(T.^vSrrS ^^rfe ■■•;SL, ^piist ti<'-kp 3ICINE NATIONAL LIBRARY OF MEDICINE NATIONAL LIBRARY OF MEDICINE NATION, MOI1VN 3NIDI03W dO AHVyaiT TVNOIIVN 3NIDI03W dO AavafllT WNOIIVN 3NIDI0! DICINE NATIONAL LIBRARY OF MEDICINE NATIONAL LIBRARY OF MEDICINE NATION DICIN ^ f ATION NOI1VN 3NIDI03W dO AHVaaiT TVNOIIVN 3NIDI03W dO AHVaaiT TVNOIIVN 3NIDI0 I FK/ I DICINE NATIONAL LIBRARY OF MEDICINE NATIONAL LIBRARY OF MEDICINE NATIOh- 0 'NOI1VN 3NIDIQ3W dO AOVaaiT TVNOIIVN 3NIDia3W dO AHVa9IT TVNOIIVN 3NIDIC t> I EDICINE NATIONAL LIBRARY OF MEDICINE NATIONAL LIBRARY OF MEDICINE NATIOI- 'NOI1VN 9NIDia3W dO AHVaan TVNOIIVN 3NOI03W dO AHVaan TVNOIIVN 3NIDK E TEDE5TDD WIN 3NID1Q3W JO Advsan 1VN0I IDICINE NATIONAL LIBRARY OF MEDICINE N X NLM001530212 NATIONAL LIBRARY OF MEDICINE NATIONAL LIBRARY OF MEDICINE SNiDiasw do Aavaan tvnouvn 3nidiq3w do Aavaan tvnouvn o. NATIONAL LIBRARY OF MEDICINE NATIONAL LIBRARY OF MEDICINE 3NIDIQ3W do Aavaan tvnouvn snidiqsw do Aavaan tvnouvn NATIONAL LIBRARY OF MEDICINE NATIONAL LIBRARY OF MEDICINE aNiDiasw do Aavaan tvnouvn 3NiDia3w do Aavaan tvnouvn NATIONAL LIBRARY OF MEDICINE NATIONAL LIBRARY OF MEDICINE 3nidici3w do Aavaan tvnouvn 3Nidiq3w do Aavaan tvnouvn NATIONAL LIBRARY OF MEDICINE NATIONAL LIBRARY OF MEDICINE "■?.<^ No. 6 IN THE PHYSICIANS' AND STUDENTS' READY REFERENCE SERIES. -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 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. SECOND EDITION. REVI3KD jSlDNTH) ENO^jOLjfiarEID. Philadelphia and London : F. A. DAVIS, PUBLISHER, 1890. Entered according to Act of Congress, in the year 1890, by F. A. DAVIS, In the Office of the Librarian of Congress at Washington, D. C, U. S. A. Philadelphia: The Medical Bulletin Printing Ilouse, 1231 Filbert Street. PREFACE TO THE FIRST EDITION. A period of ten years has elapsed since I became interested in the production of the different oleates and their introduction to the medical profession as useful remedies for the treatment of diseases of the skin, etc. From that time I constantly endeavored by investigation and experiment to test their value, and it is pleasant to say that my efforts have proved successful, as evinced both in my hospital and private practice, and in the adoption of the oleates by prac- titioners in this country and in Europe. The results of my labors were publicly made known through papers read before the Philadelphia County Medical Society, the Medical Society of the State of Pennsyl- vania, the American Medical Association, the British Medical Association, and the International Medical Congress, held at Copenhagen. This small volume is not only a resume of all that I have heretofore written concerning the oleates and their uses, but enables me to lay before my readers in a permanent form all my experience. It also contains much new matter which (iii) iv Preface to the First Edition. I think will prove interesting and of value, and which I have not heretofore published. It is with pleasure that I acknowledge the efficient aid and co-operation of my friend, Dr. L. Wolff, well known in connection with the chemistry of this sub- ject, who, with untiring assiduity, rendered me every assistance in his power to further my efforts toward a satisfactory conclusion. J. V. S. PHILADELPHIA, 1519 WALNUT STREET, April, 1885. PREFACE TO THE SECOND EDITION. Since the first edition of this work was published, in 1885, the oleates have continued to be prescribed with undoubted advantage. The best proof of this is shown by the very marked improvement in the quality of oleic acid and its salts, with the metals and alka- loids. Chemists and pharmaceutists, both in this country and abroad, have greatly interested themselves in devising improved modes of preparation, some of which I have incorporated in this second edition. I may also add that the oleates of mercury and zinc have been made official in the last edition of the British Pharmacopoeia. In order to make as complete a survey as possible of the manner in which, and the purposes for which, fatty substances are applied to the human body, I have extended the scope of the work so as to embrace a consideration of ointments. In addition to our offici- nal, I have described those which are commonly used in this country,—those substances which are used ex- temporaneously and the officinal British ointments. (v) vi Preface to the Second Edition. The official lists of France, Germany, and Austria are also given, while those familiar in the practice of Italy, Spain, and the Spanish colonies have been compiled from all accessible sources. The reader may thus obtain a conspectus of the whole subject of inunction as it exists to-day in the civilized world. In all cases the mode of preparation is given, and the therapeutical applications described seriatim, in so far as may be done without needless repetition. J. V. S. 1519 Walnut Street, Philadelphia, Pa., May, 1890. CONTENTS. PART I. CHAPTER I. PAGE Ointments,........1 Local Medication of Skin Diseases—Antiquity of Oint- ments—Different Indications for Ointments, Powders, Lotions, etc.—Information about Ointments: Scanty, Scattered, and Insufficient—Fats and Oils : Animal and Vegetable—Their Chemical Composition—Comparative Permeability of Oils into Skin: of Animal, of Vege- table—Incorporation of Medicinal Substances into Fats: (1) Mode of Preparation, (2) Vegetable Powders and Extracts, (3) Alkaloids, (4) Mineral Substances, (5) Petroleum Fat6; Chemical Composition, Uses, and Dis- advantages. CHAPTER II. Official Ointments and their Therapeutic Uses,........29 Ointments Formerly Official in the United States Pharmacopeia,.....54 National Formulary Unofficial Ointments, . 62 CHAPTER III. Ointments Official in the British Pharmaco- peia, ........67 (vii) viii Contents. CHAPTER IV. PAGE Extemporaneous Ointments, . . • .79 CHAPTER V. Ointments Official in the German Pharmaco- PCEIA,........109 CHAPTER VI. Ointments Official in the French Pharmaco- peia, ........11' CHAPTER VII. Ointments Official in the Austrian Pharma- copeia, ........127 CHAPTER VIII. Ointments Official in the Italian Pharmaco- peia, .......135 CHAPTER IX. Ointments in Spanish Pharmacy, . . .181 CHAPTER X. Ointments Official in the Mexican Pharmaco- peia, ........203 Ointments Official in the Chilian Pharmaco- Contents. ix PART II. THE: OLEjft-TES. CHAPTER I. PAGE History and Origin,......211 CHAPTER II. Process of Manufacture,.....219 CHAPTER III. Physiological Action of the Oleates, . . 237 CHAPTER IV. Therapeutic Action of the Oleates, . . .243 Part I. OIN T HXIK ISC T s. (xi) OINTMENTS AND OLEATES. CHAPTER I. OINTMENTS. Looal Medication of Skin Diseases. An ointment is a fatty substance designed for topical application. The selected fat may be used without any addition. It is, however, both customary and advan- tageous to incorporate with the fat some more active medicinal ingredient or combination of ingredients. The fat would, therefore, seem to answer the purpose of a vehicle by which the medicament is brought and retained in contact with a diseased surface. But that the oleag- inous basis possesses valuable physiological and thera- peutical properties peculiar to itself is proven by the fact that the sebaceous secretion of the skin is of an oleaginous composition and consistence. In estimating, then, the value of a medicated ointment, we must take into consideration the separate virtues of the fatty basis and the included drug or drugs. The sebaceous glands abound most particularly in those portions of the integument provided with hair. Their ducts generally communicate at an acute angle with the upper third of the hair-follicles, though some open directly upon the surface. They have not been found upon the palms of the hands, the soles of the feet,, or the dorsal surfaces of the last phalanges of the fingers and toes. Sebum consists of fat-cells, free fat, and epithelial debris. Chemical analysis has determined that it contains about 40 per cent, of olein and palmitin, 13 per cent, of casein, 8 per cent, of gelatin, a small quantity 1A (1) 2 Ointments. of the chloride, phosphate, and sulphate of sodium, to- gether with about 35 per cent, of water. It is, unmis- takably, a natural or physiological unguent. The con- nection of the sebaceous ducts with the hair-follicles suggests that the secretion must be related in some way to the nutrition of the hair. It maintains the skin in a soft and flexible condition, and fortifies it against changes of temperature. It obviates deleterious friction between opposing surfaces, and protects the outlets of the body from the effects of irritant discharges. Sebum acts as a preservative to the cuticle, protecting it from maceration by excessive perspiration and consequent exposure of the sensitive cutis vera. This brief enumeration supplies us already with an indication for the use of ointments. For, when the skin is diseased, either as the result of local or constitutional causes, its secretory functions are disturbed or sup- pressed. Inunction offers a partial substitute for the natural secretion, softens the harsh tissue, and reduces its heat. It is principally in cases of disease or injury of the integument that unguents are applicable. To a necessarily limited degree they are employed in morbid conditions of the accessible mucous membranes. Fat is also serviceable in mitigating pruritus. The irritant effect of acrid discharges, such as occur in eczema, in diseases of the vagina and uterus or of the intestinal canal, is lessened or prevented by the application of an ointment. Scabs, such frequent concomitants of affec- tions of the skin, are softened and removed by the same means. Oleaginous substances are* of avail in the treatment of fever. The intense heat and itching of the skin in scarlatina are noticeably relieved by general inunction. At the same time the pulse and general temperature of Local Medication of Skin Diseases. 3 the body are reduced. Senator ascertained that, although the external use of fat or oil produced little or no dimi- nution of the normal temperature, yet in disease its influence was more marked. The accurate experiments of Dr. Colrat, of Lyons, upon children aged from 1 to 2 years, leave no room for doubt upon this point. This observer made use of different substances, as lard, cerate, and vaseline, and found that in every instance they occasioned a decline of temperature, as noted by the thermometer placed in the rectum. The reduction varied from 1.4° F. to 3.6° F. The greatest diminution occurred at the end of about an hour. In about three hours after the application the temperature had risen again, when the inunction was repeated. During the desquamative stage of scarlatina inunction is especially valuable. It is probably, also, of some prophylactic utility by re- straining the dispersion of scales through the atmosphere. The same method is of undoubted service in measles. Fat is an important nutrient. It enters into the chemical constitution of the principal animal tissues. The blood usually contains about 0.4 per cent., the muscles 3.3, milk 4.3, brain 8, and the nerves 22 per cent. Even the digestion of albuminous food requires the presence of a small quantity of fat. It is necessary in the process of cell construction, and, in fact, is found wherever active vital processes are manifested. This being the case, when fat has been consumed by an exhausting disease the system stands in urgent need of a fresh supply. Rachitis, scrofula, chronic dysentery, and tuberculosis are exam- ples of maladies in which it is desirable to administer oleaginous materials. In these conditions, however, the stomach is often intolerant to a pabulum so beneficial to the system. In such a contingency much good may be effected by inunction. It is advisable to precede the 4 Ointments. application by a warm bath, which will relax the gland- ducts and their orifices, and thus favor absorption. Cod- liver oil is the agent usually chosen, and is generally the best; but circumstances may preclude its use, in which case the commoner fats, such as lard or suet, may be substituted. Antiquity of Ointments. In the effort to cure disease, mankind, at an early stage of intellectual development, seems generally to have regarded it as an entity inflicted by supernatural power, to be removed by spells, prayers, and incantations. The healing art in its infancy was therefore largely relegated to priests. As time progressed, however, more material modes of medication sprang into existence. The reception of wounds or injuries, in the chase or in war- fare, must early have suggested some crude local treat- ment. The same methods would soon be extended to lesions which were the result not of accident, but of dis- ease. Applications, at first restricted to cases in which the surface was visibly altered, were given a trial in those in which pain or other conspicuous symptom evidently arose from deeper portions of the body. The wide distribution of fats and oils gives assurance that unguents must very early have obtained a place in the list of external remedies. With this assumption corresponds what we learn from the observation of trav- elers and the records of history. Oleaginous applica- tions which are, to all intents and purposes, ointments, are largely employed by barbarous races. We meet with very early allusion to ointments in the hieroglyphic writings of Egypt. The Ebers' papyrus, ascribed to 1600 B.C., contains a formulary of prescriptions by noted physicians, and among many other preparations allusion is made to ointments. They are said to be Antiquity of Ointments. 5 described also in the cuneiform inscriptions. In the Old Testament reference is made in several places to " the art of the apothecary." In Exodus, xxx, 25, we read : " And thou shalt make it an oil of holy ointment," etc., and in Job, xli, 31: " He maketh the deep to boil like a pot; He maketh the sea like a pot of ointment." It is said that the diachylon ointment was devised by Menec- rates in the year 1, Anno Domini. This class of medica- ments is described in the works of Celsus, who probably lived under Augustus; Galen (130-203 A.D.), Oribasus (326-403 A.D.),^Etius and Paulus JB gin eta, whose eras are uncertain. During the Dark and Middle Ages ointments continued to be largely employed, and often included very strange ingredients. Their composition and their use became at times closely connected with superstitious beliefs. One of the most conspicuous ex- amples of this alliance is the " weapon-salve " of that enigmatical character, Paracelsus. This salve is said to have contained boar and bear's fat, rain-worms, hog's brain, yellow sandal, mummy, blood-stone, and moss from the skull of a hanged criminal, which latter was to be gathered at the waxing of the moon.* " The virtues of this salve," remarks Paracelsus, " are remarkable, for with it one can heal all kinds of wounds, though the patient be miles away, provided one can but procure the weapon with which the wound was inflicted. This weapon must be greased once a day with the salve, then tied up in a clean linen cloth, and preserved in a warm locality. It should be protected from dust and cold draughts, otherwise the patient would experience great pain and become delirious. Although this cure may appear supernatural, and therefore be discountenanced •Pictorial History of Ancient Pharmacy. By Hermann Peters. Trans- lated by Dr. William Netter. Chicago, 1889. 6 Ointments. by many, I can, nevertheless, assure the reader that this is not the case; for those instructed in the natural sciences know from experience, and have proven by diligent re- search, that the cure is accomplished by means of a cer- tain magnetic force that emanates from the stars and acts upon the salve,conveying the latter's magnetic force through the air and to the wound." The first real phar- macopoeia was published in Nuremberg, in the year 1546, by Valerius Cordus. It contains a division devoted to ointments. Among the substances mentioned is adeps hoininis, " poor sinners' fat." Indications for Ointments. Drugs may be applied to the integument in finely- powdered substance, in the form of a lotion, or an oint- ment. In the protean variations which diseases of the skin assume, we are often forced to ask ourselves which of these three forms is the best adapted to the condition of the case under consideration. Doubtless, certain maladies or stages are more successfully treated by means of a dusting-powder, while a lotion or an oint- ment is no less clearly to be preferred under other con- ditions. Yet it is not always clear, before the experiment has been made, which application shall be attended by the best results in a given case. If the surface involved is very extensive, and the attack be acute, the skin intensely red and hot, a liquid application will, as a rule, answer the best purpose. The affected part may be sub- mitted to the action of an aqueous or spirituous solution, or may be immersed in water of a suitable temperature. But if the disease be of a chronic nature, a continued subjection to the influence of water induces a swollen relaxed, softened condition of the parts, to which the term "water-logged " has been given. In this condition the local circulation is weak and retarded, and the nerve- Fats and Oils. 7 force depressed. It is essential that powders should be well ground and sifted, and free from gritty particles. The form, situation, or extent of the diseased area in- fluences our selection of a powder. Powders are scarcely suited for use on an extensive surface. Again, in many parts of the body powders can be retained in contact with difficulty. When adherent, they protect the skin from atmospheric changes and influences. They are excellently suited to absorb moisture, and consequently are especially useful when a serous or sero-purulent dis- charge is present. Ointments also serve as a protection against the atmosphere; they loosen scabs or crusts, se- curing an unprotected integument upon which the powers of the medicament may be directly exerted. They may be readily applied to a surface of any form or extent by being spread upon lint and held in position by means of a bandage. They are, perhaps, of more general appli- cability than either powders or lotions in diseases of the skin, besides being of service in numerous other affections. Fats and Oils. Fats and oils, though differing in physical state under ordinary circumstances, agree very closely in chemical composition. Fats derived from the animal kingdom are, with a few exceptions, solid, while oils of vegetable origin are, for the most part, fluid. The difference in consist- ency depends upon the presence of different proportions of their characteristic ingredients. It also depends upon temperature. The fixed oils, when chemically pure, are devoid, or nearly so, of color, taste, and smell. They are lighter than water, the specific gravity of fluid oils ranging between 0.900 to 0.970. The animal fats, likewise, when perfectly pure, are, for the most part, colorless and transparent, and, when fresh, destitute of smell and 8 Ointments. taste. They are lighter than water, in which they are insoluble, but most of them dissolve in boiling alcohol. They are all soluble in ether and in volatile oils. They melt, in general, below the boiling-point of water. They communicate to linen and paper a permanent translucent stain, and are bad conductors of heat and electricity. Fats and oils are hydrocarbons, and consist of hydro- gen, carbon, and oxygen. The proportion in which these elements are present varies, as a rule, from 76 to 80 per cent, for carbon, from 11 to 13 per cent, for hydrogen, and from 10 to 12 per cent, for oxygen. Fatty and ole- aginous substances consist essentially of a fatty acid in combination with a radical. This combination is broken up by a process of saponification. The addition of an alkali, alkaline earth, or metallic oxide, together with water, effects a decomposition. The fatty acid unites with the alkali or the metal, from which it may be readily freed by the addition of almost any other acid, mineral or vegetable. In the separation of the fatty acid gly- cerin results. The combination of acid and base is described as a gfyceride. The fatty acids most frequently met with are three in number, and are known as stearic, palmitic, and oleic. These, combined as glycerides, form the most important constituents of all fats and oils. In these combinations three equivalents of the fatty acids are substituted for the three replaceable hydrogen atoms of the gtycerin. In other words, the natural, simple fats are all triacid compounds. Glycerin is a trihydric alcohol, while the glycerides belong to the group of ethers. There are three ethers, corresponding to each of the three fatty acids which have been mentioned. They are distinguished from each other by means of the prefixes mono, di, and tri, so that each forms a series; we have monostearin Fats and Oils. 9 distearin,and tristearin ; monopalmitin, dipalmitin, and tripalmitin; monolein, diolein, and triolein. It is the triacid combinations which chiefly occur in the fats em- ployed in external medication. They are, however, generally designated simply as stearin, palmitin, and olein. No fat or oil is found to be composed solely of one of these glycerides. Each is a compound, as it exists in the natural state, formed by the association of two or more glycerides or simple fats. It is true that one of the simple fats is apt to preponderate in the constitution of a given compound or natural fat. It is chiefly to this fact that the different consistencies of different fatty materials are due. Stearic acid exists most abundantby in the more solid animal fats, such as beef and mutton suet. It is present in smaller quantity in the softer animal fats, and also in some vegetable oils. It is obtained by saponifying suet with soda-lye, and heating the soapy solution with water and dilute sulphuric acid. This frees the fatty acids from combination. After cooling they are removed, washed with water, and dissolved in as small a quantity as possible of hot alcohol. When this has cooled the greater part of the solid acid sep- arates out, and may be purified by repeated crystalliza- tion in absolute alcohol, until a substance is obtained which melts constantly at 69° to 70° C. (156° to 158° F.). Pure stearic acid occurs in the form of nacreous needles or lamina?. It is without odor or taste, and its reaction is distinctly acid. It melts at 69° to 69.2° C. (156° F.) to a colorless oil, which, upon cooling, be- comes a fine, white, crystalline mass. It is heavier than water at low temperatures, but between 9° and 10° C. (48° to 50° F.) its specific gravity is the same as that of water. l* 10 Ointments. It is to the presence of a large proportion of stearin that the firmness of mutton suet is due. Palm-oil is the principal source of palmitic acid, al- though it is found in other animal and vegetable oils. It is prepared by saponifying palm-oil with caustic potash, decomposing the soap with sulphuric acid, and crystallizing the separated fatty acid several times from hot alcohol till it exhibits a constant melting-point. Palmitic acid is a colorless solid, and has neither taste nor smell. It is lighter than water, in which it is insoluble, but is freely soluble in boiling alcohol or ether. It melts at 62° C. (144° F.). It burns with a bright, smoky flame. The origin, mode of preparation, physical and chem- ical properties of oleic acid are described in the latter portion of this work. It was formerly customary, in discussing the chemis- try of fat, to include margaric acid. It is now known, however, that this does not exist in natural fat as a distinct acid, but is really a mixture of stearic and other fatty acids having lower melting-points, especially palmitic acid. This fact could not be recognized by the older methods of separation, but has been demonstrated by Heintz. The properties of simple and compound fats depend almost entirely upon the acids which they contain, and for this reason are extremely similar to those of the acids described. RANCID FATS. When oils or fats are exposed to the air they ab- sorb oxygen freely, undergoing certain changes in their physical and chemical properties. The word " rancidity " is used to express this alteration. The substance ac- quires an acid reaction, becomes acrid to the taste. Rancid Fats. 11 offensive to the smell, and deepens in color. The re- action is due to the development of free acids belonging to the fatty acid series. The conversion from a neutral to an acid body renders a fat unfit for the purposes of an unguent. To say nothing of the repulsive odor, the fatty acids characteristic of rancidity are highly irritant and unhealthy to the skin. They would in many cases, also, promote chemical changes in the incorporated medicaments. It is interesting to observe in this connection that the German chemist, H. Hager, has lately published a method by which rancid fats may be restored.* This consists in shaking the fat or oil with ethyl alcohol of 90, 88, and 86 per cent. Generally, an alcohol of 85 to 87 per cent, will answer, since it dissolves the majority of fatty acids. " To each volume of the rancid fat con- tained in a cylindrical glass vessel, and warmed to about 35° C. (95° F.), 1 to l£ volumes of alcohol should be added, and the whole shaken violently about three times in the course of half a day, so that by each shaking an emulsion-like liquid is produced. On the second day, at a temperature of 20° to 24° C. (68° to 75.2° F.), the mixture will separate into two clear layers, the lower being the oily, the upper the alcoholic layer. Lastly, the alcohol should be drawn off, partly by decantation,partly by the aid of a siphon. Another portion of alcohol, about one-half a volume, should then be added to the oil, shaken, and, after standing, drawn off as above, save that it is advisable to allow the mixture to stand two or three days." The process is an economical one, since the alcohol can be recovered by distillation. It is stated by the author from whom I have quoted • The Druggists' Circular and Chemical Gazette, June, 1889. From the Berlin Pharuiaceutische Zeitung. 12 Ointments. that his method is not applicable to all kinds of oil. It failed with castor-oil, codliver-oil, croton-oil, and ex- pressed laurel-oil. On the other hand, it succeeded ex- cellently with oil of beech-nut and olive-oil. It was found necessary, however, to treat the latter three times with alcohol instead of twice. No mention is made of experiments with animal fats. It is recommended that, in attempting to restore rancid fats by this method, a trial should be made on a small scale. A compound hydrocarbon, derived from petroleum and belonging to the paraffin series, has of late years been introduced into pharmacy under the name of petrolatum, cosmoline, or vaseline. It is of unctuous consistency, bland, neutral, and indisposed to become rancid. It has been and is, consequently, largely em- ployed in the preparation of ointments. My opinion of the efficacy of this substance is fully expressed in a preceding chapter, and need not be repeated in this connection. The consistence of ointments should be similar to that of butter. The vehicles commonly used in their preparation are lard, suet, petroleum jelly, and lanolin. Spermaceti, cacao-butter, and the glycerite of starch are also occasionally employed. ADEPS : LARD. Lard, adeps, is defined by the U. S. Pharmacopoeia as " the prepared internal fat of the abdomen of* sus scrofa, purified by washing with water, melting, and straining." The same authority describes it as "a soft, white, unctuous solid, of a faint odor, free from ran- cidity, having a bland taste and a neutral reaction. Entirely soluble in ether, benzine, and disulphide of carbon. Specific gravity about 0.938. It melts at or Sevum: Suet. 13 near 35° C. (95° F.) to a clear, colorless liquid, and at or below 30° C. (86° F.) it is a soft solid." It consists 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. Lard is not infrequently adulterated with water, starch, alum, chalk, or cotton-seed oil. These substances may all be detected by appropriate tests. The presence of salt, also, is undesirable. The salt may be separated by boiling the lard with twice its weight of water. The tendency to rancidity may be obviated by digest- ing the lard with benzoin, beta-naphthol, or poplar-buds. Benzoinated lard is official, and is made by the addition of 2 parts of benzoin to 100 parts of lard. SEVUM : SUET. Suet, sevum, " is the internal fat of the abdomen of ovis aries, purified by melting and straining." It is de- fined as a white, smooth, solid fat, nearly inodorous, having a bland taste and a neutral reaction. Soluble in 44 parts of boiling alcohol, in about 60 parts of ether. It melts between 45° and 50° C. (113° and 122° F.) and congeals between 37° and 40° C. (98.6° and 104° F.). It is the firmest of animal fats, and contains about 70 per cent, of stearin and palmitin and 30 per cent, of olein. Its specific gravity is between 0.937 and 0.952. PETROLATUM: PETROLEUM JELLY. Petroleum jelly, petroleum ointment, or petrolatum, is "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. Melting-point, about 40° to 51° C. (104° to 125° F.), the first consti- tuting the softer and the second the firmer variety. 14 Ointments. When petrolatum is prescribed or ordered without speci- fying its melting-point, the low-melting variety, which liquefies at about 40° C. (104° F.), is to be dispensed. " A yellowish or yellow, fat-like mass, transparent in thin layers, more or less fluorescent, especially when melted ; completely amorphous, tasteless, and odorless, or giving off, at most, only a faint petroleum odor when heated, and having a neutral reaction. When gently heated until the mass is almost entirely melted, the liquid portion has a specific gravity varying from 0.835 to 0.860. It is insoluble in water; scarcely soluble in alcohol or in cold absolute alcohol, but soluble in 64 parts of boiling absolute alcohol, and readily soluble in ether, chloroform, disulphide of carbon, oil of turpentine, benzine, benzol, and in fixed or volatile oils. When heated on platinum foil, it is completely volatilized without emitting the acrid vapors of burning fat or resin." LANOLINUM: LANOLIN. Purified lanolin, lanolinum purissimum, is a valu- able ointment-basis which was brought to the notice of the profession by Professor Liebreich, in 1886. In the course of an extended series of investigations upon the nature and distribution of cholesterin, he deter- mined the presence in keratinous tissue of a substance to which he gave the name lanolin. It exists in human epidermis, hair, horn, hoof, feathers, etc. It is most abundantly present in sheep's wool, which is, conse- quently, our source of supply. F. Hartmann had, in 1868, pointed out the fact that wool-fat contained a con- siderable amount of cholesterin, and in 1872 described a method by which it could be extracted from wool-fat. Lewin, in 1876, believed that he had demonstrated the presence of cholesterin in the stratum granulosum of Lanolinum: Lanolin. 15 the epidermis, as well as in the sweat-ducts, but this assertion has lately been denied by Buzzi and Santi.* These earlier statements appear to have escaped the attention of phjsiological chemists, with the exception of Berthelot, who alludes to the probable existence in the animal body of cholesterin ethers and the fatty acids. While not belonging, in chemical composition, to the fats, cholesterin shares many of their physical properties. Crude lanolin consists of cholesterin and isocholes- terin combined with fatty acids, as stearic, and traces of others. Its odor is due to the presence of volatile fatty acids, capric and caproic. It has also been found to con- tain ceryl cerotate and its homologues, and, probably, cholesteryl cerotate. A certain proportion of glycerides of the lower fatty acids is also present. The pure product should not contain these fatty acids in the free condition. Lanolin is obtained from wool-fat b}T a species of churning. We are not fully acquainted with the details of the improved process by which it is now produced on a large scale in the chemical manufactory. The choles- terin fats or combinations of cholesterin with fatty acids do not form soaps with aqueous alkaline solutions. The free fatty acids, on the other hand, are readily saponi- fiable. The cholesterin fats, however, form emulsions with alkaline solutions, and also with the soaps formed from fatty acids. Such an emulsion, subjected to centrif- ugal action, separates ink) a thin milk and a cream. The cholesterin fats collect like a cream upon the top of the watery soap solution. They are freed from impurities (fatty acids or alkalies) by heating on a water-bath until melted. The resulting product is anhydrous lanolin. The substance used as a medicament contains from 25 to 30 per cent, of water, which is not, however, chemically • Monatshefte fur praktische DevniatQlogie, August 15, 1889. 16 Ointments. combined, and is readily expelled by heat. Hydrated lanolin, when heated upon the water-bath, separates into two layers, the lower of which is aqueous and the upper oleaginous. Anhydrous lanolin is completely soluble in ether, benzol, and chloroform, sparingly soluble in stronger alcohol, and insoluble in water. Purified lanolin, as now made, is of an unctuous, tenacious consistence and whitish color. It is almost entirely devoid of smell. The earlier samples were yel- lowish in color, and possessed a slight odor, by no means unpleasant, similar to that of wool or of new cloth. It is of neutral reaction. Anhydrous lanolin is capable of absorbing its own weight of water without losing its consistence. The specific gravity of purified lanolin is 0.973; its melting-point, 38° to 40° C. (100.4° to 104° P.). Lanolin possesses several conspicuous advantages as an ointment-base. Differing from the true fats, it mani- fests no disposition to become rancid. From this it follows that it is incapable of effecting any chemical change in the substances which may be incorporated with it, nor does it produce any irritant action upon the skin to which it is applied. Hence, an ointment made with lanolin may, as far as its base is concerned, be left in uninterrupted contact with the affected part. Dr. A. Gottstein, of the Pharmacological Institute of Berlin, has demonstrated that lanolin is indestructible or imper- meable by micro-organisms. Its employment may, con- sequently, be regarded as an aseptic measure. For this reason it has proved, unmedicated, a serviceable dressing in burns, scalds, erysipelas, frost-bites, erythema, and dermatitis. Lanolin is characterized by a peculiar penetrative Lanolinum: Lanolin. 17 power, which fes very reasonably ascribed to the fact that, as a derivative of horny tissue, it is readily absorbable by the epidermis or the gland-follicles. It rapidly dis- appears when applied to the skin with slight friction. Of the fact I have long since assured myself. To the same effect is the testimony of a Russian observer, who found that narcotic extracts embodied in lanolin were easily absorbed, and were efficient in twice the quantity Which would be a proper dose by the mouth. Quinine hydrochlorate in lanolin is said to be soon absorbed, and iodide of potassium appears in the urine in from two to six minutes after inunction. It is more rapidly absorbed by the skin of children than by that of adults, and generally is more easily taken up after the skin has been washed with ether. Contrary results have been, indeed, reported. Dr. Guttmann compared the effect of iodide of potassium and salicylic acid, rubbed up respectively with lard and with lanolin, and states that the most frequent evidence of absorption was found in the urine of those patients upon whom a lard ointment had been used. To the same effect are the experiments of Ritter and Pfeiffer. These contradictory results are, perhaps, explainable by the statement of Professor Liebreich that the early samples of lanolin obtained by him contained cholesterin ethers not readily fusible. He had, therefore, recommended that 10 per cent, of lard be used with the lanolin in pre- paring ointments, because these ethers retard absorption. But in the present product, lanolinum purissimum, this disadvantage has been overcome, and he now advises the lanolin to be used without the lard. As a matter of fact, it is penetration into and not through the skin that is our object in the application of an ointment. It is seldom the case, in these days of the hypodermic syringe, that we should think of influencing A» 18 Ointments. the system by means of an ointment applied to the sur- face of the body. That lanolin permeates the substance of the skin we have abundant evidence. Another notable property of lanolin is its power of absorbing water. This, with its blandness and its asep- tic qualities, renders it an excellent medicament or base in acute eczema. Dr. Gottstein has recently taken advantage of this property to make a very valuable proposal.* It has been found that carbolic acid, dissolved in alcohol or oil, is valueless as an antiseptic. Gottstein, in his researches, employed a definite quantity of anhy- drous lanolin, to which he added, instead of a definite proportion of water, an aqueous solution of corrosive sublimate of 1 to 1000 or 1 to 5000. This ointment he found to be actively disinfectant. It possesses certain advan- tages over irrigation of a wound with a watery solution of corrosive sublimate. But a small quantity of oint- ment is required; the quantity of corrosive sublimate is very small; it may be kept continually applied, and at the same time there is much less danger of poisoning. Irrigation, to be effective, requires the use of a thousand times as much corrosive sublimate. In fact, the two dis- tinctive properties of lanolin are closely related. Unna has demonstrated that the more water a fat is capable of absorbing, the more readily is that fat itself absorbed by the skin. The ratio in which different fats absorb water has been determined by Dieterich as follows :— 100 J >arts i of vaseline absorb . 4 parts of water. 100 u " lard absorb 15 " k i< 100 !< " " (benzoated) absorb , 17 " U (( 100 11 u ( cod-liver oil, 70 ) ti I white wax, 30 $ . 32 " U (( 100 11 ci ( oleic acid, 70 ) it ( white wax, 30 $ . 60 " 1( (I 100 (( " lanolin " . 105 " 11 l( * Wien. Med. Blatter, October 24,1889; Medical Bulletin, March, 1890. Lanolinum: Lanolin. 19 Twenty-one different ointment-bases were examined at a temperature of 15° C. (59° F.). One property pos- sessed by lanolin, particularly valuable from a pharma- ceutical point of view, is its ready miscibilit3T with metallic mercury. A mixture of equal parts of lanolin and mercury may be effected in ten minutes, while after half an hour's trituration no mercury can be perceived by the use of the lens. This fact alone renders wool-fat an important addition to pharmacy as well as medicine, the tedious and difficult manipulations formerly neces- sary in the preparation of mercurial ointment being now superseded. It is for this reason that the last edition of the Austrian Pharmacopoeia prescribes lanolin in the formula for mercurial ointment. Lanolin readily combines with other oils, fats, and glycerin, The only practical drawback—not a very serious one, however—is its stickiness. Mr. II. Helbing* has endeavored, with doubtful success, to overcome this objection by the following mixture, for which he proposes the name unguentum lanolini: 65 parts of anhydrous lanolin, 30 parts of liquid paraffin, and 5 parts of cerasin. Impure specimens of lanolin, containing free fatty acids, are decidedly irritant. It is desirable, therefore, to be acquainted with the tests for its purity, published by Liebreich. These are as follow: 1. A small quantity, on being heated in water over a water-bath, must show the absence of glycerin. 2. If a solution of caustic soda be added, ammonia must not be developed. 3. If a small amount be heated with water on a water-bath, the fat must separate in oily drops without producing an emulsion. 4. With litmus-paper the reaction must not be acid. 5. When well mixed with water upon a ground- *The Pharmaceutical Journal and Transactions, December 21, 1889. 20 Ointments. glass plate with an iron spatula, the product must con- tain over 100 per cent, of water, and the mass be sticky and paste-like, adhering to the spatula; if impure, the mass will have a soap-like smoothness, from which the spatula readily glides. 6. On exposure, the surface of lanolin and lanolin salves become darkened, owing to the escape of water, and not to decomposition. 7. It never becomes rancid, and its odor should remind one of wool.* G. Vulpius f has proposed the following reaction as a mode of identifjdng lanolin : If a few centigrammes of lanolin are dissolved in chloroform, and if this solution is cautiously stratified above an equal volume of undi- luted sulphuric acid in a test-tube, there appears at the contact of both liquids a fiery, brown-red ring. The chloroform above the ring has a violet reflection. Lanolin has been made officinal in the last (seventh) edition of the Austrian Pharmacopoeia, and also enters into the formula of the Austrian mercurial ointment. The result of my own investigations upon lanolin appeared in the Medical and Surgical Reporter for April 3, 1886. It would appear to be naturally indicated, from its presence in epithelial tissue, that lanolin is a peculiarly appropriate remedy in cases of perverted nutrition of that tissue and its modifications. Its penetrative power suggests that the deeper layers of the integument, also, may be beneficially influenced. Thus it is admirably adapted to act as an ointment vehicle. Not only, as it permeates the skin, does it act as a direct nutrient, but we may also readily take advantage of its absorbability in order to convey other medicinal agents more deeply into the integument than they could otherwise obtain •American Druggist, 1886, p. 108. United States Dispensatory, 1888 p. 1839. t Archives de Pharmacie. Lanolinum: Lanolin. 21 entrance. By adding to lanolin an aqueous solution of the substance to be incorporated, we secure a much more intimate union with the fat than is possible when lard, suet, or cosmoline is used as a basis. Its rapid absorption may, however, in some cases be a disadvantage. When cutaneous inflammation is in- tense a bland protective will often prove itself most beneficial, and in such case, provided the protective unguent undergo no chemical alteration, unabsorbability becomes a virtue. Intense hypernutrition threatens de- struction of tissue, and this is not the condition in which a nutrient agent is called for or is likely to prove use- ful. AVhen, however, the inflammation is of a less severe grade, and especially when it is dependent upon abnormalities of the secretory functions of the skin, lanolin assumes a place of first importance as a remedy. The same is likewise true when the health of hair or nails is impaired. Lanolin maintains the lustre or gloss of the hair. Therefore, wrhen this gloss has been lost, as may happen during the progress or in consequence of certain dis- eases, lanolin, in addition to tonic or specific constitu- tional remedies, improves the impaired nutrition. Nota- bly in syphilis, especially of the hereditary variety, the integumental appendages suffer. The hair becomes dry, dull, and harsh, or falls in patches of variable size. The nails are often affected, becoming thickened, cracked, or brittle, or are even cast off by ulceration. The hair also may be the subject of atrophy, become attenuated, bulbous, and splintered. This condition may be the result of syphilis, phthisis, chronic malarial intoxication, or of other severe and debilitating disease. Local con- ditions, likewise, may induce atrophy. In all of these conditions the inunction with lanolin is of benefit. In 22 Ointments. syphilitic cases it should be accompanied, of course, bj' appropriate constitutional medication. In non-specific atrophy of the hair some local stimulant may be incor- porated with the lanolin in order to invigorate the cir- culation and nervous supply of the skin. If the atrophy be due to parasitic disease some parasiticide must be combined. In some individuals the hair is naturally rather dry. This indicates an imperfect elaboration of lanolin, and again points us to the fact that we possess in this article a natural pomade. On account of its stickiness it will generally be advisable to dilute it with some bland fixed oil, such as the oil of almonds or of sesame. Senile atrophy of the skin may be benefited by the persistent and systematic use of lanolin. In this con- dition the integument becomes dry and wrinkled. Here, as suggested by Dr. Jamieson, lanolin serves a double purpose, inasmuch as, from its fatty nature, it is of important service in retaining the animal heat. Premature baldness points us indubitably, in the first place, to lowered nutrition of the hair-bulbs. This may be due to the operation of purely local causes, but, no less certainly, it is often the expression of depressed nerve-force. In the former case a mildly stimulant lano- lin ointment will improve the growth of the hair; in the latter, the local will need to be supplemented by proper systemic treatment. But not only are the cutaneous appendages, of which it is a normal constituent, and therefore a physiological remedy, benefited by the use of lanolin. It favors, also, the glandular functions of the skin. It may therefore be regarded as a tissue-nutrient. The sebaceous secre- tion, indeed, betrays a close chemical relationship to lanolin, and both are concerned in the nutrition of the Lanolinum: Lanolin. 23 hair. Lanolin has approved itself as of undoubted effi- cacy in many cases of derangement of the cutaneous glands. Nor must it be forgotten that, in all probability, the perspiratory glands share with the sebaceous the office of anointing the skin. In fact, the secretions of the skin are of mutual assistance. In anidrosis the integument becomes dry and rough, with a tendency to crack. Frequent inunction with lanolin assists in re- storing the functional activity of the crippled glands, and should be employed in conjunction with such other measures as may be prompted by our knowledge of the cause of the suppression. Jamieson recommends the use of lanolin as a pomade in cases where seborrhoea has lately existed. The same author points out the fact that lanolin is one of the best excipients we possess for ichthyol, since that substance is soluble in water in any proportion, and therefore may very easily enter into intimate combination with wool-fat as a basis. Lassar has demonstrated that chrysarobin is effective in smaller quantity when combined with lanolin, and therefore practically strengthened,—a point of consequence in the treatment of psoriasis. In ichthyosis, after the scales have been softened and removed as far as possible, inunction with lanolin tends to promote the nutrition of the affected surface. In scleroderma, also, it is of some service. It removes the dryness of the surface and may aid in absorption of the infiltration. Lanolin is an excellent vehicle for those agents which have the power of destroying the vegetable parasites of the skin. In tinea versicolor, tinea favus, and the varie- ties of tinea trichophytina, lanolin will prove more effective in introducing the remedy into the gland-ducts than any other agent. It is admirably adapted to serve 24 Ointments. as an ointment-basis for the oleate of mercury or copper in the treatment of the affections specified. Both by reason of its easy and rapid mixture with mercury and its penetrative power, it is peculiarly ser- viceable in the inunction treatment of syphilis. According to Frankel, it diminishes secretion and prevents the formation of crusts when applied to mucous membranes. This would suggest its employment in nasal catarrh and affections of tke genito-urinary tract. In these cases it is often of great benefit combined with the hydrochlorate of cocaine. Lanolin is useful, like- wise, in eczema, especially the chronic form. Lassar highly recommends it in the treatment of impetigo con- tagiosa. When suitably diluted and perfumed it is an admirable toilet pomade. It rapidly heals cliapped hands and lips, and may be spread upon the face before retiring at night in order to soften the skin after ex- posure to cold and wind. Lanolin is likewise of excellent service as a base for naphthol, salicylic acid, pyrogallic acid, and resorcin, and seems to heighten the therapeutic action of those drugs. CETACEUM: SPERMACETI. Spermaceti, cetaceum, is officially defined as " a peculiar concrete, fatty substance obtained from phy- seter macroceplialus." It is described, according to the same authority, as " white, somewhat translucent, slightly unctuous masses of a scaly-crystalline fracture ; a pearly lustre, becoming yellowish and rancid on exposure to air; odorless, having a mild, bland taste and a neutral reaction. Specific gravity about 0.945. It melts near 50° C. (122° F.),and congeals near 45° C. (113° P.). It is soluble in ether, chloroform, disulphide of carbon, and in boiling alcohol; but slightly soluble in cold b»nzin." Oleum Theobromse : Cacao-Butter. 25 Spermaceti is derived from the sperm-whale. The enormous head of this creature contains, at its upper part, between the skull and the integument, a large cavity, divided and subdivided by cartilaginous septa. These spaces are filled with an oil in which the sperma- ceti is dissolved. After deatk the substance concretes and the oil is removed ly draining. Some still remains, however, and is separated by expression, washing with hot water, melting, straining, and repeated washing with a weak potash solution. Spermaceti consists, according to Heintz, of four alcohols, which act as bases, united with lauric, myristic, palmitic, and stearic acids. OLEUM THEOBROM/E: CACAO-BUTTER. Oil of theobroma, oleum theobromse, or cacao-butter, is " a fixed oil expressed from the seed of Theobroma Cacao. A yellowish-white solid, having a faint, agree- able odor, a bland, chocolate-like taste, and a neutral reaction. It melts between 30° and 35° C. (86° to 95° F.)." It is composed of stearin, palmitin, and olein, with the glycerides probably of arachic and lauric acids. GLYCERITUM AMYLI: GLYCERITE OF STARCH. The glycerite of starch, glyceritum amyli, is prepared by adding 10 parts of starch to 90 parts of glycerin. " Rub them together in a mortar until they are inti- mately mixed. Then transfer the mixture to a porcelain capsule, and apply a heat gradually raised to 140° C. (291° F.), stirring constantly, until the starch granules are completely dissolved and a translucent jelly is formed." This is a good demulcent application in many cases. It is well adapted to serve as a vekicle when no chemical incompatibility exists with the drug to be incorporated, as, for instance, iodine. On the other hand, the hygro- 2 B 26 Ointments. scopic properties of glycerin often render it an unsuit- able local remedy. COMPARATIVE PERMEABILITY OF OILS INTO THE SKIN. In most, if not all, diseases of the skin, strictly so called, the effect of an ointment is exerted by actual penetration into the substance of the integument, and not merely by contact with the superficial layer of the epithelial cells. Indeed, it is difficult to conceive, in the latter contingency, how any benefit could be produced. The absorbability of the ointment-base becomes, for this reason, a very important question. The greater number of official ointments are made with lard, and this fat is found to be very readily absorbed. This is demonstrated by the constitutional action of powerful remedies rubbed up with lard and applied to the skin. It is explained by the chemical constitution of lard, in which so large a proportion of oleic acid is present. The drawback to the use of lard is its alterability, but this may be readily overcome; and, moreover, a large quantity of ointment should never be prescribed on account of its liability to become rancid. Suet is not nearly so well absorbed as lard, but its comparative firmness recommends it when a rather stiff unguent is desirable. Of the unalterable bases, lanolin is the best. It is well absorbed and not at all irritant. Glycerin, though unalterable, is irritant to broken surfaces. Petrolatum is unchangeable, and is suitable for the preparation of ointments that do not contain much water, and when absorption of its added ingredients is not desired. Absorption of an unguent is favored by prior im- mersion of the part in warm water and by friction. INCORPORATION OF MEDICINAL SUBSTANCES INTO FATS. Ointments are made of substances derived from vari- ous sources. Vegetable powders or extracts, alkaloids, Incorporation of Medicinal Substances into Fats. 27 metallic and alkaline salts, enter into the composition of the official preparations. It is requisite that the con- tained ingredient or ingredients should be mingled with the ointment-basis with the most uniform nicety. In order to accomplish this end a vegetable powder should be reduced to the finest form of which it is susceptible. An extract, if dry, should be softened by being rubbed up with a little water or alcohol, according to its nature. Alkaloids and mineral salts should be thoroughly and uniformly incorporated with their bases. Whether official or of extemporaneous prescription, ointments may be classified,according to the properties of their components, into sedative, astringent, and irritant. CHAPTER II. OFFICIAL OINTMENTS AND THEIR THERAPEUTIC USES. There are twenty-six official ointments according to the last revision of the United States Pharmacopoeia. A number of other preparations, formerly official, are still habituall}7 ordered under the old, familiar titles, while the number of extemporaneous combinations is indefinite. Simple Ointment. 1. Unguentum, ointment, or simple ointment. Lard, 80 parts (or 4 ounces ar.) ; yellow wax, 20 parts (or 1 ounce av.). To make 100parts (or 5 ounces av.). Melt the wax and add the lard gradually ; then stir the mix- ture constantly until cool. This non-medicated fatty substance is generally used merely as a basis, with which are commingled various medical ingredients. It possesses emollient properties, however, and may be used as a dressing to blistered or excoriated surfaces, and as an application in acute eczema, especially as it occurs in infants. It is well adapted to be employed as an unguent in scarlatina or in other exanthem or specific fever, in order to influence local and general temperature. It is serviceable, also, in lessening friction between opposed surfaces. It is like- wise beneficial when the skin is dry, harsh, or fissured on account of suppression of its secretions. This is the case, for instance, in anidrosis. It affords relief to the itching and burning sensations of erythema simplex. In pompholyx it diminishes heat and itching, and protects the surface exposed by rupture of the vesicles. (29) 30 Official Ointments and their Therapeutic Uses. Formulary. Take of Powdered arrow-root, .... 1 drachm. Subnitrate of bismuth, . . . . % Simple ointment,.....1 ounce. Mix. Use in erythema, acute eczema, herpes, etc. Take of Powdered starch,.....1 drachm. Oil of chamomile,.....5 drops. Simple ointment,.....1 ounce. Mix. Employ in scarlatina, anidrosis, dermatitis, etc. Carbolic Acid Ointment. 2. Unguentum acidi carbolici, ointment of carbolic acid. Carbolic acid, 10 parts (or 48 grains); ointment, 90 parts (or 1 ounce av.). To make 100 parts (or about 1 ounce). Mix them thoroughly. On account of the germicide properties of the car- bolic acid, an ointment containing it is serviceable in parasitic diseases of the skin, scabies, phtheiriasis, tinea favosa, tinea versicolor, and in all the varieties of tinea tricophytina. It stimulates the growth of healthy granu- lations upon indolent ulcers, and removes the odor of unhealthy, sloughing, or gangrenous wounds or surfaces, as well as that of open cancer. It alleviates itching in the various forms of pruritus, and in that due to urticaria or eczema. It serves a good purpose, also, either weak- ened or strengthened, according to the indications, in different forms of eczema, wThether acute or chronic; in eczema of the head, to which children are subject, or in eczema of the face. In psoriasis, after the scales have been detached, the ointment of carbolic acid improves the condition of the diseased integument. It relieves the burning pain of the erythematous or bullous degree of burns, while in escharotic burns it disinfects the ulcerated surface, represses exuberant and promotes healthy granu- lations. The itching and burning of erythema multi- forme and of erysipelas are lessened by this preparation. Gallic Acid Ointment. 