Materia Medica and Therapeutics 
WITH ESPECIAL REFERENCE TO THE CLINICAL 
APPLICATION OF DRUGS. 
BY 
JOHN V. SHOEMAKER, A.M., M.D., 
e 0 I 
Professor of Materia Medica. Pharmacology, Therapeutics and Clinical Medicine, and Clinical Professor of Diseases of 
the Skin in the Medico-Cliirurgical College of Philadelphia; Physician to the Medico-Chirurgical Hospital; 
Member of the American Medical Association, of the Pennsylvania and Minnesota State Medical 
Societies, the American Academy of Medicine, the British Medical Association; 
Fellow of the Medical Society of London, etc., etc. 
VOL. II OF A TREATISE ON MATERIA MEDICA, PHARMACOLOGY, 
AND THERAPEUTICS. 
BEING AN INDEPENDENT VOLUME UPON DRUGS. 
PHILADELPHIA AND LONDON: 
F. A. DAVIS, PUBLISHER, 
1891. Entered according to Act of Congress, in the year 1891, by 
F. A. DAVIS, 
In the Office of the Librarian of Congress, at Washington, D. C., U. S. A. 
Philadelphia, Pa., U. S. A. 
The Medical Bulletin Printing House, 
1231 Filbert Street. TO 
THE MANY PUPILS 
WHO HAVE ATTENDED HIS LECTURES DURING THE PAST 
SEVENTEEN YEARS AND ARE NOW PURSUING THEIR 
PROFESSION IN THE UNITED STATES OF AMERICA 
AND IN MANY FOREIGN COUNTRIES, 
THIS VOLUME, 
ILLUSTRATING AN ALL-IMPORTANT AND PRACTICAL 
DEPARTMENT OF MEDICINE, PHARMACY, 
AND DENTISTRY, 
is 
RESPECTFULLY INSCRIBED BY THEIR TEACHER, 
\ 
The Author. PREFACE. 
The issue of the second volume of this work has been unexpectedly 
and unavoidably delayed. Several circumstances have concurred to 
produce this result. In projecting a work of some magnitude it is 
necessarily difficult to estimate the time which its execution will 
demand. After the most liberal allowance seems to have been made, 
the exigencies of professional life may totally disarrange preconceived 
plans. This premise, which applies to every physician who essa}rs to 
add to the literature of his profession, gains added force in the present 
instance, since the author stood already pledged to several other literary 
undertakings. No one can regret more than the writer that his calcula- 
tions have been disturbed and the fulfillment of his present task post- 
poned. He felt, however, that it was far more important that his labor 
should be performed as thoroughly as possible than that it should be 
finished by a specified date. He certainly desired that the work should 
be based upon his own experience and convictions. Yet no less 
assuredly was he anxious to modify or extend his conclusions in the light 
of those reached by other laborers in the same field. It was his aim to 
render this volume a complete, as well as practical, exposition of the phar- 
macological, physiological, and therapeutical action of the various drugs 
now used in medicine. Practical usefulness determines the standard of 
value of a work on therapeutics. It should aim to be a complete rep- 
ertory of the various means at our command for resisting the ravages or 
removing the effects of disease. It should fnirly represent the various 
measures which have been found beneficial in the experience of the 
general profession. Though a writer may speak with conviction of 
remedies and methods which, in his own experience, have proved of ad- 
vantage, he should not lose sight of the fact that, for one reason or another, 
the practitioner is not infrequently disappointed in the action of the 
most approved medicaments. Cases constantl}' occur, especiall}'' in the 
course of chronic affections, in which our knowledge of drugs and 
methods of administration is tried to the utmost extent. One seem- 
ingly indicated remedy after another is, in vain, employed. It is well, 
therefore, that, as far as possible, all the applications of each drug should VI 
PREFACE. 
be mentioned, specifying those which are most important and constant, and 
pointing out those which may be of service only upon exceptional occa- 
sions. Impressed with this idea, the author has also introduced into this 
volume a brief consideration of many substances not actually in general 
or frequent use by the profession. Many are new, and some of these appear 
to be very valuable additions to the materia medica. A few are old 
.remedies, which have fallen into undeserved neglect. The writer has 
also endeavored to bring his description of drugs and their applications 
billy up to the date of publication. He consequently believes that much 
information is gathered in these pages which has hitherto been scattered 
through domestic and foreign journals, and often practically inaccessible 
in the hour of need. A succinct account has been given of the latest 
contribution of experimental medicine to therapy,—tuberculin, or Koch’s 
lymph. That this is a fluid of decided energy has been abundantly 
attested. Whatever be its fate as a remedy, the writer, with as little 
desire as ability to forecast the future, yet feels himself warranted in 
looking upon tuberculin as a significant index of the future treatment 
of infectious disease. The finger of science points steadil}r in one direc- 
tion. The more that is known of the life-histoiy of bacteria and their 
relations to disease, the more apparent it becomes that infection resembles 
an intoxication,—a poisoning by chemical compounds of definite, albeit 
unstable, chemical composition. Protective inoculation but substitutes 
a mild for a virulent attack. Established infection must be neutralized 
by bacterial products. Therefore, whether or not Koch’s fluid prove 
of permanent worth, its discoveiy nevertheless marks a stage in that 
progress which had already been inaugurated by Pasteur. 
The author wishes, in conclusion, to express appreciation and thanks 
to his colleagues, Professors J. Foster Flagg, James E. Garretson, H. 
Ernest Laplace, Peter D. Iveyser, William F. Waugh, Henry I. Dorr, 
Samuel B. Howell, William H. Pancoast, and Dr. E. L. B. Godfre3r, for 
therapeutical suggestions which have been included in the text of the 
work, credit being given to the opinions referred to in each case. 
During the time that this work has been passing through the press, 
the author has received much valuable assistance and very practical 
suggestions from his colleague, Prof. Frank Woodbuty, to whom he is 
most grateful. The writer is likewise indebted to Dr. George Hewitt 
for much assistance, in proof-reading and for the indexes, 
which he has most carefulty prepared. 
Philadelphia, 1519 Walnut Street, April 1, 1891. INTRODUCTION. 
Classification lias been found as difficult in Materia Medica as in 
every other branch of natural science. It is impossible to mark out, 
with exactitude, definite limits to the action of drugs. If, from one 
point of view, a medicine be described as diuretic, we are sometimes 
obliged to admit that it might be no less properly placed among the 
cathartics or diaphoretics. When we seek to understand the mechanism 
of its action and its influence upon the composition of the urine, we 
must study its effect upon the central nervous system, the cardiac nerves 
and ganglia, the heart-muscle, and the muscular coat of the arterial 
system. The organs concerned in sanguification may likewise be affected, 
and this result is evidenced by the changed proportion of the urinary 
constituents. If a drug specially impresses the chief nerve-centres, its 
range of influence must extend more or less powerfully and directly to 
every important organ. It need not, therefore, seem strange that no 
classification of remedies has permanently endured. In describing the 
properties and applications of drugs, the alphabetical arrangement is 
adopted as the most simple and convenient. Nevertheless, as our main 
object is to obtain a practical command of our therapeutical resources, it 
will always be useful to associate our remedies in classes, so that, in the 
absence or failure of any one, a substitute or a successor shall readily sug- 
gest itself to the mind. For these reasons the author deems it useful to 
precede the discussion of individual drugs by a brief summary of the sali- 
ent characteristics of the various groups into which they may be arranged. 
However imperfect a system of classification may be, it, nevertheless, 
serves to accomplish this useful object. The mental association of drugs 
which possess, in the main, similar properties renders the knowledge of 
the therapeutist more available, and assists him when it becomes neces- 
sary to alternate or combine his remedies. At the same time the individual 
or divergent action of medicinal substances is likewise emphasized, and 
this is a point of great importance in the judicious selection of agents. 
Though the combination of many remedies in one formula is to be depre- 
cated, yet it is often highly advantageous to supplement the deficient 
action of one drug by the addition of one or more endowed with different 
but desirable virtues. The existence of chemical incompatibilities, how- 
ever, should never be overlooked in forming such combinations, though it 
must be acknowledged that chemical and therapeutical incompatibilities INTRODUCTION. 
are not alwaj'S identical. Remedies may be divided into classes (after 
Garrod):— 
Classification of Medicines. 
Blood tonics (hsematinics). 
Alkalies. 
Acids. 
Astringents. 
Refrigerants. 
Antipyretics. 
Alteratives. 
Medicines 
Affecting 
Nutrition. 
The Brain. 
Exhilarants. 
Narcotics and Anodynes. 
Anaesthetics. 
Internal 
Remedies. 
Spinal Cord. 
Stimulants. 
Sedatives. 
Nerve-Centres 
and Ganglionic System. 
Antispasmodics. 
Tonics and 
Antiperiodics. 
Medicines 
Acting 
through 
THE 
Nervous 
System. 
Heart and Circulatory 
System. 
Vascular stimulants. 
Vascular sedatives. 
'Sialagogues. 
Antisialics. 
Emetics. 
Anti-emetics. 
Purgatives. 
Anthelmintics. 
.Stomachics. 
Alimentary Canal. 
The Liver. 
Hepatic stimulants. 
Hepatic depressants. 
'Expectorants (pulm. 
stim.l. 
Pulmonary seda- 
tives. 
Respiratory Apparatus. 
Special Organs, 
Cutaneous System. 
Diaphoretics. 
Urinary System. 
Diuretics. 
Lithontriptics. 
Generative System. 
Embolics. 
Emmenagogues. 
Ecbolics. 
Aphrodisiacs. 
An aphrodisiacs. 
The Eyes. 
Mydriatics. 
Myotics. 
Irritants. 
Rubefacients. 
Epispastics or blistering agents. 
Pustulants. 
Escharotics and Caustics. 
External 
Remedies. 
Sedatives. 
Demulcents. 
Emollients. 
Astringents and Styptics. 
Antiparasitics. 
Chemical 
Agents. 
Antiseptics and 
Disinfectants. INTRODUCTION. 
IX 
Haematinics are remedies which exert a direct influence upon the 
composition of the blood. Useless, or even deleterious in health, such 
a drug tends to improve, in certain diseased states, the quality of the 
blood, and, consequently, the nutrition of the entire organism. Destruc- 
tion of its corpuscular elerrtbnts and drain of its albumin indicate that 
the nutrient fluid-tissue urgently requires increased and appropriate 
pabulum. This supply is, in health, derived from the food ; but, in 
pathological conditions, must be administered in a more concentrated 
and less complex form. Remedies belonging to this class are, or contain, 
normal constituents of the body, and are necessary to the maintenance 
of structure and the performance of function. 
Haematinics are preparations of iron, preparations of manganese, 
codliver-oil, other animal oils, and vegetable oils. 
Alkalies.—When alkalies, in concentrated form, are brought into 
contact with animal tissues, they enter into chemical combination with 
the oxygen present, and thus give rise to an active, destructive inflam- 
mation. Alkalies are, likewise, solvents of albumin. These physical 
and Chemical properties render the caustic alkalies useful in producing 
powerful counter-irritation. Their escharotic effects have been made use 
of in chronic synovitis, myelitis, and meningitis, and in the destruction 
of morbid tissue, whether of neoplastic or inflammatory origin. Potas- 
sium, in large doses, depresses or paralyzes the activity of nervous and 
muscular tissue. 
The alkalies combine with and neutralize acids. Therefore, they are 
useful in overcoming ln’peracidity of the stomach, whether due to the 
excessive production of hydrochloric acid or to fermentative changes, 
with the production of fatty acids. They promote the secretion of acid 
and restrain that of alkaline fluids. Hence, when administered immedi- 
ately before a meal, an alkali excites a flow of gastric juice, and, in this 
way, promotes digestion and is serviceable in d}rspepsia. On the other 
hand, given immediately after a meal, such a remedy, by neutralizing the 
gastric juice, embarrasses digestion, and fermentation proceeds unchecked. 
It can readily be understood, therefore, how the prolonged use of alkalies 
in dyspepsia at length disorders appetite and aggravates the condition for 
which they were originally prescribed. A dilute alkaline solution checks 
the discharge of acute eczema, which possesses the same reaction ; it 
allays the itching and smarting of this disease, or the burning pain of 
superficial burns and scalds. Panesthesia, whether dependent upon con- 
stitutional disorder or excited by local causes, is often amenable to the 
influence of an alkaline lotion. The same preparation is beneficial by 
neutralizing acid secretions from the bowel, vagina, or the skin, and 
obviating their effects. INTRODUCTION. 
X 
A diminished alkalinity of the blood in rheumatism and gout is 
caused by the presence, respectively, of lactic or uric acid in excessive 
quantity. The alkalies are advantageous in these diseases, combining with 
the acid and facilitating its elimination. The same result takes place in 
the urine. The reaction of that fluid being rendered alkaline, uric acid 
is dissolved or forms soluble combinations, irritation of the urinary 
tract is quieted, and the precipitation of uric acid in the kidney or 
bladder is prevented. Alkalies are useful when a uric-acid calculus is 
present. They may be able to dissolve a small and soft stone. At all 
events, they prevent further deposit and relieve the local irritation which 
the foreign body has occasioned. 
Prolonged administration of an alkaline remedy may be injurious 
and give rise to emaciation and debility from the accelerated disintegra- 
tion of nitrogenous tissue. These remedies aid in the resolution of 
inflammatory exudations. Finally, an alkali acts as a chemical antidote 
in case of poisoning by an* acid. 
Alkaline remedies consist of: solution of potassa, carbonate and 
bicarbonate of potassium ; solution of soda, carbonate and bicarbonate 
of sodium; carbonate of lithium ; calcined magnesium and carbonate of 
magnesium ; lime-water, precipitated carbonate of calcium and prepared 
chalk. The combinations of potassium, sodium, and lithium with the 
vegetable acids do not act as alkalies in the stomach, but, being con- 
verted into carbonates in the blood, they allAlinize the urine as they 
escape from the system. 
Acids.—When given after meals, these supply the acid medium in 
which pepsin is efficient. They, therefore, improve the appetite and 
digestion, and are useful in digestive disorders. They promote secre- 
tion, allay thirst and nausea. Administered before a meal, the}' check 
hyperacidity of the stomach. The mineral acids possess astringent 
properties, and are of service in lessening haemorrhages, morbid secre- 
tions, and discharges. They are, likewise, antiseptic, disinfect the 
alimentary canal, and restrain deleterious fermentation of its contents. 
In a concentrated form they act as escharotics. 
The properties of vegetable acids are similar to, but generally 
feebler, than those of the mineral acids. The}r are, however, with the 
exception of tannic acid, devoid of astringency. On the other hand, 
they exert a more decided influence upon the eliminative organs, and 
stimulate the secretions of the skin, kidneys, and bowels. In saturated 
solution, the vegetable acids are irritant, or even caustic. They have 
antiseptic virtues and assist digestion. 
Both mineral and vegetable acids are beneficial in certain morbid 
states of the blood, as purpura or scurvy, and in fevers. The principal XI 
INTRODUCTION". 
acids used in medicine are: acetic acid, benzoic acid, citric acid, lactic 
acid, tartaric acid, hydrochloric acid, nitroliydrochloric acid, nitric acid, 
phosphoric acid, and sulphuric acid. 
Astringents coagulate albumin and excite contraction of unstriped 
muscular tissue. In strong solution, most of these substances exert a 
caustic action. They are useful in overcoming a relaxed or debilitated 
condition of muscular fibre, and, by contracting arterioles and capil- 
laries and the gland-ducts, they repress secretion. They likewise 
restrain peristalsis. Astringents are of avail in the treatment of haemor- 
rhage and hypersecretion. 
Agents of this class are derived both from the inorganic and organic 
kingdoms. The action of the vegetable astringents chiefly depends upon 
the presence of tannic acid or some of its modifications or allied forms. 
The principal members of this group of remedies are tannic and gallic 
acids, kino, catechu, krameria, geranium, and hamamelis. The mineral 
astringents comprise the salts of bismuth, zinc, alum, copper, lead, and 
silver. The salts of iron with mineral acids also exert a similar effect. 
Refrigerant remedies are those which allay thirst produced by fever. 
The local action of water, or pieces of ice allowed to melt upon the 
tongue, affords temporary relief. Glycerin, topically applied, is of 
service in moistening the tongue. The vegetable and mineral acids, in 
weak solution, excite the secretion of saliva. 
Antipyretics reduce abnormal temperature, either by limiting the 
generation of heat or by favoring its loss through radiation, conduction, 
and the work of evaporating the perspiration. Agents which diminish 
oxidation, depress the circulation, or which, presumabW, exert a specific 
corroborant influence upon the heat-centre, lowrer temperature by lessen- 
ing heat production. Those which dilate the cutaneous vascular system 
favor the loss of heat. Immersion in water below the temperature of the 
body is a highly valuable method of decreasing fever-heat. 
Drugs which limit the production of heat by diminishing tissue 
change are: alcohol, antipyrin, benzoic acid, camphor, carbolic acid, 
cinchonine, eucalyptol, phenacetine, quinine, resorcin, salicjdic acid and 
its combinations, thj’mol. Those which lower temperature by acting on 
the circulation are: aconite, antimony, digitalis, gelsemium, thallin. 
Drugs which increase radiation are: acetanilid, alcohol, antipyrin, 
nitrous ether, thallin. Those which dissipate heat in evaporating the 
perspiration are: antimonjq nitrous ether, opium and ipecacuanha, 
pilocarpus. 
Alteratives.—This term has been bestowed upon a class of remedies 
which possess the power of modifying deranged nutritive processes. 
Given persistently, in small doses, alteratives improve the quality of the INTRODUCTION'. 
blood and often increase the number of its red corpuscles. Appetite, 
digestion, secretion, absorption, and elimination are promoted. The cir- 
culation and respiration are invigorated, the nutrition and functional 
activity of the nervous centres improved. 
Alteratives counteract the effects of various forms of toxaemia, as 
that of chronic malaria, syphilis, scrofula, tuberculosis, carcinoma, and 
of slow mineral poisoning. They promote the absorption of inflamma- 
tory exudations. 
The principal agents of this class are : Chloride of gold and sodium, 
preparations of arsenic, preparations of mercury, preparations of iodine, 
iodoform, iodol, chlorate of potassium, antimony, mezereum, sulphur, 
sulphides, colchicum, guaiacum, sanguinaria, xanthoxylum, calcium 
chloride, stillingia, sarsaparilla, codliver-oil, and phosphorus. 
Exhilarants determine an active cerebral circulation and stimulate 
the functions of cerebral centres; but if administered for too long a time 
or in excessive quantities, a depressing effect is produced. The effect upon 
the higher is reflected to the lower centres, the heart strengthened, the 
respiratiop deepened, and muscular vigor promoted. Substances belong- 
ing to this class support the under prolonged and unusual strain, 
and are often useful in the treatment of mental alienation. Among 
exhilarants may be ranked the preparations of belladonna, hyoscyamus 
and stramonium, coca, tea, coffee, ether, and alcohol. 
Narcotics and Anodynes.—Narcotics cause sleep, anodynes alia}- 
pain. Sound sleep obliterates the perception of pain ; the relief of pain 
permits sleep. A close relationship exists, therefore, between these 
varieties. A narcotic or hypnotic will often abolish pain, while an ano- 
dyne will frequently overcome wmkefulness. I n some substances, however, 
the narcotic, and in others the anodyne, influence is most conspicuous. 
When sleeplessness depends upon anxiety, mental excitement, or pro- 
longed intellectual effort, the treatment differs from that to be adopted 
when insomnia is due to pain. Narcotics act chiefly by influencing the 
circulation through the brain, anodynes by their effect upon sensory 
centres. 
The chief remedies belonging to this class are the following : opium, 
chloral hydrate, chloralamid ; bromides of potassium, sodium, or ammo- 
nium ; liypnal, paraldehyde, sulphonal, somnal, and urethan. 
Anaesthetics.—Agents of this class abolish consciousness and sensa- 
tion by inhibiting the functions of the higher cerebral centres. When 
their influence is continued, the sensory and motor centres of the spinal 
cord and of the medulla oblongata are in turn affected. The first result 
of their inhalation is a stage of intellectual, emotional, and motorial ex- 
citement. This is succeeded by a stage of narcosis. Anaesthetics destroy INTRODUCTION. 
life by paralj’sis of the centres situated in the medulla oblongata. Thej7 
are employed for the purpose of relaxing spasm and producing a con- 
dition of unconsciousness, during which surgical operations may be pain- 
lessly performed. 
The chief members of this group are: ether, chloroform, bromide 
of ethyl, and nitrous oxide. 
Spinal Stimulants.—Agents belonging to this class, when given in 
medicinal doses, exalt the functions of the cord, invigorate the action 
of the heart and lungs, promote secretion and nutrition. 
These remedies are useful in atonic dyspepsia, atony of the bowel 
or bladder, cardiac weakness, emphysema, neuralgia, spinal neurasthenia, 
paralysis, and phthisis. 
The principal members of this group are : mix vomica and its related 
species, ignatia and lioang-nan, alcohol and camphor in small doses. 
Spinal Sedatives.—These are substances which have the property of 
reducing the functions of the spinal cord. They may act directly upon 
the nerve-cells, or produce their effect by an influence on the circulation 
through the cord. Excessive doses cause paralysis. Spinal sedatives 
are valuable in conditions of irritation or congestive excitement of the 
cord. The chief remedies belonging to the group are : bromide of po- 
tassium, bromide of sodium, lobelia, gelseminm, conium, hydrocyanic 
acid, potassium nitrate, and physostigmine salicylate. 
Antispasmodics.—Antispasmodic drugs allay irregular action of the 
voluntary or involuntary muscles by a calmative influence upon nerve- 
centres. They are of use in many disorders characterized by nervous 
excitement and muscular spasm, such as hysteria, colic, asthma, and 
intestinal colic. The principal antispasmodic remedies are: ammoniac, 
valerian, asafoetida, camphor, musk, castor, and ether. 
Tonics.—Tonics improve appetite, digestion, assimilation, and 
secretion, strengthen the circulatory apparatus, improve the composition 
of the blood, invigorate the muscular system, and promote the nutrition 
of nerve-centres and fibres. The most powerful members of this class 
possess anti periodic virtues. Tonics are useful in the treatment of 
digestive disorders, in depressed conditions of the nervous sj'stem and 
nutrition in general, and in diseases characterized by periodicity. The 
former variety includes: gentianv calumba, chirata, serpentaria, and 
eucalyptus. The preparations of iron and manganese act as tonics when 
the quality of the blood is impaired. Certain mineral salts, as the oxide 
of zinc, the oxide of silver, and the sulphate of zinc, exert a similar 
influence in nervous affections, as chorea and epilepsy. 
Vascular Stimulants.—Members of this class strengthen the action 
of the heart and blood-vessels. They are therefore advantageously XIV 
INTRODUCTION. 
emploj'ed in weakened conditions of the central organ of the circulation, 
in transudation due to blood-stasis, and in haemorrhage. Chief among 
vascular stimulants are: alcohol, preparations of ammonium, caffeine, 
convallaria, digitalis, strophanthus, and scoparius. 
Vascular Sedatives.—These remedies render the heart’s action more 
slow and less forcible. They moderate cardiac excitement, and are of 
service in febrile and inflammatory affections of a sthenic type. Ex- 
amples of this class are: aconite, veratrum viride, gelsemium, antimony, 
muscarine, pilocarpine, hydrocyanic acid. 
Sialagogues.—Sialagogues excite the secretion of saliva, either by 
an irritant local effect, with a reflex stimulation of the salivary glands, 
or by a specific influence upon the glands during their elimination. Ex- 
amples of the former variety are: capsicum, mustard, ginger, pellitory, 
and mezereon ; of the latter: preparations of iodine and mercury, pilo- 
carpus, muscarine, and physostigma. 
Antisialics check salivary secretion. This is the action of bella- 
donna, opium, and potassium chlorate. 
Emetics.—Emetics cause vomiting, either b}r irritating the terminal 
filaments of the gastric nerves or by exciting the nervous centre, which 
presides over the act of emesis. Remedies which act direct irrita- 
tion are: alum, mustard, copper sulphate, zinc sulphate, and mercury 
subsulphate. General or systemic emetics are: apomorphine, ipecac- 
uanha, and tartar emetic. 
Anti-emetics allay irritability of the gastric nerves or the vomiting 
centre. Bismuth, cerium oxalate, creasote, carbolic acid, chloroform, 
ether, calomel, and silver nitrate soothe gastric irritation. Opium, 
hydrocyanic acid, bromides, and chloral hydrate quiet the excitement of 
the nerve-centre. 
Purgatives produce evacuation of the contents of the intestinal canal 
by increasing secretion or transudation along the tract and by exciting 
peristaltic movements. According to the intensity of their action, pur- 
gatives or cathartics are subdivided into several varieties : 1. Laxatives 
cause slight increase of secretion and peristalsis, resulting in softened 
stools. Among laxatives are ranked manna, sulphur, figs, prunes, olive- 
oil, cascara sagrada, hj'oscymmus, soap, etc. 2. Simple purgatives, or 
purgatives proper, are more stimulant, and occasion semi- 
liquid motions. Belonging to this group are : senna, aloes, rhubarb, 
castor-oil, and calomel. 3. Drastic cathartics are strongly irritant to the 
intestinal mucous membrane, and occasion transudation from its vessels 
and almost fluid stools. The action of drastics is accompanied by con- 
siderable griping pain. Examples of drastics are : jalap, colocynth, 
gamboge, scammony, elaterium, podophyllum, and croton-oil. Excessive INTRODUCTION. 
XV 
doses of simple purgatives have a very similar effect. 4. Hydragogue 
purgatives remove abundant serum from the intestinal blood-vessels 
and produce large, watery motions. An analogous action is exerted by 
various salts of the alkalies and alkaline earths. Large doses of the 
drastic cathartics have the effect of hydragogues. The principal saline 
purgatives are the sodium sulphate, magnesium sulphate, magnesium 
citrate, potassium tartrate and bitartrate, tartrate of potassium and 
sodium. 5. Cholagogue purgatives stimulate, either directly or indi- 
rectly, the liver, cause an increased flow of bile, quicken the peristaltic 
movements, and produce greenish, liquid evacuations. Among the 
cliolagogues are included mercury, aloes, euonymin, iridin, rhubarb, lep- 
tandra, and podophyllum. 
Anthelmintics cause destruction or expulsion of intestinal worms. 
Those agents which destroy are termed vermicides; those which expel 
are known as vermifuge remedies. Tape-worms are killed or removed 
by means of aspidiuin, kamala, kousso, pomegranate or pelletierine, 
pumpkin-seed, turpentine, and chloroform. Remedies which act against 
round-worms are: santonin, spigelia, chenopodium, and azedarach. 
Seat-worms are destroyed by enemata of table salt, tannic acid, quassia, 
eucalyptol, etc. 
Stomachics.—Stomachics stimulate the gastric mucous membrane, 
increase appetite, promote the secretion of gastric juice, and assist di- 
gestion. They restrain abnormal fermentation and dispel accumulation 
of flatus. Among stomachics are : capsicum, piper, cardamom, cloves, 
mustard, ginger, horse-radish, calumba, chirata, mix vomica, etc. 
Hepatic Stimulants.—These are medicines which excite the liver to 
increased functional activity. They occasion an augmented formation 
of bile, and thus promote the normal elaboration of nitrogenous aliment. 
By many agents of this class the newlj'-formed bile is rapidly swept 
along the intestine b}r a cathartic action and its re-absorption prevented. 
The conversion of nitrogenous waste into its soluble end-product, urea, 
is thus favored by these remedies, some of which are known to cause in- 
creased elimination of urea. Others, again, stimulate the glycogenic 
function of the liver. 
The principal substances which increase the production of bile are : 
nitro-hydroehloric acid, ipecacuanha, sodium phosphate, mercuric chlo- 
ride, aloes, podophyllin, rhubarb, colocynth, euonymin, iridin, etc. The 
quantity of urea is increased by ammonium chloride, arsenic, antimony, 
phosphorus, and iron. The glycogenic function is stimulated by nitro- 
hydrochloric acid, amyl nitrite, and sodium bicarbonate. 
Hepatic Depressants.—Agents belonging to this class reduce func- 
tional activity of the liver, diminishing the formation of bile, urea, and XVI 
INTRODUCTION. 
glycogen. Those which lessen the secretion of bile are: opium, acetate 
of lead, alcohol, and quinine. The amount of urea is decreased by 
opium, alcohol, quinine, and colchicnm. Gtycogen is diminished by 
opium, phosphorus, arsenic, and antimony. 
Expectorants.—Expectorant remedies modify the character of the 
bronchial secretions and facilitate their expulsion. Small or nauseating 
doses of emetic substances increase and liquefy the secretions of the 
mucous membrane. Larger doses, by causing vomiting, mechanically aid 
the expulsion of mucus from the air-passages. The term “ stimulating 
expectorants” is given to a group of drugs eliminated by the bronchial 
mucous membrane which they stimulate, and the secretion of which 
they at the same time alter and improve. Certain substances, when 
dissolved in the mouth, aid expectoration by a stimulating influence 
upon the cilia of the trachea and bronchi. These are called ciliary 
excitants. The nauseating expectorants are: antimony, ipecacuanha, 
apomorpliine, lobelia, pilocarpus, etc. Among the stimulating expecto- 
rants are : ammonium chloride, balsams of Peru and Tolu, senega, squill, 
sulphur, and turpentine. Ciliary excitants are: ammonium chloride, 
potassium and sodium chlorate, gum acacia, etc. 
Pulmonary sedatives relieve cough by allaying irritability of the 
respiratory centre or the terminal fibres of the nerves distributed to the 
bronchi and lungs. Examples of this class are : opium, belladonna, 
stramonium, hyoscyamus, hydrocyanic acid, etc. 
Diaphoretics increase perspiration b}r stimulating the sudoriparous 
glands in the course of their removal, as sulphur, guaiacum, sarsaparilla, 
serpentaria, mezereon, and camphor. Other agents produce the same 
effect by causing relaxation of the cutaneous capillaries. In this sub- 
division are found the nauseants and emetics, as tartar emetic, ipecacu- 
anha, lobelia, and Dover’s powder, as w’ell as opium, ether, and alcohol. 
A third group of remedies excites diaphoresis by an influence upon the 
sweat-centres, as pilocarpus, veratrum viride, and salts of potassium. 
Diuretics.—The quantity of urine excreted is increased by remedies 
which raise general or local arterial tension, and by those which stimu- 
late the secreting cells of the kidney. The free ingestion of water assists 
the action of diuretic drugs, and is mechanically serviceable by irrigating 
the renal tubules. Among the stimulant diuretics are found cantharides, 
copaiba, cubeb, turpentine, colchicnm, squill, broom, juniper, potassium 
nitrate, and calomel. The principal agents which act by elevating blood- 
pressure are : digitalis, belladonna, mix vomica, and alcohol. 
Lithontriptics.—This name has been given to a class of remedies which 
increase the flow of urine, and at the same time, by modifying its chemi- 
cal reaction, dissolve and prevent the deposition in the urinary passages XVII 
INTRODUCTION. 
of uric, phosphoric, or oxalic acid, or insoluble salts of those acids. If 
precipitation has taken place, they are given with a view to dissolve or 
remove gravel or calculi. The carbonate, bicarbonate, and citrate of 
potassium, the carbonate and citrate of lithium, are the principal solv- 
ents for uric acid. The agents which are given for the purpose of acting 
upon phosphoric calculi are: benzoic acid, benzoate of ammonia, and di- 
lute nitric acid. 
Ecbolics.—These remedies, also known as oxjdocics, stimulate the 
pregnant womb to contraction. They may thus lead to abortion, if pre- 
maturely given, but, administered during labor, are often of valuable 
assistance by invigorating the organ. It is surmised that ecbolics may 
act either by causing direct irritation of the muscular structure of the 
womb, or exciting contraction through an influence upon the uterine 
centre in the cord. The principal ecbolics are: ergot, cotton-root bark, 
ustilago, savin, rue, and cimicifuga. 
Emmenagogues.—Emmenagogues excite the menstrual flux either 
by a direct stimulant effect upon the uterus, or indirectly by improving 
the quality of the blood and nutrition in general. Small doses of ecbolic 
remedies are usually emmenagogue. Direct emmenagogues are : ergot, 
savin, cantharis, rue, myrrh, etc. Indirect emmenagogues are : prepara- 
tions of iron and manganese, nux vomica, codliver-oil, etc. 
Aphrodisiacs excite the genital functions. This object they accom- 
plish by stimulation, either direct or reflex, of the centres which govern 
the genital organs. Whatever promotes nutrition tends indirectly to in- 
vigorate the sexual apparatus. The chief aphrodisiac agents are : can- 
tharis, phosphorus, small doses of opium, alcohol, camphor, and damiana. 
Anaphrodisiacs diminish sexual desire and power. They alia}" ex- 
citability of the genital centres and diminish irritation or hypersemia of 
the generative organs. Among anaphrodisiacs are included*bromides of 
potassium, sodium and ammonium, iodide of potassium, large doses of 
camphor or opium, tobacco, gelsemium, etc. Whatever depresses gen- 
eral systemic vigor has likewise an indirect anaphrodisiac effect. 
Mydriatics produce dilatation of the pupil by stimulation of the end- 
organs of the sympathetic, with contraction of the radiating fibres of the 
iris as a result, and by paralysis of the third nerve, causing relaxation 
of the circular fibres. The principal mydriatics are : atropine, homatro- 
pine, daturine, duboisine, and hyoscyamine. 
Myotics cause the pupil to contract by stimulating the circular fibres 
of the iris. Eserine, or physostigmine, acts when locally applied, and is 
used b}r ophthalmologists for this purpose. Other drugs which contract 
the pupil, though not administered for that purpose, are opium, pilo- 
carpus, and muscarine. INTRODUCTION. 
Irritants are applied to the skin in order to produce nervous and 
vascular reaction. According to the degree of their action, they are 
classed as rubefacients, or those which simply redden the surface; 
epispastics or vesicants are those which occasion blisters; and pustulants, 
which excite sufficient inflammation to form pus. The rubefacients, 
most in use are mustard, capsicum, arnica, turpentine, chloroform, ether, 
and iodine. Among vesicants are ranked cantharides, euphorbium, 
mezereon, and iodine. The principal pustulants are tartar emetic, 
croton-oil, and nitrate of silver. The prolonged application of a rube- 
facient often gives rise to a blister. 
Escharotics or caustics destroy tissue and lead to the formation of a 
slough. The principal escharotics are : carbolic acid, glacial acetic acid, 
chromic acid, strong mineral acids, caustic potash,and caustic soda. 
Local sedatives diminish nervous and vascular excitement in the 
part to which they are applied. They consequently relieve local inflam- 
mation and pain. Among agents of this group are bismuth, acetate of 
lead, aconite, cocaine, opium, belladonna, etc. 
Demulcents are bland substances used to protect mechanically 
the gastro-intestinal tube from contact with irritant poisons, to allay 
inflammation of the same canal, of the respiratory or genito-urinary 
passages. Many of them possess some nutritive value. This class 
embraces acacia, flaxseed, elm, marsh-mallow, Iceland and Irish moss, 
starch, gelatin, olive-oil, etc. 
Emollients are applied to the external surface. They resemble de- 
mulcents in being of a bland, soothing character, protect the surface 
from friction and from air, relieve tension and diminish pain. Among 
emollient substances are : lard, olive-oil, spermaceti, glycerin, starch, 
cacao-butter, etc. 
Local Astringents and Styptics.—The astringents and acids, which are 
useful in checking haemorrhages and morbid discharges when adminis- 
tered internally, have the same effect when locally applied. 
Antiparasitics, Disinfectants, Antiseptics.—The term antiparasitic, or 
parasiticide, is generally restricted to agents which have the power of 
destroying the animal and vegetable parasites which may infest the ex- 
terior of the body. Antiseptics act upon pathogenetic micro-organisms, 
prevent their growth and multiplication,and neutralize ordestroy the toxic 
products of these micro-organisms. Antiparasitics are germicidal. 
Antiseptics, though not necessarily germicidal, protect the sj’stem against 
infection. The principal antiparasitic remedies are: sulphur, iodine, 
mercury, carbolic acid, and boric acid. The most valuable antiseptics 
are: mercuric chloride, carbolic acid, creasote, salicylic acid, chlorine, 
naphthol, aristol, quinine, thymol, sulphurous acid, iodol, iodoform, INTRODUCTION. 
XIX 
resorcin, etc. Disinfectants are used for the purpose of destroying the 
organic germs of disease, as the}' ma}' exist in the atmosphere, clothing, 
water, pathological discharges, etc. Substances which accomplish this 
purpose are: sulphurous-acid gas, chlorine, bromine, zinc chloride, 
mercuric chloride, etc. Heat is also disinfectant. 
Dosage.—By the dosage of a remedy is meant the amount or 
quantity of the agent required to produce a definite therapeutic result. 
Naturally a considerable margin exists, owing to different degrees of 
vigor in patients, and to the amount of impression we desire to make 
upon the bodily functions. It is evident, then, that, even among patients 
of the same age, some will require larger doses than others in order to 
produce a particular effect. Thus arises the distinction between the 
minimum and maximum doses, the former being the smallest dose capable 
of physiological or therapeutical effect, the latter being the largest dose 
which it is considered safe to give. The toxic dose is larger than the 
maximum dose, and, when administered, rapidly develops the physio- 
logical action of the drug in a high degree, giving rise to what are 
known collectively as symptoms of poisonous action of the remedy. 
Broken or fractional doses are merely doses much smaller than those 
usually given, and intended to develop the physiological effects by 
degrees, being the reverse of toxic doses in the sense that they singly 
produce no marked disturbance, and are within perfectly safe limits. In 
the following pages reference may be found to a full or single dose, the 
interrupted dose, and the continued dose. The full dose is the maximum 
amount which the patient will require to produce the physiological 
action of the remedy, and it is usually not intended to be repeated. For 
instance, an ounce of sulphate of magnesium, or several cathartic pills, 
ma}' be ordered to accomplish a certain therapeutic result, and, this 
being obtained, there is no need to give any more. Where the symp- 
toms frequently recur, as where purgative remedies are required in 
chronic constipation, or nitrite of amyl for angina pectoris, it becomes 
necessary to repeat the administration of the remedy from time to time, 
the system having opportunity to recover fully from the effects of one 
dose before another is administered. We have' then what is called the 
interrupted dose, which is generally smaller than the full dose, although 
exceptionally it occurs that by the frequent repetition of a remedy the 
system becomes accustomed to it, and larger doses are required to pro- 
duce the same effect, or it progressively fails in therapeutic value. The 
continued dose is wrhere each succeeding dose is given before the effects 
of the preceding has passed away, so that when the intervals are short 
a cumulative action of the remedy is seen. The latter obviously depends 
upon the rapidity of rate of elimination of the agent; some drugs, like XX 
INTRODUCTION. 
alcohol or ether, are excreted very quickly, and exert a cumulative action 
only when the intervals are very short; others, like digitalis and the 
mineral poisons, are excreted slowly, and may show a cumulative effect 
after awhile, even when only one or two doses are given daily. 
Prescribing for children is an art by itself, and the dosage does not 
bear a proportionate relation to the adult, so that tables for the calcula- 
tion of doses for children are useless. Some remedies, like opium and 
narcotics, must be prescribed with great care and generally in very small 
doses; others, like alteratives or tonics, are taken in relatively large 
doses. The physiological method of regulating doses by bodily weight 
may be something of a guide; taking the average adult dose to repre- 
sent the quantity required for 150 pounds, the weight of the patient will 
give the numerator of the fraction, but with many drugs this will give 
a minimum rather than a full dose for a child, except in the case of 
narcotics. 
Systemic, Specific, and Analeptic Remedies.—A systemic remedy is 
one which is not designed to affect the organs by which it enters the 
circulation, nor those by which it is finally excreted; it is given with a 
view of bringing about some change in the general solids or fluids of 
the body, so as to affect nutrition, and, as a rule, does this through some 
effect upon the nervous S3?stem. Remedies designed to affect special 
organs, such as the liver, kidneys, heart, genito-urinary tract, or alimen- 
tary canal, are local or organic remedies. Remedies are also divided 
into inorganic and organic, in relation to their nature and origin, as they 
belong to the mineral kingdom or to the animal or vegetable kingdom. 
A specific remedy is one having the power to stop the course of a 
particular disease and act as an antidote to its effects. There are no 
“sure cures ” in medicine, and no true specifics. Still, the manifesta- 
tions of malaria are so uniformly controlled by cinchona, syphilis by 
mercury, rheumatism by salicylic acid, and gout by colehicum, that these 
remedies are considered as approaching the character of specifics, 
although they sometimes fail, and often must be combined with other 
remedies in order to produce the best results. Analeptic remedies are 
those which build up the system; they are tonics and restoratives; they 
stimulate the nutritive functions, and some of them, such as codliver-oil, 
act as food. A remedy is said technically to be indicated when the 
symptoms show that the function of some part of the body is disordered ; 
and our knowledge of the physiological action and clinical effects of the 
remedy indicates to us the probability that its administration would 
produce a favorable result; thus, an emetic would be indicated in narcotic 
poisoning or in croup, a purgative would be indicated in faecal impaction 
of the bowels or in cerebral congestion; the sponge-bath and anti- INTRODUCTION. 
pyretics are indicated in fever. It is not meant that there is any 
mysterious relation existing between certain diseases and particular 
remedies in the sense that nature is crying out for a certain drug, and 
that no other would be serviceable, or that the patient would necessarily 
die if the medical attendant failed to discern the indication or to decipher 
the cabalistic inscription by which nature tests his skill. Diseases arise 
from causes; the object of treatment is (1) to remove the cause of dis- 
order, if possible, and if not (2) to obviate its effects by removal of the 
patient to more sanitary surroundings, or place him in improved physio- 
logical condition, and better able to resist the onward course of the 
disease; and (3) to make the patient comfortable and do what is possible 
to hasten recovery. This is rational medicine ; it is also scientific medi- 
cine because based upon exact knowledge of the effects of drugs and 
other remedial agents. From various sources an immense fund of infor- 
mation has been collected and reduced to laws or rides, the application 
of which, to individual cases of disease, constitutes the art of medicine, 
or practical therapeutics. PART 111. 
Pharmaceutical Therapeutic Agents, or Drugs. 
In this section will be considered, systematically and in alphabetical 
order, the remedial agents or drugs in present use in the treatment of 
disease. All of the drugs and preparations made officinal by the United 
States Pharmacopoeia receive notice and consideration in proportion to 
their importance. Some of the most valuable of the new remedies which 
are coming largely into use by the profession have also been introduced, 
these being distinguished from the officinal agents by the absence after 
them of the letters U. S. P. 
Each drug will be considered individually and from three different 
points of view: (1) the botanical or chemical definition and physical 
characters of the remedy, with the strength and dosage of its various 
preparations; (2) its physiological actions, including toxicology and 
antidotes, with special effects, if any, upon individual organs and tissues ; 
and (3) the therapeutical indications, with illustrative formulae and sug- 
gestions as to eligible forms of administration, or cautions concerning its 
use. This arrangement is the one which lias been found by experience 
to be the most convenient to facilitate reference and study. 
ABIES BALSAMEA. See Terebinthina Canadensis. 
ABIES CANADENSIS. See Pix Canadensis. 
ABIES EXCELSA. See Pix Burgundica. 
ABRUS.—Jequirity, or Wild Liquorice, the seeds of Abrus preca- 
torius. (Leguminosae.) 
Pharmacology.—A small plant or shrub, a native of India, but natu- 
ralized elsewhere in the tropics. The seeds, or beans, are small, nearly 
round, of a bright-red color, with a black spot at the liilum. They con- 
tain mucilage, abric acid, and a peculiar ferment to which the activity of 
the infusion appears to be principally due. The}" do not contain any 
alkaloid. A globulin and an albumose have also been found in jequirity. 
These bodies, of similar chemical composition, are both toxic, and their 
systemic effects have been likened to those produced by the venom of the 
snake. The temperature is lowered and the blood remains fluid after 
death. (Martin and Wolfenden.) 356 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Therapy.—The infusion is made by triturating three seeds in a 
mortar with an ounce of cold water, to which is added an ounce of hot 
water. When cold, the solution is filtered; the resulting filtrate contains 
the active principle or ferment, which is highly irritating, and causes a 
purulent inflammation if introduced into the eye. It has accordingly 
been used in ophthalmological practice in the treatment of granular 
lids or trachoma. It is applied three times the first day and repeated 
on the second and third days, if necessary. This powerful application 
should be made with care, since Dr. T. E. Murrell, of Little Rock, Ark., 
describes three cases of stricture of the nasal duct that had resulted from 
its use too frequently repeated or carelessly watched. An emulsion, 
made by simply rubbing up the seeds with water, may be painted on with 
a brush for the treatment of unhealthy ulcers, lupus, and epithelioma.* 
The emulsion j* recommended by the writer can be prepared in the 
following manner: 200 grains of the bean are decorticated by being 
slightly bruised and cracked in a mortar; the red hulls are then care- 
fully picked from the cotyledons and placed in a bottle covered with 
water. They are thus macerated for twenty-four hours, when they are 
again transferred to a mortar and thoroughly triturated until they are 
reduced to a smooth paste, when sufficient water is added to make the 
whole weigh 800 grains. 
Abrus is not used internally. Injection of the infusion into the cir- 
culation in the lower animals causes death by septicaemia. 
ABSINTHIUM (U. S. P.).—Wormwood, the leaves and tops of 
Artemisia absinthium. (Compositae.) 
Preparations.—Wormwood has no officinal preparations, though it 
enters into Vinum aromaticum (1 part to 100). 
Pharmacology.—An herb, bitter and aromatic to the taste, indigenous 
to Europe, but naturalized in this country, and common along waysides. 
It contains Absinthin, a very bitter, yellowish-white powder, not used in 
medicine, and also a oil, to which its effects upon the nervous 
system are principally due. A tincture, flavored with aromatics, forms 
a cordial called Absinthe, used to a large extent in France, where its per- 
nicious effects have attracted the attention of sanitarians. It produces 
profound disorder of the nervous sj'stem, epileptiform convulsions, and, 
if its use is continued, it renders the subject a physical wreck. These 
effects are similar to those produced by the volatile oil of wormwood 
upon the lower animals, in which it acts as a depressor of nervous 
energy, followed by stupor, clonic muscular spasms, and fatal coma. 
* “Jequiritv : its Use in Diseases of the Skin,” by the author. Transactions of the Medical 
Society of the State of Pennsylvania, 1884. 
t Jequirity. See paper by author, in Medical Bulletin, November, 1884. ACACIA. 
357 
According to the experiments of Cadeac and Albin Meunier upon ani- 
mals, the oil of wormwood, in small and large doses, possesses decided 
antiseptic properties. 
Toxicology.—Poisonous effects may be counteracted by cold affu- 
sions, followed by friction of the skin and sinapisms, with careful ad- 
ministration of ammonia by inhalation, by the mouth, or by injection 
under the skin or into a vein. Evacuation of the contents of the stom- 
ach should be obtained by stimulating emetics, or, if these fail, by the 
stomach-pump. The treatment of absinthism calls for hygienic and 
restorative measures, particularly nerve-tonics, in addition to the usual 
treatment of alcoholism. The use of absinthe as a stimulant should be 
discouraged by every means in our power, on account of the rapid 
deterioration, moral and physical, which it produces when habitually 
employed. 
Therapy.—Wormwood has been used medicinalty in the form of 
infusion (5>-ij to the Oj), a wineglassful being the dose as a tonic, or as 
an anthelmintic for children. The dose of the powdered leaves is 
gr. xx-xl, or, of the oil, gtt. i-iij. 
It is a domestic remedy for flatulent and weak digestion. 
Externally, it has been used as a stimulant application to indolent ulcers. 
A wine slightly tinctured with wormwood, known as Vermouth, is some- 
times given to increase appetite and hasten convalescence. 
ACACIA (U. S. P.).—Gum Arabic, a gummy exudation from Acacia 
verek and other species of Acacia. (Leguminosce.) 
Preparations. 
Mucilago Acacia (U. S. P.).—Gum-Arabic Mucilage (34 parts, by weight, with water 
enough to make 100 parts). 
Syrupus Acacia (U. S. P.).—Gum-Arabic Syrup (25 parts) ; Mucilage of Gum Arabic, 
with syrup (75 parts). 
These are the only officinal preparations of acacia, and are simply used as vehicles. 
The density of the solution of gum arabic enables it to be used to suspend insoluble 
powders, or oils ; in the latter case the resulting mixture is an emulsion. As an excipient, 
gum arabic enters into Mistura Amygdala, Mistura Cretce, Pulvis Creta Compositus, Mistura 
Olycyrrhizce Composita, and several officinal troches. It is a common dusting-powder for 
pills. 
Pharmacology.—Gum arabic comes in white, or nearly colorless, 
translucent, irregular lumps, or coarse powder, brittle, odorless, almost 
tasteless. Its solution is valued for its adhesive qualities. Acacia also 
possesses some nutritive properties, and in the East it is eaten as food. 
It is soluble in water, but insoluble in alcohol. Its preparations readily 
undergo acetous fermentation, unless some antiseptic is added to preserve 
them. As a rule, they require to be freshly made. 358 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Therapy.—In bowel disorders and fevers, a thin mucilage, flavored 
with lemon and sweetened, makes a nourishing, bland drink which relieves 
thirst. Irritation in the throat is relieved by gum-arabic troches. Coryza 
is checked by a snuff of acacia and bismuth subnitrate, to which a little 
morphine can be added, as in Ferrier’s snuff:— 
R Morphinae sulphatis, gr. v. 
Pulveris acacias, 3ij- 
Bismuthi subnitratis, 3vj. 
M. et ft. pulvis. 
For sore nipples a good combination is as follows :— 
R Pulveris acaciae, giv. 
Pulveris sodii boratis, 3j. 
Pulveris camphorae, gr. v. 
Pulveris marantae, 
M. Sig.: Dust over the surface. 
Another serviceable application in some diseases of the skin is :— 
R Pulveris acaciae, 3iij. 
Pulveris zinci oleatis, 3ss. 
Lanolini, 5ss. 
M. Sig.: Ointment for sore nipples. 
The emulsion may likewise be emplo}Ted as a demulcent vehicle in 
bronchitis, and in irritation of the genito-urinary passages. 
ACETAL, or Di-methyl Acetal. 
Pharmacology and Therapy.—A colorless liquid, with ethereal odor 
and pungent, persistent taste, produced by oxidation of alcohol. In 
physical characters it resembles alcohol or ether, and is soluble both in 
alcohol and in water. It acts like alcohol in obtunding sensibility and 
producing sleep, preceded by lowering of blood-pressure and symptoms 
of intoxication. It has been administered as a hypnotic in doses of 
1 or 2 drachms, but has nothing specially to recommend it. 
ACETANILIDE, or Phenyl-acetamide (Antifebrin*). 
Dose, gr. v-xv. 
Pharmacology.—A derivative of aniline ; a white powder, of neutral 
reaction, slightly pungent, without odor, slightty soluble in water and 
freely soluble in ether and in alcoholic solutions. It is not changed by 
acids or alkalies. 
Physiological Action.—In ordinary dose the action of acetanilide is 
much less marked upon a person in health than when fever is present, as 
*As the name “Antifebrin ” was introduced by the projectors, and patented by them, it 
should not be used in scientific language or in prescriptions. ACETANILIDE. 
359 
its most evident action is to reduce temperature, possibly by converting 
oxyhffimoglobin into methaemoglobin in the red blood-corpuscle, and 
interfering with oxidation. When an excessive quantity has been absorbed 
the alkalinity of the blood is lessened, the red corpuscles destroyed, the 
haemoglobin is liberated, and eventually appears in the urine, which 
becomes dark-brown in color. The quantity of uric acid and urea present 
in the urine is increased. Large doses cause diastolic arrest of the heart, 
preceded by motor and sensory paralysis. By smaller doses, the action 
of the skin and kidneys is increased; the blood-pressure is at first 
elevated, but soon falls, and the heart’s action becomes slower. It is 
claimed that in moderate amounts it acts as a cerebral and vasomotor 
stimulant without causing any subsequent ill effects. In some cases, 
however, whether owing to peculiar susceptibility or impurity in the 
drug, symptoms of poisoning, cyanosis and collapse have resulted. 
Vomiting or profuse sweating, accompanied by profound prostration, 
have also been witnessed as the effect of moderately large doses of 
acetanilide. These ill effects of the drug must be counteracted b}r use 
of external heat, vigorous alcoholic stimulation, together with the hypo- 
dermatic use of ether, atropine, and strychnine, in order to support the 
respiration and circulation. In patients suffering with fatty or dilated 
heart, it should onty be used with great caution, if at all. Owing to its 
action upon the blood-cells, it should not be used repeatedly or in large 
doses, in the low fevers. In animals poisoned by acetanilide the heart, 
liver, kidneys, and other organs have been found affected by fatty degen- 
eration. It is eliminated by the kidneys. 
Therapy.—This substance belongs to the aromatic series of antipy- 
retics, derived from coal-tar, and possesses advantages over all the others, 
owing to its slight taste and usual freedom from ill effects. In single 
doses of 15 grains or less, or in broken doses (gr. iij every hour or less), 
it will usually be followed by prompt reduction of the temperature to the 
normal. It is also antispasmodic, and has been used (doses gr. iii-v) 
in epilepsy, asthma, and whooping-cough. For the relief of pain it is less 
efficient than Antipyrin (which is an analogous compound, protected by 
copyright); but it has been employed in nervous affections, and to relieve 
the pains of facial neuralgia, locomotor ataxia, sciatica, etc., in doses of 
10 to 15 grains. In migraine or neuralgic headache it is also an efficient 
substitute for the much-lauded antipyrin. Acetanilide may be used with 
lupulin for the affections just named :— 
R Acetanilid., gr. c. 
Lupulini, gr. c. 
M. et ft. capsulae no. xx. 
Sig.: One or two capsules every two or three hours. 360 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS, 
It may "be employed with camphor, as— 
R Camphor®, gr. 1. 
Acetanilid., gr. c. 
M. et ft. suppositoriae no. x. 
Sig.: Insert one into the bowel every two or three hours for the pain of neuralgia. 
Dr. Hollopeter recommends, in simple fevers of children, the fol- 
lowing combination :— 
Vf. Acetanilid., gr. xviij. 
Hydrarg. chlor. mitis, gr. j. 
Sodii bicarb., gr. xij. 
Sacch. lact., gr. xv. 
M. et ft. chart, no. xij. 
Sig.: One every two hours until three are taken. 
Acetanilide often proves very useful in acute inflammatory rheuma- 
tism, reducing the temperature and relieving the pain and swelling. It 
is not infrequently speedily efficacious in cases which have received no 
benefit from salicylic acid or the salicylates. It is capable of notably 
ameliorating the actual suffering, though it is not always able to prevent 
relapse. 
It has been used in croupous pneumonia by Wrocz3rnski, who believes 
that, in addition to reducing the temperature, it favorably influences the 
pathological process in the lung. In scarlatina and other febrile affec- 
tions among children acetanilide has given very excellent results, though 
here, also, it must be watched carefully, as a number of cases of intoxi- 
cation from the drug have occurred among children. 
ACIDUM ACETICUM (U. S. P.).—Acetic Acid, composed of 36 per 
cent, absolute acetic acid and water 64 per cent. 
ACIDUM ACETICUM GLACIALE (U. S. P.).-Glacial Acetic Acid, 
nearty or quite absolute acetic acid. 
Preparation. 
Acidum Aceticum Dilutum (U. S. P.) .—Dilute Acetic Acid contains 6 per cent, absolute 
acetic acid. 
Acetic acid is the basis of the Aceta, or the Officinal Vmegars: Acetum Lobelise, Acetum 
Opii, Acetum Sanguinarias, Acetum Scillse. 
Pharmacology and Poisoning.—Acetic acid in the strongest form acts 
as an escharotic to the tissues ; and, if taken internally, is a violent cor- 
rosive poison, causing vomiting of sour-smelling liquid, with intense pain, 
followed by convulsions and fatal coma. If the case is prolonged, gastro- 
enteritis is produced by the acid. It has some antiseptic qualities, and 
slightly increases the acidity of the urine. Glacial acetic acid is partially 361 
ACIDUM ARSENIOSUM. 
eliminated hy the intestinal canal, but chiefly b}7 the kidneys. In cases 
of poisoning, milk or flour and water should be freely given,and vomiting 
encouraged. Weak alkaline solutions should be administered as chemical 
antidotes. 
Therapy.—The glacial acid is used successfully as an application to 
lupus, epithelioma, ulcers, papillomata, or warts, and nasal hypertrophies, 
and also as an application to ringworm and other forms of tinea. 
Yinegar (not otlicinal), or dilute acetic acid, has been given internally to 
check night-sweats and to relieve diarrhoea. Yinegar is a convenient 
antidote for poisoning b}7 caustic alkalies. It is also used externally for 
the relief of headache, and the entire surface of the bod}7 may be sponged 
several times a day with vinegar and water to reduce high temperature 
and acid sweating. It will also prevent the formation of bed-sores. 
The following liniment is useful in chronic rheumatism of the joints. 
It is Stokes’s or St. John Long’s liniment, the Linimentum Terebinthinae 
Aceticum of the National Formulary :— 
01. terebinth., f^iij. 
Ovum recent., . . . . . . , . . . . no. j. 
01. limonis, f3j. 
Acid, acetic., f3v. 
Aquae rosae, f^iiss. 
M. et ft. linimentum. 
Properly diluted, acetic acid is sometimes able to mitigate the in- 
tense pruritus of urticaria. It is capable also of checking moderate 
bleeding, as from leech-bites, superficial wounds, and epistaxis. In post- 
partum haemorrhage, weakened acetic acid, or vinegar and water, ex- 
pressed from a mop or sponge into the cavity of the womb will cause 
that organ to contract and prevent the loss of more blood. Acetic acid 
may be of service in bleeding from the stomach. Dr. E. Maguire reports 
good results in acute gonorrhoea from the use of injections, consisting 
of 1 part of acetic acid to 4 of water.* 
ACIDUM ARSENIOSUM (U. S. P.).—Arsenious Acid. 
Preparations. 
Liquor Acicli Arseniosi (U. S. P.).—1 per cent. Lose, bli-x. 
Liquor Potassii Arsenitis (U. S. P.).—1 per cent. Fowler’s Solution. Dose, b\i-x. 
Liquor Soclii Arseniatis (U. S. P.).—1 per cent, of Arseniate of Sodium, f Dose, bli-x. 
Liquor Arsenii et Hyclrargyri Iodhli (U. S. P.).—1 per cent, each Iodide of Arsenic and 
Biniodide of Mercury. Donovan’s Solution. Dose, bli-x. 
Arsenii lodidum (U. S. P.).—Iodide of Arsenic. Dose, gr. 
Sodii Arscnias (U. S. P.).—Arseniate of Sodium. Dose, gr. 
Arsenii Sulphidum.—Sulphide of Arsenic. Dose, gr. 
♦Annual of the Universal Medical Sciences, 1890, vol. v., 
t This should not be mistaken for Pearson’s solution of arsenite of sodium, which con- 
tains only gr. % to the ounce. 362 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Pharmacology.—A white, almost tasteless, heavy powder, or in 
dense mass of crystals, soluble in 30 parts of cold water or 15 of boiling 
water; also in glycerin and in hydrochloric-acid solution. It is arseni- 
ous oxide (A203), and is prepared by roasting the ore and sublimation. 
When thrown upon burning charcoal it volatilizes and smells like garlic, 
the fumes being very poisonous. It is recognized by Marsh’s test; by 
the generation of hydrogen in the presence of a solution containing 
arsenic, arseniuretted hydrogen is produced, which leaves a dark ring 
on a cold plate held in its flame; this also is extremely poisonous if 
inhaled. Reinsch’s test consists in adding a few drops of hydrochloric 
acid to the suspected solution, and immersing in it a polished plate of 
copper; the solution being heated metallic arsenic is deposited upon 
the copper. Arsenic possesses antiseptic qualities, and preserves bodies 
from decay; when death occurs from its effects, it, therefore, remains for 
a long time in the stomach, liver, and other organs. Owing to its taste- 
lessness and want of color, arsenious acid is frequently given with homi- 
cidal intent, but it is the most easily recognized by its tests of all the 
mineral poisons. Symptoiys of poisoning have resulted from the inges- 
tion of grain of arsenious acid, and death has been produced in the 
adult by doses of 2 to 4 grains. On the other hand, a case has recently 
been reported in which recovery occurred after about 154 grains had 
been taken. Paris green, or Scheele’s green, is an impure arsenite of 
copper, used for killing potato-bugs, and as a pigment in wall-papers. 
Clemen’s solution of the bromide of arsenic is made by boiling 
powdered arsenious acid and potassium carbonate (of each grains) 
in distilled water (8 fluidounces), and the resulting solution cooled and 
increased by the addition of more distilled water (up to ll£ ounces), to 
which is added pure bromine (115 grains). The fluid is kept four weeks, 
being frequently shaken during the first week, or until it forms a per- 
manently clear solution. The dose is from 1 to 5 drops daily', freety 
diluted, and given after meals. 
Physiological Action.—To the surface of the skin, if moistened, 
arsenic acts as an irritant, and produces inflammation and sloughing. 
In order to obtain its full effects as a caustic, the epidermis should 
first be removed ; but this is not advisable because of the severe pain 
which attends its use, and on account of the danger of absorption of 
the poison, especially when used about the mouth. Arsenic is readily 
absorbed, and is supposed to enter into combination with the red blood- 
corpuscles. It diminishes the elimination of carbonic acid and probably 
of urea. 
Taken in small doses, arsenic exerts a tonic effect upon the nervous 
system, stimulates the circulation, and permits an increased amount of ACIDUM ARSENIOSUM. 
363 
exercise to be taken without fatigue or short breathing. When admin- 
istered for a long time the system becomes habituated to its use, and 
much larger doses may, in some cases, be taken without serious conse- 
quences. The arsenic-eaters of Styria can take 8 to 10 grains at a dose; 
they also administer it to the horses in order to improve their condition 
and enable them to perform more work. It is said that only very few 
are able to tolerate such large doses, and they are careful not to drink 
water after taking it; so that absorption probably goes on very slowly, 
at .the same time that it is eliminated rapidly by the kidneys. It is 
possible that the tolerance may be partly explained by heredity; at all 
events, imitators of the arsenic-eaters, sooner or later, experience the 
toxic effects of the drug. Inflammation of the stomach is one of the 
results of poisoning by arsenic, even when introduced per enema or 
absorbed through the general surface. The urine becomes scanty, albu- 
minous, or bloody. The skin is affected by arsenic; superficial oedema, 
especially of the face, appears, and may be followed by eczema, 
urticaria, herpes zoster, bronzing in patches, or exfoliation of the 
epidermis. The digestive organs are stimulated by small doses, but 
large ones cause gastro-enteritis, with burning pain in the epigastric 
region, vomiting, purging, and collapse resembling Asiatic cholera. In 
fact, when symptoms of this kind appear in the absence of an epidemic 
of cholera, they are very likely caused by arsenical poisoning, and should 
always excite suspicion of the administration of arsenic. Arsenical 
poisoning is occasionally accompanied by paralysis of one or more 
extremities. After death from arsenic, fatty degeneration of the heart, 
liver, kidneys, and other organs has been found. The temperature is 
depressed by toxic doses. Fly-poison, or cobalt, an impure oxide of 
arsenic, is sometimes swallowed by mistake; so is rat-poison, made by 
mixing arsenic and meal (“rough-on-rats” contains 50 per cent.). 
Arsenic is excreted from the body by the kidneys and intestinal canal. 
Antidotes.—The antidotes to arsenious acid are the freshly-precipi- 
tated sesquioxide of iron, or the officinal ferri oxidum li37dratum cum 
magnesia, of which about 20 grains must be given for each grain of 
arsenic swallowed. The solution of dialyzed iron is also a convenient 
preparation for this purpose. Calcined magnesia and milk may be freely 
administered, and the stomach emptied by the stomach-pump, or by free 
vomiting. Oleaginous or mucilaginous drinks are also serviceable. If 
purging has not occurred the bowels should be emptied by sulphate of 
magnesia or Rochelle salts. The case subsequently may require treat- 
ment for resulting gastric inflammation. In some cases, instead of 
the gastro-intestinal symptoms, the patient is thrown at once into a con- 
dition of coma, hs if he had taken a narcotic. The autopsy reveals 364 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
lesions of the oesophagus and stomach, with erosions and ecchymoses, 
congestion of the lungs, and fatty degeneration of different organs. The 
arsenic may be detected not only in the contents of the stomach, but also 
in the urine and in the tissues, especially the liver and great nerve-centres. 
Therapy.—When administered internally it has occasionally shown 
considerable power over morbid growths, and is the only remedy we 
have at our command that has any effect upon the development of cancer 
of the viscera. In epithelial cancer and other superficial growths arseni- 
cal paste has been employed (cinnabar, 70; dragon’s blood. 22; arseni- 
ous acid, 8), but, as previously stated, it is a very painful treatment, 
and may only be applied to a small area at a time on account of the 
danger of producing toxic effects.* 
In ague and chronic malarial disorders, and also as a prophjdactic 
against malarial poisoning, arsenic is used very effectuallj' in small doses, 
and may be combined with quinine and iron :— 
Liq. potassii arsenitis, Hliii-v. 
Tr. cinchona cotnp., f3ij. 
M. pro dosi. 
Sodii arseniatis, gr. j. 
Mass, ferri carbonatis, gr. xx. 
Quininse sulph., . gr. xx. 
M. et ft. pil. no. xx. 
Sig. : One three times a day. 
Arsenii sulphidi, gr. ij. 
Aloini, gr. j. 
Ferri pyrophos., gr. xl. 
M. et ft. pil. no. xx. 
Sig. : One three times a day. 
In neuralgia, arsenic frequently exercises a very happy effect, espe- 
cially when given in the form of the solution of sodium arseniate. 
Larger doses are required for some cases of chorea, but the effect is very 
marked. 
It may be administered with advantage thus :— 
Liq. sodii arseniatis, f3j. 
FI. ext. Hoang-Nan, f3j. 
Elix. gentianae ferrat., f^v. 
M. Sig. : One teaspoonful in water after meals. Used in neuralgia aud chorea. 
Some spasmodic disorders of respiration, asthma, hay fever, and 
chronic catarrhal bronchitis are controlled by arsenic, and if there is no 
acute inflammation it may be used with the atomizer. 
In irritative dyspepsia, with morning vomiting and clean, red tongue, 
* The ignorant or excessive use of an arsenical paste or powder has been known to cause 
death through absorption. ACIDUM ARSENIOSUM. 
365 
arsenic is of service ; also in the diarrhoea coming on immediately after 
eating. 
In skin diseases arsenic is valuable in proportion to the absence of 
irritation or acute inflammation. In all chronic processes, especially 
when accompanied by desquamation or infiltration of the skin, such as 
psoriasis, the persistent use of small doses is often curative ; also in the 
dry form of eczema and impetigo, as well as in pemphigus and lichen. 
It is contra-indicated in the early stage of each of these affections except 
psoriasis. 
The following are serviceable formulae in the diseases referred to :— 
R Liq. potassii arsenitis, . . f3j. 
Tinct. nueis vomicae, . . f3ij. 
M. Sig.: From 15 to 20 drops in water three times a day. 
Sulphuris sublimati, gr. c. 
Acidi arseniosi, gr. j. 
M. et ft. capsulse no. xx. 
Sig.: One after meals. 
In diabetes mellitus, the solution of the bromide of arsenic (not 
officinal) taken in Vichy water after each meal has produced remarkable 
results in the hands of Clemens, probably owing to its action upon the 
liver. In disease of the liver or kidneys, especially the early stage of 
cirrhosis, arsenic sometimes has a very decided effect. 
In vomiting and diarrhoea, especially in infancy, the arsenite of 
copper in infinitesimal doses (gr. to water f§iv, a teaspoonful being 
given every hour or less) has been followed by good results ; but the 
older method of using Fowler’s solution in the same way is probably 
better because less poisonous than the arsenite of copper; the effect 
being largely due to the antiseptic action of the arsenic, which acts more 
efficiently in the soluble form. 
The vomiting of pregnancy is often reiparkably relieved b}T the ad- 
ministration of a drop of Fowler’s solution immediately before each meal. 
The same preparation is valuable in chronic gastritis (especially when it 
has been produced by alcohol), in chronic gastric ulcer, and cancer of the 
stomach. Arsenic is sometimes beneficial in chronic rheumatism. 
Syphilitic affections are sometimes better treated by the combina- 
tion of mercury with arsenic than by mercury alone. Donovan’s solu- 
tion is especially useful in old syphilitic skin lesions. 
Finally, in chlorosis and anaemia the tonic effects of arsenic may 
well be combined wTith those of quinine and of iron. The usual dose of 
arsenious acid is grain, to be cautiously increased. The best method 
of administration is in solution. 
Hadcliffe was the first to use arsenic hypodermatically for the relief 366 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS, 
of chorea, in 1866, and since then it has been frequently used in scaly 
skin diseases, lynipliadenomata, and nervous disorders. 
The ointment of oleate* of arsenic is also a useful application in the 
treatment of old ulcers, epithelioma, and lupus. The following combi- 
nation will be found of service in the diseases just named :— 
R Morphinae sulphatis, gr. ij. 
Zinci chloridi, gr. v. 
Pulveris marantae, 3j. 
Ungt. arsenii oleatis, 
M. Sig.: Apply on old muslin for several hours. 
The iodide of arsenic (gr. iv or v-3j) in ointment is a valuable stimu- 
lating application in old dry eczema. In lupus it may be made stronger, 
or we may combine it with corrosive sublimate:— 
p. Hydrarg. chlor. corros., 3iiss. 
Acidi arseniosi, 3j. 
Hydrarg. sulphidi rubri, gr. xl. 
Mix with water to a paste and apply with a brush. 
In warts, Unna advises the application of mercurial ointment con- 
taining from 5 to 10 per cent, of arsenic. 
ACIDUM BENZOICUM (U. S. P.).—Benzoic Acid. See Benzoinum. 
ACIDUM BORICUM (U. S. P.).—Boric Acid, formerly Boracic Acid. 
Dose, gr. v-xxx. 
Preparation. 
Sodii Boras (U. S. P.).—Borate of Sodium, or Borax. Bose, gr. v-xxx. 
Pharmacology.—Boric acid is in transparent, colorless, six-sided 
plates, soluble in 25 parts of water or 15 parts of alcohol, and in 3 parts 
of boiling water or 5 of boiling alcohol. The alcoholic solution has a 
green flame. Borax is soluble in 16 parts of cold water, but not in 
alcohol. Boric acid has a feebly-acid taste and borax a sweetish, alka- 
line taste and alkaline reaction. Boroglyceride (not officinal) is a com- 
bination of boric acid (62 parts) and glycerin (92 parts). When diluted 
with an equal quantity of glycerin, it makes the 50-per-cent, boro- 
glyceride, in which form it is used as an antiseptic. 
Lister’s antiseptic ointment for dressing wounds is made by adding 
1 part each of boric acid and white wax to 2 parts each of paraffin and 
almond-oil. Borated lint or borated cotton wool (absorbent cotton) is 
made by steeping the substance in a saturated solution of boric acid and 
allowing it to dry. 
Physiological Action and Therapy.—Boric acid is antiseptic. It is 
entirely unirritating when applied to the skin, and has been used as a 
* See Ointments and Oleates, especially in Skin Diseases, by the author. F. A. Davis, 1890. ACIDUM CARBOLICUM. 
367 
dressing for wounds. Suppuration of the ear, or running from the ear, is 
cured by cleansing the canal and insufflating finely-powdered boric acid. 
The saturated solution is used in various chronic, scaly, and parasitic 
skin eruptions, and is the best remedy for bromidrosis of the feet, or fetid 
perspiration. Among the beneficial combinations are :— 
R Acidi borici, 3iij. 
Bismuthi subnit., . . . 3iij. 
M. Sig.: For running from the ear and in excessive and fetid perspiration. 
U Acidi borici, 3ij. 
Pulv. zinci carb. imp., gss. 
M. Sig.: In acute eczema and erythema. 
R Acidi borici, . . . 3j. 
Aquae hamamelidis dest., f^iv. 
M. Sig.: Use in fetid perspiration and in an oily state of the skin. 
Borax in substance is applied to aphthous sore mouth in infants, 
mixed with white sugar ; its solution is a cooling application to super- 
ficial inflammations of the skin, and for pityriasis versicolor and sebor- 
rhoea of the scalp, or dandruff'. Internally, borax, in 20-grain doses, 
relieves irritable bladder and reduces the acidity of the urine. (For 
Dobell’s solution see next page.) It has, in some instances, given encour- 
aging results in epilepsy. 
Boroglyceride (50 per cent.) is a pleasant and efficient application 
for conjunctivitis, pharyngitis, and as a dressing for wounds and granu- 
lating surfaces, having the important advantage of not being poisonous. 
It is especially recommended for the local treatment of diphtheria. 
Boroglyceride ointment, made by adding it to unguentum rosse, is 
a pleasant application for sunburn, pruritus, and other skin affections. 
Boric-acid ointment (in lanolin or zinc ointment, 1 to 6) is used as a 
dressing for wounds and ulcers. The solution of boroglyceride is a 
valuable application in chronic eczema of’the palms of the hands and 
the soles of the feet. It is also useful in subacute and chronic eczema 
of the genital organs, especially when the scrotum is invaded. It can 
be prescribed with witch-hazel:— 
]£ Sol. boroglyceridi (50 per cent.), f^iij. 
Aquae hamamelidis dest., fgij. 
M. Sig: Apply with old muslin. 
ACIDUM CARBOLICUM (U. S. P.).—Carbolic Acid, Phenol. 
Dose, gr. ss-ij. If liquefied, ttli—ij- 
ACIDUM CARBOLICUM CRUDUM (U.S.P.).—Crude Carbolic Acid. 
Preparations. 
Unguentum, Acidi Carbolici (U. S. P.).—Ointment of Carbolic Acid, 10 per cent. 
Sodii Sulphocarbolas (U. S. P.).—Sulphocarbolate of Sodium. Pose, gr. v-xxx. 368 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Pharmacology.—Carbolic acid is a liquid obtained during the distil- 
lation of coal-tar between the temperatures of 180°- and 190° C. (356° to 
374° F.). What is called crude carbolic acid is distilled at a somewhat 
lower temperature, and contains also cresylic acid and other substances 
which render it unfit for medicinal use except as a disinfectant for drains, 
etc. The pure acid is crystalline at ordinary temperatures, and at first 
is colorless, but reddens after exposure to the air. It has a character- 
istic odor and pungent taste ; it is very soluble in all the usual menstrua, 
having the peculiarity of being liquefied by 5 per cent, of water; but the 
further addition of water produces turbidity until the proportions are 
reversed (I to 20), when it remains permanently clear and is not affected 
by further dilution. It resembles creasote in its disinfectant properties, 
but differs from it bjr being converted into picric acid when nitric acid 
is added to it; whereas, with creasote, nitric acid forms oxalic acid. 
Resorcin is also of a similar character, but is in the form of a powder. 
Both creasote and resorcin will be considered separately. 
The following unofficinal preparations are sometimes used :— 
Unofficinal Preparations. 
Qlyceritum Acidi Carbolici (25 per cent.). External use. 
Aqua Acidi Carbolici (3ij in Oj, or glycerite, 3x in Oj). Dose, f3i—ij; also as a wash, 
gargle, or spray. 
Unguentum Acidi Carbolici (with simple ointment, 1 to 9). 
Carbasus Acidi Carbolici (gauze, containing carbolic acid 1, resin 5, paraffin 7 parts). 
Oleum, Acidi Carbolici (1 in 20 of olive- or cottonseed- oil). 
Suppositoria Acidi Carbolici (each containing 1 grain). 
Campho-Phmique.—Carbolic-Acid Camphor. Dissolve 9 parts acid in 1 of alcohol, 
and mix with 25 parts camphor, forming a clear, oily solution. 
Liquor Sodii Carbolatus.—Phenol-Sodique. Carbolic acid, gr. clxxxviij; caustic 60da, 
gr. xxxj; water, For external use, properly diluted. 
Liquor Sodii Boratis Compositus.—Dobell’s Solution. Borax and sodium bicarbonate, 
each, 3ij ; carbolic acid, gr. xxiv, in water, Oj. For external use in spray for nose and throat. 
Tri-Brom-Phenol.—A compound of Bromine with Carbolic Acid. In the form of soft, 
white needles ; used externally as an antiseptic. 
Calcium Carbolatum.—Carbolated Lime. For disinfecting purposes. 
Physiological Action.—Carbolic acid and its preparations are distin- 
guished by their destructive action upon the lower forms of life, but 
owing to their tarry smell they cannot be used for preserving food, like 
boric acid, and are not popular in the household. When applied to the 
skin, carbolic acid causes irritation, and sometimes sloughing; it is a 
local anaesthetic. It is also readily absorbed through the skin, and toxic 
effects have been produced in this way, although much more frequently 
by the absorption through the raw surface of a recent wound. The urine 
is diminished in quantity, and on standing acquires an olive-green color ; ACIDUM CARBOLICUM. 
369 
this is generally the earliest symptom of intoxication. We also notice 
loss of appetite, nausea, vomiting, frothy salivation, difficulty in swal- 
lowing, and nervous symptoms. The pupils are contracted and the 
functions of the brain and spinal cord are affected, suspended reflexes and 
impaired sensibility and motility being observed. Death occurs from 
respiratory paralysis; the temperature is at first increased, but after- 
ward is reduced. In severe cases there is shock, great pallor, and 
sudden death. At the autopsy the drug may be recognized by its 
penetrating odor; evidences of corrosive action may be seen if 
taken in concentrated form, but even in small quantities it produces 
gastritis. As elimination takes place principally by the urine, the 
kidneys may be congested or inflamed; the blood is dark and imperfectly 
coagulated. 
Treatment of Poisoning.—When carbolic acid has been swallowed 
prompt treatment is required. The soluble sulphates (soda or magnesia) 
are the best antidotes, but the liquor calcis saccharatus, or syrup of lime, 
is also useful, if at hand. Alkalies, soap, albumin, flour and water may 
be given, and the stomach washed out with the stomach-pump. Oils 
should not be given, as they favor absorption. The bowels should be 
freely opened with Epsom salt, to carry oft' any acid from the intestinal 
tract. Collapse is relieved,by hypodermatic injections of atropine, by 
hot applications, arterial stimulants, and friction. The soluble sulphates 
should be administered in small doses for several days, in order to 
remove the carbolic acid from the system. 
Therapy.—The antiz3rmotic and antiseptic qualities of carbolic acid 
have been largely utilized in surgeiy, although it has now been nearly 
superseded by the solutions of mercury, which have no offensive odor. 
Formerly the spray of carbolic water was considered an indispensable 
feature of the Listerian method, but this has been found to be unneces- 
sary and has been abandoned, as asepsis can be secured without it. It is 
still used, however, as a detergent and as an application upon dressings. 
In the treatment of carbuncle or malignant pustule, after incision and 
scraping, the application of pure carbolic acid not only acts as an anti- 
septic, but also as a local anaesthetic, relieving pain. The camplio- 
phenique, being free from offensive odor, may be used as a substitute for 
the pure acid. 
In weak solutions carbolic acid has been used as a parasiticide in 
various forms of tinea; and it has also been used topically for the 
prevention of pitting from small-pox, and in the treatment of burns, in 
the form especially of carbolized oil. In acute vesicular eczema, ery- 
thema, and in dermatitis, especially from various poisonous substances, 
the writer has employed this combination with great service:— 370 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Acidi carbolic!, gtt. vj. 
Pulveris zinci carb. imp., %j. 
Liq. calci6, 
Glycerini, 
M. Sig.: Shake well, and mop frequently over the surface. 
An ointment containing carbolic acid, sulphur, and camphor is most 
effective in many pruritic diseases of the skin, especially papular eczema, 
psoriasis, lichen, and urticaria or nettle-rash :— 
Acidi carbolici, .... gtt. vvelx. 
Sulphuris subl., 3ss. 
Camphor®, gr. x. 
Ungt. zinci oxidi, j§j. 
(M. Sig.: Apply frequently to the irritable surface. 
Internally, carbolic acid sometimes rather unexpectedly produces 
symptoms of poisoning, which fact restricts its use. In fermentation 
accompanying flatulent dyspepsia and in dilated stomach, carbolic acid 
will check the process and relieve the symptoms. It is useful in irritable 
vomiting, given frequentty in broken doses. The author suggests the 
following prescriptions in the variety of dyspepsia referred to :— 
Acidi carbolici, gtt. iv. 
Pulv. aromatic., gr. xij. 
M. et ft. pil. no. xij. 
Sig.: One before meals. 
Acidi carbolici, gtt. v. 
Syrupi acaciae, . f^iss. 
Aquae cinnamomi, f^iss. 
M. Sig.: One teaspoonful before meals. 
It lias been used in pill form in the treatment of tape-worm. It is 
part of the so-called specific treatment of typhoid fever in extempora- 
neous combination with tincture of iodine (l to 2 of iodine) in doses of 
gtt. ii-iij every three or four hours, given in mint-water. In offensive 
breath, the cause may be in the mouth, throat, or bronchi, and in any of 
these cases the use of the steam-atomizer with a 5-per-cent, solution of 
carbolic acid will often relieve the patient very promptl}’. Caries of the 
teeth may be relieved by a mouth-wash containing carbolic acid or 
phenol-sodique, well diluted. The same applied with a brush or atomizer 
has been used in diphtheria and various forms of sore throat. Weak 
solutions are used in hay fever, chronic nasal catarrh, coryza, and influ- 
enza, and afford marked relief; the one known as Dobell’s solution is 
widely used for the purpose, and for cleansing the nostrils previous to 
making local applications. 
Parenchymatous injections of a 2-per-cent, solution have been made ACIDUM CHROMICUM. 
for checking the progress of erysipelas, and also into the cavities of the 
lungs in pulmonary phthisis. In the earl}' stage of furuncle, and in en- 
larged lymphatic glands, the hypodermatic injection of the same solution 
will often prove effectual in preventing the formation of pus. The pure 
acid (npxv-xx) has been used by Levis as an injection into the tunica 
vaginalis in cases of hydrocele, with successful results. In haemorrhoids, 
carbolic acid, either pure or diluted with oil, has been employed with 
satisfactory results, but there have been some accidents. It has also 
been recommended in weak solution for the treatment of ascarides by 
enema, but the danger of absorption is too great for its use in this way ; 
it may, however, be applied externally, as it is an excellent antipruritic. 
The vapor of carbolic acid may be inhaled for wdiooping-cough or 
phthisis, in the place of the spray, b}T placing a few drops upon some 
absorbent cotton in an inhaler. 
In the septic diseases,—small-pox, septicaemia, puerperal fever, etc., 
—the sulpho-carbolates have been used with asserted success. In typhoid 
fever, Dr. Waugh has had good results from the sulphocarbolate of zinc 
in doses of gr. ii-iij, four or five times a day. It has the advantage, 
over the carbolic acid and iodine treatment, of being less depressing to 
the heart and less injurious to the kidneys. 
ACIDUM CHROMICUM (U. S. P.).—Chromic Acid, Cr03. 
Preparation. 
Potassii Biehromas (U. S. P.).—Bichromate of Potassium. Dose, gr. 
Pharmacology.—Chromic acid occurs in the form of small, crimson, 
needle-shaped crystals, deliquescent and very soluble in water. They 
should not be added to alcohol, as mutual decomposition takes place, 
sometimes explosivel}'. An explosion results instantly from a mixture 
of 1 part of chromic acid with 2 parts of glycerin. For the same reason 
chromic acid should never be combined with spirit of nitrous ether. 
Physiological Action and Toxicology.—On account of its marked 
affinity for water and its contained ox}Tgen, chromic acid rapidly destroys 
tissues, forming an eschar, and it is a powerful antiseptic. In solution 
(from 5 to 20 per cent.) it acts as a caustic. When swallowed it is a cor- 
rosive poison, and requires prompt treatment by demulcents and alkalies, 
with irrigation of the stomach. If death does not occur at once from 
shock it may result from inflammation and sphacelation of the mucous 
coats of the stomach. Workmen in factories where chromic acid is used 
are liable to have perforation of the nasal septum from the local action of 
the acid applied accidentally upon the fingers. The electropoion fluid 
(Liquor Electropoiecus, N. F.), or battery fluid, contains bichromate of 
potassium in powder, 6 ounces ; commercial sulphuric acid, 6 fluidounces ; 372 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
cold water, 48 fluidounces). Being of an attractive red color, and in such 
common use among physicians, it may be swallowed by mistake, and 
instances of poisoning are not uncommon. In such cases, soap-suds and 
milk may be given at once, and the stomach carefully washed out with a 
soft tube, as vomiting may rupture the stomach. Arterial stimulants and 
external counter-irritation and hot applications may be required. Chrome 
3’ellow, or the chromate of lead, has been used by bakers in order to give 
a rich color to cakes. A number of cases arising from this adulteration 
have been investigated by Dr. I). D. Stewart, of Philadelphia. Though 
mentioned here incidentally, the symptoms are principally indicative of 
lead poisoning. 
Therapy.—The solution of chromic acid is an excellent remedy for 
warts, syphilitic mucous patches, and enlarged tonsils (gr. x ad aq. 5j),. 
applied with cotton or a camel’s hair brush once or twice a day. It has 
also been used in gynaecological practice in uterine haemorrhage and endo- 
cervicitis, and has been injected into hemorrhoids, and applied to hyper- 
trophies of the nasal chambers, and also to some malignant growths. 
Sweating of the feet (hyperidrosis) is relieved by sponging the feet 
daily with a weak solution. Parasitic skin diseases, sycosis, lupus, tinea 
circinata, and condylomata, require a stronger solution (gr. c to §j). 
As the caustic action tends to spread, it should be used with caution, 
covering the neighboring surface with ointment, and promptly removing 
excess of acid with an alkaline wash. 
Chromic acid is not used internally; but the potassium bichromate 
has been administered in doses of to £ grain ; it acts as an emetic in 
doses of f grain. It has been used in chronic rheumatism and syphilis 
made into pill with some vegetable bitter, but is of doubtful utility. In 
cases of poisoning by bichromate of potash the same means are employed 
as in chromic-acid poisoning. 
ACIDUM CITRICUM (U. S. P.).—Citric Acid. 
Dose, gr. x-5ss. 
Preparation. 
Syntpns Acidi Citrk-i (U. S. P.).—8 to 1000 simple syrup. 
The officinal citrates are citrate of lithia, citrate of potash, and solutions of citrate 
of potash, magnesia, and iron. The syrup forms a pleasant excipient 
Pharmacology.—Citric acid is obtained from lemon-or lime-juice ; 
it occurs in the form of colorless crystals soluble in less than their own 
weight of water; it has a sour taste, not unpleasant in weak solutions. 
In substance it is irritating to the gastro-intestinal mucous membrane, 
and may thus act as a poison. It renders the urine acid. It is eliminated 
to some extent by the bowels, but principally by the kidneys. ACIDUM GALLICUM. 
373 
Therapy.—In tlie proportion of 570 grains to 1 pint of distilled 
water it forms a solution of the average acidity of lemon-juice, which 
may be further diluted and sweetened as a refrigerant drink for fever. 
Jt has been used also as a substitute for fresh lemon-juice in the treat- 
ment of scurvy, but is less efficient. Dose of the acid, gr. x to 5ss. It 
has the power of sterilizing polluted water. 
ACIDUM GALLICUM (U. S. P.).—Gallic Acid. 
Dose, gr. ii-x. 
Preparation. 
Ungtientum Aculi Gallici (U. S. P.).—10 per cent., with benzoinated lard. 
Pharmacology.—Galls are lumps or nodes upon the oak-tree, caused 
by insects. According to the pliarmacopoeial definition, gall® are 
“excrescences on Quercus lusitanica, var. infectoria, caused by the 
punctures and deposited-ova of Cynips gallae tinctoria,” ail insect of the 
order Hymenoptera. They contain about 50 per cent, of tannic acid, 
which chemically is an anhydride of gallic acid, and, in fact, is con- 
vertible into gallic acid by immersion in water. The dose is from 5 to 
10 or 20 grains. It is an antidote to antimony or tartar emetic. Its 
solutions strike a black color in the presence of iron, and they should 
not be prescribed in combination with chalybeates. 
Therapy.—Gallic acid is in the form of long needles, nearly color- 
less, slightly acid, though less astringent than tannin; it is soluble in 
100 parts of cold water, parts of alcohol, or 3 parts of boiling water. 
Like tannin, it has the effect of restraining secretion, reducing swelling, 
and hardening tissues. It is eliminated b}T the kidneys under its own 
form. In the form of the glycerite (5j to 5j of glycerin) it forms a 
favorite application to sore throat or tonsillitis; and the ointment of 
gallic acid is a good application to haemorrhoids, being an improvement 
upon the ointment made of powdered galls. The alcoholic solution is 
useful as a local application to the membranes in diphtheria. 
Internally, gallic acid is given in haemorrhage (gr. xx at a dose) from 
the alimentary canal, kidneys, or lungs; also in menorrhagia, but here it 
is inferior to ergot. 
In haemoptysis, ulcer of the stomach, haemorrhage from the bowel, 
especially in typhoid fever, the following formulae can be used :— 
R Acid, gallic., . . . 3ij. 
Acid, sulphuric, arom., ........ f^j. 
Morphinae sulph., gr. j. 
Tinct. cardamom, co., f^j. 
Aquae rosae, f^ij. 
M. Sig. : One teaspoonful in water every hour or two. 374 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
]£ Acid, gallic., 3ij. 
Glycerini, iij. 
M. Sig.: One teaspoonful every half hour or hour until relieved. 
It lias also been used to reduce the quantity of albumin in the form 
of chronic renal disease commonly called Bright’s disease. 
On account of its astringent effects gallic acid is useful in a number 
of disorders attended by excessive secretion or transudation, as chronic 
bronchitis, cystitis, chronic diarrhoea, dysentery, and the night-sweats of 
phthisis. It is likewise serviceable in purpura lnemorrhagica. It retards 
the progress of pyelitis or pyelo-nephritis, and diminishes suppuration. 
Combined with opium, it has been found beneficial in diabetes insipidus. 
Py rogallic acid is obtained from gallic acid by heat; it is used 
externally in the treatment of acne, but has the disadvantage of 
discoloring the skin. 
ACIDUM HYDRIODICUM.—Hydriodic Acid. 
Pharmacology.—Hydriodic acid is a gas prepared by the action of 
iodine upon phosphorus in the presence of water, with the aid of gentle 
heat. It is colorless, but produces white fumes in air ; it can be liquefied 
or even rendered solid by strong pressure and a low temperature. A 
solution of hydriodic acid in water, if exposed to the air, soon becomes 
discolored, and after a time deposits crystals of iodine. The solution is 
not officinal, but the United States Pharmacopoeia recognizes a 
Syrupus Acidi Hydriodici (U. S. P.), Syrup of Hydriodic Acid, 
which contains 1 per cent, of absolute acid ; the dose being from 30 
minims to half an ounce. • 
Therapy.—The syrup of hydriodic acid* is a valuable means of 
introducing iodine into the system, and it will be considered further 
under Iodine. When administered in this way the iodine is liberated in 
tbe body and is peculiarly active in the nascent form, and especially 
adapted for administration to scrofulous subjects and cases of catarrhal 
pneumonia of the chronic type. In some skin diseases of the same char- 
acter the syrup of hydriodic acid, when carefully made, has proved of 
great value. It is very efficacious in spasmodic asthma, especially of 
that variety which is linked with the gouty diathesis. 
ACIDUM HYDROBROMICUM DILUTUM (U. S. P.).—Diluted 
Hydrobromic Acid. Dose, n^x-f'5iv. 
Preparation. 
Quinine Hydrobromate is the only officinal salt. Dose, gr. i-xx. 
Pharmacology.—Hydrobromic acid resembles hydrochloric acid in 
being officinal only in solution, each being a gaseous substance. Dilute 
* “Hydriodic Acid,” by the author, in Medical Bulletin for August, 1889. ACIDUM HYDROCHLORICUM. 
375 
hydrobromic acid contains 10 per cent, of absolute hydrobromic acid. 
Its usual dose is from npx to f3iv. It is a clear, colorless solution with 
an acid taste, and can be given in lemon-syrup or simple elixir. 
Therapy.—Hydrobromic acid should be an excellent antiseptic for 
dressing wounds, being sedative, non-poisonous, and bactericide in its 
action. It was introduced as a substitute for the bromides, but it has 
not fulfilled the expectations of its projectors, although it has some ano- 
dyne and hypnotic effects. It is more pleasant to take than the bromides, 
and in some cases of nervous cough, neuralgia, headache, and nervous- 
ness it has a good effect, but is ordinarily given in too small doses. 
De Schweinitz has found it useful in headache due to eye-strain. In cases 
of annoying tinnitus after taking quinine it is said to give prompt relief, 
although it often fails in relieving tinnitus from other causes. Two 
fluidrachms are equivalent to 18 grains of potassium bromide. 
To relieve irritative cough in phthisis :— 
Codeinse, gr. j. 
Acidi hydrobromici dil., f^j. 
Syr. aurantii, f^ij. 
M. et ft. mistura. Dose, 3i-ij. 
Bromine is considered under the head Bromum, in proper order. 
ACIDUM HYDROCHLORICUM (U. S. P.)—Hydrochloric Acid, 
formerly Muriatic Acid. Preparation. 
Acidum Hydrochlorimm Dilutum (U. S. P.).—Dilute Hydrochloric Acid. Dose, Ilfx-xxx. 
Pharmacology.—The officinal hydrochlorates are of apomorphine, 
morphine, pilocarpine, and quinine. Aqua clilori is also officinal. Hydro- 
chloric acid is an irritating, irrespirable gas. The preparation officinal 
under this name contains 81.9 per cent, of absolute hydrochloric acid in 
water. The dilute hydrochloric acid contains 6 parts of the strong solu- 
tion with 13 parts of distilled water. The latter is generally used for 
internal administration, as the stronger solution allows the gas to escape, 
the pungent fumes of which are unpleasant. The solutions are clear, 
colorless, and decidedljr acid. When applied to the skin they are anti- 
septic and astringent; in some persons with delicate skin hydrochloric 
acid is irritating and slightly caustic. 
Physiological Action and Toxicology.—When taken internal!}' in poi- 
sonous doses, it acts as a violent irritant, causing burning pain, a strong 
acid taste in the mouth, red and swollen tongue, and discoloration of the 
lips. Vomiting occurs at once, and may be accompanied by bleeding. 
The patient is at first feverish, but soon falls into collapse and dies of 
shock or exhaustion. Violent gastric inflammation is found after death, 
and the oesophagus and mouth show the effects of a corrosive poison. 376 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
The vapor of ammonia escaping near the vomited matters produces a 
white cloud of chloride of ammonium. The treatment is the same as for 
other corrosive mineral acids,—demulcent drinks, flour or soap and water, 
milk, oil, or eggs. The carbonates may be given cautiously, for fear of 
rupturing the stomach by the escaping carbonic-acid gas. The stomach 
being softened b}' the acid, it should be evacuated by the tube rather 
than by emetics, if vomiting does not occur spontaneously. There is, 
moreover, danger that in the act of vomiting a portion of the acid may 
find its way into the air-passages and thus still further extend the mis- 
chief. Subsequently, the patient must be treated for the resulting lesions, 
which are not limited to the intestinal tract, since congestions of the 
kidneys and lungs may also occur. 
Therapy.—Topically, hydrochloric acid is applied to septic wounds, 
dissecting wounds, or bites of rabid animals. It has also been used, 
mixed with an equal proportion of honey, as an application to the throat 
in diphtheria. It is important that this application should be made only 
to the diseased surface. It is a good addition to baths in cases of skin 
disease, as pityriasis versicolor or tinea, and in full strength it is used 
to destroy warts on the hands of children. 
When hydrochloric acid is given well diluted it is acceptable to the 
stomach, being one of the constituents of the gastric juice. When fer- 
mentation of the food takes place, causing flatulence or “ windy dys- 
pepsia,” it may be due to a deficiency of this element. At all events, 
cases of weak digestion and dyspepsia are sometimes much benefited by 
10 or 20 drops of the dilute acid with half the quantity of tincture of 
mix vomica, after each meal. here acid stomach is caused by the 
presence of bacteria, the antiseptic action is best obtained by adminis- 
tering the hydrochloric acid when the stomach is empty, shortly before 
eating. It is also held that the excessive secretion of hydrochloric acid 
(which forms one variety of acid stomach) may be prevented by adminis- 
tering an acid solution just before eating, on the rule that acids check 
acid secretions. Hydrochloric acid sometimes affords great relief in 
nausea. In intestinal indigestion with diarrhoea, this agent is also very 
effective, given one or two hours after meals. The temporary adminis- 
tration of pepsin in combination with the acid is of great value in cases 
of this kind, but the pepsin should not be continued too long, or the 
peptic glands'may lose their functions. 
A good mixture which is very beneficial is :— 
Acid, hydroclilor. dil., , , . f3iv. 
Pepsin, pur., 3iv. 
Glycerini, f^iij. 
M. Sig.: One teaspoonful in water after meals. 377 
ACIDUM HYDROCYANICUM DILUTUM. 
In fevers, where the secretions are very much diminished and hydro- 
chloric acid is not secreted, its administration is of great service in 
assisting digestion and preventing the development of micro-organisms. 
In typhoid fever this is the most common treatment (gtt. x-xx, every 
three hours), and it exercises an important influence upon the contents 
of the bowels, being slightly astringent and preventing the multiplication 
of bacilli. Relapse is less frequent under this treatment because auto- 
infection is less likely to occur. In other infectious zymotic diseases, 
as scarlet fever, small-pox, or diphtheria, hydrochloric acid may be ad- 
ministered in the same way. In phthisis it is serviceable in disinfecting 
to some extent the alimentary canal, checking excessive sweating, or 
watery discharges from the bowels, and promoting constructive meta- 
morphosis. V 
A very beneficial combination for phthisis will be :— 
Acid, hydrochlor. dil., Nice. 
Tinct. nucis vomicae, Nice. 
Tinct. capsici,. f3j. 
Tinct. cinchonae, f^v. 
M. Sig.: Two teaspoonfuls in water after meals. 
The officinal liquor pepsini contains saccliarated pepsin, 40 parts ; 
hydrochloric acid, 12 parts; glycerin, 400 parts; and water to make 
1000 parts. The usual dose is a tablespoonful after eating. 
Chlorine, for bleaching or disinfecting purposes, can be obtained by 
pouring hydrochloric acid upon manganese binoxide. It is a greenish- 
colored, intensely irritating gas. (See Aqua Clilori.) 
ACIDUM HYDROCYANICUM DILUTUM (IT.S.P.).—Dilute Hydro- 
cyanic Acid, sometimes called Prussic Acid. 
Dose, nu-v. 
Pharmacology.—A liquid composed of 2 per cent, of absolute hydro- 
cyanic acid and 98 per cent, of alcohol and water. It is colorless, faintly 
acid, with taste and odor of peach-kernels, rapidly loses the volatile 
acid when exposed to the air and light, and deteriorates if kept too long ; 
so that the dose is variable. The usual dose is from 1 to 5 minims, but 
we should always commence with the minimum dose and cautiously in- 
crease, because of the different degrees of activity of this preparation. 
Cherry -laurel water (Aqua laurocerasi) is officinal in European pharma- 
copoeias, but not in ours ; it is also of very variable strength, but is used 
in somewhat larger doses The cyanides of mercury, potassium, 
and silver are officinal. By the addition of an acid to any of these salts, 
it will be decomposed and hydrocyanic acid set free, as in the following 
prescription :— 378 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Potassii cyanidum, gr.j. 
Acid, citric., gr. v. 
Syr. tolutani, vel iij. 
M. Sig.: A teaspoonful at a dose for an irritable cough. 
Physiological Action and Toxicology.—Hydrocyanic acid is very 
poisonous as a gas, and even in the ordinary solution, in sufficient quan- 
tities to cause death, it is almost immediately fatal. In cases where 
it does not cause death at once, there is great prostration of bodily 
powers; wreak, flattering pulse ; cold extremities, and impending col- 
lapse. Atropine, hypodermaticall-y, is the physiological antidote; but 
no time should be lost before emptying the stomach with the aid of 
stimulating emetics. Cold affusions to the spine, with frictions and 
sinapisms to the surface, and hot applications are also efficient. The 
peculiar bitter-almond odor of the ejecta indicates the character of the 
poison. Death generally occurs by suffocation from paralysis of respi- 
ration. Elimination, as well as absorption, of hydrocyanic acid is very 
rapid. Ringer states that if life can be supported for half an hour 
recovery will usually occur. 
Locally, hydrocyanic acid at first slightly irritates the skin, but 
afterward acts as a sedative. It should not be used in skin diseases 
when the skin is broken, for fear of absorption. It has some action 
upon tlie brain, causing vertigo and hebetude; the respiratory centre 
is enfeebled and the motor nerves paralyzed, producing great muscular 
feebleness. The conducting power of the sensory nerves is diminished. 
It is a decided cardiac sedative, the pulse becoming slow, with lowered 
arterial tension. The poison also acts upon the respiratory function 
of the red blood-corpuscles, and prevents them from carrying sufficient 
oxygen to the tissues. 
Therapy.—Hydrocyanic acid has been used as an antispasmodic in 
various forms of reflex vomiting, such as the vomiting of pregnancy 
and that of phthisis. It lias also been employed in nervous cough, in 
irritable heart, and asthma. As it is rapidly eliminated from the sj’stem, 
the dose should be repeated at short intervals. Its sedative effect upon 
the gastric mucous membrane renders it valuable in painful affections of 
that organ, such as gastralgia, ulcer, and cancer. The same benefit is 
obtained from its use in enteralgia. For external use it may be added 
to rose-water (5ii-3viij) with a little glycerin, to be applied in cases of 
troublesome pruritus. 
ACIDUM HYDROFLUORICUM.—Hydrofluoric Acid. 
This is also an irrespirable gas, but is dispensed in solution with 
distilled water (1 to 200), and administered in doses of 10. to 20 minims. 379 
ACIDUM LACTICUM. 
The gas has the power of acting upon glass, and the solution must be 
kept in rubber bottles. 
Under the theory that this gas would exert a destructive influence 
on the bacilli, hydrofluoric acid has been tried in phthisis, but the results 
have not supported the theory. The fluorides of ammonia and iron have 
been also tried in medicine, but with no better result. 
ACIDUM LACTICUM (U. S. P.).—Lactic Acid. 
Dose, n^xx-5ss. 
Preparation. 
Ferri lactas (U. S. P.).—Lactate of iron. Dose, gr. ii-v. 
Pharmacology.—A colorless, odorless, syrupy liquid, with an acid 
taste, containing 75 per cent, of lactic acid and 25 per cent, of water. 
On account of carelessness in manufacture it may contain hydrochloric, 
sulphuric, or sarcolactic acid and traces of metallic impurities. It is 
soluble in water and alcoholic solutions. The ordinary dose is from 
twenty minims to a half a drachm, diluted and sweetened. 
Physiological Action.—Lactic acid is present in the stomach during 
the digestion of carbohydrates, especially during the first stage of gastric 
digestion. When in excess, it forms one variet\T of sour stomach, and 
causes pains in different parts of the bod}", headache, etc. It has been 
asserted that rheumatism is due to an excess of this acid in the system, 
and the fact that rheumatoid sj’mptoms sometimes develop after par- 
taking of sour milk or lactic acid seems to lend support to this view. 
Such patients are benefited by the use of alkaline treatment. Large 
amounts act as depressors to the nervous system and decrease the normal 
alkalinity of the blood, thus favoring myalgic and neuralgic attacks. 
Therapy.—Locally, lactic acid, diluted (f) with water and glycerin, 
has been used in tuberculosis of the throat and larynx and in diphtheria 
and croup as a solvent of false membrane. In lupus or tubercular ulcer- 
ation of the tongue it has been found very useful, as well as in lupus of 
the face, diluted (15 to 30 per cent.). 
In dyspepsia, with deficient secretion,pepsin maybe combined with 
lactic acid at meal-time. In the green diarrhoea of in attributed by 
Hayem to a microbe, this agent well diluted (5j in a tumblerful of 
recentlj’-boiled water, sweetened with white sugar, of which solution a 
• teaspoonful ma}" be given every half hour or hour, according to the case) 
is a very efficient remedy, controlling irritability of the stomach, relieving 
pain, and changing the character of the discharges. From theoretical 
considerations the use of lactic acid in diabetes mellitus was proposed 
by Cantani. Cases have been reported in which, conjoined with appro- 
priate dietetic regimen, it appeared to favorably influence the disease 380 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
and lessen the quantity of sugar excreted. In other cases, again, it 
proved a failure. 
The lactate of iron, or ferrous lactate, is in the form of greenish 
crystalline scales or crusts, and is used as a chalybeate tonic, being less 
astringent and constipating than other iron salts. 
ACIDUM NITRICUM (U. S. R).—Nitric Acid. 
Preparation. 
Acidum Nitvicurn Di'utum (U. S. P.).— Dilute Nitric Acid. Dose, Nlv-xx. 
Pharmacology.—Nitric acid contains 69.4 of absolute nitric acid and 
30.6 per cent, of water. The dilute acid contains 10 per cent, of absolute 
acid, and is made by adding 6 parts of water to 1 of nitric acid. 
The nitrates of ammonium, lead, potassium, silver, and of sodium are 
officinal; also spirit of nitrous ether, bismuth subnitrate, nitroliydro- 
chloric acid, and nitrohydrochloric acid dilute. The solutions of nitrate 
of iron and of nitrate of mercury are also officinal. 
Physiological Action and Toxicology.—Introduced in a concentrated 
solution, nitric acid is a violent corrosive poison, and produces vomiting, 
pain, and distress, at once, followed by inflammation and sloughing of 
the mucous membrane of mouth and oesophagus. Alkalies, demulcents, 
and milk diet constitute the treatment. 
Therapy.—Nitric acid is an oxidizing agent in the laboratory, and 
when applied in strong solution it has a decidedly caustic action, staining 
the skin yellow. It is the preferred caustic for venereal sores, warts, 
poisoned wounds, sloughing, and pli aged ten a. In uterine ulceration, 
prolapse of bowel, and haemorrhoids, nitric acid is a useful application. 
Introduced into the system in small doses, well diluted, it acts as an 
astringent tonic, especially useful in cases of atonic dyspepsia, and in 
the uric-acid diathesis and oxaluria. In broken-down syphilitic subjects, 
or in chronic liver disease, nitric acid is a useful restorative. 
A very valuable prescription, especially for the treatment of chronic 
syphilis, is as follows :— 
Acidi nitrici dil., nice. 
Tinct. bardanae sem., f^iij. 
Tinct. xantlioxyli, f§ij. 
M. Sig. : Two teaspoonfuls in water three times a day. 
In dilute solution or xx-3j) it has been used in cases of pbos- 
phatic calculi, to wash out the bladder, and it may be used as an injection 
into sinuses connected with dead bone. A few drops of nitric acid to 
the ounce of water is an excellent stimulant application to indolent ulcers. 
In whooping-cough, or bronchial catarrh, it has been advocated, and in 381 
ACIDUM NITROHYDROCHLORICUM. 
hoarseness of public speakers a few drops in a glass of water afford 
relief. It is inadvisable to continue too long the administration of nitric 
iicid, as, in that case, it excites gastro-intestinal catarrh. The same 
remark applies to the other mineral acids. 
In many skin diseases, such as impetigo, lepra, acne, the addition 
of nitric acid to the bath has been found useful in addition to its internal 
administration. 
Mistura Antidysenlerica.—Hope’s camphor mixture :— 
If Aeidi nitrici,* f3ss. 
Tincturae opii, lllxx. 
Aquae camphorae, f^iv. 
M. Dose, a teaspoonful to a tablespoonful every hour or two, according to symptoms. 
Dilute nitric acid will often remove chronic diarrhoea, and its efficacy 
may be increased b}’ the addition of witch-hazel, thus :— 
If Aeidi nitrici dil., Ihclx. 
Ext. hamamelidis fl., f3iij. 
Syrup, aurantii, f§iv. 
M. Sig.: From one to two teaspoonfuls in water three or four times a day. 
Full doses of nitric acid every fourth or sixth hour have been found 
useful in intermittent fever. After the paroxysm has been broken up 
by quinine, nitric acid may be serviceably given in order to relieve in- 
activity of the liver and intestinal glands. Small doses of nitric acid 
are beneficial in aphthae and ulcerative stomatitis. 
Nitric acid reddens morphine, and probably decomposes it; and, 
therefore, should not be prescribed in solutions with this agent, as the 
rule. The nitrites have a decided lowering influence upon the tempera- 
ture and circulation ; they will be considered in connection with amyl 
nitrite. 
ACIDUM NITROHYDROCHLORICUM (IT. S. P.).—Nitrohydro- 
chioric Acid. 
Preparation. 
Acidum Nitrohyclrochloricmn Dilutum (U. S. P.).—Dilute Nitrohydrochloric Acid. 
Dose, ITlv-xx. ' 
This combination of nitric and hydrochloric acids (4 to 15) is officinal, 
the dilute form containing 4 parts of nitric acid, 15 of hydrochloric acid, 
and 76 parts of distilled water. It should be allowed to stand for two 
weeks after mixing, and kept in a cool place. The concentrated solution 
readily dissolves gold leaf when immersed in it; it is not used for 
medical purposes, the dilute form being preferable. It is supposed to 
have a special action upon the hepatic functions, and is a good tonic 
* The original formula for this preparation called for nitrous acid, but. as commercial 
nitric acid usually contains some nitrous, it lias become customary to order nitric acid. 382 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
and astringent. It lias been applied with compresses in chronic liver 
disorders in a solution to a pint of water). 
Symptoms of poisoning and methods of treatment same as given 
under Hydrochloric Acid. 
ACIDUM OLEICUM (IT. S. P.).—Oleic Acid. 
Preparations. 
Oleatum Hydrargyri (U. S. P.).—Oleate of Mercury, 10per cent. 
Oleatum Veratrince (U. S. P.).—Oleate of Veratrina, 2 per cent. 
Pharmacology.—Oleic acid is an oily, yellowish, tasteless liquid, 
gradually becoming brown, rancid, and acid when exposed to the air. 
It is insoluble in water, but soluble in alcohol, ether, etc. Equal volumes 
of the acid and of alcohol, heated to 77° F., should give a clear solution, 
without allowing the appearance of free drops of oil upon the surface. 
This, when freshly prepared, is a bland and unirritating application 
to the skin, and was brought forward as an addition to ointments and 
liniments to increase their penetrating power, but lanolin has now taken 
its place for this purpose. Lately, largely through the influence of the 
writings of the author, it has been much used in the manufacture of 
oleates, which are now produced in the form of true chemical compounds, 
instead of simple mixtures, as heretofore. 
The following is a summary of the action of the oleates, from 
“ Ointments and Oleates, especially in Diseases of the Skin — 
The Oleates. 
Aconitine Oleate (U. S. P.).—Not very active. Can be used in neuralgia. 
Atropine Oleate.—Not very active. Constitutional effects not produced except where 
large surfaces are anointed. 
Aluminium Oleate.—Diluted one-half with lard or some fatty substance, it forms the 
ointment of the oleate of aluminium, which is decidedly astringent. It is useful in cheek- 
ing the muco-purulent discharges of dermatitis and eczema, and in chafing, or intertrigo, 
especially in infants and young children. In hyperidrosis and in bromidrosis it is very 
effective. This ointment is also a useful dressing to burns, foul ulcers, chilblains, and 
sinuses. 
Arsenicum Oleate.—A Valuable alterative and eseharot.ic, but it must be used with 
caution. The oleate, when melted with lard or ointment base (1 to 4 or 1 to 9), forms the 
ointment of arsenicum oleate. This has little action upon a healthy skin, but when the 
epidermis has been removed, or on granulating surfaces, it produces inflammation and 
destroys the vitality of the tissues to a considerable depth. When well diluted, it exerts a 
most excellent alterative impression upon the integument; and also in ulcerating epithe- 
lioma, in lupus (after scraping), and in old scrofulous ulcers, this is of great utility. In 
sycosis, seborrhoea, and chronic eczema it is likewise of service. After scraping or punc- 
turing the affected area, it can be used to destroy warts, corns, horns, condylomata, old 
granulations, and naevi. It may be advantageously combined with opium, belladonna, 
♦Second Edition. Philadelphia and London: F. A. Davis, Publisher. Physicians’ and 
Students’ Ready-Reference Series. 1890. ACIDUM OLEICUM. 
383 
hyoscyamus, arnica, arrow-root, naphthol, etc. (For formulae, see author’s book on 
“Oleates.”) 
Bismuth Oleate.—Emollient and slightly astringent. In all pustular eruptions, in 
sycosis, it relieves the itching and often aborts the pustules. It allays irritation in erysipelas 
and sun-burn. In acne rosacea it relieves the inflammation, and in conjunction with scari- 
fication of the surface is curative. In acute eczema this oleate is considered indispensable 
in arresting the progress of the malady. Cracked and sore nipples are usually healed by 
the oleate of bismuth ointment (3j bismuth oleate to 3vij of ung. aquae rosae). 
Cadmium Oleate is stimulating and irritating. It has been used in chronic eczema 
with great infiltration, exuberant granulations, and enlarged glands, the strength of the 
ointment being adapted to each case. 
Cocaine Oleate, in the form of a 6-per-cent, alkaloid, with equal parts of ointment or 
lanolin, has not answered expectations as a local anodyne or anaesthetic, but has been used 
with some benefit in pruritus pudendi and ani, or eczema marginatum. 
Copper Oleate, in the form of 10-or “20-per-cent, ointment, has no visible effect upon the 
healthy skin, but penetrates deeply into the follicles, where it exerts a stimulating and 
antiseptic action. It is decidedly astringent to the broken skin or raw surface, reducing 
exuberant granulations, checking haemorrhage, from irritable sores and old ulcers. Owing 
to its parasiticide action, it is the best remedy for the various forms of ringworm. In tinea 
versicolor, even in favus, it is equally effective in destroying the parasite without epilation. 
Copper oleate, melted and spread as a plaster, will very often cure warts, corns, bunions, 
and thickened conditions of the epidermis. The ointment above referred to is also useful 
in freckles and other discolorations of the skin. It is essential that the salt should be 
made from pure oleic acid, as otherwise the application may be accompanied by irritation 
or inflammation of the 6kin. The weaker ointment (gr. v-x to §j) should be first tried and 
the strength gradually increased. 
Iron Oleate is a valuable styptic and astringent. The use of a weak ointment in the 
inflammatory form of eczema, in which the surface is raw and bleeding, is followed by good 
results ; also in pustular eczema, sycosis, furuncles, and in scrofulous sores. Mixed with 
the oil of ergot or any bland oil, the iron oleate is of great advantage in dry seborrhoea and 
in patches of alopecia. The early stages of acne rosacea are often entirely relieved by the 
weak application of ointment of iron oleate. In ulcers caused by arsenical poisoning, this 
has given better results than any other remedy in the hands of the writer, especially with 
the addition of 1 per cent, of carbolic acid. 
Lead Oleate, melted with equal parts of lard-oil, or lard, forms a cream-colored, semi- 
solid ointment, which is superior to Goulard’s cerate or Hebra’s litharge ointment. It allays 
irritation in papular or pustular eczema, and also in fissured eczema of the hands or feet. 
In hard and indurated papules, as in acne of the face, neck, and back, it is excellent in its 
effects. Thymol, naphthol, carbolic acid, oil of chamomile, or oil of cade may be combined 
with it, according to the ease. 
Manganese OZeate has been used (a 10-to 20-per-cent, solution in ointment) as a remedy 
in amenorrlioea and other uterine affections, applied with friction to the abdomen. Probably 
its asserted good effects are to be attributed to the massage ra ther than to any constitutional 
effect from the manganese, as there is no evidence of its absorption. 
Mercuric Oleate.—The ointment of mercuric oleate (26.2 per cent.)* is a yellowish 
substance of fatty consistence. It is stimulating to the 6kin, and has a decided alterant 
action upon the glandular structures. In old eczema, with thickening of the skin, this two- 
fold action is very beneficial; also in papular and tubercular lesions, and infiltration attend- 
ant upon abscesses. In inflammation of the hair-follicles, sycosis, and scrofulodermata, it 
is quickly curative. Its bactericide action makes it valuable in all cases of parasitic invasion 
of the skin; and in the treatment of lousiness the addition of picrotoxin (gr. i-§j) is 
*01eatum hydrargyri of the U. S. Pharmacopoeia contains 10 per cent, of yellow oxide of 
mercury, with 90 per cent, of oleic acid. 384 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
advisable, in order to destroy the vitality of the nits. If it is desired to produce a constitu- 
tional impression, lanolin maybe added, or mercurous oleate substituted. In fact, mercuric 
oleate is absorbed only very slowly. Large quantities have been applied to the surface 
without producing constitutional effects. 
Mercurous Oleate.—This ointment contains a higher percentage of mercury than the 
preceding (41.6 per cent.); it is substituted when it is desired to make a more profound 
impression upon the structures of the skin, or to practice the inunction treatment of 
syphilitic affections, and for this is far superior to either the ordinary blue ointment'or the 
mercuric oleate. In old spots of psoriasis and chronic plantar and palmar eczema it can be 
used alone, or combined with some form of tar or naphthol. 
Morphine Oleate has only a feeble action upon the integument, and has no special 
advantage. 
Nickel Oleate, in the forrp of ointment with some fatty base, has a very decided 
astringent action upon abraded surfaces. In the proportion of from 5 to 20 grains to the 
ounce of lard it acts well in epithelial ulcerations, old callous ulcers, or chronic eczemas. 
Quinine Oleate has slight stimulant and antiseptic action, but has no special advantages. 
Silver Oleate coagulates albumin, and, when sprinkled over sores, coats the surface 
and excludes the air; at the same time it stimulates granulations and cleans off the surface. 
Dissolved in oleic acid and mixed with lard (5 to 60 grains to the ounce), it forms a 
dark-brown, pliable ointment, which may be applied in cases of erysipelas to keep the 
inflammation from spreading. In superficial lupus it sometimes lessens cell-infiltration 
and reduces active inflammation. In boils, carbuncles, eczema around the genitals or on 
the buttocks, especially if attended by irritation or itching, marked relief follows the appli- 
cation, either alone or combined with opium, belladonna, or hyoscyamus. 
Strychnine Oleate has no special value as an ointment. 
Tin Oleate.—The ointment (10 to 60 grains to the ounce) is a grayish-brown oint- 
ment, possessing some astringent and tonic, action. It is of especial service in diseases of 
the nails, and in irritations of skin around the nails (agnail, etc.). 
Veratrine Ointment is officinal in 2-per-cent, solution in ointment. It has decided 
counter-irritant and benumbing effects upon the skin, making it useful in some cases of 
neuralgia or tender spots. 
Zinc Oleate is a fine, pearl-colored powder, soft and soap-like to the touch, is astringent 
in its effects, and can be used as a dusting-powder in hyperidrosis and broinidrosis. In 
local sweating of the axillae, genitalia, hands or feet, especially when attended by macera- 
tion of the epidermis, this agent is very useful. Murrell, of London, has also used it in the 
sweating of phthisis, combined with thymol (1 to 500). Salicylic acid (3 per cent.) or 
French chalk may be added to it, for the treatment of local affections, such as comedo and 
acute vesicular eczema. In all 6uch acute inflammatory affections it can be used with 
advantage, where greasy applications cannot be borne. It has also been used in gynaecology 
as an application to cancerous ulceration of the cervix uteri. Here it may be combined 
with iodoform (zinc oleate 1, iodoform 2 parts). 
ACIDUM OXALICUM.—Oxalic Acid. 
Not used in medicine, except ns a test, or in solution to remove ink 
stains. It is an irritant poison, and is sometimes taken by mistake for 
Epsom salts. Its antidote is lime, chalk, or whitewash. 
ACIDUM PHOSPHORICUM (U. S. r.).—Phosphoric Acid. 
Preparations. 
Acidum Phosphoricum Dilutum (U. S. P.).—Dilute Phosphoric Acid. Dose, l'lii-xx. 
The officinal phosphates are ammonia, iron, and soda. 
The officinal hypophosphites are lime, iron, potassium, and soda. ACIDUM PHOSPHORICUM. 
385 
Pharmacology.—Phosphoric acid in the solid form, glacial phosphoric 
acid (metaphosphoric acid), is not officinal in the present edition of the 
pharmacopoeia on account of its unreliability. The officinal phosphoric 
acid is a colorless, odorless, syrupy liquid, containing only 50 per cent, 
of orthophosphoric acid. The dilute acid is only one-fifth of this 
strength. 
Physiological Action.—Phosphoric acid, locally, is an irritant, and 
exerts some escharotie effect. When taken internally, well diluted, it aids 
nutrition and growth, as it is an essential element in all bony and 
vascular structures in the form of phosphates. It is also, like nitric acid, 
a stimulant to oxidation. It improves the appetite and the digestion, 
increases secretion, and is synergistic with the vegetable bitters. 
Therapy.—In all debilitated conditions of the system, in anaemia, 
in the exhaustion of prolonged lactation, in bronchial catarrh in the 
aged, phosphoric acid is an excellent tonic ; it is also useful in struma 
and wasting diseases. Its action being different from phosphorus in 
substance, it is less efficient than that drug in the treatment of neuralgic 
conditions. 
Phosphoric acid is especially valuable as a tonic in the following 
formulae :— 
Acldi phosphoric! dil., f^ss. 
Tlnct. nucis vomicae, Nice. 
Tinct. ferri chloridi, f^ij. 
Syr. pruni virg., '. . f^iiss. 
M. Sig.: From one-half to one teaspoonful in a wine-glass of water, taken through a 
tube after meals. 
Acidi phosphoric! dil., f3iij. 
Strychninae sulph., gr. ss. 
Glycerin!, f3ix. 
Syr. aurantii, f^iiiss. 
M. Sig.: One teaspoonful in wine-glass of water, taken through a tube after meals. 
Acidi phosphorici dil., f3v. 
Sodii hypophos., 3ij. 
Elix. calisayae, ffiiiss. 
M. Sig.: One teaspoonful in water before meals. 
Given before meals, phosphoric acid is beneficial in hyperacidity of 
the stomach, whether due to increased production of hydrochloric acid or 
the result of fermentative changes in the food. Phosphoric may reason- 
ably be preferred to the other mineral acids in the treatment of typhoid 
fever when the predominant symptoms denote great nervous prostration. 
The dilute solution ma}* be applied as a stimulant to indolent ulcers, 
and it has been proposed to inject it into enlarged glands (lymphacU 
enoma). 386 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
ACIDUM PICRICUM.—Picric Acid. 
Dose, gr. ]-ij. 
Pharmacology.—Picric or carbazotic acid (trinitrophenol) is in the 
form of pale-yellow scales, soluble in water, and has a very bitter taste. 
Owing to its power of coagulating albumin, its watery solution forms a 
convenient test for albumin in the urine; it is also a test for peptones. It 
should be used as a confirmatory test in conjunction with the heat test 
and Heller’s test with nitric acid. 
Therapy.—The application five to ten times daily of a 6-per-cent, 
solution of picric acid has been found useful in erysipelas. The am- 
monium salt has been highly praised in the treatment of whooping-cough 
and malaria, the average dose being grain four or five times daily. Picric 
acid should be used, either internally or externally, with caution, since it 
is apt to excite urticaria and other sj'mptoms of systemic intoxication. 
ACIDUM SALICYLICUM (U. S. P.).—Salicylic Acid. 
Dose, gr. x-5j. 
Preparations.—The officinal salicylates are of sodium, of lithium, 
and of physostigmine. Salicylic-acid ointment (not officinal) is made 
by incorporating the acid with lard or lanolin by the aid of gentle heat 
(10 per cent.). 
Pharmacology.—Salicylic acid occurs as fine, white, needle-shaped 
crystals, soluble in 450 parts of cold or 14 parts of hot water; and in 
alcoholic solutions in 80 parts of chloroform, 60 parts of glycerin, and 
in 2 parts of olive-oil (by aid of heat). One ounce of sweet spirit of 
nitre will dissolve 16 grains of salicylic acid. The solution remains clear 
even upon the addition of water. Ciystallized salicylic acid is pure and 
without odor; precipitated acid has a rather peculiar disagreeable taste; 
the sublimed acid is often pink-colored, and smells of phenol. Dialjzed 
salicylic acid is preferred. It is claimed that the salicylic acid made from 
oil of gaultheria is the best and purest form in which to prescribe it. 
Physiological Action.—An antiseptic and antiferment, and prevents 
souring of beer, cider, or milk, or the putrefaction of urine. It is 
injurious only' when used constantly and in relatively large doses. It is 
very irritating to mucous surfaces, and is not to be administered in pill, 
powder, or capsule, but always in solution, and preferably with the 
acetate of ammonium or potassium, citrate of potassium, or phosphate 
of ammonium, which increases its solubility in water, or it may be given 
in some syrup or elixir of orange. 
Taken internally, it reduces abnormally high temperature. In health 
this action is not observed, although some observers assert that a slight 
reduction is produced. Sometimes headache, giddiness, and ringing in ACIDUM SALICYLICUM. 
387 
the ears have been noticed, but usually no marked effect is seen upon 
either pulse or respiration. Toxic doses cause slowing of the breathing; 
and convulsions, nausea, burning in the throat, vomiting, and gastric irri- 
tability have been observed to occur, followed occasionally by albu- 
minuria, lnematuria, or almost complete stoppage of urine. This is a 
derivation from the normal action, for in ordinary cases it acts as a 
diuretic, with slight increase of elimination of the urates and urea. In 
acute nephritis it diminishes the quantity of the urine and increases the 
proportion of albumin. The treatment is that for an irritant poison ; 
the stomach should be washed out with warm water, decoction of coffee 
administered, and the patient treated symptomatically. The effects 
rapidly pass off as the acid is carried out from the system by the urine, 
principally without change, partly also as salicin and salicyluric acid. 
Probably some also escapes in the sweat and saliva. After excessive 
doses the urine becomes olive-green in color, from the presence of indi- 
can and These substances result from the action of the 
pancreatic juice upon salicylic acid. A solution of chloride of iron strikes 
a violet color with urine which contains salicylic acid. In the body, the 
acid combines with glyeocol in the liver and elsewhere, and becomes 
converted into salicyluric acid. 
Therapy.—For external use salicjdic acid may be combined with 
chalk as a dentifrice where there are carious teeth. A similar mixture 
may be used for the relief of fetid perspiration (feet or axilla), with talc 
or corn- or rice- flour. In gangrene, or sloughing cancer, it may be ap- 
plied full strength or diluted. Dressings may be saturated with an alco- 
holic solution, and subsequently dried. In this way it may be used in 
the antiseptic method of wound treatment; it is not so powerful in this di- 
rection as carbolic acid, yet it has the great advantages of being odorless 
and free from danger of toxic symptoms following absorption. It is 
also used in solution as a substitute for carbolic acid in the details of 
the modern antiseptic method. (A solution can be made by adding 
8 parts of borax to 100 parts of boiling water, and, when dissolved, 
adding 10 parts of salicylic acid, and filtering when cool. On account of 
its irritant action it is not a good application for diphtheria or croup.) 
A saturated solution of salicjdic acid in collodion is a very effective ap- 
plication to corns and wai*ts. Tincture of cannabis indica is often added, 
but it produces an unsightly stain without conferring any additional ad- 
vantage. An ointment containing this substance is sometimes of benefit, 
especially in chronic eczema and in ulcerated lupus vulgaris. From 5 to 
60 grains to the ounce of lard, lanolin, or other excipient will some- 
times remove freckles. On account of its germicidal virtue it may be 
advantageously used in the treatment of tinea circinata. 388 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
It has, however, been found useful as a topical application in thrush 
and catarrhal stomatitis, in which conditions it acts as a local anodyne. 
It allays the burning pain of the erosions left after the vesicles have 
ruptured. The solution is made by dissolving 1 part of acid in suffi- 
cient alcohol and adding 250 parts of water. Salicylic-acid solutions 
have likewise proved of value in irrigation of the large intestine for 
dysentery. Acute intestinal catarrh lias been treated in the same manner 
with very successful results. In the latter malady the internal use of the 
remedy may be conjoined. 
Salicylic acid may also be employed in fetid bronchitis as an inhala- 
tion with a steam-atomizer, using half an ounce of borax in It fluid- 
ounces of boiling water, to which half an ounce of salicylic acid is to be 
added. The same solution can be used in catarrhal pneumonia, in 
phthisis, etc. 
The following formulae will be serviceable as local applications :— 
$ Acidi salicylici, 3ij. 
Bismuth, subnitrat., 
Pulv. zinci oleatis, 3ij. 
M. Sig.: Du6t over the surface. Useful in excessive or fetid sweating and in 
sehorrhoea oleosa. 
IJc Acidi salicylici, 3ss vel 3j. 
Ungt. hydrarg. nit., 3iij. 
Beta-naphthol, gr. x. 
Ungt. zinci oxidi benz., 3v. 
M. Sig.: Rub well into the surface several times a day. For fissured eczema of 
the palms of the hands and soles of the feet. 
An excellent application for dry eczematous patches on the skin is :— 
Acidi salicylici, gr. x vel 3j. 
Bismuth, subnitrat., 
Amyli, 3ij. 
Adipis (dehydrat.), f§j.—M. 
Internail}', the use of salicylic acid in acute rheumatism (10- to 20- 
grain doses every hour until 1 or 2 drachms have been taken) for two 
days is generally followed by prompt relief. On account of its compara- 
tive insolubility, salicylic acid is now less used than the salicylate of 
sodium, which is given in the same doses. It is believed that the soda 
salt is rapidly converted into the original acid by the carbonic acid of 
the blood. 
Salicylic acid approaches the character of a specific remedy in acute 
rheumatism. Its most marked effects are reduction of the articular 
swellings, the pain, and the fever. But it is not able to prevent the 
occurrence of heart trouble, or of relapse. It is a good practice, and 
perhaps shortens the absolute duration of the case, to reduce or abandon 389 
ACIDUM SALICYLICUM. 
the salicylic acid after it has produced its most notable results, and to 
replace or combine it with an alkali. It does not prevent hyperpyrexia, 
since that condition has been known to occur while this remedy was 
being administered. The virtue of the salicylic treatment is much less 
decided in chronic rheumatism, though stillness and pain are relieved in 
a certain proportion of cases. In subjects who are much debilitated the 
salicylate of quinine may be employed, or, if anaemia be marked, the sali- 
cylate of iron. In muscular rheumatism salicylic acid will sometimes 
afford relief, and will often fail. The pain and swelling of rheumatoid 
arthritis are sometimes relieved and the progress of the disease arrested 
by the salicylate of sodium. The same salt is, in some instances, service- 
able in gonorrhoeal rheumatism. In acute articular gout and in irregular 
gouty manifestations good results have likewise attended the use of 
salicylic acid or the salicylate of sodium. 
Salicylic acid, or its sodium salt, has been found useful in those 
affections so often associated with or dependent .upon the rheumatic dia- 
thesis, as the various forms of neuralgia, especially migraine, trifacial 
neuralgia, and sciatica, chorea, tonsillitis, urticaria, and erythema nodo- 
sum. In sciatica, Ringer prefers it to any other remedy. Rheumatic 
iritis may also yield to its influence. 
Salicylic acid has been successfully used as an anthelmintic. Taenia 
solium has been removed by five hourly doses of 8 grains each, preceded 
and followed by a dose of castor-oil. Round-worms and seat-worms are 
destroyed by the same agent, the latter by the local effect of an injection, 
the former by the internal use of the drug. 
Salicylic acid may be given in 5-grain doses in order to purify the 
foul breath sometimes present in phthisis. Improvement has sometimes 
followed the administration of salicylic acid or its combination with 
sodium in diabetes. The same remedy is of service in diabetic neuralgia. 
It is also employed for its antipyretic effect in typhoid fever, pneu- 
monia, erysipelas, and phthisis, but it is regarded as especially service- 
able in blood-poisoning and sapraemia, pyaemia, etc., and the eruptive 
fevers of children. In relapsing fever it is said to render the relapse 
shorter and of less severity. It promptly checks the yeasty vomiting 
dependent upon the growth of sarcina ventriculi. Sometimes serious 
disturbances of the circulation occur from medicinal doses in cases of 
fever. It is very probable that in some of these cases the results are 
attributable to impurities in the salicylic acid. Urticaria, erythema, 
and vesicular cutaneous sj'inptoms have been noticed after its adminis- 
tration. In exceptional cases the exhibition of salicylic acid is followed 
by haemorrhage, usually from the gums or nose. The soda salt is believed 
to be free from this objection. 390 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
The granular effervescent form is a good one in which to administer 
the salicylates, or they may be given in effervescent draughts, or in com- 
bination like this :— 
$ Sodii salicylatis, 3ij. 
Tinct. lavandulae comp., f3iv. 
Syrup, aurantii, . • f^iiiss. 
M. Sig.: Give a tablespoonful every three (or four) hours for acute rheumatism. 
The following prescriptions may likewise be recommended as bene- 
ficial combinations in acute rheumatism, gout, and neuralgia:— 
Acidi salicylici, 3ij. 
Spt. aetheris uitrosi, f^iv. 
Tinct. cardamom, co., . f§j. 
M. Sig.: Two teaspoonfuls in water every two hours. 
Acidi salicylici, gr. cc. 
Liq. ammon. acetatis, 
Aquae camphorae, 
Spt. aetheris nitrosi, ad f^ij. 
M. Sig.: A teaspoonful in water every two or three hours. 
The appended formula is serviceable in chronic rheumatism and 
gout:— 
Acidi salicylici, 3iij. 
Elix. cascarae sagradae, f^vj. 
M. Sig.: A tablespoonful in water two or three times a day. 
ACIDUM SULPHURICUM (U. S. P.).—Sulphuric Acid. 
Preparations. 
Acidum Sulphuricum Dilutum (U. S. P.).—Ten-per-cent. Sulphuric Acid. Dose, hlv-xv. 
Acidum Sulphuricum Aromaticum (U. S. P.).—About 20 per cent., with tinct. ginger 
4.5, oil of cinnamon 0.1, and alcohol to make 100 parts. Elixir of Vitriol. Dose, ttlx-xx. 
Pharmacology.—The officinal acid is chemically pure, of 1.840 spe- 
cific gravity, containing not less than 96 per cent, of absolute sulphuric 
acid (hydrogen sulphate) or 80 percent, of anhydride. It must be color- 
less, and should be kept in glass-stoppered bottles ; it is without odor, and 
is of an oily consistence. The commercial acid (oil of vitriol) contains 
various impurities,—arsenic, lead, nitric acid, etc. 
Physiological Action and Toxicology.—Sulphuric acid in full strength 
chars animal substances and has a strong affinity for water. Applied to 
the skin, it acts as a caustic, re-dissolving the coagulum formed and pene- 
trating deeply, turning the surface black. When taken internally, the lips 
and other parts of the mouth are blackened, and symptoms of corrosive 
poison are produced ; there is intense pain, with efforts at vomiting. 
Collapse and death may rapidly ensue from the intense congestion of the 
oesophagus and stomach, or it may occur secondarily from the resulting 391 
ACIDUM SULPHURICUM. 
strictures of the oesophagus. The stomach-pump should he used with 
extreme care ou account of the danger of tearing the softened mucous 
membrane or rupturing the stomach. Alkalies should be given with milk 
or soap-water, and morphine given hypodermatically to relieve pain, 
combined with atropine as a cardiac stimulant. Oil, white of eggs, and 
magnesia are also appropriate. Demulcents and appropriate treatment for 
the succeeding inflammation will be needed. Sulphuric acid is sometimes 
thrown upon a person, especially in the face. In such a case water is 
freely used to wash off the excess of acid, and an alkaline wash applied ; 
to relieve pain opium internally will be needed. The subsequent treat- 
ment is that of an ordinary burn. 
Therapy.—On account of the pain following its application, sul- 
phuric acid is not much used as a caustic, although it is an efficient de- 
stroyer of tissue. Velpeau used it in cancer, and Ricord for chancres, the 
acid being mixed with some absorbing substance like sawdust or charcoal. 
In caries and necrosis, and suppurating cavities or sinuses, it may either 
be applied upon a glass rod or on lint, diluted with 4 to 6 parts of water. 
Internall}', dilute sulphuric acid acts as an astringent and antiseptic. 
The elixir of vitriol is the preferred form for the night-sweats of phthisis, 
and in some cases of diarrhoea. Sulphuric acid, with water, sweetened 
so as to make a pleasant drink, is a valuable prophylactic against lead 
poisoning when used by operatives in lead-works, and also has been 
found to be a preventive of attacks of Asiatic cholera, when taken 
regularly during the prevalence of an epidemic :— 
Acid, sulphuricum diluti, f3iiss. 
Tr. opii deodoratae, f3j 
Elixir, f§j. 
Aquae, q.s. ad f^iv. 
M. Sig.: Take a tablespoonful, for dysentery, every hour or two. Watch with care 
the action of the opium. 
This acid is very commonly given in typhoid fever. It may be pre- 
ferred to hydrochloric acid when the diarrhoea is excessive. Lead colic 
is relieved by the use of sulphuric acid, and the constipation of lead 
poisoning is effectually treated 1)3" a combination of dilute sulphuric 
acid, sulphate of quinine, and sulphate of magnesia. On account of its 
astringent properties it is beneficial in haemorrhage from the uterus, 
stomach, or intestinal canal, and in purpura. The following prescriptions 
have been found beneficial:— 
Acid, sulph. aromat., f3ij. 
Ext. hamamelidis fl., . . . f§ij. 
Ext. ergotae fl., f§ij. 
M. Sig. : Two teaspoonfuls in water every two or three hours. Use especially in 
haemorrhage from lungs, stomach, or womb. 392 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
$ Acidi sulph. aromat., f^ss. 
Magnesii sulpli., 
Spts. chloroformi, f3iij. 
Inf. rosae gallicae, ad f^viij. 
M. Sig. : A tablespoonful every three hours. Useful in haemorrhage from rectum 
and constipation. 
Acidi sulph. dil., f^ss. 
Quininae sulph., gr. xij. 
Tinct. opii, f3ij. 
Syrupi et aquae, ad f§iij. 
M. Sig. : A teaspoonful in water every four hours in enteric fever with tendency to 
diarrhoea and sweating. Also useful in sweating of phthisis. 
Acidi Sulphurici Liquor Halleri (Haller’s acid drops)—not offici- 
nal—is a mixture of equal parts, by weight, of acid and alcohol, gradually 
added with constant stirring, taking care that the temperature of the 
mixture does not get so high as to vaporize the alcohol. It contains 
ether, alcohol, sulphuric acid and sulpho-ethylic acid, and is used for the 
same purposes as the aromatic acid, in about half the dose, on account 
of the larger amount of acid. 
Acidum Sulphovinicum, or ethyl-sulphuric acid, is prepared by 
adding sulphuric acid to alcohol. It is freely soluble in alcohol, and 
mixes with water (1 or parts) without losing its oily character. It is a 
yellowish liquid, with slightly astringent taste, and is neutral in reaction. 
The ethyl sulphates are crystallizable and soluble in water. The ethyl- 
sulphate (or sulphovinate) of sodium has been used as a saline cathartic. 
Ethyl-sulphuric acid is an example of an acid ether, and is a solvent for 
camphor (25 per cent.), iodoform (3 per cent.), sulphur, naphthalin, 
ehrysarobin, etc., and can be used as a vehicle for these remedies in the 
treatment of skin diseases. 
ACIDUM SULPHUROSUM (U. S. P.).—Sulphurous Acid. 
Dose, TTv-f3j, well diluted. 
Preparations.—In combination with a base, sulphurous acid makes 
sulphites. Of its salts, the following are officinal: Sulphite of potassium, 
of magnesium, and of sodium ; also, bisulphite of sodium and hyposul- 
phite of sodium. 
Pharmacology.—Sulphurous-acid gas absorbed by water parts 
in 100) forms the officinal acid. It has the odor of burning sulphur, and 
a sour, sulphurous, somewhat astringent taste. 
Physiological Action.—This acid and its salts are very destructive 
to low forms of animal and vegetable life, owing to their affinity for 
oxygen. It is not well borne by the stomach, and should be given freely 
diluted with water, as its taste and odor are very unpleasant. Locally, 
it does not excite much irritation. ACIDUM SULPHUROSUM. 
393 
Therapy.—As a local antiseptic or bactericide, sulphurous acid is 
highly prized in those forms of skin disease caused by parasitic invasion, 
such as tinea tonsurans and tinea versicolor. It may be effectively used 
in tinea favosa by the simple device of Dr. Schuster. A net of strings 
is stretched across the lower third of a card-board box, which fits to the 
head and can be closed by a lid of the same material. A saucer contain- 
ing burning sulphur is laid upon the net of strings and the box covered. 
The patient must sit still for half an hour. An abundance of sulplmrous- 
acid gas is generated, the sulphur ceasing to burn, of course, as soon as 
all the ox3’gen is exhausted. In various forms of sore throat it is useful, 
but particularly in diphtheria, where it can be used topically and also 
taken internally. 
It is beneficially applied to unhealthy or sloughing wounds or 
ulcers. A drachm or two of the officinal acid to the ounce of water, or 
water and glycerin, is of service in chilblains and chapped hands. Sul- 
phurous acid, as Ringer points out, may be used in such a manner as to 
cure scabies with the utmost rapidity. This method consists in exposing 
the patient, his head excepted, to the influence of sulphurous-acid gas, 
generated by burning 12 drachms of sulphur in a suitable closed appa- 
ratus. The clothes should be. at the same time, put in boiling water. 
Dr. Dewar recommends equal parts of sulphurous acid and of water as 
an efficient dressing in erysipelas. 
In fermentation of food in the stomach, flatulent dyspepsia with sour 
stomach, pyrosis, dilated stomach, etc., sulphurous acid has been recom- 
mended. In typhoid fever it has also been used, and, it is asserted, with 
success, and may be tried in measles, scarlatina, and small-pox. In some 
bronchial affections, catarrh, whooping-cough, dilated bronchial tubes, it 
may be inhaled with steam-atomizer. It is also of great service in many 
skin affections, such as urticaria and purpura, after other methods have 
failed. 
The author would recommend the following formulae for the diseases 
just referred to :— 
Acidi sulpliurosi, 
Syrup, ziugiberis, f§ij. 
M. Sig.: From one to two teaspoonfuls in water three times a day. 
Acidi sulpliurosi, 
Ext. ergotse fl., 
Syrup, aurantii, aa f^j. 
M. Sig.: Two teaspoonfuls in water three or four times a day. 
The sulphites and hj'posulphites are employed to fulfill the same 
indications. The administration of the sulphites in pyaemia was advo- 
cated by Polli, but later clinical observers have not been able to obtain 394 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
the good results that he promised. The sulphides will he considered 
under the head of Sulphur. 
ACIDUM TANNICUM (U. S. P.).—Tannic Acid (Tannin). 
Dose, gr. i-xx. 
Preparations. 
Unguentum Acidi Tannici (U. S. P.) contains 10 per cent, tannic acid. 
Trochisci Acidi Tannici (U. S. P.), each 1 grain. 
Collodium Stypticum (U. S. P.).—Styptic collodion consists of 20 parts tannic acid, 
5 of alcohol, 20 stronger ether, 55 of collodion. For external use as an astringent. 
Pharmacology.—Tannic acid is a common constituent of vegetable 
organisms, especially those noted for astringency, as oak-bark. Galls 
contain about 50 per cent, of tannic acid, which can be obtained by ex- 
posing powdered galls to dampness, and afterward dissolving out the 
tannic acid with the aid of ether. It occurs in light-yellowish scales, 
soluble in 16 parts of cold water, soluble in alcohol. It is like- 
wise soluble in glycerin. It coagulates albumin and gelatin, and strikes 
a black color writh preparations containing iron. Solutions containing 
tannic acid (infusion of black tea or coffee) are antidotes for poisoning 
by some metallic salts, and especially antimony or tartar emetic, and the 
alkaloids. 
Physiological Action.—Tannic acid, when locally applied, has an 
astringent action upon the tissues owing to its affinity for albumin. In- 
ternally, it acts as a weak acid upon the digestive tract, but when its 
chemical affinities are satisfied by combination with a base or neutralizing 
it with albumin it is no longer capable of precipitating albumin, and 
therefore no longer exercises an astringent action upon the parts with 
which it comes in contact. Hence, according to Stockman, it can exert 
little, if any. action upon the vascular system, and, as it is not excreted 
by the bronchial mucous membrane, very little or none upon the flow 
of the bronchial secretions. With regard to its action upon the kidneys, 
as it is excreted principally by this channel, it is conceivable that it may 
have some influence in diminishing albuminuria, although even this he 
regards as doubtful. Lewin recommends the administration of tannic 
acid in the form of an albuminate, which is free from irritation and is 
more readily absorbed (tannic acid, 2 parts; water, 90 ; mix well, and 
add white of egg, 10 parts). Internally, tannic acid is given in doses 
from 1 to 20 grains. 
Therapy.—As a local astringent tannic acid heads the list. A com- 
bination of iodoform and tannic acid (2 to 1), finely powdered, is a good 
dusting-powder for moist eruptions, some forms of eczema, and for in- 
sufflation into the nose to reduce secretion in catarrh. After the severity 
of the inflammation has somewhat subsided, the glycerite of tannin is a 395 
ACIDUM TANNICUM. 
good application in acute eczema. It may be applied twice daily, and 
allays the stinging pain and itching. A solution of tannic acid in 
glycerin (1 to 4) is a good topical application to tonsillitis or pharyngitis. 
It may also be used as a spray, properly diluted, in haemoptysis. For 
disorders of the lower bowel, ulcers, fissures, haemorrhoids, prolapsus, 
and to expel thread-worms, a solution may be injected, or suppositories 
used, each containing 3 to 5 grains, with cacao-butter or starch. A solu- 
tion of tannic acid is useful in cases of leucorrlioea, and the gtycerite, or 
iodoform-tannin, is an excellent application for catarrhal inflammation 
of the cervix uteri. 
Even in carcinoma uteri, the glycerite of tannic acid is efficient in 
moderating discharge and allaying odor. Its virtue may be assisted by 
combining it with the glycerite of carbolic acid. In gonorrhoea, after 
the acute stage has passed off, tannic acid is a useful medicament. In 
men it may be administered, dissolved in water, as a urethral injection. 
In women, a watery solution may be used as a vaginal injection, or the 
Ayagina may be packed with tannin. Solutions of tannic acid may also 
be employed for the purpose of hardening tender nipples and tender 
feet. A lotion of tannic acid is frequently of service in herpes. It is 
useful in phagedenic ulcers and alopecia circumscripta. Made into a 
pomade, it has been found of benefit in dandruff. Ringer recommends 
the glycerite of tannic acid in otorrhoea, not, however, during the acute 
stage, but after this has been relieved and but a moderate discharge is 
left. The remedy is more beneficial when the membrana tympani is intact. 
The canal is filled with the solution, which is retained by cotton-wool. 
Tannic acid maybe used with advantage in the appended formulae :— 
II Acidi tannici, 3j. 
Glycerini, f§ss. 
Adipis, §ss. 
Balsam. Peruvian., 3ss. 
01. verbenae, Ifix. 
Lanolin., . §ss- 
M. Sig.: Apply well to the scalp for dandruff twice a day. 
II Acidi tannici, 3ss. 
Camphorae, gr. v. 
Beta-naphthol, gr. v. 
Sulphuris subl., . J)j. 
Ungt. zinci oxidi, §S8> 
M. Sig.: Spread on old muslin and use on fissured or tender nipples. The same 
prescription can be employed to tender feet or hands. 
II Acidi tannici, 3ij. 
Acidi carbolici, Ifivj. 
Glycerini, §ij. 
M. Sig.: Apply up the nose with a camel-hair brush or in the ear for catarrh and 
otorrhoea. Simple catarrh of the throat and tonsillitis are often amenable to this combination. 396 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
With alkaloids, tannic acid generally forms insoluble compounds ; 
it should not, therefore, be prescribed with preparations containing salts 
of quinine, strychnine, etc. 
Notwithstanding the chemical arguments urged by Dr. Stockman, 
tannic acid has long been successfully administered as an astringent 
remedy. As, however, it enters the blood under the form of gallic acid, 
its remote effects are in reality due to the latter acid. Tannic acid is 
preferably emploj'ed as a local application, gallic acid as a systemic 
remedy. The therapeutical uses of gallic acid have been already 
described, and need not be here repeated. 
ACIDUM TARTARICUM (U. S. P.).—Tartaric Acid. 
Dose, gr. v-xx. 
Preparations.—The officinal tartrates are tartrate of antimony and 
potassium (tartar emetic), of iron and ammonia, of iron and potassium, 
of potassium, of potassium and sodium (Rochelle salt), and bitartrate of 
potassium (cream of tartar). Seidlitz powder, or pulvis effervescens 
compositus (U. S. P.), is dispensed in two small papers, a blue one con- 
taining 2 drachms of the tartrate of potassium and sodium with 40 grains 
of bicarbonate of sodium, and a white one, containing 35 grains of tartaric 
acid. When administered these are separately dissolved, each in about 2 
ounces of water, and the two solutions mixed and drunk while effervescing. 
A slice of lemon improves the flavor of the dose. 
Pharmacology and Physiological Action.—Tartaric acid is obtained by 
the decomposition of cream of tartar (potassium bitartrate) found in old 
wine-casks. It is laxative and slightly diuretic. It reduces the alkalinity 
of the blood and makes the urine acid. In larger doses it is an irritant; 
indeed, in its effects it resembles oxalic acid, and the morbid appearances 
are also very much the same. The symptoms are best relieved by de- 
mulcents, the alkalies, magnesia, chalk, soap, milk, etc. 
Therapy.—Certain of the tartrates are used as laxatives, the tartrate 
of magnesium affording a good substitute for the citrate. Rochelle salt, 
in jounce doses, before breakfast, is a good remedy for habitual con- 
stipation. Bitartrate of potassium (in doses of gr. x-xx) exerts a de- 
cided diuretic action, and in combination with washed sulphur (1 to 2) 
it forms an excellent laxative remedy for haemorrhoids. 
The combination of diuretic and cathartic virtues renders the 
bitartrate of potassium very useful in the treatment of chronic Bright’s 
disease. It relieves oedema and delays the manifestation of uraemia. 
For a similar reason it is useful in ascites. The tartrate of potassium, 
or Rochelle salt, proves of utility in hepatic indigestion accompanied by 
an excess of uric acid in the urine. ACONITUM. 
397 
ACONITUM (U. S. P.).—Aconite. (Monkshood.) 
Preparations. 
Abstraction Aconiti (U. S. P.).—Abstract of Aconite, jDose, gr. %-j. 
Extraction Aconiti (U. S. P.).—Extract of Aconite. Dose, gr. yi~y2. 
Extraction Aconiti Fluidum (U. 8. P.).—Fluid Extractof Aconite. Dose, 
Tinctura Aconiti (U. S. P.).—Tincture of Aconite (40 per cent.). Dose, IQi-v. 
Pharmacology.—The tuberous root of Aconitum napellus (Ranuncu- 
lacese) is a perennial plant indigenous in Europe, but sometimes cultivated 
here in gardens for its ornamental spike of blue flowers. All parts of the 
plant are poisonous, but the active principle, Aconitine (not officinal), 
exists in greater proportion in the root. (Napelline is probabl}' only a 
weaker aconitine.) All the species of aconitum are more or less viru- 
lently active, but A. napellus is the only officinal one. The root of 
aconite in winter-time has been dug up in the garden and eaten in 
mistake for horse-radish, with fatal consequences. It is onty necessary 
to be aware of this liability in order to effectually guard against the 
error. The aconite-root is premorse, and is not tapering throughout its 
length, as the root of armoracia is; it is also of a browm color, and when 
scraped does not give out the irritating vapor that is so characteristic 
of the latter. Poisoning in this way apparenth’ could only occur as the 
result of grossest carelessness or of criminal intent. 
Physiological Action.—The effects of aconite are those of its active 
principle, aconitine. It should be mentioned here, in explanation of the 
difference in effect from different specimens of aconite, that the alkaloidal 
strength and the physiological activity of the plant are much affected by 
circumstances of its growth, the wild varieties being more poisonous 
than the cultivated. In this way the well-known differences between the 
activity of different kinds of aconitine are comprehensible. Murrell has 
called attention to the fact that the English drug is seventeen times 
stronger than the German, while the French is variable, but generally 
between these; the crystalline variety (Duquesnel’s or Merck’s aconitine) 
is therefore to be preferred when prescribing, on account of its uniform 
strength. 
Poisoning.—Applied to the skin or mucous surface, aconite first is 
slightly irritant, but this is soon followed by numbness, which may be 
accompanied by tingling sensations. If a bottle containing aconitine be 
held to the nose, painful irritation of nose and ej'es results. In rela- 
tively large doses death occurs very promptly, and, if given hypodermati- 
cally, the fatal result may follow in less than a minute, according to 
Wood. It is destructive to all forms of animal and vegetable life; 
sometimes very small doses produce very serious symptoms. A case of 
very marked impression from a quantity equal to 3 minims of the tincture 398 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
lias been reported by Woodbury,* in which vomiting, loss of power of 
extremities with panesthesia and numbness, loss of sight, mild delirium, 
weak pulse, and threatened stupor and collapse occurred, life being saved 
apparently only l>3r very prompt and vigorous treatment. The first symp- 
tom observed in a case of poisoning is burning or tingling in the mouth 
and throat, soon extending to the extremities, and sometimes over the 
whole body. The surface of the extremities is cool or clammy and 
numb, but at the same time the patients complain that they feel as if the 
limbs were flayed. Sight may be lost and hearing dulled, but ordinarily 
the intellect remains clear until the last. Convulsions occur occasionally. 
The pulse becomes weak and variable; slight exertion may bring on a 
fatal syncope. The muscular strength is early affected, so that the 
patient is unable to stand. Owing to the lowering of the blood-pressure 
and the dilatation of the arterioles caused by the aconite, the heat of 
the body is at first brought, with the increased blood-flow, to the surface, 
and there the blood loses its heat by radiation and the temperature of the 
interior of the body is quickly lowered. The depression is accompanied 
by increase of perspiration, which still further reduces temperature. This 
occurs more obviously when there is pyrexia present than when the tem- 
perature is normal to begin with. Death results from failure of respira- 
tion generally, but it may occur suddenly from syncope, as already stated. 
Aconite applied locally first paralyzes the sensory nerves, beginning with 
the end-organs and ascending the trunk to the centre. The motor nerves 
are next affected. The reflex function of the cord is impaired. Uncer- 
tainty still exists, however, concerning the mode and order in which 
aconite affects the different portions of the nervous system. Ringer 
concludes, upon the basis of his and Dr. Murrell’s experiments, that 
aconitine paralyzes all nitrogenous tissues, abolishing the functions, first, 
of the sensori-perceptive centre, acting next upon the nerves, and, 
finally, upon the muscles. Similarly, first the ganglia of the heart are 
attacked, next its nerves, and lastly its muscular structure. 
Antidotes.—The antidotes to aconite are tannic acid, astringent 
infusions, alcohol, and ammonia. Digitalis appears to be the physio- 
logical antagonist to counteract the depressant effect upon the heart, or 
tincture of stroplianthus may be substituted. The hypodermic injection 
of atropine also acts in the same manner. Nitrite-of-amyl inhalations, 
administered freely, appeared to save life in Dr. Elliott’s case. The 
patient should be kept in a recumbent position. The stomach-pump, 
artificial respirations, e.ther, or alcohol and tincture of digitalis hypoder- 
matically, and a hot pack may all come in requisition ; even faradization 
over the epigastrium and cardiac region might be useful. 
* Proceedings College of Physicians of Philadelphia. Third series, vol. x, p. 450. 399 
ACONITUM. 
Therapy.—Localh',the benumbing effects of aconite havebeen utilized 
in the treatment of neuralgia, the best combination, probably, being the 
Baltimore liniment, or the Linimentum Aconiti et Chloroformi (N. F.):— 
Tr. aconiti, 
Chloroformi, aa f3ij. 
Liniment, saponis, q. s. ad f^iij. 
M. Sig.: Poison. For external use. To be applied along the course of the affected nerve. 
The oleate of aconitine has also been used (2 per cent.) with asserted 
good results for this purpose. An ointment of aconitine is officinal in 
the British Pharmacopoeia. This preparation contains 8 grains to the 
ounce of lard, the aconitine being dissolved in fluidraclim of rectified 
spirit before being rubbed up with the fat. Aconitine ointment will often 
assuage the pain of chronic rheumatism, gout, and myalgia. It serves 
the same purpose, also, in herpes zoster, but care must be taken, in this 
affection, not to apply it to the abrasions produced b}1" rupture of the 
vesicles. The same ointment also affords relief in neuralgia of the skin, 
paraesthesia, or pruritus, papular eczema, and prurigo. It must never 
be placed upon a raw surface. 
Its control over the circulation places aconite in the first rank in 
the treatment of the fever process, but in order to get the best results 
it should be given in fractional doses (every ten, fifteen, or twenty 
minutes give a teaspoonful of water from a tumbler in which a few 
minims of the tincture have been dropped). This is invaluable in the 
treatment of the ephemeral fevers of childhood, and hyperp}Trexia 
attendant upon the exanthemata. In adults, the results are also very 
positive ; so that aconite has almost entirely taken the place of the lancet 
in the antiphlogistic treatment. 
In the early stage of inflammatory processes—pneumonia, pleurisy, 
pericarditis, peritonitis, erysipelas, rheumatism, meningitis—and in chil- 
dren’s diseases, it modifies materially the severity of the S3-mptoms, 
reduces temperature, and moistens the skin. Aconite serves a useful 
purpose in acute congestion of the brain. In spasmodic croup, aconite 
relieves the dyspnoea within a few hours. Asthma, especially in chil- 
dren, and preceded by coryza, is generally benefited by the use of this 
remedy. Ringer states that a drop of the tincture every hour is useful 
in acute gonorrhoea. In coryza and quinsy, or crescent tonsillitis, it is 
highly prized for its influence in shortening the course of the disease; 
and it has also been given to abort or prevent urethral fever after the use 
of instruments. It affords prompt relief in congestive dysmenorrhoea. 
In facial neuralgia, the extract or abstract may be given internally, in 
combination with quinine and a carminative, viz.:— 400 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Abstracts aconiti, gr. iv. 
Quiuinae bisulphat., 3j. 
Piperin., gr. v. 
Div. in pil. no. xx. 
Sig.: Give one every two hours until relieved, and then one every four hours as long 
as needed. 
Iii migraine, or sick-headaclie, it may be combined with cannabis 
indica :— 
Tr. aconiti, fflij. 
Tr. cannabis indicae, tfixv. 
Tr. cardamom, co., q. s. ad f3j.—M. 
For one dose, to be repeated every hour, or two hours, until patient is relieved. 
Aconitine should never be given, even in the smallest dose, where 
there is a weak or fattj7 heart. It is used b}r Gubler in the treatment of 
facial neuralgia, and Seguin also advocates the crystallized aconitine in 
trigeminal neuralgia, in doses of or grain, to begin with, repeated 
cautiously, and gradually increased. 
In nervous palpitation and overaction in a heart somewhat kypertro- 
pliied, and in the tobacco-heart, aconite cautiously used gives much relief. 
ADEPS (U. S. P.).—Lard. 
Preparations. 
Adeps Benzoinatus (U. S. P.).—Benzoinated Lard (benzoin, 2 per cent.). 
Oleum Adipis (U. 8. P.).—Lard-oil. 
Adeps Behydratus.—Purified, dehydrated Lard (for ointments). 
Pharmacology.—Lard is the prepared internal fat of the abdomen of 
Sus scrota, Linn6 (class, Mammalia; order, Pachydermata), purified by 
washing with water, melting and straining. The specific gravity of lard 
is about 0.938. It is entirely soluble in ether, benzine, and disulphide of 
carbon. It melts at or near 95° F. to a clear, colorless liquid. It con- 
sists chemically of 62 per cent, of olein, or fluid fat, and 38 per cent, of 
the hard fats, palmitin and stearin. The olein may be separated by 
pressure, or by boiling alcohol. The salt with which it is frequently 
impregnated be removed by boiling the lard with twice its weight 
of water. The tendency to rancidity may also be overcome by digesting 
the lard with beta-naphthol err poplar-buds. As a convenient animal 
fat, it is largely ifsed in pharmacy as the basis of ointments and cerates; 
and in domestic practice it is universally employed as a lubricant. By 
the addition of benzoin the lard is prevented from becoming rancid,and 
an agreeable odor is imparted to it; dehydrated lard is preferred where 
the presence of water is considered objectionable. Lard-oil is sometimes 
used for illuminating purposes, and can be administered, in cases of cor- 
rosive poisoning, as an antidote, except where phosphorus or carbolic 401 
ADHATODA JUSTICIA. 
acid has been swallowed. Lard is an article of food, or, more correctly, 
is largely employed in preparing other articles of food. 
Therapy.—Lard has more penetrating power than petrolatum or 
vaseline, and active agents (such as mercury, or the alkaloids) can be 
combined with it for administration by inunction. Washed lard, beaten 
up with an equal quantity of lime-water, and a few drops of oil of bitter 
almonds, thymol, or of carbolic acid added, makes an elegant substitute 
for Carron oil as a dressing for burns, or for some acute inflammations of 
the skiu. Stiffened with a little yellow wax, it forms the simple oint- 
ment of the pharmacopoeia. This preparation is well adapted to fulfill 
the general indications of a fat, and to serve as an excipient for more 
active ingredients. When the secretory functions of the skin are sup- 
pressed, inunction with lard serves as a partial substitute for the natural 
secretion, softens the hard tissue, and reduces its heat. It sheaths the 
surface, and prevents the contact of the atmospheric air with its floating 
germs. It lessens or prevents the effect of irritant discharges. Lard 
softens and removes scabs. Simple ointment relieves the intense heat 
of the skin and itching in scarlatina. At the same time it assists in 
reducing the pulse-rate and temperature of the body. Inunction is like- 
wise of value in measles. 
ADHATODA JUSTICIA.*—Adhatoda vasica, A. gendarussa, or A. 
pubescens. 
Pharmacology and Physiological Action.—The leaves of this plant 
(belonging to the Acanthncese, indigenous to India and neighboring 
islands) have been used with asserted benefit in and catarrhal 
affections. It contains an alkaloid, Vasicine, combined with adhatodic 
acid. Hooper found it poisonous, when used in infusion, to flies, frogs, 
and all the smaller organisms, but harmless to large animals. 
Therapy.—In asthma, 10-grain doses of the powdered leaves, given 
three times daily, afford great relief, the patient being also permitted to 
smoke the leaves in a pipe, or to inhale the smoke. On account of its 
bactericide properties, Dr. H. H. Rusby has recommended its use in 
diphtheria, and it has been suggested that it might also be efficient in 
typhoid fever, and by inhalation of the spray from the atomizer in cases 
of phthisis and fetid bronchitis. It is probable that it might also be 
useful in infectious dyspepsia due to abnormal fermentation of food in 
the stomach. 
ADONIS VERNALIS.—False Hellebore (Pheasant’s Eye). 
Preparation. 
Adonidin.—Dose, gr. 
* Annual of the Universal Medical Sciences, 1890, vol. v, p. A-7. 402 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Pharmacology.—Adonis is a perennial herb (belonging to the Ranun- 
culacete), indigenous to Europe, having bright, showy flowers. There are 
two species, the A. vernalis, flowering in May, and the A. autumnalis, 
flowering in September; the former has yellow, the latter red, flowers. 
Physiological Action.—The active principle, adonidin, appears to be 
a glucoside (although it has been asserted that this is not a simple but a 
compound body, containing picro-adonidin, a glucoside, and other un- 
determined substances). Whether used, as the peasants of Russia are 
said to be in the habit of doing, as an infusion, the fluid extract, or in 
the form of adonidin, it acts upon the heart as a stimulant or cardiac tonic, 
resembling in its action digitalis or strophantlius. According to Hare, it 
increases the arterial tension and in large doses causes diastolic arrest of 
the heart. In large doses it paralyzes both the heart and the blood-vessels. 
It is claimed that, in moderate doses, adonidin is devoid of danger 
from cumulative effect, and that it agrees with the digestive organs. 
Huchard, however, found in some cases that it caused vomiting or 
diarrhoea. In a case in which three grains of adonidin were taken by 
mistake, vomiting and diarrhoea were prominent S37mptoms. In accord- 
ance with the observation that it increases arterial pressure, there is an 
increased flow of urine, but adonidin is said to have no effect upon the 
secreting structure of the kidneys. 
Therapy.—Internally in cases of mitral or aortic regurgitation it is 
claimed to be of great value. In functional irregularity of the heart, 
Da Costa has found much benefit from adonidin (in doses of gr. to 
| thrice daily). In cardiac asthma it also affords relief to the dyspnoea. 
The fluid extract (normal) is a good preparation in doses of ny or ij 
cautiously increased. 
/ESCULUS HIPPOCASTANUM.—Horse-Chestnut. 
Pharmacology and Therapy.—This is an ornamental shade-tree (be- 
longing to the Sapindacese), coming originally from Tartary. The bark is 
astringent and antiseptic, and has been used as a substitute for cinchona- 
bark. The fluid extract has been administered in malarial disorders and 
in neuralgic affections in doses of n^xx-f5j. 
AETHER (U. S. P.).—Ether. 
Preparations. 
Fortior (U. S. P.).—Stronger Ether, consisting of 94 per cent, of ethyl oxide 
and 6 per cent, of alcohol. Anaesthetic. 
Oleum (U. S. P.).—Equal parts Stronger Ether and heavy Oil of Wine. 
Spiritus JEthei'is (U. S. P.).—Spirit of Ether (stronger ether 30, alcohol 70 parts). 
Spiritus Compositus (U. S. P.).—Compound Spirit of Ether, or Hoffman’s 
Anodyne (composed of stronger ether 30, alcohol 67, ol. aethereum 3 parts). Dose, 3ss-ij. 
Spiritus Etheris Nitrosi (U. S. P.).—Spirit of Nitrous Ether. AiTHER, 
403 
Pharmacology.—Ordinary ether represents only *74 per cent, of oxide 
of ethyl and 26 per cent, of alcohol, containing a little water. For the 
purpose of producing anaesthesia by inhalation for surgical operations, 
the stronger ether only is suitable. It is a thin, very diffusive, clear and 
colorless liquid, with a refreshing, characteristic odor, a burning and 
sweetish taste, after-taste slightly bitter, with a neutral reaction. It is 
soluble in all proportions in alcohol, chloroform, benzol, benzin, fixed 
and volatile oils; dissolves in eight times its volume of water at 59° F., 
and it boils at 98.6° F. It is very inflammable, and its vapor, mixed with 
air and ignited, explodes violently. The vapor is slightly’ irritating to 
the conjunctive, and at first to the bronchial mucous membrane. 
Physiological Action.—When ether is poured over the skin it evapo- 
rates so quickly that a sensation of cold is experienced, and when its 
application is continued, as witli the atomizer, the temperature of the 
part is lowered and it may be frozen, which is announced by sudden 
blanching of the skin. For this purpose and for local anaesthesia 
stronger ether is required. When the escape of the vapor is prevented 
ether acts as a counter-irritant, causing reddening; even vesication may 
be produced. 
When taken internally, ether is a diffusible stimulant, like alcohol 
in its effects ; although they are manifested earlier by ether, yet they are 
more transitory than when produced by spirits. When introduced into 
the circulation, by absorption from the stomach or the rectum, by inhala- 
tion, or hypodermatically, it is found to increase arterial tension and 
acts as a cardiac stimulant, the heart continuing to beat after failure of 
respiration. In these respects it is antagonistic to chloroform, which 
lowers arterial pressure and is a cardiac sedative. Ether-vapor is inhaled 
pure, while chloroform-Arapor must be combined with 95 to 97 parts of 
atmospheric air. Upon the nerve-centres ether acts very much like 
alcohol, affecting (1) the cerebrum ; (2) the sensory, and later the motor, 
functions of the spinal cord ; (3) the sensory centres in the medulla 
oblongata; and (4) finally the motor centres in the medulla. 
The State of Anaesthesia.—Anaesthesia produced by the inhalation 
of ether-vapor, when complete, nearly approximates the state of coma. 
It approaches by well-defined stages, the first being one of excitement or 
exhilaration ; the second is narcosis; the third is abolition of sensibilit}'' 
and reflexes, and, carried further, it ends in paralysis and death from 
failure of respiration, owing to paralysis of the centres in the medulla 
oblongata. The nerve-centres are affected in the following order : The 
higher centres in the brain, the motor and sensory centres in the medulla 
spinalis, and, ultimately, the sensory and motor centres of the medulla 
oblongata. The vapor of ether is, at the beginning of the inhalation, 404 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
irritating to the air-passages, and may cause strangling sensations to the 
patient, but this soon passes away as anaesthesia becomes established ; it 
may be necessary, at the outset, to allow some admixture of air, so as 
not to frighten the patient, but as soon as may be possible the pure 
ether-vapor is to be administered, so as to prevent efforts at vomiting. 
Owing to this irritation of the bronchial mucous membrane there may 
be produced congestion or oedema of the lungs, especially when the 
patient is not kept warm during the operation. During operations upon 
the mouth, and particularly in the extraction of teeth, the blood running 
down the throat, Dorr says, may cause spasm of the glottis, respiration 
becomes thus interfered with, and death may result. Blood passing 
from the mouth into the throat, he further adds, may bring on vomiting, 
which may speedily lead to asphyxia unless the operator stops for a few 
moments and cleanses out the parts. A few “ don’ts ” should be borne 
in mind when administering ether :— 
1. Don’t give it to a patient whose kidneys are diseased. 
2. Don’t give it when the stomach contains undigested food ; the 
patient should be fasting. 
3. Don’t give it without removing artificial teeth from the mouth, as 
they may fall into the throat. 
4. Don’t give it uidess the clothing is so loose as to allow freedom 
of respiration. v 
5. Don’t give anjr anaesthetic to women, especially young women, 
except in the presence of witnesses, who can testify as to your actions 
during the period of unconsciousness of the patient, as under such cir- 
cumstances women sometimes acquire fixed delusions which can only 
be met b\T testimony absolutely proving their falsity. 
6. Don’t forget that ether-vapor and air make an inflammable and 
explosive mixture, and that ether may take fire from the actual cautery 
as well as from a candle. 
7. Don’t forget that there are different qualities of ether, and that 
the proper kind for surgical purposes is washed ether or stronger ether 
(U. S. P.). 
8 Don’t forget that ether, like alcohol, lowers temperature,and that 
the patient should not be too much exposed to cold during operation. 
9. Don’t forget that ether causes death by respiratory failure, and 
that the color of the lips and ears is a better guide to the state of the 
blood than the radial pulse. 
10. Don’t forget that the anaesthetic state is a state of danger, and 
the patient is not safe until the effects of the ether have entirely passed 
off. 
11. Don’t forget that ether is eliminated rather slowly by the lungs ASTHER, 
405 
and the kidneys; so the patient should be watched for several hours 
after the administration. 
The Choice of Anaesthetics.—The anaesthetic agent should be suited 
to the operation and to the circumstances of each case. For many 
trivial operations, or those which are rapidly performed, pure nitrous 
oxide gas is sufficient and much safer than the others. In young chil- 
dren, chloroform vapor is easier of administration than ether, and com- 
paratively free from danger when properly administered ; it also is pre- 
ferred where the actual cautery is to be used, or where lights are required 
near the patient. In midwifery practice it also is the preferred anaes- 
thetic. For all ordinary cases ether is safer than chloroform, and is by 
far the most frequently used. Bichloride of methylene has been tried in 
England to shine extent, but as ordinarily sold it appears to be merely 
an impure chloroform. The bromide of ethyl is of more recent intro- 
duction, and when pure answers well for short operations, but does not 
have decided advantages over the best ether except in having a slightly 
more agreeable odor. For a lengthy operation it is well to supplement 
the action of the anaesthetic and stimulate the circulation by the pre- 
liminary administration of from 2 to 4 ounces of whisky. In a similar 
manner a hypodermatic injection of morphine (gr. £) and atropin 
may be given before operating (Nussbaum’s method). Various mixtures 
of anaesthetics have been proposed, the best known being the A. C. E. 
mixture of the London hospitals, containing alcohol 1, chloroform 2, and 
ether 3 parts ; but owing to the different densit}’ of the vapors of the 
several substances, and the unequal boiling or vaporizing point and 
varying rates of diffusion, it is impossible to tell just how much of each 
is being given ; and, therefore, these mixtures are not recommended. 
Where a patient dislikes ether, or takes it badly, the administration may 
commence with nitrous oxide and ether substituted later, or it may be 
preceded by a few whiffs of chloroform. 
Treatment for Toxic Effects.—When a patient is too deeply narco- 
tized or appears asphyxiated by the ether, artificial respiration, inhala- 
tion of ammonia, slapping the exposed surface of the chest with wet 
towels, and the faradic current will usually restore him. Rubbing the 
body so as to keep up the circulation, or the use of stimulating enemata, 
is also of service. Oxygen might be administered if at hand, or 2 atoms 
of oxygen with 1 of nitrogen monoxide,* or amyl nitrite inhaled so as to 
flush the brain and medullary centres with blood, or nitro-glycerin (gr. 
T5r>) given hypodermatically. 
What is called “ primary anaesthesia ” occurs early in the adminis- 
♦Walton’s Oxygen Works, of New York, manufacture the combination of 2 atoms of 
oxygen with 1 atom of nitrogen monoxide, and furnish this gas in metal cylinders, which can 
be ordered of all pharmacists. 406 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
tration of the ether, at the time when narcosis begins. During this stage, 
which is very brief, small operations, incisions, punctures, etc., may be 
done without waiting for complete anaesthesia. In order to ascertain when 
it occurs, the patient is directed to extend one of his arms perpendicularly 
upward and to hold it up as long as he can. At the moment when nar- 
cosis occurs the arm falls, which is the signal for the operator to cut and 
for the administration of ether to cease. The patient regains conscious- 
ness at once, and generally there is no vomiting or other ill effects. 
Ill Effects of Ether.—The unpleasant results which sometimes follow 
the administration of ether, such as nausea and vomiting, may be over- 
come by giving the patient a cup or two of either strong, hot coffee or 
tea. Dorr states* that often the bad effects of ether may be avoided by 
the patient keeping the eyelids closed for a time after regaining con- 
sciousness and interdicting the use of water either to wash out the mouth 
or to drink. In explanation he states that he has observed, in many cases 
after etherization for operations, especially in extracting teeth, nausea and 
vomiting follow from the employment of water. In the event of nausea, 
vomiting, or even wakefulness supervening, Dr. Dorr administers about 
25 grains of bromide of potassium in strong coffee. At times the same 
authority gives from a few drops to a drachm of compound spirit of ether 
in water. Pancoast allays nausea and vomiting by the following pill:— 
Argenti nitratis,f gr. ss. 
Creasoti, lTlij. 
Pulv. aromatic!, gr. iv. 
M. et ft. pil. no. ij. 
Sig.: One pill at once, the second in the course of three or four hours. 
The author can also commend bromide of sodium (15 to 20 grains, 
in soda-water, soda-mint-water, or cinnamon-water), camphor-water, the 
aromatic spirits of ammonia, citrate or hydrobromate of caffeine (1 to 
4 grains at a dose), tincture of capsicum (10 to 20 drops at a dose), 
or the effervescent salts of bromide of sodium or caffeine, all of these 
being especially suitable for the treatment of the ill effects following the 
administration of ether. 
Therapy.—Ether may be used locally for its refrigerating effects. 
In strangulated hernia the persistent dropping of ether upon the tumor 
sometimes causes spontaneous reduction. It dissolves fat from the skin, 
and is applied to wash the surface before a surgical operation, after using 
soap. The ether-spray may be used to benumb a part of the skin before 
* Henry I. Dorr, M.D., D.D.S., Lectures on Anaesthetics, at the Philadelphia Dental 
College, December, 1890. 
t N trate of silver and creasote, on being mixed, result in decomposition, and if the mixture 
is exposed to heat combustion may follow. Squire (see Squire’s Companion to the British 
Pharmacopoeia, fourteenth edition, 1886) recommends that the oxide of silver be first diffused 
through some inert powder, such as kaolin, to avoid an explosion. a;ther, 
407 
making an incision ; and, in chorea, etlier-spray has been applied to the 
spine with good results. The ether-spray is also often very serviceable 
in allaying the pain of neuralgia, especially when seated in a superficial 
structure. The ether is directed immediately upon the course of the 
aching nerve. Ethereal preparations may be used internally for hysteria, 
colic, and the passage of biliary or renal calculi. Durand’s remedy for 
gall-stones is equal parts of ether and turpentine-oil, given a teaspoonful 
at a dose. Internally, ether is a diffusible stimulant, and can be used 
hypodermatically in heart-failure Taken with water or 
syrup (5ss-_p, it affords relief in flatulence, spasmodic asthma, hysteria, 
or colic. It has similar effects to those of alcohol, and a habit of ether- 
drinking* has in like manner been established in some persons (although 
the odor of the breath plainly announces to others the fact that it has 
been taken), but its effects are more transitory than those of alcohol. 
The internal administration of ether is capable of relieving mild 
attacks of angina pectoris. It is a good plan to combine 10 or 20 drops 
of ether with cod liver-oil when the latter substance is not well borne. 
Ether facilitates the digestion and absorption of the oil, probably by 
increasing the secretion of pancreatic fluid. Hoffmann’s anodyne in 
half-drachm doses is useful in sick-headache. The hypodermatic injection 
of from 15 minims to \ drachm of ether in the neighborhood of the 
affected nerve has proved of value in sciatica. Barth obtained very excel- 
lent results in typhoid pneumonia from the subcutaneous injection of 15 
to 20 minims of ether. The injections were given from two to four times 
daily, and were followed by notable increase in the strength and volume 
of the pulse. Castel reports favorably of the same method in small-pox. 
After puerperal, pulmonary, or other severe haemorrhage, ether thrown 
under the skin stimulates the heart and may avert fatal syncope. 
The following combinations of ether will be found serviceable :— 
Spts. aetheris comp., f§ij- 
Tinct. capsici, f3j. 
Spts. ammon. arom., nice. 
Aqua sodae menth., f^ij. 
M. Sig.: A teaspoonful in water every few minutes until relieved. This prescrip- 
tion is especially useful in the treatment of syncope, flatulence, and nervous or hysterical 
paroxysms. 
Spts. aetheris comp., 
Elix. lupulini, 
Tinct. valerian, ammon., aa f^j. 
M. Sig.: Two teaspoonfuls in water every fifteen or twenty minutes. For hysteria 
and nervous sick-headache, neurasthenia, angina pectoris, and spasmodic asthma. 
* See interesting address on “Ether-Drinking, its Prevalence and Results,” by Ernest 
Hart, delivered before the Society for the Study and Cure of Inebriety, in the Provincial 
Medical Journal, November 1, 1890. 408 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Spiritus JEtheris Compositus (U. S. P.), the compound spirit of 
ether, or Hoffmann's anodyne liquor, consists of 3 parts of ethereal oil, 
with 30 of stronger ether, in 67 parts of alcohol. In hysteria, flatulent 
colic, and nervousness, this solution is much in demand. Hoffmann’s 
anodyne is likewise very serviceable in the treatment of hiccough, func- 
tional palpitation of the heart, or syncope. It will often afford relief in 
gastralgia. It is a diffusible stimulant and antispasmodic. The dose is 
from tipxv to f5j or ij, in sweetened water. 
The following formulae, containing compound spirit of ether, are 
useful:— i 
Sodii bicarbonatis, 3iss. 
Spts. ammon. arom., 
Tinct. zingiberis, f3j. 
Spts. aetheris comp., f^lv. 
M. Sig.: Two teaspoonfuls in water for hysteria or flatulence. Repeat when 
necessary. 
Spts. aetheris nitrosi, 
Vini erythroxyli cocae, aa f^ij. 
M. Sig.: From one-half to a tablespoonful in water every hour or two as a stimulant. 
Spiritus JEtheris Nitrosi (spirit of nitrous ether, sweet spirit of 
nitre) is an alcoholic solution of crude ethyl nitrite (5 per cent.), made 
by the action of sulphuric and nitric acids upon stronger alcohol, and 
consists chemically of alcohol, aldehyd, water, ethyl acetate, and pure 
ethyl nitrite (at least 4 per cent, of the last-named constituent). Upon the 
human system it acts as a diaphoretic and diuretic, and the ethyl nitrite 
acts as a sedative upon the circulation, especially when fever is present. 
The pharmacopoeia directs that it should be kept in small, glass-stoppered 
bottles, in a dark place remote from lights or fire. Very much of the 
spirit of nitrous ether has not been properly kept, is deficient in strength, 
and has become acid from age. When this has occurred it should not 
be used. When good it renders excellent service as a diuretic, especially 
in scanty secretion of urine in elderty people. 
Nitrous ether resembles the other nitrites in its sedative effects 
upon the system, but its action is overcome or modified in this form 
by the comparatively large quantity of alcohol accompanying it, which 
really makes the spirit of nitrous ether a diffusible stimulant. For this 
reason Whitla especially commends it in the dropsy of debilitated 
subjects. In fever it may be given (5ss-j) in cold water or lemonade, 
or in combination with other remedies, as aconite or veratrum viride. It 
is widely used in fever, acts upon the skin as well as upon the circulation, 
and reduces the temperature. It is useful, above all, in the febrile affec- 
tions of infancy and childhood. It enters into Brown Mixture (mist. ASTI1ER ACETICUS. 
409 
glycyrrhizae co.), of which it constitutes 3 parts in 100, forming a popular 
remedy for acute bronchitis. 
Spirit of nitrous ether can be employed in the following combina- 
tions with advantage :— 
Spts. aetheris nitrosi, 
Aquae camphorae, 
Liq. ammon. acetatis, . ... ... . aa f§ij. 
Antimonii et potassii tart., gr. j. 
Morphinae sulphatis, gr. ss. 
M. Sig.: A tablespoonful in water every hour or two until relieved. For acute 
bronchitis, acute rheumatism, and in fevers. 
Spts. aetheris nitrosi, 
Elix. humuli, 
Syr. lactucarii, ......... aa m 
M. Sig.: From a half to a tablespoonful every hour when unable to sleep. Service- 
able in insomnia, general nervousness, and debility. 
/ETHER ACETICUS (U. S. P.).—Acetic Ether. 
Dose, internally, n^x-xxx. 
The acetate of ethyl is soluble in 17 parts of water, and in all pro- 
portions of alcohol or chloroform. It enters into cologne and acetate-of- 
iron tincture. It has similar effects upon the system to ethyl oxide, and 
also can be used as an amesthetic, but is slower in its action. 
/ETHER HYDRIODICUS.—Hydriodic Ether, Ethyl Iodide. 
Dose, l>y inhalation. 
This is very analogous to ethyl bromide, iodine merely replacing the 
bromine. It can be administered from a vial in drops on a handkerchief, 
or by gelatin capsules containing 5 minims each. It is not used for 
producing anaesthesia, but may be inhaled for syphilis, bronchitis, 
phthisis, catarrh, whooping-cough, asthma, or other spasmodic disorders. 
/ETHER HYDROBROMICUS.—Hydrobromic Ether, Ethyl Bromide. 
(Not Ethylene Bromide.) 
Dose, f'5j, by inhalation. 
Pharmacology.—This liquid has rather a pleasant odor and sweetish 
taste. When pure it is colorless, volatile, non-inflammable, and resembles 
ether or chloroform in its effects when taken internally or by inhalation. 
It is very slightly soluble in water, but freely soluble in alcohol and ether. 
Under the influence of light the bromine gradually separates, causing 
discoloration of the ethyl, when it becomes unfit for use, owing to the 
poisonous effects of bromine. 
Therapy.—For anaesthesia, the pure ethyl bromide should only be 
used, as dangerous symptoms, even fatal results, have been ascribed to 
the use of impure preparations. In dosage it stands between ether and 
chloroform, and probably occupies the same relative position with regard 410 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
to safety. Its characteristic effects, when inhaled, are the rapid approach 
of aiicCstliesia, its brief duration, and the rapid return of consciousness. 
It is, consequently, ill adapted for use in prolonged operations. When 
sprayed upon a part it produces local anaesthesia. It may be inhaled in 
epilepsy, chorea, and other spasmodic diseases (about 1 drachm at a 
time). Being uninflammable and not unpleasant, it may be used instead 
of ether for surgical operations. 
AGARICUS ALBUS.—Purging Agaric. (Polyporus officinalis, 
Boletus laricis; order, Basidiomycetes, Hymenomycetes.) 
Dose, gr. x-xxx. 
Preparations. 
Agaricin.—Dose, gr. 
Extracturn Agarici.—Dose, gr. iii-vj. 
Tinctura Agarici.—Dose, Hlxx-lx. 
Pharmacology.—The European larch has a fungus which grows in 
large, hoof-shaped masses horizontally from the trunk, and penetrates, 
with its mycelium, deeply into the wood. The masses are collected in 
Europe and Asia Minor, and, after peeling and drying, they form yellow- 
isli-white, friable, spongy, irregular balls, from the size of an orange up 
to that of a cocoa-nut. It has a heavy, fungus-like odor, a sweetish, fol- 
lowed by a bitter, nauseous taste, and its powder is irritating to eyes and 
nose. It largely consists of resinous matter, Agaricin. In doses of gr. x 
or more it acts as a purgative, in small doses is tonic and anhydrotic. 
Physiological Action.—In small doses (gr. i-v) agaricin acts like 
atropine, but does not dilate the pupil. It is a compound body, the active 
principle of which is termed agaric acid. But Ilolfmeister has shown 
that the substance employed under the name of agaricin or agaric acid 
is an impure product. Pure agaric acid is a white, light, crystalline 
powater, of a silky lustre. It crystallizes out of absolute alcohol in 
groups of tuft-like needles or as distinct rosettes. Its melting-point is 
138° C. (280.4° F.). The free acid is but slightly soluble in cold water, 
but is moderately soluble in boiling water. Its alkaline combinations 
are freely soluble, but its heavy metallic salts are insoluble. It is a 
strong local irritant, and its subcutaneous injection results in active in- 
flammation with the production of pus. On account of its slow absorp- 
tion, it produces no grave symptoms in warm-blooded animals. The 
subcutaneous or intra-venous injection of a soluble salt first excites, and 
then paralyzes, the vagus and vasomotor centres. Death is preceded by 
convulsions, and results from cessation of respiration or, in animals 
when artificial respiration is kept up, from the extreme fall of blood- 
pressure. The influence upon the secretion of sweat is not central, but 
is exerted upon the secretory glands. AGARICUS CHIRURGORUM. 
411 
It, therefore, becomes a matter of prime importance that pure agaric 
acid should be employed. The pure acid is little liable to excite vomit- 
ing and purging, and it is well borne in doses of from to grain. 
Since its anhydrotic activity appears gradually, small doses, given re- 
peatedly, will be free from the unpleasant consequences which might 
follow a single large dose.* 
Therapy.—Agaricin, in doses of gr. xV-j, is used to check night- 
sweating, and sometimes to suppress lactation. 
Agaricin., gr. j. 
Acid, sulph. aromat., f3iv. 
Elixir, f^iss. 
M. Sig.: Take one drachm every four hours in water. 
It lias been also recommended to combine a small quantity of Dover’s 
powder with each dose of agaricin, when there is a tendency to loose- 
ness of the bowels following its use. 
AGARICUS CHIRURGORUM.—Polyporus Igniarius. 
This is an allied fungus to the preceding, but is used solely on 
account of its porous texture. It has been employed as a mechanical 
haemostatic and for its slow burning as a moxa. It may be soaked in 
potassium nitrate or chlorate solution, which makes it more inflammable. 
AGARICUS MUSCARIUS.—Amanita Muscaria, or Fly-Fungus (Basi- 
diomycetes, Hymenornycetes). 
Preparations. 
MuscaHna.—Muscarine. Dose, gr. J-ij. 
Muscarince Nitras.—Muscarine Nitrate. Dose, gr. 
Pharmacology.—A poisonous mushroom, consisting largely of fungus- 
cellulose. Its active principle is a syrupy alkaloid, Muscarine. It is 
without taste or odor, but produces powerfully intoxicating effects some- 
what analogous to pilocarpine in its action, and antagonized by atropine. 
The alkaloid is soluble in water, and mushroom poisoning may be pre- 
vented by soaking the mushrooms in water slightly acidulated with 
vinegar. In cases of poisoning, Wliitla has successfully used atropine 
and diffusible stimulants. Digitalis may also be given hypodermatically, 
and stimulating enemata administered. 
Physiological Action.—The action of the heart and the respiratory 
movements are diminished by large doses, the heart being finally arrested 
in diastole. Smaller doses diminish blood-pressure and reduce tempera- 
ture, although the bodily heat may be secondarily increased. The secre- 
tions of the skin, the liver, and intestinal tract are increased, while that of 
the kidneys is sometimes reduced or suppressed. The muscular system 
* Deutsch. Med. Wochensclir., September 10, 1889 ; Medical Bulletin, January, 1890. 412 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
is relaxed, but convulsions may occur from accumulation of carbonic 
acid in the blood. Upon the brain a marked narcotic or stupefying 
effect is observed, so that it has been used in Asia as an intoxicant. 
The pupil contracts from the effects of the internal administration, while 
the local application of muscarine may cause dilatation. 
Therapy.—Administered medicinally, muscarine has some reputation 
in checking the fever and sweating of phthisis. It may be used in affec- 
tions of the respiratory tract where there is deficiency of secretion, or in 
disorders of the alimentary canal where the same indication is to be met, 
and to overcome a tendency to constipation. Muscarine can therefore 
be combined with such drugs as belladonna, liyoscyamus, strychnine, 
aloin, cascara sagrada, or sulphur with advantage, as in the following 
formulae:— 
Muscarin*, gr. iij. 
Ext. ignatiae, gr. j. 
Aloini, 
Ext. belladonnae ale., aa gr. iss. 
Ext. gentian*, gr. xvj. 
M. et ft. pil. no. xvj. 
Sig. : One pill two or three times a day. Beneficial in constipation and in catarrhal 
jaundice. 
Muscarinae, gr. iiss. 
Ext. hyoscyaini ale., gr. iss. 
Ext. cascarae sagradae, gr. iv. 
Sulphuris subl., 3 iss. 
M. et ft. capsulae no. xvj. 
Sig. : A capsule three times a day. Serviceable in constipation and in haemorrhoids. 
In diabetes mellitus and polyuria, muscarine has been tried in com- 
mon with many other agents, but without constant good results. 
The dose of muscarine is usually gr. |-ij, in solution, or the nitrate 
of muscarine may be given in somewhat smaller doses. For the sweat- 
ing of phthisis, Murrell uses a 1-per-cent, solution, of which the dose is 
5 minims. 
AILANTHUS GLANDULOSA.—Ailanthus-Tree, Chinese Sumach. 
Pharmacology.—The Ailanthus, or 'free of Heaven (belonging to 
the natural order Simarubacese), has been brought from China, and is 
now naturalized in this country as a shade-tree. The inner bark, which 
is the part used, contains an oleoresin and a volatile oil. 
The fluid extract (dose, and the tincture (in doses of 3ss-ij) 
are not officinal, but have been used. The bark may be given in doses 
of from 5 to 10 grains. 
Physiological Action.—When taken in full doses, ailanthus nauseates 
and purges ; it also gives rise to vertigo, headache, pains in the back and ALCOHOL. 
413 
limbs, find prostration, with numbness or tingling. Both respiration and 
pulse-rate are reduced; death results from arrest of respiration. 
Therapy.—The fresh bark is used in the treatment of tape-worm, in 
decoction (5iv-Oj) or the oleoresin (in 5j doses). It has also been used 
in malignant scarlatina and in spasmodic disorders. 
ALCOHOL (U. S. P.).—Alcohol, Spirit of Wine. 
Preparations. 
Alcohol Dilutum (U. S. P.).—Dilute Alcohol (50 per cent, distilled water). 
Spiritus Frumenti (U. S. P.).—Whisky (contains about 50 per cent, of alcohol). 
Spiritus Vini Gallici (U. S. P.).—Brandy (contains about 50 per cent, of alcohol). 
Spiritus Ocloratus (U. S. P.).—Cologne-Water. For external use. 
Spiritus Myrcice (U. S. P.).—Bay Rum. 
Vinum Album (U. 8. P.).—White Wine (10 to 12 per cent, alcohol). 
Vinum Album Fortius (U. S. P.).—Stronger White Wine (20 to 25 per cent, alcohol). 
Vinum Rubrum (U. 8. P.).—Red Wine (10 to 12 per cent, alcohol). 
Vinum Aromaticum (U. S. P.).—Aromatic Wine (lavender, origanum, peppermint, 
rosemary, sage, wormwood, of each 1 part; stronger white wine, enough to make 100 
parts). For external use. 
Alcohol is a liquid composed of 91 per cent, by weight (94 by 
volume) of ethjdic alcohol, and of 9 per cent, by weight (6 by volume) 
of waiter. Specific gravity 0.820 at G0° F. It is a transparent, colorless, 
volatile, and inflammable substance, with a characteristic, rather pungent 
taste and odor. 
Pharmacology.—The h)’drate of the hydrocarbon radical (C2H8) is 
ordinarily understood to be meant b)r the term alcohol, although many 
other substances are known to the chemist under this name, none of 
which, however, are used in medicine,* although the physiological effects 
have been investigated. Ethylic alcohol also is the alcohol of brandy, 
whisky, wine, and various spirits and cordials. Its effects upon the 
organism are transitory and less dangerous than those of other alcohols, 
such as amylic, methylic, or butylic. During distillation of grain, un- 
less carefully managed, considerable amylic alcohol will pass over with 
the ethylic, especially if the process be continued too long. B)r keeping 
whisky stored for several years, the amylic alcohol becomes changed into 
various ethers, which impart a flavor to the spirit. The United States 
Pharmacopoeia directs that grain-spirit (whisky) should be at least two 
years old ; and the spirit from fermented grapes (brandy) at least four 
years old. Wine is made by fermentation without distillation. Red 
wine is a deep-red alcoholic liquid made by fermenting the juice of 
colored grapes in the presence of their skins; white wine is of a pale- 
* If phenol and glycerin are to be considered as alcohols, they are exceptions to this 
statement. 414 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
amber or straw color, and is obtained by fermenting the unmodified 
juice of the grape, free from seeds, stems, and skins. Gin (spiritus Ge- 
nevae) is not officinal; it is obtained by adding juniper-berries to dilute 
alcohol. Rum, or molasses spirit (spiritus fuseus or Jamaicencis), is 
made by distillation from sugar or molasses which has undergone 
alcoholic fermentation ; it is about the same alcoholic strength as whisky. 
Alcohol dissolves alkaloids, fatty and resinons substances, and is 
largely used as a menstruum in obtaining the active principles of drugs 
in an available form for administration. It is the basis of the (U. S. P.) 
spirits, tinctures, and elixirs; spirits being solutions of volatile sub- 
stances in alcohol; tinctures, solutions of active principles of plants, 
generally obtained by maceration and percolation. An elixir is a cordial 
flavored with orange and syrup, used as a vehicle for other remedies, and 
as a stomachic. Malt liquors—ale, beer, porter, etc.—are produced by 
fermentation of malt and hops, and contain nutritive material, together 
with a small proportion of diastase, which makes them useful in certain 
cases of weak digestion. They contain only from 6 to 10 per cent, of 
alcohol. Malt liquors can be taken by those who suffer from the cere- 
bral effects of wine, but to some they are unpleasant in their effects 
upon the brain, owing to the oil of hops which they contain (Rossbaeh). 
Absolutely pure alcohol is rarely found, even in the laboratory 
of the chemist. Owing to its great affinit}" for water, it will even ab- 
stract it from the air. What is known as absolute alcohol of the shops 
usually contains about 2 per cent, of water. It is a colorless, pleasant- 
smelling liquid, with a sharp, warm taste. When added to water, heat is 
developed, and the mixture does not measure as much as the sum of its 
constituents owing to combination. Besides its affinity for water and 
its power as a solvent, it has a coagulating action upon albumin, and is 
an anti ferment when in solution, containing at least 18 per cent, of 
alcohol. 
Physiological Action.—Owing to volatility, it gives a cool sensation 
to the skin at first, but afterward, if its evaporation be interfered with, 
it causes irritation and heat, and, if continued, produces inflammation. 
It also hardens the integument by abstracting water from it, coagulating 
some of its albuminoid constituents, and dissolving its fat. It has the 
same effect upon mucous membranes, thus enabling it to act as an astrin- 
gent. It has some anaesthetic action, possibly by reducing the congestion 
bv its constringent effects upon the smaller blood-vessels. Flannel wet 
with hot whisky relieves pain in neuralgia of the face. After alcohol in 
the strength of ordinary spirits is swallowed, in small quantity 
there is a sensation of heat in the epigastrium, which soon diffuses itself 
over the body. It increases the appetite and the digestive power, causing ALCOHOL. 
415 
an increased flow of gastric juice. If taken in larger quantities, appetite 
is lost and nausea appears, and the digestive power is suspended. As 
a result of long-continued indulgence in alcohol, the stomach undergoes 
changes in its coats, new areolar tissue being formed, which, by its sub- 
sequent contraction, strangulates the gastric glands; hence, dyspepsia 
and gastric catarrh, with morning vomiting are very common among 
drunkards. In addition to structural change, alcohol in excess precipi- 
tates pepsin from the gastric juice and thus increases digestive ditti- 
culties. The experiments of Dr. Beaumont showed that small amounts 
increased the vascularity of the stomach and stimulated the flow of gas- 
tric secretions. Its antiseptic powers are useful in infectious dyspepsia, 
where digestion is stopped by the growth of micro-organisms, which set 
up abnormal fermentation in the stomach and intestinal canal. Its 
acknowledged value in the Zj’motic diseases, and pre-eminently in diph- 
theria, is partly due to its antiseptic action in the alimentary tract. In 
cholera epidemics, alcohol has decided prophylactic effects, and this is not 
controverted by the fact that persons weakened by debauches and alco- 
holism are most liable to perish from the disease. In cholera infantum, 
brandy exerts an excellent influence; and, indeed, in many bowel dis- 
orders among adults (which are often connected with the growth of 
micro-organisms) alcohol in the form of brandy or red wine (Port or 
Burgundy) is of great assistance in the treatment. When flatulent colic 
or neuralgic pains occur in the abdomen, cloths wet with hot whisky 
externally and some hot toddy internally give prompt relief; in infants, 
gin and hot water is the remedy most often used for colic. 
Upon the nervous sjrstem, alcohol first has an exciting effect, followed 
by narcotism or coma. The arterioles are dilated, thus admitting more 
blood to the brain, and this is succeeded by diminution of mental activity, 
owing to the effects of the alcohol upon the ganglion-cells, weakening 
their action. A similar effect is seen on the spinal cord, usually occurring 
later than, but sometimes preceding, the brain symptoms. The reflex 
action of the cord is reduced and the power of co-ordination impaired, 
so that walking is by a staggering gait, and finally the knees will no 
longer support the body. This paralyzing effect is also seen in the 
sympathetic system, since the dilatation of certain vascular areas must 
be due to the loss of function of the vasomotor nerves. The action upon 
the centres in the medulla is seen in the lowered temperature, the slowing 
of the pulse after a preliminary acceleration, and the sighing respiration 
or stertor. Death is produced by respiratory paralysis and lowering of 
the bodily heat. From this it is seen that alcohol will not keep out cold, 
but will actually hasten the occurrence of death from cold. The experi- 
ence of Arctic voyagers is to the effect that those persons endure the 416 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
rigors of the winter best who abstain from alcohol. Dr. Parkes, in the 
Ashantee campaign, also found that the fatigue of marching in the tropics 
is borne better without the aid of a spirit ration, owing to the diminution 
of muscular and nervous energy and capacity for work, due to the physio- 
logical action of this agent. The only advantage derived from its use 
was to take away the feelings of fatigue after the men had come into 
camp, and thus enable them to eat. It is also useful, in the form of hot 
drink, to revive a person who has been exposed to cold after the exposure 
has ceased. 
As to the changes that alcohol undergoes in the body, Anstie states 
that a variable amount (3i-iv) disappears, or is burnt up in the blood or 
the tissues; this quantity may be increased by habit. The excess is 
thrown off b}’ the lungs, kidneys, bowels, and possibly by the skin. 
Toxicology.—The symptoms of acute poisoning by alcohol differ so 
much from those of the chronic form of alcoholism that each state must 
be separately considered :— 
1. Acute poisoning b}T alcohol manifests itself by an exaggeration 
of the physiological action. The rapidity with which grave symptoms 
appear is in proportion to the quantity of alcohol taken, its form,and, to 
some extent, its temperature, as hot drinks more rapidly intoxicate than 
cold. Where a large quantity is taken at once, as when a whole bottle 
of whisky is drunk on a wager, or a comparatively large quantity admin- 
istered to a child, the stage of excitement is too brief to be noticed, 
and the patient falls at once into a stupor, which may be followed by 
coma or fatal convulsions. Where the administration is spread out over 
a longer period, drunkenness comes on progressively, but ends in uncon- 
sciousness and insensibility, and the patient is said to be dead-drunk, 
because of his complete helplessness. Since alcohol increases the blood- 
supply of the brain (and especially since drunken men are apt to fall 
heavily and strike their heads, or to quarrel and have others do it for 
them), the state of alcoholic coma may often be accompanied by menin- 
geal luemorrhage or apoplexy. Intoxicated persons should never be 
allowed to sleep off their drunkenness, but should be treated as if they 
were poisoned, as in fact they are. The treatment consists simply in 
evacuating the stomach with emetics (mustard, etc.), or the pump, and 
administering ammonia, either the aromatic spirit or the carbonate, both 
by the mouth and by inhalation. The spirit of Mindererus likewise 
fulfills the same purpose. Digitalis may be given hypodermatically ; or, if 
the patient is noisy, morphine and atropine in moderate doses. It is 
said that an ounce or two of cider-vinegar has a sobering effect; and 
after emptying the stomnch with the stomach-pump it is well to intro- 
duce a pint of warm coffee,—it should not be hot coffee, for fear of 417 
ALCOHOL. 
injuring the stomach during unconsciousness. Artificial respiration and 
electricity may be required to keep up the breathing and prevent the 
undue accumulation of carbonic acid in the blood. Cold affusions 
should be used with care, on account of the lowering of temperature by 
the alcohol; but heat and sinapisms are of great utility. Apoplexy, 
or cerebral haemorrhage, may be suspected when there is marked 
deviation of the eyes or unequal dilatation of the pupils, especially 
if there is co-existing paralysis of one side of the face, or of the arm 
or leg. In such a case the question of surgical interference would come 
up, to decide upon the presence of fracture of the skull, or meningeal 
haemorrhage. 
2. Chronic poisoning by alcohol may be shown by the changes 
taking place in the stomach, liver, and kidneys, increase of fibrous or 
areolar tissue, followed by contraction and destruction of the character- 
istic secreting cells, and fatty infiltration, or, in other words, the type of 
cirrhosis due to the long-continued action of alcohol upon the tissues. 
Gastric catarrh, indigestion due to deficient action of the liver, and albumi- 
nuria from contracted and crippled kidneys are commonly met with in 
old alcoholic subjects. Chronic catarrhal pneumonia and fibroid phthisis 
are also attributable to alcohol. The effects, however, are most marked 
upon the nervous system. Dr. Wilks has reported cases of paraplegia 
and numbness. Anaesthesia and violent shooting pains have followed 
the long-continued and excessive use of alcohol. One form of insanity 
is accompanied by pachymeningitis, which may be caused by alcohol. 
But when alcoholic poisoning is mentioned we generally understand it 
to mean delirium tremens or mania a potu. These are not identical; the 
latter is, to all intents and purposes, an attack of acute mania caused or 
incited by alcoholic excess. Delirium tremens, on the contrary, is a 
milder form of delirium, due partly to the action of the alcohol upon 
the brain, but also very largely to anaemia of the great centres. In the 
former the patient is violent, and requires several men to control him; 
but once controlled, and the proper medicines given (potassium bromide, 
liyoscyamine [gr. £-£], or chloroform inhalations), the patient, after a 
period of sleep, rapidly recovers. In delirium tremens the symptoms 
are mainly those of anaemia of the brain ; it is apt to occur after a bout 
of drinking lasting several days, during which very little food is eaten, 
or is rejected by vomiting from the excess of alcohol. Here the 
patient has a quiet delirium, and has hallucinations of sight and hearing, 
which in many cases interest him, but his visions may be horrifying 
and distressing. These patients are best treated with digitalis, and 
nitrite of amyl may be cautiously given by inhalation, or nitro-glycerin 
by the mouth. Nourishment must be given in a form readily assirni- 418 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
lated and at short intervals, hot broths well seasoned being the most 
acceptable to the stomach. If, as is usually the case, the patient has 
been a steady drinker for a long time, alcohol must not be entirely with- 
held from him, but given in combination with food. In such subjects 
the blood-vessels are generally the subject of atheromatous changes, and 
the heart requires some stimulation in order to carry on the circulation. 
If the patient cannot sleep, he may be helped by bromide of sodium and 
chloral (aa gr. x),by somnal (3ss-j),by hop-tea,or the ammoniated tincture 
of valerian. For the debility and tremor, mix vomica has proved very 
useful in comparatively large doses of the tincture (f*3ss or more). 
After death from chronic alcoholism the organism shows changes in 
every part, which Bartholow sums up in two words,—•“ fibrosis and 
steatosis.” 
By inhaling the vapor of alcohol complete anaesthesia may be pro- 
duced, and the different degrees of intoxication up to insensibility. In 
such eases the stomach need not be emptied, but artificial respiration in 
the open air, or the inhalation of will soon restore the patient to 
consciousness. This ma}7 be hastened b}r a stimulating enema. 
Absintliism, a form of alcoholic poisoning attended by epilepsjr, 
following indulgence in absiutlie, has been already discussed (see page 
356). 
Therapy.—Alcohol may be used as an evaporating lotion in cases 
of local inflammation, or of bruise or sprain. Dilute alcohol (f3iij) 
with lead-water and acetate of morphine (gr. x), applied upon a 
single layer of cloth or absorbent cotton and allowed to evaporate, forms 
an excellent' lotion to keep down inflammation, and in point of cleanli- 
ness is much better than the old lead-water and laudanum. Absolute 
alcohol is used as an astringent application to exuberant granulations 
(polypi) in the ear, and also applied as just directed to control acute 
inflammation of cellular tissue. Alcohol is a good application to prevent 
bed-sores, and for this purpose it is customary to add a little alum (3j 
to Oj). Hot applications of alcohol relieve pain, and in facial neuralgia, 
cold in the face, or toothache, the employment of a small flannel bag con- 
taining hops and dipped in hot whisky will generally afford marked 
relief. In some skin diseases, as ulcers, loss of hair, frost-bite, excessive 
secretion of sweat or oil, fetid sweating, freckles, and vegetable parasitic 
affections, concentrated alcoholic preparations may be used. Some useful 
formulae are here added :— 
]£ Spt. vini rectificat.., 
Sol. boro-glyceridi (50 per cent.), aa f^ij. 
M. Sig.: Apply freely in excessive or fetid sweating, and in vegetable parasitic 
diseases of the skin. 419 
ALCOHOL. 
When glycerin does not agree, we may prescribe:— 
Spt. vini rectificat., f^ij. 
Cocainse hydrochloratis, gr. v. 
Acidi borici, 3j. 
M. Sig.: Use with old muslin or cotton in frost-bite, oily secretion, freckles, and 
other pigmentary deposits. 
Spt. vini gallici, f^iv. 
Tinct. nucis vomicae, 
Tinct. capsici, aa f^ss. 
M. Sig.: Employ it on the scalp for loss of hair. 
Its antiseptic virtues and the astringency which it possesses in con- 
sequence of its power of coagulating albumin renders alcohol an excel- 
lent gargle in pharyngitis, stomatitis, scurvy, and salivation. It is also 
useful to apply an alcoholic lotion to the nipples of nursing women, in 
order to prevent the formation of fissures. Alcohol possesses consid- 
erable value as a haemostatic, and may be utilized in cases where capillary 
oozing occurs, the following prescription being very valuable :— 
Spt. vini rectificat., 
Lin. saponis, 
Ext. hamamelidis, fl.,. . . . . . . . aa f?J. 
M. Sig.: Employ as a styptic in local haemorrhage. 
To the action upon the digestive organs, and the stimulating effect 
upon the nervous system and the circulation of alcohol judiciously 
given, are to be ascribed its usefulness in the treatment of disease. It is 
not used in the sick to reduce temperature, although it accomplishes 
this in health ; nor is it given as a narcotic, although its sedative action 
may not be undesired. In almost all cases it is intended to act as a 
restorative, and, therefore, its administration must be kept well within 
physiological limits. In some cases, especially- in typhoid fever, unfortu- 
nate results have followed its use with too free a hand. In most cases 
of fever, from f'5ii-iv of whisky daily is amply sufficient, and more than 
this does harm. It is judicious, however, to make allowance for the 
patient’s habits. One accustomed to the daily use of alcoholic beverages 
will require proportionally larger doses than an abstainer when attacked 
by any severe disease. 
In phthisis, a tolerance seems to exist and patients can take rela- 
tively large quantities without showing any symptoms of intoxication. 
The late Professor Flint reported the case of a young lady who took a 
pint of whisky daily for nearly two years for pulmonary phthisis, and 
was finally cured. In the course of a disease, when the powers of life 
are succumbing, the first sound of the heart is weak, the pulse feeble, 
soft, and irregular, but generally rapid; when syncope or delirium 
threatens, alcohol should be given, endeavoring to combine it with food, 420 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
such as broth, milk, gruel, etc. The period at which these symptoms 
generally appear is, in typhus fever, about the end of the first week ; in 
typhoid, at the end of the second week; in small-pox, when the second- 
ary fever commences. The excellent practical rules formulated by Dr. 
Armstrong for the use of alcohol in fever may be confidently followed. 
Alcohol is beneficial when the dry tongue moistens under its use, the 
rapid pulse becomes more slow, the skin less parched, and the respira- 
tion more tranquil. If opposite results follow, the remedy should be 
suspended. To the above rules, Ringer adds that alcohol does good 
when it produces sleep and quells delirium. In measles, when the erup- 
tion turns dark or haemorrhagic, alcohol is best given in as large doses 
as will be borne, and at short intervals, as pointed out by Dr. Keating. 
In acute inflammations, as in pneumonia, when the heart begins to fail 
and symptoms of debility appear, alcohol can usually be given with 
marked benefit. In hypostatic congestion of the lungs, typhoid pneu- 
monia, or the pneumonia of the aged, alcoholic stimulation is particularly 
indicated. Diphtheria, phlegmonous erysipelas, tuberculosis of bones, 
joints, or glands are affections in which stimulation is demanded. 
The stronger alcoholic beverages, such as wine, whisky, or brand}', are 
valuable in old age, when digestion is weak and insomnia marked. Hot 
spirits and water, cautiously administered, is useful as a restorative in 
the condition of shock the result of injury. During convalescence 
from fevers, when the structures of the heart and stomach have been 
altered by the fever process and digestion is weak, it is often found 
that malt liquor in some form increases appetite and digestion, improves 
nutrition, and enables the patient to sleep better at night. In the same 
way, persons who follow sedentary occupations, and whose bodies are 
insufficiently nourished, often find much benefit from the use of alcohol 
in moderate quantities, given just before or taken with their meals. 
Forms of Alcohol.—In order to estimate the effects of different 
forms of alcoholic liquors, the following comparative strength should be 
remembered :— 
Brandy, whisky, rum, gin, cordials, . 30 to 50 per cent, of absolute alcohol. 
Spanish and Italian sweet wines, . 13 to 17 “ “ “ “ 
Hock and claret, 8 to 11 “ “ “ “ 
Ale or porter, . . . . . 4 to 6 “ “ “ “ 
Stout or beer, 4 to 5 “ “ “ “ 
Koumyss, 1 to 3 “ “ “ “ 
Champagne contains from 8 to 10 per cent., but the presence of the 
carbonic-acid gas makes it more “ headythat is to say, the cerebral 
stimulation is produced more quickly, and with a smaller quantity of 
alcohol than by the still wines, and the after-effects in the way of headache, ALLIUM. 
421 
or cerebral congestion, are less apt to occur. Moreover, the carbonic 
acid acts as a sedative to the stomach, thus making champagne especially 
serviceable where the stomach is irritable, and where prompt stimulation 
is required, as in sea-sickness, or in yellow fever. Where the expense is 
an insuperable objection, a good substitute may be made extemporane- 
ously by the addition of carbonic-acid water to wine or brandy. Owing 
to the unreliability of French wines and tli£ practical impossibility of 
obtaining pure imported brandy, it is our duty to use domestic wines 
when the}" have been demonstrated to be sound and pure. The wines 
of the California Vintage Company fulfill these indications perfectly, and 
their brandy has received the indorsement of Dr. Foster, the editor of 
the New York Medical Journal, and many other prominent physicians. 
When we cannot use these wines, or brandy, it is safer to prescribe 
whisk}" of some standard make. 
Special Applications.—As an antidote in snake-bite, alcohol enjoys 
an extensive reputation, which is not without good foundation. The 
liquor should be given according to effect, a wineglassful or so at a time, 
repeated at intervals. A ligature should be thrown around the limb or 
member bitten, if possible, and the part cutout or cauterized ; if a finger, 
it might be safer to amputate it. The ligature should be loosened gradu- 
ally, and immediately tightened upon the re-appearance of the symptoms. 
In this way the system will be able to throw off the poison ; whereas, if 
the whole quantity w-ere to be introduced at once, it would be over- 
whelmed. The alcohol here acts as a stimulant to keep up the circula- 
tion until the poison is eliminated. 
In septic poisoning, septicaemia, sapnemia, dissecting wounds, etc., 
alcohol is considered to have an antidotal effect, and, with quinine, con- 
stitutes the great reliance for overcoming the tendency to a fatal result, 
and keeping up the strength. Alcohol is in some measure antidotal to 
the poison of the bacillus tuberculosis, and it is to this action that its 
unquestionable value in prolonging life in phthisis is due. 
Alcohol should not be given in cases of liver disease, nor in nephritis. 
In gout, the sweet wines and malt liquors are inadmissible, but, if a 
stimulant is required, whisky may be used cautiously, on account of the 
tendency to kidney disease. During the course of a gonorrhoea or 
urethritis, it is customary to forbid the use of alcohol in any form. It 
should not be used in hypertrophy, with overaction of the heart. 
ALLIUM (U. S. P.).—Garlic. 
Preparation. 
Sympus Allii (U. S. P.).—The Syrup of Garlic contains garlic 15, acetic acid 40, and 
sugar 65 parts. Dose, Hfx-3j. 422 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Pharmacology.—Garlic is the dried bulb of the Allium sativum 
(Liliacese), a native of Asia and Egypt, but now naturalized in Europe 
and America, and resembles the onion and leek in its chemical char- 
acters, as its active principle is a volatile, oily substance,—allyl sul- 
phide. Garlic is more active than the others owing to possessing a larger 
proportion of the active principle. Only sound, fresh, pungent bulbs 
should be used. 
Physiological Action and Therapy.—Garlic is antiseptic, but its effects 
are chiefly those of a stimulating expectorant. While its antiseptic 
properties have been tried in phthisis without successful results, it is 
useful as an expectorant in chronic bronchitis, or in suffocative catarrh 
(capillary bronchitis of infants). Here it may also be made one of the 
ingredients of poultices to be applied to the chest, or the oil may be used 
externally, but the offensive odor of garlic will in most families be a bar 
to its use. A garlic poultice may also be successfully employed in in- 
fantile convulsions, and relieves the pain of gastro-enteritis. The syrup 
is a good addition to cough mixtures, but cannot be used in conjunc- 
tion with alkalies, such as carbonate of ammonium or the bromides, on 
account of containing free acetic acid. The syrup of garlic can be ad- 
ministered thus with service in the treatment of bronchitis, especially 
of children :— 
$ Syrup, allii, f^ij. 
Spts. aether, nitrosi, f^j. 
Glycerini, f^j. 
M. Sig.: From one to two teaspoonfuls in water every hour or two. 
Syrup, allii, f^iij. 
Syrup, picia liquidae, fgij. 
M. Sig.: A teaspoonful or two in water every two or three hours. 
Garlic, like the onion, has antiscorbutic effects, and is a stimulant 
carminative. Dose, gr. xxx; best given as a syrup. It is destructive to 
lumbrieoid or round worms. 
ALLIUM CEPA.—Onion. 
Preparation. 
Syrupus Allii Cepce.—The Syrup of Onion. Dose, f3i-iv. 
Pharmacology and Therapy.—The onion (Liliaceae) is cultivated 
everywhere, and the bulb is used as a food. Although not 
officinal, onions are largely used in domestic practice, as a cataplasm 
for “ earache,” or for acute bronchitis ; also added to sugar and water 
and given as a cough-syrup. Parkes (“ Practical Hygiene ”) states that 
“ on account of its volatile oils the onion tribe is largely used, and is a 
capital condiment, and lias an effect as an antiscorbutic.” It contains ALNUS. 
423 
some citrate of lime in addition to the allyl sulphide. Dr. Whitla points 
out that, owing to the large proportion of sulphur which it contains, the 
Spanish onion may be satisfactorily employed in those cases in which 
it is desirable to administer sulphur. The action of the volatile con- 
stituents enhances that of the sulphur. Boiled Spanish onion, eaten 
freely at bed-time, is an excellent laxative. The author mentioned 
values the onion particularly in chronic catarrh of the larger respiratory 
tubes. According to George Covert, sweet milk removes the odor of 
onion from the breath.* The author can commend the appended pre- 
scription for chronic bronchitis in children. The same is also of benelit 
sometimes in chronic eczema :— 
$ Syrup, allii cepae (from Spanish onion), f§iv. 
Syrup, phosphat. eo., §j. 
M. Sig.: One or two teaspoonfuls in water or milk three or four times a day. 
The raw, sliced onion can be used as a counter-irritant; its volatile 
constituents are especially irritating to the conjunctiva. 
ALNUS.—Alder-Bark. 
Dose, gr. x-xl, in decoction, infusion, or fluid extract. 
Pharmacology and Therapy.—The bark of the American alder or 
tag alder, Alnus serrulata (Betulacese), contains tannic acid, a resin, 
and an oil. It is used for its astringent effects chiefly in the form of 
fluid extract or infusion (5j to Oj), as a mouth-wash for spongy gums, 
a gargle for sore throat, an injection in leucorrhoea, and for applications 
to ulcers. Internally, it has been given in diarrhoea and hsematuria. It 
is reported to have alterative effects, and has been used successfully in 
scrofula, syphilis, and some cutaneous diseases. 
Ainuin, an alcoholic extract, composed principally of the resin, has 
been used internally in doses of gr. i-iij. 
ALOE (U. S. P.).—Aloes. 
Preparations. 
Aloe Puriflcata (U. S. P.).—A strained alcoholic extract. Dose, gr. i-xx. 
Extractum Alois Aquosum (U. S. P.).—Watery extract. Dose, gr. ss-v. 
Pilules Alois (U. S. P.).—Purified Aloes and Soap, each gr. ij. 
Pilules Alois et Asafcetidce (U. S. P.).—Purified Aloes, Asafetida, and Soap, each 
gr- i'A 
Pilules Aloes et Ferri (U. S. P.).—Purified Aloes, Sulphate Iron, and Pulv. Aromat., 
each gr. j. 
Pilulce Aloes et Mastiches (U. S. P.).—Purified Aloes, 4 parts ; Mastic and Rose-Leaves, 
each 1 part. Two grains of aloes in each pill. 
Pilules Alois et Myrrhes (U. S. P.).—Purified Aloes, 2 parts; Myrrh, 1 part; Pulv. 
Aromat., gr. in each pill. 
* Chicago Medical Times, January, 1890. 424 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Pilules Rliei Composites (U. S. P.).—Purified Aloes, gr. iss; Rhubarb, gr. ij ; Myrrh, 
gr. j. 
Tinctures Aloes (U. S. P.).*—10 per cent. Pose, f3ss-ij. 
Tinctura Aloes et Myrrhce (U. S. P.).—Of each, 10 per cent. Pose, 3ss-ij. 
* Vinum Aloes (U. S. P.).—Purified Aloes, 6 parts; Cardamom., 1 part; Ginger, 1 part; 
in Stronger White Wine, 100 parts. Pose, 3i-iv. 
Aloin.—Pose, gr. 
Pulvis Alois et Canelles. f—Aloes, 80 parts ; Canella Alba, 20 parts. Pose, gr. xx. 
Extractum Aloes Liquidurn (50 per cent.).—Pose, Ifiv-xl. 
Pecoctum Aloes Compositum (Baurne de vie) contains about 4 grains aloes to the 
ounce, with cardamom and liquorice-extract and myrrh. Pose, f^ss-ij. 
Aloes also enters into compound extract of colocynth (50 per cent.) and compound 
tincture of benzoin (2 per cent.). 
Pharmacology.—Aloes is the inspissated juice of the leaves of Aloe 
soeotrina (Liliaceae). Owing to the fact that aloes frequently contains 
foreign matters, the pharmacopoeia directs that for making preparations 
only purified aloes should he used, obtained by dissolving aloes in 
alcohol, passing the solution through a strainer, and allowing the alcohol 
to evaporate. This occurs in dark masses of a 3’ellowish-brown color, 
the fracture presenting a liver-like appearance (hepatic aloes). It has a 
very bitter taste, is soluble in alcohol, less soluble in water, unless boiling, 
and contains Aloin, or socaloin, a volatile oil and a resin. Barbadoes 
aloes (Aloe vulgaris) and Cape aloes (Aloe Capensis), each of which 
contains a variety of aloin, are not officinal in the last revision of the 
United States Pharmacopoeia. 
Physiological Aption.—The principal effect of aloes is that of a slowly- 
acting purgative, principally affecting the large intestine. It increases 
the peristaltic movements without producing excess of secretion ; so that 
the faeces are formed and only slightly softened. It is a true cholagogue, 
increasing the secretion of biliary salts, and renders the bile more watery 
when given in large doses. As it sometimes gripes, it is best to combine 
some carminative with it. It may cause irritation of the bladder, dimi- 
nution of urine, and albuminuria from renal congestion. It also has 
emmenagogue properties. Following large doses, the uterus and append- 
ages are more or less in a state of congestion and haemorrhoids are apt to 
be irritated. If there has been an overdose and these symptoms are 
aggravated, it would be sufficient to give large draughts of demulcents, 
and an anodyne in the form of an opium suppository. It is stated that 
such phenomena do not follow the administration of aloin, which requires 
only about one-third or one-half the dose in order to produce the physio- 
logical effects of aloes. 
* This preparation is nearly three times the strength of the tincture of aloes of the United 
States Pharmacopceia of 1870, and the strength of the menstruum has been more than doubled. 
It is about the salne strength as the English tincture (P. Br.), but only half the strength of the 
German and the French. 
t Commonly known by the name of hiera picra, or “hickory pickory” by the vulgar. ALOE. 
425 
Therapy.—Aloes, or aloin, is a slowly-acting purgative, and, there- 
fore, should generally be administered at bed-time ; in this way it operates 
during sleep, and griping is avoided. For the same purpose it is well 
to combine it with a carminative, as in the compound decoction, or the 
compound rhubarb-pill, which is a useful purgative for an ordinary 
attack of constipation. The following are likewise excellent formula? to 
use in the same class of cases :— 
It Vini aloes, 
Ext. cascarae sagradae 11., aa f3vj. 
Elix. aromatic., q. s. ad f^vj. 
M. Sig.: A tablespoonful morning and evening. 
It Pil. aloes et myrrhae, 3iij. 
Pulv. glycyrrhizae comp., §iv. 
M. Sig.: From one-half to three teaspoonfuls in water or milk, early in the morning 
or on retiring. 
The pill form is also useful for the expulsion of ascarides, which are 
apt to lodge in the caecum ; with this may be combined injections of 
aloes in solution (5j to Oj) and irrigation of the bowel. For the latter 
purpose, in young children, a soft catheter can be inserted be3~ond the 
sigmoid flexure of the colon. In anaemia affecting young gills (chlorosis), 
Sir Andrew Clarke has shown that constipation has much to do with its 
causation; he calls it faecal intoxication. Here aloes, in combination 
with iron, is of much service. 
I£ Aloes purificatee, 5j- 
Massae ferri carbonatis, gr. xl. 
Pulv. aromatici, gr. xx. 
M. et ft. pil. no. xx. 
Sig.: Take one or two at bed-hour. 
Sir Andrew Clarke’s pill is likewise valuable:— 
Aloin., 
Ferri sulph. exsie., 
Ext. bellad., 
Ext. nucis vom., 
Pulv. ipecac., 
Pulv. myrrh, 
Saponis, aa gr. ss. 
M. et ft. pil. no. j. 
Sig.: One pill one hour before last meal, should the bowels not act during the day. 
Ipecac is omitted if there is any cardiac weakness. 
In cases of hysteria, with anaemia and constipation, the pills of aloes, 
with asafetida, may be given (3 to 6 daily). These have also a carmi- 
native effect. An atonic condition of the muscular coat of the large 
intestine may allow its contents to accumulate, to press upon the com- 426 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
mon bile-duct and obstruct the passage of the biliary secretion into the 
upper bowel. This condition and the jaundice which is its result are 
relieved by the administration of aloes, with which belladonna and 
strychnine, or hyoseyamus and ipecacuanha, may be very usefully com- 
bined in such formulae as the following :— 
Aloes puriflcatae, 3ss. 
Extr. belladonn* ale., gr. j. 
Strychnin* sulphatis, gr. ss. 
M. et ft. pil. no. xij. 
Sig.: A pill three times a day. 
Aloini, gr. j. 
Ext. hyoscyami ale., gr. x. 
Ext. ignatiae, gr. j. 
Pulv. ipecacuanhae, gr. ij. 
M. et ft. pil. no. x. 
Sig.: A pill three times a day. 
Aloes is an excellent emmenagogue ; given for several days before 
the expected period, it is generally successful, especially when employed 
thus :— 
$ Aloini, gr. ij. 
Mass, ferri carb., gr. xxxvj. 
Apiol., hllx. 
M. et ft. capsulae no. xij. 
Sig.: A capsule morning and evening for five or six days before the menstrual period. 
In scanty menstruation, depending upon anaemia, the clialybeates 
should also be pushed, preferably using the preparations of iron which 
are not constipating, such as the dialyzed iron, or the carbonate or pyro- 
phosphate, rather than the sulphate which is contained in the officinal 
pill. When intestinal indigestion is caused by deficient secretion of 
bile, aloes is of special value, and enjoys a reputation as an ingredient in 
“ dinner-pills ” of many kinds. Where the mental symptoms of dys- 
pepsia, drowsiness, depression of spirits, or melancholia, are marked, the 
use of a good dinner-pill immediately after dinner is often effective. 
In cases where there are haemorrhoids, the aloes sometimes irritates 
them ; under such circumstances the proper course to pursue would not 
be to neglect such a valuable remedy, but to operate surgically upon the 
piles and remove them, The passive turgescence of the inferior liaemor- 
rhoidal vessels, however, is not infrequently relieved by the use of 
aloes. Wliitla speaks of having obtained surprising results in obstinate 
diarrhoea in children or adults from the administration of a few 1- to 
2-ounce doses of the compound decoction of aloes. Prescribe the fol- 
lowing :— ALTHEA, 
427 
Aloini, gr. ij. 
Sulphuris subl., gr. c. 
Ext. belladomue ale., . . . . . . . . . gr. ij. 
M. et ft. capsulae no. xx. 
Sig.: A capsule three times a day. 
In small doses aloes acts as a hepatic and intestinal tonic, and, where 
diarrhoea is maintained by the action of germs of fermentation, the in- 
creased flow of bile exerts an antiseptic effect and the diarrhoea may be 
checked after a preliminary purge; although the rule is that, where diar- 
rhoea is due to irritation from abnormal condition of the contents, the cause 
of disturbance should be removed by a more prompt cathartic, such as sul- 
phate of magnesia or the citrate, or by an antiseptic purgative like calo- 
mel or blue mass. Aloetic purgatives should be used with care during 
pregnancy and lactation. The milk of women taking aloes will purge 
babes whom the)1, suckle. Aloes may be used as a derivative in cerebral 
disorders. 
A ghrcerole of aloes is prepared by evaporating the tincture and 
adding glycerin. This mixture may be applied to fissures, abrasions, and 
ideers. The bitter taste of aloes is sometimes utilized by applying a solu- 
tion to the finger-ends of children in order to break them of the habit 
of biting their nails or sucking their thumbs, or to the nipple wlmn it is 
desired to wean an infant, which is unnecessary cruelty. The compound 
tincture of benzoin contains 2 per cent, of aloes. This fact should be 
borne in mind when treating cracked nipples with this preparation, as 
the infant may be weaned too early. 
ALTHEA (U. S. P.).—Marsh-Mallow. 
Preparations. 
Syrupus Althece (U. S. P.).—Syrup of Althea (4 per cent.). 
Confectio Althece.—Marsh-Mallow Drops. 
Pharmacology.—The root of Althea officinalis (Malvacese) contains 
a mucilaginous principle, with about 2 per cent, of asparagin, but no 
tannin. Althea is a constituent in massa hydrargyri (blue mass) and 
phosphorus pills. 
Therapy.—The powdered root may be .used as a poultice. It is 
slightly diuretic, on account of the asparagin, which would make it of 
service in children’s diseases in the form of a fresh infusion, especially 
in Bright’s disease. The confections are useful in sore throat, in scarla- 
tina and diphtheria. The syrup is an agreeable addition to cough 
mixtures. Dose, indefinite. Althea combined with benzoinated lard is 
a bland dressing for skin diseases. Asparagin has been recommended 
as a diuretic in gout and cardiac dropsy, in doses of gr. i-ij. 428 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
ALUMEN (U. S. P.)—Alum. 
Preparations. 
Alumen Exsiccatum (U. S. P.).—Dried Alum. Dose, gr. i-v. 
Aluminii Hydras (U. S. P.).—Hydrate of Aluminium. Dose, gr. iii-xx. 
Aluminium Sulphas (U. S. P.)—Sulphate of Aluminium. For external U6e. 
Alumen Ammonio-ferricum.—Iron Alum. Dose, gr. ii-x. 
Alumen Olyceritum.—Glycerite of Alum (20-per-cent, alum.) 
Aluminium Oleate.—Oleate of Aluminium. (See the Oleates.) 
Pharmacology.—The officinal alum is potasli alum (aluminium and 
potassium sulphate). It is in the form of translucent, white, octahedral 
crystals, with a sweetish, astringent taste and acid reaction. It contains 
water of crystallization, which can he driven off by heat, forming dried 
alum. Ammonia alum, which was formerly the officinal alum, has very 
much the same properties, and is often dispensed for alum. The metal 
aluminium is not officinal. In appearance it is like silver, but is much 
lighter and more durable; is useful for making instruments, in place of 
silver. 
Physiological Action.—Dried alum is astringent, and is a mild 
escharotic for fungous granulations. The glycerite of alum is useful 
in cases of tonsillitis or pharyngitis of subacute character. In solution, 
alum condenses tissues by coagulating their albumin, and acts as an 
astringent. 
Therapy.—It checks excessive sweating in phthisis when applied 
with a sponge (5j to Oj of whisky and water). It is used as an injec- 
tion in leucorrhoea and in gonorrhoea, and a watery solution of the 
glycerite is useful as a collyrium in conjunctivitis. In the latter affection 
alum-curd is sometimes applied drachm beaten up with the albumin 
of a fresh egg). Applied localty in the form of powder or saturated 
solution, alum is an excellent styptic. A most useful alum styptic com- 
bination is the following:— 
Aluminis glyceriti, 
Spt. vini rectificati, 
Lin. saponis, aa f^ij.—M. 
Compresses soaked in the prescription just referred to, or a solution 
of alum, may be used to restrain capillary haemorrhage from wounds, 
bleeding from the gums, or leech-bites. In epistaxis a plug of cotton 
moistened in alum-water may be passed into the nares ; a solution may 
be thrown in by injection or powdered alum may be snuffed. These 
measures will frequently prove "successful. In chronic pharyngitis, ton- 
sillitis, and nasal catarrh the local action of powdered alum is beneficial. 
A prescription composed thus is often effectual:— ALUMEN, 
429 
Acidi carbolici, npij. 
Aluminis glyceriti, f^iij. 
Aristol, 3ss. 
M. Sig.: Apply with cotton or a camel’s hair brush once or twice a day over the surface. 
It may also be used in solution as a gargle with good effect. An 
injection of alum is a serviceable astringent in haemorrhage from the 
rectum, or in gonorrhoea. For gleet, the following formula is recom- 
mended :— 
$ Pulv. aluminis, 3ij. 
Ext. geranii maculati, f^ss. 
Aquae rosae, f^ivss.—M. 
A lotion containing alum may be successfully employed in the pro- 
lapsed bowel of children. A drachm or two of alum to the pint of water, 
or alcohol, is a beneficial application in hyperidrosis. It is said that 10 
grains of alum, placed dry upon the tongue, will sometimes arrest a 
paroxysm of asthma (Ringer). According to Ringer, man}r cases of 
chronic ozaena are rapidly relieved by irrigating the nasal chambers with 
a solution containing a drachm of alum to the pint of water. The dis- 
charge is checked and the foetor removed. Pruritus of the vulva some- 
times yields to an alum solution. The local astringent action of this 
substance is sometimes found beneficial in purpura. An ointment con- 
taining alum is often useful in herpes, and the same preparation removes 
the offensive odor of bromidrosis. The following formulae are of service 
in the diseases just named :— 
$ Pulv. aluminis, 3j. 
Salol, 3ss. 
Bismuth, subnit., 3j. 
Ungt. zinci oxidi, §j.—M. 
Pulv. aluminis, §ss. 
Glycerini, fgj. 
Aquae hamamelidis, f^v.—M. 
As an emetic in croup, a heaping teaspoonful of alum may be dis- 
solved in 4 ounces of simple syrup, of which a teaspoonful given every 
fifteen minutes until vomiting is produced. It is useful in bronchorrhoea, 
and in whooping-cough, especially where the secretion is excessive. 
Given internally, alum checks haemorrhage and profuse discharges. 
Wliitla esteems it the best remedy in haemorrhage of the bowel due to 
typhoid fever. It may be given with good result in the hematemesis 
dependent upon cirrhosis of the liver and in haemoptysis. The local 
action of alum may be aided by its internal administration in the night- 
sweats of phthisis. It checks excessive production of mucus in chronic 
gastric and intestinal catarrh, and Bartholow asserts that it relieves the 
pain of gastralgia and enteralgia. It is an efficient remedy in diarrhoea. 430 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Whitla considers the internal exhibition of alum of service in leucorrhoea. 
The following formulae are advised :— 
Pulveris aluminis, 3iij. 
Acidi sulph. arom., f3.j. 
Ext. geranii maculati fl., f^ij. 
Syrup, zingiberis, f^nj- 
M. Sig.: One to two teaspoonfuls in water every half hour or hour until haemor- 
rhage is arrested. For haemoptysis, haematuria, menorrhagia, and uterine haemorrhage. 
Pulveris aluminis, 
Salol, aa gr. c. 
M. et ft. capsulae no. xx. 
Sig.: A capsule three or four times a day. Employ especially in catarrh of the 
bladder and prostatitis. 
Pulveris aluminis, gr. cc. 
Tinct. kino, §iss. 
Tinct. opii camph., f§j. 
Acidi sulph. arom., f3j. 
Spt. vini gallici, q. s. ad f §v. 
M. One to two teaspoonfuls in water every three or four hours. Serviceable in 
chronic diarrhoea, dysentery, and in haematuria. 
In comparatively large doses (gr. xl-3j), alum acts as a purgative, and 
has been used in colica pictonum. Iron alum has been employed in inter- 
mittent haematuria. For boils in the ear, a solution of aluminium acetate 
(25 per cent.) may be dropped into the ear frequently, and the canal 
plugged with cotton. Alum is sometimes used as an adulterant of baking- 
powders, and, when constantly used, produces indigestion. 
