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NEW
REMEDIES:
FORMULA
FOR  THEIR  ADMINISTRATION.
BY
    ROBLEY DUNGLISON, M. D.,

PROFESSOR OF THE INSTITUTES OF MEDICINE, ETC., IN THE JEFFERSON MEDICAL
             COLLEGE OF PHILADELPHIA.
SIXTH EDITION,
Wlt^ £xUmiu 5lHitinii0,
PRODESSE QUAM CONSPICI.

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         PHILADELPHIA:
BLANCHARD  AND  LEA.
           1851. 
av




  185!
        IB n t e r e Xs, according to Act of Congress, in the year 1851,



                  By Robley Dunglison, M. D.,



in the Clerk's Office of the District Court of the Eastern District of Pennsylvania.
WM. S. YOUNG, PRINTER. 
*"
PREFACE  TO  THE  SIXTH  EDITION.
  The last few years have been rich in valuable gifts to Thera-
peutics; and amongst these, ether, chloroform, and other so called
anaesthetics, are worthy of special attention.   They  have been
introduced since the appearance of the last edition of  the "New
Remedies."   Other articles have been proposed for the first time,
and the experience of observers  has added numerous  interesting
facts to our knowledge of the  virtues of remedial agents pre-
viously employed.   To include all these, it has been necessary to
add very greatly to the dimensions of the present edition.
  The therapeutical agents  now  first  admitted into  this work,
some of which have been newly introduced into pharmacology,
and the old agents brought prominently forward with novel ap-
plications, and which may  consequently  be  regarded  as New
Remedies, are the  following:—Adansonia digitata, Benzoate of
Ammonia, Valerianate of Bismuth, Sulphate of Cadmium, Chlo-
roform, Collodion, Cantharidal  Collodfon, Cotyledon Umbilicus,
Sulphuric Ether,  Strong Chloric Ether, Compound Ether, Hura
Braziliensis, Iberis Amara, Iodic Acid, Iodide of Chloride of Mer-
cury, Powdered Iron, Citrate of Magnetic Oxide of Iron, Citrate
of Iron and Magnesia, Sulphate  of Iron and Alumina,  Tannate of
Iron, Valerianate of Iron, Nitrate of  Lead, Lemon Juice, Citrate
of Magnesia, Salts of Manganese,  Oleum Cadinum,  Arsenite of
Quinia, Hydriodate  of Iron and Quinia, Sanicula Marilandica, and
Surabul. 
IV
PREFACE.
  To increase the practical value of the work to the therapeutical
inquirer, the author has added  to the Index of Diseases the parti-
cular pages in which the various remedies prescribed in those dis-
eases are referred to.
                                   ROBLEY  DUNGLISON.
     Philadelphia,      >
18 Girard St., March, 1851. J
  Electro -Magnetism us.  Since the  above was written, the
author has received a work by Dr. Froriep,1 of Berlin, in which
he gives cases of good effects produced by Electro-Magnetism, in
"rheumatic effusions spread over the body"—acute, subacute and
chronic; in hemiplegia  rheumatica, rheumatic neuralgia, rheu-
matic facial palsy, spasmodic contractions of the muscles of the
face, writers' cramp, rheumatic paralysis of the forearm, hip,
muscles of the thigh and leg, &c, &c.   He  rarely employed any
remedial agency along  with it,  being  desirous  of ascertaining,
without  the  possibility of doubt, its real effect.   Currents  were
transmitted through the medium of sponges saturated with salt
and water, and  applied to the skin, or by acupuncturation, when
it was  requisite  to act  energetically on parts deeply seated, by
introducing two needles of platinum in the course of a nerve.
Dr. Froriep's testimony is highly confirmative of the good effects
ascribed to Electro-Magnetism  in  certain diseases, in the body of
this  wrork.2

  1 On the Therapeutic application of Electro-Magnetism in the Treatment of Rheu-
matic and Paralytic Affections.   By Robert Froriep, Doctor in Medicine and Surgery,
Public Professor of General Surgery in the University of Berlin, &c, &c, &c.  Trans-
lated from the German by Richard Moore Lawrance, M. D., Surgeon-Extraordinary to
H. R. H. the Duke of Saxe Coburg and Gotha.  London, 1850.
  * See page 296. 
PREFACE
TO  THE FIRST AND  SECOND EDITIONS.
  The  information concerning the remedies  of more  recent intro-
duction  lies scattered in so many works, that it cannot  be  accessible
to the mass of physicians.  The author has, consequently, believed,
that he would be rendering  a  service  to the profession by concen-
trating the results of experience within reasonable limits, so that they
may be readily available to all.   The majority of the new agents—
it will be  found—have been furnished  by modern chemistry; and
their employment has been attended with this advantage, that—when
properly prepared—they  are not  liable to uncertainty in  their opera-
tion;  whilst the various plants from which strychnia, emetia, quinia,
<fec, are obtained, are liable fo irregularity of action, owing to faulty
desiccation, to  the  season in which they  are culled, &c, &c.—ob-
jections which  cannot apply to the active principles when separated
from them.
  Owing to the difficulty  of  sifting the  results of true from those  of
false observation, the  author has esteemed it proper to give, as far  as
he  was able, the  recorded experience of all who have employed the
remedies  in question.
  It need scarcely be said,  that to make  a correct observer and  a
good therapeutist, a knowledge of every  department of m'edical science
is demanded.  Anatomy, physiology, pathology, and materia medica
are, indeed, but introductory to  the great object which the practitioner
has in  view—the alleviation and removal of suffering.  Were it other-
wise, it would be but necessary to institute  empirical trials, in every
caSe of disease, with various articles in and out of the  received lists
of  the  materia medica, and  from such vague trials to  endeavour to
deduce what is termed "experience."
   The erroneous idea prevails too extensively, that every one is ca-
pable  of  profiting by observation, and that, therefore,  all who have
had the same  amount  of experience,  must  be equally capable   of
treating disease.  Setting aside, however,  the  consideration of the
differences that must necessarily result  from the varied  powers of in-
dividuals, it can scarcely  be maintained, that he whose attention has 
vi
preface.
not been properly directed  to  the study of the preliminary branches
which have been enumerated, and whose mind has not been trained
in tracing the relation between cause and  effect, can ever duly profit
by mere experience in that which has been properly termed  " the
most inductive of all sciences."1
   To treat disease methodically and  effectively, the nature  of the
actions of the living tissues, in both the healthy and morbid conditions,
must be correctly appreciated;  the  effects  which the articles of the
materia medica are capable of exerting under both those conditions,
must be known from  accurate observations, and not until then can the
practitioner  prescribe with any well-founded prospect  of success.
Numerous errors would be perpetrated, were we to  profess, and to
carry out such profession, that we are guided by experience only,
unless that experience had been gained by a due consideration  of  all
the physiological, pathological, and therapeutical bearings of the sub-
ject.  In illustration  of this, the well-known case cited by Dr. Paris
in his  Life  of Sir  Humphry Davy may be adduced.  The enthusi-
astic Beddoes, having hypotheticaliy inferred that the inhalation of
the nitrous oxide might be a specific for palsy, a patient  was selected
for trial, and placed under  the care  of Davy—at the time assistant to
Beddoes. Before administering the gas, Davy thought of ascertaining
the temperature of the body  by the thermometer placed under the
tongue.  The paralytic, deeply impressed by Dr. Beddoes with the
certainty of the success of the remedy-, of which he  knew nothing—
soon after the thermometer was placed in his mouth,  believing this to
be the great curative agent—declared that he felt somewhat better.
Nothing more was, therefore, done; and he was  requested to  return
on the following day.   The same  form was then gone  through with
the same resuks; and, at the end of a fortnight, the sick man was dis-
missed  cured, no agent of any kind having been employed except the
thermometer.
   Now, if the reasoning powers  were not duly exerted, experience
would obviously teach, as the result of this case,  that the thermome-
ter is  an antiparalytic.   The rational  therapeutist is not, however,
satisfied with this  knowledge  of  the fact, for "fact  it is."   He in-
quires into the mode in which the  effect was  induced, and he is  not
long in referring it to the influence exerted by the moral over the phy-
sique;  and he classes the thermometer with Perkinism, animal mag-

   ' Propterea  sola experientia absque doctrina et ratione incerta est et conjecturalis.
Qui enim novit rhabarbarum purgare bilem, nescit tamen quando,  quibus, et cui morbo
prosit, nisi sit medicus doctus et peritus.  Primeros.  De vulgi erroribus in medicina,
 ib. i. cap. xl.  Amstelod. 1639. 
PREFACE..
vii
netism, and their congenerous arts,—amongst articles that act chiefly
through the new impressions which they make on the senses.
  It might seem to those who are unacquainted with medical history,
that in periods approaching our  own, no such  illogical  inferences
could  be deduced, and that it has been the custom with the profession
for ages to bestow all due caution and the most rational inquiry in the
collection  of facts.   Such, however, is far from being the case.   It is,
indeed, humiliating to  reflect on the  credulity or faulty observation
that has existed  among nations, who have successfully cultivated
many of the other branches of  natural science.   It ought scarcely to
be credited, and yet it  is nevertheless true, that the aqua spermalis
ranarum  or "water of frog's  spawn" was to  be found not very
long  ago  in the Pharmacopoeia of Sardinia; and the aqua hirundi-
num  cum castoreo  or  "water of swallows with castor" in those of
Manheim and Wirtemberg.  The latter preparation is directed to be
made  as follows:—Take of young swallows bruised  in a mortar,
forty; rue, two handfuls; castor, one ounce; white wine, three pints.
This  disgusting preparation was  given  in  hysteria  and  epilepsy.
Again;  the bufones exsiccati or  "dried toads" were in the Pharma-
copoeias of Spain and  Wirtemberg,—having been formerly adminis-
tered  in powder, as a diuretic, in dropsy.  In another work,1 the au-
thor has cited  many examples as strange as  those instanced, and  it
would be  easy to enumerate still more.
   In  a  recent  French journal, and in an article by M. Ricord—the
distinguished physician to the Venereal Hospital of Paris—we have
an  example of the pertinacity with which ancient prepossessions and
inculcations adhere to us, and how difficult it is to think and to act
according to the unbiassed suggestions of our own observation and
reflection.   In the treatment of blennorrhagic epididymitis or swelled
testicle from gonorrhoea, M. Ricord recommends compression to be
made by means of the  "sparadrap " or plaster of Vigo with mercury.
The history of the plaster of Vigo is singular.   Although still in the
Pharmacopoeia of Paris, it resembles its prototypes but in name.  In
the Pharmacopoeia of  Wirtemberg, it is directed to be  formed  of
living frogs and living earth-worms, boiled with various inert and
by us rejected herbs in white wine and vinegar,—the decoction being
strained, and added to  olive oil, litharge, oil of bayberries, turpentine,
yellow  wax, olibanum, euphorbium, and  liquid storax, all  melted
together,

  1 General Therapeutics, p. 55.  Philad. 1836.  [See, also, his General Therapeutics
and Mat. Medica, 5th edit. i. 66.  Philad. 1850.] 
viii
PREFACE.
   Yet it is scarcely possible to conceive, that the frog's spawn could
have been supposed to yield a product on distillation differing  from
that of other animal substances when subjected to the same process;
that the swallows—in the preparation cited—added  any thing to the
antispasmodic virtues of the castor, or that the living frogs and earth-
worms exerted any efficacy in the sparadrap de Vigo—a  plaster em-
ployed for compressing tumours, and for which purpose we use one
of simple  adhesive constituents.  They  have all been  properly re-
jected from the lists of our medicinal agents, and are looked upon as
irrational; yet we are compelled to infer from the fact of their having
been received, in some countries, into officinal publications—into the
pharmacopoeias, which emanate from congregations of those  of our
profession, who are esteemed  learned by education and by practice—
that they were originally admitted under the  sanction of  fancied ex-
perience.
   In the darker periods of medical  history,  monstrous and revolting
polypharmacal preparations  were introduced, and nothing but the
blindest devotion  to authority or to  established custom  could  have
occasioned their retention.  It is not long since the  Theriac of An-
dromachus—itself but a modification of the Antidotum Mithridatum—
was  dismissed from the British  pharmacopoeias.  It consisted of
seventy-two articles, and was a farrago—as  Dr. Heberden observed
—that had "no better title to  the name of Mithridates than—as  it so
well resembles—the numerous undisciplined  forces of a barbarous
king, made up  of a dissonant crowd collected from different countries,
mighty in appearance, but in reality an ineffective multitude, that only
hinder each other."  The electuarium opiatum polypharmacum of
the Parisian codex—the descendant of the old theriac, with even an
additional  number of ingredients—contains  acrid  substances, 5; as-
tringent, 5;  bitter, 22;  indigenous aromatics, 10;  umbelliferous aro-
matics, 7; balsams and resinous  substances, 8; fetid ingredients, 6;
narcotics,  1; earthy substances, 1;  gummy  or amylaceous, 4:  sac-
charine, 3.  Total, 72—and  one  of  these the flesh  of the viper;  a
little more than a grain of opium—which may be regarded as a  prin-
cipal effective ingredient—being contained in  a dram of the compound.
Yet, when the question arose in the  London  College of  Physicians,
as to what  should be  the  fate of this " many-headed monster," and
when it was proposed by Dr.  Heberden, that  it should be ejected  from
the pharmacopoeia,—on a division, it was found that there were thir-
teen votes for retaining and fourteen for rejecting it.   Its ostracism
was determined by a majority of one only, in a learned  body twenty-
seven of whose members were present. 
PREFACE.
ix
  Such was the fate of a "heterogeneous farrago," which, as Dr. Paris
has remarked, "can be vindicated upon no principle of combination,"
and yet enjoyed the confidence of physicians for ages—a confidence
unquestionably founded, in their belief, on experience, but  experience
based upon defective observation, and, consequently,  on erroneous
inferences—the results being consecutive rather than consequent, and
bearing no relation whatever to the assigned cause.
  Happily, more correct ideas are beginning to be entertained on the
subject of true experience.  It is now felt—to employ the language
of a distinguished surgeon—Professor Liston—that the greatest num-
ber of well-assorted facts on a particular subject constitutes experience,
whether these facts have been culled in five years or in fifty.  A better
system, too, of observation generally prevails, so  that we have dis-
carded the absurd and revolting agents  that are still retained in the
books  of authority  of some European  countries.   Much, however,
remains to be done.   The catalogue of the  Materia Medica is yet
overstocked, and the pruning knife has  still to be applied, to  lop off
many of the redundancies  which have been proved to be such by the
more accurate attention that is  daily paid to tracing the due  relation
between cause and effect.   "To purchase a  clear and warrantable
body of truth," as Sir Thomas Browne has well observed, "we must
forget and part with much we know."
  Every one will be  compelled to admit, that it  is the duty of the
correct therapeutist to doubt the existence of qualities-in  any article
until they have been adequately proved.   When such is the case, no
reasoning can set aside facts; but unless the evidence be overpowering,
it is equally his duty to remain in doubt, especially should reflection
suggest to him strong grounds  for believing, that the number of obser-
vations has been insufficient, that they have not been properly made,
or are unconsequential.
  To enable the profession to form an accurate estimate of the value
of remedies of more  recent introduction, or of the older remedies
whose use has  been revived  under novel applications, the  present
volume was undertaken by the author.   In Germany,  several works
exist on this subject, and that of Riecke—to which the  author has
repeatedly referred—served as a  basis for many of the articles; his
observations, however, do not come down farther than the  year 1836.
.Some of the statements—especially in relation to the observations of
certain of the German physicians—are given on Riecke's authority, 
X
PREFACE.
 for he has rarely appended references, by which the correctness of his
 assertions could be tested.1
   It has been a great object with the author to furnish exact references
 to works in which farther information may be obtained, and the number
 of these will show, that he has devoted no small amount of time and
 attention to  the subject.  He has likewise added the results of his own
 experience in public and in private.   The motto which he has selected
 —prodesse quam conspici—conveys, in epitome, his feelings.   His
 sole object has been, "to be useful"—and if he has succeeded, the re-
 ward is ample.
                                       ROBLEY DUNGLISON.
  Philadelphia, October 15, 1839.

  ' Recently, a second and enlarged edition of Riecke's work has appeared; but the
 therapeutical additions to it are by no means as numerous as the author had expected to
find them.  He has, consequently, made but few extracts from it in the present edition.
It is entitled "Die neuern Arzneimittel, ihre physischen und chemischen Eigenschaften,
Bereitungsweisen, Wirkungen auf den gesungen und kranken Organismus, und therapeu-
tische Benutzung.   Von Victor Adolf Riecke, Dr.  Med., Mitglied des Vereins fiir
 Heilkunde in Preussen, u. s. w.; zweite, vollig umgearbeitete Auflage.   Stuttgart, 1840."
 [Note to Preface of edition of 1841.] 
        ALPHABETICAL