31 It also mitigates the intense itching which accompanies pemphigus. It promotes the cure of sycosis, and often proves of service in the local treatment of lupus ery- thematosus. Formulary. Take of Extract of witch-hazel, .... 1 drachm. Sublimed sulphur,.....1 " Carbolic acid ointment, .... 1 ounce. Mix. Valuable in ulcers, cancer, chronic eczema psoriasis, syco- sis, etc. Take of Extract of belladonna, . % drachm. Balsam of Peru,.....% " Carbolic acid ointment, .... 1 ounce. Mix. Useful in parasitic diseases, itching of the skin, lupus, ulcers, etc. Take of Hydrochlorate of cocaine, ... 3 grains. Sulphate of atropine, .... 1 grain. Sulphate of morphine, .... 2 grains. Carbolic acid ointment, .... 1 ounce. Mix. Useful in acute eczema and all irritable conditions of the skin. Gallic Acid Ointment. 3. Unguentum acidi gallici, ointment of gallic acid. Gallic acid, 10 parts (or 48 grains) ; benzoinated lard, 90 parts (or 1 ounce av.). To make 100 parts (or about 1 ounce). Rub the gallic acid with the benzoinated lard, gradualW added, until they are thoroughly mixed, avoid- ing the use of an iron spatula. The astringent properties of gallic acid render its ointment useful as an application to haemorrhoids, espe- cially of the internal variety. It stimulates the healing of indolent ulcers, and is a useful application after the scales have been removed in eczema capitis. Formulary. Take of Camphor,.......5 grains. Calomel,.......•*> Gallic acid ointment, . . . • lA ounce. Mix. For eczema of the scalp, ulcers, excessive sweating, and bycosis. 32 Official Ointments and their Therapeutic Uses. Take of Sublimed sulphur,.....M drachm. Gallic acid ointment, 1 ounce. Mix. Use in eczema, ulcers, and chronic acne. Tannic Acid Ointment. 4. Unguentum acidi tannici, ointment of tannic acid. Tannic acid, 10parts (or 48 grains); benzoinated lard, 90 parts (or 1 ounce av.). To make 100 parts (or about 1 ounce). Rub the tannic acid with the benzoinated lard, gradually added, until they are thoroughly mixed, avoiding the use of an iron spatula. The indications for this preparation are substantially the same as for the preceding. It is, however, more decidedly astringent than the ointment of gallic acid, and may, therefore, be used not only in haemorrhoids, but also in prolapse of the rectum. It may be employed to advantage in fissured nipples and in eczema capitis. It is one of the remedies found efficacious in herpes. It is serviceable in alopecia circumscripta, in the treatment of phagedenic ulcers and chilblains. Formulary. Take of Extract of Indian hemp, ... 1 drachm. Salicylic acid,......1 scruple. Tannic acid ointment, .... 1 ounce. Mix. Beneficial in fissured eczema, frost-bite, and ulcers. Take of Salol,.......K drachm. Acetate of lead,.....5 grains. Tannic acid ointment, .... 1 ounce. Mix. Employ in 6eborrhcea, acne, eczema, and sycosis. Rose-water Ointment. 5. Unguentum aquae rosse, ointment of rose-water, cold cream. Expressed oil of almond, 50 parts (or 5 ounces av.); spermaceti, 10 parts (or 1 ounce av.) ; white wax, 10 parts (or 1 ounce av.) ; rose-water, 30 parts (or 3 fluidounces). To make 100 parts (or 10 ounces av.). Melt together, at a moderate heat, the oil, spermaceti, Belladonna Ointment. 33 and wax ; then gradually add the rose-water, stirring the mixture briskly and constantly until it is cool, and con- tinue the stirring until it has become uniformly soft and creamy. This is an elegant preparation, generally used merely as a vehicle into which more active medicinal substances are rubbed. It is, however, a bland and pleasant unguent, deriving an agreeable scent from the rose-water which it contains. It may be substituted for the simple ointment whenever desired in the cases to which the latter is applicable. It protects the integument and moderates the heat of the parts in dermatitis, acute eczema, ery- thema multiforme, and superficial burns. It is also emollient to irritated or abraded surfaces, and heals chapped lips or hands. Formulary. Take of Boric acid,......XA drachm. Powdered arrow-root, .... 1 Rose-water ointment, .... 1 ounce. Mix. For erythema, eczema, dermatitis, chapped lips or hands, etc. Take of Iodol,.......K drachm. Ro6e-water ointment, ■ • ■ ■ M ounce. Mix. Use in syphilis, chronic eczema, psoriasis, burns, frost- bite, etc. Take of Beta-naphthol,.....1 scruple. Camphor,......10 grains. Rose-water ointment, .... 1 ounce. Mix. For animal parasitic affections, itch, chronic eczema, pso- riasis, acne, etc. Belladonna Ointment. 6. Unguentum belladonna, belladonna ointment. Al- coholic extract of belladonna, 10 parts (or 48 grains); diluted alcohol, 6 parts (or £ fluidrachm) ; benzoinated lard, 84 parts (or 400 grains). To make 100 parts (or about 1 ounce). Rub the extract with the diluted alcohol 2* 34 Official Ointments and their Therapeutic Uses. until uniformly soft, then gradually add the lard and mix thoroughly Belladonna ointment relieves local pain and spasm. It also, when applied to the breasts, suppresses the secre- tion of milk. Rubbed upon the os uteri, it softens the rigidity which sometimes takes place during labor. It relaxes spasm of the neck of the bladder or of the sphincter ani. Its anodyne properties render it a useful topical remedy in neuralgia and herpes zoster, as well as in irritable or malignant ulcers and in painful haemor- rhoids. It arrests the suppurative process in boils, and promotes the resolution of enlarged glands. Belladonna ointment also affords great relief in superficial joint af- fections. It is likewise of use in excessive sweating. The pupil and the throat should be carefully watched during the employment of this ointment upon raw surfaces. Formulary. Take of Calomel,.......10 grains. Belladonna ointment, .... 1 ounce. Mix. For syphilis, boils, enlarged glands, herpes, herpes zoster, etc. Take of Hydrochlorate of cocaine, ... 5 grains. Belladonna ointment, .... 1 ounce. Mix. Use in cancer, inflamed skin around nipples, excessive Bweating, etc. Chrysarobin Ointment. 7. Unguentum chrysarobini, chrysarobin ointment. Chrysarobin, 10 parts (or 48 grains) ; benzoinated lard, 90 parts (or 1 ounce av.). To make 100 parts (or about 1 ounce). Rub the chn'sarqbin with the ben- zoinated lard, gradually added, until they are thoroughly mixed. This ointment is of especial advantage in the treat- ment of psoriasis. It should be thoroughly rubbed into the affected part after the scales have been, as far as possible, removed. Care should be taken to avoid bring- Lead or Diachylon Ointment 35 ing it into contact with healthy skin, as it is highly irritant, and may give rise to an intense dermatitis. Chrysarobin ointment has also another drawback. It leaves an indelible stain upon the linen, which must, therefore, be protected. It communicates a purple color to the hair. Patients should always be cautioned against carrying any of the ointment to the eyes. It likewise does good in chronic eczema and in the second stage of rosacea. It has been used with advantage in some cases of lupus vulgaris. Chrysarobin ointment is a good application in tinea versicolor and tinea circinata. Formulary. Take of Oil of cade,......y2 drachm. Chrysarobin ointment, .... 1 ounce. Mix. For chronic eczema, psoriasis, and vegetable parasitic 6kin diseases. Take of Calomel,.......5 grains. Chrysarobin ointment, . y2 ounce. Mix. Employ in syphilis, alopecia, lupus, chronic acne, and rosacea. Lead or Diachylon Ointment. 8, Unguentum diachylon, diachylon ointment. Lead plaster, 60 parts (or 264 grains) ; olive-oil, 39 parts (or 170 grains) ; oil of lavender, 1 part (or 5 minims). To make 100 par-ts (or about 1 ounce). Melt together the lead-plaster and olive-oil, at a moderate heat; then, having permitted the mass to become partly cool, incorporate with it the oil of lavender, and stir constantly until cold. This is a valuable application in acute and subacute eczema wherever seated, with the exception of the por- tions of the body covered with hair. In these situations, since it mats the hair, its use is inadvisable. It may, however, be employed in the eczema capitis of infants. Its mild astringency and sedative action commends it as a remedy in seborrhoea and in dermatitis. Diachylon ointment alleviates the torments of urticaria and pru- 36 Official Ointments and their Therapeutic Uses. ritus pudendi, and the pain of herpes zoster. It is a good application in sycosis, impetigo contagiosa, and is very efficacious in the treatment of sweating feet. Formulary. Take of Camphor,.......10 grains. Lead or diachylon ointment, . . • }4 ounce. Lanolin,.......]4 ounce. Mix. Beneficial in chronic eczema, especially of the hands and feet, fissured eczema, eczema of the head, sycosis, seborrhoea, and dermatitis. Take of Beta-naphthol,......10 grains. Oil of eucalyptus,.....5 drops. Lead or diachylon ointment, ... 1 ounce. Mix. For animal parasitic affections, eczema of the genital organs, excessive and odorous sweating. Take of Iodol,.......15 grains. Hydrochlorate of cocaine, ... 5 grains. Lead or diachylon ointment, ... 1 ounce. Mix. For sycosis, herpes, urticaria, impetigo, and itching of the skin. Nut-gall Ointment. 9. Unguentum gallee, nut-gall ointment. Nut-gall, in No. 80 powder, 10 parts (or 48 grains) ; benzoinated lard, 90parts (or 1 ounce av.). To make 100 parts (or about 1 ounce). Rub the nut-gall with the benzoinated lard, gradually added, until they are thoroughly mixed. The indications for this preparation are the same as those for the ointments of gallic and tannic acid. Formulary. Take of Calomel,.......10 grains. Nut-gall ointment,.....1 ounce. Mix. Use in purpura, fissured eczema, and excessive sweating. Take of Iodide of lead,.....1 scruple. Nut-gall ointment,.....y2 ounce. Mix. For enlarged glands, chronic ulcers, and scars. Mercurial or Blue Ointment. 10. Unguentum hydrargyri, mercurial ointment, blue ointment. Mercury, 450 parts (or 1 ounce av.) ; lard, 225 parts (or ^ ounce av.); suet, 225 parts (or ^ ounce Mercurial or Blue Ointment. 37 av.) ; compound tincture of benzoin, 40 parts (or 40 minims) ; mercurial ointment, 100 parts (or 100 grains). To make 1000 parts (or about 2 ounces av.). Mix the mercury with the tincture of benzoin in a mortar, add the mercurial ointment (which should con- tain 50 per cent, of mercury), and triturate the mixture until globules of mercury cease to be visible; then add the lard and suet previously melted together and par- tially cooled, and continue the trituration until globules of mercury cease to be visible under a magnifying power of ten diameters. Blue ointment, no doubt, is principally valuable in the treatment of sj^pliilis. It may be used upon the initial lesion, upon buboes, and enlarged glands in other regions, and to syphilitic ulcers. Mercurial ointment may be rubbed into the thin skin of the axilla, the groin, bosom, or abdomen, in order to secure constitutional effects in the various stages and manifestations of the disease. Spread upon the face in small-pox it retards maturation of the pustules, and therefore prevents pit- ting. It is a good topical application in erysipelas, chilblains, and allays inflammation in paronychia and in synovitis, and promotes absorption in the latter affec- tion. Benefit is derived from its employment in derma- titis, intertrigo, and in the second stage of rosacea. Combined with green soap it is of service in scleroderma. Blue ointment sometimes affords great relief in lupus erythematosus. ' In the early stage of lepra it causes absorption of some of the tubercles, and has been useful in some cases of yaws. It is also destructive to pediculi. Formulary. Take of Green soap, or sapo viridis, ... 1 ounce. Mercurial or blue ointment, ... 1 ounce. Mix. For the inunction treatment of syphilis. 38 Official Ointments and their Therapeutic Uses. Take of Oil of cade,......% drachm. Mercurial or blue ointment, . . • ]4 ounce. Mix. For indurated spots of syphilis, old syphilitic ulcers, and enlarged glands. Ammoniated Mercury Ointment. 11. Unguentum hydrargyri ammoniati, ointment of ammoniated mercury. Ammoniated mercury, in very fine powder, 10 parts (or 48 grains); benzoinated lard, 90 parts (or 1 ounce av.). To make 100 parts (or about 1 ounce). Rub the ammoniated mercury with the ben- zoinated lard, gradually added, until they are thoroughly mixed. The uses of the white precipitate ointment are the same in general as those of the preceding preparation. As it is of a stimulant nature it proves very effective in chronic eczema. It is used with benefit in sycosis, seborrhoea, comedo, rosacea, atrophy of the hair, and impetigo contagiosa, lupus erythematosus, molluscum epitheliale, and in the early stage of lepra to promote absorption of the tubercles. White precipitate oint- ment is of service, also, in scleroderma. It destroys pediculi. Formulary. Take of Carbonate of zinc,.....1 drachm. Oil of chamomile,.....5 drops. Powdered arrow-root, .... 1 drachm. Ammoniated mercury ointment, . . 1 ounce. Mix. Use in chronic eczema, particularly of the head, lousiness, sycosis, lupus, and seborrhoea. Take of Beta-naphthol,......1 scruple. Ammoniated mercury ointment, . . 1 ounce. Mix. For animal parasitic diseases, especially itch and lousi- ness, indurated acne, leprosy, and scleroderma. Nitrate of Mercury or Citrine Ointment. 12. Unguentum hydrargyri nitratis, ointment of nitrate of mercury, citrine ointment. Mercury, 7 parts (or 444 grains); nitric acid, 17 parts (or 1 fluidounce Nitrate of Mercury or Citrine Ointment. 39 and 5 fluidrachms); lard-oil, 76 parts (or 11 ounces av.). Heat the lard-oil in a glass or porcelain vessel to a tem- perature of 70° C. (158° F.) ; then add, without stirring, 7 parts (or 5 fluidrachms) of nitric acid, continue the heat so long as a moderate effervescence continues, and allow the mixture to cool. Dissolve the mercury in the re- mainder of the nitric acid, with the aid of sufficient heat to prevent the solution from crystallizing ; add this solution to the mixture before it has become entirely cold, and mix them thoroughly, avoiding the use of an iron spatula. This ointment has a very wide range of application. It is a valuable local remedy in ulcers and eruptive dis- eases generally. It prevents the development of pocks and consequent pitting in variola. Citrine ointment is a germicide, and therefore curative in the various forms of tinea and in phtheiriasis. It is one of the best external applications in syphilitic lesions, as chancres, ulcerated buboes, oz8ena,and the later cutaneous manifestations of the disease. In most cases it is the preferable form of mercurial ointment to use. It is beneficial in chronic eczema, pityriasis, psoriasis, chloasma, scrofuloderma, lupus erythematosus, lepra, and in atrophy of the hair, seborrhoea, rosacea, and sycosis. The effect of this, and, in fact, of all the mercurial ointments should be care- fully observed, as they are capable of producing salivation. Formulary. Take of Oil of cade, ...... V2 drachm. Camphor,......5 grains. Nitrate of mercury or citrine ointment, 1 ounce. Mix. For chronic eczema, psoriasis, syphilis, and lupus. Take of Salol,.......K drachm. Nitrate of mercury or citrine ointment, 1 ounce. Mix. Valuable in chancres, ulcerated buboes, and chronic eczema. Take of Beta-naphthol, ..... 1 scruple. Nitrate of mercury or citrine ointment, 1 ounce. Mix. Use in frost-bite, bites of insects, sycosis, and scrofula. 40 Official Ointments and their Therapeutic Uses. Yellow Oxide of Mercury Ointment. 13. Unguentum hydrargyri oxidi flavi, ointment of yellow oxide of mercury. Yellow oxide of mercury, in very fine powder, 10 parts (or 48 grains) ; ointment, 90 parts (or 1 ounce av.). To make 100 parts (or about 1 ounce). Rub the oxide of mercury with the ointment, gradually added, until they are thoroughly mixed. This is a useful remedy in cases of rosacea, sclero- derma, scrofuloderma, and, to a certain extent, in lepra. It forms, also, an admirable application to the eyelids in chronic conjunctivitis, being preferable, for this pur- pose, to the ointment of the red oxide, which it has largely superseded. Formulary. Take of Lanolin,.......2 drachms. Yellow oxide of mercury ointment, . 2 " Mix. Useful in syphilis, scrofuloderma, leprosy, and chronic eczema. Take of Thymol,.......3 grains. Yellow oxide of mercury ointment, . % ounce. Mix. For chronic acne, enlarged glands, and syphilis. Red Oxide of Mercury Ointment. 14. Unguentum hydrargyri oxidi rubri, ointment of red oxide of mercury. Red oxide of mercury, in very fine powder, 10 parts (or 48 grains) ; ointment, 90 parts (or 1 ounce av.). To make 100 parts (or about 1 ounce). Rub the oxide of mercury with a small quantity of the ointment until a perfectly smooth mixture is obtained ; then gradually add the remainder of the ointment and mix thoroughly. The red oxide, being of a crystalline.character, is more irritant and stimulating than the yellow oxide, which fact renders it less adapted to use upon the eye- lids. In other cases, however, its irritant properties are desirable, as upon indolent ulcers, whether syphilitic or not; upon chancres indisposed to heal; in goitre, enlarged Iodine Ointment. 41 spleen, chronic eczema, seborrhoea, rosacea, scleroderma, lupus erythematosus, and lepra. Formulary. Takeoflodol,.......10 grains. Red oxide of mercury ointment, . . y2 ounce. Mix. Employ in chronic syphilitic spots, indolent ulcers, and scleroderma. Take of Creasote, . .^.....5 drops. Red oxide of mercury ointment, . . y% ounce. Mix. For chronic ulcers, enlarged glands, and leprosy. Iodine Ointment. 15. Unguentum iodi, iodine ointment. Iodine, 4 parts (or 18 grains); iodide of potassium, 1 part (or 16 grains) ; water, 2 parts (or 8 minims); benzoinated lard, 93 parts (or 420 grains). To make 100 parts (or about 1 ounce). Rub the iodine and iodide of potassium first with the water and then with the benzoinated lard, gradually added, until they are thoroughly mixed, avoid- ing the use of an iron spatula. Iodine ointment is counter-irritant and stimulant, thus promoting absorption of old inflammatory exuda- tions. It often, in conjunction with other measures, effects a very rapid reduction of a goitre, reducing the volume of the tumefied glands characteristic of scrofula. Applied directly to the tonsils by means of a camel-hair brush, it is said b}r Dr. Cerchiari to diminish the size of the enlarged glands after the active inflam- mation has subsided. Iodine ointment is useful, like- wise, in chilblains. It relieves the aching pain of myalgia. On account of the germicide properties of iodine its ointment is appropriately used in various parasitic skin diseases, such as tinea tonsurans and tinea circinata. It may be beneficially applied to the skin in cases of erysipelas. In addition to baths and massage it is of service in the treatment of scleroderma. 42 Official Ointments and their Therapeutic Uses. Formulary. Take of Camphor,......5 grains. Iodine ointment,.....% ounce. Mix. For scrofula, frost-bite, and scleroderma. Take of Delphinia,......% drachm. Iodine ointment,.....1 ounce. Mix. Use in ringworm and to destroy pediculi. Iodoform Ointment. 16. Unguentum iodoformi, iodoform ointment. Iodo- form, in very fine powder, 10 parts (or 48 grains); ben- zoinated lard, 90 parts (or 1 ounce av.). To make 100 parts (or about 1 ounce). Rub the iodoform with the benzoinated lard, gradually added, until they are thor- oughly mixed. Iodoform is antiseptic and anaesthetic. An ointment which contains it must consequently prove of service in the treatment of inflamed and ulcerated surfaces. Chronic leg-ulcers, whether or not of syphilitic origin, are stimulated to repair. It is likewise a valuable appli- cation to bed-sores, ulcers the result of injury, scrofu- lous ulceration and upon the enlarged glands of scrofula. Iodoform ointment restrains inflammatory action in buboes, and may prevent suppuration. It diminishes the swelling and pain of orchitis, the pain of cancerous ulcers, and is a serviceable application as well in cases of rodent ulcer. It is an effectual remedy in chancroid, and is at times attended with very good results in chronic eczema. It has been found of advantage as a local measure in lupus vulgaris. Formulary. Take of Extract of witch-hazel, . y drachm. Iodoform ointment, . y ounce. Mix. Chancroids, cancerous and syphilitic ulcers, and bed-sores. Take of Oxide of zinc,.....1 drachm. Carbonate of lead,.....1 " Iodoform ointment, .... 1 ounce. Mix. Syphilitic ulcers, chronic eczema, scrofula, aud lupus. Mczereum Ointment. 43 Mezereum Ointment. 17. Unguentum mezerei, mezereum ointment. Fluid extract of mezereum, 25 parts (or 2 fluidrachms); lard, 80 parts (or 360 grains) ; yellow wax, 12 parts (or 54 grains). To make about 1 ounce av. Melt together the lard and wax with a moderate heat, add the fluid extract, and stir the mixture constantly until the alcohol has evaporated ; then continue to stir until cool. Mezereum is a local irritant and vesicant. Hence, an ointment which contains it will prove effectual in exciting indolent ulcers to reparative action. It is also adapted to maintain a raw surface after a fly-blister has been used, in cases where it is desirable to keep up for some time a powerful counter-irritation. Formulary. Take of Hydrochlorate of cocaine, ... 5 grains. Mezereum ointment, . y ounce. Mix. For indolentsyphilitic spots and exuberant,granulations. Take of Iodoform,......y drachm. Mezereum ointment, .... 1 ounce. Mix. Use iu enlarged glands and indolent ulcers. Tar Ointment. 18. Unguentum picis liquidae, tar ointment. Tar, 50 parts; suet, 50 parts. To make 100 parts. Mix the tar with the suet, previously melted with a moderate heat, and, having strained the mixture through muslin, stir it constantly until cool. The resinous, acid, and empyrenmatio substances contained in tar communicate to it decided stimulant and antiseptic properties. It is, therefore, an admirable remedy in subacute or chronic inflammatory processes. Tar ointment is also serviceable in those affections of the skin which demonstrably depend upon parasitic growths. After the scales of psoriasis have been removed, tar ointment is a useful application to the diseased surface. 44 Official Ointments and their Therapeutic Uses. It is, however, frequently objectionable to patients on account of its penetrating odor and the dark stain which it leaves upon the skin. Again, it will not infre- quently give rise to an excessive local stimulation, pro- ductive of dermatitis. Its occasional absorption into the circulation develops systemic poisoning, as evi- denced by fever, nausea, dark-colored urine and faeces. Its use, therefore, necessitates careful observation on the part of the physician. These drawbacks may be avoided by the substitution of some of the tar deriva- tives, mention of which shall hereafter be made. Tar ointment is one of the most efficient topical ap- plications in the treatment of chronic eczema, in what- ever region situated. The same preparation answers a good purpose in cases of comedo. It is capable of re- lieving prurigo, or even, in some instances, combined with appropriate internal treatment, of lessening this obstinate affection. Tar, either undiluted or in the form of an ointment, is of value in pemphigus when the bullae have burst and an excoriated surface is exposed. The ointment of tar will sometimes exhibit a remedial action in lupus erythematosus and also in lupus vulgaris. It is a good local application in sycosis. Formulary. Take of Beta-naphthol,......10 grains. Camphor,.......10 " Tar ointment, ...... 1 ounce. Mix. For chronic eczema, psoriasis, and lupus, Take of Cod-liver oil,......2 ounces. Tar ointment,......2 " Mix. Serviceable in sycosis, circumscribed spots of baldness, chronic eczema, seborrhoea, and ichthyosis. Carbonate of Lead Ointment. 19. Unguentum plumbi carbonatis, ointment of car- bonate of lead. Carbonate of lead, in very fine powder 10 parts (or 48 grains) ; benzoinated lard, 90 parts (or 1 Carbonate of Lead Ointment. 45 ounce av.). To make 100parts (or about 1 ounce). Rub the carbonate of lead with the benzoinated lard, gradually added, until they are thoroughly mixed. The sedative and astringent properties of carbonate of lead render it a valuable external remedy in lesions of the integument. From its complete insolubility it is, in fact, only made use of as a topical application. It may be advantageously employed in all non-parasitic cases of cutaneous disease accompanied by acute inflam- mation. Dermatitis is effectual^ relieved by the ointment of the carbonate of lead. It is valuable in the treatment of burns and scalds, rapidly relieving the extreme pain so characteristic of this form of injmy. Carbonate of lead ointment is likewise equally beneficial as a dressing to blistered surfaces. It is true that if the cuticle has been extensively destroyed, leaving a raw, absorbent surface, there is some danger of systemic poisoning. From the experience of those who have used the white-lead ointment largely in the treatment of burns, it would appear, how- ever, that the fear of constitutional involvement has been unduly exaggerated. It is an excellent local application in pemphigus after the bullae have been punctured or have spontaneously ruptured, and especially after excoriations have formed. This ointment may be employed with propriety in erythema simplex or erythema intertrigo, and in herpes. The same preparation proves of excel- lent service in the management of acute eczema. It is one of the best topical remedies in erysipelas, and is often efficacious in promoting the cure of acute ulcers. Formulary. Take of Powdered arrow-root, .... 1 drachm. Oil of chamomile,.....6 drops. Sulphate of morphine, .... 3 grains. Carbonate of lead ointment, . . .1 ounce. Mix. Beneficial in acute eczema, erythema, burns, and scalds. 46 Official Ointments and their Therapeutic Uses. Take of Carbonate of zinc,.....1 drachm. Creasote,.......5 drops. Powdered starch,.....1 drachm. Carbonate of lead ointment, . . .1 ounce. Mix. An excellent soothing ointment in acute eczema, herpes, pemphigus, acute ulcers, and in erysipelas. Iodide of Lead Ointment. 20. Unguentum plumbi iodidi, ointment of iodide of lead. Iodide of lead, in very fine powder, 10 parts (or 48 grains) ; benzoinated lard, 90 parts (or 1 ounce av.). To make 100 parts (or about 1 ounce). Rub the iodide of lead with the benzoinated lard, gradually added, until they are thoroughly mixed. This preparation combines alterative with astringent qualities. It is, therefore, often able to promote the absorption of chronic enlargements, whether these are the result of a chronic inflammatory process or assume the form of new growths due to exalted or perverted nutrition. The iodine which it contains renders it par- ticularly serviceable in scrofulous glandular hyperplasia. It is used with success in order to secure a return of the spleen, enlarged in consequence of malaria, to its normal volume. Similarly, it is capable of checking the progress of goitre in some cases, especially if employed in the early stage of the affection. Dr. Whitla* speaks of its having been recommended as an application to the breasts in order to check the secretion of milk. The same author states that it is efficacious in obstinate cases of tinea circinata contracted from the cow. It will also sometimes prove successful in the cure of chronic ulcers. Formulary. Take of Balsam of Peru,.....y drachm. Iodide of lead ointment, ... 1 ounce. Mix. For thickened conditions of the integument, enlarged glands, and in ringworm. * Elements of Pharmacy, Materia Medica, and Therapeutics. By William Whitla, M.D. London, 1889. Iodide of Potassium Ointment. 47 Take of Beta-naphthol,.....10 grains. Iodide of lead ointment, . . • K ounce. Mix. Serviceable in chronic eczema, chronic acne, freckles, and yellowish-brown or blackish patches on the skin. Iodide of Potassium Ointment. 21. Unguentum potassii iodidi, ointment of iodide of potassium. Iodide of potassium, in fine powder, 12 parts (or 60 grains); hyposulphite of sodium, 1 part (or 5 grains) ; boiling water, 6 parts (or ^ fluidrachm) ; ben- zoinated lard, 81 parts (or 400 grains). To make 100 parts (or about 1 ounce). Dissolve the iodide of potas- sium and the hyposulphite of sodium in the boiling water, in a warm mortar; then gradually add the ben- zoinated lard and mix thoroughly. The alterative and resolvent properties of the in- corporated salt render this ointment a valuable applica- tion in man}'- cases in which the iodide of potassium is indicated for internal administration. Enlarged scrofu- lous glands return to the normal size. Hypertrophied spleen yields to its influence, while goitre is occasionally checked in its progress, or even reduced by the use of the preparation under consideration. It may be appro- priately employed in the management of keloid tumors, and has been found of avail in causing absorption of the newly-produced connective tissue. Formulary. Take of Lanolin,.......H ounce. Iodide of potassium ointment, . . y ounce. Mix. Employ in scars, keloid growths, and enlarged glands. Take of Hydrochlorate of hydrastine, ... 8 grains. Iodide of potassium ointment, ... 1 ounce. Mix. For excessive sweating, scrofuloderm, and eczema of the hands and feet. Stramonium Ointment. 22. Unguentum stramonii, stramonium ointment. Extract of stramonium, 10 parts (or 48 grains); water, 48 Official Ointments and their Therapeutic Uses. 5parts (or ^ fluidrachm); benzoinated lard, 85 parts (or 400 grains). To make 100 parts (or about 1 ounce). Rub the extract with the water until uniformly soft; then gradually add the benzoinated lard and mix thoroughly. The close relationship which exists between the active alkaloids of stramonium and belladonna, in chemical composition, physiological and therapeutical properties, indicates that the local or systemic effects of the two drugs will closely resemble each other. Hence, it is not necessary to repeat in detail the maladies in which stramonium ointment is found bene- ficial. It is on account of its anodyne and antispasmodic properties that this preparation is chiefly employed. Stramonium ointment relieves the suffering incident to irritable ulcers, inflamed haemorrhoids, inflamed tumors, engorged breasts, open cancers, bed-sores, neuralgia, and herpes zoster. Formulary. Take of Boric acid,......y drachm. Stramonium ointment, . y ounce. Mix. Valuable in irritable ulcers and fissured eczema. Take of Powdered starch,.....1 drachm. Sulphate of morphine, .... 2 grains. Creasote,......5 drops. Stramonium ointment, .... 1 ounce. Mix. For cancerous and bed sores, herpes, herpes zoster, and rosacea. Sulphur Ointment. 23. Unguentum sulphuris, sulphur ointment. Sub- limed sulphur, 30 parts (or 130 grains) ; benzoinated lard, 70 parts (or 300 grains). To make 100 parts (or about 1 ounce). Rub the sulphur with the benzoinated lard, gradually added, until they are thoroughly mixed. Sulphur is an excellent parasiticide, and for this reason its ointment has long been esteemed a most valuable remedy in the cure of scabies. Its disagree- Sulphur Ointment. 49 able odor is an objection to its use in private practice, but its cheapness and efficiency commend its use in dis- pensary or hospital service. No more than any other application, however, should sulphur ointment be used indiscriminately. Sulphur acts as a local irritant, and, although it will destroy the acarus scabiei and the ova, it is capable of aggravating the secondary lesions which may have resulted. Regard, therefore, must be had to the actual conditions in each individual case. Another disease of the skin of parasitic origin, in which sulphur ointment may be beneficial, is tinea circinata. It is like- wise valuable in all vegetable parasitic diseases of the skin. The local irritant properties of this preparation render it available as a stimulant to indolent ulcers. Sul- phur ointment is also found very serviceable in chronic eczema. In the treatment of comedo a stimulating oint- ment, such as that of sulphur, proves of great advantage. It is productive of good results in certain cases of acne, in which a stimulant application conduces to resolution of the inflammation existing in the affected sebaceous glands. It ma}' sometimes be used with advantage in the treatment of s}Tcosis, and occasionally it will relieve the progress of prurigo. In molluscum epitheliale, when the lesions are numerous, the sulphur ointment will lead to their removal. Improvement sometimes results in yaws from the use of this unguent, either of full strength or weakened according to the circumstances of the case. Formulary. Take of Carbonate of zinc,.....1 drachm. Thymol,.......5 grains. Sulphur ointment,.....1 ounce. Mix. For vegetable and animal parasitic diseases, as scabies, or itch ; tinea circinata, or ringworm. 3 C 50 Official Ointments and their Therapeutic Uses. Take of Camphor,.......10 grains. Beta-naphthol,......5 Sulphur ointment,.....1 ounce. Mix. Useful in acne, seborrhoea oleosa, subacute and chronic eczema, and in rosacea. Take of Fifty-per-cent. solution of boroglyceride, . 3 ounces. Sulphur ointment,.....2 Mix. Employ in eczema of the scalp and hairy parts of the body, sycosis, and in parasitic diseases. Alkaline Sulphur Ointment. 24. Unguentum sulphuris alkalinum, alkaline sulphur ointment. Washed sulphur, 20 parts (or 96 grains) ; car- bonate of potassium, 10 parts (or 48 grains) ; water, 5 parts (or \ fluidrachm); benzoinated lard, 65 parts (or 312 grains). To make 100 parts (or about 1 ounce). Rub the sulphur with the carbonate of potassium and the water, gradually add the benzoinated lard, and mix thoroughly. This preparation has been lately introduced into the Pharmacopoeia. Its uses are analogous to those of the sulphur ointment. It is a serviceable local application in scabies, acne, indolent ulcers, etc. Formulary. Take of Extract of conium, . y drachm. Alkaline sulphur ointment, . . y ounce. Mix. For irritable ulcers, eczema of nipples and arms. Take of Salicylic acid,.....y drachm. Alkaline sulphur ointment, . . . y ounce. Mix. Use in chronic eczema, chronic acne, and indolent ulcers. Veratrine Ointment. 25. Unguentum veratrinse, veratrine ointment. Vera- trine, 4 parts (or 20 grains); alcohol, 6 parts (or ^ fluidrachm); benzoinated lard, 96 parts (or 480 grains). Rub the veratrine with the alcohol, in a warm mortar, until dissolved ; then gradually add the benzoinated lard and mix thoroughly. Veratrine Ointment. 51 Veratrine is a local irritant, and, when brought in contact with the skin, gives rise to a feeling of warmth and tingling. Furthermore, it occasions paralysis of the terminal filaments of the sensory nerves, and pos- sesses, therefore, local anaesthetic powers. Applied to mucous membranes, it causes evidences of irritation, as sneezing, vomiting, purging, etc., and when absorbed pro- duces vomiting, marked muscular prostration,and tremor. Given to dogs in lethal doses, the tremors are converted into convulsions. It is, therefore, necessary to watch the effects of this ointment with the utmost care when employed externally, especially if it be upon or near an abraded or denuded surface. We should caution the patient and attendant, also, to be on their guard against inadvertently depositing any of the preparation upon the eye. Anaesthetic virtues have led to the use of veratrine ointment in painful affections of the integument, and in muscular and peripheral nervous systems. It is a valu- able local remedy in neuralgia, especially of the trifacial nerve. Veratrine ointment is often, however, sufficient to relieve the lancinating pain of herpes zoster, the agony of sciatica, and likewise affords relief in migraine, chronic rheumatism, myalgia, and intercostal neuralgia. It promotes the nutrition and increases the power of muscles long disused on account of paralysis. Percepti- ble improvement not infrequently results in infantile parabysis from the continued use of veratrine ointment. Chronic swelling and stiffness of joints, dependent upon rheumatism, scrofula,traumatism, etc., are notably bene- fited by the use of this preparation. Dr. Turnbull states that he has often witnessed wonderful relief in cases of organic heart disease from veratrine ointment rubbed upon the breast. He also recommends its application to 52 Official Ointments and their Therapeutic Uses. the affected joints in the beginning of a paroxysm of gout. It has been successfully employed to produce the removal of the pigmentary patches of chloasma. The application of veratrine ointment is attended with good results in alopecia circumscripta, and it is an efficient remedy in pediculosis. Formulary. Take of Carbolic acid,......5 grains. Veratrine ointment,.....y ounce. Mix. Valuable in neuralgia and itching of the unbroken skin Take of Camphor,.......10 grains. Hydrate of chloral,.....1 scruple. Veratrine ointment,.....y ounce. Mix. Pigmentary spots, circumscribed baldness, and around the eruption of herpes zoster. Oxide of Zinc Ointment. 26. Unguentum zinci oxidi, ointment of oxide of zinc. Oxide of zinc, 20 parts (or 90 grains) ; benzoinated lard, 80 parts (or 360 grains). To make 100 parts (or about 1 ounce). Rub the oxide of zinc with 20 parts (or 90 grains) of benzoinated lard, previously melted, until the mixture is perfectly smooth; then add the remainder of the benzoinated lard and mix quite thoroughly. The mild astringent virtues of the oxide of zinc ren- der its official ointment a peculiarly appropriate applica- tion in the early stage of acute inflammation of the superficial structures. As a rule, the acute stage of eczema demands emollient treatment. A bland unguent which shall protect the inflamed area from contact with the air and gently stimulate the contractility of the engorged and paralyzed capillaries is more effectual in relieving the pathological conditions than more active remedies. Upon this ground the oxide of zinc ointment is one of the best means of local treatment that can be Oxide of Zinc Ointment. 53 adopted in the acute form of this malad}'. It forms an excellent dressing in dermatitis and in the erythematous and bullous varieties of burns. It is found very service- able in erythema, erythema intertrigo, and may often be used with good effect in impetigo when the scabs have been removed. In the latter disease, if necessary, the ointment may be made slightly stimulant by the addition of some local irritant substance. Oxide of zinc ointment is likewise beneficial in impetigo contagiosa, and may be advantageously employed in pompholyx and pem- phigus. It is successfully used in the milder herpetic eruptions, and is not without value in the lesions of herpes zoster. Though no form of local treatment is of much avail in this painful affection, the character- istic eruption of which is indicative of disease of some portion of the sensory nervous system, yet the zinc ointment will serve to protect the lesions and relieve the irritation consequent upon their rupture. It is, in- deed, usefully spread upon excoriations, from whatever cause resultant. Oxide of zinc ointment is sometimes able to diminish the tenderness and pain of sore nipples. The intolerable tingling, burning, and itching of urti- caria will sometimes yield more readily to simple inunc- tion with this bland preparation than to more powerful remedies. The local symptoms of erysipelas are also not infrequently relieved by the application of oxide of zinc ointment. In seborrhoea, when secondary inflammation of the skin is present, the sedative properties of this ointment are often of decided advantage. Formulary. Take of Calomel,......10 grains. Oil of chamomile,.....5 dr0Ps- Oxide of zinc ointment, ... 1 ounce. Mix. For acute eczema, erythema, frost-bite, herpes, and herpes zoster. 54 Ointments formerly Official in U. S. Pharmacopoeia. Take of Sublimed sulphur,.....y drachm. Powdered arrow-root, . . . .1 " Carbolic acid,......3 grains. Oxide of zinc ointment,. . . . 1 ounce. Mix. Use in subacute eczema, infantile eczema, seborrhoea oleosa, sycosis, and acne. Take of Beta-naphthol,.....5 grains. Oil of eucalyptus,.....4 drops. Oxide of zinc ointment,. ... 1 ounce. Mix. For eczema of the head, face, acne, and rosacea. Take of Balsam of Peru,.....y drachm. Boric acid,......1 " Creasote,.......8 drops. Oxide of zinc ointment, . ... 1 ounce. Mix. Employ in acne, seborrhoea, excessive sweating, and in chronic ulceis. OINTMENTS FORMERLY OFFICIAL IN THE UNITED STATES PHARMACOPCEIA. In addition to the ointments official in the last edition of the United States Pharmacopoeia, there are a num- ber of others, formerly official, most of which continue to be prescribed by title and dispensed according to their ancient formulae. The following ointments, there- fore, merit enumeration and discussion almost equally with the official preparations :— Tartar Emetic Ointment. Unguentum antimonii, tartar emetic ointment. Take of tartrate of antimony and potassium, in very fine powder, 100 grains; lard, 400 grains. Rub the tartrate of antimony and potassium with the lard, gradually added, until they are thoroughly mixed. Tartar emetic is a powerful local irritant. An oint- ment in which it is incorporated, when rubbed into or left in prolonged contact with the skin causes a pustular eruption which bears a considerable resemblance to that Benzoin Ointment. 55 of variola. This preparation is, therefore, available in many conditions in which it is desirable to produce counter-irritant effects. It is, however, open to the objection of constituting a painful method of local treatment. Again, it is capable of giving rise to severe, destructive inflammation of the integument. Tartar emetic ointment was formerly very generally employed as an application to the chest in chronic affections of the lungs or bronchial tubes. Its use in these cases has, however, been generally abandoned, being more service- able, perhaps, in chronic synovitis, relieving the swell- ing, stiffness, and pain of the affected joints. It has, in fact, fallen into disuse, and has been superseded by equally active but less painful remedies. Formulary. Take of Calomel,.......10 grains. Tartar emetic ointment, .... 1 ounce. Mix. For ringworm of the scalp and favus. Take of Sulphur,.......y drachm. Tartar emetic ointment,.... 1 ounce. Mix. Acts sometimes decidedly in arresting obstinate ring-worm of the body. Benzoin Ointment. Adeps benzoinatus, benzoinated lard. Resin in coarso powder, 2 parts (or 140 grains) ; lard, 100 parts (or 16 ounces av.). Melt the lard by means of a water-bath, and, having loosely tied the benzoin in a piece of coarse muslin, suspend it in the melted lard, and, stirring them together frequently, continue the heat for two hours, covering the vessel and not allowing the temperature to rise above 60° C. (140° F.). Lastly, having removed the benzoin, strain the lard and stir while cooling. This preparation was, in the United States Pharma- copoeia for 1870, designated as unguentum benzoini, benzoin ointment. Benzoin is a balsamic resin obtained 56 Ointments formerly Official in U. S. Pharmacopoeia. from the Sty?*ax benzoin, a tree native to Siam, Sumatra, Java, and Borneo. It is a concrete juice procured by incising the bark, and the principal ingredients are resins and benzoic acid. It is upon the presence of the latter substance that the therapeutic properties of benzoin chiefly depend. The acid possesses decided antiseptic powers, and hence benzoin has proven an excellent dress- ing to unhealthy wounds, sinuses, and ulcers. It prevents fatty substances from becoming rancid. Benzoinated lard, containing but 2 per cent, of ben- zoin, is generally used as an ointment-basis. It enters into the composition of the following official ointments : Unguentum acidi gallici, unguentum acidi tannici, un- guentum belladonnae, unguentum chrysarobini, unguen- tum gallae, unguentum hydrargyri ammoniati, unguentum iodi, unguentum iodoformi, unguentum plumbi carbo- natis, unguentum plumbi iodidi, unguentum potassii iodidi, unguentum stramonii, unguentum sulphuris, unguentum sulphuris alkalinum, unguentum veratrinae, unguentum zinci oxidi. Formulary. Take of Hydrochlorate of cocaine, ... 4 grains. Sulphate of atropine,.....1 grain. Benzoin ointment, . . . , . y ounce. Mix. For frost-bite and rosacea. Take of Hydrochlorate of hydrastine, ... 5 grains. Carbonate of zinc,.....1 drachm. Benzoin ointment,.....1 ounce. Mix. Use in seborrhoea, acne, and excessive sweating. Cantharides Ointment. Unguentum cantharidis, ointment of cantharides, ointment of Spanish flies. Take of cantharides cerate 120 grains; resin cerate, 360 grains. Mix them thoroughly. The Spanish fly which this ointment contains com- municates to it decided local irritant properties. It is, Calomel Ointment. 57 however, a comparatively weak preparation, and should not be used with the design of producing vesication, for which purpose the cantharides cerate or cantharidal col- lodion is designed. The ointment is capable of pro- ducing a blister upon a delicate, sensitive skin, and especially upon those portions of the body where the skin is naturally thin. But it is too weak and uncertain in its action to be depended upon when the object is to cause strong counter-irritation. Cantharides ointment is appropriately employed when it is deemed judicious to maintain an open blister for the sake of a continued counter-irritant or revulsive effect. It is also used with benefit in order to stimulate the nutrition and growth of the hair in alopecia circumscripta. Formulary. Take of Thymol,.......5 grains. Extract of nux vomica, .... y Av.uhm. Cantharides ointment, .... 1 ounce. Mix. Useful at times in circumscribed baldness. Take of Carbolic acid,.....6 grains. Cantharides ointment, .... 1 ounce. Mix. For alopecia circumscripta, and in obstinate cases of ring- worm of the head and face. Calomel Ointment. Unguentum hydrargyri chloridi mitis, ointment of calomel. Take of calomel 60 grains; lard, 1 troy ounce. Mix thorough^. The mild antiseptic and protective qualities of calomel render it an excellent application in abraded, excoriated, or superficially ulcerated condition of the integument. This ointment is consequently valuable in the treatment of herpes, especially of the genitals, and is a fitting dressing to chancroids. It is efficient in the relief of that troublesome and obstinate affection, pru- ritus ani. Calomel ointment may be very properly em- 3* 58 Ointments formerly Official in U. S. Pharmacopoeia. ployed upon many forms of cutaneous syphilis, and is an excellent local remedy in chronic eczema. In the weak- ened form of 10 grains to the ounce calomel ointment effects decided relief in the acute stage of sycosis. It is of service in dermatitis, particularly in the later stage of the disease, and is one of the agents made use of in psoriasis after the scales have been removed. A weak ointment of calomel—5 or 10 grains to the ounce—is a useful remedy in impetigo contagiosa. In the same strength it promotes cicatrization in ecthyma, applied to the open, granulating surfaces exposed upon separation of the crusts. Formulary. Take of Creasote,.......8 drops. Calomel ointment,.....1 ounce. Mix. For acute sycosis, subacute eczema, erythema, and in secondary syphilis. Take of Beta-naphthol,......10 grains. Calomel ointment,.....1 ounc3. Mix. Use in chancroids, syphilis of the skin, chronic acne, para- sitic diseases of the skin, and in impetigo contagiosa. Creasote Ointment. Unguentum creasoti, ointment of creasote. Take of creasote 1 fluidrachm; simple ointment, 1 ounce (av.). Mix thoroughly. Creasote ointment has been omitted from the United States Pharmacopoeia of 1880, and the formula just given is that of the British Pharmacopoeia. The British preparation is more than twice as strong as that in our Pharmacopoeia of 1870. This ointment relieves the itching and burning of erythema multiforme and of eczema. It is beneficially applied in burns, chilblains, erysipelas, and to ulcerated surfaces. It is particularly adapted to cases of indolent, foul, or gangrenous ulcers by reason of its antiseptic properties, and has been used with success in psoriasis. Red Iodide of Mercury Ointment. 59 Formulary. Take of Beta-naphthol,.....5 grains. Creasote ointment,.....1 ounce. Mix. For itching of the skin, especially in eczema, ulcers, psori- asis, and chilblains. Take of Carbonate of lead,.....1 drachm. Creasote ointment,.....1 ounce. Mix. Useful in erysipelas, erythema, acute eczema, and in burns. Red Iodide of Mercury Ointment. Unguentum hydrargyri iodidi rubri, ointment of red iodide of mercury. Take of red iodide of mercury, in fine powder, 16 grains ; simple ointment, 1 troy ounce. Mix thoroughly. The red or biniodide of mercury is possessed of very vigorous local irritant properties. For this reason it is used but seldom in this country, and then usually in half strength, 8 grains to the ounce. It is, nevertheless, a valuable remedy in certain stubborn affections, as has been demonstrated by the East India army surgeons in the treatment of goitre. The following, according to Ringer* is the mode of application: " In India this ointment is applied to the swelling at sunrise by means of an ivory spatula, and is then well rubbed in for at least ten minutes. The patient then sits with the goitre held up to the sun as long as he can endure it. In six or eight hours there will probably be some pain from the blistering action of the application, although no pustules will have arisen. At about 2 o'clock in the afternoon a second application is made, the ointment being rubbed in with a light hand ; the oint- ment is then allowed to remain, and its absorption is completed about the third day. In ordinary cases one such course cures the patient, but in bad cases it may be necessary to repeat the treatment in six or * A Hand-book of Therapeutics. By Sydney Ringer, M.D. Eleventh edition. London, 1886. 60 Ointments formerly Official in U. S. Pharmacopoeia. twelve months. In countries where the sun is less powerful the patient sits before a fierce fire, or the ointment may be rubbed over the swelling night and morning, afterward covering it with oil-skin." The Indian surgeons also very warmly commend the ointment of the red iodide of mercury as a local remedy in the case of enlargement of the spleen, or "ague-cake," not uncommonly left after a severe or prolonged attack of malarial fever. This ointment may be advantageously applied upon denuded psoriatic patches. Great care, however, should be exercised in its use. The official preparation, at least to begin with, is much too strong. Two grains to the ounce is as strong a preparation as should be used at first, for fear of complicating the disease which we seek to relieve. The unguent under consideration was the favorite remedy of Cazenave in lupus. Formulary. Take of Lanolin,.......y ounce. Red iodide of mercury ointment, . . y " Mix. For scars and enlarged glands. Take of Chian turpentine,.....y drachm. Red iodide of mercury, . . . . y ounce. Mix. Useful in old syphilitic spots, and in obstinate cases of ringworm of scalp. Compound Iodine Ointment. Unguentum iodi compositum, compound iodine oint- ment. This preparation is made by rubbing together iodine, 15 grains ; iodide of potassium, 30 grains; water, 30 minims; lard, 1 troy ounce. It has deserved^ been dismissed from the official list, since it consists of the same ingredients as the yet official unguentum iodi (q. v.), with an immaterial difference in their proportions. The curative virtues of both unguents are, therefore, Subacetale of Copper Ointment. 61 applicable to the same maladies and conditions. Both stain the skin orange-yellow. Formulary. Take of Lanolin,.......y ounce. Compound iodine ointment, . . . y " Mix. For scrofuloderma and syphilitic spots. Take of Green soap,......1 ounce. Compound iodine ointment, . . 1 " Mix. Applicable for scars and old syphilitic sores. Subacetate of Copper Ointment. Unguentum cupri subacetatis, ointment of subacetate of copper. The impure subacetate of copper of the United States Pharmacopoeia of 1870 has been replaced by the purified acetate of copper. The subacetate, or verdigris, is stimulant, cauterant, and astringent if applied locally. The ointment which contained it consequently acquired those properties. Its use has been largely abandoned. Tobacco Ointment. Unguentum tabaci, ointment of tobacco. This was made by mixing a watery extract, prepared from \ troy ounce of finely-powdered tobacco, with 8 troy ounces of lard. Tobacco is a very powerful local irri- tant, and this fact led to the former use of its ointment as an application to indolent ulcers, while the exceed- ingly poisonous properties of its alkaloid suggested its use in some of the parasitic diseases of the skin. Nico- tine is, however, very readily absorbed, even through the skin, and its depressant powers are so great that this ointment has been superseded by others, which, though stimulant and parasiticide, are less liable to produce con- stitutional effects. Formulary. Take of Subiodidc of bismuth, • Vt drachm. Tobacco ointment,.....* ounce. Mix. Useful at times in indolent ulcers, and in fissured eczema around the anus. 62 National Formulary Unofficial Ointments. Take of Extract of conium, .... M drachm. Extract of belladonna, • K Tobacco ointment,.....1 ounce. Mix. For cancerous and bed sores and irritable ulcers. NATIONAL FORMULARY UNOFFICIAL OINTMENTS. There are a number of preparations widely known and used in this country, but for which many varying formulae exist. In order to secure uniformity of compo- sition the American Pharmaceutical Association have proposed a formulary, which it commends to the use of physicians and druggists. It is styled the " National Formulary of Unofficinal Preparations," and its general adoption will prevent the embarrassments which contin- ually arise from the variation in ingredients and propor- tions of preparations ordered by the same title. In prescribing, the letters u N. F." should be appended in order to indicate that the standard formula is to be followed. The National Formulary includes directions for the preparation of five ointments, as follow:— Calamine Ointment. Unguentum calaminae, calamine ointment. Take of prepared calamine 1 part; ointment (U. S. P.), 5 parts. Mix them intimately, by trituration, so as to produce a smooth and homogeneous ointment. Calamine is the native impure carbonate of zinc. It is reduced to an impalpable powder by first heating the calamine to red- ness, then pulverizing it, and finally completing the proc- ess by levigation and elutriation. It was formerly the subject of such gross adulteration that it was dismissed from the Pharmacopoeia. It is now, however, obtained in an approximately pure condition. Calamine ointment has been retained in the British Pharmacopoeia. It is slightly Camphor Ointment. 63 astringent and desiccant. Its properties and indications may be regarded as identical with those of the official oxide of zinc ointment, and may, consequently, be recom- mended in the treatment of excoriations, superficial ulcers, dermatitis, eczema, erythema, herpes, and impetigo. Formulary. Take of Creasote,.......6 drops. Carbonate of lead,.....1 drachm. Calamine ointment, .... 