The aluminium salts are antiseptic and can be used as injections for 
leucorrhoea (gr. x-3j), and saturated solutions are mild caustics. The 
oleate of aluminium arrests morbid discharges. 
ALVELOZ is the milky juice of Euphorbia heterodoxa, belonging to 
the Euphorbiacem, a native of Brazil. 
The irritating effects of the juice of plants of this genus is very 
marked in alveloz, which is said to act as a caustic upon the skin very 
much like chloride of zinc. It has been used in treating cancerous and 
syphilitic lesions with asserted success, and the application is compara- 
tively painless. 
AMBRAGRISEA.—Ambergris is an odorous, fatty substance, found 
in large masses floating upon the water, and is believed to be produced 
in the intestines of the spermaceti whale. It has a consistence like wax, 
softening at the temperature of the hand, and melting below the boiling- 
point of water; it is almost entirely volatilized by heat, and is inflamma- 
ble. In composition it is like cholesterin, and is not saponifiable. It is AMMONIACUM. 
431 
believed to have some antispasmodic effects, and is officinal in the French 
Codex as a 10-per-cent, tincture. The dose of ambergris is gr. v-5j. 
It is used very largely in perfumery on account of its agreeable odor. 
AMMONIACUM (U. S. P.).—Gum Ammoniac. 
Preparations. 
Mistura Ammoniaci (U. S. P.).—Ammoniac Mixture, 4 per cent. Pose, 3i-iv. 
Emplastrum Ammoniaci (U. S. P.).—Ammoniac Plaster, made with the aid of acetic 
acid. 
Emplastrum Ammoniaci mm Hydrargyro (U. S. P.).— Ammoniac and Mercury Plaster 
(ammoniac, 72; mercury, 18; with lead plaster, sublimed sulphur, olive-oil, aud acetic 
acid). 
PiluloR Ammoniaci.—Ammoniac Pills (ammoniac, gr. ij ; ginger, gr. ij; squill, gr. ss; 
with soap, q. s.). 
Pharmacology.—Ammoniac is a gum-resin obtained from Dorema 
ammoniaeum (Umbelliferae, Orthospermae), containing a volatile oil. It 
forms a milky emulsion when rubbed up with water. 
Therapy.—It is a stimulating expectorant and laxative, and resem- 
bles asafoetida in its effects upon the system. It has been used, with 
alkalies, to relieve chronic bronchitis and asthma. It is especially bene- 
ficial in chronic bronchitis associated with emphysema, or occurring in 
aged persons. The plasters are useful in glandular and joint swellings. 
By fusing ammoniac and other resins with caustic potassa resorcin is 
obtained, wdiich is a valuable antiseptic. An alcoholic extract of ammo- 
niac is fused with three times its weight of potassa, and dissolving the 
resulting homogeneous mass in water, slightly acidulating with sulphuric 
acid, following and agitating with ether. On evaporating the ether, 
impure resorcin is left, which is purified by recrystallization. (See 
Resorcin.) 
AMMONIUM.—Metallic ammonium has not yet been isolated. It is 
known only in its combinations, which are numerous and important. 
According to Ampfere, its constitution is NH4, therefore not a simple 
but a compound radical, and as such it forms salts which are analogous 
to potassium salts. 
Preparations (liquid). 
■ Aqua Ammonite (U. S. P.).—Contains 10 per cent, gaseous ammonia. Pose, Hfii-x. 
Aqua Ammonite Fortior (U. S. P.).—Twenty-eight per cent, ammonia. External use. 
Linimentum Ammonite (U. S. P.).—Contains water of ammonia 30, cottonseed-oil 70 
parts. 
Spiritus Ammonite (U. S. P.).—Spirit of Ammonia, or Hartshorn (10 per cent.). 
Pose, Hlv-xv. 
Spiritus Ammonite Aromaticus (U. S. P.).—Aromatic Spirit of Ammonia (21 per cent, 
ammonium carbonate). Pose, l'3ss—ij. 
Liquor Ammonii Anisatus.—Ammoniated Spirit of Anisi. Same use as preceding. 432 
PHARMACEUTICAL THERAPEUTIC AGENTS,' OR DRUGS. 
Liquor Ammonii Acetatis (U. S. P.).—Solution of Acetate of Ammonium, Spirits 
of Mindererus. Dose, f 5i-iv. 
Tinctura Ouaiaci Ammoniata (U. S. P.). Dose, Nlxxx-lx. 
Tinctura Valeriance Ammoniata (U. S. P.). Dose, f3ss-j. 
Preparations (solid). 
Ammonii Benzoas (U. S. P.).—Benzoate of Ammonium. Dose, gr. ii-x. 
Ammonii Bromidum (U. S. P.).—Bromide of Ammonium. Dose, gr. x-xv. 
Ammonii Carbonas (U. S. P.).—Carbonate of Ammonium. Dose, gr. ii-v or xx. 
Ammonii Cliloridum (U. S. P.).—Chloride of Ammonium. Dose, gr. v-xx. 
Ammonii Iodidum (U. S. P.).—Iodide of Ammonium. Dose, gr. v-x. 
Ammonii Nitras (U. S. P.).—Nitrate of Ammonium. 
Ammonii Sulphas (U. S. P.).—Sulphate of Ammonium. 
Ammonii Phosphas (U. S. P.).—Phosphate of Ammonium. Dose, gr. iiss-xx. 
Ammonii Yalerianas (U. S. P.).—Valerianate of Ammonium. Dose, gr. ii-v. 
Trochisci Ammonii ChloHdi (U. S. P.).—Troches of Ammonium Chloride (gr. ij). 
Glycyrrhizinum Ammoniatum (U. S. P.).—Ammoniated Glycyrrliizin. Dose, gr. ss-v. 
Hydrargyrum Ammoniatum (U. S. P.).—Used only externally. 
Ammonium Boras.—Borate of Ammonium. Dose, gr. iv. 
Pharmacology and Physiological Action.—Ammonia is a gaseous 
bodjr, highly irritating to the air-passages, even suffocating, and may 
cause inflammation with oedema of the glottis. It stimulates the trifacial 
nerve, increases the blood-tension by reflex action upon the vasomotor 
centre, and prevents syncope. If applied to the skin it is rubefacient, 
and, if diffusion be prevented, it will soften and vesicate the skin. The 
strong solution also produces vesication and softens the cuticle. The 
chloride of ammonium, on the other hand, is cooling and absorbent. 
The chloride, after absorption, hastens epithelial proliferation of the 
bronchial mucous membrane and liquefies thickened mucous secretions. 
The carbonate is probably decomposed in the digestive tract, and its 
effects are identical with those of the gas or of aqua ammonia, in stimu- 
lating the heart and circulation. 
Ammonia acts upon the ganglionic nervous system especially, and 
has little effect upon the higher centres, thus differing from alcohol. It 
increases the functional activity of the spinal cord and is a promptly 
acting cardiac stimulant. Blood-pressure is moderately increased, but 
in large doses ammonia interferes with the oxygen-carrying power of 
the red blood-corpuscles, and if long continued produces emaciation. 
Again, the protracted use of ammonia, by neutralizing the gastric juice, 
enfeebles digestion, and in this manner also leads to emaciation. It 
may originate a gastro-intestinal catarrh. Injected into the blood- 
vessels, the blood-corpnseles become dissolved and the blood remains 
fluid. Ammonia likewise assists in maintaining the solution of the fibrin 
of the blood. Such injections are likely to be followed by vomiting, 
and the carbonate may be given for the same purpose by the mouth, in AMMONIUM. 
433 
doses of 20 to 30 grains. Ammonia increases the secretions, not only 
of the bronchial mucous membranes, but also the intestinal, and may 
set up diarrhoea. The solution of acetate of ammonium acts upon the 
skin, especially in fever. Ammonia has no special action upon the 
kidneys, except that the urea is increased b}r oxidation of ammonia 
(Bence Jones); it is eliminated especially by the kidneys, broncho- 
pulmonary tract, .and skin. Ammonia possesses marked antiseptic 
virtues. 
Poisoning.—As the water of ammonia, or spirit of “hartshorn,” is 
found in every household, cases of poisoning by accidental swallowing 
not rarely occur. When the stronger solutions are swallowed there is 
great distress, burning pain along the oesophagus and in the stomach, 
with choking sensations from inhaling the gas or the admission of a few 
drops into the larynx. After death there are evidences of softening and 
acute inflammation of the stomach. 
Treatment.—Vomiting is likely to occur immediately, but, if not, the 
administration of large quantities of bland liquid, such as oil or milk, 
would be serviceable, and if the solution of the gas has been taken it 
may be neutralized with vinegar or lemon-juice. Treatment should be 
promptly instituted in order to avoid such a degree of inflammation as 
would produce stricture of the oesophagus. If the patient is in a state 
of shock, hot infusion of coffee may be administered, and tincture of 
digitalis given hypodermatically. 
Therapy.—The local uses of ammonia have been already intimated. 
In sprains, bruises, and old rheumatic swellings, the liniment is of ser- 
vice, especially if some oil of turpentine or chloroform be added. 
The water of ammonia may very serviceably enter into the compo- 
sition of a stimulating application in alopecia. In the headache which 
attends disordered menstruation or the menopause, Dr. Tilt has seen 
Raspail’s sedative lotion afford much relief. This preparation contains 2 
ounces of liquor ammonise, 2 ounces of common salt, drachms of 
spirits of camphor, and 2 pints of water. The liquid may be applied upon 
a sponge or linen cloth. Weak solutions of ammonia will sometimes 
relieve the itching of urticaria. For this purpose 2 drachms of the offici- 
nal solution of ammonia ma3' be added to a pint of water, or the carbo- 
nate of ammonia may be employed in the strength of 1 drachm to 4 
ounces of water. The following combinations of ammonia are also of 
service for external use :— 
Aquae ammoniae, 
Ext. arnicae fl., 
Lin. saponis, 
Olei terebinthinae, aa ffij. 
M. Sig.: Rub in well several times a day. For rheumatism, bruises, and sprains. 434 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Lin. ammoniae, f^ij. 
Spt. chloroformi, f§j. 
Lin. menthol,* f§ij. 
Tinct. opii, f§j. 
M. Sig.: Apply well over the surface when necessary for lumbago, neuralgia, and 
sciatica. 
Spt. ammon. aromat., 
Tinct. capsici, S& f§ss. 
Spt. lavandulae, f|j. 
Tinct. nucis vomicae, f§ss. 
Lin. camphorae, f^iiss. 
M. Sig.: Apply with friction to the scalp for loss of hair and foi aandruff. 
Spirit of ammonia is a good application to wounds caused by stings 
of insects or snake-bites. In the latter case, the water of ammonia can 
also be injected into a vein in order to counteract the depressing effects 
of the venom. In poisoning by sewer-gas, intra-venous injection of 
ammonia lias saved life. The solution of chloride of ammonium 
(5ii-iv-Oj) removes ecchymosis from contusions. This solution is 
applicable likewise to epididymitis after the acute stage lias subsided. 
It is, in fact, an excellent dressing in the latter stages of superficial 
inflammation, and promotes the absorption of exudation. In neuralgia, 
thimble-blistering majr be practiced over the painful spots of Yalleix, by 
dropping some stronger aqua ammoniae upon absorbent cotton and 
confining it with a watch-glass or thimble in contact with the skin. 
Ammonia is invaluable as a cardiac and nervous stimulant in pneu- 
monia and all typhoid conditions, in poisoning by prussic acid, in 
syncope, and in heat exhaustion. The carbonate is the most eligible 
form, given in doses of gr. v-x. In capillary bronchitis in infants, the 
following answers a good purpose :— 
Ammonii carbonatis, . gr. xii-xxiv. 
Syrup, tolutani, f3iv. 
Liq. ammonii acetatis, f^iiss. 
M. Sig.: Give a teaspoonful every hour or every two hours. 
According to Dr. Beverley Robinson, the carbonate of ammonium, in 
rather large and frequently-repeated doses, is very efficient in aborting 
a cold. The following formula is often most efficient as an expectorant, 
especially in the late stage of bronchitis :— 
Ammonii carb., 3j. 
Syr. senegae, 3iv. 
Vini ipecac, 3iij. 
Syr. tolutani, 
Spt. chloroformi, 3iij. 
Aq. camphorae, ad §iv. 
M. Sig. : One to two teaspoonfuls every hour or two until relieved. 
* Linimentum menthol as suggested by Martindale (see The Extra Pharmacopoeia, London) 
is composed of menthol, 3 parts ; chloroform, 4 parts ; and olive-oil q. s. to make 16 parts. AMMONIUM. 
435 
The value of carbonate of ammonium in scarlet fever has been 
extolled by Peart, Wilkinson, and Witt. It was employed in 3- to 5- 
grain doses, hourly, or at longer intervals, according to the severity of 
the case. It reduces fever and cerebral excitement and promotes sleep. 
The solution of the acetate of ammonium is also highly recommended in 
scarlatina. The plan is to administer the remedy in large doses, which 
has been found to be well borne, even by children. The carbonate has 
likewise been emplo}-ed in measles, in which disease Ringer states that 
he has used it largeljr with considerable benefit. The same salt is valued 
by some practitioners in the treatment of small-pox and erysipelas. 
Delirium tremens, being usually associated with cerebral anaemia 
and weakened cardiac action, may be benefited by the use of carbonate 
of ammonium. Its value in this affection is conspicuous, according to 
the prominence of the symptoms just mentioned. 
The carbonate and the acetate of ammonium have been used in 
diabetes mellitus. Eichhorst states that in two of his cases the use of 
the carbonate was followed by rapid disappearance of the sugar from the 
urine; yet the progress of the pulmonary lesions was not interrupted, 
and speedily proved fatal. 
Special Applications.—The aromatic spirit of ammonia may be given 
in typhoid fever,in doses of 5ss-j, in order to sustain the circulation (Da 
Costa), or in cough mixtures in place of the carbonate. The aromatic 
spirit of ammonia is a good antacid in hyperacidity of the stomach. It 
is likewise of service in the sour stomach and tjunpanites which not in- 
frequently occur in hysterical women. Nervous headache is often relieved 
by the same preparation. It may be administered thus as a hepatic 
stimulant:— 
$ Ammonii chlor., 3iij. 
Sodii chlorid., . 3j. 
Succi tarax., . . f§ij. 
Decocti aloes co., ad f^viij. 
M. Sig.: A dessert- to a table- spoonful in water three or four times a day. 
The chloride has a special action upon the liver, increasing the flow 
of bile (Ringer). It is, therefore, useful in torpor of the liver, sick-head- 
ache, biliousness, and also in jaundice due to obstruction of the gall-ducts. 
It has some reputation as an emmenagogue. The chloride of ammonium 
is esteemed of value in catarrh of the stomach and bowels, and Rartholow 
considers it useful in the first stage of cirrhosis. 
In mjuilgia and neuralgia this salt is capable of affording relief, and 
should be given in rapidly-increasing doses until the effect is obtained or 
the system becomes intolerant of the remedy. It has also been used in 
intermittent haematuria. It is best given in capsules, on account of its 436 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
nauseating, sea-water taste. In bronchitis in its first stage, with deficient 
secretion, it may be combined as follows :— 
Ammonii chloridi, 3ij. 
Potassii iodidi, gr. xvj. 
Tinct. ipecacuanha, Hlxxxij. 
Mist, glycyrrhizae comp., q. s. ad f §iv. 
M. Sig.: Dose, a tablespoonful every four hours. 
This formula is of special service in acute catarrhal pneumonia. 
The chloride is particularly valuable in chronic bronchitis accompanied 
by profuse secretion. In catarrhal conditions of the respiratory tract 
Krakauer recommends the use of chloride of ammonium in the form of 
a spray. The carbonate of ammonia may also be used as an emetic in 
such cases. In the later stages of pneumonia expectoration is promoted 
b}' the same remedy. Liquor ammonii acetatis is one of our most reliable 
diaphoretics, and enters into the composition of many fever mixtures :— 
Ext. aconitl fld., gtt. iij. 
Spt. chloroformi, f3iv. 
Liq. ammonii acetatis, f^iiss. 
M. Sig.: Give a dessertspoonful every two or three hours in fever. 
The bromide has a special influence over whooping-cough, and may 
be substituted for the potash salt in epileps}" and nervous affections. A 
double salt, the bromide of ammonium and rubidium, has recently been 
introduced as a remedy for The substance is readily soluble 
in water. Its dose is that of the other bromides. Active doses are from 
30 grains upward, and as much as 2 drachms daily, or even more, may 
be given, dissolved in syrup of lemon and water. Laufenauer has used 
it in all the epileptic states with the exception of hystero-epilepsy.* In 
acute rheumatism with nervous s3'mptoms, Da Costa reported good results 
from the use of ammonium bromide (gr. xx-xl) several times daily. 
A veiy beneficial prescription for insomnia and in gouty subjects is : 
Sodii bromidi, 3vss. 
Tinct. lupulini, f^ij. 
Spt. chloroformi, f3ij. 
Aquae camphorae, fgij. 
M. Sig.: Two teaspoonfuls in water every hour or two w hen necessary. 
The valerianate enjoys some reputation for its influence over hys- 
terical manifestations, and may be given in capsules (5 to 20 grains) or 
as an elixir-}' (not officinal) :— 
* Medical Bulletin, July, 1890. 
fin the National Formulary the Elixirof Valerianate of Ammonia contains vanilla and 
a little chloroform to cover the odor and taste of the salt, of which there are present 2 grains to 
each drachm, as in the formula above. AMYGDALA. 
437 
Ammonii valerianatis, gr. c. 
Elixir aurantii rubri, f^viij. 
Aquae ammonii, q. s! ad react, neut. 
M. Sig.: Dose, a tablespoonful. 
Of the remaining salts, little need be said. The phosphate is diu- 
retic and has been used in gout, which may be connected with deficient 
excretion of urea. The benzoate, where the urine is alkaline, as in cystitis, 
has advocates, as it is excreted as hippuric acid, and thus prevents plios- 
phatic deposits. The nitrate is only used to prepare nitrous-oxide gas, 
which it yields by exposure to heat. The sulphate is used in making 
other salts. The iodide may be employed in syphilitic affections, where 
the other iodides are too depressing. 
Hypodermatically, aqua ammoniae may be administered in shock, in 
chloroform narcosis, in poisoning by hydrocyanic acid or hydrogen sul- 
phide, and also in heart-clot, thrombosis, and snake-poisoning. Where 
a prompt effect is needed, the remedy should be injected directly into a 
vein (rr^x-xx.). 
AMYGDALA.—Almond. 
The United States Pharmacopoeia recognizes two varieties of almond 
(Rosaceae, Amygdaleae),—(1) the seed of Amygdalus communis; variety, 
Amara; and (2) the seed of Amygdalus communis; variety, Dulcis. 
Each has its own officinal preparations. 
Preparations. 
Oleum, Amygdala Amara (U. S. P.).—Oil of Bitter Almond. Dose, ft]l^-j. 
Aqua Amygdala Amara (U. S. P.).—Bitter-Almond Water. Dose, f §ss. 
Syrupus Amygdala (U. S. P.).—Syrup of Almond, “ Orgeat” Syrup. Dose, f3ii-f§S6. 
Mistura Amygdala (U. S. P.).—Almond Mixture. Dose, f 3ii-f^ss. 
Oleum Amygdala Expressum (U. S. P.).—Expressed Oil of Almond. Dose, f3ii—f 
TJnguentum Aqua Rosa (U. S. P.).—Ointment of Rose-Water, “Cold Cream” (ex- 
pressed oil of almond 50, spermaceti 10, white wax 10, rose-water 30 parts). 
Pharmacology.—Both varieties of almond contain fixed oil and 
emulsin, but only the bitter variety has also amygdalin. Hydrocyanic 
acid is formed when amygdalin and emulsin react upon each other, and 
it is to the presence of the acid thus formed that the sedative and anti- 
spasmodic effects of oil of bitter almond are due. Its toxic effects are 
also identical, and call for the same treatment as hydrocyanic acid. 
Therapy.—In prescribing, the volatile oil of bitter almond must 
not be confounded with the fixed oil obtained from either variety by 
expression, the latter being a bland application, especially' in the form 
of ung aquae rosae, to irritable skin or chapped hands or lips. In doses 
of 5j or ij it is laxative, and may be used as a substitute for olive-oil. 
The oil of bitter almond has been employed in emulsion as a local appli- 438 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
cation in pruritus, and internally for the same purposes as hydrocyanic- 
acid solution. The mixture is a soothing application to inflamed skin, 
and it may be combined according to these formulae:— 
Mist, amygdalae, f §j* 
Bismuth, subnit., 3j. 
Aristol, 3j. 
M. Sig.: For local application to freckles and skin pigmentations. 
Mist, amygdalae, • 
Hydrarg. chlor. corros., Sv- 
Ammon, chloridi, • » gr. iv. 
M. Sig.: Valuable in skin pigmentations. 
Hydrarg. chlor. corros., gr. i-ij. 
Mist.'amygdalae, f§iv. 
M. Sig.: For external use in acne rosacea. 
Bitter-almond water is a good vehicle in which to administer 
narcotic drugs. The syrup of almond may be appropriately added to 
cough mixtures. Almond mixture is an agreeable demulcent, and may 
very well be employed as a vehicle of more active remedies. 
AMYL NITRIS (U. S. P.).— Nitrite of Amyl. 
Dose, hlir-ji internally ; by inhalation, gtt. iii-v. 
Pharmacology.—A clear, pale-yellowish liquid, of an ethereal, fruity 
odor, an aromatic taste, and a neutral or slightly-acid reaction. Insoluble 
in water, but soluble in alcohol, ether, and chloroform, in all proportions. 
It volatilizes at ordinary temperatures, and should be kept in a glass- 
stoppered bottle, or in small glass pearls, each containing 3 or 5 minims. 
It results from the reaction of nitric acid upon amylic alcohol, and may 
be contaminated with nitric or hydrocyanic acid. 
Physiological Action.—No local effects are ascribed to this remedy, 
but when taken internally, by the digestive tract, or by inhalation of its 
odor, very remarkable phenomena are produced. There is at once ob- 
served a flushing of the face, with fullness and throbbing of the temporal 
vessels; the patient complaining of headache, fullness, and oppression, 
with giddiness and confusion of ideas. The reflex excitability of the 
cord is diminished. The brain is indirectly influenced, and its functions 
exalted by the temporary flushing with blood. The action of the heart 
becomes excessively rapid, with weakening of the pulse and marked 
lowering of arterial tension, owing to the general enlargement of the 
vessels, due to action of the drug upon the muscular eo:its of the arteries, 
and not to the nervous system or vasomotor centres. Oxidation is 
diminished, and the arterial and venous blood both become of the same 
dark color. Respiration and temperature are both reduced. Sugar appears AMYL NITRIS. 
439 
in the urine after inhalation, probably as the result of flushing the liver 
with blood. It increases the flow of urine, possibly, in the same way, or 
because the liver-sugar may act as a diuretic. In poisoning from amyl 
nitrite the blood assumes a characteristic chocolate color, due to the 
formation of methsemoglobin. 
Therapy.—The application of the knowledge of physiological action 
to therapeutics has probably never been more direct and logical than the 
recommendation of Brunton to treat the paroxysms of angina pectoris 
with amyl nitrite, in which clinical experience has shown the truthful- 
ness of the hypothesis. Whether the relief be due to lowering of arte- 
rial tension, as Brunton asserts, or to the alleviation of the neuralgic 
condition, as claimed by Johnson, is not very material, since by inhala- 
tion of a few drops of this remedy the patient has complete control over 
the attacks. In asthma, where the spasmodic element is strong, amyl 
nitrite promptly affords amelioration. Amyl nitrite can often be re- 
sorted to with benefit for sea-sickness, especially in this formula, given 
by Martindale :— 
Amyl nitritis, TTlxvj. 
Spirit, reetificat., f3ij. 
Misce et adde 
Pulv. tragacanthae, gr. vj. 
Aquae destillatae, q. s. ad f§iv. 
The powdered gum tragacanth should be in a dry four-ounce bottle, into which the 
amyl solution is poured, and the water added gradually afterward. Shake well. Dose, one 
or two drachms. 
In epileps}', tetanus, neuralgia, chloroform narcosis, and in strych- 
nine poisoning, amyl has been tried with gratifying results ; in whooping- 
cough it has failed. Benefit results from its inhalation in neuralgic dys- 
menorrhoea. In anaemic epileptics, the inhalation before a fit sometimes 
prevents it. The remedy should not be given to plethoric epileptics, nor 
to elderly people with brittle arteries. 
Nitro-glycerin, glonoin has the same physiological 
effects as amyl nitrite, but is usually administered in solution (alcoholic, 
1-100). The dose of the freshly-made centesimal solution is to 2 or 3 
drops, which is preferable to the tablets of the British Pharmacopoeia, 
each containing gr. The action is slower but more permanent than 
amyl. Murrell praises this highly, not only for typical angina, 
but for breathlessness and attacks of pseudo-angina. Da Costa has 
given it in the form of Bright’s disease attended by high arterial tension 
(cirrhotic kidney), in the following combination* :— 
* These can be obtained from H. K. Mulford & Co., Philadelphia, in the form of soluble 
compressed triturates. 440 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Nitroglycerini, gr. 
Tr. digitalis, ITlij. 
Tr. strophanthi, IHij 
Tr. belladonnae, Hiss. 
M. et ft. tabella. 
Sig. : Take one every six hours until effect upon the pulse is obtained. 
In the treatment of angina pectoris and severe asthma, Hoffman* 
recommends subcutaneous injections of nitro-glycerin in dose of to 
grain. He claims remarkable results from these injections, without 
any objectionable after-effects. 
On account of the explosive properties of nitro-glycerin, it would be 
safer not to accumulate too large a number of the tablets, nor to shake 
them violently. This objection, says Murrell,f does not apply to the 
form in which nitro-glycerin is ordinarily dispensed. The 1-per-cent, 
solution, he adds, is perfectly safe, and may be used without fear; in 
fact, most chemists keep a 5-per-cent, solution. The same authority also 
gives a series of experiments made by himself in hammering and bringing 
a red-hot wrire in contact with M. Martindale’s pills of nitro-glycerin, thus 
demonstrating their safety. All pills and tablets of nitro-glycerin may 
not be so safe as those he referred to. 
Antagonists.—The physiological antagonists to the action of amyl 
and nitro-glycerin are strychnine, belladonna, selerotinic acid, and, in 
general, those remedies which raise arterial tension and diminish blood- 
supply to the great centres by producing contraction of blood-vessels. 
In case of unpleasant or serious symptoms after its use, the exhibition 
of ammonia by inhalation and by the mouth, the hypodermatic injection 
of atropine or ether, with cold water or ice-bag to the head, mustard 
poultice to the epigastric region, or to the extremities, keeping the pa- 
tient warm and in the recumbent posture, will very soon be followed by 
relief, as the symptoms are usually quite evanescent. 
Amyl valerianate is an active preparation, which is regarded as a 
valuable hypnotic and antispasmodic. It is combined according to Dr. 
W. F. Wade’s formula, by taking 1 part of valerianate of amyl to 19 of 
alcohol, to which is added acetate of amyl in the proportion of 1 minim to 
2 ounces. (Dose, This dissolves eholesterin readily, and is 
considered better in cases of gall-stone than either chloroform or ether. 
AMYLENE HYDRAS.—H}drate of amylene is tertiary amyl alcohol 
(dimethylethylcarbinol). 
Dose, n^x-xxx. 
Pharmacology.—It is a mobile, colorless liquid, with a camphor-like 
odor. It boils at 102.5° C. (216.5° F.), and at 200° C. (392° F.) is 
* Pharmaceutical Journal and Transactions, June 28, 1890. 
t Nitro-glycerin in Angina Pectoris, by W. Murrell, M.D., F.R.C.P. London, 1882. AMYLUM, 
441 
decomposed into amylene and water. It forms compounds with chlorine, 
bromine, and with iodine. Oxidation converts it into acetic acid and 
acetone. Soluble in alcohol in all proportions, and in water 1 to 8. 
Therapy.—It may be used as an antispasmodic in doses of 
given in capsules, in alcoholic solution, or with mucilage. It has been 
used in insomnia, mania, delirium tremens, and in nocturnal epilepsy. 
Nache coincided with Wildermuth as to the efficacy of hydrate of 
amylene in frequent and severe attacks of epileps)', especially where the 
bromides have failed. He thinks the petit mat and nocturnal epilepsy 
are much benefited by the drug. It has also been recommended for 
whooping-cough and to relieve the cough of phthisis. 
AMYLUM (U. S. P.).—Starch. 
Preparations. 
Amylurn Iodatum (U. S. P.).—Iodized Starch (5 per cent.). Dose, 3j. 
Olyceritum Amyli (U. S. P.).—Glycerite of Starch (10 per cent.). Local use. 
Pharmacology and Therapy.—Starch is the fecula of the seed of 
Triticum vulgare (Graminacese). It is an important element of food, and 
forms a large part of rice, wheat, barley, arrowroot, and other commonly- 
used carbohydrates for administration to the sick. Starchy foods should 
not be given to young infants, who have not sufficient saliva or intestinal 
juices to digest them, for they may undergo putrefactive changes in the 
bowel and cause colic and diarrhoea. Starch is a fine, white powder, 
becoming adhesive when moist, and is a good application for burns or 
scalds, and for intertrigo, or chafing in infants. With boiling water, the 
starch-granules swell and burst and a homogeneous mass results, which 
answers very well as a poultice for alleviating local inflammation. The 
glycerite is a useful application in some skin affections, though the 
glycerin sometimes proves irritant, on account of its affinity for water. 
Starch is a convenient antidote to most corrosive poisons, when mixed 
with water; it is a test for free iodine, as it turns blue when brought in 
contact with this agent. Starch-water is a very good basis for laudanum 
injection or some other form of medicated enema, especially when it is 
combined as follows :— 
Aquae amyli, f§j. 
Bismuthi subnit., 3ss. 
Tinct. opii, niv vel x. 
M. Sig.: Inject into the bowel when necessary. Use after a stool in diarrhoea. 
I£ Aquae amyli, f§ss. 
Chloral, hydratis, gr. iijvelv. 
M. Sig.: Throw into the bowel every two or three hours in cholera infantum. 442 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
ANISUM (U.S. P.)—Anise. 
Preparations. 
Oleum, Anisi (U.S. P.).—Oil of Anise. Dose, Nlv-x. 
Aqua Anisi (U. S. P.).—Oil (2 parts per 1000). 
Sviritus Anisi (U. 8. P.).—Spirit of Anise (10 per cent.). Dose, f3i—ij. 
Anise also enters, into paregoric elixir and liquor amraonii anisatus. 
Pharmacology and Therapy.—The physiological effects of the fruit 
of Pimpinella anisatum (Uni belli ferae) are due to its volatile oil, which 
is also found in star anise (Ulicium anisatum). It is carminative, and, 
having an agreeable odor and taste, is much used in treating flatulent 
colic in infants. Anise may be ordered thus for the latter disease :— 
It Magnesii carb., J)ij. 
Spt. chloroformi, 0\v. 
Syrup, simplicis., f3ij. 
Aquae anisi, ad f§ij. 
M. Sig.: A teaspoonful, for a child under one year, every hour. 
lit bronchial catarrh it is expectorant and slightly sedative, and is 
therefore used in cough mixtures. 
ANTHEMIS (U. S. P.).—Chamomile. 
Preparations. 
Infusun Anthemidis (U. S. P.).—Infusion of Chamomile (3iv-Oj). Dose, adlib. 
Oleum Anthemidis.—Oil of Chamomile. Dose, ITlii-viij. 
Pharmacology and Therapy.—The flower-heads of Anthemis nobilis 
(Composite) collected from cultivated plants. The oil, which is the 
active principle, has a powerful lowering action upon the reflex excita- 
bility of the spinal cord. The hot infusion acts as an emetic in large 
quantities, but in 1- or 2-ounce doses it is aromatic and carminative, and 
favors perspiration and the action of the kidneys. It checks reflex cough. 
A very good combination after a severe cold, in simple fever, and often 
in acute rheumatism, is prepared by pouring a pint of boiling water over 
an ounce each of chamomile-flowers and the leaves and flowering tops of 
boneset. The patient should drink about one-half, hot, on retiring, as a 
diaphoretic, or the entire pint, should emesis be desired. A very excel- 
lent prescription for flatulence, and especially flatulent colic in children, 
is:— 
Infus. anthemidis, 
Mist, sodae menth., aa f^iij. 
M. Sig.: From one-half to two tablespoonfuls when necessary. 
Locally, it may be used as a chamomile cataplasm, when heat and 
moisture, with some sedative action, are desired. It is used principally ANTHRAROBINUM. 
443 
in domestic practice in the treatment of colds, bronchitis, and intestinal 
disorders, or dyspepsia. The oil has been proposed as an antidote in 
strychnine poisoning, and is useful in spasmodic asthma. The oil of 
chamomile, on account of its sedative action, is a very good drug to add 
to fatty preparations for various inflammations of the skin. Used in the 
ointments named, it will prove of value :— 
I£ 01. anthemidis, TT\v vel x. 
Bismuth subnit., 3j. 
Ungt. zinei ox. benz., §j. 
M. Sig.: Apply well over the surface for erysipelas, acute eczema, and erythema. 
01. anthemidis, .......... lllvj vel xij. 
Hydrarg. chlor. mitis, gr. x. 
01. eucalypti, ITlv. 
Lanolini, §j. 
M. Sig.: Use upon old muslin, and apply to the surface in infantile eczema and in 
seborrhoea. 
ANTHRAROBINUM.—Anthrarobin. 
Pharmacology and Therapy.—A yellowish powder, not soluble in 
acids or water, but soluble in alkalies and alcohol. It is related to 
chrysarobin, for which it is a useful substitute as an application in skin 
diseases. It produces less irritation and staining than chrysarobin, and 
is said to have no toxic effects. Anthrarobin is excreted, for the most 
part, by the urine unchanged, though some of it is oxidized to form 
alizarin. It colors the skin yellow and the hair red. In psoriasis, tinea 
versicolor, and herpes it is used in 10-per-cent, ointment or alcoholic 
solution, which should be made fresh at least every week. 
can be prescribed thus at times writli advantage :— 
II Anthrarobini, 3j. 
Ungt. zinci oxidi, §j. 
Ungt. hydrarg. nitratis, §ss.—M. 
For chronic eczema and psoriasis. 
II Anthrarobini, 3j. 
Ungt. hydrarg. oleatis (10 per cent.), §j.—M. 
Use in tinea versicolor, as well as in ringworm and favus. 
ANTIMONIUM.—Antimony. 
Preparations. 
Antimonii et Potassii Tartras (U. S. P.).—Tartar Emetic. Dose, gr. 
Antimonii Oxiclum. (U. S. P.).—Oxide of Antimony (rarely used), gr. ii-iij. 
Antimonii Sulphidum (U. S. P.).—For making the Oxide. 
Antimonii Sidphidum Purificainm (U. S. P.).—Used in making Sulphurated Antimony. 
Antimonium Sulphuratum (U. S. P.).—Sulphurated Antimony. Dose, gr. i-iij. 
Pulvis Antimonialis (U. S. P.).—Antimonial or James’s Powder (antimonii oxidum \, 
calcii phosphas f). Dose, gr. i-x. 444 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Pilules Antimonii Composites (U. S. P.).—Plummer’s Pills (containing sulphurated 
antimony and calomel, each, gr. ss ; guaiaci, gr. j). Dose, 1-2 pills. 
Vinum Antimonii (U. 8. P.).—Antimonial Wine (contains about 2 grains tartar 
emetic in each ounce). Dose, Ifii-x. 
Unguentum Antimonii.—Antimonial Ointment (tartar emetic 1, lard 4 parts). 
Emplastrum Antimonii.—Antimonial Plaster (tartar emetic 1, Burgundy pitch 4 
parts). 
Tartar emetic also enters into syrupus scillse compositns (U. S. P.), 
which is a syrup of squill and senega with tartar emetic (3 per cent., 
or about gr. |, to each ounce). Mistura glycyrrhizse composita (U. S. P.), 
or brown mixture, contains antimonial wine, 6 parts in 100, or tartar 
emetic, about gr. | per ounce. 
Pharmacology.—Tartarized antimony, or tartar emetic, is a powerful 
irritant, and when applied to the skin causes redness, followed by an 
eruption resembling small-pox. When swallowed, it is a depressing 
emetic, increasing the secretions of the intestinal tract, with occasional 
diarrhoea. It has a powerful diaphoretic action, and is eliminated by 
the bile, milk, sweat, urine, and intestinal secretions. Upon the circula- 
tion it is depressing, the heart’s action becoming weak and irregular and 
the arterial tension lowered. The pulsations are likewise retarded. 
Respiration becomes slower and the bronchial secretions are increased. 
The brain is not directly affected, except that under certain conditions, 
especially when combined with opium, tartar emetic exerts a sedative 
action. Large doses diminish reflex excitability of the spinal cord, and 
may produce paralysis. A special action has been noticed upon the 
liver, the waste of nitrogenous elements being increased, with diminished 
oxidation of the non-nitrogenous elements. 
Toxicology.—When poisonous doses have been administered (gr. j 
or more), vomiting, with burning pain at the epigastrium, severe colic, 
purging, and small, frequent pulse and early collapse,’with much prostra- 
tion of muscular system, rapidly occur. Death may result from exhaus- 
tion or from resulting gastro-intestinal inflammation. The antidote is 
tannic acid, which renders the salt insoluble, to be followed by demul- 
cents and anodynes to relieve the pain. Depression is counteracted by 
alcohol and digitalis. 
Therapy.—Tartar-emetic ointment is a powerful counter-irritant, but 
is seldom used on account of the danger of producing sloughing and 
scars. The treatment of inflammations by tartar emetic in large doses 
has been abandoned, but fractional doses (gr. alone or in combina- 
tion with Dover’s powder (gr. ij) or nitre (gr. iij) have proved very 
serviceable in sthenic pneumonia and in pleurisy. In bronchial inflamma- 
tion with deficient secretion the wine of antimony or compound syrup of 
squill are frequently given. ANTIMONIUM. 
445 
Garretson recommends this Description for incipient colds:— 
$ Antimonii et potass, tart., 
Morphinae acetatis, aa gr. J. 
Liquoris potassii citratis, f^iij. 
Spts. aetheris nitrosi, f^ss. 
M. Sig. : Dessertspoonful in a little water every two to three hours. 
Tartar emetic should not he given in croup (especially diphtheritic), 
as it is too depressing. For bronchitis in children, Ringer advises a 
solution of 1 grain in 1 pint of water, of which a teaspoonful is to be 
given every quarter- or half- hour. Tartar emetic should seldom or never 
be administered to infants or very young children. It is useful in spas- 
modic asthma. A combination of tartar emetic and opium is very service- 
able in the furious delirium which attends some cases of typhoid and 
typhus fevers. A similar condition in delirium tremens is relieved by the 
same treatment, which has also been used with success in puerperal 
mania. Ringer states that chorea is sometimes benefited by tartar emetic 
given in doses sufficient to produce vomiting once or twice a day. 
The formulae added are good combinations containing antimony:— 
It Antimonii et potassii tart., gr. j. 
Morphinae sulph., gr. j. 
Aquae camphorae, f§iv. 
M. Sig.: A teaspoonful every hour or two in acute catarrh and bronchitis. 
It Antimonii et potassii tart., gr. ss. 
Hydrarg. chlor. mitis, gr. ij. 
Pulv. opii, gr. v. 
« 
M. et ft. chartae xx. 
Sig.: A powder every hour or two until relieved. For acute pleuritis and bronchitis. 
It Antimonii et potassii tart., gr.j. 
Ammonii chloridi, 3ij. 
Chloral, hydrat., 3j. 
Glycerin!, f^ij. 
Syrup, pruni virg., f^iv. 
M. Sig.: Two teaspoonfuls every hour or two. A good expectorant. 
It Vini antimonii, f3j. 
Vini ipecac., f3ij. 
Syrup, tolutan., f3vj. 
Aquae laurocerasi, 
Aquae chloroformi, ad f^iv. 
M. Sig.: Two teaspoonfuls every four hours in the early stage of pneumonia. 
In some skin diseases, as chronic eczema, psoriasis, and other 
scaly disorders, the use of tartar emetic or antimonial wine in small 
doses frequently repeated is often of much service. The author often 
uses the following formulae with benefit in the treatment of chronic 446 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
eczenm and in psoriasis, especially if the inflammatory action and thick- 
ening of the skin be marked :— 
Vini antimonii, f§j. 
Sig.: Begin with three drops three times a day and increase a drop at a time until 
ten or fifteen drops are taken at each dose. 
Antimonii et potassii tart., gr. ss. 
Ext. taraxaci, 3j. 
M. et ft. pil. no. xx. 
Sig.: From one to two pills three times a day. 
The so-called tolerance of antimoin7 Mas due to the fact that after 
the vitality of the system became lowered by its action, large doses 
could be swalloMTed without producing vomiting. 
ANTIPYRIN.—Di-methyl-oxy-quinizine. 
Dose, gr. v-xxx. 
Pharmacology.—A synthetically prepared, proprietary chemical 
product belonging to the aniline series, occurring as white crystalline 
poMrder, tasteless and freely soluble in water, but less so in alcohol, etc 
It was introduced into medical practice by Dr. Knorr, of Erlangen, who 
retains its manufacture under his own control. With spirit of nitrous 
ether, antipyrin sIiom's a green color-reaction, becoming changed into 
iso-nitrosi-anti pyrin. 
Physiological Action.—It has no local effects. Ilypodermatically 
injected, it possesses an anodyne and local sedative action. When swal- 
loMred in ordinary doses, not much physiological effect is noticed beyond 
lowering of nervous irritability and sloM’ing of respiration, with weakened 
pulse and arterial tension and increased urination. Poisoning is sIiomui by 
restlessness, anxiety, slow respiration, Mreak pulse, and vertigo. Treat- 
ment is by diffusible stimulants, heart tonics (strophanthus or nux 
vomica), and artificial respiration, or inhalation of oxygen. Heat favors 
its action ; cold retards it. The toxic effects being marked in the func- 
tions of the brain and spinal cord, convulsions of spinal origin sometimes 
occur. In some patients, even an ordinary dose will produce an erythem- 
atous, measly rash, wdiich is easily removed by administering belladonna 
MTith it or by a hypodermatic injection of atropine. 
Therapy.—Partly owing to skillful advertising, anti pyrin has been 
recommended in the greatest variety of diseases, and its praises sung in 
all languages. As it is a proprietary remedy, the profession cannot con- 
sistently use it or indorse its use. Probably acetanilide or some other 
analogous member of the series will be found to supply its place in all 
essential respects. During the epidemic of grippe in Vienna, it has been 
asserted that 17 deaths were attributed to the use of antipyrin. The APIOLINUM. 
therapeutic effects may he summed up as antipj'retic, analgesic, antispas- 
modic, and probably antiseptic. In saccharine diabetes it is claimed to 
have special value in doses of 30 to 45 grains daily (Dujardin-Beaumetz). 
APIOLINUM.—Apiol. 
Dose, n^lii-vj. 
Pharmacology.—The seeds of Apium petroselinum (Umbelliferae), or 
common parsley, contain Apiine (a glucoside), Apiol (a camphoraceous 
substance, insoluble in water, cr3Tstallizing in fine needles), and an essen- 
tial oil. The alcoholic solution of a petrol-ethereal extract leaves behind, 
upon evaporation, a product which, if treated by caustic soda, yields a 
thick, reddish liquid, commonly known as apiol, or pseudo-apiic alcohol, 
which is usually dispensed in capsules of 20 centigrammes or 3 minims 
each (Chapoteaut). 
Physiological Action.—Apiol causes congestion of the uterus and 
ovaries, and favors the occurrence of the menstrual discharge. It also 
exerts some action upon the nervous system, as in large doses it pro- 
duces noises in the ears and headache. 
Therapy.—Owing to a favorable report from a commission of the 
French Academy, apiol for a time was employed in malarial affections as 
a substitute for quinine, but, being found to be much inferior in anti- 
periodic action, it is at present seldom prescribed,except as an emmena- 
gogue. It is said to be not abortifacient. In cases of scanty or deficient 
menstruation, with pains, etc., one capsule can be given after meals, thrice 
daily, for a week before the expected period, as recommended by Dr. 
Fordyce Barker:— 
Apiolini, grm. 4 (about 3j). 
Ft. capsulse no. xx (Chapoteaut). 
Sig.: Take three each day during the week preceding menstruation. 
Apiol is especially appropriate when amenorrhoea depends upon 
anaemia. It may be given in combination thus :— 
I). Apiolini, Nil. 
Aloini, gr. j. 
Sulphuris subl., gr. 1. 
M. et ft. capsulse no. x. 
Sig.: A capsule night and morning, a week before and during the menstrual period. 
Indicated in amenorrhoea and dysmenorrhoea. 
$ Apiolini, Nil. 
Podophyllotoxin, gr.j. 
Mass, ferri carbonatis, 3ss. 
Ext. belladonnse ale., gr.j. 
M. et ft. capsulse no. x. 
Sig.: A capsule night and morning. A satisfactory prescription, especially for 
amenorrhoea with constipation. 448 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
APOCYNUM (U. S. P.).—Apocynum, or Canadian Hemp. 
Dose, gr. v-xx. 
Pharmacology and Therapy.—The root of Apocjmum Cannabinum 
(Apocynacese), a plant belonging to this country, contains Apocynin and 
Apocynein, the former soluble in alcohol, the latter in water. These prin- 
ciples in small doses act upon the circulation as a tonic, like strophanthus. 
In larger amounts they are emetic, cathartic, and diuretic. A decoction 
has been used in the dose of f Ji-ij in the treatment of dropsy. 
APOMORPHIN/E HYDROCHLORAS (U. S. P.)._Hydrochlorate of 
Apomorphine. 
Dose, gr. xV-£. 
Pharmacology and Therapy.—The hydrate of an artificial alkaloid 
prepared from morphine by subjecting it to heat in the presence of 
chloride of zinc. It is a S3Tstemic emetic, and can be used to empty the 
stomach by hypodermatic administration (gr. In smaller doses, it 
has been used as an expectorant in bronchitis. It is often serviceable in 
the treatment of asthma, the writer prescribing it thus:— 
Apomorphin. hydrochloratis, grr. ij. 
Acid, hydrochlor. dil., f3iss. 
Morphinae hydrochloratis, gr. j. 
Syr. tolutani, f^j. 
Aq. chloroformi, ad f^viij. 
M. Sig.: Half ounce every third hour until dyspnoea is relieved. 
Digitalis or strophanthus may be combined with the above if there 
is any cardiac debility. 
Apomorphine should not be continued too long, as it is liable to 
produce pulmonary oedema. 
AQUA (U. S. P.).—Water. 
Natural water, in its purest attainable state, is used in pharmacy in 
making infusions, decoctions, and solutions. Medicated waters of the 
class Aqua (U. S. P.) include the following:— 
Aqua Ammoniae, 
“ Ammoniae Fortior, 
“ Amygdalae Amarae, 
“ Aniai, 
“ Aurantii Florum, 
“ Camphorae, 
“ Chlori, 
Aqua Cinnamomi, 
“ Creasoti, 
“ Destillata, 
“ Foeniculi, 
“ Menthae Piperitae, 
“ Menthas Viridis, 
“ Rosae. 
There are also a large number of unoflicinal waters, such as aqua 
acidi carboliei, aqua chloroformi, aqua eucalypti, etc. 
ARECA.—Areca, or Betel-Nut. 
Dose, n\,v-xx (or 3>-ij)? as a vermifuge. ARGENTUM. 
449 
Pharmacology and Therapy.—The seed of Areca catechu (Palmacea?) 
contains an oil and an acid constituent in addition to tannic acid. The 
powder has for a long time been used as a taeniacide in veterinary prac- 
tice. The fluid extract is the best preparation. Its administration 
should be preceded and followed by a purgative like castor-oil. Betel- 
nut is believed also to increase the secretions from the salivary glands, 
and has a slightly stimulating effect upon the cerebral centres. 
ARGENTUM.—Silver. 
Preparations. 
Argenti Cyanidum (U. 8. P.).—Cyanide of Silver. Dose, gr. 
Argenti Nitras (U. 8. P.).—Nitrate of Silver. Dose, gr. 
Argenti Nitras Dilutus (U. S. P.).—Dilute Nitrate of Silver (nitrates of silver and 
potassium, equal parts). Cast into molds. External use. 
Argenti Nitras Fwsus (U. S. P.).—Lunar Caustic for external use. 
Argenti Oxidurn (U. S. P.).—Oxide of Silver. Dose, gr. ss-ij. 
Argenti lodidum (U. S. P.).—Iodide of Silver. Dose, gr. 
Argenti Oleatum.—For external use. 
Pharmacology.—Metallic silver is a white metal taking a high polish, 
and not usually affected by acids or by oxygen, although readily tar- 
nished by sulphur. It is officinal only in the form of salts, of which the 
nitrate is most largely used. The cyanide is convenient for the extem- 
poraneous preparation of hydrocyanic acid by adding an excess of some 
mineral acid to the solution containing this salt. Silver wire is used in 
surgery for sutures and for canulae for tracheotomy, catheters, etc. 
Physiological Action.—The nitrate of silver, in weak solutions, acts 
as an astringent, and, in substance, coagulates the albumin of the tissues 
and destroys their vitality, acting as a caustic. The mitigated stick of 
lunar caustic is mild and superficial in its action ; the pure nitrate may 
cause sloughing or ulceration. One objection to its use is the discoloration 
it leaves behind, the skin becoming black after exposure to the light. 
Local applications of nitrate of silver whiten mucous membrane. When 
swallowed, symptoms of irritant poisoning appear, with pain, distress, and 
vomiting. Common salt is the antidote, and vomiting should be encour- 
aged by administering hot salt water; after cleansing the stomach the 
bowels should be emptied by oil. When any of the silver salts (but es- 
pecially the nitrate) have been taken for a length of time, a slate-colored 
line appears along the gums and upon the ocular conjunctiva, and soon 
afterward the general surface of the body becomes dingy or slate-colored, 
due to the deposit of metallic silver in the pigment layer of the skin. This 
condition is known as Argyria, and is permanent. The patient should be 
carefully observed during the administration of silver, and the remedy 
from time to time intermitted. It is expedient also to guard against 
accumulation by an occasional purge. The uninterrupted use of silver for 450 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
a longer period than six weeks is unwise. In medicinal doses the silver 
salts act as a tonic to the nervous system, and changes occur in the 
blood ; tissue change is increased ; the flow of bile is also increased ; and 
in larger doses there is embarrassment of the respiration, depression of the 
circulation, and reduction of temperature. Tetanic convulsions or paral- 
ysis may be produced l>3r overdoses, the paralysis being of central origin. 
Therapy.—Nitrate of silver is used locally in 1-per-cent, solution 
dropped into the eyes of newborn infants to prevent purulent conjunc- 
tivitis (ophthalmia neonatorum) after the method of Credd; but it has 
fallen into disuse in treating conjunctivitis in the adult, owing to the 
discoloration which follows its use. The mitigated stick is a good appli- 
cation to granular lids, chancroids, small-pox vesicles (in order to 
prevent pitting), and in general to excite a healthy action of granulating 
surfaces. In gynaecology, the lunar caustic, in solid form, is used in 
chronic cervical catarrh and in venereal sores. An application of the 
solid stick to the scrotum has a good effect in acute epididymitis or 
orchitis; also in lymphangitis of the forearm, from a poisoned wound of 
the finger. Thoroughly applied to the wound, it is claimed to be a 
complete protection against hydrophobia. For nasal catarrh it may 
be mixed with some gum acacia, pulverized, and blown into the throat or 
nose. In pharyngitis, tonsillitis, and laryngitis, solutions (made with 
water or spirit of nitrous ether of gr. xx-xl per ounce) are applied with 
excellent results; Dr. Horace Green advocated the stronger solution 
applied with a probang to the larynx in diphtheritic croup. In appro- 
priate cases, these solutions are valuable in gonorrhoea, urethritis, etc. 
In erysipelas, the disease may sometimes be arrested by outlining it 
with nitrate of silver. It has also been used with good results in 
pruritus vulvae, herpes, eczema, and lichen when they occur iiy circum- 
scribed patches. Boils may sometimes be aborted in this way, and a 
stye on the eye may be checked by an early application. 
On account of the staining of the skin, nitrate of silver is but little 
used internally, although it has acknowledged effects upon the nervous 
system. The oxide of silver is claimed to be free from this objection 
and equally efficient, especially in the early stages of locomotor ataxia 
and in epilepsy. In gastralgia, also, the silver salts are sometimes 
remarkably curative. When, in typhoid fever, symptoms of irritation 
in the alimentary tract become prominent, and peritonitis or luemorrhage 
appears imminent, the following prescription is used by Pepper, in the 
Philadelphia Hospital:— 
If Argenti nitratis, gr. ij. 
Mucilag. aeacise, f^ij. 
M. Sig.: A teaspoonful three or four times daily, combined with tincture of opium 
or belladonna, if necessary, for diarrhoea or constipation. ARGENTUM. 
451 
The nitrate or oxide of silver may also be given as follows :— 
Argenti nitratis, 
Extracti opii, aa gr. ij. 
M. et ft. pil. no. viij. 
Sig.: A pill every four hours, for gastric ulcer. 
Argenti oxidi, gr. ij. 
Ext. belladonnae ale., gr. j. 
Ext. gentianae, 
M. et ft. pil. no. xvj. 
Sig.: A pill three times a day. 
An efficient prescription for neuralgia and chorea t— 
Argenti nitratis, gr. iij. 
Syrup, ipecac., f§j. 
Morphinae sulphatis, gr. j. 
Mucil. aeaciae, f^ij. 
M. Sig.: A teaspoonful in water three times a day, before meals. Exerts marked 
influence over chronic diarrhoea, especially of phthisis. 
The solid stick is useful in restraining the bleeding from leech-bites. 
When, in the course of a chronic illness, bed-sores threaten to form, the 
local application of a solution containing 20 grains of nitrate of silver to 
the ounce will avert the mischief. Ringer has found the same salt 
useful in whooping-cough. A solution may be applied to the throat by 
a mop or sponge, or it may be used in the form of a spray'. The latter 
method, however, is inapplicable to children less than 3 3'ears of age. 
The stain produced, moreover, is a serious objection to the spray. A 
strong solution, or the solid stick, is a good stimulant to indolent ulcers 
and to .ulcer of the rectum. A 40-grain solution in nitrous ether has 
been used in tinea trichophytosis. A solution containing from 20 grains 
to 2 drachms to the ounce of water may be employed by 
injection of small quantities (5 to 10 drops) into the sac of a hydrocele 
or cystic tumor. A sponge probang saturated with a very weak solution 
of nitrate of silver is sometimes of service in spasmodic stricture of the 
oesophagus. Applications should be made occasionally, at intervals of 
several days. In pseudo-membranous enteritis it is a good practice, in 
the intervals of paroxysms, to irrigate the bowel with a 5- to 10- grain 
solution of nitrate of silver. Prolapsed rectum, especially in children, is 
benefited by cauterization with the nitrate of silver. 
In gastric catarrh, the gastro-intestinal catarrh of phthisis, ulcer of 
the stomach, or chronic diarrhoea, we may combine it as follows :— 
$ Codeinae, gr. iij. 
Argenti nitrat., gr. vj. 
Pulv. acaciae, q. s. 
Div. in pil. no. xij. 
Sig.: Give one every two to four hours. 452 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
In pill form the effect is more sustained, and the remedy can be given 
in larger doses than when in solution. When used in affections of the 
stomach, the remedy is best given a half an hour or so before meals, in 
order that the local effect may be secured. 
Dysentery, with ulceration of the large bowel, is very much benefited 
by large injections of weak solutions of nitrate of silver (gr. to the 
ounce of mucilage). Bartholow advises the internal use of the nitrate 
combined with opium in addition to the treatment by injections. Accord- 
ing to the same writer, either the nitrate or the oxide is useful in nervous 
dyspepsia, cholera infantum, and jaundice depending upon catarrh of the 
bile-ducts. Silver is sometimes beneficial in chorea. The oxide of silver 
is occasionally able to check profuse perspiration, and may prove useful 
in menorrhagia. The nitrate has given relief in obstinate enteralgia. 
ARISTOL.—Dithymol-diodide. 
Pharmacology.—Aristol is made by adding a solution of iodine in 
iodide of potassium to an aqueous solution of hydrate of sodium contain- 
ing thymol, when it is thrown down as an abundant, red-brown,amorphous 
precipitate. In the reaction an iodine atom is substituted in hydroxyl. 
The proportion of iodine present in aristol has been estimated by Carius 
at 45.80 per cent. 
Aristol is insoluble in water and glycerin, slightly soluble in alco- 
hol, but readily so in ether. The addition of alcohol precipitates it from 
its ethereal solution. It is very soluble in oils, but the solution must be 
made by friction without the aid of heat, since aristol is decomposed by 
the action of heat or of light. The character of its chemical combina- 
tion renders it an unstable compound. It possesses but a slight odor, 
which agreeably recalls that of thymol. In this respect it is decidedly 
preferable to iodoform. 
Physiological Action.—Aristol adheres very readily to the skin, and 
is therefore well adapted for use as a dusting-powder. It is free from 
irritant action upon the unbroken skin. Applied to the mucous mem- 
brane, it promotes secretion. It is not absorbed either through mucous 
membranes or raw surfaces, and therefore produces no toxic effect. It 
has been given internally by Neisser with no appreciable result. This 
experimenter found that when dissolved in suitable menstrua and injected 
into the blood it became decomposed and iodine appeared in the urine. 
The absence of disagreeable odor and its freedom from toxic influ- 
ence are features which give aristol a great advantage over iodoform, 
and, from the evidence now before us and continually accumulating, it 
seems probable that in a wide range of conditions it may eventually 
supplant the latter substance. ARISTOL. 
453 
Therapy.—The attention of the profession was first drawn to aristol 
by Dr. Eichhoff, of Elberfeld, who warmly commended its local action in 
a number of affections. His experiments have been confirmed by various 
observers, both in Europe and America. 
Aristol is remarkably efficacious in promoting rapid cicatrization. 
Varicose ulcers of the leg, so common in the old or decrepit, heal very 
quickly under the application of an ointment containing 10 per cent, of 
aristol. A 5-per-cent, ointment proved equally efficacious in the case of 
open buboes. In lupous ulcers a smooth, sound, and healthy scar is 
at times obtained by the use of aristol, either as a powder or in the 
form of an ointment. Eichhoff points out the fact, which was confirmed 
by the investigations of Neisser, that the remedy is ineffective in lupus 
which has not advanced to the ulcerative stage. The explanation is that 
aristol has no corrosive power. It is not capable of destroying or pene- 
trating an intact cuticle, and therefore can exert no influence upon the 
cells of the lupous nodule. Its action is not upon lupus as such, but 
, upon the ulcer which is the consequence of an advanced stage of the 
disease. Eichhoff in several cases anticipated the result by the forma- 
tion of an artificial ulcer by the use of the sharp spoon or Pacquelin’s 
cautery. He found, moreover, that aristol failed in ulcerated lupus of 
the nose, and suggests that in this situation the bacilli are imbedded in 
and protected by the cartilage, and are not in a position to be attacked 
by aristol. In lupus erythematosus, likewise, the affected skin must be 
acted upon some escharotic as a preliminary, after which aristol may 
promote a speed\7 cure. In scrofuloderma, excellent results have been 
obtained by the use of the remedy under discussion. Overhanging edges 
should be trimmed away, and if the granulations are flabby the base of 
the ulcer should be scraped before the aristol is applied. Upon the 
ulcers of late secondary or tertiary syphilis this remedy exhibits a re- 
markable influence. Eichhoff, indeed, expressly asserts that as a local 
application in tertiary syphilis it is superior to any other agent. It is 
of equal value in the ulcers of the congenital form of the disease, and in 
the large, moist papules of hereditary or acquired syphilis. Another 
manifestation of this malady, which may be amenable to the influence of 
aristol, is ozsena. Within a few days the foetor and discharge disap- 
pear and scabs cease to form. Simple ozaena also is notably improved by 
the same treatment. In dry rhino-pharyngitis, atrophic rhinitis, and dry 
laryngitis the insufflation of aristol is of decided benefit. Brocq and 
others have witnessed cicatrization of ulcerated epithelioma due to the 
action of aristol. Gaud in describes a case of epithelioma of the uterus 
and vagina in which the odor was extremely offensive. A cotton tampon 
coated with aristol-powder soon removed the odor and caused the 454 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
discharge of pieces of the growth. Professor William F. Waugh relates* 
a case of ulcerated scirrhus of the breast in which a surprising improve- 
ment was effected within a few days b}' aristol thickly dusted over the 
surface. In a week, granulations of healthy appearance developed upon 
the surface of the sore. 
The writer is by no means desirous of advocating injudiciously and 
prematurely the virtues of a new medicament, especially in reference to 
such a malign affection as cancer. But, from the testimony of excellent 
observers and from his own clinical experience, aristol appears to have a 
power not hitherto exhibited by any remedy, that of originating appar- 
ently healthy granulations and cicatrization of a cancerous ulcer. 
Eichhoff obtained a prompt cure of chancres of the penis and lips, 
but, strangely enough, saw no good effects from the use of aristol in 
chancroid. His experience as regards chancroid has been corroborated 
by Neisser. Professor Keyser reports that this drug is very good in 
ulcers of the cornea, in an ointment of 1 to 2 grains to the drachm of 
lanolin and benzoate of lard mixture. He has derived great benefit from 
it in pure powder on ulcers of the lid and brow; it causes such to heal up 
very quickly. It acts, he adds, like iodoform, and has not such a very 
penetrating and unpleasant odor. 
This substance is likewise an excellent and prompt antiseptic. In 
tinea tonsurans and tinea sycosis it generally proves efficient in the form 
of an ointment containing from 5 to 10 per cent. In favus, however, it is 
of little or no avail. In gonorrhoeal urethritis in women, aristol made 
into cylinders with oil of theobroma was curative in six out of nine cases 
treated b}7 Eichhoff. In acute gonorrhoea of the male, a 5-per-cent, solu- 
tion of aristol in oil seemed to be productive of no good results. Never- 
theless, when abandoned and another remedy substituted, the patients 
made a more rapid recovery than those in whom no aristol had been 
used. In a case of gleet of twenty years’ standing, Professor Waugh 
saw a very rapid disappearance of the discharge after the introduction 
of a very small quantity of aristol mixed with liquid and solid vaseline 
to the consistency of thick cream. ' The same observer reports a case 
of endometritis with dysmenorrhoea rapidly relieved by a tampon dipped 
in gtycerin and rolled in aristol-powder, intro-uterine applications of the 
same remedy being repeated twice a week. Gaudin mentions a case of 
endometritis following abortion, in which treatment by aristol was soon 
followed by improvement. 'Similar cases have been cited by Swiecicki, 
who was the first to publish the results of aristol treatment in gynae- 
colog}7. Eichhoff, Lassar, Gaudin, Neisser, and others have witnessed 
decided improvement from the use of this agent in psoriasis. I have 
* Times and Register, September 20, 1890, p. 258. ARISTOL. 
455 
found it at least as beneficial as chrysarobin, while, unlike the latter, it 
does not stain the skin and clothing, and is free from the danger of 
exciting conjunctivitis. In eczema squamosum, likewise, notable amend- 
ment has attended its use. Rolirer has employed aristol by insufflation 
with very satisfactory results in subacute and acute inflammation of the 
middle ear. The discharge speedily diminished, the mucous membrane 
became smooth, and the perforations healed. Inflammation of the ex- 
ternal ear was also very amenable to its influence. Guerra y Estape 
obtained excellent results in twenty cases of disease among children, to 
whom iodoform is so repugnant, and, in fact, dangerous. An extensive 
ulcer over the parotid gland healed in seven days, a chronic coryza in 
six days, and in the case of an unhealthy ulcer over the thorax suppura- 
tion ceased in twenty-four hours and cicatrization soon began. No ill 
effects were seen in any of the cases. Pollack, of Prague, has found 
aristol to possess marked sorbifacient virtues. An enlarged thyroid 
gland was perceptibly decreased in less than two weeks and soon after- 
ward the neck was quite normal in size. In epididymitis, chronic 
tubercular adenitis of the neck, parametritis, and typhlitis, equal success 
attended the use of the remedy. 
At the Hopital Saint-Louis, in Paris, an aristol plaster has been 
used. The following is the method of its preparation : Finely-powdered 
aristol is mixed with a small quantity of oil, and to the mass is added 
lanolin and caoutchouc plaster, previously cooled and made very fluid by 
the addition of benzine. The benzine is sufficiently evaporated to leave 
a preparation suitable for spreading upon muslin. 
The following formulae containing aristol will* be found of great 
service:— 
II Aristol, §ss. 
Pulv. zinci carb. impur., . §ss. 
M. Sig.: Dust over the surface. Employ as a dressing to wounds; also, in excessive 
sweating and oily state of the skin. 
II Aristol, 3ss. 
Ungt. zinci oxidi, §ss. 
Ungt. plumbi subacetatis, §ss. 
M. Sig.: Apply well to the surface. Beneficial in infantile and chronic eczema and in 
psoriasis. 
II Aristol, 3j. 
Camphorae, 
Lupulinae, aa gr. xxxvj. 
01. theobromae, q. s. 
M. et ft. suppos. no. xij. 
Sig.: Insert one in the vagina for leucorrhoea and pruritus. Employ also in pruritus 
of the bowel. 456 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Aristol, 3ss. 
Ungt. aquae rosse, 
Ungt. zinci oxidi, 5SS- 
M. Sig.: Use night and morning to the parts. Valuable for acne and rosacea. 
Aristol, 3ss. 
Camphorae, gr. x. 
Lanolini, §ss. 
Ungt. zinci oxidi, §ss. 
M. Sig.: For application to fissures of the nipples, hands, feet, and genital organs. 
Aristol, gr. 1. 
Ext. belladonnae ale., gr. iiss. 
01. theobromae, q. s. 
M. et ft. suppos. no. x. 
Sig.: Insert one in the bowel when necessary, to relieve pain. For cystitis and 
prostatitis. 
ARNICA (U. S. P.).—Leopard’s Bane. 
Preparations. 
Tinctura Arnica Florum (U. S. P.).—Tincture of Arnica-Flowers (20 per cent.). Dose, 
nix-xxx. 
Tinctura Arnica Radicis (U. S. P.).—Tincture of Arnica-Root (10 per cent.). Dose, 
ITlv-x. 
Extraction Arnica Radicis (U. S. P.).—Extract of Arnica-Root. Dose, gr. i-ij. 
Extractum Arnica Radicis Fluidum (U. S. P.).—Fluid Extract of Arnica-Root. Dose, 
ffiv-xx. 
Emplastrum Arnica (U. S. P.).—Extract, 1 part; resin plaster, 2 parts. 
Inf mum Arnica Floi-um (1 in 5 of water). For local use. 
Pharmacology.—Arnicae Flores, the flower-heads, and Arnica? Radix, 
the rhizome and rootlets, are both officinal ; the}r belong to the natural 
order Compositae, indigenous to Northern Europe and Siberia, also in the 
northwestern part of the United States. The flowers are orange-yellow, 
disk shaped with rays, of feebly aromatic odor and bitter, unpleasant 
taste. Trimethylamlne has been obtained from the flowers, but the prin- 
cipal constituent to which its local effects are due is probably a volatile 
oil; besides this there is a glucoside, Arnicin, and also inulin, tannic acid, 
resin, and other unimportant elements. 
Physiological Action.—Applied to a delicate skin, arnica produces 
redness and inflammation resembling erysipelas. It acts as a counter- 
irritant and revulsive. Internally, in small doses, it has some stimu- 
lating influence, raising the blood-pressure and the action of the heart, 
producing a feeling of warmth over the body and increasing the secre- 
tions. Larger doses cause depression, paralysis of the vagi, followed by 
vomiting and collapse. Death results from the cessation of the heart’s 
action, and in part from the accumulation of carbonic acid in the blood. 
Atropine is the physiological antidote, with stimulants, artificial respira- 
tion, and counter-irritation. ASAFCETIDA. 
457 
Therapy.—Arnica is largely used in domestic practice, and by irreg- 
ular practitioners as a remedy for sprains, contusions, myalgia or rheu- 
matism and local paralysis, and it is also believed to have some influence 
over haemorrhages. The plaster is useful for external disorders. It is 
asserted by some authorities that any power it may have in causing ab- 
sorption of ecchymosis is really due to the alcohol of the tincture which 
is commonly used. The author, from clinical experience, believes that 
arnica has most effective local result upon the tissues, particularly in 
rheumatism, boils, abscesses, and in all thickened conditions of the 
integument. The following combinations are especially of value :— 
$ Ext. arnicae radicis fl., 
Lin. saponis, 
Tinct. opii, aa f^j. 
M. Sig.: Apply with friction for boils, abscesses, and thickening of the skin. 
Ext. arnicae radicis fl., 
Aquae hamamelidis dest., aa 
M. Sig. : Use on muslin or lint for haemorrhages. A rheumatic joint may be covered 
with cloths saturated with the arnica and witch-hazel, the combination often being more 
effective when applied hot. 
Arnica |ias been used internally in large doses in mania with high 
arterial excitement, in delirium ebriosum, and in acute rheumatism in 
sthenic subjects. Small doses of the tincture are useful in fever 
attended with much depression. 
ASAFCETIDA (U. S. P.).—Asafetida. 
Dose, to1- x. Preparations. 
JUistura Asafcetidce (U. S. P.).—Mixture of Asafetida (4 per cent.). Pose, f§ss-j. 
Mistura Magnesice et Asafcetidce (U. S. P.).—Mixture of Magnesia and Asafetida. 
Dewees’s Carminative (tr. opii deod., 1 per cent.). Pose, f3ss-j. 
Tinctura Asafcetidce (U. S. P.).—Tincture of Asafetida (20 per cent.). Pose, f3ss-j. 
Pilulce Asafcetidce (U. S. P.).—Pills of Asafetida (each containing gr. iij asafetida). 
Pose, 1-4 pills. 
Pilulce Aloes et Asafcetidce (U. S. P.).—Pills of Aloes and Asafetida (of each, gr. 1%). 
Pose, 1-4 pills. 
Pilulce Galbani Cdmpositce (U. S. P.).—Compound Pills of Galbanum (asafetida, 
gr. ss). Pose, 1-4 pills. 
Emplastrum Asafcetidce (U. S. P.).—Asafetida Plaster (35 per cent.). 
Pharmacology.—Asafetida. is a gum-resin obtained from the root of 
Ferula narthex and Ferula scorotlosma (Umbelliferae), usually obtained 
b)r incision from the living root. This plant is a native of Persia and 
neighboring countries. The United States Dispensatory says that the 
source of the asafetida of commerce must still be considered doubtful; 
it usually is brought to this country from India. The drug occurs as 
rough, irregular, rather soft masses, of brown color, somewhat garlicky 
odor, and acrid to the taste. The odor depends upon a volatile oil, which 458 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
appears to be a persulphide of ally 1. The agent also contains ferulaic 
acid, resin-gum bassorin, with traces of acid malate of calcium (Pelletier). 
Physiological Action.—The effects are moderately stimulating, anti- 
spasmodic, and expectorant. Large doses cause vomiting and diarrhoea, 
in persons unaccustomed to its effects. In medicinal doses it 
is carminative, and increases the quantity of the gastric juice. The 
sexual functions are said to be stimulated, and a general feeling of 
warmth is diffused through the body. Asafetida increases the action 
of the heart and arterial pressure, stimulates the functions of the skin 
and kidneys, and is a mild cerebral excitant. It is eliminated byr the 
lungs, bowels, skin, and kidneys. 
Therapy.—Asafetida is not used locally (although the plaster is 
officinal), since, to those unaccustomed to its use, the odor is very offen- 
sive. This, however, makes it additionally useful in treating some 
nervous disorders, such as hysteria. Goodell advises that a teaspoonful 
of the tincture be mixed with hot water under a hysterical patient’s nose, 
and used either by the stomach or per enema. In nervousness of chil- 
dren, the pills are serviceable, and in colic or convulsions the mixture or 
milk of asafetida may be used freely as an injection. The mixture of 
magnesia and asafetida is used as an antacid and carminative for infants 
with colic, but the opium in it must not be overlooked. The pil. galbani 
comp, are used for flatulence and intestinal indigestion in elderly people. 
The combination with aloes is theoretically useful in amenorrhoea, but, 
practically, it is just in these cases that asafetida cannot be used, on 
account of its odor and taste. Small doses of asafetida are valuable in 
the later stages of bronchitis, especially that of old people. Its combi- 
nation of expectorant and carminative virtues likewise renders it of 
service in emphysema. It may often be advantageously employed in 
spasmodic asthma, especially used as follows :— 
Mist, asafoetidae, f§j. 
Elix. ammon. valeriatis, 
Elix. humuli, aa f^iss. 
M. Sig.: A teaspoonful or two in water every hour or two. 
In the flatulence and constipation of hypochondriasis it is a good 
remedy, and is especially appropriate on account of its undoubted ex- 
liilarant effect upon the brain. The mixture of asafetida injected into the 
rectum is efficient in promoting the expulsion of flatus, and may be re- 
sorted to in the tympanites of tyTphoid fever. It can be prescribed thus : 
Tinct. asafoetidae, f^j. 
Tinct. cardamom, co., . . f§j. 
Spt. ammon. arom., f3j. 
Aquae menth. pip., f'3ij. 
M. Sig.: One to two teaspoonfuls in water every two or three hours. ASCLEPIAS. 
459 
ASCLEPIAS (IJ. S. P.).—Pleurisy-Root. 
Preparations. 
Infusum Asclepias.—Bose, 
Tinctura Asclepias.—Dose, f3ss-j. 
Asclepidin.—Dose, gr. i-v. 
Pharmacology.—The root of Asclepias tuberosum (Asclepiadaceae) 
contains resins and fatty matter. Asclepidin appears to be impure resin, 
precipitated from alcohol. 
Physiological Action.—The infusion is used in the South as a diapho- 
retic and expectorant; in large quantities it is emetic and cathartic. It 
depresses the heart’s action and increases that of the skin and kidneys. 
Therapy.—The recent infusion (1 ounce to the pint; dose, a wine- 
glassful) is used in domestic practice for colds and pulmonary affections 
of an inflammatory and catarrhal character. In diarrhoea, dysentery, 
and painful disorders of the stomach or bowels, it is often effective, a 
very good prescription being :— 
Tinct. asclepias, f§ij. 
Spt. vini gallici, f^j. 
Syrup, rubiidaei, f§iij. 
M. Sig.: A tea- to a table- spoonful every hour or two, for diarrhoea and' dysentery. 
As a diaphoretic, it is used in the exanthemata, in order to facilitate 
the eruption and reduce the fever, and it is said to be advantageous in 
articular rheumatism, in controlling the inflammation and reducing the 
heart’s action. 
ASEPTOL.—Sozolic Acid. 
Pharmacology and Therapy.—A syrupy, dark liquid, freely soluble 
in alcohol, water, and glycerin. It contains orthophenol-sulphonic acid 
per cent.) diluted with water, and resembles carbolic acid in odor, 
though fainter. It is less caustic, but is decidedly antiseptic, and is said 
not to be toxic. When used, it is to be diluted (1 to 20 of water) for 
surgical practice. 
ASPARAGUS.—Asparagus. 
Preparation. 
Asparagin.—Dose, gr. i-ij. 
Pharmacology and Physiological Action.—The root of Asparagus 
officinalis (Liliaceae), when fresh, is used in decoction or infusion (|i-ij 
to Oj) as a diuretic, laxative, and blood-purifier. The fresh shoots are 
used as food, and increase the flow of urine, while imparting to it a 
peculiar, heaver odor; in some cases it has apparently caused congestion 
of the kidneys, with lisematuria. Asparagin, which is obtained princi- 460 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
pally from the root, has a sedative action upon the circulation, reducing 
the force and frequency of the heart’s action, and causing frontal 
headache. 
Therapy.—Asparagus was believed by the ancients to have valuable 
aphrodisiac properties, and was used as an ernmenagogue; the writer 
confirms the observation of Ehrhardt, that a discharge resembling gonor- 
rhoea or urethritis is caused by eating asparagus. It has been recently 
claimed that it has special effects upon the uterus as an oxytocic after 
miscarriage, or in labor. A tincture (sv of the dried tops to Oij proof- 
spirits) is used as a diuretic, in doses of 5ss-ji by Dr. Jefl'erson, of 
England. A better preparation would result from crushing and strain- 
ing five pounds of the fresh tops and evaporating the juice to one pint, 
to which an equal quantity of rectified spirits should be added, the dose 
being the same. Asparagin in doses of two or three grains may be used 
as a diuretic in dropsy, and, according to Wliitla, appears to act in gout 
like weak doses of colchicum. It is also of some service in cardiac 
dropsy, chronic rheumatism, and gout. The combination of asparagin 
with one of the bromides for the latter affections in this prescription is 
often of value :— 
Asparagin, gr. xvj. 
Sodii bromidi, 3v. 
Syrup, aurantii, f§iv. 
M. Sig.: Two teaspoonfuls in water three or four times a day. 
ASPIDIUM (U. S. P.).—Aspidium (Male Fern). 
Dose (in powder), 5ss-5iss. 
Preparation. 
Oleoresina Aspidii (U. S. P.).—Oleoresin of Aspidium. Dose, 3ss-3ij. 
Pharmacology.—Aspidium is the rhizome of the Filix mas, or male 
fern, and of the Aspidium marginale (Filices), plants found in almost 
every portion of the world, especially the former, the latter being indige- 
nous to North America. The rhizome, the portion employed, which de- 
teriorates by being retained for a long time, has a sweetish-bitter, astrin- 
gent taste, with some slight odor. It contains an active principle, filicic 
acid, a fixed and volatile oil, resin, tannic and gallic acids. Its virtues 
are due to the ethereal extract, or oleoresin. 
Physiological Action and Therapy.—Male fern possesses the power of 
expelling and perhaps destroying taenia. Harley believes that it is only 
able to detach the entozoon from the intestinal wall. It is especially 
active against the bothriocephalus latns. 
Large doses of the ethereal extract, or oleoresin, may occasion 
nausea, vomiting, and choleraic diarrhoea, followed by death from the ATROPINA. 
461 
congestion and inflammation of the gastro-intestinal tract by the irritant 
action of the drug. The American Journal of Pharmacy recently states 
that the Wiener klinische Woclrenschrift reported the case of a child 
years old, to whom 2 drachms of the oleoresin were given in three doses 
within one hundred minutes. In an hour and a half part of the tape- 
worm was expelled, then vomiting occurred, and somnolence, followed 
by twitching, sopor, and trismus of ten minutes’ duration, ending in 
death five hours after the last dose of the extract. 
A post-mortem examination of a case of poisoning and death from 
male fern revealed congestion and ecchymoses of the stomach and blood- 
clots over its surface. Poisoning from male fern should be treated by 
the administration of castor-oil and the hypodermatic injection of spirit 
of ammonia in from 10 to 30 minims, properly diluted. 
Therapy.—Male fern is an efficient tseniacide. The ethereal extract, 
or oleoresin, is the most acceptable preparation, but, being a thick, bitter, 
nauseous substance, it is best given in capsules. It can be given, but not 
so well, in milk or mucilage. The dose (3ss to 3’j) should be preceded 
and followed bjr a purgative. Trousseau and Pidoux advise the restric- 
tion of food to a milk diet for a day or two previous to the treatment 
being undertaken. Wliitla has found that male fern is efficient among 
children in a reduced dose when combined with turpentine. 
This combination of male fern often acts well, especially if a re- 
stricted diet precede the use of the preparation, and if it be followed 
by a good purgative, castor-oil being one of the very best to employ :—• 
Oleoresin* aspidii, 
01. peponis expressi, . . . f^ss. 
01. terebinthinae, llfxxx. 
M. Sig.: Take at a dose after fasting, and follow by a purgative. 
ATROPINA.—Atropine. 
ATROPINiC SULPHAS.—Sulphate of Atropine. See Belladonna. 
AURANTIUM -Orange. 
Preparations. 
Aurantii Dulcis Cortex (U. S. P.).—Sweet Orange-Peel. Tbe rind of the fruit of 
Citrus aurantium (Aurantiaceae). 
Aurantii Amari Cortex (U. S. P.).—Bitter Orange-Peel. The rind of the fruit of 
Citrus vulgaris. 
Aurantii Flores (U. S. P.).—Orange-Flowers. The partly expanded fresh flowers of 
Citrus aurantium and Citrus vulgaris (Aurantiaceae). 
Oleum Aurantii Fores (U. S. P.).—Oil of Orange-Flowers (Oil of Neroli). 
Oleum Aurantii Corticis (U. S. P.).—Oil of Orange-Peel. 
Extractum Aurantii Amari Flniclum (U. S. P.).—Fluid Extract of Bitter Orange. 
Tinctura Aurantii Amari (U. S. P.).—Tincture of Bitter Orange (20 per cent.). 462 
PHARMAGEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Aqua Aurantii Florum (U. S. P.).—Orange-Flower Water. 
Syrupus Aurantii Florum (U. S. P.).—Orange-Flower Syrup. 
Elixir Aurantii (U. S. P.).—Elixir of Orange. Simple elixir. 
Syrupus Aurantii (U. S. P.).—Syrup of Orange. 
Tinctura Aurantii Dulcis (U. S. P.).—Tincture of Sweet Orange (20 per cent.). 
Spiritus Aurantii (U. S. P.).—Spirit of Orange (oil of orange-peel, 6 parts; alcohol, 
94 parts). 
The dried peel of bitter orange enters into compound tinctures of cinchona and 
gentian. 
Pharmacology and Therapy.—Orange-juice, with water and sugar, 
may he used as a drink for fevers, and as an antiscorbutic. Care should 
be taken, after typhoid fever, not to allow children to suck the juice from 
the orange, as death has been caused by the passage of a seed through 
an ulcerated patch in the intestine. Death has also been caused by a 
child eating the fresh rind, which contains the volatile oil. The elixir is 
an agreeable vehicle for other remedies, having the alcoholic strength of 
a cordial. The other preparations are pleasant flavoring agents. 
AURI ET SODII CHLQRIDUM (U. S. P.).—Chloride of Gold and 
Sodium. 
Dose, gr. 5V-tV 
Pharmacology.—On account of its position among metals, gold has 
been believed to have some special medicinal value, although not a normal 
constituent of the human body. It is practically non-corrosive, and, 
before the era of antiseptic surgery, it was used to some extent to protect 
instruments from rusting. In a pure state gold is too soft for most pur- 
poses, although it is the best material for wire and for filling teeth. The 
only preparation officinal is the chloride, which is combined with an 
equal quantity of chloride of sodium, corresponding with 32.4 of metallic 
gold. This forms an orange-colored powder, slightly deliquescent in the 
presence of dampness, freely soluble in water. It is best dispensed as a 
tablet triturate. 
Physiological Action.—The effects of the chloride of gold arc very 
much like those of the mercuric chloride. In concentrated form it has 
an escharotic action upon the skin. Internally, in very small doses, it 
acts upon the glandular structures of the stomach and liver; it stimu- 
lates nutrition and assimilation ; but, in larger doses, it reduces the 
oxidizing power of the red blood-cells. This salt exercises a constipat- 
ing effect upon the bowels. Upon the brain and spinal cord its effects 
are those of a tonic. Large doses may cause gastro-enteritis, vomiting, 
etc., similar to corrosive chloride of mercury, and the antidote is albu- 
min and demulcents. The remedy acts upon the kidneys, increasing the 
urinary flow, and the secretion, after large doses, is colored yellow. It 
is claimed that gold has aphrodisiac powers, causing painful erections in AVENA. 
463 
men and increasing the menstrual flow in women. It is possible that 
the well-known reference to gold as a stimulant to venery, contained in 
Burton’s “ Anatomy of Melancholy,” is a play upon words, and is 
poetical rather than medical in its application. Gold is removed from 
the body chiefly by the kidneys, but to some extent also by the liver and 
bowels. 
Therapy.—From the physiological action upon the glandular system 
of the stomach and liver, and the resulting improvement in the powers 
of assimilation, gold may be especially valuable in atonic dyspepsia, 
enabling the patient to digest more food. Also, in gastric catarrh, 
chronic inadequacy of the hepatic functions (torpid liver), and early stage 
of cirrhosis, the gold and sodium chloride is a useful remedy. Admin- 
istered in this prescription, it often is most effective in gastric catarrh 
and torpid liver :— 
Auri et sodii chloridi, gr. ss. 
Ext. nucis vomicae, gr. iij. 
Ext. taraxaci, 3j. 
M. Ft. pi], no. xxx. 
Sig.: Two pills three times a day. 
In cirrhosis of the kidney, also, it is believed to have a special place. 
Following out the physiological action, we find that in spinal sclerosis, 
premature senility, in depression and hypochondria, it has a high degree 
of efficiency. In spasmodic affections (whooping-cough, laryngismus 
stridulus) it has some advocates. Where amenorrhoea or dysmenorrhoea 
is due to deficient innervation, and not to local lesions or obstruction, 
this remedy7- has given good results, and also in habitual abortion. 
It is probably true that the gojd chloride is, in some cases, an efficient 
substitute for mercuric chloride in the treatment of syphilis, especially 
of the primary and secondary stages, and it has been tried in this com- 
bination, where there was an undue susceptibility to mercury, with decided 
benefit:— 
Auri et sodii chloridi, gr. j. 
Ext. sanguinarin®, . . . gr. ij. 
Ext. calumbae, gr. xxx. 
M. Ft. pil. no. xxx. 
Sig.: One pill three times a day. • • 
In hypochondria and melancholia the chloride of gold and sodium 
is highly7 recommended. 
AVENA.—Oat. 
Pharmacology and Therapy.—The fruit of Avena sativa (Gramina- 
cete) is used as a food in the form of meal, of which cakes, gruel, or por- 
ridge is made. It is a highly nutritious food, containing oil, nitrogenized 464 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
principles, carboliydrates, phosphates, etc., hut on account of its concen- 
trated form and the presence of irritating fragments of the outer coat, 
containing silica, oatmeal is likely to cause indigestion, and in young 
children diarrhoea. The habit of eating porridge with milk and large 
quantities of sugar is apt to cause sour stomach and pyrosis, which may 
be avoided by using butter or cream and salt instead of the milk and 
sugar. Skin eruptions have been attributed to the use of oatmeal, 
particularly eczema, in infants, which is cured by a change of diet. An 
alcoholic tincture of oats has been supposed to have a sedative action 
upon the cerebral centres and to remove the craving for drink. For 
the latter, it would be more rational to recommend an infusion than a 
tincture. 
AZEDARACH (U. S. P.).—Azedarach. (Pride of China.) 
Pharmacology and Therapy.—The bark of the root of Melia nzeda- 
racli (Meliacege) is used in our Southern States in the form of a decoc- 
tion to Oij, boiled down to Oj), as a vermifuge, ounce being 
given to a child every two or three hours until the bowels are freely 
moved. Large doses may cause vertigo, dilated pupils, and stupor. A 
fluid extract has been also used (dose, 3j)j hut the fresh decoction is 
the best preparation. 
BALSAMUM CANADENSE.—Canada Turpentine. 
Dose, niv-x, preferably in capsules. 
Pharmacology.—The fir, Abies balsamea (Coniferae), is indigenous 
to the northern part of the United States and Canada. The balsam, or 
oleoresin, is obtained by collecting the juice, which naturally exudes 
upon the tree, and through spontaneous evaporation. It is a viscid, nearly 
transparent, yellowish liquid, of rather pleasant odor and bitterish taste, 
completely soluble in ether, chloroform, or benzol. When dried it is a 
clear mass, entirely without structure, so that it is useful in microscopic 
work. It is sometimes improperly called Balm of Gilead, which is the 
name of a similar substance derived from Amyris Gileadensis, a small 
evergreen growing on the shores of the Red Sea, the use of which has 
been abandoned, owing to its impurity or sophistication. Canada tur- 
pentine is an oleo/esin, and does not contain cinnamic or benzoic acid ; it 
is therefore not, properly speaking, a balsam. 
Physiological Action and Therapy.—In their actions upon the human 
body, the various forms of turpentine resemble each other so closely 
as not to require separate treatment. It is probable that the good effects 
obtained by Mr. Clay and Paracelsus, in the treatment of uterine disease 
with Chian turpentine, might be obtained from our native turpentine. 
It may be administered in capsule or emulsion, and may also be applied BALSAMUM PERUVIANUM. 
465 
locall}'. As a surgical dressing it also is useful, owing to its adhesive 
and antiseptic qualities, resembling, in this respect, the balsam of Peru. 
BALSAMUM PERUVIANUM (TJ. S. P.).—Balsam of Peru. 
Dose, n^x-xxx. 
Pharmacology.—A balsam obtained from Myroxylon pereirae (Legu- 
minosae, Papilionaceae), a tree of South America. It is a honey-like 
liquid, of fragrant odor and a warm, rather acid taste, containing resin, 
volatile oil, and both benzoic and cinnamic acids. It is inflammable, 
burning with a white smoke and fragrant odor. It is entirely soluble in 
5 parts of alcohol, and should not diminish in volume when agitated 
with an equal bulk of benzin or water. 
Physiological Action and Therapy.—Peruvian balsam is carminative, 
stimulant, and expectorant, and has been extolled in Europe by Lan- 
derer and Schnitzler, in phthisis pulmonalis and chronic bronchial catarrh, 
given in capsules or emulsion, and also used in an inhaler. As it is a 
deodorant and antiseptic, it is useful as a local application in recent 
wounds, compound fractures, and also in the treatment of ozaena, old 
ulcers, and in uterine affections :— 
Iodoformi, 3iv. 
Balsami Peruviani, 3ij. 
Lanolini, §ij. 
M. Sig.: For local application on absorbent cotton or carded wool. 
In infantile eczema we may prescribe :— 
$ Acidi borici, 3ss. 
Balsami Peruviani, gr. x. 
Lanolini, §j. 
01. amygdalae expressi, q. s. ft. ung. 
M. Sig.: Apply frequently upon soft linen. 
Leucoplakia, or local epithelial thickening of the mucous membrane, 
is removed by applications of Peruvian balsam; in leprosy it may be 
thoroughly rubbed into the affected areas. It is also a good local appli- 
cation for diphtheria. 
BALSAMUM TOLUTANUM (U. S. P.).—Balsam of Tolu. 
Dose, gr.v-x. 
Preparations. 
Tinctura Tolutana (U. S. P.).—Tincture of Tolu (10 per cent.). Dose, Olx-xxx. 
Syrupm Tolutanus (U. S. P.).—Syrup of Tolu (§ij of tincture in Oj). Dose, f$ss or 
more. 
The compound tincture of benzoin contains in each pint 3x of tolu. 
Pharmacology and Therapy.—A balsam obtained from Myrox3'lon 
toluifera (Leguminoste), a tree of New Grenada. It is a resinous exu- 466 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
dation, containing a volatile oil, toluene, with cinnamic and benzoic 
acids, and lias an agreeable odor and taste. It is slightly antiseptic and 
expectorant; the syrup is a favorite basis for cough mixtures, chiefly on 
account of its pleasant taste. The balsam itself may be administered 
in emulsion with egg or mucilage. It should not be used during acute 
attacks of inflammation. The syrup covers the taste ot chloral or 
croton-chloral (Brunton). 
BAPTISIA.—Wild Indigo. 
Preparations. 
Extractum Baptisice.—Extract of Baptisia. Bose, gr. i-x. 
Baptisin.—Dose, gr. i-v. 
Pharmacology and Therapy.—The root of Baptisia tinctoria (Legu- 
minosse), indigenous to North America. Baptisin, an impure resin, is 
considered to have cholagogue properties (dose, gr. i-v), and has been 
found of service in amenorrhoea. The decoction or fluid extract may be 
used as a cathartic in large doses, or tonic astringent in small. In 
typhoid fever and bowel disorders, small doses of a tincture have been 
used, but not according to the best practice. The decoction may be 
employed as a douche in nasal catarrh, chronic ulcers, leucorrlioea, etc., 
or as a moutli-wash in stomatitis. 
BARII CHLORIDUM.—Chloride of Barium. 
Dose, gr. • 
Pharmacology and Physiological Action.—Barium, in its action upon 
the blood-vessels, resembles both ergot and digitalis. It causes the 
cardiac contractions to become more slow and forcible. Tonic spasm 
of involuntaiy muscular fibre is produced, peripheral blood-vessels are 
constricted, and blood-pressure rises. Peristalsis is likewise excited. 
Overdoses give rise to salivation, thirst, vomiting, purging, embarrassed 
breathing, slow pulse, dilated pupils, and paralysis of the extremities. 
Death has occurred in consequence of grains, the quantity not having- 
been taken in one dose, but in daily doses of \ grain. The symptoms 
of intoxication manifested themselves at the end of a week. This, how- 
ever, must be regarded as an exceptional case. The drug, in small, 
medicinal doses, is devoid of active poisonous properties. 
Therapy.—Barium chloride may be used as a cardiac tonic in 
valvular insufficiency with irregularity of the heart. In minute doses, 
it is a stimulant and alterant, and may be used in scrofula. It has 
yielded good results in varicose veins and aneurism. Barium chloride 
is useful in atony of the bladder or intestine and in the treatment of 
haemorrhage. BELLADONNA. 
467 
BELLADOIMN/E FOLIA (U. S. P.).—Belladonna-Leaves. 
BELLADONN/E RADIX (U. S. P.).—Belladonna-Root. 
Preparations (from the leaves). 
Extraction Belladonna} Alcoholicum (U. S. P.).—Alcoholic Extract of Belladonna. 
Bose, gr. 
Tinctura Belladonnce (U. S. P.).—Tincture of Belladonna (15 per cent.). Dose, 
niv-xx. 
TJnguentum Belladonnce (U. S. P.).—Ointment of Belladonna (contains, of the alco- 
holic extract, 10 per cent.). 
Preparations (from the root). 
Abstraction Belladonnce (U. S. P.).—Abstract of Belladonna. Dose, gr. 
Extraction Belladonnce Fluidum (U. S. P.).—Fluid Extract of Belladonna. Dose, 
"lA-ij. 
Linimentum Belladonnce (U. S. P.).—Liniment of Belladonna (contains, of fluid ex- 
tract 95, camphor 5 parts). 
Ernplastnim Belladonnce (U. S. P.).—Belladonna Plaster (representing full strength). 
Active Principles. 
Atropina (U. S. P.).—Atropine. Dose, gr. 
Atropince Sulphas (U. S. P.).—Sulphate of Atropine. Dose, gr. 
Homatropine (oxytolnylic acid-tropine'), Homatropine Hydrdbrornate, a salt of the pre- 
ceding, is largely used by oculists as a mydriatic in weak solution. It is a derivative from 
tropine amygdalate by the action pf hydrochloric acid. 
Benzoyl-tropine is a combination of benzoic acid with tropine. 
Pharmacology.—The leaves and the root of Atropa belladonna 
(Solanaceee), or deadly night-shade, are each officinal, and provide phar- 
maceutical preparations. It is a native of Europe, and is cultivated 
here. All parts of the plant are active, but the fleshy, creeping root is 
especially so. The erect, purplish, branching stems stand about three feet 
high, and the leaves with short stalks are in pairs of unequal size, oval, 
entire ; the flowers are large, bell-shaped, pendent, and of a dull-reddish 
color, the short peduncles arising from the axils of the leaves. The 
fruit, somewhat resembling a cherry, has two cells containing numerous 
seeds and a sweetish, violet-colored juice ; it has an adherent calyx at 
the base. The large, cultivated leaves are said to have less of the 
active principle than the smaller leaves gathered while the plant is in 
flower. The roots are taken from plants at least three years old ; those 
which are tough and woody, breaking with a splintering fracture, should 
be rejected. Belladonna contains atropine and hyoscA’amine, duboisine, or 
daturine (Ladenburg), which differ in chemical or physical characters 
moi’e than in their physiological effects. 
Physiological Action.—Locally, belladonna affects the end organs of 
the sensory nerves and reduces painful sensibility, contracts the vessels, 468 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
and checks,the action of the sweat- and mammary- glands. It is readily 
absorbed through the unbroken skin, and symptoms of poisoning have 
appeared after its topical application. When applied to the eyes, bella- 
donna widely dilates the pupil and relaxes the ciliary muscle, so as to 
temporarily paralyze the poAver of muscular accommodation of the eye. 
Applied to the throat, it produces dryness and choking sensations, and 
this is one of the first effects of its toxic action after it has been intro- 
duced into the 83’stem either b}’ the mouth or bj' absorption. 
Upon the brain it has an exhilarating effect, and a talkative delirium 
of mild form may appear. In some cases the delirium is of a violent 
type. Subsequently,-sleep usually occurs. In the lower animals (frogs), 
atropine produces arrest of breathing, followed by convulsions. The 
transient flushing, or erythema, which appears after its use, is probably 
owing to its effects upon the S}rmpathetic S3rstem as a stimulant. The 
influence of the drug upon the heart and circulation is belie\red to be 
indirect through the nervous system. Belladonna paralyzes the inhibi- 
tory filaments of the pneumogastric neiwe, and as a result the heart, 
under the influence of the sympathetic plexus, runs at a rapid rate with- 
out being checked by the paralyzed pneuinogastrics. The force of the 
heart’s beat is also increased. Coincident wdtli this, and as a result of 
its action upon the bloodvessels, Ave have increased arterial tension. The 
contraction of the smaller vessels may be due to action upon the mus- 
cular fibres of the walls, or it may be secondary to the action upon the 
nervous system. Respiration becomes more rapid owing to stimulation of 
the respiratory centre. The Aoav of urine is increased as the resnlt of in- 
creased arterial tension, but there is no increase in the solid constituents 
of the urine. The secretions generally are checked, notably those of the 
mouth and skin; the flow of milk is also arrested by it. Though intes- 
tinal secretion is at first diminished, it is, probably, subsequently 
increased, since the alvine evacuations become more frequent and more 
liquid, during the administration of belladonna. In small doses it 
strengthens the muscular coat of the bowel. Belladonna is eliminated 
chiefW by the kidneys. 
Toxic Effects and Antidotes.—Poisonous symptoms occasionally 
appear as the result of the introduction of a very small quantity, either 
by absorption, as stated, or by passing from the into the nose, and 
thence into the throat. In such cases nothing more serious occurs than 
dryness of the throat, dilated pupils, possibly an erysipelatous or erythem- 
atous eruption upon the skin, and some fever and restlessness. Larger 
doses cause thirst, dryness, and aching of the fauces, flushing, rapid 
pulse, and hurried breathing, without, decided increase of temperature, 
followed I13' coma or convulsions and death. The physiological antago- BELLADONNA. 
469 
nists which may be employed as antidotes are, morphine, phj'sostigmine, 
muscarine, and jaborandi,- or pilocarpine. These agents should be 
cautiously administered, keeping within safe doses. Animal charcoal, 
fixed alkalies, and demulcents, followed by free evacuation of the stomach 
and bowels, may also be prescribed. 
Therapy.—Belladonna ointment, or the liniment of belladonna, may 
be used writh good results in neuralgik and chronic rheumatism ; also, in 
local sweating. In the form of atropine it is used as a mydriatic, but 
strong solutions are liable to cause glaucoma. The solutions of atropine 
for ophthalmic practice, or for use hypodermatically, should be freshly 
prepared each time, in order to avoid the development of penicillium in 
the liquid, which destroys the alkaloid, besides giving us an infected 
solution. In eye-practice it is used to dilate the pupil and relax the 
accommodation in order to facilitate examination of the eye and deter- 
mine its refraction, and also to prevent adhesions between the pupillary 
border of the iris and the lens, or to avoid protrusion of the iris through 
an ulcer of the cornea. 
Some oculists consider the santonate of atropine as the best combi- 
nation as a mydriatic, but the sulphate of atropine is the salt generally 
employed, in from grain to 4 grains to the ounce. The same solution 
is beneficially used in treating diseases of the ear, pain from inflammation 
of the middle or external ear, or membrana tympani, or earache being 
relieved by dropping it in warm w7hen necessary. 
Rigidity of the os uteri during labor may be relieved by the local 
application of belladonna ointment. The same preparation is useful in 
spasm of the neck of the bladder or of the sphincter ani, and in vaginis- 
mus. It relieves the pain of herpes zoster, of irritable and malignant 
ulcers. It is serviceable in painful haemorrhoids and fissure of the anus, 
checks the suppurative process in boils, and promotes the resolution 
of enlarged glands. For any local pain, Garretson recommends the 
appended formula, known as Ludlow’s :— 
1$. Atropinae sulphatis, gr. ss. 
Aconitinae, gr. iss,, y 
Olei tiglii, gtt. ij. 
Petrolati, : . . ‘ . 3ij. 
M. Sig.: To be used by rubbing in a piece about the size of an ordinary pea. 
This ointment may likewise be advantageously employed in the 
relief of inflamed joints. The following are good combinations :— 
$ Ungt. belladonnae, 3ss. 
Lanolini, §ss. 
Cerati plumbi subacetat., . 3iij. 
Ungt. zinci oxidi, §ss. 
M. et ft. ungt. 
Serviceable in furuncle, abscess, carbuncle, and herpes zoster. 470 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
$ Cocainae hydrochlorat., ......... g r. v. 
Ungt. belladonnse, §j. 
M. et ft. ungt. 
A good application in ulcerated carcinoma, or sarcoma, irritable ulcers, etc. 
The pupils and throat should be carefully watched when belladonna 
ointment is used upon open surfaces. Accidents, probably due to idio- 
syncrasy, sometimes follow the use of atropine solutions in the eye. In 
addition to the more usual manifestation of belladonna poisoning, 
cellulitis of the eyelids and face and epistaxis have been observed. 
Belladonna is an excellent local remedy in intercostal neuralgia or pleu- 
rodynia, and in the chest-pains of phthisis. The liniment may be applied 
with friction, and is the more cleanly agent, but strapping the chest with 
belladonna plaster is generally more efficient in neuralgia. The plaster 
usually affords considerable relief in irritable heart. The same preparation 
is effective in lumbago and myalgia. It may be spread upon the abdo- 
men in uterine or ovarian neuralgia, or in these affections the agent may be 
employed according to the method of Trousseau. This consists in com- 
bining 1 or 2 grains of the extract with 6 or 8 grains of tannic acid, and 
applying it to the cervix uteri upon absorbent cotton, or introducing 
it into the vagina in the form of a suppository. This combination is 
often valuable in leucorrhoea :— 
Ext. belladonnae ale., ......... gr. xxiv. 
Aeidi tannici, 3iss. 
Olei theobrom®, q. s. 
M. et ft. suppositoria no. xxiv. 
Three or four suppositories may be used daily. 
A suppository containing the extract of belladonna, alone or in union 
with opium, is very valuable in dependent upon spasm of 
the cervix uteri. Belladonna, locally applied, has the power of alleviating 
that perversion of sensibility known as paraesthesia or pruritus. Hence, 
a lotion or ointment containing this agent may be successfully used in 
pruritus of the genitals, urticaria, and chronic eczema, attended with 
excessive itching. A prescription like the following may be written :— 
Naphthol., gr. xx. 
Ungt. camphor®, 
Ungt. menthol., ......... aa 3ij. 
Ungt. belladonn®, §ss. 
M. et ft. ungt. 
Or— 
$ Acid, carbolici, 3ss. 
Linimenti belladonn®, . f 
Glycerini, 
Aq. ros®, aa f§iv.—M. 471 
BELLADONNA. 
The liniment of belladonna, applied locally several times a day, has 
a remarkable power in restraining excessive sweating. A solution of 
atropine in equal parts of alcohol and chloroform, the strength being 5 
grains of the alkaloid to the ounce of menstruum, will sometimes, accord- 
ing to Bartholow, allay obstinate cerebral or reflex vomiting. 
Instead ol belladonna, atropine may be used in proper quantity in 
forming ointments and lotions. The following is an elegant ointment 
for use in chronic ovarian, uterine, or pelvic disease:— 
Atropin. sulphatis, gr. ij. 
Ol. neroli, TT\vj, 
Ungt. aquae rosse, 
M. et ft. ungt. 
Belladonna is chiefly employed internally to alleviate pain, relax 
spasm, and check excessive secretion or morbid discharge. It is a valu- 
able remedy in neuralgia, especially of the trifacial nerve, though other 
forms are frequently amenable to its influence. Anstie esteemed it 
superior to any other agent in neuralgia of the pelvic viscera. Atropine 
is often productive of the happiest results in gastralgia, enteralgia, and 
gastric ulcer. As neuralgia is often expressive of insufficient nutrition 
and is generally associated with anaemia, a combination of belladonna 
with iron, strychnine, and other tonic drugs is frequently successful. A 
formula similar to the following has been widely used:— 
Extr. belladonnse, gr. iij. 
Quinin. sulphat., gr. xviij. 
Ferri sulphat. exsic., gr. vj. 
Strychnin, sulphat., gr. £. 
Acid, arseniosi, gr. J. 
Oleoresinse piperis, fTlvj. 
M. et ft. pil. no. xij. 
Sig.: A pill thrice daily. 
For the relief of migraine, Trousseau was accustomed to administer 
A grain of the extract of belladonna every hour until the S3'inptoms 
vanished or vertigo made its appearance. The tincture or fluid extract of 
belladonna, or sulphate of atropine, is useful in relieving the spasm of 
laryngismus stridulus, hiccough, spasm of the oesophagus, or local con- 
vulsive manifestations of hysteria. Intestinal, hepatic, or renal colic is 
ameliorated by this remedy. Belladonna is of service in epilepsy, but 
needsao be given persistently in gradually increasing doses for a long 
period of time. It is particularly applicable to the petit mat or noctur- 
nal epilepsy and to anaemic subjects. Belladonna is one of the most 
esteemed remedies for whooping-cough. It should be exhibited in suffi- 
ciently large doses to produce dilatation of the pupils, and is generally 472 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
well borne by children in proportionately large doses. Belladonna is 
sometimes of signal service in spasmodic asthma. The most advan- 
tageous method of administration is that proposed by Dr. Salter, 10 
minims of the tincture being repeated every two or three hours until 
disturbance of vision occurs or relief is obtained. The paroxysm may 
likewise be alleviated, though less certainly, by smoking belladonna- 
leaves in a pipe, or made into a cigarette. The tincture of belladonna 
is capable of affording marked benefit in exophthalmic goitre. When 
nocturnal incontinence of urine is caused by spasmodic contraction of 
the bladder, the fluid extract of belladonna is the best remedy which can 
be employed. The same treatment may be of avail in the incontinence 
of the aged. The sulphate of atropine possesses considerable eflicacy in 
spermatorrhoea and prostatorrhoea. It is best given at bed-time. Torti- 
collis and muscular cramps are generally ameliorated by belladonna. 
Prsecordial pain and overaction of the heart are relieved by the internal 
use of belladonna. This drug enters very serviceably into remedies for 
habitual constipation. In disease of the kidney it relieves congestion 
by its action on the arterioles. In typhoid and typhus fevers, Dr. John 
Harley has derived decided advantage from the use of belladonna, which 
cleans and moistens the tongue and quiets the brain. Inflammation of 
the pharynx and tonsils is lessened by the use of belladonna, which may, 
with great utility, be combined with aconite and given in a solution of 
chlorate of potassium. A suitable prescription may be thus formed :— 
Potass, chloratis, J}iv. 
Acid, hydrochloric., dilut., 
Tr. aconiti, IHxvj. 
Tr. belladonnse, f3ss. 
Infus. rhus. glabr., q. s. ad f§iv. 
M. et ft. sol. 
Sig.: Tablespoonful every third hour. 
On account of its beneficial influence upon the throat, belladonna has 
been used in scarlatinal angina. Much has been written concerning its 
value as a prophylactic in scarlatina, but in the experience of the author 
no reliance can be placed upon the drug as a preventive of that disease. 
It possesses some virtue as an internal remedy in erysipelas, and in this 
affection also is usefully given in conjunction with aconite, especially if 
much fever and delirium are present. It is sometimes able to check the 
vomiting of pregnancy. Aphonia due to fatigue of the cords soon dis- 
appears under the use of atropine. Belladonna is useful in allaying 
nervous cough, and, according to Bartholow and Fothergill, has an 
excellent effect in caseous pneumonia, provided it be given in the stage 
of deposit before softening has taken place. Small doses of belladonna BENZINUM. 
473 
or atropine three or four times a day check the profuse discharge of 
mercurial ptyalism. The free sweating which occurs in weakly children 
after slight exertion or during sleep is suppressed by belladonna. The 
copious watery discharge of the first stage of acute coryza is controlled 
by atropine, which is one of the best remedies also in the night-sweats 
of phthisis, given at bed-time in the dose of gr. The free dis- 
charge of chronic bronchitis is restrained by belladonna. Atropine is a 
valuable agent for diminishing the effect of shock. It may be given, in 
the dose of gr. -75, hypodermatically, after a severe injury or prior 
to a surgical operation ; also, in shock in the stage of collapse in cholera. 
In many cases it is advisable to inject atropine into the affected 
tissues (parenchymatous administration). In deep-seated neuralgia of 
large trunks, as, for instance, in sciatica, the most rapid relief is obtained 
by this method. In sciatica and myalgia it is a good plan to combine a 
small quantity (gr. of sulphate of morphine with the atropine solution 
for subcutaneous injection. The effect of each alkaloid is heightened by 
the combination. Stirling has found the hypodermatic use of gr. of 
atropine valuable in a case of haemorrhage from the lungs. In tic doulou- 
reux, likewise, atropine thrown under the skin is especially useful. 
BENZINUM (TJ. S. P.)._Benzin. 
Dose, ttlx-xxx, in mucilage, or capsule. 
Pharmacology.—A purified distillate from American petroleum, con- 
sisting of hydrocarbons, chiefly of the marsh-gas series, and having a 
specific gravity of from .670 to .675, and boiling at 50° to 60° C. (122° 
to 140° F.). Benzin, or petroleum ether, is a clear, colorless, diffusive 
liquid, yielding inflammable vapors, which, when mixed with air, are 
explosive ; it, therefore, should be kept in a cool place, remote from lights 
or flame. Soluble in alcohol, ether, and Oils, but insoluble in water. 
Fats, resins, and caoutchouc are dissolved by it. It is used in pharmacy 
in making mustard leaves, extracting oleoresins, and other manipulations 
in which its solvent power is utilized. 
Physiological Action.—Benzin resembles oil of turpentine in its 
local effects, especially when applied with friction. It is likewise an 
irritant when swallowed, but does not cause vomiting nor diarrhoea. 
It produces intoxication, faintness, headache, palpitation, or convulsions, 
which may end fatally ; death may also be caused by gastro-enteritis, 
though relatively large amounts have been taken and the poisonous 
action overcome. The treatment should be directed toward evacuating 
the stomach and bowels, and counteracting the effects of the agent by 
diffusible stimulants and atropine, or ether, hypodermatically. 
Therapy.—Externally, benzin is used as a counter-irritant, applied 474 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
upon a flannel bandage, or with friction, for neuralgic or rheumatic pains, 
but its odor is penetrating and unpleasant. Internally, it is not used in 
medicine, although it is a domestic remedy for lumbrieoid worms and 
taenia. It is claimed to be a good parasiticide in itch and pediculosis. 
(See Petroleum.) 
BENZOINUM (U. S. P.).—Benzoin. (Gum Benjamin.) 
Preparations. 
Adeps Benzoinatus (U. S. P.).—Benzoinated Lard (2 per cent.). 
Acklum Benzoieum (U. S. P.).—Benzoic Acid. Bose, gr. x-xxx. 
Tinctura Benzoini (U. S. P.).—Tincture of Benzoin. Bose, f3ss. 
Tindura Benzoini Oomposita (U. S. P.).—Compound Tincture of Benzoin (benzoin 12, 
aloes 2, storax 8, tolu 4, alcohol q. s. ad 100 parts). Bose, f3ss-ij. 
The benzoates of ammonium, of lithium, and of sodium are officinal. 
Pharmacology.—Benzoin is a gum or balsamic resin obtained from 
Styrax benzoin (Styracese), a tree of the East Indies, containing an 
abundance of resinous fluid, which exudes from incisions made into the 
bark. The best quality is in light lumps or tears, but it also occurs in 
large masses. It contains, besides resin and a volatile oil, from 14 to 
20 per cent, of benzoic acid, which may be extracted either by washing 
the resin with lime-water or by distillation. It should not contain cin- 
namic acid in appreciable quantity. Benzoic acid is in white, lustrous 
scales, or friable needles, permanent in air, having a slight, aromatic 
odor of benzoin, a warm, acid taste, and an acid reaction. Soluble in 
500 parts of water, 15 of boiling water, in 3 of alcohol, or 1 of boiling 
alcohol. It is volatilized by heat. Two other sources of the benzoic acid 
of commerce are known ; it is a derivative of toluol and also of hippuric 
acid, the hippuric acid being derived from the urine of horses and cattle. 
The benzoic acid may retain some traces of its source, and, therefore, the 
pharmacopoeia directs that it shall smell of benzoin. Benzoin prevents 
fat from becoming rancid, and hence it is, in small quantity, a useful 
addition to ointments. 
Physiological Action.—In solution in the form of the tincture, benzoin 
is protective to excoriated surfaces, and, like other gums, is antiseptic. 
After absorption, it has a stimulating effect upon mucous membranes; 
part of it is decomposed in the system to form hippuric acid, and, being- 
excreted by the kidneys, increases the acidity and the quantity of the 
urine. Benzoic acid has some power in preventing the growth of bac- 
teria,* possessing the advantage over carbolic acid of being non-poison- 
ous. The benzoate of sodium has a stimulating effect upon the liver. 
Therapy.—The tincture, especially the compound tincture, is used 
to paint over abrasions and excoriations in order to protect the surface, 
* See page 107. BENZOINUM. 
475 
particularly in cases of tender nipples. It may also be painted on the 
skin for chilblains after bathing the surface with 5-per-cent, solution of 
carbolic acid. It was formerly employed as a dressing for ulcers. As 
an expectorant we may give tincture of benzoin in chronic bronchitis, 
and the officinal camphorated tincture of opium (paregoric elixir) con- 
tains 30 grains to the pint. In troublesome cough the combination with 
opium is necessary, although the opium checks secretion and expectora- 
tion ; a better combination would be 
Codeina, gr. vj. 
Acidi benzoici, 3iv. 
Syr. tolutani, 
Aquae camphorae, aa f^iij. 
M. Sig.: Take a dessertspoonful every four hours. 
Inhalations of steam impregnated with the compound tincture of 
benzoin are beneficial in acute and.chronic laryngitis. Morell Mackenzie 
uses a vapor of the compound tincture of benzoin, 1 drachm to a pint of 
water at 140° F., inhaled frequently for acute laryngitis. 
In liver disorders, benzoate of sodium, in 10- to 30- grain doses, is very 
useful, and also in cystitis. This salt is also of service in septic and febrile 
diseases, several drachms daily (Senator). Owing to its solubility it is 
preferable to benzoic acid, and is equalty as efficient in acute rheumatism. 
In scarlet fever and small-pox the benzoate of sodium reduces the tem- 
perature and mitigates the severity of the disease. This salt has proved 
very useful in the treatment of diphtheria, administered internally, and 
at the same time applied by insufflation to the seat of the lesion. Its 
employment has seemed to be attended with good results in typhoid fever 
and whooping-cough. The same remedy in the form of a spray has been 
extolled in phthisis, but it has no such decided effect upon the tubercle 
bacilli, as had been hoped. Benzoic acid, in daily doses of to 3 
drachms, has been found of service in acute rheumatism, but is inferior 
to salicylic acid. In its exit from the system this acid acts as a gentle 
stimulant and local antiseptic to the bladder and urethra. In chronic 
cystitis with fermentation of urine and deposit of phosphates, benzoic 
acid is extremely useful, reducing the alkalinity of the fluid and the 
irritability of the bladder. For similar reasons it sometimes proves of 
service in chronic gonorrhoea, in obstinate irritation of the urethra due 
to the condition of the urine, and in incontinence caused by an alkaline 
reaction of the urine. In all these conditions the benzoate of ammonium 
may be used instead of the acid. The usual dose of the acid is 5 to 10 
grains, of the salt 10 to 20 grains. In uraemic conditions, or what has 
been called lithaemia, the benzoate of lithium has a most happy effect, 
carrying off the excess of uric acid and urates, and acting also as a 476 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
diuretic. Even in albuminuria, the benzoates have been used with 
advantage, especially the benzoate of lime. 
Freckles may be removed by the topical application of tincture of 
benzoin, containing corrosive chloride of mercury. 
Hydrarg. chlor. corrosiv., gr. ss. 
Tinctura benzoini, f3iiss. 
Glycerini, f3ij. 
Aquae rosae, f^vj. 
M. Sig.: Use as a lotion to affected spots. 
The above may also be used in pityriasis versicolor, or moth-spots, 
and chronic urticaria. The compound tincture of benzoin is sometimes 
able to relieve the itching of urticaria and eczema. A solution of ben- 
zoic acid in colOgne-water makes a pleasant application, frequently 
successful in urticaria. Mixed with an equal quantity of glycerin, the 
tincture or the compound tincture is useful in chapped lips and hands. 
The compound tincture is a good styptic, and yields excellent results 
when injected into old sinuses. It disinfects the tract, and promotes 
healing. Benzoic acid is an efficient antiseptic application to unhealthy 
wounds and ulcers. The benzoate of bismuth is an excellent dressing 
to chronic, unhealthy, or sloughing ulcers, chancroids, open buboes, 
chancres, and ulcerated lesions of late syphilis. It is applied in the form 
of a powder, the surface having previously been thoroughly cleansed by 
a wreak solution of corrosive sublimate. 
BENZOLUM, or BENZOL. 
Pharmacology.—Benzol is often confounded with benzin, but is 
entirely different. Benzol is obtained from coal-tar, and is a definite 
chemical compound (CGII6), instead of being composite like benzin. 
It is a thin, colorless fluid, very volatile and inflammable, and has an 
aromatic, not very unpleasant odor. It is almost insoluble in water, but 
dissolves in four parts of alcohol. It may be obtained by distilling a 
mixture of benzoic acid with lime, or by fractional distillation from 
naphtha,—a derivative of coal-tar. 
Physiological Action.—Benzol is antiseptic and antiparasitic, with 
but little local action beyond the extraction of oily matters from the 
skin. Owing to its solvent action upon many alkaloids, it might be 
useful in local medication b}r enabling the remedy to penetrate the skin. 
Taken internally, benzol produces intoxication, anaesthesia, and coma. 
Therapy.—It has been given in a few drop doses as a remedy for 
dyspepsia, and also in trichinosis. It is employed in pharmacy as a 
solvent, and in the household to remove paint, oil, grease, or tar from the 
clothing, very largely, but is not often administered or employed in 
practical medicine. 477 
BERBERIS. 
BERBERIS.—Barberry. 
Preparations. 
Extractum Berberidis Fluidum.—Dose, hlx-xxx. 
Tinetura Berberidis.—Dose, Hlxx-f3j. 
Berbei'ina, or Berberinoe Hydrochloras.—Hydrochlorate of Berberine. Dose, gr. x/£-V. 
Pharmacology and Therapy.—The root of the Oregon grape, or 
Berberis aquifolium (Berberidacem), growing on the Pacific Slope of 
North America, contains an alkaloid, Berberina, or Berberine, which also 
exists in Hydrastis. 
This drug, in the form of fluid extract (dose, is tonic and 
diuretic, and is believed to have some power as an alterative, making it 
valuable for the treatment of blood diseases, dyspepsia, hepatic disorder, 
habitual constipation, and skin diseases dependent upon unhealthy secre- 
tions or conditions of the digestive tract. 
BERGAMIA.—Bergamot. 
Preparation. 
Oleum Bergamii* (U. S. P.).—Oil of Bergamot. 
Pharmacology and Therapy.—A volatile oil from the Citrus ber- 
gamia (Aurantiacese), obtained from the rind of the fresh fruit, which 
also contains Bergaptene, or bergamot camphor. The odor makes 
bergamot valuable in perfumery; and it probably has antiseptic and 
stimulating qualities, but is not used medicinally. 
BETA.—Beet. 
Pharmacology and Therapy.—The fleshy napiform root of Beta vul- 
garis (Clienopodiacene) is cultivated for food, as a vegetable, and from its 
saccharine juice a good quality of sugar is obtained. A strong infusion 
of the fresh root taken at bed-time or early in the morning) is 
said by Kazatchkolf to be useful in the treatment of chronic constipation 
and htemorrhoids. It is claimed that it does not cause pain or rumbling. 
BISMUTHUM.—Bismuth. 
Preparations. 
Bismuthi Citras (U. S. P.).—Citrate of Bismuth. Dose, gr. i-v. 
Bismuthi Subcarbonas (U. S. P.).—Subcarbonate of Bismuth. Dose, gr. v-xx. 
Bismuthi Subnitras (U. S. P.).—Subnitrate of Bismuth. Dose, gr. v-xx. 
Bismuthi et Ammonite Citras (U. S. P.).—Citrate of Bismuth and Ammonium. Dose, 
gr. i-v. 
Bismuthi Sdlicylas.—Salicylate of Bismuth. Dose, gr. i-xx. 
Bismuthi Oleas.—Oleate of Bismuth (20 per cent.). External use. 
Bismuthi Subiodiclum.—Subiodide of Bismuth. External use. 
* This is the title in the U. S, Pharmacopoeia; it should be 01. Bergamis. 478 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Pharmacology and Physiological Action.—Bismuth in the metallic 
form is not officinal, and has no medical interest. Its salts, however, are 
of great value ; the insoluble ones differing greatly in their applications 
from those which are soluble. The subnitrate and subcarbonate are or 
should be in the form of white, impalpable powder, which has a slight 
astringent and absorbent action when dusted upon excoriated or 
ulcerated surfaces. When taken internally, these salts have very much 
the same effect along the digestive tract as upon the surface of the body, 
checking excessive secretion and exerting a sedative influence. When 
injected under the skin, part of the salt is absorbed and poisoning may 
result. Or, if large doses are taken by the mouth, death may follow from 
gastro-enteritis, the symptoms being very much like those caused by gold, 
lead, and mercury. After death, bismuth is found in the liver and other 
viscera, and in the urine and saliva. A purplish line upon the gums, re- 
calling that of lead, has been noticed. The treatment is by demulcents, 
washing out the stomach, and the administration of the antidotes to 
arsenic, with which native bismuth is usually combined. When the 
soluble preparations are given for a considerable time, the bismuth is apt 
to accumulate in the liver; but this is not likely to follow the adminis- 
tration of the insoluble salts. The solutions, or elixirs, purporting to 
contain bismuth in combination with pepsin are both unscientific and 
dangerous. The discharges from the bowels are blackened by bismuth. 
Therapy.—In using bismuth it is essential that it shall be pure and 
free from arsenic. When well made, the subnitrate or subcarbonate is 
very useful as a dusting-powder for infants, or for intertrigo in adults. 
It has also been used to dust over excoriated surfaces, and as a dressing 
after wounds or amputations ; in this case its weight is an objection to 
its employment; but it is very valuable in small wounds and in some old 
ulcers. Combined with mucilage (3j to 3vi—viij), it is a good injection 
for gonorrhoea during the early stage; or it may be used as a soluble 
bougie, or as a vaginal suppository for leucorrlioea. The same preparation 
is likewise useful in ulcer of the rectum. 
A small proportion of carbolic acid or aristol will enhance its anti- 
septic effect. I11 acne, intertrigo, and erythema in infants, or vesicular 
eczema, the bismuth may be lightly dusted over the surface. In the 
case of wounds the red oxyiodide is preferred to iodoform as an anti- 
septic and as an ointment in skin diseases. This salt is a local anaes- 
thetic and antiseptic. It does not stain the skin or clothing, and may 
be employed as a dusting-powder or an ointment. It is an excellent 
application to chancres, chancroids, open buboes, ulcers, unhealthy 
wounds, and phlegmonous erysipelas. The following is a good com- 
bination :— BISMUTHUM. 
479 
Naphthalini, 3ss. 
Bismuthi subiodidi, 3j. 
Unguenti simplicis, 3viss. 
M. et ft. ungt. Useful upon chancres, chancroids, and syphilitic ulcers. 
The yellow oxyiodide is more suitable for mucous membranes (dose, 
gr. v-xx). 
Bismuth-powder has been used with success in simple ozaena, snuffed 
into the nostrils, though it is inferior to other remedies. It may also be 
employed in aphthous or nursing sore mouth, and in mercurial ptyalism. 
It may be of service in chronic conjunctivitis and granular lids. Made 
into an ointment, the subnitrate of bismuth is an excellent application to 
chancroids, irritable ulcers, erysipelas, blisters, pemphigus after the 
bullae have ruptured leaving raw surfaces exposed, the erythematous and 
bullous forms of burns, and in the first stage of dermatitis. In these 
conditions an ointment may be thus composed :— 
$ Bismuthi subnitratis, 3ss. 
Pulv. marantae, . . . §ss. 
Morphinae sulphatis, gr. iij. 
Lanolini, §ss. 
M. et ft. ungt. 
An ointment containing the oleate of bismuth is also valuable in 
diseases of the skin (see page 383). It may be prescribed as follows :— 
Extr. belladonnae ale., gr. x. 
Extr. opii, gr. xx. 
Ungt. bismuthi oleatis, §ss. 
M. For furuncles, carbuncles, and eczema of the genitals. 
The internal administration of bismuth preparations is for their 
local action upon the stomach and intestinal tract. They form a coating 
over the inflamed or irritated surfaces and keep them from coming in 
contact, wdiile they also exert an astringent knd sedative effect. In gas- 
tralgia, irritable stomach, and some dyspeptic conditions they are of 
much value:— 
$ Bismuthi subnitratis, 3ij. 
Pepsini saccharati, 3j. 
Creasoti, ,Tliv. 
M. Divide in chartulse no. xij. 
Sig.: Give one every hour until relieved. (The oil of gauliheria may be substituted 
for the creasote, in case of children, and the powders made smaller.) 
Bismuth may be given in powder also, as:— 
Bismuth, subnit., 
Magnesii carbonatis, . aa 3j. 
Morphinse sulphatis, gr. j. 
M. et ft. ehartae no. xij. 
Sig.: A powder every hour or two. Employ in gastralgia, dyspepsia attended with 
acidity, and in cancer of the stomach. 480 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
In children suffering with irritable stomach the result of improper 
feeding, a good combination is :— 
Bismuth, subnit., ...» 3ss. 
Sodii bicarb., 
Pulv. rhei, aa gr. x. 
M. et ft. chart* no. x. 
Sig.: A powder every four hours. 
The following liquid combinations of bismuth are likewise of service, 
especially in gastric catarrh and some varieties of dyspepsia :— 
Bismuth, citratis, 3ij- 
Glycerini pepsin*, f §iij- 
M. Sig. : A teaspoonful before meals. 
Bismuth, subnit., 3ij. 
Pulv. rhei, 3iss. 
Pulv. acaei*, 3ij. 
Spt. myristic*, - • • . 13ij. 
Aqu* menth. pip., ...» f^viij. 
M. Sig.: A tablespoonful in water every four honrs. 
In gastro-enteritis, or summer complaint in young infants, the sali- 
cylate gives excellent results in 1- or 2- grain doses. This combination 
is likewise valuable in the diarrhoea of typhoid fever, in which it is 
serviceably given with naphthol. 
Gastric ulcer is much benefited by the subnitrate in 10- or 15-grain 
doses, given every three hours, or oftener, if there is much pain. Where 
malignant ulceration is suspected, opium and belladonna may be admin- 
istered at the same time. The vomiting of pregnancy may sometimes be 
relieved by bismuth subnitrate. It serves a useful purpose in the chronic 
gastritis so common in drunkards. In acidity of the stomach it is use- 
ful, and in flatulent dyspepsia. A combination of bismuth with charcoal 
is efficacious in the latter condition, as— 
Bismuthi subnitratis, 
Pulveris aromatici, . . aa 3ij. 
Carbonis ligni (recentis), §ss. 
M. et div. in chart, no. xij. 
In diarrhoea, the subnitrate is usually a reliable remedy, but, as 
Ringer advises, it should be preceded by a dose of castor-oil, in order to 
remove any possible cause of irritation. In the diarrhoea of phthisis, it 
can be given in combination with pepsin or pancreatin. It may be given 
in hot milk to children ; but it is almost tasteless, and may be placed at 
once upon the tongue and washed down with water or milk. In chronic 
diarrhoea, the subnitrate of bismuth not infrequently affords marked BOLDUS. 
481 
relief. An excellent prescription for diarrhoea, particularly when 
acute, is— 
Bismuth, subnit., 3iiss. 
Pulveris myristicse, Qij. 
Aquae cinnamomi, 
Syrup, acaciae, aa f^ij. 
M. Sig.: Two teaspoonfuls every half hour, or hour, until relieved. 
A solution of citrate of bismuth and ammonia (representing about 
3 grains of the oxide in each drachm) is officinal in the British Phar- 
macopoeia :— 
Bismuthi et ammoniae citrat. gr.v. 
Aquae chloroformi, igss. 
Elixir aurantii, f§iss. 
M. Sig.: Take half an ounce three or four times daily, for irritable stomach. 
BOLDUS.—Boldo. 
Pharmacology.—The Peumus boldus (Monimiaceee) is an evergreen 
belonging to the western coast of South America. The leaves and small 
stems contain a bitter extractive, a volatile oil, and a bitter alkaloid (or 
glucoside ?), Boldoin. A tincture (5 per cent.) is used in 5 minim doses 
or more, gradually increasing, and produces vomiting and purging in 
full doses, and also a sedative or narcotic effect upon the brain. In 
small doses it is carminative and stimulant to the stomach. 
Therapy.—In South America this plant has some reputation for its 
influence upon genito-urinary disorders, gonorrhoea, gleet, cystitis, and 
catarrhal inflammations of the kidneys. It has also been used for rheu- 
matism, and as a tonic in dyspepsia and general debility. In cirrhosis, 
it is especially recommended by Campenon. Boldoin, the active prin- 
ciple, has hypnotic powers, and has been successfully tried in France as 
a substitute for opium or chloral (Juranville). 
BRAYERA (U. S. P.).—Brayera (Koosso or Kousso). 
Preparations. 
Extraction Brayera Fluidum (U. S. P.).—Fluid Extract of Brayera. Bose, n\xx-f3ij. 
Infusum Brayera! (U. S. P.).—Infusion of Brayera (6 per cent.). Dose, f §iv-viij. 
Kosin.—The active principle. Dose, gr. v-xx. 
Pharmacology and Therapy.—Brayera is the female inflorescence of 
Brayera anthelmintica (Rosaceae), a tree of Abyssinia. Kosin is a 
crystalline substance of acid reaction, combined with tannic acid, a vola- 
tile oil, and a resinous substance (koussein), which is an impure kosin. 
In large doses, brayera is a gastro-intestinal irritant, and is liable to cause 
vomiting. It is usually administered in infusion for the expulsion of 
tape-worm. It should be followed by a purgative in about two hours, 482 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
castor-oil being ordinarily used. Kosin, in 20-grain doses, is said to be 
less liable to cause nausea than the fluid preparations. Bray era should 
not be given during pregnane}', for fear of causing abortion. 
BROMUM (U. S. P.).—Bromine. 
Dose, nii-Hj. Preparations. 
Ammonii Bromidum (U. S. P.).—Bromide of Ammonium. Dose, gr. x-xl. 
Calcii Bromidum (U. S. P.).—Bromide of Calcium. Dose, gr. v-xxx. 
Potassii Bromidum (U. 8. P.).—Bromide of Potassium. Dose, gr. x-3j. 
Lithii Bromidum (U. 8. P.).—Bromide of Lithium. Dose, gr. v-xx. 
Sodii Bromidum (U. 8. P.).—Bromide of Sodium. Dose, gr. x-3j. 
Zinci Bromidum (U. S. P.).—Bromide of Zinc. Dose, gr. i-ij. 
A cidum Hydrobromicum Dilutum (U. S.P.).—Dilute Hydrobromic Acid (10 per cent.). 
Dose, Hlxx-f3ij. 
Syrupus Ferri Bromidi (U. 8. P.).—Syrup of Bromide of Iron (10 per cent.). Dose, 
>llx-f3j. 
Camphora Monobromata (U. 8. P.).—Monobromate of Camphor. Dose, gr. v. 
Niccoli Bromidum.—Bromide of Nickel. Dose, gr. i-v. 
Conince Hydrobromicum.—Hydrobromate of Conine. Dose, gr. 
Bromoform.—Tribromo-Methane. Dose, Ulii-x. 
Pharmacology.—Bromine, which obtains its name from its offensive 
odor, is a brownish-red, non-metallic liquid element, obtained from sea- 
water ; combining readily with alcohol, ether, or chloroform, and soluble 
in 33 parts of water at 59° F. When added to water, ozone is liberated. 
It completely volatilizes upon exposure to the air, giving off a highly 
irritating, suffocating odor like that of chlorine, with which it may be 
contaminated. The pliarmacopoeial tests require the chlorine to be not 
more than 3 per cent., and that there shall be only traces of iodine. 
Physiological Action.—It is unfortunate that the smell of bromine 
is so obnoxious, since it is a true disinfectant, rivaling mercuric chloride, 
and, it is claimed, has even more influence than that agent, in preventing 
the development of spores. A 2-per-cent, solution in water destroys 
the spores of anthrax. Applied to the skin, it is a penetrating caustic 
in its pure state, and, diluted, is astringent and antiseptic. Internally, 
its effects resemble those of iodine and chlorine, causing paralysis of the 
brain-centres, death resulting from parah'sis of respiration. After death 
the bromides are found in the brain, principally (Doyon). 
In cases of poisoning by swallowing this agent, the stomach must 
be thoroughly irrigated, and a purgative like croton-oil administered in 
alkaline solution (Vichy water). When inhaled, warm vapor from the 
steam-atomizer with alkaline solution (Dobell's solution) would afford 
relief to the irritation. The bromides taken upon an empty stomach in 
concentrated form sometimes cause gastralgia, which may be relieved by 
hot water and a hypodermatic injection of morphine, combined with 
atropine, if stupor be present. BROMUM. 
483 
In medicinal doses, the bromides and liydrobromic acid exert a 
sedative effect upon the functions of the brain, produce insensibility of 
the mucous membrane of the fauces, and allay irritability of sensory 
nerves, as is very well shown in the case of tinnitus aurium after admin- 
istration of quinine. It has some special effect upon the genito-urinary 
tract, obtunding sensibility and preventing erections or ovarian excite- 
ment. This is probably due largely to the influence of the bromides 
upon the spinal cord, reducing reflex action and, when continued, dimin- 
ishing motor power and producing paralysis of the legs. The circula- 
tion is also affected by action upon the cardiac ganglia. In the case of 
bromide of potassium, we have superadded the toxic action of potash 
upon the heart-muscle, by reason of which, when given in large doses, the 
arterial tension is reduced and the pulse-rate lowered. In the usual doses 
this effect is hardly observable. It is said (by Hammond) to reduce 
the cerebral circulation, causing anaemia by contraction of the arterioles. 
It is probable that the hypnotic effect of bromides is due more directly 
to their action upon the brain-centres, especially the motor and intellec- 
tual portion of the cortex cerebri. To its faculty of reducing reflex 
nervous excitability is to be ascribed its well-known antispasmodic effects 
in convulsive disorders. iS’o marked effect upon temperature or respira- 
tion has been observed from medicinal doses ; very large doses may 
reduce both, and also diminish tissue-waste. 
The rate and the force of the heart’s action are likewise diminished 
and arterial pressure reduced b}r excessive doses. When continually 
administered in moderately large doses, the bromides sometimes excite 
nausea and diarrhoea. A sedative action is exerted bjr the bromides 
upon the sympathetic nervous sj^stem. 
The bromides have considerable diffusive power, and are found in 
most of the secretions and in the interior of glands like the liver. The 
glandular elements of the skin are stimulated and an acneiform eruption 
follows their prolonged use. They are eliminated from the system by the 
secretions generally, but more particularly by those of the fauces, skin, 
bronchi, bowels, and kidneys. 
Therapy.—For its caustic effect, bromine has been used in alcohol 
(1 to 2 or 3) in hospital gangrene, and in g3'nsecology as an application 
to cancer of the uterus. Diluted with sweet-oil (nyx to 3j), it is a sedative 
dressing for rlms-poisoning or chancroids. Bromine is employed, like 
carbolic acid, as a disinfectant for drains, but is too offensive for use in 
this way in the sick-room. The bromides are not often used as topical 
remedies, though an aqueous solution of the strength of 10 or 20 grains 
to the ounce maj’ be serviceable in parsesthesia. Finely-powdered bromide 
of potassium is stimulant to chronic ulcers, and has been advantageous 484 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
iii epithelioma. It lias been applied, added to 5 parts of glycerin, to haem- 
orrhoids and fissure of the anus, in order to relieve pain. In treating 
laryngeal diphtheria, or membranous croup, the following may be used :— 
Bromi, Iflv. 
Potassii bromidi, 3j. 
Syrupi simplicis, f3viiss. » 
Decocti althaese, q. s. ad f §iv.—M. 
For a child of 1 year the bromine should be reduced to one-third, 
and from 1 to 4 years two-thirds, of the quantity in this formula, of 
which an ounce is to be given every hour, while the symptoms are urgent 
(Redenbacher). The officinal solution of hydrobromic acid has not 
answered the expectation of those who urged its use as a substitute for 
the bromides; it may be less liable to produce acne, but it is irritating 
and less efficient. It may be given for the relief of tinnitus aurium, 
headache, or to prevent unpleasant symptoms from the effects of quinine. 
Quininae hydrobromat., gr. xxiv. 
Acid, hydrobromic. dilut., f^ss. 
Elixir, aurantii, f^iiiss. 
M. Sig.: Dose, a tablespoonful after meals. 
Special Applications.—The special use of the bromides is found in the 
treatment of convulsive disorders, such as spasm of the larynx or epilepsy. 
In the former affection a few doses of 10 or more grains in a child are 
usually sufficient to accomplish a cure; but in the latter the treatment 
often extends over months and years. When the bromides are to be 
continued for a long time, bromism is apt to be produced, the physio- 
logical action of bromine being shown by eruptions upon the skin, 
especially of the face, loss of reflexes, dragging, heavy sensations, and 
difficulty in locomotion, and in some cases special tendency to convulsive 
attacks appear. It therefore becomes necessary to intermit the bromide 
or change from one to another, and if there is too much depression of 
the vital powers digitalis may be prescribed in combination, or strychnine 
given liypodermatically in minute doses (gr. TajJ-eu) several times daily. 
Rrown-Sequard prefers a combination like the following, in treating 
epilepsy, for a child 10 years of age :— 
I) Potassii iodidi, . 3j. 
Potassii bromidi, §j. 
Ammonii bromidi, 3iiss. 
Potassii bicarbonatis, ......... gr. xl. 
Spiritus chloroformi, f3ij. 
Infusi columbse, q. s, ad f§vj. 
M. Dose, two drachms morning and noon and three drachms at night, diminishing 
the quantity after the convulsions cease, but continuing the remedy at intervals, especially 
at the time when the fits are liable to recur. If the patient be weak, the infusion of 
digitalis may be substituted for the columbo. BROMUM. 
485 
In treating epilepsy the partial insensibility of the fauces is the guide 
to the administration of bromides; this should be established as soon as 
possible and maintained during the continuance of the treatment, which 
should not be pushed to the point of bromism. Small doses of arsenic 
will prevent, to some degree, the eruption in persons especially sus- 
ceptible to bromides, and it is well to alternate the iodides with the 
bromides in order to prevent undue accumulation of the latter in the 
system. The beneficial action of the bromides is particularly marked 
when epilepsy is due to disorder of the sexual apparatus. On the 
other hand, the petit mal is much less amenable to their influence 
than the general convulsive seizures. The bromide of potassium has a 
certain sphere of usefulness in whooping-cough. It is of no avail when 
the bronchitis is severe, or when pneumonia is present; but in simple 
uncomplicated pertussis, above all when convulsions or a tendency to 
convulsions exist, this remedy is of great service in allaying the conges- 
tion of the nervous centres. Spasmodic asthma is, in some instances, 
considerably benefited by the exhibition of bromide, and its efficac}" is 
enhanced by combination with the iodide. The bromides are of decided 
value in infantile convulsions, especially when these depend upon reflex 
irritation. They are likewise of service in the convulsions symptomatic 
of simple meningitis, and not altogether without avail in alleviating 
those of tubercular meningitis. Uraemic convulsions may sometimes be 
successfully treated by bromide of potassium in combination with chloral 
hydrate, assisted by active purgation and diaphoresis. When cholera 
infantum is associated with excessive nervous irritability, the bromide 
of potassium serves a useful purpose, as it does also in those cases in 
which flatulent colic of infants is connected with marked intestinal 
spasm. In treating nervous irritability, restlessness, and insomnia, it is 
well to combine bromides with other hypnotic agents. 
Potassii bromidi, gr. xv vel xx. 
Chloralis bydrat., gr. x. 
Aquae, campliorae, f3j. 
Syr. lactucarii, f3j. 
M. Sig.: Pro dosi. For nervous headache with insomnia. 
The sedative and antispasmodic effects are increased by combination 
with gelsemium, asafcetida, or valerian, and smaller doses are required 
than when each agent is administered alone. In the affections of the 
genito-urinary organs, the bromides are of especial value when spasm or 
pain is present. The quantity of urine is increased and also the propor- 
tion of urea. The sexual functions are depressed; and the bromides are 
largely used as anaphrodisiacs in priapism and nymphomania, especially 
when given in conjunction with tartar emetic in minute doses. 486 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
A good formula used by the author fqr gonorrhoea with chordee is 
the following :— 
Potassii bicarb., 3iij. 
Potassii bromidi, 3iv. 
Tincturae hyoscyami, j. 
Spiritus chloroformi, f3iv. 
Inf. buchu, . . . . , • • • . ad f^viij. 
M. Sig.: A tablespoonful in barley-water every three or four hours. This combina- 
tion relieves scalding and chordee. 
The following are also valuable prescriptions containing the 
bromides :— 
Sodii bromidi, 3vij. 
Antimonii et potassii tart., gr. ss. 
Aquae camphorae, 
Spiritus aetheris nitrosi, aa f^iss. 
Syrupi aurantii, f §ij. 
M. Sig.: Two teaspoonfuls in water every two or three hours until relieved. 
Serviceable in epididymitis, cystitis, and prostatitis. 
Ammonii bromidi, 
Saloli, aa 3j. 
M. et ft. capsulae no. xij. 
Sig.: Two capsules every hour or two. Employ in gonorrhoea and all irritable 
conditions of the genito-urinary organs. 
The menses are delayed and rendered less in quantity by the use of 
the bromides. When menorrhagia is caused by ovarian congestion the 
bromide of potassium restrains the flow, and the same agent sometimes 
proves of service in metrorrhagia. In the profuse and irregular menstrual 
discharges, which often occur as the menopause is neared, the same remedy 
is of value. The headaches, flushing of the face, subjective sensations of 
heat, and other anomalous symptoms which characterize the same period, 
receive notable relief from the bromides. Chordee occasionally yields to 
the same agent. In spermatorrha?a and atonic impotence, dependent 
upon irritation or subacute chronic inflammation of the deep urethra, the 
bromide is valuable by diminishing the reflex irritability of the genital 
centre in the cord. But in diurnal pollution due to debility of the 
genital centre, this remedy is harmful and should be avoided. In all 
cases of reflex nervous disorders having origin in ovarian irritation, the 
bromides have a well-established reputation, but should not be given 
freely in anaemic subjects. In uterine cough, stomach-cough, ear-cough, 
etc., we may give :— 
Potassii bromidi,. . . gr. v vel x. 
Syr. pruni Virg., f3ij. 
M. Take every four to six hours. The above is also useful in the cough of children. BROMUM. 
487 
When it is desired, in laryngology, to make an examination or an 
operation upon a very sensitive throat, the use, for a few days, of full 
doses of potassium bromide will greatly assist in reducing such hyper- 
esthesia. In various hysterical throat affections, the bromides are of the 
greatest value. 
In irritability of the bladder in women who use sewing-machines, or 
others, the following is serviceable:— 
Potassii vel sodii bromidi, gr. xx. 
Infus. uvae ursi, f3j. 
M. Sig.: Take every hour or two until relieved. 
In migraine the combination with opium is valuable:— 
Tr. opii deodorat., f 3j. 
Potassii broinid., 3ii—iiss. 
Acid, hydrobromic. dilut., f^ij. 
Syr. aurantii flor., q. s. ad f§iv. 
M. Sig.: Take a dessertspoonful in water every two or three hours. 
Cases of maniacal excitement, puerperal, alcoholic, or other, are 
relieved by full doses of bromides. Many acute attacks of fever in 
children, with delirium, are promptly cured by bromides in small doses 
given every few minutes. Sea-sickness and the vomiting of pregnancy 
are controlled by small doses of bromides in effervescent salt; large 
doses have occasioned temporary derangement of mind, and have 
brought this remedy into disrepute because improperly used. In 
poisoning by strychnine and in tetanus large doses of the bromides have 
proven successful in subduing the convulsions. 
In acute cerebral congestion, the bromide of potassium is of great 
value through its influence upon the vasomotor system. It is very 
serviceable given in conjunction with the fluid extract of ergot, which aids 
its action by constringing the cerebral vessels. The headache and wake- 
fulness are also relieved by the bromide. The same drug is efficacious 
in allaying cerebral vomiting. Insomnia, caused by nervous strain or 
excessive mental application, is successfully treated by means of the 
bromide. The headache of pachymeningitis is generally best controlled 
by a combination of the bromide and iodide of potassium, as— 
Potassii iodidi, 3iiss. 
Potass, bromidi, 3v. 
Syrupi aurantii, 
Syrupi simpiicis, aa f 
M. Sig.: Dose, two teaspoonfuls three or four times daily. 
In exophthalmic goitre, the excessive cardiac action may often be 
restrained b3r the bromide. This remedy may be useful in subacute and 
acute rheumatism, especially when the acute form of the disease is 488 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
accompanied by considerable fever and delirium. The restlessness and 
delirium of the third week of typhoid fever is often admirably controlled 
by a bromide. The same agent is very efficacious in preventing the 
night terrors of children. It is claimed that the bromide of potassium 
is useful in diabetes mellitus of nervous origin. This salt relaxes 
nervous spasm of the oesophagus and allays the nervous symptoms of 
rachitis. The bromide and iodide of potassium are recommended in 
eliminating metals, as mercury, copper, or lead, from the system. The 
bromide may be useful in reducing enlarged lymphatic glands and spleen, 
though far inferior to the iodide of potassium. A bromide increases the 
effect of hypnotic or narcotic medicines, and it is often able to obviate 
the unpleasant consequences of opium. 
During administration of the bromides, the digestive functions may 
become disordered and it is necessary to occasionally give cholagogue 
cathartics to keep the liver up to its work. 
In comparing the bromides we observe some difference in their 
effect and therapeutic applications. 
Potassium bromide is the most frequently prescribed, and is the 
most efficient. Where the circulation is weak the other salts, especially 
the ammonium salt, are to be preferred. 
Sodium bromide is the least toxic, and is preferred in cases where 
nutrition is poor, especially in anaemic women and children. It is not so 
efficient in cases of a uric-acid diathesis or lithaemia, as other salts, and 
notably that of lithia. Ammonium bromide combines the stimulating 
action of the ammonia with the hypnotic effect of bromine, and it is 
useful in cerebral rheumatism. 
Nickel bromide, introduced b3r Da Costa for the treatment of epi- 
has the advantage of the smallness of the dose, but the disadvan- 
tage of the metallic poisoning when too long continued. It is best given 
in effervescent salt. Zinc bromide is little used ; it is supposed to com- 
bine the well-known action of zinc upon the central nervous S3Tstem with 
the bromide action. The syrup of bromide of iron has been employed 
for chorea in anaemic children, with good results. 
Bromoform—Tribromo-Methane.—If to methane, or marsh-gas 
(CH4), be added 3 atoms of bromine in substitution for 3 of hydrogen, 
we get bromide of methyl, or bromoform (CHBr3), analogous, therefore, 
in composition to chloroform or iodoform. Bromoform is an oily liquid, 
having an agreeable odor resembling that of chloroform. Its density is 
2.77 and it boils at 150° C. Insoluble in water, it dissolves in alcohol 
and ether, its reactions being similar to chloroform. It usually is present 
in small proportion in commercial bromine, and is made by adding bro- 
mine to a solution of an alkaline li3Tdrate in alcohol or wood-spirit. BRYONIA. 
489 
Bromoform has been prescribed by Lowenthal especially for the 
treatment of whooping-cough* in from 2 to 5 drops three to four times a 
day, the most severe cases being perceptibly benefited within eight days. 
BRYONIA (U. S. P.).—Bryonia. 
Preparations. 
Tinctura Bryonia (U. S. P.).—Tincture of Bryonia. Bose, f3i-iv. 
Extractum Bryonia Fluidurn.—Fluid Extract of Bryonia. Bose, lfiv-xv. 
Bryonin.—The active principle. Bose, gr. ye- Vs- 
Pharmacology.—Bryonia alba and Biyonia dioica (Cucurbitacea?) 
are the officinal sources of the root known as Biyonia, which must be 
recently dried, as an old drug is useless ; the green root is preferred by 
some as being most active. Bryonin, a glucoside, is the principal con- 
stituent; it appears in pearly crystals or in white powder; it is very 
bitter; soluble in water and alcohol. 
Physiological Action.—The juice of the fresh plant blisters the skin. 
The drug, taken internally, acts as an irritant, and is a drastic purgative. 
It also increases the flow of urine. 
Therapy.—As there are better purgatives, biyonia is not required 
for this purpose. It is used, in small doses, in rheumatism, pleurisy, and 
other serious inflammations, after the fever has abated. It appears to be 
especially serviceable in the muscular pains and stiffness following colds. 
In chronic bronchitis it has been advocated; and also, by Petresco, in 
cases of haemorrhage, especially in epistaxis. 
BUCHU (U. S. P.).—Buchu. 
Preparations. 
Extractum Buchu Fluidurn (U. S. P.).—Fluid Extract of Buchu. Bose, Hlx-f3j. 
Infusum Buchu.—Infusion of-Buchu. Bose, i §ij. 
Pharmacology.—The leaves of Barosma betulina, B. crenulata, and 
B. serratifolia (Rutaceae),—the latter constituting “ long ” buchu, the first 
two “ short ” buchu,—coming from Southern Africa. They contain a 
volatile oil, which is the most active constituent, and is present in 
greater proportion in the short than in the long buchu. They also 
contain mucilage. A camphoraceous substance, barosma camphor, is 
deposited from the oil, in the cold. The recent infusion is made in the 
strength of one ounce to the pint. The fluid extract is made with dilute 
alcohol (alcohol, 2 parts; water, 1 part) and does not mix readily with 
water, on account of the presence of the oil and extractives. The dose 
of the fluid extract is one-half to one fluidrachm ; of the infusion, one-lnilf 
to two fluidounces. 
*See contribution by author on some “New Methods in Whooping-Cough,” in Medical 
Bulletin, December, 1890. 490 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Physiological Action.—Bnchu-leaves have a strong, mint-like odor 
and a bitter, pungent taste. When taken into the stomach a warming, 
carminative effect is produced by small doses, but very large ones cause 
irritation. The volatile oil diffuses into the blood, slightly stimulating 
the circulation, and especially acting upon the kidneys, increasing the 
quantity of the urine (both fluid and solid constituents being increased), 
and imparting to it a peculiar aromatic odor. In process of excretion 
the remedy acts as an astringent and disinfectant upon the urinary 
organs, especially the bladder. As a portion is eliminated by the 
bronchial mucous membrane, a stimulating influence is also exerted here 
in relaxed conditions accompanied by increased secretions. When used 
to excess or for a long period, the kidneys suffer and degenerative or 
inflammatory conditions are initiated. 
Therapy.—The principal use of this agent is for disorders of 
catarrhal character affecting mucous membranes, and diseases of the 
genito-urinary organs particularly. In incontinence of urine, or want 
of tone in the bladder, good results follow its administration. Through 
the enterprise of the owners of proprietary remedies, buchu has a popular 
reputation for the cure of gonorrhoea, but, owing to the quantity of 
alcohol contained in the fluid extract, it is not to be used during the 
existence of inflammation, and only with great care in chronic urethritis 
or gleet. 
There are many good reasons for believing that the much-advertised 
“ buchu cures ” for gonorrhoea contain no buchu-leaves whatever, but are 
made from the leaves of uva ursi and other domestic plants. In fact, 
buchu resembles oil of turpentine very much in its physiological effects 
and is useful in much the same class of cases. In gleet and chronic 
catarrh of the bladder unattended by kidney disease, buchu is highly 
serviceable :— 
II Sodii bromidi, 3iv. 
Tr. opii carnph., f§ij. 
Infus. buchu, fSjviij. 
M. Sig.: Take a tablespoonful every hour for irritability of the bladder, or vesical 
catarrh, and in pyelitis. 
BURSA PASTORIUS. 
Pharmacology and Therapy.—Shepherd’s Purse is a small plant be- 
longing to the Cruciferse, a native of Europe. It contains a volatile oil, 
resembling oil of mustard, a glucoside, bitter principle, resin, etc. Of 
the tincture, made with fresh leaves, the dose is TTLx-f‘5j to 5ivi given in 
cases of haemorrhage from the lungs, kidneys, or uterus, and also in 
diarrhoea and dysentery. CACTUS. 
491 
CACTUS.—Cactus. (Night-blooming Cereus.) 
Pharmacology and Therapy.—The Cereus grandiflorus (Cactaceae) is 
a plant of Mexico, with large, show}’, nocturnal-blooming flowers, of 
pearl-white petals, which have a heavy perfume. A tincture of the fresh 
stems and flowers (|iv-Oj alcohol) is claimed by Rubini to be a valuable 
cardiac tonic in doses of npi-v, three times a day. Probabty these doses 
might be much increased, as Kunge gave at once, and H. C. Wood 
was unable to perceive any effect from them at all. A difference 
might be accounted for on the ground that some use the fresh plant and 
others the flowers and leaves recently dried, the latter being the stronger 
preparation. Gregory claims that cactus increases the contractile power 
of the heart-muscle, regulates its rhythm, and improves its nutrition. It 
is claimed to be free from the unpleasant effect of digitalis. It is a special 
favorite with a class of practitioners who prefer to drop about a certain 
number of drops of the remedy in about a certain quantity of water, of 
which about a teaspoonful may be taken in about so many minutes in 
order to work the most miraculous medicinal effects. The influence of 
the mind upon the body and the therapeutic effect of expectant atten- 
tion are well illustrated by some of these cases. 
CADMIUM.—Cadmium. 
Preparations. 
Caclmii Sulplias.—Sulphate of Cadmium. Local use. 
Cadmii Iodidi.—Iodide of Cadmium (containing about 70 per cent, of iodide). 
Cadmii Iodidi Unguentum.—Ointment of the Iodide of Cadmium (3i-§j lard). Does 
not discolor the skin. 
Cadmii Oleas.—Oleate of Cadmium. See Oleates. 
Cadmium is usually found combined with zinc in the ores. It re- 
sembles tin in general appearance, and its salts are white and permanent; 
they are soluble in water. They are astringent, and resemble the corre- 
sponding zinc salts, producing emesis, but they are principally employed 
for their local effects. The ointment of the iodide, or the oleate, may be 
used in chronic enlargement of glands or joints, and especially in goitre. 
The sulphate may be employed as an astringent wash (in solutions gr. 
ii-5j), or as an ointment (1-40 benzoinated lard). 
CAFFEINA (U. S. P.).—Caffeine. See also Coffea 
Dose, gr. ii-x. 
Preparations. 
Caffeines Citras.—Citrate of Caffeine. Dose, gr. i-v. v 
Caffeines Sodio-Benzoas.—Sodio-Benzoate of Caffeine. Dose, gr. ii-x. 
Caffeines Sodio-Salicylas.—Sodio-Salicylate of Caffeine. Dose, gr. ii-x. 
Pharmacology.—Caffeine is a proximate principle of feebly-alkaloidal 
power, generally prepared from the dried leaves of Camellia tliea (Tern- 492 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
stromiaceae), or from the dried seeds of Caffea Arabica (Rubiaceae), or 
of Guarana or Paullinia sorbilis (Sapindaceae), and occurring also in 
other plants. Paraguay tea, or mate, the dried leaves of the Brazilian 
holly (Ilex Paraguensis), also contains caffeine, and is largely used as a 
hot beverage and stimulant in South America. It exists also in the 
kola-nut of Africa, the fruit of Sterculia acuminata (Sterculiaceae). It 
is closely related to theobromine, existing in theobroma cacao, and to 
cocaine, found in erythroxylon coca, both in chemical composition and 
effects upon the human body. 
The citrate of caffeine is most frequently employed in medicine 
on account of its greater solubility, but Tanret has recently shown that 
by the addition of an equal weight of salicylate or benzoate of sodium 
the solubility of caffeine is greatly increased. Antipyrin has also been 
found to have the same action, so that by this means the hypodermatic 
administration is greatly facilitated. Twenty-four grains of antipyrin 
will enable 15 grains of caffeine to dissolve in 1 ounce of distilled -water, 
with the aid of heat, forming a permanently limpid solution. 
Caffeine is in the form of colorless, silky, inodorous crystals, spar- 
ingly soluble in alcohol and cold water (75 parts), but much more 
soluble in boiling water (9.5 parts). It is precipitated from its aqueous 
solution by tannic acid, or solution of iodide of potassium and mercury ; 
with the latter reagent the deposit is crystalline, whereas, with other 
alkaloids, the product is always amorphous when this test is employed. 
Caffeine was first extracted from coffee in 1821, by Pelletier and Caventou, 
and Robiquet and Runge. According to Wurtz, it exists in coffee, 
tea, matd, and guarana, and chemically is methyl-theobromine (or tri- 
methyl-xanthine). The caffeine of commerce is usually made from 
damaged tea. 
Physiological Action.—Recently, it has been claimed by Dr. Mays 
that the physiological effects of the alkaloid obtained from coffee differ 
from those following the administration of caffeine from tea. It has 
been held that the well-known differences in the physiological effects of 
tea and coffee were due to other constituents, and especially to volatile 
oils, and in the ordinary method of manufacture these might still con- 
taminate the caffeine. Recently, it has been shown that Camellia thea 
contains another base,theophylline (Rossel, Zeitsclirift fur Physiologische 
Chemie), isomeric, but not identical with theobromine and paraxanthine. 
The presence of this base might also affect the physiological results. 
Mays claims that theine possesses analgesic properties which are absent 
in caffeine; and that the latter will not affect the heart, while the former 
causes palpitation. Theine, injected hypodermatically, produces local 
anaesthesia, whereas pure caffeine will not affect sensibility. Tanret and 493 
CAFFEINA. 
Fauvel, on the contrary, regard caffeine as an efficient local anaesthetic. 
Investigations with ordinaiy caffeine (theine) prove it to have very 
decided plysiological powers. There is, after its administration, at first 
increase, but later diminution, of the activity of the reflex centres of the 
spinal cord. In frogs, convulsions and muscular rigidity are caused ; the 
heart’s action is at first accelerated and afterward slowed. Arterial 
pressure at first rises, but subsequently falls. It has a decided diuretic 
action. The excretion of urea is at first increased, afterward diminished. 
Administered medicinall}', the rate of respiration is reduced, blood- 
pressure lowered; temperature slightly increased, afterwrard diminished. 
The cerebral functions are stimulated, and, in some persons, wakefulness 
results. It counteracts the effects of narcotic remedies, and is valuable 
in the treatment of opium poisoning, although not a complete antidote. 
When taken into the stomach, caffeine diffuses readily into the blood, and 
is eliminated by the kidneys and the liver, principally. Small doses in- 
crease the appetite and facilitate digestion; there is some irritation of 
the digestive tract, increasing peristalsis and in some cases causing 
venous congestion and haemorrhoids. From a dose of 12 grains of 
caffeine, Dr. Pratt experienced restlessness, sleeplessness, mental depres- 
sion, and tremor. A dessertspoonful of the citrate produced nausea, 
stupor, extreme pallor and debility, soft pulse, slow and sighing respira- 
tion ; but recovery followed the use of emetics, hot applications, and 
brandy. 
Therapy.—In migraine, caffeine citrate may be administered, 1 grain 
every hour, with excellent effect; or a cup of strong tea or coffee given. 
Where there is co-existing liver, kidney, or stomach disorder, this should 
also receive attention. Hemicrania may be relieved by the administra- 
tion of caffeine, and the hypodermatic injection of this agent is sometimes 
efficient in neuralgia; or, it may be administered as follows :— 
1$. Caffeinre citras, gr. xx. 
Phenacetin., 
Pulv. aromatic., . . aa 3ss. 
M. et ft. chartse no x. 
Sig.: A powder every two or three hours. Serviceable in migraine, and in neuralgia 
about the scalp, face, and in sciatica. 
$ Caffeinse eitras, gr. xx. 
Acetanilid., gr. 1. 
Ext. cannabis Indicse, gr. iij. 
M. etft. capsulm no. x. 
Sig.: A capsule every two or three hours for neuralgia. 
Caffeinse citrat., * 3ss. 
Ammonii bromidi, . . 3iij. 
Elix. guaranse, 
M. Sig.: A teaspoonful every hour or two until relieved of pain of neuralgia. 494 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
In despondency and hypochondriasis it will sometimes serve a good 
purpose. It may he given in order to dissipate the drowsiness which is 
often produced by a hearty dinner. 
As a cardiac stimulant in valvular disease, dilated or fatty heart, or 
in the myocarditis accompanying rheumatism, in low fevers, and in dropsy 
due to weak heart, caffeine may be given hypodermatically (gr. i-ij every 
two to four hours), or the sodio-benzoate may be employed as recom- 
mended b}7 Huchard. In chronic Bright’s disease it diminishes albu- 
minuria and dropsy. It may be used in co-operation with liydragogue 
cathartics in ascites. Uraemic coma may sometimes be lightened by the 
lijqiodermatic administration of caffeine. It may be used during the in- 
tervals of administration of digitalis, or, where this drug is too slow, 
given in the following combinations:— 
Caffeinae citratis, gr. 1. 
Liquor, potassii citratis, 
Spiritus aetheris nitrosi, 
Infus. digitalis, aa f§ij. 
M. Sig.: A half a tablespoonful in water every three or four hours. Employ in 
valvular insufficiency, attended with dropsy. 
In weak, dilated heart, with gouty tendency, and in nephritis, the 
following are useful:— 
Caffeinae citratis, * 
Lithii citratis. - aa gr. c. 
Strychninae sulphat., gr. 
01. gaultheriae, Illv. 
M. et ft. capsulae no. xx. 
Sig.: One every four hours. 
Caffeinae citrat., „ . gr. 1. 
Tinct. strophanthi, .. Ifllxx. 
Aquae camphorae, . f§ iij. 
M. Sig.: A teaspoonful three times a day. Use in parenchymatous nephritis attended 
with dropsy. 
In pneumonia, or congestion of the lungs with weak heart, in elderly 
patients, caffeine is an excellent remedy in moderate doses (gr. i-ij, 
given every two to four hours). It is likewise of vnlue in the weakened 
heart of typhoid fever and pneumonia, after the febrile stage has passed. 
In the diarrhoea of relaxation, typhoid fever, sporadic cholera, etc., the 
sodio-benzoate or sodio-salicylate may be used in combination with nux 
vomica or strychnine. 
Cholera infantum and the diarrhoea of phthisis are not infrequently 
benefited by caffeine. An asthmatic paroxysm may often be relieved by 
this remedy7. CAJUPUTI OLEUM. 
495 
CAJUPUT1 OLEUM (U. S. P.)—Oil of Cajuput. 
Dose, npi-v. 
Pharmacology.—The volatile oil of cajuput is of a green color, and 
lias a camplioraceous odor and neutral reaction. It is distilled from the 
leaves of Melaleuca cajuputi (Myrtaceae), a tree of the Moluccas. 
Physiological Action.—Locally it is rubefacient, antispasmodic, and 
antiseptic. It may also serviceably enter into the composition of a 
stimulating ointment for alopecia. This oil has been successfully used, 
suitably diluted with an emulsion, as an injection for ascarides or seat- 
worms. Internally it is carminative, diaphoretic and diuretic, and 
somewhat stimulating to the circulation. 
Therapy.—Externally it has been used as a counter-irritant, usually 
diluted with sweet-oil, in myalgia and cliilbains, and in various parasitic 
affections, such as tinea, pityriasis, eczema, scabies, etc. The oil of 
cajuput has been used with advantage to relieve the prostration of 
typhoid fever. This remedy is of service in intestinal colic, cholera 
morbus, and nervous vomiting, and it is said to allajT the pain of 
dysmenorrhoea. Its principal use internally is for its stomachic effects 
as an adjuvant to tonic remedies. It has been administered in com- 
paratively larger doses in the collapse stage of cholera, with 
good results. It is claimed to be useful in rheumatism and in various 
skin diseases. 
/ 
CALAMUS (IT. S. P.).—Calamus, Sweet Flag. 
Preparation. 
Extraction Calami Fluidum (U. S. P.).—Fluid Extract of Calamus, jDose, Hlxv-f3j. 
Pharmacology.—The scraped and dried rhizome of Acorns calamus 
(Aracese) is slightly aromatic and quite pungent to the taste, and is car- 
minative. It contains Acorin, a nitrogenous principle, a volatile oil, 
benzoic acid, etc. 
Therapy.—In consequence of its feebly-aromatic taste, calamus is 
sometimes useful in overcoming a tendency to flatulence, by chewing it 
slowly and swallowing the saliva. It is used also as a substitute for 
tobacco by those accustomed to chewing the weed. It is a constituent 
in various “ bitters ” used as appetizers and stimulants. An infusion 
(Ii-Oj) ma}' be administered in wineglassful doses as a stomachic tonic. 
CALCIUM.—talcium. 
Officinal Salts. 
Calx (U. S. P.).—Quicklime. Not used internally. 
Calx Chlorata (U. S. P.).—Chlorinated Lime (available chlorine, 25 per cent.). 
Calx Sulphurata (U. S. P.).—A mixture of Sulphide and Sulphate of Calcium, con- 
taining not less than 36 per cent, of absolute sulphide of calcium. Dose., gr. K-b- 496 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Calcii Chloridum (U. S. P.).—Chloride of Lime. Dose, gr. i-xx. 
Calcii Hypophosphis (U. S. P.).—Hypophosphite of Lime. Dose, gr. x-xx. 
Calcii Bromidum (U. S. P.).—Bromide of Calcium. Dose, gr. x-xxx. 
Calcii Carbonas Precipitates (U. S. P.).—Precipitated Carbonate of Calcium. Dose, 
gr. x-xl. 
Calcii Phosphas Precipitates (U. S. P.).—Precipitated Phosphate of Calcium. Dose, 
gr. x-xxx. 
Greta Preparata (U. S. P.).—Prepared Chalk. Dose, gr. x-xx. 
Preparations. 
Syrupus Calcii Lactophosphatis (U. S. P.).—Syrup of Lactophosphate of Lime (gr. 
Dose, f3i-ij. 
Syrupus Calcis (U. S. P.).—Syrup of Lime (calcium hydrate, 5 per cent.). Dose, 
f3ss-j. 
Synipus Hypophosphitum (U. S. P.)—Syrup of the Hypophosphites (lime, gr. iij; 
potassium, gr. j ; sodium, gr. j ; in f3j). Dose, f3ss-ij. 
Spmpus Hypophosphitum cum Ferro (U. S. P.).—Syrup of the Hypophosphites with 
Iron (1 per cent, lactate of iron). Dose, f3i—ij. 
Hydrargyrum cum Greta (U. S. P.).—Mercury with Chalk (mercury 38, chalk 50, 
milk-sugar 18 parts). Dose, gr. i-xx. 
Trochisci Cretce (U. S. P.).—Chalk Lozenges (prepared chalk, 4 grs. each). Dose, 1 or 
more. 
Pulvis Cretce Composites (U. S. P.).—Prepared Chalk-Powder (prepared chalk 30, 
acacia 20, sugar 50 pasts). Dose, gr. v-xxx. 
Mistura Cretce (U. S. P.).—Chalk Mixture (compound chalk-powder 30, cinnamon- 
water and water aa 40 parts). Dose, f3i-iv. 
Liquor Calcis (U. S. P.).—Lime-Water (contains about 15 per cent, calcium hydrate). 
Dose, f^ss-ij. 
Linimentum Calcis (U. S. P.).—Lime Liniment (equal parts lime-water and cotton- 
seed-oil. 
Potassa cum Calce (U. S. P.).—Vienna or Caustic Paste (equal parts caustic potassa 
and lime). 
Testa Preparata.—Prepared Oyster-Shell. Dose, gr. v-xx. 
Liquor Calcis Chloratce.—Solution of Chlorinated Lime (13 grains of available 
chlorine in each ounce). A disinfectant. 
Lotio Hydrargyri Nigra.—Black Wash (calomel, gr. xxx; lime-water, f 
Lotio Hydrargyri Flava.—YeUcm Wash (corrosive sublimate, gr. xviij ; lime-wTater, 
f§x). 
Pulvis Cretce Aromaticus cum Opio.—A mixture of Aromatics w ith Chalk, containing 
1 grain of opium in 40). Dose, gr. x-xx. 
Calcii Carbolas.—Carbolate of Lime. Used as a disinfectant. 
Pharmacology.—Lime is the oxide of a metallic element, calcium, 
which, like potassium and sodium, decomposes water at ordinary tem- 
peratures. Calcium oxide, when fresh from the lime-kilns, is in large, 
hard, gra}dsh masses, constituting what is known as quicklime, which 
has a great affinity for water, even taking it from the air. Under the 
influence of moisture, lime generates heat and breaks up into a wet 
powder, which is a mixture of calcium oxide and calcium carbonates, and 
constitutes slaked lime. Calcium oxide is more soluble in cold than in 
hot water. Chalk, or calcium carbonate, is a valuable antidote in cases CALCIUM. 
497 
of poisoning by carbolic, sulphuric, or oxalic acids. It is found in the 
household in tooth-powder, convenient for prompt administration. 
Physiological Action.—Some preparations of lime are sedative, others 
astringent or caustic ; quicklime is irritating and caustic to mucous 
membranes. Lime-water and chalk are astringent and alkaline ; they re- 
duce the acidity of the contents of the alimentary canal, thus relieving 
irritation, and also exert a slightly astringent effect. In patients suffering 
from deficiency of lime in the food, lime-water is a useful and acceptable 
remedjr, and may be continued for a long time. The chloride of calcium 
is more of an irritant; it has a reputation for its influence as an altera- 
tive in strumous patients. Vienna paste is used in surgery as a caustic. 
Therapy.—Lime is an ingredient in depilatory powders, which are 
now superseded by the process of removal of hair by electrolysis. 
Freshly-slaked lime absorbs the products of decomposition, and is used 
as a disinfectant in cess-pools, manure-heaps, etc.; but the chlorinated 
lime, which prevents decomposition by virtue of the available chlorine, is 
far better. Lime-water is a stimulating dressing for wounds and ulcers, 
and, combined with oil, is used as a dressing for burns. Carron-oil con- 
sists of linseed-oil and lime-water, but the pharmacopoeia directs cotton- 
seed-oil instead, which is cleaner. A better dressing is made by beating 
up lard (unsalted) with lime-water and adding a few drops of oil of 
bitter almonds. A xery good prescription to use in burns will be :— 
Calcis prsecip., 3j. 
Aeidi carbolici, §ss. 
01. olivae, 
Aquae calcis aa f^y.—M. 
Lime-water is of undoubted value alone, or combined with gtycerin, 
in the treatment of acute vesicular eczema. It may be emplot'ed for 
this as wnll as other varieties of eczema, especially when the surface is 
dry and irritable, with,very great relief. Pruritus, which often becomes 
intolerable in eczema and other inflammatory affections of the skin, and 
itching present in old persons, may be relieved or cured by the appli- 
cation of lime-water, with rose-water, glycerin, or one of the oils. A 
very suitable application in the diseases just referred to is :— 
IJ: Liquor, calcis, f^iij. 
Creasoti, Nix. 
Pulveris zinci carb. (impur.), §j. 
Glycerini vel ol. olivae, fgiij. 
M. Sig.: Shake well and mop over the surface. 
In seborrhoea, hyperidrosis, bromidrosis, and in bruises of the skin 
and deeper structures, the preparations o£ calcium, especially lime-water, 498 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
are often used with great benefit. The following are excellent combina- 
tions :— 
Caleis praecip., §j. 
Liq. boroglyceridae (50 per cent.), f^ss. 
M. Sig.: Smear over the parts bruised. 
Calcii chloridi, 
Caleis praecip., 
Pulv. amyli, aa 
M. Sig.: Dust over the surface, especially in oily conditions of the skin and in 
excessive and fetid perspiration. 
Prepared chalk is employed very largely, alone as well as an ingredient 
of many very good dentifrices, on account of its antacid, astringent, and 
sedative action upon the gums and the mucous membrane of the buccal 
cavity. Garretson recommends the appended formula as being a good 
tooth-powder:— 
Cretae prepar., 
.Pulv. iridis flor., ......... aa 
Pulv. ossis sepiae, 3ij 
Olei limonis, q. s.—M. 
The preparations 'of calcium are especially useful in childhood be- 
cause of the deficiency of lime in the food of man}' children. Lime- 
water added to milk gives material for bones and teeth, improves 
nutrition, and overcomes a tendency to rickets. It relieves irritability 
of the stomach and vomiting. 
The syrup of lime contains more of the base than the solution, and 
is a convenient antidote to poisoning by oxalic, sulphuric, and other 
mineral acids. In children’s diarrhoea, often due to sour stomach, chalk 
mixture is very useful, and may be combined with an antiseptic and 
opiate:— 
Creasoti, HUv. 
Tinct. opii camph., f3j. 
Mist, cretae, q. s. ad i§ij. 
M. Sig.: A teaspoonful every two hours in a child two years old. 
The same mixture is useful in adults, with corresponding increase 
of dose and the addition of a decided astringent, such as tincture of 
kino, or fluid extract of coto-bark. 
Other very effective prescriptions containing lime are:— 
$ Calcii carbonas precipitati, 3iij. 
Tincturae catechu, f§j. 
Tincturae opii, f3ij. 
Spiritus chloroformi, f3iv. 
Pulveris acaciae, 3ij. 
Aquae menth. pip., ffviss. 
M. Sig.: One or two tcaspooniuls in water every hour or two, for acute diarrhoea. f CALCIUM. 
499 
Liquor, calcis, 
Ext. coto corticis fl., 
Syrup, acaciae, aa f 
M. Sig.: From one to two teaspoonfuls in water or milk every three or four hours, 
for chronic diarrhoea. 
Special Applications.—In very young children, lime-water alone is 
sufficient, where the motions are too frequent and watery, and acid in their 
reaction. It is also used per enema against thread-worms, and it may he 
given as an injection in leucorrhoea. In diphtheria, much relief is ex- 
perienced from the use of a spray of lime-water, preferably with the 
steam-atomizer, directed to the fauces, or from inhaling the vapors from 
slaking lime ; it is claimed that the lime loosens the false membrane and 
partially dissolves it. It is also useful in the same manner in croup and 
plastic bronchitis. In adults, where it is desirable to administer milk, it 
is often found necessary to add lime-water to it to prevent curdling. 
Milk and lime-water will not infrequently relieve gastralgia, and even, in 
some instances, the pain of gastric carcinoma. In the latter affection it 
also allays the vomiting. The prolonged administration of lime-water 
renders the urine alkaline, and hence it may prove useful in lithiasis. In 
combination with opium and aromatics, as in the pulvis cretae aromaticus 
cum opio of the British Pharmacopoeia, chalk is of great value in diar- 
rhoea. The carbonate of calcium is likewise beneficial in diarrhoea, and, 
finely powdered, is a good application in intertrigo and acute eczema. 
The phosphate of lime is useful in rickets; also in anaemia, general debility, 
diarrhoea, in small doses, given frequenly; it appears to have a stimulat- 
ing effect upon the liver, and should be given in preference to mercury to 
infants with claj-colored stools, and in jaundice. The anaemia due to 
profuse suppuration, or to lactation, may be remedied by the administra- 
tion of this salt. It is advantageous, moreover, in mollities ossium, 
delayed union of fractured bone, caries and necrosis, and scrofulous in- 
flammation of the lymphatic glands. 
Calx sulphurata is useful in styes, acne, and furuncles; given in 
gr. doses several times a day, it hastens maturation of pustules. If 
given early, it prevents the formation of pus, but if suppuration has 
occurred the sulphide of calcium limits its extent and favors early and 
complete evacuation. This combination is serviceable in both acute and 
chronic eczema. It is likewise beneficial in the suppuration of scrofulous 
glands. It is given with good' effects in ophthalmia and sores in 
scrofulous children. Calx sulphurata is the officinal equivalent of sul- 
phide of calcium. 
Chloride of calcium (not calx chlorata) is given, well diluted, in 
glandular enlargements, and is said to be curative in eczema and lupus; 500 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
it is claimed that it aids cicatrization in tubercular ulcerations, and is 
useful in chorea and colliquative diarrhoeas in strumous children. The 
hypophosphite of lime has a special reputation for the treatment of 
phthisis, and is a useful tonic in such cases. The compound syrup of 
the hypophosphites with iron or strychnine, in appropriate cases, is one 
of the best general systemic tonics that we possess, especially when pre- 
scribed as follows :— 
Syrup, hypophosphitum comp., fjiv. 
Syrup, ferrl lactatis, f§iv. 
Strychnin® sulphatis, gr- K- 
M. Sig.: A half-tablespoonful in water three times a day. 
The bromide of calcium was brought forward (by Hammond) as a 
substitute for the potassium salt in cases where the depressing effects of 
the latter would forbid its use, such as epilepsy or chorea, in anaemic 
subjects (in doses of f'5ss-ij),but it is seldom used. Hugh Woods prefers 
the calcium oxyiodides to the other iodine preparations, as containing 
more iodine. The syrup of the hictophosphate of lime (made by dis- 
solving phosphate of lime in lactic acid, with orange-flower water and 
syrup) is a pleasant and very useful remedy for improving nutrition in 
young children, especially if there be a scrofulous taint. It contains 
about 12 grains of lime phosphate in each ounce. It is also a valuable 
agent in treating many skin diseases due to malnutrition. This combi- 
nation may be advantageously prescribed, in vesicular emphysema, 
chronic bronchitis, phthisis, debility, and wasting diseases, thus :— 
Syrup, ealcis lactophosphatis, f§iij. 
Olei gaultheri®, Hlxxx. 
Pulveris acaciae, . 3j. 
Liquor, pancreatici, f^j. 
Glei morrhuae, f§v. 
M. et ft. emulsio. 
Sig.: A tablespoonful three times a day. 
Hi’. H. V. Knaggs ascribes valuable antispasmodic properties to 
calcium sulphite, in spasmodic diseases. He gives gr. to a child 1 year 
old suffering with convulsions from dentition, meningitis, and even acute 
tuberculosis. A saturated aqueous solution of the bisulphite is an excel- 
lent non-poisonous disinfectant. The preparations of chalk, if given in 
large doses for a considerable period of time, may form intestinal con- 
cretions. 
CALENDULA (IT. S. P.).—Marigold. 
k 
Preparation. 
Tinctura Calendula (U. 8. P.).—Tincture of Calendula (20 per cent.). Dose, f3»8-j. 
Pharmacology and Therapy.—The fresh flowering herb of Calendula 
officinalis (Composite) contains a volatile oil, an amorphous bitter prin- CALUMBA. 
501 
ciple, Calendulin, yellow coloring matter, etc. It is used as an emmeua- 
gogue and as a diaphoretic, in recent infusion. In the form of tincture, 
it is reputed to be tonic, antispasmodic, and alterative, and may be em- 
ployed locally as a revulsive in sprains, bruises, or in superficial burns 
and scalds, resembling arnica in its applications, though less active. 
CALUMBA (U. S. P.).—Calumba, Columbo. 
Dose, gr. v-x. 
Preparations. 
Extraction Calumbce Fluidum (U. S. P.).—Fluid Extract of Calumba. Done, 
nIxv-xxx. 
Tinctura Calumba; (U. S. P.).—Tincture of Calumba. Dose, f 3i-ij. 
Extract-urn Calumbce.—Extract of Calumba. Dose. gr. ss-ij. 
Pharmacology.—The root of Jateorrhiza calumba (Menispermacete) 
of Africa contains, among its constituents, berberine, calumbin, calumbic 
acid, and starch. It is free from tannin, and therefore its preparations 
may be combined with iron. 
Physiological Action and Therapy.—In composition and physiological 
action, calumba resembles quassia and gentian, though lighter and more 
agreeable than some of the other remedies of this class, and more accept- 
able to the stomach. As a bitter tonic, calumba may be used during 
convalescence, or in atonic dyspepsia or other enfeebled constitutional 
conditions. It is believed to be somewhat sedative and antispasmodic; 
in cases where this quality is required it would be better to use the fluid 
extract or powder than the tincture. A small dose of the tincture or 
infusion of calumba will often relieve nausea and vomiting. Atonic 
diarrhoea is benefited by calumba. When prescribed as an appetizer, 
the danger of forming the alcohol habit should be kept in mind:— 
Ext. calumbae, . gr. ij. 
Sodii bicarb., gr. x. 
Pulv. rhei, gr. v. 
Pulv. zingiberis, gr. x. 
M. et ft. capsulae, mitte tales no. xxx. 
Sig.: Take one before each solid meal, for weak digestion. 
CAMBOGIA (U. S. P.).—Gamboge. 
Dose, gr. 
Pharmacology.—Gamboge is obtained from the Garcinia Hanburii 
(Guttiferce), a tree of Siam. It is a gum-resin, consisting largely of 
gam bogie acid (13 per cent.), and is partly soluble in alcohol and ether, 
and forms an emulsion with water. It has no officinal preparations, and 
is never administered by itself, but is a constituent of the compound 
cathartic pill (each pill containing gr. of gamboge). 502 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Physiological Action.—Gamboge is not a systemic but a local irri- 
tating purgative. It is at first tasteless, but afterward produces an 
acrid taste, with increased secretion of saliva. In the intestinal tract, it 
has a drastic, hydragogue, cathartic effect. It stimulates the intestinal 
glands, but not the liver (Rutherford), and is also believed to have some 
power as a diuretic, as it imparts a bright-yellow color to the urine. It 
carries off the bile in the intestinal canal and prevents re-absorption. 
Large doses cause vomiting and gastro-enteritis. 
Therapy.—Gamboge has no local effect beyond staining the skin. 
It was formerly used in cardiac dropsy to carry off large quantities of 
fluid and promote absorption, but the compound jalap-powder accom- 
plishes this result more quickly, agreeably, and certainly. The compound 
cathartic pill is a good remedy for constipation and at the beginning of 
the treatment of malarial poisoning. In minute doses (gr. every 
hour or two) it is claimed that gamboge would afford much relief in flatu- 
lence and intestinal indigestion. 
CAMELLIA.—Tea. 
Preparations. 
Extmctum Camellia; Fluklum.—Fluid Extract of Camellia. Done, fllx-f3j. 
Infusum Camellue.—Iufusion of Tea (prepared extemporaneously). Dose, f^ii-vj. 
Pharmacology.—The extemporaneously-prepared infusion of the 
dried leaves of Camellia tliea (Ternstromenceae), or Chinese tea-plant, is 
now so widely used at the table as a beverage that it has given its name to 
the evening meal. It contains caffeine (or tlieine), theophylline(Rossel),* 
a volatile oil, tannin, etc. Green tea is made from the younger leaves, 
dried with a moderate heat, so as to retain their color (sometimes fraudu- 
lently colored with Prussian blue, turmeric, and copper), while the black 
tea is made of the older leaves, and contains more tannin. 
Physiological Action and Therapy.—The effects of tea are not fully rep- 
resented by caffeine; probably theophylline, which is isomeric writh theo- 
bromine, and the volatile oil assist in producing its physiological action 
upon the system. It is an antidote to narcotic poisoning by virtue of its 
caffeine, and to antimony and many alkaloids on account of its tannin ; 
it is also a physiological antidote to agents which depress nerve-function 
or the heart. In small doses (3i—ij) infused with boiling water, tea is an 
agreeable stimulant, removing a sense of fatigue and giving a feeling of 
well-being. It is useful in headache from overwork or worry, and will 
-often relieve migraine. Tea is an accessory food, but, on account of its 
convenience, it often becomes the principal article of food for persons who 
think that they cannot spare time to prepare a full meal, or have not the 
appetite to eat it. In many cases of what has been called tea-drinkers’ 
*Zeitselirift fur Physiologisclies Clieiuie. Therapeutic Gazette, March 15, 1890. CAMPHORA. 
503 
dyspepsia, in sewing-women, it is found, upon inquiry, that the tea is 
drunk with every meal, and that veiy little food is taken with it except 
bread or hot biscuit. Such cases of debility', palpitation of the heart, 
anaemia, flatulence, anorexia, constipation, etc., are not really instances 
of “Theism,” but cases of starvation, and require good food, sunlight, 
exercise, and tonics. Men who deal in tea, and constantly taste it, only 
exceptionally show symptoms of nerve-disorder aseribable to this cause ; 
even then it may be due to idiosyncrasy, for persons have different degrees 
of susceptibilit}" to the effects of tea. Some cannot use it at all; others 
are proof, apparently, against any ill effects. Many can drink black tea 
who cannot stand the effects of green tea. 
The fluid extract of tea may be used with good effect in low fevers 
as a stimulant, and in typhoid pneumonia, in the same class of cases as 
mentioned under the head of Caffeine (see page 493). 
CAMPHORA (U. S. P.).—Camphor. 
Dose, gr. i-ij. 
Preparations. 
Oleum Camphorce.—Oil of Camphor. Dose, TTli-iij. 
Aqua Camphorce (U. S. P.).—Camphor-Water (gr. Dose, f3i-iv. 
Spiritus Camphorce (IT. S. P.).—Spirit of Camphor (10 per cent.). Z>ose,*Hlv-xx. 
Linimentum Camphorce (U. S. P.).—Liniment of Camphor (camphor 20, cottonseed-oil 
80 parts). External use. 
Ceratum Camphorce (U. S. P.).—Camphor Cerate (3 per cent.). 
Camphora Monobromata (U. S. P.).—Monobromated Camphor. Dose, gr. i-v. 
Camphor is also a constituent of soap-liniment, camphorated tincture of opium, lini- 
ment of belladonna, compound mustard-liniment, chloroform mixture, and of compound 
morphine-powder. 
Pharmacology.—The camphor-tree, Cinnamomum camphora (Lau- 
raceas), is a native of the East Indies and China; it contains a solid, 
volatile, fatty substance, or stearopten, which exists in all parts of the 
plant or crystallizes naturally in the wood and under the bark. As col- 
lected by natives, it is called crude camphor, which is purified in this 
country by sublimation. Camphor is in white, translucent, parth’-crys- 
talline masses, of penetrating, aromatic odor and a cool, acrid taste. It 
is lighter than water, in which it is \ery sparingly soluble, but is 
readily dissolved by alcohol and ethereal substances. Camphor is quite 
soluble in milk, which may often, therefore, be used as a convenient 
vehicle. It is easily ignited and burns with a smoky flame. With chloral 
hydrate, camphor combines when triturated (equal parts), forming an 
oily liquid. When three parts of camphor are rubbed with one part of 
crystallized carbolic acid, a clear liquid is formed. Camphor cannot be 
powdered by trituration alone, but can be when moistened with alcohol, 
chloroform, or ether. 504 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Physiological Action.—When applied to the skin, camphor slightly 
irritates and reddens the surface, and probably diffuses through into the 
deeper structures, so as to exert a local sedative effect. In considerable 
doses, camphor causes vertigo and confusion of ideas, diaphoresis, 
delirium or stupor, followed by epileptiform convulsions and maniacal 
excitement. There is lowering of the reflex excitability of the spinal 
cord and muscular weakness. Upon the circulation a stimulating effect 
is observed from small doses and the arterial tension is raised, but larger 
doses cause prostration and weakness of the heart’s action. Camphor is 
antispasmodic, and is a valued sedative in allaying abnormal nervous 
excitability often encountered in women, especially in cases where opium 
disagrees or is undesirable. It is, in full doses, a sedative to the genera- 
tive functions and allays pain attending menstruation. Poisoning has 
followed the use of a saturated solution in alcohol (Rubini’s tincture, or 
so-called “ mother-tincture ”), which should not be used, as so small a 
quantity as 7 minims have produced poisonous effects. Toxic doses give 
rise to inflammation of the stomach. In cases of poisoning, if any of the 
drug remain in the stomach it should be removed by the stomach-tube, 
the patient allowed to drink cold water freely, magnesium sulphate (Jj) 
given, and the S}’mptoms combated with arterial stimulants and hypo- 
dermatic injections of morphine and atropine. 
Therapy.—Camphor is highly prized in the household, for head- 
aches and various neuralgic pains, the spirit or “ Eau Sedative ” being 
applied upon a flannel bandage. It is also a common ingredient in 
popular liniments. 
Camphor-chloral is used in neuralgia and myalgia as a rubefacient 
and anodyne. It dissolves morphine readily :— 
Morphinae sulphat., gr. xx. 
Camphor, chloral., 3ij.—M. 
For local application to painful spots. 
Campho-phenique (camphor and carbolic acid) is a valuable anti- 
septic dressing for wounds, the odor being more pleasant than that of 
carbolic acid, and, the solution being anodyne, it cannot be diluted 
with water or glycerin, but mixes with oil or ointments. Salol and 
camphor and beta-naphthol and camphor also form fluids having a val- 
uable antiseptic power. A solution of camphor in ether (30 in 180) has 
been applied to erysipelatous inflammation with benefit. Camphor has 
been used for the purpose of aborting boils. The seat of inflammation is 
touched three times a day with an alcoholic solution, and, after this has 
evaporated, the surface is covered with camphorated oil. A saturated 
solution of camphor in cologne-water gives relief in the headache which 
may occur at the menopause. Camphor and morphine, incorporated in CAMPHORA. 
505 
a flaxseed poultice, allay toothache. A liniment or ointment contain- 
ing camphor is useful in chilblains. The camphor ointment of our 
National Formulary may be used as an application to indolent ulcers. 
Camphor, either alone or combined as follows, yields serviceable anti- 
pruritics in eczema and parsesthesia :— 
$ Camphorae, 
Beta-naphthol., aa gr. x. 
M. et adde 
01. antheraidis, TT\v. 
Bismuth, subnit., 3j 
Pulveris marantae, 3j. 
Ungt. zinci oxidi, §j.—M. 
Camphorae, . gr. x. 
Sulphuris sublimati, 3SS- 
Ol. eucalypti, . Itlx. 
Creasoti, ITlviij. 
Ungt. aquae rosae, 
Ungt. zinci oxidi, aa §ss.—M. 
Camphor with salicylic acid (14 to 11) combines with the aid of heat, 
and, in the form of ointment, has been used in lupus and chronic ulcers. 
The odor of camphor is inhaled with some relief in coryza. Camphor 
cerate is a useful application for chapped hands and roughness of the 
skin, or the camphor can be incorporated in suet or lanolin :— 
Camphorae, 3ss. 
01. neroli, ITliij. 
Acidi carbolici, ITliv. 
Sevi, §ij. 
M. Sig.: Rub a small piece in the palm of the hand until soft, and apply over the 
surface for chronic eczema, chapped hands, fissures on the lips, at the angle of the mouth, 
or around the nipples, anus, or genital organs. 
II Camphorae, gr. xx. 
01. juniperi, lllxx. 
Lanolin.,. §j. 
M. Sig.: Use in the diseases above named. 
Internally, camphor is valuable as an anodyne, antispasmodic, and 
carminative, in disorders of the digestive organs attended with pain or 
cramps, and is combined with astringents and opiates. Vel- 
peau’s diarrhoea mixture consists of equal parts of spirit of camphor, 
tincture of opium, and compound tincture of catechu. 
In diarrhoea, Hope’s camphor mixture is useful (see page 381), 
especially in diarrhoea of relaxation in elderly subjects. Parrish’s 
camphor mixture (mistura camphorae aromatica, N. F.) is also valued :— 
Tr. lavandulae co., f^iv. 
Sacchari, §ss. 
Aquae camphorae, f^xvj. 
M. Sig.: A tablespoonful every three hours for diarrhoea. 506 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
This remedy is likewise very serviceable in infantile diarrhoea. It 
has been found efficient in Asiatic cholera, provided it be given at the 
inception of the disease. 
Camphor in 2-grain pills is serviceable in dysmenorrhoea, hysteria, 
and obscure nervous manifestations in women. It may likewise be 
given to relive palpitation of the heart. The monobromate of camphor 
is esteemed a valuable remedy in chordee and irritable bladder; it has 
also been used in spasmodic affections, hysteria, epilepsy, chorea, delirium 
tremens, whooping-cough, etc. 
Camphor*, gr. xx. 
q.s. ad ft.pulv. 
Ammonii carbonat., gr. xvj. 
Pulv. opii, gr. iv. 
M. et div. in char.tulas no. xij. 
Sig.: Give one every two or three hours, in coryza. 
It is a curious fact that the addition of a few drops of camphor to a 
glass of water will, when injected into the rectum, produce a prompt 
evacuation of the bowels, thus offering a means of overcoming a tend- 
ency to constipation. Camphor has at times been successfully employed 
in the management of mania, melancholia, and delirium tremens. A 
combination of camphor and opium relieves the after-pains of labor. 
The same drugs are advantageously given in the form of a suppository 
after operations upon the urethra, and in prostatorrhoea (enlarged pros- 
tate), cystitis, and, in fact, in all diseases of the genito-urinary organs, 
according to these formula}:— 
Camphor*, 
Iodoform, vel aristol. vel iodol., aa 3j. 
01. theobrom*, q. s. 
M. et ft. suppos. no. xv. 
Sig.: Insert one when necessary into the bowel. 
Camphor*, 
Lupulini, aa 3j. 
Ext. belladonn* ale., gr. iiss. 
01. theobrom*, q.s. 
M et ft. no. x. 
Sig.: Insert one in the bowel every two or three hours. 
Camphor escapes from the system largely by the bronchial mucous 
membrane, and is a useful remedy in chronic bronchitis, especially when 
occurring in the weak or aged, or associated with emphysema. Its 
stimulant virtues render it useful also in capillary bronchitis and typhoid 
pneumonia. This substance may, in fact, be very serviceably adminis- 
tered in typhus or typhoid fever, or in the eruptive fevers, in order to 
strengthen the action of the heart. Camphor given in these combinations 
will be found of service:— CANNABIS AMERICANA 
507 
Camphor®, gr. xv. 
HDtheris, q.s. ad ft. pulv. 
Ammonii chloridi, 
Pulv. ipecacuanh® comp., aa 3ss. 
M. et ft. chart® no. xv. 
Sig.: A powder every hour or two until relieved, in bronchitis and in pneumonia. 
I£ Aqu® camphor®, 
Liquor, ammonii acetatis, 
Viui erythroxyli, aa f§ij. 
Sig.: From one-half to a tablespoonful in water every two or three hours, in fevers 
and in all cases of debility, to give strength to the action of the heart. 
Camphorated oil is an excellent application to swollen and painful 
breasts during lactation. 
Borneol is an artificial camphor, obtained from oil of turpentine by 
treating it with hydrochloric acid. It is said to be identical in chemical 
composition, and to closely resemble, in its physical characters, the 
natural camphor. According to Stockman, it has the same effects upon 
the circulation, but shows a tendency to depress or paralyze the pneumo- 
gastric nerves, and leads to palpitation of the heart. 
Camphoric Acid is the product of the oxidation of camphor with 
nitric acid. The 1-per-cent, solution in water may be used in laryngo- 
logical practice as a spray in catarrhal affections ; it probably exerts 
some antiseptic as well as a sedative effect. In combination with other 
remedies, such as boric acid, or borate of sodium, it is valuable in treat- 
ing strangury and irritability of the bladder; and in the night-sweats of 
phthisis. Wood recommends it in spermatorrhoea and in enuresis; it 
has also been thought to have some influence over epilepsy, chorea, hys- 
teria, and other spasmodic affections. When aniline and camphoric acid 
are heated, they combine, forming rose-colored crystals, which are solu- 
ble in ether or glycerin, and may be used (dose, gr. 1-4) in spasmodic 
affections. 
CANNABIS AMERICANA (U. S. P.).—American Hemp. 
CANNABIS INDICA (U. S. P.).—Indian Hemp. 
Preparations. 
Extractum Cannabis Indicce (U. S. P.).—Extract of Indian Hemp. Dose, gr. ss. 
Extractum Cannabis Indicce Fluidum (U. S. P.).—Fluid Extract of Indian Hemp. 
Dose, )ki-xx. 
Tinctura Cannabis (U. S. P.).—Tincture of Indian Hemp (20 per cent.). Dose, 
nfx-xx. 
Cannabince Tannas.—Tannate of Cannabin. Dose, gr. i-x. 
Pharmacology.—The Cannabis sativa (Urticacese), grown in the 
Southern United States and collected while flowering, constitutes Can- 
nabis Americana, of which there are no officinal preparations. It should 508 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
not be confounded with Asclepius incarnata, which is sometimes called 
white Indian hemp, or with Canadian hemp or apocynum (see page 448). 
The flowering tops of the female plant of Cannabis sativa, grown in the 
East Indies, constitutes Indian hemp. A confection made from it is 
“ haschisch ” or “ gunjah an inferior kind is known as “bhang.” The 
American and East Indian plants are botanically the same, but the latter 
contains a larger quantity of the active principles, which are a resin, 
Cannabin, and a volatile oil. From the latter may be obtained Canna- 
bene, of which the hydride is a crystalline substance. Cliurrus is the 
native name for the impure or crude resin. 
Physiological Action.—Indian hemp has no local action. Upon the 
digestion or circulation no marked effect is produced. It acts like opium 
in first stimulating the nervous system and afterward depressing the 
vital functions. The primary stage of intoxication is accompanied by 
exhilaration, which lasts for some time before sleep occurs. During this 
period the imagination is actively engaged, intent upon visions of its 
own creation, which at first are pleasant, but which after awhile become 
disagreeable, like the hallucinations of delirium tremens. It is noticed, 
as one of the earliest manifestations of the toxic effect, that ideas of 
distance and relation are remarkably perverted; on account of the 
rapidity of the mental operations, the ideas of space and time arejexag- 
gerated so as to be almost intolerable, and there is often a curious 
sense of double consciousness. Numbness and tingling in the extremi- 
ties are observed, followed by anaesthesia and diminution of muscular 
sense. Cannabis is antispasmodic, analgesic, hypnotic, and aphrodisiac. 
If a large dose be taken, coma or catalepsy may supervene, but a fatal 
effect rarely follows. The subsequent results from indulgence in this 
drug as an intoxicant are dullness and lassitude, vertigo and headache, 
diuresis, but not constipation. Frequent use of the drug brings about 
mental deterioration and unfitness for labor. 
Therapy.—Owing very largely to the uncertain quality of the drug, 
hemp has not been used to the extent that its physiological action 
would warrant. This has now been corrected so that reliable prepara- 
tions may be obtained from reputable drug-dealers, and we may look 
forward to a revival of its use; but it is not probable that in this 
country it will be ever used as an intoxicant as it is in India. In acute 
mania it has been used, in combination with potassium bromide, with 
excellent results. Cannabis Indica may be successfully prescribed in 
order to combat the wakefulness of delirium tremens, and good results 
have been ascribed to it in the management of tetanus. It has been 
used with advantage in chorea, and may sometimes be of avail in epi- 
lepsy. Amelioration has been produced by this remedy in senile trembling CANNABIS INDICA. 
509 
and paralysis agitans. In neuralgia and migraine good results follow its 
cautious use. In other painful affections cannabis Indica may be resorted 
to with advantage. It may be employed to mitigate the suffering caused 
by the passage of a hepatic or renal calculus. In acute or chronic rheu- 
matism. in gout, and in carcinoma, hemp may often be very serviceably 
substituted for opium, over which it has the advantage that it does not 
derange the secretions. In various uterine disorders it is used to relieve 
pain and bring about contraction of uterine muscular fibre. The pain 
of dysmenorrhoea ma}' not infrequently be controlled by cannabis Indica. 
Its influence upon the muscular structure of the womb renders it valu- 
able in menorrhagia. Its virtue is enhanced in this affection by combi- 
nation with ergot. It has been found particularly useful in the abundant 
floodings which sometimes precede the menopause, and, in fact, possesses 
considerable power as a general haemostatic. In uterine haemorrhage 
Montgomery recommends :— 
Ext. cannabis Indicse, gr. viij. 
Ext. ergotas fl., f§j. 
Ext. banlamelidis fl., f§se. 
Tinct. cinnamomi, f§ss. 
M. Sig.: A teaspoonful everjr three hours. 
Cannabis Indica may also be administered, in haemoptysis, with 
geranium :— 
Extracti cannabis Iridic86 fl., f3j. 
Extracti geranii fl., f3iv. 
M. Sig.: Two to five drops every two or three hours. 
The headaches which attend the grand climacteric will sometimes 
yield to this remedy. It may be productive of good results in impotence 
unconnected with gross lesion. In spasm of the bladder and dysnria it 
gives relief, and also in acute gonorrhoea with ehordee we see good effects 
from its use. It can be given in either of these combinations with 
marked benefit for relieving the latter distressing symptom :— 
Extract! cannabis Indica1 fl., f3ss. 
Sodii bromidi, 3iij. 
Mist, sodae menth., 1'§iij. 
Syrup, aurantii, f 5ij. 
Sig.: A tablespoouful at bed-time. Repeat every hour or two until relieved. 
I£ Extracti cannabis Indicse, g-r. iij. 
Chloral, hydratis, 3j. 
Extracti opii, gr. vj. 
01. theobromse, q. s. 
M. et ft. suppositoriae no. xij. 
Sig.: Insert one in the bowel on retiring, and every two or three hours when 
troubled with cliordee. 510 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
• By some practitioners it is esteemed of value in acute and chronic 
Bright’s disease, the presence of haematuria especially indicating its em- 
ployment. Trial has been made of the drug in diabetes mellitus. 
Though it may, at times, be able to moderate cerebral irritability, it 
exerts no marked influence upon the course or severity of the disease. 
The spasm of asthma is sometimes very rapidly relieved by hemp. In 
whooping-cough, also, it may prove of service. It is a good remedy in 
irritable or reflex cough. Germain See warmly recommends cannabis 
Indica as a gastric sedative of particular value in functional disorders 
of the stomach and bowels attended with pain, acidit3r, and flatulence. 
He advises f grain of the extract to be given in three doses, or it can 
be prescribed in the form of the fluid extract and creasote added with 
great advantage:— 
Extracti cannabis Indicae, fl., I'll. 
Creasoti, "Iv. 
Syrup, acaciae, §iij. 
M. Sig.: A teaspoonful before meals. 
Cannabis Indica is said to do good in exophthalmic goitre, and to cure, 
in some instances, the opium or chloral habit. The tannate of eannabin 
is a good hypnotic, and has been used for insomnia among the insane. 
The oil of hemp-seed (oleum cannabis) is a drying, fixed oil ex- 
pressed from the seeds ; it is green in color, disagreeable to smell, and 
bland to the taste. It is used in the manufacture of a green soft-soap 
(sapo viridis, U. S. P.) of deservedly high reputation in treating eczema 
and other skin diseases. 
CANTHARIS (U. S. P.).—Cantharides. (Spanish Flies.) 
Preparations. 
Tinctura Cantharidis (U. S. P.).—Tincture of Cantharides (5 percent.). Dose, Nli-x. 
Linimmtum Cantharidis (II. S. P.).—Liniment of Cantharides (15 per cent, in oil of 
turpentine). 
Collodium cum Cantharide (U. S. P.).—Cantharidal Collodion (60 per cent.). 
Ceratum Cantharidis (U. S. P.).—Blistering Cerate (cantharides, 35 parts; yellow 
wax and resin, aa 20 parts ; lard, 25 parts). 
Ceratum Extracti Cantharidis (U. S. P.).—Cerate of the Extract of Cantharides 
(representing 30 per cent.). 
Charta Cantharidis (U. S. P.).—Blistering Paper (cantharides and Canada turpen- 
tine, each 1 part; olive-oil, 4 parts; spermaceti, 3 parts; wax, 8 parts; water, 10 parts; 
spread on paper). 
Emplastrum Picis cum Cantharide (U. S. P.).—Plaster of Pitch and Cantharides; 
Warming Plaster (Burgundy pitch, 92 parts ; cerate of cantharides, 8 parts). 
Pharmacology.—Cantharis vesicatoria (class, Iusecta; order, Coleop- 
tera) occurs in pharmacy in a dried state, either whole or in a more or 
less fragmentary condition, or as a brownish powder, in which the bright- 511 
CANTHAKIS. 
green fragments of the elytra are very noticeable. The dust is very 
irritating, and the eyes should be protected when the drug is powdered 
in the mortar. The perfect flies are stronger than the powder, which 
often has been damaged by the ravages of mites, or lower forms of life. 
The active principle is Cantharidin, a fatty, crystallizable principle (dis- 
covered by Robiquet in 1810), contained chiefly in the soft parts, and 
especially the generative apparatus, the blood, and in the eggs (Leidy). 
It is soluble in alcohol, ether, chloroform, etc. Besides this, which is 
the active agent, there is a green oil, black matter soluble in water, a 
yellow viscid matter, fat, phosphates of calcium and magnesium, acetic 
acid, and a volatile principle upon which the fetid odor depends, and 
which, according to Dragendorff, acts upon the system like cantharidin. 
The green coloring matter appears to be identical with chloropli3’ll. 
Physiological Action.—When applied to the skin, an active prepara- 
tion of cantharides causes burning pain with hyperaemia, to which, in 
the course of a few hours succeeds the formation of vesicles, exhibiting 
a tendency to run together and form a large bleb corresponding with the 
area of application. If the action is continued, sloughing and ulceration 
result. The engorgement of the capillaries in the superficial structures 
is associated with amemia of the deeper structures. When applied to the 
chest, the lung underneath becomes pale and anaemic, and, if its action be 
too long continued, a blister may cause inflammation of the pleura ; or it 
may produce peritonitis if applied to the abdomen. Slight elevation of 
temperature attends the action of the blister, which may be followed by 
depression of temperature and weakening of the heart’s action. Con- 
stitutional effects may be caused by absorption of the active principles 
through the integument. When introduced into the stomach, cantharides 
is capable of setting up much irritation and even gastro-enteritis, with 
vomiting, or purging and tenesmus. The active principles soon pass 
into the blood, and at first slightly stimulate the heart’s action; but the 
effect is most marked upon the genito-urinary organs, as the kidneys 
are the chief organs by which they are excreted. Extreme irritation of 
the bladder is produced, the urine is voided frequently, and, owing to 
the congested state of the kidneys, often contains albumin and blood. 
There may be suppression of urine. Associated with this is priapism, 
with pain in the glans penis, urethra, bladder, and aching in the renal 
region. The vulgar notion that cantharides causes erotic sensations, or 
increased sexual power, has no foundation except in the evidences of 
congestion and inflammation of the urinary passages just referred to. 
The results of swallowing a few grains of Spanish flies may be quite 
serious, and it is regarded by the law as a penal offense to administer 
this drug surreptitiously and with evil intent. The treatment of 512 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
poisoning by cantliarides is b}7 bland drinks and opiates and a hot bath. 
Bismuth and cocaine are also of service. An anaesthetic may be 
necessary. 
Therapy.—Blisters are usually spread with cerate of cantliarides, or 
preferably with the cerate of the extract of cantliarides, the prescription 
being as follows :— 
Cerati extracti cantharidis, q. s. 
Fiat emplastrum 2X3 in. 
Sig.: Apply to designated spot and allow it to remain four hours. Then remove it 
and substitute a poultice. 
The skin overlying the effusion should not be removed, but simply 
punctured to allow the serum to escape ; the spot is then dressed with 
some bland fat, such as suet or benzoinated lard. A good way to 
raise a blister is to use the blistering collodion and paint one or two 
coats over the desired area, and la}7 over it a piece of waxed paper, 
under which the blister raises in a few hours. Saint-Philippe has sug- 
gested that the danger of strangury may be lessened by the preliminary 
use of an alkaline diuretic until the urine has become alkaline. It is 
likewise a good plan to sprinkle a few grains of morphine and camphor 
over the surface of the blister before it is placed in position. Blisters 
are employed therapeutically to relieve pain, to reduce inflammation, and 
as revulsants to promote absorption of inflammatory products. The 
warming plaster is very useful in pleurodynia. Meningeal or pleural 
inflammation may be checked by the prompt application of a good-sized 
blister to the scalp or to the chest. In iritis, blisters behind the ears are 
often serviceable. In pericarditis, marked relief may be afforded by 
blistering. A blister over the stomach will arrest obstinate vomiting; 
and gleet is sometimes cured by a blister to the perineum. Neuralgia is 
promptly relieved by a small blister to the painful point; and neuritis is 
cured by flying blisters,—that is to say, a succession of small blisters 
along the course of the nerve. In acute rheumatism, marked relief is 
sometimes afforded to a swollen joint by surrounding it with small 
blisters. A blister over the affected joint is a good remedy in chronic 
synovitis. A large blister over the heart, applied early in the course of 
acute rheumatism, is often remarkably successful in reducing tempera- 
ture and relieving pain ; probably, also, it is of use in obviating the 
tendency to endocarditis, or curing it if present. In pleural effusion, 
absorption may be hastened in a similar manner, and also the clearing up 
of the lung after pneumonia. The warming plaster here may be worn 
for several days, if the skin is not too sensitive. Blisters must be used 
with caution in aged or debilitated patients; also in children. They CAPSICUM. 
513 
should not he applied to parts deprived of vital it}' by paralysis, or to 
cicatricial tissue, or where the skin is poorly nourished. The possi- 
bility of absorption and serious results should be kept in mind. Nor 
should a blister be allowed to remain on too long. 
The cerate, or tincture, of cantharides enters sometimes into the 
composition of pomades or lotions for the treatment of alopecia circum- 
scripta, and cantharidal collodion painted over the patches, every week 
or ten days, is at times efficacious. The following are good combinations 
in alopecia:— 
R Tinct. cantliaridis, 
Tinct. capsici, aa f3ij. 
Spir. vini rect., 
Spir. rosmarini, 
Spir. ammoniae fort., aa f^j.—M. 
Or, an ointment may be thus prepared :— 
R Acid, carbolici, 
Thymol., . aa gr. v. 
Extr. nucis vomicae, 3ss. 
Cerati cantharidis, §j.—M. 
In small doses, not exceeding two or three minims daily of the tinc- 
ture, cantharides has been commended as a stimulant to the urinary 
organs, in hsematuria, Bright’s disease of the kidneys, pyelitis, cystitis, 
incontinence of urine, gleet, and leucorrhoea ; but is contra-indicated in 
active conditions of inflammation. Given in this manner, it will usually 
relieve chordee. Ringer recommends full doses of the tincture of can- 
tharides, in combination with tincture of iron and phosphoric acid or 
mux vomica, in the impotence due to old age, sexual excess, or masturba- 
tion. Cutaneous affections, especially psoriasis and other squamous 
diseases, are sometimes much benefited by similar small doses of the 
tincture. It has been used to produce abortion, and, in these small doses 
just mentioned, has emmenagogue properties. 
CAPSICUM (IT. S. P.).—Capsicum.* 
Dose, gr. i-xx. 
Preparations. . 
Extractum Capsici Fluidum (U. S. P.).—Fluid Extract of Capsicum (alcoholic). 
Dose, TTli—v. 
Oleoresina Capsici (U. S. P.).—Oleoresin of Capsicum. Dose,£j-ij. 
Tinctura Capsici (U. S. P.).—Tincture of Capsicum (10 per cent.). Dose, lRv-f3ij. 
Emplaxtrum Capsici (U. S. P.).—Capsicum Piaster (contains oleoresin). 
Infusum Capsici.—Infusion of Capsicum (§ss-Oj). Dose, f3ii-§ss. 
* See paper by author on Capsicum, in the Medical Bulletin, November, 1886. 514 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Pharmacolagy.—The fruit of Capsicum fastigiatum (Solanaceae), 
dried and powdered, constitutes capsicum, or red pepper, which grows in 
the East Indies and on the coast of Guinea. Different varieties are culti- 
vated all over the world for culinary and medicinal purposes. The Cap- 
sicum aiinuum is most common in this country, of which there are a 
number of varieties, having different-shaped pods or large berries, the 
latter being picked green and used for pickling with vinegar. The chief 
constituent of red pepper is a crystallizable, acrid substance. Capsaicin 
(Thresh) ; also a yellow oil, resin, and a volatile alkaloid which in its 
odor resembles coniine. 
Physiological Action and Therapy.—Capsicum occasions irritation 
when applied to the skin, and may produce vesication; it acts as a 
counter-irritant in relieving pain in the structures beneath, especially in 
neuralgia, subacute gout, chronic gout, rheumatism, and bronchitis. In 
the mouth the taste is hot and pungent, causing free flow of saliva, and 
similarly increasing the flow of gastric juice, producing warmth in the 
stomach, expelling flatus, and giving increased appetite and digestive 
power. Capsicum stimulates the action of the heart and increases the 
digestive functions. It promotes the excretion of urine and possesses an 
aphrodisiac influence. A prescription of much utility in debility of the 
sexual organs is :— 
I) Pulveris capsid, ; 
Extracti erythroxyli, aa 3j. 
M. et ft. pilulae no. xxx. 
Sig.: Two pills three or four times a day. 
The capsicum plaster may be used when mild counter-irritation is 
desired. 
The tincture of capsicum may be employed with advantage in chil- 
blains when the surface is unbroken. Dr. Rheims recommends that a 
strong tincture of Ciipsicum-pods should be mixed with an equal quan- 
tity of mucilage of gum arabic. The mixture is brushed two or three 
times upon tissue-paper, which is then applied to the affected surface and 
quickly relieves the itching and pain. Discolored bruises and chronic 
rheumatic pains are likewise benefited by the same treatment. Sawyer 
suggests a tincture of capsicum made with officinal, pure ether in place 
of rectified spirit. He reports* that ether, by its action on the sebaceous 
secretion of the skin, is preferable to alcohol as a menstruum for drugs 
designed to produce a therapeutic effect on or through the skin. It has 
also the advantage that oil of turpentine or a bland oil is easily miscible 
with it, if requisite to add either. He states that a mixture of equal 
parts of ethereal tincture of capsicum, liquor ammoniae, oleum terebin- 
* Loudon Lancet, May 17,1890. 515 
CAPSICUM. 
thin®, and oleum lini forms an excellent rubefacient liniment. An infu- 
sion of capsicum pods applied upon a piece of lint is remarkably effica- 
cious in acute torticollis. 
The tincture of capsicum is an excellent application to the mucous 
membrane of the mouth and especially the gums. It enters into very 
many tooth-washes, the following, used by Garretson, being very ser- 
viceable :— 
$ Tinct. capsici, f3ij. 
Spiritus odorat., fgij. 
Alcoholis, f^ij. 
Tinct. quillaiae, f^iss. 
Tinct. gentian® comp., f^j. 
Acidi acetici diluti, f^ss. 
Acidi carbolici, lTlij.—M. 
Capsicum infusion is used as an application to scarlatinal sore throat, 
or diluted as a gargle in tonsillitis, pharyngitis, or may be used as a 
gargle, thus :— 
Tinct. capsici, . . » f3j. 
Potassii chloratis, . 3iij. 
Glycerini, f gij. 
Acidi liydrochlor. dil., f3iij. 
Aquae rosae, ad f3xij. 
Capsicum may be used externally as a hair-lotion for promoting the 
capillary growth :— 
Tinct. capsici, f §ss. 
Tinct. saponariae quit., fjj. 
Glycerini, 3ij. 
Tinct. cantharidis, . . . . ' f 3iij. 
Spiritus rosmarini, f §iss. 
Aquae rosae, . ad f §viij. 
M. Sig.: Drop on the hair night and morning and brush the 6calp well. 
Capsicum is given internally after a debauch or in cases of drink- 
craving, as a substitute for alcoholic drinks. In chronic catarrh of the 
stomach of drunkards, the tincture of citpsicum, in 10-drop doses before 
meals, serves as an appetizer. The tincture of capsicum is a valuable 
stimulant in delirium tremens. It may very serviceably be administered 
in beef-tea, and supports the heart, allays restlessness, and promotes 
sleep. Capsicum, in fact, possesses a slight narcotic power, and can 
be given thus with marked effect:— 
Tinctur® capsici, f3ij. 
Sodii bromidi, 3iij. 
Elix. lupulini, f^iv. 
M. Sig.: Two teaspoonfuls in water every hour or two. 516 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
It is an excellent reined}' in flatulent dyspepsia:— 
Pulveris capsici, gr. xl. 
Extracti nucis vomicae, gr. iij. 
Extracti pancreatis, 3j. 
M. et ft. capsulae no. xx. 
Sig.: A capsule after meals. 
It is beneficial in typhoid fever and typhoid conditions, as a stimu- 
lant. As this substance invigorates the muscular coat of the arteries, 
it may be advantageously employed in order to control haemorrhage from 
the lungs or the womb. On account of its irritant effects, it is contra- 
indicated in acute inflammation of the stomach or bowels. As excretion 
takes place by the kidneys, capsicum should be prohibited in inflamma- 
tory conditions of the genito-urinary tract; but in chronic disorders it- 
may often be employed with advantage. In chronic nephritis, pyelitis, 
cystitis, and prostatorrhoea it frequently proves decidedly beneficial. 
CARBO ANIMALIS (U. S. P.).—Animal Charcoal. 
CARBO LIGNI (IT. S. P.).—Wood Charcoal. 
Dose, gr. x-xx. 
Preparation. 
Carbo Animalis Puriflcatus.—Purified Auimal Charcoal. Dcse, gr. x-3j. 
Pharmacology.—Animal charcoal is prepared from bone by exposure 
to heat; and wood charcoal is obtained by a similar process from soft 
wood. The former occurs as a black powder or mass, the latter in large 
fragments preserving the shape of the billets of wood, or as a fine light 
powder. Purified animal charcoal is the charred bone after treatment 
with hydrochloric acid, which removes the earthy salts and leaves only 
the carbon. Recently-burned charcoal not only readily absorbs gases, 
and is thus an excellent deodorizer, but it destroys organic impurities 
by oxidation, decolorizing solutions containing them and rendering them 
inoffensive to taste or smell. Internally, it is given in too small doses to 
exert much effect of this kind in the intestinal tract, but it aids in purify- 
ing the stomach, partly by mechanical action. It increases secretion and 
peristalsis. 
Therapy.—Charcoal is a good dressing to old or offensive gangrenous 
ulcers, as it absorbs the foul material and cleans the wound. It is gen- 
erally utilized in the form of the charcoal poultice, being beaten up with 
bread-crumb or flaxseed-meal, or a small bag filled with powdered char- 
coal may be laid upon the poultice when it has been placed in position. 
It is sometimes used for tooth-powder, but is open to the objection of 
scratching the teeth and discoloring the gums. Charcoal filters are useful CARBONEI BISULPHIDUM. 
517 
in pharmacy, hut not in the household, because, if not renewed daily, 
they lose their virtues, and only act as a breeding-place for germs of 
putrefaction and disease. Charcoal in powder, or animal charcoal, may 
be administered in cases of poisoning by organic poisons. In flatulent 
dyspepsia recently-burned charcoal is sometimes beneficial. It has been 
used to relieve the pain of gastric ulcer and gastralgia. 
CARBONEI BISULPHIDUM (TJ. S. P.).—Bisulphide of Carbon. 
Pharmacology and Therapy.—The bisulphide (disulphide) of carbon 
is a clear, very diffusive liquid, of extremely offensive odor, and inflam- 
mable. It is highly poisonous, and its odor is also an objection to its 
internal use, although it is a valuable antiseptic, and has been used in 
typhoid fever, dyspepsia, and in gastric cancer. It has some anaesthetic 
and anodyne properties when inhaled. Locally, the vapor has been pro- 
posed to be applied for glandular enlargements and in defective secretion 
of cerumen in the ear. Local anaesthesia may be produced by the spray 
in neuralgia, etc. 
CARDAMOMUM (U. S. I\).—Cardamom. 
Dose, gr. v-xv. 
Preparations. 
Extractum Cardamomi Compositum Fluidvm.—Compound Fluid Extract of Cardamom 
(cardamom, cinnamon, aa 400 parts; caraway, 200 parts; cochineal, 100 parts; reduce to 
powder and percolate with alcohol, obtaining 880 parts; add glycerin, 120 parts). Dose, 
Ofxv. 
Tinctura Carclamomi (U. S. P.).—Tincture of Cardamom (15 per cent.). Dose, f3i—ij. 
Tinclura Cardamomi Composita (U. S. P.).—Compound Tincture of Cardamom 
(cardamom 2, cinnamon 2, caraway 1, cochineal y2, glycerin 6, in dilute alcohol, q. s. ad 
100 parts). Dose, f3i-iv. 
Cardamom also enters into the composition of aromatic powder 
(cardamom and nutmeg, aa 15 parts ; cinnamon and ginger, aa 35 parts), 
and the aromatic fluid extract (pulv. aromatic., 100 grains ; alcohol, q. s. 
ad 100 minims) and elixir adjuvans (N. F.). 
Pharmacology.—The fruit of Elettaria cardamomum (Zingiberaceae) 
comes from Malabar, although other sources are recognized in commerce. 
The seeds are inclosed in capsules, the latter being valueless except as a 
protection for the former, which contain a volatile oil holding a cam- 
phoraceous substance in solution. 
Therapy.—The seeds of cardamom are sometimes chewed and swal- 
lowed to relieve flatulence, or the tincture or compound tincture may be 
used, the latter being a valuable carminative combination. The com- 
pound fluid extract, though not officinal, is considered a better prepara- 
tion than the compound tincture in the treatment of atonic d3’spepsia 
and flatulence. 518 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
The following is a good combination for children who are overfed 
and vomit after suckling:— 
Tinct. cardamom, co., f3iij. 
Sodii bicarb., 3ss. 
Spiritus ammon. aromat., Nlxl. 
Pulv. rhei, . . . gr. xx. 
Aquae menth. pip., ad i'§ij. 
M. Sig.: A teaspoonful every three or four hours. 
CARDUUS BENEDICTUS.—Blessed Thistle. 
Dose, 3i-v. 
Pharmacology.—This plant belongs to the Composite, and is a 
native of Asia and Europe. The leaves, sometimes the flowering tops, 
are used in decoction (sii-Oj), and a fluid extract and solid extract have 
also been used. A bitter neutral principle, Cnicin, crystallizing in color- 
less prisms, soluble in alcohol, less so in water, appears to be the prin- 
cipal constituent; nitrate of potassium is also present. 
Therapy.—Carduus is a bitter tonic used in Germany in digestive 
weakness and chronic hepatic complaints; best given as the fluid extract 
at a dose), in which the menstruum is diluted alcohol. The 
Carduus Marianus, or St. Mary’s Thistle, another variety, is used for the 
same purposes, but is especially in repute for treating cases of gall- 
stones. It has also been extolled as a haemostatic, laxative, and diuretic 
(Lobacli). 
CARMINUM.—Carmine. 
The red coloring matter obtained from cochineal; entirely soluble in 
water. (See Coccus.) 
CAROTA.—Carrot Fruit. 
Dose, gr. xxx-5j. 
Pharmacology and Therapy.—The seeds of Caucus carota (Umbel- 
liferae), of a grayish color, about £ inch in length, contain a volatile oil 
of aromatic odor and taste. Used in powder as a carminative and 
diuretic. 
CARUM (U. S. P.).—Caraway. 
Dose, gr. x-xxx. 
Preparation. 
Oleum Carl (U. S. P.).—Oil of Caraway. Dose, Nli-v. 
Enters into compound spirit of juniper and compound tincture of cardamom. 
Pharmacology and Therapy.—The fruit of Carum carvi (U in belli ferae) 
contain a volatile oil, and are prized as a condiment. They are used as 
a stimulant in flatulence, or in combination to prevent griping of other 
medicines. CARYOPHYLLUS. 
519 
Caraway is used as a carminative, especially in children, or useful 
in this formula in flatulence and colic :— 
Infusum eari, f^ij. 
Aquae menth. pip., f^j. 
Sodii bicarb., 3j. 
Syrup, rliei, f^ij. 
M. Sig.: A teaspoonful or two every three or four hours. 
CARYOPHYLLUS (U. S. P.).—Cloves. 
Preparations. 
Oleum Caryophylli (U. S. P.).—Oil of Cloves. Bose, HU-vj. 
Infusum Caryophylli.—Infusion of Cloves (2 per cent.). Bose, f^i-ij. 
Also enters into compound tincture of lavender, aromatic tincture of rhubarb, aro- 
matic syrup of rhubarb, and wine of opium. 
Pharmacology.—Cloves are the dried, unexpanded flowers of Eugenia 
caryophyllata (Myrtaceae), a large tree of the Spice Islands and Africa. 
They have a strong, spicy odor and pungent, aromatic taste, owing to 
the presence of a heavy volatile oil (15 to 20 per cent.). They also contain 
Eugenin, a tasteless crystalline substance, salicylic acid, and a neutral, 
tasteless, odorless, body, Caryophyllin, which crystallizes in needles. 
Clove-stalks are the flower-stalks of the cloves; mother-cloves are the 
whole fruit. Both of these are used to adulterate ground cloves. 
Physiological Action.—Cloves are stimulant, carminative, and anti- 
septic. The oil has some anaesthetic influence over painful areas. 
Therapy.—The oil of cloves is used to destroy the nerve in hollow, 
aching teeth, and quickly relieves pain. In combination with lanolin, it 
may be used for eczema. The infusion is used internally as a stomachic 
tonic for the relief of flatulence and pain, but it is generall}r employed in 
combination with other remedies. 
CASCA CORTEX.—Sassy Bark. 
Pharmacology.—The Erythrophlceum guineense (Leguminosse) is a 
large tree growing on the coast of Africa, which furnishes the ordeal 
bark of Angola, otherwise casca, or sassy, bark. It contains an alka- 
loid, Erythrophloeine. A tincture (10 per cent.) has been used by 
Brunton, in doses of 5 to 10 minims. 
Physiological Action.—The powder causes sneezing when inhaled. 
The infusion or tincture gives rise to vomiting and purging and intoxi- 
cation, followed by death during convulsions. Upon the circulation 
erythrophlceum has an action like digitalis. 
Therapy.—Brunton finds the tincture useful in dilated heart without 
valvular disease; also in mitral disease and dropsy. It disturbs the 
digestion more than digitalis. The hydrochlorate of erythrophlceum is a 520 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
salt in the form of a powder, soluble in water, which can be administered 
hypoderniatically in doses of gr. -T2 as a l°cal analgesic, but it is 
inferior to cocaine for this purpose. 
CASCARA AMARGA.—Honduras Bark. 
Pharmacology and Therapy.—The Cascara amarga (Simarubaceae), 
or Honduras bark, has some reputation as a tonic and alterative. The 
fluid extract (dose, f3ss-j, several times a day) may be used in s}-philis, 
chronic liver disease, nasal catarrh, and skin diseases (eczema, psoriasis, 
syphilodermata, etc.). 
CASCARA SAG RADA. See Rhamnus Purshiana. 
CASCARILLA (U. S. P.).—Cascarilla-Bark. 
Dose, gr. ii-xx. 
Pharmacology.—The bark of Croton eluteria (Euphorbiaceae) from 
the Bahama Islands. It has a warm, rather bitter taste, and emits a 
fragrant odor when burned. Cascarillin is a bitter neutral substance, with 
volatile oil, resin, and tannin as the principal constituents. There are no 
officinal preparations, but a fluid extract, infusion, and tincture are used, 
none of which are miscible with water. 
Therapy.—Cascarilla is a light tonic, somewhat stimulant and car- 
minative, and the infusion has been used in low fevers. It may be profit- 
ably employed as a tonic in convalescence from typhoid fever or other 
exhausting disease. 
CASSIA FISTULA (U. S. P.).—Purging Cassia. 
Dose, 3j- 
Pharmacology and Therapy.—The fruit of Cassia fistula (Legumi- 
nosse), a tree of the West Indies, is in cylindrical pods of a dark-brown 
color, containing from twentj'-five to one hundred seeds in separate cells, 
and a dark-brown, soft, sweetish pulp, having an odor like prunes and 
containing about 60 per cent, of sugar. Good cassia yields about 30 
per cent, of the pulp, which is the medicinal part of the drug. This is 
laxative in its action in doses of a drachm or more. There are no 
officinal preparations of cassia, but the confection of senna contains 16 
per cent, of cassia fistula. 
CASTANEA (U. S. P.).—Chestnut. 
Preparations. 
Extraction Castaneae Fluidum (U. S. P.).—Fluid Extract of Chestnut. Dose, f3i-ij. 
Jnfusum Castaneae.—Infusion of Chestnut-Leaves. Dose, f3ii-§ss. 
Pharmacology and Therapy.—The leaves of Castanea vesca (Cupel- 
liferae), collected in September or October while still green. They contain CATECHU. 
521 
tannin, gallic acid, salts, and gum. A recent infusion has been employed 
with success in whooping-cough, and might be used for diarrhoea, but for 
the latter purpose the fluid extract would be better. 
CATECHU (U. S. P.).—Catechu. 
Dose, gr. i-xxx. 
Preparations. 
Tinctura Catechu Composita (U. S. P.).—Compound Tincture of Catechu (catechu 12, 
cinnamon 8, in diluted alcohol, q. s. ad 100 parts). Dose, Hlx-f3j. 
Trochisci Catechu (U. S. P.).—Troches of Catechu (1 grain each). Dose, 1 or more. 
Pharmacology.—Catechu is obtained from tiie Acacia catechu (Legu- 
minosae), a large tree of Pegu. It is in large masses, hard and brittle, 
glossy and porous on fracture; taste strongly astringent and sweetish; 
very little odor. The constituents of black catechu, or cutch, are Catechu- 
Tannic Acid and Catechin, the latter being insoluble in water; but the 
extract is entirely soluble in alcohol, though insoluble in ether. With 
iron, greenish-brown precipitates are formed. 
Therapy.—Catechu is a valuable astringent. It may be used as a 
mouth wash for spongy gums, a gargle in pharyngitis, or as an injection 
in gonorrhoea or leucorrhoea; but is most frequently employed in diar- 
rhoeas of relaxation :— 
Tinct. catechu compositae, f3ij. 
Tinct. opii camphorat., f3vj. 
Misturae cretae, . . ... f§iij. 
M. Sig.: One or two tablespoonfuls after each liquid stool. 
Tinct. catechu compositae, f §ss. 
Tinct. kino, f§ij. 
Spiritus aetheris nitrosi, . . . . . . . . f §j. 
Bismuth, subnit., 3ij. 
Syrup, acaciae, f§iss. 
M. Sig.: Two teaspoonfuls in water every half hour or hour. 
CATHA.—African Tea. 
A small shrub of Northwestern Africa, used bjr the natives as a 
stimulant and temporary substitute for food. Forskall gave it the name 
of Catha edulis. The leaves are chewed like those of the Erythroxylon 
coca, and are invigorating and restorative, and the recent infusion acts 
like that of tea, mate, or coffee. The plant has been analyzed without 
detecting caffeine. Fluckiger has isolated an alkaloid, Katine, which is 
probably a liquid. 
In medicine, catha might be useful as an arterial and nervous stimu- 
lant like coca, and probably would afford a cheap substitute at the table 
for the expensive tea so largely used, if once introduced in this country. 522 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
CAULOPHYLLUM (U. S. P.).—Caulophyllum, Blue Cohosh. 
Dose, gr. xv-xl. n 
Preparation. 
Extractum Caulophylli Fluidum.—Fluid Extract of Caulophyllum. Dose, xv-xl. 
Pharmacology.—The rhizome and rootlets of Caulophyllum thalic- 
troides (Berberidaceae), or squaw-root, a plant indigenous to this country. 
It contains a glucoside, Saponin, and two resins, the latter constituting 
the substance supplied as Caulophyllin. 
Therapy.—Caulophyllum is emmenagogue and parturifacient and 
diuretic. It has some reputation in the treatment of rheumatism. It 
probably has some value as an expectorant, owing to the presence of 
saponin, which is analogous to senegin found in Polygala senega, and 
might be valuable in bronchitis and catarrhal pneumonia. 
CEDRON.—Cedron-Seed. 
Dose, gr. i-ij. 
Pharmacology.—The Simaba cedron (Simarubacese) of the United 
States of Columbia contains two alkaloidal substances, Cedrine and 
Cedronine. The seeds have a bitter taste. 
Therapy.—Cedron-seed has a reputation in South America for cur- 
ing malarial affections, and is largely used in derangements of the 
digestive organs, diarrhoea, cholera morbus, etc. It is also claimed to 
have decided influence over the course of hydrophobia, and is said to be 
of value in treating poisoned wounds, bites of venomous snakes, insects, 
etc. The remedy is used both topically and internally, the usual dose 
being 1 or 2 grains ; but Dr. Purple gave it in doses of 20 or 30 grains 
every four hours in intermittent fever with satisfactory results. 
CERA.—Wax. D 
Preparations. 
Cera Alba (U. S. P.).—White Wax (yellow wax bleached). 
Cera Flava (U. 8. P.).—Yellow Wax. 
Ceratum (U. 8. P.).—Cerate (white wax 30, lard 70). 
Pharmacology and Therapy.—Wax is a peculiar, concrete substance, 
prepared by Apis mellifica (Hymenoptera, class Insecta), forming the 
honey-comb; also found in certain plants. It is insoluble in water and 
cold alcohol, but soluble in boiling alcohol, ether, chloroform, and oils. 
It is a soft solid, liquefying a little above the body-temperature, and is 
unirritating, except mechanically, to the skin and mucous membranes. 
It is largely used to give consistency to ointments and suppositories. 
The following Cerates are officinal (U. S. P.):— 
Ceratum Camphorae, 
“ Cantharidis, 
“ Cetacei, 
Ceratuin Plumbi Subaeetatis, 
“ Resitiae, 
“ Sabinae, 
Ceratuin Extracti Cantharidis. CERII OXALAS. 
523 
CERII OXALAS (U. S. P.).—Oxalate of Cerium. 
Dose, gr. i-x. 
Pharmacology.—The oxalate of cerium occurs as a white, granular 
powder, odorless and tasteless, insoluble in water or alcohol, but soluble 
in hydrochloric acid. 
Therapy.—Sir J. Y. Simpson brought forward this remedy as one 
of great value in treating the vomiting of pregnancy, in which it is some- 
times successful, but often fails. It is useful in controlling excessive 
cough in phthisis or chronic bronchitis, and in nervous disorders, chorea, 
epilepsy, and dysmenorrhoea. This salt occasionally proves useful in 
vomiting depending upon uterine disease, or even in cancer of the stom- 
ach. It is a sedative to the gastric mucous membrane, and may allay the 
pain of gastralgia. The following prescriptions, containing oxalate of 
cerium, have been employed with service :— 
Cerii oxalatis, 3iss. 
Bismuth, subnit., 3iiss. 
Spiritus chloroformi, f3ij. 
Liquor, calcis, 
Syrup, acaciae, aa f §ij. 
M. Sig.: Two teaspoonfuls in water when necessary for nausea and diarrhoea. 
II Cerii oxalatis, 3j. 
Bismuth, subnit., 3ij. 
Magnesii carbonatis, 3j. 
01. einnamomi, ll(j. 
M. et ft. chartae no. xij. 
Sig.: A powder before meals in subacute and chronic gastric catarrh, and in vomiting 
of pregnancy. 
II Cerii oxalatis, gr. xl. 
Ext. hyoscyami ale., . . . gr. iij. 
Ext. conii, gr. vj. 
Ext. gent., gr. ij. 
M. et ft. pil. no. xij. 
Sig.: A pill every four hours for nausea and vomiting, especially of pregnancy. 
The oxalate of cerium is also occasionally efficacious in chronic 
diarrhoea. It is liable to be contaminated with other metals, such as 
arsenic, lanthanum, etc., to which some of its therapeutic effects have 
been attributed. 