LIST  OF  REMEDIES.
 Abeille mellifique, 703.
 Acetas chinicus, 605.
   morphicus, 523.
   morphii, 523.
   quinicus, 605.
   strychnicus, 664.
 Acetone, 645.
 Acetum ligneum, 13.
   lignorum empyreumaticum, 13.
   pyrolignosum, 13.
 Acid, acetic, empyreumatic, 13.
   auric, 127.  •
   benzoic, 17.
   chromic, 701.
   cyanhydric, 23.
   gallic, 20.
   hydriodic, liquid, 486.
   hydrocyanic, 23.
              medicinal, 24.
   lactic, 36.
   muriatic, dephlogisticated, 182.
          oxygenated, 182.
   nitric, 701.
   nitro-muriatic, 187.
   of milk, 36.
   oxymuriatic, liquid, 189.
   prussic, 23.
   pyroligneous, 13.
   pyrolignic, 13.
   tannic, 38.
Acide hydrocyanique, 23.
   benzoique, 17.
   chromique, 701.
   gallique, 20.
   iodique, 491.
   lactique, 36.
   nitrique, 701.
   prussique, 23.
   pyro-acetique,  13.
   pyroligneux, 13.
  pyrolignique, 13.
  tannique, 38.
Acidum aceticum empyreumati-
    cum, 13.
  benzoicum, 17. -
  benzoicum per sublimationem, 17.
  borussicum, 23.
  cahincicum,  148.
Acidum caincae, 148.
   chromicum, 701.
   gallicum, 20.
   hydrocyanicum, 23.
   iodicum, 491.
   lacteum, 36.
   lacticum, 36.
   lactis, 36.
   ligni pyro-oleosum, 13.
   marinum dephlogisticatum,  182.
   muriaticum oxygenatum,  182.
   muriaticum oxygenatum ad con-
     tagia,  182.
   nitricum, 701.
   prussicum, 23.
   pyro-aceticum,  13.
   pyrolignosum, 13.
   pyroxylicum, 13.
   quercitannicum, 38.
   tannicum, 38.
   zooticum, 23.
   zootinicum, 23.
Aconite, extract of, alcoholic, 51.
   extract of, ammoniated, 50.
Aconitia, 45.
Aconitine, 45.
Aconitium, 45.
Acqua balsamica arteriale, 82.
Acqua Binelli, 82.     j<
Acqua Brocchieri, 84.
Acqua Monterossi, 83.
Actaea racemosa, 212.
Actee, 212.
Acupuncturation, 51.
Acupuncture, 51.
Adansonia digitata, 702.
Adstringirende Brazilische  Rinde,
    252.
iEsculin, 410.
jEsculus hippocastanum, 410.
iEther chloricus, 196.
  hydrocyanicus, 60.
  lignosus, 615.
  prussicus, 60.
  pyroaceticus, 645.
  sulphuricus, 61.
  sulphuricus phosphoratus, 544.
  vitriolicus. 61. 
XU                  ALPHABETICAL CONTENTS.
 Aetzroggen, 312.
 Afterkorn, 312.
 Agaric blanc,  138.
   white,  138.
 Agaricus  albus,  138.
 Agathosma crenatum, 293.
 Agathotes chirayita, 399.
 Aimant, 496.
 Air-douches  into the Eustachian
     tube, 436.
 Akonitin, 45.
 Akupunktur, 51.
 Alaunerde, reine, 101.
 Alcali vegetabile salito-dephlogisti-
     catum, 581.
 Alcohol, mesitic, 645.
   sulphuris, 668.
 Alcool de soufre, 668.
 Alexiterium chloricum, 182.
 Almond, bitter, water of, 80.
 Alumina, acetate of, 74.
   pure, 101.
   salts of, 74.
   sulphate of, 74.
 Aluminas  sales, 74.
 Alumine factice, 101.
   sels d',  74.
 Aluminii oxidum, 101.
 Aluminum, chloride of, 74.
 Ammonia, arseniate of, 104.
   benzoate of, 19.
   hydriodate of, 490.
   phosphate of, 76.
 Ammonias arsenias, 104.
   ferro-cilras,  342.
   phosphas, 76.
 Ammoniak arseniksaures, 104.
 Ammoniaque,  arseniate d', 104.
  phosphate d', 76.
 Amtnoniated counter-irritants, 245.
 Ammonii  iodidum. 490.
 Ammonium arsenicum, 104.
   arseniksaures, 104.
   hydroiodicum, 490.
   iodatum, 490.
   iodide of, 490.
  phosphorsaures, 76.
Amylum iodatum, 490.
Anthrakokali,  80.
   sulphuretted, 80.
Antidynous counter-irritants, 245.
Apfelgranate, 402.
Apis domestica,  703.
  mellifica, 703.
Aqua amygdalarum, 80.
  arsenicalis Pearsonii, 105.
  balsamica arterialis,  82.
 Aqua Binellii, 82.
   Brocchierii, 84.
   chlorini, 189.
   lauro-cerasi, 30, 81.
   natri oxymuriatici, 643.
   oxygenata-muriatica, 189.
   oxygeno-muriatica, 189.
   oxymuriatica, 189.
   picis liquidae, 89.
 Argent, chlorine d',  94.
   et d'ammoniaque chlorure d?, 95,
   cyanure d', 97.
   iodure d', 98.
   oxide d', 99.
   preparations d', 92.
 Argenti chloridum, 94.
   chlorureturn, 94.
   cyanidum, 97.
   cyanuretum, 97.
   et ammoniaci chloruretum, 95,
   et ammoniae chloridum, 95.
   ioduretum, 98.
   iodidum, 98.
   muriatico-ammoniati liquor, 96.
   oxidum, 99.
   prasparata, 92.
 Argentum chloratum, 94.
   cyanogenatum, 97.
   divisum, 101.
   hydrocyanicum, 97.
   iodatum, 98.
   limatum, 101.
   muriaticum, 94.
   muriaticum ammoniatum,  95.
   oxydatum, 99.
   salitum, 94.
 Argil, pure,  101.
 Argilla pura, 101.
 Armoise commune, 108.
 Arnica, 103.
   montana, 103.
   plauensis, 103.
 Arnique, 103.
 Arsenias ammoniae, 104.
   potassse acidus, 336.
Arseniate  of soda, 105.
Arsenic, hydriodate of, 106.
   iodide of,  106.
  and mercury,doubleiodideof,429.
   iodure de,  106.
  teriodide of, 106.
Arsenici, 106.
   hydriodas,  106.
  et hydrargyri hydriodas, 429.
   et hydrargyri iodidum, 429.
   iodidum, 106.
  ioduretum, 106. 
ALPHABETICAL CONTENTS.
Xlll
Arsenici teriodidum, 106.
Arsenicum iodatum, 106.
Arsenikiodiir, 106.
Arseniksaures ammonium, 104.
Arsenite of potassa, 105.
Artanthe elongata, 506.
Artemisia vulgaris, 108.
  extractum resinosum,  111.
Aspidium filix mas, 381.
Assacou, 715.
Athyrium filix mas, 381.
Atropia, 113.
Atropin, 113.
Atropina,  113.
Atropine,  113.
Atropinum, 113.
Atropium, 113.
Auri chloretum, 120.
  chloretumcumchloretonatri, 122.
  chloridum, 120.
  chloru return, 120.
  cyanidum,  125.
  cyanuretum,  125.
  et sodii chloridum, 122.
  et sodii chloruretum, 122.
  et sodii perchloruretum, 122.
  iodidum, 126.
  ioduretum, 126.
 *murias, 116.
  nitromurias, 127.
  oxidum, 127.
  peroxidum, 127.
  praeparata, 116.
  pulvis,  129.
  terchloridum, 116.
  tercyanidum, 125.
  teroxydum, 127.
Aurico-natricum murias, 122.
Auriferes composes, les, 117.
Auro-terchloride of sodium, 122.
Aurum chloratum, 116.
  chloratum natronatum, 122.
  cyanatum, 125.
  cyanicum, 125.
  cyanogenatum, 125.
  hydrocyanicum,  125.
  iodatum, 126.
  limaturra, 129.
  metallicum, 129.
  muriaticum,  116.
  muriaticum natronatum, 122.
  nitro-muriaticum, 127.
  oxydatum, 127.
  oxydulatum muriaticum, 116.
  salitum, 116.
  sesquichloratum natronatum, 122.
Bachelor's buttons, 538.
Balaustier, 402.
Ballota lanata, 130.
Ballota wollige, 130.
Ballote cotonneuse, 130.
Bandwurmwaldfarrn, 381.
Bang, 166.
Banksia Abyssinica, 139.
Baobab, 702.
Barii iodati hydras, 132.
  iodidum, 132.
Barium iodatum,  132.
  iodide of,  132.
Bark, resinous constituents of, 636.
  astringent, of Brazil, 252.
Barosma crenata, 293.
Baryt hydriodsaurer, 132.
Baryta hydriodica, 132.
  hydriodate of, 132.
Barytae hydriodas, 132.
Barytin, 680.
Barytium iodatum, 132.
Baryumiodiir, 132.
Baumnuss, 493.
Bebeeria,  133,
Bebeerin, 133.
Bebeerina, 133.
Bebeerine, 133.
Bee, 703.
Beifusswurzel, 108.
  extract, 111.
  gemeiner, 108.
Benzoate of  ammonia,  19.
Benzoesaure, 17.
Berberin,  136.
Berberina, 136.
Berberine, 136.
Berberinum, 136,
Berberisgelb, 136.
Bergerthran, 545.
Berliner Blau,  345.
Betoine des  Savoyards, 103.
Biene, 703.
Bignonenbaum, 137.
Bignonia catalpa, 137.
Bile, ox, 708.
Bile, swine,  711.
Bilis porcina, 711.
Bilis taurina, 708.
Binellisches Wasser, 82.
Biogamia, 398.
Biomagnetismus, 398.
Bismuth, valerianate of, 704.
Bismuthi valerianas, 704.
Bismuthum  valerianicum, 704.
Bisulphuretum carbonii, 668.
Bitter almonds, water of, 80.
  oil of, 81. 
XIV
ALPHABETICAL CONTENTS.
Bittererde citronensaures, 501.
Bittermandelwasser, 80.  ■
Blankenheimer Thee, 390.
Blau, Berliner, 345.
  Pariser, 345.
Blaud's Pills, 373.
Blausaure, 23.
Blausaures  eisenoxydul  Zinkoxid,
     695.
  Quecksilber, 413.
Blaustoffeisen, 345.
Blaustoffgold,  125.
Blaustoffkalium,  588.
Blaustoffquecksilber, 413.
Blaustoffsilber, 97.
BlaustofTzink,  694.
Ble cornu, 312..
Bled avorte, 312.
  farouche, 312.
Blei hydriodsaures, 578.
  iodwasserstoffsaures, 578.
Bleichpulver,  153.
Bleiiodid, 578.
Bleioxyd, salpetersaures, 723.
Bleitannat, 580.
Bleu de Prusse, 345.
Blue, Prussian, 345.
  Berlin, 345.
Boccho, 293.
Bocchoe, 293.
Bole, Armenian, 101.
Boletus albus, 138.
  laricis, 138.
  purgans, 138.
Boocho, 293.
Brayera anthelmintica, 139.
Brechnuss, 53S.
Brechstoff, 309.
Brom,  141.
Brome, 141.
Bromeisen, 338.
Brometum ferricum, 338.
  hydrargyrosum, 412.
Bromhydras kalii, 585.
  potassae, 585.
  potassii, 585.
Bromidum potassii, 585.
Bromin, 141.
Bromina, 141.
Bromine, 141.
iJromineum, 141.
Brominium, 141.
Brominum,  141.
Bromium, 141.
Bromkalium, 585.
Bromquecksilber, 412.
  doppelt, 412.
Bromquecksilber in maximum, 412.
Bromum,  141.
Bromure de potassium, 585.
Bromuretum kalii, 585.
  potassii, 585.
Bromwasserstoffsaures eisenoxyd,
    338.
  kali, 585.
Brucia, 145.
Brucin, 145.
Brucina, 145.
Brucine, 145.
Brush, galvanic, 398.
  metallic, 398.
Buccublatter, 293.
Buchu, 293.
Buckeye,  410.
Buckhu, 293.
Bugbane, 212.
Buranhem, 512.
Butyrum zinci, 688.
Cade Oel, 721.
Cadmii sulphas, 705.
Cadmium sulphuricum, 705.
Cadmium schwefelsaures, 705.
Cadmium, sulphate of, 705.
Caeruleum Beroliniense, 345.
  Borussicum,  345.             .
Cahincae radix,  147.
Cainanae radix,  147.
Cainca root, 147.
Caincae acidum, 147.
Caincawurzel, 147.
Calcar,  312.
Calcaria chlorata, 153.
  chloretum, 153.
  chlorica. 153.
Calcariae chlorum, 153.
Calcii bichloruretum,  153.
  oxychloruretum,  153.
  oxydi chlornretum,  153.
  proto-chloruretum, 153.
Calcis bichloruretum, 153.
  chloridum, 153.
  hypochloris,  153.
  oxymurias, 153.
Calcium, oxide de, chlorure d',  153.
  protoxichlorure de,  153.
Calendula Alpina, 103.
  officinalis, 150.
  sativa,  150.
Calenclulin, 150,
Caltha alpina, 103.
  sativa, 150.
Calx chlorinata, 153.
  oxymuriatica, 153.
Candytuft, bitter, 716. 
ALPHABETICAL CONTENTS.
 Caninanae radix, 147.
 Caniraminum, 145.
 Caniramium, 145.
 Cannabine, 166.
 Cannabis indica, 164.
 Caper spurge, 334.
 Carboneum trichloratum, 705.
   chloratum, 196.
 Caro vitulina tosta,  173.
 Carbo animalis, 173.
   carnis, 173.
   mineralis, 339.
 Carbon, sesqui-chloride of, 705.
   sesqui-iodide of,  176.
   sesqui-ioduret of, 176.
   terchloride of, 196, 705.
   trichloratum, 705.
   chloratum, 196.
 Carboneum sulphuratum, 668.
   chloratum, 196.
   frichloratum, 705.
 Carbonis sesqui-chloridum, 705.
   sesqui-iodidum, 176.
   sesqui-ioduretum, 176.
   trichloridum, 705.
 Carbonicum chloratum, 705.
 Carbonium iodaturri, 176.
 Carbure de soufre, 668.
 Carburet of sulphur, 668.
 Carragaheen moss, 210.
 Carageen moss, 210.
 Carrageenin, 210.
 Castanea equina, 410.
   pavina, 410.
 Catalpa, 137.
   arborea, 137.
   arborescens,  137.
   cordifolia,  137.
   tree,  137.
 Catapuce, 334.
 Cataputia minor, 334.
 Catawba tree, 137.
 Catheterism  of the Eustachian
   tube, 436.
 Cephaelinum, 309.
 Cerussa nigra, 339.
 Cetrarin, 177.
 Cetrarina, 177.
 Cetrarine, 177.
Cetrarinum, 177.
Chanvre Indien, 164.
Charbon, animal, 173.
Charcoal, animal, 173.
Chaux, chlorate de,  153.
  chlorure de, 153.
  muriate  suroxigene  ou  oxigene
    de, 153.
 Chaux, oxichlorure de, 153.
   oximuriate de, 153.
   souschlorate de, 153.
 Chestnut, horse, 410.
 Chimaphila, 179.
 Chimophila, 179.
 Chinastoff, 603.
 Chiuicus citras, 607.
   hydrochloricus, 612.
 Chinii acetas, 605.
   citras,  607.
   ferrocyanas, 608.
   hydrochloras, 612.
   murias, 612.
 Chinii nitras, 613.
   phosphas, 613.
   sulphas, 614.
   tannas, 635.
 Chinin, 603.
   arseniksaures, 606.
   citronensaures. 607.
   citronsaures, 607.
   eisenblausaures,  608.
   essigsaures, 605.
   gerbesaures, 635.
   gerbstoffsaures, 635.
   hydrochlorsaures, 612.
   iodwasserstoffsaures, 610.
   milchsaures, 611.
   phosphorsaures, 613.
   salpetersaures, 613.
   salzsaures, 612.
   schwefelsaures, 614.
   sulphat, 614.
   tanninsaures, 635.
   valeriansaures, 633.
   zitronsaures, 607.
 Chinini acetas, 605.
   citras, 607.
   phosphas, 613.
 Chininum, 603.
   aceticum, 605.
   citricum, 607.
   hydriodicum, 610.
   lacticum, 611.
   muriaticum, 612.
   resino-sulphuricum, 636.
   salitum, 612.
   tannicum, 635.
  valerianicum,  633.
Chinioidine, 636.
Chinium, 603.
  aceticum, 605.
  citricum, 607.
  ferro-cyanogenatum, 608.
  ferro-hydrocyanicum, 608.
  hydrochloricum, 612. 
xv i
ALPHABETICAL CONTENTS.
Chinium muriaticum, 612.
  nitricum, 613.
  phosphoricum, 613.
  salitum, 612.
  sulphuricum, 614.
  tannicum, 635.
Chinoidine, 636.
Chinolein, 716.
Chiococcae radix, 147.
Chirayita, 399.
Chiretta, 399.
Chlor, 182.
Chloras.kalicus depuratus, 581.
Chloras potassicus, 581.
Chlorate de potasse, 581.
Chlorblei, 722.
Chlorcalciumoxyd, 153.
Chlore,  182.
  eau de, 189.
  liquide, 189,
Chloretum auri, 120.
  cum chloreto natrii, 122.
  calcariae, 153.
  zinci, 688.
Chlorfliissigkeit, 189.
Chlorgas, 182.
Chlorgold, 120.
  natrium, 122.
Chlorsilber, 94.
Chlorgoldnatronium, 122.
Chlorhydrasmorphicus, 527.
  quinicus, 613.
Chlori aqua,  189.
  liquor, 189.
Chloride of gold and sodium, 122.
  of soda, 643.
  of zinc, 688.
Chlorine, 182.
  solution of, 189.
Chlorineum,  182.
Chlorini aqua, 189.
Chlorinium,  182.
Chlorinum, 182.
Chlorkalk, 153.
Chlorkohlenstoff, dreifach, 705.
Chlornatron,  643.
Chlornatrum, 643.
Chloroform, 196.
Chlorplatin, 577.
Chlorplatinnatrium, 578.
Chlorsaures kali, 581.
  natrum, 643.
Chlorsilber, 94.
Chlorsodaflussigkeit,  643.
Chlorum, 182.
   calcariae,  153.
   Hquidum,  189.
i Chlorure d'argent, 94.
   d'or, 120.
   d'or et sodium, 122.
   d'oxide de sodium, 643.
   de plomb, 722.
   de soude, 643.
 Chloruretum argenti, 94.
   argenti et ammoniae, 95.
   auri, 120.
   auri et sodii, 122.
   oxidi calcii, 153.
   oxidi sodii, 643.
   potassas oxidatum, 581.
   zincicum, 688.
 Chlorwasser, 189.
 Chlor, wasseriges, 189.
 Chlorzink, 688.
 Chondrus, 210.
   crispus, 210.
   polymorphus, 210.
 Christophskraut, traubenformiges,
     212.
 Chromium, peroxide of, 701.
 Chromsaure, 701.
 Chrysanthemum, 150.
 Churrus, 166.
 Cicntinum, 706.
 Cimicifuga, 212.
 Cinchonia, 215.
   iodide of, 610.
 Cinchonin, 215.
 Cinchonine, 215.
 Cinchoninum, 215.
 Citras chinicus, 607.
   ferricus, 341.
   quinicus, 607.
 Citronensaft, 728.
 Clavus secalinus,  312.
   siliginis, 312.
 Clou de  seigle, 312.
 Codeia,  218.
 Codeine, 218.
 Codeinum, 218.
 Cod-liver oil, 545.
 Cohort, 212.
 Cohosh, 212.
 Colchicia, 224.
 Colchicum, 223.
   autumnale, 223.
 Colchique, 223.
 Collodion, 232.
   cantharidal, 236.
 Collodium, 232.
   tinctum, 235.
 Compressio,  237.
 Compression, 237.
   methodical, 237. 
ALPHABETICAL CONTENTS.
xvii
Coneine, 706.
Conia, 706.
Conicinum, 706.
Contra-irritation, 245.
Contre-irritation, 245.
Corrigeen moss, 210.
Cortex adstringens Brasiliensis, 252.
Corylus rostrata, 254.
Cotyledon umbilicus, 707.
Counter action, 245.
Counter-irritant lotions, Granville's,
     245.
  ammoniated, 245.
  antidynous, 245.
  Gondret's, 245.
  Granville's, 245.
  Raspail's, 245.
Counter-irritation, 245.
Cousso, 139.
Crayon noir, 339.
Creasote,  255.
Crocus martis aperiens, 376.
Croton oil, 561.
Crusadinha raiz, 147.
Cubeba, 281.
Cubeben.  281.
Cubebenpfeffer, 281.
Cubebin,  282.
Cubebs, 281.
Cusso, 139.
Cyanather, 60.
Cyaneisen, 345.
Cyaneisenzink, 695.
Cyanetum hydrargyri, 403.
  kalii, 588.
  zinci, 694.
  zinci et ferri, 695.
Cyangold, 125.
Cyanhydras potassae, 588.
  kalicus, 588.
  zincicus, 694.
Cyanidum kalii, 588.
  mercurii, 413.
  potassii, 588.
Cyankalium, 588.
Cyanquecksilber, 413.
Cyansilber, 97.
Cyanure d'argent, 97.
  d'or, 125.
  de mercure, 413.
  de potassium, 588.
  de zinc,  694.
Cyanuret of ethule, 60.
Cyanuretum argenti, 97.
  auri, 125.
  auricum,  125.
  ferrozincicum,  695.
Cyanuretum hydrargyri, 413.
  potassicum, 588.
  zincicum, 694.
  zinci et ferri, 695.
Cyanwasserstoffather, 60.
Cyanwasserstoffsaure, 23.
Cyanzink, 694.
Delphia, 287.
Delphin, 287.
Delphina, 287.
Delphinia, 287.
Delphinine, 287.
Delphium, 287.
Derosne'sches opiumsalz, 535.
Digitalia, 289.
Digitalin, 289.
Digitalina, 289.
Digitaline, 289.
Digitalinum, 289.
Diosma,  293.
Diosmin, 294.
Dogwood, Jamaica, 722.
Donovan's solution, 429.
Doronic d'Allemagne, 103.
Doronicum Germanicum, 103.
  plantaginis  folio, 103.
Drops, fever. Warburg's, 135.
Druck, 237.'
Duftstrauchblatter, 293.
Eau d'amandes ameres, 80.
  de Binelli, 82.
  de Brocchieri, 84.
  de chlore, 189.
  de goudron, 89.
  de Javelle,  643.
  medicinale d'Husson, 223.
  styptique de Brocchieri, 84.
Eisen, blausaures, 345.
Eisenbromid,  338.
Eisenchinin, citronensaures, 345.
Eisencyaniircyanid, 345.
Eiseniodiir, 349.
Eisen, kohlensaures,  371, 376.
Eisenoxyd, braunes, 376.
  baldriansaures, 380.
  citronensaures, 341.
  eisenblausaures, 345.
  gerbesaures, 379.
  iodwasserstoffsaures,  349.
  kohlensaures,  376.
  milchsaures, 359.
.  mit ammoniak, 342.
  salpetersaures, 361.
Eisenoxydhydrat, 364.
Eisenoxydul arsensaures, 336.
  arseniksaures, 336.
  blausaures,  345. 
xviii
ALPHABETICAL CONTENTS.
Eisenoxydul citronsaures, 341.
  hydriodsaures, 349.
  iodwasserstoffsaures, 610.
  kohlensaures, 364, 376.
  milchsaures, 359.
Eisenpraparate, 335.
Eisenzink, blausaures, 695.
Eisenzinkcyaniir, 695.
Electricitas.   See Galvanismus.
  animalis,  392.
  galvanica seu metallica, 393.
Electricity, galvanic, 392.
  magnetic, 296.
Electro-magnetismus, iv, 296.
Electropunctura, 303.
Electropuncturation, 303.
Elixir of opium, M'Munn's, 530.
Emeta, 309.
Emetia, 309-.
Emetina, 309.
Emetium, 309.
Emetine of the violet, 309.
  indigenous,  309.
Epurge, 334.
Ergot, 312.
Ergota, 312.
Ergotin,  331.
Esprit pyroacetique, 645.
Essigalkohol, 645.
Essiggeist, 645.
Essigsaures morphium, 523.
Ether, acetic,  injections of, into the
    Eustachian lube, 440.
  chloric, 196.
  chloric, strong,  207.
  compound, 209.
  hydrocyanic, 60.
  prussic, 60.
  pyroacetic, 645.
  sulphuric, 61.
  sulphurique, 61.
Etherine, hydrocyanate of, 60.
Ethyle, cyanuret  of, 60.
Eupatorium huaco,  407.
Euphorbia lathyris, 334.
Euphorbie, purgirkorner, 334.
Exoneurism, 398.
Extract,  alcoholic,  of nux vomica,
    538.
Extractum filis maris, 140.
  nucis vomicae alcoholicum, 538.
  opii aceticum, 526.
  resinosum radicis artemisiae, 111.
Exlrait  alcoholique de  noix vo-
    mique,  538.
  de guarana,  569.
  savonneux de Purine, 675.
Extrakt geistiges der Krahenaugen,
    538.
Fallkraut, 103.
Farrenkraut, 381.
  mannlein, 381.
  mannliches, 381.
Fel bovinum, 708.
  bovis, 708.  .
  tauri, 708.
Fer, arseniate de, 336.
  bromure de, 338.
  carbure de, 339.
  citrate de, 341.
  cyanure de, 345.
  deutoxicyanure de,  hydrate, 345.
  hydrate, deutocyanure de, 345.
  hydriodate de, 349.
  iodure de, 349.
  lactate de, 359.
  nitrate de, 361.
  preparations de,  335.
  protocarbonate de, 371.
  protoiodure de, 349.
  reduit par hydrogene, 335.
  souscarbonale de, 376.
  tannate de, 379.
  tritohydrocyanate ferrure de, 345.
  tritohydroferro-cyanate de, 345.
  valerianate de, 380.
Fern, male,  381.
  shield, male, 381.
Ferri et aluminae sulphas, 711.
  ammonio-citras,  342.
  et ammonia? citras,  342.
  arsenias, 336.
  borussias, 345.
  bromidum, 338.
  carbonas,  371, 376.
  carbonas praecipitatus,  376.
  carbonas saccharatum, 372.
  carburetum, 339.
  carburetum nativum, 339.
  citras, 341.
  cyanuretum, 345.
  deuto-carbonas fuscus, 376.
  ferrocyanuretum, 345.
  ferro-sesquicyanidum,  345.
  hydriodas, 349.
  hydrobromas,  338.
  iodidum, 349.
  ioduretum, 349.
  lactas, 359.
  et magnesiae citras,  344.
  nitras, 361.
  nitratis liquor, 361.
  nitrici oxydati liquor, 361,
  oxydi ferrocyanas, 345. 
ALPHABETICAL CONTENTS.
XIX
 Ferri oxydulatum  hydrocyanicum,
     345.
   oxydum fuscum, 376.
   oxydum hydratum, 364.
   oxydum rubrum, 376.
   percyanidum, 345.
   pernitras, 361.
   persesquinitratis liquor, 361.
   praeparata, 335.
   protocarbonas, 371.
   prussias, 345.
   pulvis, 335.
   et quiniae citras, 345.
   sesquicyanidum, 345.
   sesquioxidum hydratum, 364.
   sesquioxydum, 364, 376.
   subcarbonas, 376.
   tannas, 379.
   valerianas,  380.
 Ferrugo, 364.
 Ferrum ammoniaco-citricum, 342.
   arseniatum, 336.
   arsenicum oxydulatum, 336.
   borussicum, 345.
   bromatum, 338.
   carbonatum, 364, 376.
   carbonatum praecipitatum, 376.
   carbonicum oxydulatum, 376
   carbonicum saccharatum, 372.
   carburetum, 339.
   citricum, 341.
   citricum cum  ammoniaco, 342.
   cyanogenatum, 345.
   cyanuretum, 345.
   hydriodatum,  349.
   hydrobromicum oxydatum, 338.
   hydrocyanicum, 345.
   hydroiodicum oxydulatum, 349.
   iodatum, 349.
   lacticum, 359.
   nitratum, 361.
   nitricum oxydatum, 361.
   oxydatum hydratum, 364.
   oxydulatum hydrocyanicum, 345.
   oxydum hydricum, 364.
   perbromatum, 338.
   supercarburetum, 339.
   tannicum, 379.
   valeiianicum, 380.
   zooticurn, 345.
Fiel de Boeuf, 708.
Filix mas, 381.
Firing, 251.
Flechtenbitter  der  Islandischen
  Flechte, 177.
Fleischkohle, 173.
Flores Benzoes,  17.
 Flores Benzoini, 17.
 Flowers of Benjamin, 17.
 Formylsuperchlorid, 169.
 Formylsuperiodid, 176.
 Fougere male, 381.
 Fucus amylaceus, 383.
   crispus, 210.
   Irlandicus, 210.
   lichenoides, 383.
 Fuligo, 385.
   fornacum, 385.
   ligui, 385.
   splendens, 385.
 Fuligokali, 389.
 Fumigatio  muriatico-oxygenata,
   182.
 Fumigation de chlor, 182.
   de Guyton,  182.
   Guytonienne,  182.
   hygienique, 182.
 Fumigations, Guyton-Morveau, 182.
 Fungus of the larch, 138.
   laricis, 138.
 Galeopsis angustifolia,  390.
   dubia, 390.
   grandiflora, 390.
   ochroleuca,  390.
   prostrata, 390.
   segetum, 390.
   versicolor, 391.
   villosa, 391.
 Gall, ox, 708.
   swine, 708.
 Gallussaure, 20.
 Galvanic brush, 398.
   plates, 393.
   suppository, 399.
 Galvanisation localisee, 397.
 Galvanism, 392.
 Galvanopuncture, 303.
 Gebarpuiver, 312.
 Gegenreizung, 245.
 Gentiana chirayita, 399.
 Gerbsaure, 38.
 Gerbestoff, 38.
Gerbestoffblei, 580.
Gichtthran, 545.
Gigartina lichenoides, 383.
 Glanzruss, 385.
 Glycerin, 400.
Glycerina, 400.
 Glyceryle, hydrate of oxide of, 400.
 Glyceryloxyd, 400.
 Glyzerin, 400.
 Goharem, 512.
Gold and soda, hydrochlorate of, 122.
          muriate of, 122.
* 
XX
ALPHABETICAL CONTENTS.
Gold and sodium, chloride of, 122.
  chlorid, 120.
  chlorid, Baures, 120.
  chloride of, 120.
  cyanid, 125.
  cyanide of, 125.
  cyanuret of, 125.
  iodid, 126.
 ' iodide of,  126.
  iodiir, 126.
  ioduret of, 126.
  krystalle,  120.
  metallic, 129.
  metallisches, 129.
  muriate of, 120.
  natrium-chlorid, 122.
  natrum-chlorid, 122.
  natrum, salzaures, 122.
  nitro-muriate of, 127.
  oxide of, 127.
  oxyd, 127.
  oxyd, blausaures, 125.
  oxyd, hydrochlorsaureB, 120.
  oxydirtes, 127.
  oxydiil, salzaures,  120.
  oxynatrium, salzsaures, 122.
  peroxide of, 127.
  praparate, 116.
  preparations of, 116.
  pulver, 129.
  salpetersalzsaures, 127.
  salz, Figuier's, 122.
  salzsaures, 120.
  saure, 127.
  sodahaltiges, salzaures, 122.
  terchloride of, 120.
  tercyanide of, 125.
Gondret's counter-irritants, 245.
Gracilaria lichenoides, 383.
Granatapfelbaum, 402.
Granatbaum, 402.
Granatillol, 561.
Granatin, 403, 503.
Granatum, 402.
Granville's counter-irritants, 245.
Graphites, 339.
Green, winter, 179.
Grenadier, 402.
Grenadin, 403, 503.
Guaco, 407.
Guarana, 569.
Guarana-samenteig, 569.
Guncotton, ethereal solution of, 232.
Gunjah, 166.
Habbi, 139.
Hachisch, 166.
Haemospasia, 712.
Haemostasia, 713.
Hagenia Abyssinica, 139.
Hahnensporn, 312.
Haloidum oxygenatum, 581.
Hanf, 164.
Hanfnessel grossblumigte, 390.
Harnstoff, 675.
Harnstoff, salpetersaures, 677.
Haschisch, 164.
Haschischine, 166.
Hazel, beaked, 254.
Hemospasie, 712.
Hemostasie, 713.
Hemp, Indian,  164.
Henricea pharmacearcba, 399.
Herba sideritidis,  390.
Herbe a pisser, 179.
Herbe Saint Christophe, 212.
Herbstblume, 223.
Herbstzeitlose, 223.
Hippocastanum, 410.
Hohlzahns, grossbliithige, 390.
Holzessig, 13.
Holzessigsaure, 13.
Holzsaure, 12.
  brenzliche oder  brandige, 13.
Honeybee, 703.
Honigbiene, 703.
Hopfenmehl, 718.
Hopfenstaub, 718.
Homblei, 722.
Hornseed, 312.
Hornsilber, 94.
Horse chestnut, 410.
Huaco, 407.
Huile de foi de poisson, 545.
  de cade, 721.
  de genevrier, 721.
  de morue, 545.
  de pignon d'Inde, 561.
  volatile de moiitarde, 559.
Hundsnessel, gelbe oder grossblii-
  thige, 390.
Hura Braziliensis,  715.
Hydrargyri bibromidum, 412.
  bicyanidum,  413.
  biiodatum, 421.
  biniodidum, 421.
  borussias, 413.
  bromidum, 412.
  cyanetum, 413.
  cyanidum, 413.
  cyanuretum,  413.
  deuto-bromidum, 412.
  deuto-ioduretum, 421.
  deutonitras, 427.
  dipernitras, 427. 
ALPHABETICA
Hydrargyri et arsenici iodidum, 429.
  et quiniae proto-chloridum, 715.
  hydrocyanas, 413.
  iodidulatum, 418.
  iodidum, 418.
           rubrum, 421.
  nitras, 426.
  nitratum, 426.
  perbromidum, 412.
  periodidum, 420.
  pemitratis liquor, 428.
  praeparata, 412.
  protobromidum, 412.
  proto-iodidum, 418.
  proto-ioduretum, 418.
  protonitras, 426.
  prussias, 412.
  subiodidum, 418.
  supernitras, 427.
Hydrargyrum biiodatum  cum kalio
    iodato, 592.
  biniodidum, 421.
  borussicum, 413.
  bromatum, 412.
  cyanetum, 413.
  cyanogenatum, 413.
  hydrocyanicum, 413.
  iodatum, 418.
          cum chlorido  mercurii,
            491.
          flavum, 418.
          rubrum, 421.
  iodidum, 418.
  iodidulatum, 418.
  nitricum oxydatum, 427.
  nitricum oxydulatum, 426.
  perbromatum, 412.
  periodatum, 421.
  subiodatum, 418.
  zooticum, 413.
Hydras ferricus, 364.
Hydriodas ammonias, 490.
  kalicus, 595.
  lixiviae, 595.
Hydriodate of ammonia, 490.
'  of potassa, 595.
Hydriodic acid, liquid, 486.
Hydrobromsaures kali, 585.
Hydrochloras morphicus,  527.
  chinicus,  612.
Hydrocyanas kalicus, 588.
  zincicus, 694.
Hydrocyanather, 60.
Hydrocyanate of etherine, 60.
Hydrocyanic ether, 60.
Hydrocyansaure, 23.
L CONTENTS.                 XXI

