides, no remedy more efficient, when simple hypertrophy. Useless (with all other medicines) when caseation or suppuration has set in. Iodine injected into cystic and glandular growths of neck. Syrup of the Iodide of Iron occupies an important place (B.j. The iodide of potassium for mammae and testicles, but especially for thyroid ( R.). Iodoform is equal, if not superior to iodine, in enlarged scrofulous glands, and other glandular swellings (Wa.). Iodide of Lead, as an ointment. Ung. Hydrarg. Iodidi Rubri, pro- duces very striking effects in goitre, enlarged spleen, etc. (B.). Sulphides, especially the Blue Lick water, are said to abort or to mature suppuration in glanders (R.). Calcium Sulphide, for hard, swollen glands behind angle of jaw, with deep-seated suppuration ( R.). Calciu?n Chloride, highly useful in strumous inflammation and suppuration (B.). Pilocarpus, is curative in acute affections of parotid and submaxillary glands (B.). Mercury, useful in acute inflamma- tory states, tonsillitis, parotitis, etc. Hydr. chlor. corr. gr. or hydr. cum creta, gr. every 2 hours (B.). The oleate of mercury and morphine in obstinate and painful tonsillitis, and inflammation of lymphatic glands (R.). Belladotina, especially in tonsillitis (P.). Valerian with Guaiacum, in strumous enlarge- ment (P-). Hydrastis, frequently controls (P.). Carbolic Acid Injections, 615 GLAUCOMA GLEET. a 2 per cent, solution injected into substance of gland (B.). [Compare Bubo, Goitre, Tabes Mesenterica, Parotitis, Tonsillitis, etc.] Glaucoma. Atropine, gr. hypodermically, beneficial (Anstie); imprudently used has caused the disease (Von Graefe, Soelberg Wells). Eserine, lowers intra-ocular tension, and is indicated with Quinine in all cases of threatened glaucoma, to preserve the eye from the risk of consecutive glaucoma, and after iridectomy or sclerotomy (De Wecker). Iridectomy, the only remedy for the disease, medicine being worse than useless. The operation should be performed as soon as a state exists which can be called glaucomatous. Even when vision is lost, the operation will best relieve the pain (C.). Almost a certain cure in early stages; in later, nearly always palliative; often curative. Drainage of Eye, by gold wire or catgut, has had success (De Wecker). Gleet. Cantharides, in drop doses, when frequent desire and pain in region of prostate (R.); of benefit in subjects of relaxed fibre and feeble circulation (B.). Blisters, to the perinaeum, of undoubted benefit (B., R.). Piper Me- thysticum, has cured obstinate gleet (Switzer). Bismuth, 1, glycerin 1, water 6 parts, as an injection, often useful in gleet (R.). Eucalyptol, is used with benefit in chronic catarrh of the genito-urinary tract (R.). Iron, the tincture of the chloride tjss, in Oss of water with of laudanum, makes a good in- jection for gleet (R.); internally for anaemic subjects (St.). Mercury, y?, grain of corrosive sublimate in ijvj of water, is a good injection in gleet, used every 2, 3 or 4 hours (R.). Zinc Salts, the sulphate or chloride, gr. ij of the latter to a pint of water, as injection every hour (R.). Bougies, of gelatin, medicated with astringents, are extremely efficient. Turpentine, in moderate doses, when due to relaxed condition (B., R.). Copper Sulphate, a solution as injection (R.). Astringent injections may be used with benefit (Wa). Copaiba, smeared on a bougie, and introduced into the urethra, will some- times cause gleet to yield (Wa.). Oil of Sandalwood, vt\yv ter die (R.). Glycerite of Tannin, with equal quantity of olive oil or mucilage, as injec- tion, tjij enough. Persevere 8 or 10 days after discharge ceased, and do not use at bedtime (R.). Balsams of Peru and Tolu, Buchu, Canada Balsam, Copaiba, Mastic, and Tannin, are used with advantage (P., R.). Often kept up by over-treatment. Will some time or other come to an end (St.). Diet and Habits important. Stimulants, both solid and liquid, should be rigidly avoided, also coffee. Frequent ablutions, fresh air, good nourishment. [Com- pare Gonorrhoea.] R. Tinct. Ferri Chlor., . . Tinct. Cantharidis, . . M. Sig.—15 drops in water three times daily. (B.) ! Prescriptions. R. Pulv. Cantharidis, . . gr. iij. 01. Terebinth., . . gj- M. Ft. pil. no. xij. Sig. — One thrice daily in obstinate gleet. If strangury occur, stop for a day or two. R. Zinci Sulphatis, . . gr. iij. Ac. Carbol., . . . rn. ij. Ext. Hydrastis, Ext. Belladonnoe, . aa gr. vj. Gelatini, . . . q. s. M. Ft. bougia no. vj. Sig.—-One in urethra at bedtime. R. Ac. Tannici, . . . gr. x. Bismuthi Subnit., . . zij. Aq. Rosae, . . • 5 vi M. Sig.—Shake and use as an in- jection thrice daily. (Maury.) 616 GLOSSITIS—GOITRE. Glossitis. Bismuth, gr. xx of subnit. with gj of glycerin and of water, as lotion, for erythematous inflammation of tongue (A.). Purgatives, with gargles, leeches, antiphlogistic regimen generally (D.). Quinine and Iron, should be given internally, with dilute acid washes,and free purgation (Cl.). Alum, dry, powdered, may be dusted on tongue (Cl.). Leeches, applied beneath the jaw, if symptoms are urgent (Cl.). Abscess, should be opened, if any form. In- cisions, along superior surface, followed by vapor of hot water, may instantly relieve congestion (A.). Tracheotomy, or Laryngotomy, if suffocation is imminent (A.). Glottis, CEdema of. Emetics, non-depressing when oedema slight (A.). Inhalations, of steam with benzoin, or conium, of great service (A.); or of tannin, gr. viij or x to !|j of water; or alum, gr. x to the or a saturated solution of potassium chlorate, all as spray (Walker). Ethyl Iodide, by inhalation, proved curative in one case in which it was repeated twelve times (See). Scarification, by laryngeal lancet, of paramount value (A.). Tracheotomy, if the above fail (A.). O’Dwyer’s laryngeal tubation promises well. [Compare Croup, Lar- yngitis.] Goitre. Iodine, is curative in simple hypertrophy (ordinary goitre), used both inter- nally and externally. Deep injection of the tincture is very successful in cystic degeneration of the gland (B.) ; also in the fibrous and fibro-cystic varieties, if injection be made into the tumor; dangerous, if into a vein or into the surrounding areolar tissue (Wa.). Mercuric Iodide, as oint. assisted by the sun’s rays, a piece the size of a large pea rubbed in daily, very successfully used in India for simple hypertrophy (R.); the official unguent, hydrarg. iodidi rubri, I in io daily (B.) ; is too strong (Gross); gr. xvto the £ strong enough for the worst cases (Wa.). Potassium Iodide, internally, also externally as ointment, in simple hypertrophy of the gland (R.). Strychnine, gr. thrice daily, has been successful in several cases (Holmes). Chloride of Iron, injec- tions of the solution used in thirty-eight cases with curative results (Macken- zie). Ergotin, injected with benefit into the parenchyma of the goitre (P.) ; also used hypodermically with good results (Wa.). Ammonium Chloride, as an internal remedy, has proved curative (Stevens). Electrolysis, has sometimes cured in cases of simple hypertrophy and cystic gland (B.). Spongia Usta, was formerly considered a sovereign remedy (Wa.). Seton has cured. Eluoric Acid, in doses of TRxv to 3) thrice daily, largely diluted, cured seventeen cases out of twenty (Woakes). Excision, is a very difficult operation, only to be considered in extreme cases; it has been performed successfully by Desault, Harris, Hedenus, Billroth and Greene. [Compare Exophthalmos.] Prescriptions. R. Ammonii Chloridi, . . sjvss. Syrupi Simplicis, . . i^ss. Aq. Cinnamomi, . . M. Sig.—Teasp. thrice daily. R. Ung. Hydrarg. Iodidi Ru- hr! . . . . 3). Vaselini, .... M. Sig.—Use as directed. (Gross.) GONORRHOEA. 617 Gonorrhoea. Aconite, a drop of tinct. each hour in the acute stage (R.); when inflam- mation (Pf., St.). Gelsemium, serviceable, acute stage (Pf.). Cannabis Sativa, after acute symptoms subside, a few drops 3 or 4 times a day, is fully as effect- ual as copaiba or sandal, and infinitely more pleasant to take (Pf.)- Canna- bis Indica, relieves pain, diminishes discharge (P.); occasionally useful (R.). Merctiry, excellent results from corrosive sublimate (Pf.); gr. X to aquse destill, in subacute and chronic stages, as injection thrice daily; may have gr. ss-j of zinc chloride added with benefit. Often effectual (Wa.). See page 495 for formula. Hydrastis, the infusion best for injection, gj of root to jviij aquae (Pf.); the fluid extract is one of the best injections, properly diluted ; or the muriate of berberine (hydrastin) to J-iv of mucil. acaciae (B.). Col- chicutn, the wine of the seed has frequently cured gonorrhoea, and was used in thirty-minim doses nightly for the relief of chordee by Brodie (B.). Chlo- ride of Iron, when acute stage has passed and the discharge is degenerating into gleet, few remedies are more useful than this tincture, in doses of -rrtxv- xx thrice daily. See Erysipelas for formula (Wa.). Alkalies, citrates or bicarbonates to render the urine alkaline (R.); Lithium Carbonate in five-grain doses thrice daily, for the same purpose. Alkalies are the chief factor in Otis’ treatment; Potassium Bicarb., gr. x in a tumbler of water, or in flaxseed tea, or infusion of triticum, with gr. xv of Potass. Bromide if great pain present. Vichy Water (Celestin’s) freely (Otis). Turpentine, in chronic stage, when parts are relaxed, moderate doses are of great benefit (B.). Can- tharides, drop-doses may be used (R.); in the chronic stage (B.). Pulsatilla, in subacute and gonorrhoeal ophthalmia (P.). Copaiba, especially adapted to gonorrhoea (B.); pour it upon half a wineglassful of water to which add some bitter tincture (Chapman); if given too early in the disease it will aggravate the symptoms (P.); should not be used until pain in urinating is nearly gone, chordee ceased, and the discharge is diminishing and of yellow color (Wa.); is no good, but rather injurious, and prolongs the disease (Otis). See page 492 for formula. Sandalwood Oil, valuable in subacute (P.); a good quality difficult to obtain (Pf.). Best internal remedy; Copaiba next (St.). Silver Nitrate, a weak solution (gr. as injection. In vaginal gonorrhoea a strong solution (^j-Sjj) through speculum to every part of canal (B.). As abortive injection is useless and dangerous (St.). Cubeba, unlike copaiba, given with good effect in acute stage; best results from mixture of both as in electuary. See formula below. Is not irritating to the stomach, and agrees with some patients better than copaiba (Wa.). Zinc Salts, a weak injection of the chloride, gr. j to i|vj or viij of rose-water; or the sulphate gr. j to the jj, frequently repeated, is probably the best treatment (B.). The best injec- tions are those of the sulphate or acetate, gr. vj-xij to aquae, after the acute inflammation subsides (St.). Bismuth, the oleate, smeared on a sound, and inserted for 5 minutes (Shoemaker); with mucilage as an injection, excellent in chronic gonorrhoea (Hill). Lead Acetate, the dilute solution of the sub- acetate, as injection, may be employed at any stage (B.). Chloral, a weak solution, gr. j-iv to the a very good injection (Hill). Resorcin, a 1 per cent, solution makes a useful injection (Wa.). Injections, of tannin, copper sulphate, iron, cadmium, port-wine, brandy-and-water, and 1000 other agents (R.). Injections are very bad, especially in the acute stage; should never be used until the 4th week and then only if the case is not progressing (Otis). True gonorrhoea is never cured in less time than four weeks (Van Buren and Keyes); urethritis is a different disease entirely (Otis). Balsams of Peru and 618 GONORRHCEA. Tolu, also Buchu, Uva Ursi, Chimaphila, Pareira, etc., are among the numerous remedies used for gonorrhoea (R.). Alcohol, as a beverage, or any other stim- ulant, must be avoided entirely (R.),. Soluble Bougies made of iodoform, eucalyptus and cacao-butter, are highly recommended to cut the disease short (Wa.); a series of similar preparations, having a basis of gelatin and glycerin, medicated with the usual astringent and sedative drugs, is manufactured by C. L. Mitchell of Philadelphia, and may be obtained of the drug trade. Wrappings of several folds of cotton are heating and uncomfortable, also dirty, and productive of balanitis, etc. Pin a false front to shirt for a covering (St.). Best in bed is an absolute desideratum, especially during the inflammatory stage. Hot water, ioo° F., to the penis during urination, extreme cleanliness, milk diet; water freely as a beverage, flavored with a few drops of oil of gaul- theria, or flaxseed tea, or infusion of triticum with potassium bicarbonate. Sexual thoughts to be entirely avoided (Otis). [Compare Chordee, Gleet, Orchitis, Rheumatism Gonorrhceal, Urethritis, Urethral Stric- ture, Vaginitis.] For Internal Use. R. Potassii Citratis, . . jfss-j. Spt. Limonis, . . . Syr. Simplicis, . . ifij. Aquae, . . . • % M. Sig.—Dessertsp. largely di- luted, 3 or 4 times daily. As alkali for the increasing stage. [Otis.) Prescriptions. For Local Use. R. Resorcini, . . gj. Ac. Borici, . . gr. xx. Zinci Acetatis, . . gr. 14.-1^. Aquae Destil., . . M. Sig.—Dessertsp. as injection. R. Pulv. Iodoformi, . !|ss. Ac. Carbolici, . . 5{ij. Glycerini,. . . ifij. Aquae Destil., . ad£vu). M. Sig.—Teasp. as injection. The Black Paste. R. Pulv. Cubebae, . . 5iij. Copaibae, . . . 3JSS. Aluminis, . . . ,^ij. Sacchari Albi, . • o\- Magnesiae, . . . gjss. Olei Cubebae, . . . gj. Olei Gaultheriae, . • 3)• M. fiat electuarium. Sig.—Apiece the size of a walnut after each meal. (Otis.) R. Zinci Sulphatis, . gr. vj. Plumbi Acetatis, . gr. viiij. Ammonii Chloridi, . gr. iv. Aluminis, . . . gr. v. Aquae Rosae, . . M. Sig.—Injection, to be used after acute symptoms subside. R. Oleoresinae Cubebae, . Potassii Bromidi, . . £j. Olei Sassafras, . . rrqx. Syr. Acaciae, . . . Aquae, . . q. s. ad gvj. M. Sig.—Dessertsp. 3 or 4 times daily. (J. Wm. White.) R. Zinci Sulphatis, . . gr. viij. Liq. Plumbi Subacet. Dil., sjiv. M. Sig.—Use as an injection. R. Zinci Chloridi, . . gr. j. Aquse Rosse, . . Ayj-viij. M. Sig.—Use as injection. [For Alkaline Emulsion of Copaiba see ante, page 492.] [For Injection Brou and others, see ante, page 495.] 619 GOUT. Gout. Aconite, may certainly relieve pain (P.). Belladonna, the best remedy to effectually and speedily soothe pain; also in gout of the stomach, 5-up doses efficacious (P.). Potassium Iodide, especially when pain is worse at night (R.). Colchicum is merely palliative; a large dose (gj) of the wine often removes the severest pain in an hour or two, and soon after the swelling and heat subside (R.); it is especially useful in acute and rheumatic gout (B.); is not specific, nor a lasting or final remedy for gout, but acts very directly on the pain and inflammation of acute attacks. Laville’s tincture is a colchicum preparation, though colocynth is also a constituent (P.): is useful in the bron- chitis, asthma, dyspepsia, urticaria, etc., of gouty subjects (R.). Veratrine, as ointment to painful joints (R.). Sulphides, as baths in chronic gout, or fumigation with sulphurous acid, and bed-clothes exposed to strong fumes (R.); sulphur waters certainly benefit (B.). Iodine, painted round joints in chronic (R.). Strychnine, hypodermically for later stage of gout paralysis (R.). Arsenic, very serviceable in a form of chronic arthritis allied to neu- ralgia (B.). Lithuim, the bromide internally and a strong solution of lithia to the joints (B.); the carbonate (gr. v to the on lint around gouty en- largements, joints, etc. (R.). Sodium Salicylate, gr. x internally every 2 hours, also to jfviij water warmed, as lotion on lint covered with oiled silk. Guaiacum has long had a high repute, and may be given for a long time with- out injury (Wa.). Rhubarb with an alkali, regularly during intervals, very serviceable (Halford). Manganese, syrup, ferri et mang. iodidi (nq for the cachectic state (B.). Alkalies, to relieve indigestion, especially lithium salts. Alkaline mineral waters have long had a deserved reputation (BA: Magnesia and its carbonates often of great service; the latter dissolved in excess of CO2 an elegant form of administration (Wa.). Alkaline Poultice, 9 of linseed meal to I of sodium bicarb, is a useful application (R.). Turkish Baths, are useful in chronic gout (B., RA. Aliment. Farinaceous vegetables and acid fruits. Avoid animal or saccharine food. Milk-cure has improved cases, and apparently removed the diathesis (B.). Cod-liver oil in chronic gout (B., R.). Entire abstinence from alcoholic beverages is best; the worst wines are port, sherry and madeira. Local Measures. The affected limb should be raised, aud surrounded with hot, moist flannels. Wrap the hands in flannel dripping with water, and cover with water-proof bag, to dissolve gouty deposits. [Compare Rheumatic Arthritis, Lith^mia.] Scudamore's Mixture (Modified). R. Vini Colchici Radicis, . Magnesii Sulphatis, . . Magnesiae Optimae, . . Aquae Menth. Pip., . . jfx. M. Sig.—Tablesp. every hour until it operates. Prescriptions. Lallemand's Specific. R. Ext. Colchici Acet. (B. P.), Ext. Opii Aquosi, . aa gr. xv. Potas. Iodidi,. . . Potas. Acetatis, . . ,^ij. Aquae Destill., . . t^iijss. Vini Albi, . . . j|ss. M. Sig.—20 drops thrice daily. R. Colchicinae, . . . gr. j. Ext. Colocynthidis Co., . Quininae Sulphat., . . Ft. pil. no. lx. Sig.—One every four hours. (B.) R. Lithii Citratis, Magnesii Carbonat., . aa Sjj. M. et div. in pulv. no. 1. Sig.—One in water thrice daily. In chronic gout. 620 GUMS—HAIR. Gums. Myrrh, the tincture for spongy and ulcerated gums (P.); in fpv of water or infusion of cinchona, is highly serviceable as a gargle or mouth- wash (Wa.). Alum, for spongy and ill-conditioned gums, tending to recede from the teeth, whether of mercurial or scorbutic origin (Wa.). Catechu, a piece dissolved slowly in the mouth is often of service in similar conditions (Wa.). Rhatany, the powder as a dentrifice, keeps gums in good order (P.). Potassium Chlorate, gr. ij every four hours for a child of one year, for inflam- mation of gums in teething (Wa.). Carbolic Acid, gr. iij ad aquae,as lotion in diseases of the gums (Hilditch). Pomegranate, the bark an excellent basis for gargles in relaxed gums (P.). Potassium Iodide, gr. x thrice daily, for periostitis of alveolar processes, marked by looseness of teeth, pain and swell- ing of gums (Graves). Iodine, gr. j ad Jj aquae, applied by a camel’s-hair brush after each meal, for retraction of gums with loosening of the teeth (Stille). Tannin, the glycerite, for spongy and bleeding gums (B.). Carbo- late of Iodine, when fetor (B.). Benzoin, the tincture a good application (B.). fCompare Scurvy, Teeth.1 Prescriptions. R. Aluminis, . . . gss. Tinct. Myrrhae, . • 3)- Tinct. Cinchonae, . . giv. Mel. Rosae, . . . 5j. Vini Albi, . . . M. Sig.—Mouth-wash. R. Tinct Orris, Spt. Rosae, Alcoholis, . . aa Ifiv. Ol. Amygd. Amar., gtt. ij. M. Sig.—Violet Mouth-wash. (Piesse.) Hair. Rosemary, encourages the growth of hair, mitigates baldness, and is sup- posed to prevent uncurling in a damp atmosphere (P.). Hydrogen Peroxide, and other preparations of oxygen, are used to “ blonde” the hair, for pur- poses of fashion (Wilson). Hair-dyes, comprise potassium permanganate, pyrogallic acid, black oxide of lead, which are temporary, and the black oxide of silver, which is permanent in its action (Wilson). Depilatories usually consist of powders containing quicklime 3 parts, sodium sulphide I, and starch 4. A powerful depilatory is barium sulphide made into a thin paste with starch (Wilson). Another contains yellow sulphide of arsenic, gr. xx, quicklime i|ss, starch A very effective one is barium sulphide and oxide of zinc (B.). Sarsaparilla is stated by Teste to possess the curious property of changing red hair to a light flaxen color when taken internally for three months. [Compare Alopecia, Syphilis, Tinea Tonsurans, etc.] R. Sodii Boratis, . . . 5(iv. Aq. Ammoniae, . ‘ q}' Spt. Myrciae, . . . 3q. Aq. Rosae, . . . M. Sig.—Shampoo Hair Wash. Prescriptions. R. Ol. Ricini, . . , lijjss. Ol. Bergamii, . . . £jss. Ol. Cinnamomi, Ol. Caryophylli, . aa Ttlvij. Ol. Lavandulae, . . ir^xl. Tinct. Cantharidis, . • 3j- Aq. Ammoniae, . . !Jij. Alcoholis, . . q. s. ad Oj. M. Sig.—Hair Tonic. R. Ac. Salicylici,. . . gr. xl, Tinct. Benzoini, . . 2ss. Alcoholis, Glycerini, aa Jviij. M. Sig.—Hair Wash. HAY-FEVER. 621 Hay-Fever. Arsenic, especially valuable when disease is more of catarrhal than of asth- matic type, 3-minim doses of liquor arsenicalis (Mackenzie); as cigarettes, 2 or 3 daily (see Asthma for formula) (B.). Belladonna, when nasal secre- tion is very profuse (B.). Euphrasia, of decided benefit for the catarrhal symptoms (Pf.). Quinine, very useful after the more acute symptoms have subsided (R.); injected into the nares checks catarrhal discharge and spas- modic symptoms (P.) ; a solution of the hydrochlorate, gr. iv-viij ad gj aquae, applied locally to nasal mucous membrane by a spray-producer or a brush, will arrest the disease if confined to the nares and fauces (B.l. Ipecacuanha, in hay-asthma (R.); is of great value, though the smallest doses cause similar effects (P.). Aconite is better than arsenic in true hay-fever (R.); has been used with the best results (P.). Grindelia benefits cases of asthmatic type (B.). Iodides are very serviceable, locally and internally; large doses until some iodism observed, may be combined with arsenic (B.). Opium, espe- cially as morphine, of great value in any stage, but great danger of the opium- habit (B.): the tincture in doses of mij-iij every 2 hours for three doses, then try every 2 hours until the discharge abates, has given excellent results (Wa.). Black Coffee is highly recommended (P.). Cocaine, a 5 to 20 per cent, solution of the hydrochlorate, brushed over the nasal mucous membrane after drying it as far as possible, is the most efficient palliative yet obtained (R.): a 4 per cent, solution dropped from a medicine-dropper well into ante- rior nares, the head being thrown well backwards, or sprayed up the nostrils from a small atomizer; gives immediate relief, and though not curative it prevents so much suffering and distress that in no case should it be left untried (Da Costa). Ignatia, the tincture has seemed to benefit some cases, and to favorably influence the course of the disorder (Da C.). Lobelia, has been found an efficient remedy (Wa.). Tobacco, smoking helps some and aggra- vates the symptonjfi in other instances. Internally ad nauseam it helps, but there are better and safer remedies (Wa.). Removal to the sea-coast, or to a barren, mountainous district, gives the only relief to some subjects; though many of the worst cases, hitherto unaffected by medicine, are now relieved by the lotal application of Cocaine. [Compare Asthma, Catarrh, Con- junctivitis, Influenza.] Prescriptions. For Internal Use. R. Potassii Iodidi, . . . gj. Liq. Potass. Arsenit., . 2|j. Aquae Cinnam., . . giv. M. Sig.—Teasp. every 4 hours. For Local Use. R. Tinct. Iodi, . . . gj. Ac. Carbol., . . . gtt. x. Aq. Destill., . . . i|iv. M. Sig.—For local use with atom- izer or post-nasal syringe. R. Ext. Hyoscyami, . . gr. xij. Potassii Iodidi, . . g). Potassii Bicarb , . . gij. Ext. Glycyrrhizae Pur., . Aq. Anisi, . . . M. Sig.—Dessertsp. every 4 hours until relieved. (Weber.) R. Menthol, .... Ac. Carbol., . . . Zinci Oxidi, . . • 3) ■ Ol. Amygd. Dulcis, . . Sjss. Cerati Simplicis, . . gij. M. Sig.—Apply thoroughly to the nostrils every few hours. 622 HEADACHE, BILIOUS-SICK. For Internal Use. R. Liq. Potassii Arsenit.,. . §j. Tinct. Belladonn®, . . gij. M. Sig.—5 to io drops after meals, as a prophylactic. For Local Use.' R. Quininae Bisulph., . . ziij. Aquae, .... M. Sig.—Irrigate the nares, after cleansing with a weak alkaline solu- tion. R. Tinct. Euphrasiae, . . gjss. Aq. Camphorae, . ad gij. M. Sig.—Teasp. four times daily, for the catarrh. R. Cocainse Hydrochlor., . gr. vj. Aquae Destill., . . gij. M. Sig.—5 per cent, solution. A few drops to be instilled into nares while head is lowered. (Da Costa.) Headache, Bilious-sick. Nux Vomica, gtt. j of tinct. frequently, when acute gastric catarrh, with headache and nausea (R.); gtt. j every io minutes, soon after meals, often gives marked relief in sick-headache not of neurotic origin (A. A. Smith). Strychnine, with aloin and belladonna, in minute granules, for bilious head- ache from obstinate constipation, effective if given several times a day for a week or ten days (Roy). Belladonna, the extract in doses of gr. ’n similar form. Iris, blinding headache in right supraorbital region, nausea, vomiting, usually the result of hepatic derangement, mj every half-hour for three doses. Usually relieves promptly (Pf.). Bryonia, ordinary bilious with vomiting (P.). Picrotoxin, gr. by stomach, in periodical form (B.). Cha- momile, a popular remedy (R.). Podophyllum, in sick headache, with dark, bilious diarrhoea, or constipation with dark motions (R.). Sanguinaria, when due to stomach derangement, a few doses relieve (P.). Hydrastis, from con- stipated bowels (P.). Mercury, as “ blue pill,” to prevent or mitigate; or, gr. of bichloride when with light-colored Ammonium Chloride is an efficient remedy in most forms of headache (Wa.). Sodium Phosphate, a useful laxative in so-called “ bilious-sick-headache ” (B.). Po- tassium Bromide, a large dose in ordinary or sick-headaches (R.)* Ginger, in paste, as counter-irritant (P.). Water, as cold or hot effusion, or ice-bag to head; hot sometimes best. The purgative waters (as Friedrichshall) before breakfast in a cup of hot water (R.); a brisk saline purgative, or small doses of Epsom salts thrice daily, very effectual for frontal headache with constipa- tion (Br.) Nitro-7nuriatic Acid, io drops of the dilute acid in a winegl. of water, before each meal, often an effectual remedy (Br.). Charcoal, two tea- spoonfuls stirred in half-glass of water, as a draught, is an efficient remedy for sick-headache with sour stomach and flatulence, etc. [Compare Hemi- CRANIA.l R. Ammonii Chloridi, . . giij. Morphinae Acetatis, . gr. j. Caffeinae Citratis, . . sjss. Spt. Ammonii Aromat., . gj. Elix. Guaran®, . . Siv. Aqu® Ros®, . . . giv. M. Sig.—Dessertsp. every quarter- hour until relieved. (Carpenter.) Prescriptions. R. Podophylli Resin®, . gr. ij. Tinct. Zingiberis, . , Alcoholis, . q. s. ad\j. M. Sig.—Teasp. in a winegh of water every night at bed-time, or every second, third or fourth night as re- quired. {Dobell.) HEADACHE, CONGESTIVE—HEADACHE, NERVOUS. 623 Headache, Congestive. Aconite, to reduce the circulation (R.). Veratrum Viride, at menstrual periods (R.). Belladonna, relieves cerebral congestion, and distress from light and sound (P.); pain over brows and in eyeballs—often due to stomach or uterine derangements—especially in young women; miij of tinct. every three hours (R.). Potassium Bromide, a large dose (gr. xv-xx) in ordinary or sick-headaches (R.); Bromides are useful when nervous system has been irritated, but when exhausted they do harm (Hammond). Calomel, gr. every hour for ten or twelve doses, will relieve the headache of syphilis occurring at night (Tr.). Cannabis Indica is given with uniformly good results in the headache of the climacteric. Potassium Iodide, throbbing, intolerance of light, pain passing from back of neck over vertex to brow, noc- turnal, tender scalp, almost unbearable; ten-grain doses ter die will cure (R.). Hydrastis, when constipated bowels (P.). Amyl Nitrite, for headaches with severe flushing heats at menstruation or climacteric, a sufficient dose (R.). Mustard, in hot foot-bath, or as poultice to nape of neck in various forms of headache (R.). Water, cold water poured gently over forehead, sometimes warm water better (R.). A very hot foot-bath often effectually relieves (Wa.). Purgatives are often beneficial, especially when congestive 'headache arises from suppression of hemorrhoidal discharge, or in persons of phlegmatic habit; aloes best (Wa.); or colocynth, as derivative,, when cere- bral hyperaemia (Da Costa). Prescriptions. R. Ext. Colocynthidis Co., gr. xij. Pulv. Capsici, . » gr. iv. Ext. Gentianae, . . gr. xxiv. Ft. pil. no. xij. Sig.—One pill thrice daily. Also a 25-grain dose of So- dium Bromide every night at bedtime. [Da Costa.) R. Spt. Ammonise, . . ?j. Spt. Camphorse, . . !$ss. M. Sig.—For a quart of water in which a handful of common salt has been dissolved. Cork tightly, and use locally on lint as an evaporating lo- tion. Headache, Nervous. Cannabis Indica, ten-minim doses of the tincture thrice daily in the inter- vals, often curative in bad cases of neuralgic headache; or to grain doses of the extract (P.). See under Hemicrania. Belladonna, rrtiij of tinct. every 3 hours, when pain over brows and in eyeballs, especially when at menstrual periods; also when from overstudy or fatigue (R.). Nux Vomica, if with gastric symptoms (R.); is better than strychnine, and should be given in quarter-grain doses of the extract after meals, combined with iron and quinine if patient is chlorotic (Hammond). Bromides, when the nervous system has been irritated are useful, but harmful when it is exhausted (Ham- mond). Silver Nitrate, half-grain doses with minute doses of pil. coloc. comp., invaluable in headaches of hysterical women, and especially stomach headaches of delicate and literary men (Wa.). Ignatia, removes clavus hystericus (Pf.). Ammonia, the aromatic spirits or the carbonate (gr. v-x) in nervous headache (B.); the hydrochlorate (gr. x-xx) in bilious and hysterical headaches, especially in hard-worked and delicate young women (Wa.). Amyl Nitrite, inhaled when extreme pallor of face (B.). Arsenic, throbbing supra-orbital (R.); as a nerve tonic stands next in value to Zinc (Hammond). Cimicifuga, in nervous or hysterical women, especially at men- 624 HEART DISEASES. strual periods (R.); in rheumatic headaches and menstrual (P.). Coffee and Tea, when from nervousness or exhaustion (R.); coffee especially useful (P.). Guarana, a very effective palliative, gr. xx every half-hour for three doses (P.); mxv of the fluid extract every quarter-hour increased to mxl will often relieve periodical headaches not of malarial origin (A. A. Smith). Caffeine Citrate, two-grain doses, in capsule, every half-hour, a very effectual remedy for nervous and sick headache, but causes insomnia if used in the evening. Phosphorus, as dilute phosphoric acid, in doses of npxxx well diluted, thrice daily ; or zinc phosphide, gr. in pill, ter die, very useful in most forms of nervous headache (Hammond). Cajuput Oil, well rubbed in twice daily (P.). Menthol, locally to forehead in frontal headache (Wa.). Potassium Cyanide, locally in reflex headaches, as gastric, cardiac, pulmo- nary, menstrual (B.). Valerian is of great value in excitable persons (P.). Camphor, a saturated solution in eau-de-cologne rubbed on head, when of uterine origin (R.); in hysterical females, internally, with magnesium carbonate (P.). Podophyllum, purgative doses often give relief when near menstrual periods, with constipation and dark stools (R.). Zinc Oxide, two-to five-gr. doses useful (R.); a remedy of great value (Hammond). Bismuth, the sub- carbonate, in two-grain doses after each meal, often better than zinc, especially where gastric disturbance (Hammond). Ether Spray, for frontal headache after acute illness or fatigue (R.). Chloroform, rqxv-xxx of the spirit inter- nally, often effective (Wa.). Galvanism, sometimes valuable; the constant current always, avoiding too great intensity lest amaurosis ensue (Hammond). [Compare Hemicrania, Neuralgia.] Prescriptions. R. Potassii Cyanidi, . gr. x-xx. Aquae Laurocerasi, . M. Sig.—Apply locally on a com- press for to yz an hour. (B.) R. Extracti Nucis Vom., . gr. iij. Ferri Reducti, . . gr. xij. Quininae Sulphatis, . gr. vj; Ft. pil. no. xij. Sig.—One after each meal. (Hammond.) R. Zinci Phosphidi, . . gr. iij. Ext. Nucis Vom., . . gr. x. Confect. Rosae, q. s. M. et div. in pil. no. xxx. Sig.—One pill after each meal. (Fordyce Barker.) R. Ext. Cann. Ind. FI., . . j|ss. Pulv. Acaciae, . . . gv. Syr. Aurantii Cort., . . tij. Aquae, . . q. s. ad M. Sig.—Teasp. every 3 hours. Heart Diseases. Aconite, in the highest degree serviceable to diminish excitement or irrita- bility. Is more a remedy for functional derangement than for organic disease (Wa.). In pericarditis (R.). Nervous palpitations and hypertrophy (P., B.). The heart seldom affected in rheumatic fever if aconite be used from the start (P.). Veratrum Viride, as cardiac depressant (B.) ; in chronic cardiac dis- eases where excessive hypertrophy, i. e., when digitalis is contraindicated (W.). Cimicifuga, safer than digitalis in fatty heart (B.). Its action is strongly stimulating and tonic; it relieves excessive dyspnoea when weak heart (P.). Arsenic, for dyspnoea from weak heart (R.); in all cardiac neu- roses it is especially valuable when combined with iron and strychnine, and is regarded as indispensable in all forms of weak heart accompanied by pain 625 HEART, DILATED HEART, FATTY. (Wa.). Digitalis, acts as a stimulant tonic (P.); small doses for its sedative action; tonic or physiological doses to create hypertrophy in dilatation (Tr.); irregularity of pulse is best indication (R-). Irritable heart (Da Costa). The freshly-made infusion the best preparation (B.); especially indicated in weak heart acting rapidly because of its weakness, and in valvular disease (Wa.). Convallaria Majalis, will, usually succeed in all cases in which digitalis is use- ful, acting similarly to that drug, but with less reliability; is useful in aortic disease and in others where digitalis cannot be used (Wa,); valuable in all forms of heart disease where there is oedema of tissues (See). Strychnine, in medicinal doses, said to strengthen heart-beats (R.). Blisters, flying, over prsecordial region, to stimulate action in extreme weakness (R.) Alcohol, brandy when heart suddenly enfeebled by fright, loss of blood, etc. (R.). Iron, useful in various forms, especially anaemic disorders and palpitation. Also in dilatation and fatty heart, and mitral regurgitation (B.). Hyoscyamus, in functional derangement from emotion, is specially indicated ; requires large doses (TTxl-lx), or gr. of hyoscyaminae sulph. hypodermically (Wa.). Amyl Nitrite relieves heart-pains resisting all other treatment. (W.). Morphine, hypodermically, is employed in many cardiac disorders with marked advan- tage, especially in dyspnoea and angina with diseased coronary arteries; mitral regurgitation, with its dyspnoea and insomnia; aortic disease, etc. [Compare Angina Pectoris, Dropsy, Endocarditis, Pericarditis, and the five fol- lowing articles.] Heart, Dilated. Digitalis, where much dilatation, and hypertrophy of left ventricle without valvular disease. Is not contraindicated when aortic disease (R.); physio- logical doses (Tr.). In simple dilatation gives most favorable results (W.). Very useful in mitral disease, with dilatation of the left ventricle (P.) ; gives miraculous relief, is not sufficiently appreciated, but requires skilful adminis- tration. Use the infusion in preference to other preparations, a tablespoonful thrice daily, watching its effects (Da Costa). Scoparius, the infusion (broom- tea), to maintain the kidney action if digitalis is not sufficient (Da C.). Pur- gation, brisk, free watery stools next to digitalis are the best treatment (Da C.). Morphine, hypoderm. gr. two or three times a week in dilated heart with dyspnoea (B.). Amyl Nitrite, dyspnoea from dilatation (R.); is useful when great dyspnoea (cardiac asthma) (P.). Ether, the compound spirit an excellent remedy for the dyspnoea (Da Costa). Heart, Fatty. Iron, the tinct. ferri perchlor. in small doses for a long time, has been of remarkable benefit (Wa.). Cimicifuga, safer than digitalis (B.); the latter should not be used (Wa.). Digitalis of no value except for very tempo- rary use and for some special indication (Da Costa). Strychnine, often the first remedy to do good. Unduly pushed will produce nervous worry and be injurious (P.); is the remedy with iron, nourishing but not fatmaking diet, and wine to keep up the tone of the blood (Da C.). Ergot, occasional doses have been given with apparent benefit (Wa.J. Ether, the compound spirit for sudden attacks of pain or dyspnoea (Da C.). Amyl Nitrite, for the same, but chloral must be entirely debarred (Da C.). Stimulants, freely, in an acute attack of any kind, give the only chance (Da C.). 626 HEART, HYPERTROPHIED—HEART, PALPITATION. Heart, Hypertrophied. Aconite, often better than digitalis (R.); dangerous in hypertrophy of left side, with diseased valves, but useful in simple hypertrophy (P.); for over- action, with hypertrophy (B.); the one remedy which can be depended on. Small doses for months, say gtt. j of a good tincture ter die, to lower the heart gradually and keep it low (Da Costa). Digitalis, very useful in pure hypertrophy due to valvular disease or excessive muscular exertion (R.). The primary action (small doses) required, as it creates hypertrophy when given in physiological or tonic doses (Tr.). Veratrum Viride, as a cardiac depressant (gtt. v ter die) will relieve in simple hypertrophy, and irritable heart from abuse of tobacco, inadmissible when valvular lesions exist (B.); gives the best results, next after aconite (Da C.). Lead Acetate, for violent palpitations, in some instances (Wa.). Amyl Nitrite, vex dyspnoea,syncope (R.). Ergot, in enlarged heart without valvular lesion; may be combined with digitalis (B.). Potas- sium Iodide, small doses long continued, benefit some cases (Wa.). Camphor, in doses of gr. iij-xij daily for tumultuous palpitations, and dyspnoea of hyper- trophy with dilatation (Wa.). Iron is necessary where anaemia exists (DaC.). Quiet Life of great importance, no stair-climbing, no long walks ; rest in bed often of service for days at a time, moderate diet, avoiding fattening foods, meat, and stimulants (Da C.). Prescriptions. R. Ext. Ergotse FI., . . 5iijss. Tinct. Digitalis, . . M. Sig.—Teasp. thrice daily in enlarged heart without valvular le- sion. (B.) R. Spt. Athens Comp,, Liq. Morphinse Sulph. (U.S. P., 1870),. . aa£j. M. Sig.—Teasp. as required for the dyspnoea. Heart, Palpitation. Aconite, for “ fluttering ” of nervous persons, and nervous palpitations (R.); for over-action, with hypertrophy (B.); for palpitation with simple hypertro- phy (P.j. Hydrocyanic Acid, when from dyspepsia (P.). Iron, when due to anaemia, a very frequent cause. Other causes are tobacco, coffee, tea, etc., to ex- cess, dyspepsia, venery, excessive exercise (Da C.). Spigelia Anthelmia, when due to mitral and aortic disease, with much dyspnoea (P.). Digitalis, in small doses as sedative (Tr.); combined with iron in palpitations with valvular disease, or alone in very severe cases (Wa.); suits a large number of cases, especially for temporary purposes (Da C.). Camphor, recommended in nervous palpi- tations (R.). Veratrine, as ointment to chest, when rapid, irregular pulse, hurried breathing, dropsy and lividity, palpitation, inability to lie down (R.). Bromides, in “ fluttering” heart (B.); are useful when tolerated by the stom- ach (Da C.). Hyoscyamus, in nervous, and violent palpitations from excited state of the brain (P.); in large doses, for functional disturbance arising from emotion (Wa.). Belladonna, in small doses, may also be applied externally, when irregularity of rhythm (Da C.). Valerian, nervous, with dyspnoea (P.). Eucalyptus, palpitation and weak heart (B.). Galvanization, of cervical sym- pathetic and pneumogastric, for palpitation (B.). Hot Foot-Bath relieves palpitations (R.). Milk-cure, has been beneficial in irregular action (B.). Ice, to the cardiac region, has benefited many cases; is of chief value when patient can be kept in bed, which sometimes becomes necessary (Da C.). HEART, VALVULAR DISEASE—HEMATEMESIS. 627 Prescriptions. R. Pulv. Digitalis, . . gr. xx. Pulv. Colchici Sem., . gr. xl. Sodii Bicarb., . . gr. lx. M. et div. in pil. no. xl. Sig.—One pill at first 3 or 4 times daily, gradually reduced to one at bedtime. For irreg- ular cardiac action. (Bowditch.) R. Tinct. Digitalis, . . . 5[ij. Tinct. Aconiti, Tinct. Verat. Viridis, . aa 5jj. M. Sig.—Three or four drops thrice daily for palpitation. Must be used with caution, Heart, Valvular Disease. Aconite, useful for the palpitation, but dangerous in hypertrophy of left side with diseased valves (P.); when heart is acting with power (Da Costa). Digi- talis, in aortic regurgitation (R.); most effective in mitral insufficiency (P.); in rapid action with low arterial tension; and in mitral disease. Infusion best; tablesp. doses twice daily (B.); mj of tinct. every y2 hour or hour, often gives more relief than larger doses (A. A. Smith); when heart is weak and struggling (Da C.). Morphine, hypodermically for dyspnoea, better in mitral than in aortic disease (R.). Purging, with jalap, etc., in engorgement of right side of heart (R.); occasionally useful (Da C.). Treatment is directed chiefly to the dilatation or hypertrophy resulting from the valvular disease. The simplest rule is to use judgment as to when the heart needs strengthening by Digitalis or reducing by Aconite or Veratrum Viride (Da C.). [Compare Endocarditis.] Hectic Fever. Quinine, large doses, gr. xv-xx daily, if stomach and intestines don’t rebel (P.); given before the paroxysm, to limit it (Roberts). Morphine and other anodynes, are of especial value, given in full dose towards bed-time (Gross). Prunus Virginiana, the bark has been found useful, especially when irritable cough (P.). Calcium Phosphate, is especially useful (R.). Calumba, excellent for tonic effects (P.). Antipyrin, a midday dose will control the evening rise (Wa.). Digitalis, the tincture, combined with tinct. ferri chloridi, abates the temperature and diminishes the sweats (B.). Iron, the mistura ferri com- posita has obtained great celebrity, especially when much debility and anaemia (Wa.); the sulphate and tincture of the chloride of especial value in the treat- ment of hectic (Gross). Ipecacuanha. A few grains of Dover’s powder at bed-time, will stop the profuse perspirations (Wa.). Salicin, for profuse per- spirations (Wa.); as antipyretic. [Compare Perspiration, Phthisis.] K • Tinct. Digitalis, . . iij. Tinct. Ferri Chlor., . . £v. M. Sig.—15 drops 3 or 4 times a day. (B.) Prescriptions. R. Quininse Sulph., . . gjss. Elix. Taraxaci,. . . giv. M. Sig.—Teasp. every hour for six hours. Hematemesis. Ipecacuanha, is decidedly effective in small doses, also when hematemesis is vicarious of menstruation (P., Wa.). Hamamelis, trij-ij of tinct. every 2 or 3 hours (R.); effective from its tannin (B.). Alum, serviceable in passive hemorrhage; iron better (B.). Turpentine, especially in passive hemorrhage 628 HEMATOCELE, PELVIC—HEMATURIA. with debility (R.); and in hemorrhagic transudations on the free mucous sur- faces—hematemesis, etc. (B.). Ergot, has often cured when other means failed (P.); most valuable. In urgent cases ergotine in 2- to 5-gr. doses hypo- dermically (R.). Iron, the subsulphate (Monsel’s solution) or pernilrate, the best remedies; gtt. j-ij frequently diluted with ice-water (B.). Lead Acetate, especially in gastric ulcer, gr ss-gr. v (B.). Tannic Acid, gr. x-j) j, when from gastric ulcer or obstructive disease of liver (B.). Gallic Acid, an extremely useful agent; is best used in combination with dilute sulphuric acid (Wa.). Ice, small pieces swallowed, a most useful agent, with perfect rest for stomach; when hematemesis from that organ, nutrient enemata must be employed. Iced champagne to arrest faintness, if persistent; when moderate need not give cause for alarm. Prescriptions. R. Olei Terebinth., . . Ext. Digitalis Fluid., . Mucil. Acaciae, . . . Aq. Menth. Pip., . . %j. M. Sig.—Teasp. every 3 hours. R. Ac. Gallici, . . . gj. Ext. Ergota; Aquosi, Digitalis, . . . aa gr. xx. M. et div. in pil. no. xx. Sig.—One every 4 hours. Hematocele, Pelvic. Opium, or morphine, if needed for pain, with absolute rest in bed, and a moderately tight abdominal bandage (E.). Hemostatics, as gallic acid, lead, turpentine, etc., to arrest the hemorrhage, if it be still going on, combined with opiates, and the use of ice-bags or cold lotions to the abdomen or per vaginam. Tonics, as iron and quinine, while resolution of the extravasation is going on. Bromides and Iodides, to quiet the action of the ovaries, if the hemorrhage recurs at different periods. Potassium Iodide, as an absorbent, may be given with quinine (Braxton Hicks). Iodized Cotton, an excellent application to the cervix uteri in cases of hematocele (VVa ). Leeches, should be applied early in cases of peri-uterine hematocele; later, except to check inflammation, they are inadmissible (Wa.), Mercury, gr. of the bichloride thrice daily, with iron and ergot, conjoined with vaginal injections of hot water morning and evening; later in lieu of the mercurial the syrup of the iodide of iron in 20-drop doses thrice daily, was thoroughly efficient treatment in one very bad case of retro-uterine hematocele (Hengst). Surgical interfer- ence has many advocates, but is criminal in a large majority of the cases (E.). If the case does not end in resolution it will terminate in pelvic abscess. R. Iodi, . . . . %]. Potassii Iodidi, . . 2ij. Glycerini, . . • 3 viij. Prescription. Mix and saturate 8 oz. of cotton with the mixture; then carefully dry, and label “ Iodized Cotton.” Hematuria. Turpentine, when with constitutional debility (B.); in very small doses (R.) ; often is very efficacious (P.). [See ante, Hematemesis, for formula.] Hamamelis, has arrested severe cases (R.). Chimaphila, controls hematuria (P.). Gallic Acid, the most uniformly successful remedy (B.); gr. x-xx every h iur or two (Da Costa). Sulphuric Acid, alone or with gallic acid, is an efficient remedy (Da C.). Acetic Acid, in a case of alarming hemorrhage 629 HEMERALOPIA AND NYCTALOPIA HEMICRANIA. from the bladder, which occurred after an operation for vesico-vaginal fistula, and resisted all other means, an injection of apple-vinegar and ice-water, equal parts, succeeded in arresting it (Ghent). Quinine, large doses neces- sary ; cures when intermittent or from malarial infection (B.); useful in some cases of intermittent hematuria (R.). Iron. Tinctura ferri perchlor. iq,x-xx several times daily; in this affection the best form of iron for internal use (Wa.). Ipecacuanha, exercises a powerful influence (Wa.). [See ante, He- matemesis.] Ergot, by stomach or subcutaneously; may be combined with ipecac, krameria, or other astringents (B.). Ergotine, hypodermically, is far superior for efficacy and rapidity of operation (Wa.). Matico, the infusion, in doses of every 2 or 3 hours, is fully equal to gallic acid, lead, etc. (Thomp- son). Ammonium Benzoate, in 5-grain doses, for the albuminuria and hema- turia of scarlatina (Hillier). Cannabis Indica, is especially indicated in dysuria and strangury when there is bloody urine (R-). Camphor, in 2 to 5-grain doses is said to promptly remove the renal hypenemia with bloody, coagulable urine, caused by cantharis, turpentine, oil of mustard, copaiba, etc. (R.). Ice in rectum or to perineum, for vesical hemorrhage (Thompson). Prescriptions. R. Acidi Gallici, . . . Ac. Sulphurici Dil., . . Tr. Opii Deodor., . . X}. Infusi Digitalis,. . . M. Sig.—Tablesp. every 4 hours or oftener. In hematuria, menorrha- gia, purpura hemorrhagica, and the hemorrhagic diathesis. (D.) R. Ext. Ergotae Fluidi, Tinct. Krameriae, . . aa M. Sig.—Ateasp. every hour or two. R. Ext. Ergotse (Squibb), . X). Aquae, . . . •3)- M. Sig.—For hypodermic use ; tq_x contain gr. j. Hemeralopia and Nyctalopia. Strychnine, night-blindness; small doses, gradually increased, of service (Wa.). Mercury. Hydrarg. chlor. corr.gr. ij ad aqua; 3), dropped into the eye twice daily, with blister on each temple, and mild aperients, cured hemer- alopia (Smith). Quinine, in as large doses as can be borne, after cathartic and emetic, for night and day-blindness (Howard). Blisters, small, inches in diameter, close to external canthus of the eye (Bampfield). Elec- tricity, occasionally uselul (Wa.). Rest, protection of eyes from bright light, constitutional remedies, as indicated by state of general health, change of climate, speedily cures hemeralopia. It is sometimes merely a symptom of pigmentary degeneration of the retina, or a feature of scurvy. Hemicrania. Belladonna, when due to vaso-motor spasm, the face being pallid (B.); the tincture in small and repeated doses if the disease be of reflex character (H.). Iris, in blinding form, from hepatic trouble, right supra-orbital region; Tt|j every half-hour (or 3 doses, usually relieves promptly (Pf.). Cannabis Indica, one of the most valuable remedies for megrim or sick headache, apparently acting on the nervous centre whence the disorder springs; is most useful in the intervals to prevent the attacks, and especially when the paroxysms are becoming more frequent; it may be combined in pill with either iron or aloes 630 HEMICRANIA. (R.); in the congestive form of especial value, the tincture in repeated doses until physiological action is induced (H.) ; gr. of the extract before each meal, increased gradually to or Ys grain, 'n the intervals, kept up for 3 months (Seguin'). Camphor, gr. iij-v, with xx or xxx-grain dose of magnesic carbonate, is very useful, especially in hysterical females (P.). Croton-chloral, in milder forms without severe vomiting, headache being predominant; the bromides are useful after it (R.); rarely of any use, but if given it should be in 20-grain doses twice daily (H.). Guarana,\* useful (B.),a very effective palli- ative; gr. xx every for three hours (P.); efficacy diminishes by de- grees, attacks usually become longer (Tr.); of fluid extract in course of an hour or two, to anticipate the attack when expected (Seguin). Caffeine, in typical migraine; gr. j ad npxxv-xxx aqute, hypodermically (P.); is especially adapted when chronic gastric catarrh, gr. j every y£-hour (B.). The citrate in grain doses every hour for some time before a paroxysm (Wa.); gr. j every often gives marked relief (A. A. Smith). Valerian, of especial value when in excitable temperaments; after profuse or painful menstruation (P.). Ammonium Chloride, is exceptionally serviceable; seldom fails to cut short an attack (Austin), x-xv gr. doses (B„ R.) ; as a diffusible stimulant is very efficient, gr. xx up to gj every hour during the attack (H.). Podophyllin or Mercury, bilious origin (R.). Bromides, for true migraine. Raspail’s eau sedatif locally, gives great relief (B.). When due to uterine disorder (R.). Potassium Bromide, very serviceable in the paroxysm, also in continuous form (R.). Eucalyptus, in cerebral anmmia (B.). Digitalin, granules bis die), for congestive hemicrania (B.). Ergot, if due to miliary aneurisms of inter- cranial arterioles; also in congestive migraine, and in nearly all kinds (B.). Menthol, locally in frontal headache due to migraine, is said to be very effi- cient (Wa.). [See formula below.] Piscidia, is highly recommended (Wa.); efficient in doses of £ij of the fluid extract (Ford). Arsenic, for cerebral con- gestion and hemicrania (B.); for throbbing pain in one brow (R.); often has the best effect. Watson believed that gtt. iv-vj of liq. arsenic. 3 or 4 times a day, with due attention to the bowels, would cure 9 out of every 10 cases (Wa.). Aconitine or Veratrine, ointment, over brow (R.); Aconitine is of great service internally (Seguin). Phosphorus, is strongly recommended (R.). Amyl Nitrite, by inhalation, in migraine, with pallor of face (B., R.). San- guinaria, a few doses very successful, when m. due to stomach derangement (P.). Ignatia, removes clavus hystericus (Pf.). ATux Vomica, when of gastric origin (R.). Cimicifuga, is strongly recommended (P.). Rubber Bandage, applied tightly from eyes up, protecting the temporal arteries by pads, or a dry muslin bandage wetted after being put on (Weir Mitchell). Acupuncture, the needle run down to the cranium, will give relief in clavus hystericus, when nothing else will do so (Pancoast). U. Quininse Sulph., . . j^ss. Pulv. Belladon., . . gr. x. Ext. Digitalis, . . gr. xv. Ext. Valeriana;, . . Mellis, . . . . q. s. Ft. pii. no. xl. Sig.—2 to 10 pills daily, gradually increased, during 3 or 4 days before the expected attack. Prescriptions. IJ. Ammonii Chloridi, . . Ammonii Bromidi, . . Sjiv. Spt. Etheris Nitrosi, . sjj. Syr. Pruni Virgin., . . Aquae, . . q. s. ad 3-vj. M. Sig.—Dessertsp. three or four times daily, conjoined with the use of RaspaiFs Eau Sedatif (see page 61), locally. HEMIOPIA—HEMIPLEGIA—HEMOPTYSIS. 631 &. Menthol., . . . 5rj. Alcoholis, . . . gj. Ol. Caryophylli, Ol. Cinnam., . . aa rn.xx. M. Sig.—Apply with finger over seat of pain. R. Aconitinse (Duquesnel), . gr. y Alcoholis, Glycerini, aa %). Aq. Menth. Pip., q. s. ad Jij. M. Sig.—Teasp. thrice daily. (Seguin.) Hemiopia. When established, hemiopia offers little hope of cure, though it has no ten- dency to progress. In hemiopia scintillans, Potassium Bromide gr. xl-lx daily, or band of such metal as idiosyncrasy of the patient may decide, with stimulants to ward off the aura; Quinine, Iron, Hydropathy, when Potassium Bromide fails (De Wecker). Hemiplegia. Strychnine. is most useful when members are relaxed; hypodermically, when paralysis incomplete, and the muscles flaccid but not wasted (B.). [See Paralysis for formula.] Potassium Iodide, gr. x-xviij daily, occasionally proves effectual (Wa.). Galvanism, constant current to the brain or cord, faradic to the muscles opposite those contracted (Hammond). Physostigma, prevents muscle wasting, and hence is given with benefit to hemiplegics; gr. j\y of the extract repeated frequently (R.). Massage, in hemiplegia and other forms of paralysis due to intercranial lesions, when cold and blue skin, wasting and contracted muscles, ulcerations, etc. (B.). Cocculus, in hysterical epileptic, and choreic hemiplegia, acts well; also in hemiplegia from cold (P.). [Compare Paralysis, Facial.] Hemoptysis. Gallic Acid, exceedingly effective (P.); may be combined with ergotin and digitalis. [See Hematemesis and Hematuria for formulae.] Acetate of Lead, with opium (B.); proves signally useful (Wa.). Ergot, the fluid extract in 30 to 40-minim doses, every 3 or 4 hours, or hourly in severe cases; or Ergotin hypodermically for urgent cases, in 2 to 3-grain doses (R.). Opium, should be freely used for the attendant excitement (W.). Turpentine, drachm- doses every 3 hours, may cause unpleasant symptoms which soon disappear on its discontinuance (R.) ; has proved very efficient (P.) ; after other hemostatics fail it is worthy of trial (Wa.). Alum is serviceable in purely atonic hemor- rhages (Wa.) ; in 10-grain doses every 2 hours (B.). Oil of Erigeron, is very efficient when no fever or other signs of constitutional irritation (Wa.). Hama- melis, Tqj-ij of tincture, every 2 or 3 hours (R.); rn.ij-x of fresh tincture sev- eral times a day (Pf.). Ipecacuanha, has been highly praised (R.); in emetic doses (Tr.); arrests as emetic (B.); arrests, though in poisonous doses pro- ducing hemoptysis (P.). Ferric Acetate, a little added to water so as to taste, this constantly sipped (R.). Iron spray will often arrest (B.). Digitalis, has undoubted power over hemoptysis (B.). Small doses daily (P.). Infusion in large doses (R.). Arnica, of great service, if from violence (P.). Aconite, employed with best results (P.). Sodium Chloride, half a teaspoonful of common salt, taken dry, repeated till nausea (R.). Sulphuric Acid, the dilute acid a useful adjunct to other treatment (Wa.). Spinal Hot- Water 632 HEMORRHAGE, HEMORRHAGIC DIATHESIS. Bag, to cervical or upper dorsal vertebrae (R.). Auxiliaries.—Cold exter- nally, acidulated drinks, perfect rest, and antiphlogistic diet (Wa.). R. Ext. Ergotse FI., . . syss. Ext. Ipecac. FI., Tr. Opii Deod., . aa gij. M. Sig.—Teasp. every y hour. Prescriptions. R. Aluminis, . . . gj. Sacch. Alb., . , gss.^ Pulv. Ipec. Comp., . gr. xx. M. ft. pulv. no. vj. Sig.—One ev- ery 2 hours. [Skoda.) R. Plumbi Acetat., . . gr. xx. Pulv. Digitalis, . . gr. x. Pulv. Opii, . . . gr. v. M. ft. pil. no. x. Sig.—One every 4 hours. (B.) R. Liq. Ferri Subsulph., . n\.xx. Aquae, . . . . gij. M. Sig.—Use as spray by inhala- tion every hour for 5 minutes. Hemorrhage, Hemorrhagic Diathesis. Acids. Sulphuric sometimes very effective in uterine hemorrhage (B.). Dilute Vinegar to leech-bites, piles, cuts, etc. (R.). Apple- Vinegar as injec- tion for vesical hemorrhage. [See under Hematuria.] Iron, when hemor- rhagic diathesis due to anaemia; the tincture of the chloride preferred (B.). The tincture of ferric perchloride as styptic (Wa.) ; i or 2 teaspoonfuls of the concentrated solution in a glass of water, an excellent hemostatic (Tr.). The acetate, just enough to make water taste, in hemorrhage of lungs and kid- neys (R.). Ergot, in uterine hemorrhage of any kind, and many forms of hemorrhage, ergot or ergotine of great value (P.); not to be relied on alone (B.). Alum, is sanctioned by high authority (B.); dusted on in slight cases (R.); in uterine and traumatic hemorrhage, when small vessels open (Tr.). Hamamelis, TRj-ij of tincture every 2 or 3 hours, effective in many forms (R.). Ipecacuanha, produces hemorrhage in poisonous doses, yet has great energy in arresting it (P.); exercises a powerful influence on internal hemorrhage generally, and in exhaustion therefrom; gr. j-ij every hour (Wa.). In emetic doses serviceable (Tr.). Turpentine, few agents more useful in the passive forms (B.); small doses in hematuria (R.) ; for serious hemoptysis, and hemorrhage of typhoid (P.). Belladonna, hemorrhage from rectal ulcers (P.). Digitalis, in uterine, and many other forms, of great value (P.) ; with restoratives has undoubted power in the hemorrhagic diathesis (B.). [See HEMOPTYSiS.] Chimaphila, controls he- maturia (P.). Gallic and Tannic Acid, in all passive hemorrhages, especially in that of the bladder (P.). Tannic Acid for local use, Gallic for systemic effects upon remote parts. When hemorrhage occurs in relaxed and debili- tated constitutions, Gallic Acid may be combined with Ergot and Digitalis (B.). Matico, proves useful in many cases, especially menorrhagia, hematuria and hemoptysis (Wa.). Nux Vomica, in hemorrhagic diathesis, especially when occurring in anaemic subjects. Also the syrup of iron, quinine, and strychnine; no prescription more generally useful (B.). Aconite, to reduce the circulation, in epistaxis, hemoptysis, etc. (P.). Cinchona, internally, very efficient in some forms of hemorrhage (Tr.). Copper Sulphate, in stick, solu- tion, or ointment, to arrest hemorrhage from small vessels (R.). Arnica, in hemorrhages (ecchymoses), from mechanical violence (P.). Rhatany, the extract, one of the most powerful hemostatics (Tr.). Grape-cure, as tonic for HEMORRHAGE, POST-PARTUM. 633 convalescents (P.). Alcohol, in hemorrhagic diathesis, to elevate the arterial tension (B.); brandy, wine, when heart suddenly enfeebled by hemorrhage (R.). Venesection, wrill promptly arrest pulmonary hemorrhage (B.). Styp- tics, are either needless or inefficient, hence practically useless in general surgery; hemorrhage should be controlled by either pressure or ligation (Roberts). Hot IVater, sponged over a bleeding surface, the best agent to stop hemorrhage (Gross). Transfusion, when death imminent (B.). Ice, in- ternally in wounds or hemorrhage of lungs, or from stomach; small pieces frequently (R.). Rest. Perfect rest often indispensable, especially in hema- temesis, in which nutrient enemata may be required. [Compare Dysentery, Epistaxis, Hematemesis, Hemoptysis, Hemorrhoids, Hematuria, Hem- orrhage Post-partum,—Intestinal, Menorrhagia, Metrorrhagia, Purpura, Wounds, etc.] Prescriptions. Pagliari's Styptic. R. Tinct. Benzoini, . . ,^viij. Aluminis, . . .lb. j. Aquae, . . . . lb. x. Boil 6 hours in a glazed earthenware vessel, adding hot water in lieu of that vaporized and keeping well stirred; filter, and put up in stoppered bottles. Pancoast's Styptic. R. Potassii Carbonat., . . gij. Saponis, .... ij. Alcoholis, . . . 3 iij. Mix and use as a styptic, especially for operations about the face. (Jos. Pancoast.) R. Infusi Digitalis, . . Ext. Ergotse Fluidi, Tinct. Kramerioe, . aa 5J. M. Sig.—A tablesp. as required in hemorrhagic conditions generally. (B.) R. Ext. Ipecac. FI., . . gij. Ext. Ergotse FI., . . £iv. Ext. Digitalis FI., . . gij. M. Sig.—Half-teasp. to a teasp. at a dose, repeated as required. An excel- lent anti-hemorrhagic combination. (B.) Hemorrhage, Intestinal. Turpentine, should be used (B.); especially in typhoid (P.). [See Hf.ma- temesis, for formula.] Belladonna, for irritable and bleeding rectal ulcers (P.). Iodine, in passive, gtt. j-ij of tinct. frequently repeated, of great ser- vice (B.). Sulphuric Acid, is serviceable (B.). Acetate of Lead, often of great service, especially when used as an enema (Jenner). Tannin, one of the most serviceable remedies for the intestinal hemorrhage of typhoid fever (B.). Hamamelis, very effective in intestinal hemorrhage, owing to its large proportion of tannin (B.). Ergot is most valuable; may be given hypoder- mically in urgent cases (R.). Gallic Acid, gr. xv with gtt. iij-v of laudanum, in a winegl. of iced water, every 2 or 3 hours in the hemorrhage of typhoid (Jenner). Opium, a valuable adjunct to astringents, allaying the nervous ex- citement (Wa.): is most useful (Da Costa). [Compare Hemorrhoids, Dys- entery, Typhoid Fever.] Hemorrhage, Post-Partum. Hamamelis, for persistent oozing (R.). Ipecacuanha, in flooding after de- livery (R.). Iron, Monsel’s solution, j-iij of water, strong enough and safe 634 HEMORRHOIDS. as injection (B.); the perchloride diluted (R ). Amyl Nitrite, ntv by inha- lation, has stopped a hemorrhage promptly and permanently (Kerr). Ergot, a full dose of the fluid extract as soon as birth is completed as a prophylactic (Playfair); hypodermically in urgent cases, gr. ij of Bonjean’s Ergotine deeply into the tissues of the arm (Wa.): gss doses of the fluid extract every 4 hours in secondary hemorrhage. Cimicifuga, will check post-partum hemorrhage, especially when tediously prolonged (P.). Digitalis, the infusion best; a tablesp. bis die, or in urgent cases every half hour for 4 doses (B.). Nux Vomica, gtt. xx ; ext. ergot, fl. gtt. xxx; each hour for 2 or 3 doses (B.). Opium, the tincture %j, with brandy, in profuse flooding (R.). Vinegar, a handkerchief soaked in vinegar and carried into the uterus, will often check a severe hemorrhage (Landis) : is antiseptic, astringent and sufficiently irri- tating to produce contraction, yet not so irritating as to cause subsequent mis- chief, and always acts promptly (Penrose). Tamponade by absorbent cotton, plugs of linen, etc., is indicated in hemorrhage from abortion or placenta prsevia (Parvin); never tampon after delivery ! you might as well hang the woman by the neck (Wallace). Auxiliaiy Measures of importance are firm pressure on the uterus, compression of the abdominal aorta, the plug, andif necessary intra-uterine injections (Wa.). Hot Water, no° to 122° F.,inje renders incontestable servicg (B.). In pneumonia, tonsillitis, pleurisy, bronchitis, and other inflammatory affections (R.). Pulsatilla, in acute and subacute inflammations with muco- purulent discharges, especially of eyes, ears, and nasal passages (P-); also with aconite in epididymitis (Pf.). Mercury, in acute glandular inflammation of throat and neck, in ileo-colitis, iritis, syphilitic inflammations of serous 646 INFLAMMATION. membranes, laryngitis (B,, R.). Silver Nitrate, locally in strong solution, gr. clx to gj of distilled water, painted over surface and beyond, after thorough cleansing and drying; no agent so safe, powerful or efficacious in subduing external inflammation (Higginbotham). A strong solution in nitrous ether is a most efficient application to check inflammation in superficial parts, as boils, felons, orchitis, synovitis, erysipelas, erythema, eczema, etc. (B.). Iodine, as liniment in vicinity of local inflammation to produce vesication (R.). Sulphides, especially that of calcium (doses gr.) appear often to arrest sup- puration. After formation of pus they hasten maturation and circumscribe inflammation. In boils, abscesses, and deep-seated suppuration, they improve the condition and promote healing (R.). Antipyrine, Kairine, and other antipyretics. See under the title Fever. Alkalies, especially ammonium and potassium salts, are very valuable in the stage of exudation (B.). As- tringents, locally in inflammations of mucous membranes (R.). Lead, the liquor plumbi subacetatis dilutus as a soothing and astringent application to inflamed and erysipelatous surfaces (Wa.) ; to eczema and other inflammatory diseases of the skin (Pf.). For Leadwater and Opium formulae see page 493. Digitalis, the German antipyretic, is especially useful in pneumonia, bronchitis, rheumatic fever and scarlet fever (B.). Aconite safer and better (R.); locally and internally is useful in inflammations, especially those of joints, of breast, erysipelatous and varicose ; a fomentation of a teasp. of the dried leaves in half a pint of boiling water, or gj of tincture to the same quantity of water, applied by flannels to the part, will quickly subdue (Fair- bank). Quinine, in peritonitis (Tr.). It is indicated in most acute forms, unless objections occur (P.). Has power to arrest inflammation in formative stage. With morphine and in full doses (gr. xv-xx) may suppress many forms (B.). Chloral, excellent when temperature is high, much delirium; gr. v every 3 hours (B.). Opium, is important in most inflammations, but especially those of serous membranes; a full dose (gr. % of morphine) at first, smaller doses after. Is especially curative in inflammation of intestines and peritoneum, and of cerebro-spinal meningitis, arachnitis, etc. (B., R.). Saline Purgatives, valuable as part of the denutrition treatment, and to di- minish arterial tension (B.). Salicylic Acid is antipyretic, especially in septi- Csemic inflammation, and acute rheumatism, erysipelas, pneumonia (B.). Sali- cylate of sodium more soluble (R-). Colchicutn often exercises a happy in- fluence over certain acute inflammations, as bronchitis, conjunctivitis, etc., especially if occurring in gouty subjects (P.). Cocaine, locally in commenc- ing inflammations of mucous surfaces, to constrict the bloodvessels of the part (R.). Pilocarpus gives good results in the exudative stage of pleuritis, iritis, keratitis, etc. (B.). Cold, by ice in bags, or cold water, a very useful agent. Heat, by hot water, fomentations, etc., often much better. Ice, in small pieces in a bladder applied to inflamed part (R.). Water, cold and hot baths and packing very useful in all inflammations (B.). Alcohol is constantly prescribed, and is of value in low states, if symptoms after its administration are ameliorated (B.). [See Fever.] Poultices, useful in many inflammatory states, but often abused (B.). To check formation of pus and assist in matu- ration (R.). Venesection, when pulse hard, strong, full and frequent, a pleth- oric state of the system and great intensity of morbid action; if required the earlier it is done the better (Gross). Leeches very useful in many forms where sthenic reaction and plethora. Value of blood-letting probably due to de- rivative and counter-irritant effect (B.) : a remedy of great power for good or evil, now much neglected (Wa.). Local bleeding by leeches, cups, scarifica- tion, etc,, should generally be preceded by some form of general depletion INFLUENZA. 