If the remedy be pure, it may be given in doses of 10 grains every 
four hours. Failure from its use has been ascribed to the smallness of 
the dose which is generally prescribed. 
CETACEUM (U. S. P.).—Spermaceti. 
Preparations. 
Ceratum Cetacei (U. S. P.).—Spermaceti Cerate (10 percent.). 
Unguentum Aquce Itosce (U. S. P.).—Rose-Water Ointment (expressed oil of almonds, 
50 parts; rose-water, 30 parts; spermaceti and white wax, of each, 10 parts). 524 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Pharmacology.—Spermaceti is a peculiar, concrete, fatty substance 
obtained from Physeter macrocephalus (class,Mammalia; order, Cetaceae), 
or sperm-whale. It is a fatty substance, with little taste or odor ; can be 
reduced to a powder by the addition of a little alcohol. Unlike other 
fats, it does not yield glycerin when saponified, but Ethal. It is almost 
pure Cetin, or palmitate of cetyl. It is not acted upon by a boiling 
dilute solution of soda, and leaves no grease-spot on paper. 
Therapy.—Used almost exclusively as an ingredient in ointments, 
although an emulsion with wax and yelk of egg is prepared as a demul- 
cent in irritation of the bowels. The unguentum aquae rosae, or cold 
cream, is an elegant application for excoriated surfaces and chapped 
hands and lips. 
CETRARIA (U. S. P.).—Iceland Moss. 
Preparation. 
Decodum Cetrarice (U. S. P.).—Decoction of Iceland Moss (5percent.). Dose, f§i-iv. 
Pharmacology.—The sea-weed, Cetraria islandica (Lichenes), is found 
in northern latitudes. It contains Lichenin, or lichen-starch (70 per 
cent.), which forms a mucilage when hot water is added. There is also 
cetrarin or cetraric acid, a bitter principle (about 2 per cent.), which can 
be removed by washing with a weak alkali. 
Therapy.—It has some value as a food, and its demulcent qualities 
have led to its use in pulmonary affections and bowel disorders in the 
form of decoction. 
CHAULMOOGRA-OIL.—Chaulmoogra-Oil. 
Dose, in capsule. 
Pharmacology and Therapy.—The expressed oil from the seeds of 
Gynocardia odorata (Bixinese) contains gynocardic acid. The oil is 
soluble in ether, chloroform, and alcohol. In leprosy, chaulmoogra-oil 
has been used with asserted good results, both locall}- and internally. 
Though unable to cure the disease, it has in some cases delayed the 
progress and mitigated the symptoms. It may also be serviceable, com- 
bined with other ointments, in treating chronic skin diseases. Chronic 
eczema, psoriasis, and lupus are benefited by the application of an oint- 
ment containing chaulmoogra-oil. The ointment has likewise been used 
upon the enlarged glands of scrofula and in chronic rheumatic arthritis. 
From 20 to 30 grains of the oil to the ounce of excipient is the average 
strength of the ointment. Gynocardic acid, 20 grains to the ounce, has 
been used in ointment form in place of the oil. The following is a good 
combination :— CHEKAN. 
525 
Zinci carbonat., 
Pulv. marantae, aa 3j. 
Olei chaulmoograe (vel acidi gynocardici), .... f3ss. 
Ungt. hydrarg. ammoniat., 3ij. 
Lanolini, §ss. 
M. et ft. ungt. 
For chronic eczema, psoriasis, scrofuloderma, lupus, and lepra. 
CHEKAN.—Cheken. 
Preparation. 
Extractum Chekan Fluidum.—Fluid Extract of Cheken. Bose, f3i-iij. 
Pharmacology.—The leaves of Myrtus chekan, or Eugenia chekan 
(Myrtaceae), a shrub or small tree of South America. It contains tannin 
and an ethereal oil; also cliekenon, chekenic acid, cheken bitter, che- 
kenetin. Of these the ethereal oil alone offers medicinal interest (Weiss). 
This is antiseptic, diuretic, and expectorant. 
Therapy.—Cheken was introduced from Chili through the enterprise 
of Messrs. Parke, Davis & Co., as a remedy in chronic catarrhal inflam- 
mation of the respiratoiy passages. Dr. Murrell, of London, extols it 
in the winter-cougli of elderly people, and in other forms of chronic 
bronchitis. In Chili it also enjoys a reputation in the treatment of 
rheumatism. 
CHELIDOIMIUM (II. S. P.).—Chelidonium, Celandine. 
Dose, gr. x-xl. 
Pharmacology.—Celandine is the whole herb of Chelidonium mnjus 
(Papaveracese), found both in Europe and North America. It contains 
two alkaloids, Chelidonine and Sanguinarine, in combination with Cheli- 
donic Acid. A bitter, yellow, crystalline principle, Chelidoxanthine 
(Probst), is also present, besides tannic acid, starch, cellulose, etc. 
Physiological Action.—It has a bitter, acid taste, and stimulates the 
secretions of the glands along the intestinal tract, including the liver. 
In considerable doses it causes vomiting and purging, diaphoresis, and 
increases the urinary secretion and also the secretions of the bronchial 
mucous membrane. 
Therapy.—The fresh, milky juice maybe used as a local irritant, 
and has been applied upon warts and corns. Internally, in doses of 10 
grains of the extract, it acts as a drastic purgative, and has been used in 
jaundice due to catarrhal swelling of the bile-ducts. 
CHENOPODIUM (U. S. P.).—Chenopodium, American Wormseed. 
Dose, gr. x-xl. 
Preparation. 
Oleum C/ienopodii (U. S. P.).—Oil of Chenopodium. Bose, gr. v-xx. 526 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Pharmacology.—American worm seed is the fruit of Chenopodium 
ambrosiodes, variety Anthelminticum (Chenopodiaceae), a plant of North 
America and Europe. It has a peculiar aromatic odor and a warm, 
bitter taste. Its properties are due to the presence of a peculiar volatile 
oil, a thin, yellowish, offensively aromatic liquid, which is officinal. 
Physiological Action and Therapy.—The volatile oil acts as a stimulant 
to the circulation and nervous system, making it serviceable in chorea 
and neurasthenia. Its common use is for the expulsion of lumbricoid 
worms, and it is best given in doses of 10 minims, in capsules or emul- 
sion, three times a day, castor-oil being administered the following day; 
or the remedy may be administered night and morning for several days, 
and followed by a brisk cathartic. 
CHIMAPHILA (U. S. P.).—Chimaphila, Pipsissewa. (Prince’s Pine.) 
Preparation. 
Extraction Chimaphilce Fluidum (U. S. P.).—Fluid Extract of Chimaphila. Dose, 
Hlxx-xl. 
Pharmacology.—The leaves of Chimaphila umbellata (Ericaceae) 
contain tannin and a colorless, bitter, crystalline, neutral principle, 
Arbutin, and a colorless and tasteless substance, in yellow crystals, 
Chimaphilin. The fresh leaves are also slightly irritating. 
Physiological Action and Therapy.—Pipsissewa is diuretic and altera- 
tive. It has very little effect upon the heart or circulation. Upon the 
digestive organs it is tonic and astringent. As it is not an irritating 
diuretic, it can be used in Bright’s disease and nephritis; also in liaema- 
turia. In lithaemia, gout, rheumatism, and kindred disorders, this is a 
valuable remedy. As it favors elimination,it has produced good results 
in scrofula, skin diseases, gleet, leucorrhoea, and intermittent fever. A 
decoction may be used, but a good fluid extract is better. 
CHINA. China-Root. 
Pharmacology and Therapy.—The rhizome of Smilax glabra and 
Smilax China (Sinilacese) of China and Japan has the same constituents 
and properties as sarsaparilla, but is more active. It is best given in the 
form of fluid extract of China, in doses of f5ss-j, several times a day. 
CHINOIDINUM (U. S. P.).—Chinoidin, Quinoidin. 
Pharmacology.—A mixture of alkaloids, mostly amorphous, obtained 
as a by-product in the manufacture of the crystallizable alkaloids of 
cinchona. (See Cincliona.) 
CHINOLINA.—Chinolin, Quinolin. 
Dose, gr. viii-xvj. 
Preparations. 
Chinolince Salicylas.—Dose, gr. v-xxx. CMnolince Tartras.—Dose, gr. v-xxx. CHIRATA. 
527 
Pharmacology.—Chinolina is a colorless, oily liquid, darkening on 
exposure to light, and is a constituent of coal-tar, but is prepared com- 
mercially by treating anilin or nitro-benzol with glycerin in the presence 
of a dehydrating agent. In its chemical characters it is so closely related 
to quinine as to lead to its substitution in medicine. Dr. Julius Donatli 
claims that its physiological and therapeutical effects are also identical 
with the natural alkaloid. The tartrate is the salt chiefly used, which is 
in shining, silky crystals, with penetrating odor and pungent taste, per- 
manent in air, and soluble in water. 
Physiological Action and Therapy.—Chinolin is a valuable antiseptic, 
but its offensive odor has prevented its application in this direction 
in medicine; however, it is believed that much of this objection can be 
removed by better modes of preparation. If it could be obtained without 
odor or taste, it would be a valuable agent for the preservation of food. 
The tartrate and salicylate are also powerful antizymotics. Internally, 
these salts are antipyretic and antiperiodic, in doses rather larger than 
those given of quinine (3ss daily, for adults). 
It may be given to children in peppermint-water, or syrup and dis- 
tilled water, or to adults in capsules or wafers. Neuralgia dependent upon 
a malarial taint is often relieved by chinolin tartrate. In zymotic diseases, 
other than malarial, chinolin has not proved satisfactory as an anti- 
pyretie, because it has been found to be too depressing in its effects 
upon the heart. As a topical application in diphtheria, it may be diluted 
with alcohol and used with a spray, or painted on with a brush, 
to the affected part. A solution of the tartrate (gr. has been 
used as an injection for gonorrhoea. 
CHIRATA (U. S. P.).—Chirata. 
Dose, gr. xv-xxx. 
Preparations. 
Extraction Chiratce Fluidum (U. S. P.)—Fluid Extract of Chirata. Dose, Hlx-xxx. 
Tinctura Chiratce (U. S. P.).—Tincture of Chirata (10 per cent.). Dose, f3i—ij. 
Pharmacology.—The whole herb, Ophelia chirata (Gentianaceae) of 
India, is used as a bitter aromatic tonic in the East, but rarely prescribed 
in this country or England. It contains two amorphous principles, 
Ophelic Acid and Chiratin (Holm), but no tannin. 
Therapy.—Chirata resembles gentian very closely, to which it is 
allied botanically, but it is more bitter. It has similar therapeutic appli- 
cations in atonic dyspepsia, etc. Chirata may often be very serviceably 
combined with bismuth subnitrate, or with hydrochloric acid, for the 
relief of the sick stomach of drunkards. It is useful in functional 
inactivity of the liver. 528 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
CHLORAL (U. S. P.).—Chloral, Hydrate of Chloral. 
Dose, gr. ii-xx. 
Pharmacology.—Chloral (tricliloracetyl hydride) is a colorless 
liquid formed by the prolonged action of chlorine upon alcohol;* with 
water it forms a crystallizable compound. The hydrate of chloral is in 
the form of colorless, transparent crystals ; of bitterish, caustic taste ; of 
pleasant, ethereal but not acrid odor; freely soluble in water and in alcohol. 
The crystals volatilize slowly at ordinary temperatures, and should be 
kept in a tightly-stoppered bottle ; they melt at 135° F. and boil at 
208° F., and are at the same time decomposed into anhydrous chloral 
and water. If concentrated sulphuric acid be added to chloral it is con- 
verted into a white, solid substance having the same composition as 
chloral, but is not soluble in water. Chloral also combines with alcohol 
to form crystals of alcoholate of chloral, which are less soluble than 
hydrate of chloral. When triturated with camphor or crystals of 
carbolic acid, the hydrate of chloral forms a permanent oily liquid. 
Physiological Action and Poisoning.—Chloral hydrate is antiseptic 
and sedative, although slight irritation may occur at first. It is a hyp- 
notic, causing sleep by producing an anaemic condition of the brain, the 
patient waking after several hours as from natural sleep. Unpleasant 
after-effects are occasionally observed. The reflex activity of the spinal 
centres is weakened, and this extending to the medulla causes paralysis 
of the respiratory centre. No effect is seen upon the sensory nerves, but 
the motor nerves are gradually affected, muscular weakness being one of 
the prominent phenomena attending chronic chloral poisoning. Chloral 
acts powerfully upon the heart, lowering and weakening its rate of move- 
ment through a local influence upon the ganglion and muscle (Wood). 
With this there is lowering of arterial pressure, aided by dilatation of* 
the superficial vessels. When death is caused by chloral, the heart is 
arrested in diastole. The decided fall in the bodily temperature is 
probably secondary to the cooling of the blood by dilatation of the 
cutaneous blood-vessels. Dyspnoea may be produced by engorgement 
of the lungs, due to the weakened cardiac action and to the local enlarge- 
ment of the pulmonary vessels. Death is produced by respiratory 
failure usually, although it occurs sometimes with such suddenness as to 
lead to the supposition that it is due to syncope from direct action upon 
the heart. 
In a few cases, death appears to be due to some deleterious action 
upon the blood, resembling scurvy, as purpuric and scorbutic eruptions 
occur, with swollen, ulcerated gums, great prostration, and collapse. We 
treat the first class of cases of gradual respiratory failure b}r stopping 
* It derives its name from the first syllables of the substances from which it is made. 529 
CHLORAL. 
the remedy, with the administration of stimulants externally bv friction, 
local warmth, and sinapisms, and internally by hot coffee, and artificial 
respiration, galvanism, etc., with physiological antidotes, such as atropine 
and strychnine. In the second class of cases, unfortunately, death occurs 
too quickly for the action of remedies; but hypodermatic injections of 
ether, atropine, or strychnine, with evacuation of the stomach by the 
pump and the introduction of hot alcoholic stimulants, might be service- 
able in saving life. In the third class of cases, transfusion of blood 
might be required, or the administration of large doses of the tincture 
of the chloride of iron. Chronic chloralism, presenting symptoms of 
muscular weakness or paralysis, moral perversion, feeble heart, epilepti- 
form convulsions, and delirium tremens, is relieved by prompt removal 
of the drug and the administration of tonics, especiall}7 mix vomica or 
strychnine. Animals poisoned with chloral hydrate recover if they are 
kept warm. In some cases an erythematous rash follows the adminis- 
tration of chloral, and desquamation of skin from the fingers around the 
extremities has been noticed. 
An eruption from chloral is especially apt to occur in children, weak 
wild cachectic patients, and those who suffer from disease of the nervous 
system, as hysteria, chorea, myelitis, or general paralysis. The com- 
monest cause of such a rash, however, is the ingestion of alcohol at the 
same time with chloral. 
This substance is removed from the system principally by the kid- 
neys; it also escapes by the breath, to which it gives a peculiar odor. 
It is probable that some of the serious effects following the admin- 
istration of chloral are properly attributable to impurities in the drug. 
If the crystals have a pungent, acrid odor, they should not be used ; 
recrystallized chloral hydrate should be preferred for medical use. Where 
the heart is seriously affected and its walls are thin and weak, chloral 
should, as a rule, not be given. It is also dangerous to use it freely in 
alcoholic subjects. 
Therapy.—The antiseptic action of chloral is utilized in surgery, 
where 5-per-cent, solutions are used as stimulating dressings for suppu- 
rating wounds and foul ulcers. This solution also may be applied to 
parasitic skin affections (Tinea versicolor). It is also used to check 
itching in eczema and prurigo. In combination with other remedies, it 
is used as an anodyne and counter-irritant in neuralgia and rheumatism : 
Chloral., 3ij. 
Lin. saponis, l^iv.—M. 
For application to pleurodynia, lumbago, etc., the combination of 
chloral and camphor may be used :— 530 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
R Camphorae, 
Chloralis, . . . . . . . . . . 5» 3j. 
Misce et adde 
Lanolini, f§j. 
M. For neuralgia. 
In diphtheria a gargle of 2 per cent., followed application of a 
20-per-cent, solution, is said to cause prompt disappearance of the false 
membranes. 
Two or three grains of chloral to the ounce of water has been success- 
fully used as an injection in gonorrhoea. Garretson employs the follow- 
ing combination, containing chloral, with effect as an injection in 
gonorrhoea :— 
Chloralis, 
Zinci sulphatis, . aa gr. viij. 
Aquae dest., viij.—M. 
The principal stunptom for which chloral is prescribed is insomnia 
from mental overwork, or occurring during the course of typhus 
or typhoid, in delirium tremens, in phthisis, or in the aged. In acute 
mania, especially that caused by alcohol, very large doses have been 
followed by the best effects. When injected (5i-ij) into a vein, general 
anaesthesia is produced, but this method has no special advantage, and 
presents some decided disadvantages. The restlessness and insomnia 
present in general paralysis of the insane are allayed by the administration 
of this remedy, and it is also beneficial in spasmodic affections, chorea, 
whooping-cough,asthma, uterine pains, strychnine poisoning,and tetanus. 
A dose of chloral at bed-time is useful in paralysis agitans, and may be 
able to ward off an attack of nocturnal epilepsy. Chloral affords relief in 
laryngismus stridulus. The injection of 5 to 10 grains of 
chloral hydrate, in combination with to £ grain of sulphate of morphine, 
is highly recommended in cholera morbus attended with collapse and in 
the algid stage of Asiatic cholera. If the patient cannot be made to 
swallow, an emulsion may be prepared with egg containing 1 or 2 drachms 
of chloral, and given per enema. This drug also acts as an antidote in 
cases of poisoning from physostigma and picrotoxin. In cases of undue 
arterial excitement, during the early stage of pneumonia or overaction 
of a hj'pertrophied heart, or in the increased arterial tension of Bright’s 
disease, chloral judiciously used may be of service. It is given with much 
benefit in allaying the discomfort of sea-sickness. In congestive head- 
ache with insomnia a combination like the following is advantageous:— 
Chloralis, 3j. 
Morphinae hydrobromat., gr. j. 
Aquae camphorae., f^ij. 
M. Sig.: A dessertspoonful every two hours until relieved. CHLORAL. 
531 
It has been found useful in scarlet fever by Wilson, who gives gr. 
i-ij in a little syrup of lactucarium and water every two or three hours 
for a child 5 years of age. 
In tetanus 10 to 20 grains should be given every hour or two, ac- 
cording to the gravity of the case, gradually lengthening the intervals 
and afterward reducing the dose. In convulsions after labor, an enema 
containing 1 drachm of chloral should be thrown into the rectum, or 30 
or 40 grains given by the mouth. In the convulsions of children, it is a 
very prompt and efficient remedy. In restlessness and insomnia, chloral 
may be very advantageously prescribed with potassium bromide, as— 
Chloralis, 3iij. 
Potassii bromidi, 3v. 
Syrup, lactucarii, 
Syrupi aurantii flor., aa f^ij. 
M. Sig.: A dessertspoonful at bed-time. 
For the relief of night-sweats of phthisis, 1 drachm may be dis- 
solved in 3 ounces of dilute bathing-whisky and the patient’s skin bathed 
with it. This is also a good application to prevent bed-sores. 
The compounds of chloral with camphor, salicylic acid, and with 
carbolic acid, are useful as antiseptics, especiall}7 the latter, which is free 
from unpleasant odor and is anodyne as well as antiseptic. 
Chloral Butylicum.—Butyl chloral hydrate, or croton chloral (Dose, 
gr. ii-xxx), is obtained by the action of chlorine upon acetic aldehyde 
and collected by distillation. It is the hydrate of trichlorbutylaldehyde, 
and is in the form of crystalline scales, having a pungent smell and a 
disagreeable, acrid taste. 
The action is like that of chloral, but said to be less depressing to 
the circulation and heart. It is more anodyne, and is especially useful 
in neuralgia. Five grains are given every half hour in neuralgia of the 
face. Liebreicli, who was the discoverer of this drug, praises it as a 
hypnotic in doses of gr. xv-xxx. Croton chloral gives relief in head- 
ache due to e3Te-strain, and Ringer has found it very beneficial in migraine. 
It has also proved serviceable in dysmenorrhoea. 
The following combination is recommended in neuralgia:— 
Croton chloral., 3ij. 
Spt. vini rectiflcat., . . . f3ij. 
Elix. guaranae, 
M. Sig.: A teaspoonful every half hour or hour. 
Chloralamid, or chloramid, is a new hypnotic, prepared by a patented 
process by combination of 2 parts chloral hydrate and 1 part of forma- 
mide. At present it is said to cost about one-fourth as much as sul- 
phonal. According to von Mering, the drug is useful in senility, neuras- 532 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
thenia, phthisis, and diseases not attended by much pain. Mupfenbach 
( Therap. ]\[onats., No. 10, 1890), from a number of trials of chloralamid 
in Andernach Asylum, reports that it is a useful hypnotic, but that it 
possesses the disadvantage that one can never reckon certainly upon its 
action. From chloralamid no ill effects upon the circulation or in the 
feelings of patients are observed (Reichmann), although vomiting may 
occur. The usual dose is 2 or 3 grammes (30 to 45 grains). According 
to Rabow, experiments upon animals show that 3 parts of chloralamid 
equal in efficiency 2 of chloral hydrate, which is just the proportion in 
which chloral exists in the combination, in which it does not appear to 
gain hypnotic effect, although possibly there is less action upon the heart 
and blood-vessels than when chloral is given alone. In the report pre- 
sented by Dr. T. Lauder Brunton,Chairman of Committee on the Relative 
Utility of Different Hypnotics, especially with reference to the certainty 
of their action and the question of tolerance, chloralamid, in doses of 20 
to 30 grains, produced better effects than sulphonal, and was followed 
no bad result.* According to Langaard, however, this drug produces a 
decided reduction of blood-pressure, which is developed more gradually 
and is later in making its appearance than that due to chloral. He there- 
fore advises caution in the use of the drug in diseases of the heart. 
Good results have been attributed to chloralamid in chorea. 
Chlormethyl is highly praised by Debovef in cases of sciatica and 
other neuralgias. 
CHLOROFORMUM VENALE (U. S. P.).—Commercial Chloroform. 
Preparations. 
Ghloroformum Purificatum (U. S. 1’.).—Purified Chloroform. Pose, for inhalation, 
!Tlxx-f3j ; internally, Ifix-xx. 
Mistura Ghloroformi (U. S. P.).—Mixture of Chloroform (chloroform, purified, 8; 
camphor, 2 ; egg-yelk, 10 ; and water, 80 parts). Pose, f3i-iv. 
Spiritus Ghloroformi (U. S. P.).—Spirit of Chloroform (10-per-cent, purified chloro- 
form). Pose, f3ss-j. 
Linimentnm Ghloroformi (U. S. P.).—Liniment of Chloroform (commercial chloro- 
form, 40 ; soap-liniment, 60 parts). 
Linirnentum Aconiti et Ghloroformi (N. F.).—Liniment of Aconite and Chloroform 
(tincture of aconite and chloroform, of each, 2 parts ; soap-liniment, 19 parts). 
Aqua Ghloroformi.—Chloroform-Water (about gr. iij in f§j). Pose, f3i-iv. 
Pharmacology.—Commercial chloroform is impure, only containing 
98 per cent, of chloroform, and is used solely for pharmaceutical purposes, 
as a solvent, or for external application. Purified chloroform is “ a heavy, 
clear, colorless, diffusive liquid, of a characteristic, pleasant, ethereal 
odor, a burning, sweet taste, and a neutral reaction.” It is obtained by 
adding chloral hydrate to an alkaline solution, or by the action of chlor- 
* British Medical Journal, July 26, 1890. 
f Buffalo Medical and Surgic. l Journal, April, 1889. 533 
CHLOROFORMUM VENALE. 
inated lime upon ethyl oxide, or alcohol, and distillation. It is afterward 
purified by the addition of sulphuric acid, sodium carbonate, and lime, 
and re-distillation. Chloroform is only sparingly soluble in water, but 
mixes with alcohol and ether in all proportions. It is itself a remark- 
able solvent, dissolving most alkaloids, resins, gutta perclia, caoutchouc, 
paraffin, iodine, bromine, fixed and volatile oils, etc. Chloroform is not 
inflammable, but when mixed with alcohol it may be burned, and chlorine 
gas will be evolved. Chloroform-vapor is much denser than atmospheric 
air and diffuses slowly. Chloroform is unfit for anaesthetic purposes 
unless it be absolutely pure and fulfills the tests of the pharmacopoeia. 
“ If 5 cubic centimetres of purified chloroform be thoroughly agitated 
with 10 cubic centimetres of distilled water, the latter, when separated, 
should not affect blue litmus-paper (absence of acids), nor test solution 
of nitrate of silver (chloride), nor test solution of iodide of potassium 
(free chlorine). If a portion be digested, warm, with solution of potassa, 
the latter should not become dark colored (absence of aldehyde). On 
shaking 10 cubic centimetres of the chloroform with 5 cubic centimetres 
of sulphuric acid in a glass-stoppered bottle, and allowing them to remain 
in contact for twenty-four hours, no color should be imparted to either 
liquid. If a few cubic centimetres be permitted to evaporate from 
blotting-paper, no foreign odor should be perceptible after the odor of 
the chloroform ceases to be recognized.” The purified chloroform con- 
tains about £ to 1 per cent, of alcohol. It must be kept in glass-stoppered 
bottles in a cool and dark place. 
Chloroform was discovered in 1831, by Mr. Samuel Guthrie, of 
Sackett’s Harbor, N. Y., and about the same time by Soubeiran in 
France, and Liebig in Germany. It was first used as an anaesthetic by 
Sir James Y. Simpson, of Edinburgh, in 1847. 
Physiological Action.—When kept in contact with the skin for 
some time, it causes irritation and, finally, vesication. After absorp- 
tion, it exerts a sedative effect. Internally, it produces a feeling of 
warmth in the stomach and acts as a carminative, antispasmodic, 
and sedative; large doses are irritant. When introduced into the 
circulation, whether by absorption from the broncho-pulmonaiy mucous 
membrane during inhalation or by that of the stomach, the effects 
are the same. After a brief period of stimulation, the depressing effect 
of the drug is manifested, and in overdoses it is a cardiac poison, acting 
by destroying the contractility of the heart-muscle. Professor John A. 
MacWilliam, of Aberdeen, has demonstrated that, even when gently ad- 
ministered in moderate quantities and with a due admixture of air, 
chloroform causes an appreciable dilatation of the heart. This dilata- 
tion may precede the loss of the conjunctival reflex, and affects both 534 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
sides of the heart. It often occurs before any fall of blood-pressure. 
Artificial respiration, therefore, often fails to revive the patient because 
the enfeebled and distended heart is unable to maintain the circulation. 
The dilatation is not produced through the pneumogastrics, but is the di- 
rect effect of the drug upon the cardiac mechanism.* During anaesthesia 
the pupils are contracted. Dilatation of the pupils while the subject is 
fully under the influence of chloroform is an ominous sign. The anaes- 
thetic should be immediately withdrawn and measures taken to invigorate 
the respiration and circulation and restore the patient to consciousness. 
Chloroform is eliminated by the lungs and the kidneys. It proves irri- 
tant to the kidneys as it escapes from the system. It generally kills in 
Europe and America by heart-paralysis, though, according to the recent 
report of the Hyderabad Commission to the British Medical Journal, in 
India it kills dogs by failure of respiration. It has no special effect upon 
the blood, unless the decided lowering of bodily temperature is to be 
attributed to its action upon the red blood-corpuscles, interfering with 
their function as oxygen-carriers to the tissues. Upon the nervous system 
the effects are very positive. Chloroform first affects the brain, then the 
sensoiy part of the spinal cord, then the motor tract, then the sensory 
parts of the medulla oblongata, and finally the motor portion of the 
medulla, thereby producing death from failure of respiration unless the 
heart has already succumbed to the drug (Hare). 
Therapy.—Chloroform is used as a local sedative, antiseptic, and 
counter-irritant, and, owing to its solvent action upon the alkaloids,it is 
a useful vehicle for anod37nes. The solution of gutta-percha in chloro- 
form (liquor gutta-perchae, U. S. P.) is sometimes used as a protective 
in small-pox and erysipelas. This is likewise a useful application in 
psoriasis, herpes zoster, superficial burns, furuncles, and fissured nipples. 
A lotion containing chloroform is often of service in urticaria, and a 
liniment made with chloroform, aconite, and camphor soothes the pain 
of neuralgia and chronic rheumatism :— 
Chloroformi, 
Tinct. opii, 
Tinct. aconit. rad., aa f^ss. 
Liniment, saponis, f^iiss. 
M. Sig.: For external application. 
Chloroform may also be used, as suggested by South worth, in the 
following combination to overcome a rigid perineum in labor:— 
Chloroformi, f^ij. 
.dStheris sulph., f^j. 
Spiritus odorat., Oj. 
M. Sig.: Apply locally. 
* British Medical Journal, October 11,18, and 25, 1890. CHLOROFORMUM VENALE. 
535 
This mixture acts quickly and well, large heads passing the perineum 
with no tear, which without it seemed impossible unless followed with 
extensive rupture. 
Dobisch * recommends a combination containing pure chloroform 
as a spray for its local anaesthetic effect in minor surgical operations, 
incision of a paronychia, evacuation of a glandular abscess, extirpation 
of a superficial epithelioma, as follows :— 
$ Mentholi, 3.j. 
Chloroformi, f3x. 
iEtheris sulph., f3xv.—M. 
The local anaesthesia lasts from two to six minutes. 
it is useful in gastralgia as chloroform-water, or in com- 
bination with anodynes, as in chlorodyne.f It has also been given in 
hysteria, asthma, irritable cough, and seasickness. 
Chloroform-water has been found serviceable in spasmodic croup. 
A few drops of chloroform, taken in water or upon sugar, will often 
relieve vomiting when not due to inflammation of the stomach. In diar- 
rhoea, spirit of chloroform is beneficially added to a mixture containing 
astringents and opium. The chill of intermittent fever may often be 
averted by the administration of a drachm of the spirit of chloroform. 
The same preparation, given alone or in combination with morphine, 
allays hiccough. 
The mierobicide action of chloroform makes it serviceable in some 
cases of flatulent and fermentative or infectious dyspepsia. It has even 
been claimed to be useful in cholera in this way, and might be service- 
able in typhoid fever,—during the early stage, at least. 
The spirit of chloroform is used with especial advantage in the treat- 
ment of cholera morbus, and often for its sedative action upon the 
system. 
The spirit of chloroform can be advantageously combined and used 
with aromatics and other remedies. 
* Allgemeine Medicinische Central-Zeitung, No. 14, 1890. 
f Chlorodyne- The following formula is given by Oldberg and Wall as a good substi- 
tute for Collis Browne’s chlorodyne :— 
CHLOROFORMI MISTURA HYDROCYANATA (COMPOUND CHLOROFORM MIXTURE) 
Jfc Morphinae sulphat., gr. iv. 
Ol. menthse piperita, gr. viij. 
JEtheria, 
Alcoholis aa gr. cliv. 
Acid, hydrocyanic, dil., f5v gr. Ixxxvj. 
Chloroformi puriflcat., fSiii gr. ccxxx. 
Syrupi, q. s. ad fSxvij. 
Dose, njv-x. 536 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Spiritus chloroformi, f^ss. 
Aquae caraphoirae, 
Spiritus aetheriscomp., 
Tinct. capsici, ij. 
M. Sig.: A dessertspoonful in water, whenever necessary, for cholera morbus or in 
stomach-ache or intestinal pains or flatulence. 
Spiritus chloroformi, f3v. 
Creasoti, \ ,Tlvj. 
Spiritus ammon. arom., . . . . * \ f3ij. 
Aquae menth. pip., \ . q. s. ad f§v. 
M. Sig.: A teaspoonful or two before meals for nausea or vomiting. 
Spiritus chloroformi, f§ss. 
Morphinae sulphatis, gi'.j. 
Aquae cinnamomi, q. 6. ad f§iv. 
M. Sig.: From one to two teaspoonfuls every half hour for after-pains or in nervous 
or hysterical attacks. 
Iii fevers, the spirit of chloroform is useful to relieve restlessness 
and irritative cough in pneumonia, bronchitis, or pleurisy, usually given 
in a “ fever-mixture ” combination. 
Special Application.—The important application of this remedy is for 
producing anaesthesia during surgical operations. It is the most pleasant, 
the most active, and the most convenient anaesthetic. Unfortunately, 
its death-record is so much higher than that of its great rival, sulphuric 
ether, that most surgeons in this country prefer to use the latter, although 
its odor is not agreeable, and it requires a much larger quantity to pro- 
duce unconsciousness, and it has a preliminary state of excitement or 
intoxication. (Remarks upon the state of anaesthesia and the choice of 
anaesthetics may be found on page 403 et seq.) 
The Administration for Anaesthetic Effect.—The administration of 
chloroform for surgical operations requires skill and experience, and 
should never be intrusted to the hands of young graduates, whose 
attention is apt to be centred upon the operation instead of their doty. 
The greater number of fatal cases, by far, have occurred in the hands 
of those who did not appreciate the responsibility they assumed in using 
this powerful agent. To be forewarned is to be forearmed. Whereas 
deaths occur frequently in dental practice, where the operator tries 
to anaesthetize the patient and also to get ready to operate at the 
same time, the proportion of deaths in the hands of experienced anaes- 
thetizers is very small, and hence the incredulity of some surgeons as to 
the greater danger of chloroform than ether. The method to be followed 
is, first, to eliminate all cases of weak or diseased heart; and, if the 
operation is to be a long one, requiring prolonged administration of the 
anaesthetic, cases of kidney disease must also be excluded. The patient CHLOROFORMUM VENALE. 
537 
should not he in a sitting posture, nor should the chloroform he admin- 
istered soon after a full meal. The clothing about the neck and waist 
should he loose enough to allow respiratory movements, hut the patient 
should not he too much exposed, on account of the lowering of tempera- 
ture and the possibility of congestion of the lungs or kidneys subse- 
quent to the administration. The chloroform should be pure, and about 
40 minims to a drachm poured upon a napkin or towel and held a little 
distance above the patient’s nose and mouth, so that the dense vapor in 
falling shall mix with air. 
According to Clover, the cliloroform-vapor should be diluted with 
20 volumes of air, and he has devised a special inhaler designed to ac- 
complish this dilution. In many cases full anaesthesia, or coma, is not 
needed for small operations, parturition, passage of gall-stones, etc.; 
consciousness may be preserved while the sense of pain is abolished. 
Dr. Sayre, of New York, uses a much smaller amount of chloroform (5 
to 20 drops), but administers the vapor in as concentrated a form as 
he can, avoiding the admission of air as far as possible, and speaks 
very confidently of the efficiency and safety of this method. The 
patient’s pulse should be watched during the administration of chloro- 
form, and, if it suddenly drops or becomes fluttering, Nelaton’s method 
should be at once employed, in which the patient is placed in a vertical 
position, with the head downward, while artificial respiration is employed, 
which is usually successful. Nitrite of amyl or ammonia inhalations 
should also be practiced ; or ether, digitalis, or whisky injected hypoder- 
matically. Efforts at resuscitation should not be discontinued in less 
than one hour, as patients have recovered after artificial respiration had 
been continued for this length of time. The faradic current is likely to 
do more harm than good, as it interferes with other measures, and if 
applied to the phrenic nerve may cause stoppage of the heart by in- 
hibitory action. Slapping the chest with the fringe of a towel wet with 
cold water was the favorite resource of the elder Gross. 
From his studies upon animals, H. C. Wood is led to regard 
digitalis, hypodermatieally injected, as by far the most valuable agent 
in combating the depressant effect of chloroform upon the heart. He 
also advises the conjoined use of strychnine on account of its stimulant 
influence upon the circulation, and particularly upon the respiration. 
He believes that small amounts of alcohol are valueless, while large 
quantities assist the paralyzing action upon the heart. When danger 
threatens, the angle of the jaw should be raised and the tongue drawn 
forward, so that no mechanical impediment shall be offered to free 
respiration. 
In administering chloroform, it is important to gain the confidence 538 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
and co-operation of the patient, because struggling and resistance often 
disturb the judgment and lead to the employment of a larger quantity 
than is desired. Chloroform ought never to be administered rapidly, for 
the sudden entrance of a small quantity into the circulation is more 
dangerous than the gradual absorption of a larger quantity. In major 
operations, before the administration of the chloroform, it is customary 
with surgeons to give the patient 1 or 2 ounces of whisky as an arterial 
and cardiac stimulant. Chloroform is also often administered by inhala- 
tion for the relief of infantile and puerperal convulsions. The paroxysms 
of whooping-cough are checked or moderated by this agent. About 
drachm may be poured upon the hand of the mother and held near the 
child’s nose, or it may be vaporized b)’ means of hot water, 2 or 3 drops 
being used for each year of the child’s age. Used in the latter manner, four 
times daily, it is said to shorten the paroxysmal stage. In severe cases of 
chorea, in which the convulsive movements interfere with deglutition and 
rest, chloroform inhalations answer a very good purpose by inducing 
sleep, which is followed by notable improvement. Administered at first 
three times a day, and less often as the s3’mptoms improve, this plan is said 
to cure the disease, on an average, in twenty-eight days. Chloroform is of 
value in painful delivery, not given so as to produce unconsciousness, but 
merely to blunt the sensibility. Used in this way, the uterine contrac- 
tions ai’e not weakened nor the danger of post-partum haemorrhage in- 
creased. Chloroform is better borne by women in labor than by any other 
class of subjects. But if pushed to anaesthesia the contractions become 
less vigorous and haemorrhage is favored. It is asserted that the inhala- 
tion of chloroform for a few minutes at a time several times a day is 
beneficial in phthisis, relieving the cough and reducing the temperature. 
For this purpose, Fraser recommends also the hypodermatic injections 
of atropine (gr. X2<y-?rV) with hydrochlorate of morphine (gr. xV“i); for 
the latter Dr. Laborde substitutes narceine.* In sciatica, Bartholow has 
given deep injections of 10 to 20 minims of chloroform near the sheath 
of the nerve. In some cases this method has also afforded marked relief 
in facial neuralgia. 
CHLORUM.—Chlorine. 
Preparations. 
Aqua Chlori (U. S. P.).—Chlorine-Water (0.4 per cent, chlorine), jDose, largely 
diluted, f3i-v. 
Calx Cldorata (U. S. P.).—Chlorinated Lime (25 per cent, of available chlorine). 
Dose, gr. iii-vj. 
Liquor Soda Chloratce (U. S. P.).—Solution of Chlorinated Soda (2 per cent.). Dose, 
Hlx-f3j, largely diluted. 
* Therapeutic Gazette, September, 1890, p. 639. 539 
CIILOKUM. 
Pharmacology.—Chlorine is a gaseous element, more than twice the 
density of air, of a greenish color, strong and suffocating odor, irre- 
spirable and, even in a state of dilution, very irritating to the air-passages. 
For disinfecting purposes, it may be disengaged by adding hydrochloric 
acid to binoxide of manganese. Chlorine is soluble in water, and under 
the influence of sunlight slowly decomposes that liquid, combining with 
the hydrogen and setting the oxygen at liberty’. Owing to the affinity 
for hydrogen, chlorine acts energeticall}r upon organic substances, and 
often destroys them. Coloring matters of organic origin are bleached 
when exposed to its action. Chlorine is an efficacious disinfectant, de- 
composing hydrogen sulphide and destroying putrefying material. It 
also destroys the infectious miasms in the air, but should be in excess 
and in a closed room in order to be very effective. The generation of 
chlorine in the same room with patients is of very little use so far as 
disinfection is concerned. The combination with lime (chlorinated lime, 
or bleaching powder) is largely used for disinfecting drains and cess- 
pools. 
For the sick-room, the solution of chlorinated soda (Labarraque’s 
solution) is more convenient and less offensive, for use in commodes, 
bed-pans, etc., or for internal administration. The inhalation of ammonia 
gas is antidotal to chlorine when absorbed by the air-passages, chloride 
of ammonium resulting from their combination. In cases of accidental 
poisoning from swallowing a chlorine solution, albumin, in the form of 
milk, eggs, or flour, is the best remedy at our command. 
Physiological Action.—Chlorine gas, in concentrated form, when 
directed upon the skin, causes smarting and redness, followed by 
erysipelatous or pustular inflammation. It is a disinfectant, destroying- 
parasitic vegetable growths. The inhalation of dilute chlorine is irri- 
tating to the lungs and stimulates the end organs of the pneumogastric 
nerve, causing coughing and strangling sensations. Internally, chlorine 
was formerly given in various infectious diseases, but this is rarely done 
at the present day, although Labarraque’s solution or (freshly prepared) 
chlorine-water has decided influence in maintaining the stomach in an 
aseptic state during low forms of fever. 
Therapy.—In the form of solution, chlorine is used to clean offensive 
ulcers and to remove patches of pityriasis. This liquid is also an excel- 
lent disinfectant to sloughing wounds, and may be injected into abscess- 
cavities, sinuses, or fistula?, for the purpose of removing and neutralizing 
unhealthy or decomposing pus. As an antiseptic wash, it may be em- 
ployed in puerperal metritis. One part of Labarraque’s solution to 10 or 
12 of water is a useful injection in vaginitis. The same solution may be 
used as a prophylactic against poison from bites of serpents or insects. 540 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Chlorinated oil*—that is, olive-oil saturated with chlorine—is a very 
efficient remedy in scabies. It acts without irritating the skin. In 
diphtheria the extemporaneous solution of Sir Thomas Watson is still 
used by some.f It may be made by adding a drachm of hydrochloric 
acid to 10 grains of chlorate of potassium in a pint bottle, and, adding 
water gradually, shaking the bottle each time, until it is filled. This 
solution can be used freely for internal administration for its local and 
constitutional effects. Aqua chlori, or Labarraque’s solution, may be simi- 
larly used, much diluted with water. The sore throat of scarlet fever is 
also benefited by the same methods. Gangrene of the montU or tongue 
is likewise amenable to the same influence. The solution of chlorinated 
lime of the British Pharmacopoeia is one of the best antidotes to hydro- 
sulphuric acid, ammonium sulphydrate, potassium sulphide, and hydro- 
cyanic acid (given in doses of Sheets wrung out of this 
solution may be wrapped around the body of a person dead of infectious 
disease or in a decomposing condition. 
CHONDRUS (U. S. P.).—Chondrus. (Irish Moss.) 
Pharmacology and Therapy.—Irish moss, or carrageen, is Chondrus 
crispus and Chondrus mammillosus (Algae) bleached and dried by ex- 
posure to the sun. It is in hard, translucent, yellowish-white fragments 
of sea-weed, -with characteristic odor and saline, mucilaginous taste. It 
contains iodine and bromine in small quantities ; its principal constituent 
is mucilage, but it contains no starch. Boiled with milk and water 
(§j in Oj) and properly sweetened with white sugar and flavored, it 
makes blanc mange; or, in more dilute decoction (5iv to Oiij), a demul- 
cent drink for the sick. It has not much food value, but is deemed useful 
in bronchial affections. 
CHRYSAROBINUM (U. S. P.).—Chrysarobin. 
Dose, gr. |-xx. 
Preparation. 
Uhguentum Chnjsarobini (U. S. P.).—Ointment of Chrysarobin (10 per cent., with 
benzoinated lard). 
Pharmacology.—Chrysarobin is a mixture of proximate principles, 
commonly misnamed chrysoplianic acid, extracted from goa-powder, a 
substance found deposited in the wood of the trunk of Andira araroba 
(Leguminosse), a native of East Indies and Brazil. It is an orange-yellow 
powder, odorless and without taste, nearly insoluble in water and in 
alcohol, but soluble in ether, sulphuric acid, and solutions of alkalies. 
* “ Chlorinated Oil.” Bee paper by the author. Medical Bulletin, 188i, p. 271. 
f The strength of this solution is one avoirdupois pound of chlorinated soda to the 
imperial gallon. 541 
CIMICIFUGA. 
Physiological Action.—In comparatively large doses (3ss) it causes 
irritation of the intestinal mucous membrane, and gives rise to vomiting 
and purging, with large, bilious stools. 
It excites inflammation of the skin from its local application, and 
produces a yellowish-brown stain of the skin and clothing. (The stain is 
removable with a weak solution of chlorinated lime or soda.) The der- 
matitis may be diffuse, or expressed by follicular and furuncular eruptions. 
Chrysarobin is parasiticide, and destructive to epiphytic organisms. 
Therapy.—The principal use of chrysarobin is for its cathartic 
action. It has been administered internally, in doses of gr. several 
times daily in psoriasis. But its extremely irritant effect upon the 
intestinal mucous membrane so soon compels its abandonment that 
it is practically valueless as a systemic remedy. When applied ex- 
ternally for a considerable period, a small portion may probably act by 
absorption. Chrysarobin ointment should not be allowed to come in 
contact with the healthy skin, but, in psoriasis, the disease for which it 
has been principally employed, should be carefully rubbed into the 
affected area. The parts should then be covered by a bandage in order 
to protect the linen. Another method of applying chrysarobin is by 
making a paste of it by means of water, rubbing the paste upon the 
patches after the scales have been removed, allowing the mixture to 
harden and, finally, penciling collodion over the surface. 
Chrysarobin is curative by its stimulating action on psoriasis, chronic 
acne, and vegetable parasitic skin diseases; but the officinal ointment 
should be diluted several times before application, for fear of exciting 
too much inflammatory reaction. Chronic eczema and the second stage 
of rosacea also receive benefit from chrysarobin ointment. The same 
preparation has sometimes proved of service in lupus vulgaris. 
A very good combination in chronic eczema and psoriasis is the 
following:— 
Oleicadint, f3ss. 
Chrysarobini, gr. xx. 
Unguent, zinci oxidi, §j.—M. 
CIMICIFUGA (U. S. P.).—Cimicifuga, Black Snake-Root, Black 
Cohosh, Actaea. 
Dose, gr. xx-xxx. 
Preparations. 
Extradum Cimicifugce Fluidum (U. 8. P.).—Fluid Extract of Cimicifuga. Dose, f3ss. 
Extradum Cimicifugce.—Extract of Cimicifuga. Done, gr. i-v. 
Tindura Cimicifugce (U. S. P.).—Tincture of Cimicifuga (20 per cent.). Dose, f3i-ij. 
Decodum Cimicifugce.—Decoction of Cimicifuga (1 i—Oj). Dose, fovi-^iss. 
Macrotin.—An impure resin. Dose, gr. ss-ij. 542 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Pharmacology.—The rhizome and rootlets of Cimicifnga racemosa 
(Ranunculaceae), a plant common in woods in Northern United States, 
contain a neutral principle of acrid taste, soluble in dilute alcohol, water, 
chloroform, or ether. Its chemical nature is not known positively. 
Mr. Geo. II. Davis has discovered a volatile oil in the gathered 
roots; and Prof. Geo. B. Wood thought that this might be the active 
principle, since the drug deteriorates upon keeping. It also contains two 
resins. So-called cimicifugin, or macrotin, is an impure resin, deposited 
from the concentrated tincture upon the addition of water. There is also 
in the recent drug, besides the volatile oil, some tannic and gallic acids. 
The odor of the plant is rather fetid. 
Physiological Action.—Cimicifnga has decided effects upon the human 
sj'stem. Small doses stimulate the digestive function and increase secre- 
tions along the alimentary canal. The secretions of the bronchial mucous 
membrane are also increased, the action of the heart stimulated, and the 
urine is augmented in quantity, The menstrual flow is increased, and 
some aphrodisiac qualities have been ascribed to the drug. Upon the 
heart and circulation an effect is noticed resembling that of digitalis, 
though less marked. Full doses slow the pulse and increase its force, 
raise arterial tension and stimulate uterine contraction; the latter action 
recalls that of ergot, though it is less powerful. Cimicifnga lowers the 
reflex activity of the spinal cord. The pupils are dilated ; dimness of 
vision, vertigo, intense headache, nausea, and vomiting result from large 
doses. Even soporific effects have been observed, with relief from pain 
or spasm. Death may be caused by failure of respiration. 
Therapy.—The applications of cimicifnga are in accordance with its 
physiological activity. Externally, a saturated tincture is said to relieve 
pain in rheumatism and neuralgia. In chorea it is of decided value, 
especially in weak, anaemic children. It is, moreover, very applicable to 
those cases which manifestly depend upon rheumatism, or to those which 
develop in girls at the age of puberty and are associated with menstrual 
irregularity. In neuralgia, especially when the consequence of rheuma- 
tism, cimicifnga is of undoubted benefit. In certain cases of sciatica 
improvement follows the administration of this agent. It was introduced 
into England by Sir J. Y. Simpson as a remedy for chronic rheumatism, 
myalgia, and hypochondriasis with depression. Cimicifnga is likewise 
serviceable in some cases of acute rheumatism, and Ringer has found it 
useful in rheumatoid arthritis. The fluid extract is the best and most 
reliable preparation. In uterine subinvolution, ovarian neuralgia, and 
amenorrhoea, it is highly commended. It has a good effect, also, in other 
constitutional manifestations dependent upon disorder of the female gen- 
erative system, as, for instance, convulsions caused by disturbance of the CINCHONA. 
543 
catamenial function, and in puerperal mania. Congestive dysmenorrhoea 
is likewise relieved by this remedy. By reason of its action upon the 
womb, cimicifuga may be employed during parturition as a substitute for 
ergot. Though not so powerful as the latter drug, it strengthens the 
normal uterine contractions. For its tonic effects, it is used in treating 
gastric catarrh and irritable stomach of alcoholism ; also in delirium 
tremens and functional impotence. In weak and fatty heart it is safer 
than digitalis. On account of its stimulating effects upon the uterus, it 
should not be given during pregnancy. 
In headache from eye-strain, cimicifuga has been given with benefit, 
and is especially useful in acute bronchitis as an expectorant. It may 
even be serviceably prescribed in phthisis, as it facilitates expectoration, 
sustains the appetite and digestion, and reduces fever. 
Cimicifuga may be administered in the appended formulae:— 
Ext. cimicifugae fl., f§iss. 
Tinct. nucis vomicae, f3j. 
Tinct. cinchonae comp., q. s. ad f3;v. 
M. Sig.: A teaspoonful or two in water every three or four hours. For ovarian and 
uterine neuralgia and amenorrhoea. 
Ext. cimicifugae 11., f^j. 
Morphinae sulphatis, gr.j. 
Spiritus aetheris nitrosi, 
Liquor, ammonii acetatis, aa § ij. 
M. Sig.: Two teaspoonfuls in water every three or four hours. For neuralgia, acute 
rheumatism, and acute bronchitis. 
Ext. cimicifugae, gr. xxiv. 
Ext. belladonnae ale., gr.j. 
Pulv. capsici, gr. xij. 
M. et ft. pil. no. xij. 
Sig.: From one to two pills three times a day. For gastric catarrh, delirium tremens, 
and functional impotence. 
CINCHONA (U. S. P.).—Cinchona, Peruvian Bark. 
Cinchona Flava (U. S. P.).—Yellow Cinchona. 
Cinchona Rubra (U. S. P.).—Red Cinchona. 
Preparations of the Yellow Bark. 
Infusum Cinchona (U. S. P.).—Infusion of Cinchona (6 per cent, of yellow cinchona 
when not otherwise specified, 1 per cent, sulphuric acid, and water). Dose, f^ss-iij. 
Extradum Cinchonce (U. S. P.).—Extract of Cinchona. Dose, gr. i-x. 
Extractum Cinchona Flnidum (U. S. P.).— Fluid Extract of Cinchona. Dose, !Tlx-f3ij. 
Tinctura Cinchotue (U. S. P.).—Tincture of Cinchona (20 per cent.). Dose, Hlxxx-f3ij. 
Preparation of the Red Bark. 
Tinctura Cinchona Composita (U. S. P.).—Compound Tincture of Cinchona (cinchona 
10, bitter orange-peel 8, serpentaria 2, glycerin 10, alcohol q. s. ad 100 parts). Dose, f3i-iv.  PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Alkaloids and Salts. 
Quinina (U. S. P.).—Quinine. A white, amorphous powder, soluble in 1600 parts 
water and in 6 parts alcohol. Dose, gr. i-3j. 
Quinince Sulphas (U. S. P.).—Sulphate of Quinine. Dose, gr. i-3j. In snow-white, 
loose, filiform crystals, fragile, and in a light, easily-compressible mass; lustreless (owing 
to superficial efflorescence), odorless, having a persistent bitter taste and neutral reaction. 
Soluble in 740 parts of water, and in 65 parts of alcohol at 15° C. (59° F.), in small pro- 
portions of acidulated water. Very slightly soluble in ether. Aqueous solution, especially 
if acidulated with sulphuric acid, has a vivid, blue fluorescence. When treated first with 
fresh chlorine-water, and then with slight excess of water of ammonia, the salt produces an 
emerald-green color (thalleioqum). Crystals are formed of the same color by treating an 
acidulated solution of quinine sulphate with saturated alcoholic solution of iodine 
([herapathites). 
Ferri et Quinince Citras (U. S. P.).—Citrate of Iron and Quinine (contains 12 per 
cent, of quinine, 88 of iron citrate). Dose, gr. ii-x. 
Liquor Ferri et Quinince Citratis.—Solution of Citrate of Iron and Quinine (contains 6 
per cent, of quinine, 32 of iron citrate). Dose, lflv-xv. 
Yinum Ferri Amarum (U. S. P.)—Bitter Wine of Iron (contains solution citrate of 
iron and quinine 8, tincture sweet orange-peel 12, syrup 36, and stronger white wine q. s. ad 
100 parts). Dose, f3i-ij. 
Quinince Disulphas (U. S. P.).—Bisulphate of Quinine. Dose, gr. i-xv. Similar to 
the sulphate, but much more soluble, dissolving in 10 parts of water or 32 parts of alcohol 
at 59° F. 
Quinince Hydrochloras (U. S. P.).—Hydrochlorate of Quinine. Dose, gr. i-xv. 
Soluble in 34 parts of water. 
Quinince Hydrobromas (U. S. P.).—Hydrobromate of Quinine. Dose, gr. i-xx. 
Qicinince Valerianas (U. S. P.).—Valerianate of Quinine. Dose, gr. i-xx. 
Cinchonince (U. S. P.).—Cinchonine. Dose, gr. v-xxx. White crystals, almost in- 
soluble in water. Has an alkaline reaction. Tasteless at first, afterward bitter. 
Cinchonince Sulphas (U. S. P.).—Sulphate of Cinchonine. Dose, gr. v-xxx. In white 
needles, soluble in 70 parts of water and in 8 parts of alcohol. Very bitter. 
Cinchonhlince Sulphas (U. S. P.).—Sulphate of Cinchonidine. Dose, gr. v-xl. Similar 
to preceding, but less soluble. 
Quinidince Sulphas (U. S. P.).—Sulphate of Quinidine. Dose, gr. v-xxx. Similar to 
the preceding. 
Chinoidinum (U. S. P.).—Chinoidine. Dose, gr. iii-xxx. A mixture of the alkaloids, 
in an amorphous form, and dark colored ; obtained from the residue left from the manufac- 
ture of the crystallizable salts. 
Quinince Hydrochloras Carbamidata.—Double Salt of Quinine and Urea. Soluble in 
an equal part of water, and used hypodermatically in congestive chills. Dose, gr. i-x. 
Quinetum, or Hospital Quinine, is the mixed alkaloids precipitated by an alkali; 
largely used as a febrifuge in India. Dose, about the same as quinine. 
Cinchcnidince Salicylas.—Salicylate of Cinchonidine. Dose, gr. ii-x. 
Cinchonince Iodosulplias.—Iodosulphate of Cinchonine (50 per cent, iodine). A sub- 
stitute for iodoform. 
Pharmacology.—Cinchona is the most valuable contribution which the 
new hemisphere has made to medicine; one that is as universally known 
and prized as its two contributions to social economy and lamity life 
from the Solanncete,—the tobacco-plant and the potato. The pharma- 
copoeia recognizes the bark of any species of cinchona (Rubiaceae) con- CINCHONA. 
545 
taming at least 3 per cent, of its peculiar alkaloids; but, of the many 
varieties of quinine-bearing trees, two are specifically mentioned : Cin- 
chona flava, which is the bark of the trunk of Cinchona calisaya, contain- 
ing at least 2 percent, of quinine; and Cinchona rubra, the bark of the 
trunk of Cinchona succirubra, containing at least 2 per cent, of quinine. 
There have been isolated from cinchona-bark about twenty alkaloids, 
differing slightly in physical qualities, solubilit}’, reaction, and affinities, 
but all possessing, to greater or less degree, the characteristic physio- 
logical actions of quinine. They may be divided into two groups: 
(1) quinine, quinidine, and quinicine ; (2) cinchonine, cinchonidine, and 
cinchonicine. They exist in the bark combined with eineho-tannic, kinic, 
and kinovic acid, with a tasteless, inactive substance,—cincliona-red. 
While South America remains the principal source of cinchona, yet the 
cultivation of the tree has been successfully carried on in India and 
Java, and a considerable portion of the supply now is derived from this 
source. The constantly-growing demand for quinine has stimulated 
chemical investigation; and laboratory products, chiefly of the coal-tar 
series, are now offered in great variety, that closely approach the cin- 
chona alkaloids in physical and chemical characters, and also have been 
proven valuable as antipyretics. Prominent among these are chinoline, 
antip37rin, acetanilid. resorcin, salicylic acid, naphthalin, which are con- 
sidered separately under their individual titles. Thus far, however, no 
synthetically-prepared salt rivals quinine and cinchonine in their control 
over malarial manifestations, or in their tonic effects upon the system 
when given for a length of time in small doses. With regard to the 
comparative alkaloidal value of the bark, the C. calisaya contains the 
greatest proportion of quinine, the C. succirubra the greatest amount of 
tannin and coloring matter. Under the name of pale bark, the C. mieran- 
tha and C. condaminea were formerly officinal; they are intermediate 
between the two just named, in their alkaloidal value. The C. pitayensis, 
euprea-bark, and other quinine-yielding barks are employed in manu- 
facturing the alkaloids, but are not specifically named by the pharma- 
copoeia ; all are officinal which contain at least 3 per cent, of the peculiar 
alkaloids of cinchona. 
Physiological Action.—The preparations of the bark are not fully 
represented by the salts of the alkaloids because they possess astrin- 
gency, which is absent from the latter, and because the physiological 
action is increased by the association of different principles in accord- 
ance with the well-known rule of combination of synergistic remedies. 
The bulk of the powdered bark is inconveniently large, although the 
early victories of Jesuits’ bark, as it was called, were made with the 
recent infusion, swallowed wdth the dregs,—a dose which modern patients 546 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
could scarcely be prevailed upon to take. In 1820, Pelletier and Caventou 
first isolated quinine, which has since taken the leading place in therapeu- 
tics of fever, and is second only to morphine in importance. As the other 
salts approximate more or less closely to this, we may omit consideration 
of their physiological action and simply take quinine as the type. 
Quinine is a powerful antiseptic, and is very destructive to infusorial 
and vegetable life. A solution of 1 grain to the ounce destroys micro- 
organisms, and double this strength prevents fermentation and putre- 
faction. Upon the sound skin very little effect is produced, but upon a 
part denuded of epidermis or upon mucous membranes it is a decided irri- 
tant. It causes muscular contractions when applied directly to the muscle, 
but not when applied to a nerve (Eulenberg). It is therefore a muscle-irri- 
tant and not a nerve-irritant. Taken into the stomach, it exercises a 
local effect upon its contents, checking abnormal fermentation and de- 
stroying infectious micro-organisms. For this purpose it should be given 
in solution or in powder (capsule), so as to insure its solution in the 
stomach. In moderate doses, it stimulates the muscular fibres of the 
stomach, increasing its motor power, and also by its irritant action in- 
creases the secretion of gastric juice and, as a bitter tonic, improves the 
appetite. In larger quantities, hunger is abolished and the excess of 
irritant action causes arrest of gastric secretion. No influence has been 
noticed upon respiration and very little upon temperature of a person 
in health. In conditions of fever, the administration of several full doses 
reduces the temperature nearly to the normal; and there appears to be a 
tolerance during this condition, for the system can stand a much larger 
quantity at a dose than it can in health, without producing toxic effects. 
This may, in part, be due to the fact that absorption is checked by the 
fever. The effect upon the nervous system of small doses is best seen in 
cases of debility, where the agent acts as a tonic, invigorating the vital 
functions and aiding the digestion and assimilation of food. In larger 
doses, symptoms referable to the brain are noticed, such as fullness, 
frontal headache, deafness, ringing in the ears, and mental dullness. 
These symptoms are attributed to partial anaemia of the brain, owing to 
contraction of blood-vessels and lowered heart action, possibly to direct 
action upon the multipolar cells, analogous to the action of morphine. 
There is stimulation of the sympathetic and auditory nerves (Gubler). 
With deafness there is associated disturbance of vision or temporary 
blindness, due to extreme contraction of the arterioles and anaemia of 
the retina, the optic nerve being perfect^7 white, resembling white atrophy.. 
This condition of the eye-ground is more or less permanent, but the 
function of vision is restored. Large doses lower or abolish the reflex 
excitability of the spinal cord. Soon after being introduced into the CINCHONA. 
547 
stomach it diffuses into the blood and may be detected in the urine, 
elimination taking place slowly and lasting for several days. The quan- 
tity of urine is slightly increased in persons unaccustomed to its effects; 
the uric acid is decreased and urea not affected. In the blood, quinine 
arrests the migration of the white corpuscle and checks its amoeboid 
movements; the red cells are rendered less adhesive tyid their oxygen- 
carrying function is impaired. It probably tends to destroy infectious 
micro-organisms in the blood and tissues. The pulse-rate is increased by 
moderate doses, but larger ones (3 i—iss) cause lowering of the pulse and of 
arterial tension. In animals, death results from paralysis of respiration 
after large doses of quinine. In some patients various forms of eruption 
have been noticed upon the skin ; even purpura* occasionally follows. 
Poisoning.—The toxic symptoms produced by quinine and allied 
salts are spoken of collectively as Cinchonism, which ordinarily is not 
allowed to go farther than tinnitus annum. Where these symptoms are 
annoying, or the patient is suffering with an overdose, the alimentary 
tract should be cleared b}’ a purge and brandy and a cup of hot coffee 
administered, or a dose of ergot. Hydrobromic acid (f'5ss-ij), given with 
quinine, prevents the occurrence of ringing in the ears or headache. 
Some patients show idiosyncrasy to the effects of quinine; urinary irri- 
tation, even congestion of the kidneys and haemorrhages, may follow 
quite a small dose. Some, indeed, cannot take a single grain without 
great inconvenience from cinchonism. Where there is much irritation 
of the skin, urticaria, or erythema, a warm bath containing bicarbonate 
of sodium is useful; a hypodermatic injection of morphine maybe neces- 
sary. Quinine is eliminated rather slowly and principally bj- the kidneys. 
It has also been detected in the sweat, saliva, and milk. 
Therapy.—The application of powdered bark was formerly one of 
the accepted methods of treatment of ulcers, but is now obsolete. In 
hay fever, a spray of cocaine, followed by a spray of hydrochlorate of 
quinine (gr. used frequently, is highly recommended. A solution 
of quinine sprayed into the throat is attended with good results in diph- 
theria. Quinine has also been used as an injection in gonorrhoea for its 
antiseptic action. In a similar way, Garretson employs it as a paint in 
cases of erysipelas to limit the spread of the disease:— 
Quininpe sulphat., 3ij. 
Tincturae ferri chloridi, f§ij. 
Tincturae cinchonae, f§j vel f§iss. 
M. Sig.: Apply with a camel’s hair pencil. In using this preparation, the affected 
part is to be painted and repainted until it turns black. The application may have to be 
made from a dozen to fifty times. So long as redness of any surface or any point of a sur- 
face shows through the black, the cure is incomplete. The quantity of cinchona tincture 
used is graduated by the state of the skin ; coarse 6kin requiring less, tender skin more. 
* Cases by Dr. Frank Woodbury reported to State Medical Society of Pennsylvania. 
Philadelphia Medical Times, September 18,1886. 548 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
In cystitis, irrigation of the bladder with a 2-per-cent, solution pre- 
vents decomposition of the urine. The hypodermatic injection of qui- 
nine is of great value in pernicious malarial attacks and in sun-stroke. 
The best salts for this purpose are the neutral hydrochlorate, the liydro- 
bromate, or the carbamid-hydrochlorate, the solution being freshly made 
and filtered and,a perfectly aseptic syringe being used, as otherwise 
abscess or septicaemia, or even tetanus, may follow. 
As ah ordinary tonic, in conditions of debility or convalescence, the 
tincture of the bark, either simple or compound (the latter being more 
astringent), is more useful than the alkaloids, for reasons already stated, 
and because the alcohol in the tincture is synergistic. The usual dose 
of either tincture is 1 or 2 drachms, as a tonic, and of quinine 2 grains, 
three times daily. In cases of diarrhoea, the antiseptic action of cin- 
chona is very valuable, and quinine is of service in typhoid fever, espe- 
cially during the second week ; but it does not approach the character of 
a specific, as it does in malarial attacks. In ordinary chills and fever, 
1G grains daily of the sulphate or bisulphate, or 12 of the liydrochlorate 
or hydrobromate, given in two or three doses, at least five hours before 
the time of the expected paroxysm, will generally prevent its appearance, 
or greatly modify it. The treatment should be continued for a week or 
ten days, diminishing the dose, or suspending it, if cinchonism appear, 
but resuming the full dose at septenary periods, after the appearance of 
the last chill, for a month or more. The following prescriptions may be 
used in malaria :— 
$ Quinine sulphatis, 3ij. 
Acidi sulphurici arom., f3j. 
Ol. menth. pip., n\v. 
Ext. glycerrhizae fl. f^j. 
Glycerini, f§iv. 
M. Sig.: A teaspoonful or two every three or four hours. 
Quininae sulphatis, 
Ferri pyrophos., aa gr. xl. 
Acidi arseniosi, gr. j. 
Pulveris capsici, gr. xx. 
Aloini, ............ gr. ij. 
M. et ft. pil. no. xx. 
Sig.: A pill three or four times a day. 
Tinct. cinchonae comp., f ?iv. 
Tinct. nucis vomicae, ...... ... f3j. 
Extract! taraxici 11., 
Ext. cascarae sagradae fl., aa f^ij. 
M. Sig.: A half to a tablcspoouful in water three or lour times a day. 
A patient once poisoned by malaria may find it necessary to take a 
course of quinine for several weeks each year, at the season when the CINCHONA. 
549 
attack first appeared ; and if unacelimated persons, wishing to stay in a 
malarious locality, or traveling through one at certain seasons of the 
year, will make use of the prophylactic action of quinine, they may 
escape infection by taking from 4 to 6 grains daily. Surgeon-General 
John B. Hamilton considers cinchonine preferable to quinine for this 
purpose. In children, as well as in adults having a weak or irritable 
stomach, it is more convenient to administer the remedy in suppositories 
of cacao-butter, on account of the bitter taste and unpleasant effects on 
the digestion. The taste of quinine is tolerably well disguised by milk, 
and, as Dr. F. E. Stewart suggests, by coffee prepared with milk and 
sugar, the dose to be followed by a sip of coffee which contains no 
quinine. Ringer states that an equal portion of powdered ginger con- 
ceals the taste of quinine. In enlargement of the spleen (ague-cake) 
quinine is. very efficient in moderate-sized doses. In intermittent fever 
it is not given during the paroxysm, because its irritant action may in- 
crease the nervous disturbance ; but in other fevers pyrexia is no contra- 
indication to its use. In infectious diseases,haemorrhagic measles, small- 
pox, diphtheria, and pj’aemia, quinine combined with alcohol is the chief 
reliance. 
This drug quite favorably influences the broncho-pneumonia of 
measles and counteracts the tendency to caseous degeneration. Com- 
bined with iron, quinine is very serviceable in erysipelas. Ten grains of 
quinine, given with Dover’s powder, opium, or morphine, is efficient in 
averting an attack of acute catarrh. The same quantity of quinine given 
at the beginning will sometimes abort acute tonsillitis and prevent the 
formation of pus. As quinine checks the principal phenomenon in in- 
flammation and suppuration, which is the escape of the white blood-cell, 
and by preventing the exchange of oxygen by the red blood-cells reduces 
inflammation, it is especially serviceable in pneumonia and other localized 
inflammations, and also in reducing discharge from abscesses and pre- 
venting sapremia or pyaemia. Bartholow considers that a larger dose— 
from 20 to 40 grains—has the power, if administered during the congestive 
stage, before exudation has occurred, of suppressing a croupous pneu- 
monia, pleurisy, or endocarditis. 
In this country, quinine is rarel}r, if ever, given in doses of several 
drachms, as it has been in Germany, for the purpose of reducing high 
temperature in erysipelas, scarlatina, or rheumatism, although Lieber- 
meister regards it as being a better antipyretic than the cold bath. It is 
not considered advisable to use such large amounts in typhoid, on 
account of the inflammation of the patches in the small intestine. In 
typhoid and other fevers it may be administered in the following manner, 
especially if the action of the heart be weak:— 550 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
II Extract, cinchonse fl., f3vj. 
Tinct. cardamom, comp., f3iv. 
Spiritus aetheris comp., f^j. 
Tinct. digitalis, f3ij. 
Aquae chloroformi, ad f§x. 
M. Sig.: A half to a tablespoonful every three or four hours. 
Iii whooping-cough, which is regarded by some as a parasitic infec- 
tion, its use has been attended by much benefit in comparatively large 
doses, conjoined with the local use of a spray of quinine solution (Henke). 
In many disorders of atonic character, such as neuralgia, dyspepsia, 
night-sweats of phthisis, general debility,neurasthenia, quinine is highly 
serviceable. It is particularly valuable in those manifestations of neural- 
gia which result from anaemia or malaria, and is well combined in the 
former case with iron, and in the latter with arsenic, thus :— 
II Quininae sulphatis, 
Massae ferri carbonatis, 8a 3ss. 
Ext. nucis vomicae, gr. iij. 
Ext. belladonnae ale., gr.j. 
M. et ft. pil. no. xij. 
Sig.: A pill three or four times a day. 
II Quininae sulphatis, 3j. 
Arsenici sulph., 
Ext. ignatiae ale., aa gr. ij. 
M. et ft. pil. no. xx. 
Sig.: A pill three times a day. 
Its stimulating effects have led to its common use by ladies, who 
have learned to take it as a “ bracer ” when going shopping. Dr. St. John 
lloosa has called attention to the dangers of the abuse of this drug, its 
causing many serious disturbances of the ear, even when taken in small, 
though long-continued doses. Many skin disorders and.eruptions are 
due to malaria, as pointed out by the late Dr. L. P. Yandell, in which 
quinine produces good effects. In old malarial cases the sulphate of 
cinchonine or cinchonidine may be substituted for the more expensive 
quinine salts :— 
II Chloroformi, Hfxxx. 
Cinchonidinae sulphas, gr. xlviij. 
Tinct. cardamom, comp., f3ij. 
Mucilaginis acaciae, q. s. ad f§iv. 
M. Sig.: Take a dessertspoonful every four hours, for malarial toxaemia. 
II Chinoidini, 3j. 
Citichonidinae sulph., . . gr. xl. 
Piperinae, gr. vj. 
Cupri sulphat., gr. ij. 
M. et ft. pil. vel capsulae no. xxx. 
Sig.: One or two every three or four hours in congestive chills. CINCHONA. 
551 
Other evidences of chronic malarial intoxication, as diarrhoea, 
dysentery, jaundice, and chorea, disappear under the administration of 
quinine. Intermittent lnematuria, due generally to the same cause, is 
cured by large doses of quinine. Small doses of quinine, temporarily 
employed, are useful in cases of catarrh of the stomach, whether due or 
not to alcoholic excess. Its action is aided by association with a mineral 
acid. Quinine is an excellent remedy in aphthous ulceration consecutive 
to enterocolitis, and in the j’easty vomiting produced by the growth of 
sarcina ventriculi. The same agent is of utility in the treatment of 
ascarides and taenia, not by virtue of a direct toxic influence upon the 
parasites, but by correcting the unhealthy condition of the intestinal 
mucous membrane which favors their development. Tonic doses of 
quinine render excellent service in delirium tremens. The laryngismus 
stridulus to which rickety children are subject is ameliorated by the 
liydrobromate of quinine. In many skin diseases dependent upon low- 
ered nutrition,—as, for instance, acne, impetigo, or ecthyma,—small, daily 
doses of this remedy are beneficial. Quinine is of value as a support 
to the system during the course of a prolonged suppuration ; and a full 
dose is prudently given before the use of a catheter or bougie, in order 
to prevent the occurrence of a chill. It is an excellent tonic in bron- 
ehorrhoea. Good results have been claimed by certain French physicians 
from the use of quinine in acute rheumatism, but the experience of most 
observers is unable to confirm these reports. It is of more decided 
benefit in chronic rheumatism, especially when occurring in aged or debili- 
tated subjects. In these cases it is best given in conjunction with the 
tincture of iron, or in the form of salicylate of quinine, or with iodide 
of potassium :— 
Ih Qnininse sulphatis, 3j. 
Tinct. ferri chloridi, f^j. 
Elix. eascarse sagradae, f^iv. 
M. Sig.: Two teaspooufuls three or four times a day. 
II- Potassii iodidi, 3vij. 
Spiritus chloroformi, f 3ij. 
Tinct. cinchonae comp., f §x. 
M. Sig.: A half to a tablespoonful in water three or four times a day. 
Special Applications.—In obstetrics, quinine is valued as an oxytocic, 
increasing the energy of the uterine contractions, though not capable of 
inciting them. Abortion has been produced by the administration of 
quinine and strychnine as a tonic, the accident being attributable to the 
latter agent. Quinine is also useful in preventing putrid infection from 
the uterine discharges, in the treatment of so-called milk fever (a mild sep- 
ticaemia) or milk-leg, and also in cases of uterine subinvolution after 552 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
parturition. In small doses it stimulates tlie menstrual flow and acts as 
an emmenagogue. In anaemic patients it may lie given combined with 
iron :— 
Ferri et quininae citratis, 3j. 
Ol.tanaceti, Nix. 
M. et div. in pil. no. xx. 
Sig.: One four times daily, or two morning and night. 
Warburg’s tincture is highly prized in England in fevers, and in 
shock or collapse. Each ounce contains quinine, 10 grains, in combina- 
tion with aromatics, half of the quantity being given at a dose and the 
remainder in three or four hours.* Its administration is to be preceded 
b\r a brisk purgative. In severe cases of poisoning by malaria, large 
doses are absolutely necessary to save life when given b}r itself, but when 
given in the above combination much smaller quantities are found to 
answer the purpose. 
lodosulphate of Cinchonine is the precipitate resulting from the 
addition of a solution of iodated iodide of potassium (Bouchardat’s 
reagent) to a watery solution of the sulphate of cinchonine. It is col- 
lected and washed free from iodine, and dried. The resulting product is 
an amorphous, impalpable powder, of a brownish color, without odor, in- 
soluble in water, though soluble in alcohol or chloroform. The dose of 
this preparation is from 1 to 5 grains. The interesting point in connection 
with it is that it contains 50 per cent, of iodine. M. Ivon (Le Progres 
Medicale, July 12, 1890) has recently completed some studies upon the 
antiseptic qualities made with this agent, which, on account of its effects, 
he styles Antiseptol, and recommends as a substitute for iodoform on 
account of the low price and superiority as a surgical dressing. 
lodosulphate of cinchonine has the action of the two substances 
that enter into its combination, being at the same time free from the 
toxic effect which follows sometimes from the use of iodoform Exter- 
nally it has been used by the writer for its antiseptic action with ex- 
cellent results, especially in the treatment of chronic ulcers, sinuses, 
abrasions, lupus vulgaris, abscesses, chronic acne, and various inflamma- 
tory thickenings of the integument. The following formulae may be 
recommended :— 
Cinchoninae iodosulphatis, 3j. 
Ungt. zinci oxidi, §j. 
M. For chronic acne, eczema, and psoriasis. 
* The National Formulary has the following formula for Warburg’s tincture, under 
the name of Tinctura Antiperiodica (N. F.): Rhubarb, angelica-seed, aa gr. 56; elecampane, 
saffron, fennel, aa gr. 28 ; aq. extract of aloes, gentian, zedoary, cubeb, myrrh, white agaric, 
camphor, aa gr. 14; sulphate of quinine, gr. 160; d.lute alcohol, q. s. ad Oj. M. sec. art. Or 
the formula may be prescribed without aloes. 553 
CINCHONA. 
Cinchoninge iodosulphatis, 3j. 
01. eucalypti, Tflx. 
Lanolini, §j. 
M. For syphilis, chronic ulcers, and eczema. 
The author’s attention lias been directed to this preparation by Dr. 
Frank Woodbury, who has emplo3Ted it largely in the treatment of con- 
sumption and many systemic affections in which antiseptics are indicated. 
It has been used with advantage in place of iodoform, iodol, or aristol, 
or in those cases in which these agents are not well borne. Woodbury 
has given from 1 to 5 grains of the drug in phthisis, three or four times 
a day, and the author has also administered similar doses with marked 
benefit in the treatment of scrofuloderma, lupus vulgaris, psoriasis, 
chronic eczema, secondaiy and tertiary syphilis. Iodosulphate of cin- 
chona has both a tonic and an alterative action upon the system. At this 
time the author has several cases of the different diseases alluded to 
upon this drug, with a most decidedly good effect. 
Dextro-Quinine is probably an impure quinidine (Wood). 
Contra-Indications to the use of quinine consist in :— 
1. Idiosyncrasy, where nervous disturbances, headache, skin erup- 
tions, purpura, are caused by small doses, and where this cannot be 
overcome by the use of bromides, ergot, or arsenic. 
2. Acute inflammation of the genito-urinary tract or congestion of 
the kidneys. 
3. Acute inflammations of the gastro-intestinal tract. 
4. Inflammation of the middle ear and dullness of hearing (nervous 
deafness). 
5. Infants suffering with eczema. 
The comparative antiperiodic value of the alkaloids is thus esti- 
mated by Bartholow : Quinidine is first as an antiperiodic ; quinine comes 
next. Cinchonine requires about twice the dose in order to equal qui- 
nine. Cinchonidine is a little stronger than cinchonine. Amorphous 
chinoidine is about one-fourth the strength of quinine. As already 
stated, Dr. J. B. Hamilton prefers cinchonine sulphate as a prophylactic 
to quinine sulphate. In the United States Army the hydrochlorate is 
generally given the preference over the sulphate on account of its greater 
solubility. The hydrobromate and valerianate are supposed to cause less 
nervous irritation in susceptible subjects than the other salts. The ad- 
dition of a few drops of dilute sulphuric acid to quinine sulphate makes 
it much more soluble ; or, the disulphate may be prescribed in pill form 
in the same doses as the sulphate. The borate, carbolate, and salicylate 
of quinine have been introduced as especialty serviceable in neuralgia, 
but possess no special advantages sufficient to compensate for their 554 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
higher cost. Quinine sulphovinate is a very soluble salt, requiring 
only twice its weight of water to dissolve it, and might be used 
hypodermatically. 
Quininae Tannas.—The tannate of quinine is sometimes called “ taste- 
less quinine,” because the bitterness is almost entirely overcome by the 
combination, largely because of insolubility of the salt. Although in- 
soluble in water, it is soluble in the acid gastric juice, and when admin- 
istered with food, or soon afterward, it answers equally well with the 
other salts. In the combination with sweet chocolate all objectionable 
taste is overcome, and, made into troches, or compressed tablets, each 
containing 1 grain, we have a sort of confection, probably the very best 
form in which to administer quinine to children. It may be made 
extemporaneously :— 
Quininae, gr. xxiv. 
Acidi tannici, gr. xij. 
Syrupi cinnamomi, fjiij- 
M. Each drachm contains one grain of quinine. If the quinine sulphate is used 
the tannic acid must be doubled. 
I£. Quininae hydrochlorat., gr. xxiv. 
Acidi tannici, 
Glycyrrhizin. ammoniat., ........ aa gr. xij. 
M. Divide in chartae no. xij. 
Sig.: Three daily. 
Quininae sulphatis, gr. xxiv. 
Elixir glycyrrhizin. ammon., . fSjiij. 
M. Sig.: A teaspoonful to a tablespoonful, according to circumstances. 
The aromatic elixir of gtycyrrhizin is a good excipient for the 
sulphate which is suspended in the mixture. No acid should be added 
when the extract is used. 
An adult can take a powder of quinine in a dessertspoonful of syrup 
of red orange, or syrup of wild cherry, without experiencing much un- 
pleasant taste. Some prefer to take it in a little whisky and water. 
The sugar-coated or gelatin-coated pills are most commonly used, and, 
if properly made (and if they contain the full amount of the drug), they 
answer all ordinary demands. In cases of irritability of the stomach 
and diarrhoea it is better to use the remedy in the form of a solution. 
CINNAMOMUM (U. S. P.).—Cinnamon. 
Dose, gr. x-xxx. 
Preparations. 
Oleum Cinnamomi (U. S. P.).—Oil of Cinnamon. Dose, hli-iij. 
Tinctura Cinnamomi (U. S. P.).—Tincture of Cinnamon. Dose, f3i-iv. 
Aqua Cinnamomi (U. S. P.).—Cinnamon-Water. Dose, f^ss-iv. CINNAMOMUM. 
555 
Spiritus Cinnamomi (U. S. P.).—Spirit of Cinnamon. Dose, f3i-ij. 
Pnlvis Aromaticus (U. S. P.).—Aromatic Powder (cinnamon, ginger, aa 35 parts; 
cardamom, nutmeg, aa 15 parts). Dose, gr. v-xxx. 
Aromatic sulphuric acid, compound tincture of catechu, compound tincture of 
lavender, syrup of rhubarb, aromatic tincture of rhubarb, aromatic syrup of rhubarb, 
compound tincture of cardamom, chalk mixture, and wine of opium also contain cinna- 
mon as a constituent. 
Pharmacology.—Cinnamon is the inner bark of the shoots of Cinna- 
momum zeylanicum (Ceylon cinnamon), or the bark of the shoots of 
one or more undetermined species of Cinnamomum grown in China 
(Chinese cinnamon, or cassia), large trees belonging to the natural 
order Lauraceae. Besides the volatile oil, which is used for flavoring 
purposes, cinnamon contains tannic acid, mucilage, coloring matter, an 
acid and lignin. 
The Ceylon cinnamon is the choice variety, but the greater portion 
of this valued spice brought to this country is the cassia cinnamon, 
the flavor of which is less sweet and more pungent and astringent. The 
physiological properties are the same. 
Physiological Action.—Cinnamon is an aromatic, with considerable 
astringency. It acts as a haemostatic, not so much through its astrin- 
gent constituents as b}r virtue of the volatile oil, which may be used 
efficiently alone. 
Therapy.—In cases, especially among children, where counter-irrita- 
tion is needed, the use of a spice plaster is recommended, as in croup, 
colic, neuralgia, etc. They can be obtained already prepared for use, or 
may be prepared extemporaneously by placing aromatic powder between 
two layers of flannel and moistening it with hot whisky. As a stomachic, 
in flatulence and feeble digestion, cinnamon is of some value, but its car- 
minative effect is most frequently utilized in combination with other 
remedies, especially purgatives, to prevent griping. It is of service 
in diarrhoea, as in the chalk mixture, to which other agents may be 
added :— 
Bismuthi salicylat., gr. i-iij. 
Misturse cretse, ... 4 ■ f 3j. 
M. pro dosi. 
For irritative diarrhoea of infants, especially summer diarrhoea, this dose to be repeated 
according to urgency every hour or more. 
It will at times be found capable of allaying nausea and vomiting, 
or even of relieving sea-sickness. In passive uterine haemorrhage we 
may give an extemporaneous infusion in milk, or give the oil upon sugar. 
The oil may also be utilized, at least as an adjuvant, in pulmonary 
haemorrhage. 556 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
COCCULUS—COCCULUS INDICUS.—Indian Berry, Fish Berry. 
Preparations. 
Extraction Cocculi Fluidum.—Fluid Extract of Cocculus. Dose, flll-ij. 
Ttnctura Cocculi.—Tincture of Cocculus (25 per cent.). Dose, lili-iv. 
Picrotoxinum (U. S. P.).—Picrotoxin (the active principle). Dose, gr. 
TJnguentum Picrotoxini.—Ointment of Picrotoxin (gr. of lard). 
Pharmacology.—Cocculus Indicus is the fruit of Anamirta panicu- 
lata (Menispermaceae), a native of the Malabar coast and of India. In 
1812, Boullay discovered and isolated a peculiar bitter principle, which 
he denominated Picrotoxin,—a white, crystallizable, neutral substance, 
soluble in 150 parts of cold water, or in 25 of boiling, and very soluble 
in alcohol and ether, but not soluble in oils. Picrotoxin does not form 
salts. Like digitalin, picrotoxin appears to be made up of several bodies, 
which vary in their chemical properties and effects. Barth and Kretschy 
assert that it contains at least three: (1) picrotoxin, a bitter, poisonous 
principle; (2) picrotin, a bitter, non-poisonous principle; and (3) ana- 
mirtin. To these has been added cocculin (which is said to be identical 
with anamirtin). These pharirfaceutical bodies may have scientific in- 
terest, but, practically, the prescriber is confined to the picrotoxin of 
Boullay, which is officinal in the United States Pharmacopoeia. In the 
pericarp have been found menispermia, paramenispermia, hypo-picrotoxic 
acid, resin, fat, and gum, which do not possess much medical interest. 
Physiological Action.—Cocculus, or picrotoxin,is very destructive to 
lower forms of life, and to many acts as an acrid, narcotic poison. In 
lower animals, death is preceded by convulsions, and in a fatal case of a 
child six }Tears old, poisoned b\r absorption of a strong alcoholic solution 
of the fruit applied to the scalp, tetanic spasms occurred. Where this 
agent has been swallowed, the usual treatment, by evacuating the stomach, 
should be practiced, with inhalation of ether or ammonia and the internal 
administration of chloral or bromides. There is an antagonism between 
chloral and picrotoxin, and this can be utilized when poisoning has 
occurred from absorption through the integument. 
In an article by William Murrell, of London, on “ Picrotoxin and its 
Properties.”* this able authority states that the peculiar convulsions pro- 
duced by this agent “ differ essentially from the tetanic condition caused 
by strychnine, and are due to stimulation of the motor centres in the 
cerebrum, or in the medulla and cord. They assume various forms, the 
swimming, running backward, and moving round in a circle being the 
most common. Picrotoxin raises the temperature, stimulates the respi- 
ratory centre, and in large doses produces salivation.” It acts as 
♦The Medical Bulletin, Nov., 1890, p. 402. COCCULUS—COCCULUS INDICUS. 
557 
an anhydrotic byr stimulation of the respiratory centre. “It is allied to 
Cicutoxin—the active principle of the water-hemlock—and to Coria- 
myrtin, derived from Coriaria myrtifolia. These drugs stimulate the 
origins of the inhibitory fibres of the vagus, the vascular and respiratory 
centres, and the motor areas of the medulla oblongata. In its action on 
the secretions, pierotoxin is allied to Pilocarpine and Muscarine, and is 
antagonized by atropine and other members of that group. The best 
antidotes to pierotoxin are chloral hydrate and bromide of potassium.” 
On account of its poisonous effects, coeculus has been used from ancient 
times, made up into a paste and thrown into the water, where the fish 
are stupefied by it, and are easily captured. Death has occurred in a 
boy from eating a small quantity- (40 grains) of such paste, but it is said 
that the flesh of the fish so taken is edible. This unsportsmanlike method 
of fishing in some parts of this country is illegal. On account of its 
bitterness, cocculus, or “ fish berry,” is sometimes added to malt liquor 
to save hops and check fermentation. Possibly this may enter into 
the solution of the problem of what is the matter with a man when he is 
drunk, and still further emphasize the importance of regarding intoxica- 
tion as a condition of poisoning, demanding prompt, intelligent, and 
skillful treatment. 
Therapy.—This is an ancient remedy for phtheiriasis, or lousiness, 
but care should be exercised in the case of children, or where there are 
abrasions on the scalp, not to use strong solutions, nor to leave them for 
many minutes in contact with the skin. The hairy scalp, after being 
thoroughly washed with soap and water, is wet with a solution of 
the tincture to water), or decoction (3j-Oj), and after a few minutes 
washed off' with an abundance of warm water. Two of three daily 
applications are sufficient, especially in cases where the hair can be cut 
short, as in charitable institutions and asylums. It has been claimed 
that an ointment of pierotoxin is equally efficient with the decoction, but 
it cannot be regarded as being as safe. For the same reason, cocculus 
is not advised in the treatment of tinea and other skin affections, 
although still used for this purpose in India. A small quantity, however, 
of pierotoxin—not exceeding 1 per cent.—may be usefully- prescribed, in 
combination with ointment of mercuric oleate, for the relief of animal 
and vegetable parasitic diseases, as scabies, pediculi, trichophytosis, and 
tinea versicolor. 
In small doses it appears to act as a bitter tonic to the digestive 
tract, and has therefore been advised in atonic conditions of the stomach 
and intestinal indigestion attended by torpor of the intestinal wralls, and 
constipation. In epilepsy, chorea, alcoholic tremor, paralysis agitans, 
and functional nervous disorders (migraine, dysmenorrhoea), pierotoxin 558 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
lias been used successfully b}- Planat and Hammond, Gubler, Phillips, 
and others. There is good evidence in support of the statement made 
by Murrell as to its value in controlling night-sweating in phthisis in 
doses of gr. in a pill with sugar and tragacanth (a single dose, at bed- 
time, or given three times a day). It does not have the disagreeable 
action upon the throat and skin that atropine has, and frequentty suc- 
ceeds where that fails ; but it is slower in producing its anhydrotic effect, 
requiring several days. Bokai regards picrotoxin as an excellent anti- 
dote to opium b}- reason of the stimulant action of the former substance 
upon the respiratory and vasomotor centres. 
COCCUS (U. S. P.).—Cochineal. 
Pharmacology.—The dried females of Coccus cacti (class, Insecta; 
order, Hemiptera), when crushed, produce a very brilliant red coloring 
matter; which consist principally of carminic acid, various salts, tyro- 
sin, urea, fatty matters, etc. The pigment called Carmine is the color- 
ing matter precipitated from the decoction by acids, and the salts of tin, 
or by gelatin ; and other colors, such as lake, purple, and lilac, may be 
obtained by various reagents. It is highly prized in the arts as a color- 
ing agent. As such it is also used in pharmacy, and is an ingredient in 
the compound tincture of cardamom. 
Physiological Action.—The pln-siological reaction of cochineal is not 
very evident,’ but it is believed to have antispasmodie and anodyne 
qualities. 
Therapy.—Cochineal was used by a preceding generation of phy- 
sicians for whooping-cough (in%r. doses) and in neuralgia. Its color 
might lead to its use under the old doctrine of signatures. 
COCILLANA.—Cocillana, Guarea. 
Preparations. 
Extradum Codllance Fluidum.—Fluid Extract of Cocillana. Dose, Hlx-xx. 
Tinctura Cocillance.—Tincture of Cocillana (25 per cent.). Dose, lllxxx-f3ij. 
Pharmacology.—The Cocillana of Bolivia, a Guarea of undetermined 
species, is a large tree belonging to the Meliacene, of which the bark is 
used as an expectorant, having an influence upon the respiratory organs 
similar to ipecac, but “ superior to it in certain diseases of the air- 
passages, in which the latter is often used ” (D. D. Stewart).* It also 
has a tonic effect upon the digestive organs, and gives promise of useful- 
ness as a laxative. It was discovered and brought to this country by 
the eminent botanist, Dr. H. H. Busby, who also introduced pichi, 
another valuable South American remedy. The constituents of the bark 
* Medical News, August 24,1889. CODEINA. 
559 
have not been determined, but it is probable that it owes its effects to an 
active principle, resinous in character, soluble in chloroform (Schrenk), 
or perhaps an alkaloid (Rusby). 
Physiological Action and Therapy.—In native medicine, cocillana is 
used as an emetic and cathartic. A free discharge of mucus, nausea and 
gagging, with some tendency to perspiration, also dizziness and lassitude, 
were caused in one case where 20 grains were given. Larger doses 
(gr. xxx-1) caused vomiting at the end of an hour, evacuations of the 
bowels, sneezing, and prostration, the effects resembling those of emetine. 
The active principle is excreted chiefly by the mucous membrane of 
the respiratory tract, upon which it acts as a stimulant. • 
This drug finds its special usefulness in bronchitis, particularly the 
subacute and chronic forms. The fluid extract is preferable to the tinc: 
ture in acute bronchial attacks. It renders the cough less frequent and 
difficult, loosens and liquefies secretions, and facilitates expectoration, 
which it at the same time has the effect of reducing in quantity (Stewart). 
CODEINA (U. S. P.).—Codeine. 
Dose, gr. £-ij. 
An alkaloid prepared from opium. It is more antispasmodic than 
morphine and has less narcotic effect.* It is used preferably in the treat- 
ment of cough, cramps in the stomach or bowels, and in neuralgia and 
painful affections of the genito-urinary organs. In diabetes it checks 
the formation of sugar, and in some cases permanently arrests it. In 
these cases it is borne well in larger amounts, as much as 10 to 15 grains 
daily having been taken with benefit. Fraser claims, however, that 
equally good effects may be obtained in smaller doses from the hydro- 
chlorate of morphine, which is also very much cheaper. 
COFFEA.—Coffee. 
Preparation. 
JExtradum Coffece Viridis Fluidum.—Fluid Extract of Green Coffee. Dose, f3ss-ij. 
Pharmacology.—The seeds or berries of Coffea Arabica (Rubiacete) 
are only officialljr recognized as one of the sources of caffeine. Before 
roasting, coffee contains Caffeine and caffeo-tannic acid. During roasting 
a volatile oil is developed and several substances formed, which give to 
coffee its aroma and flavor, these empyreumatic substances being known 
collectively as Caffeone. 
Physiological Action.—Coffee differs from caffeine in being more 
stimulating to the intestinal tract, especially increasing the peristaltic 
movements, which are not affected by caffeine. It produces a general 
* Codeine, by Dr. Loewenmeyer, Deut. Med. Woch., Weekly Medical Review, November 
29, 1890. 560 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
feeling of warmth and well-being, dilates the superficial blood-vessels, and 
lowers arterial pressure. It also stimulates the nervous sj’stem, in some 
persons causing exhilarating effects upon the cerebrum and increasing 
capacity for intellectual labor, and frequently is the cause of headaches 
in persons who take it habitually or in excess. A case has lately been 
reported* in which about ounces of the ground berries were made into 
a strong infusion and swallowed by a vigorous man. Two and a half 
hours later he was attacked by dizziness, severe cardiac pains, palpitation, 
nausea, vomiting, and generalized tremors. The tremors persisted for 
twelve hours after all other symptoms had disappeared. 
Therapy.—It is valuable as a stimulant in cases of narcotic poison- 
ing, especially by opium. In some cases it produces fullness of the 
portal circulation, interfering with the activity of the hepatic functions 
and causing haemorrhoids. Its laxative effects are useful in persons 
leading sedentary lives, in preventing constipation. It has some astrin- 
gent and antiseptic qualities, and is believed to have some effect in pre- 
venting malaria. The fluid extract of the unroasted coffee contains 
caffeine, but no caffeone. It is used in anaemic headache, and in cases of 
low fever as a cardiac stimulant where collapse is threatened. A solu- 
tion of green coffee, prepared by macerating drachms over night, has 
been employed by Landarrabilco in nephritic colic and migraine. 
COLCHICI RADIX (U. S. P.).—Colchicum-Root, Meadow-Saffron. 
COLCHICI SEMEN (U. S. P.).—Colchicum-Seed. 
Preparations from the Root. 
Extradum Colchici Radicis (U. 8. P.).—Extract of Colchicum-Root. Dose, gr. ss-ij. 
Extraction Colchici Radicis Fluidum (IT. S. P.).—Fluid Extract of Colchicum-Root. 
Dose, Ulii-iv. 
Vinum Colchici Radicis (U. S. P.).—Wine of Colchicum-Root (40 per cent.). Dose, 
n\v-f3ss. 
Preparations f rom the Seed. 
Extradum Colchici Seminis Fluidum (U. 8. P.).—Fluid Extract of Colchicum-Seeds. 
Dose, I'lii-v. 
Tinctnra Colchici (U. S. P.).—Tincture of Colchicum (15 per cent.). Dose, 0lv-f3j. 
Vinum Colchici Seminis (U. S. P.).—Wine of Colchicum-Seeds (15 per cent.). 
Dose, H\x-f3j. 
Colchicina.—Colchicine (the active principle). Dose, gr. 
Colchicum-root is the whole, or sliced, and dried conn of Colchicum 
autumnale (Melanthacese), or meadow-saffron, a native of the temperate 
parts of both Europe and Northern Africa, of which the seed is also 
officinal. It contains Colchicine ('rather more in the seeds than in the 
root) ; and traces of Veratrine in combination with gallic acid and a fixed 
* Theiapeutische Moiiatsliefte, March, 18y0. COLCHICI SEMEN. 
561 
oil are found. The value of colchicum is tested by its bitterness, due to 
the presence of colchicine, an alkaloid, appearing in small crystals 
(Geiger and Hesse); is soluble in water and alcohol, but changed by 
most acids into Colchiceine, a neutral substance and a resin, both iso- 
meric with colchicine. Wine and vinegar extract the medical principles 
from the drug, and the officinal extract is made with the aid of acetic 
acid. Probably each of them contains a small amount also of colchiceine. 
In ordering the wine, it is necessary to designate which preparation is 
required, as the wine of the seeds differs in effects from that of the root 
on account of the difference in content of colchicine, which is not en- 
tirely equalized by the pharmacopoeial expedient of altering the propor- 
tion of crude drug in each. The fresh seed contains a small portion of 
volatile but very active oil, and the best preparation would be a tincture 
made from the fresh seeds in alcohol; but colchicine, when administered 
in granules, pill, or by hypodermatic injection, is said to secure the full 
therapeutic effect. 
Physiological Action.—When applied to the skin, colchicum acts.as an 
irritant, causing liyperseinia and smarting, and the dust inhaled causes 
sneezing and conjunctival injection. In small doses it occasions an acrid 
taste in the mouth, increased secretions from the salivary glands due to 
reflex action, and gastrointestinal disturbance, which increases with the 
quantity taken. A single large dose or small ones long continued cause 
violent vomiting and purging (first serous, then mucous, then bloody), 
or acute gastrointestinal irritation. Marked symptoms of collapse 
supervene; the pulse becomes small, rapid, and thready; the skin cold 
and bedewed with sweat; respiration slow and painful. Death ensues 
from collapse, the brain remaining clear to the last. Sometimes nervous 
symptoms, flying pains, and numbness, may appear, and occasionally, 
though rarely, convulsions (Brunton). Pains in the joints and urinary 
passages also may be produced by colchicum. A very large dose does 
not cause a more marked effect than a moderately large one. The action 
upon the alimentary canal is the same, whether the drug be swallowed 
or hypodermatically injected. When, during the administration of 
colchicum, there appear irritation of the fauces, loaded tongue, loss of 
appetite, flatulence, uneasiness, or pain in the stomach and diarrhoea, the 
drug is beginning to exercise toxic effects, and should be discontinued 
or suspended for a time. Colchicum has a selective action upon the 
sensory nerves and spinal cord, which are more or less paralyzed ; the 
brain, motor nerves, and muscles are not affected. The inhibitory fibres 
of the vagus are paralyzed only by very large doses; The discharge of 
bile and of urine is largely increased ; Rutherford claims that it is a true 
cholagogue,and Christison and others assert that it is diuretic, increasing 562 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
the quantity of salts as well as the water, both of which have been 
denied by Gubler, who simply regards it as cathartic, only exercising 
good effects when three or four discharges from the bowels are obtained 
daily through its action. When symptoms of poisoning make their 
appearance, the patient should be kept in a recumbent posture, encouraged 
to vomit, and allowed to drink freely of infusion of tea or coffee, on 
account of the tannin they contain as well as their action as arterial 
stimulants. Morphine and atropine may be administered hypodermati- 
cally in small doses. If there is much distress, sinapisms should be 
applied to the abdomen and the patient kept warm. Poisoning may 
occur in refilling prescriptions, as the preparations vary greatly in their 
activity; some samples of fluid extract contain very.little, if anjr, of 
colchicine, while others are of standard strength. 
Therapy.—Colchicum may be used in small doses as an ingredient in 
cliolagogue pills, but its chief use is in the treatment of attacks of gout 
and in the relief of symptoms more or less directly attributable to gout, 
as dyspepsia, bronchitis, asthma, etc. In rheumatic arthritis or rheu- 
matic gout, we may give :— 
Tincturse colchici, Dlx. 
Potassii iodidi, . . , gr. x. 
Syr. sarsaparillae comp., ... .... f3iss. 
Aquas destillatas, f3ss. 
M pro dosi. Take every three or four hours, well diluted. 
Vini colchici semiuis, f3iv. 
Sodii salicylatis, 3iij. 
Sodii iodidi. 3j. 
Spiritus chloroformi, f3iij. 
Inf. buchu, ad f^viij. 
M. Sig.: A tablespoonful every three or four hours. 
Scudamore’s gout mixture is also very good :— 
I£ Magnesii sulph., gij. 
Magnesii carbonatis, 3ij. 
Vini colchici seminis, f 3vj. 
Aquae menth. pip., ad f^xij. 
M. Sig.: A tablespoonful every four hours. 
Colchicum is generally given in acute attacks of gout, in combination 
with an alkali:— 
Magnesii sulphat., §ss. 
Magnesias, 3ij. 
Tiuct. colchici, f3ij. 
Syrupi zingiberis, . . . . f^j. 
Aquae menthae pip., f 
M. Sig.: Take a tablespoonful every two hours, until the bowels are freely moved 
from four to six times in twenty-four hours. COLLINSONIA CANADENSIS. 
563 
Or the extract of the root may be given (gr. i-ij) several times daily, 
or the wine of the seeds in doses. 
Colchicinse, gr. ss. 
Codeinae, gr. x. 
Quiuinae hydrobromatis, "3j. 
M. et ft. pil. no. xl. 
Sig.: Take one every two hours for gouty neuralgia. 
The wrine of the seeds is, perhaps, the preparation most frequently 
prescribed, and in an acute paroxysm of gout is best given in a moder- 
ately large dose 1 drachm). Within a few hours the pain is allayed, 
the heat and swelling begin to subside. In order to secure relief it is 
not necessary that the drug should manifest its diuretic or purgative 
effects. In chronic gout small doses three or four times a 
day are appropriate. Though colchicum exerts an action which may be 
termed specific, it is nevertheless but palliative, since attacks recur. Of 
little or no value in acute rheumatism, colchicum is sometimes of service 
in the chronic form of the disease. Neuralgia dependent upon a gouty 
or rheumatic condition is often effectually treated by means of colchicum, 
a drachm of the wine being given at bed-time, together with a dose of 
sulphate of morphine. The same preparation is not infrequently service- 
able in gonorrhoea, and 30 minims at bed-time is an old treatment for 
chord ee. 
Cli. Abadie has found very minute doses of colchicine (0.001 gramme 
= T5*o grain) two “to four times a day to be of great value in scleritis, 
whether due to gout or rheumatism. 
F. Woodbury recommends its hypodermatic injection in sciatica, 
into the sheath of the nerves, and in muscular rheumatism.* 
COLLINSONIA CANADENSIS.f 
Preparations. 
Cortex Collinsonice.—Powdered root. Dose, gr. x-lx. 
Infusum Collinsonice..—Infusion of Collinsonia. Dose, f §i-iv. 
Extraction Collinsonice Fluidum.—Fluid Extract of Collinsonia. Dose, Ul—f 3j. 
Tinctura Collinsonice.—Tincture of Collinsonia. Dose, !Tlxx-f3ij. 
Pharmacology.—This indigenous plant, belonging to the natural 
order Labiatte, and popularly known as stone-root, or knob-root, 
grows from April to October in riclily-wooded soils throughout the 
United States. All parts of the plant may be used, but its virtues reside 
chiefly in the root, and depend principally upon the presence of a volatile 
oil. It possesses a rank, aromatic odor, and a warm, somewhat pungent 
taste. 
* Phila. Med. Times, vol. xiii, p. 154. 
t See paper by author, in Transactions of the Ninth International Medical Congress, vol. 
iii, p. 76. Washington, D. C., U. S. A. 564 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Physiological Action.—Collinsonia is a local astringent. It exerts a 
sedative effect upon mucous membranes, and produces a sensation of 
warmth in the stomach and bowels. Large doses give rise to diaphoresis, 
nausea, and, perhaps, vomiting. 
Therapy.—Collinsonia is a good local application to incised or con- 
tused wounds. A drachm of the powdered root to an ounce of lard con- 
stitutes a stimulant application to indolent ulcers. The fluid extract, 
diluted with 4 parts of water and used as a rectal injection, effectually 
destroys ascarides. 
This remedy, given internally, acts as an astringent tonic, antispas- 
modic and sedative. It increases the appetite, promotes digestion and 
elimination, and is therefore useful in anaemia, chlorosis, the early stage 
of phthisis, and in convalescence from the eruptive fevers. Relaxed 
uvula, chronic pharyngitis, and hoarseness due to impaired tonicity of 
the vocal cords are benefited by the local action of collinsonia. A cup 
of hot infusion at bed-time will abort an ordinary cold, or mild lumbago. 
The fluid extract is very beneficial to gastro-intestinal catarrh, whether 
dependent upon alcoholism or other cause. The remedy is especially 
useful in the former case, since it seems to lessen the desire for liquor. 
Various spasmodic affections are relieved by collinsonia. The hot 
infusion is a useful remedy in spasmodic croup. In whooping-cough the 
paroxysms are ameliorated, and it is valuable in nervous cough and the 
irritative cough of pharyngitis. It is sometimes of service in chorea. 
Spasmodic contraction of the sphincter ani not uncommonly gives rise 
to constipation, haemorrhoids, neuralgia of the rectum, with vague pelvic 
and abdominal symptoms. This spasm and the train of disorders depend- 
ent upon it may often be relieved by the employment every night of a 
suppository containing from 10 to 60 grains of powdered collinsonia- 
root. Some cases of dysmenorrhoea are markedly benefited by the 
administration of the fluid extract for a week preceding and during the 
period. It is probable that vaginal suppositories containing this remedy 
would be of service in vaginismus. Excellent results are obtained from 
collinsonia in renal and biliary colic. Spasm of the ducts is relaxed,and 
the irritation of the mucous membranes soothed. The increased flow of 
urine induced facilitates the expulsion of small calculi. Infantile colic 
and flatulent colic in adults are also amenable to the influence of this 
drug. In combination with aconite and morphine it is more rapidly 
efficacious than any other treatment of acute cystitis, and should be tried 
in chronic cystitis. Incontinence of urine in children and the dripping 
of a few drops of urine after the act of micturition is apparently com- 
pleted, due to hyperaesthesia of the prostatic urethra or neck of the 
bladder, may be effectually relieved by the fluid extract. The writer has COLLODIUM. 
565 
seen it arrest the discharge of chronic gonorrhoea after the customary 
blenorrhetics had been exhibited in vain. It has likewise been found 
very beneficial in leucorrlioea and prostatorrhoea. 
COLLODIUM (IT. S. P.).—Collodion. 
Preparations. 
Collodium cum Cantharide (U. S. P.).—Cantharidal Collodion. External use. 
Collodium Flexile (U. S. P.).—Flexible Collodion. External use 
Collodium Stypticum (U. S. P.).—Styptic Collodion. External use. 
Pharmacology.—Collodion is pyroxylon, or gun-cotton (4 parts) dis- 
solved in stronger ether (10 parts) and alcohol (26 parts). Blistering 
collodion has cantliarides (60 parts), exhausted by chloroform and evap- 
orated (to 15 parts), to which is then added flexible collodion (85 parts). 
Collodion flexile is collodion (92 parts), to which Canada turpentine 
(5 parts) and castor oil (3 parts) have been added. Styptic collodion 
contains tannic acid (20 parts) dissolved in alcohol (5 parts), stronger 
ether (20 parts),and collodion (55 parts). Collodion is a clear, syrupy 
fluid, smelling strongly of ether; and should be kept in a glass-stoppered 
bottle, tightly corked, remote from lights and fire. When painted upon 
a surface, the ether quickly evaporates, leaving a film of pyroxylon, 
which is adhesive and tends to contract or pucker up. 
Therapy.—Collodion is used to cover excoriated surfaces and to 
seal small wounds. Larger wounds may be drawn together and kept in 
position by strips of gauze, the ends of which are made to adhere to the 
skin by several coats of collodion painted on with a camel’s hair pencil. 
Sometimes it gives rise to pain, irritation, and even blistering when a 
comparatively large area is thus covered. The contraction caused by 
the drying of collodion is made use of in the treatment of the early 
stages of boils and styes, arid the papules in small-pox, to prevent 
pitting. Where several coats are to be applied, the flexible collodion is 
preferable. It has also been used in herpes zoster and erysipelas, and 
the compression exerted by it has been utilized in the treatment of 
epididymitis, painting freely over the testicle and cord. A coating of 
collodion is likewise beneficial in the erythematous variety of burns. 
This substance is an exceedingly useful application to scalp-wounds, in 
which, besides approximating the edges and excluding the air, it does 
away with the necessity for a bandage. The pressure produced by the 
contraction of collodion has been successfully utilized in the treatment 
of umbilical hernia, varicocele, and spina bifida. In the nocturnal incon- 
tinence of urine in children it is often advantageous to seal the orifice of 
the urethra or the end of the prepuce with collodion. This method will 
not infrequently break up the habit within a few weeks. The styptic 
collodion may be used on cracked nipples, or for small wounds where an 566 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
astringent may be desired. Extract of cannabis Indica (2 parts), with 
salicylic acid (11 parts) in flexible collodion (87 parts), is a deservedly 
popular remedy for soft corns, under the name of the green solution for 
corns (collodium salicylatum composition, N. F.). Iodine and iodoform 
have been used, dissolved in collodion, as an application to gouty or 
rheumatic joints, but the former sometimes exerts an unexpectedly 
caustic action, and has been followed by sloughing. 
COLOCYNTHIS (U. S. P.).—Colocynth, Bitter Cucumber. 
Dose, gr. ii-v. 
Preparations. 
Extractum Colocynthidis (U. S. P.).—Extract of Colocynth. Dose, gr. ii-iij. 
Extractum Colocynthidis Cornpositutn (U. S. P.).—Compound Extract of Colocynth. 
Dose, gr. iv-x. 
The compound extract of colocynth contains aloes (100 parts), exhausted by alcohol 
and strained, to which are added colocynth extract (32 parts), resin of scammony (23 parts), 
and white castile-soap (28 parts). After thoroughly incorporating with the aid of heat 
(not above 275° F.), add cardamom in powder (12 parts), and when cold reduce the 
product to a fine powder. It should be kept in tightly-closed bottles. It is an ingredient 
in compound cathartic pill (comp. ext. of colocynth, gr. abstract of jalap, gr. j ; calo- 
mel, gr. j; gamboge, gr. J; in each pill. Dose, i-iij). 
Pharmacology.—The fruit of Citrullus colocynthis deprived of its 
rind, a native of Western Asia, but cultivated in various portions of the 
world (Cucurbitaeese). The pulp of the fruit after separation of the 
seeds, which are inert, contains a yellow, either amorphous or crystal- 
line, bitter, alkaloidal principle, Colocynthin, soluble in water and in 
alcohol; also a resin,Colocynthein, and Colocynthitin, the latter insoluble in 
water and not possessed of purgative effects, a tasteless crystalline body. 
Physiological Action.—In small doses colocynth acts as a simple 
bitter, increasing the secretions and improving appetite. In larger doses 
it augments the flow of bile and acts powerfully as a drastic and hvdra- 
gogue cathartic. Overdoses cause gastro-intestinal irritation, griping 
and purging. It is generally combined with other drugs to avoid this 
unpleasant action. Colocynth has some diuretic properties and indirectly 
acts as an emmenagogue. 
Therapy.—Colocynth is a valnnble purgative in chronic constipation 
or torpidity of the bowels. It produces soft, pulpy stools by stimulat- 
ing peristalsis. Its griping tendency may be overcome by combining it 
with aromatics or a small proportion of hyoseyamus or belladonna :— 
Extracti colocynth. comp., 3j. 
Ext. belladonnse ale., gr. ij. 
Saponis, ........... gr. x. 
01. cajuputi, lllv. 
M. et ft. pil. no. xx. 
Sig.: Take one or two at night for habitual constipation. CONDURANGO. 
567 
In chronic dropsy of serous cavities, or cerebral congestion, the 
compound extract may be given with compound liquorice-powder. The 
compound cathartic pills are excellent for cases of embarras gastrique, 
or so-called biliousness. In chlorosis, colocyntli is useful with iron. 
COIMDURANGO.—Condurango. 
Pharmacology.—Of the several plants known in New Grenada under 
the name of condurango, the Condurango bianco is that which has the 
greatest medical interest from the remarkable claims that have been made 
for it. It is a vine stated to belong to a new genus of Asclepiadacese, 
and the name Pseusmagenuetus equatorium has been proposed for it.* 
The bark is separated from the stem by beating with a wooden mallet 
and afterward dried in the sun. It is from to inch in thickness; 
its external surface is smooth and of an ashy-gray color. It contains a 
yellow resin, extractive, tannin, etc. 
Physiological Action.—To the resin the effect of the bark is ascribed, 
as it yields its virtues to alcohol. In the form of a decoction represent- 
ing 2 or 3 drachms, however, it produces decided therapeutic effect. It 
has caused diaphoresis, increased secretion of urine, and even vertigo and 
disturbance of vision, with increased activity of the circulation. Brunton 
failed to find any therapeutic value in a specimen examined l>3r him. 
Therapy.—About a score of years ago condurango was brought to 
the notice of the profession as a specific for cancer, and especially gastric 
cancer, and reports were published of its wonderful cures in its native 
habitat. Having failed to fulfill the extravagant claims that were made in 
its favor, and no other use being then proposed for it, condurango was 
allowed to retire into obscurit}'’ along with its introducers. About four 
or five years ago, however, some prominent German clinicians—Ruble, 
Binz, Immermann, and Riess—again directed attention to it, claiming that 
it was a good stomachic tonic ; and in a large number of cases presenting 
symptoms of cancer of the stomach, in which the drug was used, the result 
was favorable. The remedy was not without success in a single one out 
of over a hundred cases. Riess administered a decoction (5 per cent.), 
of which 6 ounces are given every day, with syrup of orange-peel. Im- 
mermann advises the use of a wine of condurango as a good preparation. 
The tincture is a valuable remedy in gastric catarrh. 
CONIUM (U. S. P.).—Hemlock. 
Preparations. 
Extractum Conii Fluidum (U. S. P.).—Fluid Extract of Conium. Dose, Ifi-v. 
Abstraction Conii (U. S. P.).—Abstract of Conium. Dose, gr. i-iv. 
Extractum Conii Alcoholicum (U. S. P.).—Alcoholic Extract of Conium. Dose, 
gr. ss-ij. 
* United States Dispensatory, Wood, Remington, and Sadtler, p. 1628. 568 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Tinctura Conii (U. S. P.).—Tincture of Conium (15 per cent.). Dose, Hfx-xxx. 
Coniina.—Coniine (the active principle). Dose, 
Coniinee Hydeobrornas.—Hydrobromate of Coniine. Dose, °;r. j. 
Succus Conii.—Conium-juice expressed from fresh leaves and alcohol added (% of the 
volume) to preserve it. Dose, f3ss-ij. 
Pharmacology.—The full-grown fruit of Conium maculatum (Umbel- 
liferse) gathered while yet green is officinal as hemlock; although the 
leaves are still used, they are less active, the seeds being about three 
times as strong. A tincture of the leaves per cent.) was formerly 
officinal (dose, f5ss-j),but, like conium-juice, it is unreliable in strength, 
and should be abandoned in favor of preparations from the seeds. The 
habitat of hemlock is Europe and North America. It contains three 
alkaloids and both volatile and fixed oils. The most important alkaloid 
is Coniine, a colorless, oily liquid, alkaline in reaction, with an acrid? 
tobacco-like taste and a characteristic odor resembling the urine of rats. 
Coniine is soluble in alcohol; only very slightly so in water. It is very vola- 
tile, and easily decomposed by light or heat. It is most abundant in the 
nearly-ripe fruit of the plant in its second year. Methyl-coniine, another 
alkaloid, is associated with the preceding, and also Conhydrine, a crystal- 
lizable alkaloid, convertible into coniine by abstraction of the elements 
of one molecule of water. Their medicinal effects are less evident than 
those of coniine. 
Physiological Action.—The local effects are sedative in painful con- 
ditions. No influence upon secretion has been noticed. Gastric disturb- 
ance results from a full dose of conium ; nausea and vomiting appear 
early. Following this, there are staggering gait, weakness of the limbs, 
numbness, fatigue, ptosis, double vision, pupils slightly dilated, vertigo, 
lowered inspiration, and labored speech. In poisonous doses there are 
loss of power of muscles, commencing in the lower extremities ; loss of 
sight and of speech, and, finally, death from paralysis of respiration. 
The function of the sensory nerves is likewise impaired by excessive 
doses. 
The heart’s movements seem to be unaffected and the mind remains 
clear until the brain is overcome by accumulation of carbonic-acid gas in 
the blood. In a case of poisoning, the stomach should be emptied and 
coffee promptly given, with hypodermatic injections of atropine. Mus- 
cular exercise delays the action of the poison. Free counter-irritation 
b)T mustard would doubtless be serviceable. The physiological antago- 
nists are strychnine, physostigmine, and atropine; tannic acid is incom- 
patible. Upon the nervous system methyl-coniine acts slightly differ- 
ently from coniine; the latter paralyzes the motor nerves from the 
extremities, gradually extending up to the motor centres; the former 
affects first the motor columns of the spinal cord. The sensory nerves 569 
CONIUM. 
and muscular irritability remain unaffected. The excretion from the 
system of coniine is chiefly by the breath and the urine. 
Therapy.—Poultices of the leaves of hemlock and flaxseed (2 of the 
former to 6 of the latter), with boiling water, have been used as a soothing 
dressing to painful swellings ; they should be applied with caution where 
there are abrasions or ulcers. Conium possesses both anodyne and anti- 
spasmodic virtues, and has long been reputed to exercise a deobstruent 
influence upon glandular and other enlargements. A hemlock ointment, 
made by bruising the leaves with sufficient water, extracting and incorpo- 
rating the juice with lard or other excipient, is an efficacious local remedy 
in painful maladies. It assuages the pain of cancer and may be bene- 
spread upon irritable or painful ulcers and painful haemorrhoids. 
It likewise affords relief when applied over the seat of pain in neuralgia, 
herpes zoster, chronic rheumatism, gout, or synovitis. The ointment is 
appropriately used in order to reduce the volume of enlarged scrofulous 
glands, enlarged mammary glands, liver, or spleen, and goitre. It may 
be spread upon the breast when the secretion of milk is excessive or 
requires suppression. In whooping-cough and asthma, hemlock ointment 
may be applied to the chest to assist the action of other remedies. 
Conium maj’ be prescribed in form of ointment as follows:— 
Extracti conii ale., 3j. 
Cocainae hydrochloratis, gr. v. 
Atropinae sulphatis, gr. j. 
Veratrinae, gr. xx. 
Ungt. aquae rosae, . . . §j. 
M. For neuralgia, chronic rheumatism, gout, and synovitis. 
Extracti conii ale., 3j. 
Mentholi, gr. v. 
Extracti helladonnae ale., gr. x. 
Ungt. zinci oxidi, 
Lanolin., aa §ss. 
M. For painful cancer, scrofulous glands, herpes zoster, and enlarged mammary 
glands. 
The vapor of coniine, or the fluid extract with hot water in an in- 
haler, yields good results in catarrh, laryngitis, irritative cough, and acute 
bronchitis, or the persistent cough of phthisis. The local hypodermatic 
injection of coniine has been employed in order to quiet the intercostal 
muscles in pleurisy and pneumonia ; but the liydrobromate, being more 
permanent, is a better preparation. Other painful and spasmodic diseases 
have been benefited by the same method. Among these may be in- 
stanced angina pectoris, emplrysema, asthma, acute mania, and tetanus. 
Dr. Harley warmly advocates the use of conium in chorea; also in 
nervous twitcliings, blepharospasm, and post-liemiplegic tremor. In 570 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
various spasmodic affections of children, convulsions, spasm of the 
larynx, trismus, spasmodic wryneck, and whooping cough, it has also 
been much approved. In ovaritis and in dysmenorrhoea, its adminis- 
tration in the following prescription is frequently followed with great 
relief from the pain :— 
Succi conii, ........... f3vj. 
Potassii bromidi, 3iij. 
Spiritus chloroformi, f3ij. 
Aquae camphorae, ad viij. 
M. Sig.: From a half to a tablespoonful every two or three hours. 
Conium has been highly recommended in paralysis agitans and 
hysteria. In acute mania, mania a potu, and active delirium tremens, it 
quiets motor excitement, finding, as it does, its principal usefulness in 
diseases attended by excessive motor activity. In some cases it is well 
to combine it with a little morphine for its effect upon the brain, and in 
others with bromide of potassium. Conium has been emplo3Ted in 
epilepsy, but here it is inferior to the bromides. It may, however, 
prove of benefit in those cases marked by vertigo and disturbance of 
the cerebral functions. Walslie Hias known it to relieve the pain of 
gastric cancer. For the latter disease, as well as gastric ulcer, it may be 
used in this combination :— 
Tinct. conii, . f3ss. 
Morphinse sulph., gr. j 
Acidi carbolici, llfiv. 
Syrup, acacias, .......... 
M. Sig.: A teaspoonful whenever in pain. 
Dr. Seguin, of New York, recommends rapid increase of the dose 
until physiological effects are noted. He gives a drachm of the fluid 
extract at a dose, and never less than 20 minims. Owing to the very 
volatile character of the coniine it is possible to administer large doses 
of some old fluid extracts without getting any effects whatever. If the 
strong, mousey odor is missing, the preparation will have very little 
therapeutic value. It is also said that preparations from cultivated 
plants, such as the succus, or tincture of the leaves, are apt to be inert. 
This explains the enormous doses used by Dr. Harley to f,$iij or 
iv) of the juice. It has been likewise noticed that children bearconium- 
juice well. Dr. Squibb calls attention to the possible danger following 
dilution of the fluid extract, by which a precipitate is formed, so that 
toward the end a poisonous dose may be accidentally taken. Death has 
been caused by the administration of 150 minims of the fluid extract. 
The poison administered to Socrates was apparently a strong, recent 
infusion of conium. 571 
CONVALLARIA MAJALIS. 
CONVALLARIA MAJALIS.—Lily of the Valley. 
Preparations. 
Extradum Convallarice.—Extract of Convallaria. Dose, gr. v-xx. 
Extraction Convallarice Fluidum.—Fluid Extract of Convallaria. Dose, f3ss-j. 
Infusum Convallarice.—Infusion of Convallaria (25 parts, in water 75 parts). Dose, 
f §ss—ij. 
Convallamannum.—Convallamarin. Dose, gr. yfc-ij. 
Pharmacology.—Convallaria mnjalis (Liliacese), a perennial plant, is 
native to Europe, Northern Asia, and our Allegheny Mountains. Its 
rhizome is about the size of a quill, its flowers bell-shaped and six-lobed. 
The flowers possess a fragrant odor and a bitter, acrid taste. All parts 
of the plant possess medicinal value, but its virtues reside principally in 
the flowers. Two glucosides have been isolated, known respectively as 
Convallarin and Convallamarin. The latter is the active principle of the 
plant, but seems to be unequally distributed in its different parts, and 
to be present in different proportions at different stages of its growth. 
A fluid extract, prepared from the root or flowers, is given in doses of 5 
to 15 minims. A fluid extract of the entire plant is also made, the dose 
of which is from 10 to 30 minims. 
Physiological Action.—Convallarin, in doses of 3 or 4 grains, acts as 
a purgative, but has no marked toxic effect. Convallamarin, in small 
doses, excites vomiting and manifests a special influence upon the action 
of the heart. At first the contractions are suddenly retarded and the 
blood-pressure increased; subsequently the cardiac pulsations are 
quickened and arterial pressure further augmented. Finally, the beat is 
arrested. Death takes place within a few minutes after introduction of 
the poison. The reflex function of the cord is abolished ; otherwise the 
action of the nervous system seems but slightly affected. 
Therapy.—In small doses this drug strengthens the heart’s action ; 
in larger quantities it restrains excessive cardiac activity. It has been 
found of especial value in mitral insufficiency. It quicklj'' relieves the 
dyspnoea and palpitation, and, after having been given for two or three 
days, may be discontinued for a week or more without recurrence of the 
symptoms. Convallaria seldom disagrees with the stomach, and no cumu- 
lative action has been observed. It increases the secretion of urine, and, 
after compensation has failed, invigorates the organ and reduces oedema. 
In disease of the aortic valve, though ot some service, the value of'con- 
vallaria is less marked. In angina pectoris and various forms of func- 
tional heart disease this remedy has proved beneficial. In chronic 
Bright’s disease it strengthens the circulation, relieves dyspnoea, in- 
creases the flow of urine, reduces dropsy, and lessens the albuminuria. 
Good results have also followed its administration in cardiac debility  PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
due to pneumonia or typhoid fever. In some cases of idiopathic asthma 
it relaxes the spasm of the arterioles. It sometimes is serviceable in tic 
douloureux aud other forms of neuralgia, insomnia, and the restlessness 
of fever. The palpitation and of phthisis are mitigated by the 
use of convallaria. It is of utility, likewise, in the irregularity of the 
heart dependent upon acute pneumonia, bronchitis, or emphysema, but 
is ineffective in fatty degeneration of the heart. 
Extr. convallariae flor. fid., . . f3ij. 
Syrup, aurantii, q. s. ad l§ij. 
M. Sig.: A teaspoonful to a tablespoonful three times a day. Useful in mitral 
insufficiency and functional heart disease. 
Potassii bitartratis, f§ss. 
Extr. convallariae flor. fid., f3iss. 
Syr. simplicis, q. 6. ad f^iv. 
M. Sig.: From one-half to a tablespoonful, in water, three or four times a day. 
Valuable in general dropsy from heart or kidney disease. 
COPAIBA (IT. S. P.).—Copaiba. 
Preparations. 
Massa Copaiba; (U. S. P.).—Mass of Copaiba (copaiba 94, magnesia 6 parts). Dose, 
gr. x-3ss. 
Oleum Copaibce (U. S. P.).—Oil of Copaiba. Dose, ffiv-x. 
Resina Copaibce (U. S. P.).—Resin of Copaiba. Dose, gr. viii-xv. 
Pharmacology.—Copaiba is an oleoresin obtained from Copaifera 
LangsdorfHi and other species of Copaiferse (Leguminoseae), coming 
principally from Brazil. It is not a balsam. In physical character it is 
a clear, transparent, oity liquid, of a pale-straw color and a characteristic 
unpleasant odor and taste. It contains a large quantity of volatile oil 
(the best specimens, 70 to 85 per cent.), in which two resins are dissolved. 
Copaibic acid, the principal one of the resins, is crystallizable, with faint 
odor and bitter taste; insoluble in water, easily soluble in absolute alcohol 
and in ammonia. Both the oil and the resin are medicinally active. 
Physiological Action.—Locally applied, copaiba is slightly stimulating 
to the skin and mucous membrane. The taste of copaiba is peculiarly 
disagreeable, and it imparts its odor to the breath, being partly excreted 
by the bronchial mucous membrane. It is heating and irritating to the 
stomach, causing offensive eructations and frequently exciting vomiting 
and purging. Taken in medicinal doses, it soon interferes with the 
digestion, causing loss of appetite, disordered bowels, and diarrhoea. 
Copaiba.is very diffusive, and stimulates secretion at its points of elimi- 
nation by the kidneys, bronchial mucous membrane, and skin. Its 
special action is upon the mucous membrane of the genito-urinary tract, 
and in large amounts it gives rise to irritation or inflammation of the 573 
COPAIBA. 
kidneys, in its discharge through these organs. Bloody urine, pain in 
the bladder, and strangury are occasional results of the administration 
of copaiba. It acts locally upon the genito-urinary tract, at first stimu- 
lating and subsequently checking secretions. The resin has a decided 
diuretic action and is also expectorant. 
Therapy.—Copaiba has been used for its stimulating and antiseptic 
effects in chronic skin diseases, psoriasis, lupus, and leprosy, being in its 
action very much like gurjun-oil. It can be used with benefit in old 
ulcers, and in thickened and irritable conditions of the tongue, mouth, 
rectum, vagina, uterus, and the urethra. Copaiba, applied to the urethra 
in gleet, is sometimes followed with a complete removal of the discharge : 
Copaibae, 3ss. 
Liq. boro-glycerini (50 per cent.), 3ss. 
M. Sig.: For application to the urethra with bougie or camel’s hair brush. 
Internally, it is also given in the treatment of psoriasis, and for this 
purpose it is best administered in capsules, one or two hours after meals. 
For bronchitis, given as an expectorant, and in dropsy, for its diuretic 
effect, it is better to use the resin, which is nearly free from the objections 
to the volatile oil of causing offensive eructations. In bronchitis its effects 
are more decided after subsidence of the acute stage, and it is particu- 
larly valuable in chronic bronchitis associated with dilatations of the 
tubes and marked by a profuse purulent discharge. In ascites and some 
kidney disorders the resin is a valuable means of increasing the urine. 
Copaiba is of service also in cardiac dropsy. The remedy is not, how- 
ever, invariably successful in removing these transudations, even when 
the conditions are apparently the same. Ringer concludes that this 
difference depends upon individual peculiarity, and adds that, whereas 
copaiba may cause bloody urine, he has seen a large amount of blood in 
the urine quickly disappear when copaiba was administered. The oleo- 
resin is principally used as an antiblennorrlietic in gonorrhoea, after the 
acute stage has passed, and in c}7stitis and pyelitis. It may be given in 
combination with cubebs, or in the well-known Lafayette Mixture (mist, 
copaibae comp., N. F.) :— 
$ Copaibse, f§ij. 
Tr. lavandul* co., f §ij. 
Liq. potass*, f3iv. 
Spiritus setheris nitrosi, f§ij. 
Syrupi, f?v. 
Mucilaginis, . q. s. ad Oj. 
M. To be well agitated when used (each f3 = ITlviiss). Dose, a tablespoonful taken 
after meals. 
To each dose of the above, 3 to 5 drops of oil of sandal-wood may 
be added, with good results. 574 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Among the many combinations of copaiba found of service in gon> 
orrlioea and gleet, the author suggests the following:— 
Resin* copaib*, 3iiiss. 
Oleoresinae cubebae, f3j. 
Saloli, 3iij. 
Pepsin* pur., . gr. xl. 
M. et ft. capsulae no. xl. 
Sig.: From six to ten a day. 
Resinae copaibae, . 3iv. 
Acidi sulpburici arom., f3ij. 
Acaciae, q. s. 
Infus. rosae, f^viij. 
M. Sig.: A tablespoonful three or four times a day. 
Resinae copaibae, §ss. 
Extracti glycerrhiz* fl., . f§j. 
Spiritus aetheris nitrosi, f 
Acaciae, q. s. 
Aquae cinnamomi, ad § viij. 
M. Sig.: A tablespoonful three or four times a day. 
Olei copaibae, 
Oleoresinae cubebae, ........ a* bllxx. 
Aloini, 
Extracti belladonnae ale., aa gr.j. 
01. menth. pip., ,rU- 
M. et ft. pilulae no. xij. 
Sig.: From three to six pills a day. 
It is safe to begin the administration of copaiba in gonorrhoea as 
soon as the initial severity of the attack has subsided and the bowels 
have been freely opened. In the chronic cystitis of women, Dr. Whitla 
has derived great benefit from injection into the bladder of equal parts 
of copaiba and warm castor-oil. One ounce of this mixture is injected 
and allowed to remain until expelled. In the gonorrhoea of females, an 
emulsion of copaiba is sometimes used as an injection. In certain affec- 
tions of the intestinal tract this remedy is sometimes of service. Chronic 
diarrhoea and dysentery may improve under the administration of copaiba 
after other agents have failed. It may prove beneficial in chronic intesti- 
nal catarrh accompanied by ulceration, and is recommended lnr Ailing- 
ham ill chronic proctitis. Clark and others have found it useful in 
pseudo-membranous enteritis, given in the intervals between paroxysms. 
It has been used successfully in the treatment of haemorrhoids, 20 drops 
being administered in capsules four times a day, or £ drachm in combina- 
tion with 15 drops of liquor potassae, taken three times a day. 
When nitric acid is added to the urine in making Heller’s test for 
albumin, a cloud is formed if copaiba has been taken,but the application 
of heat causes it to disappear, and thus proves that it is not albumin. COPTIS, 
575 
During the administration of copaiba, a coarse, measly rasli sometimes 
breaks out over the body, especially in persons with a delicate skin ; it 
also causes annoying itching. The administration with an alkali renders 
this accident less likely to occur. The mass of copaiba (pilulre copaibse, 
Ph., 1870) was introduced with this object in view; but it is less efficient 
therapeutically than the other preparations. It may be made into pills 
of gr. iii-x, sugar-coated. 
COPTIS.—Coptis, Gold Thread. 
Preparation. 
Extraction Coptidis Fluidum.—Fluid Extract of Coptis. Dose, f3ss-j. 
Pharmacology.—The Coptis trifolia, or gold thread (Ranunculaceae), 
is a native of the temperate portions of North America and tne Old 
World. The entire plant is used, and was formerly officinal. The rhizome 
is thread-like, and of a bright-yellow color. It is bitter to the taste, 
without odor. Its constituents are Berberine, a white alkaloid, Coptine, 
resin, but no tannin. 
Physiological Action and Therapy.—On account of the berberine 
principally, coptis is a pure, bitter tonic, agreeing well with the stomach, 
and without astringencv. It is used to increase appetite, and as a general 
tonic. Locally, the infusion has been employed in aphthous ulceration 
of the mouth, and is a good gargle in ulcerative tonsillitis. The effects 
of berberine are discussed below. 
The East Indian variety, Coptis teeta, of which the root only is 
employed in medicine, contains a very large proportion of berberine,— 
more than any other plant known. 
A prescription containing gold thread, of much value in the treat- 
ment of dyspepsia, especially when attended with diarrhoea alternating 
with constipation, is :— 
I) Extracti coptidis fl., f§ij. 
Tinct. nucis vomicae, f3j. 
Aquae ciimamomi, viij. 
M. Sig.: From one-half to a tablespoonful before meals. 
Berberine is an alkaloid found in numerous plants (berberis, coptis, 
columbo, hydrastis, menispermum, podophyllum, xanthorrhiza, xanthox}- 
lum, etc.), belonging to the natural orders Berberidacese, Menisper- 
macese, and Ranunculacene. It occurs in yellow, prismatic crystals, 
soluble in hot water and in alcohol, but insoluble in ether. It yields 
bright-yellow, crystal!izable salts, of which the hydrochlorate and sul- 
phate are employed in medicinal doses of gr. ii-x. It is a bitter tonic, 
antipyretic, and antiperiodic, also cholagogue. It is useful in dyspepsia, 
malaria, and diarrhoea. 576 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
CORIANDRUM (U. S. P.).—Coriander. 
Dose, gr. v-xxx. 
Preparations. 
Coriandri Extractum Fluidum.—Fluid Extract of Coriander. Dose, x-xxx. 
Oleum Coriandri (U. S. P.).—Oil of Coriander. Dose, lUi-v. 
Confectio Stnnce (U. S. P.).—Confection of Senna (coriander, 6 per cent.). 
Pharmacology.—Coriander is the fruit of Coriandrum sativum 
(Uinbelliferae), native of Southern Europe. They sometimes are im- 
properly called seeds. They have an agreeable, spicy odor, due to a 
volatile oil. The fruit also contains fixed oil. 
Therapy.—This agent is used as an aromatic and stomachic, and is 
usually employed to prevent griping from other remedies, or as a flavor- 
ing excipient. A few drops of the oil may be given upon sugar for the 
relief of colic. 
CORNUS (U. S. P.).—Cornus, Dogwood. 
Preparations. 
Extractum Cornus Fluidum (U. S. P.).—Fluid Extract of Cornus. Dose, f3ss-j. 
Extractum Cornus Floridce.—Extract of Cornus Florida. Dose, gr. i-v. 
Pharmacology.—The bark of the root of Cornus Florida (Cornaeese), 
a small tree indigenous to the United States, has decided physio- 
logical properties. It contains a crystallizable, bitter principle, Cornin, 
or cornicacid; also tannic acid, resin, etc. As the active principle is 
altered by air and heat, a decoction or aqueous fluid extract is not an 
eligible preparation in order to obtain the effect of the drug, Cornin 
is found also in other species of dogwood, Cornus circiuata, Cornus 
sericea, etc. 
Physiological Action and Therapy.—Cornus belongs to the class of 
vegetable bitters, and is used as a stomachic tonic to increase appetite, 
etc. It has also considerable reputation for control over malarial mani- 
festations, and is considered the best substitute for cinchona among the 
native astringent bitters. 
CORYDALIS (U. S. P.).—Corydalis, Turkey Corn. 
Preparation. 
Extractum Corydalis Fluidum.—Fluid Extract of Corydalis. Dose, Hlxv-f3j. 
Pharmacology and Therapy.—The Dicentra Canadensis (Fuinariacese), 
a native of the northern part of this country, has some reputation as an 
alterative, especially used as a tonic in syphilis and other conditions of 
debility. The tubers are the part of the plant used ; they contain an 
alkaloid, Corydaline, combined with fumaric acid, also acrid resin and 
bitter extractive. Corydaline has been given in doses of 1 to 5 grains. COTO CORTEX. 
577 
COTO CORTEX.—Coto Bark. 
Preparations. 
Pulvis Coto Cortieit.—Powder of Coto Bark. Bose, gr. v-xxx. 
Extractum Coto Corticis Fluidum.—Fluid Extract of Coto Bark. Bose, Nlxii-xxx. 
Tinctura Coto Corticis.—Tincture of Coto Bark. Bose, ITlx-xv. 
Cotoina.—Cotoine. Bose, gr. ss-j. 
Paracotoina.—Paracotoine. Bose, gr. ss-ij. 
Pharmacology.—Coto bark is obtained from Bolivia, but its botanical 
origin is still undetermined. Several authors believe that it comes from 
a member of the natural order Lauraceae, and this statement is adopted 
by the National Dispensatory of 1886. It is received in the form of flat 
or curved pieces a foot or more in length and f inch broad. Externally 
it is of a cinnamon-brown color, but when broken it appears studded 
with numerous scattered spots. It has an aromatic odor, 
which is more perceptible when the bark is bruised. The powder is very 
irritant to the Schneiderian mucous membrane. The taste is aromatic, 
sharp, and slightly bitter, but not astringent. The active principle is a 
ciwstallizable substance termed Cotoine, of a pale-3'ellow color, slightly 
soluble in cold water, but soluble in hot water, alcohol, ether, chloroform, 
and alkaline solutions. Cotoine is precipitated by hydrochloric acid 
with a clear, yellow color. It is colored blood-red by nitric acid, brown- 
ish yellow by sulphuric acid, and black by ferric chloride. A bark differ- 
ing in external appearance from coto, but similar in chemical composition 
and therapeutic effects, and probably derived from an allied species, has 
been designated paraeoto. Paracoto contains an active principle called 
Paracotoine, analogous to cotoine in composition and effects, but feebler. 
Powdered paracoto is unirritant to the nasal mucous membrane. Para- 
cotoine is of a bluish color, and but soluble in boiling water. 
Physiological Action.—Applied to the unbroken skin, powdered coto 
causes heat and redness. Taken internally, it gives rise to a sensation 
of warmth in the stomach, and in large doses to nausea and vomiting. It 
stimulates the secretion of saliva. Small doses may increase the appe- 
tite. It is eliminated in the urine. Coto retards the development of 
bacteria and the occurrence of putrefaction. It causes active dilatation 
of the intestinal blood-vessels. Coto does not produce constipation in 
healthy individuals. 
Therapy.—Coto and paracoto are remarkably efficient remedies in 
diarrhoea. They are applicable to all varieties of the disorder, except that 
dependent upon ulcers of the bowel, in which they have generally failed. 
Abundant testimony exists as to its worth in functional diarrhoea, acute 
and chronic gastro-intestinal catarrh, cholera infantum, the diarrhoea 
of typhoid fever, of rachitis, insanity, and in that form resulting from 578 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
reduced nutrition. It is exceedingly valuable in the treatment of tuber- 
culous diarrhoea, and is at the same time of service in reducing the fevei 
and checking the night-sweats. Professor Baelz, of Tokio, Japan, suc- 
cessfully treated live cases of Asiatic cholera by hypodermatic injections 
of pnracotoine. Coto has been found effective also in hyperidrosis. In 
a cnse mentioned by Dr. J. Burney Yeo, coto not only arrested the 
diarrhoea of a severe case of exophthalmic goitre, but also seemed to 
have a remarkable influence upon the nervous phenomena. Yeo recom- 
mends the following mode of administration :— 
Fluid extract of coto, 1 drachm. 
Compound tincture of cardamom, 1 “ 
Mix these together and slowly triturate them with 
Mucilage of acacia, 3 drachms. 
Simple syrup, 2 “ 
Water, enough to make 6 fluidounces. 
Dose, a tablespoonful. 
This is an opaque mixture of a not unpleasantly warm and aromatic 
taste. Two or three doses generally arrest or check the severest forms 
of tuberculous diarrhoea. The author has employed the following pre- 
scription in chronic and in tuberculous diarrhoea, the effect being com- 
plete cessation of all discharge :— 
Extracti coto cort., f3ij. 
Extracti hamaraelidis fl., i^ss. 
Aquae cinnamomi, f§x. 
M. Sig.: A dessertspoonful every three or four hours. 
Laborde prepared a wine of coto according to the following- 
formula :— 
Coarsely-powdered coto-bark, 30 grammes. 
Malaga wine (16 degrees), 1000 “ 
Macerate for ten days, shaking occasionally, and filter. 
Professor Albertoni, to whom we owe the most comprehensive study 
of the physiological action of coto, observed no favorable results in 
drunkards or where the portal circulation was embarrassed, as in 
cirrhosis. He considers it contra-indicated when there is hypersemia of 
the bowel and a tendency to intestinal haemorrhage. For the same 
reason it should be used with circumspection in acute intestinal catarrh. 
According to this writer the beneficial effects of coto are due to its 
favorable influence, through active dilatation of the blood-vessels, upon 
the intestinal epithelium, promoting its nutrition and modifying its 
physiological functions.* 
* See paper by author, “The Physiological and Therapeutical Action of Coto-Eark,’’ in 
Medical Bulletin for February, 1891. CREASOTUM. 
579 
CREASOTUM (U. S. P.).—Creasote. 
Dose, n^i-iij. 
Preparations. 
Aqua Creasoti (U. S. P.).—Creasote-Water (1 percent.). Bose, f3ss-iv. 
Unguentum Creasoti.—Ointment of Creasote (IT\xxx-§j). 
Pharmacology.—Creasote is a product of the distillation of wood- 
tar, or, more correctly, one of the products of the distillation of wood, 
separated from tar by fractional distillation ; it xvas discoArered in 1830 
by Reichenbacli. It is largely contaminated or substituted in commerce 
by a similar substance obtained from the distillation of bituminous coal, 
made up of carbolic and cresylic acids principally. Wood-tar creasote 
is chiefly composed of the following- phenols, Guaiacol, Creasol, Methyl- 
creasol, and Phloral. The creasote made from beech-wood is of a reddish- 
amber color; it is the best for medicinal use. It is an oily liquid, nearly 
colorless; of smoky odor, caustic taste, and neutral reaction; soluble in 
80 parts of water, and in all proportions of alcohol, ether, etc. It differs 
from carbolic acid in being less caustic and in not coagulating collodion 
or albumin,* but has probably equal, if not superior, antiseptic effects, 
as seen in its power of preserving meat, from which it derives its name. 
With the tincture of the chloride of iron, an alcoholic solution of creasote 
develops a deep, greenish-blue color; but carbolic acid produces a light 
brown. 
Physiological Action.—Creasote is a local sedatix-e. Internally, it 
very closely resembles the effects of carbolic acid as an anaesthetic anti- 
septic and astringent. It escapes from the body by the bronchial mucous 
membrane in part,and has expectorant powers ; in part it is also excreted 
by the kidneys. Creasote has a special sedative action upon the nerves 
of the stomach and allays irritability and nausea. It has a similar effect 
upon the bronchial mucous membrane when its vapor is inhaled with the 
vaporizer or steam-atomizer. In overdoses, creasote causes giddiness, 
depressed action of the heart, faintness, convulsions, or coma. The 
antidotes are probably the same as those to carbolic acid, since Hare has 
found that the soluble sulphates are efficacious antidotes to creasote- 
poisoning. 
Therapy.—As a local anaesthetic, creasote is largely used by dentists 
in aching teeth with sensitive dentine, and as an application to an exposed 
nerve-pulp; the remedy being taken up on a little absorbent cotton, and 
excess removed by allowing it to rest upon blotting-paper before being 
inserted into the cavity of a tooth, from which debris of food or other 
material should first be removed by syringing with warm water. Crea- 
sote-water has some haemostatic qualities, and is an antiseptic dressing 
* The United States Dispensatory says that creasote “ powerfully coagulates albumin.” 580 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
of value in sloughing ulcers, or for injection into sinuses. In gleet and 
other catarrhal diseases, creasote often acts well when used as follows :— 
$ Creasoti, Nlv. 
Ext. geranii fl., f3ss. 
Aquae rosae, f §iv. 
M. Sig.: Inject night and morning into the urethra,—alone or slightly diluted 
with warm water. 
Creasote is believed to have special value in the treatment of burns 
and in chilblains. In skin diseases of a scaly character and pruritus, 
creasote is a useful application ; and in erysipelas the ointment is of 
benefit in relieving the pain and reducing the inflammation. This oint- 
ment relieves the itching and burning of erythema multiforme and 
of eczema, and is beneficially applied to ulcerated surfaces and psoriasis. 
Creasote ointment is very advantageously prescribed in connection with 
carbonate of lead, as :— 
Plumbi carbonatis, ......... 3j. 
Unguenti creasoti, §j. 
M. For erysipelas, erythema, acute eczema, and burns. 
A gargle containing creasote in sloughs of the mouth or throat, 
purifies the breath, and stimulates the ulcer to repair. 
For catarrhal laryngitis, and tubercular disease of the air-passages, 
creasote can be sprayed over the surface as in this prescription:— 
Creasoti, f3j. 
Tinct. benzoin, co., f3ij. 
Aquae hamamelidis dest., 
Glycerini, aa f^iss. 
M. Sig.: Use in an atomizer. Spray over the surface three or four times a day. 
Taken into the stomach, it checks fermentation and reduces irri- 
tability, checking nausea and correcting the causes productive of diar- 
rhoea. It is a useful remedy in sea-sickness and the vomiting of 
pregnancy, and in the summer diarrhoea of adults as well as of infants. 
In the first-mentioned disease the nausea and vomiting may be overcome 
by this combination of creasote :— 
$ Creasoti, Hlv. 
Morphinae sulphatis, gr. j. 
Aquae menth. pip., f^iij. 
M. Sig.: A teaspoonful every two or three hours until relieved. 
In chronic bronchitis, bronchorrhoea, and phthisis, creasote has been 
given with marked benefit, especially where cavities have formed, as in 
the following combinations :— CREASOTUM. 
581 
Creasoti, Uli-iij. 
Tr. gentian® comp., lfixxx. 
Spiritus frumenti, , q. s. ad f3ij. 
M. Sig.: Take four times daily. 
Creasoti, 
Tinct. eapsici, aa f3j. 
Syrup, acaci®, f§j. 
Syrup, limonis, f §iv. 
M. Sig.: A teaspoonful with water after meals. 
Creasoti, f3ss. 
Syrup, ferri iod., 
Glycerini, aa f § iij. 
M. Sig.: A teaspoonful in water three or four times a day. 
Creasote may be given in a pill, or the prescribed number of drops 
added to a teaspoonful of old Jamaica rum, diluted with water. In a 
considerable proportion of cases, cough and expectoration are diminished 
and fever and night-sweats are lessened. 
As creasote is of variable composition, containing from 60 to 90 per 
cent, of Guaiacol, Sahli has proposed that the latter body should be em- 
ployed instead of creasote in the treatment of phthisis. Guaiacol is a 
colorless liquid, sparingly soluble in water, but very soluble in ether, 
alcohol, and fatty oils. It is more agreeable in odor and taste than crea- 
sote, and is said to be better borne. It improves the appetite and digestion 
and prevents or relieves flatulence. It is probably eliminated by the lungs, 
exerting a directly local beneficial action. It indirectly reduces hectic 
fever and checks night-sweats. When given at an early stage of the dis- 
ease, the bacilli diminish remarkably in number and may even entirely dis- 
appear. Labadie-Lagrave has advantageously prescribed guaiacol in the 
form of pearls or capsules. Bourget, of Geneva, prescribes it dissolved 
in wine or codiiver-oil.* Dr. Charles Eloy, of Paris, recommends 
creasote to be given in emulsion, as follows:— 
01. amygdal. dulc., f§v. 
Creasoti, f3ij. 
Misce et adde 
Pulv. acaci®, f?iii3v. 
Aq. menth. pip., f§xvj. 
M. Sig.: From two to five tablespoonfuls a day. 
Seitz prefers to combine creasote with codliver-oil and make an 
emulsion with the aid of saccharin. Both creasote and guaiacol have 
been injected beneath the skin or into the lung. Creasote affords relief 
in flatulent dyspepsia, sarcina ventriculi, and gastralgia. It can be pre- 
scribed, in the diseases just referred to, as follows :— 
* Le Progres Medical, April 26, 1890 ; Medical Bulletin. July, 1890, p. 253. 582 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Creasoti, hlv. 
Tinct. capsici, f'3ss. 
Aquae sodse menth., q. s. ad f §iij. 
M. Sig.: A teaspoonful in water at meals. 
Creasoti, n\vj. 
Glycerini, 
Syr. acaciae, aa f^iss. 
M. Sig.: A teaspoonful before meals. 
Creasote has been successfully employed in diabetes mellitus by P. 
Valentin, who gave it in daily doses of 4 drops, increased gradually to 10 
drops. The sugar soon disappeared, and did not return even when a diet 
containing starch and sugar was allowed. Good results have been 
obtained from creasote in typhoid fever, diphtheria, scarlet fever, and 
erysipelas. A. Atkinson has found it efficacious in the treatment of 
tape-worm. A mixture of creasote, spirit of and tincture 
of lavender may be used in an inhaler in diseases attended with profuse, 
bad-smelling expectoration. This mixture, or those of similar compo- 
sition, all prove of great value in removing the offensive odor of gan- 
grene of the lung in phthisis, laryngitis, chronic bronchitis and also in 
asthma:— 
Creasoti, 
Ethyl iodidi, 
Terebenis, aa f3j. 
M. Sig.: For inhalation. Ten to twenty drops in an inhaler when necessary. 
Creasoti, 
Eucalyptolis, 
Spt. vini rectificat., 
Terebenis, aa f3j. 
M. Sig.: For inhalation. Ten to twenty drops, as necessary. 
Creasoti, 
Thymoli, 
Spiritus vini rectificat., aa f3j. 
M. Sig.: For inhalation. Ten to twenty drops. 
Koch’s method of treating eiysipelas consists in applying the followr- 
ing ointment, spread evenly with a camel’s hair pencil, in a thin layer 
over the affected part:— 
Creasoti vel Creolini f3j. 
Iodoformi, 3iv. 
Lanolini, 3x. 
M. After applying the ointment as directed, cover the surface with a thin sheet of 
gutta-percha or rubber cloth. CREOLINUM. 
583 
CREOLINUM.—Creolin. 
Dose, n^ii-v. 
Pharmacology.—Creolin is obtained from English coal by dry distil- 
lation, the carbolic acid being separated and the residue emulsified by a 
special process with the addition of caustic soda. The details of its 
mode of manufacture, however, have not yet been published. It is a 
syrupy, dark-brown, or blackish fluid of a tar-like odor. It mixes with 
water in all proportions, forming an opaque, whitish emulsion. It is 
soluble in alcohol. The exact chemical constitution of creolin has not 
been determined, but it seems to consist largely of hydrocarbons joined 
with phenols free from any trace of carbolic acid, together with a small 
proportion of organic bases of the pyridine order and alkaline ash. 
Physiological Action.—A 3-per-cent, aqueous dilution excites no irrita- 
tion when applied to the skin. When the skin is subjected to the action of 
a 5-per-cent, dilution for a considerable time, a slightly burning sensation 
results, but soon disappears. Creolin is irritant to mucous membranes. 
It is an efficient germicide, in some respects more powerful than carbolic 
acid. It is more destructive than carbolic acid to the micro-organisms of 
typhoid fever, Asiatic cholera, and suppuration ; while, upon dried spores 
of the anthrax bacillus, carbolic acid exerts a more powerful inhibitory 
influence than creolin. Carbolic acid is likewise the more efficacious anti 
permanent disinfectant of putrefaction. Creolin possesses the advantage 
of being much less toxic. It was at first, in fact, supposed to be entirely 
devoid of toxicity. This claim can be no longer upheld, since several 
patients, especially among the 2000 midwifery cases reported by Dr. 
Bitter*, of Breslau, showed symptoms of nausea, chill, fever, dyspnoea, 
collapse, and albuminous urine following its use. In one case reported, 
a scarlatiniform rash, with thirst, fever, and itching of the skin, was pro- 
duced. In another instance, however, as much as 8 ounces were used 
without fatal consequences. The addition of 1 or 2 per cent, of creolin 
removes the characteristic odor of iodoform. 
Therapy.—It is almost exclusively as a local application that creolin 
has been used, though it has been administered internally in a few instances 
with the effect of preventing gastro-intestinal fermentative processes. As 
an efficient and safe antiseptic, it is very advantageously employed in a 
1- or 2- per-cent, solution to irrigate accidental or surgical wounds. A 
2- dilution in olive-or linseed-oil,applied upon absorbent cotton, 
is an excellent dressing to abscess-cavities, sinuses, to wounds left after 
resection of bone, removal of a sequestrum, to compound fractures, etc. 
In addition to its parasiticide virtues, it is additionally serviceable as a 
* British Medical Journal, December 13,1890. 584 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
dressing to fresh wounds from its haemostatic properties, promptly arrest- 
ing the oozing from divided capillaries. A weak dilution of creolin in 
water or alcohol makes a good wash in ozaena. Five or six drops may 
be added to a pint of water, or we may follow the method of Moure and 
prescribe :— 
Creolini, Hlxv. 
Spt. viiii rect., f^iiiss. 
M. A teaspoonful of this solution is added to a quart of tepid water. 
Schnitzler has used creolin in diseases of the larynx, especially 
tuberculosis, by inhalation (l part in 1000 of water), by insufflation (from 
1 to 5 parts to 100 of sugar of milk), or 1 to 5 parts to 100 of water 
directly to the diseased parts by mopping. Schnitzler and Kortiim like- 
wise recommend it as a gargle in diphtheria. A 1-per-cent, solution has 
been found curative in thrush and aphthae. The injection, two or three 
times a day, of 2 to 4 pints of a solution has yielded excellent 
results in dysentery. In this strength the intestinal mucous membrane 
was not irritated ; no burning or abdominal pain was produced. The 
offensive odor of cancer is removed by creolin. A 5- to 10- per-cent, 
creolin-oil is efficient in pediculosis and scabies, or prescribed thus :— 
Creolini, f3ss. 
Balsam. Peruviani, f3ij. 
Adipis, §j. 
M. Sig.: Apply well over the surface. Use in scabies. 
A l-to-1000 aqueous solution has been used in gonorrhoea. It has 
seemed much more beneficial in gonorrhoea of women than of men. A 
1-per-cent, solution is a very efficacious injection in the cystitis of women. 
In diseases of women it can also be employed according to the following- 
formulae :— 
Creolini, f3j. 
Ext. hydrastis Canadensis fl., f§ss. 
Glycerini, f^iiss. 
M. Sig.: One or two teaspoonfuls in a pint of water, to be employed at one injectiou. 
Use in leucorrhma and pruritus of the vagina. 
f Creolini, f3j. 
Boro-glyceridi (50 per cent.), fgv. 
M. Sig.: Use as an injection, one to two teaspoonfuls in a pint of water, for uterine 
and vaginal diseases. 
Asa wash in puerperal septicaemia, and as an antiseptic vaginal injec- 
tion before or after labor, a creolin solution is of value. Five or six drops 
to a pint of water have been successfully used in otorrhoea. In extensive 
burns and in bed-sores, Kortiim recommends a 5-to-1000 aqueous solution. 
A 1- or 2- per-cent, solution is an excellent deodorant and stimulant CROCUS. 
585 
dressing to leg-ulcers. Rothe* has used creolin in the form of an oint- 
ment with marked success in the treatment of erysipelas, tinea versi- 
color, eczema, and in scabies. 
A 2-per-cent, solution is an admirable disinfectant to the hands of 
the surgeon. A creolin-soap is also made. The opacity of its watery 
solution renders creolin inferior to carbolic acid as an immersion fluid 
for instruments. Moreover, resinous particles are soon deposited upon 
the instruments, though this drawback has been overcome b)r the manu- 
facture of vessels having a perforated false bottom upon which the instru- 
ments may rest. Gauze, bandages, and absorbent cotton may often be 
impregnated with a creolin solution. A 1- or 2- per-cent, 
ointment of creolin, and a powder composed of 2 parts of creolin to 100 
of boric acid, will in many conditions be found serviceable. In the 
acute gastro-enteritis of children, Schwing has obtained satisfactory 
results from doses of 2 or 3 drops of creolin administered in some 
demulcent vehicle. 
CROCUS (U. S. P.).—Saffron. 
Dose, gr. x-xx. 
Preparation. 
Tindura Croci (U. S. P.).—Tincture of Saffron (10 per cent.). Dose, f3i-ij. 
Pharmacology.—The stigmas of Crocus sativus (Iridacem) are of- 
ficinal under the title of Crocus. They are obtained from cultivated 
plants in the south of Europe. Spanish saffron has a strong, peculiar 
odor, an aromatic, bitter taste, and imparts a yellow hue to the saliva 
Avhen chewed. So-called American saffron is a different plant, the Car- 
thamus tinctorius, or safflower, of which the flowers are used. Saffron 
of good quality, however, is cultivated in Pennsylvania. 
Therapy.—Saffron is slightly aromatic and feebly anodyne and anti- 
spasmodic. A hot infusion called saffron-tea is made from the safflower 
and not from saffron ; it is used in domestic practice to bring out the 
eruption in measles and scarlet fever and as a diaphoretic. In Europe 
the tincture of saffron is employed as an emmenagogue, but here its only 
use, as a rule, is that of a coloring agent. 
CUBEBA (U. S. P.).—Cubeb. 
Dose, gr. xx-5ij (of the recently-powdered drug). 
Preparations. 
Extradum Cubebce Fluidum (U. S. P.).—Fluid Extract of Cubeb. Dose, blx-xxx. 
Oleoresina Cubebce (U. S. P.).—Oleoresin of Cubeb. Dose, Hfv-xxx. 
Oleum Cubebce (U.S.P.).—Oil of Cubeb. Dose, Hlv-xij. 
Tindurce Cubebce (U. S. P.).—Tincture of Cubeb. Dose, f3ss-ij. 
Trochisci Cubebce (U. S. P.).—Troches of Cubeb ( hiss oleoresin). 
* Brit. Journ. of Dermatology, November, 1890. 586 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Pharmacology.—The unripe fruit of the Cubeba officinalis (Piper- 
acete), a plant cultivated in Java, contains a volatile oil and an acrid 
resin ; the latter composed of Cubebin, a tasteless, insoluble, neutral sub- 
stance, and cubebic acid, with fat, gum, etc. Cubebene, a camphoraceous 
substance, can be separated from the volatile oil, leaving Cubeben, a 
liquid oil, behind. The medicinal activity of the drug consists princi- 
pally in the volatile oil and cubebic acid, which are both present in the 
oleoresin. 
Physiological Action.—The effects of cubeb are those of an aromatic 
stimulant to the stomach, improving the digestion in small doses and 
increasing appetite ; deranging digestion in larger doses and acting as an 
irritant. Cubeb increases the force and frequency of the heart’s action, 
stimulates the genital organs, and promotes menstruation. It is elimi- 
nated by the skin (frequently causing an urticarial or vesicular eruption), 
by the bronchial mucous membrane (acting as an expectorant and anti- 
septic), but chiefty by the kidneys (increasing the quantity of urine and 
disinfecting the urinary passages). 
Therapy.—The powder of cubeb is considered a good application in 
hay fever, chronic nasal catarrh, and follicular pharyngitis. In hay 
fever, if it does not increase the irritation, it may be useful. In asthma, 
or swollen “ hypertrophies ” in the nose, cubeb cigarettes are smoked 
with relief. Cubeb is principally used in blennorrhoea, cystitis, and 
purulent affections of the genito-urinary tract. In gonorrhoea it may be 
given in all stages of the disease, acting best in the acute stage. Some 
patients, however, appear to be very susceptible to the effect of this drug, 
small doses causing digestive disturbance, irritability of the bladder,and 
bloody urine. A mixture of cubeb and alum is an efficacious, though 
nauseous, remedy in chronic gonorrhoea. It may be thus prescribed :— 
Pulv. aluminis, 3j. 
Pulv. cubebse, giv. 
M. Sig.: A tablespoonful three times a day. 
By a combination of cubeb and copaiba the effect of each agent in 
gonorrhoea is increased :— 
Oleoresinae cubeba?, 
Copaibae, aa f3j. 
Pulv. sacch. alb., 
Pulv. aeaciae, . aa ?ss. 
Aquae ineuthae piperitae, q. s. ad f§iv. 
M. Sig.: Teaspoonful three times a day. 
Functional irritability of the bladder, so common in women, is often 
relieved by cubeb. In chronic catarrh of the lower bowel and in the CUPRUM. 
587 
interparoxysmal periods of pseudo-membranous enteritis, cubeb is like- 
wise advantageous. 
Atonic dyspepsia may receive benefit from the temporary em- 
ployment of small doses of cubeb, which are of service also in bron- 
chorrhcea. 
The troches of cubeb may be used in the treatment of sore throat 
and hoarseness, from two to live daily being allowed to slowly dissolve 
in the mouth. 
CUPRUM.—Copper. 
Preparations. 
Cupri Acetas (U. S. P.).—Acetate of Copper. Dose, gr. . 
Cupri Sulphas (U. S. P.).—Sulphate of Copper. Dose, gr. I (gr. ij as an emetic). 
Cuprum Amrnoniatum.—Ammoniated Copper. Dose, gr. £-j. 
Cupri Arsenis.—Arsenite of'Copper. Dose, gr. . 
Cuprum. Aluminatum.—Aluminated Copper. Lapis Divinus. External use. 
Ceratum Cupn Acetatis.—Cerate of Acetate of Copper. (Melt together yellow wax, 
50 parts; Burgundy pitch, 25 parts; European turpentine, 15 parts; strain; incorporate 
thoroughly finely-powdered acetate of copper, 5 parts; pour into molfis, to form cakes of 
about 1 centimetre thickness). Green cerate, for corns, warts, etc. 
Pharmacology.—Copper has two oflicinal salts—the acetate and sul- 
phate—which are irritating poisons, although the metal is inert, because 
insoluble. Copper was formerly used very much in making cooking- 
utensils for family use, but it was found that, unless kept very bright and 
clean, they would give rise to poisoning by the formation of verdigris, a 
basic acetate of copper. Copper is sometimes added to pickles to make 
them of a brighter-green color, a fraud which can be detected byr placing 
a blade of a knife, or polished piece of steel, in the liquor; if it contain 
copper, there will be a deposit of metallic copper upon the iron in the 
course of a few minutes. It is held that the very small amount of copper 
that would be introduced into the system by7 eating such a pickle would 
be only' a mere fraction of a grain, and not enough to cause symptoms. 
A far more dangerous source of poisoning is found in the wall-paper 
pigments containing arsenite of copper, which is very poisonous. It is 
not only the green colors that are dangerous, but all vivid colors, such 
as scarlet, crimson, or lake. It is especially velvet or embossed papers 
that are likely to be loaded with pigment, and these should never be used 
for a dwelling-house unless first tested and found to be free from arsenic 
by7 the ordinary tests for that poison. 
Physiological Action.—When locally applied, the sulphate of copper 
is an astringent or a caustic, according to the manner of application. 
Injected hypodermatically, it causes coma and convulsions in cats, and 
death from respiratory failure; in overdose by the stomach it causes 
fatal gastro-enteritis. Copper in very small proportion exists normally 588 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
ill the blood, and in minute doses it exerts a tonic effect upon the organ- 
ism. This is well shown in some skin diseases of a dry t\-pe, due to 
defective nutrition, and in incipient or threatened phthisis. The secretions 
along the gastro-intestinal tract are increased, as shown by the salivation, 
vomiting, and purging. It is a local and not a systemic emetic. Copper 
is eliminated by the liver, kidneys, salivary and intestinal glands. It 
may remain, like other metals, stored up for a considerable period within 
the liver. 
When any of the salts of copper have been swallowed in overdose, 
there are nausea, vomiting and retching, purging of blood and mucus, and 
rapid depression of bodily powers ; and the latter may be the more 
prominent. In chronic poisoning,pharyngeal irritation, bronchial catarrh, 
colic, diarrhoea, or dysentery, salivation, anaemia, and emaciation occur. 
There is sometimes a green line upon the gums. Jaundice and fatty 
degeneration or atrophy of the liver ensues, and pulmonary congestion 
or consolidation may set in. The effects upon the nervous system are 
seen in headache, defective co-ordination, and Aveakness, with nervous 
vomiting. The chemical antidote is the yelloAV prussiate of potash, 
followed Ity demulcents, eggs, milk, oil, etc., and the stomach should 
be irrigated with an alkaline solution, counter-irritation applied, and 
anodynes given. 
Therapy.—The sulphate of copper, in solid stick, is used as a super- 
ficial caustic in indolent ulcers, exuberant granulations, and in syphilitic 
and other sores in the mouth and throat. It may also be lightly applied 
in cases of granular lids, or a solution (gr. i-ij to 1*3j) instilled into the 
eye in subacute conjunctivitis, but for this the acetate is preferred. A 
crystal of sulphate of copper is likewise serviceable as a haemostatic 
in checking haemorrhages from slight wounds, leech-bites, or the surface 
of irritable ulcers. A solution of this salt is employed locally with 
benefit in order to suppress excessive and chronic discharges. In the 
strength of from 10 to 20 grains to the ounce of menstruum it may be 
tliroAvn into the bowel for the relief of chronic diarrhoea or dysentery. 
The same method is beneficial in acute diarrhoea of severe form. From 
5 to 10 grains of the sulphate dissolved in an ounce of glycerin is one of 
the preparations which may be recommended for use in pseudo-mem- 
branous enteritis. The fluid should be injected into the bowel during 
the interparoxysmal period for the purpose of modifying the condition 
of the mucous membrane. A weak, aqueous solution of the sulphate of 
copper is an excellent stimulant dressing to chancres and chancroids, 
and forms a good injection in leucorrhoea, vaginitis, and gleet. It enters 
into the composition of injections for gonorrhoea, and may be advan- 
combined as follows :— CUPRUM. 
589 
Cupri sulphatis, gr. xij. 
Zinci sulphatis, 
Plumbi acetatis, aa gr. xxiv. 
Ext. krameiiae fl., f3j. 
Yini opii, f 3ij. 
Aquae rosse, q. s. ad f^vj.—M. 
Cupri sulphatis, gr. v. 
Ext. geranii fl., . f§ss. 
Glyeerini, f^j. 
Aquae rosae, if iiiss.—M. 
The oleate of copper is an admirable astringent, antiseptic, and anti- 
parasitic preparation, especially valuable in the various forms of tinea 
trichophytosis. 
The sulphate is sometimes effective as a local stimulant in an indo- 
lent impetigo, and a weak solution is efficacious in ulcerative stomatitis 
and thrush. An ounce of the sulphate in a pint of water is a solution 
which has been found very efficacious in the treatment of scabies. Other 
cutaneous affections, as psoriasis, chronic eczema, s}'cosis, favus, acne, 
liyperidrosis, and bromidrosis, are ameliorated by the topical application 
of the sulphate or acetate of copper in the form of an ointment or a lotion, 
or the oleate made into a 10- or 20- per-cent, ointment. A gargle contain- 
ing 5 grains of the sulphate of copper to the ounce of water does good 
in relaxed sore throat. The sulphate, or other salts of copper, may be 
employed externally in the following formulae :— 
Cupri sulphatis, gr.v. 
Aquae hamamelidis dest., f^v. 
M. For a gargle, or apply over the surface for hyperidrosis or bromidrosis. 
Cupri sulphatis, gr. x. vel xxx. 
Acidi borici, 3j. 
Creasoti, Nix. 
Ungt. aquae rosae, §j. 
M. Useful in sycosis and parasitic diseaces of the skin. 
In summer diarrhoea and cholera infantum the sulphate of copper is 
of undoubted efficacy. It is likewise a valuable remedy in the diarrhoea 
and dysentery of adults. Diarrhoea, whether acute or chronic, will often 
yield to the sulphate of copper. It has been found of service in re- 
straining tuberculous diarrhoea, and has been highly praised by some 
writers for its virtue in the diarrhoea of typhoid fever. The same salt is 
useful in bronchorrlioea. A small dose of the sulphate, grain three 
times a day, will sometimes allay the vomiting of pregnancy. Small doses 
of the same salt, given with or after meals, improve nutrition, and have 
been recommended as of service in ecthyma, scrofula and tuberculosis. 590 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Its action as a prompt emetic is best utilized in phosphorus poison- 
ing, where it is also antidotal. In other cases the zinc salts, or mercury 
subsulphate, are better, because safer. Copper has very decided action 
upon the nervous system, and the ammoniated copper particularly is 
used and highly praised for its effects in chronic neuroses, epilepsy, 
chorea, hysteria, and in the treatment of facial neuralgia. Dr. Board- 
man Reed, of Atlantic City, speaks favorably of the use of arsenite of 
copper in minute doses as an antispasmodic in cases of after-pains.* 
He gives ysVff grain every half hour with complete relief. It has also 
been highly extolled in the treatment of diarrhoea of infancy, where 
it may exert an antiseptic action upon the contents of the intestinal 
tract, when given in small and frequently repeated doses, as first sug- 
gested by Dr. Reed. A solution prepared in this manner is often of 
marked benefit in after-pains, diarrhoea, and in cholera morbus. 
Cupri arsenitis, gr. ss. 
Aquae camphorae, 
Aquae cinuamomi, aa f§iv. 
M. Sig.: From one-half to a teaspoonful every half hour or hour until relieved. 
The aluminate of copper is used externally as a stimulant and 
astringent to ulcers, and as a collyrium for inflammation of the con- 
junctiva. It is a powder compound of equal parts (30 parts) of copper 
sulphate, alum, and nitrate of potassium, with a small proportion (2 
parts) of campor. 
CURARE.—Curare, Woorara, or Arrow-Poison. 
Dose, gr. to hypodermatieally administered. 
Pharmacology.—A blackish-brown, brittle substance, of unknown 
composition, made by natives of South America as a\i arrow-poison, and 
probably contains Paulinia curare and other plants of the Strvchnos 
family, or Cocoulus. An extremely poisonous alkaloid, Curarine, has 
been obtained from curare. 
Physiological Action.—No effect follows the introduction of this drug 
into the stomach, as absorption is slow, and it is very rapidly thrown out 
of the circulation by the kidneys, and hence it is unlikely that it is a 
poison allied to strychnine or cocculus, but it seems more like a virus of 
animal origin. 
It must be injected hypodermatieally in order to produce its char- 
acteristic symptoms, which are : paralysis of the voluntary muscles by 
loss of power of the end organs of the motor nerves ; subsequently, the 
brain-centres are affected, if life be sustained by artificial respiration, 
death being brought about by respiratory failure. The blood-pressure is 
* Times and Register, December 6,1890. CYDONIUM. 
591 
lowered and the heart is weakened. Sugar appears in the urine. The 
antidotes are strychnine and atropine, diffusible stimulants, artificial 
respiration, warmth and friction to the extremities, the use of the 
catheter, etc. 
Therapy.—The use of curare in practical medicine at present is 
limited to the treatment of hydrophobia, two cases having been reported 
in which the symptoms disappeared under its use and the patient re- 
covered. The drug is very variable in composition and effects, but 
grain may be given hypodermatieally and repeated according to the 
symptoms. Trial has been made of curare in other affections charac- 
terized by spasm, as chorea, tic douloureux, epilepsy, and tetanus; and 
although a certain measure of success has attended its employment, }Tet 
different samples vary so greatly in composition that it has been found 
of less practical value than would be inferred from its powerful physio- 
logical action. 
CYDONIUM (U. S. P.).—Cydonium, Quince-Seed. 
Preparation. 
Cydcmii Mucilago (U. S. P.).—Mucilage of Cydonium (2 per cent.). 
Pharmacology and Therapy.—The seeds of Cydonium vulgaris (Rosa- 
cese) are officinal in order to provide the mucilage of Cydonium, these 
seeds containing about 20 per cent, of vegetable mucilage. It is best 
made with rose-water. It is used locally in inflammation of the skin, or 
conjunctivitis, or it may be used internally, ad libitum, in disorders of 
the alimentary canal requiring a demulcent. 
CYNOGLOSSUM.—Cynoglossum. 
Pharmacology and Therapy.—The root of the Cynoglossum officinale 
(Boragineae), an indigenous plant, is of interest, because it contains 
Cynoglossine, a brown, amorphous substance, soluble in water and alcohol, 
having an alkaline reaction, which Buchheim, its discoverer, found to 
possess narcotic powers. Its physiological action is said to be analogous 
to that of curare. 
CYPRIPEDIUM (U. S. P.).—Cypripedium, Ladies’ Slipper. 
Dose, gr. xv-xxx. 
Preparations. 
Extractum Cypripedii Fluidum (U. S. P.).—Fluid Extract of Cypripedium. Dose, lfix-xx. 
Extractum Cypripedii.—Extract of Cypripedium. Dose, gr. i-v. 
Pharmacology.—The rhizome and rootlets of Cypripedium pubescens 
and of Cypripedium parviflorum (Orchidacem). The rootlets have a 
heavy, disagreeable odor, and contain a volatile oil, a volatile acid, resins, 
and tannin. Cypripedin is an impure alcoholic extract (dose, gr. ii-iij). 592 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Physiological Action and Therapy.—In its effects it resembles valerian 
as an antispasmodic, tonic, stimulant, and diaphoretic. It is given in 
neurasthenia, nervous hyperesthesia, neuralgia, nervous headache, hypo- 
chondria, insomnia, and epilepsy. 
DAMIANA.—Damiana. 
Dose, 3ss, in infusion or decoction. 
Preparations. 
Extractum Damiana.—Extract of Damiana. Dose, gr. v-xv. 
Extraction Damiana Fluidum.—Fluid Extract of Damiana. Dose, f3ss-iv. 
Glycerol Damiana, Phosphori et Nucis Vomica (containing in each fiuidounce, damiana, 
3j ; phosphorus, gr. nux vomicae, gr. iv). Dose, f3j. 
Elixir Damiana.—Elixir of Damiana. Dose, f3ii—§j. 
Pharmacology.—A small, mint-like plant (Turnera diffusa, micro- 
phylla, or aphrodisiaca; natural order, Turneraceae), bearing yellowish- 
white, fragrant flowers, growing near the western coast of Mexico. 
Several years ago it was introduced into medical circles in this country 
with statements concerning its wonderful invigorating powers, especially 
in stimulating the generative functions, and of the esteem in which it 
was held amoiig the natives. Other plants have been sold under the 
name of damiana, and it is probable that some of the uncertainty of 
result has been due to the substitution of some other drug for the 
Turnera. The leaves are the part used; they contain a volatile oil, a 
resin, and other constituents. 
Physiological Action.—Upon the sexual appetite and function, dami- 
ana undoubtedly exerts some stimulant effects; but it is also a general 
tonic. Upon the digestive organs it acts as a carminative, and in larger 
doses as a cathartic or laxative. It is slightly eholagogue, and is also 
a stimulating diuretic. 
Therapy.—In nervous dyspepsia, neuralgia, cerebral exhaustion, 
neurasthenia, or want of tone in the nervous system, also in sick-head- 
ache or migraine, damiana has been found to be useful. It is specially 
however, in treating functional impotence from any cause, 
combined with hygienic and other treatment, especially nux vomica, iron, 
and phosphorus. 
DIGITALIS (U. S. P.).—Digitalis, Foxglove. 
Dose, gr. ss-ij. 
Preparations. 
Abstraction Digitalis (U. S. P.).—Abstract of Digitalis. Dose, gr. ss-j. 
Extractum Digitalis (U. 8. P.).—Extract of Digitalis. Dose. gr. 
Extractum Digitalis Fluidum (U. S. P.).—Fluid Extract of Digitalis. Dose, Nlss-ij. 
Infasum Digitalis (U. S. P.).—Infusion of Digitalis (I3.4 per cent.). Dose, f3i-iv. 
Tinctura Digitalis (U. 8. P.).—Tincture of Digitalis (15 per cent.). Dose I'lx-xxx. 
Digitalinum.—A mixture of several active principles. Dose, gr. DIGITALIS. 
593 
Pharmacology.—The leaves of Digitalis purpurea (Scrophulariaceae), 
gathered from plants of the second year’s growth. Digitaline, which was 
formerly officinal, and considered as the active principle, is a mixture of 
several, the most active of which is Digitoxin, which, with Digitalin and 
Digitalein, represents the cardiac, stimulating action of the drug, while 
Digitonin appears to exert a contrary effect, acting like saponin (Schmiede- 
berg). A fifth substance, Digitin, seems to be devoid of physiological 
and therapeutical actions. These are all non-nitrogenous, and, with the 
exception of digitonin, are glucosides. No alkaloid is present in digi- 
talis. It also contains tannin, volatile oil, fatty matter, red coloring 
matter, chlorophyll, albumin, starch, sugar, gum, lignin, and salts. Two 
acids have been discovered by M. Morin,—digitalic and antirrhinic. The 
varying solubility of the active principles in the vehicles used explains 
the difference of therapeutical effect. Digitalin is insoluble in water,but 
soluble in alcohol; digitoxin is insoluble in water, sparingly soluble in 
alcohol; digitalein is soluble in either; digitonin, soluble in water, 
sparingly in alcohol. The ordinary commercial digitaline is principally 
digitalin ; Nativelle’s digitaline is principally digitoxine with a little 
digitalin; it is a very active preparation. The tincture of digitalis 
and alcoholic fluid extract contain both digitalin and digitoxin ; the 
infusion contains principally digitonin and very little digitoxin. In 
order to get the full physiological effect it is necessary to use the care- 
fully-selected leaves, according to the pharmacopoeial requirements. 
Physiological Action.—Digitalis is readily absorbed by the skin, and 
is thought to have some local sedative effects when used on spongio- 
piline,or in a cataplasm. Although it has a bitter taste, digitalis has no 
tonic action upon the stomach, but, on the contrary, often disorders the 
digestion, and may cause vomiting or diarrhoea when too long continued. 
Its active principles readily diffuse into the blood, reducing the rate of 
the heart’s action by lengthening the period of rest or asystole, thus 
allowing its cavities to receive more blood. At the same time that it 
increases the inhibition it stimulates the motor ganglia and increases the 
force of the contraction. Moreover, digitalin causes contraction of the 
arterioles throughout the body, and thus combines its effects with the 
preceding in order to raise arterial tension. The temperature is reduced 
in pyretic conditions, though not in health. The slowness of its action 
(requiring from thirty-six to forty-eight hours) in reducing fever and its 
likelihood of disturbing the stomach tend to preclude its use for this 
purpose in acute fevers. Its action upon the circulation may be summed 
up as being that of a vascular stimulant, raising arterial pressure, lower- 
ing abnormal temperature, and steadying the heart. Upon the brain and 
spinal cord it produces little direct effect. The reflex action of the spinal 594 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
cord is reduced by large doses, and there is stimulation of the pneumo- 
gastric and vasomotor nerves. It is liable to cause headache, delirium, 
and vertigo, possibly from distui'bance of the cerebral circulation, the 
effects of the volatile oil, or from sick-stomach. Syncope may be due to 
heart-failure from overstimulation after the drug has been used for some 
time, especially if the patient suddenly sits up in bed or assumes an 
erect posture. It stimulates the vasomotor ganglia in the medulla. 
Large doses excite Setschenow’s centre and produce muscular paraly- 
sis; the peripheral nerves, both motor and sensory, being also paralyzed. 
Respiration becomes feeble and more rapid, coma and convulsions follow, 
and death is attended by S3rstolic arrest of the heart’s action, from its 
tetanizing effect upon the cardiac muscle or from exhaustion of motor 
ganglia. The general action upon muscular tissue is to lessen contrac- 
tility and cause lassitude and want of vigor. The venereal functions are 
depressed. The effect upon the kidneys is peculiar. The increase of 
arterial tension in the glomeruli accompanying the general effect on the 
circulation is assisted by a special action, by which the renal arteries are 
dilated, thus acting as a true diuretic ; while the excretion of urea is at 
first increased, it subsequently diminishes. The greatest effect as a 
diuretic is obtained in diseased conditions, accompanied by oedema and 
low arterial pressure. Digitalis also has some effect upon the muscular 
tissue of the uterus, stimulating it to contraction. 
Aconite and digitalis are antagonistic. The former slows the heart 
by expanding the peripheral vessels and lowering blood-pressure; the 
latter reduces the number of contractions by stimulating the inhibitory 
fibres in the pneumogastric nerve, and tightens up the arterioles, thus 
causing increased blood-pressure. Aconite directly lowers the action of 
the cardiac motor ganglia, and is a cardiac poison; digitalis indirectly 
exhausts the motor ganglia by permitting overaction and exhaustion ; 
in the former, the heart is found, after death, in a condition of dilatation 
or asystole ; in the latter, it is in a state of contraction or systole. The 
action of aconite upon the heart is rapid ; the action of digitalis is gradual 
and slow; so that the latter is not a practical antidote for the other. 
Poisoning.—When digitalis or digitalin has been taken by mistake in 
an overdose, tannin, or infusion of tea or coffee, should be given at once, 
the stomach washed out and stimulants given. Saponin is the physio- 
logical antagonist, according to Bartholow. The compound tincture of 
cinchona might be useful, as it contains tannin, alcohol, and quinine. The 
sulphate of iron or tincture of the chloride should also prove useful. The 
patient should be kept in a recumbent posture ; hot drinks and hot-water 
bottles should be around him and spirit of ammonia inhaled. As long 
as the functions of the kidueys are maintained, it has been observed that DIGITALIS. 
symptoms of so-called “ accumulation ” are not apt to arise. As already 
explained, these are attributed to overstimulation and exhaustion of 
the heart, but possibly there may be an uraemic element in some-cases 
which would require appropriate treatment. 
Therapy.—Locally, digitalis is employed in joint inflammation, com- 
bined with moisture and heat, acting as a sedative and possibly reducing 
the calibre of the vessels. Part of it is absorbed and carried to the kid- 
neys, where it produces a diuretic effect, especially when the hot applica- 
tion is made over the loins. A half ounce or more of tincture of digitalis 
may be sprinkled upon spongio-piline, or flannel wrung out of hot water, 
and applied to the lumbar region ; or a cataplasm containing a drachm 
or two of the leaves, applied in cases of dysuria or suppression of urine. 
Bronchial congestion due to heart disease may also be relieved by the 
local application of digitalis. Internally, it is chiefly prescribed as a 
lieart-tonic in all cases of failure of circulation due to the feebleness of 
the heart’s action. It should not be used in valvular disease as long as 
compensating hj’pertrophy is keeping up the work of the heart; but when 
this fails and dilatation is commencing, digitalis will not onty slow and 
steady the heart, but improve the nutrition of the heart-walls by in- 
creasing the pressure in the coronary arteries and allowing them a 
longer time in which to be filled. In mitral stenosis, digitalis is to be 
used in order to allow the left auricle a longer time to empty itself into 
the ventricle ; also, in tricuspid regurgitation with dilated right heart. It 
is not to be used in aortic stenosis, as a rule, although exceptional circum- 
stances may require its use for a time, to regulate the rhythm of the 
heart, or to relieve dropsy. Cardiac dyspnoea or cardiac asthma, due to 
engorgement of the pulmonary circulation, is usually relieved by digitalis ; 
and functional weakness, with irritable heart or low arterial tension, with 
migraine, or delirium tremens, is very promptly benefited by it. Large 
doses (fgss or more of the tincture) have been given in mania a potu 
and acute mania, with success. It is a useful remedy in haemorrhages, 
as in .menorrhagia or haemoptysis, and in the first stage of pneumonia. 
Digitalis is of particular advantage in the metrorrhagia or menorrhagia 
of plethoric individuals, or when dependent upon mitral disease. Post- 
partum haemorrhage likewise be restrained by the use of digitalis, 
which may here be appropriately combined with ergot. This remedy is 
of service in controlling epistaxis, and is a valuable adjunct to the tincture 
of iron in purpura haemorrhagica. In the treatment of haemorrhages, 
digitalis is usefully prescribed in combination, as— 
Tr. digitalis, f3iss. 
Tr. catechu, ’. . . f §j. 
Extr. ergotae fl., q. s. ad f§ij. 
M. Sig.: A dessertspoonful every hour or two. 596 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
The infusion, however, is usually the most efficient preparation in 
haemorrhage :— 
II Plumbi acetatis, gr. xl. 
Morphinae acetat., gr. j. 
Iufus. digitalis, f^iv. 
M. et ft. sol. 
Sig.: Tablespoonful every three hours. 
Digitalis may also he prescribed for haemorrhage in phthisis and in 
the first stage of pneumonia, thus :— 
If Extracti digitalis, gr. iij. 
Pulveris ipecacuanhae comp., gr. xxiv. 
M. et ft. pil. no. xij. 
Sig.: A pill every two or three hours. 
In exophthalmic goitre and in congestive heaclaches, it sometimes 
succeeds remarkably in controlling the symptoms of disease. 
Besides the special action above referred to, as a cardiac tonic or 
current regulator to the circulation, digitalis is the chief reliance in 
drops}7 and serous effusions, owing to its diuretic action. In acute renal 
dropsy the best effects are obtained by combination with calomel or 
other mercurial, and with squill, as in the famous Guy’s pill:— 
II Pulv. digitalis, gr.es.’ 
Pulv. scillae, gr. iss. 
Mass, hydrargyri, gr. iij. 
M. et ft. pil. 
Sig.: Take one or two at bed-time. 
In cases of oedema due to Bright’s disease, with scanty albuminous 
urine, the following are useful:— 
II Potass, acetat., .......... 3vj gr. xl. 
Spiritus juniperi, f §iss. 
Inf. digitalis, q. s. ad f§v. 
M. Sig.: A dessertspoonful every three hours. 
II Infus. digitalis, 
Infus. scoparii, 
Infus. bucliu, aa f^ij. 
M. Sig.: A dessertspoonful every three hours. 
II Infus. digitalis, 
Infus. taraxaci, 
Spiritus aetheris nitrosi, aa f^ij. 
M. Sig.: A dessertspoonful every three hours. 
In menorrhagia, haemoptysis, and in the haemorrhagic diathesis, the 
tincture of digitalis is usefully given in doses of 20 to 30 minims. The 
same doses may be given in cases of surgical shock or syncope. Sper- DIOSCOREA VILLOSA. 
597 
matorrhoea with nocturnal emissions is benefited by digitalis in combina- 
tion with ergot or with bromide of potassium, according to circumstances. 
In this country it is not used for its antipyretic effect, although in Ger- 
many it has been given in the hyperpyrexia of rheumatism and scarlet 
fever. The infusion of digitalis is employed in the treatment of scar- 
latina, especially when the urine becomes scanty. The following com- 
binations are very serviceable in the latter condition :— 
II Inf. digitalis, 
Spiritus setheris nitrosi, aa f§ss. 
Potassi bitartratis, 3ij. 
M. Sig.: A teaspooni'ul in water every three or four hours. 
II Inf. digitalis, 
Misturae potassii citratis, aa f^jj. 
M. Sig.: A teaspoonful every two or three hours. 
Digitalis should be given with great care, if at all, to persons with 
fatty degeneration of the heart and dilatation. It should not be given 
in pericarditis, although passive pericardial effusion may be removed 
without much danger. In simple hypertrophy or compensating hyper- 
trophy, or conditions of high arterial tension or vascular excitement, it 
should rarely, if ever, be given. In any disease accompanied by changes 
in the heart-muscle or atheroma of the blood-vessels, digitalis should 
not be prescribed except for a temporary emergency. In dilatation of the 
heart, however, this remedy serves an excellent purpose. In typhoid 
fever, digitalis is liable to increase the diarrhoea and cause vomiting. In 
gastritis or acute nephritis, it would also prove injurious. In fibroid 
lung, digitalis lessens the cough, steadies the heart, and reduces oedema. 
It has been successfully employed in erysipelas. Digitalin should not be 
prescribed on account of the uncertainty of its action, the smallness of 
the dose of the leaves rendering it unnecessary. 
Digitalis is the physiological antidote to muscarine and to aconite, 
but requires the aid of diffusible stimulants on account of its slowness of 
action, when treating cases of poisoning by these agents. It may be ad- 
ministered liypodermatically in such cases in combination with whisky, 
} and in surgical shock as recommended by Dr. Thomas G. Morton, of the 
Pennsylvania Hospital. 
DIOSCOREA VILLOSA.*—Wild Yam. 
Preparations. 
Decoctum Bioscorece.—Decoction of Dioscorea. Bose, f fi-iv. 
Tinctura Dioscorece.—Tincture of Dioscorea. Bose, lT\x-lx. 
Extradum Bioscorece Fluidum.—Fluid Extract of Dioscorea. Bose, ITfv-xxx. 
* See paper by the author, in Journal of the American Medical Association, Sept. 21, 1889. 598 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Pharmacology.—Dioscorea villosa (Dioscoreaceae), wild 3mm or colic 
root, grows abundantly in our Southern States, but less plentifully in 
the Northern and Western States. The part made use of is the root. 
This is without odor when intact, but when bruised develops a slightly 
woody smell. The taste is somewhat pungent and sweetish-bitter. The 
powdered root is yellowish-gray in color, is soluble both in water and 
alcohol. 
The root contains an active principle called Dioscorein, to which 
it chiefly owes its medicinal virtues. The physiological action of tlie 
drug has never been systematically studied. 
Therapy.—Wild yam possesses diaphoretic and expectorant proper- 
ties, but derives its principal value from its effect upon the hepatic func- 
tions. In large doses it is emetic. It is of especial service in the 
treatment of gall-stone. It quickly relieves pain and spasm, and, pro- 
vided the calculus or calculi are not of extreme size, leads to their prompt 
expulsion. After the concretions have passed into the bowel this remedy 
is of service in reducing the congestion or inflammation which they have 
caused. 
A 3’ellowish discoloration of the skin and conjunctiva, joined with 
colicky pain and nausea, suggests the employment of dioscorea. Hepatic 
indigestion, with its train of evil consequences, is effectually relieved by 
the fluid extract in 15-drop doses before meals. The same preparation 
effects a marked improvement and gradual cure in chronic congestion 
of the liver. 
In chronic malaria this agent is of decided advantage, and may 
be combined with arsenic, quinine, or nux vomica, as follows :— 
Liq. potass.*arsenit., f3j. 
Tinct. dioscoreae villosae, ....... . f^ss. 
Tinct. eardamomi comp., f^iiss. 
M. A teaspoonful in water after meals. 
In chronic gastritis the result of alcoholic excess, wild yam is very 
serviceable and may be prescribed thus :— 
II Tinct. belladonnae, ITlxxiv. 
Tinct. nucis vomicae, f3j. 
Tinct. dioscoreae villosaa, f§ss. t 
Syrupi zingiberis, f^iiss. 
M. Teaspoonful in water every fourth hour. 
The progress of cirrhosis of the liver seems to be delayed by the 
administration of wild yam, which is at least as efficient in this disease 
as the mercuric chloride. Furthermore,, the addition of dioscorea in- 
creases the analgesic effect of morphine in hepatic carcinoma. DITA, 
599 
D1TA.—Dita-Bark. 
Dose, 5i—iv, best given in the form of a fluid extract. 
Dita-bark (Apocynaceae) is from the East Indian Archipelago. It 
contains two bitter alkaloids, Ditain and Ditamine, and has been used 
as an antiperiodic in treatment of ague. 
DRACONTIUM.—Dracontium, Skunk-Cabbage. 
Dose, gr. x-5j. 
Pharmacology.—The root of Dracontium foetidum (Aracese),a small 
plant of North America, has acid properties, and, when fresh, a very 
disagreeable smell, which warrants its common name. Besides this 
volatile principle the drug contains a resin, tannin, etc. 
Therapy.—It is regarded as an antispasmodic, and has been used in 
chorea and hysteria, asthma and chronic catarrh, using the recently 
dried root or a good fluid extract (§ alcoholic). 
DROSERA.—Drosera, Sundew. 
Pharmacology.—The Drosera rotundifolia (Droseraceae), growing in 
Europe and North America, has a very limited use in medicine. The 
whole plant is used, and a recent infusion or fluid extract is the best 
method in which to administer it. It contains a resin and a peculiar 
acid. 
Physiological Action.—Drosera is irritating to the skin, and the 
juice is used as an application for corns or warts. Internally, it is 
expectorant. 
Therapy.—It is used in chronic bronchial catarrh, and has some 
reputation in the treatment of phthisis. In spasmodic affections of the 
chest, whooping-cough, and paroxysmal asthma it is said to be serviceable. 
Three or four ounces of the expressed juice have been given during the 
day, but this probably did not contain the acrid resin. The fluid extract, 
in doses of npv-xv, is the best preparation. 
DUBOISIA.—Duboisia. 
Preparations. 
Tinetura Duboisice.—Tincture of Duboisia. Dose, blv-x. 
jExtraction Duboisice Fluidum.—Fluid Extract of Duboisia. Dose, blx-xx. 
Extractum Duboisice.—Extract of Duboisia. Dose, gr. %~y2. 
Duboisines Sulphas vel Hydrobromas.—Sulphate or Hydrobromate of Duboisine. Dose, 
Sr- T&rxV 
Pharmacology.—The portion of the Duboisia myoporoides (Sola- 
naceae), a large Australian tree, which is used in medicine is the leaves, 
which have a bitter, acrid taste, but very slight odor, and contain an 
alkaloid, Duboisine, closely resembling atropine, and identical with 
hyoscyamine. The sulphate of duboisine is a yellowish, soft, gum-like 
mass, soluble in water. 600 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Physiological Action.—The effects of duboisia are the same as those 
of belladonna, although, on account of its greater solubility, its effects 
are manifested more quickly and pass away sooner than those of 
belladonna. 
Therapy.—It is used in medicine for the same purposes as bella- 
donna, and is antagonistic to morphine. In ophthalmology a solution 
of 1 per cent., or 4 grains to the ounce of distilled water, may be instilled 
for making examinations, etc. Its effects upon the pupil pass off more 
quickly than a similar solution of atropine. Various nervous disturb- 
ances occasionally follow the use of a collyrium containing duboisine,— 
faintness and strange sensations in the head, as in Dr. Seely’s case, and 
a feeling of impending death, giddiness, pain over the heart, and hallu- 
cinations, as in a case reported bjr Aubone.* 
DULCAMARA (U. S. P.).—Dulcamara, Bitter-Sweet. 
Preparations. 
Extraetum Dulcamara. Fluidum (U. S. P.).—Fluid Extract of Dulcamara. Dose, 
Flxxx-f3j. 
Extraetum Dulcamara.—Extract of Dulcamara. Dose, gr. v-x. 
Pharmacology.—The young branches of Solanum dulcamara (Sola- 
naceoe) are officinal and also a fluid extract. A decoction may be made 
(1 to 16).and given in doses of A bitter, amorphous substance 
exists in this plant, which, upon being decomposed, 3Tields a bitter 
alkaloid, Solanine, crystallizing in white needles, readily soluble in 
alcohol, less soluble in water; its salts are soluble in either alcohol or 
water. 
Physiological Action.—Eruptions upon the skin attended by duski- 
ness and itching are among the effects of poisoning, which is likely to 
occur in children, from eating the berries. It also causes vomiting, 
dizziness, convulsive attacks, abdominal pains, thirst, heat and dryness 
of throat, rapid respiration and pulse, and prostration of vital powers. 
In the ordinary doses it does not produce these effects, but acts as a 
sedative and mild narcotic. The treatment in cases of overdose would 
be large amounts of warm water to wash out the stomach, and hypo- 
dermatic injections of morphine and atropine, with ether or alcohol. 
Therapy.—Dulcamara is seldom used at present, although it is 
believed to be serviceable in chronic skin affections of a scaly character. 
The recent decoction may be used as a diaphoretic in rheumatism, or 
acute bronchitis and colds. The extract may be given in mania, and 
especially nymphomania or satyriasis. 
* Medical Bulletin, January, 1890, p. 14. ELATERINUM. 
601 
ELATERINUM (U. S. P.).—Elaterin. 
Dose, gr. -sq-is- 
Preparation. 
Trituratio Elaterini (U. S. P.).—Trituration of Elaterin. Dose, gr. 
Pharmacology.—The fresh, expressed juice of the fruit of Ecbalium 
elaterinum (Cucurbitacese), upon standing, deposits a peculiar, resinous 
substance, which is collected upon muslin and dried, forming flat pieces 
of variable thickness and irregular shape, of a pale-green or grayish 
color, mostly amorphous, but containing some crystals. This constitutes 
commercial, and formerly officinal, elaterium. Elaterinum exists in the 
proportion of from 15 to 40 per cent, in elaterium, and on account of this 
variability in strength the latter has been dropped from the Pharma- 
copoeia, and the more reliable elaterin substituted. The elaterin is 
extracted from elaterium by chloroform and precipitated from the 
chloroform solution by the addition of ether, in which it is nearly 
insoluble. In prescribing, elaterin must not be dispensed for elaterium, 
as it is from two to six times stronger., Elaterin is crystalline, odorless, 
intensely bitter and acrid, soluble in chloroform, fusel-oil, or bisulphide 
of carbon, and in 125 parts of alcohol. It is a neutral substance, and is 
not precipitated by tannic acid or by salts of mercury. 
Physiological Action.—It is violently purgative, causing profuse, 
watery stools with griping, and in large doses producing great prostra- 
tion. Death has resulted from excessive doses. Dangerous symptoms 
require demulcents, opiates, and stimulants. It must be used with 
caution in elderly persons. It purges when injected hypodermatically, 
but to obtain its full effects it must be mixed with the bile. It also 
occasions an excessive flow of saliva. 
Therapy.—In ascites, uraemia, cerebral congestion, pulmonary 
oedema, and poisoning by narcotic substances, elaterin affords a ready 
means of evacuating the bowels, and of reducing the volume of circula- 
tion by draining water from the vessels, or bleeding through the tis- 
sues.” It should not be given for ordinary constipation, as it is too 
depressing. On account of its great activity a small fraction of a grain 
may produce collapse from hypercatharsis. The trituration, therefore, 
in which the drug is reduced by triturating it with 9 parts of sugar 
of milk, is an eligible and useful preparation. According to Dr. Ilyde 
Salter, a small dose of elaterium, given on alternate mornings, is of value 
in dropsy dependent on aortic disease. 
ELEMI.—Elemi. 
Pharmacology.—The Canarinm commune (Burseraceae), a tree of the 
Philippine Islands and the southern portion of the American continent, 602 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
affords an oleoresin, obtained from incisions into the living bark. This 
substance, somewhat resembling granular honey when fresh, becomes 
more solid and friable when kept for some time. The taste is rather 
pungent and bitter. It contains 60 per cent, of amorphous resin, Brein ; 
25 percent, of crystallizable resin, Amyrin ; about 10 per cent, of a volatile 
oil, besides a crj-stallizable, bitter, acrid substance, Bryoidin ; also, breidin 
and elemic acid. 
Physiological Action.—It has stimulating and irritating properties, 
and is only used as an ingredient in plasters and ointments, or for use 
externally. It is similar to other terebinthinate agents in its effects. 
The British Pharmacopoeia recognizes an ointment of elemi, composed 
of £ ounce of elemi and 1 ounce of simple ointment. 
Therapy.—Used as an application to enlarged joints, and as a 
resolvent to swollen glands. It may also be applied to indolent ulcers, 
and is a good dressing for burns, blisters, and chilblains. 
EMBELIA RIBES.—Babarang. 
Dose, 3i-iv. 
Pharmacology and Therapy.—The Embelia ribes (Mvrsinere) is a 
climbing plant of Southern China, Eastern India, and Malaya. The dried 
and powdered fruit is used, or the fluid extract of the fruit (dose, f5i-iv). 
It is an efficient anthelmintic and tseniacide; is believed to be a specific 
in rheumatism; and is an alterative in chronic skin diseases. Incases 
of flatulent dyspepsia it is claimed to be serviceable. The active principle 
was found to be an acid, which has been named Embelic acid (Warder), 
and is insoluble in water. It forms salts with soda, potash, and ammonia, 
the latter being most readily obtained crystalline. This ammonium salt 
was found effective as an anthelmintic against taenia, in doses of 6 grains 
for adults, or 3 for children. It is administered in syrup, to be followed 
by castor-oil; it has the advantages over male fern of smallness of dose 
and tastelessness. It kills the worm. The powdered seeds may be given 
with milk early in the morning, fasting, followed b}r a purgative some 
hours later. The dose of the powder for a child is a teaspoonful twice a 
as a tseniacide, or about the same quantity of a fluid extract. 
EPHEDRA.—Ephedra, Mormon Tea. 
Pharmacology.—The stems or the whole herb of Ephedra 
litica (Gnetacese?) is used in Arizona as a i*ecent infusion, or in the form 
of fluid extract (dose, f5i-ij) as an alterative, and especially in treat- 
ment of gonorrhoea and syphilis. It contains a peculiar kind of tannin, 
to which its effects are probably attributable, according to Professor • 
Oscar Loew’s analysis; although in a Japanese variety, E. vulgaris, 
Professor Nagai discovered an alkaloid, which he named Ephedrin. 603 
EPIGiEA, 
Therapy.—Dr. H. H. Rusby* is satisfied that the reputation of this 
drug as a remedy in gonorrhoea and in syphilis has some solid foundation. 
As an antiblennorrhagic its aetion is probably very similar to that of 
astringents now in use. As a remedy in syphilis, he says, its value is, 
probably, solely that of a depurative. In the removal from the system 
of the accumulated products of the disease, ephedra will take rank with 
any agent now in use, with the single exception of potassium iodide, and 
it may well serve to alternate or combine with that drug. It is also 
considered by persons living in the region of its growth to be a “ sure 
and speedy cure for skin diseases.” 
EPIG>CA.—Epigaea, Trailing Arbutus. 
Dose, 5ss-ij, in infusion or fluid extract. 
Pharmacology.—The Epigaea repens (Ericaceae) is a small, herbace- 
ous plant, with sweet-smelling flowers. The part used is the leaves, 
which are odorless, bitter, and astringent. They contain Arbutin, Ursone, 
and tannic acid. 
Therapy.—The constituents of the plant are very much the same as 
those of Uva ursi, and its uses are similar. It is given as an astringent 
in vesical catarrh, blennorrhoea, etc. 
ERGOTA (IT. S. P.)._Ergot of Rye. 
Dose, gr. x-5j. 
Preparations. 
Extractum Ergot a Fluidum (U. S. P.).—Fluid Extract of Ergot. Dose, ttlx-f3ij. 
Extractum Ergotce (U. S. P.).—Extract of Ergot. Dose, gr. v-x. 
Yinum Ergotce (U. S. P,).—Wine of Ergot (15 per cent.). Dose, f3j-f§j. 
Ergotin.—A mixture of constituents of varying strength and physiological action, 
best represented by the officinal extract. 
Pharmacology.—Ergot is the compact spawn or scleroticum of the 
Claviceps purpurea (Fungi) replacing the grain of Secale cereale (Grami- 
nacese). The rye-ergot is the only one officinal, although it affects other 
grasses. The TJstilago maidis of corn is very similar in chemical compo- 
sition and effects. Ergot is in grain-like masses, from 1 to 2 inches long 
and about inch thick. The grains are nearly triangular, somewhat 
curved, and marked lengthwise by three grooves, thickest in the middle 
and tapering toward each end ; of a dark-purplish color externally, they 
are nearly white in the centre. They have a heavy, unpleasant odor and 
a fatty, mawkish, disagreeable taste. The addition of a strong alkali 
develops an odor like that of herring-brine (trimethylamine). It con- 
tains about 35 per cent, of fixed oil, a peculiar sugar, and two coloring 
matters. Chemists have isolated or derived a number of more or less 
* Druggists’ Bulletin, 1888, p. 220. 604 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
•active principles from ergot, the most prominent being Sclerotinic acid 
(Dragendorff), Scleromucin, and Trimethylamine; but, according to 
Robert, sclerotinic acid is itself a compound body, of which ergotinic 
acid is the largest constituent. Sphacelinic acid and Cornutin, according 
to this authority, represent the portion of the drug causing ergotism, the 
former producing gangrenous ergotism through its action upon the blood- 
vessels and vasomotor centres, the latter causing convulsive ergotism 
having a special action upon the nerve-centres. Cornutin is also held by 
him to be the principle which acts upon the uterus, causing contraction 
of its muscular fibres. None of these so-called principles, singly, repre- 
sent the physiological activity of the drug; which, however, can be 
nearly substituted by the combination of them in the aqueous extract, or 
ergotine, or a good fluid extract, which is the most reliable form in which 
to use it. When kept for some time ergot loses its virtues, and should 
be as fresh as possible in order to be effective. A substance similar in 
composition to cliolesterin, and therefore termed ergosterin, has been 
extracted from ergot by C. Tan ret. 
Physiological Action.—No local effects are observed from application 
of ei’got to the skin; upon mucous membranes it acts as an astringent. 
Upon the nervous system little effect'is produced directly, although in 
ergotism we have convulsions and other nervous symptoms, caused indi- 
rectly. It induces anaemia of nerve-centres by exerting a selective 
action upon their blood-vessels, which it causes to contract. When 
introduced into the circulation, there is, first, a fall of blood-pressure, 
soon followed by a rise; the primary fall is most marked where a large 
amount comes in contact with the heart-muscle, which is depressed by 
it, and paralysis of the heart may cause death after intra-venous injection 
of ergot. The rise of blood-pressure represents the physiological stimu- 
lating action of the drug upon the vasomotor centres and upon the 
unstriped muscular fibres in the arterioles. The effects of ergot upon 
the parturient uterus are those of a stimulant to the contractions, 
increasing their force and frequency until the full action is brought 
about of tetanic contraction of the organ. Upon the non-parturient 
uterus the effects are more marked in checking the blood-supply. The 
lower animals abort after eating ergotized grain, and in some States 
there are laws against the administration of ergot to pregnant women in 
order to produce miscarriage ; but such result does not follow the use of 
ergot in ordinaiy medicinal doses, although in chronic ergotism this 
accident may occur. 
Toxic Effects.—When an overdose is administered, effects result 
which are known as acute ergotism. The symptoms are pecu- 
liar restlessness, with anxiety, headache, vertigo, dilated pupils, tinnitus- ERGOTA. 
605 
auriam, with hyperacusis, the action of the heart is slowed, the pulse is 
weak, respirations reduced in frequency, and, as the effects increase in 
intensity, suddenly nausea and vomiting occur, even when the drug is 
introduced hypodermatically. This cerebral vomiting is distinct from 
the local effects of the drug when taken by the mouth, when vomiting 
may occur early if the stomach is very sensitive. 
Chronic ergotism occurs in regions of the country, notably in 
Europe, where rye-bread is the staple food, in seasons when ergot is 
most present in the grain. It appears in two forms, the convulsive and 
the gangrenous : the former being characterized b\r vertigo, dimness of 
vision, and numbness of the extremities, followed by tonic contractions 
particularly of the flexor groups of muscles. Attacks of dyspnoea also 
occur, resembling asthma, caused by tetanoid contractions of the respi- 
ratory muscles. Cramps of abdominal muscles, colic, and diarrhoea take 
place ; the pulse is slow and weak; the surface of the body is cold ; 
the symptoms increase in intensity ; the special senses are affected; 
hearing and smell are lost; the pupils are permanently dilated, and vision 
is impaired. The case may be terminated by clonic convulsions or death 
result from exhaustion. The gangrenous form is marked by the intensity 
of the local phenomena : the numbness of the fingers and toes terminat- 
ing in vesications, and moist or dry gangrene, more or less extensive, 
destroys these parts, or may affect the nose or other portions of the 
body. It is evident that in chronic ergotism there is a profound 
d}’scrasia, perhaps attributable as much to the unhygienic mode of life 
and poor food as it is to the toxic effects of ergot. Such grave effects 
are not observed from the medicinal administration of ergot, even when 
continued for a long time. 
Treatment of Poisoning.—The phenomena of acute ergotism are 
easil}' controlled by placing the patient in a hot bath and administering 
cardiac and arterial stimulants, such as coffee. Amyl nitrite, aconite, 
veratrum viride, and tobacco antagonize the effects of ergot upon the 
circulation. The treatment of chronic ergotism is mainly hygienic and 
symptomatic. 
Therapy.—Ergotin made into a paste with water has been employed 
locally in conjunctivitis, gonorrhoea, endocervicitis, acne rosacea, and in- 
cipient boils. Ergot is valuable in haemorrhoids, prolapsed rectum, and 
relaxation of the sphincter ani, when applied upon a tent or introduced 
as suppositories. Incontinence of urine, due to relaxed sphincter, is 
cured by ergot given in this manner, or administered by the mouth. 
Chronic follicular pharyngitis is sometimes improved by the topical 
application of the fluid extract, or of ergotin in the proportion of 10 to 
20 grains to the ounce. The oil of ergot is a valuable local medicament 606 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
ill seborrhoea, removing the sebaceous material, and, at the same time, by 
its astringent and stimulant action, benefiting the diseased follicles and 
glands. Locally, in the diseases referred to, ergot may be prescribed 
according to the appended formulae :— 
II- Ergotinae, - . 3ss. 
Cocainae hydrochloratis,. ........ gi\ V. 
Plumbi carbon atis, 3ss 
Ungt. aquae rosae, §ss. 
M. For external use in acne rosacea and in boils. 
Ergotinae, 3j. 
Sulphuris sublimati, 3ss. 
Mentholi, gr. v. 
Ext. belladonnae ale., gr. x. 
Ungt. zinci oxidi, 
M. Valuable in fissures of the nose, mouth, rectum, and in haemorrhoids. 
Ergotinae, gr. v. 
Camphorae, gr. x. 
Ext. opii, gr. iiss. 
Plumbi acetatis, gr. xx. 
01. theobromae, q. s. 
M. et ft. suppositoriae no. x. 
Sig.: Insert one in the bowel when necessary for prolapsed rectum, diarrhoea, or for 
fissure of rectum. 
Extracti ergotae fl., 
Extracti hamamelidis fl., aa f^iss. 
Glycerini, f^j. 
M. Sig.: Apply several times a day for chronic pharyngitis and nasal catarrh. 
01 ei ergotae, f§iij. 
Lanolini, §j. 
01. verbenae, hlv. 
01. rosae, n\iij. 
M. Sig.: Rub into the scalp well once or twice a day for dandruff. Useful, also, in 
loss of hair and sycosis. 
Ergot is a, reliable remedy in the several forms of capillary haemor- 
rhage, and in overcoming the congestion attendant upon and causing the 
oozing. In haemoptysis, epistaxis, liaematuria, discharges from 
the bowels (melaena), and in uterine haemorrhage, ergot in half-drachm 
doses of the fluid extract, repeated every hour or two, will generally 
promptly cause cessation of the bleeding. Ergot may be prescribed for 
various haemorrhages with advantage, combined with geranium and 
witch-hazel :— 
Extracti ergotae fl., f^iss. 
Extracti geranii fl., f^j. 
Extracti hamamelidis fl., f^iss. 
M. Sig.: A teaspoonful or two every half hour or hour until bleeding ceases. 607 
ERGOTA. 
In severe cases of hgemoptA'sis, in post-partum haemorrhage, and 
haematemesis, a better practice is to administer the fluid extract or ergotin 
by subcutaneous injection. The same method is preferable when ergot 
is used in the treatment of fibromyomata of the womb, and majr be re- 
sorted to in order to check the intestinal haemorrhage of typhoid fever. 
Where uterine haemorrhages are due to submucous potypi or fibronyo- 
mata,«3i*got not only checks the haemorrhages, but causes the separation 
and expulsion of the growth; in such cases the progress of the treatment 
should be accelerated by dilatation of the cervix uteri, incision into the 
capsule, if one exists, and removal of the growth by surgical operation. 
In multipara, where there is a history of flooding after previous labors, 
full doses of ergot should be given just before the deliver}' of the child. 
The usual rule for the administration of -ergot is to wait until the 
child’s head is upon the perineum before giving it; otherwise there may 
be hour-glass contraction, or tetanic contraction with unyielding os, and 
the child’s life be endangered. The administration of a drachm of fluid 
extract of erg§t, after labor has terminated, prevents relaxation of the 
organ and the formation of large clots which cause after-pains. In 
night-sweats, ergot may be given alone in full doses, or combined with 
picrotoxin or atropine. Ergot is often of avail in lyperidrosis It is effi- 
cacious in all varieties of purpura, and in severe cases of the haemorrhagic 
form may very properly be hypodermatically injected. This drug is of 
value in the treatment of chronic diarrhoea and dysentery. Good results 
have also been obtained from the administration of the fluid extract of 
ergot in acute dysentery alone or combined :— 
Extracti ergotae fl., 
Extracti harnamelidis fl., aa f^iss. 
Elix. guaranis, f§ij. 
M. Sig.: Two teaspoonfuls in water every two or three hours. 
In passive or hypostatic congestion of the lungs, it may be com- 
bined writh digitalis with advantage :— 
$ Ergotinae, gr. iv. 
Extracti digitalis, . . . gr. iij. 
Pulv. ipecacuanhae co., gr. xxiv. 
M. et ft pil. no. xij. 
Sig.: A pill every three or four hours. 
!£. Ergotinae, gr. xv. 
Glycerini, 
Aquae destillatae, aa f3j. 
Aquae aeidi carbolici, lTlxxx. 
M. Sig.: Inject, hypodermatically, from 20 to 30 minims from two to four times a 
day in haemoptysis. 608 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Ill diabetes insipidus the fluid extract of ergot produces marked 
effect on the disease, having a decided influence in controlling the 
urinary excretion of water. It is serviceable in congestive dysmenor- 
rlioea, paralysis of the bladder, and the congestive form of migraine. 
Varicose veins are restored to their normal calibre by hypodermatic in- 
jections of ergotin, and Bartholow strongly recommends this mode of 
treatment as efficacious in varicocele. The needle should be thrust 
among the enlarged veins in such a manner as not to wound their walls. 
Injected into the neighborhood of an aneurism, or administered by the 
mouth, eTgot proves valuable by favoring the coagulation of blood within 
the sac. Enlarged spleen may be reduced by the same methods. Ergot 
combined with iron has very often a beneficial action in this same 
affection :— 
Extracti ergotae fl., 
Tincturae ferri cliloridi, 
Glycerini, aa f^j. 
M. Sig.: From one to two teaspoonfuls in water three or four a day. 
In some skin diseases, notably acne rosacea, the internal administra- 
tion of ergot conjoined to local measures is of advantage. 
From its effects upon the vascular supply of the spinal cord, Brown- 
Sequard has proposed its use in some forms of paraplegia attended uv 
signs of local irritation and hyperaemia of the cord. It is useful in con- 
gestive headache and in chronic mania, and has been used with asserted 
good result in spermatorrhoea and incontinence of urine. 
ERIGER0NT1S OLEUM (U. S. P.).—Oil of Erigeron, Canada 
Fleabane. 
Dose, npxx-xxx. 
Pharmacology.—A volatile oil distilled from the fresh flowering herb 
of Erigeron Canadense* (Compositae). It is an amber-colored liquid, with 
slightly-pungent taste and characteristic aromatic odor, resembling that 
of turpentine. It has diuretic and haemostatic properties. The fluid 
extract (alcoholic) is also used. Dose, f5i-ij. 
Therapy.—The oil of erigeron is very efficient in cases of uterine 
haemorrhage (metrorrhagia), especially when of passive character. 
Menorrhagia may likewise be checked by the exhibition of this remedy. 
It has also been used in controlling other haemorrhages, such as epistaxis, 
and haemorrhage from the bowel is similarly controlled b}' the oil of 
* Prof. J. Foster Flagg, in his lectures at the Philadelphia Dental College, recommends 
the dried flowering herb of erigeron as a good local styptic for bleeding of the skin, espe- 
cially from cuts after shaving. He also gives two drops of a tincture made by absolute alcohol 
two or three times a day as an antihsemorrbagic. One or two drops of this same tincture of 
erigeron in half a teaspoonful of water is likewise given by Dr. Flagg for acute haemorrhage 
every minute to a half hour, or as indicated. ERIODICTYON. 
609 
erigeron, which has proved successful likewise in dysentery. This 
remedy may be given simply dropped upon sugar, in an emulsion, or in 
capsules. It has also some influence over the genito-urinary mucous 
membrane, and is useful in the declining stage of gonorrhoea. 
ERIODICTYON.— Eriodictyon, Yerba Santa. 
Preparations. 
Extractum Eriodictyi Fluidum.—Fluid Extract of Yerba Santa. Dose, H\xv-xxx. 
Extractum Eriodictyi.—Extract of Yerba Santa (made by evaporating the fluid extract 
to a pilular consistency). Dose, gr. iii-xv. 
Pharmacology.—The leaves of the Eriodictyon glutinosum (Hydro- 
pliyllaceae), of California, have a fragrant odor and an arhmatic, sweetish 
taste, and contain an acrid resin and a volatile oil. The effects are most 
evident in the bronchial mucous membrane, to which it is a stimulant 
and expectorant. 
Therapy.—Yerba santa has a reputation in the treatment of bron- 
chitis, laryngitis, and consumption. It has likewise been found beneficial 
in asthma, and may be ver}r well administered in conjunction with grin- 
delia robusta. It is used as a vehicle for the administration of quinine, 
the bitterness being overcome by the aromatic principles of the plant, 
Messrs. Parke, Davis & Co., who introduced this remedy to the profes- 
sion, provide an aromatic syrup of yerba santa, of which a teaspoonful 
completely masks the bitterness of 2 grains of quinine sulphate. 
Quininse sulphatis, gr. xlviij. 
Ext. belladonnae fl., lflij. 
Syrupi eriodictyi aromat., q. s. ad f3 iij. 
M. Sig.: A teaspoonful four times daily in laryngitis or chronic bronchitis. 
ERYTHROPHLCEUM.—Erythrophlceum. See Casca Cortex. 
ERYTHROXYLON (TJ. S. P.).—Erythroxylon. Coca, or Cuca. 
Preparations. 
Extractum Erythroxyli Fluidum (U. S. P.).—Fluid Extract of Erythroxylon. Dose, 
ntx-f3j. v 
Extractum Erythroxyli.—Extract of Erythroxylon. Dose, gr. iii-xv. 
Vinum Erythroxyli.—Wine of Coca. Dose, f^ss-iv. 
Cocaina.—Cocaine. 
Cocaines Hydrochloras.—Hydrochlorate of Cocaine. Dose, gr. . 
Cocaines Oleas.—Oleate of Cocaine. 
Pharmacology.—Coca or cuca leaves, taken from the Erythroxylon 
coca (Erythroxylacese), a small tree of Peru and Bolivia, contain a 
crystallizable alkaloid, Cocaine; a second alkaloid, Hygrine, which is 
liquid and volatile; and probably a third, also volatile, and only found 
in the recently-dried leaves, resembling the volatile oil in tea, the effects 
of which, and those of coca, are analogous. Coca-leaves are chewed 610 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
by the natives to sustain their strength during long journej'S and to 
invigorate them when fatigued, and the reports of travelers establish the 
truth of the observation, that with the assistance of a small quantity of 
the leaves they can endure privation from food and perform remarkable 
feats of endurance. The fact that the same effects cannot be obtained 
in this country from the imported dried leaves makes it probable that 
the fresh leaves contain a volatile principle of considerable physiological 
which is lost after a sea-voyage, by partial fermentation and 
drying, as maintained by I)r. H. H. Rusby. They also contain coca- 
tannic acid and some oil, aromatic and coloring matters, etc.; but cocaine 
is the most important constituent. As cocaine is decomposed into 
benzoic acid and ecgonine by the action of mineral acids, these should 
not be prescribed with the fluid preparations made from coca-leaves. 
Physiological Action.—Coca and, to a marked degree, cocaine cause 
local numbness or anaesthesia when applied to mucous membranes and 
when injected hypodermatically. When cocaine is applied to the con- 
junctivae, sensibility is reduced, the pupils become dilated, and the 
accommodation impaired; it constricts the blood-vessels, diminishes 
the intra-ocular tension, causes enlargement of the palpebral fissure and 
protrusion of the eyeball. When applied to the tongue, it causes numb- 
ness and loss of tactile sensibility without affecting the movements. The 
application of cocaine to the pharynx, or larynx, and nasal chambers, re- 
duces the sensibility so as to permit manipulation or operation, and also 
by its effect upon blood-vessels reduces congestion and inflammation. 
Taken in small doses frequently repeated, coca acts as a general tonic 
and prevents waste. In somewhat larger doses it is a nerve-stimulant, 
increasing the blood-suppty to the nerve-centres ; improves the digestive 
powers, increases the force of the heart’s action and arterial tension by 
its influence upon the vaso-motor centres and cardio-motor ganglia. It 
also gives a sense of well-being that enables the organism to bear more 
fatigue and to sustain the powers of the body with less food or less 
sleep than usual. Coca increases the flow of urine, but the quantity of 
urea is lessened ; it thus acts as an indirect food by preventing waste. 
After an overdose the pulse becomes rapid and weak, respiration is 
labored and shallow, and oppression of the chest is complained of, with 
threatening collapse, clammy skin, hallucinations, and delirium. Clonic 
convulsions of cerebral origin are occasioned and the bodily temperature 
markedly increased. Death is due to the paralysis of the heart, the 
spinal centres, or the centres in the medulla. Diarrhoea is produced by 
large doses, with headache (Hammond). 
Poisoning.—The treatment is the same as for toxic doses of caffeine. 
Morphine, atropine, chloral, amyl nitrite, and chloroform, alcohol or ERYTIIROXYLON. 
611 
ether are physiological antidotes. In some cases toxic effects have 
apparently been produced, with great depression and imminent collapse, 
by extremely minute doses, as where cocaine is used as a mydriatic, or 
applied to the throat. They can only be explained by idiosyncrasy, and 
the symptoms usually promptly disappear after the administration of 
stimulants, or the inhalation of ammonia or ether. A form of pro- 
tracted acute cocainism has been lately described by Hallopeau, who has, 
in several instances, observed the injection of a single small dose to pro- 
duce distressing symptoms, which may endure for several months. These 
symptoms bear much resemblance to those which immediately follow the 
injection, and consist, above all, of persistent headache, accompanied by 
profound malaise, insomnia, numbness of the limbs, vertigo, syncope, 
mental excitement, and loquacity.* Cocainism, or the evil results from 
constantly resorting to this drug as a stimulant, requires moral treat- 
ment more than medicinal; possibly the addiction may be, in some cases 
at least, the first manifestation of insanity. Cocaine is eliminated by the 
kidneys, much of it, however, being oxidized within the system. 
Therapy.—The introduction of cocaine to the profession as a local 
anaesthetic is due to Dr. Roller, who first called attention to its useful- 
ness in eye-surgery in 1884. Since then its influence in causing local 
anaemia and dilatation of the pupil having been discovered, it is now 
one of the necessary drugs in eye-practice (a 4-per-cent, solution being 
the usual strength as first recommended b}T Roller). Anaes- 
thesia of the conjunctiva results in from one to five minutes after in- 
stillation of a solution of cocaine. Dilatation of the pupil does not 
occur until ten or twenty minutes after the instillation; it continues for 
about an hour, and then gradually disappears. Though impaired, the 
accommodation is not paralj-zed, and is restored wdiile the pupils jret 
remain dilated. The conditions of the eye in which cocaine is par- 
ticularly applicable are diseases of the conjunctiva and cornea, accom- 
panied by pain and photophobia. By its local anaesthetic properties it 
facilitates many of the operations upon the eye. The removal of foreign 
bodies imbedded in the cornea, the excision of pterygium, the cauteriza- 
tion of corneal ulcers, dilatation of the lachrymal canal, the operation 
for strabismus, staphyloma, or chalazion, iridectomy, and extraction 
of the lens may all be accomplished by the aid of cocaine anaesthesia. 
It is not so well adapted for use when enucleation of the eyeball is to 
be performed, though this operation may be done when the alkaloidal 
solution is injected deeply around the orbit. Mr. Leahy has found 
cocaine serviceable in gonorrhoeal ophthalmia. He incorporates \ grain 
of the sulphate of atropine and 4 grains of sulphate of cocaine in 100 
* La Tribune Me'dicale, December 4,1890. Medical Bulletin, January, 1891. 612 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
grains of vaseline (lard or lanolin the writer suggests as a better vehicle 
for the absorption of the drugs incorporated), and applies the mixture 
beneath the upper lids. In aural surgery, a solution of cocaine may 
be introduced within the external meatus for the relief of acute and 
chronic purulent otitis, ulcers of the canal, or to render possible opera- 
tive procedures within the tympanic cavity. The application of this 
solution to the lower nasal passages and the orifice of the Eustachian 
tube is a valuable assistance in catheterization of the tube through the 
nose. By injection of this remedy into the tube itself the inflation and 
injection of remedial liquids into the tube and the middle ear is rendered 
much easier of performance. In dental and nasal surgery this substance 
fulfills numerous indications. The local anaesthesia produced by cocaine 
permits operation for ingrown nails and the removal of intra-laryngeal 
tumors. 
The rectal injection of a cocaine solution relieves the tenesmus 
and pain of dysentery. Used as an injection, or applied upon a pledget 
of cotton, cocaine allows many gynaecological operations to be painlessly 
performed. Vesico-vaginal fistulae, laceration of the cervix uteri, and 
urethral caruncles have been successfully treated in this way without 
a resort to general anaesthesia. Cocaine likewise affords relief in 
vaginismus. 
Dr. Corning, of New York, has shown that, by using the drug 
liypodermatically and confining it within limits, a degree of local 
anaesthesia can be obtained that permits of large operations, such as 
removal of tumors, extirpation of the breast, or amputation of a limb. 
It is used as an injection into the urethra in gleet and previous to passage 
of instruments or surgical operations. Cocaine is employed as a 
spray or in wafers with gelatin, in the throat or nose, for simple catarrh, 
pharyngitis, laryngitis, and for the relief of hay fever (4- to 20-per-cent, 
solution). I)r. Isidor Gluck avoids the toxic effects of a cocaine solution 
that sometimes ensues by using the following formula:— 
Phenol., TTflj. 
Aquae destillatae, . . . f3j. 
M. et adde 
Cocaine hydrochloratis, gr. x. 
M. Phenol renders the solution aseptic and prevents absorption of the cocaine. 
An ointment containing erythroxylon or hydrochlorate of cocaine 
is an admirable local remedy in affections characterized by severe 
pain or distressing itching. The extract of erythroxylon (gr. xxx-5j) 
may be incorporated in an ounce of lard, or the salt of the alkaloid may 
be used in the proportion of 4 to 8 or 10 grains to the ounce, or as 
follows :— ERYTHROXYLON. 
613 
Extract! erythroxyli eocae, 3ss. 
Creasoti, hlv. 
Ungt. zinci oxidi, §j. 
Ungt. plumbi subacetatis, §ss. 
M. For subacute eczema or psoriasis. 
Cocainae, gr. x. 
Plumbi carbonatis, 3j. 
Pulveris marantae, 3j. 
01. eucalypti, Uliv. 
Ungt. zinci oxidi, %j. 
M. Useful in acute eczema, dermatitis, burns, and irritable ulcers. 
]£ Cocainae hydroehloratis, gr. xij. 
Atropinae sulphatis, ......... gr.j. 
Acidi carbolici, Tfiv. 
01. anthemidis, ........... Itliv. 
Ungt. zinci oxidi, §j. 
M. For herpes, herpes zoster, dermatalgia, and parsesthesia. 
Extract! erythroxyli cocae, 3j. 
Zinci carbonatis, 3ij. 
Camphorae, gr. x. 
Sulphuris sublimati, gr. xx. 
Ungt. aquae rosae, §j. 
M. For eczema around the genital organs. 
Cocainae hydroehloratis, gr. x. 
Mentholi, gr. x. 
Bismuth, subnit., 3j. 
Ungt. zinci oxidi, 
Lanolini, aa 
M. Beneficial in urticaria, herpes, and herpes zoster. 
Cocainae hydroehloratis, 
Hydrarg. chloridi mitis, aa gr. x. 
Zinci carbonatis, 3j. 
Beta-naphthol, 
Camphorae, aa gr. v. 
Ungt. zinci oxidi, §j. 
M. Valuable in infantile eczema. 
These ointments are serviceable in dermatitis, aente eczema, derma- 
talgia, herpes zoster, parsesthesia, urticaria, burns, irritable and painful 
ulcers. Cocaine ointment allays the pain of ulcerated carcinoma and is 
beneficially applied to painful haemorrhoids. On account of its astringent 
and slightly stimulant action, erythroxylon ointment is sometimes an 
efficient application in acne and rosacea. An anodyne ointment may be 
thus composed :— 
Cocainae hydroehloratis, gr. x. 
Morphinae sulphatis, gr. ij. 
Atropinae sulphatis, gr.j. 
Pulveris marantae, . 3j. 
Ungucnti zinci oxidi, §j.—M. 614 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Ill the treatment of burns the hydroclilorate of cocaine should be 
preferably mixed with lanolin, since the latter substance possesses un- 
doubted efficacy in the treatment of this accident. 
$ Cocainae, . gr. xv. 
Lanolini, §iss. 
Sodii bicarbonatis, 3ij. 
01. olivae, q. s. 
M. etft. ungt. mollis. 
Cocainae, gr. x. 
Lanolini, §j. 
Bismutbi subnit. vel pluinbi carbonatis, 3ij. 
Ol. olivae, . . . q. s. 
M. et ft. ungt. molli6. 
Cocaine is a valuable remedy in pruritus ani or vulvte and in some 
cases of eczema. In rhus poisoning and erythema the solution of cocaine 
promptly relieves the burning pain. Cocaine can be employed in the 
form of a solution according to the following formulae :— 
Cocainae hydrochloratis, . . gr. iij. 
Plumbi acetatis, gr. x. 
Glycerini, f^iss. 
Aquae destillatae, f^ivss. 
M. Sig.: Use as an injection in the urethra in subacute and chronic gonorrhoea. 
Cocainae hydrochloratis, ........ gr. ij. 
Creasoti, Ifiviij. 
Glycerini, f^j. 
Aquae hamamelidis dest., f^iij. 
M. Sig.: Spray into the nose or throat in simple catarrh, pharyngitis, laryngitis, and 
in hay fever. 
Cocainae hydrochloratis, ........ gr. iv. 
Plumbi glyceroli, 
Aquae hamamelidis dest., aa f^ij. 
M. Sig.: Apply over the surface on old muslin, for burning and itching of eiysipelas, 
poisoning of the skin from various plants, and in sun-burn and superficial heat burns. 
Cocainae hydrochloratis, 
Hydrastin. hydrochloratis, aa gr. iij. 
Aquae rosae, f 
M. Sig.: Mop upon the skin or apply with old muslin or cotton, for seborrlioea 
oleosa, urticaria, acne, and rosacea. 
Iu gastralgia, the use of cocaine, or of a hot infusion of coca-leaves, 
is often highly serviceable and yields prompt relief. The hydroclilorate 
of cocaine is an efficient remedy in nausea and vomiting. In the hands 
of Dr. Manassein it yielded excellent results in the incessant vomiting 
and collapse of cholera morbus. Prompt relief often follows its use in ERYTHROXYLON. 
615 
migraine. In sea-sickness and the vomiting of pregnancy the alkaloid 
is often useful. In the latter condition it has been used by the mouth, 
by injection into the epigastrium, or applied in ointment form to the os 
uteri. Mr. John Phillips afforded permanent relief by administration 
of the following mixture :— 
Cocainae hydrochloratis, . • gr. &• 
Tinct. aurantii, lUx. 
Mist, chloroformi, f3ss. 
Aquae, q. s. ad fjj. 
M. pro dosi. 
When coca is used as a tonic in cases of debility, slow convalescence 
after fever, weak digestion, etc., it is usually in the form of an elixir or 
wine, the alcohol in these cases being synergistic, and possibly in many 
instances the more active agent in the combination. In these conditions 
the dangers of the formation of an alcohol habit must be borne in mind, 
and a change made to the solid extract or an infusion. The weak heart of 
typhoid fever is supported by doses, every two hours, of cocaine 
hydrochlorate. It is useful in sexual debility. In various nervous dis- 
orders—hiccough, asthma, chorea, paralysis agitans, alcoholic tremors, 
senile tremor—Bartholow declares that cocaine produces more favorable 
effects than any other remedy. Dr. J. K. Bauduy, of St. Louis, has 
found the alkaloid of decided service in melancholia. Murrell, of Lon- 
don, recommends the local use in neuralgia of a 20-per-cent, solution of 
the hydrochlorate of cocaine dissolved in oil of cloves. Five to 10 
minims of this solution are rubbed in with the finger over tlTe seat of 
pain. The pain of gouty joints may also be diminished by local applica- 
tion of this remedy. Waugh has used coca largely in the treatment of 
alcoholism. For acute cases he employs the following:— 
Tinct. capsici, f^j. 
Vini cocae, f^vij. 
M. Sig.: A tablespoonful every two to four hours. 
To assist in overcoming the habit of alcohol-drinking, he gives coca- 
leaves in the form of a masticatory, which can be easily carried and taken 
without attracting notice. He believes that the source of the longing 
for drink is often to be found in the mouth, and that coca when chewed 
exerts a local anaesthetic effect, as well as a general systemic action. The 
wine of coca is useful in giving tone to the vocal cords and preventing 
hoarseness in professional speakers or singers. 
Finally, cocaine, or the fluid extract of is an efficient 
antidote to narcotic poisoning by opiates or chloral, and may be used 
hy poder matically. 616 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
ESCHSCHOLTZIA.—Eschscholtzia. 
Dose, gr. xxx. 
Pharmacology.—The Eschscholtzia Californica (Papaveraceae) enjoj'S 
a reputation upon the Pacific coast of this country as a soporific and 
analgesic, and is known as the California poppy. It is represented by a 
number of varieties, and it is necessary to obtain the genuine species, as 
some appear to be inert. It is claimed that it possesses a small amount 
of Morphine, although other principles not yet isolated contribute toward 
producing its effects, among which is Sanguinarine. 
Physiological Action.—The effects upon animals are gradual slowing 
of respiration after a brief preliminary increase of rapidity; death is 
due to failure of respiration. The effect upon the nervous system is that 
of a narcotic. The motor nerves are affected before the sensory. The 
cumulative effects in human subjects resemble those produced by codeine. 
Though its narcotic effects are not very decided, yet they continue for 
a considerable period after its discontinuance. 
Therapy.—It is claimed that the eschscholtzia is an efficient though 
harmless soporific agent, especially for children. It relieves pain and 
induces sleep, relieves tremor, and agrees well with the digestive organs. 
Eschscholtzia, in the form of the fluid extract or the syrup (f5ss-v at 
a dose), is a good addition to cough mixtures where the use of opium 
is not considered advisable. 
EUCALYPTUS (U. S. P.).—Eucalyptus, Australian Blue-Gum Tree. 
Preparations. 
Oleum Eucalypti (U. S. P.).—Oil of Eucalyptus. Dose, Pliii-xx. 
Extractum Eucalypti Fluidum (U. S. P.).—Fluid Extract of Eucalyptus. Dose, 
Hlv-f3j. 