1 ounce. Mix. Excellent for acute eczema, erythema, dermatitis, and herpes. Take of Borax, .......y drachm. Calamine ointment, . . .1 ounce. Mix. For burns, excoriations, and acne. Camphor Ointment. Unguentum camphorse, camphor ointment. Take of camphor, in coarse powder, 2 parts ; white wax, 1 part; lard, 6 parts. Melt the white wax and lard with a gentle heat, then add the camphor, and stir the ointment until it is cold. Camphor is a topical irritant, and even gives rise to inflammation if left long in contact with the skin. Its ointment might, therefore, be appropriately used as a stimulant to indolent ulcers. Camphor ointment also acts as an anodyne and counter-irritant, applied with friction, in rheumatism, myalgia, and neuralgia. It is also serviceable as an external remedy in many forms of chronic inflammation, being capable of exciting the vascular and absorbent systems. Camphor ointment serves a good purpose, too, as an addendum to unguents employed in eczema, paraesthesia. and other affections of the integument. ^ ° Formulary. Take of Subnitrate of bismuth, .... 1 drachm. Prepared suet,.....3 drachms. Camphor ointment, .... 3 Mix. Serviceable in eczema and herpes of the lip. 64 National Formulary Unofficial Ointments. Take of Calomel,.......10 grains. Beta-naphthol,......8 " Camphor ointment,.....1 ounce. Mix. For eczema, especially of the head and face, and all irrit- able conditions of the integument. Compound Lead or Brown Ointment. Unguentum fuscum, brown ointment. Take of cam- phorated brown plaster 2 parts ; olive-oil, 1 part; suet, 1 part. Melt them together, and stir the mass until it is cold. Camphorated brown plaster is made according to the following formula: Take of red oxide of lead 30 parts; olive-oil, 60 parts; 3Tellow wax, 15 parts; camphor, 1 part. Triturate the red oxide of lead with a portion of the oil in a capacious copper kettle until a smooth paste results. Then add the remainder of the oil, excepting a small quantit}' required for trituration with the camphor, and boil the whole over a naked fire, under constant stirring, until gas-bubbles rise, or until the red color of the mixture begins to turn brown. Then moderate the heat, but keep up the stirring until the mixture has ac- quired a dark-brown color, and from time to time allow some drops of it to fall into cold water to test its con- sistence. When this is satisfactory, remove the vessel from the fire, add the wax in small pieces, and finally the camphor, previously rubbed to a smooth paste with a little olive-oil. Mix thoroughly, allow the mixture to become somewhat cool, and, while it is still warm, pour the plaster into paper molds, previously coated with mucilage containing about 5 per cent, of glycerin and dried. The red oxide of lead is a more highly oxygenated form than the litharge, which is so extensiveby employed in the preparation of plasters. It is not official, and is brought into pharmaceutical use only as an ingredient Compound Tar Ointment. 65 of the brown plaster and ointment. It possesses the mild astringent and sedative virtues common to most of the salts of lead, and the brown ointment may, there- fore, be beneficially applied for medicinal purposes to the same class of diseases in which diachylon ointment is found so efficient,—subacute and acute eczema, par- aesthesia, dermatitis, erythema, herpes, seborrhoea, and sycosis. Formulary. Take of Ergotinc,......y drachm. Compound lead or brown ointment, . 1 ounce. Mix. Use in acne, rosacea, acute eczema, and dermatitis. Take of Lanolin,.......y ounce. Compound lead or brown ointment, . y " Mix. For chronic eczema and chronic sycosis. Compound Tar Ointment. Unguentum picis compositum, compound tar oint- ment. Take of oil of tar 4 parts ; tincture of benzoin, 2 parts; oxide of zinc, 3 parts; yellow wax, 26 parts; lard, 32 parts; cotton-seed oil, 35 parts. Melt the yellow wax and lard with the cotton-seed oil at a gentle heat. Add the tincture of benzoin, and continue heat- ing until all the alcohol has evaporated. Then withdraw the heat, add the oil of tar, and, finally, the oxide of zinc, incorporating the latter thoroughly, so that, on cooling, a smooth, homogeneous ointment may result. The combination of astringent and antiseptic proper- ties render the compound tar ointment an excellent remedy in a wide range of cutaneous diseases. It is of service in inflammations due to the more usual causes, while it is equally efficacious in those which depend upon the development of an animal or vegetable parasite. The oxide of zinc present qualifies its irritant action. This combination, therefore, is well adapted for use in chronic eczema, psoriasis, pemphigus, sycosis, and tinea o3 66 National Formulary Unofficial Ointments. circinata. It has also been successful in cases of lupus erythematosus. Formulary. Take of Extract of witch-hazel, . . . . 1 drachm. Compound tar ointment, ... 1 ounce. Mix. For tinea circinata, sycosis, chronic eczema, and psoriasis. Take of Borax,.......y drachm. Compound tar ointment, . . . 1 ounce. Mix. Use in lupus erythematosus, pemphigus, and sycosis. Compound Sulphur Ointment. Unguentum sulphuris compositum, compound sulphur ointment. Take of precipitated carbonate of calcium 10 parts; sublimed sulphur, 15 parts; oil of cade, 15 parts; green soap, 30 parts; lard, 30 parts. Mix the lard with the green soap and oil of cade. Then grad- ually incorporate the sublimed sulphur and precipitated carbonate of calcium. This compound ointment is indifferently known as Wilkinson's ointment, or Hebra's itch ointment, the formula being originally devised by the former and modified by the latter authority. The sulphur, the green soap, and the oil of cade all possess stimulant properties, and an ointment which contains them is admirably adapted to be used upon the patches of psoriasis, the investment of scales having been pre- viously removed. As implied by one of its titles, it con- stitutes an effective mode of treatment in scabies. Its use is,however, attended by the drawback of being tedious and painful. It is an effectual remedy in tinea circinata. Formulary. Takeoflodol,.......% drachm. Compound sulphur ointment, . . 1 ounce. Mix. For scabies, or itch, and in tinea circinata, or ringworm. Take of Beta-naphthol,.....y drachm. Compound sulphur ointment, . . y ounce. Mix. Useful in chronic psoriasis and in thickened conditions of the integument. CHAPTER III. OINTMENTS OFFICIAL IN THE BRITISH PHARMACOPCEIA. The Pharmacopoeias of the United States and of Great Britain agree in all essential respects. That of the latter, however, has retained, as official, a number of ointments which are no longer recognized as official by that of the United States. The official ointments of Great Britain are thirty-four in number. Of these nineteen are unofficial in this country. Most of them, however, are well known and frequently prescribed, either according to their official title and formula, or in extemporaneous combination, which approximates the authoritative proportions. I deem it proper, therefore, in a work of this character, to enter into a brief enu- meration of these preparations. Boric Acid Ointment. Unguentum acidi borici, ointment of boric acid. Take of boric acid, in fine powder, 2^ ounces (av.); soft paraffin, 10 ounces (av.) ; hard paraffin, 5 ounces (av.). Melt the hard and soft paraffins together, and add the boric acid distributed over the surface of the liquid b}' passing it through a sieve, then stir them together con- stantly until cold. Boric acid is one of the most valuable of the disin- fectants, having the power of destroying pathogenic germs, while at the same time it is destitute of local irritant properties, and hence can be applied to open wounds. To unhealthy wounds and ulcers, to erysipelas and to septic lesions, the boric acid ointment is an (67) 68 Ointments Official in the British Pharmacopoeia. admirable application. It is a very good dressing in dermatitis, the bullous variety of burns, and is often successful in the removal of warts. It is a good local adjuvant in comedo, and an excellent remedy in bromi- drosis. Dr. Russell Sturgis is very fond of boric acid combined with lanolin in the treatment of certain cu- taneous affections of children, especially eczema of the head or face, intertrigo and seborrhoea. He employs 20 per cent, of boric acid to 80 per cent, of lanolin. Formulary. Take of Lanolin,.......y ounce. Boric acid ointment,.....y " Mix. Employ in unhealthy wounds, ulcers, burns, warts, and in odorous sweating. Take of Hydrochlorate of hydrastine, ... 6 grains. Boric acid ointment,.....1 ounce. Mix. For acne, seborrhoea, and in subacute eczema. Salicylic Acid Ointment. Unguentum acidi salicylici, ointment of salicylic acid. Take of salicylic acid 60 grains; soft paraffin, 1080 grains; hard paraffin, 540 grains. Melt the hard and soft paraffin together, add the salicylic acid, and stir the whole constantly until cold The germicidal properties of salicylic acid are superior to those of carbolic acid. An ointment con- taining the former substance is a suitable application to cutaneous disorders of mycotic origin, though, owing to the absence of local irritant properties, it has a less wide field of usefulness than the ointment of carbolic acid. It is valuable in the treatment of tinea circinata, and is occasionally of service in lupus vulgaris. A weak ointment of salicylic acid—5 grains to the ounce—is found serviceable in the removal of freckles. Not in- frequently it is capable of conferring relief in paraes- thesia. It has been successfully employed in the Aconitine Ointment. 60 management of eczema rubrum and chronic eczema, espe- cially of the palms of the hands and soles of the feet. Aconitine Ointment. Unguentum aconitinae, ointment of aconitine. Take of aconitine 8 grains; rectified spirit, \ fluidrachm; benzoated lard, 1 ounce (av.). Dissolve the aconitine in the spirit, add the lard, and mix thoroughly. Aconitine, the active principle of aconitum napellus, produces, when applied locally, paralysis of the sensory nervous system, beginning with the end-organs and ascending the trunk to the centre. The first effect is a sensation of warmth, which is succeeded by tingling and finally numbness. Used externally, it is, therefore, valu- able in affections characterized by severe pain. Aconitine ointment finds its principal indication in the treatment of neuralgia, and, above all, in neuralgia of the trifacial. It is likewise serviceable in the treatment of sick-head- ache. Rubbed upon the brow it will arrest the nausea and vomiting. The pain of chronic rheumatism, gout, and myalgia is often relieved by this preparation. Aconitine ointment often relieves the pain present in herpes zoster, provided it be applied around the eruption, attention being particularly paid to not bringing the preparation in contact with the unbroken skin. It should be rubbed into the skin until it occasions tingling or numbness. Especial care should be taken to avoid an open surface on account of the powerful cardiac depressant properties of the alkaloid when absorbed. Formulary. Take of Menthol,.......10 grains. Aconitine ointment,.....y ounce. Mix. For neuralgia of the skin and paresthesia. Take of Sublimed sulphur,.....1 scruple. Carbolic acid,......5 grains. Aconitine ointment,.....y ounce. Mix. Use in papular eczema, prurigo, and dermatalgia, 70 Ointments Official in the British Pharmacopoeia. Atropine Ointment. Unguentum atropinee, ointment of atropine. Take of atropine 8 grains; rectified spirit, ^ fluidrachm; ben- zoated lard, 1 ounce (av.). Dissolve the atropine in the spirit, add the lard, and mix thoroughly. Atropine paralyzes motor nerve-trunks and their end-organs. Its effect upon sensory nerves is slighter, diminishing but not destroying their excitability. This ointment is, therefore, more likely to do good in dis- eases of which spasm, rather than pain, is the most marked feature. The internal rather than the local use of atropine should, however, be preferred. It has been emplo}Ted as an outward application in neuralgia, herpes, and in irritable venereal sores, but other agents are often superior. Care should be taken in its external use, as it is very readily absorbed by abraded surfaces and severe constitutional effects may result. In a case of syphilitic ulcer on the penis, treated at the Medico-Chirurgical Hospital, the application of atropine in half the strength just suggested, in conjunc- tion with the ointment of oleate of mercury, while relieving the local symptoms, gave rise to marked phj'sio- logical action of the atropine. Dyspnoea, acceleration of the pulse, dryness of the throat, and dilatation of the pupil followed to such an extent as to cause the appli- cation to be withdrawn and morphine administered. Formulary, Take of Hydrochlorate of cocaine, ... 2 grains. Carbonate of zinc,.....y drachm. Ammoniated mercury, .... 5 grains. Atropine ointment,.....y ounce. Mix. For chancre, chancroids, syphilitic and irritable ulcers. Take of Tannic acid,......10 grains. Acetate of lead,.....1 scruple. Atropine ointment,.....y ounce. Mix. Useful in fissures around the anus, the penis, the scrotum, and in herpes. Spermaceti Ointment. 71 Spermaceti Ointment. Unguentum cetacei, spermaceti ointment. Take of spermaceti 5 ounces (av.) ; white wax, 2 ounces (av.) ; almond-oil, 1 pint (imperial measure), or a sufficiency; benzoin, in coarse powder, \ ounce (av.). Melt together the spermaceti, wax, and almond-oil; add the benzoin, and, frequently stirring the mixture, continue the appli- cation of heat for two hours; remove from the source of heat, take out the residual benzoin by straining, and stir constantly until quite cold. Spermaceti ointment constitutes a bland protective dressing. It may be applied to superficial inflamma- tions, blistered surfaces, abrasions, etc., and is some- times better borne than more powerful remedies. This is true of all demulcent ointments, and the spermaceti preparation possesses no peculiar advantage. It is sel- dom or never used alone in this country, but enters into the composition of our official unguentum aquae rosae. Spermaceti ointment soon becomes rancid. Formulary. Take of Powdered arrow-root, . . ■ ■ 14 drachm. Camphor,......5 grains. Prepared suet,.....3 drachms. Spermaceti ointment, .... 3 Mix. For chapped lips and excoriations around the genital organs. Take of Powdered starch,.....K drachm. Subnitrate of bismuth, • }4 Spermaceti ointment, . . . • ]4 ounce. Mix. Valuable for irritation in the axilla, about the groins, and in erythema of the female breasts. Elemi Ointment. Unguentum elemi, ointment of elemi. Take of elemi 1 ounce; simple ointment, 1 ounce. Melt, strain through flannel, and stir constantly until the ointment solidifies. Elemi is a resin akin to the turpentines, and pos- 72 Ointments Official in the British Pharmacopoeia. sesses mild irritant properties. It is occasionally used in Great Britain as a stimulant to indolent ulcers. Eucalyptus Ointment. Unguentum eucalypti, ointment of eucalyptus. Take oil of eucalyptus, by weight, 1 ounce (av.); soft paraffin, hard paraffin, of each, 2 ounces (av.). Melt the hard and soft paraffins together, add the oil, and stir until cold. Eucalyptus contains a volatile oil, several resinous substances, tannic acid, etc. Its distinctive properties depend upon the presence of eucalyptol. Eucalyptus is a decided local irritant. It is also a disinfectant of considerable power, surpassing quinine in this respect. Like the latter substance it inhibits amoeboid movements, The ointment under consideration, therefore, consti- tutes a good dressing to chronic, indolent, or unhealthy ulcers. Galls and Opium Ointment. Unguentum gallse cum opio, ointment of galls and opium. Take of ointment of galls 1 ounce (av.) ; opium, in powder, 32 grains. Mix thoroughly. This preparation is used chiefly in the treatment of painful haemorrhoids, and fissured eczema around the nose, lips, and anus. Glycerin of Subacetate of Lead Ointment. Unguentum glycerini plumbi subacetatis, ointment of glycerin of subacetate of lead. Take of glycerin of subacetate of lead 4\ ounces (av.) ; soft paraffin, 18 ounces (av.); hard paraffin, 6 ounces (av.). Melt the hard and soft paraffins together; then add the glycerin of subacetate of lead and stir until the moisture has cooled. This is an excellent astringent and sedative ointment. Compound Mercurial Ointment. 73 It ma}r be usefully employed in dermatitis, erythema, erysipelas, herpes, and to blistered or abraded surfaces. Formulary. Take of Salol,.......10 grains. Glycerin of subacetate of lead ointment, 1 ounce. Mix. Use in erysipelas, erythema, and in blistered or abraded surfaces. Take of Dried carbonate of sodium, . . .10 grains. Hydrochlorate of morphine, . . 4 " Glycerin of subacetate of lead ointment, 1 ounce. Mix. For dermatitis, burns, acute eczema, and erythema. Compound Mercurial Ointment. Unguentum hydrargyri compositum, compound oint- ment of mercury. Take ointment of mercury 6 ounces; yellow wax, olive-oil, of each, 3 ounces; camphor, 1^ ounces. Mix the wax and oil by the aid of heat, then incorporate the ointment of mercury, and, when the mixture is nearly cold, add the camphor in powder. Stir the whole thoroughly together. Pharmaceutical rather than therapeutical reasons have dictated the formula of the compound ointment of mer- cury. The addition of camphor softens the mass and renders it more readily applied, Diluted Nitrate of Mercury Ointment. Unguentum hydrargyri nitratis dilutum, diluted oint- ment of nitrate of mercury. Take of nitrate of mercury ointment 1 ounce (av.) ; soft paraffin, 2 ounces (av.). Mix. This official dilution fulfills the same indications as our unguentum hydrargyri nitratis, but is intended to replace the latter when that preparation is found too irri- tant. An official dilution, however, seems unnecessary, since the stronger ointment can be extemporaneously weakened to any degree, i P 74 Ointments Official in the British Pharmacopoeia. Acetate of Lead Ointment. Unguentum pldmbi acetatis, ointment of acetate of lead. Take of acetate of lead, in fine powder, 12 grains; benzoated lard, 1 ounce (av.). Mix thoroughly. This ointment possesses the virtues of the other sat- urnine preparations. It may be used in dermatitis, erythema, herpes, to blistered surfaces, to pemphigus after the vesicles have ruptured, etc. Formulary. Take of Extract of calamus, . y drachm. Powdered arrow-root, . . . . 1 " Acetate of lead ointment, ... 1 ounce. Mix. For scrotal eczema and eczema of the hands and feet. Take of Carbolic acid,......4 grains. Sublimed sulphur,.....1 scruple. Acetate of lead ointment, ... 1 ounce. Mix. Use in infantile eczema, rosacea, and in excessive sweating. Sulphurated Potash Ointment. Unguentum potassse sulphurate, ointment of sulphu- rated potash. Take of sulphurated potash 30 grains; hard paraffin, £ ounce (av.) ; soft paraffin, f ounce (av.). Triturate the sulphurated potash in a glass or porcelain mortar, and gradually add the melted mixture of the hard and soft paraffins, rubbing them together until the ointment is perfectly smooth and free from grittiness. This ointment should be recently prepared. The therapeutical virtues of sulphurated potash are analogous to those of sulphur. Hence, it is used exter- nally in the same class of affections to which sulphur is applied,—chronic eczema, tinea circinata, and scabies. Formulary. Take of Beta-naphthol,.....1 scruple. Sulphurated potash ointment,. . . 1 ounae. Mix. Especially useful in scabies and in ringworm. Take of Balsam of Peru,.....1 drachm. Sulphurated potash ointment, . . .1 ounce. Mix. For chronic eczema, psoriasis, itch, and ringworm. Resin Ointment. 75 Resin Ointment. Unguentum resinae, ointment of resin. Resin, 35 parts (or 7 ounces av.) ; yellow wax, 15 parts (or 3 ounces av.) ; lard, 50 parts (or 10 ounces av.). To make 100 parts (or 20 ounces av.). Melt them together at a moderate heat, strain the mixture through muslin, and allow it to cool without stirring. The resin cerate of the United States Pharmacopoeia is made according to the above formula, and is substan- tially the same preparation as the ointment of resin of the British Pharmacopoeia. The unguentum resinae is made as follows:— Take of resin, in coarse powder, 8 ounces; yellow wax, 4 ounces; simple ointment, 16 ounces. Melt with a gentle heat, strain the mixture while hot through flannel, and stir constantly while it cools. From a pharmaceutical point of view resin is valuable in communicating to fatty substances a proper consist- ence for use as ointments, The cerate or ointment of resin is an excellent mild stimulant to ulcers, burns, and blistered surfaces. Formulary. Take of Menthol,.......10 grains. Hydrochlorate of cocaine, . . . 5 " Resin ointment,.....1 ounce. Mix. Serviceable in boils, carbuncles, and indurated acne. Take of Oil of cade,......1 drachm. Resin ointment,.....1 ounce. Mix. For eczema of the hands and feet. Savine Ointment. Unguentum sabinse, ointment of savine. Take of fresh savine-tops, bruised, 8 ounces; white wax, 3 ounces; prepared lard, 16 ounces. Melt the lard and wax together on a water-bath, add the savine, and digest for twenty minutes. Then remove the mixture and express through calico. 76 Ointments Official in the British Pharmacopoeia. In the United States Pharmacopoeia an official cerate is substituted for the ointment. The directions for pre- paring the cerate are as follow :— Fluid extract of savine, 25 parts (or 5 ounces av.); resin cerate, 90 parts (or 8 ounces av.). Melt the resin cerate by means of a water-bath, add the fluid extract of savine, and continue the heat until the alcohol has evap- orated; then remove the heat, and stir constantly until cool. Savine possesses very decided local irritant proper- ties. An ointment or cerate which contains it is conse- quently useful in those conditions which demand stimu- lation, as in chronic gout. Its most general use, perhaps, is in maintaining a blister, and for this purpose it has the advantage over the ceratum cantharidis of not pro- ducing strangury. Stavesacre Ointment. Unguentum staphisagriee, ointment of stavesacre. Take of stavesacre-seeds 4 ounces (av.) ; benzoated lard, 8 ounces (av.). Crush the seeds and macerate them in the lard, kept melted over a water-bath for two hours. Strain through calico and set aside to cool. This oint- ment contains about 10 per cent, of oil of stavesacre. Staphisagria is a powerful irritant. Its properties depend mainly upon an oil which it contains in large quantities, and an alkaloid called delphine. Both the oil and the alkaloid are highly stimulant local applications. The ointment of stavesacre is an efficient agent in the destruction of pediculi and the acarus scabiei. The preparation, however, is open to the serious drawback of provoking severe cutaneous irritation. The ointment, as made according to the official for- mula, is apt to be a gritty mass. Squire prefers using the oil of stavesacre diluted with olive-oil. Iodide of Sulphur Ointment. 77 Formulary. Take of Sublimed sulphur,.....1 drachm. Stavesacre ointment, .... 1 ounce. Mix. For pediculi and scabies. Take of Beta-naphthol,......1 scruple. Stavesacre ointment, . . . . 1 ounce. Mix. Use in animal parasitic diseases. Iodide of Sulphur Ointment. Unguentum sulphuris iodidi, ointment of iodide of sulphur. Take of iodide of sulphur 30 grains; hard paraffin, ^ ounce (av.); soft paraffin, f ounce (av.). Triturate the iodide of sulphur in a glass or porcelain mortar, and gradually add the melted mixture of the hard and soft paraffins, rubbing them together until the ointment is perfectly cold and free from grittiness. The iodide of sulphur seems to combine the thera- peutic virtues of the elementary substances which it contains. Its ointment is a useful remedy in alopecia circumscripta, tinea circinata, and in cutaneous affections associated with a scrofulous taint. It may also prove of service in psoriasis, chronic eczema, acne, lupus and lepra. Form-alary. Take of Oil of cade,......y drachm. Iodide of sulphur ointment, ... 1 ounce. Mix. For alopecia circumscripta, chronic eczema, and psoriasis. Take of Oil of eucalyptus,.....4 drops. Carbonate of zinc,.....1 drachm. Iodide of sulphur ointment, . . . y ounce. Mix. Valuable in chronic acne, rosacea, and lupus erythematosus. Turpentine Ointment. Unguentum terebinthinse, ointment of turpentine. Take of oil of turpentine 1 fluidounce; resin, in coarse powder, 54 grains; j'ellow wax, prepared lard, of each ^ ounce (av.). Melt the ingredients together by the heat of a steam- or water- bath. Remove the vessel and stir the mixture constantly while it cools. 78 Ointments Official in the British Pharmacopoeia. Turpentine acts upon the skin as a rubefacient. It possesses, also, marked antiseptic powers. The oint- ment has been used successfully as a local application in erysipelas, alopecia circumscripta, and is sometimes of service in psoriasis. Formulary. Take of Pilocarpine hydrochlorate, ... 5 grains. Turpentine ointment, . . . . y ounce. Mix. For alopecia and chronic circumscribed eczema. Take of Citrine ointment,.....y ounce. Oil of juniper,.....y drachm. Turpentine ointment, . . . . y ounce. Mix. Beneficial for psoriasis, chronic eczema, and alopecia. CHAPTER IV. EXTEMPORANEOUS OINTMENTS. In addition to the list of ointments official either in our own or the British Pharmacopoeia, and those for which a standard formula has been recommended by the American Pharmaceutical Association, an indefinite variety of substances are made use of in extempora- neous prescriptions. Some of these are metallic salts, many are vegetable products, while modern chemistry has of late made valuable contributions to the list of local medicaments. I shall enumerate those which are most frequently used and justly esteemed. Some of them, doubtless, will hereafter be made official. Oint- ments composed of these unofficial substances may be divided, like those of which I have hitherto treated, into sedative, astringent, and stimulant. Menthol Ointment. Menthol.—This substance has been made official in the British Pharmacopoeia, by which it is defined as a stearopten obtained by cooling the oil derived from the fresh herb of Mentha arvensis and Mentha piperita. It occurs in the form of colorless crystals or fused crystal- line masses. It has the odor and taste of peppermint, and melts at 108° to 110° F. It is soluble in alcohol. When brought into contact with the skin it produces first a burning sensation, followed by one of coolness, and finally of numbness. It possesses decided antiseptic properties. Its principal therapeutical value is as a local anaesthetic. Rubbed up into an ointment, 5 to 15 grains to the ounce of suitable fatty vehicle it has the power (79) 80 Extemporaneous Ointments. of relieving itching and pain. Menthol ointment may, therefore, be emploj'ed to mitigate the distress of paraes- thesia and urticaria, and in lessening the itching due to eczema. It assuages the pain of neuralgia, especially when seated in superficial nerves. It has been success- fully employed in trifacial neuralgia, in pleurodynia, and in herpes zoster. Formulary. Take of Salol,......-10 grains. Carbonate of lead,.....y drachm. Menthol ointment,.....y ounce. Mix. Employ in dermatalgia, herpes zoster, and paresthesia. . Take of Boric acid,......1 drachm. Powdered arrow-root, . . . . 1 " Menthol ointment,.....1 ounce. Mix. For urticaria, papular eczema, and herpes zoster. Salicylated Camphor Ointment. Salicylated Camphor.—A compound ointment bearing this title is in frequent use in the Hotel Dieu, of Paris.* It is made by heating together 11 parts of salicylic acid with 14 of camphor. This combination secures stimulant and antiseptic properties. The preparation has been found extremely useful, it is said, in the treatment of unhealthy, specific, or malignant ulcers. It is a useful application to septic surfaces. Phagedaena, syphilitic ulcers, lupus, and open cancer are the affections in which it is reported to be of service. Formulary. Take of Boric acid,......y drachm. Carbonate of zinc,.....1 " Salicylated camphor ointment, . . 1 ounce. Mix. For ulcers, lupus, and eczema of the hands and feet. Take of Sublimed 6ulphur,.....y drachm. Ointment of oxide of zinc, . . . y ounce. Salicylated camphor ointment, . . y " Mix. Serviceable in acne, rosacea, and painful ulcers. * Whitla, op. cit. Cucumber Ointment. 81 Cucumber Ointment. Cucumber.— An ointment containing this vegetable is made in the following manner : Take of green cucum- bers 7 pounds (av.) ; pure lard, 24 ounces; veal-suet, 15 ounces. Grate the washed cucumbers to a pulp, express, and strain the juice. Cut the suet into small pieces, heat it over a water-bath till the fat is melted out from the membrane; then add the lard, and, when melted, strain through muslin into an earthen vessel capable of holding a gallon and stir until thickening commences, when one-third of the juice is to be added, and the whole beaten with a spatula till the odor has been almost wholly extracted. The portion which separates is to be decanted, and the remaining two-thirds of the juice are to be consecutively incorporated and decanted in the same manner. The jar is then closely covered and placed in a water-bath until the fatty matter entirely separates from the juice. The green coagulum floating on the surface is now removed, and the jar put in a cool place that the ointment may solidify. The crude ointment is then separated from the watery liquid on which it floats, melted and strained and placed in glass jars, which must be kept closely sealed.* Formulary. Take of Subnitrate of bismuth, . . . . 1 drachm. Oil of rose,......2 drops. Cucumber ointment, . . . .1 ounce. Mix. For burns, blisters, excoriations, erythema, and chapped lips. Take of Powdered arrow-root, .... 1 drachm. Hydrochlorate of cocaine, . . .5 grains. Cucumber ointment, .... 1 ounce. Mix. Useful in dermatitis and acute eczema. * Formula of Professor Procter, United States Dispensatory. Six- teenth edition. Philadelphia, 1888. 4* 82 Extemporaneous Ointments. CUCUMBER CREAM. The following formula for the preparation of" cucum- ber cream " is given by A. Zimmerman in the Pharma- ceutical Record, December 16, 1887: "White wax, 1 ounce (av).; spermaceti, 1 ounce (av.); benzoimited lard, sufficient, 1 pound (av.); 6 fair-sized cucumbers (those which have not become quite green appear to possess most flavor), peeled and cut in slices; borax, sufficient quantity. Melt the wax and spermaceti; add lard and cool; add cucumbers; mix well; then 160 grains borax ; mix intimately ; allow to stand ten hours ; melt over water-bath at slowly increased heat; when melted, strain through cheese-cloth to separate cucum- bers ; place upon ice at once; when solidified pour water from underneath, and after separation of water incor- porate 160 grains more of borax. The borax develops more odor and tends to preArent decomposition of the juice while macerating, besides adding to the healing qualities of the ointment. It should not stand longer than the ten hours, for danger of fermentation starting, which would spoil the cream. More heat than is actually necessary should not be applied, for it tends to drive off some of the odor." This preparation forms an admirable bland unguent. It is often the case in acute diseases of the skin that none but the most emollient application will be toler- ated. The appreciation of this fact is of prime im- portance in treatment. In erythema simplex and in the early stage of dermatitis and in lichen planus, when the papules are numerous and attended by considerable itch- ing, cucumber ointment affords relief. It is w7ell adapted, also, to the acute form of eczema, or to infantile eczema, in which the mildest stimulant is very apt to increase the mischief. It promotes the healing of a blistered surface. Balsam of Peru Ointment. 83 Balsam of Peru Ointment. Balsam of Peru.—This aromatic contains resin, volatile oil, bezoic and cinnamic acids. Its local action is antiseptic and mildly stimulant. It forms an excellent protective dressing to wounds, and may be used either alone or mixed with a fat in such proportion as to form an unctuous mass. The irritant power of Balsam of Peru ointment recommends it as a useful application in comedo, falling of the hair, and in chilblains. It hastens reparative action in fissured nipples, bed-sores,and indo- lent ulcers. Formulary. Take of Salicylic acid,.....y drachm. Oil of juniper,.....y " Balsam of Peru ointment, . . . 1 ounce. Mix. For psoriasis, eczema of the hands and feet, and indolent ulcers. Take of Sublimed sulphur,.....y drachm. Carbonate of zinc,.....2 drachms. Extract of Indian hemp, . . . y drachm. Balsam of Peru ointment, ... 1 ounce. Mix. Valuable in chilblains, bed-sores, and in fissured nipples. Hamamelis Ointment. Hamamelis.—The astringent and sedative virtues of witch-hazel are exemplified in its local action upon con- gested or inflamed tissues. It has the power, also, of restraining excessive secretion. For this reason an ointment containing it sometimes yields good results in seborrhoea, enrsipelas, eczema, herpes, and rosacea. Witch-hazel ointment is likewise an excellent remedy in the treatment of varicose ulcers. It may be made from the extract in the proportion of 15 to 20 grains or more to the ounce of ointment. Formulary. Take of Beta-naphthol,......10 grains. Hamamelis ointment, .... 1 ounce. Mix. Employ in purpura, chronic ulcers, and in the second and third stages of rosacea. 84 Extemporaneous Ointments. Take of Oxide of zinc ointment, . . . . y ounce. Carbonate of zinc,.....1 drachm. Powdered starch,.....1 " Hamamelis ointment, .... 1 ounce. Mix. For erysipelas, the first stage of rosacea, herpes, and sub- acute eczema. Chaulmoogra Ointment. Chaulmoogra Oil.—This is a fixed oil obtained by expression from the seeds of Gynocardia odorata, an East Indian plant. The oil is of a whitish or 37ellowish- brown color, of an acid reaction, solid at ordinary tem- peratures, and melts at 107.6° F. It is soluble in alco- hol, ether, chloroform, bisulphide of carbon, and benzine. Its activity depends upon the presence of a fatty acid termed gynocardic acid. Chaulmoogra oil has been used with some success in the treatment of lepros}'. It has not shown itself able to cure the disorder, but it has in some cases delayed the progress and mitigated the symptoms. Its internal administration is conjoined. An ointment is made by mixing from 20 to 30 grains of the oil with lard, suet, lanolin, or other appropriate fatty vehicle. It is ser- viceable in eczema, particularly in the very chronic, obstinate variety. Other rebellious cutaneous affections may derive benefit from the use of this ointment. It has been employed advantageously in psoriasis and lupus. Chaulmoogra ointment has been thought also by some observers to exercise a modifying effect upon chronic constitutional disorders, such as rheumatism, scrofulosis, and even tuberculosis. The ointment has been applied with asserted good results to scrofulous enlargements, to chronic rheumatic arthritis, in pulmo- nary tuberculosis, and tabes mesenterica. Gynocardic acid has also been made into an oint- ment, 20 grains to the ounce, and substituted for the oil in the same cases. Styrax Ointment. 85 Formulary. Take of Citrine ointment,.....y ounce. Chaulmoogra ointment, . . . . y " Mix. For obstinate chronic eczema, scrofuloderma, lupus, leprosy, and tuberculosis of the skin. Take of Oil of cade,......y drachm. Ammoniated mercury, . . . .10 grains. Chaulmoogra ointment, .... 1 ounce. Mix. Use in chronic eczema, psoriasis, lichen, and scleroderma. Take of Cod-liver oil,......2 ounces. \\'itch-hazel ointment, . . . . y ounce. Chaulmoogra ointment, . . . 1 " Mix. Useful in alopecia, seborrhoea, and scrofuloderma. Styrax Ointment. Styrax.—This semi-liquid balsam is deservedly held in repute in the treatment of scabies. It possesses two advantages over man}7 of the agents employed in this disease, having a pleasant odor and being devoid of irritating properties. Its consistence renders it easily miscible with olive-oil or lard. Formulary. Take of Sublimed sulphur,.....y drachm. Styrax ointment,.....y ounce. Mix. For scabies and pediculi. Take of Calomel,.......10 grains. Creasote,.......5 drops. Styrax ointment,.....1 ounce. Mix. For scabies and pediculi. Cevadilla Ointment. Cevadilla.—An ointment made from cevadilla-seeds is sometimes used in the treatment of pediculosis capitis. While it is an efficient remedy, it possesses no advantage over the official unguentum veratrinie, since its virtues depend upon the presence of that alkaloid. Resorcin Ointment. Resorcin.—This compound was first obtained in 1864 by fusing galbanum resin with potash, and it has since 86 Extemporaneous Ointments. been obtained from other gum-resins. It is a diatomic phenol, isomeric with pyrocatechin and hydroquinone, is crystallizable, melts at 219.2° F., distills at 512.6° F., is soluble in water, alcohol, and ether, and insoluble in chloroform and bisulphide of carbon. Resorcin is an exceedingly valuable addition to the list of drugs which act topically. It arrests or prevents the processes of fermentation and putrefaction, and is deodorant and antiseptic. It consequently fulfills a host of indications. An ointment containing from 1 to 2 drachms to an ounce of lard is a ver}r good dressing to foul ulcers and sloughing wounds. It removes foetor, checks the suppurative action, and promotes cicatriza- tion. Resorcin ointment has been found useful in the treatment of open chancres or buboes, the later secondary exanthems, and ulcerated gummy tumors. Chancroids, especially of the serpiginous or phagedenic variety, are found very amenable to resorcin ointment. On account of its germicidal properties it has been employed in cer- tain infectious or mjcotic diseases. Andeer, who has devoted much study to the drug, extols it as a local application in diphtheria. He uses resorcin either by dusting the crystals upon the affected surface or in the form of a concentrated vaseline ointment. The same authority recommends an ointment of resorcin as an efficient application in affections of the vagina and neck of the womb. It is an efficient topical remedy in ery- sipelas and anthrax, and serves a good purpose in, at least, removing the offensive odor of open cancer. Vene- real warts may be cured by the daity use of an ointment containing from 50 to 80 per cent, of resorcin. It stimu- lates the absorption of inflammatory exudates, and hence is effective in chronic eczema. Resorcin ointment is an excellent remedy in all the varieties of tinea, and has Ergot Ointment 81 been successfully employed in the treatment of alopecia circumscripta. It is said to be beneficial in lupus ery- thematosus. Resorcin is but slightly irritant, and hence may often be used when many agents of the antiseptic class are contra-indicated. It possesses also the advantage of being free from odor. The white, chemically-pure drug only should be used, as those samples which have a yellowish or brownish hue are impure and valueless. It should be observed that an ointment containing resorcin will sometimes turn blue when applied to the skin. This change of color is due to contact with free ammonia or carbonate of ammonium. Formulary. Take of Carbonate of lead,.....1 drachm. Resorcin ointment, . . . . .1 ounce. Mix. For erysipelas, ulcers (especially of the venereal character), venereal warts, boils, and carbuncles. Take of Creasote,.......10 drops. Lanolin,.......y ounce. Resorcin ointment,.....y " Mix. Useful in chromophytosis, tinea capitis, barbae, and corporis; also in chronic eczema. Ergot Ointment. Ergot.—Ergot has an important range of applicability in diseases of the skin. The local effects of this substance are stimulant and astringent. The drug may be used in the form of powder, the watery extract known as ergotin, or the oil of ergot. The action of ergotin is substantiall}' the same as that of powdered ergot. The oil is decidedly irritant, and is used to stimulate the nervous, vascular, or absorbent sj'stem of the part to which it is applied. The powder or the extract is very serviceable in promoting the cure of ulcers, and may very appropriately be combined with the chlorate of 88 Extemporaneous Ointments. potassium. An ointment of ergotin, made by incorpo- rating it with a fatty basis in the proportion of 1 part of the former to 8 or 10 of the latter, is not infrequently attended by good results in rosacea. The oil of ergot is exceedingly useful in a certain class of cases. It may be employed either in full strength or diluted with lard, suet, lanolin, oxide of zinc, simple ointment, or, in fact, any suitable fatty vehicle. It is exceedingly valuable in the management of alopecia. It softens and smooths the hair and promotes the nutri- tion of the hair-bulb. Its effects are equally beneficial in seborrhoea sicca. It clears the surface of the scalp of the vitiated sebum mixed with epithelial debris, and at the same time invigorates the local circulation and glandular action. A very good oleaginous application is made by adding 1 part of oil of ergot to 4 parts of olive-oil. The nutrition of the affected tissue is pro- moted in ichthyosis by the oil of ergot. Formulary. Take of Powdered chlorate of potassium, . . y drachm. Sulphate of morphine, .... 4 grains. Sulphate of atropine, . . . . 2 " Ergot ointment,.....1 ounce. Mix. For ulcerating epithelioma and chronic ulcers. Take of Borax,.......1 drachm. Cod-liver oil,......1 ounce. Ergot ointment,.....1 " Mix. Useful in alopecia, seborrhoea, and in sycosis. Erythroxylon or Cocaine Ointment. Erythroxylon.—This is an admirable medicament, more especially in affections characterized by severe pain or distressing itching. Its activity, as is well known, depends upon the presence of the alkaloid, co- caine; but it contains, in addition, a certain proportion of tannic acid, besides resin, volatile oil, etc. An oint- Erythroxylon or Cocaine Ointment. 89 ment may be made from erythroxylon by incorporating its extract in lard in the proportion of from ^drachm to 2 drachms to the ounce. It acts as a sedative astrin- gent to irritated or inflamed surfaces, and constitutes, therefore, a proper dressing in dermatitis and acute eczema. This preparation is likewise of service in der- matalgia, herpes, and paresthesia. The virtues of erythroxylon being dependent mainly upon the alkaloid, cocaine, the latter—or rather its salt, the hydrochlorate of cocaine—should be preferred. The predominant property of cocaine is that of produc- ing local anaesthesia. Cocaine likewise exerts a powerful influence upon the blood-vessels of the part to which it is applied, constringing their calibre and reducing the circulation. It may be doubted, therefore, whether its influence is primarily upon the end-organs and terminal fibres of sensory nerves, or whether these are affected secondarily in consequence of the restricted circulation. However this may be, and it is probable that the sensory nerves are primarily and definitely affected, the analgesic power of cocaine is undoubted. Cocaine allays, also, those perversions of sensibility so common in cutaneous affections, viz., burning and itching. It therefore plays an important role as a topical ap- plication in superficial inflammations, reducing the blood- supply which maintains and the pain which results from the disease. The maladies enumerated as benefited by erythroxylon are amenable, perhaps in a superior de- gree, to unguents containing cocaine. The intolerable burning, tingling, and itching of urticaria are palliated by the same preparation. It is efficacious in the relief of the pain produced by burns. As an application to burns, coeaine hydrochlorate is preferably mixed with lanolin, since that substance itself possesses undoubted 90 Extemporaneous Ointments. virtue in the treatment of this accident. Cocaine oint- ment may, with very good results, be applied to the surface of irritable and painful ulcers. It mitigates the pain of epithelioma, particularly after ulceration has taken place, as its effect is greater than upon the un- broken skin. This same ointment is successfully em- ployed in the treatment of painful haemorrhoids. It may be used to heal excoriations which result from acrid discharges, and the fissures which are apt to occur in chronic eczema. The ointment of Irydrochlorate of cocaine may be made of a strength from 4 to 8 or 10 grains to the ounce. Erythroxylon ointment, on account of its astringent and slightly stimulant action, is sometimes an efficient application in acne and rosacea. Formulary. Take of Carbonate of lead, . Sulphate of morphine, Sulphate of atropine, Powdered arrow-root, Erythroxylon or cocaine ointment, Mix. Serviceable in epithelioma, and in all painful ulcers, burns, and paraesthesise. Take of Bicarbonate of sodium, ... .1 drachm. Powdered starch,.....1 " Creasote, ....... 5 drops. Erythroxylon or cocaine ointment, . . 1 ounce. Mix. For burns, urticaria, erythema, herpes zoster, and chronic eczema. Hydrastine Ointment. Hydrochlorate of Hydrastine.—This salt is slightly stimulant and antiseptic. From 5 to 30 grains rubbed up with an ounce of lard, or other unguent, forms a salve which is useful in allaying the odor produced by foul, unhealthy, or sloughing ulcers, chronic leg-ulcers, or ulcerated carcinoma. It stimulates scrofulous and varicose ulcers to repair. It promotes the cure of 1 drachm. 2 grains. 1 grain. 1 drachm. 1 ounce. Cade Ointment. 91 cracked nipples, and is a good application to chancroids. Chronic eczema often receives benefit from the use of this preparation. It checks the excessive discharge in hyperidrosis, and is serviceable in acne and seborrhoea. The compound under consideration, indeed, exerts a distinctive, individual action upon the perspiratory and sebaceous glandulae. Formulary. Take of Ergotin,.......]4 drachm. Carbonate of magnesium, ... 1 Hydrastine ointment, .... 1 ounce. Mix. For hyperidrosis, acne, and seborrhoea. Take of Borax,.......K drachm. Hydrastine ointment, .... 1 ounce. Mix. Use in chronic ulcers, cracked nipples, and chancroids. Cade Ointment. Oil of cade—Oleum cadini—is a tarry liquid obtained by distillation from juniper-wood. It is readily made into an ointment with any suitable fatty material in the strength of 1 drachm or more to the ounce. It is well adapted to the treatment of the chronic form of eczema. In the proportion of 4 drachms to the ounce it is a serviceable application in psoriasis. In lichen, also, its employment has been attended with good results. In the chronic stage of sycosis it is found beneficial. The oil of cade possesses germicidal prop- erties, in virtue of which its ointment is employed in tinea circinata, and is often combined with sulphur in the treatment of scabies. It is used, either alone or combined, in cases of prurigo. Formulary. Take of Sublimed sulphur,.....1 drachm. Cade ointment,.....1 ounce. Mix. Use in scabies, psoriasis, and chronic eczema. Take of Citrine ointment,.....Vi ounce. Camphor,......10 grains. Cade ointment,.....y ounce. Mix. Employ iu sycosis, lichen, and tinea circinata. 92 Extemporaneous Ointments. Pyrogallic Acid Ointment. Pyrogallic Acid.—This substance is a triatomic phe- nol, and is obtained in the decomposition of gallic acid by heat. It occurs in the form of white scales, is odorless, bitter to the taste, very slightly soluble in water, but freely soluble in alcohol and ether. It fuses at 239° F. and sublimes at 410° F. It is a powerful escharotic, and an ointment should not usually be made to contain more than 10 per cent. Pyrogallic acid ointment should never be spread over extensive areas of surface, and its effect should be carefully watched. Otherwise, it is apt to produce sloughing of tissue, and may even cause grave constitutional symptoms from absorption. In the strength already indicated, pyrogallic ointment forms an excellent application to previously-denuded patches of psoriasis. It gives rise to a brownish stain upon any surface with which it comes in contact. An ointment containing 1 or 2 drachms of pjTOgallic acid to the ounce is an excellent application in lupus vulgaris. In about three days' use a black eschar forms. The raw surface is then dressed with any soothing ointment, and in time a smooth scar is the result. The same method is applicable in epithelioma, and is sometimes successful in removing all the diseased tissue. A much weaker ointment—15 grains to the ounce—is destructive to the tricophyton fungus. Formulary. Take of Hydrochlorate of cocaine, ... 4 grains. Sulphate of morphine, . . . . 2 " Pyrogallic acid ointment, . . . y ounce. Mix. Use in circumscribed chronic eczema and psoriasis, and in limited spots of lupus vulgaris. Take of Creasote,.......5 drops. Powdered starch,.....1 drachm. Pyrogallic acid ointment, . . • y ounce. Mix. For epithelioma, small ulcers, limited spots of rosacea, and ringworm. Naphthalin Ointment. 93 Naphthalin Ointment. Naphthalin.—This is a derivative of coal-tar obtained by distillation, passing over after the coal-naphtha. It is a white, shining, crystalline substance, soluble in alcohol, ether, and chloroform, but insoluble in water. It is an efficient antiseptic and usefully employed, made into an ointment, in many cutaneous diseases and lesions. Spread upon the surface of indolent ulcers it stimulates cicatrization. Naphthalin ointment may be used as a detergent upon ulcerated carcinomata, and is a good application to chancres, chancroids, and syphilitic ulcers. It serves a good purpose in the treatment of sloughing wounds, and is well adapted for use in chronic eczema and psoriasis. The ulcers of leprosy are occasionally benefited by a strong ointment of naphthalin. Naphthalin being non-irritant, may be combined with a fatty basis in the proportion of | drachm to the ounce and upward, according to the indications of the case. It is not harmful if absorbed. Formulary. Take of Subiodide of bismuth, . . . .10 grains. Carbonate of zinc,.....1 drachm. Naphthalin ointment, .... 1 ounce. Mix. For chancres, chancroids, and syphilitic ulcers. Take of Calomel,.......10 grains. Oxide of zinc ointment, . y ounce. Naphthalin ointment, . . . . y " Mix. Use in indolent ulcers, leprosy, and chronic eczema. Naphthol Ointment. Beta-naphthol is derived from naphthalin. " The usual method of manufacture is as follows : Naphthalin and sulphuric acid are heated together for several hours, the mixture poured into a large quantity of hot water, the excess of the naphthalin filtered off, and the solution saturated with lead carbonate. On evaporation the beta- 94 Extemporaneous Ointments. salt c^stallizes out first, the alpha-salt last. The for- mer is soluble in boiling alcohol, the latter is not; hence they are easily separated. From these lead-naphthalin sulphonates the respective acids are prepared, and from the acids fused with an alkali two naphthols are made, —the alpha and beta,—and these are the only possible, naphthols." * It occurs as colorless scales, or as a white crystalline powder, melts at 253.4° F., is soluble in 75 parts of boiling water, is readily soluble in alcohol, ether, and chloroform. Naphthol is one of the most valuable additions to our list of resources. Its range of application is very wide. It is detergent, deodorant, and antiseptic, is compara- tively unirritant, and, according to Professor Bouchar- dat's investigations, absolutely safe, as it would require nearly ^ pound of it, taken internally, to produce fatal results in a healthy person weighing 150 pounds. Naph- thol has five times the antiseptic power of carbolic acid, four times that of creasote, three times that of iodoform, four times that of naphthalin. Naphthol is a local anaesthetic and antipruritic. These, combined with its germicidal properties, render it of thera- peutic value in parasitic, infectious, and inflammatory dis- eases of the integument. In the strength of ^ drachm to the ounce of lard it is destructive to the pediculi and their ova, whether they infest the trunk, the scalp, or the pubis. Naphthol ointment is curative in the various forms of tinea dependent upon the development of the tri- chophyton fungus. It is no less efficient in scabies. An ointment may be made of any desired strength, and thus suited to the various circumstances of the age or sex of * Mr. Louis Genois, Medical Times, June 15, 1888; Medical Bulletin, June, 1889. See paper by author, "Further Observations on Beta-Naphthol," Therapeutic Gazette, October, 1889. Naphthol Ointment. 95 the patient, the delicacy of the skin, the variety and ex- tent of the secondary lesions. It proves, in fact, at once destructive to the parasite and soothing to the in- flammation produced by scratching. Twenty grains of naphthol to the ounce of ointment afford great relief in paraesthesia or pruritus wherever manifested. It is, like- wise, an excellent local remedy in urticaria. Pemphigus is accompanied by an itching which is frequently intense, and in which naphthol ointment is found one of the most successful applications. The itching of prurigo is re- lieved by the same treatment. Naphthol ointment serves a double purpose in chronic eczema, relieving the itching caused by the disease and stimulating the ab- sorbent vessels to remove the exudation. This agent is particularly indicated when the skin is rough and in- filtrated. In the proportion of 1 or 2 drachms to the ounce of ointment, naphthol is one of our most relia- ble medicaments in psoriasis. It is devoid of the strong odor of tar, and does not communicate a stain to every- thing with which it comes in contact. Naphthol exerts a corrective influence upon the secretory functions of the skin. It diminishes the excessive flow in hyperidrosis, while the offensive odor of bromidrosis is destro}red by the same means. An unguent containing 10 grains of naphthol to the ounce is a good stimulant application in acne. It is of advan- tage, also, in S3rcosis, either alone or added to some more stimulant preparation. One drachm of naphthol to the ounce of lard is an effective remedy in falling of the hair and in alopecia circumscripta. In lupus ery- thematosus success has followed the use of an ointment containing from 10 to 50 grains of naphthol to the ounce. The same preparation has been of advantage in lupus vulgaris. 96 Extemporaneous Ointments Formulary. Take of Boric acid,......1 drachm. Naphthol ointment, .... 1 ounce. Mix. For hyperidrosis, bromidrosis, and in vegetable and ani- mal parasitic diseases of the skin. Take of Oil of eucalyptus,.....10 drops. Calomel,.......10 grains. Naphthol ointment, .... 1 ounce. Mix. Beneficial in acne, rosacea, sycosis, and lupus erythema- tosus. Take of Citrine ointment,.....y ounce. Oil of chamomile,.....5 drops. Naphthol ointment, . . . y ounce. Mix. Use in alopecia, prurigo, urticaria, and chronic eczema. Take of Ergotin,.......1 drachm. Venice turpentine,.....1 scruple. Naphthol ointment, .... 1 ounce. Mix. For alopecia, acne, rosacea, and sycosis. Take of Iodide of sulphur,.....y drachm. Naphthol ointment, .... 1 ounce. Mix. For hyperidrosis, bromidrosis, chronic eczema, and pso- riasis. Thymol Ointment. Thymol.—Thymomas defined by the British Pharma- copoeia, is " a stearopten obtained from the volatile oil of Thymus vulgaris, Linn.; Monarda punctata, Linn.; and Carum ajowan, Benth. and Hook., by saponifying with caustic soda and treating the separated soap with hydrochloric acid, or from a distilled fraction of the oil by exposure at a low temperature. It may be purified by re-crystallization from alcohol." It forms " laro-e crystals of the hexagonal system, having an aromatic, thyme-like odor, a pungent, aromatic taste, .... and a neutral reaction. Soluble in ab#ut 1200 parts of water and 1 of alcohol, at 15° C. (59° F.); in 900 parts of boiling water ; freely soluble in boiling alcohol; also in ether, chloroform," etc.* Its chemical composition * United States Pharmacopoeia. Ichthyol Ointment. 97 is analogous to that of carbolic, salicylic, benzoic acids, and creasote, and, like those substances, thymol pos- sesses distinct antiseptic powers. It unites with alka- lies to form soluble salts. It is a mild caustic. It impairs the function of the end-organs of sensory nerves. It acts beneficially upon the diseased patches in psoriasis, and is a more elegant remed}' than the tar or sulphur preparations, on account of its agreeable odor and absence of color. Twenty grains of thymol to the ounce constitutes an effective ointment in tinea circinata. The stimulant effect of a weaker combination is of ser- vice in comedo, acne, and alopecia circumscripta. Formulary. Take of Oxide of zinc ointment, . . . y ounce. Oil of rose,......2 drops. Thymol ointment,.....y ounce Mix. For acne, rosacea, and hyperidrosis. Take of Sublimed sulphur,.....y drachm. Thymol ointment,.....1 ounce. Mix. Use in tinea circinata, alopecia, and sycosis. Ichthyol Ointment. Ichthyol.