647 (Gross). Aliment, when no inflammation of digestive tract, use milk and beef-tea alternately every 3 hours. No starches or fats. In intestinal inflam- mation, milk, eggs, animal broths, oysters, fish, but must be used with great caution. Skim-milk treatment (B.). Cod-liver oil in many chronic inflam- mations, as of heart, lungs, kidneys, etc. (R.). [Compare the various titles, as Bronchitis, Pleuritis, etc., also the list of Antiphlogistics, on page 422.] Prescriptions. R. Tinct. Aconiti, . . . £j. Tinct. Belladon., . . tjij. M. Sig.—Three or four drops in water every hour. (B.) R. Ant. et Pot. Tart., • gr. ijss. Magnesii Sulph., . !|ij. Morphinae Sulph., . gr. ]y£. Ac. Sulph. Aromat., . gss. Tinct. Verat. Virid., . Syr. Zingiberis, . . Sij. Aquae Destill., . . §x. M. Sig.—Tablesp. every 2, 4, or 6 hours. Antimonial and Saline Mix- ture. (Gross.) R. Ammonii Chloridi, . . gv. Acidi Acetici, Alcoholis, . . . aa Zx. Aquae, . . q. s. ad gx. M. et fiat lotio. Evaporating and discutient lotion. [See pages 493 and 494 for Lotion and Liniment formulae.] Influenza. Sulphurous Acid, by fumigation or inhalation, a few drops on boiling water or as a spray, often controls (R.). Tartar Emetic has been recommended strongly, but is too depressant (Wa.). Quinine has been used beneficially throughout the disease, especially after the acute stage, for neuralgic pains (Wa.). Ammonium, the liquor ammonii acetatis, combined with nitric or chloric ether, is often of great service (Wa.). Sanguinana, used with much benefit (Wa.). Cimicifuga has been given with much success (R.). Spirilus Etheris Nitrosi, in doses of zj-jss, in any convenient vehicle, is a popular and efficacious remedy (Wa), Cocaine, a 4 per cent, solution snuffed up nostrils or applied by spray-producer, very efficacious in the early stage (R.). Cubebs, zss or doses of the tincture in y^-glass of linseed tea thrice daily, for the subsequent cough, often curing like a charm (R.). Opium, best avoided in early stage, but later for the cough, with ipecac., gives great ease. Dover’s powder, with nitre and lobelia is a good form (Wa.). Potassium Nitrate, nitre largely diluted, as lemonade, gj-ij in the course of the day, proves highly useful (Wa.). Turkish Baths have been employed with marked advantage (Wa.). Hot Fomentations, for headache (R.). Benzoin, the compound tincture, gss-j, inhaled from a pint of hot water frequently (Da Costa). [Compare Bronchitis, Catarrh, Hay- Fever.] Prescriptions. R. Ext.-Ipecac. FI., . . gij. Tinct. Opii Deod., . . giv. Tinct. Aconiti, . . %j. M. Sig.— Five to ten drops every two hours. For the bronchitis. R. Ammonii Chloridi,. . gjss. Morphinse Sulph., . . gr. ij. Tinct. Sanguinarise, Syr. Ipecac., . . aa 3*v- Mist. Glycyrrh. Co., Aquae, . . . aa M. Sig.—Teasp. as required for the cough. Each dose has of Morph. Sulph. gr. TV R. Ext. Cimicifugae FI.,. . t^ss. Tinct. Opii Deod., . . Syr. Tolutani, . . . gxj. M. Sig.—Teasp. every four hours. 648 INSOMNIA. Insomnia. Chloral, the best hypnotic (gr. xv-xx), quite unrivalled. Cautiously in de- lirium tremens, which see (B.). In many forms of sleeplessness (R.); acts best in cases which are of purely nervous type (Wa.); in combination with alcoholic preparations, especially if potassium or sodium bromides are present, it is apt to separate to the top as an alcoholate. See ante, page 136. Croton Chloral, 5jj may be given (R.). Potassium Bromide, when from cerebral overaction, gr. xv before each meal, and gr. xxx on retiring. Cumulative effect (B.). It increases hypnotic effect of hyoscyamus, belladonna, cannabis indica, ether and chloroform (R.). Hyoscyamus, an effective substitute for opium in children, :jij-Sj of tinct. necessary, and without danger (B.); when opium disagrees (R.). Belladonna, hypnotic in some morbid states, especially those marked by prostration, low arterial tension, contracted pupils. Atropine, gr. to -fa (B.). Paraldehyde, in doses of rn.xxx-1, is an efficient hypnotic with little or no depressing action on the heart (R.). Ignatia, for sleepless- ness from nervous erethism, better than morphine (Pf.). Gelsemium, in simple wakefulness (B.); and in that of drunkards, mania and over-excite- ment (R.). Coffee, insomnia from lowering of nervous power, and chronic alcoholism (P.). Opium, Morphine the best form, gr. ss, when pain (B.). Codeine and Narceine, also hypnotic, should be given to act at natural time for sleeping (R.). Sumbul, nqxxx-xl of tinct. with a little chloric ether, very efficient in the insomnia of chronic alcoholism (P.). Tartar Emetic, and opium, very effective when due to cerebral congestion, and when opium stimulates (B.). Ether or Chloroform in a full dose (R.). Phosphorus, nutri- tion inactive. Insomnia of the aged (B.). Humnlus, a hop-pillow effective (B., P ); tinct. lupulince, as cerebral sedative (B.). Cocaine has been used with some success (Wa.). Chamomilla, T?ij of the tinct. every quarter- hour, an excellent sedative for children (A. A. Smith). Cannabin Tannate, in 8-grain doses, a good hypnotic (Fronmiiller); very inefficient (W.). Can- nabis is very uncertain in its action (R.). Alcohol, if from cerebral anaemia, a full dose of whiskey or brandy; or in some a glass of ale or beer answers better (B.). Water, a tepid bath just before retiring often effective. When head is hot, cold to it, and tepid bath to the body (B.). [Compare Nervous- ness; also the List of Hypnotics on page 403.] Prescriptions. R. Paraldehyd., . . . gijss. Alcoholis (90 per cent.),. 3jss. Tinct. Vanillae, . . £ss. Aquae, . . . . pj. Syr. Simplicis, . ad 3iv. M. Sig.—A teasp. or two every hour until sleep is obtained. ( Yvon's Hypnotic Elixir.) R. Potassii Bromidi, . . sjiv. Chloralis Hydrat., . . giij. Tinct. Asafoetidae, . . Syrupi, .... gvj. Aquae, . . q. s. ad pv). M. Sig.—Tablesp. every 2 hours until sleep is induced. In the insom- nia of hysteria. R. Chloralis Hyd., . . Potassii Brom., . . giij. Tinct. Opii, . . • 3j- Syr. Aurantii Cort., . . giij. Aquae, . • . ad ppj- M. Sig.—Teasp. dose. May be repeated if necessary. [Kane.) R. Potassii Bromidi, Chloralis Hydrat., . aa 3;ss. Syr. Pruni Virgin., . . ?j. Aquse, . . q. s. ad M. Sig.—Teasp. in a winegl. of water. Repeat in one hour if neces- sary. INTERMITTENT FEVER. 649 Intermittent Fever. Cinchona. Quinine as prophylactic, gr. v-x each morning in black coffee; begin with gr. v, add gr. j each week (R.). In ordinary intermittents give 6 or io grain doses up to 20 or 30 grains, so as to have it all in 4 or 5 hours before the expected paroxysm; give the sulphate and in solution to get its full action (Da Costa). For acute ague, gr. x in sweating stage, and same 5 hours before next paroxysm, and gr. x-xv at the septenary periods, until the third has passed. In pernicious form, gr. xx-xl are required, by stomach, rectum or skin, to secure safety of patient. Best in combination with morphine, and with continuous administration of arsenic during intermissions. May be given in solution by rectum, or hypodermically (B., R.). Is almost specific in inter- mittents when uncomplicated, and of recent origin (Wa.). Chinoidine may be used as a substitute for quinine in doses twice as large (B.). Cinchonine, Cinchonidine, Quinidine, the sulphates of these alkaloids are scarcely, if at all, inferior to quinine as therapeutical agents. (Report of the Madras Commis- sion, 1866.) Average dose of each, gr. x (Wa.). Salicylate of Cinchonidine, promises well as an antiperiodic (B.). Opium, as morphine, gr. Ye-1/, hypo- dermically, not only lessens the chill but aids the action of the antiperi- odic; is to be strongly urged (Da Costa); is useful in the pernicious variety, in combination with quinine (B.). Arsenic, the best remedy next to quinine, especially useful in long-standing agues, of quartan type (R.). Useful as adjunct to quinine daily, to prevent relapse. Most important in chronic ague, with iron; also as prophylactic small doses of Fowler’s solution (B.). Capsi- cum, the resin of black and red pepper, as adjuvants chiefly (B.) ; promotes action of quinine (Pf.). Nux Vomica, has been used with success, but now used as adjunct to quinine (B.); good in convalescence (P.); has antiperi- odic virtue not inferior to quinine. Strychnina; gr. , equals gr. j of quininse sulphas (Wa.). Hydrastine, stands next after arsenic; same indications as quinine (B.); in doses of gr. ij-ix is strongly recommended (P.). Pilocarpine, gr. Y of the muriate, in the cold stage, is strongly recommended by high authority, to excite profuse perspiration and thus lessen the attack (Da Costa). Apiol, when prejudice exists against quinine. Gtt. xv during an hour, in divided doses, 4 hours before paroxysm (B.); is one of the minor remedies which often prove successful in mild cases (Wa.). Salicin, as substitute for quinine, but inferior (B.); grs. x-lx, in mild cases (P.). Chloroform, to pre- vent an impending paroxysm; (?, ?) before the chill, or by inhalation (B.). Narcotine, gr. ij-v ter die, is eminently antiperiodic. No drug (except quinine) cures intermittents so rapidly and surely, or with more freedom from disagreeable effects (Wa.); said to be superior to quinine (R.). Nitric Acid, full doses every 4-6 hours (B.). Sodium Chloride, in large doses during the apyrexia, may occasionally prove efficacious (Wa.). Eucalyptus, during convalescence (B.); has been successfully used in treatment of ague, gj-ij of a tincture (Wa.). Carbolic Acid, in 4-grain doses with infusion of ginger, cured a series of 8 cases which had resisted quinine (Wa.); its value established; Tqss-ij in mint-water; or gr. Y >n ttixx of water,hypodermically (Tessier); combined with iodine is of great value in chronic malaria, and in acute cases after quinine has stopped the paroxysm (B.). Mercury, uncalled for in ordinary cases; but hydrarg. cum creta, quinine and rhubarb of service in obstinate intermittents of children in tropical regions (Wa.). Sodium Hyposulphite, gr. xv-xx every two hours is said to cure (R.). Cascarilla, Chamomile, Quassia, used (R.). Gentian, is valued chiefly as vehicle (P.). 650 INTERMITTENT FEVER. Emetics, may cure many cases; one each morning will assist the action of quinine. Ipecacuanha preferred to antimony (R.); only at commencement, inadmissible if gastric irritation (Wa.). Antimony, at the onset, and continu- ously in mild, uncomplicated cases. Tartar Emetic, gr. everT 2 hours, has been followed by complete cures (Moore). Antipyrine, is useless (Falken- heim). Resorcin, and similar agents, have no specific action, merely control- ling the pyrexia (Wa.). Warburg's Tincture is a remedy of great power, but produces such severe diaphoresis as to be dangerous to adynamic subjects (Prof. Maclean). Purgatives, in the intermission, before using the antiperi- odic, is good practice; podophyllum, colocynth or jalap (Da Costa). Iron is valuable in chronic cases; the system should be thoroughly saturated with it (Da C.). Ergot, for the enlarged spleen (Da C.). [Compare the title Mala- ria ; also the List of Antiperiodics on page 422.] Prescriptions. R. Quininse Sulph., . . gr. Ixxx. Mucil. Acacise, . . Syr. Eriodyctii Aromat. (Parke, Davis & Co.), vel Mist. Glycyrrhizae Co., vel Syr. Zingiberis, q. s. ad M. Fiat emulsio. Sig.—A teasp. contains gr. v of Quin. Sulph. Sus- pension of the quinine without dis- solving it makes the bitter taste less perceptible (Squire), and the Syrup of Yerba Santa covers the taste well. [Potter.) R. Quininse Sulphat., . gr. Ixxx. Ac. Sulph. Diluti, . q. s. Spt. Etheris Nitrosi, . Syr. Tolu, Aquse, ad M. Sig.—A teasp. contains gr. v of Quin. Sulph. [Da Costa.) R. Quininse Sulphat., . £j. Ac. Hydrobrom. Dil.,. gij. Aquse, . . . gxiv. M. Sig.—A teasp. contains gr. of Quin. Sulph. The acid directed pre- vents the unpleasant cerebral action. (B.) R. Ac. Carbolici, • . gj. Tinct. Iodi Comp., . M. Sig.—4 drops every 4 hours in sufficient water. (B.) R. Quininse Sulph., . Pulv. Acacise, . . t^ss. Syr. Zingiberis, . Jiv. M. Sig.—A teasp. contains one grain of Quin. Sulph. A good form- ula for children, the quinine being suspended, not dissolved. R. Massoc Ferri Carb., . gj. Ac. Arseniosi, . . gr. j. M. Ft. pil. no. xx. Sig.—One thrice daily in chronic ague. (B.) R. Quininse Sulph., . . gr. xl. Ferri Sulph. Exsic., . gr. xx. Ac. Arseniosi, . . gr. j. M. Ft. pil. no. xx. Sig.—One thrice daily. (B.) R. Quininse Sulph., . . gr. xxx. Capsici, . . . gr. xv. ()pii Pulveris, . . gr. iij. M. Ft. pil. no. xxx. Sig.—One to five pills as required. (Piffard.) INTERTRIGO—IRRITABILITY. 651 Intertrigo. Bismuth, nitrate or carbonate, as dusting powder (R., B.). Tannin, the glycerite, excellent (R., P.). Camphor, added to dusting powders, to allay heat and itching (R.). Lime water, to obviate irritating urine (R.). Soap, free ablution with, when caused by acid secretions; use greasy applications after- wards (R.). Boracic Acid, as ointment, gjss to 5j of vaseline, a very useful application (Wa.). Glycerin, with tragacanth, etc. [See under Herpes for formula.] Calomel as ointment, 2[j to is especially useful (Wa.). Zinc Carbonate. Calamine is a good dusting powder; so also is the oxide, or fuller’s earth. Intestinal Obstruction. Opium, even ]/2-grain doses every 4 hours, for 2-4 days, arrests dangerous symptoms, and brings a painless purgation (Brinton, P.). Morphine, endermi- cally (Wa.). Belladonna, often successfully employed (P.): gr. every few hours, when from want of tone and partial spasm (Tr.). Strychnine, occa- sionally beneficial; cautiously in acute cases (Wa.). Mercury. A full dose of calomel, followed in a few hours by castor oil, and a turpentine enema, affords relief (Wa.). Caffeine acts upon the muscular tissue and often proves of the utmost value (Wa.). Senna, the infusion, in doses of forms an efficient purgative (Wa.). Purgation to be refrained from (Brinton). Enemata, insufflation and surgical measures are often necessary. [Compare Constipa- tion, Intussusception, Hernia.] Intussusception. Belladonna, gr. iv of extract in an enema, has been successfully used (Wa.). Opium, in full doses carried to narcotism, has been successful in many cases (Wa.); must be used freely to prevent inflammation (Macleod). Effervescent Enemata, have been employed with success (B.). Tobacco Enema, may over- come, and has proved exceedingly effective, but is dangerous. Produces most depressing nausea. Not safe to use more than of the infusion ; jj-Oj (B.). Inflation of intestines with air (Hippocrates) seems a most reasonable mechan- ical remedy. Irrigation by hydrostatic pressure is resorted to with success. Requires care and gentleness (B.). Hot water (Wa.); ox-gall, gr. x-xxx in the solution used, is especially efficient in cases arising from partial paresis of the bowels (Hawkins). The knee-chest position is the best during irrigation or inflation. [Compare Hernia, Typhlitis.] Irritability. Ignatia, in small doses diminishes, in large doses excites irritability of cerebro-spinal axis. The remedy par excellence (Pf.). Chloral, gr. v, 2 or 3 times a day, in irritability with nervousness and restlessness (R.). Chamomilla, is an excellent sedative for children, in doses of mj of the tincture every hour (A. A. Smith). Opium, gives calm to the nervous system if used in medium doses. Strychnine, in functional irritability of the nervous system. [Compare Insomnia, Nervousness.] 652 IRITIS—JAUNDICE. Iritis. Belladonna, locally and internally (R.) ; tn. v every 3 hours, also lotion of extract to ijiv aquae), is of great value (P-). Atropine (solution gr. iv ad has a wide field of utility, as mydriatic (B.); should never be omitted (C.); is essential in the treatment of every form, should be applied early in the case and persevered in throughout its continuance (Lawson). Mercury, when of syphilitic origin, as it usually is (B.); the bichloride is of great ser- vice (R.). In plastic iritis of original severity, or in cases aggravated by im- proper treatment, mercury is imperative, gr. ij of blue pill twice a day, until blue line on gums (C.). Duboisine, as substitute for atropine, is more rapid for effecting dilatation, less irritating to the conjunctiva, and has less perma- nent after-effects (B.). Turpentine, in so-called “ rheumatic iritis” is very successfully used; small repeated doses (P.). Opium, when much pain, an indispensable adjuvant. Morphine, hypodermically (C.). Copaiba, pp) in mucilage, thrice daily, gives excellent results in iritis and sclerotitis, diminish- ing pain in 24 to 48 hours, and restoring sight (Hall). Quinine and Iron, when the patient is feeble or anaemic. Irritants, or astringents should never be employed (C.). Surgical. Paracentesis when increased tension. Core- lysis when only one or two adjacent adhesions. Iridectomy. Complete func- tional rest to the eyes, by atropine and a bandage with compression-pad, an absolute necessity during the whole period of treatment (C.). [Compare Syphilis.] R. ITydr. Chlor. Corr., . . gr. j. Potassii Iodidi, . . %j. Tinct. Calumbse, . . 5ij. Aquae Destil., . . ad M. Sig.—A dessertsp. in a wine- glass of water, 2 or 3 times daily. (Lawson.) Prescriptions. R. 01. Terebinth., . . . Syr. Acaciae, . . . Sjss. Aquae Cinnamomi, . . Jss. M. Sig.—A tablesp. 4 or 5 times daily. R. Extracti Belladon., . . Ung. Hydrargyri, . , j|yj. M. Sig.—For inunction to brow. Jaundice. Mercury, in attacks with depression, sickness and coated tongue, gr. of gray powder taken at onset, and repeated three or four times a day, very valuable (R.). As purgative in jaundice from both deficiency and excess of bile, singularly enough (B.). Gray powder with ipecac, followed next morn- ing by castor oil, is well adapted to the jaundice of infancy and childhood (Wa.), Mercurials and podophyllum are better avoided, especially in obstruc- tive jaundice, unless very marked indications for them exist ( Da Costa). Cel- andine, was formerly employed as deobstruent (P.); energetically affects the liver (Pf.). Hydrastis, useful if continued for some time, in jaundice from catarrh of ducts (B ). Arsenic, has been used with success in jaundice from catarrh of bile ducts after catarrh of duodenum. Better for jaundice of ma- larial origin (B.). ATitro-Hydrochloric Acid, internally, and acid bath to right hypochondrium; temperature of bath 96°, giij-gall. j (B.); when jaundice depends on torpor of the liver, or is catarrhal in origin (W.); during conva- lescence, Tttv-x of the dilute acid in jj of a compound elixir of taraxacum before each meal (Da Costa). Quinine, when due to malarial miasm, or when JOINT AFFECTIONS. 653 periodic (B.). Euonymin, an hepatic stimulant of especial power (B.). Po- dophyllum, in catarrhal and malarial jaundice (B.); when stools exhibit no trace of bile, one dose has cured (Wa.). Best avoided, unless markedly in- dicated (Da C.). Sodium Phosphate, no remedy superior in jaundice from catarrh of gall-ducts; gj doses every four hours for adults: gr. for chil- dren (B.). Manganese, in jaundice from malarial origin, or catarrh of biliary passages (B.). Aloes, for simple jaundice of an atonic kind (B.); when hypo- chondriasis (P.). Rhubarb, for above maladies in children; white or clay- colored pasty stools; skin jaundiced (B.). Saline Purgatives to depurate the upper bowel, as Rochelle salt; with alkaline baths, diaphoretics and diuretics (Da C.). Ammonium Iodide, gr. j-iij in water every 2 or 3 hours in catarrh of bile ducts and jaundice. Also Ammonium Chloride, with fluid extract of taraxacum (B.). The Chloride, in 20-grain doses every 4 hours, produces a decided change (Wa.). Stillingia, relieves jaundice and torpid liver follow- ing intermittent fever (B.). Dulcamara, employed with advantage (P.). Iris, in malarial jaundice and that from duodenal catarrh (B.). Alkaline Mineral Waters, especially in catarrh of duodenum or bile-ducts (B.). Potassium Salts. The Chlorate in chronic or asthenic jaundice. The Sulphate the most useful saline purgative in jaundice (Wa.). Aliment. No starches or fats. Milk, eggs, oysters, beef-broth, broiled or raw beefsteak, or whitefish (B.). Plenty of green vegetables at each meal, use cold water freely, avoid all high seasoning in food, and all liquors. [Compare Hepatic Cirrhosis, Hepatic Diseases, Calculi.] Joint Affections. Aconite, for pains in inflamed joints (R.); the liniment locally in chronic arthritic swellings (Wa.). Mercury, the oleate in chronic inflammation of the knee (R.). Diluted Ung. Hydrarg. Ammoniat. f) to 5jiv at first, then 5|j to zj, by gentle friction 2 or 3 times daily, in chronic articular inflammations by far the best application (P.). Rhus Toxicodendron, internally and as lotion, is invaluable for subacute stiffness and aching of joints after acute rheumatic fever (P.). Iodine, giij-vj ad glycerini aq. destil. in numerous ob- stinate cases of joint affections consequent on rheumatism (Wa.). Ferric Iodide, with Iodine locally, in scrofulous affections of the bones and joints (Wa.). Iodoform has been used with satisfactory results in scrofulous affec- tions of the joints and bones by many continental authorities (Wa.). Arsenic, often serviceable in rheumatoid arthritis and nodosity of joints. Large doses continued necessary (R.). Alcohol, and water, equal parts, an excellent evapo- rating lotion (B.). Silver Nitrate, a strong solution in nitrous ether is the most efficient application to check inflammation in small joints if applied early to adjacent vascular parts (B.). Cod-liver Oil,vc\ strumous subjects (R.j : the remedy on which most reliance may be placed in scrofulous joint affections (Wa.). Cold Douche, Galvanism, Turkish Baths, for stiff joints (R.). Digi- talis, as fomentation, 5|j of tincture to Oyi boiling water, applied on flannel, has proved very efficient in acute inflammations of the joints (Fairbank). Turpentine, the liniment a serviceable application in chronic enlargement of the joints (Wa.). Sulphuric Acid, as irritant ointment, 2[j of acid to gj of lard, very beneficial in chronic diseases of joints (Wa.). [Compare Bursitis, Coxalgia, Gout, Rheumatic Arthritis, Rheumatism, Synovitis.] 654 KERATITIS—LABOR. Keratitis. Atropine, renders great service by contracting vessels (B.). Atropine by instillation, with enforced disuse, and a protective bandage, should be re- garded as measures of course (C.). Mercuric and ferric perchlorides, with cod-liver oil, will accomplish all that medicine can do for interstitial keratitis in syphilitic subjects (C.). Calcium Sulphide, proves most useful in doses of gr. to \, thrice daily, in sugar-of-milk trituration (Snell). Arsenic, Potassium Iodide ox Bromide, Iron or Quinine, for constitutional effects in vascular kera- titis. Also counter-irritation by iodine painted on the temples till soreness (C.). Ferric Perchloride, successfully employed in panniform keratitis. A large drop of the solution dropped from a quill every second or third day (Wa.). Eserine, lowers intra-ocular tension (B.). Astringents ox Irritants (as alcohol in any form, zinc sulphate, silver nitrate, etc.), are entirely inad- missible (C.). Iridectoi?iv is often beneficial in severe vascular keratitis (C.). Pressure-Bandage, in severe suppurative forms, limits extent. Water, cold when inflammatory symptoms marked: hot (90-100° F.) in non-inflammatory form, to excite inflammatory reaction; should be discontinued when marked injection. [Compare Corneal Opacities.] R. Hydrarg. Chlor. Corr., . gr. j. Ammonii Chloridi, . gr. vj. Tinct. Belladonnse, . Aquae Destillatae, . . M. et fiat collyrium. Prescription. Sig.—A teasp. in a winegl. of tepid water, to be applied frequently with a pledget of lint on the closed lids. In phlyctenular keratitis of children. ( Turnbull.) Labor. Ergot, when uterine inertia, after the first stage passed. Is dangerous if any obstacle in front. Danger to child in paralysis of foetal heart (B.). Is best given when head has passed the brim of pelvis (Wa.). Anesthetics, in protracted and painful labor; cautiously with primiparae (B.); increase the risk of post-partum hemorrhage (W.). Chloroform, not to complete anaes- thesia, lest uterine action be interrupted. Usually begin when os is dilated (Simpson). Chloral, of great value to relieve pain; does not interfere with the exhibition of chloroform; should be given in 15-grain doses every till effect produced (Wa.); the best of all remedies for rigid, undilatable cer- vix, gr. xv every 20 minutes for 3 doses, perhaps a 4th after an hour’s interval (Playfair.). Ethyl Bromide, a rapid, sure and safe anaesthetic, particularly suited to labor cases (Levis). Opium, facilitates dilatation, promotes expulsive power of uterus, lessens hemorrhage, stimulates longitudinal and oblique fibres of the os (Wa.). Cimicifuga, exercises special action, similar to that of ergot; is less dangerous to life of child and soft parts of mother (Wa.); for mental disturbance and suppressed lochia (R.); as partfts accelerator in lieu of ergot, also to allay nervous excitement after labor, and to check post-partum hemor- rhage (P.). Morphine, for relief of pains and after-pains, or painful compli- cations (Wa.). Hypodermically in rigid os and cervix (R.). Belladonna, topically to uterus, of great service in long-protracted labors from rigidity of os and cervix (H.). Gelsemium, quiets the “nagging” pains of the first stage; requires physiological doses (B.); relaxes spasm in rigidity of the os (Wa.). Quinine, to strengthen uterine contractions; used by many in place of ergot (R.). Cannabis Indica, the tincture gtt. xxx, as stimulant to uterine LACTATION—LARYNGISMUS STRIDULUS. 655 contractions, more prompt, less lasting, than ergot (Wa.). Ipecacuanha, after delivery; to promote natural functions (R.). Cotton-root, as excitant of uterine contractions may be more energetic than ergot (P.). Althcea, the decoction, as vaginal injection in difficult labor (P.). Sodium Borate, excites activity of the uterus, and is well employed in tedious labor, where there is deficiency of uterine contraction (Rigby). Amyl Nitrite, has acted admirably in a case of hour-glass contraction of the uterus; seems to antagonize the action of ergot (Barnes). Oil of Eucalyptus is very valuable in effecting antiseptic midwifery (Wa.). Mercury. The bichloride, gr. vijss to a quart of hot water gives a toW solution, probably the best of all antiseptics for this purpose. [Compare Abortion, After-pains, False Pains, Hemorrhage Post-partum, Lac- tation, Puerperal Convulsions,—Mania,—Fever,—Disorders.] Lactation. Belladonna, internally or externally or both in excessive lactation (R.). Atropine gr. aquae rosae on lint around the breast to arrest secretion of milk. Remove when fauces become dry and pupils dilated (B.l. Camphor, locally to arrest the secretion; a saturated solution in olive oil or glycerin, is more efficient than belladonna (Wa.). Potassium Iodide, in 25 to 30-grain doses internally, for the same purpose, is very effectual (Rousset). Calcium Phos- phate and Hypophosphite, in debility from over-lactation (R., Wa.). Ammo- nium Chloride, for the intercostal neuralgia of suckling women; gr. x- xx, every 3 or 4 hours (Wa.). Quinine, Tannin, are used to arrest the secretion (R.). Alcohol, as beer or porter, often useful in excessive lactation—not always (R.). [Compare Abscess, Agalactia, Mastitis, Nipples.] Prescription for Milk-Fever. R. Tinct. Aconiti, . . m xx. Antim. et Potass. Tart., . gr. ij. Spt. Etheris Nitrosi, Syr. Simplicis, . aa 5j. Aquae Aurantii Flor., . gij. M. Sig.—A teaspoonful in a wine- glassful of sweetened water, every two hours. (Fordyce Barker.) Laryngismus Stridulus. Aconite, checks the spasm and relieves the croupous breathing (R.). Bella- donna, promises to be of value (Wa.). Atropine, gr. in a goblet of water (60 doses), of which give a teasp. every hour or will give prompt relief (A. A. Smith). Bromides, when uncomplicated except with convulsions (R.). Full doses will suspend an attack, and moderate doses steadily contin- ued, will prevent recurrence (B.). Ipecacuanha, an emetic dose to cut short an attack (B.). Lobeliarhas> been employed (R.). Chloroform, quickly cures the paroxysm, a few drops on a handkerchief sufficient (B.); may often be used with advantage (W.). Nitroglycerin, will speedily allay the spasm (B.). Chloral, gr. v-xv to prevent or arrest (B.). Quinine, given between attacks to prevent (B.); a most valuable remedy, but in small, repeated doses (P.). Emetics. Tartar emetic: mercuric sulphate (gr. iij — v) safer and better (B.). Conium, is valuable, carried to a point of physiological effect (B.). Water, wet pack to neck (B.) ; cold sponging twice or thrice daily more successful than anything else, with out-of-door exercise. Cautiously if hoarse voice indi- cates laryngitis (R.) [Compare Croup, Laryngitis.] 656 LARYNGITIS, Prescriptions. R. Potassii Bromidi, . . gij. Chloralis Hydrat., . . gss. Syr. Aurantii Cort., Aq. Menthse Viridis, . aa %j. M. Sig.—A teasp. every y2 hour. R. Syr. Hypophosphitum cum Ferro, .... Sig.—A dessertsp. to a tablesp. thrice daily. Laryngitis, Acute Catarrhal. Aconite, very valuable (R.); especially indicated in inflammatory states of respiratory parts; gtt. ss-j every half-hour till an impression is made on the fever, then every hour or two (B.). Antimony. Tartar emetic, gr. a very excellent remedy internally; larger doses in oedematous laryngitis, gr. with gr. iij of Dover's powder every 2 or 3 hours (Da Costa). Iodine, inhaled; also as counter-irritant painted over neck (B.). Alorphine, small doses to allay cough (A.). Sulphurous Acid Spray, is vaunted (Wa.). Leeches to throat are valuable auxiliaries to general treatment in sthenic cases; or cupping at the nape of the neck (Wa.). Rumex, has selective action on the laryngeal mucous membrane. See page 335. Zinc or Copper Sulphates, as emetics, in large quantities of warm water, where oedema slight (A.); a solution of zinc sulphate, gr. xx to 5j on sponge to larynx with aid of the laryngoscope if pos- sible to use it (Da6.). Scarification, by Mackenzie’s laryngeal lancet, of great service in the oedematous form (Da C.). A Purgative and Diaphoretic, with mucilaginous drinks, if given at the start may be sufficient (Da C.). Iron, Monsel’s solution, 1 part to 2 or 3 of water and glycerin, an excellent local application (Da C.). Heat, by poultices or fomentations (A.). Hot-water stupes may succeed (Wa.). Inhalations of hot steam, with benzoin, the comp, tinct. gtt. x-xv to gj, with gtt. x tinct. opii, or hops, or conium, of great service (Da C.). Tracheotomy ought not to be delayed, if inhalations, leeches, and fomen- tations fail (A., Wa.): is especially indicated in sudden attacks of oedematous laryngitis, as those occurring in Bright’s disease (Da C.). Ice, steadily applied in bags over the larynx, if tracheotomy refused, has succeeded in bad cases. Small pieces may be slowly swallowed (Da C.). [For Croupous Laryngitis, see Croup, Membranous ; for Spasmodic Laryngitis, see Croup, Catarrhal ; for (Ede- matous Laryngitis, see Glottis, (Edema. Compare also Laryngismus Stridu- lus, Pharyngitis.] Laryngitis, Chronic. Iodine, painted over neck as a counter-irritant, and inhalation of its vapor (B.). Sulphur. Sulphurous acid as spray in syphilitic or tubercular laryn- gitis, or a solution of sodium sulphite (gj to the oz.) in water (B.); by inha- lation, spray, or fumigation (R.). Carbolic Acid, where long-standing hyper- aemia with diminished secretion, gj-ij to the of glycerin is a most successful application (Morell Mackenzie). Silver Nitrate, powdered or in solution to chronically inflamed larynx, as in phthisis (R.); a solution of gr. x or xx ad j|j, applied with a brush by the aid of the laryngoscopic mirror (W.). Form- erly much used, but is objectionable (B.). Should be used with great caution, and only when a particular point can be seen for it with the laryngoscope (Da C.j. Ferric Perchloride, solution gr. lx-cxx ad glycerini as local application (A.). Zinc Chloride, gr. xx-xxx ad in glycerin. Alternation of topical applications, of great value (A.). Copper Sulphate, gr. xx to 25j of water, locally twice a week (Da C.). Bismuth, the sub-nitrate by insufflation, is highly recommended in the worst forms of laryngitis, even in that accom- LARYNGOTOMY—LEUCORRHCEA. 657 panying phthisis (Tr., Wa.). Guaiacum, as lozenges, very useful in mucous laryngitis (A.). Althcea, as pectoral lozenges to relieve laryngeal irritation (P.). Cubebs, the berries chewed are very efficient in relaxation of the larynx following a cold or long speaking (Wa.). Cocaine, a 20 per cent, solution of the hydrochlorate by spray, mop, or brush, is very efficient in many laryngeal affections (Prosser James). Benzoin, in strumous laryngitis (Wa.) ; in chronic, benzoin on hot coals, or inhaled from boiling water, of great service (Tr.). Tannin, in chronic catarrh and ulcerations, a solution (gr. applied by hand-ball or steam atomizer (B., A.). Inhalations, or spray, of the best agents very grateful (B.); air loaded with vapors of ammonium muriate by inhaler, said to be used successfully (W.); vapors from boiling tar, turpentine, etc., placed on hot water, or better by steam atomizer (Da C.); chloroform, hops, benzoin, etc., by atomization (Walker). Insufflation, substances to be in small quantity, mixed with bland powder (B.). Functional Rest of voice often requisite, especially in phthisical and syphilitic laryngeal ulceration (A.). Chronic Laryngitis includes many disorders of the larynx, which of late years have been differentiated, as—thickened vocal cords (chronic laryngitis proper), laryngeal ulcers, polypi, cysts, cauliflower growths, tubercular and syphilitic laryngitis, etc., in all the voice being similarly affected. Dysphagia, as a concomitant symptom, is constantly indicative of tubercular laryngitis (Da Costa). [Compare Cough, Phthisis, Syphilis, Dysphagia.] Laryngotomy. Laryngotomy is more quickly and easily performed on the adult than trache- otomy, being further from the lungs and less dangerous. It is usually directed to be performed by cutting longitudinally through the skin, then horizontally through the crico-thyroid membrane, which may be felt as a soft depression, an inch below the pomum Adami. In urgent cases, however, Prof. Wood recommends a narrow-bladed knife to be passed horizontally through both skin and membrane at once, and then to enlarge the opening laterally to the required extent. The advantage of having a horizontal incision in the skin is the greater openness of the wound when the patient throws up his head under a sense of dyspnoea (D.). In Laryngo-Tracheotomy, the deep incision is car- ried downwards from the crico-thyroid membrane, through the cricoid carti- lage and one or two of the upper rings of the trachea (Cl.). Leucocythsemia. Alkaline Hypophosphites, have been used with more or less benefit (Wa.). Digitalis, in young subjects (B.). Nitro-muriatic Bath, should not be neg- lected, with tonics and nutrients (A.). Iron, is of little value (B.); large doses may do good in early stage, with careful diet, and Ergot to contract the spleen (Da Costa). Phosphorus, gr. increased to gr. -fo, has proved suc- cessful in several cases (Wa.). Arsenic, in as full doses as can be borne, may be of service though hitherto ineffectual (Gowers). Galvanization of the spleen causes improvement of the blood, increasing the number of its red cor- puscles (Gowers); is curative in uncomplicated cases (B.). Leucorrhcea. Hydrastis, the fluid extract, undiluted topically, quickly improves in uterine and vaginal leucorrhoea (B.). Pulsatilla, 5-drop doses ter die for a few 658 LICHEN. weeks; also a teasp. in a pint of cold or tepid water, as vaginal enema daily, when pain in loins, depression of spirits, loss of appetite, etc. (P.). Silver Nitrate, in solution locally, also tampon saturated with each of alum and bismuth, when leucorrhoea due to granular vaginitis (Parvin). Balsam of Peru and Tolu, internally (P.). Glycerin, is largely prescribed for vaginal leucorrhoea, and for erosions and ulcerations of the cervix uteri (B.); the best vehicle for other agents (E.). Borax, to Oj water as vaginal wash for the leucorrhoea of pregnancy (Parvin). Cimicifuga, is said to be useful (P.). Copaiba, has been used with success (P.). Cocculus Indicus, when sero-puru- lent discharge, pain in lumbar region (P.). Carbolic Acid, diluted, as injec- tion (B.); for vaginal leucorrhoea (R.). Bismuth, with mucilage, as injection ; or with cocoa-butter as suppository (B.). Copper Sulphate, in solution, as injection (R.). Tannic Acid, in chronic cases serviceable as injection, £ss of tannic acid in !|viij of claret wine (B ). If os ulcerated, a suppository of tannin and cocoa-butter to mouth of uterus (R.). Iodo-Tannin, an excellent application, gj of iodine to gj of tannic acid, a sufficient quantity to be packed dry around the cervix (B.). Alum and Borax, makes a useful injection in vaginal leucorrhoea (R.). Belladonna, with tannin as bolus where neuralgia or ulceration of os. When disease due to over-secretion of mucous glands about the os, and much pain present, inject sodii bicarbonas, £j; tinctura belladonna;, fi); aquae, Oj ( R.). Potassium or Sodium Bicarbonate, zj to Oj aquae as injection, especially when discharge alkaline and copious (R.). Pa- reira, Uva Ursi, successfully used (P.). Sumbul, recommended in atonic form (P.). Myrrh, with iron or aloes, beneficial (P.). Ergot, said to be useful in some cases (R.). Potassium Permanganate, has no special advantage ; is used in solution (gr. (B.). Potassium Chlorate, f) to Oj of water as injection in simple cases (Parvin). Iron, the iodide, internally and exter- nally has proved serviceable; the mistura ferri composita, when anaemia and general debility (Wa.). The styptic preparations, locally (B.). Phosphates, for the cachexia (B.). The calcium phosphate, gr. j-ij several times daily, of great value in checking profuse discharge (Wa.). Injections, water at 6o° F. to prevent recurrence (R.). Hot water injections best tonic to pelvic ves- sels; to relieve venous congestion use with elevated hips (E,). [Compare Endo-metritis, Uterine Ulceration, Vaginitis.] R. Aluminis, . . . 3). Zinci Sulph., . . . Sodii Boratis, . . . gr. iv. Aq. Rosse, . . . ijviij. M. Sig.—Injection. (B.) Prescriptions. R . Liq. Flumbi Subacet., . !|jss. Ac. Carbolici, . . . 5ss. M. Sig.—One-fourth to be added to a pint of water and used as an in- jection. Lichen. Aconite, sometimes useful (R.). Mercury, calomel and nitrate of mercury oint. mixed (also tar oint. added), in patches of obstinate lichen (R.). Silver Nitrate, the nitrous ether solution painted every day or two over patch (R.). Baths, warm, or of sulphides (R.); sponging with alkaline lotions, diluted lead-water, fluid extract of grindelia well diluted, or solution of copper sul- phate, gr. x to the 25, in miliaria, or prickly heat (lichen tropicus); with dust- ing powders of lycopodium,zinc oxide or starch, singly or combined (Hughes). Potassium Citrate, or some other refrigerant diuretic, and light, unstimulating food (Da Costa). [Compare Eczema.] LITHAEMIA—LUMBAGO. 659 v Lithaemia. Lithium Salts, especially the citrate, gr. xx thrice daily, is very efficient (Da Costa) ; the carbonate invaluable (Wa.). Arsenic, in small doses, is also useful (Da C.). Nitric Acid, io-minim doses of the dilute acid in half-glass of water thrice daily, with an occasional dose of pil.rhei compos, at bedtime, is the most efficient treatment for the class of patients who will not diet them- selves (Hughes). Purgatives, especially alkaline mineral waters, to clear the portal system (Da C.). Sodium Phosphate, in laxative doses, gj thrice daily, gives good results. Alkalies, in biliousness; also the continued use of al- kaline waters rich in potassium salts, for solution of calculi (B.). Acids, hy- drochloric often of great service; also lactic acid, when faulty digestion and assimilation (Br.). Potassium Permanganate, prevents calculi by converting uric acid into urea (B.). Buchu, combined with an alkali, has been a bene- ficial remedy (P.). Colchicum, 15711. doses of the wine, twice or thrice daily ; is very useful (Wa.). Chimaphila is believed to check the secretion of lithic acid (P.). Aliment, farinaceous vegetables and acid fruits are suitable (B.). Alcohol in any form is poison to a lithaemic (Da C.). Succulent vegetables and fruits, occasional abstinence from animal food. High living, alcoholic liquors, and sedentary habits are injurious. Milk diet, and frequent draughts of pure water also recommended. Removal to a locality where pure soft water can be procured, is often curative. [Compare Calculi, Dyspepsia, Gout.] Locomotor Ataxia. Belladonna and Ergot are highly recommended by Brown Sequard (R.). Silver Nitrate, when motor disturbances are very marked. Improved I in 20 (R.); gives the best results in doses of gr. % to gr. ]/2 thrice daily, with- holding it after a few weeks to prevent argyria. The Oxide may be used instead of the nitrate, in half-grain doses (Da Costa). Potassium Iodide, Corrosive Sublimate, or Chloride of Gold and Sodium, all in full doses, often retard the progress of the disease (Da C.). Physostigma has proved beneficial (-R.). Phosphorus, useful, but may not cure (B.). Hyoscyamine, ameliorative, gr. -1% gradually to gr. T*5 (B.). Electricity, galvanic, relieves pain ; faradic Stops wasting of muscles (B.); in stage of irritation the constant current (as- cending) through spinal column (R.). Water, one of the most efficient agents; friction with a cloth dipped in water of 60-65° F.» a cold com- press to head; 4-8 minute bath of 70-75° gradually lowered to 6o°, then shower-bath, frictions (R.). Rest, as complete as possible, must be insisted on; with good, nutritious diet, milk being very desirable (Da C.). Pilocar- pine produces general improvement if given in the incipiency, gr. j to %j of water, of which tqxxx twice daily (B.). Strychnine, gr. 0 in Sjj of syr. hy- pophosphitum, thrice daily, when the system is saturated with silver (Da C.). Lumbago. Cimicifuga, said to be more effectual than any other remedy (R.); has sometimes wonderful success; no indications can be given for it; of fluid extract (B.). Curative (P.). Rhus Toxicodendron, in subacute muscular or tendinous rheumatism, worse at night; completely relieves some cases (Pf.). Veratrum Viride, the tincture useful (R.). Aconite in HI doses of tincture every two hours, with linim. aconiti locally (Wa.). Iodides, if refer- able to syphilis, mercury, copper, tin, or lead poisoning (B.). Morphine, hy- 660 LUNG DISEASES. poderm. to relieve pain (B., R.); gr. with Atropine gr. hypodermically, will frequently cure lumbago in two or three hours (Da C.). Capsicum, a strong infusion applied on lint, and covered with oiled silk, very efficient in recent lumbago (R.); a capsicum plaster is a very efficient application. Po- tassium Nitrate, in ten-grain doses hourly or every two hours, when urine scanty and high-colored (R.). Belladonna, as plaster, very valuable for per sistent lumbago remaining in a small spot (R.). Turpentine, in doses of rrtxx-xxx (carefully, lest strangury and nephritis), of greatest value when the bowels regular and urine clear and abundant (Wa.). Ether Spray, externally as freezing mixture (R.). Guarana, xv-xl-gr. doses removed severe chronic (Rawson). Chloroform Liniment, affords relief (Wa.). Canada Balsam, gr. v-xx, is useful, or Burgundy Pitch, as plaster (P.). Acupuncture, occasion- ally gives instant relief (B.). Not when high fever (R.). Aquapuncture, has been employed with extraordinary success (B.). Ideal, by hot douche to seat of pain (B.); or by very hot poultices for three hours, then the skin covered with flannel and oiled silk; or a hot flat-iron (R.). Galvanism, the constant current (B.); is highly useful; faradization almost as successful as acupunc- ture (R.). Strapping from the thigh upwards, with layers of adhesive plaster which overlap each other. Nothing is so instantaneously beneficial. Diet, should be generous and nutritive. Lemon-juice as a beverage. Absolute rest is of great importance. [Compare Rheumatism.] Lung Diseases. Aconite, is indicated in most acute congestions (P.) ; is especially indicated in inflammatory states of respiratory organs (R.); Belladonna, in nl doses of the tincture frequently, is of great benefit in pulmonary oedema, to retard ex- udation of serum and to counteract the failure of the heart (A. A. Smith). Ve- ratrum Viride renders important service in acute parenchymatous congestions (B.) ; gr. of resin in pill when temperature and pulse are high. It tends to induce prostration, collapse, etc. (A.). Blisters. Flying blisters to chest, and perhaps along pneumogastnc nerves in hypostatic congestion (R.). Copaiba, exercises a powerful influence over the pulmonary mucous membrane, and is beneficial in lung diseases generally, when attended with excessive secretion (Wa.). Jaborandi, is serviceable for the attacks of breathlessness attendant on lung affections, but must be watched lest collapse ensue (Berkart). Liquor Potasscc, in doses of Hlx-xv added to an ordinary expectorant mixture, is often attended with good results in congestions of bronchi and lungs, chronic bronchitis, plastic bronchitis, etc. (Walshe). Cimicifuga, is a useful sedative in many irritative affections of the lungs and bronchial tubes, relieving cough, improving appetite, and ameliorating the general condition (Wood). Croton Oil, as liniment, is a highly useful counterirritant in many chronic lung dis- eases, and even in the bronchitis of infancy (Park). Cubebs, in small and oft-repeated doses, is efficient in chronic bronchitis and other lung affections of old persons, checking the excessive secretion and gently stimulating the system (Wa.). [Compare Bronchitis, Emphysema, Hemoptysis, Phthisis, Pleuritis, Pleurodynia, Pneumonia.] Lungs, Gangrene of. Creasote, by inhalation, to obviate the fetor (R.). Carbolic Acid inhalations, are used with marked benefit (Wa.). Mineral Acids, especially nitro-hydro- chloric, with Quinine, the main reliances in chronic pulmonary gangrene 661 LUPUS—LYM PH ANGEIT IS. (A.). Stimulants, as malt liquors, with general tonic treatment, are necessary (A.). Ammonium Carbonate, one of the most reliable remedies; is best given in decoctum cinchonse (Wa.). Eucalyptus, the oil with alcohol, equal parts of each, of which 5[j as inhalation by steam atomization, is useful (Wa.). Turpentine, the spirit on boiling water inhaled for fifteen minutes every two hours, successfully employed (Skoda). [Compare Pneumonia, Phthisis.] Lupus. Arsenic, in chronic cases, not of syphilitic origin (B.). Arsenious acid as caustic (R.). The best remedy in lupus of head and face (Wa.). The oleate of arsenic, in ulcerating forms, constantly applied, will destroy cell-infiltra- tion in a mild and comparatively painless manner; is also well employed in the tubercular variety (Wa.). Iodine, useful, whether syphilitic or scrofulous; the tinct. or a glycerin solution (B.); as tincture or liniment to edges and around (R.). Mercury, as ointments in erythematous lupus, calomel ointment in scrofulous and tubercular lupus of children (R.). Calomel int.,gr. j-ij in- creased to iv, will quickly check ( Wa.). Emplastrum hydrargyri very efficient in lupus erythematodes and allied affections (Kohn). Cod-liver Oil, internally and locally (B.). Lead, liq. plumbi, with one or two parts of glycerin, ap- plied warm after removal of crusts, in milder forms (R.). Carbolic Acid, as a mild escharotic (B.). Zinc Sulphate, dried, as caustic, freely dusted over surface, and a poultice to remove slough (B.). Jeriquity, a most useful ap- plication (Shoemaker). Sodium Ethylate on absorbent cotton, is the best of all caustics, followed by the Oleopalmitate of Bismtith as a soothing and astrin- gent application ( Shoemaker). Chromic Acid, an efficient local application. Gr. aqute destil. (B.). Phosphorus, as substitute for arsenic (B.) Silver Nitrate, a weak solution, gradually strengthened, in superficial forms (R.). Cauterization, with the actual cautery at white heat, after sera; ingout as mfich as possible of the diseased parts, so as to destroy the lupus cell. Seek to re- place the lesion by a cicatrix, to prevent relapse in situ, and the development of the disease elsewhere. Internal remedies only useful for the general health. Prescriptions. R., Iodi, Potassii Iodidi,. . ati ,^ss. Glycerini, . . . M. Sig.—Locally in Lupus. (.McCall Anderson.) R. Hydrargyri Bromidi, . gjss. Adipis, .... £v. M. ft unguentum. Sig.—To cover the part affected, using cod-liver oil freely, and the following solution in- ternally. In tubercular lupus of the face. (Hardy.) R. Ung. Arsenici Oleat., . Ung. Simplicis,. . . gj. M. ft. unguentum. Sig.—Use con- stantly over the affected surface. If pain sets in Opium may be added. {Shoemaker.) R. Potassii Iodidi, . . gr. lxxv. Sodii Chloridi, . . Aq. Destill., . . M. Sig.—Tablesp. before meals, night and morning. (Hardy.) Lymphangeitis. Belladonna, the extract softened with glycerin, freely applied, is of great service; when pain is severe a poultice may be applied over the extract for a 662 MALARIA, CHRONIC. few hours only (Wa.). Lead, liq. plumbi subacet. dil., as an external appli- cation, constantly applied, to soothe and restrain the inflammation (Wa.). Iodine, in strong tincture, around glands, to prevent suppuration (Roberts). Quinine, or Salicin, with alcoholic stimulants freely, in septic cases (Roberts). [Compare Bubo.] Malaria, Chronic. Quinine is less curative than when the infection is recent, but in periodical affections depending on the malarial cachexia it is of specific value, large doses being required (B.). Salicylates of quinine and cinchonidine are es- pecially effective in chronic malarial disease (B.). Arsenic plays an important role in chronic malarial disease (B.); diminishes splenic engorgement, and combined with iron is rapidly curative of many affections due to the paludal miasm ( Boudin); is a powerful prophylactic against malaria, and in chronic malarial poisoning, with frequent return of fever and neuralgia, the continued use of arsenic is of great benefit (Fayrer). Iron, the sulphate has decided antiperiodic power, and is particularly successful in anaemic subjects and in those with enlargement of the spleen (Wa.); it improves the anaemia of chronic malaria, and should generally be combined with arsenic (B.). Iodide of Iron and Manganese, the syrup in doses of tRxx-xxx, is a successful rem- edy for chronic malarial infection, and the Sulphate of Manganese gives ex- cellent results in jaundice of malarial origin (B.). Cornus, Calumba, and other bitters, are highly efficient, especially the first-named, in chronic malarial poisoning, and in convalescence after malarial fever (B.). Carbolic Acid and Iodine combined, are of great value in chronic malarial infection ; both are highly antiperiodic, and the latter is the best substitute for quinine and the most active reducer of splenic enlargement (Gimwell). Eucalyptus is of high utility to reconstruct the damages in the organs of assimilation (B.). Baths, the vapor-bath and Turkish baths are efficient aids to medicinal treat- ment in breaking up chronic cases, and may of themselves cure such by in- ducing profuse perspiration (Da Costa). [Compare Intermittent Fever, Remittent Fever.] R. Cinchonidinse Salieylat., spj. Ac. Arseniosi, . . gr. j. Ferri Sulph. Exsiccat., . gr. xx. M. ft. cachets no. xx. Sig.—One wafer thrice daily. Prescriptions. R. Ac. Arseniosi, . . . gr.j. Mas. Ferri Carb., . . zj. M. ft. pil. no. xx. Sig.—One pill thrice daily. R. Quininse Sulph., . . gr. xl. Ferri Sulph. Exsic., . gr. xx. Ac. Arseniosi, . . gr.j. M. ft. pil. no. xx. Sig.—One pill thrice daily. R. Corahs, Calumbse, Liriodendri, Pruni Virgin., . . aa Eupatorii, Capsici, . . . aa Pulv. et misce. Sig.—A teasp. in cold or warm water, three or four times daily. A good tonic tincture may be made from the above combina- tion. (B.) R. Tinct. Iodi, . . . t^ij. Ac. Carbolici, . . . gj. M. Sig.—Two to three drops three or four times a day in water. MANIA MASTITIS. 663 Mania. Stramonium, of value; allays irritation and induces tranquil sleep; wild and furious delirium, but intermittent; also in nymphomania (P.). Many facts seem to confirm its reported value (Tr.). Daturine, gr. hypo- dermically in acute mania, but is less useful than atropine or hyoscyamine (Wa.). Duboisine, gr. gL hypodermically in acute mania (Gubler). Bella- donna, is useful, especially in monomania, with fixed hallucinations, though a large dose causes a temporary insanity (Tr.); one of the very best remedies in all hypercemic conditions of the brain (P.). Hyoscyamus, in violent inter- mittent forms, to procure sleep and calm violent delirium (R.); delirium with hallucinations but not congestion ; milder and less inflammatory forms; also in hypochondriacal monomania (P.). Veratrum Viride, successfully combats the excitement in acute mania (B.). Camphor, has been used successfully; its action is uncertain (P.). Opium, and tartar emetic are satisfactory for many cases; also morphine hypodermically to induce sleep (R.); narcotic effect of doubtful utility; better in insanity with depression (P.). Cannabis Indica, pj of tinct. with pj of potassium bromide, is recommended (R.). Bromides are used in puerperal mania, that of pregnancy, nymphomania and other forms (R.). The combined use of potassium bromide and tinct. of cannabis indica, in equal parts, pj of each thrice daily for weeks and months, has proved very efficient in acute and periodical mania, senile mania, and other forms (Clouston). Chloral, as calmative, hypnotic, has induced mental improvement, gr. v-xx (B.). Conine, most suitable to acute mania, quiets muscular action or hypoder., commencing with 'm.T1ena, Polypus, Sneezing.] Nausea. Ipecacuanha, has no rival in sickness of pregnancy, scarcely less useful in that of chronic alcoholism. Very small doses, gr. equals ntj of wine (P.). 672 NECROSIS—NERVOUS AFFECTIONS. Pulsatilla, in dyspeptic nausea, with coated tongue, flatulence, sick headache (P.). Cocculus hidicus, in cephalic nausea, violent but ineffectual efforts at vomiting (P.). Caluruba, in nausea of languid stomach with flatulence, has considerable reputation (P.). Cinnamon or Cloves, will check nausea (P.). Nutmeg, the simple powder in wine (P.). Pimenta, Pepper, Peppermint, relieve (P.). Tartaric Acid, as effervescing draught, with a few drops of tinct. opii, tinct calumbse, or hydrocyanic acid added, when from morbid gas- tric irritation (Wa.), Cold Compress or Ice-bag, over the stomach very useful. Bistnuth Subnitrate, or the Liquor Bismuthi, when the salt in substance dis- agrees, is a remedy of established value in nausea and vomiting arising from gastric disorders ; may be combined with Hydrocyanic Acid (Wa.). [Com- pare Vomiting, Vomiting of Pregnancy, Seasickness.] Necrosis. Sarsaparilla, a very useful medicine in diseases of the bones (P.). Rest, in a “ Salter’s swing,” with poultices, water-dressing, or stimulating lotions, to aid work of repair (Cl., Hilton). Tonics, nutritious food, baths, good hy- giene, all are necessary adjuncts to local treatment (Andrews). Acid Solu- tions, of no use as solvents, may be employed with benefit for detergent and alterative effects to expedite the sloughing and restorative processes (Gross). Operation to remove sequestrum is generally necessary; or resection of the devitalized bone, the latter in young subjects greatly exhausted, where delay would endanger life (Gross). Potassa cum Calce introduced into fistulae, to convert them into large openings, permitting the removal of diseased bone (Kirkpatrick). [Compare Caries, Bone Diseases, Syphilis, Scrofulosis.] Nervous Affections. Arsenic, of especial value in nervous affections resulting from malaria, in which large doses are required ; of Liq. Arsenicalis, increased to n|_xxx thrice daily (Wa.). Asafcetida, is a remedy of much value in nervous affec- tions connected with uterine derangement, also in dyspeptic hypochondriasis and other nervous affections ; may be combined with bitter tonics and mild aperients (Wa.). Potassium Bromide, takes precedence in epilepsy, epilep- tiform convulsions, hysterical convulsions and spasms, tetanus, etc., is of great value in chorea, insanity, acute mania, insomnia, delirium tremens, some forms of neuralgia, and the numerous symptoms of vaso-motor disturbance, such as—numbness, coldness, deadness, pricking sensations, indefinable but distressing sensations in abdomen, hypogastrium or epigastrium; feelings similar to rigors, with anxiety, palpitation or fluttering of the heart,—all due to interference with the local circulation (Reynolds). Valerian and Valeri- anates, are thought to exercise some special influence over nervous affections, especially the Valerianate of Zinc, in half-grain to grain doses in pill, or the Ammoniated Tincture of Valerian, from which every good that can be expected from the valerianates will be more certainly obtained (Wa.). Sumbul, acts as a nervous stimulant, and is especially efficacious in neurotic migraine, also in hysteria and the obscure paralytic affections associated therewith (Wa.). Caf- feine, is of signal value in neuralgia, hemicrania and other nervous affections (Shaffer); grain-doses in solution hypodermically, afford great relief in dorso-intercostal neuralgia attending shingles, insomnia, etc. (Anstie). Co- caine is a powerful nerve stimulant, destroying the sense of fatigue, and often 673 NERVOUS EXHAUSTION—NERVOUSNESS. evincing marked analgesic power in neuralgiae. Is effective in melancholia, hypochondriasis, etc., as well as locally in nerve pain over a limited area. It acts as an excitant upon the central nervous system (R.). Opium is a remedy of marked value in insanity, melancholia, mania, and all nervous affections accompanied by pain (Wa.); gives general repose to both body and mind, is of decided value in diabetes, and produces marked improvement in melan- cholia and despondency (R.). Lupulin, is peculiarly useful in nervous affec- tions when Opium cannot be tolerated, especially in chronic hysteria attended with morbid vigilance, io-grain doses every 6 hours afford great relief, with- out causing any unpleasant symptoms (Eberle). Santonin, in convulsions, epileptiform seizures, and affections regarded as choreic, etc., the result of reflex irritation from worms (Wa.). Phosphorus, of occasional utility in affec- tions of the nervous system induced by mental exertion or over-excitement. Danger from its use is its liability to produce fatty degeneration of the internal organs (Wa.). Phosphate of Silver is regarded as of special value in myelitis with disturbance of bladder and rectum, and in sclerosis of the nervous sub- stance (Wa.). Nitrate of Silver, the only remedy which has done good in progressive locomotor ataxia; gr. two or three times daily, with Hypo- phosphite of Sodium, both to be discontinued when blue line appears on gums (Althaus). Cold Shower Baths, are often beneficial in nervous diseases unconnected with disease of the brain. [Compare Hysteria, Melancholia, Mania, Diabetes, Locomotor Ataxia, Hemicrania, Neuralgia, Ner- vousness, Insomnia, Hemiplegia, Paralysis, Spinal Paralysis, etc.] Nervous Exhaustion. Ammonia, the Aromatic Spirit proves very serviceable; sjss-j in water thrice daily (Wa.). Hypophosphites of lime or sodium, or iron, are actively tonic in cases of nervous depression and torpor, with occasional shooting pains (Wa.). Strychnine Acetate, a remedy of great promise, when combined with a rigid system of diet, mental discipline, etc. (Marshall Hall). Oxide of Zinc, often excellent as a tonic and sedative, in nervous irritability and depression from anxiety, over-study, etc. (Wa.). Phosphorus, of occasional utility in nervous break-down from over-study, etc. (Wa.). Caffeine, gr. j or more in a cup of coffee, to relieve brain weariness and nervous exhaustion (Wa.). Cocaine, in doses proves serviceable in nervous exhaus- tion (R.). R. Strychninse Acetatis, . gr. j. Ac. Acetici Diluti, . . npxx. Alcoholis, . . . gij. Aquae destill., . . M. Sig.—Ten drops thrice daily. (.Marshall Hall.) Prescriptions. R. Ac. Phosphorici Dil., . 5j. Elixir Calisayse(U. S. Disp.), Elix. Ammonii Valerian.,. £ij. Glycerini, . . . i i j. Vini Xerici, . . q. s.adO). M. Sig.