Hydroiodas kalicus, 595.
  lixiviae, 595.
Hydroiodsaures Eisenoxydul, 349.
Hypochloris sodicus aqua solutus,
    643.
Iberis amara, 716.
Indicum, 432.
Indicus color, 432.
Indig, 432.
Indigo,  432.
Indigum, 432.
Infusum picis liquidae, 89.
  picis empyreumaticae liquidae, 89.
Injections of air, &c. into the Eusta-
    chian tube, 436.
Iod, 443.
Iodammonium, 490.
Iodarsen,  106.
Iodarsenik, 106.
Iodatherid, 176.
Iodbaryum, 132.
Iodblei, 578.
Iodchlorquecksilber, 492.
lode, 443.
Iodeisen, 349.
Iodetum hydrargyricum, 421.
  hydrargyrosum, 418.
  zinci, 698.
Iodgold, 126.
lodhydras kalicus seu potassae, 595.
lodhydrargyrate  of ioduret of potas-
    sium, 592.
Iodhydrargyrite  de chlorure mer-
    cureux, 491.
Iodic acid, 491.
Iodide of ammonium, 490.
  of arsenic, 106.
  of carbon, 176.
  of chloride of mercury, 491.
  of iron,  349.
  of potassium, 595.
  of quinia, 610.
  of silver, 98.
  of starch, 490.
  of sulphur, 673.
  of zinc, 698.
Iodidum ammonii, 490.
  amyli, 490.
  argenti, 98.
  arsenici, 106.
  baryi, 132.
  carbonis, 176.
  hydrargyri chlorid), 491.
  hydrargyricum, 421.
  hydrargyrosum, 418.
  plumbi, 575.
  potassii, 595. 
xxii
ALPHABETICAL CONTENTS.
Iodidum quiniae, 610.
Iodine, 443.
lodinum, 443.
Iodinschwefel, 673.
Iodium, 443.
Iodkalium, 595.
Iodkohlenstoff, 176.
lodkohlenwasserstoff,  176.
Iodoforma, 176.
lodohydrargyrate of potassium, 592.
  of ioduret of potassium, 592.
Iodquecksilber doppelt, 421.
  gelbes, 418.
  in maximum, 421.
  in minimum des Iods, 418.
  rothes, 421.
Iodsaure, 491.
lodschwefel,  673.
Iodsilber, 98.
Iodstarke, 490.
Iodstarkmehl, 490.
Iodum, 433.
Iodure d'amidon, 490.
  de carbon,  176.
  de fer, 349.
  plombique, 578.
  de potassium,  595.
  de quinine, 610.
  de soufre, 673.
  double  de mercure et de mor-
    phine, 432.
Ioduret of quinia, 610.
  of silver, 98.
  of sulphur, 673.
Ioduretum ammonii, 490.
  amyli, 490.
  argenti, 98.
  arsenici, 106.
  barytii,  132.
  carbon ii, 176.
  hydrargyrosum, 418.
  potassicum, 595.
  quiniae,  610.
Iodwasserstoffsaure  Schwererde,
    132.
Iodwasserstoffsaures  Eisenoxydul,
    349.
Iron, ammonio-citrate  of, 342.
  and alumina, sulphate of, 711.
  and magnesia, citrate of, 344.
  and quinia, citrate of, 345.
  arseniate of, 336.
  bromated or bromide of, 338.
  carbonate of, 371.
  carburet of, 339.
  citrate of, 341.
  citrate of magnetic oxide of, 342.,
Iron, cyanuret of, 345.
  hydriodate of, 349.
  hydrobromate of, 338.
  hydro-oxide of, 364.
  iodated, 349.
  iodide of, 349.
  ioduret of, 349.
  lactate of, 359.
  nitrate of, solution of, 361.
  oxide of, hydrated, 364.
  oxyhydrate of, 364.
  peroxide of, 376.
  peroxide of, hydrated, 364.
  pernitrate of, 361.
  persesquinitrate  of, solution  of,
    361.
  potassio-citrate of, 342.
  preparations of, 335.
  proto-carbonate of, 371.
  proto-iodide of, 349.
  proto-ioduret of, 349.
  protoxide of, hydriodate of, 349.
  protoxide of, lactate of, 359.
  prussiate of, 345.
  sesquioxide of, 376.
  sesquioxide of, hydrated, 364.
  sodio-citrate of, 342.
  subcarbonate of, 376.
  tritoxide of, hydrated, 364.
  valerianate of, 380.
Irritamentum metallorum seu me-
    tallicum, 392.
Johanniswurzel, 381.
Juglans regia, 493.
Kabliauthran, 545.
Kahincee radix, 147.
Kali blausaures, 588.
  borussicum, 588.
  bromwasserstoffsaures, 585.
  chloricum, 581.
  chlorinicum, 581.
  chlorsaures, 581.
  cyanwasserstoffsaures, 588.
  elainicum, 641.
  hydriodicum, 595.
  hydriodsaures, 595.             •*
  hydrobromicum, 585.
  hydrobromsaures, 585.
  hydrocyanicum, 588.
  hydroiodat, 595.
  hydroiodinicum, 595.
  hyperoxygenirt salzsaures, 581.
  iodwasserstoffsaures, 595.
  iodatum hydrargyratum,  592.
  muriaticum  hyperoxygenatum,
    581.
  olsaures, 641. 
ALPHABETICA
Kali oxychlorieum, 581.
   oxydirt, salzsaures, 581.
   oxymuriaticum, 581.
   salpetersaures, 724.
Kalii cyanuretum, 588.
   cyanetum, 588.
   cyanidum, 588.
   iodidum, 595.
Kaliseife, 641.
Kalium bromatum, 585.
   bromid, 585.
   bromur, 585.
   cyanid, 588.
   cyanogenatum, 588.
   cyaniir, 588.
   hydriodatum  hydrargyratum,
     592.
   iodatum, 595.
   iodiir, 595.
Kalk, chlorigsaure, 153.
   oxydirt salzsaures, 153.
Kalkchlorid, 153.
Kaminruss, 385.
Kaniramin, 145.
Katalpa, 137.
Katzermaul, 390.
Kinine, 603.
Kinini citras, 607.
Kininum,  603.
Kinium, 603.
Klapperschlangenwurzel, 212.
Klaprothii  sulphas,  705.
Knorpeltang, krauses. 210.
Kodein, 218.
Kohle mineralische, 339.
  thierische, 173.
Kohlenschwefel,  flussiger,
     668.
Kohlenstoffeisen, 339.
Kohlenstofftrichlorid, 705.
Kohlensulfurid, 668.
Konigswallnuss, 493.
Kosso, 139.
Kousso, 139.
Krahenaugen, 538.
Krahenaugen bitter, 649.
  geistiges, extrakt der, 538.
Krahenaugenstoff, 649.
Krauser Tang, 210.
Kreasot, 255.
Krea60te,  255.
Kreasoton, 255.
Kreasotum, 255.
Kreosote,  255.
Krotonol, 561.
Kubebenpfeffer, 281.
Kubebin, 282.
lL CONTENTS.                Xxiil

Labarraque's  disinfecting  liquid,
     163, 643.
Lactas ferrosus, 359.
Lactucarium, 496.
Lathyris, 334.
Lattichopium, 496.
Lattigbitter, 496.
Lattigmilchsaft, 496.
Lead, black, 339.
   chloride of, 722.
   iodide of, 578.
   ioduret of, 578.
   nitrate of, 723.
   tannate of, 580.
Leberthran, 545.
Lemonade, magnesian, 501.
Lemonjuice, 728.
Leonurus lanata, 130.
Leopard's bane, 103.
Lerschenschwamm, 138.
Letheon, 61.
Lettuce opium, 496.
Leucolein, 716.
Leukoleinum, 716.
Liebersche  Brust  oder Auszeh-
     rungskrauter,  390.
Lichen carrageen  210.
Lime, chloride of, 153.
   chlorinated, 153.
   chlorite of, 153.
   chloruret of,  153.
   hypochlorite of,  153.
   oxymuriate of, 153.
Limon, sue de, 728.
Liqueur desinfectante de Labarra-
     que, 163, 643.
Liquid, disinfecting, Labarraque's,
     163, 643.
   adhesive, Maynard's, 232.
Liquor  acidi  muriatici  oxygenati,
     189.
   alexiterius oxygenatus, 189.
   argenti muriatico ammoniata, 96.
   chlori, 189.
   disinfecting, of Labarraque, 163.
   ferri iodidi, 352.
   ferri nitratis, 361.
   ferri nitrici oxydati, 361.
   ferri persesquinitratis, 361.
   hydrargyri et arsenici  iodidi,430.
   hydrargyri pernitratis, 428.
   hydrargyri supernitratis, 428.
   hydriodatis arsenici et hydrargy-
     ri, 430.
   morphiae citratis, 529.
   natri chloreti, 643.
   opii, 526. 
IAL CONTENTS.
XXIV               ALPHABETIC

Liquor opii sedativus, 526.
  sodae chloridi, 643.
       chlorinatae, 643.
Lithanthrakokali, 80.
Lithia, carbonate of, 717.
Lithiae carbonas, 717.
Lithine, carbonate de, 717.
Lithion kohlensaures,  717.
Lithium, kohlensaures, 717.
Lithon kohlensaures, 717.
Lupulin, 718.
Macrotrys racemosa, 212.
Magnes, 498.
Magnesia and iron, citrate of, 344.
Magnesia, citrate of, 501.
  citronensaures, 501.
Magnesiae citras, 501.
Magnesian lemonade, 501.
Magnesie, citrate de, 501.
Magnet, 498.
Magnetes, 498.
Magnetic electricity, 296.
Magnetism, animal, 398.
Magnetstein, 496.
Malambo, 505.
Malogranatum, 402.
Manganese, salts of, 720.
  sulphate of, 718.
Manganesii  sulphas, 718.
Manganoxydul,  schwefelsaures,
    718.
Manganum  sulphurieum  oxydula-
    tum, 718.
Mannastoff, 503.
Mannazucker, 503.
Mannite, 503.
Mannitum, 503.
Mannleinwurmtiipfelfarrn,. 381.
Marigold, garden, 150.
  single, 150.
Marronier,  410.
  d'Inde, 410.
Matias, 505.
Matico, 506.
Matiere de Derosne, 535.
  vomitive,  309.
Matter of Derosne, 535.
Meadow  saffron, 223.
Melambo, 505.
Melini sulphas, 705.
Mercure, cyanure de,  413.
  deuto-iodure de, 421.
  deuto-nitrate de, 427.
  dipernitrate de, 427.
  hydrocyanate de, 413.
  nitrate acide de, 428.
  nitrate de, 426.
Mercure, periodure de, 421.
  preparations de, 412.
  protoiodure de, 418.
  protonitrate de, 426.
  prussiate de, 413.
Mercurii deuto-ioduretum, 421.
  protobromuretum, 412.
  protoioduretum, 418.
Mercurius   hydrocyanicus,
    413.
  nitrosus calide paratus, 427.
  nitrosus frigore paratus, 426.
Mercury and arsenic, hydriodate of,
    429.
                   iodide of, 429.
  and morphia, iodide  of, double,
    432.
  bicyanide of, 413.
  biniodide of, 421.
  bromide of, 412.
  cyanide of, 413.
  deutoiodide of, 421.
  deutonitrate of, 428.
  dipernitrate of, 428.
  hydrocyanate of, 413.
  iodide of, 418.
  iodide of, red, 421.
  iodide of chloride of, 491.
  iodoarsenite of, 429.
  nitrate of, acid, 428.
  nitrate of suboxide of, 426V
  periodide of, 421.
  preparations of, 412.
  protoiodide of, 418.
  proto-ioduret of, 418.
  protonitrate of, 426.
  prussiate of, 413.
  subiodide of, 418.
  supernitrate of, 428.
                 solution of, 428.
Mere de Seigle, 312.
Mesitalkohol, 645.
Mesitylene, bihydrate of,  645.
Mesmerism, 398.
Milchsaure, 36.
Mixture, Scudamore's, 231.
Mohnstoff, 516.
Moleplant,  334.
Monesia, 512.
Monesin, 512.
Moosbitter,  177.
Moos, carragaheen, 210.
Moos, Irlandisch, 210.
Morphei acetas, 523.
Morpheum, 516.
Morphia, 516.
  acetate of, 523. 
ALPHABETICAL CONTENTS.
XXV
Morphia and codeia, muriate of, 531.
  bimeconate of, 530.
  citrate of, 529.
  hydriodate of, 527.
  hydrochlorate of, 527.
  iodhydrate of, 527.
  iodide of iodhydrate of, 527.
  ioduret of,  529.
  muriate of, 527.
  salts of, 516.
  sulphate of, 528.
  tartrate of, 530.
Morphiae acetas, 523.
  hydriodas,  527.
  hydrochloras, 527.
Morphii murias, 527.
  sulphas, 528.
Morphin, 516.
  essigsaures, 523.
  iodwasserstoffsaures, 527.
  salzsaures, 527.
  schwefelsaures, 528.
Morphina, 516.
Morphinae acetas, 523.
  bimeconas, 530.
  hydrochloras, 527.
  murias, 527.
  sulphas, 528.
  tartras, 530.
Morphine, 516.
  acetate of,  523.
  and zinc, double iodide of,  666.
  bimeconate of, 530.
  citrate of, 529.
  et codeine, double muriate de,531.
  hydriodate de, 527.
  hydrochlorate de, 527.
  iodhydrate de, 527.
  muriate of, 527.
  sels de, 516.
  sulphate of, 528.
  tartrate of, 530.
Morphinsalze, 516.
Morphinum, 516.
Morphium, 516.
  acetat, 523.
  aceticum, 523.
  essigsaures, 522.
  hydrochlorsaures, 527.
  muriaticum, 527.
  salzsaures, 527.
  schwefelsaures, 528.
  Bulphat, 528.
  sulphurieum, 528.
Mort aux chiens, 223.
Moss, carageen, 210.
  Ceylon, 383.
Moss, corrigeen, 210.
  edible, 383.
  Irish, 210.
  Jaffna, 383.
  marine, 383.
Mousse d'Irlande, 210.
  perlee, 210.
Moxa, 531.
Moxiburium,  531.
Moxibustion, 531.
Mugwort,  108.
Murias aurico-nitricum, 127.
  morphicus, 527.
  zincicus, 688.
Muriate d'or, 120.
Murid, 141.
Muride, 141.
Murigene,  182.
Murin, 141.
Murine, 141.
Mustardseed  oil, 559.      •*
Mutterkorn, 312.
Nadelstich, 51.
Naphtha, 645.
  phosphorata, 544.
  sulphurica, 61.
  vitriol, 61.
  wood, 645.
Naphthalin, 720.
Naphthaline, 720.
Narcotina,  535.
  muriate of, 535.
Narda celtica altera, 103.
Narkotin, 535.
Natrium-gold-chlorid, 122.
Natriumplatinchlorid, 578.
Natron phosphorsaures, 728.
Natronwasser,  oxydirt salzsaures,
    643.
Natrum chloratum, 643.
  chloricum, 643.
  chlorsaures, 643.
  oxydirt oder hyperoxygenirt salz-
    saures, 643.
  oxymuriaticum, 643.
Navelwort, 707.
Nephrine,  675.
Nephrodium  filix mas, 381.
Neurogamia, 398.
Nierenfarrn,  mannlicher, 381.
Niesswurzstoff, 678.
Nitras ferricus, 361.
  hydrargyricus, 427.
  hydrargyricus acido nitrico solu-
    tus, 428.
  hydrargyrosus, 426.
  plumbicus, 723. 
xxvi
ALPHABETICAL CONTENTS.
Nitre, 724.
Nitro-muriatic mixture, 187.
Nitrum saturninum, 723.
Noix vomique, 538.
  extrait alcoolique de, 538.
Nombril de Venus, 707.
Noyer, 493.
Nussbaum, 493.
Nux vomica, 538.
  alcoholic extract of, 538.
Ochsengalle, 708.
Oelsuss, 400.
Ofenruss, 385.
Oil of bitter almonds, 81.
  cod, 545.
  codliver, 545.
  croton, 561.
  of mustard seed, 559.
Oleum aethereum florum arnicae, 103.
  aethereum seminum sinapis, 559.
  cadinum, 721.
  crotonis, 561.
  euphorbias lathyridis, 334.
  jecoris aselli, 545.
  juniperi empyreumaticum, 721.
  morrhuae, 545.
  ricini officinale, 566.
  seminis crotonis, 561.
  sinapis, 559.
  tiglii, 561.
  vitrioli dulce, 61.
  volatile seminum sinapis, 559.
Opiane, 585.
Opiumalkaloid, 516.
  lettuce, 496.
Opiumsalz, Derosne'sches, 535.
Or, chlorure d' 120.
  cyanure d',  125.
  divise, 129.
  oxide de, 127.
  et de sodium chlorure d', 122.
:  et soude, hydrochlorate d', 122.
  et soude, muriate d', 122.
  metallique,  129.
  muriate d', 122.
  nitromuriate d', 127.
  oxide d', 129.
  preparations d', 116.
  protoiodure d', 126.
Oxide d'argent,  99.
Oxidum ferricum hydratum, 364.
Oxydirtes silber, 99.
Oxydirt-salzsaures natronwasser,
   643.
Oxydum argenti, 99.
Oxyhydrocarburetum ex oleo pyrox-
    ilico paratum, 255.
Panacea lapsorum, 103.
Papaverinum, 218.
Pariser blau, 345.
Passerage, 716.
Pasta seminum paulliniae, 569.
Pate de guarana, 569.
Paullinia, 569.
Perlmoos Irlandisch, 210.
Pfefferstoff, 572.
Pferdekastanie, 410.
Pferdekeste, 410.
Phloiorrhizina, 571.
Phloridzin, 571.
Pierre d'aimant, 498.
Pigmentum indicum, 432.
Pills, Blaud's, 373.
  ferruginous, of Vallet, 372.
Piper angustifolium, 506.
  caudatum, 281.
  cubeba, 281.
  elongatum, 506.
Piperin, 281, 572.
Piperina, 572.
Pipsissewa, 179.
Piscidia erythrina, 722.
Platina, bichloride of, 577.
  muriatica, 577.
  muriatica natronata, 578.
  perchloride of, 577.
  preparations of,  575.
Platinae chloridum, 577.
Platinchlorid, 577.
Platine, bichlorure de, 577.
  et sodium, chlorure double de, 578.
  perchlorure de,  577.
  preparations de, 575.
Platini bichloridum, 577.
  perchloridum, 577.
  praparata, 575.
Platinoxyd, salzsaures, 577.
Platinpraparate, 575.
Platinum, 575.
  bichloratum, 577.
  bichloride of, 577.
  chloride of, 577.
  perchloride of, 577.
  and sodium, double chloride of,
  578.
Plocaria Candida,  383.
Plomb, chlorure de, 722.
  iodure de, 578.
  nitrate de, 723.
  tannate de, 580.
Plombagine, 339.
Plumbago, 339.
Plumbi chloridum, 722.
  hydriodas, 578. 
ALPHABETICAL CONTENTS.
xxvii
Plumbi iodhydras, 578.
  iodidum, 578.
  ioduretum, 578.
  nitras, 723.
  tannas, 580.
Plumbum iodatum, 578.
  hydroiodicum, 578.
  nigrum, 339.
  nitricum, 723.
  scytodepsicum, 580.
  tannicum, 580.
Poison nut, 538.
Poivre a queue, 281.
Polypodium filix mas, 381.
Polyporus officinalis, 138.
Polystichum filix mas, 381.
Pomegranate, 402.
Potassa, arsenite of, 105.
  chlorate of, 581.
  hydrocyanate of, 588.
  hydriodate of, 595.
               ioduretted, 598.
  hydrobromate of, 585.
  hyperoxymuriate of, 581.
  nitrate of, 724.
  oxymuriate of, 581.
Potassae bromhydras, 585.
  chloras, 581.
  cyanhydras, 588.
  euchloras, 581.
  hydriodas, 595.
  hydrobromas, 585.
  hydrocyanas, 588.
  murias hyperoxygenatum, 581.
  murias oxygenatum, 581.
  nitras, 724.
Potasse, bromure de, 585.
  chlorate de, 581.
  hydriodate de, 595.
  iodure de, 595.
  nitrate de, 724.
Potassii bromidum, 585.
  cyanidum, 588.
  cyanuretum, 588.
  hydrargyro-iodidum, 592.
  iodidum, 595.
  iodohydrargyras, 592.
  ioduretum, 595.
  oxygeno-chloruretum, 581.
  proto-hydriodas, 595.
  protoxidi hydriodas, 595.
Potassium, bromide of, 585.
  cyanide of, 588.
  cyanuret of, 588.
  dihydrargyro-blniodide of, 592.
  hydrargyro-iodide of, 592.
  iodide of, 595.
Potassium, iodohydrargyrateof,592.
  ioduret of iodohydrargy rate of,592.
  ioduret of, 595.
  protoxide of, chlorate of, 581.
Potio picea, 89.
Poudre de blanchement, 153.
  de Tennant, 153.
Powder, bleaching, Tennant's, 153.
Preta; raiz, 147.
Principium adstringens, 33.
  scytodephicum, 38.
Prussiate de potasse et de fer, 345.
Pseudoangusturinum, 145.
Ptarmica montana, 103.
Pulvis ad fumigationes muriaticas,
     182.
Punica granatum, 402.
Purgirkorner-Euphorbie, 334.
Pyrola umbellata, 179.
Pyrola corymbosa, 179.
Pyrole en ombelle, 179.   {
Quecksilber, blausaures, 413.
  bromid, 412.
  bromur, 412.
  cyanid, 413.
  deuto-bromur, 412.
  deuto-iodiir, 421.
  deuto-iodur  des, 421.
  iodid, 418, 421.
  iodid, gelbes, 418.
  iodidul, 418.
  iodiir, 418.
  oxyd, blausaures, 413.
  oxydul, salpetersaures, 426.
  praparate, 412.
  proto-iodiir des, 418.
  proto-bromiire des, 412.
Quecksilberiodidkalium, 592.
  salpetersaures, kaltbereitete?,426.
               heissbereitetes,427.
Quillaia, 512.
Quina, 603, see Quiniae.
  acetica, 605.
  citrica, 607.
Quinia, 603, (for its salts see Qui-
      nine.)
Quiniae acetas, 605.
  arsenias, 606.
  areenis, 607.
  citras,  607.
  et cinchoniae tannas, 635.
  ferrocyanas, 608.
  hydriodas, 610.
  iodidum, 610.
  lactas, 611.
  murias, 612.
  nitras, 613. 
XXV111
ALPHABETICAL CONTENTS.
Quiniae phosphas, 613.          -   i
  sulphas, 614.
          impurus, 636.
  valerianas, 633.
Quinin,  603.
Quinina, see Quinine.
Quinine, 603.
  acetate of, 605.
  amorphous,  637.
  arseniate of, 606.
  arsenite of,  607.
  brute, 604.
  citrate of, 607.
  disulphate of, 614.
  extract of, 636.
  ferrocyanuret of, 608.
  hydriodate of, 610.
  iodide of, 610.
  iodide of iodhydrate of, 611.
  lactate of, 611.
  muriate of,  612.
  nitrate of, 613.
  phosphate of, 613.
  sulphate of, 614.
  valerianate  of, 633.
  and cinchonine, tannate of, 635.
  and iron, hydriodate of, 611.
Quininum, 603.
Quiniodine, 636.
Quinium, 603.
Raiz crusadinha,  147.
  preta,  147.
Reissblei, 339.
Resina chinae praeparata, 636.
Rindsgalle, 708.
Ringelblume,  150.
Rochenleberthran, 546.
Rosscastanien, 410.
Rosskeste, 410.
Russ, 385.
Russkali, 389.
Rye, corned, 312.
  spurred,  312.
Sabadillina, 678.
Saccharum mannae, 503.
Safran batard, 212.
  de mars aperitif, 376.
  des pres, 223.
  wilder, 223.
Saffron, meadow, 223.
Saint Christophe, herbe, 212.
Sal essentiale corticis Peruviani,603.
Salicina, 637.
Salicinum, 637.
Salpetersaure, 701.
Salt of Derosne, 531.
Salzsaure, dephlogistisirteoder oxy-
     dirte, 189.
Salzaure iibersaure,  189.
Salzsaures silberammonium, 95.
Sanicula Manlandica, 726.
Sanicle, 726.
Sanicle, Maryland, 726.
Sapo domesticus mollis, 641.
  ex oleo et potassa confectus, 641.
  elainicus, 641.
  kalicus, 641.
  mollis,  641.
  niger, 641.
  viridis, 641.
Satzmehliodiir, 490.
Sauerdornbitter, 136.
Savon a base de potasse, 641.
  mou,  641.
  noir, 641.
Scheel'sches suss, 400.
Schmierseife, 641.
  griine, 641.
Schwanzpfeffer, 281.
Schwarzkorn, 312.
Schwefelather, 61.
Schwefelalcohol,  668.
Schwefeliodiir, 673.
Schwefelkohlenstoff, 668.
Schwererde,  iodwasserstoffsaure,
     132.
Schwindelkorner, 281.
Scorodite, 336.
Scudamore's mixture, 231.
Secale clavatum, 312.
  cornutum, 312.
  luxurians, 312.
Secalis cerealis, semina monstrosa,
     312.
  mater,  312.
Seemoos, Irlandisch, 210.
  geperltes, 210.
Seetang, 210.
Seife, kali, 641.
  schwarz, 641.
Seigle cornu ou corrompu, 212.
  a eperon, 312.
  ivre,  312.
  noir,  312.
  ergote, 312.
  faux, 312.
Sel de Derosne, 531.
  de Gregory,  531.
  essentiel d'opium, 531.
Senfol atherisches, 559.
Serpentaria, cimicifuga, 212.
Serpentariae Braziliensis radix, 147.
Sidhee, 166.
Silberammonium, salzsaures, 95.
,  chloriir, 94.
  iodur, 98. 
ALPHABETICAL CONTENTS.
xxix
Silberammoniumoxyd, 99.
  oxyd, cyansaures, 97.
  oxydirtes, 99.
  praparate, 92.
  salmiak,  95.
  salzsaures, 94.
  zertheiltes, 101.
Silver, ammonio-chloride of, 95.
  chloride of, 94.
  chloruret of, 94.
  cyanide of, 97.
  cyanuret  of,  97.
  iodide of, 98.
  ioduret of, 98.
  metallic, 101.
  muriate of, 94.
  and ammonia, chloride of, 95.
                chloruret of, 95.
  preparations of, 92.
Sinapis oleum, 559.
Sipeerine, 133.
Snake root,  black, 212, 726.
Soap, soft, 641.
Soda, arseniate of, 105.
  chlorinata, 643.
  chloruret of, 643.
  chlorite of, 643.
  hypochlorite of, 643.
  hyposulphite of, 727.
  phosphate of, 728.
Sodae chloridum, 643.
  chloruretum, 643.
  hyposulphis, 727.
  oxymurias, 643.
  phosphas, 728.
Sodii auri-terchloridum, 122.
  chloroplatinas, 578.
Sodium, auro-terchloride of, 122.
  chloroplatinate of, 578.
  chlorure d'oxide de, 643.
Soldier's weed, 506.
Solutio alexiteria oxygenata, 189.
  chlorinii,  189.
  ferri nitratis, 361.
Solution of chlorine, 189.
  Coindet's, 597.
  de Pearson, 105.
  Donovan's, 429.
  Fowler's, 105.
  Lugol's, 489, 598.
  of nitrate of iron, 361.
  of persesquinitrate of iron, 361.
Soot, 385.
Souci, 150.
  ordinaire, 150.
Soude, chlorure de, 643.
  hyposulfite de, 727.
Soude, phosphate de, 728.
  sulfite sulfure de, 727.
Soufre carbure, 668.
  iodure, 673-
Species  pro vaporibus superoxydi
    muriatici, 182.
Sphaerococcus crispus, 210.
  lichenoides, 383.
Spicanard,  729.
Spiegelruss, 385.
Spinnblume, 223.
Spirit, pyro-acetic, 645.
Spiritus pyro-aceticus, 645.
  salis marini dephlogisticatus, 182.
Sponsa solis, 150.
Springkraut, kleines, 334.
Spur, the, 312.
Spurge, caper, 334.
  garden, 334.
Starch, iodide of, 490.
Starkmehliodur, 490.
Steinkohlenkali, 82.
Stephensia elongata, 506.
Stink st off, 141.
Stockfischleberthran, 545.
Stockung des Blutes in der Gefas-
    sen, 713.
Strychna, 649.
Strychnia, 649.
  acetate of, 664.
  hydriodate of, 665.
  iodate  of, 665.
  iodide of iodhydrate of, 666.
  nitrate of, 667.
  sulphate of, 668.
Strychnia and zink, double iodide
    of, 666.
Strychnin,  645.
  acetat, 664.
  essigsaures, 664.
  iodsaures, 665.
  iodwasserstoffsaures, 665.
  nitrat, 667.
  salpetersaures, 667.
  schwefelsaures, 668.
  sulphat, 668.
Strychnine, see  Strychnia.
Strychninum, 645.
  aceticum, 664.
  iodicum, 665.
  nitricum, 667.
  sulphurieum, 668.
Strychnium, 645.
Subjee, 166.
Succus limonis, 728.
Suffitus chlorini, 182.
  oxymuriaticus, 182. 
XXX
ALPHABETICAL CONTENTS.
 Sugar of manna, 503.
 Suie, 3a5.
 Sulfure de carbon, 668.
 Sulphas cadmicus, 705.
   manganosus, 718.
   morphicus, 528.
   quinicus, 614.
 Sulphur, iodide of, 673.
 Sulphuret of carbon, 668.
 Sulphuretum carbonii, 668.
 Sulphuris carburetum, 668.
   iodidum, 673.
   ioduretum, 673.
 Sumbuli radix, 729.
 Surnbul root, 729.
 Sumbulwurzel, 729.
 Superchloridum formylicum, 196
 Suppository, galvanic, 399.
 Swertia chirayita, 399.
 Tabac de Montagne, 103.
   des Savoyards, 103.
   des Vosges, 103.
 Tang, krauser, 210.
 Tannas chinii seu  cinchonicus
   quinicus, 635.
   plumbi, 580.
 Tannic acid, 38.
 Tannicum, 38.
 Tannin, 38.
 Tanninum, 38.
 Tar water, 89.
 Tellurismus, 398.
 Terra aluminis,  101.
   aluminosa pura, 101.
   argillacea pura, 101.
   bolaris, 101.
   sigillata, 101.
 The de seigle noirci des sages-l
    mes Americaines, 312.
 Theerwasser, 89.
 Thierkohle, 173.
 Thonerde, gereinigte, 101.
   reine, 101.
 Thonerdensalze, 74.
 Thridace,  496.
 Tithymalus latifolius, 334.
 Todtenblume, 150.
 Tue-chien, 223.
Ulva crispa, 210.
Urea, 675.
   nitrica,  677.
Ureae nitras, 677.
Uiee,  675.
   nitrate de, 677.
Uricum. 675.
Ussacu, 715.
Ustilago, 312.
   Vallet's ferruginous pills, 372.
   Vauquelin, 645.
   Veratria, 678.
     sulphate of, 687.
   Veratrin, 678.
   Veratrina, 678.
   Veratrium, 678.
   Verrucaria, 150.
   Vieillotte, 223.
   Vinaigre de bois, 13.
   Violine, 309.
   Volta'sche Electricitat, 392.
   Voltaism, 392.
   Vomicina, 145.
   Vomic nut, 538.
   Wachholder-oel, brenzliches, 721.
   Wallnussbaum, 493.
   Walnut tree, 493.
   Walschennuss, 493.
   Wasser, Binellisches, 82.
     Brocchierisches, 84.
     oxydirt, salzsaures, 189.
   Wasserstoffblausaure, 23.
u  Water, Binelii, 82.
     of bitter almonds, 80.
     Brocchieri, 84.
     tar, 89.
   Weed, soldier's, 506.
   Weidenbitter, 637.
   Weidenstoff, 637.
   Weisensafran,  223.
   Winter green,  179.
   Wintergrun, 179.
     holdenbliithigen, 179.
   Wismuth, valeriansaures, 704.
   Wohlverlei, 103.
     blumenol, 104.
i-  Wohlverleiol, 104.
   Wclfstrapp, wolliger, 130.
   Woodsoot, 385.
   Yerba del Soldada, 506.
   Zeitlose, 223.
   Zinc  and morphia, double iodide of,
      698.
     and strychnia, double  iodide of,
      666.
     butter of, 688.
     chloride of. 638.
     cyanuret of,  694.
     ferrocyanuret of, 695.
     ferrohydrocyanate of, 695.
     hydrochlorate of, 688.
     hydrocyanate of, 694.
     io'dide of, 698.
     muriate of, 6-8.
     prussiate of,  694.
   Zinci butyrum, 688. 
ALPHABETICAL CONTENTS.
XXXI
Zinci chloridum, 688.
  chloruretum, 688.
  cyanhydras, 694.
  cyanidum, 694.
  cyanuretum, 694.
  ferrocyanuretum, 695.
  ferrohydrocyanas, 695.
  iodidum, 698.
  ioduretum, 698.
  valerianas, 699.
Zincum borussicum, 694.
  chloratum, 688.
  cyanogenatum, 694.
  ferrohydrocyanicum, 695.
  hydrocyanicum, 694.
  iodatum, 698.
  muriaticum oxydatum, 688.
  salitum, 688.
Zincum valerianicum, 698.
  zooticum, 699.
Zink, baldriansaures, 699.
Zinkbutter, 688.
Zinkchlorid, 688.
Zinkchlorur, 688.
Zink, chlorwasserstoffsaures, 688.
Zinkcyaniir, 695.
Zinkeisenblausaures, 695.
Zinkeisencyaniir, 694.
Zinkiodiir, 698.
Zinkoxyd, eisenoxydul, blausaures,
    695.
  salzsaures, 688.
  valeriansaures,  699.
Zinkoxydul, blausaures, 695.
Zink, salzsaures, 688.
Zoomagnetismus,  398. 
• 
NEW   REMEDIES.
   I. ACIDUM ACE'TICUM EMPYREUMAT'ICUM.
Synonymes. Acidum pyro-aceticum seu Ligni  pyro-oleosum seu pyrolig-
  nosum seu pyroxylicum, Acetum ligneum seu pyrolignosum seu lignorum
  empyreumaticum, Pyroligneous, and Pyrolignic acid.
French. Acide pyro-acetique, A. pyrolignique, A. pyroligneux, Vinaigre de
  bois.
German. Brenzliche  oder  brandige Holzsaure; Holzsaure;
  Holzessig; Holzessigsaure.