Tinctura Eucalypti.—Tincture of Eucalyptus (ffjii-Oj). Dose, f3i-iv. 
Aqua Eucalypti.—Water of Eucalyptus. Dose, f3ii-iv. 
Pharmacology.—The blue gum of Australia is a tall tree that has 
been of considerable interest to sanitarians, since it is easily cultivated 
in marshy grounds, and is said to render malarious districts health}', 
such as the Campagna, where they have been recentl}' planted. This is 
partly on account of the volatile oil and resins of the tree, and partly 
because it drains the soil of water, the exhalation of water from the 
leaves being said to be equal in amount each day, on an average, to the 
weight of the tree. The leaves are the officinal portion of the plant, 
Eucalyptus globulus (Myrtacese). They should be collected from rather 
old trees, as those from young trees are smaller and less aromatic. They 
have a camphor-like odor and a pungent, bitter taste ; contain a volatile 
oil, a crystallizable resin, and some tannin. The volatile oil, by frac- EUCALYPTUS. 
617 
tional distillation, is separated into three oils of different densitj', the 
lightest and most important being Eucalyptol, the others being Terpene 
and Cymol. The fluid extract, being made by percolation with alcohol, 
is a strong tincture. A medicated water, made like the officinal waters, 
is useful as a vehicle for alkaloids for hypodermatic use, as it prevents 
fermentation and deterioration; it is also a vehicle for medicated sprays. 
Alkalies, mineral acids, and metallic salts (iron, mercury, lead, zinc) are 
chemically incompatible with preparations of this drug; while tonics, 
simple and aromatic bitters, essential oils, turpentine, camphor, cubeb, 
etc., are synergistic, and increase its physiological and therapeutic 
effects. 
Physiological Action.—Eucalyptus is obnoxious to lower forms of 
life and is a good disinfectant. Applied to the skin, the oil is an irri- 
tant, increasing the local blood-supply and partly diffusing into the 
blood, where it produces systemic effects. The vapor of eucalyptus, in- 
haled in quantity, also produces systemic effects, besides its local action 
upon the bronchial mucous membrane. In the mouth it is pungent, aro- 
matic, camplior-like, or resembling cubeb in its impressions upon the 
nerves of taste. Eucalyptus excites the flow of saliva and leaves a dis- 
agreeable, hot, astringent flavor. In the stomach a sensation of warmth 
is felt, and it acts as a carminative and antiseptic ; the appetite and 
digestion improve, and the secretion of the gastric juice and of the intes- 
tinal fluids is increased. It favors the evacuation of the bowels, and the 
alvine evacuations are somewhat more copious. This drug is a diaphoretic 
and diuretic, the eucalyptol being eliminated largely by the kidneys, but 
also through the skin and bronchial mucous membrane. The excretion 
of urea is augmented ; the action of the heart is increased ; the arterial 
tension is at first increased, then lowered. The respiratory movements 
are accelerated. Eucalyptus inhibits the amoeboid movements of the 
white blood-cells. Very large doses cause gastric distress, indigestion, 
diarrhoea, with congestion of the kidneys, the characteristic odor of 
eucalyptus being recognized in the urine, breath, and discharges from 
the bowels. The action of the heart and lungs is decreased and the tem- 
perature falls. Wakefulness is one of the physiological results, but it 
ma}r indirectly favor sleep in debilitated conditions of the system. 
Paralysis of the respiration causes death in the lower animals to which 
a lethal dose has been given. Its action maybe summed up as antiseptic, 
carminative, digestive, tonic, laxative, diaphoretic, expectorant, and 
diuretic. 
Therapy.—Eucalyptus is used as an antiseptic in the treatment of 
wounds and ulcers, acting as a substitute for carbolic acid. An ointment 
of eucalyptus is officinal in the British Pharmacopoeia. It is made by 618 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
incorporating 1 ounce, by weight, of the oil of eucalyptus with 2 ounces 
each of soft and hard paraffin, and is a good dressing to chronic, indolent, 
or unhealthy ulcers. The tincture, or the water, of eucalyptus may be 
used externally for the same purpose. A combination of eucalyptus 
and iodoform is a serviceable application to chancres and chancroids. 
The oil is a very useful addendum to preparations for the relief of 
chronic eczema, in which the following combination is often found bene- 
ficial :— 
]$. Hydrarg. ammoniat., gr. xv. 
Olei eucalypti, ITlviij. 
Beta-naphthol., gr. x. 
Pulv. marantae, 3ij. 
Unguent, zinci oxidi, §j.—M. 
The vapor may be used by dropping the oil upon hot water, or upon 
cotton-wool placed in an inhaler ; or the steam-atomizer may be employed 
with eucalyptol-water for inhalation in phthisis, dilated bronchial tubes, 
bronchial catarrh with fetid expectoration, etc. Applied to the 
diseased membrane, or inhaled in a vaporized state, the oil is a good anti- 
septic in diphtheria. One part of the oil to 50 of plain or medicated 
water may be advantageously used as an injection in gonorrhoea. It may 
likewise be employed as a mild counter-irritant in bronchial and arthritic 
inflammations. In alopecia, when the scalp is covered and the glands 
occluded by a thickened and vitiated sebum, the oil of eucalyptus is of 
very material service. Its local stimulant effects sometimes prove valuable 
in anidrosis. A soap (sapo eucalyptoli) containing 5 per cent, of the oil 
is of utility in the treatment of foul wounds, or ulcers, and bromidrosis. 
In phthisis, J. Roussel recommends hypodermatic injections of 1 part of 
the oil of eucalyptus in 4 parts of pure olive-oil. In asthma, cigarettes 
may be smoked, containing leaves of eucalyptus, with belladonna or coca, 
and stramonium-leaves, associated with tobacco, if desired, and much 
advantage derived from it, especially if the fumes be inhaled. The fluid 
extract is an efficient stomachic in indigestion due to deficient secretion 
or to gastric or intestinal catarrh ; by its use the intestinal tract becomes 
more healthy in character, and no longer affords a place of development 
for intestinal parasites. Eucalyptus is an efficient remedy in the vomiting 
caused by sarcinse. In the ordinary oxyurides, or seat-worms, injections 
of a decoction of eucalyptus-leaves are useful, and this preparation may 
also be employed as a gargle for sore throat and stomatitis, scurvy, etc. 
The stimulating effect upon the circulation of the volatile oil is well 
ishown in cases of palpitation, irregularity, sudden flushes, and flatulence. 
As the drug is antiseptic, and escapes by the bronchial mucous membrane 
to a considerable degree, it is serviceable in chronic bronchitis, in the 619 
EUONYMUS. 
declining stage of pneumonia, in incipient phthisis, gangrene of the 
lungs, and diphtheria. Where there is an anaemic state of the nerve- 
centres manifested by chorea, neurasthenia, hysteria, and asthma, benefit 
is derived from eucalyptol given in capsules, emulsion, or simply dropped 
upon sugar (npi-v at a dose). In rheumatic or malarial headache it 
sometimes proves efficacious. 
Eucalyptus is believed to be especially serviceable in catarrhal affec- 
tions of the genito-urinary organs, desquamative nephritis, pyelonephritis, 
chronic catarrh of the bladder, with putrid urine, and in gleet. It likewise 
effects improvement in vaginitis. In fevers, especially malarial fevers, it 
is useful; but it is inferior to quinine in controlling the paroxysms, being 
most employed in chronic malarial poisoning and in convalescence from 
acute attacks, when it may be used in alternation with cinchona. This 
remedy causes reduction of the enlarged spleen, or “ ague-cake,” due to 
malarial toxaemia. 
Dr. Benjamin Bell recommends the tincture of eucalyptus to be given 
in drachm doses every third or fourth hour in typhoid fever, and believes 
that it exerts a favorable influence upon the diarrhoea. In scarlatina it 
is a good practice to add 5 drops of the oil of eucalyptus to the ounce 
of prepared lard, for use as an unguent. 
EUONYMUS (U. S. P.).—Euonymus, Wahoo. 
Preparation. 
Extractum Euonymi (U. S. P.).—Extract of Euonymus. Dose, gr. i-v. 
Pharmacology.—The bark of Euonymus atropurpureus (Celastracete) 
contains a bitter, amorphous substance; also, resins, euonic acid, and 
asparagin. The impure resin, with the bitter principle, is known com- 
mercially as Euonymin (dose, gr. ss-v). 
Physiological Action.—Euonymus is in small doses a tonic, increasing 
appetite and gastric secretions; in larger doses it is an irritant and 
cathartic. Euonymus is also an expectorant and diuretic, and exerts 
considerable influence upon the liver, as a cholagogue, resembling rhubarb 
in its action. The excretion of uric acid is at first increased, but sub- 
sequently diminished, by the use of euonymus. 
Therapy.—It has been employed as a cholagogue purgative, especially 
in conjunction with antiperiodic treatment, in malarial poisoning. In 
torpid liver and chronic constipation, it aids the action of other remedies. 
Intestinal indigestion and jaundice are benefited by the administration 
of this agent. As a diuretic, it has also been employed in cases of dropsy. 
Euonymin is a convenient form in which to prescribe it, although the 
solid extract is practically the same. 620 
PHARMACEUTICAL THERAPEUTIC AGEXTS, OR DRUGS. 
EUPATORIUM (U. S. P.).—Eupatorium, Thoroughwort, Boneset. 
Dose, gr. xv-3j. 
Preparations. 
Extractum Eupatorii Fluidum (U. S. P.).—Fluid Extract of Eupatorium. Dose, 
H\xxx-f3 j. 
Infusum Eupatorii.—Infusion of Eupatorium, Boneset-Tea. Done, or more. 
Pharmacology.—The leaves and flowering tops of Eupatorium per- 
foliatum (Composite), an indigenous plant, enjoy considerable reputation 
in recent infusion (boneset-tea) for acute colds, rheumatism, and dys- 
menorrhoea. They contain Eupatorin, a neutral, bitter principle, with 
volatile oil and tannic acid. 
Therapy.—The hot infusion (§i-Oj) is a diaphoretic and (in large 
doses) emetic, acting like chamomile-flowers. The powdered dried herb 
is a domestic remedy for dyspepsia, but is best given in fluid extract. 
The Eupatorium purpureum, gravel-root or trumpet-weed, an allied 
species, contains in its root an acrid resin and an oil, and is a stimulating 
diuretic. It is best given as a fluid extract of the root in dose of 
«ixxx-f3ij. 
EUPHORBIA PILULIFERA.—Pill-bearing Spurge/Snake-Weed. 
Preparations. 
Deeoctum Euphorbia Piluliferce.—Decoction of Euphorbia Pilulifera. Dose, f^ij. 
Extractum Euphorbia Pilulifera.—Extract of Euphorbia Pilulifera. Dose, gr. i-ij. 
Tinctura Euphorbia Pilulifera.—Tincture of Euphorbia Pilulifera. Dose, hlx-xxx. 
Extractum Euphorbia Pilulifera Fluidum.—Fluid Extract of Euphorbia Pilulifera. 
Dose, irixxx-f3j. 
Pharmacology.—Euphorbia pilulifera (Euphorbiacete), pill-bearing 
spurge, is a native of most tropical countries. The variety which has 
been introduced into medical practice comes from Queensland, Australia. 
It is an annual herbaceous plant, growing to the height of one or two feet. 
The fresh root is red ; the dry is reddish brown. The stalk is more or 
less procumbent and covered with yellowish hairs. The leaves are of a 
deep-green color. The fruit incloses three seeds, which bear some 
resemblance to a coffee-grain. The plant yields its virtues to water. 
The aqueous solution seems to contain tannin, but no alkaloid. 
Physiological Action.—A strong solution of this drug has no irritant 
effect upon the skin. The taste is slightly astringent. It causes no 
redness or smarting of the tongue or buccal cavity, but is irritant to the 
gastric mucous membrane, and may occasion nausea or epigastric pain. 
No effect has been observed upon the spinal cord or muscular system. 
It produces no change in the calibre of the capillary vessels. The 
secretions are unaffected. Small doses are fatal to frogs and guinea-pigs, EUPHORBIUM. 
621 
first accelerating and then retarding the respiration and circulation, 
probably acting directly upon their respective centres. It is thought to 
be eliminated by the liver, and is devoid of cumulative effects. 
Therapy.—Euphorbia pilulifera is chiefly of value as a remedy in 
spasmodic asthma, though it is not without merit in other thoracic dis- 
eases. Dr. Marsset, to whom we owe our knowledge of its physiological 
action, employed it in a number of cases in private practice, and reports 
others from the service of Dujardin-Beaumetz. It was found of signal 
benefit in paroxysmal asthma, whether uncomplicated or connected with 
chronic bronchitis and'emphysema. The effect was favorable and prompt, 
irrespective of the origin of the disorder. Dr. Tison has found the 
remedy beneficial in the dyspnoea of cardiac disease. In Australia the 
plant is highly esteemed for its power of allaying the asthmatic par- 
oxysm. It has likewise been found of service in chronic bronchitis, 
especially when occuring in old people. I)r. Marshall has prescribed it 
with advantage in phthisis, in which it checked the cough, promoted 
expectoration, and exerted some anodyne influence. The decoction is 
slightly tonic. The leaves have also been smoked in a pipe with satis- 
factory re3ults in cases of asthma. In asthma complicated with emphy- 
sema it may very serviceably be combined with quebracho:— 
II Tinct. euphorbiae pilulif., f3ij. 
Ext. quebracho fl., q. s. ad f§ij. 
M. Sig.: A half to two teaspoonfuls in water, every three or four hours, for asthma, 
chronic bronchitis, and emphysema. 
EUPHORBIUM.—Euphorbium. 
Pharmacology.—The Euphorbia resinifera (Euphorbiacese) is a native 
of Morocco, the officflnal portion being a gum-resin, which flows from 
incisions in the stem and hardens in the air. The substance is yellowish, 
opaque, or slightly translucent, and brittle ; without odor, but the pow- 
der causes much irritation and sneezing ; taste acrid and burning. It is 
insoluble in water, only partly soluble in alcohol. It consists of an acrid 
resin (38 per cent.), euphorbon (22 per cent.), gum (18 per cent.), malates 
(12 per cent.), etc. 
Physiological Action.—It is irritating to the skin and vesicant, owing 
to the acrid resin. Euphorbon is a drastic purgative and emetic. 
Therapy.—It is only employed for external purposes as a rubefacient 
and counter-irritant. When combined with cantharides, it forms a good 
vesicating plaster (Janin’s plaster). 
The Euphorbia corollata, or large flowering spurge, is emetic, dia- 
phoretic, and expectorant. The root is used (gr. xv-xx), of which a 
decoction may be made. 
The Euphorbia ipecacuanha, or ipecacuanha spurge, grows along the 622 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Atlantic coast of the United States, and possesses considerable medicinal 
virtues. The root is the part used; it contains eupliorbon, acrid resin, 
and possibly some glucoside. As an infusion or fluid extract, it is used 
as an emetic, diaphoretic, or expectorant, according to the dosage ; large 
quantities act as a hydragogue cathartic. It has been emploj'ed in 
domestic practice for menstrual irregularity, dropsy, bilious colic, and 
catarrhal affections of the air-passages. 
EUPHRASIA.—Euphrasia, Eyebright. 
Pharmacology.—The Euphrasia officinalis (Scrophulariaceae), a small 
herb of the White Mountains and Lake Superior region and also of 
Europe, with opposite leaves and spikes of blue flowers. In spite of its 
title, it is not officinal in the United States Pharmacopoeia. It is as- 
tringent, containing tannin, euphrastic acid, etc. A tincture (10 per 
cent.) is useful in incipient catarrhal affections, hay fever (dose, njx 
every two hours), and measles. 
EXALGINE.—Orthomethyl-Acetanilid. 
Dose, gr. i-vj, or from 6 to 12 grains in the course of the day. 
Pharmacology.—This is a recent introduction into medicine from 
the chemical laboratory. It is a new derivative of the aromatic series, 
with the formula, C9HnNO (or C6H5, 02II30, NCH3), and is one of 
the three methyl derivatives of acetanilid. It is in fine, acicular, or long, 
tablet-like crystals, the first being obtained by evaporation from solution, 
the latter from fusion. Sparingly soluble in cold water, more so in hot 
water, and extremely soluble in dilute alcohol. 
Physiological Action.—Exalgine has been brought forward by Brigon- 
net, of the Cochin Hospital, and has been extensively employed as an 
analgesic; its effects being principally manifested upon the sensory 
nerves. Exalgine, which is also an antiseptic, is eliminated by the urine, 
the amount of which it diminishes. It reduces abnormal temperature 
like other members of the group, and is claimed to be equally efficient 
in about half the dose of antipyrin. It is not followed by a rash upon 
the skin or other disagreeable effects. As it is soluble in dilute alcohol, 
it may be given in water flavored with elixir of orange or rum. The 
smallness of the dose gives it a decided advantage over some other prepa- 
rations of this group. 
Therapy.—In all forms of neuralgia, especially the visceral forms, 
exalgine has been shown to have marked control over pain. It is said 
to decrease the quantity of sugar excreted in diabetes mellitus. In 
diabetes, from 6 to 12 grains daily may be given. In facial neuralgia and 
myalgia, especially in anaemic, neurotic patients, good results are obtained 
from doses of 1 grain every four hours. FABIANA IMBRICATA. 
623 
FABIANA IMBRICATA.—Pichi. 
Preparation. 
Extractum Eabiance Fluidum.—Fluid Extract of Fabiana. Dose, ITlxv-xl. 
Pharmacology.—Fabiana imbricata (Solanacese), or Pichi, a South 
American plant, is a shrub, or small tree, which grows upon high, dry hill- 
tops. Its branchlets are arranged in the form of plume-like sprays, which 
have a peculiar, light bluish-green color, due to the large amount of bluish 
or greenish-gray resin, with which all its tender parts are covered. Besides 
this resin the drug contains tannin, starch, a minute quantity of some alka- 
loid, probably peculiar to itself, and an abundant proportion of a gluco- 
side analogous to esculin. The preparations are made from the leaves. 
Therapy.—A tincture of pichi has a disagreeable, persistent, bitter 
taste, and, unless combined with an alkali, its resin is precipitated upon 
the addition of water. Pichi exerts a stimulant effect upon the kidneys, 
but its physiological action has not been closely studied. Its therapeutical 
influence is chiefly manifested in affections of the genito-urinary apparatus. 
In enuresis nocturna, pichi has often a most beneficial action. The 
following combination will be found of service :— 
Extract, fabianae fluid., f3j. 
Tinct. belladomii®, lllxij. 
Aquae cinnamomi, f§iij. 
M. Sig.: A teaspoonful morning and night. 
Pichi lias been given with success in jaundice and dyspepsia depend- 
ent upon an insufficient secretion of bile. The essential oil of pichi acts 
as a stimulant to'secreting organs generally, and modifies or cures chronic 
purulent discharges from mucous membranes. Pichi is a valuable remedy 
in the treatment of lithiasis, or calculus of the kidney or bladder. Espe- 
cially when given in combination with an alkali, it holds uric acid in 
solution, and it is thought that its resin dissolves the mucus which binds 
together the particles of a stone, leading to disintegration and facilitating 
expulsion. In chronic renal congestion and calculous pyelitis this dfhg 
Is of service, but is believed to be contra-indicated when degeneration of 
renal tissue exists. Acute or chronic cystitis is benefited by the ad- 
ministration of pichi. Dr. Hal. C. Wyman reports very favorably upon 
this remedy in cystitis dependent on stricture or manipulative pro- 
cedures within the urethra, and likewise in cases of lumbago and sciatica 
associated with the deposition of uric acid. Dr. Wyman commends the 
following formula :— 
$ Extract, fabianae fluid., . , . , . . . . . f^j. 
Potassii nitratis, . . . . 3j. 
Elixir, simplicis, . f§iij. 
M. et ft. sol. 
Sig.: A teaspoonful once in two hours. 624 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
FEL BOVIS (IT. S. P.).—Ox-Gall. 
Preparations. 
Fel Bovis Inspissatum (U. 8. P.).—Thickened Ox-Gall (strained and evaporated to one- 
half in a water-bath). Pose, in pill, gr. v-viij. 
Fel Bovis Purificatum (U. S. P.).—Purified Ox-Gall (pilular consistence). Pose, in 
pill, gr. iii-vj. 
Pharmacology.—Fresh ox-gall (from Bos taurus ; class, Mammalia ; 
order, Ruminantia) is a greenish-brown, viscid liquid, with a peculiar, 
nauseating odor and bitter, offensive taste. Its solution froths when shaken 
and saponifies fats. Its reaction is alkaline; specific gravity, 1018 to 1028. 
Physiological Action and Therapy.—Ox-gall is antiseptic and laxative, 
assisting in the absorption and digestion of fats in the intestinal tract and 
stimulating peristalsis. The local application of bile causes absorption 
of h}7pertrophies, and enlarged tonsils. It may be used internally to 
assist the digestion and assimilation of fatty foods or of codliver-oil, 
and may be given in habitual constipation with deficient assimilation. 
In jaundice, Harley recommends ox-gall, given in 5-grain doses, in 
capsules, in order that it may reach the duodenum before being acted on 
by the stomach. It is also of benefit, in combination with other drugs, 
in hepatic and intestinal affections. The following prescriptions con- 
taining ox-gall are recommended :— 
Fel bovis purificati, 
Magnesii carbonatis, aa c. 
01. menth. pip., iflj. 
M. et ft.capsulse no. xx. 
Sig.: A capsule three or four times a day, after meals, in dyspepsia and constipation. 
Fel bovis purificati, 3j. 
Extracti nucis vomicae, gr. j. 
Aloini, gr. j. 
01. ciunamomi, Hlj. 
M. et ft. pil. no. xx. 
Sig.: Two pills between meals. Serviceable in torpor of the liver and in dyspepsia. 
Pancrobilin is a combination of purified ox-bile and a preparation of 
fresh pancreas. It is best given in pills (3 grs.) after meals. Useful in 
duodenal dyspepsia, constipation, insufficient digestion, or assimilation 
of fats. A liquid pancrobilin (dose, f5i—ij) is also furnished by Messrs. 
Reed & Carnrick, New York. 
FERMENTUM.—Yeast. 
Pharmacology.—Yeast is a pale-brown* viscid, frothy liquid, with a 
bitter taste. Used externally in a poultice for boils and suppurating 
wounds or foul ulcers, and internally* as an alterative tonic in furuncles 
and typhoid fever. It is said to cause disappearance of sugar from the 
urine in diabetes. 
Dose, f|ss-j before meals. 625 
FERRUM. 
FERRUM (U. S. P.).—Iron. 
Preparations. 
Ferrum Redudnm (U. S. P.).—Reduced Iron. Dose, gr. i-v. 
Ferri Carbonas Saccharatus (U. S. P.).—Saccharated Carbonate of Iron (at least 15 
per cent, of ferrous carbonate). Dose, gr. ii-x. 
Massa Ferri Carbonatis (U. S. P.).—Mass of Carbonate of Iron. Yallet’s Mass (iron 
sulphate 100, sodium carbonate 110, honey 38, sugar 25, syrup and water q. s. ad 100 
parts) has 42 per cent, ferrous carbonate. Dose, gr. iii-v. 
Mistura Ferri Composite/, (U. 8. P.).—Compound Mixture of Iron. Griffith’s Anti- 
hectic Mixture (iron sulphate 6, myrrh 18, sugar 18, potassium carbonate 8, compound 
tincture of lavender 50, rose-water 900 parts). Dose, f3ii-f^ss. 
Pilules Ferri Composites (U. S. P.).—Compound Iron Pills (iron sulphate gr. |, sodium 
carbonate gr. £, myrrh gr. iss, in each pill). Dose, 2 to 4. 
Fend Iodidum Saccharatum (U. S. P.).—Saccharated Iodide of Iron. Dose, gr. v-xx. 
Pilules Ferri Iodidi (U. S. P.).—Pills of Iodide of Iron* (each gr. j ferrous iodide, 
coated with tolu). Dose, 2 to 4 pills. 
Syrupus Ferri Iodidi (U. 8. P.).—Syrupof Iodide of Iron (10 percent, ferrous iodide). 
Dose, ffiv-xxx. 
Fend Chloridum (U. 8. P.).—Chloride of Iron (or perchloride). Used as a haemo- 
static. 
Liquor Ferri Chloridi (U. S. P.).—Solution of Chloride of Iron (37.8 of ferric chlo- 
ride). Principally used in making the tincture. Dose, ffiii-x. 
Tinctures Fern Chloridi (U. 8. P.).—Tincture of Chloride of Iron (solution of ferric 
chloride 35, alcohol 65 parts). Dose, ffiv-f3j. 
Ferri Citras (U. S. P.).—Citrate of Iron. Dose, gr. v-xx. 
Liquor Ferri Citratis (U. 8. P.).—Solution of Citrate of Iron (35.5 per cent, of an- 
hydrous citrate of iron). Dose, ffix-xl. 
Vinum Ferri Citratis (U. 8. P.).—Wine of Citrate of Iron (contains citrate of iron 
and ammonium, 4 parts; tincture sweet-orange peel and syrup, each 12, stronger white wine 
72 parts). Dose, f 3i-iv. 
Ferri et Ammonii Citras (U. S. P.).—Citrate of Iron and Ammonium (ammonio-ferric 
citrate). Dose, gr. iii-v. 
Ferri et Quinines Citras (U. 8. P.).—Citrate of Iron and Quinine (citrate of iron 88, 
quinine 12 parts), ilo.se, gr. iii-v. 
Liquor Ferri et Quinines Citratis (U. 8. P.).—Solution of Citrate of Iron and Quinine 
(citrate of iron and ammonium 65, quinine 12, acid citric 28, alcohol 30, distilled water 
q. s. ad 100 parts). Dose, ffiv-xv. 
Vinum Fern Amamm (U. 8. P.).—Bitter Wine of Iron (8 per cent, of above solution). 
Dose, f 3i—f § j. 
Fe/riet Strychnines Citras (U. 8. P.).—Citrate of Iron and Strychnine (98 per cent, 
citrate of iron and ammonium, 1 per cent, each of strychnine and citric acid). 
Dose, gr. i-iij. 
Sympus Fend, Quinines, et Strychnines Phosphatum (U. 8. P.).—Syrup of the Phos- 
phates of Iron, Quinine, and Strychnine (phosphate of iron 133, quinine 133, strychnine 
4, phosphoric acid 800, sugar 6000 parts, and water sufficient quantity to make 10,000 
parts) contains per cent, of strychnine, or gr. to each ounce. Dose, f 3i-iv. 
Ferri Ladas (U. S. P.).—Lactate of Iron. Dose, gr. ii-x. 
Syrupus Hypophosphitum cum Ferro (U. 8. P.).—Syrup of the Hypophosphites with 
Iron (lactate of iron, 1 per cent.). Dose, f3i-iv. 
*Blancard’s Unchangeable Iodide of Iron Pills are especially protected by a coating of 
reduced iron ; but they are less soluble in the gastric juice. 626 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Ferri Oxalas (U. S. P.).—Oxalate of Iron. Bose, gr. ii-v. 
Fern Oxidum Hydratum (U. S. P.).—Hydrated Oxide (sesquioxide) of Iron (freshly 
precipitated by the addition of an excess of ammonia to the solution of the tersulphate of 
iron and washed and strained. For use as an antidote to arsenious-acid poisoning, 20 
grains to be taken for each grain of arsenic swallowed, a tablespoonful the ordinary dose 
as an antidote). 
Ferri Oxidum Hydratum cum Magnesia (U. S. P.).—Hydrated Oxide of Iron with 
Magnesia. When required for use, is obtained by mixing (1) solution of tersulphate of iron 
1000 grains, water 2000 grains, with (2) magnesia 120 grains, in water 32 fluidounces. The 
precipitate is collected as before. “The dilute solution of tersulphate of iron and the 
mixture of magnesia with water should alwTays be kept on hand for immediate use.” 
To be used like the preceding in arsenical poisoning. 
Liquor Ferri Acetalis (U. S. P.).—Solution of the Acetate of Iron (33 per cent, anhy- 
drous salt). Used in the next preparation. 
Tinctura Ferri Acetate (U. S. P.).—Tincture of the Acetate of Iron (IC)]4 per cent, 
anhydrous salt). Bose, Hlx-f3j. 
Ferri et Ammonii Sulphas (U. S. P.).—Sulphate of Iron and Ammonium (ammonio- 
ferrie alum). Bose, gr. iii-v. 
Ferri et Ammonii Tartras (U. S. P.).—Tartrate of Iron and Ammonium. Ammonio- 
Ferric Tartrate (about 25 per cent, ferric oxide). Bose, gr. v-xx. 
Ferri et Potassii Tartras (U. S. P.).—Tartrate of Iron and Potassium. Potassio-Ferric 
Tartrate. Bose, gr. v-xv. 
Ferri Phosphas (U. S. P.).—Phosphate of Iron. Bose, gr. v-x. 
Ferri Pyrophosphas (U. S.P.)—Pyrophosphate of Iron. Bose, gr. ii-v. 
Ferri Ilypophospliis (U. S. P.).—Hypophosphite of Iron. Bose, gr. v-x. 
Ferri Yalerianas (U. S. P.).—Valerianate of Iron. Bose, gr. i-iij. 
Ferri Sulphas (U. S. P.).—Sulphate of Iron. Bose, gr. i-v. 
Ferri Sulphas Exsiccatus (U. S. P.).—Dried Sulphate of Iron. Bose, gr. i-ij. 
Ferri Sulphas Prcecipitatus (U. S. P.).—Precipitated Sulphate of Iron. Bose, gr. i-ij. 
Liquor Ferri Subsulphatis (U.-S. P.).—Solution of the Subsulphate of Iron (Monsel’s 
Solution). Bose, Ifiii-x. 
Liquor Ferri Tersulphatis (U. S. P.).—Solution of Tersulphate of Iron (for making 
hydrated oxide of iron). 
Mistura Fernet Ammonii Acetatis (U. S. P.).—Mixture (solution) of Acetate of Iron 
and Ammonium (Basham’s Mixture). Bose, f3i-iv. 
Pilulce Aloes et Ferri (U. S. P.).—Pills of Aloes and Iron (purified aloes and dried 
sulphate of iron, 1 gr. each. Bose, 1 to 3 pills. 
Emplastnim Ferri (U. S. P.).—Iron Plaster (ferric oxide, 10 per cent.). 
Trochisci Ferri (U. S. P.).—Troches of Iron (each ferric oxide, gr. v). Bose, 1 to 2 
troches. 
Liquor Ferri Hitratis (U. S. P.).—Solution of Nitrate of Iron (6 percent..). Bose, tfix-xx. 
Syrupus Ferri Bromidi (U. S. P.).—Syrup of Bromide of Iron (10 percent, ferrous 
bromide). Bose, ,rlv-f3j. 
Ferri Alburninas.—Albuminate of Iron. Bose, gr. v-xxx. 
Ferri Arsenias.—Arseniate of Iron. Bose, gr.-^-^. 
Ferri Ferrocyanidum.—Ferrocyanide of Iron (Prussian Blue). Bose, gr. iii-vj. 
Ferri Malatis Liquor.—Solution of Malate of Iron. Bose, f'3ss-ij. 
Ferrum Bialysatum.—Dialyzed Iron (a 10-per-cent, solution of ferric oxychloride in 
water. If properly made, is an easily assimilated chalybeate, free from astringency. Useful 
in arsenical poisoning. Does not keep well). Bose, Ifix-xxx. 
Mistura Ferro-Salina.—Ferro-Saline Mixture (sulphate of magnesia, ; cream of 
tartar, 3j; dried sulphate of iron, gr. x; water, Oij). Bose, a wineglassful before break- 
fast each morning. FERRUM. 
627 
Pharmacology.—Iron is a metallic element, the most abundant, the 
most widely distributed and most useful to mankind of all the metals. 
In its pure state it is malleable and ductile, and the pharmacopoeia 
directs its use, therefore, in the pure form of “line, bright, non-elastic 
wire,” out of which preparations should be made. Ferric salts in solution 
or in crystals are generally red, and the ferrous salts green; they are likely 
to be decolorized by drying and become white. The iron compounds 
are also known as chalybeates, or martial preparations ; a large number 
are used in medicine, besides those found as constituents in natural 
water, iron being of common occurrence in mineral springs. The chem- 
ical tests—vegetable astringents containing tannic or gallic acid, alka- 
lies and their carbonates, acidulous salts and mucilage of acacia—are 
incompatible with iron preparations. 
Physiological Action.—As one of the proximate principles of the 
human organism, and playing an important part in the red blood-cor- 
puscle (as haemoglobin) in the nutrition of the bod}", iron is a necessary 
element in the food. When applied to the tissues, most of the salts of 
iron exercise an astringent effect, producing coagulation of albumin. 
Some of the preparations, notably the solution of the subsulphate and the 
chloride, are very useful in coagulating blood and checking haemorrhage, 
when locally applied. A similar astringent effect is observed in the 
mouth and along the alimentary canal. One of the objections to the use 
of most of the iron salts in medicine is the fact that they cause consti- 
pation and headache. The phosphate and pyrophosphate are exceptions 
to this, being non-constipating. Only a small proportion of the iron 
administered is assimilated, the larger proportion being discharged with 
the faeces, to which a black color, due to the formation of the sulphide, 
is imparted. The portion absorbed is largely thrown out again in the 
bile. Iron augments the amount of urea and increases the frequency 
of micturition, the tincture of the chloride especially being credited with 
diuretic properties. It has a tonic influence upon the nerve-centres, but 
improves nutrition principally by its effect upon the circulation. While 
iron has little power of increasing the number of blood-corpuscles in 
health, this power is shown very decidedly in conditions of anaemia or 
hydraemia ; the number of globules being rapidly increased, and the haem- 
oglobin of the blood gradually brought up to the healthy standard. It 
is supposed that the iron present in the blood-corpuscles has the property 
of converting ox}"gen into ozone, and that it thus promotes oxidation. 
The heart is also toned up by the effects of the iron preparations, prob- 
ably owing largely to the stimulus of a better blood-supply to its walls. 
The stomach is stimulated by the astringent action of the iron, and the 
appetite and digestive capacity are improved under small doses not too 628 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
long continued. Iron slightly raises the temperature of the body, partly 
by increasing tissue waste, parti}' by its ozonizing effects. Some of the 
stronger preparations, sulphates, nitrate, iodide and chloride, are irritant, 
and, in large doses, poisonous. 
Therapy.—The styptic qualities of iron are best shown Monsel’s 
solution and the choride, in powder or solution, when applied directly to 
the oozing surface, as in surgical operations, post-partum haemorrhage, 
haemorrhage from the uterus after miscarriage, or cancer of that organ. 
The resulting clot is very tough and dark-colored, and makes a 
dirty, disagreeable mass, so that, in ordinary surgical practice, iron is 
rarely used as a haemostatic, when a substitute can be found. In some 
forms of uterine haemorrhage, Monsel’s solution may be used, diluted (1 
to 3) or applied in full strength, upon a small swab to the inner surface 
of the uterus, if the os is previously dilated ; or the vagina may be packed 
with absorbent cotton wet with a 5-per-cent, solution. 
In epistaxis, or liaemopt}Tsis, a spray of 1- or 2-per-cent, strength of 
Monsel’s solution may be inhaled. Excessive haemorrhage from leech- 
bites or after the extraction of teeth may be controlled by the direct 
application of the same agent. A solution of the subsulphate ma}' 
be successfully used to restrain bleeding from haemorrhoids. The 
same preparation is effective in destroying syphilitic vegetations. 
Fissured nipples may be cured by painting them with a mixture of 1 part 
Monsel’s solution and 3 or 4 of glycerin. A spray of the subsulphate is 
beneficial in chronic ozaena. In erysipelas, the tincture of iron is an 
excellent local application. The astringent preparations of iron may 
be used Avith good effect as injections in gonorrhoea and gleet. Half a 
drachm of the tincture to pint of water, with a drachm of laudanum or 
12 grains of the sulphate to the same quantity of water and laudanum, 
are forms in which iron may be used for this purpose. These solutions 
of iron, liowe\rer, are open to the objection that they stain the patient’s 
clothing. A liquid containing an astringent salt of iron is also a ser- 
viceable wash in leucorrhoea. In tonsillitis, pharyngitis, and diphtheria, 
the same agent may be applied directly to the throat, either pure or 
diluted with an equal quantity of glycerin; this application is sometimes 
painful, but is very efficient. The tincture of the chloride of iron, though 
less astringent than Monsel’s solution may be used locall}' in the same way. 
In diphtheria, it can be administered internally in this form, and if, as is 
usually done, the preparation is suitably diluted with water, and then taken 
through a glass tube (so as to prevent the iron from staining and corroding 
the teeth), the solution will come directly in contact with the pharynx as 
it is swallowed, and thus combine the local and systemic effects. In 
such cases it is sometimes prescribed in combination, as follows:— FERRUM. 
629 
$ Tincturae ferri ehloridi, f^j. 
Potassii chloratis, 3j. 
Syr. aurantii rubri, f §ij. 
M. Sig.: Half a teaspoonful to a teaspoonful every two hours, in diphtheria or erysipelas. 
Dr. Garretson’s formula for local application in erysipelas contains 
the tincture of chloride of iron with the tincture of cinchona and the sul- 
phate of quinine (see page 547), and it is applied as an astringent lotion. 
These st3'ptic preparations have also been injected into naevi and 
vascular tumors, to produce coagulation of their contents, but death 
has resulted from the escape of some of the fluid into the general 
circulation. 
The principal employment of the iron preparations is for their effect 
upon liaematosis, They are pre-eminently useful in cases of anaemia, 
hj'draemia, or chlorosis, and in many cases of debility. They should 
not be used in plethora. As they all to a greater or less degree interfere 
with the digestive function, checking the secretions along the alimentary 
tract, and frequently constipate, the state of the stomach should always 
be considered when prescribing iron. Where the tongue is red and dry, 
Fothergill has shown that iron always disagrees and should not be 
ordered. On the other hand, a pale, broad, and flabby tongue, marked 
bjr the impression of the teeth, is especially indicative of the demand of 
the S3Tstem for iron. There are great differences in this respect, however, 
between the several preparations of iron, and new chalybeates are being 
constantly brought forward with the recommendation that they do not de- 
range the digestion nor produce constipation. In amenorrlioea, Blaud’s 
pills of carbonate of iron are of great service, or the compound mixture 
may be used with excellent effect. Iron is of most value in simple 
anaemia, such as that following haemorrhage; it is of less service where 
the anaemia is symptomatic and accompanies organic diseases, or 
blood-poisoning. In such cases it acts more quickly when given 
dermatically, the ammonio-citrate dissolved in distilled water being 
preferred. Chicandard emplo3rs the ammonio-ferrous sulphate because 
it is permanent and soluble. The anaemia which results from chronic 
malaria is veiy amenable to the influence of iron. The enlarged spleen 
of malaria diminishes in size and malarial neuralgia is relieved. Iron is 
of constant service in the treatment of neuralgia, which so often depends 
upon a condition of anaemia :— 
Mass, ferri carbonatis, gr. xxiv. 
Extract! hyoscyami ale., ! gr. v. 
Podophyllotoxin, gr. j. 
Quininae sulphatis, gr. xij, 
M. et ft. pil. no. xij. 
Sig.: From four to six pills a day, for neuralgia. 630 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
$ Liquor, ferri et quininae citratis, 
Liquor, potassii arsenitis, aa f3ij. 
Elix. guaranae, q. s. ad f§iij. 
M. Sig.: A teaspoouful three or four times a day. Use in malaria and neuralgia. 
Improvement takes place in pseudo-leukaemia, or Hodgkin’s disease, 
when iron is administered, especially in conjunction with arsenic, though 
the chalybeate preparations are of no utility in true leukaemia:— 
Ferri pyrophosphatis, gr. xl. 
Acidi arseniosi, gr. j. 
Extracti nucis vomicae, gr. iij. 
Extracti belladonnae ale., gr. ij. 
M. et ft. pil. no. xx. 
Sig.: A pill three times a day. 
The tincture of iron is, at times, beneficial in acute rheumatism. It is 
in the case of weak and pale individuals that iron is likely to be of service. 
In such subjects the same remedy is capable of acting, to a certain 
extent, as a prophylactic. It is frequently judicious in syphilis, when 
accompanied by evidence of profound deterioration of general nutrition, 
to suspend specific remedies temporarily, and place the patient upon a 
tonic course containing iron, which may be favorabljr combined with 
quinine, strychnine, or hoang-nan. In the so-called gonorrhoeal rheuma- 
tism, iron will generally be found advantageous. Hecquet for nearly 
twenty years has used the bromide of iron in nervous affections, and Da 
Costa found it useful in chorea. Anaemic epileptics are benefited by iron, 
which may be very appropriately given in the form of the bromide and 
combined with potassium bromide, as:— 
R Potassii bromidi, 3vj. 
Syrupi ferri bromidi, f3vj. 
Tincturae cliiratae, 
Elixir, simplicis, aa f S-j. 
Aquae cinnamomi, . q. s. ad f^vj. 
M. Dose, a tablespoonful three times a day. 
The following combinations containing iron may be emplo}~ed with 
good effect in gonorrhoea and syphilis :— 
R Pilulae ferri iodidi, .......... 3j. 
Abstracti ignatiae, 
Extracti belladonnae ale., aa gr. ij. 
M. et ft. pil. no. xxx. 
Sig.: From four to six pills a day, in gonorrhoeal rheumatism and in gleet. 
II Ferri phosphatis, 
Saloli, ........... aa gr. cl. 
Terebenae, f3ij. 
M. et ft. capsulae no. xxx. 
Sig.: Three to six capsules a day, in gonorrhoea, gonorrhoeal rheumatism, and cystitis. 631 
FERRUM. 
Ferri et potassii tartratis, 3ij. 
Acidi arseniosi, gr. j. 
Extracti erythroxyli, 3j. 
M. et ft. pil. no. xl. 
Sig.: Two pills three times a day, in syphilis. 
Liquor, ferri malatis, 
Aquae cinnamomi, 
Glycerini, aa f^j. 
M. Sig.: One to two teaspoonfuls in water three times a day, for syphilis with irritable 
stomach. 
Ferri lactatis, gr. xl. 
Extracti cannabis Indicae, gr. iss. 
Extracti cascarae sagradae, gr. iij. 
M. et ft. pil. no. xij. 
Sig.: A pill three or four times a day, in syphilis. 
Syrup, ferri iodidi, f§ij. 
Extracti hoang-nan fl., Nil. 
Aquae cinnamomi, f§j. 
M. Sig.: A teaspoonful three times a day, for infantile syphilis. 
Hysteria, especially when associated with antenna and amenorrhoea, 
is improved by the systematic administration of iron. Certain cerebral 
disorders depend more or less immediately upon anaemia, as some forms 
of puerperal mania and the insanity of lactation ; chronic mania and 
melancholia, also, are not infreqnentl}' due to impoverishment of the 
blood. In all these cases the tincture of the chloride of iron is a valuable 
remedy. The continued use of iron is very beneficial in rachitis. In 
this disease a combination of the phosphate of iron and phosphate of 
calcium is especially advantageous. 
Ferri phosphatis, 
Calcii phosphatis, aa 3ij. 
Extracti nucis vomicae, gr. v. 
01. eucalypti, hlv. 
M. et ft. pil. no. xl. 
Sig.: Two pills three times a day. 
The styptic preparations of iron, given internally, are useful in 
haemorrhage. A drop or two of the nitrate or subsulphate solution, 
given in ice-wmter and frequently repeated, will usually check bleeding 
from the stomach; 5 to 10 drops of the tincture given upon shaved ice 
every half hour is recommended in the haemorrhagic vomiting of yellow 
fever. The tincture of the chloride is an excellent in haemor- 
rhage from the bowels or kidneys, and in purpura kaemorrhagica. Iron 
is useful, likewise, in the treatment of menorrhagia. Profuse discharges 
from mucous membranes, due to chronic inflammation, are restrained by 
the exhibition of iron, which acts as an astringent and at the same time 632 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
favorably modifies the nutrition of the cells. Chronic diarrhoea and 
dysentery, chronic bronchitis, prostatorrhoea, gleet, and leucorrhoea are 
ameliorated by a chalybeate course. Dilatation of the stomach, de- 
pendent upon or connected with anaemia, is sometimes improved by the 
administration of iron, and, owing to its beneficial effect upon the 
mucous membrane, the syrup of iron is useful in the treatment of thread- 
worms. (A drachm of the tincture to half a pint of water is a good rectal 
injection when these parasites are present.) By maintaining the quality 
of the blood and promoting nutrition, iron is of service in phthisis and 
emphysema. Affections of the heart are notably improved by this 
remedy. In fatty degeneration, dilatation, and valvular disease, iron is 
demanded, in order to maintain the quality of the blood and the nutrition 
of the heart and to promote compensatory growth. The anaemia and 
indigestion of Bright’s disease also receive benefit from this remedy, 
especially in the form of the tincture of the chloride or acetate. The 
nocturnal incontinence of urine in children often yields to iron. This 
is especially true of strumous children, for wdiom the syrup of the iodide 
is the best preparation. Iron is remedial in spermatorrhoea when that 
affection is the result of anaemia and relaxation. Both amenorrhoea and 
dysmenorrhoea are often due to impoverished blood, and, when this is 
the case, are best treated by iron. The menstrual irregularity, anaemia, 
and neurasthenia so often seen in overworked and underfed women in 
our great cities are conspicuously benefited by the administration of 
the “ four chlorides,” as recommended b}T Professor Goodell. The com- 
bination may be made as follows :— 
Tinct. ferri chloridi, f3iiss. 
Hydrarg. chloridi corrosiv., gr. ij. 
Liquor, arsenici chloridi, f3iiss. 
Acid, hydrochlorici dilut., f3v. 
Syrup, simplicis, q. s. ad l§iv. 
M. et ft. sol. 
Sig,: Teaspoonful in water three times a day. 
The vasomotor disturbances incident to the menopause are often 
relieved by full doses of the tincture of iron, given several times a day. 
Phagedsena usually occurs in dissipated and debilitated individuals, and 
iron internally materially assists the action of the appropriate topical 
applications. 
Special Applications.—Among the new preparations are the solutions 
of ferrous malate and of dialyzed iron, both of which cause very little 
disturbance and rarely constipate. That the latter does exert astringent 
effects, however, may be inferred from the fact that Dr. W. Judkins has 
found it a useful remedy in the diarrhoea of childhood. Lsevulose ferride 633 
FERRUM. 
is another very eligible preparation of iron, differing, in man}'- respects, 
from the others. It is of alkaline reaction, agreeable to the palate and 
the stomach, and, it is said, can be mixed with the ordinary fluid extracts 
and tinctures without causing chemical union between the iron and the 
tannin and the formation of insoluble tannates. The albuminate of iron 
is an aromatic, reddish-brown, alkaline solution, which is said to be more 
readily assimilable than other iron-salts, less frequently the cause of gas- 
tric disorder, and is promptly assimilated, causing rapid increase in the 
globular richness of the blood. It may be given in milk (Dumont). Dr. 
J. A. Ouckterlony* finds it especially serviceable when anaemia and de- 
bility are associated with weak and irritable digestive organs. The reduced 
iron, or Quevenne’s iron, is in such a minute state of subdivision that it 
is readily acted upon by the acid of the gastric juice, and generally 
agrees with the stomach. As it is tasteless, it may be given to children 
in the form of chocolates, each containing 1 grain, and thus forms an 
excellent tonic for anaemic and poorly-developed children. When used 
for its systemic effect, small doses are as efficient as large ones; it is best 
given when digestion is active,—about half an hour after meals. 
Ferri reducti, gr. xl. 
Sodii arseniatis, gr. j. 
Abstract, ignatise, . gr. v. 
Ext. gentianse, gr. xx. 
M. etft. pil. no. xx. 
Sig. : Take one three times a day, after meals, as a general tonic for an adult. 
It is well to bear in mind that the prolonged administration of iron 
is liable to cause intestinal concretions. 
The diuretic action of the tincture of the chloride is aided by saline 
combination. Thus, in chronic Bright’s disease of the kidneys with 
oedema, we may give :— 
Tinct. ferri chloridi, 
Acid, phosphoric, dilut., aa f3ij. 
Glycerini, f§j. 
Liq. ammonii acetatis, q. s. ad f§vj. 
M. Sig.: A tablespoonful three or four times daily in dropsy attending Bright’s 
disease or pregnancy. 
Instead of this, we may order the officinal mixture of the acetate of 
iron and ammonium (Basham’s mixture), or the following:— 
Tr. cantharidis, f3j. 
Tr. ferri chloridi, f §ij.' 
M. Sig.: Give twenty to thirty drops, well diluted, four times daily, to be taken 
through a glass tube, in gleet. 
The syrup of the iodide of iron is valuable in strumous skin diseases, 
* Communication to Louisville Clinical Society, October 22, 1889. 634 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
in conjunction with codliver-oil. The same remedy, alone or in conjunc- 
tion with codliver-oil, is of undoubted efficacy in the treatment of 
enlarged strumous glands prior to the occurrence of caseous degenera- 
tion. In erysipelas, comparatively large doses of the tincture of the 
chloride are well borne (Tl|xl-f5j every two hours) and exert almost a 
specific effect, rapidly checking the course of the disease. 
FICUS (U. S. P.)—Fig. 
Pharmacology.—The fig-tree is a native of the south of Europe and 
is cultivated in the southern part of the United States. The officinal 
part is the dried fruit, or, rather, the fleshy receptacle of Ficus carica 
(Urticaceae), bearing fruit upon its inner surface. Figs are used as food, 
and contain 62 per cent, of sugar, with gum, fat, salts, etc. Confection 
of senna contains 12 per cent, of figs. 
Therapy.—Figs are slightly laxative, and may be used as a dessert 
to correct a tendency to constipation, especially in children. The seeds 
act mechanically in stimulating peristalsis. Split open and heated, they 
may be used, particularly in the mouth, to fulfill the indications of a 
poultice. 
FCENSCULUM (U. S. P.).—Fennel-Seed. 
Preparations. 
Oleum Faeniculi (U. S. P.).—Oil of Fennel, jDose, Hfv-xv. 
Aqua Fceniculi (U. S. P.).—Fennel-Water. Dose, f3ii-§j. 
Spiritus Faniculi.—Spirit of Fennel. Dose, f'3ss-j. 
Pharmacology and Therapy.—The fruit of Fceniculum vulgare (Um- 
belliferae) contains an agreeable volatile oil (3 per cent.), which is used as 
a flavoring and carminative. It is an ingredient in the compound infu- 
sion of senna, compound licorice-powder, and compound spirit of 
juniper. Fennel-tea (infusion) is used to relieve colic in infants and in 
dysmenorrhoea. The oil may be added to purgative medicines for the 
purpose of preventing griping. Fennel has been thought to have an 
influence in promoting the secretion of milk. 
FRANGULA (U. S. P.).—Frangula, Buckthorn. 
Preparations. 
Extractum Frangulce Fluiclum (U. S. P.).—Fluid Extract of Frangula. Dose, f3ss-j. 
Extractum Frangula.—Extract of Frangula. Dose, gr. iii-viij. 
Pharmacology.—The bark of Rhamnus frangula (Rhamnacese), col- 
lected at least one year before being used. It is a European species of 
a plant of which this country has a valuable variety in the California 
buckthorn, or Cascara sagrada. (See Rhamnus Purshiana.) It contains 
a lemon-yellow, odorless, and tasteless glucoside, Frangulin for rhamno- 
xanthin), insoluble in water, but soluble in alcohol or ether. The recent FRANKENIA. 
635 
bark contains a gastro-intestinal irritant, which is lost or modified by 
age, and therefore it is directed that only bark that lias been dried for a 
year shall be used. Old bark contains Emodin, probably the most valu- 
able constituent. The fluid extract is made with dilute alcohol, and 
better represents the bark than the preparations made simply with water, 
as the decoction to 16) or the extract. 
Therapy.—Frangula is a good laxative or purgative, resembling 
senna in its action. It can be used during pregnancy and is improved 
byr the addition of a small amount of some aromatic to prevent griping. 
FRANKENIA.—Frankenia, Yerba Reuma. 
Pharmacology and Therapy.—A California plant, the Frankenia 
grandiflora (Frankeniacem), is recommended as a mild astringent. It is 
best given as a fluid extract, made with dilute alcohol, in diseases of the 
mucous membranes, as catarrh, leueorrhcea, gonorrhoea, etc. Dose, 
npx-xv. 
FRASERA.—Frasera, American Coiumbo. 
Pharmacology and Therapy.—The root of Frasera Walteri (Gentian- 
acese) contains a bitter principle, Geniiopicrin, and a yellow, crystal- 
lizable substance, Gentisic acid. It is used like gentian and other vege- 
table bitters. The fluid extract (alcoholic) is the best preparation. Dose, 
npxxx-l‘3j, several times daily, as a bitter tonic and gastric stimulant. 
FUCHSIN.—Fuchsine, Rosaniline Hydrochlorate. 
Pharmacology and Therapy.—A derivative of aniline, of special 
interest from the beautiful magenta-red solution which its greenish 
crystals make with water. Like other preparations of this group, it may 
be contaminated with arsenic. When administered internally, it colors 
the urine and the saliva ; and also the fluids of the body, since the vision 
is affected (chromatopsia). It is claimed to have some influence over 
chronic kidney disease and that some cases of albuminuria have been 
arrested by it (given in doses of gr. ss-iv daily, with some vegetable 
extract). 
FUCUS VESICULOSUS.—Fucus, Bladder-Wrack, Gulf-Weed. 
Pharmacology and Therapy.—Fucus vesiculosus is an alga, or unicel- 
lular plant, growing to immense size, forming masses of sea-weed in the 
Atlantic Ocean, found principally in the Gulf-stream. It occurs in dried 
pieces of dark-brown or greenish color, with a disagreeable, fishy odor, 
and a mucilaginous, bitter, sea-water taste. It contains mucilage, a bitter 
extractive, small amounts of iodine and bromine, with chlorides, phos- 
phates, etc. It is supposed to be alterative and to have the power of 
reducing obesity, probably from the observation that pigs feeding upon 636 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
it in Ireland do not fatten. It has been used with some success in 
enlarged scrofulous glands, bronclioeele, and psoriasis. The decoction 
(1 to 16) may be used before meals to take away the appetite for food, 
or if used warm it acts as an emetic. The fluid extract and solid extract 
are irrational preparations ; the only form in which to obtain the effects 
of the plant is the recent decoction. 
GALANGA.—Galanga. 
Pharmacology.—The Alpinia officinarum (Zingiberaceae) is a native 
of China, where the root is prized as a medicine. It is aromatic, resem- 
bling ginger and anise, and contains a volatile oil and an acrid resin. 
Galanga is stimulating and carminative, resembling ginger or cubeb. 
It is an ingredient in the powder for colds or catarrhs, “ catarrh-snuff,” 
and is also used in lozenges for pharyngitis and coughs. 
GALBANUM (U. S. P.).—Galbanum. 
Preparations. 
Emplastrum Oalbani (U. S. P.).—Galbanura-Plaster. 
Pilulce Galbani Composites (U. S. P.).—Compound Galbanum Pills (containing galba- 
num, gr. iss ; myrrh, gr. iss ; asafoetida, gr. ss). Pose, ii-iij. 
Pharmacology.—Galbanum is a gum-resin from Ferula galbaniflua, 
a native of Persia, and probably from other allied plants (Umbelliferae). 
It contains a volatile oil (6 to 9 per cent.), resin (60 to 67 per cent.), and 
gum (19 to 22 per cent.). The resin contains sulphur. By fusion with 
caustic potash, galbanum produces resorcin. 
Therapy.—As a local application, it is stimulant, and the plaster is 
used as a counter-irritant and resolvent over old swellings. Asafoetida 
may be combined with it, as in the officinal asafoetida plaster. Internally, 
it is an expectorant and antispasmodic. The compound pills of galba- 
num may be used in chronic bronchitis ; also in chronic rheumatism and 
rheumatic affections. Some emmenagogue power has been attributed to 
the compound pills of galbanum. 
GALLA (U. S. P.).—Galls, Nutgall. 
Preparations. 
'tindura Gall® (U. S. P.).—Tincture of Galls (20 per cent.). Pose, f3ss-j. 
Unguentum Gallce (U. S. P.).—Ointment of Galls (10 per cent.). 
Pharmacology.—Galls are excrescences on the oak, Quercus lusi- 
tanica, Infectoria (Cupuliferae), caused by the punctures and 
deposited ova of the gall-fly, Cynips gallae tinctoria (class, Insecta; 
order, Ilymenoptera). Galls are hard, irregularly-spherical bodies, 
heavy and brittle. Externally, they are dark-green or gray ; internally, 
yellowish-gray and dark in the centre, with a central cavity. The GAULTHERIA. 
637 
important constituents are tannic acid (40 to 75 percent.) and gallic acid 
(2 to 3 per cent.). The Aleppo galls are the best; light-colored, spongy 
bulbs are inferior. Their preparations are incompatible with metallic 
salts and generally form insoluble precipitates with alkaloids. 
The powdered galls are very astringent locally to the skin and to 
the gastro-intestinal mucous membrane. Stockman doubts.if they exert 
any astringent effect in the blood or by systemic action; any such action 
he considers as merely reflex, from the effect upon the stomach. 
Therapy.—In the form of ointment, galls are used as an application 
to haemorrhoids; a drachm of powdered opium to each ounce of gall 
ointment is a good addition for this purpose. Nutgall ointment is also 
a useful dressing to indolent ulcers, to eczema of the scalp after the 
scales have been removed, to herpes, fissured nipples, chilblains, and 
alopecia circumscripta. It is also serviceable in prolapse of the rectum. 
The tincture of galls may be used, diluted with water, as a wash or 
gargle ; but, for internal use, gallic or tannic acid (see pages 373 and 394) 
are preferable. An infusion or decoction is sometimes made use of as 
an enema in diarrhoea and dysentery. The aromatic syrup* of galls 
(containing galls, cinnamon, ginger, brandy, and sugar) is a pleasant 
astringent for children (dose, t^xxx-3j). 
GAULTHERIA (U. S. P.).—Partridge-Berry, Wintergreen, Tea-Berry. 
Preparations. 
Oleum Oanltlierice (U. S. P.).—Oil of Gaultheria. Dose, Iflii-xx. 
Spiritus Oaultherice (U. S. P.).—Spirit of Gaultheria (3 per cent, in alcohol). For 
flavoring. 
Pharmacology.—The Gaultheria procumbens (Ericaceae) is a small 
plant growing in the woods in North America; the leaves are officinal; 
they contain a volatile oil, Arbutin, Urson, Ericolin, tannic acid, etc. The 
taste is aromatic, slightly bitter and astringent; the flavor is agreeable. 
The volatile oil consists principally of Gaultherilene and methyl salicylate 
(90 per cent.), which yields a pure salicjdic acid. The oil of sweet-birch 
is frequently sold for oil of gaultheria and is chemically identical with it, 
according to Proctor and Kohler. It is sometimes fraudulently adulter- 
ated with oil of sassafras. 
Therapy.—The oil of gaultheria is antiseptic and antipyretic. It 
may be used in doses of TTLx-xx in articular rheumatism as a substi- 
tute for salicylic acid. The decoction of the leaves or a fluid extract 
may be used in bowel disorders as an astringent. The infusion is in 
some parts of the country used as a substitute for tea at the table. It 
is also used as a galactagogue and emmenagogue. It is a good addition 
to liniments for rheumatic pains and swollen joints. 638 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
GELSEMIUM (U. S. P.).—Gelsemium, Yellow Jasmine. 
Dose, gr. ii-xx. 
Preparations. 
Extradum Oelsemii Fluidum (U. S. P.).—Fluid Extract of Gelsemium. Dose, Nlii-x. 
Tinctura Gelsemii (U. S. P.).—Tincture of Gelsemium (15 per cent.). Dose, Hlv-xx. 
Gelsemina.—Gelsemiue. The active principle. Dose, gr. 
Pharmacology.—The rhizome and rootlets of Gelsemium sempervi- 
rens (Logan iaceae), a climbing-plant, growing in the southern portion of 
the United States, contain an alkaloid, Gelsemine, which is amorphous, 
bitter, soluble in alcohol and ether, sparingly in water, and a volatile oil, 
resin, gelseminic acid, etc. 
Physiological Action.—It has no special local action beyond slight 
sedative influence or astringency. Internally, it is a powerful motor 
depressant and sedative, motion being affected before sensibility in warm- 
blooded animals. It acts especially upon the centres in the spinal cord 
and medulla. Small doses occasion injection of the conjunctive, pain in 
the eyelids, contraction of pupils (if locally applied or in very large doses 
it may cause dilatation), with drooping of the upper lid, or, more de- 
cidedly, vertigo and confusion of vision. Larger doses exert a paralyzing 
influence upon the spinal cord; the power of voluntary movement is pro- 
gressively lost, numbness and staggering gait being observed as prelimi- 
nary symptoms. Reflex irritability is lowered, the pupils dilate, and the 
sensory columns of the cord become paralyzed. No brain symptoms are 
produced directly, but the cerebral functions may be disturbed by the 
accumulation of carbonic acid in the blood, the result of paralysis of 
muscles of respiration. Death results from asphyxia. In animals con- 
vulsions may appear. Little effect is observed upon the heart directly; 
the pulse-rate is lessened by lowering the excitability of the excito-motor 
ganglia of the heart (Ott) and the arterial pressure by diminution of 
vasomotor tonus. It produces a decided lowering of the bodily tempera- 
ture and is diaphoretic. There are languor, muscular depression, and 
prostration. 
Poisoning.—In cases suffering with toxic symptoms from an over- 
dose, diffusible stimulants, hot drinks, friction to the surface of the body, 
and artificial respiration are useful, after evacuation of the contents of 
the stomach. Hypodermatic injections of morphine and atropine are 
antagonistic to gelsemium. Tannic acid and caustic alkalies and their 
carbonates are chemically incompatible. In case of poisoning with 
gelsemium, the stomach should be promptly emptied by an emetic or 
the stomach-pump. External heat should then be employed, together 
with cardiac and respiratory stimulants, as digitalis, ammonia, atropine, 
and strychnine. GENTIANA. 
639 
Therapy.—Gelsemium ma}7 be given to alia}7 excessive nervous irri- 
tability, as in neuralgia, ovaralgia, tic douloureux, and in some cases of 
myalgia. Gelsemium will often allay the pain of dental neuralgia. In 
facial neuralgia, comparatively large doses of the tincture (npx-xx),eveiy 
two hours, are well borne. It has also been proposed as a remedy for 
tetanus, and might be useful in hydrophobia to control the spasms, 
llinger has found the tincture, in 10-minim doses thrice daily, beneficial in 
some cases of Meniere’s disease. The same preparation,in 5-drop doses 
every quarter of an hour, will sometimes arrest an attack of bilious colic. 
In the spasmodic stage of whooping-cough, in asthma, laryngismus 
stridulus, and torticollis, gelsemium has given relief. It is of service 
in migraine and in headache from eye-strain, in maniacal paroxysms, 
mania a potu, and insomnia. Certain fevers, notabl}’ cerebro-spinal and 
remittent, are benefited b}T the administration of gelsemium. When 
acute eczema is accompanied by considerable constitutional reaction 
gelsemium may be given with marked advantage. This agent, likewise, 
especially when administered at bed-time, relieves the itching of eczema. 
It allays the pain of dysmenorrhoea, favors dilatation of a rigid os in labor, 
and quells after-pains. It is of considerable service in the treatment of 
haemoptysis. It is used in small doses as an antispasmodic in coughs, 
and in pneumonia and pleurisy. It is safer, on account of possible idio- 
syncrasy, to begin with very small doses of the tincture or extract, and 
gradually increase until slight drooping of the eyelid shows the begin- 
ning of full physiological effect. Gelsemium may be employed locally in 
the treatment of prurigo in the form of fluid extract, diluted. It has 
been also used as a mydriatic in eye practice. 
GENTIANA (IT. S. P.).—Gentian. 
Dose, gr. viii-xxx. 
Preparations. 
Extractum Gentiance (U. 8. P.).—Extract of Gentian. Done, gr. iii-xv. 
Extractum Gentiance Fcuidum (U. 8. P.).—Fluid Extract of Gentian. Dose, 01xxx-f3j. 
Tinctura Gentiance Composita (U. S. P.).—Compound Tincture of Gentian contains 
gentian 8, bitter orange-peel 4, cardamom 2, dilute almond q. s. ad 100 parts). Dose, f3i-iv. 
Elixir Gentiance Ferratum.—Ferrated Elixir of Gentian. Dose, f3i-iv. 
Elixir Gentiance et Ferri Phosphatis of the National Formulary contains phosphate of 
iron, gr. viij ; gentian, gr. xvj; in each f§j. Dose, f3i-iv. 
Infusum Gentiance Composition.—Compound Infusion of Gentian (contains gentian 10, 
bitter orange-peel 2.50, coriander 2.50, in dilute alcohol, 1 to 10, q. s. ad 320 parts). Dose, 
f^ss-j. 
Pharmacology.—Gentian is the root of Gentiana lutea (Gentianaeeae), 
a native of Europe. Many species are indigenous, as the Gentiana 
puberula, Gentiana saponaria, Gentiana Andrewsii, and the beautiful 
Gentiana crinita, which differ in therapeutical effects only in degree from 640 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
the officinal gentian, and may be employed for like purposes. Both water 
and alcohol dissolve the active principle, which is very bitter, and appears 
to be a glucoside, Gentiopicrin, combined with gentisic acid, a coloring 
ingredient. There is no tannin present; although the preparations are 
darkened by most of the iron salts (the citro-chloride is excepted), due 
to a change in this coloring matter, probably. Of the American varieties 
a decoction or infusion may be used, although a fluid extract would better 
represent the drug. 
Physiological Action.—Gentian is a simple bitter, with little, if any, 
astringency, and has the same physiological action as others of this class. 
When combined with an alkali its local effects upon the stomach are 
much increased. Gentian has been thought to exert a slight stimulant 
effect upon the liver. The chalybeates are synergistic, with reference to 
general tonic effects. It enjoys a reputation as a succedaneum for cin- 
chona, as an antipyretic and antiperiodic, though to a less marked degree ; 
its actions have not been as much studied as those of the latter. No 
toxic effects have been noted. 
Therapy.—As a stomachic tonic, the preparations of gentian are 
deservedly esteemed in cases of weak stomach during convalescence, 
catarrhal gastric disorder in infants, or ordinary atonic dyspepsia:— 
R Sodii bicarb., 3iv. 
Infusi gentianae comp., f§vj. 
M. Sig.: A tablespoonful or two half an hour before meals. 
The compound infusion of gentian is a good vehicle for adminis- 
tration of potassium iodide in cases where its tonic effects would be 
useful. Combinations of gentian and iron are numerous, but none are 
used so much as the ferrated tincture of gentian (not officinal) :— 
R Tincturae gentianae, f§iv. 
Tiucturae ferri citro-chlorid. (N. F.J, f§j. 
M. Sig.: Two teaspoonfuls after each meal. 
The gentian mixture officinal in the British Pharmacopoeia is, accord- 
ing to Whitla, excelled by few remedies in the treatment of the vomiting 
of pregnancy, especially when combined with a mineral acid. 
The infusion, or decoction, is us’eful as a stomachic in gastric dis- 
orders associated with gout or malarial fever, or the compound tincture 
may be used where the alcohol is not objectionable :— 
R Tincturae cinclionae, 
Tr. cardamom, comp., aa f^j. 
Tr. gentianae comp., * f§ij. 
M. Sig.: A dessertspoonful to a tablespoouful in malarial dyspepsia and debility 
with loss of appetite. GERANIUM. 
641 
Gentiana Quinquefolia.—The five-flowered gentian is common in the 
United States. The whole plant is bitter, and may be given in infusion, 
but a fluid extract would be better (dose, ntv-xxx). It may be used for 
the same purpose as the preceding. 
GERANIUM* (U. S. P.).—Geranium, Cranesbill. 
Dose, gr. xv-5j. 
Preparations. 
Extraction Oeranii Fluidum (U. S. P.).—Fluid Extract Gentian. Pose, Hlxxx-f3j. 
Extraction Geranii.—Extract of Geranium. Dose, gr. i-v. 
Pharmacology.—An indigenous plant, found in the -woods from 
Canada to Florida, of which the rhizome only is officinal. The spotted 
geranium, as it is called, or Geranium maculatum (Geraniacene), contains 
tannic (13 to 17 per cent.) and gallic acids, which are its most important 
constituents, besides some resin, gum, starch, pectin, coloring matter, etc. 
As it imparts its virtues to both water and alcohol, it may be used hi de- 
coction and tincture, as well as in the officinal fluid extract, which is 
made with dilute alcohol. 
Physiological Action and Therapy.—Geranium improves the appetite 
and digestion and promotes nutrition. As it is decidedly astringent, the 
drug may be used, in fine powder, as a st}qitic in haemorrhages after 
extraction of a tooth, epistaxis, etc. Its astringency renders it an excel- 
lent haemostatic. The writer has obtained good results from the local 
application of the fluid extract, diluted with 3 or 4 parts of water, in 
buccal ulcer, fissure of the anus, and metrorrhagia. The same treatment 
promptly arrested a haemorrhage from the urethra and at the same time 
cured a rebellious gleet which had been in existence for two years. 
Geranium makes a useful throat- and mouth- wash :— 
II Potassii chloratis, 3ij. 
E xt. geranii fl., f3 vj. 
Glycerin i, f^j. 
Aquae rosae, q. s. ad f3vj. 
M. Sig.: Add a tablespoonful to two tablespoonfuls or more of water, and use 
as a gargle. 
In catarrhal inflammations, as an injection in gonorrhoea, gleet, 
and leucorrlioea, the decoction is more serviceable, according to Prof. L. 
Johnson, than a simple solution of tannin, doubtless from the fact that 
there is present mucilaginous material, -which acts as a demulcent. The 
fluid extract is useful internally in diarrhoea. In infantile diarrhoea, the 
decoction may be very acceptably administered in milk, which covers its 
taste. It is a valuable remedy in the early stages of phthisis, diminish- 
ing cough and expectoration, reducing the fever and pulse-rate, checking 
*See paper by author in the Atlanta Medical and Surgical Journal, October, 1889. 642 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
night-sweats and haemoptysis. Under its use the appetite improves and 
the patient gains in weight. In a rapid case of phthisis, accompanied 
b}7 profuse night-sweats, complete loss of appetite, and a severe, harass- 
ing cough, marked temporary relief was obtained by the following- 
prescription :— 
01. menth. pip., ITlxx. 
Ext. gerauii fl., f^iss. 
Yini Portensis, f§j. 
M. Sig\: Teaspoon ful every third hour. 
Geranium is mild and unirritating, and especially suited to the later 
stages of diarrhoea and dysentery in children. It has also been employed 
in internal haemorrhages, with good results. 
GEUM.—Avens. 
Preparation. 
Extractum Gei Fluidum.—Fluid Extract of Avens. Dose, Hlxx-f3j. 
Pharmacology.—Two species of Geum (Rosaceae) are used in medi- 
cine,—the Geum urbanum, or European avens, and the Geum rivale, or 
water avens, a native of North America. In each, the root is the part 
possessing medicinal properties. Geum contains a bitter principle called 
Gein by Buchner, a little volatile oil, a large proportion of tannic acid 
(10 to 40 per cent.). A recent infusion or decoction would best represent 
the physiological action of geum, though a fluid extract made with dilute 
alcohol is also used. 
Therapy.—Avens is tonic and astringent. It is chiefly useful in 
relaxation of mucous membranes. An infusion made with boiling water 
is given for diarrhoea. 
GILLENIA.—Gillenia, American Ipecacuanha. 
Dose, gr. v-xxx. 
Preparation. 
Extradum Gillenice (Trifoliatce) Fluidum.—Fluid Extract of Gillenia (Trifoliata). 
Dose, Hlv-xxx. 
Pharmacology.—The Gillenia trifoliata, or Indian physic, and Gille- 
nia stipulacese, which is a species closely resembling it, were formerly 
officinal, but have been dropped from the pharmacopoeia, as they are 
very inefficient substitutes for ipecacuanha. The}7 belong to the natural 
order Rosaceos, and are indigenous to this country, growing from Canada 
to Georgia. The part used is the root, which contains Gillenin, a peculiar 
bitter principle, to which its therapeutic properties are due. It also 
contains tannic acid, gum, resin, starch, etc. 
Physiological Action and Therapy.—Gillenia is an active emetic, and 
in small doses is thought to resemble ipecacuanha as a tonic and chola- 
gogue, and is also diaphoretic and expectorant. GLYCERINUM. 
643 
It lias been used as a substitute for ipecacuanha, as an emetic, stom- 
achic tonic, and diaphoretic, and in domestic practice in dyspepsia, etc. 
GLYCERINUM (U. S. P.) — Glycerin. 
Dose, f 5i—iv- 
Preparations. 
Glyceritum Amyli (U. S. P.).—Glycerite of Starch (glycerin 90, starch 10 parts). For 
external use. 
Glyceritum Vitslli (U. S. P.).—Glyconin (glycerin 55, egg-yelk 45 parts). Fox- 
external use. 
Glyceritum Acidi Tannici.—Glycerite of Tannic Acid (gr. xx-lx in f§j). For 
external use. 
Glycerolum Pepsini.—Giycerole of Pepsin (If j = saccharated pepsin, gr. ij). Pose, 
Olii-x. 
Glyceritum Pepsini Vitulini.—Glycerite of Calf-Pepsin. Dose, lfxxx-f3j. 
Boro-Glyceridum.—Boro-Glyceride (boric acid 62, glycerin 92 parts). 
Nitro-Glycerinum.—Nitro-Glycerin, Glonoin. Dose (in solution or tablet), gr. 
Glycerin is also a constituent in several extracts, fluid extracts, pill 
masses, mucilage of tragacanth, solution of pepsin, and other pharma- 
copoeia! preparations. 
Pharmacology.—Officinal glycerin is a liquid obtained by the decom- 
position of fats or fixed oils, and containing not less than 95 per cent, of 
absolute glycerin. In the process for making lead plaster, the olive-oil, 
being decomposed by the lead oxide, yields lead oleate and free glceryin. 
It is also produced in the ordinary process of soap-making, being a con- 
stituent of the waste, from which it is now recovered in large quantities 
for commercial purposes. A purer glycerin is obtained by decomposing 
fats by steam, or superheated water,and distillation. A superior article 
is made from vegetable fats by Messrs. Proctor and Gamble, of Cincin- 
nati, which is best adapted for medical use. Pure glycerin is a trihydric 
alcohol, is clean and colorless, resembling syrup, oily' to the touch, with- 
out odor, very sweet, slightly warm to the taste, neutral in reaction, hygro- 
scopic, soluble in all proportions in water or alcohol, and insoluble in 
ether, chloroform, benzole, or fixed oils. Under certain conditions it be- 
comes a mass of dense, brilliant crystals, but may be cooled to — 40° C. 
without congealing, only becoming more viscid. Treated with strong- 
nitric acid, it forms glonoin, or nitro-glycerin,—a substance of powerful 
explosive properties. (See page 439.) 
Physiological Action.—As it has an affinity for water, glycerin ab- 
sorbs the latter from mucous surfaces and excites secretion. It is irri- 
tating in its concentrated state to both skin and mucous membrane, being 
entirely different in its effects from oils or fats, although, when diluted, it 
keeps the skin moist and prevents cracking or chapping. Glycerin is 
absorbed by the skin and passes into the blood. It has very little effect 
upon the stomach. A certain amount is absorbed, with the effect of 644 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
increasing nutrition and improving the appetite; it is slightly laxative, 
and is said to lessen the excretion of urea, though, according to the ex- 
periments of Lewin, it exerts no influence upon the quantity of urea 
eliminated. Large doses have produced haemoglobinuria, owing to some 
action, as yet unexplained, upon the blood. Glycerin is considered 
antiseptic, yet Koch found that it did not destroy spores nor the 
of formed ferments, although a solution in water (1 to 3) arrests the 
action of some enzjunes (pepsin, ptyalin, emulsin), and a stronger solu- 
tion (1 to 2) prevents the action of others (myrosin, diastase, invertin), 
but preserves their activity unimpaired, and is used to preserve them 
(Wernitz). Glycerin is destructive to parasites, intestinal and external. 
It increases the action of codliver-oil, and is a solvent for some of the 
alkaloids, though not for others. Owing to its sweetness, it has been 
used as a substitute for sugar in the diet of diabetics, though saccharin 
has now largely taken its place. According to the clinical observations 
of Pavy, glycerin increases polyuria, and he therefore opposes its use as 
a substitute for sugar. It seems to augment considerably the quantity 
of glycogen contained in the liver, though it probably prevents the trans- 
formation of glycogen into sugar. 
Glycerin can be combined with admirable effect as follows:— 
II Glycerini, 
Liquor, calcis, 
Aquae rosae, aa f^ij. 
M. For excoriations, erythema, superficial burns, and scalds. 
31 Glycerini, 
Aquae hamamelidis dest., 
Aquas rosae, a a f^ij. 
M. Use on chapped face and hands, sore nipples, and haemorrhoids. 
II Glycerini, 
Aquae hamamelidis dest., aa f^iij. 
Bismuth, subnit. vel sodii bicarbonatis, 3ij. 
Acidi. carbolic!, Ifix. 
M. For erythematous or vesicular eczema, burns, and seborrhcea, especially around 
the axilla and genital organs. 
II Glycerini, 
Acidi lactici, 
Aquae rosae, aa f^ss. 
M. For freckles and other pigmentations of the skin. 
Glycerini, f$v. 
Creasoti, f3j. 
01. menth. pip., lfix. 
M. Valuable for catarrh, pharyngitis, and laryngitis, in the form of a spray. It can 
be mopped on the skin or sprayed over the surface for pruritus, eczema, and urticaria. GLYCERINUM. 
645 
Therapy.—Diluted with 3 parts of rose-water, glycerin is a good 
application to the hands and lips to prevent chapping during cold 
weather. Glyeonin is also used for this purpose. The same mixture is 
one of those employed in ichthyosis, after a warm-water, hot-air, or 
vapor hath, in order to protect the diseased area and aid in maintaining 
its nutrition. In more concentrated form it has been used with success 
in pityriasis, pruritus, acne, eczema, fissured nipples, or acute coryza, 
applied with a* brush or spray. In combination with collodion per 
cent.) it forms collodium elastic uni, which is less painful than pure col- 
lodion, and is a good protective for fissures and abrasions. The glycerite 
of tannic or of gallic acid is a useful astringent as an application for 
sore throat, relaxation of mucous membrane, and upon tampons to the 
cervix uteri for leucorrhoea. A pledget of absorbent cotton, saturated 
in glycerin, is an excellent application, also, in congestion of the womb, 
as, on account of its affinity with water, it provokes an abundant serous 
transudation. The glyceritum vitelli is used as a vehicle for chloroform or 
heavy powders. Glycerin alone, or with some astringent or sedative, is 
useful in preventing bed-sores. Injected into the bowels, it is a mild 
enema, and in small quantities is efficient in evacuating the lower bowel, 
and may be introduced in the form of suppositories. 
In obstruction by faecal impaction, the injection of several ounces 
into the colon, through a long tube, was successful in the hands of Dr. 
Edward Mayer, of Wilkesbarre, Pa., in saving life after failure of all 
ordinary means of relief. Glycerin administered by the mouth has a 
peculiarly soothing effect upon inflamed and painful haemorrhoids. Equal 
parts of glycerin and distilled water may be used as an application to 
keep the tongue moist in typhoid and other fevers; and a dilute solution 
may be sipped to moisten the throat during an attack of tonsillitis or 
pliarjmgitis, although the direct application by spray or brush should not 
be omitted. The red, dry, and glazed mouth of advanced phthisis is 
moistened by the use of a wash of glycerin and water. Reflex cough is 
often allayed by the application of glycerin to the fauces, and, adminis- 
tered internally in drachm doses, the same agent may prove of advantage 
in the cough of phthisis. It may be given to infants as a laxative in com- 
bination with oil. Administered alone, it has been used for the same 
purposes as codliver-oil, but is less efficient, although possessing some 
nutritive properties. It is the best remedy in cases of trichiniasis, ad- 
ministered in tablespoonful doses, as successfully used bjT Dr. James M. 
Barton ; and is used as a laxative in cases of piles. Some forms of indi- 
gestion are improved by its administration after meals ; and it is the 
best solvent and preservative for pepsin, either from the pig or the calf, 
the latter having been introduced by Dr. Woodbury as the special digestive 646 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
ferment for infants or adults upon a milk diet. In acidity of the 
stomach and flatulence, glycerin in drachm doses two or three times a 
day is beneficial. It is often extremely useful in improving the appetite. 
Glycerin given in the form of suppository is often serviceable in relieving 
and overcoming constipation, especially when the lower bowel is inactive. 
Griffith has employed it with marked effect in the treatment of constipa- 
tion. An enema of glycerin and infusion of flaxseed (1 to 4) allays tenes- 
mus in cases of acute dysentery (Bartholow). The glycerite of starch is a 
bland material, which can be impregnated with various medicaments, 
astringents, etc., for application to the eye or to the skin. Glycerin is a 
good vehicle for alkaloids, and it is thus used in various diseases of the 
ear, in abnormal dryness of the external auditory canal, and impaction 
of cerumen. . Boroglyceride and its uses are discussed on pages 366 
and 367. 
Glycerita.—The pharmacopoeial class of glyceritcs is limited to the 
glycerite of starch and the glycerite of egg-velk, although various other 
medicinal combinations may be made extemporaneously. The Glycerinum 
Boracis (Ph. B.), containing 20 per cent, of borax, is useful in infantile 
thrush and in facial erysipelas, applied with a camels’ hair brush. 
Glycerite of the Borate of Bismuth is recommended by Keyser as a 
good remedy in phlyctenular and scrofulous conjunctivitis. 
The urine of persons using glycerin reduces copper in Fehling’s test, 
and is liable to lead to error, being mistaken for glycosuria. This is not 
due directly to the presence of glycerin, but to a decomposition product. 
GLYCYRRHIZA (IT. S. P.).—Glycyrrhiza, Liquorice-Root. 
Dose, gr. v-5ss, in powder. 
Preparations. 
Extractum Glycyrrliizce (U. S. P.).—Extract of Liquorice (commercial). 
Extractum Glycyrrliizce Purum (U. S. P.).—Pure Extract of Liquorice. Pose, gr. v~3j. 
Extractum Glycyrrliizce Fluidum (U. S. P.).—Fluid Extract of Liquorice (made with 
aqua ammonia and dilute alcohol). Dose, lflxx-f3j. 
Mistura Glycyrrliizce Composita (U. S. P.).—Brown Mixture (pure extract 3, paregoric 
12, antimonial wine 6, spirit of nitrous ether 3, sugar 3, acacia 3, water 70 parts). Dose, f^ss. 
Trochisci Glycyrrliizce et Opii (U.S.P.).—Wistar’s Cough Lozenges (extract liquorice, 
gr. ij; ext. opium, gr. in each, with ol. anise, sugar, and acacia). Dose, j orij. 
Pulvis Glycyrrliizce Compositus (U. S. P.).—Compound Liquorice-Powder (senna 18, 
liquorice-root, powd., 16; fennel 8, washed sulphur 8, sugar 50 parts) Dose, f3i-ij. 
Glycyrrhizinum Ammoniatum (U. S. P.).—Ammoniated Glycyrrhizin (for flavoring). 
Infusum Lini Compositum (Ph., 1870).—Compound Infusion of Flaxseed (contains 
flaxseed, §ss; liquorice-root, contused, 3ij, in a pint). Dose, adlib. 
Pharmacology.—The Glycyrrhiza glabra (Leguminosae) is a native 
of Southern Europe; its root contains an amorphous, bitter-sweet glu- 
* See Medical Bulletin for June, 1890, p. 201. GOSSYPIUM. 
647 
coside, Glycyrrhizin, which is probably in combination with ammonia; 
it also contains Asparagin, sugar, resin, starch, gum, pectin, coloring- 
matter, etc. Glycyrrhizin, when acted upon by dilute acids, splits up 
into sugar and a brownish-yellow, bitter substance, Glycyrrhetin. The 
resin is also bitter. 
The ammoniated glycyrrhizin masks the taste of sulphate of quinine 
when prescribed with it in about double the quantity, but the after-taste 
is still bitter. The elixir of ammoniated glycyrrhizin is a good vehicle 
in which to administer sulphate of quinine, but no acid should be added, 
since the quinine is largely suspended and not dissolved. Liquorice 
enters into the other adjuvant elixirs for the administration of bad-tasting 
medicines. A syrup of liquorice may be used as a flavoring agent or 
as a vehicle. 
Physiological Action.—Liquorice-root is demulcent and slightly 
stimulating to the bronchial mucous membranes, and is laxative. It has 
an agreeable taste, the bitterness being masked by the sweet principle, but 
leaves an acrid taste in the fauces. The extract covers the taste of other 
remedies. The root is used as a dusting-powder and coating for pills. 
Therapy.—The compound infusion of flaxseed (Pi)., 1870) is a good 
demulcent in acute bronchitis and diarrhoea. The extract is useful in 
relieving dryness of the throat and hoarseness, especially if combined 
with chloride of ammonium. The troches contain gr. of opium, and 
may be used where an opiate is not objectionable, but are dangerous, 
since their pleasant taste leads children to take an overdose; one every 
hour is sufficient for an adult with irritable cough. 
The compound mixture is a good expectorant for bronchitis, and is 
often combined with syrup of senega and chloride of ammonium. 
In constipation,especially during pregnancy, the compound liquorice- 
powder is very valuable ; given at night on retiring, it causes one or two 
natural stools in the morning, generally without griping. Where a more 
decided effect is desired, it may be combined with an equal portion of 
compound jalap-powder. 
GOSSYPIUM (U. S. P.).—Cotton. 
Preparations. 
Gossiypii Radicis Cortex (U. S. P.)—Cotton-Root Bark. Dose, 3ss-j, in decoction. 
Extraetum Gossypii Radicis Fluidum (U. S. P.).—Fluid Extract of Cotton-Root 
Bark. Dose, f3ss-j. 
Oleum GossypiiSeminis (U. S. P.).—Cotton-Seed Oil. 
Pyroxylinum (U. S. P.).—Pyroxylin. Soluble gun-cotton (for making collodion). 
Collodium (U. S. P.).—Collodion. Pyroxylin dissolved in ether and alcohol. 
Pharmacology and Therapy.—Cotton is a native of the southern 
portion of the United States, and is the hairs of the seed of Gossypium 648 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
herbaceum (Malvaceae), and of other species of Gossypium, freed 
from adhering impurities and deprived of fatty matter. It is com- 
posed almost entirely of cellulose, and is in a mass of white, interlacing 
fibres, forming sheets of so-called carded cotton-wool. By a preliminary 
treatment with alkalies to extract the fatty matters, it becomes absorbent 
cotton, which is of great value in modern surgical practice, and has suc- 
ceeded the sponge as a dressing for wounds. Absorbent cotton may be 
treated with various agents, so as to be of special value (carbolized, 
borated, salicylated, or treated with mercuric chloride, etc.). These are 
used to exclude air from wounds, burns, etc., and afford some support, 
and may also be applied to a blister after puncture. In inflammations, 
as in acute articular rheumatism, the part may be enveloped in cotton, 
either dry or moistened with anodynes, with great comfort to the 
patient. It is also a good material for tampons, or for making an 
artificial ear-drum after perforation. Cotton is much in use as a padding 
for splints. Dr. Wliitla speaks very favorably of its use in phlegmasia 
dolens, enveloping the entire limb in a thick layer surrounded by oiled 
silk and carefully bandaged. Haemostatic cotton may be made by 
dipping absorbent cotton in a solution of chloride of iron, and afterward 
drying and picking it, or dilute Monsel’s solution may be used (1 in 24) 
and the cotton kept immersed in it until used as a tampon, in uterine 
cancer, etc. 
Pyroxylinum, or gun-cotton, is officinal only as a source of 
collodion. (See page 565.) 
The oil of the seeds is bright, pale, odorless, and free from acrid 
after-taste. It is a good substitute for olive-oil, and is frequently sold 
for it. It enters into the officinal liniments of ammonia, of lime, of 
camphor, and of subacetate of lead. In pharmacy it answers a similar 
purpose to olive-oil. 
The bark of the root of gossypium contains resin, tannic acid, and a 
red coloring matter. A solid and a fluid extract can be obtained (bqjh 
alcoholic), the dose of the former being 1 to 5 grains; of the latter, half 
a drachm to a drachm. A recent decoction is also used in the South. 
It has a special action upon the uterus, like ergot, and is employed in 
the same class of cases—in scanty menstruation, dysmenorrhoea, and 
during labor. Phillips has found it useful in haemoptysis, and in the 
West Indies it is administered in dysentery. 
GRANATUM (U. S. P.).—Pomegranate. 
Dose, 5i—ij- 
Preparations. 
Decodnm Granati.—Decoction of Pomegranate (4 to 16). Bose, f^iv-vj. 
JExtractum Granati Fluidum.—Fluid Extract of Pomegranate. Dose, f3i—ij. 649 
GRINDELIA. 
Pharmacology.—Pomegranate is the hark of the root of Punica 
granatum (Granatacese), cultivated in subtropical countries. The rind 
of the fruit and the bark of the stem, though not officinal, contain 
similar constituents, and are also useful. The liquid alkaloid, 
per cent.), is found in this plant in combination with punico-tannic 
acid, and to these the peculiar virtues of the bark are due. The tannic 
acid is largely in excess (20 to 28 per cent.). 
Physiological Action and Therapy.—Pomegranate has powerful 
astringent properties, and a decoction flavored with orange or aromatics 
is useful in sore throat or pharyngitis, and as an astringent injection for 
gonorrhoea. The special use of this agent is for the destruction of tape- 
worms, for which a wineglassful should be taken every hour for three 
hours, to be followed by a purgative dose of castor-oil. The drug itself, 
in large doses, acts both as an emetic and purgative. The pelletierine 
tannate, 15 grains (1 gramme) at a dose, in capsules, is an effective, but 
expensive, remedy. The decoction is so astringent that it may not be 
possible for the patient to take it, in which case the same result may be 
obtained by evaporating it, in a water-bath, to a pilular consistency, and 
administering the extract thus made in gelatin capsules, preceded and 
followed by a cathartic. Pomegranate has been used with success in the 
diarrhoea and dysentery of hot climates. 
GRINDELIA (TJ. S. P.)._Grindelia. 
Preparations. 
Extraction Grindelice Fluidnm (U. S. P.).—Fluid Extract of Grindelia. Dose, Hlx-f3,j. 
Ext) actum Grindelice.—Extract of Grindelia. Lose, gr. i-v. 
Pharmacology.—The leaves and flowering tops of Grindelia robusta 
(Composite), a perennial California plant, contain a volatile oil, a resin, 
and, possibly, an alkaloid. The plant possesses a balsamic odor, a warm, 
aromatic, and bitter taste. The resin is precipitated by Avater. The 
active principles are not completely extracted by alcohol, but an aqueous, 
alkaline solution has been found by Dr. W. P. Gibbons to be the most 
satisfactory menstruum. 
Physiological Action.—Grindelia creates a sensation of warmth in the 
stomach, and, in small quantities, if not too long continued, improves the 
appetite and digestion. It slows the action of the heart and lungs, and 
augments the blood-pressure. It possesses antispasmodic and expecto- 
rant qualities. Large quantities dilate the pupil, produce a hj'pnotic 
effect, and paralyze first the sensory and then the motor nervous system. 
Death occurs from paralysis of the muscles of respiration. The plant, 
however, is but feebly poisonous. It exerts some diuretic effect. 650 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Therapy.—Grindelia is an efficient local application in dermatitis, 
caused by contact with the rlius toxicodendron, or poison-ivy. Cloths 
dipped in a mixture of \ drachm or a drachm of the fluid extract to 4 or 
6 ounces of water, and laid upon the affected surface, will, in many in- 
stances, afford rapid relief. This mixture has also been advantageously 
employed upon burns and blisters. A combination with ereolin is 
likewise efficient in these conditions :— 
Extract, grindelise fid., f^ss. 
Creolini, 13ij. 
Aquae, q. s. ad f^v.—M. 
An injection of the above strength is useful in vaginitis, or, applied 
upon absorbent cotton, in pruritus vaginae. It may likewise be resorted 
to in leucorrhoea and endometritis. A weaker solution thrown into the 
urethra is of service in gonorrhoea and gleet. Diluted with water or 
glycerin, the fluid extract of grindelia is a beneficial application to chronic 
or irritable ulcers, and in these cases it is a good practice to conjoin the 
internal administration of the remedy. One part of fluid extract to four 
parts of water as a local dressing, together with the internal exhibition 
of the same preparation, has been found efficient in iritis. 
As an internal remedy the chief value of grindelia is in the treat- 
ment of asthma. The paroxysm may usually be notabty abridged by the 
administration of 20 or 30 drops of the fluid extract, repeated every 
twenty or thirty minutes. Two or three such doses will, in many in- 
stances, allay the spasm. After the attack has subsided, the medi- 
cine should be continued in order to avert recurrence. In the interval 
grindelia may very profitably be combined with other agents having 
similar power, as, for example :— 
Potassii iodidi, . 3vj. 
Liq. potassii arsenitis, f.^iss. 
Ext. grindelise fid., f§ij. 
Tinct. euphorbiae pilulif., f3v. 
Ext. yerbae santss fid., q. s. ad fjiv. 
M. et ft. sol. 
Sig.: Teaspoonful three times a day. For asthma and chronic bronchitis. 
Grindelia is eliminated in part by the bronchial mucous membrane, 
which it stimulates. It is an excellent expectorant in chronic bronchitis, 
and hence when this condition, as is so often the case, complicates em- 
physema and asthma, grindelia is no less efficacious than in [Hire nervous 
asthma. It relieves cough and promotes expectoration in chronic pneu- 
monia. It is sometimes of advantage in ameliorating the cough of 
phthisis. In shortness of breath due to anaemia, and in some cases of 
dyspnoea dependent upon valvular disease of the heart, grindelia has 651 
GUAIACUM. 
proved beneficial. In certain cases of hay fever this remedy has been 
used successfully. The paroxysms of whooping-cough are diminished in 
frequency and mitigated in severity by the administration of grindelia. 
As it escapes from the system principally by the kidneys, it exerts a 
favorable influence upon pyelitis and chronic cystitis. The dried leaves 
may be moistened with nitre solution, and, mixed with a little tobacco, 
rolled into cigarettes for use in asthma. 
Grindelia squamosa is an allied plant, considered by some as a mere 
variety of the preceding, contains similar constituents, and is used for 
same purposes, but has some reputation also for the cure of malarial 
affections. 
GUAIACUIVI.—Guaiac. 
Preparations. 
Guaiaci Lignum (U. S. P.).—Guaiac-Wood. Tlie heart-wood of Guaiacum officinale 
and of Guaiacum sanctum (Zygopliyllaeeae). 
Guaiaci Resina (U. S. P.).—Guaiac. The resin of the wood of Guaiacum officinale. 
Dose, gr. v-xv. 
Tindura Guaiaci (U. S. P.).—Tincture of Guaiac (resin, 20 percent.). Dose, ffix-f 3j. 
Tinctura Guaiaci Ammoniata (U. S. P.).—Ammoniated Tincture of Guaiac (resin 20, 
aromat. spts. of ammonia80 parts). Dose, ffix-f 3j. 
Rilulce Antimonii Composite (U. S. P.).—Compound Antimonial Pills. (Contain resin 
of guaiac, gr. i, and sulphuretted antimony and calomel, each, gr. y). 
Pharmacology.—The wood of guaiac, or lignum-vitse, enters into 
two officinal preparations of doubtful value, the compound decoction of 
sarsaparilla and the compound syrup of sarsaparilla, formerly in repute 
as alteratives, but seldom used at present except as a vehicle for potas- 
sium iodide, to cover its unpleasant taste. The resin is the most im- 
portant constituent of the wood (20 to 25 per cent.), from which it is 
obtained by heating or by boiling with water. The resin contains Guaia- 
cetic acid (10 per cent.), Guaiaconic acid (10 per cent.), Guaiacic acid 
(a small quantity), and Beta-Guaiac resin (10 per cent.), with some 
Guaiac yellow. The active principles are insoluble in water, but soluble 
in alcohol and alkaline fluids. 
Physiological Action.—It is esteemed to be alterative and expecto- 
rant, but the taste is so unpleasant as to greatly limit its use in medicine. 
It is a gastro-intestinal irritant, stimulating the liver, and is stated by 
some to act also on the excretory organs of the skin ; and, when it fails 
to act upon the skin, is diuretic. Dr. Murrell finds it an efficient laxative. 
Therapy.—Guaiac was formerly used as an alterative and antisyphi- 
litic, but it is not much valued for this at present,—only as an ingredient 
in the compound preparations of sarsaparilla, which are used as vehicles 
for the iodides. In tonsillitis, frequent small doses of the tincture will 
sometimes cut an attack short. In various neuralgic and rheumatic 652 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
affections, in rheumatoid arthritis, in amenorrhoea, and in dysmenorrhoen, 
it is also very useful. In rheumatic sore throat, the ammoniated tinc- 
ture may he administered and added to hot water makes a 
good gargle. Good results are sometimes obtained from guaiac in 
chronic gout, gouty bronchitis, and lumbago. The ammoniated tincture 
is regarded as the best preparation ; it be given in milk, in glycer- 
itum vitelli, or in aromatic elixir of liquorice. In chronic constipation 
Murrell* has obtained very satisfactory results from the administration 
of the resin in 10- or 20- grain doses, in ounce of thick extract of malt, 
two or three times daily, according to the case. It occasionally produces 
a rash. Murrell advises the trial of a triturate with cream of tartar, 
sugar of milk, or some other inert substance. 
GUARANA (U. S. P.).—Guarana. 
Preparation. 
Extraction Guarance Fluidum (U. S. P.).—Fluid Extract of Guarana. Dose, Nlx-f3j. 
Pharmacology.—A dried paste prepared from the crushed or ground 
seeds of Paullinia sorbilis (Sapindaceae), a climbing plant of Brazil. It 
is in round masses or cylindrical sticks, resembling chocolate in color 
and odor. It contains Guaranine (5 per cent.), an alkaloid probably iden- 
tical with Caffeine, besides tannic acid (25 per cent.), traces of volatile 
oil, saponin, etc. 
Physiological Action.—The ph3Tsiological effects are the same as 
those of coffee or chocolate, but it is of very uncertain strength. 
Therapy.—The principal use of guarana is in nervous headache, 
doses of the fluid extract being administered every hour during 
the beginning of the attack. It has also been used in diarrhoea. 
GURJUN.—Gurjun Balsam or Oil, Wood-Oil. 
Dose, 5ij, in emulsion or capsules, or with extract of malt. 
Pharmacology.—An oleoresin obtained from the Dipterocarpus tur- 
binatus and other species of Dipterocarpaceae of East India. The balsam 
flows from the wounded tree. It contains from 40 to TO per cent, of 
volatile oil, some resin, and Gurjunic acid. It resembles copaiba in phys- 
ical and physiological properties, but is more acceptable to the digestive 
organs and lias less effect upon the kidneys. 
Therapy.—Gurjun-oil is antiseptic and alterative. In combination 
with lime-water (1 to 4) it is a useful application in psoriasis and chronic 
eczema. It has been employed in leprosy, both internally and locally, 
with asserted curative effect. The oil has been administered successfully 
in the treatment of gonorrhoea and gleet, also in chronic bronchitis. 
* Medical Bulletin, January, 1891, “Guaiacumas a Laxative,” by William Murrell, M.D., 
of London, England. GUTTA-PERCHA. 
653 
GUTTA-PERCHA (U. S. P.).—Gutta-Percha. 
Preparation. 
Liquor Outtce-Perchce (U. S. P.).—Solution of Gutta-Percha (gutta-percha 9 per cent., 
lead carbonate 10, in chloroform). Used externally. 
Pharmacology.—The concrete exudation of Isonandra gutta (Sapo- 
tacese), a tree of the East Indies. It is insoluble in water or in alcohol, 
but soluble in chloroform, oil of turpentine, and bisulphide of carbon. 
Softens easily and can be cut writh a hot knife. 
Therapy.—Used externally in sheets for making molded splints, as, 
after softening with hot water, it adapts itself to the surface and soon 
hardens again. It is also used in making mechanical appliances such 
as pessaries, specula, etc. The solution is used as a protective, like 
collodion. 
H/EMATOXYLON (U. S. P.).—Haematoxylon, Logwood. 
Preparations. 
Decoctum Hrnnatoxyli (U. S. P.).—Decoction of Logwood (§i—Oj). Dose, f§i—f5ij• 
Exlractum Hcematoxyli (U. S. P.).—Extract of Logwood. Dose, gr. v-x. 
Pharmacology.—Logwood is the heart-wood of Haematoxylon cam- 
pechianum (Leguminosae), a large tree of Central America and the West 
Ind ies. It occurs as chips or raspings of a reddish-brown color. Tannin 
is the principal medical constituent. It also contains Haematoxylin (12 
per cent.), a red coloring constituent resembling liquorice in its taste, 
which is soluble in water and in alcohol. 
Physiological Action.—Haematoxylon is astringent and tonic, and 
unirritating. It colors the urine and stools red, and has the disadvantage 
of staining the linen. It does not produce constipation. 
Therapy.—Formerly used as an astringent for children’s diarrhoeas, 
but, as the medicine was spilt or vomited upon the clothing, 
it was productive of much dissatisfaction, and Avas abandoned, especially 
since the new dietetic and antiseptic method has come into vrogue. 
Nevertheless, it is of decided value in tuberculous diarrhoea, and should 
not be entirely overlooked. The decoction has been used as an astrin- 
gent in leueorrhoea and bleeding haemorrhoids. 
HAMAMELIS* (U. S. P.).—Hamamelis, Witch-Hazel. 
Preparations. 
Extractum Hamamelidis Fluidum (U. S. P.).—Fluid Extract of Hamamelis. Dose, 
nix-f3j. 
Aqua Hamamelidis Destillata.—Distilled Extract of Witch-Hazel. Dose, f3i—ij. 
* See papers by the author on “Hamamelis Virginica,” read before the British Medical 
Association, Section of Therapeutics, at Brighton, August, 1886—The Medical Register, June 4, 
1887; “ Hamamelis in the Treatment of Diseases of the Skin,” read before the Section of Derma- 
tology at the meeting of German Naturalists and Physicians, held in Berlin, September, 1886— 
The Medical Bulletin, December, 1886. See also paper on ‘‘Hamamelis and Alcohol,” by Dr. 
E, H. Griffin—Medical Record, December, 1890. 654 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Pharmacology.—The leaves of Hamamelis Yirginica (Hamameiacese) 
collected in autumn are officinal, and, although not stipulated the 
pharmacopoeia, they should be fresh, as the}* owe their efficacy largely 
to some volatile principle not yet isolated ; they also contain tannin and 
a bitter extractive coloring matter, etc. The old leaves and many 
preparations are devoid of physiological activity, but a well-made fluid 
extract, and especially the distilled extract, have been found to have 
decided therapeutic power. The bark of the younger branches is more 
astringent than the leaves; it contains about 8 per cent, of tannin, and 
can be used for the same purposes as the leaves. It is probable that the 
popular distilled extract is made from the leaves and smaller twigs, 
freshly gathered and treated with dilute alcohol before distillation. Some 
of the undoubted good results of this agent as a local application, as a 
wash, a gargle, etc., may be due to the alcohol present. 
Physiological Action.—Negative physiological results from an inves- 
tigation of the root have been reported by Wood and Marshall. These 
observers think that the so-called virtues of the preparations of witch- 
hazel depend upon the alcohol they contain and the faith of the patient. 
Duja rdin-Beaumetz, on the other hand, believes that witch-hazel owes its 
utility to an action on the muscular fibres of the veins. Hector Guy 
( These de Paris, 1884) reports, after experiments with witch-hazel, that it 
shows no special physiological action on the vascular system, but that 
headache sometimes follows full doses. 
Therapy.—For sprains, bruises, and superficial inflammations, the 
distilled extract is a pleasant and valuable application. It is also useful 
diluted with 2 to 3 parts of water or alcohol in inflammation of the gums, 
pharyngitis, nasal catarrh after the removal of nasal polypi, in the form 
of a spray or wash. Either form may be injected into the bladder, 
properly diluted, in cases of catarrhal inflammation or haemorrhage. 
The topical application of hamamelis is much more decidedly haemostatic 
than is explained by our present knowledge of its composition. It is a 
reliable agent in the treatment of capillary haemorrhage from wounds, 
epistaxis, bleeding sockets after the extraction of teeth, and in bleeding 
piles is one of the most efficient agents at our command. This medica- 
ment, Flagg, is very efficacious, and is particularly valuable from its 
constant and persistent power of inducing response; in chronic and 
incurable haemorrhagic, anaemic, and inflammatory conditions, it has 
frequently maintained its beneficial effects for many consecutive years. 
Leg-ulcers, especially those occasioned by varicose veins, are remarkably 
benefited by the application of a lotion or ointment containing witch- 
hazel. This drug possesses a marked sedative as well as astringent 
action upon congested or inflamed tissues. Hamamelis ointment, in the HEDEOMA. 
655 
proportion of 15 to 20 grains or more of excipient, often, therefore, 
proves of avail in burns, erysipelas, eczema, and herpes. Excessive 
secretion is likewise restrained, and for this reason it is sometimes of 
service in seborrlicea, acne, and rosacea :— 
Ext. hamamelidis fld., f3i-iss. 
Zinci oxidi, . . . . 3j. . 
Amyli, gr. xl. 
Glycerini, , Hlxxx. 
Ung. aquae rosse, . §j. 
M. An ointment for sunburn, eczema, intertrigo, etc. 
A lotion made from the fluid extract relieves the pain and stiffness 
of chronic rheumatism. A diluted fluid extract is an efficient lotion in 
carbuncle, chancroid, freckles, hyperidrosis, and lupus erythematosus. 
In burns and frost-bites the following combination is useful:— 
Liq. plumbi subacetatis, 
Tiuct. opii, . aa f^j. 
Aq. hamamelidis dest., f gij. 
Aquae, Oj.—M. 
Fissures of the anus and ulcers of the anus or rectum are improved 
b}' the application of a wash or ointment containing witch-hazel. 
Given by the mouth, hamamelis is scarcely less astringent and seda- 
tive than when applied externally. It renders good service in cases of 
acute or chronic diarrhoea, enteritis, and dysentery. It restrains suppu- 
ration in pyelitis and reduces the inflammatory congestion of cystitis. 
In haemorrhage from internal organs it is an admirable remedy, and may 
be given with considerable confidence in bleeding from the stomach, 
bowels, kidneys, womb, or lungs, and in purpura hsemorrhagica. Ham- 
amelis is useful in chronic bronchitis attended by copious discharge. It 
may be of service in the night-sweats of phthisis. Its internal, conjoined 
with its external, use is productive of excellent results in epistaxis and 
varicose ulcers. Varicose veins, varicocele, and internal haemorrhoids 
may, not infrequently, be entirely cured by the persistent administration 
of hamamelis. It has been found serviceable in phlegmasia dolens and 
often mitigates the pain of dysmenorrhoea. The combined internal and 
external use of witch-hazel is useful in gonorrhoea after subsidence of the 
acute stage, and in leucorrhoea. Witch-hazel, also, has the reputation 
of preventing abortion. 
HEDEOMA (U. S. P.)—Hedeoma, Pennyroyal. 
Preparations. 
Oleum Hedeomae (U. S. P.).—Oil of Pennyroyal. Dose, lllii-x. 
Spiritus Hedeomce (U. S. P.).—Spirit of Hedeoma (10 per cent, of oil). External use. 656 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Pharmacology.—The leaves and tops of Hedeoma pulegioides (La- 
biatae) contain an aromatic, volatile oil, which is officinal, and is its only 
important constituent. It is stimulant, carminative, and emmenagogue. 
Physiological Action and Therapy.—Pennyroyal-tea, or a recent infu- 
sion of the leaves and tops, is used in flatulent colic and recent suppres- 
sion of the menses. The oil may be similarly employed, but is very 
seldom used internally except as a constituent of emmenagogue pills. 
Dr. Wingate has reported the case of a woman who took a teaspoonful of 
the oil of pennyroyal with half a teaspoonful of the fluid extract of ergot. 
In an hour she was unconscious, with small pulse-, cold extremities, and 
slightly-dilated pupils. Several convulsions occurred, and opisthotonos 
was well marked. Morphine and atropine liypodermatically with heat 
externally proved restorative. Hedeoma is carminative and can be used 
for flatulence. 
The fresh herb is said to be obnoxious to mosquitoes, and may be 
hung about a sleeping room, or the hands and face bathed with a recent 
infusion or a solution of the oil in alcohol (1 to 10), in order to keep off 
these midnight marauders. The spirit may be used with an atomizer or 
as an embrocation for the same purpose. 
HELIANTHEMUM.—Helianthemum, Frostwort. 
Pharmacology and Therapy.—The whole herb of the Helianthemum 
Canadense (Cistaceae) is a domestic remed}' as an alterative and astrin- 
gent. It contains tannin and some bitter substance. A recent decoction 
may be used, but a fluid extract made with dilute alcohol (dose, f 5i-ij, 
several times a day) is a better preparation for diarrhoea and dysentery. 
It is also esteemed useful as a tonic in scrofula and syphilis. 
HELLEBORUS.—Hellebore. 
Dose, gr. iv-xv. 
Pharmacology.—The black hellebore, Helleborus niger (Ranuncu- 
laceae), an ancient is a native of Central and Southern Europe, 
and is cultivated in England and the United States for its showy flowers. 
The rhizome with rootlets is the part used. The most important constitu- 
ents are two glucosides,—Helleborin and Helleborein,—both crystalline, 
which are cardiac and nervous poisons. There is no tannin. 
Physiological Action.—The taste is bitter and acrid ; the freshly 
bruised drug, but not the dried preparation, has a somewhat rancid odor. 
The dust is irritating and causes violent sneezing. Internally the effects 
are emetic, drastic, cathartic and emmenagogue. In its action upon the 
heart it resembles digitalis. Yeuturini and Gasparini have ascertained 
that solutions of helleborein, dropped into the conjunctival sac of rabbits 
and dogs, produce, within fifteen minutes, such complete anaesthesia HELONIAS. 
657 
that the cornea can be penetrated without causing pain. At the same 
time, the sensibility of other parts of the eye and its appendages are 
left intact. The anaesthesia is of longer duration than that due to 
cocaine. No alteration of the pupil or the intra-ocular pressure is 
produced.* 
Therapy.—Rarely used at present, except as an ingredient in some 
proprietary emmenagogue pills. (For American hellebore, see Veratrum 
Viride.) 
HELONIAS.— Helonias, False Unicorn. 
Dose, gr. xv. 
Pharmacology and Therapy.—The Chamaelirium luteum (Gray) or 
Helonias dioiea (Pursh), belonging to the natural order, Melanthaceae, 
is a native of North America, east of the Mississippi. The root is the 
portion used, and, from its resemblance to a horn, is called unicorn-root. 
It contains a bitter principle, Chamaelirin. A fluid extract is made with 
the aid of alcohol, of which the dose is It is reported to be 
tonic and anthelmintic. 
HEMIDESMUS.—Hemidesmus, Indian Sarsaparilla. 
Pharmacology and Therapy.—The Hemidesmus Indicus (Asclepia- 
dacese), as is indicated by its name, is a native of India. The root is 
used in the same way as sarsaparilla. It contains Coumarin and a little 
tannin. It is said to be diaphoretic, alterative, diuretic, and tonic. The 
fluid extract may be given in doses of f 5ss-j. 
HEPATICA.—Hepatica, Liverwort. 
Dose, t‘5ss-iss, in fluid extract. 
Pharmacology and Therapy.—The Hepatica triloba (Ranunculacese) 
is a native of North America. Its leaves contain mucilage and tannin ; 
a recent infusion of them, taken hot, is useful in the early stage of 
bronchitis. The fluid extract may be employed as a demulcent astrin- 
gent in diarrhoea. 
HEUCHERA.—Heuchera, Alum-Root. 
Dose, gr. xxx-5ij. 
Pharmacology and Therapy.—The Heuchera Americana belongs to 
the Saxifragacese, and is a native of the United States. The root con- 
tains considerable tannin (18 to 20 per cent.), and an infusion or fluid 
extract is useful as a mouth-wash, gargle, etc., or may be given for 
diarrhoea. 
HIPPOCASTANUM.—Hippocastanum, Horse-Chestnut Bark. 
Dose, f 3i—Uj in fluid extract. 
* Medical Bulletin, January, 1890, p. 14. 658 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Pharmacology and Therapy.—The horse-chestnut, AHsculus hippo- 
castanum (Hippocastaneae), is a large tree cultivated in Europe and 
North America as a shade-tree; its original habitat is unknown. The 
hark contains tannic acid and two neutral bitter principles—/Escu'in and 
Fraxin. The effects are those of the vegetable bitters ; it has some anti- 
periodic powers. A fluid extract, with dilute alcohol, is the best 
preparation. 
HOANG-NAN.* 
Preparations. 
Extractum Hoang-Nan Fluidum.—Fluid Extract of Hoang-Nan. Dose, hlv-xxx. 
Tinctura Hoang-Nan.—Tincture of Hoang-Nan. Dose, ITtxx-xl. 
Pharmacology.—Strychnos gaultheriana, hoang-nan, tropical bind- 
weed, natural order Loganiaceae, is an exogenous plant, native to the 
mountainous districts of Laos, Anam, Tonquin, and Cambodia. Its 
bark, which is the portion used, contains the alkaloids strychnine and 
brucine, the latter in larger proportion. 
Physiological Action.—In small doses hoang-nan quickens and invig- 
orates the heart, accelerates and deepens the respiration, and stimulates 
secretion. In moderately large doses it produces clonic, succeeded by 
tonic convulsions. In excessive doses it causes a rapid and considerable 
decline of arterial pressure, powerful tetanic spasms, and death from 
respiratory failure. Medicinal doses improve the appetite and digestion, 
augment intestinal secretion and peristalsis, and exert a stimulant or 
alterative influence upon the cutaneous glandular systems, both perspi- 
ratory and sebaceous, but more particularly the latter. 
Therapy.—Hoang-nan is an excellent general tonic. It may be 
appropriately used in the treatment of chronic alcoholism. In small 
doses it allays nausea, relieves the tremor and prostration which follow 
a debauch, and sustains the heart upon the withdrawal of alcoholic drink. 
In anaemia, given in conjunction with iron, hoang-nan is very useful. In 
amenorrhoea also it is frequently of service. By improving the innerva- 
tion of the muscular coat of the bronchioles it tends to diminish the 
frequency and severity of attacks of spasmodic asthma. This remedy 
is worthy of trial in tobacco amaurosis. It is of value in dyspepsia, and 
may be used in small doses in the vomiting of pregnancy. In con- 
valescence from typhoid fever it is a good tonic, and is useful in neuralgia 
and post-paralytic tremor. It may be serviceably given in Bell’s palsy, 
rheumatic, diphtheritic, or lead paralysis, and for reflex paraplegia. It is 
a useful drug in neurasthenia. In its home it is of great repute in the 
* “Notes on Hoang-Nan,” by the author, Therapeutic Gazette, November 15,1889; “Notes 
on Hoang-Nan in Diseases of the Skin,” The Journal of the American Medical Association, 
October 26, 1889. HOMATROPIN/E HYDROBROMAS. 
659 
treatment of leprosy, hydrophobia, snake-bite, and fevers. The claim 
for any decided virtue in these affections cannot, however, be maintained. 
Hoang-nan is of marked efficacy in a number of skin diseases. The 
writer has witnessed marked improvement follow its use in seborrheea. 
It has also proved valuable in alopecia. In hyperidrosis and anidrosis 
this agent possesses an excellent corrective influence upon the disordered 
secretion, and in bromidrosis it will efficiently assist the action of the 
local measures employed. In acne and sycosis it has manifested an 
excellent remedial quality'. In eczema pustulosum hoang-nan will often 
be found very beneficial. In purpura it has sometimes been successful. 
Diseases attended by nervo-muscular debility7- and defective glandular 
action, such as lichen planus, lichen scrofulosus, herpes zoster,pemphigus, 
and ecthyma, are benefited by the administration of hoang-nan. In 
chronic ulcers, scrofula, and the eczema of scrofulous children, this 
remedy7 is of service. In scrofuloderma it is especially7 valuable. In 
late sy’philis, or in syphilis as it occurs in broken-down individuals, 
hoang-nan is a valuable tonic agent. Iloang-nan may be combined as 
follows :— 
Ext. hoang-nan fld., f3iss. 
Acid, hydrochlorici dil., f3iiss. 
Tinct. gentianse co., q. s. ad f §ij. 
M. Sig.: Teaspoonful in water three times a day. For dyspepsia, neurasthenia, etc. 
Tr. hoang-nan., f3iss. 
Syr. aurant., f^j- 
Aq. mentli. pip., q. s. ad f §ij. 
M. Sig.: Teaspoonful three times a day. Useful in acne, seborrheea, eczema 
genitalium, etc. 
HOMATROPIN/E HYDROBROMAS.—Hydrobromate of Homatro- 
pine. 
Dose, gr. sV 
Pharmacology and Therapy.—Homatropine is a derivative of atropine, 
obtained by the decomposition of amy7gdalate oftropine by7 hydrochloric 
acid. It is a reliable mydriatic for examination and determination of 
refraction in ophthalmological practice, having the advantage over other 
mvdriatics in being prompt in its action, but more transitory in its 
effects, which pass away in from thirty-six to forty-eight hours, while 
those of hyroscyamine last eight or nine days and those of atropine con- 
tinue for ten or twelve days. The ordinary solution for paralyzing the 
accommodation is of the strength of 4 grains to the ounce of distilled 
water, a few drops of which are instilled into the eye every five or ten 
minutes until the full effect is obtained. Some hypersemia of the con- 
junctiva generally follows its use, but not true inflammation, unless 660 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
under very exceptional circumstances. The danger of systemic infection 
is much less than from atropine. In the treatment of choroiditis, and 
other disorders for which a mydriatic is used, atropine is more suitable 
because its action is more prolonged, and it causes less hyperaemia. 
In making homatropine solutions the distilled water should be boiled 
just before using, and small quantities only made at a time, as distilled 
water, unless recently boiled, usually contains bacteria and other germs 
derived from the air, which might induce irritation. 
The hydrochlorate and salic)late of homatropine are salts which 
have a similar action to the hydrobromate, the dose of each being from 
tIit t° sV grain. Besides the mydriatic properties alread}' referred to, 
these salts have likewise been used in checking night-sweats, especially 
of phthisis. (See also page 467.) 
HUMULUS (U. S. P.).—Hops. 
Preparations. 
Tinctura Humuli (U. S. P.).—Tincture of Hops (20 per cent.). Pose, f3i-iv. 
Lupulinum (U. S. P.).—Lupuline. (The glandular powder separated from the stro- 
biles.) Pose, gr. v-xx. 
Extraction Lupvlini Fluidnm (U. S. P.).—Fluid Extract of Lupuline. Pose, Tflv-xv. 
Oleoresina Lupulini (U. S. P.).—Oleoresin of Lupuline. Pose, gr. ii-v. 
Infusum Humuli.—Infusion of Hops, Hop-tea (3iv to Oj). Pose, f^ii-v. 
Extraction Hamuli.—Extract of Hops (inspissated fluid extract). Pose, gr. v. 
Pharmacology.—Hops are the strobiles (or fruit-cones) of Humulus 
lupulus (Urticaceae). The glandular powder adhering to the axis and 
bracts, lupulinum, is the most important part. The constituents are a 
liquid alkaloid, Lupuline, and a bitter principle, Lupulinic acid ; besides 
nearly 1 per cent, of volatile oil, 9 to 18 per cent, resin, and 3 to 4 per 
cent, tannin, etc. The fluid extract of lupuline is made with alcohol; the 
oleoresin is extracted with ether; both are eligible preparations. 
Physiological Action.—The preparations of hops are stomachic, 
tonic, hypnotic, slightly diaphoretic, and anaphrodisiac. 
Therapy.—Malt liquors, containing hops, are largely used as aids 
to the appetite and digestion ; unfortunately, many of them contain a 
very small proportion of hops, the deficiency being made up with aloes 
or other bitter substances, with eocculus Indicus, grains of paradise, 
glycerin, soap, salicylic acid, etc., which detract from their value both 
from a medicinal and a commercial stand-point. A well-made beer of 
good quality, however, is a useful preparation of hops, and has con- 
siderable medicinal value as a tonic during convalescence, or in feeble 
digestion, or as a stimulant to the appetite and nutrition. The sedative 
effect of the hops is assisted by the alcohol and carbonic acid, making 
beer useful in gastric catarrh with gastralgia and as a hypnotic in lieu- 661 
HUMULUS. 
rastlienia with insomnia. In this condition a hop-pillow is appropriately 
used. Though not of much efficacy in itself, yet it assists in producing a 
narcotic effect. Beer may he given when all other forms of nourishment 
are refused, as in diphtheria; and eggs, milk, or beef-powder (Mosquera 
beef-meal) may be added to it to increase its value. The tincture of 
hops, or the fluid extract of lupuline, are also alcoholic, but in them the 
proportion of alcohol is so considerable as to make it the chief constit- 
uent. Malt liquors increase the flow of milk during lactation. 
The sedative effects of hops are obtained from a hop-poultice in 
local painful affections, or the hops may be placed in flannel and moist- 
ened with hot whisky and applied to painful areas, as in toothache or 
earache, where the warmth and steam are very soothing. 
The inhalations of the vapor of hops are often attended with good 
results, especially in diseases of the throat and chest. Lefferts used 
with benefit this combination :— 
I) Sodii carbon atis exsiccati, gr. xx. 
Aquae ferv. (140°), Oj. 
Solve et adde 
Extracti humuli, .......... 3j. 
M. The vapor to be inhaled. 
In delirium tremens hop-tea, with a quantit}7 of cayenne-pepper, 
quiets drink-craving and settles the stomach. In hysteria and nervous- 
ness preparations of hops are useful. Hops, especially when emploj’ed 
in the form of the infusion or tincture, are often most efficacious for 
the hypnotic action in insomnia and restlessness. The following are 
useful:— 
Tinct. humuli, f^iij. 
Tinct. capsici, f3ij. 
Glycerin i, f § ij. 
M. Sig.: A tablespoonful every hour or two. For nervousness. 
II Tinct. humuli, 
Tinct. ammon. valerianatis, 
Spiritus aetheris nitrosi, aa f §ij. 
M. Sig.: Two teaspoonfuls in water every hour or two. Use in insomnia, hysteria, 
and nervousness. 
In irritation of the genito-urinary passages full doses of the oleo- 
resin of lupuline afford much relief, and it has also been used as an 
anaphrodisiac in priapism, chordee, spermatorrhoea, and similar affec- 
tions. A very suitable prescription in genito-urinary irritation, of service 
in the diseases just referred to, is :— 
II Lupulini, 
Camphorae monobromatae, aa 3j. 
01. theobromae, q. s. 
M. et ft. suppositorias no. xij. 
Sig.: Insert one up the bowel every three or four hours. 662 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
HYDRANGEA.—Hydrangea. 
Preparation. 
Extraction Hydrangea? Fluidum.—Fluid Extract of Hydrangea. Dose, Hlxxx-f 3j. 
Pharmacology and Therapy.—The root of Hydrangea arborescens 
(Saxifragacese) has long been used by the aborigines, in the South, in the 
form of a decoction, in the treatment of calculous affections. A fluid 
extract, made with diluted alcohol, is a convenient form in which to 
administer the remedy. It is of especial utility in gravel and renal colic. 
HYDRARGYRUM (U. S. P.).—Mercury, Quicksilver. 
Preparations and Salts. 
Hydrargyrum cum Creta (U. S. P.).—Mercury with Chalk, Gray Powder (mercury 38, 
milk-sugar 12, prepared chalk 50 parts). Dose, gr. ss-x. 
Massa Hydrargyri (U. S. P.).—Mass of Mercury, Blue Mass, Blue Pill (mercury, 33 
per cent., with althea, liquorice, glycerin, and honey; a 3-grain blue pill contains 1 grain 
of mercury). Dose, gr. ss-xij. 
Unguentum Hydrargyri (U. S. P.).—Mercurial or Blue Ointment (mercury, 50 percent., 
triturated with lard, salt, compound tincture of benzoin, and some old mercurial ointment). 
Eniplastrum Hydrargyri (U. S. P.).—Mercurial Plaster (mercury, 30 parts; lead 
plaster, 50 parts; olive-oil and resin, each 10 parts). 
Eniplastrum Ammoniaci cum Hydrargyro (U. S. P.).—Plaster of Ammoniac and Mer- 
cury (contains mercury 18, and ammoniac 72 parts). (See page 431.) 
Hydrargyri Oxidum Rubrum (U. S. P.).—Red Oxide of Mercury. Dose, gr. AtV 
Unguentum Hydrargyri Oxidi Rubri (U. S. P.).—Ointment of the Red Oxide of Mercury 
(10 per cent.). 
Hydrargyri Oxidum Elavum (U. S. P.)—Yellow Oxide of Mercury. For external use. 
Unguentum Hydrargyri Oxidi Flavi (U. S. P.).—Ointment of the Yellow Oxide of 
Mercury (10 per cent.). 
Oieatum Hydrargyri (U. S. P.).—Oleate of Mercury (yellow oxide, 10 per cent.; oleic 
acid, 90). 
Hydrargyri Chloridum Mite (U. S. P.).—Mild Chloride of Mercury, Calomel, Mercurous 
Chloride. Dose, gr. 
Hydrargyri Chloridum Corrosivum (U. S. P.).—Corrosive Chloride of Mercury, 
Corrosive Sublimate, Mercuric Chloride. Dose, gr. 
Hydrargyrum Ammoniatum (U. S. P.).—Ammouiated Mercury, White Precipitate. 
For external use. 
Unguentum Hydrargyri Ammoniati (U. S. P.).—Ointment of White Precipitate (am- 
inoniated mercury 10, benzoinated lard 90 parts). 
Hydrargyri lodidum Viride (U. S. P.).—Green Iodide of Mercury, Protiodide. Dose, 
gr- %• 
Hydrargyri lodidum Rubiiim (U. S. P.).—Red Iodide of Mercury, Biniodide, Mer- 
curic Iodide. Dose, gr. 5*5—1*5. 
Liquor Arsenii et Hydrargyri Iodidi (U. S. P.).—Donovan’s Solution (1 per cent, each 
iodide of arsenic and biniodide of mercury). Dose, lUi-x. 
Liquor Hydrargyri Nitratis (U. S. P.).—Solution of Nitrate of Mercury, Acid Nitrate 
(contains 50 per cent, of mercuric nitrate). A powerful caustic. 
Unguentum Hydrargyri Nitratis (U. S. P.).—Ointment of Nitrate of Mercury, Citrine 
Ointment (mercury 7, nitric acid 17, lard 76 parts). 
Hydrargyri Subsulphas Flavus (U. S. P.).—Yellow Subsulphate of Mercury. Dose, gr. 
ii-v, as an emetic for children. HYDRARGYRUM. 
663 
Hydrargyri Sulpliidum Jtubrum (U. S. P.).—Red Sulphide of Mercury, Cinnabar. 
Used only in pharmacy and for fumigation. 
Hydvargyvi Salicylas.—Salicylate of Mercury (mercurous salicylate, dose, gr. 
mercuric salicylate, dose, 
Hydrargyri Uyanidum (U. S. P.).—Cyanide of Mercury. Dose, gr. gV. 
Hydrargyri Formarnidatum.—Formamide of Mercury. For hypodermatic use. 
Dose, gr. £. 
Hydrargyri '1’annas.—Tannate of Mercury (mercurous tannate). Dose, gr. ss-j. 
Lotio Flava.—Yellow Wash (corrosive sublimate, gr. xxiv, in lime-water, f §xvj). For 
external use. 
Lotio Nigra.—Black Wash (calomel, gr. lxiv, in lime-water, f §xvj). 
Triturations can be made with any mercurial and sugar of milk, usually in decimal 
proportions. 
Pharmacology.—Commercial mercury is always impure, being com- 
bined with tin, antimony, zinc, and other metals. It can be purified by 
treating it with dilute nitric acid, and afterward washing it free from the 
acid with water. In the pure state, it is a shining, silver-white metal, 
liquid at common temperatures, and having the specific gravity of 13.5. 
The chlorides are the salts of the greatest medical importance. They are 
made by double decomposition; thus, sulphate of mercury and chloride 
of sodium are triturated together and heat applied, when the mercuric 
(or corrosive) chloride sublimes in the form of white crystalline masses 
or powder; in order to form the mercurous chloride (calomel), an 
additional proportion of mercuric sulphate is added before subliming. 
Owing to the tendency to combine with other metals, the presence of 
mercury may be ascertained by half immersing a gold piece in a sus- 
pected solution, when the mercury will be deposited as a gray or silver 
coating, if present. Reinsch’s test and the reduction test may be em- 
ployed as in testing for arsenic, when the small globules of mercury may 
be detected upon the glass, which are as easily recognized with the 
microscope as the ciystals of arsenic. 
In accordance with the chemical theory of Mialhe, it is usually 
taught that calomel is converted within the body into corrosive subli- 
mate by the agency of sodium chloride. As a result of careful experi- 
ments, Dr. Paul Adams finds that, although this change may take place 
in the air, the access of air is practically excluded from the alimentary 
tract and that but a trace of calomel passes into solution. This is the 
case even in the presence of organic matter, and he arrives at the conclu- 
sion that sodium chloride is not incompatible with calomel. For the 
same reason it had generally been held that muriatic or nitro-muriatic 
acid should not be given in conjunction with the mild chloride. 
Physiological Action and Antidotes.—The salts of mercury are very 
poisonous to all lower forms of life, and mercurial solutions form our 
most convenient and useful antiseptics. Applied to the skin, in concen- 664 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
trated form, most of them are irritating, and some are destructive, to 
the tissues. They easily diffuse through the integument, and may 
in this way cause systemic effects, even from the solutions employed 
for antiseptic purposes, but especially from inunctions with mercu- 
rial ointment or fumigations. When taken into the blood, mercury, 
in very minute doses, increases the number of red blood-corpuscles, 
especially in conditions of cachexia or anaemia. This has been called the 
tonic action, and is obtained from doses of a hundredth of a grain or less 
of the corrosive chloride three times a da}'. In larger doses the salt is a 
cardiac poison, lowering its action and destroying the red blood-corpus- 
cles and reducing the fibrin. At the same time mercury has a marked 
influence upon the nervous system, causing debility with tremors ; it also 
affects the digestive organs, causing diarrhoea, more or less salivation, 
and a fetid breath; if continued a sufficient length of time emaciation 
also occurs. These symptoms, taken collectively, constitute Hydrargism, 
or Mercurial Cachexia, or Erethism, which might be mistaken for malig- 
nant disease, especially if accompanied by some enlargement of the liver. 
Pure metallic mercury is not poisonous, and passes through the-alimen- 
tary tract unchanged, acting as a mechanical laxative. Acute poisoning 
by corrosive sublimate occurs when a toxic dose has been swallowed. 
The symptoms are immediate and violent: these are vomiting ; purging, at 
first serous, afterward bloody ; burning pain in the stomach and oesopha- 
gus, suppression of urine, face swollen and bloated, with much prostration 
of the bodily powers, etc. 
Albumin is the antidote to corrosive sublimate; eggs and milk 
should be freely swallowed, the stomach washed out with a stomach- 
pump, arterial stimulants administered, hypodermatic injections of mor- 
phine and whisky given, and external heat applied. After the first symp- 
toms are over, the patient is liable to perish from ulceration or stricture 
of the oesophagus, destruction of the peptic glands in the stomach, sali- 
vation, and exhaustion. 
The action of mercury upon the liver has occasioned much contro- 
versy, and is not yet satisfactorily settled. It is believed that the cor- 
rosive chloride in small doses is a hepatic stimulant and cholagogue ; but 
this action is denied to calomel, yhich directs its action principally to 
the excretory glands in the lower part of the small intestine and colon. 
It is not yet known, however, in what form calomel enters the blood, but 
it is possible that a soluble combination is formed with albumin and hy- 
drochloric acid ; it is even possible that part of it may be changed into cor- 
rosive chloride, in which case some action upon the liver would naturally 
follow. Whatever ingenious explanation the laboratory may have to offer 
with regard to the cholagogue action of the mercurials, and calomel 665 
HYDRARGYRUM. 
especiall}*-, clinical medicine has already settled the fact that where the 
tongue is heavily coated and the conjunctivae slightly jaundiced, the skin 
sallow, and the liver inactive, with clay-colored stools, it can all be set 
right with a few small doses of calomel, and bilious stools be produced. 
The diuretic action of mercury has of late years attracted consid- 
erable attention. It has been found that mercury, and more especially 
calomel and blue-pill, have the power of decidedly promoting the action 
of diuretics. Boem (British 3Jedical Journal) claims that the absorption 
of mercury salicylate, which is incomplete, is, however, greater than that 
of calomel. It is stated, as the result of some recent investigations by 
F. Klemperer,* that, in rabbits, corrosive sublimate injected into the 
blood was eliminated by the intestinal glands and kidneys. In acute 
cases there was congestion of the kidneys, with extravasations, and, if 
prolonged, the parenchyma showed signs of inflammation, with a deposit 
of chalk in the straight tubules ; while, in the dog, there occurred fatty 
degeneration instead of chalky deposit. It is evident that mercury in 
small doses is capable of acting as a stimulant to the kidneys, and this 
agrees with the observations of Jendrassik upon the use of calomel as 
a diuretic. Mercurials, therefore, are useful additions to squill, digitalis, 
and other diuretic remedies. 
Upon the salivary glands, mercurials have very stimulating effects. 
The salivary secretions may be increased to several pints daily, the 
fluid at first being albuminous and thick, but subsequently becoming 
thin and watery. The irritation may cause inflammation, and ulceration 
or sloughing of the mouth or cheek may result, especially where the pa- 
tient is in poor ]^hysical condition or suffers with some cachexia, or is 
exceptionally susceptible to the action of mercury. The condition of the 
general system accompanying the action of the mercurial upon the sali- 
vary glands and mouth is known as “ ptyalism,” or salivation. It is 
best treated by mouth-washes containing chlorate of potash and tincture 
of mvrrh, and by tonics and small doses of belladonna, or atropine with 
morphine. The gums may become inflamed, soft, and bleeding, and the 
teeth loose, but under this treatment the inflammation subsides and the 
teeth again , become firm. Salivation was of such common occurrence 
when mercury was given freel}' that it was looked upon as salutary, and 
it was thought necessary to “ touch the gums” in order to obtain thera- 
peutic results from the remedy ; but this idea no longer prevails, and pa- 
tients are no longer salivated intentionally, and this part of the so-called 
antiphlogistic treatment has fallen into disuse. 
Therapy.—The most common local application of mercurials at 
present is in antiseptic surgery. The solutions have the advantage 
* Therapeutic Gazette, October 15, 1890, p. 693. 666 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
of convenience, being easily made and cheap, odorless and permanent. 
The field of operation, having been well soaped and shaved and washed 
with ether, is usually irrigated with a solution of corrosive sublimate 
(1 to 2000, or stronger if the skin is unbroken). For washing out wound- 
cavities, or the peritoneum, much weaker solutions should be made use 
of (1 to 6000 or 10,000), or simply freshly-boiled warm water employed 
for a douche. In lying-in hospitals, or where the surroundings are 
decidedly unhygienic, and also where symptoms of septic infection are 
manifested after delivery, the danger may be averted by the free use of 
antiseptic vaginal douches several times a day. An extract* will show 
the value of corrosive sublimate in combination with an acid as an anti- 
septic as follows :— 
“ In 1880, Koch demonstrated that bichloride of mere nr}7 (sublimate) 
was the most powerful of antiseptics. It was found that in a solution of 
1 to 1000 it would soon destroy the spores of anthrax, the most virulent 
of all germs. This was true with regard to non-albuminous media, but 
when the medium to be disinfected contained albumin the mercury 
coagulated the albumin, formed an albuminate of mercury, which de- 
posited, leaving the supernatant liquid practically free from mercury, 
and, hence, without antiseptic power. Dr. Ernest Laplace, in Koch’s 
laboratory, seeking a method to prevent this coagulation, and, therefore, 
to retain for the mercury its same disinfecting power in albuminous as 
in non-albuminous fluids, found that an addition of a small quantity of 
any acid to the ordinary solution would fulfill this purpose. Accord- 
ingly, the acid sublimate solution consists of— 
Sublimate, 1 part. 
Hydrochloric acid (pure), 5 parts. 
Water, q. s. ad 1000 “ 
“ Hydrochloric acid is used preferably to all others. When, however, 
the acid sublimate must be carried in a solid form, tartaric acid is sub- 
stituted for the hydrochloric acid. 
Sublimate, . 1 part. 
Tartaric acid, 5 parts. 
To be made into a tablet, which must be dissolved in 1000 parts ol water. 
“ This form was adopted by the Academy of Medicine of Paris, to 
be used by midwives throughout France. The acid sublimate is the only 
disinfectant used in Koch’s laboratory. It is also used in the Pasteur 
Institute of Paris. Besides being the surest and most powerful anti- 
septic, it is the only solution of mercury that will always retain its 
integrity, and never form a deposit of earthy salts. 
* Laplace, Deutsche Med. Woch., No. 40, 1887. HYDRARGYRUM. 
667 
“ It is used for nil manner of disinfection, except that of instruments. 
In a solution as weak as 1 to 50,000 it retains sufficient power to destroy 
the germs of suppuration.” 
Bernardy prefers as an antiseptic the biniodide (1 to 4000 or 1 in 
20,000) to the sublimate solutions, as recommended by Miquel,* and 
which Punas prefers in eye surgery, it being less irritating than corrosive 
sublimate. It might also be added that there is much less danger of a 
mercurial impression being made upon the system by absorption where 
this salt is used, as the solutions usually only contain half as much 
mercurial. 
Mercury may be applied to the skin with a view to absorption, and 
for this purpose the ointment or the oleate may be used, a piece the size 
of a marble or larger being rubbed upon the inner side of the arms and 
thighs once or twice daily. The place of inunction must be changed, as 
the mercury causes some local irritation, and a crop of papules is likely 
to follow its repeated application to the same spot. (A case of eruption 
all over the body, resembling variola from mercurial application, is 
reported in Deutsch. Med. Zeituvg, January 2, 1890.) A small piece of 
ointment may be rubbed upon the soles of the feet before putting on the 
stockings each morning, the friction in the act of walking being sufficient 
to cause absorption. In the case of infants suffering with congenital or 
acquired syphilis, the ointment may be rubbed upon the abdomen under 
the belly-band. This method is resorted to when it is desired to impress 
the system rapidly, as, for instance, in the treatment of the inflamma- 
tory manifestations of syphilis, especially in- iritis. The constitutional 
effect can be most rapidly obtained in this way without disturbing the 
digestive organs. In syphilis, especially when the infiltration is marked 
upon the skin, the efficacy of one of the mercurial ointments may be 
increased combining with some stimulating oil or green soap :— 
I) Ungt. hydrargyri nitratis, 
Sapo viridis, 2a §iss. 
01. eucalypti, f3ss.—M. 
I). Ungt. hydrargyri ammoniat., . §ij. 
Olei antheinidis, f3ss.—M. 
Ungt. hydrargyri oleatis (10 vel 20 per cent.), .... §ij. 
Olei cadini, f 3ij.—M. 
I); Ungt. hydrargyri oleatis (10 per cent.), §j. 
Olei carophylli, l'lxx.—M. 
Often the most rapid way to mercurialize a patient is by using the 
drug in the form of suppositories. Fumigation is also a method of 
introducing mercury into the blood by way of the skin. The usual 
* Philadelphia Medical Times, vol. xvi, p. 521. 668 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
method is to place the patient in a vapor-bath until he is perspiring 
freety, and then to expose the body to the fumes arising from 10 or 20 
grains of calomel sublimated by the flame of an alcohol-lamp. The 
fumes should not be inhaled, and, therefore, the patient, sitting on a 
chair, has a blanket or his clothing fastened around his neck and extend- 
ing down to the floor all around, making a canopy; under the chair is 
placed a small spirit-lamp, and over it, upon a sheet of tin, is placed the 
mercurial. The patient, after about fifteen minutes’ exposure, is wrapped 
up in dry, warm blankets, and the skin allowed to dry spontaneously. 
If perspiration continue it may require a small dose of atropine. In 
this way the mereuiy is deposited upon the skin, and is gradually ab- 
sorbed, producing the greatest impression with the least disturbance. 
This method is especially valuable in controlling the skin disorders attend- 
ing syphilis (syphilides), and in the treatment of other manifestations of 
the poison when mercury is not well borne by the bowels. The hypo- 
dermatic method of administering mercurials has been practiced of late 
years in Germany and, to a limited extent, in this country. For this 
purpose solutions of corrosive chloride (hydrarg. ehlor. cor., gr. j; 
aquae destillatae, f3ij. Sig.: Ten minims a dose once a day) have been 
increased, minim by minim, until 50 or more are administered, or until 
the physiological action of the mercury is apparent. This plan of treat- 
ment is as cleanly, quick in results, and more successful, than any other 
in preventing relapses. 
It may, however, cause irritation, and has, in some rai'e instances, 
when given improperly, led to abscess and sloughing. If the hypo- 
dermatic needle be properly inserted, the instrument and needle aseptic, 
the author has never observed any case of abscess follow the hypodermatic 
injection of the corrosive chloride of mercury. The moment the least 
mercurial impression is made by the subcutaneous injection, the dose 
should be reduced to the smallest amount. A few minims of the solu- 
tion already named should be again injected into the muscle or skin, and 
the system kept under the impression of the drug b}r injections every 
day or two, until all evidence of syphilis disappears. In place of using 
small doses of mercury every day hy poderma tically, the writer sometimes, 
especially in lean subjects, injects from £ to grain of corrosive sublimate 
two or three times a week into the muscular tissue of the gluteal region 
or back. The hypodermatic method thus administered is for old cases 
of syphilis, especially in broken-down individuals, and offers a most posi- 
tive way of limiting or curing the disease. 
The albuminate and peptonate of mercury have been proposed with 
a view to obviate any accidents, but with little improvement. In the 
clinic of the late Auspitz the following solution wTas employed:— HYDRARGYRUM. 
669 
Hydrarg. chlor. corrosiv., gr. xv. 
Sodii chloridi,........... gr. xxx. 
Aquae destillatae, f §iij. 
M. Dose, n\x-xx every second day hypodermatically. 
Matlies states that no irritation results beyond a little tumefaction. 
About twenty or thirty injections constituted the course of treatment, 
which resulted in a cure. Liebreich recommends the formamide of 
mercuiy, which does not coagulate albumin, is neutral in reaction, 
readily combines with water, and is not precipitated by alkalies. 
Formamide of Mercury* is prepared as follows : 10 to 13 grammes of 
freshly precipitated, completely washed, and still moist mercuric oxide are 
gently warmed with a little water in a porcelain capsule, with a gradual 
addition of 10 grammes of formamide (resulting from the reaction of am- 
monia upon formate of ethyl). As soon as solution has taken place the 
resulting colorless liquid is filtered into a litre-flask, and the latter filled 
to the litre-mark with distilled water. Each cubic centimetre contains 0.01 
gramme of mercury (gr. which is one hypodermatic dose. It should 
be dispensed in brown-colored bottles. Zeissel, of Vienna, after trial of 
this agent, was well satisfied with it, and found twenty injections the 
maximum number required to disperse the syphilitic manifestations, even 
in severe cases. • Kopp’sf conclusions from over 3000 injections were less 
favorable; he says that “ Liebreich’s preparation is decidedly useful in 
certain of the milder forms of primary syphilis, as also for slight second- 
aries. The formamide should not be employed in severe cases where 
there are large papules or thick infiltrations; inunction is still the best 
method of treating, these cases. The tertiary forms are likewise not to 
be treated by the formamide. Relapses are by no means prevented by 
Liebreich’s method ; on the contrary, they appear to be extraordinarily 
common after this treatment.” In order to obtain more permanent 
effects than are possible by the use of the soluble preparations, it has 
been thought that by depositing the more stable compounds under the 
skin a more lasting effect can be obtained, and calomel is now used in 
this manner. The calomel may be suspended in liquid vaselin or olive- 
oil (1 in 10). There should be at least a week’s interval between the 
injections, which are usually thrown deeply into the tissues of the but- 
tocks or retro-trochanteric space (Besnier). The part should be washed 
with antiseptic solution, and the needle sterilized before each operation ; 
the puncture should be immediately covered with emplastrum de Vigo 
or by a drop of collodion.| It should be pointed out that the subcu- 
* “Notes on Hydrargyrum Formamidatum,” by J. C. Wilson, M.D., Philadelphia Medical 
Times, vol. xiv, p. 149. 
t Vierteljahrsehrift fur Dermatologie und Syphilis, 1885. 
t Revue Ge'n. de Clinique et de Therapeutique, September 12,1889. 670 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
taneous injection of calomel, or other insoluble preparation of mercury, 
is not without danger. There is liability to the local deposit of the 
mineral at the point of injection, with continuous slow absorption. 
Embolic pulmonary infarction has occurred in direct consequence of the 
procedure, while in other cases a dysenteric condition was established. 
In France, the blue ointment (made with oil instead of fat) is used, 
but it has occasioned abscess and repeated attacks of stomatitis. The 
benzoate of mercury, proposed by StukovenkofF, has been adopted by 
some of the French physicians as the material for injection; 3 grains of 
the salt with f grain of chloride of sodium are added to 1 ounce of water, 
and of this solution about 6 milligrammes (TJj grain) are injected daily 
into the buttock. Urethral injections (1 to 5000 or 1 to 10,000) of the 
benzoate have likewise been successfully employed in gonorrhoea. 
Other mercurial preparations have been used in the same manner 
for the same purpose. Gray oil is much in vogue in Vienna, while the 
salicylate, 3’ellow iodide, and cyanide have been experimentally emploj'ed 
by Roussel and Chernoguboff. Gray oil consists of mercury, lanolin, 
and olive-oil. A case has lately been reported in which a 30-per-cent, 
solution (hydrarg., lanolin., aa 3 parts; olei olivae, 4 parts) had been used 
during seven weeks as a subcutaneous injection. At the date of the last 
injection no sign of mercurialism was present, but a week later the gums 
became tender, ptyalism and violent gastro-enteritis soon ensued, and in 
about a month the patient died. 
The writer has employed the mercurials, the corrosive 
chloride, hypodermatically in the treatment of several cases of psoriasis, 
with a complete removal of all the eruption from the bod3*, the dose 
and injection used being similar to that already described in treating 
S3rphilis. Poncel,* of the Marseilles Hospital, has also emplo37ed injec- 
tions of the corrosive chloride of mercury into tumors of a cancerous 
appearance, followed by their complete disappearance. 
Mercurials are used for their local effects upon mucous membranes; 
for instance, in syphilitic ulceration of the tongue, lozenges of liquorice 
containing grain corrosive sublimate ina3' be allowed to slowly dis- 
solve in the mouth, and the solution being swallowed also produces its 
constitutional effects. In diseases of the uterus and pelvic organs, Dr. 
L. Smith, of Montreal, uses cotton and wool tampons containing mer- 
curic chloride, grain, in conjunction with boro-gtyceride solution 
(10 per cent.), introduced into the vagina twice a week. These may be 
left in place from four days to a week without decomposing or causing 
irritation. The3r take the place of pessaries, are cleanly convenient, and 
efficient in the treatment of vaginitis, endometritis, salpingitis, ovaritis, 
* Medical Press and Circular, September 17, 1890. HYDRARGYRUM. 
671 
and pelvic peritonitis, and the}' entirely remove any unpleasant odor 
from the discharges.* 
In ear affections an ointment of the yellow oxide of mercury, 5 to 
10 grains to the ounce of lard or cold cream, is much used to relieve 
inflammation and keep the canal clean. A similar ointment has been 
used in eye practice in the treatment of chronic blepharitis, tinea tarsi, 
and eczema., or by rubbing in at night a little diluted citrine ointment. 
The irritant properties of the red oxide render its ointment a useful 
application to indolent ulcers, whether of syphilitic or common origin ; 
to enlarged scrofulous glands, or goitre, rosacea, scleroderma, and lepra. 
The oleate is a milder and a safer application, though less efficient. The 
yellow wash is a good application in scrofulous conjunctivitis. Finely- 
powdered calomel may be dusted over the surface of the lids in phlyc- 
tenular ophthalmia and corneal ulcerations. The ointment of the red 
oxide is a valuable counter-irritant and resolvent in enlarged glands, 
goitre, and ague-cake, the application being made in the direct rays of 
the sun or before a fire. This ointment may also be serviceably applied 
to indolent ulcers, seborrhoea, and lupus erythematosus. Ulcers, espe- 
cially venereal, are stimulated by the application of dilute acid nitrate 
of mercury (1 to 10 or 20), but this preparation often gives rise to pain 
and haemorrhage, and should be used very cautiously upon soft parts for 
fear of causing sloughing. It should never be used for venereal ulcers in 
full strength. A better method is to wash the sores or condylomata with 
solution of chlorinated soda, and, after drying with absorbent cotton, 
dust calomel, or equal parts of calomel and starch, over the surface, as 
practiced by Ricord. The black wash also makes a good dressing in 
such eases and in rlius poisoning. In acne or eczema of the scalp, lotions 
containing 1 or 2 grains of corrosive sublimate to each ounce are much 
used. Calomel alone or combined thus is of service in herpes and irrita- 
tion around the genital organs :— 
II Hydrargyri chloridi mitis, 3iij. 
Bismuth, subnit., 
Pulv. lycopodii, ......... aa §ss. 
M. Sig.: Dust over the surface. 
Calomel is also of much value, dusted over the surface, to diminish 
exuberant granulations, as follows :— 
II Hydrargyri chloridi mitis, . . . . . . . . 
Iodoformi vel iodoli, §ss. 
M. Sig.: Sprinkle over the ulcer or ulcerated surface. 
Calomel likewise forms an ingredient of many cancer powders for 
* Canada Medical Record, October, 1890. 672 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
destroying malignant growths upon and in the skin. Esmarch’s painless 
powder contains calomel, and is composed as follow's :— 
Hydrargyri chloridi mitis, gr. lxxx. 
Acidi avseniosi, 
Morphinae hydrochloratis, ....... SS gr. x. 
Pulveris acacise, §j.—M. 
For acne wre may use the following:— 
Hydrarg. chloridi corrosiv., gr.vj. 
Mist, amygdalae, f§vj. 
M. Sig. : Apply night and morning. 
Stronger solutions are useful in scabies, tinea versicolor, ringworm, 
and alopecia :— 
Hydrargyri chloridi corrosivi, gr. xij. 
Spiritus thymoli, f3ij. 
Aquae hamamelidis dest., . f^v.—M. 
$ Hydrargyri chloridi corrosivi, gr. x. 
Spiritus rosmarini, f§j. 
Ammonii chloridi, 3ss. 
Spiritus vini rectiflcat., f^iv.—M. 
The ointment of the nitrate, diluted, or the mercurial ointment, have 
long been used upon the face in small-pox in prder to prevent the devel- 
opment of the pocks and consequent pitting. Whether the effect is 
dependent upon the mercury or exclusion of light and air still remain 
undecided. A weakened citrine ointment is valuable in the topical man- 
agement of ozaena. In the varieties of trichophytosis and in plitheiriasis 
the ointment of the nitrate of mercury is valuable. It is beneficial, more- 
over, in chronic eczema, psoriasis, rosacea, sycosis, and in numerous 
chronic disorders of the skin. 
An ointment of calomel, 20 grains to 1 ounce of lard, is also ser- 
viceable in similar cases, and Ringer considers it of special service in 
itching affections, especially around the anus. A weak calomel ointment, 
5 or 10 grains to the ounce, is of service in impetigo contagiosa and 
ecthyma after separation of the crusts. The later stage of dermatitis is 
benefited by the use of this unguent. 
The following formulas, containing one of the mercurial ointments, 
may be employed in the diseases referred to above :— 
Ungt. hydrargyri ammoniat., §ss. 
Olei lavandulae, , hfxx. 
Ungt. zinci oleatis, §ss. 
M. Use in acne, rosacea, and chronic eczema. 
Ungt. hydrargyri nitratis, . . . , . . . . §ss. 
Olei juniperi, f3ssvel3ij. 
Lanolini, §ss. 
M. For chronic psoriasis and eczema, especially of the hands and feet. HYDRARGYRUM. 
673 
Uugt. liydrarg}'rioleatis (20 per cent.), 
Aristol., 3j. 
M. Serviceable in animal and vegetable parasitic diseases. 
, Ungt. hydrargyri ammoniat., §j. 
Menthol i, 
Cocainse, aii gr. x. 
01. caryophylli, . ITlx. 
M. Beneficial in herpes, herpes zoster, seborrhoea, and eczema, especially of the 
genital organs. 
]> Hydrargyri oxidi flav., gr. vj. 
Camphorse, gr. iij. 
Ungt. aquae rosae, 
Lanolini, . . . aa 3ij. 
M. For irritable and inflamed eyelids. 
Flagg recommends the red oxide of mercury combined ns follows :— 
Hydrargyri oxidi rub., 3iij. 
Ceratum benzoati, §j.—M. 
This preparation maintains its integrity, lie adds, for many months 
and sometimes for years. 
Its use in dental practice, says Flagg, is for the anointing of chapped 
lips, the treatment of sores and cracks at mouth-corners, and for the cure 
of fissured lips. B}T distending the fissures and filling them repeatedly 
with the ointment—distending the fissure with each insertion of oint- 
ment—a quality of cicatricial tissue is produced which, by its tough- 
ening, almost always prevents any subsequent Assuring. 
The late Dr. Marshall employed a 5-per-cent, solution of the oleate 
in oleic acid, adding one-eighth part of ether, for sycosis and parasitic 
and itching affections. The oleates are useful where induration exists. 
The ointment of mercurous oleate is preferable to blue ointment in the 
inunction treatment of syphilis, being more elegant and cleanly, and 
equally efficient. This preparation is of decided value in old patches of 
psoriasis and chronic eczema of the palms or soles. The mercuric oleate 
exerts a powerful resolvent influence upon enlarged glands and upon a 
thickened, indurated condition of the integument. It is, likewise, cura- 
tive in animal and vegetable parasitic affections. 
In troublesome ulcerations of the throat, corrosive-sublimate solu- 
tion is often beneficial as a local application, accompanied by other treat- 
ment suitable to the case. In diphtheria the best results are obtained by 
the internal administration of mercurials, conjoined with local disinfec- 
tion by salt-water douche, permanganate of potassium, trypsin, Monsel’s 
solution, or boro-glyceride, instead of local applications of mercurials, 
since wdiere they are frequently used it is impossible to estimate how 
much has been swallowed. In ozsena, white precipitate may be used in 674 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
the form of a snuff with -white sugar, or with gum acacia and subnitrate 
of bismuth in the strength of 4 to 8 grains to each ounce. 
In chronic gonorrhoea or urethritis, irrigation of the urethra writh weak 
solutions of corrosive sublimate (gr. i—f 3xij), used every four hours, is 
sometimes followed by rapid cure. A little tartaric acid should be added 
to the solution to keep the mercury from becoming changed into an 
albuminate. In gonorrhoea and gleet injection of a solution of salicylate 
of mercury, 1 to 4 grains to the ounce, may rapidly remove the discharge. 
In affections of the joints, orchitis, enlarged glands, an ointment 
containing 1 or 2 grains of morphine and a drachm of calomel in each 
ounce is very useful in reducing the swelling and averting threatened 
abscess. By the use of the Vigo plaster, compression may be made 
around a joint or a swollen testicle with great benefit; 2 or 3 grains of 
corrosive sublimate incorporated in an ounce of ointment is sometimes 
found of service in acne, and from 2 to 5 grains to the ounce is an effect- 
ive application to freckles. An ointment of the latter strength is also 
useful in the ulcerated stage of lupus vulgaris. The officinal blue oint- 
ment is useful in erysipelas as a local application, allays inflammation in 
paronychia, and is a good dressing in chilblains and dermatitis. The 
solution of the nitrate of mercury is serviceably applied to warts, chan- 
croids, syphilitic condylomata, mucous patches, and ulcers of the mouth. 
The ointment of ammoniated mercury is valuable as a stimulant and 
resolvent. 
Since fermentation is now known to play an important part in dis- 
orders of digestion, it is to be expected that the antiseptic powers of 
mercury wrould make it conspicuously useful in treating digestive dis- 
orders. When there is a foul stomach, coated tongue, some vertigo or 
headache, constipation, and depression of spirits,—what is commonly 
called a bilious attack,—10 or 12 grains of blue mass or calomel, followed 
in from six to eight hours by a saline purgative, will entirely change the 
state of affairs. It is probably true that these doses are larger than 
necessary, but, as the excess is carried away by the saline, no harm is 
done. In some cases much smaller quantities given in broken doses, say 
TV grain of calomel with a little soda, given each hour until 5 doses are 
taken, is sufficient to produce the same effect if followed by a cathartic. 
If there is much engorgement of the liver, larger doses are preferable, 
and we may use with advantage the old “ten and ten ” (10 grains of 
calomel and 10 of jalap). During the first week of typhoid fever, 2 or 3 
full doses of calomel are useful in cleaning the alimentary canal and 
making it to some degree aseptic. This is a part of the so-called specific 
treatment of typhoid. In infancy, digestive disorders are very common 
and the}' are promptly controlled by mercurials. Mercury with chalk is HYDRARGYRUM. 
675 
a common ingredient in teething-powders, but should not be used freely 
unless the infant suffers with congenital sj’philis; for, although children 
are not easily salivated, yet they be affected by the mercurial, as is 
shown by the peculiarity in the shape of the permanent teeth due to 
malformation, the result of the incautious use of teething powders con- 
taining mercury. Calomel is used for the same purpose, as well as the 
corrosive chloride, both of which are particularly useful in Asiatic 
cholera and mucous diarrhoea or enterocolitis, in small or minute doses 
given every hour, dissolved in recently-boiled water. In strumous 
children, with poor digestion and small appetite and irregular bowels, 
the following is a valuable tonic :— 
Hydrarg. chlor. corrosiv., gr. j. 
Tr. gentian*, f^v. 
Syr. aurantii, f 
M. Sig.: A teaspoonful four times daily, at meal-times. 
In vomiting of adults and infants, grain of corrosive subli- 
mate, or minute doses of calomel with soda or saccharated will 
often check the irritability of the stomach if the diet is properly 
restricted. In infants having vomiting it may be necessaiy to stop the 
use of milk for a few days, and rely altogether upon rice-water or albumin- 
water until the digestion is normal again. The vomiting of cholera in- 
fantum is often relieved by small doses of calomel, and the nausea of 
adults frequently yields to the same treatment. A minute dose of calomel 
or corrosive sublimate, administered at hourly intervals, is advantageous 
in acute or chronic dysentery, soon causing the disappearance of blood 
and mucus from the discharges. The corrosive chloride, in doses of 
to 3V grfd'i before each meal, promotes cicatrization of a gastric ulcer. 
The occasional use of a mercurial purge aids in expelling intestinal 
worms, and, in fact, calomel is an efficient remedy against tape-worm. 
Given in full cathartic dose, mercury also is an excellent anthelmintic in 
case of lumbricoid worms. It is a common and good practice to use 
a mercurial in combination with santonin. 
Mercury is no longer regarded as essential in the treatment of all 
forms of inflammation of internal organs, but small doses are valuable in 
promoting the absorption of inflammatory exudations, in 
glandular affections, in orchitis, in croupous pneumonia or broncho-pneu- 
monia, tonsillitis and meningitis. The same mode of treatment is effica- 
cious in acute pleurisy, peri- or endo- carditis in previously robust 
patients. In dropsy due to deficient excretion, calomel, 1 grain three 
times daily, with squill or digitalis, will cause a free diuresis in a few 
days, but should not be pushed too far on account of the danger of sali- 676 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
vation in a depressed subject. It is in dropsy dependent upon disease 
of the heart that the diuretic action of calomel is especiall}' advantageous. 
In the treatment of diphtheria, Dr. Daly,* of Pittsburgh, strongly 
advocates Reiter’s method of using calomel; 2 to 5 grains being given 
every hour, or every two or three hours, to young children, until the dis- 
charges from the bowels appear as colorless serum, with a little greenish 
mucus or bile upon the surface resembling .chopped spinach. Then the 
interval is lengthened, but the same dose continued. Shortsf gives from 
5 to 15 grains every two or three hours to an adult until the greenish 
stools are obtained, avoiding salivation by the simultaneous administra- 
tion of 5 to 8 grains of chlorate of potassium. The bichloride of mercury 
has also its advocates in this disease, and here the system tolerates com- 
paratively large doses not only with impunity but -with benefit. From 
to tV grain may be given every two hours to an infant for twenty-four 
to forty-eight hours, until the -worst part of the illness has passed over, 
when the intervals can be lengthened and the dose reduced. This has 
the advantage of being less likely to cause salivation than the calomel. 
In true %nembranous or diphtheritic croup this plan of treatment may 
avert the necessity of intubation or tracheotomy. In diphtheria, Dr. E. 
L. B. Godfrey uses iron in combination with corrosive chloride of 
mercury :— 
Hydrargyri chloridi corrosivi, gr. j. 
Tinct. ferri chloridi, f3ij. 
Syrup, simplicis, f3vj. 
Aquae, . . q. s. ad f giij. 
M. Sig.: A teaspoonful in water every three hours. 
The yellow sulphate of mercury is a valuable adjunct in the treat- 
ment, for 2 or 3 grains administered to a child are followed by prompt 
emesis and the ejection of false membrane from the throat. Fordyce 
Barker considers it uniformly successful In croup. It should not be 
allowed to remain in the stomach in case the first dose does not produce 
vomiting, as it may cause gastritis or mercurial poisoning; it generally 
is rejected too rapidly for absorption to take place. 
In other constitutional diseases attended by inflammation of the 
throat we may give £ grain of gray powder three or four times a day, as 
recommended by Ringer. This high authority also advises the same 
preparation in the same dose, given hourly, in acute tonsillitis when the 
swollen glands interfere with deglutition and respiration. 
The appended formulas containing mercury will be of benefit in diph- 
theria, acute tonsillitis, and often in acute laryngitis :— 
* Transactions of American Laryngological Association, 1886. 
t Physician and Surgeon, September, 1889; Annual of Universal Medical Sciences, 1890. HYDRARGYRUM. 
677 
Hydrargyri chloridi mitis, gr. ij. 
Antimonii et potassii tart., gr. j. 
Saechari albi, 3ss. 
M. et ft. chart* no. x. 
Sig.: A powder every hour or two. 
Hydrargyri chloridi corrosivi, gr. j. 
Tinct. guaiaci, . f§j. 
Glycerini, f §ij. 
M. Sig.: A half to a teaspoonful every two or three hours. 
The sore throat of scarlatina is benefited by the administration of 
the gray powder, or the bichloride. Petresco, after numerous bacterio- 
logical and clinical experiments, relies upon Van Swieten’s solution* in 
the treatment of measles, scarlet fever, and small-pox. In scarlet fever 
the solution of the corrosive chloride was applied directly to the throat, 
either by penciling or in the form of a gargle.f 
MapotherJ employs mercury externally and internally in the treat- 
ment of psoriasis, the blue pill or the protiodide of mercury being 
usually prescribed. 
In syphilis, the role of mercury has been considerably abbreviated 
in recent years. There is no denying that it does rapidly control the 
earl}- manifestations of syphilis and also those of congenital so 
that it may be considered, within limits, as antagonistic to the syphilitic 
poison. As mercury is most efficient when it encounters the poison in 
the blood, it should be given as soon as induration is observed around the 
primary sore, and the treatment by small doses, avoiding ptyalism, main- 
tained for several months. In some cases there will be no further symp- 
toms ; in others, secondaries will appear, but will be much modified. In 
the secondary stage the mercurial may be combined with iodides, and the 
tertiary manifestations are generally best treated by iodine without mer- 
cury. The mercury with chalk is preferred by Mr. Hutchinson, of 
London (gr. j, four times daily); Ricord prefers the green iodide (gr. 
three times daily). Calomel is used by some, corrosive chloride by 
others. The elder Gross was fond of a biniodide made extemporaneously, 
as follows :— 
Hydrarg. chlor. corrosiv., gr. j. 
Potass, iodidi, 3j. 
Aquae destillatae, f §yj. 
M. Sig.: A tablespoonful three times a day. 
* Van Swieten’s solution is composed as follows: 10 grains each of corrosive sublimate and 
chloride of ammonium dissolved in a pint of distilled water. Dose, f5ss-j. 
t Recherches Cliniques et Experimentales sur l’Antisepsie Medicate. Par le Dr. Z. 
Petresco. Memoire presente au Congres de Tlierapeutique a Paris en 1889. Jassy: Iinprimiere 
National, 1889. 
X “The Parasitic Nature of Psoriasis, its Treatment by Mercury,” by E. D. Mapother, M.D., 
F.R.C.S., in British Medical Journal, January 17,1891. 678 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
It may be given directly, as in the “ Syrup Gibert”:— 
Hydrarg. iodidi rubr., gr. iij. 
Potassii iodidi, gr. cij. 
Aquae destillatae, f'3iij. 
Cola et adde 
Syrupi, q. s. ad f§x. 
M. Sig.: A half to a tablespoonful three times a day. 
Hurd* writes that the country physicians, as a rule, prefer the 
“ mixed treatment,” believing that the combination of mercury with 
iodide of potassium is admirably adapted to secondary syphilis, and that 
much less mercury is needed when the mercurial is given along with the 
iodide of potassium. 
In administering mercury for the treatment of syphilis, the author 
recommends the preparation or the combination with it which he deems 
best for each case, depending in all instances upon the patient’s system. 
Some do best upon calomel, others upon gray powder or the corrosive 
chloride, while in very many instances the biniodide or blue pill acts 
more decidedly. One after the other of the various mercurials first 
named have often to be tested or combinations containing them made 
before the form of the drug suitable to the case under consideration can 
be selected and its use continued for a proper time. In the treatment 
of secondary and tertiary syphilis by mercury, the author suggests the 
following formulae :— 
Hydrargyri chloridi corrosivi, gr. j. 
Tinct. xanthoxyli, f^v. 
M. Sig. Two teaspoonfuls in water three or four times a day. 
Hydrargyri chloridi mitis, gr. v. 
Sacchari albi, 3ss. 
M. et ft. chart* no. x. 
Sig.: A powder three or four times a day. 
Hydrargyri protiodidi, gr. v. 
Quinin* sulphatis, . . gr. xl. 
M. et ft. pil. no. xx. 
Sig.: A pill three or four times a day. 
Pilul* hydrargyri, 
Pulveris zingiberis, 
Pulveris capsici, 85 gr.xvel xx. 
M. et ft. pil. no. x. 
Sig.: A pill three or four times a day. 
IJ: Hydrargyri cum cret&, 
Pulveris glycyrrhiz*, aa gr. x. 
Creasoti, . 'Hj. 
M. et ft. chart* uo. xx. 
Sig.: From four to six powders a day. 
* “The Place of Mercury in Therapeutics,” by E. P. Hurd, M.D., Therapeutic Gazette, 
January 15, 1891. 679 
HYDRASTIS. 
Hydrargyri chloridi corrosivi, gr. j. 
Tinct. stillingiae, f^ij. 
Tinct. gent, comp., . . . . , . . . . f§iij. 
M. Sig.: Two teaspoonfuls in water three times a day. 
Mention lias already been made of the hypodermatic, fumigation, and 
inunction methods of treating syphilis, and it is only needed to add that 
a drachm or two of corrosive chloride of mercury with twice as much 
common salt can be added to a bath for syphilitic subjects with skin- 
lesions. When the patient is much broken down, cachectic and anaemic, 
mercury should only be given in the tonic doses already mentioned; but? 
as a rule, the general health should be built up before putting the patient 
on a mercurial course. 
As a rule, the mercurial preparations should not be combined with 
any other on account of their affinities, which would induce changes that 
either lessen their efficiency or possibly make them more active than is 
desirable. 
HYDRASTIS (U. S. P.).—Hydrastis, Golden Seal, Yellow Puccoon. 
Preparations. 
Extraction Hydrastis Fluidum(U. S.P.).—Fluid Extract of Hydrastis. Dose, Hlv-xxx. 
Extractum Hydrastis.—Extract of Hydrastis (inspissated fluid extract). Dose,gr. ii-v. 
Tinctura Hydrastis (U. S. P.).—Tincture of Hydrastis (20 per cent.). Dose, f3ss—ij. 
Hydrastina.—Hydrastine. Dose, gr. ss-v. 
Hyclrastince Hydrochloras.—Hydrochlorate of Hydrastine. Dose, gr. ss-v. 
Pharmacology.—The officinal portions of golden seal, Hydrastis 
Canadensis, are the rhizome and rootlets. It is a small plant belonging 
to the Ranunculaceae, and grows in rich, moist woods, from Canada to 
Carolina, in the Alleghenies and westward. Its most important constit- 
uents are Hydrastine, a white crystalline alkaloid, not bitter, although 
leaving an acrid sensation in the mouth and throat, and Berberine, a 
yellow and intensely bitter crystalline alkaloid, with traces of a third 
alkaloid, Xanthopuccine, which exists in such small quantity as to be of 
little consequence. It also contains a resin, starch, sugar, etc. The sub- 
stance used by irregular practitioners under the name of lydrastin is 
an impure muriate or hydrochlorate of berberine. Both hydrastine 
and berberine unite with acids to form salts. The dose of the pure non- 
bitter hydrastine is from gr. to \; of the impure bitter extract hy- 
drastin the dose is from gr. iii-x ; it is unfortunate that the names are 
almost identical, since the dose is much smaller of the alkaloid than of 
the common preparation. By decomposing hydrastine with the aid of 
gentle heat and dilute nitric acid, a new alkaloid, Hydrastinine, is formed, 
together with opianic acid. Recent experiments by Falk show that the 
hydrochlorate of hydrastinine is a highly valuable remedy. Besides the 680 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
officinal fluid extract, which is made with dilute alcohol as a menstruum, 
an aqueous fluid extract called “ fluid hydrastis ” is sold, which does 
not fully represent the root, as it is made with water and glycerin, but is 
an attractive and useful preparation. 
Physiological Action.—Hydrastine is an active poison, causing con- 
vulsions, followed by paralysis. Berberine is less convulsant,and has been 
already discussed. (See page 477.) Hydrastis is possessed of anti- 
periodic qualities, though ranking much below cinchona. In small 
amounts it promotes appetite, increases the gastric secretions, acts as a 
cholagogue, and stimulates peristalsis ; in larger doses it deranges di- 
gestion and causes constipation. In poisonous doses death may be caused 
by its action upon the nervous system, from convulsions or paralysis. 
Introduced into the circulation it causes rise in pressure after a prelimi- 
nary fall; if in large dose, the pressure falls, the irritability of the vagus is 
destroyed, aud the heart’s action is arrested in diastole. As hydrastine 
is eliminated chiefly the kidneys, it exerts some diuretic action. The 
derived alkaloid, hydrastinine, being sparingly soluble in water, the hydro- 
chlorate of liydrastinine has been employed to some extent recently, and 
the result of the investigation shows it to possess powers like ergot. It 
is used in 5- to 10- per-cent, solution, liypodermatically. The injections 
do not cause pain and do not discolor the tissues, but they so readily 
control haemorrhage, and especially uterine haemorrhage, as to constitute 
this agent a rival of the preparations of ergot. Falk reported 26 cases of 
uterine haemorrhage, receiving 400 injections in all, and considers it much 
more prompt and sustained in its action than ergotine. 
Therapy.—The hydrochlorate of hydrastine, 3 grains to the ounce of 
gtycerin, Keyser reports is excellent in some cases of conjunctivitis 
granulosa. It is also used in nasal catarrh, and in uterine catarrh, or 
leucorrhoea, both internally and locally. In gonorrhoea, after the acute 
stage is passed, we may use hydrastin (commercial) in water (gr. v-sj) 
twice daily, or drachm of fluid extract may be added to pint of 
water, and used as an injection in subacute gonorrhoea, vaginitis, and 
leucorrhoea. As a mouth-wash in syphilitic affections the tincture may 
be added to water and freely used. The fluid extract, either in full 
strength or diluted with water, is likewise a beneficial local remedy in 
mercurial or aphthous stomatitis and follicular pharyngitis. The same 
application may be made with advantage to fissured nipples and otorrhoea. 
Hyd rastis and the hydrochlorate of hydrastine possesses a sphere of use- 
fulness in dermatology.* From 2 to 6 grains to the ounce of water, 
or distilled witch-hazel, makes an excellent lotion in hyperidrosis. 
* See paper by the author, on “Hydrastis and Hydrastine Hydrochlorate in Diseases of 
the Skin,” in The Medical Bulletin for May, 1885. HYDROGEN PEROXIDUM. 
681 
Its stimulant effect upon the sebaceous glandular sj'stem renders 
it also of avail in acne and dry seborrhcea. A useful ointment 
be prepared by incorporating 5 to 30 grains of the hydrochlorate of 
hydrastine in an ounce of ointment basis. Hydrastine ointment stimu- 
lates ulcers to repair and at the same time destroys the foetor of unhealthy 
discharges. For this reason it may be appropriately used as a dressing 
upon ulcerated carcinoma and in bromidrosis. This ointment is an 
excellent application to chancroids and chronic eczema :— 
I£ Ergo tin se, 
Naphthol., aa 3ss. 
Hydrastinse hydroc.hloratis, gr. v vel xx. 
Bismuthi subnitratis, 3j. 
Unguenti simplicis, . . * , . . . q. s. ad §j. 
M. Sig.: Useful in hyperidrosis, bromidrosis, acne, and seborrhcea. 
II Hydrastinse hydrochloratis, gr. v vel xx. 
Naphthol., 3ss. 
Tinct. quillaise, f 
Tinct. hamamelidis, q. s. ad f §iv. 
M. et ft. sol. 
A lotion for hyperidrosis, acne, and seborrhcea. 
I£ Ext. hydrastis fid., 
Ext. ergot* fid., aa f gj. 
M. Sig.: Use as a local application. In fissure or prolapse of the anus, ulcerations 
of the rectum, haemorrhoids, and ulcerations or erosions of the os uteri. 
Unhealthy ulcers, sloughing sores, and chancroids are benefited by the 
local application of the fluid extract. In affections of mucous mem- 
branes, especially of catarrhal character, hydrastis and its preparations 
are most efficient. In the chronic gastric catarrh of drunkards, in duo- 
denal catarrh with or without jaundice, or chronic catarrh of the intestine 
with ulceration, it is an excellent remedy. As a vegetable, bitter tonic, 
it is employed in anorexia and convalescence from fevers. Jordan* 
reports that in an obstinate case of membranous ctysmenorrhoea 25 drops 
of the fluid extract of hydrastis twice daily, beginning eight days before 
each menstruation, was followed by a cure. In malarial attacks it is 
less efficient than quinine in checking the paroxysms, but is useful as a 
stomachic and general tonic. Hydrastis lessens the discharge of albumin 
in chronic Bright’s disease and of mucus in catarrh of the bladder. Scliatz 
pronounces it a useful agent in controlling haemorrhages from the uterus. 
The effects of hydrastis in cancer are very probably limited to its action as 
a motor nerve-tonic and its stimulating effect upon the digestive organs. 
HYDROGEN PEROXIDUIVI.—Peroxide of Hydrogen. 
Pharmacology.—The commercial dioxide or peroxide of hydrogen is 
a colorless solution of this agent in water. It is without odor, of a harsh, 
* Centralblatt fur Gynakologie, No. 2, 1890. 682 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
slightly acrid taste, and readily yields oxygen at ordinary temperatures. 
The usual strength is called the fifteen-volume solution, because each por- 
tion of the solution yields fifteen volumes of the oxygen. It is prepared by 
Charles Marchand, New York,for medical use, and is an active oxidizing 
and antiseptic agent. Gtycozone is the trade name of a similar prepara- 
tion in which glycerin is the vehicle. 
Therapy.—Though less powerful than many other antiseptics, the 
solution of hydrogen peroxide has a special place in surgery,- gynse- 
cology,* and obstetrics, on account of its power of decomposing pus and 
destin ing the microbes of •suppuration. Being free from all irritating 
qualities, it can be poured over wounds, injected into sinuses, or into the 
ear, or used as a spray in ulcerations of the pharynx and of the larynx. 
It produces a frothing up when it encounters pus, owing to the libera- 
tion of ox3’gen, and the cessation of this commotion indicates the 
removal of all the pus. The surface of the wound or ulcer becomes 
blanched, but is not injured by the application. Tubercular and 
mammary abscesses especially are well treated in this way. In ulcera- 
tive tonsillitis, fetid breath, and in some bronchial affections, a spray 
of dilute hydrogen peroxide is productive of benefit. A spray of 
this agent is likewise of utility in chronic nasal catarrh, ozaena, and scar- 
latinal angina. It has been administered, well diluted, in gastric affec- 
tions, and is said to be very useful in flatulent dyspepsia, heartburn, 
catarrh of the stomach and bowels, etc. In diphtheria and croup its value 
has been established; a two-volume solution is specially recommended 
in young children as a local application, and particularly after separation 
of the membranes, in order to remove the odor and disinfect the surface.f 
Internally it is too quickly decomposed in the stomach to render much 
service as a source of oxygen to the blood. It might prove of value in 
gastric ulcer. 
HYOSCYAMUS (IJ. S. P.).—Hyoscyamus, Henbane. 
Dose, gr. v-x. 
Preparations. 
Abstractnm Hyoseyami (U. S. P.).—Abstract of Hyoscyamus. Pose, gr. %-ij. 
Extractum Hyoseyami Alcoholicum (U. S. P.).—Alcoholic Extract of Hyoscyamus. 
Dose, gr. %-]. 
Extractum Hyoseyami Fluidum (U. S. P.).—Fluid Extract of Hyoscyamus. Dose, Uli-v. 
Tinctura Hyoseyami (U. S. P.).—Tincture of Hyoscyamus (15 per cent.). Dose, 
Tllxx-3ij. 
Hyoscyaminw Sulphas (U. S. P.).—Sulphate of Hyoscyamine. Dose, gr. 
Extractum Hyoseyami.—Extract of Hyoscyamus. Dose, gr. i-ij. 
Hyoscince Hydrobromas.—Hydrobromate of Hyoscine. Dose, gr. liypodermatically. 
* “Peroxide of Hydrogen in Gynaecology and Obstetrics,” by E. H. Grandin, in The Times 
and Register, January 31, 1891. 
f Dr. E. R. Squibb, “ On the Medical Uses of Hydrogen Peroxide,” Gaillard’s Medical 
Journal, March, 1889. HYOSCYAMUS. 
683 
Pharmacology.—The leaves of Hyoscyamus niger (Solanacete), col- 
lected from plants of the second year’s growth, a biennial, growing in 
the Northern United States and in Europe. The chief constituent is an 
alkaloid, Hyoscyamine, which is either an oity liquid or in tufted crystals, 
yellowish or colorless ; with acids it forms permanent, crystallizable salts; 
its sulphate is officinal. It is isomeric with atropine, and probably 
identical with daturine and duboisine. Hyoscine is a derivative of 
hyoscyamine (which is composed of hjoscine and tropaic acid, according 
to Gfnauck), and is very much more powerful, even grain producing 
decided effects. The root and the seeds contain more hyoscyamine 
than the leaves, but their strength is more variable. The inspissated 
extract of the leaves was dropped from the pharmacopoeia on account 
of its variability and the uncertainty of the dose. 
Physiological Action.—The effects of hyoscyamus are similar to those 
of belladonna and stramonium, but it is more calmative and less irritant. 
The delirium occasioned by it is not accompanied by hyperaemia. 
It is sedative in painful affections of the genito-urinary organs, and 
exerts a mild diuretic effect. Hyoscyamus occasionally gives rise to a 
bright scarlatiniform rash similar to that produced by belladonna. It 
is carminative and laxative to the digestive tract. Hyoscyamine and, to 
a greater degree, hyoscine are valuable as hypnotics in disordered con- 
ditions of the mind. They lower the pulse-rate and frequenc}'' of the 
respirations. The heart is slightly depressed ; the respiration finally is 
paralyzed. 
Therapy.—In painful affections of the bladder hyoscyamus exerts a 
soothing influence when administered either by the mouth or in supposi- 
tories. Decided relief is given by hyoscyamus in incontinence of urine 
due to irritability of the bladder and in vesical tenesmus. Dyspnoea 
and tumultuous action of the heart, dependent upon valvular disease, are 
materially relieved by the exhibition of hyoscyamus. In colic of various 
kinds and in constipation it is beneficial, especially" to correct the drastic 
effects of purgatives. In the pains of ataxia, and in tremor, 
hyoscyamus is very efficient, as it is also in delirium tremens and the 
delirium of fever. Irritative cough, asthma, or whooping-cough is some- 
times markedly improved by it. The antispasmodic action of hyoscy- 
amus renders it of avail in the management of chorea and 
convulsions. 
In nervous cough the following prescription will often be found of 
service:— k 
It Tinct. hyoscyami, f §ss. 
Syrup, pruni Virg., fgiiiss. 
M. Sig.: Dessertspoonful every third or fourth hour. 684 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Il3Tosc3'fimus is capable of ameliorating painful maladies, such as 
neuralgia, especially visceral neuralgia, herpes zoster, and dysmenorrhoea. 
In these affections hyoscyatnus may be combined with opium in order to 
counteract the constipating effects of the latter, or ma37 substitute that 
remedy when peculiar susceptibility to its action exists. Mr. Embleton 
has found grain each of lyoscyamine and strychnine, given every ten 
minutes, very useful in seasickness. But it is in asylum practice that 
the best results from its use have been obtained. Chronic mania and 
delusional insanity derive benefit from it. Ringer records a case where 
gr. j of amorphous lyoscyamine was given in acute mania, and it quieted 
the patient and produced sleep; but he considers it useless in delirium 
tremens. Hyoscyamine separates from ether in an amorphous form, 
which is considerably less potent than the cr37stalline alkaloid obtained 
from solutions in chloroform. Amorphous hyoseyamine may be given 
from to § or even 1 grain. Ringer expressly states, however, that the 
maximum dose causes sleep so deep and paratysis so marked as to be 
alarming, and that smaller doses should be preferred. As a rule, much 
smaller doses are efficient in acute mania than in the exacerbations of 
chronic mania. 
Hyoscyamine has also proved of great value in recurrent mania. 
Murrell has found it of good service in chronic dementia, with agitation 
and destructiveness. It diminishes the number and violence of the 
attacks in epileptic mania. Hyoscine hydrobromate produces similar 
results in much smaller doses (gr. the mouth, gr. hypodermati- 
cally). Both of these agents have nydriatic effects, and can be used in 
ophthalmic practice to dilate the pupil; but duboisine is equally efficient 
and less expensive for this purpose, and homatropine lydrobromate safer 
and more reliable. In cases of great nervous excitement and insomnia, 
Prof. S. B. Howell reports to the author that hypodermatic injections 
of from t1q to grain of hydrobromate of lyoscine were usually 
followed, a few moments after administration, b37 calm slumber. Sleep 
general^7 continued for several hours, with no ill effects, as a rule, upon 
awakening. Slight mental disturbance was occasionally observed as the 
patient awakened, but even this condition rapidly disappeared. Howell 
further states that injections of hydrobromate of lyoscine have never 
failed him in cases which had been upon the protracted use of morphine. 
H3roscyamus excels belladonna and stramonium in hypnotic effect, and 
is consequent^7 useful when a remedy of this character is required by 
children, ly whom it is remarkabl3r well borne. On tlm contrary, it is 
not well supported by aged people. A poultice may" be made (leaves 2, 
flaxseed-meal 6, boiling water 20) and employed for the reduction of 
swellings and the relief of the pains of sores. 685 
HYPNAL. 
HYPNAL.—Monochloral-Antipyrin. 
Dose, gr. xv-xxx vel itlxv-xxx. 
Pharmacology.—Chloral forms two definite crj’stnlline combinations 
with antipyrin, mono- and hi- chloral antipyrin. The first is known as 
Hypnal, an oily liquid with an ether odor and chloral taste. 
Physiological Action and Therapy.—Dr. Schmidt, of Nancy, found 
that 1 gramme (15 grains) is equal to about \ gramme grains) of 
chloral as a hypnotic; upon respiration it is about equal, while upon 
arterial pressure and cardiac contractions it has less effect than chloral 
alone. In the stomach it is more poisonous than the amount of chloral 
contained in it. Dr. Fraenkel prefers it to chloral because it is nearly 
tasteless, is devoid of irritating qualities to the mouth or stomach, and 
considers it an unrivalled soporific, especially when insomnia is the result 
of pain. It is sparingly soluble, and is given suspended in mucilage, 
in capsules or cachets. Mattison writes (Medical Record) that he regards 
hypnal as particularly adapted to children and to patients with phthisis, 
lessening fever, pain, insomnia, and unrest. He recommends the follow- 
ing formulae of hypnal:— 
Hypnal, Hfxv. 
Alcohol, TTllx. 
Elixiris vel syrupi, ad blccxl. 
M. Sig.: One dose; to be followed by one-third of a tumbler of water. 
!£. Hypnal, llfxxx. 
Mucilag. acaciae, .. . . f§j. 
M. Sig.: One injection. 
II- Hypnal, Hfxv. 
M. Sig.: One dose, hypodermatically. 
HYSSOPUS.—Hyssop. 
Dose, gr. ii-v. 
Pharmacology and Therapy.—The herb Hyssopus officinalis (Labiatae) 
contains about per cent, of a volatile oil, with tannin and a bitter prin- 
ciple. It is stimulant, carminative, and sudorific, and is given in solid 
or fluid extract in stomach disorders, recent colds, etc. 
HYSTERIONICA.—Hysterionica. 
Pharmacology and Therapy.—The Hysterionica baylaliuen (Com- 
posite) is a native of South America. It is a perennial plant with oval 
leaves, bears a yellow flower, and contains an ethereal oil having the 
specific odor of the plant; a greenish-black resin, also of the same odor; 
gum, and glucose. The resin is excreted b}T the kidneys, the oil by the 
lungs. Dr. G. Bailie* reports that the infusion is an excellent remedy in 
* Paris Letter, Therapeutic Gazette, September, 1890, p. 640. 686 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
diarrhoea, and it has produced good results in both acute and chronic 
dysentery. It has also been proved useful in the diarrhoea of phthisis or 
cancer. Ilysterionica allays inflammation of the bronchial mucous mem- 
brane, lessens expectoration, and quiets cough without causing sickness of 
the stomach. It promotes the action of the kidneys and diminishes the 
offensive odor of the urine in vesical catarrh. This remedy increases 
the acidity of the urine, seems to be without effect upon the perspiratory 
glands, and assists the healing of wounds. It may be used as a vehicle 
for remedies like the mercurials in order to prevent the production of 
diarrhoea. Given in alcoholic tincture it does not produce constipation.* 
The tincture is made by macerating 100 parts of the drug in 500 parts 
of 90-per-cent, alcohol for ten days, and its dose is from 15 to 35 drops. 
ICHTHYOCOLLA (U. S. P.).—Isinglass, Fish-Glue. 
Preparation. 
Emplaslrum Ichtlujocollce (U. S. P.).—Isinglass-plaster, Court-plaster. 
Pharmacology.—The swimming bladder of Acipenser huso and of 
other species of Acipenser (class, Pisces; order, Sturiones), or, more 
definitely, the inner membrane of the swimming bladder, which is gen- 
erally spread out in drying, forming flat sheets, or leaf-isinglass. The 
kind imported from Russia is the most valued. Chemically, it is an ex- 
ceptionally pure gelatin, known to chemists as glutin; it is free from 
odor and taste, and is soluble almost without residue in boiling water 
and in boiling diluted alcohol. Isinglass does not dissolve in cold water 
as gelatin does, and, therefore, is a valuable constituent of cements. 
Both are precipitated by tannin. 
Therapy.—Isinglass is used for clarifying infusions, and may be 
boiled with milk for internal use in bowel disorders. A codliver-oil jelly 
is made by means of isinglass, according to the formula given by Dr. 
Wliitla in his excellent work on Materia Medica :— 
]£ Olei morrhuas, f^v. 
Iclithyocollse, 3ij. 
Pulv. sacch. alb., . giss. 
Olei amygd. essen., Ttliv. 
Olei pimentae, llliv. 
Olei cinnamomi, iriiij. 
Aquae, f^j. 
M. This preparation is sometimes taken readily by children, and can be given in tea- 
spoonful doses, alone or in milk, orange-juice, etc. 
The well-known court-plaster, spread on silk, affords a convenient 
method of approximating small wounds and excluding the air; the addi- 
tion of an antiseptic, like salicylic acid, is an improvement, forming 
salicylated isinglass-plaster. 
* Therapeutic Gazette, vol. xiii, p. 287. IGNATIA. 
687 
IGNATIA (U. S. P.).—Ignatia, Bean of St. Ignatius. 
Dose, gr. i-ij. 
Preparations. 
Abstraction Ignatice (U. S. P.).—Abstract of Ignatia. Dose, gr. 
Tinctura Ignatia (U. S. P.).—Tincture of Ignatia (10 per cent.). Dose, bfii-x. 
Extracturn Ignatice.—Extract of Ignatia. Dose, gr. 
Extraction Ignatice Fluidum.—Fluid Extract of Ignatia. Dose, TTli-ij. 
Pharmacology.—The seed of Strychnos Ignatii (Loganiacese) con- 
tains two alkaloids, both highly poisonous, Strychnine and Brucine (from 
.5 to 1.5 per cent, of each). Strychnine and strychnine sulphate are 
officinal. (See Nux Yomica for physiological action.) 
Therapy.—The medicinal uses are the same as those of nux vomica, 
except that the dose should be smaller. Ignatia is employed almost 
for the preparation of the alkaloids. 
ILEX.—Holly. 
Pharmacology.—The leaves of several American species of Ilex con- 
tain Caffeine, and may be used as substitutes for the Camellia thea. In 
the Southern United States, the Ilex cassine (Aquifoliaceae) is used in 
this way to some extent, but the Brazilian holly, Ilex Paraguayensis, is 
much richer in caffeine, and is extensively used in South America, in re- 
cent infusion, where it is known as matd or Paraguay tea. The matd is 
the gourd in which the infusion is made by pouring upon the leaves suc- 
cessive quantities of boiling water. The following analysis will show 
the analogy and the slight differences between the Ilex and tea and coffee; 
it was made b}’ Dr. T. Cranstoun Charles:— 
Caffeine. 
Tannic Acid. 
Ash. 
Percentage. 
Percentage. 
Percentage. 
Tea, .... 
22.7 
5.8 
Roasted coffee,. 
. 1.2 
5.8 
4.6 
Mat6, 
. 0.79 
21.9 
4.1 
Besides these constituents there are small amounts of volatile aro- 
matic oils, empyreumatic products, etc., which modify the effects of each 
upon the system, and upon different individuals. In the main, however, 
the effects of matd are those of caffeine. (See page 491.) 
Physiological Action and Therapy.—Charles found holly stimulant to 
the brain and also to the sympathetic system; the contractions of the 
muscular tissue of the heart and of the bladder and intestines were 
increased, and the whole muscular system stimulated to increased labor 
and wakefulness. Ilex augments the flow of urine and amount of urea 
and phosphoric acid. At present its therapeutic applications seem limited 
to the treatment of headaches accompanied by constipation, especially 
when tea and coffee do not agree.* 
* British Medical Journal, July 26,1890. 688 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
ILLICIUM (U. S. P.).—Illicium, Star Anise. 
Pharmacology and Physiological Action.—The Illicium anisatum 
(Mngnoliaceae) is a native of China and Siam ; its fruit, which is officinal, 
contains a pleasant aromatic volatile oil resembling that of anise, and also 
some fixed oil. Two species, I. floridanum and I. parviflorum, are natives 
of this country, being found in Florida and adjacent States. The Japa- 
nese variety, Illicium religiosum, contains a much smaller quantity of 
the oil, besides a crystalline substance called sikimin or shikimi, which 
is poisonous; so that dangerous results have followed the substitution 
of the latter for the officinal, such as violent epileptiform convulsions 
with cyanosis, ending in death. Illicium is recognized by the pharma- 
copoeia as one of the sources of the oil of anise; and, in fact, it is the 
chief source. Dr. E. Barral has recently isolated a poisonous glucoside 
from the kernel of Illicium parviflorum, which is not in the pericarp. 
The decoction of the seeds produces attacks of gastric irritation and 
vomiting, followed by paralysis, anaesthesia, convulsions, and death, if 
the dose be sufficiently large.* 
Therapy.—The medicinal virtues are similar to those of anise and 
other carminatives. The crushed seeds are applied externally to allay the 
pain of earache, colic, rheumatism, etc. It also has some reputation in 
Germany in the treatment of bronchitis in the form of a tea; although 
this form of administration is not recommended. 
INDIGO.—Indigo. 
Pharmacology.—Indigo is a vegetable coloring agent, obtained from 
several species of Indigofera (Leguminosse), of India. It is precipitated 
from the juices of these plants by macerating the green twigs and leaves 
and developing a kind of fermentation process. It is sold in masses 
of a blue or purplish color, and should contain from 70 to 90 per cent, of 
Indigo-blue or Indigotin. Indigo is insoluble in water and alcohol. The 
sulphate of indigo is a pasty mass and mixes with water, forming liquid 
blue. Used only as a coloring agent and in solution for chemical tests. 
INULA (U. S. P.).—Inula, Elecampane. 
Dose, gr. xv-5j, in infusion. 
Pharmacology.—The root of Inula helenium (Composite) contains 
a volatile oil and a resin, a crystallizable substance called Helenin, some 
bitter extractive, and about 20 per cent, of Inulin, a peculiar kind of 
starch, not colored blue by iodine. 
Therapy.—The powdered root is used in decoction sweet- 
ened and flavored, which is taken freetyas a diaphoretic and expectorant 
in chronic bronchial and pulmonary affections, dyspepsia, dysmenorrhoea, 
* Rev. Gen, de Clinique et de Therapeutique, October 24,1889. IODOFORMUM. 
689 
etc. It has been used both internally and externally in skin diseases 
(eczema and psoriasis). Inulin is said to be an excellent stimulant t'o 
granulations. 
IODOFORMUM (U. S. P.).—Iodoform. 
Dose, gr. ii-v. 
Preparation. 
TJnguentum Iocloformi (U. S. P.).—Ointment of Iodoform (10 per cent.). 
Pharmacology.—Iodoform was discovered by Serullas in 1822, and 
introduced into medicine in 1837 by Bouchardat, and also by Dr. R. M. 
Glover, of London. It is produced by the action of iodine in the pres- 
ence of alkalies upon alcohol, aldehyde, ether, acetic ether, metliylie 
alcohol, and in minute quantities when acting upon carbohydrates or 
proteid compounds. Its formula is CHI3. It occurs in yellow, scaly 
crystals, having the odor of saffron. It is insoluble in water, but soluble in 
alcohol, ether, and the fixed and volatile oils. By a temperature of above 
239° F. it is fused and decomposed, giving off violet vapors. It is 
prepared usually by treating an alcoholic solution of potassium iodide 
with lime. Iodoform has a sweetish taste and a peculiar penetrating odor 
which adheres persistentty to the vessels in which preparations of it have 
been made, and to the clothing and hands of those who use it. Many 
attempts have been made, with more or less success, to mask the pecu- 
liarly offensive odor of this substance. The essential oils, balsam of 
Tolu or of Peru, musk, Tonka bean, menthol, eucalyptol, tli3*mol, naphtha- 
line, tar, and creolin have all been used for this purpose. Lindermann’s 
mixture consists of iodoform 1, balsam of Peru 3, and vaselin 8 parts. 
Instead of vaselin 12 parts of alcohol, glycerin, or collodion ma3r be em- 
ployed. Iodoform mixed with 1 or 2 per cent, of creolin and well 
triturated presents itself in the form of a light-brown powder, 
having a faint, aromatic odor and soluble in alcohol and ether. This 
powder has been applied with success by von Jaksch to fulfill all the 
indications of iodoform. Caubrelle’s formula for deodorizing iodoform 
is as follows :— 
Iodoformi, gr. xv. 
Mentholis, gr. %. 
Spiritus lavanduias, Nix.—M. 
Pulvis iodoformi dilutus (N. F.) contains iodoform 2, boric acid 3, 
liaphthalin 5 parts, with oil of bergamot q. s. It is in a fine powder, and 
the odor is entirety masked. The iodoformum aromaticatum (N. F.) 
contains 4 per cent, of coumarin. The odor of iodoform may be removed 
from utensils or the hands l>3r washing with a wateiy solution of tannic acid. 
Spirit of lavender is also recommended for the removal of the odor of 
f 
iodoform from the hands. 690 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Iodoform is very volatile, and should be kept in well-stoppered 
bottles in a cool place. 
Physiological Action.—Applied to the sound skin, to mucous mem- 
branes, or to ulcers, iodoform (although containing 29 out of 30 parts of 
iodine by weight) is not in the least irritating, but, on the contrary, 
blunts sensibilit}r and acts as a local anaesthetic. Internally, in doses 
up to 5 or 6 grains, it produces no symptoms, except slight increase of 
appetite; iodine appears in the urine and saliva within two hours and traces 
continue fyr several days. In larger doses, iodoform produces decided 
narcotic effects in dogs, with inco-ordination and staggering, convulsions, 
and death. In man, poisonous effects have followed its very free use in 
wounds, the principal symptoms being prostration, headache, faintness, 
and persistent iodoform taste in the mouth. The temperature is affected, 
being increased to 104° F. or more ; the pulse becomes soft, feeble, and 
rapid ; delirium and suicidal mania have also been noticed. Several cases 
of death have been caused in this way, preceded by great anxiety and 
restlessness and sudden collapse. In cases of death from this substance 
the kidneys, liver, heart, and voluntary muscles have been found in a 
state of fatty degeneration. There is no doubt that in some patients an 
idiosyncrasy exists with regard to iodoform, just as there is with regard 
to the other iodides. In a case witnessed by Demme, chorea appeared as 
one of the manifestations of iodoform poisoning. A severe general der- 
matitis, followed by desquamation and accompanied b}r a profuse diar- 
rhoea, was observed by Kloman in consequence of the application of 
iodoform to a chronic leg-ulcer. The first step in the treatment of toxic 
symptoms is the prompt removal of the iodoform from the body in order 
to prevent further absorption ; in many cases this is all that is necessary. 
As remedial agents, stimulants are required, and elimination favored, by 
sponging the skin frequently with warm water and alcohol, and the 
administration of mild diaphoretics. It is especially advised that iodo- 
form should not be used with carbolic acid; that only small quantities 
should be dusted over the wound; that close sutures and tight bandages 
be avoided and free drainage maintained. As some specimens of iodo- 
form have been found to be adulterated and colored with picric acid, bad 
results might be due to this cause. Potassium bicarbonate, given hourly 
in the dose of 10 grains, is said to counteract the toxic effects of iodo- 
form. 
The potassium bromide is also regarded as antidotal, not only as 
a neutral potash salt, but also by virtue of its specific bromide action, 
and the fact that it excels all other salts as a solvent for iodoform. 
Iodoform escapes by the breath under its own form, and by the urine as 
iodide with a little iodate. IODOFORMUM. 
691 
Therapy.—The anaesthetic and antiseptic qualities of this agent 
make it a useful application, especially in gunshot and infected wounds, 
chancroids, phagedaena, and sloughing ulcers. It acts as an antiseptic, 
not by destroying bacteria, but by sterilizing the soil in which might 
develop, and, possibly, by neutralizing or destining bacterial products. 
Either in the form of powder or the officinal iodoform ointment, it is 
valuable in bed-sores, lupus vulgaris in the ulcerative stage, enlarged or 
ulcerated scrofulous glands. The ointment reduces inflammatory action 
in buboes and may prevent suppuration. It is at times attended with 
very good results in chronic eczema, and has been recommended in pru- 
rigo. In half or quarter strength this ointment is useful in ophthalmia 
and granular lids. It diminishes the pain of ulcerated carcinoma. In 
cancer of the womb, a bolus is recommended by Ringer containing from 
8 to 16 grains of iodoform incorporated in cacao-butter. This suppository 
can be deposited in the cavity of the malignant ulcer. The swelling and 
pain of orchitis are diminished by the application of iodoform ointment. 
A saturated solution of iodoform in chloroform relieves the pain of 
neuralgia and chronic gout. 
It is a useful application, in the form of ointment or soluble bougies, 
to the urethra in the treatment of gleet or chronic gonorrhoea. In pain- 
ful affections of the rectum and bladder, fissures, haemorrhoids, supposi- 
tories of iodoform containing 5 grains afford great relief. Its solution 
in ether (1 to 4), kept in red-glass bottles, is a valuable agent in treating 
ulcers of the mouth and throat. It has been shown by P. Carles that a 
saturated solution of iodoform in ether is very unstable, liable to sudden 
decomposition, the liquid assuming a reddish color as a result of the 
liberation of iodine. The addition of alcohol and absence of light retard 
this change. Combined with tannin and triturated together, iodoform is 
a good astringent for soft hypertrophies in the nose, or insufflated into the 
pharynx for post-nasal catarrh, and into the nasal chambers for ozsena. 
The following emulsion is recommended by L. Frey as an injection 
for cystitis :— 
Iodoform, • . 50 parts. 
Glycerin, 40 “ 
Distilled water, 10 “ 
Tragacanth, 25 “ 
A teaspoon ful of this mixture is added to a pint of warm water, and, 
after being shaken thoroughly, used as an injection. The procedure is 
repeated every three days until four injections have been given, after 
which once a week will suffice. Professor Billroth has obtained most 
gratifying results from the use of an iodoform emulsion in cold abscess 
and tuberculous caries. His mixture contains 10 grammes of pulverized 692 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
iodoform in 100 grammes of glycerin. After the most scrupulous anti- 
septic precautions, the abscess is cut down upon and opened, the carious 
bone is scraped thoroughly, and the cavity in each case cleansed. The 
inner surface of the abscess-wall is firmly rubbed bjr a large pledget of 
iodoform gauze, the wound is then stitched up, except a large opening 
through which the emulsion is poured into the cavity of the abscess or 
the bone. Recovery sometimes takes place by the first intention. 
Usually a second dressing is soon required ; drainage-tubes are inserted, 
the deep parts close by first intention, and the superficial granulating 
wound heals under an ointment. In other cases more suppuration occurs 
and recovery is less rapid, or, perhaps, the operation must be repeated. 
The most forbidding cases of large abscesses, with numerous fistulae, 
yielded the best absolute results. A 4-per-cent, solution of iodoform in 
spirit of turpentine has been found useful, administered in the form of 
inhalation, for laryngeal or pulmonary tuberculosis and bronchorrhoea. 
I£ Iodoform., 3j. 
Ol. terebinth., f§j. 
Administer from 3 to 5 drops by inhalation in phthisis and bronchiectasis with high 
temperature.* 
It may merely be added, in conclusion, that in children intoxication 
rarely occurs as a result of the local use of iodoform, but that old 
people are very susceptible to its action. 
Various expedients have been suggested to disguise or cover the 
odor of iodoform, such as the addition of a small quantity of oil of citron- 
elle, balsam of Peru, or mixture with recently-ground coffee (see also page 
689). The best is, probably, that discovered by Shufelt, of dissolving the 
iodoform in the volatile oil of camphor. This combination was used both 
as an ointment and a paste, and good results have been obtained from its 
inhalation in bronchiectasis and phthisis. If preferred, the odor of 
camphor can also be removed by the admixture of either oil of bitter 
almonds or Canada balsam. Bienert states that washing the hands once 
or twice with flaxseed-meal in water causes rapid disappearance of the 
odor of iodoform. For venereal sores :— 
Iodoform., 3j. 
01. camphorae, 
Acid, salicylic., aa 3iv. 
Amyli, .. . q. s. 
M. Sig.: Make a stiff paste for application to ulcerated surface. 
It can also be obtained combined with dressings, as iodoform gauze, 
cotton, or wool, for use as tampons. When applied to the surface of the 
body dissolved in collodion, it reduces temperature. In cancer of the 
* Dr. Powell, Quarterly Bulletin of Clinical Surgery of N. Y. Post-Graduate School. 693 
IODOL 
breast, iodoform in powder, or in ointment, markedly relieves pain and 
renders the progress of the disease slower. 
Internally, iodoform has been employed as an alterative and 
as a means of bringing the S37stem under the effects of iodine in 
phthisis, scrofulous affections, and liver disorders, but has not always 
fulfilled anticipations. Dr. Whitla speaks in very favorable terms 
of the internal use of iodoform in phthisis, confirming the reports 
of Dreschfeld and other writers. It is administered in pills, together 
with extract of gentian or other stomachic tonic. The same combina- 
tion has been employed in haemoptysis with the most satisfactory results 
by Chauvin and Jorisenne. They have seen it succeed where ergotin had 
failed. If considered judicious, tannin may be incorporated in each pill. 
Thus given, it creates no gastric irritation. In constitutional syphilis 
iodoform has failed to approve itself as a superior remedy. In gastric 
catarrh iodoform renders service in checking fermentations, but its 
powerful odor renders it objectionable to patients. 
IODOL.—Tetra-iodo-pyrol. 
Dose, gr. £-v. 
Pharmacology and Physiological Action.—By the action of iodine 
upon pyrol, a constituent of mineral oil, a chemical compound is formed 
containing about 90 per cent, of iodine; therefore a little less than iodo- 
form, but having the important advantage of freedom from odor. Iodol 
occurs as a grayisli-white powder, which darkens upon exposure to light; 
insoluble, or nearly so, in water; freely soluble in ether, chloroform, or 
alcohol, and in fatty oils. It is soluble in the gastric secretions, and, like 
iodoform, is decomposed in the organism. 
The effects of iodol are similar to those of the preceding agent, but 
it is said never to produce toxic action when used either as a topical ap- 
plication to wounds, or when administered internally in the ordinary 
medicinal'doses. 
Therapy.—Iodol may be dusted over wounds in the form of an 
impalpable powder, or it may be used in ointment or solution. An oint- 
ment of iodol may be made of any desired strength, from 10 grains to the 
ounce upward, and constitutes an excellent antiseptic dressing to venereal 
and common ulcers, furuncles, and carbuncles. A weak ointment con- 
taining this substance is beneficial in variola, in which it mitigates the 
active cutaneous inflammation. A stronger preparation ma}' be einplo3’ed 
in tinea tonsurans, and is capable of the course of psoriasis. 
Iodol ointment is used with advantage upon the enlarged glands of 
scrofula, or upon the ulcers consequent to their caseous degeneration. 
Mazzoni prefers a solution in alcohol and glycerin (iodol 1, alcohol 16, 694 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
glycerin 34 parts) as a topical application. An ethereal solution (1 to 8) 
is used as that of iodoform is,—in ulcers of mucous membranes. Ad- 
ministered by insufflation or inhalation, this remedy has afforded relief in 
tuberculosis of the larynx or lung, and in bronchorrlioea. The powder 
has been found of service in various diseases of the eye, and is of special 
value in catarrhal conjunctivitis. Iodol is also made into suppositories, 
soluble bougies, iodol cotton, iodol gauze, etc. It may be administered 
internally in any form—since it has very little taste and 3'ields iodine to 
the organism very readily—in the treatment of the tertiary stage of 
syphilis, in scrofula, phthisis, etc. In these affections from 5 to 20 grains 
have been given daily, and in the dose of 2 to G grains thrice daily Cerna 
has seen good results from the use of iodol in diabetes. 
IODUM (U. S. P.).—Iodine. 
Dose, gr. ss-j. 
Preparations. 
Amylum Iodatum (U. S. P.).—Iodized Starch (5-per-cent, iodine). Dose, gr. ii-3,j. 
Liquor Io:li Compositus (U. S. P.).—Compound Solution of Iodine, I.ugol’s Solution 
(iodine 5, potass, iod. 10, distilled water 85 parts). Dose, hlv-xx. 
Tinctura Lodi (U. S. P.).—Tincture of Iodine (iodine 8 per cent). Dose, hli-v. 
Unguentum Jodi (U. S. P.).—Iodine Ointment (iodine 4, potass, iodid. 1, water 2, 
benzoinated lard 93 parts). 
Liquor Arsenii et Hydrargyri Lodidi (U- S. P.).—Solution of Iodide of Arsenic and of 
Mercury (Donovan’s solution, 1 per cent, each of iodide of arsenic and of biniodide of 
mercury). Dose, ITli-x. 
Dilutee Fern Lodidi (U. S. P.).—Pills of Iodide of Iron (ferrous iodide, gr. j). Dose, 
1 or 2 pills. 
Ferri lodidum Saccliaratum (U. S. P.).—Saccharated Iodide of Iron (iron 6, iodine 17, 
with sugar of milk 80 parts). Dose, gr. ii-x. 
Syrupus Ferri Lodidi (U. S. P.).—Syrup of Iodide of Iron (10 per cent. Fe I). Dose, 
ITlv-xxx. 
Syrupus Acidi ILydriodici (U. S. P.).—Syrup of Hydriodic Acid (1 percent, of abso- 
lute acid). Dose, f3ss-ij. 
Potassii Lodidum (U. S. P.).—Iodide of Potassium. Dose, gr. v-xxx. 
Unguentum Potassii Lodidi (U. S. P.).—Iodide of Potassium Ointment (iodide 12, 
sodium hyposulphite 1, boiling water 6, benzoinated lard 81 parts). 
Sodii Lodidum (U. S. P.).—Iodide of Sodium. Dose, gr. v-xxx. 
Ammonii lodidum (U. S. P.).—Iodide of Ammonium. Dose, gr. v-xxx. 
Argenti Lodidum (U. S. P.).—Iodide of Silver. Dose, gr. i-ij. 
Arsenii Lodidum (U. S. P.).—Iodide of Arsenic. Dose, gr. 
Snlphuns lodidum (U. S. P.).—Iodide of Sulphur. Dose, gr. i-iv. 
Unguentum SulphuHs Lodidi.—(gr. xxx to lard §j). 
Hydrargyri Lodidum Virule (U. S. P.).—Green Iodide of Mercury. Dose, gr. yVA- 
Hydrargyri Lodidum Dubrum (U. S. P.).—Red Iodide of Mercury. Dose, gr. 
Plumbi Lodidum (U. S. P.).—Iodide of Lead. For external use. 
■Zinci Iodklum (U. S. P.).—Iodide of Zinc. Dose, gr. i-iij. 
Lodidi Trichloridum.—Trichloride of Iodine. For external use. 
Acidum Carbolicum Iodatum.—Iodized Phenol (iodine 20, carbolic acid 76, glycerin 4 
parts). For external use. 
Ethylilodidum.—Iodide of Ethyl (hydriodic ether). Dose, Hlx-xv. For inhalation. IODUM, 
695 
Pharmacology.—Iodine is a bluish-gray, non-metallic element, ob- 
tained principally from the ashes of sea-weeds. It was discovered in 
1811 by Courtois, and its properties investigated by Gay Lnssac in 1813. 
Iodine melts and 'sublimes at about 225° F., but volatilizes at ordinary 
temperatures so that the upper part of the bottle containing it is usually 
liiled with the characteristic violet vapor of iodine. It is very slightly 
soluble in water, requiring 7000 parts of water; on the contrary, alcohol 
and ether dissolve it freely, forming dark-brown solutions. The addition 
of water to the alcoholic solution precipitates part of the iodine, unless 
iodide of potassium be added to the solution. The tincture of iodine 
may be decolorized by the addition of a small quantity of ammonia-water, 
followed by a few drops of carbolic acid, or by combination with hypo- 
sulphite of sodium, making colorless tincture of iodine. The ammonia 
preparation should not be made in quantity or kept on hand, as it may 
deposit the iodide of nitrogen, which is a dangerous explosive compound. 
The combinations of iodine are numerous, and many of them are officinal 
The iodide of ethyl is not included in the pharmacopoeia, but has some 
medical interest. It is prepared by the action of alcohol on iodine in 
presence of amorphous phosphorus. Phosphorus iodide is formed and 
reacts upon the alcohol, yielding ethyl iodide and an acid of phosphorus. 
The former distils into the receiver together with the alcohol, which 
escapes the reaction. Water is added and the lower layer of liquid is 
separated, dried with calcium chloride, and rectified in a water-bath. 
Ethyl iodide is a colorless liquid, but becomes brown when long kept, if 
exposed to light. Its characters have been already considered (see page 
409). The syrup of hydriodic acid contains 1 per cent, of absolute hydri- 
odic acid, which is a gaseous body containing per cent, of iodine by 
weight; it is readily decomposed, and is a valuable agent for the purpose 
of introducing iodine into the system in the least irritating form, though 
therapeutically active. The iodide of starch, amylum iodatum (not to be 
confounded with amyli iodidum, iodide of amyl), was made officinal as a 
means of administering iodine, but it has been given in quantities as 
high as an ounce at a time with little noticeable effect, and is seldom used 
at present. This may be explained by the fact that starch is the anti- 
dote to iodine, and is the chemical test for free iodine, by which it is 
turned from a white color to blue. (For a combination of iodine and 
thymol, see Aristol, page 452.) Iodine trichloride occurs in pieces, 
and is decomposed by water into hydrochloric and iodic acids. It is 
liquefied by the addition of iodine. 
As the iodides are easily decomposed this fact must be borne in min’d 
when prescribing them, and, as a rule, it is best to administer them simply 
dissolved in water or combined with other iodides. When potassium 696 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
iodide is present in solution with corrosive sublimate the biniodide is 
formed, which is again dissolved in an excess of potassium iodide, form- 
ing iodohydrargyrate of potassium. Alkalies, alkaloids and metallic 
salts generally are incompatible with iodine and its salts. 
Physiological Action.—Iodine discolors the skin, turning it brown, 
and, if sufficiently concentrated, acts as an irritant, and may cause 
vesication or sloughing. After a coat of iodine there is some hyperaemia, 
and the sensory nerves are stimulated so that the effects of a counter- 
irritant are obtained; subsequently,the superficial epithelial lajer becomes 
dry and peels off, leaving a reddened surface Its vapor is rather irritat- 
ing to the air-passages. Iodine is a valuable antiseptic, and, when inhaled 
into the bronchial tubes, or separated from the general circulation and 
deposited upon the surface of the bronchial mucous membrane, it exer- 
cises a beneficial influence upon the tissues and prevents decomposition 
of the secretions. In the stomach it is at first irritant, but rapidly forms 
combinations with organic or starchy compounds and passes into the 
blood, where it acts as an alterant, and especially counteracts the effects 
of the syphilitic virus and promotes the absorption and removal of its 
products from the body. To a less marked degree this remedy acts upon 
the tissues affected by tuberculosis, removing effete material and rendering 
them less favorable for the development of bacilli. The iodides of the 
alkalies are very soluble (potassium iodide dissolving in its own weight 
of water), and diffuse readily into the blood. They are excreted espe- 
cially by the air-passages, and frequently set up a coryza and profuse 
mucous discharge from the bronchial mucous membrane, accompanied 
swelling, congestion, or inflammation of the throat and conjunctiva?, 
with more or less irritation of the kidneys and skin. 
The most common form of iodide eruption is that of papules, or 
wheals, which are darker than the surrounding skin and surrounded by a 
zone of inflammation (acneiform); but occasionally, from some peculiar 
susceptibility to the action of the drug, the degree of hyperaemia is so great 
as to lead to effusion beneath the epidermis, and vesicles are formed, filled 
with clear lymph, which afterward becomes white or milky. Sometimes the 
eruption is so universal that it resembles chicken-pox, purpura, or small- 
pox, but is unaccompanied by fever, or by more than a temporary eleva- 
tion of temperature. Other symptoms, such as headache, unpleasant taste 
in the mouth, ptyalism, disordered digestion, malaise, and emaciation, 
appear after the system has become saturated with the drug, and these 
symptoms indicate the condition of iodism, which varies in degree from 
merely a few acneiform papules upon the forehead to a state of irritant 
poisoning. (Edema of the glottis is an occasional effect of the ingestion 
of iodide of potassium. This manifestation, which takes place in the 697 
IODUM, 
absence of any pathological condition of larynx or kidney, has recently 
been made the subject of a paper by Dr. Groenouw. This writer refers 
the origin of the accident to idiosyncrasy, and remarks that it does not 
follow the repeated administration of large doses of the salt, but mani- 
fests itself after a few comparatively small doses have been taken.* 
Other unusual manifestations of iodine poisoning are occasionally 
witnessed. Gautier lately reported a case in which the S}Tmptoms were 
thought to be due to prolonged inhalation of sea-air, and another in 
which iodism was caused by inunction with iodide of potassium. Each 
of these cases was marked by emaciation and prostration. In the second 
case fixed delusions and melancholic mania were present. The treat- 
ment of iodism is largely symptomatic, using starch if there is free iodine 
in the alimentary canal, deodorized tincture of opium, warm baths, and 
large draughts of water and demulcents. 
Chemical considerations have suggested the theory that the phe- 
nomena of iodism are due to the liberation of iodine by nitrites present 
in'the blood. This change can only take place in regions where the re- 
action is acid. Since sulphanilic acid nitrous acid, it has been 
proposed that the former substance, together with the bicarbonate of 
sodium, should be used as an antidote. According to Rohmann and 
Malachowski, from 2 to 3 drachms of the bicarbonate of sodium, given 
in two doses within twenty-four hours, will cause the symptoms of chronic 
iodine poisoning to disappear. These writers likewise claim that when 
iodide of potassium and bicarbonate of sodium are administered in com- 
bination, the symptoms of iodism are prevented. The carbonate or the 
aromatic spirit of ammonium has been given with the iodide for the 
same purpose, but with doubtful results. A few drops of Fowler’s solu- 
tion, given in conjunction with the iodide, is, however, more effective, 
and will usually prevent the development of iodism. It should not be 
forgotten that even a small dose of iodine will, in some persons, produce 
marked physical and mental depression without the occurrence of coryza, 
sore throat, or disturbed stomach. An acute form of intoxication may 
also arise from the administration of iodine, the symptoms being those 
of acute gastro-enteritis, the treatment consisting of starch-water, evacua- 
tion of the stomach, external heat, and hypodermatic injections of cardiac 
and respiratory stimulants. In a case of chronic poisoning, with alarm- 
ing prostration, Whitla availed himself of the fact that elimination takes 
place largely by the salivary glands, and directed his patient to chew 
pellitory root, a powerful sialagogue. A remarkably profuse secretion 
of saliva containing the iodide was followed b}r rapid improvement. 
The iodides remove certain metallic poisons from the sj’stem by 
* Revue de Laryngologie, etc., September 15,1890; Medical Bulletin, February, 1891. 698 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
combining with them to produce soluble salts; in such cases large doses 
of iodides might liberate so much of the metal from the tissues as to 
produce symptoms of metallic poisoning. This is exemplified by the 
fact that the iodide of potassium may occasion salivation in an individual 
who has been upon a mercurial course. If a considerable quantity of 
the metal have been stored up within the system, its solution and entrance 
into the circulation may be followed by ptyalism. On the other hand, 
when there has been less accumulation of-the mercury, iodide of potassium 
will rapidly remove it from the system. The iodide thus exerts an 
apparently paradoxical action, in that it sometimes relieves and at others 
augments mercurial ptyalism. In recent cases of mercurialism, however, 
the iodide will but add to the mischief. 
Patients should be warned, on the appearance of such symptoms or 
on the occurrence of iodism, to at once discontinue the remedy. Some 
are unable to bear more than a few grains, and even so small a quan- 
tity as 5 grains may produce coryza, salivation, or a general vesic- 
ular eruption upon the skin; others can take as many drachms without 
the slightest inconvenience, and some dermatologists give from 12 to 16 
drachms of potassium iodide a day for tertiary syphilis without produc- 
ing iodism. Part of the good effects of codliver-oil in these disorders 
is ascribed to a small proportion of iodine which it contains. 
In the normal condition the iodides and iodine have no effect upon 
temperature or blood-pressure, when administered by the ordinary chan- 
nels. Introduced into the veins, they cause slight increase, soon followed 
by decrease, of pressure. Anaphrodisiac effects are observed after the 
long-continued use of the iodide of potassium, and the belief is generally 
entertained, though disputed by some, that such protracted use causes 
atrophy of the mammary glands and testicles. 
Owing to its solubility the iodide of potassium is rapidly absorbed 
and rapidly eliminated. Within fifteen minutes after its ingestion it is 
present in the saliva and the urine. It is likewise removed by the skin, 
and in the milk of nursing women. Iodine has been found in the urine 
of a suckling babe, whose mother was taking iodide of potassium. The 
urine is increased in quantity by the iodide of potassium, though we lack 
exact knowledge of the effect of this drug upon the urinary constituents. 
It often causes oxalates to appear. In a series of experiments upon 
himself, M. Georges Doux took 45 grains of the iodide of potassium 
twice daily for twenty consecutive days. After the second day the 
quantity of the salt present in the urine varied but little, and amounted 
to about 90 per cent, of the dose ingested. The normal proportion of 
urea was decreased by about one-fifth. Seventy-five hours after discon- 
tinuance of the drug no trace of it could be discovered in the urine. The IODUM. 
experiments were twice repented with the same results. The amount of 
iodide eliminated fell to 60 per cent, if a little absinthe had been taken 
on the preceding day.* 
Therapy.—Iodine in substance may be used as a disinfectant for 
drains, but it has no advantage over much less expensive agents which 
are better antiseptics. In the form of tincture it is very generally used 
as a counter-irritant and resolvent for various swellings, enlarged glands, 
buboes, swollen joints, abscesses, chilblains, and inflammation of the 
gums. 
The dental tincture of iodine used by Flagg is as follows :— 
Tinct. iodi, 13iij- 
Spiritus vini rectificati, . . . l§j. 
M. Dissolve the iodine by succussion during several days. 
The object attained, says Flagg, by this extraordinary tincture is 
the ability to make accurate spottings upon the inflamed gums, which 
shall maintain circumscribed and persistent absorbent or counter-irritant 
effect. The parasiticide effects are shown when this tincture is painted 
over a spot of tinea or ringworm, which may yield to this treatment. 
For toothache from exposed pulp, Garretson recommends the 
following :— 
]$. Creasoti, h]vj. 
Tinct. iodi, f3j. 
Liq. plumbi subacetatis, f3j. 
Chloroformi, 
Tinct. opii, . Sa f3ss. 
M. Sig.: Apply on the softest cotton-wool, laid delicately upon the pulp. Brush the 
same on the surrounding gum. 
The dental iodide-of-potassium ointment, recommended by Flagg, 
consists of the following :— 
IJc Potassii iodidi, gr. xx. 
Liquoris potassse, >hii vel iij. 
Ceratum simplicis, §j. 
M. et ft. ungt. 
This is a valuable ointment which will not discolor the skin, used 
in discussing indurations on or about the face and jaws. 
In pneumonia and pleurisy, especially of the chronic form, or fibroid 
phthisis, great benefit resnlts from painting the affected side of the 
chest with iodine, giving several coats of the tincture with a camel- 
hair brush, repeated each day until sufficient action is set up or the skin 
peels off. Part of the iodine is absorbed and exercises a local alterative 
effect. 
In chronic bronchitis, also, the tincture of iodine is serviceably 
* British Medical Journal, September 27, 1890. 700 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
applied to the chest. The ointment, tincture, or liniment of iodine affords 
relief in intercostal neuralgia and rheumatism affecting the intercostal 
muscles. The conjoined internal and external use of iodine is of great 
value in bronchocele. In simple glandular hypertrophy the compound 
solution of iodine or the iodide of potassium, preferably the latter, is 
administered by the mouth ; while the tincture, liniment, or ointment is 
locally applied, care being taken to avoid vesication. The iodide-of- 
potassium ointment is sometimes employed for the same purpose or the 
formerly officinal ointment of the red iodide of mercury. 
Another excellent method consists in the injection of tincture of 
iodine into the substance of the goitre. It is best to begin with no more 
than 5 drops, the operation being repeated weekly or semi-weekly, and 
the quantity gradually increased to 10, 15, or 20 drops. In cystic or 
calcareous degeneration of the thyroid this plan of treatment is of no 
avail. Other hypertrophies are amenable to the same method, as, for 
instance, enlarged lymphatic glands prior to caseation and enlarged 
spleen. The cavities of abscesses and monoc3rstic tumors are, after 
evacuation, advantageously flushed with water impregnated with a small 
quantity of tincture of iodine. Empyema has been treated in the same 
way after aspiration. 
Since proposed, in 1848, by Dr. Brainard, the injection of iodine has 
been practiced with varying and doubtful success in spina bifida. Cures 
have been reported, while, on the other hand, many failures, whether 
reported or not, have occurred. If this opei’ation be undertaken the 
quantity injected should be small and the solution weak. No more 
serum should be withdrawn than the quantity of fluid about to be in- 
jected. Pepper and others have injected the tincture of iodine into 
pulmonary cavities with a view to disinfection, and, possibly, oblitera- 
tion by healthy reparative inflammation. Though the plan seems 
rational it is not always feasible, is attended by some pain and reaction, 
and certainly has never been generally approved or adopted. 
An iodized wash disinfects these cavities and promotes their 
obliteration. The parenchjunatous injection of a few drops of tincture 
of iodine causes resolution of enlarged tonsils. In performing this 
operation the close proximity of the carotid artery should be borne in 
mind. The ointment, applied directly to the tonsils by means of a 
camel-hair brush, is said b}r Cerchiari to accomplish the same result. 
The following prescription can sometimes be used with good effect in 
enlarged tonsils or in chronic pharyngitis :— 
Tinct. iodi, f3j. 
Glycerini, 
Extracti ergotas fl., aa f^j. 
M. Sig.: Apply once or twice a day with a camel-hair brush. IODUM, 
701 
Garretson emploj's in sore throat, especially that which occurs in 
clergymen and public speakers, the following combination of iodine :— 
Liq. iodi compositi, f 3j )T|mr. 
Acidi carbolici, TTlxij. 
Glycerini, f gij. 
Aquae, f^xiv. 
M. Sig.: To be used as a gargle from eight to a dozen times a day. 
The tincture of iodine is often painted upon or around patches of 
erysipelas, and, although the application sometimes does good, it not 
infrequently aggravates the condition. It is judicious to dilute the 
preparation with an equal quantity of glycerin or alcohol, or combine the 
iodine as follows :— 
Tinct. iodi, 
Acidi carbolici, aa f 3ss. 
Glycerini, f^iv. 
M. Sig.: Apply with a camel-hair brush several times a day for erysipelas. 
In ringworm, iodine may be used in the form of colorless tincture, 
or in combination with the colorless oil of tar (1 in 4):— 
Potassii iodidi, '. . . . . 3ij. 
01. menth. pip., lhxx. 
Lanolini, f§j. 
M. Sig.: Embrocation for painful joints, neuralgia, chronic rheumatism, etc. 
The tincture of iodine is one of the articles employed to prevent 
pitting in small-pox. The solution should be painted over the surface 
of each pustule. An ointment containing iodine is occasionally followed 
by good results in keloid and scleroderma. Alone or combined with an 
equal quantity of glycerin or carbolic acid, the tincture of iodine is some- 
times beneficial when painted upon lupous areas. Lentigo and chloasma 
may be cured by the local application of tincture of iodine, and the 
same preparation added to salt water forms a beneficial wash in chronic 
ozfena. In orchitis, after active inflammation has subsided, the cautious 
local application of the tincture promotes absorption of the exudation 
material. The same treatment is of service after subsidence of inflam- 
mation of the mammary gland or ovary. 
Boils and carbuncles may be checked by painting iodine freety upon 
a neighboring vascular area. Iodine may be used as a stimulant to old 
ulcers, especially in gynaecology, as iodized phenol; although iodoform, 
on account of its anaesthetic effects, has largely taken the place of iodine. 
A saturated solution of tannic acid in tincture of iodine is also a useful 
topical application in chronic inflammation of the uterine canal. The 
iodide of starch is valued by Mr. Marshall as a dressing to syphilitic 
ulcers. Hydrocele is cured by evacuation of the contents of the sac 702 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
and injecting 15 to 20 minims of tincture of iodine into the cavity, as 
practiced by Professor Pancoast. Severe inflammation results and the 
sac becomes obliterated. Iodized wool is useful for making extemporized 
pessaries. 
Internally, tincture of iodine and camphor may be inhaled for acute 
coryza and hay asthma.* Inhalation of the vapor of iodine is very 
beneficial in chronic bronchitis with bronchiectasis, or profuse and fetid 
muco-purulent expectoration. Bartholow speaks favoraWy of the in- 
ternal use of iodide of ammonium in acute catarrh, a grain being given 
every second hour. Hay asthma is ameliorated by larger doses of the 
same which is useful, moreover, in capillary bronchitis and 
bronchorrhoea. An acute coryza may not infrequently be aborted by 
10 grains of iodide of potassium taken at bed-time. The same salt in 
the same dose repeated several times a day is said to relieve paroxysmal 
sneezing. 
The iodide of ethy l (see page 409) is administered by inhalation 
(nyx—xxx) whenever necessary to relieve coughing, especially in 
bronchitis, asthma, and phthisis, and is the most direct method of in- 
troducing iodine into the»blood. In phthisis, good results have been 
reported from inhalation, by means of an atomizer, of a fine spray con- 
taining 1 part each of iodide of potassium and bichloride of mercury in 
1000 of water, the solution being made stronger or weaker, according to 
the effects upon the patient. From its stimulating effects upon the 
kidneys iodide of potassium is occasionally used to heighten the effect 
of other diuretics. The oedema of Bright’s disease is, in some instances, 
markedly decreased by this remedy, though it has little power to check 
the escape of albumin. The iodide of potassium, from its special 
determination to the mucous membrane of the air-passages, is frequently 
combined with expectorants and cough-mixtures in order to render the 
secretions more fluid. Its stimulating action upon the absorbents renders 
iodine useful, both internally and by topical application, in cases of in- 
flammatory exudation or chronic enlargements. Where these are of 
syphilitic character the iodides are pre-eminently serviceable. For 
many brain diseases, more those occurring during tertiary 
sjqfliilis, where gummata form or meningitis with exudation occurs, 
causing great pain, the iodide of potassium, in combination with bromide, 
is more efficient than any other agent known; here the iodide must be 
given in or drachm doses, and pushed in order to get its 
full effect. If given well diluted with water, when the stomach is 
emptjr, no serious danger exists of producing iodism. In aortic aneurism, 
iodide of potassium, in doses of 20 to 30 grains four times a day, with 
* Therapeutic Gazette, October 15,1890, p. 678. IODUM. 
703 
low diet and rest in bed, favors deposit of fibrin and obliteration of the 
tumor; the treatment must extend over months or for a year or more. 
Many of these cases may be occasioned by syphilitic disease of the aorta, 
and in this way the iodide is doubly serviceable. In the primary and 
secondary forms of syphilis iodine compounds are of little use, but in 
the later changes of the skin, mucous membranes, and deeper structures 
they act promptly, and we may pfescribe them with confidence. 
In some of the late varieties of syphilis* the author can recommend 
the following formulae containing the iodides :— 
ify Potassii iodidi, 3v. 
Tinct. cimicifugse, f3ij. 
Syr. sarsaparillae comp., f^v. 
M. Sig.: Two teaspoonfuls in water three or four times a day. 
I£. Sodii iodidi, 3iiss. 
Vinicocse, f§x. 
M. Sig.: A tablespoonful three or four times a day. 
$ Ammonii iodidi, 3v. 
Tinct. nucis vomicae, . . f 3j. 
Ext. cascarae sagradae fl., . . . f§j. 
Glycerin!, f§iv. 
M. Sig.: Two teaspoonfuls in water three or four times a day. 
In the treatment of gonorrhoeal rheumatism, Schuller, of Berlin, 
gives iodide of potassium (gr. v-vij) every two hours for two or three 
days. He considers it especially beneficial in the acute form. For local 
treatment he uses, in acute cases, compresses wet with carbolic-acid so- 
lution (1 to 100), and in chronic cases mercurial ointment. Aspiration of 
the joint is done where there is abundant effusion, and this procedure 
aids the action of the remedy. In chronic gout and in gouty affections, 
iodide of potassium affords great relief, as it will also in chronic rheuma- 
tism. Considerable improvement sometimes follows the use of iodide 
of potassium or of iron in rheumatoid arthritis. Acute rheumatism is 
often relieved by large doses of iodide of potassium, or the latter in 
combination with the salicylate of sodium or salicin :— 
Potassii iodidi, 
Sodii salicylatis, aa 3iiiss. 
Spiritus aetheris nitrosi, f§ij. 
Syrupi aurantii, f giij. 
M. Sig.: Two teaspoonfuls in water every two or three hours. 
Potassii iodidi, 
Salicin., 6a gr. c. 
M. et ft. capsulae no. xx. 
Sig.: Two to three capsules every two or three hours. 
* For the general medicinal treatment of late syphilis see author’s Practical Treatise 
on Diseases of the Skin, pages 178 and 179. D. Appleton & Co., New York, 1888.  PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
In acute rheumatism or gout, when attended with constipation, 
the following prescription, containing iodide of potassium, is service- 
able :— 
$ Potassii iodidi, 
Potassii acetatis, . . 3iiiss. 
Extraeti cascarae sagradae fl., 
Glycerini, 3h 
Aquae cinnamomi, 1 §iij. 
M. Sig.: Two teaspoonfuls in water every two or three hours. 
In the treatment of psoriasis* large doses of one of the iodides, and 
preferably the iodide of potassium, is at times attended with complete 
removal of the eruption. Psoriasis is, however, more frequently con- 
trolled or cured by the iodide of potassium when the disease is depend- 
ing upon rheumatism or gout. In periostitis, resulting from exposure 
to cold or wet, the iodides are rapidly curative, and the tincture may also 
be applied locally. In chronic mercury or lead poisoning the metal 
may be removed from the system b}r iodides, but the dose should be 
small and the treatment continued for some time. Chronic bronchitis 
with thick, tenacious sputa and asthma are very much helped by the 
administration of the iodides. Catarrhal pneumonia, acute or chronic, 
is benefited by doses large enough to liquefy the sputa (5 to 20 
grains):— 
Potassii iodidi, 3iiiss. 
Tinct. lobeliae, f3iv. 
Spiritus astheris comp., f§ij. 
Syrup, aurantii, f^iiss. 
M. Sig.: From one to two teaspoonfuls in water every two or three hours until 
relieved. Serviceable in chronic bronchitis and in asthma. 
In cardiac dropsy the iodide of sodium, alone or combined with 
digitalis and buchu, is often most beneficial in its effect. It can be pre- 
scribed thus:— 
$ Sodii iodidi, 3iv. 
Infus. digitalis, 
Infus. buchu, aa f^iij. 
M. Sig.: Two teaspoonfuls every three or four hours. 
In chronic bronchitis and in pleurisy, the following combinations 
are useful:— 
Potassii iodidi, . . . . 3iv. 
Syr. ferri iodidi, 
Glycerini, aa f^iss. 
M. Sig.: A teaspoonful in water four times a day. 
*See paper by the author on “The Cause and Treatment of Psoriasis,” Transactions of 
the Pennsylvania State Medical Society, 1888. IODUM. 
705 
Potassii iodidi, gr. xxiv. 
Potassii bromidi, 3j. 
Ammonii chloridi, 3ij. 
Syr. yerbae santse, 
Aquae, aa fS-iss. 
M. Sig.: A dessertspoonful every two to four hours, for cough with scanty expecto- 
ration. 
Iodide of potassium may be combined with bromide of potassium 
for the treatment of epilepsy, as in Brown-Sequard’s formula (page 484). 
The tincture of iodine has been administered internally in 5- to 8- 
drop doses in the treatment of malarial affections ; and the compound 
solution (Lugol’s solution) is widely known as a remedy in scrofulous 
affections of the skin and of the lymphatic glands, in syphi- 
litic children. The solution, with arsenic, is very serviceable in some old 
syphilitic skin diseases attended by thickening and scaling. 
The iodide of zinc is in white, needle-shaped crystals, and is unstable. 
It is best administered as a syrup (5i-oj) 5 dose, It has been 
used in ointment, with lard (10 per cent.), in the treatment of tumors, 
and a solution (gr. i-ij to f§j) has been injected in gonorrhoea. Stronger 
solutions have been applied to enlarged tonsils. 