—thrice daily. Nervousness. Aconite, gtt. j of tinct. at bedtime, repeated if needful, for restlessness and “ fidgets ” of men as well as women (R.). Ignatia, in small doses better than morphine for mental excitement and nervous erethism (P.); for the nervous exaltation of cinchonism (Pf.). Caffeine, for restlessness due to great lower- ing of nervous power (P.). Chamomile lowers reflex excitability (P.J ; minim 674 NEURALGIA. doses of the tincture every 15 minutes an excellent sedative for children (A A. Smith). Potassium Bromide, especially for women who are despondent* irritable, and sleepless, from overwork, grief, worry, etc.; often connected with migraine 1 R.); gr. ss-j of any bromide every is very efficient for the nervous disturbances of children (A. A. Smith). Strychnine, affords re- lief in functional irritability of the nervous system, manifested by restlessness and wandering neuralgic pains (B.); especially useful as a tonic in nervous- ness from over-use of tobacco (H.). Valerian, extremely useful as a sedative to reflex excitability, calms nervousness, does much good in fevers where rest- lessness, fidgets, anxiety, etc. (P.). Musk, serviceable in nervous affections when from uterine derangement (Wa.). Opium, calms the nervous system and gives general repose to both body and mind (R.). Sumbul, often inval- uable in restlessness of pregnancy ; rrtxxx-xl of tinct. with a little Chloric Ether as draught (P.). Camphor, a powerful subduer of reflex excitability (P.). Chloral, where restlessness, debility (R.). Chloroform, the spirit of chloroform internally (R.). Hops, the hop-pillow is deserving of trial. Lu- pulin, peculiarly useful when opium cannot be tolerated (Wa.). Water, warm sponging to induce sleep and calm restlessness in convalescence. Also, cold sponging (R.). [Compare Insomnia, Irritability.] Prescriptions. R. Strychnin® Sulphatis, . gr. j. Quininae Sulphatis, . . zj. Tinct. Ferri Chloridi, . gv. Ac. Phosphor. Dil., Syrupi Limonis, . aa 5ij. M. Sig.—A teasp. in water thrice daily. (H.) R. Potassii Bromidi, . . Ext. Guaranae FI., . . Sjss. Syr. Tolutani, . . . £iij. Aquae, . . . q. s. ad%\\. M. Sig.—Teasp. to a dessertsp. three or four times daily. To relieve nervousness. Neuralgia. Morphine, hypoder. in the neighborhood of the affected nerve, the best treatment. Caution; morphine-habit (B.); gr. to often relieves and fre- quently cures after a few repetitions (P.). No remedy promises more speedy and permanent relief than morphine by subcutaneous injection in sciatica, lumbago, tic douloureux and other neuralgic affections (Wa.). Aconite, when arterial excitement (B.); in congestive neuralgias, and acrodynic, at extremi- ties; has important rSle (P.) ; as ointment or liniment, especially when fifth nerve affected; also in neuralgic headache (R.). A remedy of great value (Wa.); a perfect physiological remedy against neuralgia, especially those forms which are based on congestive or sub-inflammatory affections; but its action is often slow, so that Morphine must be given with it as a pallia- tive. Aconitine, with Veratrine as an ointment locally, a good application (Da Costa). Belladonna, must be persisted in with full doses ; gr. of atro- pine, or gr. to hypodermically, in vicinity of nerve, has special utility in tic douloureux and sciatica; also in peri-uterine and dysmenorrhoeal neuralgias (B.). mj of solution of gr. j-gij of water hypodermically (P.). Spinal irrita- tion, intercostal neuralgia. The liniment or ointment of atropine in facial (R.). Gr. 0.15 of the extract every hour till giddiness, then lessen dose. Continue for several days (Tr.). Veratrum Viride, tincture, said to be very useful (R.). Veratrine, the ointment for face and sciatica (R.). Oint. (gr. viij-gj) frequently of much benefit (P.). Nux Vomica, is most useful in visceral neuralgise, as gastralgia, hepatalgia, etc., the tincture with carminatives in the former affec- NEURALGIA. 675 tion; or strychnine, gr. to twice or thrice daily. In all forms of neu- ralgia this remedy should be used in small doses (P.). Arsenic, cures by its influence on bodily nutrition ; directly so in neuralgias of malarial origin, though inferior to quinine (B.). In various neuralgias, also in angina pec- toris (R.). Phosphorus, gr. every few hours, has made very effective cures (B.). Gr. to every 3 hours. Very useful in all forms, especially when uncomplicated (R.); always a good remedy except for cases due to cold or inflammation, and those not depending on depraved nutrition (H.). Quinine, large doses (gr. v-xx, in sherry), just before attack in periodical neuralgia, whether malarial or not. Useful also in small, frequently repeated doses in other types, especially of supra-orbital nerve (P.). Sumbul, for certain types, of more value than any other remedy. Facial, sciatic, or ovarian, in women of nervous constitution, often yield to it at once (P.). Cimicifuga, in neuralgia of the 5th from cold, and in ovarian neuralgia (B.). Gelsemium, successful in neuralgia of 5th (B.), especially dental branches (R.); of value in trige- minal, ovarian, etc. (W.); in suitable cases small doses answer as well if not better than large ones (Pf.); Trpiij of the tincture every hour often succeed miraculously with no ill results in neuralgise about the head and face (A. A. Smith); no better remedy in tic douloureux, but must be given in large doses, ■nix-xv of a strong tincture or fluid extract (H.). Zinc Valerianatetremely beneficial in neuralgia from reflex irritation of female pelvic organs (B.). Spigelia Anthelmia, useful in facial (P.). Ammonium Valerianate, or Zinc Vat. in neuralgia of face or head (R.); the latter in nervous cases, and uterine (Wa). Chamomile, in neuralgia of 5th nerve (R.). Staphisagria, internally and externally often curative in obstinate facial and cervical neuralgia (P.). Ignatia, in hysterical and intercostal neuralgia, with nervous erethism, is valu- able (P.). Ergot, much employed in visceral forms, especially gastralgia (P.); said to be useful (R.). Ammoniated Copper, in neuralgia of the 5th, lately used by Fereol with remarkable success; )4-grain doses pushed. Eserine, very efficient in neuralgia of the eye-ball, a solution of gr. ij to the g by instil- lation. Cocaine, as a hypodermic injection, a 4 or 5 per cent, solution is very effective if administered in the vicinity of the aching nerve (R.); also by instil- lation in neuralgia of the eyeball, and whenever it can be applied to a mucous surface in the vicinity of the pain. Cannabis Indica, doses of ex- tract 2 or 3 times a day; especially for neuralgic headache (P.); found useful (R.). Cod-Liver Oil, when low nutrition, faulty assimilation (W.). Iron, when from anremia. Tincture of chloride ( rrp xxx-xl ter die), also chalybeate waters (B.). Moderate doses only required (R.). In chlorotic subjects, of whom nearly all will have neuralgia (Tr.). Iodides, for neuralgia of fifth, dependent on syphiloma of the nervous system, pain nocturnal chiefly (B.). Bromides, benefit some kinds, especially ovarian (B.) : potassium bromide occasionally relieves (R.). Ammonium Chloride, half-drachm doses in facial and other neuralgise, is much used (R.); a very efficient and diffusible stimulant, gr. xx — at first, repeated every hour during the attack (H.). Chloroform, as anaes- thetic to relieve pain, is occasionally useful locally, also as spray for uterine neuralgia (R.); by deep injection into vicinity of affected nerve, mv-xv of pure chloroform, a very efficient method of dealing with long-standing cases (B.); used in one case it caused symptoms so severe as to imperil the life of the patient (W.). Caffeine, hypodermically has been found useful, especially in cervico-brachial neuralgia (P.). Croton Chloral, very effective, especially in tic douloureux and sciatica, gr. ij-v every hour till gr. xv are taken (B.) ; in facial, that from carious teeth, that of neck and back of head, tic douloureux, etc. (R.). Gr. j every y£ hour is a very efficient dose (A. A. Smith); rarely of any 676 NEURALGI A. value, but when used is best given in 20-grain doses twice daily (H.). Chloral and Camphor, partes aequales, triturated together, and painted over surface (B., R.); also with morphine (B.). Aquapuncture, strangely relieves pain in a superficial nerve, so much so, that some hold the curative effects of morphine injection to be due to the water (B.). Counter-irritation. Mustard poultices in neuralgic pains (P.). Blisters to a posterior branch of the spinal nerve- trunk from which painful nerve issues (Anstie). Amyl Nitrite, inhaled in dysmenorrhoeal neuralgia (B.); and when of 5th nerve (R.). Nitro-glycerin, has often afforded great relief (Wa.). Carbonic Acid Gas, injected into vagina for neuralgia of uterus (R.). Digitalis, is strongly recommended in sciatica, also locally in earache (P.). Valerian, serviceable in facial neuralgia of hys- terical type(P.). Biburu Bark, in intermittent forms (P.). Pyrethrum, root, is chewed with benefit in facial neuralgia (P.). Capsicum, a strong infusion on lint covered with gutta-percha (R.). Coccus Cacti, has been very successful in 20-30 minim doses of a f/gth tincture twice daily, the larger dose in the par- oxysm (W.). Peppermint, Oil of, painted over the part in facial neuralgia (R.); especially the Chinese oil which contains a large excess of Menthol, a very useful application in superficial neuralgiae (W.). Turpentine, has cured tic douloureux and sciatica (B.); often of wonderful service (P.). Potassium Chlorate, for facial neuralgia (B.). Alcohol, with much volatile ether; care must be taken in prescribing it (R.). Piscidia, almost specific in many forms, useless in many cases (W.). Tonga, is efficient in facial neuralgia, rqx-xx every two hours (H.). Osmic Acid, a one per cent, aqueous solution with glycerin to prevent change, of which 5 to 10 drops hypodermically, has made striking cures of inveterate neuralgiae, with no ill effects resulting (Shapiro). Wet Pack, is of great benefit, especially in sciatica. Galvanism of the affected nerve, one of the most important curative measures; a continuous current of 4 to 8 cells down the nerve generally answers best, though some cases are helped more by a rapidly interrupted faradic current. Electricity is of no value in cases dependent upon organic lesions, and in any individual case is purely experimental (W.). Diet. Animal fats necessary, as cod-liver oil, butter, cream, etc., in as large quantity as can be digested. Rest often needed, with protection from cold and damp, flannel clothing, bathing and shampooing. [Compare Gastralgia, IIepatalgia, Sciatica, Tic Douloureux, Hemi- CRANIA, etc.] Local Use. R. Chloroformi, Tinct. Aconiti, . aa 5ss. Linirn. Saponis, . . £j. M. Sig.—Apply on flannel and cover with oiled silk, for superficial neuralgia. Prescriptions. Internal Use. R. Phosphori, . . gr. ss-jss. Alcoholis, q. s. ad solv. Spt. Menthae Piperitae, q. s. Glycerini, . . q. s. ad Jjiv. M. Sig.—A teasp. after each meal. (H.) R. Aconitine (Duquesnel), gr. iv. Veratrinae, . . . gr. xv. Glycerini, . . . Cerati, .... gvj. M. Sig.—To be rubbed over the part, avoiding any abraded surface carefully. (Da Costa.) R . Cupri Ammonio-sulphat., gr. j-iv. Syr. Aurantii Flor., . gj. Aquae Destil., . . M. Sig.—One-third as a dose, thrice daily. (Prof. Fbreol.) NIGHT-MARE—NODES. 677 Local Use. R. Veratrinae, . . . gr. xl. Adipis, vel Unguenti, . 3{j. M. Sig.—Local use. (Da Costa.) Internal Use. R . Quininae Sulphatis,. . gj. Ferri Pyrophosphatis, . gj. Strychninae Sulphat., . gr. ss. Ac. Phosphor. Diluti, . g\j. Syr. Zingiberis, . . Aquae, . . q. s. ad M. Sig.—A tablespoonful twice daily. R. Menthol, .... gj. Alcoholis, .... Solve. Sig.—Paint over the painful area. Night-Mare. Potasshim Bromide, in night-mare of adults; and children’s attacks of night-screaming often associated with squinting. Digestive organs may also require attention (R.). Camphor-water, a teaspoonful or two the most suitable medicine (H.). Sleep, in abundance, may prevent (H.). Diet, light; avoid late meals. Nipples, Sore, Fissured. Benzoin, an admirable local application (P.); the tincture locally for slight erosions (Parvin). Arnica, the cerate, or Glycerin of Starch, or glycerin, I to 2 of eau de cologne (R-). Silver Nitrate, touched lightly; effectual (Wa.). Sulphurous Acid, solution neat or diluted, constantly applied, or with equal quantity of glycerin as lotion (R.). Collodion, sometimes used (R.); useful for protection (P.); as coating (B.). Alcohol, brandy and water as lotion before delivery and after each suckling to prevent cracking (R.). Borax, saturated solution, beneficial (Wa.). Iron, the solution of the subsulphate diluted with 3 parts of glycerin, and applied with a camel’s-hair brush, an effective applica- tion for fissured nipples (B.). Tannin, the glycerite, one of the best applica- tions to fissured nipples (B.). Lead Nitrate, in glycerin, or ointment gj-£j, in fissured nipples (B.). Zinc Shield, constantly worn (R.). Balsam of Peru or Tolu, valuable as application, with oil of almonds, gum arabic, and rose- water (P.). Rhatany, as wash or cerate, has had great success in fissure (Tr.); I part of extract to 15 of cocoa butter (Wa.). Nipple-Shield, to give tbe nipple rest while the child sucks, gives great comfort. [Compare Lacta- tion, Mastitis.] R. Balsam. Peruvian., . . gi). Olei Amygdalae, . . jjss. Mucil. Acaciae, . . gi). Aquae Rosae, . . . q. s. M. Sig.—Apply to the nipples after each nursing. (Phillips.) Prescriptions. R . Liq. Plumbi Subacet. Dil., gss. Ext. Opii Aquosi, . . g). Aquae Rosae, . . . M. Sig.—Lotion, to be used after a bread-and-milk poultice, for inflamed nipples. (F. Barker.') Nodes. Mercury. The oleate of mercury and morphine externally, is very valuable (R.). Potassium Iodide, as ointment in conjunction with internal use, in syph- ilitic nodes of children; also in non-syphilitic periosteal thickenings (R.). In 678 NYMPHOMANIA ODONTALGIA. syphilitic nodes it holds the first place, especially when pains are worse at night, and by heat of bed (Wa.). Stramonium leaves, locally, relieve (Wa,). [Compare Exostosis, Periostitis.] Nymphomania. Potassium Bromide, when from plethora; not useful when relaxation, or from cerebral lesion (B.); large doses required, at least gr. xx ter die (R.) ; an abundance of evidence testifies to its value (W.) Tobacco, to nausea, effect- ually cures, but is horribly depressing (B.). Camphor, in considerable doses said to control inordinate sexual desire (R.); at present not much relied on (Wa.) Lupulin, seems worthy of fair trial (Wa.). Sulphur, or dilute sul- phuric acid, internally, when arising from hemorrhoidal congestion, not an infrequent cause (Wa.). Obesity. Banting Dietary is alone sufficient to improve the condition. Its chief fea- ture is the exclusion of two elements—starch and sugar—from the food. There- fore bread (except toast, or the crust of a common loaf), potatoes, sweet roots, butter, sugar, cream, beer, porter, and champagne, should be avoided. In one year, on this diet, Mr. Banting reduced his weight 46 pounds, and his girth about 12 inches; at the same time, his numerous corporeal infirmities were greatly mitigated or altogether removed. Cannot be recommended indiscriminately. This was the method of Hippocrates, avoiding all fats, starches, and sugars ; in fact, all roots or vegetables grown underground (B.). Alkalies. Solutions of oxides or bicarbonates (R.); alkaline mineral waters, with exercise and dietary (B.); serviceable (Wa.). Liquor potassae 5fss in milk, thrice daily, of established value (Wa.); generally fails (R.). Ammonium Bromide, sets up gastric catarrh (B.); but lessens corpulency (Wa.). Sulphurous Waters, espe- cially Blue Lick, before each meal (B.). Potassium Permanganate, for attendant dyspepsia and flatulence; also useful for the obesity; gr. ter die, in aq. dest. (B.). Vinegar, only successful at expense of serious injury to the body (R.). Fucus Vesiculosus, has power to reduce adipose tissue. An extract is sold under the title “Antifat” as a proprietary medicine (W.). Exercise, daily, in the open air is necessary, and if carried on sytematically is the most efficient and least injurious method of reducing an excess of adipose tissue. Odontalgia. Aconite ointment or liniment for facial neuralgia due to diseased teeth, will succeed quickly if at all (R., Wa.). Arsenic, gr. as escharotic to destroy pulp, when used for pain may be mixed with opium. It sometimes at first aggravates pain (R., W.). Staphisagria, the alcoholic solution dropped into the cavity (P.). Alum, a solution in nitric ether (gij-gvij) is said to be an effectual application (B.). Alum and salt powdered and placed in the cavity, excellent when nerve exposed. Chloral, rubbed up with equal weight of camphor, rubbed or put into cavity (R.). Chloroform or Croton-Chloral, equal parts of the former and creasote, a good application (R.). Tannin, a solu- tion in ether is a good application to a carious tooth (B.). Creasote, with 679 ONYCHIA AND PARONYCHIA. tannin or opium or chloroform, placed in the cavity of a decayed tooth, often gives relief (R.). Cocaine, a 5 per cent, solution of the hydrochlorate on cot- ton applied to a cavity will often bring instant relief. Conine, solution in alcohol placed into a hollow painful tooth (R.). Collodion and Carbolic Acid, equal parts as jelly for stopping carious teeth (R.). Opium, mixed with tannin or creasote inserted in cavity of painful tooth (R.). Morphine, hypodermically for severe toothache (R.). Oil of Cloves, inserted into cavity (B., P.). Camphor, with morphine and flaxseed, as a cataplasm to the cheek (B.). Xanthoxylum, a domestic remedy (B.). Capsicum, a strong infusion on lint (R.). Gelse- mium, useful in some forms (R.). Zinc Chloride, to destroy exposed painful pulp (R.). Ginger, Mezereon, Pyrethrum, are useful masticatories in tooth- ache (P.). . Linim. Aconiti (B. P.), Chloroformi, . . aa giij. Tinct. Capsici, . . . gj. Tinct. Pyrethri, Olei Caryophylli, Pulv. Camphorse, . aa gss. M. Sig.—A few drops to be placed on a pellet of cotton and applied to the cavity. (Mason.) Prescriptions. R . Morphinse Sulph., . . gr. iv. Atropinae Sulph., . . gr. j. Aquae Destill., . • §j- M. Sig.—A few drops on cotton, placed in the cavity. (B.j . Ac. Tannici, . . . gr. xx. Mastiches, . . . gr. x. .Etheris, . . . M. Sig.—On cotton to cavity. (D.) (Esophagus, Affections of. Belladonna, the liniment with frictions to the sternum, often very useful as a palliative in stricture of the oesophagus (Wa.). Conium, in spasmodic con- tractions, with crampy pains of stomach, flatulence, and globus hystericus, has proved very serviceable (Wa.). Hyoscya?nus, or Conium, in stricture of oesophagus, if much irritability ; with occasional leeching to relieve exacerba- tions of pain or spasm (D.). Silver Nitrate, in stricture of the oesophagus, a weak solution on sponge probang (D.). Anesthetics, should be used only to meet temporary indications (W.). Nutrient Enemata, in stricture of the oesophagus, when swallowing impossible (R.); may, in some cases, even pre- serve life (Wa.). [See Enemata.] Bougie Dilatation, in non-spasmodic (structural) stricture, the only appropriate treatment (H.). [Compare Dys- phagia, Choking.] Onychia and Paronychia. Silver Nitrate, a strong solution in nitrous ether, painted over the adjacent tissue, will abort if applied early (B.); frequently causes resolution of the inflammation (Wa.). Lead Nitrate, dusted over night and morning (R.); relieves pain, and hastens healing process (B.). Turpentine, applied on a piece of lint or other absorbent material, stops the pain at once, and seems to kill the felon. Mercury, as ointment, for io minutes in every hour; poul- tices in interim (R.). Arsenic, gr. ij ad Jjj Adipis, as ointment, almost specific in onychia maligna (Wa.). Tartar Emetic, will shorten course, and render 680 OPHTHALMIA. it milder (R.). Iodoform, oint. or powder dusted on (B.); or I part to 9 of Ether applied by a dropper in syphilitic onychia (Fox). Iodine, a strong al- coholic solution locally will often subdue the disorder (Wa.). Chloral, a solution locally, as antiseptic, and to promote healing (B.). Sodium Chloride, common salt roasted until chlorine is driven off, equal parts of this, castile soap and Venice turpentine, as a poultice, is a very efficient application. Car- bolic Acid, to benumb surface during incision (R.); which should be carried down to the bone, especially in tendinous whitlow (D.). Cocaine, hypoder- mically, will accomplish the local anaesthesia more thoroughly, if delivered deeply into the tissue. Morphine, powdered, as local application to relieve pain. Heat, by poultices, is very useful. Ophthalmia. Silver Nitrate, a strong solution (gr. xx ad in granular lids; cautiously when corneal ulcers exist (B.); solid stick diluted with 2 to 4 parts of potas- sium nitrate, applied lightly and quickly, or a solution (gr. ij-x ad j|j) painted over everted lids, which should be washed with a solution of common salt, and then with water before being replaced (C.); in solution, gr. v ad aquae destillatae, locally once a day in purulent ophthalmia of the new-born, washed off with a weak solution of common salt (Noyes); in solution, gr. iij to the £ to abort the discharge in catarrhal ophthalmia (Fox). Boro-Glyceride, in many catarrhal affections, especially ophthalmia neonatorum, is a most effica- cious application, the solutions used being of 10, 25 and 50 per cent, strength (Fox). Alum, gr. viij ad aquae, applied every or x/2 hour in purulent ophthalmia of children; success depends on the frequency of the application (R.); a crayon formed of a crystal of alum, a mild and occasionally useful application (C.). Mercury. Calomel dusted over membrane in phlyctenular ophthalmia; or after detaching scales rub in brown citrine ointment every night for eczema of margin of lids (B.). Pulsatilla, as lotion to conjunctiva 8 or 10 times in 24 hours, also internally (P.); much used by homoeopaths (B.). Spigelia, useful in rheumatic ophthalmia (P.). Antimony. Tartar emetic, gr. fg to three or four times a day in strumous ophthalmia, with sharp purgation at commencement (R.). Belladonna, or Atropine, locally, of great service in strumous ophthalmia to relieve pain; constitutional treat- ment also required (Wa.). Atropine, gr. ij of neutral sulphate to the 3 of aqua destillata, twice or thrice daily, as soothing application (C.). Arsenic, invaluable in inveterate cases of strumous ophthalmia, especially when com- plicated with cutaneous eruptions (Wa.). Copper Sulphate, gr. j ad Jj aquae camphorae as collyrium in purulent ophthalmia of infants; in substance to inner part of lids in granular conjunctivitis (Wa.). Tannin, powdered (or in solution gr. j-x ad f)) produces remarkable results (B.). Lead Acetate, gr. j ad aquae destillatae, applied by camel’s-hair pencil to surfaces of everted lids, washed away before the lid is replaced. Or the Tannate of Lead ad 3 parts fine oil, and 1 of fresh lard, a very small piece as ointment to lid (C.). Carbonic Acid Gas, said to relieve the pain and photophobia of strumous ophthalmia when locally used (R.). Physostigma, to reduce pupil and shut out the light (P.). Iodine, is employed in scrofulous ophthalmia, locally for its al- terative stimulation (W.). Iodoform, in gonorrhoeal ophthalmia, and purulent conjunctivitis, of very great value locally, but should be pulverized very finely (Grossmann); does not bear out the claims made for it (Keyser). Zinc Chloride, gr. j ad j aquae as collyrium, in gonorrhoeal ophthalmia, used with marked bene- OPIUM HABIT. 681 fit; also a stronger solution (gr. ij-iv ad !|j), effectually arrests the muco-puru- lent discharge remaining after subsidence of purulent ophthalmia, and has suc- ceeded admirably in diphtheritic conjunctivitis and pustular ophthalmia (Wa.). Zinc Sulphate, as collyrium, gr. j-iv ad gj, is very serviceable in ophthalmia of infants or adults; liquor plumbi added improves (Wa.). Stapkisagria, especially in tarsal ophthalmia (P.). Colchicum, when gouty diathesis (P.). Cod-liver Oil, in strumous subjects, tends to remove the manifestations of the disease (R.). Cold Wet Compresses, or iced, are held to be essential in early stage of acute purulent and gonorrhoeal ophthalmia (C.). [Compare Ble- pharitis, Conjunctivitis, Keratitis.] Opium Habit. Capsicum, very serviceable from its power as a stimulant to the stomach, and its sedative action on the cerebrum (B.); removes the sinking sensation at the pit of the stomach experienced by alcoholics, when trying to break off that habit (R.). Cocaine, or the fluid extract of Coca (Erythroxylon), has been used to relieve the depression caused by the withdrawal of the drug (B.); has been, by many careful observers, pronounced of great benefit, re- storing appetite, inducing sleep, promoting digestion, while soothing the brain and inducing a feeling of contentment and calm (R.). Bromide of So- dium in large and increasing doses, £j twice daily, increased by 20 grains each day, to a maximum of 100 to 120 grains twice in twenty-four hours, with simultaneous gradual reduction of the opiate dose, so that from the 8th to the 10th day it is entirely abandoned. Each dose of the salt should be given in 6 or 8 fluid ounces of cold water (Mattison). Cannabis Indica,ma.y be required in full doses, for restlessness after withdrawal of the opiate, 3-doses of Squibb’s fluid extract, repeated every hour or two, as required (M.). Galvanism, is very efficient for the neuralgic pains in various parts; a strong faradic current sometimes acting better (M.). Baths, if hot, 105° to 112° F., are of great value to relieve disquiet; warm baths are worthless (M.). Chloral, as a hypnotic, fails in the first few days of abstinence; later in full doses, 45 grains at once, rather than three 15-grain doses, alone or with a bromide, it can be relied on (M.). Hyoscyamine, Merck’s amorphous, gr. T'j to £ hypo- dermically, or more, is useful as a hypnotic, and perfectly safe, in patients of good general condition, in whom the disuse of Opium produces unusual in- somnia and motor activity (M.). Lupulin, with Phosphoric Acid (see formula below), helps to sustain the patient, lessens the force of his suffering, and shortens its duration (Fleming). Zinc and Iron as blood tonics, given for a month at least, are valuable, and are best given on alternate days (see formula below) (Fleming). Piscidia Erythrina, has been proposed as a substitute, and highly commended, but is worthless, as are also Avena sativa and many other falsely termed substitutes (M.); there is no remedy for the opium-habit (Da Costa). Zinc Oxide, for the vomiting and diarrhoea, beginning with gr. j once daily and increasing to tolerance (Da C.). Withdrawal of the drug sud- denly and completely, is the method of Levinstein and other Germans, and is preferred when we can have absolute control and surveillance of the pa- tient (Da C.); entails horrible suffering, and is utterly inexcusable (M.). A more gradual reduction is the method usually employed, taking off one-third the first day, one-fourth the second day, and then gradually reducing the amount until the sixth or seventh day, when it is entirely withdrawn. 682 ORCHITIS. Prescriptions. R. Tinct. Capsici, . . . Potassii Bromidi, . . Spt. Ammoniae Aromat., . Aquae Camphorae, . adppij. M. Sig.—A dessertsp. several times daily, in the depression of al- coholism and opium-habit. Instead of the bromide, Fowler’s Solution (Liq. Potas. Arsenitis), th.1, may be added; or Tinct. Nucis Vomicae gij, or Tinct. Aurantii Amari gv. {Ringer.) R. Strychninae Sulphatis, . gr. ss. Tinct. Belladonnae, Tinct. Capsici, . aa M. Sig.—Ten drops every three hours, increasing three drops daily. R. Strychninae Sulph., . gr. ss-j. Tinct. Gentianae Co., Tinct. Cinchonae Co., . aa M. Sig.—Teasp. before each meal, as a stimulant to the appetite and nervous system. R. Acidi Phosphor. Dil., . £x. Tinct. Lupulini, . . gxx. M. Sig.—A dessertsp. in a wine- glass of water every 4 hours, I hour before food. {Fleming.) R. Tinct. Cannabis Ind., . nixl-lx. Spt. Aitheris, . . zj. Aquae, . q. s. adgj. M. Sig.—One dose, if insomnia is very protracted. {Fleming.) R. Zinci Valerianatis, . gr. xxiv. Quininae Sulph., . gr. xij. Ext. Lupuli (B. P.), . q. s. M. ft. pil. no. xij. Sig.—One pill morning and evening, every second day, alternating with the Iron Mix- ture. {Fleming.) R. Syr. Ferri Phosph. (B. P.), gxiv. Ac. Phosphor. Diluti, . 3vj. M. Sig.—A teasp. in a winegl. of water, after meals, twice daily every second day, alternating with the Zinc pill. (Fleming.) Orchitis. Pulsatilla, try or less, every hour, relieves pain rapidly, though not the oedema (St.). Belladonna, int. and as oint. (extract j ad iij adipis) when in- flammation has subsided (Wa.). Iodine, tinct. locally to remove swelling after the acute stage has passed (B.). Mercury, the oleate locally (B.); Calomel- gr. iij with Ipecac, gr. x at once, followed by a saline next morning, and smaller doses of calomel and ipecac, every 6 hours, with morphine hypoder- mically, gr. into cellular tissue of scrotum (McElroy). Ammonium Chlo- ride, makes a good evaporating lotion, in solution with alcohol and water (B.). Silver Nitrate, a strong solution to the scrotum, with gentle pressure ( Wa.). Tartar Emetic, in acute orchitis (R.). Digitalis, locally, is found most useful (P.). Alcohol, with equal quantity of water, as evaporating lotion (B.). Ice, benefits and relieves pain (B.). [Compare Epididymitis.] Prescriptions. R. Ammonii Chloridi, . gr. xl. Alcoholis, Aquse, . aa M. Sig.—Lotion, to be applied on cloths to the part. R. Hydrarg. Ammoniat., . zj. Cerati Simplicis, . . M. ft. unguent. Sig.—Apply lo- cally, with gentle friction. OTALGIA—OVARIAN NEURALGIA. 683 Otalgia. Aconite and Opium, equal parts of the tinctures, a few drops well down the external meatus, will often subdue the pain. Bliste?'ing Fluid, or Croton Oil Liniment, behind the ear often relieves earache (R.). Glycerin, for dryness of meatus (R.); or oil for accumulation of wax in external meatus, dropped in every night, gentle syringing in the morning with warm water (Cl.). Opium. Morphine in solution, gr. iv to the with gr. j-ij of Atropine, is an excellent application (B.). Atropine, gr. in jxx of water, a teasp. every three hours for a child in the acute otitis media of children from coryza, very successfully use4 to abort the otitis, and relieve the earache (Miot). Pulsatilla, internally and externally, is often used with advantage (P.). Cocaine, a 4 per cent, so- lution sprayed over the tympanic membrane through the external meatus, and forced into the Eustachian tubes by inhaling the vapor and then expanding the tubes by Valsalva’s method; this repeated every three minutes, is a very sure method of curing otalgia (R.). Otitis. Pulsatilla, in inflammation of external auditory canal; in otitis, as lotion warmed and applied by syringe, three or four times a day (P.). Aconite, quickly relieves the pain (R.); should be used internally and locally. Atro- pine, in the acute otitis media of children, is very efficient. See Otalgia, above. Blisters, behind ears, either kept discharging or repeated, often very useful (Wa.). Leeches, behind the ear, afterwards a small blister upon the same place, when leech-bites have healed (H.). Warm Douche frequently, to the ear (Roosa). [Compare Otorrhcea.] Otorrhoea. Mercury, in chronic cases, the brown citrine ointment (B.). Lead lotions much employed (B.). [See Conorrhcea, for formula.] Potassium Per- manganate, as injection or spray, gr. j-3jj aq. destil. (B.). Silver Nitrate, locally, a solution of gr. iv. to the £ (B.) ; gr. x to the 3 (Roosa). Copper Sulphate, gr. j-v to the g (Roosa). Tannin, the glycerite, locally, is suc- cessful (B.); especially in children (Wa.). Zinc Sulphate, locally, in solu- tions of gr. ij-viij to the % (B.); gr. j-v to the (Roosa). Cadmium, gr. ij- rose-water (B.). Liquor Sodce Chlorates, nqxv-xxx ad !|j aquae when dis- charge fetid: is highly useful as injection (Wa.). Quinine, with sulphuric acid, advisable in otorrhoea after scarlatina (Wa.) Boracic Acid, finely pul- verized, as astringent and disinfectant application; may be mixed with pulv. Alum, and just enough powdered Lycopodium to keep it dry this packed carefully through speculum, after washing with a weak and tepid alkaline solution. Absorbent Cotton on holder, may be used every few hours by patient to keep pus removed from the canal. Syringing with warm salt water, once daily, as absolute cleanliness is essential in the treatment. Politzer Bag is a useful adjunct in keeping secretions out of tympanum and breaking up adhe- sions (Roosa). [Compare Otitis.] Ovarian Neuralgia. Atropine, subcutaneously, the best remedy for pain in the pelvic viscera (Wa.). Ammonium Chloride, gr. xxx with gtt. ij-v tinct. aconiti, repeated in 684 OVARITIS—OZALNA. )4-hour if necessary to remove pain (W.). Camphor, with Cannabis Indica, of great service in relieving ovarian pain, especially when spasmodic in character (Wa.). Opium, often the cause; if use stopped entirely improvement may ensue (E.); one of the best remedies in ovarian pain of non-inflammatory character (Graily Hewitt). Hot Water, vaginal injections, night and morn- ing; sunlight baths, fresh air (E.). Ether, the compound spirit, in doses of Ttpxxx-xl as a palliative (Anstie). Gelsemium, deserves a trial; its power is great but not certain (Wa.). Leeches over the groin, or inside the thigh, where ovarian pain persistent, or tenderness and aching (Wa.). Surgical. Battey’s operation as a last resort (E.). [Compare Dysmenorrhoea.] • Ovaritis. Turpentine Epithems, may be applied hot over the seat of the disease (Wa.). Tartar Emetic, as ointment for counter-irritation over seat of disease, in sub- acute ovaritis; at same time a pill of opium, hemp and camphor. See for- mula below (Hewitt). Opiutn, in suppository or enema, more effectual than internally (Tilt). Mercurial Ointment, combined with camphor and bella- donna, over the seat of the disease by friction (West). Blisters, in subacute ovaritis are often of great service, placed over the region or to the cervix uteri (Wa.). EnemaSi of warm water, simple or medicated, in subacute ovaritis, are warmly recommended ; they should be retained as long as possible (Wa.). Ergot, is valuable in chronic ovaritis, with rest and Potassium Bromide (Tait). Ice, in bag, over seat of pain, when intolerable, and patient too much reduced to bear leeches; is often of benefit (Wa.). Poultices of Linseed meal, as light as possible, often produce great benefit in ovarian inflammation. Prescriptions. R. Ext. Opii, . . . gr. iij. Ext. Cannabis Ind., Camphorae, . . aa gr. vj. M. ft. pil. no. vj. Sig.—One pill twice daily. (Graily Hewitt.) R. Ung. Hydrargyri, . . gvj. Camphorae, . . . gr. xl. Ext. Belladonnae, . . gij. M. ft. unguent. Sig.—To be rubbed in twice daily. ( West.) Oxaluria. Mineral Acids, when eructations of sulphuretted hydrogen (R.). Nitro- muriatic Acid, is of important service (B.); especially in the condition show- ing general malaise, weakness, and depression of spirits, with oxalate crystals in the urine (W.); also in sciatica and other forms of neuralgic rheumatism accompanied with oxaluria, full doses (ntyj-x) of this acid, with an occasional brisk purgative, and cold douche, followed by friction (Wa.). Zinc Sulphate, often very serviceable in irritability of the nervous system, associated with dyspepsia and oxaluria (Bird). Lactic Acid, aids imperfect digestion (B.). Ozaena. Gold, the auric salts are very serviceable in syphilitic ozaena (B.). Mercury, ointment of the nitrate in syphilitic form; the white or red precipitate with 58 times its weight of sugar snuffed after clearing the nose in non-syphilitic forms (R.). Potassium Permanganate, gj-Oj solution as injection or spray (B.). Hydrastis, the fluid extract locally (B.); gj-jfviij solution as lotion with upv PAIN. 685 of the tincture thrice daily internally (P.). Bromine, as inhalation (see form- ula below); or Iodine with Carbolic Acid, ox the latter in one per cent, solution, as inhalations (B.). Carbolic Acid, inhaled, 1 per cent, solution (B.). Silver Nitrate, applied behind veil of palate;—gr. v-xx ad sjj (B.) Alum, solution for irrigation (R.). Glycerite of Tannin, by irrigation (R.). Sali- cylic Acid, in very weak solution (1 to 500), as cleansing, astringent, and dis- infectant wash, used by retro-pharyngeal syringe, and followed by applications of Calomel, in powder, to the ulcerated portions of the mucous membrane (Massei). Cubeba, the oleo-resin, gtt. xv-xx on sugar after each meal, to restrain the secretion and perhaps modify its character (Cohen). Chloride of Lime, gr. xxx-lx with j|j decocti kramerise; of which xij-ii), diluted with an equal quantity of water, should be injected twice daily after cleansing with salt and water (Cohen). [Compare Catarrh, Chronic Nasal.] R. Tinct. Iodi, . . . Ac. Carbolici, . . . t^j-ij. M. Sig.—Use on sponge in a wide-mouthed bottle as inhalation. (Potter.) Prescriptions. R. Sodii Carbonatis, Sodii Boratis, . aa ,^ij. Liq. Sodae Chloratae, . zss-ajij. Glycerini, . . . Sj. Aquae,. . q. s. ad gvj. M. Sig.—Apply by means of a hand-spray apparatus. ( Thornton.) R. Bromi, .... gss. Alcoholis, . . .. M. Sig.—Inhalation when vapor- ized by heat of the hand. R. Acidi Carbolici, . . tt| xx. Aquae Calcis, . . Oj. M. Sig.—Use as wash or spray. Pain. Opium, is universally used to quiet pain. Morphine, hypodermically, in vicinity of nerve, is curative when not so by stomach. Morphinae acetas vel sulphas gr. with atropinae gr. to T|5. Caution, morphine habit (B.). Sometimes a single injection curative of sciatica and neuralgia. Poultices con- taining laudanum useful in inflammation. Linimentum opii by friction, relieves pleurodynia, neuralgias, etc. Opiates soon lose their influence in any certain dose, requiring increased quantities to keep up analgesic influence, so in chronic cases it is best to exhaust all other means before resorting to it (R.). Chloral, has no direct pain-relieving power, except in dangerous doses. To relieve pain and promote sleep, the best agent is a combination of chloral and morphine, cautiously, if heart trouble, or to old drunkards; gr. xv-xxx-j-gr. % (B.). Some- times relieves neuralgia, chronic rheumatism, gall-stones, colic, gastralgia, and even cancer (R.). Aconitine, locally over seat of pain; one of the most certain and powerful palliatives in neuralgic, rheumatic, and gouty affections (Wa.); espe- cially seviceable in neuralgia of 5th nerve (B.). Belladonna, the best remedy for every kind of pain in pelvic viscera (Anstie). Atropine hypodermically in local pain, neuralgia, sciatica, glaucoma, etc. When it succeeds, has more lasting effect than morphine (R.); sciatica, tic douloureux, etc. (B.). Iodides, are magical in syphilitic nocturnal pains of head (B.). The iodide of ammo- nium, gr. iij ad 3;j ol. olivse, with friction ; causes the disappearance of noc- turnal syphilitic pains (Wa.). Cimicifuga, relieves many kinds; neuralgia of 5th, rheumatic headache, ovarian neuralgia, dysmenorrhcea. Inferior to ergot in labor-pains or after-pains, gj doses (B.). Conium, in cancer, rheu- 686 PARALYSIS. matism, neuralgia, etc. (R.). Chloroform, locally, inferior to other local anaes- thetics, two or three drops on cotton into the ear for faceache or toothache ; vapor on raw surface of cancers, neuralgia of uterus, photophobic eye, etc., by inhalation in renal and biliary colic, and to produce general anaesthesia, which see (R.). Ether, spray for local anaesthesia; inhaled for general anaesthesia (R.). Carbolic Acul, as local anaesthetic (R.). Cocaine, as a local anaesthetic to mucous surfaces, or hypodermically for minor operations involving a small area, as circumcision, eye operations, etc., has no equal; a 4 per cent, solution of the hydrochlorate is generally employed (R.); has many applications, as odon- talgia, otalgia, neuralgia of superficial nerves, etc., etc. Iodoform, as supposi- tory in painful diseases of the rectum or bladder (R.). Stramonium, is used as ointment (R.). Duboisine, used instead of atropine (B.). Rhatany, relieves the pain of ulcerative disease of mucous membranes, pain of burns, ulcers, and especially of blisters (Tr.). Cannabis Indica, formerly used (B.). Aquapuncture (B.). [See Neuralgia.] Galvanism, of an affected nerve gives certain relief. Positive pole on point of emergence ; negative over supe- rior ganglion of cervical sympathetic (B.). Heat, if pain is without fever or inflammation (B.); warm injections soothe the pain of cystitis, prostatitis and abdominal pains generally (B.). Cold, when pain is inflammatory (B.). [See After-pains, Anesthesia, Boils, Chest-pains, Colic, Gastralgia, Head- ache, Hepatalgia, Inflammation, Lumbago, Myalgia, Neuralgia, Odontalgia, Otalgia, Rheumatism, etc.] Paralysis. Strychnine, gr. fa to [gr. fa to fa (R.) ] ; also hypodermically into the affected muscles,—for hemiplegia, paraplegia, local, mercurial, paludal, rheumatismal, facial, infantile, and diphtheritic paralyses; in that of spinal muscles, of bladder and all local forms (B.) ; often of use in hysterical (P.) ; all forms, except, according to Barwell, in cerebral and spinal paralyses (R.). Nux Vomica, in hysterical, and in that from lead-poisoning; only in chronic cases (P.); in paraplegia from softening and wasting of cord (Brown-Sequard). Hyoscyamine, gr. fa gradually increased to fa in par. agitans, locomotor ataxia (B.). Rhus Toxicodendron, certainly efficacious in cases depending on rheu- matism (P.). Ammonium, the iodide and carbonate to aid in absorption of thrombi and thus promote cerebral nutrition in cases of incipient hemiplegia, due to endarteritis deformans reducing the lumen of the vessels in the brain (B.). [See formula below.] Arnica, paralysis of the bladder, and many forms (P.). Phosphorus, with cod-liver oil in paralysis agitans, small doses; also in the paralysis of white softening of the brain (B,); in hysterical paralysis (R.); in myelitic paraplegia from excessive venery ; the only drug which really affects the nerve-centres (W.). Belladonna, when depending on chronic inflammation of the cord (R.); externally as ointment along spine, with Ergot internally (Brown-Sequard). Physostigma, into the eye in ocular paralyses (B.); in general paralysis of the insane, also in progressive muscular atrophy without much mental disorder, long-standing hemiplegia, paraplegia, loco- motor ataxia (R.). Conine, in some cases of paralysis agitans (B.). Ergot, in paralysis of bladder from over distension (B.) ; paralytic dys- uria, sensation of but partial emptying of bladder (P.); said to be useful in paraplegia (R.); in paraplegia complicated with menstrual irregularity and forms of paralysis arising from spinal congestion (Wa.); has cured cases of constipation of the paralytic when all the most powerful cathartics PAROTITIS PEMPHIGUS. 687 failed (Curran). Cocculus Indicus, valuable in hemiplegia, paraplegia, and paralytic stiffness (P.). Ignatia, in paralysis of lower extremities (P.). Can- nabis Indica, for retention of urine from spinal disease (R.). Capsicum, in to 2-grain doses every 4 hours as general stimulant (P.). Colocynth, in cere- bral paralyses, sometimes seems to act favorably upon principles of revulsion or counter-irritation (P.). Mustard, as an emetic to stimulate failing heart in certain forms of paralysis (P.). Senega, in rheumatic, is a powerful help (P.). Nutmeg, the oil as external stimulant (P.). Oil of Bay, has been given; is obsolete (P.). Cajuptit Oil, efficacious in palsy (P.). Counter-irritation, by blistering fluid in peripheral paralysis of the 7th nerve (R.). Cod-liver Oil, Anstie insists on it when low nutrition and faulty assimilation (B.). Galvan- ism, in hemiplegia and many forms (B.). Electricity, faradization of the muscles affected. Localized electricity probably of more importance in confirmed spinal paralysis than medicinal treatment. Massage, in infantile paralysis, given with lacto-phosphate of calcium and cod-liver oil. Strychnine injected into the muscles (B.). [Compare Hemiplegia, Locomotor Ataxia, Tongue. 1 Prescriptions. R. Strychninae Sulph., . . gr. ij. Aquae Destillatae, . . 5j. M. Sig.—For hypodermic admin- istration : tti_v = gr. -fa of strychnine sulphate. R. Ammonii Iodidi, . . gj. Ammonii Carbonatis, . s(ij. Liq. Ammonii Acetatis, . gvj. M. Sig.—A tablesp. thrice daily. See Ammonium, above. (B.) Parotitis. Aconite, in febrile conditions (R.). Mercury, grain of gray powder, 3 or 4 times a day very useful, relieving pain and swelling (R.). Poultice of flaxseed meal, a good local application for gland. Leeching, often gives speedy relief, when pain is great and resists hot fomentations (Wa.). Care to avoid chilling, important. Incision, when suppuration occurs. Stimulants and Tonics internally are very necessary in symptomatic parotitis, occurring as a complication or sequel of other diseases, with adynamic symptoms. Pediculi. Mercury. Citrine ointment or wash of corrosive sublimate, for lice on all parts of body. The oleate destroys lice immediately, and also kills the ova (R.). Cocculus Indicus, destroys pediculi (P.). Staphisagria, as oil or oint- .ment of the powder (R.); “ lice-bane ” (P.); the tincture a very efficient application, and much more cleanly than an oil or an ointment. Tobacco, a decoction of the leaf is an efficient application, but requires care, especially if the surface is abraded (Wa.). Essetitial Oils, will kill, as rosemary, anise (P.); or powdered pyrethrum (R.). Cleanliness, cannot be dispensed with, and in many cases may alone be sufficient. Boil underclothing. Isolation of person, and of brushes, towels, etc., to prevent infection. Pemphigus. Arsenic, is curative, especially when chronic (B.); largest dose, nxv liquor arsen. 3 times a day, on full stomach (R.); exercises a powerful influence 688 PERICARDITIS—PERITONITIS. (Wa.). Mercury. Citrine ointment is largely used (Wa.). Potassium Iodide, improves the condition in pemphigus (Wa.) ; with good, simple diet; quinine, coddiver oil, etc. Silver Nitrate, in pemphigus, after the bullae have burst, and excoriations remain (gr. ij ad j|j aquae) (Wa.). M/ater Dressings, on lint, covered with oiled silk, constantly, in pemphigus and rupia (Wa.). Cod- liver Oil, with nutritious diet, is a powerful auxiliary to treatment (Wa.). Puncturing the blebs and evacuation of their contents is necessary as soon as formed. Then dusting-powders of zinc oxide, starch, or buckwheat flour, or lotions of liquor plumbi subacetatis dilutus. Pericarditis. Aconite, when violent throbbing and extreme pain (R.); of great value, if given early (P ); proves in the highest degree serviceable, when object is to diminish vascular excitement or irritability (Wa.). Spigelia Anthelmia, useful in rheumatic pericarditis (P.). Digitalis, when rapid and feeble heart, cyan- osis and dropsy (P. N.); in second stage when heart flags, a tablespoonful of the infusion every 4 hours is beneficial. Bryonia, exceedingly valuable in sec- ond stage, that of exudation; fully equals any remedy in pericarditis (P.). Opium, regularly in grain doses, every 3, 4, 6, or 8 hours, is very beneficial (Wa.). Veratrzmi Viride, extract made by inspissating the juice of the root, of which gr. ij, with j of calomel, every 2 hours, valuable (Waring-Curran). Quinine, gr. xv-xx may suppress an acute attack, if given at critical mo- ment (B.); may be used as an antipyretic. Counter-irritation, has been much abused; useful at commencement, but not in acute inflammatory stage (B.). Iodine painted over the cardiac region, or flying blisters in the second stage. Iron, the tincture in full doses may be required in the second stage. Poultices, large, hot, often renewed (R.). Ice may be used instead of poul- tices in the early stage. Paracentesis by aspiration may be required in the second stage. [Compare Endocarditis.] Periostitis. Mezereon, in the rheumatic and scrofulous form (P.). Mercury and Mor- phine. The oleate externally (R.). Potassiu?n Iodide, in syphilitic children, also in non-syphilitic periosteal thickening (R.) ; holds the first place for syph- ilitic affections of the bones (Wa.), Ammonium Iodide, cures periostitis most readily when syphilitic (Wa.). Staphisagria, when long bones affected (P.). Iodine, the tincture, or blisters locally, of great service in chronic form (R.); under the external use of Iodine it often rapidly improves (Wa.). Poultices, after an early and free incision, when suppuration takes place (C.). Incisions, carried deeply, should be made without waiting for fluctuation, when great tension exists and there is a tendency to suppuration. The sides of the abscess should then be brought together with compresses and a bandage (Gross). Tonics and stimulants, as milk-punch, quinine, iron, and opium, in full and sustained doses, are imperatively demanded in many cases (Gross). [Com- pare Nodes, Onychia.] Peritonitis. Aconite, of great utility when sthenic reaction; see Opium {B.); should be given early in all inflammations of serous membranes (P.). Bryonia, ex- 689 PERSPIRATION. ceedingly valuable in second stage, when exudation (P.). Mercury, when tendency to fibrinous exudations, is employed with good effect (W.). Opium, to quiet intestinal movements (R.); by far the best agent (P., B.). Morphine, gr. Yi hypodermically, will often abort, if given early. Aconite and Opium, the tinctures, gtt. ij of the former with gtt. vj of the latter, in water every hour or two; a larger dose of opium if pain is severe (B.). I.arge doses easily borne in this affection (Wa.). Cocculus Indicus, for tympanites; a few doses will often remove the pain and relieve distension (P.). Quinine, strongly urged by Trousseau ; is naturally indicated in most inflammations (P.). Turpentine, for tympanites (P.); turpentine stupes, v-xv drops of turpentine on flannel wrung out of hot water during acute stage, then blisters for a short time (B.). Leeches, to abdomen, if patient plethoric, and sthenic reaction, relieve pain (B.). Purgatives, are inadmissible when from perityphlitis or inflammation of appendix vermiformis (B.). Poultices, large hot, and frequently renewed. Should be thin, and covered with cotton-wool (R.). Ice, to abdomen (B.). Cold relieves (W.). Water, hot fomentations to relieve pain, sometimes cold compress better. Ice, sucked or swallowed, to assuage the vomiting ; sips of cold water. Diet, after acuteness of attack passed, should be mild and unstim- ulating. [Compare Puerperal Peritonitis.] Perspiration. Belladonna, as liniment locally, also the tincture internally, especially in weakly children who sweat profusely (R.). Atropine, gr. to T^5 hypo- der. (or in exceptional cases even gr. in pill) in sweating of phthisis and exhausting diseases (R.); gr. at bedtime for sweats of phthisis (B.). Ja- borandi, gr. fa of pilocarpine, thrice daily, checks profuse perspiration (R., Pf.). Quinine, in exhausting diseases. In many, a night-draught of quinine, sulphate of zinc, and sulphuric acid, useful (R.). Opium, as Dover’s pow- der, may succeed in profuse colliquative sweating (R.); a fact, though hard to account forit(Wa.). Aromatic Sulphuric Acid, to check sweats of phthisis. Bad for digestion (B.). Muscarine, has been used with great success in the sweats of phthisis and of other morbid states (R.). Sage, an infusion at bedtime, for the night-sweats of phthisis (Da Costa). Zinc Oleate, rapidly controls excessive and offensive sweating on slight exertion in the axillae and groins, also the night-sweats of phthisis (Murrell). Zinc Oxide gr. iij, with gr. ss of ext. belladonnae, in a pill at bedtime for the sweats of phthisis (R.). Gallic Acid, is very useful for the same condition, and may be combined with extract of belladonna (B.). Tannic Acid, may also be used with benefit. Aluminium, the oleate, checks hyperidrosis and antiseptizes the sweat, thus forming a useful application to the axillae and groins of children (Wa ). Po- tassium Permang., gr. j-|jj, for fetid perspirations of axillae, feet, etc. (B.). Salicin, profuse sweats of hectic fever (Wa.). Salicylic Acid, in solution with borax, the most agreeable and efficient deodorant for fetid perspirations (B.). Carbolic Acid, 2 parts to 3 of glycerin and water, twice daily for fetid sweat (Wa.). Oils, rubbed into the whole skin to prevent sweating accompanying exhausting diseases, as phthisis; but sponging with a weak acid wash better (R.). Ergot, said to arrest sweating (R.). Sponging, with acidulated water, or very hot sponging in phthisis (R.). [Compare Feet.] 690 PERTUSSIS. Prescriptions. R. Acidi Gallici, . . gr. xxx. Ext. Belladonnse, . gr. ij. M. ft. pil. no. x. Sig.—Two pills at bedtime (B.). For sweating of phthisis. R. Acidi Tannici, . . gr. xxx. Pulv. Digitalis, . . gr. xv. Ext. Cinchonae, . . q. s. M. ft. pil. no. xx. Sig.—One pill at bedtime. Pertussis. Aconite, in all acute congestions (P.); as a preventive or abortive remedy very efficient, when associated with ipecac, and cherry-laurel water (Der- vieux). See formula below. Amyl Nitrite, with Carbolic Acid, in steam atomizer, has proved a very efficient inhalation (Bayliss). Ipecacuanha, use- ful in many cases (R.); ntj for 5 years of age, every hour or two, with the greatest relief (P.); when bronchitic or pneumonic complications, combined with ammonium bromide (Wa.). Pulsatilla, gr. J-j of anemonine (P.). Belladonna, obviously of value in febrile stage, is of special use when denti- tion is in progress; relieves the congestion of air-passages and also the deter- mination of blood to the head (P.); good when profuse bronchial secretion; best in spasmodic stage. Children bear this drug well; Tltx of tinct. may be given hourly to a child 2 or 3 years old (R.). Benzoate of Sodium is highly efficient. See formula below. Conium, or the Ilydrobromate of Conine, in doses of gr. -fo to gr. | according to age, a very efficient remedy (W.). Dro- sera, small doses are very effective (Murrell). Chamomile Oil, a very useful remedy (P.). Coccus Cacti (Cochineal), in doses of gr. thrice daily for infants, has been highly recommended (W.); proves very effective in most cases. Hydrocyanic Acid, very serviceable in cough by habit, after cessation of whooping-cough proper, or in nervous sympathetic cough of mothers (B., P.). Opium, in convulsive stage, to produce and maintain slight heaviness (R.), Brotnides, relieve spasmodic element (B.); that of ammonium will readily cure many cases; gr. ij or iij ter die for infants (Wa.). Lobelia, in spasmodic stages; well tolerated by children; rrix of tinct. every hour for child 2 years old; also additional dose when cough is imminent (R., P.). Alum, when acute stage over and no complication, gr. ij-vj every 3 hours, or less every hour in glycerin or honey (R.). Chloroform or Ether, to lessen severity of the paroxysms; as inhalations (R.). Chloral, gr. v-x in spas- modic stage, relieves quickly (B.) ; gr. iij-viij every 4 hours (Porter). Car- bolic Acid, as vapor, with steam atomizer; found to be very beneficial (J. L. Smith). Castanea, a decoction of chestnut leaves has been used with much success; dose ad libitum (B.); the fluid extract, in 3-doses, exercises a re- markable influence over the cough (W.). Valerian, said to control the par- oxysms (R.). Nitric Acid, well diluted in sweetened water, after the subsist- ence of the catarrhal stage (B.). Gelsemium, in spasmodic stage(B.). Mono- bromide of Camphor, gr. v in mucilage and syrup, tolu. 3 or 4 times a day, has been very serviceable (B.). Zinc Sulphate, gr. with ext. belladon. gr. /4~/4> has varying degree of success (B.). Lactucarium, the syrup as vehicle for cough-mixtures (B.). Quinine, in solution, locally to fauces (Dawson); the tannate with sodii bicarb, of each 5, and pulv. acacise 100 parts, used with an insufflator (Pollack). Petroleum, on rags around head of the bed, is recommended highly by Hildebrandt. Silver Nitrate, when acute stage passed (Tr.) ; probably inferior to alum (Wa.). [Compare Cough.] PHARYNGITIS, 691 Prescriptions. R. Chloralis gj. Potassii Bromidi, . . F\). Syr. Pruni Virgin., . *. 5j. Aquae, . . . • 5). M. Sig.—A teasp. thrice daily for infants in the convulsive stage. (Dessau.) R, Sodii Benzoatis,. . gr. Ixxx. Aquae Menth. Pip., Aquae Destillatae, aagx. Syr. Aurantii, . . M. Sig.—A dessertsp. every hour or two. (Letzerich.) R. Ext. Aconiti,. . . gr. j. Syr. Ipecacuanhse,. . TRxlv. Aquae Laurocerasi, . Mucil. Acaciae, . . 3vjss. M. Sig.—A teasp. to a tablesp. according to age, every hour. (Dervieux.) R. Acidi Carbolici, . . Potassii Chloratis, . . Glycerini,.... giv. Aquae, . . q. s. ad 3 vj. M. Sig.—Use with steam atomizer thrice daily. (J. Lewis Smith.) R. Amyl. Nitritis,. . . £ss. Acidi Carbolici, . . ttl x. Glycerini, Alcoholis, . . aa M. Sig.—Use by inhalation with steam atomizer. (Bayliss.) R. Olei Morrhuae, Mellis Despumat., Succi Limonis, . . aa p. seq. M. Sig.—A teasp. or two as re- quired. (Sir Wm. Gull.) Pharyngitis. Aconite and Belladonna, for acute attacks (B.); when high temperature (R.). Belladonna, is very useful, relaxes the pharyngeal muscles (W.). Cap- sicum, as gargle, gj ad 0}4 aquae, in very early stage only (R.). Alum, gar- gles, in chronic inflammations (R.). Silver Nitrate, gr. v-xx ad gj, on sponge probang, successful if systematically applied (B.) ; in early stage of inflamma- tion; also in chronic on brush, or as spray (R.). The solid stick to each dis- eased follicle, after scraping (A.). Ammonium Chloride, gr. ij with Tqxv of tinctura cubebae, every half-hour, often controls acute pharyngitis; when a gouty diathesis exists add Tq.x of the ammoniated tincture of guaiac, and give every hour (A. A. Smith). Xanihoxylum, a decoction of the bark locally to throat, and trx-xxx of the fluid extract thrice daily, a very successful remedy for chronic pharyngitis (B.). Tannin, insufflation to affected surface (B.). Cubebs, powdered, locally, useful (B.). Glycerin, pure, locally, with tannic acid, very serviceable (B.); in chronic inflammation of the throat (R.). Hy- drastis, the fl. extr., locally, and gtt. v-x per stomach (B.). Alcohol, dilute, gargle in relaxed throat (R.). Cimicifuga, when pharynx dry and spotted over with inspissated mucus (R.). Ipecacuanha, the wine as spray in non- inflammatory sore throat, with hoarseness from congestion of vocal chords (R.). Pomegranate Bark, as gargle (P.). Potassium Chlorate, as lozenge to stimulate the follicular secretions to a healthy condition (A.). Iron, Qumine, and Strychnine, as tonics, are mainly indicated (A.). Zinc Sulphate, as gargle, occasionally employed in relaxed throat (R.). Inhalation of vapors, or of pulverized fluids, by the atomizer, found very beneficial (Wa.). Food, of piquant kind, spices, pepper, mustard, etc., should be strictly prohibited. All 692 PHIMOSIS PHLEGMASIA. fluids should be used at a moderate temperature (A.). Water, by throat com- press, relieves; also in daytime, in obstinate cases. Rest to voice, and culti- vation of beard, are useful aids. R. Tinct. Aconiti, Tinct. Belladonnae, . aa gss. Tinct. Guaiaci Ammon., . zv. Syr. Limonis, . . . zss. Aquae Cinnamomi, . ad M. Sig.—A teasp. every 3 hours for acute pharyngitis. Prescriptions. R. Aluminis, . . gr. xxx-^ij. Sodii Boratis, . Glycerini, . . jij. Tinct. Myrrhae, . Zij. Aquae, . q. s. ad jfiv. M. Sig.—Use as an astringent gar- gle, 4 or 5 times a day. R. Tinct. Aconiti, . . Ac. Hydrocyan. Dil., . rtp xl. Liq. Ammonii Acetat., . |jiv. M. Sig.—Teasp. every 2 or 3 hours according to the severity of the case. In acute and subacute pharyngitis. R. Acidi Tannici, . . gr. lx. Alcoholis, . . . TTlxxx. Aquae Camphorae,. . t^iv. M. Sig.—An astringent gargle, to be used several times a day. Phimosis. Belladonna, as ointment, extract vij-ad xx of lard, has proved effectual (Wa.). Lupulin, 5-15-gr. doses, of advantage after operation, to keep penis at rest. (Wa.). Surgical. Division of the prepuce by a bistoury and director; circum- cision (D.). Cocaine, a 4 per cent, solution injected at several points around edge of prepuce, as local anaesthetic during the operation of circumcision. Chloroform, or Ether, may be used as anaesthetic in paraphimosis, before at- tempting reduction (Wa.). Phlebitis. Hamamelis, has as decided an influence on the venous system as Aconite on the arterial (Pf.). Mercury, in frequent and liberal doses, to early and decisive constitutional impression, the best form being Calomel, or Calomel and Blue Mass Rest, fomentations, poultices, early incision of ab- scesses, aperients, opium to relieve pain and insure quiet of mind and body (D.). Blister, over course of an inflamed superficial vein(R.). Diet, nu- tritious, and wine, especially if great loss of blood (D.). Stimulants, as Quinine and Iron, especially the tincture of the Chloride, also milk-punch, are needed to combat the depression which is sure to arise. The disease is always dangerous and often fatal (Gross). Incisions, must be freely made if abscesses form, and the internal organs watched for multiple abscess. Ulcera- tion, if it occur, must be watched for hemorrhage, which should be arrested by compression and styptics (Gross). [Compare Phlegmasia, Varicosis.] Phlegmasia Alba Dolens. Belladonna, and Mercury, equal parts, as ointment, often of much benefit (Wa.). Hamamelis, has specific action on venous system (P.); extolled by Dr. Preston (R.). Blisters, in early stage: are extremely useful if judiciously PHLEGMON—PHTH ISIS. 693 employed (L.). Ammonium, Carbonate often valuable where great prostra- tion ; full doses (Wa.). Creosote, injections daily (Wa.). Hydrochloric Acid, gj of dilute acid in Oij of barley-water, with ($ss of potassium chlorate, to be taken daily (Mackenzie). Opium, large doses internally, with leeches and anodyne ointments (Wa.); laudanum, if pain severe, sprinkled on hot fomen- tations (L.). Leeches, of great service during the acute inflammatory stage (Wa.). Bandaging, when the more acute symptoms subside; at first with flannel, afterwards with ordinary roller bandage (L.). Regimen, should be tonic (L.). Water, compresses in active stage; douches, hot and cold in chronic form. Phlegmon. Aconite, ox Belladonna, are certainly efficacious. Aconite best (R.). Sul- phides, to abort, or, if inevitable, to promote ; gr. ss-j every hour or two of Po- tassa Sulphurata (B.). Silver Nitrate, strong solution may check if applied early in the vicinity (B.). Carbolic Acid, injections; a 2 per cent solution (B.); used with great success (W.). Iodine Injections, after evacuation (B.). [Compare Erysipelas.] Photophobia. Atropine, a neutral solution of the sulphate, gr. j ad gj, for adult, dropped into the eye every 4 hours (C.). If much lachrymation, so as to dilute the solution, it may be applied more frequently. In some cases belladonna irri- tates and has to be abandoned (Wa.). Conium, in scrofulous photophobia, gr. ss of Conine in of Ol. Amygdalte, locally twice or thrice daily; or the vapor of Conine (Wa.). Mercury, Calomel by insufflation (C.). Cantho- plasty, for the spasm of the orbicularis in severe photophobia (C.). Glasses of cobalt blue, the best (R.) Arsenic, in the condition described by old writers as strumous ophthalmia, with its attendant photophobia, is very valu- able as an internal remedy (C.). Chloroform, the eye exposed to the vapor of a few drops in severe photophobia will be speedily relieved (Jones). Croton- Chloral, gr. v-x, in young people and those suffering from syphilitic corneo- iritis (Bader). Potassium Chlorate, internally, is most useful in some cases (Vernon). Cocaine, a solution of the hydrochlorate, from 2 to 4 per cent., a few drops upon the conjunctiva, will be found promptly efficient in most cases. Phthisis. Calcium Phosphate, in diarrhoea, and in chronic forms of phthisis, with little or no fever (R.). Iodine, should be more used than it is; the compound solution, gtt. j-iij thrice daily, or when ansemia and not much fever use Iodide of Iron, gr. xv of the syrup pushed to gj ter die (Da Costa); as inhalation in chronic phthisis; to lessen expectoration and cough; also as liniment painted under clavicles, to allay harassing cough, and to check secretion (R.). Cimicifuga, useless in tuberculosis, but in phthisis it relieves cough, improves appetite, lessens intercurrent bronchitis, and so improves the patient’s general condition (Wa.). Arsenic, valuable in chronic forms as is no other remedy ; but not in caseous, or where much hectic; may be given by stomach or fumi- gation (B.). [See under Asthma.] As cigarettes, useful in the diarrhoea, probably diminishes temperature; caution required (R.); of great value in early stage, in later stages it is of no avail. Arsenious Acid, gr. or tq.iij 694 PHTHISIS. of Fowler’s solution, thrice daily (Da Costa). Cocaine, locally, for the throat symptoms, to be applied just before meals are eaten (Da C.). Cinchona, for the hectic and sweats, gr. xv-xx quinine (B.); if small doses fail, a dose of 6 or 8 grains at once, or in portions repeated hourly (R.). Ipecacuanha, spray to throat when bronchial asthma and emphysema combined with fibroid phthisis (R.). Cod-liver Oil, holds first rank as a remedy and food in the chronic forms; a teasp. after meals ter die is enough; when not well borne may be combined with aqua calcis, comp, tinct. of gentian; or, when not digested, with ether (B„ R.); is of great utility by improving nutrition, and by affecting the tubercle; give thrice daily one hour after meals, with rn.x-xv of Ether, or an equal quantity of malt or whiskey; do not give it in hot weather (Da C.). Terebene, with Thymol and Carbolic Acid, equal parts of each, and to a pint of hot water as an inhalation. Creasote, tar or car- bolic acid, to check expectoration (R., P.); Creasote is often curable in many forms, gr. iij in a pill with Bals. Tolu., three or four times daily, the dose being increased until urine is darkened; or it may be inhaled with Iodine from hot water (B.). Sanguinaria, helps expectoration, and revives the enfeebled stomach (P.). Chloroform, with glycerin or honey, for the cough in fibroid phthisis (R.). Ferrurn, often prescribed ; has no especial influence on deposit (B.). Prescribed in tuberculosis (Tr.). Liquor Ferri Perchloridi, aqute, the most serviceable local application in laryngeal phthisis, diminishing irritability of the mucous membrane, and quieting cough (Mackenzie). Mer- cury, gr. of corrosive sublimate every two or three hours, for the diarrhoea (R.). Benzoin, as inhalation, to lessen cough and expectoration (R.). Acids, Mineral, for the indigestion. The acidum muriaticum dilutum (B.). Prunus Virginiana, the wild cherry has a domestic reputation, probably due to its influence over cough; the syrup is much used as vehicle for cough-mixtures (B.). Hypophosphites, are very useful in chronic cases (B.); have no special effect (Da C.). Digitalis, as antipyretic ; deranges intestinal canal, therefore injurious in phthisis (B.). Opium, or morphine, in a viscid vehicle for cough, or morphine lozenges when cough due to inflamed throat (R.); must in time be given for the cough, which is an irritative one. Codeine, gr. yfa to in simple elixir, is useful and does not constipate (Da C.). Sulphurous Acid, inhalation, spray, or fumigation, in chronic phthisis (R.). Alcohol, an im- portant remedy; may be given with cod-liver oil; or spts. frumenti with some bitter, immediately after meals, or the stronger wines. If it dis- agrees, it harms. Curiously, it induces an intractable form of phthisis (B.). Verbascum, the Mullein-plant, has long been a popular remedy in phthisis; it facilitates expectoration, improves the general condition, and palliates the cough. Copper Sulphate, gr. -j or Silver Nitrate, gr. \, or Bismuth, gr. xx, for the diarrhoea (Da C.). Baths, sea-bathing, if chronic, little or no fever, without active deposition of tubercle, or scrofulous pneumonia; Turkish baths for the cough (R.). Grape-cure, is serviceable (B.). Aliment, should be nutritious and digestible, malt liquors better than wine or spirits. Extract of malt, cod-liver oil, plenty of meat, and alcohol in moderation (Da C.). Warm clothing, bathing and friction of skin, moderate exercise, and a suitable climate. Climate, the best by far is that of Egypt, or Algeria; next coming New Mexico, Southern California, South Carolina, and portions of Georgia and Florida; the latter being especially suitable for cases having a co-exist- ing bronchitis. For some cases Colorado is very good, and the Adirondack region for early cases in which there is no tendency to hemorrhage (Da Costa). [Compare Cough, Hemoptysis, Hectic Fever, Perspiration.] PITYRIASIS. 