   Pyroligneous acid, although brought much into notice—revived
as it were—in recent times, is by no means  the product of those
times exclusively.   The cedria,  with  which  the  Egyptians em-
balmed  the bodies of the dead, it is presumed, was identical with
it.   Pliny recommends cedria, or the  oil of tar, got from  the
cedar, in toothach,1 and Galen unites with him.3   The virtues of
pyroligneous acid are often also referred to by Boerhaave.5

                   METHOD OF  PREPARING.
   Pyroligneous acid  is prepared  in chemical laboratories by the
dry distillation of wood, especially of hard wood, which is placed
in an iron  retort heated  to  redness.   First of all, there passes
over a light brown  or  greenish fluid, w?hich contains some empy-
reumatic  oil;  to this succeeds the pyroligneous  acid,  which  is
formed  during distillation.   If the distillation be  continued, more
empyreumatic oil passes over, and lastly tar.
   The  chief constituent of  pyroligneous acid is  vinegar,  which
can be deprived of  its empyreumatic constituents by rectification
with fine porous animal  charcoal.  Besides vinegar, it  contains
empyreumatic  oil (pyrelain;)  empyreumatic resin [pyrretin,) a
peculiar matter containing nitrogen, and similar to  an extract (em-
pyreumatic extract,) and  spirit  of tar (spiritus  pyrolignicus.)
Reichenbach discovered in it the  new substance, creasote,4 which
seems to be the most important ingredient,—its medicinal efficacy
appearing to be dependent upon that substance.
   Impure pyroligneous acid is of  a brownish colour, and of an acid
smoky  smell  and taste.   This is  the preparation which  is gene-
  1 Hist.  Nat. xxxiv. 11.
  a De Sirupl. Medic. Facult. lib. vii.   See Cormack on Creasote, p. 59.  Edinbureh
1836.                                             *           6
  ' Riecke, Die neuern Arzneimittel.  u. s. w. S. 6, Stuttgart, 1837.
  • See the article Creasote.
        2 
14           ACIDUM ACETICUM EMPYREUMATICTJM.
 rally  used externally; but, by chemical means, the acid may be
 purified so as to furnish the acidum aceticum  empyreumaticum
 recti/icatum.   This cfiffers from impure  pyroligneous acid in con-
 taining less empyreumatic resin and extract, and  creasote.   The
 London College, again,  prepare  from  it a  stronger  acid,—the
 acidum aceticum fortius,—which is extremely volatile and  pun-
 gent,  and  is used as a revellent.

           EFFECTS ON THE ECONOMY IN HEALTH.
   From experiments instituted on animals, it would appear, that
 the administration of pyroligneous  acid in large doses occasions
 vomiting of a considerable quantity of frothy fluid, having a strong
 odour of the acid; tremors of the limbs; convulsions; tetanus; pro-
 trusion of  the eyes; insensibility; paralysis of the limbs; dyspnoea;
 croupy cough; hoarseness, &c.  The death of the animal super-
 venes  with symptoms of suffocation, and the fatal termination is
 often  rapidly induced.   Inspection  after death exhibits  manifest
 venous congestion  in the brain, spinal  marrow, lungs, liver, and
 spleen, and in the right side of the heart,—with, at  times, in-
 flammation of the  stomach.   According to Berres, it occasions
 marked narcotic effects.   In  by no means considerable doses, he
 found  it to cause violent pain in the stomach  and  bowels, nausea
 and vomiting, general  weakness,  heaviness, vertigo, convulsions,
 and even  death, without exhibiting any decided  effect upon  the
 vascular system.  In  smaller doses, it is said to produce a sensa-
 tion of burning in  the stomach, and after  a  time to quicken the
 pulse, and augment the cutaneous and renal depurations.   Others
 —and the  best observers, we think—deny it  any narcotic  pro-
 perties.1
 v* As an antiseptic, its efficacy is undoubted, and this has been long
 known.   Creasote  is, doubtless, a  main agent  in  producing  this
 result;  and wherever the  administration of creasote  is indicated,
 the use of  pyroligneous acid may be proper.

           EFFECTS  ON THE ECONOMY IN DISEASE.
   Possessed of the properties  described above, pyroligneous  acid
was at once suggested in cases of gangrene and sphacelus, in
which  it was  successfully used, as well  as in  cachectic conditions
brought  on by  the misuse of mercury, and in herpetic, flabby,
fungous, and sloughing ulcers, in porrigo, and in toothach   pro-
duced by caries—the  acid being dropped upon  cotton and  applied
to the hollow tooth.  In most  of these cases, it was generally ex-
hibited both internally and externally.   Numerous  experiments
have been made with it in various affections by different  observers;
but its use  has been more especially extolled in cases of gangrene,
in which it  corrects  fcetor, and promotes the separation of the dead

            1 Richter's Specielle Therapie, S. 255. Berlin, 1828. 
              ACIDUM ACETICUM EMPYREUMATICUM.           15

parts.1   The physicians of the Berlin Charite experimented with
it in cases of sloughing gangrenous sores, with such success, that
they pronounced it an antiseptic of the highest order.2   Besides the
cases mentioned, it has been advised, mixed with white of egg, in
excoriated  nipples,3  in cancerous  and  scrofulous  affections,
in cancrum  oris, by Berres, Klaatsch, Heira and Romberg;  in
mercurial salivation by Schneider; in caries of the bones, and  as
a gargle in scarlet fever by Barth.  It  has, moreover, been  re-
commended by  Buchanan4  in deafness  caused by deficient secre-
tion of the cerumen of the ear, and in discharges of an offensive
character from the  meatus auditorius, as well as from other
outlets; in chronic  inflammation of the tarsal edges of the
eyelids; in scabies; in favus by Berres and Wigan; in toothach by
Berres.  In gastromalacia it has  been recommended by Pitschaft5
and Teufel;6 in phthisis by Harless, and in  dropsy, diarrhoea,
putrid nervous fevers, &c, by Ampach ;7 and  in scorbutus by
Berres,8 yet, as was  before remarked,  it is rarely  employed  in-
ternally:  indeed both externally and internally, it has been  greatly
supplanted by creasote.

                  MODE OF ADMINISTRATION.
   The  inequality in the strength of the preparation renders it diffi-
cult to  fix upon  any precise  dose. Of the impure pyroligneous acid,
Sachs administered from  five to thirty  drops, three cr four times
a day, in simple or aromatic water.
   Externally, it  is applied both in a pure and dilute state; in the
former  case to ulcers,  by means of  a pencil, several times in the
day.   It  is generally diluted with simple water: but in  cases of
cancrum oris, sugared  water has commonly formed the diluent.  It
is also applied at times in the way  of cataplasm.   As a wash in
porrigo, and  as  an injection, it may be diluted with six or eight
parts of wrater; as a collyrium, the proportion may be one part
of the acid to twTelve of water, and it may be  employed, of about
the same strength, as a gargle.
  Heim has recommended the following application in  cancrum
oris.

  1 T. Y-. Simons, in American Journal of the Medical Sciences, vol. v.
  2 Riecke, Op. cit. S. 9.
  3 Bursharat, in Gazette Medicale, cited in Amer. Joum. of the Medical Sciences. Feb.
1833, p. 503.
  4 Illustrations of Acoustic Surgerv, Lond. 1825.
  8 Med. Chirurg. Zeitung, No. 7J825.
  6 Annal. fur die gesammte Helkund. unter der Redact, d. Mitglied. der  Badensch.
Sanitatsk. 2ter Jahrg. 1825.
  1 Rust's Magazin, B.xvi. H. 2, S.353, and Richter.  Op. cit. B. x. S. 257, Berlin, 1 S2=«.
  8 Aschenbrenner, Die neueren Arzneimittel  und Arzneibereitungsformen u. s.w. S. 7,
Erlargen, 18-18. 
16           ACIDUM ACETICUM EMPYREUMATICUM.

             Mel acidi acetici  empyreumatici.
                 Honey of pyroligneous acid.
             R. Acid. acet. empyreum. crud. f sjiss.
                Mellis rosae §j.  M.
  To be applied by means of a pencil.

  Buchanan  advises  the following form of injection in cases of
purulent discharges from the meatus auditorius.
          Injectio acidi acetici empyreumatiei.
               Injection of pyroligneous acid.
               R. Acid, acetic,  empyreum. fgij.
                 Aqu« destillatae f ^vj.  M.
  Fiat injectio bis die utenda.
  The following drops he recommends in cases where the  ceru-
men is deficient in quantity.

            Guttffi acidi acetici empyreumatici.
                Drops of pyroligneous acid.
        R. Acidi acet-  empyreum. crud.
            Olei. terebinth, rectif.
            Sp. setheris sulphur, comp. aa. partes sequales.  M.
  Two drops of this compound are to  be dropped every night into
the  meatus auditorius.
        Cataplasma  acidi  acetici empyreumatici.
               Cataplasm of pyroligneous acid.
      R. Furfur, ffiss.
         Lin. pulv. §j.  M. bene et adde
         Acid, acetic, empyreum. crud. q. s. ut fiat cataplasma.
  To be applied to foul ulcers.

       Linimentum acidi acetici empyreumatici.
               Liniment  of pyroligneous  acid.
                 R.   Acid. acet. empyreum.  gss.
                     Myroxyl. ^ij.
                     Vitell. ovi q. s. ut fiat linimentum.
  To be applied on lint three times a  day to sloughs and ulcers.

        Collutorium  acidi  acetici empyreumatici.
              Mouth-wash of pyroligneous acid.
             R. Acid. acet. empyreum.  rectif. f ^ss.
               Aquae cinnamomi f ^iv.
               Syrup, mori f§ij. M.
  Phobus advises this as a wash for the raouth in cases of cancrum
oris.  It should be kept in a glass vessel covered with black paper
to prevent decomposition. 
ACIDUM BENZOICUM.
17
                 II.  ACIDUM BENZOICUM.
Svnonymes.  Acidum Benzoicum per sublimationem, Flores  Benzoes seu
  Benzoini, Benzoic Acid, Flowers of Benjamin.
French. Acide Benzoique.
German.  Benzoesaure.

   Benzoic acid exists in the various balsamic substances, as ben-
zoin, storax, tolu balsam, &c.
                   METHOD OF PREPARING.
   In pharmacy it is  obtained from benzoin by sublimation.  The
following process is given in the last edition of the Pharmacopoeia
of the United States  (1842.)  Take of benzoin, in coarse powder,
a pound.  Put the benzoin, previously thoroughly mixed with an
equal weight of  fine  sand, into a suitable vessel, and, by means of
a sand bath, with a gradually increasing heat, sublime until vapours
cease to rise.   Deprive the sublimed matter of oil, by  pressure on
bibulous paper, and again sublime.
   A superior method, according to Messrs. Ballard and Garrod,1
is to boil  the benzoin in powder with  hydrate of lime, so as to
form a benzoate of lime, which is dissolved in the water, while the
resin remains  combined with the lime in the form of an insoluble
compound.   Muriatic acid  being added to the filtered liquid, the
benzoic acid is set free, and  crystallizes  on cooling.
   Benzoic acid,  obtained by the process of  the Pharmacopoeia of
the  United States, is in  white  feathery crystals, of  an agreeable
odour, fusible, wholly  volatilizable if cautiously heated, and sparingly
soluble in cold  water, more so in  boiling water, which deposits it
on cooling; very soluble  in  alcohol,  and readily dissolved by solu-
tion of potassa, from which  it is precipitated by chlorohydric acid.
                 EFFECTS ON THE ECONOMY.
   In another work2 the author has remarked:—"The therapeuti-
cal action of benzoic  acid is doubtless excitant, and  it has been
imagined by Dr. Pereira3 and others, that  its influence is princi-
pally directed to the  mucous surfaces,  and especially to the aerian
membrane."  The author has no reason for believing in this affi-
nity, and such would appear to be the general feeling  of the pro-
fession, as  it is now  scarcely used except in one or  two prepa-
rations, in which it seems to be retained only from old prepossessions
and  associations.  Of late years, however, it has been introduced
for a special purpose, and on this account is noticed  here.  In a
paper communicated by Mr. A. Ure to the Medico-chirurgical So-
ciety, January  7th, 1841,4 he stated, that when a certain portion
  1 Elements of Mat. Med. and Therap. p. 275, Lond. 1845.
  1 General Therapeutics and Materia Medica, 4th edit. 1, 236.  Philad. 1850.
  3 Elements of Mat. Med. and Therap. 2d Amer. edit. 1. 373.  Phila. 1846.
  ' Provincial Medical and Surgical Journal, July 17, 1841. 
18                    ACIDUM BENZOICUM.
of benzoic acid or of a soluble benzoic salt is introduced into the
stomach, the urine, in  the  course of a couple of hours, is found,
upon adding a portion of muriatic acid, to yield a copious precipi-
tate of  beautiful  rose pink  acicular crystals of hippuric acid.   In
pursuing his investigations farther, he ascertained, that no trace
whatever of uric acid or of any of its salts could be discovered in
the urine in question.   It had been wholly superseded by the hip-
puric;  and  as the  salts, which this  acid forms with  the ordinary
bases occurring in the animal fluids, as soda, ammonia and potassa,
are all  of  easy solubility, Mr. Ure inferred, that in  benzoic acid
we have an agent of great  value in  the uric  acid diathesis; and
he affirmed, that" the application of the above  principle had proved
of material benefit in the treatment of certain  unhealthy conditions
of the urine occurring in subjects of a calculous or gouty diathesis;
since it  enabled the practitioner to obviate entirely the various de-
positions resulting  from excess of uric acid, the  fruitful source of
that most distressing malady, stone in the bladder; as also to con-
trol and prevent the formation of  the so called tophaceous concre-
tions or chalkstones, which occasion so much inconvenience, defor-
mity and pain to individuals labouring under gout."
   The statement of Mr. Ure attracted the attention  of chemists,
whose observations  did not however confirm the inference, that
the hippuric acid was formed at the expense of the uric acid in the
urine,1 although they established,  that the benzoic acid  was  con-
verted  into the hippuric.2   Neither, therefore,  in the  uric acid
diathesis, nor in cases of the formation of gouty or tophaceous de-
posits, the  chief constituent  of which is generally urate of soda,
can the administration of benzoic acid be of service, and its ineffi-
ciency in these diseases is  now admitted ;3  but from its power of
causing increased acidity of the urine, it has been considered to
slightly stimulate the mucous membrane of the urinary organs, and
has been found useful in catarrh of the bladder, and in cases where
there exists a secretion of granular mucus mixed with phosphates.4.
   The  suggestions of Mr. Ure, in  regard  to the action of ben-
zoic acid on the urates, induced Dr. Walker  of  Huddersfield,5 to
administer it  in  chronic dysuria  incidental chiefly to  persons in
the decline of life, or in what he terms dysuria senilis,—an affec-
tion, which is, of course, dependent upon various  pathological con-
ditions,—and  he asserts, that he was disposed  to  augur favourably
of its utility.   " In  some instances," he says, " we may account
for the  benefit resulting from its  use by its chemical  action on the
  1 Keller, in appendix to Liebig's Animal Chemistry, p. 315, Cambridge, 1842.
  1 Garrod, Lond. Edinb. and Dubl. Phil. Mag. June, 1842, Lond. Lancet, vol. 2,1844,
p. 239, and Profs. Booth and Boye, Transactions of the Amer. Philos. Soc, vol. ix. pt. 2,
p.  185.   Phila. 1845.
  2 Ballard and Garrod, op. cit. p. 408, Lond. 1845.
  4 Ballard and Garrod, p. 409, and Mr. Ure, Provincial Med. and Sur. Journ. Feb. 11,
1843, and Lond. Lancet, Nov. 16, 1844.
  6 Ibid. Feb. 26, 1842. 
ACIDUM BENZOICUM.
19
urates, which if in  excess  may add  to the acrimony of the urine,
and  thus  prove a source of irritation to the mucous membrane of
the bladder.   But it is often of service where  the gravel in the
urine is inconsiderable, and where the irritation and  pain would
seem to have arisen from some other cause." Dr. Walker, however,
used it in  association with copaiba;  and  his remarks induced Mr.
Soden1 to employ the combination in some urinary affections, ac-
companied with vesical irritation and increased secretion from the
mucous membrane.   The most remarkable result appeared to Mr.
Soden to  be its  decided efficacy in  diminishing, and in some in-
stances of completely suppressing, the muco-purulent deposition in
the urine,  which is so prominent a symptom in most cases of affection
of the bladder.   He properly remarks, however, that, a doubt may
be very fairly entertained, whether  this  effect be attributable to
the benzoic acid or to the copaiba, or to their  combination; and in
the doubt Mr. Ure deduces no positive inference in regard to the
precise agency of the benzoic acid.2
   It may  be concluded, then, that benzoic acid has been introduced
as a  remedy in lithuria  on erroneous chemical deductions: and
hence that the  favourable results recorded have been fallacious, or
depending on other causes.
   Dr. Seymour3 states, that he has frequently used the benzoate
of ammonia in  gout, in cases in  which the small joints were red and
swollen, or where fluid was deposited in the joint  of the great toe;
and also in cases where the urate of soda existed in the joints of
the fingers; and that it was  decidedly useful.   He thinks, that
early depositions  were arrested, and  large  depositions  diminished,
under its  use.   He  esteems it a good  diuretic, and  especially
adapted for those cases of dropsy, in which an  irritable stomach
renders the employment of ordinary diuretics impracticable.  He
has also seen the albumen in renal dropsy diminish under its  use.