Small and repeated doses of the iodide of ammonium are efficacious 
in catarrhal jaundice. Drop doses of the tincture of iodine will some- 
times allay the vomiting of pregnancy. In the form of tincture, com- 
pound solution, or iodide of potassium, this agent has been employed in 
typhoid fever, and, though no marked influence is exerted upon the 
course of the disease, the temperature, or the diarrhoea, Liebermeister 
believes that it effects a notable reduction of the mortality. Bartliolow’s 
combination of the tincture of iodine and carbolic acid seems to 
moderate the severity of typhoid fever:— 
II Tinct. iodi, f3ij. 
Acidi carbolici, 13j. 
M. Sig.: One to three drops thrice daily. 
Iodine has been made use of in exophthalmic goitre, but tvitli doubt- 
ful results. Ringer states that “ in some epidemics of diphtheria ” the 
inhalation of the vapor of iodine proves of signal service, and Dr. S. N. 
Zenenko* has lately spoken very highly of the internal administration of 
the iodide of potassium in that affection. From to 3 grains were given 
to children, 5 to 8 grains to adults, and repeated every second, third, or 
fourth hour. Antiseptic gargles, alcoholic stimulation, and inunction of 
the enlarged cervical glands with mercurial ointment were used in con- 
junction. Of a series of 21 patients so treated none died, while of 19 
cases treated during the same time, in the same hospital (at Nijni Nov- 
* Vlatch, No. 42, 1890; Satellite, January, 1891. 706 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
gorod), after ordinary plans, 84 per cent, ended in death. The internal 
administration of the iodide of potassium will sometimes reduce enlarge- 
ment of the mammary gland or testicle, and by some physicians is said 
to check the secretion of milk. Sciatica and lumbago are sometimes re- 
lieved by the same remedy. It is useful in the first stage of hepatic 
cirrhosis, in hypertrophic metritis, and in various syphilitic manifesta- 
tions, especially when other remedies are not wrell borne by the stomach. 
Chronic urticaria has been successfully treated with iodide of potassium. 
Stern reported * 5 cases treated in this way. None were syphilitic, and 
all were rapidly cured. The itching was promptly relieved, and one pa- 
tient became well after only 2J drachms had been administered, although 
he had suffered previously for four months. Kobner administers an 
iodide-of-potassium combination by means of enema. Given once a day 
at first, but subsequently twice daily, the therapeutic action is said to be 
very rapid. He combines mercurial inunctions, and believes that this 
method is equally efficacious and better tolerated than subcutaneous 
injections. His formula is as follows :— 
Potassii iodidi, gr. xlv. 
Potassii bromidi, gr. xv. 
Extract, belladonnas ale., gr. v. 
Aquae, f§vij.—M. 
Six drachms of this solution are added to 2 or 3 ounces of water and 
thrown into the rectum. Kobner frequently adds from 5 to 10 drops of 
pure tincture of iodine to each enema, and finds the mixture well toler- 
ated by the large intestine. He has never observed any resulting local 
inflammation. 
Hydriodic-acid syrup is a very pleasant and certainly an efficient way 
of giving iodine in chronic broncho-pulmonary affections. It should not 
be used if discolored; one of the best preparations is that made by 
R. W. Gardner, of New York, of unchangeable syrup of hydriodic acid. 
It renders excellent service in asthma, chronic induration of the lungs after 
pneumonia, pleuritic exudations, and in some skin diseases (page 374). 
Dr. James Craig, of Jersey City, speaks very highly of the syrup of 
hydriodic acid in acute rheumatism. He gives from 2 to 3 drachms in 
a wineglassful of water every two or three hours until relief is ex- 
perienced, afterward reducing the dose and continuing the remedy for 
several days if required. The pain and fever are reduced within forty- 
eight hours, and he believes that this treatment exerts an important 
influence in preventing cardiac complications. Its power over serous 
exudation and fibrous adhesive inflammation is well illustrated in pleu- 
risy with large effusion, or in plastic pleurisy with adhesions. As the 
* JLondon Medical Recorder, November 20. 1890. ICHTHYOL. 
707 
latter is a prominent predisposing cause of phthisis, it is important that 
it should receive attention early and be overcome by the administration 
of iodine, especially in the form of syrup of hydriodic acid. Wile has 
used this preparation with success in various forms of lead poisoning. 
Aristol is a combination of iodine and thymol. A ready and cheap 
method of making it is that proposed by M. Boule,* byr dissolving 3 parts 
each of crystallized thymol and caustic soda with 5.8 parts of iodide of 
potassium in 50 parts of distilled water by gentle heat. When cool, the 
solution is mixed with 250 parts of a concentrated solution of hydro- 
chlorate of sodium and well shaken. Aristol is precipitated, and in about 
a quarter of an hour may be collected on a linen filter, washed with distilled 
water, and dried in the dark. (For properties and uses see page 452.) 
Antiseptol, or the iodosulphate of cinchonine, is a new preparation of 
iodine intended as a substitute for iodoform or the more expensive aristol. 
It is obtained by adding to a solution of sidphate of cinchonine another 
solution containing iodide of potassium, with an excess of iodine; the 
iodine precipitates the alkaloid as a reddish-brown powder, insoluble in 
water, free from odor, and containing a large percentage of iodine. 
(See page 552.) 
ICHTHYOL.—Icthyosulphate of Ammonium or Sodium. 
Pharmacology.—A peculiar mineral deposit found in the Tyrol, of a 
bituminous character, yields, upon distillation, a tarry-looking substance 
called ichthyol, so named from the fact that the deposit appears to be 
the fossil remains of fishes. It is purified by distillation and with 
sulphuric acid. Ichthyol has a decided odor, which to some is very un- 
pleasant; it is faintly alkaline, and contains 10 percent, of sulphur in 
the form of a sulphur acid. It is soluble in a mixture of alcohol and 
ether, readily mixes with ointment and fats. It is generally used in a 
10- to 20- per-cent, ointment. 
Physiological Action and Therapy.—Ichthyol applied externally, as 
well as when administered, has similar action, in many respects, to sulphur 
and tar. The resin contained in makes it exceedingly objection- 
able for external application on account of the sticky or gummy deposit 
left upon the skin. According to the experience of the author, ichthyol 
is irritating to the integument of many, and is poorly absorbed in the 
majority of cases. Ichthyol given internally has, in some instances in 
the writer’s experience, occasioned more or less gastro-intestinal irrita- 
tion, followed by diarrhoea. The free application of a 20-per-cent, oint- 
ment caused narcotism and stupor in a child, followed, however, by 
recovery. Unna considers ichthyol the best agent for treating certain 
* Repertoire de Pliarmacie, August 10, 1890, and Therapeutic Gazette, vol. xiv, p. 718. 708 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
chronic skin diseases, especially eczema and psoriasis. A 20-per-cent, 
ointment is sometimes useful in acute erysipelas, and also for the pain 
and swelling of the joints accompanying acute rheumatism. Iehthyol 
ointment has been employed in chronic eczema, acne, urticaria, lupus, 
and keloid. Dr. Agnew indorses its value in enlargement of lymphatic 
glands, and it acts well at times as an application in chilblains and burns. 
In other conditions, accompanied by pain, as in acute sprains, the 
results of its use are sometimes satisfactory when applied with friction 
or massage. In uterine cancer, a 25-per-cent, ointment is said to relieve 
the pain and modify the course of the disease. 
IPECACUANHA (U. S. P.).—Ipecacuanha, Ipecac. 
Dose, gr. ss-j to xx, as an emetic. 
Preparations. 
Extractnm Ipecacuanha Fluidum (U. S. P.).—Fluid Extract of Ipecac. Pose, ttli-xxx. 
Syrupus Ipecacuanha (U. S. P.).—Syrup of Ipecac (extract ipecac, 5 per cent.). 
Pose, f 3 i—ij. 
Vinurn Ipecacuanha (U. S. P.).—Wineof Ipecac (extract 7 percent.). Pose, n\x-f3j. 
Trochisci Ipecacuanha (U. S. P.).—Troches of Ipecac (gr. % in each). Pose, one or 
more. 
Trochisci Morphina et Opii (U.S.P.).—Troches of Morphine and of Ipecac (morphine, 
gr. and ipecac, gr. , in each lozenge). Pose, one or more. 
Fulvis Ipecacuanha et Opii (U. S. P.).—Powder of Ipecac and Opium (1 part each of 
opium and ipecac and 8 parts of sugar of milk). Pose, gr. ii-x. 
Tinctura Ipecacuanha et Opii (U. S.P.).—Tincture of Ipecac and Opium (deodorized 
tincture of opium 100, fluid extract ipecac 10, alcohol q. s. to make 100 parts.). Pose, lfli-xv. 
Emetina.—Emetine, or Emetia. Pose, gr. 
Pharmacology.—The Cephaelis ipecacuanha of A. Richard (Rubi- 
aceoe) is a small shrub of Brazil. The officinal portion is the root, which 
contains Emetine, a crystalline alkaloid, and Ipecacuanhic acid, a glucoside, 
with a trace of volatile oil, tannin, starch, gum, etc. The powdered root 
has a slight but characteristic and nauseous taste, which is not entirely 
covered in the officinal lozenges by the oil of gaultlieria, added for this 
purpose, for which cinnamon or chocolate answers better. 
Physiological Action.—The prolonged application of ipecac to the 
skin causes irritation, followed by vesicles, pustules, or even ulceration. 
Inhalation of the powdered root irritates the air-passages and occasions 
coryza, or, in some persons, an asthmatic attack. Taken into the mouth, 
it increases the salivary secretion and excites nausea ; and, in the stomach, 
in a similar way, small doses (gr. £) .promote secretion, while large ones 
cause nausea and vomiting. Ipecac is a systemic emetic and causes 
vomiting when swallowed, and also when injected hypodermaticalty in the 
form of fluid extract or the alkaloid, Emetine. This drug has a peculiar 
effect upon the pulmonary circulation, sometimes causing hyperasmia 709 
IPECACUANHA. 
and at others reducing the amount of blood in the lungs and producing 
relative anaemia. Small doses stimulate the liver, and larger ones, after 
tolerance has been established, act as cholagogue cathartics. The active 
principle is excreted by the liver and gastro-intestinal tract. The skin is 
relaxed and perspiration increased; the secretions of the broncho- 
pulmonary mucous membrane are also increased. No marked effect 
upon the circulation is noticed, but emetine exercises a solvent action 
upon the red corpuscles when injected into a vein. The pulse is reduced 
in tension as a result of the act of vomiting, which also favors diaphoresis. 
Therapy.—Ipecacuanha has been used externally with benefit in 
insect-bites. Neal* recommends the following, especially in mosquito- 
bites :— 
Pulv. ipecacuanha, 3ss. 
Spirit! vini rectiflcati, 
suiphuris, aa §ss.—M. 
In the form of a spray with a hand-atomizer a dilute solution of the 
wine of ipecacuanha, as recommended by Murrell and Ringer, is of great 
service in emphysema, fibroid phthisis, chronic bronchitis, and winter 
cough, in allaying the spasmodic vomiting and liquefying the secretions. 
Ringer dilutes the wine with 1 or 2 parts of water, and, using an ordinary 
hand-atomizer, twenty or more squeezes of the bulb are made, and the 
spray deeply inhaled, once daily at first, afterward more frequently. The 
mouth should be well rinsed out afterward and a piece of lemon-peel 
chewed to avoid a nauseating effect. When fractional doses of wine of 
ipecac are administered (Try every hour or half-hour) they may act as a 
stimulant and overcome obstinate vomiting and retching, just as small 
doses of brandy do. In the vomiting of pregnancy, it is said that a single 
drop taken every hour is curative; it certainly makes a decided mental 
impression, and also may overcome the morbid action of the stomach by 
substitution. Bartholow, however, declares that it has always failed in 
his hands, and that the statement is apocryphal. In haemoptysis, small 
doses of the following combination have sometimes proved of service:— 
Pulveris ipecacuanhae, gr. xij. 
Bismuth, subnit., gr. xxiv. 
Creasoti, TTlvj. 
M. et ft. chart* no. xij. 
Sig.: A powder every hour or two until relieved of nausea or vomiting. 
In haemoptysis, small doses of the powder, short of producing vom- 
iting, serve to reduce the bleeding by decreasing the pulmonary conges- 
tion. When, in bronchitis, the secretions are viscid and the cough hard, 
ipecac in combination with other expectorants is generally resorted to. 
* New York Medical Times, January, 1891. 710 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
The appended formulae containing ipecacuanha are to be recommended 
in bronchitis:— 
Vini ipecacuanhae, f3ij. 
Syrup, scillae, f§ij. 
Tinct. opii camph., f^ss. 
Glycerini, q. s. ad f§v. 
M. Sig.: One or two teaspoonfuls whenever necessary for the relief of cough. 
Syrup, ipecacuanhae, f §ss. 
Ammonii chloridi, 3ij. 
Spiritus aetheris nitrosi, f^iss. 
Morphinae sulphatis, gr.j. 
Syrup, pruni Yirg., q. s. ad f^v. 
M. Sig.: Two teaspoonfuls every hour or two for the relief of cough. 
For bronchitis, especially of elderly persons, ipecacuanha can be 
combined thus with advantage :— 
Syrup, ipecacuanhae, ........... f§.j. 
Potassii nitratis, . 3ij. 
Creasoti, 1[lv. 
Glycerini, 
Aquae aurantii florum, aa f^ij. 
M. Sig.: Two teaspoonfuls in water every two or three hours. 
In croup, especially where the mucus is not expelled, but is swallowed 
or accumulates in the air-passages, an emetic dose of syrup of ipecac 
often gives great relief and may prevent suffocation. For cases of this 
kind it is much superior to tartar emetic or the compound syrup of 
squill, also containing this salt, which is too depressing. In delirium 
tremens, or acute alcoholic poisoning, ipecac produces evacuation 
of the contents of the stomach and stimulates the action of the liver. 
It is too slow in its action as an emetic to be of much service in other 
forms of poisoning. In dysentery, 40 to 60 grains are given with 
wonderfully successful results ; if necessary to quiet the stomach an 
opiate is administered about twenty minutes previously; no liquids 
swallowed for an hour after the ipecac has been taken, and absolute rest 
in the recumbent posture observed. The same treatment is useful in 
cholera morbus and, presumably, in Asiatic cholera. In dysenteric diar- 
rhoea, when blood and mucus appear in the stools, small doses may be 
given, combined Avith opiates or Dover’s powder. Ipecacuanha, with 
mercury and opium, often acts Avell in both diarrhoea and dysentery :— 
Pulveris ipecacuanhae et opii, 3j • 
Pilulae hydrargyri, gr. x. 
Camphorae, 
Pulveris capsici, 
Extracti kino, aa gr. xv. 
M. et ft. pil. no. xxx. 
Sig.: One or two pills every hour or two until relieved. IRIS FLORENTINA. 
711 
Ipecacuanha is also used in fractional doses for insufficient excretion 
of bile and torpor of the liver, and may be combined with a digitalis 
pill or other agents, as follows :— 
Pulv. ipecacuanhse, gr. iv. 
Quiuinas hydrochlorat., 3j. 
Pepsin., gr. xxiv. 
Olei eucalypti, . •Hiij. 
M. et ft. pil. no. xxiv. 
Sig.: Take one after meals. 
When the tongue is heavily coated and the stomach contains indi- 
gestible food, especially at the beginning of a fever, an emetic dose of 
ipecac will prove very serviceable in relieving symptoms ; it is a means 
of treatment that has been allowed to fall into undeserved neglect. In 
the treatment of malarial poisoning, this method of stimulating the liver 
is very useful previous to the administration of quinine or other anti- 
period ics. 
In laryngismus stridulus, an emetic of syrup of ipecac usually 
aborts the paroxysm and affords time for the use of bromide of potas- 
sium to produce its effects. Trousseau recommended its use in the 
puerperal state, in cases of post-partum haemorrhage, and d3’sentery, etc. 
In other forms of haemorrhage, such as epistaxis, menorrhagia, and me- 
trorrhagia, ipecacuanha is serviceable when given in doses sufficient to 
provoke vomiting. An attack of asthma may be cut short by full doses 
of ipecac, and an occasional emetic is useful in whooping-cough and 
capillary bronchitis to dislodge the secretions. 
The Euphorbia Ipecacuanha (Euphorbiaceoe), Ipecacuanha spurge, 
growing in the eastern part of the United States, from New York south- 
ward, although belonging to a different natural order, yet contains in its 
root an emetico-cathartic principle, which renders it a good substitute 
for ipecac where emesis is required and catharsis is not objectionable. 
It is commonly administered in the form of powdered root, but a fluid 
extract may also be obtained. It is of more agreeable taste than ipecac. 
(See Euphorbium, page G21.) 
IRIS FLORENTINA.—Orris-Root. 
Pharmacology and Therapy.—Several species of the genus Iris 
(Iridaceae) furnish the rhizome known by the name of orris-root. It 
contains a volatile oil of violet color and pleasant odor, much used in 
perfumery ; besides an acrid resin, starch, mucilage, etc. The powder, 
which is said to be alterative, cathartic, and diuretic, is rarely employed 
internall3r, but is used in making sachets, tooth-powders, and in alcoholic 
tincture, in perfumery and flavoring extracts. PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
IRIS (U. S. P.).—Iris, Blue Flag. 
Preparations. 
Iridis Extractum (U. S. P.).—Extract of Iris. Done, gr. J-j. 
Iridis Extractum Eluidum (U. S. P.).—Fluid Extract of Iris. Dose, Flxxx-f 3j. 
Tinctura Iridis.—Tincture of Iris (saturated), made from fresh root. Dose, Ulx-f3j. 
Iridin.—An impure resin. Dose, gr. ss-iij. 
Pharmacology.—The Iris versicolor (Iridacete) is a common in- 
habitant of moist places and borders of ponds, and is one of the most 
attractive among our wild flowers. It is a herbaceous perennial, with a 
thickened root-stock, which is the officinal portion—rhizome and rootlets. 
The flowers are large and showy, violet-blue, variegated with greenish- 
yellow and white, with purple veins; they appear in May and June. It 
contains an acrid resin, upon which its medicinal activity depends, besides 
ordinary vegetable principles. Iridin is an impure resin, precipitated 
from alcoholic tincture by water. 
Physiological Action.—The powdered root, when fresh, is a powerful 
emetic and cathartic, less so after drying. It is a decided cholagogue, 
and also diuretic and alterative, having a stimulant action upon the in- 
testinal glands. It is best given in combination with aromatics and 
milder purgatives. 
Therapy.—In chronic hepatic derangements, especially of malarial 
origin, the preparations of iris are very useful, and particularly the 
recent saturated tincture. In duodenal catarrh, obstructive jaundice, 
bilious remittents, iris preparations are frequently used with advantage. 
In drops}r they are also useful, both as a diuretic and cathartic. Iris, 
administered in small doses, is very beneficial in sick-lieadache dependent 
upon indigestion. In larger doses it has vermifuge properties, and may 
be used to expel the round worm, ascaris lumbricoides. 
Ext. iridis fld., 
Ext. hydrastis fld., , aa f^ss. 
Elixir, aromatic., . . i^j. 
M. Sig.: Take a dessertspoonful in hot water before meals for indigestion. 
JABORANDI. See Pilocarpus. 
JALAPA (U. S. P.)._Jalap. 
Dose, gr. viii-xx. 
Preparations. 
Abstractum Jalapce (U. S.P.).—Abstract of Jalap. Dose, gr. i-x. 
Pulvis Jalapce Compositus (U. S. P.).—Compound Powder of Jalap (jalap 35, cream 
of tartar 65 parts). Dose, gr. x-3j. 
Mesina Jalapce (U. S. P.).—Resin of Jalap. Dose, gr. i-iv. 
Pharmacology.—The tuberous root of Exogonium purga (Convolvu- 
lacese), obtained from Mexico, contains from 12 to 18 per cent, of resin, JAMBOL. 
713 
which is officinal and is composed of Jalapin, a soft resin soluble in 
ether, and Convolvulin, a hard resin insoluble in ether, the latter of w hich 
has been found to be the more active; also starch and sugar, of each 
about 18 per cent. The pharmacopoeia requires that the root shall con- 
tain at least 12 per cent, of resin. The abstract of jalap, being a more 
uniform preparation than the extract, is now used in making the com- 
pound cathartic pills ; it is about 20 per cent, stronger than the old 
extract of 1870, and is twice the strength of the crude drug. 
Physiological Action.—Jalapin is a liydragogue cathartic, increasing 
the intestinal secretions and the flow of bile; overdoses may produce 
hypercatharsis and prostration. Convolvulin is an irritant, and may 
cause gastric enteritis and collapse ; it is a local purgative, and is not 
excreted in the urine or faeces, but is probably' destroyed by oxidation or 
by the hepatic cells. 
Therapy.—The compound powder of jalap is one of the best hydra- 
gogue cathartics for dropsy either of heart or kidney disease; and in 
cases of pulmonary congestion and distended right heart, with lividity, 
shortness of breath, and so-called cardiac asthma, a teaspoonful of com- 
pound jalap-powder affords great relief. As an ordinary laxative it may 
be combined writh compound liquorice-powder where the latter fails 
alone, and is a good cathartic for children. Jalap may be used as a 
cathartic after administration of santonin or calomel, or where a taeniacide 
has failed to bring away the parasite. As a purgative it is sometimes 
combined with calomel, but, as it acts more rapidly than the latter, the 
effect of the mercurial is lost unless it precedes the former from four 
to six hours. Jalap is not so rapid in its action as croton-oil, but is more 
manageable. In haemorrhoids, it does not cause increased irritation, but 
relieves them by emptying the vessels above and clearing out the liver. 
JAMBOL, or JAMBAL. 
Pharmacology and Therapy.—The Syzygium jambolanum (Euge- 
niodeae, Myrteae) is a tree indigenous in tropical America and the West 
and East Indies, where the acid fruit is eaten as food and as a remedy 
for diarrhoea and diabetes by the natives. It has also been used to some 
extent in Europe in the form of an extract in the treatment of diabetes. 
In some experiments* made in Professor Binz’s laboratory, it Avas 
shown by Dr. C. Graeser that in dogs in wdiich diabetes had been 
artificially induced by the administration of phloridzin, the simultaneous 
exhibition of jambal reduced the proportion of sugar materially (80 to 
85 per cent.). There Avere no signs of toxic action after administration 
of large doses, 6 to 18 grammes daily7, of extracts partly made from the 
* Lancet, November 2, 1889; Therapeutic Gazette, January, 1890. 714 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
whole fruit and partly from the rind or kernel. It is still uncertain 
whether the active principle is situated in the rind or the kernel; it 
probably exists in both, though more abundantly in the former. Mahomed 
has published notes of a case in which the use of jambal resulted in the 
diminution of the sugar in the urine and, at the end of a week, in its 
entire disappearance. On discontinuing the drug the sugar returned, 
and on resuming the jambal it again disappeared. It appears, however, 
to have been only a mild case.* 
JEQUIRITY. See Abrus, page 355. 
JUGLANS (U. S. P.).—Butternut. 
Dose, 5 i—U* 
Preparations. 
Extradum Juglandis (U. S. P.).—Extract of Butternut. Dose, gr. v-xxx. 
Extradum Juglandis Fluidurn (U. S. P.).—Fluid Extract of Butternut (alcoholic). 
Dose, f3i-ij. 
Pharmacology.—The inner bark of the Juglans cinerea (Juglanda- 
cese), a large tree of North America, collected in the autumn, contains 
Nucin or Juglandic acid (resembling crysophanic acid), also resin, volatile 
oil, and lixed oil and tannin. 
Therapy.—It is a mild cathartic, useful in chronic constipation and 
djrsentery. 
Nut-oil is the fixed oil obtained by expression from the crushed seeds 
of several species of Juglandaceie. Walnuts and hickory-nuts yield 
about 25 per cent, of a fine, bland, pleasant-tasting oil, which can be 
tised in pharmacy, or in medicine for massage, like other fixed oils. It 
is a drying oil, containing linolein.j* 
JUNIPERUS (U. S. P.).—Juniper, Juniper-Berries. 
Preparations. 
Oleum Jumped (U. S. P.).—Oil of Juniper. Dose, blv-xx. 
Spiritus Juniperi (U. S. P.).—Spirit of Juniper (oil of juniper 3 and alcohol 97 parts). 
Dose, f3j—§j. 
Spiritus Juniperi Compositus (U. S. P.).—Compound Spirit of Juniper (oil of juniper 
10, oil of caroway 1, oil of fennel 1, alcohol and water q. s. a(j 5000 parts). Dose, f3ii-iv. 
Infusum Juniperi.—Infusion of Juniper-Berries (§j to Oj). Dose, fgii-iv. 
Extradum Juniperi Frudus Fluidurn.—Fluid Extract of Juniper Berries (dilute 
alcohol). Dose, f3ss-iss. 
Spiritus Genevce.—Gin. Dose, f3j-§j. 
Pharmacology.—The fruit of Juniperus communis (Conifer®), an 
evergreen of this country and Northern Europe, contains from 2 to 
per cent, of a volatile oil, about 15 to 30 per cent, sugar, etc.; also a 
* Practitioner, December, 1888. 
t A Companion to the U. S. Pharmacopoeia, Oldberg & Wall, New York, 1887. 715 
JUNIPERUS. 
non-ciystallizable principle, Juniperin. The volatile oil also exists in the 
leaves and other parts of the plant, and by macerating them in alcohol 
or spirits a liquor is produced, commonly known as gin, or spiritus 
Genevse. As the commercial article is frequently adulterated with oil of 
turpentine and other ingredients known to the trade, the pharmacopoeia 
offers a substitute in the compound spirit of juniper. The oil of juniper 
obtained from the wood is inferior to that distilled from the berries, 
which is the officinal form from which the spirit and compound spirit are 
made. 
Physiological Action.—Juniper stimulates the kidneys, but in health, 
while the discharge of urea is increased, the urinary water is actually 
diminished temporarily ; an overdose may produce strangury and sup- 
pression of urine. In diseased conditions, however, the flow of urine is 
much more free, and especially where dropsy exists. The oil is carmi- 
native as well as diuretic, and in alcoholic solution is a frequently-used 
stimulant. It is contra-indicated in acute inflammation of the kidneys. 
Therapy.—In various forms of dropsies juniper is useful. In the 
form of an infusion, to which ounce of cream of tartar is a good 
addition, a pint being drunk through the day, the effects are soon manifest 
in Bright’s disease and its attendant oedema and effusions. A combina- 
tion with the acetate of potassium is also very effective, as— 
Potassii acetatis, ,3vj. 
Spiritus jumperi comp., f^iss. 
Infusi scoparii, f^ivss. 
M. et ft. sol. 
Sig.: A tablespoonful three or four times a day. 
Juniper gives relief in passive congestion of the kidneys mid the 
lumbar pain which accompanies that condition. This remedy is inap- 
propriate, however, in acute nephritis on account of its stimulant prop- 
erties. In large doses it sometimes excites priapism, strangury, or 
hsematuria. Benefit is obtained from juniper in chronic pyelitis, pros- 
tatorrhoea, and gleet. The juice of the berries has been successfully used 
in doses of two or three teaspoonfuls as a diuretic for young children 
and in renal dropsy. The oil may be dropped in boiling water and 
inhaled to produce the same effect. In infantile colic a few drops of the 
compound spirit in hot water relieves flatulence and pain. 
Oleum Cadini, the oil of cade, is obtained by the destructive distilla- 
tion of juniper-wood ; it is tarry and empyreumatic, and is useful as a 
stimulant application in chronic eczema and in psoriasis. In the latter 
malady, after the scales have been removed, Hebra’s modification of 
Wilkinson’s ointment often proves of considerable efficacy7. The 
formula is as follows :— 716 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Sulphuris sublimati, 
Olei cadini, .......... aa §ss. 
Saponis viridis, 
Adipis, . . . . aa 5.j. 
Cretae preparatae, 3iiss. 
M. et ft. ungt. 
KAMALA (U. S. P.).—Kamala, Rottlera (Ph., 1870). 
Pharmacology and Therapy.—The glands and hairs from the capsules 
of Mallotus philippinensis (Euphorbiaceae), a small tree of India and 
China, are used, mixed with molasses or other vehicle, as a vermicide. 
It also possesses purgative properties. For tape-worm from 1 to 2 
drachms are given at a dose, with a little hj’oscyamus to prevent griping. 
An ethereal extract deposits crystals of what is called Rottlerin. A fluid 
extract (not officinal) is also used to expel lumbricoid worms. In the 
form of ointment, kamala is used in the East in the treatment of scabies 
and ring-worm. 
KAVA-KAVA.—Ava-kava, Methysticum. 
Dose, ; best in the form of a fluid extract. 
Pharmacology.—The Piper methysticum (Piperaceae) is a shrub of 
the Sandwich Islands, having a large root, which yields about per 
cent, of soft resin (consisting of two kinds, distinguished as a and b), 
about 1 per cent, of a neutral, crystalline principle, methisticin (or 
kavahin), and some yellow volatile oil. This resembles pipeline and 
cubebin, and is probably inert, the medicinal qualities depending upon 
the resins and volatile oil. It is best given in the form of a tincture or 
fluid extract made with alcohol as a menstruum. 
Physiological Action.—In the Sandwich Islands the natives prepare 
an intoxicating beverage by chewing the root and infusing it with water 
or cocoanut-milk to grace their festivals. The fluid extract is diuretic 
and depressant. The peculiar effects of this drug do not seem to be 
entirely due to either of the resins which it contains, but no other active 
principle has yet been isolated. 
The physiological action of kava-kava has been investigated by 
Lewin, Randolph, and others, and quite recently Dr. David Cerna has 
published an account of a series of experiments* upon the same subject. 
When the fluid extract or the resin is placed upon the tongue a burning 
sensation is at first produced, soon followed by an-increase of saliva and 
local anaesthesia. The loss of sensation endures for hours and normal 
sensibility slowly returns. The same benumbing influence is exercised 
upon the cornea and conjunctiva by a local application. The mucous 
membrane is rendered anaemic. Taken internally in considerable quantity, 
* Therapeutic Gazette, January 15,1891. 717 
KINO 
it induces somnolence. As the result of his researches, Cerna concludes 
that kava-kava produces general anaesthesia, and is especially a powerful 
local anaesthetic. It diminishes and finally destroys the action of the 
afferent nerves by affecting their peripheral ends. Keflex action is 
diminished and ultimately abolished. Paralysis of spinal origin is an 
effect of the drug. The action of the heart is rendered slower and more 
powerful; arterial pressure is at first reduced and subsequently raised. 
Respiration is at first stimulated, afterward depressed, and finally 
paralyzed. Small doses of kava-kava slightly increase, while large 
quantities reduce, bodily temperature. 
Therapy.—In cystitis and chronic gonorrhoea, kava-kava is often 
remarkably successful. It has also been recommended for gout. It is 
suggested that the anaesthetic properties of this substance maj' prove 
useful to dentists, and that, though irritant to the conjunctiva, it may- 
be employed subsequent to cocaine for the purpose of prolonging the 
anaesthesia due to the alkaloid, and may be used, also, to disguise the 
taste of bitter or nauseous medicines. 
KINO (U. S. P.).—Kino. 
Dose, gr. x-xx. 
Preparations. 
Tinctura Kino (U. S. P.)—Tincture of Kino (10 per cent.). Dose, f3i-ij. 
Extractum Kino Liquidum.—Liquid Extract of Kino (about 50 per cent.). Dose, 
ftlxv-xxx. 
Pharmacology.—Kino is the inspissated juice of Pterocarpus marsu- 
pium (Leguminosae), a tree of the East Indies. It occurs in fragments 
of a ruby-red color, without odor, of a sweetish, astringent taste; 
scarcely soluble in cold, but entirely soluble in boiling water; soluble 
also in alkalies. Kinotannic acid is the most important constituent; 
there are also present Kinoin, a crystalline neutral substance, Pyrocate- 
chin, Pectin, etc. The officinal kino is the so-called Malabar kino ; there 
are other varieties, notably one from Botany Bay, obtained from several 
species of eucalyptus. 
Physiological Action and Therapy.—Kino is a mild astringent, useful 
in diarrhoea, especially with chalk mixture and paregoric. Kino, locally 
and internally, possesses some value as a haemostatic, and is a service- 
able remedy in pyrosis. The tincture is often an ingredient of injections 
in gonorrhoea, and may be applied as a stimulant dressing to chronic 
ulcers. The compound powder (Ph. Br.) is used for the same purpose 
(it contains kino 15, cinnamon 4, opium 1). It has 5 per cent, of opium, 
and is used in doses of 5 to 20 grains. Kino may also be employed as a 
gargle, but has no advantage over tannic acid for this purpose. 718 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
KOLA-NUT. 
Dose, gr. v-3ij, in the form of a paste. 
Pharmacology.—The seeds of Sterculia acuminata (Sterculiaceae) are 
used by the natives in various parts of Africa for the purpose of increas- 
ing bodily force and restoring impaired energy. The seeds are chewed, 
and from the powdered dried seeds an agreeable stimulant and nutritious 
beverage is prepared with milk and honey. The tree grows to the 
height of 30 to 60 feet, bears some resemblance to the horse-chestnut, is 
a native of the western coast of Africa, and is found as far inland as 500 
or 600 miles. It has been introduced, and with success, into other tropical 
regions of Asia and South America. From 5 to 15 seeds, some red and 
others white, are contained in a single capsule. They contain a large 
proportion of caffeine or tlieine (2.348 per cent.), together with tannic 
acid and theobromine (0.023 per cent.), other constituents being sugar, 
albumin, cellulose, starch, fat, and fixed salts. These seeds have lately 
been employed in a number of clinical experiments. An alcoholic extract 
has been made by exhausting the fresh nuts with 5 parts of 60° alcohol 
and a wine by macerating in a sweet white wine for a fortnight. But 
neither of these preparations extract all the caffeine. A tincture and a 
syrup have also been made, though water is an imperfect menstruum on 
account of the starch contained in the seeds. According to Simmonds* 
there is also a false or bitter kola, the male kola, named also the Garcinia 
kola, the seeds of which are oval or cuneiform ; these are four in number, 
contained in a large berry. The false kola-nuts are destitute of alkaloid. 
Physiological Action.—The taste of the fresh seeds is at first sweet, 
becoming astringent and finally bitter. From his investigations upon 
himself and others, R. II. Firth concludes that kola increases the secre- 
tion of urine, stimulates the nervous system and heart, and increases 
arterial tension. It prevents the feeling of exhaustion from exercise or 
hunger. It communicates an agreeable taste to water or food, and, 
according to Armitrous, renders tainted meat edible and clarifies 
polluted water by a mechanical action. 
Therapy.—Kola exercises a preservative action upon the teeth and 
gums and promotes appetite and digestion. It favorably modifies the 
functions of the liver. It is, therefore, adapted to act as a remedy in 
dyspepsia, whether of gastric or hepatic origin. Its combined stomachic 
and astringent properties render it of service in the treatment of acute 
and chronic diarrhoea. In its native country it is thought to protect 
Europeans against affections of the liver, and the natives esteem it as a 
prophylactic against dysentery. It has been proposed as likely to be of 
service in cholera. As a heart-stimulant, it may be employed in weak- 
* Pharmaceutical Record, January 5, 1891. KRAMERIA. 
719 
ened conditions of that organ, in fever, and in phthisis. Its favorable 
influence upon the nervous system suggests its employment in neuralgia. 
It is stated that kola has a remarkable power of promoting cheerfulness, 
and may be very serviceably used in hypochondria and melancholia. It 
is probably of value in overcoming the taste for alcoholic liquors. 
Simmonds states that the false kola-seeds, when chewed, are an effectual 
remedy for cold in the head. 
KRAMERIA (U. S. P.).—Krameria, Rhatany. 
Dose, gr. v-xx. 
Preparations. 
Extraction Kramerice (U. S. P.).—Extract of Krameria. Dose, gr. i-x. 
jExtraction Krameria Flaidum (U. S. P.).—Fluid Extract of Krameria. Dose, rtf i-x x 
Syrupus Krameria (U. S. P.)—Syrup of Krameria (35 per cent.). Dose, f3i-iv. 
Tinctura Krameria (U. S. P.).—Tincture of Krameria (20 per cent.). Dose, t'3i-iv. 
Trochisci Krameria (U. S. P.).—Troches of Krameria (each, gr. j of extract). Dose, 
one or more. 
Pharmacology.—Krameria is the root of Krameria triandra and of 
K. tomentosa (Polygalacese), growing in South America. It contains 
about 20 per cent, of Kramerio-tannic acid, which is the active constitu- 
ent. The infusion (§i to Oj) and an abstract, though not officinal, are 
useful preparations. 
Physiological Action.—It is a powerful astringent. 
Therapy.—In Peru it is largely used as a remedy for bowel dis- 
orders, diarrhoea, dysentery, etc. The infusion is a satisfactory gargle 
for relaxed throat, and the lozenge is also used for this purpose. The 
tincture of krameria may be combined with chalk mixture in the treat- 
ment of summer diarrhoea. Krameria is employed as a systemic remedy 
in epistaxis, lnematemesis, haematuria, and other forms of haemorrhage. 
It is of service, both locally and internally, in haemorrhoids and leucor- 
rlioea, and the tincture or the fluid extract is used, diluted and in combi- 
nation with other astringents, as an injection, in gonorrhoea. A mixture 
of the decoction and the tincture was recommended by Trousseau as an 
injection in fissure of the anus. The powdered extract enters into the 
composition of many tooth-powders. 
KUMYSS.—Koumiss, Milk-Wine. 
Pharmacology.—Originally made in Asia by the Tartars as an in- 
toxicating drink by fermenting mares’ milk, kumyss has been intro- 
duced into European medicine as a food and as a remedial agent. It 
can be made for medical use by adding a small piece of compressed yexast 
to diluted cows’ milk containing a small amount of grape-sugar; it 
should be kept in a cool place, with frequent agitation, and used on the 
fourth or fifth day. 720 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
The late Prof. S. W. Gross (College and Clinical Record) gave the 
following simple directions for preparing kumyss:— 
Dissolve ounce of grape sugar in 4 ounces of water. Dissolve 
20 grains of yeast-cake in 4 ounces of milk. Pour both into a quart 
bottle and fill nearly to the top with milk. Cork tightly, fastening the 
cork with wire. Put into a cool place and shake two or three times daily 
for three days. Keep for use no longer than six days. 
A champagne-tap introduced through the cork is necessary. 
Kumyss contains about 16 per cent, of alcohol, and is a pleasant, acid- 
ulous drink. 
Physiological Action and Therapy.—The combined action of the 
carbonic acid and alcohol in kumyss produces an exhilarant impression. 
It raises the arterial tension and assists in assimilation. It adds tone 
to the stomach, aids the appetite, excites the action of the kidneys 
and skin, and favors sleep. Kumyss, by reason of its utility as a 
nutriment during inflammatory action, is of great service in phthisis, 
scrofula, chronic bronchitis, and in the treatment of surgical cases. 
In an irritable stomach it is a most beneficial remedy in its sedative 
and nutritive effect. 
In the nausea and vomiting of pregnancy, owing to the action 
just referred to, kumyss very often acts in a most happy manner, the 
nutrition and bodily vigor of patients being increased b\' the continued 
use of kumyss during this period. At the time of confinement, when 
nausea and vomiting supervenes, followed by exhaustion, kumyss will 
often assist in restoring the flagging powers. During the state of lacta- 
tion kumyss will be very grateful, will assist the nutrition of the system, 
and will be productive of better and more nourishing milk. In con- 
valescence from acute diseases, in diarrhoea and dysentery, kumyss will 
be serviceable to feeble digestion, and will aid in assimilation. In cholera 
infantum, gastro-intestinal diseases of childhood, and in fevers, kumyss 
is a most agreeable form of food. It is also an admirable remedy and 
food in acute and chronic alcoholism, in albuminuria, diabetes, gastralgia, 
gastric ulcer, and in the various forms of cancer and dyspepsia. Kumyss 
is especially useful in cachexia of kidney disease four or five times 
a day). 
The amount of kumyss administered to each case should vary 
according to the disease. In some instances from 1 to 4 ounces can be 
given every one to three hours; in others as much as a good-sized glass- 
ful or two can be taken frequently during the day and night. The writer 
has administered as much as three or four quarts of kumyss a day in 
diseases attended with much exhaustion, and often with decidedly good 
effect. LACTUCARIUM. 
721 
LACTUCARIUM (U. S. P.).—Lactucarium, Lettuce-Opium. 
-Oose, gr. x-xx. 
Preparations. 
JEJxtractum Lactucarii Fluidum (U. S. P.).—Fluid Extract of Lactucarium. Dose, 
variable. IHi-iij for a child, Hlx-loj for an adult. 
Syrupus Lactucarii (U. S. P.).—Syrup of Lactucarium. Dose, f3i-§iss. 
Glyceritum Lactucarii.—Glycerite of Lactucarium. Dose, f3ii-iij. 
Pharmacology.—'Hie concrete milk-juice of Lactuca virosa (Composi- 
te), a wild variety of lettuce growing in Europe, blit also found in garden- 
lettuce, Lactuca sativa. The only* important constituent is the mixed 
substance, Lactucarium, obtained by evaporation of the milky juice. It 
is in flattened pieces or cakes, of reddish-brown color, internally white 
or wax}'-looking, of heavy, opium-like odor, and a bitter taste. It is 
administered in 10-grain doses. French lactucarium, being simply a 
blackish-brown extract of lettuce, is inferior to that of the pharmacopoeias 
of the United States and England, which is made from the expressed 
juice. Lactucarium consists of Lactucerin, Lactucin, and Lactucic acid. 
The syrup is pleasant to the taste ; a glycerite may be made of the same 
strength as the syrup, but using glycerin instead of simple syrup. 
Physiological Action.—It is a feeble narcotic,and owes its reputation 
largely to the observation that eating lettuce causes drowsiness. Its 
preparations vary greatly in activity, but are not toxic, and are therefore 
much safer for children than those of opium. Some action upon the 
kidneys is also observed, and it allays spasmodic cough. 
Therapy.—The syrup is used in cough mixtures for children, Auber- 
gier’s syrup having the reputation of being active and uniform in strength. 
To allay nervous irritability, and as a substitute for the soothing syrups 
containing morphine, it has decided value. The fluid extract may be 
used in elderly persons, or where there is an idiosyncras}' against opium, 
to fulfill the same ends. 
LAMINARIA.—Laminaria, Sea-tangle. 
Pharmacology and Therapy.—The small stems of the Laminaria digi- 
tata (Algee), when dried, are cut into appropriate lengths and shape and 
their surface made smooth, to be used as substitutes for sponge tents in 
dilating the cervix uteri, owing to their property, when moistened, of 
swelling up to several times their original size. 
LANOLINUM.*—Lanolin, Wool Fat. 
Pharmacology.—In the washings of wool is found a variety of fat 
which, owing to the presence of cholesterin, combines readily with more 
* For further observation on lanolin see author’s work on Ointments and Oleates, Espe- 
cially in Diseases of the Skin, second edition, pp. 14 to 24. F. A. Davis, Philadelphia and 
London, 1890. 722 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
than its own weight of water; it does not become rancid and resists sa- 
ponification. It is neutral and is a good vehicle for remedies to be used 
by inunction, as it passes readily through the skin; it is not adapted as 
a protective for the same reason. The sheepy smell of the fat is removed 
by repeated washings, and pure lanolin is now obtainable that is nearly 
odorless. 
Physiological Action.—Lanolin has a soothing action on a delicate or 
irritable skin. It is not used internally, but only as an unguent. 
Therapy.—In psoriasis and in chronic eczema with infiltration,lanolin 
softens the skin and favors the action of remedies combined with it. It 
is a good vehicle for the anodynes,—atropine, cocaine, morphine, veratriue, 
etc.,—in cases of neuralgia or rheumatic joints. As an ointment alone for 
the eye, lanolin is too thick, tenacious, and sticky, and to remedy these de- 
fects Prof. P. D. Keyser uses a combination of 1 part of benzoated lard to 
3 parts of lanolin, which makes a fine, smooth ointment; he has found 
it the best vehicle for eye ointments, and, even alone, is often used to 
apply at night to the e3'elids in conjunctivitis and almost all external 
inflammations. 
LAPPA (U. S. P.)_Burdock-Root. 
Pharmacology.—The seeds (achenes) and root of Lappa officinalis 
(Compositae) contain a bitter principle, volatile oil, resin, mucilage,sugar, 
a little tannin, etc. The root is used for similar purposes to those of sar- 
saparilla. A fluid extract of the seeds (dose, TtLxv-fJj) and a tincture 
of the seeds (1 pound to 1 gallon) are employed, also an infusion or de- 
coction of the seeds or root, but none of the preparations are officinal. 
Physiological Action and Therapy.—Burdock is diaphoretic, diuretic, 
and laxative, without causing irritation. The fluid extract is used exter- 
nally for swellings, haemorrhoids, ulcers, etc., and internally for rheuma- 
tism, syphilis, and chronic skin diseases. 
According to Squibb, the tincture* is a useful tonic and is curative 
in psoriasis. 
LAUROCERASUS.—Cherry-Laurel. 
Preparation. 
Aqua Laurocerasi.—Cherry-Laurel Water. Dose, f3ss-ij. 
Pharmacology.—The fresh leaves of Primus laurocerasus (Rosaceae) 
contain Laurocerasin, a compound of amvgdalin and amygdalic acid, and 
also Emulsin, which, when in the presence of water, form a volatile oil 
(benzaldehyde) and hydrocyanic acid, to which it owes its medicinal 
qualities. Cherry-laurel water is distilled from the fresh leaves, bruised 
* Epliemeris, vol. i, p. 116. LAURUS. 
723 
and macerated in water; it contains the volatile oil and hydrocyanic 
acid, but is of uncertain strength. 
Therapy.—It is used in Europe (very rarely in this country except by 
foreign physicians) for the same purposes as bitter-almond water and 
chiefly as a vehicle for anodyne and antispasmodic remedies. A cherry- 
laurel ointment, consisting of 1 part of essence of cherry laurel to 8 
parts of lard, is used in Italy in painful affections, as neuralgia, herpes 
zoster, chronic rheumatism, and carcinoma. 
LAURUS.—Laurel, Bay, or Bay-Laurel. 
Preparation. 
Ungucntum Lauri.—Laurel Ointment (suet 350 parts, rectified oil of amber 20, oil of 
turpentine 45, and expressed oil of bay-benies 585 parts). 
Pharmacology.—The leaves and berries (Lauri folia and Lauri 
baccse) of Laurus nobilis (Lauraceae), a tree of Southern Europe, con- 
tain volatile oil, Laurin, or laurel-camphor, a liquid fixed oil, a solid 
fixed oil known as Laurostearin, and starch. The volatile oil of laurel- 
berries, consisting of a camphene and eugenic acid, is occasionally em- 
ployed externally in rheumatism. By boiling the fresh fruit in water and 
using pressure, the expressed oil of laurel is obtained, which is used in the 
form of ointment as an anodyne. Leaves, berries, and oil are stimulant 
and narcotic. A laurel ointment is officinal in the French Codex. It is 
composed of 1 part each of fresh laurel-leaves and laurel-berries, with 2 
parts of lard. This preparation is applicable to erythema, dermatitis, 
erysipelas, acute eczema, and superficial burns. The leaves are used in 
cooking for flavoring (bay leaves, bay-laurel leaves); they should not be 
con founded with the leaves of Myrcia acris, from which the volatile oil of 
bay is distilled, that is used as a perfume (and enters into spiritus 
myrciae, or bay-rum), or Myricae Cerifera Cortex,—bay-berry bark. 
LAVANDULA (U. S. P.).—Lavender, Lavender Flowers. 
Preparations. 
Oleum Lavandulce (U. S. P.).—Oil of Lavender. Dose, Ihiii-v. 
Oleum Lavandulce Florum (U. S. P.).—Oil of Lavender Flowers. Dose, Uliii-v. 
Spiritus Lavandulce (U. S. P.).—Spirit of Lavender (oil of lavender flowers 30, alcohol 
970 parts). Dose, f3ss-j. 
Tinctura Lavandulce Composita (U. S. P.).—Compound Tincture (formerly Spirit) of 
Lavender (oil of lavender 8, oil of rosemary 2, cinnamon 18, cloves 4, nutmeg 10, red 
saunders 8, in dilute alcohol, q. s. ad 1000 parts). Dose, f3ss-j. 
Pharmacology.—The flowers of Lavandula vera (Labiatte), much cul- 
tivated in England for their perfume, are officinal. They contain volatile 
oil, some resin, and tannin. The oil of lavender, distilled from the whole 
herb or flowering tops, is coarser than that distilled from the flowers 724 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
alone ; of the latter there are several varieties, differing in value and fine- 
ness. An inferior, greenish, turpentine-like oil,distilled from Lavandula 
spica, is known as oil of spike-lavender. The oil of lavender has 
the property of checking decomposition. The compound tincture is 
an elegant preparation of aromatics and stimulants. 
Lavender is carminative and stimulant. It is useful in flatulence, 
nervous dyspepsia, gastralgia, colalgia, hysteria,and syncope. It is used 
in perfumery, and enters into spiritus odoratus, vinum aromaticum, 
liquor potassii arsenitis, and spiritus ammoniae aromaticus. 
LEDUM.—Ledum, Wild Rosemary. 
Dose, gr. xv-xxx. 
Pharmacology and Therapy.—The small twigs, tops with undeveloped 
flowers and leaves of Ledum palustre (Ericaceae), hut without the fruit 
even partly formed, contain volatile oil, Valerianic acid, Ericolein, Ledi- 
tannic acid, resin, etc., and are used in infusion, as marsh-tea. Ledum is 
said to be somewhat narcotic, astringent,and tonic; it is used externally to 
destroy parasites, and internal!}- in diarrhoea and dysentery, gout, rheu- 
matism, and chronic skin diseases. 
LEONURUS.—Leonurus, Motherwort. 
Dose, f5i-ij, in fluid extract. 
Pharmacology and Therapy.—The flowering tops and leaves of Leon- 
urus cardiaca (Lahiatre) contain a hitter principle, some volatile oil, etc. 
It is used in recent infusion, and, as a fluid extract, with dilute alcohol, 
as a menstruum to promote the menstrual discharge and in suppression 
of the lochia. It is also deemed useful in hysterical pains. 
LEPTANDRA (U. S. P.).— Leptandra, Veronica, Culver’s Root. 
Dose, gr. xx. 
Preparations. 
Extradum Leptandrce (IT. S. P.).—Extractor Leptandra. Dose, g r. fii-x. 
Extraction Leptandrce Fluklum (U. S. P.>.—Fluid Extract of Leptandra. Dose, f3ss-j. 
Pharmacology.—The rhizome and rootlets of Leptandra Yirginica 
(Scrophulariaceae) contain a hitter principle, Leptandrin; also saponin, 
tannin, resin, starch, etc. What is ordinarily designated leptandrin is 
merely an impure resin or alcoholic extract. Leptandra is common in 
woods from Vermont to Wisconsin and southward. 
Physiological Action.—Leptnndra-root, or Culver's physic,is a chola- 
gogue cathartic. It should he dried, for in its recent condition it acts 
too violently to he used. The extract is an eligible form in which to use 
the drug, which, in small doses, is tonic and laxative. 
Therapy.—In indigestion, with deficiency of secretions and consti- 
pation, leptandra has been found useful,and may he combined with podo- LIMON. 
725 
phyllum, which it resembles in its effects, or with aromatics. When the 
stools are clay-colored and show a deficiency of bile, this agent may be 
used to bring about bilious discharges, even when there is diarrhoea. 
UNION.—Lemon. r. 
Preparations. 
Limonis Cortex (U. S. P.).—Lemon-Peel. The rind of the recent fruit of Citrus 
limonum (Aurantiaeeae). 
Limonis Succus (U. S. P.).—Lemon-Juice. The freshly-expressed juice of the. ripe 
fruit of Citrus limonum. 
Preparations from the Cortex, or Rind. 
Oleivm Limonis (U. S. P.).—Oil of Lemon. Used for flavoring. 
Spiritus Limonis (U. S. P.).—Spirit of Lemon. Used for flavoring. 
Syrupus Limonis (U. S. P.).—Syrup of Lemon. Used for flavoring. 
Preparations from the Juice. 
Mistura Potassii Citratis(U. S. P.).—Neutral Mixture. Lose, f3ii-iv. 
Syrupus Acidi Citrici (U. S. P.).—Syrup of Citrie Acid. As a vehicle. Dose, f3i-ij. 
Acidum Citricum (U. S. P.).—Citric Acid. Dose, gr. v-xxx. 
Syrupus Limonis.—Lemon Syrup. Contains both juice and rind. Dose, f3i-§ss. 
Pharmacology.—Lemons, owing to their pleasant flavor and agree- 
able acidity, are very useful in the sick-room. The rind is glanduious, and 
by expression yields an oil of great fragraney, much superior to that 
obtained by distillation. Each lemon yields from 2 to 8 drachms of 
acidulous juice, containing citric acid (7 to 9 per cent.), besides phos- 
phoric and malic acids, in combination partly with potassa and other 
bases. A solution of citric acid in water (gr. xxxiv to 3j) corresponds 
in acidity with fresh lemon-juice, but not therapeutically on account of 
absence of other constituents. Half an ounce of lemon-juice should neu- 
tralize 25 grains of potassium bicarbonate, 20 of sodium bicarbonate, 
or 14 of ammonium carbonate. Lime-juice, obtained from a smaller 
fruit of the same genus (Citrus acris), closely resembles fresh lemon- 
juice, but acquires a peculiar, slightly musty taste from the wood in which 
it is imported. When fresh the rind of lemon, besides the oil above 
mentioned, contains a bitter, crystalline glucoside, Hesperidin. When 
preserved, boiled in syrup and dried (candied), lemon-peel is useful in 
flavoring, for cooking, etc. 
Therapy.—Lemon-juice is applied to the surface of the skin to re- 
move freckles or ephelides, moth-spots, sunburn, pruritus, and ink-stains. 
Used internally, lemon or lime-juice is antiscorbutic, probably owing to 
the presence of phosphoric acid or potash salts, as citric acid does not 
possess this property. It is now so constant a companion of voyagers by 
sea that scurvy7 is rarely seen, except where the regular ration of lemon- 
or lime-juice has been neglected. It is also curative in scurvy, and in 
various scorbutic manifestations upon the skin, or in the form of muscu- 726 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
lar pains. In some eases of chronic rheumatism, the administration of 
several ounces of lemon-juice dail}' affords marked relief. Lemon-juice 
has been likewise used in acute rheumatism with, at times, apparent good 
results. Lemonade, made by diluting lemon-juice with water and adding 
sugar, is a useful drink during convalescence; it increases the urinary 
water and reduces the acidity of the urine. Hot lemonade is useful as 
a diaphoretic in recent colds; its effects are increased by the addition 
of a little whisky or gin. Neutral mixture, made by neutralizing fresh 
lemon-juice by the addition of crystals of bicarbonate of potassium, is 
useful as a refrigerant and to satisfy thirst in fevers. Atheromatous 
changes in the arteries are retarded by the persistent use of lemon-juice, 
which is also useful in obesity. In Italy, an infusion of the lemon, the 
rind being incised to allow' the juice to escape, is administered in ague 
and other malarial attacks attended b}' fever. 
LINDER/E CORTEX.—Lindera-Bark, Spicebush-Bark. 
Dose, ri_xxx-f‘3j, in fluid extract. 
Pharmacology.—The Benzoin odoriferum (Lam-ace®), Lindera ben- 
zoin, or spicebush,is one of our common forest shrubs, belonging to the 
same natural order as the sassafras, the cinnamon,and the camphor tree. 
The bark and fruit contain a volatile oil, resin, and the common vegetable 
principles. The bark lias a pleasant, spicy taste, due to the oil. 
Physiological Action.—It is aromatic, stimulant, and tonic, and a 
recent, hot, weak infusion is diaphoretic. 
Therapy.—In some disorders of digestion the carminative and tonic 
effects are available ; the infusion is used in chills and to abort a cold. A 
decoction of the inner bark made into an ointment with cold cream is 
recommended by Hyde as a valuable remedy in rlius poisoning. 
LINUM (U. S. P.).—Linseed, Flaxseed. 
Preparation. 
0\mm Lini (U. S. P.).—Linseed-Oil. 
Pharmacology and Therapy.—Flaxseed (Linum usitatissimum ; natu- 
ral order, Linaceae) contains mucilage and linolein. It is demulcent and 
emollient. A hot infusion flavored with liquorice-root or lemon- 
peel, is used in bronchial inflammations, as a diaphoretic and expec- 
torant; also in cystitis, strangury, and haematuria. A plain infusion is 
an excellent enema for use in inflammation of the rectum, fissure, haemor- 
rhoids, etc. Ground flaxseed mixed with boiling water forms flaxseed 
poultice, which is spread at least half an inch in thickness upon muslin or 
flannel,and applied as hot as possible in order to relieve pain and conges- 
tion in peritonitis, and in pneumonia, pleurisy, etc., as jacket poultices, 
renew'ed every two to three hours. They should be covered with LIPPIA MEXICANA. 
727 
oiled silk to retain heat and moisture, and, if desired to increase the 
counter-irritant effect, a little dry mustard or a few drops of turpentine 
may be sprinkled over the surface. They afford great relief to the pa- 
tient. Laudanum, also, or lead-water and laudanum, are often used with 
a flaxseed poultice in inflammatory and painful affections. Flaxseed 
poultices are also applied to boils and abscesses to abort the process 
or to hasten ripening. They are also applied occasionally to ulcers and 
wounds to encourage granulations and bring about healthy action. 
Whole flaxseed, in ounce doses, has been ordered in habitual constipa- 
tion as a laxative. 
The long-continued application of poidtices is likely to bring out an 
eruption of small boils upon the skin, the result of liypersemia and irri- 
tation. Poultices are often useful for temporary purposes, but too long- 
applied are mischievous. The integument and the vessels subjected to 
their influence become relaxed, suppuration is prolonged, granulations 
rendered unhealthy, and the repair of ulcer or wounds retarded. 
Oil of flaxseed is an old application to burns to exclude the air ; 
combined with lime-water, it forms Carron-oil, which was formerly used 
largely for this purpose, having been originally used at an iron works of 
that name in Scotland, where the workmen were frequently burned. It 
is dirty and soon smells badly, and has been driven out of use by petro- 
latum and Listerism. 
LIPPIA MEXICANA. 
Pharmacology.—Lippia Mexicana (Yerbenacese), a creeping, eArer- 
green shrub, with very long roots and numerous branches, grows abun- 
dantly in Southern Mexico. Its medicinal virtues reside in the leaves 
and stalks, especially in the leaves, which possess an agreeable, sweetish,, 
and aromatic taste. The plant contains a small proportion of tannic 
acid, an ethereal oil, and a volatile camphor termed Lippiol. A fluid ex- 
tract and a tincture have been prepared, the dose of the former being 
from 5 to 30 minims, and of the latter from to 1 fluidrachm. 
Physiological Action.—Lippia causes a sensation of warmth in the 
stomach,and in large doses may give rise to vomiting. This is succeeded 
by free perspiration and sleepiness. 
Therapy.—The drug is endowed with valuable expectorant proper- 
ties. It allays irritation of the bronchial mucous membrane and pro- 
motes healthy secretion. Its effects are rapidly manifested. Lippia is use- 
ful in both acute and chronic bronchitis. In the former it allays the cough, 
and in the latter it liquefies the viscid secretion and facilitates expecto- 
ration. It is of service in the cough of phthisis, has an excellent effect 
in irritative cough, and in whooping-cough mitigates the paroxysms, 728 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
though it is not able to shorten the course of the disease. It has, in 
some instances, proved useful in spasmodic asthma. 
LIQUIDAMBAR.—Liquidambar, Sweet Gum. 
Pharmacology.—The Liquidambar styraciflua (Hamamelacese) of 
North and Central America supplies a brownish-yellow balsam, resem- 
bling storax,and containing stryrol (3| per cent.), cinnamic acid (5 per 
cent.), styracin, and resin. A good substitute for the imported drugs 
which it resembles,—storax, tolu, and benzoin,—and used for the same 
purposes. 
LITHIUM. c u 
baits. 
Lithii Benzoas (U. S. P.).—Benzoate of Lithium. Dose, gr. v-xx. 
Lithii Bromidum (U. S. P.).—Bromide of Lithium. Dose, gr. v-xx. 
Lithii Carbonas (U. S. P.).—Carbonate of Lithium. Dose, gr. v-xx. 
Lithii Gitras (U. S. P.).—Citrate of Lithium. Dose, gr. v-xx. 
Lithii Salicylas (U. S. P.).—Salycilate of Lithium. Dose, gr. v-xx. 
Lithii lodidum.—Iodide of Lithium. Dcse, gr. i-v. 
Lithii Gnaiacas.—Guaiacate of Lithium. Dose, i-v. 
Pharmacology.—Lithium is a metal of an alkali, generally prepared 
from the native silicate, or Lipi dolite. It decomposes water at ordinary 
temperatures, but without melting like sodium, and is less easily oxi- 
dized than either sodium or potassium. The metal, which is not officinal, 
resembles tin. It was first obtained by Bunsen by electrolysis of the 
chloride. Its salts are soluble in water, but the carbonate and phosphate 
only slightly so. 
Physiological Action.—The urate of lithium is freely soluble, and 
therefore when lithium, in combination with the vegetable acids, is admin- 
istered, these salts are decomposed in the system and the lithium combines 
with uric acid, renders it soluble, and thus facilitates its expulsion from 
the body. These salts are also diuretic, and the administration of lithium 
produces an increase in the urinary secretion. The carbonate of lithium 
promotes the assimilation and metabolism of nitrogenous material and 
increases the elimination of urea. Some mineral waters largely owe their 
medicinal effects to the small proportion of these salts which they con- 
tain, being rendered more effective by natural combination with other 
salts. 
Therapy.—In the uric-acid diathesis, the several salts of lithium are 
used with great advantage, even where chalky deposits exist. It has 
been also stated that they7 can dissolve uric-acid calculi in the urinary 
passages or bladder. Where there is vesical catarrh and alkaline urine, 
the benzoate is the best salt to use, since it renders the urine more acid ; 
where the urine is already7 too acid the other officinal salts are preferable. 
In gouty7 subjects, especially those suffering with indigestion, lithium 729 
LITHIUM. 
renders good service, and can be given in the form of an effervescent 
salt or in Vichy water. In gravel, lithium affords prompt relief. 
The salts of lithium have likewise been advantageously employed in 
chronic articular and muscular rheumatism. In rheumatoid arthritis 
they sometimes seem to delay the progress of the malady. In gout, sub- 
acute and chronic rheumatism, as well as in irritable bladder from excess 
of acid and in uric-acid calculi, lithium may be given thus:— 
Lithii citratis, 3iss. 
Liquor, ainmonii acetatis, 
Syrupi limonis, aa f^ij. 
M. Sig.: Two teaspoonfuls in water every two or three hours for rheumatism and 
gout. 
Lithii iodidi, 3j. 
Syrup, sarsaparillse comp., f§v. 
M. Sig.: A half to a tablespoonful three or four times a day for syphilis. 
b Lithii guaiacat., 
Quininae sulphatis, ......... aa gr. xl. 
M. et ft. capsulse no. xij. 
Sig.: A capsule or two every two or three hours for rheumatism and gout. 
Lithii bromidi, 3iiss. 
Tinct. cardamom, comp., f§j. 
Glycerini, f §iij. 
M. Sig.: Two teaspoonfuls in water every hour or two hours for rheumatism and 
gout. 
Lithii benzoat., 3ij. 
Tinct. belladonnae, Ilflxxij. 
Extracti tritici repentis fl., . . f Jiij. 
M. Sig.: A teaspoonful every two or three hours for irritable bladder, depending on 
excess of acid, and in uric-acid calculi. 
In glycosuria, the combination of arsenic with a litliia water lias 
been vaunted as curative. The bromide of lithium has been found bene- 
ficial in epilepsy by Weir Mitchell, who states that it will in some cases 
succeed after failure of the bromide of potassium or sodium. The lithium 
should always be administered in a large excess of water, and distilled 
water is better for this purpose on account of its diuretic properties. The 
H}rgeia lithia-water is a definite solution of lithium in distilled water, and 
is more reliable than many of the commercial, natural lithia-waters. The 
iodide of lithium contains a large proportion of iodine, and is a good 
method of administering this remedy, the only objection being its high 
cost. Woodbury* recommends the administration of a solution of iodide 
of lithium by electricity, or the cataphoric action of the galvanic current 
in tubercular syphilides and other local inflammatory exudations and 
infiltration, and suggests its application in cancer. 
* Transactions of the College of Physicians of Philadelphia, 1890, and Medical News. 730 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
LITMUS. 
Pharmacology.—A blue pigment from Rocella tinctoria (Liclienes), 
imparting its blue coloring-matter, Orcein, to water and alcohol. Paper 
stained with a solution changes its color to red in the presence of an acid ; 
the blue color is restored by plunging the paper in an alkaline solution. 
Hence we have blue and red test-papers for acids and for alkalies. 
LOBELIA (U. S. P.).—Lobelia. 
Dose, gr. viii-xx, as an emetic. 
Preparations. 
Acetum Lobelias (U. S P.).—Vinegar of Lobelia (10 per cent.). Dose, ITlx-f3j. 
Tinctura Lobelice (U. 8. P.).—Tincture of Lobelia (20 per cent.). Dose, Hlv—f3j. 
Extractum Lobelice Fluidum (U. 8. P.).—Fluid Extract of Lobelia. Dose, llli-x. 
Lobeline.—Impure Alcoholic Extract. Dose, gr. ss-j. 
Pharmacology.—Lobelia consists of the leaves and tops of Lobelia 
inflata (Lobeliacese) collected after a portion of the capsules have become 
inflated. It is a small herb, common by the waysides, with alternate 
leaves, an erect, hairy stem, with blue flowers in the axils of the leaves. 
The herb has a slight odor and a burning, tobacco-like taste. The chief 
constituent is a liquid alkaloid, Lobeline, combined with Lobelic acid and 
Lobelacrin. It forms ciystallizable salts. The seeds contain about 30 
per cent, of oil. The preparation sold as lobelin is an impure resin or 
powdered extract. 
Physiological Action.—Lobelia has no local action, but there is some 
danger that it may be absorbed and produce systemic effects if applied 
too freely to the skin. Internally, it is a powerful depressant in large 
doses, and sialagogue, expectorant, emetic, and purgative, according to 
circumstances. This drug frequently produces headache and vertigo,and 
may cause death from exhaustion, or by paralysis of the respiratory 
centre. It depresses the circulation and action of the heart, favors 
diaphoresis through the violent emesis which it causes, and also lowers 
temperature. Lobelia also promotes the discharge of urine and has some 
narcotic properties. 
Should alarming symptoms follow an overdose of lobelia the proper 
treatment consists in washing out the stomach with a solution of tannic 
acid, the external application of heat, hypodermatic injection of alcohol, 
ether, ammonia, or strychnine. Subsequently, moderate doses of opium 
will allay vomiting. 
Therapy.—An infusion of lobelia (1 ounce to the pint) has been used 
as a lotion in dermatitis due to rhns toxicodendron. It has valuable anti- 
spasmodic powers, though it is generally employed in too small doses in 
asthma. Ringer administers a drachm of the tincture every hour, or 10 
minims every ten minutes, immediately at the onset of a paroxysm of LUPULINUM. 
731 
asthma with marked benefit in shortening the attack. Lobelia may be 
employed thus for asthma :— 
Tinct. lobeliae, f§j. 
Tinct. hyoscyami, f §ss. 
Aquae camphorae, 
Spiritus aetheris nitrosi, aa f 
Syrupi pruni Virg., f§ss. 
M. Sig.: A teaspoonful in water every half-hour or hour until relieved. 
, Acetum lobeliae, f3ss. 
Sodii bromidi, 3v. 
Syrup, ipecacuanhae, . . f§ss. 
Glyceriui, f^iv. 
M. Sig.: Two teaspoonfuls every one or two hours. 
Lobelia should not be employed as an emetic, as it produced too 
much nausea and depression, and when so used has caused death. For the 
same reason lobelia is detrimental when dyspnoea is occasioned by dis- 
ease of the heart. The spasmodic stage of whooping-cough is often ame- 
liorated and shortened by the exhibition of this remedy. It is, relatively, 
better tolerated by children than by adults. On account of its expectorant 
properties, lobelia is of service in bronchitis, especially when the mucus 
is dry, the cough hard and barking, or the expectoration is extremely 
tough and hard to raise. In the treatment of whooping-cough and 
bronchitis, lobelia may be administered as follows :— 
Tinct. lobeliae, f3ij. 
Sodii bromidi, 3iij. 
Spiritus aetheris nitrosi, f^j. 
Syrup, limonis, . . q. s. ad f §iij. 
M. Sig.: A half to a teaspoonful every one or two hours to a child for whooping- 
cough. 
Tinct. lobeliae, f§ss. 
Ammonii iodidi, 3ij. 
Spiritus aetheris comp., f gij. 
Syrup, tolutani, fgiiss. 
M. Sig.: Two teaspoonfuls every two or three hours for bronchitis. 
In constipation and impaction, the tincture of lobelia in 1-minim 
doses every hour promotes peristalsis and stimulates intestinal secre- 
tions ; or a 10-drop dose may be given at bed-time, acting in a similar 
way to tobacco :— 
Acetanilid., * . 3ij. 
Tinct. lobeliae, f 3ij. 
Syr. eriodictyi aromat., q. s. ad f § iij. 
M. Sig.: Take a teaspoonful every quarter of an hour during attack of asthma until 
relieved. 
LUPULINUM (U. S. P.).—Lupulin. 
Pharmacology.—The glandular powder separated from the strobiles 
of Humulus lupulus (Urticaceae), or hops. (See Humulus, page 660.) 732 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
LYCOPERDON.—Puff-Ball. Lycoperdon solid lira or giganteum 
(Fungi) in powder is haemostatic. It is credited with narcotic properties, 
but has been occasionally used for food. 
LYCOPODIUM (U. S. P.).—Lycopodium. 
Pharmacology.—The sporules of Lycopodium clavatum and of other 
species of lycopodium (Lycopodiaceae) ; they contain nearly 50 per cent, 
of oil. , 
Physiological Action.—Lycopodium, given internally, had been said 
in the past to have diuretic and antispasinodic action. Merrell (“ Digest 
of Materia Medica ”) states* that the eclectics claim that lycopodium acts 
as a stimulant to the sympathetic visceral nerves, and therefore is of 
value in functional diseases of the organs under their control. Greene be- 
lieves that 13’copodium stimulates the liver, thus lessening the work of the 
kidneys, and that it has an anaesthetic effect upon the mucous membranes. 
Therapy.—Lycopodium is a bland powder, and, if not contaminated 
by fraudulent addition of starch, is an excellent dusting-powder for 
intertrigo, or to prevent excoriations, especially in infants. 
A tincture of lycopodium has been made by subjecting the powder 
to prolonged trituration with sugar of milk, after which it readily dis- 
solves in alcohol. This preparation, in doses, is commended 
by Hurry Fenwick and others as of value in incontinence of urine 
among adults. Greene states that flatulent dyspepsia, attended by a 
copious deposit of uric acid in the urine, is markedly benefited by this 
tincture, f 
Li’copodium has also been employed for the treatment of rheuma- 
tism, dyspepsia, pulmonary and renal diseases. Sectarian physicians 
use it triturated with sugar of milk in minute doses for affections of the 
mucous tract, particularly dyspepsia, pyrosis, ileo-colitis, and for diseases 
of the urinary organs. 
LYCOPUS.—Bugle-Weed. 
Dose, f’5i—iv, in infusion or fluid extract. 
Pharmacology.—The Lycopus Virginieus (Labiatre) is a small herb 
common in w*et places, resembling the mints, but wanting their aroma. 
The whole herb is used in decoction or infusion, but a fluid extract is 
the most eligible form in which to give it. It contains a volatile oil, with 
a little resin and tannin. 
Physiological Action and Therapy.—Bugle-weed is astringent and 
sedative. It has been used in pulmonary disorders and phthisis to allay 
fever, cough, and expectoration. It reduces the force and frequency 
* The Medical Standard, Chicago, January, 1891. 
f British Medical Journal, November 29, 1890. MACIS. 
733 
of the heart’s action, and acts as a sedative, and in large doses is de- 
pressant to the nervous system. By virtue of the volatile oil it is some- 
what carminative, and in small doses is considered tonic. It has Been 
used in organic and functional heart disease, and in exophthalmos by 
Dr. Hector.* It is of service in spasmodic cough in combination with bel- 
ladonna, but is rarely used. Probably when its composition and physio- 
logical properties are better understood, it may be better appreciated. 
MACIS (U. S. P.).—Mace. 
The arillus of Myristica fragrans (Myristicacese) is used principally 
for flavoring purposes. (See Myristica.) 
MAGNESIUM. 
Salts and Preparations. 
Magnesia (U. 8. P.).—Light Magnesia, Calcined Magnesia. Dose, 3i-iv. 
Magnesia Ponderosa (U. S. P.).—Heavy Magnesia. Dose, 3ss-iv. 
Magnesii Carbonas (U. S. P ).—Carbonate of Magnesium. Dose, 3ss-ij. 
Magnesii Sulphas (U. S. P.).—Sulphate of Magnesium, Epsom Salts. Dose, 3j-^j. 
Magnesii Sulphis (U. S. P.).—Sulphite of Magnesium. Dose, gr. xv-xxx. 
Trochisci Magnesite (U. S. P.).—Troches of Magnesia (each containing gr. iii). Dose, 
two or more. 
Liquor Magnesii Citratis (U. S.P.).—Solution of Citrate of Magnesia (dispensed in 
bottles containing 1 pint, effervescing when opened). Dose, f§iv-xvj. 
Mistura Magnesice et Asafcetidce (U. S. P.).—Mixture of Magnesia and Asafetidaf 
(magnes. earb. 5, tr. asafeetida 7, tinct. of opium 1, sugar 16, water q. s. ad. 100 parts). 
Dose, f3ss-j. 
Magnesii Citras Granulatus (\J. S. P.).—Granulated Citrateof Magnesia. Dose, 3i-iv. 
Ferri Oxidurn Hydratum cum Magnesia (U. S. P.).—See Iron, page 626. 
Pulvis Rliei Compositus (U. S. P-).—See Rhubarb. 
Pharmacology.—Magnesium is a light, silver-like metal, which, rolled 
in thin plates or ribbons, can be ignited, and will burn with a brilliant, 
white flame, forming a white smoke of the oxide. The carbonate of 
magnesia is of two varieties, one heavier than the other; by calcination 
in a crucible they yield the two forms of oxide of magnesia and heavy 
magnesia. The carbonate and oxides of magnesia are white in color, 
alkaline, insoluble, and tasteless, or nearly so. The sulphate is in color- 
less crystals, of a bitter taste, and quite soluble in water; it occurs 
native, and is a constituent of sea-water. It enters into the compound 
infusion of senna. The sulphite is a white, crystalline powder, obtained 
from the preceding, of slightly bitter taste, soluble in 20 parts of water. 
It oxidizes upon exposure to the air. 
Physiological Action.—Magnesia (or calcined magnesia, as it is com- 
monly called) and the carbonate have a slightly astringent effect upon 
the skin. When taken into the stomach, they are antacid and laxative. 
* Chicago Medical Times, June, 1889. 
t This is known as Dewees’ Carminative ; a similar preparation, Dalby’s Carminative, con- 
tains grains of opium in each ounce.  PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
It may be used as an antidote to acids, and also in poisoning b}’ phos- 
phorus, copper, or arsenic ; for the latter an officinal combination with 
hydrated sesquioxide of iron is provided. The citrate and sulphate are 
saline cathartics; the latter has no cholagogue effect, as was formerly 
thought, but it is a powerful irritant to the intestinal glands. 
Therapy.—The carbonate of magnesia, which comes in small cubes, 
is used to dry the skin and prevent chafing or excoriation. Internally it 
is an antacid for indigestion, heart-burn and pyrosis, and is used as a 
laxative for infants. Sick headache, dependent upon gastric acidity, is 
often relieved by the administration of carbonate of magnesium. Mag- 
nesia ponderosa is a convenient form in which to administer the oxide; 
it may be given suspended in orange-juice or milk. Magnesia has been 
used with variable success in sympathetic vomiting and the vomiting of 
pregnane}7. It is of service in neutralizing uric acid, and may, therefore, 
be emplo}Ted in lithiasis, though inferior in this condition to lithium. 
In adults, if constantly administered, it may form large concretions in 
the intestines. The citrate is more purgative, and, in the officinal effer- 
vescent salt and solution, is a pleasant cathartic for simple evacuation of 
the bowels. The sulphate is more active, causing free watery discharges. 
It may be given in repeated small doses, every hour, in order to over- 
come faecal impaction; also in the constipation of lead poisoning:— 
Magnesii sulphatis, 3ij. 
Morphia® sulphatis, gr. j. 
Aquas menthas piperitae, f §iij. 
M. Sig.: A tablespoonful every two hours in lead colic. 
Dr. Matthew Hay advocates the use of magnesium sulphate in the 
treatment of pleural and other serous infusions, administering 1 or 2 
ounces at a dose and restricting the fluids drunk. The citrate and 
sulphate cause little, if any, irritation, and imiy safely be used in enteritis 
or in peritonitis to keep the bowels open. In many acute febrile dis- 
orders small doses of these salines are beneficial, and in atonic condi- 
tions they may be combined with iron. The purgative mineral waters, 
Friedrichshall, Pullna, Seidlitz, Hunjadi Janos, owe their property 
principally to the sulphate of magnesia. The bitter taste of the Epsom 
salt is covered by adding some coffee to its solution. It is the cathartic 
to administer in cases of the peculiar diarrhoea caused by impacted 
masses of feces in the colon, and in d}sentery it proves very service- 
able associated with aromatic sulphuric acid and laudanum. In acute 
dysentery magnesium sulphate sometimes acts remarkably -well, often 
removing fever, the blood and mucus from the stools, together with the 
tenesmus. 
Dr. A. W. D. Leahy, who has treated 95 cases of acute dysentery MAGNOLIA. 
735 
with magnesium sulphate, with only 2 deaths, recommends the remedy, 
combined as follows : “ Take a sufficient quantity of sulphate of magne- 
sia to saturate 7 fluidounces of water, and to this solution add 1 ounce 
of diluted sulphuric acid. The dose of this is a tablespoonful every hour 
or two in a wineglassful of water until it operates. Sulphate of morphine 
may be added, or starch enemata with laudanum may be employed.”* 
In anaemia and chlorosis, which Clarke attributes to faecal intoxication, 
the following combination forms a useful tonic laxative ; it is known as 
Mistura ferro-salina:— 
Magnesii sulpliatis, §j. 
Potassii bitartratis, 3j. 
Ferri sulphat. exsiccat., gr. x. 
Aquae, Oij. 
M. Sig.: A wineglassful half an hour before breakfast each morning. 
Where a more decided purgative effect is desired, the remedies should 
be given in more concentrated form, thus: equal parts of Rochelle and 
Epsom salts may be taken, say, each a teaspoonful, dissolved in a small 
quantity of water. The sulphite of magnesium has been recommended as 
a remedy for infectious dyspepsia and inflammatory or febrile diseases of 
infectious origin. A sulpho-carbolate has likewise been introduced to 
fulfill the same indications. The sulphate and carbonate of magnesium are 
said to be serviceable given internally for the treatment of warts. 
The carminative mixture of magnesia and asafoetida (U. S. P.) should 
be used with care in infants on account of the opium which it contains. 
MAGNOLIA (U. S. P.).—Magnolia. 
Dose, nyxxx-fjj of a fluid extract. 
Pharmacology.—The bark of Magnolia glauca, M. acuminata, and 
M. tripetala (Magnoliacene), all indigenous trees of our Eastern and 
Southern States. The drug contains, besides resin and tannin, a bitter, 
crystallizable, neutral principle, Magnolin, soluble in alcohol, but not in 
water. A fluid extract made with alcohol is the best preparation. 
Physiological Action.—An aromatic bitter, which can be used in ap- 
propriate dose as a tonic or as an antiperiodic. Diaphoretic properties 
are also ascribed to magnolia. 
Therapy.—Magnolia is used in debilitated conditions of the system 
attending malarial attacks, rheumatism, etc. In intermittent fevers it has 
been used successfully as a substitute for quinine. 
MAID1S STIGMATA.—Corn-Silk. 
Preparations. 
Extractum Stigmatorum Maidis Fluidum.—Fluid Extract of Corn-Silk. Lose, f 3i—ij. 
Vinum Stigmatorum Maidis.—Wine of Corn-Silk. Bose, f^ss-j. 
Sympus Stigmatorum Maidis.—Syrup of Corn-Silk. Bose, f^ss-j. 
* London Lancet, October 4, 1890. 736 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Pharmacology.—The green pistils (Stigmata, Maidis, corn-silk) of 
Zea Mays, Linne (Graminaceae), maize, or Indian corn, gathered when 
the tassel has shed its pollen, are said to contain an active principle 
which is termed Maizenic acid. The plant is too well known to need 
any description. A native of America, it has been extensively cultivated 
in all temperate climates. 
Physiological Action and Therapy.—The preparations of corn-silk are 
palatable and well tolerated by the stomach. Its principal action is as a 
diuretic, and it likewise seems to exert a sedative action upon the urinary 
passages. When cedema is associated with an enfeebled condition of the 
heart, corn-silk, by exciting diuresis, acts indirectly as a heart-tonic; the 
pulse becomes regular and increases in force, while arterial tension is 
raised. Corn-silk is of service in congestion of the kidney, chronic 
nephritis and pyelitis. During its administration albuminuria is less- 
ened and the excretion of urea is augmented. It also answers a good 
purpose in suppression of urine. In lithiasis, renal colic, and haematnria 
corn-silk has been found of benefit. Irritability of the bladder, acute and 
chronic cj stitis (especially the latter), retention of urine, and prostatitis 
are ameliorated by this remed}\ According to Dufau it is contra-indi- 
cated in acute traumatic cystitis and gonorrhoeal cystitis, increasing the 
pain of the malady. Other observers, however, report good results from 
its use in cystitis dependent upon gonorrhoea or stricture. Some, after 
having thoroughly washed out the bladder, employ the fluid extract of 
corn-silk diluted with water, as an injection, with asserted good results. 
Others speak favorably of its use as an internal remedy in acute gonor- 
rhoea. It has been given with success in nocturnal incontinence of urine. 
In oedema of the lower extremities, associated with disease of the heart 
and in general dropsy from heart or kidney disease, corn-silk is service- 
able alone or combined thus :— 
$ Extract! stigmatorum maidis fl., fpss. 
Extract! taraxaci fl., 
Infusi digitalis, aa f§iij. 
M. Sig.: Two teaspoonfuls in water every three or four hours. 
R Extracti stigmatorum maidis fl. f^ij. 
Potassii bitartratis, 3iij. 
Spiritus aetheris nitrosi, f§ij. 
M. Sig.: A half a tablespoonful every two or three hours. 
MAIDIS USTILAGO (U. S. P.).—Corn-Smut. 
Preparation. 
Extraction Ustilaginis Fluidum.—Fluid Extract of Ustilago. Dose, H|x-f3j. 
Pharmacology and Therapy.—Ustilago, or corn-smut, is a fungus re- 
sembling ergot, growing upon all parts of the Zea Mays. It should be MALTUM. 
737 
preserved in a dry state, and should not be kept longer than a year. Corn- 
smut contains about 5 percent, of an amorphous, reddish-brown substance 
resembling sclerotic acid. The fluid extract is used in a similar manner 
to ergot, in order to stimulate the contractions of the uterus during and 
after labor. The usual dose is about 30 grains, or 15 to 75 minims of a 
fluid extract. 
MALTUM (U. S. P.)—Malt. 
Preparations. 
ExtractumMalti (U. S. P.).—Extract of Malt. Bose, f3i-iv. 
Extractum Haiti Biastasicurn.—Diastasic Extract of Malt. Bose, f3j—§ij. 
Pharmacology.—Malt is the seed of Hordeum disticliuin (Gramina- 
cea?) caused to enter the incipient stage of germination by artificial 
means and dried. Extract of malt is made with water at a moderate 
heat and evaporated by means of a vacuum apparatus to the consistency 
of thick honey. The method adopted in making the “ diastasic ” extract 
of malt, the author is informed by Mr. Louis Genois, a Philadelphia 
chemist, who prepares an admirable form of it, is to macerate well-malted 
barley in warm water for several hours, until the starchy matter has 
been changed to dextrine and maltose; the infusion is then simmered 
with fresh hops at a temperature under 160° F., in order to retain the 
diastase and other albuminoids unimpaired,and the resulting liquid sub- 
jected to fermentation until the percentage of extractive matter amounts 
to about 12 per cent.,-and that of alcohol to about 4 per cent. This 
takes from seventy-five to one hundred days. 
When properly made, the extract and diastasic extract of malt not 
only contain all the nutritive substances of malted barley, but also a pecu- 
liar ferment (diastase), which has the power of converting starch to the 
soluble form, thus assisting in the digestion of amylaceous food. 
The liquid malt extract, resembling honey in density, is a good 
vehicle for iron, the hypopliosphites, quinine, etc. 
Therapy.—Extract of malt is a valuable food, in concentrated form, 
and easily assimilated. It is pleasant to the taste, can be eaten upon 
bread or mixed with milk, and agrees with the digestive organs. It 
forms, with an equal quantity of good codliver-oil, an emulsion which 
children readily take, and which is useful in convalescence or wasting- 
diseases. The water may be entirely extracted in the vacuum apparatus, 
giving us dry extract of malt, which is the basis of some largely-used 
food preparations for young children and invalids. The other form of 
liquid malt just referred to is made by fermentation, and several varieties 
of this malt are sold, varying in alcoholic strength from the smallest 
traces to 8 or 10 per cent., making, in fact, a beer. A good liquid malt 
is a valuable remedy in cases of general debility, deficient digestive 738 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
power, or loss of appetite. It is probably one of tlie best agents for 
increasing muscular tissue and augmenting fat; many persons gain con- 
siderable weight from a malt course. The use of malt liquors has been 
already referred to under the head of alcohol. 
MANACA. 
Dose, npv-xx, in fluid extract. 
Pharmacology.—Brunfelsia hopeana (Scrophulariaceas), Mar.aca or 
Mercurio vegetal is a Brazilian shrub, the root of which possesses medici- 
nal virtues. The bark of the root, when reduced to powder, has a yellowish- 
brown color and an odor which recalls that of corn-meal. An energetic 
alkaloid, difficult to isolate in a state of puritj', has been discovered by 
Dragendorff. Manaca is officinal in the Brazilian dispensatories, the 
dose of the powdered root being given as 8 to 20 grains. In this 
country a fluid extract has been made and may be given in doses of 5 
to 20 minims. 
Physiological Action.—According to the investigations of Dr. E. P. 
Brewer,* of Norwich, Conn., manaca has no influence upon the brain or 
special senses, but stimulates the motor centres of the spinal cord, and 
in full doses abolishes the reflex function of the cord. It depresses the 
cardiac and respiratory reflex centres and stimulates the glands, espe- 
cially the salivary, gastric, intestinal, and cutaneous ; also the liver and 
kidneys. Signs that its physiological action is produced are, in man, 
a feeling of band-like constriction around the head, nausea, and profuse 
perspiration. When these symptoms manifest themselves the remedy 
should be suspended or reduced in quantity. In its home, manaca is 
regarded as purgative, diuretic, and eminenagogue; also antisyphilitic 
and antirheumatic. In small doses it is resolvent, in large doses an 
acrid poison. 
Therapy.—Manaca has been principally used as a remedy in rheuma- 
tism. In the acute form of this disease, the articular pain and swelling not 
infrequently subside rapidly after the development of the physiological 
effects of the drug. In a considerable proportion of cases, chronic rheu- 
matism is notably ameliorated by the administration of manaca. In mus- 
cular rheumatism this drug is likewise serviceable and may be profitably 
combined with the iodide of potassium and cimicifuga, as in the following 
prescription :— 
Potassii iodidi, .......... 3iss. 
Extract, cimicifugae fl., , 
Extract, manacae fl., aa f3iss. 
Syrup, sarsaparillae comp., q. s. ad f^iv. 
M. Sig.: A tablespoonful four times a day. 
* Therapeutic Gazette, 1882, p. 326. 739 
MANGANUM. 
In neuralgia of rheumatic origin, mauaca may sometimes be used 
with advantage. In scrofulous manifestations and in secondary syphilis, 
it has been administered with asserted g%od effects. From its action 
upon the secretions, Dr. "Brewer infers that it might be of benefit in gas- 
tric and gastro-duodenal catarrh, and jaundice dependent upon the latter 
condition, as well as in simple jaundice due to inaction of the liver. 
MAN GAN UM.—Manganese. 
Preparations. 
Mangani Oxidum Nigrum (U. S. P.).—Black Oxide of Manganese. Dose, gr. ii-x. 
Mangani Sulphas (U. S. P.).—Sulphate of Manganese. Dose, gr. ii-v. 
Potassii Permanganas (U. S. P.).—Permanganate of Potassium. Dose, gr. ss-j. 
Pharmacology. is whitish gray, very hard and almost 
as infusible as platinum, but in the metallic state is not used in medicine 
or surgery. It exists in small quantity in the blood and bile, in company 
with iron. The binoxide or black oxide, treated with h\’drochloric acid, 
yields manganous chloride, water, and chlorine, and is sometimes used to 
-obtain chlorine in the sick-room. ‘When heated with chlorate of potas- 
sium it undergoes no change, but favors the steady evolution of oxygen- 
gas from the potassium salt, and this method is generally followed for 
the production of oxygen on a small scale for laboratory purposes. 
Physiological Action.—The sulphate is an emetic and purgative in 
doses of 1 or 2 drachms, and has decided cholagogue properties ; in 
smaller doses it may be used as a hepatic stimulant. Overdoses of man- 
ganese salts, especially if long continued, depress the system, lower the 
heart-action, favor fatty degeneration of the muscles and of the liver, 
and reduce blood-pressure. Excessive doses occasion gastro-enteritis. 
These salts are intestinal irritants, and the black oxide has emmenagogue 
properties. Small doses favor haematosis, acting like iron, as a tonic. The 
permanganate of potassium is an oxidizing agent and a generator of ozone ; 
it is a valuable antiseptic and disinfectant. In the stomach it arrests 
fel-mentation, but probably is at once decomposed,so that it is not absorbed 
into the circulation in its own form ; but it, nevertheless, does exercise 
some systemic effect and is considered a good emmenagogue. 
Therapy.—In solution, gr. i-v to each ounce of water, or even more 
dilute, the permanganate is useful as a deodorant to foul wounds,compound 
fractures, and ulcers; it is also injected into the nose in ozama, or used 
as a mouth-wash in diphtheria, scarlatina, necrosis of jaw, cancer of the 
tongue, and conditions causing foul breath. In bromidrosis (fetid perspi- 
ration) of the feet, sponging with permanganate solution and the use of a 
drying powder of starch and salicylic acid will often correct the con- 
dition. Injections of permanganate are sometimes slightly irritating, or 
even caustic, and they should not be used in gunshot wounds of the 740 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
abdomen or abscesses connected with tlie peritoneal cavity, for fear 
of injurious consequences. treating purulent discharges from the 
external ear the permanganate is thought to favor perforation of the 
tympanic membrane, and if used at all here it should be in very dilute 
solution. In the strength of 2 grains to the ounce, permanganate has 
been used with success as an injection in gonorrhoea and leucorrhoea. 
An ointment containing the oxide of manganese has been used in tinea, 
scabies, and porrigo. M. Galewouski, of Paris, reports good results from 
the use of baths of permanganate of potash in the treatment of small-pox. 
In the treatment of disorders of the uterine functions many practitioners 
speak highly of the manganese salts, especially when the trouble is due 
to functional and not to any mechanical or obstructive cause. Dr. John 
N. Upshur, of Richmond, Va., reports* especially good results in mem- 
branous dysmenorrhcea from the use of the oxide (gr. ij each) in gelatin- 
coated pills, given four or five times daily. The permanganate is often 
not well borne by the stomach. The oxide of manganese is also of 
service in amenorrhcea, or sudden suppression of the menses as a result 
of cold, and when the menstrual discharge is scanty and irregular. 
Manganese is useful in anaemia and chlorosis, particularly when given 
in conjunction with iron :— 
1$. Potassii permanganatis, gr. v. 
Mass, ferri carbon atis, 
Quininae sulphatis, . . aa gr. x. 
M. et ft. pil. no. x. 
Sig.: A pill three or four times a day. 
An unofficinal syrup of the iodide of iron and manganese is a good 
alterative tonic in scrofula and the debility due to prolonged suppuration. 
The oxide, in doses of 10 or 15 grains, is recommended by Dr. Leaved in 
gastrodynia and pyrosis. The same preparation relieves catarrhal or 
malarial jaundice, especially when combined as follows :— 
Mangani oxidi nig., 3ss. 
Resinae podophylli, gr. ij. 
Extract, belladonnae ale., gr. j. 
M. et ft. capsulae no. x. 
Sig.: A capsule three or four times a day, in catarrhal jaundice. 
The permanganate is of avail in flatulent d3rspepsia and lithiasis. It 
has occasionally produced good results in acute rheumatism, and has 
been employed, with varying success, in a number of infectious disorders, 
as scarlet fever, diphtheria, erysipelas, septicaemia and pyaemia. In the 
first two named, this remedy, in solution, is applied to the throat with 
advantage. It is also recommended, locally and internally, in snake- 
bites. The sulphate of manganese has been used in chronic rheumatism 
and neuralgia, but with doubtful results. 
* Transactions of the Ninth International Cong ess, Washington, 1887, vol. iii, p. 71. MANGOSTANA. 
741 
MANGOSTANA.—Mangosteen. 
Pharmacology.—The rind of the fruit of the mango, or Garcinia 
mangostana (Guttiterae), growing in India, contains tannin and a hitter, 
crystallizable principle, Mangostin. The fruit is about the size of a 
small orange; the rind is hard, dark brown, smooth, inodorous, with 
bitter, astringent taste. 
Therapy.—Used in diarrhoea and dysentery; also in the form of 
decoction, as an astringent, in sore throat, nasal catarrh, leucorrhoea, etc. 
A fluid extract of mango (dose, f5ss-j), made from the bark of Mangifera 
Indica, of the same natural order as the preceding, has very much the 
same properties and is used for the same purposes. It is also recom- 
mended as a haemostatic. 
MANNA (U. S. P.).—Manna. 
Dose, 5j. 
Pharmacology.—Manna is the concrete saccharine exudation of the 
Fraxinus omits (Oleaceae), or manna-ash of Itaty, Sicily and Asia Minor; 
also growing elsewhere, but yielding manna only in southern climates. 
Other sources of manna exist, as the tamarisk, oak and larch, and a 
small, leguminous plant of India (Alhagi manna); but neither of these 
is of any importance compared with that derived from the flowering ash- 
tree, which is the universally-known manna, both commercially and medici- 
nally. It contains Mannite (70 to 80 per cent.), a sugar-like substance, and 
traces of Fraxin, a neutral, bitter substance found in the bark of several 
species of ash ; also glucose, resin, mucilage, etc. The flake-manna is 
the selected, homogeneous, clear masses; manna, in sorts, contains more 
or less foreign material, such as straw, chips, etc. The best sort is 
scarce and expensive. There are no officinal preparations, except that 
manna is a constituent of compound infusion of senna (U. S. P.), or black 
draught, which a former generation of physicians especially favored 
(consisting of senna 6, manna 12, magnesium sulphate 12, fennel 2, boiling 
water q. s. ad 100 parts.) 
Therapy.—Manna is laxative in doses of an ounce or an ounce and a 
half for adults, but is liable to cause flatulence and colic. It has been 
used for children boiled in milk, alone or combined with senna, or it may 
be eaten as a sort of sugar, a drachm or two at a time. Molasses-cand}*- 
is also a good laxative and is considerably cheaper. 
MANZANITA. 
Pharmacology.—The Arctostaphylos glauca (Ericaceae) is a native 
of California. Its leaves possess medicinal properties, due to tannin, 
arbutin, and probably, also, ericolin and ursone, resembling uva ursa in 
composition and medicinal effects. 742 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Physiological Action.—The drug is astringent, and in small doses 
tonic and carminative. It is decidedly diuretic. 
Therapy.—Manzanita is useful in various affections of the urinary 
tract, pyelitis, cystitis, stone in the kidneys or bladder; also in strangury 
incontinence of urine, irritation of bladder, etc. It is best given in the 
form of a fluid extract (dilute alcoholic) in doses of f 5ss—ij, four to six 
times a day. 
MARANTA.—Arrowroot-Starch. 
Pharmacology and Therapy.—The fecula from the rhizome of the 
Maranta arundinacete (Cannaceae),of the West Indies and South A merica, 
consists wholly of a beautifully-white starch in line granules. It is used 
in preparing nourishing articles of food for the sick, with milk, eggs, etc. 
MARRUBIUM (U. S. P.).— Horehound. 
Pharmacology.—The leaves and tops of Marrubium vulgare (La- 
biatse), a small herb of Europe and America, contains a bitter principle, 
Marrubiin, with a peculiar volatile oil, resin, tannin, etc. It is best given 
as fluid extract (dose, f 5i-ij). 
Therapy.—Horehound is employed as a bitter tonic and stomachic, 
and as an expectorant, diaphoretic, laxative, and diuretic. It is popular 
in confectionery as cough-drops, used for sore-throat, cough, and catarrhal 
conditions of the air-passages. When a diaphoretic effect is desired, the 
herb may be used in infusion (,yj to Oj), taken hot in recent colds. 
The cold decoction is serviceable in chronic pulmonary affections. 
MASTICHE (U. S. P.).—Mastic. 
Pharmacology.—A concrete, resinous exudation from Pistachia len- 
tiscus (Terebinthinacese), consisting of Mastichic acid (90 per cent.), solu- 
ble in alcohol, and another resin, Mastichin, soluble in ether. It enters 
into the officinal pills of aloes and mastich, and has no other application 
at present in medicine, except that it may be used as a temporary filling 
for decayed teeth, the ethereal solution being used to saturate a small 
plug of absorbent cotton, which is pressed into the cavity. Mastic is also 
used in making cements and varnishes. 
MATE. See Ilex, page 687. 
MATICO (U. S. P.).—Matico. 
Dose, gr. xxx-3j. 
Preparations. 
Extraction Matico Fluidum (U. S. P.).—Fluid Extract of Matico. Dose, >kxx-f3ij. 
Tinctnra Matico (U. S. P.).—Tincture of Matico. Dose, f3j-f^j. 
Extraction Matico.—Extract of Matico. Dose, gr. ii-xij. 743 
MATRICARIA. 
Pharmacology.—The leaves of Artantlie elongata (Piperacese), of 
South America, contain volatile oil per cent.), a soft, green, pungent 
resin, a bitter principle termed maticin, Artanthic acid, and tannin. The 
odor is aromatic and the taste astringent. 
Therapy.—Powdered matico acts as a mechanical haemostatic, the 
roughness of the leaves favoring clotting of the blood. Internally the 
fluid extract is used in inflammations and catarrhal affections of the 
urinary organs, as chronic cystitis, leucorrhoea, incontinence of urine, and 
menorrhagia. In haemorrhages from the stomach, bowels, and kidneys, 
and even from the lungs, it has also been employed, as well as in 
diarrhoea and dysentery. 
MATRICARIA (U. S, P ).—German Chamomile. 
Dose, l'5i-iij, in infusion or fluid extract. 
Pharmacology.—The flower-heads of Matricaria chamomilla (Com- 
positae) are officinal under this name. It is a European annual, bearing 
small, yellow flowers, with white ray-florets; receptacle conical, naked, and 
hollow. The odor of the plant is due to a blue volatile oil existing in 
the flower-heads, together with bitter extractive, tannin, etc. 
Physiological Action and Therapy.—A decoction, drunk as hot as pos- 
sible, is a remedy for colds as a diaphoretic ; in large doses it acts as an 
emetic. The cold infusion can be used in smaller quantities as atonic and 
stomachic. It is highly prized among the common people in Germany 
for its wonderful virtues, and in a form of sectarian practice which arose 
in that country toward the close of the last century “ chamomilla ” occu- 
pied a prominent place, in company with such agents as charcoal, silica, 
and milk-sugar,—all administered in infinitesimal doses. 
MAYS.—Maize, Indian Corn. 
Pharmacology and Therapy.—The maize, Zea Mays (Graminacese), is 
a cereal of North America, largely cultivated for food. The fruit, or 
Indian corn, Maidis fructus, contains starch 65 per cent., nitrogenized 
substances 8 to 10 per cent., with a yellow, fixed oil, sugar, cellulose, and 
water. Green corn, boiled, is a highly-prized summer vegetable. There 
are varieties, but the principal ones are yellow corn and white corn. 
When ground they afford corn-meal (Maidis farina). Corn-meal is 
also used for food, as bread, cakes, etc., and, with boiling Avater, makes 
a mush, or “ hasty pudding.” The hot, boiled mush also makes a good 
poultice, as it retains heat well. Corn-starch (Maidis amylum), made 
from the ripe corn in the same manner as Avlieat-starch is prepared, is 
also an acceptable article of food, used for making puddings, blanc 
mange, etc. It is in the form of a white, impalpable powder, which can 
be utilized as a substitute for lycopodium, as a dusting-powder for pills  PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
and. troches, and for excoriated surfaces, or as a baby-powder. (For 
Maidis Stigmata and Maidis Ustilago, see pages 135 and 736.) 
MEL (U. S. P.).—Honey. 
Preparations. 
Mel Denpumatum (U. S. P.).—Clarified Honey. 
Mel Bonce (U. S. P.).—Honey of Rose (rose 8, clarified honey 92 parts, dilute alcohol 
q. s.) 
Confectio Bosce (U. S. P.).—Confection of Rose (red rose 8, sugar 64, clarified honey 
12, rose-water 16 parts). 
Pharmacology.—Honey is a saccharine secretion deposited in the 
honey-comb by the honey-bee, Apis mellifica (class, Insecta; order, Hy- 
menoptera). Virgin is that obtained from recent combs by in- 
cision and straining ; when heat is used to separate the comb the product 
is of a darker color, and there is a loss in flavor. What is known as 
clarified honey is prepared by heating honey on a water-bath, removing 
the frothy scum which rises, and straining. The flavor of honey is de- 
pendent upon the time of the season and the character of the flowers 
that furnish the saccharine material. It is believed that, at times, 
poisonous principles have been taken by bees from narcotic plants, and. 
consequently, the character of the honey has been affected injuriously. 
The constituents of honey are fruit-sugar, which remains always liquid, 
and glucose, which tends to crystallize and thicken the honey. Much 
of the honey used for household purposes has glucose fraudulently 
added, or it may be entirely an imitation honey. 
Physiological Action.—Honey is slightly laxative, and a pleasant, 
SAveet article of food. It is a good excipient for pill-masses. 
Therapy.—The old mixture of borax and honey for babies’ sore 
mouth is now rarely used, as the honey favors fermentation, and, besides, 
adds nothing therapeutically to the mixture, for the borax acts better 
Avithout it. In glycosuria, the use of honey greatly increases the quantity 
of sugar voided, and it has been used, therefore, to aid in the diagnosis 
of diabetes. In sore throat, mel rosm may be used as an application, in 
combination with astringents. 
MELISSA (U. S. P.).—Melissa, Balm. 
Pharmacology.—The leaves and tops of Melissa officinalis (Labiatae), 
a small herb growing in Europe and in the United States. It contains 
gum, tannin, bitter extractive, and volatile oil. The odor of the plant is 
fragrant, and it has an aromatic, slightly bitter taste ; the bruised leaves 
liaAre a lemon-like odor. 
Physiological Action and Therapy.—Melissa is carminative, and may be 
used in infusion, medicated Avater (distilled), or fluid extract, the dose 
of the latter being 1 to 2 fluidrachms. The compound spirit of melissa. 745 
MENISPERMUM. 
or Carmelite spirit, is a cordial containing a number of spices, which 
make it stomachic and corrective of flatulence. 
MENISPERMUM (U. S. P.).—Menispermum, Canadian Moon-Seed. 
Dose, gr. v-xx, in infusion or fluid extract. 
Pharmacology.—The rhizome and rootlets of Menispermum Cana- 
dense (Menispermaceae), a vine or climbing plant of the eastern part of 
the United States, bearing greenish-yellow flowers in clusters, and kidney- 
shaped fruit, from which it derives its name. The rhizome may be 
several feet in length; it contains Berberine, also an unnamed white 
alkaloid, soluble in alcohol and ether, sparingly soluble in water. 
Therapy.—Moon-seed, or yellow parilla, is believed to resemble sar- 
saparilla in possessing diuretic, tonic, and alterative powers, and is also 
a laxative. In domestic practice it is used to purify the blood in 
scrofulous affections, etc. 
MENTHA.—Mint. 
MENTHA PIPERITA (U. S. P.).—Peppermint. 
The leaves and tops of Mentha piperita (Labiatae). 
Preparations of Peppermint. 
Aqua Menthce Piperita; (U. S. P.).—Peppermint-Water. Pose, f 3j-f §ij. 
Oleum Menthce Piperita! (U. S. P.).—Oil of Peppermint. Pose, Nfi-v. 
Spintus Menthce Piperita; (U. S. P.).—Spirit of Peppermint. Pose, Hfx-f 3j. 
Troehisd Menthce Piperitce (U. S. P.).—Peppermint Lozenges. Pose, one or more. 
Menthol.—Peppermint-Camphor (a crystalline solid). Pose, gr. i-v. 
Also entering into compound pills of rhubarb and aromatic wine. 
MENTHA VIRIDIS (U. S. P.).—Spearmint. 
The leaves and tops of Mentha viridis (Labiatae). 
Preparations of Spearmint. 
Aqua Menthce Yiriclis (U. S. P.).—Spearmint-Water. Pose, f3j—f §ij. 
Oleum Menthce Viridis (U. S. P.).—Oil of Spearmint. Pose, Ihii-v. 
Spiritus Menthce Viridis (U. S. P.).—Spirit of Spearmint. Pose, Hfv-x. 
Pharmacology.—The leaves and tops of both the Mentha piperita 
and the Mentha viridis, of the natural order Labiatae, are indigenous to 
Great Britain, but are naturalized in the United States and many other 
countries. Each variety owes its properties to a volatile oil, from 1 to 1£ 
per cent, being present, with some tannin in peppermint. Menthol, 
which is the stearopten or camphor of peppermint-oil, is deposited, on 
cooling, from the oil of the fresh herb of Mentha arvensis and Mentha 
piperita. It smells and tastes like peppermint, is soluble in alcohol, ether, 
and the fixed and volatile oils, but slightly soluble in water. Menthol 
occurs in the form of colorless crystals or fused crystalline masses, and 
resembles Epsom salts in appearance. It is quite volatile and melts at 
108° to 110° F. 746 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Physiological Action.—Peppermint, especially the oil, locally has an 
anodyne, anaesthetic, and antiseptic action. Its taste is rather pleasant 
and pungent, and it acts as a carminative and stimulant in the stomach, 
especially in the form of the spirit; the troches are also used for this 
purpose as well as to disguise a bad breath. Spearmint corresponds, in 
its effects, with peppermint, but is less powerful and less agreeable. 
The taste of menthol is sharp and penetrating. When placed upon 
the skin it gives rise at first to a burning sensation, which is succeeded 
by one of coolness, and finally by numbness. It has decided antiseptic 
power, being comparable in this respect to thymol. 
Therapy.—In neuralgia, oil of peppermint may be painted over the 
painful spot or along the course of the nerve. If the oil is employed, 
evaporation should be prevented by covering the painted surface with oiled 
silk. It may also be used for myalgia and many local pains, commonly 
called rheumatic, and is often of service in chronic gout. In flatulent 
colic, the spirit of peppermint in hot water is a good household reined}’’, 
particularly applicable to children. The oil of peppermint allays nausea, 
and is serviceable in disguising the taste of unpalatable drugs. Pepper- 
mint is a good addition to purgative remedies, as in the compound 
rhubarb pill, to prevent griping. In pruritus pudendi, peppermint- 
water is a good application, with a drachm or two of borax to each 
pint. 
Menthol has been employed almost exclusively as a topical remedy, 
though it has been given internally in the dose of 5 grains for the relief 
of neuralgia. Its principal usefulness is in the alleviation of itching and 
pain. It may be applied in the form of a solid pencil or cone, an alco- 
holic solution, or an ointment. It has also been administered by inhala- 
tion in hay fever and diphtheria. In neuralgia (especially when it in- 
volves a superficial nerve), in herpes zoster, and dermatalgia, a lotion or 
ointment containing menthol is capable of affording considerable relief. 
The pain of a carious tooth may be lessened or removed by placing a 
menthol solution within the cavity, or menthol dissolved in 15 parts of 
oil of cloves. The itching of parresthesia, eczema and urticaria may often 
be alleviated by the same remedy. Inhalations of menthol have also 
been successfully resorted to in asthma. It is readily volatilized in a 
teapot by the addition of hot water. The teapot being closed, the vapor 
is inhaled as it issues from the spout. Ointments and lotions of menthol 
may be compounded as follows :— 
1$. Acidi carbol., 3ss. 
Menthol., ........... gr. xx. 
Ungt. aquae rosae, —M. 
M. Sig.: For parsesthcsia, urticaria, and herpes zoster. METHYL-VIOLET. 
747 
Tinct. belladonnas, 
Tinct. aconiti, f3iss. 
Menthol., ... .... .... 3?s. 
Sp. vini rect., fgij. 
Glycerini, 
Aquae rosae, aa §ss. 
M. Sig.: Use as a local application in dermatalgia, herpes zoster, and neuralgia. 
Dr. Wolf (Therap. Mon at she ft, September, 1890) recommends men- 
thol rubbed up with sugar (5 to 10 per cent.) applied with a large camel- 
hair brush, as a local disinfectant in diphtheria, used early in the disease. 
He advises applications to be made several times in the dav, removing 
as much as possible of the membrane at a time. In laryngeal and tracheal 
phthisis, and in the laryngeal ulcerations occurring during the course of 
pulmonary tuberculosis, Rosenberg uses a 20-per-cent, solution of menthol 
in olive-oil, introduced with a syringe ora spray into the larynx; two or 
three injections of 15 minims each are made at the affected spot, followed 
by inhalations of the same from boiling water, or a respirator can be used. 
The relief from dyspnoea is very great. The secretions grow less, and 
the ulcers cicatrize and general improvement is noted. 
METHYL-VIOLET.- Pyoktanin. 
Pharmacology.—Pyoktanin (pus-destroyer) is a descriptive name 
applied to methyl-violet, an aniline dye which occurs in the form of a 
paste and in crystals. It was brought forward by Prof. J. Stilling, of 
Strasburg, who stated his belief that it was able to penetrate tissues and 
act upon deeply-imbedded pathogenetic micro-organisms. That the ctye 
is absorbed by microphytes is shown by the fact that they are rapidly 
stained, and absorption is said to produce their death, or, at least, suspen- 
sion of their energies. 
Pyoktanin is devoid of odor, is but slightly irritant, and gives rise 
to no sjrmptoms of systemic intoxication. It has been employed in the 
form of powder, pencil, or solution. The paste can be readily molded 
into pencils. The powder is made by mixing 2 parts of methyl-violet 
or pyoktanin with 100 parts of talc or other inert material. The solu- 
tion may be made of any strength, from 1 part in 100 to 1 in 2000. It is 
also used in the form of an ointment containing from 2 to 10 per cent. 
The same title is given to another variety, j'ellow aniline, chemically 
pure and free from arsenic. The blue is the stronger agent. 
Physiological Action.—Methyl-violet is an efficient germicide. 
According to the laboratory experiments of Fessler, the micro-organisms 
of pus are destro}red in fifteen minutes by exposure to a l-to-1000 solu- 
tion of pyoktanin. This conclusion, however, is contradicted by Troje, 
who found that, although the development of germs was inhibited by 748 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
pyoktanin, 3ret even after subjection to its action for twelve hours the pus- 
germs were not certainly destroyed. The latter writer, therefore, asserts 
that pyoktanin is less powerful than carbolic acid or bichloride of mer- 
cury. Pyoktanin does not coagulate albumin. A solution of this sub- 
stance dropped into the eye is said to cause dilation of the pupil without 
paralysis of accommodation. 
Therapy.—Pyoktanin has been employed almost exclusively as a 
topical medicament, though Ehrlich and Leppmann state that given 
liypodermatically it relieves neuralgic and rheumatic pains. The diluted 
powder, the solution, and the pencil of pyoktanin, from the writer’s expe- 
rience, disinfect suppurating or ulcerated wounds, stimulate reparative 
action in chronic ulcers,, and form excellent applications to chancroids, 
open buboes, and gummous ulcers, to boils and carbuncles. Good results 
have been reported in gonorrhoea from the injection of weak solutions. 
In some cases of chronic cystitis, the injection of a l-to-1000 or a l-to-500 
solution has been found markedly beneficial. As a dusting-powder, it 
has been used upon moist eczema. Stilling, in his original paper, laid 
great stress upon the value of this agent in affections of the eye, especially 
corneal ulcers, parenchymatous keratitis, and serous iritis. These asser- 
tions have not been generally confirmed. In the experience of most 
ophthalmologists, pyoktanin is by no means superior, if even equal, to 
corrosive sublimate. It is conceded, however, that pyoktanin acts as a 
mild, local anaesthetic. 
In conjunctivitis, dacryocystitis, etc., pyoktanin is best employed in 
the form of a solution. In chronic ophthalmia, trachoma and fistulous open- 
ings into the lachrymal sac, the pencils of the drug are preferable to use. 
Cheatham* reports good results from the use of methyl-violet or 
pyoktanin in affections of the eye, ear, nose, and throat. Milder con- 
junctival diseases yielded readily to solutions of pyoktanin, and trachoma 
was markedly improved by the same remedy. Gouldf states that the 
effects of pyoktanin in dacryocystitis and lachrymal conjunctivitis have 
been in his experience extraordinarily good. The same observer writes 
that excellent results follow the application of pyoktanin in unhealthy 
orbital cavities after enucleation. It likewise acts well in a certain class 
of corneal opacities, serving to clarify the tissues and increase visual 
acuitjL Tiffany (Medical Age) likewise reports good results from methyl- 
violet in eye diseases ; particularly in marginal blepharitis, or tinea tarsi, 
pomade made with this- drug and carefully worked into the 
roots of the laslns brings about a speedy cure. 
* “Pyoktanin in Diseases of the Eye, Ear, and Throat,” by W. Cheatham, M.D. The 
Cincinnati Lancet and Clinic, November 15, 1890. 
f “ Pyoktanin in Diseases of the Eye,” by George M. Gould, M.D. University Medical 
Magazine, December, 1890. 749 
METHYSTICUM. 
Some observers, on the other hand, report in eye diseases bad or 
negative results from the employment of methyl-violet. Bayer,* for 
instance, states that after its use in 46 cases of scrofulous pannns, various 
types of corneal nicer, dacryocystitis, parenchymatous keratitis, iritis, 
and sympathetic iridocyclitis, he came to the conclusion that the excellent 
qualities attributed by Stilling to this aniline did not exist in fact; 
and, moreover, in addition to disagreeable discolorations, may occasion 
harmful results from their application. 
In eye diseases Braunschweig also found pyoktanin to cause great 
damage; Kolliker observed no benefit from it, and Mauthner considers 
pyoktanin useless. 
The great difference in the results thus reported from the use of 
pyoktanin is explained by the observation made l>3r Liebreich ( Tlierap. 
Monatshefte, Jy\\y, 1890), namely, that pyoktanin, or methyl-violet, is a 
mixture of aniline products of uncertain composition. 
In otology,f likewise, testimony as to its value is conflicting. While 
in some cases its use was attended with excellent results in purulent 
inflammation of the middle ear, furuncle of the external meatus, or after 
removal of a polypus from the meatus, in other cases of otitis pyoktanin 
proved a failure. Mosetig good results of metli37l-violet in the 
treatment of malignant growths. 
The absence of odor is one feature which makes this substance 
preferable to iodoform. On the other hand, methyl-violet communicates 
a deep-purple color to the skin or linen with which it comes in contact. 
This stain nuyy be removed, however, b3T dilute hydrochloric or nitric acid, 
alcohol, or cologne-water. 
METHYSTICUM. See Kava-Kava, page 716. 
MEZEREUM (U. S. P.).—Mezereon. 
Dose, gr. x. 
Preparations. 
Extraction Mezerei (U. S. P.).—Extract of Mezereon. Used only as an irritant. 
Extractum Mezerei Fiuidum (U. S. P.).—Fluid Extract of Mezereon. Used only as an 
irritant. 
Unguentum Mezerei (U. S. P.).—Ointment of Mezereon (contains fluid extract of meze- 
reou 25, lard 80, yellow wax 12 parts; the alcohol of the extract being entirely evaporated 
by heat). 
Pharmacology.—Mezereon is the bark of Daphne mezereum (Tli3'me- 
lacese) and of other species of Daphne, growing in Europe and Asia in 
mountainous regions. It contains Daphnin, a bitter glucoside in colorless 
* “Pyoktanin in Diseases of the Eye,” Medical News, December 6, 1890. 
t See paper on “ Experiences with Pyoktanin in Oplithaltnological and Otological Practice,” 
by Adolf Alt, M.D., St. Louis Courier of Medicine, January, 1891. 
| The British Medical Journal, February 7, 1891. 750 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
crystals, sparingly soluble in cold solvents ; an acrid, rubefacient, volatile 
oil, and a soft, brown, acrid resin, which is the anhydride of Mezereinic 
acid. Mezereon is an ingredient in the compound decoction and com- 
pound syrup of sarsaparilla, and the extract enters into the compound 
mustard liniment. (See Sinapis.) 
Physiological Action.—The powrdered bark is irritating to the skin 
and, when fresh, causes vesication ; it excites violent sneezing when in- 
haled into the nostrils. In small doses internally it is sialagogue, laxa- 
tive, and diuretic, and is considered tonic and alterative. In large doses, 
it is a violent, irritant poison, causing vomiting, purging, and inflamma-. 
tion of the stomach and intestines. Nephritis is said to follow its tonic 
administration. The treatment would be eliminative and symptomatic. 
Demulcent drinks, starch-water, etc., may be freely swallowed, and hypo- 
dermatic injections of morphine given. The ointment is used as an 
irritant to keep up discharges from ulcers and blistered surfaces. 
Therapy.—The use of mezereon in medicine is restricted to its ex- 
ternal application in the form of an irritant ointment, as first mentioned, 
and its combination with sarsaparilla and other remedies in the forms 
above referred to, as an alterative in syphilis and chronic rheumatism, 
associated with iodide of potassium. 
Potassii iodidi, 3ij. 
Syr. sarsaparillse co., 
Aquae, aa f^iij. 
M. Sig.: A tablespoonful two hours after meals, for syphilis, rheumatism, and 
skin diseases. 
Mezereon-bark has been successfully used to relieve toothache, and 
as a masticatory in paralysis of the tongue. 
MITCHELLA.—Squaw-Vine, Checker-Berry, Winter-Clover, Par- 
triige-Berry. 
Dose, f5ss-j, in infusion or fluid extract. 
Pharmacology.—The whole plant of Mitchella repens (Rubiacete) is 
used in making the infusion and fluid extract. It is a small, creeping, 
evergreen herb, with red berries appearing in the autumn, which may 
remain until spring. The leaves and berries have a flavor like that of 
gaultheria ; the composition is unknown. 
Physiological Action.—The preparations of Mitchella are said to be 
astringent, diuretic, and parturifacient; the}’ are also supposed to favor 
the occurrence of menstruation. 
Therapy.—In dropsy and suspension of urine the infusion is given, 
and also in dysmenorrhoea, menorrhagia, etc. Its name of “ squaw-vine ” 
was gained.from its use by the Indians, who administered the infusion 
to women for several weeks before the expected occurrence of parturition 
in order to facilitate delivery. 751 
MORPHINA. 
MQRPHINA (U. S. P.).—Morphine, Morphium. (See Opium.) 
MORRHU/E OLEUM (U. S. P.).—Codliver-Oil. 
Dose, f'5j-sss. 
Pharmacology.—A fixed oil, obtained from the fresh liver of Gadus 
morrliua, or of otlier species of Gadus (class, Pisces ; order, Teleostia; 
family, Gadida). It is a nearly colorless or straw-colored, thin, oily 
liquid, consisting chiefly of Olein and other fatty principles. The best 
oil is that containing the largest proportion of olein, which congeals at 
a lower temperature than the oils of inferior quality. It also contains 
a peculiar principle named Gaduin, with Trimethylamine, and traces of 
iodine, bromine, phosphoric and sulphuric acids, and biliary salts. Good 
oil should be pale in color ; should not have a strong, fishy smell or 
taste; should not deposit much granular fat at 32° F., and should, 
when treated with sulphuric acid, give a violet color-reaction, changing 
to brownish red. “If 1 drop of the oil be dissolved in 20 drops of 
disulphide of carbon, and the solution shaken with 1 drop of sulphuric 
acid, it will acquire a violet-blue tint, rapidly changing to rose-red and 
brownish yellow. With nitric acid the oil yields a purple color, changing 
to brown ” (U. S. P.). The investigations of Gautier and Mourgues 
in 1888, into the composition of codliver-oil, showed its complex char- 
acter; they claimed to have found several new alkaloids, the principal 
ones being hydrolutidine, aselline, and morrhuine, besides an unstable, 
fatty substance, morrhuic acid, containing phosphorus and resembling 
lecithineof nerve-tissue. Under the name of Morrhuol, M. Chapoteaut has 
isolated these principles from codliver-oil, in the form of an amber- 
brown, bitter, aromatic liquid, partially crystallizing at a low temperature, 
and consisting of the free oleic acid of the oil, alkaloids, and the fatty 
combinations with sulphur, iodine, bromine, and phosphorus. Thus, 
morrhuol represents the medicinal value of codliver-oil in very much 
reduced bulk. The usual dose of morrhuol is 1 or 2 capsules, each 
containing 20 centigrammes (about 3 grains), taken with or immediately 
after meals. Children take 2 to 4 daily and adults 6 to 8 daily. Cap- 
sules of morrhuol creasote may also be obtained (each containing 3 grains 
of morrhuol and 1 minim of pure beech-wood creasote). 
Physiological Action.—Externally, codliver-oil acts as a bland oil 
without causing irritation, and is even instilled into the eye b}r oculists. 
Its fishyr smell is an objection to its use by inunction, and yet in infants 
this is such a valuable method of introducing it into the blood that the 
objection is overlooked. Applied to the surface in fevers, it reduces 
bodily temperature. Internally, in doses suited to the powers of assimi- 
lation, it increases the appetite and improves nutrition, enhances the 
number of red blood-corpuscles, stimulates healthy cell formation, and 752 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
exerts an alterative effeet. Morrlmol, not being fatty (to the same 
extent, at least), does not directly increase the bodily weight, but other- 
wise acts physiologically in the same manner as the oil. According to 
Gautier and Mourgues, many of the alkaloids of codliver-oil, as butyla- 
mine, amylamine, and especially morrhuine, together with morrhuic acid, 
stimulate the nervous system, promote tissue change, cause a rapid in- 
crease of the urine and perspiration, and, proportionately, sharpen the 
appetite. In addition, the phosphorus exists in organic combination 
capable of being readily appropriated by young cells. The association 
of fatty bodies with biliary matter promotes absorption and assimilation. 
The properties of the iodine and bromine are also enhanced by the state 
of organic combination in which they exist.* 
Therapy.—In children suffering with marasmus, scrofula, chronic skin 
affections, tuberculosis, and wasting diseases generally, the use of codliver- 
oil by inunction daily, or several times a week, produces rapid improve- 
ment. The patient is stripped and the oil applied over the surface of the 
body, with the manipulations of massage, before a warm fire; a blanket is 
wrapped around him, which is to be kept on for an hour or two; the excess 
of oil is then removed by a warm bath containing a little whisky or bay 
rum. In this way the child does not have such a disagreeable odor as 
when the oil is simply applied under its binder. In the coeliac affection 
of children, characterized by suspension of function of the pancreas, this 
method is particularly applicable, and is absolutely necessary in order 
to keep up nutrition. In cases of whooping-cough similar inunctions to 
the chest are very serviceable. These inunctions are likewise valuable in 
the case of children exhausted b}r chronic diarrhoea, anti of adults who 
suffer with chronic dysentery and scaly skin tliseases. The daily in- 
unction of codliver-oil is of some service in reducing the susceptibility 
to taking cold. The local application of this agent is useful in chronic 
rheumatism and rheumatoid arthritis. The internal administration or 
external use of codliver-oil is advisable in rachitis and laryngismus 
stridulus. As an internal remedy it is sometimes effective in habitual 
constipation in children. This oil has been used with advantage in 
diabetes mellitus characterized by great debility, and is especially indi- 
cated if it is associated with pulmonary phthisis. 
Codliver-oil is used internally as a nutrient as well as a medicine. 
Its value is most marked in chronic disorders attended by malnutrition, 
in phthisis, chronic pulmonary processes, rheumatic affections, rheuma- 
toid arthritis, and atheroma. It is also very useful in nervous affections, 
chorea, neuralgia and epilepsy, in syphilitic and strumous cachexia, and 
various eruptions upon the skin due to them. In convalescence from 
* Annales de Thdrapeutique Medico-Cliirurgicales, March, 1890. MORRHUiE. 
753 
many diseases, codli-ver-oil is an easily-assimilated form of nourishment. 
Chronic gout is ameliorated by the administration of codliver-oil. In 
chronic bronchitis it is of service, facilitating expectoration and promot- 
ing the nutrition of the diseased membrane. It is also a valuable 
remedy in emphysema. Codliver-oil is indicated in caries or necrosis 
of bone due to tuberculosis. In neurasthenia it may be given with 
advantage. The exhibition of this remedy is of especial utility in many 
cases of convalescence from measles or scarlatina. In pan mis and 
chronic conjunctival affections, codliver-oil has been instilled into the 
eye with good results. 
Special Forms.—There can be no question that the digestibility* of 
the oil is increased by mechanical and chemical conditions, as when given 
in the form of a good emulsion (not a soap, but a minute subdivision of 
fat-globules in a mucilaginous medium, resembling milk), and by the 
addition of pancreatin, and also by association with certain restorative 
agents, like the hypophosphites, or the lacto-phospliate of calcium. The 
immense demand for these emulsions, stimulated by judicious adver- 
tising, has led to a very large production and much competition among 
manufacturing pharmacists to supply the requirements of the physician 
and patient. In manufacturing on a large scale, cost is carefully esti- 
mated, and the result in man}- cases is that an inferior grade of oil is 
used. It would be better for physicians to order an extemporaneous 
emulsion made with the best oil by responsible pharmacists, or instruct 
patients how to make it (white of egg, pancreatin, oil, and, if desired, a 
little whisky or Jamaica rum, stirred with an egg-beater or simply shaken 
together in a bottle, make a very acceptable preparation). A service- 
able emulsion for children is made by rubbing together codliver-oil and 
extract of malt (or maltine), equal parts. Gubb maintains that codliver- 
oil forms a solution with aqueous extract of malt, and that this combina- 
tion is the most efficient means of disguising the taste of the oil. If 
there are fishy eructations, liquid pancrobilin may be given with the 
oil, or liquor pancreaticus, which will emulsify the oil and favor its 
absorption. 
The following emulsions, containing codliver-oil, will be found to 
be serviceable:— 
Olei morrhuse, 
Glycerini, 
Syrup, hypophosphitum, aa f^iv. 
Olei cinnamomi, hlx. 
M. et ft. emul. mist. 
Sig.: A tablespoonful three times a day. Valuable for tuberculosis, debility, and 
chronic skin diseases, such as eczema, psoriasis, acne, and seborrhnea. 754 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Olei morrhuae, f^viij. 
Liquor, panereatini, f^ij. 
Pulveris myristicae, 3iij. 
M. et ft. emul. mist. 
Sig.: A tablespoonful just before meals. Use in debility and weak digestion. 
$ Olei morrhuae, 
Liquor, caleis, . aa f^y. 
Olei gaultheriae, Iflx. 
M. et ft. emul. mist. 
Sig.: A dessertspoonful three times a day. Serviceable in scrofula, tuberculosis, and 
in chronic skin diseases. 
Olei morrhuae., 
Syrup, pruui Virg., 
Ext. malti, aa f 
M. et ft. emul. mist. 
Sig.: A tablespoonful three times a day. Employ in debility, in diseases of the throat, 
and in chronic bronchitis and tuberculosis. 
fy Olei morrhuae, 
Spiritus vini gallici, 
Syrup, hypophosphitum cum ferro, aa f§iv. 
01. menth. pip., . . . lllx. 
M..etft. emul. mist. 
Sig.: A tablespoonful three times a day. For syphilis, scrofula, and chronic diseases. 
$ Olei morrhuae, f^iv. 
Olei eucalypti, 
Creasoti, aa H\x. 
Spiritus aetheris comp., . f§j. 
M. et ft. emul. mist. 
Sig.: Two teaspoonfuls three times a day. Beneficial in tuberculosis and chronic 
tuberculosis. 
The preliminary administration of an ethereal preparation, like Hoff- 
man’s anodyne or pure ether, in cold water will favor the digestion of 
the oil by stimulating the flow of the pancreatic fluid. An addition of 
1 per cent, oil of eucalyptus is said to make it more acceptable to the 
palate. It is a good plan to eat a slice of lemon after taking the plain 
oil, in order to remove the oily taste from the mouth. Numerous other 
methods have been suggested in order to conceal the taste of codliver-oil 
and aid its assimilation. Alcohol in some form is frequently used for 
this purpose. Washing the mouth out with brandy or whisky will 
partially obtund the sense of taste, so that a dose of oil may be quickly 
swallowed without exciting much sensation. The oil may be poured into 
the froth of beer in such a manner as not to touch the edge of the glass, 
or it may be taken in a hot punch. A few drops of chloroform will, it is 
said, disguise the taste. A little salt, taken just before and after the oil, 
has been recommended. Some prefer to take it in black coflee. It is 
stated that tomato catsup covers the taste of codliver-oil, and that MOSCHUS. 
755 
chewing smoked herring, or a sardine, accomplishes the same purpose. 
Others administer it in milk or in lime-water, to which a drop or two of 
some essential oil has been added. A formula given by Seig may 
effectually disguise the taste, while the odor of the mixture resembles 
that of roasted meat:— 
Olei morrhuse, f §lxx. 
Creasoti, >11x1. 
Saccharin., . gr. iiss.—M. 
Some patients prefer to take the oil before meals, and find the eruc- 
tations do not occur, as when taken after eating. The mistake is gen- 
erally made of giving it in doses larger than can be digested, with the 
result of disordering the stomach and even exciting diarrhoea. A fer- 
rated codliver-oil is made bjr dissolving 10 parts of benzoate of iron in 
1000 parts of the oil, with the aid of gentle heat and frequent agitation. 
It is a clear, reddish-brown liquid. The oleate of quinine may be com- 
bined with it in any desired quantity. 
Lipanin is an artificial mixture, intended as a substitute for codliver- 
oil. It was devised by von Mering, and consists of 6 parts of oleic acid 
to each 100 of olive-oil. It is free from disagreeable odor and taste, and 
is readily emulsified and easily digested ; it may be given with the hypo- 
phosphites of calcium and sodium (gr. x of each) several times a day. 
Galatti* finds lipanin palatable and well borne by children ; under its 
use they increase in weight and appetite, but the tuberculous process 
does not seem to be influenced by it. It costs more than codliver-oil. 
MOSCHUS (TJ. S. P.).—Musk. 
Dose, gr. v-viij. 
Preparation. 
Tindura Moschi (U. S. P.).—Tincture of Musk (10 per cent.). Dose, f3ss-j. 
Pharmacology.—Musk is the dried secretion from the preputial 
follicles of Moschus moschifera (class, Mammalia ; order, Ruminantia) or 
musk-deer. The musk-sac is, in the living male animal, situated between 
the navel and the genitals, but nearer the latter, between the skin and 
the muscles of the abdomen. Musk in pods, or musk in the unopened 
sacs, is the only kind to be used in medicine, each sac containing from 60 
to 130 grains of actual musk. It is imported from China. Genuine 
Tonquin musk is composed of roundish grains of irregular size, dark 
reddish-brown, of a peculiar, penetrating, persistent odor and a bitter 
taste. It is partly soluble in water, and less so in strong alcohol; dilute 
alcohol dissolves about one-half. The odorous principle is probably a 
# Annual of the Universal Medical Sciences, 1890, vol. v, p. A-88. 756 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
product of decomposition, constantly being formed; complete drying 
destroys it, but it returns again after moisture has been added. It is also 
destroyed by hydrocyanic acid and by camphor. Musk contains am- 
monia, fat, cholesterin, resinous matter, fatt}’’ acids, etc. It is largely used 
in perfumery, being very lasting and holding more evanescent perfumes 
with it. Musk in grains is much adulterated, or spurious. An artificial 
musk* has been produced, but quinine sulphate has the property of 
destroying its odor, while genuine musk is in no way affected by it. 
Physiological Action.—Musk is a diffusible stimulant and antispas- 
modic. It creates a sensation of heat in the stomach, and in some 
persons excites nausea and vomiting. Headache and giddiness are also 
produced, with stimulation of the sexual appetite. A primary excite- 
ment of the central nervous system is succeeded by a more or less 
marked soporific effect. According to Brunton, musk appears to stimu- 
late the respiratory centre. Artificial musk is reported to have little or 
no physiological or therapeutical effect, even when used subcutaneously. 
Therapy.—Musk has been used in collapse of typhoid and other low 
fevers; also in hiccough, delirium tremens, and in convulsions of chil- 
dren. In many of the manifestations of hysteria—emotional crises, 
palpitation of the heart, vomiting, or spasm—this remedy is of value. 
The same may be said regarding other spasmodic affections, as chorea, 
whooping-cough, and laryngismus stridulus. It has been considered 
beneficial in melancholia and irregular gout. Its high price and the 
difficulty of obtaining an unadulterated article take it out of the ordinary 
range of remedies. 
MUCUNA.—Mucuna, Cowhage. 
Pharmacology and Therapy.—The hairs scraped from the pods of 
Mucuna pruriens (Leguminosae), of the East and West Indies, were 
formerly used as a vermifuge, a drachm or two being mixed with molasses 
and administered to children suffering with round worms. It causes irrita- 
tion, simulating an erythematous or urticarial eruption when brought in 
contact with the skin. It is said that dishonest horse-dealers use cowhage 
to make horses appear more spirited, by applying it to anus, or genitals, 
just before exhibiting the animal for sale. 
MUSCARINA.—Muscarine. See Agaricus Muscarius, page 411. 
MYRCI/E OLEUM (U. S. P.).—Oil of Myrcia, Oil of Bay. 
Preparation. 
Spiritus Myrcirn (U. S. P.).—Spirit of Myrcia (bay-rum). External use. 
* “Artificial Musk,” Pacific Record, December 15,1890. MYRICA. 
757 
Pharmacology and Therapy.—The oil of myrcia is distilled from the 
leaves of Myrcia acris (Myrtaoece), or ba}’-tree, of the West India Islands. 
It contains Eugenic acid and a hydrocarbon. It is used only as a per- 
fume. The spirit, or bay-rum, is an agreeable cooling application in 
fevers, headache, etc. 
MYRICA.—Myrica, Bayberry-Bark. 
Dose, gr. xx-xxx. 
Pharmacology.—The Myrica cerifera (Myricacere), a native of North 
America, contains in its bark a volatile oil and acrid resin. 
Physiological Action.— Myrica is stimulant and astringent. 
Therapy.—Externally, the infusion or diluted fluid extract of Myrica 
may be used as a gargle or injection in various affections of the mucous 
membranes. It has also been employed in dysentery and diarrhoea. 
MYRISTICA (U. S. P.).—Nutmeg. 
Dose, gr. v-xx. 
Pi'eparations. 
Oleum Myristicce (U. S. P.).—Volatile Oil of Nutmeg. Bose, lTli-v. 
Spiritus Myristicce (U. S. P.).—Spirit of Nutmeg. Dose, f3i—ij. 
Pulvis Aromaticus (U. S. P.).—Aromatic Powder (cinnamon 35, ginger 35, cardamom 
and nutmeg each 15 parts). Bose, gr. v-3j. 
Pharmacology.—The nutmeg is the kernel of the seed of Myristica 
fragrans (Myristicacese) deprived of its testa. The outer covering or 
arillus of the fruit is officinal under the name of Macis, or mace. The 
tree is a native of the East Indies, but grows also in the West Indies 
and in South America. The kernels of the seeds are round or elliptical 
in shape, about an inch in greater diameter and f inch in smaller 
diameter. They are rather dense and heavy, and contain 2 to 8 per cent, 
of a volatile oil (which is officinal), and from 25 to 30 per cent, of fixed 
oil, usually known as oil of mace, with some resin. Nutmeg is fragrant, 
spicy, and somewhat bitter. It is useful in flavoring, and enters into a 
number of pharmaceutical preparations: aromatic spirit of ammonia, 
aromatic tincture of rhubarb, aromatic powder, compound tincture of 
lavender, troches of chalk, of magnesia, and of bicarbonate of sodium, 
and also is a constituent in vinegar of opium. 
Physiological Action.—With aromatic and carminative qualities, nut- 
meg unites considerable narcotic power, and in oArerdoses produces stupor 
and delirium. I)r. John Gillespie has reported a case* where five powdered 
nutmegs, taken to procure an abortion, had produced frontal headache, 
vertigo, free perspiration and urination, narcosis, and collapse. The 
treatment was an emetic of sulphate of zinc (gr. xxx), followed by 
* Philadelphia Medical Times, vol. xvii, page 726. 758 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
small, repeated doses of aromatic spirit of ammonia. A similar case 
has been reported by Waugh. 
Therapy.—The volatile oil of nutmeg is rubefacient, and may be 
used in rheumatism, neuralgia, and paralysis. Internally, the powdered 
or grated nutmeg is employed as a carminative, anodyne and astringent, 
to relieve sick stomach and for diarrhoea; it also allays colalgia and 
intestinal spasm. Garretson employs nutmeg for diarrhoea combined 
as follows :— 
b Pulveris myristicae, 
Bismuth, subnit., aa 3jss. 
Cretae praeparatae, gr. lxxx. 
Syrup, zingiberis, f 
M. Sig.: From a teaspoonful to a dessertspoonful every two hours. 
Small doses favor digestion by stimulating the secretion of gastric 
juice. Nutmeg may be used to disguise the taste of unpalatable mix- 
tures and to prevent the griping of a cathartic medicine. Mace acts 
similarly, but is used as a spice or condiment more than as a medicine. 
The expressed oil of nutmeg may be combined with wax and olive-oil, with 
heat, as ordered in the German Pharmacopoeia, to form the myristicae 
ceratum used as a warming application to the abdomen of babies suffer- 
ing with colic or indigestion. 
MYRRHA OJ. S. P.).—Myrrh. 
Dose, gr. ii-xxx. 
Preparations. 
Tinctura Myrrhce (U. S. P.).—Tincture of Myrrh (20 per cent.). Dose, f3ss-ij. 
Tinctura Aloes et Myrrhce (U. 8. P.).—Tincture of Aloes and Myrrh (of each 10 per 
cent.). Dose, f3i-iv. 
Pilulce Alois et Myrrhce (U. S. P.).—Pills of Aloes and Myrrh (purified aloes, gr. ij ; 
myrrh, gr. j ; aromatic powder, gr. ss, in each pill). Dose, one to three. 
Tinctura Myrrhce et Capsici.—Tincture of Myrrh and of Capsicum, “ Hot Drops” or 
“ No. 6 ” (myrrh 6, capsicum 3, alcohol 100 parts). Dose, f3ss-j. 
Pharmacology.—Myrrh is a gum-resin obtained from Balsamodendron 
myrrha (Burseraceae). It contains 60 per cent, of gum, 35 per cent, of 
Myrrhin, a resin, and about 2 per cent, of myrrhol, an ethereal oil; also 
some bitter principle. It forms an emulsion when rubbed up with water, 
which dissolves about 60 per cent. With alcohol it is partly soluble, 
forming a brownish-yellow tincture. Myrrh enters into several offici- 
nal preparations besides those mentioned above, as the compound iron 
mixture, compound iron pills, compound galbanum pills, and compound 
rhubarb pills. 
Physiological Action.—Myrrh is slightly astringent and stimulant 
locally, and internally is carminative in small doses, but large ones MYRTOL. 
759 
cause vomiting and purging. It has some expectorant qualities, and is 
a stimulant to the ovarian and uterine functions. 
Therapy.—Diffused in water, with the addition of a little carbolic 
acid or thymol, tincture of myrrh is a good mouth-wash for spongy gums, 
sore throat, or wounds after operations upon the mouth, or ptyalism 
occurring after the use of mercury. It may be applied in the full strength 
to ulcerated gums, aphthous patches, relaxed uvula, and freckles. It is 
also used in dentifrices and to correct bad breath. A lotion or ointment 
containing myrrh is a stimulant and antiseptic dressing to indolent or 
unhealthy ulcers. Favorable reports have been made of its action in 
atonic dyspepsia and gastralgia, though it has usually been prescribed in 
combination with other remedies. In amenorrhoea, it is often given in con- 
junction with iron. Internally, myrrh is considered valuable in checking 
excessive discharges, bronchorrhoea, leucorrhoea, cystitis, etc. 
MYRTOL. 
Dose, gr. iv. 
Pharmacology.—The Myrtus communis (Myrtacese) is a beautiful 
evergreen shrub or small tree, a native of the countries surrounding the 
Mediterranean. Its leaves and berries contain a volatile oil. According 
to E. Jalins, the myrtle-oil of Spanish origin contains various terpenes, 
cineol, and a camplior-like and the myrtol of commerce should 
more appropriately be termed rectified myrtle-oil. 
Physiological Action.—Myrtol is disinfectant and antiseptic. It 
causes no irritation when applied to the sound skin. Upon an abraded 
surface it gives rise to a slight burning sensation, which, however, soon 
disappears, and a 9-per-cent, emulsion of myrtol completely arrests the 
growth of the micro-organisms of pus. The decomposition of organic 
material is prevented by myrtol. Taken internally it promotes diges- 
tion. Large doses occasion nausea and headache. It is removed from 
the system by the lungs and kidneys, and communicates a violet-like 
odor to the breath and urine. 
Therapy.—Externally, mjTrtol has been used with success as a disin- 
fectant to surfaces covered with unhealthy, or decomposing, pus. It has 
proved efficacious in cutaneous diseases of vegetable parasitic origin, 
and has been recommended as a local remedy in psoriasis. Griven in- 
ternally, it has been found destructive to lumbricoid and thread worms. 
Eichliorst advises its use in chronic bronchitis attended with profuse and 
fetid muco-purulent expectoration. The sputum becomes less abundant, 
less purulent, and less offensive. It diminishes foetor in gangrene of 
the lung. In pulmonary tuberculosis it is said to decrease the number 
of bacilli. This remedy has also given relief in chronic pyelitis and 760 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
cystitis, and lias proved useful in passive luiemorrliage. Myrtol was 
introduced to the notice of the profession in 1878 by Dr. Linarix.* 
IMAPHTHALINUM.—Naphthaline, Coal-Tar Camphor. 
Dose, gr. i-x. 
Pharmacology.—Naphthaline is a benzine derivative, separated from 
coal-tar by distillation, occurring in the form of white .crystals, which 
may be compressed into cakes like camphor, and having a peculiar odor. 
It was discovered by Garden in 1820. Naphthaline is insoluble in water, 
but soluble in alcohol, ether, and chloroform. Being destructive to 
insect life, it is employed as a substitute for camphor in preventing 
the invasion of moths. 
Physiological Action.—Naphthaline may be prescribed internally as 
an intestinal antiseptic in doses of gr. ii-x (or to children, gr. i-iij) 
every three or four hours. It may be given with white sugar in capsules 
or wafers. It has also decided expectorant powers, although its insolu- 
bility only permits a small quantity to be absorbed, which is discharged 
as naplithol or phenol by the bronchial mucous membrane or the urinary 
passages, thus acting as a local disinfectant at the point of excretion. 
It is devoid of local irritant properties. 
Therapy.—Naphthaline is a useful antiseptic in treating ulcers, 
cancers, and pus-cavities; it can be used in watery emulsion, in alcoholic 
solution, or in a dry form. In addition to the affections named, a naph- 
thaline ointment is advantageously applied to chancres, chancroids, 
syphilitic ulcers, sloughing -wounds, chronic eczema, and psoriasis. This 
ointment may contain 30 grains or more to the ounce of basis:— 
Hydrarg. chloridi mitis, gr. x. 
Naphthalini, 3j. 
Ungt. camphoras, 3vij. 
M. For chancroids, ulcers, and chronic eczema. 
In intestinal disorders due to infection, e. g., typhoid fever, diarrhoea, 
and possibly in cholera, naphthaline is of eminent usefulness in diminish- 
ing the activity of the bacteria of the intestinal canal, as shown by C. 
Sehrwald, who also advises the use of calomel in conjunction with naph- 
thaline in order to increase the bactericidal effect. 
NAPHTHOL, ALPHA and BETA. 
Dose, gr. ss-v. 
Pharmacology.—Alpha- and beta- naplithols nre obtained by heating 
together for several hours naphthaline and sulphuric acid. A large 
quantity of hot water being then added to the mixture, the excess of 
naphthaline is filtered off and the solution saturated with lead carbonate. 
*I)e l’Emploi du Myrtol on l’Essence de Myrte principalement dans les Maladies des Yoies 
Respiratoires et Genito-Urinaires. NAPIITHOL, ALPHA AND BETA. 
761 
From these lead-naphthaline sulphonates the respective acids are pre- 
pared, and from the acids fused with an alkali two naphthols are made,— 
the alpha and beta. Beta-naphthol is the first to crystallize, and is readily 
separated from the alpha variety by boiling alcohol, in which the latter 
is insoluble. Pure alpha-naphtliol is perfectly white, melts at 122° C. 
(241.6° F.), and boils at 286° C. (546.8° F.). Genois shows that when 
alpha-naphtliol is treated with chloride of iron the solution turns green, 
and white di-naphthol is precipitated. Alpha-naphtliol is insoluble in 
cold and slightly soluble in hot water. It is very soluble in ether and 
alcohol, from either of which it crystallizes in white, shining needles. 
Alpha-naphtliol has an aromatic odor and somewhat pungent taste, and 
is converted, with heat and dilute hydrochloric acid, into naphthaline and 
sulphuric acid. Genois states that impure alpha-naphtliol is dangerous 
and quite unfit for medicinal use. 
Physiological Action.—Alpha-naphtliol, used internally, produces 
warmth in the stomach, stimulates the glands of the entire gastrointes- 
tinal tract, and tends to make the faecal discharges of rather a soft con- 
sistency. Large doses have caused increase in the arterial tension and 
of cerebral h}-peraemia. The systemic action of alpha- 
naphtliol differs but little from that observed from the administration of 
beta-naphthol. ' Alpha-naphtliol has marked antiseptic properties. Maxi- 
movitsch reports (Merck's Bulletin) that alpha-naphtliol, in the propor- 
tion of 1 to 10,000 of culture-gelatin, prevents the growth of the most 
various pathogenic microbes; even in the proportion of 0.6 or 0.8 to 
10,000 it retards the development of microbes by three to eight days. 
This experimenter, further, adds that similar antiseptic effects were pro- 
duced by beta-naphthol, but twice as much, he reports, had to be used 
to produce the same results. Alpha-naphtliol has a stimulating and 
astringent action upon the skin. 
Therapy.—Alpha-naphtliol, from the writer’s experience, is certainly 
a good antiseptic. It is also a useful disinfectant. Alpha-naphtliol solu- 
tion. from 1 to 30 grains to the ounce of distilled or boiled water, is 
serviceable in treating wrounds or ulcers, and for all surgical procedures 
requiring an antiseptic agent. Alpha-naphtliol solutions are beneficial 
in seborrhoea, acne, rosacea, chronic eczema, and alopecia. Nasal catarrh, 
buccal inflammations, pharyngitis, and laryngitis, are often relieved or 
removed bv the application of alpha-naphtliol solutions. The solution 
can, in the diseases just named, be used with advantage in the form of a 
spray. Solutions of alpha-naphtliol can be emplojmd with advantage in 
injections for gonorrhoea in both sexes, in gleet, in leucorrlioea, and in 
irritation and inflammation of the lower portion of the rectum. Alpha- 
naphtliol incorporated in some fatty substance (gr. v to lx to the ounce), 762 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
as lard, suet, butter, lanolin, zinc or lead ointment, can be used for very 
many diseases of the skin, such as chronic acne, rosacea, psoriasis, 
chronic eczema, alopecia circumscripta, and for chronic ulcers. Accord- 
ing to the author’s experience, alpha-naphthol, while a good stimulating 
and astringent substance, having also antiseptic properties, lacks, to a 
great extent, the anaesthetic or sedative effects upon the integument which 
belong to beta-naphthol. Further, the internal use of alplia-naphthol 
has not been followed, in the writer’s experience, with that decided action 
observed from beta-naphthol. Alpha-naphthol can, however, be emploi'ed 
internally in from to 5 grains, three or four times a day, for chronic 
catarrh of the stomacli or bowels, and in constipation. It can also be 
used as an antiseptic in smaller doses to 10 grains three or four 
times a day) in typhoid and other fevers. 
NAPHTHOL, BETA. 
Dose, gr. ss-v. 
Pharmacology.—Beta-naphthol occurs as colorless scales, or as a 
white, crystalline powder, melts at 253.4° F., is soluble in 75 parts of 
boiling water, and is freely soluble in alcohol, ether, chloroform and 
fixed oils. M. Charrin (Le Bulletin Medical) states that a saturated 
solution of boric acid in water increases the solubility of beta-naphthol. 
Beta-naphthol has a pungent taste, but is free from odor. Naphthol and 
salicylic acid have been combined and used under the name of sali-naph- 
thol.* (See under Salicin.) It is odorless, tasteless, and insoluble in water. 
Physiological Action.—When taken internally naphthol gives rise to 
a sensation of warmth in the stomach. The faeces are softened and clay- 
colored. Diarrhoea is occasionally produced. Large doses sometimes 
cause vertigo, buzzing in the ears, and symptoms of cerebral hyperaemia. 
Beta-naphthol is slightly stimulant to the skin and mucous membranes, 
allays pain and pruritus. It is one of the most powerful antiseptic 
agents, possessing three times the strength of carbolic acid or iodoform 
and four times that of creasote or naphthaline. It may be regarded as 
absolutely safe, since, according to Professor Bouchard’s investigations, 
nearly half a pound would be required to cause death in a healthy person 
weighing 150 pounds. Robert believes that by the action of the pan- 
creatic juice and the intestinal ferments, naphthol with salic3rlic acid, or 
sali-naphthol, is split up into salicylic acid in the urine. Lepine,f on the 
contrary, stated that the intestinal juice is incapable of producing this 
decomposition, but added that it may be brought about by the pancreatic 
secretion. The decomposition of sali-naphthol he reports may be due 
simply to an alkaline reaction. 
* Therapeutic Gazette, January 15, 1891. 
t Journal de Medecine de Paris, November 16,1890. NAPHTHOL, BETA. 
763 
Therapy.—Beta-naplithol is a valuable local remetty in parasitic dis- 
eases of the skin. An ointment containing drachm to the ounce is de- 
structive to pediculi and their ova. The same preparation is equally fatal 
to the itch-mite, and at the same time relieves the inflammation occasioned 
by the parasite. It soothes the irritation produced by the bites of fleas, 
bed-bugs, and mosquitoes. The various forms of tinea trichophytina 
yield to the influence of naphthol ointment. The itching of paresthesia, 
urticaria, pemphigus, and prurigo is very successfully treated in the 
same manner. Beta-naplithol is especially valuable when the skin is rough 
and infiltrated. In chronic eczema and psoriasis it is a reliable medica- 
ment. The secretions of the skin are favorably influenced, and it very 
often proves useful in the treatment of hyperidrosis and bromidrosis. 
Benefit also results from the emploj-ment of this substance in acne, 
seborrhoea, sycosis, alopecia circumscripta, lupus erythematosus and 
vulgaris, chronic ulcers, chancres, and chancroids. The remedy may be 
used in the form of a powder, lotion, or ointment. It is often well 
combined with bismuth or other mild powder, as— 
Naphthol. beta, gr. xv. 
Bismuthi subnitratis, §j. 
M. For use as a dusting powder. 
The odor of cancer and ozrena is overcome by naphthol. It is an 
excellent antiseptic dressing to wounds, and may often be advantageously 
employed, according to the method of Professor Reverdin, by impreg- 
nating previously sterilized gauze bandages with an ethereal solution. 
An aqueous solution may be used with good result in mercurial saliva- 
tion and chronic pharyngitis. Yaginitis, vulvitis, gonorrhoea, and gleet 
are notably improved by the use of naphthol. For gonorrhoea and gleet 
an injection may be composed as follows:— 
Naphthol. beta, gr. v. 
Glyeerini, f^j. 
Aquae, f §iij.—M. 
A solution of beta-naplithol in glycerin and water is useful in chronic 
otorrhoea. An aqueous solution of the strength of 1 to 2500 has yielded 
good results in purulent ophthalmia. In simple or granular conjunctivitis 
and trachoma, likewise, this agent has proved a valuable remedy. This 
substance is very advantageously combined with camphor. Camphorated 
naphthol is formed by adding 1 part of naphthol to 2 parts of camphor, 
and is a colorless, syrupy liquid, well adapted for use as a local anti- 
septic. It may be beneficially employed in wounds, ulcers, sinuses, 
diphtheria, tubercular laryngitis, and, rubbed up with lard, it forms a 
valuable application in many diseases of the skin. Inhalations of 
beta-naplithol are of service in pharyngitis, chronic nasal catarrh, hay 
asthma, whooping-cougji, and chronic bronchitis. 764 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Beta-naphthol is administered internally chief! jr as a means of secur- 
ing antisepsis. Being almost insoluble, it is one of the best agents at 
our command for disinfection of the alimentary tract. In typhoid fever 
it mitigates the severity of the disease and reduces the rate of mortality. 
The stools are deodorized, tympanites lessened, and the tongue moist- 
ened. Grave deliriufn rarely makes its appearance. These results, 
announced by Professor Bouchard, have been amply confirmed by the 
writer and numerous observers at home and abroad. Dr. Mitchell 
Bruce* concludes that the duration of typhoid fever is shortened, and 
the tendency to secondary complications overcome, by the use of beta- 
naphthol. The testimony of Dr. Petresco, of Bucharest, a zealous 
therapeutist, is strongly to the same effect.f The remedy is equally 
valuable in the typhoid fever of young children. When the diarrhoea is 
profuse it is advisable to combine naplitliol with the salicylate of bismuth, 
thus :— 
Naphthol. beta, 
Bismuth, salicylat., aa 3ij. • 
M. et div. in chart, no. xv. 
Sig.: A powder every hour or as required. 
Good results are derived from the internal administration of this 
drug in diphtheria, erysipelas, and scarlatina. In flatulent dyspepsia,- 
chronic, gastric, or intestinal catarrh, and dilatation of the stomach, it is 
no less efficacious. Professor Dujardin Beaumetz recommends, in dila- 
tation of the stomach, the following combination :— 
R Naphthol. beta, 
Bismuth, salicylat., 
Magnes. calcinat., aa gr. cl. 
M. et div. in chart, no. xxx. 
Sig.: One powder before each of the two principal meals. 
In obstinate constipation, connected with disturbed digestion, the 
author has witnessed excellent results from to 8- grain doses of beta- 
naphthol given three or four times a day. Beta-naphthol is likewise often 
of utility in chronic cj’stitis. 
Beta-naphthol with salicylic acid (sali-naphthol) is reported to act 
similarly to salol, without being as toxic, in articular rheumatism, in 
doses of from 4 to 8 grains. 
Beta-naphthol is well given in the form of tablet triturates. Milk, 
glycerin, and mucilage are also excellent vehicles for its administration.J 
* Practitioner, December, 1888. 
t J. Petresco : Recherches cliniques et experimentales sur l’Antisepsie Medicate, January, 
1889. 
t See papers by the author, “Naphthol: its Medicinal Use and Value,” Journal of the 
American Medical Association, October, 1883; Therapeutic Gazette, October 15, 1889. 
* NEROLI OLEUM. 
765 
Hydro-Naphthol, as the writer and others have already shown,* exists 
only as an impure form of beta-naplitliol. It is a quasi-proprietary 
preparation. 
NEROLI OLEUM.—Oil of Neroli, Volatile Oil of Orange-Flowers. 
Pharmacology.—The oil of neroli is distilled from the flowers of 
Citrus aurantium and Citrus vulgaris (Aurantiacese). Dissolved in 
alcohol (2 per cent.) it forms the spirit of neroli, used for flavoring. 
The oil of neroli is obtained in the distillation of orange-flower water, but 
is not the same volatile oil as that contained in the water (see Aqua 
Aurantii Florum, page 462), and orange-flower water cannot be made 
from the oil of neroli. 
NICOTINA.—Nicotine. 
Nicotine is an alkaloid obtained from tobacco. See Tabacum. 
NITROGLYCERINUM.— Nitro-Glycerin. See Glonoinum, page 439. 
NUX VOMICA (IT. S. P.).—Nux Vomica, Poison-Nut. 
Preparations. 
Abstractum Nucis Vomicce (U. S. P.).—Abstract of Nux Vomica. Dose, ss-j. 
Extractum Nucis Vomicce (U. S. P.).—Extract of Nux Vomica. Dose, gr. 
Extractum Nucis Vomicce Fluidum (U. S. P.).—Fluid Extract of Nux Vomica. 
Dose, bti-v. 
Tinctura Nucis Vomicce (U. S. P.).—Tincture of Nux Vomica (20 per cent.). Dose, 
lTlv-xx. 
Strychnina (U. S. P.).—Strychnine. Dose, gr. ArAf 
Strychnines Sulphas (U. S. P.).—Sulphate of Strychnine. Dose, gr. Art*?- 
Pharmacology.—Nux vomica is the seed of Strychnos nux vomica 
(Loganiaceae), of East Indies. The seeds are disk-shaped, about an inch 
in diameter, covered writh silky hairs, of a greenish-gray color, and 
grayish-white internally ; very tough, and diflicult to powder. Odor 
none, but the taste is very bitter. Strychnine to § per cent.), and 
Brucine to 1 per cent.) with Igasuric acid, are the important constitu- 
ents, besides fixed oil, tannin, etc. A third alkaloid, isolated by Desnois, 
in 1853, and termed Igasurin, is crystallizable, bitter to the taste, and 
shares the poisonous properties of the other alkaloids. The powdered 
drug varies in allcaloidal strength, and in using the fluid preparations it 
is necessary to have them standardized in order to insure uniformity of 
physiological and therapeutic effect. Strychnine represents the medicinal 
activity of nux vomica. Strychnine crystallizes out of alcohol in the 
form of colorless prisms and dissolves in pure sulphuric acid without 
change of color. If a few drops of this solution be placed upon a white 
* See papers by the author, “The Imputations on Beta-Naphtliol,” and “ The Beta-Naph- 
thol vs. Hydro-Naphthol Contention,” Journal of the American Medical Association, July 14, 
1888, and May 11, 1889. 766 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
plate and an equal quantity of potassium-bichromate solution be 
cautiously brought into contact with its edge, a beautiful and character- 
istic play of colors is produced, ranging through blue, purple, crimson, 
and red-brown. This color change is distinctive and is available as a 
delicate test for strychnine. Morphine obscures this test, and hence, if 
present, should first be removed by means of an alkaline mixture of 
chloroform. A physiological test is also utilized in cases of suspected 
poisoning; grain of strychnine sulphate in a drop of water, applied 
to the dried skin of a frog, will produce spasm in about ten minutes. 
Brucine, which gives rise to a similar physiological reaction, is likewise a 
crystalline body, soluble in 320 parts of cold or 150 parts of boiling 
water, has a strongly bitter and persistent taste, and, although generally 
resembling strychnine in its properties, will sometimes destroy life 
without the occurrence of convulsions. Strong sulphuric acid strikes a 
blood-red or scarlet color with brucine and its salts. Igasurine occurs in 
colorless, silky prisms, is more soluble in water than either of the other 
alkaloids, has a similar bitter taste and toxic action, is colored rose-red 
by strong sulphuric acid and a deeper red by nitric acid. It is soluble 
in water and in alcohol, making intensely bitter preparations, thus ren- 
dering the pill form preferable for administration. The abstract of nux 
vomica is a good preparation, and should be more frequently used. 
Physiological Action.—In minute doses, repeated three or four times 
daily, which is the best way to get its tonic effect, strychnine increases 
the appetite, stimulates secretion, improves digestion, and exalts the 
vital powers, improving also sight and hearing. Strychnine is a stimu- 
lant to the respiratory centre, also to the heart and vaso-motor centres. 
Arterial pressure is raised and the pulse becomes more slow. The pupil 
dilates under its influence. Peristalsis is increased and the bowels some- 
what loosened ; even diarrhoea may result from full doses. Strychnine 
stimulates the genito-urinary sjTstem, lias some influence upon the mus- 
cular tissue of the uterus, favors the occurrence of the menses, increases 
the venereal appetite, and excites erections. The functions of the spinal 
cord are exalted as well as stimulated, according to Biernacki,* and 
especially those of the anterior gray columns, but a very large dose 
paralyzes and destroys them. The brain is not affected directly until 
the accumulation of carbonic-acid gas in the blood causes coma and 
insensibility. This drug is absorbed rather slowly by the stomach, 
more rapidly by the rectum. Its toxic effects are, consequently, more 
promptly manifested after injection into the rectum than when adminis- 
tered by the mouth. Strychnine is slowly excreted by the kidneys, but 
elimination is more rapid in children than in old people. Strychnine 
# Therap. Monatshefte, August, 1890. 767 
NUX VOMICA. 
also escapes in the saliva. This drug, therefore, tends to accumulate in 
the system, and produce muscular stiffness, cramps, and other symptoms 
of toxic action. On account of its slow rate of absorption and elimina- 
tion, its exhibition should be occasionally suspended for a time, lest a 
dangerous quantity should accumulate within the sj-stem. Stiychnine 
is a local irritant. It possesses some antiseptic virtue, and, to a certain 
extent, inhibits the movements of leucocytes, though far feebler in this 
respect than quinine. 
Poisoning by Strychnine.—When a large dose.(TV to is given to 
an adult and absorbed, the face is drawn into a grin (risus sardonicus), 
the lower jaw becomes immovable, the neck rigid, the pupils dilate, the 
reflexes are heightened so that the muscles contract spasmodically and 
painfully ; then paroxjrsmal attacks of tonic contraction, especially of the 
extensor muscles of the body, in which the patient assumes the position 
of opisthotonos, occur; finally, the muscles of respiration become tetani- 
cally fixed, and death occurs from apnoea and carbonic acid accumulation 
in the blood, producing narcosis. The fatal result may ensue in a few 
minutes if the dose be a large one. It acts more rapidly and effectively 
when given by the rectum, or hypodermatically, than when swallowed. 
As is the case witljother active poisons, the lethal dose varies within 
considerable limits. Death has resulted from \ grain of strychnine or 
3 grains of extract of mix vomica; on the other hand, as much as 6 
grains of strychnine sulphate have been taken without fatal effect. One- 
third of a grain of strychnine b}r the mouth, or grain subcutaneously 
injected, must be considered a dangerous quantit}'.* A very instructive 
case, showing the after-effects which may be caused by strychnine 
poisoning, has been published by Dr. G. Honigmann, from the clinic of 
Professor Riegel, of Giessen.f A man who suffered from the classical 
symptoms of this accident had recovered under the liberal use of chloral 
hydrate. At the expiration of twenty hours after taking the poison, only 
a minute quantity of urine had been voided. Albumin was unmistakably 
present. There was abdominal pain with constipation. During the second 
night a small quantity of clear urine was passed which contained an 
abundant precipitate of albumin. It deposited a sediment in which were 
detected both white and red blood-corpuscles and a few hyaline casts. The 
pain and constipation continued and the pulse remained slow and strong. 
On the fourth day albuminuria persisted; the urine was still scanty; the 
sediment rich in blood-corpuscles, hyaline and epithelial casts, with renal 
epithelium. The kidneys began to resume their functions upon the 
* Materia Medica and Therapeutics, by Charles D. F. Phillips, M.D., Phila., 1886, p. 456. 
t Deutsche Mediciaischa Wochenschrift, May 30, 1889; Medical Bulletin, October, 1889, 
p. 324. 768 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
fourth and fifth days,after the skin had been roused to free perspiration. 
The albumin, casts, and cells began to decrease at the same time, but did 
not finally disappear until the fourteenth day. During all this time the 
pulse remained very slow. The renal insufficiency and albuminuria were 
probably7 due to limitation of the circulation through the kidney b}r con- 
traction of its vessels. But the composition of the sediment indicated 
that a more permanent injury had occurred. The reporter plausibly con- 
jectured that the renal epithelium had been affected, giving rise to an 
acute glomerulo-nephritis. 
Diagnosis of Strychnine Poisoning.—The convulsions do not resemble 
those occurring during the epileptic paroxysm, because they are always 
tonic and never clonic in character. They may be distinguished from 
those of tetanus by the history of the case and by the symptoms. In 
tetanus, the muscles of the lower jaw are first attacked ; locked-jaw exists 
for some time before the other muscles are involved ; moreover, in tetanus 
they do not entirely relax; some remain rigid; whereas, in strychnine 
poisoning, all the muscles are affected almost simultaneously, and then are 
relaxed until the next paroxysms. In what is known as tetany, the muscles 
about the neck are usually not affected, but there is persistent rigidity 
of other muscles. In hysterical convulsions the muscular contractions 
are not painful, and the patient does not retain'full sensation, nor full 
consciousness, but is in a dreamy7 or stupid condition. In convulsions 
of hydrophobia the patient is semi-delirious, there are no tonic spasms 
of muscles or cramps, and there is a history of wound from an animal. 
Antidotes and Treatment.—Tannin is the chemical antidote to mix 
vomica and to strychnine. The antidote should be given immediately, 
and a convenient form is tea or coffee that has been standing for an hour 
or more, given grounds or leaves and all, washing out the stomach after- 
ward with warm water or coffee. After spasm has developed, the in- 
troduction of the tube may excite convulsions. In order to obviate this 
occurrence the patient should be placed under the influence of nitrite of 
amyl or chloroform. The same caution applies to catheterism. The physi- 
ological antidotes are bromide of potassium, chloral, and physostigmine, 
or Calabar bean. Nitrite of amyl, chloroform, or ether inhalations may be 
cautiously employed at the onset of the paroxysms, and artificial respi- 
ration practiced. The catheter should be used frequently, and the 
bowels thoroughly7 evacuated with croton-oil. The physiological anti- 
dotes may be given by the rectum. If relaxation does not occur, nitrite 
of amyl may be injected hypodermatically. Animal charcoal and fats 
are useful adjuvants. Sanquirico prefers paraldehyde to chloral, and 
warmly recommends intra-venous injections of a considerable quantity 
of an 8-per-cent, soda solution, which produces active diuresis and elimi- NUX VOMICA. 
769 
nation. Opium and conium may also be brought into requisition as 
physiological antidotes. Dr. Whitla* writes with decided approval of 
tobaccof and alcohol in poisoning from strychnine. lie states that he 
would not hesitate to use alcohol alone in a desperate case, and believes 
that it will afford the best chance of success in dealing with the spasms, 
but poisonous doses must be boldly administered by the mouth and 
rectum. Chloroform has been given by the mouth (5i-ij) successfully. 
Siebold, in some experiments conducted upon himself as to the 
pli3Tsiological action of stryehnine.J reports that tannin in 10-gffiin doses 
was valueless as an antidote. Charcoal in 1-ounce doses had some 
slight effect, injections of morphine were useful, but chloral hydrate and 
chloroform sufficed to entirety prevent the muscular contractions, when 
administered in time. 
Therapy.—Nux vomica is not applied externally, and, although an 
oleate of strychnine is made, yet it has little, if any, use on account of 
its uncertainty with regard to absorption. Strychnine not being very 
soluble, its salts, sulphate, or acetate, may be used hypodermatically in 
the treatment of paralysis (gr. to or injected into the tissues 
around the eye for amaurosis in tetanus,§ as an antidote to snake- 
poison || and tobacco-alcohol amblyopia. Dr. after experi- 
ments on guinea-pigs, declares that hypodermatic injection of strych- 
nine for snake-poison is useless. Internally, the tincture of nux vomica 
does good as a bitter tonic, and in sick-headaehe from disordered stomach 
Ilinger gives it in 1-drop doses in a teaspoonful of water, every ten or 
fifteen minutes, until 10 drops have been taken. 
Cases of nausea and vomiting of pregnancy, not infrequently, yield 
to minute doses of the tincture, a drop, or a fraction of a drop, being 
given in water, and repeated in an hour or two hours. This preparation, 
likewise, does excellent service in the morning vomiting to which 
drunkards are subject. Nux vomica, indeed, fulfills more than one indi- 
cation in this class of patients. It is beneficial in the chronic gastritis 
of alcoholism, and affords support to the system when the accus/omed 
alcoholic stimulus is suddenly withdrawn. The poor appetite and diges- 
tion, the miserable sense of weakness, the insomnia and tremor, are 
* Op. cit.. p. 338. 
t “ Chloroform should be used in strychnine poisoning; not tobacco.” Francis L. Haynes, 
M.D., Phila. Med. Times, vol. xiv, p. 504. 
1 The Chemist and Druggist, September 6.1890. 
§ "Strychnine as a Preventive of Tetanus,” by Dr. Peyraud, Bulletin Medical, Septem- 
ber 2, 1890. 
|| “ Strychnine as an Antidote to Snake-Poison,” by Dr. Muller, Druggists’ Circular and 
Chemical Gazette, January, 1891; " Snake-Poison and its Antidotes,” by T. Lauder Brunton, M.D., 
F.R.S., British Medical Journal, January 3, 1891. 
IT “Strychnine in Snake-Bite.” Journal of American Medical Association, February 21, 
1891. 770 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
relieved by tlie tincture of nux vomica. At the same time,and especially 
being combined with capsicum, it diminishes the craving for drink, and 
is of value in assisting to break up the habit. The gastric catarrh de- 
pendent upon chronic disease of other organs, as bronchial tubes, heart, 
or liver, is also alleviated, as Ringer has pointed out, by the administra- 
tion of 1 or 2 drops of the tincture in a teaspoon ful or two of water ever}' 
two hours, or oftener, for twenty-four to fort}'-eight hours. 
In atonic dyspepsia and insufficient secretion, nux vomica is useful 
in pills, \#th quinine and some carminative. Owing to its effects upon 
motor nerves, it is valuable in constipation produced by defective mus- 
cular activity, and also in the form due to lead poisoning. 
In the former condition, the contractions of the lower bowel become 
so energetic that, according to Whitla, the stools are occasionally much 
altered in size, and may be seen to present the attenuated appearance 
observed in stricture of the rectum. The effects of nux vomica in con- 
stipation are often enhanced by a combination with a purgative and 
chalybeate. 
For constipation, nux vomica can be commended combined as 
follows :— 
$ Extract! nucis vomicae, gr. v. 
Extracti belladonnae ale., gr. iij. 
Extract! cascarae sagradae, gr. xv vel xxx. 
M. et ft. pil. no. xxx. 
Sig.: A pill after each meal. 
Extracti nucis vomicae, gr. v. 
Pulveris ipecacuanhae, gr. x. 
Extracti hyoscyami ale., gr. xx. 
M. et ft. pil. no. xx. 
* Sig.: A pill three times a day. 
Waugli recommends for constipation this prescription containing 
nux vomica:— 
Extracti nucis vomicae, gr. v. 
Aloes purifieat., gr. v. 
Ext. belladonnae ale., . . gr. iij. 
Oleoresina capsici, gr. ij. 
M. et ft. pil. no. xx. 
Sig.: One pill after each meal until two passages occur in a day, when half pills are 
to be taken; and the reduction is to be continued until the habit of regular evacuations 
has been formed. 
Atony of the large intestine leads to prolapsus ani, and here also 
the tincture of nux vomica is of advantage, both by internal administra- 
tion and local injection. Phillips has seen excellent results, in haemor- 
rhoids, from the tincture. In opposite conditions of the intestine, and for NUX \TOMICA. 
771 
different reasons, strychnine is remedial. In nervous or atonic diarrhoea 
it materially assists the action of other remedies, and may be thus 
prescribed with advantage :— 
Strychnin® sulphat., gr. ss. 
Acidi sulphurici aromat., f3v. 
Aq. hamamelidis dest., q. s. ad f^iv. 
M. et ft. sol. 
Sig.: A teaspoonful in water every three hours. 
In dysentery attended by unusual prostration and tympanites this 
remedy has proved of advantage. In combination with a mineral acid it 
has sometimes seemed to do good in Asiatic cholera. 
Strychnine is one of the best of the cardiac stimulants in failing 
heart or weakness of the circulation. Prof. Thomas G. Morton uses it 
in surgical shock. Weakness of the heart due to depressed nerve-force 
and dilatation of the heart are materially benefited by strychnine. It is 
a good plan to give this remedy sometimes in combination, and again 
alternating, with digitalis. Iron is often profitably added to the combi- 
nation, as:— 
Strychnin® sulph., gr. Vs. 
Tinct. ferri chloridi, f3ij. 
Infus. gentian®, q. s. ad fgvj. 
M. Sig.: Tablespoonful in water three times a day. 
In fatty heart it is capable of service, but should be given with 
circumspection, since it will sometimes induce a nervous and sleepless 
state, which is decidedly harmful to the patient. In emphysematous 
asthma it is especially serviceable. The various forms of muscular 
paralysis—hemiplegia, paraplegia, diphtheritic paralysis, wrist-drop—are 
well treated by strychnine internally, or hypodermatically (gr. 
thrown deeply into the affected muscles, in conjunction with electricity. 
It has also been employed with success- in infantile palsy and writers’ 
cramp. In progressive lead-palsy, strychnine stops the advance of the 
disease if used in full doses, a careful watch being kept up for toxic 
symptoms and potassium iodide being given simultaneously on account 
of its eliminative effects. Other forms of paralysis in which this agent 
renders conspicuous service, are torticollis; mercurial, malarial, and hys- 
terical paralysis; neurasthenia from sexual excess and aphonia due to 
paralysis of the vocal cords. In conjunction with out-door life and calis- 
thenics, mix vomica is useful in lateral curvature of the spine. In atony 
of the bladder, leading to incontinence or retention, a combination of 
strychnine and electricity forms the most valuable restorative means at 
our command. 
In dyspnoea and shortness of breath attending emphysema, winter 
cough, or phthisis, strychnine is useful; also in maintaining respiration 772 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
in narcotic poisoning, as from opium. Nux vomica is of considerable 
value in the treatment of phthisis. By promoting digestion it maintains 
nutrition; it deepens respiration and exerts a beneficial effect upon the 
cough. It relieves the vomiting to which consumptive subjects are liable, 
and, as Murrell has shown, has some power to check night-sweats. When 
given with the latter object in view it is best combined with aromatic 
sulphuric acid. Pinnoy has latety reported good results from the hypo- 
dermatic injection of the arseniate of strychnine in 4 cases of phthisis ; 
4 to 15 minims of a solution in liquid vaseline were given 
daily.* 
In amaurosis and failing eye-sight the tincture of mix vomica may 
be administered, gradually increasing the dose and watching its effects 
in order to prevent toxic symptoms. In delirium tremens large doses 
of tincture of nux vomica are not only well borne, but are rapidly 
curative. • 
Strychnine is not to be used while neuritis exists, or during the 
period of vascular reaction after apoplexy. In hypertrophy of the 
heart it should be given cautiously. In neuralgia due to impaired 
nutrition we may employ the following pill:— 
Zinci phosphid., gr. 
Ext. nucis vomicae, gr. 
M. et ft. pil. 
Sig.: To be taken every three or four hours. 
In simple indigestion and atonic dyspepsia use :— 
Abstract, nucis vomicae, gr. vj. 
Quininae hydroclilorat., gr. xxiv. 
Pulv. capsici, ITjj. 
Ext. gentianae, 3j. 
M. et ft. pil. no. xxiv. 
Sig.: Take one or two before meals. 
In tobacco amaurosis, de Schweinitz recommends :— 
$ Tr. nucis vomicae, f3ij. 
Take 3 drops three times daily, increasing 2 drops daily until physiological effects are 
obtained. 
Tr. nucis vomicae, f3j. 
Acid, nitro-muriatic. dilut., f3j. 
Spiritus chloroformi, f3j. 
Infus. gentianae, q. s. ad f^vj. 
M. Sig.: Take a tablespoouful or two after each meal for flatulent colic. 
Strychnine sulphate, given hypoderinatically in doses of rhs grain, 
is a very efficacious remedy in gastralgia and visceral neuralgia in 
* Annual of tlie Universal Medical Sciences, 1890, vol v, page A-96. OLEUM iETIIEREUM. 
773 
general, as ■well as in the milder forms of angina pectoris. The same 
treatment has also been recommended for infra-orbital neuralgia. The 
tincture has been given with good results in those cases of chorea which 
arise about the age of puberty, and seem to have no connection with 
rheumatism, as well also in some cases of chorea major. In idiopathic 
epilepsy of ill-nourished patients, mix vomica will frequently afford a 
decided relief. Haamatosis is promoted bjr nux vomica, and hence it 
is of value in the management of anaemia, chlorosis, amenorrhoea, and 
dysmenorrhoea. It is serviceable in purpura and in post-partum haemor- 
rhage. By promoting capillary circulation it is beneficial in cases of 
habitual coldness of hands and feet. Strychnine aids in overcoming 
subinvolution of the uterus. It is useful in some cases of spermatorrhoea 
and impotence. 
OLEUM /ETHEREUM (IT. S. P.).—Ethereal Oil. See JEtlier, page 
402. 
OLEUM MORRHU/E (U. S. P.).—Codliver-Oil. See Morrliua 
Oleum, page 751. 
OLEUM MYRCI/E (U. S. P.).—Oil of Myrcia or Bay. See Myrcia, 
page 756. 
OLEUM OLIWE (U. S. P.).—Olive-Oil, Sweet-Oil. 
Pharmacology.—Sweet-oil is a fixed oil expressed from the ripe fruit 
of Olea Europea (Oleaceae). It consists largely of Olein (more than two- 
thirds), with some solid fat, Tripalmitin. The best or virgin oil is ob- 
tained from the crushed ripe fruit, by expression without heat; a second 
quality is obtained by the addition of hot water to the same crushed 
fruit and expressing again. An inferior grade is made from the residue, 
after boiling, with the aid of very strong pressure. The best is nearly 
tasteless and without color, the second has more taste and color, and the 
third is dark and more or less rancid, with strong odor. The better varie- 
ties are used upon the table, as salad-oil, and also in pharmacy. Olive-oil 
enters into lead plaster and diachylon ointment. Cottonseed-oil and 
peanut-oil are used very largely as substitutes, but have not the agreeable 
flavor of olive-oil. 
Physiological Action and Therapy.—Olive-oil is a lubricant, and 
is added to poultices as an emollient in pneumonia and in skin 
diseases. Carbolized oil (1 to 24) is a valuable dressing for wounds. 
Internally, olive-oil is nutritious and laxative, and is a purgative 
for infants (in doses of a teaspoonful). During its use, the infant 
pass lumps of white fat, resembling beans, composed of undigested 
tripalmitin. In adults, it is a useful remedy in all forms of irritant poison- 774 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
ing, except that by phosphorus ; it is also a good enema. Given inter- 
nally, in the dose of ounce to 1 ounce, olive-oil will often relieve simple 
constipation in adults, especially when the condition has been produced 
by opium. It may be employed with advantage as a demulcent laxative 
in haemorrhoids and fissure of the anus. Much has been written of late 
concerning the value of this oil in gall-stone and hepatic colic. It has 
been freely administered in large doses (3 to 6 ounces) and wras thought 
to aid in the expulsion of the concretions. While it seems to have some 
power to alleviate pain, it hp,s no other influence, and the‘stones sup- 
posed to be passed during its use have been shown to be merely fatty 
masses. 
In scarlatina and other febrile affections, the application of oil to 
the skin reduces the temperature. In the desquamative stage of scarla- 
tina, it is of prophylactic utility by restraining the dispersion of scales 
through the atmosphere. Olive-oil has likewise been used by inunction 
in wasting diseases, and is of undoubted service, though of less value 
than codliver-oil. Insects, which occasionally find their way into the 
external auditory meatus, may be easily removed by dropping a small 
quantity of this oil into the canal. I)r. C. R. Earley administers sweet- 
oil freely in cases of snake-bites, and says it has never failed in his hands. 
A white emulsion is made by rubbing up powdered gum acacia (308 
grains) with olive-oil (3 ounces), and when thoroughly mixed gradually 
adding orange-flower water and syrup (of each, 2 ounces). It is used, either 
alone or in combination with opium, in treating dysentery, tenesmus, 
irritation of the bowels, etc. Lipanin, a combination of olive-oil and oleic 
acid, has already been referred to. It is recommended von Mering as 
a substitute for codliver-oil, but it is too expensive as compared with the 
other, and is not so serviceable as an alterative. (See page 751.) 
OLEUM RICINI (U. S. P.).—Castor-Oil. See Ricinus. 
OLEUM SANTALI FLAVI (U. S. P.).—Oil of Sandal-Wood. See 
Santalum. 
OLEUM SUCCINI (U. S. P.).—Oil of Amber. See Succinum. 
OLEUM THEOBROMyE (U. S. P.).—Cacao-Butter. See Theo- 
bromas. 
OLEUM THYMI (U. S. P.).—Oil of Thyme. See Thymus. 
OLEUM TIGLII (IT. S. P.).—Croton-Oil. See Tiglium. 
OLEUM ZE/E MAIDIS.—Oil of Indian Corn. See Zea Mays. OPIUM, 
775 
OPIUM (TJ. S. P.).—Opium. 
Dose, gr. i-iij. 
Preparations. 
Opium Denarcotisatum (U. S. P.).—Denarcotized Opium (morphine, 14 per cent.). 
Dose, gr. ss-j. 
Extractum Opii (U. S. P.).—Extract of Opium (morphine, at least 20 per cent.). 
Dose, gr. %-%. 
Opii rulvis (U. S. P.).—Powdered Opium (morphine, 12 to 16 per cent.). Dose, gr. ss-j. 
Dilutee Opii (U. S. P.).—Pills of Opium (each 1 gr. powdered opium). Dose, one pill. 
Emplastrum Opii (U. S. P.).—Opium Plaster (extract, 6 per cent.). 
Trochisci Glycyrrhizce et Opii (U. S. P.).—Troches of Liquorice and Opium, Wistar’s 
Cough Lozenges (extract, 6 per cent., or gr. extractof opium in each troche). Dose, jtox. 
Pulvis Ipecacuanha et Opii (U. S. P.).—Powder of Ipecac and Opium, Dover’s 
Powder (ipecac and opium, of each 1 part, sugar of milk 8). Dose, gr. x. 
Tinctura Opii (U. S. P.).—Laudanum (opium, gr. j in hlxiij). Dose, lhi-xx. 
Tinctura Opii Deodorata (U. S. P.).—Deodorized Tincture of Opium (opium, gr. j to 
lllxiij). Dose, Uli-xx. 
Tinctura Ipecacuanha et Opii (U. S. P.).—Fluid Dover’s Powder. Dose, "Iv-x. 
Tinctura Opii Camphorata (U. S. P.).—Paregoric Elixir (opium, gr. j in ffss). Dose, 
f 3j-§ss. 
Vinum Opii (U. S. P.).—Wine of Opium (10 per cent.). Dose, Olv-xx. 
Acetum Opii (U. S. P.).—Vinegar of Opium (10 per cent.). Dose, Hlv-xx. 
Mistura Magnesia et Asafatida (U. S. P.).—Dewees’s Carminative (mag. carb. 5, 
tr. asafeetida 7, tr. opium 1, sugar 10, water q. s. ad 100 parts). Dose, f3ss-iv. 
Mistura Glycyrrhizce Gomposita (U. S. P.).—Compound Liquorice Mixture, Brown 
Mixture (paregoric 12, antimonial wine 6, sweet spirit of nitre 3, extract liquorice, sugar, 
acacia, of each 3 parts, water 70 parts). Dose, f 3j-f §ss. 
Codeina (U. S. P.).—Codeine, gr. %-ij. (See Codeina, page 559.). 
Narcotina Hydrochloras.—Hydrochlorate of Narcotiue. Dose, gr. ii-x. 
Morphina (U. S. P.).—Morphine. Dose, gr. 
Morphina Acetas (U. S. P.).—Acetate of Morphine. Dose, gr. %-%. 
Morphina Hydrochloras (U. S. P.).—Hydrochlorate of Morphine. Dose, gr. %-%. 
Morphina Sulphas (U. S. P.).—Sulphate of Morphine. Dose, gr. %-%. 
Pulvis Morphina Compositus (U. S. P.).—Compound Morphine Powder, Tully’s 
Powder (morphine sulphate, 1 part; liquorice, camphor, and calcium carbonate, of each 
20 parts). Dose, gr. v-xv. 
Morphina Oleaturn.—Oleate of Morphine (10 per cent.). External use. 
Tinctura Chloroformi et Morphina (B. P.).—Tincture of Chloroform and Morphine. 
(See Chlorodyne, page 535.) Dose, )T\v-x. 
Mistura Opii et Ipecacuanha Gomposita.—Swedish Cholera Drops, Thielemann’s 
Cholera Drops (oil of peppermint, 1 oz.; alcohol, 8 oz.; tincture of opium and saffron [Syden- 
ham’s laudanum], 3 oz.; tinct. of opium, 8 oz.; tinct. of valerian, 13% fl.oz.) Dose, f 3 i—ij. 
Gonfectio Opii (Ph. 1870).—Confection of Opium (powd. opium 1, aromatic powder 12, 
honey 28 parts). Dose, gr. x-xx. 
Papaveris Gapsula.—Poppy-Capsules (of uncertain and variable narcotic effect). 
Syrupus Papaveris.—Syrup of Poppy-Capsules (of variable narcotic strength). Dose, 
to a child, f 3ss-j ; to an adult, f fss-j. 
Syrupus Rhceados.—Syrup of Red Poppy-Flowers (no narcotic effect). Used as a 
vehicle. 
Oleum Papaveris Seminis.—Poppy-seed-Oil (a bland oil, used to adulterate olive-oil and 
resembling it in character). 776 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Pharmacology.—The concrete, milky exudation, obtained in Asia 
Minor by incising the unripe capsules of Papaver somniferum (Papave- 
raceae), constitutes Opium, which, in its inspissated form, occurs in 
chestnut-colored masses or lumps, with an earth}", narcotic odor and 
bitter taste. In its commercial condition, as a moist, soft solid, it should 
contain not less than 9 per cent, of morphine; it loses about 20 per cent, 
of its weight in the process of drying. When dried and powdered, the 
pharmacopoeia directs that it shall contain not less than 12 per cent., nor 
more than 16, of morphine. The principal properties of crude opium are 
extracted by water, alcohol, and dilute acid, but not by ether. When 
broken it should exhibit a notched fracture, and should leave an inter- 
rupted stain when drawn acros.s white paper. Since all commercial 
opium contains more or less admixture of foreign material, or adultera- 
tion, the best preparation is the denarcotized opium, obtained by dis- 
solving and removing narcotine and other matters soluble in ether, and 
standardizing the product to the uniform strength of 14-per-cent, mor- 
phine. By employing denarcotized opium in making Dover’s powder a 
superior product is obtained, less disagreeable to the taste and less 
likety to cause nausea than that made from the ordinary powdered 
opium. A syrup of opium and ipecac may also be made with denar- 
cotized opium, so that each teaspoonful will represent 10 grains of Do- 
ver’s powder. The preparations that pharmacy offers to the physician 
of this ancient and valuable remedy are innumerable, but they are all 
dependent for their activity upon the presence of certain proximate prin- 
ciples. It had been long suspected that a vis dormitiva, or narcotic 
element, existed in opium and gave it medicinal value, but it was not 
until 1817 that a crystalline body was isolated by Sertiirncr, which he 
correctly considered as the salt of an organic acid to which he gave the 
name of Meconic acid. The sleep-producing principle he named mor- 
phium in honor of the drowsy god, but this has been since changed to 
Morphine, in order to make it conform in terminology to the other organic 
alkaloids of the pharmacopoeia. Since then, other alkaloids and proximate 
principles have been separated from opium, some of which possess nar- 
cotic power, some have not, and one, at least, is a tetanizer resembling 
strychnine. The principal constituents and alkaloids are as follow :— 
Morphine (at least 9 per cent, in crude opium) ; the principal narcotic 
constituent. Codeine per cent.); about half the narcotic strength of 
morphine, but more calmative. Narcotine (2 to 10 per cent.) ; no nar- 
cotic effects; antiperiodie. Thebaine or paramorphine (less than J per 
cent.); convulsive agent and spinal excitant. Narceine (0.02 per cent.); 
resembles morphine, but has less disagreeable after-effects. (A new and 
more soluble narceine has recently been prepared by Dr. Laborde and M. OPIUM 
777 
Duquesnel.*) Papaverine (1 percent.); narcotic and convnlsant. Also, 
cryptopine, pseodo-niorphine, protopine, cotomine, landanine, codamine, 
rhoeadine, meconidine, landanosine, lanthopine, and gnoscopine in small 
amounts, with neutral principles, meconin, meconoisin, and porpliyroxin, 
and meconic and lactic acids. 
It is probable that these principles exist in a highly complex ar- 
rangement in opium, and that separately none of them completely repre- 
sents the drug; possibly some of them are derivatives of the others, and 
not separate compounds. Apomorphine is a derivative of morphine, 
devoid of narcotic effect, causing prompt emesis. (See page 448.) 
Some of the chemical reactions and tests of opium are interesting. 
Solutions containing meconic acid turn red in contact with the tincture 
of the chloride of iron, and the same reagent turns morphine blue, after- 
ward changing to green ; nitric acid turns morphine to blood-red, 
changing to yellow. According to Wormley,the nitric-acid test is capa- 
ble of detecting gram of morphine in the dry state. Opium prepa- 
rations, in solution, afford precipitates with solutions of many of the 
metals in the form of an insoluble meconate. The alkaloids are precipi- 
tated by the addition of an alkali or tannic acid. This is of importance 
in prescription-writing. It should also be stated that there is present a 
small proportion of glucose in gum opium, which chemicall}' makes it 
incompatible with nitrate of silver, and pills containing these in combi- 
nation may explode. The formerly much used lead-water and laudanum 
mixture is dependent for some of its effects upon the extemporaneously 
formed meconate of lead, which is of a 3Tellow color and is unsightly 
and dirty; dilute lead-water, with alcohol, will probably answer the 
purpose nearly as well and is colorless. 
Morphine occurs in the form of colorless, flat, six-sided prisms, 
destitute of smell, but having a very bitter taste. It melts at about 
330° F., and is destined by more elevated temperatures, is insoluble in 
cold water and ether, sparingly soluble in boiling water, more freely 
soluble in alcohol and chloroform. The solutions of morphine possess 
an alkaline reaction. It dissolves without decomposition in solution of 
potassium. On account of its insolubility in water it is employed for 
medicinal purposes in the form of its soluble salts. 
Codeine is present in opium combined with meconic acid, and is 
separated from morphine by means of an alkaline solution. This is a 
colorless, crystalline substance, anhydrous or hydrated, depending upon 
whether it crystallizes from an ethereal or aqueous solution. Its solutions 
are bitter to the taste and of an alkaline reaction. Codeine dissolves in 
water, alcohol, ether, and chloroform. In this country it is generally 
* Therapeutic Gazette, September 15,1890, p. 639. 778 
PHARMACEUTICAL THERAPEUTIC AGENTS, .OR DRUGS. 
administered in the form of the sulphate of codeine. Apocodeine is a 
derivative of codeine, obtained by heating codeine hydrochlorate with a 
concentrated solution of chloride of zinc. 
Physiological Action.— Opium is a stimulant, narcotic, anodyne, anti- 
spasmodic, and intoxicant. Its taste is bitter and somewhat acrid ; it 
gives rise to a sensation of dryness in the mouth and throat, and sub- 
sequently to a viscid secretion, with liuskiness of the voice. It restrains 
the movements and checks the secretions of the stomach and intestinal 
canal. As a result of his experiments, Nothnagel concluded that opium 
in moderate doses stimulates the inhibitory nerves of the intestine, but 
paralyzes them when given in excessive doses. This accords with the 
observed fact that under the influence of this drug constipation is not 
infrequently followed by exaggerated peristalsis and free evacuation of 
the bowels. The pancreatic and hepatic secretions are lessened, and the 
stools sometimes become clay-colored under the influence of opium. 
The drug is not perfectly represented by morphine, and many persons 
are able to take some of the opium preparations with good results, although 
made sick by morphine. In discussing the physiological action, how- 
ever, it will lead to no confusion if we consider them together. In order 
to produce its characteristic effects, opium, or its active principles, must 
be absorbed into the blood and carried to the motor and sensory and 
higher nervous centres, and to the terminal end-organs of nerves. 
Having been carried to the brain and cord, the functions of the ganglion- 
cells are at first stimulated, and secondarily depressed or inhibited, 
probably owing to the salts diffusing through the cell-wall and entering 
temporarily into combination with the protoplasm. Subsequently they 
are removed by fresh supplies of blood and carried to the excretory 
channels, particularly the alimentary canal and kidneys. E. Tauber 
found that when morphine was administered hypodermatically to dogs, 
for several he was able to recover 41.3 per cent, of the drug from 
the feces.* Alt had already shown that after injection, subcutaneously, 
morphine could be detected in the stomach. Morphine does not appear to 
be destroyed or materially altered in passing through the animal organism. 
It seems probable, however, that small amounts of the alkaloid are decom. 
posed within the body, while larger quantities escape without change 
Opium is likewise eliminated by the skin and kidneys. The paper of Drs. 
R. Stockman and I). B. I)ott on “ The Pharmacology of Morphine and its 
Derivatives ” {British Med. Journal, July 26, 1890), and that read by 
Dr. Stockman “ On the Pharmacology of Some Bodies Derived from Mor- 
phine ” ( Transactions Ninth International Med. Congress, Washington, 
* “ Ueber das Schicksal des Morphine im thierischen Organismus,” Archiv fur Experimen- 
telle Pathologie und Pkarmakologie, July 24, 1890. 779 
OPIUM, 
1887, vol. 3, p. 47), contain the results of a laborious series of investiga- 
tions in a very interesting field, and form a valuable contribution to our 
knowledge of the influence of chemical change on physiological action, 
as well as to the pharmacology of morphine. Their conclusions only 
can be stated here; for details the reader is referred to the original 
sources. Morphine primarily affects the nervous system ; in small doses 
it depresses the action of the spinal cord; in larger doses it stimulates it, 
even to the production of convulsions. The late appearance usually of 
increased reflexes is accounted for on the ground that at first only a 
small quantity of morphine reaches the cord. It has been held by some 
observers that morphine is capable of directly paralyzing the motor 
endings of nerves. Stockman and Dott record experiments tending to 
show that morphine does paralyze more or less the nerve- 
endings, but only when large amounts come in contact with them. In 
the case of the sensory nerves the action is much the same. In man, 
tetanic symptoms are very exceptional, for, after therapeutic doses, the 
amount of morphine reaching the peripheral nerves is not usually suf- 
ficient to affect them. In infants and young children, however, convul- 
sions not uncommonly occur as a result of poisoning by opium. View- 
ing morphine (Cj 9N03) as a compound containing two hydroxyl 
groups, the hydrogen of one or both of these groups may be substituted 
by more or less complex radicles, forming derived bodies, which, being 
tested, produce positive physiological results, more or less approaching 
those of morphine. From these researches they conclude that chemical 
changes, restricted to what may be called the outlying groups of the 
molecules cause very little change in the physiological action, but where 
a change is made in the kernel or groundwork of the molecule the action 
is much more profoundly altered. In codeine or methyl-morphine, they 
found that the narcotic action was much diminished by the substitution 
of the alkyl radicle for the hydrogen atom, whilst the tetanic action and 
the action on the motor nerves were increased. The paralyzing effect on 
the motor nerve-endings was also more decided. Codeine is anodyne and 
hypnotic, and causes less general disturbance than accompanies the action 
of morphine. The generative functions are depressed by opium, and in 
chronic poisoning the menses cease and men become impotent while 
under its influence. The secretion of urine is lessened, but the bladder 
is often rendered irritable and urine is passed frequently in small quan- 
tities. On the other hand, partial paralysis, with retention, may occur. 
This drug increases the amount of urea and phosphoric acid eliminated. 
The hypnotic action of opium is due partly to the lessened activity 
of the cerebral cells and partly to a reduction of the blood-supply to 
the brain-centres. It is therefore a cerebral depressant. Small doses, 780 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
however, 1 grain or less, temporarily arrest all the secretions except that 
of the skin, and stimulate the circulation; the heart’s action is in- 
creased, arterial tension raised, and the pupils contract and do not 
respond well to light. Slightly quickened at first, the action of the heart 
soon becomes more slow and forcible. Immoderate doses may cause 
rapid and feeble action. These effects are attributable to exaltation or 
depression of the function of the pneumogastric nerve. 
With this, in some persons, there is exhilaration and increased cere- 
bration, with a sense of calm and indisposition to sleep until the effect 
passes away, when sleep occurs, from which the subject wakens with a 
headache, disordered stomach, and constipated bowels. In others, 
cerebral activity does not occur, but the spinal functions are exalted and 
restlessness occurs, with some irritation of the skin, or even an ery- 
thematous eruption. At times a general rash, resembling that of scarlet 
fever, is witnessed, and this eruption may be succeeded b}r desquamation. 
In other cases an urticarial efflorescence may appear. Itching of the 
skin is a very common result of a dose of opium. This substance exerts 
little or no local action. Its active principles, however, are quite readily 
absorbed through the unbroken skin. 
Morphine, liypodermatically injected, is less apt to affect the appetite 
and bowels than opium given by the mouth. If, however, the solution 
should be thrown directly into a vein, temporary dyspnoea and clonic 
spasm may be produced. Larger doses arrest digestion and may cause 
vomiting with diaphoresis. The heart and circulation are depressed ; the 
bodily temperature is reduced. A stuporous sleep is produced, with 
irregular and slow respiration, cool, clammy skin, and pin-point con- 
tracted pupils. In other eases coma-vigil and delirium may occur. 
Infants are extremely susceptible to the influence of opium. The drug 
should be administered to them in small doses, and its effects carefully 
watched. Aged people, also, bear it less Avell than those in the prime 
of life. Women are more amenable to the drug than men, and require 
smaller doses. The action of codeine resembles that of morphine, but 
is less decided. It is not so apt to derange the stomach or produce con- 
stipation. Codeine is not so potent an anod3’ne or hypnotic as morphine. 
Excessive doses have caused alarming prostration and distressing pru- 
ritus. A tolerance of opium is soon established, and, in those to whom 
it is constantly given, the dose must, from time to time, be increased in 
order to produce the desired results. Protopine, according to the experi- 
ments of Engel,* produces in mammals an action similar to camphor, 
death following its use by a paralysis of the respiratory centre. 
Poisonous Effects.—If a fatal dose has been taken, the above symptoms 
* Gazette Medicate de Paris, October 11, 1890. OPIUM, 
781 
intensify, the pulse becomes slower, respiration is reduced to five or six 
to the minute, the reflexes become abolished, and death occurs from 
paralysis of the respiratory centre, or carbonic-acid accumulation in 
the blood. Post-mortem examination ma}’- show some of the drug yet 
remaining in the stomach or intestines, and the internal organs reveal 
considerable venous congestion, especially the lungs. Laudanum is the 
agent most frequently taken with suicidal intent, and its presence may 
often be detected simply by the odor of the contents of the stomach. 
Diagnosis of Opium Poisoning.—Opium poisoning may be mistaken 
for cerebral apoplexy or alcoholic intoxication, but attention to a few 
points of diagnosis will prevent error. The liistoiy may, or may not, 
assist in deciding the question. In apoplexy there is no contraction of 
the pupils (except in one case which will be mentioned presently), the 
eyes are deviated to one side, the sides of the face may not be symmetri- 
cal, and there is also paralysis of one or both limbs. The symptoms 
come on suddenly, often on rising in the morning; there is generally no 
history of taking any poison or food immediately before the attack; the 
face is congested or pale, not swollen and cyanosed as in opium-poisoning. 
In lmemorrhage into the pons Yarolii, there is contraction of the pupils, 
but, as such cases are rare and generally fatal, the mistake will not be 
often made ; moreover, the attack is sudden and the entire body is re- 
laxed with involuntary evacuations of the contents of the bowels or 
bladder, which does not occur in opium poisoning. In alcoholic intoxi- 
cation the patient can be roused and will answer questions; the pupils 
may be contracted, but will dilate when the patient is disturbed, or his 
beard is pulled ; the odor of alcohol may assist in the diagnosis. It is 
possible, however, for the patient to swallow laudanum at the close of a 
drinking bout, and thus have both forms of intoxication. Urasmic coma 
might possibly be mistaken for opium poisoning, but in the former con- 
dition oedema is generally present, and the urine contains albumin and 
casts. 
Treatment of Poisoning.—The stomach should be promptly evacu- 
ated with sulphate of zine or ipecacuanha, or by using the stomach-pump. 
Emetics must be given in large doses on account of the insensitive con- 
dition of the stomach. A tablespoonful of mustard or alum in water 
acts as an efficient emetic, or apomorphine may be given hypodermati- 
cally. Tannic acid may be given as a chemical antidote. A pint or two 
of warm (not boiling-hot) coffee should be injected into the stomach 
and rectum. Artificial respiration should be practiced both by Sylves- 
ter’s method and by the application of the faradic current, one pole to the 
cervical region and one over the ensiform cartilage. No attempt should 
be made to directly faradize the phrenic nerve, on account of the danger 782 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
of paralyzing the heart. The circulation should be maintained by mass- 
age, rubbing the blood up toward the body from the extremities, and, 
if the blood is heavily carbonized, venesection of 12 to 16 ounces may be 
performed with advantage. The surface of the body may be stimulated 
by the faradic brush, or by whipping with the fringed ends of towels or 
with twigs. The patient should be made to walk about supported by two 
assistants, as soon as he is restored to consciousness, and kept walking 
for six or eight hours, or until the influence of the opium has entirely 
passed off1. Nevertheless, this exercise should not be too long continued 
on account of its exhausting effect upon the muscular system and heart. 
The capital point in the treatment is maintenance of respiration. If the 
measures instituted are found to gradually increase the number of respi- 
rations per minute, the coma, in itself considered, need not be feared. 
The catheter should be used from time to time in order to encourage 
excretion by the kidneys. The patient should not be exposed too much 
to cold, on account of his lowered temperature and the danger of pul- 
monary congestion. The physiological antagonists—atropine, caffeine, 
or strychnine*—may be used cautiously, but only in physiological doses. 
Atropine may be injected hypodermatically in doses of gr. if 
the respirations become very slow, but the state of the pupil is no guide 
to the effect of the antidote. Strychnine can be administered subcuta- 
neously in from to grain every hour or two until an improvement 
in the respiration takes place. Ammonia inhalations are useful, and when 
properly used are harmless. Opium poisoning produces no characteristic 
lesion. By reason of idiosyncrasy alarming results have followed the 
administration of small medicinal doses. 
Treatment of Opium Addiction.—The treatment of chronic morphine 
poisoning, or opium-eating, is more moral than medical. In such cases the 
will of the unfortunate victim is so weakened by self-indulgence that the ac- 
quired taste for the drug cannot ordinarily be resisted, and he will acquire 
means for its gratification at anjr cost, or, if it is not obtainable, he may 
destroy himself. In such cases the medical attendant, before undertaking 
the treatment, must thoroughly gain the confidence of the patient; he 
should try to establish an understanding, and, if possible, sympathy, with 
him. He should make sure that the patient really wishes to escape from 
the terrible thraldom of the drug, and will co-operate with his physician. 
The patient should be put upon his honor, and pledge himself to obey 
orders and confine himself to the quantity permitted by his physician 
and to medicines passing through his hands. The daily amount must 
* See papers, “Strychnine in Poisoning from Narcotics,” by Di\ G. A. Gibson, in Prac- 
tice, December, 1888; “ Some of the Uses of Nux Vomica and Strychnine,” by Dr. Frank R. 
Fry, in Weekly Medical Review, February 23, 1889; “Strychnine in Opium Poisoning,” by 
Dr. Clara T, Dercum, in University Medical Magazine, January, 1891. OPIUM. 
783 
first be accurately determined, and an effort made at once to reduce 
this one-half, afterward diminishing day by day, supplementing the treat- 
ment by valerianate of ammonia, fluid extract of coca, or camellia, with 
tonics, easily-digested food frequently given, and some alcohol, in the 
form of an elixir preferably. It is advantageous to change the form of 
the drug: if the patient has been taking laudanum or other opiate, give 
morphine instead ; if he has been taking sulphate of morphine, change it 
to the valerianate or some other salt. A change of scene is often bene- 
ficial. Dr. Waugh recommends a paste of coca-leaves and aromatics 
(Coca-bola, page 615) and the galvanic current in treating such cases. 
Dr. Woodbury prefers the gelatin-coated valerianate of morphine pills, 
owing to their convenience, and because other pills can be gradually sub- 
stituted without the patient’s knowledge. Massage is a useful adjunct 
to the treatment. Cottel (American Practitioner and News) recommends 
the following prescription for morphinism:— 
Morph, sulph. or tr. opii, . q. s. 
Ext. viburni prunifol. fl., f^ss. 
Elixir, ammoniae valerianat., f §iij. 
Elixir, sodii bromidi (gr. v to the f3), q. s. f§vj. 
M. Sig.: Teaspoonful when required. 
This is a mixture from which one is readily weaned when the opiate 
is withdrawn. 
Therapy.—Powdered opium may be mixed into a paste with water 
and applied to an incipient boil with relief. Laudanum with water 
is a useful application to sprains and bruises; and it may be added to 
poultices to form an anodyne fomentation. Laudanum may be applied to 
wounds as an antiseptic and to relieve pain ; and after heating in a 
spoon, to drive off the alcohol, it is a domestic remedy for earache, but 
the auditory canal should, in a few moments, be washed out with hot water. 
If there is a perforation of the ear-drum, a child might be narcotized in 
this way, by the drug passing down the Eustachian tube into the throat. 
Many anodyne liniments contain opium, and when these are applied with 
friction the remedy is partly absorbed. Such applications assuage the 
pain of chronic or muscular rheumatism, and even, at times, of sciatica. 
A warm lotion containing opium affords relief in synovitis and orchitis. 
Laudanum is usually a serviceable topical remedy in painful ulcers. 
Opium may be combined and used thus locall}’:— 
!£. Tinct. opii, . . . f^j. 
Chloroform i, 
Tinct. aconiti, aa f^ss. 
01. menth. pip., f3j. 
Lin. saponis, f§ij. 
M. Sig.: Apply well over the surface for neuralgia or rheumatism. 784 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Tinct. opii, 
Aquae liamamelidis dest., 
Aquae campliorae, aa f 
M. For an application to acute gout or rheumatism. 
Tinct. opii, 
Spiritus vini rectificati, 
Aquae liamamelidis, . . aa f§ij. 
M. Serviceable in synovitis, felons, or orchitis. 
$ Tinct. opii, 
Ext. arnicae fl., 
Lin. saponis, aa f^j. 
M. For enlarged glands and thickened states of the skin. 
$ Extract! opii, 
Extracti arnicae, 
Extracti belladonnae ale., aa 3j. 
Ungt. hydrargyri oleatis (10 per cent.), ..... §j. 
M. For arthritis. 
$ Extracti opii, . 3ss. 
Cocainae liydrochloratis, gr. x. 
Mentholi, gr. xv. 
Ungt. zinci oxidi, . . §j. 
M. Beneficial in anal fissure, rectal eczema and in haemorrhoids. 
The inhalation of steam impregnated with paregoric, or the watery 
extract of opium, is beneficial in acute pharyngitis. Ringer recommends 
the topical application of morphine dissolved in honey or glycerin, in 
order to relieve the throat-cough of phthisis. This solution, or an opiated 
lozenge, is not without efficiency, even when the cough is entirely 
dependent upon the pulmonary condition. Gargles containing opium 
are often of benefit in the diseases named :— 
Tinct. opii camphoratae, 
Tinct. benzoini comp., 
Tinct. kino, aa j. 
M. Sig.: Employ, diluted with water, as a gargle. 
I> Tinct. opii camphoratae, 
Aquae menth. pip., 
Glycerin i, aa f^j. 
M. Sig.: Use as a gargle. 
The oleate of morphine, with lanolin and a little chloroform, is a 
sedative application, or we may dissolve morphine in chloral-camphor 
and apply it over the site of pain. In various inflammatory conditions 
of the skin or conjunctive, fomentations with the recent decoction of 
poppy-heads is a soothing treatment, but is less anodyne and astringent 
than laudanum and hot water. Opium, morphine, or codeine may be 
introduced into the rectum in the form of suppositories, each containing OPIUM, 
785 
1 grain of the crude drug, or grain of the extract, or of morphine or 
codeine, in painful conditions of the bowel and neighboring organs, and 
also, for its general effects, in producing sleep and quieting cough or rest- 
lessness. A warm bath and an opium suppository are of material value in 
relaxing the spasm which accompanies organic stricture of the urethra. 
These measures will frequently permit the escape of enough urine to 
cause considerable temporary relief in retention and, at the same time, 
facilitate the passage of a filiform bougie and catheter. An opium sup- 
pository often averts the chill which may follow instrumentation of the 
male urethra, quiets the nervous system after operations upon the female 
pelvis, and relieves the pain and tenesmus of cystitis and strangury. 
Dr. von Klein, of Dayton, advocates the administration, in certain 
cases, of morphine by the nostrils. He states that, snuffed into the nose, 
this alkaloid is active in smaller doses than when given by the mouth, 
and that it is readily absorbed. 
Hypodermatic Administration.—Morphine is frequently injected hy- 
podermatically in order to produce its physiological effects, and the rule 
is to begin with a dose, at the most, only half as large as would be given 
by the mouth. Atropine is frequently combined with the morphine, and 
administered in this way to enhance its effect in treating neuralgia; they 
are also used in this combination (gr. £ and gr. Hu) previous to the use 
of chloroform, especially when a prolonged operation is anticipated. In 
cases of local pain, as first pointed out by Dr. Alexander Wood, of 
Edinburgh, who introduced the hypodermatic method, there is an 
advantage in making the injection close to the spot affected, although, 
for a general anodyme or hypnotic effect, the skin on the arm or dorsum 
of forearm is generally selected. The rules for hypodermatic medication 
may' be briefly' stated as follows : — 
1. The instrument must be surgically clean and aseptic. 
2. The solution used should be made with recently-boiled distilled 
■water, or at least with recently-boiled water. 
3. The patient should not be allowed to prescribe the injection, but 
it should be used only when, in the judgment of the physician, it is 
appropriate, necessary, and justifiable. 
4. The spot selected should be cleansed, and the needle pushed 
through a fold of the skin pinched up with the fingers of the other hand 
to that holding the instrument, being careful, in introducing it, to avoid 
proximity of veins. The desired amount being gradually injected into 
the loose cellular or muscular tissue, the needle is withdrawn, while with 
the finger pressure is made over the slight puncture and the fluid is 
gently' dispersed under the skin. 
It should be remembered that the morphine enters the circulation 786 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
more quickly than when absorbed from the alimentary canal, and onc< 
injected cannot be withdrawn. In a strange patient, where idiosyncrasies 
are unknown, it would be wise to give not more than gr. to am 
watch the effects, repeating and increasing the dose if required. Oi 
account of the extreme susceptibility of young children to opium, tin 
hypodermatic method is considered inadvisable for them; and in elderly 
persons, or patients suffering with Bright’s disease of the kidne3*s, it is 
used only with extreme caution. 
Special Applications.—Opium is used S3Tmptomaticallv to relieve 
pain and irritation, to relax spasm, to produce sleep, to check secretions 
and to influence nutrition. The preparations of opium and its salts are 
so efficient and convenient in the treatment of all forms of pain tliai 
the habit of indulgence is readily formed. It is therefore prudent foi 
the physician not to inform the patient of what he is using, or to always 
give it in combination with other drugs. In some forms of brain disease 
attended by congestion of the hemispheres, opium is inadmissible, espe 
cialty in the form accompanying alcoholism. Meningitis, however, is 
benefited b3' opium, and in the cerebro-spinal form the deodorized tine 
ture should be given in doses large enough to keep the patient fron 
suffering. In biliary, renal, or intestinal colic, morphine, given 1)3* tin 
mouth or is the most common means of relief; also ir 
angina pectoris, palpitation of the heart, or cardiac d3*spnoea. 
Small doses of opium—5 drops of the tincture, for instance—have ar 
excellent stimulant effect in the case of a weak or dilated heart. In par 
oxysmal cardiac dyspnoea, as contradistinguished from asthma and tliaf 
due to pleural effusion, the hypodermatic injection of morphine is folio wee; 
by wonderfully good results, as pointed out 1)3* Allbut and confirmed 1)3 
Ringer. Respiration becomes comparatively free, livid Ry disappears 
and sleep is rendered possible. At first, l grain twice or thrice a weel< 
is sufficient; subsequently it may be necessar3r to gradually increase tin 
dose. This treatment more particularly applies to mitral than to aortic 
disease. 
In bronchial and pulmonary affections, irritation of the sensory end 
organs often excites cough, which is in excess of what is demanded foi 
the expulsion of the inflammatory products from the air-passages. Model* 
ate doses of morphine or opium, added to an expectorant mixture, restrain 
the cough of irritative origin, the irritation accompanying hr on 
cliitis being relieved by opium, and cough overcome so as to permit 
sleep; the secretions are also checked b3r it, so that it is a useful remedy 
especially in the declining stages of bronchitis, but a dangerous one in 
the early or congestive stage, where even a small dose may be fatal. 
In bronchial asthma, opium alone or combined thus has a most 787 
OPIUM 
decided action in giving relief and in assisting to check the morbid 
process :— 
Tinct. opii, 
Tinct. lobeli*, .. 0 ...... aa f3j. 
Ammonii iodidi, 3ij. 
Extracti grindeli* robust, fl., f§ss. 
Giycerini, q. s. ad fgiv. 
M. Sig.: A teaspoonful three or four times a day or at any time during a paroxysm. 
In pneumonia, opium is of advantage in relieving pain and excessive 
cough ; here it is best given in the form of Dover’s powder or in the 
following combination :— 
Antimonii et potassii tart., gr. j. 
Pulv. ipecac et opii, gr. xl. 
Potassii nitratis, 3j. 
M. Div. in chart* no. xx. 
Sig.: Take one every two hours, in pneumonia. 
In pneumonia and pleurisy, when the pain is severe, opium may also 
be prescribed as follows :— 
Pulveris opii, gr. iv. 
Hydrarg. chloridi mitis, gr. j. 
Pulveris aromatici, gr. xij. 
M. et ft. chart* no. xij. 
Sig.: A powder every half-hour or hour until relieved. 
1$: Pulveris ipecac et opii, 
Camphor* monobromat*, aa 3ss. 
M. et ft. capsul* no. x. 
Sig.: A capsule every half-hour or hour. 
In typhus and typhoid fevers, small-pox, and other acute fevers, 
attended by poisoned blood and great delirium and restlessness, opium 
in appropriate doses at night will often be of great service in maintain- 
ing the strength of the patient. The above combination of tartar emetic 
and opium is extremely efficacious in those cases of typhus and typhoid 
fever characterized by furious delirium, insomnia, and exhaustion. In 
various other conditions the beneficial effects of opium are apparent. 
For instance, in rupture of the uterus, bladder, or intestines, in perito- 
nitis, the only chance of recovery consists in keeping the patient fully 
under the sedative influence of opium, using the deodorized tincture in 
preference to any other form. In after-pains, in threatened abortion, in 
some cases of dysmenorrlioea, the judicious use of an opiate will afford 
immunity from suffering. 
A hypodermatic injection of morphine is of much service in ovar- 
algia, as in other forms of neuralgia. Another statement may be made 
here in regard to the efficacy of this mode of treatment in neuralgia 788 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
generally, viz., not only is the attack temporarily relieved, hut not infre- 
quently the disorder is cured, or, at least, remains in abeyance for a con- 
siderable period. Cancer of the womb, or,indeed,malignant disease wher- 
ever seated, demands, almost without exception, the administration of 
some form or preparation of opium. Here, and, in fact, as in all essentially 
painful diseases, the remedy should be given with judicious boldness. 
Excessive pain requires full doses; smaller fail to relieve pain, increase 
nervous excitement, and are prejudicial rather than beneficial. In the 
treatment of cancer, there need be little or no fear of founding the mor- 
phine habit. Opium is useful in acute suppression of the menses when 
owing to moral or emotional excitement. Severe and deep burns are always 
marked by profound shock and excruciating pain, and in these conditions 
the hypodermatic use of morphine is invaluable. Herpes zoster is an- 
other malady in which morphine, especially in union with atropine, is of 
notable service in relieving the violent, lancinating pain. 
In cough mixtures, opium or morphine is a standard ingredient, but 
codeine has advantages when the cough is spasmodic and violent:— 
Codeinse, gr. iij. 
Tinct. belladonna,. . ; . ; . . . . f 3j. 
Syr. pruni Virginian*, q. s. ad f § iij. 
M. Sig.: Take a teaspoonful, when cough is annoying, four or five times daily. 
( 
In phthisis, the above formula will be useful in checking the cough 
at night and reducing to night-sweats. 
Opium is very serviceable in treating diabetes mellitus, and is prefer- 
able to codeine, which is also recommended for this purpose. Opium is, 
perhaps, the most efficient drug which we possess in the treatment of this 
disorder. It diminishes hunger and thirst, the quantity of urine excreted, 
and the amount of sugar eliminated. The progress of the disease is 
checked and the condition of the patient ameliorated. Large doses are 
required and well-borne in diabetes mellitus. The proper plan is to begin 
with moderate doses, and rapidly, but watchfully, increase according to 
the effect of the remedy upon the glycosuria, or until sjunptoms of nar- 
cotism make their appearance. Opium is also of service in diabetes 
insipidus, though less active than in saccharine diabetes. 
In treating chronic ulcer, the administration of small amounts of 
opium several times daily will bring about a healthy condition and 
encourage healing. Given in larger quantities, 1 or 2 grains every 
three or four hours, opium is of equal value in the treatment of phage- 
daena, alleviating pain and checking the tendency to spread. This drug 
is beneficial in ulcerative stomatitis. Where there are excessive secre- 
tions opium will reduce them, as in bronchorrhoea, diarrhoea, dysentery, 
etc. In the diarrhoea of typhoid fever, opium may be judiciously and use- 789 
OPIUM. 
fully employed, and it is often successful in controlling tuberculous diar- 
rhoea. In various formulae for cholera, opium holds a prominent place. 
In infants suffering with summer complaint, enterocolitis, or cholera 
infantum, all forms of narcotics are so dangerous as to be almost pro- 
hibited. The object of treatment is evacuation and disinfection of the 
intestinal tube, with administration of sterilized food ; where this has 
been done, opium will generally not be required. In selected cases, how- 
ever, it may be given in starch-water enemata (a drop or two of laudanum 
with 5 grains of chloral hydrate), in order to afford relief from restlessness 
and pain. 
In the diseases previously referred to, opium is often so necessary in 
the treatment that we may append a few prescriptions containing this 
very important drug :— 
Pulveris opii, gr. ss. 
Pepsini sacch., 
Bismuth, subnit., aa 3ss. 
Ol. cinnamomi, Iflj. 
M. etft. chart® no. x. 
Sig.: A powder every two or three hours for diarrhoea in children. 
Extraeti opii, gr. viij. 
Pulv. ipecaeuanhae, gr. xxiv. 
Hydrargyri chloridi mitis, . gr. xvj. 
M. et ft. pil. no. xvj. 
Sig.: A pill every hour or two for diarrhoea or dysentery in adults. 
Tinct. opii camphoratae, 
Tinct. cardamom, comp., 
Tinct. lavandulae co., . aa f§j. 
Aquae menth. pip., f §iij- 
M. Sig.: One tablespoonful every two or three hours for cramps and diarrhoea. 
Tinct. opii, f3ss. 
Syrup, rhei aromatic., f3ij. 
Tinct. cardamom, comp., f§j. 
Aquae anisi, q. s. ad §v. 
M. Sig.: From one to two teaspoonfuls every two or three hours for diarrhoea of 
children. 
Tinct. opii, 
Spiritus menth. pip., 
Spiritus camphorae, 
Tinct. capsici, f3j. 
M. Sig.: Ten to forty drops every hour or two for diarrhoea with cramps. 
Tinct. opii, 
Spiritus chloroformi, 
Tinct. capsici, 
Spiritus ammoniae aromat., ....... f 3j. 
M. Sig.: Twenty to forty drops every half-hour or hour for cramps attended with 
diarrhoea. 790 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Tinct. opii camphoratse, 
Mist, cretae, 
Tinct. kino, f 
M. Sig.: From a half a teaspoonful to a tablespoonful every hour or trvo for 
diarrhoea. 
Nausea and nervous vomiting are generally alleviated by the admin- 
istration of opium. This remedy is useful in seasickness and the vomit- 
ing of pregnancy, in each of which it is apt to be more efficient if given 
subcutaneously. The same method is of value in obstinate hiccough. 
The pains of gastralgia, ulcer, and gastric carcinoma are amenable to the 
influence of opium, which is, furthermore, useful in ulcer in restraining 
haemorrhage. There is a form of dyspepsia in which opium is of signal 
service. This is of an irritative character, occurs in thin people of an 
irritable, anxious temperament, and is indicated by a dry tongue, red at 
the tip and edges. Lead colic is lessened by opium. In acute obstruc- 
tion of the bowels, due to spasm, \ grain of opium every four hours, for 
two or three days, will often relieve stercoraceous vomiting and permit 
normal evacuations. Even in faecal impaction, good results have ensued 
from the daily injection of to 1 grain of morphine. This treatment is 
adapted to instances in which the gut has been injured by con- 
gestion or inflammation.* In chronic constipation, opium alone or com- 
bined with ipecacuanha often relieves the mutable bowel and assists in 
restoring tone and a healthy action to the mucous membrane. In 
gastritis, especially the acute variety produced by alcoholism, opium 
relieves pain and vomiting. The nervous manifestations of exophthalmic 
goitre sometimes receive benefit from opium. 
The antispasmodic influence of this drug has been utilized in various 
convulsive affections. It is of undoubted service in severe cases of 
chorea in which twitchings abolish sleep, and it was given by Trousseau 
in large doses with good effects. The petit mal and nocturnal epilepsy 
are benefited b}r opium. Scanzoni and Loomis have amply demonstrated 
the safety and the value of hypodermatic injections of morphine in 
uraemic coma. Although inefficiency of the eliminative organs ordinarily 
furnishes a contra-indication to the use of this remedy, yet in this alarm- 
ing accident the morphine promotes the action of the skin and seems to 
exert a protective influence upon the nerve-centres. In tetanus, the deep 
injection of morphine into the affected muscles seems to be of some 
service. A hypodermatic injection of morphine will frequently break 
up a spasm of asthma. Opium is of advantage in emphysema, hay fever, 
and the spasmodic stage of whooping-cough. Ten grains of Dover’s 
powder alone, or, preferably, combined with an equal quantity of quinine 
* Phillips, op. cit., p. 103. OPIUM, 
791 
sulphate, will abort a cold if given in its incipient stage. Morphine is 
a reliable stimulant in surgical shock and heat exhaustion; in both 
cases it should be administered liypodermatically. In acute and chronic 
mania, and in melancholia, opium is capable, in selected cases, of afford- 
ing decided benefit, especially in melancholia. Its administration in 
cases of alienation needs, however, to be directed with enlightened judg- 
ment. Dover’s powder, in 10-grain doses, is often successful in checking 
the night-sweats of phthisis. The hypodermatic injection of a small 
dose of morphine is of avail in haemoptysis. 
Apomorphine.—As the result of a series of clinical experiments, 
Murrell* has ascertained that apomorphine, given by the mouth, is toler- 
ated in much larger doses than had been supposed. He was able to 
administer 1, or even 2 grains, thrice daily without exciting nausea. 
In these quantities he found apomorphine hydrochlorate an excellent 
expectorant in chronic bronchitis, bronchorrhoea, and emphysema. Mur- 
rell usually prescribes the apomorphine in syrup of wild cherry, syrup of 
tar or of lemon. The addition of a few drops of nitro-hydrochloric acid 
to the mixture is advantageous. The same observer has employed apo- 
morphine as a spray with very satisfactory results. He has frequently 
given as much as drachm of a 1-per-cent, solution in a little water for 
each inhalation. A combination of apomorphine and morphine is valu- 
able, and has been employed by Rossbach in phthisis. The cough 
becomes less frequent and the sputum more fluid. 
Apocodeine.—The properties of apocodeine are similar to but 
weaker than those of apomorphine. Dujardin-Beaumetz states that it 
has been found useful in hsemopt3'sis, croup, and whooping-cough, and 
recommends it in doses of grain hj-podermatically and § grain by the 
mouth. Dr. Murrell has demonstrated that apocodeine l)3’drochlorate is 
beneficial in chronic bronchitis by virtue of its expectorant properties. 
He administered it b3T hypodermatic injection, which produces no local 
irritation, provided the solution be neutral. 
Idiosyncrasy, Cautions as to Use of Opium, etc.—Some persons areex- 
tremely susceptible to even minute doses of opium or morphine, being made 
very uncomfortable l>3r it,and rendered wakeful and irritable,or annoyed 
by itching of the nose and eruptions upon the skin. When this fact has 
been ascertained some other narcotic must be selected, because opium 
would be worse than wasted upon such a case. The famity physician is 
expected to keep such an idios37ncrasy in mind when prescribing, and 
cases of this kind are not rare, by any means. 
*“On the Action of Apomorphine and. Apocodeine, with Reference to their Value as 
Expectorants in the Treatment of Chronic Bronchitis,” by William Murrell, M.D., F.R.C.P., 
in the Medical Bulletin for March, 1891. 792 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Flagg states that when opium, or any of its ordinary preparations, 
foils to produce a good effect, a solution of bimeconate of morphine 
often acts well. This preparation, he adds, is an anodyne of decided 
ellicacy where ordinary preparations of opium are idiosyncratieally 
contra-indicated. The dose is from 5 to 25 drops, as required. When 
mothers are suckling their babes, opium should be given sparingly, if at 
all, because, being partly eliminated hy the milk, it may narcotize the 
infant. As previously stated, infants are easily affected; and when 
children have coma or convulsions, and the pupils are contracted, the 
attendant may suspect that some one has administered an overdose of 
opiate to them. 
The other alkaloids and constituents of opium are not used in 
medicine. 
ORIGANUM (U. S. P.).—Origanum, Wild Marjoram. 
Dose, 3i-i.b in infusion or fluid extract. 
Pharmacology.—The entire plant of Origanum vulgare (Labiatae) is 
officinal; it is a small herb of Europe and the United States, with pale- 
purple flowers. It contains volatile oil (1 to 2 per cent.), with tannin, 
resin, and some bitter principle. It enters into aromatic wine. The oil 
is an aromatic stimulant, carminative, and counter-irritant. 
Therapy.—Rarely used internally or externally; though formerly 
employed as a diaphoretic, emmenagogue, and stimulant tonic, or as a 
fomentation for bruises and sprains. 
ORTHOSIPHON STAMINEUS.—Java-Tea. 
Preparation. 
Extradnm Orthosiphon Fluidum.—Fluid Extract of Orthosiphon. Dose, Flxx-xxx, 
largely diluted. 
Pharmacology.—Orthosiphon stamineus (Labiatse), or Java-tea, is a 
perennial plant from one to three feet in height, growing in India, the 
East Indian islands, Java, and Australia. It contains a glucoside, which 
has been named Orthosiphonin. The leaves are the portion employed. 
Physiological Action and Therapy.—This plant possesses diuretic 
properties, and has been found beneficial in diseases of the urinary 
tract. It has been given with good effect in gravel, pyelonephritis, and 
chronic cyrstitis, and is said to be serviceable also in gout. Dr. Frochard 
has reported a case in which this drug reduced ascites due to cirrhosis 
of the liver. 
OSMII PEROXIDUM.—Peroxide of Osmium, Osmic Acid. 
Pharmacology.—Osmic acid is the tetroxide of osmium. It forms 
colorless, acieular crystals, which sublime even at ordinary temperatures, 
and are easily fusible to a colorless liquid, with irritating vapor resembling PANCREATINUM. 
793 
chlorine, and capable of setting up inflammation of the eyes or of the air- 
passages. 
Physiological Action.—In animals, osmicacid is acthrely poisonous in 
doses of only a few grains. A 1-per-cent, solution in water, or water and 
glycerin, is injected subcutaneously in man in the treatment of painful 
tumors and superficial neuralgia. No reaction, as the rule, follows these 
punctures, but sanguineous cysts and boils have been reported. A pain- 
ful eruption upon the skin sometimes results from the application. 
Therapy.—In some cases of neuralgia, the injection of a few drops 
of the centesimal solution deeply into the neighborhood of the nerve 
affected affords prompt relief to pain. It has also been applied to the skin 
in treatment of chronic indurated acne and some tubercular syphilides. 
Administered internally in epilepsy, in doses of gr. daily in pill form, 
it failed to have any decided beneficial effect in the hands of Dr. 
Schroeder* (Inaug. Thesis, Univ. of Kiel). 
PANCREATINUM.—Pancreatin. 
Dose, gr. i-v. 
Preparations. 
Extraction Pancreatis.—Extract of Pancreas. Pose, gr. i-v. 
Pulvis Pancreatini.—Powdered Pancreatin. Pose, gr, v-x (usually mixed with 
powdered malt). 
Liquor Pancrcaticus.—Solution of Pancreatin. Pose, l'3i-iv. 
Pharmacology and Physiological Action.—Pancreatin is a digestive 
ferment obtained from the fresh pancreas, usually from the pig, resem- 
bling pepsin in origin, mode of preparation, physical characters, effects 
and therapeutic uses. Pancreatin contains an amylolytic ferment (similar 
to ptyalin or diastase); a proteolytic ferment (like pepsin, except that it 
is active in an alkaline medium) called Trypsin ; a fat-emulsifier (like that 
found in bile); and a milk-curdling ferment (also present in calf-pepsin). 
The product may be obtained in the form of a powder for administration, 
like saccliarated pepsin ; but a better form would be in a recent solution 
made directly from the pancreas in dilute alcohol (the pancreas is minced 
or ground, thoroughly mixed and exhausted with water, strained, and 
dilute alcohol added to preserve it), this being known as liquor 
pancreatic us. 
Pancreatin is an efficient digestive agent in an alkaline medium, thus 
differing from pepsin. It will peptonize milk, gruel, oysters, and many 
articles of food, thus rendering them more easily digested and more nour- 
ishing for the invalid. As it emulsifies fat, it will aid in the assimilation 
of codliver-oil and prevent its coming up in the throat. Trypsin will 
digest, and render soluble, mucous and fibrous deposits. 
* Therapeutic Gazette, November 15,1889, p. 786. 794 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Therapy.—In diphtheria, a spray of trypsin, or of pancreatin solution, 
will dissolve the false membrane and favor its expulsion. In haemor- 
rhage into the bladder, with the formation of clots, the deposit may be 
dissolved in the same manner as by the use of pepsin. If pancreatin be 
administered two hours after meals, it will assist intestinal digestion. 
It should be preceded by full doses of sodium bicarbonate, to insure an 
alkaline condition of the gastric contents. The pancreatin may be 
prescribed as folloivs :— 
Pulveris pancreatini, 3j. 
Hydrargyri chloridi mitis, gr. ij. 
M. et ft. chart* no. xij. 
Sig.: A powder two hours after meals. 
Liquor, pancreatici, f §iij. 
Tinct. nucis vomic*, 'he. 
Glycerini, f §ij. 
M. Sig.: A tablespoonful after meals. 
Pancreatin, or food predigested by its action, is aAmilable in cases 
of enfeebled digestion due to severe and prolonged illness and in wasting 
disease. It is frequently useful, moreover, in the vomiting of hysteria 
or pregnancy. 
PAPAIN, or PAPAYOTIN. 
Dose, gr. i-v. 
Pharmacology.—Nearly ten years ago, Wertz, of Paris, isolated from 
the milky juice of the pawpaw-tree, or Carica papaya (Passifloracese), a 
peculiar ferment, capable of rendering albuminous substances soluble. 
The attention of the profession was called to this new digestive agent by 
Dr. Finkler, of Bonn. Papain is soluble in water, though not in alcohol, 
but is active in either an acid or alkaline solution, and is more energetic 
than pepsin in dissolving false membranes. Recently Woodbury has pub- 
lished an article* stating that Mr. Mosquera, of Bolivia, has found that 
this ferment also exists in pine-apple and other plants of the natural order 
Bromeliaceee, and has applied it to the peptonizing of meat on a large 
scale, making a preparation of powdered beef, which is very easil3r 
digested and the proteid matter of which consists of 50 per cent, of pep- 
tones. It is especially serviceable in making nourishing broths as a 
substitute for beef-tea. It is known as the Mosquera-Julia beef-powder, 
for which Parke, Davis & Co. are the agents for the United States. The 
juice of the fig and many other plants possess slight digestive powers, 
as beautifully shown in the well-known Dionsea, or Venus’s fly-trap, and 
other members of the Drosera family, which Darwin found to secrete an 
acid juice which would digest small pieces of meat. 
*“On the Use of Nitrogenized Food in Fever and Wasting Diseases,” Therapeutic 
Gazette, December, 1890, p. 811. PARALDEHYDE. 
795 
Therapy.—Papain lias been used to dissolve the false membranes in 
diphtheria and croup, by the spray and by a camel-hair brush dipped in 
aqueous solution (gr. xxx or 5j-foj)- Though it accomplishes this useful 
purpose, it has no power to prevent fresh formation of the membrane, 
and must, consequently, from time to time, be re-applied. An alkaline 
solution of papain has been found beneficial in fissures and ulcers of the 
tongue. A paint containing 50 grains of papain and 25 grains of borax 
to the ounce of water has been used with success in the treatment of 
warts and eczema squamosum chronica. Papain dissolves intestinal 
worms. It has also been injected into the interior of tumors to promote 
absorption. 
In the various forms of dyspepsia, papain has been employed with 
good effect. Grineritslii recommends papain (Bull. Gen. de Therap.) in 
habitual indigestion attended with acid eructations, painful symptoms of 
gastric fermentation, and constipation. He uses 2 grains of this drug in 
sugar of milk an hour or two after taking food. The following combina- 
tion is suggested :— 
Papaini, 3ss. 
Liquor, ammonii acetatis, f§ij. 
Creasoti, Iflv. 
Glycerini, P g ij. 
M. Sig.: Two teaspoonfuls an hour or two after taking food. 
Papain has not been much used as a substitute for pepsin or pancreatin 
on account of its much higher cost, but it is probable that this may be 
overcome in time, and that a pure vegetable digestive agent of superior 
activity to pepsin, and possessing the advantage of being efficient in an 
alkaline as well as an acid medium, may be supplied at a reasonably low 
price. 
PARALDEHYDE.—Paraldehyde. ' 
Dose, hyxx-f 3ij- 
Pharmacology.—Paraldehyde, chemically, is a polymeric modification 
of aldehyde, formed by the action of a trace of sulphuric acid, or of zinc 
chloride, on aldehyde. It is a colorless, mobile liquid, dissolving in eight 
A'olumesof cold water, is less soluble in hot water, but dissolves freety in 
alcohol and ether. Paraldehyde crystallizes below 50° F. and boils at 
about 225° F. It lias a burning, unpleasant taste and a penetrating, 
ether-like odor. It may be given with syrup and a vegetable bitter, or 
with an ounce of aromatic water. 