695 Prescriptions. R. Quininae Sulphatis, . gr. xviij. Pulv. Digitalis, . . gr. vj. Pulv. Opii, . . gr. iij. M. ft. pil. no. xij. Sig.—One pill thrice daily, for the irritative fever. (Da Costa.) R. Codeinae Sulphat., . gr. v-viij. Ac. Hydrocyan. Dil., npxx. Syr. Tolutani, . . M. Sig.—A teasp. several times daily, for the cough. R. Pepsini (Jensen), . . gr. xl. Ac. Hydrochlor. Dil., . Glycerini, . . . ;jv. Sued Limonis, . . apv. Aq. Aurantii Flor., q. s. ad M. Sig.—Dessertsp. with meals for the dyspeptic symptoms. (Hughes.) R. Tinct. Belladonnae, . . 5pj. Syr. Scillae, . . . Morphinae Sulph., . . gr. j. Syr. Tolutani, . . ad$iv. M. Sig.—Tablesp. at bedtime, for cough and restlessness, to be repeated if necessary. (H. Gibbons, Jr.) R. Petrolei Massae, . . Pulv. Cubebm, Pulv. Doveri, . . aa Cinchonidinse Sulph., . gij. M. ft. massa, et div. in pil. no. cclxx. Sig.—One pill every 3 or \ hours. (Griffith.) R. Olei Morrhum, . . %^ss. Mucil. Acacise, . . gij. Sacchari, . . . Tinct. Lavandulae Co., . ttixx. Aquae, .... M. Sig.—Teasp. for children. An agreeable mixture. (Farquharson.) [For a Cod-liver Oil Emulsion see formula on page 492.] Pityriasis. Alkaline and Tonic Remedies generally control mild cases, together with baths and emollients; the more severe ones requiring constant envelopment in oil, as linseed or cod-liver oil (Bulkley). Mercury, in obstinate cases, Donovan’s solution of Arsenic and Mercury is highly successful (Wa.) ; the green iodide, gr. x to of lard, or a 5 per cent.- solution of the oleate of mercury in oleic acid with one-eighth part of ether, applied by a camel’s-hair brush (B.) ; citrine ointment, especially when the hairy parts of the face are affected (R.); an ointment of ammoniated mercury and calomel is very useful in ordinary cases of dandruff or pityriasis simplex (Bronson). Sulphur, 5jj of sulphur lotum to of vaseline applied every morning to the scalp, with sweet almond oil anointing at night (Jackson). Soap, the tincture of green soap as shampoo, every morning for cleanliness, or Borax and water, or the yolks of three eggs beaten up in a pint of limewater with 5ss of alcohol, all of which make good shampooing mixtures (Jackson). Borax, to cleanse the scalp, a saturated solution; or the glycerite of borax (R.). Lead, the liquor plumbi, with glycerin equal parts, and two parts of water, as lotion for cases where there is high inflammation and abundant weeping (R.). Carbolic Acid, 2 parts to 3 of glycerin and water, twice daily, with the daily use of a carbolized soap, is often effectual (Wa.). Sulphides, of Potassa Sulphurata to Oj of Lime-water, as a lotion, or the Bareges Pomade, see formula below (B.). Baths, frequently, and hard rubbing after shampooing the scalp; avoid stim- 696 PLETHORA—PLEURITIS. ulating food in bad cases, as well as the use of a fine-toothed comb on chil- dren’s heads. [Compare Seborrhcea, and for Pityriasis Versicolor, see Tinea Versicolor.] R. Sodse Sulphuratse, Sodii Carbonatis, . aa zij. Axungiae, . . . M, Sig.—Pomade de Bareges. Prescriptions. R. Hydrarg. Ammoniat., . gr. xx. Hydrarg. Chlor. Mitis, . gr. x. Petrolati, . . . gj. M. ft. unguent. Sig.—Local use. Plethora. Aconite, is useful for affections of plethoric subjects. Decidedly the best remedy for apoplexy in the plethoric (P.). Arsenic, used with advantage when determination of blood to the head(Wa.). Sulphur, as mild purgative for plethora, from cessation of the menses (Wa.). [Compare Abdominal Ple- thora.] Pleuritis. Aconite, no remedy more effective prior to stage of effusion (R., P.). [See Inflammation.] The tincture in doses of drop every 3 hours to a child 3 years old, for 2 or 3 days (J. Lewis Smith). Veratrum Viride. Opinions differ as to whether it should be used in sthenic or asthenic forms (R.); gtt. viij of tincture every 3 hours, with a drop added to each dose until pulse reduced or nausea (Wa.). Bryonia, exceedingly valuable in second stage; should follow aconite (P.). Tartar Emetic, see INFLAMMATION. In early stages and young plethoric subjects, when much febrile action, small doses (gr. j-1,. to 1) may be useful (Wa.). Digitalis, as antipyretic (R.); deranges intestinal canal (B.); aconite preferred (P.); the tincture in doses of one drop every 3 hours to a child of 2 years old (J. Lewis Smith). Potassium Iodide, to promote absorption of effusions, steadily for a long time (R.)', also chest painted with tincture of iodine, one day on each wall alternately; may be washed off with iodide of potassium, alcohol or ether (B.); as a diuretic to remove effusion (Clark). Iodine, also as injections, with great benefit and with- out risk, in empyema and hydrothorax (B., R.). Quinine, has abortive power, increased by combination with morphine (gr. xv -f- gr. ss); also as restorative tonic in low-type cases (B.). Opium, cannot be too highly extolled (P.); is es- pecially beneficial; gr. ss of morphine hypodermically at beginning will often cut short an attack. During the disease, its effects are very beneficial. A slight physiological effect should be maintained (B.). Morphine for severe pain (R.). Burgundy Pitch, plaster externally as a mechanical support (P.). Asclepias, the popular “pleurisy-root,” is a favorite remedy in the south (W.). Pilocarpus, in subacute cases to remove fluids (Caro); or the nitrate of pilocar- pine, gr. | bis die, for children (Vigier); is too depressing and therefore unsafe (Smith). Bloodletting, by cups or leeches, useful by reason of counter- irritation produced, and to relieve pain, only in robust sthenic cases (B.). Blisters, often greatly abused ; are harmful during inflammatory stage (B.). Poultices, large, hot, and frequently renewed (R.). Water, cold wet-pack to chest probably better than a hot one, pinned tightly to limit movement of chest-walls (B.). Thoracentesis, by aspiration, if the quantity of fluid seriously embarrasses respiration. [For Chronic Pleurisy see Empyema, also com- pare Hydrothorax, Pleuro-pneumonia.] PLEURODYNIA—PNEUMONIA. 697 R. Potassii Acetat,. . . zj. Infusi Digitalis, . ad 3iv. M. Sig.—Teasp. every 3 hours to a child of 4 or 5 years, in the second stage. Prescriptions: R. Mist. Ferri et Ammonii Ace- tatis, .... 5vj. Sig.—Teasp. to a tablesp. according to age, in the second stage, or in sub- acute form. Pleurodynia. imicifuga, curative when rheumatic, valuable in sympathetic cases from irritability of uterus (P.); or uterine derangements (R., Wa.), Croton Oil, in obstinate pleurodynia especially when blackened feces (R.). Belladonna, plaster or liniment; the latter generally best (R.). Chloral, made liquid with equal weight of camphor, rubbed in gently, often affords instant relief in severe pleurisy (R.). Sodium Salicylate, gr. xv-xx, every 2 or 3 hours, useful in most cases (Hughes). Ether, as spray, sometimes immediately and perma- nently removes the pain (R.). Opium, liniment rubbed in after warm fomen- tations (Wa.); or a hypoaermic injection of morphine (R.). Iodine, as liniment painted on the chest, often relieves where mustard fails (R.). Blis- tering, often successful when other means fail; sometimes strong vesication necessary (R.). Rest, is important and may be obtained by strapping the affected side with strips of adhesive plaster. Poultices, very hot, followed by application of lint and oil-skin. Belladonna liniment generally better (R.). Rfustard, as a poultice, is generally efficient, and can be renewed when pain returns (R.). [Compare Neuralgia, Myalgia.] Pleuro-Pneumonia. Bryonia, often of great service; limits effusion and assists absorption (P.). Carbolic Acid, a 2 per cent, solution injected parenchymatously, once or twice a day, has had remarkable success (B.). Sanguinaria, as a contra-stimulant (P.). Turpentine, as a fomentation (P ). Arnica, the tincture in doses of Ttqx every 3 or 4 hours, very useful in controlling the heart’s action (Wa.). Pilocarpine, gr. ss, or sjij of the tincture of Jaborandi, benefits cases of pleuro- pneumonia (Wa.). [Compare PNEUMONIA.] Pneumonia. Aconite, gives good results in catarrhal and fibrinous (B.) ; has marked effect (R.); very valuable in first stages (P.); in several cases it apparently cut short the attack (Wa.); to reduce circulation either Aconite or Veratrum Viride, until pulse is impressed (Da Costa). Veratrum Viride, valuable (P.); in the very incipiency (B.) ; opinions differ as to whether it should be used in sthenic or asthenic cases (R.). Bryonia, when pleural complications (P.). Phosphorus, especially when typhoid symptoms; approved by Fleischmann (R.). Belladonna is useful in the first stage (P.); Harley esteemed it highly in pneumonia (Wa.); as an adjuvant to Digitalis in infantile pneumonia, to soothe the irritable nervous system and curtail superabundant secretion (Brown). Tartar Emetsc, formerly given in large doses; now abandoned; small doses may be useful, but should be used with care, lest depression ensue 698 PNEUMONIA. (B.); at commencement with alcoholic stimulants, if patient be weak (R.); may benefit young, robust subjects (Wa.). [See Pleuritis.] Sanguinaria, as a contra-stimulant, when fever abated, and graver symptoms have amended (P.). Iodides, none more efficient; the Iodide of Ammonium with Arsenic, to prevent caseation of inflammatory products (R.); Ethyl Iodide, gtt. v— xx ter die by inhalation, very valuable in catarrhal form (B.). The Iodide of Sodium is useful in catarrhal pneumonia (Da C.). Ipecacuanha, the wine in infantile pneumonia, should never be dispensed with, as it promotes expectora- tion, controls hemorrhage and regulates secretion (Brown). Senega, in advanced stages as expectorant, when cough is dry, irritating and painful, tightness and oppression of chest (P.). Opium, morphine by injection, sometimes needed for severe pain (R.); opium is very desirable in many cases, relieves the symptoms and arrests delirium (Wa.). Copper Acetate, Kissel regards it cura- tive; under it the mortality was only per cent. Ammonium Carbonate, at crisis for depression; give in infusion of senega (B.): see formula below: is useful as expectorant late in disease when lung tissue breaks down (Da C.). Digitalis, of doubtful value; may be useful for high temperature, ischaemia, and low tension of vessels (B.); as case goes on and circulation is to be further controlled, digitalis is indicated (Da C.): the best agent to slow the heart in infantile pneumonia, with Belladonna as an adjuvant (Brown). Anti- pyrine, to reduce pyrexia; is decidedly more serviceable in pneumonia than quinine (Wa.); gr. xv several times a day, or 3 hourly doses each of gr. xxx, then stopping until temperature rises again (R.). Stimulants, in asthenic cases, those of malignant type, and those occurring in aged people (Wa.). Ammonia, the aromatic spirit as substitute for Ammon. Carbonate, in doses of gss in simple elixir (Da C.). Turpentine, as stimulant at crisis (B.). Serpen- taria, with carbonate of ammonium in low types, as a stimulant about the crisis. Quinine ox Salicylic Acid, to reduce temperature (R.); Quinine as a tonic in cases which are asthenic from the first (P.); in conjunction with Aconite and Veratrum, gr. viij-xij daily at start, is benficial (Da C.). Blisters, useful at very beginning only or at crisis of disease; harmful in inflammatory stage (B.); to lessen the pain, but should be used in moderation (R.). Wet- pack, hot, tightly pinned to limit motion of chest-walls (B.). Poultices, encir- cling whole chest in children (R.). Diet, farinaceous, mucilaginous drink, and rest in a warm room (R.). Prescriptions. R. Tinct. Verat. Viridis, . rqxl. Spt. ZEtheris Nitrosi, . Liq. Potassii Citratis, . c^ivss. Syr. Zingiberis, q. s. ad M. Sig.—A tablesp. every 3 hours, in the early stage. [Da Costa.) R. Ammonii Carbonat., . gr. xl. Infusi Serpentariae, . . M. Sig.—A teasp. every 3 hours, as a stimulant about the crisis. (B.) R. Ammonii Iodidi, . gr. xl. Spt. Ammon. Aromat., . zij. Elixir. Simplicis, . . j^j. Aquae, . . q. s. ad J;viij. M. Sig.—One-eighth thrice daily, in syphilitic lobar pneumonia, to- gether with the following pill. [Da Costa.) R. Sodii Iodidi, . . . gjss. Morphinae Sulph., . . gr. ss. Elixir. Simplicis, . . j|ij. M. Sig.—Teasp. thrice daily, with blisters over the apex, in catarrhal pneumonia. [Da Costa.) POLYPUS—POULTICES. 699 R. Potassii Iodidi, . . . gj. Ammonii Muriatis, . . 3jss. Mist. Glycyrr. Comp., . M. Sig.—Tablesp. 4 times daily, to promote absorption, together with blisters to the chest. (Univ. Penna.) R. Digitalis, . . . gr. vj. Quininse Sulph., . . gr. xij. Extr. Opii, . . . gr. iij. Extr. Ipecac,. . , gr. iij. M. ft. pil. no. xij. Sig.—One pill thrice daily, with the preceding mix- ture. (Da Costa.) Polypus. Sanguinaria, has been employed as snuff for nasal polypi (P.) ; with doubt- ful benefit (Wa.). Tannin, finely powdered, as snuff blown daily into nostrils through a quill,is especially adapted to the soft and gelatinous varieties; while it has apparently no effect on the healthy mucous membrane, it causes the complete withering of the polypus (Wa.). Zinc Chloride, has been injected interstitially with success in a case of naso-pharyngeal polypus (Barthfelemy). Iron, a solution of the perchloride is advised as an interstitial application (Auger). Acetic Acid, glacial, injected into the body of the tumor, will cause it to shrink up and to drop off in a few days. Alum, in powder, applied to point of origin to prevent recurrence (D.). Surgical. A nasal polypus should be seized with polypus forceps and twisted off at the neck ; it may be removed through the mouth or the nostril. In a few cases the nostril must be dilated with a speculum, or the ala slit to give access to root of tumor (D.). Poultices. Poultices and Fomentations are simply local baths utilizing warmth and moisture, relaxing the tissues and relieving pain. If applied early they will check inflammation, or assist the evacuation of pus when suppuration has set in. Poultices should be applied thick (thin in peritonitis), as hot as possible, covered with cottonwool, and frequently changed; large at onset, very small after maturation. Belladonna and Glycerin, partes aequales, smeared over tis- sues under a poultice, aid the latter greatly, also Tinctura Opii, especially where skin is broken. Linseed-meal or Oatmeal, Starch, Bread, Bran, are best in the order mentioned; add meal to boiling water, stir and spread quickly on warm linen. Charcoal under the poultice, when foul sores are being treated. An excellent method of preparing poultices is to make a lot of bags of various sizes, and of the fabric known as “ Swiss,” filling each one half-full of the linseed-meal or other agent employed before sewing up its open end. When wanted for use one of these bags is submerged in boiling water for a few minutes, and on taking it out the meal is found to have swelled so as to fill the bag, which should then be squeezed enough to rid it of the superfluous water, laid on the part and covered with oiled silk and a bandage. Fomentations. Flannel should be wrung very dry out of boiling water, and covered with oiled silk. Spongio-piline, a fabric composed of sponge and wool, coated with india-rubber, is an excellent vehicle for the application of warmth and moisture. The inner surface is moistened with hot water; and its utility may be increased by sprinkling the moistened surface with charcoal, yeast; or saturating it with any desired lotion or liniment. 700 PREGNANCY PROLAPSUS UTERI. Pregnancy, Disorders of. Mercury, a few grains of blue pill to correct clay-colored stools (L.). Iodine, the tincture internally for cardialgia (Wa.). Aloes, have cured piles in preg- nancy, by removing constipation ; cautiously (P.). Alum, Tannin, or Catechu, in medicated pessaries for vaginal leucorrhcea (L.). Castor Oil, an excellent laxative (P.); to clear out the bowels in diarrhoea (L.). Cocculus Indicus, when intestines much distended with flatus, and frequent desire to urinate from flatulent pressure on bladder (P.). Bismuth, Calu?nba and Antispasmodics, with minute doses of Opium, for gastrodynia and pyrosis (L.). Potassium Bromide, with chloroform, as an antispasmodic in dyspnoea (L.). Sumbul, is invaluable in restlessness—rn_ xxx-xl of tincture with a little chloric ether, giving quiet nights for a long time (P.). Galla, unguentum gallae cum opio, the best local application to hemorrhoids, also fomentations with sponges wrung out in very hot water, to relieve pain (L.). Digitalis, in infusion, very bene- ficial in albuminuria (L.). Potassium Acetate, with Basham’s mixture (Liq. Ammonii Acetatis), when albuminuria with anaemia. Calcium Phosphate, believed to exert an influence on the foetus if administered during pregnancy, so that mothers who have borne only rachitic or scrofulous children will bear healthy ones (W.). Berberine, found very useful in the periodical neuralgiae of pregnancy, even in cases in which quinine had previously failed (Maclagan). Camphor, liniment for lumbar pains (Wa.). Senna, the confection proves a mild and efficient purgative in the constipation of pregnancy (Wa.). Milk- diet, for albuminuria of pregnancy the best remedy, if strictly carried out (Parvin). Injections must be used carefully, even tepid water often induces uterine contractions (L ). [Compare Vomiting of Pregnancy, Ptyalism, Albuminura, Nephritis, Nervousness.] Prolapsus Ani. Nux Vomica. Strychnine, especially when in children, with constipation; in the latter event add nux vomica to a purgative, as tincture of rhubarb (R., P.), or strychnine hypodermically, gr. TJ2 for an adult every 48 hours, inch from anus and parallel to rectum, into the cellular tissue ; generally requires 4 to 8 injections (Weber). Piper, the confectio piperis in doses of gr. lx-gr. cxx, persevered in for 3 or 4 months, in chronic, weak subjects (Wa.). Sul- phur, has a beneficial effect in addition to its laxative value (R.). Alum, in solution, gr. vj to the £ (R.). Ice, locally, when parts inflamed (R.). Ergot, the fluid extract injected into the perineum, is followed by immediate relief (Vidal). Ferrum Sulphate, sjj to aquae, of which one-third by enema twice daily. Podophyllin, in small doses for rectal prolapse in children (P.). Tannin, injection to restrain the prolapsus (R.). Hydrastis, by enema, or as a lotion (P.). Prolapsus Uteri. Cimicifuga, to prevent miscarriage in prolapsus uteri (R.); has a remarkable effect upon the uterus (P.). Astringents, decoctum quercus, decoctum gallae, (Wa.). Pomegranate bark (P.). Tannin, as catechu, kino, red gum, rha- tany. Alum, a solution gr. vj ad fj) (R.); lb. j ad Cj aquae, as hip-bath, also should be passed well up vagina (Wa.). Ice, locally when parts inflamed (R.); applied to the spine (Wa.). Pessaries, in any form, are of but tem- porary benefit, and in the end positively detrimental (E.); but many cases cannot be treated without mechanical support of some kind. PROSTATE, HYPERTROPHIED—PRURIGO. 701 Prostate, Hypertrophied. Alkalies, for the cystic irritation with acid urine. Great benefit from liquor potassge, citrates and acetates of potassium (B.). Triticum Repens, benefit follows its use in the prostatic enlargement of old men (Sir H. Thompson). Ammonium Benzoate, for the cystitis, urine alkaline (B.). Ammonium Chloride, is occasionally useful, gr. xv-xxx, 3 or 4 times daily (Wa.). Iodine Injections, through rectal walls (B.); a weak ointment applied by rectum (Wa.). Iodine, has been tried in all forms, but is of no value (Thompson). Iodoform, as suppository in rectum, has proven of great value (B.). Colchi- curn, in persons of a gouty diathesis (Wa.). Medicine is not likely to have any control over this condition, which is a simple hypertrophy. Prostatitis. Cantharides, gtt. j of tincture (5 may be required) 3 or 4 times a day (R.). Triticum Repens, is found to be of benefit (Sir H. Thompson). Urino-Gen- itals, especially turpentine, cubeb, juniper, cantharis (B.); cubeb, in doses of gr. xx daily, is found of much benefit (Wa.); buchu relieves (P.). Silver Nitrate, a solution (gr. v-x ad applied to the prostatic urethra in chronic prostatitis, may be useful (Wa.). Blisters, in chronic prostatitis, a small blister on each side of the raphe of the perineum, kept open 4 to 6 weeks, has given the best results (Wa.). Tonic medicines and regimen should be prescribed (Wa.). Hot Injections, to relieve pain (R.). [Compare Prostatorrhcea.] Prostatorrhcea. Iron, the tincture of the chloride, when there is much debility (B.); chaly- beate tonics, with quinine and strychnine (Gross). Atropine, indicated in all cases, with potassium bromide (Gross). Potassium Bromide, when irrita- bility and excitement (B.); indicated in all cases (Gross). Lead, injections of Goulard’s extract, sjj to i$x of water, night and morning, for 10 minutes at a time (Gross). Ergot, when relaxation exists (B.). Bougie, methodically introduced, is one of the best local measures (Gross). Hydrastis, locally applied, a useful medicine (B.). [Compare Prostatitis.] Prurigo. Alkaline Baths, followed by a carbolized ointment, and carbolic acid in- ternally, are of value in the papular eruption known as prurigo (Bulkley). Sulphides, Potassa Sulphurata, with tar and benzoated lard, as ointment in genuine prurigo (R.). Arsenic, in doses of n\v of liquor arsenicalis thrice daily and gradually increased, has exercised a more or less powerful influ- ence (Wa.); has only a moderate effect (Bulkley). Belladonna, controls cases which have resisted ordinary treatment (B.). Carbolic Acid, locally and internally, is especially serviceable in prurigo senilis (B.). Borax, a sat- urated solution in rose-water locally (R.) ; gr. v-x to of hot water for pruriginous eruptions on mucous membrane of vulva and vagina (R.). Gal- vanism, when prurigo is referable to alterations in the cutaneous nerves (B.). Tonics, are required, nerve-tonics as well as general ones, Cod-liver Oil, Quinine, Strychnine and Phosphorus (E. Wilson). Quinine, in large doses, gr. v-x, will control violent exacerbations (Wilson). Baths, the Turkish, fre- quently repeated, with inunction of the skin, may be regarded as curative in most cases (Wilson). [Compare Pruritus.] 702 PRURITUS. Pruritus. Alkaline Baths, locally, followed by the application of Carbolic Acid Oint- ment, gives great comfort in all forms of pruritus (Bulkley). Sodium or Potassium Carbonate preferred (Tr.) ; in solution locally, giij ad (B.). Carbolic Acid, as lotion with glycerin, to the itching surface, gives great relief (Bulkley) ; internally and locally in pruritus senilis (B.) ; a one per cent, solution as lotion in pruritus ani (R.). Mercury, strong solutions of the Bi- chloride, black wash, yellow wash or mercurial ointment, in itching of skin affections (R.); solutions of the Bichloride are very useful applications in pruritus vulvse et ani (Tr.) ; for pruritus vulvse a lotion of the Bichloride I to 2500 parts of water, with alum and starch, is recommended (B.). Calomel to of lard, as ointment, is the best application, except in the pruritus of urticaria; very useful in pruritus ani, less so in pruritus pudendi (R.). The Oleate, a 5 per cent, solution in oleic acid with one-eighth part of ether, ap- plied by a camel’s hair brush, in pruritus ani et pudendi (Marshall). Alum, a strong solution is very useful for pruritus vulvse (Tr.). Hydrocyanic Acid, diluted as lotion, often very serviceable; may be prescribed in solution with borax (B.); or laurel-water as lotion, especially in pruritus senilis (P.b Po- tassium Cyanide, to Oj of water, as lotion for pruritus of various kinds when the skin is unbroken (R.) ; as ointment or solution, if strong enough, relieves greatly, but must be used with caution (B.); or ntxxx of the dilute acid of the Br. Pharmacopoeia in of water or glycerin, may be used instead (R.). Silver Nitrate, a solution, gr. xx ad painted over the affected parts in pruritus vulvse, is very effective (B.). Tobacco, is an effective but dangerous application (B.). Iodoform, as ointment, ad adipis (R.). Iodine, for itching of the nose or inner canthus, sneezing, etc., iodine inhalations have a marked effect (R.). Arsenic, for itching of the nose, accompanying asth- matic symptoms (R.). Benzoin, the compound tincture painted on the skin, for the itching of eczema, urticaria, etc. (R.). Boracic Acid makes an excel- lent lotion in pruritus pudendi, a teasp. to the pint of hot water (R.). Borax, gr. v-x ad hot water (R.). See Prurigo. Balsam of Peru, is a very good application in pruritus ani, scabies, and many other forms of itching (Auer- bach). Camphor, with Chloral, rubbed together, makes a liquid which, added to vaseline, makes an ointment which is powerfully antipruritic (Bulkley); added to dusting powders, allays heat and itching of eczema and intertrigo (R.). Chloroform, as ointment to allay itching of skin diseases (R.). Gel- semium, rqxv of the tincture every half-hour, up to gj, for itching which is out of proportion to the cutaneous lesion (Pelcher). Lead Lotions, to ease the itching of urticaria, pruritus pudendi, etc., especially when the mucous membrane is red and excoriated (R ). Salicylic Acid, as ointment, in pru- ritus ani et vulvse (R.). Sodium Salicylate, in 15-grain doses by mouth every four hours, will greatly relieve pruritus vulvse, when due to diabetes (Goodell). Tar, as ointment, is strongly recommended (Tr.); for general pruritus, if no cause can be found, the two best remedies are Tar and Sul- phur, as lotion or bath (Sparks); ointments containing Tar give relief in many instances (Bulkley). Sulphur, may be employed as a bath, Potassa Sulphu- rata, i|ij ad Cxv of hot water (Sparks); or the alkaline sulphites locally (Wa.); the iodide of sulphur externally and internally, in pruritus senilis (Wa.). Chlorine, the liquor Sodse Chloratae, diluted, a useful application in pruritus ani (Wa.). Cocaine, in 5 per cent, solution or oleate, is by far the most effi- cient of all antipruritics; relieves the itching of scrotal eczema, pruritus ani et pudendi, and especially in lesions of the epidermis where the oleate or so- PSORIASIS. 703 lution can penetrate at once to the true skin. [Compare Eczema, Ery- thema, Lice, Pediculi, Prurigo, Scabies, Urticaria.] Prescriptions. R. Ac. Carbolici,. . . zij. Glycerini, . . . 5j. Aquae Rosae, . q. s. ad 3viij. M. Sig.—Lotion for pruritus. R. Ac. Hydrocyan. Dil., . gij. Sodii Boratis, . . Aquae Rosae, . . . M. Sig.—Lotion. {Fox.) R. Ac. Hydrocyanici Dil., 7ss-j. Infusi Altheae, . M. Sig.—Lotion. (Fox.) R. Potassii Qyanidi, . . gr. vj. Pulv. Cocci, . . . gr.j. Ung. Aquae Rosae, . • §j- M. Sig.—Ointment. (Anderson.) R. Potassii Cyanidi, . . gr. xv. Aquae Laurocerasi, . !|viij. M. Sig.—Lotion. {Anderson.) R. Cretse Prseparatse, . . %j. Coal Tar, . . . 01. Lini, . . . Jijss. M. ft. unguent. R. Liq. Carbonis Detergentis, Sss. Glycerini,. . . . ij. Aquse, . . . ad£x. M. Sig.—Lotion. {Sparks.) R. Gummi Camphorae, Chloralis Hydratis, . aa Rub together until liquefied, then add, slowly with friction,— Unguenti Aquae Rosae, . Sig.—Ointment for itching. {Bulk ley.) R. Acidi Benzoici, . . gr. cx. Ol. Caryophylli, . . gtt. xl. Alcoholis, . . . gijss. Solve et adde— Cerati Simplicis, . . 5viij. Balsami Peruviani, . 33. M. ft. unguentum. Especially good for scabies, but may be used for any pruritus. R. Hydrarg. Chlor. Corr., . gr.j. Pulv. Aluminis, . . gr. xx. Amyli, .... £jss. Aquae, .... 5Jvj. M. Sig.—Apply locally. ( Goodell.) Psoriasis. Arsenic, at first apparently aggravates, but soon heals the disease (R., B.); in lepra must be persistently used for a long time (B.); exercises a powerful influence (Wa.); maximum dose rqv liquor arsenicalis ter die, never on empty stomach (R.). Mercury, in patches of obstinate psoriasis, especially of hands even when not syphilitic. Calomel and mercuric nitrate ointment may be mixed, and tar ointment added (R.). Lappa Major, a tincture of the seeds in whiskey, used by tablespoonful doses, curative of psoriasis of long stand- ing (Reiter). Carbolic Acid, I to 4 of lard, as ointment (Wa.). Mezereon, a useful adjunct (Wa.). Sulphur, internally (R.) ; a solution of potassa sulphu- rata in water, is excellent in chronic psoriasis (B.) ; not in acute (R.). Sul- 704 PTERYGIUM—PTYALISM. phur Iodide, externally and internally, in doses of gr. j-vj used with great ad- vantage (Wa.). Silver Nitrate, in psoriasis of tongue and buccal mucous membrane occasionally ; if syphilitic, mercurials best (R.). Chrysarobin, has the most decided effect on psoriasis, ad of ung. aquae rosae; often irri- tates, and should be employed at first with caution i Bulkley). Nitric and Nitro-Hydrochloric Acids, when symptomatic of imperfect digestion and as- similation (B.). Phosphorus, as substitute for arsenic (B.). Coptis, has repu- tation in New England (B.). Copper Sulphate, applied solid to spots (R.). Lead, the ointment of the iodide (B.). Tar, painted on, in obstinate cases (R.). Oils, Cod-liver Oil internally and locally, is the sheet-anchor, especially when of strumous origin (B.) ; oils and fats to lubricate skin, with warm baths (R.). Diet and Hygiene, nourishing diet, frequent small quantities of raw vegetables. Cod-liver oil for growing persons, especially when stale fish the cause. Rest and change for overworked subjects. Daily baths and cold sponging. Free, open-air exercise is also most useful. Warm or tepid soft- water baths at night, with use of pure soap. Pterygium. Silver Nitrate, locally, especially when pterygium with catarrhal conjunc- tivitis (Wa.). Treatment unavailing. Benefit seldom derived from any opera- tion (C.). Arlt's Operation, the most satisfactory; cut away as little tissue as possible, dissect cleanly, close with suture (Green). Ptosis. Veratrine, gr. x in gij of sulphuric ether and j|j of alcohol, brushed over the eyelids, brows and temples every morning, till a slight burning sensation is produced; conjoined with the use of electricity (Wa.). Ergot, aqueous infusion as collyrium (Wa.). Electricity, the constant current may often re- lieve recent cases (C.). Operation for shortening the lid, by removing an elliptical piece of skin and subjacent muscle (C.); is not advisable unless the ptosis is nearly or quite complete, and of great inconvenience. Ptyalism. Iodine, as gargle, gij of tinct. ad aquae (R.); is worthy of trial (Wa.). Acids, as astringents, small medicinal doses (R.b Sulphuric, int. and as a gargle with decoctum cinchonae, of great benefit in mercurial ptyalism (Wa.). Potassium Chlorate, in simple or mercurial ptyalism (R.); in the latter form 2j ad Svj aquae as mouthwash, and internally in teasp. doses, 4 or 5 times daily (St.). Belladonna, very effective in mercurial ptyalism, and that of pregnancy. Gtt. v-x, or Atropine gr. to every 4 to 6 hours (B.). Atro- pine hypodermically (R.); should be useful (W.). Tannic Acid, in mercurial ptyalism is an excellent gargle, of tannin to of mel rosae, and of water (B.). Alcohol, diluted, as a gargle (R.). Potassium Iodide, sometimes beneficial in mercurial ptyalism, but often aggravates it (R.). Prescriptions. R. Sodii Boratis, . . . t^ij. Pulv. Myrrhae, . . gj. Aquae, .... M. Sig.—Mouth wash or gargle. R. Tinct. Myrrhae,. . . gj. Aquae, .... £vj. M. Sig.—Mouth-wash. PUERPERAL CONVULSIONS—PUERPERAL FEVER. 705 Puerperal Convulsions. Aconite, one of the best agents (P.); gtt. j-ij of tinct. every io or 15 minutes for the first hour, then at longer intervals (P.). Belladonna, the tincture in- ternally with atropine hypoder., of verified utility (P.). Veratrum Viride, in zss doses of fluid extract every 15 minutes, to nausea, invaluable (R.); the fl. extract, in doses of Ttlviij-x hypodermically, may be repeated in half hour with Morphine, or nix by enema, promptly efficient in the worst cases (El- mer). Opium, as morphine hypodermically : the most important agent for cure of uraemic convulsions (B.); with the lancet, sometimes required (P.). Anesthetics, especially chloroform (R.); utility unquestionable, when not due to cerebral hemorrhage (B.). Chloral, full doses (gr. xx-xxx) every 2 hours, may arrest (B.); a remedy of the greatest value, a full dose, gr. xx-xxx, be- fore proceeding to one of the bromides (Playfair, Barnes, etc.). Amyl Nitrite, by inhalation (B.); may cause alarming hemorrhage (W.). Ice, to the head (R.); and mustard poultices at same time to the feet (Wa.). Venesection, by far the most efficient measure (Wallace); when great cerebral congestion and vascular tension, shown by a livid face, a full and bounding pulse, and strong pulsation in the carotids (Playfair). Puerperal Disorders. Cimicifuga, in puerperal hypochondriasis, and depression (Wa., P.). Opium, either alone or with alteratives, highly serviceable in puerperal intestinal irri- tation; a few drops of tincture effectually arrests the diarrhoea (Wa.); when shock and marked exhaustion, a moderate dose is of benefit (L.). Castor Oil, undoubtedly the best laxative (L.); purgatives generally are not required. Castor oil the very worst (Fordyce Barker); action uncertain (Parry). Rhu- barb, or enemas, best means of stimulating bowels after fourth day (L.); gr. xx-xxx in some aromatic water a good aperient (Wa.). Aliment, in puerperal state should be easy of digestion and sustaining (L.). Catheter necessary often for several days when bladder paralyzed, if warm water lavements fail to excite (L.). Water, tepid sponging of external parts, vaginal washings daily with warm water, with part carbolic acid (L.). [See After-pains, Hem- orrhage, Labor, Lactation, Mastitis, Nipples, Phlegmasia Alba Do- lens, etc.] Puerperal Fever. Aconite, drop doses every one or two hours steadily, with an occasional dose of castor oil, and repeated hot poultices or laudanum fomentations, the most successful treatment, even in the worst cases, but is useless if not promptly efficient (P.). Veratrum Viride, is used with great benefit in most cases (F. Barker). Opium, for wakefulness and delirium (B.).; a very valuable rem- edy, tending to allay pain, and reduce excitement of the nervous and vascular systems (Wa.). Alkaline Sulphites, especially valuable in early stages, internally and locally; gr. xx-xxx of magnesium or calcium sulphite every 2 or 3 hours, with injections every day (Wa.). Stramonium, when cerebral excitement (P.). Potass. Permang., gr. %-] ter die, has been given with benefit (B.). Calumba, preferable to cinchona (P.). Quinine, only large doses are useful; gr. v-xx every 4 hours (B.); reduces temperature (P.). Turpentine, when depression of vaso-motor nervous system, cardiac weakness, and tympanitic distension of abdomen (P., R.). Resorcin, is much used in Vienna by Braun; 706 PUERPERAL MANIA PULSE. gr. xl repeated p. r. n. Antiseptic Injections, into uterus opposed very strenu- ously by many of our best men. See N. Y. Med. Rec., 1884, p. 14. For an- tiseptic treatment by Hydrarg. Bichlor., see Dr. Garrigues in N. Y. Med. Rec. of December 29, 1883, and N. Y. Med. Jour, of March x, 1884, and the dis- cussion in the N. Y. Academy of Medicine, reported in the N. Y. Med. Record of January 5 and Feb. 16, 1884, et seq. Water, hot fomentations frequently to parts, a valuable preventive. Rest, and quiet but attentive nursing; frequent liquid nourishment. Warburg's Tincture, is more efficient than the largest doses of quinine in cases of puerperal malarial fever, every four hours until fever abates, then in diminishing doses to until convalescence is es- tablished (Fordyce Barker). [Compare Puerperal Peritonitis.] Puerperal Mania and Melancholia. Stramonium, will allay cerebral excitement, and soothe nervous system; when delirium wild and furious, but intermittent; tendency to suicide or to destroy the child. Tq.x-xx of tinct. every 3-4 hours (P.). Hyoscyamus, in milder cases; nervous system greatly excited (P.). Aconite, in puerperal mania, with high fever, restlessness ; speedy and marked success if given soon after chill (P.). Cimicifuga, has cured (B.); its effects are truly remarkable in mania, and hypochondriasis of puerperal state (P.). Chloral, often alle- viates symptoms (B.); to produce sleep (Wa.). Potassium Bromide, in sthenic cases (R.); its effects are very variable (Wa.). Ancesthetics, ether inhaled in violent paroxysms of mania (B.). Tartar Emetic, in frequently repeated doses (Wa.). Quinine, when much weakness; skin cold and sweating (B.). Chalybeates, tinct. ferri chlor. (nj.v-xx) in anaemic form (B.). Opium, cau- tiously (B.); gives the best results in such doses as may be necessary to allay irritation and procure sleep (Wa.). Poultices, hot fomentations, enemas, or gentle laxatives ; nutritious and stimulating diet. Lochia should be watched (P.). Weaning, imperative in melancholia; not so in acute mania. Puerperal Peritonitis. Aconite, has cured cases of the usual type (P.). [See Puerperal Fever.] Ci?nicifuga, in rheumatic form especially, has remarkable effects (P.). Opium, its curative power in this, one of the best established facts in therapeutics (B.); is good, but aconite often better (P.); especially valuable in adynamic cases (Wa.); the drug of all others to be relied on (Godson). Turpentine, as stimulant, qx frequently repeated; better than alcohol (B.); enemas, also hot turpentine epithems, may be used with advantage (Wa.). Quitiine, in con- siderable doses, with or without opium (B.); gr. x-xx twice daily as an anti- pyretic (Wa.). Antimony, as Tartar Emetic, gr. to £ every hour to shorten attack and render it more mild (R.). Cathartics, advised by many, prohibited by as many; evidence is in favor of mild aperients combined with Dover’s powder or Hyoscyamus (Wa.). Poultices, hot, of very great value (B.). Water, ice in mouth or swallowed, hot fomentations to abdomen. In some cases cold compresses best. [Compare Puerperal Fever.] Pulse. Aconite, for a quick, resisting pulse (P.); a moderate dose, while it makes the pulse less frequent, renders it fuller, stronger and less compressible PURPURA—PYAEMIA AND SEPTICAEMIA. 707 Veratrum Viride, reduces febrile heat with abnormal rapidity of pulse (P.). Veratrine, pulse at first quick and strong, then slowed; afterwards quick, weak and irregular (R.). Purpura. Sulphuric Acid, often acts happily (B.). Ergot, has been strongly urged (R.); is most useful in removing purpura (P.); many cases are recorded as cured by hypodermic injections of Ergotin (Wa.). Turpentine, has been used (R.); with invariable benefit (Wa.). [See Hematemesis.] Nux Vomica, no pre- scription more generally useful than the Syrup of Iron, Quinine, and Strych- nine (B.). Iron, when due to anaemia; the tincture of the chloride (B.); is preeminently the curative remedy for purpura hemorrhagica, arresting the hemorrhagic tendency in 24 to 48 hours (Pize). Vinegar, and water, is an excellent application by sponging over the body (E. Wilson). Quinine, or Huxham’s tincture of bark, are much used (H.). Potassium Nitrate, gr. x thrice daily in purpura simplex, used successfully (Wa.). Styptics, as the ammonio-ferric alum, tinct. of ferric chloride (Tr.); tannic and gallic acids, used in some cases (H.). Alum, and brandy, or whiskey and water at such temperature as is not chilling, applied by sponging the body, is the best local measure (H.). Wines are generally indicated (B.). [Compare Hemorrhage, Scurvy.] Pustule, Malignant. Nitric Acid, strong, applied steadily (after thorough cleansing and drying) to destroy the diseased mass (D.). Bromine, to saturate the surface (D.). Carbolic Acid, undiluted, as caustic, or with oil, the favorite (D.) ; the most preferable caustic (Greenfield). Quinine and Carbolic Acid, internally, are indicated in all forms, also stimulants, as Ammonia, Ether, and Alcohol (Greenfield). Eschar should be promptly destroyed, to avoid contagion (R.). Excision and cauterization demanded, when from direct inoculation; the two most successful remedies (Greenfield). Pyaemia and Septicaemia. Quinine, large doses only (gr. xv-xx) are useful (B.): supposed to diminish the temperature (R.); to cinchonism, in childhood the best remedy (Wa.); is probably the most useful medicine, given in full and frequently repeated doses (Haward). Salicin, to reduce temperature ih septicaemia and to relieve the cerebral symptoms (R.). Salicylic Acid, lias decided value (B.). Potas- sium Permanganate, given with advantage, gr. thrice daily in distilled water (B.). JBoracic Acid, a saturated solution to wounds, ulcers, etc. Also Chlorine, as disinfectant (B.). Oleum Carophylli, locally. Also olei gaul- therise, thymi, etc. (B.); as antiseptics. Water, cold, as dressing. Hot better, 95°-ioo° F. Hamilton’s immersion plan for wounds (B.). Stumps to be im- mersed in a warm bath, to avert pyaemia (R.). Sulphites, may do some good in chronic cases, but the use of sulphurous acid has not given the results in man which Polli obtained from its use on animals (Haward). Turpentine, is a better stimulant than alcohol (B.). Ice, dissolved in the mouth (Wa.). Ali- ment. Plentiful nourishment, with wine and good ventilation, are not to be neglected (Wa.). Malt liquors are justly esteemed-(B.). Stimulants neces- sary; brandy the best (Wa.). Abscesses, must be opened early, especially when in joints. 708 PYROSIS—RECTUM, ULCERATION. Pyrosis and Cardialgia. Capsicum., in atonic dyspepsia, with heartburn and diarrhoea (P.). Nux Vomica, of the highest possible value in atonic dyspepsia with heartburn, hic- cough, regurgitation, etc. An excellent combination is m v-x of the tinc- ture with Ttixv of dilute nitric acid for one dose (P.). Pulsatilla, a good medicirte in heartburn of dyspepsia in phlegmatic subjects (P.). Podophyllin, gr. -jJj night and morning in obstinate heartburn, with liver derangement (P.). Almonds,six'*, or eight blanched, said to relieve heartburn (P.). Diet, lemon- juice, aerated bread, plain biscuit, etc.; but avoid new bread, much vegetable food, and pastry. [Compare Acidity, Dyspepsia.] Rachitis. Lime, as lime-water, or the carbonate, or the syrupus calcii lacto-phosphatis (B.); in small doses (R.); the phosphate maybe advantageously combined with cod-liver oil (Wa.). Iron, the syrup of the iodide preferred; calcium and ferric phosphates excellent in combination (B.); must be continued a long time (R.). Nitro-hydrochloric Acid, as baths, gives excellent results (Wa.). Quinine, often very valuable (P.). Aliment, food rich in phosphate of lime and other phosphatic salts; oatmeal, Graham bread, etc. (B.). Cod-liver oil, the best constructive agent (B.). A full animal diet (Wa.). Cold sponging (R.). Rectum, Diseases of. Podophyllum, in doses of gr. to fa night and morning, for a child, may re- move prolapsus of the rectum (P.). Belladonna, the extract locally in fissure (R.); and irritable ulcers (P.); internally and locally to remove ulcers, also excellent in burning pain following defecation, or with mercurial ointment in equal parts, for fissures and ulcers (P.). Phosphorus, in chronic inflammation of the rectum, has been highly recommended (R.). Potassium Bromide, in 5 parts of glycerin, locally, fissures and painful growths (R.). Iodoform, as sup- pository in painful diseases, relieves greatly (R.). Pepper, the confection, as gentle stimulant in fistula, ulcers, hemorrhoids (P.). Castor Oil, in fissure and hemorrhoids, is commonly used as purgative (R., P.). Sulphur, with confec- tio sennse, in irritable rectum, is very soothing (Wa.). Stramonium, ointment from fresh leaves to alleviate pain (P.). Conium, the extract in doses of gr. x to allay pain and irritability in cancer (Wa.). Purgatives, best for proctalgia (D.). Surgical, in ulcer*>r fissure, an incision through mucous membrane, and in severe cases to divide part of the sphincter. A flake of cotton should be laid in the wound, so that it may heal by granulation (D.). [See Anus, Diarrhcea, Dysentery, Rectum Ulceration of, Hemorrhage Intesti- nal, Hemorrhoids, Prolapsus.] Rectum, Ulceration of. Mercury, the red oxide, zj to the 3 of unguentum, as ointment in flat ulcers of rectum existing just within the anus (Coulson). Belladonna, locally the ex- tract for rectal ulcers, is very efficient (P.). Carbonic Acid, the gas, per anum, is strongly advised (Wa.). Chloroform, as ointment, in irritable ulcer of rectum (Curling). Iodoform, in suppository, extiemely useful in painful ulceration (R.); used in many cases with very satisfactory results, but in some instances poisoning occurs; hence it should be used with caution (Wa.). Phosphorus, RELAPSING FEVER—RETINA. 709 as an internal remedy, is highly recommended in chronic inflammation of the rectum (R.). Copper Sulphate, with opium, may often be used internally with advantage, and a weak solution of the same, or of Silver Nitrate, locally (Curling); the writer had a case which resisted treatment for 3 years, and in which a cure was effected by a persevering use of a pill of Cuprum Sulphate, Extract of Opium, and Quinine Sulphate. Silver Nitrate, gr. combined in pill with Opium, gr. ss ; and a solution, gr. x-xx to the pint, by enema (B.). R. Cupri Sulphat., Morphinse Sulphat., aa gr. ij. Quininae Sulphat., . . gr. xxiv. M. ft. pil. no. xxiv. Sig.—One pill thrice daily. (Potter.) Prescriptions. R. Chloroformi, . . . Zinci Oxidi, . . . Olei Olivse, . . . gj. Cerati Cetacei, . . giv. M. ft. unguentum. (Curling.) Relapsing Fever. Cathartic, mild at beginning (H.); if jaundice or other hepatic derange- ment, a calomel purgative, cautiously, lest irritation (Wa.). Potassium. Citrate, as cooling diaphoretic. Quinine, in moderate doses after the crisis, at least until the relapse, which will not be prevented by any amount of quinine (Wa.). Leeches or Cupping, best for headache (A.). Alcohol, required by some pa- tients. Diet, supporting, especially in third week, beef-tea, etc. Urine, should be watched carefully (A.). [Compare Typhus Fever.] Remittent Fever. Aconite, in hot stage, if any febrifuge is required, frequently repeated doses (B.) ; is next in value to quinine for high fever and headache, gtt. j of a good tincture every hour (Da Costa). Quinine, 20 to 30 grs. in single dose once or twice daily till temperature is reduced, with other appropriate remedies (B.); 15 to 20 grs. at most (Maclean); 30 to 50 or 60 grs. in severe cases of pernicious remittents several times a day without regard to exacerbation (P., B.). Warburg's Tincture, has achieved a very high reputation, but must be used in less dosage than directed, and supporting treatment given when its sudorific action commences (Wa.). Gelsemium, exercises a really beneficial influence; depresses temperature (B.); valuable in bilious remittents of the South (Pf.). Morphine, gr. % hypodermically to abort pernicious remittent fever (B.). Purgation, by calomel with jalap or salines afterwards, is very necessary during course of the disease (Da Costa). Quassia, an excellent tonic in convalescence, combined with mineral acids (Wa.). Packing, by wet sheet, is resorted to with advantage, except when hepatic or splenic congestion (Wa.). Retina, Affections of. Mercury, in syphilitic retinitis is of great value ; calomel gr. j-ij with opium gr. every 4 or 6 hours ; also mercurial inunction till the gums are affected or the disease yields (Wa.). Potassium Iodide and Bromide, in combination, in retinal hemorrhage, to promote absorption of the effused blood, and benefit congestion (C.). Eserine, locally to contract pupil, and diminish the amount of light admitted to the eye (Wa.). Iron, in full doses, generally the tinct. of the perchloride, in pigmentary retinitis; seems to have a tendency to arrest the malady (C.). Leeches, to the temple better than general bloodletting (Wa ). 710 RHEUMATIC ARTHRITIS RHEUMATISM. When much local congestion present, depletion by artificial leech is almost always indicated (C.). Pilocarpus, in detached retina and optic neuritis; has been found a very useful remedy in retinal affections generally. [Compare Amaurosis.] Rheumatic Arthritis. Aconite, highly spoken of; as liniment, conjoined with internal use (Wa.). Cimicifuga, when joints enlarged and much stiffened, and when traceable to uterine derangement, is very useful (R.); when pains worse at night (Wa.). Iodine, tinct. internally, said to be better than potassium iodide (R.). Iodoform, 10 parts to 20 of Ether and 20 of Alcohol, as liniment to the joint, applied by a pencil, and covered with oiled silk (Gubler). Iodides, often signally benefit, especially when due to syphilitic, mercurial, or mineral poisoning (B.). Large doses of potassium iodide sometimes required (R.); combined with guaiacum, or corrosive sublimate, often curative in cases resisting these rem- edies given separately (Wa.); Potassium Iodide should always be fairly tried (Da Costa). Guaiac, the ammoniated tincture, in doses of gj-ij in milk, often gives excellent results (Da C.). Colchicum, with alkalies, extremely useful (B.). [See Gout, for formulae.] Arsenic, when referable to nervous affec- tions (B.); as a bath containing washing soda and gr. xx arseniate of so- dium ; in large doses, continued for some time, sometimes of great benefit, but action is capricious (R.); in small doses is of great benefit (Da Costa). Lithium Bromide, of great value in acute and chronic (B.). Potassium Bro- mide, sometimes allays the severe pain (R.). Arnica, the tincture and infu- sion are said to be of great value (P.). Cod-liver Oil, internally and locally, of much value (R.). Baths, Turkish or sulphur. The cold douche, which may be slightly warmed in winter; use for one or two minutes and rub dry (R.). Adhesions may be broken up under anaesthetics (Da C.). Massage may be used with benefit to ameliorate the condition in chronic cases, where a cure cannot be obtained (Da C.). R. Vini Colchici Sem., . sjiij. Spt. Ammon. Aromat., . M. Sig.—A teasp. every 3 hours, until some physiological effect is pro- duced. (B.) Prescriptions. R. Lithii Bromidi, . . 2iij. Syr. Zingiberis, . . 5ss. Aquae, .... }|jss. M. Sig.—A teasp. thrice daily, conjointly with a lotion of the same. (B.) Rheumatism, Acute. Aconite, very serviceable when much heat and dry skin (B.); subdues pain in inflamed joints and perhaps shortens the fever (R.); small doses frequently repeated of the greatest value, and if used from the start prevent permanent organic disease (P.); is not reliable as a cure, but a valuable adjunct to other remedies (Wa.). Veratrum Viride, tinct. said to be useful (R.); as antipy- retic, small doses; may be combined with opium (P.). Bryonia, has proved useful, especially for painful and stiff rheumatic joints (P.). Salicin, gr. x- xxx every 2, 3, or 4 hours. Gr. xv every 3 hours in powder mixed with water (Maclagan), or same dose of Salicylic Acid, is of great benefit; good effects generally experienced within 48 hours (R.) ; the acid is better than the sali- cylates, but must be abandoned if not effective after 3 or 4 days (Da Costa). Sodium Salicylate, behaves as Salicin (R.). Oil of Ganltheria, as a substitute for salicylic acid, used very successfully in form of emulsion (B.). Rhus Toxi- RHEUMATISM, ACUTE. 711 codendron, positively invaluable in after-stage, also in subacute forms, mus- cular or tendinous, worse at night (P., Pf.). Hy dr iodic Acid, the syrup, in dessertsp. doses every 2 or 3 hours, the best remedy for acute and subacute rheumatism, relieving, pain and swelling in 18 to 24 hours (Craig). Cimici- fuga, excellent reports from (B.); has been much used, said to quell the pain speedily (R.); found very serviceable (P.). Dulcamara, recommended especially in persons who are subject to catarrhal affections in cold and damp weather (P.). Ammonium Bromide, a very excellent treatment, followed by quinine; gives a very low proportion of cardiac complications, gr. xv-xx every 4 hours (Da C.); disagreeable but strongly recommended (B.). Arnica, lowers pulse and temperature, relieves articular pain and swelling, diminishes urea (P.). Trimethylamine, Trtiv—viij in peppermint water, often has remarkable power in acute rheumatism and gout (B.). Spigelia Anthelmia, rheumatic pericarditis and endocarditis; rheumatic fever with pain shifting from joint to joint (P.). Sulphurous Acid, fumigation, and patient covered with blankets exposed to strong fumes, produces perspiration, sleep and relief (R.). Colchicum, alleviates the symptoms, and shortens their duration (Wa.). Laville's Mixture, is said to be a tincture of quinine and colocynthine, but it is more than probable that colchicine is the active agent therein. (See N. Y. Med. Record, Dec. 5, 1885, page 642.) Quinine, as antipyretic; not so useful as wet pack or cold bath; gr. ij-v after the more acute symptoms have subsided (B.) ; is best for the head symptoms (Da C.). Opium, strongly recommended as anti-rheumatic ; gr. j every 2 or 3 hours, in- creased to gr. xij in 24 hours; tolerance remarkable in this disease. Also, in rheumatic carditis it is indispensable (Wa.); a very good remedy in moderate doses (Da C.). Lithium Bromide, equally good in all forms, especially for insomnia, delirium, etc. (B.). Digitalis, in powder, gr. ij every 4 hours, usu- ally effective after 2 to 7 days; especially useful in cardiac complications with cyanosis and oedema. Iron, tincture of chloride very serviceable in pale, delicate subjects, nixx-xxx every 4 hours; also as prophylactic where ten- dency (Anstie); harmful to the plethoric and overfed (B.). Alkalies. The alkaline treatment is now seriously questioned ; an injurious dyscrasia results from their use (B.). Potassium Bicarbonate, gr xxx every 4 hours, in a dilute solution, until joint-symptoms and fever disappear (Wa.). Lime-juice, Jjviij daily, lemon-juice inferior (R.). Blisters, are a very effective method; a num- ber of small blisters applied to vesication around a joint (B.); large flying blisters around a joint (R.). Water, cold baths for the hyperpyrexia (Da C.) ; the wet pack very efficacious in rheumatism, also a vinegar vapor bath (B.); the wet pack, 20 or 30 minutes, and tepid (70°) shallow bath 1 or 2 minutes. Cold applications only when skin hot and dry, and temperature high. Warm baths, or hot compresses very useful. Spongio-piline an excellent substance for applications. Diet, low during the fever, water, barley-water, milk-and- water, gruel, etc. All through use liquid food. Avoid malt liquors, port wine, and sugar. Lemon-juice maybe used freely. Blankets, instead of sheets to sleep in, and flannel underclothing are useful adjuncts. Pack the joints with cotton covered with rubber cloth or oiled silk. Plans of Treatment, may be resolved into three, viz.,—(1) that by Salicin, (2) that by Alkalies, (3) that by Iron. Salicylic Acid and the Salicylates, in 20-grain doses, to not less than in 24 hours, in solution with excess of alkali, is especially suited to vigorous, sthenic subjects, whose stomachs will bear it, in whom it often effects a cure in 3 or 4 days. Alkalies, for flabby, fat subjects; alkaline carbonates, as the Potas. Carb., .fjss, every 24 hours, alone or with a vegetable acid, until the urine becomes neutral or alkaline, 712 RHEUMATISM, CHRONIC. when it may be reduced one-half, and so maintained for some days, when quinine or iron maybe used. If successful, this treatment brings about a cure in two weeks. Tincture of the Chloride of Iron, for the feeble, anaemic, and nervous subjects, ttlxxx every 4 hours, with an occasional saline laxative, blisters around joints, and Atropine as an anodyne rather than Opium, used hypodermically in the vicinity of the affected joints (B.). Cardiac Complications require Ammonium Carbonate, in 5-grain doses fre- quently, also Infusion of Digitalis with hypodermics of Morphine, and a blister over the praecordium, followed by Iron and Quinine after the acute symptoms have subsided (B.). Prescriptions. R. Olei Gaultheriae, . gj. Acidi Salicylici, . . gr. lxxx. Sodii Boratis, . . zj. Syr. Picis Liquidae, . 5ij. Aquae Anisi, . -. M. Sig.—A dessertsp. every two hours. R. Potassii Iodidi, . . * Vini Colchici Sem., Syr. Simplicis, . aa ziv. Aquae Menthae Pip., . 3V. M. Sig.—Tablesp. every 4 hours. {New Orleans Charity Hosp.) R. Ammonii Phosphatis, . srjss. Tinct. Colchici Seminis, . Tinct. Aconiti, . . £ij. Syr. Simplicis, . . £iij. M. Sig.—A teasp. every three or four hours. {Corson.) R. Propylaminae Chlorid., gr. xxiv. Aquae Menthae Pip., . M. Sig.—A tablesp. every two or three hours. ( Tyson.) R. Sodii Salicylatis, . . Tinct. Lavand. Co., . £iij. Glycerini, . . . Aquae, . . q. s. ad gvj. M. Sig.—A tablesp. every three hours, well diluted. R. Acidi Salicylici, . . sjij. Sodii Bicarbonat., . . gj. Aquae, .... M. Sig.—A teasp. or two every two hours. (B.) Rheumatism, Chronic. Arsenic, is very good in most cases, given in small doses steadily (Da C.). Bryonia, is useful, especially for painful and stiff joints (P.). Rhus Toxico- dendron, a very powerful agent in subacute muscular or tendinous rheumatism, worse at night (Pf.); the tendons, ligaments, and fascise are most benefited ; externally, as lotion on compresses ; also, internally, small doses every two hours (P.). Potassium Iodide, especially when pains are worse at night, or of syphilitic origin (R.) ; should always be fairly tried in chronic rheumatism (Da C.). Cimicifuga, sometimes has wonderful success, yet often fails; no indications (B.); in rheumatic neuralgias and headaches, and rheumatism of uterus (P.) ; signally beneficial in many forms (R.). Mercury, and Morphine, the oleate locally, for joint affections (R.). Colchicum, is of decided advan- tage in neuralgia of chronic rheumatism (B.). Mezereon, strongly recom- mended (P„ R.). Phytolacca, has been useful (B.). Iodides, often prove very satisfactory, especially in strumous or syphilitic subjects (B.). Aconite, the extract as plaster to joints is unquestionably very useful (P.); is more useful in chronic than acute rheumatism (Wa.); the liniment of the B. P. locally RHEUMATISM, GONORRHCEAL. 713 over the sciatic nerve when affected (Fothergill). Dulcamara, has been em- ployed with advantage (P.). Sulphur, locally, also sulphides as baths (R.); is certainly of benefit (B.); sulphur waters are undoubtedly efficient (Da C.). Iodine, for pain around joints (R.). Lithium Bromide, gives excellent re- sults, when smaller joints swollen, tender (B.). Lithium Salicylate, in 15 to 20 grain doses every four hours, gives good results in lingering, subacute cases after acute attacks (Da C.). Quinine, in rheumatism with debility, shown by night sweats, or sweats during sleep, and only then (Wa.). Arnica, the tinct- ure and infusion are useful (P.). Cajeput Oil, internally and externally in muscular rheumatism (P.). Turpentine, benefits and relieves the pains; in- ternally and externally as liniment (P.). Guaiac, used with varying success (B.); often gives excellent results; the ammoniated tincture, !jj-ij in milk (Da C.); is vile to the taste. Eucalyptus, the leaves wrapped around the affected part, renewing them daily for a week or more, often very efficient as a local stimulant, and will produce vesication if too long continued (Gibbons). Xanthoxylum, has long had deserved reputation, Tr].xv-gij fluid extract (B.). Thuja Occidentalis, is useful for rheumatic pains (P.). Manganese Sulphate, is one of the remedies (B.). Belladonna, the extract locally very valuable for pains (P.). Cod-liver Oil, internally and externally,'exercises some influence (B.). may prove useful, especially when lithiasis (P.). Lupulin, as an anodyne (P.). Burgundy Pitch, as plaster locally (P.). Aliment, avoid animal and saccharine food. The farinaceous vegetables and acid fruits suit- able (B.). Alkaline mineral waters have deserved reputation (B.). Turkisk Baths, in chronic muscular rheumatism (B.); steam bath daily of great benefit, may be obtained at home by pouring water on hot bricks in a tub, the patient sitting on a board or chair above, enveloped in a blanket (Brick). Red Flan- nel, next skin, very popular, but white better, as the red gives rise often to eruptions (Da C.). [Compare Lumbago, Myalgia, Pleurodynia, Rheu- matic Arthritis, Sciatica.] Prescriptions. R. Pulv. Resin. Guaiaci, Potassii Iodidi, . Hag). Tinct. Colchici Seminis, . Aquae Cinnamomi, Syrupi, . . aa q. s. ad :$vj. M. Sig.—A dessertsp. to a tablesp. thrice daily. {Pepper) R. Linim. Aconiti (B. P.), Linim. Belladon., . . aa Xi). Glycerini, . . q. s. ad pj\). M. Sig.-—Apply locally over the seat of pain. (Fothergill.) R. Olei Sinapis, . . . gss. Olei Terebinth., . . Camphorse, . . . Liq. Ammon. Fort., . . giij. Tinct. Capsici, . . . xiv. Alcoholis, . q.s. adgvj. M. Sig.