                 MODE OF ADMINISTRATION.
  The dose of benzoic acid may be from five  grains to half  a
drachm.
             Mistura Acidi Benzoici  et  Copaiba1.
            Mixture of Benzoic acid and Copaiba.
                    R. Acid. Benzoic. gj.
                       Copaib. f ^ss.
                       Vitell. ovi  q.  s.
                       Aq. Camphor, f 3vij.  M.
  Dose.   Two table-spoonfuls three times a day.

  1 Ibid. July 29, 1842.                           2 Ibid. Feb. 11, 1843.
  3 Thoughts on the Nature and Treatment of several severe Diseases of the Human
Body, vol. i.  p. 123, Lond. 1847. 
20
ACIDUM GALLICUM.
                    ACIDUM GALLICUM.
  Synontmes. Gallic acid.
  French. Acide Gallique.
  German. Gallussaure.

  Gallic acid is  by no means so abundant as  tannic acid.  A so-
lution of the latter in water, exposed to the air, gradually absorbs
oxygen,  and deposits  crystals of  gallic acid, formed by the  de-
struction of tannic acid.
                   METHOD OF PREPARING.
  A strong  extract of gall-nuts in cold water may be precipitated
in the cold by sulphuric acid: the thick mass  must be mixed with
dilute sulphuric  acid; be expressed whilst still humid, and be in-
troduced, in  this  state, into a mixture of sulphuric acid with two
parts of  water at the  boiling temperature.   The liquid is  boiled
for some minutes, and then allowed to cool.   Crystals of gallic acid
are deposited, which may be purified by crystallizing again from
water;—converting the  new product—which is  still coloured—
by  means of acetate of  lead—into  an insoluble gallate of lead,
which is washed, then diffused through water, and decomposed by
a stream of sulphuretted hydrogen gas.   The sulphuret of lead,
thus formed, assists in carrying down the colouring matter.1
  It may also be produced by adding sulphuric acid to  a solution
of tannic acid, which causes a precipitation of the tannic acid in
combination with the sulphuric: the precipitate is dissolved in di-
lute sulphuric acid  by the aid of heat, and the solution  is boiled
for a few minutes; the tannic acid is all decomposed; and, on cool-
ing, crystals of gallic acid, coloured, are obtained.3
   Gallic acid is  in  thin  silky needles.  It requires  one hundred
parts of cold water, and  three of  hot  water, to dissolve it.   It is
very soluble in alcohol,  and slightly so in ether.   The solution
in water has an acid and astringent taste, and is gradually decom-
posed by keeping.

                  EFFECTS ON THE ECONOMY.
   Gallic acid has long been esteemed a valuable astringent; yet
doubts appear to have been entertained in  regard to its being pos-
sessed of such property;  and until its use was revived of late it
had fallen into disrepute.   Sir Benjamin Brodie, according to Dr.
A. T. Thomson,3 gave a  patient, who  had a frightful  hemorrhage
from the prostate gland, and in whose case all other remedies had

  1 Graham's  Elements of Chemistry, American edit.,  p. 637, Phila. 1843.
  3 Ballard and Garrod, Elements of Materia Medica and Therapeutics, p. 415, London,
 1845.
  3 Elements  of Mat. Med. and Therap. 3d edit., and Watson, in Lond. Med. Gaz.
 July 8, 1842, p. 547,  or in his Lectures on the Principles and Practice of Physic, Amer.
 edit. p. 921, Phila. 1845. 
ACIDUM GALLICUM.
21
failed, a dose of " Ruspini's styptic," and repeated the dose twice
in the course of twelve hours.  About half an hour after the first
dose was taken, the bleeding  ceased, and it never recurred.  This
styptic is said to consist of gallic acid, a small quantity of sulphate
of zinc, and opium, dissolved in  a mixture  of alcohol  and rose
water; but as the quantity of sulphate of zinc and of opium appears
to be too small to influence the medicine, a simple solution of gallic
acid in diluted  alcohol, it has been conceived, may answer all the
purposes of the expensive nostrum.  Hence  gallic  acid  has been
used  in cases in which the styptic has been found efficacious.
   In  a paper read  before the medico-chirurgical society of Edin-
burgh,  Professor Simpson1 stated, that  in the previous year he
had  employed  gallic acid in menorrhagia with the most success-
ful results.   Some of the cases, which had yielded under its  use,
were of old standing, and of an  aggravated description.   He gave
it during the interval, as well  as during the discharge; and he was
first induced to prescribe it from finding that a case of very obsti-
nate menorrhagia got well under the use of Ruspini's styptic, after
many other remedies had failed.   Professor Simpson   suggests,
whether the anti-hemorrhagic properties of some of our common
astringent drugs may not depend upon  the gallic acid, as much as,
or more than, upon the tannic acid  which they contain, or upon
the tannic acid becoming converted into gallic acid within  the
body.
   Dr. Stevenson0 has published several cases to show the value of
this acid in uterine hemorrhage and hematuria ; and Mr. James
S. Hughes3 has recorded a case of profuse hematuria, the result
of injury on the lumbar region,  which was treated successfully by
it in  the form of pill with extract of gentian—two  grains and a
half of the acid to each pill,—one of these being given  at inter-
vals of three hours;  and Homburger4 administered it successfully
in hematuria renalis; in bloody diarrhoea accompanying the mor-
bus maculosus;  and in the hcemoptysis of phthisis.   Dr. Christi-
son5 has seen several  cases of menorrhagia recover promptly  un-
der its use.  He has likewise seen hematuria repeatedly yield to
it, and  in two instances of hcemoptysis the  hemorrhage rapidly
ceased after the  third  dose of six grains given every hour. Messrs.
Ballard and Garrod6 declare it to be  one of the most powerful as-
tringents that chemical art has  derived from the vegetable king-
dom ; and that a tolerably extensive experience by them  of its use

  1 Lond. and Edinb. Monthly Journal of Med. Science, July, 1843, p. 661.
  3 Edinb. Med. and Surg. Journal, July, 1843.
  3 Dublin Quarterly Journal of Med. Science, cited in Med. Examiner, July, 1847,
p. 447. ■>
  4 Canstatt and Eisanmann's Jahresbericht iiber die Fortschritte in der Heilkunde
im Jahre, 1848, S. 149.
  5 Dispensatory, American edit, by R. E. Griffith, p. 967.  Philad. 1848.
  6 Op. cit p. 415.  Lond. 1845. 
22                    ACIDUM GALLICUM.
 enables them to declare it to  be an invaluable remedy in  most
 forms of passive hemorrhages and fluxes.   The chief of the  cases
 in which  they have employed  it, and where they have found  it
 of the greatest service, are menorrhagia and leucorrhoea, as well
 as for checking the distressing  night-sweats of phthisis.  In the
 first two of these especially, no astringent that they had  employed
 would bear a comparison with this, either for the  rapidity with
 which the cure was effected,  or the permanency of  the result.
 Their eulogy, however, of its action in the night-sweats of phthisis
 is calculated to throw some doubts on the accuracy of  their expe-
 rience in other cases.  No medicine can be expected to exert much
 efficacy on them, any more than on the hectic, inasmuch as  they
 are mere morbid expressions of the condition of the lungs and ge-
 neral system.   Messrs. Ballard  and  Garrod  state, that if the use
 of the acid be continued beyond two or three days, it  manifests
 some constipating tendency, whilst Professor Simpson affirms that
 it has the advantage over most  other anti-hemorrhagic medicines,
 that it has no constipating effect.  The observations  of Messrs.
 Ballard and Garrod are probably the most accurate.  They affirm,
 also, that the excessive  expectorations of  chronic bronchitis and
 phthisis are much influenced by its administration.   In leucorrhoea
 they have found it highly useful as an injection, and Mr. Sampson1
 gave it with good effect in gonorrhoea in the quantity of  a drachm
 in the twenty-four hours, taken in  twelve grain doses; and  he
 places  great confidence in its  use in cases of albuminuria.  Dr.
 Christison,2 too, had his attention turned to its apparent power of
 arresting the excretion of albumen in the urine in Bright's  Dis-
 ease of the Kidney, and in a few instances it appeared to him to have
 that effect.

                 MODE OF  ADMINISTRATION.
  Gallic acid may be given in doses of from two grains  to five or
more, in the form of pill, repeated every two or three hours.

                    PilulaB acidi gal lie i.
                     Pills of gallic acid.
                 R.  Acid, gallic, gr. ij.—v.
                     Confect. rosae q. s. ut fiat pilula.

                   Injectio acidi gallici-
                    Injection of gallic acid.
                 R.   Acid, gallic. 9j. ad 3j.
                     Aquas Oij.  M.
1 London Lancet, Dec. 1st, 1849.
2 Op. cit. 
ACIDUM HYDROCYANICUM.
23
             IV.   ACIDUM HYDROCYANICUM.
 Synonymes. Acidum Prussieum seu Borussicum seu Zooticum seu Zoo-
   tinicum, Hydrocyanic, Prussic, Cyanohydric or Cyanhydric Acid.
 French.  Acide Hydrocyanique, Acide Prussique.
 German. Blausaure,Wasserstoffblausaure, Hydrocyansaure,
   Cyanwasserstoffsaure.

   This acid  can scarcely be looked  upon as new ; yet it is only in
 recent times  that its application to pathological conditions has been
 well appreciated.  It was discovered by Scheele in 1780;  but its
 preparation in a state of purity, and  its exact chemical  constitu-
 tion, were not understood until Gay-Lussac published the  results
 of his investigations on the subject in the year 1815.»
                   METHOD OF PREPARING.
   The three chief modes for preparing hydrocyanic acid at one
 time received into the pharmacopoeias were those of Scheele, Gay-
 Lussac, and  Vauquelin;  the first of which was adopted by the
 framers of the United States Pharmacopoeia of 1820, and  by those
 of Belgium,  Paris, and Ferrara; the second, by the pharmacopoeias
 of Paris and Ferrara; and the third by those of Belgium, Paris,
 and  the United States. (Edition of 1830.)
   1. Scheele's Method.— Take of Prussian  blue, 128  parts;
 Red oxide of mercury, 64 parts ; Distilled water, 105 parts.   Boil
 for  a quarter of an  hour, constantly shaking;  strain, filter, and
 wash the residuum with  Boiling  water, 128  parts.  Mix the
 two  liquids  together; introduce them into  a flask, and add Por-
phyrized iron filings, 96 parts; Sulphuric acid (66°,) 24 parts :
 diluted  with  Distilled water,  24 parts.   Shake the mixture, and
 keep the flask for an hour in cold water; pour the decanted liquor
 into  a tubulated retort placed in a sand bath, to the neck of which
 is attached an adapter that passes into a tubulated receiver, whence
 a curved tube issues that  passes into a flask filled with water ; lute
 the apparatus;  cover the receiver with wet  rags;  raise  the heat
 until the liquid boils, and until there have passed into the receiver
 192  parts.   Add  to this liquid, 8 parts of Carbonate  of lime.
 Distil again,  and draw off 128 parts, which must be kept in a bot-
 tle covered with black paper.
   The process of Scheele always affords an acid mixed with a va-
 riable quantity of water.
  2.  Gay-Lussac's  Method.—Take Cyanuret  of mercury,
at pleasure.  Introduce  it into a tubulated retort, the neck  of
 which is furnished with  a wide tube of glass filled with broken
marble and chloride of calcium, which tube  communicates, through
a smaller one, with a  bell glass surrounded  by a  freezing mixture.
         1 Annales de Chimie, torn, lxvii. p. 128, and torn. xcv. p. 136. 
24
ACIDUM HYDROCYANICUM.
Pour on muriatic acid sufficient to rise  above  the  cyanuret to
the height of a finger; heat gradually and moderately, and receive
the condensed product into the bell  glass.
  The acid obtained in this way is  anhydrous, and of the  specific
gravity .700.

  S. Vauquelin's Method.—Take of Cyanuret of mercury,
1 part; Distilled water, 8 parts.   Pass a current of sulphohydric
acid gas into the  solution,  until the gas is in excess; pour into
the liquid pulverized subcarbonate of lead  in sufficient quantity
to remove the excess of sulphohydric acid; shake the  mixture
constantly, and when it has no longer the smell of putrid eggs, and
ceases  to blacken paper impregnated with acetate of lead, filter
and preserve it carefully.
  The product of this operation  has been considered  to approxi-
mate the average density of the acid of Scheele.1
  The variable density of the acid prepared after Scheele's me-
thod has prevented  it from being  generally used in medicine.  The
acid of Gay-Lussac is most  commonly employed; but as its  de-
gree of concentration renders it dangerous, it is  diluted with dis-
tilled water.   Robiquet has proposed to bring its density to .900,
by  adding two parts of  water to it.   Thus  reduced, it resembles
the acid of  Scheele, with  the advantage, that there is a  constant
and known ratio between the pure  or anhydrous acid  and  the
quantity of  wTater united with  it.   Magendie adds to it six times
its  bulk, or eight and a  half  times its weight, of distilled water,
and calls the mixture Acide prussique medicinal? Medicinal
prussic or Medicinal hydrocyanic acid.   Others  have advised
the employment of a mixture of three parts of wrater, and  one part
of  acid, under the  name of Acide  hydrocyanique au quart or
"Hydrocyanic acid of quarter strength."3
   Dr.  Bache  asserts, that  he had  the process (Proust's or Vau-
quelin's) of the United  States' Pharmacopoeia  (1830)  repeated,
when he found the acid obtained to have the specific  gravity .998.
   In  the last edition of  the  Pharmacopoeia  of the United States,
(1842,) the following form was introduced.   It is essentially that
of the  London Pharmacopoeia.  Take of Ferrocyanurel of Po-
tassium, §ij.; Sulphuric  acid, §iss,;  Distilled water, a sufficient
quantity.  Mix the  acid  with four fluidounces of distilled water,
and pour the mixture, when cool, into a glass  retort.  To  this
add the ferrocyanuret of potassium, previously dissolved  in  ten

  1 See Notes on Hydrocyanic acid, by R. E. Griffith, in  Philad. Journ. of Pharmacy,
iv. 17.   Philad. 1833; also, Pereira, Elements  of Materia Medica, 2d edit. i. 429. Lond.
1842.  The Dispensatory of the United States of America, by Wood and Bache, 6th
edit. p. 786, Philad. 1845, and Mr. David Stewart, Maryland Medical and Surgical Jour-
nal, April, 1840, p. 264.
  2 Formulaire pour la preparation etc. de plusieurs nouveaux medicamens.
  ' Pharmacopee Universelle, par Jourdan, i. 31.  Paris, 1828. 
ACIDUM HYDROCYANICUM.
25
fluidounces of distilled water.   Pour eight fluidounces of distilled
water into a cooled  receiver, and having attached this to the re-
tort, distil, by means  of a  sand bath,  with a moderate heat, six
fluidounces.   Lastly,  add  to the product five fluidounces of dis-
tilled water, or as much as may be sufficient to render the hydro-
cyanic acid of such  a  strength, that 12.7 grains of nitrate of sil-
ver, dissolved  in distilled water, may be accurately saturated  by
100 grains of the acid.
   When hydrocyanic  acid is wanted for immediate use, the follow-
ing formula  is recommended.—Take of  Cyanuret of silver, fifty
grains and a half; Muriatic acid, forty-one grains; Distilled wa-
ter, a fluidounce.  Mix the muriatic acid with the distilled water,
add the cyanuret of silver,  and  shake the whole in a wrell-stopped
vial.   When the insoluble  matter has subsided, pour  off the clear
liquor and keep it for  use.
   The characters that hydrocyanic acid should possess, according
to the forms last given, are as follows:—It is colourless, of  a pe-
culiar odour, and wholly volatilizable by heat.  One hundred grains
of it produce, with solution of nitrate of silver, a white precipitate,
which, when washed and dried, weighs ten grains, and is readily
dissolved by boiling nitric  acid.  The acid of the Pharmacopoeia
of the United States contains two per cent, of pure anhydrous acid.1
   No  matter how prepared, hydrocyanic acid should be kept in
well-stopped bottles from which the light is excluded.

           EFFECTS ON THE ECONOMY IN HEALTH.
   Hydrocyanic acid is usually  classed  amongst the narcotic poi-
sons,2 yet there is reason for believing, that ils ordinary effects are
purely sedative.   Whilst the agents belonging to the class of nar-
cotics  produce, first of all, excitation in  the  organic actions, fol-
lowed, sooner or later, when the agent is in sufficient dose, by signs
of sedation, this acid would seem to occasion thelatter results  only.
   It is the most powerful  of our poisons, at  times producing, in
an adequate  dose, the  fatal result so suddenly, that the  animal ex-
perimented  upon can scarcely be removed from the lap of the ex-
perimenter before all  signs of  life  are extinct.   This  rapidity of
action has  seemed  to be  unfavourable  to the  idea, that it acts
through  the mass of  blood, and to  favour the view of those who
believe, that the impression is made immediately on  the nerves of
the part with which it is placed in contact, or on the nerves that
are distributed to the lining membrane of the blood-vessels, as sug-
gested by Messrs. Addison and Morgan.3  The  same  objection,
however, applies to the explanation of these gentlemen as to that

  1 Pharmacopoeia of the United States, p. 59.  Philadelphia, 1842.
  a Christison, Treatise on Poisons, 1st Amer. from 4th  Edin. ed. p. 582. Phila. 1845.
  * An Essay on the Operation of  Poisonous Agents upon the Living Body. London,
1829. 
26
ACIDUM HYDROCYANICUM.
 which ascribes the effects to the poison being taken into the blood—
 that the fatal  result is often too sudden  for us to  presume, that  it
 has entered the blood-vessels; unless we esteem it an agent pos-
 sessed of powerfully penetrating  properties.
   A female, who was deceived by the odour of a  solution  of hy-
 drocyanic acid  in  alcohol, drank a small vialful,  and died  in two
 minutes  as  if struck  with  apoplexy.   A strong healthy man,
 thirty-six years of age, being  detected  in  thieving, swallowed  a
 small vialful of the acid, staggered a few steps, and fell dead.   Four
 or five minutes afterwards, the physician who was called found him
 lifeless, without the slightest trace of pulse or respiration.   In  a
 few minutes, convulsive expirations were observed, but no indica-
 tions of returning life:  the face was sunken and livid ; the hands
 and feet deadly cold; the  forehead and face cold and dry; and the
 eyes half open and glassy.1
   M. Damason2 relates the case of a  druggist, who had some hy-
 drocyanic acid in a vial with a ground stopper, and, as it had been
 prepared  almost three  months, thinking that  it was decomposed,
 he opened the  vial, and applied it to his nose to ascertain whether
 the  acid retained any smell; he instantly fell down, and remained
 for half an hour without giving the slightest signs of life; but  finally
 recovered after an  illness of several days.
   Many experiments have been  made on animals with this acid.
 A drop, introduced into the bill or anus  of  a sparrow, induced
 death in from one to  two minutes, preceded by convulsions.  Even
 holding the bill over a vial filled  with the acid proved fatal.  A
 duck was destroyed by fourteen drops.   Twenty drops introduced
 into the stomach of a rabbit killed it in three  minutes.   When a
 few drops wrere injected into the jugular vein, death  supervened
 still sooner.  A small dog, to which two drops had been given,
 experienced shortness of breath, staggered, fell, passed its urine re-
 peatedly, vomited twice, and afterwards seemed quite well.   The
 same animal took, five hours later, eight drops, and fell into a te-
 tanic, comatose condition,  but recovered  in half an hour.  More
 severe but not  fatal effects resulted from sixteen drops.  Thirty to
 forty drops administered to dogs  and  cats  produced violent con-
 vulsions and death, in from six to fifteen  minutes.
   The experiments of Emmert and  Coullon seem to have shown
 that the action of  hydrocyanic acid  is more violent  when it is in-
jected into the  jugular  vein, or inhaled  in a  concentrated  form;
 less  so when injected into the rectum.  In the case of a horse, into
 whose jugular  it was injected, death occurred  in twenty-one mi-
 nutes.  When  placed in contact with  the dura mater,  or  with
  1 Hufeland. Journal der Practisch. Heilkund. Band. xl. St. 1, S. 85—92, and Osann,
 in Art. Blaus'aure, in Encyc. Worterb. der  Medicinischen Wissenschaft. Band  v. S.
 528, Berlin, 1830.
  * Journal de Chimie Medicale.  Juin, 1831. 
ACIDUM HYDROCYANICUM.
27
 nerves, no striking  phenomena were perceptible.  This  fact was
 confirmed by Viborg.1  On the other hand, when received into a
 wound in its concentrated state, it acts most violently.   Scharring,
 who broke a glass containing the acid, and received some of it into
 the wound produced thereby, died in an hour after the accident.
   It is not easy to deduce comparative results from the discordant
 statements of different experimenters, inasmuch as we are ignorant
 of the precise strength of the acid employed.  A French physician
 made some experiments on  the  uncertainty of the strength of the
 medicinal acid; and found, that he could swallow a  whole ounce
 of one sample, and a  drachm of a stronger sample, without  sus-
 taining any injury:  but on trying some, which had been recently
 prepared by Vauquelin,  he was immediately taken ill, and nar-
 rowly escaped with life.3   Dr.  Pereira3 caused the instantaneous
 death of a rabbit by applying its nose to a receiver filled with the
 vapour of the pure acid:  the animal  died without  a struggle.   A
 drop of the pure acid of Gay-Lussac, placed in the throat of the
 most vigorous dog, caused it to fall dead after two or three hur-
 ried respirations.4
   We have already alluded to the effect of the acid when  dropped
 upon the conjunctiva—a  mucous surface, and therefore possessed
 of highly absorbing powers; but it cannot even be placed with im-
 punity in contact with surfaces, which, owing to  their being co-
 vered with cuticle, do  not readily absorb.  Orfila5 states, that a
 professor of Vienna having prepared  a pure and concentrated acid,
 spread a certain quantity of it on his naked  arm,  and  died a short
 time afterwards.  Dr.  Christison,6 however, says  this was proba-
 bly a mistake.   On repeating some of the experiments, he found,
 that a single drop, weighing scarcely a  third of a grain, dropped
 into  the  mouth of a  rabbit, killed it in eighty-three seconds,
 and began to  act  in  sixty-three;  that three  drops,  weighing
 four-fifths of a  grain, in like manner, killed  a strong cat in thirty
 seconds, and began to act in ten  ; that another was affected by the
 same dose  in five, and died in forty seconds; that  four drops,
 weighing a  grain and a fifth, did not  affect a rabbit for twenty se-
 conds, but  killed it in ten seconds  more; and that  twenty-five
 grains, corresponding with an ounce and a half of medicinal acid,
 began to act on  a rabbit, as soon as it was poured into its mouth,
 and killed it outright  in  ten  seconds at  farthest.  Three drops,
projected into the eye, acted on a cat  in twenty seconds, and killed
it  in  twenty more;  and the same quantity, dropped on  a  fresh

  ' Osann. loc. cit. S. 580.
  2 Revue M^dicale, xvii. 2C5, and Christison on Poisons, 1st American Edit. p. 582
Phila. 1H45.
  3 Elements of Mat. Med. &c, 2d edit. i. 437, Lond. 1842.
  4 Magendie. in Annales de Chimie et de Physique, vi. 347, and  Formulaire, &c.
  5 Toxicologie.                     6 Op. cit. p. 592. 
28
ACIDUM HYDROCYANICUM.
wound in the loins, acted in forty-five, and proved  fatal in one
hundred  and five, seconds.1
  As before  remarked, from the  rapidity with which the toxical
effects are observed after hydrocyanic acid has been  taken, it has
seemed to be almost impossible for the  poison to have entered the
blood-vessels, and have passed with the current of the circulation
to the great vital organ on which its deleterious agency is exerted.
The well devised and carefully conducted experiments of Professor
Blake,2 of St. Louis, show, however, that in the case of this poison,
as of every other, the velocity of the circulatory current is so great,
as to enable  us to understand  that the deadly influence  may be
exerted in all cases by the reception of the poison into the blood.
He  found, that sufficient time always elapses between the applica-
tion of the poison and the first  evidences of  its action to admit of
such  contact.  In  an experiment on a rabbit with  hydrocyanic
acid,3 the animal, immediately after the contact of the  acid with
the lining  membrane  of the mouth, jumped from the table, and
when on the floor was perfectly able to stand on its feet.  At two
seconds and a half after  the  application  of the poison it  fell on its
side,  and in five seconds was dead.  " This," says Dr. Blake, " is
but one of many experiments which have been performed on cats
and rabbits, and in no  instance  have  I observed instantaneous
death, or even the instantaneous action  of the poison."4
  If given in rather too strong a dose,  or—if in proper  doses—at
too short intervals, it produces headach, and  vertigo,  which go off,
however, in a few  minutes.   When  inhaled, even if  diluted with
atmospheric air, it causes vomiting, prostration, pains in the back
part of the head, and  great  diminution  of the arterial pulsations.
In a  more concentrated  state, the effects are more  rapidly fatal
than in any other form of administration.  M. Robert found, that
when a bird, a rabbit, a cat, and  two dogs, were made to breathe
air  saturated with its vapour, the first  and second  died  in one se-
cond ; the cat in two seconds, one dog in five, the other in ten se-
conds.5
  With regard  to  the  parts of  the economy that are  primarily
acted upon  by the hydrocyanic acid after it has entered the blood,
most observers have designated the nervous system.6   In no other
way, it has been conceived,  is it as easy to account for the extreme

  1 See, also, Geoghegan, in Dublin Medical Journal, for 1835, and Pereira, On. cit
p. 242.                                                      l
 ^ 2 Edinb. Med. and  Surgical  Journal, April, 1839, p. 339, and St. Louis Med. and
Surg. Journal, Nov. and Dec,  1848.
  2 American Journal of the  Medical Sciences, July, 1849, p. 106.
  *  See the Author's General Therapeutics and Materia Medica, 4th edit., 8vo., Phila.
1840.                                                  '.
  6 Annates de Chimie, xcii. 59.
  •  Lonsdale, Edinb. Medical and Surgical Journal, January, 1839, and Lond. Lancet,
June 15th, 1839, p. 440. 
ACIDUM HYDROCYANICUM.
29
rapidity of its action in fatal cases.  When mixed with the blood,
however,  out of the  body, it altogether changes the character of
that fluid, and opposes its coagulation;1 and a  recent writer, M.
Coze,' of Strasburg, is of opinion, that it  affects more especially
the circulatory  apparatus;  death resulting from  the suspension of
the movements of the heart, and  the constriction of the ultimate
arterial divisions, whence follow repletion  of  the  larger arterial
trunks and stasis of the blood—the  convulsions being owing to a
defective  supply of blood to the spinal marrow.  Some of the Ger-
man writers3 have endeavoured to indicate three grades  of its ac-
tion on the economy.  First.  In moderate  doses, long continued,
it occasions a marked diminution in the  action of the nervous and
vascular systems; vertigo; disposition to syncope; epistaxis as a
consequence  of  thinness of the blood;  and a disposition  to putrid
diseases."*  Secondly. In larger doses, the sedative effect of the
acid on the spinal marrow, and the abdominal ganglia, is indicated
by  feelings of weakness, numbness, tremors, and other involuntary
motions of the extremities; involuntary  discharge of the urine and
faeces; augmentation of  the  cutaneous and  urinary depurations;
palpitations; anxiety at  the praecordia ; weak pulse; and, accord-
ing to some,  headach, especially in the back part of the head;  ex-
coriation  of the  tongue and inner parts of the cheeks,5 and saliva-
tion.   This  last symptom is given by Dr. Christison6 on the au-
thority of Drs.  Macleod  and Granville.7   It has been suspected,
however, that salivation, in these cases, was brought about by the
use of an  impure acid, containing probably a small quantity of the
corrosive  chloride of mercury, particularly if the acid had been pre-
pared—according to  the  process of the Dublin  College—with bi-
cyanuret of mercury, muriatic acid and water.  Mercury is, indeed,
asserted to have been actually discovered in the acid  by Sylvester's
test.   Thirdly. In still larger doses, it induces violent affections of
the spinal marrow, convulsions, trismus, opisthotonos, e'mprosthoto-
nos, fainting, &c.
  From the  results of all his observations, Osann8 infers, that hy-
drocyanic acid  acts  dynamically on the  nervous system,  by di-
minishing, depressing, and annihilating  its life;  and, through the
nervous system, affecting the organs of vegetation or nutrition, and
of hsematosis;—that it incontestably has a specific relation to the
spinal marrow, the ganglions of the abdomen, and  the dependent

  1 Migendie, Lectures on the Blood. Lect.xvii. in Lancet, for Jan. 26,1839, p..636,
and  Blake, Op. cit.
  2  liouchardat, Annunire de Therapeutique pour 1850, p. 20.   Paris, 1850.
  * Richter, Specielle Therapie, Band. x. S. 280.  Berlin, 1828; and Osann, loc. cit
S. 527.                    4 Enryc. Worterb. B. ii. S. 315.  Berlin, 1828.
  ' Bom, in Rust's Magazin, B. xiii. S. 282.           6 Op. citaf.
  "■ Lond. Med. and Phys. Journ. xlvi. 359 and 363.     8 Loc. citat. S. 526.
3 
30
ACIDUM HYDROCYANICUM.
organs; and hence it is, that, in comparison with other narcotic
agents, it  is less stupefying, whilst it influences more deeply the
phenomena of vegetative  or organic  life.   He properly remarks,
however,  that the inferences of Jorg,' from his  experiments, are
apparently opposed to this view.   Jbrg considered its effects upon
the brain to be excitant, and that it occasioned turgescence of that
organ.
  There would seem to be no distinct  evidence of hydrocyanic acid
being a cumulative poison, although  this has been  at  times sus-
pected.  Its operation must be diligently watched  at  first, until
the proper dose is  ascertained.   This, says Dr. Christison,* is the
only secret for using it with  safety and confidence.