Physiological Action.—A hypnotic agent, exercising no depressing 
effect upon the heart in ordinary doses and causing no headache or disturb- 
ance of digestion. Paraldehyde is a good substitute for chloral, especially 
in low fevers or where the heart is weak. It is also diuretic, but not dia- 796 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
plioretic. The solid constituents of the urine, it is said, are not in 
creased, though, in the case of three boj’s to whom paraldehyde was 
experimentally administered, Gordon found a marked increase of urea. 
This substance is possessed of antiseptic properties. Death, preceded by 
unconsciousness and coma, has been caused by a dose of 6 or 7 drachms 
in a patient suffering with typhoid fever (Lancet, August 20, 1890). 
The fatal result from a toxic dose is attributed to its action upon the 
respiratory centre. In some cases, it has been accused of producing albu- 
minuria, but this might be explained by the presence of cirrhotic kidneys, 
with transitory attacks of albuminuria. Paraldehyde is very rapidly ab- 
sorbed, and is eliminated by the lungs, its odor having been recognized in 
the breath twenty-four hours after administration. Paraldehyde is a 
pli3’siological antidote to strychnine. 
Therapy.—Bright’s disease does not prohibit the use of paraldehyde. 
In such cases, where insomnia is persistent, the dose should be nyxxx-xl 
to commence with, given at the bed-hour, and cautiously increased to 
a drachm if necessary. In the irritability, restlessness, and insomnia 
attending heart disease, 20 drops may be given every four hours, with 
large doses at night, with marked benefit. In bronchitis, pneumonia, 
and headache, paraldehyde is generally less useful than chloral hydrate 
and bromide, but in phthisis with persistent insomnia, in 40-minim doses 
at bed-time, it produces a natural sleep lasting twelve hours. Some pa- 
tients, however, complain of headache next day and persistent drowsi- 
ness, so that it soon has to be discontinued. Paraldehyde is, perhaps, 
particularly applicable to wakefulness associated with psychical disturb- 
ances. Yery favorable accounts have been given by various observers 
of its beneficial influence in the cerebral manifestations of hysteria, in 
mania, melancholia, and in the general paralysis of the insane. Paral- 
dehyde is the preferred hypnotic* in the neurological clinic at Porpat. 
It seldom fails to produce a good night’s sleep; though, in some instances, 
tolerance is soon established. It may give rise to indigestion and diar- 
rhoea, but its use is not followed by headache and depression. It has been 
used with advantage in delirium tremens, morphinism, and epilepsy. 
Paraldehyde, in order to disguise its unpleasant taste, may be admin- 
istered as follows :— 
Paraldehydis,. „ * f §ss. 
Olei gaultheri®, ffix vel xx. 
Pulveris acaciae, ..." 3ij. 
Syrupi pruni Virginian®, q. s. ad f §iv. 
M. et ft. enmlsio. 
Sig. A half to a tablespoonful in water every hour or two. Use as a hypnotic, or 
to lessen bronchial or pulmonary iriitation. 
* “The Hypnotic Efficiency of Paraldehyde,” New York Medical Journal, November 
29, 1890. PAREIRA. 
797 
With the combined administration of caffeine (4 to 8 grains daily) 
and paraldehyde (30 to 45 drops at night), Cevello found, in cases of 
oedema, ascites, and pleuritic effusion, that the amount of urine was 
greatly increased. 
PAREIRA (U. S. P.).—Pareira, Pareira Brava. 
Dose, 5ss-j, in infusion (1-17) or fluid extract. 
Preparation. 
Extraction Pareira Fluidnm (U. S. P.) —Fluid Extract of Pareira. Pose, f3ss~j. 
Pharmacology.—The root of Chondodendron tomentosum (Meni- 
spermacete) is officinal as Pareira ; products of allied genera also appear 
in commerce under the name of “ false Pareiras.” It is a climbing, 
wood}*- vine of Brazil, where it is extensively used as a medicine. Pareira 
contains Buxine, a bitter, somewhat tonic alkaloid; found also in false 
pareiras and other plants occasionally employed in medicine. Buxine 
is identical with the beberine of Nee tan dr a, and is the active principle of 
box-wood ; it has also been known as “ pelosine,” or “cissampeline.” 
Physiological Action.—Pareira is slightly tonic, but is esteemed 
principally as a diuretic and laxative, though, probabl}', without much 
reason. 
Therapy.—It is principally used in fluid extract, decoction, or infu- 
sion, with alkalies, in the treatment of irritable bladder, cystitis, pyelitis, 
chronic urethritis, and leueorrhoea. In South America it is given for 
snake-bite, and applied externally to the wound. 
PEPO (U. S. P.).—Pumpkin-Seed. 
Dose, 5i—U- 
Pharmacology.—The seeds of Cucurbita pepo (Cucurbitacese), or 
pumpkin, contain a resin, an alkaloid, Cucurbitine, oil, starch, sugar, etc. 
The seeds are crushed and beaten into a paste with milk and white sugar, 
and the resulting emulsion strained ; or the seeds may be decorticated 
first and the contents rubbed up with sugar and milk, or sugar and 
water. 
Therapy.—The principal medicinal use of pepo is for destroying 
tape-worms. It is generally efficient, cheap, and not very difficult to 
take. A preliminary purge of calomel should be given iii the morning 
and the emulsion swallowed fasting at night. In the morning, a laxa- 
tive (castor-oil, Rochelle salt, etc.) is administered, and the tape-worm is 
discharged, with the head. It is said that the resin (in doses of gr. xv) 
or the fixed oil (in doses of fsss) are also efficient when administered in 
the same manner. The combination of oleoresin of aspidium (or male 
fern) is very serviceable in destroying the tape-worm :— 798 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
If Oleoresinae aspidii, . f3j. 
Chloroform!, IHx. 
Emulsion, peponis,. ......... f^xij. 
M. Sig.: To be divided into two doses, to be taken one hour apart, and followed by 
castor-oil an hour later. 
PEPSINUM SACCHARATUM (U. S. P.).—Saccharated Pepsin. 
Dose, gr. x. 
Preparations. 
Liquor Peps ini (U. S.P.).—Solution of Pepsin (saccharated pepsin 40, hydrochloric 
acid 12, glycerin 400, water q. s. ad 1000 parts). Lose, f §ss. 
Pepsinum in Lamellis.—Pepsin in Scales, Pure Pepsin. Lose, gr. i-ij. 
Vinum Pepsini.—Wine of Pepsin. Lose, f'3i-ij. 
Glycerol Pepsini.—Glycerol of Pepsin. Lose, ttlx-xxx. 
Vinum, Pepsini Seriparum.— Rennet-Wine. Lose, f 3j—§j. 
Glyceritum Pepsini Vitidini.—Glycerite of Calf-Pepsin. Lose, f 3i-iv. 
Pharmacology.—Of the numerous methods proposed for obtaining 
for medicinal use the digestive ferment from the gastric mucous mem- 
brane of certain domestic animals (hog, calf, sheep, principally) the most 
prominent are (1) scraping the acid mucous secretion from the surface 
of the stomach, spreading on glass and drying in scales (Beale); 
(2) extracting by maceration in acidulated water and precipitation with 
alcohol or lead acetate, and (3) by precipitation with sodium chloride. 
(Scheffer.) The digestive preparations of the United States Pharmacopoeia 
are based upon the results of Professor Scheffer’s experiments; they are 
one solid and one liquid. Saccharated pepsin is pepsin obtained from 
the gastric mucous membrane of the hog, mixed with sugar of milk. 
It is a white powder, of a peculiar but not disagreeable odor and taste, 
and a slightly acid reaction. One part dissolved in 500* parts of water, 
acidulated with parts of hydrochloric acid, should digest at least 50 
parts of hard-boiled-egg albumin in five or six hours at a temperature of 
38° to 40° C. (100° to 104° F.). Liquor pepsini, or solution of pepsin, 
is an acidulated solution of the preceding, containing glycerin (40 per 
cent.). It is an artificial gastric juice, with an agreeable, acidulous 
taste; it should not become moldy, nor acquire a fetid odor when kept 
for some time. Many kinds of pepsin are upon the market, varying 
greatly in purity and digestive activity. Those containing a considerable 
quantity of mucus, which have a strong odor of the pig-sty, and 
which do not prove to have digestive activity when tested with boiled 
egg-albumin, should be rejected. Under comparative tests made by 
Professor Chittenden not long ago, the pepsinum in lamellis, made by 
Parke, Davis & Co., was found to have the greatest digestive power and 
to be the purest in the market at that time. The glycerole of pepsin, 
madeby the same house, is also a very active preparation. The pepsin prep- 
arations of Messrs. Fairchild Bros. & Foster, of Xew York, are likewise PEPSINUM SACCIIARATUM. 
799 
active and acceptable agents, and are very largely used. Pepsin requires 
an acid medium in order to exert its digestive power upon albumin, 
while trypsin, or pancreatin, is active in a neutral or alkaline solution. 
As already stated, papain or papayotin is also active in either acid or 
alkaline solutions. A preparation from the same plant (Carica papa}Ta) 
is sold under the name of Papoid, and is claimed to have special utility 
in dissolving false membranes. (See Pancreatinum, page 798.) 
Physiological Action.—Pepsin is a constituent of normal gastric 
juice, associated with hydrochloric acid. It is a complex, albuminous 
substance, capable of causing changes in other albuminoids by a proc- 
ess similar to fermentation, or catalysis, converting them into peptones 
or albumoses. It also converts blood-coagula, fibrin, etc., from the 
solid to the soluble or liquid state. It is an unorganized ferment, peculiar 
to gastric juice of the higher animals, although similar ferments have been 
discovered in carnivorous plants, and in the paw-paw, pine-apple, etc. 
Alcohol precipitates pepsin, and, even in dilute form, checks its activit}'. 
Alkalies and some mineral salts also precipitate it. 
Therapy.—Pepsin, in concentrated solution, may be localty applied 
to digest blood-clots in the urinary bladder; and, in atomized solution 
or spray, to dissolve the false membrane in diphtheria and croup. In 
the former affection the diphtheritic membrane may be treated wdtli 
this solvent, containing pepsin :— 
Pepsini (in lamellis), 3ij. 
Acidi hydiochlorici dil., lllx. 
Aquae menth. pip., 
Glycerini, .......... aa f^ss. 
M. Sig.: Paint over the surface several times a day. 
A 5-per-cent. solution of scale-pepsin, in lanolin, is a useful applica- 
tion to clean off old ulcers. In connective-tissue tumors of non-malignant 
character pepsin may be used by parenchj'matous injection to promote 
absorption. Mr. John Clay has seen good results follotv the application 
of pepsin to cancer of the cervix uteri. He states that much of the neo- 
plastic tissue be destroyed, and that in some instances an apparently 
sound surface is obtained. The chief use of pepsin is to aid w’eak diges- 
tion and it is invaluable in atonic dyspepsia, especially following acute 
diseases. While the stomach should not be expected to depend entirely 
upon outside sources for its gastric juice, yet, in conjunction with hy- 
gienic treatment, the temporary resort to pepsin is followed by the best 
results. Given in this manner pepsin acts, in fact, as a true stimulant to 
the gastric glands and promotes their functional energy. In chronic mal- 
adies, such as anaemia, chlorosis, diabetes, tuberculosis, and carcinoma, 
the administration of pepsin is of service by promoting nutrition. In  PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
malnutrition, foods may be partly'' peptonized previous to administration, 
thus saving time in stomach digestion. The use of peptonizing tubes,each 
containing sufficient for a pint of milk,is of great assistance in preparing 
such food, especially in the ease of infants. In irritable stomach, pepsin 
acts as a sedative, and may be given in conjunction with subnitrate of 
bismuth or minute doses of calomel:— 
Pepsini (in lamellis), 
Bismuth, subnit., aa 3j. 
Olei cinnamomi, Hjxij. 
M. et ft. capsulae no. xij. 
Sig.: A capsule after meals. 
Hydrarg. chlor. rnitis, gr. j. 
Pepsini saccharati, 3j. 
Pulv. myristicae, gr. iv. 
M. et ft. chart, no. xij. 
Sig.: Take one every half-hour to relieve nausea and vomiting. 
Pepsin is also useful in gastralgia, pyrosis, gastric catarrh, and 
apepsia of infants. In gastric cancer or simple ulcer, feeding may” be 
carried on by the rectum, provided some pepsin be added to the nutri- 
tive enemata. But this remedy', when given by the mouth, is. frequently 
of value in relieving the vomiting due to ulcer or cancer of the stomach. 
Sickness of the stomach, produced byT indigestion, is generally relieved 
by pepsin, which is sometimes able, also, to allay the vomiting of preg- 
nancy. Infantile diarrhoea, excited by the presence of undigested food in 
the intestinal tube, is markedly' benefited by the administration of pepsin. 
The most satisfactory shape in which to administer pepsin is in its pure 
form, as the saccharated pepsin is too w'eak to have much digestive 
power:— 
Pepsini (in lamellis), 3j. 
Ext. nucis vomicae, , . gr. v. 
Pulv. ipecac., gr. ij. 
Pulv. aromat., . . . gr. xv. 
M. et ft. pil. vel capsulae no. xxx. 
Sig.: Take one immediately after meals for atonic dyspepsia. 
$ Gljrcerol. pepsin., f§j. 
Acid, hydrochlor. dilut., ........ f3j. 
Aquae anethi, f §iss. 
M. Sig.: Take a teaspoonful after meals for indigestion. 
Pepsini (in lamellis), . gr. cc. 
Stryclminae sulpliatis, gr. %. 
Aloini, gr. ij. 
01. menth. pip., Hlj. 
M. et ft. capsulae no. xx. 
Sig.: A capsule after meals. For atonic dyspepsia accompanied by constipation. PERSIA. 
801 
Rennet-wine is obtained by macerating calves’ stomachs in sherry or 
other light wine. It is useful in apepsia in infants ; but the glycerite of 
calf-pepsin is a more active and eflicient preparation. 
PERSIA.—Cudbear. 
Pharmacology.—A dark, purplish powder, prepared from certain 
lichens (Lecanora tartarea, and other species). It yields a coloring 
matter to alcohol, and is principally used in dyeing. The tincture of 
cudbear, tinctura persionis, is used as a coloring agent for liquids. 
PETROLEUM.—Rock-Oil. 
Preparations. 
Petrolatum (U. S. P.).—Petroleum Ointment. A semi-solid substance, consisting of 
hydrocarbons, chiefly of the marsh-gas series, obtained by distilling off the lighter and more 
volatile portions from American petroleum and purifying the residue. 
Bhigolenum.—Rhigole.ne. Used with atomizer to anaesthetize a part by cold. 
Benzinum.—Benzine. Bose, ITlx-xxx, in mucilage or capsule. (See page 473.) 
Pharmacology.—Petroleum is a very complex fluid, of natural origin, 
known from time immemorial, and found in various regions of the Old 
and New World. In this country the principal source of supply is the 
wells of Pennsylvania, though it exists in Ohio, Western 
Virginia, and Kentucky. Crude petroleum, though occasionally clear, 
usually presents a greenish tinge. Its specific gravity varies from 
0.865 to 0.771. Petroleum consists chiefly of two homologous series of 
isomeric hydrocarbons, at one extremity of which marsh-gas is found 
and solid paraffin at the other. It is not a fluid of definite composition 
or fixed boiling-point. American petroleum consists chiefly of paraffins. 
Barbadoes tar, Seneca oil, and Rangoon oil are thick varieties of petro- 
leum. The Rangoon oil contains a larger proportion of both the olefine 
and the benzole series than American oil. Oxygen, nitrogen, and sul- 
phur have been found in certain varieties of petroleum, but are present 
as impurities, though, according to H. Void, all kinds of petroleum 
contain sulphur. 
Petroleum does not saponify. It is soluble in ether, but nearly in- 
soluble in chloroform; it is a solvent for caoutchouc and many resins. 
By fractional distillation and purification, it yields a number of commer- 
cial products, the lighter oils being used as solvents, the heavier for 
illumination, fuel, and various mechanical purposes. 
Naphtha, a name which was formerl}1- applied to the lighter varieties 
of crude petroleum, is now used to designate all that portion which dis- 
tills over at or below 122° F. By repeated fractional distillations the 
most volatile hydrocarbons are obtained from naphtha. Benzine con- 
sists of the more volatile portions, being very inflammable, and yields 802 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
vapors, which, if combined with air, are explosive. Coal-oil for illuminating 
purposes consists of less volatile hydrocarbons, which should not evolve 
explosive vapors under 110° F., and the better oils require 150° or over. 
Petrolatum, petroleum-jelly, or petrolatum ointment,is “a semi-solid 
substance, consisting of hydrocarbons, chiefly of the marsh-gas series 
(C16H34, etc.), obtained by distilling off the lighter and more volatile 
portions from American petroleum and purifying the residue.” It has a 
melting-point about 104° to 125° F., the first constituting the softer, the 
second the firmer variety. It is an amorphous, pale-yellowish, odorless, 
tasteless, or nearly so, transparent, fatty substance, in thin layers more 
or less fluorescent. Petroleum is insoluble in water, scarcely soluble in 
cold absolute alcohol, soluble in 64 parts of boiling absolute alcohol, 
soluble in ether, chloroform, fixed and volatile oils. Petrolatum is com- 
monly sold as cosmoline, A’aseline, aboline, etc. It does not become 
rancid, and is used as a basis for ointments as a substitute for lard. It 
can also be obtained as a liquid oil by the name of fluid cosmoline, 
vaseline, etc. The properties and actions of benzine have already been 
described. 
Physiological Action.—Petroleum possesses decided antiseptic power, 
is stimulant, and, taken internal!}' in small quantities, is antispasmodic, 
diaphoretic, and expectorant. It disinfects the gastro-intestinal and 
respiratory mucous tracts. In large doses it gives rise to headache, 
vertigo, pain in the throat and stomach, palpitation of the heart, 
vomiting, and tetanic spasm. 
Therapy.—Rock-oil is seldom professionally prescribed, but enjo}Ts 
considerable popular repute both as an internal and external reined}’. 
As a counter-irritant it is used in chronic rheumatism, synovitis, sprains, 
chilblains, and paralysis. It is likewise applied to the neck or chest for 
inflammatory affections of the throat and air-passages. Petroleum, alone 
or combined with other drugs, has been employed in psoriasis, eczema, 
seborrhoea, scabies, and almost every variety ot skin disease. In eczema, 
Kaposi recommends the following :— 
II- Petrol ati, 
Emplast. plumbi, . . aa §ss. 
Dissolve and thoroughly incorporate with the aid of heat, and add a little oil of 
bergamot to flavor, if desired. 
Sig.: Apply to the affected surface on soft cotton or linen. 
The stimulating properties of petroleum render it of service in loss 
of hair and alopecia circumscripta. Petrolatum has been widely em- 
ployed as an unguent, and as a basis with which to incorporate more 
active topical medicaments. It is cleanly, devoid of odor, is net subject 
to alteration, and is available when the object is solely to cover the in- PETROLEUM. 
803 
tegument with a bland protective layer. It frequently happens, how- 
ever, that petrolatum contains irritant constituents which have not been 
removed in the process of manufacture, and which render this substance 
useful as a stimulant ointment. 
When it is desired that a fatty material should penetrate the skin, 
one of the animal fats—as lard, suet, butter, or lanolin—is entitled to 
the preference as an ointment base.* 
Liquid Cosmoline, vaseline, and other similar, petroleum, liquid fats 
are now prepared and are available as applications for bougies, catheters, 
and other instruments. Liquid petrolatum, in one of the forms named, 
has also been employed, by means of the atomizer, in inflammatory 
conditions of the nares, and after operations upon these and other parts 
of the body. Liquid petrolatum has also been used as a menstruum for 
suspending various substances in it, for external and internal use. Some 
clinicians have been incorporating certain of the mercurial salts in liquid 
petrolatum, and employing the combination for hypodermatic injections 
into the tissues. 
Internally, the crude oil has been given, in the oil regions, in tea- 
spoonful doses to children suffering with croup and whooping-cough, 
with asserted good results. It is occasionally given in chronic bronchial 
and pulmonary disorders with advantage. It is employed in Germany 
as a vermifuge, dose 20 to 30 drops. The finer qualities of petroleum 
have been given with success in cholera in doses of 10 to 20 drops in 
mint-water or white wine. 
The vapor of naphtha has some irritating qualities to mucous mem- 
branes, and produces oedema of the eyelids. In a case reported recently 
by Dr. J. Leidy. Jr., a man was rendered unconscious by breathing the 
vapors of naphtha from’ a tank, which he was set to work to clean. The 
inhalation of naphtha vapor has been recommended in asthma. 
Rhigolene, one of the lightest products of the distillation of petroleum, 
is an extremely volatile fluid, boiling at about F. So great is 
the rapidity of its evaporation, that local temperature is depressed to 
15° F. by a spray of rhigolene. The fluid should be kept in a cool place 
and in tightlj'-corked bottles. It can be used with a hand-atomizer to 
produce cold for local anaesthesia, as a substitute for ether. Rhigolene 
sprayed upon the skin soon deadens sensibility and facilitates the per- 
formance of any brief surgical operation. Its garlicky odor and inflam- 
mability are objections to its use, except in the histological laboratoiy, 
where it is employed to freeze specimens for section-cutting. Paque- 
lin’s tliermo-cautery is fed by one of the lighter hydrocarbons of 
petroleum. 
* See Diseases of the Skin, p. 74; also Ointments and Oleates, second edition, pp. 244, 245. 804 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
PETROSEUNUM.—Parsley. 
Dose, gr. xxx-5ij ; or in infusion (sj to Oj), f^ss-ij. 
Pharmacology.—The root of Petroselinuin sativum (Umbelli ferae) 
contains a neutral principle, Apiin, soluble in alcohol and water; also a 
volatile oil. Parsley-root is carminative, diuretic, and emmenagogue. 
'It is likewise slightly laxative, and stimulates the circulation, the skin, 
and bronchial mucous membrane. The seeds of parsley yield a peculiar, 
oily principle known as Apiol (see page 447). A new principle, termed 
Cariol, has recently been extracted from the same source by Mourgues 
and Laborde, who have studied the physiological effects of the active 
principles. Thrown under the skin or into a vein of guinea-pigs, cariol 
determined genital liyperaemia, increased urination, and, subsequently, 
general tremors and slight convulsions, paresis or motor inco-ordination, 
and, finally, death from asphyxia. The spinal cord in the dorso-lumbnr 
region Avas markedly congested. The uterine vessels of a bitch became 
engorged when cariol Avas injected into the circulation. Both apiol and 
cariol possess excito-motor properties, and their physiological action 
justifies their employment in genito-spinal atony.* 
Therapy.—The fresh root is preferred, of which a hot infusion is 
administered in amenorrhcea and dysmenorrhoea. Parsley is also useful 
as a diuretic in dropsy, strangury, gonorrhoea, etc. 
PHENACETINE.—Para-Acetphenitidin. 
Dose, gr. ii-viij. 
Pharmacology.—A coal-tar product, analogous in composition to 
acetanilide, occurring in white, crystalline powder, of slightly bitter 
taste, without odor; soluable in alcohol, glycerin, lactic acid, and spar- 
ingly in water. It is not toxic in ordinary doses, and does not appear to 
be followed by dangerous depression, as is the case with some other 
members of the aromatic group of coal-tar products. The drug should 
be chemically pure.f It is stated that some pharmacists have dispensed 
phenacetine mixed with acetanilid, on account of the lower price of the 
latter. The comparative solubilitj' of the two substances iu water affords 
a ready means of detecting this adulteration. 
Physiological Action.—A nervous sedative, with little effect upon the 
circulation. In very large amounts, Hare claims that it is more apt to 
disintegrate the blood than antipyrin, but its influence upon other vital 
functions is not so se\rere, and it is therefore less dangerous. Phen- 
acetine is not, however, totally devoid of toxic influence. Cases haA'e 
been reported in which vomiting, collapse, cyanosis, vertigo, profuse 
sweats, and an urticarial rash have followed its administration. These 
* La Tribune Medicate, Nos. 2, 3, and 4, 1891. 
f Pharmaceutical Record, December 1, 1890. PHENACETINE. 
805 
after-effects are of less frequent occurrence than those produced by anti- 
febrin or antipyrin.* Plienacetine slightly reduces normal bodiW heat, 
but more decidedly when pjTrexia is present. It acts upon sensory nerves 
and relieves pain and spasm. In some cases an hypnotic effect seems 
to be produced. It favors the action of the skin and kidneys, but is not 
decidedly diuretic. 
Therapy.—Plienacetine was originally introduced into medical prac- 
tice as an antipyretic, and subsequently was found to possess analgesic 
powers, resembling antipyrin in this respect. In diseases attended by 
hyperpyrexia, such as rheumatism, pneumonia,typhoid fever, and phthisis 
pulmonalis, plienacetine exerts a very happy effect in about half the dose 
of antipyrin, the ordinary dose being from 3 to 8 grains (Hinsberg and 
Kast). The mortality of the typhoid fever of children has been very 
materially reduced by the employment of plienacetine, or acetanilid. The 
fall of temperature does not occur until half an hour after the drug has 
been taken, and the reduction continues for four to eight hours. As an 
antipyretic, it is considered by many good authorities as the safest and 
most efficient member of the aniline group. Some, on the contrary, have 
not so much confidence in it as in other drugs for the prompt and certain 
relief of pyrexia. In epidemic influenza, plienacetine rapidly relieves the 
muscular pains and favors diaphoresis; the catarrhal symptoms subse- 
quently require other remedies. In ordinary colds, one or two 5-grain 
powders of plienacetine rapidly remove all the symptoms. Where fever is 
present, the combination of salol with plienacetine is especially useful in 
influenza and rheumatism. Pills containing grains each of phenacetine- 
Bayer and salol are furnished by the well-known firm of W. H. Schieffelin 
<fc Co., New York. The analgesic effects of plienacetine are very marked in 
various forms of headache, including migraine and the headaches from 
eye-strain, having the advantage over antipyrin in not so frequently 
causing a rash. In the neuralgic pains of tabes dorsalis, in herpes zoster, 
and intercostal neuralgia, 5-grain doses, given every hour for three or 
four hours, usually afford complete relief and cause sleep. Phenacetine 
is extremely useful in chronic neuritis, and, according to Kater, is unsur- 
passed in the treatment of cerebral disorder due to excessive indulgence 
in alcoholic drinks :— 
Phenacetin., gr. cc. 
Tinct. humuli, . . . f^iij. 
Tinct. capsici, f3ij. 
Glyceriui, . . q. s. ft. f^v. 
M. Sig.: A teaspoonful every hour or two for acute alcoholism 
* Dr. Goldmann, “Drawbacks to the Use of the New Antipyretics,” Medical Bulletin, 
June, 1890. 806 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Phenacetin., 
Lupulini, aa 3j. 
M. et ft. capsulae vel chartae no. xij. 
Sig.: Use every hour or two for neuralgia and insomnia. 
For migraine the following powder, containing phenacetine, is often 
beneficial:— 
Phenacetin., 
Caffeinae citratis, 
Pulv. aromatici, aa 3ss. 
M. et ft. chartae no. xv. 
Sig.: A powder every two or three hours. 
In whooping-cough, doses dissolved in 10 drops of glycerin 
are readily taken by children, and afford prompt relief, permitting sleep 
and ameliorating the attacks :— 
Phenacetin., gr. viij. 
Spt. vini rectificati, f3ij. 
Elixir, erythroxyli, f§j. 
Glycerini, q. 6. ft. f§ij. 
M. Sig.: A half a teaspoonful every hour or two for a child. 
In delirium, a dose of 10 grains will usually afford a quiet night. 
Franz Mahnert* considers phenacetine a specific in acute articular rheu- 
matism, as it reduces fever, relieves pain, and lessens the duration of the 
attack. It has been found useful in some cases of gonorrhoeal rheuma- 
tism, and is worthy of more extended trial in this rebellious affection. 
Given several hours before the time of the paroxysm of intermittent 
fever, it prevents the chill, but does not obviate its recurrence. In 
insomnia from simple exhaustion, phenacetine acts admirably. The fol- 
lowing prescriptions, containing phenacetine, will be found convenient for 
the diseases just named :— 
E Phenacetin., 
Quininae sulphatis, aa 3j. 
M. et ft. capsulae no. xij. 
Sig.: A capsule or two before the time for paroxysm of intermittent fever. 
Phenacetin., 3iv. 
Glycerini, 
Elix. erythroxyli, aa f^iij. 
' M. Sig.: A teaspoonful or two every hour or two lor neuralgia, muscular rheumatism, 
and in insomnia. 
PHOSPHORUS (U. S. P.).—Phosphorus. 
Dose, gr. 
Preparations. 
Aeidum riiospliormim (U. S. P.).—Phosphoric Acid (page 384). Dose, hfii-xx. 
Oleum Phosphoratum (U. S. P.).—Phosphorated Oil (1 per cent.). Dose, ltli-v. 
Pilidce rhosphori (U. S. P.).—Phosphorus Pills (each gr. xJjj). Dose, one to five. 
* Annual Univ. Med. Sciences, 1890, vol. v, p. A-105. PHOSPHORUS. 
807 
Zinci Phosphidum (U. S. P.).—Phosphide of Zinc. Pose, gr. 
Liquor Phosphori (N. F.).—Thompson’s Solution of Phosphorus (each fluidrachm 
contains about grain of phosphorus preserved in absolute alcohol and glycerin). Pose, f3j. 
Elixir Phosphori (N. F.).—Elixir of Phosphorus (each fluidrachm contains grain 
in glycerin, alcohol, and elixir). Pose, f3i-ij. 
Elixir Phosphori et Hurts Vomicee (N. F.).—Elixir of Phosphorus and Nux Yomica 
(same as preceding, except that to each fluidrachm is added the equivalent of 2 minims of 
tinctureof nux vomica). Pose, f3i-ij. 
Tinctura Phosphori (Bellevue).—Tincture of Phosphorus (used in Bellevue Hospital). 
Twice the strength of the solution of phosphorus of the National Formulary. Pose, Hlx-xxx. 
Resina Phosphori.—Resin containing 4 percent, of Phosphorus. Pose, gr. ){-]. 
The officinal hypophosphit.es are of lime, iron, potassium, and sodium ; 
their preparations are :— 
Syrupus Hypophosphitum (U. S. P.).—Syrup of Hypophosphites (contains of the lime 
salt 35, sodium and potassium salts 12 each, citric acid 1, spirit of lemon 2, sugar 500, and 
water q. s. ad 1000 parts). Pose, f3j—§j. 
Syrupus Hypophosphitum cum Ferro (U. S. P.).—Syrup of Hypophosphites with Iron 
cent, of lactate of iron added to the preceding). Pose, f3j—§j. 
Syrupus Hypophosphitum Compositus (N. F.).—Compound Syrup of the Hypophos- 
phites (each fluidrachm contains lime hypophosphite, gr. ij; sodium and potassium hypo- 
phosphite, aa gr. j; iron and manganese hypophosphite, gr. %; quinine hydrochlorate, gr. 
; and tincture of nux vomica, IT Pose, f3j—§j. 
Liquor Hypophosphitum Acidus.—Acid Solution of the Hypophosphites.* Pose, f3i-iv. 
The officinal phosphates are of ammonia, iron (also pyrophosphate 
of iron), soda (and sodium pyrophosphate), and the precipitated phos- 
phate of lime. The preparations are :— 
Syrupus Calcii Lactophosphatis (U. S. P.).—Syrup of the Lactophosphate of Lime (con- 
tains of the precipitated phosphate 22, lactic acid 33, orange-flower water 80, sugar 600, 
hydrochloric acid, water of ammonia, and water q.s. ad 1000 parts). Pose, f3i-iv. 
Syrupus Fend, Quinines, et Strychninee Phosphatum (U. S. P.).—Syrup of the Phos- 
phates of Iron, Quinine, and Strychnine (contains iron phosphate 1.33, quinine 1.33, strych- 
nine 0.04, phosphoric acid 8, sugar 60, water q. s. ad 100 parts). Each drachm represents 
of strychnine about gr. Pose, f3j. 
Syrupus Phosphatum Compositus (N. F.).—Compound Syrup of the Phosphates, or Par- 
rish’s Chemical Food (each fluidrachm contains of lime phosphate, gr. ij; iron phosphate 
and ammonium phosphate, gr. j each; and smaller quantities of phosphates of sodium and 
of potassium). Pose, f3i—ij. 
* In the Philadelphia Medical Times, vol. xiv, p. 93, is a short communication by Geo. S. 
Gerhard, M.D., on “ An Acid Solution of the Hypophosphites,” for use where patients object to 
the dead sweet of the syrup. The formula is as follows (sometimes called Hayes’s Solution of 
the Hypophosphites) 
R Calcii hypophosphit., 
Potassii hypophosphit., 
Sodii hypophosphit., aa gr. j. 
Quininae hypophosphit., 
Manganesii hypophosphit., aa gr. 
Ferri hypophosphit., gr. 
Strychninae hypophosphit., gr. TJB. 
Glycerini, TTgilj. 
Syr. acid, hypophosphorici, Tipi j. 
Aquae, . . q. s. ad fSij. 
M. et ft. solutio. 808 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Pharmacology.—Phosphorus, a noil-metallic element, was obtained by 
Brandt, in 1G69, from urine. It is a soft, flesh-colored solid, very inflam- 
mable, oxidizing upon exposure to the air. Phosphorus melts at 110° F., 
and friction causes it to ignite at ordinary temperatures. It possesses 
an alliaceous odor, is insoluble in water, sparingly soluble in alcohol, 
ether, and chloroform; more soluble in oils, and dissolves readily in 
bisulphide of carbon. Occurs in nature as tribasic phosphate of lime in 
primitive and volcanic rocks, and in the bones of vertebrates. In brain- 
and nerve- tissue it exists in combination with fat as lecithin ; and in all 
vascular structures, in the form of triple phosphate, it is an important 
constituent. It is excreted in small quantity normally by the urine in the 
form of phosphates; occasionally when oxidation is interfered with or an 
excess of phosphorus introduced into the blood, it is excreted in its own 
form b}r the breath, urine, and perspiration, making the person luminous ; 
iu cancer of the breast, it has appeared in the discharge, making the sur- 
face sufficiently luminous to see the figures upon the dial of a watch. 
Phosphorus is likewise eliminated the liver. 
Physiological Action.—In medicinal doses the action of phosphorus 
upon the nervous system is that of a tonic and stimulant, and it also 
accelerates cell-growth in organs and tissues and particularly in the skin. 
On the circulation it acts primarily as a stimulant, making the pulse 
fuller and more frequent; the capillary expansion is flushed, and free per- 
spiration follows; as a consequence, the temperature of the surface is at 
first slightly raised, but subsequently falls several degrees. The kidneys 
are also flushed, the quantity of urine becomes larger, the proportion of 
urates and urea are decidedly increased; haematuria often results from 
a poisonous dose. No influence is observed upon the digestion from 
small doses, though larger ones cause irritation. Muscular power is 
enhanced and the sexual appetite stimulated. Mental operations are 
easily performed, and it is said that tactile sensibility is heightened. 
The body weight is increased. Jaundice may occur from interference 
with the function of the liver, and biliary acids ma}' appear in the urine. 
The nutrition of the ckin is affected, and this is especially seen in chronic 
skin diseases. Wegner has shown that phosphorus also exerts a marked 
influence in promoting the growth of bone. The preceding observations 
apply to phosphorus in substance, and not to its compounds to the same 
extent; although these also have been found useful as reconstructives, 
especially the lacto-phosphate of lime and the hypophosphites. 
Phosphorus in substance is very inflammable and produces extremely 
painful burns. Death has been caused by inflammation following a 
* Carpenter’s Human Physiology. Dr. F. G. Smith, Ed. Am. Edition, Philadelphia, 1876, 
p. 550. PHOSPHORUS. 
809 
burn of the end of the index finger, due to some of the phosphorus from 
a parlor-match getting under the nail. 
Toxic Effects.—In single poisonous doses phosphorus is a violent irri- 
tant, causing gastric inflammation ; and if death does not quickly occur, 
fatty degeneration of muscular tissues and acute j’ellow atrophy of the 
liver will follow. This result may also succeed the medicinal use of phos- 
phorus, when continued too long, or if the dose be considerable. When 
the poisonous action is very slow, as where workmen are exposed to the 
fumes of phosphorus in making friction-matches, the toxic effects are 
shown by the death of certain bones, particularly the jaw-bone. This 
occurs frequently, and is known as “phosphor-necrosis.” 
Acute Phosphorus Poisoning.—When, as not rarely happens, an infu- 
sion of match-heads is swallowed, or phosphorus-paste* used for poisoning- 
rats is taken with suicidal intent, or an overdose of a medicinal prepara- 
tion of crude phosphorus is swallowed, the first symptom is pain and 
burning at the epigastrium, with vomiting. The vomited matter and even 
the stools are sometimes phosphorescent, with intestinal irritation and 
purging, and death occurs from exhaustion. The blood is robbed of its 
oxygen, becomes black, unusually liquid, and loaded with products of 
decomposition ; the capillary tissues y ield and the extravasations of 
blood produce purpura, hsematuria, and haemorrhages. Temperature 
is reduced, jaundice is frequent, and convulsions and coma are not un- 
common. One and a halt grains of phosphorus have proved fatal. 
Antidotes.—The best antidote is sulphate of copper, used freely as an 
emetic, followed by sulphate of magnesia to clear the intestinal canal. 
Albuminous and mucilaginous drinks, in which magnesia hydrate is 
suspended, are useful. Oil, being a solvent of phosphorus, should be 
avoided, except old French oil of turpentine, which contains oxygen and 
is a chemical antidote. Oxygen inhalations have been proposed to over- 
come the depression due to altered blood. If the poison has been re- 
tained for a time, death will occur from the fatty degeneration of the 
stomach, liver, and other organs. Phosphor-necrosis may be prevented 
b}' thorough ventilation ot the work-room, or by the' workmen wearing- 
masks or respirators, covering the mouth and nose. It is also believed 
that the vapor of turpentine, carried in a small bottle suspended from the 
neck while at work, exerts some protective influence. 
Since carious teeth favor the occurrence of phosphor-necrosis, those 
working amid these fumes should be warned to keep their teeth in good 
condition. When necrosis occurs, the patient is to be put under good 
* Phosphorus-paste, for destruction of house-vermin, is made by rubbing together 6 parts 
of phosphorus and sulphur with 6 parts of cold water until they liquefy. Then add 2 parts 
mustard-flour, 8 parts of sugar, and 12 of rye-flour, making a paste. To be kept closely stopped in 
tin boxes. 810 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
hygienic conditions until the sequestrum separates, when it is removed 
by surgical operation. 
Therapy.—In neurasthenia, or nervous debility, where the system is 
weakened by anxiet}', overwork, or sexual excesses, and in neuralgia, 
phosphorus is a valuable tonic and restorative, but has Jess control over 
pain than many other agents :— 
R Elixir, phosphori (N. F.), 
Elixir, eiuchonae calisayaa, aa f^iss. 
M. Sig.: Take one or two teaspoonfuls every three hours for facial neuralgia and 
debility. 
Or, 
R Resinae phosphori, gr. iv. 
Quininae hydrobromat., 3j. 
Ext. belladonnae ale., gr. j. 
M. et div. in capsulae no. xx. 
Sig.: Take one four times a day in brow-ague or headache from nervous strain. 
R Acidi phosphorici dil., 
Tinct. ferri chloridi, . . aa f^j. 
Glycerini, fgij. 
M. Sig.: From a half to a teaspoonful, in -water, after meals as a tonic. 
Phosphorus is not infrequently of service in the treatment of an- 
gina pectoris. In reduced nutrition of nervous centres, this remedy is 
valuable, as in atheroma of the cerebral vessels, white softening, in- 
somnia of the aged, hysterical paralysis and melancholia, morphino- 
mania, and chronic alcoholism. It checks sweating due to nervous 
debility. Phosphorus may be employed as a restorative after typhoid 
fever or typhoid pneumonia, and phosphorated oil is said to be valuable 
in intermittent fevei\ In anaemia, small doses in conjunction with iron 
are of considerable service. In lymphadenoma we may give:— 
R Zinci phosphidi, gr. ij. 
Ferri reducti, 3j. 
Abstract! ignatiae, gr. viij. 
M. et div. in pil. no. xxiv. 
Sig.: Take one three times a day. 
In so-called pernicious anaemia, or anhaematosis, small doses of phos- 
phorus seem to have some influence in checking the progress of the 
disease. In rickets and osteomalacia, also, clinical experience has 
pronounced in favor of phosphorus, especially in the form of oleum 
phosphoratum given with codliver-oil:— 
R 01. phosphorati, ITlxvj. 
01. morrhuae, . . f^iv. 
M. Sig.: A teaspoonful four times daily. PHOSPHORUS. 
811 
When, in eruptive fevers (in scarlatina, measles, etc.), the exanthem 
does not come out or it recedes, the administration of phosphorus is often 
resorted to with advantage. 
In skin diseases, phosphorus and its compounds are useful as substi- 
tutes for arsenic, and in some cases are superior to this drug. In crops 
of boils, acne indurata or inveterata, and eczema of nervous origin, the 
phosphate of lime or the alkaline hypophospliites are highly serviceable. 
Phosphates and Hypophosphites.—In some cases, medicinal doses of 
phosphorus cause feebleness of the heart’s action with threatening col- 
lapse, or acute gastric pain ; and, in others, fatty degeneration of the 
muscles and viscera. This does not occur after using the salts of phos- 
phoric and hypophosphoric acids and their preparations. The phosphates 
have physiological actions and therapeutical powers differing from those 
of phosphorus. The phosphate of soda, for instance, is a valuable cliola- 
gogue and is slightly laxative, making it of special service in treating chil- 
dren who pass clay-colored faeces, and also in catarrhal jaundice, owing 
to its action upon the liver. The phosphate of soda is of benefit in 
rheumatism, either alone or combined, thus:— 
II Sodii pliosphat., 
Acidi salicylici, aa gr. c. 
M. et ft. capsulae no. xx. 
Sig.: A capsule or two every two hours for rheumatism. 
For gout and rheumatism, Dr. F. L. Satterlee recommends the 
following prescription containing the phosphate of soda:— 
II Lithii benzoat., 3ss. 
Sodii bromid., 
Potassii carbonat. pur., . 3ij. 
Potassii acetat., §iss. 
Sodii phosphat., §ss. 
Syr. zingiberis, 
Aq. menth. pip., f?vj. 
M. Sig.: A teaspoonful to a tablespoonful in half a glass of water every four or six 
hours after food. 
The phosphate of lime, made soluble by combination with lactic 
acid in the form of the syrup of lacto-phosphate of calcium, is a 
valuable reconstructive and tonic in feeble children with deficient devel- 
opment of bone, and also in surgeiy, in treating ununited fracture. 
Exhaustion and anaemia, produced by long-continued suppuration or 
lactation, leucorrhoea, or chronic diarrhoea, are benefited by this prepa- 
ration, which is also useful in caries. The compound sjo-up of the phos- 
phates, or chemical food, has been found to be especially serviceable in 
these cases. The hypophosphites have been largely used and highly ex- 
tolled by Dr. Churchill in the treatment of pulmonary consumption, 812 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
especially the alkaline hypophosphites, which should be perfectly pure, 
like those of Dr. It. W. Gardner, of New York. The object of treatment 
being to obtain calcareous degeneration of the tubercles, the hypophos- 
pliite of lime may be administered alone, having the advantage of being 
nearly tasteless; it may be given in doses of gr. v-xx in pill form, or with 
an equal quantity of milk or cane-sugar. The following prescription, 
containing the hypophosphites, is suitable as a tonic, especially in chronic 
bronchitis :— 
Acidi phospliorici dil. f3iij. 
Syrup, pruni Virg., f3ij. 
Syr. hypophosphitum comp., q. s. ad f§v. 
M. Sig.: A teaspoonful in water three or four times a day. 
Caution.—As a subject of interest and possible importance,it should 
be mentioned that the hypophosphites should not be triturated in a mor- 
tar, as they are liable to explode. Dr. II. Gifford, of Syracuse, while tritu- 
rating a mixture containing 3 parts of liypophospliite of lime and 1 of 
hypophosphite of soda, made this discover}", the compound exploding 
like gunpowder, severely burning his face and eyes and destroying the 
sight of one of them. 
PHYSOSTIGMA (IT. S. P.).—Calabar Bean. 
Preparations. 
Extraction Physostigmatis (U. S. P.).—Extract of Physostigma. Pose, gr. % -iv. 
Tinctura Physostigmatis (U. S. P.).—Tincture of Physostigma (10 per cent.). Pose, 
Plxv-xl. 
Physostigmince Salicylas (U. S. P.).—Salicylate of Physostigmine. Pose, 
The hydrobromate and sulphate of physostigmine are also employed in doses of from 
sW& grain. 
Pharmacology.—The ordeal bean of old Calabar is the seed of 
Physostigma venenosum(Leguminosse, Papilionaceae), growing in Western 
Africa along the river Niger. It contains the alkaloid Physostigmine 
(also known as Eserine) and Calabarine, starchy matters, oils, etc. The 
salts of physostigmine vary in solubility; that with salicylic acid is 
soluble and permanent, and has been made officinal. Jobst and Hesse, 
in 1864, first isolated the active principle as an amorphous alkaloid, to 
wdiicli they gave the name of physostigmine. Subsequently, a crys- 
talline, alkaloidal principle was found in the seeds by Vee and Leven, 
who gave it the name of eserine; the former was tasteless, the 
latter has a bitter taste. In physiological effects they are analogous, 
and they are now regarded as different forms of the same substance. 
Bihringer has recently discovered in Calabar bean a new alkaloid, which 
he proposes to call Eseridine. It is said to act as a laxative or motor 
excitant, and to be six times weaker than physostigmine. A substance 
termed Physosterin, related to cliolesterin, is also present in physostigma. PHYSOSTIGMA. 
813 
Physiological Action and Toxic Effects.—In large closes, physostigma 
is a powerful poison, producing extreme muscular debility, vomiting, 
slow and weak pulse; it causes death either by cardiac syncope or, in 
smaller quantity, by paralysis of the respiratory centre and suffocation. 
Atropine counteracts the respiratory depression and strychnine stimu- 
lates the cord, and thus act as physiological antidotes. Applied to the 
surface of the bod}r, no effect is observed unless absorption occurs 
(except, when introduced into the eye, it causes contraction of the pupil, 
beginning in about fifteen minutes and lasting for about eight hours, 
attended by slight twitching of the lids, supra-orbital pain, dimness of 
vision, fall of intra-ocular tension, spasm of accommodation, and myopia). 
The pupil contraction is held to be due to paralysis of the peripheral 
vaso-motor nerve-fibres, and to stimulation of the fibres of the third 
nerve supplying the iris (Farquliarson). Contraction of the pupil may 
also be produced by the internal administration of the drug, but this 
result does not alwa}'s follow. This fact, as Phillips remarks, may aid 
in distinguishing poisoning due to physostigma from that of opium. 
The brain is not affected, but the spinal cord suffers great depression of 
both motor and reflex activity. The conductive of the motor nerves 
is also reduced. The pulse and respiration become slower and fuller 
after small doses, the arterial tension being at first increased ; but in 
larger amounts, as the system becomes more influenced by the toxic 
action of the drug, the pulse becomes feeble and irregular and the 
arterial tension falls. This is explained by the primary stimulation and 
subsequent exhaustion of the peripheral cardiac filaments of the vagi. 
The secretions are slightly increased by Calabar bean, and vomiting and 
retching are apt to occur. Peristaltic action as well as the intestinal 
fluids are increased, and diarrhoea is a usual physiological consequence. 
The sulphate of eserine is said to have excited the pregnant womb to 
contraction. The bladder and spleen also contract under the influence 
of physostigma. The active.principle is largely excreted by the kidneys, 
and likewise by the saliva and bile, and has even been found in the 
gastric secretions after intra-venous injection. 
Therapy.—Eserine, or physostigmine, is used by oculists to break 
up adhesions of the iris, diminish intra-ocular tension, and prevent the 
prolapse of the iris after wound or ulcer of the cornea. It is service- 
able in treating glaucoma; a solution of gr. ij to fjj of distilled water, 
being instilled into the eye every fifteen minutes, soon gives relief. It is 
useful in photophobia, reducing the amount of light by contracting the 
pupil, and diminishing the blood-supply by emptying the blood-vessels. 
Eserine is also employed in neuralgia of the eyeball, and to counteract the 
excessive action of atropine. In ulceration or suppuration of the cornea 814 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
and in strumous ophthalmia the local action of eserine is very beneficial. 
Internally, it is useful in constipation due to defective secretion and to 
insufficient peristalsis, combined with other remedies, such as belladonna. 
Ext. physostigmatis, • . . . gr. iij. 
Ext. belladonnae ale., gr. j. 
Res. podophylli, gr. iij. 
Ol. cajuputi, dliv. 
M. et ft. pil. no. xij. 
Sig.: Take two at bed-time. 
Bartholow gives the following formula :— 
Tinct. physostigmatis, 
Tinet. nucis vomica?, 
Tinct. belladonnae, aa f3ij. 
M. Sig.: Thirty drops in water morning and evening for constipation of the bowels. 
This combination is useful in treating the digestive disorders of 
women at the change of life, relieving headache, vertigo, and flatulence. 
In tetanus physostigma gives excellent results, recovery following in 
more than half the cases. Care should be taken that the extract or 
other preparation used is of good quality, and it should be pushed until 
decided physiological effects are produced, as recommended by Fraser; 
1 grain by the stomach, or grain li}7podermatically, of a good extract, 
is enough to commence with, repeated every two hours, and increased 
or reduced, according to effect. In other nerve affections, chorea, and 
epilepsy, and in progressive paralysis, great improvement has been noted. 
Ph3'SOStigma has been successfully used in infantile convulsions after the 
failure of chloroform. In convulsive disorders of individual muscles of 
the face (histrionic spasm, tic, twitching of orbicularis, etc.), good results 
follow its emplojnnent. Calabar bean has likewise proved beneficial in 
writers’ cramp. Temporary improvement, or arrested progress, was 
observed by Ringer and Murrell in paraplegia supposed to be due to 
myelitis. The same authorities saw improvement follow administration 
of the drug in locomotor ataxia. Physostigma is also capable of con- 
trolling the night-sweats of phthisis ; at least, in some cases. Murrell gave 
grain of extract in pill two or three times during the night, or err 
grain of an eserine salt, and found that not onty was sweating suppressed 
for the time, but that in some instances it did not recur for three or four 
weeks. 
In strychnine poisoning, while the symptoms are modified, there lias 
been no case of recovery from the use of pliysostigmine alone, but the 
bromides might be combined with it advantageously. In some affections 
of the air-passages, bronchitis, congestion of the lungs, and pneumonia, 
physostigma may be used to lower the excitability of the vagus and the PHYTOLACCA. 
815 
activity of the heart and respiration. On account of its tonic effect upon 
the muscular coat of the bronchi, this drug is occasionally serviceable 
in bronchial asthma and emphysema. The tincture of physostigma, when 
well made, is a good preparation, but for hypodermatic and ophthalmo- 
logical purposes the salicylate of physostigmine is preferable. 
PHYTOLACCA.—Poke. 
PHYTOLACC/E BACCA (U. S. P.).—Poke-Fruit. 
PHYTOLACC/E RADIX (U. S. P.).—Poke-Root. 
Preparations. 
Pitlvis Phytolaccce Radicis.—Powdered Phytolacca-Root. Dose, gr. i-v. 
Extractum Phytolaccce Radicis Fluidum.—Fluid Extract of Phytolacca. Dose, hlv-f 3j. 
Tinctura Phytolaccce Radicis.—Tincture of Phytolacca (1 to 10). Dose, hlx-f3j. 
Pharmacology.—The fruit and root of Phytolacca decandra (Phyto- 
laccaceae) are each officinal. The activje principle has not been isolated ; 
but the plant contains a resin and a neutral principle, Phytolaccin, and 
Phytolaccic acid; also tannin, oil, starch, etc. The bei'ries are dark, 
purple, globular, about inch in diameter, comprising ten carpels, each 
holding one black seed. The juice is red, acrid, rather sweet to the taste, 
as is also the root. 
Physiological Action.—The powdered root is irritating to the air- 
passages, and when inhaled causes pains in chest, back, and abdomen, 
with injection and irritation of the eyes, and occasionally vomiting and 
purging. Applied to the skin, it occasions an erythematous eruption and 
excoriations. Poke is emetic, cathartic, narcotic, and is claimed to be 
alterative. As it only acts slowly", and creates much nausea and depres- 
sion, it is never used as an emetic. It reduces the force of the pulse 
and frequency of the heart’s action, and also the rate of respiration. It 
acts decidedly" upon the nerve-centres, paralyzing the cord and medulla, 
death being produced by carbonic-acid poisoning from failure of respi- 
ration. As it is a remedy easily" obtained and used by a class of “ herb- 
doctors,” it is not surprising that cases of fatal poisoning have occurred. 
The antidotes are the diffusible stimulants, ammonia, alcohol, and ether, 
with hypodermatic injections of digitalis and small doses of morphine 
and atropine, with artificial respiration and counter-irritation. 
Therapy.—In follicular pharymgitis, tonsillitis, granular eyelids, mas- 
titis, malignant disease, varicose veins and ulcers, and in a large variety 
of skin disorders, such as chronic eczema, sycosis, favus, and abscesses, 
various observers have reported good results from the external and 
internal use of poke-root. The following formulae are recommended :— 816 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Pulveris phytolaccae radicis, 3j. 
Camphorae, gr. x. 
Extracti belladonnae ale., 3j. 
Ungt. zinci oxidi benz., §j* 
M. For chronic ulcers, fissure and fistula, and mammary abscesses. 
Pulveris phytolaccae radicis, 3j. 
Ungt. resinae comp., §j. 
M. Useful in boils and carbuncles. 
Pulveris phytolaccae radicis, 3j. 
Menthol i, gr. x. 
Lanolini, §j. 
M. Useful in chronic eczema and chronic sycosis. 
The pain produced by burns is alleviated by the local application of 
pliytolacca. An abstract of poke-root and fluid extract have also been 
used. The}' are esteemed valuable in the treatment of syphilis, scrofula, 
rheumatism, and in chronic skin diseases. The tincture and the fluid ex- 
tract have yielded good results in chronic rheumatism and rheumatic 
swelling of the joints. Phytolacca is highly esteemed as a reined}’ for 
acute mastitis, applied locally and taken internally. M. M. Griffith 
claims that this remedy has very decided power in diminishing obesity. 
PICHI. See Fabiana Imbricata, page 623. 
PICROTOXINUM (U. S. P.).—Picrotoxin. 
A neutral principle prepared from the seeds of Anamirta paniculata 
(Menispermacene) or Cocculus Indicus (see page 556). 
PILOCARPUS (U. S. P.).—Pilocarpus, Jaborandi. 
Dose, gr. x-5j. 
Preparations. 
Extraction Pilocarpi Fluiclum (U. S. P.).—Fluid Extract of Pilocarpus. Dose, hlx-lx. 
Pilocarpince Hydrochloras (U. S. P.).—Hydrochlorate of Pilocarpine. Dose, gr. 
Difusum Pilocarpi.—Infusion of Jaborandi (3j-Oj). Dose, f3ij—§iv. 
Pharmacology.—Pilocarpus is the leaflets of Pilocarpus pinnatifolius 
(Rutacete) of Brazil. They contain an alkaloid, Pilocarpine (£ to or 1 
per cent.), Jaborine, volatile oil, and probably a peculiar acid. The 
active principles are soluble in alcohol, but only imperfectly so in water. 
Physiological Action.—In about fifteen minutes after jaborandi has 
been swallowed, the face flushes and perspiration occurs, with more or 
less salivation ; the two being related to each other in such manner that 
if there is little action upon the skin there will be more discharge of 
secretion from the salivary glands, and when the skin acts freely the 
salivation will be less. The profuse sweating removes not only water 
but other matters from the blood, as it has been found to carry off urea 
and certain excrementitious materials. Arterial tension is reduced and PILOCARPUS. 
817 
temperature falls 1° to 4°. This action upon the skin is attributed to 
vasomotor paralysis, and the sialagogue action to stimulation of the 
peripheral nerves of the glands. Jaborandi also increases the action of 
the heart and respiration, but in larger doses depresses them by its para- 
lyzing action on the vagus. Contraction of the pupil, with impaired 
power of accommodation, has been observed to follow its use. The 
same result is produced by its topical application. Atropine and mus- 
carine are antagonistic in their effects to jaborandi or pilocarpine. 
Pilocarpine readily diffuses into the blood, and is eliminated chiefly 
by the skin and salivary glands. Most secreting glands are similarly 
affected, to a greater or less degree. The gastric and pancreatic fluids 
are decidedly augmented. A certain though less powerful stimulant 
effect is exerted upon the liver. The lachrymal, mammary, and bronchial 
mucous glands are also excited. It increases the discharge of urea by 
the kidneys, but not the urinary water. It causes contractions of the 
uterus, and may induce abortion ; it also reduces the size of the spleen. 
Children are less susceptible than adults to the action of pilocarpine. 
Demme, of Berne, has observed that under 4 years of age the action of 
this substance is more decided upon the salivary glands than upon the 
skin. Jaborine, the second alkaloid which is separated from pilocarpus, 
acts similarly to atropine. The presence of this alkaloid explains the 
different effects following the use of pilocarpine which has been improperly 
made. It is therefore very necessary, in using pilocarpine,or any of its 
preparations, to obtain them free from jaborine. 
Therapy.—It has been noticed by Prentiss that under the use of 
pilocarpine the color of the hair darkens. It may thus be combined with 
a stimulant application to the scalp:— 
Ext. pilocarpi fl., 
Lin. saponis, aa f§ss. 
Spiritus odorati, f §ij. 
M. Sig.: To be applied to the scalp once daily, with friction, for alopecia and falling 
of the hair. 
In cases where diaphoresis is desired in order to remove matters 
from the blood or reduce temperature, pilocarpus is a convenient agent. 
Thus, in acute erysipelas, its action is so prompt and effective that 
it might almost be regarded as a specific. Professor Waugh points out 
that the diaphoresis is at ouce followed by retrogression of the rash 
and improvement of the general condition, but that in atonic cases, 
when the heart is weak and perspiration cannot be induced by jaborandi, 
no beneficial action is observed. In diphtheria, also, it is serviceable, 
but the depressing effect upon the heart must be kept in mind. Pulmo- 
nary oedema, also, may follow the administration of this drug; so that, 818 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
although it is capable of detaching false membrane, it is of doubtful 
value, demands vigilant watchfulness, and should onty be administered 
to previously strong individuals. Similarly, in mumps or parotitis, it 
often abruptly stops the course of the disease. In agalactia of nursing 
women, small doses of pilocarpine restore the secretion of milk. Where 
there is oedema or effusion, the fluid extract of jaborandi is very com- 
monly employed, in moderate doses, to keep up the action of the skin 
and increase the elimination of urea. In diabetes insipidus, alternated 
with the fluid extract of ergot, it reduces the urinary flow very decidedly. 
In asthma, or hiccough, a hypodermatic injection of pilocarpine is some- 
times promptly curative. Jaborandi has been advantageously employed 
in whooping-cough. In small doses it, or its alkaloid, is useful in 
chronic bronchitis and winter cough. In doses sufficient to excite free 
diaphoresis, this remedy has proved very efficacious in the congestive 
stage of pneumonia, rapidly ameliorating the local condition and re- 
ducing the fever. AVhen atropine is administered to check night sweats 
in phthisis, it may be combined with fluid extract of jaborandi, which, as 
pointed out by Da Costa, relieves the dryness of the throat caused by the 
atropine. Pilocarpine itself is by no means an inefficient remedy for this 
manifestation, and the hydrochlorate may be given nightly in sVgrain 
dose by the mouth, with, usually, a good effect both upon the sweats and 
the cough. In amblyopia of tobacco and alcohol origin, and in amauro- 
sis, pilocarpine is frequently used with good effect, and also in many 
other lesions and disorders of the eyeball. A few drops of a solution of 
pilocarpine (2 grains to the ounce) may be locally employed with advan- 
tage in rheumatic iritis. Internally, the alkaloid is sometimes beneficial 
in detachment of the retina, and decidedly so in optic neuritis. Its 
action upon the pupil enables it to be used in place of eserine. Sta- 
derini* (Annali di Otalmologia) advises the nitrate of pilocarpine in gr. 
£ to TV, subcutaneously, in many inflammatory diseases of the eyes, es- 
pecially in those that are the consequence of rheumatism, as episcleritis, 
iritis, and idiopathic optic neuritis. Nitrate of pilocarpine thus given, 
he states, subdues inflammatory conditions of the iris and of the ciliary 
body which supervene when masses of the cortical substance of the lens 
remain in the anterior chamber after the operation of extraction of cata- 
ract. Pilocarpine, the same writer believes, promotes the absorption of 
non-organized opacities in the vitreous humor, especially when these 
opacities are the consequence of recent infiltration. Progressive myopia, 
he further adds, shows improvement of vision after pilocarpine injections. 
The action of jaborandi upon the glands of the skin makes it useful 
in many cases of chronic skin disorder, especially of the dry character. 
* “ Pilocarpine in Ocular Therapeutics,” by G. Staderini, St. Louis Clinique, January, 1891. PILOCARPUS. 
819 
Klotz lias recently reported very favorable results from the hypoder- 
matic injection of 10 to 15 drops of a 1-per-cent, solution of pilocarpine 
hydrochlorate in chronic eczema. The hard, dry,and fissured condition of 
the skin was remarkably improved. In some instancesjaborandi given in- 
ternally has alleviated urticaria. Small doses of jaborandi by the mouth, 
or of'its alkaloid subcutaneously, have proved remedial in hyperidrosis 
and bromidrosis. Pruritus is not uncommonly relieved by this agent. 
The itching of jaundice is amenable to the influence of pilocarpine, pro- 
vided, as Waugh remarks, that the drug is well borne and sweating occurs. 
Pilocarpus can be administered for the diseases just named as 
follows:— 
Extracti pilocarpi fl., ......... f^ss. 
Spiritus aetheris liitrosi, 
Spiritus juniperi, aa f §ij. 
Syrup, limonis, q. s. ad f^vj. 
M. Sig.: From a half to a tablespoonful in water every two or three hours. 
Infus. pilocarpi, 
Infus. digitalis, f^ij. 
M. Sig.: Two teaspoon fills every two or three hours. 
By Wilkowski the hypodermatic injection of pilocarpine is re- 
garded as almost a specific in catarrhal jaundice. He attributes, more- 
over, a diagnostic value to the procedure. If a treatment of ten to 
fifteen daj’S produces no effect upon the jaundice the presence of a ma- 
lignant growth of the liver is to be sinspected. For the relief of dry 
tongue, or aptyalism, J. P. Blackmans strongly recommends to 
grain of pilocarpine, inclosed in gelatin and allowed to melt on the 
tongue, which should be previously moistened with a little water. A 
moderate flow of saliva is excited within twenty-four hours, and general 
diaphoresis is never produced. Pilocarpine has been found useful in the 
exanthemata in case of suppression or retrocession of the rash. 
Pilocarpine may be used hypodermatically for the same purposes as 
jaborandi by the stomach, and is less apt to be followed by nausea and 
vomiting. One-third of a grain under the skin generall3r causes free 
diaphoresis, while | grain produces such an amount of sweating as to 
lead to dangerous degree of prostration. As a rule, the first dose 
should not exceed £ grain, and in this dose it is well borne, even by sub- 
jects of heart disease. Pilocarpine is a good substitute for the Turkish 
and other sweating baths in the treatment of ascites and serous effusions 
generally, and of oedema. 
Pilocarpine subcutaneously has been employed successfully in bella- 
donna poisoning. McGowan relates a case (London Lancet), in which 
two injections of grain each were undoubtedly the means of saving 820 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
the patient’s life. It can likewise "be used with ranch effect in the 
albuminuria of pregnancy. Dr. E. L. 13. Godfrey has prescribed pilo- 
carpine very advantageously in this disease as follows :— 
13 Pilocarpfnae hydrochloratis, gr. ij. 
Potassii bicarbonatis, 3iij. 
Acidi benzoici, 3j. 
Tiuct. cardamom!, f^ss. 
Aquae, '. q. s. ad f^iij. 
M. Sig.: A teaspoonful in water every three hours. 
Pilocarpine is, however, an inappropriate remedy in oedema dependent 
upon disease of the heart, and should never be employed if the heart- 
muscle be decidedly weak and its cavities dilated. In malarial or renal 
dropsy, on the contrary, this alkaloid is of signal efficacy. In chronic 
rheumatic disorders and some skin affections such diaphoretic treatment 
is serviceable. Muscular rheumatism and sciatica have also been 
ameliorated by the same method. In acute parenchymatous inflamma- 
tion of the kidneys, pilocarpine is of the greatest service, increasing the 
urinary water and decreasing the albumin and blood. In acute scarla- 
tinal nephritis pilocarpine is a valuable remedy, especially employed as 
follows :— 
13 Extracti pilocarpi fl., . . . f^ss. 
Misturae potassii citratis, f §ij. 
Syrup, auvantii, f§iss. 
M. Sig.: A teaspoonful or two every three or four hours. 
In uraemic accidents and puerperal eclampsia, the hypodermatic in- 
jection of pilocarpine is of marked benefit. The fulgurant pains of 
locomotor ataxia may sometimes be relieved by this method, and in 
septicaemia it has materially modified the symptoms, even when failing 
to prevent death. In some instances it has proved successful in hydro- 
phobia. A hypodermatic injection of pilocarpine may arrest an attack 
of asthma, and should be given a trial in acute pulmonary oedema. A 
cold may be broken up by small doses of pilocarpine followed by quinine. 
A dose of pilocarpine will generally succeed in averting a malarial chill. 
PIMENTA (U. S. P.)._Allspice. 
Do9e, gr. x-xl. 
Preparation. 
Oleum Pimentce (U. 9. P.).—Of) of Pimenta. Dose, ftliil-v. 
Pharmacology.—The nearly ripe fruit of Eugenia pimenta (Myr- 
tacefe), of Tropical America, is an aromatic stimulant, mainly used as a 
spice to promote appetite and digestion. It contains a volatile oil, 
which is also officinal (3 to 4 per cent.), some fixed oil, resin, tannin, 
gum, etc. A fluid extract is also made, but is not officinal (dose, 
P3,viii-xl), and an aromatic water. PIMPINELLA. 
821 
Physiological Action and Therapy.—Allspice is a pungent, aromatic 
stimulant, acting as a carminative, and stimulating the secretions of the 
mouth and stomach. It may be used to disguise the taste of unpalatable 
drugs, and is one of the ingredients of spice plasters. The oil can be 
added to pill-masses to prevent the griping of purgatives. 
PIMP1N ELLA.—Pimpernel. 
Dose, n^xv-xxx. 
Pharmacology.—The root of Pimpinella saxifraga (Umbellifene), 
growing in Europe, contains a golden-yellow volatile oil with an odor 
resembling that of parsley-seed, some acrid resin, and benzoic acid. 
Physiological Action.—It exerts decided effects over mucous mem- 
branes, and is diuretic and expectorant. 
Therapy.—Used in catarrh of various parts of the body, including 
gastric catarrh and bronchorrhoea. It is best given as fluid extract. 
PINUS CANADENSIS.—Hemlock Spruce. 
Pharmacology.—The bark of Abies Canadensis (Conifer*) of North 
America is very astringent, containing large quantities of tannin and 
some volatile oil. 
Therapy.—In the form of a dilute, alcoholic fluid extract it is a 
convenient agent to be employed where the effects of tannin are desired. 
It is used principally as a local astringent in pharyngitis, tonsillitis, 
uterine catarrh, and haemorrhoids, applied in full strength; or it may be 
used diluted as a wash in leucorrhoea or gleet. This drug may be em- 
ployed in diarrhoea of adults, although in such cases the prescription 
had better be written at once for tannic acid in the desired quantity. 
Caution.—A white extract of Pinus Canadensis is believed to com 
tain a certain proportion of zinc chloride, and should therefore not be 
taken internally, although it is useful as an external application or wash. 
It rapidly relieves the pain of a burn, when applied in full strength, 
according to Dr. Wm. C. Wile. 
PIPER (U. S. P.) —Pepper, Black Pepper. 
Dose, gr. ii-xv. 
Preparations. 
Oleoresina Piperis (U. S. P.).—Oleoresin of Pepper. Dose, 
Piperina (U. S. P.).—Pipeline (a proximate principle of feebly alkaloidal power pre- 
pared from pepper, and occurring also in other plants of the same natural order). Dose, 
gr. ss-x. 
Pharmacology.—Pepper is the unripe fruit of Piper nigrum (Piper- 
ace*) of India and neighboring islands. The berries are small, pungent, 
and spicy to the taste, and of aromatic odor; they contain Piperine, 
volatile oil, pungent resin, fatty matter, etc. The oleoresin, extracted 822 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
b\r ether, contains the volatile oil and acrid resin, with a little pi peri ne. 
The piperine is in pale-yellow prisms, and may be contaminated with 
some of the volatile oil. 
Physiological Action.—Pepper is an irritant externally and internal]}-. 
Owing to its pleasant pungency it is largely used as a condiment at the 
table. It is decidedly stimulating to the digestive organs and to the cir- 
culation, and also to the kidneys, but to a less degree, as it passes out of 
the body by the urine. Pepper likewise promotes the action of the skin. 
If taken in excessive quantities its local action is sufficiently powerful 
to excite inflammation of the gastro-intestinal mucous membrane, and 
cases are on record in which pepper has produced delirium, rigors, and 
convulsions. 
Therapy.^—In flatulent dyspepsia and feeble digestion pepper may 
be advantageously taken with the food. It is an ingredient of the 
Asiatic pill, which has been used in lnemorrhoids with decided benefit. 
Acid, arseniosi, gr. iij. 
Piperis, §ss. 
M. et ft. pil. no. lx. 
Sig.: A pill after meals for indigestion and haemorrhoids. 
Lozenges containing pepper have also been successfully employed 
for the relief of haemorrhoids, ulcers of the rectum, and fissures of the 
anus. Dr. Whitla suggests that cubeb be added, and the balsam of 
copaiba be substituted for the inert honey which enters into the formula 
of the British confection of pepper. He also recommends the following 
preparation in atonic condition of the lower bowrel:— 
Pulv. piperis nigr., 
Pulv. carui, 
Pulv. cubebae, aa §ss. 
Mel despumatae, q. s. 
Ft. eleetuarium. 
Sig.: A teaspoonful three times a day. 
Pepper is largely used in domestic medicine in the form of a gargle 
for sore throat, and is not without effect in relaxed uvula. It has also 
been made into an ointment, and applied with success to tinea capitis. 
The alkaloid has some antiperiodic powers, and is a good addition to 
a pill for chronic malaria. 
PISCIDIA ERYTHRINA.—Jamaica Dogwood. 
Preparations. 
Extraction Plscidice.—Extract of Jamaica Dogwood. Dose, gr. ii-x. 
Pulvis Extracti Fiscidicc.—Powdered Extract of Jamaica Dogwood. Dose, gr. ii-x. 
Pilula Plscidice.—(Made from the extract.) Dose, gr. ij. 
Extraction Piscidue Fiuidum.—Fluid Extract of Jamaica Dogwood. Dose, f3ss-ij. PISCIDIA ERYTHRINA. 
823 
Pharmacology.—The bark of the root of Piscidia erytlirina (Legu- 
minosie), a tree of the West Indies, growing to the height of 20 feet, 
has a heavy, narcotic odor, recalling that of opium, and has a bitterish, 
acrid taste. It contains Piscidin, a yellowish, crystallizable, resinoid 
substance, insoluble in water, but soluble in alcohol, besides other resin- 
ous substances, oil, tannin, etc., but it has not yet been determined to 
which of these the physiological effects are attributable. 
Physiological Action.—According to the experiments of Dr. Isaac 
Ott, Jamaica dogwood is narcotic to frogs, animals and men. It en- 
hances the secretion of the skin, reduces the frequency of the pulse, 
raises arterial tension by stimulating the vasomotor centre, the in- 
crease being soon followed by a fall due to a weakening of the heart. 
It causes a tetanoid state by a stimulant action upon the spinal cord. 
Jamaica dogwood likewise causes dilatation of the pupil, followed by con- 
traction, as asphyxia develops. It causes death by either heart-failure 
or, what is more frequent, by arresting respiration. Pitcher has observed 
several cases in which alarming symptoms supervened from 8-drop doses 
every three hours. Jamaica dogwood, used medicinally in suitable 
doses, will not diminish the appetite or cause constipation. It is seldom 
followed by nausea, headache, or other unpleasant effect. 
Therapy.—Jamaica dogwood, in haemorrhoids, has been successfully 
used locally in conjunction with the acetate of lead. A cloth saturated 
with the fluid extract has been found efficient in superficial burns and 
scalds. Flagg states that the fluid extract of Jamaica dogwood has 
been found to possess decided value as a local and systemic analgesic. 
In general practice this combination of effect is frequently desirable, and 
in dental practice it will be recognized as especially valuable in treatment 
of periodontitis, alveolar abscess, pulp irritation, and other painful con- 
ditions within the oral cavity7, as topical applications, with directions to 
swallow the saliva, promptly induce relief. Flagg also recommends 5 to 
10 drops of the fluid extract given at the same time, in the diseases 
named, every hour or so as required. 
Internally, Jamaica dogwood allays pain, relaxes spasm, quiets reflex 
excitability, and promotes sleep. It is consequently well adapted to act 
as a substitute for opium, especially when, as is not infrequently" the 
case, the latter drug is not Avell borne. In the various forms of 
neuralgia, including sciatica, Jamaica dogwood has proved of value. 
Gastro-enteralgia, consequent to tyrplioid fever, has been also notably 
relieved by it. In the lancinating pains of locomotoi' ataxia it has, how- 
ever, proved inefficient. In pelvic neuralgia, the pain produced by fibroma 
of the uterus, and in d.ysmenorrhoea, piscidia has been found of much 
service. This remedy is likewise able to quell the pains of false labor 824 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
and of threatened abortion, in which, and in dysmenorrhoea, it is well 
combined with viburnum prunifolium, as :— 
If Extract, piscidiae fl., 
Extract, viburui prunifol. fl., 
Syrupi aurantii, f§j- 
M. Sig.: A teaspoonful, to be repeated every hour or two. 
The pain due to a fractured bone may be ameliorated by administra- 
tions of this agent, which is also beneficial in acute or chronic rheu- 
matism. The pains of inflammation may likewise be ameliorated by 
Jamaica dogwood. In panophthalmitis, iritis, irido-cyclitis, and in acute 
abscess of the auditory meatus, it is also capable of relieving the 
suffering. The pain of carcinoma has been assuaged by this remedy, 
which may here not infrequently replace opium with advantage. On 
account of its antispasmodic virtues it is of considerable service in 
alleviating the paroxysms of asthma and whooping-cough. It is also 
beneficial to coughs of reflex origin, of bronchitis and of pulmonary 
tuberculosis. Hysterical convulsions have yielded to the influence of 
this drug. Piscidia quiets restlessness and delirium, and induces sleep in 
delirium tremens, or mania a potu, and has been employed with gratifying 
success in the insomnia of insane patients. In insomnia, however caused, 
this agent fulfills an excellent service. Uterine colic and cholera morbus 
likewise prove amenable to its action. 
PIX BURGUNDICA (U. S. P.).—Burgundy Pitch. 
Preparations. 
Emplastrum Picis Biorgnndicce (U.S. P.).—Burgundy-Pitch Plaster (Burgundy pitch, 
9 parts; yellow wax, 1 part). 
Emplastrum Picis Cum Cantharkle (U. S.P.).—Warming Plaster (cerateof cantharides, 
1 ounce; Burgundy pitch, 11)4 ounces). 
Pharmacology and Therapy.—Burgundy pitch is the prepared, resin- 
ous exudation of Abies excelsa (Coniferae), a tree of Southern Europe. 
It is a resin with traces of volatile oil. It has some balsamic properties, 
and is slightly irritating to the skin. In exceptional instances its local 
action is severe, and it gives rise to vesicles and pustules, or even pro- 
duces ulceration. The officinal plasters are mild counter-irritants. 
The warming plaster is useful in chronic rheumatic swellings and in 
affections of the chest. Burgundy pitch has been thought to have some 
special action upon the rectum, and for this reason has been given in 
luemorrlioids, made into a [till with tar. Burgundy pitch also enters into 
plasters of galbanum, of iron, and of opium. PIX CANADENSIS. 
825 
PIX T)ANADENSIS (U. S. F.).—Canada op Hemlock Pitch. 
Preparation. 
Emplastrum Picis Canadensis (U. S. P.).—Hemlock Plaster (Canada pitch, 9 parts; 
yellow wax, 1 part). 
Pharmacology.—The prepared resinous exudation of Abies Cana- 
densis (Conifer*) contains resin and a trace of volatile oil. The uses 
are similar to the preceding. (For Hemlock-Spruce Bark, see page 821.) 
PIX LIQUIDA (U. S. P.).—Tar. 
Preparations. 
Syrupus Picis Liquids (U. S. P.).—Syrup of Tar (6 per cent.). Pose, f3i-ij. 
Unguentum Picis Liquicke (U. S. P.).—Tar Ointment (tar and suet, equal parts). 
Vinum Picis (N. F.).—Wine of Tar (a saturated solution in sherry wine). Pose, t'3i-iv. 
Pharmacology.—Tar is an empyreumatic oleoresin, obtained by the 
destructive distillation of the wood of Finns palustris and other species 
of pinus (Coniferae) of Europe and America; that coming from North 
Carolina and Sweden is the best. It should be free from mechanical im- 
purities. It contains oil of turpentine, pyrocatechin, acetic acid, acetone, 
methylic acid, xylol, creasote, phenol, etc., and is blackened by wood- 
smoke. Tar is soluble in less than its own bulk of alcohol or chloroform, is 
slightly soluble in olive-oil or oil of turpentine. By distillation it yields 
an acid liquor called pyroligneous acid, and an empyreumatic oil, called 
oil of tar, which is officinal. What is left behind is Pitch, which is a black 
solid, presenting a shining, fractured surface, melts in boiling water, and 
consists of resin with various empyreumatic resinous products, which 
have collectively received the name of Pyretin. The creasote of tar is of 
special interest on account of its antiseptic and preservative properties, 
from whence it derived its name. The creasote of beecli-wood is used 
largely in medicine. (See page 579.) 
Lysol, a new tar combination, is derived, according to Gerlach, 
from tar-oils by boiling with alkalies and fats. It possesses the consist- 
ency of soft, or potash, soap, and is readily soluble in water. 
Physiological Action.—Tar is an irritant, and is liable to produce a 
papular eruption upon the skin if applied too freety; it is also absorbed 
readily, so that when a large surface is exposed to its action, feverish 
symptoms, blackish urine, and symptoms of carbolic-acid poisoning may 
ensue. The stools become blackish, and, as well as the urine, possess 
the odor of tar. Epigastric pain, vomiting, severe headache, or a sense 
of oppression in the head may also occur. Tar has an astringent effect 
upon mucous membranes. It has decided antiseptic power. When 
tar is taken internally, small doses exert a stimulating effect upon the 826 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
circulation and secretory apparatus. Large, or too long continued, doses 
destroy appetite and impair digestion, depress the action of the heart, and 
cause nervous exhaustion. 
Therapy.—Tar is a good application to scaly skin diseases, such as 
psoriasis, but the officinal ointment is liable to cause irritation and 
should be diluted when used :— 
Ung. picis, 3ij. 
Ung. zinci oxidi, 3vj. 
M. For the relief of itching in chronic eczema. 
Tar ointment has been used with success in scabies and tinea. It is 
necessary, always, to be careful in applying tar, as it may excite dermatitis 
or an acne-like eruption which Hebra called “ tar-acne.” Tar ointment is 
of value in prurigo, and is sometimes capable of lessening this notoriously 
rebellious affection. Pruritus ani is often allayed by a weakened tar 
ointment. The same preparation, either in full strength or modified, is 
serviceable in lichen, comedo, sycosis, pemphigus, lupus erythematosus 
and vulgaris. An alkaline tar-water, made'by adding tar f3ij, caustic 
potash 5j, to water f5v, is a useful agent in the treatment of eczema. 
Lysol, the tar combination, is said by Gerlach to be a good disinfectant 
and antiseptic. He advises lysol to be employed, in from to 1- per- 
cent. solution, whenever an antiseptic or aseptic operation is desired. 
Pix solida, or pitch, is used externally in plasters. It is entirely 
different from the residue of coal-tar or “ gas-pitch.” 
A tar-water (made by mixing 1 part with 4 parts of water) was for- 
merly officinal. It is a sherry-colored, slightly-acid liquid, having a strong 
odor of tar. It may be used with an atomizer or vaporized by heat in 
chronic catarrhal disorders of the air-passages. Ringer and Murrell 
have demonstrated the usefulness of tar in winter cough, and have ascer- 
tained that it materially lessens the tendency to taking cold. Dr. 
Phillips finds it of service in chronic pulmonary tuberculosis; it 
improves appetite and digestion, checks diarrhoea, and quiets cough. 
A tar-water made with tar and lime-water, and percolated through pow- 
dered wild-cherry bark, is highly esteemed by H. C. Wood in chronic 
diarrhoea. The tar-water spray is beneficial in pharyngitis and laryngitis. 
It is also an efficient antiseptic application to unhealthy wounds or ulcers. 
Tar is likewise taken internail}' for the same class of diseases for which 
terebinthinate preparations are usually prescribed. Pills containing 1 or 
2 grains are useful in winter cough and other bronchial disorders. In 
many chronic skin disorders the internal administration of tar is a 
valuable adjunct to local treatment. McCall Anderson speaks favorably 
of the action of small doses of tar,taken internally, in both psoriasis and 
chronic eczema. PLANTAGO. 
PLANTAGO.—Plantain. 
Pharmacology and Therapy.—The leaves of plantain (Plantago major 
and lanceolata, N. 0. Plantaginaceae) are used as a vulnerary, the fresh 
leaves being pounded in a mortar into a paste and applied to wounds to 
check bleeding. In rhus poisoning, burns, scalds, bruises, and even 
erysipelas, it is said to be extremely efficient. An infusion may be 
administered internally, or a fluid extract may be given in doses of 
It does not appear in Prof. Laurence Johnson’s “Medical 
Botany of the United States,” and probably has very little therapeutic 
merit. 
PLUMBUM.-Lead. 
Salts and Preparations. 
Plumbi Oxiclum (U. S. P.).—Oxide of Lead, Litharge. 
JSrnplasti'um Plumbi (U. S. P.).—Lead Plaster, Diachylon. 
Unguentum Diachylon (U. S. P.).—Diachylon Ointment. (See page 831.) 
Liquor Pairnbi Subacstatis (U. S. P.).—Solution of Lead Subacetate, Goulard’s Extract. 
Liquor Plumbi Snbacetatis Dilytus (U. S. P.).—Dilute Solution (3 per cent.). 
Ceratum Plumbi Subaeetatis (U. S. P.).—Goulard’s Cerate (20 of Goulard’s Extract to 
80 parts of camphor cerate). 
Liuimcntum Peumbi Subaeetatis (U. S. P.).—Liniment of Subacetate of Lead (40 to 
cottonseed-oil 60 parts). 
Pumbi Acetas (U. S. P.).—Acetate of Lead, Sugar of Lead. Dose, gr. i-iv. 
PiUmbi Carbonas (U. S. P.).—Carbonate of Lead. 
Unguentum Plumbi Carbonatis (U. S. P.).—Ointment of Lead Carbonate (10 per cent.). 
Plumbi Jodidum (U. S. P.).—Iodide of Lead. Dose, gr. 
Unguentum Plumbi lodicli (U. S. P.).—Ointment of Iodide of Lead (10 per cent.). 
PiUmbi Nitras (U. S. P.).—Nitrate of Lead. Used as a disinfectant. Ledoyen’s solu- 
tion is a solution in water, 3j 
Plumbi Oxidum Rubrum.—Ited Lead. 
Pumbi Chromas.—Chromdte of Lead, Yellow Pigment. 
Pharmacology.—Metallic lead is readily affected by the oxygen of 
the air or by carbonic acid of water, and, although not poisonous itself, 
its salts are all deleterious, even in small amounts. Lead is therefore 
not a suitable lining for a reservoir for drinking-water, and lead pipes 
should not be used for conveying water for household purposes unless 
lined with tin. White lead and red lead are largely used both by 
painters and plumbers, who are liable to be affected owing to absorption 
through the skin. The chromate of lead is a yellow pigment used as a 
protective applied to the covers of hams, and is also sometimes fraudu- 
lently used by bakers to color cake, in order- to make up for a deficiency 
of eggs The acetate of lead is astringent and sweetish, and has been swal- 
lowed by mistake for other drugs, such as sulphate of magnesium. Fortu- 
nately, it is irritant to the stomach and acts as an emetic, but, if retained 
long enough to be absorbed, coma or paralysis may ensue. Sugar of lead 828 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
lias also been used in clarifying cider; and earthen vessels are glazed 
with a tlux containing lead, so that the sources of lead poisoning are 
numerous. A case of lead poisoning in a young infant has been reported, 
caused by the mother’s cleaning out the nursing-bottle with lead shot. 
Poisoning has also occurred from the use of cosmetics and hair-dyes 
containing lead. Lead is sometimes present in Hour by reason of the 
mill-stones, I)}" which the grain was ground, having been repaired by 
filling their cracks with lead. Numerous cases of lead poisoning have 
thus originated. 
Symptoms and Treatment of Lead Poisoning.—Acute lead poisoning 
following a single large dose of one of the salts of lead is very rare; but 
acute attacks as the result of slow absorption of the drug are very com- 
mon. The most striking symptoms are obstinate constipation with 
cramps (“dry gripes ”), loss of appetite, nausea, and vomiting of white, 
curd-like material, the color being due to the formation of chloride 
of lead with the hydrochloric acid of the gastric juice. If the bowels 
open, the passages are of a blackish hue from the presence of sulphide 
of lead. Vertigo or headache may occur, and neuralgic attacks; even 
stupor and convulsions. Upon examination of the mouth, a blue line 
will be found in the gums near their margin, over the incisor teeth, 
caused by a deposit of the metal, or its sulphide, in the tissues. This 
line is particularly noticeable in those who neglect the care of their teeth. 
Various forms of paralysis may occur, the most common being “ wrist- 
drop,” or extensor paralysis of the muscles of the forearm. A fatal case 
of lead poisoning has lately been reported* by Dr. G. L. Walton, in which 
ataxia was the prominent symptom. Three similar cases have been pub- 
lished by Dr. J. J. Putnam. Among the symptoms attending plumbism, 
or Saturnism, are an offensive odor of the breath, pallor, emaciation, mus- 
cular pains, and loss of power. Plumbism is a frequent cause of abor- 
tion. The wives of workmen in lead factories frequently abort, even when 
they are not directly exposed to the influence of the metal. According 
to the investigations of M. Paul of 50 children born alive, nearly all died 
within a few years after birth and only 14 reached the age of 10 years. 
Amaurosis, atrophy of the optic nerve, and a train of nervous phenomena 
dependent upon alterations occurring in the brain (lead encephalopathy) 
appear from the influence of lead. A valuable memoir on the subject of 
cerebral symptoms due to lead intoxication has been published by Dr. 
Westphal.j* Four forms have long been recognized under which the effects 
of the metal upon the brain are manifested,—the delirious, comatose, con- 
vulsive, and composite. The last named is by far the commonest, and in 
* Boston Medical and Surgical Journal, October 30, 1890. 
t See summary of his paper in the Medical Bulletin, August, 1889, p. 251, from Deutsche 
Medizinal Zeitung, May 9,1889. PLUMBUM. 
829 
it the characters of the other three varieties appear to he united. Apo- 
plectic and chorea-like forms have likewise been observed. Progressive 
paralysis, paresis of the laryngeal muscles, and a peculiar variety which 
runs a typhoid course have been described by different writers. From 
a careful study of 13 cases, Westphal divided them into those which pre- 
sent general cerebral symptoms and those showing symptoms due to 
pressure. The first group were characterized by depressed spirits, de- 
mentia associated with melancholia, hypochondriasis, irritability, head- 
ache, and vertigo. Convulsions were very common, at times general, 
and again limited to certain groups of muscles. In 5 cases the spasms 
assumed a genuine epileptic character. Among pressure symptoms, the 
most frequent was paresis in districts supplied by certain cranial nerves. 
Disturbances of smell and vision, circulation and respiration, hemianes- 
thesia, and liemiparesis were observed. The author finally enumerates 
four modes in which lead acts upon the central nervous system : (1) by 
direct influence upon the brain, producing neuroses of various kinds, 
disturbances of intellection, and symptoms due to structural change; 
(2) by influence upon the blood-vessels, leading to haemorrhage and soft- 
ening; (3) by influence upon the kidneys, resulting in the cerebral 
symptoms of anaemia; (4) by a combination of the preceding methods. 
The post-mortem examination reveals chronic catarrh of the 
gastro-intestinal tract, thickening of the walls of the smaller arteries, 
interstitial inflammation of the kidneys, with the deposit of lead in the 
nerve-centres, and, in fact, in every part of the bod}'. The lead, accord- 
ing to the experimental researches of Prevost and Binet, accumulates 
especially in the kidne}\ The longer the course of poisoning, the more 
lead is contained in the kidneys. The metal may be found in these 
organs long after the administration of the poison has ceased. The bones 
also were rich in lead, which was stored up in the form of a phosphate. 
The principal cerebral lesions of lead encephalopathy are atrophy of 
certain regions, haemorrhagic depots, apoplectic cysts, and, above all, 
alterations in the cerebral vessels, such as endo- and peri- arteritis, 
atheroma, and hyaline degeneration. Chronic plumbic intoxication is 
very apt to lay the foundation of kidney disease. 
Physiological Action.—Given in medicinal doses, lead salts are seda- 
tive, astringent, and haemostatic. They enter the blood, slow the heart 
and respiration, interfere with the nutritive functions of the red blood- 
corpuscles, and lead to their destruction, thus causing anaemia. Lead 
escapes from the blood by the skin, the liver, the kidneys, and intestinal 
tract. It is also found in the lacteal secretion. The excretion of uric 
acid is reduced, and thus lead favors the occurrence of gouty attacks in 
those predisposed. Persons working among white lead may escape lead 830 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
poisoning b}T using sulphuric-acid lemonade and fatty articles of food, 
and frequent bathing. Sulphuric acid forms an insoluble compound 
with lead. In lead colic we may give 20 to 40 grains of sulphate of 
magnesium with to \ grain of morphine, with syrup of ginger, and water 
enough to make a tablespoonful every hour or two to relieve pain and 
constipation. Belladonna, or atropine, has also been found efficient in 
relieving the pain, while Bardenhewer recommends pilocarpine as rapidly 
accomplishing the same purpose. Alum is of value in the treatment of 
chronic lead poisoning. Where the lead is in the tissues, it may be 
slowly removed by the administration of small doses of potassium iodide, 
and by vapor baths or Turkish baths, keeping up also the action of the 
kidneys. 
Therapy.—Lead is used locally in the form of metallic plates in the 
treatment of leg-ulcers, with good effect, to repress exuberant granula- 
tions. Nitrate of lead is employed in onychia with good result. As 
Goulard’s solution, or cerate, it is applied to erysipelas, acute eczema, 
contusions, and inflammations of various kinds, but should be diluted. 
The early application of Goulard’s solution is occasionally able to abort 
a felon. This liquid will often relieve itching, and is therefore of avail 
in paraesthesia and urticaria. Lead-water with laudanum was formerly 
much used to relieve pain and inflammation:— 
Liq. plumbi subaeetatis, f§j. 
Tr. opii, 15 U * 
Aquae destillatae, . f§v. 
M. For external use. 
The acetate of lead is used for the same purpose, and also as an 
injection for gonorrhoea or leucorrhoea:— 
Plumbi acetatis, gr. xlj. 
Zinci sulphatis, gr. viij. 
Aquae rosae, f^iij. 
M. Sig.: Use as an injection every six hours for gonorrhoea or gleet. 
Plumbi acetatis, . gr. x. 
Glycerini, f§ss. 
Aq. hamamelidis dost., f 
Aquae dest. f^iss. 
M. Sig.: For injection. 
Plumbi acetatis, gr. viij. 
Acidi carbolici, lllij. 
Glycerini, f^ss. 
Aquae, rosae, f^iiiss. 
M. Sig.: For injection. 
In many acute and chronic diseases of the skin the various lead 
salts are most useful on account of their soothing and astringent action. 
The following formulae are suggested:— PLUMBUM. 
831 
Plumbi acetatis, . . gr. x vel xx. 
Morphinae sulphatis, gr. v. 
Mentholi, gr. x. 
Creasoti, ITlx. 
Pulveris marantse, 3j. 
Uugt. zinci oxidi, • §j. 
M. For subacute and chronic eczema. 
Plumbi carbonatis, 
Creasoti, iT\x. 
01. olivae q. s. ft. ungt. mollis. 
M. Useful in erysipelas, burns, and in bruises, especially when the skin assumes a 
blue or dark tinge. 
Plumbi carbonatis, 3ij. 
Zinci carbonatis, §ss. 
Ol. eucalypti, . ITlv. 
M. A serviceable dusting-powder in acute eczema, herpes, and seborrhcea. 
In conjunctivitis, dilute lead-water was formerly much used, hut if 
ulceration of the cornea exist it may cause a permanent white patch. 
In diarrhoea and sporadic cholera, acetate of lead and opium pills are of 
great service; and the acetate, in doses of gr. ss-iij, is valuable in in- 
ternal haemorrhage or haemoptysis. 
Special Forms.—The glycerin of the subacetate of lead of the 
British Pharmacopoeia is a good application to eczema. It corre- 
sponds in strength to Goulard’s solution, but has glycerin as the men- 
struum. The liniment of the subacetate is a good astringent application 
to inflamed skin, chapped hands, and bruises. White-lead paint (without 
turpentine) is a good application to a burn or scald where the skin is 
unbroken. The ointment of the iodide of lead is used as a resolvent on 
glandular swellings, scrofulous tumors, goitre, etc., and also as an appli- 
cation in acne and other skin diseases. The nitrate of lead, in dilute 
solution, is useful in ozaena as a wash, also in leucorrhcea, and to correct 
the fetid odor of discharges from ulcers, etc. Fissures of the nipples are 
cured by applications of a 2-per-cent, solution in glycerin. The oleate 
of lead, melted with an equal amount of lard-oil, is a useful application 
in eczema, acne, etc. (See page 383.) Lead plaster is employed by sur- 
geons to protect parts of the bod}’ exposed to chafing by splints or 
apparatus ; it is also good to prevent bed-sores and as a base for other 
plasters. Hebra’s diachylon ointment* is made by melting equal parts, 
by weight, of lead plaster and linseed oil, to which a proportion of 
* An improved process for making Hebra’s diachylon ointment is given by Deringer: Dis- 
solve acetate of lead 200 grammes in 1 litre of distilled water and mix with 300 grammes of white 
castile-soap previously dissolved in \x/2 litres of warm, distilled water. Filter both solutions 
before mixing. The precipitate is then washed with water, freed as much as possible from water 
by kneading, and 1 part is melted with \y2 parts of olive-oil on the warm bath. The mixture is 
then triturated in a mortar until it forms a flue, white salve.—Proceedings Am. Pharm. Associa- 
tion, 1881, p. 63. 832 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
balsam of Peru and a little oil of lavender are sometimes added. 
Diachylon ointment is serviceable in hyperidrosis. It should be spread 
upon pieces of linen large enough to cover the foot and separate pieces 
placed between the toes. The foot is then covered with linen and band- 
aged, and this procedure is repeated every day for one or two weeks. 
This ointment often proves an excellent application also in subacute and 
acute eczema. In seborrhoea, dermatitis, herpes zoster, and sycosis, the 
use of lead ointment is attended with good results. 
In the treatment of the muscular weakness or paralysis following the 
absorption of lead, besides the iodide of potassium and occasional purges 
of sulphate of magnesium, with hot baths, etc., it is necessary to employ 
galvanism, to keep up the nutrition of the muscles and prevent fatt}' 
degeneration, and to employ systematic exercise, with massage. Semmola 
and others have published the details of a method by which the continuous 
current Avas successfully employed according to a systemic—as opposed 
to local—method, the poles being applied to the tongue and pit of the 
stomach. The sole reliance Avas placed upon galvanism, and no iodide 
of potassium Avas emploj-ed. The blue line upon the gums disappeared 
at the end of about three Aveeks, and at the same time the muscles began 
to be capable of feeble movements. The method proved of no avail when 
cerebral symptoms Avere present. 
The acetate of lead fulfills a double purpose in the treatment of 
gastric ulcer. It checks haemorrhage and at the same time promotes 
cicatrization. In the diarrhoea of typhoid fever and phthisis, this salt 
is an excellent remedy, and can be prescribed with service thus in 
ordinary diarrhoea, as well as in that from phthisis :— 
1$. Plumbi acetatis, 
Pulv. ipecacuanha et opil, S3, gr. xxiv. 
M. et ft. chart® no. xij. 
Sig.: A powder every hour or two. 
Plumbi acetatis, . . . 3j. 
Tinct. opii, f3ij. 
Tiuet. catechu, f§j. 
Syr. zingiberis, q. s. ad f^iij. 
M. Sig.: One to two teaspoonfuls in water every hour or two for diarrhoea. The 
dose for a child from two to six years old, from ten to thirty drops. 
The acetate possesses some power, likewise, over the night-sweats of 
pulmonary disease. It is of service in chronic gastric catarrh and dimin- 
ishes the copious secretion of chronic bronchitis. Asthma associated Avith 
chronic bronchitis and the catarrhal stage of pertussis are relieved by 
the same preparation. The acetate of lead has been found beneficial in 
dysentery, given either by the mouth or in the form of suppositories, as 
follows :— PODOPHYLLUM. 
833 
Plumbi acetatis, 
Camphorse, aa, 3ss. 
Extract! opii, gr. iiss. 
01. theobromse, . . q. s. 
. M. et ft. suppositoriae no. x. 
Sig.: Insert one into the bowel every hour or two for severe diarrhoea and dysentery, 
especially when attended with tenesmus. 
The acetate of lead is useful in hypertrophy of the heart on account 
of its power of retarding the action of that organ. From its influence 
upon the heart and its astringency, it is sometimes employed in the 
treatment of internal aneurism. Trocy advocates its use in pneumonia, 
especially when that disease attacks drunkards or persons of depressed 
vitalit}\ lie claims that the temperature and rate of respiration are 
lowered, and the disease is prevented from passing into a chronic form. 
PODOPHYLLUM (U. S. P.).—Podophyllum, May-Apple, Mandrake. 
Preparations. 
Abstraction Podophylli (U. S. P.).—Abstract of Podophyllum. Pose, gr. ii-v. 
Extractum roclophylli (U. S. P.).—Extract of Podophyllum. Pose, gr. ii-iv. 
Extractum Podophylli Fluidum(\J. S. P.).—Fluid Extract of Podophyllum. Pose, 
i-xxx. 
Eesina Podophylli (U. S. P.).—Resin of Podophyllum. Pose, gr. |-j. 
Podophyllotoxin. Pose, gr. 
Pharmacology.—The rhizome and rootlets of Podophyllum peltatum 
(Berberidacese), growing in United States and Canada, possess valuable 
medicinal properties. This plant contains about 4 per cent, of resin, which 
is a mixture of Picropodophyllin, Podophyllinic and Pyrocatechuic acids, 
Podophylloquercitin (the coloring principle), with Saponin, gum, starch, 
gallic acid, flxed oil, salts, etc. It contains no alkaloidal principle. Ac- 
cording to Podwissotzky, the active principle is a neutral crystalline 
body, picropodophyllin, which exists in combination with an inactive 
resin-acid called picropodophyllic acid, and the resulting combination he 
named Podophyllotoxin ; it is a bitter, white, resinous powder, soluble in 
weak alcohol and in hot wTater, but is precipitated from alcoholic solution 
by cold water in excels. The officinal resin of podophyllum consists of 
two resins, one soluble both in ether and in alcohol, the other only in alco- 
hol. The former, comprising from 75 to 80 per cent., is the active part, the 
other being without any effect, according to Cadbury. The resin is very 
irritant to the eyes, and when handled the dust is apt to cause conjunc- 
tivitis. The resin of podophyllum is insoluble in benzol, like that of jalap 
and scammony, but differs from these in being soluble in alkaline solu- 
tions, from which it may be precipitated by acids. 
Physiological Action.—Podophyllum is a slow cathartic, acting upon 
the liver and the intestinal glands. It also exerts its purgative effects 834 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
when introduced into the blood ; also by absorption, when applied to a raw 
surface. In small doses it is laxative, in large doses drastic, and may 
cause gastro-enteritis. Podophyllotoxin has lately been isolated in a 
pure, crystalline form, and Neuberger has made an experimental study 
of its physiological action. Upon frogs and rabbits it has but little 
effect. Cats, however, proved extremely sensitive to its influence. Se- 
vere vomiting and diarrhoea occurred in a few hours after its administra- 
tion. As death approached the animal became apathetic and paretic, and 
the temperature fell. Similar effects were produced in dogs. After 
death there was found great irritation, or even abscess, at the point of 
injection. The mucous membrane and adenoid tissue of the intestines 
were congested or inflamed ; the liver and kidneys were swollen. Neu- 
berger, therefore, concludes that the substance acts simply as an irritant, 
exciting catharsis in its elimination by the intestinal glands. 
Therapy.—On account of the smallness of the dose and slight taste 
of podophyllotoxin, or the resin, it is very applicable to the treatment of 
constipation of young children, or the opposite condition of diarrhoea 
from want of proper secretion. A grain may be dissolved in spirit of 
ginger, and a drop or two given on sugar. It will also be found useful 
in adults, administered in the same manner, to check vomiting. In 
chronic constipation the following formulae may be used :— 
• 
Ik Podophyllotoxini, 
/ Aloini, 
Extracti belladonnae ale., 
Abstracti ignatias, aa gr. ij. 
Extracti taraxaci, gr. xl. 
M. et ft. pil. no. xx. 
Sig.: A pill three times a day. 
Boucliut* recommends in infantile constipation this syrup:— 
Resinae podophylli, gr. %. 
Alcoholis, gr. lxxv. 
Syr. althaese, . f §iij. 
M. Sig.: A dessertspoonful daily. 
It is also useful in malarial liver disorders and jaundice, and in dys- 
pepsia dependent upon deficient secretion of the liver and intestinal 
glands. In that form of sick headache associated with loose and dark- 
colored stools, podophyllum generally affords relief. 
POLYGONATI RADIX.-Root of Solomon’s Seal. 
Dose, gr. xv-xxx, in fluid extract. 
Pharmacology.—The Polygonatum giganteum and P. biflorum (Lili- 
acese), common plants in the Eastern United States, have peculiar, boot- 
* L’Union Medicale, August 5,1890, p. 180. POLYGONUM. 
835 
shaped rhizomes, bearing the scars of preceding leaf and flower-stalks, 
which look like the impress of a seal. They contain a bitter, acrid 
principle, Convallarin, with other vegetable constituents, such as tannin, 
mucilage, etc. 
Physiological Action.—Slightly tonic, astringent, and alterative. 
Therapy.—Used externally, in decoction or fluid extract, as an appli- 
cation to freckles, and for relieving bruises, sprains, and local inflamma- 
tions ; also as an injection for leucorrhcea, menorrhagia, and as a wash 
for haemorrhoids. Internally, it has been used in rheumatism, gout, and 
dropsy. It is claimed to have special effects upon relaxed mucous 
membranes. 
POLYGONUM.—Water-Pepper, Smart-Weed. 
Dose, in fluid extract. 
Pharmacology.—The smart-weed, Polygonum hydropiperoides (Poly- 
gonaceae), is a small, indigenous herb, with narrow, green leaves and 
spikes of small, greenish or white flowers. It contains Polygonic acid, 
an acrid principle insoluble in water, with tannin, etc. The active 
principle is dissipated by heat, and therefore an alcoholic tincture of the 
fresh plant is the best form, or a well made fluid extract. The dose of 
the fluid extract is from to f3j. A solid extract has also been pre- 
pared, the dose of which is from 1 to 5 grains. 
Physiological Action.—Polygonum has a burning, acrid taste; inflames 
the skin when rubbed upon it, and internally has stimulating effects, espe- 
cially to the ovarian functions and to the kidneys. 
Therapy.—Employed in domestic practice, externally as counter- 
irritant and internally as an emmenagogue, doses of the fluid 
extract being administered for several days before the expected period, 
in amenorrhoea. Water-pepper is likewise of service in functional im- 
potence. On account of its diuretic virtue it has been employed for the 
purpose of washing out sand or gravel from the kidney or bladder. It 
has also been used in diarrhoea, bronchitis, and catarrhal disorders. 
POPULI CORTEX.—White Poplar-Bark, American Aspen. 
Dose, gr. xxx-5j, in fluid extract. 
Pharmacology and Therapy.—The Populus tremuloides (Salicaceae), 
a forest tree of the United States, contains in its bark Populin, a bitter 
principle, resembling quinine or cinchonine in its physiological and 
therapeutical effects. Poplar-bark has been used as a tonic and anti- 
periodic in doses of 30 to 75 grains several times a da}7 in decoction or 
fluid extract. An extract may be obtained by evaporating the fluid 
extract to the pilular consistence. Dose, gr. ii-xij. 
The terminal buds of the poplar have a balsamic odor, and contain 836 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
volatile oil, resin, etc., and possess the medicinal properties of terebinthin 
ate substances. The ointment of poplar-buds (made by digesting freshly 
bruised poplar-buds with twice their weight of hot lard, and gentb 
boiling until all moisture is dissipated) is a fragrant ointment resembling 
benzoinated lard in antiseptic qualities. 
POTASSIUM.—The metal Kalium. 
Salts and Preparations. 
Potassa (U. S. P.).—Caustic Potash, Potassium Hydrate. 
Liquor Potassae (U. S. P.).—Solution of Potash (5 per cent.). 
Potassa cum Calce (U. S. P.).—Vienna Paste (equal parts potassium hydrate am 
lime. Made into paste with alcohol). Escharotic. 
Potassii Acetas (U. S. P.).—Acetate of Potassium. Dose, gr. x-3j. 
Potassii Bichromas (U. S. P.).—Bichromate of Potassium. Dose, gr. 
Potassii Bitartras (U. S. P.).—Bitartrate of Potassium, Cream of Tartar. Dose 
gr. xx-3iv. 
Antimonii et Potassii Tartras (U. S. P.).—Tartar Emetic, gr. 
Ferri et Potassii Tartras (U. S. P.).—Tartrate of Iron and Potassium. 
Potassii et Sodii Tartras (U. S. P.).—Tartrate of Potassium and Sodium, Roehell 
Salt. Dose, gr. xx-3iv. 
Potassii Tartras (U. S. P.).—Tartrate of Potassium. Dose, gr. v-xx. 
Potassii Bromidum (U. S. P.).—Bromide of Potassium. Dose, gr. x-3j. 
Potassii Carbonas (U. S. P.).—Carbonate of Potassium. Dose, gr. ii-xx. 
Potassii Bicarbonas (U. S. P.).—Bicarbonate of Potassium. Dose, gr. v-xxx. 
Potassa Sulphurata (U. S. P.).—Sulphurated Potassa (sometimes called sulpliuret o 
sulphide of potassium). Dose, gr. ii-viij. 
Potassii Sulphas (U. S. P.).—Sulphate of Potassium. Dose, gr. xx-3ij. 
Potassii Sulphis (U. S. P.).—Sulphite of Potassium. Dose, gr. v-3j. 
Potassii Chloras (U. S. P.).—Chlorate of Potassium. Dose, gr. ii-x. 
Trochisci Potassii Chloratis (U. S. P.).—Troches of Chlorate of Potassium (each con 
taining gr. v of chlorate of potassium). Dose, one or two troches. 
Potassii Citras (U. S. P.).—Citrate of Potassium. Dose, gr. x-xl. 
Liquor Potassii Citratis (U. S. P.).—Solution of Citrate of Potassium. 
(Effervescing draught is the extemporaneous solution of potassium citrate, made b; 
mixing the equal quantities of two solutions, one containing §ij of citric acid to the pint, th< 
other 3ii§ bicarbonate of potassium to the pint. It contains about 9 per cent, of potassiun 
citrate, with a little free citric and carbonic acids. Dose, or f§ss of each of th 
solutions.) 
Mistura Potassii Citratis (U. S. P.).—Mixture of Potassium Citrate (made by neutral 
izing fresh lemon-juice with crystals of bicarbonate of potassium. Must be freshly pre 
pared). Dose, f^ss. 
Potassii Cyanidum (U. S. P.).—Cyanide of Potassium. Dose, gr. 
Potassii Ferroeyahidum (U. S. P.).—Ferrocyanide of Potassium, or Yellow Prussia! 
of Potash. Dose, gr. x. 
Potassii Hypopliosphis (U. S. P.).—Hypophosphite of Potassium. Dose, gr. ii-xxx. 
Syrupus Hypophosphitum (U. S. P.).—See page 807. 
Potassii lodidum (U. S. P.).—Iodide of Potassium. Dose, gr. v-3j. 
Ungueivtum Potassii Lodidi (U. S. P.).—Ointmeut of Iodide of Potassium (potass 
iodide 12, sodium hyposulphite 1, water 6, benzoinated lard 81 parts, or about 3j to §j. 
Potassii Mtras (U. S. P.).—Nitrate of Potassium, Saltpetre. Dose, gr. ii-xx. POTASSIUM. 
837 
Charta Potassii Niiratis (U. S. P.).—Nitre Papers (unsized papers moistened with a 
25-per-cent, solution in water, and dried and cut into pieces about 8 inches square). 
Argenti Nitras Dilutus (U. S. P.).—Dilute Lunar Caustic (contains 50 per cent, of 
nitrate of potassium). 
Potassii Permanganas (U. S. P.).—Permanganate of Potassium. Dose, gr. ss-ij. 
Liquor Potassii Arsenilis (U. S. P.).—Solution of Arsenite of Fotassium. Fowler’s 
Solution (strength nearly 1 per cent.). See page 361. Dose, TTli-x. 
Ptdvis Effervescent Compositus (U. S. P.).—Seidlitz Powder (sodium bicarbonate 40 
grains, Rochelle salt 3ij, in a paper together; tartaric acid 35 grains in a separate paper. 
Dissolve separately in water and mix). Dose, 1 or 2 taken while effervescing. 
Pharmacology.—Potassium salts exist in certain minerals, but they 
are derived principally from the ashes of plants ; the)- are also present in 
animal tissues, especially in the muscles. Potassium is a white metal 
discovered by Humphry Davy in 1807. It decomposes water with such 
violence that it ignites the hydrogen, burning with a red flame and form- 
ing the hydrate or caustic potash, which is a most powerful alkaline base, 
soluble in half its weight of water. When dissolved in 20 parts of water 
it forms liquor potass®. The chlorate of potassium, when triturated in a 
mortar with sugar, sulphur, tannin, charcoal, glycerin, and numerous other 
substances, and occasionally even triturated alone, is liable to explode ; 
and therefore, in making the troches, the Pharmacopoeia directs that the 
chlorate of potassium shall be added to the other ingredients last and 
mixed carefully by means of a horn spatula. The troches sometimes 
explode spontaneously. At all events, the proportion is too large ; there 
should not be more than 1 or 2 grains in each lozenge. The bichromate 
also forms an explosive mixture with glycerin. The salts of potassium 
are usually colorless or white and are generally soluble in water; some 
of them are deliquescent. 
Physiological Action.—Caustic potash abstracts water and fat from 
the tissues and produces a soft eschar when applied to the skin, which is 
subsequently separated by inflammation from the uninjured parts. This 
substance, moreover, dissolves the albuminous constituents of parts with 
which it is brought into contact. Taken internally in concentrated 
form, it is a corrosive mineral poison, destroying the soft parts and 
causing much irritation and secondary inflammation of the larynx or 
oesophagus, leading to stricture and gastritis. Even by liquor potass® 
these symptoms may be produced, unless the remedy be very largely 
diluted. The carbonate is a powerful antacid, both in.the intestinal tract 
and in the blood, favoring the expulsion of uric acid, with which it forms 
salts more soluble than those of sodium; the bicarbonate, however, is 
preferable for internal administration, being more acceptable to the 
stomach. Under its use the urine becomes alkaline. Potassium is a 
cardiac poison, a muscle and nerve paralyzer through an influence upon 
protoplasm, and destructive to the ozonizing function of the red blood- 838 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
corpuscle. These effects are shown to a different degree by different 
salts, and vary with the dose. In physiological doses they increase the 
secretions, stimulate retrograde metamorphosis, and promote oxidation : 
if too long continued, they produce anaemia and wasting of the body, 
Small doses of the bicarbonate, taken before meals, stimulate the secre 
tion of gastric juice and make the urine more acid ; larger doses disordei 
digestion, are partly decomposed by the gastric juice, which is made less 
acid, and partly enter the blood, increasing its alkalinity and the alka 
1 i 11 ity of the urine also. The potassium salts with vegetable acids art 
generally decomposed in the blood, the vegetable acid being destroyed 
the base combining with carbonic acid and escaping in the urine, which 
it renders alkaline. The salts with mineral acids are not decomposed 
but in passing through the body exercise more or less effect upoi 
the blood and certain organs. The nitrate, in large doses, exerts r 
paralyzing influence upon the spinal cord, and produces great musculai 
weakness and reduction of reflex sensibility. In moderate doses, tin 
nitrate raises arterial tension and slows the heart’s action, but large] 
doses weaken its movements and finally arrest them. The fibrin of tin 
blood is less coagulable and the red blood-corpuscles have their oxygen 
carrying powers reduced. The urine is increased in quantity. Nitre 
paper, in burning, gives off fumes which afford relief to asthmatic 
sufferers. A little compound tincture of benzoin added to the papei 
makes the fumes more effective and agreeable. The chlorate of potas 
sium acts like the nitrate upon the spinal cord, but has a more pro 
found action upon the blood, disintegrating the corpuscles and making 
it of a chocolate color. Taken in large doses, vomiting, with hnema 
temesis, delirium, lnematogenous jaundice, and coma result. The bodih 
temperature is markedly depressed by large doses of the salts of 
potassium, and especially by the nitrate and chlorate. 
Landerer* reports a case of a man 18 years of age, who, for tonsil 
litis, had been given 460 grains of chlorate of potassium, to be dissolver 
in water and used as a gargle. He dissolved the whole in hot water ant 
drank it in two portions within half an hour, in the evening. He subse 
quently was faint and extremely thirsty, and drank some beer, wliicl 
produced violent vomiting through the night and pain in both hypo 
chondria. Next morning he came to the hospital, with headache, faint 
ness, and constipation. His skin was anaemic, eyes and lips cyanotic ; In 
had rigors and slight jaundice. The liver was slightly enlarged ; then 
was pain over the stomach and kidneys. The urine was very smal 
in quantity, only about a drachm ; very albuminous, and deposited i 
brown sediment of altered blood-corpuscles. On filtration, the color was 
* British Medical Journal, December 13,1890. 839 
POTASSIUM. 
dark-cherry red. It gave the guaiac reaction and, on spectroscopic 
examination, the lines of methaemoglobin. Blood from the linger also 
showed altered blood-disks in masses, as well as unaltered blood-corpus- 
cles, which formed imperfect rouleaux. Death occurred six days later, 
without convulsions or special anaemic symptoms. During this time 
suppression of urine -continued. The lesions, post-mortem, were dis- 
tributed through the body, but chiefly seen in the intestinal tract (wlJich 
was hyperaemic, inflamed, and eroded in places) and in the kidneys (which 
were much enlarged, oedematous, capsule adherent, blood-vessels over- 
filled, the tubes plugged with brownish masses, to which some detached 
epithelial cells adhered). The liver and spleen were also enlarged. The 
symptoms appear to be primarily dependent upon excessive blood 
destruction, blocking up of the urinary tubules with the detritus, and the 
consequent nephritis and anaemia. Jaundice and cyanosis were due to 
the same cause. As a rational treatment, Landerer advises blood-letting, 
followed by transfusion. The preceding case is presented here as a 
typical illustration of the effects of chlorate of potassium when taken in 
a poisonous dose. In many cases, death occurs earlier from collapse ; 
in others the patient becomes cyanosed and prostrated, but slowly 
recovers after stopping the medicine and using antidotes. It was 
formerly thought that the chlorate, which contains a large proportion of 
oxygen, was capable of yielding some of it to the tissues, but this is not 
now believed possible, as the salt is excreted unchanged very largely by 
means of the salivary glands. The nitrate, likewise, passes through the 
body unchanged. The treatment of poisoning will be considered in the 
next paragraph. The sulphate is a powerful purgative, but is too irri- 
tant to be used for this purpose, and less pleasant than lloelielle salt. 
The bitartrate, or cream of tartar, as it was formerly called, is diuretic 
as well as laxative. It is an ingredient in the compound jalap-powder, 
which is a very safe and efficient cathartic in dropsy attending heart or 
kidney disease. The salts of potassium are eliminated principally by 
the kidneys, though the salivary, mammary, and sudoriparous glands 
also assist in their removal. 
Treatment of Poisoning by Potassium Salts.—Poisoning by cyanide 
of potassium is not vety frequent, but it occurs, the symp- 
toms and treatment being those of hydrocyanic-acid poisoning. Alkalies 
should be promptly administered to prevent decomposition of the salt by 
the acid gastric juice, and the stomach and intestinal canal emptied as 
soon as possible, followed by the administration of arterial stimulants, 
such as coffee and ammonia, with cold affusions to the spine and friction 
of extremities. Doses of 3 to 5 grains have proved fatal. When caustic 
potash has been swallowed, it is necessary to use demulcents freely, with 840 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
vinegar as a chemical antidote, and encourage vomiting, giving digitalis 
and stimulants liypodermatically to sustain the heart. After death there 
is found inflammation, with softening, erosion, and sometimes perforation 
of the stomach. Death may ensue from shock, cardiac paralysis, or inflam- 
mation of the stomach and intestines. The chlorate of potash causes death 
by depression of vital powers, due to its destructive action upon the 
blood and the congestive obstruction of the kidnejs. The treatment 
is by saline purgatives and diuretics, especially calomel and caffeine, 
with hot baths, and, in case there is much cyanosis, transfusion of blood. 
The bromide of potassium causes gastralgia occasionally when taken 
into an empty stomach; this is relieved by hot drinks and carminatives. 
Therapy.—Although an efficient escliarotic, caustic potash is not 
often used because it produces a burn that is attended b}r a good deal of 
inflammation and pain. It was formerly the custom, in the treatment of 
diseases of internal organs, to establish an issue b}r application of caustic 
potash, and the resulting ulcer was kept irritated by a dried pea or a 
small piece of orris-root; but this practice is rarely resorted to at present. 
On account of the powerful, extensive, and penetrating action of this 
substance, it should never be used without precautionary measures being- 
taken for the purpose of limiting its effects. A hole cut in a piece 
of adhesive plaster, or in several pieces overlying each other, then 
placed upon the skin, is a simple device by which the application of the 
caustic may be circumscribed. Nor should it be left long in contact 
with the integument, since its influence continues for some hours after it 
has been removed. When the integument acquires a bluish tinge, and 
the epiderm is softened, it is time that the remedy should be discon- 
tinued. The spot should then be washed with some weakened vinegar, 
in order to neutralize any alkali which might remain. Finally, a poultice 
is applied to the area of action. Surgeons use caustic potash in treat- 
ing fistula in ano after operation, in order to prevent immediate union; 
also to soften ingrowing toe-nail. Dr. Purckhauer, of Bamberg,* describes 
a method which he has used with entire success in the treatment of this 
painful affection. The portion of nail which needs to be removed is 
I painted with a 40-per-cent, solution of caustic potash. At the end of a 
few seconds the upper layer of the nail has become so soft that it can be 
easily scraped off with a sharp-edged piece of glass. The procedure is 
repeated until all that remains of that portion of the nail is a thin scale, 
which can be excised by means of a pair of fine scissors. A valuable 
advantage of this practice is, that the patient is able to follow his usual 
avocation without the loss of any time. 
It is likewise used as an application to enlarged tonsils. Caustic 
* See Medical Bulletin, March, 1891. POTASSIUM. 
841 
potash is sometimes employed for the destruction of carcinomatous 
growths, the limitation of sloughing ulcers, or the removal of the hard, 
callous edges of chronic ulcers. It was formerly applied, not infre- 
quently, to the surface of chancres, chancroids, and syphilitic ulcers, 
hut is far too severe for such a purpose. In phagedama, however, it 
may he advantageously employed ; hut in most cases the Vienna paste 
will he found a desirable substitute. The solution of permanganate of 
potassium (gr. v-xl in l'5j) was formerly known as Condy’s fluid ; it is an 
oxidizing disinfectant, and a useful agent in dilute solution for irrigating 
wounds or ulcers. A solution of this substance is a serviceable applica- 
tion to the throat in diphtheria and scarlet fever. The permanganate of 
potassium is recommended by Weir Mitchell as the best antidote to the 
venom of snake-bite, provided that it can be brought into direct contact 
with the virus before absorption. The permanganate, and caustic potash 
as well, have been employed with a view to neutralizing or destroying 
the poison of rabid animals, though the results have not been encourag- 
ing. A solution of the permanganate is an efficient deodorizer in ozoena 
and inflammation of the middle ear. The bicarbonate of potassium is a 
good lotion (5j-Oj) for eczema and rheumatic joints, and in stronger 
solution (5ij-Oj) as an application in pruritus vulvae, and to bites of 
animals or insect-stings. Leucorrhoea, dependent upon excessive func- 
tional activity of the glands of the cervix uteri, is markedly benefited 
by vaginal injections of weak bicarbonate-of-potassium solutions. The 
same solution has been uspd, with asserted success, injected into the 
bladder as a solvent of uric-acid calculi. A drachm of the cyanide of 
potassium dissolved in a pint of water will often allay parsesthesia. 
The chlorate is also emplo37ed as a detergent wash, especially in the 
mouth and throat (oj-Oj)7 and in mercurial salivation it is particularly 
useful. In weaker solutions it may be applied to unhealthy wounds, or 
injected into sinuses and into the bladder or rectum for local inflamma- 
tion. In the form of powder it is dusted over exuberant granulations 
and malignant ulceration, and acts as an antiseptic and astringent. 
Prof. P. D. Ke}Tser has had much success in treating small epitheliomata 
of the eyelids by the daily application of finely-powdered chlorate of 
potassium, and has thus saved a resort to the use of the knife in some 
cases. As troches, chlorate of potassium is dissolved slowly in the 
mouth, so as to constantly moisten the throat; and in this way it is very 
valuable in scarlatinal and diphtheritic sore throat. The bichromate of 
potash, in solution, is a good application to warts and corns, and to 
venereal excrescences or mucous patches. It is largely used with sul- 
phuric acid as a battery fluid, and accidents occur by swallowing some 
of the fluid ; the symptoms of irritant corrosive poisoning at once appear, 842 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
with vomiting, pain, and restlessness, requiring the use of demulcents 
and anodynes, and free evacuation of the stomach and bowels. 
Internally, where alkalies are required, the salts of potassium have 
been very largely used. In acid dyspepsia, the bicarbonate, in large 
doses after meals, neutralizes the excess of acid and relieves heart-burn 
and pyrosis; while small doses, before meals, in atonic dyspepsia, stimu- 
late the free secretion of an acid gastric juice. In some cases of gas- 
tralgia the pain may be relieved by the bicarbonate in some effervescent 
water. The same salt is of value in the indigestion of obese individuals, 
also of rheumatic and gouty subjects. It is of material assistance, more- 
over, in the digestion of fatty food. In diarrhoea, excited by an ex- 
cessive quantity of acid in the bowel, the bicarbonate of potassium is 
an efficacious reined}7. The carbonate, in doses of a grain or two several 
times a day, is a remedy of some utility in whooping-cough. In some 
forms of bronchitis, especially in gouty persons, the liquor potass® is a 
good addition to a cough mixture, to liquefy the mucus and facilitate 
expectoration:— 
Liquoris potass*, f 3j. 
Syr. seuegae, f^j. 
Mist, glycyrrhiz* co., q. s. ad f §vj. 
M. Sig.: Take a dessertspoonful in a wineglassful of water every three hours for 
bronchitis, with scanty and tough expectoration. 
As the urine is rendered alkaline under its use, liquor potass® is 
frequently combined with other remedies in treating gonorrhoea:— 
Liquoris potass*, 
Copaib*, aa f3vj. 
Mucilag. acaci*, f § iij. 
Spiritus *theris nitrosi, f3vj. 
Tinctur* opii, f 3j. 
Aqu*, q. s. ad f^vj. 
M. Sig.: Take a tablespoonful well diluted, three or four times daily, in acute 
gonorrhoea. 
In cystitis and pyelonephritis, the same combination can be used, in 
order to render the urine less irritating. If, however, in cystitis, alka- 
line decomposition has occurred, the administration of alkaline remedies 
will, as Ringer points out, aggravate the disorder by assisting the trans- 
formation of urea into carbonate of ammonium. The alkaline treatment 
in acute rheumatism is suited to plethoric subjects, with strongly acid 
perspiration. The bicarbonate is used in doses of 20 to 30 grains every 
four or five hours in cinnamon-water, or the citrate or acetate may be 
given in full doses. If the system is alkalinized early in the disease, there 
is less danger of cardiac complication. Very often the treatment is best 
begun with the iodide of potassium for a day or two, and then the bi- POTASSIUM. 
843 
carbonate is substituted. The iodide is of special value in clironic rheu- 
matism in 10-grain doses, with compound syrup of sarsaparilla and 
water, three times a day. The carbonate may be added to a warm bath 
for rheumatic cases with benefit, especially in diseases of the skin of 
rheumatic origin. The acetate of potassium is the most diuretic of 
these salts, and is useful in oedema, ascites, and other effusions :— 
If Potassii acetat., 3iv. 
Infusi pilocarpi, 
Spts. junip. co., aa fgij. 
M. Sig.: A dessertspoonful in water, every two hours, in suppression of urine. 
In litliaemia and disorders of the urinary secretion, we obtain good 
results from the administration of the citrate or bitartrate:— 
If Potassii bitartrat. (crystals), §ss. 
Infus. juniper!, . . . Oj. 
M. et ft. sol. 
Sig.: To be drunk during the day to increase the flow of urine. 
The diuretic properties of the bitartrate render it valuable in chronic 
Bright’s disease. For the same reason this salt is of advantage in the 
treatment of puerperal eclampsia. Both the bitartrate and acetate are 
of avail in oedema dependent upon disease of the heart. The deposition 
of uric acid and formation of stone in the bladder may be prevented by 
the persistent administration of an alkali, and it is probable that small 
calculi may thus be dissolved within the bladder. Continued alkalinity 
of the urine is best maintained by means of the citrate, as that salt is 
less apt to derange the functions of the stomach or exert a deleterious 
influence upon the blood-corpuscles. 
If Potassii citrat., 
Lithii citrat., aa 3ij* 
Div. in chartulas no. xxiv. 
Sig.: Take one in a glass of Vichy water, every four hours, in lithsemia. 
In haemorrhoids the following is a useful laxative :— 
If Potassii bitartrat., §j. 
Sulphuris loti, §ss. 
Pulv. aromat., §ss. 
M. Sig.: A teaspoonful once or twice daily, made into a bolus with orange-syrup. 
The citrate of potassium is of service in the first stage of acute 
bronchitis, and in the form of neutral mixture or effervescing draught it 
affords marked relief to the nausea and vomiting which accompany 
febrile affections. It is, likewise, well adapted to the irritable stomach of 
phthisis. Incontinence, from a too concentrated condition of the urine, 
is benefited by administration of the citrate. The tartrate of potassium 844 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
and sodium is a very useful saline laxative, and is serviceable in fevers. 
The Seidlitz powders are most efficient taken early in the morning, when 
the stomach is empty. Potassium sulphate is not used as a purgative, 
although it has some cholagogue power; its action is too severe, and it 
is very bitter. Being a hard and dry powder, the sulphate is utilized in 
pharmacy for the trituration of powders and pill-masses. The nitrate 
of potassium in small doses reduces temperature and the force and 
frequency of the heart’s action, and is useful in the treatment of pneu- 
monia, as in the following combination:— 
Potassii nitrat., . gr. iij. 
Pulv. ipecac, et. opii, gr- i-ij* 
M. et ft. chartulae mitte tales no. xij. 
Sig.: Take one every two or three hours. 
The nitrate of potassium is also used in acute rheumatism. Unsized 
paper, saturated in a solution of nitre, is burned, and its fumes inhaled 
with good results in asthma. Potassium nitrite is still more depressing 
to the circulation, resembling nitro-glycerin,—indeed, practically identical 
in action,—according to Atkinson.* It may be substituted for the latter 
in the treatment of neuralgic heart affections (angina pectoris) and in 
epilepsy, in doses of gr. iii-v. Larger doses are dangerous. In asthma, 
it also may be given in conjunction with inhalation of nitre-paper fumes. 
The cyanide of potassium is used as a means of introducing hydrocyanic 
acid into the system for relief of the cough of bronchitis and phthisis. 
The permanganate has been given internally, it is said, with good results 
in flatulent dyspepsia and lithaemia. This salt, however, soon dis- 
agrees with the stomach. Neusser has recently reported favorably 
upon the action of the tellurate of potassium in the night-sweats of 
phthisis. He has found that this substance, in many cases, either sup- 
presses or considerably diminishes the sweats. Pills containing 2 centi- 
grammes grain) were given at first, but, in some instances, it was 
necessary to double the dose after the}’ had been in use for about a week. 
No toxic symptoms were ever manifested ; the appetite sometimes seemed 
to be improved by the drug. It communicates a strong odor, resembling 
garlic, to the breath of the patient. For the therapeutic action of 
bromide of potassium see pages 485 to 488. 
The Chlorate of Potassium is extravagantly praised by some and 
neglected almost entirely by others. It has been shown that, administered 
in 15-grain doses three times a da}’, it is serviceable in preventing 
disease of the placenta, and thus enabling a woman to go on to the end 
* Journal of Anatomy and Physiology, January, 1888; paper on the “ Pharmacology of the 
Nitrites and of Nitro-Glycerin,” read before Section on Therapeutics and Materia Mediea, Ninth 
International Medical Congress, Washington, D. C., September, 1887. POTASSIUM. 
845 
of term who had previously had several miscarriages. It appears, then, to 
he valuable in preventing intra-uterine death of the foetus, if administered 
for four or five months in the above doses. In maternal stomatitis it is 
regarded by Bartholow as the only remedy worth mentioning, given in 
doses of gr. xv-xx, three times a day. In the sore mouth of mercurial 
salivation it should be given internally and used locally as a wash, and 
also in the membranous and ulcerative sore mouth of children. From a 
review of its action it appears that persons are not equally susceptible 
to its effects, since one can take, with very little evident effect, a dose 
which would produce very decided symptoms in another. Hence arises 
a necessity for commencing with small doses, and gradually increasing 
to the quantity required to produce the effect. Dr. J. Gr. Sinclair Cog- 
hill, of Yentnor, Isle of Wight, England, contributed to the Proceed- 
ings of the International Medical Congress, at Washington, a paper on 
the subject, which very fairly and ably sums up the value of the drug. 
He found it useful in cases of deficient oxygenation of the blood, 
especially in placental inadequacy (as above stated); also in pulmonary 
insufficiency, arising from many pathological conditions interfering with 
the function of the lungs. He finds it a cardiac stimulant in debility 
of the heart, whether organic or functional, probably by improving the 
quality of the blood ; where the blood is impoverished, as after haemor- 
rhages, in anaemia, chlorosis, malarial cachexia, and in convalescence 
after acute diseases. In chlorosis, he gives the tincture of the chloride 
of iron in an effervescing solution containing 25 grains of chlorate of 
potassium, thrice daily, after meals. Quinine, digitalis, and nux vomica 
may also be used. It is best given in aerated water after food. It has 
decided antiseptic effects, and these are well shown when there is suppura- 
tion along the genito-urinary tract. In combination with arsenic 
(Fowler’s solution) internally and chlorate lozenges (aa gr. iiss) localty, 
it is of singular efficacy in clergyman’s sore throat or follicular pharyn- 
gitis. In diphtheritic croup Dr. Drysdale recommends:— 
Potassii chloratis, 3ij. 
Syrupi limonis, f§j. 
Aquae, f^iij. 
M. Sig.: Dose to a child under 2 years a teaspoonful, from 2 to 10 two teaspoonfuls, 
every half hour in urgent cases. 
In diphtheria, it should not be used in full doses on account of the 
depressing action of the potash upon the heart. Waugh uses :— 
!£. Potassii chloratis Cpulv.), 3j. 
Acidi hydrochlorici, f3iss. 
Misce et adde 
Tr. ferri chloridi, f 3ij. 
Aquae, q. s. ad f^iv. 
M. Sig.: A teaspoonful to be given undiluted every two hours. 846 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Free chlorine is generated in this mixture, which is based on Wat- 
son’s celebrated formula. It has been very successful in Waugh’s hands, 
succeeding in one case where sublimate applications (1 to 500) failed to 
check the spread of the disease. When diluted with water the above 
formula makes an excellent gargle. In the sore throat of phthisical 
patients we may give :— 
$ Potassii cliloratis, gr. xl. 
Glycerin I, f^ss. 
Morphinse taydroclilorat., gr. iss. 
Syrup, aurantii, q. s. ad f'^iv. 
M. Sig.: A teaspoonful occasionally. 
The chlorate of potassium will often be found beneficial in chronic 
bronchitis, and may be serviceably combined with ipecacuanha and 
senega. In liaematuria, purpura, scrofula, and many chronic affections, 
the chlorate has been used in some cases with marked results. In many 
affections of the skin, especially those attended with suppuration, the 
author can speak with unqualified approval of the action of the chlorate. 
In sycosis, pustular acne, eczema pustulosum, furuucles and carbuncles, 
the suppurative stage is decidedly abridged. It exerts a tonic influence 
in scrofula, and is peculiarly appropriate in the case of debilitated sub- 
jects of syphilis. The chlorate of potassium, as a rule, should be pre- 
scribed alone and not in combination with other agents, which may 
decompose it. The iodide of potassium has been already discussed 
under Iodine. (See page 695.) 
PRINOS (II. S. P.).—Prinos, Black Alder. 
Dose, 5ss. 
Pharmacology.—The black alder, Prinos verticillatus (Aquifoliacese), 
or winter berry, is an indigenous shrub, or small tree, bearing clusters of 
bright-red berries. The bark, which is the officinal portion, contains 
resin, tannin, and some bitter principle not j'et isolated. 
Physiological Action.—It is astringent, tonic, and alterative. 
Therapy.—Prinos is administered in the form of fluid extract, or a 
decoction, in gastric disorder and diarrhoea. Antiperiodic virtues 
have been attributed to this drug. It is also used internally and as an 
application in skin diseases. 
.PRUNUM (U. S. P.).—Prune. 
Pharmacology.—The Prunus domestica (Ilosaceae), or prune-tree, 
is cultivated as an article of food in all temperate climates. The dried 
fruit is officinal. The French prunes are the best; they should be large, 
sound, and not too dry. As stewed fruit they are used as a relish upon 
the table, and are generally liked. The cooked fruit is laxative, and is PRUNUS VIRGINIANA. 
847 
given to vomen after confinement, and to children. They may be made 
cathartic by the addition of senna or podophyllin, forming “medicated 
prunes.” 
PRUNUS VIRGINIANA (U. S. P.).-Wild Cherry. 
Preparations. 
Extraction Pruni Tirginiance Fluidum (U. S. P.).—Fluid Extract of Prunus Virgin- 
iana. Pose, ll\x-f3j. 
Infusum Pruni Tirginiance (U. S. P.).—Infusion of Prunus Virginiana (4 per cent). 
Pose, f§i-iv. 
Syrupus Pruni Tirginiance (U. S. P.).—Syrup of Prunus Virginiana (made by per- 
colation, without heat, with 30 per cent, of bark and a little glycerin). Pose, f3i-iv. 
Pharmacology.—The bark of the Primus serotina, or the Cerasus 
serotina (Rosaceae), collected in autumn, has an aromatic, astringent, 
bitterish taste, and on maceration in water has the characteristic odor of 
liydrocj’anic acid. This is developed by the presence of water, as the 
bark contains amygdalin and emulsin, which form hydrocjanic acid and 
an oil like the oil of bitter almond. Glycerin aids in keeping the dis- 
solved matters in permanent solution, and is therefore added to both the 
fluid extract and the syrup. The former more fully represents the drug 
than the latter, since the tannin is soluble in the dilute alcohol, but not 
in water. The infusion and syrup, therefore, are less astringent than the 
fluid extract. A wine of wild cherry nmy be made by extracting the 
medicinal principles from the bark, or bt’ the addition of 2 ounces of the 
fluid extract of wild cherry to 8 ounces of sherry wine. Dose, f5j-f3j. 
Physiological Action.—Wild cherry is astringent, tonic, and seda- 
tive. Its pleasant flavor has made the syrup a popular vehicle for cough 
remedies. It increases appetite and promotes digestion, reduces ex- 
pectoration and cough, and diminishes nervous irritability. 
Therapy.—As a tonic, the infusion is very serviceable in phthisis, 
where it also lessens the cough and expectoration, strengthens the di- 
gestive organs, and reduces fever. In the cough of phthisis we get good 
results from the following combination :— 
Codeinse, gr. ij. 
Tr. belladonna, f3ij. 
Syr. pruni Virg., q.s. ad fgiij. 
M. Sig.: A teaspoonful, or two, when cough is troublesome at night. 
Wild cherry allays nervous or reflex cough, and may very appro- 
priately serve as a vehicle for more potent remedies in whooping-cough. 
Palpitation of the heart, whether purely nervous or of dyspeptic origin, 
is benefited by the administration of this drug. Cases have been re- 
ported by Dr. Clifford Allbutt in which wild cherry was of service in 
mitral insufficiency, and in dilatation of the heart with chronic bronchitis 848 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
and dyspnoea. In nervous debility, insomnia, and poor digestion, small 
doses of the fluid extract are useful as a stomachic, taken before meals. 
In such cases, also, a ferrated wine of wild cherry, containing phosphate 
of iron (gr. ij in each f 3j) and fluid extract wild cherry, 10 per cent., will 
be found a good general tonic in doses of a drachm or two several times 
a day. 
PTELEA CORTEX.—Ptelea Bark, Hop-tree Bark. 
Pharmacology.—The Ptelea trifoliata (Rutaceae), a tree of North 
America, affords, in the bark of the root, an appetizing tonic, occasionally 
useful during convalescence in dyspepsia, etc. It is best given in fluid 
extract; dose, r^viii-xxx.* 
PULSATILLA (U. S. P.).—Pulsatilla, Meadow Anemone. 
Dose, gr. i-v, in fluid extract or tincture. 
Pharmacology and Therapy.—The herb of Anemone pulsatilla and 
Anemone pratensis and of Anemone patens (Ranunculacese), collected 
soon after flowering. It should be carefully preserved and not kept 
longer than one year. Pulsatilla contains an acrid, fluid, volatile prin- 
ciple, which readily breaks up into Anemonin and Anemonic acid. The 
active principle being volatile, the herb must be fresh or, at least, not 
kept longer than a year, if carefully preserved. 
Physiological Action.—The recent plant has some irritant properties, 
the juice causing numbness, tingling, and inflammation of the part to 
which it is applied. Internally, it lowers the pulse-rate and temperature 
in the inferior animals, and stupor and convulsions have been produced 
by large doses. In considerable quantity in the human subject it causes 
nausea and vomiting. 
Therapy.—Pulsatilla has been used principally by irregular practi- 
tioners of German proclivities, and its reputation is based almost exclu- 
sively upon statements many of which do not bear exact and unprejudiced 
criticism. It is possible that to some of these observations there is some 
substratum of fact, but at present pulsatilla can scarcely be said to have 
any status in scientific medicine. Bartholow, however, considers pulsa- 
tilla adapted to the treatment of acute catarrh of the respiratory passages 
unattended by gastro-intestinal disorder. Borchain praises its action in 
acute epididymitis, given in doses of 1 or 2 minims of the tincture even- 
two hours. Shapter has found it useful in hysterical convulsions and 
reflex spasms due to uterine disease. Phillips states that he has seen 
pulsatilla do good in mental disorders, and in sudden suppression of the 
menses, or lochia. 
*01dberg and Wall’s Companion to the United States'Pharmacopoeia, second edition. PUNICINE. 
849 
PUNICINE. 
Punicine, or Pelleti^rine.—The crystallizable alkaloid representing 
the tamiacidal properties of pomegranate-bark, named punicine by Carl 
Julius Sender* is commonly known as pelletierine. It can be used in 
drachm doses of a 10-per-cent, solution of the sulphate, or tannate, for 
tape-worm. (See Pomegranate, page 648.) 
PYRETHRUM (U. S. P.).—Pellitory. 
Preparation. 
Tinctura Pyrethri (U. S. P.).—Tincture of Pellitory (20 per ct.). Not used internally. 
Pharmacology and Physiological Action.—The root of Anacyclus 
P3’rethrum (Rosacete), a small plant of Africa, cultivated in Europe, con- 
tains an alkaloid, Pyrethrine, an acrid resin, a volatile oil, tannic acid, 
starch, mucilage, etc. Pyrethrum has an acrid taste, and causes a free 
flow of saliva (sialagogue), with a prickling, pungent effect upon the 
tongue when chewed. If swallowed in considerable doses, it causes diar- 
rhoea and tenesmus and dysenteric or blood}' stools, with depression and 
stupor. A child years old nearly died with gastro-enteritis after 
swallowing 50 minims of the tincture. It is irritating to the skin and 
causes sneezing w'hen inhaled into the nostrils. 
Therapy.—In neuralgic, rheumatic, and other painful affections of 
the tongue or teeth, pellitory may be chewed or held in the mouth. 
Pellitory-root is sometimes used as a masticatory in paralysis of the 
tongue, and may be employed in order to stimulate the salivary glands 
when their secretion is deficient. Dr. Whitla finds that the sialagogue 
action of pellitoiy constitutes an excellent means for the removal of iodine 
from the system. A few drops of the tincture may be introduced into 
hollow, aching teeth; or, diluted with water, it may be used as a stimu- 
lating mouth-wasli or gargle in scorbutus and sore throat, with relaxed 
mucous membrane. 
Pyrethrum roseum, or Persian insect-powder, is a variety of pel- 
litory growing in Asia, of which the flower-heads are very destructive to 
insect life. The powdered flowers are largely used to kill insects. If a 
small quanta is placed upon a plate and wet with alcohol and ignited, 
the fumes w'ill kill or drive from the room small insects like flies or mos- 
quitoes. It is also used in household econoni}', and in furniture to de- 
stroy chink-bugs, and also to remove fleas from dogs. Schagdenhauffen 
and Reeb'j' have discovered recently in these flowers an active principle, 
which they name Pyrethrotoxic acid. When hypodermatically injected 
into animals, it causes at first excitement, soon followed by complete 
* Midland Medical Miscellany, June, 1885. 
t American Journal of Pharmacy, September, 1890l 850 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
prostration and paralysis of lower extremities, and death by failure of 
respiration and circulation. 
PYRIDINUM.—Pyridine. (C6TI6N.) 
Dose, f3i-ij, for inhalation. It is not administered internally. 
Pharmacology.—Pyridine is a clear, colorless, volatile liquid, with 
characteristic odor and pungent taste; in aqueous solution it has a 
marked alkaline reaction. It boils at 116° C. (240.8° F.), and is mis- 
cible with water, oil, alcohol, ether, and benzine, forming clear solutions. 
It gives precipitates with solutions of most metals, but not with lead 
acetate and magnesium sulphate. Pyridine is the foundation of a group 
of compounds known as pyridine bases, formed in the dry distillation 
of bones and other nitrogenous compounds, and as a decomposition 
product of nicotine and some other alkaloids. It was discovered in 184(i 
b}f Anderson. Chapman and Smith have made it by synthesis, by dehy- 
drating amyl nitrite with phosphoric anhydride. 
Physiological Action.—Upon the healthy adult, inhalations of the 
vapors of pyridine mixed witli air produce flushing of the face, with 
quickening of the pulse and of the respiration, the latter lasting only a 
few moments, the former from lifteen minutes to ten hours, depending 
upon the amount inhaled. Pyridine produces slight giddiness and 
sometimes headache. In asthmatic patients the quickening of the 
respiration is not observed ; on the contrary, the heart’s action slowly 
falls to the normal, if it had been previously accelerated, without change 
in rhythm or force, while the respiration becomes slower, easier, and 
fuller, the dyspnoea disappearing. In most cases there is a desire to 
sleep without narcotism or interference with brain functions, the patient 
being easily wakened, as out of natural sleep. The odor of the drug is 
soon recognized in the urine, and it is probably partly expelled b}’ the 
kidneys and in part by the lungs. 
Therapy.—From the fact that tobacco-smoke, when inhaled, gives 
relief in asthma, German See was led to attribute the effect to pyridine; 
and from clinical experience, in a woman suffering with asthma and 
d3rspnoea from heart disease, he was induced to advocate its further 
employment. One or two teaspoonfuls were poured upon a plate, and the 
fumes inhaled by the patient with her head directly over it. These in- 
halations were continued from twenty to thirty minutes, and were found 
to afford much relief, and frequently to abort or arrest the dyspnoeic 
attack. In a number of other cases, including some both of pure asthma 
and of cardiac asthma, this treatment was resorted to with remarkably 
good results. S£e believed that pyridine is the most certain agent for 
bringing relief when iodine fails, and that it is superior to the h ypodermatic 
use of morphine, its action being more lasting and better borne by the PYROXYLINUM. 
851 
system. Dr. Neff* also reported good results. Of 12 cases, 3 were of 
nervous asthma, with complete relief and no return of the attack; 3 cases 
of cardiac asthma were relieved; 3 of bronchial asthma had no return 
of attack; of 2 cases of dyspnoea in advanced phthisis 1 was slightly 
relieved, the other was not benefited ; 1 case of asthma, as complication 
of gout, was cured. All unpleasant symptoms were confined to cases 
with long-standing emphysema, or valvular or degenerative heart disease, 
with small, irregular pulse. In advanced phthisis it should be used with 
care, and probably will fail. Pyridine is worthy of trial in angina pectoris. 
PYROXYLINUM (U. S. P.).—Pyroxylin, Soluble Gun-Cotton. 
Gun-cotton is white, dry, and entirely soluble in a mixture of alcohol 
and ether. It is inflammable and violently explosive. Used in making 
collodion. (See page 565.) 
QUASSIA (U. S. P.).—Quassia. 
Dose, gr. x-xxx. 
Preparations. 
Extradum Quassia* (U. S. P.).—Extract of Quassia. Pose, gr. i-v. 
Extractum Quassice Fluidum (U. S. P.).—Fluid Extract of Quassia. Pose, Nlv-xx. 
Tindura Quassice (U. S. P.).—Tincture of Quassia (10 per cent.). Pose, lilxx-fo.j. 
Infusum Quassice.—Infusion of Quassia (3ij-Oj). Pose, f3i-ij. 
Pharmacology.—Quassia is the -wood of Picraena excelsa (Simaru- 
baceae), a large tree of the West Indies, usually occurring in the form 
of small chips or raspings, nearly white, without odor, but very bitter. 
It is sometimes made into cups or vases, in which hot water is poured at 
night, to be drunk early in the morning, or through the day, as a bitter 
tonic. Quassia-wood contains a bitter, neutral principle, Quassin, crys- 
tallizing in needles, and readily soluble in alcohol and in hot water. It 
also has a minute quantity of volatile oil, but no tannin. The solid 
extract is aqueous, but the fluid extract is made with dilute alcohol. 
The tincture is 50 per cent, stronger than the same preparation in the 
preceding revision of the pharmacopoeia. 
Physiological Action.—Quassia is very destructive to flies and insects. 
A concentrated solution is poisonous to the lower animals, and caused 
serious symptoms of narcotism in a child of 4 years, as mentioned by 
Potter. Quassia is a simple bitter, without astringency ; it is a good 
stomachic, and increases the appetite. 
Therapy.—This drug is used as a tonic in dyspepsia, where it prob- 
ably exerts both a tonic and an antiseptic action. It can be given with 
iron on account of the absence of tannic acid, and often has aromatics 
combined with it to improve the taste. It is useful during convalescence 
* New York Medical Journal, March 13,1886. 852 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
to stimulate tlie appetite, and may he combined with an alkali and given 
before meals. In children, an infusion of quassia is a useful agent as an 
enema to destroy thread-worms. 
QUEBRACHO.—Aspidosperma. 
Dose, f5ss-j, in fluid extract. 
Pharmacology.—The bark of the Quebracho bianco,or, more correctly, 
the Aspidosperma quebracho, Var. Blanco (Apocynaceae), a large tree of 
Brazil, contains two alkaloids, Aspidospermine and Quebrachine, and 
other principles not yet studied. It has also been obtained in Catamarea, 
of the Argentine Republic, where it has a popular reputation as a 
febrifuge and antiperiodic. A fluid extract is the best preparation. 
Physiological Action.—Quebracho is bitter and stimulant to the sali- 
vary glands, astringent to the intestinal tract. In large doses in animals it 
produces paralysis of the limbs, of central origin.* It also causes saliva- 
tion, paralysis of respiration, and diminished frequency of the heart’s 
action; death is caused by paralysis and convulsions due to apnoea. 
Moderate doses retard breathing, and make inspiration slower and fuller. 
Therapy.—The special action upon the motor apparatus of respira- 
tion makes quebracho valuable in treating d yspnoea of all kinds, whether 
bronchial, cardiac, or nervous. In emphysema, with or without asthma, 
it has been very serviceable in the form of fluid extract, several 
times a day. Quebracho is also of service in spasmodic croup. Dr. 
Picot states that it is advantageous to the respiration when taken before 
hill-climbing. The effect of quebracho in relieving cyanosis is very 
marked. This drug very sensibly diminishes the pulse and temperature 
in acute rheumatism and inflammations of serous membranes. An elixir, 
a wine (6 per cent.), and a tincture (40 to 50 per cent.) have also been 
used. The alkaloid aspidospermine has been employed as a febrifuge, 
and, according to Guttmann, its dose as an antiperiodic is 18 grains, the 
ordinary dose being 1 or 2 grains. It is soluble in oils or 50 parts of 
pure alcohol. 
QUERCUS ALBA (U. S. P.).—White-Oak Bark. 
Dose, f3ss-j, in fluid extract or decoction. 
Pharmacology.—The bark of Quercus alba (Cupuliferre) contains 
Quercitannic acid, and a bitter principle, Quercin; also pectin, coloring 
matter, etc. There are no officinal preparations ; but a decoction (oj-Qj) 
is usually employed, and a fluid extract made with diluted alcohol is 
obtainable, but they are rarely used internally. Oak-galls from Quercus 
lusitanica also contain tannin, and, as they answer a similar purpose, they 
are more convenient for use than the white-oak bark. 
*F. Penzoldt, Berliner klin. Woclienschrift, No. 19, 1879. QUILLAIA. 
853 
Physiological Action and Therapy.—A decoction of white-oak bark is 
occasionally used as an injection or wash in leucorrhoea; also in sore 
throat and nasal catarrh, but stains clothing, and ma}1, be substituted by 
solutions of tannic acid. The applications of tannic acid have been 
already considered (page 394). The powdered bark is an ingredient in 
tooth-powders; it was also formerly used as an absorbent application to 
ulcers and as a poultice in gangrene. 
QUILLAIA.—Quillaia, Soap-Bark. 
Preparations. 
Pulvis Quillaice.—Powdered Quillaia. Dose, gr. x-xxx. 
jExtraction Quillaice Fluidum.—Fluid Extract of Quillaia. Dose, Hlxv-f3ss. 
Tinctura Quillaice.—Tincture of Quillaia (20 per cent.). Dose, f3i—ij. 
Decoctum Quillaice.—Decoction of Quillaia (5 parts in 200). Dose, f3i—ij. 
Saponin. Dose, gr. ss-ij. 
Pharmacology.—The bark of the Quillaia saponaria (Rosacete), a 
tree of moderate size, a native of Chili, is brought to this country in flat 
pieces several inches wide and from 2 to 3 feet in length. The outer 
surface is brownish white, the inner whitish and smooth. It has a 
splintery fracture. It is destitute of odor, but is very acrid to the nasal 
passages. The infusion of saponaria, when shaken, froths like soap. This 
property depends upon the presence of an irritant, poisonous glucoside 
called Saponin, which has been found in a number of vegetable species 
and genera, and is probably identical with polygalin. Saponin was 
isolated in 1850 b}r Le Boeuf. It is a white, crystalline powder, the taste 
of which is at first sweet and afterward acrid. Saponin is slightly solu- 
ble in water, but more readily soluble in strong and boiling alcohol. The 
solutions of saponin froth when shaken. Its saturated alcoholic solution 
is a solvent for gums, resins, and oils, with which, after being mixed 
with water, it forms permanent emulsions. 
Physiological Action.—The powder of soap-bark and solutions of 
saponin are strongly irritant to the Schneiderian membrane and excite 
sneezing. In weak solutions, saponin is a local anaesthetic; in concen- 
trated form, it is a protoplasmic poison, and its local action destroys the 
energy of nervous and muscular tissue. Saponin exerts a specific influ- 
ence upon the alimentary tract, since even intra-venous injections give 
rise to gastro-enteritis. Schroff found that to 3 grains of saponin pro- 
duced irritative cough and secretion of mucus in the bronchial tubes, 
lasting for several hours, but no effect was manifested upon either the 
kidneys or skin. Saponin reduces the force and frequency of the heart’s 
action, and finally paralyzes it. 
Therapy.—It is principally as a topical remedy that quillaia has been 
employed, but, although its range of application is limited, it exhibits 854 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
decided power. Quillaia* is an excellent stimulant to chronic ulcers 
and chronic eczema, the affected parts being covered by a roller-bandage 
which has been saturated in an infusion of soap-bark. The same prepa- 
ration is of value in hyperidrosis and bromidrosis. The hands and feet 
may be advantageously bathed in this solution every day or every second 
day, while the axillae or face can be mopped by a sponge which has been 
dipped in the infusion. In dandruff and simple pityriasis, the watery 
solution of soap-bark is an efficient application. The tincture may be 
employed where more powerful action is required, as in chronic eczema 
or alopecia circumscripta, in which conditions it will often prove superior 
to the tincture of green soap. Piffard recommends a mixture of fluid 
extract of soap-bark with glycerin in certain forms of acne. 
QUININA. For quinine and its associated alkaloids and prepara- 
tions, see Cinchona, page 543. 
RESINA (II. S. P.).—Resin or Rosin, Colophony. 
Preparations. 
Ceratum Itesinre (U. S. P.).—Resin Cerate (resin 35, yellow wax 15, lard 50 parts). 
Emplastrum Itesince (U. S. P.).—Resin Plaster, Adhesive Plaster (resin 14, lead plaster 
80, yellow wax 6 parts; spread on muslin). 
Linimentum, Tcrebinthince (U. S. P.).—Turpentine Liniment (resin cerate 65, oil of 
turpentine 35 parts). 
Pharmacology.—Resin is the solid residue after distilling off the vola- 
tile oil from turpentine. (See Terebinthina.) It enters into several 
officinal cerates and plasters, to which it gives adhesiveness. Resin is 
insoluble in water, but soluble in alcohol, ether, fixed and volatile oils. 
Physiological Action.—It is slightly irritating to the skin, and inter- 
nally is antiseptic and slightly astringent in its effects upon the alimen- 
tary canal. 
Therapy.—Resin has been employed as a domestic remedy for diar- 
rhoea, a few grains finely powdered being given every hour or two, but it 
is seldom used internally by regular practitioners. The fumes coming 
from boiling resin may be inhaled in chronic bronchitis and winter-cough. 
Resin cerate, or basilieon ointment, as it is sometimes called, is a popular 
dressing for ulcers, promoting cicatrization and granulation. Compound 
resin cerate, or Deshler’s salve (Pharm. 1870), no longer officinal, con- 
tains crude turpentine, and is more stimulating than the plain cerate ; it 
is sometimes applied to blisters to prevent their healing too quickly and 
to promote suppuration. 
* See paper by author “ On a Natural Soap and its Use in the Treatment of Diseases of the 
Skin,” The Medical Bulletin, July, 1879. 855 
RESORCINUM. 
RESORCINUM.—Resorcin. 
Dose, gr. x-xv to 5j- 
Preparations. 
Unguentum Resorcini.—Ointment of Resorcin. 
Pheno-Resorcinum.—Pheno-Resorcin (carbolic acid 67, resorcin 33 parts). 
Pharmacology.—Resorcin is obtained by fusing certain gum-resins 
with caustic potash. The process for obtaining it from gum ammoniac is 
described upon page 431. It is now prepared on a large scale syntheti- 
cally. It crystallizes in small, colorless prisms or plates, has a neutral 
reaction, a sweetish taste, with slight pungency or acidity, and an odor 
which resembles that of carbolic acid. Resorcin melts at 219.2° F. and 
distills at 512.6° F. It was discovered by Hlasiwetz and Barth. 
Resorcin is an oxyphenol, homologous with orcin, derived from 
benzol by the substitution of two hjdroxjd groups for two atoms of 
hydrogen. Chemically, it is meta-di-hydrox)7-benzol, C0II4(II2O)2. It 
is soluble in water and other solvents, except chloroform and carbon 
disulphide. The best vehicles for medicinal purposes are alcohol, 
glycerin, and syrup of orange. The dose usually is from 5 to 15 grains; 
a drachm may be given at a single dose as an antipyretic. It is a 
most efficient antiseptic and antiferment. Andeer* recommends butter 
as a vehicle for making an ointment (1 per cent.) extemporaneously. 
Physiological Action.—Resorcin is non-irritant to the skin, and, 
injected subcutaneously, causes very little inflammation and no suppura- 
tion. In strong solutions, it irritates mucous membranes and sometimes 
vesicates them. In full doses (30 to 60 grains) resorcin acts as an anti- 
pyretic, reducing the temperature for two or three hours, but at the same 
time has the disadvantage of causing nausea, oppression, languor, and 
free perspiration. Above these amounts it is not safe to go, since by 
larger doses cerebral sjunptoms are induced, such as deafness, vertigo, 
confusion of vision, convulsions (clonic and tonic), rigidity of the muscles 
of the back of the neck. In lower animals, death occurs from failure of 
respiration and paralysis of motor tracts in the spinal cord. It is 
excreted chiefly by the urine, which it darkens or even changes to a 
bluish color; the addition of tincture of chloride of iron to such urine 
causes it to become a dark-violet color. Symptoms of poisoning in man 
are best treated by diffusible stimulants and diuretics; atropine and 
strychnine might be given hypodermatically. 
Therapy.—The decided antiferment and antiseptic qualities of resor- 
cin, with its solubility and not unpleasant odor or taste, make it a valuable 
application for the throat and nose in diphtheria ;f it may also be adminis- 
* Proceedings Ninth International Congress, vol. iii, p. 100. 
| “Resorcin in Diphtheria,” Centralblatt f. d. gesammte Therapie, Heft 9,1890. 856 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
tered internally to disinfect the gastro-intestinal tract, and thus prevent re- 
infection. It is furthermore of service to impregnate the atmosphere of 
the sick-chamber by the spray of a 5-per-eent. solution of the same agent. 
In erysipelas, puerperal fever, and septicaemia, resorcin has been used, 
both locally and internally, with marked benefit. A 2-per-cent, solution 
makes a spray for various catarrhal and other affections. In saturated 
ethereal solution, resorcin acts as a slight caustic, especially to raw sur- 
faces or mucous membranes. The powder may be dusted on granulations 
or combined with boracic acid (1 to 20 or 1 to 10) ; it is very efficient in dis- 
charges from the ear. The ear should be thoroughly cleansed with a 
solution of boric or carbolic acid, and dried ; after this the above powder 
can be blown into the canal. To foul ulcers and sloughing wounds an 
ointment containing I or 2 drachms of resorcin to the ounce is an excel- 
lent application. Chancroids and ulcerated syphilitic lesions receive 
decided benefit from the same preparation. A 1- or 2- per-cent, watery 
solution of resorcin is of service in acute or chronic conjunctivitis and 
wounds of the cornea. It is likewise a beneficial application to tubercu- 
losis of the larynx, to mercurial and other forms of stomatitis, and to 
thrush. In whooping-cough and hay fever this remedy is 
used in the form of a spray, a 2-per-cent, solution being efficacious in the 
former disease, while in hay fever the solution has been made as strong 
as 20 percent. Resorcin ointment has been emplojed with good effect in 
certain diseases of the skin, as chronic eczema, psoriasis, alopecia circum- 
scripta, and lupus erythematosus. In the abortive treatment of herpes, 
M. Leloir employs the following solutions (Medical News) :— 
Resorcin., 3ss. 
Cocain. hydrochloratis, gr. viij vel xxx. 
Acidi tannici, 3iss. 
Alcohol. (90 per cent.), 1 §iij.—M. 
Or, 
Cocain. hydrochloratis, gr. xv. 
Ext. cannabis Indicae, 3iiss. 
Spt. menth. pip., f^iiss. 
Alcohol. (90 per cent.), f 3ij.—M. 
M. et ft sol. 
Resorcin-soap (5 or 10 per cent.) has been found useful in ringworm 
of the scalp and other parasitic skin diseases, as first used by Julius An- 
deer. Resorcin is preferable to carbolic acid for internal administration, 
and can be given as an antiferment in dyspepsia and digestive disorders. 
In gastric catarrh, gastralgia, and ulcer of the stomach, resorcin has ren- 
dered good service. It is also serviceable in the diarrhoea of children. A 
solution of resorcin has been successfully employed as an injection in 
gonorrhoea and for washing out the bladder, there being but little danger RETINOL. 
857 
from absorption of the remecty. Pheno-resorcin is soluble, forming a 
liquid with 10 percent, of water, and maybe used like carbolic acid. In 
epithelioma of the skin, resorcin has given excellent results in the hands 
of Dr. Mario Luciani, who reports .2 cases of cutaneous epithelioma 
in which he claims to have effected a complete cure by the application of 
an ointment containing resorcin. He used the following formula:— 
Resorcini, 3iiss. 
Petrol ati, §j. 
M. Sig.: Apply once a day to the ulcerated surface after previously cleansing with 
a 2-per-cent, watery solution of borax. 
One case, a woman of 48 years, with an ulcer upon her forehead, was 
cured in three months ; and in another, 60 years of age, with the same 
disease upon her lip of about a year’s duration, this simple treatment was 
followed by an equally happy result. No microscopic examination 
appears to have been made in either case in order to establish the 
diagnosis (Journal American Medical Association). 
RETINOL 
Pharmacology and Physiological Action.—Retinol, or Rosinol 
(C35H16), is a liquid h}’drocarbon, obtained by the dry distillation of 
colophony. It is of a brown or yellowish color, has the consistency of a 
fat, and has a slightly bitter taste ; its reaction is slightly acid on account 
of the presence of traces of picric acid. It forms a varnish-like coating- 
over a surface when applied. It shares the antiseptic properties of the 
other balsams, and possesses the additional advantage of dissolving a 
great number of active substances, such as oil of cade, camphor, naphthol, 
balsam of Peru, etc. By mixing with a proper proportion of colophony, 
with oak-leaves or borate of sodium, a mass can be obtained sufficiently 
adhesive to allow it to be made into suppositories for vaginitis, etc.* 
Retinol is non-irritating when applied to the skin, and is an excellent 
vehicle for medicaments in cutaneous diseases. It does not become rancid 
and is unchangeable by time or light. The price is moderate. 
Therapy.—M. Barbier gives a number of formulae for its use, from 
which the following are taken *.— 
Retinol., 3iiss. 
Lanolini, 3j gr. xv. 
Sodii bicarbonatis, gr. ij. 
M. et ft. unguentum. 
This is used in the ophtlialmological clinic of Dr. Hubert for con- 
junctivitis, simple or gonorrhoeal affections of the lids, the tear-ducts, 
and for the preparation of dressings and protection of instruments; or 
the following, of greater consistence, may be ordered :— 
* Drs. Balzar and Clievalet, La Medecine Moderne, April 21,1890. 858 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
R Retinol., 
Resinse, 
Lanolini, aa 3ij. 
M. et ft. unguentum. 
Iii diphtheria, the following has been used as a topical application :— 
R Retinol., §ss. 
Camphors, gr. xxx. 
Naphthol., gr. xv. 
M. et ft. ung. 
Sig.: Apply to the affected areas. 
II Retinol., 
Beta-naphthol., . 3iss. 
Saponis viridis, §ij. 
Cretae preparatae, . . . 3iij. 
M. Sig.: Apply to affected parts, for scabies. 
In some skin affections, the following may be used with advantage :— 
R Retinol., 3ij. 
Glycerit. amyli, 3iij. 
M. Sig.: For external application as directed. 
Or this :— 
R Retinol., 
01. cadini, JS, 3iv. 
M. Sig.: For psoriasis, chronic eczema, etc. 
M. Vigier* states that retinol gives excellent results in vaginitis 
and in blenorrhoea, as a topical application. It is antiseptic, unirritating, 
and, in a large number of skin diseases, it gives excellent results either 
alone or as an antiseptic excipient for other substances. 
RHAMNUS CATHARTICUS.—Common Buckthorn. 
Preparations. 
Extr actum lihamni Catliarticw Fructus Fluuium.—Fluid Extract of Buckthorn-Berries. 
Dose, f3i-iss. 
Jthamni Cathartics Succus.—Buckthorn-Juice. Dose, >hxv-f3j. 
Syrupus Rhamni Cathartics.—Syrup of Buckthorn (buckthorn-juice with ginger, 
sugar, allspice, and alcohol). Dose, 3i—ij. 
Pharmacology.—The fruit of the common buckthorn, Rhamnus 
catharticus (Rhainnacete), is decidedly cathartic and cholagogue; the 
bark also has these properties, and, this species being naturalized in this 
country, probably it is often substituted for the officinal frangula-bark, 
which is the alder buckthorn, an allied species of rhamnus. (See page 
634.) Cascara sagrada, or Rhamnus purshiana, is another variety of the 
same species. The fruit is purplish black, and, when dried, is about the 
* “Dii Retinol et de Son Emploi en Medecine,” par F. Vigier. Journal de Medecine de 
Paris, November, 1890, page 641. KIIAMNUS PURSHIANA. 
859 
size of a pea ; the pulp contains four seeds ; odor slight; taste nauseating, 
bitter, and acrid. The active principle is Rhamnocathartin, an amorphous, 
yellow, brittle substance. 
Physiological Action.— All the species of Rhamnus possess purgative 
properties of greater or less activity, but some are much more violent in 
action than others. Nausea, vomiting, and severe griping pains often 
attend their purgative action, to avoid which aromatics are usually 
added, as in the syrup, which formerly was largely used in Europe, but 
not in this country to any extent. The common buckthorn likewise 
produces extreme dryness of the mouth and throat. 
Therapy.—The preparations of Rhamnus catharticus are used for the 
same purposes as frangula, but are more severe in their action than the 
next variety to be considered. It may be employed in dropsy, and was 
formerly used in the treatment of gout and rheumatism. 
RHAMNUS PURSHIANA.—Cascara Sagrada. 
Pharmacology.—Rhamnus purshiana (Rhamnacere) is a shrub or 
small tree, 10 to 20 feet high, growing on the Pacific coast, and is some- 
times known as the California buckthorn. The bark is the portion used, 
and an analysis by Prof. A. B. Prescott * showed its chief constituents 
to be a bitter, brown resin ; a red resin, a light-3Tellow resin ; tannic, malic, 
and oxalic acids; a neutral, crystallizable substance; a volatile oil, wax- 
starcli, and a fat oil of yellowish color. Professor Wenzell also distin- 
guished a glucoside, and Meier and Webber a peculiar ferment. 
Physiological Action.—Cascara sagrada is not a purgative so much 
as it is a laxative with tonic properties, the latter being attributable to 
the bitter principle. 
Therapy.—This agent, in the form of fluid extract (in doses of 
three times daily), is useful in chronic constipation. The dose should be 
gradually increased until the bowels naturally once daily, and 
the remedy can then be given less frequently and the dose reduced. It 
is a peculiarity of this drug that it is not a cathartic, and its use should 
be preceded a dose of castor-oil to clear the alimentary canal. It has 
the advantage of producing natural motions of the bowels by its tonic 
action upon the intestinal glands, increasing secretion and peristalsis. 
The dose is reduced after the natural condition of the bowels is estab- 
lished ; it does not require to be given in increasing quantities, as do 
the ordinary resin-bearing cathartics. It also is a valuable hepatic tonic in 
congested liver and in duodenal catarrh. Cases of indigestion, with 
furred tongue, sallow skin, eructations of gas, constipation, are benefited 
by the following prescription :— 
* New Preparations, February, 1879, page 27. 860 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Ext. rhamni purshianae fl., f^j. 
Glycerini, 
Elixir, aromat., aa f^ss. 
M. Sig.: Take from one-half to one teaspoonful, directly after eating, three times 
daily, until the symptoms are relieved. 
In cases of chlorosis, Luteaud gives :— 
Ammonii et ferri citrat., 40 parts. 
Ext. rhamni purshiana fl., 40 “ 
Saccharin., 1 part. 
Aquae destillatae, 4000 parts. 
M. Sig.: A teaspoonful to be taken before each meal, for constipation. 
In of the bowels, a combination with berberis aquifolium is 
useful:— 
Ext. rham. pursh. fl., 
Ext. berberis aquiiol. fl., 
Syrupi, f§j- 
M. Sig.: Dose, a teaspoonful four times a day. 
In constipation with gastric irritability, Dr. J. H. who first 
introduced the remedy to the profession, proposed the following:— 
Ext. rhamni catharticae fl., f§ss. 
Ext.berberisaquifol.il., f§j. 
Acid, hydrocyanici dilut., f3j. 
Syrup, (vel ext. malti), q. s. ad f§iv. 
M. Sig.: Teaspoonful after meals and at bed-time. 
Special Forms.—Where the bitterness is an objection we may use 
the Cascara Cordial of Messrs. Parke, Davis & Co., in which the taste 
is well covered by aromatics, or the fluid-extract formula of 1887 (P., D. 
& Co.) may be used. This tasteless preparation is permanent, will not 
precipitate, and is entirely soluble in water. The solid extract of cascara 
sagrada makes a pill-mass which does not soften or decompose when 
made up with powdered marsh-mallow. Messrs. Parke, Davis & Co. 
also prepare a concentrated preparation, Cascarin (formula 1887), which is 
presented in scale form, is not hygroscopic, is readily reduced to powder, 
almost tasteless, soluble in water, and contains only the active principles 
of the drug. (Dose, gr. £-^.) 
RHEUM (U. S. P.).—Rhubarb. 
Dose, gr. i-xx. 
Preparations. 
Extractum Rhei (U. S. P.).—Extract of Rhubarb. Dose, gr. ii-x. 
Extractum Rhei Fcttidum (U. S. P.).—Fluid Extract of Rhubarb. Dose, hlx-f3j. 
Mistura Rhei et Sodce (U. S. P.).—Mixture of Rhubarb and Soda (fluid extract rhu- 
barb 30, sodium bicarbonate 30, spirit of peppermint 30, water q. s. ad 1000 parts). Dose, 
3i-iv. 
Filulce Rhei (U. S. P.).—Rhubarb Pills (each gr. iij). Dose, one to three pills. RHEUM, 
861 
Pilulce Rhei Composite (U. S. P.).—Compound Pills of Rhubarb (rhubarb, gr. ij ; 
aloes, gr. iss; myrrh, gr. j). Dose, one to three. 
Pulvis Rliei Compoxitm (U. S. P.).—Compound Rhubarb-Powder (rhubarb 25, mag- 
nesia 65, and ginger 10 parts). Gregory’s Powder. Dose, 3ss-j. 
Sympus Rhei (U. S. P.).—Syrup of Rhubarb, 9 per cent, (sliced rhubarb 90, cinna- 
mon 18, potassium carbonate 6, sugar 600, and water ad 1000 pts). Dose, for a child, f 3j. 
Sympus Rhei Aromaticus (U. S. P.).—Spiced Syrup of Rhubarb (aromatic tincture 
of rhubarb 1, simple syrup 9 parts). Dose, l§ss. 
Tinctura Rhei (U. S. P.).—Tincture of Rhubarb (rhubarb 12, cardamom 2, diluted 
alcohol q. s. ad 100 parts). Dose, §ss. 
Tinctura Rhei Aromatica (U. S. P.).—Aromatic tincture of rhubarb (rhubarb 20, 
cinnamon 4, cloves 4, nutmeg 2, diluted alcohol q. s. ad 100 parts). Dose, f 3i-vj. 
Tinctura Rhei Dulcis (U. S. P.).—Sweet Tincture of Rhubarb (rhubarb 8, liquorice 4, 
anise 4, cardamom 1, diluted alcohol q. s. ad 100 parts). Dose, f3i-vj. 
Vinum Rhei (U. S. P.).—Wine of Rhubarb (rhubarb 10, calamus 1, and stronger white 
wine q. s. ad 100 parts). Dose, 13i-iv. 
Tinctura Rhei Aquosa (N. F. and Ph.G.).—Watery Tincture of Rhubarb, or Compound 
Infusion of Rhubarb (rhubarb 100, borax 10, potassium carbonate 10, macerated for ten 
minutes with boiling water 850 ; then add alcohol 120, and after one and a quarter hours ex- 
press and filter; add through the filter cinnamon-water 125 parts. Each fluidrachm repre- 
sents 5% grains of rhubarb). Dose, f3i-vj. 
Tinctura Rhei et Gcntiance (N. F.).—Tincture of Rhubarb and Gentian (each flui- 
drachm represents rhubarb, gr. iv, and gentian, gr. j). Dose, 13i-§ss. 
Pharmacology.—Rhubarb is the root of Rheum officinale and of 
other undetermined species of Rheum (Polygonacemb Its habitat is 
China. The European rhubarb, R. rhaponticum, is not one-half as active 
and is not recognized b}’ the pharmacopoeia. The peeled and dried root 
of the Chinese or East India rhubarb, of a light color and good odor, 
should only be used in medicine ; powdered rhubarb is inferior, and, if 
not adulterated, at least is largely made up of inferior, damaged, and 
worthless or worm-eaten rhubarb. The active principles are a gluco- 
side called Chrysophan, with Chrysophanic acid, Phaeorhetin, Emodin, 
Erythrorhetin, Aporhetin, Rheotannic and Rheumic acids. The grittiness 
of rhubarb is due to crystals of oxalate of lime contained in the root. 
Physiological Action.—When taken into the mouth, rhubarb has a 
peculiar, bitter, slightly astringent taste, and increases the flow of saliva ; 
in the stomach and intestinal tract the secretions are likewise increased 
and the peristaltic movements stimulated proportionately to the size of 
the dose, but after the first effects have been displa3'ed the secretions 
are reduced by the secondary astringent action of the drug. The resin- 
ous constituents act upon the liver, increasing the quantity of bile; ac- 
cording to Rutherford, it is a certain though not a powerful hepatic 
stimulant. The bile secreted under its influence has the normal compo- 
sition, and it is, therefore, a true eholagogue. The coloring matter is 
largely excreted by the kidneys, and the urinary flow is increased. In 
small doses, up to 5 grains, rhubarb is a stomachic tonic, which makes 862 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
it a valuable constituent in dinner pills to aid digestion and prevent con- 
stipation. As a purgative, in doses of j draclnn to a drachm, it acts 
slowly and in the course of seven or eight hours produces copious yellow 
stools containing bile. Griping may be due to the drug itself, or to the 
bile which is poured out under the action of its resinous constituents, 
notabl}' phseorlietin. The cathartic principles may be absorbed through 
the integument, when applied on a poultice or spongio-piline; it is, there- 
fore, a systemic purgative. These purgative constituents are excreted 
by the liver mainly, but also by the intestinal glands, the kidneys, and 
skin. • After a woman has taken a dose of rhubarb, her milk may contain 
enough of these principles to purge the nursing child. Powdered rhu- 
barb has been successfully employed as a dressing to chronic ulcers, but 
more powerful remedies have generally taken its place. 
Therapy.—Rhubarb is a good stomachic purgative, especially in the 
treatment of children’s disorders caused by errors in diet, rich food, etc. 
The spiced syrup of rhubarb in teaspoonful doses may be given to an 
infant with indigestible food or curd in its stomach, or when its gastro- 
intestinal tract contains mucus from bronchial catarrh, etc. The mixture 
of rhubarb and soda is a good antacid and carminative for babies suffer- 
ing with colic and cramps. In adults, it maybe given with special ad- 
vantage in hot water, fifteen or twenty minutes before eating meals, 
especially in cases of gastric catarrh. In summer diarrhoeas of adults or 
infants, the irritation arising from the presence of unsuitable or undi- 
gestible food is at once relieved and the cause removed by a dose of 
the aromatic syrup or tincture of rhubarb. Where there is intestinal 
dyspepsia and colalgia or cramps, the sweet tincture will be found 
very efficient and acceptable. Rhubarb may be combined thus :— 
Pulv. rhei, 3iss. 
Sodae bicarb., 3ij. 
Spiritus ammonii aromat., f3iij. 
Spiritus myristicas, f3vj. 
Infus. carophylli, ad f§viij. 
M. Sig.: A half to a tablespoonful three or four times a day. 
In children with acid discharges from the bowels, the combination 
with magnesia is especially useful. In weak digestion with deficient 
secretion, small doses of the tincture are valuable:— 
Tinct. rhei, f3ij. 
Tinct. cardamom, co., 
Elixir, aromatic., a.a f §ss. 
M. Sig.: Take twenty to forty drops before each meal. 
Urticaria due to indigestion may sometimes be relieved by rhubarb. 
It is a useful ingredient in purgative pills, where a cholagogue effect is 
desired, especially where hremorrlioids are present:— RHCEAS, 
863 
Mass® hydrarg., . gr. vj. 
Ext. rhei, gr. iij. 
Ext. colocynth. co., gr. vj. 
Saponis, gr. ss. 
M. et ft. pil. no. iij. 
Sig.: To be taken at bed-hour, and followed in the morning by a teaspoonful of 
Rochelle salt in water before breakfast. 
Constipation and haemorrhoids, dependent upon pregnancy, are 
benefited by the administration of rhubarb. This remedy is considered 
by some practitioners as of special value in gouty subjects. Rhubarb 
has been known to cause a macular or vesicular rash. 
RHCEAS.—Red Poppy. 
Preparations. 
Extrachun Rhceados Fluidum.—Fluid Extract of Poppy-Flowers. Dose, Nlxxx-f3iss. 
Syrupw Rhceados.—Syrup of Red Poppy. Dose, f3i-ij. 
Pharmacology and Therapy.—The petals of the red poppy, Papaver 
rhceas (Papaveracese), cultivated in gardens, contain a coloring matter 
and Rhceadine, but probably no morphine. The preparations are used as 
coloring agents in pharmacy; although doses are quoted above, the 
remedy is seldom, if ever, employed. The taste is mucilaginous and 
bitter; it may act as a simple bitter, as a stomachic tonic during con- 
valescence. 
RHUS AROMATICA.—Fragrant or Sweet Sumach. 
Dose, TTLv-fpiss, in fluid extract. 
Pharmacology.—The bark of the root of Rhus aromatica (Anacar- 
diaceae), growing in the eastern portion of this country, contains a 
resin, volatile oil, and tannin. 
Physiological Action.—Rims aromatica is astringent, tonic, stimulant, 
and diuretic. 
Therapy.—Sweet sumach has been used as an astringent in diseases 
of the kidneys and genito-urinary tract, as in C3’stitis and haematuria. It 
is likewise said to check menorrhagia and night-sweats. It is employed 
in atonic diarrhoea or summer dysentery, after a preliminary purge to 
remove offending substances from the alimentary canal. It has been 
lauded as a remedy for nocturnal enuresis of children, a drachm of a good 
fluid extract being administered in diminished doses during the day. In 
larger doses this drug has exerted a good effect in hysterical enuresis. 
In diabetes, both mellitus and insipidus, it has also proved of service. 
RHUS GLABRA (U. S. P.).—Sumach-Berries. 
Preparation. 
Extractum Rhois Glabrce Fluidum (U. S. P.).—Fluid Extract of Sumach-Berries. 
Dose, f 3i—ij. 864 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Pharmacology.—The fruit of Rhus glabra (Terebintliaceae, Anacar- 
diae), a common shrub along the roadsides in the United States, contains 
tannic acid, besides potassium and calcium malates and a red coloring 
matter. 
Therapy.—It is a good astringent in the form of decoction, or fluid 
extract, for a mouth-wash or gargle in stomatitis, spongy gums, or pharyn- 
gitis, and as a topical application in skin diseases and ulcers in domestic 
practice. The following is a useful gargle for sore throat :— 
Potassii ehloratis, . . 3ij. 
Ext. rhois glabrae fl., 1 58s. 
Glycerini, l^iss. 
Aquae rosae, . . fjiv. 
M. Sig.: Add a tablespoonful to a wineglassful of water, and use as a gargle, fre- 
quently. 
Rhus glabra is rarely used internally, but has been given for 
catarrhal disorders of the stomach and bow'els, with diarrhoea. 
RHUS TOXICODENDRON (U. S. P.).—Poison-Oak, Poison-Ivy. 
Pharmacology.—The fresh leaves of Rhus toxicodendron (and Rhus 
radicans, N. O. Terebintliaceae, Anacardiae), indigenous to the eastern 
portion of North America, contain a volatile acid, Toxicodendric acid, 
tannin, etc. As the volatile acid is the chief constituent, the fresh leaves 
only are used ; dried leaves are worthless. Several other species of rhus, 
as the swamp-sumach (R. venenata), contain this constituent. The lac 
or varnish upon Chinese or Japanese boxes is made of some species of 
sumach, and very susceptible individuals may be poisoned by handling 
them, or by being present when such varnish is used. The rhus radicans 
is not a distinct species from the officinal rhus toxicodendron, which is 
sometimes erect and sometimes climbing. The poison-sumach may be 
recognized by trifoliate, compound leaves, resembling the ordinary ivy 
in having adventitious roots along the under side of the climbing stem, 
with the exception that in the poison-sumach the roots are given off in 
bunches at the nodes opposite the insertion of the petiole or leaf-stem, 
while in the ivy they grow from the‘entire under side of the stem. It is 
distinguished from the Ptelea trifoliata by having petiolate instead of 
sessile leaflets. The poisonous principle resides especially in the juice, 
which is acrid and milky, turning black upon exposure to the light. 
Physiological Action.—The fresh leaves are very irritating to the 
skin, although the effect is much more marked in some individuals than 
in others. In characteristic cases of poisoning there is set up an acute 
dermatitis, with a great deal of oedema and hypersemia of the skin; fre- 
vesicles or blebs are formed, accompanied by much irritation 
and itching. This inflammation resembles erysipelas, spreading from RICINI OLEUM. 
865 
the parts first affected to surrounding skin and mucous membrane. 
With this there is considerable general disturbance, pains in the abdo- 
men, nausea and vomiting; diarrhoea or diuresis may occur, with passage 
of blood. Fever and profuse perspiration may also be observed, with 
pains in the joints and lumbar region. The effects of the poison last 
from a week to a fortnight, and are followed by free desquamation of the 
affected surface. 
Poisoning.—Many remedies have been advocated ; probably the free 
application of a carbolized alkaline wash to neutralize the poison, such 
as Dobell’s solution (page 308), followed by fluid extract of grindelia 
diluted with water (1 to 10) or distilled extract of hamamelis, will give 
as good results as any other. When the inflammation is in the face, and 
accompanied by much swelling of the eyelids, alum curd is very efficient. 
Therapy.—Rhus toxicodendron is rarely used by regular practi- 
tioners, although Phillips declares that it is useful in rheumatic pains and 
affections of fibrous tissues; also in certain skin affections, erythema, 
erysipelas, herpes, and pemphigus. In rheumatic paralysis it is claimed 
to be efficient. Externally, half a drachm of the tincture (1 to 2 of 
alcohol) in a pint of water may be used as a stimulating application, with 
advantage, for sprains, chilblains, burns, stings of insects, etc. 
Recently some contributions have appeared in medical journals, 
attempting to revive the former internal administration in cases of 
rheumatism and neuralgia, or so-called rheumatic pains. Prof. H. C. 
Wood, as editor of the Therapeutic Gazette, gives his experience as 
follows : “Nearly ten years ago I was much impressed with the accounts, 
published in various homoeopathic journals of Philadelphia, of rhus 
toxicodendron for rheumatism, and being at the time visiting physician 
to the Philadelphia Hospital, with a large number of cases of subacute, 
chronic, and acute rheumatism under my care, I availed m}'self of the 
opportunity to test the virtue of the drug. I obtained the homoeopathic 
tincture from a large homoeopathic pharmacy. I tried it in all forms 
and doses, homoeopathic, small and large, and found it exceedingly un- 
certain in its action and giving no definite good result. I was not able 
to see that the patients progressed, on the average, any more rapidly 
when taking it than when .left to nature and nursing.” * 
RICINI OLEUM (U. S. P.).—Castor-Oil. 
Dose, f3j-oj- 
Pharmacology.—Castor-oil is a fixed oil, expressed from the seeds 
of Ricinus communis (Euphorbiaceae), cultivated largely as an orna- 
mental plant in our gardens, coming originally from India. The oil 
* Therapeutic Gazette, February 15, 1890, p. 95. 866 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
should be obtained without heat simply by crushing and pressing the 
seeds. It consists mainly of ricinoleic acid, combined with the base 
glyceryl as Ricinoleate of glyceryl, together with other fixed oils, a resin, 
and possibly an alkaloid, Ricinine (not purgative), and an acrid, drastic 
principle. It is a colorless, rather viscid, oily liquid, of faint, peculiar 
odor, and a bland, nauseating, acrid taste. It is soluble in an equal part 
of alcohol. It is a good addition to liniments on account of its density, 
and enters into the compound liniment of mustard (15 per cent.) and 
flexible collodion (3 per cent.). Castor-oil is completely soluble in abso- 
lute alcohol, which is employed as a test for the detection of impurities. 
Pure castor-oil dissolves in spirit of 0.838 specific gravity at a tempera- 
ture between 38° and 43° C. (100.4° to 109.4° F.), while foreign oils 
only dissolve at a considerably higher degree.* 
Physiological Action.—When applied to the skin no irritation re- 
sults ; on the contrary, it is borne by the conjunctiva, acting as a protect- 
ive and sedative. The nauseating taste is due almost entirely to its 
odor, and it can be taken much better if the nose be held during the act 
of swallowing. The odor may also be overcome bjr peppermint and other 
flavoring agents. As a purgative, it is classed as a laxative in small 
doses (trLx-f‘5j), becoming more active in full doses The 
laxative effect results about four hours after administration. 
Therapy.—Castor-oil may be used as a menstruum to retain drugs 
in contact with the surface. The following is a suitable formula :— 
II Olei ricinl, f§ss. 
Spiritus vini rectiftcati, f§ij. 
Tinet. cantharidis, f§j. 
Spiritus rosmarini,. . . •. f 
Spiritus odorati, ad f §viij.—M. 
A drop of castor-oil in the eye will often relieve the irritation caused 
by a particle of sand, or by granular lids. Dr. S. Mitchell has found a solu- 
tion of cocaine in castor-oil to be an excellent application to corneal 
ulcer, relieving pain and healing the lesion after other solutions had been 
used in vain. Fomentations of the mammary glands with castor-oil 
plant leaves, wilted with hot water, are useful in promoting the secretion 
of milk. Castor-oil as a purgative is useful in children, and in pregnant 
women, for piles or fissures of the anus, or after parturition, acting with- 
out any irritant effect, according to Brunton ; but this is denied by For- 
dyce Barker, who, from clinical experience, declares that it is not 
suitable for such cases, and in pregnancy or after parturition aloes is a 
preferable purgative. Castor-oil is a good vermifuge, and should be 
given before and after the administration of other anthelmintics. In 
*J. Arthur Wilson, in American Journal of Pharmacy, December, 1890. RICINI OLEUM. 
867 
acute diarrhoea or dysentery, treatment should commence with 1 or 2 
drachms of oil, combined with 5 to 10 minims of laudanum. This re- 
moves irritating substances and soothes the intestines. Dr. Young, of 
Florence, has successfully treated acute diarrhoea with small doses of 
castor-oil, and suggests the following formula:— 
Olei ricini, iflxxiv. 
Sp. chloroformi, f3iss. 
Morphinse hydrochlor. gr. j. 
Pulv. acacise, . 3iiss. 
Syr. simplieis, f 
Aquae, q. s. ad f§iv. 
M. Sig.: A dessertspoonful every hour and a half for an adult. 
Phillips, also, has found the above mixture efficacious. In chronic 
dysentery, Brunton recommends 15 minims of castor-oil with 5 to 10 
minims tincture of opium, given three times daily, or used thus:— 
$ Ol. ricini, f3ss. 
Tinct. opii, . lflx vel xxx. 
Syr. sarsaparillae vel 
Aquae menth. pip., f^iss. 
Pulv. acaciae, q. s. 
M. Sig.: A teaspoonful or two three or four times a day. 
A teaspoonful of oil will greatly relieve an infant suffering with 
bronchial catarrh. 
Special Forms for Administration.—It may be given in soft capsules, 
which can be obtained of any size from 10 minims to ounce. If the 
oil be given the first thing in the morning, an hour before breakfast, 10 
or 20 drops are generally sufficient to open the bowels. This dose may 
be given in a teaspoonful of peppermint-water and brandy, the propor- 
tion being such that the oil neither sinks nor swims in the mixture.* 
Lemon- or orange-juice, coffee, froth of porter or beer, are also used as 
vehicles, but the best is the extemporaneous dose prepared at the soda- 
water fountain by the obliging druggist. The following mixture is 
recommended by a contributor to the American Druggist.f In it the 
disagreeable taste of the oil is replaced by a pleasant flavor of almonds :— 
Castor-oil, 30 parts. 
Bitter almonds, 2 “ 
Sugar, 30 11 
Gum tragacanth., part. 
Orange-flower water, . . . 10 parts. 
Water, . . . 120 “ 
The only drawback to this mixture is that it requires a good deal 
of it for a dose, a teaspoonful of the oil being contained in about 5 tea- 
* Brunton’s Pharmacology, Therapeutics, and Materia Medica, 1885, p. 938. 
t Boston Medical and Surgical Journal, February 12,1891, p. 175. 868 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
spoonfuls of the mixture. The taste of codliver-oil is tolerably well dis- 
guised by liighty-seasoned beef-tea. R. R. Mitchell advises for the same 
purpose a mixture of equal parts of the oil, aromatic syrup of rhubarb, 
and caseara cordial. Dr. Wabah McMumiy, of Sydney, Australia, says, 
to disguise the unpleasant taste of castor-oil, a good idea is to ask the 
patient to take cream in the mouth and apply it with the tongue over 
the entire surface. This prevents the oil from adhering to the mucous 
membrane. In children with griping diarrhoea and green stools contain- 
ing casein, to disguise the taste of the oil and act well, Dr. McMurray 
recommends the following combination :— 
01. ricini, . f 3j- 
Mucil. acacia;, * . . q. s. 
Tinct. opii, Htv. 
Aquae menth. pip. vel 
Aquae chloroformi, f 3 ij- 
M. Sig.: A teaspoonful every four hours. 
ROSA.—Rose. 
Preparations. 
Rosa Centifolia (U. S. P.).—Pale Rose. The petals of Rosa centlfolia (Rosacea;). 
Rosa Gallica (U. S. P.).—Red Rose. The petals of Rosa Gallica collected before 
expanding. 
Oleum Rosce (U. S. P.).—Oil of Roses (“attar of rose ”). The volatile oil distilled 
from the fresh flowers of Rosa Damascena (Rosacese). 
Aquae Rosce (17. S. P.).—Rose-Water (from pale rose). 
Unguentum Aquae Rosce (U. S. P.).—Rose-Water Ointment, or Cold Cream (rose-water 
30, expressed oil of almonds 50, spermaceti and white wax, of each 10 parts). 
Extractum Rosce Fhiidum (U. S. P.).—Fluid Extract of Roses (from red roses). Dose, 
mv-f3j. 
Confedio Rosce (U. S. P.).—Confection of Roses (red rose 8,sugar 61, honey 12, rose- 
water 16 parts). 
Mel Rosce (U. S. P.).—Honey of Roses (red rose 8, honey 92 parts, dilute 
alcohol q. s.). 
Syruptcs Rosce (U. S. P.).—Syrup of Roses (fluid extract of red rose 10, syrup 90 
parts). As a vehicle. 
Pharmacology.—Red rose contains tannic and gallic acids and a 
volatile oil, which the pharmacopoeia directs shall be obtained from 
another species. Red rose is an ingredient in the pills of aloes and 
mastic, and pale rose enters into the compound syrup of sarsapa- 
rilla. In the British Pharmacopoeia an acid infusion of rose appears, 
which is an agreeable mouth-wash. It is made with dried red-rose 
petals, broken up. \ ounce: dilute sulphuric acid, I fluidraehm ; boiling 
distilled water, 10 fluidounees. This preparation may be given inter- 
nally, in the dose of 1 or 2 fluidounees, and is, in effect, but an agreeable 
method of administering sulphuric acid. ROSMARINUS. 
869 
Physiological Action and Therapy.—Preparations of rose are some- 
what astringent. They are used as agreeable flavoring agents and 
vehicles. The confection is a good base for pills. The compound 
infusion is of service for overcoming the bad taste of sulphate of mag- 
nesium. Aqua rosae is a favorite vehicle for e3’e-washes and urethral injec- 
tions, and for cosmetic preparations. Rose-water ointment is an elegant, 
bland unguent, principally used as an excipient, but available in super- 
ficial burns, chapped lips or hands, abrasions, and erythema. 
ROSMARINUS (U. S. P.).—Rosemary. 
Preparations. 
Oleum Rosmarini (U. S. P.).—Oil of Rosemary. Dose, ftli-v. 
Spiritus Rosmarini.—Spirit of Rosemary (1 to 60). As a perfume. Dose, 01i-v. 
Pharmacology.—The leaves of Rosmarinus officinalis (Labiatae) are 
aromatic, pungent, and bitter. They contain volatile oil (about 1 per cent.), 
some resin, tannin, and a bitter substance. Rosemary enters into aro- 
matic wine (see page 413), perfumed spirit, or eau de Cologne, soap 
liniment, and compound tincture of lavender. 
Physiological Action.—Rosemary is stimulant, diuretic, carminative, 
emmenagogue, and somewhat diaphoretic, but is now rarely employed 
in substance, the oil taking its place. The latter is stimulant and car- 
minative. It reduces temperature, imparts a peculiar odor to the urine, 
and in large quantities has caused death. It is chiefly used as a rube- 
facient in liniments and ointments. 
Therapy.—In alopecia from defective nutrition of hair-bulbs, a lotion 
containing oil of rosemary and tincture of cantharides, with Cologne 
water, is frequently given. It may also lie used as a rubefacient for 
sprains and painful joints, and is efficacious in the different forms of 
pediculosis. The compound rosemary ointment of the German Pharma- 
copoeia contains 1 part each of oil of rosemary and oil of juniper-berries 
in 30 parts of ointment, and is used in neuralgia, chronic rheumatism, 
and lumbago. The oil of rosemary is of some service as an internal 
remedy in hysteria accompanied by depressed spirits. 
RUBUS (IT. S. P.).—Blackberry. 
Preparations. 
Extractum Rubi Fluidum (U. S. P.).—Fluid Extract of Blackberry. Dose, f3ss. 
Syrupus Rubi (U. S. P.).—Syrup of Blackberry (containing fluid extract, 20 per 
cent.). Dose, f3j-f§j. 
Stjrupus Rubi Aromatieus (N. F.).—Aromatic Blackberry-Syrup (blackberry, cinna- 
mon, nutmeg, cloves, and allspice). Dose, f3i-iv. 
Elixir Rubi.—Blackberry-Cordial, Blackberry-Brandy (fluid extract blackberry-root o, 
aromatic fluid extract brandy 13)4, syrup of blackberries 17, elixir 17 parts). Dose, 
f 3ij—f 3ss. 870 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Elixir Rubi Compositum (N. F.).—Blackberry Compound (blackberry-root, galls, and 
cinnamon, each 10 parts, with cloves, mace, ginger, in blackberry-juice and syrup). 
Lose, f 3j—l'§j. 
Cordialis Rubi Fructus.—Blackberry-Cordial (fresh blackberry-juice 3, cinnamon, 
cloves, and nutmeg, in tincture with dilute alcohol, 2, simple 6yrup 3 parts). 
Lose, f 3j—f§j. 
Pharmacology.—The bark of the root of Rubus villosus, Rubus 
Canadensis, and Rubus trivialis (Rosaceae, Dryadeae) is officinal as 
Rubus. The wood should be rejected, only the bark being of medicinal 
value. It contains tannic acid (10 per cent.). The fluid extract is 
made by percolation with diluted alcohol, and contains glycerin (20 per 
cent.). 
Physiological Action.—Blackberry is astringent. 
Therapy.—In diarrhoea of relaxation, especially after cleansing the 
bowels with castor oil, the preparations are useful. The combinations of 
the fruit for the table (jams, preserves, etc.) are not astringent, and are 
not only useless in treating diarrhoea, but also injurious, since the hard 
seeds increase the irritation. The best form is the fluid extract, but there 
is a popular demand for blackberry-cordials and blackberry-brandy, for 
which formulae are given above. They are pleasant to the taste carmina- 
tive, and slightly astringent. 
RUBUS ID/EUS (U. S. P.).—Raspberry. 
Preparation. 
Syi'upus Rubi him (U. S. P.).—Raspberry-Syrup. As a vehicle. 
Pharmacology.—The fruit of Rubus idseus (Rosaceae, Dryadeae) has 
a pleasant flavor. It contains sugar, malic and citric acids, pectin, 
proteids, coloring matter, and a trace of volatile oil, consisting of com- 
pound ethers producing the peculiar flavor. 
Therapy.—Its sole use in medicine is to prepare the syrup, which 
lias a pleasant, acid taste and a fruity odor. The leaves of the wild 
raspberry (R. strigosus) contain tannin, and are used in decoction as an 
astringent in diarrhoea. Raspberry-syrup with vinegar is a grateful drink 
in hot weather, added to cold water. 
RUMEX (U. S. P.).—Rumex, Yellow Dock. 
Preparations. 
Extradum Rumicis Fluidum (U. S. P.).—Fluid Extract of Rumex. Lose, f3ss-j. 
Lecoctum Rumicis.—Decoction of Dock (fresh root, §ij, to water, Oj). Lose, f§i-iv. 
Pharmacology.—Rumex is the root of Rumex crispus, and of other 
species of rumex (Polygonaceae) growing along roadsides in Europe 
and America. The officinal root is 8 by 12 inches long, | inch thick, 
somewhat fusiform. It contains tannin, ehrysophanic acid, mucilage, 
calcium oxalate, starch, etc. ruta: oleum. 
871 
Physiological Action.—Dock is alterative, tonic, and slightly 
astringent. 
Therapy.—In strumous affections, especially enlargement of the 
glands and cutaneous disorders, rnmex has been found particularly valu- 
able. It is also considered antiscorbutic. In chronic laryngeal affections, 
with cough and soreness under the sternum, it will give relief. The 
decoction is sometimes employed externally in various skin diseases and 
glandular swellings. Also used internally in dyspepsia and liver disorders. 
RUT/E OLEUM (U. S. P.)._Oil of Rue. 
Dose, itlii—v. 
Pharmacology.—Volatile oil distilled from Ruta graAreolens (Ruta- 
ceoe, Rutese). Its color is light yellow, which becomes brown when the 
oil is long kept; the taste is sharp and bitter; the odor is aromatic, dis- 
agreeable, and distinctive. This oil is soluble in all proportions in 
absolute alcohol. 
Physiological Action.—Applied to the skin, oil of rue occasions 
hyperaemia, inflammation, and vesication. In ordinary doses it is car- 
minative, and is a general stimulant to the circulation and the secretions. 
Large doses cause gastro-enteritis, convulsions, stupor, dimness of vision 
and contracted pupils, suppression of urine or strangury. Abortion 
may result from toxic doses. It has some special action upon the 
genito-urinary tract. Rue is eliminated, and may be recognized by its 
odor in the breath, urine, and perspiration. 
Therapy.—The oil of rue is useful in amenorrlioea due to defective 
excitement of the ovaries, and in passive menorrhagia of debility or 
following abortion. Hysteria, especially when associated with amenor- 
rlioea, is benefited by this remedy. It has been used with success in 
flatulence and infantile convulsions dependent upon that condition. 
Used as an abortifacient, in accordance with popular reputation, it has 
several times caused death from irritant poisoning, as above indicated. 
Rue is beneficial in defective activity of the sexual organs, acting as an 
aphrodisiac and as an emmenagogue. The irritant properties of the oil 
of rue have caused it to be sometimes used as a topical remedy. It is 
said to have the power of destroying warts. Phillips states that the 
bruised leaves of rue laid upon the forehead will often check epistaxis. 
Rue has been added to liniments for application to the chest in chronic 
bronchitis. 
SABADILLA.—Cevadilla. 
Pharmacology.—The seeds of Asagraea officinalis (Melanthnceae), of 
Mexico and Central America, contain Veratrine, Cevadine, and Ceva- 
dilline, combined with Cevadic and Cevadillic acids. 872 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Physiological Action and Therapy.—An ointment 1ms been used to 
destroy lice and other vermin, and as a cure for itch. The physiological 
effects are those of veratrine. (See Yeratrina.) Cevadilla* is a powerful 
emetic, cathartic, and anthelmintic, and has been given in doses of 1 to 
5 grains. It is seldom now used,and its principal value is as a source of 
veratrine. 
SABAL SERRULATA.—Saw-Palmetto. 
Preparation. 
Extradum Sabal Fluidum.—Fluid Extract of Sabal. Dose, f3ss-ij. 
Pharmacology.—The Sabal serrulata, or saw-palmetto (Palmacese), 
grows abundantly along the sea-coast from South Carolina to Florida, 
and is found as far as 8 or 10 miles inland. This plant possesses a 
creeping and branched stem, leaves of a bright-green color, fan-shaped 
and spiculated. The roots, large and fibrous, extend several feet from 
the stem and are half exposed above the sand. The berries or drupes, of 
a dark-purple color and about the size of an olive, ripen in October and 
November. The seeds are very hard, and enveloped in a tough, fibrous 
membrane. The plant contains a volatile oil (soluble in alcohol), a fixed 
oil, and a large proportion of saccharine matter. 
Physiological Action.—The taste, at first sweet, soon becomes acrid 
and pungent; to the pungent succeeds a smooth sensation, which extends 
from the tongue and mouth to the larynx and nasal cavities, all of which 
parts feci as if lubricated with oil. Saw-palmetto is said to increase 
appetite, digestion, and strength, and to promote nutrition. It also exerts 
a sedative and diuretic influence, and has been thought to have a special 
tonic effect upon the reproductive system. The berries seem to have nutri- 
ent value, as the animals who feed upon them rapidly fatten. The physio- 
logical action of saw-palmetto has not been systematically investigated. 
Therapy.—Saw-palmetto is said to be an excellent expectorant, and, 
at the same time, a sedative to the mucous membranes of the respiratory 
tract. Troublesome nervous cough is allayed and secretion promoted 
by its use. This remedy has been employed with benefit in coryza, acute 
and chronic laryngitis and bronchitis. Bronchorrhoea with bronchiectasis 
is relieved by the administration of sabal serrulata. Dr. Readf states that 
an acute nasal catarrh may be aborted by two or three doses and that the 
vapor is inhaled with advantage in chronic ozama. Sabal is claimed to 
possess some efficiency in cardiac asthma. On account of its combina- 
tion of tonic and expectorant properties, it has been found of service in 
*Two new alkaloids, Sabadine and Sabadinine, are said to have been obtained from saba- 
d'lla seeds by Merck. Pharmaceutical Record, New York, February 19. 1991. 
f "Sabal Serrulata, Saw-Palmetto,” by Dr. J. D. Read, of Savannah, Georgia. American 
Journal of Pharmacy, April, 1879, p. 169. SABBATIA. 
873 
phthisis pulmonalis, and especially in tuberculosis of the larynx. Saw- 
palmetto is thought to he valuable in atrophy of the mammae, testicles, or 
uterus, and to exert a beneficial influence upon enlarged prostate. 
SABBATIA.—American Centaury. 
Dose, gr. xxx-5iss, in infusion or fluid extract. 
Pharmacology and Therapy.—The entire flowering plants of Sabbatia 
angularis and of Sabbatia paniculata (Gentianaceae) are used in medicine 
for the same purposes as gentian, col umbo, and other simple bitters. 
A solid extract, obtained by evaporating the fluid extract and adding 
5 per cent, of glycerin, may be given as a tonic in atonic dyspepsia in 
doses of gr. ii-xij. 
SABINA (U. S. P.).—Savin. 
Preparations. 
Extraction Sabina Fluidiini (U. S. P.).—Fluid Extract of Savin. Dose, Nlv-xx. 
Ceratum Sabince (U. S. P.).—Savin Cerate (fluid extract 25, resin cerate 90 parts). 
Oleum Sabina (U. S. P.)—Oil of Savin. Dose, lflii-v. 
Pharmacology.—The tops of Juniperns sabime (Conifer®), a small 
evergreen tree common in the northern hemisphere, often cultivated as 
an ornamental shrub. It contains a volatile oil, which, when separated 
by distillation, is officinal as oil of savin; also tannin, resin, etc. Oil 
of savin is colorless or yellowish, has a strong, characteristic smell and 
a burning taste. It is freely soluble in absolute alcohol. 
Physiological Action.—Locally, savin causes rube fact ion; or even 
vesication. Internally, it is a stimulant to the digestive organs, increases 
the action of the heart, and stimulates the bronchial, cutaneous, and renal 
secretions. It causes hyperaemia of the kidneys, of the ovaries and 
uterus, and, in large doses, excites strangury, hsematuria, violent vomiting 
and purging, gastro-enteritis, unconsciousness, stertor, and convulsions. 
Savin may, as part of its toxic effects, cause abortion in a pregnant woman, 
and death has occasionally resulted from its irritant action when admin- 
istered for this purpose. The odor of savin appears in the breath, sweat, 
and urine as elimination takes place. 
Therapy.—Savin used to be added to blisters, or blistered surfaces 
were dressed with savin ointment, to increase the effect,but this practice 
is now obsolete. The cerate may be applied as a caustic for the destruction 
of warts. A mixture of powdered savin and verdigris has been success- 
fully employed for the removal of condylomata. Powdered savin may 
be used as a stimulant to indolent ulcers. A cerate or ointment of savin 
is a serviceable counter-irritant in chronic gout or rheumatism. This 
drug is efficient in tinea capitis and scabies, and has been used internally 
with success as a taeniacide. As an emmenagogue, Phillips considers it 874 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
highly valuable and safe, in proper doses. It is used in functional dys- 
menorrhoea, in passive haemorrhages after abortion, and, as Whitla 
suggests, may prove beneficial in subinvolution of the uterus. 
SACCHARINUM.— Saccharin (Anhydro-ortho-sulphamin-benzoic 
acid). 
Pharmacology.—Saccharin is a coal-tar derivative, discovered in 
Professor llemsen’s laboratory of Johns Hopkins University, and first 
described by C. Fahlberg in a communication to the American Chemical 
Journal, 1879 (vol. i, p. 436). It is a white, crystalline powder, with an 
acid reaction, but an intensely sweet taste. This substance is soluble in 
500 parts of cold water, readily soluble in alcohol and ether, and forms 
soluble salts with the hydrates or carbonates of the alkaline metals. It 
melts at 220° C. (428° F.), and when fused with potassic hydrate it forms 
salicylic acid. One part dissolved in 70,000 parts of water imparts to the 
solution a distinctly sweet taste ; it is about 300 times sweeter than cane- 
sugar, which it resembles in taste, except for a peculiar slight flavor of 
bitter almonds. 
Physiological Action.—Sachharin is excreted by the kidneys 
unchanged; it is not decomposed in the body, and has little if any 
effect upon digestion. The only noticeable effects upon the urine are 
that it does not so readily undergo fermentation and the chlorides are 
slightly increased. Pure saccharin is not possessed of toxic or deleteri- 
ous effects upon the human organism, even in doses as large as 75 grains. 
Saccharin has considerable antiseptic virtue, which, according to 
Constantine Paul, is impaired when it acts in an acid medium. 
Therapy.—Saccharin is chiefly employed to take the place of sugar in 
the diet of obese and diabetic patients. For this purpose it is best pre- 
scribed in the form of a syrup containing 10 parts of saccharin and 12 
parts of bicarbonate of sodium in 1000 parts of distilled water, made with 
gentle heat at 40° C. (104° F.). It has also been claimed by Dreschfeld that 
saccharin relieves some of the symptoms of acid dyspepsia. Two parts 
of saccharin dissolved by means of 3 parts of the bicarbonate of sodium 
are said to form an excellent tooth-wash. Fournier has found a mouth-wash 
containing saccharin efficacious in aphthae. Saccharin is largely used in 
confectionery to add to glucose and make it correspond more closely in 
sweetness with cane-sugar. It may be prescribed with quinine, in order 
to overcome the bitterness :— 
II Qulnin. sulphat., 3j. 
Saccharin., ....... tl t # gj*. xxx. 
M. et div. in chartulse no. xxx. 
Sig.: Take one four times a day. SACCHARUM. 
875 
SACCHARUM (U. S. P.).—Sugar, Saccharose. 
Pharmacology.—The refined sugar of Saccliarum oflicinarum (Grami- 
nacese), or cane-sugar, tlie product of the sugar-cane, grown in sub-tropi- 
cal countries, is a widely used article of food. The officinal syrup 
consists of 65 parts of sugar and water q. s. ad 100 parts. Sugar is the 
basis of the syrups, conserves, and many other pharmaceutical prepara- 
tions. With lime it forms a chemical combination,—the saecharate of 
calcium,—which is an antidote to carbolic acid ; it is officinal as Syrup us 
Calcis, which contains 1 per cent, of lime. 
Saccharum lactis (U. S. P.), sugar of milk, is a peculiar crystalline 
sugar obtained from the whey of cows’ milk by evaporation, and purified 
by recrystallization. It is also known as lactose ; cane-sugar is saccha- 
rose, and glucose is grape-sugar or starch-sugar. Sugar of milk is largely 
made in Switzerland from the whey remaining after making cheese. It 
is a white, rather gritty sugar, less sweet than saccharose, and has a 
neutral reaction. It is used in pharmacy as a diluent, on account of its 
hardness, in making triturates and abstracts. Lactose enters into Dover’s 
powder, saecharated pepsin, denarcotized opium, and other preparations. 
According to Dr. Brush, it is very commonly adulterated. 
SAGO.—Sago. 
Pharmacology.—Sago is a prepared starch from the interior of the 
stem of Metroxylon sagu or Sagus Rumphii (Palmaceae) of the Indian 
Archipelago. It occurs in hard, whitish, spherical grains, which form a 
gelatinous mass with boiling water. Pearl sago is the best variety. An 
imitation sago is made from potatoes. 
Therapy.—It is useful as an easily digested and acceptable article 
of food for the sick when added to broth, or in the form of light 
puddings. 
SAL-BROMALIDE (Salicylanilide-Bromacetanilide). 
Dose, gr. v-viij. 
Pharmacology.—A combination of acetanilide, salicylic acid, and 
bromine, with the formula C5II5NH [C6H4 (Oil) (CO) ] -f- C6H4Br.NH,- 
CII3CO, has been recently introduced by Dr. S. Radlaucr, of Berlin. It 
is a white, crystalline, granular powder, without odor, and almost tasteless. 
This substance is soluble in alcohol, dilute alcohol, and hot water, and 
almost insoluble in cold water; it is more soluble in water slightly acidu- 
lated with hydrochloric acid or in dilute solution of caustic potassa. 
Physiological Action and Therapy.—Its physiological action is simi- 
lar to that of other remedies of this class ; it is antiseptic, antipyretic, and 
hypnotic. It resembles antip\u’in in its effects upon the sensory nerves. 
Woodbury lias used it clinically (1) to relieve pain; (2) to produce 876 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
sleep; (3) to allay spasmodic cough; (4) to reduce fever; (5) to arrest 
fermentation in infectious dyspepsia. In the small doses usually given 
(gr. v-viij), it relieves headache and restlessness and produces natural 
sleep. It has not so much influence over high temperature as some of 
the other remedies of this class, but it does not produce sweating or 
cyanosis. In the treatment of influenza, or grippe, this salt reduces the 
fever and allays pain and restlessness. Where cough becomes spasmodic 
and paroxysmal, the sal-bromalide exercises a sedative effect and pro- 
duces sleep. It is of advantage in whooping-cough (gr. i-ij every 
two hours) or in asthma, whether of cardiac or bronchial origin. It 
has been used in Germany, Avith successful results, in diabetes, reducing 
both the sugar and the amount of urine; and it is stated to be particu- 
larly serviceable in acute articular rheumatism. 
SALEP.—Salep. 
Pharmacology and Therapy.—The tubers of several species of Orchis 
(Orchidaceae, Ophrydeae) growing in Germany and France, collected in 
the autumn, deprived of epidermis and dried. They contain bassorin 
(48 per cent.), or vegetable mucilage, and starch (27 percent.). With 
forty times its weight of boiling water, salep forms a thick jelly, which 
can be flavored and used as a nutritious article of food during convales- 
cence from acute diseases and in bowel disorders. 
SALIX (IT. S. P.).—Willow, Willow-Bark. 
Dose, 3j, or more, in infusion. 
Preparations. 
Salicinum (U. S. P.).—Salicin. Dosr, gr. x-3ij. 
Salol.—Phenol Salicylate. Dose, gr. iii—3j. 
Pharmacology.—The bark of Salix alba (Salicacete) and of other 
species of salix are officinal under this title. The most important con- 
stituents are Salicin, a neutral principle, in white, silky crystals, of very 
bitter taste, and tannic acid. Salicin is a crystalline glucoside, Avhich, by 
fusing with potassium hydrate, yields oxalic and salicylic acids. Salicylic 
acid and the salicylates of sodium, lithium, and of physostigmine are also 
officinal. (See page 386.) The oil of gaultheria, or of birch, also contains 
salicin as methyl-salicylate, and may be used to obtain salicylic acid, 
which may also be made synthetically by combining phenol with carbon 
dioxide (Kolbe and Lautemann). 
Physiological Action.—The bark is an astringent bitter toxic and 
antiperiodic. One variety, the Salix nigra, is considered a diuretic and 
sexual sedative, the fluid extract being used in doses of seA’- 
eral times a day. Salicin acts as a bitter tonic, with antiperiodic and 
antiseptic powers. It is not toxic in the human subject, and is acceptable SALOL. 
877 
to the stomach. This agent is excreted mainly as salicyluric, salicylous, 
and salicylic acids by the kidneys. Salicylic acid has already been consid- 
ered. (Page 386.) 
Therapy.—Salicin is a useful, bitter tonic, in feeble digestion, in 
doses of 2 to 5 grains. In the diarrhoea of phthisis it is effective in 
restoring a more healthy condition and promoting digestion, and it also 
reduces the fever, given in doses of 20 grains, two or three times 
daily :— 
Salicin., 
Bismuth, subnit., . gr. c. 
01. cinnamomi, Ilfj. 
M. et ft. capsules no. xx. 
Sig.: One or two capsules every hour or two for diarrhoea. 
Salicin is a beneficial remedy in the chronic diarrhoea of children. 
In acute rheumatism, Maclagan considers it safer than salicylic acid, as 
it does not depress the heart, the dose being from 10 to 50 grains every 
three or four hours; or, in order to get the full antipyretic effect, these 
doses may be administered every hour until two or three are taken, and 
then less frequently. He also commends its use in neuralgia and coryza. 
In full doses its antipyretic effect may be accompanied b}’ free perspira- 
tion, but it is not toxic, and can be given in amounts of several drachms 
daily. 
SALOL. 
Dose, gr. v-3j. 
Pharmacology.—The combination of salicylic acid and phenol—the 
phenylic ether of salicylic acid—is sold under the trade name of salol. It 
consists of 60 parts by weight of the former and 40 of the latter. Salol is 
a wdiite, crystalline powder, insoluble in water, odorless, and almost taste- 
less. It was first prepared by von Nencki in 1883, and introduced into 
practice in 1886 by Sahli. In the organism it becomes decomposed, 
yielding salicylic acid and carbolic acid in nascent form. It is antisep- 
tic, germicide, and antipyretic to a more marked degree, and is propor- 
tionately less toxic than either of its constituents. 
Physiological Action and Therapy.—It must not be forgotten that in 
administering salol internally the therapeutic effect is due to the salicylic 
acid and carbolic acid, and therefore that large doses cannot be given with 
impunity for fear of phenol poisoning. Salol is absorbed slowly and 
eliminated slowly, so that there is danger of accumulation in the system 
if given too frequently, except where diarrhoea is present. Josefowitsch 
reports the case of a man, 40 years of age, to whom 350 grains had been 
given in the course of four days, who suffered with intense albuminuria 
and violent pains in the loins. Black urine (carboluria) may continue for 878 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
some time after its ingestion. Kobert insists that, from the large pro- 
portion of phenol which salol contains, it is, comparatively speaking, a 
toxic substance, so that any exceeding of the maximum dose must be 
regarded as hazardous. Dr. Hesselbach reports the case of a woman 
who died after taking 120 grains of salol within eight hours. It was 
found that she had been suffering with chronic nephritis, which was 
made acute by the drug. Dr. Hesselbach, from his study of the action 
of the agent, concludes that the large proportion of phenol contained in 
salol renders it such a toxic substance that its unrestricted therapeutic 
use is fraught with danger; and, secondly, that in renal disease, acute 
or chronic, salol is contra-indicated.* 
Salol is an excellent dressing for wounds, burns, ulcers, erysipelas, 
and other cutaneous disorders. A camphorated salol is highly esteemed 
by Cuirllier in the treatment of suppurative otitis. The meatus is first 
cleansed by means of a solution of boric acid, and the camphorated salol 
applied upon a tampon of wool, which is left in position not more than 
twenty-four hours.f 
It may be prescribed thus :— 
R Salolis, 3j. 
Acidi borici, 3ss. 
Bismuth, subnit., §j. 
M. Sig.: Use by insufflation for catarrh and ozasna. 
R Salolis, 3j vel 3iij. 
Pulv. zinci oleatis, 
Bismuth, subnit., ......... aa 
M. Sig.: Dust well over the surface for excessive and odorous sweating. Service- 
able sometimes in acute and subacute eczema. 
R Salolis, 3j. 
Ungt. hydrargyri nitratis, 
Lanolin., aa §ss. 
M. For Assured eczema, especially on the hands and feet. 
R Salolis, 3j vel 3ij. 
01. eucalypti, . fflx. 
Ungt. zinci oxidi, . . ' . . §j. 
M. Sig.: To be used in chronic acne and chronic eczema. 
In both acute and chronic rheumatism, the following will serve as an 
excellent application :— 
R Salolis, gr. xx. 
Altheris, . . . . , , . . . . . . q. s. ad solv. 
Collodii, 3iiss. 
M. Sig.: Apply to painful joints once or twice daily. 
* “The Action of Salol on the Kidneys,” Therapeutic Gazette, October, 1890, p. 704, 
t American Journal of Pharmacy, January, 1891. SALOL, 
879 
Iii fermentative disorders of the stomach (dilated stomach espe- 
cially), in intestinal dyspepsia, salol, in 2- to 5- grain doses, is remark- 
ably effective in relieving the annoying symptoms of flatulence, pyrosis, 
pain, sick headache, etc. In duodenal catarrh, or catarrh of the bile-ducts, 
with or without jaundice, good results are obtained from salol. This 
substance is of value in diarrhoea, and is strongly recommended by 
Moncorvo, of Rio Janeiro, in the malarial diarrhoea of children. 
The following prescriptions containing salol are useful :— 
Salolis, 3ij. 
Pulv. ipecacuanhae et opii, gr. xxiv. 
M. et ft. chartse no. xxij. 
Sig.: A powder every hour or two until relieved of diarrhoea. 
Salolis, 
Bismuth, subnit., 
Cretse praeparatae, aa 3j. 
M. et ft. chartae no. xij. 
Sig.: A powder every hour or two, for diarrhoea. 
Dr. W.L. Carr has found it of decided service in the first stage of acute 
gastro-enteritis, and, being excreted as salicylic acid, it acts as a disin- 
fectant to the urinary passages, and is useful in pyelitis, catarrh of the 
bladder, and ammoniacal urine. Dr. S. L. Abbott treated 3 cases of 
cystitis in women with salol (gr. x thrice daily or gr. v every three hours). 
Under its use the symptoms disappeared and the urine became acid, and 
the patients were cured after the failure of other remedies. Recently M. 
Heiz reported 20 cases of blennorrhagia treated by salol, in which the dis- 
ease lasted only ten or twelve days. In the same communication* he 
praises it highly in typhoid fever, giving it in doses of a drachm daily, 
combined with salicylate of bismuth. Salol is especially valuable in the 
treatment of acute rheumatism, given in 15- to 30- grain doses three or 
four times daily. It reduces the temperature and causes free perspiration, 
and is somewhat analgesic. 
M. Gouguenheimj* says that salol has a very manifest action in sup- 
purative sore throat (tonsillitis, etc.). Salol is valuable as an intestinal 
and urinary antiseptic. It is especially serviceable in cystitis, enlarged 
and irritable prostate, gonorrhoea, and gleet. In the treatment of dis- 
eases of the genito-urinary tract, salol can be prescribed as follows :— 
Salolis, gr. c. 
Terebense, Nlc. 
M. et ft. eapsulae no. xx. 
Sig.: A capsule or two every two or three hours. For irritation of the genital organs. 
Valuable especially in gleet. 
* Repertoire de Pharmac'e, July 10, 1890. 
t La Tribune Medicale; also Medical Mirror, December, 1870. 880 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
The following have also proved of service in gonorrhoea and gleet:— 
Salolis, gr. c. 
Ext. belladonna; ale., gr. ij. 
M. et ft. capsul® no. xx. 
Sig.: From four to six capsules a day. 
Salolis gr. c. 
Ergotin®, gr. xx. 
M. et ft. capsul® no. xx. 
Sig.: One or two capsules every two or three hours. For cystitis and in enlarged 
prostate. 
Dr. J. William White* recommends salol given in capsules as follows 
in the treatment of recent anterior urethritis:— 
Salolis, gr. iiiss. 
Oleoresin. cubeb®, gr. v. 
Balsam, copaibae (Para), . . gr. x. 
Pepsin®, gr. j. 
M. et ft. capsulae no. j. Mitte no. xxx. 
Sig.: One capsule four to six times daily. 
This writer reports that the discharge thus treated in two-thirds of 
the cases ceased within a week. In the majority of patients he also 
recommended an injection of gr. ij of sulphocarbolate of zinc in a 10- to 
15- per-cent, solution of peroxide of hydrogen. 
Salipyrin is a combination of salicylic acid and antipyrin. This sub- 
stance can be made by gradually adding 73.4 parts of salicylic acid to a 
boiling aqueous solution of 100 parts of antipyrin. On cooling, salicy- 
late of antipyrin is thrown down in the form of colorless, transparent 
crystals or scales, which are very slightly soluble in cold water, but 
readily soluble in alcohol, ether, or chloroform. Salipyrin is used by 
Gruttmann in doses of a drachm or more in twenty-four hours, given in 
doses of 15 grains, the first dose to be double (30 grains). It has decided 
antipyretic and analgesic action, and is especially useful in the pyrexia 
of rheumatism and intermittent fevers. 
Salinaphthol is a combination of salicylic acid with nnphthol, 
analogous to salol. It is given in doses of gr. iii-viij. is insoluble in 
water, and devoid of taste and smell. 
For the physiological action of Salinaphthol, see page 7(12, 
Sal naphthol seems less objectionable than salol, because the nnphthol 
resulting from its decomposition is less poisonous than the phenol liber- 
ated by the latter; but thus far clinical evidence has not sufficiently 
accumulated to declare that it should in all cases be preferred to salol, 
which has been given in much larger doses. 
* The Philadelphia Medical News, June 14, 1890. SALVIA. 
881 
SALVIA (U. S. P.)—Sage. 
Dose, gr. x-xxx, in infusion or fluid extract (with dilute alcohol). 
Pharmacology.—The leaves of Salvia officinalis (Labiatae), a garden 
herb, used for its flavor in cooking; but the wild sage (Italian sage) is 
better for medicinal purposes. It contains from to f per cent, of 
volatile oil, Salviol, with tannin, resin, etc. 
Physiological Action.—The infusion (5ivtoOj),of which the dose 
is from an ounce to a wineglassful, is tpnic, astringent, and stimulant. 
The latter quality is increased in the fluid extract by the diluted alcohol, 
used as a menstruum. 
Therapy.—Infusion of sage by itself is a-very good gargle and 
astringent wash for the nose or mouth. Internally it has been admin- 
istered for its tonic effects in fevers, and to check sweating, especially 
in phthisis pulmonalis. Sage may be combined with other remedies as 
an injection for urethritis or vesical catarrh. The compound sage-gargle 
consists of:— 
Aluminis, 3iv. 
Salvias, §j. 
Mel despumatse, fjij. 
Aquae bullientis, Oj. 
Ft. infusuin et cola. 
Sig.: Dilute with water and use as a gargle. 
SAMBUCUS (U. S. P.).—Elder-Flowers. 
Dose, 3ss-j, in infusion, drunk while hot. 
Pharmacology and Therapy.—The flowers of Sambucus Canadensis 
(Caprifoliaceae), of North America, are stimulant and diaphoretic, and, 
to some extent, diuretic. The flowers are used for flavoring purposes. 
They contain a small proportion of a volatile oil, which has the odor of 
the flowers in a high degree; also valerianic acid, acrid resin, and mucil- 
age. Elder-flower water is a good vehicle for lotions and eye-washes. 
In hot infusion the remedy acts as a stimulant, diuretic, and diaphoretic, 
and may be emetic if given in too large quantity. The berries are edible, 
and the juice is considered antiscorbutic and alterative; it is used in 
rheumatism and s}-philis. Elder-berry jam or conserve is laxative. The 
inner bark of elder is cathartic and, in large doses, emetic. 
SANGUINARIA (IT. S. P.).—Blood-Root. 
Dose, gr. ii-xx. 
Preparations. 
Acetum Sanguinarice (U. S. P.).—Vinegar of Sanguinaria. Dose, ttlxv-xl (or as an 
emetic, f 3i-v). 
Tinctura Sanguinarice (U. S. P.).—Tincture of Sanguinaria (15 per cent.). Dose, 
nix-f3j. 
Extraction Sanguinarice Fluidum (U. S. P.).—Fluid Extract of Sanguinaria. Dose, 
niv-xv. 882 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Pharmacology.—The rhizome of Sanguinaria Canadensis (Papaver- 
aceae), collected in autumn, is about 2 inches long, cylindrical, reddish 
brown, containing small, red resin-cells; taste, very bitter and acrid. It 
contains three alkaloids, Sanguinarine, Porphyroxine, and Puccine, with 
chelidonic and puccinic acids. 
Physiological Action.—The powder is extremely irritating to the air- 
passages, causing violent sneezing and free secretion. It is a feeble 
escharotic. The taste is harsh and bitter. Taken internally, it is a sys- 
temic emetic, its action being followed by salivation and much depression, 
causing also an increase of hepatic secretion. Sanguinaria majr cause 
hypercatharsis and act as an irritant, acro-narcotic poison. It is emmena- 
gogne and expectorant,and, after a preliminary increase of arterial tension, 
depresses the heart’s action ; death is produced by paralysis of the medul- 
lary, respiratory, and cardiac centres. The spinal reflexes are reduced and 
spinal centres finally paralyzed ; the pupils become dilated, the muscles 
relaxed,the skin cold and clamm}', with collapse of the vital powers ; the 
fatal result often is preceded by convulsions, either of spinal origin or 
arising from carbonic-acid poisoning, due to failure of respiration. 
Antidotes.—The antidotes are diffusible stimulants,—digitalis, nitrite 
of amyl, strychnine hypodermatically, with morphine and atropine, if 
necessary, to relieve pain or severe nausea. The patient should be kept 
warm, and warm water may be used to wash out the stomach and 
bowels. 
Therapy.—Blood-root has been used in powder as an application to 
ulcerated surfaces, and is regarded by some as a cure for cancer ; but it is 
painful, and, if freely applied, may be absorbed and cause vomiting and 
other symptoms of poisoning. Keyser employs nitrate of sanguinarine 
(Merck’s) \ grain, with 1 ounce of glycerin, as a remedy for conjunctivitis 
granulosa. Powdered sanguinaria, snuffed or blown into the nose, is 
said to cure polypi, and may prove successful. A decoction may be 
used with advantage as a gargle in the scarlatinal angina. An ointment 
containing blood-root has been successfully used in tinea. The powdered 
root is recommended by some as a sternutatory in nasal catarrh, and the 
treatment is certainly very effective, because the patient will not be 
likely to return for further treatment. The conjoined internal use of the 
tincture, dose 10 minims, thrice daily, is also advised. In small doses of 
the tincture (5 or 10 minims several times a day), it is considered valuable 
in atonic dyspepsia, gastric catarrh, or duodenal catarrh with jaundice. 
Large doses, a teaspoonful to a tablespoonful of the vinegar, or the 
tincture, causes vomiting, with increase of hepatic secretion. It has 
been used in croup as an emetic, but is too violent and too depressing. 
In various spasmodic affections and disorders, accompanied by cough, SANGUINARIA. 
883 
as in pneumonia, asthma, bronchitis, etc., small doses of the tincture may 
be given at short intervals. Sanguinaria may be prescribed thus with 
expectorants for the diseases referred to :— 
Tinct. sanguinariae, f.^j. 
Syrupi ipecac., f^ss. 
Tinct. lobeliae, f3j. 
Glycerini, f§ss. 
M. Sig. : A teaspoonful every two or three hours, for subacute bronchitis. 
Tinct. sanguinariae, f3ij. 
Ammonii bromidi, 3iij. 
Spiritus petheris nitrosi, f§j. 
Syrup, pruni Yirg., q. s. ad f§v. 
M. Sig. : Two teaspoonfuls in water every two or three hours, for asthma and in 
bronchitis. 
Sanguinarine may be given as an expectorant in doses of gr. TV-|- 
in pneumonia, bronchial catarrh, winter cough, etc., the alkaloid having 
the advantage of not disturbing the stomach, although its secretions are 
increased by fractional doses. A syrup of sanguinaria, made by adding 
sugar to the vinegar, may be used as an ingredient in cough mixtures 
or as an emetic (f5i-ij). 
In hysteria, due to pain or moral causes, sanguinaria is said to be 
sometimes of advantage, either given alone or in combination with 
podophyllum.* For various functional affections of the genital system, 
amenorrhoea, dysmenorrhoea, and in impotence, with seminal incontinence 
and relaxation of the organs, sanguinaria is pronounced a serviceable 
remedy. Blood-root can be combined as follows, for the diseases 
named :— 
Tinct. sanguinariae, 
Ext. hoang-nan fl., 
Ext. ergotae fl., . aa f3ij. 
M. Sig.: Twenty to forty drops in water three times a day, in amenorrhoea ; useful 
also in impotence and seminal weakness. 
$ Sanguinariae, gr. ij. 
Aloini, 
Abst. ignatiae, aa gr. ij. 
Ferri lactatis, gr. xx. 
M. et ft. pil. no. xx. 
Sig.: A pill three or four times a day ; beneficial as an emmenagogue and in genital 
debility. 
Sanguinaria is also regarded as an alterative, on account of its in- 
fluence upon secretions, and may be used in syphilis, especially of the skin. 
♦Phillips, op. cit, 884 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
SANTALI OLEUM (IT. S. P.).—Oil of Sandal-Wood. 
Dose, tijv-x ; in emulsion or capsules. 
Pharmacology.—A volatile oil distilled from the wood of Sant Alum 
album (Santalaceae), of India. It is a pale-yellowish or yellow liquid, 
of a peculiar, strongly-aromatic odor, a pungent and spic3r taste, and 
slightly-acid reaction. It is readily soluble in alcohol, ether, and chlo- 
roform, and is used in perfumery. 
Physiological Action.—Sandal-wood-oil acts as an internal antiseptic 
and as an astringent to mucous surfaces, checking secretions and caus- 
ing dryness of the throat and thirst. It is largely excreted by the 
kidneys and imparts an odor to the urine, to which it gives also medi- 
cinal qualities, so that it acts upon the urinaiy passages. Absorption 
and elimination are very rapid, and it may be detected in the urine half 
an hour after administration. This oil partly escapes by the broncho-pul- 
monary mucous membrane, and here also exerts a local effect. 
Therapy.—Sandal-wood-oil is used principally in the treatment of 
gonorrhoea, even in the acute stage, given in capsules of 5 minims each, one 
or two, three times daily. It seems to be best adapted to plethoric indi- 
viduals, with abundant discharge. It generally relieves the pain and dis- 
charge within four or five days. If the discharge is not materially dimin- 
ished within ten da}’S the doses should be cautiously increased. The 
use of the oil is not contra-indicated by the presence of any of the compli- 
cations of the disease. 11 is also valuable in pyelitis, cystitis, gleet, ureth- 
ral haemorrhage, and chronic bronchial catarrh. It is important to note 
that much of the oil of sandal-wood, especially in the form of proprietary 
capsules, is impure, and is adulterated with other oils. The French 
preparation, known as Santal-Midy, prepared by Midy’s process from 
freshly-felled Mysore sandal-wood, is a reliable preparation, put up in 
capsules of 5 drops each in the laboratory of Rigaud and Chapoteaut, 
Paris. The leading manufacturers of soft capsules in this country, 
Messrs. Parke, Davis & Co., also employ an oil of good quality and 
therapeutical activity. The advantage of pure oil of sandal-wood over 
copaiba and cubeb is that it does not nauseate or disturb digestion, 
and can be given with good results during the inflammatory stages of 
blennorrhoea or cystitis. The fluid extract, obtained from the S. citrinum, 
or yellow sandal-wood, has been used for the same purposes as the oil. 
The wood is largely used as an ingredient of incense, in China, in temple- 
worship, and is prized for its perfume. 
SANTALUM RUBRUM (U. S. P.).—Red Saunders. 
Pharmacology.—The wood of Pterocarpus santalinus (Leguminosae, 
Papilionaceae) usually is met with in the shops as raspings. It contains SANTONICA. 
885 
a red coloring matter of a resinous character, known as Santalic acid, 
which is soluble in alcohol, but insoluble in water. It is used in phar- 
macy for coloring alcoholic liquors or tinctures red. It enters into the 
compound tincture of lavender. 
SANTONICA (U. S. P.).—Santonica, Levant or German Wormseed. 
Dose, 3ss-j* 
Preparations. 
Extractum Santonicce.—Extract of Santonica. Dose, gr. ii-viij. 
Extractum Santonicce Fhddnrn.—Fluid Extract of Santonica. Dose, Hlviii-xxx. 
Santoninum (U. S. P.).—Santonin, Santoninic Acid. Dose, gr. i-iv. 
Sodii Santoninas (U. S. P.).—Santoninate of Sodium. Dose, gr. v-x. 
Trochisci Sodii Santoninatis (U. S. P.).—Troches of Santoninate of Sodium (each con- 
taining 1 grain of the soda salt). Dose, i-v. 
Trochisci Santonini.—Troches of Santonin, Worm Lozenges (each gr. ss). Dose, i-v. 
Pharmacology.—The unexpanded flower-heads of Artemisia mari- 
tima, var. Stechmanniana (Composite), growing in Turkestan and sur- 
rounding countries, are generally known as wormseed. They contain 
about 1 per cent, of volatile oil and from to 2 per cent, of Santonin, a 
peculiar, crystalline principle, with faintly-acid properties, forming salts 
with alkalies, of which the sodium salt is officinal. As the object of 
administration of this remedy is to act locally upon the parasites of the 
digestive tract, it is better to employ the slightly-soluble santonin than 
its more soluble combination. The troches, therefore, made with santo- 
nin, instead of the santoninate of sodium, are better, because less likely 
to occasion toxic effects. 