—Russian Spirit, a lini- ment for rheumatism. R. Tinct. Guaiaci . j$j. Tinct. Colchici . Tinct. Cann. Ind. gij. M. Sig.—25 to 30 drops on sugar, every 4 hours, for rheumatic and neu- ralgic symptoms. (Atlee.) Rheumatism, Gonorrhoeal. Opium, as Dover’s powder, in the acute stage, full doses (Wa.). Potassium Iodide, with tonics and stimulants, after the acute stage has passed, followed by friction, shampooing, and passive movements of the joints (Wa.). Ammo- 714 RHEUMATISM, MUSCULAR SCABIES. nium Chloride, in free doses, especially when the muscles are affected (Fuller). Potassium Chlorate, internally, and as urethral injection, until urethral dis- charge is entirely stopped, then npxx of tinct. ferri chlor. 4 times daily, with gr. x of quinine daily, and good food (Da Costa). Aspirate, when pus is dis- covered around the joints, as the case will be one of pysemic rheumatism, and may involve more joints than one (Da C.). Rheumatism, Muscular. Diaphoretics, as Dover’s powder, with Potassium Nitrate, or Salts of Ammo- nium, with dry heat to the part involved and rest in bed (Da C.). Morphine and Atropine, gr. ]- and gr. together hypodermically, are of great service in most forms (R.). Jaborandi, or Pilocarpine hypodermically, to get the skin acting freely, a great desideratum (Da C.). Potassium Iodide and Col- chicum, or Quinine, gr. xij-xvj in 24 hours, if case lingers over a week (Da C.). Liniments are of little use except to amuse the patient, but Chloral 5j in 5vj of Linim. Saponis, makes a good one (Da C.). Capsicum, powdered, with lard, gij ad rubbed over the part, night and morning, with a gloved hand, is very efficient (Macdonald). Cimicifuga, is often very efficient in lum- bago, myalgia, pleurodynia, and similar conditions (Wa.). Xanthoxylum, gives relief in some cases of muscular rheumatism (B.). Lithium and its salts, where there is a uric-acid diathesis (B.). Colchicine, 5-minim doses of a solution of Merck’s, hypodermically into affected muscles, thrice daily, very effective in cases resisting other treatment. [Compare Lumbago, Myalgia, Pleurodynia, Torticollis.] Roseola. Scarcely any treatment called for; no local application needed, as the rash is but slightly irritating. Aconite or Belladonna, according to the symptoms, or the Carbonate of Ammonium, answers all the indications. Sarcinse. Sulphites and Hyposulphites, have been employed to destroy sarcinas and torulae in the stomach (Rl); or Sulphurous Acid, diluted, before each meal (Wa.). Scabies. Sulphtir, a solution of potassa sulphurata as local application. An extemporaneous sulphide may be made by boiling one part of quick-lime and two of sulphur in ten of water (B.). Sulphurous acid, as gaseous bath, the quickest method. Hebra’s mixture of sulphur, chalk, tar, soap, and lard, less irritating, and equally sure (R-). Calcium Sulphide, as a bath (Wa.). Sul- phuric Acid, internally, has cured when other remedies failed (Wa.). Storax, equally serviceable and not irritating as is sulphur, one part to two of olive oil, with a warm bath (R.). Mercury, the bichloride is very efficient, if used strong enough, but caution is required in its employment (B.). See formula below. Staphisagria, a certain remedy; 3 parts to 5 of lard, boiled at 212° F. for 24 hours, when cooled after straining add a little essence; friction with this 4 times daily (Wa.). Balsam of Peru, the best of all applications, killing the acarus, relieving the itching and dermatitis, and disinfecting the parts; rub in over the body after a warm bath (Bruce); is fatal to the itch-mite (Oldberg). SCARLATINA. 715 RIanganese, the oxide, spj-ijj adipis suilli as ointment (B.). Copper Sulphate, as lotion (.ifj-Oj) has been used with great success, after crusts are thoroughly removed with soap-and-water (B.). Alkalies, as soaps or ointments to remove cuticle and break up burrows (R.). Carbolic Acid, locally (B.). [See Tinea for formula.] Cocculus Indicus, as ointment, useful (P.). Tar Ointment, relieves itching quickly and cures disease in 10 or 12 days (P.). Anise, Ka- rnala, as ointments, efficient (P.). Benzoic Acid, gr. x-xx ad 0)4 aquae, as lotion, effectual for the pruritus (R.). [See last formula on left-hand column, under Pruritus.] Linen should be immersed in boiling water ; other gar- ments well fumigated with sulphur vapor to destroy insects or their ova, or baked in oven (R.l. Prescriptions. R. Styracis Liquidis, . . Ung. Sulphuris, . . Ung. Petrolei,. . M. Sig.—Apply after washing. (Bulkley.) R. Sulph. Sublimat., . . gj. Balsam. Peruv., . . 2ss. Adipis, . . . . gj. M. Sig.—For children. (Duhring.) R. Hydrarg. Chlor. Corr., . gr. iv. Alcoholis, . . . ijvj. Ammonii Chloridi,. . Aquae Rosse, . q. s. ad%\j. M. Sig.—Lotion for scabies, phthei- riasis, and tinea versicolor. (Pox.) R. Sulph. Sublimat., Olei Cadini, . . aa gij. Cretse Preparatae, . . gijss. Saponis Viridis, Adipis, . . . aa %j. M. ft. unguentum. (Bulkley.) Scarlatina. Aconite, of the highest value for all marked increase of temperature (B„ R.); helps the development of eruption when due (P.); in the early stage, when not decidedly adynamic, is very useful (W.). Belladonna, during the erup- tive stage, when depression exists, and rash is imperfectly evolved (B.). As prophylactic has been recommended (R.); is often efficacious as prophylactic (P.) ; the preponderance of evidence is certainly in favor of such use of the drug (Pf.) ; this virtue is claimed by imposing authorities ; when so given its dose is gr. | several times a day (Tr.). Mercury, gr. of gray powder every hour has marked effect on inflamed tonsils (R.). Ammonium Carbonate, feeble circulation, cyanosis, delirium (B.); in all forms, especially if given early (R.); one of the most reliable remedies; gr. iij-vij, according to age, in milk or cinnamon water, every hour or two (Wa.). Potassium Iodide, in full doses, a very satisfactory remedy (Mitchell). Mineral Acids. Muriatic, internally and as gargle; Nitric, to sloughs in throat (R.). Carbolic Acid, internally and as gargle, successfully used. [See Measles, for formula.] Seems to exercises some influence as prophylactic (Wa.); is good for the vomiting and for its general effect on the disease; mss, every 2 or 3 hours (Da Costa.). Veratrum Viride, \n convulsions (R.). Rhus Toxicodendron, of great service, if typhoid or rheumatic symptoms (P.). Digitalis, very useful; lowers temperature and maintains kidney action (B.); the best antipyretic and diuretic, the infusion with dry cups for the renal dropsy in its inception. Later on, milk diet and Basham’s Mixture (Da C.). Potassium Permanganate, locally to throat, and internally (gr. %-] ter die) has undoubted benefit (B,). Sulphurous Acid, by inhalation, spray, or fumigation, in malignant 716 SCIATICA. sore throat (R.). Chlorine Water, in sloughing of throat (R.); seemingly prophylactic (Wa.). Quinine, small doses, in adynamic states, large in hyper- pyrexia (B.); very successful when used systematically from the start (Wa.). P'errum Perchloride, the tincture in doses of np-xv, according to age, in advanced stage, when with albuminuria and hematuria, is very valuable (Wa.). Potassium Chlorate, in grain-doses every )/2 hour, will not injure the kidneys, and will give equal results as larger doses on the throat inflammation (A. A. Smith). Asclepias, to promote the eruption (W.). Zinc Sulphate, gr. y every 3 hours, believed to have specific influence on the disease (Hoyt). So- dium Benzoate, is highly efficient, having slower but more permanent effects on the fever than quinine or the salicylates (Klebs). Boric Acid, makes an excellent gargle (Da C.). Juniper, as diuretic when dropsy (R.). Magnesium Sulphate, as purgative, to prevent sore throat and other sequela; (R.). Sodium Sulpho-carbolate, as a means of introducing carbolic acid into the system. Has been successfully employed (Wa.j. Mustard Bath, on recession of rash, to bring it back (R.). Oil Inunctions, very grateful, especially useful in des- quamative stage. Cocoa butter the most elegant (B.). Ice sucked, in the sore throat (R.). Water, cold baths with oil are all that are needed in mild cases. When temperature above 104°, urine scanty and rash retroceding, the cold wet-pack renders signal service (B., R.). A cold wet compress to neck, through the whole course, renewed every 3 hours (R.). Diet, fruit, if ripe, in season, toast, gruel, etc., in simple cases. In malignant, extract of beef, stimulants as per pulse. Milk the most suitable aliment, both as nutrient and as diuretic. Prescriptions. R, Ac. Borici, . . . £ss. Potassii Chloratis, . < gi). Tinct. Ferri Chloridi, . '^ij. Glycerini, Syrupi, . aa tj. Aquae, .... %i). M. Sig.—Tablesp. every 2 hours, to a child of five years. (Smith.) R. Acidi Salicylici, . . gij. Tinct. Aconiti, . . gtt. xij. Infusi Digitalis, , . Spt. Ammon. Aromat., ziij. Syr. Aurantii Cort., . Sss. Aquae,. . . . M. Sig.—Teasp. every 3 hours, for a child of five years. • {Brown.) R. Acidi Carbol., . . gss-j. Vaselini, . . . ,§iv. M. Sig.—By inunction to the en- tire surface. R. Acidi Borici, . . 2iij. Glycerini, . . . M. Sig.—For a pint of water as a gargle. {Da Costa.) Sciatica. Aconite, locally (P.); as ointment controls in some instances (R.); valuable and efficient in many obstinate forms (Wa.). Rhus Toxicodendron, a very pow- erful therapeutic agent in various rheumatic affections of the fibrous tissues (P.). Cimicifuga, is highly extolled (R.). Turpentine, causes an exquisite sensibility along the track of the great nerves (Tr.); occasionally of great value in sciat- ica, yet not a specific, nor have we scientific indications for its use (P.); doses for 4 or 8 successive nights (R.). Sulphur, locally, believed to relieve the pain; effect probably due to the flannel surrounding it (R.); is worthy of trial after active symptoms are subdued (Wa.). Phosphorus, in neuralgic form ; less satisfactory in sciatica than in other neuralgias (R.). Nux Vomica, often SCLERODERMA—SCROFULOS1S. 717 successful in chronic (Wa.). Belladonna, has afforded relief (R.). Atropine, hypodermically, is curative ; large doses, gr. to in vicinity of nerve (B.). Cocaine, hypodermically along the nerve, has afforded instant relief (Wa. j. Veratrine, as strong ointment; Veratrum Viride, as tincture, is also recom- mended (R.). Ammonium Chloride, in mild forms (R.); occurring in the young (Anstie). Ether Spray, generally of temporary value (R.); Chloro- form on flannel along course of nerve, covered with oiled silk (Wa.); injected deeply into vicinity of nerve, gives the best results in old cases, nqxv of the spirit hypodermically (B.p Stramonium, gr. every 3 or 4 hours for 4 or 5 doses, often affords decided relief. Stop when slightest symptoms of nar- cotism appear (P.). Opium, internally and externally (Wa.); Morphine, hy- podermically is especially curative in sciatica (B.); 3 or 4 injections of gr. each; it may almost be regarded as a specific (Wa.); a single application sometimes cures long-standing cases permanently; if not it may be repeated every second day or so (R.); should be injected deeply into the adjacent muscular structure (Pepper). Iodides, in syphilitic or metal-poisoned subjects (B.); often fails (R.). Potassium Iodide in doses of daily, dissolved in decoction of sarsaparilla, most efficacious in subacute or chronic (Wa.). Cantharides, as counter-irritant, to free vesication (R.). Aquapuncture, has had extraordinary success (B.). [See under Neuralgia.] Acupuncture, occasionally affords instant relief (B.); often cures cases of long standing (R.). Nerve-stretching, by forcibly flexing the thigh on the abdomen (Lange). Poultices, applied very hot (R.). Turkish Baths, are often very useful (R.). Electricity, produces excellent results (B.); does great good, but often aggra- vates ; the continuous current best, when stage of acute inflammation past (W.); galvanism often quickly relieves the pain (Pepper). Cod-liver Oil, should always be tried in obstinate cases (W.). [Compare Neuralgia, Rheu- matism Chronic.] Scleroderma. Cod-liver Oil, our sheet-anchor, used internally and locally (B.). Elec- tricity, is used successfully (B.) ; with stimulating inunctions offers the best prospect of improvement (Bulkley). Scrofulosis. Iodides, the Iodide of Ammonium when glandular enlargement; that of Iron when debility and emaciation, a powerful and efficacious remedy ; also in anaemia of scrofula, the syrup mxx-gj, ter die (Wa.); disappointing, useful in simple glandular hypertrophy (B.). Iodine, tinct. or oint. applied over scrofulous glands—take care not to increase inflammation (R.). Iodine and Iron the best remedies, but all medicines utterly useless without strict hygiene (A.). Calcium, the chloride, in doses of gr. x-xx in milk after food, when glandular enlargement of neck and chronic diarrhoea. The phosphate of great use for sores (R.); is of eminent service as a palliative (Wa.); see Sul- phides below. Spongia Usta, formerly held in high repute; has fallen into perhaps unmerited neglect. Contains sodium iodide, magnesium bromide, calcium phosphate, and ferric protoxide, in small quantities (Wa.). Iron, ferrum and calcium phosphates combined give good results, also chalybeate waters (B.) ; must be long continued (R.). Sulphides, for sores, abscesses, suppurating glands; gr. or of calcium sulphide every hour or two (R.). Conine, grain to 3j almond oil, locally, two or three times a day to con- junctive in “ scrofulous ” photophobia; has proved very successful (P.). Cod- 718 SCURVY SEBORRHOEA. liver Oil, the best remedy to promote assimilation (B.) ; of great service in the various manifestations of this disease (R.). Slillingia, a domestic remedy, used with much success (B.). Capsicum, in scrofulous and fistulous ulcera- tions, a weak infusion becomes a useful stimulant (P.). Mezereum, strongly recommended (P.). Sarsaparilla, useful by reason of its tonic and alterative properties (P.). Hyoscyamus, the bruised leaves as cataplasm for scrofulous ulcers (P.). Phosphates, for mal-nutrition (B.). Prunus Virginiana, is found very useful in the hectic (P.). Chimaphila, holds a certain amount of repu- tation as a useful remedy (P.). Tussilago, was employed by Cullen (P.). Gen- tian, is valued. As infusion a useful vehicle for chalybeates, etc. (P.). Blis- ters, for scrofulous glands (R.). Grape-cure, renders much service (B.). Al- cohol, no doubt as to its great value; with cod-liver oil, or in small amounts at meals (Wa.). Phosphorus, eminently serviceable in scrofuloderma, gr. x in Ol. Olivse %j, doses of iq.v-x, thrice daily after meals (Broadbent). Aliment, raw or broiled meat, the latter for children. Abundance of fresh air and sun- shine. Sea-air, sunlight, moderate exercise, and light, digestible food are necessary. [Compare Cachexia, Glands, Coxalgia, Ophthalmia.] Scurvy. Citric Acid, used with great advantage, though inferior to lemon-juice (Wa.). Lemon- or Lime-juice, of the utmost value, both as preventive and a curative agent. Efficacy believed to be due to its potassium salts. Oranges highly useful (Wa.). Acids, especially vinegar, to prevent scurvy, in the absence of lime-juice or fresh vegetables (R.) ; dilute Muriatic Acid, gtt. v, thrice daily, with juice of three lemons daily, vegetables and fresh meat (Da Costa). Po- tassium Chlorate, is probably a remedy of some value (Wa.) ; is not (W.). Cinchona, a decoction, or the dilute tincture with myrrh or the chlorates, a very useful gargle. Quinine, internally when much prostration, combined with mineral acids (Wa.). Alcohol, diluted, as gargle (R.). Atropine, hypo- derm. for salivation (R.). Alum, a solution in water with tinct. myrrhse several times daily as lotion for ulceration of the gums (W.). Liquor Sodce Chlorata, gvj ad ijxij aquae, as a mild application to gums (Wa.). Dietetic Treatment alone required. Lemon-juice plays no essential part in the treat- ment. The full diet of an hospital, comprising fresh meat, vegetables, and milk, is generally sufficient. [Compare Cancrum Oris, Purpura.] Seasickness. Chloral, the most effective remedy; gr. xv-xxx every four hours (R.). Sta- phisagria, has given relief (P.). Creasote, checks the vomiting (R.). Chloro- form, drop doses pure (R.); Ttlij-v on sugar (B.). Atropine, hypodermically, gr. in epigastrium, will relieve (B.). Morphine, gr. Tlj—£ hypoder. will often relieve severe cases (B.); often fails (Wa.). Amyl Nitrite, by inhala- tion (B.) ; is strongly recommended, but must be cautiously used. Cham- pagne, iced; tablesp. doses every quarter-hour (B.). Calumba, a few drops of the tincture will sometimes relieve (B.). Spinal Ice-bag, often successful (R.). Cocaine is reported quite successful. Bromides, in full doses (Beard). [Compare Nausea, Vomiting.] Seborrhoea. Glycerin, especially useful; with lead acetate, borax, zinc, diminishing se- cretion ; also acts efficiently when there is a want of sebaceous secretion (W.). SNEEZING—SPERMATORRHOEA. 719 Zinc Oxide, plumbi carbonat. Jjj, cetacei ol. olivse q. s. Ft. unguent. (B.). Oleate of Arsenic, is of benefit (Wa.). Mercury, an ointment of the white precipitate is serviceable on the scalp, with an occasional shampoo with tar soap or green soap in solution, followed later by mildly stimulating lotions (Bulkley). [Compare Acne, Pityriasis.] Sneezing. Arsenic, a drop of liquor arsenicalis three times a day in paroxysmal sneez- ing, allied to asthma (R.). Potassium Iodide, gr. x, several times a day (R.). Iodine, inhalations in paroxysmal sneezing, with itching of nose (R.). Cam- phor, in incessant sneezing, with profuse running from eyes and nose. The powder should be snuffed, or the alcoholic solution inhaled (R.). [Compare Catarrh, Hay-fever, Influenza.] Somnambulism. Potassium Bromide, will give decided relief in the somnambulism of chil- dren allied to epilepsy, often with squinting, which may become permanent; generally the result of deranged digestion. The night-mare of adults will usually yield to the same drug (R.). [Compare Night-mare.] Spasmodic Affections. Aconite, ext. and int. for spasms not of a severe type; Aconitine, as oint- ment in the most severe, as well as in the milder local spasmodic affections; in angina pectoris, spasmodic asthma, cough, etc. (P.); in spasmodic laryn- gitis of good effect (R.). Camphor, in many forms said to relieve, as stran- gury, etc. (R.). Belladonna, of value for spasms of sphincter muscles, es- pecially of pelvic organs (P.); atropine hypoderm. in local spasm (R.). Strychnine, of great value in spasmodic asthma (P.); also in tetanus, chorea, and epilepsy (Pf., S.). Veratrine, as solution, brushed over lids once a day in painful spasmodic contraction of the orbicularis (Wa.). Opium, very useful as an antispasmodic, especially if given with a stimulant, as alcohol, ether, or chloroform (R.). Ipecacuanha, in spasms of respiratory organs, of great value (P.). Chamomile Oil, in spasms of hysterical persons, in 4 to 6 up doses, a very excellent remedy ; also useful in pseudo angina pectoris (P.). Lobelia, a valuable antispasmodic in cautious hands (P.). Lupulin, in gouty spasms (P.). Tobacco, in spasmodic asthma, and for relaxation of muscular spasms (P.). Sumbul, in gastric spasms is of use (P.). Cardamoms, are usefully em- ployed in gastric spasms (P.). Ammonia, useful in children’s colic (R.). Chloroform, inhaled for intestinal spasm (R.). Sulpho-carbolates, in flatulent “ spasm,” sometimes phosphorus better (R.). Mustard Poultice, an excellent counter-irritant in spasmodic affections (P.). [Compare list of Antispasmodics on page 405, and in this section the titles, Angina Pectoris, Asthma, Cho- rea, Colic, Cough, Convulsions, Croup, Dysuria, Epilepsy, Gastro- dynia, Hydrophobia, Hysteria, Laryngismus, Pertussis, Tetanus, Torticollis, Trismus.] Spermatorrhoea. Potassium Bromide, when plethora-erections normal, but persistent and teasing; is harmful in debilitated states, or daily losses (B.) ; with cold spong- ing and use of a hard bed (R.). Digitalis, gj or ij of the infusion twice or 720 SPERMATORRHCEA—SPINAL CONGESTION. thrice daily; few remedies are more successful in arresting spermatorrhoea (R., P.); feeble erections, frequent emissions, cold hands and feet (B.). Can- tharis, deficient tone of seminal vesicles, erections feeble, sexual feeling tor- pid; tinct. gtt. ij-iij ter die(R.); with Iron internally in emissions (R.). Phosphorus, for the induced physical and mental debility; also, hypophos- phites of lime and soda (R.). Gelsemium, as anaphrodisiac, maybe combined with Belladonna or Cimicifuga (B.). Nux Vomica, relaxation and atony (B.). Strychnine, in large doses, especially when impotence (R.). Quinine has been recommended (R.). Belladonna, gr. y of extract with gr. jss zinci sulphat., three or four times a day, often successful in nocturnal emissions (R ). Atro- pine, relaxed genitalia, no dream or orgasm (B.). Camphor Bromide, has been useful (W.). I.upulin, is a good anaphrodisiac; with Camphor, when a genital sedative is required (B.). Iron, the iodide, useful in anaemic cases (B.). Ergot, beneficial in relaxed state (B.). Hydrastis, is a useful injection, gtt. x of the fluid ext. through a urethral tube to the prostatic portion of the urethra (B.). Cimicifuga, useful in weak, relaxed conditions (B.) ; with hypochon- driasis, very beneficial (P.). Silver Nitrate, a vesicating solution applied to perineum generally useful, and without danger (B.). Arsenic, when from weak and relaxed seminal vesicles. Kind Advice, frequently the best treatment, as this is often the phantasm of a morbid imagination. Bladder should be emptied after the first sleep. [Compare Emissions, also List of Anaphrodisiacs on page 427.] Prescriptions. R. Potassii Bromidi, . . g). Sodii Bicarbonat., . gr. xv. Infusi Digitalis, . . jjss. Atropinse Sulphat., . gr. ■sV M. Sig.—One dose, to be taken at bed-time. (Gross.) R. Lupulini, . . . gr. x. Pulv. Camphorae, . . gr. vj. Ext. Belladonnae, . . gr. ij. M. ft. pil. no. xij. Sig.—One pill thrice daily. (B.) R. Tinct. Gelsemii, . . gj. Tinct. Belladonnae, . . gi], M. Sig.—15 drops thrice daily. (B.) R. Tinct. Cantharidis, . . gij. Tinct. Ferri Chlor., . . gv). M. Sig.—20 drops in water thrice daily. In impotence with spermator- rhoea, of great utility. (//. C. Wood.) Spina Bifida. Iodine, injected into the sac, of tinct:, or gr. ss, with potassium iodide gr. v, aquae g), has cured numerous cases (B.); iod. gr. y, pot. iod. gr. y ad aq. g] (Wa.J. Collodion, as a means of compression (B.). Spinal Concussion. Lead-water and. Opium, as lotion over the seat of injury (A.). Leeches, if pain persistent (A.). Spinal Congestion. Ergot, gives excellent results (Brown-Sequard). Turpentine, hot epithems, useful (Wa.). Antiphlogistic measures, with rest and absolute diet; wet cups or leeches to the column ; cool affusions to the spine while patient in a warm half-bath (Ros.). [Compare Meningitis.] SPINAL IRRITATION—STAINS. 721 Spinal Irritation. Aconite, as ointment locally (R.). Belladonna preparations, locally, gen- erally are better than Aconite (R.). Ignatia, in small doses diminishes irri- tability of cerebro spinal axis (Pf.). Strychnine, persistently, will ameliorate wandering neuralgic pains due to irritability of nervous system (R.). Ergot, large doses for congestion (Hammond). Conium, in functional derangement of the cord, with excessive irritability of the reflex function (Wa.). Firing, sometimes very beneficial (B.). Electricity. An inverse galvanic current gives much relief (Hammond). Blisters, with hot-water bag to spine, large doses of strychnine, phosphorus, phosphoric acid, and opium, are the methods based upon the ansemic theory of the disease. Out of 156 cases 133 were thoroughly cured (Hammond). [Compare Meningitis, Myelitis.] Spinal Paralysis and Softening. Ergot, to starve the inflammation by occluding the spinal arteries (Ham- mond). Electricity, best; galvanic current from spine to nerves and muscles (Ros.). Treatment must be palliative and supporting only, in softening (H.). Splenic Affections. Mercury Biniodide, gr. j ad unguent, gj, rubbed in before a hot fire, has given excellent results in chronic malarial enlargements of spleen (Wa.). Quinine, in simple malarial enlargement (B.); gr. xv or xx or more daily, one of the most effectual remedies (Wa.). Ergot, the most effective remedy for enlarged spleen (Da Costa). Ammonium Iodide, effective in chronic splenitis, with unguent, hydrarg. iod. rubri externally; also small doses fre- quently repeated in all splenic derangements from malaria (B.). Iodine, locally in chronic forms (B.). [Compare Leucocyth^mia.] Sprains. Arnica, is very useful; the infusion internally and externally (P.); the tinct. diluted as lotion is very effectual (Wa.). Aconite, the liniment to painful sprains often affords speedy relief (Wa.). Turpentine, the oil as a liniment (P.). Ammonium Chloride, in solution, as lotion, or with bread as poultice, to remove discoloration from sprains (Wa.). Rhus Toxicodendron, the tinct. 3ss to Oj of water a good external application to sprains. Oil of Bay, as stimulating liniment (P.). Cold Douche, salt maybe added. The force must be regulated by the condition of the tissues (R.). Rest, the most essential measure, should be perfect. Warm fomentations, or cold affusion, opiates, and plain diet (D.). A roller bandage with splints, often required to secure rest of the part. Stains. Nitrate-of-silver Stains may be removed by washing with Potassium Cyanide ; Iodine, gr. xv.; Water, 2iij; or, after moistening the spots, drop on them a few drops of Tinct. Iodine, and wash out with a solution of Sodium Hyposulphite, (B.). Blood-stains, if on dark-colored materials are best seen by an artificial light. After a few hours they become of a rusty, reddish-brown color, which they maintain for years. 'The microscope shows the characteristic corpuscles. These stains when on iron are difficult to dis- STAMMERING—STOMATITIS. 722 tinguish from rust; the latter is not soluble in water, while blood is extremely so. Heat applied to the metal will cause the blood to peel off, unless the stain has been exposed long enough to have rust mingled with the blood. A solution of blood in water, heated, forms a coagulum which is soluble in hot caustic potash, the solution thus formed is green by transmitted light, and red by reflected light. Menstrual blood cannot be distinguished from that resulting from a wound (Husband). Stammering. Vocal Training. The rhythmical method, the most successful; the chief end in view is to regulate the precipitate, irregular form of respiration. Long continuance necessary, six months, a year, or more, in special institutions (Ros.). The patient must be taught the use of language anew, treated with especial kindness, and never subjected to mockery or punishment. See Potter on Defects of Speech, Lea Prize Essay, Philadelphia, 1882. Sterility. Aurum, cures sterility when dependent on chronic metritis or amenorrhoea or coldness, more certainly than any other remedy. Auri chlor. gr. (B.). Potassium Iodide, when due to syphilis (R.). Dilation of os and cervix care- fully when sterility depending on obstruction, with dysmenorrhcea (H.). Ster- ility is frequently associated with uterine displacement (Meadows); less often with atresia. In persons of good health may be caused by an acid discharge from the uterus, which kills the spermatozoa ; for this Vichy water internally and per vaginam, and alkaline baths (Charrier). Is due to aspermatism of the husband in more cases than generally believed (Gross). Stings and Bites. Ammonia or Alkalies, a weak solution, in stings of insects, to neutralize the formic acid (R.). Ammonia, as nervine stimulant in snake-bites, more useful than brandy or any other stimulant: Ttlx-xx of liquor ammonise in water or wine, every half-hour or oftener ; also externally or hypodermically, 1 part to 2 aquae into a vein (Wa.). Carbolic Acid, a weak solution sponged over the body, to keep off mosquitoes (R.). Arsenic, I part to 5 of black pepper, is the “ Tanjore Pill,” highly esteemed in India for bites of venomous snakes (Wa.). Chloride of Lime, a filtered solution injected into wound from snake- bite, successful in seventeen cases (Binz). Silver Nitrate, the sharpened stick applied to every sinuosity of the wound. Excision safer (Wa.). Sugar, ap- plied to stings of wasps, said to relieve almost instantly (Wa.). Ipecacuanha, as poultice or paste, allays pain and irritation; is regarded by some as almost specific (Wa.). Stimulants, in snake bites, freely; most important. Liquor ammonise the best (Wa.); stimulants are indicated in snake-bites, but there is no remedy of any value (Gross). Sting, should always be removed if left in the wound; pressing upon it with the barrel of a small key will expose it. Stomatitis. Potassium Chlorate, locally and internally. Large doses necessary (gr. x-xx); in ulcerative stomatitis of nursing women, and aphthse; of no value in mercurial form (R.). Hydrastis, fluid extract locally in mercurial and STRABISMUS SYCOSIS. 723 aphthous stomatitis (B.). Carbolic Acid, concentrated, in glycerin, carefully, as a mild caustic in aphthous stomatitis (Wa.). Alcohol, Brandy-and-water an excellent lotion (B.). Acids, Mineral, pure Hydrochloric on pine wood to ulcers (B.). Eucalyptus, a decoction of the leaves an efficient local appli- cation (B.). Glycerin of Tannin, in ulcerative stomatitis (R.). Copper Sul- phate, solution painted over edges of gums in ulcerative stomatitis; generally dry alum better (R.). Alutn, in ulcerative, applied dry with the finger several times a day, especially when disease affects one-half the jaw (R.). Salicylic Acid, to ease the pain of catarrhal stomatitis. One part (dissolved in sufficient alcohol) to 250 parts of water (R.). [Compare Aphth/e, Cancrum Oris.] Strabismus. Belladonna, for the strabismus of encephalitis (P.). Atropine, with strong convex glasses, to suspend accommodation for months, or years if necessary ; may cure convergent strabismus in its earlier stages, in children of 3 years of age or younger (Green in C.). Operation, required in most cases, especially when of congenital origin. Strophulus. Glycerin, locally, combined with bismuth, and digitalis (Wa.). Lancing the gums is proper (H.). Sunstroke. Water. Cold affusion when patient is stricken down unconscious (R.); absolute rest and quiet, free air, loose clothes. Potassium Bromide, in cold water enemata. Stimulants when frequent and feeble pulse. Chloroform, if convulsions. Leeching, in stage of reaction (Wa.). Suppuration. Sulphides, small doses (gr. ss-j), frequently repeated, are very serviceable (B.). Calcium Sulphide, when ichor secreted instead of pus; also arrests suppuration, or if that is impossible will hasten maturation (R.). Quinine, recommended in profuse suppuration (R.); to sustain system when suppura- tion prolonged (B.). Sarsaparilla, is very useful (P.). Phosphates, Parrish’s to repair waste from suppuration (B.). Iodide of Manganese and Lron, the syrup, in cachectic states resulting from suppuration (B.). Alcohol, an excel- lent antiseptic dressing (B.). [Compare Abscess, Boils, Carbuncle, Pyaemia.] Surgical Fever. Aconite, quickly and repeatedly in early stages, during chill or soon after, the safest treatment (P.). Salicylic Acid, or Salicylate of Sodium, especially useful as an anti-pyretic (B.). Chloral, gr. xx-xxx of the hydrate every 2 hours, no better treatment (Wa.). Sycosis. Nitric Acid, §j to Oj aquae, as wash, used frequently (R.). Boracic Acid, gjss finely powdered and incorporated with fp of vaseline, is found most useful (Wa.). Mercury, citrine ointment has been extensively employed, also 724 SYNCOPE—SYPHILIS. the oleate of mercury, both with good results (Wa.). Arsenic, the oleate is found beneficial, and the Solution of Arsenic and Mercury, Donovan’s solu- tion, internally is highly useful. Mercurial Ointments are extensively em- ployed (Wa.). Sodium glycerini, %j; aquae, giij; locally, when of parasitic origin (Wa.). [Compare Condylomata, Mentagra.] Syncope. Cinnamon, the oil, as a powerful stimulant, sometimes employed (P.). Al- cohol, as brandy, or wine, when heart suddenly enfeebled from fright, etc. (R.). Amyl Nitrite, in some forms, especially in anaemic subjects, its inhalation speedily restores consciousness (O’Neill). Atropine, gr. ??Tontis Aq. font. « << Aqua marina Aq. mar. Sea water. Aqua nivialis Aq. niv. Snow water. Aqua pluvialis, or Aq. pluv. Rain water. pluviatilis Aqualis Pertaining to water. Aqualis Aut Aut Or. Balneum arense B. A. Sand-bath. Balneum marise, or B. M. Salt-water bath. mar is Balneum vaporosum, B. V. Vapor-bath. or vaporis Balsamum Bals. Balsam. Barbadensis B. B. Barbadoes. Bene Bene Well. Bibe Bib. Drink (thou). Biduum Bid. Two days. Bis Bis Twice. Bis in die, or dies Bis die Twice a day. Bolus Bol. A lafge pill. Bulliat or Bulliant Bull. Let boil. Butyrum But. Butter. Geruleus Gerul. Blue. Calefactus Calef. Warmed. Calomel or Calo- Cal. The mild chloride of mercury. melas Cape Cap. Take (thou). Capiat Cap. Let him take. Capsula Capsul. A capsule. Caute Caute Cautiously. Charta Chart. Paper. Chartula Chartul. A small paper. Cibus Cib. Food. Cochlear, or Coch- Coch., Cochleat. A spoonful, By spoonfuls (gj). leare, or Coch- leatim LIST OF LATIN WORDS, PHRASES, ETC. 751 Word or Phrase. Contraction. English Equivalent. Cochleare amplum Coch. amp. A dessertspoonful (,^ij). Cochleare magnum Coch. mag. A tablespoonful (^ss). Cochleare medium, Coch. med. or mod. A dessertspoonful (£ij). or modicum Cochleare parvum Coch. parv. A teaspoonful (gj). Coctio Coct. Boiling. Cola Col. Strain. Colaturse Colatur. To the strained liquor. Colatus Colat. Strained. Coletur Colet. Let it be strained. Colentur Colent. Let them be strained. Collutorium Collut. A mouth-wash. Collyrium Collyr. An eye-wash. Coloretur Coloret. Let it be colored. Compositus Comp. Compounded. Concisus Concis. Cut. Confectio Conf. Confection. Congius Cong. A gallon. Conserva Cons. A conserve, also Keep (thou). Continuantur remedia Cont. rem. Let the medicines be continued. Contusus Contus. Bruised. Coque, Coquantur Coq. Boil, let them be boiled. Coque ad medietatis Coq. ad med. con- Boil to the consumption of half. consumptionem sump. Coque secundem Coq. S. A. Boil according to art. artem Coque in sufficiente Coq. in S. A. Boil in sufficient water. quantitate aquae Cor, cordis Cor. The heart. Cortex, corticis Cort. The bark. Coxa Cox. The hip. Cras, Crastinus Crast. To-morrow. Cras mane sumendus Cras mane sumend. To be taken to-morrow morning. Cras nocte Cras nocte To-morrow night. Cras vespere Cras vesp. To-morrow evening. Crastinus Crast. For to-morrow, early. Cujus, Cujus-libet Cuj. Of which, of any. Cum C. With. Cyatho these Cyatho these In a cup of tea. Cyathus, vel Cyathus Cyath., C. vinar. A wine-glass (^j-ij)* vinarius Da, detur D., det. Give, let be given. De De Of, or from. Deaurentur pilulse Deaur. pil. Let the pills be gilded. Debita spissitudo Deb. spiss. A proper consistence. Debitus Deb. Due, proper. Decanta Dec. Pour off. 752 LIST OF LATIN WORDS, PHRASES, ETC. Word or Phrase. Contraction. English Equivalent. Decern, Decimus Decern. Ten, The tenth. Decoctum Decoct. A decoction. Decubitus Decub. Lying down. De die in diem De d. in d. From day to day. Dein vel Deinde Dein Thereupon. Deglutiatur Deglut. Let be swallowed. Dejectiones alvi Dej. alv. Stools. Detur in duplo Det. in dup. Let twice as much be given. Dexter, Dextra Dext. The right. Diebus alternis Dieb. alt. Every other day. Diebus tertiis Dieb. tert. Every third day. Diluculo Diluc. At break of day. Dilue, Dilutus Dil. Dilute (thou), Diluted. Dimidius Dim. One-half. Directione propria D. P., or Direct. With a proper direction. Dividatur in partes prop. D. in p. seq. Let it be divided into equal parts. aequales Dividendus, -a, -um Divid. To be divided. Dolor Dolor Pain. Donee Donee Until. Donee alvus bis de- Donee alv. bis dejic. Until the bowels have been twice jiciatur evacuated. Donee alvus soluta Donee alv. sol. ft. Until the bowels shall be opened. fuerit Donee dolor nephrit- Donee dolor neph. Until the nephritic pain is re- icus exulaverit exulav. moved. Dosis D. A dose. Drachma Dr. or % A drachm (60 grains). Durante dolore Dur. dolor. While the pain lasts. Eadem (fern.) Ead. The same. Eburneus Eburn. Made of ivory. Ejusdem Ejusd. Of the same. Electuarium Elect. An electuary. Emesis Emesis Vomiting. Enema En. A clyster or enema. Enemata Enem. Clysters. Et Et And. Evanuerit Evan. Shall have disappeared. Exhibeatur Exhib. Let it be exhibited. Extende Ext. Spread. Extende super alutem Ext. sup. alut. moll. Spread upon soft leather. mollem Extractum Extr. An extract. Fac F. Make. Fiat Ft. Let be made (sing.). Kiant Ft. Let be made (pi.). LIST *)F LATIN WORDS, PHRASES, ETC. 753 Word or Phrase. Contraction. English Equivalent. Fac pilulas duodecim F. pil. xij Make 12 pills. Farina Farina Flour. Fasciculus Fasc. A bundle which can be carried under the arm. Febre durante Febr. dur. During the fever. Febris Febr. Fever. Femoribus intends Fern, intern. To the inner thighs. Fervens Ferv. Boiling. Fac cataplasmatem Ft. cataplasm. Make a poultice. P iat ceratum Ft. cerat. Let a cerate be made. Fiant chartulse xij Ft. chart, xij Let 12 powders be made. Fiat collyrium Ft. collyr. Let an eye-wash be made. Fiat emplastrum ves- icatorium Ft. emp. vesic. Let a blister be made. Fiat emulsio Ft. emuls. Let an emulsion be made. Fiat enema Ft. enema. Let an enema (an injection for the rectum) be made. Fiat injectio Ft. inject. Let an injection (for the urethra) be made. Fiat lege artis F. L. A. Let it be made by the rules of art. Fiat massa, et divide Ft. mas. div. in pil. Let a mass be made, and divide it in pilulas xij xij into 12 pills. Fiant pilulse xij Ft. pil. xij Let 12 pills be made. Fiat pulvis Ft. pulv. Let a powder be made. Fiant pulveres xij Ft. pulv. xij Let 12 powders be made. Fiat pulvis in chartu- Ft. pulv. in chart, xij Let a powder be made to be divided las xij dividenda div. into xij little papers. Fiat solutio Ft. sol. Let a solution be made. Fiant suppositoria iv Ft. suppos. iv Let 4 suppositories be made. Fiant trochisci xxiv Ft. troch. xxiv Let 24 troches be made. Fiat unguentum Ft. ung. Let an ointment be made. Fiat venesectio Ft. venesec. Let a bleeding be done. Fictilis Fict. Earthen. Filtra Filtra Filter (thou). Filtram, Filtrum Filt. A filter. Fistula armata Fistul. arm. A syringe ready for use. Fluidus Fluid., FI. Liquid. Formula Form. A prescription. Frustillatim Frust. In small pieces. Fuerit Fuerit. Shall have been. Gargarysma Garg. A gargle. Gelatini quavis Gelat. quav. In any kind of jelly. Gradatim Grad. By degrees, gradually. Grana sex pondere Gran, vj pond. Six grains by weight. Granum, Grana Gr. Grain, Grains. Gramme Grm. Gram. Gratus Grat. Pleasant. 754 LIST OF LATIN WORDS, PHRASES, ETC. Word or Phrase. Contraction. English Equivalent. Gutta, Guttae Gtt. A drop, Drops. Guttatim Guttat. By drops. Guttis quibusdam Gtt. quibusd. With a few drops. Harum pilularum Har. pil. sum. iij Let three of these pills be taken. sumantur tres Haustus Haust. A draught. Haustus purgans H. p. n. A purgative draught after my own noster (formula). Hebdomada Hebdom. A week. Herba Herb. An herb. Herbarum recentium Herb, recent. Of fresh herbs. Heri Heri Yesterday. Hie, Haec, Hoc Hie, Hsec, Hoc This. Hirudo Hirudo A leech. Hora H. An hour. Hord. somni Hor. som. At the hour of sleep. Hora undecirmt ma- Hor. xj matut. At the eleventh hour of the morn- tutina ing. Horse decubiths Hor. decub. At bedtime. Horse unius spatio Hor. j spat. After one hour. Horis intermediis Hor. in term. In the intermediate hours. Idem Id. The same. Idoneus Idon. Proper. Imprimis Impr. First. Incide, Incisus Inc. Cut (thou), Being cut. In dies Ind. Daily, or From day to day. Infunde Infun. Pour in. Infusum Infus. An infusion. Injectio Injec. An injection. Injiciatur enema Injic. enem. Let a clyster be given. In pulmento In pulm. In gruel. Instar Instar As big as. Inter Inter Between. Internus, -a, -um Int. Inner, or Internal. Intus Intus Inwardly. Jam Jam Now. Julepus, Julepum, jul. A julep. Julapium Jusculum Juscul. A broth. Juxta Juxta Near to. Kali prseparatum Kal. ppt. Prepared Potash, or the Carbonate of Potassium. Lac, Lactis Lac. Milk, of Milk. Lagena Lag. A flask, or bottle. Lana Lana Flannel. Languor Lang. Faintness. Lateri dolenti Lat. dol. To the painful side. LIST OF LATIN WORDS, PHRASES, ETC. 755 Word or Phrase. Contraction. English Equivalent. Lectus Lect. A bed. Libra Lb. or lb A pound. Linimentum Linim. A liniment. Linteuni Lint. Lint. Liquor Liq. A solution. Lotio Lot. A lotion. Macera Mac. Macerate. Magnus Mag. Large. Mane Mane In the morning. Mane primo Mane primo In the very early morning. Manipulus M. or Man. A handful. Manus Manus The hand. Massa Mass. A mass, or pill-mass. Matutinus Matut. In the morning. Medius Med. Middle. Mensura Mensur. By measure. Mica panis Mic. pan. Crumb of bread. Minimum M. or Min. A minim. Minutum Minut. A minute. Misce M. Mix. Mistura Mist. A mixture. Mitte Mit. Send. Mittatur Mit. Let (it) be sent. Mittantur Mit. Let (them) be sent. Mitte sanguinem ad Mit. sang, ad uncias Take away blood to 12 ounces at uncias duodecim xij salt. least. saltern. Modicus Modic. Middle-sized. Modo prsescripto Mod. prsesc. In the manner prescribed. Mora Mora Delay. More dictu Mor. diet. In the manner directed. More solito Mor. sol. In the usual manner. Morturarium Mort. A mortar. Ne tradas sine num- Ne tr. s. num. Do not deliver without the money. mo Necnon Necn. Also. Nisi Nisi Unless. Non Non Not. Non repetatur Non repetat. Let it not be repeated. Noc, Noctis Noc, Noct. The night, of the night. Nocte maneque Noct. maneq. At night, and in the morning. Nucha Nucha The nape of the neck. Numero No. In number. Numerus No. Number. Nux Moschata Nux Mosch. A nutmeg. Octarius O., Oct. A pint (fxvj). Octavus Octav. Eighth. 756 LIST OF LATIN WORDS, PHRASES, ETC. Word or Phrase. Contraction. English Equivalent. Octo Octo Eight. Oleum Lini sine igne Ol. Lini sine ig. Cold-drawn Linseed Oil. Oleum olivse opti- 01. O. opt. Best olive oil. mum Omni hor& Omn. hor. Every hour Omni bihorio Omn. bih. Every two hours. Omni quadrante horse Omn. quadr. hor. Every hour. Omni mane Omni mane Every morning. Omni nocte Omn. noct. Every night. Opus Opus Need, or occasion. Ovum Ov. An egg. Pannus Pan. A rag. Pars, Partis Par., Pt. A part, Of a part. Partes sequales Pt. seq. Equal parts. Partitis vicibus Part. vie. In divided doses. Parvulus Parvul. An infant, A parvule. Parvus Parv. Little. Pastillus, Pastillum Pastil. A Pastille. Pediluvium Pediluv. A foot-bath. Penicillum cameli- Penicil. cam. A camel’s-hair pencil, or brush. num Per Per Through, By. Peracta operatio Peract. operat. emet. When the action of the emetic is emetici finished. Per deliquium Per deliq. By deliquescence. Per fistulam vitream Per fistul. vit. Through a glass tube. Pergo, Pergere Perg. To go on with. Phiala prius agitata P. P. A. The bottle having been first shaken. Phiala Phil. A vial, or bottle. Pilula Pil. A pill. Poculum Pocul. A cup. Pocillum Pocill. A little cup. Pondere P. By weight. Pondus civile P. civ. Civil weight (avoirdupois). Pondus medicinale P. med. Medicinal weight. Pone aurem Pone aur. Behind the ear. Post singulas sedes Post sing. sed. liq. After every loose stool. liquidas Potus Potus Drink. Prseparata Prsep. Prepared. Primo mane Primo mane Very early in the morning. Primus Primus The first. Pro Pro For. Pro ratione setatis Pro rat. set. According to the age of the patient. Pro re nata P. r. n. Occasionally. According to cir- cumstances. Pugillus Pug. A pinch. LIST OF LATIN WORDS, PHRASES, ETC. 757 Word or Phrase. Contraction. English Equivalent. Pulmento Pulm. Gruel. Pulvis Pulv. A powder. Pulverizatus Pulvz. Powdered. Pyxis Pyxis A pill-box. Quadrans,—antis Quad. A quart. Quantum libet Q. lib. As much as you please. Quantum placet Q- P- ii it ii ii it Quantum vis Q. v. a a u ii a Quantum volueris Q. vol. a a a a a Quantum sufficiat Q. s. As much as is sufficient. Quantum satis Q. s. ti it a tt a Quaqu& hor& Qq. hor. Every hour. Quaque Qq. Each, or Every. Quartus Quart. Fourth. Quater Quater Four times. Quatuor Quat. Four. Quibus Quibus From which. Quinque Quinq. Five. Quintus Quint. The fifth. Quoque Q- q- Also. Quorum Quor. Of which. Quotidie Quotid. Daily. Ratio Ratio Proportion. Recens, -entis Rec. Fresh. Recipe R Take. Redactusin pulverem Red. in pulv. Let it be reduced to powder. Redigatur in pulve- Redig. in pulv. ii ii H rem Regio umbilici Reg. umbil, The umbilical region. Reliquus Reliq. Remaining. Repetatur Rept. Let it be repeated. Repetantur Rept. Let them be repeated. Respondere Respond. To answer. Retinere Retin. To keep. Saltern Saltern At least. Saturatus, -a, -um Sat. Saturated. Scatula Scat. A box. Scilicet Scil. Namely. Scrupulum Scrup. or A scruple (20 grains). Secundum artem S. A. According to art. Secundum naturam S. N. According to nature. Secundus Secund. Second. Sedes Sed. The alvine evacuation. Semel Semel Once. Semis, or Semissis Ss. A half. Semi-drachma Semidr. Half a drachm. Semi-hora Semih. Half an hour. 758 LIST OF LATIN WORDS, PHRASES, ETC. Word or Phrase. Contraction. English Equivalent. Septem Sept. Seven. Septimana Septima. A week. Sesuncia Sesunc. An ounce and a half. Sesquihora Sesqh. An hour and a half. Sex Sex Six. Sextus Sext. Sixth. Si Si If. Signa Sig. Write, or Mark (thou). Signetur nomine pro- Sig. nom. prop. Let it be written upon with its prio proper name. Simul Simul Together. Sine Sin. Without. Singularum Sing. Of each. Singulorum Sing. Of each. Si non valeat Si. non val. If it does not answer. Si opus sit Si op. sit If necessary. Si vires permittant Si vir. perm. If the strength will bear it. Sit Sit Let it be. Solus Sol. Alone. Solve Solv. Dissolve. Sol vo, Solvere Solv. To dissolve. Solutus Solut. Dissolved. Somnus Somnus Sleep. Spiritus vini rectifica- Spt. vin. rect. Rectified spirit of wine (i.e. Alco- tus hoi). Spiritus vini tenuis Spt. vin. ten. Proof spirit. Spiritus vinosus Spt. vinos. Ardent spirit (of any strength). Statim Stat. Immediately. Stet, or Stent St. Let it (or them) stand. Stratum superstratum S. S. S. Layer upon layer. Subactus Subact. Subdued. Sub finem coctionis Sub fin. coct. When the boiling is nearly finished. Subinde Subind. Frequently. Sumat talem Sum. tal. Let him take one like this. Sume Sum. Take. Sumat “ Let him take. Sumatur U Let it be taken. Sumantur i( Let them be taken. Sumendus ii To be taken. Summitates Summit. The summits. Superbibendo haus- tum Sup. bib. haust. Drinking afterwards this draught. Supra Supra Above. Tabella Tab. A lozenge. Tabs Tal. Such a one. Tempori dextro Tempor. dext. To the right temple. Tempus, -oris Temp. Time, or Temple. LIST OF LATIN WORDS, PHRASES, ETC. 759 Word or Phrase. Contraction. English Equivalent. Ter Ter Thrice, or Three times. Ter in die, or Ter T. i. d., or T. d. Thrice daily. die Tere Tere Rub. Tere simul Tere sim. Rub together. Tero Tero I rub. Tertius Tert. Third. Tinctura Tinct. or Tr. Tincture. Tincturae Herbarum Tinct. Herb. Recent. Tinctures of Fresh Herbs. Recentium Tres Tres Three. Triduum Trid. Three days. Tritura Trit. Triturate. Trochiscus, Tro- chisci Troch. A lozenge or troche, Lozenges or troches. Tussis Tus. A cough. Ultimo {or Ultima) Ult. praesc. The last ordered. prsescriptus Una Una Together. Uncia Unc. or An ounce. Ut dictum Ut diet. As directed. Utendum Utend. To be used. Uto, Uti Uto, Uti To make use of. Vas vitreum Vas vit. A glass vessel. Vehiculum Vehic. A vehicle, or menstruum. Vel Vel Or. Venaesectio brachii Vensesec. brach. Bleeding in the arm. Vesper, -eris Vesp. The evening. Vices Vic. Turns. Vinum Vin. Wine. Vires Vir. Strength. Vitellus Vitel. Yolk. Vitello ovi Solutus Vitel. ovi Sol. Dissolved in the yolk of an egg. Vitellus ovi Vitel. ovi Yolk of egg. Vitreum, Vitrum Vitr. Glass. Vomitione urgente Vom. urg. Vomiting being severe. Note.—For the dangerous abbreviations, see ante, page 475, under the title Prescription Writing. 760 HYPODERMIC FORMUI.^E. HYPODERMIC FORMULAE. Apomorphine. R. Apomorphinae Muriat., . gr. j. Div. in pulv. xvj. One to four in trpxx of water as required. Carbolic Acid. R. Ac. Carbol. Purif., . . gr. x. Aquae Destil., . . . sjj. M. Sig.—upviij contain gr. £ of the acid, which may be given up to gr. ij or iij. Aqua-puncture. R. Aquae Destillatae, . . gj. Sig.— as an injection. Chloral. R. Chloralis Hydratis, . . Aquae Destil., . . . gj. M. Sig.—Tqxxx contain gr. xv of Chloral Hydrate. Arsenic. R. Liq. Potassii Arsenitis, q. s. Sig.—upij-x, hypodermically. Chloroform. R. Chloroformi Purif., . . Jjss. Sig.—rn.v-xv can be used at one deep injection. (See ante, page 675.) The spirit is safer, in somewhat larger doses. R. Liq. Arsen, et Hydr. Iodidi, q. s. Sig.—rrpv-xx, hypodermically. Conine. R. Coninae Hydrobromat., . gr. j. Aquae Destillat., . . M. Sig.—rqx contain gr. Amyl Nitrite. R. Amyli Nitrit., . . zj. Sig.—npiij-v at a dose, which may be repeated in an hour if necessary. Atropine. R . Atropinae Sulphatis, . gr. ij. Aquae Destillatae, . . §j. Solve. Sig.—For hypodermic use, miij = gr. Ttpij —gr. x!tf. Cocaine. R . Cocainae Hydrochlorat., . gr. v. Aquae Destillatae, . . gj. Solve. Sig.—npyj contain gr. ss. Curare. R. Curarae (Merck), . . gr. j. Acidi Acetici, . . . nty. Aquae Destillatae, . ad npc. M. et filtra. Sig. — rrpx contain gr- iV Caffeine. R. Caffeinae Citratis, . gr. xxlv. Aquae Destillatae, . §j. Solve. Sig.—upxx contain gr. j. HYPODERMIC FORMULAE. 761 Curare.—(Continued.) R. Curarinae Sulphat., . . gr. j. Aquae Destillat., . . M. Sig.—iqiv contain gr. fa. Hyoscyamine. R. Hyoscyaminae, . . . gr. j Ac. Sulphur. Dil., . . mv. Aquae Destil., . . • §)• M. Sig.—m.v contain gr. fa. Daturine. R. Daturinae, . . . gr. ss. Aquae Destil., . . • ,lj- Solve. Sig.—niiv contain gr. Dose, miv-x. Mercury. R. Hydrarg. Chlor. Corr., . gr. j. Aquae Destillat., . . j|j. M. Sig.—mx contain gr. fa. Digitaline. R. Digitalinae, . . . gr. ss. Alcoholis, Aquae Destil., . aa Ab- solve. Sig.—niiv contain gr. Dose, miv-viij. R. Hydrarg. Chlor. Corrosivi, Ammomi Chloridi, . aa gr. iij Misce et solve in— Aquae Destillatae, . . sjjss. Dein adde— Albuminis Ovi, . . gjss. Aquae Destillatae, . . gv. Filtra, et adde— Aquae Destil., . q. s. ad fix. Sig.—mj contains gr. Dose, rn_iij—x. Duboisine. R . Duboisinae Sulphat., . . gr. j. Aquae Destil., . . . M. Sig.—miv contain gr. r£u. R. Hydrarg. et Sodii Iodidi, gr. iij. Aquae Destillatae, . . giijss. Solve. Sig.—rn.x contain gr. J. Dose, fipx every second day. Ergot and Ergotine. R. Extr. Ergotae Fluid., . . Filtra. Sig.—Dose, nix. R. Extracti Ergotae (Squibb), . zj. Aquae Destillat., . . • Solve et filtra. Sig.—mx contain gr. j. Dose, rqx-xx. Morphine. R. Morphinse Sulphatis, . gr. xvj. Aquae Destillatae, . . ifj. Solve et filtra. Sig.—mvbss con- tain gr. J. (Magendie's.) Eserine. R. Eserinae Hydrochlor., . gr. j. Aquae Destil., . . . -jiv. Solve. Sig.—npiv contain gr. fa. R. Morphinae Sulphatis, . gr. xvj. Acidi Carbolici, . . miij. Aquae Destillat., . . Solve et filtra. Sig.—nivijss con- tain gr. {Antiseptic Magendie'si) Hydrocyanic Acid. R. Acidi Hydrocyan. Dil., q. s, Sig.—miv, a maximum dose. 762 HYPODERMIC FORMULAE. Morphine and Atropine. R. Morphinae Sulphatis, . gr. xvj. Atropinae Sulphatis, . gr. ss. Acidi Carbolici, . . TUiij. Aquae Destillat., . . jfj. Solve et Ultra. Sig.—rnvijss con- tain gr. } of Morphine Sulph., and gr. of Atropine Sulphate. [Potter.) Quinine. R. Quininae Disulph., . gr. 1 (50I. Ac. Sulphurici Dil., . TH.c (100). Ac. Carbolici, . . rqv (5). Aquae Fontanae, . %j. Solve. Sig.—contains gr. vj. (Lente). Is irritant. (B.) R. Morphinae Sulphatis, . gr. xxiv. Atropinae Sulphatis, . gr. j. Ol. Amygdalae Amar., gtt. j. Aquae Destillat.,. . j^ij. Solve. Sig.—rqx contain gr. J of Morphine Sulphate, and gr. of Atropine Sulphate. [Didama’s Solution.) R . Quininae Hydrobrom., gr. xlviij. Aquae Destillat., . sjiv. Solve. Sig.—Ttlxx contain gr. iv. R. Quininae Bimur. Carbamidat., Aquae Destillatae, . aa giv. Solve. Sig.—Ttlx contain gr. v. Pilocarpine. R. Pilocarpinae Nitratis, . gr. xvj Aquae Destillat., . . M. Sig.—n]v contain gr. Strychnine. R. Strychninae Sulphat., . gr. j. Aquae Destillatae, . . Solve sine alcohol. Sig.—TTlx con- tain gr. Potassium Iodide. R. Potassii Iodidi, . . . gj. Aquae Fontanae, , , giv. Solve. Sig.—Dose, nivj-xx. R . Strychninae Sulphatis, . gr. j. Aquae Destillatae, . . TUccl. Solve. Sig.—TTlv contain gr. Dose, tn_v-viij. Notes.—Solutions for hypodermic use should be neutral in reaction, neither acid nor alkaline; and freshly prepared, especially solutions of the alkaloids, which develop a penicillium, which grows at the expense of the alkaloid. Aqua Fontana, if filtered, is a better menstruum than Aqua Destillata which has been kept for a week, and frequently exposed to the atmosphere. To run the least risk of producing a sore at the point of injection, use very fine needles, and deliver the injection into the areolar tissue beneath the skin, instead of into the skin, as lay parties generally do for themselves. I have given injections of Morphine and Atropine to a dying girl 3 and 4 times daily for two months, and never produced a sore. Always force out all fluid, and wipe the needle-point dry between the fingers, before returning it to the case ; the sebaceous matter on the fingers keeping it free from rust. There is an area of several inches square, on the upper and exterior aspect of the thigh, just below the great trochanter of the femur, which is remarkably insensible, being sparingly supplied with cutaneous nerves. (See Fig. 307, Gray’s Anat- omy, 10th English edition.) An injection delivered in this area will not be felt by the patient. Avoid puncturing a vein; if you do so, watch the patient GENITIVE CASE ENDINGS. 763 and prepare an injection containing gr. fa of Atropine Sulphate, to administer if dangerous symptoms arise. Never, except under special circumstances, ad- minister the salts of Morphine or Atropine hypodermically to children less than 15 years of age. [Sam’’/ O. L. Potter.] GENITIVE CASE ENDINGS, ETC. Nom. Gen. Exceptions. a Cataplasma, Enema, Physostigma, Aspidosperma and Gargarysma, all have the genitive in -atis. Coca is unchanged, though the genitive Cocae is written by some authorities. Folia is plural, gen. Foliorum. us um os on i Rhus, Rhois; Flos, Floris; Bos, Bovis; Limon, Limonis; Erigeron, -ontis. Fructus, Cornus, Quercus, Spiritus, do not change. as atis Asclepias, -adis ; Mas, Maris. is idis Pulvis,-eris: Arsenis, -itis ; Phosphis,-itis ; Sulphis,-itis, and all salts ending in -is, have genitive in -itis. o onis Mucilago, -inis ; Ustilago, -inis ; Solidago, -inis. i lis Fel, Fellis; Mell, Mellis. en ps rs r X inis pis rtis ris cis Words which do not change in the Genitive. *Amyl. fCannabis. JFructus. JQuercus. *Apiol. *Catechu. fDigitalis. *Sassafras. *Azedarach. *Coca. fHydrastis. *Sago. fBerberis. *Cundurango. *Jaborandi. fSinapis. *Buchu. JCornus. *Kino. JSpiritus. ♦Cajuputi. *Curare. *Matico. fSumbul. * Indeclinable. f 3d Declension. $ 4-th Declension. But some authorities give Apiolum, -i; Sumbul, -i; Amyl, Amylis; Coca, -ae. Verbs. The Verbs used in prescription-writing are nearly all in the imperative mood, giving directions to the compounder, and having their object in the accusative case. Such are— 764 VERBS—PARTICIPLES—PREPOSITIONS. Adde, add. Cola, strain. Divide, divide. Fxtende, spread. Fac, make. Filtra, filter. Macera, macerate. Misce, mix. Recipe, take. Signa, write. Solve, dissolve. Tere, rub. A few verbs are found in the subjunctive mood, taking their subject or predicate in the nominative case. The most usual are— Fiat, let be made. Fiant, let be made. Coletur, let be strained. Coloretur, let be colored. Sumatur, let be taken. Bulliat, let boil. Capiat, let take. Detur, let be given. Dividatur, let be divided. Sit, let it be. Participles. Participles or Verbal Adjectives are occasionally used, and should agree with their respective nouns in gender, number and case. Such are the following, viz.— Dividendus, -a, -um, to be divided. Sumendus, —a, -um, to be taken. Adhibendus, -a, -um, to be administered. Prepositions. Those in the first column require the noun following to be in the accusa- tive case,—those in the second column require the ablative case. Ad, to, up to. In, into. Supra, upon. Cum, with. Pro, for. Sine, without. Ana, of each,—governs the genitive case. Sundry Words and Phrases, in most frequent use. Bene, well. Bis, twice. Deinde, Dein, thereupon. Ft, and. Gradatim, gradually. Guttatim, by drops. In dies, daily. Non, not. Numerus, number. Octarius, a pint. Semel, once. Simul, together. Statim, at once. Ter, thrice. Ad saturandum, to satura- tion. Numero, to the number of. Quantum sufficiatra.s, much as necessary. Pro re nata, according to need. In partes cequales, into equal parts. Redactus in pulverem, let be pulverized. Secundum artem, according to art. CHLORODYNE. 765 CHLORODYNE. A COMPARISON OF ITS INGREDIENTS, ACCORDING TO TEN FORMULAE THEREFOR, THE QUANTITIES BEING CAL- CULATED FOR EACH FORMULA TO A FOUR- OUNCE MIXTURE, OR rtf 1920. Quantity of each article in a Jiv mixture as per the formulae of Articles. Squire, P.* | Smith, Edw.f ++ Jj e rt X U d 5 in P Nat'l Disp. » o' u Q Oh‘ ji •s Bartholow. Gilman. dr 3 0 S gr. TTl gr. m TTl gr. TTl HI TTl TTl TTl TTl TTl gr. gr. TTl TTl TTl TTl m TTl TTl I 236 l6 192 16 240 33 372 33% 375 14 207 16 240 247 4/4 62 2 120 120 59 96 120 20 62 248 250 207 80 32 16 4 Hydrocyanic Acid, 2 p. c Il8 2 192 6 50 10 5° 8 42 7 90 7 123 2 62 80 4 290 37 7 120 62 80 4 994 126 236 810 IOIO 62 690 247 495 36 30 20 Glycyrrhizae, Extr.... 147 154 384 903 150 236 760 760 247 992 744 495 1033 818 760 1520 Anna^ 126 128 24O I92O 1920 1920 1920 1920 1920 1920 I92O 1920 I92O TTl 5-10 5-3° 5-15 5-3° 5-3° 5-15 60 120 bV gr. Vs Vs Vk A Vs , Note.—See ante, page 140, for remarks on this preparation, and the number of formula; representing it. * Author of “A Companion to the Br. Pharmacopoeia.” t See Hartshorne’s “ Essentials,” 5th ed., p. 625. J Made by Eli Lilly & Co., Indianapolis. ** Parke, Davis & Co., Detroit 2d ed., page 430. tt Elixir Chloroformi Compositus (McNutt). 766 PATENT MEDICINES. PATENT MEDICINES. Note.—These formulae have been published from time to time in various journals and formularies, and are supposed to represent the preparations designated. The name of the author is appended in each case when known. Ayer’s Cherry Pectoral. R. Morphinae Acetat., . gr. iij Vini Antim. et Potass. Tartrat., Vini Ipecacuanhae, Tinct. Sanguinariae, . zij. Syr. Pruni Virginian., . Pierce’s Golden Discovery. R. Ext. Lactuci, . . . c^j. Mellis, .... Jj. Tinct. Opii Deodorat., . Alcoholis Diluti, . . Siij. Aquae, .... giij. {Hager.) Brandreth’s Pills. R. Podophylli Radicis, . gr. x. Extracti Podophylli, . gr. x. Extr. Phytolaccae Baccae, gr. xxx. Pulv. Caryophylli, . gr.x. Cambogiae, . . . gr. ij-v. Ol. Menthae Piperitae,. npiij. Croci, . . . gr. ij. Misce, fiat massa, et div. in pil. xxiv. {Hager.) Pierce’s Favorite Prescription. R. Sabinge, Cinchonae, Agarici Albi, . aagij. Cinnamomi, . . . gr. xv. Coq. in aq. suff., ut ft. de- coct., . . . j|viij. Deinde cola, et adde— Sacchari Albi, . . j|ss. Acaciae, . . . £j. Solve, et addantur— Tinct. Opii Deodorat., Tinct. Digitalis, . aa Ol. Anisi, gtt. viij, in Al- coholis, . . . j|jss. Misce. {Hager.) Hamburg Tea. R. Sennae Foliorum, . pt. viij. Mannae, . . . pt. iv. Coriandri, . . . pt. j. Hamlin’s Wizard Oil. R. Spt. Camphorae, . . j|j. Spt. Ammoniae, Olei Sassafras, . aa j|ss. Olei Caryophylli, . . Chloroformi, Olei Terebinthinae, . aa ,^ss. Alcoholis, . . ad l|v. Van Buskirk’s Sozodont. R. Saponis Albi, . . . Alcoholis, . . . Jj. Aquae, .... gvj. Glycerini, . . . gij. Olei Gaultheriae, Olei Caryophylli, Olei Menthae Piperitae, aa q. s. ad saporem grat. Cocci Cacti, q. s. ad coloret. Perry Davis’s Pain Killer. R. Tinct. Capsici,. . . 5j. Spt. Camphorae, . . Sij. Guaiaci Resinae, . . Alcoholis, . . . 3iij. Tict. Myrrhae, q. s. ad coloret. R. Calcis Praecipitat., Magnesii Carbonatis, Iridis Florent. Radicis, aa p. aeq. M. et trit. {Hoffmann. THE TREATMENT OF POISONING. 767 Hostetter’s Bitters. R. Sacchari Albi, Aurantii Corticis, Calami, Cinchonae, Gentianae, Calumbae, . . aa Ibj. Rhei Pulv., . . . 5iv. Cinnamomi, . . . t^ij. Caryophylli, . . . 'Jj. Alcoholis Diluti, . . Cij. (Med. Bulletin, 1884.) Radway’s Resolvent. R. Vini Zingiberis, Vini Cardamomi, . aa Sacchari Albi, . . . q. s. M. (Hager.) Walker’s Vegetable Vinegar Bitters. R. Aloes Socotrin., . . Guaiaci Resinae, . . • Sassafras Mucil., . §j. Aceti gij. Aquae, . . . . q. s. Coque, et ft. decoctum, ad deinde cola, et addantur— Sodii Sulphatis, . . 5|j. Acacise, . . . . Spt. Anisi, io p. c., . . t^ij. Alcoholis, . . . ;jj. M. Dose gij. (Eberbach.) Radway’s Ready Relief. R . Tinct. Capsici, Aquae Ammoniae, Alcoholis, . . aa Sj. Linimenti Saponis, . . giij. M. . (Hager.) Note.—For St. Jacob's Oil, see ante, page 40; and for Laville's Anti-Gout Remedy, see page 157. THE TREATMENT OF POISONING. The most energetic poisons are Hydrocyanic Acid, some reptile poisons, Strychnine, and Nicotine. (See pages 29,271, 372.) Those usually selected for criminal purposes are Arsenic, Colchicum, and Tartarized Antimony, the symptoms of which resemble those of natural disease. General Principles of Treatment. Jeaunel's General Antidote.—R . Liq. Ferri Sulphatis (sp. gr. 1.45) ; Magnesiae Calcinat. 3jij; Carbonis Animalis ; Aquae The ingredients should be kept separate—the so- lution of the sulphate in one vessel, the others together. When needed, the former should be added to the latter and violently agitated. Dose, This is a perfect antidote to Arsenic, Zinc, Digitaline, etc. It delays the action of salts of Copper, Morphine, and Strychnine, and slightly influences compounds of Mercury. It is valueless for Cyanide of Mercury, Tartar Emetic, Hydrocyanic Acid, Phosphorus, or the caustic Alkalies. Bellini, of Florence, considers the Iodide of Starch a valuable antidote to alkaline Sulphides, earthy Sulphides, vegetable and caustic Alkalies, and Am- monia. In the first two cases, he considerers it superior to all other antidotes. A fresh mixture of the Sulphide of Iron, Magnesia, and the Sulphide of Sodium, is a perfect antidote for salts of Copper, the Bichloride of Mercury (Corr. Sub.), and the Cyanide of Mercury. If the nature of the poison is unknown, a harmless yet in most cases effect- ual antidote is: R. Magnesiae, Carbonis Ligni, Ferri Oxidi Hydrati, aa partes aequales; Aquae q. s. Give ad libitum. 768 THE TREATMENT OF POISONING. Castile Soap,dissolved in 4 times its bulk of hot water, drunk by the cupful, is one of the best remedies in many cases, especially poisoning with metals, corrosive acids, or corrosive vegetable substances. It is injurious in cases of alkali poisoning Albumen. White of egg, dissolved in water, is especially useful for me- tallic substances. Vinegar, for alkalies, and many narcotics. Coffee, made strong (black), in general antidoting narcotic poisons. Camphor, the princi- pal antidote to all vegetable poisons, especially the corrosive. Milk, Oil, Mucilaginous Substances, for corrosive acids, and alkalies. Charcoal, for Arsenic, Corrosive Sublimate, etc. Emetics.—Zinc Sulphate is the best (R.); gr. is non-nauseating. Apo7iiorphine, gr. hypodermically ..when narcosis prevents administration by stomach. For children, Antim. Tart. gr. in a little sweetened water. Use but little water in mixing the antidotes. Antidote Bag, designed by Martindale of London, contains the following- named articles, labeled with directions for use, viz.— Dialysed Iron. Syrup of Chloral. Chloroform. Spt. Chloroformi. Spt. Ammonias Aromat. Oil of Turpentine. Acetic Acid. Tinct. Digitalis. Amyl Nitrite. Zinc Sulphate. Ipecacuanha. Potassium Bromide. Calcined Magnesia. Tannic Acid. Also a Hypodermic Syringe and Solutions therefor of— Morphine Acetate. Atropine Sulphate. Apomorphine. Pilocarpine Nitrate. Strychnine Nitrate. Acids. Alkalies, for those least irritating. Magnesium Oxide, Slaked Lime, chalk, or magnesia; plaster from wall, with water, milk, oil, white of egg. Bland mucilaginous and oily fluids, and poultices (R.). Acetic.—Magnesia, or its carbonates. Arsenious; see Arsenic Carbolic.