—This complex body is derived from the dry distillation of a bitumen found in the Tyrol, and which contains fossil fish. The distillate is treated with sulphuric acid, and then neutralized with either sodium or ammonium carbonate. According to the alkali made use of, the resulting substance is designated as the ichthyol-sulphonate of sodium or of ammonium. It is the former compound which I have employed. This is a semi-liquid substance, resembling tar in appearance, having a gas-like odor, of an alkaline reaction, and per- fectly soluble in water. It contains from 10 to 15 per cent, of sulphur, readily mixes with fatty substances, and is used from a 5- to a 30-per-cent., or even 50-per- cent, ointment. It seems to combine the therapeutic 5 E 98 Extemporaneous Ointments. virtues of tar and sulphur. Ichthyol ointment is moder- ately irritant to the healthy integument, but in the chronic diseases of the skin, in which it is generally used, it is usually devoid of irritant qualities. It is possessed of peculiar penetrative powers. An ointment containing ichthyol is a suitable appli- cation in those cases of acne which require stimulation. It is a good dressing to frost-bitten and burnt surfaces and to many varieties of ulcers. Chancroid, ulcerated bubo or lymphatic gland, as well as the ulcers of the leg so common in old and broken-down people, are amenable to the influence of this drug. The ulcerations of lupus vulgaris will often cicatrize under its employment. Good results have been reported from its use in lepra. Chronic eczema will usually amend, in consequence of the improved condition of the vascular and absorbent systems induced by ichth}rol. It diminishes the tingling and smarting of urticaria. In chronic urticaria Unna conjoins the internal with the external use of ichtli37ol. A weak preparation is curative in erythema intertrigo. A 35- or 50-per-cent. ointment of ichthyol is one of the measures upon which we may place reliance in the management of psoriasis. The same treatment has some- limes been attended with success in some of the most chronic forms of cutaneous disease. Lichen ruber and lichen planus are ameliorated, and rosacea frequently manifests great improvement by the use of ichthyol ointment. The prognosis of keloid, either as regards absorption of the new growth or its recurrence after operation, is very unfavorable, yet it does sometimes happen that absorption seems to be promoted by the remedial agents emplo)red, among which may be ranked ichthyol ointment. The congenital hypertrophy of the skin denominated ichthyosis is in its nature incurable. Ichthyol Ointment. 99 Nevertheless, it is of advantage to soften, as far as possible, the diseased tissue and to remove the epithe- lium which accumulates in masses upon the surface. After a preliminary hot-water, hot-air, or vapor bath, inunction with ichthyol exerts an emollient effect. An ichthyol ointment has been found of service in acute inflammatory rheumatism. Dr. Lorenz, a German military surgeon, has derived marked benefit from ichthyol in the treatment of wounds, contusions, and deep loss of tissue. He has used it both in solution and in ointment form. After the parts have been cleansed with soap and water and dried, the ointment is rubbed in and soon disappears. The part is then cov- ered with a layer of cotton and a roller bandage applied. He found that pain and swelling rapidly subsided after a few inunctions. Acute coryza and inflammation of all kinds, involving the mucous membrane and the skin of the nose, are greatly relieved by an ointment con- taining from 1 to 10 per cent, of ichthyol. It is esteemed by Nussbaum as of great utility as a local application in erysipelas. Dr. Joseph Schmidt, of Ber- lin, has related the particulars of a case in which a fatty tumor was removed by the external use of ichthjTol. A healthy medical student, 25 j'ears of age, had been afflicted for eight years with a lipoma of the neck, situ- ated directly over the carotid artery. A 50-per-cent. solution was rubbed in for ten successive days. On the fourth and fifth days it was evident that the growth had begun to diminish in size. On the ninth day it was greatty reduced, and a focus of suppuration made its appearance. The pus was evacuated, and the sides of the cavity drawn together by ichthyol plaster. By the twelfth day the wound had healed and no sign of a tumor remained. 100 Extemporaneous Ointments. Formulary. Take of Ammoniated mercury, . . . .10 grains. Camphor,.......10 " Ichthyol ointment,.....1 ounce. Mix. For chronic eczema, psoriasis, lichen, keloid, scais, and lupus vulgaris. Take of Subnitrate of bismuth, .... 1 drachm. Ichthyol ointment,.....1 ounce. Mix. Useful in chancre, chancroids, and old ulcers. Take of Prepared calamine,.....1 drachm. Iodol,.......1 scruple. Ichthyol ointment,.....1 ounce. Mix. For indurated acne, second and third stages of rosacea, and in chronic sycosis. Iodol Ointment. Iodol, or, in chemical nomenclature, tetraiodopyrol, is a yellowish-brown, crystalline substance, soluble in alcohol, almost insoluble in water ; soluble in chloroform and fatty oils and in 3 parts of absolute ether. It is destitute of odor or taste. It is prepared from Dippel's animal oil. This is first purified and then treated with a solution of iodine in iodide of potassium. The tetraiodide, or iodol, is precipitated, is purified by redissolving it in hot alcohol and again precipitating it by the addition of water. Nearly 80 per cent, of iodine enters into the composition of this substance. Iodol possesses considerable antiseptic power and has been used as a substitute for iodoform, over which it has the advantage of freedom from disagreeable odor. Iodol is much less apt to produce constitutional sjTmp- toms than iodoform on account of being a less active poison and also being much less rapidly absorbed. It may be compounded with any desired unguent in the proportion of 10 grains and upward to the ounce. Iodol ointment promotes the healing of ulcers (common or syphilitic), lupus, and ulcerated impetigo. It has Iodol Ointment. 101 been thought by some to have antisyphilitic virtue, and has been administered internally, as well as applied di- rectly to the lesions produced by the disease. What- ever efficiency iodol manifests depends upon the iodine present. It is a serviceable application to chancroid, chancre, and to the ulcers of every stage of syphilis. Half a drachm of iodol to the ounce of lard, lanolin, oxide of zinc ointment, or other bland fatty material, is an excellent dressing in scrofuloderma. Its prompt employment tends to limit the extent of unsightly cica- trices produced by this affection. Being destructive to the pathogenic germs of inflammation, iodol is a useful medicament in furuncle or carbuncle. It may be applied alone or in combination with another drug or drugs hav- ing the same action. If acute inflammation results in the formation of an ulcer, the work of repair is assisted by spreading an ointment of iodol upon the raw surface. A weak ointment of this drug is a beneficial external application in variola, mitigating the severity of the eruption. Its germicidal power is sufficient to render it one of the substances to be used in the treatment of tinea tonsurans. We may also resort to iodol in pso- riasis in order to relieve and modify the course of the disease. Formulary. Take of Extract of cinchona, .... 1 drachm. Oxide of zinc ointment, . . . y ounce. Iodol ointment,.....y '< Mix. For syphilitic and scrofulous ulcers, lupus, chancre, and chancroids. Take of Resin ointment,.....y ounce. Iodol ointment,.....y << Mix. Valuable in boils, carbuncles, ulcers, and enlarged glands. Take of Powdered chlorate of potassium, . . y drachm. Iodol ointment,.....y ounce. Mix. Useful in epithelioma, lupus, impetigo, and chronic ulcers. 102 Extemporaneous Ointments. In addition to those unofficial substances of vege- table orioin and those obtained in the distillation of coal-tar, a number of metallic salts are frequently used in ointment form. The principal extemporaneous prep- arations are those of bismuth, lead, mercury, and zinc. Occasionally alum is incorporated in an ointment. SUBNITRATE OF BISMUTH OINTMENT. Bismuth subnitrate is probably more frequently employed as an ointment than any other metallic combi- nation not prescribed by the Pharmacopoeia. It is, in fact, an admirable local remedy, being a mild astringent, a sedative, and an antiseptic. This combination of qualities renders it specially adapted to the relief of a congestive, irritative, or inflamed condition of the superficial parts Being an innocuous substance, the subnitrate of bis- muth may be made into an ointment in the strength of a drachm or more to the ounce, the only limit being the pharmaceutical problem of how much bulky powder may be incorporated into a fatty material with the preservation of an unctuous consistence. Bismuth oint- ment is all the local treatment demanded in erythema simplex. It is almost equally efficient in erythema inter- trigo, in the first stage of dermatitis, as well as in the erythematous and bullous varieties of burns. It is a pleasant emollient to place upon a blistered, abraded, or excoriated surface. Ulcers usually require more power- ful remedies, but in the condition known as irritable ulcer bismuth ointment serves a good purpose in mod- erating the excessive sensibility of the terminal nerve- fibrils. Bismuth ointment is soothing to the raw sur- face left after rupture of the bullae of pemphigus. It is a favorite and excellent application in erysipelas, especially the so-called facial erysipelas. Chancroids, Subiodide of Bismuth Ointment. 103 if the inflammatory action be not extreme, heal well under the use of this preparation. It is often serviceable in herpes, and is of particular value in acute eczema. This variety of the affection is, as a rule, aggravated by any but the most gentle remedies. The bismuth oint- ment, a drachm to the ounce, usually commends itself in this disease. It is of benefit, likewise, in infantile eczema in which harsh measures are contra-indicated. Eczema differs extremely in different individuals, under different surroundings, and even in different portions of the body. It is modified in its manifestation or course according to these various circumstances. The dis- ease, as it appears upon the face, neck, scalp, or ears, is more particularly susceptible to the influence of this unguent. Formulary. Take of Creasote,.......6 drops. Powdered arrow-root, .... 1 drachm. Subnitrate of bismuth ointment, . . 1 ounce. Mix. For acute eczema, erythema, burns, irritable ulcers, ery- sipelas, and chancroids. Take of Oxide of zinc ointment, . y ounce. Beta-naphthol,......5 grains. Subnitrate of bismuth ointment, . . y ounce. Mix. Serviceable in infantile eczema, dermatitis, and burns. Subiodide of Bismuth Ointment. The subiodide of bismuth was brought into notice by Dr. A. S. Reynolds. Subsequently Dr. Chassaignac reported very favorably of its action in the New Orleans Medical and Surgical Journal for August, 1877. The costliness of subiodide of bismuth at first prevented it from coming into extensive use, but that objection has since disappeared. It is a brick-red powder, almost odorless and tasteless; insoluble in water,alcohol, ether, or chloroform. It is non-irritant, and, in fact, appears to be a local anaesthetic antiseptic, and will not stain 104 Extemporaneous Ointments. the skin or apparel. When dusted upon the skin, sub- iodide of bismuth produces a thin film. It may be used in powder form or incorporated into an ointment. Subiodide of bismuth checks inflammation and suppu- ration, promotes cicatrization, disinfects unhealthy se- cretions, and discharges and promptly removes their offensive odor. It consequently proves an admirable dressing to simple or syphilitic ulcers, open buboes, unhealthy wounds, phlegmonous erysipelas, chancres, chancroids, etc. Formulary. Take of Chrysarobin,......y drachm. Subiodide of bismuth ointment, . . y ounce. Mix. For chancre, rosacea, and chronic acne. Take of Beta-naphthol,.....5 grains. Subiodide of bismuth ointment, . . y ounce. Mix. Useful in syphilitic ulcers, open buboes, and chancroids. Nitrate of Lead Ointment. Nitrate of lead possesses the sedative and astringent properties common to the plumbic combinations gener- ally. Its indications, therefore, are similar to those of the official carbonate of lead ointment. An extempo- raneous ointment may be prepared by adding from 5 to 10 grains of the nitrate to an ounce of lard, or other fat, and mixing thorough^. Erythema, dermatitis, burns, blisters, and excoriations are benefited by the use of this ointment. It promotes the healing process in ulcers, though its effects need to be closely watched, if applied to a large, open surface, for fear of lead poison supervening upon absorption. Nitrate of lead ointment often affords relief to pruritus ani or pudendi, provided this be not dependent upon organic affections of the rectum or urethra. It is an efficient application to fissured nipples and palliates the pain caused by fissure of the anus. Alum Ointment. 105 Formulary. Take of Extract of conium, . y drachm Carbonate of zinc,.....1 " Camphor,......5 grains. Nitrate of lead ointment, . . . y ounce. Mix. For pruritus ani and pudendi, Assured nipples, and ulcers. Take of Borax,.......1 drachm. Powdered starch,.....1 " Oxide of zinc ointment, . . . . y ounce. Nitrate of lead ointment, . . . y " Mix. For dermatitis, erythema, burns, and excoriations. Alum Ointment. Alum.—This cauterant and decidedly astringent sub- stance is sometimes used in ointment form in from 5 to 60 grains to the ounce of fatty vehicle. Alum ointment not infrequently affords relief in herpes. In purpura its local astringent action is sometimes found beneficial, while in bromidrosis it is successful in overcoming the offensive odor characteristic of the affection. Formulary. Take of Sublimed sulphur,.....1 drachm. Carbolic acid,......5 grains. Alum ointment,.....1 ounce. Mix. For hyperidrosis, bromidrosis, herpes, and purpura. TakeofSalol,.......1 scruple. Oil of chamomile,.....8 drops. Alum ointment,.....1 ounce. Mix. Useful in acne, rosacea, and seborrhoea oleosa. Corrosive Sublimate Ointment. The bichloride of mercury or corrosive sublimate is sometimes employed in ointment form, and is highly irritant or even escharotic when undiluted. It is one of the most powerful antiseptic agents we possess. A weak ointment fulfills some valuable purposes. In the pro- portion of 3 grains to the ounce it is a serviceable parasiticide, and may be used to destroy the tricho- phyton fungus and the pediculus pubis. It may be 5* 106 Extemporaneous Ointments. used in conditions of the unbroken skin where a strongly stimulant ointment is calculated to be of benefit. An ointment containing 2 or 3 grains to the ounce will sometimes be found of avail in acne. A preparation in which from 2 to 5 grains of corrosive sublimate is mixed with an ounce of lard is an effective application in freckles. Five grains to the ounce of ointment may be applied with good results to ulcerated lupus vulgaris. The bichloride ointment should not be employed upon extensive ulcerated surfaces on account of the danger of absorption. It may be used upon ulcerated epithelioma. Syphilitic ulcers also improve under its application in the strength of about 2 grains to the ounce. Formulary. Take of Beta-naphthol,.....10 grains. Oxide of zinc ointment, . y ounce. Corrosive sublimate ointment, . . y " Mix. Valuable in animal and vegetable parasitic affections, as 6cabies, pediculi, tinea capitis, tinea barbae, and tinea circinata. Take of Carbonate of zinc,.....1 drachm. Creasote,.......5 drops. Iodol,.......1 scruple. Corrosive sublimate ointment, . . 1 ounce. Mix. For syphilitic ulcers, lupus vulgaris, and epithelioma. Sulphate of Zinc Ointment The sulphate of zinc is a stimulant and astringent salt not infrequently incorporated into an ointment, in from 2 to 30 grains to the base, and applied to ulcerations either simple or specific. Sulphur of zinc ointment may be applied to chancroids, open chancres, and the various ulcerated lesions of late syphilis. It is also deodorant in bromidrosis. Formulary, Take of Subnitrate of bismuth, .... 1 drachm. Glycerin,......2 drachms. Sulphate of zinc ointment, . . .1 ounce. Mix. For chancres, chancroids, and syphilitic ulcerations. Sulphate of Zinc Ointment. 107 Take of Boric acid,......y drachm. Salicylic acid,......y " Lanolin,.......jounce. Sulphate of zinc ointment, . . . y " Mix. Serviceable in seborrhoea oleosa, and in eczema of the head, hands, and feet. The modification of strength and the combination of remedies in order to form compound ointments are practically endless. In the application of local remedies as ointments, just as in the administration of solutions, we seek to supplement or to moderate the effect of one agent by that of another. The stage of the disease, the age and sex of the patient, and the susceptibility of the skin are circumstances which suggest various deviations from the official formulae. In the formulary of extemporaneous ointments, whether organic or inorganic substances, an average strength is to be understood by the reader. Thus, when in a formula, resorcin, iodol, thymol, ichthyol, alum, corrosive sublimate, or sulphate of zinc ointment is mentioned, though it is true that there is no official strength ordained, yet the quantities applicable in dif- ferent conditions have in each case been given in the text. The physician, therefore, may frame his prescrip- tion in accordance with those directions. CHAPTER V. OINTMENTS OFFICIAL IN THE GERMAN PHARMACOPCEIA.* In order to furnish a complete summary of approved formulae for ointments in use throughout the civilized world, I have selected the official directions for this class of preparations from several other foreign Phar- macopoeias. The German are twenty in number, as follow :— Basilicon Ointment. Unguentum Basilicum. K6nigssalbe. Ceratum Resinae, Resin Cerate, U.S.P. Common olive-oil, forty-five parts,.....45 Yellow wax, fifteen parts,.......15 Resin, fifteen parts,........15 Mutton-suet, fifteen parts,.......15 Common turpentine, ten parts,......10 It should have a yellowish-brown color. This prep- aration corresponds closely to the resin cerate of the United States and the resin ointment of the British Pharmacopoeia. It is used to fulfill the same indications. Cantharidal Ointment. Unguentum Canthariduin. Spanischfiiegensalbe. Cantharides, coarsely powdered, two parts, . . .2 Olive-oil, eiglit parts,........8 Digest them for ten hours on a steam-bath, express and filter the oil. Prepare the ointment with— Filtered oil, seven parts,.......7 Yellow wax, three parts,.......3 Cantharides ointment should have a yellow color. This ointment is used for the purpose of producing * Pharmacopoeia Germanica, editio altera. German Pharmacopoeia, second edition. 1883. Translated by C. L. Lochmaii. (109) 110 Ointments Official in the German Pharmacopoeia. vesication. It is intermediate in strength between the ceratum cantharides of our own pharmacopoeia and the unguentum cantharidis formerly but not now official. Wax Ointment. Unguentum Cereum. Wachssalbe. Prepare it from— Olive-oil, seven parts,........7 Yellow wax, Ihreeparts,.......3 This ointment should have a yellow color. Wax ointment is of a demulcent nature, and is useful like- wise as a basis for extemporaneous preparations. It may be employed wherever a bland, soothing application is indicated. Carbonate of Lead Ointment. Unguentum Cerussae. lileiweissalbe. Unguentum Plumbi Carbonatis, U. S. P. Prepare it from— Carbonate of lead, three parts,......3 Paraffin ointment, seven parts,......7 A very white ointment. This is comparable to our ointment of carbonate of lead, though of thrice the strength. It is applicable to the same class of cases,— burns, scalds, blisters, herpes zoster, pemphigus, acute eczema, dermatitis, erythema simplex, erythema inter- trigo, and erysipelas. Camphorated Carbonate of Lead Ointment. Unguentum Cerussae Camphoratum. Campherlialtige Bleiweissalbe. Prepare it from— Ointment of carbonate of lead, ninety-five parts, . . 95 Camphor, powdered, five parts,......5 A white ointment, having the odor of camphor. The presence of a small proportion of camphor communi- cates decided desiccant and anodyne properties to this preparation. It is, therefore, peculiarly adapted to the Diachylon Ointment. Ill treatment of acute and subacute eczema and paraes- thesia. It is applicable as well to the acute inflam- matory affections of the skin in which the ointment of the carbonate of lead is useful. Diachylon Ointment. Unguentum Diachylon. Diachylonsalbe. Lead-plaster, five parts,.......5 Free it from glycerin by washing Avith water; then, after allowing the water to evaporate on a water-bath, add— Olive-oil, five parts,........5 and melt them together, at a gentle heat, on a water- bath ; then stir the mixture until it is cold. Having allowed the finished ointment to stand for a few hours, stir it again. Diachylon ointment is nearly white. This approxi- mates very closely the composition of our official diachylon ointment, than which it contains a slightly smaller proportion of lead-plaster. Its indications are identical with those of the unguentum diachylon of the United States Pharmacopoeia. Glycerin Ointment. Unguentum Glycerini. Glycerinsalbe. Tragacanth, powdered, one part,.....1 Alcohol, five parts,........5 Rub them together, add— Glycerin, fifty parts,........50 and heat the mixture on a steam-bath. A white, translucent ointment of a uniform consist- ence. Combined and stiffened with tragacanth, a muci- laginous demulcent, glycerin ointment forms,—an ele- gant and admirable application in erythema, herpes, acute eczema (especially in children), dermatitis, etc. 112 Ointments Official in the German Pharmacopoeia. Ammoniated Mercury Ointment. Unguentum Hydrargyri Album. Weisse ojuecksilbersalbe. Unguentum Hydrargyri Ammoniatum, U. S. P. Prepare it from— Ammoniated mercury, one part,.....1 Paraffin ointment, nine parts,......9 A white ointment. This contains the same propor- tion of ammoniated mercury as the corresponding prepa- ration of the United States Pharmacopoeia, the former being made with paraffin ointment, the latter with ben- zoinated lard. Their indications, consequently, are identical. Red Oxide of Mercury Ointment. Unguentum Hydrargyrum Rubrum. Rothe Ojuecksilbersalbe. Unguentum Hydrargyri Oxidi Rubri, U. S. P. Prepare it from— Red oxide of mercury, one part, ..... 1 Paraffin ointment, nine parts,......9 A red ointment. The German and American ointments are of the same strength, though prepared by the aid of different vehicles. Their applications, therefore, are the same. Mercurial Ointment. Unguentum Hydrargyri Cinereum. Graue Ojuecksilbersalbe. Unguentum Hydrargyri, U. S. P. Lard, thirteen parts,........13 Mutton-suet, seven parts,.......7 Melt them together at a gentle heat, and, when cold, take 3 parts of the mixture and rub it in an iron capsule with— Mercury, ten parts,........10 Add the mercury in small portions at a time, wait- ing after each addition until no more globules of mer- cury are visible to the naked eye. Finally, add the remainder of the fatty mass and mix intimately. A bluish-gray ointment in which no globules of Iodide of Potassium Ointment. 113 mercury can be seen by the naked eye. Three grammes of the ointment, after the removal of the fat by ether, should yield nearly a gramme of mercury. The Ameri- can contains a larger proportion of mercury (50 per cent.) than the German preparation (33^ per cent.). They may, however, be used interchangeably. Iodide of Potassium Ointment. Unguentum Kali Iodati. Kaliiimjodidsalbe. Unguentum Potassii Iodidi, U. S. P. Iodide of potassium, tioenty parts,.....20 Water, ten parts,........10 Dissolve and mix with— Paraffin ointment, one hundred and seventy parts, . . 170 A white ointment. The American ointment contains a slightly higher per- centage of the salt than the German. The two preparations, however, have precisely the same range of application. Rose-water Ointment. Unguentum Leniens. Unguentum Aquae Rosae, U. S. P. Prepare it from— White wax, four parts,.......4 Spermaceti, five fiarts,.......o Expressed oil of almond, thirty-two parts, . . .32 Water, sixteen parts, ........ 16 To 50 grammes of the ointment add 1 drop of oil of rose. Cold cream is a soft and white ointment. This is substantially the same preparation as our rose-water ointment, differing slightly in the proportion of the ingredients. It is used for the same purposes as an emollient and a vehicle. Paraffin Ointment. Unguentum Parafnni. Paraffinsalbe. Vaselinum, vaseline. Prepare it with— Solid paraffin, one part,.......1 Liquid paraffin, four parts,......4 114 Ointments Official in the German Pharmacopoeia. The mixture should be white, translucent, and of the consistence of an ointment, interspersed with small crystals when examined under the microscope, and should melt between 35° and 45° C. (95° and 113° P.). This substance forms, it is true, an excellent oint- ment-basis from a purely pharmaceutical point of view. It is open, however, to the objection that it does not permeate the skin. This subject has been discussed with detail in the latter portion of the work. Subacetate of Lead Ointment. Unguentum Plumbi. Bleisalbe. Ceratum Plumbi Subacetatis, U. S*. P. Prepare it from— Lard, ninety-two parts, . . ..... 92 Solution of subacetate of lead, eight parts, ... 8 A white ointment. This preparation is analogous to our ceratum plumbi subacetatis and the unguentum glycerini plumbi sub- acetatis of the British Pharmacopoeia. Like them, it is an excellent dressing to burns, scalds, blisters, herpes, dermatitis, etc. Tannate of Lead Ointment. Unguentum Plumbi Tannici. Tannin-Bleisalbe. Tannic acid, one part,.......1 Solution of subacetate of lead, two parts, .... 2 Rub them to a smooth paste; then prepare an oint- ment by mixing the paste with— Lard, seventeen parts, ........17 The ointment has a slight 3-ellowish color. It should be prepared only when ordered. The combination of tannic acid confers additional astringency upon this preparation. It is a useful ap- plication to indolent ulcers, internal haemorrhoids, sore nipples, bed-sores, chilblains, etc. Compound Rosemary Ointment. 115 Compound Rosemary Ointment. Unguentum Rosmarini Compositum. Rosmarinsalbe. Lard, sixteen parts,........16 Mutton-suet, eight parts,.......8 Yellow wax, two parts,.......2 Expressed oil of nutmeg, twoparts,.....2 Mix and add to the finished ointment— Oil of rosemary, one part,.......1 Oil of juniper-berries, one part,.....1 The ointment has a yellowish color. The stimulant properties of the volatile oils, especially that of rosemary, render this preparation a local irritant, and as such it is used for the purpose of relieving the pain of neuralgia, chronic rheumatism, lumbago, etc. It will also promote the healing of ulcers. Savine Ointment. Unguentum Sabinae. Sabinasalbe. Prepare it from— Extract of savine, one part,......1 Wax ointment, nine parts,......9 Savine ointment should have a brown color. A savine cerate is official in the United States Phar- macopoeia and a savine ointment in the British Pharma- copoeia. Both are of greater strength than the German preparation. The latter, therefore, is considerably less irritant. It may, however, be used with the object of maintaining a blister. Tartar Emetic Ointment. Unguentum Tartar! Stibiati. Brechweinsteinsalbe. Prepare it from— Tartrate of antimony and potassium, twoparts, . . 2 Paraffin ointment, eight parts,......8 A white ointment. This is of the same strength as the unguentum antimonii formerly official in the United States Pharma- 116 Ointments Official in the German Pharmacopoeia. copceia, paraffin ointment being used as a base instead of lard. The remarks upon the use of the American apply exactly, therefore, to the German preparation. Turpentine Ointment. Unguentum Terebinthinae. Terpenthinsalbe. Prepare it from equal parts of common turpentine, yellow wax, and oil of turpentine. A soft, yellow ointment. The official British turpentine ointment is prepared from oil of turpentine, resin, and yellow wax. The German ointment may be used to meet the same indications. Oxide of Zinc Ointment. Unguentum Zinci. Zinksalbe. Unguentum Zinci Oxidi, U. S. P. Prepare it from— Common oxide of zinc, one part,.....1 Lard, nine parts,.........9 A white ointment. The uses of this preparation have been described in connection with the oxide of zinc ointment of the United States Pharmacopoeia. The American is twice the strength of the German ointment. CHAPTER VI. OINTMENTS OFFICIAL IN THE FRENCH PHARMACOPOEIA.* The French official ointments are thirteen in number. They are as follow :— Althea Ointment (so called) Onguent dit d'AItlia-a. Unguentum Althaeae. Oil of fenugreek, . 800 grammes (25 ounces, 353 grains) .f Yellow wax, . .200 " ( 6 " 211 " ). Resin, . . .100 " ( 3 " 105^ " )■ Venice turpentine, .100 " (3 " 105y " ). Melt, at a gentle heat, the wax and the resin in the oil of fenugreek, add the turpentine, strain through a cloth, and stir the ointment until it has become nearly cold. The oil of fenugreek is derived from the seeds of Trigonella fcenumgrsecum, Nat. Ord. Papilionaceae, an annual plant indigenous to the south of Europe and some parts of Asia. It is cultivated in France on account of the seeds, which yield oil and mucilage. This ointment is used as a mild stimulant to ulcers, blisters, etc. Arc/eus Ointment. Onguent d'Arcaeus. Unguentum Arcaei. Balsam of Arcaeus. Compound Klemi Ointment. Mutton-suet, . . 200 grammes (6 ounces, 211 grains). Venice turpentine, .150 " (4 " 398 " ). Elemi, .... 150 " (4 " 398 " ). Lard, .... 100 " (3 " 105>^ " ). Melt at a gentle heat the suet, lard, and resin ; then add the turpentine. Strain through a cloth and stir the mixture until it has become nearly cold. * Todex Medicamentarius, Pharmacopee Francaise. Paris, 1884. t The metric weights are translated into troy ounces and parts thereof. (Ill) 118 Ointments Official in the French Pharmacopoeia. This nearly corresponds to the British unguentum elemi. Each contains the same proportion of elemi, but an equal quantity, by weight, of turpentine is added to the French preparation. This addition will serve to increase somewhat the gentle irritant properties of the elemi. It will form an excellent dressing to burns, ulcers, blisters, chilblains, etc. Basilicon Ointment. Onguent Basilicum. Unguentum Basilicum. Black pitch, . . 100 grammes ( 3 ounces, 105% grains). Resin, . . .100 " ( 3 " 105% " ). Yellow wax, . . 100 " (3 " 105% " ). Olive-oil,. . .400 " (12 " 412 " ). Melt at a gentle heat the pitch and the resin; add the wax and the oil. When melted, strain and stir until the ointment has nearly become cold. The composition of this ointment is nearly the same as that of the American resin cerate and the British and German resin ointments. The uses of basilicon are, consequently, those of its corresponding preparations. Rhazes' White Ointment. Pommade de Carbonate de Plomb. Pomatum cum Carbonato Plumbico. Carbonate of lead, . . 10 grammes (154% grains). Benzoinated lard, . .50 " (1 ounce, 292 grains). Mix thoroughly. This ointment should be prepared only as needed. The French ointment of the carbonate of lead is nearly twice the strength of the American and British corresponding preparations. This ointment contains a less proportion of the plumbic salt than the German unguent. It is adapted to the relief of the same class of affections which need not here be repeated. CaneVs Ointment. 119 Canet-s Ointment. Emplatre de Canet. Emplastrum cum Oxido Ferrico. Simple plaster, . . 100 grammes (3 ounces, 105% grains). Gum-diachylon plaster, . 100 " (3 " 105% " ). Yellow wax, . . .100 " (3 " 105% " ). Olive-oil, . . . .100 " (3 " 105% " ). Colcothar—anhydrous sesquioxide of iron, . 100 " (3 " 105% " ). Divide the oil into two parts ; into one incorporate the colcothar while pulverizing it; in the other, melt at a gentle heat the plasters and the wax. Unite the two mixtures, stir until the plaster mass is nearly cold, and divide it into cylinders. Simple plaster corresponds to the emplastrum plumbi, lead or diachylon plaster, of the United States Pharma- copoeia. Gum-diachylon plaster is official in the French Codex, and is made according to the following formula:— Gum-Diachylon Plaster.* Emplatre Diachylon Gomme. Emplastrum Diachylum Gom- matum. 620 grammes (19 ounces, 254% grains). Powdered litharge, 620 Lard, . 620 Olive-oil, 620 Water, . 250 Yellow wax, 120 White pitch, 120 Venice turpentine, 120 Ammoniac, . 100 Galbanum, . 100 Essence of turpentine, 60 (19 k 254% << )■ (19 (< 254% k )• (40 it 101 a )• ( 3 << 413 it ). ( 3 (< 413 k )• ( 3 k 413 k )• (3 u 105% t< )• ( 3 11 105% (< )• ( 1 (( 432 k )• Prepare the lead plaster with the litharge, lard, olive- oil, and water, taking care, at the end of the operation, that most of the water is evaporated in order to preserve the gtycerin. *The formula for gum-diachylon plaster is given because it is an in- gredient of Canet's ointment, and without it the formula of the latter would be incomprehensible to the American reader. 120 Ointments Official in the French Pharmacopoeia. Place separately in a water-bath with four times their weight of water the powdered ammoniac and galbanum and the essence of turpentine; shake constantly until the gum-resins are emulsionized as completely as possi- ble; strain through a cloth. Evaporate this emulsion over a naked flame to the consistence of thick honey. Mix this product with the simple plaster, liquefied at a gentle heat. Melt the mixture, strain through a cloth, and then add the yellow wax, white pitch, and turpen- tine, stirring until the plaster mass is sufficiently cool. Then divide it into cylinders. This excellent preparation approximates the compo- sition of the iron or strengthening plaster, emplastrum ferri, of the United States Pharmacopoeia. The presence of the gum-resins adds to its counter-irritant properties. The iron, together with the large proportion of lead plaster, renders it astringent. Canet's ointment is con- sequently an excellent application in chronic rheuma- tism, chronic synovitis, lumbago, enlarged glands, herpes zoster, dermatitis, paraesthesia, etc. Citrine Ointment. Onguent Citrin. Pommade Citrine. Pomatum Citrinum. Lard,. . • . 400 grammes (12 ounces, 412 grains). Olive-oil, . . .400 " (12 " 412 " ). Mercury, . 40 " ( 1 " 139 ). Officinal nitric acid, .80 " ( 2 " 278 " ). Dissolve the mercury in the nitric acid without the aid of heat. Melt separately the lard in the oil at a gentle heat. When the fatty substances are half-cooled add the mercurial solution. Mix thoroughly by shaking and pour the pomade into paper molds. This ointment should not be kept exposed to the light. It is analogous to our official citrine ointment, with which its properties are identical. Simple Digestive Ointment. 121 Simple Digestive Ointment. Onguent Digestif Simple. Unguentum Digestivum Simplex. Venice turpentine, . . 40 grammes (1 ounce, 139 grains). Yelk of one egg, . .20 " (309 grains). Olive-oil,. ... 10 " (154% grains). Mix the yelk of egg and turpentine in a mortar, and add gradually the olive-oil. This preparation possesses the stimulant, antiseptic, and haemostatic properties of the turpentine, of which it is so largely composed. It may be used upon unhealthy, sloughing, or indolent ulcers, in burns, erysipelas, and alopecia circumscripta. Gray Ointment. Onguent Gris. Onguent Mercuriel Simple. Pommade Mercurielle Faible. Pomatum Cum Hydrargyro Simplex. Equal-parts mercurial ointment, . . . 100 grammes (3 ounces, 105% grains). Benzoinated lard, . . 300 " (9 " 316 " ). Mix in a mortar. This is a diluted form of our mercurial or blue oint- ment, and may be employed whenever the latter, for any reason is considered too strong an application. Equal-Parts Mercurial Ointment. Pommade Mercurielle a Parties Egales. Onguent Mercuriel Double Onguent Napolitain. Pomatum Cum Hydrargyro. Mercury, . . . 500 grammes (16 ounces,48 grains). Benzoinated lard, . 500 " (16 " 48 " ). Melt the lard; pour about one-third of it into a brass pot, and maintain it at such a temperature that the sub- stance remains sufficiently soft; add the mercury gradu- ally, rubbing briskly with a pestle, until the metal is completely extinguished ; then add the remainder of the lard and stir until the mixture is perfect. This prepa- 0 F 122 Ointments Official in the French Pharmacopoeia. ration corresponds almost exactly to the mercurial or blue ointment, unguentum hydrargyri, of the United States and British Pharmacopoeias. Its therapeutic employment has been pointed out under the latter head. Laurel Ointment. Onguent de Eaurier. Pommade de Eaurier. Pomatum Eaurinum. Fresh laurel-leaves, . 500 grammes (16 ounces, 48 grains). Laurel-berries, . . 500 " (16 " 48 " ). Lard, .... 1000 " (32 " 96 " ). Bruise the leaves and the berries, and subject them, with the lard, to a gentle heat until all the water of vege- tation is evaporated. Strain, and allow to cool slowly ; separate the deposit; melt the ointment anew, and when it is half-cooled pour it into a pot. Laurus nobilis, Nat. Ord. Lauraceae, or bay-tree, is an evergreen bush or tree, a native of Asia Minor, but growing in all the countries surrounding the Mediterra- nean Sea. The leaves have a fragrant odor, a bitter and aromatic taste. The berries are of an oval shape, about the size of a cherry, purple when fresh, black and wrinkled when dried. A greenish-yellow volatile oil is obtained from the leaves by distillation. The berries have a similar but more pungent odor and taste, and contain both a volatile and a fixed oil. Leaves, berries, and oil are stimulant and narcotic. Laurel ointment is a pleasant emollient preparation which may possess also some slight sedative action in virtue of the narcotic principle contained in the plant. It may be employed in erythema simplex, erythema in- tertrigo, dermatitis, erysipelas, acute eczema, upon abraded or blistered surfaces, impetigo after the scabs have been removed, pemphigus and pompholyx after the blebs have ruptured, in herpes, urticaria, and the erythematous and bullous forms of burns. Mother The/cla's Ointment. 123 Mother Thekla-s Ointment. Emplatre Brun. Emplastrum Fuscum Theclae. Xhekla's Brown Plaster. Olive-oil, . 1000 grammes (32 ounces, 96 grains). t< (16 " 48 " ) Butter, 500 k (16 " 48 " ) Yellow wax, 500 a (16 " 48 " ) Powdered litharge, . 500 it (16 " 48 " ) Mutton-suet, 500 tt (16 " 48 " ) Purified black pitch,. 100 n (3 " 105% " ) Place the fatty substances in a large copper pan, and heat them until they give off vapors due to the altera- tion of the fats; then add the powdered litharge, pass- ing it through a sieve; stir constantly with a wooden spatula. Leave the mixture over the fire, stirring it until the mass has assumed a dark-brown color; then add the purified black pitch. When the plaster is suf- ficiently cold pour it into a pot or into paper molds. This combination is analogous to the brown or compound lead ointment, unguentum fuscum, of our National Formulary preparations. The American brown ointment is made with red oxide of lead instead of litharge, and contains a small proportion of camphor, which is lacking in the French preparation, while the pitch present in the latter is absent in the former. The therapeutical applications of the French and American brown ointments are the same, and in both cases are substantially those of the diachylon ointment, un- guentum diachylon, of the United States Pharmacopoeia. Poplar Ointment. Onguent Populeum. Pomatum Populeum. Poplar-bud Pomade. Recently-dried poplar-buds, 800 grammes ( 25 ounces, 350 grains) Fresh poppy-leaves, . .500 " ( 16 " 48 " Fresh belladonna-leaves, Fresh hyoscyamus-leaves, Fresh dulcamara-leaves, Lard, .... 500 " ( 16 " 48 500 " ( 16 " 48 500 " ( 16 " 48 4000 " (128 " 384 124 Ointments Official in the French Pharmacopoeia. Bruise the plants in a marble mortar, place them in a pan with the lard and subject them to a gentle heat, stirring until the water of vegetation is entirely evap- orated. Then add the bruised poplar-buds and digest in a water-bath for twenty-four hours. Strain and allow to cool slowly. Separate the deposit and melt the oint- ment anew in order to pour it into a pot. This preparation possesses decided anodyne and anti- spasmodic properties, owing to the large proportion of solanaceous narcotics which it contains. The poppy- leaves are feebler, but whatever action they exert tends in the same direction. The poplar-buds, from which the preparation takes its name, are chiefly valuable for pharmaceutical rather than therapeutical reasons. They have the property of preserving lard unaltered for an indefinite period. Poplar ointment is efficacious in those diseases in which pain pr spasm is a marked feature. Neuralgic affec- tions are especially relieved by poplar ointment, which is likewise efficacious in quelling the pain characteristic of herpes zoster. Chronic rheumatism or gout, lumbago, and chronic synovitis are also amenable to its influence. It is a useful application to engorged breasts, to furuncles and abscesses. Poplar ointment diminishes the pain due to cancer and lessens that caused by irritable ulcers, painful haemorrhoids, or bed-sores. It relaxes spasm of the os uteri, sphincter vesicae, or ani. It suppresses ex- cessive sweating. An ointment of this composition may in some cases relieve the torments of paraesthesia or urticaria. The throat and the pupil should be watched during its use upon open surfaces. The pain incident to epididymitis is materially less- ened by the application of the ointment in question, combined with gentle support of the affected part. Styrax Ointment. 125 (5 it 384 (3 i< 105% (3 << 105% Styrax Ointment. Onguent de Styrax. Unguentum cum Styrace. Olive-oil, . . 150 grammes (4 ounces, 398 grains Liquid styrax, . . 100 " (3 " 105% " KeMn, . ... 180 " Elemi, .... 100 ' Yellow wax, . . 100 ' The principal employment of styrax is in scabies. The pleasant odor and blandness render this agent an acceptable remedy, as it is able to destroy the parasite without aggravating the secondary skin troubles. In this combination with resin and elemi slightly irritant properties are obtained. The ointment becomes available, therefore, in those cases in which gentle stimulation may be needed. CHAPTER VII. OINTMENTS OFFICIAL IN THE AUSTRIAN PHARMACOPCEIA. The ointments officinal in the Austrian Pharmaco- poeia* are thirteen in number. The list is as follows :— Aromatic Ointment. Unguentum Aromaticuin. Aromatische Salbe. Absinth-leaves, finely divided, 125 grammes (4 ounces, 14% grains); Dilute alcohol, . . . 250 " (8 " 24 " )• are brought to a pulp, digested for six hours, then heated with— Lard, . . . . 1000 grammes (32 ounces, 96 grains); until all the moisture has evaporated and strained. The straining is melted with— Yellow wax, . . 250 grammes (8 ounces, 24 grains); Oil of laurel, . . 125 " (4 " 14% " ); and again strained. When cold it is mixed with— Oil of juniper, Oil of peppermint, Oil of rosemary, Oil of lavender, of each, . . 10 grammes (154% grains); and made into a homogeneous ointment. This is a similar preparation to the compound rose- mary ointment of the German and Italian Pharmaco- poeias, and is used for the same purposes. Carbonate of Lead Ointment. Unguentum Cerussae. Bleiweissalbe. Lard, .... 200 grammes (6 ounces, 211 grains). Simple diachylon plaster, 40 " (1 ounce, 139 " ). * Commentar zur siebenten Ausgabe der Oesterreichischen Pharma- copoe. Dritter Band. Text der siebenten Ausgabe in deutscher Ueber: setzung mit Erlauterungen verselien von Dr. Fr. C. Schneider und Dr Aug. Vogl. Wien, 1889. (127) 128 Ointments Official in the Austrian Pharmacopoeia. These are melted together, and the mass, when cooled, is mixed, constantly stirring, with— Finely-powdered carbonate of lead, 120 grammes (3ounces, 412 grains). This ointment contains a still larger proportion of lead than the corresponding German ointment. It ful- fills the same indications, and may be easily reduced in strength whenever desirable. Diachylon Ointment. Unguentum Diachylon. Diachylonsalbe. To 100 grammes (3 ounces, 105^ grains) of freshly pre- pared and still fluid diachylon plaster enough olive-oil, about 70 grammes (2 ounces, 120 grains), is added to make a soft ointment. With this is mixed— Oil of lavender, .... 4 grammes (61% grains). Instead of the olive-oil, the Hungarian Pharmaco- poeia directs 100 grammes (3 ounces, 105^ grains) of oil of sesamum to be used. The indications of diachylon ointment have been detailed when treating of the American preparation of the same name. The American, German, and Austrian ointments agree closely in composition and strength. Emollient Ointment. Unguentum Kmolliens. Erweichende Salbe. Creme Celeste. White wax, . . .10 grammes (154% grains). Spermaceti, ... 20 " (308% " ). Expressed oil of almond, 80 " (2 ounces, 278 grains). Melt, strain, and to the half-cooled mass add, con- stantly stirring,— Rose-water, . . . .20 grammes (308% grains). Make into a white ointment. The title of the above preparation sufficiently indi- cates the purpose for which it is intended. Its uses have been described in connection with the cold cream Glycerin Ointment. 129 or rose-water ointment of the Pharmacopoeia of the United States, the composition of which it closely re- sembles. The unguentum leniens of the German Phar- macopoeia, the Galen cerate, emollient ointment, and spermaceti pomade of the Italian Formulary, are all constructed upon the same plan, and are all of about the same strength and adapted to the same uses. Glycerin Ointment. Unguentum Glycerin!. Glycerlnsalbe. 8tarch>......4 grammes (61% grains). Mix gradually in a porcelain dish with__ Glycerin, . . . 60 grammes (1 ounce, 432 grains); stirring constantly. Heat gently until it becomes a gelatinous, transparent mass. The Hungarian Pharmacopoeia directs 1 part of powdered tragacanth rubbed up with 5 parts of alcohol, to be thoroughly mixed on a water-bath with 49 parts of glycerin. In the German Pharmacopoeia, also, traga- canth is employed instead of starch. Glycerin ointment is emollient. Its uses have been designated under the head of the German unguentum glycerini. It may be suitably employed, likewise, as a basis or vehicle for more active drugs or combinations. Mercurial Ointment. Unguentum Hydrargyri. Quecksllbersalbe. Mercury, Lanolin, of each, . . 200 grammes (6 ounces, 211 grains). The metal is rubbed constantly with the fat until no particles of mercury remain visible. Then it is grad- ually mixed with— Simple ointment,. . 200 grammes (6 ounces, 211 grains). In the present (seventh) edition lanolin is substituted for suet and lard, and, after the mercury is extinguished, 6* 130 Ointments Official in the Austrian Pharmacopoeia. the mass is mixed with simple ointment. The propor- tion of fatty matter and mercury, 2 to 1, is preserved. According to the Hungarian Pharmacopoeia, 300 parts of mercury are mixed with 150 parts of suet and 450 parts of lard. According to the German Pharma- copoeia, 10 parts of mercury, 7 of suet, and 13 of lard are employed. The quantity of mercury present in the ointment may be determined by treating it with ether, by which the fat is dissolved. The mercury left behind should amount to one-third by weight of the ointment. The mercurial ointment of the American, British, French, and Italian Pharmacopoeias is made with equal parts of mercury and fatty matter. The cases benefited by the use of this preparation have been indicated under the head of the American unguentum hydrargyri. Juniper Ointment. Unguentum Juniperi. Wachholdersalbe. Absinth-leaves, finely divided, . 60 grammes (1 ounce, 432 grains). Dilute alcohol, . . . .120 " (3ounces,413 " ). Digest the pulpy mass for six hours. Then heat with— Lard, .... 500 grammes (16 ounces, 48 grains); until all the moisture is evaporated. Melt in the strain- ing- Yellow wax, . . 100 grammes (3 ounces, 105% grains). Strain the melted mass and mix with the cooled oint- ment— Oil of juniper, . . 50 grammes (1 ounce, 293 grains). This resembles the juniper ointment of the Italian Pharmacopoeia, and may be employed with the same objects in view. Acetate of Lead Ointment. 131 Acetate of Lead Ointment. Unguentum Plumbi Acetici. Bleisalbe. Lard, .... 300 grammes (9 ounces, 317 grains). White wax, . . .100 " (3 » 105% " ). Melt, strain, and to the half-cooled mass add— Acetate of lead, * 6 grammes (92% grains); dissolved in Distilled water, .... 20 grammes (309 grains). Stir constantby until thoroughly mixed. The Austrian acetate of lead ointment resembles the preparations of acetate and subacetate of lead officinal in the Pharmacopoeias of the United States, Great Britain, Germany, and Italy. These vary as regards strength, but their general indications are the same. Rose Ointment, Unguentum Kosatum. Kosensalbe. Unguentum Pomadinum. Lard, .... 300 grammes (9 ounces, 317 grains). White wax, ... 75 " (2 " 197 " ). Melt, strain, and when half-cooled add— Oil of bergamot, .... 1.5 grammes (23 grains). Oil of rose,.....0.5 gramme ( 7% " ). Mix thoroughly. Under this title the Hungarian Pharmacopoeia has an ointment which is prepared by mixing 20 grammes (309 grains) of oil of cacao, 30 grammes (463^ grains) of oil of sesamum, and 10 grammes (154^ grains) of rose-water. This is an excellent emollient,analogous to cold-cream or rose-water ointment of the American, the unguentum leniens of the German Pharmacopoeia, as well as the Austrian unguentum emolliens, the Italian Galen cerate, emollient ointment, spermaceti pomate,and ointment of rose. They are all useful as a basis for ointments or to soothe an irritable skin. 132 Ointments Official in the Austrian Pharmacopoeia. Cevadilla Ointment. Unguentum Sabadillae. Sabadillasalbe. Simple ointment,. . 200 grammes (6 ounces, 211 grains). Melt at a gentle heat and mix gradually with— Powdered cevadilla-seeds, 50 grammes (1 ounce, 293 grains). To the mass add— Oil of lavender, .... '2 grammes (30% grains). Cevadilla ointment is useful in pediculosis capitis, but, as stated elsewhere, the ointment of veratrine, offici- nal in the United States Pharmacopoeia, is preferable. Simple Ointment. Unguentum Simplex. Einfache Salbe. Lard, .... 200 grammes (6 ounces, 211 grains). White wax, . . 50 " (1 ounce, 293 " ). Melt, strain, and make into an ointment by constant stirring. This preparation is of the same strength as the simple ointment of the United States Pharmacopoeia. Sulphur Ointment. Unguentum Sulphuratum. Schwefelsalbe. Green soap, Lard, of each, . . 60 grammes (1 ounce, 432 grains). Melt and strain. To the mixture add— Flowers of sulphur, . . . 30 grammes (463% grains). Native carbonate of calcium, . 20 " (309 " \ Passed through a sieve, and, finally,— Tar,......30 grammes (463% grains); is added, and the mass brought to the consistence of an ointment. The Austrian sulphur ointment combines the virtues of a sulphur and tar ointment, containing, as it does, equal parts of each substance. It is beneficial in sca- bies, psoriasis, chronic eczema, lupus vulgaris, etc., and approximates the composition of the well-known Wil- kinson's ointment. Oxide of Zinc Ointment. 133 Oxide of Zinc Ointment. Unguentum Zinci Oxydati. Zinksalhe. Unguentum Zinci Wilsoni. Benzoinated lard, . 100 grammes (3 ounces, 105% grains). White wax, . .20 " (309 grains) Melt with a gentle heat, strain, and to the half-cooled mass add— Oxide of zinc, .... 20 grammes (309grains); Oil of almonds, .... 10 " (154>£ " ); and bring to the consistence of an ointment. This preparation fulfills the same indications as the oxide of zinc ointment of the American Pharmacopoeia. The Austrian ointment, however, is a somewhat weaker preparation. CHAPTER VIII. OINTMENTS OFFICIAL IN THE ITALIAN PHARMACOPOEIA. The following list is selected from the Italian Formulary.* Abbey di Bec Ointment. Unguento dell' Abbazia di Bec. Burgundy pitch, two hundred and fifty parts, . . . 250 Resin, eighty parts,........80 Naval pitch, eighty parts,.......80 Yellow wax, one htmdred parts,.....100 Lard, two hundred and forty parts,.....240 Powdered olibauum (frankincense), twenty parts, . . 20 Mix thoroughly. The proportion of pitch and resin contained in this preparation is considerably larger than in the ceratum resinae of the United States or the unguentum resinae of the British Pharmacopoeia. It consequently possesses more decided irritant and stimulant properties and forms a fitting and efficacious application to indolent ulcers, chronic eczema, and psoriasis. Abortive Ointment. Sedative and Abortive Pomade. Pomata Sedativa ed Abortiva. Neapolitan ointment,' eight parts,.....8 Extract of belladonna, four parts,.....4 Opium, four parts,........4 This is an excellent application in furuncle, abscess, and carbuncle. It limits the inflammatory action and tends to prevent the formation of pus. This ointment may also appropriately be spread upon engorged or in- flamed breasts. It is servicable in cases of enlarged * Farmacopea Italiana ossia Dizionario di Farmacia e di Terapeutica, etc. Tornio, 1887. (135) 136 Ointments Official fn the Italian Pharmacopoeia. glands, ovaritis, and epididymitis. The large proportion of narcotics present renders it a very valuable anodyne preparation. Acetate of Lead Ointment. Unguento d' Acetato di Piombo. Olive-oil, twenty-four parts,......24 White wax, three parts,.......3 Solution of acetate of lead, six parts, .... 6 Melt the wax in the oil, then add the acetate of lead solution, stirring the mixture until it is cold. Acetate of lead ointment is analogous in composition to the American ceratum plumbi subacetatis, the British unguentum plumbi acetatis,and the German unguentum plumbi. Its indications, therefore, are the same as those of the above preparations. Goulard's Cerate. Cerato di Goulard. Galen's cerate, thirty-two parts,......32 Extract of lead, four parts,......4 Mix. This cerate does not markedly vary in composition from the acetate of lead ointment. Its virtues are sedative and astringent, and it is one of the most gener- ally useful of external applications. Goulard's cerate may be applied advantageously in almost any acute inflammation of the integument,—dermatitis, herpes, eczema, urticaria, pemphigus, pompholyx, burns, chil- blains, etc. It is a serviceable local application in er}- sipelas. Galen's Cerate. Cerato di Galeno. Olive-oil or,preferably, almond-oil,400grammes(12ounces,412grains). White wax, .... 100grammes( 3 " 105% " ). Melt the wax with the oil in a well-cleaned tin vessel, stirring the mixture until it commences to thicken; Boric Acid Ointment. 