Physiological Action and Therapy.—Santonin is a very popular 
vermifuge against the round-worm, Ascaris lumbricoides, and, to a less 
extent, against the thread-worm, Oxyuris vermicularis. It has no effect 
upon the tape-worm. The crystals of santonin and its officinal salt are 
colorless, but turn 3’ellow upon exposure to light. When taken into the 
body, this change occurs in the blood, which disturbs the nutrition of 
the cerebral centres, so that chromatopsia is produced, the patient com- 
plaining that everything has a lurid, yellow, or greenish tinge, and he 
may even entirely lose his vision for a few days. The urine is stained a 
greenish-yellow, or, if it should be alkaline, it has a reddish-purple color. 
This is due to xanthopsin, a derivative of santonin. Elimination, which 
takes place by the kidneys, is slow, about two da}Ts being required for 
the removal of an ordinary dose. The flow of urine is considerably 
increased, and the calls for micturition are frequent. Acute poisoning 
sometimes occasioned by children eating worm-candy, or lozenges, is 
manifested by cerebral and digestive disorder and muscular prostration, 
with tremors, or even convulsions. Death occurs from respiratory 886 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
failure. Urticaria lias been caused by its prolonged administration. It 
should be given cautiously to feeble children, and be followed in a few 
hours by a dose of magnesia or rhubarb. Some practitioners prefer to 
administer santonin with castor-oil, and, in the experience of Dr. Whitla, 
this combination is of decided value in diminishing the danger of any 
ill effects. The treatment of poisoning is by diffusible stimulants, a hot 
bath, demulcent drinks, belladonna, and strychnia,with ether to control 
convulsions. 
In case children show symptoms of intestinal irritation, suggesting 
the presence of worms, their passages should be watched in order to 
detect the presence of parasites, and this may be assisted by a saline 
purgative, such as magnesia, or rhubarb and magnesia, which removes 
the mucus in which worms breed. Then a dose of santonin should be 
given at night and followed by a purgative in the morning. 
Santonini, gr. iij. 
Hydrarg. chloridi mitis, gr. vj. 
Sodii bicarb., gr. xij. 
M. et div. In chart, no. vj. 
Sig.: Give one each night to a child 6 years old. 
Ilex* gives the following prescription, containing santonin, for 
lumbricoid worms :— 
Santonini, gr. viij. 
Ext. spigelise et sennse fluid., f§j. 
M. Sig.: One teaspoonful three times a day. 
In color-blindness, santonin has been tried with asserted success, 
but is probably of no service in the congenital form, though it might be 
serviceable where vision had been impaired or the appreciation of color 
lost by accident or disease. It has been advocated as a remedy for some 
disorders of the optic nerve, but without clinical evidence to support the 
suggestion. Nocturnal enuresis occasionally yields to santonin after the 
failure of other remedies. By Mr. Whitehead, of Manchester, santonin 
is recommended in amenorrhcea, especially when that condition is de- 
pendent upon chloro-amemia. He gives a 10-grain dose on two successive 
nights. 
Santoninoxime (obtained by heating 5 parts of santonin with 4 parts 
of hydroclilorate of liydroxylamine and 3 or 4 parts of lime in the 
presence of alcohol) is in the form of white, silky7, needle-shaped crys- 
tals, insoluble in cold water, slightly soluble in boiling water, soluble in 
alcohol and acetic acid ; it has been brought out recently as a substitute 
for santonin. It is claimed that this substance may be administered in 
doses two or three times as large as santonin, and without producing ill 
effects.f 
♦The College and Clinical Record. February, 1891. 
t Repertoire de Pliarmacie, 1890; Journal de Med. de Paris, November 16, 1890. SAPO, 
887 
SAPO (U. S. P.).—Soap. Soap prepared from soda and olive-oil. 
SAPO VIRIDIS (U. S. I\).—Green Soap. Soap prepared from 
potassa and fixed oils. 
Preparations. 
Emplastmm Saponis (U. S. P.).—Soap Plaster (soap 10, lead plaster 90 parts). 
Linimentum Saponis (U. S. P.).—Soap Liniment (soap 10, camphor 5, oil of rosemary 
1, alcohol 70, water q. s. ad 100 parts). 
Tinctura Saponis Viridis (U. S. P.).—Tincture of Green Soap* (green soap 65, oil of 
lavender 2, alcohol q. s. ad 100 parts). For external use. 
Tinctura Saponis Viridis Composita (N. F.).—Compound Tincture of Green Soap 
(contains green soap, 15 per cent.; oil of cade, 2 per cent.). For external use. 
Pharmacology.—Soup may be either hard or soft. The combination 
of soda and fatty acids makes a hard soap ; potassa makes a soft or jelly- 
like soap. The latter is officinal as green soap, although it is generally 
brownish yellow rather than green. The sapo mollis, or soft soap, of the 
British Pharmacopoeia, is made with olive-oil with an excess of potassa. 
Even hard soap usually retains considerable water when cut into bars, 
and, as this afterward evaporates, the soap shrinks, becomes wrinkled, 
and increases in hardness so that it may be powdered. Old Castile soap 
is a good excipient for pills, especially cathartic masses, and enters into 
compound extract of colocynth, pills of asafcetida, of aloes and asafoetida, 
of opium, and of rhubarb, compound pills of rhubarb, and compound pills 
of squill. Nearly all soaps are palmitates or oleates of sodium or potas- 
sium, or a combination of them. These fatty acids may also combine 
with other bases, as in the lead-soap, emplastrum plumbi, and lime-soap, 
linimentum calcis. Soap also enters into chloroform liniment. 
Physiological Action.—Soap is a useful detergent, removing fat from 
the skin, together with dirt, foreign matter, bacteria, and epithelial 
scales. In antiseptic surgery the field of operation is usually first washed 
with soap and water and afterward with disinfectants. Taken internally, 
soap is a laxative and is an antidote to acid and corrosive poisoning. In 
the form of soap plaster, it is a good protective for the prevention of bed- 
sores. Applied to raw surfaces, soap augments secretions and keeps up 
discharge; soap and brown sugar form a stimulating dressing. Soap 
acts as an alkali internally and affords relief in cystitis, and was formerly 
vaunted as a specific for stone in the bladder, but it has been proven 
that this claim was not well founded. Suppositories made with soap 
and glycerin are very convenient for the purpose of unloading the 
rectum, and small suppositories of soap will relieve infantile constipation. 
In the treatment of diseases of the skin, the author has witnessed signal 
benefit from the judicious employment of medicated hard soap. It is 
prudent to begin its use upon a small area, and, if it prove beneficial, it 
* Also known as Spiritus Saponis Kalinus of Hebra. 888 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
can afterward be applied to the whole of the affected area. In some in- 
stances medicated soap can be profitably used every day; in others, two 
or three times a week, or even less frequently. Numerous active drugs 
have been incorporated in soda-soap.* Among these may be enumerated 
boro-glyceride, carbolic aeid,eucalyptol,naphthol, salicylic acid.corrosive 
sublimate, tar, etc. Most medicated soaps are made of 10-per-cent, 
strength. Some of the more active substances, as carbolic acid, eucalyptol, 
salicylic acid, are usually but half this strength, while 1 per cent, of corro- 
sive sublimate is a sufficient proportion. Green soap is more decidedly 
alkaline, and exerts a softening effect on the tissues, on account of the 
excess of potassa which it contains. Its preparations are not used 
internally. 
Therapy.—Powdered soap is an ingredient in some kinds of denti- 
frices and undoubtedly helps to preserve the teeth. As an ingredient in 
cathartic pills, it prevents griping and is useful in ordinary consti- 
pation :— 
Res. podophylli, gr. ij. 
Ext. belladonnse ale., gr. j. 
Saponis, gr. xxx. 
01. cajuputi, Itliv. 
M. et div. in pil. no. xij. 
Sig.: Take one or two at bed-time, as a laxative. 
Soap-suds, made b}' rubbing soap in hot water, form a convenient 
enema for unloading the bowels ; a couple of pints or more may lie used, 
to which some castor-oil or oil of turpentine may be added. Green soap is 
useful in chronic induration of the skin, especially in the form of the 
officinal tincture, which is Hebra’s spiritus saponis kalinus, and may 
be diluted with Cologne water (1 to 3). It is useful as a cleansing agent 
for the scalp in seborrhoea. In sprains, rheumatic stiffness and pains, 
the liniment is very useful, and may have anodynes, like aconite, chloro- 
form, or laudanum added to it:— 
IJ: Chloral, hydrat., 3ij. 
Lin. 6aponis, f^v. 
M. Sig.: Use with friction in rheumatic pains. 
The green soap is used in chronic eczema, the best form being the 
officinal tincture, which is well rubbed into the affected area and followed 
by a soothing application. In psoriasis, if there be much itching, we 
may use the following :— 
Saponis viridis, 
Olei cadini, 
Alcoholis, aa f^j. 
M. Sig.: Rub, every day or two, firmly into the patches, previously denuded of scales. 
* For a list of medicated soaps, with a description of their composition and indications, 
see author’s treatise on Diseases of the Skin, loc. cit., p. 606. SAPONARIA. 
889 
Liveing recommends the following :— 
Saponis viridis, f^j. 
Alcoholis, f^iss. 
Aquae, f^iii-vj. 
Solve cola et adde 
01. lavandulae florum, lllxx. 
M. Sig.: To he rubbed in at suitable intervals and allowed to dry on, preferably at 
night, in chronic psoriasis, acne, tinea, and sometimes lupus.* 
Kappesser, Senator, and others have found soft sonp a useful appli- 
cation to enlarged glands, whether of simple inflammatory, scrofulous, 
or syphilitic origin. Other scrofulous or tuberculous manifestations, as 
disease of the mesenteric glands, periostitis, or caries, have been benefited 
by the same topical treatment. The same remark may be made concern- 
ing exudations into serous cavities. 
A caution should be given with regard to the use of soap upon deli- 
cate skins, especially in infants. Most toilet-soaps are too alkaline, and 
may contain irritating essential oils. Moreover, many cheap soaps are 
made with animal fat which has not been properly purified, and there- 
fore they contain the bacteria of putrefaction and perhaps of disease. 
That vegetable-oil soap is preferable is acknowledged by the pharmaco- 
poeia, which requires it to be made with olive-oil. This is also called 
Castile soap, which may be either white or colored, the former being pre- 
ferred. A good cottonseed-oil soap for the toilet or household is made 
by the Cotton Seed Oil Product Company. A pure glycerin soap is 
probably the best for the skin, it having been made transparent by 
dissolving it in alcohol, which is afterward driven off by heat. 
SAPONARIA.—Soapwort-Root. 
Dose, 3ss—iss, in infusion, several times daily. 
Pharmacology and Physiological Action.—The root of Saponaria 
officinalis of Europe and America, contains Saponin, 
resin, and other vegetable principles. It resembles senega, sarsaparilla, 
quillaya, and other drugs containing saponin, in making a soapy emul- 
sion with water, and as an expectorant, but is not used in medicine at 
present. In the arts, it is largely employed for washing silk, etc. 
Therapy.—The smaller roots are to be preferred for making the 
infusion, which may be used in chronic cutaneous diseases, rheumatism, 
gout, and bronchial catarrh. About an ounce and a half of the drug 
may be employed in this Avay in the course of twenty-four hours. 
SAPONINUM.—Saponin, 
Pharmacology.—Saponin is a vegetable, active principle, a glucoside, 
found in caulophyllum, quillaya, saponaria, senega, and other plants. In 
* Materia Medica and Therapeutics, p. 442. Phillips, 1886. 890 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
watery solution, it acts like soap, making a froth when the solution is 
shaken up, and forming emulsions. (See Quillaia, page 853.) 
Physiological Action.—Saponin is a local irritant; also an anaesthetic 
and muscular poison. It causes pain when injected hypodermatieally, 
and excites the air-passages and causes sneezing if applied to the nose. 
Locally applied, it paralyzes both sensory and motor nerves, producing 
local paralysis with anaesthesia and stiffness of the muscles. It counter- 
acts the effects of digitalis upon the heart. Saponin also paralyzes the 
respiratory and vasomotor centres, and after large doses respiration fails 
before the heart ceases to beat. If injected into a vein, death follows 
from cardiac paralysis. 
Therapy.—In aortic disease with hypertrophy, Brunton suggests the 
employment of quillaya for the saponin which it contains. Saponin may 
also be used, in small doses, as an expectorant in chronic bronchitis. 
Senegin, which is probably identical, has been administered in 2-grain 
doses to check uterine haemorrhage. Saponin might be useful in snake- 
bite, and in other affections for which senega has been recommended, as 
snake-root is thought to owe its activity to this active principle. 
SARSAPARILLA (U. S. P.).—Sarsaparilla. 
Preparations. 
Extractum Sarsaparilla Fluidum (U. S. P.).—Fluid Extract of Sarsaparilla. Dose, 
f 3 ss—ij. 
Extractum Sarsaparilla Compositum Fluidum (U. S. P.).—Compound Fluid Extract 
of Sarsaparilla (sarsaparilla 75, glycyrrhiza 12, sassafras-bark 10, mezereum 3, glycerin 10, 
alcohol and water, of each q. s. ad 100 parts). Dose, f3ss-j. 
Decoctum Sarsaparilla Compositum (U. S. P.).—Compound Decoction of Sarsaparilla 
(sarsaparilla 10, sassafras, guaiac-wood, and liquorice-root, of each 2, mezereon 1, water 
q. s. ad 100 parts). Dose, f§i-iv. 
Syrupus Sarsaparilla Compositus (U. S. P.).—Compound Syrup of Sarsaparilla (sarsa- 
parilla 150, guaiaeum-wood 20, pale rose 12, liquorice-root 12, senna 12, sassafras 6, anise 
6, gaultheria 6, sugar 600, diluted alcohol and water ad 1000 parts). Dose, f3ss-§ss. 
Extractum Sarsaparilla.—Extract of Sarsaparilla (made from fluid extract by evapora- 
tion). Dose, gr. v-xxx. 
Pharmacology.—The roots of Smilax officinalis, S. medica, and of 
other undetermined species of Smilax (Smilacese) are officinal in the 
U. S. P. under the general title of sarsaparilla. They are brought here 
from Mexico, Central America, and Brazil, chiefly, the roots varying in 
value and appearance. Smilax officinalis, or so-called Jamaica sarsaparilla, 
is the only one recognized by the British Pharmacopoeia. The roots are 
small, about inch in diameter, 6 or 7 feet in length ; they are usually 
folded up into bundles about 26 inches long. They are inodorous ; the 
taste is mucilaginous, bitter, and acrid. The flavoring known as sarsa- 
parilla at the soda-water fountain is made from oil of sassafras and SASSAFRAS. 
891 
gaultheria. An acrid, neutral principle, Parillin or Smilacin (closely re- 
sembling saponin) has been found, combined with resin percent.) and 
traces of volatile oil. It is not known to which of these constituents 
the physiological effects are to be attributed. 
Physiological Action.—The experiments undertaken to determine the 
physiological effects of sarsaparilla have yielded negative results, and 
deductions from the therapeutical effects are not available because it is 
always given with other drugs, classed by Brunton among stimulant diu- 
retics and alteratives. It is probably inert, or nearly so, in the doses usually 
given, though moderate doses sometimes seem capable of improving the 
appetite and digestion. In much larger doses it would, probably, give 
the physiological effects of smilacin (saponin ?). The chief value of the 
preparations of sarsaparilla is that they are pleasant vehicles for dis- 
guising the taste of iodide of potassium and of mercury, with which they 
are usually prescribed for syphilis :— 
Potassii iodidi, §ss. 
Syr. sarsaparillse co., 
Aquae destillatae, aa f^iij. 
M. Sig.: A dessertspoonful in a glass of water two hours after meals in syphilitic 
skin affections. 
Or, in the tertiary form of syphilis, we may give the recent decoc- 
tion, which, if drunk hot, causes diaphoresis and diuresis, thus greatly 
increasing the alterative effects. There is no evidence of a curative 
action of sarsaparilla by itself in syphilis ; nevertheless, in debilitated 
subjects in whom mercury has, for a time, lost its beneficial action, or be- 
come positively harmful, a temporal recourse to sarsaparilla has been 
considered useful by excellent observers. Phillips believes that this 
remedy is serviceable in chronic pulmonary affections, where there is 
much wasting; in chronic rheumatism and cutaneous disorders,in which 
there may be suspected a venereal taint, sarsaparilla is useful. Sir 
Astley Cooper considered it serviceable in cachectic conditions of the 
system, caused by long-continued suppuration ; also, in chronic abscesses, 
old ulcers, and bone disease. In German}7, a compound decoction con- 
taining alum, kino, calomel, senna, and aromatics (Zittman’s decoction) 
is used in syphilis, chronic rheumatism, and in scrofulous disorders. 
SASSAFRAS (U. S. P.).—Sassafras-Root Bark. 
Preparations. 
Sassafras Medulla (U. S. P.).—Sassafras-Pith. 
Mucilago Sassafras Medullce (U. S. P.).—Mucilage of Sassafras-Pith (2 parts iu 
water 100). 
Olerum Sassafras (U. S. P.).—Oil of Sassafras. Dose, hli-iv. 
Infusum Sassafras (U. S. P.).—Iufusiou of Sassafras (§j to Oj). Dose, f 3ii-viij. 892 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Pharmacology.—Sassafras is the bark of the root of Sassafras 
officinalis (Lauraceae), common in the United States from Canada to 
Florida. The principal constituent of the bark is the volatile oil; it also 
contains tannic acid, resin, etc. The oil of sassafras is of a light-yellow 
color, and is a mixture of two oils, one lighter, the other heavier, than 
water. Sassafras also contains a peculiar principle, termed Sassafrin. 
The pith of the branches contains mucilage, which is used in pharmacy 
as a vehicle or diluent. 
Physiological Action.—The oil is stimulant and rubefacient, and, 
taken internally, is a carminative. It is largely used as a flavoring- 
agent in confectionery as well as pharmacy. It enters into the officinal 
sarsaparilla preparations, and adds to their alterative influence. 
Therapy.—Sassafras is an aromatic stimulant, and small bundles of 
the fresh bark are sold b}7 herb-gatherers to be chewed for its flavor and 
as a carminative. A recent infusion is used in some parts of the country 
as a blood-purifier; or, taken hot, as an emmenagogue and diaphoretic. 
Sassafras is generally given in combination with guaiac and sarsaparilla, 
and in those cases where the latter agents are considered indicated. The 
mucilage of sassafras-pith may be used as a demulcent drink in inflam- 
mation of the stomach or bowels, especially when this has been excited 
by irritant or corrosive substances. It is a cooling application to in- 
flamed eyes or erysipelas, and may be used as a vehicle for other remedies. 
The following is known as Jackson’s Pectoral Syrup :— 
$ Medullse sassafras, 3ss. 
Acaciae, 3v. 
Aquae, f^viss. 
Allow this to stand for twelve hours, stirring occasionally, then add 
Sacchari, %x. 
Dissolve without the aid of heat, strain, and add 
Morpliinae hydrochloratis, . . gr. iij. 
M. Sig.: Dose, one to two teaspoonfuls several times daily (each drachm contains 
about gr. morphine). 
Another formula for this syrup is given by Remington :— 
01. sassafras, . ifilxiv. 
Tinct. tolutani, f §viij. 
Magnesii carb., §ij. 
Aquae, Oviij. 
Sacchari, lbs. xiv (avoir.). 
Morphinae hydrochloratis, gr. lxiv. 
M. Rub up the tincture and oil with the carbonate, gradually add yi pound of the 
sugar and then the water, filter and recover 8 pints, in which dissolve the remainder of the 
6ugar. Dissolve the morphine in one fluidounce of water, add to the syrup, and make the 
measure up to 16 pints. 
Sig.: Take a teaspoonful or more several times daily for cough (each drachm contains 
g’ij grain of hydrochlorate of morphine). SCAMMONIUM. 
893 
SCAMMONIUM (IT. S. P.).—Scammony. 
Dose, gr. v-xv. 
Preparations. 
Resina Scammonii (U. S. P.).—Resin of Scammony. Rose, gr. iv-viij. 
Extraction Colocynthidis Composition (U. S. P.).—Compound Extract of Colocynth 
(resin of scammony 14, aloes 50, colocynth 16, cardamom 6, soap 14 parts). Rose, gr. ii-x. 
It is also an ingredient in the compound cathartic pill. (See page 566.) 
Pharmacology.—Scammony is a resinous exudation from Convol- 
vulus scammonia (Convolvulaeeae). It contains about 80 per cent, of a 
resin, soluble in alcohol and ether (which is officinal), and gum, starch, etc. 
Scammonin (Jalapin) is the active principle. Scammony has a slightly 
acrid taste and a peculiar odor, which recalls that of cheese. Scam- 
monin is a glucoside, nearly insoluble in water, soluble in alcohol, 
chloroform, ether, and alkaline solutions. 
Physiological Action.—This drug is a hydragogue cathartic, and feebly 
cholagogue; in large doses it causes symptoms of irritant poisoning. 
Absorption depends upon its intimate mixture with the alkaline bile and 
intestinal fluids, and for this reason the action of scammony is liable to 
vary in rapidity and power. Its effects are usually manifested in about 
four hours. 
Therapy.—In children, where active purgation is required, calomel 
and scammony may be given, triturated with sugar of milk. In cerebral 
affections and dropsies, scammony is useful, especially in the form of com- 
pound extract of colocynth. It clears mucus from the intestines, and is 
an anthelmintic against both round-worms and tape-worms. Scammony 
is serviceable in obstinate constipation and impaction of feces. It is a 
purgative well adapted to cases of mania and hypochondriasis. 
SCILLA (U. S. P.).—Squill. 
Dose, gr. ii-iij. 
Preparations. 
Extractum Scillce Fluidum (U. S. P.).—Fluid Extract of Squill. Rose, Hli-v. 
Acetum Scillce (U. S. P.).—Vinegar of Squill (10 per cent.). Rose, Hlv-f3j. 
Tinctura Scillce (U. S. P.).—Tincture of Squill (15 per cent.). Rose, hlv-xxx. 
Syrupus Scillce (U. S. P.).—Syrup of Squill (vinegar of squill with sugar). Rose, 
Hlx-f3j. 
Syrupus Scillce Compositus (U. S. P.) .—Compound Syrup of Squill (squill and senega, 
of each 30 grains, tartar emetic % grain in each ounce). Rose, 0lx-f3j. 
Oxymel Scillce.—Oxymel of Squill (equal parts honey and vinegar of squill). Rose, 
01xx-f3ij. 
Pharmacology.—The sliced and dried bulb of Urginea scilla (Lili- 
acese), coming from the Mediterranean. The white squill is the best. It 
readily absorbs moisture and deteriorates; it should be kept in a dry 
place. The active principles are Scillipicrin, Scillitoxin, and Scillin; 894 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
sculein and scillitin are probably impure scillitoxin, which is the most 
active of the three. 
Physiological Action.—In large doses squill is emetic and purgative; 
in smaller quantities, diuretic and expectorant. In excessive quantity it 
gives rise to severe or even fatal gastro-enteritis. Brunton classes scilli- 
toxin among the cardiac tonics, as medicinal doses slow the heart and 
raise the arterial tension, like digitalis. When applied to the skin it is 
absorbed, and produces systemic effects. Elimination takes place by the 
bowels, kidneys, and bronchial mucous membrane. Squill has a bitter 
taste and feeble smell. 
Therapy.—Squill is not used by itself as an emetic, although the 
compound syrup, containing tartrate of antimony and potassium, is 
sometimes used for this purpose in young children suffering with bron- 
chitis or croup; but it is too depressing for ordinary cases. In weak 
heart, associated with dropsy or bronchial disorder, squill is especially 
useful, the vinegar of squill being a good preparation. Its diuretic 
action is enhanced by combination with calomel and digitalis. In 
ordinary catarrhal bronchitis, squill is useful after the first stage has 
passed, and the secretions are becoming more tenacious. As the syrup 
contains acetic acid, it should not be prescribed with carbonate of am- 
monium. In whooping-cough it is very serviceable. It should not be 
given in acute renal disease on account of causing irritation of the 
kidneys. 
SCOPARIUS (U. S. P.).—Broom. 
SCOPARIUS SUMMITATES.—Broom-Tops. 
Dose, 5j, in infusion. 
Pharmacology.—The tops of Sarothamnus scoparius (Leguminosae), 
of Europe, contain Scoparin, which is a crystallizable neutral principle, 
and Sparteine, a volatile liquid alkaloid. There are no officinal prepara- 
tions, but an infusion or decoction is frequently used (5j-Oj),a pint or 
more in divided doses being taken during the dajT. Sparteine sulphate is 
given in doses of gr. to \ hypodermatically, and gr. or more, 
the mouth. 
Physiological Action.—No local action. Internally, broom, in large 
doses, excites vomiting and purging, and in smaller doses causes 
marked increase of urinary flow. It is asserted that scoparine is the 
agent which acts upon the kidneys, and that sparteine acts upon the 
heart as a stimulant or tonic, like scillitoxin or digitalin. Sparteine 
has also a decided effect upon the nerves and spinal cord, lowering reflex 
action, paralyzing motor nerves, reducing the electrical excitability of 
the vagus, and finally causing death by respiratory paralysis, both as the SCUTELLARIA. 
895 
result of its action upon the centre and upon the muscles of respiration. 
The action upon the heart, due both to a nervous and a muscular stimu- 
lation, is manifested soon after its administration ; the pulse becomes 
slower at first, and, in about an hour, arterial tension is raised, and the 
effects last five or six hours. When taken regularly for a few weeks, 
the effects continue for several day-s after the remedy has been stopped. 
According to the experiments of Gluzinski, the effects of sparteine 
are much more marked upon cold-blooded animals than mammals, and 
are more striking in the former when the drug is applied directly to the 
heart than when injected subcutaneously or into a vein.* Clarke found 
no evil results following the administration of gr. every four hours, 
or as much as gr. xij in twenty-four hours, nor was there any evidence 
of cumulative action when it had been given for several months. Spart- 
eine is a true diuretic, increasing both the urea and the water of the urine, 
being more rapid in its action, but weaker than digitalis. 
Therapy.—In renal inadequacy or deficiency of urine, owning to in- 
sufficient arterial tension, scoparius is an excellent remedy; also in the 
oedema, or dropsy,accompanying heart-lesions. This remedy should not 
be given during the progress of inflammation of the lungs, heart, or 
kidneys, but in chronic parenchymatous nephritis broom may be used 
with advantage. In hydrothorax and ascites, the use of broom, in con- 
junction with occasional doses of compound jalap-powder, is very 
successful:— 
Potassii acetatis, 3iss. 
Aceti scillae, f3iv. 
Infus. scoparii, q. s. ad f §viij. 
M. Sig.: Take a tablespoonful every four hours, as a diuretic. 
Sparteine sulphate is used by Germain See, in weak and irregular 
action of the heart, in doses of gr. every four hours. It gives the 
best results in heart-failure, the result of mitral disease. In irregular 
action of the heart this has been found specially" serviceable. In cases of 
valvular disease, with defective compensation, Gluzinski states that small 
doses of the sulphate of sparteine (i to f grain) are more efficacious 
than larger quantities. In exophthalmic goitre (Graves’s disease), it is 
claimed to relieve all the symiptoms; and, given at the onset of a 
paroxysm of asthma (of cardiac origin?), it promptly checks it. Hare f 
considers sparteine sulphate valueless, and a useless drug. 
SCUTELLARIA (U. S. P.).—Skull-Cap. 
Preparation. 
Extraetum Scutellarice Fluidum (U. S. P.).—Fluid Extract of Skull-Cap. Dose, f3ss-j. 
•Wien. Med. Blatter, Dec. 26,1889 ; The Medical Bulletin, March, 1890, p. 91. 
f Practical Therapeutics, Philadelphia, 1890, p. 267. 896 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Pharmacology and Physiological Action.—The herb of Scutellaria 
lateriflora (Labiatse) has a bitter taste, and contains a little volatile oil 
and a bitter principle. The eclectic “ Scutellarin ” is an impure extract, 
probably devoid of medical qualities. It is given in doses of gr. ii-iv. 
The fluid extract is esteemed to possess tonic, antispasmodic, and altera- 
tive powers, but Dr. Lawrence Johnson states that if it possess any 
valuable medicinal properties the fact remains to be demonstrated. 
Therapy.—In various diseases, accompanied by twitching of the 
muscles, restlessness, tremors,—such as chorea, delirium tremens, epi- 
lepsy, etc.,—Scutellaria has been employed, chiefly, however, in domestic 
practice. Its claims for usefulness in hysteria and hydrophobia are not 
well founded. 
SECALE CORNUTUM.—Spurred Rye. (See Ergot, page 603.) 
SEDUM ACRE.—Stonecrop, or Wall-Pepper. 
Dose, 3ss-j. 
Preparation. 
Extractum Sedi Acriii Fluidum.—Fluid Extract of Sedum Acre (made from the 
whole plant). Dose, Hlxv-xxx, gradually increased. 
Pharmacology.—Sedum acre (Crassulaceae), stonecrop or wall- 
pepper, is a small, moss-like, spreading plant, a native of Europe. It 
grows in dry fields and on old walls, with no smell, but has a mucilaginous 
and acrid taste. 
Physiological Action and Therapy.—The juice of the stonecrop is a 
decided local irritant, and is capable of blistering the skin. Taken inter- 
nally, in large doses, it acts as an acrid emetic and purgative. The 
bruised plant, or its juice, has been used with success upon indolent or 
unhealthy sores and enlarged lymphatic glands. The juice has been 
used to remove warts or corns. Dr. Louis Duval, of Madrid, asserts 
that sedum is of signal service in diphtheria, made into a decoction with 
beer. From 1 to 2 litres (If to 3| pints) of this decoction are given in 
hourly doses. When about four doses have been taken, free vomiting 
ensues, with removal of the false membranes. Injection of the decoc- 
tion into the nares is said to be effective in nasal diphtheria. It is 
claimed that this drug possesses the power of loosening the diphtheritic 
membrane, and that it does not form anew. These statements have been 
confirmed by several physicians in other European countries, and by Dr. 
P. 0. Wagener.* The latter writer cannot commend the decoction in 
beer, but obtains the same effects from the remedy used locally, and 
combined as follows :— 
* Therapeutic Gazette, 1885, p. 449. SENEGA. 
897 
01. terebinthinse, 
Acid, lactiei, 
Ext. aconiti fl., ila f 3ij. 
Ext. sedi acris fl., f§j. 
M. This mixture is applied with a brush, every three minutes, for twenty minutes, 
when vomiting occurs and the membrane is expelled. 
SENEGA (U. S. P.).—Senega. 
Dose, gr. x-xx. 
Preparations. 
Abstractum Senega (U. S. P.).—Abstract of Senega. Dose, gr. v-x. 
Extractum Senega Fluidum (U. S. P.).—Fluid Extract of Senega. Dose, n\x-xx. 
Syrnpus Senega (U. S. P.).—Syrup of Senega (fluid extract 160, ammonia-water 4, 
sugar 600, water 1000). Dose, f 3i—ij. 
The compound syrup of squill contains 6 per cent, of senega. 
Pharmacology.—The root of Poly gala senega (Polygalacese) is a 
knobby root-stock, with spreading, tortuous rootlets, twisted and keeled. 
It growrs in the United States, especially in the South. The active prin- 
ciple, which is contained especially in the cortex,is Senegin,or Polygalic 
acid, and is apparently the same as saponin from saponaria, or quil- 
laya-bark. It is a white powder, easily soluble in hot water anti alcohol, 
forming a soapy emulsion when mixed with water, even in small 
quantities. 
Physiological Action.—Senega is irritating to the air-passages and 
causes sneezing when inhaled. The root, when chewed, gives rise to a 
burning sensation. When swallowed in large doses, senega excites sali- 
vation and gastro-intestinal and renal irritation. It is likewise irritant 
when applied to the integument. It is a stimulating expectorant, diuretic, 
and diaphoretic. It does not liquefy the secretions of the bronchial 
tubes, but simply facilitates their expulsion. When the expectoration is 
tough and scanty, senega is of little use. It is usually given in combina- 
tion with other expectorants and diuretics. Senega is excreted by the 
bronchial mucous membrane, skin, and kidneys, exercising upon these 
organs a stimulating action. 
Therapy.— Senega is useful in the second stage of bronchitis, or pneu- 
monia in the stage of resolution. In chronic bronchitis, associated with 
emphysema and occurring in aged people, it will often answer a good 
purpose. By some practitioners it is esteemed beneficial in croup. In 
bronchial asthma with emphysema, this remedy is likewise of considerable 
efficacy. Whooping-cough is sometimes ameliorated by the administra- 
tion of senega. In dropsy, accompanying renal disease, it is useful. In 
palpitation, associated with aortic disease, and also in amenorrhoea, it has 
been found serviceable :— 898 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Ext. 6eneg8e fl., 
Spts. chloroformi, aa f 3j. 
Syr. pruni Virg., . . q. s. ad f§ij. 
M. Sig.: Take a dessertspoonful every two or three hours, for cough. 
Senega is not to be used in heart disease on account of the depress- 
ing effects of its active principle. (See Saponin, page 889.) Senega has 
been administered, in doses of gr. ij, in uterine haemorrhage. A d-ecoction 
of seoega-root, a pint being taken daily for a fortnight before the expected 
period, has been successfully employed in amenorrhoea. In chronic 
rheumatism, its diaphoretic and diuretic effects are useful. 
SENNA (IT. S. P.).—Senna. 
Dose, 3i-iiss. 
Preparations. 
Extractum Sennce Fluidum(XJ. S. P.).—Fluid Extract of Senna (made by percolation). 
Dose, hlxxx-f3iv. 
Syrupus Sennce (U. S. P.).—Syrup of Senna (contains senna, coriander, alcohol, and 
syrup; or, fluid extract, f^j; spirit of coriander, ITlxvj; and simple syrup, f § ij). Dose, f3i-iv. 
Infusum Sennce Uompositum (U. S. P.).—Black Draught (senna, §j; manna, §ij ; Epsom 
salt, §ij; fennel, bruised, gr. cl; water, Oj). Dose, f§i—iiss, every four hours until it 
operates. 
Confectio Sennce (U. S. P.).—Confection of Senna (cassia fistula 16, 6enna 10, cori- 
ander 6, tamarind 10, prune 7, fig 12, sugar 50, water 60, to make 100 parts). Dose, 3i-i.j. 
Pulvis Olycyrrhizce Compositus (U. S. P,).—Compound Liquorice-Powder (senna 18, 
liquorice-root 16, fennel 3, washed sulphur 8, sugar 50 parts). Dose, 3i—ij. 
Extractum Sennce.—Extract of Senna (fluid extract evaporated). Dose, 3i-iv. 
Extractum Sennce Faiidum Deodor ahem (N. F.).—Deodorized Fluid Extract of Senna. 
(The leaves of senna are first washed with alcohol to extract the odorous and griping quali- 
ties of the drug, and are then used to prepare a fluid extract, as in the officinal preparation. 
This form is a pure, deodorized liquid senna of definite strength* and pleasant and certain 
in its effects.) Dose, f'3i-iv. 
Infusum Sennce.—Infusion of Senna (§j-Oj). Dose, f^i-v. 
Also enters into the compound syrup of sarsaparilla. 
Pharmacology.—Senna is the phnrmacopueial title for the leaflets of 
Cassia acutifolia (Alexandria senna) and of Cassia elongata (India 
senna), plants of the natural order Leguminosae, Caesalpiniese, freed 
from stalks, discolored leaves, and other admixtures. The principal con- 
stituent is Cathartic acid, a sulphurated glucoside, which exists in the 
drug in combination witlt earthy bases, such as calcium and magnesium, 
in salts which are soluble in water. Sennacrol and Sennapicrin, found in 
the drug, do not contribute to its physiological action, since they are in- 
soluble in water. Senna also contains chrysophanic acid (Phillips). The 
activity of senna is destroyed by heat. In addition to the princi- 
ples just named, senna contains some odorous and other constituents, 
which impart to it a nauseating taste, but do not add to its therapeutic 
value, since they may be extracted with alcohol without impairing the 
effects. SERPENTARIA. 
899 
Physiological Action.—Senna has a faint, disagreeable smell and a 
bitter, nauseous taste. Senna is an active, but not an acrid, cathartic. 
It generally acts in about four hours, producing copious, yellow stools; 
any tendency to griping nmy be avoided using the deodorized fluid 
extract, or by combining aromatics with the other preparations. It is a 
hepatic stimulant of feeble power, rendering the bile more watery. Its 
use as a cathartic does not produce constipation. The menstrual flow 
may be excited by it, and if given to a nursing woman her milk may ac- 
quire purgative properties. Injected into the veins, it produces both 
vomiting and purging, and in overdoses it acts as a drastic cathartic, 
but is never poisonous in its effects. It is too irritant to the bowel to 
use in full doses where haemorrhoids are present. When taking senna the 
urine sometimes has a red color. 
Therapy.—This drug is a safe, efficient, and, when combined with 
other drugs, a pleasant cathartic for constipation, or where simple un- 
loading of the bowels is required. It should not be given where there is 
danger of abortion, or where inflammatory conditions of the intestine 
exist. It is a favorite laxative for pregnant women in the form of confec- 
tion of senna and compound liquorice-powder, and the syrup is a good 
laxative for children. The infusion is useful to carry off worms from the 
intestinal canal. Black draught is an efficient but decidedly uninviting 
cathartic, and has nearly gone out of use, because its place has been 
taken by more pleasant remedies. Bartholow states that the addition of 
coffee masks the unpleasant taste of senna. The following formula for 
a cheap and efficient laxative is given by Mr. G. H. Dunn : One-half ounce 
of senna-leaves are placed in a quart of water and boiled fifteen minutes in 
a covered dish. The liquid is then strained and ounce of dr}- sugar 
added ; pound each of figs and prunes are cut up, added to the liquid, 
and the whole is boiled until the fruits get thoroughly soft. Dose, one 
teaspoonful after each meal. A better method of making this would be 
to stew the fruit separately, and, after it has cooled, to add \ ounce of 
the deodorized fluid extract, since the active principle, cathartic acid, is 
destroyed by heat. Laxative prunes may be made by adding syrup of 
senna or the fluid extract to the stewed fruit. The confection of senna 
made into a flattened bolus (3i—ij), and coated with sugar or chocolate, 
is sometimes known as fruit laxative, or “ Tamar Indien,” as it contains 
tamarind. They are readily eaten by children. 
SERPENTARIA (U. S. P.).—Serpentaria, Virginia Snake-Root. 
Dose, gr. x-3j. 
Preparations. 
Extraction Serpentarice Fluidum (U. S. P.).—FJd. Ext. of Serpentaria. Dose, Hlx-xxx. 
Tinctura Serpentarice (U. S. P.).—Tincture of Serpentaria (10 per cent.). Dose, f3i-ij. 
The compound tincture of cinchona contains 2 per cent, of serpentaria. 900 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Pharmacology.—The rhizome and rootlets of Aristolochia serpentaria 
and of Aristolochia reticulata (Aristolochiaceae), plants growing in the 
southern and western portions of the United States. The name snake- 
root, of itself, is not distinctive, and should not be used, because by this 
title several different plants are commonly called; for instance, Canada 
snake-root is Asarum Canadense, or wild ginger; black snake-root is 
Actaea racemosa, or cimicifuga; evergreen snake-root is Polygala pau- 
cifolia, or fringed polygala ; while rattlesnake-root, or seneka snake-root, 
is Polygala senega, and Virginia snake-root is Aristolochia serpentaria. 
The latter contains a bitter principle, Aristolochin, soluble in water and 
alcohol; also a volatile oil and some resin. The active principle is not 
used in medicine. All the preparations should be made from the fresh 
root, as it deteriorates by keeping. 
Physiological Action.—Serpentaria is a tonic, a cardiac stimulant, 
and has some antiperiodio powers. It has a pungent, characteristic 
flavor, and small doses promote appetite and digestion, and are slightl}' 
exhilarating. Large doses cause considerable intestinal disturbance, 
flatulence, tenesmus, and frequent evacuations of semi-solid stools ; they 
are also productive of nausea and vomiting, with much headache and 
dizziness. Haemorrhoids are irritated and menstruation is stimulated. 
The drug is expectorant. The compound syrup of sarsaparilla owes its re- 
storative and alterative qualities largely to the presence of serpentaria. 
Although asserted to possess aphrodisiac powers, it is doubtful if serpent- 
aria has an}* direct influence of this kind; probably acting simply as a 
stimulant to the circulation and as a general tonic. 
Therapy.—Though physiologically active, serpentaria is rarely used 
alone. In atonic dyspepsia it is a useful adjunct to cinchona in the 
compound tincture. It is also a good general tonic. Tablespoon fill 
doses of a decoction of serpentaria are often able to allay bilious vomit- 
ing. The infusion is a useful wash for spongy gums, diphtheritic in- 
flammation, or the sore throat of scarlatina. In pneumonia of a low 
type, serpentaria is useful in combination with the aromatic spirit of 
ammonia; and in bronchial catarrh it is a good expectorant. Its com- 
bination of expectorant and stimulant properties renders serpentaria 
useful, also, in capillary bronchitis. It has some reputation as a restora- 
tive in typhoid and typhus fevers, and in depressed conditions of the 
system generally. In chronic rheumatism it may be given in combina- 
tion, with excellent results. In amenorrhoea dependent upon anaemia or 
chlorosis, serpentaria is said to have given good results. 
SESAMI OLEUM (U. S. P.).—Oil of Sesami, Benn<5 or Teel Oil. 
Pharmacology.—A fixed oil, similar to cottonseed-oil, expressed 
from the seed of Sesamum Indicum (Pedaliaceae). It is bland, iuodor- SEVUM. 
901 
ons, or nearly so, neutral in reaction, rich in olein, and is said to keep 
better than olive-oil. In large doses it is laxative, and emmenagogue 
properties have been attributed to it without much foundation. The 
seeds are used as food by the negroes of the South. 
SEVUM (U. S. P.).—Suet. 
Pharmacology and Therapy.—The internal fat of the abdomen of 
Ovis aries (class, Mammalia ; order, Ruminantia), purified by melting and 
straining. If in well-closed vessels, it will keep for ail indefinite time in 
a cool place, without turning rancid, which would spoil it for pharma- 
ceutical purposes. It is a solid fat, with slight taste and very little odor, 
consisting chiefly of stearin. It is used to give greater consistency to 
ointments, and enters into the officinal ointments of mercury and tar. 
For warm weather, a good ointment can be made as follows :— 
Hydrarg. chloridi mitis, gr. xl. 
Sodii benzoatis, . . gr. x. 
Sevi, §j. 
Olei amygdalae amarse, ITlij. 
M. Sig.: For eczema or intertrigo. Apply upon soft linen. 
SILICON.—Silica. 
Preparation. 
Liquor Sodii Silicatis (U. S. P.).—Solution of Silicate of Sodium, or Soluble Glass. 
For external use. 
Pharmacology and Therapy.—Silicon is a non-metallic, elementary 
body, discovered by Berzelius in 1825. Its atomic weight is 28. It is 
obtained in two forms,—amorphous and crystalline. In nature, its com- 
pounds, with fluorine (silicon fluoride) and oxygen (silicic oxide), are 
widely diffused, and are known as fluor-spar and rock-crystal, or quartz, 
and, in a granular form, as sandstone or sand. Chalcedon}7, opal, and 
onyx, prized by the lapidary, are forms of the oxide. Crystallized quartz, 
or rock-crystal, is used for the manufacture of spectacle glasses and 
lenses. Window-glass is a mixture of potassium or sodium silicate 
with calcium silicate, and often contains aluminium silicate also. It is 
made by the prolonged fusion of potassium or sodium carbonate with 
pure quartz-sand and lime. Flint-glass contains lead, introduced in the 
form of red lead. Various colored glasses are made by adding metallic 
oxides to the above ingredients previous to fusion. Hydrofluosilicic 
acid is a saturated aqueous solution of this acid, prepared by passing 
silicon fluoride (which is a colorless, suffocating gas, producing white 
fumes when allowed to escape into the air) through water. It is em- 
ployed as a reagent in the laboratory. 
The Silicate-of-Sodium solution is a clear, almost colorless, viscid 
fluid, odorless, with alkaline taste and reaction, and should not produce 902 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
any irritant effects upon the skin. It dries in a short time, and has a 
smooth, glassy surface. In making dressings for fractures, successive 
layers of bandage are applied smoothly to the limb, rubbing the solution 
into each layer of bandage, until a sufficient thickness is obtained. The 
dressing is then allowed to diy, and a finishing coat is given with the 
brush, making a good, permanent dressing. If desired, when applied to 
a limb, the apparatus may be slit up the back and front, and trimmed 
with scissors, so as to make two lateral molded splints. 
A solution of Silicate of Potassium is used in the same manner 
as the preceding, and, by some, a mixture of these two is considered 
preferable to either alone. It also has antiseptic qualities, and has been 
used as an injection, properly diluted, in gonorrhoea, vaginitis, and 
cystitis; or applied’as a dressing to erysipelas, with asserted good 
results. 
The compound known as the silico-fluoride of sodium has had a 
limited use as an antiseptic. Laplace reports that in the laboratory, as 
well as in the clinic-room, negative results have followed its employment 
as an antiseptic. Flagg, on the other hand, in dental practice, says 
silico-fluoride of sodium is both a disinfectant and antiseptic. It is used 
in the form of a salt or solution (5 to 8 per cent.) in water. It is, he 
adds, noteworthy as possessing the unusual and most desirable charac- 
teristics of being non-irritant, non-poisonous, neither discoloring nor 
staining, of decided rank as disinfectant and deodorizer, odorless, and 
of positively indefinite maintenance of integrity,—the solutions of three 
years’ duration giving clinical evidence of being unchanged. The 
hydrated silicate of magnesium has been utilized in France as a protect- 
ive and absorbent in diarrhoea, in the same way that bismuth is ordi- 
narily used in doses of 5i-*j- Friction with sand has been employed by 
Ellinger as a method of detaching the scales in psoriasis. 
SIMIILO.—Simulo. 
Dose, npxx-f3j, in fluid extract or as a tincture. 
Pharmacology.—An herb of the Caper family, Capparis corriacese 
(Capparidaceae), known as the simulo-plant, has had attention directed 
toward it recently by the investigations of Eulenberg* and others. No 
analysis has yet been made, and it is not known definitely whether or not 
it has any principle with positive therapeutic action. The kernel of the 
fruit, which is almond-shaped, is the portion used. An alcoholic tinc- 
ture of the drug has been employed, but it is less A\al liable than a fluid 
extract, since the alcohol may counteract the sedative influence of the 
remedy. 
Physiological Action.—The physiological effects have not been 
* Therapeutic Gazette, October 15, 1888. SINAPIS ALBA. 
903 
investigated. Under its therapeutic use, Dr. Starr observed no change 
in pulse, respiration, or temperature; no effect upon the pupils, no mus- 
cular weakness, no mental depression or stimulation, and no digestive 
disturbance. It appears to be quite innocuous, even in large doses, 
according to Dr. V. Paulet. 
Therapy.—Simulo is one of the many agents which have been 
brought forward to cure cases of epilepsy, and in other nervous affec- 
tions favorable results from its use have also been reported. Dr. V. 
Paulet found it to have decidedly good effects in hysteria and chorea.* 
Dr. W. II. White used the tincture of simulo in 7 cases of epilepsy, 
giving 1 or 2 drachms three times a day. • In all the patients considerable 
improvement took place, though complete cure was attained in none. 
Eulenberg administered it to 4 cases of epilepsy and 3 of grave hysteria, 
and with benefit in only one of the epileptics. In this instance it 
diminished the number of paroxysms at first, but afterward seemed to 
lose its effect. He considered simulo inferior to the bromides. Dr. M. 
Allen Star finds that it has some effect in modifying the frequency’ and 
severity of attacks of grand mal, but is in this respect inferior to the 
bromides. It is useless in petit mal and in hystero-epilepsy. About the 
only field of usefulness for simulo would appear to be when, for any 
reason, it is deemed necessary to temporarily suspend the use of the 
bromides. Dr. L. C. Gray’, in several cases, found the drug useless.^ 
SINAPIS ALBA (U. S. P.).—White Mustard. 
SINAPIS NIGRA (U. S. P.).—Black Mustard. 
Preparations. 
Chartce Sinapis (U. S. P.).—Mustard-Leaves. 
Oleum Sinapis Volatile (U. S.P.).—Volatile Oil of Mustard. 
Linimentum Sinapis Compositurn (U. S. P.).—Compound Mustard Liniment (volatile 
oil of mustard 3, ext. mezereon 2, camphor 6, castor-oil 15, alcohol q. s. ad 100 parts). For 
external use. 
Pharmacology.—White and black mustard are the seeds of Sinapis 
alba and Sinapis nigra (Cruciferse, Siliquosse), respectively’. They form 
the flour of mustard when ground to a fine powder; commercial flour of 
mustard is a mixture of both kinds of seeds ground together. The pun- 
gency’ of the moist powder is due to the volatile oil of mustard, which does 
not exist in the whole seeds. The black and white varieties each contain 
a crystalline substance,—in the former Sinigrin, in the latter Sinalbin,— 
together with an albuminous ferment, Myrosin. When water is added, 
both sinigrin and sinalbin are split up by the myrosin and produce a 
* American Journal of Insanity, July, 1890. 
f Therapeutic Gazette, June 15,1889, p. 396. 904 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
volatile oil which is not quite identical in the two mustards, that from 
the black mustard being the more pungent. (This is known as the 
sulphocyanate of allyl, while the other is the sulphocyanate of aerinyl.) 
The action of myrosin is suspended at 60° C. (140° F.) ; so that mustard 
poultice should not be made with boiling water. White mustard, even 
when ground and mixed with water, is inodorous, but when added to the 
black variety it increases the jdeld of volatile oil. Both kinds also con- 
tain fixed oil; as well as Sinapine (an alkaloid), brassic acid, and other 
vegetable principles. 
Physiological Action.—When applied to the skin, if moisture is 
present, mustard-flour causes hypersemia, and, if the action is continued, 
it will vesicate, making a painful and slow-healing blister. The seeds 
of white mustard have been used as a condiment and mechanical laxative, 
in tablespoonful doses after meals. Table-mustard is made by adding 
water to mustard-flour; it may also contain spices or vinegar. 
Therapy.—Mustard-leaves (4 inches square) are very convenient 
for applying counter-irritation, being always ready for use and only 
needing dampening with cold water, in pleurodynia, lumbago, colic, 
croup, and numerous other conditions requiring this treatment; applied 
to the calves of the legs, as well as other parts of the body. They should 
remain ordinarily about four or five minutes, but may remain longer; 
they should not be left on all night, for fear of making a slough which 
wrould leave a scar. Mustard poultices to the feet and legs are emploj'ed 
as derivatives in apoplex}r and intoxication from alcohol or opium. In 
weak digestion, a little mustard, as a condiment with meats, assists di- 
gestion and stimulates the secretion of gastric and intestinal fluids. 
Mustard foot-baths, made by adding a handful of ground mustard to 
hot water, is a good revulsant in recent colds, sleeplessness, amenorrlioea, 
headache, etc. Mustard-water is a useful emetic in nai’cotic poisoning. 
A hot mustard-bath is an efficient aid to other treatment in allaying 
maniacal excitement. It is of value, moreover, in cases of recession of 
the eruption in scarlet fever and measles. 
In medicinal preparations, mustard is occasionally administered 
with advantage as an internal remedy. Obstinate hiccough has been 
relieved by an infusion made by steeping a teaspoonful of mustard in 4 
ounces of boiling water for twenty minutes and then straining (Ringer). 
An alcoholic solution of the oil of mustard has been found of efficiency 
in chronic gastric and bronchial catarrh. The solution contains 24 drops 
of the oil to the ounce of spirit, and is given in doses of 3 to 5 drops 
in an emulsion. The same preparation is said to have been of service as 
a diuretic in dropsy. A mustard-wliey, made by boiling \ ounce of 
mustard-flour in a pint of milk, has also been utilized in dropsy. SODIUM. 
905 
SODIUM. —The metallic element, Sodium (Natrium). Not used in 
medicine, except in combination. 
Preparations. 
Soda (U. S. P.).—Soda, Caustic Soda. 
Sodii Aceias (U. S. P.).—Acetate of Sodium. Dose, gr. xv-3j. 
Sodii Arsenias (U. S. P.).—Arseniate of Sodium. Dose, gr. 
Sodii Benzoas (U. S. P.).—Benzoate of Sodium. Dose, gr. x-xx. 
Sodii Boj'as (U. S. P.).—Borate of Sodium, Borax. Dose, gr. x-xl. 
Sodii Bromidum (U. S. P.).—Bromide of Sodium. Dose, gr. xx-3j. 
Sodii Carbcmas (U. S. P.).—Carbonate of Sodium (washing-soda). Dose, gr. y-xx. 
Sodii Carbonas Exsiccatus (U. S. P.).—Dried Carbonate of Sodium. Dose, gr. v-x. 
Sodii Bicarbonas (U. S. P.).—Bicarbonate of Sodium (baking-soda). Dose, gr. v-xl. 
Sodii Bicarbonas Venalis (U. S. P.).—Commercial Bicarbonate of Sodium.* 
Sodii CMoridum (U. S. P.).—Chloride of Sodium (table-salt). Dose, gr. v-xl. 
Sodii Chloras (U. S. P.).—Chlorate of Sodium. Dose, gr. ii-x. 
Sodii Ilypophosphis (U. S. P.).—Hypophospliite of Sodium.f Dose, gr. x-xx. 
Sodii Hyposulphis (U. S. P.).—Hyposulphite of Sodium. Dose, gr. x-xx. 
Sodii Iodidum (U. S. P.).—Iodide of Sodium. Dose, gr. x-xl. 
Sodii Extras (U. S. P.).—Nitrate of Sodium (saltpetre). Dose, 3i-ij. 
Sodii Phosphas (U. S. P.).—Phosphate of Sodium. Dose, gr. v-§ j. 
Sodii Pyrophosphas (U. S.P.).—Pyrophosphate of Sodium. Dose, gr. v-xl. 
Sodii Sulphas (U. S. P.).—Sulphate of Sodium (Glauber’s salt). Dose, §ss-j. 
Sodii Sulphis (U. S. P.).—Sulphite of Sodium. Dose, gr. xx-3j. 
Sodii Bisulphis (U. S. P.).—Bisulphite of Sodium. Dose, gr. x-3ss. 
Sodii Salicylas (U. S. P.).—Salicylate of Sodium. Dose, gr. x-3j. 
Sodii Santoninas (U. S. P.).—Santoninate of Sodium. Dose, gr. ii-x. 
Sodii et Potassii Tartras (U. S. P.).—Tartrate of Sodium and Potassium (Rochelle 
salt). Dose, 3i-iv. 
Sodii Stdphocarbolas (U. S. P.).—Sulphocarbolate of Sodium. Dose, gr. ii-v. 
Liquor Soda? (U. S. P.).—Solution of Soda (5 per cent.). Dose, Iflv-x. 
Liquor Sodce Chloratis (U. S. P.).—Solution of Chlorinated Soda (Labarraque’s solu- 
tion). Should contain at least 2 per cent, of available chlorine. Dose, f3ss-j. 
Liquor Sodii Arseniatis (U. S. P.).—Solution of Arseniate of Sodium (1 per cent.). 
Dose, hliii-v. 
Liquor Sodii SUicatis (U. S. P.).—Solution of Silicate of Sodium (specific gravity, 
1300-1400). 
Mistura Rhei et Sodce (U. S. P.).—Mixture of Rhubarb and Soda (bicarbonate of 
sodium 30, fluid extract of rhubarb 30, spirit of peppermint 30, water q. s. ad 1000 parts). 
Dose, f 3ij-gj. 
Pulvis Effervescens Compositus (U. S. P.).—Compound Effervescing Powder, or Seidlitz 
Powder. Dose, one powder. 
Trochisci Soclii Bicarbonatis (U. S. P.).—Troches of Bicarbonate of Sodium. Each, 
gr. iij. Dose, one or more troches. 
Trochisci Sodii Santoninatis (U. S. P.).—Troches of Santoninate of Sodium. Each, gr. ij. 
Dose, one to five troches. 
Sodii Kilns.—Nitrite of Sodium. Dose, gr. iii-xx. 
Sodii Ethylas.—Ethylate of Sodium. For external use. 
Pasta Londoniensis.—London Paste is prepared by rubbing together equal parts of 
caustic soda and unslaked lime. For external use. 
* The commercial bicarbonate is used only for pharmaceutical purposes, 
t Enters into the syrup of the hypophosphites (see p. 807). 906 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Pharmscology.—The metal sodium, a monatomic, metallic element, 
Natrium (Na. = 23), was discovered by Sir Humphry Davy, in 1807, 
the same year that he succeeded in isolating the metal potassium, 
which, in many respects, it resembles. It is found only in the laboratory 
and in the arts, not being used in its own form in medicine. Many of its 
salts are officinal; they are generally white or colorless, soluble in water, 
and less irritant than the corresponding potassium salts. They tinge the 
light yellow, in the spectroscope, dr when a small portion, on a piece of 
platinum wire, is held over burning alcohol. The chloride of sodium 
occurs native in sea-water and in salt-mines, and is found in all the lluids 
and solids of the human body. The urate of sodium is not soluble in 
water, and, therefore, when uric acid is formed in excess, deposits of 
urate of sodium are apt to occur in various portions of the body. The 
potassium and lithium salts with the uric acid, on the contrary, are 
soluble in water, and assist in carrying off from the system the less 
soluble uric acid. In gouty patients, therefore, soda-salts should be only 
cautiously given. 
Physiological Action.—Soda, when locally applied, in concentrated 
form, to muscle or nerve, is a paralyzing agent, but to a decidedly smaller 
extent than potassa. Caustic soda in its action resembles caustic 
potash, but has less tendency to spread. Solutions of the chloride are 
antiseptic, and table-salt, as an article of food, plays a very important part 
in digestion and in tissue change. Weak solutions of salt (5 to 6.5 parts 
per 1000), if injected into the veins, do not affect the integrity of the red 
blood-corpuscles. The carbonate may be used in the same manner, to 
replace a quantity of blood lost by haemorrhage, or in the collapse of 
cholera. Applied to the skin, solutions of the bicarbonate are cleansing 
and non-irritant; and, in cases of burns or scalds, insect-bites, or ivy 
poisoning, a saturated solution rapidly relieves pain. Borax is also anti- 
septic and unirritating to the skin. The hyposulphite is antiseptic by 
virtue of the sulphuric acid which it contains. The ethylate of sodium 
is also an antiseptic, and decidedly caustic. Liquor sodoe is a valuable 
antacid, without affecting nutrition as much as potassa does, and it is 
less poisonous to the heart and nerves. The acetate, being the salt of an 
organic acid, becomes converted into the carbonate in the blood; it is 
diuretic, although to a less extent than the potassium acetate. Carbonate 
of sodium is used in pharmacy in preparing other salts; as it is a good 
alkali for combining with grease or fat, it is found in every household as 
“ washing-soda.” The bicarbonate is used as an antacid when there is an 
excess of acid in the stomach ; given when the stomach is empty, it 
stimulates the secretion of gastric juice; it also increases the alkalinity 
of the blood, reduces the acidity of the urine, and relieves irritability SODIUM. 
907 
of the bladder. The chloride is a very convenient emetic, especially 
combined with mustard-water. Haemorrhages are sometimes checked by 
it through reflex influence. The nitrate is refrigerant in fever, and in- 
creases the secretions of the intestinal tract. The nitrite acts like the 
other nitrites, in depressing the heart’s action and reducing blood-press- 
ure. The sulphate is a bad-tasting and harsh cathartic; it is a common 
constituent in purgative mineral waters, where its effects are enhanced 
and modified by natural combination. 
In recent experiments undertaken to determine the influence of 
alkalies on the excretion of uric acid, made by Dr. Spilker, under the 
direction of Prof. Salkowski, it was found that the addition of alkalies 
to the diet diminishes the excretion of uric acid, or, rather, its formation 
in the human subject, while in the dog the reverse was the case.* This 
should teach us to accept, with some reserve, the deductions from physio- 
logical experiment in the laboratory, with regard to the action of medi- 
cine upon the lower animals, especially where they conflict with clinical 
teaching and the results of experience. 
Therapy.—Soda, which is a corrosive poison in concentrated form, 
the symptoms and treatment being the same as for poisoning bjT the cor- 
responding potassium salts, may be used locally as a substitute for caustic 
potash, being more manageable and less severe. A combination of equal 
parts of soda and lime, known as London paste, is a favorite caustic ap- 
plication, especially for the removal of morbid growths, by some prac- 
titioners. Gfarretson employs London paste as follows for the removal 
of tonsil-glands, as well as for the destruction of certain warts :— 
“ To apply this agent, the practitioner uses enough water to con- 
vert the powder into a thick paste, which he directs against the 
body to be removed by means of the cup found upon the handle of a 
director. Each application secures a certain extent of slough. Five or 
six repetitions are necessary. London paste worked into the interstices 
of seed-warts allows of their being brushed off in a couple of minutes. 
Return is uncommon.” The ethylate of sodium is one of the most pow- 
erful caustic preparations that can be used. It combines with water of 
the tissues, and continues to act deeply in abstracting this element. It 
is serviceable in destroying warts and various morbid growths, but is 
liable to leave the skin scarred on account of its destructive action 
upon the tissues. The writer has employed ethylate of sodium with 
great benefit in lupus erythematosus and vulgaris; likewise in callous 
ulcers, epithelioma, and in thickened and ulcerated spots of syphilis. 
If the ethylate of sodium is used for the removal of excessive growth of 
hair, especially upon the face (polytrichia), as has been recommended by 
* Therapeutic Gazette, October 15, p. 706,1890, 908 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Jameson, the physician may expect, from the observations made by the 
author, more or less scarring of the skin on account of the destructive 
action of this caustic upon the true skin and deeper structures. Sodium 
bicarbonate, in powder or solution, is applied to burned or scalded sur- 
faces, and quickly relieves pain. It can also be used to subdue inflam- 
mation in sun-burn, rlius poisoning, pruritus, eczema, insect-bites, etc. 
Borax acts very similarly, but is more antiseptic on account of contain- 
ing boric acid. Both of the foregoing are also employed in solutions for 
washing out the bladder in cystitis, for injecting into the auditory canal 
to remove cerumen from the ear, and for intra-venous injection in collapse 
from cholera, etc. The following combinations containing one of the 
sodium preparations will be found serviceable :— 
$ Sodii bicarbonatis, §ss. 
Aquae camphorae, 
Aquae menth. pip., aa f§iv. 
M. Sig.: For itching and burning of the mucous membrane and skin in the various 
eruptions upon the integument. 
Liq. sodae chloratae, f3j vel 3iij. 
Tinct. kino, f^ij- 
Aquae, f§iij. 
M. A disinfectant gargle for ulceration of the throat. 
Sodii benzoat., gr. xx. 
Creasoti, Nlv. 
Glycerini, 
Aquae rosae, aa f^ss. 
M. Employ with an atomizer in nasal catarrh, pharyngitis, and in laryngitis. 
Sodii bicarbonatis, 3iij. 
Glycerini, 
Aquae hamamelidis dest., aa f^iij. 
M. To allay itching and burning of the skin, especially in eczema, lichen, urticaria, 
dermatitis, burns, and frost-bite. 
In acute tonsillitis, sodium salicylate may be rubbed upon the tonsils 
with the finger, with excellent results. In this affection a solution of 
the bicarbonate has been beneficial, applied upon a brush or mop, or used 
as a gargle. For catarrhal conditions, chronic bronchitis, etc., a solu- 
tion of this salt may be used with the steam-atomizer, with liamamelis, 
belladonna, or other combinations if desired. The chlorate of sodium is 
recommended by Prof. Traill Green, of Easton, to be used in place of 
chlorate of potassium in acute affections of the throat or fauces. A 
2-grain lozenge made with tragacanth is just as efficient, locall}', as the 
officinal potash-lozenge, and will not cause depression of the heart like 
potash. In children suffering with oxyuris vermicularis, or seatworm, 
injections of chloride of sodium solution will bring away the parasites SODIUM, 
909 
and relieve the itching. The snlphocarbolate is useful as a disinfectant, 
being less irritant and not caustic ; but for internal use the salicylate is 
safer. The bicarbonate of sodium is used as an antacid in gastritis and 
sour stomach, and affords temporary relief, especially in combination 
with mint or rhubarb. The bicarbonate, with rhubarb, is especially use- 
ful in cases of catarrhal jaundice. The bicarbonate of sodium is of 
benefit when the urine is acid, and in all forms of cystic irritation, and is 
especiallj' useful in renal calculi, cystitis, gonorrhoea, gleet, stricture, and 
in enlarged prostate. The following prescriptions, containing the bicar- 
bonate of sodium, are recommended :— 
Sodii bicarbonatis, 3iiiss. 
Tinct. zingiberis, 
Tinct. capsici, aa f3j. 
Tinct. nucis vomicae, Nice. 
Tinct. gent, comp., q. s. ad f§v. 
M. Sig.: Two teaspoonfuls in water, three times a day, in acid dyspepsia. 
$ Sodii bicarbonatis, • 3iiss. 
Glycerini, 
Aquae menth. pip., aa fgij. 
M. Sig.: Two teaspoonfuls after meals, in acid dyspepsia. 
Sodii bicarbonatis, . . . . 3j. 
Pulv. ipecacuanhae et opii, gr. xl. 
M. et ft. chartae no. xx. 
Sig.: A powder every two or three hours, for cystitis or irritable bladder or prostate. 
Sodii bicarbonatis, gr. xl. 
Hydrargyri chloridi mitis, gr. ij. 
M. et ft. chartae no. xij. 
Sig.: A powder every two or three hours, for acute gastritis. 
When used as an antidote to acids in corrosive poisoning, the car- 
bonate is better than the bicarbonate, on account of there being less 
carbon dioxide formed. The hyposulphite is a useful antiseptic in sarci* 
nous vomiting and infectious dyspepsia. Sodium phosphate, on account 
of its cholagogue effects, is useful in cases of inaction of the liver in 
children who pass clay-colored stools. 
The sodium acetate is not as deliquescent as potassium acetate, and 
has this advantage over the latter salt. It has been given with benefit as 
an antacid in acute rheumatism, and as a diuretic in dropsies. Sodium 
acetate is likewise serviceable in gout, and in the treatment of irritation 
of the genito-urinary apparatus. The appended prescription is sug- 
gested :— 
Sodii acetatis, 3iij. 
Syr. aurantii, f §iij. 
Spiritus setheris nitrosi, f§ij. 
M. Sig : Two teaspooufuls iu water, every two or three hours, for rheumatism, gout, 
or genital irritation. 910 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Sodium benzoate is a safe and effective antipyretic. It lias been 
employed for its antiseptic virtues in phthisis, diphtheria, the eruptive 
fevers, and in irritation of the genital organs. The following combina- 
tion of sodium benzoate is recommended :— 
Sodii benzoatis, 3iij. 
Ext. tritici repentis fl., 
Ext. buchu fi., aa f^iiss. 
M. Sig.: A teaspoonful or two, every two or three hours, for cystitis, or lor an irrita- 
ble bladder and prostate. 
The pulvis effervescens compositus (U. S. P.), or Seidlitz powder, is a 
mixture taken while effervescing,containing 40 grains sodium bicarbonate 
and 2 drachms of Rochelle salt (blue paper) and 35 grains of tartaric acid 
(in a white paper).* The contents of each paper are dissolved in a wine- 
glassful or more of water, and drunk while effervescing,.to relieve simple 
constipation. In obstinate vomiting, small doses of Seidlitz powder are 
often efficient in overcoming the nausea and retching. A teaspoon ful of 
chloride of sodium, dissolved in a tumblerful of water and taken before 
breakfast, will often answer the same purpose as some mineral waters. 
The salicylate of sodium is used very largely in the treatment of 
acute rheumatism, and rheumatic throat inflammation, pyrexia of influ- 
enza, etc. In acute rheumatism, about 2 drachms a dajT, in divided 
doses, relieve pain and fever and make the patient more comfortable. 
(See page 387.) Sodium salicylate, mixed with theobromine, has such 
diuretic effects that it has been called diuretin, of which the dose is 
a drachm, or a drachm and a half, daily, in divided doses. (See Theo- 
broma.) Good resuits may be obtained in fevers, by using the fluid 
extract of erythroxylon coca to sustain the heart’s action and support 
strength, at the same time that the salicylate of sodium is used to keep 
down temperature. The nitrate of sodium, in doses of 3 or 4 grains, is 
recommended by Pearce as serviceable in asthma. 
SOLANUM PANICULATUM.—Jerubeba. 
Preparation. 
Extradum Solant Paniculati Fluidum.—Fluid Extract of Solanum Paniculatum (from 
the root). Pose, Hlv-xxx. 
Pharmacology.—Solanum paniculatum (Solanaceae), or jerubeba, is a 
common, shrubby plant, which grows in the wild country of the North 
of Brazil. It has a woody stem, and reaches a height of 8 or 10 feet. 
The stem, branches, and under side of the leaves are almost covered by a 
white, downy hair. An alkaloid, termed Jerubebin, has been found in the 
fruit and the root. 
♦These may also be put up without Rochelle salt, and were formerly officinal in this shape 
as soda-powders, orPulveres Edervescentes (Ph., 1870). SOLIDAGO. 
911 
Physiological Action and Therapy.—The effects of jerubeba upon 
frogs and guinea-pigs have been investigated by Duprat. Torpidity 
soon came on after hypodermatic injection of a hydro-alcoliolic extract, 
and reflex movements disappeared. Respiration was retarded, and the 
action of the heart slow and irregular. Jerubeba is an excellent laxative, 
and is said to be valuable in the treatment of habitual constipation. The 
drug is held in great esteem in Brazil, where it is considered tonic and 
alterative. 
SOLIDAGO.—Solidago, Golden Rod. 
Dose, gr. xxx-3ij. 
Pharmacology.—The Solidago odora (Composite), or fragrant golden 
rod, is a conspicuous feature of autumn landscapes in the northern 
United States. It has many varieties, but the usual form bears a terminal 
spike, or one-sided raceme, of yellow flowers. The plant is yellowish 
green, fragrant, and yields, by distillation, a volatile oil, resembling anise 
in odor. The fluid extract, made with dilute alcohol as a menstruum, is 
often used as a flavoring excipient. A solid extract may be obtained by 
evaporating the fluid extract to the proper consistence and incorporating 
with it one-twentieth of its weight of glycerin. 
Physiological Action.—Golden rod is carminative and gently stimu- 
lant. The hot infusion produces diaphoresis and relieves the pains of 
dysmenorrhoea. 
Therapy.—This drug is scarcely used by the profession, but pos- 
sesses some, though not very decided, medicinal value. The decoction 
and warm infusion are used in domestic practice to produce diaphoresis, 
to relieve colic, and to promote menstruation. The oil may be used for 
similar purposes, and also as a carminative to relieve flatulence, etc. 
SOMNAL.—Ethylated Chloral-Urethan. 
Dose, T^xx-f3ss. 
Pharmacology.—In 1889, Dr. S. Radlauer, of Berlin, brought to the 
notice of the profession a compound of chloral, urethan, and alcohol, 
which he considered a definite compound and not a simple mixture of 
these substances. It is a colorless liquid, resembling chloroform in 
appearance ; very slightly, if at all, soluble in cold water, but soluble in 
hot water and in alcoholic solutions. The odor is faint, resembling- 
spirit of nitrous ether; the taste is very pungent. For administration 
it requires free dilution, and can be given with simple elixir, whisky, or 
syrup of liquorice.* 
Physiological Action.—Dr. W. Gilman Thompson,f from a series of 
* “ Somnal: a New Hypnotic,” by Frank Woodbury, M.D., Dietetic Gazette, July, 1890. 
f New York Medical journal, November 29, 1890. 912 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
experiments, both physiological and clinical, concluded that “the effects 
of somnal are much more striking and certain than those of urethan, 
and far less depressing than those of chloral. There is no vertigo or 
depression after taking somnal, such as may follow the use of sulphonal. 
The action of somnal is usually very prompt, and doses of drachm, dis- 
guised in a little syrup of tolu or whisky, are always well borne, easily 
taken, and entirely without deleterious effect. The drug, in doses of a 
drachm, is not powerful enough to decidedly control delirium tremens, 
maniacal delirium, or severe pain. In doses of 30 or 40 minims somnal 
is a safe and reliable hypnotic for ordinary insomnia.” The blood- 
pressure is increased under somnal instead of being depressed, as it is 
after taking chloral. It does not disturb digestion, and does not affect 
the pulse or temperature. An adverse opinion regarding this substance 
has been published* by Dr. Langgaard, who maintains that its narcotic 
effect is less than that of chloral, appears later, and is of shorter dura- 
tion. Langgaard affirms that respiration and circulation are affected in 
the same manner, and, at least, as energetically as b}r chloral hydrate. 
The blood-pressure sinks, in rabbits, to 40 millimetres (15f inches) of 
mercury, or even lower, after doses that only produce two hours’ light 
sleep. 
Therapy.—Somnal, as generally observed b}r all who have used it, is 
a valuable hypnotic for cases of simple insomnia and sleeplessness after 
acute diseases, delirium tremens, parturition, etc. It should not be used 
in chronic interstitial nephritis and endarteritis with abnormally high 
tension, as it would increase the latter condition. Pain or cough is not 
much affected, though soothed by the sleep produced. Out of 54 various 
cases coming under Dr. Thompson’s care, it produced sleep in about 50 
per cent, within fifteen minutes, and in 43 cases out of 54 within an hour. 
In 6 cases onty did it fail to produce sleep, and in some of these it had 
a quieting and soothing effect. In an obstinate case of insomnia in a 
business man, Dr. Geo. H. Pierce administered 40 drops of somnal at a 
dose, in milk, and the patient slept for fourteen hours and wakened re- 
freshed; previously he had run the gamut of the usual hypnotic remedies 
without benefit. The continuance of somnal for a short time entirely 
cured him and overcame a habit which had been formed for years. 
Owing to its comparative innocuousness it may be used in combination 
with syrup of tolu for fretful infants during dentition. 
SOZOIODOL.—Di-iodo-phenol-sulphuric Acid. 
Pharmacology.—From phenol is derived, by combination with iodine 
and sulphuric acid, the remarkable substance, sozoiodol, which was first 
* Suddeutsche Apotheker-Zeitung, November 21,1889; Medical Bulletin, February, 1890. 
p. 56. SOZOIODOL. 
913 
discovered by one of our own countrymen in San Francisco; but it was 
not until its manufacture was conducted upon a larger scale in Europe 
that it could be obtained sufficiently pure for medicinal use. The com- 
ponents of this remedy would indicate its value; it contains 55 per cent, 
of iodine, 20 per cent, of phenol, and 7 per cent, of sulphur. It forms 
salts with alkalies and with metals; those most used are potassium, 
sodium, mercury, and zinc. As manufactured in this country b}r the 
Mallinckrodt Chemical Company, of St. Louis and New York, in a pure 
form, the salts are generally perfectly white, odorless, and vary in 
solubility, the mercury salt being the least soluble. The potassium salt, 
with 2 parts of talc or other inert vehicle, may be used as a substitute 
for iodoform, being free from all the objectionable features of the latter 
drug. 
Physiological Action.—The sozoiodolates of sodium and potassium 
are non-irritating, and may be used in full strength as antiseptics and 
slight astringents. The mercurial and zinc salts are more active, and are 
used in solution (10 to 20 per cent.) for the same purposes. In solu- 
tions ranging in strength from to 2 percent., sozoiodol and its com- 
binations are destructive to the micro-organisms of suppuration. So- 
diuin-sozoiodol has been given to rabbits in doses of 1 gramme (15£ 
grains) without producing any toxic effect. Sozoiodol is not decom- 
posed within the body, but passes through the organism unchanged. 
According to Buflalini, the quantity of urea eliminated after the inges- 
tion of sozoiodol is materially diminished, though the quantity of urine 
is increased. 
Therapy.—As a topical application in uterine catarrh or ectropion, 
Nitschmann praises the soda salt, which is to be blown directly on the 
cervix and a dry tampon placed over it. He also uses a 5- to 7- per-cent, 
solution in rhinitis hypertrophica, ozaena, acute coryza, and in inflamma- 
tions of mucous membranes generall}T, applied in a douche or by means 
of a camel-hair brush. 
A 5-per cent, sodium sozoiodol solution has proved to be useful as 
a collyrium in acute purulent conjunctivitis and in ophthalmia neona- 
torum. The combination with zinc is commended in chronic inflamma- 
tion of the ear and upper air-passages. Dr. Seifert, of Wurzburg, has 
obtained satisfactory results in tuberculous ulcers of the larynx from 
insufflation of sodium sozoiodol diluted with an equal bulk of some 
innocuous powder, such as sugar of milk. The sozoiodol combinations 
have been applied with success, it is said, to unhealthy wounds and 
ulcers, parasitic skin diseases, eczema, impetigo, burns, dermatitis, and 
cracked nipples. An interesting observation was made by C. Schwarz, 
who gave 2 grammes (31 grains) daily of sodium sozoiodol to a diabetic 914 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
patient without any restrictions as to diet. The symptoms at once 
improved, the urine and sugar diminished, and in two months not a 
trace of sugar could be found,* Buffalini tried the drug in phthisis (1G 
grains daily) without results. 
The soda salt has been recommended as a substitute for carbolic 
acid or creasote in cases of infectious dyspepsia, and may be adminis- 
tered in daily doses of 1 to 3 grammes to grains). In the same 
dose lithium sozoiodol has seemed to be beneficial in several cases of 
articular rheumatism. 
For insufflation in ozrena, rhinitis, and rhino-pharyngitis, the zinc 
and mercury compounds ma\r be used, diluted with considerable excess 
of milk-sugar; the sodium and potassium salts may be employed pure or 
diluted to 3- or 10- per-cent, solutions. If a prolonged action is desired, 
the potassium salt is used, either alone (10 per cent.) or mixed with talc 
or sugar. In urethritis or vaginitis, the zinc sozoiodol, in 2-per-cent, 
solution, answers well as an injection, used several times a day. 
SPARTEINE. See Scoparius, page 894. 
SPECIES are mixtures of various comminuted vegetable drugs pre- 
pared for making extemporaneous infusions or decoctions, either by the 
dispensing pharmacist or the purchaser. Some are cathartic in their 
action, others diaphoretic and expectorant. They are often sold as “ teas,” 
on account of the manner of preparation. 
SPERMINI HYDROCHLORAS.—Spermine Hydrochlorate or Muriate. 
Dose, gr. £ to j, hypodermatically. 
Pharmacology.—Spermine, according to Dr. G. Archie Stockwell, 
of Detroit (from whose excellent papers, in the Therapeutic Gazette, on 
Brown-Sequard’s discovery, the following extracts are taken), is the true 
factor in inducing the physiological phenomena chronicled by M. Brown- 
Sequard, in his communication to the French Academy which created so 
much stir two years ago. It is obtained from the testicular juice of the 
lower animals by a carefully-conducted process, which protects the 
product from contamination by infectious micro-organisms and isolates 
it, chemically pure, as a salt of hydrochloric acid. 
Physiological Action.—From experiments upon rabbits, Dr. Stock- 
well declares that it invariably produced powerful and prolonged stimu- 
lation of the sympathetic nervous system, most strongly manifested 
through the spermatic plexus. It stimulates the vasomotor centre, 
increases blood-pressure, and aids oxidation. In toxic doses it induces 
distressing tetanic spasm and interferes with respiration 1)3T spasmodic 
* Annual of the Universal Medical Sciences, 1890, vol. v, p. A-124. SPIGELIA. 
915 
fixation of muscles, including the diaphragm. Cutaneous ht’pertesthesia 
and increased muscular activity were observed. Sexual erethism was 
marked in many instances. 
Therapy.—The hypodermatic injection of an extract from the recent 
testicles of mammals was found by Brown-Sequard* to have a stimulating 
effect upon nutrition, and to be especially active as a restorative in failing 
nutrition due to old age. Dr. H. P. Loomis, of New York, found that 
the injections “as claimed, produce nutritive modifications in the 
tissues of elderly men, due, probably, to stimulation of the nerve- 
centres.” In tuberculosis this substance has also been recommended.f 
The injections were followed by relief in cases of insomnia, hypochondria, 
feeble heart, cardiac asthma, and spinal ’irritation, as reported by Dr. H. 
C. Brainerd, of Cleveland. Dr. Stockwell believes the subject deserves 
further investigation.| 
SPIGELIA (U. S. P.).—Spigelia, Pink-Root. 
Dose, 5i-ij, for an adult; gr. x-xv, for a child of 3 years. 
Prepay'at ion. 
Extractum Spigelice Fluidum (U. S. P.).—Fluid Extract of Spigelia. Dose, f3i-ij. 
Pharmacology.—Spigelia is named in honor of Adrien Spigelius, an 
Italian botanist of the seventeenth century. Medicinally it is the rhizome 
and rootlets of Spigelia mainlandica (Loganiaceae), growing in thickets 
from Pennsylvania to Illinois and southward. It has a scarpoid spike, 
with funnel-shaped, sessile flowers, crimson externally and orange within, 
which appear in June. The roots contain a bitter principle, volatile oil, 
resin, etc., but which is the true active agent is not known. 
Physiological Action.—Spigelia is a popular anthelmintic against 
round worms. It has some cathartic action, but this is uncertain, and it 
is therefore usually administered with senna. When it does not produce 
purgation promptly, some sjunptoms of cerebral disorder, as vertigo, 
dimness of vision, strabismus, dilated pupils, even convulsions may 
appear. Therefore it is best to administer a dose of a saline, like mag- 
nesium sulphate, about two hours after taking spigelia. 
Therapy.—This remedy ranks among the best of our agents for the 
destruction of lumbricoid worms. Professor Stille advises the follow- 
ing formula :— 
* See paper by the author on “ The Case of Dr. Brown-Sequard,” The Times and Register, 
November 30, 1889. 
f See lecture by Dr. D. ITspenski, on “ Brown-Sequard Fluid in Tuberculosis,” in Deutsche 
Medizinal Zeitung, December 29, 1890. 
J “Historical, Critical, and Scientific Aspects of Brown-Sequard's Discovery—the So- 
called Elixir,” The Therapeutic Gazette, vol. v, p. 819; vol. vi, p. 14. 916 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Spigelise, §ss. 
Semiie, oij. 
Sem. faeniculi, 3ij. 
Manuae, §j. 
Aquae bullientis, U„. 
M. et ft. infusum. 
Sig.: Dose for a child, one or two tablespoonfuls; for an adult, a wineglassful or two. 
The combined extracts of spigelia and senna (5 to 3), with aromatics, 
were formerly officinal, the dose being 1 or 2 fluidrachms. In this 
combination the narcotic effects are obviated. An objection to this 
remedy is its color, which stains the child’s clothing if it should vomit 
or have loose passages. 
The Spigelia anthelmia, in structural characteristics, resembles 
spigelia, but has insignificant, greenish-red flowers ; the root is short and 
divided into long rootlets. It is an annual and a native of South 
America and the West Indies. Its constituents are unknown. 
Full doses cause vomiting, diarrhoea, giddiness, stupor, dilated 
pupils, tremors, muscular contractions, convulsions, dyspnoea, and 
death. It is an acrid, narcotic poison. It has been emplo3Ted as a 
vermifuge ; and also in rheumatic affections of the heart and pericardium, 
and of the eye. In palpitation of the heart accompanying valvular 
disease, it has been used with asserted success in 10-minim doses of a 
tincture (12 per cent.). 
SPIRITUS FRUMENTI and VINI GALLICI. See Alcohol, page 413. 
STAPHISAGRIA (U. S. P.).—Stavesacre. 
Dose, gr. i-iij. 
Pharmacology.—The seeds of Delphinium stapliisagria (Ranuncula- 
cere), growing along the Mediterranean, contain several alkaloids, the 
most important being Delphinine, Delphisine, and Delphinoidine. They 
also contain a bland lixed oil, which, when extracted b>T ether, is apt to 
be contaminated by the alkaloids. There are no officinal preparations, 
but an ointment (20 per cent.) and a fluid extract are used. 
Physiological Action.—Stavesacre is used principally for killing ver- 
min. It is irritating to the skin, producing erythematous inflammation 
when locally applied ; a narcotic poison when taken internally, lowering 
the action of the heart, causing profound depression of the vital powers 
and spinal paralysis, with death from asphyxia. A fatal result has 
even attended its local application to the scalp, when used too freely in a 
child. 
Charalampi (Inaug. Dissert. Dorpat) found that, although delphinine 
and delphisine have the same chemical composition, they differ slightly in 
their behavior to water, alcohol, ether, and benzol, but still more in their ST A PH ISA GRI A. 
917 
physiological effects. Delphinine has an acrid, benumbing taste, while 
delphisine is bitter, leaving a burning sensation on the tongue. Del- 
phinoidine, which is amorphous, has a bitter, scarcely acrid taste, is 
soluble in ether, and yields amorphous salts, which are soluble in water. 
The mixture of principles insoluble in alcohol, which has been known 
hitherto as Staphisagrine, consists of at least four alkaloids, all of which 
are amorphous and have a bitter taste. The physiological action of the 
different alkaloids was determined by Professor Robert. He found that 
the}" do not dilate the pupil ; otherwise they resemble aconite, though 
decidedly weaker, differing among themselves in their effects. Delphinine 
shows a very close relation to aconitine. The lethal dose for cats is 
grain of delphinium or grain of delphisine ; of delphinoidine the lethal 
dose was also grain, but it was more decidedly narcotic in its action.* 
Therapy.—The use of stavesacre in medicine is restricted almost 
entirely in its effects as a parasiticide. The dry powder may be dusted 
over the affected surface, for head- or body- lice, or the following formula 
employed, which has been highly recommended :— 
Ext. staphisagriae fl., f3ij. 
Acid, acetici dilut. (vel aceti), q. s. ad f fvj. 
M. Sig.: For pediculosis. If applied several times a day, usually effects a cure in 
two days. 
The ointment may be used in scabies as a parasiticide, but its com- 
mon employment is for the destruction of pediculi. Care should be 
taken not to apply it too freely, and to remove it at once upon the ap- 
pearance of toxic sjunptoms. The oil has also been used for this pur- 
pose. Squire recommends the oil of stavesacre diluted with olive-oil. 
As suggested Professor Leidy, any bland oil would answer the pur- 
pose, as lice are air-breathing insects, and are suffocated by being im- 
mersed in oil; poison is therefore unnecessary. An ointment consisting 
of 1 part of the oil of stavesacre to 7 parts of lard has been found effi- 
cacious in prurigo senilis. Delphinine has been employed in painful 
affections, as in neuralgia, where an ointment (gr. x-xx to 3j) may be 
applied over the course of painful nerves. Given internally (gr. to 
|), it was found to act as a cardiac sedative and to relieve excitement in 
acute rheumatism bjT von Mering. It has also been used in asthma and. 
as an antipyretic in the same doses. A decoction of stavesacre-seeds 
has sometimes proved useful as an anthelmintic, and has known 
the tincture apparently useful in long-standing amenorrhoea and also in 
the nausea of pregnancy. 
* American Journal of Pharmacy, August, 1890. 
f Op. cit., p. 48. 918 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
STERCULIA. See Kola-Nut, page 118. 
STILLINGIA (U. S. P.).—Stillingia, Queen’s Root. 
Preparations. 
Extraction Stillingia; Fluidum (U. S. P.).—Fluid Extract of Stillingia. Dose, nlx-f,^j. 
Extraction Stillingia! Fluidum Composition (stillingia 130, corydalis 130, chimaphila 
60, iris 60, satnbucus 60, xanthoxylurn-berries 30, and coriander 30, to make 500 parts fluid 
extract with dilute alcohol). Bose, f3i-ij. 
Syrnpus Stillingia: Compositus.—Compound Syrup of Stillingia (compound fluid extract 
1 to simple syrup 3 parts). Dose, f3j-§j. 
Tinctura Stillingice.—Tincture of Stillingia (10 per cent.). Dose, f3ss-j. 
Decoction Stillingice.—Decoction of Stillingia (l to 16). Dose, f^ji-ij. 
Pharmacology.—The root of Stillingia sylvatica (Euphorbiaceae), an 
indigenous perennial, growing in the Southern portion of the United 
States. The most noteworthy constituent is a soft resin, but it also 
contains a bitter, acrid principle and some volatile oil. 
Physiological Action.—When taken in rather large doses, this drug 
acts as a severe cathartic and emetic. In small doses, frequently re- 
peated, it is believed to stimulate various secretions so as to warrant its 
being considered alterative. It is also regarded as a stimulant to the 
heart and circulation. 
Therapy.—Stillingia has been employed as an alterative in syphilis, 
scrofula, and liver disorders. 'In the former it is often combined with 
sarsaparilla. In jaundice, haemorrhoids, constipation, and disordered 
digestion from insufficient action of the liver, stillingia is valuable. It 
can be prescribed thus in the diseases just referred to :— 
Tinct. stillingiae, f 
Tinct. phytolaccse, f^j. 
Tinct. nucis vomicae, i3j. 
Tinct. xanthoxyli, q. s. ad f§v. 
M. Sig.: Two teaspooufuls in water three or four times a day, in syphilis or 
scrofula. 
R Ext. stillingiae fl., 
Ext. cascarae sagradae fl., aa f3ij. 
Tinct. belladounae, f3ss. 
M. Sig.: Fifteen to thirty drops in water before meals. Serviceable in constipation, 
haemorrhoids, and digestive disorders. 
It has likewise been recommended in the first stage of hepatic cir- 
rhosis and in ascites due to that disorder. Intermittent fever being fre- 
quently associated with torpid or deranged liver, the combination of this 
drug with antiperiodic treatment is very successful. The compound fluid 
extract is a good vehicle and adjuvant for potassium iodide in syphilis, 
chronic rheumatism, etc. In various cachectic skin disorders also this 
combination is useful. STRAMONIUM. 
919 
STRAMONIUM.—Stramonium, Thorn-Apple. 
Stramonii Folia (U. S. P.).—Stramonium-Leaves. Dose, gr. i-v. 
Stramonii Semen (U. S. P.).—Stramonium-Seed. Dose, gr. ss-ij. 
Preparations from the Seed. 
Extraction Stramonii (U. S. P.).—Extract of Stramonium. Dose, gr. x/i~xA- 
Mctractum Stramonii Fluidum (U. S. P.).—Fluid Extract of Stramonium. Dose, HI i-v. 
Tinctura Stramonii (U. S. P.).—Tincture of Stramonium (10 per cent,.). Dose, Hfx-xx. 
TJnguentnm Stramonii (U. S. P.).—Ointment of Stramonium (extract, 10 per cent.). 
Daturina.—Daturine. Identical with Atropine. Dose, gr. T^y. 
Pharmacology.—The leaves and seed of Datura stramonium (Solana- 
ceae) are each officinal, but no preparations of the leaves are recognized 
by the present edition of the pharmacopoeia on account of their varia- 
bility in strength. The plant is an annual with green stem, coarse, rank- 
smelling leaves, and white flowers; the seed-capsule is green and fleshy. 
It grows wild in Europe and the United States, being commonly known 
here as Jamestown weed (Jimsun weed), or thorn-apple. The last name 
is unfortunate, for when the seeds are eaten by children poisoning occurs, 
sometimes with fatal results.* It contains an alkaloid, Daturine (0.02 to 
0.03 per cent.), which appears to be chemically and physiologically the 
same as atropine of belladonna, but is said to be twice as strong (Oldberg 
and Wall). 
Physiological Action.—The physiological properties of stramoniifln 
are the same as those of belladonna, except that the sympathetic nervous 
system is more influenced by stramonium, the heart becoming irregular 
and more delirium being manifested under its use. It is held to be 
aphrodisiac in full doses. Stramonium is eliminated from the system by 
the kidneys. The toxic effects are not very different and the treatment 
is the same as for belladonna poisoning. (See page 468.) 
Therapy.—The leaves of stramonium are sometimes used locally in a 
poultice or fomentation as an anodyne for tumors, rheumatic joints,sprains, 
etc. When dried, they may be mixed with tobacco and smoked for 
asthma, the fumes being inhaled so as to enter the bronchial tubes, an 
attack being checked or materially alleviated in this manner. Some relief 
may be afforded in the same way, in a case of biliary colic and the 
passage of a stone along the ureter, or gravel. About 15 grains may 
be mixed with an equal quantit}% or more, of tobacco and smoked in a 
pipe, or made into a pastille, with a little nitre, and moistened with alco- 
hol, or burned on a hot shovel in a close room. Stramonium has like- 
wise been administered internally in asthma with some success, but its 
* Pellicini (II Progresso Medico) reports 5 cases of poisoning in one family owing to the use 
of a decoction for a cough. The patients recovered under the use of caffeine, morphine, black 
coffee, and camphor. 920 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
action is much more uncertain when taken by the mouth than when 
inhaled. 
The ointment is used for haemorrhoids, fissures, and painful affec- 
tions, especially around the anus. It is much better if made from the 
extract of the fresh leaves. This is a good application, also, to irrita- 
ble ulcers and open cancers. A stramonium poultice is a good local 
remedy in cases of engorged breasts. In mania of acute character, 
puerperal or other, the tincture should be given in decided doses, every 
two to four hours, until physiological symptoms are manifested. In 
spasmodic neuralgia (tic douloureux) and various forms of visceral neu- 
rosis, dysmenorrhoea, etc., stramonium may be combined with other 
agents of the same group, or with opium. 
$ Ext. stramonii, gr. iv. 
Pulv. ipecacuanhae et opii, gr. xxiv. 
Ext. belladonnse ale., gr. iij. 
Arsenii sulphidi, . gr. ij. 
M. et ft. pil. no. xij. 
Sig.: A pill three or four times a day, for neuralgia. 
Ext. stramonii, 
Ext. belladonnae ale., 
Ext. opii, aa gr. iv. 
Camphorse, gr. xl. 
01. theobromae, q. s. 
M. et ft. suppositoriiB no. xij. 
Sig.: Insert a suppository into the bowel, every hour or two, for the relief of pain in 
dysmenorrhoea. 
In spasmodic cough, the tincture might be used as a substitute for 
belladonna, in small doses. Stramonium is sometimes given with advan- 
tage in chorea, epilepsy, and nymphomania. The remedy seems especially 
beneficial when the last-named affection is associated with depressed 
spirits. Chronic rheumatism is not infrequently benefited by the internal 
use of stramonium. 
STRONTIUM.—Strontium. 
Pharmacology.—Strontium is a metal of an alkaline earth, in many 
respects resembling barium. Its salts, except the nitrate and chloride 
are generally insoluble. They impart a red color to flame, and are largely 
employed in the manufacture of fireworks. 
Physiological Action.—A comparative study of the salts of strontium, 
potassium, and calcium has been recently made by Dr. J. V. Laborde.* 
These studies possess considerable importance, especially from the point 
of view of probable relationship between the toxicit}r of a metal and its 
atomic weight, together with their possible applications to the arts and 
* La Tribune Medicate for July, 1890, and Therapeutic Gazette for October, 1890, p. 689. STROPHANTHUS. 
921 
manufactures. Dr. Laborde pursued his investigations principally on 
the dog, and in one case on man, employing intra-venous, hypodermatic, 
and intra-muscular injections, also the introduction into the stomach by 
the oesophageal sound. Differing from Gmelin, who investigated this 
subject in 1824, Laborde finds that the chloride and carbonate of stron- 
tium are innocuous in small doses (30 grains a day), while the chloride 
of barium possesses strong toxicity, being a respiratory or medullary 
poison. The salts of strontium and of calcium are very closed allied in 
innocuousness, though the latter may produce vomiting when injected 
intra-venously,—a result which never follows the use of the former. The 
lactate of strontium was found harmless, while potassium lactate is 
poisonous. An interesting fact, which may have a therapeutic applica- 
tion, is that in the dog the lactate of strontium, given by the stomach, 
produces marked diuresis. These results do not agree with those of 
Blake, who found that strontium salts kill by parah’zing the ventricles 
of the heart. The varying effects of members of this group of elements 
upon the heart are pointed out by Brunton,* who finds that strontium in- 
creases the power of contraction of muscle, and also the duration, and 
holds that its effects are increased by combination with calcium, which is 
antagonistic to the action of barium. Strontium salts also cause con- 
traction of the blood-vessels, which occurs gradually, while barium 
causes rapid contraction. 
Therapy.—Strontium salts have no therapeutic applications at 
present, although the diuretic properties of the lactate might prove 
serviceable in removing serous effusions, oedema, etc., and also in rheu- 
matism or lithaemia. 
STROPHANTHUS HISPIDUS.—Strophanthus. 
Preparation. 
Tinctura Strophanthi.—Tincture of Strophanthus (5 percent.). Bose, Hlii-xv. 
Pharmacology.—The Strophanthus hispidus (Apocjmacete) is a 
climbing plant of western Africa, from which the natives make a toxic 
extract known as the Kombe arrow-poison. There are several varieties 
of strophanthus, but the above is believed by Kirk to be the one used in 
medicine. Important communications relative to the different varieties 
of hispidus and their distinctive alkaloids were made by M. Gley to the 
Biological Society of Paris, at the sessions of November 8, 1889, and 
February 22, 1890.f According to M. Gley, while strophanthus hispidus 
is used by the natives of the western coast of Africa, the Somalis of the 
* American Journal of Science and Arts, vol. vii, March, 1874. Quoted by Brunton. 
t Le Progres Medical, November 16, 1889, and March 1, 1890; Medical Bulletin, March, 
1890, p. 92, and June, 1890, p, 218. 922 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
eastern coast, for similar purposes, make use of the juice of another 
species. Products brought from these two different parts of the African 
coast by M. Arnaud, of the Museum, yielded upon examination the 
same active principle, which is termed ouabaine. In South Africa is 
found a third Apocynuin, Strophanthus Kombe, the seeds of which yield 
a second principle, strophanthine. M. Arnaud states that the chemical 
composition of strophanthine is very analogous to that of ouabaine, 
The substance isolated by Arnaud is regarded as the only genuine 
strophanthine. Ouabaine is a transparent, white, crystalline powder, 
slightly bitter; soluble with difficulty in cold water, but readily soluble 
in hot water; insoluble in chloroform and ether. 
The active principle is Strophanthin, from which Strophanthidin may 
be derived by the action of sulphuric acid. Strophanthin is a crystal- 
lizable glucoside present in different parts of the plant, but especially in 
large proportion in the seeds (8 to 10 per cent.). It is bitter, acidulous, 
insoluble in ether and chloroform, but soluble in alcohol and in water. 
A good fluid extract would probably be the best preparation, but the 
effects of the tincture have been most observed by Professor Fraser,* of 
Edinburgh, who first introduced it to the profession in 1870. The active 
principle may be administered simply dissolved in water (gr. i-fsj), the 
dose being gr. to (or 5 to 8 minims of the solution). Bartholow 
advises chloroform-water as a solvent, in order to prevent the formation 
of penicillium. 
Physiological Action.—Strophanthus has no local action, apart from 
the observation of Stein bach that the seeds caused anaesthesia when 
applied to the cornea. This local action has been studied by Gley and 
is common to both ouabaine and strophanthine, but is more decided in 
the former substance. Three or four drops of a solution of 1 to 1000 
dropped into the cornea anaesthetize it for a considerable time, which 
may extend to several hours. The effects are unaccompanied by any 
irritation of the conjunctiva. Strophanthine and ouabaine are much 
more powerful local anaesthetics than cocaine, and the anaesthesia which 
they produce is total, including all varieties of sensibility. The feeling 
of heat and cold is the last to be extinguished and the first to revive. 
Strophanthus is bitter, and promotes appetite and digestion, if given 
in small doses. Its principal use is as a cardiac tonic, resembling digitalis. 
It slows the heart-beat, lengthens the intervals between the contractions, 
and increases the energy of the muscular tissue. Some effect is also seen 
upon the arteries, but the rise of blood-pressure is due principally to the 
increased force of the cardiac contractions. In fatal cases the heart’s 
* British Medical Journal, January 22, 1887, and Transactions of the Royal Society of Edin- 
burgh, vol. xxxv, part iv (No. 21), 1890. STROPHANT1IUS. 
923 
action is arrested in diastole. It has some diuretic power and it is 
claimed lias no cumulative effect, but, as pointed out by Bartliolow, this 
must depend upon the interval between the doses, for if they are given 
too frequently the effects must overlap each other. The action ot* oua- 
baine and strophanthine upon the heart is identical. The prolonged use 
of strophanthus sometimes gives rise to diarrhoea. 
Therapy.—Strophanthin has recently been employed as a local anaes- 
thetic, administered percutaneously by means of cataphoresis, the anode 
being moistened with the solution, or a tissue-paper disk used containing 
usd g'r;dn or more and a current of 5 to 8 milliamperes employed.* It 
is in cases of' mitral disease not compensated where digitalis is not well 
borne, or in intervals of digitalis treatment, that strophanthus has been 
particularly praised. It lessens the ischaemia of the arteries and increases 
the rate of blood-current to the veins; but, unlike digitalis, it does not 
materially affect the calibre of the arteries, and consequently does not 
so much increase the work of the heart by contracting them. Strophan- 
thus is especially useful in the progressive heart-failure of elderly' 
patients, with attacks of dyspnoea simulating angina. Strophanthus is a 
serviceable cardiac stimulant in typhoid fever, and some authorities 
advocate its employment in angina pectoris. Cardiac dropsy is relieved 
by it. It can be prescribed thus :— 
Tinct. strophantlii, 
Tinet. nucis vomicae, 
Tinct. cardamomi, aa f3j. 
Aquae menth. pip., q. s. ad f§v. 
M. Sig.: A teaspoonful or two every two or three hours. 
In the treatment of psoriasis, the author has had some good results, 
especially when the integument is much congested, from strophanthus, 
with hoang-nan :— 
Tinet. strophanthi, 
Ext, hoaug-nan fl., aa f3ij. 
M. Sig.: Ten to twenty drops in water three times a day. 
Strophanthus is of advantage in bronchial asthma and whooping- 
cough. Dr. William Gemmel, of Glasgow, has made use of ouabaine in 
49 cases of whooping-cough.'f He found it, when cautiously employed, to 
be of notable benefit in all stages of the disease. It is destitute of cumu- 
lative action. In an uncomplicated case it reduces the pulse, tempera- 
ture, and respiration a little below the normal. Ouabaine increased the 
activity of the skin. The bowels were unaffected. The excretion of 
* Fortschritte der Medizin, February 1,1890. Also see article by Frederick Peterson, M.D., 
on “A Farther Study of Anodal Diffusion as a Therapeutic Agent,” Medical Record, New York, 
January 31,1891. 
f British Medical Journal, April 26, 1890, p. 950. 924 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
urine was slightly increased. The appetite and the general condition 
were considerably improved. Sleep was sound while onabaine was being 
administered. This substance was given in very small doses. 
Dr. Gemmell states that the dose of onabaine, to begin with, should 
not exceed grain every three hours ( grain daily). For children 
under 1 year of age, not more than grain should be given every 
three hours. From the sixth to the twelfth year, if the symptoms are 
severe, grain may be given in each dose, but the action must be care- 
fully watched. Onabaine may be administered alone, dissolved in water, 
or in combination with potassium bromide or chloral hydrate. The sim- 
plest way is to dissolve 1 grain of onabaine in distilled water, so that each 
minim of the solution shall be equal to T0V<i grain of onabaine. Thus :— 
$ Liq. ouabain., lTlxlviij. 
Syr. aurantii, . . * f^iv. 
Aquae, q. s. ad f^vj. 
M. Sig.: A teaspoonful, every three hours. 
Rothziegel * recommends strophanthine in the treatment of respira- 
tory diseases, according to the following formula:— 
Strophanthini, gr. vel 
Aquae destillatae, . f3iiss. 
M. Sig.: Ten to twenty drops, in capsules, every two hours. 
The active principle of stroplianthus may be administered hypoder- 
matically, in doses of gr. not more than once daily. The hypo- 
dermatic injections are useful in chills, due to urethral shock, following 
passage of a sound or an operation ; also in malarial or nervous chills. 
In Bright’s disease, the symptoms of uraemia and dyspnoeal attacks are 
rapidly relieved by stroplianthus, which also reduces the dropsy of 
chronic kidney disorder. For exophthalmus, with irregular overaction 
of the heart (Graves’s disease), it has been successfully tried. Dr. E. D, 
Ferguson f says that in 8 cases out of 9, to which he gave stroplianthus 
in exophthalmic goitre, there was marked relief; the other one had pre- 
existing pulmonary disease. He thinks it a probable explanation that 
stroplianthus relieves the overtaxed heart by overcoming resistance in the 
systemic circulation. He advises beginning with doses of Tqviij, and 
gradually increasing them to iqxxv, of a good tincture, several times 
daily. 
Dr. Wm. A. Hammond, in a recent article in the Therapeutic 
Gazette,% on “ Weak Heart and its Treatment,” considers stroplianthus 
*L’Union M&licale, No. 140, 1890. 
t Proceedings N. Y. Medical Association, October 22, 1890 ; Medical Record, November 1st, 
p. 592. 
+ Oct. 15, 1890, p. 668. STRYCHNINA. 
925 
a valuable remedy, though inferior to digitalis, and states that it appears 
to him “ to bear the same relation to digitalis that brucine does to strych- 
nine, and when administered with a view to its tonic effect upon the 
heart it should be given in much larger doses than those ordinarily pre- 
scribed.” Hare suggests its use in children, where digitalis does not 
answer well; but Demme holds the view that in children more care is 
needed in using strophanthus than in using digitalis,* stating that the 
toxic effect of strophanthus on the heart-muscle often occurs unexpect- 
edly and more suddenly than writh digitalis. In the case of very young 
children, Demme observed strophanthus to cause indigestion. If it 
cause nausea and cold-sweating, it should be withdrawn and coffee and 
brandy be administered. On the other hand, Moncorvo, of Rio Janeiro, 
also an excellent observer, values strophanthus as a cardiac stimulant 
and diuretic in the diseases of children. He considers it prompt and 
energetic, but devoid of danger, and claims that its good effects last long 
after the cessation of its administration. 
STRYCHNINA (U. S. P.).—Strychnine. (See Nux Vomica, p 765.) 
STYRAX (U. S. P.).—Storax, Liquid Storax. 
Dose, gr. v-xx. 
Pharmacology.—The inner bark of the Liquidambar orientalis (Hama- 
melaceae), growing in Asia Minor, or oriental sweet gum, yields sty rax, 
which is a true balsam, containing a volatile oil, Styrol, Cinnamic acid, 
Styracin, and other cinnamic ethers, two resins, etc. It enters into the 
compound tincture of benzoin (8 per cent.). 
Physiological Action.—It is stimulant and expectorant. 
Therapy.—Mixed with olive-oil, equal parts, storax is used in 
treating scabies, and in some cutaneous diseases requiring slight 
stimulation. Storax is a good application to foul ulcers, and, made 
into an ointment, is an excellent dressing to the ulcers of frost- 
bite. It is a stimulating expectorant in chronic bronchitis, 
generally used, however, in combination, both internally administered 
and by inhalation, the tincture being volatilized by hot water. 
Storax has also been brought forward as a remedy for gonorrhoea and 
gleet, also for chronic catarrhal affections of the genito-urinary organs, 
and it has been found useful in amenorrhoea. Styrone, a derivative of 
styracin, which is resolved by caustic potash into a cinnamate and cinna- 
mic alcohol or stj’rone, is a very efficient antiseptic, and its use has been 
enthusiastically advocated by its introducer, Dr. H. H. A. Beach,f who 
♦Annual of the Universal Medical Sciences for 1890, vol. v, p. A-120. 
f “Stvrone: A Consideration of its Value as an Antiseptic,” by H. H, A. Beach, M.D., 
Boston Medical and Surgical Journal, August 1 and 8,1889, 926 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
based his observations upon numerous surgical cases treated by him in 
the wards of the Massachusetts General Hospital. 
It is a prompt deodorizer of foul wounds or ulcers,—malignant or 
not,—and in bronchial catarrh it can be used in a spray :—- 
Styron., 3j. 
Glycerini, 
Aquae destillatae, aa f^j. 
M. For external application. 
Being non-poisonous, styrone can be used in emulsion with olive-oil 
or water for injecting into cavities, as after the operation for empyema; 
and, having an agreeable,cinnamon-like odor, it has been utilized in den- 
tistry. Various combinations of styrone are suggested, as with liquid 
vaseline (ol. petrolati), 1 to 12, which was used with success upon the 
dressings as an antiseptic, after removal of the female breast. 
Dr. Beach suggests the internal use of styrone in treatment of 
cholera for the disinfection of the alimentary canal. It may also be sub- 
stituted for carbolic acid in gargles, requiring antiseptic action, and 
probabl}' would be a useful enema for oxyurides, or ulceration of the 
rectum. A solution of 1 to 60, containing a small amount of glycerin, 
would be well suited for internal use. Styrone is likewise an excellent 
deodorant and disinfectant in cases of purulent inflammation of the ear. 
SUCCINUM.—Amber. 
Preparation. 
Oimm Snecini (U. S. P.).—Oil of Amber (a volatile oil obtained by the destructive 
distillation of amber and purified by subsequent rectification.) Dose, lfiv-xx. 
Pharmacology.—Amber is a resin found among fossil alluvial de- 
posits in different parts of the world, representing the resinous exuda- 
tion of a number of varieties of extinct coniferous trees. The amber 
consumed in this country is brought from the ports of the Baltic, but it 
has been found in small quantities in New Jersey and Maryland. It is 
a light-yellow, brittle solid, in irregular masses, resembling colophony. 
Water and alcohol scarcely act on it. It becomes negatively electrified 
b}r friction. By distillation, oil of amber and succinic acid are obtained, 
and by repeated distillations from nitric acid it yields a liquor from 
which ether separates pure camphor. Amber consists of a volatile oil, 
a yellow resin, .‘mother resin, succinic acid, and a bituminous principle, 
the latter constituting about 80 per cent. It also contains a yellow 
coloring matter. The oil of amber is largely adulterated, and has fallen 
almost completely into disuse. 
Physiological Action.—The rectified oil of amber is stimulant and 
antispasmodic, and excites the secretions of the bronchial mucous mem- 
brane and kidneys. Locally it is counter-irritant. SULPHAMINOL. 
927 
Therapy.—The volatile oil of amber has been used as a counter- 
irritant to the chest in cases of whooping-cough, and to the back, along 
the spine, for certain spasmodic affections, such as chorea and infantile 
convulsions. It is a useful ingredient, in liniment, for chronic rheuma- 
tism, though probably inferior to oil of turpentine. Internally it has 
been given for amenorrhoea, digestive disorders, with pain, but is rarely 
prescribed at present. The oil of amber has likewise been found of avail 
in spasmodic affections, as hysteria, hiccough, and whooping-cough. 
SULPHAM1N0L.—Thio-oxy-di-phenyl-amine. 
Pharmacology.—When salts of oxydiphenylamine, dissolved in 
water, are exposed to the action of sulphur, a yellow powder is precipi- 
tated, which is without taste, odorless, readily dissolves in alkaline 
solutions; and in alcohol, with acetic acid, it forms yellow salts. In con- 
tact with animal liquids, sulpliaminol, like salol, is split up into its 
components, forming nascent sulphur and phenol. 
Physiological Action.—From its nature it is inferred that it is an 
active intestinal and systemic disinfectant. It is excreted by the urine, 
being converted again into oxydiphenylamine. Prof. Robert found that 
in animals it is comparatively innocuous, even in doses of more than 7-| 
grains for each pound of body-weight. He also declares it to be without 
poisonous properties when administered in the human subject. 
Therapy.—Sulpliaminol has been tested as a disinfectant bjr Dr. 
Schmidt, of Frankfort, in laryngological practice, and found to be a 
good deodorizer, as well as antiseptic. Clinical observations in other 
fields of practice are wanting. It should be a good intestinal disinfec- 
tant in cholera Asiatica and summer cholera; also in typhoid fever, 
diarrhoea, infectious dj'spepsia, etc. 
SULPHONAL.—Di-ethyl-sulphoni-dl-methyl-methane. 
Dose, gr. xv-xl. 
Pharmacology.—This is a synthetical compound, first manufactured 
in Germany, by Baumann, and is a quasi-proprietary preparation, as 
usually sold. It is a whitish, crystalline solid, without odor or taste, 
soluble in 100 parts of cold water and in 18 or 20 parts of hot water. 
It is generally administered in hot broth, coffee, or milk. The insolu- 
bility and slow rate of absorption of this substance, particularly 
when given in capsules or suspended in a mucilage, is accountable, in 
the opinion of Dr. D. D. Stewart, for much disappointment in the use of 
the drug, which he esteems as the most satisfactory of the neAver 
hypnotics.* He suggests that at bed-time the sulphonal be completely 
dissolved in boiling water, and drunk as soon as it has been cooled to a 
* Journal American Medical Association, February 21, 1891. 928 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
temperature which can be borne. At this point not the slightest pre- 
cipitation occurs. The solution, if desired, may be flavored with some 
such liqueur as creme de menthe (u green-mint cordial ”). 
Physiological Action.—Sulphonal is a hypnotic. The committee, of 
which I)r. T. Lauder Brunton is chairman, appointed by the British 
Medical Association to determine the relative value of the different hyp- 
notics, especially with regard to the certainty of their action and ques- 
tion of tolerance, reported* that sulphonal was an efficient hypnotic in 
doses of 10 to 20 grains, given at night, and that it was generally 
well borne, and its effects were not lost during periods of several months. 
In a case of chronic gout, 30 grains produced no effect. In 6 out of 10 
cases, in which 20 grains had been given, disagreeable after-effects were 
noted ; drowsiness the following day was observed six times, giddiness 
four times, and headache and inco-ordination of gait, each twice. In 
7 cases, with 30 to 60 grains, drowsiness was noted four times, giddiness 
twice, headache twice, inco-ordination of gait and vomiting, each once. 
Several cases showed that a second dose on the succeeding night (20 
grains) has a greater effect than on the first night. In some cases, pro- 
longed use of the drug seems to diminish its effects. Thus, in 1 case 
(asthma and bronchitis) 20 grains were given every other night for 
eight weeks. During the iirst fortnight, sleep came on in an hour and 
lasted twelve hours each night. The drug Avas then omitted for a week, 
when the insomnia returned. In the succeeding five weeks the drug, 
after three hours, produced six hours’ sleep. In a case of phthisis, 20 
grains were given every other night for twenty-six days, except for five 
days, when the dose was reduced to 5 grains, but afterward was in- 
creased. During the time the patient Avas taking 20 grains, after an 
hour he slept for six hours. The drug was omitted for a fortnight, and, 
on recommencing it, only droAvsiness and no sleep folloAA'ed. In a case 
of neurasthenia with insomnia, quoted by Mr. Priestley, sulphonal, 10 to 
20 grains, did not lose its effect during six months. 
Smith, of London, finds that while under the influence of the drug 
the amount of urea and the quantity of urine are each slightly increased, 
but no evidence of marked destructive action upon nitrogenous tissues 
exists. In moderate doses, the drug is completely changed during its 
passage through the body into a sulphuretted organic substance. 
Dr. Win. F. Shirk, of Easton, Pa., finds that sulphonal acts especially 
upon the higher nerve-centres. It produces relaxation of the muscles 
and a staggering gait. Motor nerves are unaffected. Little if any effect 
was exerted upon the circulation or the composition of the blood ; upon 
the respiration the drug is depressant. Dr. Crozer Griffith reports a 
* British Medical Journal, July 2G, 1890; Therapeutic Gazette, October, 1890, p. 623. SULPHONAL. 
929 
•number of cases where the after-effects were more or less severe.* As a 
result of a review of the literature of the subject and 18 cases of his own, 
he concludes that the chief disadvantages of sulphonal are: 1. Its hyp- 
notic action usually develops very slowly. 2. This action is very liable 
to be prolonged throughout a greater or lesser part of the following day. 
3. It is difficult to determine the dose which may be given with effect 
and with comfort in each individual case, and this dose may vary at 
different times in the same case. 4. The drug is liable to produce 
unpleasant secondary effects, which may even replace the primary hyp- 
notic action ; chief among these are mental excitement, nausea, vomit- 
ing, dizziness, headache, langour, exhaustion, depression, and a stag- 
gering gait; these symptoms may appear after large or after quite small 
doses. 5. It very often fails to exert anj- hypnotic action, either in any 
dose whatever or in any amount which can be given with comfort to the 
patient. It sometimes produces a scarlet eruption upon the skin, as noted 
by Engeimann. Dr. Hugh R. Beevor advises caution in the use of sul- 
phonal, and believes that it may exert a deleterious influence upon the 
composition of the blood. 
Dr. Knaggsj' reports a fatal result on the third day, in spite of 
treatment. The patient, after taking an ounce of sulphonal, fell into a 
stupor; pulse and respiration Avere slow, temperature a little elevated 
(100° to 103°), and there was general and complete anaesthesia. Death 
resulted from failure of the respiration. Dr. T. II. Dillingham J reports 
a case of recovery, after taking 90 grains, in an elderly lady; stupor, 
with stertorous respiration, pulse slow, muscular inco-ordination, ptosis, 
slight facial palsy, dysuria, no albuminuria. Patient recovered gradually 
in about two weeks. Dr. R. R. Pettit reports a case of death from failure 
of respiration of a woman, after taking 30 grains. She was suffering from 
melancholia, with hysterical manifestations. 
Therapy.—From the preceding summary, the therapeutic applica- 
tions of sulphonal may be readily inferred. It has been given successfully 
in nervous insomnia and in insanity. Dr. William H. Flint considers 
it a safe and reliable hypnotic, but is not an analgesic. It has recently 
been introduced into the British Pharmacopoeia, so that it may be 
regarded as possessing established value as a somnifacient. A very good 
review of its therapeutic applications is contained in the “Annual of the 
Universal Medical Sciences for 1890,” by Drs. Griffith and Cattell. 
Boettrich asserts that 7-| grains of sulphonal are generally successful in 
the prevention of night-sweats. He thinks that the effects of sulphonal 
* Therapeutic Gazette, May, 1890. 
t British Medical Journal, October 2o, 1890. 
t Medical Record, December 13, 1&90.  PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
equal those of atropine, and finds the former to retain its power, the 
sweating being decidedly less the night after a dose has been taken.* 
Jeffries reports (Weekly Medical Review) chorea much improved by the 
conjoined use of sulphonal and arsenic. He regards sulphonal as a 
valuable adjuvant to arsenic in the treatment of this disease. Casarelli 
has made use of sulphonal in the treatment of diabetes, upon which he 
observed this drug to have a favorable influence, gradually lessening the 
quantity of sugar. The amelioration is evident after the remedy has 
been used for several days in dose of 15 to 30 grains per diem. In the 
dose of 45 grains, long continued, it produced a condition of lethargy 
and sometimes delirium. But if intermitted for a day, or if the dose be 
diminished, these manifestations cease. If the drug be abandoned the 
sugar soon re-appears.f 
SULPHUR.—Sulphur, Brimstone. 
Officinal Forms and Preparations. 
Sulphur SuJblbuatum (U. S. P.).—Sublimed Sulphur, Flowers of Sulphur. Dose, gr. 
xx-3j. 
Sulphur Lolum (U. S. P.).—Washed Sulphur (sublimed sulphur thoroughly washed 
with water). Bose, 3s8-^ss. 
Sulphur Precipitatum (U. S. P.).—Precipitated Sulphur (sublimed sulphur treated 
with lime, hydrochloric acid, and boiling water). The preferred form for internal adminis- 
tration. Dose, gr. xxx-3ij. 
Sulphuris Iodidum (U. S. P.).—Iodide of Sulphur. Bose, gr. ss-j. 
Unguentum Sulphuris (U. S. P.).—Sulphur Ointment (sublimed sulphur 30, benzoin- 
ated lard 70 parts). 
Unguentum Sulphuris Alkalinum (U. S. P.).—Alkaline Sulphur Ointment (washed 
sulphur 20, carbonate of potash 10, water 5, benzoinated lard 65 parts). 
Pidvis Olycyrrhizce Compositus (U. S. P.).—Compound Liquorice-Powder (contains 
washed sulphur 8 per cent.) (See page 646.) 
The officinal sulphites are of sodium, potassium, and magnesium, and the bisulphite and 
hyposulphite of sodium. Sodium sulphocarbolate is also officinal. 
The recognized sidphides are Calx Sutphurata (U. S. P.), commonly misnamed sulphide 
of calcium (consisting chiefly of sulphide of calcium and sulphate of calcium, in varying 
proportions, but containing not less than 36 per cent, of absolute sulphide of calcium); Anti- 
monium Sulphuratum (U. S. P.), chiefly antimonious sulphide, with a very small amount of 
antimonious oxide; Antimonii Sulphidum and Sulphidum Puriflcatum (U. S. P.), see page 
443 ; and Potassa Snlphurata (U. S. P.), which should contain at least 56 per cent, of true 
sulphide of potassium. 
Oil of Sulphur is the popular name of a preparation made by boiling olive-oil 8 parts 
and 1 part of sublimed sulphur together in an iron pot until a uniform mixture is obtained ; 
according to the old Edinburgh Pharmacopoeia, it was also known as balsam of sulphur. 
The oil is partly decomposed, and the resulting preparation has an extremely fetid odor and 
acrid taste. The German Pharmacopoeia has a similar preparation, made with linseed- 
instead of olive- oil. $ 
* Therap. Monatsheften, March, 1890; American Practitioner and News, January 31, 1891. 
t Annales de Therapeutique Medico-Chirurgicales, September, 1890, 
t Druggists’ Circular, January, 1891. SULPHUR. 
931 
Spirit of Sulphur, or liquor fumans (Boyle), is the name applied to a preparation pre- 
pared by adding washed sulphur 1 part to concentrated ammonia 6 to 8 parts, and passing 
hydrogen sulphide through the mixture until the sulphur is dissolved.* 
Ichthyol contains a large proportion of sulphur. (See page 707.) 
Pharmacology.—Sulphur is a non-metallic, solid element, found 
native in Sicily and Iceland in the neighborhood of extinct volcanoes ; it 
is widely distributed in combination with metallic bases as sulphides, 
especially of iron, copper, lead, mercury, etc. It is of a lemon-yellow color, 
tasteless, odorless and brittle. At a temperature of 111.5° C., it melts 
into a brownish-yellow, transparent liquid, which crystallizes on cooling. 
It is dimorphous, having two distinct forms of crystals. Sulphur is insol- 
uble in water, but very slightly soluble in alcohol, ether,and benzine; its 
best solvent is bisulphide of carbon. It is likewise soluble in the oil of 
turpentine and in alkaline fluids. It has powerful chemical affinities, and 
in combination with oxygen forms sulphurous and sulphuric acids, which, 
with bases, form sulphites and sulphates. (See pages 390 and 392.) Sul- 
phur is an important constituent in certain native mineral springs, which 
furnish sulphuretted waters. In this place the action of sulphur need alone 
be considered. The sublimed sulphur contains a trace of free acid, which 
makes it irritating, and, when taken into the intestines, it occa- 
sionally causes griping. Owing to its insolubility in water, sulphur, either 
washed or precipitated, has no effect upon the skin, although when kept 
in contact with it for some time it may be partially oxidized, forming sul- 
phurous acid, which is an energetic disinfectant. In the alimentary canal, 
the pure sulphur acts as a laxative, partly as a result of chemical change 
(since li3rdrogen-sulphide gas is formed in considerable quantity, and sul- 
phur compounds are found in the blood) and partly mechanically as a 
dry powder. 
Physiological Action.—The fact that sulphur enters the blood from 
the small intestine is shown by its chemical effects upon silver coins or 
jewelry worn by persons while taking it; secondly, by the physiological 
effects,—its appearance in many secretions; and, thirdly, its therapeutic 
results as an alterative. The intestinal secretions are moderately in- 
creased by it, as well as the peristaltic movements, and the stools are 
rendered softer. It is believed to exert a stimulant effect upon the mu- 
cous membranes and skin, and strong applications in the form of an oint- 
ment bring out an eruption of an eczematous character. Sulphur is 
excreted principally by the bowels, but also by the skin, the perspiratory 
and the milk-glands, and by the urine; in the latter it usually appears as 
a sulphate, in the others it is in the form of sulphuretted hydrogen. 
Sulphur plays an important part in the normal physiological processes 
of the body, being a constant constituent of albumin, and present in 
* Druggists’ Circular, January, 1891. 932 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
nearly all the solids and fluids of the body. From this fact and others, 
we are led to believe that sulphur is essential to the health of albumin- 
ous organs and tissues, and is an important element in nutrition. The 
antiseptic and germicidal effect of sulphur may exercise an important 
prophylactic influence in preventing, under ordinary circumstances, the 
invasion of the tissues by micro-organisms. Observations were pub- 
lished a short time ago by Prof. H. C. Wood as to the absorption of 
sulphuretted hydrogen gas by the intestinal mucous membrane and its 
passage into the blood to be carried to the lungs, where it escapes from 
the bronchial mucous membrane and acts as a local disinfectant. This 
gives a hint of the unsuspected role, played by sulphur, of a pulmonary 
disinfectant and expectorant, in addition to the property, for which it is 
already valued, of an intestinal disinfectant. It probably, after absorp- 
tion, favors the bile-producing function of the liver, since taurocholic 
acid normally contains a large proportion of sulphur. Upon the circu- 
lation no direct effect is noticed, but it is believed that it increases the 
heart’s vigor, as it does that of muscular tissue in the arteries and in 
the various hollow viscera, as well as the voluntary muscles.* 
Therapy.—Sulphur is used in a very large number of diseases ex- 
ternally, and often with marked curative action. In acute infectious 
disorders (diphtheria or scarlatina, for instance), the flowers of sulphur 
may be insufflated into the throat or nose with marked benefit, limiting 
the spread of the disease, destroying the micro-organisms, and prevent- 
ing blood-poisoning. In scarlatina, erysipelas, measles, and small-pox, 
an ointment containing sulphur moderates the heat of the skin, allays 
congestion or inflammation, and disinfects the pustules of variola. The 
use of baths containing sulphide of potassium, or a resort to a sulphur 
spring, are of great value in syphilis. In very many integumentary 
inflammations, especially chronic eczema and psoriasis, sulphur alone, or 
combined with other drugs, will lessen the congestion and overcome the 
infiltration of the parts. It is often employed with advantage in chronic 
acne and rosacea, but great care should be exercised in applying it upon 
the face, especialty if the sebaceous glands are in patulous condition. 
If brought in contact with the skin under the latter circumstances, the 
glands often become filled with sulphur and occasion many black points 
(acne punctata) upon the skin. The following formulae are useful in 
acne, especially of the face :— 
It Sulphur, sublimati, 3j. 
Glycerini, f3ij. 
Aquae rosae, q. s. ad f §vj. 
M. Sig.: Apply with a soft sponge at night, after evacuation of pustules and the 
local use of hot water. 
* See paper by author on “The Physiological and Therapeutical Action of Sulphur,” 
Transactions of the Pennsylvania State Medical Society, 1890. SULPHUR. 
933 
$ Sulplmris sublimati, 
Pulv. marantae, 
Saloli, , , aa 3j. 
U.ugt. zinci oxidi, §j. 
M. Sig.: For acne ; apply once or twice daily. 
Iii alopecia, especially the circumscribed variety, sulphur often acts 
well in assisting to restore the growth of the hair. In very many dis- 
eases of the skin, especially those of a parasitic nature, this agent can be 
used more effectively in the form of a sulphur-vapor bath. Sulphur is 
very largely employed as an external remedy in scabies, but it is also ex- 
cellent for pediculosis, tinea capitis, barb® and corporis, and tinea versi- 
color. As a germicide, its effects are most evident when combined with 
oxygen, as sulphurous-acid gas. (See page 592.) In treating scabies, no 
permanent result should be expected, unless measures are taken to prevent 
re-infection by the parasite. The under-clothing must be destroyed,or, at 
least, exposed to an elevated temperature for several hours, and thor- 
oughly washed with soap and boiling water. The patient should take 
a warm bath, rubbing the interdigital spaces and flexures of affected 
points thoroughly with potash or soft soap. After the bath the follow- 
ing ointment may be rather freely applied to the affected spots, or where 
itching is experienced, and allowed to remain until morning, when it may 
be wiped off':— 
Ol. cadiDi, f3j. 
Ungt. sulphuris, . 3ij. 
Lanolini, 3v. 
M. Sig.: Apply at night, as directed. 
A repetition of this treatment, once or twice, may effectually relieve 
the patient of his parasites. When the sulphur ointment is used it 
sometimes causes an eczematous eruption, which may be avoided by 
diluting the preparation. In pediculosis of the body a similar treatment 
to the above is generally effective, providing the clothing be changed at 
the same time. In either of the preceding cases, the cure is not to be 
attributed to the direct parasiticide effect of sulphur, but is owing to 
the fact that it makes a dense and tenacious substance with lard, which 
suffocates the itch-insect. Indeed, Professor Leidy is of the opinion 
that the sulphur is unnecessary, as the oil would block up the air-pores 
of the acarus just as well without it. In sciatica, II. G. de Mussy en- 
velops the limb in a cloth containing a thick paste of the flowers of 
sulphur. One night is sufficient to relieve the patient. The urine ac- 
quires a very strong odor of sulphuretted hydrogen. L. Duchesne also 
reports success with this in a case of several years’ standing.* 
* Annual of the Universal Medical Sciences for 1890, vol v, p. A-144. PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Internally, sulphur is used as a simple laxative, especially combined 
with potassium bitartrate, in affections of the lower bowel, irritable piles, 
stricture, fissure or fistula. By relieving engorgement of the haemor- 
rhoidal vessels, sulphur proves useful in cases of bleeding from piles. 
After operations upon the pelvic organs it is the best laxative to ad- 
minister. The dose ordinarily need not be more than 5 to 10 grains 
daily in order to insure a free evacuation of the bowels, and if it is 
continued for some time we obtain valuable systemic effects. In chronic 
sore throat, associated with, or springing from, indigestion, these small 
doses of sulphur, with some attention to hygiene, will effect a cure. In 
digestive difficulties due to disordered action of the liver, which ulti- 
mately lead to lithaemia and structural lesions, the habits of life must 
first be corrected, and the hepatic torpor will then be overcome by small 
doses of sulphur. I)r. Garrod has reported remarkable relief from obsti- 
nate hepatic colic by the daily use of a 5-grain sulphur lozenge, per- 
sisted in for months. In hepatic disorder attended by constipation, it 
may be well to administer a mercurial purge to initiate the treatment, 
before giving the tonic doses of sulphur. As sulphur stimulates mucous 
membranes, it is useful in chronic bronchitis, as Graves long ago pointed 
out in his clinical lectures. For this purpose sulphuretted mineral 
waters and the springs from which they flow are justly celebrated. 
This remedy is especially suitable to the chronic bronchitis, accom- 
panied with copious secretion, of aged and debilitated persons. In 
whooping-cough, small doses of sulphur lessens the paroxysms; and the 
following formula, as modified from See, may be administered : — 
Sulphuris praeeip., gr. 1. 
Abstract, belladoniiae, gr. j. ■ 
Pulv. ipecacuauh* et opii, . gr. v. 
Sacchari albi, gr. xx. 
M. et ft. capsulae vel chart* x. 
Sig.: From two to ten capsules or powders a day, according to the age of patient and 
effect produced. 
Garrod suggests that sulphur may be of service in cystitis, and, per- 
haps, in some disorders of the kidne\\ It might very properly be tried in 
tubercular or gouty pyelitis, and likewise in disordered menstruation, when 
largely or entirely functional in character. In muscular pains, attending 
lithaemia, gout, and rheumatism, Garrod employed*small doses of sulphur 
in conjunction with iodine or arsenic, and he has seen great improvement 
from this treatment, even in rheumatoid arthritis. Sulphur has not, 
hitherto, given very positive results in tuberculosis, but might be of 
great service in the incipient stages of pulmonary disease. The con- 
tinued administration of fractional doses of sulphur is often beneficial 
in seborrhoea, sycosis, chronic eczema, psoriasis, and other cutaneous 935 
SUMBUL. 
diseases, especially when the upper hiyer of the skin and the glands are 
involved. In alopecia, small doses of sulphur will often increase the 
activity of the hair-forming apparatus, and may also assist in restoring 
the hair to the parts. In diseases of the nails, especially when they 
become brittle, covered with ridges and white spots, the continued use 
of small doses of sulphur will frequently bring about a healthy and pol- 
ished appearance of these useful appendages. 
The sulphide of calcium, in the treatment of acne, has alread}r been 
referred to (page 499). Spirit of sulphur was formerly believed to be a 
panacea, or a remedy possessing the quintessence of healing qualities ; it 
was given in syphilis, rheumatism, diabetes, consumption, in doses of 3 or 
4 drops, well diluted. It is merely a solution of ammonium sulphide, and 
might be given in larger doses without doing either much harm or good 
to the patient. 
SUMBUL (U. S. P.).—Sumbul, Musk-Root. 
Dose, gr. x-3j. 
Preparations. 
Tinctura Sumbul (U. S. P.).—Tincture of Sumbul (10 per cent.). Pose, f 2>ss-j. 
Extradum Sumbul.—Extract of Sumbul. Pose, gr. |-j. 
Pharmacology.—Sumbul is the root of Ferula sumbul (Urn belli ferae), 
growing in Asia. The drug consists of transverse sections of the root. 
Sumbul has a decided odor, resembling musk, and a somewhat bitter, 
balsamic taste. It contains two acids, angelic and valerianic, two bal- 
samic resins, a volatile oil, bitter extractive, etc. 
Physiological Action.—In its effect upon the nervous system, sumbul 
resembles valerian, and is an efficient nerve-tonic. 
Therapy.—Sumbul is probably of some value in hysteria and 
neurasthenia, in anaemic women. For such cases Goodell prescribes :— 
Extracti sumbul ale., 
Ferri sulphatis exsiccat., . aa gr. xx. 
Asafoetidse, gr. x. 
Acid, arseniosi, gr. ss. 
M. et ft. pilulse no. xx. 
Sig.: Take one, thrice daily, after meals. 
The tincture may be given in hysteria, chronic bronchitis with spas- 
modic cough, also in delirium tremens, as a substitute for musk. By 
Russian practitioners, sumbul is esteemed a valuable stimulant in 
typhoid fever, atonic dyspepsia, asthenic diarrhoea, and dysentery. Dr. 
Granville, who introduced this remedy into England, recommended it 
in epilepsy and dysmenorrhoea. Phillips testifies to its decided efficacy 
in facial, sciatic, or ovarian neuralgia occurring in women of a quick 
and lively nervous temperament. He has seen it useful, also, in certain 936 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
stages of phthisis, in the restlessness of pregnancy, and the insomnia of 
chronic alcoholism. It is essential that a fresh specimen, in good con- 
dition, should be employed in making the tincture, in order to get any 
results. 
SYMPHYTUM.—Symphytum, Comfrey. 
Pharmacology.—The Symphytum officinale (Boraginaceae), a small 
herb of Europe and the United States, has a root possessing some 
medical properties. It contains some Asparagin, a large amount of 
mucilage, and traced of tannin. It is used in decoction. 
Physiological Action.—The asparagin has little, if any, physiological 
effects beyond slight diuretic action ; but the mucilage makes it demulcent 
and slightly astringent. The pulp of the root has been utilized as a 
means of stiffening bandages applied to fractures. 
Therapy.—The fresh root, bruised and cut, is applied to fresh 
wounds, bruises, cracked nipples, etc. Internally the decoction is given 
in diarrhoea, dysentery, pulmonary affections, and other relaxed con- 
ditions of mucous membranes. It is utilized for the purposes to which 
marsh-mallow is ordinarily applied, in domestic cough mixtures, etc. 
SYZYGIUM JAMBOLANUM. See Jambol, page 713. 
TABACUM fU. S. P.).—Tobacco. 
Preparations. 
Infnsum Tabaci.—Infusion of Tobacco (3j-Oj). Pose, as an enema, f3ij—5ij- 
Vinum Tabaci.—Wine of Tobacco (5j-Oj). Pose, lHv-xxx. 
Oleum Tabaci.—Oil of Tobacco. A virulent poison. 
Nicotina.—Nicotine. Pose, 
Unguentum Tabaci.—Tobacco Ointment (3j or more to §j). 
Pharmacology.—The commercial dried leaves of Nicotiana tabacum 
(Solanaceae), indigenous to the southern portions of this country and 
cultivated indifferent parts of the world, are known as tobacco. It was 
carried to Europe by the Spaniards, and from the court at Lisbon it 
was taken to France, in 1560, by the French ambassador, whose name, 
Nicot, is preserved in the generic title applied to the plant. Its active 
principle is a liquid alkaloid, Nicotine. The fumes, when burning, con- 
tain pyridine, hydrocarbons of the aromatic series, small amounts of 
creasote, hydrocyanic and acetic acids, sulphur and carbon compounds, 
and certain gases, but little, if any, nicotine, which is decomposed by heat 
(Zeise). The existence of Nicotianin, a camphoraceous substance, has 
been affirmed by Hermbstadt, but is denied by Fluckiger, who con- 
siders it a fatt}r acid contaminated with a little volatile oil. Slight dif- 
ferences in composition exist in specimens grown in different places, as 
it is well known that the variation in flavor and quality is very decided. 937 
TABACUM. 
The best tobacco is grown in Cuba and Virginia. The Turkish 
is almost free from nicotine, and is very mild. In the East, the tobacco 
is sometimes tinctured with opium, in order to increase the narcotic 
effect. There are no officinal preparations. 
Physiological Action.—Tobacco is an acro-narcotic poison, acting 
energetically, in small doses, upon persons unaccustomed to its use. It 
is a nauseating emetic, its action being accompanied by great muscular 
relaxation ; the respiration and circulation are depressed, the temperature 
lowered, and the surface becomes cold and moistened with perspiration. 
It is a stimulant to the salivary and intestinal secretions, increases the 
peristaltic movements of the bowel and the flow of urine and perspira- 
tion. The muscles, which at first are relaxed, may be seized later by 
tremor or clonic spasms, or even tonic contractions, followed !)}• paresis 
of a transitory character. The nervous system is early affected by the 
drug. The motor nerves are paralyzed progressively from the periphery 
to the central organs; there are no marked effects upon the sensory 
nerves. The spinal and central centres become affected, and inco- 
ordination, a staggering gait, and vertigo are prominent symptoms of 
the toxic action. Finally, collapse and death may occur from paralysis 
of the heart or of the respiration. Similar results also follow the inha- 
lation of tobacco-smoke, though generally the}r appear in a much milder 
form than when the drug is swallowed. Poisoning has also followed the 
application of tobacco-leaves to a wound, in the case of a child 12 years 
of age. Nicotine is a most active poison, resembling hydrocyanic acid 
in the rapidity of its fatal effects. It is a powerful antiseptic. The use 
of tobacco in the form of snuff, or by chewing or smoking, is almost 
universal, and extends to Uncivilized and civilized alike, and is especially 
prevalent among the robust and those who lead an active life. In fact, 
tobacco must perform some important part in physiological life, or in the 
struggle for existence, or it would not be so widely used by men who are 
distinguished by the soundness of their judgment and their success in 
solving the problems of social existence in every other detail. The 
slightly depressing effects of tobacco, the power of increasing the secre- 
tions along the alimentary canal, while favoring peristalsis and the func- 
tion of the kidneys, are valid arguments for moderate indulgence in the 
post-prandial cigar; but there are also psychic effects which follow its 
use: it allays restlessness and muscular irritability, and creates a lassi- 
tude which is favorable to the pleasant flow of fancy, so happily illus- 
trated in the “ Reveries of a Bachelor ” of Donald G. Mitchell. The 
fact that it is a sexual sedative may or may not contribute to its popular- 
ity among those who lead sedentary lives, and who find it helpful to them 
from experience of its effects, rather than from any judgment based upon 938 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
an exhaustive knowledge of its physiological action. Occasionally, 
from smoking an unusually strong cigar, or too many of them, there is 
nausea and vertigo, even in practiced smokers. In such cases, a stimu- 
lant, such as aromatic spirit of ammonia or compound spirit of ether, 
promptly alleviates the distress. 
Poisoning and Antidotes.—In cases of acute poisoning and collapse, 
strychnine, and ether, or other stimulant may be given liypodermatieally, 
and the patient kept quiet and warm. Mustard-leaves may be applied to 
the chest and other parts of the body, and artificial respiration practiced, 
if needed. Stimulating enemata, containing alcohol or turpentine, may 
be useful; and, if there is much vomiting, brandy and ice may be given 
in small quantities. Tannic acid and iodides are chemically incompati- 
ble, and camphor is a physiological antidote. In what might be called 
chronic tobacco-poisoning, we have various inflammations of the mouth; 
epithelial cancer occasionally of the lip or tongue; follicular pharyngitis; 
bronchial catarrh; rapid, weak, and irregular action of the heart, which 
may become hypertrophied; dyspepsia, and weakness of sight, due to 
restriction of the field of vision (scotoma), which may progress to total 
blindness. Color-blindness has been attributed to the excessive use of 
strong tobacco. Muscular weakness and tremors and reduced capacity 
for physical and mental exercise are common symptoms of an abuse of 
tobacco. Probably, the need of something to restore the nervous system 
after using tobacco is one explanation of the frequent resort to alcoholic 
stimulants by users of the weed. The habit of excessive indulgence is 
especially injurious when the fumes are inhaled, as in cigarette-smoking, 
as by this means the poisonous products are brought directly into the 
air-cells, and are absorbed by the blood. In all such cases the treatment 
must begin by reduction, or complete cessation, of the habit of smoking, 
and the administration of strychnine sulphate in small doses, with open- 
air exercise. If there is much overaction of the heart, it can be steadied 
by small doses of opium, with digitalis or strophanthus. 
Therapy.—Tobacco is not used medicinally, its good effects as a 
cathartic not being of sufficient value to counteract its depressing action 
upon the heart and respiration, to which some persons are especially' 
liable to suffer. The only practical application is to afford an excuse for 
the prescription of an Havana after a good dinner, as an aid to digestion. 
Tobacco may be mixed with stramonium or belladonna, and the smoke 
inhaled, with relief in asthma. It should not be administered internally 
for strychnine poisoning, nor in tetanus, nor used per enema. 
Previous to the introduction of chloroform and ether, tobacco was 
much employed in order to produce muscular relaxation in strangulated 
hernia, after fracture of the femur, etc. Every purpose for which to- TAMARINDUS. 
939 
bacco was formerly used is now accomplished more efficiently and safely 
by the anesthetics. 
TAMARINDUS (U. S. P.).—Tamarinds. 
Pharmacology and Therapy.—The preserved pulp of the fruit of 
Tamarindus Indica (Leguminose) is ouly used in medicine for the 
purpose of making a refrigerant and somewhat laxative infusion, and 
also as an ingredient in the confection of senna. A tamarind whey, which 
may be used as a refrigerant in fevers, is made by infusing an ounce of 
the pulp in a little boiling water, and adding this to a quart of milk. 
TANACETUM (U. S. P.)._Tansy. 
Pharmacology.—The leaves and tops of Tanacetum vulgare (Com- 
posite), or common tansy, contain a bitter principle, Tanacetin, a vola- 
tile oil, tannic acid, etc. The dose of the volatile oil is n\i—iij; a fluid 
extract and an infusion (5j-Oj) are also used. 
Physiological Action.—Tansy is an aromatic, bitter tonic, and, by 
virtue of its volatile oil, it is diuretic and emmenagogue. Large doses, 
half an ounce or more of the oil, taken to procure abortion, cause dis- 
turbance of the respiration, depression of heart’s action, clonic spasms, 
stupor, and death ; sometimes it causes abortion, but only because of its 
violent irritant action upon the gastro-intestinal tract, which may lead to 
inflammation. 
Poisoning.—The treatment of an overdose is the free use of demul- 
cents and purgatives to clean out the stomach and bowels, followed b}' 
opium and bismuth and diffusible stimulants. 
Therapy.—Tansy is a useful ingredient in functional dysmenorrhoea, 
amenorrlioea, and ovaralgia, in doses of in pill, or dropped on 
sugar. In suppressed menstruation from cold, it may be given in con- 
junction with hot drinks and hot applications. It has some anthelmintic 
effects, but should not be used for this purpose. 
TARAXACUM (U. S. P.).—Dandelion. 
jPreparations. 
Extraction Taraxaci (U. S. P.).—Extract of Taraxacum. Dose, gr. x-xl. 
Ext. Taraxaci Fluidurn (U. S. P.).—Fluid Extract of Taraxacum. Dose, f 3i-ij. 
Infusum Taraxaci.—Infusion of Taraxacum (§ij-Oj). Dose, f§i-ij. 
Pharmacology.—The root of Taraxacum dens-leonis (Composite), 
or dandelion, should be gathered in the autumn. It is a well-known 
common perennial of America and Europe, bearing a yellow head of 
flowers on a slender peduncle, from a cluster of radial leaves. All 
parts of the plant contain a milky, acrid juice, which exudes when the 
plant is cut or bruised. It contains asparagin (found also in asparagus, 
marsh-mallow, liquorice-root, wahoo or euonymus, the potato-plant, and 940 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
the root of the locust-tree—Robinia pseudacacia), which has little, if 
any, therapeutical value. The active principles are Taraxacin and 
Taraxacerin ; the former is dissolved out by hot water, the latter by 
alcohol, from the insoluble residue. The root also contains inuline, 
mannite, and resin. 
Physiological Action.—Dandelion preparations are bitter, and probably 
stimulate the digestive secretions and act as a tonic. It is a feeble, 
hepatic stimulant, according to Rutherford. It is somewhat laxative, 
and also diuretic. 
Therapy.—In deficient secretion of gastric juice or of the bile in 
atonic dyspepsia and torpid liver, taraxacum acts as a mild stomachic 
and is of service in duodenal dyspepsia. Dandelion is also prescribed 
in catarrhal jaundice. It has no specific action in liver disorders, but 
is often combined with other remedies which have such effect:— 
Potassii iodidi, 3j. 
Ext. taraxaci fl., 
Syr. glycyrrhizae, fia f^jj. 
M. Sig.: A tablespooul’ul four times daily, for incipient cirrhosis of the liver. 
The fluid extract of taraxacum is an acceptable vehicle for nitro- 
hydrochloric acid or the chloride of ammonium. 
TEREBINTHINA (U. S. P.).—Turpentine. 
Preparations. 
Oleum TereUnthinee (U. S. P.).—Oil of Turpentine. Dose, blv-xv, or as an anthel- 
mintic, f§ss. 
Linimenlum Terebinthince (U. S. P.).—Turpentine Liniment (resin cerate, 65 parts; 
oil of turpentine, 35 parts). 
Linimentum Cantharidis (U. S. P.).—Cantharides Liniment (cantharides, 15 parts ; 
oil of turpentine, 85 parts). A strong counter-irritant. 
Pharmacology.—Turpentine is a concrete oleoresin, obtained from 
Pinus Australis, and from other species of Pinus (Coniferte). It con- 
sists of a volatile oil, which is known as oil of turpentine, or, incorrectly, 
spirit of turpentine, and resin. (See page 854.) The oil is distilled from 
any variety of Pinus capable of furnishing it, and, at first, is a thin, 
limpid liquid, but afterward gradually absorbs oxygen from the air and 
forms resin, which makes it thicker. Old oil of turpentine is an ozonizing 
agent, and is recommended in cases of phosphorus poisoning. Chian 
turpentine (Pistacia terebinthus), coming from Chio and Cyprus, does not 
materially differ from the ordinary form, except that it has a more agree- 
able odor, resembling that of lemon or fennel; and as it does not come from 
anjr species of Pinus, but is produced by a larch-tree (belonging to the 
Anacardiaceae), it is not an officinal variety. It is given in doses of 
gr. iii-v, in an emulsion. White turpentine (Thus Americanum, Ph. B.) 941 
TEREBINTHINA. 
is identical with the whitish, granular, under layer, or solid matter, de- 
posited by turpentine upon standing ; it is the spontaneous exudation 
upon the tree, which is scraped off' and sent to market in yellowish-white 
masses, known under this name. The various forms of turpentine are 
soluble in alcohol, forming what is commonly called varnish. Turpen- 
tine is very inflammable, and burns with a heavy cloud of black smoke 
of unconsumed carbon. The oil is inflammable and explosive. The oil 
of turpentine possesses a peculiar, characteristic odor and taste, has a 
specific gravity of 0.86, is soluble in alcohol, ether, chloroform, glacial 
acetic acid, benzol, and insoluble in water. It is a solvent for wax, 
iodine, sulphur, phosphorus, and fixed oils. Rectified oil of turpentine 
is oil which has been re-distilled ; it is the only form suitable for internal 
administration. 
Canada Turpentine, or balsam of fir, is officinal (see Terebinthina 
Canadensis). It is a liquid oleoresin, obtained from Abies balsamea, 
used principally in the arts and in mounting microscopic objects. 
Physiological Action.—The oil of turpentine has valuable antiseptic 
qualities. When applied to the skin it produces redness, tingling, and 
irritation, and may cause inflammation and blistering. In some cases it 
even gives rise to ulceration. Some persons are very susceptible to its 
effects, and the local application will cause marked systemic disorder, 
with an erythematous rash. Desquamation may follow. In small doses 
(rqix-xx), oil of turpentine is a stimulant; in large amounts, an irri- 
tant. Doses of f3i—ij cause burning in the mouth and stomach, with 
thirst; larger quantities give rise to vomiting and purging, with tenesmus ; 
these effects, however, be avoided by combination with other agents, 
and especially demulcents. Upon the circulation, the effects are those 
of a cardiac stimulant, the pulse is increased in force and in frequency, 
but toxic doses occasion collapse, with feeble pulse. According to 
Kobert, medicinal doses increase the blood-pressure by “ powerfully 
stimulating the inhibitory reflex centre, and also the vasomotor centre,” 
but very large doses paralyze both centres, the blood becoming dark and 
the heart paralyzed. Injection of oil of turpentine into the vessels 
causes lowering of blood-pressure, with increase of pulse-rate. In small 
doses it produces vascular contraction. From the very diffusible nature 
of this substance, it readily finds its way into the circulation, and is 
carried to the nerve-centres. After poisoning by it, the brain has the 
characteristic odor of turpentine ; it has, therefore, been inferred by 
Bartholow that it exerts a direct influence upon the nerve-cells. It is 
through the nervous system that its effects are mainly manifested. After 
moderate or continued doses, slight exhilaration, like that following- 
alcohol, is observed, followed by an hypnotic effect; toxic amounts cause 942 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
delirium, with depressed intellection or stupor, impaired physical power, 
defective co-ordination (followed by paralysis), coma, with dilated pupils, 
and death. Such amounts have caused complete muscular relaxation, 
profound insensibility, and abolition of all reflex movements. Six ounces 
have occasioned death in an adult, preceded by opisthotonos ; “ the brain, 
heart, lung, and viscera were found gorged with blood.” 
Turpentine is eliminated by the skin and bowels, but principally by 
the bronchial mucous membrane and kidneys. Its odor is perceptible in 
the breath. It communicates to the urine a smell similar to that of 
violets, though, when the dose has been large, the urine possesses a tere- 
binthinate odor. Heat and dryness of the skin, pruritus, and a red rash 
sometimes result from the internal use of turpentine. 
Treatment of Poisoning.—Where persons have been made sick by the 
vapor of turpentine, as by sleeping in a newly-painted room, it is neces- 
sary to give them a supply of piire, fresh air, with cardiac stimulants 
and diuretics, encouraging the action of the kidnej’s and skin by hot 
drinks and pilocarpine. If large amounts have been swallowed, demul- 
cents with opiates are required. 
Therapy.—Oil of turpentine is a valuable counter-irritant in perito- 
nitis, pneumonia, bronchitis, asthma, and painful disorders, such as lum- 
bago, pleurodynia, myalgia, etc. A turpentine stupe consists of a piece 
of flannel heated by steam or by being wrung out of hot water, with a 
few drops of turpentine sprinkled upon its surface just before application. 
Spongiopiline may be similarly used. A mixture of equal parts of tur- 
pentine and yelk of egg is also serviceably applied to the skin for the 
same purpose. A turpentine stupe should be removed as soon as it 
causes pain. In rheumatic joints, a liniment containing turpentine is 
useful, but the officinal liniment requires dilution :— 
I) Liniment, terebinthinae, 
Tr. opii, aa f^j. 
Lin. saponis, l^iij. 
M. Sig.: For external use in rheumatism, to be used with friction. 
In peritonitis turpentine can be applied over the abdomen, either 
alone or combined thus, with much benefit:— 
Oiei terebinthinae, 
Olei olivae, aa f 
Mass, hydrargyri, 
M. Sig.: Apply warm with flannel over the abdomen, in peritonitis. 
Preparations containing turpentine are advantageous external appli- 
cations in inflammatory affections of the larynx, pharynx, and tonsils. 
In diphtheria it has been beneficially employed as a topical remedy, 
being applied by means of a brush, or administered in the form of a spray 943 
TEREBINTH IN A. 
or by inhalation of the vapor. This substance has been used with suc- 
cess in the treatment of severe burns, accompanied by constitutional de- 
pression. The injured area is first washed with turpentine, after which 
a mixture of resin ointment and turpentine is applied. Turpentine is 
likewise efficacious in the treatment of chilblains. An ointment of tur- 
pentine is officinal in the British Pharmacopoeia, and is used with advan- 
tage in chronic eczema, psoriasis, and alopecia circumscripta. It may 
also be applied with good effect to unhealthy or indolent ulcers. Inter- 
nally, the oil of turpentine is antiseptic and astringent in some forms of 
diarrhoea, especially of a catarrhal character. 
It is valuable in acute dysentery after the violence of the attack has 
somewhat subsided. Turpentine is likewise useful in epidemic dysentery. 
A few drops of this oil form an excellent remedy in flatulence. In typhoid 
fever, small doses, given in conjunction with the mineral-acid treatment, 
are a valuable adjunct, especially when the tongue is red, dry, and clean,, 
and there is abdominal distension. It is best given in emulsion :— 
01. terebinthinae, . f^ss. 
Pulv. acaciae, . . . . v 3iv. 
Aquae einnamomi, f j|viij. 
M. secundem artem. 
Sig.: One tablespoonful every two or thrCfe hours in typhoid fever, or the whole 
amount may be taken at once to remove a tape-worm. 
This remedy is, furthermore, valuable in typhoid fever b}7 relieving 
tympanites and restraining hemorrhage. If diarrhoea persist or recur 
during convalescence from this disease, recourse should be had to tur- 
pentine. In various forms of haemorrhage, turpentine is valuable, as in 
haematuria, purpura haemorrhagica, and in gastric ulcer. It has been 
found efficient in post-partum haemorrhage, and is peculiarly valuable in 
this condition on account of the rapidity of its action. Turpentine also 
checks the bleeding of scurvy. It is especially in passive haemorrhage 
that this remedy is of service. In haematuria it has likewise been given 
with success, but it must be employed only in small doses, and its effects 
very carefulty watched. The unpalatable taste of this liquid is not 
infrequentl}7 a bar to its administration. When the dose consists of but 
a few drops they may conveniently be given in capsules. Glycerin, with 
the addition of a drop or two of oil of gaultheria, is said to disguise the 
taste of turpentine. The following has been recommended as a mixture 
of not unpleasant taste :— 
$ 01. terebinthinae, f3lj. 
f3iss. 
Syrup, aurantii, f^iss. 
Aquae, q. s. ad f§vj. 
M. Sig.: Dose, a teaspoonful. 944 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
In chronic cj’stitis, p3relitis, and gleet, and in broncliovrhoea, small 
doses of oil of turpentine check the discharge and act as an antiseptic. 
Incontinence of urine, spermatorrhoea, and prostatorrhoea dependent 
upon relaxation are not infrequently relieved by turpentine. In low 
fevers the addition of a drachm of this oil to a hot punch often rouses 
the patient from a condition of stupor, and acts as a •stimulant to the cir- 
culation. Asa cardiac stimulant, turpentine is of service in puerperal fever, 
phlegmonous erysipelas, and yellow fever, in capillary bronchitis, pneu- 
monia, and emphysema. In gangrene of the lung it diminishes foetor. 
A mixture of turpentine and ether (equal parts) is supposed to have 
some influence in removing gall-stones, but it is not probable that it has 
the effect of dissolving them, as was claimed by Durande; the elfects 
are those of a carminative and antispasmodic. It is useful in this com- 
bination (1 part to 3 of ether) in colic as an anodyne. Dr. Huglilings 
Jackson used oil of turpentine in chorea. The vapor of steam, impreg- 
nated with turpentine, is employed for inhalation in laryngeal and bron- 
chial disorders. In erysipelas it may be painted on the surface and taken 
internally. It is a good local application in ringworm, and has been also 
employed in some cases of psoriasis by Dr. Crocker in the 
form of an embrocation with olive-oil (1 to 4), gradually increasing the 
strength until the pure turpentine-oil is used. The same writer has derived 
good results in psoriasis and chronic eczema from the internal administra- 
tion of oil of turpentine in doses of 10 to 40 minims in emulsion after each 
meal. King Chambers has found that an enema containing half an ounce 
of the oil, or more, is of great value in sciatica ; in which affection this rem- 
edy is sometimes beneficially given internally in doses, repeated 
for several successive nights. In other forms of neuralgia it has proved 
of service. It seems to be of particular value in debilitated or aged sub- 
jects, in whom degeneration of nerve-tissue has occurred. In such 
cases 2-drachm doses have been found more efficient than smaller 
quantities. Phillips thinks turpentine particularly indicated when 
neuralgia is of rheumatic origin. This oil is of undoubted efficac3T in 
chronic rheumatism, relieving the pain and checking the progress of the 
disease. Amendment takes place under the influence of turpentine in 
rheumatic sclerotitis, iritis, and choroiditis. Nervous headache is some- 
times relieved by this agent; 20 drops of turpentine thrice daily is 
strongly recommended in lumbago b3’ Dr. George Bird. According to 
Begbie, turpentine is of service in hydatid cysts, especially of the lung. 
Phillips has found this remedy, in doses of 1 or 2 minims, night and 
morning (not fasting), to be of service in certain chronic cases of albu- 
minuria unattended by pronounced symptoms of Bright’s disease, re- 
ducing the amount of albumin and improving the general condition. TEREBINTHINA. 
945 
As a general rule, the addition of a drachm or two of oil of turpen- 
tine to an enema makes it more stimulating, and therefore this treatment 
can he adopted in narcotic poisoning. An enema containing turpentine 
relieves flatulence and constipation, and, as a derivative, is of value in 
sun-stroke and cerebro-spinal meningitis. As an anthelmintic, it may be 
combined with castor-oil and is very effective against round worms as 
well as tffinia. 
Caution.—Being a stimulating diuretic, the oil of turpentine should 
be used with caution, as it is apt to produce frequent and painful mictu- 
rition, with bloody urine, strangury, and inflammation of the kidneys. 
These symptoms may result from constant inhalation of its vapor. 
Hsematuria is not uncommon among sailors engaged on vessels carrying 
turpentine. Priapism, menorrhagia, and dysmenorrhcea are sometimes 
occasioned by turpentine. The free use of barle}'-water and other demul- 
cents, the hot bath, and free purgation will generally quickly relieve the 
symptoms unless nephritis should occur. Turpentine should not be 
employed when cardiac hypertrophy or atheroma of vessels exists. 
Chian turpentine has been recommended for the cure of scirrhus and 
other malignant disease of the uterus by Mr. Clay, of Manchester. In 
spite of his favorable experience, similar good results have not followed 
its administration in the hands of other observers. The pain of cancer 
is, however, not infrequently assuaged by Chian turpentine. Its adminis- 
tration in doses of 5 to 15 grains has likewise been followed by improve- 
ment in pityriasis rubra. 
Terebene is obtained by subjecting oil of turpentine to the action 
of sulphuric acid and distilling at a temperature of 160° F. It is a 
clear, mobile liquid, having a peculiar, fresli-pine odor and pungent taste; 
freely soluble in alcohol, chloroform, and ether, but sparingly soluble in 
water. In doses of it is given with benefit in winter cough, with 
muco-purulent expectoration, by Dr. Murrell. He finds it useful as an 
antiseptic in flatulent dyspepsia; also in cystitis and gleet. In diseases 
of the genito-urinary tract, it can be prescribed as follows :— 
Terebense, flic. 
Tinct. belladonna;, Hllx. 
Salolis, gr. c. 
M. et ft. capsulse no. xx. 
Sig.: From four to six capsules a day, in gleet, stricture, and irritation of the bladder. 
In bronchitis and bronchorrhoea, in emphysema, in catarrhal affec- 
tions of the upper air-passages, even in phthisis, it has been found highly 
valuable for inhalation. It has no specific action when administered in 
phthisis, but probably exerts some local astringent and antiseptic effect 
upon the bronchial mucous membrane, by which it is chiefly excreted. 946 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Terebene has been used with benefit in puerperal fever. In genito- 
urinary disease, it has been given as a substitute for oil of sandal-wood. 
It should be administered in capsules in the dose of 5 or 10 minims, 
repeated every three hours. In some cases it irritates the stomach, and 
might then be made into an emulsion. 
Terebinthine, a hydrocarbon of similar composition, is obtained by 
distilling oil of turpentine with an alkali. By hydration, it is converted 
into terebinthine hydrate, commonly called terpene hydrate, a crystalline, 
solid bod}r, soluble in glycerin. Acids convert it into terpinol, another 
liquid body similar to terebine, but given in smaller doses ("lii-v). It 
is used to fulfill very much the same indications as the preceding. The 
hydrate of terpene, being a solid, is given in capsules, in bronchial affec- 
tions, coughs, catarrhs, colds, etc., in doses of gr. ii-x. It should not be 
confounded with a body of similar name, terpene, found in eucalyptus. 
TETRONAL. 
Dose, gr. v-5j. 
Pharmacology and Physiological Action.—Tetronal and trional are 
allied to sulphonal, having the same general formula, except that whereas 
sulphonal contains only two ethyl groups, trional and tetronal con- 
tain three and four, respective!}'. Baumann and Kast have published 
the results of a number of physiological experiments with compounds 
allied to sulphonal, from which they drew the conclusion that the hyp- 
notic action of this class is a function of the ethj’l groups in the com- 
pound, and proportionate in intensity to their number, and that the 
SOg group exercises no influence in this direction. These results were 
so suggestive that Barth and Rumpel repeated the experiments clini- 
cally and on the human subject. The results obtained corresponded to 
the observations made upon dogs only so far as to demonstrate that 
tetronal and trional actually possessed hypnotic properties, but they did 
not confirm the theory, since practically the same doses were required in 
order to produce the same effects as those of sulphonal, instead of one- 
half to two-thirds, as might have been expected. These agents might 
be useful in cases where sulphonal cannot be taken. No injurious effects 
were observed in any of the 220 cases in which trional and tetronal were 
administered.* 
Therapy.—In delirium tremens, tetronal is less efficient than sul- 
phonal; but as a hypnotic tetronal was found, in 14 cases out of 30, 
superior to the latter drug, in 6 cases equal, and in only 4 inferior. 
Trional in 17 cases was superior, in 6 cases equal, and in 7 inferior. 
* Pharmaceutical Journal and Transactions, August 30, 1890, and Therapeutic Gazette, 
October 15, 1890, p. 700. THEINA. 
947 
Barth and Rumpel conclude that the indications for the use of these 
compounds correspond with those of sulphonal, and in certain nervous 
conditions which are refractory to this drug the others may prove more 
effective, or, at least, are useful substitutes. 
THEINA.—Theine. 
An alkaloid obtained from Camellia tliea, probably identical with 
caffeine. (See pages 491 and 502.) 
THEOBROMA.—Cacao, Chocolate. 
Preparation. 
Oleum Theobromce (U. S. P.).—Cacao-Butter. 
Pharmacology.—The seeds of the Theobroma cacao (Sterculiacese) 
are oval, and consist of shells and kernels, both of which contain an alka- 
loidal principal called Theobromine (about 2 per cent.), analogous to caf- 
feine (the former being dimethyl-xanthine, the latter trymethyl-xanthine), 
and a yellowish-white, solid oil,or fat, known as Cacao-Butter. This has 
a faint, characteristic, pleasant odor, is almost tasteless, and has a neutral 
reaction, melting at the temperature of the surface ot the body. It is 
nutritious, but in medicine is chiefly valuable as a basis for supposi- 
tories, and for external application in massage. Chocolate is an article 
of food prepared from the roasted kernels, which are ground into a fine 
paste with sugar and flavored with vanilla. When this is added to boil- 
ing milk in proper proportion, a pleasant restorative article of diet is made, 
but rather oily', on account of the presence of the cacao-butter. When 
the cacao-butter is partly removed by pressure and the kernels roasted 
and ground, as before, it is known as cocoa,—an unfortunate name, since 
it causes confusion by resembling cocoa, or the cocoanut-tree, and coca or 
the erythroxylon coca, the latter also being the source cf an exhilarating 
beverage used in South America. Cacao-butter is chiefly stearin ; it does 
not become rancid. It has recently been ingeniously substituted in a 
milk food for infants (Lacto-Preparata of Reed and Carnrick) in order to 
overcome the objection of the deficienc}’- of fat, since in all these prepa- 
rations most of the cream has to be removed, because it readily becomes 
rancid and cannot be kept without developing fatty acids. Cacao-butter 
is largely used in making suppositories, of which the following may be 
taken as an illustration :— 
Ext., krameriae, gr. v. 
Ext. opii, gr. ss-j. 
01. theobromae, gr. xv. 
M. et ft. suppositorium no. i; mitte tales no. vj. 
Sig.: Insert one at night for irritable haemorrhoids. 948 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
In preparing suppositories the addition of spermaceti causes the 
mass to congeal more rapidly and renders it less apt to adhere to the 
molds. There are no officinal suppositories in the United States Phar- 
macopoeia. 
Physiological Action.—The physiological effects of theobromine are 
analogous to those of caffeine, but it does not stimulate the central 
nervous system to anything like the same extent, and is poisonous only 
in doses five or six times as great as the latter drug. The effects upon 
the vasomotor centre in the medulla are also much less. Schroeder* 
demonstrated that caffeine acted as a diuretic by direct stimulation of 
the renal epithelium, and subsequently has shown that theobromine acts 
in the same way.f He also showed that theobromine was less poisonous, 
and that it was a more powerful and lasting diuretic. GramJ confirmed 
these observations, but found theobromine insoluble and likely to cause 
nausea. He, therefore, recommends a double salicylate of theobromine 
and sodium, containing 50 percent, of theobromine, as a substitute, which, 
from its effects, has been called diuretin. This salt has a bitter taste; is 
a white powder, soluble in half its weight of hot water, and not deposit- 
ing in cooling. It is best given in solution with an aromatic water; in 
syrups it is liable to deposit, and in powders it is apt to decompose in a 
short time. He gave it in 15-grain doses, five or six times daily. 
Therapy.—Diuretin has been tried in various diseases by Hoffmann.§ 
who gave about 75 grains daily; he found it useful in pleuritic effusion. 
In acute nephritis the amount of urine was tripled. In disorders of the 
circulation attending lesions of the heart, Hoffmann reports in all great 
diuresis, decrease in oedema, and strengthening of the pulse. The diu- 
retic action is usually manifested within the first twenty-four hours, and 
gradually reaches its maximum between the second and the sixth day. It 
falls rapidly upon discontinuing the drug, or after the disappearance of 
the dropsy. The amount of albumin in the urine was not much affected, 
except that in the heart-cases there was distinct lessening. No cumula- 
tive effects were observed, and the theobromine was rapidly excreted in 
the urine. Dyspnoea, bronchitis, anorexia, and general condition were 
all improved. Sometimes slight diarrhoea was noticed, but the drug was 
well borne by the stomach. Excitement and sleeplessness did not occur, 
but as the circulation improved the patient slept better. In some cases, 
where digitalis and strophanthus had failed to give relief, theobromine 
acted well, but, as a rule, it is not so generally useful. It may be com- 
bined with them in certain cases so as to assist in promoting diuresis. 
* Archiv fur Experiment. Pathologie, xxii, 1886. 
t Ibidem, xxiv, 1887. 
1 Therap. Monatshefte, January, 1890. 
§ Archiv fur Exp. Pathologic, xxviii, Ileft 1, 1890. 949 
THIOL 
In Hoffmann’s opinion it is much superior to caffeine. It lias the ad- 
vantage, over calomel and other mercurials, of acting upon the heart as 
well as the kidneys.* 
Cacao-butter is a good emollient and protective to apply to exco- 
riated nipples of nursing women, and to the thighs of children suffering 
with intertrigo. 
THIOL. 
Pharmacology and Physiological Action.— A. chemical composed of 
hydrocarbons and about 12 percent, of sulphur. It occurs as a soft, gray 
powder, or scales, as prepared bj- Riedel, who also furnishes it in liquid 
form. It resembles ichthyol in chemical composition, and it may pro- 
duce the same physiological and therapeutical effects. It is said to be 
non-toxic. 
Therapy.—Thiol is employed for the same purposes as an antiseptic 
and local stimulant as ichthyol, over which it has the advantage of being 
more agreeable in odor. Professor Schwemmer reportsf cases of herpes 
zoster and dermatitis herpetiformis successfully treated with a 10-per- 
cent. solution of thiol, used twice daily. He recommends it in other 
erythematous disorders. 
Thio-Resorcinum.—Thio-resorcin is a sulphur substitution-com- 
pound of resorcin. It is in amber-yellow crystals, and is used instead 
of iodoform in minor surgery. It probably might also be used internally, 
in the same doses as resorcin. 
THUJA (U. S. P.).—Thuja, Arbor Vitae. 
Dose, f‘5ss-j, in fluid extract or tincture (20 per cent.). 
Pharmacology.—The fresh tops of Thuja occidentalis (Comferrej, or 
white cedar,| growing in the Northern United States, contain Pinipicrin, 
a bitter principle; Thujin, a yellow coloring principle. Thujetin is derived 
from the preceding. Its most important constituent is a volatile oil, 
which resembles savin in its physiological effects. 
Therapy.—Externally, the recent leaves have been used, rubbed up 
with ointment, as a stimulating antiseptic dressing for ulcers and con- 
dylomata. A strong tincture may be applied externally, in warts and 
excrescences, and given internally in 5-minim doses. In papillomata of 
various kinds, Dr. Piffard speaks highly of it, and considers it useful in 
gleet dependent upon granular urethritis. The oil has been given with 
the view of expelling worms, but should be cautiously used, as-it is a 
gastro-intestinal irritant. It has even brought on abortion in pregnant 
* Supplement to the British Medical Journal, January 3, 1891. 
t Wiener klinische Wochensclirift, No. 18, 1890. 
1 The Cupressus thyoides, an entirely different tree, is also known by the name of white 
cedar, and more appropriately. 950 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
women, but only does so by the violent disturbance it creates in the 
gastro-intestinal tract. In bronchitis, the vapor of thuja, steeped in 
boiling water, often increases expectoration, and has a secondaiy astrin- 
gent effect. 
Thuja has been used both internally and externally, with some 
success, in chronic rheumatism. In ainenorrhoea and prostatitis it lias 
been found of avail, and is said to have been serviceable in intermittent 
fever. This remedy seems to exert a certain influence upon the growth 
of malignant tumors, and has been thought to have a special power in 
restraining the haemorrhage which they occasion. It has also been 
employed in haemoptysis. 
The Oil of Pumilio Pine, from an allied species, has been used in 
drachm doses, given in milk, as a taeniacide. It is pleasant, effective, 
and apparently a safe remedy. 
THYMUM.—Thyme. 
Preparations. 
Oleum, Thymi (U. S. P.).—Oil of Thyme (principally used externally). Pose, Uli-ij. 
Tltymol (U. S. P.).—Thymol. Pose, gr. es—ij. 
Pharmacology.—The Thymus vulgaris (Labiateae), or thyme, is in- 
digenous to Europe, but cultivated in gardens as an herb. The volatile 
oil is officinal; it has a strong odor, a characteristic pungent taste, a 
neutral reaction. It consists of two portions, the lighter and more vola- 
tile being the hydrocarbons Cymene and Thymene, the second being 
chiefly Thymol, which is officinal. It should be quite free from carbolic 
acid, with which it might be adulterated. Thymol crystallizes in hex- 
agonal forms, nearly or quite colorless; has an aromatic, thyme-like 
odor ; a pungent, aromatic taste, with very slight caustic effects upon the 
lips, and a neutral reaction. It liquefies with camphor. It is soluble in 
about 1200 parts of water and 900 of boiling water, freely soluble in 
alcohol, ether, chloroform, benzine, glacial acetic acid, and oils. 
Physiological Action.—In its effects, the oil of thyme is very much 
like the oil of peppermint, or origanum, and, in fact, is often commer- 
cially substituted for the latter. Thymol is a valuable antiseptic; it is 
less powerful than carbolic acid, but, on the other hand, is ten times 
less poisonous and much less caustic and irritating. 
Thymol paralyzes the end-organs of sensoiy nerves in the skin and 
mucous membranes, but is a local irritant, and cannot be used well for 
the purposes to which cocaine is applied. It is a powerful antiseptic 
and disinfectant. Internally, in doses of gr. xx-xxx per diem, it 
causes epigastric heat, sweating, singing in the ears and deafness, and 
it escapes chiefly by the urine, which is increased, and becomes olive- 
greenish, as after carbolic-acid poisoning. It lowers arterial tension 951 
TIGLII OLEUM. 
find reflex action, reduces tlie temperature, and may cause fatal coma. 
The nerve-centres of the cord are paralyzed by large doses. 
Therapy.—Yolkmau and other surgeons have utilized thymol in 
antiseptic dressings as a substitute for the more toxic and less agreeable 
carbolic acid. It has been found a good application in eczema, psoriasis, 
and ringworm. An ointment containing 10 grains of thymol to the 
ounce is of service in acne and alopecia circumscripta. The addition of 
a little alcohol renders it possible to prepare a l-to-1000 watery solution, 
which is efficient, and sometimes even needs to be weakened. A thymol 
solution is a useful injection in leucorrlioea. Thymol has been used both 
locally and internally, with success, in diphtheria. In solution it has 
been inhaled with benefit in laryngitis, and in phthisis it disinfects the 
sputum. It has also been administered internally in phthisis. Kuessner 
reported good results from the internal use of tlymol in diabetes, vesical 
catarrh, and infantile diarrhoea. 
Glycerin is a good vehicle, and, when properly diluted, a glycerite 
of thymol makes a good mouth-wash. In acute and chronic intestinal 
disorders, thymol has been employed by a number of clinical observers. 
Dr. Fred. P. Henry has used thymol, prepared with Castile soap, in gr. 
ii-iij doses every six hours. He reports that in typhoid fever the tem- 
perature falls, the stools become less frequent, cerebral symptoms 
diminish, and the tongue cleans off* and becomes moist. Testi has 
employed thymol in 150 cases of typhoid. lie says that the drug lowers 
temperature, diminishes tympanites, hinders fermentative processes in 
the intestinal tract, reduces the excretion of the urea, and increases the 
blood-pressure, without injury to the heart. Cainpi has used thymol 
with success as a tseniacide, according to the following method : 5 or 6 
fluidraclims of castor-oil are given at bed-time, and the next morning, 
beginning early, 10 grains of thymol are given every fifteen minutes. 
The worm is said to be expelled entire.* 
TIGLII OLEUM (IT. S. P.).—Croton-Oil. 
Dose, "li-ij- 
Pharmacology.—Croton-oil is a fixed oil expressed from the seed of 
Croton tiglium (Euphorbiaceae), an East Indian tree of moderate size. 
It is a pale-yellow, or brownish-yellow, rather viscid, and slightly fluor- 
escent liquid, having a somewhat fatty odor, a mild, oily, afterward acrid, 
burning taste, and a feebl\T-acid reaction. When fresh it is soluble in 
about 60 parts of alcohol; the solubility and therapeutic activity increase 
by age. It is freely soluble in ether, chloroform, disulphide of carbon, 
olive-oil, and oil of turpentine. It contains Tiglinic acid, and also 
several glycerides of fatty acids. 
* Annual of the Universal Medical Sciences, 1890, vol. v, A-136, 952 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Physiological Action.—The topical application of croton-oil to the 
skin causes irritation, inflammation, and a papular eruption, subsequently 
becoming pustular. Occasionally its application produces a general papulo- 
pustular eruption, scattered over the bod}". The pustules afterward dry 
up, and may give rise to scars if the oil was applied undiluted. The 
pustules are sometimes umbilicated, and, upon careless examination, the 
eruption might be mistaken for that of small-pox. When 1 or 2 drops 
of croton-oil have been swallowed vomiting may be produced, but in the 
course of an hour or two copious watery stools are passed, with symp- 
toms of irritant poisoning, particularly when larger doses have been 
taken. Congestion of the gastro-intestinal tract occurs, and death may 
ensue from resulting inflammation of the bowels or peritonitis. Part of 
the oil diffuses into the blood, and produces glandular liyperaemia, and 
possibly an eruption upon the skin. Sometimes, when applied to the 
skin, the contrary is observed, the remedy passing through into the 
blood and causing watery discharges from the bowels. When combined 
with an alkali, or with some other agents, while it promotes the peri- 
staltic action, the effects are more manageable and there is less danger 
of general toxic effects. It is a feeble hepatic stimulant, according to 
Rutherford. The toxic effects of croton-oil are combated by means of 
demulcent drinks and opiates. 
Therapy.—Croton-oil was formerly a favorite method of exciting 
counter-irritation, because it was convenient, simple, and rapid in its 
effects. On account of the danger of exciting suppuration and the re- 
sulting scars, it is rarely resorted to at present. If it be diluted with 
3 parts of oil of sweet almonds it is a little less prompt, but the result- 
ing inflammation is much milder, and several applications are sometimes 
required in order to bring out sufficient papules. It is valuable in 
disease of the chest, in incipient phthisis, pleuris}7, bronchitis, neuralgia, 
rheumatism, and glandular swellings. Counter-irritation b}r croton-oil 
is likewise serviceable in chronic laryngitis, ovaritis, and metritis. 
Pustulation of the shaven scalp was formerly esteemed beneficial in 
meningitis, but is a method of treatment scarcely to be advocated. Its 
use in ringworm induces an artificial kerion, which soon subsides and 
the disease disappears. It should not be used for this purpose in deli- 
cate children, especially those under 6 or 7 years of age; it should also 
be applied to a small spot, a little larger than a dime, and it should be 
used oidy in chronic cases. 
A liniment of croton-oil, officinal in the British Pharmacopoeia, 
contains 1 part of this oil, parts of oil of cajnput, and parts 
of rectified spirit; 5 minims of this preparation to an ounce of olive- 
oil is a stimulant application sometimes used in alopecia. In other TILIA 
953 
cases of $kin affection occasional small doses of croton-oil are useful in 
clearing the alimentary canal. 
Internally croton-oil is used as a drastic purgative in cerebral affec- 
tions, apoplexy, etc., acute mania, and in cases of injury to the head. 
It is serviceable on account of its depletory and derivative effect in 
uraemic coma. In comatose conditions the dose may be simply dropped 
upon the tongue, and two or three times the usual dose are required. It 
is a better plan, however,‘to dilute the oil with a little lard, butter, sweet- 
oil or castor-oil. This medicament is valuable as a hydragogue cathartic 
in the treatment of anasarca, and in many cases where a complete 
evacuation of the bowels is desired, to bring about prompt diminution 
of arterial pressure and derivative action. In some instances it would 
be proper to give croton-oil in obstruction of the bowels from impaction 
of feces, lead colic, or paralysis of the intestine. It may also be used 
as a vermifuge to expel tape-worms, but is so violent that the head is 
apt to be torn off and remain, unless an anthelmintic has been admin- 
istered previousl}7. Croton-oil should not be given to a pregnant woman, 
nor to a patient subject to haemorrhoids. 
TILIA.—Tilia, Linden-Tree. 
Pharmacology and Therapy.—The inflorescence of the linden-tree 
of Europe (Tilia vulgaris, T. parviflora, and T. grandiflora), nut. ord. 
Tiliaceae, has a faint but pleasant odor and sweetish taste. The flowers 
are employed in making an aromatic water, which is used as a vehicle, in 
France especial!}'. 
TOLUTANUM. See Balsamum Tolutanum, page 465. 
TONGA. 
Dose, gr. xx-5j, in fluid extract. 
Pharmacology.—A drug from the Fiji Islands, composed apparently 
of a mixture of several varieties of barks and roots, which are arranged 
in bundles. Drs. Ringer and Murrell, having made a series of experi- 
ments, which were reported in 1880, recommended it to the profession for 
further trial. It was supposed to be derived principally from the Rapliida- 
phora vitiensis (Schott), a creeping-plant of the order Aracese,and Premna 
taitensis (Schauer), a small tree of the natural order Verbenacese. A vola- 
tile alkaloid, Tongine, has been isolated from the former; the latter 
contains some volatile oil. The fluid extract, as made by Parke, Davis 
& Co., of Detroit, represents the therapeutic properties of this new drug. 
Physiological Action.—Beyond slight drowsiness, Ringer and Mur- 
rell observed no systemic effects from an ounce and a half of the fluid 
extract, given within three hours. The pupils and the secretion of the 954 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
mouth and skin were unaffected. The sensibility of the skin supplied 
by the fifth nerve remained unaltered. They saw no influence upon the 
pupil from a topical application. Dr. C. Bader states that the alcoholic 
extract, dropped into* a healthy eye, seemed to increase the power of 
accommodation, without affecting the size of the pupil, lie remarked, 
however, that in some cases large doses, taken internally, caused great 
dilatation of both pupils. Dr. T. II. Streets, U. S. N., reports the expe- 
rience of himself and several colleagues. They found a decided diminu- 
tion in the excretion of urea from 1-ounce doses, but no increase in the 
quantity of uric acid. The pulse, temperature, and pupils were un- 
changed. Two of the four experimenters noticed a tendency to cerebral 
congestion of short duration ; one was slightly purged. The S3,mptoms 
disappeared in about two hours, leaving no after-effects. 
Therapy.—From the claims made by its introducers, it was thought 
that tonga would be a valuable addition to the list of antineuralgic 
remedies, but the attempt of a London drug house to make a monopoly 
of the drug, which was defeated by a lawsuit, probably interfered with 
its use by the profession. In order that it should gain a secure position 
among remedies, it would be necessary to exercise supervision over the 
source of supply, so that it shall be of uniform strength and quality. 
Tonga is of marked service, however, in the treatment of neuralgia, 
especially when it involves branches of the fifth nerve. It has relieved 
pain in a large majority of the cases in which it has been employed. The 
fluid extract should be given in 1-drachm doses, and repeated at intervals 
of about two hours, while needed. Tonga is rather slow in its action, 
and it requires about two hours for the full effects of the drug to be 
manifested. Dr. Bader has seen good results from the local use of tonga 
in asthenopia, rheumatic iritis, and photophobia. 
TOXICODENDRON. See Rhus Toxicodendron, page 864. 
TRAGACANTHA (U S. P.).—Tragacanth. 
Preparation. 
Ifucilago Tragcwanthm (U. S. P.).—Mucilage of Tragacanth. 
Pharmacology.—Gum tragacanth is the product of trees growing in 
Asia Minor and Persia. It is a gummy exudation from Astragalus gum- 
mifer, and from other species of Astragalus (Leguminosae, Papilionacene). 
It is in white, flattened bands, which, in drying, become curled or 
twisted, and are afterward broken in small pieces. It is horn-like, or 
translucent; and, when moistened with water, it is converted into a 
gelatinous mass. It consists of Arabin, Rassorin, and a little starch. 
Tragacanth-paste is adhesive, and is used in practical pharmacy to paste 
1 *bels on bottles, boxes, etc. It is also the basis of most of the officinal TRIFOLIUM PRATENSE. 
955 
troches, and is of service in emulsions for the suspension and division of 
various powdered drugs, and for codliver-oil. 
Therapy.—Onl}' used in medicine, other than already stated, as a de- 
mulcent in pharyngitis, gastritis, and inflammation of the howels. Large 
amounts do not agree with the stomach, unless some antiseptic agent, 
like creasote or naphthol, is administered at the same time, to prevent 
fermentation. It contains a little starch, and has slight nutritive 
properties. 
TRIFOLIUM PRATENSE.—Red Clover. 
Dose, 5i-ij, in fluid extract or infusion. 
Pharmacology.—The flower-heads of red clover, or Trifolium pra- 
tense (Leguminosae), are fragrant and sweetish, containing a flavoring 
principle and sugar. The fluid extract and infusion are both employed. 
Physiological Action.—It is considered diuretic and alterative. 
Therapy.—The infusion of clover-tops is given to children suffering 
with whooping-cough, with good results. The fluid extract, containing 
alcohol, is employed externally in domestic practice for wounds and 
ulcers. A compound syrup of red clover, containing red clover, gr. 
xxxij ; stilliugia, gr. xvj ; berberis aquifolium, gr. xvj ; prickly-ash 
bark, gr. iv ; burdock-root, gr. xvj ; poke-root, gr. xvj ; cascara amarga, 
gr. xvj ; potassium iodide, gr. viij, in each fluidounce of the syrup, has 
been furnished to meet professional demands by Parke, Davis & Co., to 
take the place of several proprietary preparations of uncertain compo- 
sition. It is useful as an alterative in syphilis, struma, and some chronic 
forms of skin disease. 
TRILLIUM.—Trillium, Beth-Root. 
Dose, 5i-'j, in the form of fluid extract. 
Pharmacology.—The Trillium erectum (Liliaceae), growing in woody 
places in the Northern United States, contains in its rhizome an acrid 
principle, with tannin, etc. 
Physiological Action.—It is astringent, tonic, and antiseptic. 
Therapy.—In genito-urinary affections, luematuria, and pulmonary 
affections, trillium is used in the form of a fluid extract, which is also 
used externally for wounds. 
TRIMETHYLAMINI HYDROCHLORAS.—Hydrochlorate of Trime- 
thylamine. 
Dose, gr. iii-x. 
Pharmacology.— Trimetliylamine, with dimethylamine and tetra- 
methylammonium hydrate, are compound ammonia bodies, discovered 
by Hoffmann. Dimethylamine is a combustible gas. Trimetliylamine is 
also a gas at ordinary temperatures, with a strong ammoniacal odor and 956 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
an intense alkaline reaction ; with methyl iodide it forms a salt which, 
being treated, in solution, with silver oxide, yields silver iodide and 
tetra-methylammonium hydrate. The latter body, being subjected to 
dry distillation, decomposes into trimetliylamine and.methyl alcohol. 
Trimethylamine, (CH3) N3, exists already formed in Arnica montana, 
Chenopodium vulgaris, in the flowers of Crataegus oxyacantha, in ergot, 
in codliver-oil, and in various decomposing albuminous compounds, par- 
ticularly herring-brine, guano, urine, and coal-gas tar. Vincent extracted 
large quantities from the residue of the distillation of fermented beet- 
juice, or the refuse left after making beet-sugar. Propylamine is usually 
an impure trimethylamine in solution ; the name properly belongs to an- 
other, though similar, compound. The hydrochlorate of trimethylamine 
is a comparatively stable salt and has been used in medicine. 
Physiological Action.—Trimethylamine hydrochlorate, in strong 
solution, acts as a caustic ; when applied to the lip it causes a burning 
sensation and the epithelium afterward exfoliates, leaving a superficial 
ulcer. Internally, it acts as an irritant to the digestive tract, and to its 
local action Dujardin-Beaumetz ascribes the cause of the fatal result from 
a large dose; he states, however, that as much as 75 grains may be given 
without fatal effect. Doses of about 20 grains, repeated several times, 
cause, in rabbits, general distress, tremor, with loss of motor power, 
hypernestliesia, and increased reflex excitability; the same amount 
injected under the skin produces death. In the human subject, the first 
effect, from moderate doses, is increase of the heart’s action, but soon, 
especially if full doses are given, the opposite condition is set up; the 
pulse-rate and temperature are lowered. No colic or diarrhoea occurs, 
but the odor and taste are so unpleasant that the remedy is often rejected 
by the stomach. No increase of perspiration or of the urine is reported. 
Dujardin-Beaumetz states that the excretion of urea is diminished by the 
drug. Fatal narcosis may occur from retention of carbonic-acid gas in 
the blood, but Phillips ascribes death more commonly to the depressing 
effects of the remedy upon the spinal cord. 
Antidotes to Toxic Action.—The proper treatment of poisoning 
would be by external heat, and counter-irritation by mustard or turpen- 
tine, and opium and belladonna or atropine to control the symptoms. 
The tincture of capsicum, with digitalis, strophanthus, or nux vomica, 
would be useful in counteracting the effects upon the circulation. 
Therapy.—This drug was introduced for the purpose of treating 
acute rheumatism, and in cases with high temperature and active circu- 
lation it has produced good effects. It has also been used as an anti- 
pyretic in other maladies, in doses of 2 grains repeated every three or four 
hours. It should be given in capsules or in solution with peppermint- TRITICI FARINA. 
957 
water, well diluted. Trimethylamine is of service sometimes in chronic 
rheumatism, in which it has been also used as a liniment, 1 part being 
mixed with 3 parts of glycerin. It has been administered in gout. 
TRITICI FARINA.—Wheat-Flour. 
Pharmacology.—The Triticum vulgare or wheat, is a 
well-known source of food. The farina is a line, white flour, prepared 
from the seed ; it is impalpable, inodorous and of insipid taste. It con- 
sists of starch, 70 per cent.; gluten, 12 per cent.; fixed oil, 2 per cent.; 
together with cellulose, sugar, and water. It yields about 2 per cent, 
of ash, containing 50 per cent, phosphoric acid. It is highly nutritious, 
and contains a large amount of nitrogenous matters. With cold water, 
it forms a granular, pasty mass, not very adhesive ; but, with hot water, 
the starch-granules swell up and burst, making a homogeneous, jelly- 
like mixture. 
Physiological Action.—It is bland and unirritating, and forms a good 
antidote, when mixed with water, in case of corrosive poisoning. The 
starch is antidotal to iodine and its preparations. 
Therapy.—Wheat-flour dusted upon an inflamed surface coats it 
over with a layer which protects it from the air. It is a convenient 
application to recent burns and scalds, or erysipelas; but in hot weather 
it should be associated with some antiseptic, to prevent the development 
of insects, the ova or larvse of which very often find their way into flour, 
especially if exposed to the air. It has been asserted that a tablespoonful 
of flour, in a glass of cold water, swallowed night and morning, will check 
the development of boils. As the basis of bread, wheat-flour enters into the 
question of nourishment for the sick, which belongs more to the province 
of the nurse than the physician, although the medical attendant should 
be perfectly familiar with the digestive and nourishing qualities of any 
preparation which may be submitted to his judgment, in order to pro- 
nounce upon its fitness, or the reverse, for the patient. 
TRITICUM (U. S. P.).—Couch-Grass. 
Dose, 5i-iv, in infusion or fluid extract. 
Pharmacology.—The rhizome of Triticum repens (Graminacese). It 
should be gathered in the spring and deprived of its rootlets. It is a 
common perennial, growing in the fields, and regarded as a weed. The 
rhizome contains Triticin, a gum, sugar (22 per cent.), but is devoid of 
starch and resin. 
Physiological Action.—It is demulcent and diuretic. 
Therapy.—Triticum may be given, in decoction, as a demulcent 
drink in fevers. This preparation, or the fluid extract, is useful in irri- 
tability of the bladder and chronic cystitis. In the latter affection, Sir 958 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Henry Thompson recommends a pint of the infusion or decoction, to be 
taken during the day. In chronic cystitis, irritable prostate, and in 
gleet, the writer has prescribed the following with triticum :— 
II Ext. tritici fl., f§iij. 
Tinct. belladonnae, ifllxxij. 
Sodii bicarbonatis, 3ij. 
M. Sig.: A teaspoonful in water every two or three hours. 
The fluid extract is a pleasant, malt-like preparation, lias some 
nutritive properties, and possibly may be of value in chronic bronchial 
disorders. The decoction is one of the many popular remedies for con- 
sumption. 
TUBERCULINUM—Tuberculin, Koch’s Lymph. 
Dose, gr. hypodermatically. 
Pharmacology.—At the meeting of the Tenth International Medical 
Congress, held at Berlin, September, 1890, Professor Robert Koch, the 
eminent bacteriologist, who, in 1874, had announced his discovery of the 
causus morbi of phthisis in the bacillus tuberculosis, again startled the 
medical world by declaring that he had finally, after much research and 
experiment, discovered an antidote to its effects. From observat ion upon 
animals, he felt warranted in stating that he had in his possession a 
means of protective inoculation which prevented the further develop- 
ment of the bacilli, and caused them to cease to become active, thus 
enabling the organism to recover and to defy subsequent inoculations. 
The history of this widely-heralded, great discovery is too recent to 
require to be detailed here. The profession was profoundly moved by 
the publication of the results of Koch’s experiments, and still further 
agitated by the clinical success that appeared, at first, to follow the 
trials of this wonderful agent in the human subject. The German gov- 
ernment took the very extraordinary, and probably unprecedented, po- 
sition among civilized nations, of becoming protector and sponsor for 
the novel remedy, by placing Dr. Koch, Dr. Pfuhl, and Dr. Libbertz, the 
physicians who alone knew the secret, under pledges of secrecy, and 
giving to them alone permission to prepare the “ lymph,”f as it was 
*One milligramme, by hypodermatic injection, cautiously increased, 
t The Berlin letter to the British Medical Journal, February 28, 1891, says: “The official 
regulations as to the sale of tuberculin have appeared. The chemists are to obtain their supply 
from Dr. Libbertz, who will continue to prepare the lymph under the supervision of Prof. 
Koch. It will be sold in sealed bottles containing from 1 to 5 cubic centimetres, and marked 
with the date of preparation. The chemists are to use the same precautions as with poison, and 
only to sell it in the original bottles and upon the written prescription of med cal men. A 
special book is to be kept for the entry of sales, etc., and in each case the quantity sold, the 
date of preparation, of purchase, and of sale, and the name of the physician prescribing it 
must be noted. Six months after preparation the lymph may no longer be sold. Bottles six 
months old should be returned to Dr. Libbertz, who will exchange them for new ones without 
extra charge. The price has been fixed at 6 marks (6s.) for a cubic centimetre, and 25 marks 
(£15s.) for 5 cubic centimetres. TUBERCULINUM. 
959 
called. Under strong pressure to remove the veil of secrecjq which 
placed the new agent under the ban as a proprietary remedy, Dr. Kocli 
revealed its composition and method of production, as a sterilized cul- 
ture of tubercle bacilli in blood-serum, preserved with gelatin ; but, not 
being absolved from his pledge by the German government, he refrained 
from giving full details of manufacture. The title “ tuberculinum,” 
applied by the medical journals to the product of Koch’s laboratory, is 
not a very fortunate one. In the first place the name may already be found 
in a dispensatory of homoeopathic materia medica, applied to an alleged 
remedy for phthisis, made by rubbing up the sputum of consumptive 
patients witli sugar of milk, and intended to be administered to other 
consumptives, who, if they properly understood the principle of the 
treatment, need only swallow their own expectoration in order to be 
cured. Koch’s lymph, on the contrary, consists of a tuberculous 
guinea-pig’s serum, diluted with glycerin and with some antiseptic agent, 
forming a liquid of a brown color, which is kept until used in hermeti- 
cally-sealed tubes. To use the lymph for the treatment of tuberculosis, 
it is dissolved in water, so that, as a rule, the first dose given a patient 
is 1 milligramme of lymph. This is given in the form of a hypoder- 
matic injection by means of a peculiar, hypodermatic syringe.* 
Physiological Action.—The following account of the technique and 
physiological action of the new remedy is taken from the report made 
by Prof. Ernest Laplace to Governor Beaver, Mayor Fitler, and the 
Faculty of the Medico-Chirurgical College, by request of whom he 
visited Berlin and investigated the method of Koch and the results of 
the new treatment:— 
“ The pure lymph keeps indefinitely, but, once dissolved, it soon 
becomes turbid from the development of micro-organisms; hence, Koch 
advises that the water used be a 2-per-cent, solution of carbolic acid, or, 
if pure water be used, the liquid to be injected should be sterilized by 
boiling previous to its being used. 
“ The forms of tuberculosis to be treated must be divided into two 
great classes :— 
“ 1. Tuberculosis of the skin and surgical tuberculosis. 
“ 2. Pulmonary tuberculosis. 
‘‘ In all cases of tuberculosis the remedy acts by creating a violent 
inflammatory process around the tuberculous tissue. This inflammation 
or reaction takes place after each injection of the lymph, and continues 
to take place until all the tuberculous tissue has been destroyed. The 
patient then reacts no longer, even under largely-increased doses; that 
is, 5 centigrammes, or even as much as 5 decigrammes of lymph. A 
*For description, see The Medical Bulletin, February, 1891, p. 69. 960 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
patient who does not react after any injection, even one as strong as 5 
centigrammes, is said to he free from any tuberculosis. A patient who 
ceases to react is likewise said to have, through the constant reaction, 
become free from his tuberculous condition. With these general con- 
siderations, the following is the result of the treatment in lupus and 
surgical tuberculosis :— 
“ Therapy.—From three to eight hours after receiving a sufficient 
dose, a lupus will redden, swell, and begin to secrete a thick serum. 
Fever rises to 39° C. (102.2° F.), or even as high as 41° C. (105.8° F.), 
in some cases, and will last from eight to twelve hours, when the tem- 
perature gradually sinks to below normal, sometimes as low as 36° C. 
(96.8° F.). When the reaction is very violent after one day’s inter- 
val, the same dose is again given, and the dose is increased only when 
the reaction ceases to be as violent. Gradually, during the course of 
treatment, the lupus, after thus oozing continuously, begins to cicatrize, 
and, by the time the patient ceases to react under increased doses of 
lymph, there exists a perfectly smooth surface where formerly an indolent 
tuberculous ulceration existed. 
“ In tuberculous affections of joints, these show the reaction by 
swelling, and, as a result, pain. The tuberculous tissue, being deep, 
cannot eliminate itself as promptly as in the case of skin tuberculosis ; 
hence the greater tediousness. Fistulae and open tubercular abscesses 
show increased secretion, and finally close after the elimination of the 
tubercular surfaces. 
“ In tuberculosis of bone, nothing short of the surgical removal of 
the sequestra can eliminate the parts acted upon by the lymph. 
“ In all cases the reaction consists in an apparently chemical union 
of the lymph with the tuberculous cells, resulting in a violent congestion 
or even inflammation of the neighboring parts. Tuberculous cells seem 
to be the only ones thus acted upon. This fact must be borne in mind 
to thoroughly understand the conditions of treatment in the second 
great class of cases; that is, pulmonary tuberculosis. Only such cases 
as are in the incipient stage are selected for treatment. In these the 
initial dose is always 1 milligramme. The patient reacts in exactly the 
same wa}’ as in other forms of tuberculosis, except that, owing to the 
inflammation, which must of necessity take place in the lungs, the res- 
piration is much more labored. Inasmuch as it is not always possible to 
diagnose the presence of small tubercles when they are disseminated, 
the danger of the treatment becomes apparent from the inflammation 
which will follow wherever tubercles exist, sometimes leaving not enough 
lung capacity to supply the needs of life; hence the fatal cases 
reported. TUBERCULINlDf. 
961 
“ Furthermore, the lung, not being able to rid itself of the tuber- 
culous material as easily as a superficial tuberculosis, it follows that even 
after the cessation of reaction, when the case ought to be considered as 
cured, the physical signs remain almost unchanged by auscultation and 
percussion, as it would require a very long time for such tissue to be 
resorbed. In a case of tuberculosis of the lungs, under the care of Dr. 
Cornet, the patient, aged 27, reacted, at first violently, under a dose of 
1 milligramme, and in one month of treatment did not react under a 
dose of 1 gramme of the pure lymph. In these cases, notwithstanding 
the fever that necessarily accompanies the reaction, the patients, as a 
rule, retain their appetite and increase in weight. Koch has determined 
that the treatment does not destroy the bacillus, the seeds of the disease. 
What is destroyed is that which has developed from the tissues under 
the irritation of the bacillus. If the remedy only did this, Koch’s 
object would not be reached. There is one means left for curing the 
tuberculous process. This is that the lymph should so act upon the 
system as to render it unsuited to let the bacilli of tuberculosis develop 
in it; in other words, Koch hopes that the remedy will confer immunity 
against tuberculosis in man, as he says it does in the guinea-pig. 
“ Professor Sonnenburg, under the direction of Koch, has applied 
surgical procedures to the treatment of cavities in the lungs, by 
resecting the ribs and scraping the cavit\r, then establishing drainage. 
The case is further treated by the lymph injections. 
“ So far, there are no cases, or, at least, a sufficient number, to estab- 
lish that immunity is conferred. Several cases of apparently-cured 
lupus have returned after a week’s cessation of treatment; and, as for 
the apparently-cured cases of other forms of tuberculosis, it takes a 
longer time for a recurrence to attract attention. 
“ Evil Results and Contra-Indications.—As to the evil effects of the 
h’mph, a collapse from even a dose of 1 milligramme has sometimes 
taken place, though no death has resulted in that condition. Patients 
have always been restored by the ordinary stimulants. The most 
dreaded after-effect, and the one upon which the French la}’ the most 
stress, is the possible constant irritation of the kidne}’s by the lymph, 
leaving these organs in a permanently-impaired condition. Albuminuria 
and hsematuria have not unfrequently been noticed. Whether this was 
due to the mere irritation by the lymph, or a local reaction in the kid- 
neys and the bladder because of the unsuspected existence of tubercles 
in these organs, is, of course, impossible to decide. 
“ The contra-indications to treatment arc, therefore, those lesions 
which, when undergoing the reaction, would directly or indirectly 
endanger life. They are, principally :— 962 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
“ 1. Extensive disease of the larynx. 
“ 2. Miliary tuberculosis or very extensive tuberculosis of the 
lungs. 
“ 3. Tubercular meningitis. 
“ Although there have been, by this time, many thousand cases 
already treated, it will be apparent, from the above, that the greatest 
difficult}' exists in forming even the slightest idea as to the number of 
true cures, if any. Of improvements there can be no doubt, but, since 
tuberculosis is such a slow process, it is manifest that at least two.years 
are required to ascertain positively whether the patient, who, after a 
course of treatment for any form of tuberculosis, has to-day ceased to 
react, has attained that immunity without which he is not to be called 
cured of tuberculosis. 
“ In a few cases a rapid development of tuberculosis has occurred 
in patients who have been treated with the ‘ lymph,’ and the question 
has arisen whether the inflammatory reaction had not provoked a migra- 
tion of tubercle bacilli from the original focus of disease to new locali- 
ties in the lungs, and, developing there, formed separate and rapidly- 
developing foci of disease. Whether it be really the case, or whether 
unsuspected tubercles already existed in other parts than where diag- 
nosed, must remain unsettled.” 
A Summary of the Present Status of Koch’s New Discovery.—Dr. 
Laplace concludes that, in his opinion : “ 1. This discovery marks a dis- 
tinct epoch in the history of therapeutics. Contrary to our ideas of the 
physiological action of drugs, this substance acts solely when tubercu- 
lous tissue exists in the body. It thus exercises a specific and selective 
action. And this is the more admirable, as we have all reasons to sur- 
mise that the lymph is directly or indirectly the result of cultures of 
the bacillus tuberculosis. 
“ 2. It is, therefore, a valuable means of diagnosis as to even the 
unsuspected existence of tuberculosis in the body. 
“ 3. Under its continued action tuberculous tissues are destroyed, 
and, when possible, are cast off by sloughing. 
“4. No case of permanent cure has, to our knowledge, been 
positively recorded. 
“ 5. The large amount of clinical experience already existing war- 
rants the further trial and careful observation of the remedy in 
tuberculous cases. 
“ Even should the future prove the lymph unsuited to permanently 
cure tuberculosis, the discovery will still remain an index for future 
researches in the domain of scientific therapeutics.” 
Since the above report was made Professor Virchow has publicly 963 
TUBERCULTNUM. 
culled attention to the danger of thus lighting into fresh activity 
quiescent tubercular foci; and cases have been reported where death has 
followed from this cause. Where tubercle has been deposited in the 
brain the resulting inflammatory reaction is likely to produce a fatal 
result. Up to the present time no well-authenticated case of marked 
tubercular disease of the lungs or joints has been cured, and it is now 
only thought to be of avail in incipient cases of phthisis, which we know 
are amenable usually to hygienic treatment without hypodermatic injec- 
tions. Cases of lupus, which have been thought cured, have subse- 
quently returned with the disease as intractable as ever. The latest 
accounts are even more unfavorable, if they can be relied upon as 
accurate statements of the results obtained by leading Paris therapeutists. 
Dujardin-Beaumetz, on repeating Koch’s experiments with guinea-pigs, 
failed completely to observe any protective or therapeutic value as com- 
pared with animals not so treated. “ All died at about the same time and 
with the same sjnnptoms and lesions; in none were the symptoms made 
at all better by injections of tuberculin.”* Jaccoud.at a late meeting of 
the Academy of Medicine, announced similar experience, going “to 
prove that the antecedent impregnation of the organism by Koch’s 
liquid does not prevent the development of tuberculosis.” Da Costa 
lias protested strongly against the practice of hypodermatic administra- 
tion of Koch’s lymph solely for diagnostic purposes, which had been 
recommended by several surgeons. 
In some countries the use of tuberculin has been interdicted by lawr, 
since the death of several patients has followed its administration. On 
the other hand, Fraenkel, one of the closest clinical observers, in an 
address before the Berliner Medizinische Gesellschaft, states his thorough 
belief in the efficacy of tuberculin. He says : “ I am of the opinion that 
tuberculin exercises a direct influence on those parts of the body where 
tubercle bacilli exist, and where they have caused changes to take place; 
and that this influence consists in a corrosive action, with supervening 
necrosis. Thus I uphold my opinion that tuberculin is a specific for 
tuberculosis. If this be so, whence comes it that its therapeutic action 
is so much called in question? I think the answer is: because tuberculin 
(1) does not affect the tubercle bacilli, and (2) because it has some un- 
toward by-effects.” He carefully weighed, adds a writer in the British 
Medical Journal for February 28, 1891, the pros and cons of the tuber- 
culin treatment, such as his own experience had made known to him, 
and said that, though fully alive to the possible dangers of the injections, 
he had found the curative effect in many cases so marked, so much 
greater than he had 3-et observed to follow any other therapeutic method, 
* Boston Medical and Surgical Journal, vol. cxxiv, No. 11, March 12,1891, p. 271. 964 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
that in his opinion the physician, after having carefully and conscien- 
tiously selected suitable cases, mnst calmly face the danger, in the same 
way as the surgeon does, day after day. 
The author, in connection with Laplace, has treated some cases of 
severe lupus vulgaris by the injection of tuberculin, at the Medico- 
Chirurgical Hospital of Philadelphia, with a most decided change in the 
lesions. One case, of thirty or more years’ standing, in which the in- 
tegument was covered with infiltration and ulceration, has improved 
very much. The ulcers have healed, but some lesions still remain, with 
infiltration, especially around the border of the patches. The patient 
has had a number of injections, and failed recently to react to the last 
one administered. In another case, that of a large lupous patch upon the 
left cheek, the lesions have disappeared in the centre, leaving a cicatricial 
patch, with slight infiltration around the margin. A small patch of in- 
filtration upon the mucous membrane of the lips has likewise vanished, 
but small lesions still exist, although the patient has failed to react upon 
the last injection. In several other cases the apparent result of the 
injections is good, for the present, upon the lesions, but time alone can 
decide the ultimate effect in tuberculosis, lupus, and other diseases of 
tuberculin, or Koch tymph. 
TUSSILAGO.—Tussilago, Coffs Foot. 
Dose, 3i-ib hi decoction or fluid extract. 
Pharmacology.—The leaves of Tussilago farfara (Compositse), grow- 
ing in cold, clayey banks, in the Northern and Middle States, contain 
mucilage, tannin, and a bitter extractive. 
Physiological Action.—Tussilago is demulcent, tonic, and, as the 
name indicates, it is also deemed expectorant or pectoral. 
Therapy.—In cough attending chronic pulmonary affections, chronic 
bronchitis, etc., colt’s foot is used, often in combination with licorice 
or horehonnd. The fresh leaves are applied in the form of a poultice to 
scrofulous ulcers. The fluid extract is a stomachic, and has some tonic 
properties, owing chiefly to the alcohol which it contains. 
ULMUS (U. S. P.).—Elm. 
Preparation. 
llucilago Ulmi (U. S. P.),—Mucilage of Elm (dried bark 6, boiling water 100 parts). 
Pharmacology.—The inner bark of Ulmus fulva (Urticacese), or elm, 
a handsome forest tree of North America, contains mucilage principally. 
Physiological Action.—Elm-bark is used as a demulcent externally 
and internally. The dried bark, in flat pieces or strips, is sometimes 
chewed, as the taste is not unpleasant, and the mucilage moistens the 
mouth and throat. URETHAN". 
965 
Therapy.—Poultices of ground elm-bark, with lead-water, are service- 
able in erysipelas and various forms of local inflammation ; the\r are used 
cold or hot. Internally the mucilage may be given ad libitum in stomach 
and bowel disorders, and in painful affections of the urinary passages, 
dysuria, etc. Pieces of elm-bark, of suitable size and shape, may be 
made into tents for the dilatation of fistuloe, and in the treatment of 
uterine affections. 
URETHAN.—UrethanJ (C2II50, NH2, CO.) 
Dose, gr. viii—3j- 
Pharmacology.—TJrethan is a recently-introduced hypnotic. It is 
the etliylic ether of earbaminie acid, and is in the form of very soluble, 
tasteless, white crystals. 
Physiological Action.—Yon Jakscli* found it markedly hypnotic in 
doses of to 15 grains in various pathological conditions. It is not 
an analgesic, and does not relieve the neuralgic pains of locomotor 
ataxia, for instance. It is considered unsuitable for alcoholic delirium 
or insanity, since we have agents better suited to control these con- 
ditions. 
Therapy.—In adults, it is recommended for use as a sedative and 
hypnotic, where other agents cannot be used, in doses of gr. xv, or less, 
every two hours. Demme considers it especially suited to children, 
giving 4 grains at the age of 1 year as a true hypnotic. He considers 
that larger doses are safe even in weakly children,as he has seen no effect 
upon the circulation, respiration, digestion, or nerve-centres. As an 
enema, he used it successfully in eclampsia. Abbott reports a case of 
tetanus cured in two days, from 9 grains of urethan every two hours, 
with grains administered at night. Crozer Griffith looks upon ure- 
than, in ordinary dose, as an uncertain and unreliable hypnotic, though 
in large dose it may at times prove useful.f Chloral and urethan may 
be combined, forming Chloral-Urethan, or Somnal. Uraliumjj; appears to 
be a similar substance to, if not identical with, somnal. (See page 911.) 
USTILAGO (U. S. P.).—Corn-Smut, Corn-Ergot. (See page 736.) 
UVA URSI (U. S. P.).—Uva Ursi, Bearberry. 
Dose, 
Preparations. 
Extractum Uvce Ursi Fiuidum (U. S. P.).—Fluid Extract of Uva Ursi. Bose, f3ss-j. 
Decoctum Uvce Ursi (U. S. P.).—Decoction of Uva Ursi (1-17). Bose, f§ss-ij. 
Pharmacology.—The leaves of Arctostaphylos Uva Ursi (Ericaceae), 
or Bearberry, a small herb of North America and Europe, contain 
* Jahresbericht dev Pharm. Therap., 1885. 
t Annual of the Universal Medical Sciences, 1889, vol. v, p. A-150. 
t Gazetta degli Ospitali, Milan, February 6, and British Medical Journal- March 16,1890. 966 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
tannic and gallic acids, to which they owe their astringeney. Three princi- 
ples have been separated, Arbutin, Ericolin, and Ursone, the latter being 
tasteless, the others bitter and crystallizable, soluble in water and 
alcohol. 
Physiological Action.—The preparations of Uva ursi are astringent, 
and in proper dose carminative and tonic, but may constipate the bowels. 
The astringent principles pass off by the kidneys and are sedative to the 
urinary passages. An overdose of uva ursi produces vomiting, purging, 
and genito-urinary irritation, with, sometimes, vesical tenesmus and 
hsematuria. 
Therapy.—The infusion or decoction of uva ursi is a valuable agent 
in treating irritation of the bladder, strangury, dysuria, pyelitis, or 
cystitis. It may7 be combined with an alkali as follows :— 
Sodii bicarbonat., f Jij. 
Decocti uvae ursi, f^viij. 
M. Si"-..: Take a tablespoonful every two hours for vesical irritation, or in the 
strangury following the use of a blister. 
Uva ursi has some reputation in calculous affections, gravel, etc. 
Arbutin is used in doses of gr. ii-v as a diuretic in dropsy, and also in 
urethritis. It has been asserted by7 Dr. Harris, of Alabama, that uva ursi 
causes uterine contractions, and can be used as a substitute for ergot, but 
further observations are needed to establish its value in this direction. 
Uva ursi has been given with success in leucorrhoea, menorrhagia, 
chronic dysentery, and bronchovrhoea, and is reported to have been 
beneficial in diabetes. 
VALERIANA (U. S. P.).—Valerian, Valerian-Root. 
Dose, gr. x-xxx. 
Preparations. 
Abstractum Valerianae (U. S. P.).—Abstract of Valerian. Bone, gr. v-xx. 
Extraction Valerianae Fluidum (U. 8. P.).—Fluid Extract ofValerian. Dose, f3ss-j. 
Oleum Valerianae (U. S. P.).—Oil of Valerian. Dose, ITlii-v. 
Tindura Valerianae (U. S. P.).—Tincture of Valerian (20 per cent.). Dose, f 3i—ij. 
Tmctura Valerianae Ammoniata (U. S. P.).—Ammoniated Tincture of Valerian (pow- 
dered valerian-root 20, aromatic spirit of ammonia, to make 100 parts). Dose, f3i-ij. 
The officinal valerianates are of ammonia, iron, quinine and zinc. 
Pharmacology.—The rhizome and rootlets of Valeriana officinalis 
(Yalerianacete), a native of Europe, but cultivated in this country. 
The root contains a volatile oil, which is officinal, and by oxidation 
yields Valerianic acid. When the drug is recently dried it contains 
more volatile oil and less valerianic acid ; as it gets older, the oil 
decreases and the proportion of valerianic acid increases, while the 
odor becomes more marked. Valerianic acid is a colorless, oily7 fluid, 
/ 967 
VALERIANA. 
with an odor resembling that of the drug, and a strongly acid and burning 
taste, it also contains Valeren, which is a terpene, and valerian camphor, 
with resin and water, constit uting Valerol, which is changed by contact with 
air into valerianic acid. Valerianic acid may be made artificially by the 
oxidation of amylic alcohol, and it is from this acid that the valerianates 
are formed; but it does not quite correspond with the natural acid in its 
physiological effects. The oil is the best form of the drug, and can be given 
in cinnamon-water and mucilage. The ammoniated tincture is a valua- 
ble preparation, owing to the stimulating and carminative effects of the 
ammonia. The valerianates are rarely used, as their effects do not cor- 
respond with those of valerian. An elixir of the valerianate of ammonia, 
however, is an excellent preparation when well made, the odor and taste 
of the salt being covered by the addition of vanilla and a little chloro- 
form ; it contains 2 grains to the fluidrachm, and is given in tablespoonful 
doses. In this a certain part of the result must be attributed to the 
alcohol which it contains. 
Physiological Action.—Valerian is antispnsmodic and slightly stimu- 
lating to the circulation. It reduces irritability and reflex contractions, 
and is a sedative to the spinal cord. In small quantities, valerian excites 
a sensation of warmth in the stomach, improves the appetite and diges- 
tion. Bouchard states that valerian materially decreases the amount of 
urea excreted. Large doses cause nausea and vomiting, diarrhoea, fre- 
quent micturition, tenesmus, increased discharge of urates, with giddi- 
ness, hallucinations, and mental disturbance, the oil being a paralyzing 
agent to the great nerve-centres. Elimination takes place through the 
kidneys, lungs, and skin. 
Therapy.—There are no local applications, and the internal use has 
practically become limited to the treatment of nervous disorders in women, 
especially nervous headache and hysteria, or hystero-epilepsy. The follow- 
ing prescription, containing valerian, is serviceable :— 
Tinct. ammon. valerian., 
Spiritus setheris cotnp., 
Tinet. humuli, aa f^ij. 
M. Sig.: Two teaspoonfuls in water, every hour or two. 
The various nervous disturbances which occur at the menopause are 
relieved by the administration of valerian. This remedy is also of 
service in pruritus dependent upon disorder of the nervous system. 
Favorable reports have been made of its utility in diabetes insipidus and 
mellitus. The improvement, however, does not continue. In various 
spasmodic disorders in children, such as convulsions or chorea due to 
worms, nervous cough, whooping-cough, and in delirium with depression, 
it has been beneficially employed. The oil has been given to arouse 968 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
patients from coma during the progress of a fever, like typhus. The 
valerianate of morphine is sometimes used with the idea that it is better 
borne than the officinal salts. The valerianate of zinc has been used in 
nervous diseases, chorea epilepsy, and neuralgia, in doses of gr. ii-iij, 
with considerable success. 
VANILLA (U. S. P.).—Vanilla. 
Preparation. 
Tinctura Vanillce (U. S. P.).—Tincture of Vanilla (10 per cent.), used for flavoring. 
Pharmacology.—Vanilla isfrhe fruit of Vanilla planifolia (Orchidaceae), 
a native of tropical America. The fruit appears in market in bundles 
of about fifty pods, 6 to 10 inches long, dark-colored, one-celled, con- 
taining a blackish pulp, in which are imbedded numerous very small, 
black seeds, and some crystals of the characteristic principle Vanillin 
(about 2 per cent.), which is the methyl ether of pyrocatechuie aldehyde. 
Mexican vanilla is the best. The odorous active principle is soluble 
in alcohol; the pulp also contains fixed oil, sugar, resin, etc. Vanillin 
has also been made synthetically. 
Therapy.—Vanilla is used in flavoring troches and in making arti- 
cles of food for the sick. It is added to chocolate during the preparation 
of this article for the market. It is an aromatic, and probably exerts 
some stimulating effects upon the human organism, which would make 
it serviceable in nervous affections. Some persons are more influenced 
by it than others. Vanilla is said to have aphrodisiac properties. 
VERATRINA.—Veratrine. 
Preparations. 
Oleatum Veratrincc (U. S. P.).—Oleate of Veratrine (2 per cent.). 
TJnguentumVeratrincc (U. S. P.).—Ointment of Veratrine (4 per cent.). 
Pharmacology.—Veratrine is an alkaloid, or mixture of alkaloids, 
prepared from the seeds of Asagrsea officinalis (Melanthacete), or Vera- 
trum sabadilla. 
Physiological Action.—This agent is very irritating to mucous mem- 
branes ; it powerfully depresses the heart’s action, reduces the tempera- 
ture, and causes fatal collapse. It lowers the sensibility of the sensory 
nerves. 
Therapy.—It is not used internally; but, applied to the affected 
spots, in the form of oleate or ointment, it quickly relieves neuralgic and 
myalgic pains. Veratrine ointment mitigates the pain of herpes zoster, 
and is used in weakened form in infantile paralysis, for the purpose of 
promoting the nutrition of the affected muscles. This preparation is 
beneficially applied in cases of chronic swelling and stiffness of joints, 
and to the affected articulations in the beginning of a paroxysm of gout. VERATRUM VIRIDE. 
969 
Veratrine ointment is useful in pleurodynia or chronic pleurisy, alopecia 
circumscripta, chloasma, and pediculosis. For ordinary use the officinal 
ointment is too strong, and should be reduced once or twice. Care should 
be taken not to introduce an\r of the ointment into the eyes, or violent 
conjunctivitis may be set up. Veratrine has been given internally in 
rheumatism, neuralgia, etc., in doses of gr. but is too depressing. 
VERATRUM VIRIDE (U. S. P.).—Veratrum Viride, American 
Hellebore. 
Preparations. 
Extractum Veratri Virklis Fluidum (U. S. P.).—Fluid Extract of Veratrum Viride. 
Dose, ITli-xl. 
Tinctura Veratri Viridis Fluidum (U. S. P.).—Tincture of Veratrum Viride (50 per 
cent.). Dose, lTliii—f3j. 
Pharmacology.—The rhizome and rootlets of Veratrum viride 
(Melanthaceae) are officinal. It is an indigenous plant; from its place of 
growth being called swamp-hellebore, also Indian poke, or poke-root, 
but is an entirely different species from phytolacca, which yields the poke- 
berries and poke-root of the pharmacopoeia. Veratrum-viride root con- 
tains jervine, pseudo-jervine, and cevadine, principally; but traces of 
rubi-jervine, veratrine, and veratralbine are also found. Veratroidine, 
which was formerly regarded as one of its constituents, is thought by 
Brunton to be, in all probability, simply rubi-jervine with resin. Jervine 
has not been used medicinally, but would probably prove valuable, as it 
does not produce vomiting. It forms crystallizable salts with acids. 
Physiological Action.—The action of veratrum viride is due to the 
jervine and other alkaloids, which it contains. In small doses of the 
fluid extract, the pulse is lowered in force, without at first affecting 
its frequency; it afterward becomes slow, soft, and moderately full, 
and liable, upon the patient making any exertion, to become rapid, small, 
and even imperceptible. Nausea and vomiting frequently occur, with 
much muscular weakness. Large doses bring on a condition of collapse, 
with retching, cold, clammy skin, imperceptible pulse, intense muscular 
weakness, giddiness, and gradual loss of consciousness. Jervine was 
found by Dr. H. C. Wood to greatly lessen the functions of the spinal 
cord and medulla, especially the vasomotor centre, and at the same time 
to cause convulsions by irritation of motor centres in the brain; the 
principal effects being shown in muscular weakness, followed b}r tremors, 
lowered blood-pressure, and slow pulse, Bartholow attributes death to 
asphyxia from paralysis of muscles of respiration, and considers the 
cerebral effects to be due to the accumulation of carbonic acid in the 
blood. It is possible that the convulsions may really be due, in part, to 
cerebral anaemia, and death may occur from syncope. 970 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Treatment of Toxic Effects.—Notwithstanding the very formidable 
symptoms produced by large doses, fatal elfects are rare. An ounce of 
the tincture has been swallowed without producing death, probably 
because the prompt emesis which was excited caused the rejection of the 
most of it. Ordinarily the symptoms are rapidly relieved by the sus- 
pension of the remedy and the administration of opium and stimulants. 
Therapy.—The form and mode of administration is of some impor- 
tance. The fluid extract is a saturated tincture, and resembles, in this 
respect, Norwood’s. The tincture is preferred by Bartholow in doses 
of about 5 drops, not at a longer interval than two hours. The recum- 
bent posture must be strictly enforced, in order to avoid the emetic 
effects, which are so depressing that the remedy is never used for this 
purpose. In various forms of overaction of the heart, hypertrophy, irri- 
table heart, and abnormal tension of Bright’s disease, it isof great service. 
It should not be used where there are valvular lesions and the cardiac 
muscle is enfeebled, or where there is dilated or fatty heart. I n aneurism, 
in conjunction with the proper regimen and rest in bed, veratrum viride 
favors coagulation of the blood and diminishes the pressure, the effects 
being carefully watched so as to avoid vomiting. In exophthalmic 
goitre or Basedow’s disease, Germain See, Guyat, Huchard, and others 
have had successful results from the use of 20 to 25 drops daily of the 
tincture.* In the first stage of pneumonia and acute congestions of the 
viscera, there is an accumulation of favorable testimony ; it directly 
reduces the tendency to accumulation of blood, and diminishes the 
danger of exudation. In pneumonia, when taken at the very beginning, 
and doses of npx-xv of the tincture given every two hours or less, until 
there is a reduction in the pulse-rate and temperature, will produce the 
best results ; it is useless after fibrinous deposit has taken place. Green 
veratrum has been employed as an antipyretic in acute rheumatism. In 
active haemorrhage or acute mania, in the plethoric, this remedy also 
moderates the force of the circulation, and may at once check the seizure. 
In typhoid fever it is inadmissible, except in cases of hyperpyrexia with 
active delirium. In puerperal convulsions it has been given in doses of 
half a drachm of the fluid extract every fifteen minutes until vomiting 
is produced, or the convulsions cease. Veratrum viride, in small doses, 
often rapidly relieves or cures tonsillitis, especially when combined with 
morphine :— 
Tinct. veratri viridis, hlxvj vel xxxij. 
Morphinae sulphatis, gr.j. 
Aquae menth. pip., f^ij. 
M. Sig.: A teaspoonful every hour or two, until relieved. 
* Annual of the Universal Medical Sciences, 1890, vol. v, p. A-137. VERBASCUM. 
971 
Phillips reports tlifit this remedy seemed to relieve a case of per- 
sistent priapism after antimony, belladonna, and bromides had failed. 
VERBASCUM.—Mullein. 
Pharmacology.—Yerbaseum thapsus (X. 0. Scrophulariaeese), or 
mullein-plant, grows by the roadside and in neglected fields. Its leaves 
are large and woolly, and it bears yellow flowers in dense spikes. The 
leaves contain a large proportion of mucilage, and a small quantity of 
volatile oil exists in the flowers. 
Physiological Action and Therapy.—Mullein is demulcent, expecto- 
rant, and contributes to nutrition. It has long enjoyed a popular repute 
in Ireland as a remedy in pulmonary affections. Quinlan esteems it of 
considerable value in phthisis and other wasting diseases. lie states 
that this plant relieves cough, diminishes expectoration, and increases 
the bodily weight. It is given in the form of an infusion made with 
milk, 4 ounces of the fresh, or a corresponding quantity of the dry, leaves 
being boiled for ten minutes in a pint of fresh milk. This is 
to be drunk thrice daily, while still warm. Though the milk doubtless 
adds to the effect, Quinlan saw benefit result from administration of the 
juice alone. The taste is unpalatable and is disguised by the milk. 
Mullein has likewise been used in diarrhoea, irritable bladder, and 
cystitis. 
VIBURNUM PRUNIFOLIUM.—Black Haw. 
Preparations. 
Extraction Viburni Fbiidum.—Fluid Extract of Viburnum. Dose, lilxv-f3j. 
Pitlvis Extracti Viburni.—Powdered Extract of Viburnum. Dose, gr. iii-x. 
Extraction Viburni.—Extract of Viburnum. Dose, gr. iii-x.* 
Pharmacology—Viburnum prunifolium (Caprifoliaceae), or black 
haw, is a tree which is common in the United States east of the 
Mississippi. Its height varies from 10 to 30 feet. It is generally found 
upon rocky hill-sides, in rich soil. Its trunk rarely exceeds 6 inches in 
diameter. The wood is heavy, hard, and brittle, reddish-brown in color. 
The bark of the root is the portion employed. The chemical con- 
stituents of the bark are Viburnic acid, identical with valerianic acid ; 
Viburnin, a bitter, resinous body, and also sugar and tannic, oxalic, citric, 
and malic acids. 
Physiological Action.—Black haw sometimes causes nausea and vomit- 
ing, but when retained it is a tonic, astringent, antispasmodic, and nerve- 
sedative. No exact study seems to have been made of the physiological 
action. 
* Under the name of Liquor Sedans, Parke, Davis & Co., have offered a substitute for 
certain copyrighted preparations. Each fluidounce contains 60 grains each of black haw and 
golden seal, 30 grains of Jamaica dogwood, combined with aromatics, q. s., making an elixir, or 
compound extract, of viburnum. Dose, foij. 972 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Therapy.—The attention of the medical profession was drawn to 
viburnum bj' Dr. Phares,of Mississippi, in 1866. This writer described it 
as “nervine, antispasmodic, tonic, astringent, and diuretic,” and of par- 
ticular value in the prevention of abortion, whether habitual or other- 
wise, whether threatened from accidental cause or criminal drugging. 
An abundance of testimony on both sides the Atlantic has accumulated 
to confirm this statement as to its value in threatened abortion. Given 
before the membranes have been detached, it rarely fails to quiet uterine 
action, provided the foetus be living. Black haw affords relief to the after- 
pains and the so-called “ false pains.” It has been found of value in the 
treatment of dysmenorrhoea, especially when associated with profuse tlow, 
and in the absence of serious mechanical obstruction. Even in the latter 
case, however, it is often able to diminish the pain. In spasmodic dys- 
menorrlioea it is thought to be more efficient when combined with Jamaica 
dogwood. Dr. Allan S. Payne obtained very good results from viburnum 
in severe cases of membranous dysmenorrhoea. In amenorrhoea depend- 
ent upon anaemia it is likewise of service. In menorrhagia and metror- 
rhagia due to systemic causes, as malaria, angemia, disease of heart or 
liver, this remedy has proved particularly valuable. The uterine haemor- 
rliages which attend the menopause, as well as the various vasomotor and 
nervous disorders so frequent at that period, are materially relieved by 
viburnum. Dr. R. D. Style, of Richmond, Va., in charge of the small- 
pox hospital of that city, remarks that the occurrence of the catamenial 
epoch during an attack of small-pox is frequently a serious and trouble- 
some complication, but that the use of viburnum in such cases obviates 
the necessitj’ of a resort to mechanical methods of checking ligemorrhage. 
The vomiting of pregnancy has occasionally been relieved by this remedy, 
and its use has sometimes been attended with success in sterility of the 
female. For its astringent effects viburnum has been given in diarrhoea 
and dysentery. Locally, the diluted fluid extract has been used as a gargle 
in aphthous sore, mouth and as a lotion to indolent ulcers. 
The Viburnum opulus, or cramp-bark, belongs to tlie same natural 
order as the preceding, and is used in similar doses. It is used only in 
the form of fluid extract, and is given to prevent or relax cramps of all 
kinds resulting from hysteria, dysmenorrhoea, or pregnancy. 
VIOLA TRICOLOR.—Heart’s Ease, or Pansy. 
Preparation. 
Extraction Violce Fluidum.—Fluid Extract of Viola Tricolor. Dose, f3ss-ij. 
Pharmacology.—iola tricolor (Yiolaceae), heart’s ease, or pansy, 
is a native of continental Europe and cultivated in the United States. 
Its medicinal virtue resides in the leaves of the wild plant. Mandelin VISCUM. 
973 
lms discovered that the plant contains salicylic acid. It likewise pos- 
sesses a small quantity of an emetico-catliartic principle, Violin ; also 
existing in Viola odora, or sweet violet. The syrup of viola, made from 
violets, is a pale-violet colored, agreeable vehicle for medicines for 
aesthetic patients. 
Physiological Action and Therapy.—The little that has been recorded 
concerning the physiological action of viola betrays a certain resemblance 
to the effects of salicylic acid. Viola is said to produce a sense of con- 
fusion and dullness in the head, with headache ; some dimness of vision ; 
salivation; vesical tenesmus, with frequent and profuse micturition; 
turbid urine, olfensive to the smell; a sense of heat over the whole body ; 
sweats, itching, and nettle-rash. The first publication upon the action 
of this drug seems to have been by Schrack, in 1779, who recommended 
it as a specific remedy in crusta lactea, or infantile eczema of the head 
and face. In Germany, it gradually fell into disuse, but is still employed 
in France, and the advocacy of Professor Hardy induced I)r. H. G. Pif- 
fard, of New York, to make use of viola in eczema. It is used as an 
internal medicine. An infusion in milk of the fresh herb, deprived of 
root and flowers, was long employed. Hardy advised a combination with 
senna. Piffard now makes use of the fluid extract, and speaks favorably 
of its results. It is most successful in the second stage, with serous or 
sero-purulent exudation and crusting. Full doses,given in acute eczema, 
cause aggravation and extension of the eruption, with increased local 
heat and itching. These effects continue several days. In order to 
avoid them, Piffard advises that but from 1 to 5 drops should, in begin- 
ning, be given to a young child, once or tAvice a day. If no improvement 
occur, the dose may be increased; if aggravation result, the drug 
should be discontinued for a few days, and then resumed in smaller 
quantity. A larger commencing dose (from 10 to 15 drops) is required 
in subacute or chronic eczema. In adults, drachm to 2 drachms may 
be given as the beginning dose in subacute cases. The dose should be 
taken in a small quantity of water, on an empty stomach, and, if possible, 
about half an hour before meals. 
VISCUM.—Mistletoe. 
Dose, gr. x-5j, in decoction, fluid extract, or tincture. 
Pharmacology.—The mistletoe was formerly known botanically as 
Viscum, but is now called Phoradendron (N. 0. Lorantliaceoe); the 
European variety being P. album, the American being P. flavescens. 
They are parasitic plants, the latter growing on oaks, elms, etc. The 
plant contains mucilage, fixed oil, resin, starch, etc., and Viscin (“ bird- 
lime ” or “bird-glue”), a viscous, glutinous substance; also found in 
other plants. 974 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Physiological Action.—Mistletoe is a valuable oxj'tocic and nerve- 
sedative. It is a cardiac tonic resembling digitalis in its action upon 
the cardiac muscle. The berries cause emesis and catharsis, with pros- 
tration, bloody stools, and convulsions in children who have eaten them. 
Therapy.—In epilepsy, chorea, asthma, and many other nervous 
affections, mistletoe deserves further trial. In weak heart, with insuffi- 
cient contractile force, it has some value; in uterine haemorrhage it has 
been found useful. Viscum has likewise been employed in dropsy and 
ameuorrhoea. 
VITELLUS (U. S. P.).—Yelk of Egg. 
Preparation. 
Olyceritum Vitelli (U. S. P.).—Glycerite of Egg-Yelk (fresh egg-yelk 45, glycerin 
55 parts). External use. 
Pharmacology.—Yi tell us is the yelk of the egg of the domestic fowl 
Gall us bankivus (var. Domesticus; class, Aves; order, Gallinae). It 
contains Vitellin, resembling casein ; Lecithin, a phosphorized fat, with 
albumin, a yellow, fixed oil, cholesterin, salts, sugar, etc. 
Physiological Action.—Egg-yelk is a bland, substance, very 
useful in making emulsions. It is highly nourishing, and, as it contains 
phosphorus, it is especially restorative to the nervous system. The 
glycerite is a good vehicle for codliver-oil, for children. 
Therapy.—Yitellus is beneficial in consumption and wasting diseases, 
as a special food for the nervous structures, and it can be given in con- 
junction with codliver-oil, or as a substitute for it. The glycerite is a 
good application to sore nipples, chopped lips and hands. It is a good 
protective in erysipelas and other acute skin affections. 
XANTHOXYLUM (U. S. P.).—Prickly Ash. 
Dose, gr. x-xxx. 
Preparation. 
Extraction Xanthoxyli Fluidum (U. S.P.).—Fluid Extract of Prickly Ash. Z)ow,f 3ss-j. 
Pharmacology.—The bark of Xanthoxylum fraxineum and of Xan- 
thox3rlum Carolinianum (Rutaceae) contains a bitter principle, Xanthoxy- 
line, which is an alkaloid, probably identical with berberine. It also 
contains a volatile oil, resin, gum, a fixed oil, etc. 
Physiological Action.—Prickly-ash bark is an aromatic bitter; it is 
also diaphoretic, diuretic, and sialagogue. It causes augmented secretions 
along the intestinal tract, including the liver, and has emmenagogue prop- 
erties. It is also considered alterative. Xanthoxyline increases the 
action of the heart and raises, arterial tension. 
Therapy.—Xanthoxylum is used in a variety of disorders, from 
toothache to jaundice. It is an ingredient in the compound syrup of ZEA MAYDIS OLEUM. 
975 
clover (see Trifolium), which is used in tlie treatment of syphilis and 
scrofula; also in chronic and muscular rheumatism and skin disorders. 
Prickly ash is a very effective tonic to the mucous membrane of the 
gastro-intestinal canal. It assists glandular action and can be employed 
for the treatment of many diseases in which the glands of the skin or 
mucous membranes are affected. The following combination will be 
serviceable :—■ 
Tinct. xanthoxyli, . . . . . . . . f§iv. 
Tinct. nucis vomicae, nice. 
Tinct. eardamomi, q. s. ad f§v. 
M. Sig.: Two teaspoonfuls in water three times a day. A suitable tonic, useful in 
atonic dyspepsia, acne, and seborrhoea. 