—Stomach-pump; a strong solution of the official Syrup of Lime. Atropine is a good physiologi- cal antagonist (B.). Characteristic symptoms, very dark, black urine. When used locally to excess, apply a strong solution of Sodium Carbonate ; also as awash for the mouth, if necessary. Carbonic; see Gas. Hydrocyanic (Dilute).—rrpxl have killed. Ammonia, in any form ; cold douche ; Calcium or Sodium Chloride, git xxx-xl, in water ; Aqua Chlori is the antidote. In- halations of Chlorine or Ammonia; artificial respiration. Muriatic,Nitric, or Sulphuric.—Albumen, Carbonate of Magnesium, Calcium, Potassium, or Sodium, Chalk, Soap, or whiting, in milk ; Oil. No water in Sulphuric cases. Oxalic.—Calcium Carbonate the antidote (R.); Magnesium Oxide (R.). Prepared Chalk, plaster from ceiling, or common whiting, made into a creamy paste with a little water. Biand mucilaginous drinks, and poultices to the abdomen. Avoid potash or soda, and all alkaline carbonates. “ Salts of Lemon,” or of “ Sorrel,” is Potassium Oxalate, used for removing ink stains; it should be treated as Oxalic Acid. Aconite (compare Belladonna). Stimulants, emetics, Castor-oil or other purgatives ; powdered animal Charcoal, in water; coffee. Bland fluids, and poultices, for abdominal irritation. Digitalis, to restore heart’s action (Fother- giU). Alcohol. [Compare Alcoholism and Delirium Tremens in Part III.] Cold water smartly sprinkled over face, or cold douche from a height on the THE TREATMENT OF POISONING. 769 head (R.). Stomach-pump; warmth to cardiac and gastric regions, and ex- tremities. Artificial respiration. Alkaloids. Tannic Acid, holds a high place (P.). Alkalies. Dilute Acids, especially Vegetable Acids; fixed oils (R.). Vinegar unites with them, producing innocuous acetates (L.). Alum. Ammonium, or Potassium Carbonates, etc. Ammonium. (Common Sotirces of Danger, Spt. of Hartshorn, Smell- ing Salts, Liquor Ammoniae kept for cleaning purposes by housekeepers.) Vinegar, Lemon-juice, Orange-juice, followed by demulcents. If vapor has been inspired, inhale Acetic or Hydrochloric Acid. Antimony. Alkalies, Tannin, or strong tea and coffee (R.). Astringent infusions; Magnesium and Sodium Carbonates; milk ; large draughts of warm water; emesis by tickling; Magnesia in milk, especially for Chloride of Anti- mony. Tannic Acid especially valuable (P.). Arsenic (Arsenious Acid). Or. ij have been fatal. Magnesium Bicarbo- nate, or other alkalies (R.). Charcoal or more (R.). Magnesium Oxide (R.). Emesis by Zinc Sulphate (avoid tartar emetic), or by feather tick- ling. Albumen. Oil and Lime-water mixed (Taylor), before and after emesis. Milk or other bland fluids to aid emesis in washing stomach. Castor-oil after emesis. Linseed-tea and Magnesia. Dialysed Iron is a good antidote, espe- cially for chronic poisoning. After free emesis, the Ferri Oxidurn Hydratu?n (add Liq. Ammon, to Tinct. of Iron) ; Ferri Subcarbonate just as good; 5ij followed by Ol. Ricini (Leale); or Hydrated Magnesia; or Magnesia and sugar (Carl), as antidotes. Poultices and fomentations over abdomen. Com- mon sources of danger are arsenical wall-papers, arsenic mistaken for “ salts ” or “ magnesia,” or adulerated confectionery ; Paris Green (Arsenite of Copper) taken with suicidal intent. Barium. Fixed oils; Calcium, Magnesium, Potassium, or Sodium Sul- phates. Belladonna, or Atropine (Compare Aconite). Opium a direct antidote, gtt. iij-v, or more. Brandy, astringent infusions, Coffee. Cold to head, elec- tricity, flagellation, pepper. Alkalies, especially Magnesium Bicarbonate, in poisoning by alkaloids (R.). Ammonia, breathed into air-passages (R.). Charcoal, j|ss or more necessary (R.). Physostigma possibly (R.). Bees and Insects. Aq. Ammoniae, solution of Sodium Bicarb., or Chlo- ride, or Carbolic Acid, applied to the wound ; or Tqxv of a 2 per cent, solution hypodermically, Liq. Ammon. Acetatis internally. [Compare Stings, in main Index, Part III.] Cannabis Indica. Stimulation by Brandy, evacuation of stomach, Stiych- nine and Faradic Electricity are antagonistic, also Lemon-juice freely. Camphor. Stimulants, as wine, and Opium. Cantharis. Emesis. No oils, but oleaginous injections into bladder. Warm bath, Camphor, Milk copiously, Broths, Enemata of demulcents, Opium. Chloral. Strychnine, the antidote (R.). Hot bath, or pack, frictions, stimulants, artificial respiration. Coffee, fresh air, warmth over cardiac region. In fact, the treatment of narcotism. Chlorine. After emesis with warm water, give milk, white of egg, flour and water, or Lime-water; Aqua Ammonite. Chloroform, or Ether. Fresh air, cold affusions, flagellation, coffee, elec- tricity, artificial respiration. Amyl Nitrite, as antidote (Schuller). Atropine, hypodermically as antagonist to Ether (Amidon in N. Y. Med. Record, May 2d, 1885); is equally efficient in chloroform narcosis, as I have found by ex- 770 THE TREATMENT OF POISONING. perience (Potter). Invert patient, draw tongue well forward with forceps then compress and relax chest; the position to be maintained until breath and pulse are good (Nelaton). Ice in rectum. Faradization of respiratory muscles. If swallowed, use stomach-pump, then Ammonia and warmth. Liq. Ammon. injected (ntx-xl aq.) into veins,—Bartholow says unsuccessfully. Colchicum. Treatment same as for Aconite. Conium. Alcohol, etc.; external warmth after evacuation from stomach. Copper. Albumen, gluten, milk, sugar, Potassium Ferrocyanide. No vinegar. In absence of eggs, give a thin paste of flour and water. Creasote. Mucilage, Oil, are antidotes. Ammonia when great depres- sion. Digitalis. The treatment is similar to that for Aconite. Emetics, brandy, horizontal position; galvanism, in bad cases. Fish. Capsicum, Chloroform, Potassium Chlorate freely; Liq. Ammon. Acet., Opium. Gamboge. Potassium or Sodium Carbonate, or Magnesium in milk; mu- cilaginous drinks, Opium. Gases. Carbonic Acid.—Galvanism, Oxygen inhaled; artificial respira- tion indispensable. Ammonia inhalations. Sponge with brandy or alcohol and water. Open air, horizontal position, clothing removed, cold douche, hot water to feet, stimulants, frictions. Subsequently, warm bed, open win- dows; Condy’s fluid about room; stimulants sparingly; cold acid drinks ad libitum. Sulphuretted Hydrogen. — Chlorine Gas, well diluted with com- mon air. Gelsemium. Galvanic current, stimulants, Brandy and Cayenne Pepper, warm baths, frictions, hot bricks to feet. Glass, coarse or in powder,—Much bread in crumbs to envelop it, then emetics. Gold. Ferric Sulphate, Mucilage. Hyoscyamus. See Belladonna. Iodine. Starch or flour given in tepid water; white of egg and milk; free emesis, so long as liquid rejected tinges blue a solution of starch. Sodium Bicarbonate. Iron. Carbonates of Ammonium and Sodium; Magnesia; Mucilaginous drinks. Lead. Albumen, milk; alkalies, especially Magnesium Bicarbonate (R.). Lukewarm drinks, or Sulphates of Sodium or Magnesium, or freshly precip- itated Ferric Sulphate (R.). Promote vomiting; stomach-pump (R.). Sul- phuric Acid and Magnesium Sulphate, for the constipation. The cachexia is much relieved by a combination of Sulphate of Quinine, Sulphate of Iron, and dilute Sulphuric Acid(B.). Potassium Iodide, gr. xv-xx 3 or 4 times each day (B.); as after-eliminative, in chronic cases (R.). When great pain at defecation give Extr. Belladon., gr. Rhei, gr. ij, in pill twice daily (Da Costa). Alum, the most effective agent for the colic. [See Colic for formula.] Or to a pint of boiling milk add 90 grs. of alum, powdered ; sep- arate the curd, and sweeten with sugar. Sig.—A wineglassful every hour or two (B.). Electricity, in the paralysis (dropped wrist), a slowly-interrupted current until it causes reaction. Cure to be completed by the faradic current (B.). Strychnine, in paralysis, gives good results (B.). Sulphides, as baths, in chronic form (R.). Marked Diagnostic Signs.—Drop-wrist (paralysis, of extensor muscles) dark-blue line around edges of gums. Lime. Calcium Chloride. Albumen, mucilaginous drinks, oils, milk, flour, and water. No acids. THE TREATMENT OF POISONING. 771 Mercury. Gr. iij of Corrosive Sublimate have proved fatal. Albumen, Yolk-of-egg, vegetable astringents, gluten, flour, milk ; Potassium Iodide, as after-treatment. The Hydrated Protosulphide of Iron, if given within twenty minutes, is said to be a chemical antidote. Potassium Iodide, converts the metal into soluble combinations (B.). Bismuth, locally in salivation (B.). Sodium Sulphite, locally ajj-5j aquae (B.). Tannic Acid, locally, as gargle in salivation. R. Acidi Tannici, ff), Mel. Rosae gij, Aquae M. Gargle (B.). Belladonna, to diminish secretion in ptyalism, v-x drops of tincture every 4 to 6 hours (B.). Hyoscyamine, for tremor, gr. gradually to mont). Alkalies, Bicarb, of Magnesium best(R.). Baths, simple or sul- phurous (R.). Charcoal, or more necessary in poisoning by Corrosive Sublimate (R.). Cod-liver Oil, in chronic cases (B.). Nitric Acid, gtt. ij of the dilute acid in water ter die; also gargles of lukewarm water, acidulated with same (R.). Sulphurous Acid, int. and as gargle (R.). Mezereum. Albuminous and mucilaginous drinks; milk, oils, and fats; albuminous enemata; cool poultices to abdomen ; Opium. Mushrooms. Emetics, if soon after; Purgatives, if some time has elapsed. After general treatment, Stimulants, unless inflammatory symptoms present themselves. Poultices to abdomen. Tannic Aeid has been recom- mended. Opium or Morphine.— Common Sources of Danger.—Soothing Syrups for quieting of children. (The American Journal of Pharmacy estimates the loss from this cause at 150,000 every year.) Paregoric. Overdosing with Cough-mixtures. Treatment.—Vegetable astringents; strongest, hot black Coffee. Cold douche, flagellation, artificial respiration, persevered in for hours. Bella- donna, Hyoscyamus or Stramonium. Faradism of phrenic nerves; Stimulants. Comp. Tinct. Iodine. Emetics by mouth are usually useless, may be given as enemata; or Apomorphine, gr. fa to \ as emetic (hypoder. -jig), must be administered before narcosis has set in (B.). Stomach-pump probably best, after which Vegetable Acids, to counteract the narcotism. Cream of Tartar and water, Vinegar and water, Lemon-juice, etc., every ten minutes (R.). Atropine, gr. X- hypodermically (R.); gr. every 15 minutes up to three doses (B.); in large amounts till pupil dilates, a successful antagonist (R.). No one is warranted in omitting Belladonna (P.). Amyl Nitrite, inhaled, has proved eminently successful in a case in which Belladonna or its alkaloid proved useless to restore the patient. Ammonia, as intra-venous injection for failure of heart’s action from Opium and Chloroform narcosis, etc. (B.); breathed into air-passages (R.). Potassium Bromide, controls the disagreeable cerebral effects and vertigo resulting from Opium (R., B.). Water, hot water and ice alternately to nape of neck, in stupor of opium-narcosis (B.). Copper Sul- phate, as emetic, prompt and effective (B.). Zinc Sulphate, gr. vj as emetic, well diluted with water (B.). Effervescent Emetics, effective but dangerous (B.). Caffeine, hypodermat. (B., P.). Heat, alternately with cold(B.). Char- coal, or more (R.). Phosphorus. Emesis by Cupric Sulphate; Magnesia in Linseed-tea; Carbo Animalis; mucilaginous drinks ; Liquor Calcis. Avoid all oleaginous mixtures. Poultices to epigastrium. Sulphate of Copper, the best emetic, combining to form the less active phosphide (B.). Turpentine emulsion with hydrated Magnesia, freely (B„ R.) ; nixxx in mucilage, every f hpur, excel- lent (P.)- Transfusion, has been employed to repair blood (B.). Physostigma. Minimum fatal dose, grain ifa. Chloral, the antidote (R.), if administered very early. Belladonna, gr. fa to fa Atropinae, hypodermi- 772 THE TREATMENT OF POISONING. cally, repeated until effects are evident. The nine-thousandth of a grain of Atropine, injected five minutes before giving a minimum fatal dose of phy- sostigma. prevents its fatal effects (R.). Ficrotoxine, or Cocculus Indicus. Chloral, the antidote (B.). Potassium Salts. Potassium Bromide. Nervous Stimulants—Brandy, Opium. Potassium Nitras (Saltpetre),—No chemical antidote. Emetics and stomach-pump, demulcent drinks, Opium, milk, aromatics, emollient enemata. Quinine. Emetics and cathartics, Opium, Coffee, Brandy, or wine, diuret- ics and sudorifics as after-eliminatives. Reptiles. (Compare Stings.) Ligate limb above wound; cleanse thor- oughly, and cauterize with mineral acids or strong Carbolic. The wound should be forcibly sucked by a person with perfect mucous surface. Inter- nally, Arsenic, when rapid prostration (R.); Ammonium, diaphoretics, So- dium Bisulphate, Whiskey, largely. Agave Americana. . Potas. Iodidi gr. iv, Hydrarg. Chlor. Corr. gr. ij, Bromi. gv, Aquae gj ; gtt. x in °f Brandy; repeat if necessary (Hammond). Ammonia, by intra-venous injec- tion, is shown to be unavailing by Brunton and Fayrer (B.) Rhus (Poison Oak*or Ivy),— Carbolic Acid, locally, a 5 per cent. sol. Sul- phide of Potassium, baths, j|j to Cxx. Lobelia, as infusion, ad Oj, a good application locally. Grindelia, the fluid extract, 1 part to 10 of water, as lotion ; may be used undiluted. Cocaine, a 10 per cent, oleate, or a 5 per cent, solution in water, as a local application, promptly relieves the symptoms. Silver Nitrate. Alkalies, especially the Magnesium Bicarbonate (R.). Sodium Chloride, largely diluted, effects a double decomposition, precipitating the silver as the harmless insoluble chloride (R-). The resulting irritation may be allayed by milk, which should serve as food until the stomach is re- stored. Silver, Metallic. Albumen, Milk. Stramonium. See Belladonna. Strychnine or Nux Vomica. Fatal dose of Strychnine gr. X for adult, gr. y for child. Chloral, the antagonist, especially when given soon. Phy- sostigma, as an antidote (R.). Chamomile Oil, remarkably subdues reflex excitability in frogs after poisoning by Strychnine or Brucine (P.). Tobacco, a good antagonist. The Stomach-ptimp, if available before tetanic symptoms. Animal Charcoal, largely ; Tannin freely; Solution of Iodine. Chloroform Inhalations, injections of Curare, or Urethan, or Methyl and Ethyl com- pounds of Strychnine, Brucine, or Thebaine. Artificial respiration; fats; Nitrite of Amyl, inhaled; Magnesia (R.). Tube into oesophagus, and flexible catheter into larynx (R.). Veratrum Viride has cured a bad case; a teasp. was given at once, then gtt. ij every 10 minutes (R.). Ice to spine. Tobacco enemata. Lobelia, Potassium Bromide, Monobromated Camphor, hot bath. Valerian mitigates the spasms (P.). Curare, warmly recommended, but its claims are doubtful (P.). Nicotine, many cases prove its curative power (P.). Tin. Albumen, Ammonium and Sodium Carbonates, Milk. Tobacco. Strong Coffee and Brandy; warmth and friction; artificial respiration. Vegetable Poisons. Generally albuminous or mucilaginous drinks, oils, etc. Stimulants, Opium, ice ; cool poultices and fomentations to abdomen. Veratrum Viride. Digitalis, Opium, Stimulants. Zinc. Albumen, mucilaginous drinks, milk, Tannin. Potassium and So- dium Carbonates, if given early. Soapsuds given freely. Warm water in copious draughts. DIFFERENTIAL DIAGNOSIS. 773 DIFFERENTIAL DIAGNOSIS. [Adapted chiefly from Da Costa’s Lectures.] Table No. i. Forms of Bright’s Disease. (Tabulated from Da Costa, and Hoffmann <5r> Ultzmann.) (i) Acute Nephritis. (2) Chron. Parench. Nephritis (targe white kidney). (3) Chron. Desquam. Nephritis (con- tracted kidney). (4) Fatty Kidney. Amyloid or Waxy Kidney. Clinical Headings. Desq. or Catarrhal Nephritis. Acute Parench. Nephritis. Quantity | Normal or — - — or + Normal or + Normal or — Normal or + Acid. Acid. Acid. Acid. Acid. Acid. Color | Wine yellow. Dark smoky. Brown yellow. Clear. Pale. Pale. Sfi. Gr { Normal or — High. - I.OIO I.OI 5-I.O3O —, above I.OIO a Urea | Normal. - - Normal. - Normal or — a Normal. Normal. Albumen(per ctl) | i-io to 1-5 1 to 6 Vi to 2 1-10 to Yz 1 to 6 i-ioto % of globuline. Casts -j Hyaline and Epithel. Blood Epithel. Hyaline. Granular Hyaline. No blood. Very few. Fatty. Few and hyaline. Sediment (macroscopical) j Mucus. Blood. Brown cells. Urates. Kidney Epithel’m. Blood. Lymph. Seldom any. Free oil. Seldom any. Dropsy Seldom. Great, especially of face. Never absent. In last stages. Great. Trifling. Often Not marked. Great. Rare. great. Other Symptoms..- Stiff joints Sacral pain. Lassitude. Fever. Tempera- ture low. No fever. Inflam, of serous membr’s. Cardiac hyper. Retinitis. Tense, quick pulse. Hyper, ol heart. Face pale, puffy. Cardiac hyper. Emacia- tion, sal- low face, enlarged liver and spleen, thirst, diarrhoea. Prognosis - Favorable Recovery or No. 2. Recovery (?)orNo.4 Unfavor- able, but course perhaps long. Always fatal. Depends on con- stitutional disease present. Noth.—The signs + and — respectively denote a specific gravity greater than 1.024, or less than 1.018. 774 DIFFERENTIAL DIAGNOSIS. Table No. 2. Cancer. Cancerous (Malignant) Tumors. Are of constitutional origin. Have no cyst, but invade and convert the surrounding tissues. Cancer material is short-lived from rapid deterioration, but is rapidly reproduced. Severe increasing pain. Extend to remote parts, reappearing chiefly in lymphatic glands. Cancerous cachexia of general health. Recur after extirpation, fatal in end. Scirrhus. Is hard. Appears mostly on female breast. Hard kernel, movable under skin. Becomes fixed to adjoining structures, which it puckers. Single and grows slowly. Course slow—2-4 years. Never in the young. Non-malignant tumors. Origin, some local error of growth. Limited by a cyst; may compress, but do not invade adjacent tissues. Have uncertain period of increase, after which may remain stationary. Usually no pain. Are local, have no disposition to spread. Impair functions of parts pressed on. Do not recur. Encephaloma. Is soft and brain-like. Most frequently on the limbs. At first deeply seated, hard to recog- nize. Spreads through loose textures, which it pushes aside and distends. Has numerous tumors, grows rapidly. Generally fatal in 1-2 years. Often in the young, even at birth. Table No. 3. Carditis. Endocarditis. Blowing sound. Excited heart action. Slight if any increase of percussion dulness. Impulse strong. Sounds normal, or more distinct, except at site where murmur is heard. Pericarditis. Friction sound. Excited heart action. Marked increase in effusion stage. Wavy and feeble. Feeble and muffled; no blowing sounds. Table No. 4. Cerebral. Concussion. Patient can be roused; pupils act. Breathing seldom stertorous. Urinary action normal. Symptoms appear closely after acci- dent. Compression. Complete insensibility; motionless pupils. Breathing usually stertorous. May be either retention or inconti- nence. Frequently do not. DIFFERENTIAL DIAGNOSIS. 775 Table No. 5. Chancre. Chancre. Commences about 3d week after coitus. First as a papule, abrasion, or crack. Generally indurated (rarely not). Develops slowly. Discharge slight, unless irritated. Is soon limited and seldom phagede- nic. Edges sloping, not undermined. Scanty serous secretion. Sore remains solitary, and cannot be multiplied. Followed by numerous buboes, rarely suppurating, never furnish inocu- able pus. Chancroid. In 24 hours to 3 days. First as a red spot, then a pustule, then a soft suppurating sore. Not on an indurated base. Develops rapidly. Suppurates profusely. Tends to invade surrounding tissues, or become phagedenic. Edges undermined. Discharge is pus, and copious. May be transplanted at will, and is seldom single. A single bubo may appear and sup- purate. Table No. 6. Cholera. Asiatic. Preceded by painless diarrhoea. Not directly from error in diet. First pain, shooting down thighs. Prostration rapid and overwhelming, and out of ratio to evacuations. Rapid reduction of surface tempera- ture ; high temperature in cavities. Evacuations like rice-water from first. Cramps commence in extremities. Veins congested; tongue, lips, and extremities livid purple. Urine albuminous. Simple. Seizure sudden. Generally is from error in diet. First pain, abdominal colic. Prostration gradual, less marked than the vomiting and purging. Gradual reduction of surface tempera- ture; internal temperature normal. Discharges bilious, causing burning and smarting pain; only colorless at very last. Cramps commence in abdomen. Not so. Not so. Table No. 7. Croup and Diphtheria. Croup. Premonitory hoarse, metallic cough, without illness. A child’s disease. Tenacious mucus, covers the swollen membrane. A local disease. Diphtheria. Promonitory illness, shivers, fevers, sore throat, without cough. Attacks adults as well. Distinguished by a false membrane. A blood poison; great general depres- sion. 776 DIFFERENTIAL DIAGNOSIS. Table No. 8. Epilepsy and Hysteria. Epilepsy. Sudden, complete loss of conscious- ness. Livid face, frothy saliva escapes, eye- lids half open, eyeballs rolling, teeth grinding, tongue biting; more or less insensibility of pupils to light. Countenance is distorted. Patient shows no feeling. Aura epileptica, Short paroxysm, followed by heavy comatose sleep and dull intellect. Frequently occurs at night. Not necessarily of uterine connection, though a paroxysm often occurs at the menstrual period. Hysteria. Gradual and partial or apparent. Face flushed, or complexion unaltered, no froth on lips, eyelids closed, eyeballs fixed, no grinding of teeth, or biting of tongue; pupils react readily. Is not. Sighs, or laughs, or sobs. Globus hystericus. Longer paroxysm, not sleepy, but usually wakeful and depressed in spirits. Rarely occurs at night. Often connected with uterine or men- strual disorders. Table No. 9. Gout and Rheumatism. Gout. Chiefly affects small joints, especially the metatarsal joint of the great toe. From 35-50 years; rarely before puberty. Most frequent in men, and result of idle, intemperate and luxurious life. Is strongly hereditary. Chalk stones (urate of soda) in ext. ear, on tops of fingers, or elsewhere. Uric acid in the blood, absent from urine. A fit often affords temporary relief. Is confined to temperate zone. Rheumatism. Large joints chiefly implicated. Generally in young adults. Affects both sexes equally, and equally the poor and the rich. But slightly so. Not so. Lactic acid in the blood. Quite the contrary. Is ubiquitous—prevails in all climates. Table No. io. Hematemesis and Hemoptysis. Hematemesis. If from the stomach, the blood is of a dark color, and is vomited. Often mixed with food, not froth. Preceded by nausea and stomach dis- tress, and blood is passed with the stools. Hemoptysis. If from the lungs, it is bright red, and generally coughed up. Generally frothy, mixed with sputa. Preceded by pain in the chest and dyspnoea. No blood in the stools. DIFFERENTIAL DIAGNOSIS. 777 Table No. ii. Pleurisy and Pneumonia. Pleurisy. Sharp pain, friction sound, dry cough, impaired chest motion. In stage of effusion, obliteration of in- tercostal spaces, enlargement of the side, viscera displaced. Dulness, with enfeebled or absent res- piration, voice, and fremitus. Sputa frothy, rarely any rales. Febrile symptoms slight usually. Temperature irregular, rarely high. Pneumonia. Dull pain, crepitant rale, cough fol- lowed by expectoration. In stage of hepatization none of these signs are present. Dulness, with marked bronchial res- piration, distinct thoracic voice, in- creased vocal fremitus. Sputa rusty color, rales common. Febrile symptoms severe. Sudden elevations and falls, high tem- perature not uncommon. Table No. 12. Phthisis. Tubercular. ' First symptom, a dry, short cough. No exciting cause apparent. Hereditary cases are of this class. Frequently preceded by enlarged or suppurating glands, or other evi- dence of scrofula. Voice changes from tubercular deposit. Non- Tubercular. First stage follows catarrh, bronchitis, or some other acute disease. Is referable to some exciting cause, as cold, inflammation, or inhaling of heavy dust. Not hereditary. No evidence of scrofula. No change of voice. Table No. 13. Exanthemata. Scarlet Fever. Incubation x day to weeks. Fever, great heat of skin, and frequent pulse, unabated during erup- tion. Brilliant stare. Eruption on second day, not rough, first on neck and chest, spreads rapidly, white streak on pressure with nail. Measles. Incubation, 7-14 days. Same fever rather in- creased by eruption. Liquid watery eye. On fourth day, on face, rough,spreads gradu- ally, streak lasts short time. Small-pox. Incubation, 6-20 days. Average 10. Fever often violent, bounding pulse, pain in loins, greatly re- lieved by eruption. At end of third or on fourth day on lips and forehead. 778 DIFFERENTIAL DIAGNOSIS. Scarlet Fever. Uniform, or large patches, interspersed raised spots and some vesicles, rash scarlet, on its seventh day very complete desquama- tion in large patches. Sore throat, rarely coryza or bronchitis. “ Raspberry ” tongue, red. Cerebral symptoms fre- quent and grave. Temperature may be io5°-ii2° to 10th day, subsides gradually, falls on 5th, 10th, and 15 th days. No secondary fever. Pneumonia rare, pleu- risy more frequent. Sequelae: Bright’s dis- ease, dropsy, deafness, conjunctivitis, phthi- sis, chronic diarrhoea; glandular enlarge- ments. Measles. Crescentic patches, last about 5 days, then partial desquamation, scales very fine. Coryza and bronchitis very constant, rarely sore throat. Tongue coated, may be red at edges. Not so. io3°-io6° before erup- tion, remains high for 1-2 days after, then falls suddenly. None. Pneumonia a frequent complication. Sequelae: chronic bron- chitis, phthisis, con- junctivitis. Small-pox. Papular, then vesicular, finally pustular; pus- tules maturate on 8th day of eruption. Sore throat often and dry cough. Coated and swollen, may be red at edges. Cerebral symptoms are frequent. Before eruption often 1060, then rapidly sinks to ioo° in 36 hours; rises during secondary fever. Always secondary fever. Pneumonia not a very frequent complication. Sequelae: chronic diar- rhoea, glandular en- largements, various eye diseases. Table No. 14. Typhus and Typhoid. Typhus Fever. Attacks quickly, incubation 9 days. Occurs at any age. Rare among the higher classes, except those exposed. Mulberry eruption on 4th or 5th day, on extremities, lasts till close. Brain chiefly affected; bowels are often but little so; abdomen natural, evacuations dark, but never bloody (these are occasion- ally reversed). Contracted pupils, dusky face. Typhoid (Enteric) Fever. Commences slowly, incubation about 13 days. Most common in youth and child- hood, rarely after 40. As common among rich as the poor. Rose eruption, few, on abdomen, and in successive crops, which fade and disappear. Bowels chiefly affected, evacuations ochre-color and watery, sometimes hemorrhage, or even ulceration, ab- domen tumid. Dilated pupils, cheeks flushed. DIFFERENTIAL DIAGNOSIS. 779 Typhus Fever. Pulse and temperature rise to 120 and 105° till 3d day, high for 6 days, then fall. Lasts 2-3 weeks. Relapses rare. Death from coma, or congestion of lungs, in 1st or 2d week. Arises from destitution, over-crowd- ing, bad ventilation, is contagious, and generally epidemic. Post-mortem: not constant, most fre- quent are dark blood and enlarged spleen, soft heart. Typhoid (Enteric) Fever. Pulse and temperature rise and fall independently, and without uni- formity, but both are usually high to 15 th day. Lasts 4-6 or more weeks. Relapses frequent. Death from asthenia, pneumonia, hemorrhage, or perforation of in- testine, in or after 3d week. Bad drainage, poisoned drinking water, putrid animal matter, want of ozone, certain electrical condi- tions ; is not contagious, often sporadic. Post-mortem: morbid Peyer’spatches, enlarged mesenteric glands, ulcer- ated mucous coat of intestines; enlarged and soft spleen, ulcerated pharynx. Table No. 15. Yellow and Bilious Fevers. Yellow Fever. Short duration; ends in 3-7 days. Incubation 5-9 days. A disease of one paroxysm, termi- nating in recovery or collapse. Very severe nausea and vomiting, early epigastric tenderness. Black vomit. Hemorrhages from various parts. Tongue clean, or slightly coated. Pulse variable, slow at end. Injected and humid eye. Supra-orbital pain, pain in back and in calves of legs. Rarely delirious, mind clear gener- ally. Urine albuminous, usually sup- pressed. Rapid convalescence, no sequelse. Little muscular prostration. High mortality, epidemic. Treatment unsatisfactory. Autopsy: inflamed or congested stomach, enlarged yellow liver, filled with oil globules, muscular fibres of heart are often disinte- grated. Bilious Remittent. Lasts 9 days or more. Incubation may extend to months. A disease of several paroxysms, with intervening remissions. These symptoms not so severe nor so early. Bilious vomiting. No hemorrhagic tendency. Tongue heavily coated. Pulse quick to convalescence. Eye natural. Headache, sense of fulness in head, often no loin or leg pains. Delirium frequent, mind dull. Not so. Slow convalescence, tedious sequelse. Greater muscular prostration. Slight mortality, endeiric. Very amenable to treat, nent. Autopsy: stomach congested, rarely inflamed, liver olive or bronze hue, not fatty. 780 TEMPERATURE IN DISEASE. Table No. 16. Vomiting. Cerebral. Little or no nausea, vomiting con- tinues after stomach is emptied. No tenderness on pressure over the liver'or stomach. Pulse infrequent and hard. Tongue clean, breath sweet, conjunc- tive normal or injected, and head- ache primary. Generally obstinate constipation. No salivation. Gastric or Hepatic. Nausea relieved by discharge, returns when food is taken. Liver and stomach are tender, pressure produces inclination to vomit. Pulse frequent and.weak. Tongue furred, breath offensive, con- junctivse often yellowish, and head- ache secondary as to time. Griping abdominal pain, diarrhoea and clay-colored stools. Increased salivation. NOTES ON TEMPERATURE IN DISEASE. Temperature, average normal, of adults, 98.6° F.; of children, 990; of the aged, 98.8°. Diurnal variation i° to 1.50 F., highest in the evening. Above 1080 F. is a fatal sign, which issue may be averted by cold baths, reduced by ice from 96° to about 6o° F. (A.). The clinical thermometer placed in the mouth, axilla or rectum, and retained in si/71 for five minutes, should go hand in hand with Aconite in the treatment of inflammations (R.). [For anti- pyretics see the articles Fever, Inflammation, in Part III, also the list of these agents on page 421.] Clinical Thermometry is one of the principal means of positive diagnosis. The thermometer should be self-registering, certified, and accurately marked according to the Fahrenheit scale. The most reliable temperature is that in recto, or in the vagina; less so in the axilla and folds of skin, and still less reliable in the mouth. A correct reading of the thermometer cannot be ob- tained in less time than five to seven minutes. (DaCosta.) The Average Normal Temperature of the body is 98.6°; which, like the pulse, will vary somewhat in individual cases; as a general practical result, it is agreed that in temperate regions the normal temperature at completely sheltered parts of the surface of the human body amounts to 98.4° Fahr., or a few tenths more or less ; and a rising above 99.50, or a depression below 97.30 F., are sure indications of some kind of disease, if the increase or depression is persistent. The temperature is increased at the prime of life, is raised and depressed temporarily by the influence of diet, stimulants, exercise, etc. The minimum diurnal temp, is observed at 2 A.M., the maximum at 4 to 6 p.m. Any rise above 99.50, or fall below 97.30, if persistent, indicates disease; on the other hand, a normal temperature does not always indicate good health. The greatest recorded range of temperature in disease is 33.40; the minimum is 89.6°, the maximum 1230. In severe and fatal cases it rarely exceeds 107°. It may rise 3°-4° after death, as observed in a case of typhoid fever in which death occurred with a temperature of 107°, which increased shortly afterwards 781 TEMPERATURE IN DISEASE. to 110.50. A temperature of 107° indicates malignancy, and where met with for two consecutive days in typhus, scarlatina, measles, pneumonia, pyoemia, meningitis or rheumatism, death may be expected shortly. In relapsing, re- mittent and intermittent fevers, and in the initial chill of an abortion, the temperature may reach 107° without indicating great danger. During the last hours of life, in many diseases, the temperature rises to io9°-iii°; for ex- amples n tetanus, sun stroke, typhus, etc. With a temperature of 950, col- lapse is imminent. A High Average Temperature (above I04°),is found in severe pneumonia, scarlatina, remittent, typhus, typhoid and relapsing fevers, pysemia, etc. A Moderately High Temperature (102° and above), is seen in peritonitis, acute rheumatism, pericarditis, pleurisy, dysentery, cerebro-spinal-meningitis, ca- tarrhs, etc. A temperature of ioo° and above, is found in chronic affections, incipient inflammations, and mild fevers. When, in effervescence, the heat increases rapidly, it will, in defervescence, decline proportionately fast, and vice versa. Beware of a grave affection when the temperature is of a con- tinuous type. A distinct interval between morning and evening temperature is a favorable sign. A slow and gradual increase indicates typhoid fever; in rheumatism and anomalous fevers the increase is more rapid, and still more so in acute inflammatory disease, pneumonia, angina, pleurisy, typhus, scarla- tina, rubeola, etc. It is usually very rapid in intermittent fever, febricula, and ephemeral fevers. A rapid effervescence and slow defervescence indicates some complication of disease ; the reverse order indicates great danger. When the temperature begins to fall from the evening to the morning, it is an indica- tion of improvement; while a rise of temperature from the evening till the morning is a sure indication that the patient is worse. Stability of tempera- ture from morning to evening is a good sign, but from evening till the morn- ing, unfavorable. A Decrease of Temperature below the normal heat is rare. It occurs some- times transitorily, announcing thereby a favorable crisis, by preceding the return to a normal temperature. It is also met with occasionally during the morning remission of remittent fever; also during the apyrexia of intermit- tents; in acute collapse, preceded or not by fever; in chronic wasting dis- eases ; and sometimes, also, on the approach of death, especially in typhus fever. In Phthisis, the temperature is higher in the evening than in the morn- ing : later, higher at early bedtime than at noon, and high again at dusk. This is a valuable and delicate test of the progress of tuberculization. In Typhoid Fever, the accession is by a rise of one degree each day, with the diurnal variation. If the evening temperature does not exceed 103.50, the disease will probably be mild; but a temperature of 105° in the evening in- dicates a severe type and much danger. A sudden reduction to 950 in the third week denotes intestinal hemorrhage; a lingering temperature of ioi°- 1020 in the fourth and fifth weeks indicates noncicatrization of the intestinal ulceration. In Scarlatina, the rise of temperature is rapid, 104.70 may be reached in a few hours. It seldom rises above 105° and never above 106°; it is con- tinual until the eruption begins to fade, when remissions take place, unless complications arise. In Measles, 103° is the usual temperature, with daily variations, increas- ing with the eruption and catarrhal symptoms. A high temperature lasting beyond the tenth day denotes complications. In Diphtheria, the temperature by the end of the third day will, in uncom- 782 OBSTETRICAL MEMORANDA. plicated cases, not exceed I03°-I04°. It falls temporarily with the exuda- tion. Defervescence in the severe, favorable cases, is from the twelfth to the fourteenth day; in the milder cases not before the sixth. In some fatal cases it occurs early, from the third to the fourth day. In asthenic cases, the tem- perature of the surface falls, while that of the interior remains high—ioo° in the axilla, and 103° in the rectum. During convalescence, the temperature is low, and readily depressed, but may be raised by intercurrent maladies. Any increase after the first five days, or a continuous high temperature after the first ten days, is unfavorable. A sudden rise may indicate complications. Co- Relations of Pulse and Temperature.—As a general rule the co-relation of pulse and temperature may be stated as follows, namely: an increase of temperature of one degree above 98° F. corresponds with an increase of ten beats of the pulse per minute, as in the following table; Temperature of 98° corresponds with a pulse of 60. “ 990 “ “ 70. “ ioo° “ “ 80. “ ioi° “ “ 90. “ 102° “ “ IOO. “ 103° “ “ no. “ 104° “ “ 120. “ IO50 “ “ I30. “ 1060 “ “ 140. OBSTETRICAL MEMORANDA. Pregnancy.—Duration about 275 days; usually reckoned as about 280 days from the first day of the last menstruation. The extremes of 405 cases at the Hotel Dieu were 6 months, and II months 8 days. Many rules for the calculation of the date when labor may be expected are given; as good a one as any is to count backward three calendar months from the last day of the last menstruation, then add 7 days to obtain the date of expected confinement (Naegele). The French law makes a child illegitimate if born within 200 days after marriage, or over 300 days after the husband’s death. Evidences of pregnancy may include: suppression of the menses; nausea and vomiting, morning sickness; salivation; changes in the appearance of the breasts and nipples; changes in the position of the uterus, which descends during the first two months, rising from the third month, until, at the fifth, its fundus is level with the umbilicus, at the eighth nearly to the sternum, settling down at the ninth month; oedema of limbs; neck of uterus becomes shortened, the os patulous. The most positive signs are: quickening, if the statements of the women are creditable; ballottement; and above all, the pulsations of the foetal heart. Labor. Preliminary Signs.—Abdominal tumor sinks lower, occasional uterine pains and contractions, freer respiration, discharge of glairy fluid from vagina, frequent desire to urinate, hemorrhoids, oedema of legs. Essential Signs.—Paroxysmal pains,at regular intervals; os uteri generally low, neck effaced, os affected by each pain (easily ascertained by keeping finger on it). Dilatation of os uteri, requiring longer to acquire the size of a half-dollar, than from thence to completion. Shiverings and vomiting, tremblings and fainting, especially at complete dilatation. Head Positions (4).—Right (1st), or left (2d) occipito-anterior, forehead 783 OBSTETRICAL MEMORANDA. backwards; right (3d), or left (4th) occipito-posterior, forehead forwards. Order of their comparative frequency: 1st, 3d, 2d, 4th. The 3d rotates into the 2d, the 4th into the 1st. Facial Positions (4).—Right (ist), or left (2d) mento-posterior, forehead forwards; right (3d), or left (4th) mento-anterior, forehead backwards. The 2d rotates into the 3d, and the ist into the 4th. Pelvic, or Breech Positions (4).—Left dorso-anterior (ist), left trochanter forwards; right dorso-anterior (2d), right trochanter forwards; left dorso- posterior (3d), right trochanter forwards; right dorso-posterior (4th), left trochanter forwards. Order of their comparative frequency, 1st, 2d, 4th, 3d. Shoulder Positions.—Varieties (2): dorso-anterior, and dorso-posterior, the former occurring twice as often as the latter. In each variety the head may lie in either iliac fossa; the presenting shoulder being, in dorso-anterior posi- tion, the left if the head is in the right fossa; in dorso-posterior position, the left if the head is in the left fossa, and vice versa. Measurements. AVERAGE PELVIC DIAMETERS As usually given. Prof. E. Wallace gives— Antero- Posterior. Oblique. Transverse. Antero- Posterior. Oblique. Transverse. Brim Cavity Outlet 4% in- 4.7 “ 5-0 “ 4.8 in. 5.2 “ 5.2 in. 43/ “ 4.2 “ 4.0 in. 4.X “ 4.0 “ —5.0 in. 4% “ 4.0 “ +5 ° in. 43/i “ 4.0 “ Circumferential measurement of the brim—about 17 inches. DEVELOPMENT OF THE FOETUS. [Entries in the column headed “ Month ” refer to the end of each month.] Month. Name. Length in inches. Weight. Appearance. 1st Ovum one-twelfth Appears as a gray gelatinous mass. 2d Embryo 1.2 60 grains. Extremities apparent: points of ossifi- cation appear. 3d it to y/2 3TO “ Neck, eyes, fingers, nails begin to form; sexes distinct. 4th Foetus 6'A to 7^4 9 oz. Hair, fat; muscles capable of contrac- tion. 5th it 8 to 10 10 to 12 oz. Eyebrows, skin, scrotum; nails nearly solid. 6th tt 11 to 12 1 lb. Pupillary membrane formed,lips closed. 7th “ to 14 2% lbs. Eyelids open, testes begin to descend, foetus is viable. 8th « 15 to 17 4 to 5 lbs. Skin red, smooth, covered with down. 9th tt 19 to 24 7 to lbs. Testes near scrotum, left often therein. 784 ASPHYXIA AND APNCEA. DIAMETERS OF THE FCETAL SKULL AT TERM. Diameter. Where measured. Inches. Fronto-mental Occipito-mental Occipito-frontal Sub-occipito-bregmatic.. Cervico-bregmatic Bi-parietal Bi-temporal Apex of forehead to chin Occipital protuberance to point of chin... Occiput to centre of forehead Midway between occiput and foramen magnum to centre of ant. fontanelle.... Ant. margin of foram. mag. to centre of ant. font 3X SX-5^ 4^-5 3% 3% 3^-4 3)4 Between the parietal protuberances Between the ears [Compare the articles in Part III entitled—Abortion, After-pains, False-pains, Hemorrhage Post-partum, Labor, Lactation, Preg- nancy, Puerperal Disorders, Vomiting of Pregnancy, etc.]. ASPHYXIA AND APNCEA. From Drowning.—Remove the person from the water as rapidly and gently as possible, turn the face downwards for a moment, and depress the tongue, in order that water, mucus, etc., may be removed from immediately over the entrance of the windpipe. Give the patient plenty of fresh air, fully exposing neck and chest to the breeze, unless inclement. Turn gently on the face, one forearm being under the forehead, and raise the body up that the water may have free discharge from the mouth. Place patient upon the side and apply stimulants (ammonia, etc.) near the nostrils; or the cold douche, in order to excite respiration. The above measures being ineffectual, convey the body to the nearest con- venient spot, strip it carefully and dry it, and place it on a warm bed, with head and shoulders slightly raised, and at once employ one of the following methods, known as Silvester’s and Marshall Hall’s. Silvester's Method.—Pull the tongue forward, to prevent obstruction to entrance of air into the windpipe ; produce expansion of the chest by drawing the arms from the sides of the body and upwards until they almost meet over the head. Then bring the arms down to the sides again, causing the elbows almost to meet over the pit of the stomach, and thus producing contraction of the chest. This imitation of the act of respiration should be continued at the rate of fifteen or sixteen times a minute, as in health. Marshall Hairs Method.—The person should be placed flat on the face, gentle intermittent pressure being made with the hands on the back, the body turned on the side, or a little beyond, then on the face, and the same pressure, etc., continued as at first. The whole body must be worked simultaneously. ASPHYXIA AND APNCEA. 785 The same number and frequency of these artificial processes of respiration should be employed as in the other method. The Michigan Method.—Lay the body face down, the head upon the arm, and stand astride it; grasp it then about the shoulders and armpits, and raise the chest as high as you can without lifting the head quite off the arm, and hold it about three seconds; then replace the body upon the ground, and press the lower ribs downwards and inwards, with slowly-increasing force, for ten seconds; then suddenly let go, to perform the lifting process again. Whichever process be employed, the effort to restore the temperature of the body must be maintained, the body being well rubbed in an upward direction with the hands, with warm flannels, etc.; bottles of hot water, hot bricks, etc., being applied to the stomach, the axillae, the soles of the feet, etc., stimulants and beef-tea being judiciously administered when restoration is about taking place. The attempts at resuscitation must be persevered in for several hours, if necessary. Laryngotomy or tracheotomy, with or without catheterization, or forced in- sufflations of air or oxygen, have proved successful, as also electro-puncture (Garratt). In artificial inflation, always press the larynx and trachea against the ver- tebral column, so as to close the oesophagus and thus prevent the air entering the stomach. After Long Submersion is Recovery Possible ?—According to Harley (p. 881), dogs kept under water I *4 minutes always died, if water had entered the lungs. If it had not, the trachea being plugged, they survived a submer- sion of 4 minutes. When persons rise after sinking they usually get some air, and less speedily come into a state from which recovery is impossible. The greatest period between the last inspiration and the stoppage of the heart is 4 minutes. Some think that no recovery has been made after complete cessa- tion of the heart’s action. We infer that after complete submersion for 5 minutes recovery is improbable,unless the person had been previously choked, or in a fainting state, so that no water entered the lungs. But in Anderson’s case, the patient had been under water at least 15 minutes, and in Garratt’s the time was variously estimated at from 15 to 60 minutes. When is a Case Hopeless ?—Harley says (p. 892): “ If the eyes are open, the pupils dilated, the conjunctiva insensible, the countenance placid, the skin cold, frothy mucus round the nostrils and mouth, no attempt at respiration, and the heart’s action inaudible (when the ear is applied to the chest), the case is hopeless.” Signs of Heath.—The following have been suggested as methods of deciding whether death has occurred : (a.) Tie a string firmly about the finger. If the end of the finger becomes swollen and red, life is not extinct. (b.) Insert a bright steel needle into the flesh. If it tarnishes by oxidation in the course of half an hour, life may be considered not extinct. (c.) Inject a few drops of Liquor Ammoniae under the skin. During life a deep red or purple spot is formed. (d.) Moisten the eye with Atropine. During life the pupil will dilate. (e.) Look at a bright light, or at the sun, through the fingers held closely side by side. During life the color is pink ; after death a dead white. (/.) After death a dark spot is said to form gradually on the outer side of the white of the eye, from drying of the sclerotic, so that the dark choroi4 shows through. 786 CLINICAL EXAMINATION OF THE URINE. (g-.) Putrefaction is an absolute sign of death. Better delay for it than run any .risk of burying alive. From Foreign Bodies in Air Passages.—If round and smooth, invert the patient and strike on the back : laryngotomy : tracheotomy. Of the New-Born,—Clean the mucus out of nostrils and throat; cathe- terize the trachea, and suck up the mucus. “ Marshall Hall’s methodby placing child on abdomen, then bringing into lateral posture, repeating slowly and deliberately. “ Schultze’s methodby placing the thumbs upon the anterior surface of thorax, the indices in the axillae, and the other fingers along the back, the face of the child being from you; rotate the child, by swinging upwards, so that the inferior extremities turn over towards you. In a moment re-rotate to the original position. Do not support head or legs in the forward rotation; their bending upon or towards the abdomen gives a forced expiration. CLINICAL EXAMINATION OF THE URINE. Note.—Use morning urine, or a sample of all passed during the 24 hours. Pale (and copious), 1.030-I- indicates Sugar. Pale (and copious), below 1.018 “ Hysteria and convulsions, Of urine and froth, very yellow nervous disease. or greenish...,.,,,, “ Bile, Rhubarb. Bright yellow to crimson “ Santonin. Dark, odor of violets “ Turpentine. High (scanty), sp. gr.-f- “ Fever, Uric Acid Dia- thesis. High (scanty), sp. gr.— “ A grave symptom of Bright’s Disease. Dark, muddy, smoky Blood, strong Coffee. Black “ Putridity, disintegrated Blood, Tar, Creasote. Color Smell Fragrant “ Cystine, Sugar, etc. Fetid “ Alkalinity. Of violets ,.., Turpentine. Quantity (in 24 hours). Normal about 50 fl. qz., from which there may be considerable variation either way, according to the quantity of sweat, the fluidity of food used, etc. Specific Gravity. If possible, take the mixed urine. Normal is about 1.018, i.e. 18 grains of solids in each fl. oz. If sp. gr. is high, suspect sugar; if low, suspect albumen. Reaction, in health is always acid in 24-hours’ urine. It may be alkaline from medicine, or disease, or shortly after a meal. If excessively acid, ex- amine for crystals of uric acid. If alkaline, let the test-paper dry, so as to ascertain whether the alkali be fixed or volatile. Albumen by Heat and Nitric Acid. With Acetic Acid, or dilute Am- monia, make the urine slightly acid. If a precipitate appear on boiling, it CLINICAL EXAMINATION OF THE URINE. 787 may be Albumen or Phosphates. Add a drop or two of Nitric Acid. If the precipitate dissolve, it is Phosphates ; if not, it is Albumen. If a deposit or turbidity disappears on heating, it consists of Urates : if not, add a drop of Nitric Acid. If now dissolved, we have Phosphates ; if not, Cystine. Other Tests are the Potassio-Mercuric Iodide, the Sodium Tungstate, Potassium Ferrocyanide, and Picric Acid Tests; but the above described one, if care- fully done, will give as good results as any. Bile Pigment and Acids, if necessary. Vogel's color-table. MarechaPs Test, as follows: Put of urine in a test-tube, and pour one or two drops of Tinct. Iodi. to trickle down along the side of the tube, held horizontally nearly, so that the two fluids may touch, but not mix. If bile pigment bt present, a fine green color will at once be developed below the red Iodine layer. Noel's Test, Pettenkofer's Test, Nitric Acid Test, Oxide of Silver Test. Sugar, if necessary. Urine containing sugar is usually light-colored, froths readily when poured from one vessel to another, and has a high specific gravity. Fehling's Test, as follows; Add to the boiling urine a few drops of freshly-prepared solution of Potassio-Cupric Tartrate (Fehling's Solution). If sugar be present, a yellow, orange, or red precipitate of Cuprous Oxide will form, io cubic centimeters of the solution being reduced by 0.05 gram of diabetic sugar. To prepare Fehling's Solution, dissolve 34,639 grams of pure, crystallized Copper Sulphate in about 200 grams of Distilled Water; also 173 grams of chemically pure, crystallized, neutral Tartrate of Sodium in 500 or 600 grams of a solution of Caustic Soda, of specific gravity 1.12, pouring the first solution into the latter, slowly and a little at a time. The clear, mixed fluid is then diluted with distilled water up to a litre. This solution soon spoils, and must be kept in a dark, cool place. Much more convenient are Dr. Piffard’s Cupro-Potassic Paste, and Dr. Pavy’s Cupric Test Pellets (see Tyson on Urine, page 57); and still more handy are Wyeth’s Co77ipressed Tablets for preparing Fehling’s Solution of Potassio-Cupric Tartrate, U. S. P. 1880, a box of which costs 50 cents, and may be obtained from any good drug-store. The writer has used these Tablets for some two or three years, with extreme satisfaction. Pavy's Solution is a modification of Fehling’s, is equally good for qualita- tive and volumetric testing, and is intended for those who prefer the apothe- caries’ weights and measures to the metric system. It is made in the same manner as Fehling’s, 100 minims corresponding to grain of diabetic sugar, and consists of—Copper Sulphate, gr. 320; Potassium Tartrate (neutral), gr. 640; Caustic Potash, gr. 1280; and Distilled Water, f^20. Other Tests for Sugar are Bottcher's Bismuth Test, the FeT-mentation Test, Moore's, Trommer's, the Picric Acid and the Indigo-Carmine. They are all useful, but will not be detailed here, as one good method is all that the average practitioner wants. Chlorides. Add a drop of Nitric Acid, and then Silver Nitrate until a precipitate ceases to form. Thus estimate the amount of Chlorides. Urea. — Place a drop of urine on platinum-foil, and to it add a drop of Nitric Acid, and leave undisturbed in a cool place for a minute or two. If the urea is in excess, crystals of Uric Nitrate form immediately. Mucus and Pus resemble each other so nearly under the microscope, that it is almost impossible for any one, except an expert, to distinguish between them thereby. Mucus is more cloudy and flocculent to the naked eye than Pus, which latter is generally of a stringy consistence and thickish yellow appearance at the bottom of the vessel. The supernatant liquid being poured off, and an equal bulk of Liquor Potassse added, the deposit, if containing 788 ETHICS. much pus, becomes gelatinized, and so tough that it cannot be poured out. If Mucus, Acetic Acid added coagulates it, forming delicate molecular fibres. Other Deposits are best examined with the microscope, and compared with good plates, rather than with printed descriptions. The plates in Hoff- man and Ultzman on Analysis of the Urine, will answer the wants of most general practitioners, but the text follows the metric system. The urinary deposits may be classified thus: In Alkaline Urine only. In Alkaline or Acid Urine. Organized Deposits. Calcium Phosphates Uric Acid Mucus, Torulae, Ammonium Urates Urates Pus, Sarcinae, Ammoniaco- Phosphates Blood,' Vibriones, magnesian, or the Oxalates Tube-casts, Bacteria, Triple Phosphates. Cystine Spermatozoids, etc. Necessary Apparatus. A dozen test-tubes. Alcohol lamp. A small porcelain dish. 2 watch-glasses. A sheet of platinum foil, inch square. 3 pipettes of different sizes, to be used only for urine. A 2-oz. graduate. Uri- nometer. Blue and red litmus-paper. The reagents mentioned above. A little Grape-sugar, for use in testing the Fehling’s solution. The foregoing directions comprise all that the average practitioner will usually perform in the matter of urinary analysis. For fuller directions, the reader is referred to one of the numerous manuals on the subject, among which may be mentioned Da Costa on Medical Diagnosis, chapter vii.—Tyson on the Practical Examination of Urine,—and Sir Henry Thompson’s Clinical Lectures on Diseases of the Urinary Organs, Lecture xxiv. A “ Physician's Pocket Reagent Case," intended for urinalysis at the bed- side, is put up by Parke, Davis & Co., and sold at the low price of $1.50. It contains a set of Dr. Oliver’s Test Papers, a color scale, specific gravity beads, two test tubes, a pipette, and full directions for the use of the reagents which are absorbed by the test papers. ETHICS. The Hippocratic Oath.—I swear by Apollo, the physician, and yEsculapius, and Health, and All-heal, and all the Gods and Goddesses, that, according to my ability and judgment. I will keep this oath and this stipulation :—to reckon him who taught me tiiis Art equally dear to me as my parents, to share my substance with him and relieve his necessities if required; to look upon his offspring in the same footing as my own brothers, and to teach them this Art, should they wish to learn it, without fee or stipulation ; and that by precept, lecture, and every other mode of instruction, I will impart a knowl- ETHICS. 789 edge of the Art to my own sons, and those of my teachers, and to disciples bound by a stipulation and oath, according to the law of medicine, but to none others. I will follow that system of regimen which, according to my ability and judgment, I consider for the benefit of my patients, and abstain from what is deleterious and mischievous. I will give no deadly medicine to any one, if asked, nor suggest any such counsel; and in like manner I will not give to a woman a pessary to produce abortion. With purity and holiness I will pass my life, and practice my art. I will not cut persons labor- ing under the stone, but will leave this to be done by men who are practition- ers of this work. Into whatever houses I enter, I will go into them for the benefit of the sick, and will abstain from every voluntary act of mischief and corruption ; and further from the seduction of females or males, of freemen and slaves. Whatever, in connection with my professional practice, or not in connection with it, I see or hear in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret. While I continue to keep this oath unviolated, may it be granted me to enjoy life and the practice of the Art, respected by all men, in all times! But, should I trespass and violate this oath, may the reverse be my lot! [Adams’s Genuine Works of Hippocrates, Sydenham Society, London, 1849.] Extracts from the Code. Consultations should be promoted in difficult cases. During them no jeal- ousy or rivalship should be indulged. Candor, probity, and all due respect should be exercised towards the physician in charge. The attending physician should first question the patient, the consulting one afterwards putting such other questions as may seem fit to further elucidate the case. The discussion should take place in a private place, and no opinions delivered which are not the result of concurrence. In discussion, the attendant delivers his opinion first, the others in the order in which they have been called. A Regular Medical Education furnishes the only presumptive evidence of professional abilities and acquirements, and ought to be the only acknowl- edged right of an individual to the exercise and honors of his profession. No one can be considered a fit associate in consultation, whose practice is based on an exclusive dogma, to the rejection of the accumulated experience of the profession. Punctuality should especially mark the keeping of these engagements; if one of the parties be delayed, the other should wait a reasonable time, and then, if the attendant, prescribe; if the consulting, he should retire, unless the case is urgent or he be called from a distance, when he should either pre- scribe for the emergency or leave a written opinion under seal. All theoreti- cal discussions should he avoided. Should diversity of opinion prevail, the majority should rule; should the numbers be equal on each side, the decision should rest with the attending physician. The consulting physician should always justify, as far as may be consistent with truth, the course pursued by the attending one, and no hint impairing confidence in him, or his reputation, should be thrown out. A double fee should be expected in all consultations. Interference.—A physician should not visit or prescribe for a patient who has been under the care of another for the same malady, unless in, 1st, a case of emergency ; 2d, of consultation ; 3d, of relinquishment, by the physician, of the case; 4th, or a regular notification to him that his services are not longer desired. When the case is assumed by another, he should indulge in no insinuations against the former attendant. If called because the family 790 NEW REMEDIES. physician is not at hand, or is sick, he should resign the case to him on his arrival. In case several physicians are simultaneously called, as in acci- dents, the first arriving should take full charge of the case, unless the family attendant be present, when he should assume the charge; if not present, he should be sent for, and the further treatment resigned to his hands. Miscellaneous.—A case should never be abandoned because it is supposed to be a hopeless one. Contumelious and sarcastic remarks relative to the Faculty, as a body, should always be avoided. “ It’s a foul bird that fouls its own nest.” It is held unprofessional to resort to “ public” advertising, to hold a patent upon an instrument, or to dispense or prescribe a secret nostrum. Gratuitous services should be given to an afflicted brother practitioner. If compelled to temporarily suspend his practice, on account of sickness, the physician who has been invited to take charge of his cases should turn the accruing fees over to the sick one, save in surgical or obstetrical cases. NOTES ON SOME NEW REMEDIES. AND SOME OLD ONES WHICH HAVE RECENTLY COME INTO PROMINENCE. Antifebrin, Phenyl-acetamid (C6H5NHC2H301),—is the latest gift of the German laboratories to the antipyretic list of drugs (pp. 151, 421) It is a white, odorless and crystalline powder, almost insoluble in water, cold or hot, but freely soluble in alcohol and diluted alcohol. It has neither acid nor ba- sic properties, and resists the action of most reagents. It is employed in doses of gr. iv to gr. xv, dissolved in wine, or enclosed in wafers, up to a maximum of gr. xxx in 24 hours. Its antipyretic power is stated in general terms as about four times the strength of Antipvrine. Its effect upon the body tem- perature begins to become manifest at the end of an hour after its ingestion, reaching its maximum in about four hours, and passing off, according to the size of the dose, in from three to ten hours. The pulse-rate falls proportion- ately with the decline of temperature. It produces no nausea, even in large doses, nor have any other untoward symptoms yet been caused by it. In many varieties of disease with high temperature it has already proved efficient, in- cluding acute rheumatic fever, erysipelas, typhoid fever, septicaemia, and phthisis pulmonalis,—and has the additional advantage of being a cheap drug selling at wholesale for about 25 cents per oz. If these claims of Drs. Cahn and Hepp, of Strassburg, become strengthened by further experience, we may have found at last the long-sought substitute for Quinine in pyrexia; though the reported discovery of a synthetical method of making Quinine itself by Dr. C. Hewitt, of London, if true, would seem to leave nothing to be desired in this respect. After all the experiments with other antipyretics, the experience of the profession, as voiced by Dr. Carter at this year’s meeting of the British Medical Association, is that Quinine must be placed at the head of the list. (See ante, page 421.) In a recent publication on the comparative value of the various antipyretics, NEW REMEDIES. 