137 then wash with water, stirring briskly, renewing the water twice or thrice. Then wash with rose-water. Some processes prescribe the wax to be melted with the oil and 300 grammes (9 ounces, 317 grains), of rose- water, to stir the mixture briskly, and pour it into a marble mortar to cool. Galen's cerate nearly corresponds to the cold-cream or rose-water ointment, unguentum aqua? rosae, of our Pharmacopoeia,and to the cold cream, unguentum leniens, of the German Pharmacopoeia. Its uses have been de- scribed under the title of the American preparation. According to the Italian formulary, cherry-laurel water may be substituted for the rose-water in the above combination, in which case it is known as lloux's sedative cerate, cerato calmante di Roux. If yellow be substi- tuted for white wax it is called yellow cerate, cerato giallo. Nine parts of this yellow cerate (cerato giallo) mixed with 30 parts of Neapolitan ointment (unguento napolitano) form mercurial cerate (cerato mercuriale), largely used as a dressing to venereal ulcers. So, if to 30 parts of white or yellow Galen's cerate, 10 parts of laudanum be added, laudanum cerate (cerato laudaniz- zato) is produced. The extract of lead used in making Goulard's cerate (cerato di Goulard) is the subacetate of lead. Boric Acid Ointment. Unguento d' Acido Borico. Oleo-cerato d' Acido Borico. Boric acid in fine powder, one part,.....1 White wax, one part,........1 Paraffin, twoparts,........2 Sweet almond-oil, twoparts,......2 Melt the wax, paraffin, and oil together; then add the boric acid and stir constantly until cold. This is rather stronger than unguentum acidi borici pa 138 Ointments Official in the Italian Pharmacopoeia. of the British Pharmacopoeia, but is applicable to the same diseases. Phosphoric Acid Ointment. Unguento d'Acido Fosforico. Pomata d'Acido Fosforico. Phosphoric acid of 45°, three parts,.....3 Lard, thirty parts,........30 Mix thoroughly The Italian Pharmacopoeia advises the use of this ointment in cases of rachitis. Tannic Acid Ointment. Unguento d'Acido Tannico. Pomata d'Acido Tannico. Tannic acid, three and six-tenths parts, .... 3.6 Lard, fifty parts,.........50 Mix thoroughly, adding the acid gradually and avoiding the use of an iron spatula. This is a slightly weaker preparation than the un- guentum acidi tannici of the American Pharmacopoeia. It is available in precisely the same affections as the latter. Aconitine Ointment. Unguento d'Aconitina. Aconitine, twoparts,........2 Alcohol, six parts,........6 Benzoinated lard, ninety-two parts,.....92 Dissolve the aconitine in the alcohol, then mix thor- oughly with the ointment. This preparation is considerably stronger than the British unguentum aconitinae. The Italian ointment is used for the same purposes, but will sooner produce the characteristic effects of tingling and numbness. Open surfaces should be sedulously avoided. Andrew della Croce's Ointment. Unguento di Andrea della Croce. Resin, eight parts, ........ 8 Elemi, twoparts,.........2 Turpentine, one part,........1 Laurel ointment, one part, . ...... 1 Mix thoroughly. Anthelmintic Ointment. 139 The composition of this ointment resembles that of the French onguent d'Arcaeus and the British unguentum elemi. It may be used in the same class of diseases as those preparations. Anthelmintic Ointment. Unguento Antelmintico. Ox-gall, ^we parts,........5 Aloes, five jiarts, ......... 5 Althea ointment, forty parts,..... 40 Mix thoroughly. Anthelmintic ointment is recommended to be applied by friction to the abdomen. An ointment of this nature can seldom be needed, since we possess several more effective and direct remedies. It may, however, be used in connection with internal medication, and may occa- sionally be found useful when the stomach is rebellious. Pile Ointment. Unguento Antiemorroidale. Pomata Antiemorroidale. Extract of stramonium-seeds, twoparts, .... 2 Extract of hyoscyamus, five parts,.....5 Poplar ointment, ninety parts,......90 Mix thoroughly. This resembles the poplar ointment, onguent popu- leum, of the French Codex. Like that preparation, it nmy be used to relieve pain or spasm in neuralgia, herpes zoster, malignant disease, rheumatism, painful haemor- rhoids, etc. Itch Ointment. Unguento Antipediculare. Lard, three hundred and seventy-five parts, . . . 375 Mercurial ointment, sixty parts,.....60 Stavesacre, ninety parts,.......90 Mix thoroughly. This is a weaker preparation than the British unguen- tum staphisagriae, but is used for the same purpose. 140 Ointments Official in the Italian Pharmacopoeia. Arthanita Ointment. Unguento d'Artanita. Juice of arthanita-root, twenty-four parts, . . .24 Juice of wild watermelon, twenty-four parts, . . .24 Butter, twelve parts,........12 Olive-oil, twenty-four parts,......24 Colocynth, five parts,........5 Yellow wax, nine parts,.......9 Ox-gall, one part,........1 Sagapenum, one part,.......1 Common salt, one part, ....... 1 Chamomile-flowers, four parts,......4 Divide finely the colocynth and macerate it for twenty-four hours in the juices. Then boil until the mixture is reduced one-half; strain, and express the residue. Add the ox-gall and evaporate to the consist- encjr of an extract. Mix the wax and butter melted in the oil, stirring constantly. Then mix the other ingre- dients, previously powdered, until a homogeneous oint- ment is obtained. Arthanita-root and colocynth, both drastic, hydra-* gogue cathartics, are the most active constituents of this preparation, which is intended to be rubbed upon the abdomen in cases of ascites. Basilicon Ointment. Unguento Basilico o Unguento Tetrafarmaco. Resin, one part,.........1 Black pitch, one part, ....... 1 Yellow wax, one pari,.......1 Olive-oil, four parts,........4 Mix thoroughly. The proportions and ingredients of the Italian are the same as those of the French preparation, and differ but little from the German, British, and American oint- ments of the same title. In Italian pharmacy turpentine is sometimes substituted for the resin. Benzoin Ointment. 141 Benzoin Ointment. Unguento di Benzoino. Tincture of benzoin, ten parts,......10 Lard, ninety parts,........90 Melt the lard on a water-bath, and add the tincture of benzoin gradually, stirring until the alcohol is evapo- rated. Then allow to cool. Or it may be made by thoroughly mixing 1 part of powdered benzoin with 50 parts of lard. This is the same preparation as our adeps benzoinatus. Rhazes' White Ointment. Unguento bianco di Khasis. Simple cerate, five parts,.......5 Powdered carbonate of lead, one pari, . . . . 1 Mix thoroughly. It should be made in small quantities at a time. This contains the same proportion of carbonate of lead as the corresponding French unguent, the excipients differing slightly. Bole Ointment. Unguento di Bolo. Oil of hypericum, twenty-four parts,.....24 Yellow wax, eight parts,.......8 Armenian bole, six parts,.......6 Dragon's blood, owe pari,.......1 Melt the wax in the oil, then add the bole carefully and afterward the dragon's blood, stirring the mixture until it has become cold and homogeneous. The oil of hypericum is obtained from hypericum perforatum, the well known St. John's wort, by macer- ating the flowering tops in olive-oil. The plant contains tannic acid, resin, a volatile oil, and coloring matter. The latter is a resin of red color, and hence the oil of hypericum is known as red oil. Though well-nigh dis- used at the present day in this country, hypericum cer- tainly possesses stimulant and astringent virtues. 142 Ointments Official in the Italian Pharmacopoeia. Bole is the name given to an earthy mineral resem- bling clay, and consisting principally of hydrated silicate of aluminium with ferric hydrate. It is greasy to the touch, forms a paste with water, adheres to the tongue, varies in color, and has a resinous lustre. Armenian bole possesses a red color. It is prepared from various European earths in imitation of a variety which was formerly obtained from Armenia. Dragon's blood, or gum dragon, is a resin derived from several species of East Indian palm. It exudes from the surface of the fruit. It is dark red and opaque in mass, of a bright-scarlet color when powdered, is devoid of odor or taste, but when burned emits an odor resembling that of benzoin. It contains benzoic acid, a resin, oxalate and phosphate of calcium. An ointment containing these ingredients possesses stimulant and astringent properties. It is well adapted to the treatment of contused wounds, stimulating the local circulation, the absorbent vessels, the nervous vitality of the parts, and restraining inflammatory action. Bole ointment may appropriate^' be used upon enlarged glands with a view to securing absorption. As a coun- ter-irritant it will prove serviceable in chronic rheuma- tism and synovitis, and lumbago. It is likely to be beneficial in chronic eczema and psoriasis. Bryonia Ointment. Unguento di Brionia. Oleo-cerato di Brionia d'Agrippa. Fresh squill, one hundred and eighty parts, . . . 180 Common iris-root, one hundred and eighty parts, . . 180 Root of male fern, one hundred and eighty parts, . . 180 Elaterium-juice, seven hundred parts, .... 700 Bryonia-juice, eleven hundred parts, . . . 1100 Macerate for twelve hours, then boil. Strain and evaporate to the consistence of a soft extract, to which add— Bryonia Ointment. 143 White wax, five hundred parts,.....500 Oil of mucilages, fifteen hundred parts, .... 1500 Mix thoroughly. The following is the composition of the oil of mucilages :— Flaxseed, five hundred parts,......500 Fenugreek, five hundred parts,.....500 Althsca-root, five hundred parts,.....500 Boiling water, five hundred parts,.....500 Digest for twelve hours, stir and add— Olive-oil, one thousand parts,......1000 Heat until all the water is evaporated. Common iris, which the formula prescribes, is the Iris Germanica, and grows abundantly in Northern Italy. Its rhizome is one of those known under the corrupt designation of orris-root. The active ingredients of this preparation are pos- sessed of a greater or less degree of acridity. They act as local irritants to unprotected surfaces. Recent bryonia-root is said to be capable of producing a blister. These substances exert an energetic effect upon the kidneys and intestinal glandulae. Iris is likewise an efficient hepatic stimulant. These powerful drugs are applied to the integument in cases where it is thought desirable to assist their internal administration, or where their internal adminis- tration is inadmissible or impossible on account of an irritable stomach. B^onia ointment is used in Italy in order to reduce dropsy and invigorate circulation and absorption. Larrevs Brown Ointment. Unguento bruno di Larrey. Basilicon ointment, five hundred parts, .... 500 Red oxide of mercury, thirty parts,.....30 Mix thoroughby. 144 Ointments Official in the Italian Pharmacopoeia. Larrey's ointment forms a good local stimulant to indolent ulcers, chancroids, chancres, chronic eczema, scleroderma, etc. Its composition assimilates to that of the unguentum hydrargyri oxidi rubri of the United States Pharmacopoeia. The latter contains a much larger proportion of the mercurial, but the difference of strength is diminished by the fact that basilicon ointment is the excipient of the Italian preparation. Calamine Ointment. Unguento Calaminare. Yellow wax ointment, one hundred and sixty parts, . 160 Prepared calamine, thirty-two parts, .... 32 Mix thoroughly. This is the same as the calamine ointment of our National Formulary. Like that preparation, its uses are those of the oxide of zinc ointment. Sedative Ointment. Unguento Calamante. Glicerato di Solfato di Morfina. Sulphate of morphine, twenty-five hundredths of a part,. 0.25 Glycerite of starch, fifteen parts,.....15.00 Sedative ointment is useful as a local narcotic in neuralgia, herpes, herpes zoster, or to relieve the pain caused by a morbid growth. It may be spread upon irritable ulcers or blistered surfaces if the absorbent area be not too large. It may be applied, with very good effect, upon a vesicated surface in acute gastritis, relieving both the pain and vomiting. Sedative ointment may also be used in order to relieve painful haemorrhoids. Calomel Ointment. Unguento di Calomelano. Pomata di Calomelano. Calomel, . . . 10 grammes (154% grains). Benzoinated lard, . 90 grammes (2 ounces, 470% grains). This is a slightly weaker ointment than that formerly official under the same name in the United States Phar- macopoeia, but it is adapted to the same uses. Canefs Ointment. 145 Canet's Ointment. Unguento di Canet. Empiastro di Canet. Simple diachylon cerate, one hundred parts, . . . 100 Gum-diachy Ion cerate, one hundred parts, . . . 100 Olive-oil, twelve parts,.......12 Yellow wax, twelve parts,.......12 Colcothar (anhydrous sesquioxide of iron), twenty-five parts,..........25 Melt, at a gentle heat, the diachylon cerates, the olive-oil, and the wax. Strain, incorporate the colcothar, and divide the mass into cylinders. This is analogous to the French ointment of the same name, though it contains a much lower proportion of iron. It may be used, however, in the same class of cases. Camphor Ointment. Unguento Canforato. Pomata Canforata. Lard, .... 90 grammes (2 ounces, 154% grains). White wax, . .10 " (154% grains). Powdered camphor, . 30 " (463% " ). Melt in a water-bath the wax and the lard. Then add the camphor, stirring until cold. This preparation very nearly corresponds to the un- guentum camphorae of our National Formulary, and is available for the same purposes. Cantharidal Ointment. Unguento Cantaridato. Pomata Cantaridata. Powdered cantharides, one part,......1 Olive-oil, four parts,........4 White wax, two parts,........2 Digest the cantharides in the oil for eight days. Strain and filter. Melt, at a gentle heat, the wax in the filtered oil. This preparation is about equal in strength to the cantharidal ointment formerly official in the United States Pharmacopoeia. Its uses, therefore, are precisely the same. 7 G 146 Ointments Official in the Italian Pharmacopoeia. Sore-Nipple Ointment. Unguento pei CapezzoU. Pomata Mirabile pei Capezzoli. Finely-powdered red oxide of mercury, one part, . . 1 Lard, twenty parts, . ......20 Mix thoroughly. The strength of this preparation is rather less than half that of our official red oxide of mercury ointment. It is especially designed, as is indicated by its name, for the cure of fissured nipples. The nipples should be carefully washed and all traces of the ointment removed before the babe is allowed to nurse. Carbonate of Ammonium Ointment. Unguento di Carbonato Ammonico. Oleo-cerato di Carbonato Ammonico. Simple cerate, eight parts,.......8 Carbonate of ammonium, one part,.....1 Mix thoroughly. Carbonate of ammonium is a local irritant, and an ointment into which it enters may be employed when stimulation is desirable, as in comedo, seborrhoea, chronic eczema, the later stages of dermatitis, frost-bite, etc. Tar Ointment. Unguento di Catrame. Pomata di Catrame. Tar, ten parts,.........10 Lard, thirty parts,........30 Tar is defined by the Italian Pharmacopoeia as " a resinous extract mixed with empyreumatic products obtained from various coniferse, especially the pines, which furnish no more turpentine by incision. The wood and root, cut into small pieces, are subjected to distillation per descensum. Tar has the consistence of a turpentine, is of a dark-gray color, tenacious odor, and acrid taste. It commences to boil at about 87° C. (188.6° P.), and burns at 105° C. (221° F.), after having boiled for twelve minutes. It contains acetic acid, un- altered resin, paraffin, creasote. benzine, etc." Carbonate of Lead Ointment. - 147 Tar ointment is valuable in the treatment of scrofulous indurations, psoriasis, chronic eczema, and lepra. Its applications have been fully described on pages 43 and 44. Carbonate of Lead Ointment. Unguento di Cerussa. Oleo-cerato di Cerussa. White wax, three parts,.......3 Oil of rose, twelve parts,.......12 Powdered carbonate of lead, four parts, .... 4 Mix thoroughly. This preparation approaches the composition of the unguentum cerussae of the German Pharmacopoeia, and is used for the same purposes. Cucumber Ointment Unguento di CetriuoU. Cucumber-juice, twelve hundred parts, .... 1200 Lard, one thousand parts, ...... 1000 Veal-6uet, six hundred parts,......600 Rose-water, ten parts,.......10 Balsam of Tolu, two parts,......2 Melt the fats in a water-bath ; add the balsam of Tolu, previously dissolved in a little alcohol; then the rose-water. When the fats have become clear, decant into a tin basin, and add one-third of the juice, stirring continually for four hours. Decant the portion which separates, and repeat the operation with the remaining two-thirds of the juice. The fatty- matter is then sepa- rated from the liquid by melting in a water-bath, and after a few hours the coagulum is removed. The oint- ment is then strained into vessels and kept in a cool place. Finally, it should be softened in a tin basin without entirely melting it, and beaten with a wooden spoon until its volume is doubled. The composition and mode of preparation of this ointment are substantially the same as that of the un- official cucumber ointment of this country, the formula and indications of which have been already given. 148 Ointments Official in the Italian Pharmacopoeia. Hemlock Ointment. Unguento di Cicuta. Pomata di Cicuta. Fresh leaves of conium maculatum and of artemisia absinthium, . . . equal parts of each. Oxygenated pomade* .... a sufficient quanity. Bruise the leaves in a mortar with a sufficient quantity of water and extract the juice. To this add an equal weight of the pomade, and heat the mixture in a capsule until the water is evaporated and the pomade has acquired a homogeneous appearance. Conium paralyzes the motor nerves and impairs like- wise the function of the sensory nerves. It is, there- fore, both anodyne and antispasmodic. Conium has long been reputed to possess resolvent properties in cases of enlarged glands. Wormwood, by virtue of the volatile oil it contains, is also capable of exerting a narcotic influence. Hemlock ointment is an efficacious local remedy in painful maladies. It is capable of assuaging the intense pain of cancer, and may be applied with success over the seat of pain in neuralgia, in herpes zoster, chronic rheumatism, gout, or synovitis, to painful or irritable ulcers and painful haemorrhoids. Discutient powers have been attributed to both conium and wormwood,—a fact which has suggested this combination. Enlarged scrof- ulous glands, tumefied mammary glands, goitre, enlarged liver and spleen, may be reduced in volume by the use of hemlock ointment. It may be spread upon the breast when the secretion of milk is excessive or requires sup- pression. It may be used upon the chest in order to supplement the effect of internal remedies in whooping- cough and asthma. * Oxygenated pomade, pomata ossigenata d'alyon, or pomatum nitri- cum, consists of 1 part of nitric acid (35 ° Beaume) to 8 parts of lard. Citrine Ointment. 149 Citrine Ointment. Unguento ('it rino. Pomata Citrina. Pure mercury, one part,.......1 Nitric acid, of 32 degrees,* two parts, .... 2 Place the acid and the mercury in a porcelain vessel, and subject them to a gentle heat without disturbing the reciprocal action until it spontaneously subsides. Melt separately in a porcelain capsule 12 parts of pre- pared lard, add gradually, until it is nearly cold, and stirring constantly the still warm mercurial solution. When the mixture approaches the consistence of cream, pour it into oblong paper molds, and when solidified divide it into square tablets. Instead of using only lard, Guibort advises a mixture of equal parts of olive-oil and lard, and states that this prevents the ointment from becoming unduly hard from age. This corresponds very closely to our unguentum hydrargyri nitratis, and is useful in the same diseases. Creasote Ointment. Unguento di Creasoto. Creasote,. . . 0.025 gramme (% grain). Lard, . . . 60.000 grammes (1 ounce, 446% grains). Mix thoroughly. This is a very weak preparation. The cases in which creasote ointment are serviceable are specified under the unguentum creasoti of the British and United States Pharmacopoeias. Daphne Ointment. Unguento di Dafnoide. Pomata Epispastica di Dafnoide. Ethereal extract of daphne gnidium,/orty parts, . . 40 Lard, nine hundred parts,......900 White wax, one hundred parts,.....100 Alcohol, ninety parts,.......90 Dissolve the extract in the alcohol, then add the lard * According to Beaumd's areometer. 150 Ointments Official in the Italian Pharmacopoeia. and the wax. Heat moderately in order to evaporate the alcohol; strain and stir until cold. Daphne ointment is analogous to the unguentum mezerei of the United States Pharmacopoeia and is used for the same purposes. Depilatory Ointment. Unguento Depilatorio. Turpentine, thirty-eight parts,.....38 Resin, thirty parts,........30 Melt the mixture and preserve in water. This is an irritant preparation, the use of which is sufficiently indicated by its name. Stronger Digestive Ointment. Unguento Digestivo Animato. Purified storax, one hundred parts, .... 100 Simple digestive ointment, one hundred parts, . . 100 Mix thoroughly The uses and indications of simple digestive oint- ment have been given in connection with the French preparation of the same name, which is identical in com- position and strength with the Italian. The addition of an equal bulk of storax renders it an available agent in the treatment of scabies. Compound Digestive Ointment Unguento Digestivo Composto. Turpentine, one hundred and twenty pan Yelk of egg, forty parts, . Powdered myrrh, twenty-five parts, Incense, twenty-five parts, Mastic, twenty-five parts, Incorporate the powders with the turpentine and the yelk of egg with the aid of heat. It is better to reduce the turpentine to 60 grammes, and add 60 grammes of lard. Incense is a substance of variable composition, the chief ingredient of which is olibanum, a gum-resin, ts, ... 120 40 25 25 25 Mercurial Digestive Ointment. 151 to which other fragrant gum-resins and balsams may be added. The local action of most of these materials is mildlj7 stimulant. Another formula for the same ointment is as follows : Turpentine, forty-eight parts,......48 Oil of hypericum, nine parts,......9 Saffron, one part, ........ 1 Olibanum, one part,.......1 Myrrh, one part, .......1 Yelk of one egg. The turpentine and the egg are beaten up together, the oil is then incorporated, and, lastly, the other sub- stances, previously reduced to powder. The indications for the use of compound digestive ointment are, in gen- eral, the same as those for the simple digestive ointment. Mercurial Digestive Ointment. Unguento Digestivo Mercuriale. Simple digestive ointment, one hundred parts, . . 100 Mercurial ointment, one hundred parts,. . . . 100 Mix thoroughly. This ointment is especially applicable to venereal ulcers, though it may be used to fulfill the objects of a stimulant unguent in non-venereal cases. Opiated Digestive Ointment. Unguento Digestivo Oppiaceo. This is prepared by mixing laudanum with simple digestive ointment in the proportion of 1 part of the former to 8 of the latter. The addition of the opiate alleviates the pain which may be caused by the turpen- tine without impairing its efficiency. Simple Digestive Ointment. Unguento Digestivo SempUce. Turpentine, forty parts,......40 Yelk of egg, twenty parts,......20 Olive-oil, ten parts,.......10 Mix thoroughly. 152 Ointments Official in the Italian Pharmacopoeia. (4 " 53 ii )■ (3 " 38 u )• ( 2 " 273 it )• ( 2 " 273 .<< )• ( 3 " 38 II )• (61% grains). For the olive-oil Orosi substitutes oil of hypericum. This formula is precisely the same as that of the French preparation of the same title. Red Desiccant or Defensive Ointment. Unguento Disseccativo Rosso o Unguento Difensivo. Oil of rose, . . 500 grammes (16 ounces, 48 grains). Yellow wax, . . 128 Brown oxide of zinc, . 96 White oxide of lead, . 80 Litharge, ... 80 Armenian bole, . 96 Camphor, ... 4 Mix thoroughly. This is a good combination, possessing the astringent properties of the zinc and the bole, together with the sedative virtues of the lead. It forms a beneficial appli- cation in acute and subacute eczema, dermatitis, herpes, etc. It may also advantageously be spread upon ulcer- ated surfaces. Diuretic Ointment. Unguento (pomata) Diuretico. Powdered 6quill, twoparts,......2 Mercurial ointment, five parts,.....5 Mix. The name of this preparation sufficiently indicates the purpose for which it is intended. It is to be applied, with friction, to the loins, and may be employed in aid of a diuretic given by the mouth. Divine Ointment. Unguento od Oleo-cerato Divino. Olive-oil, sixteen parts,.......16 Yellow wax, sixteen parts,......16 Carbonate of lead, twelve parts,.....12 Powdered camphor, one part,......1 Add the carbonate of lead to the melted oil and wax, stirring constantly. Continue the heat until the mix- Duke's Ointment. 153 ture becomes opaque, and, when it is nearly cold, add the camphor. The class of cases in which a carbonate of lead oint- ment is efficacious have been described when treating of the official American ointment, unguentum plumbi car- bonatis. The corresponding French, German, and Italian preparations are all of greater strength than the Ameri- can or British, and are all about equal in strength. The unguento divino approximates the most closely to the German unguentum cerussae camphoratum, which, as pointed out by its name, also contains a small propor- tion of camphor. The white ointment of Rhazes is of the same strength in the French Codex and Italian Formulary, and is 50 per cent, weaker than the divine ointment. All the carbonate of lead ointments have practically the same indications. Duke's Ointment. Unguento del Duca. Walnut oil, eighty parts,......80 Flowers of sulphur, twenty parts,.....20 Lard, eighty parts,.......80 Yellow wax, ten parts,.......10 Melt the sulphur on a sand-bath in the oil until the mixture becomes red. Melt separately the lard and the wax, and then mix it in a mortar with the sulphur and oil, coloring the mixture with a sufficient quantity of alkanet. Walnut-oil or nut-oil, as it is often termed, is a bland fixed oil obtained by expression from the fruit of the Juglans regia, or common walnut, of the south of Europe. The proportion of sulphur present in this prepara- tion is too small to render it an efficacious remedy in scabies. It is however, found beneficial as a stimulant 7* 154 Ointments Official in the Italian Pharmacopoeia. to chronic ulcers and in other cases in which stimulation is desirable, as chronic eczema, comedo, acne, etc. SOLLEYSEL'S EGYPTIAN OINTMENT. Unguento Egiziaco di Solleysel. Verdigris, one hundred and fifty parts, . . . 150 Litharge, one hundred parts,......100 Arsenious acid, sevenparts,......7 Honey, six hundred parts,......600 Mix all the ingredients at a moderate temperature, stirring until the mass has acquired a deep-red color. In urgent cases the litharge and arsenious acid may be mixed with 800 grammes (25 ounces, 350 grains) of com- mon Egyptian ointment.* Egyptian ointment is an excellent astringent and somewhat escharotic ointment, well adapted to the treat- ment of chronic ulcers with callous margins. Elemi Ointment. Unguento d'elemi. Turpentine, eighteen parts,......18 Elemi, eighteen parts,.......18 Lard, twelve parts,........12 Beef-suet, twenty-four parts,......24 Melt together at a gentle heat, strain the liquid mass, and stir until it is cold. This is the same preparation as the French ointment of Arcaeus, except that beef-suet is substituted for mutton-suet. The proportions of the components are identical. Hellebore Ointment. Unguento Elleborato. Rhizome of veratrum viride, powdered, twelve parts, . 12 Powdered nitrate of potassium, one part, Sublimed sulphur, forty-five parts, Lard, one hundred and forty-four parts, Domestic green soap, forty- eight parts, . 1 45 144 48 * Plain Egyptian ointment is composed of : verdigris, 100 parts; burnt alum, 1 part; clarified honey, 32 parts.;, best vinegar, 14 parts. WJiite Hellebore Ointment. 155 Mix thoroughly the powders with the melted lard and soap. Hellebore ointment is calculated to be useful in pain- ful affections, such as neuralgia, herpes zoster, myalgia, and chronic rheumatism. White Hellebore Ointment. Unguento d'elleboro Uianco. Rhizome of veratrum album, sixty-four parts, . . 64 Lard, two hundred and fifty parts, .... 250 Essence of lemon, twenty drops. This is a stimulant and counter-irritant preparation, available in the treatment of neuralgia and chronic inflammation. It may also be employed to stimulate the repair of chronic ulcers. Emollient Ointment. Unguento Emolliente. Cerato Cosmetico. Pomata Cosxnetica. Pomata di Spermaceti. Cold Cream. Oil of sweet almonds, . 215 grammes (6 ounces, 437 grains). Spermaceti, . White wax, . Rose-water, . Essence of rose, Tincture of benzoin, 60 " (1 ounce, 437 " ). 30 " (432 " ). 60 " (1 " 437 " ). 6 drops. 4 drops. Emollient ointment is prepared in the same manner as the cerate of Galen, cerato di Galeno. Some authors sub- stitute essence of bergamot or eologne-water for the essence of rose. The formula may be further varied by the substitution of the essence of almond o* of rosemary or camphor for the essence of rose. It is a bland unguent, useful as an emollient applica- tion or as an ointment basis. It approaches the compo- sition of Galen's cerate of the Italian Formulary, the unguentum leniens of the German Pharmacopoeia, and the unguentum aquae rosae of the United States Phar- macopoeia. 156 Ointments Official in the Italian Pharmacopoeia. Spermaceti Pomade. Pomata di Spermaceti. Oil of sweet almonds, 75.00 grammes (2 ounces, 197 grains). Mutton-suet, . . 25.00 " (384 grains). White wax, . . 12.50 " (193 " ). Spermaceti, . . 12.50 " (193 " ). Melt the fats in the oil and stir until entirely cold. Spermaceti pomade is an analogous preparation to the spermaceti ointment of the British Pharmacopoeia, and is available for the same purposes. This ointment or pomade is made, according to another formula, by mixing 1 part of spermaceti with 4 parts of white wax and 8 parts of olive-oil. A third formula is as follows :— Oil of sweet almonds, 100 grammes (3 ounces, 105)4 grains). White wax, . .25 " (384 grains). Spermaceti, . .25 " (384 " ). Rose-water, . .25 " (384 " ). Melt in a water-bath the wax and the spermaceti in the oil, add the rose-water, and stir until cold. Epispastic Ointment. Unguento Kpispastico. Poplar ointment, thirty parts,.....30 Basilicon ointment, thirty parts,.....30 Powdered cantharides, one part,.....1 Mix thoroughly. Epispastic ointment is useful in maintaining a blister. It may be employed as a counter-irritant in chronic visceral inflammations or may be applied to chronic ulcers. Ethiopian Ointment. Unguento Etiopico. Pomata Mercuriale Solforata. Mercurial ointment, two parts,.....2 Lard, twoparts,........2 Sulphur, one part,........1 Mix thoroughly. Domestic Ointment. 157 Ethiopian ointment may be serviceable employed in the treatment of pediculi, scabies, indolent ulcers, etc. Domestic Ointment. Unguento Familiare. Mercurial ointment, one part,.....1 Lard, four parts, ......•• 4 Mix thoroughly. It should be prepared in small quantities at a time. This is used to fulfill the indications of a weakened mercurial ointment. Nut-gall Ointment. Unguento di Galla. Finely-powdered Aleppo galls, one part, ... 1 Benzoinated lard, eight parts,.....8 Mix thoroughly. The addition to 15 parts of this ointment of 1 part of powdered opium forms the opiated nut-gall ointment, unguento di galla oppiaceo. This is a slightly stronger preparation than the nut- gall ointment of the United States Pharmacopoeia, and, like it, is used for the same purposes as the ointment of gallic or of tannic acid. Juniper Ointment. Unguento di Ginepro. Cerato di Ginepro. Juniper-berries, bruised and washed with water, two hundred and fifty parts,......250 Lard, five hundred parts,......500 Yellow wax, eighty parts,......80 Oil of juniper, twenty parts,......20 Boil gentby the berries in the lard until the}- cease to give off watery vapor; strain, add the wax, melt, strain anew, and mix the oil of juniper with the nearly-cold mass. Juniper ointment is designed to be used in the same manner and for the same purposes as the diuretic oint- ment, unguento diuretico, of the Italian list. 158 Ointments Official in the Italian Pharmacopoeia. Helimund's Narcotico-Balsamic Ointment. Unguento Helimund Narcotico-Balsamico. Powdered acetate of lead, ten parts, .... 10 Extract of conium, thirty parts,.....30 Simple cerate, two hundred and forty parts, . . . 240 Balsam of Peru, thirty parts, ...... 30 Tincture of opium, five parts,......5 Mix the acetate of lead with the extract, add the mixture to the simple cerate; then add the balsam and the tincture, stirring until the mass is homogeneous. This combination forms a sedative, astringent, and antiseptic medicament, well adapted to the treatment of unhealthy ulcers and wounds, inflammation of the breast, furuncle, carbuncle, etc. Helimund's Arsenical Ointment. Unguento Helimund Arsenicale. Helimund's narcotico-balsamic ointment, eight parts, . 8 Brother Cosimo's arsenical powder,* one part, . . 1 Mix thoroughly. Arsenical ointment may be used upon indolent and malignant ulcers, carefully watching for symptoms of the constitutional action of the conium or the arsenic. Compound Salicylic Acid Ointment. Unguento Contro le Immondizie della Testa. Salicylic acid, tenparts,......10 Powdered borax, three parts,......3 Yellow wax, fifty parts,......50 Lard, colored with some red coloring matter, two hun- dred and fifty parts, ......250 Peruvian balsam, ten parts, .... .10 Essence of bergamot, _/?/arts, 128 Rhus toxicodendron-leaves, sixtoen parts, ... 16 Aromatic essence, sufficient quantity. Mix thoroughly. Blistering Ointment. Unguento Vesicatorio Senza Cantaridi. Powdered mustard, five parts,.....5 Powdered peUitory, four jjarts,.....4 Powdered stavesacre, fourparts,.....4 Powdered pepper, fourparts,......4 Powdered euphorbium, four parts, .... 4 Basilicon ointment, one hundred and twenty parts, . 120 Mix thoroughly. The association of these powerful irritants produces a vesicant as capable ns an ointment of Spanish fly, and CHAPTER IX. OINTMENTS IN SPANISH PHARMACY. The list of ointments familiar to Spanish pharmacy* is as follows :— Carbonate of Ammonia Ointment. Ungiiento Amoniacal. Unguentum Ammonia turn. Carbonate of ammonium, . . 4grammes ( 61% grains). Ointment of rose, . . .30 " (463^ " ). Essence of jasmine, . . . 4 drops. This nearly corresponds to the carbonate of ammonia ointment of the Italian Pharmacopoeia. The Spanish is, however, a somewhat stronger preparation. Edinburgh Itch Ointment. Ungiiento Antipsorico de Edinburgo. Unguentum Antipsoricum Edlnburgense. Black pitch, . . 500 grammes (16 ounces, 48 grains). Lard, .... 1000 " (32 " 96 " ). Precipitated sulphur, . 1000 " (32 " 96 " ). This preparation contains a larger proportion of sul- phur than the sulphur ointment officinal in the United States Pharmacopoeia. The addition of black pitch enhances its irritant properties. While, therefore, its general indications are the same as those of the American ointment, it requires caution in its use. Basilicon Ointment. Ungiiento Basilicon. Unguentum Basilicum. Unguentum Tetra- pharmacum. Black pitch, . . 100 grammes ( 3 ounces, 105^ grains). Resin, . . .100 " ( 3 " 105^ " )■ Yellow wax, . . 100 " (3 " 105}^ " )• Olive-oil, . .400 " (12 " 422 " ). *Dorivault: Recetario Farmaceutico. This is an adaptation of Dori- vault's great work, L'Offlcine au Repertoire General de Pharniacie Pratique. (181) 182 Ointments in Spanish Pharmacy. The Spanish basilicon ointment is precisely the same as the Italian unguento basilico or unguento tetrafar- maco, and the onguent basilicum of the French Codex. The German, British, and American ointments of the same name differ but slightly in composition or strength. The pitch is omitted in the latter preparations. The Italian ointment of the Abbey di Bec is of similar com- position to the Spanish and Italian basilicon ointments, with the addition of frankincense. Peruvian Balsam Ointment. Ungiiento Balsamico Peruviano. Uuguentum Balsamicum Peruvianum. Olive-oil, 690 grammes (22 ounces, 96 grains). Yellow wax,. 345 u (H u 48 " )■ Carbonate of lead, 230 11 (7 k 192 " )• Litharge, 115 It (3 a 336 " )• Greek pitch, 115 It ( 3 it 336 " )• Castile-6oap, 115 a (3 n 336 " )• Carbonate of zinc, 58 k (1 it 216 " )• Liquid balsam of Peru, 58 k (1 n 216 " )• Melt the wax and the pitch with the oil and strain the mixture. Add the coarsely-powdered soap and the remaining solid substances, finely powdered. Heat the mass, stirring continually until it has acquired a bright chestnut color and the consistence of a syrup. Remove from the fire, and, when half-cooled, add the Peruvian balsam. Then pour into paper molds. The Spanish ointment of Peruvian balsam is of kindred composition to the Ricour ointment of the Italian Pharmacopoeia. The former is a more stimulant preparation, as it contains a larger proportionate quan- tity of Peruvian balsam, and, in addition, pitch and soap. It is an admirable astringent and antiseptic combination, suitable in cases of unhealthy ulcers, dermatitis, subacute and acute eczema, seborrhoea, sycosis, and impetigo. Pile Ointment. 183 Pile Ointment. Ungiiento Contra las Hemorroides. Unguentum ad Haemor- rlioides. Poplar ointment, . . 90 grammes (2 ounces, 432 grains). Litharge ointment, .90 " (2 " 432 " ). Saffron, in powder, . 6 " (92^ grains). Crude opium, . . 1 gramme (15% " ). Yelks of 3 eggs. The addition of litharge ointment communicates astringency to this preparation, which resembles, in other respects, as regards its composition, the pile oint- ment and the poplar ointment of the Italian Pharmaco- poeia. These, in their turn, are founded upon the poplar ointment of the French Codex. The Spanish ointment is an excellent application to irritable ulcers, painful haemorrhoids, herpes zoster, and all painful inflammatory conditions of the integument and subcutaneous cellular tissue. Tinea Ointment. Ungiiento Contra la Tina. Unguentum ad Tineam Capitis. Lard, . . . 480 grammes (15 ounces, 211 grains). Pulverized charcoal, 125 " ( 4 " Uy " ). Sulphur, . . .125 " ( 4 " Uy " ). Soot, . . .60 " ( 1 " 432 " ). Charite Tinea Ointment. Ungiiento Contra la Tina, de la Caridad. Unguentum ad Tineam Capitis. Onguent Centre la Teigne, de la Charite. White vinegar, . . 150 grammes (4 ounces, 398 grains). Wheaten flour, . . 25 " (386 grains). Black pitch,. . .25 " (386 " ). White pitch, . 25 " (386 " ). Melt the pitch ; dissolve the flour in the hot vinegar and mix thoroughly with the pitch. The use for which the three preceding preparations are intended is sufficiently indicated by their titles. They are, however, far inferior to more modern modes of medication in trichophytosis, notably to the oleate of 184 Ointments in Spanish Pharmacy. copper or of mercur}- and to ointments containing cor- rosive sublimate, acid nitrate of mercury, oil of cade, thymol, or resorcin in proper quantities. Henke-s Tinea Ointment. Ungiiento Contra la Tina de Henke. Unguentum ad Tineam Capitis ex Henke. Althaea ointment, . . 60 grammes (1 ounce, 432 grains.) Juniper ointment, . .60 " (1 " 432 " ). Hydrochloric acid, . .15 " (231% grains). Juniper ointment (unguento de enebro, unguentum juniperi) consists of— Juniper-leaves, .... 1 gramme (15% grains). Resin cerate,.....6 grammes (92% " ). Pediculosis Ointment. Ungiiento Contro los Piojos. Unguentum Pediculorum. Unguentum Staphisagria? cum Mercurio. Lard,. . . . 375 grammes (12 ounces, 38 grains). Mercurial ointment, .60 " (1 ounce, 432 " ). Powdered 6tavesacre,. 90 " ( 2 ounces, 432 " ). This preparation is efficient in pediculosis and scabies. Compound Corrosive-Sublimate Ointment. Ungiiento de Cloruro Mercurico Compuesto. Unguentum Chloruri Mercurici Compositum. Beef-suet, Turpentine, . Oil of rose, . Carbonate of lead, Corrosive sublimate, Dried alum, Citric acid, . Yelks of 2 eggs. Mix the finely-powdered salts in a stone mortar. Add the citric acid dissolved in about 50 grammes (1 ounce, 293 grains by weight) of water, and then the yelks. When these are well mixed, incorporate grad- ually the lard, turpentine, and oil, previously melted at gentle heat. Stir the mixture from time to time for two or three days and preserve for use. iu giau . 29 ' (448 grains). . 29 ' (448 " ). . 72 ' ' (2 ounces, 149 grains). 7 < ' (108 grains). 7 * ' (108 « ). 6 < ' ( 92% « ). Acetate of Lead Ointment. 185 Each 30 grammes (463^ grains) of the ointment con- tain 0.60 gramme (9£ grains). This forms a powerful stimulant, antiseptic, and para- siticide application, serviceable in scabies, chronic ec- zema, purpura, bromidrosis, trichophytosis, and lupus vulgaris. It may also be spread upon chronic ulcers. The ointment must be watched carefully on account of the danger of mercurial intoxication. It may be em- ployed likewise as a resolvent to promote the absorption of plastic exudations. The same preparation may be of service in ulcerated epithelioma and in syphilitic ulcers. Acetate of Lead Ointment. Ungiiento de Acetato de Plomo. Unguentum Tennis Acetatis Plumbi. Solution of acetate of lead, . 100 grammes (3 ounces, 105% grains). Olive-oil, . . . .100 " (3 " 105% " ). Mix in a stone mortar and stir constantly until the mass is of the consistence of a liniment. The indications of this oleaginous preparation are similar to those of the American ceratum plumbi sub- acetatis and the British unguentum plumbi acetatis. Analogous combinations are found in the German and Italian Pharmacopoeias. Nut-gall and Morphine Ointment. Ungiiento de Agallas y Morfina. Unguentum Gallarum cum Morphina. Morphine, .... 1 gramme (15% grains). Olive-oil,. .... 72 grammes ( 2 ounces, 149 grains). Zinc ointment, . - . 280 " (9 ounces). Powdered nut-gall, . . .36 " ( 1 ounce, 77 grains). This preparation is analogous to the British ungueiir tum gallae cum opio. It is used for the same purpose in the treatment of painful haemorrhoids. u3 186 Ointments in Spanish Pharmacy. Alth/ea Ointment. Ungiiento de Altea. Unguentum Althaea?. Oil of fenugreek, . 800 grammes (25 ounces, 350% grains). Yellow wax, . .200 " ( 6 " 211 " ). Resin, . . .100 " ( 3 " 105% " ). Turpentine . .100 " ( 3 " 105% " ). Melt the wax and resin with the oil of fenugreek. This is the same preparation as the onguent dit dAlthsea of the French Codex. Arc>eus Ointment. Ungiiento de Arceo. Unguentum Arcaei. Mutton-suet, . . 200 grammes, (6 ounces, 211 grains). Turpentine, . . 150 " (4 ounces, 398% " ). Elemi, . . . 150 " (4 " 398% " ). Lard, . . .100 " (3 " 105% " ). This corresponds exactly to the French onguent d Arcaeus. Compound Myrtle Ointment. Ungiiento de Arrayan Compuesto. Unguentum Myrtinum Com- positum. Unguento de la Condesa. Unguentum Comitissae. Oil of myrtle, . Yellow wax, . Powdered myrtle-berries, Powdered cypress-fruit, . Powdered pomegranate-bark, Powdered nut-gall, Powdered sumach, Powdered mastic, . Melt the wax in the oil at a gentle heat; then with- draw the mixture from the fire, add the powders, and stir until the mass is nearly cold and has acquired the consistence of an ointment. Compound myrtle ointment is a powerful vegetable astringent preparation. It is beneficial in the same con- ditions as the tannic acid ointment of the United States Pharmacopoeia. . 29 lauiui !< e» ^ij. ounces, *o grams;. (448 grains). 7 It (108 " ). 7 U (108 " ). 7 (< (108 " ). . 86 (< (2 ounces, 369% grains) . 29 (( (448 grains). . 14 u (216 " ). Compound Arthanita Ointment. 18*7 Compound Arthanita Ointment. Ungiiento de Artanita Compuesto. Unguentum Arthanitae Com- positum. 690 grammes (22 ounces, 96 grains). Compound oil of arthanita, Beef-suet, Yellow wax, Purified sagapenum, Ox-gall, .... Powdered 6cammony, Powdered jalap, Powdered colocynth, Powdered aloes, Powdered mezereon-leaves, Powdered chloride of sodium, Powdered euphorbium, . Powdered myrrh, Powdered allspice, . Powdered ginger, . Powdered chamomile-flower, 230 230 14 14 14 14 14 14 14 7 7 7 7 7 7 ( 7 " 192 ( 7 ounces, 192 (216 grains). (216 < ' ) (216 ' ' ) (216 < ' ) (216 ' ' ) (216 ' ' ) (216 ' 1 ) (108 ' ' ) (108 ' ' ) (108 < ' ) (108 ' ' ) (108 < ' ) (108 ' ' ) Dissolve the wax and the beef-suet in the oil at a gentle heat, add the sagapenum and the ox-gall, and when these are mixed withdraw from the fire. Then incor- porate the powders, stirring constantly until the mass is entirely cold. The compound oil of arthanita (aceite de artanita compuesto, oleum arthanitae compositum) contains the following substances :— Strong decoction of arthanita root, Decoction of cucumber, 690 gr 230 ammes (22 ounces, 96 grains). " (7 " 192 » ). Fresh oil of orris, . 690 i< (22 " 96 " ). Colocynth, Polypodium, . Euphorbium, 58 86 7 n n ( 1 ounce, 216 " ). ( 2 ounces, 369% " ). (108 grains). The compound arthanita ointment bears a resem- blance to the arthanita ointment of the Italian Formu- lary. The Spanish preparation, however, is considerably more complex than the Italian. It must be looked upon 188 Ointments in Spanish Pharmacy. as a survival from the times in which polypharmacy was prevalent. It was intended to be rubbed upon the ab- domen with friction, in order that it might act by ab- sorption, and was employed in ascites or general dropsy, and also among children, as an anthelmintic. Bryonia Ointment. Unguento de Brionia. Ungiiento de Agripa. Unguentum Bryonise Agrippa?. Fresh squill, , 180 j grammes ( 3 ounces , 384 grains). Common iris-root, . 180 << ( 5 k 384 " ). Root of male fern,. 180 (i ( 5 K 384 " ). Elaterium-juice, , 700 (i (22 !< 249% « ). Bryonia-juice, 1100 (< (35 (1 192 " ). Macerate for twelve hours, then boil. Strain and evaporate to the consistence of a soft extract, to which add— White wax, . . 500 grammes (16 ounces, 48 grains). Oil of mucilages, . 1500 " (48 " 144 " ). The Spanish preparation is identical with thebi^onia ointment of the Italian Formulary. The composition of the oil of mucilages was given when treating of the latter ointment. Cucumber Ointment. Ungiiento de Calabaza. Unguentum Cucurbitae. Cucumber, .... 500 grammes (16 ounces, 48 grains). Purslane-leaves, . . .500 " (16 " 48 " ). Violet-leaves, .... 500 " (16 " 48 " ). Powdered arrow-root, . .500 " (16 " 48 " ). Leaves of black nightshade, . 500 " (16 " 48 " ). Bruise the leaves in a stone mortar. Then macerate for two days in a warm place with— Olive-oil,. . . 2500 grammes (80 ounces, 240 grains). Heat until all the moisture is evaporated. Strain, and with the clear oil which is expressed mix— Wax, .... 500 grammes (16 ounces, 48 grains). Cantharidal Ointment. 189 The Spanish cucumber ointment differs considerably from the Italian and the unofficial American preparation of the same name. Purslane is the Portulaca oleracea, a plant growing near the sea-shore in tropical and sub- tropical countries. The leaves contain a large quantity of mucilage. Violet-leaves are likewise emollient. The common garden or black nightshade possesses, though to a less degree, the anodyne virtues of the more power- ful members of the solanaceous group, such as bella- donna and stramonium. Like those, it has been applied in ointment form to mitigate the pain of inflammation or of malignant disease. Its presence renders the oint- ment under discussion serviceable in neuralgia, herpes zoster, irritable ulcers, painful haemorrhoids, and bed- sores. Cantharidal Ointment. Ungiiento de Cantaridas. Unguentum Cantharidum. Finely-powdered cantharides, 32 grammes (494 grains). Distilled water, . . .125 " (4 ounces, 14% grains). Resin ointment, . . .125 " (4 " 14% " ). Boil the cantharides in the water until the quantity is reduced one-half; filter the liquid; incorporate the resin ointment, and evaporate to the consistence of an ointment. The name and composition of this preparation suffi- ciently indicate its use. The fifth edition of the Spanish Pharmacopoeia pre- scribes the following formula :— Resin ointment, . 86 grammes (2 ounces, 369% grains). Yellow wax, . .14 " (216 grains). Powdered cantharides, 43 " (1 ounce, 144 grains). Mix the wax with the ointment at a gentle heat. When the mixture has become liquid withdraw it from the fire. Then add the powdered cantharides and stir the product until it acquires, in cooling, a semi-solid consistence. 190 Ointments in Spanish Pharmacy. Deobstruent Hemlock Ointment. Unguento de Cicuta Deopilativo. Unguentum Cicutao Deopilativum. Hemlock-leaves, . 375 grammes (12 ounces 38% g raic s). Celery-leaves, . 375 " (12 it 38% ii )• Dwarf elder, . 375 " (12 n 38% u )■ Parsley-leaves, . . 375 " (12 it 38% ii )■ Savine-leaves, . 375 " (12 ii 38% u )• Bark of caper-bush root, . 180 " ( 5 u 384 (< )• Iris-root, . 180 " (5 it 384 ii )• Bryonia-root, . 180 " ( 5 ^ " ). Camphor,.....7 " (108 « ). Myrrh,.....7 " (108 " ). Essence of turpentine, . - a sufficient quantity. Mucilaginous Marrow Ointment. Ungiiento de Medula Mucilaginoso. Unguentum Medullar Mucilagineum. White wax, . . 180 grammes (5 ounces, 384 grains). Beef-marrow, . . 180 " (5 " 384 " ). Lard, . . . .180 " (5 " 384 " ). Flaxseed-oil, . .150 " (4 " 398% " ). 9 I 194 Ointments in Spanish Pharmacy. Melt at a gentle heat, and when half-cooled add— Very thick flaxseed mucilage, 180 grammes (5 ounces, 384 grains). Stir until the mucilage is thoroughly mixed, and stir during several days in order that no mold may form upon the surface. This is simply an emollient preparation. MONTPELLIER OINTMENT. Ungiiento de Montpellier. Unguentum Mons-pessulani. Althaea ointment, 60 grammes (1 ounce, 432 grains). Ointment of rose, . .60 " (1 " 432 " ). Poplar ointment, . .60 " (1 " 432 " ). Honey, .... 60 " (1 " 432 " ). The Spanish is identical with the Italian Montpellier ointment. Red Oxide of Mercury Ointment. Ungiiento de Oxido Mercurico. Unguentum Oxydi Hydrargyrici. Resin ointment, . 58 grammes (1 ounce, 216 grains). Red oxide of mercury, 4 " (61% grains). Powder finely the red oxide, add the ointment gradually, and mix thorough^. This nearly corresponds to the red precipitate oint- ment of the Italian Formulary. Both are considerably weaker than the red precipitate ointment of the United States Pharmacopoeia. Both are of about the same strength as Larrey's brown ointment common to the Italian and Spanish Formularies. Piderit-s Ointment. Ungiiento de Piderit. Unguentum ex Piderlt. Honey, . . . 220 grammes (7 ounces, 38% grains) 220 " (7 " 38% " 42 " (1 ounce, 179 " 42 " (1 " 179 " 42 " . (1 " 179 " This preparation is recommended for use in subacute or chronic rheumatism. Boiled onion-bulb, Yellow wax, Resin, . Black soap, Depilatory Ointment. 195 Depilatory Ointment. Ungiiento Depilatorio. Unguentum Depilatorium. Turpentine, . . 38 grammes (1 ounce, 105% grains). Resin, . . . 30 " (463% grains). This corresponds exactly to the Italian ointment of the same name. Liquorice Ointment. Ungiiento de Regaliz. Unguentum Liquiriti.-e. Powdered pulp of fresh liquorice-root, . 480 grammes (15 ounces, 211 grains). Butter,. . . . 480 " (15 " 211 " ). Heat until all the moisture is evaporated, strain, and add— Oxide of zinc, . 23 grammes (355 grains). Carbonate of lead, . 90 grammes (2 ounces, 432 grains). Camphor, . . 2.5 " (38% grains). This preparation is identical with the Italian liquorice ointment. Ricour'S Ointment. Ungiiento de Ricourt. Unguentum ex Ricourt. Oil of rose, . . 100 grammes (3 ounces, 105% grains). Wax, ... 80 " (2 " 29 " ). Carbonate of lead, . 40 " (1 ounce, 134% " ). Litharge, . . .20 " (308% grains). Heat together, and then add— Liquid balsam of Peru, 5 grammes (77% grains). This is the same preparation as the Italian unguento di Ricour. Sulphide of Mercury Ointment. Ungiiento de Sulluro de Mercurio. Unguentum Sulphurl Hydrar- gyri Kubrum. Litharge, . . 125 grammes (4 ounces, 14% grains). Calomel, 8 " (123% grains). Carbonate of lead, . 45 " ( 1 ounce, 216 grains). Sulphide of mercury, 60 " (1 " 432 " ). Oil of rose, . . 750 " (24 ounces, 77 " ). Yellow wax, . .180 " (5 " 384 " ). Melt the wax in the oil. Then withdraw from the 196 Ointments in Spanish Pharmacy. fire and add the metallic salts, stirring the mixture until cold. The ointment prepared according to the above formula will prove of especial service in venereal ulcerations. Tobacco Ointment. Unguento de Tabaco. Unguentum Nlcotina?. Yellow wax, . . 45 grammes (1 ounce, 216 grains). Resin, .... 45 " (1 " 216 " ). Oil of myrrh, . . 125 " (4 ounces, 14% " ). Melt and add— Tobacco-juice, . . 90 grammes (2 ounces, 433 grains). The uses and the disadvantages of an ointment con- taining tobacco have been considered under the head of the tobacco ointment formerby officinal in the Pharma- copoeia of the United States. Knachstedt-s Zinc and Myrrh Ointment. Ungiiento de Zinc con Mirra de Knacbstedt. Unguentum Oxidi Ziucici ex Knachstedt. Oxide of zinc, 8gr ammes (123% grains). Calamine, 8 " (123% " )■ Lycopodium, 8 u (123% " )■ Acetate of lead, . 2 u (31 " )■ Powdered myrrh, 2 u (31 " )■ Lard washed with rose- water, . 45 ii (1 ounce. , 216 grains). The uses of this preparation are essentially thos the oxide of zinc ointment officinal in the United States Pharmacopoeia. Simple Digestive Ointment. Ungiiento Digestivo Simple. Unguentum Digestivum Simplex. Turpentine, . . 40 grammes (1 ounce, 139 grains). Yelk of egg, ... 20 " (309 grains). Olive-oil, . . .10 " (154% " ). The formula for the simple digestive ointment is the same as that for the preparation of the ointment of the same name officinal in the French Codex. Stronger Digestive Ointment. 197 Stronger Digestive Ointment. Unguento Digestivo Animado. Unguentum Digestivum Animatum. Simple digestive ointment, . 100 grammes (3 ounces, 105% grains). Liquid storax, . . .100 " (3 " 105% " ). This corresponds exactly to the Italian ointment of the same name. Mercurial Digestive Ointment. Ungiiento Digestivo Mercurial. Unguentum Digestivum Mer- curiale. Simple digestivo ointment, . 100 grammes (3 ounces, 105% grains). Mercuriafointmeut, . . 100 " (3 " 105% " ). The mercurial digestive ointment is the same in the Spanish and Italian Pharmacopoeias. Opiated Digestive Ointment. Ungiiento Digestivo Opiado. Unguentum Digestivum Opiatum. One part of Sydenham's laudanum, vinum opii, added to 8 parts of simple digestive ointment forms the opiated digestive ointment. The Italian preparation of the same name differs from the Spanish only in using the tincture instead of the wine of opium. The Formulary of the Hospitals of Madrid modifies the composition of the simple digestive ointment in the following manner :— Turpentine, .... 30 grammes (463% grains;. Yellow ointment, . . .30 " (463% " ). Oil of hypericum, . . .15 " (231% " ). Yelks of 2 eggs. The fifth edition of the Spanish Pharmacopoeia pre- scribes the following formula :— Turpentine, . . . 58 grammes (1 ounce, 216 grains). Oil of hypericum, . .14 " (216 grains). Yelks of 2 eggs. Ethiopian Ointment. Unguento Ktiopico. Unguentum e Sulphure Hydrargyrato. Sulphur,.....1 gramme (15% grains). Mercurial ointment, . . . 2 grammes (31 " ). Lard,......2 " (31 " ). 198 Ointments in Spanish Pharmacy. The formula for the Spanish is the same as that for the Italian Ethiopian ointment. Epispastic Ointment. Ungiiento Epispastico. Unguentum Epispasticum. Basilicon ointment, . 125 grammes (4 ounces, 14% grains). Mustard-seed, . .15 " (231% grains). Stavesacre,. 4 " ( 61% " ). Allspice, . . . 4 " ( 61% " ). Pellitory, . . . 4 " ( 61% « ). Euphorbium, . . 1.20 " (18% " ). Turpentine, . . sufficient quantity. This ointment bears a close resemblance, both as re- gards ingredients and proportions, to the Italian blister- ing ointment without cantharides, unguento vesicatorio senza cantaridi, and its uses are the same. Opiated Resolvent Ointment. Ungiiento Fundente Opiado. Unguentum Minii Opiatum 1000 grammes (32 ounces, 96 250 " ( 8 " 24 250 " ( 8 " 24 250 " ( 8 " 24 90 " (2 " 432 30 " (463% grains). grains) " ) " ) " ) " ) Oil of flaxseed, Red oxide of lead,. Carbonate of lead,. Yellow wax, . Turpentine, . Powdered opium, . This belongs to a class of preparations formerly much used, now almost abandoned. They were thought to act beneficially in causing retrogression, absorption, resolution, or discussion of morbid growths. This ointment, by virtue of the lead it contains, may restrain inflammatory action, and thus lead to the reduction of glandular tumors, but we should not expect it to diminish the bulk of a neoplasm. Canquoin's Maturative Ointment. Ungiiento Madurativo de Canquoin. Canquoin. Unguentum Maturans ex Acetic infusion of daphne gnidium, 45 grammes (1 ounce,216grains). Sugar,......45 " (1 " 216 " ). Olive-oil,......45 " (1 " 216 " ). Ox-gall,......3 " (46 grains). Martial Ointment. 199 Evaporate to the consistence of honey and add— Basilicon ointment, . . 45 grammes (1 ounce, 216 grains). Mother Thekla's ointment, 45 " (1 " 216 " ). Subnitrate of mercury, .4 " (61% grains). This is substantially the same preparation as the maturative ointment of the Italian Formulary. Martial Ointment. Ungiiento Marcial. Unguentum Martiale. Solution of nitrate of iron, A of iron, . 