In functional dysmenorrhoea, or suppression of the menses, prickly 
ash is successful, in doses of 30 minims of the fluid extract, which is a 
strong tincture. In pharyngitis and post-nasal catarrh, a decoction may 
be used as a wash or gargle, and the fluid extract administered internally. 
In liver disorders, combined with cascara and other drugs, it is often 
very decided in its effects. 
Xanthoxyli fructus, or prickly-ash berries, contain volatile oil and a 
resin, and are antiseptic. They’ are used in fluid extract or decoction, in 
affections of mucous membranes, especially diarrhoea, cholera morbus 
flatulence, colic, etc. The fluid extract is alcoholic, and doubtless the 
menstruum aids in the effect. Prickly ash is useful in constipation due 
to deficiency’ of the intestinal secretions. 
ZEA MAYDIS OLEUM.—Oil of Zea Mays. 
Pharmacology.—The stigmata of Zea Mays, and the fungus or Usti 
lago, have already been considered. The fruit or seed, commonly' known 
in this country as corn, contains a considerable quantity of a bland, 
yellow, fixed oil, which adds to its value as food and might be utilized 
in pharmacy’ in making ointment.* (See also pages 735 and 736.) 
ZINCUM (U. S. P.).—Zinc. 
Salts and Preparations. 
Zinci Oxidum (U. S. P.).—Oxide of Zinc. Dose, gr. l/£-v. 
Zinci Bromidum (U. S. P.).—Bromide of Zinc. Dose, gr. i-v. 
Zinci Chloridum (U. S. P.).—Chloride of Zinc. For external use. 
Zinci Acetas (U. S. P.).—Acetate of Zinc. Dose, gr. ss-ij, or as an emetic, gr. x-xxx. 
Zinci Carbonas Precipitatus (U. S. P.).—Precipitated Carbonate of Zinc. Dose, gr. ii-iij. 
Zinci lodidum (U. S. P.).—Iodide of Zinc. Dose, gr. ss-ij. 
Zinci Phosphidum (U. S. P.).—Phosphide of Zinc. Dose, gr. 
Zinci Sulphas (U. S. P.).—Sulphate of Zinc. Dose, gr. i-xx. 
Zinci Valerianas (U. S. P.).—Valerianate of Ziuc. Dose, gr. i-ij. 
Zinci Lactas.—Lactate of Zinc. Dose, gr. ss-j. 
* An interesting article on “Oil of Indian Corn,” by Dr. Cliarles O. Curtman, appeared in the 
Drugman, July 25, 1886. 976 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
Unguentum Zincl Oxidi (U. S. P.).—Ointment cf Zinc Oxide (20 per cent.). 
Liquor Zinci Chloridi (U. S. P.).—Solution of Zinc Chloride (50 per cent.). 
Zinci Sulpho-Carbolas.—Sulpho-Carbolate of Zinc. Dose, gr. ii-iij. 
Zinci Bromidum.—Bromide of Zinc. Dose, gr. ii-x. 
Zinci Cyanidum.—Cyanide of Zinc. Dose, gr. %-\s,s. 
Oleatum Zinci.—Oleate of Zinc (5 per cent.). 
Unguentum Zinci Carbonatis.—Ointment of Zinc Carbonate (20 percent.). 
Unguentum Zinci Carbonatis Impurum.—Calamine Ointment (made with native car- 
bonate of zinc). 
Pharmacology.—Zincum is metallic zinc, in the form of sheets or of 
irregular, granulated pieces. It is a silvery metal when polished,but soon 
tarnishes, and, when exposed to the air, forms oxide or carbonate. The 
zinc salts are white, and are usually soluble in water, but the oxide, car- 
bonate, phosphide, and cyanide are insoluble. The soluble salts are 
usually poisonous, and zinc cannot be used for cooking utensils on this 
account. 
Physiological Action.—Most of the salts of zinc are astringents, but 
some are corrosive poisons; among the latter are the chloride, acetate, 
sulphate, iodide, and cj-anide. They produce pain, nausea, vomiting 
with great retching, and sometimes catharsis and muscular depression. 
Continued use of zinc salts causes symptoms of disorder of the nerve- 
centres resembling those of lead poisoning, showing less tendency to 
accumulate in the system than some other metals; but elimination, as in 
other cases, takes place through the action of the liver and intestinal 
glands. In cases of poisoning, the object of treatment would be to favor 
evacuation and to relieve symptoms. It is best to give flour and water, or 
milk, or soapy water ; the alkaline bicarbonates, especially soda, are the 
chemical antidotes. The hypodermatic injection of morphine may be 
required to relieve vomiting. Subsequently, the use of iodide of potas- 
sium, warm baths, and laxatives will remove the metal compounds from 
the tissues. 
Therapy.—In weak solutions, the zinc salts may ne employed as 
astringents. The acetate (gr. ss-j) in rose-water is useful as a col- 
lyriumin conjunctivitis ; it is beneficial, also, as an injection in gonorrhoea 
and gleet.:— 
I> Zinci sulph., gr. v. 
Bismuth, subnit., 3iss. 
Glycerin!, f^ss. 
Aquue cinnamprni, q. s. ad f§v. 
M. For injection in gonorrhoea after the acute stage lias passed. 
Ijt Zinci sulph., gr. vj. 
Tinct. opii deod., 
Tinct. catechu, aa f^ss. 
Aquae rosse, f jjj, 
M. Sig.: For injection in chronic gonorrhoea or gleet. ZINCUM. 
977 
The sulphate is likewise used as a coltyrium (gr. ii-iv to 5j), especially 
when conjunctivitis tends to become chronic, and is beneficial in inflam- 
mations of the skin. In acne, Dr. Fred. J. Leviseur * uses in conjunction 
with hot-water applications :— 
Zinci sulphatis, 
Potassii sulphitis, aa 3j. 
Aquae rosse, f^iv. 
Dissolve each ingredient separately in 2 ounces of the rose-water, mix 
and add 
Resorcini, 3j. 
Sig.: Lotion ; shake well. This is to be used hot at night and cold in the morning. 
The ointment of the oxide of zinc is largely used as a protective and 
slightly astringent application to acute skin affections, and to an ounce or 
more can be added carbolic acid, 3ss ; oil of cade, 5j ; tar, 5ss-j, and other 
agents, according to the case, for treatment of eczema, herpes, erysipelas, 
and burns. The chloride is a powerful caustic and antiseptic. In 
dilute solution (gr. i-ij to £viij), it is useful as an injection in gonor- 
rhoea or leucorrlicea; in stronger solutions, or mixed into a paste with 
flour and water, it can be applied to lupus or malignant growths, or be used 
for creating sloughs. 
The chloride of zinc, in the form of a paste, made with starch, or 4 
parts of the chloride of zinc, farina 3 parts, and oxide of zinc 1 part, as 
used by Tohwinkel, is often a very effective application to morbid 
growths. Haberlin ( Gorrespondenzblatt fur Schweizer Aerzte), in inoper- 
able uterine carcinoma, employs a paste of chloride of zinc, which he 
regards as a good palliative treatment. The elder Penrose, of Philadel- 
phia, has likewise applied the chloride of zinc in the form of a saturated 
solution by means of a tampon in malignant disease of the uterus with 
decidedly good effect. This salt may also be emploj-ed for the purpose of 
destroying epitheliomata, naevi, enlarged glands, warts, and condylomata. 
The liquor is* a strong preparation, and, greatly diluted (3j-Oj), it is a 
detergent and stimulating application to old ulcers, and has likewise been 
employed as a disinfectant for wounds. 
The iodide of zinc is only used in ointment for enlarged glands 
(5j-oj of simple ointment), or in solution as an application to enlarged 
tonsils. The oxide, when in a smooth, dry powder, is useful as a dusting- 
powder for infants, but the carbonate is better for this purpose. Oleate 
of zinc has been already considered (page 384). W. D. Haslam states 
that a mixture of equal parts of iodoform and oleate of zinc is of great 
value in gynaecolog3r, applied by insufflation or on a tampon. 
The application of solutions of zinc, especially of the chloride, is 
*Med. Record, September 13, 1890. 978 
PHARMACEUTICAL THERAPEUTIC AGENTS, OR DRUGS. 
not without danger. It lias been the practice of some gynaecologists to 
apply chloride of zinc to the inner surface of the uterus in the treatment 
of metritis. Ur. Poggi warns against its use in young women and in 
acute inflammation, on account of the risk of producing atresia and ob- 
literation of the uterine cavity, or setting up tubal inflammation. Do- 
leris* prefers curetting to the application of caustics, which also receives 
the sanction of Goodell. Aseptic curetting is commonly safe, and causes 
no such ill effects, even in complicated cases. 
The sulphate of zinc is a decided astringent, and in doses of gr. 
x-xx is a prompt emetic. It has been used for the latter purpose in 
narcotic poisoning, croup, and for promptly evacuating the stomach. It 
is a systemic emetic, and causes vomiting when injected into the blood. 
As an astringent, it has been administered in combination.with opium or 
Dover’s powder, in diarrhoea, and chronic dysentery. In small doses, it 
has been employed as an antispasmodic in asthma, chorea, epilepsy, an 
gina pectoris, hysteria, etc. The stomach becomes remarkably tolerant 
of the sulphate, so that as much as 40 grains have been given; thrice 
daily, without exciting sickness of the stomach. Such massive doses, 
however, should not be long continued, as they eventually occasion 
superficial ulceration of the stomach. The sulphate of zinc is also 
frequently employed internally for the relief of bronehorrlioea. 
In the treatment of chorea the sulphate of zinc is used, beginning 
■with 1-grain doses three times daily and gradually increasing them until 
the limit of tolerance is reached. The sulpho-carbolate of zinc is an anti- 
septic and astringent. Dr. W. F. Waugh has used this salt for several 
years in cholera infantum (see page 371) and typhoid fever, and all 
cases in which the occurrence of fetid stools, with tympanites, etc., 
indicate the need of intestinal antisepsis. In cholera infantum he has 
treated numerous cases for three seasons, writh no deaths. In typhoid 
fever, he has treated upward of 70 cases, with no death in any case where 
this salt was employed from the beginning. The dose is gr. ss to gr. j 
for children, gr. iiss to gr. v for adults, to be given every two hours 
until the stools are odorless, and thereafter in doses sufficient to keep the 
stools in this condition. The effects are a reduction of the fever, tym- 
panites, diarrhoea, and delirium; the attack is shortened and rendered 
less dangerous. When the symptoms of cholera infantum assume the 
dysenteric form, the zinc is given in enemas, 10 grains to 2 ounces 
of warm water. The cyanide of zinc is used in Germany as a substi- 
tute for hydrocyanic acid ; the dose is gr. £ gradually increased to gr. iss, 
given in a mixture. It has also been employed in epilepsy, chorea, and 
in neuralgia, in painful affections of the stomach, and dysmenorrhoea. 
* Provincial Medical Journal, December 1, 1890. ZINGIBER. 
979 
In man}' nervous affections, the valerianate of zinc has special advantages 
of other salts in neuralgia, nervous headache, nervous cough, ovaralgia, 
chorea, epilepsy, etc ; if given in small doses, repeated at short intervals, it 
is beneficial. The night-sweating of phthisis is sometimes checked by the 
oxide of zinc, given in pill form (gr. iij at night) ; the oxide may also be 
given in the summer diarrhoea of infants or adults. In chorea the same 
salt is of much value alone, or combined as follows :— 
Zinci oxidi, gr. v. 
Ferri pyrophos., . . . gr. xl. 
M. et ft. pil. no. xx. 
Sig.: Two or three pills a day. 
The oxide of zinc is serviceable in gastralgia, and has sometimes 
proved useful in epilepsy. Bartholow believes that it is most successful 
when epilepsy is the result of peripheral irritation, having its origin in 
the stomach. The same writer esteems the oxide as of prophylactic 
value in spasmodic asthma. Whooping-cough and chronic alcoholism 
have their symptoms relieved by the oxide. 
ZINGIBER (U. S. P.).—Ginger. 
Dose, gr. x-xv. 
Preparations. 
Extractum Zingiberis Fluidum (U. S. P.).—Fluid Extract of Ginger. Dose, >hi-xx. 
Oleoresina Zingiberis (U. S. P.).—Oleoresin of Ginger. Dose, Tlss-ij. 
Synipus Zingiberis (U. S. P.).—Syrup of Ginger (2 per cent.). Dose, f3i-iv. 
Tinctura Zingiberis (U. S. P.).—Tincture of Ginger (20 per cent.). Dose, Olx-f 3j. 
Trochisci Zingiberis (U. S. P.).—Troches of Ginger (each lozenge contains GTij of the 
tincture). Dose, one to three troches. 
It also enters into aromatic powder (page 555), compound rhubarb-powder (page 861), 
and wine of aloes (page 424). 
Pharmacology.—Ginger is the rhizome of Zingiber officinale (Zin- 
giberaceae), cultivated in tropical countries as a spice. Green ginger is 
put up in syrup or candied, and used as a digestive confection at the 
dinner-table as a corrective of flatulence. It comes from different 
sources, but the Jamaica ginger is preferred for culinary purposes, 
having the best flavor. Ginger contains a volatile oil, to which the 
flavor is due, and a pungent resin. 
Physiological Action.—It is an agreeable carminative and stimulant, 
increasing the secretions and promoting peristalsis. It increases slightly 
the amount of urine, and acts as an irritant to the bladder and urethra. 
Externally it is rubefacient. 
Therapy.—Ginger is added to purgative pills to prevent griping, and 
to salines in order to disguise their taste. It is useful in atonic dyspep- 
sia, especially in elderly persons, and is of service in flatulence and 
diarrhoea. The syrup is commonly used as a vehicle for stomachic 
preparations and tonics. FORMULAE FOR HYPODERMATIC USE. 
ALCOHOL. 
R Spir. frumenti, f Jss. 
(Dose: ITlxx-xxx.) 
Or, R Spir. vini gallici, f §ss. 
(Dose: Hlx-xxx.) 
For syncope, haemorrhage, heart-failure, shock, cholera, and snake-bites. 
AMYL NITRITE. 
R Amyl nitritis, ’ f3j. 
Alcoholis, i 3iij. 
(Dose: ttlx-xx.) 
For angina pectoris, chloroform narcosis, strychnine poisoning, and surgical shock. 
APOCODE1NE. 
R Apocodeinae hydrochloratis, gr. ij. 
Sodii chloridi, gr. x. 
Aquae eucalypti, f 3-ss. 
M. (Dose: blxxx = gr. 
For chronic bronchitis, croup, whooping-cough, and haemoptysis. 
APOMORPHINE. 
R Apomorphinse hydrochloratis, gr. ij. 
Aquae camphorae, Hlc. 
M. (Dose: Nlii-viij = gr. 
For chronic bronchitis, bronchorrhcea, emphysema, haemoptysis, chorea, whooping- 
cough, laryngismus stridulus, epilepsy, capillary bronchitis, and in narcotic poisoning. 
AQUAPUNCTURE. 
R Aquae destillatae, ffij. 
(Dose: f 3ss-j.) 
For neuralgia, myalgia, and paralysis. 
ARSENIC. 
R Liquoris potassii arsenitis, 
Aquae destillatae, »» f3ij. 
(Dose: blv-xx.) 
Or, R Liquoris sodii arseniatis, f 3j. 
(Dose : blv-xx.) 
Or, R Liquoris arseuii et hydrargyri iodidi, f 3ij. 
(Dose : Hli-x.) 
For chorea, neuralgia, epilepsy, lymphadenoma, enlarged spleen, psoriasis, and 
chronic eczema. 982 
FORMULAE FOR HYPODERMATIC USE. 
ATROPINE. 
1$. Atropinae sulphatis, gr. %. 
Aquas destillatae, f^ss. 
M. (Dose: H\xxx = gr. 
For sciatica, ovarian neuralgia, dysmenorrhoea, surgical shock, cholera collapse, pul- 
monary haemorrhage, locomotor ataxia, mania, spasmodic asthma, seasickness, poisoniug 
from aconite, muscarine, physostigmiue or eserine, and opium. 
CAFFEINE. 
R Caffeinae citratis, gr. xvj. 
Aquae destillatae, .'.... f §j. 
M. (Dose: lhxv-xxx = gr. ss-j.) 
For neuralgia, hypochondriasis, asthma, organic heart disease, chronic Bright’s 
disease, and uraemic coma. 
CARBOLIC ACID. 
R Acidi carbolici pur., . gr. iv. 
Aquae destillatae, f§ss. 
M. (Dose: hlxv-xxx = gr. J^-ss.) 
•For erysipelas, phthisis pulmonum, furunculus, carbunculus, enlarged lymphatic 
glands, bubo, and neuralgia. 
CHLORAL HYDRATE. 
R Chloral, hydratis, §ss. 
Aquae destillatae, f§j. 
M. (Dose: Hlx-xxx = gr. v-xv). 
Chloral Hydrate and Morphine. 
Or, R Chloral, hydratis, 3ij. 
Morphinae sulphatis, gr. ij. 
Aquae destillatae, f§j. 
M. (Dose : Hlxxx = gr. viiss chloral hydrate ; gr. % morphine sulphate.) 
Chloral Hydrate, Morphine, and Atropine. 
Or, R Chloral, hydratis, 3ij. 
Morphinae sulphatis, gr. ij. 
Atropinae sulphatis, gr. %. 
Aquae destillatae, f§j. 
M. (Dose : lhxxx = gr. viiss chloral hydrate ; gr. morphine sulphate ; gr. atro- 
pine sulphate.) 
For obstinate vomiting or hiccough, collapse from cholera Asiatica or cholera nostras, 
spasmodic asthma, mania, convulsions, and neuralgia. 
CHLOROFORM. 
R Chloroformi purificat., f^ss. 
(Dose: ll\v-xv.) 
Or, R Spirit, chloroformi, . f^ss. 
(Dose: ltlx-xx.) 
For sciatica, tic douloureux, and other neuralgiae. 
COCATNE. 
R Cocainae hydrochloratis, ........ gr. viij. 
Aquae eucalypti, f§j. 
M. (Dose: lllxxx = gr. ss.) 
For producing local anaesthesia. Also in seasickness and vomiting of pregnancy. FORMULAE FOR HYPODERMATIC USE. 
983 
CODEINE. 
R Codeinae, gr. iv. 
Aquae destillatae, f^ss. 
M. (Dose: n\xxx = gr. ss.) 
For neuralgia, hypochondria, delirium tremens, mania, and diabetes mellitus. 
CODLIVER OIL. 
R Olei morrhuae, f 
(Dose: f3i-iv.) 
For scrofuloderma, paraesthesia, ecthyma, pemphigus, lichen, etc. 
CONIINE. 
$ Coniinae, f3iii Nlxij. 
Acidi acetici fort., f 3iii >Uxij. 
Aquae chloroformi, q. s. ad f §ij. 
M. (Dose: Hlj to begin with. Dlv contain D Ij of coniine.) 
Or, $ Coniinae hydrobromatis, gr. j. 
Aquae eucalypti, f§ss. 
M. (Dose: Hlx == gr. 
For pleurisy, pneumonia, angina pectoris, emphysema, asthma, acute mania, and 
tetanus. 
COTOINE. 
R Cotoinae, gr. viij. 
Sodii bicarbonatis, gr. xx. 
Aquae destillatae, f^ss. 
M. (Dose: >Tlx-xxx = gr. %-j.) 
For acute and chronic diarrhoea, diarrhoea of phthisis and typhoid fever. Also for 
night-sweats and Asiatic cholera. 
CURARA. 
$ Curarae, gr. j. 
Aquae destillatae, f3v. 
M. (Dose: Ihxxx = grain.) 
Or, R Curarinae sulphatis, gr. 
Aquae destillatae, f3v. 
M. (Dose: iHxxx = gr. 
For tetanus, hydrophobia, chorea, and epilepsy. 
DATURINE. 
R Daturinae, gr. £. 
Aquae eucalypti, . . fjj. 
M. (Dose: lllx-xx = gr. 
For neuralgia, asthma, epilepsy, and mania. 
DIGITALIS. 
R Tincturae digitalis, f3ij. 
(Dose: Hlv-xv.) 
Or, R Tincturae digitalis, 
Spir. frumenti, £& f3ij. 
M. (Dose: Hlx-xxx.) 984 
FORMULAE FOR HYPODERMATIC USE. 
Or, Digitaline, . gr. £. 
Spir. vini gallici, 
Aquae destillatae, aa f3ij. 
M. (Dose: mx-xx = gr. 
For heart-failure, surgical shock, acute mania, haemorrhage, and aconite poisoning. 
DUBOISINE. 
Duboisinae hydrochloratis, gr. £. 
Aquae destillatae, f§j. 
M. (Dose n\x-xx = gr. 
For asthma, locomotor ataxia, mania, sciatica, and dysmenorrhcea. 
ERGOT. 
Extract, ergotae fl., f §ss. 
(Dose: hlxv-xxx.) 
Or, Ergotin., gr. xxxij. 
Acidi carbolici pur., itliij. 
Aquae destillatae, f§ss. 
M. (Dose: filviiss-xv = gr. i-ij.) 
For haemoptysis, post-partum haemorrhage, intestinal haemorrhage of typhoid fever, 
purpura, uterine fibromata, varicose veins, varicocele, aneurism, enlarged spleen, enlarged 
prostate, leukaemia, and exophthalmic goitre. 
ETHER. 
$ iEtheris loti, f§ss. 
(Dose: TTlxx-xxx.) 
For heart-failure, surgical shock, syncope from haemorrhage, snake-bites, typhoid 
pneumonia, variola, sciatica, biliary and renal colic, poisoning from aconite and veratrum 
Viride. 
GLONOIN (N1TRO-GLYCERIN). 
Glonoini, . . Hlj. 
Sp. vini rectificati, lficcc. 
M. (Dose: Uli-iv.) 
For angina pectoris, asthma, epilepsy, tetanus, chloroform narcosis, and strychnine 
poisoning. 
HOMATROPINE. 
Homatropinae hydrobromatis, gr. £. 
Aquae destillatae, f^j. 
M. (Dose: mx-xxx = gr. 
For night-sweats of phthisis, mania, and sciatica. 
HYOSOINE. 
Hyoscinae hydrobromatis, gr. £. 
Aquae destillatae, f 3x. 
M. (Dose: Hlxxx = gr. TJty.) 
For chronic mania and dementia, insomnia, asthma, and sciatica. 
HYOSCY AMINE. 
Hyoscyaminae sulphatis, gr. §. 
Aquae eucalypti, f §j. 
M. (Dose: hlxx-xxx = gr. iIjrA-) 
For acute and chronic mania, chronic dementia, epilepsy, paralysis agitan6, and 
chorea. FORMULAE FOR HYPODERMATIC USE. 
985 
MERCURY. 
$ Hydrarg. chlorid. corros., gr. j. 
Aquae destillatae, f3ij. 
M. (Dose: lhx = gr. once daily.) 
Or, I£. Hydrarg. chlorid. corros., gr. v. 
Sodii chloridi, gr. x. 
Aquae destillatae, f §j. 
M. (Dose: lTlx-xx = gr. every second or third day.) 
Or, Hydrarg. chlorid. corros., gr. v. 
Glycerini, f3j. 
Aquae destillatae, f3vij. 
M. (Dose: Rlxij = gr. every second day.) 
Or, Hydrarg. chloridi mitis, gr. viij. 
Olei olivae, ffss. 
M. (Dose: Hlxv-xxx = gr. ss-j, twice weekly.) 
Or, Hydrarg. chloridi mitis, gr. xvj. 
Petrolatifl., i’^ss. 
M. (Dose: hlxv-xxx = gr. i-ij, twice weekly.) 
Or, Hydrarg. formamid., gr. ij. 
Aquae destillat., f3vj. 
M. (Dose: njxxx = gr. %.) 
Or, Hydrargyri benzoatis, gr. iv. 
Sodii chloridi, gr. ss. 
Aquae destillatae, . . . f^iss. 
M. (Dose: ITlxv =gr.-j^.) 
For syphilis and psoriasis. 
MORPHINE. 
Morphinae sulphatis, gr. j. 
Div. in chart, no. viij. 
(Dose : One powder = gr. dissolved in 30 minims of water.) 
Or, Morphinae sulphatis, gr. ij. 
Div. in chart, no. viij. 
(Dose : One powder = gr. dissolved in 30 minims of water.) 
For neuralgia, uraemic convulsions, asthma,‘angina pectoris, colic, and cancer. 
MORPHINE AND ATROPINE. 
Atropinae sulphatis, gr. ss. 
Morphinae sulphatis, gr. xx. 
M. et div. in chart, no. cxx. 
(One powder = atropine sulphate gr. morphine sulphate gr. y6, to be dissolved 
in 30 minims of water.) 
Or, H Atropinae sulphatis, . gr. 
Morphinae sulphatis, gr. vj. 
Acid, carbolici pur., gr. v. 
Aquae eucalypti, f§j. 
M. (Dose: hlx = atropine sulphate gr. morphine sulphate gr. %.) 
For insomnia, asthma, hiccough, myalgia, colic, herpes zoster, sciatica, angina pec- 
toris, cancer, and surgical shock. 986 
FORMULAE FOR HYPODERMATIC USE. 
MUSCARINE. 
R Muscarinse nitratis, js:r. xij. 
Aquae destillatae, l^j. 
M. (Dose: hlx-xxx = gr. %-%■) 
For night-sweats of phthisis and atropine poisoning. 
NICOTINE. 
R Nicotinae, gr. ss. 
Mucilag. acaciae, 
Aquae destillatae, 5A 13j. 
M. (Dose : Olx = of nicotine.) 
For tetanus. 
OSMIC ACID. 
R Acidi osmici, gr. j. 
Aquae destillatae, f3v. 
M. (Dose: TTlx-xxx = gr. 
For sciatica. 
PARACOTOINE. 
$ Paracotoini, gr. xxiv. 
Glycerini, 
Aquae destillatae, aa f3ij. 
M. (Dose: Hlx-xxx = gr. i-iij.) 
For intestinal tuberculosis and other forms of diarrhoea. 
Or, R Pelletierinae sulphatis, 3j. 
Aquae destillatae, f3ij. 
M. (Dose: Hlx=gr. v.) 
For paralysis, tetanus, and hydrophobia. 
PHYSOSTIGMINE. 
R Physostigminae hydrochloratis, gr. j. 
Aquae destillatae, f3v. 
M. (Dose: Hlx-xxx = gr. 
Or, R Physostigminae salicylatis, gr. £. 
Aquae destillatae, . f§ss. 
M. (Dose: IUx-xxx = gr. ) 
Or, R Extract, physostigmatis, gr. iv. 
Aquae destillatae, f3vj. 
M. (Dose: hlxxx = gr. %.) 
For tetanus, hydrophobia, and strychnine poisoning. 
POTASSIUM IODIDE. 
R Potassii iodidi, 5SS- 
Aquae destillatae, f^j. 
M. (Dose: Hlx-xxx = gr. v-xv.) 
For syphilis, psoriasis, scrofula, lead poisoning, rheumatism, and gout. 
PILOCARPINE. 
R Pilocarpini hydrochloratis, gr. ij. 
Div. in chart, no. xij. 
(Dose : One or two powders =*gr. %~}4, dissolved in 30 minims of distilled water.) 
For hiccough, asthma, dropsy, uraemia, and chronic eczema. FORMULAE FOR HYPODERMATIC USE. 
987 
Or, Pilocarpinoe nitratis, gr. xvj. 
Aquae eucalypti, f§j. 
M. (Dose : blv = gr. >£.) 
QUININE. 
Quininae sulphatis, T)iv. 
Acid, sulphurici dilut., f3iiss. 
Acid, carbolici pur., gr. ij. 
Aquae destillatae, q. s. ad f §ss. 
M. (Dose: Hlx-xxx = gr. iii-x.) 
Or, Quininae hydrochloratis carbamidatae, 3ij. 
Div. in chart, no. xxiv. 
(Dose : One or two powders = gr. v-x, in 30 minims of distilled water.) 
For pernicious malarial fever, malarial cachexia, and sun-stroke. 
RICINI OLEUM. 
Olei ricini, 
Olei amygdalae dulcis, &a f^j. 
M. (Dose : 3i-iv.) 
Useful in obstinate constipation. 
STRYCHNINE. 
Strychninae sulphatis, gr. j. 
Aquae eucalypti, fjj. 
M. (Dose: ll\x = gr. 
Or, I£. Strychninae sulphatis, gr. 
Acid, carbolici pur., gr. j. 
Aquae, f§j. 
M. (Dose: Hlxv-xxx = gr. 
For paralysis, progressive muscular atrophy, neuralgia, amaurosis, amblyopia, sur- 
gical shock, and aconite poisoning. 
SPARTEINE. 
. $ Spartein. sulphatis, gr. ij. 
Aquae eucalypti, f§ss. 
( Dose : Hlx-xx = gr. .) 
For cardiac and renal dropsy. 
URETIIAN. 
Urethan., . . . 3j. 
Aquae eucalypti, f^j. 
M. (Dose : f3j = gr. viiss.) 
For insomnia, tetanus, mania, and neuralgia. TABLE OF DOSES. 
Preparation. Dose. 
Absinthium gr. xx—xl 
Abstraction acouiti gr. ss—j 
belladonna; gr. 1-20—j 
conii gr. i—iv 
digitalis : gr. ss—j 
hyoscyami gr. ss—ij 
ignatue gr. %—% 
jalapas gr. i—x 
nucis vomicae gr. ss—j 
podophylli gr. ii—v 
senegas gr. v—x 
valerianae gr. v—xx 
Acetanilide gr. v—xv 
Acetum lobeliae TlLx—fjj 
opii HLv—xx 
sanguinarisB TTfxv—xl 
scilUe TH.V—15j 
Acidum arseniosuin gr. 1-30—1-12 
benzoicum gr. x—xxx 
boricum gr. v—xxx 
carbolicum gr. ss—ij 
citricum gr. x—3ss 
gallicum -.gr. ii—x 
hydrobromicum di'.utum Tl\x—f3iv 
hydroehloricum dilutum HI x—xxx 
hydrocyanicum dilutum Tn_i—v 
lacticum Tlfxx—f3ss 
nitricum dilutum TT^v—xx 
nitrohydrochloricum dilutum Ttfv—xxx 
phosplioricum dilutum TTjji—xx 
picricum gr. %—ij 
salicylicum gr. x—3j 
sulphuricum aromaticum 1T|x—xx 
dilutum Tttv-_XY 
sulphurosum TTLv-—P5j 
tannicum gr. i—xx 
tartaricum gr. v—xx 
Aconitina gr. 1-300-1-250 
Adhatoda justicia gr. x 
Adonidin gr. 1-20—1-5 
aceticus TTjx—f3j 
hydriodicus TTj^v—xx 
hydrobromicus f3.j 
Agaracin gr. 1-121—j 
Ailanthus gr. v—x 
Alnuin gr. i—iij 
Alnus gr. x—xl 
Aloe purifieata gr. i—xx 
Aloin gr. i—xx 
Alumen gr. i—xx 
ammoaio-ferricum gr. ii—x 
exsiccatum gr. i--v 
Aluminii hydras gr. iii—xx 
Ambragrisea gr. v—3j 
Ammonii benzoas gr. ii—x 
boras gr. iv 
bromidum gr. x—xv 
carbonas gr. ii—xx 
chloridum gr. v—xx 
iodidum gr. v—x 
phosphas gr. iiss—xx 
valerianas gr. ii—v 
Amyl nitris. TTj_%—j 
Amylene hydras Tljx—xxx 
Amylum iodatum gr. x—5.1 
Antimonii et potassii tartras..: gr. 1-40—j 
oxidum gr. ii—iij 
Antimonium sulphuratum gr. i—iij 
Antipyrin gr. v—xxx 
Apiolinum TT\.iii—vj 
Apocynum gr. v—xx 
Apomorphinae hydrochloras gr. 1-16—% 
Aqua ammonias Tf^ii—x 
amygdalae amarae fjss 
anisi fjss—j 
aurantii florum fjss—j 
Preparation. Dose. 
Aqnas camphors; f3i—iv 
chlori i3i—v 
chloroformi f3i—iv 
cinnamomi fjss—iv 
creasoti f5ss—iv 
fceniculi f5>>—fSj 
menthae piperitae fS*—f3>.l 
viridis f,ji— fSi.j 
rosae fjss—fjij 
Argenti cyanidum gr. 1-40—1-20 
iodidum gr. %—% 
nitras gr. 1-6—% 
oxidum gr. ss—ij 
Asafoetida gr. x 
Asclepidin gr. i—v 
Asparagin gr. i—ij 
Aspidium 3ss—3iss 
Atropina gr. 1-21X1—1-60 
Atropiqae sulphas gr. 1-21X1—1-60 
Auri et sodii chloridum gr. 1-50—1-10 
Balsamum Canadense n^v—x 
Pernvianum Tlj^x—xxx 
Tolutanum gr. v—x 
Baptisin gr. i—v 
Barii chloridum gr. 1-20—% 
Benzinum TT^x—xxx 
Berberina gr. %—v 
Berberina; hvdrochloras gr. %—v 
Bismuthi citras gr. i—v 
et ammonia; citras gr. i—v 
subearbonas gr. v—xx 
subnitras gr. v—xx 
Bryonin gr. 1-6—% 
Caffeina gr. ii—x 
Caffeinae citras gr. i—v 
sodio-benzoas gr. ii—x 
sndio-salicvlas gr. ii—x 
Cajnpnti oleum Ttjj—v 
Calcii bromidum gr. x—xxx 
carbonas precipitatus gr. x—xl 
chloridum gr. i—xx 
hypophosphis gr. x—xx 
phosphas precipitatus gr. x—xxx 
Calumba gr. v—x 
Calx sulphurata gr. %—ij 
Cambogia gr. 1-10—iij 
Camphora gr. i—ij 
monobromata gr. i—v 
Cannabinae tannas gr. i—x 
Capsicum gr. i—xx 
Carbo animalis purificatus gr. x—3j 
Cardamomum gr. v—xv 
Carduus benedictus 3j—v 
Carota gr. xxx—3j 
Carum gr. x—xxx 
Cascarilla gr. ii—xx 
Cassia hstula 3j 
Catechu 1 gr. i—xxx 
Caulophyllum gr. xv—xl 
Cedron gr. i—ij 
Cerii oxalas gr. i—x 
Chaulmoogra-oil Tl^v—xx 
Chelidonium gr. x—xl 
Cheaopodium gr. x—xl 
Chinoidinum gr. iii—xxx 
Chinolina gr. viii—xvj 
Chinolinae salicylas gr. v—xxx 
Chirata gr. xv—xxx 
Chloral gr. ii—xx 
Chloralamid gr. xxx—xlv 
Chloral butylicum J gr. ii—xxx 
Chloroformum purificatum Tf^x—xx 
Chrvsarobinum gr. %—xx 
Cimicifuga gr. xx—xxx 
Cinchouidinae salicylas gr. ii—x 990 
TABLE OF DOSES. 
Preparation. Dose. 
Cinchonidina? sulphas gr. vi—xl 
Cinchonina gr. y—xxx 
CinchoninaB iodosulphas gr. i—v 
sulphas gr. v—xxx 
Cinnamomum gr. x—xxx 
Cocaina? hydrochloras gr. >4—ij 
Codeina gr. >4—ij 
Colchicina gr. 1-100—1-60 
CoHinsonia Canadensis gr. x—xl 
Colocynthis gr. ii—v 
Confectio opii gr. x—xx 
senna? 3>—iij 
Coniina Tltl-10—j 
Conii use hydrobromas gr. 1-12—j 
Convallamarinuin gr. —ij 
Copaiba TTtxx—f3j 
Coriandruin gr. v—xxx 
Coto gr. v—xxx 
Cotoina gr. ss—j 
Creasofcum TTti—ii.) 
Creoliuum TTtii—v 
Creta preparata gr. x—xx 
Crocus gr. x—xx 
Cubeba gr. xx—3ij 
Cupri acetas gr. 1-10 
arsenis gr. 1-40—j 
sulphas gr. 1-6—ij 
Cuprum ammoniatum.. gr. 1-6—j 
Curare gr. 1-20—% 
Cypripedium gr. xv—xxx 
Daturina gr. 1-120 
Decoctum aloes compositum fjss—ij 
apocyni f%\—ij 
azednrach fjss 
cetraria? fji—iv 
cimicifuga? f 3vi—Jiii 
dioscorea? f Ji—iv 
euphorbias piluliferee f Si.j 
granati f S)v—vj 
ha?matoxyli f Si—ij 
quillaia? f 3i— ij 
rumicis f JJi—iv 
sarsaparilla? compositum f 5i—iv 
uvae ursi fjss—ij 
Digitalinum gr. 1-60—1-30 
Digitalis gr. ss—ij 
Dita 5i—iv 
Diuretin....* gr. xv 
Dracontium gr. x—3j 
Duboisina? hydrobromas gr. 1-150—1-30 
sulphas gr. 1-150—1-30 
Elaterinum err. 1-20—1-12 
Em be lift ribes 3i—iv 
Emetina gr. 1-120—% 
Epigaea 3ss—ij 
Ergota gr. x—3j 
Ergotinum gr. i—v 
Erigerontis oleum TTtxx—xxx 
Eschscholtzia gr. xxx 
Eupatorium gr. xv—5j 
Euphorbia corrollata gr. xv—xx 
Exalgine gr. i—vj 
Extractum aconiti gr. % 
fluidum TTt 1-10—j 
fesculi hippocastani fluidum TTtxx—f 3j 
agarici gr. iii—vj 
ail&nthi glandulosa? fluidum TTtx—f 3j 
alnus fluidum TT^x—xl 
aloes aquosum gr. ss—v 
liquidum Tltv—xl 
arnicne radicis gr. i—ij 
fluidum Tltv—xx 
azedarach fluidum f5.l 
baptisise.. gr. i—x 
belladonna? alcoholicum er. 1-40—j 
belladonna? fluidum TTt 1 -10—ij 
berberidis fluidum Tit x—xxx 
brayera? fluidum TTtxx—f^ij 
buchu fluidum TT^x—f 3i 
calami fluidum TTtxv—fjj 
calumbse gr. ss—ij 
fluidum TTt xv—xxx 
camellia? fluidum TTtx—f 3j 
cannabis Indica? gr. ss 
fluidum TTt i—xx 
capsici fluidum*. Tl\i—v 
cardamomi compositum fluidum TTtxv 
cascarne amarga? fluidum f 3ss—j 
cascarillne fluidum TTtii—xx 
castanene fluidum f 3i—ij 
caulopliylli fluidum TTtxv—xl 
Preparation. Dose. 
Extractum chekan fluidum f3i—iij 
chelidonii gr. x 
chimaphila? tiuidum 7T( xx—xl 
china? tiuidum f 3*8—j 
chiratae tiuidum Tl^x—xxx 
cimicifuga? gr. i—v 
tiuidum f5*8 
cinchonue gr. i—x 
tiuidum TTtx—f 5ij 
cocculi tiuidum ; TTti—ij 
cocillana? tiuidum TT[x—xx 
ootfeae viridis tiuidum f3ss—ij 
colcliici radicis gr. ss— ij 
tiuidum TT] ii—iv 
colchici seminis tiuidum TTtii—v 
coHinsonia? tiuidum Tt| x—f5j 
colocvnthidis gr. ii—iij 
compositum gr. iv—x 
conii nlcoholicum gr. ss—ij 
tiuidum TT] i—v 
conva 11 arise gr. v—xx 
tiuidum ss—j 
coptidis tiuidum f 3ss—.1 
coriandri tiuidum Tljx—xxx 
cornus tiuidum f 3ps—j 
Florida? gr. i—v 
corvdalis tiuidum TT\ xv—fjjj 
coto corticis tiuidum TTj xii—xxx 
cubeba? tiuidum TT^x—xxx 
cypripedii gr. i—v 
tiuidum TTLx—xx 
damiana? gr. v—xv 
tiuidum f 3ss—iv 
digitalis gr. 
tiuidum TT\ss— ij 
dioscorea? tiuidum TT^v—xxx 
d rose me tiuidum Ttfv—xv 
duboisia? gr. 1-6—% 
tiuidum Tit x—xx 
dulcamara? gr. v— x 
tiuidum TTtxxx—fjj 
embeline tiuidum f Ji—iv 
ephedrae tiuidum f 3i—ij 
ergota? gr. v—x 
tiuidum Tlj x—f.%ij 
eriodictyi gr. iii—xv 
tiuidum TT\ xv—xxx 
erythroxyli gr. iii—xv 
fluidum 11] x—f 3.j 
eucalypti fluidum TTtv—f 5j 
euonymi gr. i—v 
eupatorii fluidum TTt xxx—f 5j 
euphorbia? pilulifeme gr. i--ij 
euphorbia? pilulilera? fluidum TT[xxx—f 5j 
fabiana? fluidum . TTlxv—xl 
frangula? gr. iii—viij 
fluidum f 3ss—j 
frankeuiae fluidum x—xv 
frasera? fluidum TT[ xxx—f 5j 
gelsemii tiuidum TTtii—x 
gentiana? gr. iii—xv 
tiuidum Tit xxx—f 5j 
geranii gr. i—v 
fluidum TTtxxx—f 3j 
gei fluidum TT[xx—f 3j 
gillenia? (trifoliata?) tiuidum Tlfv—xxx 
giveyrrhiza? fluidum Til xx—f3i 
purum gr. v—J5j 
gossypii radicis fluidum f 3ss—j 
granati fluidum f*5i—ij 
grindeliae gr. i—v 
fluidum TT^x—f 3j 
guaranae fluidum TT\ x—f 3j 
haematoxvli gr. v—x 
hamnmelidis fluidum Til x—f 5j 
helianthemi fluidum f 3»—ij 
helonias fluidum xx—xxx 
hemidesmi fluidum f$8S—j 
hepaticae fluidum f 3ss—iss 
hoang-nan fluidum TT{v—xxx 
humuli gr. v 
hydrangea? fluidum TT|xxx—f5j 
hydrastis gr. ii—v 
fluidum TTjv—xxx 
hyosevami gr. i—ij 
alcoholicum gr. 1-6—j 
fluidum TTti—v 
ignatia? gr. 1-6—% 
fluidum TTti—ij 
ipecacuanhse fluidum TTti—iij 
iridis gr. j 
fluidum IT] xxx—f 5j 
jambolauum fluidum Tltv—x TABLE OF DOSES, 
991 
Preparation. Dose. 
Extractum juglaudis gr. v—xxx 
Huidum f 3i—ij 
juniperi fructus Huidum f3ss—iss 
kino liquidum TTfxv—xxx 
krameri* gr. i—x 
Huidum TT|_i—xx 
lactucarii Huidum TTf x—f3j 
lapp* Huidum TTfxv—t'5j 
leonuri Huidum f 3i—ij 
leptandr* gr. iii—x 
Huidum f5ss—j 
linder* Huidum TTf xxx —f5j 
lippi* Huidum Ilf y—xxx 
lobelia Huidum llfi—x 
lupulini Huidum TTf v—xv 
lycopi Huidum f3»—iv 
magnoli* Huidum TTf xxx—f oj 
maidis stigmatorum Huidum f 3>—ij 
malti f 3i—iv 
diastasicum f 3i—S*j 
manac* Huidum Tlfv—xx 
mango Huidum f5ss—j 
manzanit* Huidum f 5ss—ij 
marrubii Huidum f 3i—ij 
matico gr. ii—xij 
Huidum Tlf xx—f 5ij 
matricari* Huidum fRi—iij 
meliss* Huidum f 3*—i.| 
menispermi Huidum fjss—j . 
methystici Huidum TTfxv—f5ss 
mitehell* Huidum f 5ss—j 
myric* Huidum f3ss—j 
nucis vomic* gr. V4— 
Huidum llfi—v 
opii gr. 
origani Huidum f3ss—j 
orthosiphon Huidum Tlf xx—xxx 
pancreatis gr. i—v 
pareir* Huidum f 3ss—j 
physostigmatis gr. 1-6—iv 
phytolace* radicis Huidum Tlfv—f3j 
pilocarpi Huidum TTfx—f3j 
piment* Huidum Tlf viii—xl 
pimpinell* Huidum TTfxv—f3ss 
piscidi* gr. ii—x 
Huidum f*3ss—ij 
plantago fiuidum Tlfv—f 3j 
podophvlli gr. ii—iv 
fiuidum llfi—xxx 
polygonati Huidum TTfv—xv 
polygoni Huidum TTfx—f5j 
populi Huidum f5ss—j 
prinos Huidum f3ss—-j 
pruni Virginian* Huidum TTfx—f 3j 
ptele* Huidum Tlf viii—xxx 
pulsatill* Huidum TTfi—v 
quassi* gr. i—v 
Huidum Tlfv—xx 
quebracho Huidum f3ss—j 
quercus alb* Huidum f 3ss—j 
quillai* Huidum TTfxv—f3ss 
rhamni cathartic* fructus Huidum 4.f 3i—jss 
purshian* Huidum TTfxv—f3.j 
rhei gr. ii—x 
Huidum TTfx—f^j 
rhoeados Huidum Tlf xxx—i'3iss 
rhois aromatic* Huidum Tlfv—fjiss 
glabr* Huidum f 3i—ij 
rhois toxicodendri Huidum Tlf i—v 
ros* Huidum TTfv—f3j 
rubi Huidum f.3ss 
rumicis Huidum f 3ss—j 
sabal Huidum f3ss—ij 
sabbati* Huidum f 3ss—j 
sabin* Huidum TTfv—xx 
salvi* Huidum f^ss—ij 
sanguinari* Huidum TTfv—xv 
santonic* gr. ii—viij 
Huidum Tlf viii—xxx 
sarsaparill* gr. v—xxx 
Huidum f 3ss—ij 
compositum f 3ss—j 
scill* Huidum TTfi—v 
scutellari* Huidum f3ss—j 
sedi acris Huidum TTfxv—xxx 
seneg* Huidum TTfx—xx 
senn* 3>—iv 
Huidum TTf xxx—f£iv 
deodoratum f 3i—iv 
serpentari* Huidum TTfx—xxx 
simulo Huidum TTf xx—f 5j 
solani paniculati Huidum TTfx—xxx 
spigeli* Huidum f 3i—ij 
Preparation. Dose. 
Extractum stillingi* Huidum TTfx—t‘5j 
composition f 3 i—ij 
stramonii gr. >4— 
Huidum TTfi—v 
taraxaei gr. x—xl 
Huidum f3i—ij 
thujse fiuidum f 5ss—j 
tong* fiuidum TTfxx—f5j 
trifolii fiuidum f 5i—ij 
trillii fiuidum t'31—ij 
tritici Huidum 5i—iv 
tussilago Huidum fji—ij 
uv* ursi Huidum f3ss—j 
valerian* Huidum gr. v—xx 
veratri viridis Huidum TTfi—xl 
viburni gr. iii—x 
fluiifum nfXv-f3j 
viol* Huidum f 5ss—ij 
visci Huidum TTfx—5j 
xanthoxvli Huidum f 3ss—j 
ziugiberis Huidum TTf 1—xx 
Fel bovis inspissatum gr. v—viij 
puriHcatum gr. iii—vj 
Fermentum f 3ss—j 
Ferri albuminas gr. v- xxx 
arsenias gr. 1-20—1-10 
carbonas saccharatus gr. ii—x 
citras gr. v—xv 
et ammonii citras gr. iii—v 
sulphas gr. iii—v 
tartras gr. v—xx 
potassii tartras gr. v—xv 
quinin* citras gr. iii—v 
strychnin* citras gr. i—iij 
ferroeyanidutn gr. iii—vj 
hypophosphis gr. v—x 
iodidum saccharatum gr. v—xx 
lactas gr. ii—v 
oxalas gr. ii—v 
phosphas gr. v—x 
pyrophosphas gr. ii—v 
sulphas ..gr. i—v 
exsiccatus gr. i—ij 
pr*cipitatus gr. i—ij 
valerianas gr. i—iij 
Ferrum dialysatuin TTfx—xxx 
reductum gr. i—v 
Fuchsiu gr. >4—j 
Gelsemium gr. ii—xx 
Gentiana gr. viii—xxx 
Geranium gr. xv—5j 
Gillenia gr. v—xxx 
Glycerinum f £i—iv 
Glyceritum lactucarii f 3ii—iij 
pepsini vitulini TTf xxx—f 5j 
Glycerolum pepsini ITFii—x 
Glycyrrhiza gr. v—5ss 
Granatum 5*—ij 
Guaiaci resina gr. v—xv 
Gurjun TTfx—f 3U 
Helleborus gr. iv—xv 
Helonias gr. xv 
Heuchera gr. xxx 
Homatropin* hydrobromas gr. 1-120—1-20 
liydrargyri chloridum corrosivum gr. 1-30—1-10 
mite gr. 1-20—x 
cvanidum gr. I-100—1-82 
formamidatum gr. 1-0 
iodidum rubrum gr. 1-50—1-10 
viride gr % 
oxidum rubrum gr. 1-50—1-10 
salicylas gr. 1-12— 
subsulphas flavus gr. ii—v 
tannas gr. ss—j 
Hydrargyrum cum creta gr. ss—x 
llydrastina gr. ss—v 
Hydrastin* hydrochloras gr. ss—v 
Ilyoscin* hydrobromas gr. 1-100 
Hyoscyamin* sulphas gr. 1-60—1-32 
Hyoscyamus gr. v—x 
Hypnal TTfxv—xxx 
Hyssopus gr. ii—v 
Ignatia gr. i—ij 
Infusum asclepias f£i—ij 
braver* f^iv—viij # 
buchu f^ij 
camel 1 i * f$ i i—vj 
capsici f3 i j—f^ss 
caryophylli —ij 992 
TABLE OF DOSES 
Preparation. Dose. 
Infusum castane® fjii—iv 
cinchon® fjss—iij 
collinsoni® fji—iv 
convallari® f.^ss—ij 
digitalis fji—iv 
eupatorii fjii—iv 
?;entian® compositum f.3ss—j 
lumuli fjii—v 
juniperi fjii—iv 
petroselini f'Sss—ij 
pilocarpi f3ij—fjiv 
pruni Virginian® fji—iv 
quassi® f$i—ij 
sassafras f3ii—viij 
senn® fji—v 
compositum fjj—iiss 
taraxaci f|i—ij 
Inula gr. xv—3j 
Iodoformum gr. ii—v 
Iodol gr. >4—v 
Ioduin gr. ss—j 
Ipecacuanha gr. ss—xx 
Iridin gr. ss—iij 
Jalapa gr. viii—xx 
Jambol gr. v—x 
Juglans 5i—ij 
Kamala 5i—ij 
Kava-kava TlXxv—f3ss 
Kino gr. x—xx 
Kola-nut gr. v—5ij 
Kosin gr. v—xx 
Krameria gr. v—xx 
Laetucarium gr. x—xx 
Ledum gr. xv—xxx 
Leptandra gr. xx 
Liquor acidi arseniosi llji—x 
ammonii acetatis f3i—iv 
arseniiet hydrargyri iodidi Tl\i—x 
calois fjss—ij 
ferri chloridi Tljji— x 
citratis Tl^x—xl 
et quinine citratis ll^v—xv 
malatis f3ss—ij 
nitratis Tf^x—xx 
subsulphatis Ttl'i—x 
hypophosphitum acidus f.3>—iv 
iodi composites TT^v—xx 
magnesii citratis fjiv—xvj 
pancreaticus fT5i—iv 
pepsini f.3s* 
phosphori t~> ] 
potass® Tltx—xx 
potassii nrsenitis TTjy—x 
citratis fSss 
sod® Ttlv—x 
chlorat® fftss—j 
sodii arseniatis Tl|jii—v 
Lithii benzoas gr. v -xx 
bromidum gr. v—xx 
carhonas gr. v—xx 
citras gr. v—xx 
guaiacas gr. i—v 
iodidum gr. i—v 
salicylas gr. v—xx 
Lobelina". gr. ss—j 
Lupulinum gr. v—xx 
Macrotin gr. ss—ij 
Magnesia .' 3*—iv 
ponderosa 3ss—iv 
Magnesii carhonas 3ss—ij 
citras grannlatus 3i—iv 
sulphas 3i—Sj 
sulphis gr. xv—xxx 
Mangani oxidum nigrum gr. ii—x 
sulphas gr. ii—v 
Manna Sj 
Massa copaib® gr. x—3ss 
ferri carbonatis gr. iii—v 
hydrargyri gr. ss—xij 
Matico gr. xxx—3j 
Meuispermum gr. v—xx 
Menthol gr. i—v 
Mezereum gr. x 
Mistura ammoniaci f3'—iv 
amygdal® f3”—iv 
asafoetid® f Sss—j 
cret® f 3i—iv 
chlornformi f 3i—iv 
ferri composita f3ii—iv 
Preparation. Dose. 
Mistura ferri et aminonii acetatis f 5i—iv 
glycyrrhiz® composita PS.i—fjss 
magnesi® et asafoetid® f 5ss—jv 
potassii citratis fgii—iv 
rhei et sod® fjjj—f Sj 
Morphina gr. 1-10—^ 
Morphine acetas gr. 1-6—3t> 
hydrochloras gr. 1-6— 
sulphas gr. 1-6— 
Morrhu® oleum f5.j—fjss 
Morrhuol TTLxv—xl 
Moschus gr. v—viij 
Muscarina gr. %— ij 
Muscarin® nitras »..gr. 1-12—j 
Myrica gr. xx—xxx 
Myristica gr. v-xx 
Myrrha gr. ii—xxx 
Myrtol gr. iv 
Naplithalinum gr. i—x 
Naphthol, alpha- gr. ss—v 
beta- gr. ss—v 
Nicotiua TT11-30-1-10 
Oleoresina aspidii f 5ss—ij 
capsici Tt^l-20—ij 
cubebe Tl^v—xxx 
lupulini gr. ii—v 
ptperis .j 
Oleum amygdalae ainar® j 
expression f 3ij—f Jss 
anisi TT^v—x 
anthemidis TTLii—viij 
camphoras TT\i—iij 
cari TTl_i—v 
caryophylli Tlji—vj 
chenopodii Ttfv—xx 
cinnamomi THJ- iij 
copaib® Tt^v—x 
coriandri TT^i—v 
eubebte TH_v—xij 
eucalypti Ttliii—xx 
foeniculi Ttfv—xv 
gaultherise TTLii—xx 
hedeomae Ttj ii—x 
juniperi TT^v-xx 
lavandule TTLiii—v 
florum TTfiii—V 
menthae piperit® Ttti—v 
viridis ITfii—v 
mvri8ticae ll^i-v 
phosphoratum Ttj i—v 
pimentae Tltiii—v 
rosmarini Til i—v 
saliinae TtXii—v 
sassafras TTLi—iv 
terehinthin® Tt^v-xv 
Opii pulvis gr. ss—j 
Opium gr. iij 
deuarcotisatum gr. ss--j 
Panereatini pulvis gr. v—x 
Pancreatinum gr. i—v 
Papain gr. i—v 
Paraldehyde f5ij 
Pepo 3i—ij 
Pepsinum in lamellis gr. i—ij 
saccharatum gr. x 
Petroselinum gr. xxx—$ij 
Phenacetine gr. ii -viij 
Phosphorus gr. 1-150—1-12 
Physostigminse hvdrobromas gr. 1-60—1-20 
salicylas gr. 1-64—1-20 
sulphas gr. 1-60—1-20 
Phytolaccae radicis pulvis gr. i—v 
Pilocarpinae hydrochloras gr. 1-12—% 
Pilocarpus gr. x—5j 
Pilule aloes 1 to 8 pills 
et asafoetid® 1 to 8 “ 
et ferri 1 to 3 “ 
et mastiches 1 to 5 “ 
et myrrh® 3 to 8 “ 
antimonii oompositae 1 to 2 “ 
asafcetidm 1 to 4 “ 
cathartic® composit® 1 to 3 “ 
ferri composit® 2 to 4 “ 
iodidi 2 to 4 “ 
galbani composit® 2 to 3 “ 
opii I pill 
phosphori 1 to 8 “ 
rhei 1 to 3 “ 
composit® 1 to 3 “ 
Pimenta ....gr. x—xl TABLE OF DOSES. 
993 
Preparation. Dose. 
Piper gr. ii—xv 
Pi peri gr. ss— x 
Plumbi acetas gr. i—iv 
iodidum gr. 1-12— 
Podophyllotoxin gr. 1-20—1-6 
Potassa sulphurata gr. ii—viij 
Potassii acetas gr. x—3 j 
bicarbonas gr. v—xxx 
bichromas gr. 1-5 
bitartras gr. xx—3iv 
bromidum gr- x—3j 
carbonas gr. ii—xx 
chloras gr. ii—x 
citras gr. x—xl 
cvanidmn gr. 1-12—| 
et sodii tartras gr. xx—3iv 
ferrocvanidum gr. x 
hypophosphis gr. ii—xxx 
iodidum gr. v—3i 
nitras gr. ii—xx 
sulphas gr. xx—3y 
sulphis gr. v—3j 
tartras gr. v—xx 
Prinos 5ss 
Pulvis aloes et canell* ;r. xx 
antimonialis gr. i—x 
aromaticus gr. v—xxx 
cret* aromaticus cuin opio gr. x—xx 
compositus gr. v—xxx 
extracti piseidi* gr. ii—x 
glyoyrrhiz* compositus 3'—|j 
ipecacuanh* et opii gr. ii—x 
jalap* compositus gr. x—3j 
morphin* compositus gr. v—xv 
pancreatini gr. v—x 
rhei compositus 3ss—j 
Quassia gr. x—xxx 
Quillai* pulvis gr. x—xxx 
Quinetum gr. i—3.) 
Quinidin* sulphas gr. v—xxx 
Quinina gr. i—3l 
Quinin* bisulphas gr. i—xv 
liydrobromas gr i—xx 
hydrochloras gr. i—xv 
carbamidata gr. i—x 
sulphas gr. i—3.1 
valerianas gr. i—xx 
Resorcinum gr. x—3i 
Rheum gr. i—xx 
Ricim oleum f 3j—■f3j 
Rut® oleum TQii—v 
Sal-bromalide gr. v—viij 
Salicinum gr. x—3i.l 
Salinaphthol gr. iii—viij 
Salipyrin gr. xv—xxx 
Salix. 3i 
Salol gr. v—3j 
Sanguinaria gr. ii—xx 
Santali oleum TTtv—-x 
Santonica 3ss—j 
Santoninoxime gr. iii—xij 
Santoninum gr. i—iv 
Saponinum gr. ss—ij 
Scammonium gr. v—xv 
Scilla gr. ii—iij 
Sednm acre 3ss—j 
Senega gr. x—xx 
Senegin - gr. ss—ij 
Senna 3>—*>8s 
Serpentaria gr. x—3j 
Sodii acetas gr. xv—3j 
arsenias gr. 1-12—3^ 
benzoas gr. x—xx 
bicarbonas gr. v—xl 
bisulphis gr. x—3ss 
boras gr. x—xl 
bromidum gr. xx—5j 
carbonas gr. v—xx 
exsiccatus gr. v—x 
chloras gr. ii—x 
chloridum gr. v—xl 
hypophosphis gr. x—xx 
hypnsulphis gr. x—xx 
iodidum gr. x—xl 
nitras 3i—ij 
nitris gr. iii—xx 
phosphas gr. v—Jj 
pyrophosphas gr. v—xl 
salicylas gr. x—3j 
santoninas gr. ii—x 
Preparation. Dose. 
Sodii sulphas Sss—j 
sulphis gr. xx—3j 
sulphocarbolas gr. ii—v 
Solidago gr. xxx—3ij 
Somnal T^xx—f3ss 
Spartein* sulphas gr. ss—ij 
Spigelia 3'—'j .. 
Spiritus mtheris compositus t'3ss—ij 
uitrosi f 3'—'j 
ammonias Tl\v—xv 
aromaticus f 3?s—ij 
anisi f 3>—ij 
camphor* TQv—xx 
chloroformi f3ss—j 
cinnamomi f3>~ ij. 
foeniculi - f.3ss—.j 
juniperi f3j—fjj 
compositus f 3ii—i.v 
lavandul* f,3ss—j 
menthse piperit®.. - TTLx—f3j 
viridis TT^v—x 
myristic* t f 3i—ij 
rosmarini Tn_i—v 
Staphisagria gr. i—iij 
Strainonii folia gr. i—v 
semen gr. ss—ij 
Strophanthiu gr. 1-100—1-60 
Strychnina gr. 1-60—1-20 
Strychnin* sulphas gr. 1-60—1-12 
Styrax gr. v—xx 
Succus conii f.3ss—ij 
Sulphur lotum 3ss—Jss 
prsecipitatum gr. xxx—$ij 
sublimatum gr. xx—3j 
Sulphuris iodidnm gr. ss -j 
Syrupus acidi hydriodici IT^xxx—fjss 
allii x—f 3j 
cep® f 5>—iv 
amygdalae f 3'i—iv 
calcii lacto-phosphatis ft'—ij 
calcis f3ss—j 
ferri brotnidi TT^x—f3j 
iodidi - DXv—xxx 
quininae et strychnin* phosphatum..f 5i—iv 
hypophosphitum f 5ss—ij 
compositus f 3.j—f S.j 
cum ferro f 3.]—fSj 
ipecacuanh* f 5i—ij 
kraineri* f F»i—I v 
lactucarii f 3j—fSiss 
maidis stigmatorum f Sss—j 
papaveris f3ss —f 3j 
phosphatum compositus f 3*—i.i 
picis liquid* f,3'—ij 
pruni Virginian* f3'—iv 
rhamni cathartic* f3i—ij 
rhei - f3j 
aromaticus fgss 
rhoeados f 3'—ij 
rubi f3ii—iv 
aromaticus f3> —iv 
sarsaparill* compositus f 3*8—iv 
scill* Tl^x—3j 
compositus TQ x—f 3j 
seneg* f 5j—j.j 
senn* f 5i—iv 
tolutanus f Sss 
stillingi* compositus f 5i—fSj 
trifolii compositus fSj-’jv 
zingiberis f 3i—iv 
Terebene TQv —xx 
Terebinthina. Chian gr. v—xx 
Terpene hydrate gr. ii—x 
Tetronal gr. v—5j 
Thymol gr. ss—ij 
Tiglii oleum TT^—ij 
Tinctura aconiti Tt\i—v 
ngarici Tt^xx—3j 
aloes f 3ss—ij 
et myrrh* f3ss—if 
arnica: florum TT] x—xxx 
radicis TQv—x 
asafcetida f 3ss—.j 
asclepias f 3ss—j 
belladonn* TT^x—xx 
benzoini f 3ss 
com posi ta f 3ss—ij 
berberidis TT|_ xx—f 3j 
bryoni* f 3i—iv 
calendul* f Sss—j 
calumb* f 3i—ij 
cannabis tn.x—xx 994 
TABLE OF DOSES, 
Preparation. Dose. 
Tinctura cantharidis Pj,i—x 
capsici Tl^v—f 3iij 
cardamomi f 3i—i.j 
composita f 3i—iv 
catechu composita TT|_x—f 3j 
chiratae f 3i—ij 
chloroformi et morphinae Tl\v—x 
cimicifugae f 3>—ij 
cinchonas PXxxx-f 5ij 
composita f 3i—iv 
cinnamomi f 3<—iv 
coceuli Tt^i—iv 
cocillanae P]_xxx—f 3ij 
oolchici Plv—5j 
collinsoniie Pj_xx — f 3>j 
conii Tllv—xxx 
coto corticis Pfv—xv 
croci f 3i--ij 
cubebie f S^s—ij 
digitalis TT^x—xxx 
dioscoreae PI x—f 3j 
duboisiae P^v—x 
eucalypti f3i—iv 
euphorbiae piluliferae.... P^v—xxx 
ferri acetatis Tl|_x—f 3j 
chloridi PXv—3j 
gallae f 3ss—j 
gelsemii P^v—xx 
gentian® composita f3i—iv 
guaiaci PXx—f 3j 
ammoniata Pl_x—f 5.1 
hoang-nan P\xx—xl 
humuli f Si—iv 
hydrastis f5*s—ij 
hyoscy ami P\ xx—f 3>j 
ignatiae P\ii—x 
iodi Pl_i—v 
ipecacuanhae et opii Pfi—xv 
iridis Pl_x— f 3j 
kino f 5i—ij 
krameriae 1 f.3i—iv 
lavandulae composita. f3ss—j 
lobcliae pj_v—f 5j 
matico f 5.1—f Sj 
moschi f 3ss—j 
myrrh® f 3*s—ij 
et capsioi f3ss—j 
nucis vomicae P^v—xx 
Preparation. Dose. 
Tinctura opii TT^i—xx 
catnphorata f 3j—f Sss 
deodorata P^i—xx 
phosphori P^v—xxx 
physostigmati s v—x 1 
phytolaccse radicis TTLx—f3.1 
quassiae PI xx—fjjj 
quillaiae f3i—ij 
rhei f3ss 
aquosa f 5i—vj 
aromatica f 3i—vj 
dulcis f 31—vj 
et gentianae f 3i—iv 
sanguinariae Trj_v—xv 
seillae Pl_v—xxx 
serpentariae f 3>—ij 
stillingiae f 5ss—j 
sumbul f 3ss—,1 
thujae f3ss—j 
Valerianae 1 3i—ij 
ammoniatse f 3i—ij 
veratri viridis TTXiij—f 3j 
zingiberis Til*—f 3j 
trimethylamini liydrochloras gr. iii—x 
Tuberculinum (hypodermatieally) gr. 1-64 
Urethan gr. viij—3j 
Uva ursi 3>—>j 
Valeriana. gr. x—xxx 
Veratrina gr. 1-50—1-12 
Viscum gr. x—3j 
Xanthoxylum gr. x—xxx 
Zinci acetas gr. ss—ij 
(as emetic) gr. x—xxx 
bromidum gr. i—v 
carbonas precipitatus gr. ii—iij 
cyanidum gr. iss 
iodidum gr. ss— y 
lactas gr. ss—j 
oxidum gr. v 
phosphidum gr. 1-20— 
sulphas gr. i—xx 
sulpho-carbolas gr. ii—iij 
valerianas gr. i—ij 
Zingiber. gr. x—xt INDEX OF DRUGS AND PREPARATIONS. 
PAGE 
Abies balsamea 355 
Canadensis 355 
excelsa 355 
Abric acid 355 
Abrns 355 
Absinthe 356 
Absinthin 356 
Absinthium 356 
Absorbent cotton 366 
Abstractum aconiti 397 
belladonnae r 467 
conii 567 
digitalis 592 
hyoscyami 682 
ignatiae 687 
ialapae 712 
nucis vomic* 765 
podophylli 333 
senegse 897 
Valerianae 966 
Acacia 357 
Acetal 358 
Acetanilide 358 
Acetate of copper 587 
of lead 827 
of morphine 775 
of potassium 836 
of sodium 905 
of zinc 975 
Acetic acid ,360 
glacial 360 
ether 109 
Acetum lobeliae 730 
opii 775 
sanguinariae 881 
scillae 893 
Acids ix 
Acidum aceticum 360 
dilutum 360 
glaciale 360 
arseniosum 361 
benzoicum 366, 474 
boricum .366 
carbolicum 367 
crudum 367 
iodatum 694 
chromicum ,371 
citricum 372, 725 
gallicum 373 
hy driodi cu in 374 
hydrobromicum dilutum...374, 482 
hydrochloricum 375 
dilutum 375 
hydroeyanieum dilutum 377 
hydroflnoricum 378 
lacticum 379 
nitricum .380 
nitricum dilutum 380 
nitrolivdrochloricum 381 
dilutum 381 
oleicum 382 
oxalicum 384 
phosphoricum 384, 806 
dilutum .384 
picricum 386 
salicylicum .386 
sulphurieum 390 
aromaticum 390 
dilutum v 390 
sulphovinicum .392 
sulphurosum 392 
tannicum 394 
tartaricnm 396 
Aconite 397 
Aconitine .397 
oleate 382 
Aconitum 397 
PAGE 
Actaen 541 
Adeps 400 
benzoinatus 400, 474 
dehvdratus 400 
Adhatoda justicia 401 
Adhesive plaster 854 
Adonidine 401 
Adonis vernalis 401 
ASseulin 658 
AOsculus hippocastanum 402 
Aether 402 
acetieus 409 
fortior 402 
liydriodicus 409 
hydrobromicus 409 
African tea 521 
Agaric, purging 410 
Agaricin 410 
Agaricus albus 410 
chirurgorum 411 
muscarius 411 
Ailanthus glandulosa 412 
tree 412 
Albuminate of iron 626 
Alcohol 413 
dilutum 413 
Alder-bark 423 
Alkalies ix 
Allium 421 
cepa 421 
Allspice 820 
Allyl sulphide 422 
Almond 437 
Alnuin 423 
Alnus 423 
Aloe 423 
purificata 423 
Aloes 423 
Barbadoes 424 
Cape 424 
Aloin 424 
Alteratives xi 
Althaea 427 
Alum 428 
curd 428 
dried 428 
glycerite of. 428 
iron 428 
root 657 
Alumen 428 
amtnonio-ferricum 428 
glyceritum 428 
Aluminated copper 587 
Aluminii hydras 428 
sulphas 428 
Aluminium oleate 382, 428 
Alveloz 430 
Amber 926 
Ambergris 430 
Ambragrisea 430 
American aspen 835 
centaury 873 
columbo 635 
hellebore 969 
hemp 507 
ipecacuanha 642 
American wormseed 525 
Ammoniacum 431 
Ammoniated glvcyrrhizin 432, 616 
mercury 432 
Ammonii benzoas 432 
boras 432 
bromidnm 432. 482 
carbonas 432 
chloridum 432 
iodidiim 432, 691 
nitras 432 
PAGE 
Ammonii phosphas 432 
sulphas 432 
valerianas 432 
Ammonium 431 
Amygdala 437 
Amygdalic acid 722 
Amyl nitris 438 
valerianate 440 
Amylene hydras 440 
Amylum 441 
iodatum 441, 094 
Amyrin 602 
Anaesthetics xii 
Anaphrodisiacs xvii 
Anemonicacid 848 
Aneinonin 848 
Angelic acid 935 
Anise 442 
Anisum 442 
Anthelmintics xv 
Anthemis 442 
Anthrarohin ; 443 
Anthrarobinum 443 
Anti-emetics xv 
Antifebvin 358 
Antimonial ponder 443 
Antimonii et potassii tartras.,443, 836 
oxidum 443 
sulphidum 443 
purifieatum 443 
Antimonium 443 
sulphuratum 443 
Antimony 443 
Antiparasities xviii 
Antipyretics xi 
Antipyrin 446 
Antiseptics.... xviii 
Antiseptol 552 
Antisialics xv 
Antis) asmodics xiv 
Aphrodisiacs xvii 
Apiine . 447, 804 
Apiol 447,804 
Apiolinum 447 
Apocodeine 778, 791 
Apocynein , 448 
Apocynin 448 
Apocynum 448 
Apomorphinm hydrochloras 448 
Apomorphine 791 
Aporhetin 861 
Aqua acidi carboliei 368 
ammonise 431 
fortior 431 
amygdala; amara; 437 
anisi 442 
nurantii Durum 462 
camphorae 503 
chlori 538 
chloroformi 532 
cinnamomi 554 
creasoti 579 
eucalypti 616 
fceniculi 634 
liamamelidis destillata 653 
laurocerasi 377, 722 
menthte piperitae 745 
viridis 745 
rosae , 868 
Arabin 954 
Arbor vitae 949 
Arbutin 526, 603, 637, 741, 966 
Areca 448 
Argenti cyanidum 449 
iodidiim 449, 694 
nitras 449 
dilutus 449, 837 996 
INDEX OF DRUGS AND PREPARATIONS. 
PAGE 
Argenti nitras fusus 449 
oleatum 449 
oxidum 449 
Argentum 449 
Aristol 452 
plaster 455 
Aristolochin 900 
Arnica 456 
Arnicin 456 
Aromatic sulphuric acid 390 
Arrow-poison 590 
Arrow-root starch 742 
Arseniate of iron 626 
of sodium 905 
Arsenic, bromide of. 362 
Arsenicum oleate 382 
Arsenii iodidum 361, 694 
sulphidu m 361 
Arsenite of copper 587 
Artanthic acid 743 
Asafictida 457 
Asclepias 459 
Asclepidin 459 
Aseptol 459 
Asparagin 459, 617, 936 
Asparagus 459 
Aspidium 460 
Aspidosperma 852 
Aspidospermine 852 
Astringents xi 
Atropina 461, 467 
Atropinas sulphas 461, 467 
Atropine oleate 382 
Aurantii amari cortex 461 
dulcis cortex 461 
flores 461 
Aurantium 461 
Anri et sodii chloridum 462 
Australian blue gum-tree...- 616 
Ava-kava 716 
Avena 463 
Avens 642 
Azedaraeh 464 
Babarang 602 
Balm 744 
Balsam of Peru 465 
of Tolu 465 
Balsamum Canadense 4454 
Peruvianum 465 
Tolutanum 465 
Baptisia 466 
Baptisin 466 
Barberry 477 
Barii chloridum 466 
Bassorin 876, 954 
Battery fluid 371 
Baume de vie 424 
Bay 72.3 
Bavberry-bark 757 
Bay-laurel 723 
Beau of St. Ignatius 687 
Beet 477 
Belladonnas folia 467 
Belladonnas radix 467 
Belladonna-leaves 467 
Belladonna-root 467 
Ben/.in 473. 801 
Benzinum 473, 801 
Benzoate of sodium 905 
Benzoic acid 366, 47 4 
Benzoin 474 
Benzoinated lard 474 
Benzoinum 174 
Benzol 476 
Benzolnm 476 
Benzoyl-tropine 467 
Berberina 177 
Berherinas hydrochloras 177 
Berberine 575, 679, 745, 974 
Berberis 477 
Bergamia 477 
Bergamot 477 
Bergaptene 477 
Beta 477 
Beta-guaiac resin 651 
Betel-nut 448 
Beth-root 9 55 
Bicarbonate of potassium 8*16 
of sodium .-..905 
of sodium, commercial 905 
Bichromate of potassium .371, 876 
Bismuth 477 
PAGE 
Bismuth oleate 383 
Bismuthi citras 477 
et ammouii citras 477 
oleas 477 
sal icy I as 477 
subcarbonas 477 
subiodidum 477 
subnitras 477 
Bismuthum 477 
Bisulphide of carbon 517 
Bisulphite of sodium 905 
Bitartrate of potassium 836 
Bitter cucumber 566 
Bitter-sweet 600 
Black alder 843 
cohosh 541 
draught 898 
haw 971 
pepper. 821 
snake-root 541 
wash 496, 663 
Blackberry 869 
compound 870 
cordial 869 
Bladder-wrack 635 
Blessed thistle 518 
Blistering cerate 510 
paper 510 
Blood-root 881 
Blue cohosh 522 
flag 712 
mass 662 
ointment 662 
Boldo 481 
Boldoin 481 
Boldus 481 
Boneset 620 
tea 620 
Borate of ammonium 432 
of sodium 366, 905 
Borax 366 
Borneol 507 
Boroglyceride 366,643 
Boroglyceridum. 64.3 
Braye ra 481 
Breidin 602 
Brein 602 
Bromide of ammonium 482 
of calcium 482, 496 
of lithium 482 
oi nickel 482 
of potassium 482. 836 
of sodium 482, 905 
of zinc 182, 975 
Bromine 482 
Bromoform 432, 488 
Bromum ...482 
Broom 891 
Brucine 687, 765 
Bryoidin 602 
Bryonia 489 
Bryonin 489 
Buchu I''!) 
Buckthorn 634 
Bugle-weed 732 
Burdock-root 722 
Burgundy pitch 824 
Bursa pastorius 490 
Butternut 714 
Butyl chloral hydrate 531 
Buxine 797 
Cacao-butter 947 
Cactus 491 
Cadmii iodidi 491 
sulphas 491 
Cadmium 491 
oleate .383 
Caffeina 491 
Cafleinm citras 491 
sodio-benzoas 491 
sodio-salicylas 491 
Caffeine 491 
Caffeone 559 
Cajuputi oleum 495 
Calabar bean 812 
Calabarine 812 
Calamus 495 
Calcii bromidum 482. 496 
carbol ns 496 
carbon as pneci pi tatus .‘. .496 
chloridum 496 
hypophosphis .496 
PAGE 
Calcii phosphas prrecipitatus 496 
Calcium 495 
carbolatum 368 
Calendula .. 500 
Calendulin 501 
Cal u in ba 501 
Calx 196 
chi ora ta 495, 538 
sulphurata 495 
Cainbogia 501 
Camellia 502 
Campho-phenique 368 
Camphor 503 
Camphor-chloral 504 
Camphora 503 
monobromata 482, 503 
Camphoric acid 507 
Canada fleabane 608 
pitch 825 
turpentine 464 
Canadian hemp 448 
moon seed 745 
Cannaben j 508 
Cannabiu 508 
C&nnabime tan n as 507 
Cannabis Americana 507 
Indica 507 
Cantharidal collodion 510 
Cantharides 510 
Cantharidin 511 
Cantharis 510 
Capsaicin 514 
Capsicum ; 513 
Caraway 518 
Carbasus acidi carbolici 368 
Carbazotic acid 386 
Carbo animalis 516 
purificatus 516 
ligni 516 
Carbolic acid 367 
Carbolized oil .‘468 
Carbonate of ammonium 432 
of calcium, precipitated 196 
of iron, saccharated 525 
of lead 827 
of lithium 728 
of magnesium 733 
of potassium 836 
of sodium 905 
dried 905 
of zinc, precipitated 975 
Carbonei bisulphidum 517 
Cardamom 517 
Cardamomuin 517 
Carduus benedictus 518 
Marianus 518 
Cariol 804 
Carmine 518.5.58 
Carininum 518 
Ca rota 618 
Carrot fruit 518 
Carom 518 
Caryophyllin 519 
Caryophyllus 519 
Casca cortex 519 
Cascara atnarga 520 
sagrada 859 
Cascarilla 520 
bark 520 
Cascarillin 520 
Cassia fistula 520 
Castanea 520 
Castor oil 865 
Catechin 521 
Catechu 521 
Catechu-tannic acid 521 
Catha 521 
Cathartic acid 898 
Caulophyllin 522 
Caulophyllum 522 
Caustic potash 836 
soda :...905 
Caustics xviii 
Ceirine 522 
Cedron 522 
seed 522 
Cedron ine 522 
Cera 522 
alba 522 
flava v..*. 522 
Ceratutn cam phone 503 
cantharidis *. 510 
cetacei 523 INDEX OF DRUGS AND PREPARATIONS. 
997 
PAGE 
Ceratum cupri acetatis 587 
extracti eantharidis 510 
plunibi subacetatis 827 
resinae 854 
sabinae 873 
Cerii oxalas 523 
Cetaceum 523 
Cetraria 524 
Cevadic acid 871 
Cevadilla 871 
Cevadillic acid 871 
Cevadilline 871 
Cevadine 871, 969 
Chalk mixture 496 
Chamaslirin 657 
Chamomile 442 
Charcoal 516 
Charts eantharidis 510 
potassii nitratis 837 
sinapis 903 
Chaulmoogra-oil 524 
Checker-berry 750 
Chekan 525 
Cheken 525 
Chelidonic acid 525, 882 
Chelidonine 525 
Chelidonium 525 
Chelidoxanthine 525 
Chenopodium 525 
Cherry-laurel 722 
Chestnut 520 
Chimaphila 526 
Chimaphilin 526 
China 526 
Chinese sumach 412 
Chinoidin 526, 544 
Chinoidinum 526, 544 
Chinolin 526 
Chinolina 526 
Chinolinae salicylas 526 
Chirata 527 
Chiratin 527 
Chloral 528 
butylicum 531 
Chloralamid 531 
Chlorate of potassium 836 
of sodium 905 
Chloride of ammonium 432 
of barium 466 
of calcium 496 
of gold and sodium 462 
of mercury, corrosive 662 
mild 662 
of sodium 905 
of zinc 975 
Chlorinated lime 495 
oil 540 
Chlorine 538 
Chlorodyne 535 
Chloroformum purificatum 532 
venale 532 
Chlormethy 1 532 
Chlorum 538 
Chondrus 540 
Chromate of lead 827 
Chromic acid 371 
Chrysophan 861 
Chrysophanic acid 861 
Chrvsarobin 540 
Chrysarobinum 540 
Cicu toxin 557 
Cimicifuga 541 
Cinchona 543, 544 
Cinchoninae iodosulphas 544 
sulphas 544 
Cinchonidinae salicylas 544 
sulphas 544 
Cinnamic acid 925 
Cinnamomum 554 
Cinnamon 554 
Citrate of bismuth...; 477 
of bismuth and ammonium...477 
of caffeine 491 
of iron 625 
of iron and ammonium 625 
of iron and quinine 544, 625 
of iron and strychnine 625 
of magnesia 733 
of potassium 836 
Citric acid 372 
Classification of Medicines vi 
Clemen’s solution 362 
Cloves 519 
PAGE 
Cnicin 518 
Coca 609 
Cocaina 609 
Cocainae liydrochloras 609 
Cocaine oleate 303, 609 
Cocculus 556 
Indicus 556 
Coccus 558 
Cochineal 558 
Cocillana 558 
Codeina 559, 775 
Codliver-oil 751 
Coffeae 559 
Coffee 559 
Cohosh, black 541 
blue 522 
Colchiceine 561 
Colchici radix 560 
semen.... 560 
Colchicina 560 
Colchicnm-root .560 
seed 560 
Cold cream 437, 523, 868 
Collinsonia Canadensis 563 
Collodium 565 
cum eantliaride 510, 565 
flexile 565 
stypticum 394 
Colocynth 577 
Colocynthein 566 
Colocynthin 566 
Colocynthis 566 
Colocynthitin 566 
Colophony 854 
Common buckthorn 858 
Compound chloroform mixture 535 
spirit of ether 408 
Condurango 567 
Confectio althaeae 427 
opii 775 
rosae 744, 868 
sennse 576, 898 
Conhydrine 568 
Coniinaa hydrobromas 568 
hydrobromicum 482 
Conium 567 
juice 568 
Convallamarin 571 
Convallamarinum 571 
Convallaria majalis 571 
Convallarin 571, 835 
Convolvulin 713 
Copaiba 572 
Copaibic acid 572 
Copper 587 
ammoniated 587 
oleate 383 
Coptine 575 
Coptis 575 
Cordialis rubi fructus 870 
Coriamyrtin 557 
Coriander 576 
Coriandrum 576 
Corn-silk 735 
Corn-smut 736 
Cornin 576 
Cornus 576 
Cornutin 604 
Corydaline 576 
Corydalis 576 
Coto-bark 577 
Cotoina 577 
Cotton 647 
Cotton-root bark 647 
Couch-grass 957 
Coumarin 657 
Court-plaster 686 
Cowhage 756 
Cranesbill 641 
Cream of tartar 836 
Creasol 579 
Creasote 579 
Creasotum 579 
Creolinum 583 
Creta preparata 496 
Crocus 585 
Croton chloral 531 
oil 951 
Cubeb 585 
Cubeba 585 
Cubeben 586 
Cubebene 586 
Cubebio acid 586 
PAGE 
Cubebin 586 
Cuca (il)9 
Cucurbitine 797 
Cudbear 801 
Culver's root 724 
Cupri acetas 587 
arsenis 587 
sulphas 587 
Cuprum 587 
aluminatuiu 587 
ammoniatum 587 
Curare 590 
Curarin 590 
Cyanide of mercury 663 
potassium 836 
of silver 449 
of sine 976 
Cydonium 591 
Cymene . 950 
Cymol 617 
Cynoglossine , 591 
Cynoglossum 591 
Cypripedin 591 
Cypripedium 591 
Daminna 592 
Daphnin 749 
Daturine ...919 
Decoctum aloes compositum 424 
cetrarias 524 
cimicifugse- 541 
dioseoreae 597 
euphorbise piluliferse 620 
granati 648 
haematoxyli 653 
quillaiae 853 
sarsaparillse compositum 890 
stillingise 918 
tussilago 964 
uvae ursi 965 
viopj Q7Q 
Delphinine....916,917 
Delphinoidine 916 
Delphisine 916 
Demulcents xviii 
Dewees's carminative 457,733, 775 
Dextro-quinine 553 
Diachylon 827 
Dialyzed iron 626 
Diaphoretics xvi 
Digital ein 593 
Digitalin 593 
Digitaline 593 
Digitalinum 592 
Digitalis 592 
Digitin 593 
Digitonin 593 
Digitoxin 593 
Dilute hydrobromic acid 374, 482 
hydrochloric acid 375 
hydrocyanic “ 377 
lunar caustic 837 
nitrate of silver 449 
nitric acid 380 
nitrohydrochloric acid 380 
sulphuric acid 390 
Dioscorea villosa 597 
Dioscorein 599 
Disinfectants xviii 
Dita 599 
bark 599 
Ditain 599 
Ditamine 599 
Diuretics xvi 
Diuretiu 948 
Dobell's solution 368 
Dogwood 576 
Donovan's solution 361, 662, 694 
Dracontium 599 
Dried sulphate of iron 626 
Drosera 599 
Duboisia 599 
Duboisinte hydrobromas 599 
sulphas 599 
Dulcamara 600 
Eau sedative 504 
Ecbolics xvil 
Elaterin 601 
Elaterinum 601 
Elder-flowers 881 
Elecampane 688 
Elemi... 601 998 
INDEX OF DRUGS AND PREPARATIONS. 
PAGE 
Elemic acid 602 
Elixir aurantii 462 
damianae 592 
gentian* ferratum 639 
et ferri phosphatis 639 
phosphori 807 
et nucis vomic* 807 
rubi 869 
Elm 964 
Embelia ribes 602 
Einbelio acid 602 
Emetics xv 
Emetina 70S 
Emmenagogues xvii 
Emodin 635, 861 
Emollients xvii 
Emplastrum ammoniaci 431 
cum hydrargyro 431, 662 
antimonii 444 
arnicas 456 
asafoetid* 457 
belladonn* 467 
capsici 513 
ferri 626 
galbani 636 
hydrargyri 662 
ichthyocollae 686 
opii 775 
picis Burgundicae 824 
Canadensis 825 
cum cantharide 510, 824 
plumbi S27 
resin* 854 
saponis 887 
Emulsin 722 
Ephedra 602 
Ephedrin 602 
Epig*a 603 
Ergot 603 
Ergota 603 
Ergotin 603 
Ericolein 724 
Ericolin 637, 741, 966 
Erigerontis oleum 608 
Eriodictyon 509 
Erythrophl*ine 519 
Erythrorhetin 861 
Erythroxylon 509 
Escharotios xviii 
Eschscholtzia 616 
Eseridine 813 
Eserine 812 
Ether 402 
Ethereal oil 402 
Ethyl bromide 409 
iodide 409, 694 
iodidum 409, 694 
Ethyl-sulphuric acid 392 
Ethylate of sodium 905 
Eucalyptol 617 
Eucalyptus 616 
Eugenic acid 757 
Eugenin 519 
Euonymin 619 
Euonymus 619 
Eupatorin 620 
Eupatorium 620 
purpureum 620 
Euphorbia corollata 621 
ipeoacuanha 621 
pilulifera 620 
Euphorbium 621 
Euphorbon 621 
Euphrasia 622 
Exalgine 622 
Exhilarants xii 
Expectorants xvi 
Extractum aconiti 397 
aconiti fluidum 397 
agarici 410 
aloes aqnosum 423 
liquidum 424 
arnicas fluidum 456 
radicis 456 
aurantii amari fluidum 461 
baptisi* 466 
belladonn* alcoholicum 467 
fluidum 467 
berberidis fluidum 477 
brayer* 481 
bryoni* 489 
buchu 489 
calami fluidum...., 495 
PAGE 
Extractum calumbae 501 
calumbas fluidum 501 
camellias fluidum 502 
caunabis Indicas 507 
fluidum 507 
capsici fluidum 513 
cardamomi compositum flu- 
idum 517 
chimaphil* fluidum 526 
china; fluidum 526 
chirat* fluidum 527 
cimieifugae 541 
fluidum 541 
cinchonas 543 
fluidum 543 
cocculi 556 
cocillanse 558 
coffeae viridis 559 
colchici fluidum 560 
radicis 560 
seminis 560 
collinsoniae 563 
colocynthidis 566 
compositum 566,893 
conii alcoholicum 567 
fluidum 567 
eonvallarias 571 
fluidum 571 
coptidis 575 
coriandri .576 
cornus Florid* 576 
fluidum 576 
corydalis— 576 
coto corticis 577 
cubebae 585 
damian* 592 
fluidum .592 
digitalis 592 
fluidum 592 
dioscoreae 597 
duboisiae 599 
fluidum 599 
dulcamaras 600 
fluidum 600 
ergot* 693 
fluidum 603 
eriodictyi >09 
fluidum 809 
erythroxyli 609 
erythroxyli fluidum 609 
eucalypti fluid 616 
euonymi 619 
eupatorii 620 
euphorbias piluliferae 620 
fluidum 620 
fabianae : 623 
frangul* 634 
fluidum 634 
gelsemiuin 638 
gentian* 639 
fluidum 639 
gei fluidum 642 
geranii 641 
fluidum 641 
gillenias trifoliatae fluidum 642 
glycvrrhiz* 646 
fluidum 646 
purum 646 
gossypii radicis fluidum 647 
granati fluidum 648 
grindeliae 649 
fluidum 649 
guaranas , 652 
h*matoxyli 653 
hainamelidis fluidum 653 
hoang-nan fluidum 658 
humnli 660 
hydrastis 679 
fluidum ...679 
hyoscyami 682 
alcoholicum 682 
fluidum 682 
ignatias 687 
fluidum 687 
ipecacuanh* fluidum 708 
iridis 712 
fluidum 712 
juglandis 714 
fluidum 714 
iuniperi fructus fluidum 714 
kino liquidum 717 
krameriae 719 
fluidum 719 
PAGE 
Extractum lactucarii 721 
leptandr* 724 
fluidum 724 
lobelias fluidum 730 
lupulini fluidum 660 
maidis stigmatorum fluidum...735 
malti 737 
diastasicum 737 
matico -742 
fluidum 742 
mezerei 749 
fluidum 749 
nucis vomicae 765 
fluidum 765 
opii 775 
ortbosiphon fluidum 775 
pancreati 793 
pareirae fluidum 797 
physostiginatis 812 
phytolaccae radicis fluidum 815 
pilocarpi fluidum 816 
piscidiae 822 
fluidum 822 
podophylli 833 
fluidum 833 
pruni Virginianae fluidum 847 
quassias 851 
fluidum 851 
quillaiae fluidum 853 
rhamni catharticae fructus A....858 
rhei 860 
fluidum 860 
rhoeados fluidum 863 
rhois glabra: fluidum 863 
ro8ae fluidum 868 
rubi fluidum 869 
sabal fluidum 872 
sabinae fluidum 873 
sanguiuarias fluidum 881 
santonicae 885 
fluidum 885 
sarsaparillae 890 
fluidum 890 
compositum fluidum 890 
scilla: fluidum 893 
Scutellariae fluidum 895 
sedi acris fluidum 896 
senega; fluidum 897 
sennae gqg 
fluidum 898 
deodoratum 898 
serpentarias 899 
solani paniculati fluidum 910 
spigelias fluidum 915 
stillingi* fluidum 918 
sumbul 935 
taraxaci 939 
fluidum 939 
trifolii fluidum 955 
trillii fluidum 955 
tritici fluidum 957 
tussilago fluidum 964 
uvae ursi fluidum 965 
valerianas fluidum 966 
veratrum viridis fluidum 969 
viburni 971 
fluidum 971 
pulvis 971 
viola! fluidum 972 
viscum fluidum 973 
xanthoxvli fluidum 974 
zingiberis fluidum 979 
Eyebright 622 
Fabiana imbricata 623 
False hellebore 401 
unicorn 657 
Fel bovis 624 
inspissatum 624 
purifleatum 624 
Fennel-seed 634 
Fermentum 624 
Fern, male 460 
Ferri albutninas 626 
arse ni as 626 
carbonas saccharatus 625 
cliloridum 625 
citras 625 
et ammonii citras 625 
sulphas 626 
tariras 626 
et potassii tartras 626, 836 
et quininae citras 544, 625 INDEX OF DRUGS AND PREPARATIONS. 
999 
PAGE 
Ferri et strychninae citras 625 
ferrocyanidum 626 
hypop*hosphis 626 
iodidum saccharatum 625, 694 
lactas 379, 625 
oxalas 626 
oxidum hydratum 626 
hydra turn cum magnesia..626 
phosphas 626 
py rophosp has 626 
sulphas 626 
exsiccatus 626 
praecipitatus 626 
valerianas 626 
Ferrier’s snuff. 358 
Ferrum reductum 625 
dialysatum 626 
Ficus 634 
Fig 634 
Fish-berry 556 
glue 686 
Flaxseed 726 
Fluid Dover’s powder 775 
Fly fungus 411 
Fceniculum 634 
Fowler’s solution 361, 837 
Foxglove 592 
Frangula 634 
Frangulin 634 
Frankenia 635 
F rasera 635 
Fraxin 658, 741 
Frost wort 656 
Fuchsin 635 
Fucus vesiculosus 635 
Fumaric acid 576 
Gnduin 751 
Galanga 636 
Galbanum 636 
Gal la 636 
Gallic acid 373 
Galls 636 
Gamboge -501 
Garlic 421 
Gaultheria 637 
Gaultherilene 637 
Gein 642 
Gelsemina 638 
Gelsemium 638 
Gentiana 639 
Gentiopicrin 635, 640 
Gentisic acid 635, 640 
Geranium 641 
German chamomile 743 
worm-seed 885 
Geum 642 
Gillenia 642 
Gillenin 642 
Gin 714 
Glonoin 439 
Glycerin 643 
Glycerinum 643 
Glyceritum acidi carbolici 368 
acidi tannici 643 
amyli 441, 643 
lactucarii 721 
pepsini vitellini 643, 798 
vitelli 643, 974 
Glycerol damianae, phosphori, et 
nucis vomicae 592 
Glycerole of aloes 427 
of pepsin 643, 798 
Glyconin 643 
Glycvrrhetin 647 
Glycyrrhiza 646 
Glycyrrhizin 647 
G1 v cy r rh izinum ammoni atum .432,646 
Goa-powder 540 
Gold thread 575 
Golden rod. 911 
seal 679 
Gossypii radicis cortex 647 
Gossypium 647 
Goulard's cerate 827 
extract 827 
Granatum 648 
Griffith's mixture 625 
Grindelia 649 
Green soap 887 
Guaiac 651 
wood 651 
yellow 651 
PAGE 
Guaiacetic acid 651 
Guaiaci lignum 651 
resina 651 
Guaiacic acid 651 
Guaiacol 579 
Guaiaconic acid 651 
Guaiacum 651 
Guarana 652 
Guaranin 652 
Guarea 558 
Gulf-weed 635 
Gum ammoniac 431 
arabic 357 
Gurjun 652 
Gurjunic acid 652 
Gutta-percha 653 
Gy nocardic acid 524 
Hsematinics ix 
Hsematoxylin 653 
Haematoxylon 653 
Haller’s acid drops 392 
llamamelis 653 
Heart's ease 972 
Hedeoma 655 
Helenin 688 
Helianthemum 656 
Hellebore 656 
false 401 
Helleborein 656 
Helleborin 656 
Ilelleborus 656 
Helonias 657 
Hemidesmus 657 
Hemlock 567 
pitch 825 
spruce 821 
Hemp, American 507 
Canadian 448 
Indian 507 
Henbane 682 
Hepatic depressants xv 
stimulants xv 
Hepatica 657 
Ilesperidin 725 
Heuchera 657 
Hickory pickory 424 
Hiera picra 424 
Hippocastanum 657 
Hoang-nan 658 
Hoffmann's anodyne 408 
Holly 687 
Homatropina 467 
Ilomatropinae hydrobromas...467, 659 
Honduras bark 520 
Honey 744 
clarified 744 
of rose ...744, 868 
Hop-tree bark 848 
Hope’s camphor mixture 381 
Hops 660 
Horehound 742 
Horse-chestnut 402, 657 
Ilumulus 660 
Hydrargyri chloridum corrosi- 
vum 662 
mite 662 
cyanidum 663 
formamidatum 663 
iodidum rubrum 662, 694 
viride 662, 694 
oxidum flavum 662 
rubrum 662 
salicylas 663 
subsulphas flava 662 
sulphidum rubrum 663 
tannas 663 
Hydrargyrum ammoniatum...432, 662 
cum creta 496, 662 
Hvdrastina 679 
Hvdrastinae hydrochloras 679 
Ilydrastinine 679 
Hydrastis 679 
Hydrate of chloral., 528 
Hydrated oxide of iron 626 
oxide of iron with magnesia...626 
Hvdriodic acid 374 
ether . 409 
Ilydrobromate of coniine 482 
of homatropine 467, 659 
of hyoscine 682 
Hydrobromic ether 409 
Hydrochlorate of apomorphine 448 
PAGE 
Hydrochlorate of berberine 477 
of cocaine 609 
of hydrastin 679 
of morphine 775 
of narcotine 775 
of pilocarpine 816 
Hydrochloric acid 375 
Hydrofluoric acid 378 
Ilydrofluosilicic acid 901 
Hydrogen peroxidum 681 
Hygrine 609 
Hyoscina 683 
Hyoscinm hydrobromas 682 
1 lyoscy amina 683 
Iiyoscyaminse sulphas 682 
Hyoscyamus 682 
llypnal 685 
llypophosphite of iron 626 
of lime 496 
of potassium 836 
of sodium 905 
Hyposulphite of sodium 905 
Hyssop 685 
Ilyssopus 685 
Hysterionica 685 
Iceland moss 524 
Ichthyocolla 686 
Ichthyol 707 
Igasuric acid 765 
Igasurin 765 
Ignatia 687 
Ilex 687 
Illicium 688 
Indian berry 556 
Indian corn 743 
hemp 507 
sarsaparilla 657 
Indigo 688 
blue 688 
wild 466 
Indigotin 688 
Infusum anthemidis 442 
arnicae florum 456 
asclepias 459 
brayerae 481 
bucnu 489 
camelliae 502 
capsici 513 
caryophylli 519 
cinchonae 543 
collinsoniae 563 
convallariae 571 
digitalis 592 
eupatorii 620 
gentianae compositum 639 
humuli 660 
juniperi 714 
lini compositum 646 
pilocarpi 816 
pruni Virginiana 847 
quassiae 851 
sassafras - 891 
sennse 898 
compositum 898 
tabaci 936 
taraxaci 939 
trifolii 955 
tritici 957 
Inula 688 
Inulin 688 
Iodi trichloridum 694 
Iodide of ammonium 694 
of arsenic 694 
of lead 694, 827 
of mercury 662, 694 
of potassium 836 
of silver 449, 694 
of sodium 905 
of sulphur 691, 930 
of zinc 694, 975 
Iodine 694 
Iodized phenol 694 
starch 441 
Iodoform 689 
Iodoformum 689 
Iodol 693 
Iodosulphate of cinchonine 553 
Iodum 694 
Ipecacuanha 708 
Ipecacuanhic acid 708 
Iridin 712 
Iris 712 1000 
INDEX OF DRUGS AND PREPARATIONS, 
PAGE 
Iris Florentina 711 
Irish moss 540 
Iron oleate 383 
plaster 626 
Irritants xviii 
Isinglass 686 
plaster 686 
Jaborandi 816 
Jaborine 816 
Jackson’s pectoral syrup 892 
Jalap *712 
Jalapa 712 
Jalapin 713 
Jamaica dogwood 822 
Jambol 713 
James's powder 443 
Java-tea 792 
Jequirity 355 
Jerubeba 910 
Jerubebin 910 
Jervine -959 
Juglandic acid 714 
Juglans 714 
Juice, buckthorn 858 
conium 568 
Juniper 714 
Juniperin 715 
Juniperus 714 
Kamala -716 
Katine 521 
Kava-kava 716 
Kino 717 
Kinoin 717 
Kino-tannic acid 717 
Kola-nut 718 
Koosin 481 
Kosin 481 
Krameria 719 
Kramerio-tannic acid 719 
Kumyss .719 
Labarraque’s solution 539 
Lactate of iron .379 
of zino 975 
Lactic acid 379 
Lactucarium 721 
Lactuccrin 721 
Lactucic acid... 721 
Lactucin 721 
Ladies' slipper 591 
Lafayette mixture 573 
Laminaria 721 
Lanolin 721 
Lanolinum 721 
Lappa 722 
Lard 400 
dehydrated 400 
oil 400 
Laudanum 775 
Laurel 723 
Laurin 723 
Laurocerasin 722 
Laurocerasus 722 
Laurostearin 723 
Laurus 723 
Lavandula 723 
Lavender 723 
flowers 723 
Lead 827 
oleate 383 
Lecithin 974 
Ledi-tannic acid 724 
Ledum 724 
Lemon 725 
juice 725 
peel 725 
Leonurus 724 
Leopard's bane 456 
Leptandra 724 
Leptandrin 724 
Lettuce opium 721 
Levant wormseed 885 
Lichenin 524 
Lily of the valley 571 
Lime-water 496 
Limon 725 
Linden-tree 953 
Lindera-bark 726 
Linimentum aconiti et chloro- 
formi 399,532 
ammonias 431 
PAGE 
Linimentum belladonnas 467 
calcis 496 
camphorae 503 
cantharidis 510, 940 
chloroformi 532 
mentholi 434 
plumbi subacetatis 827 
saponis 887 
sinapis eompositum 903 
terebinthinae 854, 940 
aceticum 361 
Linseed 726 
Liuum 726 
Lipanin 755 
Lipidolite 728 
Lippia Mexicana 727 
Lippiol 727 
Liquidambar 728 
Liquor acidi arseniosi 361 
ammonii acetatis 432 
anisatus 431 
arsenii et hydrargyri iodidi, 
361, 662, 694 
calcis 496 
chloratae 496 
electropoiecus 371 
ferri acetatis 626 
chloridi 625 
citratis ..625 
et quininae citratis 544, 625 
malatis 626 
nitratis 626 
subsulphatis 626 
tersulphatis 626 
gutta-perchae 653 
hydrargyri nitratis 662 
hypophosphitum acidus 807 
iodi compositus 694 
magnesii citratis 733 
pancreaticus 793 
pepsini 798 
phosphori 807 
plumbi subacetatis 827 
dilutus 827 
potassae 836 
potassii arsenitis 361, 837 
citratis 836 
sodae 905 
chloratie 538, 905 
sodii arseniatis 361, 905 
boratis compositus 368 
carholatus 368 
salicatis 901, 905 
xinci chloridi 976 
Liquorice-powder, compound 6 46 
Liquorice-root 646 
Lister's antiseptic ointment 366 
Litharge 827 
Lithii benzoas 728 
bromidutn 728 
carbonas .728 
citras 728 
guaiacas 728 
lodidum 728 
salicylas 728 
Lithontriptics xvi 
Litmus 730 
Liverwort 657 
Lobelacrin 730 
Lobelia 730 
Lobelic acid 730 
Lobeline 730 
Local astringents and styptics....xviii 
sedatives xviii 
Logwood 653 
London paste 905 
Lotio hydrargyri flava 496 
nigra 496 
Lunar caustic 449 
Lupuline 660, 731 
Lupulinic acid 660 
Lupulinum 660, 731 
Lycoperdon 732 
Lycopodium 732 
Lycopus 732 
Lysol 825 
Mace 733 
Macis 733 
Macrotin. 541 
Magnesia. 733 
ponderosa 733 
Magnesii oarbouas 733 
PAGE 
Magnesii citras granulatus 733 
sulphas 733 
sulphis 733 
Magnesium .733 
Magnolia 735 
Magnolia 735 
Maidis stigmata 735 
ustilago 736 
Maize 743 
Maizenic acid 736 
Male fern ." 460 
Malt 737 
Maltum 737 
Manaca 738 
Mandrake 833 
Manganese 739 
oleate 383 
Mangani oxidum nigrum 739 
sulphas 739 
Manganum 742 
Mangostaua 741 
Mangosteen 741 
Mangostin 741 
Manna 741 
Mannite 741 
Manzanita 741 
Maranta 742 
Marigold 500 
Marrubiin 742 
Marrubium 742 
Marsh-mallow 427 
drops .....427 
Massa copaibas 572 
ferri carbonatis 625 
hydrargyri 662 
Mastic 742 
Mastiche 742 
Mastichic acid 742 
Mastichin 742 
Matico 742 
Matricaria 743 
May-apple 833 
Mays 743 
Meadow anemone 848 
Meconic acid 776 
Mel 744 
despumatum 744 
rosas 744, 868 
Melissa 744 
Menispermum 745 
Mentha 745 
Menthol 745 
Mercuric oleate 383 
Mercurous oleate 384 
Methyl coniine 568 
creasol 579 
violet 747 
Methysticin 716 
Methysticum 716 
Mezereinic acid 750 
Mezereon ....749 
Mezereum 749 
Milk-wine 719 
Mint 745 
Mistletoe 973 
Mistura ammoniaci 431 
amygdalae 437 
antidysenterica 381 
asafoetida 457 
camphorae aromatica 505 
chloroformi 532 
hydrocyanata 535 
cretse 496 
ferri composite 625 
et ammonii acetatis 626 
ferro-salina 626 
glycvrrhizas composita 646. 775 
magnesias et asafnetid..457,733.775 
opii et ipecacuanhas composita,775 
potassii citratis 725, 836 
rhei et sodae 860, 905 
Mitchella 750 
Monkshood . 397 
Monobromate of camphor 482, 503 
Mormon tea 602 
Morphine 775 
Morphinae acetas 775 
hydrochloras 775 
oleatum 775 
sulphas 775 
Morphine oleate 384 
Morrhuae oleum 751 
Morrhuol 751 INDEX OF DRUGS AND PREPARATIONS, 
1001 
PAGE 
Moschns 755 
Moss, Irish 540 
Motherwort 724 
Mucilago acaciae 357 
cydonii 591 
sassafras medullae 891 
tragacanth* 954 
ulmi * 964 
Mucuna 1 756 
Mullein f 971 
Muriatic acid 375 
Muscarina 411 
Muscarinae nitras 411 
Musk 755 
Musk-root 935 
Mustard-leaves 903 
Mydriatics xvii 
Myotics xvii 
Myrciae oleum 756 
Myrica 757 
Myristica 757 
My rosin 903 
Myrrh 758 
Myrrha 758 
Myrtol 759 
N aph thal i ne 760 
Naphthalinum 760 
Naphthol, alpha- 760 
beta- 762 
hydro- 765 
Narcotics and anodynes xii 
Nareotinae hydrochloras 775 
Neroli oleum*. 765 
Niccoli bromidum 482 
Nickel oleate 384 
Nicotina 936 
Nitrate of lead 827 
of potassium 836 
of silver 449 
of sodium 905 
Nitre-papers 837 
Nitric acid 380 
Nitrite of amyl 438 
of sodium 905 
Nitro-glycerin 439, 643 
Nitrohydrochloric acid 381 
Nucin 714 
Nutgall 636 
Nutmeg 757 
Nut-oil 714 
Nux vomica 765 
Oat 463 
Oleatum hvdrargyri 382, 662 
veratrinae 382 
zinci 976 
Oleic acid 382 
Olein 751, 773 
Oleoresina aspidii 460 
capsici 513 
cubebae 585 
lupulini 660 
pi peris ....821 
zingiberis 979 
Oleum acidi carbolici 368 
adipis 400 
aethereum 402 
amygdalae amarse 437 
expressum 437 
anisi 442 
anthemidis 442 
aurantii corticis 461 
flores 461 
bergamii 477 
cadini 715 
cajuputi 495 
camphor* 503 
cari 518 
cariophvlli 519 
chenopodii 525 
ci n n am om i 554 
copaih* 572 
coriandri 576 
cubebae 585 
eucalypti 616 
foenicuii 634 
gaultheriae 637 
gossvpii seminis 647 
hedeomae 655 
juniperi 714 
lavandulae 723 
florum 723 
PAGE 
Oleum limonis 725 
menthae piperitae 745 
viridis 745 
myristicae 757 
olivae 773 
papaveris seminis 775 
phosphoratu m 806 
pimentae 820 
rosae 868 
rosmarini 869 
sabinas 873 
sassafras 891 
sinapis volatili 903 
succini 926 
tabaci 936 
terebinthinae 940 
thy mi 950 
valerianse 966 
Olive-oil 773 
Onion 422 
Ophelic acid 527 
Opium 775 
denarcotisatum 775 
Orange 461 
flowers 461 
peel, bitter 461 
sweet 461 
Orgeat syrup 437 
Origanum 775 
Orris-root 711 
Orthosiphon stamineus 792 
Orthosiphonin 792 
Osmic acid 792 
Osmii peroxidum 792 
Ouabaine 922 
Oxalate of cerium 523 
of iron 626 
Oxalic acid 384 
Oxide of antimony 443 
of lead 827 
of silver 449 
of zinc 975 
Oxymel scillae 893 
Pale rose 868 
Pancreatin 793 
Pancreatinum •. 793 
Pancrobilin 624 
Pansy 972 
Papain 794 
Papaveris capsulae 775 
Papayotin 794 
Papoid 799 
Paracotoina 577 
Paraldehyde 795 
Paregoric elixir 775 
Pareira 797 
brava 797 
Parillin 891 
Paris green 362 
Parsley 804 
Partridge-berry 637 
Pasta Londoniensis 905 
Pectin 717, 852 
Pelletierine 619, 849 
Pellitory 849 
Pennvroval 655 
Pepo 797 
Pepper 821 
Peppermint 745 
Pepsinum in lamellis 798 
saceharatum 798 
Permanganate of potassium...739, 837 
Peroxide of hydrogen 681 
of osmium 792 
Persia 801 
Persian insect-powder 849 
Peruvian bark 543 
Petrolatum 801 
Petroleum 801 
Petroselinum 804 
P has or he tin 861 
Pheasant’s eye 401 
Phenacetine 804 
Pheno-resorci n 855 
Pheno-resorcinum 855 
Phenol 367 
Phenol-salicylate 876 
Phloral ‘ 579 
Phosphate of ammonium 432 
of iron 626 
of sodium 905 
Phosphide of zinc 807, 975 
PAGE 
Phosphorated oil 806 
Phosphoric acid 384.806 
Phosphorus 806 
Physosterin 812 
Physostigma 812 
Physostigmina 812 
Physostigmina* sal icy las 815 
Phytolacca 815 
Phytolaceic acid 812 
Phytolaccin 815 
Pichi 623 
Picric acid 386 
Picropodophyllin 833 
Picrotoxin.... 556 
Picrotoxinmn 556 
Pill-bearing spurge 620 
Pilocarpina 816 
Pilocarpinae hydrochloras 816 
Pi’ocarpns 816 
Pilulae aloes 423 
et asafoetidae 423, 457 
et ferri 423, 626 
et mastiches 423 
et myrrhae 423, 758 
ammoniaci 431 
antimonii coni posit a) 444, 651 
asafoetidae 457 
ferri compositae 625 
iodidi 625, 694 
galbani compositae 457, 636 
opii 775 
phosphori 806 
piscidiae 822 
rhei 860 
compositae 424, 861 
Pimenta 820 
Pimpernel 821 
Pimpinella 821 
Pinipicrin 949 
Pi nk-root 915 
Pinus Canadensis 821 
Piper 821 
Piperina 821 
Pipsissewa 526 
Piscidia erythrina 822 
Piscidin 823 
Pitch 825 
Pix Burgundica 824 
Canadensis 825 
liquida 825 
PI an ta go 827 
Plantain 827 
Pleurisy-root 459 
Plumbi acetas 827 
carbon as 827 
chromas 827 
iodidum 827 
nitras 827 
oxidum 827 
rubrum 827 
Podophyllinic acid 833 
Podophylloquercitin 833 
Podophyllotoxin 833 
Podophyllum 833 
Poison-ivy 864 
oak 864 
Poke 815 
Polygalic acid 897 
Polygonati radix 834 
Polygonic acid 835 
Polygonum 835 
Pomegranate 648 
Poppy capsules 775 
Populi cortex 835 
Populin 835 
Porphyroxine 882 
Potassa cum calce 496 
sulphurata 836 
Potassii acetas 836 
bicarbonas 836 
bichromas 371, 836 
bitartras 836 
bromidum..., 482, 836 
carbon as 836 
chloras 836 
citras 836 
cyan i du m 836 
et sodii tartras 836, 905 
ferrocv ani dum 836 
hypophosphis 836 
iodidum 694, 836 
nitras 836 
permanganas 739, 837 1002 
INDEX OF DRUGS AND PREPARATIONS, 
PAGE 
Potassii sulphas 836 
sulphis 836 
tartras 836 
Potassium hydrate 836 
Precipitated carbonate of calcium..496 
of zinc 975 
phosphate of zinc 496 
sulphate of iron 626 
sulphur 930 
Prepared chalk 496 
Pride of China 464 
Prince’s pine 526 
Prinos 846 
Protopine 780 
Prune 846 
Prunum 846 
Prunus Virginiana 847 
Prussic acid 377 
Pseudo- jervine 969 
Ptelea-bark 848 
Puccine 882 
Pucci nic acid 882 
Puff-ball 732 
Pulmonary sedatives xvi 
Pulsatilla 848 
Pulvis aloes et canellse 424 
antimonialis 443 
aromaticus 555, 757 
cretae aromaticus cum opio 496 
compositus 496 
effervescens compositus 
396, 837, 905 
extracti piscidiae 822 
glycyrrhizse compositus 
646, 898, 930 
ipecacuanhae et opii 70S, 775 
jalapae compositus 712 
morphinae compositus 775 
pancreatini 793 
rhei compositus 861 
Pumpkin-seed 797 
Punicine 849 
Purgatives xv 
Purging cassia 520 
Purified animal charcoal 516 
Pyoktanin 747 
Pyrethrine 849 
Pyrethrotoxic acid 849 
Pyrethrum 849 
roseum 849 
Pyretin 825 
Pyridine 850 
Pyridinum 8.50 
Pyrocatechin 717 
Pyrocatechuic acid 833 
Pyrophosphate of iron 626 
of sodium 905 
Pyroxylin 647 
Pyroxylinum 647 
Quassia 851 
Quassin 851 
Queb rach i ne 852 
Quebracho 852 
Queen’s root 918 
Quercin 852 
Quercus alba 852 
Quicklime 495 
Quillaia 853 
Quince-seed 591 
Quinetum 544 
Quinidinae sulphas 544 
Quinina 544 
Quininae bisulphas 544 
hydrobromas 544 
liydrochloras 544 
carbamidataj 544 
sulphas 544 
tan nas 554 
valerianas 544 
Quinine oleate 384 
Quinoidine 526 
Quinolin 526 
Raspail’s sedative lotion 433 
Raspberry 870 
Red clover 955 
lead 827 
rose 868 
saunders 884 
Reduced iron 625 
Refrigerant remedies xi 
Rennet-wine 801 
PAGE 
Resin 854 
Resina 854 
copaibae 572 
jalapae 712 
phosphori 807 
podophylli 833 
scammonii 893 
Resorcin 855 
Resorcinum 855 
Retinol 857 
Rhamnocathartin 859 
Rhamnus catharticus 858 
purshiana 859 
Rhatany 719 
Rheotannic acid 861 
Rheum 860 
Rheumic acid 861 
Rhigolene 801, 803 
Rhigolenum 801 
Rhoeadine 863 
Rhoeas 863 
Rhubarb 860 
Rhus aromatica 863 
glabra 863 
toxicodendron 864 
Ricini oleum 865 
Ricinine 866 
Ricinoleate of glyceryl 866 
Rochelle salt 836, 905 
Rock-oil 801 
Rosa 868 
centifolia 868 
gallica 868 
Rosaniline hydrochlorate 635 
Rose 868 
Rosemary 869 
Rosinol 857 
Rosmarinus 869 
Rottlera 716 
Rottlerin 716 
Rubi-jervine 969 
Rubus 869 
idaeus .870 
Rumex 870 
Rutae oleum 871 
Sabadilla 871 
Sabal 8emi lata 872 
Sabbatia 873 
Sabina 873 
Saccharated carbonate of iron 625 
iodide of iron 625 
pepsin 798 
Saccharin v.874 
Saccharinum .\.874 
Saccharose 875 
Saccharum 875 
lactis 875 
Saffron 585 
Sage 881 
Sago 875 
Sal-bromalide 875 
Salep 876 
Salicin 876 
Salicinum 876 
Salicylate of bismuth 477 
of lithium 728 
of phvsostigmine 812 
of sodium 905 
Salicylic acid 386 
Salinaphthol 880 
Salipyrin 880 
Salix 876 
nigra 876 
Saltpetre 836 
Salol 876 
Salvia 881 
Sal viol 880 
Sambucus 881 
Sanguinaria 881 
Sanguinarine 525, 616, 882 
Santali oleum 884 
Santalum rubrum 884 
Santonica 885 
Santonin 885 
Santoninate of sodium 885, 905 
Santoninic acid 885 
Santoninoxime 886 
Santoninum 885 
Sapo 887 
viridis ...887 
Saponaria 889 
Saponin 522, 833, 853, 889 
PAGE 
Saponinum 889 
Sarsaparilla 890 
Sassafras - 891 
medulla 89L 
Sassafrin 892 
Sassy-bark 519 
Savin 873 
Saw-pal metto 872 
Scammonin 893 
Scammonium 893 
Seammony 893 
Scheele's green 362 
Sri 1 la S93 
Scillin 893 
Scillipicrin 893 
SeUUtoxin 80S 
Scleromucin 604 
Sclerotinic acid 604 
Scoparin 894 
Scoparius 894 
Scutellaria ....894 
Scutellarin 896 
Sea-tangle 721 
Sedum acre 896 
Seidlitz powder 396, 837, 905 
Senega 897 
Senegin 897 
Senna .. 898 
Sennacrol 898 
Sennapicrin 898 
Serpen tari a 899 
Sesami oleum 900 
Sevum 901 
Shepherd s purse 490 
Shikimi 688 
Sialagogues xv 
Sikimin 688 
Silica 90L 
Silicon 901 
Silver oleate 384 
Simulo 902 
Sinai bin 903 
Sinapin 904 
Sinapis 903 
Sinigrin 903 
Skull-cap 894 
S k u n k -cabba ge 599 
Smart-weed 835 
Smilacin 891 
Snake-root, black 541 
Snake-weed 620 
Soap 887 
Soap-bark..... 853 
Soda 905 
Sodii acetas 905 
arsenias 361, 905 
benzoas 905 
bicarbonas 605 
venal is 905 
bisulphis 905 
boras 356, 905 
broinidum 482, 905 
carbon as 905 
exsicoatus 905 
chloras 905 
chloridum 905 
ethylas 905 
hypophosphis 905 
hyposulphis 905 
iodidum 694. 905 
nitras 905 
nitris * 905 
phosphas 905 
pyrophosphas 905 
sal icy las 905 
santoninas 885, 905 
sulphas . 905 
sulphis 905 
sulphocarbolas 367, 905 
Sodio-benzoate of caffeine 491 
Sodio-salicylate of caffeine 491 
Solanine 6(H) 
Solidago 911 
Solomon’s seal 834 
Somnal 911 
Sozoiodol 912 
Sozolic acid 459 
Spanish flies 510 
Sparteine 894 
sulphate 894 
Spearmint 745 
Species 914 
Spermaceti 523 INDEX OF DRUGS AND PREPARATIONS, 
1003 
PAGE 
Spermini hydrochloras 914 
Sphacelinic acid 604 
Spice-bush 726 
Spigelia 915 
Spinal sedatives xiv 
stimulants xiv 
Spiritus atheris 402 
compositus 402 
nitrosi 402 
ammonia 431 
aromaticus 431 
anisi 442 
aurantii 462 
camphor* 503 
chloroformi 532 
cinnamomi 555 
foeniculi 634 
fruinenti 413 
gaultheria 637 
geneva 714 
hedeom* 655 
juniperi 714 
compositus 714 
lavandula 723 
limonis 725 
menth* piperita 745 
viridis 745 
myrcia 413, 756 
myristic* 757 
odoratus 413 
rosmarini 869 
vini galliei 413 
Squaw-vine 750 
Squill 893 
St. Mary's thistle 518 
Staphisagria 916 
Staphisagrine 917 
Star anise 688 
Starch 411 
Stavesacre 917 
Stillingia 918 
Stomachics xv 
Storax 925 
Stramonii folia 919. 
semen 919 
Stramonium 919 
Strontium 920 
Strophanthidin 922 
Strophanthine 922 
Strophanthus 921 
hispidus 921 
Strychnina 765 
Strychnin* sulphas 765 
Strychnine 687, 765 
oleate 384 
Styracin 925 
Styrax 925 
Styrol 925 
Styrone 925 
Subcarbonate of bismuth 477 
Subiodide of bismuth 477 
Sublimed sulphur 930 
Subnitrate of bismuth 477 
Subsulphate of mercury, yellow 662 
Succinum 926 
Succus conii 568 
Suet .901 
Sugar 875 
Sulpliaminol 927 
Sulphate of aluminium 428 
of atropine 467 
of cinchonidine 544 
of cinchonine 544 
of copper 587 
of hyoscyamine 682 
of iron 626 
dried 626 
precipitated 626 
and ammonium 626 
of magnesium 733 
of manganese 739 
of morphine. 775 
of potassium 836 
of qninine 544 
of sodium 905 
of strychnine 765 
of zinc 975 
Sulphide of antimony 443 
purified 433 
■of calcium 495 
of mercury, red 663 
Sulphite of magnesium 73.3 
of potassium ,,......836 
PAGE 
Sulphite of sodium 905 
Sulphocarbolate of sodium 905 
of zinc 976 
Sulphur lotum 930 
pracipita tu m 935 
sublimatum 930 
Sulphurated antimony 440 
calcium 495 
potassa 836 
Sulphuric acid 390 
Sulphuris iodidum 694, 930 
Sulphurous acid 392 
Sumach, Chinese .....412 
sweet 863 
Sumbul 935 
Sundew 599 
Suppositoria acidi carbolici 368 
Swedish cholera drops 775 
Sweet flag 495 
gum 728 
oil 773 
spirit of nitre 408 
Syrupus acacia 357 
acidi citrici 372, 725 
hydriodici 374, 694 
allii. 421 
cepa 422 
althe*...., 427 
amygdala 437 
aurantii 462 
florum 462 
calcii laeto phospliatis 496, 807 
calcis 496 
ferri bromidi 482, 626 
iodidi 625, 694 
quinina et strychnin* phos- 
phatum 625, 807 
hypophosphitum 496, 807, 836 
compositus 807 
cum ferro 496, 625, 807 
ipecacuanha ....708 
krameria 719 
lactucirii... 721 
linionis...,, 725 
maidis stigmatorum 735 
papaveris 775 
phosphatum compositus 807 
picis liquid* 825 
pruni Virginian* 847 
rhamnl cathartic* 858 
rhei 861 
aromaticus 861 
rhoeados 775, 863 
rosa 868 
rubi .,869 
aromaticus 869 
idai 870 
sarsaparilla compositus 890 
scilla 893 
compositus 893 
senega 897 
senna 898 
stillingia compositus 918 
tolutanus 465 
zingiberis 979 
Symphytum 937 
Tabaoum 936 
Tamarindus 939 
Tanacetin 939 
Tanacetum 939 
Tannate of cannabin 507 
of quinine 554 
Tannic acid 394 
Tannin 394 
Tar 825 
Taraxacerin 940 
Taraxacin 940 
Taraxacum 939 
Tartar emetic 443, 836 
Tartaric acid. 396 
Tartrate of antimony and potas- 
sium 396 
of iron and ammonium 626 
and potassium 626, 836 
of potassium 836 
and sodium 836,905 
Tea 502 
Tea-berry 637 
Teel-oil 900 
Terebene 945 
Terebinthina 940 
Terebinthine 946 
PAGE 
Terpens 617 
hydrate 946 
Testa praparata 496 
Tetronal 946 
Theina 947 
Theobroma 947 
Theobromine 947 
Thielemann’s cholera drops 775 
Thio-resorcinum 949 
Thiol 949 
Thorn-apple 919 
Thoroughwort 620 
Thuja 949 
Thuietin 949 
Thujin 949 
Thyme 950 
Thymene 950 
Thymol 950 
Thymum 950 
Tiglii oleum 951 
Tiglinic acid 951 
Tilia 953 
Tin oleate 384 
Tinctura aconiti 397 
agarici 410 
aloes 424 
et myrrh* 424, 758 
antiperiodioa 552 
arnica florum 456 
radicis 456 
asafatid* 457 
asclepias 459 
aurantii amari 461 
dulois 462 
belladonna 467 
benzoini 474 
composita 474 
berberidis 477 
bryoni* 489 
calendulas 500 
calumbae 501 
cannabis 507 
cantharidis 510 
capsici ....513 
cardamomi 517 
composita 517 
catechu composita 521 
chiratae 527 
chloroformi et morphinae 775 
cimicifugae 541 
cinchona 543 
composita 543 
cinnamomi 554 
cocculi 556 
cocillana 558 
colchici 560 
collinsonia 563 
conii 568 
coto corticis 577 
croci 585 
cubeba 585 
digitalis 592 
dioscorea 597 
duboisia 599 
eucalypti 616 
euphorbia pilulifer* 620 
ferri acetatis 626 
chloridi 625 
gal la 636 
gelsemii 638 
gentiana composita 639 
guaiaci 651 
ammoniata 432, 631 
hoang-nan 658 
humuli 660 
hydrastis 679 
hyoscyami 682 
ignatia 687 
iodi 694 
ipecacuanha et opii 708, 775 
iridis 712 
kino 717 
krameria 719 
lavandula composita 723 
lobelia 730 
matico 742 
moschi 755 
myrrha 758 
et capsici 758 
nucis vomica 765 
opii 775 
camphorata 775 
deodorata 775 1004 
INDEX OF DRUGS AND PREPARATIONS, 
PAGE 
Tinctura phosphori 807 
physostiguiatis 812 
pliytolacese radicis.. 815 
pyrethri 849 
quassias 851 
quillaiaa 853 
rhei 861 
aquosa 861 
aromatioa 861 
dulcis 861 
et gentian® 861 
Banguinariae 881 
saponis viridis 887 
composita 887 
scillas 893 
Borpoutariae 899 
stillingise 918 
surnbul 935 
tolutana 465 
Valerianae 966 
ammoniata 432, 966 
visci 973 
zingiberis 979 
Tobacco 936 
Tonga 953 
Tongine 953 
Tonics xiv 
Toxicodendric acid 834 
Tragacantha 954 
Trailing arbutus 603 
Tri-brom-phenol 368 
Tribromo-methane 432, 488 
Trichloride of iodine 694 
Trifolinm pratense 955 
Trillium 955 
Trimethylamine 751 
Trimethylamini hydroehloras 955 
Trinitro-glycerin 439 
Tripalmitin 773 
Tritici farina 957 
Triticin 957 
Tritieum 957 
Trituratio elaterini 601 
Trochisci acidi tannici .394 
ammonii chloridi 432 
catechu 521 
cretse 496 
cubebae 585 
ferri 626 
glycyrrhizae et opii 346, 775 
krameriae 719 
magnesia; 733 
menthas piperitae 745 
morphinas et ipecacuanhas 708 
potassii chloratis 836, 885 
santonini .....885 
Bodii bicarbonatis 905 
santoninatis 885, 905 
zingiberis 979 
Trypsin 793 
Tuberculinum 958 
Tally's powder 775 
Turkey corn 576 
Turpentine 910 
Canada 464 
Chian 945 
Tussilago 964 
Ulmus 964 
Unguentum acidi carbolici 367 
PAGE 
Unguentum acidi gallici 373 
acidi tannici 394 
antimonii 444 
aquae rosae 437, 523, 868 
belladonnas 467 
cadinii iodidi 491 
chrysarobini 540 
creasoti 579 
diachylon 827 
gall® 636 
hydrargyri 662 
ainmoniati 662 
nitratis 662 
oxidi fiavi 662 
rubri , 662 
iodi 694 
lauri 723 
mezerei .74 9 
picis liquid® 825 
plumbi carbonatis 827 
iodidi ...827 
potassii iodidi 694, 836 
resorcini 855 
sulphuris 930 
alkalinum 930 
iodidi 694 
tabaci 936 
zinci carbonatis 976 
impuri 976 
oxidum.... 976 
Urethan 965 
Ursone 603, 637, 741, 966 
Ustilago 736 
Uva ursi 965 
Valeren 967 
Valerian 966 
Valeriana 966 
Valerianate of ammonium 432 
of iron 626 
of quinine 544 
of zinc 975 
Valerianio acid 724, 935, 966 
Valerol 967 
Vanilla 968 
Vanillin 94>8 
Vascular sedatives xv 
stimulants xiv 
Veratralbine 969 
Veratrine 560, 871, 968, 969 
oleate 384 
Veratrum viride 969 
Verbascutn 971 
Vermouth 357 
Veronica 724 
Viburnic acid 971 
Viburnin 971 
Viburnum prunifolium 971 
Vienna paste 496, 836 
Vinum album 413 
fortius 413 
aloes 424 
antimonii 444 
aromaticuin 413 
colchici radicis 560 
seminis 560 
ergotse .’ 603 
erythroxvli 609 
ferri amarum 544, 625 
citratis ..,..625 
PAGE 
Vinum ipecacuanh® 708 
maidis stigmatorum 735 
opii 775 
pepsini 798 
seriparum 798 
picis 825 
rhei 861 
rubrum 413 
tabaci 936 
Viola tricolor 972 
Virginia snake-root 809 
Viscum 973 
Vitellin 974 
Vitellus 974 
Wahoo 619 
Washed sulphur 930 
Water 448 
pepper 835 
Wax 522 
Wheat-dour- 957 
White-oak bark 852 
White-poplar bark 855 
Wild cherry 847 
indigo 406 
marjoram 792 
rosemary 724 
yam 597 
Willow 876 
Winter-clo\ er 750 
green 637 
Wistar’s cough lozenges 646, 775 
Witch-hazel 633 
Wood-oil 652 
Wool-fat 721 
Woorara. 590 
Worm lozenges 885 
Wormseed, American 525 
Wormwood 356 
American 525 
Xanthopsin 885 
Xanthopuccine 679 
Xanthoxyli fructus 975 
Xnnthoxyline 974 
Xanthoxylum 974 
Yeast 624 
Yelk of egg 974 
Yellow dock 870 
jasmine 638 
pigment 827 
prussiate of potash. 836 
pxiccoon 679 
wash 496, 603 
Yerba reuma 635 
santa 609 
Zea maidis oleum 975 
Zinc oleate 384 
Zinci acetas 975 
bromidnin 482, 975 
carbonas prmcipitatus 975 
chloridnm .' 975 
cvanidum \ 976 
iodidum ...694, 975 
1 act as 975 
oxidum 975 
phosphidum 807 975 
sulphas 975 
valerianas 975 CATALOGUE 
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FOR SALE BY ALL BOOKSELLERS. Principles of Surgery. 
By N. SENN, M.D., Ph.D., P rofessor of Principles of Surgery" and 
Surgical Pathology in Rush Medical College, Chicago, 111.; Professor of 
Surgery in the Chicago Polyclinic; Attending Surgeon to the Milwaukee 
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Opinions and Criticisms on Senn’s “Principles of Surgery.” 
STEPHEN SMITH, M.D., Professor of 
•Clinical Surgery Medical Department 
University of tlie City of New York, 
writes:—“I have examined the work with great 
satisfaction and regard it as a most valuable addi- 
tion to American Surgical literature. There has 
long been great need of a work on the principles of 
Surgery which would fully illustrate the present ad- 
vanced state of knowledge of the various subjects 
embraced in this volume. The work seems to me to 
meet this want admirably.” 
E. C. PANE, A.M., M.I>., M.R.C.S., 
LL.D., Professor of Surgery in and Presi- 
dent of tlie Cooper Medical College, San 
Francisco, thus writes:—‘‘Especially is the 
work valuable as a comprehensive review of the sub- 
ject of the bacteriological causation of surgical 
disease ; in no other work can so much be found told 
so briefly and so well as has been done by Professor 
Senn in this book.” 
ROSWELL PARK, M.D., Professor of 
Principles and Practice of Surgery and 
Clinical Surgery in the University of Buf- 
falo, N. Y., writes:—“ I must congratulate both 
author and publisher on the excellent work laid 
before us. For years I have wanted just such a book 
to put into the hands of my students, and now I can 
give no warmer commendation of it than to state 
that I have urged all my class to lose no time in 
procuring it.” 
“ The achievements of Modern Surgery are akin 
to the marvelous, and Dr. Senn has set forth the prin- 
ciples of the science with a completeness that seems 
to leave nothing further to be said until new discover- 
ies are made. The work is systematic and compact, 
without a fact omitted or a sentence too much, and it 
not only makes instructive but fascinating reading. A 
conspicuous merit of Senn’s work is his method, his 
persistent and tireless search through original inves- 
tigations for additions to knowledge, and the prac- 
tical character of his discoveries. This combination 
of the discover and the practical man gives a special 
value to all his work, and is one of the secrets of his 
fame. No physician in any line of practice can 
afford to be without ‘Senn’s Principles of Sur- 
gery.’”— The Review of Insanity and Nervous 
Diseases, JUST PUBLISHED—A NEW AND VALUABLE WORK ON 
Practical Electricity 
—IN— 
MEDICINE AND SURGERY. 
—BY— 
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sicians and Surgeons, Baltimore; Member of the American Institute 
of Electrical Engineers, etc., 
—AND— 
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Professor of Obstetrics and Hygiene, College of Physicians and Surgeons, Baltimore; Visiting Physician 
to Bay View and City Hospitals; Director of the Maryland Maternite; Associate 
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The part on Physical Electricity, written by Dr. Liebig, one of the recognized 
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Professor Rohe, who writes on Electro-Therapeutics, discusses at length the recent 
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The applications of Electricity in dermatology, as well as in the diseases of the 
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THE SECOND VOLUME IN THE PHYSICIANS’ AND STUDENTS’ 
READY REFERENCE SERIES. 
MiOaST D-BOOK 
OF 
Materia Medica,Piianeacj), and Therapeutics 
By CUTHBERT BOWEN, M.D., B.A., 
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EXTRACT FROM THE PREFACE.—“ While this is essentially a Student’s Manual, a large 
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This excellent manual comprises in its 366 small 
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In going through it, we have been favorably im- 
pressed by the plain and practical suggestions in 
regard to prescription writing, and the metric sys- 
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Medical and Surgical Reporter. 
Many works claim more in their title-pages than 
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The book is one of the very best of its class.— 
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—Cincinnati Medical News. 
It is short and concise in its treatment of the 
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Medical and Surgical Journal, Montreal. 
Medical Symbolism. 
Historical Studies in the Arts of Healing and Hygiene. By 
THOMAS S. SOZINSKEY, M.D., Ph.D., author of “ The Culture of 
Beauty,” “ The Care and Culture of Children,” etc. 
No. 9 in the Physicians’ and Students’ Ready-Reference Series. 12mo. 
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The subjoined letters will show with what interest this work is 
regarded (a brief article having first appeared in the “ Medical and 
Surgical Reporter ” of Philadelphia) :— 
Dr. Sozinskey. 
Dear Doctor:—Many thanks. You ought to enlarge the article to a little book. It interested 
me greatly. In a bas-relief of myself by St. Gaudens, New York, he has set beside the head the caduceus 
and twin serpents as symbolical ; at all events, they will symbolize my relation to snakes. 
Yours truly, 
1524 Walnut Street, Philadelphia. S. WEIR MITCHELL. 
Philadelphia, Jan. 24, 1884. 
Dr. T. S. Sozinskey. 
Dear Sir Please accept my thanks for your paper on “ Medical Symbolism,” received this 
morning. I have read it with great interest, more especially as it is in the direction of the higher education 
of Physicians. The preponderance of the so-called practical (empirical) in medical literature, which appeals 
strongly to the trade element in the profession, makes such a contribution all the more enjoyable. 
Very truly yours, 
1427 N. Sixteenth Street. FRANCES EMILY WHITE. 
Philadelphia, Jan. 23, 1884. 
Dr. T. S. Sozinskey. 
My Dear Doctor :—I write to thank you for a copy of your interesting and instructive paper on 
“Medical Symbolism." In Fergusson, on “Tree and Serpent Worship,” which you quote, you can readily 
trace the connection between the emblems of religion and medicine. I recognize that, as priest and Physi- 
cian were once the same person, medicine is yet justly termed “ the divine art.” It affords me much pleasure 
to see your studious interest in your profession. 
Yours truly, 
HENRY H. SMITH. AN IMPORTANT PUBLICATION OF GREAT VALUE TO THE MEDICAL 
AND LEGAL PROFESSIONS. 
Spinal Concussion: 
Surgically Considered as a Cause of Spinal Injury, and Neurologi- 
cally Restricted to a Certain Symptom Group, for 
which is Suggested the Designation 
ERICHSEN'S DISEASE, AS ONE FORM OF THE TRAUMATIC NEUROSES. 
BY 
S. V. CLEVENGER, M.D., 
CONSULTING PHYSICIAN REESE AND ALEXIAN HOSPITALS; LATE PATHOLOGIST COUNTY INSANE ASYLUM, 
CHICAGO; MEMBER OP NUMEROUS A M ERICAN SCIENTIFIC AND M EDICA L SOCIETIES ; COLLABORATOR. 
AMERICAN NATURALIST, ALIENIST AND NEUROLOGIST, JOURNAL OP NEUROLOGY AND 
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For more than twenty years this subject lias occasioned bitter con- 
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The literature of Spinal Concussion has been increasing of late years 
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and to enable a clear comprehension of the anatomical and pathological 
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The Chapters are: I. Historical Introduction; II. Erichsen on 
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Symptoms; X. Diagnosis; XI. Pathology; XII. Treatment; XIII. 
Medico-legal Considerations. 
Other special features consist in a description of modern methods 
of diagnosis by Electricity, a discussion of the controversy concerning 
hysteria, and the author’s original pathological view that the lesion is 
one involving the spinal sympathetic nervous system. In this latter 
respect entirely new ground is taken, and the diversity of opinion con- 
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Every Physician and Lawyer should own this work. 
In one handsome Royal Octavo Volume of nearly 400 pages, with 
Thirty Wood-Engravings. Net price, in United States and Canada, 
$2.50, post-paid ; in Great Britain, 10s. 6d.; in France, 15 fr. 
(F. A. DAVIS, Medical Publisher, Philadelphia, Pa., U.S.A.J 
6 JUST READY-A NEW AND IMPORTANT WORK. 
ESSAY 
MEDICAL PNEUMATOLOGY # AEROTHERAPY: 
A PRACTICAL INVESTIGATION OF THE CLINICAL AND THERAPEUTIC VALUE 
OF THE GASES IN MEDICAL AND SURGICAL PRACTICE, WITH ESPECIAL 
REFERENCE TO THE VALUE AND AVAILABILITY OF 
OXYGEN, NITROGEN, HYDROGEN, AND NITROGEN MONOXIDE. 
By cJ. N. DEMARQUAY, 
Surgeon to the Municipal Hospital, Paris, and of the Council of State; Member of the Imperial Society 
of Surgery; Correspondent of the Academies of Belgium, Turin, Munich, etc.; Officer 
of the Legion of Honor ; Chevalier of the Orders of Isabella-the- 
Catholic and of the Conception, of Portugal, etc. 
TRANSLATED, WITH NOTES, ADDITIONS, AND OMISSIONS, 
By SAMUEL S. WALLIAN, A.M., M.D., 
Member of the American Medical Association ; Ex-President of the Medical Association of Northern New 
York; Member of the New Y ork County Medical Society, etc. 
-ON- 
In one Handsome Octavo Volume of 316 Pages, Printed on Fine Paper, in the Best 
Style of the Printer’s Art, and Illustrated with 31 Wood-Cuts. 
United States. Canada (duty paid). Great Britain. France. 
NET PRICE, CLOTH, Post- paid, S3.OO S3.30 8s. 6d. 13 fr. 40 
“ “ 3.00 3.30 13s. 18 fr. 60 
For some years past there has been a growing demand for something more satisfac- 
tory and more practical in the way of literature on the subject of what has, by common 
consent, come to be termed “ Oxygen Therapeutics.” On all sides professional men of 
standing and ability are turning their attention to the use of the gaseous elements about 
us as remedies in disease, as well as sustainers in health. In prosecuting their inquiries, 
the first hindrance has been the want of any reliable, or in any degree satisfactory, 
literature on the subject. 
C Purged of the much quackery heretofore associated with it, Aerotherapy is now 
recognized as a legitimate department of medical practice. Although little noise is made 
about it, the use of Oxygen Gas as a remedy has increased in this country within a few 
years to such an extent that in New York City alone the consumption for medical pur- 
poses now amounts to more than 300,000 gallons per annum. 
This work, translated in the main from the French of Professor Demarquay, contains 
also a very full account of recent English, German, and American experiences, prepared 
by Dr. Samuel S. Wallian, of New York, whose experience in this field antedates that of 
any other American writer on the subject. 
Plain Talks on Avoided Subjects. 
—BY— 
HENRY N. GUERNSEY, M.D., 
Formerly Professor of Materia Medica and Institutes in the Hahnemann Medical College of Philadelphia; 
Author of Guernsey’s “ Obstetrics,” including the Disorders Peculiar to Women and 
Young Children ; Lectures on Materia Medica, etc. 
IN ONE NEAT lGmo VOLUME. BOUND IN EXTRA CLOTH. Price, Post-paid, in 
United States and Canada, SI.00 ; Great Britain, 4s. 6d.; France, 6 fr. 20. 
This is a little volume designed to convey information upon one of the most important subjects con- 
nected with our physical and spiritual well-being, and is adapted to both sexes and all ages and conditions 
of society ; in fact, so broad is its scope that no human being can well afford to be without it, and so com- 
prehensive in its teachings that, no matter how well informed one may be, something can yet be learned from 
this, and yet it is so plain that any one who can read at all can fully understand its meaning. 
The Author, Dr. H. N. Guernsey, has had an unusually long and extensive practice, and his teachings in 
this volume are the results of his observation and actual experience with all conditions of human life. 
His work is warmly indorsed by many leading men in all branches of professional life, as well as by 
many whose business connections have caused them to be close observers. 
The following Table of Contents shows the scope of the book :— 
CONTENTS. Chapter I.—Introductory. II.—The Infant. III.—Childhood. IV.—Adoles- 
cence of the Male. V.—Adolescence of the Female. VI.—Marriage: The Husband. VII.— 
The Wife. VIII.—Husband and Wife. IX.- To the Unfortunate. X.—Origin of the Sex, 
(F. A. DAVIS, Medical Publisher, Philadelphia, Pa., U.S.A.) NEW EDITION 
Lessons m Gynecology. 
By WILLIAM GOODELL, A.M., M.D., Etc., 
Professor of Clinical Gynecology in the University of Pennsylvania. 
With 112 Illustrations. Third Edition, Thoroughly Revised and Greatly Enlarged. 
ONE VOLUME, LARGE OCTAVO, 578 PAGES. 
This exceedingly valuable work, from one of the most eminent specialists and teachers in gynecology 
in the United States, is now offered to the profession in a much more complete condition than either of the 
previous editions. It embraces all the more important diseases and the principal operations in the field of 
gynecology, and brings to bear upon them all the extensive practical experience and wide reading of the 
author. It is an indispensable guide to every practitioner who has to do with the diseases peculiar to 
women. 
Fig. 44. 
Natural Position op the Womb When the Bladder is Pull, 
after Briesky. 
These lessons are so well known that it is en- 
tirely unnecessary to do more than to call attention 
to the fact of the appearance of the third edition. 
It is too good a book to have been allowed to remain 
out of print, and it has unquestionably been missed. 
The author has revised the work with special care, 
adding to each lesson such fresh matter as the prog- 
ress in the art rendered necessary, and he has en- 
larged it by the insertion of six new lessons. This 
edition will, without question, be as eagerly sought 
for as were its predecessors.—American Journal 
of Obstetrics. 
The former editions of this treatise were well 
received by the profession, and there is no doubt 
that the new matter added to the present issue makes 
it more useful than its predecessors.—New York 
Medical Record. 
His literary style is peculiarly charming. There 
is a directness and simplicity about it which iseasier 
to admire than to copy. His chain of plain words 
and almost blunt expressions, his familiar compari- 
son and homely illustrations, make his writings, like 
his lectures, unusually entertaining. The substance 
of his teachings we regard as equally excellent.— 
Phila. Medical and Surgical Reporter. 
Extended mention of the contents of the book is 
unnecessary: suffice it to say that every important 
disease found in the female sex is taken up and dis- 
cussed in a common-sense kind of away We wish 
every physician in America could read and carry 
out the suggestions of the chapter on “the sexual re- 
lations as causes of uterine disorders—conjugal 
onanism and kindred sins." The department treat- 
ing of nervous counterfeits of uterine diseases is 
a most valuable one. — Kansas City Medical 
Index. 
Price, in United States and Canada, Cloth, $5.00; Full Sheep, $6.00. Discount, 20 per 
cent., making it, net, Cloth, $100; Sheep, $180. Postage, 27 Cents extra. Great 
Britain, Cloth, 17s.; Sheep, 21s., post-paid, net. France, 30 ft. 80. 
(A. DAVIS, Medical Publisher, Philadelphia, Pa., U.S.A.) 
8 AMERICAN RESORTS, 
WITH NOTES UPON THEIR CLIMATE. 
By BUSHROD "W. JAMES, JfX.MT., 3Xt.D., 
Member of the American Association for the Advancement of Science, the American Public Health Association, th# 
Pennsylvania Historical Society, the Franklin Institute, and the Academy of Natural Sciences, Philadelphia; 
the Society of Alaskan Natural History and Ethnology, Sitka, Alaska, etc. 
WITH A TRANSLATION FROM THE GERMAN, BY Mr. S. KAUFFMANN, 
Of ‘uose chapters of “Die Klimate der Erde” written by Dr. A. Woeikof, of St. Petersburg, Russia, that 
relate to North and South America and the islands and oceans contiguous thereto. 
In One Octavo Volume. Handsomely Bound in Cloth. Nearly 300 Pages. Price, 
Post-paid, in U. S. and Canada. 882.00, net. Great Britain, 8s. 6d. France, 12 fr. 40. 
This is a unique and valuable work, and useful to physicians in all parts of the country. It is just 
a volume as the Medical Profession have stood in need of for many years. We mention a few of the merits 
it possesses: First. List of all the Health Resorts of the country, arranged according to their climate. 
Second. Contains just the information needed by tourists, invalids, and those who visit summer or winter 
resorts. Third. The latest and best large railroad map for reference. Fourth. It indicates the climate 
each one should select for health. Fifth. The author has traveled extensively, and most of his suggestions 
are practical in reference to localities. r- 
Taken altogether, this is by far the most complete ex- 
position of the subject of resorts that has yet been put 
forth, and it is one that every physician must needs possess 
intelligent information upon. We predict a large demand 
for this useful and attractive book.—Buffalo Med. and 
Surg. Jour. 
The special chapteron the therapeutics of climate . . 
is excellent for its precautionary suggestions in the selec- 
tion of climates and local conditions, with reference to 
known pathological indications and constitutional predis- 
positions.—The Sanitarian. 
It is arranged in such a manner that it will be of great 
service to medical men whose duty it often becomes to rec- 
ommend a health resort.—N. IF. Med. Jour. 
A well-arranged map of the United States serves as the 
frontispiece of the book; and an almost perfect index is 
appended, while between the two is an amount of informa- 
tion as to places for the health-seeker that cannot be gotten 
elsewhere. We most cordially recommend the book to 
travelers and to the doctor.— Virginia Med. Monthly. 
This is a work that has long been needed, as there is 
scarcely a physician who has not had occasion to look up 
the authorities on climate, elevation, dryness, humidity, 
etc , etc., of the various health resorts, and has had great 
difficulty in finding reliable information. It certainly 
ought, as it deserves, to receive a hearty welcome from the 
profession.—Medical Advance. 
The book before us is a very comprehensive volume, 
giving all necessary information concerning climate, tem- 
perature, humidity, sunshine, and indeed everything neces- 
sary to be stated for the benefit of the physician or invalid 
seeking a health resort in the United States.—Southern 
Clinic. 
This work is extremely valuable, owing to the liberal 
and accurate manner in which it gives information regard- 
ing the various resorts on the American continent, without 
being prejudiced in the least in favor of any particular one, 
but giving all in a fair manner. . . . All physicians 
need just such a work, for the doctor is always asked to 
give information on the subject to his patients. Therefore, 
it should find a place in every physician's library.— The 
Med. Brie/. 
The author of this admirable work has long made a 
study of American cliina e. from the stand-point of a phv- 
sician. with a view to ascertaining the most suitable locali- 
ties for the residence of invalids, believing proper climate 
to be an almost indispensable factor in the treatment, pre- 
vention, and cure of many forms of disease. . . . The 
book evidences careful research and furnishes much useful 
information not to be found elsewhere.—Pacific Med. Jour. 
JUST PUBLISHED 
RECORD-BOOK OF MEDICAL EXAMINATIONS 
For Life Insurance. 
UDesig-uaecL JOHN- HA£.ID. 
In examining for Life Insurance; questions are easily overlooked and the answers to 
them omitted ; and, as these questions are indispensable, they must be answered before the 
case can be acted upon, and the examiner is often put to much inconvenience to obtain 
this information. ' 
The need has long been felt among examiners for a reference-book in which could be 
noted the principal points of an examination, and thereby obviate the necessity of a 
second visit to the applicant when further information is required. 
After a careful study of all the forms of examination blanks now used by Insurance 
Companies, Dr. J. M. Keating has compiled such a record-book which we are sure will fill 
this long-felt want. 
This record-book is small, neat, and complete, and embraces all the principal points 
that are required by the different companies. It is made in two sizes, viz. : No. 1, cover- 
ing one hundred (100) examinations, and No. 2, covering two hundred (200) examina- 
tions. The size of the book is 7 x 3| inches, and can be conveniently carried in the 
pocket. 
NET PRICES, POST-PAID, 
U. S. and Canada. 
Great Britain. 
Franoe. 
No. 1» For 100 Examinations, in Cloth, 
No. 2, For 200 Examinations, in Full 
k) .50 
2s. 6d. 
3 fr. 60 
Feather, with Side Flap, - 
1.00 
4s. 6d. 
6 fr. 29 
C F. A. DAVIS. Medical Publisher. Philaaelohia. Pa.. USA 1 DISEASES 
OF THE 
Heart and Circulation 
IN INFANCY AND ADOLESCENCE. 
t 
Witli ail Appendix entitled “ Clinical Studies on the 
Pulse in Childhood.” 
BY— 
JOHN M. KEATING, M.D., 
Obstetrician to the Philadelphia Hospital, and Lecturer on Diseases of Women and Children; Surgeon to 
the Maternity Hospital; Physician to St. Joseph’s Hospital; Fellow of the 
College of Physicians of Philadelphia, etc., 
—and— 
WILLIAM A. EDWARDS, M.D., 
knstructor in Clinical Medicine and Physician to the Medical Dispensary in the University of Pennsylvania; 
Physician to St. Joseph’s Hospital; Fellow of the College of Physicians; formerly 
Assistant Pathologist to the Philadelphia Hospital, etc. 
ILLUSTRATED BY PHOTOGRAPHS AND WOOD-ENGRAVINGS. 
About 225 Pages. 8vo. Bound in Clotb. Price, post-paid, in U. S. 
and Canada, $1.50, net; Great Britain, 6s. 0d.; France, 9 fr. 35. 
There are many excellent text-books on children’s diseases, but they have failed to give a satisfactory 
account of the diseases of the heart ; and, indeed, as far as known, this work of Keating and Edwards' now 
presented to the profession is the only systematic attempt that has been made to collect in bopk form the 
abundant material which is scattered throughout medical literature in the form of journal articles, clinical 
lectures, theses, and reports of societies. 
The authors have endeavored, in their difficult task, to collect these valuable materials and place them 
within easy reach of those who are interested in this important subject. That they have succeeded will, we 
believe, be conceded by all who obtain and make use of their very valuable contribution to this hitherto 
neglected fie'd of medical literature. 
An appendix, entitled “ Clinical Studies on the Pulse in Childhood,” follows the index in the book, and 
will, we are sure, be found of much real value to every practitionerof medicine. The work is madeavailable 
for ready reference by a well-arranged index. We append the table of contents showing the scope of the 
book:— 
-C OITSTTIS 3STTS 
Chapter I.—The Methods of Study—Instruments— 
Foetal Circulation—Congenital Diseases of the 
Heart—Malformations—Cyanosis. 
Chapter II.—Acute and Chronic Endocarditis— 
Ulcerative endocarditis. 
Chapter HI.—Acute and Chronic Pericarditis. 
Chapter IV.—The treatment of Endo- and Peri- 
carditis—Paracentesis Pericardii—Hydropericar- 
dium—Hatmopericardium—Pneumopericardium. 
Chapter V.—Myocarditis—Tumors, New Growths, 
and Parasites 
Chapter VI.—Valvular Disease: Mitral, Aortic, 
Pulmonary, and Tricuspid. 
Chapter VII.—General Diagnosis, Prognosis, and 
Treatment of Valvular Disease. 
Chapter VIII.—Endocarditis—Atheroma — Aneu- 
rism. 
Chapter IX.—Cardiac Neuroses—Angina Pectoris 
—Exophthalmic Goitre. 
Chapter X.—Diseases of the Blood: Plethora, 
Anaemia, Chlorosis, Pernicious Anaemia, 1 eu- 
kamia—Hodgkin’s Disease—Haemophilia,Throm- 
bosis, and Embolism. 
INDEX. 
APPENDIX.—Clinical Studies on the Pulse 
in Childhood. 
Drs. Keating and Edwards have produced a work that 
will give material aid to every doctor in his practice among 
children. The style of the book is graphic and pleasing, 
the diagnostic points are explicit and exact, and the thera- 
peutical resources include the novelties of medicine as well 
as the old and tried agents.—Pittsburgh Med. Review. 
A very attractive and valuable work has been given to 
the medical profession by Drs. Keating and Edwards, in 
their treatise on the diseases of the heart and circulation 
in infancy and adolescence, and they deserve the greatest 
credit for the admirable manner iu which they have col- 
lected. reviewed, and made use of the immense amount of 
material on this important subject.—Archives of Pediatrics. 
The plan of the work is the correct one, viz., the sup- 
plementing of the observations of the better class of prac- 
titioners by the experience of those who have given the 
subject systematic attention.—Medical Age. 
It is not a mere compilation, but a systematic treatise, 
and bears evidence of considerable labor and observation on 
the part of the authors. Two fine photographs of dissec- 
tions exhibit mitral stenosis and mitral regurgitation ; 
thero are also a number of wood-cuts.—Cleveland Medical 
Gazette. 
As the worlts upon diseases of children give little nr no 
attention to diseases of the heart, this work of Rrs. Keat- 
ing and Edwards will supply a want. We think that 
there will be no physician, who takes an interest in the 
affections of young folks, who will not wish to consult it, 
—Cincinnati Med. News. 
The w ork takes up, in an able and scientific manner, 
diseases of the heart in children. This is a part of the 
field of medical science which has not been cultivated t'- 
the extent that the importance of the subject deserves — 
Canada Lancet. 
*0 
(F. A. DAVIS, Medical Publisher, Philadelphia, Pa., U.S A.) Text-Book of Hygiene. 
A Comprehensive Treatise on the Principles and Practice of Pre- 
ventive Medicine from an American Stand-point. By GEORGE H. 
ROHE, M.D., Professor of Obstetrics and Hjgiene in the College of 
Physicians and Surgeons, Baltimore; Member of the American Public 
Health Association, etc. 
Second Edition, thoroughly revised and largely rewritten, with 
many illustrations and valuable tables. In one handsome Royal Octavo 
volume of over 400 pages, bound in Extra Cloth. 
United States. 
Canada (duty paid). Great Britain. 
France. 
Price, post-paid, $2.50 Net 
$2.75 Net 14s. 
16 fr. 20 
Every Sanitarian should have Rohe’s “Text-Book of Hygiene” as a 
work of Reference. Of this NEW (second) edition,one of the best quali- 
fied judges, namely. Albert L. Gihon, M.D., Medical Director U. S. Navy, 
in charge of U. S. Naval Hospital, Brooklyn, N. Y., and ex-President of 
the American Public Health Association, writes: “ It is the most admirable, 
concise resume of the facts of Hygiene with which I am acquainted. 
Prof. Rohe’s attractive style makes the book so readable that no better 
presentation of the important place of Preventive Medicine, among their 
studies, can be desired for the younger members, especially, of our 
profession. 
Twelve Lectures 
ON THE 
Structure of the Central Nervous 
System. 
For Physicians and Students. By Dr. LUDWIG EDINGER, Frank- 
fort-on-the-Main. Second Revised Edition. With 133 Illustrations. 
Translated by WILLIS HALL VITTUM, M.D., St. Paul, Minn. Edited 
by C. EUGENE RIGGS, A.M., M.D., Professor of Mental and Nervous 
Diseases, University of Minnesota; Member of the American Neuro- 
logical Association. 
The illustrations are exactly the same as those used in the latest 
German edition (with the German names translated into English), and 
are very satisfactory to the Physician and Student using the book. 
The work is complete in one Royal Octavo volume of about 250 
pages, bound in Extra Cloth. 
Price in United States and Canada, post-paid, $1.75 Net; 
Great Britain, IQs.; France, 12 fr. 20. 
This work is thus spoken of by those who are eminently qualified to 
pass judgment:— 
B. SACHS, M.D., Professor of Diseases of the Mind and Nervous 
System, etc., in the New York Polyclinic and Hospital, says : “ I know the 
translation well, and can say that it is done extremely well. I shall 
recommend it at once to my students at the Polyclinic.” 
N. SENN, M.D., Ph.D., of Milwaukee, and Professor of Principles of 
Surgery and Surgical Pathology in Rush Medical College, Chicago, and a 
distinguished author of several able and authoritative works on Surgery and 
Surgical subjects, says : “ A critical examination of the contents of the 
book has satisfied me that it is the most important and explicit work on 
this intricate subject in the English language, alike indispensable to the 
student and practitioner. The translation has been done in a masterly 
manner and the illustrations are excellent. ” © IMPORTANT ANNOUNCEMENT-JUST READY. 
Materia Medica and Therapeutics 
WITH ESPECIAL REFERENCE TO THE 
CLINICAL APPLICATION OF DRUGS. 
By JOHN V. SHOEMAKER, A.M., M.D., 
Professor of Materia Medica, Pharmacology, Therapeutics, and Clinical Medicine, and Clinical Professor 
of Diseases of the Skin in the Medico-Chirurgical College of Philadelphia; Physician 
to the Medico-Chirurgical Hospital, etc., etc. 
BEING THE SECOND AND LAST VOLUME OF A TREATISE ON MATERIA MEDICA, 
PHARMACOLOGY, AND THERAPEUTICS. AN INDEPENDENT 
VOLUME UPON DRUGS. 
This is the long-looked-for second volume of Shoemaker’s 
Materia Medica, Pharmacology, and Therapeutics. It is wholly taken 
up with the consideration of drugs, each remedy being studied from 
three points of view, viz.: the Preparations, or Materia Medica; the 
Physiolog}' and Toxicology, or Pharmacology; and, its Therapy. 
Dr. Shoemaker has finally brought the work to completion and now this 
second volume is ready for delivery. It is thoroughly abreast of the 
progress of Therapeutic Science, and is realty an indispensable book to 
every student and practitioner of medicine. Royal Octavo, about 675 
Pages. Thoroughly and Carefully Indexed. 
Price in Cloth, post-paid, 
United States. Canada (duty paid). Great Britain. France. 
$3.50 Net $100 Net 20s. 22 fr. 10 
“ Sheep, “ 
150 “ 5.00 “ 26s. 23 fr. 60 
(The first volume of the work is devoted to Pharmacy, General Phar- 
macology, and Therapeutics, and remedial agents not properly classed 
with drugs. Rojml Octavo, 353 pages. Price of Volume I, post-paid, in 
United States, Cloth, $2.50 Net; Sheep, $3.25 Net. Canada, duty paid, 
Cloth, $2.75 Net; Sheep, $3.60 Net. Great Britain, Cloth, 14s.; Sheep, 
18s. France, Cloth, 16 fr. 20; Sheep, 20 fr. 20.) 
THE VOLUMES ARE SOLD SEPARATELY. 
PUBLISHED BY 
F. A. DAVIS, Medical Publisher and Bookseller, 
1231 FILBERT STREET, PHILADELPHIA. 
BRANCH 
OFFICES: 
CHICAGO, ILL.—24 Lakeside Building, 214-220 S. Clark Street. 
NEW YORK CITY—117 W. Forty-second Street. 
ATLANTA, GA—25 Old Capitol, 
LONDON, ENG.—40 Berners Street, Oxford Street, W. 
ORDER FROM NEAREST OFFICE. 
FOR SALE BY ALL BOOKSELLERS. 
(oyer) SHOEMAKER’S THERAPEUTICS (VOL. II OF A TREATISE ON MATERIA MeDICA, 
Pharmacology, and Therapeutics) 
STANDS ALONE. 
1 
It Stands Alone among Materia Medica text-books in that it 
includes every officinal drug and every preparation contained in the 
United States Pharmacopoeia. 
2 
It Stands Alone in that it is the only work on therapeutics 
giving the strength, composition, and dosage of every officinal preparation. 
3 
It Stands Alone in giving the latest investigations with regard 
to the physiological action of drugs and the most recent applications in 
therapeutics. 
4 
It Stands Alone in combining with officinal drugs the most 
reliable reports of the actions and uses of all the noteworthy new reme- 
dies, such as acetanilide, antipyrin, bromoform, exalgine, pyoctanin, 
pyridine, somnal, spermine (Brown-Sequard), tuberculine (Koch’s lymph), 
sulphonal, thiol, uretlian, etc., etc. 
5 
It Stands Alone as a complete encyclopedia of modern thera- 
peutics in condensed form, arranged alphabetically for convenience of 
reference for either physician, dentist, or pharmacist, when immediate 
information is wanted concerning the action, composition, dose, or anti- 
dotes for any officinal preparation or new remedy. 
6 
It Stands Alone in giving the physical characters and chemical 
formuhe of the new remedies, especially the recently introduced anti- 
pyretics and analgesics. 
* 7 
It Stands Alone in the fact that it gives special attention to 
the consideration of the diagnosis and treatment of poisoning by the 
more active drugs, both officinal and non-officinal. 
8 
It Stands Alone and unrivaled in the number and variety of 
the prescriptions and practical formulae, representing the latest achieve- 
ments of clinical medicine. 
9 
It Stands Alone in that, while summarizing foreign thera- 
peutical literature, it fully recognizes the work done in this department 
by American physicians. .It is an epitome of the present state of 
American medical practice, which is universally acknowledged to be the 
best practice. 
10 
It Stands Alone because it is the most complete, convenient, and 
compendious work of reference, being, in fact, a companion to the U. S. 
Pharmacopoeia, a drug-encyclopsedia, and a therapeutic hand-book all in 
one volume. AS ENTIRELY NEW VISITING LIST. 
THE 
jVpnicAL Bulletin Visiting List 
-OR- 
PHYSICIAN’S 0ALL RECORD. 
ARRANGED UPON AN ORIGINAL AND CONVENIENT MONTHLY AND WEEKLY PLAN 
FOR THE DAILY RECORDING OF PROFESSIONAL VISITS. 
frequent Rewriting of Names Unnecessary. 
This Visiting List is arranged upon a plan best adapted to the most 
convenient use of all physicians, and embraces a new feature in recording 
daily visits not found in any other list, consisting of stub or half leaves 
in the form of inserts, a glance at which will suffice to show that as the 
first week’s record of visits is completed the next week’s record may be 
made by simply turning over the stub-leaf, without the necessity of re- 
writing the patients’ names. This is done until the month is completed, 
and the physician lias kept his record just as complete in every detail of 
visit, charge, credit, etc., as he could have done had he used any of the 
old-st3Tle visiting lists, and has also saved himself three-fourths of the 
time and labor formerly required in transferring names every week. 
There are no intricate rulings; everything is easily and quickly under- 
stood ; not the least amount of time can be lost in comprehending the 
plan, for it is acquired at a glance. 
The Three Different Styles Made. 
The Wo. 1 Style of this List provides ample space for the daily 
record of seventy (TO) different names each month for an entire year 
(two full pages, thirty-five [35] names to a page, being allowed to each 
month), so that its size is sufficient .for an ordinary practice; but for 
physicians who prefer a List that will accommodate a larger practice we 
have made a Wo. 2 Style9 which provides ample space for the daily 
record of one hundred and five different names (105) each month for 
an entire year (three full pages being allowed to each month), and for 
physicians who may prefer a Pocket Record Book of less thickness than 
either of these styles we have made a Wo. 3 Style, in which “ The 
Blanks for the Recording of Visits In” have been made into removable 
sections. These sections are very thin, and are made up so as to answer 
in full the demand of the largest practice, each section providing ample 
space for the daily record of two hundred and ten (210) different 
names for one month; or one hundred and five (105) different names 
daily each month for two months ; or seventy (TO) different names daily 
each month for three months; or thirty-five (35) different names daily 
each month for six months. Six sets of these sections go with each 
copy of No. 3 Style. 
Special Features Not Found in Any Other List. 
In this No. 3 Style the printed matter, and such matter as the 
blank forms for Addresses of Patients, Obstetric Record, Vaccination 
Record, Cash Account, Births and Deaths Records, etc., are fastened 
permanently in the back of the book, thus reducing its thickness. The 
addition of one of these removable sections does not increase the size 
quite an eighth of an inch. This brings the book into such a small com- 
pass that no one can object to it on account of its thickness, as its bulk is very much less than that of any visiting list ever published, r Every 
physician will at once understand that as soon as a section is full it can 
be taken out, filed away, and another inserted without the least incon- 
venience or trouble. 
This Visiting List contains a Calendar for the last six months 
of last year, all of this, and next year; Table of Signs to be used 
in Keeping Accounts; Dr. Ely’s Obstetrical Table; Table of Cal- 
culating the Number of Doses in a given H, etc., etc.; for converting 
Apothecaries’ Weights and Measures into Grammes ; Metrical Avoirdu- 
pois and Apothecaries’Weights; Number of Drops in a Fluidrachm ; 
Graduated Doses for Children ; Graduated Table for Administering 
Laudanum ; Periods of Eruption of the Teeth ; The Average Frequency 
of the Pulse at Different Ages in Health; Formula and Doses of Hypo- 
dermic Medication; Use of the Hypodermic Syringe; Formulae and 
Doses of Medicine for Inhalation; Formulae for Suppositories for the 
Rectum; The Use of the Thermometer in Disease; Poisons and their 
Antidotes; Treatment of Asphyxia; Anti-Emetic Remedies; Nasal 
Douches; Eye-Washes. 
Most Convenient Time- and Labor- Saving List Issued. 
It is evident to every one that this is, beyond question, the best and 
most convenient time- and labor- saving Physicians’ Record Book ever 
published. Physicians of many years’ standing and with large practices 
pronounce this the Bent Lint they have ever neen. It is handsomely 
bound in fine, strong leather, with flap, including a pocket for loose 
memoranda, etc., and is furnished with a Dixon lead-pencil of excellent 
quality and finish. It is compact and convenient for carrying in the 
pocket. Size, 4 x 6| inches. 
IN THREE STYLES-NET PRICES, POST-PAID. 
U. S. and Canada. Great Britain. 
France. 
No. i. Regular Size, for 70 patients daily each month for one year, 
*1.25 5s. 3. 
7 fr. 75 
No. 2. Large Size, for 105 patients daily each month for one year, 
No. 3. In which “The Blanks for Recording Visits in” are in re- 
1.50 6s. 6. 
9 fr. 35 
12 fr. 20 
movable sections, as described above, - 
1.75 7s. 3. 
EXTRACTS FROM REVIEWS. 
“ While each page records only a week’s visits, 
yet by an ingenious device of half leaves the names 
of the patients require to be written but once a 
month, and a glance at an opening of the book 
shows the entire visits paid to any individual in a 
month. It will be found a great convenience.”— 
Boston Medical and Surgical Journal. 
“Everything about it is easily and quickly 
understood.”—Canadian Practitioner. 
“ Of the many visiting lists before the profes- 
sion, each has some special feature to recommend 
it. This list is very ingeniously arranged, as by a 
series of narrow leaves following a wider one, the 
name of the patient is written but once during the 
month, while the account can run for thirty-one 
days, space being arranged for a weekly debit 
and credit summary and for special memoranda. 
The uraal pages for cash account, obstetrical 
record addresses, etc., are included. A large 
ar-tour. of miscellaneous information is presented 
in a condensed form.” — Occidental Medical 
Times. 
“It is a monthly instead of a weekly record, 
thus obviating the transferring of names oftener 
than once a month. There is a Dr. and Cr. column 
following each week’s record, enabling the doctor 
to carry a patient’s account for an indefinite time, 
or until he is discharged, with little trouble.”— 
Indiana Medical Journal. 
“Accounts can begin and end at any date. 
Each name can be entered for each day of every 
month on fhe same line. To accomplish this, four 
leaves, little more than one-third as wide as the 
usual leaf of the book, follow each page. Oppo- 
site is a full page for the recording of special 
memoranda The usual accompaniments of this 
class of books are made out with care and fitness.” 
— The American Lancet. 
“This is a novel list, and an unusually com 
venient one.”—Journal of the Atner. Med. Assoc. 
“This new candidate for the favor of physi- 
cians possesses some unique and useful points. 
The necessity of rewriting names every week is 
obviated by a simple contrivance in the make-up 
of its pages, thus saving much valuable time, 
besides reducing the bulk of the book.”—Buffalo 
Medical and Surgical Journal. 
“This list is an entirely new departure, and 
on a plan that renders posting rapid and easy. It 
is just what we have often wished for, and really 
fills a long-felt want.”—The Medical Waif. 
“It certainly contains the largest amount of 
practical knowledge for the medical practitioner 
in the smallest possible volume, besides enabling 
the poorest accountant to keep a correct record, 
and render a correct bill at a moment’s notice”— 
Medical Chips. 
s \ A. DAVIS. Medical Publisher. Philadelphia, Pa., U.S.A.) Hand-Book of Eclampsia; 
OR, 
Notes and Cases of Puerperal Convnlsions. 
BY 
E. Michener, M.D., J. H. Stubbs, M.D., R. B. Ewing, M.D., 
B. Thompson, M.D., S. Stebbins, M.D. 
Price, in United States and Canada, Bound in Cloth, lSmo, Net, 75 Cents; in Great 
Britain, 3 Shillings; in Prance, i fr. 20. 
In our medical colleges the teachers of Obstetrics dwell upon the use of blood-letting (phlebotomy) in 
eases of puerperal convulsions, and to this method Dr. Michener and his fellows give their unqualified 
support—not to take a prescribed numberof ounces, but to bleed for effect, and from a large orifice. This 
is plainly and admirably set forth in his book. To bleed requires a cutting instrument,—not necessarily a 
lancet,—for Dr. M. states how in one case a pocket-knife was used and the desired effect produced. 
Let the young physician gather courage from this little book, and let the more experienced give testi- 
mony to confirm its teaching. 
Wo have always thought that this treatment was 
indorsed, approved, and practiced by physicians generally: 
and to such as doubt the efficacy of blood-letting we would 
commend this little volume.—Southern Clinic. 
The authors are seriously striving to restore the 
“ lost art ” of blood-letting, and we must commend the 
modesty of their endeavor.—North Carolina Med. Jour. 
The cases were ably analyzed, and this plea for vene- 
section should receive the most attentive consideration from 
obstetricians.—Medical and Surgical Reporter. 
TTJST 
A MANUAL OF INSTRUCTION 
FOR GIVING 
Swedish MoTBient«iassage Treatment. 
BY 
Prof. Hartvig Nissen, 
Director of the Swedish Health Institute, Washington, D.C. ; I,ate Instructor in Physical Culture and 
Gymnastics at the Johns Hopkins University, Baltimore, Md.; Author of 
“ Health by Exercise without Apparatus." 
ILLUSTRATED WITH 29 ORIGINAL WOOD-ENGRAVINGS. 
In One 12mo Volume of 128 Pages. Neatly Bound in Cloth. Price, 
post-paid, in United States and Canada, Net, $1.00; in 
Great Britain, 6s. 3d.; in France, 6 fr. 20. 
This is the only publication in the English language treating this very important 
subject in a practical manner. Full instructions are given regarding the mode of 
applying 
The Swedish Movement and Massage Treatment 
in various diseases and conditions of the human system with the greatest degree of 
effectiveness. Professor Nissen is the best authority in the United States upon this prac- 
tical phase of this subject, and his book is indispensable to every physician who wishes to 
know how to use these valuable handmaids of medicine. 
This manual is valuable to tbt practitioner, as it 
contains a terse description of a subject tut tee little under- 
stood in this country The book is p*cf up very 
creditably.—N. Y. Med. Jonr. 
The present volume is a modest accouiK oi tr.e appli- 
cation of the Swedish Movement and Massag? Treatment, 
in which the technique of the various procedures are clearly 
stated as well as illustrated in a very excellent manner. 
—North American Practitioner. 
This little manual seems to be written by an expert, 
and to those who desire to know the details connected with 
tbe Swedish Movement and Massage we commend the 
book.— Practice. 
This attractive little book presents the subject in a very 
practical shape, and makes it possible ror every physician to 
understand at least how it is applied, if it does not give him 
dexterity in the art of its application. He can certainly 
acquire dexteritv by following the directions so plainly ad- 
vised in this book.—Chicago Mai. Times. 
It is so practical and clear in its demonstrations that 
if yon wish a work of this nature you cannot do better than 
peruse this one.—Medical Brie/. 
16 
(F. A. DAVIS, Medical Publisher, Philadelphia, Pa., U.S.A.) JUST READY—THE LATEST AND BEST PHYSICIAN’S ACCOUNT- 
BOOK EVER PUBLISHED. 
THE PHYSICIAN’S 
““f Account-Book: 
BEING A LEDGER AND ACCOUNT-BOOK FOR PHYSICIANS' USE, MEETING ALL 
THE REQUIREMENTS OF THE LAW AND COURTS. 
DESIGNED BY 
WILLIAM SEIBEET, ZL/E.ID., 
Or Easton, IPsl. 
Probably no class of people lose more money through carelessly kept 
accounts and overlooked or neglected bills than physicians. Often 
detained at the bedside of the sick until late at night, or deprived of 
even a modicum of rest, it is with great difficulty that he spares the 
time or puts himself in condition to give the same care to his own 
financial interests that a merchant, a lawyer, or even a farmer devotes. 
It is then plainly apparent that a system of * ookkeeping and accounts 
Tiat, without sacrificing accuracy, but, on the other hand, ensuring it, at 
the same time relieves the keeping of a physician’s book of half their 
complexity and two-thirds the labor, is a convenience which will be 
eagerly welcomed by thousands of overworked physicians. Such a sys- 
tem has at last been devised, and we take pleasure in offering it to the 
profession in the form of The Physician’s All-Requisite Time- and 
Labor- Saving Account-Book. 
There is no exaggeration in stating that this Account-Book and 
Ledger reduces the labor of keeping your accounts more than one-half, 
and at the same time secures the greatest degree of accuracy. We may 
mention a few of the superior advantages of The Physician’s All- 
Requisite Time- and Labor- Saving Account-Book, as follow:— 
any similar book; the 300 page book 
contains space for 900 accounts, and the 
600-page book contains space for 1800 
accounts. 
Ninth—There are no smaller spaces. 
Tenth—Compact without sacrificing com- 
pleteness ; every account complete on 
same page—a decided advantage and 
recommendation. 
Eleventh—Uniform size of leaves. 
Twelfth—The statement of the most com- 
plicated account is at once before you 
at any time of month or year—in other 
words, the account itself as it stands is 
its simplest statement. 
Thirteenth—No transferring of accounts, 
balances, etc. 
First—"Will meet all the requirements of 
the law and courts. 
Second—Self-explanatory ; no cipher code. 
Third—Its completeness without sacrificing 
anything. 
Fourth—No posting; one entry only. 
Fifth—Universal; can be commenced at any 
time of year, and can be continued in- 
definitely until every account is filled. 
Sixth—Absolutely no waste of space. 
Seventh—One person must needs be sick 
every day of the year to fill his account, 
or might be ten years about it and re- 
quire no more than the space for one 
account in this ledger. 
Eighth—Double the number and many times 
more than the number of accounts in 
To all physicians desiring a quick, accurate, and comprehensive 
method of keeping their accounts, we can safely say that no hook as 
suitable as this one has ever been devised. 
No. 1. 300 Pages, for 900 Accounts per Year, 
Size 10x12, Bound in % Russia, Raised 
In U. S. 
Canada 
(duty paid). 
Great 
Britain. 
France. 
Back-Bands, Cloth Sides, 
$5.00 
$5.50 
21s. 
30 fr. 30 
No. 2. 600 Pages, for 1800 Accounts per Year, 
Size 10x12, Bound in yA Russia, Raised 
Back-Bands, Cloth Sides, . . . 
8.00 
8.80 
1.13s. 
49 fr. 40 
NET PRICES, SHIPPING EXPENSES PREPAID. 
(F. A. DAVIS, Medical Publisher, Philadelphia, Pa., U.S.A.) 
17 PHYSICIANS’ INTERPRETER 
IN FOUR LANGUAGES. 
(ENGLISH, FRENCH, GERMAN, AND ITALIAN.) 
Specially Arranged for lliagnosis by M. von V. 
The object of this little work is to meet a need often keenly felt by 
the busy physician, namely, the need of some quick and reliable method 
of communicating intelligibly with patients of those nationalities and 
languages unfamiliar to the practitioner. The plan of the book is n sys- 
tematic arrangement of questions upon the various branches of Practical 
Medicine, and each question is so worded that the only answer required 
of the patient is merely Yes or No. The questions are all numbered, 
and a complete Index renders them always available for quick reference. 
The book is written by one who is well versed in English, French, Ger- 
man, and Italian, being an excellent teacher in all those languages, and 
who lias also had considerable hospital experience. 
Bound in Full Russia Leather, for Carrying in the Pocket. (Size, 5x2J 
Inches.) 206 Pages.' Price, post-paid, in United States and 
Canada, $1.00, net; Great Britain, 4s. 6d.; France, 6 fr. 20. 
To convey some idea of tlie scope of the questions contained in the 
Physicians’ Interpreter, we append the Index :— 
NOS. 
General health 1- 50 
Special diet 31- 47 
Age of patient 52- 62 
Necessity of patients undergoing an opera- 
tion 63- 70 
Office hours 7._ 77 
Days of the week 78- 84 
history: hereditary affections in his 
family; his occupation; diseases from 
his childhood up... 85-130 
#>nths of the year 106-117 
Seasons of the year 118-121 
Symptoms of typhoid fever ..131-158 
Symptoms of Bright's disease 159-168 
Symptoms of lung diseases 169-194 and 311-312 
Vertigo 195-201 
The eyes 20 r—232 
Paralysis and rheumatism 236-260 
Stomach complaints and chills 261-269 
NOS. 
Falls and fainting spells 271-277 
How patient’s illness began, and when pa- 
tient was first taken sick 278-279 
Names for various parts of the body; 283-299 
The liver 300-301 
The memory 304-305 
Bites, stings, pricks 314-316 
Eruptions 317-318 
Previous treatment 319 
Symptoms of lead-poisoning 320-324 
H emorrhages 32 5-328 
Burns and sprains SS^SS1 
The throat 332-335 
The ears .* 336-339 
General directions concerning medicines, 
baths, bandaging, gargling, painting 
swelling, etc 340-373 
Nun bers pages 202-204 
The work is well done, and calculated to he of great 
service to those who wish to acquire familiarity with the 
phrases used in questioning patients. More than this, we 
believe it would he a great help in acquiring a vocabulary 
to be used in reading medical books, and that it would fur- 
nish an excellent basis for beginning a study of any one of 
the languages which it includes.—Medical and Surgical 
Reporter. 
Many other hooks of the same sort, with more ex- 
tensive vocabularies, have been published, but, from their 
size, and from their being usually devoted to equivalents 
in English and one other language only, they have not had 
the advantage which is pre-eminent in this—convenience. 
It is handsomely printed, and bound in flexible red leather 
in the form of a diary. It would scarcely make itself felt 
in one's hip-pocket, and would insure its bearer against any 
ordinary conversational difficulty in dealing with foreign- 
speaking people, who are constantly coming into our city 
hospitals.—New York Medical Journal. 
In our larger cities, and in the whole Northwest, the 
physician is constantly meeting with immigrant patients, 
to whom it is difficult for him to make himself understood, 
or to know what they say in return. This difficulty will 
be greatly obviated by use of this little work.— The Phy- 
sician and Surgeon. 
The phrases are well selected, and one might practice 
long without requiring more of these languages than this 
little book furnishes.—Phila. Medical Times. 
How often the physician is called to attend those with 
whom the English language is unfamiliar, and many ph3r- 
siciani are thus deprived of the means, save through an 
interpreter, of arriving at a correct knowledge on which to 
base a diagnosis. An interpreter is not always at hand, 
but with this pocket interpreter in your hand you are able 
to ask ail the questions necessary, and receive the answer 
in such manner that you will be able to fully comprehend. 
—The Media(l Brief. 
This little volume is one of the most ingenious aids 
to the physician which we have seen. We heartily com- 
mend the book to any one who, being without a knowledge 
of the foreign languages, is obliged to treat those who do 
not know our own language.—St. Louis Courier of Medi- 
cine. 
It will rapidly supersede, for the practical use of the 
who cannot take the time to learn another language 
all other suggestive works.—Chicago Medical Times. 
18 
(F. A. DAVIS, Medical Publisher, Philadelphia, Pa., U.S.A.) An Important Aid to Students in tie Study of Anatomy. 
Three Charts op 
Tlie Nervo-Vascular System. 
PART I.—THE NERVES. 
PART II.—THE ARTERIES. 
PART III.—THE VEINS. 
Arranged by W. HENRY PRICE, A.M., M.D., AND S. POTTS EAGLETON. 
ENDORSED BY LEADING ANATOMISTS. 
PRICE, IN THE UNITED STATES AND CANADA, 50 CENTS, NET, COMPLETE; 
GREAT BRITAIN, 2s. 6d. FRANCE, 3 fr. 60. 
“ THE NERVO-VASCULAR SYSTEM OF CHARTS ” far Excels Every Other System 
in their Completeness, Compactness, and Accuracy. 
Part I. The Nerves.—Gives in a, clear form not only the Cranial 
and Spinal Nerves, showing the formation of the different Plexuses 
and their branches, but also the complete distribution of the 
Sympathetic Nerves, thereby making it the most complete and 
concise chart of the Nervous System yet published. 
Part II. The Arteries.—Gives a unique grouping of the Arterial 
System, showing the divisions and subdivisions of all the vessels, 
beginning from the heart and tracing their continuous distribution 
to the periphery, and showing at a glance the terminal branches 
of each artery. 
Part III. The J eins.—Shows how the blood from the periphery 
of the body is gradually collected by the larger veins, and these 
coalescing forming still larger vessels, until they finally trace 
themselves into the Right Auricle of the heart. 
It is therefore readily seen that “The Nervo-Vascular System of 
Charts” offers the following superior advantages:— 
1. It is the only arrangement which combines the Three Systems, 
and yet each is perfect and distinct in itself. 
2. It is the only instance of the Cranial, Spinal, and Sympathetic 
Nervous Systems being represented on one chart. 
3. From its neat size and clear type, and being printed only upon 
one side, it may be tacked up in any convenient place, and is always 
ready for freshening up the memory and reviewing for examination. 
r 4. The nominal price for which these charts are sold places them 
within the reach of all. 
For the student of anatomy there can possibly be no 
more concise way of acquiring a knowledge of the nerves, 
veins, and arteries of the human system. It presents at a 
glance their trunks and branches in the great divisions of 
the body. It will save a world of tedious reading, and will 
impress itse.f on the mind as no ordinary vade mecum, 
even, could. Its price is nominal and its value inestima- 
ble. No student should be without it.—Pacific Record of 
Medicine and Surgery. 
We take pleasure in calling attention to these charts, 
as they are so arranged that a study of them will serve to 
impress them more indellibly on your mind than can be 
gained in any other way. They are also valuable for 
reference.—Medical BrieJ. 
These are three admirably arranged charts for the 
use of students, to assist in memorizing their anatomical 
studies.—Buffalo Med. and Surg. Jour. f > 
This is a series of charts of the nerves, arteries, and 
veins of the human body, giving names, origins, distribu- 
tions, and functions, very convenient as memorizers and 
reminders. A similar series, prepared by the late J. H. 
Armsby, of Albany, N.Y., and framed, long found a place 
in the study of the writer, and on more than one occasion 
was the means of saving precious moments that must 
otherwise have been devoted to tumbling the pages of ana- 
tomical works.—Med. Age. 
These three charts will be of great assistance to 
medical students. They can be hung on the wall and read 
across any ordinary room. The price is only fifty cents for 
the set.—Practice. 
These charts have been carefully arranged, and will 
prove to be very convenient for ready reference. They 
are three in number, each constituting a part 
It is a high recommendation that these charts have been 
examined and approved by John B. Deaver, M.D.. Demon- 
strator of Anatomy in the University of Pennsylvania.— 
Pacific Med. and Surg. Jour, and Western Lancet. 
(F. A. DAVIS Medical Publisher Philadelphia, Pa., U.S.A.) 
19 Fever: Its Pathology and 
Treatment. 
Being the Boylston Prize Essay of Harvard University for J 890. 
Containing Directions and the Latest Information Concerning the 
Use of the So-Called Antipyretics in Fever and Patn. By HOBART 
AMORY HARE, M.D. (Univ. of Penna.), B.Sc., Clinical Professor of the 
Diseases of Children and Demonstrator of Therapeutics in the Univer- 
sity of Pennsylvania; Physician to St. Agnes’ Hospital and to the 
Children’s Dispensary of the Children’s Hospital; Laureate of the Royal 
Academy of Medicine in Belgium, of the Medical Society of London,etc.; 
Member of the Association of American Physicians. 
No. 10 in the Physicians’ and Students’ Ready-Reference Series. 
12mo. Neatly bound in Dark-blue Clotli. 
Illustrated with more than 25 new plates of tracings of various fever 
cases, showing beautifully and accurately the action of the antipyretics. 
The work will also contain 35 carefully prepared statistical tables of 
249 cases showing the untoward effects of the antipyretics. 
Price in the United States and Canada, post-paid, $1.25 Net; 
Great Britain, 6s. 6d.; France, 7 fr. 75. 
PHYSICIANS’ AND STUDENTS’ READY-REFERENCE SERIES 
JTXJST ISSUED 
-35T©. 4b.- 
The Neuroses of the Genito-Urinary System 
ill tme: male, 
WITS STERILITY AYE IMPOTENCE. 
BY 
DR. R. ULTZMANN, 
Professor of Genito-Urinary Diseases in the University of Vienna. 
TRANSLATED, WITH THE AUTHOR’S PERMISSION, BY 
GARDNER W. ALLEN, M.D., 
Surgeon in the Genito-Urinary Department Boston Dispensary. 
Illustrated. 12mo. Handsomely Bound in Dark-Blue Clotli. Net Price, in tlie United 
States and Canada, ISl.OO, Post-paid ; Great Britain, 4s. 6d. ; France, 6 fr. 20. 
This great work upon a subject which, notwithstanding the great strides that have 
been made in its investigation and the deep interest it possesses for all, is nevertheless 
still but imperfectly understood, has been translated in a most perfect manner, and pre- 
serves most fully the inherent excellence and fascinating style of its renowned and 
lamented author. Full and complete, yet terse and concise, it handles the subject with 
such a vigor of touch, such a clearness of detail and description, and such a directness to 
the result, that no medical man who once takes it up will be content to lay it down until 
its perusal is complete,—nor will one reading be enough. 
Professor Ultzmann was recognized as one of the greatest authorities in his chosen 
specfalty, and it is a little singular that so few of his writings have been translated into 
English. Those who have been so fortunate as to benefit by his instruction at the Vienna 
Polyclinic can testify to (he soundness of his pathological teachings and the success of his 
methods of treatment. He approached the subject from a somewhat different point of 
view from most surgeons, and this gives a peculiar value to the work. It is believed, 
moreover, that there is no convenient hand-book in English treating in a broad manner 
the Genito-urinary Neuroses. 
SYNOPSIS OF CONTENTS. First Part.—I. Chemical Changes in the Urine in 
Cases of Neuroses. II. The Neuroses of the Urinary and of the Sexual Organs, classi- 
fied as: 1, Sensory Neuroses ; 2, Motor Neuroses; 3, Secretory Neuroses. Second Part,—■ 
Sterility and Impotence. 
The Treatment in all Cases is Described Clearly and Minutely. 
20 
(F. A. DAVIS, Medical Publisher, Philadelphia, Pa., US.A.) Hay Fever 
•^.^T3D- 
ITS SUCCESSFUL TREATMENT BY SUPERFICIAL ORGANIC 
ALTERATION OF THE NASAL MUCOUS MEMBRANE. 
CHARLES E. SAJOUS, >1.1)., 
Lecturer on Rhinology and Laryngology in Jefferson Medical College: Vice-President of the American Larvngologioal 
Association: Officer of the Academy of France and of Public Instruction of Venezuela; Corresponding 
Member of the Royal Society of Belgium, of the Medical Society of Warsaw (Poland), 
and of the Society of Hygiene of France ; Member of the American 
Philosophical Society, etc., etc. 
-B5T- 
WITH 13 ENGRAVINGS ON WOOD. 12mo. BOUND IN CLOTH. BEVELED 
EDGES. PRICE, IN UNITED STATES AND CANADA, NET, *1.00- 
GREAT BRITAIN, 4s. 6d.; FRANCE, 6 fr. 20. 
The object of this little work is to place in the hands of the general 
practitioner the means to treat successfully a disease which, until lately, 
was considered as incurable; its history, causes, pathology, and treat- 
ment are carefully described, and the latter is so arranged as to be 
practicable by any physician. 
Dr. Sajous’ volume must command the attention of 
those called upon to treat this heretofore intractable com- 
plaint.—Medical and Surgical Reporter. 
Few have had the success in this disease which has 
so much baffled the average practitioner as Dr. Sajous, con- 
sequently his statements are almost authoritative. The 
book must be read to be appreciated.—American Medical 
Digest. 
Dr. Sajous has admirably presented the subject, and, 
as this method of treatment is now generally recognized 
as efficient, we can recommend this hook to all physicians 
who are called upon to treat this troublesome disorder.— 
The Buffalo Medical and Surgical Journal. 
The symptoms, etiology, pathology, and treatment of 
Hay Fever are fully and ably discussed. The reader will 
not regret the expenditure of the small purchase price of 
this work if he has cases of the kind to treat.—California 
Medical Journal. 
We are pleased with the author's views, and hearti'y 
commend his book to the consideration of the profession. 
— The Southern Clinic. 
PHYSICIANS’ AND STUDENTS’ READY REFERENCE SERIES. 
Uo. 1. 
OBSTETRIC SYNOPSIS. 
By JOHN S. STEWART, M.D., 
Demonstrator of Obstetrics and Chief Assistant in the Gynaecological Clinic of the Medico-Chirurgical 
College of Philadelphia. 
WITH AN INTRODUCTORY NOTE BY 
WILLIAM S. STEWART, A.M., M.D., 
Professor of Obstetrics and Gynaecology in the Medico-Chirurgical College of Philadelphia. 
42 ILLUSTRATIONS. 202 PAGES. 12mo. HANDSOMELY BOUND IN DARK-BLUE CLOTH. 
Price, Post-paid, in the United States and Canada, Net, $1.00; 
Great Britain, 4s. 6d.; France, 6 fr. 20. 
By students this work will be found particularly useful. It is based 
upon the teachings of such well-known authors as Playfair, Parvin, 
Lush, Galabin, and Cazeaux and Tarnier, and, besides containing much 
new and important matter of great value to both student and practi- 
tioner, embraces in an Appendix the Obstetrical Nomenclature sug- 
gested by Professor Simpson, of Edinburgh, and adopted by the 
Obstetric Section of the Ninth International Medical Congress held in 
Washington, D.C., September, 1887. 
It is well written, excellently illustrated, and fully up 
to date in every respect. Here we find all the essentials of 
Obstetrics in a nutshell, Anatomy, Embryology, Physi- 
ology, Pregnancy, Labor, Puerperal State, and Obstetric 
Operations all being carefully and accurately described.— 
Buffalo Medical and Surgical Journal. 
It is clear and concise. The chapter on the develop- 
ment of the ovum is especially satisfactory. The judicious 
use of bold-faced type for headings and italics for impor- 
tant statements, gives the took a pleasing typographical 
appearance.—Medical Record. 
This volume is done with a masterly hand. The 
scheme is an excellent one. . . . The whole is freely 
and most admirably illustrated with well-drawn, new 
engravings, and the book is of a very convenient size. — 
St. Louie Medical and Surgical Journal. 
(F A. DAVIS, Medical Publisher, Philadelphia, Pa., U.S.A.) 
21 DIPHTHERIA: 
Croup, Tracheotomy, m* Intubation. 
FROM THE FRENCH OF A. SANNE. 
TRANSLATED. AND ENLARGED BY 
HENRY Z. GILL, M.D., LL.D. 
Net Price, Post-paid, Cloth, - 
United States. Canada (duty paid). Great Britain. France. 
-$100. $140. £ 0.17s. 24 fr. 60 
* “ Leather, 
5.00. 5.50. 1. Is. 30 fr. 30 
The above work, recently issued, is a translation from the French of Sanne’s great 
work on “ Diphtheria,” by 11. Z. Gill, late Professor of Surgery in Cleveland, Ohio. 
Sanne's work is quoted, directly or indirectly, by every writer since its publication, 
as the highest authority, statistically, theoretically, and practically. The translator, 
having given special study to the subject for many years, has added over fifty pages, in- 
cluding the Surgical Anatomy, Intubation, and the recent progress in the branches 
treated down to the present date; making it, beyond question, the most complete work 
extant on the subject of Diphtheria in the English language. 
Facing the title-page is found a very fine Colored Lithograph Pfate of the parts con- 
cerned in Tracheotomy. Next follows an illustration of a cast of the entire Trachea, and 
bronchi to the third or fourth division, in one piece, taken from a photograph of a case 
in which the cast was expelled .during life from a patient sixteen years old. This is the 
most complete cast of any one recorded. 
Over fifty other illustrations of the surgical anatomy of instruments, etc., add to the 
practical value of the work. 
Diphtheria having become such a prevalent, wide-spread, and fatal disease, no 
general practitioner can afford to be without this work. It will aid in preventive meas- 
ures, stimulate promptness in the application of, and efficiency in, treatment, and 
moderate the extravagant views which have been entertained regarding certain specifics 
in the disease Diphtheria. 
A full Index accompanies the enlarged volume, also a List of Authors, making 
altogether a very handsome illustrated volume of over G80 pages. 
In this book we have a complete review and 
compendium of all worth preserving that has hitherto 
been said or written concerning diphtheria and the 
kindred subjects treated of by our author, collated, 
arranged, and commented on by both author and 
translator. The subject of intubation, so recently 
revived in this country, receives a very careful and 
impartial discussion at the hands of the translator, 
and a most valuable chapter on the prophylaxis of 
diphtheria and croup closes the volume. 
His notes are frequent and full, displaying deep 
knowledge of the subject-matter. Altogether the 
book is one that is valuable and timely, and one 
that should be in the hands of every general practi- 
tioner.—St. Louis Med. and Surgical Journal. 
Sannd's work is quoted, directly or indirectly, 
by many writers since its publication, as the highest 
authority, statistically, theoretically, and practi- 
cally. The translator, having given special study 
to the subject for many years, has added over fifty 
pages, including the surgical anatomy, intubation, 
and the recent progress in the branches treated, 
down to the present date; making it, beyond ques- 
tion, the most complete work extant on the subject 
of diphtheria in the English language. Diphtheria 
having become such a prevalent, wide-spread, and 
fatal disease, no general practitioner can afford to 
be without this work. It will aid in preventive 
measures, stimulate promptness in application of, and 
efficiency in, treatment.—Southern Practitioner. 
STANTON’S PRACTICAL AND SCIENTIFIC PHYSIOGNOMY; 
OP 
MOW TO READ FACES. 
By MARY OLMSTED STANTON. 
United States. 
Canada (duty paid). 
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Copiously Illustrated. Two Large Octavo Volumes. 
$1.00 Discount for Cash. Sold only by Subscription, or sent direct on receipt of price, shipping expenses prepaid. 
The author, Mrs. Mary O. Stanton, has given over twenty years to the preparation of this work. Her 
style is easy, and, by her happy method of illustration of every point, the book reads like a novel, and 
memorizes itself. To physicians the diagnostic information conveyed is invaluable. To the general 
reader each page opens a new train of ideas. (This book has no reference whatever to Phrenology.) 
(F- A. DAVIS, Medical Publisher, Philadelphia, Pa., U.S.A.) New Edition of an Important and Timely Work Just Published. 
Electricity in the Diseases of flfomen, 
With Special Reference to the Application of Strong Currents. 
By G. BETTON MASSEY, M.D., 
Physician to the Gynecological Department of Howard Hospital; Late Electro-Therapeutist to the Phila- 
delphia Orthopaedic Hospital and Infirmary for Nervous Diseases ; Member of the American 
Neurological Ass’n, of the Philadelphia Neurological Society, of the Franklin Institute, etc. 
Second E<a.itlo23.. T2.e-trise<d. a.m.cl. ZEn-larg-ed.. 
WITH NEW AND ORIGINAL WOOD-ENGRAVINGS. HANDSOMELY BOUND IN CLOTH. OVER 200 PAGES. 
12mo. Price, in United States and Canada, $1.50, net, post-paid. 
In Great Britain, 6s. 6d. In France, 9 fr. 35. 
This work is presented to the profession as the most complete treatise yet issued on 
the electrical treatment of diseases of women, and is destined to fill the increasing demand 
for clear and practical instruction in the handling and use of strong currents after the 
recent methods first advocated by Apostoli. The whole subject is treated from the present 
stand-point of electric science with new and original illustrations, the thorough studies of 
the author and his wide clinical experience rendering him an authority upon electricity 
Itself and its therapeutic applications. The author has enhanced the practical value of 
die work by including the exact details of treatment and results in a number of cases 
taken from his private and hospital practice. 
Fig. 15.—Author’s Fibroid Spear. 
Fig. 18.—Ball Electrode eor Administering Franklinic Sparks. 
-COiTTElTTS- 
Chapter I, Introductory; II, Apparatus required in gynecological applications of the galvanic current; 
III, Experiments illustrating the physical qualities of galvanic currents; IV, Action of concentrated gal- 
vanic currents on organized tissues; V, Intra-uterine galvano-chemical cauterization; VI, Operative details 
of pelvic electro-puncture; VII, The faradic current in gynecology ; VIII, The franklinic current in gyne- 
cology; IX, Non-caustic vaginal, urethral, and rectal applications ; X, General percutaneous applications in 
the treatment of nervous women; XI, The electrical treatment of fibroid tumors of the uterus ; XII, The 
electrical treatment of uterine hemorrhage; XIII, The electrical treatment of subinvolution; XIV, The 
electrical treatment of chronic endometritis and chronic metritis; XV, The electrical treatment of chronic 
diseases of the uterus and appendages; XVI, Electrical treatment of pelvic pain; XVII, The electrical 
treatment of uterine displacements; XVIII, The electrical treatment of extra-uterine pregnancy; XIX, 
The electrical treatment of certain miscellaneous conditions ; XX, The contra-indications and limitations to 
the use of strong currents. 
An Appendix and a Copious Index, including the definitions of terms used in the work, concludes 
the book. 
The author gives us what he has seen, and of which 
he is assured by scientific study is correct We 
are certain that this little work will prove helpful to all 
physicians who desire to use electricity in the management 
of "the diseases of women.— The American Lancet. 
To say that the author is rather conservative in his 
ideas of the curative powers of electricity is only another 
way of saying that he understands his subject thoroughly. 
The mild enthusiasm of our author is unassailable, because 
it is founded on science and reared with experience.—The 
Medical Analectic. 
The work is well written, exceedingly practical, and 
can be trusted. We commend it to the profession.”—Mary- 
land Medical Journal. 
The book is one which should be possessed by every 
physician who treats diseases of women by electricity.— 
The Brooklyn Medical Journal. 
The departments of electro-physics, pathology, and 
electro-therapeutics are thoroughly and admirably con- 
sidered, and by means of good ’.vood-cnts the beginner has 
before his eye the exact method of work required.—The 
Medical Register. 
“The author of this little volume of 210 pages ought 
to have added to its title, “ and a most happy dissertation 
upon the methods of using this medicinal agent; ” for in 
the first 100 pages he has contrived to describe the techni 
of electrization in as clear and happy a manner as no 
author has ever succeeded in doing, and for this part of the 
book alone it is almost priceless to the beginner in the 
treatment with this agent The little book is 
worthy the perusal of every one at all interested in the 
subject of electricity in medicine.—The Omaha Clinic. 
The treatment of fibroid tumor of the uterus will, 
perhaps, interest the profession more generally than any 
other question. This subject has been accorded ample 
space. The method of treatment in many cases has been 
recited in detail, the results in every instance reported be- 
ing beneficial, and in many curative.—Pacific Med. Jour, 
(F. A. DAVIS, Medical Publisher, Philadelphia, Pa., US.A.} JUST PUBLISHED.: 
THE PHYSIOLOGY 
OF THE 
Domestic Animals. 
A TEXT-BOOK FOR VETERINARY AND MEDICAL 
STUDENTS AND PRACTITIONERS. 
—BY— 
ROBERT MEADE SMITH, A.M., M.D.. 
Professor of Comparative Physiology in University of Pennsylvania ; Fellow of the College of Physician* 
and Academy of the Natural Sciences, Philadelphia ; of the American Physiological 
Society; of the American Society of Naturalists; Associe Etranger 
de la Societe D' Hygiene, etc. 
Fig. 117.—Parotid and Submaxillary Fistulas in the Horse, after Colin. 
(Thanhoffer and Tormay.) 
K, K7, rubber bulbs for collecting saliva; cs, cannula in the parotid duct. 
In One Handsome Royal Octavo Volume of over 950 Pages, Pro- 
fusely Illustrated with more than 400 Fine Wood- 
Engravings and many Colored Plates. 
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'THIS new and important work, the most thoroughly complete in the English language 
on this subject, has just been issued. In it the physiology of the domestic animals 
is treated in a most comprehensive manner, especial prominence being given to the sub- 
ject of foods and fodders, and the character of the diet for the herbivora under different 
conditions, with a full consideration of their digestive peculiarities. Without being over- 
burdened with details, it forms a complete text-book of physiology, adapted to the use of 
students and practitioners of both veterinary and human medicine. This work has already 
been adopted as the Text-Book on Physiology in the Veterinary Colleges of the United 
States, Great Britain, and Canada. * 
24 
CF. A. DAVIS, Medical Publisher, Philadelphia, Pa., U.S.AJ HERE IS JUST THE BOOK TO PLACE ON THE WAITING-ROOM TABLE OF EVERY 
PHYSICIAN, AND A WORK THAT WILL PROVE USEFUL IN 
THE HANDS OF YOUR PATIENTS. 
Heredity, Health, and Personal 
Beauty. 
Including the Selection of the Best Cosmetics for the Skin, Hair, 
Nails, and All Parts Relating to the Body. By JOHN V. SHOE- 
MAKER, A.M., M.D., Professor of Materia Medica, Pharmacology, 
Therapeutics, and Clinical Medicine, and Clinical Professor of Diseases 
of the Skin in the Medico-Chirurgical College of Philadelphia; Physi- 
cian to the Medico-Chirurgical Hospital, etc., etc. 
The health of the skin and hair, and how to promote them, are dis- 
cussed; the treatment of the nails; the subjects of ventilation, food, 
clothing, warmth, bathing; the circulation of the blood, digestion, ven- 
tilation ; in fact, all that in daily life conduces to the well-being of the 
body and refinement is duly enlarged upon. To these stores of popular 
information is added a list of the best medicated soaps and toilet soaps, 
and a whole chapter of the work is devoted to household remedies. 
The work is largely suggestive, and gives wise and timely advice as 
to when a physician should be consulted. 
Complete in one handsome Royal Octavo volume of 425 pages, 
beautifully and clearly printed, and bound in Extra Cloth, Beveled 
Edges, with side and back gilt stamps and Half-Morocco Gilt Top. 
Price in Cloth, post-paid, 
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$2.50 Net $2.75 Net 14s. 
France. 
15 fr. 
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ONE OF THE MOST TIMELY AND USEFUL SMALL VOLUMES 
PUBLISHED LATELY IS 
The Daughter. 
Her Health, Education, and Wedlock. Homely Suggestions to 
Mothers and Daughters. By WILLIAM M. CAPP, M.D., Philadelphia. 
It is just such a book as a family physician would advise his lady patients 
to obtain and read. It answers many questions which every busy prac- 
titioner of medicine has put to him inthe sick-room at a time when it is 
neither expedient nor wise to impart the information sought. 
It will not mar the most proper womanly modesty or refined feelings, 
and may wisely be put into the hands of any woman or girl; is a book 
for the family; will bear repeated readings and will be useful to refer to 
in emergencies. 
It is complete in one beautifully printed (large, clear t}rpe) 12mo 
volume of 150 pages. Attractively bound in Extra Cloth. 
Price, post-paid, in the United States and Canada, $1.00 Net; Great Britain, 
5s. 6d.; France, 6 fr. 20. THE 
International Pocket Medical Formnlarj, 
ARRANGED THERAPEUTICALLY. 
By G. SUMNER WlTHERSTlNE, M.S., M.D., 
Associate Editor of the “Annual of the Universal Medical Sciences;” Visiting Physician of the Home for 
the Aged, Germantown, Philadelphia; Late House-Surgeon Charity Hospital, New York. 
More than 1800 Formulae from Several Hundred Well-Known Authorities. 
With an Appendix containing a Posological Table, the newer remedies included ; Important lncompati- 
bles ; Tables on Dentition and the Pulse; Table of Drops in a Fluidrachm and Doses of Laudanum graduated 
for age; Formula; and Doses of Hypodermic Medication, including the newer remedies; Uses of the Hypo- 
dermic Syringe; Formulae and Doses for Inhalations, Nasal Douches, Gargles, and Eye-washes; Formulae 
for Suppositories; Use of the Thermometer in Disease; Poisons, Antidotes, and Treatment; Directions for 
Post-Mortem and Medico-Legal Examinations; of Asphyxia, Sun-stroke, etc.; Anti-emetic 
Remedies and Disinfectants; Obstetrical Table; Directions for Ligation of Arteries; Urinary Analysis; 
Table of Eruptive Fevers ; Motor Points for Electrical Treatment, etc., etc. 
This work, the best and most complete of its kind, contains about 375 printed pages, besides 
extra blank leaves. Elegantly printed, with red lines, edges, and borders; with illustrations. Hound 
in leather, with side tlap. It contains more than 1800 Formulae, exclusive of the large amount of 
other very valuable matter. 
Price, Post-paid, in the United States and Canada, $2.00, net; 
Great Britain, 8s. 6d.; France, 12 fr. 40. 
TEN PT/lQilA/Q WHY EVERY MEDICAL MAN SHOULD POSSESS A COPY OF 
/ C/f nc/iuiz/ro THE INTERNATIONAL pocket medical formulary. 
1. Because it is a handy book of reference, replete with the choicest formula; (over 1800 in number) of 
more than six hundred of the most prominent classical writers and modern practitioners. 
2. Because the remedies given are not only those whose efficiency has stood the test of time, but also the 
newest and latest discoveries in pharmacy and medical science, as prescribed and used by the best- 
known American and foreign modern authorities. 
3. Because it contains the latest, largest (66 formulae) and most complete collection of hypodermic formulae 
(including the latest new remedies) ever published, with doses and directions for their use in over 
fifty different diseases and diseased conditions. 
4. Because its appendix is brimful of information, invaluable in office work, emergency cases, and the 
daily routine of practice. 
5. Because it is a reliable friend to consult when, in a perplexing or obstinate case, the usual line of treat- 
ment is of no avail. (A hint or a help from the best authorities, as to choice of remedies, correct 
dosage, and the eligible, elegant, and most palatable mode of exhibition of the same.) 
6. Because it is compact, elegantly printed and bound, well illustrated, and of convenient size and shape 
for the pocket. 
7. Because the alphabetical arrangement of the diseases and a thumb-letter index render reference rapid 
and easy. 
8. Because blank leaves, judiciously distributed throughout the book, afford a place to record and index 
favorite formula;. 
9. Because, as a student, he needs it for study, collateral reading, and for recording the favorite prescriptions 
of his professors, in lecture and clinic; as a recent graduate, he needs it as a reference hand-book for 
daily use in prescribing (gargles, nasal douches, inhalations, eye-washes, suppositories, incompatibles, 
poisons, etc.) ; as an old practitioner, he needs it to refresh his memory on old remedies and combi- 
nations, and for information concerning newer remedies and more modern approved plans of treatment. 
10. Because no live, progressive medical man can afford to be without it. 
It is sometimes important that such prescriptions as 
have been well established in their usefulness be preserved 
for reference, and this little volume serves such a purpose 
better than any other we have seen.—Columbus Medical 
Journal. 
Without doubt this book is the best one of its class 
that we have ever seen The printing, binding. 
and general appearance of the volume are beyond praise.— 
University Medical Magazine. 
It may be possible to get more crystallized knowledge 
in an equally small space, but it does not seem probable.— 
Medical Classics. 
A very handy and valuable book of formulas for the 
physician’s pocket.—St. Louis Medical and Surg. Journal. 
This little pocket-book contains an immense number 
®f prescriptions taken from high authorities in this and 
other countries.—Northwestern Lancet. 
This one is the most complete as well as the most 
conveniently arranged of any that have come under our 
attention. The diseases are ennmerated in alphabetical 
order, and for each the latest and most approved remedies 
from the ablest authorities are prescribed. The book is in- 
dexed entirely through after the order of the first pages of 
a ledger, the index letter being printed on morocco leather 
and thereby made very durable.—Pacific Medical Journal. 
It is a book desirable for the old practitioner and for 
his younger brothers as well.—St. Joseph Medical Herald. 
As long as “combinations” are sought such a book 
will be of value, especially to those who cannot spare the 
time required to learn enough of incompatibilities before 
commencing practice to avoid writing incompatible and 
dangerous prescriptions. The constant use of such a book 
by such prescribers would save the pharmacist much 
anxiety.— The Druggists' Circular. 
In judicious selection, in accurate nomenclature, in 
arrangement, and in style it leaves nothing to be desired. 
The editor and the publisher are to lie congratulated on the 
production of the very best book of its class.—Pittsburgh 
Medical Deview. 
One must see it to realize how much information can 
be got into a work of so little bulk.—Canada Medical 
Record. 
To the young physician just starting out in practice 
this little book will' prove an acceptable companion.— 
Omaha Clinic. 
The want of to-day is crystallized knowledge. This 
neat little volume contains in it the most accessible form. 
It is bound in morocco in pocket form, with alphabetical 
divisions of diseases, so that it is possible to turn instantly 
to the remedy, whatever may be the disorder or wherever 
the patient may be situated To the physician 
it is invaluable, and others should not be without it. We 
heartily commend the work to our readers.—Minnesota 
Medical Journal. 
26 
(F. A. DAVIS, Medical Publisher, Philadelphia, Pa., U.S.A.' JUST ISSUED 
PHYSICIANS’ AND STUDENTS’ READY-REFERENCE SERIES. 
-3STo. 3. 
Synopsis of Human Anatomy: 
Being a Complete Compend of Anatomy, including the 
Anatomy of the Viscera, and Numerous Tables. 
BY 
JAMES K. YOUNG, M.D., 
Instructor in Orthopaedic Surgery and Assistant Demonstrator of Surgery, University of Pennsylvania; 
Attending Orthopaedic Surgeon, Out-Patient Department, University Hospital, etc. 
ILLUSTRATED WITH 76 WOOD-ENGRAVINGS. 390 PAGES. 
12mo. HANDSOMELY BOUND IN DARK-BLUE CLOTH. 
Price, Post-paid, in the United States and Canada, $1.40, net; 
Great Britain, 6s. 6d.; France, 9 fr. 25. 
While the author has prepared this work especially for students, sufficient de- 
scriptive matter has been added to render it extremely valuable to the busy practitioner, 
particularly the sections on the Viscera, Special Senses, 
and Surgical Anatomy. 
The work includes a complete account of Osteology, 
Articulations and Ligaments, Muscles, Fascias, Vascular 
and Nervous Systems, Alimentary, Vocal, and Respiratory 
and Genito-Urinary Apparatuses, the Organs of Special 
Sense, and Surgical Anatomy. 
In addition to a most carefully and accurately prepared 
text, wherever possible, the value of the work has been 
enhanced by tables to facilitate and minimize the labor of 
students in acquiring a thorough knowledge of this impor- 
tant subject. The section on the teeth has also been 
especially prepared to meet the requirements of students 
of Dentistry. 
In its preparation, Gray’s Anatomy [last edition], 
edited by Keen, being the anatomical work most used, has 
been taken as the standard. 
Anatomy is a theme that allows such concen- 
tration better than most medical subjects, and, as 
the accuracy of this little book is beyond question, 
its value is assured. As a companion to the dis- 
secting-table, and a convenient reference for the 
practitioner, it has a definite field of usefulness.— 
Pittsburgh Medical Review. 
This is a very carefully prepared compend of 
anatomy, and will be useful to students for college 
or hospital examination. There are some excellent 
tables in the work, particularly the one showing the 
origin, course, distribution, and functions of the 
cranial nerves.—Medical Record. 
Dr. Young has compiled a very useful book. 
We are not inclined to approve of compends as a 
general rule, but it certainly serves a good purpose 
to have the subject of anatomy presented in a com- 
pact, reliable way, and in a book easily carried to 
the dissecting-room. This the author has done. 
The book is well printed, and the illustrations well 
selected. If a student can indulge in more than one 
work on anatomy,—for, of course, he must have a 
general treatise on the subject,—he can hardly do 
better than to purchase this compend It will save 
the larger work, and can always be with him during 
the hours of dissection,—Buffalo Medical and 
Surgical Journal. 
Excellent tables have been arranged, which 
tersely and clearly present important anatomical 
facts, and the book will be found very convenient 
for ready reference.—Columbus Medical Journal. 
The book is much more satisfactory than the 
‘‘remembrances” in vogue, and yet is not too cum- 
bersome to be carried around and read at odd 
moments—a property which the student will readily 
appreciate.— Weekly Medical Review. 
If a synopsis of human anatomy may serve a 
purpose, and we believe it does, it is very important 
that the synopsis should be a good one. in this 
respect the above work may be recommended as a 
reliable guide. Dr. Young has shown excellent 
judgment in his selection of illustrations, in the 
numerous tables, and in the classification of the 
various subjects —Therapeutic Gazette. 
Every unnecessary word has been excluded, out 
of regard to the very limited time at the medical 
student’s disposal. It is also good as a reference 
book, as it presents the facts about which he wishes 
to refresh his memory in the briefest manner 
consistent with clearness. — New York Medical 
Journal. 
It is certainly concise and accurate, and should 
be in the hands of every student and practitioner.— 
The Medical Brief. 
(F. A. DAVIS, Medical Publisher, Philadelphia, Pa., U.S.A.) ANNUAL 
OF THE 
Universal Medical Sciences. 
A YEARLY REPORT OF THE PROGRESS OF THE GENERAL SANITARY 
SCIENCES THROUGHOUT THE WORLD. 
Edited by CHARLES E. SAJOUS, M. D., 
LECTURER ON LARYNGOLOGY AND RHINOLOGY IN JEFFERSON MEDICAL COLLEGE, PHILADELPHIA, ETC., 
AND 
SEVENTY ASSOCIATE EDITORS, 
Assisted by over TWO HUNDRED Corresponding Editors and Collaborators. 
In Five Royal Octavo Volumes of about 500 pages each, bound in Cloth and Half-Russia, 
Magnificently Illustrated with Chromo-Lithographs, Engravings, 
Maps, Charts, and Diagrams. 
1st. To assist the busy practitioner in his efforts to keep abreast of the rapid strides 
of all the branches of his profession. 
2d. To avoid for him the loss of time involved in searching for that which is new in 
the profuse and constantly increasing medical literature of our day. 
3d. To enable him to obtain the greatest possible benefit of the limited time he is 
able to devote to reading, by furnishing him with new matter only. 
4th. To keep him informed of the work done by all nations, including many other- 
wise seldom if ever heard from. 
5th. To furnish him with a review of all the new matter contained in the periodicals 
to which he cannot (through their immense number) subscribe. 
6th. To cull for the specialist all that is of a progressive nature in the general and 
special publications of all nations, and obtain for him special reports from countries in 
which such publications do not exist, and 
Lastly, to enable any physician to possess, at a moderate cost, a complete 
CONTEMPORARY HISTORY OF UNIVERSAL MEDICINE, 
edited by many of America’s ablest teachers, and superior in every detail, of print, paper, 
binding, etc., etc., a befitting continuation of such great works as “ Pepper s System of 
Medicine,” “Ashliurst’s International Encyclopaedia of Surgery,” “Buck’s Reference 
Hand-Book of the Medical Sciences,” etc., etc. 
BEING INTENDED 
EDITORIAL STAFF of the ANNUAL of the UNIVERSAL MEDICAL SCIENCES. 
ISSUE OF 1888. 
Chief Editor, Dll. CHARLES E. SAJOUS, Philadelphia 
ASSOCIATE STAFF. 
Volume I.—Obstetrics, Gynaecology, Pediatrics, Anatomy, Physiology, Pathology, 
Histology, and Embryology. 
Prof. Wm. L. Richardson, Boston. 
Prof. Theophilus Parvin, Philada. 
Prof. Louis Starr, Philadelphia. 
Prof. J. Lewis Smith, New York City. 
Prof. Paul F. Munde and Dr. E. II. 
Grandin, New York City. 
Prof. William Goodell and Dr. W. C. 
Goodell, Philadelphia. 
Prof. E. C. Dudley, Chicago. 
Prof. W. II. Parish, Philadelphia. 
Prof. William S. Forbes, Philadelphia. 
Prof. H. Newell Martin and Dr. W. H, 
Howell, Baltimoro. 
Dr. Chas. S. Minot, Boston. 
Dr. E. O. Shakespeare. Philadelphia. 
Dr. W. X. Sudduth, Philadelphia. 
Volume II.—Diseases of the Respiratory, Circulatory, Digestive, and Nervous Systems; 
Fevers, Exanthemata, etc., etc. 
Prof. A. L. Loomis, New York City. 
Prof. Jas. T. Whittaker, Cincinnati. 
Prof. W. II. Thomson, New York City. 
Prof. W. W. Johnston, Washington. 
Prof Jos. Leidy, Philadelphia. 
Prof. E. C. Seguin, New York City. 
Prof. E. C. Spnzka, New York City. 
Prof Chas.K. Mills and Dr. J. H.Lloyd, 
Philadelphia. 
Prof. Francis Delafield, N. Y. City. 
Prof. Jas. Tyson, Philadelphia. 
Prof. N. S. Davis, Chicago. 
Prof. John Guiteras, Charleston, S. C. 
Dr. Jas. C. Wilson, Philadelphia. 
Volume III.—General Surgery, Venereal Diseases, Anaesthetics, Surgical Dressings, 
Dietetics, etc., etc. 
Prof. D. Hayes Agnew, Philadelphia. 
Prof. Hunter McGuire, Richmond. 
Prof. Lewis A. Stimson, New York. 
Prof. P. S. Conner, Cincinnati. 
Prof. J. Ewing Mears, Philadelphia. 
Prof. E. L. Keyes, New York City. 
Prof. F. R. Sturgis, New York City. 
Prof. N. Senn, Milwaukee. 
Prof. J. E. Garretson, Philadelphia. 
Prof. Christopher Johnston. Baltimore. 
Dr. Chas. B. Kelsey, New York City. 
Prof. T. G. Morton and Dr. Wm. Hunt, 
Philadelphia. 
Dr. Morris Longstreth. Philadelphia. 
Dr. Chas. Wirgman. Philadelphia. 
Dr. C. C. Davidson, Philadelphia. 
Volume IV.—Ophthalmology, Otology, Laryngology, Rhinology, Dermatology, Dentistry, 
Hygiene, Disposal of the Dead, etc., etc. 
Prof. William Thomson, Philadelphia. 
Prof. J. Solis Cohen, Philadelphia. 
Prof. I). Bryson Delavan, New York. 
Prof. A. Van Harlingen, Philadelphia. 
Prof. C. N. Peirce, Philadelphia. 
Prof. John B. Hamilton. Washington. 
Prof. H. M. Lyman, Chicago. 
Prof. S. H. Guilford, Philadelphia. 
Dr. Chas. S. Turnbull, Philadelphia. 
Dr. Edw. C. Kirk, Philadelphia. 
Dr. John G. Lee, Philadelphia. 
Dr. Chas. E. Sajous, Philadelphia. 
28 Prof. James Truman, Philadelphia. 
Prof. J. A. Marshall, Chicago, 111. 
Prof. A. W. Harlan, Chicago, 111. 
Prof. G. V. Black, Chicago, 111. 
Prof. C. H. Stoweil, Ann Arbor, Mich. 
Prof. L. C. Ingersoll, Keokuk, Iowa. 
Prof. F. J. S. Gorgas, Baltimore. Md. 
Prof. II. A. Smith. Cincinnati, Ohio. 
Prof. C. P. Pengra, Boston, Mass. 
List of Collaborators to Dental Department. 
Prof. E. H. Angle, Minneapolis, Minn. 
Prof. J. E. Cravens, Indianapolis, Ind. 
Prof. R. Stubblefield, Nashville, Teun. 
Prof. W. C. Barrett, Buffalo, N. Y. 
Prof. A. H. Thompson, Topeka, Kan. 
Dr. James W. White, Philadelphia. 
Dr. L. Ashley Faught, Philadelphia. 
Dr. Robert S. Ivy, Philadelphia. 
Dr. W. Storer How, Philadelphia. 
Dr. J. D. Patterson, Kansas City, Mo, 
Dr. J. B. Hodgkin, Washington, D. C. 
Dr. R. R. Andrews, Cambridge. Mass. 
Dr. Albion M. Dudley, Salem, Mass. 
Dr. Geo. S. Allen, New York City. 
Dr. G. S. Dean, San Francisco, Cal. 
Dr. M. H. Fletcher, Cincinnati, Ohio. 
Dr. A. Morsman, Omaha, Neb. 
Dr. G. W. Melotte, Ithaca, N. Y. 
Volume V.—General and Experimental Therapeutics, Medical Chemistry, Medical 
Jurisprudence, Demography, Climatology, etc., etc. 
Prof. William Pepper. Philadelphia. 
Prof. F. W. Draper, Boston. 
Prof. J. W. Holland, Philadelphia. 
Prof. A. L. Ranney, New York City. 
Prof. George H. Rohe, Baltimore. 
Dr. Albert L. Gihon, U. S. N. 
Dr. R. J. Dunglison, Philadelphia. 
Dr. W. P. Manton, Detroit, Mich. 
Dr. Hobart A. Hare, Philadelphia. 
Dr. C. S. Witherstine, Philadelphia. 
THE STJBSCEIPTIOIT PRICE 
(Including the “SATELLITE” for one year). 
Cloth, 5 Vols., Royal Octavo, 
United States. Canada (duty paid). Great Britain. France. 
$15.00 $16.50 £3.5s. 93 ft. 95 
Half-Rusaia, 5 Vols., Royal Octavo, - 
20.00 22.00 16s. 124 fr. 35 
EXTRACTS FROM REVIEWS. 
We venture to say that all who saw the Annual as it appeared in 1888 were on the 
lookout for its reappearance this (1889) year; but there are many whose knowledge of this 
magnificent undertaking will date with this present issue, and to those a mere examina- 
tion of the work will suffice to show that it fills a legitimate place in the evolution of 
knowledge, for it does what no single individual is capable of doing. 
These volumes make readily available to the busy practitioner the best fruits of 
medical progress for the year, selected by able editors from the current literature of the 
world; such a work cannot be overlooked by anyone who would keep abreast of the 
times. With so much that is worthy of notice incorporated in one work, and each depart- 
ment written up with a minuteness and thoroughness appreciated particularly by the 
specialist, it would avail nothing to cite particular instances of progress. Let it be suffi- 
cient to say, however, that while formerly there was a possible excuse for not having the 
latest information on matters pertaining to the medical sciences, there can no longer be 
such an excuse while the Annual is published.—Journal of the American Medical 
Association. 
We have before us the second issue of this Annual, and it is not speaking too 
strongly when we say that the series of five volumes of which it consists forms a most 
important and valuable addition to medical literature. 
Great discretion and knowledge of the subjects treated of are required at the hands 
of those who have taken charge of the various sections, and the manner in which the 
gentlemen who were chosen to fill the important posts of sub-editors have acquitted 
themselves fully justifies the choice made. We know of no branch of the profession to 
which this Annual could fail to be useful. Dr. Sajous deserves the thanks of the whole 
profession for his successful attempt to facilitate the advance of medical literature and 
practice.—London Lancet. 
This very valuable yearly report of the progress of medicine and its collateral 
sciences throughout the world is a work of very great magnitude and high importance. 
It is edited by Dr. C. E. Sajous, assisted, it is stated, by seventy associate editors, whose 
names are given, making up a learned and most weighty list. Their joint labors have 
combined to produce a series of volumes in which the current progress throughout the 
world, in respect to all the branches of medical science, is very adequately represented. 
The general arrangements of the book are ingenious and complete, having regard to 
thoroughness and to facility of bibliographical reference.—British Medical Journal. 
ANNUAL, 8891. 
The editor and publishers of the Annual of the Universal 
M edical Sciences take this opportunity to thank its numerous friends 
and patrons for the liberal support accorded it in the past, and to 
announce its publication, as usual, in 1891. Recording, as it does, the 
progress of the world in medicine and surgery, its motto continues to 
be, as in the past, “ Improvement,” and its friends may rest assured that 
no effort will be spared, not only to maintain, but to surpass, the high 
standard of excellence already attained. 
The Subscription Price will be the same as last year’s issue and 
the issues of 1889 and 1888. 
(F. A. DAVIS, Medical Publisher, Philadelphia, Pa., U.S.A.) OF 
The Annual of the Universal Medical Sciences. 
In Five Royal Octavo Volumes of over 500 pages each, bound in Clotli and 
Half-Russia, Magnificently illustrated with Chromo-Lithographs, 
Fngravings, Maps, Charts, and Diagrams. 
THE SUBSCRIPTION PRICE (including the “Satellite” for one year). 
TISSUE OK 1889 
Cloth, 5 Vols., Royal Octavo, 
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• $15.00 $16.50 £3.5s. 93 fr. 95 
Half-Russia, 5 Vols., Royal Octavo, 
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This work is bound in above styles only, and sold by subscription. 
Published in Connection with the Annual and for Subscribers Only. 
THE SATELLITE 
•OF THE- 
ANNUAL OF THE UNIVERSAL MEI1ICAE SCIENCES. 
A Monthly Review of the most important articles upon the practical branches of medicine appearing in 
the medical press at large, edited by the Chief Editor ol the Annual and an able stall. 
Editorial Staff of the Annual of the Universal Medical Sciences, issue of 1889, 
Chief Editor, Dr. CHAS. E. SAJOUS, Philadelphia. 
ASSOCIATE STj&.IF'iF’. 
Volume I.—Diseases of the Lungs, Diseases of the Heart, Diseases of the Gastro- 
Hepatic System, Diseases of the Intestines, Intestinal Entozoa, Diseases of 
the Kidneys and Bladder, Fevers, Fevers in Children, Diphtheria, Rheu- 
matism and Gout, Diabetes, Volume Index. 
Prof. Jas. T. Whittaker, Cincinnati. 
Prof. A. L. Loomis, New York City. 
Prof. E. T Bruen, Philadelphia. 
Prof, W. W. Johnston, Washington. 
Dr. L. Emmett Holt, New York. 
Prof. Jos. Leidy, Philadelphia. 
Dr. Jas. C. Wilson, Philadelphia. 
Prof I ouis Starr, Philadelphia. 
Prof. J. I.ewis Smith, New York. 
Prof. N. S. Davis, Chicago. 
Prof. Jas. Tyson, Philadelphia. 
Volume II.—Diseases of the Brain and Cord, Peripheral Nervous System, Mental 
Diseases, Inebriety, Diseases of the Uterus, Diseases of the Ovaries, Diseases 
of the External Genitals in Women, Diseases of Pregnancy, Obstetrics, Dis- 
eases of the Newborn, Dietetics of Infancy, Growth, Volume Index. 
Prof. E. C. Seguin, New York City. 
Prof. Henry Hun. Albany. 
Dr. E. N. Brush, Philadelphia. 
Dr. W. R. Birdsall, New York. 
Prof. Paul F. Alunde. New York City. 
Prof. Wm. Goodell, Philadelphia. 
Dr. W. C. Goodell, Philadelphia. 
Prof W. H. Parish. Philadelphia. 
Prof. Theophilus Parvin, Philadelphia. 
Prof. Wm. L. Richardson. Boston. 
I)r. A. F. Currier, New York. 
Prof. I ouis Starr, Philadelphia. 
Dr. Chas. S.. Minot, Boston. 
Volume III.—Surgery of Brain, Surgery of Abdomen, Genito Urinary Surgery, Dis- 
eases of Rectum and Anus, Amputation and Resection and Bias tie Surgery, 
Surgical Diseases of Circulation, Fracture and Dislocation, Military Surgery, 
Tumors, Orthopaedic Surgery, Oral Surgery, Surgical Tuberculosis, etc., Sur 
gical Diseases, Results of Railway Injuries, Anesthetics, Surgical Dressings, 
Volume Index. 
Prof. N. Senn, Milwaukee. 
Prof. E. T. Keyes, New York City. 
Prof. J. Ewing Mears, Philadelphia. 
Dr. Chas. B Kelsey, New York City. 
Prof. P. S. Conner, Cincinnati. 
Dr. John H Packard, Philadelphia. 
Prof. I.ewis A. btimson, New York City. 
Dr. J. M. Barton, Philadelphia. 
Prof. D. Hayes Agnew, Philadelphia. 
Dr. Morris Longstreth, Philadelphia. 
Dr. Thos. G. Morton, Philadelphia. 
Prof. J. F, Garretson. Philadelphia. 
Prof. J. W. White, Philadelphia. 
Prof. C. Johnston, Baltimore. 
Prof. E. C. Seguin, New York City. 
Volume IV.—Skin Diseases, Ophthalmology, Otology, Rhinology, Diseases of Pharynx, 
etc., Intubation, Diseases of Larynx and (Esophagus, Diseases of Thyroid 
Gland, Legal Medicine, Examination for Insurance, Diseases of the Blood, 
Urinalysis, Volume Index. 
Prof. A. Van Harlingen, Philadelphia. 
Dr. Chas A. Oliver and Dr. Geo. M. 
Gould, Philadelphia. 
Dr. Charles S. Turnbull, Philadelphia. 
Prof. J. Solis Cohen, Philadelphia. 
Prof. John Guiteras, Charleston, S. C. 
Dr. Chas. E. Sajous, Philadelphia. 
Prof. D. Bryson Delavan, New York. 
Prof R. Fletcher Ingals, Chicago. 
Prof. F. W. Draper. Boston. 
Prof. Jas. Tyson, Philadelphia. 
Volume V.—General Therapeutics, Experimental Therapeutics, Poisons, Electric 
Therapeutics, Climatology, Dermography, Technology, Bacteriology, Embry- 
ology, Physiology, Anatomy, General Index. 
Dr. J. P. Crozer Griffith, Philadelphia. 
Dr. Hobart A. Hare, Philadelphia. 
Prof Geo. H. Rohe, Baltimoie. 
Prof. John B. Hamilton, Washington. 
Dr. Harold C. Ernst, Boston. 
Prof. H. Newell Martin, Baltimore. 
Dr. R. J. Dunglison, Philadelphia. 
Dr. C. Sumner Witherstine, Philadelphia. 
Prof. J. W. Holland, Philadelphia. 
Prof. A L. Ranney, New York. 
Dr. Albert H. Gihon, U. S. N. 
Dr. W. P. Manton, Detroit. 
Dr. W. X. Sudduth, Philadelphia. 
Prof. Wm. T. Forbes, Philadelphia. 
30 
(F. A. DAVIS, Medical Publisher, Philadelphia, Pa., U.S.A.) THE LATEST BOOH OF REFERENCE ON NERVOUS DISEASES. 
Lectures on Nervous Diseases, 
FROM THE STAND-POINT OF CEREBRAL AND SPINAL LOCALIZATION, AND 
THE LATER METHODS EMPLOYED IN THE DIAGNOSIS AND 
TREATMENT OF THESE AFFECTIONS. 
By AMBROSE L. RANNEY, A.M., M.D., 
Pri'dssor of the Anatomy and Physiology of the Nervous System in the New York Post-Graduate Medical 
School and Hospital ; Professor of Nervous and Mental Diseases in the Medical Department of the 
University of Vermont, etc ; Author of “ The Applied Anatomy of the Nervous System,” 
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ILLDTSTEA-TED 
With Original Diagrams and Sketches in Color by the Author, carefully selected Wood- 
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ONE HANDSOME ROYAL OCTAVO VOLUME OF 780 PAGES. 
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It is now generally conceded that the nervous system controls all of the physical 
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The unprecedented sale of this work during the short period why k has elapsed since 
its publication has already compelled the publishers to print a second edition, which is 
already nearly exhausted. 
We are glad to note that Dr. Ranney has pub- 
lished in c :ok form his admirable lectures on nervous 
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honest opinion.—American Journal of Insanity. 
LECTURES 
ON THE 
Diseases of the Nose and Throat. 
DELIVERED AT THE JEFFERSON MEDICAL COLLEGE, PHILADELPHIA, 
By CHARLES E. SAdOUS, M.D., 
Lecturer on Rhinology and Laryngology in Jefferson Medical College; Vice-President of the American Laryngological 
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of the Royal Society of Belgium, of the Medical Society of Warsaw (Poland), and of the Society of 
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ONE HANDSOME ROYAL OCTAVO VOLUME. SOLD ONLY BY SUBSCRIPTION. 
United States. 
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Since the publisher brought this valuable work before the profession, it has become. 
1st, the text-book of a large number of colleges; 2d, the reference-book of the U. S. Army, 
Navy, and the Marine Service; and, 3d, an important and valued addition to the libraries 
of over 7000 physicians. 
This book has not only the inherent merit of presenting a clear expose of the subject, 
but it is written with a view to enable the general practitioner to treat his cases himself. 
To facilitate diagnosis, coloredploies are introduced, showing the appearance of the differ- 
ent parts in the diseased state as they appear in nature by artificial light. No error can 
thus be made, as each affection of the nose and throat has its representative in the 100 
chromo-lithographs presented. In the matter of treatment, the indications are so complete 
that even the slightest procedures, folding of cotton for the forceps, the use of the probe, 
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It is intended to furnish the general practitioner 
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(F. A. DAVIS, Medical Publisher, Philadelphia, Pa., U.S.A.J 
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OINTMENTS AND OLEATES, 
ESPECIALLY IN DISEASES OF THE SKIN. 
By JOHN V. SHOEMAKER, A.M., M.D., Professor of Materia 
Medica, Pharmacology, Therapeutics, and Clinical Medicine, and Clinical 
Professor of Diseases of the Skin in the Medico-Chirurgical College of 
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No. 6 in the Physicians’ and Students’ Ready-Reference Series. 
Second Edition, revised and enlarged. 298 pages. 12mo. Neatly 
bound in Dark-blue Cloth. 
Price in United States and Canada, post-paid, $1.50 Net; 
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The author concisely concludes his preface as follows : “ The reader 
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It is invaluable as a ready reference when ointments or oleates are to be used, and is serviceable to both 
druggist and physician.—Canada Medical Record. 
To the physician who feels uncertain as to the best form in which to prescribe medicines by way of the 
skin the book will prove valuable owing to the many prescriptions and formulae which dot its pages, while 
the copious index at the back materially aids in making the book a useful one.—Medical News.