791 Dr. Pavay, Chief of the Presburg Hospital, gives the palm to Antipyrine (see page 72), as a practical antipyretic, being equally efficient with Quinine and Salicin, while comparatively devoid of the secondary symptoms which detract so much from the value of these two agents. He uses only per diem, and denounces larger doses. Comparing its action with that of other anti- pyretics, he says that Chinoline causes vomiting, Resorcin and Hydroqliinon great nervous excitation, and Kairin a very unpleasant sensation in the face and nose, besides vomiting, cyanosis and collapse. A vena Sativa, the common Oat, a plant of the nat. ord. Gtaminacese,— was official in the U. S. P. 1870, as Avence Farina, or Oat-meal. A concen- trated tincture or fluid extract has recently been extensively advertised by drug manufacturers as a nerve stimulant and tonic, especially efficacious in the treatment of chorea, epilepsy, insomnia, nervous exhaustion, alcoholism and the Opium-habit. The seeds contain starch, gluten, gum, etc., and form a nutritious food, the meal being made into a porridge, or gruel. In the latter form it is a good demulcent for coughs. The pericarp contains an amorphous alkaloid, which has doubtless some stimulant and narcotic power; but the claims advanced for it, as a specific remedy for the cure of the opium- habit, have been strenuously denied by many competent observers. Dose of the concentrated tincture or fluid extract, may be stated at npx-^ij. Cocaine (see page 182). Besides the great value of this alkaloid and its salts for producing local ansesthesia, it is coming into daily use as a general stimulant, a diuretic, an analgesic and an anti-pruritic. Doses of gr. ss of the Hydrochlorate twice daily have marked diuretic action, and as such it should be decidely useful in cases of anaemia, uraemia, and weak heart with dropsy. Prof. Laskevitch ascribes to it the power of relieving the paroxysms of angina pectoris, at first only tempering their acuteness, but after a few days’ use the attacks decrease in strength and duration, finally disappearing altogether. In sea-sickness it is reported to be very useful, if used in solution; cases in which the tablet form was employed deriving no benefit from it. It is further re- ported efficacious in the insomnia and diarrhoeas of children. The writer has found it to be an extremely prompt and efficient application, in ointment, oleate or solution (5-10 per cent.), for the burning and itching of Rhus- poisoning, and for pruritus ani et scroti, and similar affections. Mr. Jessup declares that Cocaine, as used in ophthalmic practice, is often injurious, that it may produce glaucoma, and will increase exophthalmos. The internal dose of Cocaine Hydrochlorate is gr. ij for an adult; gr. ■5V gr,ss, according to age, for a child. Hoang Nan (from Strychnos Gaultheriana'),—is, in common with the other members of the Strychnos family, a tetanizing agent. It is recommended in leprosy, syphilis, scrofula, varicose ulcers, eczema and other skin diseases; and has iately received attention as a preventive of hydrophobia, if given dur- ing the period of incubation in daily doses of gr. xv, which suffice to produce the physiological effects of the drug, namely—heightened reflexes, convulsions and trismus (Barthilemy). The ordinary dose is gr. ss, in pill. Ichthyol, is a preparation obtained from a bitumen found in the Tyrol, and regarded as the animal residue of antediluvian sea-animals and fishes. Ichthyol has a peculiar odor, a faintly alkaline reaction, and contains Sulphur 792 NEW REMEDIES. in the proportion of ten per cent. It has been introduced by Dr. Unna, of Hamburg, the celebrated dermatologist, as a promptly efficient remedy in cer- tain chronic skin diseases, particulaly eczema and psoriasis. It mixes with vaseline, lard and oils, is soluble in a mixture of ether and alcohol, and is not irritant locally, even if covered with oiled silk. In one case of eczema infantile, an ointment was applied containing I part of Ichthyol to 5 of Vaseline, resulting in the child’s sinking into a stupor which lasted for 12 hours. Though recovery was complete, the result of the application shows that care must be used in the employment of the remedy, as it is not devoid of danger (Sinclair). Lanolin, is a cholesterin fat obtained from the suds from the washing of sheep’s wool, by a process patented in the United States by Prof. Liebreich, the discover of Chloral; and though a very old medicament, being mentioned by Ovid, Herodotus, Pliny and Aristophanes, it is now being introduced to the medical world as the best basis for ointments. It contains 25 to 30 per cent, of water, and readily unites with no percent, of its own weight of water; differing from all other fatty substances, chiefly in resisting saponifica- tion and the action of water, having no tendency to become rancid. It readily passes through the integument, carrying with it any medicament with which it is charged. It is a perfectly neutral base, and hence is not liable to decom- pose any ordinary substance. The difficulty about its use has been its very disagreeable sheepy smell, but recent samples, exhibited to the British Medi- cal Association, seem to have been devoid of this objeciionable quality. It is particularly useful in chronic skin diseases where there is infiltration, and a penetrative action is desired for medicaments. In a few cases of acute and subacute eczema it has proved irritating, but as a rule it is perfectly bland. Where a simple protective action is desired it is inferior to Lard, Vaseline or Cold Cream. Manganese (see page 256!,—is becoming more of an acknowledged rem- edy in derangements of the menstrual function, as irregular or scanty menstrua- tion, amenorrhoea, menorrhagia, and even metrorrhagia. By some authorities, the emmenagogue power of Potassium Permanganate is ascribed to its large proportion of Oxygen, which it is supposed to give up to the uterus; as, until recently, Potassium Chlorate was supposed to do by the system at large. According to the views of others who have studied its action, Manganese should be classed with the excito-motors, increasing arterial tension, and specifically acting upon the uterus. The best preparation is the Binoxide, in freshly-made pills of two grains each, of which 1 to 3 or 5 pills may be taken twice or thrice daily. The Permanganate of Potassium has generally been the preparation given when the effects of Manganese were desired (see page 2571; but as it causes great gastric irritability, with abdominal pains and burning sensations, besides other decidedly unpleasant symptoms, it is a diffi- cult matter to get patients to take it for any length of time. Salol, or Phenol Salicyl,—is a new antiseptic and antipyretic, lately dis- covered by Prof. Von Nencki, of Berne. It is a white, greasy body, of slightly aromatic odor, but no taste, almost insoluble in water, but soluble in alcohol. It is decomposed in the organism by the pancreatic juice, appearing in the urine as urate of salicyl, the decomposition taking place in the duodenum, without any modification of its constituent parts. It, therefore, causes no NEW REMEDIES. 793 nrusea whatever, but colors the urine almost black, without any untoward symptoms; and is administered in quantities of tjj-ij daily in divided doses. As an Antiseptic it is hoped that Saiol will displace the disagreeable Iodo- form and the dangerous Bichloride of Mercury. It certainly prevents the development of bacilli, and is the best substance to apply to wounds. Inter- nally it will be of benefit in all intestinal catarrhs, in typhoid fever to disinfect the ulcerations; in cystitis and catarrh of the bladder, rendering the urine completely aseptic;—in cholera, and against intestinal parasites. As an Anti- pyretic, it has been used in phthisis, diminishing the temperature J° F., from 104° to 970; also in various rheumatic affections, in which it has given better results than the Salicylate of Sodium; while being tasteless and non-nauseant it has a great advantage over the latter salt. Terebene, is a clear, colorless fluid, having a pleasant odor, something like that of pine wood, and is prepared by the action of Sulphuric Acid upon Oil of Turpentine. It imparts a violaceous odor to the urine, and does not mix with water; but its small doses for internal administration (TTIv-xv), enables it to be given on sugar. Being less irritating and less disagreeable than Oil of Turpentine, and possessing most of the properties' belonging to the latter, it will doubtless largely displace it in many affections for which Turpentine is now employed. It has been extensively used by Dr. Murrell, with excellent results, as a remedy for obstinate winter-cough and emphysema of the lungs, in flatulence, and flatulent dyspepsia, also in cystitis and in gleet. ITe has employed it with benefit as a spray in phthisis and post-nasal catarrh, also with Cocaine in solu- tion as a spray for coryza and hay-fever. Other observers, of several years’ experience with this remedy in England, praise it highly as an inhalant rem- edy in phthisis, bronchiectasis, chronic bronchitis, and other pulmonary affec- tions characterized by profuse, purulent expectoration. Dr. Rieu employs it extensively in bronchitis and bronchorrhcea, in doses internally of gr. xv-xxx per diem,—but says that it does not affect the muco-purulent expectoration of phthisis [Bull. Gen. de Therap., April 30, 1886). It probably has no superior efficacy to Creasote, Venice Turpentine, etc., except that it is without much odor, and has no taste. TJrethan, the new hypnotic, is chemically a Carbamate of Ethyl, very soluble in water, and may be administered hypodermically, as it is free from local irritant action. It is decidedly hypnotic, slows the pulse and lowers the tem- perature. In large doses it produces complete muscular resolution and gen- eral anaesthesia. It does not derange nutrition, nor does it coagulate the fluids of the body. Extensive experimental observations have been made with Ure- than on animals, by Prof. Coze, of Nancy, which prove it to be a complete functional antagonist to the action of Strychnine. It should be useful in any form of convulsions and especially in tetanus. SPECIFIC GRAVITIES AND SPECIFIC VOLUMES. 794 TABLE OF SPECIFIC GRAVITIES AND SPECIFIC VOLUMES. (Temperature at 590 F., except when otherwise stated.) Liquid. Specific Gravity. Specific Volume. Liquid. Specific Gravity. Specific Volume. Acid, Acetic Ac. A-cet. Dil Ac. Hydrobromic (34 per cent.) Ac. Hydrobrom. Dil Ac. Hydrochloric Ac. Hydrochior. Dil Ac. Lactic Ac. Nitric Ac. Nitric. Dil Ac. Oleic Ac. Phosphoric Ac. Phosphor. Dil Ac. Sulphuric Ac. Sulphuric, Dil Hither Hither Fortior Alcohol, at 6o°F. Alcohol, at 77°F Alcohol, Dil., at 6o° F Alcohol, Dil., at 770 F.... Aqua Destill., at 390 F... Aqua Ammonite Aq. Ammon., Fort Benzin Carbon Bisulphide Chloroform, Purif Chloroform. Venale Glycerin Liq. Ferri Acet Liq. Ferri Chlor 1.048 x .008 1-3°3 1.077 1.160 1.049 1.212 1.420 1.059 0.800 1-347 1 -°S7 1.840 1.094 • 75° • 72S .820 .812 .928 .920 1.000 •959 .900 .670 1.272 1.488 1.470 1.250 1.160 1.405 • 954 .992 .767 .928 .862 •953 •833 .704 •944 1.250 .742 • 945 • 543 .9x4 i-333 1 -379 1.219 1.231 H077 1.087 1.000 1.043 1. in 1-403 .786 .672 .680 .800 .862 .711 Liq. Ferri Tersulph Liq. Potassae Liq. Sodae Mel (Honey) Ol. Adipis 01. Amyg. Expres Ol. Aurant. Cort 01. Bergamii Ol. Caryophilli Ol. Copaibae Ol. Cubebae Ol. Eucalypti Ol. Gaultheriae Ol. Gossyp. Sem Ol. Lavandulae 01. Limonis Ol. Lini Ol. Menthae Pip Ol. Morrhuae Ol. Olivae Ol. Ricini Ol. Rosmarini Ol. Sassafras 01. Sesami Ol. Terebinthinae Spt. /Etheris Nitrosi... Spt. Frumenti Spt. Vini Gallici Syrupus Simplex Vinum Album Vinum Rubrum 1.329 1.036 1.059 i-333 .900 • 9T7 .860 • 875 I .050 .89O .920 .900 I- 173 • 925 .890 • 850 •936 .900 .920 .9l6 .960 .900 1.091 .918 .862 .824 .920 .930 1.310 1.000 1.000 •757 • 965 • 944 • 75° I .III I .OpI I . l63 I- H3 .952 I. 123 I .087 I . Ill .832 I .08l 1.123 I . I76 I .068 I . Ill I .087 I .092 1.042 I . Ill •9I7 1.089 1.160 1.214 1.087 1.075 •763 1.000 1.000 DROPS IN A FLUIDRACHM. 795 TABLE SHOWING THE NUMBER OF DROPS IN A FLUIDRACHM OF VARIOUS LIQUIDS, ALSO THE WEIGHT OF ONE FLUIDRACHM IN GRAINS. (Compare page 469.) Liquid. Drops in f 3j. (nilx.) Weight of f5j in grains. Liquid. Drops in f 3j. (nil*.) Weight of f3j in grains. 9° 68 59 58 58 88 68 I3° 52 51 66 Ac. Nitro-hydrochlor... 76 66 Oleum Juniperi 148 49 Ac. Sulph Dil 148 45 Alcohol I46 44 Spt. iEtheris Nitrosi.... 146 47 77 102 106 Ext. Buchu FI 150 ' 47^ Tinctura Belladonnse... 137 53 Ext. Digitalis FI 134 62 Tinct. Benzoini Comp.. 148 48 51 TOO 128 53 158 53 Ext. Senega: FI 137 62 Tinct. Iodi 148 47 Ext. Valeriana: FI 150 49 Tinct. Opii 130 53 Ext. Zingib. FI 142 48 Tinct. Opii Camph 13° 52 Glycerin 67 68 Tinct. Opii Deodor no 54 Hydrargyrum I5° 760 Vin. Colchici Rad 107 55 Liq. Acidi Arseniosi 57 55 Vin. Colchici Sem III 54 Liq. Ferri Chloridi 71 72 Vinum Opii 100 55 796 METRIC CONVERSIONS. TABLE FOR CONVERTING APOTHECARIES’ WEIGHTS AND MEASURES INTO GRAMS. (Maisch.) Troy Weight. Metric. Apothecaries’ Grams for Liquids. Specific Gravity! of Water. Grains. Grams. Measure. Lighter* than Water. Heavier! than Water. I-64 .OOI "X i ■055 .06 .08 I-40 .0015 2 .10 .12 .15 I-30 .002 3 .16 .18 •24 1-20 .003 4 .22 .24 .32 I-l6 .004 5 .28 •30 .40 I-I2 .005 6 •32 •36 .48 I-IO .OO6 7 •38 .42 •55 % .008 8 •45 •50 •65 A .OIO 9 •50 •55 •73 X .Ol6 10 •55 .60 .80 H .02 15 .80 •72 .96 .03 16 .90 1.00 1.32 1 .065 20 1.12 !-25 1.60 2 •13 25 1.40 *•55 2.00 3 .20 30 1.70 1.90 2.50 4 .26 35 2.00 2.20 2.90 5 •32 40 2.25 2.50 3-30 6 •39 48 2.70 3.00 4.00 8 •52 50 2.80 3.12 4-i5 10 •65 6°f3j 3-40 3-75 5.00 15 1.00 72 4.00 4-5o 6 00 20 gj 1.30 80 4-5° 5.00 6.65 24 1.50 90 5-io 5.60 7-5o 26 1.62 96 5-40 6.00 8.00 30 3SS 1 -95 100 5.60 6.25 8.30 40 2.60 120 f gij 6.75 7-50 10.00 50 3.20 160 9.00 10.00 1330 6° zi 120 3'j 3-90 7.80 180 f giij 240 f 3SS 10.10 13-50 11.25 15.00 18.75 15.00 20.00 180 11.65 f 3v 16.90 25.00 240 gss i5-5o f3vj 20.25 22.50 30.00 300 19.40 f Zvij 23.60 26.25 35-oo 360 23-3° 27.00 30.00 40 00 420 27.20 54.00 60.00 80.00 480 EL 31.10 f giij 81.00 90.00 120.00 62.20 f 2iv 108.00 120.00 160.00 £iv 124.40 f 5v 13500 150.00 200.00 186.60 f|vj 162.00 180.00 240.00 §viij 248.80 f 3 viij 216.00 240.00 320.00 * Lighter than water are tinctures, spirits, compound spirits of ether, sweet spirit of nitre, fixed and volatile oils. ./Ether Fortior, f 5j=grams 2.80. f Same as water are waters, liquids, decoctions, infusions, most fluid extracts, and tinct- ures made with dilute alcohol. f Heavier than water are syrups, glycerin, a few fluid extracts, and chloroform. Of the latter, f 3j=grams 5.30. INDEX. Note.—This Index has been arranged with the object of enabling instant reference to be made to the mention of every article of the Materia Medica—every drug, official or unofficial, and each preparation, derivative or constituent thereof, which is treated of in the first part of the book— every article, preparation or operation discussed in the pharmaceutical portion, and every disease or other title contained in the therapeutical section. Many of the entries are onlv made once, but double and even treble entries are made for every item which seemed of sufficient importance to warrant such repetition. Salts are each placed but once in the Index, under their English names and the titles of their acid factors, thus, Acetate of Potassium. A basic view of the salts under their basis titles, is seen in the section on Materia Medica, but as no such view of the Allyl, Ethyl, Methyl, Propyl, and similar compounds is in the book, these are each indexed twice, under both the acid and basic portions of their names, as Cetyl Palmitate and Palmitate of Cetyl. Plants are indexed under both English and Latin names, except where the technical name of the plant corresponds in part with the official drug- title, in which case the one entry serves for both. Thus the entry Conium answers for the plant Coniumniaculatum, as well as for the official drug; but the drug Nux Vomica and the plant Strychnos Nux-vomica require separate index entries. Alkaloids are each entered once only and under their chemical termi- nation, ine-, their salts following the same rule as other salts. Glucosides and similar principles (except such as are acids) are indexed under their chemical termination, in. Preparations are indexed under their Latin names where the reference is to the class, as Infusa, 451; but the several individual preparations are placed under their English titles, thus, Infusion of Digitalis, 173 ; the refer- ence being to the Infusum Digitalis, page 173. Abbreviations, their use, 475 Table of, 749 Abdominal Plethora, 515 Abies, 301 Abies balsamea, 375 canadensis, 301 excelsa, 301 Abortion, 516 Abrus, 17 Abscess, 516 of the Liver, 639 Multiple, 692 Absinthe, 18 Absinthium, 18 Absorbent Cotton, 206 Abstract of Aconite, 40 of Belladonna, 95 of Conium, 158 Abstract of Digitalis, 172j of Hyoscyamus, 226 of Ignatia, 229 of Jalap, 238 of Podophyllum, 307 of Senega, 353 of Valerian, 385 Abstracta, 459 Acacia, 18 Catechu, 130 Aceta (see also Vinegars), 458 Acetate of Copper, 167 of Ethyl, 43 of Iron, 190 of Iron and Ammonium, 193 of Lead, 303 of Morphine, 277 of Potassium, 309 798 INDEX. Acetate of Sodium, 360 of Zinc, 394 Acetic Ether, 43, 46 Acetous Preparations, 458 Acetum, 19 Acid Abietic, 322 Abric, 17 Acetic, 19 Aconitic. 39 Agaric, 47 Aloetic, 55 Anemonic, 316 Angelic, 371 Arabic, 18 Arsenious, 84 Artanthic, 259 Benzoic. 93, 99 Boracic, 20 Boric, 20 Brassic, 358 Calumbic, 113 Camphoric, 115 Camphretic, 115 Capronic, 82 Caprylic, 82 Carbazotic, 35 Carbolic, 21, 52, 301 Solutions of, 22 Gauze, 22 Carminic, 155 Caryopliyllic, 127 Caryophyllinic, 127 Catechuic, 130 Catechu-tannic, 130 Cathartic, 325, 354 Cathartogenic, 354 Cerotic, 131 Cetraric, 132 Cevadic, 387 Chelidonic, 133, 343 Chromic, 23 Chrysammic, 55 Chrysophannic, 145, 325, 335 Cinnamic, 93, 99, 367 Citric, 247 Coca-tannic, 182 Copaibic, 161 Cresylic, 21 Cubebic. 166 Ergotic, 178 Ergotinic, 178 Erucic, 358 Eugenic, 267 Euonic, 188 Euphrastic, 189 Eilicic, 90 Fluoric, 25 Gallic, 25 Gallo-tannic, 38 Gambogic, 114 Gelsemic, 201 Gentesic, 202 Gentianic, 202 Glycyrrhizic, 205 Guaiac, 209 Guaiaconic, 209 Guaiaree, 209 Gurjunic, 211 Gynocardic, 133 Hydriodie, 232, 235 Hydrobromic, 26 Acid Hydrochloric, 27 Hydrocyanic, 29, 64, 65, 315 Hypopicrotoxic, 295 Igasuric,270 Ipecacuanhic, 235 Juglandic, 239 Kinic, 148 Kinotannic, 148, 242 Kino vie, 148 Kinovo-tannic, 148 Lactic, 31, 275, 339 Lactucic, 244 Linoleic, 249 Lobelic, 250 Lupulinic, 215 Maizenic, 394 Malic, 95 Mastichic, 259 Meconic, 275 Melassic, 338 Methyl-salicylic, 200 Mezereinic, 264 Muriatic, 27 Myristic, 268 Nitric, 27, 32 Nitro-hydroehloric. 27, 32 Nitro-muriatic, 27, 32, Oleic. 33, 273 Ophelic, 135 Palmaric, 322 Palmitic, 273 Phenic, 21 Phosphoric, 27, 34 Picric, 35 Picrotoxic, 295 Pinic, 322 Piperonylic, 163 Podophyllinic, 307 Polygonic, 308 Prussic, 29 Punico-tannic, 208 Pyrogallic, 25, 26 Pyroligneous, 301 Quercitannic, 38, 321 Rhatania-tannic, 38, 242 Rheotannic, 325 Rheumic, 325 Ricinoleic, 330 Sabadillic, 387 Salicylic, 340 Salicylous, 340 Salicyluric, 340 Sanguinarinic, 343 Sclerotinic, 178,179 Silvic, 322 Sphacelinic, 178 Strychnic, 270 Sulphuric, 27, 35 Sulphuric, Aromatic, 35 Sulphurous, 36 Succinic, 57.133 Tannic, 25 37 Tannic and Iron, 486 Tartaric, 39 Thebolactic, 275 Tiglinic, 380 Toxicodendric, 328 Tropic, 95, 226 Valerianic, 216, 371, 384, 390 Vanillic, 386 Veratric, 387 INDEX. 799 Acid Viburnic, 390 Xylic, 21 Acids, their action, 414 Acidity, 517 Acipenser Huso, 228 Acne, 518 Aconine, 39 Aconite, 39 Aconitine, 39, 40 Aconitum, 39 Cammarum, 39 Chinense, 39 ferox, 39 Japonicum, 39 Napellus, 39 Acorin, 111 Acorus Calamus, 111 Acrinyl, Sulpho-cyanate, 358 Acrolein, 204 Addison’s Disease, 519 Administration of Medicines, 12 Adynamia, 519 Adeps, 42 Benzoinatus, 42, 99 Hither, 42 Hither, Acetic, 43, 46 After-pains, 520 Agalactia. 520 Agaricin, 47 Agaricus albus, 47 chirurgorum, 48 muscarius, 48 Agave Americana, 55 Ague, see Intermittent Fever, 649 Ailanthus glandulosa, 49 Albau, 212 Albumin, 392 Albuminate of Mercury, 222 Albuminuria, 520 Alcohol, 50, 339 Caustic, 360 Phenylic, 21 Alcoholic Preparations, 452 Alcoholism, 53, 521 Aldehyde, 52, 285 Proto-catechuic, 386 Alder bark, 25, 55 Alder, Black, 314 Buckthorn, 197 Ale, 51 Alkalies, their action, 414 Alkaline Mineral Waters, 76 Alkaloids, Liquid, 372 Allium cepa, 54 porrum, 54 sativum, 54 Allspice, 299 Allyl Sulphide, 54, 88 Sulpho-cyanide, 358 Almond, 63 Alnus, 25 Aloe socotrina, 55 Alopecia, 522 Aloes, 55 Alstonia scholaris, 175 Alteratives. 420 Uterine, 428 Althaea officinalis, 57 Alum, 57 Alum, Ammonio-ferric, 192 Alum root, 25 Alumen, 57 Alumen Exsiccatum, 58 Aluminium, 58 Amanita Muscaria, 48 Amaurosis, 523 Amber, 367 Amblyopia, 407, 523 Amenorrhoea, 523, 792 Ammonia, 59 Ammonia-alum, 57 Ammoniated Mercury, 217 Ammoniacum, 59 Ammonium, 59 Amorphous Bodies, 443 Amygdala, 63 Amara, 29, 63 Dulcis, 64 Amygdalin, 29, 64, 315 Amyl Chloride, 45 Hydrate, 52 Hydride, 46 Nitrite, 65 Amylene, 45 Amylic Alcohol, 52 Amylum, 67, 338 Iodatum, 68, 231 Anaemia, 524 cerebral, 551 Anaesthesia, 45, 526 Local, 184 Anaesthetics, 45, 404 Local, 402 Mixtures, 44 Modes of using, 142 Analgesics, 404 Anamirta paniculata, 295 Anaphrodisiacs, 427 Pills, 503 Anasarca, see Dropsy, 582 Ancyclus Pyrethrum, 318 Andira Araroba, 145 Anemone, Meadow, 316 patens, 316 pratensis, 316 Pulsatilla, 316 Anemonin, 316 Aneurism, 526 Angelate of Butyl, 69 Angina.—See Croup, Laryngitis, Pharyn- gitis, Throat, Tonsillitis, etc. Angina Pectoris, 527 Anhidrotics, 426 Anilin Red, 198 Anise, 68 Star, 230 Anodynes, 404 Local, 402 Ant-acids, 414 Antagonists, 433 List of, 484 Anthelmintic, 419 Anthemis, 68 Anthrax.—See Carbuncle, 546 Antidote, Jeaunel’s, 767 Antidote-bag. 768 Antidotes, 433 Anti-emetics, 415 Anti-fat, 199 Antifebrin, 790 Antilithics, 424 Antimonial Powder, 70 800 INDEX. Antimony, 69 Sulphurated, 70 Antiperiodics, 422 Antiphlogisties, 422 Antipyretics, 151, 154, 421, 790 Antipyrine, 72 A ntiseptics, 224, 431 Antisialics, 413 Antispasmodics, 404 Antizymotics, 431 Anus, Fissured, 527 Aperients, 416 Aphonia, 527 Aphrodisiacs, 426 Aphthae, 528 Apiin, 73 Apiol, 73 Apis mellifica, 131, 260 Apncea, 784 Apocynin, 74 Apoeynum, 74 Apomorphine, 74, 275 Apoplexy, 528 Apotheme, 459 Appetite, 529 Approximate Measures, 469 Aqua, 75 Bulliens, 75 Communis, 75 Destillata, 75 Fervens, 75 Fluvialis, 75 Fontana, 75 Marina. 75 Pluvialis, 75 Aquae (see also Water of), 448 Aqueous Preparations, 448 Arabin, 18, 382 Arbor Vitae, 134 Arbutin, 134,151, 384 Arctostaphylos glauca, 384 Uva-ursi, 383 Argentum, 80 Argol, 309 Argyria, 81 Aristolochia reticulata, 355 Serpentaria, 355 Aristolochine, 355 Arnica, 82 Arnicin, 82 Aromatic Fluid Extract, 155 Aromatic Powder, 155 Aromatic Sulphuric Acid, 35 Arseniate of Iron, 193 of Sodium, 85 Arsenic, 84 Arsenium, 84 Artemisia Absinthium, 18 maritima, 345 Arterial Transfusion, 13 Artanthe elongata, 259 Asafoetida, 88 Asagrsea officinalis, 387 Ascarides.—See Worms, 745 Ascites, 529 Asclepias, 89 Ash. Flowering, 258 Prickly, 392 Asparagin, 57,188, 205 Asphyxia, 784 Aspidium, 89 Aspidosperma Quebracho, 320 - Aspidospermine, 320 Asthenia.—See Adynamia, Convales- cence, Atrophy. Asthenopia. 530 Asthma, 530 Astigmatism, 531 Astragalus gummifer, 382 Astringents, 25, 421, 430 Intestinal, 417 Urinary, 424 Atheroma, 532 Atrophy, 532 Atropine, 95 and Morphine, 281, 283 Atrosin, 95 Aurantiin, 90 Aurantium, 90 Aurum, 91 Ava-kava, 241 Avena Sativa, 791 Ayer’s Cherry Pectoral, 766 Azedarach, 92 Azoturia.—See Urinary Disorders, 736 Azulen, 260 Balanitis, 532 Baldness.—See Alopecia, 522 Balm, 261 of Gilead, 375 Balnea, 495 Balneum Maris, 75 Vaporis, 75 Balsam of Copaiba, 161 of Fir, 375 Friar’s, 99, 367 of Peru,93 of Tolu, 94 Balsamodendron Myrrha, 269 Balsamum Dipterocarpi, 211 Peruvianum, 93 Tolutanum, 94 Bandoline, 171 Baptisia, 94 Baptisin, 94 Barberry, 100 Bark, Cuprea, 148 Peruvian, 147 Barley, 255 Barosma, 107 Barosmin, 107 Basham’s Mixture, 193, 521 Basilicon Ointment, 322 Bassorin, 382 Baths, Formulae, 495, 493 Bay-berry, 267 Bay Rurri, 267 Bear-berry, 383 Bed-sores, 532 Beer, 51 Belladonna, 95 Belladonnine, 95 Benne, Benn6 Oil, 356 Benzene. 45, 98 Benzin, 98 Benzoate of Ammonium, 60, 99 of Lithium, 99 of Sodium, 99 Benzoin, 99 Benzoinated Lard, 42 Benzol, 98 INDEX. 801 Benzyl Cinnamate. 93 Berberine, 100,113, 224, 261, 285, 307 Muriate of, 101 Berberis, 100 Bergaptene, 101 Bergamium, 101 Bergamot, Oil of, 101 Beta vulgaris, 337 Bhang, 118 Bibliography and References, 514 Bicarbonate of Potassium, 309 of Sodium, 360 commercial, 360 Bichloride of Ethene, 46 of Mercury, 217 of Methylene, 140 Bichlorinated Chloride of Methyl, 139 Bichromate of Potassium, 23, 24 Bile, Agents affecting the, 417 Biliary Solvents, 425 Biliousness, 533 Bilious Remittent Fever, 779 Biniodide of Mercury, 218 Bird-lime, 391 Bismuth, 101 Bismuth Mixture for Children, 490 Bisulphate of Quinine. 149 Bisulphide of Carbon, 45,124 Bisulphite of Sodium, 36 Bitartrate of Potassium, 310 Bites and Stings, 722 Bitters, Action of the Simple, 114 Bittersweet, 176 Black-berry, 25 Bark, 333 Black Draught, 354 Black Drop, 276 Bladder, Inflammation of, 570 Irritable, 533 Paralysis of, 534 Bladder-wrack, 198 Blende, 394 Blepharitis, 534 Blistering Cerate, 120 Blisters, 429 Blood-root, 342 Blood-stains, 722 Blue Flag, 237 Mass, 217 Ointment, 217 Pill, 217 Boiling, 438 Boils, 534 Boldine, 102 Boldo, 102 Boldus, 102 Bolus, 496 Bone Diseases, 535 Boneset, 188 Borate of Quinine, 149 of Sodium, 20 Borax, 20 Boro-citrate of Magnesium, 20, 545 Boro-glyceride, 20 Bos-taurus, 189 Bots, 93 Bougie’s, Formulae for, 509, 510 Boxwood, 285 Brain Disorders.—See Cerebral Anaemia, Cerebral Concussion, etc. Brain Fever.—See Meningitis. Cerebro- spinal Meningitis, Typhoid Fever, Typhus Fever, Brandreth’s Pills, 766 Brandy, 60 Brayera, 103 Breasts.—See Abscess, Lactation,Mastitis, Nipples. Breath, Fetid, 535 Bright’s Disease, Acute, 535 Chronic, 536 Diagnosis, 773 Bromide of Ammonium, 60,103 of Calcium, 103 of Ethyl, 43, 45 of Iron, 104, 105 of Lithium, 103 of Methyl, 45 of Potassium, 103 of Sodium, 103 of Zinc, 103 Bromidrosis, 605 Bromine and Bromides, 103 Bromism, 104 Bronchiectasis, 537 Bronchitis, Acute, 537 Capillary, 538 Chronic, 589 Bronchocele.—See Goitre, 616 Bronchorrhoea, 541 Broom, 352 Brown Mixture, 205 Brucine, 229, 270, 271 Bruises, 541 Bryonia, 106 Bryonin, 106 Bubo, 542 Buchu, 107 Buckthorn, 197 Bulimia, 529 Bunion, 542 Burdock, 244 Burnett’s Disinfectant, 395, 432 Burns, 542 Bursitis, 543 Butternut, 239 Butyl Angelate, 69 Butyl-chloral Hydrate, 139 Chloride, 45 Hydride, 46 Valerianate, 69 Buxine, 285 Buxus sempervirens, 285 Cacao-butter, 377 Cachets, 505 Cachexiae, 543 Cadmium, 108 Caffea, 108 Caffeine, 109, 378 Cajuput Oil, 110 Caiuputene Bihydrate, 110 Cajuputol, 110 Calabar Bean, 292 Calabarine. 293 Calamine, 394 Ointment, 397 Calamus, 111 Calcination, 439 Calcium, 111 Calculi, Biliary, 544 802 INDEX. Calculi, Renal, 544 Solvents of, 425 Vesical, 544 Calendula, 113 Calomel, 70, 217 Calumba, 113 Calx, 111 Chlorata, 143 Sulphurata, 369 Cambogia, 114 Camellia Thea, 109 Camp Fever.—See Typhus, 734 Camphor, 115 Baldrian, 384 Bergamot, 101 Carbolated, 117 -Chloral, 117 -Cymol, 115 Monobromated, 116 Peppermint, 262 Salicylated, 117 Canadian Hemp, 74 Cancer, 545 Diagnosis of, 774 of Uterus, 738 Cancrum Oris, 546 Cane Sugar, 337 Cannabene, 118 Cannabin, 118 Cannabis, 117 Americana, 118 Indica, 118 sativa, 117 Cantharides, 120 Cantharidin, 120 Cantharis, 120 Capsiein, 122 Capsicum, 122 Capsules, 503 Carawav, 126 Carbo, 123 Animalis, 123 Purified, 124 Ligni, 124 Carbolate of Iodine, 231 Carbon, 123 Bisulphide, 45 Dioxide, 45 Monoxide, 46 Tetrachloride, 45,140 Carbonei Bisulphidum, 124 Carbonate of Ammonium, 60 of Calcium, Precipitated, 111 of Iron, 190 Saccharated, 190 of Iron and Manganese, 256 of Lead, 303 of Lithium, 249 of Magnesium, 253 of Potassium, 309 of Sodium, 360 Dried, 360 of Zinc, Precipitated, 395 Carbonated Mineral Waters, 76 Carbonization, 439 Carbuncle, 546 Carcinoma.—See Cancer, 545 Cardiac Disorders.—See Heart. Sedatives, 411 Stimulants, 410 Tonics, 411 Cardialgia.—See Pyrosis, 708 Carica Papaya, 284 Caries, 547 Carminatives, 416 Dewees’, 253 Carmine, 155 Caroval, 169 Carron Oil, 112, 249 Carthamus tinctorius, 165 Carueu, 126 Carum, 126 Caruol, 126 Caryophyllin, 127 Caryophyllus, 126 Casea Bark, 127 Cascara Amarga, 128 Sagrada, 128 Cascarilla, 128 Cascarillin, 128 Cassia acutifolia, 354 elongata, 354 Fistula, 129 Castanea, 25,129 vesca, 129 Castor Oil, 330 Emulsion, Formula, 564 Catalepsy, 547 Cataplasmata, 512 Cataract, 547 Catarrh, Acute Nasal, 548 Broncho-pulmonary.— See Bronchitis Bronchorrhcea. Chronic Nasal, 549 Duodenal, 584 Epidemic.—See Influenza, 647 Gastric.—See Gastritis, Chronic, 612 Genito-urinary.—See Bladder,Catarrh of, Cystitis, Endometritis, Gonor- rhoea, Leucorrhoea, etc. Catarrh, Intestinal. — See Dysentery, Jaundice, etc. Summer.—See Hay Fever, 621 Catechol, 151 Catechu, 25,130 Cathartics, 416 Catharto-mannite, 354 Caullophyllin, 130 Caulophyllum, 130 Caustic Potash, 309 Caustics, 429 Cedar, Oil of, 344 Red, 336 Celandine, 133 Cellulose, 206, 338 Centaurea benedicta, 126 Cephaelis Ipecacuanha, 235 Cephalalgia, 622 Cera, 131 Cera Alba, 131 Flava, 131 Cerata, 463, 510 Cerate of Camphor, 116 of Cantharides, 120 of Cantharides Extract, 120 of Cetaceum, 132 of Lead Subacetate, 304 of Resin, 322 of Sabine. 336 Cerates, 463, 510 Compounding of, 511 Ceratum, 42,131 INDEX. 803 Cerebellum, Agents affecting, 405 Cerebral Anaemia, 551 Compression, Diagnosis, 774 Concussion, 551 Diagnosis, 774 Congestion, 551 Depressants, 403 Excitants, 402 Softening, 552 Vomiting—Diagnosis, 780 Cerebro-spinal Fever. — See Meningitis, Cerebro-spinal, 666 Cerium Oxalate, 131 Cerolein, 131 Cetaceum, 132 Cetin, 132 Cetraria, 132 Cetyl Palmitate, 132 Cevadilla, 387 Cevadilline, 387 Cevadine, 387 Chalk, Prepared, 111 Chalybeate Waters, 77 Chamomile, 68 German, 260 Chamomilla, 260 Chancre, 552 Diagnosis of, 775 Chancroid, 552 Diagnosis of, 775 Change of Life —See Climacteric. Chapped Hands and Lips, 553 Charcoal, 124 Chart;**. (See also Papers), 464 Chartulse, 506 Chaulmoogra Oil, 133 Chelerythrine, 133, 343 Chelidonine, 133 Chelidonium, 133 Chelidoxanthin, 133 Chelsea Pensioner, 505 Chemical Incompatibility, 480 Chenopodium, 133 Cherry-laurel, 29, 31 Cherry, Wild, 315 Chestnut, 129 Chestnut-leaves, 25 Chest-pains, 553 Chian Turpentine, 375 Chicken-pox, 553 Chilblains, 553 Children, Dosage for, 16 Chimaphila, 134 Chimaphilin, 134 China, Pride of, 92 Chininum Amorphum Boricum, 149 Chinoidin, 150 Chinoline, 135 Chiratin, 135 Cbiretta, 135 Chittem Bark, 128 Chlorasma.—See Pityriasis, 695 Chloral, 136 Butylic, 139 Hydrate. 136 Chloral-habit, 137 Chlorate of Potassium, 309 of Sodium, 360 Chloride of Ammonium, 60 of Amyl, 45 of Arsenic, 85 Chloride of Butyl, 45 of Calcium, 111 of Cocaine, 182 of Ethene, 45 of Ethyl, 45 of Ethylidene, 140 of Gold, 91 of Gold and Sodium, 91 of Iron, 190 of Lime, 143 Mercur-ammonium, 217 of Mercury Corrosive, 217 Mild, 217 of Methane, 45 of Methyl, 45 of Sodium, 360 of Zinc, 395 Chlorinated Waters, 77 Chlorine, 143 Chlorine-water, 143 Chlorodyne, 140 Formulse for, compared, 765 'Chloroform, 44, 46, 139 Commerical, 139 Methylic, 139 Purified, 139 Chlorosis, 554 Chlorum, 143 Chocolate, 377, 378 Choking, 554 Cholagogues, 417 Purgatives, 416 Cholera Asiatica, 554 Infantum, 555 Simplex, 556 Diagnosis of, 775 Cholera Mixture (Squibb), 276, 555 Cholesterin, 189, 392 Chondodendron tomentosum, 285 Chondrus, 145 Chordee, 556 Chorea, 557 Choroiditis, 557 Chrysarobin, 145, 212 Chrysophan, 325 Churrus, 118 Cigarettes, Formulse for, 531 Ciliary Excitants, 409 Cimicifuga, 146 Cimieifugin, 146 Cinchona, 147 Flava, 148 Rubra, 148 Cinchonidine, 148 Cinchonine, 148,150 Cinchonism, 152 Cinnabar, 218 Cinnamein, 93 Cinnamomum, 154 Camphora, 115 Cinnamon, 154 Circulatipn, Agents affecting, 410 Circumcision, 692 Cissampeline, 285 Cissampelos Pareira, 285 Citrate of Bismuth, 101 of Bismuth and Ammonium, 101 of Caffeine, 109 of Cocaine, 183 of Iron, 190 of Iron and Ammonium, 192 804 INDEX. Citrate of Iron and Quinine, 193 of Iron and Strychnine, 193 of Lithium, 249 of Magnesium, Granulated, 253 of Potassium, 310 Citrates, 247 Citrine Ointment, 218 Brown, 219 Citron, 247 Citrullus Colocynthis, 157 Citrus acris, 247 Aurantium, 90 Bergamia, 101 Limonum, 246 medica, 247 vulgaris, 90 Clarification, 442 Classification of Medicines, 399 Claviceps purpurea. 178 Clavus.—See Headache, 623 Climacteric Disorders, 558 Cloves, 126 Club-moss, 252 Clysters, 494 Cnicin, 126 Cnicus benedictus, 126 Coca, 109,182 Cocaine, 110,182,791 Cocaine-habit, 184 Cocculus Indicus, 295 Coccus, 155 Coccyodynia, 558 Cochineal, 155 Cocoa, 110 Codamine, 275 Codfish, 264 Codeine, 275, 277 Cod-liver Oil, 264 Emulsion, 492 Coffee, 108 Cohosh, Black, 146 Blue, 130 Colation, 442 Colchiceine, 156 Colchicine, 155,156 Colchicum, 155 Coldness, 558 Colic, Hepatic, 560 Intestinal, 558 Lead, 559 Renal, 560 Colic-root, 175 Collodia, 457 Collodion, 206 with Cantharides, 120, 206 Flexible 206 Styptic, 38, 206 Colloids, 444 Collunarium, 495 Collyrium, 493 Formulae for, 494 of Four Sulphates, 494 Coloeynth, 157 Colocynthein, 157 Colocvnthin. 157 Colocynthis, 157 Colocyntliitin, 157 Cologne-water, 5J Colophony, 322 Columbo. 113 Coma, 560 Combination. Principles of, 473 Comminution, 440 Compounding Medicines, 465 a Mixture, 489 Condylomata, 560 Condy’s Fluid, 432 Confectio Damocratis, 505 Confection of Rose, 332 of Senna, 354 Confectiones, 461, 504 Formulae for, 504, 505 Conhydrine, 158 Conine, 158 Conium, 158 Conjunctivitis, Catarrhal, 560 Diphtheritic, 562 Gonorrhoeal, 562 Granular, 562 Phlyctenular, 562 Purulent, 563 Conspergative, 498 Constipation, 564 Constituents of Drugs, 436 Convalescence, 565 Convallamarin, 160 Convallaria Majalis, 160 Convallarin, 160 Convolvulin, 238, 350 Convolvulus Scammonia, 350 Convulsions. 565 Infantile, 565 Puerperal, 705 Copaiba, 161 Emulsion, 492 Copaifera Langsdorffii, 161 Copper, 167 Cordial, Cascara, 128 Coriander, 163 Coriandrum, 163 Corneal Opacities, 566 Corneitis.—See Keratitis, 654 Corn, Indian, 393 Silk, 394 Smut, 393 Cornin,163 Corns, 567 Corn us, 163 Cornutin, 178 Corpulence.—See Obesity, 678 Corrosive Sublimate, 217 Coryza.—See Catarrh, Acute, 548 Coto Bark, 163 Cotoin, 163 Cosmoiine, 288 Cotton, 206 Iodized, Formula for, 628 Cotton-seed Oil, 273 Couch-giass, 382 Cough, 567 Mixtures, Formulae, 568 Counter irritants, 429 Court Plaster, 229 Coxalgia, 569 Coxe’s Hive Mixture, 70, 351 Cramp Bark, 390 Cramps.—See Trismus, Spasmodic Affec- tions. Cranberry Tree, 390 Cranesbill, 25, 203 Cream, Cold, 332 of Tartar, 39, 310 INDEX. 805 Creasol, 164 Creasote, 22, 164, 301 Greta Praeparata, 111 Crocus, 165 Croton-chloral, 139 Croton Eluteria, 128 Oil, 380 Tiglium, 380 Croup, Catarrhal, 569 Membranous, 569 Diagnosis, 775 Cryptopine, 275 Crystallization, 443 Cubeba, 166 Cubeben, 166 Cube bene, 166 Cube bin, 166 Cuca, 182 Cucumber, Squirting, 177 Cucumber tree, 254 Cucurbita Pepo, 286 Cucurbitine, 286 Culver’s Root, 246 Cuprea Bark, 148 Cuprum, 167 Ammoniatum, 167 Curare, 169 Curarine, 169 Cutaneous Irritants, 429 Cyanide of Mercury, 218 of Potassium, 29, 30 of Silver, 80 Cyanosis, 570 Cydonin, 170 Cydonium, 170 Cymene, 379 Cynips Gallse tinctoriae, 199 Cyprepedin, 171 Cyprepedium, 171 Cystitis, Acute, 570 Chronic, 571 Cysts, 572 Damiana, 171 Dandelion, 374 Dandruff.—See Pityriasis, 695 Daphne Mezereum, 263 Daphnin, 263 Datura Stramonium, 365 Tatula, 172 Daturine, 172, 366 Deafness, 573 Death, Signs of.—See Asphyxia, 785 Debility.—See Adynamia, Anaemia, Con- valescence. Decantation, 442 Decocta, 451 Decoction of Cetraria, 132 of Chimaphila, 134 of Dulcamara, 176 of Granatus, 208 of Hwmatoxylon, 212 of Hydrangea, 217 of Inula, 230 of Prinos, 314 of Quercus, 321 of Quillaia, 322 of Rumex, 335 of Sarsaparilla, Compound, 348 of Stillingia, 364 of Viola Tricolor, 391 Decoction of Viscum, 391 of Xanthoxylum, 393 Decoloration, 442 Deer, Musk, 266 Deflagration, 439 Deliquescence, 444 Deliquescent Salts, List of, 500 Deliriants, 402 Delirium, 573 Tremens, 573 Delphinine, 364 Delphinium Staphisagria, 363 Dementia, 574 Paralytica, 575 Demulcents, 431 Dengue, 575 Dentition, 576 Dentifrices, 412 Deodorants, 432 Depressants, Cerebral, 403 Hepatic, 418 Renal, 423 Respiratory, 408 Uterine, 428 Dessication, 438 Destructive Metamorphosis, 421 Dew-berry, 334 Dewees' Carminative, 88, 253 Dextrin, 338 Dextrose, 269, 338 Diabetes Insipidus, 576 Mellitus, 576 Diachylon Ointment, 304 Plaster, 304 Diagnosis, Differential, 773 Dialysis, 444 Dialysed Iron, 87,193, 444 Diaphoretics, 425 Diarrhoea, 577 Diastase, 255, 338 Pancreatic, 284 Dich loro-methane, 140 Diffusate, 444 Digestive System, Agents which affect it, 412 Digitalein, 172 * Digitalin, 172,173 Digitalis, 172 Digitonin, 172, 353 Digitoxin, 172 Diluents, 425, 488 Dioscorea, 175 Dioscore'in, 175 Diospyros, 25 Dioxide of Carbon, 45, 339 Diphtheria, 579 Diagnosis of, 775 Dipsomania.—See Alcoholism, and De- lirium Tremens. Discutients, 420 Disinfectants, 432 Burnett’s, 895, 432 Condy’s, 432 Labarraque’s, 143, 432 Dislocations, 609 Dispensatories, 436 Dispensing, 465 by Physicians, 477 Displacement, 445 Distillation, 438 Dry, 438 806 INDEX. Distillation, Fractional, 438 Dita Bark. 175 Ditaine, 175 Ditamine, 175 Diuretics, 422 Formulae for, 583 Dizziness.—See Vertigo, 742 Dock, Yellow, 334 Dog-wood, 163 Jamaica, 300 Domestic Measures, 469 Donovan’s Solution, 85 Dorema Ammoniacum, 59 Dosage of Medicines, 16 of Opium, 276, 280 Dover’s Powder, 236, 277 Fluid, 277 Drastic Purgatives, 416 Draught, 492 Black, 354, 492 Effervescing, 492 Drink, 493 Imperial, Formula, 493 Drops, 469 Table of Drops to a drachm, 469, 795 Dropsy, 582 Drowning.—See Asphyxia, 785 Drugs, Their constituents, 436 Drug-experimentation, 11 Duboisia, 175 Duboisine, 175 Dulcamara, 176 Dulcamarin, 176 Duodenal Catarrh, 5S4 Dutch Liquid, 140 Dyscrasise.—See Cachexise, 543 Dysentery, 584 Dyspepsia, 587 Dysphagia, 589 Dysmenorrhoea, 586 Dyspnoea, 589, 595 Dysuria, 590 Ear, Agents affecting it, 407 Earache, 683 Eau Sedatif, 61, 63, 116 Ebullition, 438 Ecballium Elaterium, 177 Ecbolics, 427 Ecboline, 178 Ecchymosis, 590 Ecgonine, 182 Eclampsia—See Puerperal Convulsions, 705 Ecthyma, 590 Ectropium, 591 Eczema, 591 Efflorescence, 444 Efflorescent Salts, List of, 500 Egg, Yolk of, 392 Elaterin, 177 Elaterium. 177 Elder, 342 Elecampane. 230 Electuaria, 461, 504 Electuary for Piles, 505 Elephantiasis, 593 Elm, Slippery, 383 Elutriation, 441 Elixir of Orange, 91 Elixiria, 456, 492 Emaciation, 593 Embrocation, 494 Emetics, 414 General or Systemic, 415 Local, 415 Emetine, 235, 236 Emissions, 594 Emmenagogues, 427 Formulae for, 524 Pills, 502 Emollients, 431 Emphysema of Lungs, 594 Emplastra, 463, 511 Empyema, 595 Emulsification, 490 Emulsin, 29, 64 , 315 Emulsion of Cod-liver Oil, 265, 492 of Copaiba, 492 Pancreatic, 284 Emulsions, 490 Natural, 490 Encephaloma. — See Cancer, 545 Diagnosis of, 774 Endarteritis.—See Atheroma, 532 Endocarditis, 595 Diagnosis of, 774 Endometritis, 595 Enema of Tobacco, 372 Enemas, Formulae for, 495 Enemata, 596 Enteralgia.—See Colic, Intes., 558 Enteric Fever.—See Typhoid, 732 Enteritis, 597 Entropium, 591 Enuresis, 597 Epididymitis, 598 Epilation.—See Tinea Circin. 728 Epilepsy, 598 Diagnosis of, 776 Epispastics, 429 Epistaxis, 599 Epsom Salt, 253 Epulis —See Teeth, 727 Equinia.—See Glanders, 614 Erections, 594 Ergot of Rye, 178 of Corn.—See Ustilago, 393 Ergota, 178 Ergotine, 179 Ergotinine, 178 Ergotism, 179 Ericolin, 200, 383 Erigeron, 181 Eriodyction, 181 Errhines, 408 Eructations.—See Dyspepsia, Flatulence, 587, 608 Eruptions caused by Drugs, 600 Erysipelas, 600 Erythema, 602 Erythrophleine, 127 Erythrophlceum Guinense, 127 Erythroretin, 325 Erythroxylon, 182 Escharotics, 429 Eserine, 294 Essence of Lemon, 247 of Peppermint, 262 of Spearmint, 263 Ethene, 45 Chloride* 45 INDEX. 807 Ethene, Dichloride, 46 Ether, 42 Chloric, 140 Chlorinated Muriatic, 140 Methylic, 45 Petroleum, 98 Ethereal Oil, 43 Preparations, 456 Ethics, 788 Ethyl Acetate, 43 Alcohol, 50, 52 Bromide, 43, 45 Carbamate, 793 Chloride, 45 Hydrate, 52 Hydride, 46 Iodide, 43, 233 Nitrite, 43, 65 Oxide, 42 Ethylate of Sodium, 360 Ethylene Bichloride, 140 Ethyiidene Chloride, 140 Eucalyptene, 186 Eucalyptol, 186 Eucalyptolen, 186 Eucalyptus, 186 Eugenia caryophyllata, 126 Eugenia Pimeuta, 299 Eugenin, 127 Eugenol, 127 Euonymin, 188 Euonymus, 188 Eupatorin, 188 Eupatorium, 188 perfoliatum, 188 purpureum, 188 Euphrasia, 189 Evaporation, 437 Spontaneous, 438 Exanthemata, Diagnosis of, 777 Excipients, 460, 488 for Emulsions, 490 for Pills, 497 Excitants, Cerebral, 402 Ciliary, 410 Excoriation.—See Intertrigo. 651 Excretion.—Agents affecting, 422 Exhaustion, 603 Exogonium purga, 238 Exophthalmos, 603 Exostosis, 603 Expectorants, 409 Explosive Compounds, 482 Expression, 445 Exsiccation, 439, 444 Extemporaneous Pharmacy, 464 Preparations, 486 Prescriptions, 470 Extract of Aconite, 40 of Aloes, Watery, 55 of Arnica-root, 83 of Baptisia, 94 of Belladonna, Alcoholic, 95 of Cannabis Indica, 118 of Cinchona, 149 of Colocynth, 157 Compound, 157, 350 of Colchicum-root, 156 of Conium, Alcoholic, 158 of Convallaria, 160 of Damiana, 171 Extract of Digitalis, 172 of Duboisia, 175 of Ergot, 179 of Eriodyction, 185 of Euonymus, 188 of Gentian, 202 of Glycyrrhiza, 205 Pure, 205 of Haematoxylum, 212 of Black Hellebore, 214 of Hyoscyamus, Alcoholic, 226 of Iris, 237 of Juglans, 239 of Krameria, 242 of Leptandra, 246 of Malt, 255 of Mezereum, 264 of Opium, 276 of Physostigma, 293 of Podophyllum, 307 of Polygonum, 308 Of Quassia, 319 of Quebracho, 320 of Rheum, 325 of Rhus Toxicodendron, 328 of Stramonium, 365 of Taraxacum, 375 Extracta, 458 Extracta Fluida.—See Fluid Extracts, 452 Extractive, 459 Eye-bright, 189 Eye Diseases, 603 Ointments.—Formulfe for, 561 Sensibility, Agents affecting it, 406 Water, Formulae for, 561 Eyelids, 604 Face, 604 Face-ache.—See Neuralgia, also Tic Dou- loureux. Fainting.—See Syncope, 724 False Pains, 605 Farcy, 614 Fat.—See Obesity, 678 Fatigue.—See Exhaustion, 603 Favus.—See Tinea Favosa, 729 Febricula.—See Fever, Simple, 607 Febrifuge, 150 Feet, 605 Fehling’s Solution, 167, 787 Fel Bovis, 189 Inspissatum, 189 Purificatum, 189 Felon—See Onychia, 679 Fennel, 197 Fermentation, Lactic, 339 Ferrier's Snuff, Formula, 549 Ferro-cyanide of Potass., 29, 31 Ferrum, 189 Dialyzatum, 87,193, 444 Reductum, 189 Ferula galbaniflua, 199 Narthex, 88 Scorodosma, 88 Sumbul, 371 Fever, 605 Bilious Remittent, Diagnosis, 779 Cerebro-spinal.—See Meningitis, Cere- bro-spinal, 666 Hectic, 627 Intermittent, 648 808 INDEX. Fever, Miliary, 669 Milk.—See Lactation, 655 Pernicious.—See Intermittent Fever, Remittent Fever. Puerperal, 705 Relapsing, 709 Remittent, 709 Diagnosis of, 779 Rheumatic, 710 Scarlet, 715 Diagnosis of, 777 Simple, 607 Spotted.—See Typhus Fever, also Meningitis, Cerebro-spinal. Surgical, 723 Traumatic.—See Surgical Fever, 723 Typhoid, 732 Diagnosis of, 778 Typho-malarial.—See Typhoid, 732 Typhus, 734 Diagnosis of, 778 Yellow, 747 Diagnosis of, 779 Ficus (Fig), 197 Filtering-paper, 442 Filtration, 442 Fir, Balsam of, 375 Silver, 375 Firs, 301 Fistula, 607 Fits,—See Apoplexy, Convulsions. Epi- lepsy, Hysteria, Syncope. Flatulence, 608 Flavoring Agents, 488 Flax-seed, 248 Flea-bane, 181 Fleming’s Tincture of Aconite, 40 Flooding.—See Hemorrhage Postpartum, Menorrhagia and Metrorrhagia. Fuavil, 212 Fluid Extract of Aconite, 40 of Ailanthus, 50 of Arnica-root, 83 Aromatic, 155 of Aurantium Amarum, 91 of Baptisia, 94 of Belladonna, 95 of Berberis, 100 of Brayera, 103 of Buchu, 107 of Calamus, 111 of Cannabis Indica, 118 of Capsicum, 122 of Cascara Amara, 128 of Cascara Sagrada, 128 of Castanea, 129 of Chimaphila, 134 of Chirata, 136 of Cimicifuga, 146 of Cinchona, 149 of Cocculus, 295 of Coffee, Green, 109 of Colchicum-root, 156 of Colchicum-seed, 156 of Conium. 158 of Convallaria, 160 of Corn-silk, 394 of Cornus, 163 of Coto, 164 of Cotton-root, 206 of Cubeb, 166 Fluid Extract of Cyprepedium, 171 of Damiana, 171 of Digitalis, 173 of Dulcamara, 176 of Ergot, 179 of Eriodyction, 182 of Erythroxylon, 182 of Eucalyptus, 186 of Eupatorium, 188 of Frangula, 198 of Gelsemium, 201 of Gentian, 202 of Geranium, 203 of Ginger, 398 of Glycyrrhiza, 205 of Gossypium, 206 of Granatum, 208 of Grindelia, 209 of Guarana, 211 of Hamamelis, 213 of Hellebore, Black, 214 of Hydrangea, 217 of Hydrastis, 225 of Hyoscyamus, 226 of Ipecacuanha, 236 of Iris, 237 of Jaborandi, 297 of Krameria, 242 of Lactucarium, 244 of Leptandra, 246 of Liquorice, 205 of Lobelia, 251 of Lupulin, 216 of Manaca, 256 of Matico, 259 of Mezereon, 264 of Orange, Bitter, 91 of Pareira, 286 of Phytolacca, 294 of Pilocarpus, 297 of Pink-root. 363 of Piscidia, 300 of Plantago, 303 of Podophyllum, au7 of Poke-root, 294 of Polygonum, 308 of Prunus Virginiana, 315 of Quassia, 319 of Quebracho, 320 of Rhatany, 242 of Rheum, 325 of Rhubarb, 325 of Rhus Aromatica, 327 of Rhus Glabra, 327 of Rose, 332 of Rubus, 334 of Rumex, 335 of Sabina, 336 of Sanguinaria, 343 of Santalum, 344 of Sarsaparilla, 348 Compound, 348 of Savine, 336 of Seilla, 351 of Scutellaria, 352 of Senega, 353 of Senna, 354 of Serpentaria, 355 of Spigelia, 363 of Stigmata Maydis, 394 of Stillingia, 364 INDEX. 809 Fluid Extract of Stramonium, 365 of Sumach, Smooth, 327 Sweet, 327 of Taraxacum, 375 of Triticum, 383 of Ustilago, 393 of Uva-ursi, 384 of Valerian, 385 of Veratrum Viride, 387 of Viburnum, 390 of Wild Cherry, 315 of Witch-hazel, 213 of Xanthoxylum, 393 of Zingiber, 398 Fluid Extracts, 452 Flushing-heats, 608 Fly-agaric, 48 Fieniculum, 197 Foetal Development, 783 Skull, Its Diameters, 784 Fomentation, 493 Food, Horlick’s, 255 Mellin’s, 255 Foods, 419 Foreign Bodies, 608 Formulae. Hypodermic, 760 Formyl Iodide, 231 Fotus, 493 Fowler’s Solution, 85 Fox-glove, 172 Fractures, 609 Franciscea uniflora, 255 Frangula. 197 Frangulin, 197 Franklinite, 394 Fraxin, 258 Fraxinus Ornus, 258 Freckles, 609 Friar’s Balsam, 99, 367 Fuchsin, 198 Fucus Vesiculosus, 198 Furuncle.—See Boils, 534 Fusel Oil, 52 Fusion, 439 Gaduin, 264 Gadus Morrhua, 261 Galactagogues, 428 Galbanum, 199 Gal la, 25, 199 Galena, 303 Gallipots, 511 Gall-stones.—See Calculi, Biliary. Gallus Bankiva, 392 Gamboge, 114 Gangrene, 610 of Lungs, 660 Garcinia Hanburii, 114 mangostana, 258 Gargarysma. 493 Gargles, Formula; for, 493, 581, 692 Garlic, 54 Gaseous Preparations, 513 Gastralgia. 610 Gastric Dilatation, 611 Gastric Fever.—see Fever Simple, Ty phoid Fever, Gastritis. Gastric Pain,415 Sedatives, 415 Tonics, 413 Ulcer, 613 Gastric Vomiting, Diagnosis, 780 Gastritis, Acute, 612 Chronic, 612 Gastrodynia, 610 Gaultheria, 200 Gaultherilene, 200 Gauze of Thymol, 379 Gelatin, 228 Capsules, 503 Gelsemine, 201 Gelsemium, 200 Generative System, Agents affecting, 426 Genitive Case-endings, 763 Gentian, 202 Gentianin, 202 Gentopicrin, 202 Geranium, 25, 203 Gin, 51, 240 Ginger, 397 Glanders, 614 Glandular Enlargements, 614 Glass, Soluble, 310, 357 Glauber's Salt, 360 Glaucoma, 615 Gleet, 615 Glonoin, 65, 67 Glossitis, 616 Glottis, CEdema of, 616 Gluco-pepsin, 287 Glucose, 338 Glycerin, 203 Preparations, 458 Glycerita, 458 Glycerite of Carbolic Acid, 22 of Tannin, 38 of Starch, 68 of Yolk-of-egg, 392 Glyceryl, 273 Trinitrate, 65 Glycocholate of Sodium, 189 Glycogen,338 Agents affecting production, 418 Glyconin, 392 Emulsion of, 265 Glycyrrhetin, 205 Glycyrrhiza, 205 Glycyrrhizin, 205 Glycyrrhizinum Ammoniatum, 205 Gnoscopine, 275 Goa-powder, 145 Goitre, 616 Gold, 91 Golden Seal, 224 Gonorrhoea, 617 Gossypii Radicis Cortex, 206 Gossypium, 206 Goulard’s Cerate, 304 Extract, 304 Gout, 619 Diagnosis of, 776 Granatum, 25, 208 Granular Lids.—See Conjunctivitis, Oph- thalmia. Granulation, 444 Granule, 496 Grass. Ribbed, 303 Gravel-root, 188 Graves’ Disease.—See Exophthalmos, 608 Grav Powder, 217 Griffith's Mixture, 190 Pills, 190 810 INDEX. Grindelia, 208 Guarana, 110, 210 Guaranine, 110, 211 Guaiac, 209 Lignum, 209 Resina, 209 Guaiacol, 164 Gum Arabic, 18 Gumboil.—See Gums, 620 Gum-tree, Blue, 186 Gums, 620 Gun-cotton, 206 Gunjah, 118 Gurjun Balsam, 211 Gutta, 212 Gutta-percha, 211 Gutta; (Drops), 469 Gynocardia odorata, 133 Hair, 620 Hair-tonic, 522 Hair Washes, Formal*, 620 Haller’s Dictum, 11 Hamamelin, 213 Hamamelis, 25, 213 Hamburg Tea, 766 Hamlin’s Wizard Oil, 766 Hands.—See Chapped Hands. Hashish, 118 Haustus, 492 Haw, Black, 390 Hay-fever, 621 Haematics, 419 Ilaematoxylin, 212 Ilaematoxylon, 25, 212 Head-ache, Bilious Sick, 622 Congestive, 623 Nervous, 623 Heart, Fatty, 625 Dilated, 625 Diseases, 624 Hypertrophied, 626 Palpitation, 626 Valvular Disease, 627 Heartburn.—See Pyrosis, 708 Heart’s-ease, 391 Hectic Fever, 627 Hedeoma, 214 Helenin, 230 Hellebore, 214, 389 American, 387 Swamp, 387 White, 387 Helleborein, 214 Ilelleborin, 214 Helleborus, 214 Hematemesis, 627 Diagnosis of, 776 Hematocele, Pelvic, 628 Hematuria, 628 Hemeralopia, 629 Hemicrania, 629 Hemiopia, 631 Hemiplegia, 631 Hemlock, 158 Hemlock Spruce, 301 Hemoptysis, 631 Diagnosis of, 776 Hemorrhage, 632 Intestinal, 633 Post-partum, 633 Hemorrhagic Diathesis, 632 Hemorrhoids, 634 Hemostatics, 430 Hemp, 118 American, 118 Canadian, 74 Indian, 118 Henbane. 226 Hepar Sulphuris, 369 Hepatalgia, 636 Hepatic Abscess, 639 Congestion, 636 Cirrhosis, 636 Depressants, 418 Diseases, 638 Stimulants, 417 Vomiting, Diagnosis, 780 Hepatitis, 639 Hernia, 639 Herpes, 639 Zoster, 640 Hesperidin, 90 Heuchera, 25 Hiccough, 640 Hip-joint Disease, 569 Hippocratic Oath, 788 Hive Mixture, 351 Syrup, 70 Hives.—See Urticaria, 737 Hoang Nan, 791 Hoarseness —See Aphonia, 527 Hoffman’s Anodyne, 43 Hoff’s Malt Extract, 255 Homatropine, 96 Honduras Bark, 128 Honey, 260 Clarified, 260 of Rose, 260 Honeys (Mellita), 450 Hong-Pang-Chong, 326 Hooper’s Female Pills, 503 Hope’s Mixture, 579 Hopeine, 215 Hops, 215 Hordeolum.—See Eyelids, 604 Hordeuin distichum, 255 Horehound, 258 Horlick’s Food, 255 Housemaid’s Knee.—See Bursitis, 543 Humulus, 215 Hunger.—See Appetite, 529 Huxham’s Tincture of Bark, 149 Hydragogue Purgatives, 416 Hydrangea, 216 Hydrargyrism, 220 Hydrargyrum, 217 Ammoniatum, 217 cum Creta, 217 Hydrastin, 101, 225 Hydrastine, 224 Hydrastis, 224 Hydrate of Aluminium, 58 of Amyl, 52 of Butyl-chloral, 139 of Chloral, 136 of Ethyl, 52 of Magnesium, 253 of Methyl, 52 of Potassium, 309 of Sodium, 359 Hydrated Oxide of Iron, 191 INDEX. 811 Hydrated Oxide of Iron with Magnesia,191 Hydrated Silicate of Magnesium, 357 Hydride of Amyl, 46 of Butyl, 46 of Ethyl, 46 Trichloracetyl, 136 Hydriodic Ether, 43, 46 Hydrobromate of Conine, 159 of Hyoscine, 227 of Quinine, 149 Hydrobromic Ether, 43, 46 Hydrocele, 641 Hyrocephalus, 641 Hydrochlorate of Apomorphine, 74 of Cocaine, 182 of Quinine, 149 Carbamide, 149 of Morphine, 277 of Narcotine, 278 of Oxy-ethyl-chinoline-hydride, 151 of Pilocarpine, 297 of Rosanilin, 198 Hydrocotarnine, 275 Hydrocotvle, 226 Hydrogen, Sulphuretted, 369 Hydrophobia, 642 Hydroquinone, 151, 323, 383 Hydrothorax, 6-42 Hygrine, 182 Hygroscopic Bodies. 444 Hyoscine, 226 Hyoscyamus, 226 Hyoseyamine, 226 Hyperidrosis, 689 Hypnotics, 403 Hypochondriasis, 642 Hypodermic FormuLe, 760 Injections, 13, 762 Hypopliosphite of Calcium, 289 of Iron, 191, 289 of Potassium, 289 of Sodium, 289 Hypophosphites, 289 with Iron, Syrup of, 193 Hyposulphite of Sodium, 36 Hysteria, 643 Diagnosis of, 776 Ice, 78 Iceland Moss, 132 Ichthyocolia, 228 Ichthyol, 791 Ichthyosis, 643 Icterus.—See Jaundice, 652 Igasurine, 270 Ignatia, 229 Ignition, 439 Ileus.—See Intestinal Obstruction, 651 Ilex Paraguayensis, 110 Illicium, 230 Anisatum, 68 Impetigo, 644 Impotence, 644 Incineration, 439 Incompatibility, 480 Chemical, 480 Pharmaceutical, 483 Therapeutical, 484 Rules for avoiding, 485 Indigestion.—See Dyspepsia, 587 Indigo, Wild, 94 Inflammation, 645 Influenza, 647 Infusa, 451 Infusion of Arnica, 83 of Brayera, 103 of Buchu, 107 of Caraway. 126 of Cascarilla, 129 of Cinchona, 149 of Cloves, 127 of Convallaria. 160 of Digitalis, 173 of Gentian, Compound, 202 of Hops, 216 of Juniper, 240 of Linseed, 249 of Lobelia, 251 of Pareira, 286 of Quassia, 319 of Sassafras, 349 ot Senna, Compound, 354 of Spigelia. Compound, 363 of Tansy, 374 of Tar, 302 of Wild Cherry, 315 of Uva-ursi, 384 Infusions, 451 Ingluvin, 287 Inhalations, Formulae for, 513 Injections, Formulae, 494. 495 Injuries.—See Bruises, Burns, Ecchy- mosis. Fractures, Sprains, Wounds. Inoculation, 15 Inosit, 338 Insanity, 574 Insolation.—See Sunstroke, 723 Insoluble Salts, 482 Insomnia, 648 Intemperance.—See Alcoholism, Deliri- um Tremens. Intermittent Fever, 648 Intertrigo, 651 Intestinal Astringents, 417 Intestinal Diseases.—See Colic, Constipa- tion, Diarrhoea,Duodenitis, Dysentery, Enteritis, Hemorrhoids, Hernia, Intes- tinal Obstruction, Intussusception, Typhlitis, Tabes Mesenterica, Worms. Intestinal Obstruction, 651 Parasites.- See Worms, 745 Intussusception, 651 Inula, 230 Inulin, 82, 230 Iodide of Ammonium, 60, 231, 234 of Arsenic. 85 of Cadmium, 108 of Ethyl, 43, 233 of Formyl, 231 of Iron, 191 Saccharated, 191 and Manganese, 193 of Lead, 303 of Manganese 256 of Mercury, 85 Green, 218 Red, 218 of Potassium, 231, 234 of Silver, 80 of Sodium, 231 of Sulphur, 369 of Zinc, 395 812 INDEX. Iodides, 232 Iodine, 231 Iodism, 232 Iodized Cotton, 628 Phenol, 231 Starch, 68, 231 Iodoform, 231, 235 Iodum, 231 Ipecacuanha, 235 Iridin, 237 Iris, 237 Irish Moss, 143 Irisin, 237 Iritis, 652 Iron, 189 Dialysed, 193,444 and Tannic Acid, 486 Irritability, 651 Irritants, Cutaneous, 429 Ischuria.—See Urinary Disorders, Isonandra Gutta, 211 Itch.—See Scabies, 714 Itching.—See Lichen, Prurigo, Pruritus, Pediculi, Scabies,Urticaria, etc. Jaborandi, 297 Jaborine, 297 Jalap, 238 Jalapin, 238, 350 James’ Powder, 70 Jamestown Weed, 365 Japaconitine, 39 Jasmine, Yellow, 200 Jateorrhiza Calumba, 113 Jaundice, 652 Jeriquity, 17 Jervme, 387, 388 Joint Affections, 653 Juglans, 239 Juniperin, 240 Juniper, 240 Juniperus communis, 240 Sabina, 336 Virginiana, 336 Kairine, 73,151 Kairoline, 151 Kalium, 309 Kalmia latifolia, 261 Kamala. 241 Kavahin, 241 Kava-kava, 241 Kawin, 241 Kefir, 244 Keratitis, 654 Kidneys, Diseases of.—See Albuminuria, Bright’s Disease, Calculi, Diabetes, Dropsy, Hematuria, Litheemia, Ne- phritis. Kino, 25,242 Kinoin, 242 Kino-red, 242 Kinovate of Calcium, 148 Kinovin, 148 Koussin, 103 Kousso, 103 Krameria, 25, 242 Kumyss, 52, 54, 243 Kurung Oil, 308 Labarraque’s Solution, 143, 432 Labor, 654 Labor, Positions in, 782 Signs of, 782 Lac Sulphuris, 368 Lactate of Iron, 191 Lactation, 655 Lactopeptine, 287 Lactophosphates, 290 Lactose, 339 Lactuca virosa, 244 Lactucerin, 244 Lactucin, 244 Lactucarium, 244 Ladies’ Slipper, 171 La Fayette's Mixture, 162 Lallemand’s Specific. 619 Lanolin, 792 Lanthopine, 275 Lapathin, 335 Lappa, 244 Larch, 47 European, 375 Lard, 42 Benzoinated, 42 Oil, 42 Larix Europcea. 375 Laryngismus Stridulus, 655 Laryngitis, 656 Laryngotomy, 657 Latin Phrases and Terms, 749 Laudanine, 275 Laudanosine, 275 Laudanum, 276 Laurel, Mountain, 261 Laurocerasus, 29 Lavandula, 245 Lavender, 245 Water, 246 Laville’s Anti-gout Remedy, 157 Laxatives, 416 Lead, 303 Colic, 559 Plaster, 304 Sugar of, 303 Water, 304 and Laudanum, 493 White, 303 Leek, 54 Lemon, 246 Juice, 247 Peel, 247 Lentigo.—See Freckles, 609 Leopard’s Bane, 82 Lepra.—See Psoriasis, 703 Leprosy.—See Elephantiasis, 593 Leptandra, 246 Leptandrin, 246 Lettuce, 244 Leucocythsemia, 657 Leucoline, 135 Leucoma.—See Corneal Opacities, 566 Leucorrhoea, 657 Levigation, 440 Levulose, 260, 338 Lice.—See Pediculi, 687 Lichen, 658 Lichenin, 132 Licoperdon giganteum, 246 Lignum Vitae, 209 Lily-of-the-Valley, 160 Lily, Water, 273 Lime. 111. 247 INDEX. 813 Lime, Chlorinated, 143 Water, 112 Limon, 246 Limonis Cortex, 247 Succus, 247 Linimenta. 457, 494 Liniment, Aconite, 40 Ammonia, 60 Belladonna, 95 Camphor, 116 Cantharides, 120 Chloroform, 140 Compound, 140 Croton, 381 Lime, 112 Mustard, Compound, 358 Soap, 347 Turpentine, 375 Liniments, Formula; for, 494 Linseed, 248 Linum, 248 Lips.—See Chapped Lips, 553 Lip salve, Red, 378 Liquid-ambar orientalis, 366 Liquids, Normal, 454 Liquores (See Solution of), 449 Liquorice Root, 205 Wild, 17 Litluemia, 659 Litharge, 304 Lithium, 249 Lithontriptics, 424 Liver.—See Hepatalgia, etc., 636 Lixiviation, 445 Lobelacrin, 250 Lobelia, 250 Lobelin, 251 Lobeline, 250 Lochia.—See Labor and Puerperal Disor- ders, 654, 705 Lock-jaw.—See Tetanus, 727 Locomotor Ataxia, 659 Log-wood, 25, 212 Lotion. 493 Black, of Mercury, 219 Yellow, of Mercury, 219 Loxopterygium Lorentzii, 320 Lozenges, 461, 504 Lugol’s Solution, 231, Lumbago, 659 Lumbrici.—See Worms, 745 Lungs, Diseases of, 660 Gangrene of, 660 Lupulin, 215 Lupuline, 215 Lupus, 661 Lycopodium, 252 Lyctonine, 39 Lymphangeitis, 661 Mace, 268 Oil of, 268 Maceration, 445 Macis, 268 Macrotin. 146 Magendie’s Solution, 277 Magenta, 198 Magma, 443 Magnesia, 253 Ponderosa, 253 Magnesium, 252 Magnolia, 254 Magnolin, 255 Maize, 393 Malaria, 662 Male Fern, 89 Mallotus phillipinensis, 241 Malt, 255 Extract, Hoff’s, 255 Maltum, 255 Mammary Abscess, 516 Manaca, 255 Mandrake, 307 Manganese, 256 Oxide, 792 Manganum, 256 Mangifera indica, 258 Mango, 258 Mango-fruit, 258 Mangosteen, 258 Mania, 663 Manna. 258 Mannit, 258 Manzanita, 384 Marasmus.—See Atrophy, Emaciation, Tabes Mesenterica. Marginal Shield Fern, 89 Marigold, 113 Marjoram. Wild, 283 Marrubiin, 258 Marrubium, 258 Marsh-mallow, 57 Mass of Copaiba, 162 of Ferrum Carbonate, 190 of Mercury, 217 Mass®, 460 Mastic, 259 Mastiche, 259 Mastichin, 259 Mastodynia, 664 Mastitis, 663 Masturbation.—See Emissions, Sperma- torrhoea, 594, 719 Mat£\ 110 Materia Medica, 9 Matico, 259 Matricaria, 260 Chamomilla, 69, 260 May Apple. 307 McMunn’s Elixir of Opium, 276 Meadow Saffron. 155 Measles, 664 Diagnosis of, 777 False.—See Roseola, 714 Measures, Approximate, 469 Domestic, 469 and Weights, 465 Meconidine, 275 Meconoiosin, 275 Meconin, 275 Medicines, Administration of, 12 Mel, 260 Despumatum, 260 Rosee, 260, 333 Melaleuca Cajuputi, 110 Melancholia, 665 Melia Azedarach, 92 Melissa, 261 Mellin’s Food, 255 Mellita, 450 Meningitis, Cerebral, 665 Cerebro-spiual, 666 814 INDEX. Meningitis, Spinal, 667 Tubercular.—See Hydrocephalus, 641 Menispermin, 295 Menispermum, 261 Cocculus, 295 Menopause.—See Climacteric, 558 Menorrhagia, 667 Menstrual Disorders, 668 Menstruum, 445 Mentagra, 668 Mentha Piperita, 262 Viridis, 263 Menthol, 262 Mercurial Ointment, 217 Plaster, 217 Mercuric Chloride, 217 Iodide, 218 Mercurio-vegetal, 256 Mercurous Chloride, 217 Iodide, 218 Mercury, 217 Ammoniated, 217 with Chalk, 217 Mesenteric Disease—See Tabes Mesen- terica, 726 Metabolism, Agents affecting, 419 Methane, 45 Methene Chloride, 45 Methyl Alcohol, 45 Bromide, 45 Chloride, 45 Bichlorinated, 139 Conine, 158 Creasol, 164 Ether of Protocatechuic Aldehyde,386 Hydrate, 52 Salicylate, 200 Terchloride, 139 Methylal, 45 Methylene Bichloride, 140 Methylic Alcohol, 52 Ether, 45 Methysticin, 241 Metric Prescriptions, 468 System of Weights, etc., 467 Table for Converting, 796 Metritis, Acute, 669 Metrorrhagia, 669 Mezereon, 263 Mezereum, 263 Migraine, 629 Miliary Fever, 669 Milk.—See Agalactia, Lactation. Milk Fever.—See Lactation, 655 Mineral Waters, 76, 79 Mint, 263 Miscarriage.—See Abortion, 516 Mistletoe, 391 Misturse, 450, 486 Mixture, Almond, 64 Ammoniac, 59 Asafetida, 88 Bismuth, 490 Chalk, 112 Chloroform, 140 Copaiba, Compound, 162 Coxe’s Hive. 351 Ferro-saline, 194 Gentian, Alkaline, 202 and Senna, 202 Irop, Aromatic, 194 Mixture Iron and Ammonium Acetate, 193 Iron, Compound, 190 Iron, Laxative, 194 Liquorice, Compound, 205 Magnesia and Asafetida, 88, 253 Neutral, 310 Quinine, 490 Potassium Citrate, 310 Rhubarb and Soda, 325 Mixtures. 450, 486 Compounding of, 489 Substances suitable to, 486 Molasses, 338 Mole.—See Nsevus, 671 Mollities Ossium.—See Bone Diseases, Rachitis, 535, 708 Monoxide of Carbon, 46 Monsel’s Solution, 192 Moonseed, Canadian, 261 Morbilli.—See Measles, 664 Morphine, 275, 277, 280 and Atropine, 281, 283 Habit, 681 Morrhuse Oleum, 264 Morrison's Pills, 115 Moschus, 266 Motor Depressants, 401 Excitants, 400 Mouth Diseases.—See Aphthfe, Cancrum Oris, Gums, Parotitis, Ptyalism, Stom- atitis, Toothache, Tongue. Mouth Washes, Formulae, 620 Mucilage of Acacia, 18 of Cydonium, 170 of Elm, 383 of Sassafras-pith, 349 of Tragacanth,382 Mucilagines, 450 Mullein, 389 Mumps, 687 Muriate.—See Hydrochlorate, of Berberine, 225 of Cocaine, 182 Muscaj Volitantes, 669 Muscarine, 48 Muscular Disorders.—See Atrophy. Cho- rea, Hydrophobia,Laryngismus,Lum- bago, Myalgia, Pleurodynia, Rheum- atism, Tetanus, Torticollis. Musk, 266 Mustard, 357 Black, 358 Flour of, 358 Oil of, 358 White, 357 Myalgia, 670 Mydriasis, 96 Mydriatics, 405 Myelitis, 670 Mykose, 178 Myopia, 670 Myotics, 406 Myrcia, 267 Myrica, 25 cerifera, 131 Myricin, 131 Myristica, 268 Myristicol, 268 Myronate of Potassium, 358 Myrosin, 358 INDEX 815 Myroxylon toluifera, 94 Pereirae, 93 Myrrh, 269 Myrrh in, 269 Myrrhol, 269 Myrtle, 25 Neevus, 671 Nails, Ingrowing, 671 Napelline, 39, 42 Naphthalin, 269 Narceine, 275, 280 Narcotics, 403 Narcotine, 275, 280 Nasal Affections, 671 Injections, Formulae, 581 Natrium, 359 Nausea, 671 Necrosis, 672 Neetandra, 285 Nervous Affections, 672 Exhaustion, 673 Nervousness, 673 Nervous System, Agents affecting, 400 Neuralgia, 674 Ovarian, 683 Neutral Mixture, 310 New Remedies, Notes on, 790 Nicotiana Tabacum, 371 Nicotianin, 372 Nicotine, 372 Nightshade, Black, 176 Deadly, 95 Woody, 176 Night-mare, 677 Night Sweats.—See Hectic Fever, Perspi ration. Phthisis. Nipples, Sore, 677 Fissured, 677 Nitrate of Ammonium, 60 of Ethyl, 43, 65 of Lead, 304 of Mercury, 218 of Muscarine, 48 of Potassium, 226, 310 of Silver, 80 Fused, 80 of Sodium, 360 Nitre, 310 Chili, 360 Sweet Spirit of, 43 Nitrite of Amyl, 65 Of Ethyl, 66 of Potassium, 65 of Sodium, 65, 67 Nitro-benzol, 64 Nitro-glyeerin, 65, 67 Nitrous Ether, 43, 46 Nitrous Oxide, 45 Nodes, 677 Normal Liquids, 454 Norway Spruce, 301 Nucin, 239 Nutgall, 25,199 Nutmeg, 268 Nux Vomica, 270 Nyctalopia, 629 Nympha-a, 25 Odorata, 273 Nymphomania, 678 Oak-bark, 25 Black,321 Oak, Dyer’s, 199 White, 321 Obesity, 678 Obstetrical Memoranda, 782 Odontalgia, 678 (Esophagus, Affections of, 679 Official Operations, 437 Preparations, 448 Officinal.—See Preface. Oil of A mber, 367 of Allspice, 299 of Almond, Bitter, 64, 331 Expressed, 64 of Anise, 68 of Anthemis, 69 of Aurantium Cortex, 91 Flores, 91 of Bay, 267 Benni, 356 of Bergamot, 101 of Cade, 240 of Cadinum, 240 of Cajuput, 110 of Caraway, 126 of Carum, 126 Carron, 249 Castor, 330 of Caryophyllus, 127 of Cedar, 345 Chaulmoogra, 133 of Cbenopodium, 134 of Cinnamon, 154 of Cloves, 127 Cod-liver, 264 of Copaiba, 162 of Coriander, 163 of Cotton-seed, 206, 273 of Cubeb, 166 Ethereal, 43 of Erigeron, 181, of Eucalyptus, 186 of Fennel, 197 of Gaultheria, 200 of Gossypium-seed, 206, 273 of Hedeoma, 214 of Hemlock, 302 of Juniper, 240 of Lavender, 245 Flowers, 245 of Lemon, 247 of Linseed, 248 of Linum, 248 of Mace, 268 of Mentha Piperita, 262 of Mentha Yiride, 263 of Mirbane, 64 of Morrhua, 264 of Mustard, Volatile, 358 of Myrcia, 267 of Myristica, 268 of Neroli, 91 of Nutmeg, 268 Olive, 206, 273 of Orange-flowers, 91 of Orange-peel, 91 of Origanum, 283 of Pennyroyal, 214 of Pepper-mint, 262 Phosphorated, 289 816 INDEX. Oil of Pimenta, 299 of Pinus Sylvestris, 302 of Pix Liquida, 240, 301 of Pongamia, 308 of Ricinus, 330 of Rose, 331, 332 of Rosemary, 333 of Rue, 335 of Ruta, 335 of Sabina, 336 Salad, 273 of Sandalwood, 344 of Santal, 344 of Sassafras, 349 of Sesamum, 356 of Sinapis, Volatile, 358 of Spearmint, 263 of Spruce, 302 Sweet, 273 of Succinum, 367 of Tabacum, 372 of Tanaeetum, 374 of Tansy, 374 of Tar, 240, 301 of Terebinthina, 375 of Theobroma, 377 of Thuja, 378 of Thyme, 379 of Tiglium, 380 of Turpentine, 375 of Valerian, 385 of Wintergreen, 200 Wood, 211 Oils, Expressed, 445 Fixed, 445 Ointment, 42,131 Basilieon, 322 Belladonna, 95 Calamine, 397 Carbolic Acid, 22 Chrysarobin, 145 Citrine, 218 Diachylon, 304 Gallic Acid, 25 Gall, 199 Hamamelis, 213 Iodine, 231 Iodoform, 232 Lead Carbonate, 304 Iodide, 304 Mercurial, 217 of Mercury, Ammoniated, 217 Nitrate, 218 Red, 219 Oxide, Red, 218 Yellow, 218 Mezereum, 264 Nutgall, 199 Petroleum, 288 of Pix Liquida, 301 of Potassium Iodide, 231 of Rose-water, 332 of Staphisagria, 363 Stramonium, 366 Sulphur, 368 Alkaline, 368 of Tannic Acid, 37 Tar, 301 Thymol, 379 Veratrine, 388 Witch-hazel, 213 Ointment of Zinc Oxide, 395 Ointments, 462, 510 Compounding, 511 Formula; for, 511, 592, 635 Olea Europa;a, 273 Oleaginous Preparations, 457 Oleata, 33, 34, 457 Oleate of Aconitine, 34 of Aluminium, 34 of Arsenic, 34 of Atropine, 34 of Bismuth, 34 of Cocaine, 183 of Copper, 34 of Iron, 34 of Lead, 34, 304 of Mercury, 33, 218 of Morphine. 34, 277 and Mercury, 34 of Quinine, 34 of Silver, 34 of Strychnine, 34 of Veratrine, 34, 388 of Zinc, 34 Oleates, 33, 34, 457 Olein, 273 Oleoresina, 456 Oleoresin of Aspidium, 90,103 of Capsicum, 122 of Cubeb, 166 of Lupulin, 216 of Pepper, 299 of Zingiber, 398 Oleoresins, 456 Onion, 54 Onychia, 679 Operations, Official, 437 Ophelia Chirata, 135 Ophthalmia, 680 Opisthotonos.—See Tetanus, 727 Opium, 274 Denarcotized, 276 Habit, 681 Opodeldoc, 347 Orange, 90 Orchitis, 682 Ordeal Bark, 127 Origanum, 283 Otalgia, 683 Otitis, 683 Otorrhoea, 683 Ovarian Neuralgia, 683 Tumors.—See Cysts, 572 Ovaritis, 684 Ovis Aries, 356 Oxalate of Iron, 191 Oxaluria, 684 Ox-gall, 189 Oxide of Antimony, 70 of Calcium, 111 of Ethyl, 42 of Iron, Hydrated, 191 with Magnesia, 191 of Lead, 304 of Magnesium, 253 of Manganese. Black, 256 of Mercury, Red, 218 of Mercury, Yellow, 218 of Propyl, 264 of Silver, 80 of Zinc, 395 INDEX. 817 Oxymel, 261 Oxytocies, 427 Oyster-shell, 112 Ozsena, 684 Pagliari’s Styptic, 633 Pain, 685 Gastric, 415 Pains, False, 605 Paints, 512 Palmitate of Cetyl, 132 I’almitin, 273 Pancoast’s Styptic, 633 Pancreas, Agents affecting, 419 Pancreatin, 284 Pancreopepsin, 287 Pannus.—See Corneal Opacities, 566 Pansy, 391 Papain, 284 Papaiva, 284 Papaver Somniferum, 274 Papaverine, 275 Papaw Milk, 285 Paper of Cantharides, 120 of Mustard, 358 of Potassium Nitrate, 310 Papers (Chart®), 464, 506 Papine. 