           EFFECTS ON THE ECONOMY IN DISEASE.
  From  the effects  produced  by  the hydrocyanic acid  on the
healthy body, we  may infer the cases of disease  in which  it may
be indicated.   It is decidedly sedative, allaying nervous irritability
and vascular action, and therefore adapted for all cases in which
these  are  inordinately excited.   Yet its power, as a medicinal
agent, is not as great as was at one time presumed,  and as is still
presumed, by many.  In  some countries, too. it  has found more
favour than in others.  In Italy, France and England, it has been
more extensively used than in Germany;  yet in many of the Phar-
macopoeias of the last country it has been admitted into the list of
officinal agents.  The great objections that have been urged against
it are—its danger, even in a  small dose,  if not carefully adminis-
tered; the difficulty of having it always of the same strength; the
impossibility of administering it undiluted, and the danger of giving
too strong a dose in consequence of its rising  to the surface of
water.  More than once the difference in the strength of the acid
prepared  by different methods would  seem to have occasioned un-
fortunate results.  Orfila,* mentions the case of a sick person, who
had used it for a length of time in increasing doses, with advan-
tage;  when, being compelled to send her  prescription to another
apothecary, the  acid he employed was  so strong as to produce
death, with all the symptoms of poisoning by hydrocyanic acid.
For these and other  reasons,  Riecke, L. W. Sachs,  and Osann
greatly prefer the  Aqua lavrocerasi and  the Aqua amygdalarnm
amararum, which, although in  other respects not less objection-
able,  are  less dangerous.4   Sir  George   Lefevre5 affirms that
cherry-laurel water  is a more effective  preparation than hydro-

  ' Materialien zu einer kiinftigen Heilmittellehre, B. i. S. 53, 117.
  1 On Poisons, edit. cit. p. 588.
  1 Toxicologic.
  ' Die neuern Arzneimittel, u. s.  w. von V. A. Riecke, S. 5. Stuttgart, 1837; Osann,
loc citat, and Encyclop'ad.  Worterb.  ii. :>I5.
  * An Apology for the Nerves, &c.. p. 291.  Lond. 1844. 
ACIDUM HYDROCYANICUM.
31
cyanic acid.   In many nervous affections, as palpitation, hysteria,
&c, he generally prescribes the following draught:
                  R.  Aq. lauro-cerasi trj/ xx.
                      ----flor. aurant. f £i.
                      Syrup tolut. f gj.   M.
   The draught to be  taken pro re nata.
   Possessed of the  powerful sedative  agency which has been de-
 scribed, it is not to  be wondered at, that hydrocyanic acid should
 have been given in  a  multitude of  cases; and, as constantly hap-
 pens, that unsuccessful trials, suggested by the merest empiricism,
 should have been made with it.
   It is rarely employed in fevers,—intermittent, remittent, or con-
 tinued.   By  many, it has been esteemed  beneficial in hectic; but
 here its agency must  be doubtful.1
   In  inflammations, especially when accompanied  with  marked
 erethism of the nervous system, it  has been greatly extolled, and,
 next  to  blood-letting, has   been  regarded by many as one of our
 most valuable antiptiiogistics.  The followers of the contra-stimu-
 lant school esteem it as one of their most efficacious contra-stimu-
 lants.   In the  acute inflammations of internal organs, it has been
 highly recommended  by the Italian physicians, Borda and  Brera ;
 in thoracic inflammation,  after blood-letting, in conjunction writh
 tartrate of antimony and potassa, and similar sedative agents; and
 by  others yi enteritis, metritis,  and  nephritis, and  in  active he-
 morrhages.   In chronic  inflammations it has been advised  by
 Granville, Magendie, Heller, Elwert, Behr, Rocb, &c, and  espe-
 cially  in chronic catarrh, bronchitis, and  hooping cough.  In
 the last affection it  is  conceived  by Dr. A. T. Thomson* to  be
 "the sheet anchor of the  practitioner;" and by Dr. Roe!  to pos-
 sess a " specific" (?) power.   In warm weather, he thinks,it will
 cure  almost  any case of simple hooping cough  in a short time;  in
 all seasons it will abridge its duration, and in almost every instance,
  where it does not cure, it will,  at least, materially relieve the se-
  verity of the cough.
    In pulmonary consumption it has  been recommended by Gran-
  ville,  Magendie, S.  G. Morton,4  Fantonetti,5  and  others,  parti-
  cularly where there is any inflammatory or spasmodic complication;
  but others as  Neumann, Weitsch,  Sir James Clark, Andral,0 For-
  get,7 and, we may add, ourselves, have given it in these very caves
  without any success.   By some, indeed, it has been affirmed, that

   1 See the author's General Therapeutics and Mat. Med., 4th edit. ii. 183, Phila. 1850.
   J Elements of Mat. Med. and Therapeutics, i. 435.  Lond. I8H2.
    3 A Treatise on the Nature and Treatment of Hooping Cough. &c , p. 10. Lond. 1838.
    ' Illustrations of Pulmonary Consumption, p.  131. Philad. 1834.
    • (Jazette des Hopitaux. U» Fev., Ib39.
    5 Bulletin General de Therapeutique, Mars, 1840.
    1 L'Experience, 14 Nov., 1839; and Amer. Med. Intel., Sept. I, 1840, p.  170. 
32
ACIDUM HYDROCYANICUM.
its  administration in phthisis is to be adopted with caution, as in
many cases, instead of allaying, it appears to increase, the cough
and fever, diminish the expectoration, and occasion a sense of suf-
focation.1  It has been, moreover, asserted, that its depressing and
destructive agency has acted injuriously on  the  organism of the
consumptive.3
  In chronic nervous diseases, especially when  of a  spasmodic
character—as in spasmodic affections of the heart—even when
organic, hydrocyanic acid has been  advised  as a soothing agent,
as well as in spasmodic asthma;  in the sense of suffocation
that accompanies hydrothorax and other affections; and in spas-
modic dysphagia.   Its efficacy, too, has been marked, according
to Dr. Elliotson,5 in  various neuropathic disorders  of the sto-
mach, especially in those in which  pain at  the  epigastrium was
the leading symptom,—in  every form, indeed, of gastrodynia;
and in painful affections of the bowels, of a similar character
—enteralgia—it has been  found useful by Dr. Pereira.4
  In  enlargement of the heart it was found by Heller to dimi-
nish the force and frequency of the pulsations, and  in this way to
afford essential relief.  In an old person, labouring under anasarca
accompanied by great pain in the breast, Dr. Rees observed,
after  the administration of Vauquelin's  acid, great diuresis, with
the removal of the dropsy and its concomitant symptoms.5
  In the asthma pulverulentum of the Germans, (Staubasth-
ma,)  that is, in  the variety to which millers,  bakers, grinders and
others are liable, Creutswicher is said  to have  found it  highly
serviceable.6   Its efficacy has  not been so marked in epilepsy,
chorea, and  kindred  affections;  yet  it has been  strongly  recom-
mended in tetanus.  Trevezant ordered it in  a case of irau t attic
tetanus, after opium had been  given in vain, in  the dose of from
two to twelve drops with  favourable results.7   On the other hand,
Klein gave it in a similar  case, with no other  apparent effect than
that of rendering death more easy.8   It has likewise been advised
in spasmodic pains of the  uterus.   Yet, although it would seem
to be soothing and antispasmodic in many cases of erethism, Grin-
del  and Osann9 consider  it by no means  adapted for  the radical
cure of spasmodic diseases.
  In violent  neuralgia, especially in an impressible condition of

  1 Schneider, Med. prakt. Adversatien am Krankenbette, Erste Liefer. S. 62, referred
to by Osann.
  2 Piebenznndi. in Hufeland's Journal der pract.  Heilkund.  B. liii.. St. 6, S. 15.
  * Cn the Efficacy of Hydrocyanic or Prus*ic Acid in Affections of the Stomach, &c.
Lond 1 *20.
  4 Op. citat.. p. 443.
  5 Osann Op. cit.. and Harless, Rhein-Westphal. Jahrbuch. Bd. x. St 1, S. 82.
  " Rust's Mngazin, Bd. xxii. 8. 335.
  ' Fn.riep's Noti/.en, Rd. xiv. No. 15, S. 324.
  ' Heidelberger  Klinische Annalen, Bd. ii. S. 112.
  * Loc. citat., S. 535. 
                   ACIDUM HYDROCYANICUM.                 33

the vascular system in  nervous  cephalalgia, hemicrania,  tic
douloureux, and in gouty rheumatic sciatica, it has been  ex-
tolled.   Dr. E.  S.  Bonnet,1 of Charleston, treated  successfully
some cases of facial neuralgia of great severity, by applying it
externally in the form of the distilled water  of prunus lauro-cera-
sus.  It is  proper, however, to remark, that in  two of the three
cases described, belladonna was employed in combination.  The
mode of applying it was by lotion, composed of four ounces of the
laurel water, one  ounce  of sulphuric ether,  alone, or with  half a
drachm or a drachm of extract  of belladonna.  With  this lotion
the affected parts, previously covered with  carded cotton or cotton
wadding, were kept constantly wet.  It has likewise been  recom-
mended  by Dr. Elliotson2  in the cure of vomiting not dependent
upon inflammation.
   These are the chief cases in which  its internal use has been
prescribed.   It has been  employed externally in the following.
As a soothing  agent in  severe pain;—for example, in toothach
from caries; one to two drops, according to Elwert, being put into
the hollow tooth.  Krimer applied it in a dilute state  to painful
ivounds; and it has been  injected with advantage into fistulce.
   In neuralgia, the application of a cataplasm of belladonna and
hydrocyanic acid has been advised by some.
   In cutaneous affections, of an  itching, painful  or inflammatory
nature, it has been used  with much success.   In five cases  of  ob-
stinate herpes, Schneider used a solution of the acid in  alcohol: in
similar cases Dr. A. T.  Thomson, besides  the use of a purgative
of calomel  and colocynth, applied compresses to the parts wetted
with the dilute acid.  In two cases of impetigo, the local applica-
tion completely  allayed the distressing and intolerable itching and
tingling, after other external applications,  and the internal use of
anodynes, had  been of no avail.   The discharge was  diminished
and rendered milder: alterative doses of mercury, combined with
sarsaparilla, formed  the internal treatment.3   Dr. Thomson found
the lotion useful, in combination with small doses of corrosive chlo-
ride of mercury, in acne rosacea,  and in several other cutaneous
affections.   In herpes,  Magendie advises  a  lotion of hydrocyanic
acid and lettuce water in the proportions mentioned hereafter.
   The acid has likewise  been used, in the form of glyster, in scir-
rhus  of the pylorus, in the strength of six drops of Vauquelin's
acid to eight ounces of water;* and uterine pain from scirrhus,
injections of the acid, combined with infusion of  belladonna, have
been employed  with advantage.

  1 North American Archives of Medical and Surgical Science, April. 1835.
  2 Lond. Med. Gazette. 1H.3I, and  Amer. Journ. of Med. Sciences. May, 1831. p. 242.
  * London Medical and Physical Journal Feb. 1^2; and the author's edit, of Magen-
dies Formulary, p. I 12.  Lond.  1*24.  Philad. 1825.
  ' Bernd, in Rust's Magazin. Bd. xiii., S. 273. 
34
ACIDUM HYDROCYANICUM.
  In ophthalmia, especially of the scrofulous kind, with engorge-
ment  of the conjunctiva, it has been  advised  by  Elwert1—two
drops of the acid being mixed with a drachm of water, and a little
dropped frequently into the eye; and it has been given in the ac-'
tive inflammatory stage of blennorrhcea.2
  Its vapour has been advised in amaurosis, and in opacity of the
cornea;3 but  it does  not seem to be  entitled  to  much  credit in
those affections.
  Lastly, when a portion of taenia has protruded from  the rectum,
it has been advised by Cagnola, Golnecke,and others,  that hydro-
cyanic acid should be applied  to  it with the view of destroying
it.4
  Such are the principal affections in which tne hydrocyanic acid
has been used.   The  author has often employed  it internally in
many of the cases recommended, especially in  painful  affections
accompanied by great  nervous impressibility, anrl  in consumption,
but he has not had sufficient reason to place it high  in rank amongst
medicinal  agents.5  He has  certainly  had no  evidence,  that  it
can cure consumption  when not beyond its  first stage, as remarked
by Magendie.6   If the practitioner will bear in mind the  effects
which the  acid is capable of inducing upon healthy man, when the
dose is carried to the requisite extent, he will have no  difficulty in
decirling upon  the cases in which  its agency may  be appropriate.
If not a true sedative, it  is the nearest approach  to  one  in the
catalogue of the materia medica; and  therefore its employment is
clearly indicated in all diseases in which there is much  erethism,—
administered alone or  along with other appropriate agents.

                  MODE OF ADMINISTRATION.
   After the remarks that have been made on the varying strength
of the hydrocyanic acid, according to the particular form by which
it may have been prepared, it is hardly necessary  to say, that the
physician  must be acquainted with the character of  the acid  he
prescribes.   The ordinary dose of that  of the  Pharmacopoeia
of the United States is a drop,  given three  times a day in a little
sugared water: it must be borne in mind, however, that  the spe-
cific gravity of the acid is less than  that of water, and  hence the
necessity of dropping the quantity of acid  at the time of using it,
rather than forming a mixture with a larger quantity of the acid,
which will certainly rise  to the surface, if the mixture  be  put to

  1 Rust's Magazin, B. xiii., S. 182.
  ' Ibid. B. xiii., S. 228.
  ' Paterson in Lond. Med. Gaz. May 15, 1844, p. 808.
  * Osann, Op. cit, and Gerson and Julius, Magaz. d. ausl'andischen Litteratur der
gesammt. Heilkund. B. ii. 177.  Also, Hufeland und Osann's Journal  der prakt. Heil-
kund.  Bd. Iviii, St. 6, S. 122, and Richter, Op. cit, S 313.
  'See, also, Becquerel. Gazette Medicate de Paris, 13 Jan., 1840.
  ' The author's edit, of his Formulary, p. 108. 
ACIDUM HYDROCYANICUM.
35
one side:  and unless the vial is shaken, a much larger dose may
be administered than  was intended.   It  must also be  recollected,
that the acid loses its strength by keeping.   Magendie remarks,1
that when left to itself in a close vessel, it sometimes becomes de-
composed in less than an hour, and that it rarely preserves its in-
tegrity  for more than a fortnight.
   The substances  that are incompatible with it in  the same pre-
scription,  are  most metallic oxides, particularly those of mercury
and  antimony, nitrate of silver,  salts of iron, sulphurets, mineral
acids and chlorine.
   The proper plan is to begin with  a small dose and  to augment
it  carefully until some effect is induced, but if  any of  the signs—
mentioned above as  indicating the  supervention of the sedative
effects of  the acid—should supervene, it ought to be discontinued.
   Magendie, it has been seen, uses the hydrocyanic acid of Gay-
Lussac, diluted with 8.5 times its weight of  water;  and this mix-
ture he  denominates medicinal prussic acid.
   The following are forms in  which the acid may be administered.
               Mistnra  acidi  hydrocyanici.
                Mixture of hydrocyanic acid.
                       {Melange  pectoral.)
              R.  Acidi hydrocyanici medicinalis f gj.
                 Aquae destillatse Oj.
                     Sacchari albi Jiss.   M.
   A dessert-spoonful  of this is directed to be taken every morn-
ing and evening at bed  time—the dose being gradually increased
to six or eight  spoonfuls in the 24 hours.           Magendie.
             R. Acidi hydrocyanici (Scheele's) ITLxij.
                 Vin. antimon. f gj.
                 Tinct. opii camphoratae f ^iiss.
                 Aquas camphora f ^vijss.  Fiat mistura.
   Dose.—In hooping cough, a table-spoonful every four hours for
a delicate  boy four  years old, to be given in some warm drink. The
child to remain in  a warm room,  and to live upon  light pudding
and  broth.                                             Roe.
          R.  Acidi hydrocyanici (Scheele's,) nr, xx.
             Vin.  antimon. f jiss.
              ----ipecacuanhas f ,^iss.
              Aquae f ^xiij.  Fiat mistura.
   Dose.—A  tea-spoonful every  two hours for a healthy-looking
female child, five years of age.                          Roe.
              Sympns  acidi  hydrocyanici.
                 Syrup of hydrocyanic acid.
              R.  Syrupi purificat.   Oj.
                  Acidi hydrocyanici medicinalis f 3j.  M.
' Op. citat. p. 104. 
36                     ACIDUM LACTIS.

  This syrup may be added  to  common  pectoral mixtures, and
used as other syrups are.                          Magendie.
               Lotio  acidi  hydrocyanici.
                Lotion of hydrocyanic acid.
              R.   Acidi hydrocyanici f ^ss.
                  Alcohol, f §j.
                  Aquae destillat. f ^xss.
  This was the lotion employed  by Professor Thomson  in  cases
of impetigo.
  The following was used by Schneider in herpes.
              R.   Acidi hydrocyanici f 31SS.
                  Alcohol, fgvi.  M.
  And in the same cases  Magendie employed the subjoined for-
mula.
              R.   Acidi hydrocyanici f ,^ij.
                  Aq'iae lactucae Oij.  M.
  The distilled water of the garden lettuce probably contains no-
thing to recommend it over common distilled water.
  Dr. Joy1 advises  the  following lotion in acne and impetigo
to correct itching; and in ulcerated cancer to diminish pain.
              R.   Acid hydrocyan. dil. f gi—3iv.
                  Decoct, malvae Oj.  M.
  The bottle should be shaken before each application.
  All these formulae are objectionable for  the reasons before as-
signed;  and it is consequently  better to drop the acid  at  the time
of using it,  taking care that it  has not lost its properties.
                   V.  ACIDUM  LACTIS.
  Svnonymes. Acidum Lacteum seu Lactis seu Lacticum, Lactic Acid, Acid
of milk.
  French. Acide Lactique.
  German.  Milchsaure.
  This  acid has been  recommended  as  a therapeutical agent  by
Magendie.3

                   METHOD OF  PREPARING.
  Lactic acid may be obtained  either from milk or from ihe juice
of the red beet.  In the latter case, the juicp is put in a situation
the temperature of which is between 77° and 86° Fah.   After  the
lapse of a  few days, a commotion is observed in the  mass, which

  1 Tweedie's Libr. of Med., v. 288, Lond 1840. or Amer. edit.
  2 Formulaire pour la preparation et 1 emploi de plusieurs nouveaux medicamens, &c,
Edit. 9erne. Paris, 1836. 
ACIDUM LACTIS.
37
 is known under the name " viscous fermentation," [fermentation
 visqueuse,) and hydrogen and  carburetted hydrogen are evolved
 in considerable quantity.  When the mass has become fluid again,
 and the fermentation has ended, which generally requires  about
 two months, it is evaporated  to the  consistence  of syrup, the
 whole  then becomes traversed  by a multitude of mannitic crys-
 tals, which—when  washed with a small quantity of water, and
 dried—are entirely pure. . The mass, moreover, contains a saccha-
 rine matter, which affords all the signs  of the sugar of the grape.
 The product of the evaporation is next  treated  with  alcohol; this
 dissolves the lactic acid, and  precipitates several substances that
 have not yet been examined.   The alcoholic extract is then dis-
 solved  in water, which  occasions  a  fresh precipitation.  The li-
 quid is now saturated with carbonate of zinc, and by this means
 a fresh precipitation is effected, more copious than the preceding.
 By concentration, the lactate of zinc shoots into crystals, which
 are collected and heated  in water, to which animal charcoal,
 previously washed  in muriatic  acid, has been added: the fluid is
 then filtered, and the lactate of zinc is deposited in perfectly white
 crystals: these are washed in boiling alcohol, in which they are
 insoluble; afterwards they are treated with baryta, and then with
 sulphuric acid, which separates the lactic acid.  This is finally
 concentrated in vacuo.1
   Mitscherlich3 gives the following process for preparing it  pure.
 Lactate of lead, formed in the usual way, is decomposed by sul-
phate of zinc; the sulphate of  lead is separated, and the lactate
 of zinc crystallized by evaporation; this is at first yellow, but by
 repeated crystallizations it is obtained of a pure white.  This so-
 lution  of the lactate is decomposed by pure baryta ; the oxide of
 zinc separated, and  the lactate of baryta, which is  in solution, is
 decomposed  by sulphuric acid, and the fluid evaporated; this
 yields  a clear, colourless, syrupy, not volatile acid, which is de-
 composed,  and  leaves a residue of charcoal when heated at a suffi-
 ciently high temperature.
   Milk, which has been suffered to ferment for a long while, and
 is treated in the same way, affords lactic acid.  Corriol has like-
 wise detected it in an aqueous infusion of the  nux vomica.
   When concentrated in vacuo until it partswith no more water,
 lactic acid is a  colourless liquor, of syrupy consistence; its specific
 gravity being about  1.215.   It is inodorous, but of a very sour
 taste, similar to that of the strongest vegetable acids.   When ex-
 posed to the air, it attracts moisture.   Water and alcohol dissolve
 it in all proportions.  One of its most striking  properties, which

  1 Gay-Lussac and Pelouze, Annates de Chimie et de Physique, Avril, 1833   (Tom
lii. 410.)                                                    v
  Q Report to British Association, 2d meeting, and Phila. Journal of Pharmacy, vi 83.
Philadelphia, 1834-5.                                         '' 
38
ACIDUM LACTIS.
is of especial interest to the physician, is, that it quickly dissolves
phosphate of lime, especially that which is contained in bones.

                 EFFECTS ON THE ECONOMY.
  As lactic acid was conceived to play a part amongst the juices
which effect the solution of the food in the  stomach, Magendie
thought it might be given with advantage in  cases of dyspepsia
produced by simple debility of the digestive  apparatus; and his
experiments afforded him very encouraging  results.
 , In consequence  of the facility with which  lactic  acid dissolves
pnosphate of lime, it has been suggested, whether it might not
be administered with  advantage in cases of while gravel, or, in
other words, of phosphalic depositions from the urine.  Magen-
die has not yet been able to institute experiments on this matter.
At the time when the edition of his Formulary, to which we have
referred, was published, he had commenced  some clinical experi-
ments with lactate of potassa,and lactate of soda, but without any
results worthy  of being communicated to the profession.   He re-
commends these salts, however, to  the attention of physicians.

                 MODE OF ADMINISTRATION.
   Magendie gives lactic acid either in the form of lemonade or of
lozenges.
                    Fotns acidi lactis.
                   Lemonade of lactic acid.
                R. Acid. lact.  liquid, f £j. ad ^iv.
                   Aquae Oij.
                   Syrupi f £ij.  M.