8 grammes (123% grains). Aloes.......sufficient quantity. Make into a mass of the consistence of an ointment. This preparation is the same as the martial ointment of the Italian Formulary. Velpeau-s Black Ointment. Ungiiento Negro de Velpeau. Unguentum Nigrum ex Velpcau. Mother Thekla's ointment, . 15 grammes (231% grains). Oil of sweet almonds, . . 5 grammes (309 " ) Mix at a gentle heat. This corresponds exactly to the Italian ointment of the same name. Nervine Ointment. Ungiiento Nervino. Unguentum Nervinum. Suet, . . . .100 grammes (3 ounces, 105% grains). Oil of laurel-berries,. 150 " (4 " 398% " ). Oil of turpentine, .15 " (231% grains). Oil of peppermint, 2 " (31 " ). Rectified oil of amber, 8 " (123% " ). Oil of rosemary, 2 " (31 " ). Ammonia, . . 10 " (154% " ). Melt the suet, then add the oils and the ammonia. Nervine ointment is formed upon the same model as the compound rosemary or nervine ointment of the Italian Formulary, the compound rosemary ointment of the German Pharmacopoeia, the aromatic ointment of the Austrian Pharmacopoeia, the nervine ointment of the Mexican and Chilian Pharmacopoeias. They 200 Ointments in Spanish Pharmacy. are all used to fulfill the same indications, which have been given under the title of the German compound rosemary ointment. Laurel Ointment. Ungiiento de Bayas de Laurel. Unguentum Baccarum Uauri. Suet,......16 grammes (247 grains). Oil of turpentine, ... 1 gramme ( 15% " ). Oil of laurel-berries, . . .24 grammes (370% " ). Laurel ointment, prepared according to the above directions, nearly resembles the laurel ointment of the French Codex. It is, however, more stimulant, since it is largely composed of a volatile oil, and contains, also, a certain quantity of oil of turpentine. Spanish pharmacy employs the oil of laurel-berries on account of the difficulty of procuring, at all seasons of the year, fresh laurel-leaves and berries. Acetate of Lead Ointment. Ungiiento Nutrido. Unguentum Nutritum. Unguentum Plumbi Acetatum. Olive-oil,......9 grammes (139 grains). Litharge,......3 " ( 46 " ). Vinegar,......3 " ( 46 " ). Mix in a glazed earthenware dish and heat gently until the mixture has acquired the consistence of a soft ointment. An ointment prepared according to the above for- mula is useful in the cases already mentioned under the heads of the British unguentum plumbi acetatis and unguentum glycerini plumbi subacetatis. The fifth edition of the Spanish Pharmacopoeia pre- scribes the following proportions :— Finely-powdered litharge, . 345 grammes (11 ounces, 47 grains). Olive-oil, .... 1035 " (30 " 139 « ). White vinegar, . . .460 " (14 " 383 " ). Larreifs Brown Ointment. 201 Larrey's Brown Ointment. Ungiiento Pardo de Uarrey. Unguentum Fuscum ex Liarrey. Basilicon ointment, . . . 30 grammes (463% grains). Red oxide of mercury, . .2 " (31 " )■ To be prepared only as needed. This ointment is a trifle stronger than the Italian preparation of the same name, but is used in the same cases. Mercurial Resolvent Ointment. Ungiiento Kesolutivo Mercurial. Unguentum Hydrargyri Resolutivum. Mercurial ointment, . 30 grammes (463% grains). Soap, .... 60 " (1 ounce, 432 grains). Camphorated alcohol, .90 " (2 ounces, 432 " ). Mix thoroughly. This ointment is used in the treatment of chronic glandular enlargements. Sulphuric Acid Ointment. Unguento Sulfurico. Unguentum Sulphuricum. Olive-oil,.....8 grammes (128% grains). Sulphuric acid, . . . . 5 " (309 " ). This preparation is exactly the same as the Italian sulphuric acid ointment, unguento solforico. Vermifuge Ointment. Ungiiento Vermifugo. Unguentum Vermifugum. Root of male fern, 45 grammes (1 ounce, 216 grains). Bryonia-root, . . 45 a (1 " 216 " ). Garlic, 45 << (1 " 216 " ). Southern wood, 8 i< (123% grains). Absinth, . 8 it (123% « ). Tansy, 8 it (123% « ). Olive-oil, 500 it (16 ounces, 48 grains). Heat until all the moisture is evaporated. Strain and add- Yellow wax, . . .45 grammes (1 ounce, 216 grains). Aloes, .... 30 " (463% grains). Colocynth, . . .15 " (231% grains). Ox-gall, .... 60 " (1 ounce, 432 grains). 9* 202 Ointments in Spanish Pharmacy. This powerful compound is directed to be rubbed upon the abdomen in the neighborhood of the umbilicus three times a day. Its name indicates the purpose for which it is used. Mercurial Ointment. Pomada Mercurial. Unguentum Hydrargyri Coaruleum Fortius. Mercury, . . . 500 grammes (16 ounces, 48 grains). White wax, . . .40 " ( 1 ounce, 139 " ). Benzoated lard, . . 460 " (11 ounces, 48 " ). Melt the lard and the wax. Place the mercury with part of the melted fat in an iron pot and heat gentty, so that the product is maintained under the form of a semi- fluid mass. Triturate until the mercury is entirely extinguished. Then add the remainder of the fat. Oleate of Quinine Pomade. Pomada Oleica de Quinina. Pomatum Cjuininae Oleicum. Sulphate of quinine, . . 1 gramme ( 15% grains). Stearic acid, .... 2.50 grammes ( 38% " ). Oleic acid, .... 7.50 " (116% " 5- Oleate of Veratrine Pomade. Pomada Oleica de Veratrina. Pomatum Veratrinae Oleicum. Veratrine,.....0.05 gramme (% grain). Oleic acid,.....3.00 grammes (46 grains) Stearic acid, .... 1.00 gramme (15% " ). My experiments upon animals, detailed in another portion of this work, as well as careful observation of patients, have convinced me that the oleates, much less the stearates, do not act by systemic absorption, but by penetration of the follicles of the area upon which they are spread, or by influencing the superfices to which they are applied. CHAPTER X. OINTMENTS OFFICIAL IN THE MEXICAN PHARMACOPCEIA. The Mexican Pharmacopoeia* includes sixteen offici- nal ointments. They are as follow :— Yellow or Basilicon Ointment. Ungiiento Amarillo. This preparation is similar to the basilicon ointment of the other pharmacopoeias. Rhazes* White Ointment. Ungiiento Blanco Simple. Pomada de Rbazis de Carbonato de Plomo. This is essentially the same as the ointment of the same name in the French Codex. Brown Ointment. Ungiiento Bruno. Brown ointment consists of— Red oxide of mercury, twenty parts,.....20 Alum, ten parts,.........10 Basilicon ointment, one hundred and fifty pai-ts, . . . 150 Compound Carbonate of Lead Ointment. Ungiiento contra Escabia. Pomada de Carbonato de Plomo Coinpuesta. This is prepared from— White wax, one hundred and twenty parts, . . . . 120 Turpentine, two hundred and fifty parts, .... 250 Lard, one thousand parts,.......1000 Pure carbonate of lead, three hundred and eighty parts, . 3S0 Lemon-juice, two hundred and fifty parts, .... 250 Corrosive B\ib\ima,te, fifteen parts,.....15 Alum, fifteen parts,........15 Yelk of egg, six parts,.......6 *Nueva Farniacopea Mexicana de la Sociedad Farmaceutica de Mexico. Segunda edicion. Mexico, 1884. (203) 204 Ointments Official in the Mexican Pharmacopeia. Althea Ointment. Ungiiento de Altea. The formula for the Mexican resembles that of the French onguent d'Althaea. Ungiiento de Arceo. This is the French onguent d'Arcaeus. Storax Ointment. Ungiiento de Estoraque. Similar to the French onguent de styrax. Green Ointment. Ungiiento de Isis. U. Verde. U. Digestivo Verde. Unguentum cum Acetate Cuprico. An acetate of copper ointment. Soap Ointment. Ungiiento de Jabon. Unguentum Saponis. Soap ointment contains— Finely-powdered hemlock, thirty-six parts, ... 36 Soap, sixty parts,........60 Mercurial ointment, thirty parts,.....30 Lar'd, one thousand parts, ....... 1000 Mercurial or Blue Ointment. Ungiiento de Mercurio Doble. U. Napolitano. Onguent Mercuriel Double. This is made from— Mercury, five hundred parts,......500 Storax, forty parts,........40 White wax, sixty parts,.......60 Lard, four hundred parts, .... ... 400 Osorius'S Ointment. Ungiiento de Osorio. The formula is :— Suet, five hwndred parts,.......500 Lard, one thousand parts,.......1000 Strained storax, one hundred and twenty parts, . . . 120 Oil of lavender, twenty-five parts,.....25 Suet Ointment. 205 Suet Ointment. Ungiiento de Todos Sebos. Suet ointment is made from— Suet, one hundred and twenty-five parts, .... 125 Simple plaster, fifteen parts, . . ... 15 Lard, five hundred parts, ....... 500 Cordial Ointment. Ungiiento del Corazon. Pomade de Sandolo Alcauforado. This preparation contains— Finely-powdered red saunders, thirty parts, ... 30 Aromatic powder of rose, twelve parts, .... 12 Powdered camphor, fourparts,......4 Lard, five hundred parts,.......500 Countess's Ointment. Ungiiento de la Condesa. Unguentum Coinitissa?. Finely-powdered nut-gall, thirty parts, .... 30 Powdered cypress-fruit, thirty parts,.....30 Finely-powdered pomegranate-bark, thirty parts, . . 30 Finely-powdered myrtle, fifty parts,.....50 Lard, six hundred parts,.......600 Aii astringent preparation. Its composition is simi- lar to that of the Countess's or compound myrtle oint- ment of the Spanish Formulary. Red Oxide of Lead Ointment. Unguento Encarnativo. Unguentum cum Plumbico Rubro. Red oxide of lead, sixty parts,......60 Lard, five hundred parts,.......500 Nervine Ointment. Ungiiento Xervino. Fresh rosemary-leaves, two hundred ami fifty parts, . . 250 Fresh laurel-leaves, two hundred and fifty jmrts,. . . 250 hard., eight hundred and seventy-five parts, .... 875 Suet, three hundred and cigMy-sixparts, .... 386 Yellow wax, ninety-eight parts,......98 Oil of bvick, fifteen parts,.......15 Oil of rosemary, fifteen parts,......15 Oil of juniper, fifteen parts,......15 206 Ointments Official in the Chilian Pharmacopoeia. Zinc and Copper Ointment. Ungiiento Santo. Pomada con Oxido de Zinc y Cardenilla. Unguentum cum Oxido Zincico et Subacetate Cuprico. Prepared tutty, thirty parts,......3^ Acetate of copper, eight parts,..... hard, five hundred parts,...... 500 OINTMENTS OFFICIAL IN THE CHILIAN PHARMACOPOEIA. Five ointments are enumerated in the Chilian Phar- macopoeia*:— Yellow or Basilicon Ointment. Ungiiento Amarillo. Unguentum Elavum. This resembles the Mexican ointment of same name. Unguento Diapalma. Unguentum Diapalmum Simple plaster, three hundred parts, Oil of rose, three hundred parts, . Yellow wax, twentyjxirts, . Sulphate of zinc, tenparts, Turpentine, sixty parts, 300 300 20 10 60 Ungiiento de Arceo. Unguentum Arcaei. This corresponds to the French onguent d'Arcaeus Nervine Ointment. Ungiiento Nervino. Unguentum Nervinum. Prepared lard, one thousand parts, Yellow wax, one hundred parts, Turpentine, tenparts, Fresh rosemary-leaves, fifty parts, Fresh mint-leaves,^?/??/parts, . Fresh rue-leaves, fifty parts, fresh fennel-leaves,^/??/parts,. Fresh sage-leaves, fifty parts, . Essence of turpentine, six parte, Essence of lavender, five parts, Essence of juniper, five parts, . Essence of thyme, five parts, . * Farmacopea Chilena. Leipsic, 1886. 1000 100 10 50 50 50 50 50 6 5 5 5 Althea Ointment. 207 Althea Ointment. Ungiiento de Altea. Unguentum Althaea?. Prepared lard, one hundred parts,.....100 Yellow wax, twenty parts,.......20 Resin, twenty parts,........20 Venice turpentine, fifteen parts,.....15 Part II. tme; oleates. i» (209) CHAPTER I. History and Origin. When Chevreul, in 1811, proclaimed the chemistry of fats and oils, and isolated fatty acids from their bases, the first step in the direction of a more thorough understanding of their nature and action had been taken. Quickly following this discovery it was proved that fatty acids, especially the oleic acid, could be united to other bases as well as the original one. This is undoubtedly the first comprehensive knowl- edge we had of a class of remedial substances which forms the subject of this treatise, and which are known as oleates. While as such they had been in use for cen- turies previous to this period, they were applied em- pirically without a knowledge of their constituents. Thus, we had lead plaster, soaps, etc., but they were only known as such, and not as salts or combinations of a fatty acid with metallic or alkaline bases, which stamped them, respectively, as lead oleo-palmitates and sodium, or potassium oleo-palmitates or stearates. Their medicinal application, in various ways, by using oleic acid as a solvent for alkaloidal substances, was subsequently agitated by Professor Attfield, in 1862 ; and a paper on their use in medicine, by Dr. John Marshall, ten years later, brought them prominently before the medical profession. Dr. Marshall's valuable communication and its suggestions soon attracted at- tention, and efforts were made to further perfect both the acid and its products. It was about this time that Dr. L. Wolff, a well-known chemist of Philadelphia, was (211) 212 The Oleates. experimenting on oleic acid and its derivatives, and in- terested me in his investigations, which we afterward pursued together. The oleic acid of the market of that period was an unsightly, dark, and rancid body, of very offensive odor, known to the trade as the red oil of the candle- maker,—the refuse, after the separation of most of the stearic acid,—which is utilized for illuminating purposes. It represented a combination of oxyoleic and stearic acids, along with numerous volatile fatty products, and if it were, either alone or otherwise, applied to the skin, it proved an irritant rather than a mild vehicle of medicinal substances. Purification of this acid availed very little, and to this day its use, though advocated by manufacturers, is often accompanied, as I shall point out hereafter, with unpleasant and injurious results. As the oleates, as then known, were at best only oleic solutions, or solutions of some oleate in a large excess of oleic acid, the disappointments they caused in their action seriously interfered with their successful introduction and use by the profession. While oleic acid sufficiently pure to overcome these objections could be had, and was so produced by Dr. Wolff, the price, in consequence of the manner of its production, was such that it precluded its extensive use in hospital or general practice. It now became our principal object to make an acid sufficiently pure and at a reasonable cost. This object was accomplished by using oil of sweet almonds —which contains a large amount of olein—and saponi- fjdng it with litharge, in the same manner as is em- ployed in the process of making ordinary lead plaster, and dissolving the mixture in petroleum benzine at a low boiling-point, which left the lead palmitate undis- History and Origin. 213 solved. The clear solution of lead oleate, decanted from its palmitate, was then put into an agitator and thoroughly shaken with dilute hydrochloric acid (1 in 8), and on settling, when it gave no longer evi- dence of the presence of lead on the introduction of a stream of hydrogen sulphide, the benzine was distilled off from it, in the presence of water, so as to obviate the possibility of the oxidation of the acid. The acid was now deprived of the odor of the heavier coal-oil prod- ucts by introducing a current of steam, and was kept under a surface covering of water all the time in order to prevent oxidation. It was subsequently separated from the water, and filtered in an apparatus admitting of no access of atmospheric air. The oleic acid so obtained contains no palmitic acid (or almost none) ; is of very light color; has a specific gravity of 0.800 at 19° C. (66.2° F.) ; mixes in its pro- portions with stronger alcohol without giving rise to turbidit}', proving the absence of olein ; it begins to solidify only at -4° C. (24.8° F.), and not + 4° C, as often erroneously stated, which it does only when con- siderable quantities of palmitic acid are in it; has a specific odor without being acrid, and readily dissolves the principal metallic oxides and alkaloids. This acid can be produced at a moderate expense, and was by us subsequently employed in making the oleates as directed by Attfield and Marshall.* Messrs. Saytzeff have recently described a solid isomer of oleic acid, obtained, together with ordinary oleic acid, by treating with alcoholic potash the iod- stearic acid produced by the action of hydriodic acid * See paper on Oleates, with discussion, read before the Section of Pharmacology and Therapeutics at the Fifty-second Annual Meeting of the British Medical Association, in the British Medical Journal, October 18,1884, pp. 749-7W. 214 The Oleates. upon ordinary oleic acid. The same compound is formed during the distillation of oxystearic acid pro- duced by the successive action of sulphuric acid, and water upon ordinary oleic acid. The isoleic acid, or solid oleic acid, is said to be insoluble in water, freely soluble in alcohol and ether, and melting at 44° to 45° C. (111.2° to 113° F.).* Granval and Talser have lately announced that the commercial oleic acid of the present day is largely adulterated with linoleic acid, which is made from lin- seed-oil by saponification. " In testing for the adul- terant, comparative experiments should be made on commercial oleic acid of good quality. 1. The im- pure acid has a yellowish-brown tint, paler than the standard. 2. The density is higher, say 0.912 to 0.919 in various samples at 15°, whilst the standard never ex- ceeds 0.905. As the impure sample is clotty at 15°, it is necessary to take the specific gravity at a higher tem- perature, and add 0.00064 for each degree above 15°. 3. On heating the impure acid to 50°, it becomes more consistent after cooling, and this change is accentuated each time the operation is repeated up to a certain point. 4. Fifty grammes dissolved in 450 cubic centi- metres of 85-per-cent. alcohol produces, on shaking, a glistening precipitate, whilst pure oleic acid dissolves completely ; other oils give deposits, but not of the same character. The precipitate is collected, washed with alcohol, dried, and is then found to melt at about 4T°. It is easily saponified, yielding a soda soap completely soluble in water, with which it forms a jelly on cooling when only present to the amount of 1 to 100. 5. If Poulet's reagent be applied to the impure acid, the mass remains more or less liquid, whilst the oleic acid be- * Pharmaceutical Journal and Transactions, June 2, 1888. History and Origin. 215 comes solid by the following day. -6. A thin film of impure acid soon becomes resin-like, whilst the oleic re- mains almost unchanged. 7. If a few drops of impure acid are added to soda-lye, an intense yellow color is produced, whilst the pure acid gives a grayish tint only."* Oleates are remedies of which I spoke in my paper presented to the State Medical Societyf in 1879, and the use of which I advocated at that time, and sug- gested that it was a subject worthy of further investiga- tion and improvement. While they possessed great advantages over many of the ointments then in use, they were by no means perfect, and, on account of their instability and their indefinite chemical character, often gave negative and discouraging results. This became evident in the so- called mercuric oleate, which has had the most exten- sive use, and was, in our terminology, not even treated as an oleate, but only as a solution of mercuric oxide in oleic acid, the former being referred to by the per- centage in which it was added to the latter and mis- named an oleate of so much strength. Although it possessed valuable properties, representing those of the oxide, it failed to show them very long, as, by its chemical nature, the acid very quickly oxidized at the expense of the oxide, reducing and precipitating the latter both as a mercurous oxide and metallic mercury. This is unavoidable, as oleic acid is a readily oxidizable body, the replaceable hydrogen of which, when not fully saturated, is sure to produce like results with oxides of diads. * American Journal of Pharmacy, September, 1889. t Transactions of the Medical Society of the State of Pennsylvania, vol. xii, p. 707. 216 T7ie Oleates. The oleates of the alkaloids prepared in this way contain large excesses of acid, and represent, according to their chemical character, a more stable class of remedies. As many of the alkaloids, however, are not entirely freed from their acid radicals, and the latter are not displaced by the weaker oleic acid, their production is not always easily accomplished, and the desire of the manufacturer to produce clear oleates creates the danger of removing by filtration some, or even a greater part, of the alkaloid which the}' contain ; or even if fully dissolved by heat or other solvents they are very apt to re-crystallize or separate from their solutions on standing. These oleates of the alkaloids, as the}' are termed, are little else than acid solutions, or, as implied by their name, they are regarded as such by the manu- facturers, as proved by their statement of the percentage of the alkaloid held in solution by the oleic acid. Thus, while 25-per-cent. quinine oleate contained 45.3 per cent. of the oleate, it also contained 54.7 per cent, of free oleic acid ; 2-per-cent. aconitine oleate, 3 per cent, of oleate, 97 per cent, free acid; 2 per-cent. atropine oleate, 3.94 per cent, oleate and 96.06 per cent, acid; 5-per-cent. morphine oleate, 6.5 per cent, oleate and 93.5 per cent. of the acid ; 2-per-cent. veratrine oleate, 2.94 per cent. oleate and 97.06 per cent, acid; 2-per-cent. strychnine oleate, 3.68 per cent, oleate and 96.32 per cent, of acid. It will thus be readily seen that there is a vast differ- ence between oleic solutions of alkaloids and the oleates thereof. While in other salts we lose sight of the acid radical or the base, which we consider to have lost their identity in the chemical reaction of their constituents, we have most unscientifically upheld a series of prepara- tions which, while we have termed them chemically, we have treated as mechanical mixtures altogether. To History and Origin. 217 imply that only alkaloidal substances give force to such preparations is to frame a theory which would upset our present knowledge that two bodies, on entering a true chemical combination, lose their identity in form- ing a third at variance with its components. Even the oleates of the alkaloids, if the}' are to be used in medi- cine, must be considered as oleates only, and be lost sight of as a mixture of alkaloid and acid. Impressed with the many defects, disadvantages, and the instability of the oleates as then made, we worked toward the end of getting oleates that would be what their name implied—stable, such as could be relied on for their action. To accomplish this it is, first of all, necessary to have an oleic acid both in nature and name, next to combine it full}', i.e., saturate it with the base to be used, and thus produce neutral and chemical oleates having neither base nor acid in excess. This was effected, as described in a brief and incom- plete manner in my paper presented to the Pennsylvania Medical Society in 1882, by first using the above-de- scribed oleic acid in making a sodium oleate as the source for all the other oleates, and the manufacture of which I shall now proceed to describe. 10 K CHAPTER II. Process of Manufacture. sodium oleate. nac18h330.,. m. w. 304. Sodium oleate is perhaps one of the oldest, if not the oldest, oleates known. It does not occur in a pure state in commerce, the substance representing it being known as the soap of the market. That the sodium is combined with not only oleic acid, but also palmitic, stearic, and other acids, making it an oleo-palmitate or oleo-stearate, or both, is well known ; also, that in the process of saponification a great deal of the oleic acid is changed into oxyoleic acid. To make a pure and true sodium oleate, therefore, is easily effected by saponifying oleic acid, as I have stated, with a solution of sodium hydrate or potassium hydrate, on the saturation of which water is added and heat applied until a clear solution of the sodium oleate is obtained. This, if it were neutral, might at once be utilized to make the oleates; but as this cannot practically be accomplished, and an excess of alkali would reduce the salts used for their precipita- tion, or an excess of oleic acid would again cause an excess of acid, which was found of such disadvantage in the earlier oleates, it is therefore necessary to have, in the process of making the sodium oleate, the alkali slightly in excess, and then by the salting-out process of the soap-maker to separate the oleate from its solution. This accomplished, it is strained from the liquid, well expressed, and then allowed to dry. As yet, however, it contains salt and water and other admixtures, which are best removed by dissolTing the mass in stronger (219) 220 The Oleates. alcohol, filtering it, and recovering the alcohol in it by distillation. The pure sodium oleate so derived is a diaphanous, almost colorless body, readily soluble in warm and only slowl}- soluble in cold water. A solution of this in 8 parts of water is what I shall term here- after the sodium-oleate solution, by means of which all oleates are to be made. The manufacture of oleates from the sodium-oleate solution is very simple and easily accomplished. A neu- tral solution of a salt of the substance to be derived as an oleate is added to the sodium-oleate solution until the latter is completely decomposed, a degree to be ascertained with a little experience in the manipulation, and most readily detected when, on rapid stirring, no froth appears on the surface or bubbles cease to form. As some of the salts, however, on addition of water, not only decompose but fail to }'ield oleates, and their puri- fication, besides, is a matter of difficulty, I will treat the process employed for each separatel}7, giving, however, first a synopsis of the general plan to be adopted for making oleates of the alkaloids. Mr. G. M. Beringer, Ph.G., has published {American Journal of Pharmacy, December, 1889) a series of formulae by which the oleates may be produced by double decomposition. Sodium oleate is the substance which he generally makes use of, adding a solution of it to a solution of the salt of whose base an oleate is desired. On account of the difficulty of preparing a neutral soap with an aqueous solution of an alkali, he recommends the use of hydro-alcoholic solutions of the alkaline hydrate and finds that, with proper manipula- tion, the quantity of alcohol can be reduced to a com- paratively small amount. As many of the salts of the alkaloids are not readily Process of Manufacture. 221 soluble in water, their solution is accomplished by the addition of a slight excess of their acids, which, upon being filtered, are added to a warm solution of sodium oleate. The amount of the salts so used is to be noted, and the corresponding amount of their alkaloids com- puted from their molecular weights, along with the necessary amount of oleic acid necessary for complete saturation. The separated oleate, deprived of its water, is then weighed and the result in excess of the computed oleate is set down as free oleic acid. As the oleates of these preparations are at present principally used as acid solutions (a method which I do not recommend, however), sufficient oleic acid is added to bring it up to the requisite percentage, the true alkaloidal oleate serving as a base. ALUMINIUM OLEATE. Al2 (C^H^O,^. M. W. 397. This is a substance of a yellowish color, of the con- sistence of a soft plaster mass, but elastic to the touch, resembling hardened gelatin both in consistence and appearance. It is often manufactured of a white color, and streaked with yellow and brown or spotted with foreign ingredients. This is due to the fact that it has not been purified or deprived of the water it holds inclosed in the spongy mass as first precipitated. If pure and true, it should readily and without turbidity dissolve in ether, chloroform, or petroleum benzine, should make a clear solution with fats or oils when melted with them over a water-bath, and should be veiy tenacious. It is best prepared by precipitating the sodium-oleate solution with a solution of aluminium sulphate. The white, spongy precipitate should be first expressed, then freed from the adhering water at a tem- perature not exceeding 100° C, after which it is dis- 222 The Oleates. solved in good and very volatile petroleum benzine. The benzine solution is then filtered and the benzine allowed to evaporate or distilled off. The aluminium oleate thus derived, well heated over a water-bath to rid it of any adhering petroleum odor, is then ready, and presents the condition and appearance that I have noted. Aluminium oleate, according to its molecular weight, contains about 3.1 per cent, metallic aluminium, equivalent to about 17.9 per cent, aluminium hydrate. Mr. Louis Genois informs me that, as prepared from aluminium sulphate, aluminium oleate becomes, in time, so tough and stiff that it can scarcely be spread or softened. Even after liquefaction by heat it cannot be satisfactorily manipulated. He has found that if made from aluminium acetate it is of much more convenient consistence, and can be handled with comparative ease. ARSENICUM OLEATE. A3 (C18 H33 G2)3. M. W. 918. This oleate, if properly prepared, is of a reddish-brown color, of a solid, somewhat wax-like consistence, breaks on bending, and melts at about 85° C. (185° F.). As generally offered in the market, and by some very good manufacturers, too, it is not an oleate, but simply a mixture of oleic acid, chloride of sodium, and arsenious acid (to the latter of which its apparent effect has been due), and is readily miscible with alcohol, yielding therewith a clear solution. If a portion of this bei treated with ether, or, still better, petroleum benzine, and this, by filtration or separation, be separated from the underling aqueous layer, and into it a current of hydrogen sulphide be led, no precipitate occurs, show- ing the total absence of arsenicum oleate. The arseni- cum oleate, besides possessing the characteristics and appearance as above stated, should be insoluble in Process of Manufacture. 223 alcohol, but readily and entirely soluble in petroleum benzine. When a current of hydrogen sulphide is in- troduced into the latter solution, after filtration it gives a copious yellow precipitate of arsenicum sulphide. In my last paper on the "Oleates and Oleo-palmitates in Skin Diseases," already referred to, I gave in brief simply a few hints as to how arsenicum oleate may be obtained, with no attempt at accuracy or detail, and I am therefore not surprised at the failure of many manu- facturers with it, in view of the fact that the arsenicum chloride is at once decomposed into arsenious acid and hydrochloric acid on the addition of water. If the arsenicum chloride be simply added to the sodium-oleate solution, the result will be invariably a pseudo-oleate, as already pointed out, and I therefore give the method employed by Dr. Wolff, which he describes as follows : "A solution of arsenicum chloride is made in the usual way, and then diluted with about four times its bulk of glycerin. Instead of the sodium-oleate solution, I use the alcoholic solution before the alcohol is distilled from it. This alcoholic sodium-oleate solution is mixed with the glycerin solution of arsenicum chloride until the former is fully decomposed. After the precipitate is strained off, washed well with alcohol to get rid of any adhering glycerin, the washed precipitate dissolved in benzine and the benzine fully evaporated, the residue will present a chemically true and pure arsenicum oleate. According to computation it contains about 8.16 per cent, of metallic arsenic, representing about 21.5 per cent, of arsenious acid." BISMUTH OLEATE. Bi(C18H3303)3. M. W. 1053. This is a soft, unguent body, of a pearly-gray color, and should be termed, chemically, a bismuthous oleate, 224 The Oleates. as bismuthyl does not enter into combination with oleic acid, a fact which is overlooked by many in endeavoring to make a direct union of bismuth oxide with that acid. Ointments so named simply hold the oxide in suspen- sion, but contain none of it in solution or chemical combination. It should, when properly prepared, be semi-diaphanous, and on being rubbed on the skin should present no evidence of any solid particles sus- pended therein, i.e., it should leave no white mark on the skin or its crevices. It parts very reluctantly with the water it holds in suspension, and many of the articles of this name in the market have a watery, sponge-like appearance. When first precipitated it is very white, and on manipulation a great deal of water may be liberated ; while in this state it does not readily mix or dissolve in benzine, but on driving off all the water by evaporation it fully dissolves, yielding an almost clear solution. Its preparation is not quite so easy as some of the others, as it requires, first of all, the formation of bismuthous nitrate in crystals. This is accomplished by treating purified metallic bismuth with nitric acid, evaporation, and subsequent crystalli- zation. The cr3rstals thus derived are first drained off, dried between bibulous paper, and then dissolved in glycerin. This glycerole of bismuthous nitrate is then decomposed with the solution of sodium oleate, yielding a bulky White precipitate, as before remarked. Bis- muthous nitrate cannot be dissolved in water, as it yields then the bismuthyl nitrate. Any bismuth oleate made in that way is little more than a suspension of bismuthyl nitrate (bismuth subnitrate) in oleic acid. The precipitate should be well washed with copious repetitions of hot water until no traces of sodium nitrate are detected in the washing. It is then trans- Process of Manufacture. 225 fcrred to a water bath and evaporated until samples taken from it dissolve in benzine without turbidity. The true and pure bismuth oleate contains about 19.9 per cent, metallic bismuth in combination with oleic acid, that amount of bismuth representing about 44.3 per cent, bismuth oxide. Mr. Beringer prefers to boil together oxide of bis- muth and oleic acid. As commercial subnitrate of bis- muth is a substance of variable composition, he emploj's an oxide dried at 212° F. The formula is as follows :— Take of bismuth oxide dried at 100° C. (212° F.) until it ceases to lose water, 1 troy ounce. Oleic acid,.......3 troy ounces, 295 grains. Water, a sufficient quantity. Rub the oxide of bismuth to a fine powder, and thoroughly mix it with the oleic acid in a capacious vessel, add 2 pints of water, and boil the mixture, re- pricing the water as it evaporates, and stirring fre- quently until complete saponification has taken place and a small quantity of the mass dropped into cold water yields an ointment-like mass without any separa- tion of oleic acid. Decant the water from the oleate, and work the mass with a horn or wooden spatula to free it from retained water. CADMIUM OLEATE. Ca(C18II3302)2. M. W. 673.8. It is of a wax}r consistence, yellowish white, and dis- solves readily in benzine. If dissolved in petroleum fats it gives a solution of great brilliancy, which, on cooling, assumes a semi-diaphanous appearance. It is readily made by precipitating the sodium-oleate solution with an aqueous solution of cadmium sulphate. The precipitate should be well washed out with warm water until the washings fail to show any sulphate if tested with barium-chloride solution. It is then dried well 10* 226 The Oleates. over the water-bath or between bibulous paper. It con- tains about 16.5 per cent, of metallic cadmium. COPPER OLEATE. Cu(C18H3302)2. M. W. 635.4. This is a beautiful, green, waxy substance of the cupric group, resembling on drying slight efflorescence of cupric salts. It dissolves readily and without tur- bidity in benzine, ether, and chloroform, oil of turpen- tine imparting to these solutions its beautiful dark-green color. On account of its easy method of manufacture it is generally obtained in a good and pure condition, pro- vided that the oleic acid used in the process of making sodium oleate is pure and devoid of oxyoleic and other irritant impurities. It is readily made by precipitating the sodium-oleate solution with a solution of cupric sul- phate, the precipitate well washed with hot water until freed from the sodium sulphate formed in the decompo- sition, then dried between bibulous paper and subse- quently air-dried. So made, it contains about 10.1 per cent, of copper. Mr. Beringer advises the following method :— Take of Oleic acid,.....1000 grains. Soda,.......160 " or q. s. Alcohol,......6 fluidrachms. Copper sulphate, .... 412 grains. Water, a sufficient quantity. Saponify the oleic acid as directed in the formula for zinc oleate and dissolve the resulting soap in three pints of water. Dissolve the copper sulphate in one pint of warm water and filter. Warm the solutions to about 140° to 150° F., and slowly add the copper solution to the oleate of soda solution, stirring con- stantly ; warm until the copper oleate fuses into a mass, decant the clear supernatant liquid, wash several times with warm water, and finally dry on the water-bath. Process of Manufacture. 227 IRON OLEATE. Fe(C18H3302)2. M. W. 617.9. This is a dark, reddish-brown, plaster-like substance, of a distinctively ferruginous odor. As generally found, it meets all indications, excepting that impure oleic acid still further renders its odor more disagreeable. It is prepared by precipitating the sodium-oleate solution with a solution of ferrous sulphate. When first precipi- tated it is of a greenish-white color, which, upon boiling and exposure to the atmosphere, changes to a reddish and subsequently to a dark, reddish-brown color. It should be well washed in the usual way to remove the sodium sulphate of the decomposition process, as well as the ferrous sulphate used in excess in the precipitation. It contains about 9.4 uer cent, of metallic iron. LEAD OLEATE. Pb(C1BH3302)2. M. W. 669. This is one of the oldest-known oleates, antedating as such even the knowledge of oleic acid and its com- pounds. It represents as such a purer state of the lead plaster of the pharmacopoeias. It is of a 3'ellowish- white color, of plaster consistence, though harder than the ordinary lead plaster, and devoid of the slippery feeling conveyed to the latter owing to the presence of glycerin. It should be readify soluble in benzine with slight turbidity, and, after filtration of the solution and evaporation of the latter, leaves a semi-diaphanous plas- ter body, which, on exposure to the air, assumes at first a yellowish color, giving wa}- to a pure white. It is readily and easily prepared by precipitating the sodium- oleate solution with a solution of the neutral lead ace- tate. In its precipitation there is always some lead hydrate and carbonate formed, which, however, as a contamination, is not objectionable. After precipitating it should be well washed with warm water unt.il the 228 ■ The Oleates. washings come off pure, and, if desired to obtain it ab- solutely pure, it should be dissolved in benzine after being thoroughly pressed out and dried. The benzine should then be allowed to evaporate. It contains about 26.7 per cent, of metallic lead. The following is the formula given by Mr. Beringer :— Take of Oleic acid,......1000 grains. Soda,.......160 " orq.s. Alcohol,......6 fluidrachms. Lead acetate,.....675 grains. Water, a sufficient quantity. Saponify the oleic acid as directed in the formula for zinc oleate, and dissolve the resulting soap in three pints of warm water and filter. Dissolve the lead acetate in two pints of water, adding a few drops of acetic acid, if necessaiy, to produce a clear solution, and filter. Warm the solutions and add the lead-acetate solution slowly to the soap solution, stirring constantly. Collect the mass on a strainer wash, and diy. MANGANESE OLEATE. Dr. Franklin H. Martin, of Chicago, gives the fol- lowing description of the mode of preparation of man- ganese oleate :— A solution of sulphate of manganese was made in distilled water, and to it a solution of sodium oleate was added. On mixing these two solutions gradually, and with constant stirring, a precipitate of oleate of manga- nese resulted. This precipitate, upon heating, changed to a putty-like mass. This was thoroughly washed several times with warm distilled water to remove the sodium sulphate, and the resulting putty-like mass was the pure oleate of manganese. This oleate, when dis- solved in oleic acid to the required percentage, is ready for use. Process of Manufacture. 229 MERCURIC OLEATE. Hg(C18H3302)2. M. W. 762. This oleate is by far the most important one, and up to the present time has been the most extensively used. It is of a j^ellow color, of a somewhat tenacious oint- ment consistence, and of the general odor of all oleates. As usually found in the market it has a greenish-gray color, owing to the fact that its mercuric component is reduced to a mercurous oxide and metallic mercury, and has an excess of oleic acid favoring the reduction process. If pure and properfy made, it will show no sign of this excess; it should be insoluble in alcohol, but readily soluble without turbidity in benzine. Mixed with several times its weight of stronger alcohol, and the oleate allowed to deposit in this solution, it will give the amount of mercuric oleate in the latter alter all the alcohol is evaporated, while the evaporated alcoholic washings will give the amount of free oleic acid. A bright strip of copper immersed in the oleate will speedily be covered with a film of metallic mercury. It has been the custom to use as mercuric oleates oleic solutions thereof, to the detriment of the prepara- tion, as, by its oxidizing tendency, the oleic acid soon deoxidizes the mercuric oxide entering into its compo- sition and deposits it in such solutions as mercurous oxide, as well as globular metallic mercury. That such solutions, when used, fail to give satisfaction in results is, therefore, not to be wondered at, and I feel satisfied that none of the so-called oleates, or rather oleic solu- tions, contain, after standing for some time, any appre- ciable or serviceable amount of mercuric oleate. The utmost care has been exercised by chemists to overcome this, both by using purer acids as well as by nicety of manipulation, but to no purpose, as the fault lies in the excess of the acid which will never admit the keeping 230 The Oleates. of such an unobjectionable preparation. The process of making mercuric oleate may be conducted in two ways: The direct one is to unite the pure acid directly with the mercuric oxide in its chemical proportions, i.e., 71.65 parts of oleic acid with 28.35 parts of mercuric oxide. But this process is subject to the excess of either one or the other, which, however, can be remedied by washing with stronger alcohol in order to remove any excess of acid. To remove any undecomposed par- ticles of mercuric oxide which would become detrimental as local irritants, dissolve the oleate so derived in ben- zine, filter the benzine solution, and allow the benzine to evaporate. Care must be taken in the direct process to conduct it entirely under wrater and only with a mod- erate heat, else the process of reduction will begin before the entire reaction has taken place. The second, and by far the most simple and rapid of the two, as well as that admitting of a better product, is by the double decomposition of sodium oleate and mercuric nitrate. The mercuric nitrate for that purpose is made by the action of strong nitric acid on mercuric oxide in sufficient quantities to entirely dissolve the latter, taking care to use as little acid in excess as pos- sible. The solution so obtained is diluted with some water, an excess being avoided, and is then decomposed by additions to it of solutions of sodium oleate until the latter is in excess, which will be the case when the characteristic froth of soap is observed on the surface. The heavy precipitate so formed is next drained off and washed with warm water to remove all traces of soap and potassium nitrate, and, when this is accom- plished and it is free from water, it is mixed with alco- hol, which dissolves the free oleic acid from the oleate, caused by the excess of nitric acid in the mercuric Process of Manufacture. 231 nitrate solution, and after this is decanted the alcohol is evaporated from the oleate. The washings contain- ing oleic acid can be distilled and the alcohol recovered for use in similar subsequent proceedings. The mer- curic oleate so prepared is a pure and true oleate, per- manent under all ordinary atmospheric conditions, and can be relied on for its action. If to be diluted, it is best done with a neutral fatty body which will not cause its decomposition. A neutral mercuric oleate thus prepared contains about 26.2 per cent, of metallic mercury, equivalent to about 28.35 per cent, of mercuric oxide. A third and rapid process for the preparation of mercuric oleate is to effect direct combination by gently heating the acid and mercuric oxide (yellow) on a water- bath, having previously deprived the oxide of any adherent moisture present. The most favorable tem- perature is about 150° F., and immediately after the oleate is formed it should be transferred to a well-closed vessel. In order to prepare mercuric oleate, Mr. Beringer uses the following formula :— Take of Oleic acid,......1000 grains. Potassa,......220 " orq. 8. Red oxide of mercury, . . . 383 " Nitric acid,......823 " orq.s. Alcohol,......6 fluidrachms. Water, a sufficient quantity. Saponify the oleic acid with the potassa as directed in the formula for zinc oleate, dissolve the resulting soap in 2 pints of warm water, and filter. Mix the nitric acid with the 2 fluidounces of water, heat to boiling, and add the mercuric oxide, previously reduced to powder. Boil until it is entirely dissolved, adding, if necessary, a few drops of nitric acid additionally. 232 The Oleates. Dilute the solution of mercuric nitrate with 4 fluid- ounces of water. Warm both solutions to 66° C. (150° F.), and add the oleate of potassium solution to the mercury solution, stirring constantly. Decant the aqueous solution and wash the precipitate with warm water not exceeding 150° F. MERCUROUS OLEATE. Hg2(C18H3302)2. M. W. 963. This is an oleate not generally known or used, and only recently brought out by me. It is a whitish-gra}', granular, sticky substance, which is very prone to de- compose, forming mercuric oleate and mercurous oxide, also globular mercury. It is at once so decomposed if boiled or treated with hot water, and should be washed out cold only to free it from the adhering sodium ni- trate, and then freed from adhering water between bibu- lous paper. It is quite distinct, both in appearance as well as in effect, from the mercuric oleate, and, on ac- count of its ready decomposition and the liberation of free mercury, it is apt to produce the same effect as the mercurial ointment of the Pharmacopoeia. It makes a turbid solution with benzine, and dissolves readily and clear in warm fats and in the petroleum ointments. It is prepared from crystallized mercurous nitrate, which, in turn, is prepared by treating metallic mercury in excess with nitric acid, evaporating the solutions crys- tallizing the same, and drying the drained ciTstals between bibulous paper. This aqueous solution,decom- posed with sodium oleate, gives at first a whitish pre- cipitate, which, if washed with hot and boiling water, yields a grayish-blue ointment, representing mercurial plaster both in appearance and physical properties. In that form it represents a mercuric-mercurous oleate, and combines both the sorbefacient effect of the mercuric Process of Manufacture. 233 oleate with the constitutional impression of the mercu- rial ointment. Its advantage is that it contains double the amount of mercury of the preceding mercuric oleate, which amounts to about 41.5 per cent, of the metal. NICKEL OLEATE. Ni(C18H3302)2. M. W. 621. This is another new oleate recently brought out and investigated by me. It is of a beautiful, blended light- green color, a glossy, waxy appearance, and plaster consistence. It mixes readily with fats and oils and dissolves in benzine. It is made by decomposing sodium-oleate solution with a solution of nickel sul- phate, washing the precipitate with warm water and expressing and drying it at an ordinary temperature. It contains about 9.5 per cent, metallic nickel. SILVER OLEATE. Ag.C18H3302. M. AV. 389. The silver oleate is a grayish-brown pulverulent body, of an odor resembling oleic acid. It differs from the other oleates in the respect that it is not, by itself, soluble in either benzine or neutral fats, but needs an excess of oleic acid to render it so. That it is an oleate, which might be doubted from what is said above, can readily be substantiated by burning it on platinum foil, when it will give off profuse vapors, of an acrid odor, of a fatty, empyreumatic nature, while a small quantity of silver oxide will be left behind. It is easily prepared by precipitating a solution of the silver nitrate with the solution of sodium oleate, washing the precipitate with warm, distilled water, excluding light while conducting the process to prevent darkening of the precipitate, and also expressing and drying it with exclusion of light. It, however, soon changes color, getting darker, and therefore should be preserved in either blue or, better still, amber-colored bottles. It contains about 27.6 per 234 The Oleates. cent, of metallic silver, equivalent to about 59.3 per cent. of silver oxide. TIN OLEATE. Sn(C18H3302)2. M. W. 680. This is a new oleate that I had occasion to introduce. It is an unguent body of soft consistence and brownish- gray color, has a characteristic metallic odor and a very fine, greasy touch. It readify dissolves in benzine, and makes a clear solution when mixed with warm, fatty substances or petroleum products. It is prepared by decomposing a solution of tin chloride with sodium- oleate solution. As, however, a certain amount of tin oxide is separated in this process, it should, after separating it from the liquids of decomposition and washing, be dissolved in benzine. The solution, after filtration, leaves, on the evaporation of the benzine, the tin oleate. It contains about 17.3 per cent, of metallic tin. ZINC OLEATE. Zn(C18H3302)2. M. W. 629.9. This, one of the most important of this series of preparations, is, in its most useful form, an impalpable white powder, of a fine, soapy touch, somewhat oily odor, and if heated it melts into a homogeneous yellow liquid, which, on cooling, hardens into a mass present- ing a crystalline fracture, with a specific gravity of 1.0663. In powder form, while not entirely soluble in benzine, it readily dissolves, if warmed over the water- bath, with fat oils or petroleum fats, which is requisite in order to test its purity ; for, if zinc oxide is present, warmed fats will not affect it. If burnt on platinum- foil it should burn off to a large extent, leaving but a small, white residue soluble in concentrated mineral acids. Its complete solubility in warmed fats, absence of a dis- agreeable, smoky odor, and combustion are the surest Process of Manufacture. 235 tests of its purity. While it is easily prepared, it re- quires some skill to obtain it as an impalpable, perfectly white powder. This is accomplished by using a dilute solution of zinc sulphate and decomposing it while cold with the sodium-oleate solution. It is of impor- tance that the solutions should be cold and the zinc solution perfectly neutral, else an oleate will result that is coarse, granular, and soft, unfit for any other use than making ointments. The more dilute the zinc-sulphate solution, the finer and whiter the oleate will be. After thoroughly washing it with cold water it should be ex- pressed, and the cake air-dried and ultimately powdered, which is easily accomplished. It contains about 10.4 per cent, of metallic zinc, in combination with oleic acid, which is equal to about 12.9 of zinc oxide. Mr. Beringer's formula is as follows :— Take of Oleic acid,......1000 grains. Soda,.......160 " or q. a. Alcohol,......6 fluidrachms. Zinc sulphate,.....550 grains. Water, a sufficient quantity. Warm the oleic acid in a capacious vessel on the water-bath to a temperature of 60° to 66° C. (140° to 150° F.), and, having dissolved the soda in a mixture of the alcohol and 2 fluidounces of water, slowly add the soda solution, stirring constantfy until the acid is entirely neutralized and a small portion of the resulting soap dissolved in alcohol yields but a faint-pink tint on the addition of a few drops of alcoholic solution of phenol phthaleine. Dissolve the resulting soap in three pints of warm water and filter if necessary. Dis- solve the zinc sulphate in one pint of water and filter. Warm the solutions to 43° C. (110° F.), and slowly add the zinc-sulphate solution to the soap solution, 236 The Oleates. stirring constantly. Collect the precipitate upon a moist filter, wash thoroughly with distilled water, and finally dry on bibulous paper at a temperature not exceeding 38° C. (100° F.). CHAPTER III. Physiological Action of the Oleates. With a view of determining whether the oleates are absorbed into the blood when applied to the skin, and thus produce systemic effects, the following experiments were made by Dr. L. Wolff, Dr. Brubaker, and myself. In all instances the observations were made upon rabbits, and were conducted in the same way, viz.: After being properly secured on a Czermak holder, the hair was carefully removed from the abdomen so as to pre- sent as clean a surface as possible for the action of the drug. The animals were then placed in a large glass jar, so that the excretion might be collected and exam- ined chemically, to determine whether the drug had been absorbed. The first oleate experimented with was the— QUININE OLEATE (25 per cent.). One ounce was thoroughfy rubbed over the abdomen for a period of five minutes. At the end of twenty-four hours the urine was carefulfy examined, but no trace of quinine could be detected. In all other respects the animal was in a normal condition. In the second rabbit 2 drachms of the same oleate were injected into the abdominal cavity. At the end of six hours no apparent effect had been produced, but in eighteen hours it was dead. Post-mortem examination showed evidences of irritation and congestion of the peritoneal membrane, while the coagulated oil was found over the viscera and in the peritoneal cavitj\ In this case no quinine was discernible in the urine. (237) 238 The Oleates. THE MERCURIC OLEATE was next experimented with in the same way. Two drachms were applied over the skin of the abdomen. At the end of twenty-four hours the faeces had lost their hard character, and had become soft and of a yellowish- brown color. The faeces and urine were both examined, but no mercury could be obtained. The change in the consistency of the faeces might have been due to the rub- bing of the abdomen. The animal exhibited no other evidences of the action of mercury. THE COPPER OLEATE was next applied. Two drachms, softened with oleic acid, were rubbed upon the abdomen thoroughly. The rabbit remained in an apparently normal condition ; at the end of twenty-four hours the urine did not contain a trace of copper. THE ZINC OLEATE (one-half ounce) was applied in an exactly similar manner. At the end of twenty-four hours the subject was de- cidedly stupid, and almost helpless as regards motion. Upon killing it with ether and then opening the abdo- men, a thick layer of gelatinous material was found just beneath the skin. The blood-vessels of the skin were enlarged. The irritability of the nerves and muscles remained normal, as was shown by stimulation with electricity. The urine, which was drawn from the bladder, contained no zinc. THE STRYCHNINE OLEATE (two drachms, containing 1\ grains of strychnine) was rubbed along the groin and inner surface of the thigh for five minutes; no effect had been observed during forty-eight hours after thoroughfy applying the oleate to the abdominal walls. Physiological Action of the Oleates. 