276 Parachinanisols, 151 Paraconine, 158 Paracoto Bark, 164 Paracotoin, 164 Paraldehyde, 285 Paralysis, 686 Paramenispermin, 295 I’aramorphine, 275 Paraphimosis.—See Phimosis. 692 Paraplegia.—See Paralysis, 686 Parasiticides, 432 Paregoric, 276 Pareira, 285 Parigenin, 348 Parillin, 348 Paronychia, 679 Parotitis, 687 Participles, 764 Parvule, 496 Pastilles, 461 Pasque-flower, 316 Patent Medicines, 766 Paullinia curare, 169 Paullinia sorbilis, 110, 210 Pearson’s Solution, 85 Pectin, 321 Pediculi. 687 Pelletierine, 208 Pellitory, 318 Persian, 318 Pelosine, 285 Pelvic Diameters, 783 Pemphigus, 687 Pencils, 509 Penis.—See Chancre, Chancroid, Chor- dee, Gleet, Gonorrhcea, Phimosis, Urethra. Pennyroyal, 214 Pennywort, 226 Pepo, 286 Pepper, Black, 299 Water, 308 Peppermint, 262 Pepsin, 286 Liquid, 287 Saccharated, 287 Pepsinum, 286 Peptogenic Milk Powder, 287 Perchloride of Iron, 190 Percolation. 445 Pericarditis, 688 Diagnosis of, 774 Periostitis, 688 Peritonitis, 688 Puerperal, 706 Permanganate of Potassium, 256, 792 Pernicious Fever.—See Intermittent Fe- ver, Remittent Fever. Perry Davis’ Pain-Killer, 766 Persimmon, 25 Perspiration, 689 Pertussis, 690 Peruvian Bark, 147 Petrolatum, 288 Petroleum Ether, 98 Ointment, 288 Petroselinum sativum, 73 Peumus Boldo, 102 Phseoretin. 325 Phagedena.—See Chancre, Chancroid, Gangrene, Ulcers. Pharmaceutical Incompatibility, 483 Pharmaceutists. — Their objectionable practices, 476 Pharmacology, 9 Pharmacopoeias, List of, 435 Pharmacy, 9, 435 Extemporaneous, 464 Official, 437 Rules for neophytes, 480 Pharyngitis, 691 Phaseo-mannit, 338 Phenol, 21, 52 Iodized, 231 Salicyl. 792 Pheno-resorcin, 151 Phenyl-acetamid, 790 Phenylic Alcohol, 52 Phimosis, 692 Phlebitis, 692 Phlegmasia Alba Dolens, 692 Phlegmon, 693 Phlorol, 164 Phosphate of Ammonium, 60 of Calcium, Precipitated, 290 of Iron, 191 of Iron and Manganese, 193 of Sodium, 290 Phosphates, 290 Syrup of the, 193 Phosphide of Zinc, 289 Phosphites, 289 Phosphorus, 289 Photophobia, 693 Phthisis, 693 Diagnosis of, 777 Physeter macrocephalus, 132 Physiological Antagonists, 484 Physostigma, 292 Physostigmine, 293 Phytolacca, 294 Picrsena excelsa, 319 Picrates, 35 Picroglycion, 176 818 INDEX. Picropodophyllin, 307 Picrotoxin, 295 Pierce’s Favorite Prescription, 766 Golden Discovery, 766 Pigmenta, 512 Piles, 634 Pill of Aloes, 56 of Aloes and Asafetida, 56, 88 of Aloes and Iron, 56 of Aloes and Mastic, 56 of Aloes and Myrrh, 56 of Antimony. Compound, 70 of Asafetida, 88 Compound Cathartic, 115,157 of Galbanum, Comp., 88,199 of Iodide of Iron, 191 of Iron. Compound, 190 Lady Webster's, 56 of Opium, 276 of Phosphorus, 289 of Rhubarb, 325 of Rhubarb, Compound, 325 Tanjore, 722 Pill-masses, 460 Pills, 460, 496 Coated, 501 Compressed, 501, 502, 507 Excipients for, 497 Formulae for, 502 Process of making, 496 Official, 460 Substances suitable for, 498 Substances unsuitable for, 499, 500 Pilocarpine, 297 Pilocarpus, 297 Pilulse, 460, 496 Pimenta, 299 Pimpinella Anisum, 68 Pimples.—See Acne, 518 Pine, Prince’s, 134 Yellow, 375 Pines, 301 Pinipicrin, 378 Pinites Succinifer, 367 Pink, Carolina, 363 Pink-root, 363 Pinus, 301 Australis, 375 Palustris, 301 Piper, 299 angustifolium, 259 methysticum, 241 Piperine, 299 Pipsissewa, 134 Piscidia, 300 Piscidin, 300 Pissenlit, 374 Pistaceae Terebinthus, 375 Pistacia Lentiscus, 259 Pitch, 301 Burgundy, 301 Canada, 301 Hemlock, 301 Pityriasis, 695 Pix, 301 Pix Liquid a, 301 Planat’s Tincture, 295 Plantago, 303 Plantain, 303 Plaster, Adhesive, 323 Ammoniac, 59 Plaster, Ammoniac, with Mercury, 59 Arnica, 83 Asafetida, 88 Belladonna, 95 Capsicum, 122 Carbolic Acid, 22 Galbanum, 199 Ichtbyocolla, 229 Iron, 191 Lead, 304 Mercurial, 217 Opium, 277 Pitch, Burgundy, 302 Pitch with Cantharides, 120, 302 Pitch, Canada, 302 Resin, 323 Soap, 347 Strengthening, 191 Warming, 302 Plasters, 463, 511 Formulae for, 512 Preparation of, 464 Plethora, 696 Abdominal, 515 Pleurisy, 696 Diagnosis of, 777 Pleurisy-root, 89 Pleuritis, 696 Pleurodynia, 697 Pleuro-pneumonia, 697 Plumbum, 303 Plummer’s Pills, 70 Pneumonia, 697 Diagnosis of, 777 Podopyhyllin, 307 Podophyllitoxin, 307 Poisoning by Acids, 768 Acid, Acetic, 768 Arsenious, 87, 769 Carbolic, 23, 768 Chromic, 24 Gallic, 26 Hydrocyanic, 31, 768 Mineral, 28, 768 Oxalic, 768 Sulphuric, 768 Sulphurous, 36 Tannic, 38 Aconite, 41, 768 Agaricus, 49 Alcohol, 53. 768 Alkalies, 312, 362, 769 Alum, 769 Ammonia, 62, 769 Antimony, 71, 769 Arsenic, 87, 769 Atropine, 97, 769 Barium, 769 Bees, 769 Belladonna, 97, 769 Bromides, 105 Camphor, 116, 769 Cannabis Indica, 119, 769 Cantharis, 121, 769 Chloral, 138, 769 Chlorine, 144, 769 Chloroform, 140, 769 Coculus Indicus, 772 Colchicum, 156, 770 Conium, 159, 770 Copper, 168, 770 INDEX. 819 Creasote,770 Curare, 170 Digitalis, 174, 770 Duboisine, 176 Ergot, 180 Ether, 45, 769 Fish, 770 Gamboge, 770 Gas, Carbonic Acid, 770 Sulphuretted Hydrogen, 770 Gelsemium, 201, 770 Glass, 770 Gold Salts, 92, 770 Hyoscyamus, 228 Insects, 769 Iodine, 233, 770 Ipecacuanha, 236 Iron, 770 Lead, 305, 770 Lime. 112, 770 Lobelia, 251 Mercury, 222. 771 Mezereum, 771 Muscarine, 49 Morphine, 281, 771 Mushrooms, 771 Nitrites, 66 Nux Vomica, 272, 772 Oak or Ivy, 329, 772 Opium, 281, 771 Phosphorus, 291, 771 Physostigna, 293, 771 Picrotoxin, 296, 772 Pilocarpine, 298 Potassa, 312 Potassium Salts, 772 Pulsatilla, 317 Quinine, 153, 772 Reptiles, 772 Resorcin. 324 Rhus, 329, 772 Sanguinaria, 343 Silver Salts, 81, 772 Sodium, 362 Stramonium, 366 Strychnine, 272, 772 Sulphur, 370 Sulphuretted Hydrogen, 37C, 770 Sumach, 329, 772 Tin.772 Tobacco, 373, 772 Turpentine, 377 Vegetable Poisons, 772 Veratrum Viride, 389, 772 Zinc Salts, 396, 772 Poisoning, 433, 767 Antidotes and Antagonists, 433 Indications for Treatment, 433 General Principles, 767 Poisonous Compounds, 483 Poisons, Energetic, 767 Poke-berry, 294 Poke, Indian, 387 Poke-root, 294, 387 Polygala Senega, 353 Polygonum Hydropiperoides, 308 Polyporus fomentarius, 48 Polypus, 699 Polyuria.—See Diabetes Insipidus, 576 Pomade de Bareges, 696 Pomegranate, 25, 208 Pond’s Extract, 213 Pond Lily. 25 Podophyllum, 307 Pongamia, 308 Poppy. White, 274 Porphyrization, 441 Porphyroxin, 343, 275 Porrigo Capitis.—Tinea Tonsurans, 729 Porter, 51 Port Wine, 51 Potassa, 309 Alum, 57 cum Calce, 309 Sulphurata, 369 Potassio Cupric-Tartrate, 167 Potassium, 309 Potato, 176 Potus, 493 Poultices, 512, 699 List of Br. official, 512 Powder of Aloes and Canella, 56 Antimonial, 70 Aromatic. 155 Chalk, Compound, 111 Dover’s, 236, 277 Effervescing, Comp., 310 Gray, 217 Ipecac and Opium, 236, 277 Jalap, Compound, 238 James’, 70 Kino, Compound, 242 Liquorice, Compound, 205 Morphine, Compound, 277 Opium, 275 Rhubarb, Compound, 325 Seidlitz, 310 Tully’s, 277 Powders, 461,505 Formulae for, 506, 507 Substances suitable to, 506 Precipitant Solutions, Table of, 481 Precipitate, White, 217 Precipitation, 443 Pregnancy, Disorders of, 700 Signs of, 782 Vomiting of, 743 Premna tatiensis, 382 Preparations, Acteous, 458 Alcoholic, 452 Aqueous, 448 Ethereal, 456 Extemporaneous, 486 Gaseous, 513 Glycerin, 458 Official, 448 * Oleaginous, 457 Solid, 458 Prepositions, 764 Prescriptions, 470 Analysis of, 471 Blanks for, 475 Filling of, 478 Metric, 468 Renewals of, 476 Prescription-Writing, 474 Prickly Heat.—See Lichen, 658 Prince’s Pine, 134 Prinos, 314 Proctitis.—See Rectum, 708 Prolapsus Ani, 700 Uteri, 700 820 INDEX. Propyl Oxide. 264 Propylamine, 83 Prosopalgia.—See Neuralgia, Odontalgia, Tic Douloureux. Prostate, Hypertrophied, 701 Prostatitis, 701 Prostatorrhcea, 701 Protectives, 431 Protiodide of Mercury, 218 Protopine, 275 Prune, 315 Prunum, 315 Prunus domestica, 315 Laurocerasus, 29 serotina, 315 Virginiana, 315 Prurigo, 701 Pruritus, 702 Pseudaconitine, 39 Pseudo-jervine, 387 Pseudo-morphine, 275 Pseudotropine, 226 Psoriasis, 703 Ptelea trifoliata, 328 Pterocarpus marsupium, 242 santalinus, 345 Pterygium, 704 Ptosis, 704 Ptyalism, 704 Puccine, 343 Puerperal Convulsions, 705 Disorders, 705 Fever, 705 Mania, 706 Melancholia, 706 Peritonitis, 706 Puff-ball, 246 Pulmonary Sedatives, 409 Pulsatilla, 316 Pulse, 706 Pulveres, 461, 505 Pulverization, 440 Pumpkin-seed, 286 Punica Granatum, 208 Purgatives, 416 Purging Agaric, 47 Cassia, 129 Purpura, 707 Pustule, Malignant, 707 Pustules.—See Ecthyma, Eruptions, Im- petigo, Pustule Malignant. Pustulants, 429 Pya;mia, 707 Pyrethrine, 318 Pyrethrum, 318 * Roseum, 318 Pyridin, 372 Pyrocatechin, 151, 301, 323 Pyrophosphate of Iron, 191 of Sodium, 290 Pyrosis, 708 Pyroxylin, 206 Quassia, 319 Surinam, 319 Quassin, 319 Quebraehine, 320 Quebracho, 320 Queen's Delight, 364 Root, 364 Quercin, 321 Quercitrin,321 Quercus Alba, 25, 321 Lusitanica, 199, 321 Tinctoria, 321 Quicksilver, 217 Quillaia, 321 Quince-seed, 170 Quinetum, 150 Quinidine, 148 Quinine, 148 Mixture, 490 Quinoidin-, 150 Quinquinine, 150 Quinsy.—See Tonsillitis, 730 Rabies.—See Hydrophobia, 642 Rachitis, 708 Radway's Ready Relief, 767 Resolvent, 767 Raspail’s Eau Sedatif, 61, 63,116 Raspberry, 334 Rectum, Absorption by, 13 Diseases of, 708 Ulceration of, 708 Red Gum.—See Strophulus, 723 References and Bibliography, 514 Refrigerants, 413 Relapsing Fever, 709 Remittent Fever, 709 Diagnosis of, 779 Renal Depressants, 423 Renewals of Prescriptions, 476 Repercolation, 446 Resin, 322 Cerate 322 of Copaiba, 162 of Jalap, 238 Plaster, 323 of Podophyllum, 307 of Scammony, 350 Resina, 322 Resinse, 460 Resolvents, 420 Resorcin, 22, 323 Respiration.—See Bronchitis,Croup,Dysp- noea, Emphysema, Pneumonia, etc. Respiration, Agents affecting, 408 Respiratory Depressants, 408 Stimulants, 408 Restoratives, 419 Retina, Affections of, 709 Rhamnoxanthin, 198 Rhamnus Frangula, 197 Purshiana. 128 Rhapliidophora vitiensis, 381 Rhatanine, 242 Rhatany, 25, 242 Rheum, 324 Rheumatic Arthritis, 710 Rheumatism, Acute, 710 Chronic, 712 Diagnosis of, 776 Gonorrhoeal, 713 Muscular, 714 Rhinacanthin, 326 Rhinacanthus, 326 Rhinitis.—See Catarrh Acute Nasal, also Nasal Affections. Rhoeadine, 275 Rhubarb, 324 Rhus Aromatica, 327 INDEX. 821 Rhus Diversiloba, 328 glabra, 327 pumila, 328 radicans, 328 Toxicodendron, 328 venenata, 328 Ricinus communis, 330 Rickets.—See Rachitis, 708 Rigors.—See under Fever, 605 Ring-worm, 728 Roasting, 440 Rochelle Salt, 310 Rosa centifolia, 331 Damascena, 332 Galliea, 25, 332 Rosanilin, 198 Rose, 25 Attar of, 332 Cabbage, 331 Pale, 331 Red, 332 Ros6ine, 198 Rosemary, 25, 333 Roseola, 714 Rosin, 322, 375 Rosmarinus, 333 Rottlera, 241 tinctoria, 241 Rottlerin, 241 Rubefacients, 429 Rubeola.—See Measles, 664 Rubijervine, 387 Rubini’s Tincture, 116 Rubus, 25, 333 Canadensis, 333 Id*us, 334 occidentalis, 334 trivialis, 334 strigosus, 334 villosus, 333 Rue, 335 Rules for Incompatibility, 485 for Pharmaceutists, 480 Rum, 51 Bay, 267 Rumex, 334 Rumicin, 335 Rupia.—See Pemphigus, 687 Ruta, 335 Russian Spirit, 713 Rye, 178 Sabadilla, 387 Sabina, 336 Saccbarum, 337 Lactis, 339 Sacred Bark, 128 Safflower, 165 Saffron, 165 American, 165 Meadow, 155 Saffron-tea, 165 Sage, 341 Salicin, 340 Salicylate of Cinchonidine, 150 of Cocaine, 183 of Lithium, 340 of Methyl, 200 of Physostigmine, 293 of Sodium, 340 Saligenin, 340 Saline Mineral Waters, 76 Purgatives, 416 Saliva, Agents affecting, 418 Salivation, 220, 413 See also Ptyalism, 704 Salix, 339 Salol, 792 Salt, Epsom, 253 Glauber’s, 360 Salt, Rochelle, 310 Salt-petre, 330 Chili, 360 Salt-rheum —See Eczema, 591 Salts, Deliquescent, List, 500 Efflorescent, List of, 500 Salve, Red Lip, 378 Salvia, 341 Sal viol, 342 Sambucus, 342 Sandal-wood Oil, 344 White, 344 Yellow, 344 Sanguinaria, 342 Sanguinarine, 133, 343 Santalum Album, 344 citrinum, 344 Rubrum, 345 Santonica, 345 Santonin, 345 Santoninate of Sodium, 345 Sapo, 346 Animalis, 347 Medieatus, 347 Mollis, 347 Viridis, 347 Sapogenin, 353 Saponification, 347 Saponin, 130, 246, 322, 353 Sarcin*, 714 Sarcocele.—See under Cancer, Testicles. Sarothamnus Scoparius, 352 Sarsaparilla, 348 Sassafras, 349 Medulla, 349 Swamp, 254 Sassy Bark, 127 Saunders, Red, 345 Savine, 336 Sayre’s Method of administering Chloro- form, 142 Scabies, 714 Scald-head.—See Eczema, Tinea Tonsu- rans, etc. Scalds, 542 Scammonium, 350 Scammony, 350 Scarlet Fever, 715 Diagnosis of, 777 Sciatica, 716 Scilla, 350 Scillin, 351 Scillipierin, 351 Scillitin, 351 Scillitoxin, 351 Scirrhus.—See Cancer, 545 Diagnosis of, 774 Sclere rythrin, 178 Scleroderma, 717 Scleromucin, 178 Scleroxanthin, 178 Scoparin, 352 822 INDEX. Scoparius, 352 Scorbutus.—-See Scurvy. 718 Screaming.—See Nightmare, 677 Scrofulosis, 717 Scudamore’s Mixture, 619 Scurvy, 718 Scutellaria, 352 Scutellarin, 353 Sea-sickness, 718 Seborrhaea, 718 Sea-wrack, 198 Secale cereale, 178 Secalin, 393 Sedatives. 400 Cardiac, 411 Gastric, 415 Pulmonary, 409 Urinary, 424 Vascular, 412 Vesical, 424 Seidlitz Powder, 310 Senega, 353 Senegin, 353 Senna, '354 Sennacrol, 354 Senapicrin, 354 Separation, 443 Septicaemia, 707 Serpentaria, 355 Serpent-bites.—See Poisoning by Reptiles, also Stings. Sesamum, Oil of, 356 Sevum, 356 Shampoo Mixtures, 695 Sheep, 356 Sherry Wine, 51 Shingles.—See Herpes Zoster, 640 Sialogogues, 413 Sickness at Stomach.—See Nausea, Sea- sickness, Vomiting. Siddhi, 118 Silicate of Magnesium, 357 Hydrated, 357 of Potassium, 310, 357 of Sodium, 357 Silicious Mineral Waters, 77 Silver, 80 Sinalbin, 358 Sinapine, 358 Sinapis, 357 Alba, 357 Nigra, 358 Singultus.—See Hiccough, 640 Sinigrin, 358 Sinistrin, 351 Skin, Agents affecting, 429 as an Absorbent, 14 Skin Diseases.—See Acne, Boils, Burns, Carbuncles, Chapped Hands and Lips, Chilblains, Condylomata, Ec- chymosis, Ecthyma, Eczema, Ele- phantiasis, Eruptions, Erysipelas, Erythema, Freckles, Herpes, Herpes Zoster, Ichthyosis, Impetigo, Intertri- §o, Lichen, Lupus, Mentagra, Nsevus, nychia, Pemphigus, Phlegmon, Pityriasis, Prurigo, Pruritus, Psori- asis, Roseola, Scabies, Scleroderma, Seborrhoea, Strophulus, Syphilis, Tin- ea, Ulcer, Urticaria, Wart) Wen. Scull-cap, 352 Sleep, Abnormal.—See Delirium, Insom- nia Nightmare, Somnambulis m Slippery Elm Bark, 383 Small-pox, 741 Diagnosis of, 777 Smart-weed, 308 Smell, Agents affecting, 407 Smilacin, 348 Smilax, 348 Snake-root, Black, 146 Virginia, 355 Sneezing 719 Agents producing, 408 See also Catarrh, Hay Fever, Influ- enza. Soaloin, 55 Soap, 346 Bark, 321 Curd, 347 Green, 347 Insoluble, 347 of Lead Monoxide, 347 of Lime, 347 Soft, 347 Soda, Caustic, 359 Chlorata, 143 Chlorinated, 143 Sodium, 359 Solanine, 176 Solanum Dulcamara, 176 Solid Preparations, 458 Soluble Substances, 487 Solution, 441 Aids to, 487 Circulatory, 441 of Aluminium Benzoate, 59 of Ammonium Acetate, 60 of Arsenious Acid. 85 of Arsenic and Mercuric Iodide, 85 Donovan’s, 85 Fowler’s, 85 of Gutta-percha, 212 of Iodine, Compound, 231 of Iron Acetate, 190 of Iron Citrate, 190 of Iron Chloride, 190 of Iron Nitrate, 191 of Iron and Quinine Citrate, 193 of Iron Subsulphate, 192 of Iron Tersulphate, 192 of Lead Subaeetate, 304 of Lead Subacet., Dilute, 304 of Lime, 112 of Lime, Chlorinated, 143 of Lime, Saccharated, 23 Labarraque’s, 143 Lugol’s, 231 Magendie’s, 277 of Magnesium Citrate, 253 of Mercuric Nitrate, 218 of Morphine Sulphate, 277 of Opium, Compound, 276 Pancreatic, 284 Pearson’s, 85 of Pepsin, 287 of Potassa, 309 of Potassium Arsenite, 85 of Potassium Citrate, 310 of Potassium Silicate, 317 of Soda, 359 of Soda Chlorinated, 143 INDEX. 823 Solution of Sodium Arseniate, 85 of Sodium Silicate, 357 of Thymol, 379 of Zinc Chloride, 395 Solutions (Liquores), 449 Precipitant, Table of, 481 Stock, 479 Solvents, 441 Somnambulism, 719 Sores, 734 Sorghum, 337 Sorrell, 334, 768 Sozodont, 766 Spanish Flies, 120 Sparteine, 352 Spasmodic Affections, 719 Spearmint, 263 Specific Gravity and Volume, 470 Table of, 794 Spermaceti, 132 Spermatorrhoea, 719 Spigelia. 363 Spina Bifida, 720 Spinal Concussion, 720 Congestion, 720 Inflammation.—See Meningitis, Mye- litis. Irritation, 721 Paralysis, 721 Softening, 721 Spirit of Ammonia, 60 of Ammonia, Aromatic, 60 of Ammonia, Fetid, 88 of Anise, 68 of Camphor, 115 of Chloroform, 140 of Cinnamon, 154 of Ether, 43 of Ether, Compound, 43 of Nitrous Ether, 43 of Gaultheria, 200 Grain, 52 of Hedeoma, 214 of Juniper, 240 of Juniper, Compound, 240 of Lavender, 245 of Lemon, 247 of Mentha Piperita, 262 of Mentha Viride, 263 of Myrcia, 267 of Myristica, 268 of Nutmeg, 268 of Orange, 91 of Pennyroyal, 214 of Peppermint, 262 Potato, 52 Proof, 51 Rectified, 51 Russian, 713 of Spearmint, 263 of Turpentine, 45, 375 Wood, 52 Spirits (Spiritus), 456 Spleen, Affections of, 721 Spongia Usta, 717 Spotted Fever.—See Typhus Fever, Men- ingitis Cerebro-spinal. Sprains, 721 Spruces, 301 Spunk, 48 Squamse.—See Ichthyosis, Pityriasis, Pso- riasis. Squaw-root. 131 Squibb’s Mixture, 276, 555 Squill, 350 St. Ignatius’ Bean, 229 St. Jacob's Oil, 40 Stains, 721 Stammering, 722 Staph isagria, 363 Star Anise, 68, 230 Starch, 67, 338 Iodized, 231 Statice, 25 Stavesacre, 363 Sterility, 722 Sternutatories, 408 Stigmata Maydis, 394 Stillingia. 364 Stimulants, 399 Cardiac, 410 Hepatic, 417 Local, 401 Respiratory, 408 Vascular, 411 Stings, 722 Stock Solutions, 479 Stomach Diseases.---See Dyspepsia, Gas- tralgia, Gastric Ulcer, Gastritis, etc. Stomachics, 413 Stomatitis, 722 Stone.—See Calculi, 544 Storax, 366 Strabismus, 723 Straining, 442 Stramonium, 365 Strangury.—See Cystitis, Dysuria. Stricture.—See Rectum, Urethral Stric- ture. Stricture of Urethra, 736 Strophulus, 723 Struma.—See Scrofulosis, 717 Strychnine, 229, 270 Strychnos Ignatii, 229 Gaultheriana, 791 Nux-Vomica, 270 Sturgeon, 228 Stye.—See Eyelids, 604 Styptic Collodion, 38 Styptics, 430, 633 Styracin, 367 Styrax, 366 Benzoin, 99 Styrol, 367 Subcarbonate of Bismuth, 101 Subchloride of Mercury, 217 Sublimation, 438 Subnitrate of Bismuth, 101 Substances best given alone, 485 difficult to combine in pill, 499 suitable for mixtures, 486 suitable for pills, 498 suitable for powders, 506 unsuited to pill-form, 500 Subsulphate of Iron, 192 of Mercury, Yellow, 218 Succinum, 367 Sudorifics, 425 Suet, 356 Sugar, 337 Beet, 337 824 INDEX. Sugar Cane, 337 Diabetic, 338 Fruit, 338 Grape, 338 of Lead, 303 . of Milk, 339 Starch, 338 in Urine, Tests for, 787 Sulphate of Aluminium, 58 of Aluminium and Ammonium, 57 of Aluminium and Potassium, 57 of Ammo i ium, 60 of Atropine, 95 of Cadmium, 108 of Cinchonidine, 150 of Cinchonine, 150 of Copper, 167 of Doboisine, 175 of Hyoscyamine, 227 of Iron, 192 of Iron, Dried, 192 of Iron, Precipitated, 192 of Iron and Ammonium, 192 of Magnesium, 253 of Manganese, 256 of Morphine, 277 of Potassium, 310 of Quinidine, 150 of Quinine, 149 of Sodium, 360 of Strychnine, 270 of Tetra-hydromethyl-chinoline, 151 of Zinc, 395 Sulphide of Allyl, 88 of Antimony, 70 of Antimony, Purified, 70 of Calcium, 369 of Hydrogen, 369 of Mercury, Red, 218 Sulphite of Magnesium, 36, 253 of Potassium, 36 of Sodium, 36 Sulpho-carbolate of Sodium, 22 Sulpho-cyanate of Aerinyl, 358 Sulpho-cyanide of Allyl, 358 Sulphur, 368 Liver of, 369 Lotum, 368 Milk of, 368 Precipitated, 368 Sublimed, 368 Washed, 368 Sulphurated Antimony, 70 Lime, 369 Potassa, 369 Sulphuretted Hydrogen, 369 Sulphurous Mineral Waters, 77 Sumach, Poison, 328 Smooth, 327 Swamp, 328 Sweet, 327 Sumbul. 371 Sunstroke, 723 Suppositoria, 462, 508 Suppositories, Formulae, 510 Official in Br. Phar., 509 of Tannic Acid, 38 Suppuration, 723 Surgeon’s Agaric, 48 Surgical Fever, 723 Svapina, 276 Swallowing.—See Dysphagia; CEsopha- gus, Disorders of. Swamp Sassafras, 254 Sweet Bay, 254 Flag, 111 Gum, 366 Sycosis, 723 Sydenham's Laudanum, 276 Syncope, 724 Synovitis, 724 Syphilis, 724 Syrup of Acacia, 18 of Allium, 54 of Almond, 64 of Althaea, 57 of Amygdala, 64 of Citric Acid, 247 of Garlic, 54 of Ginger, 398 of Hydriodic Acid, 232 of Hypophosphites, 290 of Hypophos. with Iron, 193, 290 of Ipecacuanha, 236 of Iron Bromide, 104, 190 of Iron Iodide, 191 of Iron and Mang. Iodide, 193, 256 of Iron and Mang. Phosphate, 193 of Iron,Quinine and Strychnine Phos- phates, 193. 290 of Krameria, 242 of Lactophosphate of Calcium, 290 of Lactucarium, 244 of Lemon, 247 of Lime, 23,112 of Manganese Iodide, 256 of Orange, 91 of Orange-flowers, 91 of Phosphates, Compound, 290 of Prunus Virginiana, 315 of Rhubarb, 325 of Rhubarb, Aromatic, 325 of Raspberry, 334 of Rose, 333 of Rubus, 334 of Rubus, Aromatic, 334 of Rubus Idseus, 334 of Sarsaparilla, 348 of Sarsaparilla, Comp., 848 of Scilla, 351 of Squill, 351 of Squill, Compound, 70, 353 of Senega, 353 of Senna, 354 of Stillingia, Comp., 364 of Tar, 301 of Tolu, 94 of Wild Cherry, 315 of Zingiber, 398 Syrupi (Syrups), 449 Tabacum, 371 Tabellee Nitroglycerin!, 65 Tabes Mesenterica, 726 Table of Drops, etc., in f5j, 470, 795 of Latin Words, Phrases, etc., 749 for Metric Conversion, 796 of Precipitant Solutions, 781 of Specific Gravities and Volumes, 794 Tables of Differential Diagnosis, 773 of Weights and Measures, 466, 467 Tablets, 461 INDEX. 825 Tablets, Compressed, List of, 504 Hypodermic, List of, 504 Tag Alder, 55 Tamarind, 373 Tamar-Indien, 354 Tamarindus, 373 Tanacetin, 374 Tanacetum, 374 Tanjore Pill, 722 Tannate of Cannabin, 118,120 of Pelletierine, 208 Tannin, 37 and Iron, 486 Tansy, 374 Oil of, 374 Tea of, 374 Tapeworm, 90 Tar, 301 Tar-water, 301 Taraxacerin, 374 Taraxacin, 374 Taraxacum, 374 Tartar, Crude, 309 Emetic, 69 Tartra-borate of Potassium, 20, 545 Tartrate of Antimony and Potas., 69 of Chinoline, 135 of Iron and Ammonium, 192 of Iron and Potassium, 192 Potassio-Cupric, 167 of Potassium, 39, 310 of Potassium, Acid, 310 of Potassium and Sodium, 310 Tartrates, 39 Taste, Agents affecting, 407 Disordered, 726 Taurocholate of Sodium, 189 Teeniafuges, 419 Tsenise.—See Worms, 745 Tea, 109 German Breast, 57 Tansy, 374 Worm, 363 Teeth, 727 Agents affecting, 412 Teething—See Dentition, 576 Temperature of the Body, 780 Tenesmus.—See Dysentery, 584 Terchloride of Methyl, 139 Terebene, 377, 793 Terebinthina, 375 Canadensis, 375 Tersulphate of Iron, 192 Testa Prseparata, 112 Testicles, 727 Testing, 447 Tests for Morphine, 278 for Opium, 278 Tetanus, 727 Tetrachloride of Carbon, 45,140 Tetter.—See Herpes, Pityriasis, Psoriasis. Thallin, 151 Thebaine, 275, 280 Theine, 109 Theobroma Cacao, 110, 377 Theobromine, 378 Therapeutical Incompatibility, 484 Therapeutics, 9 Applied, 10, 514 Empirical, 10 Natural, 10 Therapeutics, Rational, 11 Special, 514 Thenaca, 338 Thermometer, Clinical, 780 Thimble-berry, 334 Thirst, 727 Agents allaying, 413 Thistle, Blessed, 126 Thorn-apple, 365 Thorough-wort, 188 Throat.—See Aphonia, Croup, Diphthe- ria, Laryngitis, Pharyngitis, Scarlet Fever, Tonsillitis, etc. Throat, Sore, 728 Thrush.—See Aphth0e,528 Thuja. 378 Thujetin, 378 Thujin, 378 Thyme, Garden, 379 Thymene, 379 Thymol, 379 Thymus vulgaris, 379 Tic Douloureux, 728 Tiglii Oleum, 380 Tincture of Aconite, 40 of Ailanthus, 50 of Aloes, 56 of Aloes and Myrrh, 56 of Arnica-flowers, 83 of Arnica-root, 83 of Asafetida, 88 of Aurantium Amarum, 91 of Aurantium Dulce, 91 of Baptisia, 94 of Belladonna, 95 of Benzoin, 99 of Benzoin, Compound, 99, 367 of Berberis, 100 of Bryonia, 106 of Calendula, 113 of Cannabis Indica, 118 of Cantharides. 120 of Capsicum, 122 of Cascarilla, 129 of Catechu, Compound, 130 of Chirata, 136 of Cimicifuga, 146 of Cinnamon, 155 of Cinchona, 149 of Cinchona, Compound, 149 of Cocculus, 295 of Colchicum, 156 of Conium, 158 of Coto, 164 of Crocus, 165 of Cubeb, 166 of Digitalis, 173 of Duboisia, 175 of Eucalyptus, 186 of Euphrasia, 189 of Galls, 199 of Gelsemium, 201 of Gentian, Compound, 202 of Ginger, 398 of Guaiac, 210 of Guaiac, Ammoniated, 210 of Hemp, Indian, 118 of Hops, 216 of Humulus, 216 of Hydrastis, 225 of Hyoscyamus, 227 826 INDEX. Tincture of Ignatia, 229 of Iodine, 231 of Ipecac and Opium, 236 of Iron Acetate, 190 of Iron Chloride, 190 of Kino, 242 of Krameria, 242 of Lavender, Compound, 245 of Lobelia, 251 of Lupulin, 216 of Matico, 259 of Musk, 266 of Myrrh, 269 of Nitro-glyeerin, 65 of Nutgali, 199 of Opium, 276 of Opium, Camphorated, 276 of Opium, Compound, 276 of Opium, Deodorized, 276 of Opium and Ipecac, 277 of Orange Peel, Bitter, 91 of Orange Peel, Sweet, 91 of Phosphorus, 289 of Physostigma, 293 of Phytolacca, 294 of Pulsatilla, 316 of Pyrethrum, 318 Pyrexialis, 150 of Quassia, 319 of Quebracho, 320 of Rhubarb, 325 of Rhubarb, Aromatic, 325 of Rhubarb, Sweet, 325 of Rhus Toxicodendron, 328 of Sanguinaria, 343 of Serpentaria, 355 of Soap, Green, 347 of Squill, 351 of Stillingia, 364 of Stramonium, 365 of Sumbul, 371 of Thuja, 378 of Tolu, 94 of Valerian, 385 of Valerian, Ammoniated, 385 of Vanilla, 386 of Veratum Viride, 387 of Viseum, 391 of Zingiber, 398 Tinctur®, 454 Tinea Circinata, 728 Decalvans, 729 Favosa, 729 Sycosis.—See Mentagra, 668 Tonsurans, 729 Tobacco, 371 Symptoms.—See Nervousness, 674 Toe-nails.—See Nails, 671 Tolene, 94 Tomato, 176 Tonga, 381 Tongine, 382 Tongue, 729 Tonics, 420 Cardiac, 411 Formulae, 520, 525 Gastric, 413 Hair, 522 Pills for Women, 503 Uterine, 428 Vascular, 412 Tonics, Vesical, 424 Tonsillitis, 730 Tonsils, Enlarged, 730 Ulcerated, 731 Toothache.—See Odontalgia, 673 Toothrash.—See Strophulus, 723 Torrefaction, 440 Torticollis. 731 Torulse.—See Sareinae, 714 Tracheitis.—See Croup, 569 Trachoma.—See Conjuctivitis Granular, Ophthalmia, 562, 680 Tragacantha, 382 Traumaticine, 212 Traumatic Fever, 723 Treacle, 338 Tree of Heaven, 49 Tri-chloracetyl Hydride, 136 Trieophytosis Capitis.—See Tinea, 729 Trimethylamine, 83, 84,178, 215, 393 Trinitrophenol, 35 Trinitrate of Glyceryl, 65 Trismus. 731 Triticum, 382 Vuigare, 67 Trituration, 440 of Elaterinum, 177 Triturationes, 462, 507 Triturations, Advantages of, 507 Formulae, 508 of Mercury, 218 Troches, 461 of Ammonium Chloride, 60 of Catechu, 130 of Chalk 112 of Cubeb, 166 of Ginger, 398 of Ipecac, 236 of Iron, 191, 386 of Krameria, 242 of Liquorice and Opium, 205, 277 List of, 504 of Magnesia, 253 of Morphine and Ipecac, 236, 277 of Peppermint, 262 of Potassium Chlorate, 310 of Santonin, 346 of Sodium Bicarbonate, 360 of Sodium Santoninate, 346 of Tannic Acid, 38 Trochisci, 461, 504 Tropeius, 96 Tropical Fruit-Laxative, 354 Tropin, 95 Trvpsin, 284 Tubercular Meningitis.—See Hydroceph- alus, Acute, 641 Tuberculosis.—See Phthisis, Scrofulosis, 693, 717 Tully’s Powder, 277 Tumors, 731 Diagnosis of, 774 Uterine, 731, 740, 774 Turnera aphrodisiaca, 171 Turpentine, 375 Canada, 375 Chian, 375 Oil of, 375 Venice, 375 Turpeth Mineral, 218 Tussilago, 718 INDEX. 827 Tympanitis, 731 Typhlitis, 731 Typhoid Fever, 732 Diagnosis of, 778 Typho-malarial Fever.—See Typhoid Fe- ver, 732 Typhus Fever, 734 Diagnosis of, 778 Dicers and Sores, 734 Ulcers of Stomach, 613 of Tonsils, 731 of Uterus, 740 Ulmus, 383 Umbelliferon, 199 Umbrella-tree, 255 Unguenta, 462, 510 Unguentum, 42,131, 463 « Urajmia, 736 Urea, Agents affecting, 418 Urethan, 793 Urethra, Stricture of, 736 Urethral Injections, 615, 618 Urethritis, 736 Urginea Scilla, 350 Uric Acid Diathesis.—See Lithsemia, 659 Urinary Astringents, 424 Disorders, 736 Sedatives, 424 Urine, Acidifiers of, 424 Alkalinizers of, 423 Examination of, 786 Urticaria, 737 Ursone, 200, 383 Ustilago, 393 Uterine Alteratives, 428 Cancer, 738 Congestion, 738 Depressants, 428 Diseases, 739 Displacements, 739 Hypertrophy, 738 Tonics, 428 Tumors, 740 Ulceration, 740 Uva Ursi, 383 Uvula, 740 Vaccination, 740 Vaginismus, 741 Vaginitis. 741 Valerene, 384 Valer an, 384 Valerianate of Ammonium, 60 of Butyl, 69 of Iron, 192 of Quinine, 149 of Zinc, 395 Valerianates, 385, 386 Valerol, 215, 384 Vallett’s Mass, 190 Van Buskirk’s Sozodont, 766 Vanilla, 386 Vanillin, 386 Vao, 169 Vapores, 513 Vaporization, 437 Vapors, 513 Varicella, 553, 741 Varicocele, 741 Varicosis, 741 Variola, 741 Diagnosis of, 777 Vascular Sedatives, 412 Stimulants, 411 Tonics, 412 Vaseline, 288 Vegetable Drugs, their Constituents, 436 Veins.—See Phlebitis, Phlegmasia, Vari- cosis. Veins, Transfusion bv, 13 Veil a rine, 226 Venous Medication, 13 Veratralbine, 387, 388 Veratrine, 387 Veratroidine, 387 Veratrum Album, 387 Sabadilla, 387 Viride, 387 Verbascum, 389 Verbs, 763 Vermicides, 419 Vermifuges, 419 Vertigo, 742 Verucca.—See Warts, 745 Vesical Tonics, 424 Sedatives, 424 Vesicants, 429 Viburnin, 390 Viburnum, 390 Compound, 391 Opulus, 390 Prunifolium, 390 Vienna Paste, 309 Villa te’s Solution, 169, 547 Vina ("See also Wines), 455 Vinegar, 19 Bitters, 767 of Lobelia. 251 of Opium, 276 of Sanguinaria, 843 of Squill, 351 Vinegars (Aceta), 458 Vinum, 51 Album, 51 Aromaticum. 51 Official (See W’ine of—) Portense, 51 Rubrum, 51 Xericum, 51 Viola Tricolor, 391 Violine, 391 Viscin, 391 Viscum, 391 Visions, Agents producing, 406 Vitellin, 392 Vitellus, 392 Vitriol, Elixir of, 35 Vomiting, 742 of Pregnancy, 743 Diagnosis of, 780 Vulva, Eczema, etc., of, 744 Vulvitis, 744 Wade’s Bougies, 510 Wafers, 605 Wah oo, 188 Walker’s Vinegar Bitters, 767 Warburg’s Tincture, 150,154 Warming-plaster, 120 Warts, 745 Wash, 493 828 INDEX. Wash, Black, 219 Yellow, 219 Washing, 441 Waste, Agents promoting, 421 Wasting.—See Atrophy, Emaciation, 532, 593 Wasting Diseases, 593 Water, 75 Almond Bitter, 64 of Ammonia, 60 of Ammonia, Stronger, 60 Anise, 68 Camphor, 115 Carbolic Acid, 22 Chlorine, 143 Cinnamon, 154 Creasote, 164 of Crystallization, 444 Distilled, 75 Elder-flower, 342 Fennel,.197 Laurel, 29 Orange-flower. 91 Peppermint, 262 Rose, 352 Spearmint, 263 Water-lily, 273 Waters (Aquae), 448 Mineral, 76, 79 Nomenclature, 75 Wax, 131 Weakness.—See Adynamia, Exhaustion, 519,603 Weights and Measures, 465 Apothecaries’, 467 British Pharmacopceial, 467 Metric, 468 Wen, 745 Whiskey, 50 White-leg.—See Phlegmasia, 692 White Swelling.—See Joints, Synovitis, 653, 724 Whitlow.—See Onychia, 679 Whooping-cough, 690 Willow, 339 Wine, 51 of Aloes, 56 of Antimony, 69 Aromatic, 51 Wine of Cocaine, 183 of Colehicum-root, 156 of Colchicum-seed, 1-56 of Ergot. 179 of Ipecac,936 of Iron, Bitter, 193 of Iron Citrate, 191 of Opium. 276 Port, 51 of Quebracho, 320 Red, 51 of Rhubarb, 325 Sherry, 51 of Tar, 302 of Tobacco, 372 White, 51 Wines (Vina), 51, 455 Winter-berry, 314 Wintergreen, 200 Witch-hazel, 25, 213 Wood-Oil, 211 Woorura, 169 Words and Phrases, Latin, 719 Sundry, 764 Worms, 745 Wormsecd, 133 Levant, 345 Worm Tea, 363 Wormwood, 18 Wounds, 746 Writer’s Cramp.—See Spasmodic Affec- tions, 719 Xantho-puecine 224 Xanthoxyline, 393 Xanthoxvlum, 392 Xeroderma.—See Ichthyosis, 643 Yam, Wild, 175 Yellow Fever, 747 Diagnosis of, 779 Ycrba Santa, 181 Yolk of Egg, 392 Zea Mays, 337, 393 Zincite, 394 Zineum, 394 Zingiber, 397 Zona.—See Herpes Zoster, 640 FINIS. CATALOGUE No. 7. DECEMBER, 1886. A CATALOGUE OF Books for Students; INCLUDING A FULL LIST OF The ? Quiz- Compends?, MANUALS, Text-Books and Students5 Aids, PUBLISHED BY P. BLAKISTON, SON & CO., Medical Booksellers, Importers and Publishers. LARGE STOCK OF ALL STUDENTS' BOOKS, AT THE LOWEST PRICES. No. 1012 WALNUT STREET, PHILADELPHIA. *** For sale by all Booksellers, or any book will be sent by mail, postpaid, upon receipt of price. Catalogues of books on all branches of Medicine, Dentistry, Pharmacy, etc., supplied upon application. PQUIZ-COMPENDS? A NEW SERIES OF COMPENDS FOR STUDENTS For Use in the Quiz Class and when Preparing for Examinations. Price of Each, Bound in Cloth, $1.00 Interleaved, $1.25. Based on the most popular text-books, and on the lec- tures of prominent professors, they form a most complete, practical and exhaustive set of manuals, containing infor- mation nowhere else collected in such a condensed, practical shape. Thoroughly up to the times in every respect, containing many new prescriptions and formulae, and over two hundred and thirty illustrations, many of which have been drawn and engraved specially for this series. The authors have had large experience as quiz- masters and attaches of colleges, with exceptional oppor- tunities for noting the most recent advances and methods. The arrangement of the subjects, illustrations, types, etc., are all of the most improved form, and the size of the books is such that they may be easily carried in the pocket. They are constantly being revised, so as to include the latest and best teachings, and can be used by students of any college of medicine, dentistry or pharmacy. No. 1. ANATOMY. 100 Illustrations. A NEW REVISED EDITION. A Compend of Human Anatom), including Visceral Anatomy, formerly published separately as No 8 of this series. By Saml. O. L. Potter, m.a., m.d., Late Surgeon U. S. Army; Professor of Practice, Cooper Medical College, San Francisco, ioo Illus. “ The work is reliable and complete, and just what the student needs in reviewing the subject for his examinations.”—The Physi- cian and Surgeon's Investigator, Buffalo, N. Y. “ The arrangement is well calculated to facilitate accurate memo- rizing, and the illustrations are clear and good.”—North Carolina Medical Journal. Nos. 2 and 3. PRACTICE. NEW REVISED EDITIONS. A Compend of the Practice of Mcuicine, especially adapted to the use of Students. By Dan’l E. Hughes, m.d., Demonstrator of Clinical Medicine in Jefferson Price of each Book, Cloth, $1.00. Interleaved for Notes, $1.25 Medical College, Philadelphia. Second Edition. En- larged and thoroughly Revised. In two parts. Part I.—Continued, Eruptive, and Periodical Fevers, Diseases of the Mouth, Stomach, Intestines, Peritoneum, Biliary Passages, Liver, Kidneys, Intestinal Parasites, etc., and General Diseases. 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Miller, M.D., Instructor in Histology, for- merly Demonstrator of Physiology, University City of New York. “ ‘ Quiz-Compend ’ No. 4 is fully up to the high standard estab- lished by its predecessors of the same series.”—Medical Bulletin, Philadelphia. “ I can recommend it as a valuable aid to the student.”—C. N. Ellinwood, M.D., Professor of Physiology, Cooper Medical Col- lege, San Erancisco. “ This is a well written little book.”—London Lancet. Price of each Book. Cloth, $1.00. Interleaved for Notes, $1 25 THE ? QUIZ-COMPENDS ?. 3 4 THE ? QUIZ-COMPENDS ?. No. 5. OBSTETRICS. Second Ed. A Compend of Obstetrics. For Physicians and Students. By Henry G. Landis, m.d., Professor of Obstetrics and Diseases of Women, in Starling Medical College, Columbus. New Revised Ed. New Illustrations. “ We have no doubt that many students will find in it a most valuable aid in preparing for examination.”—The American four- nal of Obstetrics. “ It is complete, accurate and scientific. The very best book of its kind I have seen.”—y. S. Knox, M.D., Lecturer on Obstetrics, Rush Medical College, Chicago. No. 6. MATERIA MEDIC A, THERAPEU- TICS AND PRESCRIPTION WRITING. Fourth Edition. A Compend on Materia Medica, Therapeutics and Prescription Writing, with especial reference to the Physiological Actions of Drugs. By Saml. O. L. Potter, m.a., m.d., Professor of Practice, Cooper Medical College, San Francisco, Late Surgeon U. S. Army. “ I have examined the little volume carefully, and find it just such a book as I require in my private Quiz, and shall certainly re- commend it to my classes. Your Compends are all popular here in Washington.”—fohn E. Brackett, M.D., Professor of Materia Medica and Therapeutics, Howard Medical College, Washington. “ Part of a series of small but valuable text-books. . . . While the work is, owing to its therapeutic contents, more useful to the medical student, the pharmaceutical student may derive much use- ful information from it.”—N. Y. Pharmaceutical Record. No. 7. CHEMISTRY. Revised Ed. A Compend of Chemistry. By G. Mason Ward, m.d., Demonstrator of Chemistry in Jefferson Medical Col- lege, Philadelphia. Including Table of Elements and various Analytical Tables. “ Brief, but excellent. ... It will doubtless prove an admirable aid to the student, by fixing these facts in his memory. It is worthy the study of both medical and pharmaceutical students in this branch.”—Pharmaceutical Record, New York. No. 8. DISEASES OF THE EYE AND REFRACTION. Compend on Diseases of the Eye and Refraction, in- cluding Treatment and Surgery. By L. Webster Fox, m.d., Chief Clinical Assistant, Ophthalmological Department, Jefferson Medical College Hospital; Price of each Book, Cloth, $1.00. Interleaved for Notes, $1.25. THE ? QUIZ-COMPENDS?. 5 Ophthalmic Surgeon, Germantown Hospital, Phila- delphia ; late Clinical Assistant at Moorfields, London, England, etc., and Geo. M. Gould, a.b. 6o Illus. No. 9. SURGERY. Second Edition. ILLUSTRATED. A Compend of Surgery; including Fractures, Wounds, Dislocations, Sprains, Amputations and other opera- tions, Inflammation, Suppuration, Ulcers, Syphilis, Tumors, Shock, etc. Diseases of the Spine, Ear, Eye, Bladder, Testicles, Anus, and other Surgical Diseases. By Orville Horwitz, a.m., m.d., Demonstrator of Anatomy, Jefferson Medical College, Philadelphia. With 62 Illustrations. Second Edition. Enlarged. *** This compend has been prepared with great care, from the standard authorities on Surgery and from notes taken by the author during attendance on lectures by prominent professors. “ Ail the essential facts of surgery are presented in a well- arranged and condensed manner.”—Medical Brief. “ Useful to the student in fixing the essentials firmly in his mind.”—Prof. G. F. Shears, Chicago. No. 10. ORGANIC CHEMISTRY. A Compend of Organic Chemistry, including Medical Chemistry, Urine Analysis, and the Analysis of Water and Food, etc. By Henry Leffmann, m.d., Pro- fessor of Clinical Chemistry and Hygiene in the Phila- delphia Polyclinic; Professor of Chemistry, Penn- sylvania College of Dental Surgery. “ Compact, substantial and exact; well suited as a remembrancer to students.”—Pacific Medical and Surgical Journal. “ It contains, in compact form, the most of modern organic and medical chemistry essential to the student of medicine, and will be of great value in bringing this subject within his grasp.”—C. C. Howard, Prof, of Chemistry, Starling Med. College, Columbus. “ It has the decided merit of being written in a clear and under- standable language.”—Dr. J. Sickels, Instructor in Chemistry, University Medical College, New York. No. 11. PHARMACY. A Compend of Pharmacy. Based upon “ Remington’s Text-Book of Pharmacy.” By F. E. Stewart, m.d., ph.g., Quiz Master in Chemistry and Theoretical Pharmacy, Philadelphia College of Pharmacy; De- monstrator and Lecturer in Pharmacology, Medico- Chirurgical College, and Woman’s Medical College; ? Quiz-Compends ? contain the latest and best infor- mation, in such a shape that it can be easily memorized. Price of each Book, Cloth, $1.00. Interleaved for Notes, $1.25. 6 ANATOMY. Holden’s Anatomy. A manual of Dissection of the Human Body. Fifth Edition. Enlarged, with Marginal References and over 200 Illustrations. Octavo. Cloth, 5.00; Leather, 6.00 Bound in Oilcloth, for the Dissecting Room, $4.50. “No student of Anatomy can take up this book without being pleased and instructed. Its Diagrams are original, striking and suggestive, giving more at a glance than pages of text description. * * * The text matches the illustrations in directness of prac- tical application and clearness of detail.”—New York Medical Record. Holden’s Human Osteology. Comprising a Description of the Bones, with Colored Delineations of the Attachments of the Muscles. The General and Microscopical Structure of Bone and its Development. With Lithographic Plates and Numerous Illus- trations. Sixth Edition. 8vo. Cloth, 6.00 Heath’s Practical Anatomy. Sixth London Edition. 24 Col- ored Plates, and nearly 300 other Illustrations. Cloth, 5.00 CHEMISTRY. Bartley’s Medical Chemistry. A text-book prepared specially for Medical, Pharmaceutical and Dental Students. With 40 Illustrations, Plate of Absorption Spectra and Glossary of Chemi- cal Terms. Cloth, 2.50 *** This book has been written especially for students and phy- sicians. It is practical and concise, dealing only with those parts of chemistry pertaining to medicine ; no time being wasted in long descriptions of substances and theories of interest only to the advanced chemical student. Bloxam’s Chemistry, Inorganic and Organic, with Experiments. Fifth Edition, nearly 300 Illustrations. Cloth, 3.75 ; Leather, 4.75 Richter’s Inorganic Chemistry. A text-book for Students. Second American, from Fourth German Edition. Translated by Prof. Edgar F. Smith, ph.d. 89 Wood Engravings and Colored' Plate of Spectra. Cloth, 2.00 Richter’s Organic Chemistry, or Chemistry of the Carbon Compounds. Translated by Prof. Edgar F. Smith, ph.d. Illustrated. Cloth, 3.00; Leather, 3.50 Watt’s (Fowne’s) Chemistry. 13th Edition. 2 Volumes. Volume 1, Inorganic, 2.25; Volume 2, Organic. 2.25 *** These volumes are based on Fowne’s Chemistry, being, in fact, the 13th edition of Fownes, etc. *S“ See pages 2 to 5 for list 0/ ? Quiz-Compen.ls ? STUDENTS’ TEXT-BOOKS AND MANUALS. STUDENTS’ TEXT-BOOKS AND MANUALS. 7 Chemistry:— Continued. Trimble. Practical and Analytical Chemistry. A Course in Chemical Analysis, by Henry Trimble, Prof, of Analytical Chem- istry in the Phila. College of Pharmacy. Illustrated. Second Edition. 8vo. Cloth, 1.50 Wolff's Applied Medical Chemistry. By Lawrence Wolff, m.d., Demonstrator of Chemistry in Jefferson Medical College, Philadelphia. Cloth, 1.50 CHILDREN. Goodhart and Starr. The Diseases of Children. A Manual for Students and Physicians. By J. F. Goodhart, m.d., Physi- cian to the Evelina Hospital for Children; Assistant Physician to Guy’s Hospital, London. American Edition, Revised and Edited by Louis Starr, m.d., Clinical Professor of Diseases of Children in the Hospital of the University of Pennsylvania; Physician to the Children’s Hospital, Philadelphia. Containing many new Prescriptions, a List of over 50 Formulae, conforming to the U. S. Pharmacopoeia, and Directions for making Arti- ficial Human Milk, for the Artificial Digestion of Milk, etc. Just Ready. Demi-Octavo, 738 Pages. Cloth, 3.00; Leather, 3.50 The New York Medical Record says ;—“ As it is said of some men, so it might be said of some books, that they are ‘born to greatness.’ This new volume has, we believe, a mission, particu- larly in the hands of the younger members of the profession. In these days of prolixity in medical literature, it is refreshing to meet with an author who knows both what to say, and when he has said it. The work of Dr. Goodhart (admirably conformed, by Dr. Starr, to meet American requirements) is the nearest approach to clinical teaching, without the actual presence of clinical material, that we have yet seen. The details of management so gratefully read by the young practiticner are fully elucidated. Altogether, the book is one of as great practical working value as we have seen for many months.” Day. On Children. A Practical and Systematic Treatise. Second Edition. 8vo. 752 pages. Cloth, 3.00; Leather, 4.00 Meigs and Pepper. The Diseases of Children. Seventh Edition. 8vo. Cloth, 5.00; Leather, 6.00 Starr. Diseases of the Digestive Organs in Infancy and Childhood. With chapters on the Investigation of Disease, and on the General Management of Children. By Louis Starr, m.d., Prof, of Diseases of Children, Hospital of the University of Pennsylvania. Illus. Cloth, 2.50 See /ages 2 to 5 for list of ? Quiz-Com/ends ? 8 STUDENTS’ TEXT-BOOKS AND MANUALS. DENTISTRY. Flagg’s Plastics and Plastic Filling. 2d Ed. Cloth, 4.00 Gorgas. Dental Medicine. A Manual of Materia Medica and Therapeutics, by Professor F. J. S. Gorgas, M.n., d.d.s , Pro- fessor of the Principles and Practice of Dental Science, in Den- tal Dept., University of Maryland. Second Edition. Cloth, 3.25 Harris’ Principles and Practice of Dentistry. Including Anatomy, Physiology, Pathology, Therapeutics, Dental Surgery and Mechanism. Eleventh Edition. Revised and enlarged by Professor Gorgas. 744 Illustrations. Cloth, 6.50 ; Leather, 7.50 Richardson’s Mechanical Dentistry. Fourth Edition. 458 Illustrations. 710 pages. 8vo. Cloth, 4.50; Leather, 5.50 Stocken’s Dental Materia Medica. Third Edition. Cloth, 2.50 Taft’s Operative Dentistry. Dental Students and Practitioners. Fourth Edition. 100 Illustrations. Cloth, 4.25 ; Leather, 5.00 Tomes’ Dental Anatomy, Human and Comparative. Sec- ond Edition. 191 Illustrations. Cloth, 4.25 Tomes’ Dental Surgery. New Revised Edition. Preparing. DICTIONARIES. Cleaveland’s Pocket Medical Lexicon. Thirty-first Edition. Giving correct Pronunciation and Definition of Terms used in Medicine and the Collateral Sciences. Very small pocket size, red edges. Cloth, .75 ; pocket-book style, 1.00 Longley’s Pocket Dictionary. The Student’s Medical Lexicon, giving Definition and Pronunciation of all Terms used in Medi- cine, with an Appendix giving Poisons and Their Antidotes, Abbreviations used in Prescriptions, Metric Scale of Doses, etc. 24mo. Cloth, 1.00; pocket-book style, 1.25 EYE. Arlt. Diseases of the Eye. Including those of the Conjunc- tiva, Cornea, Sclerotic, Iris and Ciliary Body. By Professor Fred. Ritter von Arlt. Translated by Dr. Lyman Ware. Illus- trated. 8vo. Cloth, 2.50 Higgins. Ophthalmic Practice. A Handbook for Students and Practitioners. i6mo. Cloth, .50 Macnamara. On Diseases of the Eye. Fourth Edition, revised, with Marginal References, numerous Colored Plates and Diagrams, Wood Cuts and Test Types. 'Cloth, 4.00 Morton. Refraction of the Eye. Its Diagnosis and the Cor- rection of its Errors. Third Edition. Illustrations and Test- types. Cloth, 1.00 6®” See pages 2 to 5 for list of ? Qun-Compends ? STUDENTS’ TEXT-BOOKS AND MANUALS. 9 HYGIENE. Parke’s Practical Hygiene. Sixth Edition, enlarged. Illus- trated. 8vo. Cloth, 3.00 Wilson’s Handbook of Hygiene and Sanitary Science. Sixth Edition. Revised and Illustrated. Cloth, 2.75 MATERIA MEDICA AND THERAPEUTICS. Biddle’s Materia Medica. Tenth Edition. For the use of Students and Physicians. By the late Prof. John B. Biddle, m.d., Professor of Materia Medica in Jefferson Medical College, Phila- delphia. The Tenth Edition, thoroughly revised, and in many parts rewritten, by his son, Clement Biddle, m.d., Past Assistant Surgeon, U. S. Navy, assisted by Henry Morris, m.d., Demon- strator of Obstetrics in Jefferson Medical College. 8vo., illus- trated. Just Ready. Cloth, 4.00 ; Leather, 4.75 “ The larger works usually recommended as text-books in our medical schools are too voluminous for convenient use. This work will be found to contain in a condensed form all that is most valuable, and will supply students with a reliable guide.”—Chicago Med. Jl. Merrell’s Digest of Materia Medica. 8vo. Half Calf, 4.00 Potter, Materia Medica, Pharmacy and Therapeutics. Including Action of Medicines, Special Therapeutics, Pharma- cology, etc. Cloth, 3.00; Leather, 3.50 Roberts’ Compend of Materia Medica and Pharmacy. By the author of “ Roberts’ Practice.” Cloth, 2.00 “ It contains an immense amount of matter.”—The National Druggist. Headland’s Action of Medicines. 9th Ed. 8vo. Cloth, 3.00 Waring. Therapeutics. With an Index of Diseases and an Index of Remedies. A Practical Manual. Fourth Edition. Revised and Enlarged. Cloth, 3.00; Leather, 3.50 MEDICAL JURISPRUDENCE. Reese. A Text-book of Medical Jurisprudence and Toxi- cology. By John J. Reese, m.d., Professor of Medical Juris- prudence and Toxicology in the Medical and Law Departments of the University of Pennsylvania ; Vice-President of the Med- ical Jurisprudence Society of Philadelphia; Physician to St. Joseph’s Hospital; Corresponding Member of The New York Medico-legal Society. Cloth, 3.00; Leather, 3.50 “ Professor Reese is so well known as a skilled medical jurist, that his authorship of any work virtually guarantees the thorough- ness and practical character of the latter. And such is the case in the book before us. * * * * We might call these the essentials for the study of medical jurisprudence. The subject is skeletonized, tfciT See pages 2 to 5 for list 0/ ? Quiz- Comp ends ? 10 STUDENTS’ TEXT-BOOKS AND MANUALS. Medical Jurisprudence :—Continued. condensed, and made thoroughly up to the wants of the general medical practitioner, and the requirements of prosecuting and de- fending attorneys. If any section deserves more distinction than any other, as to intrinsic excellence, it is that on toxicology. This part of the book comprises the best outline of the subject in a given space that can be found anywhere. As a whole, the work is everything it promises, and more, and considering its size, con- densation, and practical character, it is by far the most useful one for ready reference, that we have met with. It is well printed and neatly bound.”—New York Medical Record. Abercrombie’s Students’ Guide to Medical Jurisprudence. i2mo. Cloth, 2.50 Mann’s Manual of Psychological Medicine, and Allied Ner- vous Diseases. Their Diagnosis, Pathology and Treatment, and their Medico-Legal Aspects. Illus. Cloth, 5.00 ; Leather, 6.00 Woodman and Tidy's Medical Jurisprudence and Toxi- cology. Chromo-Lithographic Plates and 116 Wood engravings. Cloth, 7.50; Leather, 8.50 MISCELLANEOUS. Beale. Slight Ailments. Their Nature and Treatment. Illus- trated. 8vo. Paper cover, .75 ; Cloth, 1.25 Dulles. Surgical and other Emergencies. Illustrated. Sec- ond Edition, umo. Cloth, .75 Fothergill. Diseases of the Heart and Their Treatment. Second Edition. 8vo. Cloth, 3.50 Tanner. Memoranda of Poisons. Their Antidotes and Tests. Fifth Edition. i2mo. Cloth, .75 Allingham, Diseases of the Rectum. Fourth Edition. Illus- trated. 8vo. Paper covers, .75 ; Cloth, 1.25 OBSTETRICS AND GYNAECOLOGY. Parvin’s Winckel’s Diseases of Women. Edited by Prof. Theophilus Parvin, Jefferson Medical College, Philadelphia. 130 Illustrations. Cloth, 3.00; Leather, 3.50 Galabin’s Midwifery. A New Manual for Students. By A. Lewis Galabin, m.d., f.r.c.f., Obstetric Physician to Guy’s Hospital, London, and Professor of Obstetrics in the same Insti- tution. 227 Illustrations. Cloth, 3.00; Leather, 3.50 “ The illustrations are mostly new and well executed, and we heartily commend this book as far superior to any manual upon this subject.”—Archives of Gynaecology, New York, June, /88b. Rigby’s Obstetric Memoranda. By Alfred Meadows, m.d. 4th Edition. Cloth, .50 See pages 2 to S for list of ? Quiz- Contpends ? STUDENTS’ TEXT-BOOKS AND MANUALS. 11 Obstetrics and Gyncecology :—Continued. Meadows’ Manual of Midwifery. Including the Signs and Symptoms of Pregnancy, Obstetric Operations, Diseases of the Puerperal State, etc. 145 Illustrations. 494 pages. Cloth, 2.00 Swayne’s Obstetric Aphorisms. For the use of Students commencing Midwifery Practice. 8th Ed. i2mo. Cloth, 1.25 PATHOLOGY AND HISTOLOGY. Rindfleisch’s General Pathology. By Tyson. For Students and Physicians. By Prof. Edward Rindfleisch, of Wurzburg. Translated by Wm. H. Mercur, m.d., of Pittsburg, Pa., Edited by James Tyson, m.d., Professor of Pathology and Morbid Anatomy in the University of Pennsylvania. i2mo. Cloth, 2.00 Gilliam’s Essentials of Pathology. A Handbook foi Students. 47 Illustrations. i2mo. Cloth, 2.00 *** The object of this book is to unfold to the beginner the funda- mentals of pathology in a plain, practical way, and by bringing them within easy comprehension to increase his interest in the study of the subject. Though it will not altogether supplant larger works, it will be found to impart clear-cut conceptions of the generally accepted doctrines of the day, and to prevent confusion in the mind of the student. Gibbes’ Practical Histology and Pathology. Third Edition. Enlarged. i2mo. Cloth, 1.75 PHYSICAL DIAGNOSIS. Bruen’s Physical Diagnosis of the Heart and Lungs. By Dr. Edward T. Bruen, Assistant Professor of Clinical Medicine in the University of Pennsylvania. Second Edition, revised. With new Illustrations. i2mo. Cloth, 1.50 ***The subject is treated in a plain, practical manner, avoiding questions of historical or theoretical interest, and without laying special claim to originality of matter, the author has made a book that presents to the student the somewhat difficult points of Physi- cal Diagnosis clearly and distinctly . PHYSIOLOGY. Yeo’s Physiology. Second Edition. The most Popular Stu- dents’ Book. By Gerald F. Yeo, m.d., f.r.c.s., Professor of Physiology in King’s College, London. Small Octavo. 750 pages. Over 300 carefully printed Illustrations. With a Full Glossary and Index. Cloth, 3.00; Leather, 3.50 “ The work will take a high rank among the smaller text-books of Physiology.”—Pro/. H. P. Bowditch, Harvard Med. School, Boston. “ The brief examination I have given it was so favorable that I placed it in the list of text-books recommended in the circular of the University Medical College.”—Prof. Lewis A. Stimpson, M. D., 37 East 33d Street, New York. See pages 2 to 3 for list of ? Quiz-Compends ? 12 STUDENTS’ TEXT-BOOKS AND MANUALS. Physiology:—Continued. Kirke’s Physiology. nthEd. Ulus. Cloth,4.00; Leather, 5.00 Landois’ Human Physiology. Including Histology and Micro- scopical Anatomy, and with special reference to Practical Medi- cine. Second Edition. Translated and Edited by Prof. Stirling. 583 Illustrations. Cloth, 6.50; Leather, 7.50 “ So great are the advantages offered by Prof. Landois’ Text- book, from the exhaustive and eminently practical manner in which the subject is treated, that, notwithstanding it is one of the largest works on Physiology, it has yet passed through four large editions in the same number of years. Dr. Stirling’s annotations have materially added to the value of the work. . . . Admirably adapted for the practitioner. . . . With this Text-book at his command, no student could fail in his examination.”—Lancet. Sanderson’s Physiological Laboratory. Being Practical Ex- ercises for the Student. 350 Illustrations. 8vo. Cloth, 5.00 Tyson’s Cell Doctrine. Its History and Present State. Illus- trated. Second Edition. Cloth, 2.00 PRACTICE. Roberts’ Practice. Fifth American Edition. A Handbook of the Theory and Practice of Medicine. By Frederick T. Roberts, m.d. ; m.r.c.p., Professor of Clinical Medicine and Therapeutics in University College Hospital, London. Fifth Edition. Octavo. Cloth, 5.00; Leather, 6.00 *** This new edition has been subjected to a careful revision. Many chapters have been rewritten. Important additions have been made throughout, and new illustrations introduced. Recom- mended as a Text-book at University of Pennsylvania, Long Island College Hospital, Yale and Harvard Colleges, Bishop’s College, Montreal, University of Michigan, and over twenty other Medical Schools. “ I have become thoroughly convinced of its great value, and have cordially recommended it to my class in Yale College.”— Prof. David P. Smith. “ I have examined it with some care, and think it a good book, and shall take pleasure in mentioning it among the works which may properly be put in the hands of students.”—A. B. Palmer, Prof, of the Practice of Medicine, University of Michigan. “ A clear, yet concise, scientific and practical work. It is a capi- tal compendium of the classified knowledge of the subject.”— Prof. f. Adams Allen, Rush Medical College, Chicago. “ It is unsurpassed by any work that has fallen into our hands, as a compendium for students preparing for examination. It is thoroughly practical, and fully up to the times.”—The Clinic. Aitken’s Practice of Medicine. Seventh Edition. 196 Illus- trations. 2 vols. ' Cloth, 12.00; Leather, 14.00 Tanner’s Index of Diseases, and Their Treatment. Cloth, 3.00 “ This work has won for itself a reputation. ... It is, in truth, what its Title indicates.”—N. V. Medical Record. tfii~ See pages 2 to J for list of ? Quiz- Compends ? STUDENTS' TEXT-BOOKS AND MANUALS. 13 PRESCRIPTION BOOKS. Wythe’s Dose and Symptom Book. Containing the Doses and Uses of all the principal Articles of the Materia Medica, etc. Sixteenth edition. 32010. Cloth, 1.00; Pocket-book style, x.25 Pereira’s Physician’s Prescription Book. Containing Lists of Terms, Phrases, Contractions and Abbreviations used in Prescriptions, Explanatory Notes, Grammatical Construction of Prescriptions, etc., etc. By Professor Jonathan Pereira, m.d. Sixteenth Edition. 32010. Cloth, 1.00; Pocket-book style, 1.25 SKIN DISEASES. Van Harlingen on Skin Diseases. A Handbook of the Dis- eases of the Skin, their Diagnosis and Treatment. By Arthur Van Harlingen, m.d., Prof, of Diseases of the Skin in the Phila- delphia Polyclinic; Consulting Physician to the Dispensary for Skin Diseases, etc. With colored plates. 12010. Cloth, x.75 ***This is a complete epitome of skin diseases, arranged in alphabetical order, giving the diagnosis and treatment in a concise, practical way. Many prescriptions are given that have never been published in any text-book, and an article incorporated on Diet. The plates do not represent one or two cases, but are composed oi a number of figures, accurately colored, showing the appearance of various lesions, and will be found to give great aid in diagnosing. “ This new handbook is essentially a small encyclopaedia. * * * We heartily commend it for. its brevity, clearness and evidently careful preparation.”—Philadelphia Medical Times. “ This is an excellent little book, in which, for ease of reference, the more common diseases of the skin are arranged in alphabetical order, while many good prescriptions are given, together with clear and sensible directions as to their proper application.”—Boston Medical and Surgical Journal. Bulkley. The Skin in Health and Disease. By L. Duncan Bulkley, Physician to the N. Y. Hospital. Illus. Cloth, .50 SURGERY. Heath’s Minor Surgery, and Bandaging. Eighth Edition. 142 Illustrations. 60 Formulae and Diet Lists. Cloth, 2.00 M ears’ Practical Surgery. Second Edition. Enlarged. 490 Illustrations. Cloth, $3.75; Leather, $4.75 Pye’s Surgical Handicraft. A Manual of Surgical Manipula- tions, Minor Surgery, Bandaging, Dressing, etc., etc. With special chapters on Aural Surgery, Extraction of Teeth, Anaes- thetics, etc. 208 Illustrations. 8vo. Cloth, 5.00 Watson on Amputation of the Extremities, and their Compli- cations. 2 colored plates and 250 wood cuts. 8vo. Cloth, 5.50 See pages 2 to 5 for list of ? Quiz- Comp ends ? 14 STUDENTS’ TEXT-BOOKS AND MANUALS. THROAT. Mackenzie on the Throat and Nose. By Morell Mackenzie, m.d., Senior Physician to the Hospital for Diseases of the Chest and Throat; Lecturer on Diseases of the Throat at the London Hospital, etc. Vol. I. Including the Pharynx, Larynx, Trachea, etc., with Formulae and 112 Illustrations. Vol. II. Diseases of the (Esophagus, Nose and Naso-Pharynx, with Formulae and 93 Illustrations. The two volumes, Leather, 7.50 Vol. II, separately, Cloth, 3.00; Leather, 4.00 “ It is both practical and learned ; abundantly and well illustrated ; its descriptions of disease are graphic and the diagnosis the best we have anywhere seen.”—Philadelphia Medical Times. Cohen. The Throat and Voice. Illustrated. Cloth, .50 James. Sore Throat. Its Nature, Varieties and Treatment. i2mo. Illustrated. Paper cover, .75; Cloth, 1.25 URINE AND URINARY ORGANS. Acton. The Reproductive Organs. In Childhood, Youth, Adult Life and Old Age. Sixth Edition. Cloth, 2.00 Beale. Urinary and Renal Diseases and Calculous Disorders. Hints on Diagnosis and Treatment. i2mo. Cloth, 1.75 Ralfe. Kidney Diseases and-Urinary Derangements. 42 Illus- trations. i2mo. 572 pages. Just Ready. Cloth, 2.75 Legg. On the Urine. A Practical Guide. 6th Ed. Cloth, .75 Marshall and Smith. On the Urine. The Chemical Analysis of the Urine. By John Marshall, m.d., Chemical Laboratory, University of Pennsylvania, and Prof. E. F. Smith, ph.d. With Colored Plates. Cloth, 1.00 Thompson. Diseases of the Urinary Organs. Seventh Edition. Illustrated. Cloth, 1.25 Tyson. On the Urine. A Practical Guide to the Examination of Urine. By James Tyson, m.d., Professor of Pathology and Morbid Anatomy, University of Penn’a. With Colored Plates and Wood Engravings. 5th Ed. Enlarged, iamo. Cloth, 1.50 VENEREAL DISEASES. Hill and Cooper. Student’s Manual of Venereal Diseases, with Formulae. Fourth Edition. i2mo. Cloth, i.co Durkee. On Gonorrhoea and Syphilis. Illus. Cloth, 3.50 g z) • See pages 2 to 5 for list of ? Quiz- Compends ? Richter’s Chemistries. AUTHORIZED TRANSLATIONS. By EDGAR F. SMITH, M.A., Ph.D., Prof, of Chemistry in Wittenberg College, Springfield, Ohio : formerly in the Laboratories of the University of Pennsylva- nia and Muhlenburg College; Metnber of the Chemical Societies of Berlin and Paris . of the Academy of Natural Sciences of Philadelphia, etc., etc. EACH VOLUME SOLD SEPARATELY. INORGANIC CHEMISTRY. Second American, from the Fourth German Edition; thoroughly revised and in many parts rewritten. With 89 Illustrations and Colored Plate of Spectra. Cloth, $2.00 THE CHEMISTRY OF THE CARBON COM- POUNDS, or Organic Chemistry. First Ameri- can, from Fourth German Edition. Illustrated. Cloth, $3.00 The success attending the publication of the first edi- tion of Richter’s Inorganic Chemistry encourages the translator and publishers to believe that the companion volume will have an equally warm reception. Professor Richter’s methods of arrangement and teaching have proved their superioiity, abroad, by the very large sale of his books all over the Continent, translations having been made in Germany, Russia, Plolland and Italy. From Prof. B Silliman, Yale College, New Haven, Conn. “ It is decidedly a good book, and in some respects the best manual we have.” From John Marshall, m.d., nat. sc. d. (Tubingen), Demonstra- tor of Chemistry in the University of Pennsylvania, Medical Department. “ fhe work is of undoubted value. The theory of chemistry, which is generally the bugbear of students, is, in this book, very clearly explained, and the explanations are so well distributed through the book that students are brought easily from the simplest to the most difficult problems. “ That part descriptive of the elements and their compounds is full, and all that could be desired in a text-book, while the cuts, with which the work is profusely illustrated, are an excellent aid to the student. Altogether, it is one of our best modern works on chemistry.” A New Series of Manuals FOR Medical Students. Price of each Book, Cloth, $3.00 ; Leather, $3.50. MIDWIFERY. By Alfred Lewis Galabin, m.a., m.d., Ob- stetric Physician to, and Lecturer on Midwifery and the Diseases of Women at, Guy’s Hospital, London, etc. 227 fine Engrav- ings. 753 pages. PHYSIOLOGY. By Gerald F. Yeo, m.d., f.r.c.s., Professor of Physiology in King’s College, London. Second Edition, re- vised. 750 pages. 301 carefully printed Illustrations. MATERIA MEDICA, PHARMACY AND THERAPEU- TICS, including the Physiological Action of Drugs, Special Therapeutics, Official and Extemporaneous Pharmacy, with numerous Tables, Formulae, Notes on Temperature, Clinical Thermometer, Poisons, Urinary Examinations and Patent Medi- cines. By Sam’l O. L. Potter, m.a., m.d.. Professor of Practice of Medicine, Cooper College, San Francisco, late Sur- geon U. S. Army. 750 pages. CHILDREN. By J. F. Goodhart, m.d., Physician to the Eve- lina Hospital for Children; Assistant Physician, Guy’s Hospital, London. American Edition. Revised and Edited by Louis Starr, m.d., Clinical Professor of Diseases of Children in the Hospital of the University of Pennsylvania: Physician to the Children’s Hospital, Philadelphia. 50 Formulae, and Directions for preparing Artificial Human Milk, for the Artificial Digestion of Milk, etc. 738 pages. PRACTICAL THERAPEUTICS, With an Index of Diseases. By Ed. John Waring, m.d., f r.c.p. Fourth Edition. Re- written and Revised. Edited by Dudley W. Buxton, Assistant to the Professor of Medicine, University College Hospital, Lon- don. 744 pages. MEDICAL JURISPRUDENCE AND TOXICOLOGY. By John J. Reese, m.d., Professor of Medical Jurisprudence and Toxicology, University of,Pennsylvania, etc. 6c6 pages. ORGANIC CHEMISTRY. By Prof. Victor von Richter, University of Breslau. Translated from Fourth German Edition by Edgar F. Smith, m.a., ph.d., Professor of Chemistry, Wit- tenberg College, Springfield, O., formerly in the Laboratories of the University of Pennsylvania, etc. Illustrated. 710 pages. DISEASES OF WOMEN. By Dr. F. Winckel, Professor of Gynaecology, etc., Royal University of Munich. The Transla- lation Edited by Theophilus Parvin, m.d., Professor of Ob- stetrics and Diseases of Women and Children, Jefferson Medical College, Philadelphia. 132 Engravings, most of which are new. 700 pages. *** Other Volumes in Preparation. A complete illustrated circu- lar with sample pages sent free, upon application. Price of each Book, Cloth, $3.00; Leather, $3.50.