                  Pastil li acidi  lactis,
                    Lozenges of lactic acid.
                  R.  Acid. lact. pur. 31J.
                     Sacch. puiv. ^j.
                      Gum. tragac. q. s.
                     01. aether, vamol. gtt. iv.  M.
   Make into  lozenges weighing  half  a  dram each.  Let them
be kept in a well closed vessel.  Of these, from two to six may be
taken in the 24 hours without any evil consequences.
                VI. ACIDUM TAN'NICUM.
Synonymes. Acidum Querc-tannicum, Tanninnm Purnm, Tannicum, Prin-
  cipium Adstringens seu Scytodephicum, Tannin, Tannic acid.
French. Acide Tannique.
German. Tannin, Gerberstoff, Gerbsaure.

  This article, in its pure state, has been subjected to experiment
of late years only. 
ACIDUM TANNICUM.                    39
                   METHOD  OF PREPARING.
   According to Buchner,1 tannic acid should be prepared for me-
dical use in the following manner.  From eight to twelve parts of
hot water must be poured on one part of powdered galls, and  the
mixture be allowed  to  digest for an  hour, frequently  agitating it.
It must then be filtered, and  the  residue be again  treated in  the
same manner with  a little hot  water.   The different infusions,
which generally pass through the filter turbid, must be mixed to-
gether, and a little dilute sulphuric acid be added by drops, con-
stantly shaking the mixture so long as any precipitate of tannic
acid follows.   The  acid is  deposited very soon  in this way, in a
collected yellowish white, gelatiniform mass, which  by the influ-
ence of air gradually assumes a brown colour.
   After the fluid is  poured off, the  residue  is washed  twice with
cold water acidulated  with sulphuric acid:  carbonate  of bary-
ta, or  carbonate of potassa, is then added  to it in small portions,
carefully shaking  the mixture, until there is no farther efferves-
cence, and until a  portion of the mass dissolved in water and test-
ed by chloride of  barium affords no more evidence of the presence
of sulphuric acid.   The yet  moist mass is  then put into a  retort
with alcohol of about ninety per cent., which is added repeatedly
in small portions;  the alcohol is made to boil, to dissolve  the tan-
nic acid, and  separate it from  the sulphate of baryta or sulphate of
lime;  the  alcoholic solution  is then poured off clear, and by a gen-
tle heat evaporated  to dryness.
   The following form for its preparation is given in the last edi-
tion of the Pharmacopoeia of  the United States (1842.)  Take of
Galls, in  powder; Sulphuric ether,  each a  sufficient quantity.
Put into a glass adapter, loosely closed at its lower end with card-
ed cotton, sufficient powdered galls to fill about one half of it; and
press the powder slightly.   Then fit the adapter accurately to  the
mouth of  a receiving vessel;  fill it with the sulphuric ether, and
close  the upper orifice so as to prevent the escape of the ether by
evaporation.   The liquid which passes separates into two unequal
portions,  of  which  the lower is much smaller in quantity and
much denser than the upper.
   When the ether ceases to pass, pour fresh  portions upon  the
galls, until the lower stratum of liquid in the receiver no longer
increases.  Then separate this from the upper, put it into a cap-
sule, and evaporate with a moderate heat to dryness.   Lastly, rub
what  remains into  powder.   The  upper  portion of liquid will
yield by distillation  a quantity of elher, which, when washed with
water, may be employed in a subsequent operation.
  1 Repertorium, B. xxxiv. H. 3; also, A. W. Buchner. Neueste Entdeckung. uberdie
Gerbsiiure, u. s. w. Frankf. 1833, and Dierbach, in Heidelberger Klinische Annalen,
B. x. H.3, S. 339, Heidelb. 1834.
  For the process of M. Duval, see Annal.de Chimie et de Physique, and Amer.
Journal of Pharm. July, 1841, p. 171. 
40                    ACIDUM TANNICUM.
   Tannic  acid, thus prepared, is of a yellowish-white colour; of a
strongly astringent taste ;  very soluble in water, and less so in  al-
cohol and in ether.  It reddens litmus paper.1

                 EFFECTS ON THE ECONOMY.
   Tannic  acid  is a strong  astringent,2 which  has hitherto  been
mainly used in uterine hemorrhage, and especially by the  Italian
physicians.  Porta3 was,  perhaps, the  first  who tried it.   He
found  it very efficacious  in  cases not  dependent upon any or-
ganic mischief in the uterus.   It exhibits its powers, according to
him, even  in small doses—as of two grains, and is well borne  by
the stomach.   Ferrario4  likewise administered  it with advantage
in the same affection, but  he does not consider it adapted for cases
in which either partial  or general plethora, or local excitement of
the  uterus,  or  any organic  disease, exists: it is indicated  only
where mere atony is present.   He gives it in the form of powder
or pill, in  two grain  doses, six times a day.   The effect is gene-
rally good:  the hemorrhage diminishes and  soon ceases,  and, at
the same time, the strength augments, and  recovery succeeds with-
out any disturbance of the functions.   Giadorow5 details two cases
of diabetes cured by it, when given in combination with opium, as
in the prescription  at the end of this article.  The first  patient
was cured in ten, the second in twelve days.   M. Dumars6 ex-
tols  it in the same disease, administered by the mouth as well as
by the rectum.
   According to Ricci,7 tannic acid has  frequently been  employed
in Italy both   in internal  and  external  hemorrhages.   G.  A.
Ricbter,8 however, affirms, that he  has given it  in habitual me-
trorrhagia without any  advantage whatever.   Within the last
few years,  M. Cavarra9 has instituted many experiments on animals,
as well as  on himself, from which  he concludes, that when tannic
acid is placed in contact with certain parts of the living economy,
it exerts upon them the same chemico-vital action which it does on
an inert organic tissue, or,  in other words, it tans them as it tans lea-
ther.  " These  parts," he says, " are the mucous membranes of the
urethra,  vagina, intestines, and lungs.   The action of tannic acid
appears to be, to cause such a condensation or contraction in them,
that the glands with which they are studded no longer afford pas-
sage for the mucus which they secrete."
  1 Pharm. of the United States,  p. f!3, Philad.  1842.
  3 See. on the action of this agent. Mitscherlich, Medicinische Zeitung, No. 43, 1838,
and Bullet. General de Therap. 30 Mars, 1837.
  * Delpech,  Memorial des Houitaux du Midi,  tSrc. Fevrier, 1829, p. 51.
  4 Annali universal-! di Medicina, Gennajo, 1S29.
  ' Annali universali di Medicina,and Gazette Medical, Sep. 15, 1832.
  s Cited in the Provincial Medical and Surgical Journal, Nov. 18, 1842.
  ' Bulletin des Sciences Medicales, Sept. 1*28.
  ■ Arzneimittellehre, Supplement, s. (>0; also, Cavalier, in Archiv. Generates, xix. 5^9.
  * Bulletin de 1'Academie Royale de Medecine, Janvier, 1^37; also, American Medical
Intelligencer, Oct. 16, 1837, p. 258. 
                       ACIDUM TANNICUM.                    41

   M. Cavarra asserts, that he has proved  these  positions by nu-
 merous experiments and demonstrations.  When tannic acid is taken
 internally, its immediate effect  is constipation,  by  arresting the
 secretion from the  mucous membrane.   When  it has reached the
 stomach, it is absorbed, and carried into  the current  of  the cir-
 culation.  There exists between this  organ and the  vagina, the
 urethra, and the lungs, no communication except through the cir-
 culatory system, and, consequently, the tannic  acid—it is fair to
 presume—must be absorbed  to cure leucorrhcea,gonorrhoea, and
 the most obstinate chronic catarrhs.   M. Cavarra concludes, that
 of all the effects of tannic acid, two of the most surprising are, the
 cures operated by it in cases of obstinate nervous coughs, and the
 excellent action it exerts in phthisis.  Farther experiments are,
 however, demanded before this last point can be admitted.   From
 our  knowledge of  the properties of tannic acid,  it is not  easy to
 see  how it—or any  astringent —can  be of much service in the
 latter malady.  Mixed with powdered sugar, in the  proportion of
 from two to ten parts of the  acid to ten parts of sugar, it has been
 blown, with  advantage, by M. P. de Mignot,1  into  the fauces to
 facilitate the expulsion of false membranes.
   Dr. S. S. Allison,- who has for six years constantly prescribed
 tannic acid internally with much success in various diseases, speaks
 highly of it in chronic bronchial catarrh, chronic diarrha>a, leu-
 corrhoea, menorrhagia, the hemorrhagic  diathesis, and albuminu-
 ria.   As a local application, he extols it in  sponginess and hemor-
 rhage of the  gums,  relaxation of the  throat, prolapsus  ani, he-
 morrhoidal tumours, gonorrhoea: and  as  an external  application
 to the skin where astringents  are indicated.  He has found it like-
 wise of service in dyspepsia ;  and as a nervine  in several  cases of
 nervous debility, languor and excitability.   In  these last cases, he
 generally combines it with camphor,  hops, or hyoseyamus.
   M.  Subregondi3 strongly  recommends  it in  hooping-cough,
 when the period of excitement has passed away.   His practice is
 to give from  a quarter to half a grain every two hours-along with
 some soothing agent, as the  extractum  conii, and  Durr*  speaks
 highly of a combination of it  with  benzoin in the latter stages of
 the  same,  malady.    He prepares powders, each  containing  from
 two  to five cmtigrammes,—gr. ^ to  § —with 50 centigrammes—
 gr. 8 of sugar;  one to be given every two hours.

  1 Bouchardat, Annuaire de Therapeutiqne pour 1848, p. 138.
  ' London  Journal of Medicine, Jan.  1850. cited in Ranking's  Half yearly Abstract,
&c. Amer. edit., xi. 77.  Phila. 1850; and in Amer. Jour, of the Med.  Sciences, Oct.
 1R50. p. 507.
  * Cited in Northern Journal of Medicine, Dec  1844, and in Braithwaite's Retrospect,
Amer. edit. viii. 54.  New York. 1845.
  ' Cited in Provincial Med. and Surg. Journal, April  3,  1850. 
42
ACIDUM TANNICUM.
  M. Amtdee Latour1 has  highly extolled  it  for  its efficacy in
hcemoptysis'  In one case, it completely succeeded when other re-
medies .had failed; and  in three cases of hemorrhage to a  slighter
degree, it was wholly successful.   M.  Charvet; has  also recom-
mended  it in the sweats of phlhisis.   He gives it  in the dose of
from  half a  grain  to a grain  and a half,  alone or associated with
opium, and generally at bed-time.
  Hiiter affirms, that tannic  acid, prepared from dried galls, in  the
form of ointment, or  diluted with distilled water, is very serviceable
in most cases of Egyptian ophthalmia.   It has likewise been  ad-
vised  in hemorrhoids and fissures of the anus.*
  In  the hyperemesis induced  by ipecacuanha  or emetia, it may
be administered as an antidote.
  M. Druitt4 thinks, that in any case in which a vegetable astrin-
gent is indicated, tannic acid  should have the preference.  A simple
solution  in distilled water, he says, is much more easily and quickly
prepared, as  well as much more elegant, than  the ordinary decoc-
tions  or  injections of oak  bark, catechu, &c.   It can be made,
moreover, of uniform strength, and free from foreign inert matter,
and is not liable to decompose quickly.  In sore nipples, he  found
it to be invaluable.   He employs it in solution—five  grains to  the
fluidounce of distilled water—on lint covered with oiled silk.  He
has also found it of  great service in toothach.  The  gum around
the tooth is firs'  scarified with  a fine lancet, and then a little cot-
ton wool, imbued with  a  solution of a scruple of tannic acid,  and
five  grains of mastich  in two fluidrachms of ether, must be  put
into the  cavity; and, "if the  ache is to  be cured at all, this plan
will put an end to it in nine  c.itses out of ten."
  In  a  case of open, almost  incurable, cancerous ulceration, in
which it was applied by Dr. Michaelsen,5  to arrest the bleeding, it
excited a wonderful effect on the ulcer and the carcinoma itself.
  According to the  experiments of Magendie,6 tannic acid is  one
of the substances that oppose the coagulation of the  blood.

                 MODE OF  ADMINISTRATION.
  It  may be given in  the form of pill, or draught, or as a lave-
ment.  In ihe dose of  from  a  quarter of a grain to  two grains, it
does not produce any unpleasant constipation, but its effects must
be observed  with care.7

  1 Journal de Medecine  et de  Chirurg. Pratiq. Nov. 1839. See,  also, Bouchardat,
Annuaire, &c, pour I *49, d. 2(13.
  " Bulletin General de Therapeutique, Mai, 1840.
  * Oidnv, in Bouchardat. Annuaire  de Therapeutique pour 1847, p. 170. Paris, 1847,
  ' Provincial Med. .lourn Oct. 9, 1H44.
  • Med. Chir. Zeitung, xviii.  24, cited in Schmidt's Jahrbucher, u. s. w. No. 6, S. 287.
Jahrgang lrM<).
  6 Lond. Lancet Jan. 20. 1W29. p. (>1fi.
  ' Cavarra, in Bulletin General de Therapeutique, 30 Mars, 1837. 
                      ACIDUM TANNICUM.                    43

         Vinum  aroraaticum  cum  acido  tannico.

                Aromatic wine with tannic acid.

                   R. Vini aromat. f ^viij.
                      Acid, tannic. Qij.  M.
                   R. Vini aromat. fjviij.
                      Acid, tannic. Qij.
                      Ext. opii purif. ^ss.  M.
   Used as local dressings to chancres.                 Ricord.

   The vinum aromaticcm of the French Codex, used by Ricord,
is composed of  four  ounces of aromatic herbs,  (rosemary, rue,
sage, hyssop, lavender, absinthium, origanum, thyme, laurel leaves,
red rose  leaves,  chamomile, melilotum, and elder,) digested in two
pints of  red wine for eight days.

                   Injectio  acidi tannici.

                    Injection of tannic acid.
                        R.  Acid, tannic. J)iv.
                      Infunde per minut. x. in
                           Aquas bullientis Oj.

   To be injected  slowly into the rectum in cases  of uterine he-
morrhage.                                         Dumars.

                   R.  Vin. rubr. f gvj.
                      Acid, tannic, gr. xviij.  M.

   Used in chronic blennorrhcea, or what is called an old gleet.'
                                                     Ricord.

   In the case of the female,  the quantity of tannic acid may be
doubled,  or  still  farther increased.

                   Pilulae  acidi  tannici.

                     Pills of tannic acid.

       R.   Acid, tannic, pulv. gr. vj.
            Acac. pulv. gr. xij.
            Sacchar. pulv. gr. Ixxij.
         Syrup, q. s. ut fiat rnassa in piJulas pond. gr. iv. sing, dividend.

   Dose.—One to four, morning and evening, where an astringent
is needed.                                         Cavarra.
            Pilule  acidi tannici  composite.
               Compound pills of tannic acid.
                    {Pilules de tannin composees.)
              R. Acidi tannic, gr. xvss.,  (1 gramme.)
                 Morphiae acetat.
                 Antimon. et potassae tartrat. aa gr. iss.
                 Confect. q. s. ut fiant pilulae xx.

  ' La Lancette Francaise, No. 33, Paris, 1W3S, and Parker, Modern Treatment of Sy-
philitic Diseases, American Med. Library edit. p. 44.  Philad. 1840. 
\
44                   acidum tannicum.

  Dose.—One or two in the day in hemorrhage, diarrhoea, &c.
                                               Jourdain.

            Pilula) acidi  tannici  cum opio.
             Pills of tannic acid ivith opium.
                {Pilules narcotiques astringentes.)
             R.  Acid, tannic, ,3ss.
                Extract, opii gi. f.
                Confect. rosae q. s.  M.  et divide in pilulas xx.
  One every hour in uterine hemorrhage.         Dumars.

             Pulveres  acidi tannici et opii.
            Powders of tannic acid  and opium.
             R.  Acid tannic. £)ij.
                Opii pulv. gr. ss.   Misce et divide in pulveres tres.

  Dose.—One, morning, noon, and night; gradually increasing
the quantity of tannic acid to four scruples daily.    Giadorow.

                Syrupus  acidi  tannici.
                   Syrup of tannic  acid.
                R.  Acid, tannic, p. v.
                    Syrup, p. 500.—Mix and filter.
                                           Bouchardat}
               Unguentum acidi tannici.
                 Ointment of tannic acid.

                R.  Acidi tannici gr. xvss.
                    Adipis ^ss.  M.

  This is the Pommade contre les gergures de Vanus, of M.
Diday, applied, in fissure  of the  anus, on the extremity of the
little finger.                                       Diday.

      Dentifricium  acidi tannici compositum.
            Compound dentifrice of tannic acid.
                   R.  Acid, tannic, ^ss.
                      Sacchar. lact. lb. iiss.
                      Carmin. giiss.
                      Essent. Menth.
                      ------ Anis. aa  gtt. xx.
                      ------ Flor. aurant. gtt.  x.  M.

  To prevent accumulation of tartar, and give  tone to the gums.
                                                 Mialhe*
               Pomatum acidi  tannici-
                 Pomatum of tannic acid.
                     {Liparole de tannin.)
                    R.  Adipis suill. ^xij.
                        Acid, tannic, gij,
                        Aqua? pur. f ^ij.

  1 Annuaire de Therapeutique pour 1848, p. 138, Paris, 1848.
  ' L'Abeille Medicale, Mai, 1848, p. 116'. 
                           ACONITIA.                         45

  Dissolve the tannic acid in the  water, by triturating in a glass
mortar;  add the fat and mix.1                         Beral.

                   Lotio  acidi  tannici.
                    Lotion of tannic acid.
                 Hydrolotif de tannin, pour Vurithre.
                    R.  Aquae deslillat. f ^viij.
                       Acid,  tannic, gr. xxxij.  Solve.
  Employed in obstinate btennorrhcea.               Beral.
                        VII.  ACONITIA.
 Synonymes.  Aconitina, Aconita, Aconitium, Aconitinum, Aconitine.
 German.  Akonitin,  Aconitin.
   This active principle, which was discovered by Peschier,2 and
 by Brandes, has been recommended by Dr. Turnbull,3 whose eulo-
 gies on the medical virtues of the natural order Ranunculaceae are
 evidently, however, overstrained.

                   METHOD OF PREPARING.
   Turnbull gives two processes;  the former  being the more easy
 of manipulation; the latter yielding  a purer result, and on the
 whole being preferable.  A quantity of the fresh root of Aconitum
 napellus  being  very carefully and cautiously dried, and reduced
 to powder,—one part of it by weight, and two parts by measure
 of strong alcohol, are to be digested  together at a gentle heat for
 seven  days, and  the tincture, whilst  warm, is to be filtered.  It
 must then be reduced to the consistence  of an  extract, by careful
 evaporation, at a low and well  regulated temperature; the object
 of this being to prevent the destruction or expulsion of the active
 principle,  which would very probably ensue, if the temperature
 employed were higher than barely sufficient to carry  off the alco-
 hol.  To the  extract, thus prepared,  liquid  ammonia is  to be
 added, drop by drop, and mixed well with it, to precipitate the al-
 kaloid : in this part of the process care must be taken that too
 much be  not added, as in some instances the product  appears to
 have been decomposed by inattention  to this circumstance.  It  is
 not easy to give  a  precise rule as to the quantity; but enough will
 have been added, if the extract exhales the odour of ammonia when

  1 Bulletin  General de Therapeutique, Janvier, 1838.
  * TrommsdorfFs  Journal der Pharmacie, v. 84.
  * On the medical properties of the natural order Ranunculaceas, and more particularly
on the uses of sabadilla seeds, delphinium staphysagria and aconitun ra;xTus, and their
alcaloids, veratria, sabadilline, delphinia and aconitine.  Chap. iii.  Lond. 1835.
4 
46                        ACONITIA.
 stirred.  The mass now consists of impure aconitia, mixed with a
 quantity of extractive, and other matters soluble in water, and it
 may be taken up either by boiling alcohol or by sulphuric ether;
 or the soluble matter may be removed by repeated  washings with
 small quantities of cold water, which will leave the aconitia.  This
 latter process, Turnbull says, is the one he has generally employed,
 and it is performed  by pouring  a little wTater on the extract, and
 mixing them carefully together; then allowing the  undissolved
 part to subside, pouring  off the fluid, and repeating the operation
 as long as any soluble  matter  is taken up:  a quantity  of light
 brown  or gray powder  is left, which may be purified by subse-
 quent solution in alcohol.   This powder contains the active pro-
 perties of the aconite, in a high degree of concentration.
   The second process consists in dissolving the alcoholic extract,
 prepared  as  above,  without  the  addition of  the ammonia, in as
 much cold water as will take it up, carefully decanting the solu-
 tion from  the insoluble part, and filtering it.   To the filtered solu-
 tion liquid ammonia  is to be  added, drop  by drop, as long as
 any precipitation is  occasioned.  When the  precipitate has sub-
 sided, the supernatant fluid must be carefully poured, or drawn off
 by means of a syphon; and after the precipitate has been deprived
 of as much of the fluid as possible, it should be purified by a suffi-
 cient number of washings with  small quantities of cold water, or,
 what  is better, it may be  dissolved in as much  alcohol as will take
 it up, and the solution be thrown into cold water: the precipitate
 thus formed is to be carefully dried.  The product obtained by
 this process is white.
  The London College,  in  their  Pharmacopoeia of 1836, give the
 following  form:—Take  of aconite root, dried and bruised, two
 pounds; rectified spirit, three gallons; diluted sulphuric acid,
 solution of ammonia and purified animal  charcoal, of each a
 sufficient quantity.   Boil the aconite with  a gallon of the spirit for
 an hour, in a retort with  a  receiver fitted to  it.   Pour off the
 liquor, and again boil the residue with another gallon of the spirit,
 and with the spirit recently distilled, and pour off the liquor also.
 Let the same be done a  third time.   Then press the aconite, and
 having mixed all the liquors and filtered them, distil the spirit.
Evaporate the remainder to the proper consistence of an extract.
Dissolve this in  water and filter.  Evaporate  the solution with  a
gentle heat,  so that it  may thicken  like syrup.   To this  add
diluted sulphuric acid, mixed  with distilled water sufficient to dis-
solve the aconitia.   Next drop in solution of ammonia, and dissolve
the aconitia which is thrown  down in dilute sulphuric acid, mixed
as before with water; then mix in the  animal  charcoal, occasion-
ally shaking for a quarter of  an hour.   Lastly, filter; and having
again  dropped in solution  of ammonia so as  to precipitate  the
aconitia, wash and dry  it.  This process, however, according to 
ACONITIA.
47
Messrs. Ballard and Garrod,1 mostly fails in procuring the alka-
loid.
   Aconitia occurs in the form of an amorphous powder, having an
intensely acrid and bitter taste.  It is not volatile, and should leave
no ash when heated to destruction.  When well prepared, accord-
ing to Geiger, it is a firm, colourless,  and translucent mass;  of a
shining appearance, friable and inodorous: the taste is disagreeably
bitter, leaving behind it an acrid sensation in  the throat,  but not
corrosive or burning.  It does not dissolve readily in water:  at
the  ordinary temperature  requiring one hundred  and fifty parts
thereof, but  only fifty parts of boiling water.   It is soluble, in al-
cohol and in ether.   Tincture  of  iodine  occasions in the  solution
a  reddish-brown precipitate ;  tincture of galls  a white  one.  It
forms, with the acids, for the most part,  salts that are not crystal-
lizable, which readily dissolve both in water and alcohol.