239 THE ACONITINE OLEATE was applied in a similar manner. Two drachms, con- taining 2^ grains of aconitine, were rubbed along the groin and inner surface of the thigh for five minutes. At the end of twenty-four hours no effect had been observed. The animal was in a normal condition. It thus appears, from the foregoing experiments, that the supposition that the oleates were directly absorbed and taken up by the lymphatics and conveyed into the blood is entirely erroneous; on the contrary, the}' prove that the oleates at no time can penetrate deeper than the epidermis and its continuation into the glands and folli- cles. Herein consists, in fact, the advantage that oleates have over ordinary ointments: that the}" can enter into minute openings of the glands and follicles, on ac- count of being dissolved in the fatty base and vehicle; whereas, in the ordinary ointments, no matter how mi- nutely subdivided, the medicating agents would be pre- vented from acting in this wa}r, the fatty vehicle alone being filtered off and entering. All the suppositions and hypotheses, setting forth how the oleates are absorbed and enter into the blood at once, are erroneous, and have not been confirmed by practical results, the most powerful of the oleates scarcely showing an}' of their physiological effects. By what physiological process or manner the advocates of such theories would demon- strate their assertions is to me unaccountable. Thus, when a prominent writer claims that, on brushing oleic acid or oleates lightfy over the epidermic surface, it dis- appears with an astonishing rapidity, equalling that of some evaporant, I can onfy account for it by supposing he is endowed with extraordinary powers of observation, or has made his statements without observation and on the most favorable basis of his own expectations. 240 The Oleates. While there is plenty of room and use for the oleates, the worst that can be done by their friends or advocates is to claim for them what they do not or can not possess. The principal advantage of the oleates is their solubility in the fatty vehicles by which they are enabled to pene- trate, not through the skin and the walls of the vessels, as might be inferred from the writings of some authors, but into the natural openings of the skin, the glands, and follicles; there they may, by osmosis, be interchanged with some of the systemic fluids and be absorbed to a certain extent; but physiological experiments seem to make even this unlikely. The onfy instance in which this might be the case is with the mercurous oleate, which is so loosely attached to its fatty radical as easily to give it up in exchange for other acids, forming salts with them, which are more readify absorbed and assimi- lated, producing then the characteristic effects and symptoms of the drug. Mercuric oleate, on the con- trary, while easily, by its own constitution, decom- posing into mercurous oleate, will not in itself so readily exchange its acid radical for another of the sudorific excretion. That oxide of zinc is not carried into the follicle is quite as well understood as that white or red precipitate should or could not do so. Take the oint- ment of either of these precipitates and melt it, and then place it on filtering paper, and }rou will readily see the unguent base permeating the porous tissue, while the suspended substance is retained on its folds. Dis- solve an oleate in any of the fatty vehicles, and you will find that it passes through the porous substance unde- composed and in its entirety, and is thus able to act on the follicle and gland, both b}' its action on the near- lying cutis as well as by the possibility of an osmotic process. In this, and in this alone, consists the advan- Physiological Action of the Oleates. 241 tage of the oleates, and a material advantage it is. Thus, while the ointments of white and red precipitate will destroy the conidia and mycelium of superficial fungi in tricophytosis, chromophytosis, etc., the mer- cury and copper oleates alone can dip into the folli- cles and there exert a like destructive action. It might be said that if their principal value consisted in their solubility, as much could be accomplished by watery solutions applied to the surface; but such is not the case. Water or aqueous solutions have a tendemry to swell up the epiderni, and by so doing completely to occlude the orifices of glands and follicles; while fats or oils, and fatty acids, as well as their derivatives, produce the opposite effect, and are, for that reason, enabled to enter into those structures. 11 L CHAPTER IY. Therapeutic Action of the Oleates. Bkfore entering into detail on the medicinal action of the individual oleates, I would dwell on the proper method of preparing them for use. There has been some misconception as to their nature from the fact that one or two of them can be used to great advantage in their pulverulent state, owing to their mechanical ac- tion, besides the chemical influence they exercise not on the unbroken surface, but on denuded and pathologi- cally-affected skin. Thus, we find that the zinc oleate, in its powdered state, is a very excellent agent on ac- count of its capacity to lessen friction, and, at the same time, to contract the congested and tumefied integument. Again, we see, in the application of the powdered silver oleate to denuded and ulcerating surfaces, a most useful measure to coagulate the albumen locally, and to lead to the formation of a protective covering over these surfaces. In an attempt, however, to extend the use of powders to the other oleates we simply lose sight of the one great advantage that is of such importance with this class of preparations,—their solubility in vehicles that can penetrate into the depression of the epidermic cov- ering. That some of the oleates occur as powders, and some as plasters, and others as ointments, is part of their phj-sical constitution, which the chemist, by ad- mixtures, should not try to pervert. Their principal use must always be as ointments, and it is, therefore, that I would speak here of them and their proper preparations. AVhile I omit now the proportions to be used,—to which I will refer under their respective (243) 244 The Oleates. headings,—I can say that, as a general rule, the oint- ments should be made by melting the oleates with the fatty substance intended for their bases at as low a tem- perature as possible to effect solution, which is, as a rule, best accomplished by a water-bath, in which the vehicle is first melted and then the oleate introduced and stirred therewith until completely dissolved. This is done without much trouble and difficulty by any one, either physician or chemist, and holds good for all save the ointment of the silver oleate ; and for its preparation more specific directions will be given hereafter. The fatty vehicles intended for ointment bases are a matter of choice, according to the indications of the case. While no doubt the most elegant preparations can be made with the petroleum fats as bases, they form, in my opinion and in that of others, the least desirable sub- stances for such use.* I stated in my paper read before the Medical Society of the State of Pennsylvania (loc. cit.), that I considered the petroleum products as objec- tionable for such a purpose, and Dr. Robson, of Eng- land, has made a similar observation in the use of vaseline as a surgical dressing. I also consider them to possess a feebler power, if any at all, to penetrate than animal fats, which have more affinit}- for the integu- ment. They always contain some stimulant constituent left after their manufacture, which prevents them from having an emollient action,—a great objection to their use as external remedies if 3-011 desire to soothe and allay active inflammation. Irritant ointments of vera- trine and other like substances, which I had made re- spectively of paraffinates and simple ointments, proved, in the former, almost inert, while the activity of that * See an article on the "Irritation of the Skin following the Applica- tion of Vaseline" in the London Lancet of November 8, 1884. TJierapeutic Action of the Oleates. 245 made with simple ointment very soon became evident. Dr. J. G. Kiernan, of Chicago, who repeated my experi- ments with the petroleum products (as have also several others), both upon himself and the lower animals, ar- rived at the same conclusion. I am also confirmed in my opinion by Dr. Herman Hager, who, in his celebrated work on Pharmaceutical Practice, states that the use of vaseline (or cosmoline, or whatever their pseudonyms may be) in place of lard, or an ointment of such mixtures containing a remedial agent intended for absorption by the skin, should be discouraged, as vaseline (cosmoline, etc.) prevents absorption. In fact, the experiments of Drs. Randolph and Dixon* have shown that vaseline, or cosmoline, is not even absorbed by the gastro-intestinal mucous membrane, which certainly offers less obstruc- tion to absorption than the integument. Although this has been disputed by some, who, how- ever, constitute no medical authority, having only a com- mercial interest in the sale of their goods, and for pharmaceutical reasons lay more stress on their hand- some appearance than on their utility, I think this matter should rest with the physician to decide rather than with the biased vender. All of the oleates, if desired in a very concentrated form, can be rendered thin and pliable by the addition of a small quantity of oleic acid, which, if warmed and melted with them, readily renders their consistence fit for the purpose of inunction. As a diluent, when either the oleate itself or its oleic dilution would make them too powerful, I know of nothing better than good fresh lard, lard ointments, lanolin, or one of the fatty bases of animal origin recommended in the first part of this *"On the Behavior of Petroleum in the Digestive Tract." Notes from Physiological Laboratory of University of Pennsylvania, 1885. 246 Hie Oleates. work. Again, under no circumstances, however, should ointments of the oleates be prepared by simply rubbing them up with the diluent, nor should any of them be accepted by the physician which are not perfectly homogeneous. The advantages of these ointments may be set forth as being economical, as they need only be used in small quantities, and, if properly applied and well rubbed into the dry skin, there will be very little adherent to the surface that can be rubbed off or soil the clothing,—a very desirable property. If, however, they are used, as was evidently done by some who raised objections to them on that point, by daubing them on in large quantities, on the principle that if a little does good more will be better, they may fail to accomplish the purposes they are intended for, and exert their influence on the patient's clothing alone. Such persons evidently forget the anat- omy of the integument, and imagine the minute glands and follicles to possess the capacity of much larger organs. Where, for reasons of contact and surface ac- tion, the ointment has to be applied copiously, as in the instance of the iron-oleate ointment to arsenical ulcers, the ointment has to be secured by protective measures, both to prevent soiling the clothing as well as to insure its continued action on the parts affected. To proceed to the consideration of the individual oleates, their remedial action and indication for use, I will take up first the— ACONITINE OLEATE. Aconitine oleate has been lauded for its rapid con- stitutional effect, which the writer has failed to observe even after a number of careful experiments pursued for years. It has a slight local action, but the effect is very Therapeutic Action of the Oleates. 247 feeble; it can be used in mild cases of neuralgia owing to its weak anaesthetic impression. Dr. M. R. Richard, however, reports,* before the Harlem Medical Association, a case of severe constitu- tional poisoning from the external application of small quantities of aconitine oleate. ATROPINE OLEATE. Atropine oleate has a mild action upon the integu- ment, the toxic effect of the drug being almost impossi- ble, except it be applied freely over a large surface. ALUMINIUM OLEATE. Aluminium oleate, melted with an equal proportion of lard and some fatty substance, represents the oint- ment of aluminium oleate. The aluminium-oleate ointment coagulates the albu- men of the parts to which it is applied, constringes the vessels, checks and corrects all secretion, and has marked styptic as well as antiseptic action. It has a decidedly astringent effect, and is very serviceable in checking muco-purulent discharges that occur in dermatitis and in eczema. It can be applied with advantage over the flexor surfaces, and upon those parts that have an ex- cessive discharge from friction or apposition of two por- tions of integument. It is also well adapted to cases in which the axilla, groin, and buttocks of infants and chil- dren become involved, its application often rapidly checking the profuse secretion and restoring the integ- ument to a normal condition. In hyperidrosis it lessens and frequently removes the excessive secretion, while in bromidrosis the fetid discharge will either be entirely overcome by its use or very much diminished in its activity. It is both beneficial and useful employed as a * New York Medical Journal, May 10,1890. 248 TJir Oleates. dressing to foul ulcers, abscesses, sinuses, chilblains, and burns. Formulary. Take of Ergotin,......1 drachm. Ointment of aluminium oleate, . . 3 drachms. Mix. For hyperidrosis, bromidrosis, ulcers, and pustular eczema. Take of Extract of arnica,.....10 grains. Ointment of aluminium oleate, . . 3 drachms. Mix. For dermatitis, eczema, chilblains, and burns. Take of Sublimed sulphur, . . . .15 grains. Ointment of aluminium oleate, . . y ounce. Mix. Useful in fissured eczema, especially about the nose, lips, and genital organs. Take of Camphor,......5 grains. Creasote,......2 drops. Ointment of aluminium oleate, . . y ounce. Mix. Excellent for seborrhoea oleasa, rosacea, and sycosis. ARSENICUM OLEATE. Arsenicum oleate, melted in the proportion of 1 part to 9 parts of lard as an unguent base, or 1 part in 4, according to the strength desired forms the oint- ment of arsenic oleate. It is both a valuable alterative and escharotic, but should always be used with caution. Applied to the skin in the natural state, little or no change is produced, but when used moderately strong on abrasions, wounds, and ulcerating and granulating surfaces, it acts as an escharotic, exciting active inflammation and destroying the tissue to some depth. On the other hand, it will have a most excellent alterative impression on the in- tegument in the form of a very weak ointment. In ulcerating epithelioma it is one of the very best reme- dies, by reason of its being better borne for a longer period in its application than any other form of arsenic. In lupus it is especially serviceable, destroying, by its constant use, cell infiltration in a comparatively mild TJhcrapeutic Action of the Oleates. 249 and painless manner. In the erythematous and tuber- cular forms of lupus the parts, however, should be thoroughly scraped, in order to bring the oleate in con- tact with the abraded surface. In old ulcers, especially those of a scrofulous nature, the arsenic-oleate oint- ment is of great iitilit}^. It is, likewise, of value as an alterative in the form of a weak ointment, either alone or combined with other remedies, in chronic sycosis, seborrhoea, and in some of the chronic varieties of eczema. It can be employed, after scraping or puncturing the surface, to destroy warts, corns, horns, condylomata, old granulations, and nsevi. It can also be combined with such preparations as opium, belladonna, hyoscyamus, arnica, arrow-root, naphthol, etc., either to lessen its activity or enhance its effect by the additional impres- sion of one or more of these remedies. Formulary. Take of Hydrochlorate of cocaine, ... 3 grains. Sulphate of morphine, . . . . 2 " Powdered starch,.....1 drachm. Ointment of arsenic oleate, . . . y ounce. Mix. Valuable in epithelioma and lupus vulgaris. Take of Sulphate of atropine, .... 2 grains. Chloride of zinc,.....20 " Powdered arrow-root, .... 1 drachm. Ointment of arsenic oleate, . . . y ounce. Mix. Useful in old ulcers, horns, warts, and condylomata. Take of Extract of hyoscyamus, .... 10 grains. Extract of arnica, ..... 1 scruple. Ointment of arsenic oleate, . . . y ounce. Mix. For scrofuloderma and old granulations. BISMUTH OLEATE. The ointment of bismuth oleate, a pearl-gray, soft, bland substance, possesses an emollient and slightly- astringent action, and is useful in soothing and relieving cutaneous irritation. It is a valuable remedy in all ii* 250 The Oleates. pustular eruptions lightly penciled over the surface. In sycosis it relieves the engorgement of the parts, often aborts the pustules, and will lessen or remove the dis- tressing itching and pricking that is so wearing to the patient. It allays and often overcomes the high inflam- mation in erysipelas and sunburn. In acne and rosacea it soothes the hypersemic skin, relieves the engorgement of the glands, frequently subduing some of the most intractable cases, and consequently giving ease and comfort where prolonged suffering formerly existed. In some of the more obstinate forms of acne and rosacea, however, I always deplete the parts thoroughfy, first by puncturing them with a needle-knife and afterward penciling the surface with the ointment. This oleate is not only an important but also a use- ful remedy in the treatment of the different varieties of acute eczema, soothing and arresting rapidly the irritated integument. It is generally an effective agent for cracked and sore nipples, used either alone or in com- bination with opium and belladonna and arnica, the dry and excoriated condition of the parts yielding on its application. Formulary. Take of Extract of witch-hazel, .... 10 grains. Bismuth oleate,.....y ounce. Mix. For acne, sycosis, rosacea, and 6eborrhcea. Take of Creasote,.......2 drops. Carbonate of zinc,.....y drachm. Bismuth oleate,.....y ounce. Mix. For erysipelas, acute eczema, and erythema. Take of Sulphate of atropine, .... 1 grain. Bismuth oleate,.....3 drachms. Mix. Useful in cracked and sore nipples and sycosis. Take of Camphor,.......3 grains. Aristol,.......5 " Bismuth oleate,.....y ounce. Mix. For fissured eczema, chronic acne, and rosacea. Tlxerapeutic Action of the Oleates. 251 Take of Extract of belladonna, .... 1 scruple. Tannic acid,......1 " Sulphate of morphine, .... 2 grains. Bismuth oleate,.....y ounce. Mix. For eczema of the anus, genital organs, and in boils and carbuncles. CADMIUM OLEATE. The ointment of cadmium oleate has had, as yet, but little practical use. It is a very strong stimulant, hav- ing an almost caustic action upon the denuded integu- ment, resembling, in this respect, very much the action of the ointment of nickel oleate. It has been used, with some advantage, in enlarged glands, especially in scrofu- lous subjects, stimulating to renewed activity the dor- mant absorbents, and thus removing the abnormal condition from the tissue. It has also been serviceable at times in cases of chronic eczema with great infiltra- tion, exuberant granulations, and old ulcers. Formulary. Take of Citrine ointment,.....2 drachms. Ointment of cadmium oleate, . . 2 " Mix. For chronic eczema and psoriasis. Take of Chrysarobin,......10 grains. Ointment of cadmium oleate, . . 3 drachms. Mix. For chronic ulcers and enlarged glands, especially from scrofula. COCAINE OLEATE. Cocaine oleate (6-per-cent. alkaloid) has a slight anaesthetic action upon the integument. The decided effect, however, that has been claimed by some on its application to the skin has not been observed in my experience, even after repeated experiments with it in operations on warts, corns, horns, cancer, lupus, and the removal of superfluous hairs. Squibb* states, in a con- tribution, that when applied to the skin it should be * An EDhemeris of Materia Medica, etc., January, 1885. 252 The Oleates. somewhat effective. On the contraiy, I have found, by clinical experience, that its action is so weak as to make it of little practical value. It has been recommended in mild cases of neuralgia, local spots of eczema, and in painful ulcers. Keys* reports that he has relieved with it, temporarily, mild anal pruritus. Jacksonf also relates that by its application the pain under the opera- tion for the removal of superfluous hairs is somewhat lessened. LustgartenJ employs oleate of cocaine in the treat- ment of pruritus ani, acute and subacute eczema. This same alkaloidal oleate§ has been used for the relief of herpes and pruritus of the vulva. Formulary. Take of Lanolin,.......1 ounce. Cocaine oleate (6-per-cent. alkaloid), . 1 " Mix. Employ in pruritus of the genital organs, papular eczema, and in chilblain. Take of Carbonate of lead,.....y ounce. Cocaine oleate (6-per-cent. alkaloid), . 2 ounces. Mix. For burns and irritable ulcers, and itching of the skin. COPPER OLEATE. Copper oleate, melted with either 4 or 9 parts of fat or lard, gives, respectively, a 20 or 10 per cent, of the ointment of copper oleate. Applied in this form to the unbroken skin it has no visible effect on the surface, but penetrates deeply into the follicles, causing slight stimu- f lation. If brought into contact with the broken skin it has both an astringent and stimulating effect, and an in- soluble albuminate is formed which coats over the sur- face, thus supplying the place of the abraded skin. It * Journal of Cutaneous and Venereal Diseases, January, 1885. t Loc. cit. I Wiener Med. Wochenschrift, November, 12, 1887. $ Gaz. Hebd. des Sci. Med. de Montpellier, January 14, 1888. Therapeutic Action of the Oleates. 253 condenses the tissues, constringcs the blood-vessels, and thus lessens the determination of blood to the part. It acts as an irritant to any delicate surface, causing in- flammation and pain. It is a most effective application to arrest bleeding, particularly in irritable sores and in- dolent ulcers. Obstinate granulations will often jneld to the ointment of the copper oleate after resisting the usual applications. It is a most excellent antiseptic, as well as an antiparasitic agent. The most successful results, however, have followed its use upon vegetable parasitic affections, both in my own experience and in that of Sawyer and Startin,* of England. The last- named observer gives the following testimony concern- ing the copper oleate :f " I have been using the drug for two 3'ears, and am so satisfied with its results that I recommended it to my colleagues, who also expressed their satisfaction on trying it. An impure oleate will irritate the skin, but the oleate now made by a process ot double decomposition is perfectly pure, and in my opinion a very reliable application in ringworm. I have never had complaints, either by hospital or private pa- tients, from its use, and I have used it to some hundreds." Many American physicians have also reported very effect- ive results from its use in their practice. M}^ attention was directed to the curative action of the ointment of copper oleate in parasitic affections, by the remarks of some of my patients ; and I believe I was the first to recommend it for its antiparasitic effects in a paper read before the Pennsylvania State Medical Society, already referred to, and from which I quote: " For several years I have had patients tell me, at the hospital and in my * See an interesting paper on "Oleate of Copper in Ringworm," by James Startin, surgeon, of England, read before the Willan Society, December, 1884. f British Medical Journal, January 10,1885. 254 The Oleates. private practice, that they cured this or that member of their family of ringworm by putting an old copper penny in vinegar and applying the liquid to the patches. Some, however, resisted the treatment, and members of the latter class were brought to me with the statement that if other children had been cured by putting a copper penny in vinegar and applying the infusion, how was it that it did not in this particular case do any good! After due thought it occurred to me that this copperv liquid might destroy the fungus on the surface, but if the parasite after a time passed into the follicles at its lowest depth and invaded the hair-bulbs, it could not affect it in any way; and, also, if the copper solution had the power to kill the parasite on the surface, why could it not do the same within the follicles, providing it could be carried there ? Acting upon this idea, and remembering the great penetrating action of oleic acid, I had it combined with copper and mixed with a fatty base. The ointment thus prepared I applied to an in- veterate and extensive case of ringworm on the scalp of a child that had been treated with numerous remedies without benefit, and in the period of six weeks the pa- tient was completely cured. Other cases, both of ring- worm on the scalp and body, were afterward treated likewise with equally good results." Dr. Joseph Adolp says :* " To combat ringworm, I find oleate of copper generally efficacious; I employ 60 grains of the oleate amalgamated with 1 or 2 drachms of lard, rubbing into the diseased surface thoroughly. Success depends alike upon the strength of the medicament and the persistence with which it is em- ployed." In tinea versicolor, or chromophytosis, it acts in a * Medical Age, April 10, 1890. Therapeutic Action of the Oleates. 255 most decided manner, rapidly removing the parasite from the surface, as also the one which penetrates deep into the follicles. The red, yellowish, and often dark- brown desquamating spots will clear up generally quicker and better from the applications of the ointment of copper oleate than by the use of any other remedy. It is equally effective in favus, which yields quickly to its application. In all vegetable parasitic affections to which it is applied care should be taken to avoid the too frequent use of water to the parts, which may pre- vent the copper oleate from penetrating to the lowest depth of the follicle, and thus interfere with its action on the fungus. In fact, I always, at the present time, continue the application of the oleate alone until all evidence of the fungus has disappeared, interdicting water entirely during the treatment, which, I believe, assists in nourishing the parasite, thus making it more active. In case it becomes necessary to clean the parts, the use of oleic acid, alcohol, boric acid, or beta- naphthol solutions, or ether, will fully accomplish the purpose. In using the ointment of copper oleate in parasitic affections, it is not required to epilate or pluck out the diseased hairs, as the deep and effective action of the remedy will usually alone complete a cure, without fol- lowing the old routine plan, which I have for some time abandoned as painful and unnecessary. Copper oleate, melted and spread as plaster, will relieve, and very often cure, hard and horny warts, corns, bunions, and thick- ened conditions of the epidermis to which it is applied. The ointment of copper oleate is a useful remedy for freckles and other yellowish-brown or blackish patches of the skin. The ointment of copper oleate should not be em 256 The Oleates. ployed too strong, inasmuch as it may cause irritation, like all the copper salts, if brought under such circum- stances in contact with the skin. More or less irritation, and even inflammation and the formation of furuncles on the skin, have been reported* from the application of an ointment containing a large quantity of the salt. From 5 to 20 grains of the copper oleate should first be prescribed to the ounce of the fatty base. The quantity of the salt employed should always varjr according to the condition of the skin, whether in the normal con- dition or inflamed, as well as the locality to which it is to be applied. For instance, on the face, especialfy of some persons possessing freckles, the skin is very delicate, and therefore the quantity of the copper oleate used in the ointment should, in the beginning of the application, be very small, from 5 to 10 grains to the ounce of the base being, as a rule, the quantity to em- ploy. On the other hand, on scalp, back, elbows, knees, hands, and feet, the integument is much thicker and the quantity of salt to the fatty base can be much stronger. Examples of the above combinations will be added for the reader in the formulary. Lastly, the plrysician should alwa}s obtain copper oleate made from good oleic acid, otherwise the resulting salt may not only be unserviceable but absolutely injurious by readily irritat- ing or inflaming the skin. Several casesf have come under my observation, not alone with copper oleate but also with other of the oleates in which the ointments made from the salts improperly prepared produced unpleasant and harmful results, in place of good effects, upon the diseased skin. * E. Borcheim, Journal of Cutaneous and Venereal Diseases, New York, September, 1883. t See letter by author to the Journal »>f Cutaneous aud Venereal Diseases, New York, November, 1883. Therapeutic Action of the Oleates. 257 Formulary. Take of Ointment of oxide of zinc, . . . jounce. Ointment of copper oleate, . . . y " Mix. For ulcers, chronic eczema, and psoriasis. Take of Creasote,.......8 drops. Ointment of copper oleate,. . . . jounce. Mix. Valuable in ringworm of the scalp, face or barbers' itch, and the body; also in favus and tinea versicolor. Take of Resin ointment,.....3 drachms. Ointment of copper oleate, . . 3 " Mix. Useful in corns, callosities, and warts. Take of Salicylic acid,......y drachm. Ointment of copper oleate, . . . jounce. Mix. For chronic eczema of the hands and feet. Take of Carbonate of zinc,.....1 drachm. Oil of eucalyptus,.....8 drops. Ointment of copper oleate, . . . y ounce. Mix. Use in hyperidrosis and bromidrosis. Take of Lanolin,.......y ounce. Oil of chamomile, ..... 5 drops. Ointment of copper oleate, . . . jounce. Mix. For lentigo, or freckles, and chloasma, or yellowish-brown patches on the skin. Take of Boric acid,......y drachm. Ointment of copper oleate, . . . jounce. Mix. Beneficial in favus, tinea versicolor, and ringworm of all parts of the body. Take of Beta-naphthol,......1 scruple. Ointment of copper oleate, . . . jounce. Mix. For chronic acne, chronic sycosis, and old syphilitic and scrofulous ulcers. Take of Carbonate of lead,.....1 drachm. Carbonate of zinc,.....1 " Carbolic acid,......3 grains. Camphor,......3 " Ointment of copper oleate, . . . y ounce. Mix. For pustular eczema, boils, impetigo, and sycosis. IRON OLEATE. Iron oleate is readify soluble in fats. Experiments with this oleate, mixed with the various fats and given 258 The Oleates. internally, have not brought about any good results. The use of the ointment of iron oleate by the inunction method has no apparent constitutional effect, for the reasons that have already been cited under their physi- ological action. It was thought by the writer, after some clinical experiments, which were presented in a former paper, and in which the inunction of iron oleate appeared to be of systemic value in anaemic and scrofu- lous cases, that it would be an invaluable remedy for those diseases, but subsequent and more extended experience has shown its action on the system to be of no value. The action of iron oleate, like all the other oleates of the metals and alkaloids, is mainly upon the parts to which it is applied. The ointment of iron oleate is a valuable styptic and astringent. In the inflamma- tory form of eczema, in which the surface has become denuded, red, raw, and bleeding, the application of a weak ointment of iron oleate or the oleate itself used in other soothing and slightfy astringent combinations for the same affection will prove of the greatest value, its st3rptic and astringent action having the happiest effect upon the parts. It has marked effect in pustular eczema, sj^cosis, furuncles, and in scrofulous ulcers and sinuses. The iron oleate, mixed with oil of ergot or any of the ordinary oils, can be used with advantage in dry seborrhoea and in certain forms of alopecia that result from an irritable condition of the glands of the parts. The first and second stages of acne rosacea are vastly benefited and often entirely relieved by the application of a weak ointment of iron oleate. The lesions that re- sult from arsenical poisoning, especially the pustules and ulcers, are more amenable to the action of this oint- ment than any other remedy that I have used in such conditions. A number of cases of arsenical poisoning Therapeutic Action of the Oleates 259 have come under my observation, particularly in work- ingmen in several large chemical establishments, and in all cases the pustules and deep and angry ulcers that were present, and upon which other remedies had failed, rapidly yielded to its application. Formulary. Take of Thymol,.......5 grains. Ointment of iron oleate, . . . . jounce. Mix. For idiopathic haemorrhage of the skin resulting from wounds and the bites of insects. Take of Sublimed sulphur, ..... 1 scruple. Ointment of iron oleate,. . . . jounce. Mix. For acne, rosacea, and sycosis. Take of Ointment of oxide of zinc, . . . y ounce. Iodol,.......10 grains. Ointment of iron oleate, . . . . y ounce. Mix. For pustular eczema, impetigo, and sycosis. Take of Carbolic acid, . . . . . . 3 grains. Ointment of iron oleate, .... y ounce. Mix. For ulcers, especially those following arsenical poisoning. LEAD OLEATE. Lead oleate, melted with equal parts of lard or lard- oil, or a mixture of the two, according to the season, to present it in ointment form, gives a cream-colored semi-solid ointment of the consistence of simple cerate. It is more easily and cheaply prepared than either Gou- lard's cerate or Hebra's litharge ointment, or any of the later modifications, and is also more readily absorbed, and is superior to all of them. Unna and many other physicians who have tested the action of the ointment of lead oleate report excellent results from its use. The ointment of lead oleate, when applied to the de- nuded skin, has both an astringent and. sedative action, arresting b}T this effect morbid discharges and allaying irritation. It soothes effectually the intense irritation that is often present in papular eczema, and in those 260 The Oleates. forms of the same disease that appear in the flexures of the joints, around the axillae, the inner part of the thighs, and perinseum. Pustular eczema of young infants, which is so annoying to the little sufferers, is often benefited, and the inflammation, discharge, and itching entirely checked by its free application; it is equally beneficial in fissured eczema of the palmar and plantar surfaces. If the inflammation and cracking, however, be severe and deep, and require a certain amount of stimulation, the addition of naphthol, oil of chamomile, or oil of cade will increase ver3' much its curative action. This ointment is a useful remedy in hard and indurated papules, in acne of the face, neck, and back, and in rosacea. Thymol, carbolic acid, naphthol, and many other stimulating or soothing agents can sometimes with advantage be combined with it. Formulary. Take of Hydrochlorate of cocaine, ... 3 grains. Camphor, ...... 5 " Ointment of lead oleate, . . . . y ounce. Mix. For acne, rosacea, and papular eczema. Take of Menthol,.......5 grains. Carbonate of zinc,.....1 drachm. Creasote,.......3 drops. Ointment of lead oleate,. . . . y ounce. Mix. Useful in subacute eczema and fissured eczema, particularly that which occurs around the nose, mouth, and genital organs. Take of Beta-naphthol,.....10 grains. Ointment of oxide of zinc, . . . y ounce. Ointment of lead oleate, . . . y " Mix. Employ in seborrhoea, acne, rosacea, and sycosis. MANGANESE OLEATE. Dr. Franklin H. Martin* has proposed the use of this combination as a remed}' in functional amenorrhoea, menorrhagia, and metrorrhagia. The permanganate of * Medical Record. TJierapeutic Action of the Oleates. 261 potassium is held to be difficult of administration and irritant to the stomach. The binoxide of manganese has also, on account of its insolubility, proved to be almost inert. He therefore recommends that 1 drachm of a 20-per-cent. solution of the oleate should be applied by friction to the abdomen of the patient, and in amenor- rhoea should be made every night for a week before the expected period. In menorrhagia or metrorrhagia it may be employed in smaller quantities every night until the desired effect is produced. The writer is of the opinion, by his experiments with the various oleates of the metals and alkaloidal solutions of the oleates, that none of them have any appreciable S3'stemic action to warrant their use. These experiments are referred to under the physiological action of the oleates, and are to the writer sufficient evidence of negative constitutional action of manganese oleate. If any result has followed the application of this oleate with friction over the ab- domen in any of the diseases referred to, it is due, beyond all question, to the action of the massage emplo}red upon the parts. MERCURIC OLEATE. The ointment of mercuric oleate is a yellowish chemical combination having a fatty smell, and is of an unctuous consistence. It has a stimulating, resolvent, and alterative impression used on the integument, es- pecially upon tumors, glandular enlargements, indura- tions, and thickening of the skin. In some of the old cases of eczema, in which the skin becomes greatly infiltrated, the twofold action of the ointment of mer- curic oleate is often attended with happy effects. It is an acceptable and, at the same time, beneficial agent in obstinate ulcers and indolent papules, tubercles, and in infiltration that often is attendant upon or follows 262 The Oleates. abscesses, in inflammation of the hair-follicles of the beard, and scrofuloderma. It can be used with success in the excess and deficiency of pigment that occur, either as a disease, from applications, or from an effect of disease. It is a useful remedy in both the animal and vegetable parasitic affections. In animal parasitic disease, especially in phtheiriasis, or lousiness, the ointment of mercuric oleate has alike the effect of destroying both the parasite and nits, which are not always reached by other mercurial preparations. In all varieties of vegetable parasites it is not onfy effective on the surface, but possesses the power of penetrating into the hairs, the follicles, and sebaceous glands, and thus killing the fungus that has pushed into these parts. In the treatment of parasitic affections, 1 per cent. of picrotoxin, the active principle of cocculus Indicus, may be combined very serviceably with mercuric oleate. The advantages of the ointment of mercuric oleate over the old mercurial ointments for its topical use are:— 1. Its chemical combination, which makes it more easily absorbed, gives greater penetrating action, and thus manifests itself in more prompt remedial effect. 2. It possesses the advantage of being free from rancidity,—so objectionable a feature in the ointments of other mercurial combinations. 3. It is both economical and clean. In concluding the description of the ointment of mercuric oleate, I wish to call attention to the fact that, while it is more rapidly absorbed, yet, for the reasons already mentioned, it is slow under its physiological action to give rise to systemic effect. Large quantities can be applied over the general surface, either in chil- dren or adults, with great impunity, its toxic or con- Therapeutic Action of the Oleates. 263 stitutional effect seldom following in the majority of cases in which it is used. Formulary. Take of Oil of cade,......y drachm. Ointment of mercuric oleate, . . . jounce. Mix. For psoriasis and chronic eczema, especially of the palms of the hands and soles of the feet. Take of Beta-naphthol,.....5 grains. Camphor,......5 " Ointment of mercuric oleate, . . . y ounce. Mix. Use in chronic acne, sycosis, and alopecia circumscripta. Take of Picrotoxin.......1 grain. Ointment of mercuric oleate, . . . 1 ounce. Mix. For animal and vegetable parasitic diseases, as scabies, pediculi, trichophytosis, and tinea versicolor. MERCUROUS OLEATE. The ointment of mercurous oleate is very much stronger in mercury than that of mercuric oleate. In the ratio of 41.6 to 26.2, or about one and a half times as strong, it has marked stimulating action bordering on congestion on the integument, and has a decided resolvent and alterative effect. It is therefore appli- cable to the same class of affections in which the oint- ment of mercuric oleate is used, particularly if it is desirable to make a more decided impression. Having had repeated failures with the ointment of mercuric oleate in the inunction treatment of syphilis, I requested Dr. L. Wolff to make me a stronger prepara- tion, and the result was the development of the oint- ment of mercurous oleate. In the inunction treatment of syphilis this oleate is far superior to either the ordinary blue ointment or the mercuric oleate. It is a very powerful agent, and should be applied cautiously, as it possesses deeply-penetrating 264 Hie Oleates. power, and its quick diffusion will often bring about rapid constitutional effects. Its advantages over the ordinary blue ointment are its cheapness and the cleanly manner of its application. A piece about the size of a bean can be gently rubbed in the axillae, as well as the same quantity on each limb or on each side of the trunk. It will be quickly absorbed, may leave a reddened sur- face, but will neither stain nor discolor the linen, nor occasion the annoyance that follows the old inunction treatment of syphilis. An eczematous condition that is often feared, and that has been referred to as an objection in the inunction treatment of syphilis by Dr. John Ash- hurst, in his paper on the " Treatment of Syphilis," presented to the Philadelphia County Medical Society, can always be avoided bjT having the patient use vapor and hot-air baths every second or third day; and I regard the constant use of these baths now as essential to success. I would further add that, after some years' experience, the constant application of the ointment of mercurous oleate for a short length of time, or any fatty substance, to the skin will attract dust and dirt to the parts, the glands and follicles will become distended, both with the substance applied and the foreign material, and the parts must be opened up very often by baths; otherwise, any form of mercurial combination sus- pended in a fatty vehicle would naturally fail to pass in, and would consequently set up an inflammation on the surface. The ointment of mercurous oleate is a most effective application in old spots of psoriasis and in chronic pal- mar and plantar eczema, in which the integument becomes thickened, harsh, dry, and cracked. In these lesions the oleate can be used alone, or it can be advantageously combined with some form of tar or naphthol. Therapeutic Action of the Oleates. 265 Formulary. Take of Green soap,.......3 ounces. Ointment of mercurous oleate, . . 3 " Mix. For the inunction treatment of syphilis. Take of Oil of juniper,.....y drachm. Oil of eucalyptus,.....8 drops. Ointment of mercurous oleate, . . 1 ounce. Mix. For chronic eczema, psoriasis, and pigmentary spots on the skin. MORPHINE OLEATE. Morphine oleate has, like all the alkaloidal oleates, a feeble action, and only upon the part to which it is applied. It can be emplo}red in all irritable conditions of the integument, but many other stronger sedatives are preferable. NICKEL OLEATE. Nickel oleate mixed with a fatty base, in the pro- portion of from 1 to 60 grains to the ounce, has a very decided astringent action, almost bordering upon the effect of a caustic on abraded surfaces. The oint- ment of nickel oleate, of a weak strength, from 5 to 20 grains to the ounce of lard, acts at times very well in epithelial ulcerations. It is often effective in exuberant granulations and in old callous ulcers. In some chronic cases of eczema, especially of the extremities, in which the skin is deeply infiltrated, hard, and of a leathery state, if it be applied in the proportions named, it will generally be attended with good results. Formulary. Take of Chrysarobin,......10 grains. Ointment of nickel oleate, . . . jounce. Mix. For callous ulcers and chronic psoriasis. Take of Citrine ointment,.....3 drachms. Oil of cade,......M drachm. Ointment of nickel oleate, . . . 3 drachms. Mix. Useful in eczema of the palms of the hands and soles of the feet. 12 M 266 The Oleates. QUININE OLEATE. Quinine oleate, both from physiological experiments which have heretofore been given and from repeated clinical experience has proved with me of little if of any service. Cases have been reported in the medical journals in which its use has been extolled as an invaluable remedy in cases of intermittent fever, in debility, and, in fact, wherever quinine is indicated and js not well borne by the alimentary canal. In my service in the Philadelphia Hospital for Skin Diseases, the Medico-Chirurgical Hospital, and in private practice, I have used large quantities of quinine oleate from all the prominent manufacturers, and have as yet to observe a single case that has had any decided constitutional effect from its topical application. I have repeatedly employed it freely in intermittent fever, both with children and adults, but without the desired result, the paroxysms returning unless arrested by some other means. SILVER OLEATE. Silver oleate, applied in its natural form to the abraded skin or sores, combines with the albumen and fibrin of the parts, forming a coat and thus excluding the air. It likewise causes a powerful contraction of the blood-vessels, and condenses and superficially destroys the tissue. Silver oleate, sprinkled over ulcers, bed- sores, and exuberant granulations, will set up a healthier action of the surface. When previously dissolved with an equal amount of oleic acid and then mixed with lard in the proportion of from 5 to 60 grains to the ounce, it forms a dark-brown, soft, and pliable ointment. The ointment of this oleate is a safe and efficacious remedy applied over the inflamed surface of erysipelas, or around the margins to prevent the inflammation from Tlicrapeulic Action of the Oleates. 267 spreading. In superficial lupus, if kept constantly applied to the parts, it lessens the cell infiltration and thus reduces the active inflammation. In boils and carbuncles it is serviceable, and often arrests pustulation in its early stage. Eczema that occurs around the mucous outlets, especialfy the anus and genitalia, attended with an intolerable itching, will frequently be quickly relieved by applying the ointment of silver oleate, either alone or combined with opium, belladonna, or hyoscyamus. Its deep penetration, stability, and prompt action, together with its comparatively painless and mild effect, are the advantages it possesses over the ordinary silver ointments. Formulary. Take of Creasote,.......4 drops. Powdered starch,.....y drachm Ointment of silver oleate, .... jounce. Mix. For erysipelas and lupus vulgaris. Take of Extract of belladonna, .... 1 scruple. Extract of opium,.....1 " Ointment of silver oleate, . . . . jounce. Mix. For eczema of the anus and genitalia. Take of Iodol,........1 scruple. Ointment of silver oleate, . . . . jounce. Mix. For chronic sycosis and old ulcers. STRYCHNINE OLEATE. Strychnine oleate can be applied to the integument in large quantities and for some time without producing any systemic action of the drug. Its local impression is weak, and it is a remedy of but little use or value. TIN OLEATE. Tin oleate, mixed with lard or a fatty base, in the proportion of from 10 to 60 grains of the former to 1 ounce of the latter, forms a grayish-brown ointment, possessing an astringent and nutritive action. It is of 268 The Oleates. value and service in papular and fissured eczema. The ointment of tin oleate is of the greatest utility in dis- eases of the nails, or when they are abnormal or deficient in growth. It assists in such cases in overcoming the brittle, split, and soft conditions that result from injury to the parts or that follow certain affections of the skin. The ointment of tin oleate, especially when combined with a little carmine, forms an elegant article of toilet for the nails and surrounding parts, giving them a beau- tiful lustre. Agnail, or the ragged and attenuated skin of the base of the nail that is so frequently observed from neglecting these appendages, can be relieved or checked by the astringent action of this ointment. Formulary. Take of Powdered cochineal, .... 5 grains. Rose-water ointment, .... 2 drachms. Ointment of tin oleate, . . .2 " Mix. Excellent for atrophy of the nail. Take of Ointment of mercuric oleate, . . 1 drachm. Rose-water ointment, . . . .1 " Ointment of tin oleate,. . . . 1 " Mix. For excessive growth of the nail, in all irritable conditions of the matrix, and in thickened and friable state of the nail. Take of Camphor,......10 grains. Prepared suet, or lanolin, . . . 2 drachms. Ointment of tin oleate, ... 1 drachm. Mix. For agnail. Take of Beta-naphthol,.....10 grains. Citrine ointment,.....3 drachms. Ointment of tin oleate, . . . 3 " Mix. Useful in papular and fissured eczema. Take of Prepared suet,.....2 drachms. Subnitrate of bismuth, . . . 1 scruple. Thymol,......1 grain. Ointment of tin oleate, ... 3 drachms. Mix. For lentigo and chloasma. Therapeutic Action of the Oleates. 269 Take of Iodol,.......! scrUpie. Oxide of zinc ointment, . . . \y ounces. Ointment of tin oleate, . . . jounce. Mix. For pustular eczema, sycosis, and excessive secretion. VERATRINE OLEATE. Veratrine oleate has a valuable action as a counter- irritant when used upon the integument. ZINC OLEATE. Zinc oleate occurs as a fine, pearl-colored powder, with a soft, soapy feeling, very much like powdered French chalk. It has both an astringent and stimulat- ing action. In hyperidrosis and osmidrosis, or excessive sweating, fetid or otherwise, it is one of the very best remedies for topical use. It is especially applicable to those who suffer from an increased flow of sweat around the axillae, genitalia, and palmar and plantar surfaces. It is to the latter unfortunate and distressing class of cases, in which the epidermis often macerates, leaving a tender and exposed skin, attended with a disagreeable odor, that it can be used for relief and at times with permanent good results. Dr. William Murrell, in the London Medical Record of November 15, 1883, also calls attention to the value of the zinc oleate in local sweating. He reports that the zinc oleate mixed with thymol (1 in 500), and used as a dusting powder, forms an excellent application in many varieties of local sweat- ing. He also states that he has used it with much success in the night-sweating of phthisis. Dr. Jamieson speaks of its use in sudamina as a dusting powder, combined with an equal quantity of French chalk and 3 per cent, of salicylic acid. He also recommends the zinc oleate in the treatment of comedo. If a paste has been applied during the night, he directs that it shall be washed off in the morning and 270 The Oleates. the face dusted with equal parts of oleate of zinc and finely-powdered talc. In acute vesicular eczema, in which the parts become covered with small vesicles, swollen, hot, inflamed, or raw, weeping, and attended with intense itching, the combined protecting, astringent, and stimulating action of the zinc oleate will usually cause all the inflammatory symptoms to abate, the discharge to dry up, and the swollen skin to resume its normal condition. Dr. McCall Anderson has referred to its utility in eczema, especially of the nares, in an article published in the Journal of Cutaneous and Venereal Diseases. The great advantage and value of the zinc oleate among the same class of cutaneous affections has been referred to by Dr. James Sawyer in a communication to the British Medi- cal Journal of February 10, 1883, and also in another to the Birmingham Medical Review, published a year later. Dr. Sawyer, in speaking of this and other oleates used in the same form, adds that " they can be employed in those troublesome, acute, and discharging affections of the skin in which greasy preparations of any kind cannot be borne." Zinc oleate will cling to the skin, and will not fall or brush off like ordinary dusting powder, and is, therefore, of veiy great value in sebor- rhoea oleosa. It forms a most excellent and useful toilet- powder for ladies who are troubled with shining faces or seborrhoea oleosa, dusted over the parts either alone or mixed with an equal quantity of arrow-root, bismuth, subnitrate, or lead carbonate, and scented with the oil of verbena or rose. It likewise acts in a most efficacious manner dusted on an inflamed surface that is hot and tumid, in cases of erythema about the groins and axillae, and is also beneficial in herpes and herpes zoster. One Therapeutic Action of the Oleates. 271 part of the powdered zinc oleate melted with 4 parts of a fatty vehicle yields the ointment which can be used in the same class of affections just enumerated, and in acne, rosacea, and in subacute and chronic forms of eczema.* Dr. Bernard, in the Gazette de Gynecologie, describes his employment of the zinc oleate in gynaecological prac- tice. In cancerous ulceration of the cervix uteri it diminishes the pain, discharge, and offensive odor. It lessens turgescence of the mucous membranae, and hence is of service in endometritis. He applies it either by insufflation or by tampon. In order to secure a decided antiseptic action, Haslam recommends its mixture with iodoform, either in equal parts or in proportion of 1 part zinc to 2 of iodoform. Formulary. Take of Subnitrate of bismuth, .... 2 drachms. Powdered oleate of zinc, . . . 2 " Mix. For excessive sweating and in seborrhoea oleosa. Take of Powdered arrow-root, .... 3 drachms. Powdered impure carbonate of zinc, . 3 " Powdered oleate of zinc, . . .3 " Oil of rose,......1 drop. Oil of verbena,.....3 drops. Mix. A valuable dusting powder for toilet purposes. Especially useful for greasy and shining 6tate of the skin of the face. Take of Carbonate of lead, .... 3 drachms. Powdered starch,.....3 " Powdered oleate of zinc, . . . 4 " Mix. Useful in acute erythematous and vesicular eczema. Take of Beta-naphthol,.....1 scruple. Carbonate of bismuth, .... y ounce. Powdered oleate of zinc, . . . y " Mix. For excessive and fetid sweating, ulcers, sinuses, and sycosis within the nares. *See report on "Oleate of Zinc in Eczema," by Dr. A. A. Wells, Boston, Mass., in the New England Medical Monthly, January, 1885. 272 The Oleates. Take of Sublimed sulphur, .... 1 scruple. Oil of eucalyptus,.....5 drops. Hydrochlorate of cocaine, ... 4 grains. Oleate of zinc ointment, . . . 1 ounce. Mix. Serviceable in subacute and chronic eczema, acne, rosacea, herpes, and herpes zoster. Take of Calomel,......10 grains. Camphor,......10 " Oil of chamomile,.....5 drops. Oleate of zinc ointment, . . . 1 ounce. Mix. For erythema, sycosis, infantile eczema, and lupus. I have now described in detail the special effect of each individual oleate, and the deductions that have been drawn from a personal and most careful observa- tion during the past fifteen 3rears in laboratories with the chemist and plrysiologist, and from ray private practice and clinical service. A large number of prac- titioners, who have used the oleates in the manner in which they should be employed, have reported highly favorable and practical results from them. Others have been unfortunate enough to apply impure or improperly- prepared oleates, and the results in such cases have generally been either negative or irritating and inju- rious to the parts. A very few unfortunate, careless, and injudicious observers, skeptics in therapeutics, who only believe in the older and oft-tried remedies, have taken up the oleates for fashion or popularity's sake, and, after a very limited experience in their application, condemn them without a fair trial. The communica- tions that have appeared from the latter class speak of their action disparagingly and their effects as problem- atical, but are devoid of research, which appears when they speak of quinine oleate being limited to inunctions for its systemic impression, showing an absence of prac- tical experience or proper deductions from their results. Therapeutic Action of the Oleates. 273 In concluding myT remarks, I would sum up by stating that, although the oleates have not been found to fill the place they were originally intended for b}' those who in- troduced them, they have made for themselves a most prominent place among the more scientific means we possess for treating affections of the cutaneous cover- ing. The3T have opened up a new branch for therapeu- tics, and occupy a position which has not been held either b3T ointment or lotion, and which they will occupy, not in a transitory manner, but permanentfy, and in in- creased ratio as their nature, use, and effect shall become more thoroughly understood and known. In the following papers will also be found much of instructive interest in regard to the oleates :— "Oleates," by Prof. John Marshall, American Journal of Phar- macy, 1872, p. 317; " Acidum Oleicum," by Charles Rice, American Journal of Pharmacy, 1873, p. 1; " Acidum Oleicum," by E. C. San- ders, New Remedies, June, 1880; " Falsification of Oleic Acid by Linoleic Acid," by Granval and Vulser, Journal Chemical Society, August, 1889; " Oleates," by L. Wolff, American Journal of Phar- macy, 1881, p. 545 ; " Working Formula for the Oleates," by Henry B. Parson, Druggists' Circular and Chemical Gazette, January, 1885; "Oleates," by F. C. J. Bird, London Pharmaceutical Journal and Transactions, January 3, 1885; " Neutral Oleate of Mercury," by Charles R. C. Tichborne, LL.D., London Medical Press, September 24, 1884; " Acidum Oleicum and Oleates," by Dr. Squibb, Ephemeris, 1882 and 1885; " Oleate of Mercury," by R. C. Harrison, The London Pharmaceutical Journal and Transactions, November 30, 1889; "Ole- ates," by G. M. Beriuger, Ph.G., The American Journal of Pharmacy, December, 1889. 12* INDEX. PAGE Abrasions............33, 57, 71, 73, 102, 122, 266 Abscesses...................124, 135, 248 Absorption of ointment-bases.............18, 2G Acid, gynocardic...................' 84 margaric..................... 10 oleic................! ! . ! ! 10, 213 adulterated with linoleic acid..........214 solid.....................213 palmitic...................... 8 preparation of................. 10 properties of.................. 10 stearic....................... 8 preparation of................. 9 properties of.................. 9 Acids, fatty............... 8 Acne.....49, 50, 77, 91, 95, 97, 98, 10G, 154, 250, 260, 271 Aconitine oleate, experiments with...........239 therapeutic uses of...............246 Adeps......................... 12 benzoinatus.................... 55 Advantage of oleates over ordinary ointments .... 239, 246 Advantages of mercuric-oleate ointment........202 Agnail........................268 Alkaloids, oleates of..................216 Alopecia.......................258 circumscripta......32, 52, 57, 78, 87, 83, 95, 97, 121 Alterative....................218, 249 Aluminium oleate...................221 uses of......................247 Amenorrhoea....................200 Anaesthetic effects of aconitine oleate..........247 Anderson, McCall, eczema...............270 Anidrosis....................... 23 Animal parasites....................262 Anthelmintic.....................188 Anthrax........................ 86 Antiparasitic .....................253 Antiseptic......................253 aluminium oleate as an...............247 Anus, fissure of.................. . 104 Aromatischc salbe...................127 Arsenical poisoning lesions...............258 Arsenicum oleate...................222 uses of......................218 (275) 276 Index. PAGE Arthritis, chronic . •.................191 Ascites......................140, 188 Asthma........................148 Astringent............252, 258, 265, 26G, 268, 270 Atropine oleate, use of.................247 Attfield, Professor, on oleic acid............213 Balsamo di Noe....................167 Bed-sores............42,47,83,114,124,189,260 Bismuth oleate....................223 uses of......................249 Bleeding, to arrest...................253 Bleisalbe.....................114, 131 Bleiweissalbe...................110, 127 Blister, to maintain a.............43, 57, 76, 171 Blisters, 29, 45, 71, 73, 74, 75, 82,102, 104, 110, 114, 117, 118, 122, 144 Boils.....................34, 166, 267 Breasts, engorged............46, 124, 135, 166, 191 inflammation of..................158 Brechweinsteinsalbe..................115 Bromidrosis..............67, 95, 10G, 185, 247 Bronchocele......................191 Bubo...................37, 39, 42, 86, 98 open.......................104 Bunions .......................255 Burns, 30, 33, 45, 53, 68, 75, 83, 98, 102, 104, 110, 114, 118, 121, 122, 136, 159, 162, 248 Cacao-butter...................... 25 Cadmium oleate....................225 uses of......................251 Campherhaltige bleiweissalbe............110 Cancer...........30, 42, 86, 124, 139, 148, 161, 1S9 Carbuncle..............101, 135, 158, 166, 267 Cerate, Galen's....................136 Goulard's.....................136 laudanum.....................137 mercurial.....................137 sedative, Roux's..................137 yellow .................137 Cerato, caimante di Roux . . '.............137 cosmetico.....................155 di Galeno.....................136 di ginepro.....................157 di Goulard.....................131 giallo....................... 137 laudanizzato....................137 mercuriale.....................137 per le labia....................161 Index. 277 PAGE Cetaceum........... .... 24 Chancre.......37,' 39('40, 86,' 93,101," 104, 144, 163, 104 Chancroid......42, 57, 86, 93, 98, 101, 102, 104, 144, 175 Chapped hands.................... 33 bps........................ 33 Chevreul, chemistry of fats....... . 211 Chilblains..........32, 37, 41, 58,' 114, 118, 136, 248 Chloasma......................39, 52 Cholesterin................. . . . ' 14 Chromophytosis...............'..... 254 Cocaine oleate..................." . 251 Cold cream.................... 32, 113 Comedo..........38, 44, 49, 68, 83, 93, 146, 154J 269 Condylomata.....................249 Conjunctivitis, chronic................. 40 Contusions...................... 99 Copper oleate.....................226 experiments with.................238 uses of.......................252 Corns.......................249, 255 Coryza, acute..................... 99 Counter-irritant....................269 Cucumber cream.................... 82 Cutaneous irritation..................249 Debility........................266 Dermatalgia...................... 89 Dermatitis, 33, 35, 37, 53, 58, 63, 65, 68, 73, 74, 82, 102, 104, 110, 111, 114, 120, 122,136, 146, 152,159,162, 171,172, 182, 247 Diachylonsalbe..................Ill, 128 Diluent for oleates................... 245 Diolein........................ 9 Dipalmitin....................... 9 Diphtheria ...................... 86 Distearin....................... 9 Dropsy........................143 Dysentery, chronic.................. 3 Economy of oleates............,.....246 Ecthyma....................... 58 Eczema .... 30, 63, 86, 136, 247, 249, 251, 252, 264, 265, 270 acute, 29, 33, 35, 45, 52, 65, 68, 82, 89,103, 110, 111, 122, 152, 1C2, 171, 172, 182, 250 capitis................ 31, 32 chronic, 35, 38, 39, 41, 42. 44, 49, 58, 65, 74, 77, 84, 86, 91, 95, 98, 132, 135, 142, 144, 146, 147, 154, 185 fissured....................260, 268 infantile.................29, 35, 82, 103 inflammatory...................258 itching in....................30, 80 278 Index. PAGE Eczema of mucous outlets...............267 old cases of....................261 papular................. . . . 259, 268 pustular......................258 rubrum...................... 69 subacute............35, 65, 111, 152, 171, 182 Effusions.......................191 Einfachesalbe.....................132 Enipiastro di Canet..................145 ossicroceo................... . . 168 Emplastrum cum oxido ferrico.............119 diachylum gommatum...............119 fuscum Theclae...................123 Emplatre brun.....................123 de Canet.....................119 diachylon gomme.................119 Endometritis.....................271 Epidermis, thickened.................255 Epididymitis ...................124, 136 Epithelial ulcerations.................265 Epithelioma...................90, 92, 185 Eruptions, pustular..................250 Erweichendesalbe...................128 Erysipelas, 30, 37, 41, 45, 53, 58, 73, 78, 83, 86, 99,102, 104, 110, 121, 122, 136, 159, 162, 166, 191, 250, 266 Erythema .... 53, 63, 65, 73, 74, 102, 110, 111, 162, 172, 270 multiforme....................30, 33 simplex.............30, 45, 82, 102, 110, 122 Escharotic.......................248 Ethers, fatty....................'.'. 8 Excoriations............29, 53, 57, 63, 90, 102, 104 Exuberant granulations...............265, 266 Exudations, absorption of................ 41 Face, shining......................270 Fats, absorption of water by.............. 18 chemical composition of..............8, 211 properties of....................' 7 rancidity of..................... 10 restoration of.................... 11 Fatty acids.......................211 bodies used in medicine............ . '. . 211 Favus.......................' \ ; 255 Fetid discharges....................247 sweat....................... 269 Fever........................173 Foul ulcers.................... 248 Freckles................'.'.'.'. 68, 106, 255 Frost-bites.............. 98 146 Fungi................'.''.'.'.'.'...' 255 Index. 279 PAGE Furuncle................101, 124, 135, 158, 258 Furuuculosis from copper oleate.............256 Gastritis, acute.....................144 Glands, enlarged, 34, 37, 41, 42, 120, 135, 142, 148, 165, 191, 201,251, 261 syphilitic................... 37 ulcerated...................... 98 Glicerato di solfato di morflna..............144 Glycerin........................ 8 Glycerinsalbe...................Ill, 129 Glycerite of starch..................■ 25 Glyceritum amyli................... 25 Goitre ................41, 46, 47, 148, 159 Gout ................52, 69, 76, 124, 148, 165 Granulations.............248, 251, 253, 265, 266 Graue quecksilbersalbe.................112 Haemorrhoids....................31, 161 inflamed...................... 48 internal......................114 painful. .... 34, 72, 90, 124, 139, 144, 148, 183, 185, 189 Hager, H., on vaseline, etc., as bases..........245 Hair, atrophy of...................38, 39 falling of.....................83, 95 follicles, inflammation of..............262 Heart disease, organic...............■ • 51 Herpes, 32, 45, 53, 57, 63, 65, 73, 74, 83, 89, 103, 105, 111, 114, 122, 136, 152, 270 zoster, 34, 36, 48, 51, 53, 80, 110,120, 124, 139, 144, 148, 155, 161, 165, 183, 189, 270 History of oleates...................211 Horns.........................249 Horny warts......................^55 Hydroa........................ 66 Hyperidrosis.................9b 95, 247, 269 Hyperplasia......................191 Impetigo8 : :'.'.'.■'.'.'.'.''■ • 53, 63,' 122, 162, 171?'l82 contagiosa.................36, 38, 53, 58 Indolent papules....................261 Indurations......................£°1 Intermittent fever..........• • • • • • • • *°» Intertrigo..............37, 45, 53, 102, 110, 122 Inunction.......................nc~ Iron oleate, 227 uses of. ......................|57 Irritant......................267 270 Itching...................... #>l, ^0 mercurioso..................159 288 Index. PAGE Pomata di ioduro di piombo..............160 di potassio...................160 di zolfo....................160 di lauro-ceraso...................161 di linaria.....................161 di liquirizia....................162 di naftalina....................167 di nicoziana....................168 di precipitato rosso.................171 di rosmarino composto...............172 di ruta.......................172 disabina......................173 di sambuco....................173 di solfato di chinina................173 ferroso.....................174 di spermaceti...................156 di stafisagria...................174 di stearato di chinina e soda alia glicerina......175 di ferro....................175 di tartaro emetico.................176 di tuzia......................176 diuretica.....................152 epispastica di dafnoide...............149 malvina......................162 mercuriale.....................103 solforata ...................156 mirabile pei capezzoli...............146 oftalmica.....................108 ossigenata.....................148 saturnina sapon . ................174 sedativa ed abortiva................135 solforica......................174 vaselina bianca..................177 rossa....................177 Pomatum ad ulcera foetida ex Rust...........193 citrinum.....................120 cum carbonato plumbico..............118 cum hydrargyro..................121 simplex....................121 laurinum.....................122 populeum.....................123 quininae oleicum..................202 veratrinae oleicum.................202 Pommade citrine .................120 de carbonate de plomb...............118 de laurier.....................122 mercurielle faible.................121 a parties egales............ ... 121 Pompholyx ...............29, 53, 122, 136 Powders in skin disease................ 0 Index. 289 PAGE Precautions in the use of copper oleate.........256 Process of manufacture of oleates...........219 Prurigo....................44, 49, 91, 95 Pruritus...............30, 36, 57, 104, 252 Psoriasis, 30, 34, 39, 43, 58, 60, 65, 77, 78, 84, 91, 92, 93, 95, 97, 98, 132, 135, 142, 147, 159, 174, 264 Purpura......................105, 185 Pustular eczema....................258 eruptions.....................250 Pustulation......................267 Quecksilbersalbe....................129 Quinine oleate.....................266 experiments with.................237 Rachitis.......................3, 138 Resorcin, discoloration of................ 32 Rheumatism, acute inflammatory............ 99 chronic, 51, 63, 69, 84, 120, 124, 139, 142, 148, 155, 161, 165 Rigidity of os uteri................... 34 Ringworm.....................253, 254 Robson, on vaseline................244 Rosacea......37, 38, 39, 41, 83, 90, 98, 250, 258, 260, 271 Rosensalbe.......................131 Rosmarinsalbe.....................115 Rothe quecksilbersalbe.................112 Sabadilla salbe.....................132 Sabinasalbe......................115 Sawyer, on copper oleate................ 253 James, on zinc oleate...............270 Scabies, 30, 48, 50, 66, 70, 85, 91, 94, 125, 132, 150, 157, 174, 184, 185 Scalds...................45, 110, 114, 162 Scarlatina.......................3, 29 Schwefelsalbe.....................132 Sciatica ........ 51 Scleroderma '. '. '.'.'.'.'.'..'.......37, 38, 40, 41, 144 Scrofula................... 3, 51, 84, 148 Scrofuloderma................39, 40, 101, 262 Scrofulous ulcers.................249, 258 Seborrhea, 35, 38, 39, 41, 53, 55, 83, 88, 91, 14G, 171, 182, 249, 258, 270 Sebum.........................1> 2 Secretions, profuse...................247 Sedative........................259 Sevum......................... Ijj Shining face......................*»[ Sick-headache..................... ^ Silver oleate........ •............Z6d 13 N 290 Index. PAGE Silver oleate, uses of..................266 Sinuses.......................56, 248 Skin-patches......................255 Skin, thickenings of................- • 261 Small-pox....................37, 39, 101 Sodium oleate.....................219 solution......................220 Sore nipples......................250 Sores..........................266 Spanischfliegensalbe..................109 Spasm, anal.....................34, 124 os uteri......................124 vesical......................34, 124 Spermaceti....................... 24 Spleen, enlarged...........40, 46, 60, 148, 159, 191 Squibb on cocaine...................251 Starch, glycerite of................... 25 Startin on copper oleate................253 Strychnine oleate...................267 experiments with................. 238 Styptic......................247, 258 Sublimate lanolin................... 18 Sudamina.......................269 Suet ......................... 13 absorption of.................... 26 Sunburn........................250 Suppression of milk...............34, 46, 148 Suppuration, to produce................163 Sweating, excessive.................34, 124 feet........................ 36 fetid........................209 Sycosis, 31, 36, 38, 39, 44, 49, 58, 65, 91, 95,17i, 182, 249, 250, 258 Synovitis.................37, 142, 148, 165 chronic..................51, 120, 124 Syphilis..........37, 58, 101, 160, 164, 165, 185, 203 Tabes mesenterica................... 84 Tannin-bleisalbe....................114 Terpenthinsalbe ....................116 Therapeutic action of the oleates............243 Thickened epidermis..................255 Thickening of the skin.................261 Tin oleate.......................234 uses of......................207 Tinea circinata......35, 40, 49, 65, 66, 68, 74, 91, 97, 159 favosa....................... 30 tonsurans....................41, 71 trichophytina.........30, 39, 86, 92, 94, 105, 183 versicolor..................30, 35, 254 Toilet of the nails...................268 Index. 291 PAGE Toilet powder.....................270 Tonsils, enlarged................... 41 Transudations......................191 Triolein........................ 9 Tripalmitin...................... 9 Tristearin....................... 9 Tubercles ......................261 Tuberculosis......................3, 84 Tumors........................261 inflamed...................... 48 Ulcerating epithelioma.................248 Ulcerations, epithelial................265 Ulcers, 39, 42, 45, 57, 58, 63, 75, 87, 98, 100, 104, 106, 115, 117, 118, 151, 152, 159, 165, 169, 178, 266 callous........ ......205 indolent, 30, 31, 40, 42, 43, 46, 49, 50, 61, 63, 72, 83, 90, 93, 114, 121, 144, 154, 155, 156, 157, 158. 164, 173, 176, 185, 251, 261 irritable......34, 48, 90, 102, 124, 144, 148, 182, 189 malignant.........30, 34, 42, 80, 90, 93, 106, 158 painful...................90, 148, 252 phagedaenic.................... 32 rodent ...................... 42 scrofulous................42, 90, 249, 258 sloughing...................90, 121 syphilitic ... 37, 80, 93, 100, 104, 106, 160, 164, 165, 185 unhealthy..........72, 80, 86, 90, 121, 158, 182 varicose....................83, 90 venereal.............151, 159, 160, 175, 196 Unguento antelmintico.................139 antiemorroidale..................139 antipediculare...................139 basilico ......................140 bruno di Larrey..................143 calaminare . . .•.................144 calmante.....................144 canforato.....................145 cantaridato....................145 citrino.......................149 contro le immondizie della testa...........158 d'acetato di piombo................136 d'acido borico...................137 fosforico....................138 tannico....................138 d'aconitina....................138 d'artanita.....................140 d'elemi......................154 d'elleborato....................154 d'elleboro bianco..................155 292 Index. PAGE Unguento d'oppio...................168 d'ossidogiallo di mercurio.............109 di zinco....................169 del Duca.....................153 dell'Abbazia di Bec................135 della Madre Tecla.............. . . . 162 depilatorio.....................150 di Andrea della Croce..............° 139 di benzoino....................141 di bolo.....................[ \ 141 di brionia.....................142 di calomelano ..................144 di Canet.....................145 di carbonato ammonico...............146 di catrame.....................146 di cerussa...................' 147 di cetriuoli.....................147 di cicuta..................'...'. 148 di creasoto.....................149 di dafnoide................'.'... 149 di galla..................'.'.'.'. 157 di ginepro.....................I57 di iodio...................' ' 159 di iodoformio......... ..... ... 159 di ioduro di piombo................160 di potassio..................' 160 di zolfo.................'.'.'. 160 mercurico................... 159 mercurioso............... . . . 159 di lauro-ceraso................... 161 di linaria.................. Igl di liquirizia................. \ 162 di mezereo....................'. 166 di minio..................... 166 di Montpellier............. " ' igg di naftalina......., .....' ... 167 di nicoziana...............] [ Igg di Noe................' ! 167 di precipitato rosso............. ' 171 di Rhasis.............. . . . . ' 141 di Ricour................ " 171 di rosmarino composto .....'........'' 172 di ruta.................. . ' 472 di sabina...................... di sambuco............... 173 di solfato di chinina........'.'.'. '. 173 di ferroso...........'.'.'.'. '. 174 di stafisagria............. . '. '. . 174 di stearato di chinina e soda alia glicerina . . . . . 175 di ferro 175 Index. 293 PAGE Unguento di storace..................175 di tartaro emetico.................176 di terebintina...................176 canforato...................176 di tuzia......................176 di vaselina bianco.................177 rosso.....................177 digestivo animato.................150 composto...................150 mercuriale...................151 oppiaceo....................151 semplice....................151 disseccativo rosso o difensivo............152 diuretico.....................152 divino.......................154 egiziaco di Solleysel................152 emolliente.....................155 epispastico.....................156 etiopico......................156 familiare......................157 Helimund arsenicale................158 narcotico-balsamico..............158 laurino......................160 malvino......................1G2 marziale......................103 maturativo....................163 mercuriale.....................163 al burro di cacao e canfora...........165 alia belladonna................165 col burro di cacao...............164 composto...................164 semplice....................1G4 nero di Velpeau..................107 nervino......................172 oftalmico.....................108 ossicroceo.....................168 pei capezzoli....................146 per le labra....................161 pettorale ..................• . . 169 populeo......................170 rasino......................- • 171 rosato.......................171 rosso.......................172 saturnino sapon..................174 solforico......................174 tetrafarmaco....................140 verde ......................178 vesicatorio . . .................178 o blister officinale...............178 senza cantaridi ................179 294 Index. PAGE Ungiiento amarillo.................203, 206 ammoniacal....................181 antipsorico de Edimburgo.............181 balsamico-peruviano................182 basilicon .....................181 bianco simple...................203 bruno.......................203 contra escabia...................203 la tina.....................183 de Henke.................184 de la Caridad ...............183 las hemorrhoides................183 los piojos .................184 de acetato de plomo................185 de agallas y morflna................185 de Agripa.....................188 de altea..................186, 204, 207 de Arceo.................186, 204, 206 de arrayan compuesta...............186 de artanita compuesta...............187 de bayas de laurel.................200 de bryonia.....................188 de calabaza....................188 de cantaridas...................189 de chloruro mercurico compuesta..........184 de cicuta deopilativo................190 de cobre......................191 de diapalma..................191, 206 de estoraque..................193, 204 de Isis ......................204 de jabon......................204 de la Condesa...................205 de la Madre Tecla.................192 de medula mucilaginoso..............193 de mercurio doble.................204 de Montpellier...................194 de Osorio.....................204 de oxido mercurico.................194 de Piderit.....................194 de regaliz.....................195 de Ricour.....................195 de sulfuro de mercurio...............195 de tabaco.....................196 de todos sebos...................205 de zinc con mirra de Knachstedt..........196 del corazon....................205 del Duque.....................192 depilatorio....................[ 195 digestivo animado..............." " 197 mercurial...................197 Index. 295 PAGE Unguento digestivo opiado...............197 simple.....................196 encarnativo....................205 epispastico.................... . 198 etiopico......................197 fundente opiado..................198 madurativo de Canquoin..............198 marcial......................199 negro de Velpeau.................199 nervino....................199, 206 nutrido......................200 pardo di Larrey..................201 resolutivo mercurial................201 santo.......................206 sulfurico......................201 vermifugo.....................201 Unguentum...................... 29 acidi borici.................... 67 carbolici.................... 30 gallici .................... 31 salicylici................... 68 tannici.................... 32 ad haemorrhoides..................183 ad tineam capitis..................183 ex Henke...................184 aconitinae................... 69 althaeae..................117, 186, 207 ammoniatum....................181 antimonii..................... 54 antipsoricum edimburgensi.............181 aquae rosse.................... 32 Arcsei...................117, 186, 206 aromaticum....................127 arthanitae compositum............... 187 atropinae...................... 70 baccarum lauri...................200 balsamicum peruvianum.............182 basilicum .................109, 118, 181 belladonnae.................... 33 bryoniae Agrippae.................188 calami nae..................... 62 camphorae..................... 63 cantharidis..................... 56 cantharidum..................109, 189 cerussae....................110, 127 camphoratum.................110 cetacei....................... 71 chloruri mercurici compositum...........184 chrysarobini.................... 34 cicuta; deopilativum................190 296 Index. PAGE Unguentum Comitissae.................205 creasoti..................... 58 cucurbitae................... " 188 cum acetate cuprico................204 oxido zincico et subacetate cuprico.......206 plumbico rubro...... .........205 styrace..................." 125 cupratum.....................191 cupri subacetatis.................. 61 depilatorium.................. 195 diachylon...........'.'.'.'.'.'. 35, ill, 128 diapalmum ............. .... 191 206 digestivum animatum...........'.'...' 197 mercuriale..............'.'.'... 197 opiatum................' 197 simplex..........'.'.'.'.'.'.'.'. 121, 196 Ducis...................... 192 e sulphure hydrargyrato...........'.'.'. 197 elemi............t....... ' ^j emolliens.............. ' '. '. ' 128 epispasticum...................'. 198 eucalypti..................[ 72 ex Piderit..................... 194 ex Ricourt........ • • • _ ?avum........'■'.''.'.'..'.'.'.'. 206 fuscum................ g4 exLarrey......'..'■'.'.'.'■'.'.'.'.'.'. 201 gallse • • ;.................... 36 cum opio.............. 72 gallarum cum morphina.............I85 glycerin! . ... ......'.'.'.'.'.'.' 111,129 plumbi subacetatis...... 72 hydrargyri.........• ...'.'.'!.' .* '36, 129 album................. H2 ammoniati.............._" [ 33 chloridi mitis............. '. . . 57 cinereum 112 coeruleum fortius............. 209 compositum............ . . . . 73 iodidi rubri............'.'.'' 59 38 73 nitratis dilutum oxidi fiavi..........'.'.'.'.'. . ' ' 40 rubri 40 resolutivum............. ' 201 rubrum...... ......no ^di..........:::::::::::;■ 11 compositum .... fift iodoformi.......\..........J" juniperi...........••■'.'.'.'.'.'. 130 Index. 297 PAGE Unguentum kali iodati.................113 leniens......................113 liquiritiae.....................195 martiale......................199 medullse inucilagineum...............193 mezerei...................... 43 minii opiatum...................198 mons-pessulani.................194 myrtinum compositum.............. 186 naturans ex Canquoin..............198 nervinum...................109, 206 nicotianae.....................196 nigrum ex Velpeau.................199 nutritum......................200 oxidi hydrargyrici.................194 zincici ex Knachstedt.............196 paraffini......................113 pediculorum................... . 184 picis compositum.................. 65 liquidae.................... 43 plumbi ......................114 acetatis.................... 74 tenius.................. . 185 acetatum...................200 acetici.....................131 carbonatis................... 44 iodidi..................... 46 oxidi fuscum..................192 tannici....................114 pomadinum.................... 131 potassae sulpkuratse................ 74 potassii iodidi................... 47 resinae....................... 75 rosatum......................131 rosmarini compositum...............115 sabadillae.....................132 sabinae....................75, 115 saponis......................204 simplex..................... 132 staphisagriae..................76, 184 stramonii..................... 47 stryacis......................193 sulphuratum....................132 sulphuri hydrargyri rubrum............195 sulphuricuin....................201 sulphuris..................... 48 alkalinum................... 50 compositum.................. 66 iodidi..................... 77 tabaci....................... 61 13* 298 Index. PAGE Unguentum tartari stibiati..............177 jjr terebinthinae.................. 77> !™ veratrinae .................... 50 vermifugum....................*yl oxidi..................... pj oxydati....................£•*> Unna, on lead oleate . . • ...........j ^5J Urticaria .......30, 85, 53, 80, 89, 95, 98, 122, 124, 136 Vegetable parasitic affections............255, 262 Veratrine oleate....................209 Vesicular eczema...................270 Wachholdersalbe...................130 Wachssalbe..................... 110 Warts....................... 68, 249 Weisse quecksilbersalbe................112 Whooping-cough....................148 Wolff, L., experiments of................211 Wolff's method for arsenicum oleate......... 223 Wounds.......................83- 99 contused................... • • 142 unhealthy............30, 56, 67, 104, 158, 159 sloughing................... 86, 93 Yaws........................37,49 Zinc oleate.......................234 experiments with.................238 Zinksalbe.....................116, 133 CATALOGUE OF THE PUBLICATIONS — OF— K. A. DAVIS, ]XIe;d.ie:a.l IF'-ix'blislaesi' and Bo<seslle:!', 1231 FILBERT STREET, PHILADELPHIA. BRANCH OFFICES: NEW YORK CITY—117 West Forty-second Street. CHICAGO, ILL—24 Lakeside Building, 214-220 S. Clark Street. ATLANTA, GA—1 Kimball House, Wall Street. LONDON, ENG—40 Berners Street, Oxford Street, AV. BASHORE—Improved Clinical Chart. For the Sepa- rate Plotting of Temperature, Pulse, and Respiration. But one color of ink necessary. Designed for the Convenient, Accurate, and Permanent Daily Recording of Cases in Hospital and Private Practice. By Harvey B. Bashore, M.D. Fifty Charts, in Tablet Form. Size, 8x12 inches. Price, United States and Canada, post-paid, 50 cents, net; Great Britain, 2s. 6d.; France, 3 fr. 60. BOWEN—Hand-Book of Materia Medica, Pharmacy, and Therapeutics. By Cuthbert Bowen, M.D., B.A., Editor of " Notes on Prac- tice." One 12mo volume of 370 pages. Handsomely bound in Dark- Blue Cloth. Xo. 2 in tlie Physicians' and Students' Heady-Reference Series. 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By Hobart Amort Hare, M.D. (University of Pennsylvania), B.Sc; Clinical Professor of the Diseases of Children and Demon- strator of Therapeutics in the University of Pennsylvania; Physician to St. Agnes' Hospital and to the Children's Dispensary of the Chil- dren's Hospital; Laureate of the Royal Academy of Medicine in Bel- gium, of the Medical Society of London, of the Rhode Island Medical Society, the Massachusetts General Hospital, and the College of Phy- sicians and Surgeons of New York; Member of the Association of American Physicians, of the American Neurological Association, and Fellow of the College of Physicians of Philadelphia and the Medical Society of London, etc., etc. In one neat 12mo volume. No. 7 in the Physicians' and Shidsnts' Heady-JReference Series. Handsomely bound in Dark-Blue Cloth. Just Published. Net Price, in United States and Canada, $1.25; Great Britain, 5s. 3d.; France, 7 fr. 75. JAMES—American Resorts, with Notes upon Their Climate. By Bushrod W. Jambs, A.M., M.D., Member of the American Association for the Advancement of Science, the American Public Health Association, the Pennsylvania Historical Society, the Franklin Institute, and the Academy of Natural Sciences, Philadelphia; the Society of Alaskan Natural History and Ethnology, Sitka, Alaska, F. A. Davis, Philadelphia, Pa. o etc. W itli a translation from the German, l>\- Mr. S. Kauffmaxn, of those chapters of "Die Klimate der Erde," written by Dr. A. Woei- Kof, 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. Net Price, post-paid, in I'nited States and Canada, $2.00 ■ Great Britain, 8s. Gd. ; France, 12 fr. 40. KEATING—Record-Book of Medical Examinations for Life-insurance. Designed by John M. Keating, M.D. This record-book is small, neat, and complete, and embraces all the principal points that are re- quired by the different companies. It is made in two sizes,viz.: No. 1, covering one hundred (100) examinations, and No. 2, covering two hundred (200) examinations. The size of the book is 7x3% inches, and can be conveniently carried in the pocket. Net Price, post-paid: No. 1, for 100 Examinations, in Cloth, I'nited States and Canada, 50 Cents; Great Britain, 2s. 6d. ; France, 3 fr. 60. No. 2, for 200 Examinations, in Full Leather, with Side-Flap, United States and Canada, $1.00; Great Britain, 4s. Gd.; France, G fr. 20. KEATING AND EDWARDS—Diseases of the Heart and Circulation in Infancy and Adolescence: with ax appendtx 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 Collc.ireof Physicians of Philadelphia, etc.; and William A. Edwards, M.D., Instructor 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 l>v Photographs and Wood-Eugraving6. About 225 pages. 8vo. Bound iii Cloth. Price, post-paid, in United States and Canada, $1.50, net; Great Britain, 6s. Gd.; France, 9 fr. 35. KELLER—Perpetual Clinical Index to Materia Med- ica, Chemistry, and Pharmacy Charts. By A. H. Keller, Ph.G., M.D., consisting of (1) the " Perpetual Clinical Index," an oblong volume, 9x6 inches, neatly bound in Extra Cloth ; (2) a Chart of "' Materia Medica," 32x44 inches, mounted on muslin, with rollers; (3) a Chart of " Chemistry and Pharmacy," 32x44 inches, mounted on muslin, with rollers. Net Price for the Complete "Work, I'nited States, $5.0O; Canada (duty paid), $5.50 ; Great Britain, £1 Is.; France, 30 fr. 30. 6 Catalogue of Medical Publications. LIEBIG and ROHE—Practical Electricity in Medicine and Surgery. By G. A. Liebig, Jr., Ph.D., Assistant in Electricity, Johns Hop- kins University; Lecturer on Medical Electricity, College of Phy- sicians and Surgeons, Baltimore ; Member of the American Institute of Electrical Engineers, etc.; and George H. Rohe, M.D., Professor of Obstetrics and Hygiene, College of Physicians and Surgeons, Balti- more; Visiting Physician to Bay View and City Hospitals; Director of the Maryland Maternite; Associate Editor " Annual of the Uni- versal Medical Sciences," etc. Profusely Illustrated by Wood-Engrav- ings and Original Diagrams, and published in one handsome Royal Octavo volume of 383 pages, bound in Extra Cloth. Net Price, post-paid, in United States and Canada, $2.00; Great Britain, 8s. 6d.; France, 12 fr. 40. The constantly increasing demand for this work attests its thor- ough reliability audits popularity with the profession, and points to the fact that it is already the standard work on this very important subject. The part on Physical Electricity, written by Dr. Liebig, one of the recognized authorities on the science in the United States, treats fully such topics of interest as Storage Batteries, Dynamos, the Elec- tric Light, and the Principles and Practice of Electrical Measurement in their Relations to Medical Practice. Professor Robe, who writes on Electro-Therapeutics, discusses at length the recent developments of Electricity in the treatment of stricture, enlarged prostate, uterine fibroids, pelvic cellulitis, and other diseases of the male and. female genito-urinary organs. MANTON—Childbed; its Management; Diseases and their Treatment. By Walter P. Manton, M.D., Visiting Physician to the Detroit Woman's Hospital; Consulting Gynaecologist to the Eastern Michigan Asylum ; President of the Detroit Gynaecological Society ; Fellow of the American Society of Obstetricians and Gynaecologists, and of the British Gynaecological Society; Member of Michigan State Medical Society, etc. In one neat 12mo volume. Xo. 10 in the Physicians' and Students' Heady-Reference Series. In Preparation. MASSEY—Electricity in the Diseases of Women: with Special Reference to the Application of Strong Currents. By G. Betton Masset, M.D., Physician to the Gynaecological Department of Howard Hospital; late Electro-Therapeutist to the Philadelphia Orthopaedic Hospital and Infirmary for Nervous Diseases; Member of the American Neurological Association, of the Philadelphia Neurological Society, of the Franklin Institute, etc. No. 5 in the Phy- sicians' and Students' Ready-Reference Series. Second Edition Re- vised and Enlarged. With New and Original Wood-Engravings. Handsomely bound in Dark-Blue Cloth. 240 pages, 12mo. Price, post-paid, in United States and Canada, $1.50, net • Great Britain, 6s. Gd.; France, 9 fr. 35. F. A. Davis, Philadelphia, Pa. 7 MEARS—Practical Surgery. By J. Ewing Mears, M.D., Lecturer on Practical Surgery and Demonstrator of Surgery in Jefferson Medical College; Professor of Anatomy and Clinical Surgery in the Pennsylvania College of Dental Surgery, etc. With 490 Illustrations. Second Edition, Revised and Enlarged. 794 pages. 12mo. Cloth. Priee, in United States and Canada, Cloth, $3.00. Discount, 20 per cent., making it, net, $2.40 ; Postage, 20 Cents Extra. Great Britain, 13s. France, 18 fr. 75. Medical Bulletin Visiting List, or Physicians' Call Record. Arranged upon an Original and Convenient Monthly and Weekly Plan for the Daily Recording of Professional Visits. This is, beyond question, the best and most convenient time- and labor- saving physicians' pocket record-book ever published. Phy- sicians of many years' standing and with large practices pronounce this the best list they have ever seen. 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, 4x6% inches. In three styles. Net Price, post-paid: No. 1, Regular Size, for 70 patients daily each month for one year, United States and Canada, SI.25 ; Great Britain, 5s. 3d.; France, 7 fr. 75. No. 2, Large Size, for 105 patients daily each month for one year, United States and Canada, SI.50 ; Great Britain, 6s. 6d.; France, 9 fr. 35. No. 3, in -which "The Blanks for Recording Visits in " are in removable sections, United States and Canada, 81.75; Great Britain, 7s. 3d. ; France, 12 fr. 20. MICHENER—Hand-Book of Eclampsia; or, Notes and Cases of Puerperal Convulsions. By E. Michener, M.D.; J. H. Stubbs, M.D.; R. B. Ewing, M.D.; B. Thompson, M.D.; S. Stebbins, M.D. 16mo. Cloth. Net Price, 75 Cents; Great Britain, 3s.; France, 4 fr. 20. NISSEN—A Manual of Instruction for Giving Swedish Movement and Massage Treatment. By Prof. Hartvig Nissen, Director of the Swedish Health Insti- tute, Washington, D.C.; late Instructorin Physical Culture and Gym- nastics at the Johns Hopkins University, Baltimore, Md.; Author of '•Health by Exercise without Apparatus." Illustrated with 29 Original Wood-Engravings. Iu one 12mo volume of 1:28 pages. Neatly bound in Cloth. Price, post-paid, in United States and Canada, SI.00, net; Great Britain, 4s. 6d.; France, 6 fr. 20. 8 Catalogue of Medical Publications. Physicians' All-Requisite Time- and Labor- Saving Account-Book. Being a Ledger and Account-Book for Physicians' Use, Meeting All the Requirements of the Law and Courts. Designed by William A. Seibert, M.D., of Easton, Pa. There is no exaggeration in stating that this Account-Book and Ledger re- duces the labor of keeping your accounts more than one-half, and at the same time secures the greatest degree of accuracy. To all physicians desiring a quick, accurate, and comprehensive method of keeping their accounts, we can safely say that no book as suitable as this one has ever been devised. Net Price, Shipping Expenses Prepaid: No. 1, 300 Pages, for 900 Accounts per Year, Size 10 x 12, Bound in ^-Russia, Raised Back-Bands, Cloth Sides, in United States, S5.00 ; Canada (duty paid), S5.50; Great Britain, 21s.; France, 30 fr. 30. No. 2, 600 Pages, for 1800 Accounts per Year, Size 10 x 12, Bound in %-Russia, Raised Back-Bands, Cloth Sides, in United States, S8.00 ; Canada (duty paid), S8.80 : Great Britain, 1.13s.; France, 49 fr. 40. A circular showing the plan of the book will be sent free to any address on application. Physicians' Interpreter: In Four Languages (English, French, German, and Italian). Specially arranged for diagnosis 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 communicat- ing intelligibly with patients of those nationalities and languages un- familiar to the practitioner. The plan of the book is a "systematic arrangement of questions upon the various branches of Practical Medicine, and each question is so worded that the only answer re- quired 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, German, and Italian, being an excellent teacher in those languages, and who has also had considerable hospital experi- ence. Bound in full Russia Leather, for carrying in the pocket. Size, 5x2^ inches. 206 pages. Price, post-paid, in United States and Canada, S1.00, net; Great Britain, 4s. 6d. ; France, 6 fr. 20. PTJRDY—Diabetes: its Cause, Symptoms, and Treat- ment. By Ciias. W. Purdy, M.D. (Queen's University), Honorary Fellow of the Royal College of Physicians and Surgeons of King- ston ; Member of the College of Physicians and Surgeons of Ontario ; Author of " Bright's Disease and Allied Affections of the Kidneys ;" F. A. Davis, Philadelphia, Pa. 9 Member of the Association of American Physicians ; Member of the American Medical Association; Member of the Chicago Academy of Sciences, etc., etc. With Clinical Illustrations. In one neat 12mo volume. No. 8 in the Physicians' and Students' Ready-Reference Series. Handsomely bound in Dark-Blue Cloth. Ready October, 1890. Net Price, United States and Canada, SI.25 ; Great Britain 5s. 3d.; France, 7 fr. 75 ; post-paid. PRICE AND EAGLETON—Three Charts of the 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, M.D. Endorsed by leading anatomists. " The Nervo- Vascular System of Charts " far excels every other system in their completeness, compactness, and accurac\\ Price, United States and Canada, 50 cents, net, complete ; Great Britain, 2s. Cd.; Fiance, 3 fr. 60. ROHE—Text-book of Hygiene: A Comprehensive Trea- tise on the Principles and Practice of Preventive Medi- cine from an American Stand-point. By George H. RonE, M.D., Professor of Obstetrics and Hygiene in the College of Physicians and Surgeons, Baltimore; Director of the Maryland Matcrnite; Member of the American Public Health Asso- ciation; Foreign Associate of the Society Francaise d'Hygiene, of the Society des Chevaliers-Sauveteurs des Alpes Maritimes, etc. Second Edition, thoroughly Revised and Largely Rewritten, with many Illus- trations and valuable Tables. Roh6's Hygiene is the Standard Text- book in many Medical Colleges in the United States and Canada. It is a sound guide to the most modern and approved practice in Ap- plied Hygiene. In one handsome Octavo volume of about 400 pages, bound in Extra Cloth. Net Price, United States and Canada, $2.50; Great Britain, lis. Gd.; France, 16 fr. 20. SA JOTJS—Hay Fever and its Successful Treatment by Superficial Organic Alteration of the Nasal Mucous Membrane. By Charles E. Sajous, M.D., Lectwrer on Rhinology and Laryn- gology in Jefl'erson Medical College ; Vice-President of the American Laryngological 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. With 13 Engravings on Wood. 12mo. Bound in Cloth. Beveled edges. Price, United States and Canada, Net, Sl.OO; Great Britain, 4s. 6d.; France, 6 fr. 20. 10 Catalogue of Medical Publications. SANNE—Diphtheria, Croup: Tracheotomy and Intu- bation. From the French of A. Sanne. Translated and Enlarged by Henry Z. Gill, M.D., LL.D. 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 the application of and efficiency in treatment, and moderate the extravagant views which have been entertained re- garding 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 680 pages. Net Price, post-paid, United States, Cloth, $4. OO; Leather, $5.00. Canada (duty paid), Cloth, $4.40; Leather, $5.50. Great Britain, Cloth, 17s.; Leather, £1 Is. France, Cloth, 24 fr. 60 ; Leather, 30 fr. 30. SENN—Principles of Surgery. By N. Senn, M.D., Ph.D., Milwaukee, Wis.; Professor Principles of Surgery and Surgical Pathology'in Rush Medical College, Chicago, 111.; Professor of Surgery in the Chicago Polyclinic; Attending Sur- geon to the Milwaukee Hospital; Consulting Surgeon to the Mil- waukee County Hospital and to the Milwaukee County Insane Asylum ; Honorary Fellow College of Physicians in Philadelphia, Pa. ; Perma- nent Member of the German Congress of Surgeons ; Member of La Academie de Medicina de Mexico, of the D. Hayes Agnew Surgical So- ciety in Philadelphia, Pa., of the Ohio State Medical Society, and of the Minnesota State Medical Society; Member of the American Surgical As- sociation, of the American Medical Association, of the British Medical Association, of the Wisconsin State Medical Society, and of the Brainard Medical Society, etc. In one handsome Royal Octavo volume, with over 100 illustrations. In Press. Will be issued in October, 1890. SHOEMAKER—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 Philadelphia; Physician to the Medico-Chirurgical Hos- pital ; Member of the American Medical Association, of the Pennsyl- vania and Minnesota State Medical Societies, the American Academy of Medicine, the British Medical Association ; Fellow of the Medical Society of London, etc. Second Edition, Revised and Enlarged. No. 6 in the Physkians' and Students' Ready-Reference Series. 12mo. Neatly bound in Cloth. Price, in United States and Canada, net, $1.50, post-paid; Great Britain, 6s. 6d.; France, 9 fr. 35. F. A. Davis, Philadelphia, Pa. 11 The accompanying Table of Contents will give a general idea of the work :— Contents.—Part I. History and Origin. Part II. Process of Manufacture. Part III. Physiological Action of the Oleates. Part IV. Therapeutic Effect of the Oleates. Part V. Ointments : Local Medication of Skin Diseases. Antiquity of Ointments. Different Indications for Ointments, Powders, Lotions, etc. Information about Ointments : Scanty, Scattered, and Insufficient. Fats and Oils : Ani- mal and Vegetable. Their Chemical Composition. Comparative Permeability of Oils into the Skin ; of Animal, of Vegetable. Incor- poration of Medicinal Substances into Fats : (1) Mode of Prepara- tion, (2) Vegetable Powders and Extracts, (3) Alkaloids, (4) Mineral Substances, (5) Petroleum Fats : Chemical Composition : Uses and Disadvantages. List of Officinal Ointments. Indications. Substances often Prescribed Extemporaneously in Ointment Form. Indications. A full index renders the book convenient for quick reference. SHOEMAKER AND ATJLDE—Materia Medica, Phar- macology, and Therapeutics. By John V. Shoemaker, A.M., M.D., Professor of Materia Medica, Pharmacology, and Therapeutics in the Medico-Chirurgical College of Philadelphia, and Member American Medical Association, and Johx Aulde, M.D., Demonstrator of Clinical Medicine and of Physical Diagnosis in the Medico-Chirurgical College of Philadelphia, and Member American Medical Association. Royal Octavo. Vol. I Now Ready. Net Price, per volume, in United States and Canada, Cloth, $2.50 ; Sheep, $3.25. Great Britain, Cloth, 10s. 6d.; Sheep, 14s. 6d. France, Cloth, 16 fr. 20 ; Sheep, 20 fr. 20. Several blank sheets of closely-ruled letter-paper are inserted at convenient places in the work, thus rendering it available for the stu- dent and physician to add valuable notes concerning new remedies and other important matters. Part I embraces three subdivisions, as follows :— First. A brief synopsis upon the subject of Pharmacy. Second. A Classification of Medicines is presented under the head of General Pharmacology and Therapeutics, with a view to indicate more espe- cially the methods by which the economy is affected. Third. A sum- mary has been prepared upon Therapeutics, covering methods of Administration, Absorption and Elimination, Incompatibility, Pre- scription-Writing, and Dietary for the Sick. This section of the work embraces nearly one hundred and fifty pages. Part II is devoted to Remedies and Remedial Agents not Properly Classed with Drugs, and includes elaborate articles upon Electro- Therapy, Hydro-Therapy, Masso-Therapy, Heat and Cold, Oxygen, Mineral-Waters, and other subjects, such as Climatology, Hypnotism and Suggestion, Mefallo-Therapy, Transfusion, and Baunscheidtismus, have received a due share of attention. 12 Catalogue of Medical Publications. SHOEMAKER—Heredity, Health, and Personal Beauty. By John V. Shoemaker, A.M., M.D., Professor of Materia Medica, Pharmacology, Therapeutics and Clinical Medicine, and Clinical Professor of Diseases of the Shin in the Medico-Chirurgical College of Philadelphia, etc. In one Royal Octavo volume. In Press. Ready in Autumn, 1890. SMITH—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 Compara- tive Physiology in University of Pennsylvania; Fellow of the College of Physicians and Academy of the Natural Sciences, Philadelphia; of the American Physiological Society ; of the American Society of Naturalists; Associe Etranger de la Societe Franeaise d'Hygiene, etc. In one handsome Royal Octavo volume of over 950 pages. Profusely Illustrated with more than 400 fine Wood-Engravings and many Colored Plates. Net Price, in United States, Cloth, $5.00; Sheep, $6.00. Canada (duty paid), Cloth, $5.50; Sheep, $6.60. Great Britain, Cloth, 21s.; Sheep, 24s. France, Cloth, 30 fr. 30; Sheep, 36 fr. 20. 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 subject 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 overburdened 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. STEWART—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. Forty-two Illustrations ; 202 pages. 12mo. Handsomely bound in Dark-Blue Cloth. No. 1 in the Physicians' and Students' Ready-Reference Series. Price, post-paid, in United States and Canada, net, $1.00 ; Great Britain, 4s. 6d. ; France, 6 fr. 20. F. A. Davis, Philadelphia, Pa. 13 ULTZMANN—The Neuroses of the Genitourinary System in the Male: -with Sterility and Impo- tence. By Du. 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 De- partment Boston Dispensary. Just Issued. No. 4 in t7ie Physicians' and Students' Ready-lbference Series. Illustrated. 12mo. Handsomely bound in Dark-blue Cloth. Net Price, in United States and Canada, $1.00, post-paid ; Great Britain, 4s. 6d.; France, 6 fr. 20. 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, classified as : 1, Sensory Neuroses ; 2, Motor Neuroses ; 3, Secretory Neuroses. Second Part.—Sterility and Impo- tence. The Treatment in all Cases is described Clearly and Minutely. WITHERSTINE—International Pocket Medical For- mulary. Arranged Therapeutically. By C. Sumner Witherstine, 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 formulaa from several hundred well-known authorities. With an Appendix contain- ing a Posological Table, the newer remedies included ; Important In- compatibles; Tables on Dentition and the Pulse ; Table of Drops in a Fluidrachm and Doses of Laudanum graduated for age; Formulae and Doses of Hypodermic Medication, including the newer remedies; Uses of the Hypodermic Syringe; Formulae and Doses for Inhalations, Nasal Douches, Gargles,and Eye-washes ; Formulae for Suppositories; Use of the Thermometer in Disease ; Poisons, Antidotes, and Treat- ment; Directions for Post-Mortem and Medico-Legal Examinations; Treatment 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 Elec- trical Treatment, etc. This work, the best and most complete of its kind, contains about 275 printed pages, besides extra blank leaves. Elegantly printed, with red lines, edges, and borders; with illustra- tions. Bound in Leather, with Side-Flap. It contains more than 1800 Formula?, exclusive of the large amount of other very valuable matter. Price, post-paid, in United States and Canada, $3.00, net. Great Britain, 8s. 6d. France, 12 fr. 40. YOUNG—Synopsis of Human Anatomy : Being a Com- plete Compend of Anatomy, including the Anatomy op the Viscera, and Numerous Tables. By James K. Young, M.D., Instructor in Orthopaedic Surgery and Assistant Demonstrator of Surgery, University of Pennsylvania,- 14 Catalogue of Medical Publications. Attending Orthopaedic Surgeon, Out-Patient Department, University Hospital, etc. No. 3 in tlie Physicians' and Students' Ready-Reference Series. Illustrated with 76 Wood-Engravings; 390 pages. 12mo. Handsomely bound in Dark-Blue Cloth. Price, post-paid, in United States an# Canada, $1.40, net. Great Britain, 6s. 6d. France, 9 fr. 35. THE FOLLOWING BOOKS ARE SOLD ONLY BY SUBSCRIPTION: 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 Illus- trated with Chromo-Lithographs, Engravings, Maps, Charts, and Diagrams. Being intended 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, ete., a befitting continuation of such great works as " Pepper's System of Medicine," " Ashhurst's Interna- tional Encyclopaedia of Surgery," " Buck's Reference Hank-Book of the Medical Sciences." SUBSCRIPTION PRICE Per Year (Including the « SATEL- LITE" for one year) : in United States, Cloth, 5 Vols., Royal Octavo, $15.00, Half-Russia, 5 Vols., Royal Octavo, $20.00. Canada (duty paid), Cloth, $16.50; Half-Russia, $22.00. Great Britain, Cloth, £3 5s; Half-Russia, £4 6s. France, Cloth, 93 fr. 95 ; Half-Russia, 124 fr. 35. The Satellite of the" Annual of the Universal Medical 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 of the Annual and an able staff. Published in connection with the Annual, and for Subscribers Only. F. A. Davis, Philadelphia, Pa. 15 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., Professor 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," "Prac- tical Medical Anatomy," etc., etc. Profusely Illustrated with Original Diagrams and Sketches in Color by the Author, carefully selected Wood-Engravings, and Reproduced Photographs of Typical Cases. One handsome Royal Octavo volume of 780 pages. Price, in United States, Cloth, $5.50; Sheep, $6.50; Half- Russia, $T.OO. Canada (duty paid), Cloth, $6.05 ; Sheep, $7.15; Half-Russia, $7.70. Great Britain, Cloth, 24s.; Sheep, 28s.; Half-Russia, 30s. France, Cloth, 34 fr. 70 ; Sheep, 40 fr. 45 ; Half-Russia, 43 fr. 30. Lectures on the Diseases of the Nose and Throat. Delivered at the Jefferson Medical College, Phila- delphia. By Charles E. Sajous, M.D., Lecturer on Rhinology and Laryngology in Jefferson Medical College; Vice-President of the American Laryngological Association ; Officer of the Academy of France and of Public Instruction of Venezuela; Corresponding Mem- ber 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. Illustrated with 100 Chromo-Lithographs, from Oil-Paintings by the author, and 93 En- gravings on Wood. One handsome Royal Octavo volume. 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