                 EFFECTS ON THE ECONOMY.
   The effects of aconitia appear to  be essentially analogous  to
those of delphinia.   A grain of the first of the two preparations
described  by  Turnbull  was  dissolved  in  a dram  of alcohol;
twenty drops of the solution put  into the mouth of a guinea-pig
occasioned death in a few minutes.  Other experiments, too,  have
been performed, all of which demonstrate the extreme activity of
the substance.   If a grain or two  of aconitia or veratria or delphi-
nia be mixed with  a little lard, or dissolved in a dram of alcohol,
and a small quantity be rubbed on the  skin, a  sensation of  heat
and tingling is experienced after the friction has  been persevered
in for a minute or two.   There is a slight difference, however, in
the  effects  produced, and  the resemblance  is greatest  between
those of delphinia  and aconitia.
   When a small quantity of aconitia,  says Dr. Turnbull, either
 made into an ointment, or dissolved in alcohol, is rubbed for a mi-
 nute or two upon the skin, a sensation of heat and prickling is ex-
 perienced ;  to this  succeeds a feeling of  numbness and constriction
 in the  part, as if a heavy weight were  laid  upon  it, or as if the
 skin were drawn  together by the powerful  and  involuntary con-
 traction of the muscles beneath.   This effect lasts from two or
 three to twelve or more hours, according to the quantity rubbed
 in.   So small a portion as the one hundredth part of a grain has
 produced a sensation that has continued a whole day.   A minute
 portion of  it mixed with lard, and applied to the  eye, occasions
 contraction of the  pupil according to  Dr. Pereira, whilst Geiger
 and Hesse  affirm that the aconitia which they obtained  produced
 dilatation  of the pupil.   Dr.  Pereira states, that the aconitia pre-
 pared  by Mr. Morson of London is so  powerful, that one-fiftieth

          1 Elements of Mat. Med.  and  Therap. p. 164. Lond. 1845. 
48
ACONITIA.
 of a grain has endangered the life of an individual.   It is, he con-
 siders, the most virulent poison known,  not excepting hydrocyanic
 acid.1
   Whilst  employing aconite itself  in  his clinical practice,  Dr.
 Lombard,3 of  Geneva, tried  its effects on animals, and chiefly in
 reference to  its action on the heart.   The experiments were made
 on frogs, whose hearts beat with great  regularity, and for a consi-
 derable  time after the animal has been mutilated.   The medicine
 was introduced into  the  stomach or applied locally to the heart,
 which was laid bare  after the animal had been  stupified by blows
 on the head.    He found, that aconite employed internally rendered
 the pulsations  less frequent,  but not irregular, and consequently
 that it exerted a decidedly sedative effect on the heart; whence he
 infers, that it is a proper remedy in  active diseases of that organ,
 and indeed in inflammatory affections in general, in which he ex-
 hibited it with success.   In  cases of poisoning by it, the contrac-
 tions of the  heart have been found diminished and almost suspend-
 ed.3  The homceopathists regard it  as an energetic antiphlogistic.
   Dr. Eades4 concludes,  from his own observations, that the most
 remarkable symptoms  exhibited by animals  from the use of aco-
 nite or  its   alkaloid, are—weakness;  staggering;  gradually  in-
 creasing insensibility  of the surface; slowly increasing weakness of
 the voluntary muscles, ending,  perhaps,  in paralysis; great lan-
 guor of  the pulse; more  or less blindness, and convulsive twitch-
 ings before death.
   The ablest investigation yet undertaken into the actions of aco-
 nite, according to Dr. Christison,5 is contained in the inaugural  dis-
 sertation of  Dr.  Fleming6 since published,  and with a  copy of
 which the author was favoured by Dr. Fleming.   He found  that
 the most remarkable  symptoms are weakness and staggering, gra-
 dually increasing paralysis of the voluntary muscles, slowly in-
 creasing insensibility of the surface, and more or less blindness.
 He farther observed,  that the pupil becomes much contracted;  the
 irritability of the voluntary muscles is impaired; the veins are con-
 gested after  death, the blood unaltered, and the heart capable of
 contracting for some  time after respiration has ceased.  From its
 action on the cerebro-spinal and  muscular systems, he  deduces the
following practical inferences.  First, it is sedative, anodyne and
 antispasmodic.   Secondly, it is an advisable antiphlogistic in apo-
 plexy, phrenitis, or any disease in which  the circulation of the brain
 is  excited.   Thirdly, it is  contra-indicated in head-ach arising

  ' Elements of  Mat. Med.  &c, 2d edit. ii. 1811.  Lond. 1842.
  3 Gazette Medicale de Paris, Oct. 10, 1835.
  3 Orfila, Toxicologic, ii.221,
  4 Dublin Journal  of Med. Science, March, 1845, p. 55.
  6 Treatise on Poisons, Amer. edit. p. G65.  Phila. 1845.
  6 An Inquiry into the Physiology and Medicinal Properties of the Aconitum Napellus,
&c. Lond. 1845. 
ACONITIA.
49
from anEemia or chlorosis, and wherever there is a torpid or para-
lytic condition of the muscular system, and, Fourthly, Its proper-
ties suggest its employment in convulsive or spasmodic diseases.
   From its action on  the  circulation  he infers, First, that it is a
powerful antiphlogistic.  Secondly, it is calculated  to be of great
value in all cases where there is inordinate  activity  of the circula-
tion.    Thirdly, it  is  contra-indicated when there is obvious  me-
chanical impediment to  the passage of the  blood, particularly
through the heart or lungs: it is requisite,  therefore, in every  case
before commencing its use,  to ascertain that no  such obstruction
exists;  and fourthly', it is  contra-indicated whenever there is  irri-
tability of the  circulation, with  great diminution of power, such as
occurs after severe hemorrhage.
   Its  results on the  respiratory system led him to the inference,
First, that it will probably be found  a highly advantageous anti-
phlogistic in pneumonia, pleuritis, &c.  Secondly,  it  seems calcu-
lated to be serviceable in spasmodic  asthma.   Thirdly, it is  con-
tra-indicated in difficulty of breathing, arising from  any other cause
than  inflammation  or spasm; and fourthly, in cases of advanced
bronchitis, with excess of secretion, it would  prove highly injuri-
ous by  diminishing  still farther the power of expectoration.
   Dr. Fleming has  not  met with any convincing evidence that it
is  a cumulative remedy;  although in  two cases he  was induced to
suspect it.  The individuals were affected with  general tremors,
severe pain in the head and  eye-balls, constant lachrymation, in-
tense photophobia, heat of skin,  quick pulse, and great restlessness.
In many other  instances, however, where the administration of the
remedy was continued for weeks, and  even  months, no such effects
were observed.
   The  diseases in  which Dr. Turnbull chiefly employed aconitia
externally, were of  the neuralgic kind; but he used it as well in
gouty antirheumatic cases; and its  success, he remarks, fully an-
swered  his anticipations.    He employs it either in the form of so-
lution  in alcohol, in the proportion  of one or more grains to the
drachm,—or of ointment, made according to  the  following  for-
mula :
               R.  Aconitise gr. ij.
                   Alcohol, gtt.  vj. Tere optirae et adde.
                  Adipis 3J. ut fiat unguentum.
   The  alcohol  is  added to prevent  the aconitia  from forming a
thick compound with part of the lard, so  as to render it difficult
to make a  proper ointment.  In one case of tic douloureux, of ex-
treme severity, as much as eight grains was prescribed in the oint-
ment with the most marked benefit.   The best mode of applying
it is simply to rub a small portion of  it over the whole seat of the
affection, until  the pain is either for the time removed,or until  the
full effect, described above, is   induced on the cutaneous nerves; 
50
ACONITIA.
and the  friction should be  repeated  three  or four times, or more
frequently, during the day, according to the effect on the disease;
the proportion of the aconitia being increased at  every second or
third  rubbing.
   Dr. Turnbull found, in the case of aconitia—as well as in that
of veratria and  delphinia—that  unless the friction occasioned a
full development of the peculiar impressions caused  by it when
rubbed on the skin, no benefit whatever was to be looked for from
its employment; and  he observes, that if  there  be  the slightest
abrasion of the skin, an application of such activity should not be
resorted  to; and that it should be carefully kept from coming in
contact with  any of the mucous membranes.
   Aconite and  its  alkaloid have been used internally  and exter-
nally in neuralgia, with  marked  advantage  by Jahn, Tealier,
Hufeland, Wildberg, Fleming1 and others; but Drs. Copland, A.
T. Thomson  and others have prescribed it in several cases with-
out success.   By many, the external application of the remedy is
considered to be more likely to be beneficial;  whilst others give a
preference to its internal use.  Mr. F. C. Skey2  details two cases
which were  cured  by it.   It was  rubbed  down into an ointment
with lard, in the proportion of one grain of the former to one dram
of the latter, and applied in a small quantity by the forefinger over
the  track  of  the painful nerve,  and was gently rubbed or rather
smeared over the surface for half a minute or longer, once or twice
a day, according to the degree of pain.
   The observations of Turnbull and Skey have been confirmed by
Drs.  Roots, Sigmond, Fleming and others.3  In neuralgia of the
heart, Dr. Copland4 found  it highly  serviceable.
   Aconitia is not   much used.  The extravagance of its price,
which is said to have been in England 3s. 6d. or upwards  of three
quarters of a  dollar per grain,5 would necessarily limit its use, had
it proved to  be more advantageous than it has.   It would appear,
that all  its powers are possessed by the tincture of aconite or by
the alcoholic extract.

   Dr. Turnbull likewise advises  the external application of an am-
moniated extract of aconite, which is made by evaporating
very carefully, and at a low temperature, the tincture of the dried
root of the plant, prepared as directed in the process for obtaining
aconitia, to the consistence of an extract.   To every dram of this,
eight or ten  drops  of liquor ammonias should be added, and after
 the mixture has stood a short time in  a very gentle heat, to drive

   1 Op. cit. p. 56.               3 London Med. Gaz. Nov. 5,1836.
   3 Dr. Cowan, Provincial Med. and Surg. Journ. May, 1843; cited in Braithwaite's
 Retrospect, Amer. edit. viii. 26.  New York, 1844.
   4 Dictionary of Practical Medicine, vi. 803.
   ' Pereira, Elements of Mat. Med. and Therap. 2d Amer. edit. p. 757. Phila. 1846. 
ACONITIA.                        51
off the excess of ammonia, it may be used in the form of an oint-
ment, according to the following prescription:

       Unguent urn extracti aconiti  ammoniati.
         Ointment of ammoniated extract of aconite.
            R.  Ext. aconit. ammon. gj.
               Adipis giij.  Misce ut fiat unguentum.
   When this ointment is rubbed upon the skin, it  occasions sen-
sations in the part similar to those produced by the aconitia oint-
ment : they are, however, rather more pungent.
   In less severe cases, Dr. Turnbull advises the simple saturated
tincture  of  the  dried  root,  with  or without the addition  of
a  little ammonia.  The external use of this tincture of aconite has
been recommended  in neuralgia and chronic rheumatism  by
Dr. Pereira,1 and Mr. Jos.  Curtis;3 and  in hemicrania3  by Dr.
Fleming.
   The alcoholic extract of aconite—Extractum aconiti alco-
holicum—which is officinal in  the  last edition of the Pharmaco-
poeia of the  United  States,  1842—has likewise been advised  by
Drs. Lombard  of Geneva,4  Busse, J. B. Watkins,5 and others, in
articular rheumatism.  Dr. Lombard gives it in doses of half a
grain every two hours, and  gradually  augments the dose to six or
nine grains in the same period.  A case of poisoning by five grains
of this extract—from which, however, the patient recovered—has
been published by M. E. L. Pereyra, of Bordeaux.6
   The applications of the different preparations of aconite to the-
rapeutics have been given elsewhere.7
                  VIII. ACUPUNCTU'RA.

Synonymes. Acupuncture, Acupuncturation.
German. Die Akupunktur; der Nadelstich.

  Although acupuncturation is really  an ancient  therapeutical
agent, attention to it has been so much revived of late years, and
its use has been so largely extended, that it may be looked upon
as constituting one of the novelties of therapeutics.   It consists in
the introduction of needles into different parts of the body with a
view of removing or mitigating disease; and appears to have been
entirely unknown to the Grecian, Roman, and Arabian physicians.8

  1 Elements of Materia Medica, 2d edit. ii. 1808.  Lond. 1842.
  a Lond. Lancet, June 26, 1841.                       3 Op. cit p. 60.
  4 Gazette Medicale, Juin 28, 1834. See, also, Sigmond, in Lancet for August 5,
1837.                              6 Philad. Med. Examiner, No. 33.
  G La Lancette Francaise, No. 37, Mars 26, 1839.
  1 General Therapeutics and Materia Medica, i. 374.  4th edit Philad. 1850.
  • V. A. Riecke, Die neuern Arzneimittel, u. s. w. S. 12, Stuttgart, 1837. 
52                       ACUPUNCTURA.
 From the most ancient times, however, it has been in use with the
 Chinese and Japanese, by whom  it was regarded  as one  of the
 most important of remedial agencies.   By these people it was sys-
 tematically taught on appropriate  phantoms or mannekins, called
 Tsoe-Bosi,  and  the  practice  of the  operation was permitted to
 those only who were  able to pass a rigid examination thereon.   In
 Europe, it was first known about 170 years ago, from the writings of
 a Dutch surgeon, Ten-Rhyne, who wrote in 1683 ;l and attention'
 was subsequently drawn to it by Kampfer;3 but after this  it was
 almost forgotten, until Berlioz, in  1816, drew  attention to its em-
 ployment.   His example was soon followed by Beclard,3 Breton-
 neau,4  Haime,5  Demours,6 Sarlandie,7  Pelletan, Segalas, Dantu,
 Velpeau,  Meyranx,8 Dance,  in  France;  by Churchill, Scott,  El-
 liotson,9 and others in England;  by Friedrich,10 Bernstein11 L. W.
 Sachs,  Heyfelder, Michaelis,12 Grafe,13 and others, in Germany;
 by Carraro,14 Bergamaschi,'5 Bellini, and others, in Italy; and by
 Ewing,16 E.  J. Coxe,17 F. Bache,13 and others, in this country.   M.
 Jules Cloquet had much to do in reviving its  employment  in  his
 own  country and elsewhere,  by his treatise on  the subject pub-
 lished at Paris, in 1826, where it was for a long period a fashion-
 able article in the hospitals; so much so, it is affirmed, that attempts
 were even made to heal a fractured bone  by it without the appli-
 cation  of  any appropriate apparatus;  and, at  one time,  it is said,
 the patients  in one hospital actually revolted against the piqueurs
 medecinsf '9.

                  MODE OF ADMINISTRATION.
   In the  operation of acupuncture, needles are employed, which
 are very fine, well polished and sharp pointed.   They are usually
 from  two to four inches long, the length being adapted to  the depth
it  may be desired to make them penetrate.  If steel needles are

  1 Mantissa  schematica de Acupunctural ad dissert, de Arthritide.  London, 1683.
  a Amoenitat exotic, politico-physico medic,  p. 583.   Lemgov. 1712; and History of
Japan, vol. ii  , Appendix, sect. 4, p. 34.
  3 Mem. de la  Societe Medic. d'Emulation, viii. 575.
  ' Journal Universel des Sciences Med. xiii. 35.  Paris, 1817.
  5 Journal Gener. de Medec. torn, xiii., and Journal Univers. des Sciences Medic.
torn. xiii. 1819.                                        6 Ibid. torn. xv.
  ' Mem. sur l'EIectropuncture.  Paris, 1825.
  8 Archives Generates de Med. torn. vii.  Paris, 1825.
  9 Med. Chir. Trans, xiii. 467.  Lond. 1827; and art. Acupunture, in Cyclop. Pract.
 Med.  Amer. edit. Philad.  1845.
  10 Translation of Churchill's work in German, p. 40.
  " Hufeland's Journal, Ixvii.  Berlin, 1828.
  " Grafe und Walther's Journal, B. v. St. 3, S. 552.
  13 E. Grafe, in art. Acupunctur, in Encyc. Worterb.der medicinisch. Wissenschaft. B.
 L S. 312.  Berlin, 1828.               ,4 Annali Universali d'Omodei, 1825.
  "Ibid. 1826.        ,6  N. Amer. Med. and Surg. Journal, ii. 77.  Phila. 1S26,
  " Ibid. ii. 276.  Phila. 1826.
  " Ibid. i. 311.  Phila. 1826; and art Acupuncture, in Cyclop, of Pract.  Med. i. 200,
 Phila. 1833.                                  » Riecke, Op. cit. S. 13. 
                        ACUPUNCTURA.                     53

selected, they are heated to redness, and allowed to cool slowly, in
order that they may be less brittle.  At the blunt extremity of the
needle a head of lead, or sealing wax is  attached—to prevent it
from being  forced entirely into  the  body.  This  is the simplest
method of acupuncturation, and  it is as  effectual as any other.
By various acupuncturists, needle-holders or handles of ivory have
been devised, to some of which the needle  is permanently  attached.
Perhaps  the porte-aiguille or 'needle-holder' recommended by
Dr. F. Bache,1 is as  good  as any that has been invented.  The
needle, with its porte-aiguille,  consists  of a handle with a steel
socket to receive  the end  of the  needle,  which may be  fixed se-
curely, after having  been  inserted, by the pressure of a small la-
teral screw.  By this construction, the operator can at pleasure
fix in the handle a needle of the  length he may desire, and  after
inserting  it  he is enabled to detach  the handle by  relaxing the
screw.   After all, however, needles prepared in the simple manner
mentioned above  are  adequate to  every useful purpose.
   Besides common steel needles, those of gold, silver and plati-
num have been used,  but it does not appear that one metal is pre-
ferable  to another.
   To  introduce the needles, the skin  is stretched, and the needle
inserted by a movement of rotation  performed in opposite direc-
tions, aided by gentle  pressure.  As a general rule, the seat of pain
will indicate the place where the needle should be introduced ; but
where the feelings of  the patient do not point out the spot, it must
be suggested  by our knowledge of  anatomy and physiology.  From
the experiments of Beclard, Bretonneau, Segalas, Dantu,  Velpeau,
and others, it would  appear, that perforation of arteries, nerves,
and even of important viscera with very fine needles, has not been
followed by  any injurious results; yet, at times, accidents have
been produced thereby;  and, therefore, it  may be  laid down as a
rule, that the greater nerves and  arteries of a certain  size, should
be avoided.  Prudence would likewise suggest, that important vis-
cera, as the  heart, stomach, intestines, &c, should not be  pene-
trated.
   The  number of needles  to  be  used varies according to the ex-
tent of the parts  affected.   In the  opinion of many experienced
physicians, we ought  not to be afraid of the number, but rather in-
sert too many than  too  few, and  not at too great a distance  from
each other.  The length of time,  during which they should be suf-
fered to continue  in  the part, differs: no fixed rule can be laid
down.   Some suffer  them  to  remain for an  hour and a half, or
two hours: at  times, a  period of five minutes  is  sufficient.  In
other cases, they have been kept  in for two or three days.  It ap-
pears to be by no means settled what medicinal influence is exerted
by their longer or shorter continuance in the parts.
1 Cyclop, p. 202. 
54
ACUPUNCTURA.
                 EFFECTS ON THF ECONOMY.
  Allusion has already been made to the impunity with which, in
the generality of cases, acupuncturation may be practised even on
important organs.
  As respects the nerves, Cloquet has seldom or never seen the
puncture of them give rise to so much pain as  to render it neces-
sary to withdraw the needles: the pain was generally trifling and
speedily  passed  away.   He inserted needles  into the  brain and
spinal marrow, and into the crural nerve of a cat, without any evi-
dence of severe   suffering or of change of function.   Similar ex-
periments were  made by E. Grafe with the same results.1   Nor
was inconvenience found by Delaunay, Beclard and Cloquet  to be
sustained  on puncturing  the arteries  and veins.   A few drops of
blood perhaps issued, but the flow was readily stopped by pressure
with the  finger. The slight ecchymosis which at times super-
vened, disappeared rapidly of itself.   In  Grafe's experiments, he
never found much bleeding ensue, although he properly esteemed
it advisable to keep  clear of the  nerves and blood-vessels, in order
to avoid  any unnecessary pain or  mischief.
  As regards the fasciae  and periosteum,  Grafe found, that the in-
sertion of needles into them was  always very painful, and he re-
commends, therefore, that the operation should be performed  with
care on those parts.   Should, however, the needles be introduced,
and much pain be experienced, it rapidly ceases, when  they are
withdrawn.
  Lastly—MM. Haime,Bretonneau, Velpeau, and Meyranx insti-
tuted several  experiments on dogs  by passing needles into the
brain, heart, lungs, stomach, &c, and little or no inconvenience,
as remarked above,  was experienced, provided the  needles  were
extremely  fine.   Cloquet passed his needles  so deeply into the
chest of  an animal as to  leave no doubt, that they had penetrated
the lungs, and he subsequently pierced the liver, stomach, and tes-
ticles without the supervention of any unpleasant result, and Bel-
lini2 affirms, that he  has  repeatedly passed them into the stomach,
liver and intestines without injury.
  The pain occasioned  by acupuncturation  is  generally easily
tolerated;  but at times it is  so violent, that the patients cry out;
the violence, however, usually passes away either when the needle
is drawn out or  forced in deeper.   It would seem, that the opera-
tion is, as  a general rule, most  successful when it occasions the
least pain.  Cloquet asserts, that  a kind of electric shock is some-
times experienced in the  surrounding  parts at the moment of the
introduction of the needle; in other  cases, a tremulous motion is
observable in the fibres of the muscles penetrated.  Almost always,

  1 Art. Acupunctur. in Encyc. Worterb. u. s. w. S. 317. Berlin, 1828.
  a Cited in Brit. & Foreign Medico-Chirurg. Review, for July, 1848, p. 232. 
ACUPUNCTURA.                     55
some time after the entrance of the needles, a more or less regular
aureola or halo of a red  colour, and without tumefaction, is  per-
ceptible around them, which soon disappears after they are with-
drawn; but when they are suffered  to remain long in the part it
may persist for hours.
  When the operation is productive of benefit, relief is  speedily
experienced.
  The extraction of the  steel needles is ordinarily accompanied by
more pain than their insertion, especially if they have penetrated
deeply, and been retained in the flesh for a long time.  The diffi-
culty is owing to their having become  oxidized, and  consequently
rough  on the surface.   In withdrawing them, it is  advisable to
give them a movement of rotation,  and at the same time  to  press
upon  the  skin  surrounding  them  with  the thumb and index
finger.
  In the hospitals of St. Louis, La Pitie, and the Hotel Dieu of Paris,
acupuncturation was practised some thousands  of times, and in
every  case, according to  Guersent, without the occurrence of any
thing unpleasant.   Pelletan, however, affirms, that he saw  it on
four occasions  followed  by slight  faintness at  the hospital St.
Louis,  but none of  the cases  assumed  the characters of full  syn-
cope.  Gaultier de  Claubry has  frequently seen  faintness, febrile
movements, spasm, and  insupportable pain produced by  it, and
Heyfelder saw it followed  by convulsions and fainting.   Beclard
has related a case where the needle penetrated  to the bone, and
occasioned intense pain.  The patient remained  a long time faint,
and afterwards  violent delirium ensued, which gradually ceased
in the  course of the day, and  was followed by  great  debility.
Subsequently, an abscess  formed  in  the part on which the opera-
tion was practised.
  As to  the modus  operandi of  acupuncturation, we cannot  con-
ceive its effects to be any thing more than a new nervous im-
pression produced by the needle  on the parts which it penetrates.
The needles having been  found oxidized, especially at the point, it
has been supposed  by some,  that the oxidation is connected with
the remedial agency, and it has  been even affirmed,  that in  some
diseases they oxidize more readily than in others.1  It  is a  suffi-
cient reply to this view, that beneficial results are obtained from
the use of needles made of metals that do not become oxidized,
and that the  steel needles oxidize in  the sound, as well  as in the
diseased  body,  and even in  parts  that have been removed from
the body, and placed  in warm water;  for in  the cold dead body,
it is affirmed, the phenomenon is not observed.   Cloquet and Pel-
letan think, from their experiments, that the effects of acupunctu-
ration  are a consequence  of the development of the nervous  fluid
« Grafe, loc. cit. S. 319, 
56
ACUPUNCTURA.
—which they liken to the galvanic—around the needles;  a view
which is denied by Pouillet and  Beclard, but  adopted in a modi-
fied form by Dr.  Bache,1 wTho throws out the conjecture "that in
many cases of local  pain this accumulation of the nervous (elec-
trical) fluid depends  upon the altered state of the  various  fasciae
or condensed sheets  of tissue, giving them the power, to a certain
extent,  of insulating the  parts which they serve  to embrace."
  The explanation is ingenious, but we do not think it necessary, if
adequate, to explain the phenomena.   We have no doubt, that the
effects are owing to  a concentration of the nervous power towards
the part transfixed by the needle, so that a  derivation of the ner-
vous influx is induced towards the seat of pain, or towards the nerves
particularly  concerned in the  production of the pain; but farther
than this we know not.
  There is one phenomenon which is dependent on the oxidation of
the needle.  When the free extremity of an  inserted needle is con-
nected with  the ground by means of a conducting substance, or is
put in connexion  with a  soft part of the  patient's body, it becomes
the seat of a galvanic current, which is exhibited by the multiplier
of Schweiger.  That this phenomenon is dependent upon the oxi-
dation of the metal, is proved by the circumstance that  it does not
take place when an unoxidizable  metal is employed.3
  Acupuncturation has been used by Berlioz- in gouty and rheu-
matic cases; by Haime in  rheumatic, spasmodic, and  convulsive
affections, and by  Demours in  amaurosis and  ophthalmia, the
needles  being  inserted  into  the temples;  Finch  advised it in
anasarca, practised on the  feet; he  also discharged, in this way,
the fluid of  ascites.4  Pipelet5 employed it  advantageously in a
violent convulsive affection.  The needles did not remove or mark-
edly diminish the symptoms, but  they postponed their recurrence.
Michaelis6 cured a case of rheumatism  by it, but he did not find
it so serviceable in oedema of the feet, as the fluid would not flow
readily  through  the minute apertures.   Friedrich proposed, in
cases of asphyxia, when every other remedy had  been employed un-
successfully, that the cavities of the  heart should be penetrated by
a needle to excite its contraction, and this plan  was subsequently
advised  by Carraro,7 who  found, from  his  experiments on cats,
that they could in this way be  resuscitated  after drowning, when
every manifestation of  vitality had ceased.  His experiments, how-
ever, when repeated by Dr. E. J. Coxe,8 of Philadelphia, were not
found to succeed.  J.  Cloquet obtained  the happiest  results from
acupuncturation in neuralgia, rheumatism, muscular contractions,
  ' Op. citat. p. 305.              a Riecke, S. 16.
  3 Op. citat.  Paris, 1816.         4 Lond. Med. Repos. Mar.  1823.
  5 Journal Complem. du  Diet, des Sciences Medic, t xvi. Paris, 1823.
  8 Grafe und Walther's Journal, B. v. St. 3.
  1 Annal. univ. di Medicin,  1825.   See, also, Provincial Med. and Surg. Joum., May
15, 1841.              8 North Amer. Med. and Surg. Joum. ii. 292. 
ACUPUNCTURA.
57
spasms, pleurodyne, cephalalgia, ophthalmia, toothach, epilepsy,
gout, gastrodynia, contusions,  lumbago, periodical amaurosis,
diplopia, paralysis, &c  A case of neuralgia, after amputation,
has been reported as cured by it.1   The patient was attacked by
agonizing  pains, not only in the stump, but  also  in the opposite
thigh, accompanied by convulsions and  fainting.  In  this  state,
two needles were planted in the course of the sciatic nerve.   These
produced no  effect, but as soon as the third was  introduced, the
patient exclaimed, "The doctor has struck the  toe of my foot."
The needle was then pressed still deeper, so as to pass through the
nerve, and the  pain immediately ceased.  After the needles had
remained in half an hour, they were removed, and  the patient en-
joyed abound sleep and awoke free from pain.  About twenty days
afterwards, the pain recurred; the needles were again applied, and
relief as instantaneously followed.
  - Several  cases of neuralgia, removed by it,  have  been published
by Prof. Riberi, of Turin.2
   A case has been  recently published by Dr. Seller,3 in which*5it
was employed with beneficial results in protracted lockjaw, con-
nected with attacks of  suppurating sore throat, and  accompanied
with  hysterical and also inflammatory symptoms.   The  needles
were usually inserted to the depth  of half an  inch, and sometimes
an inch: most commonly, one was placed on each side of the mesial
line, between the  chin and hyoid bone;  whilst sometimes  two  or
three were introduced,  one above another, as near as possible along
the  mesial  line in  the  same region, and were  kept  in  about  a
minute.
   It  is  in rheumatic  affections that its success  has  been most
marked.   Dr. Elliotson4 cured  30 out  of 42 cases by it in St.
Thomas's hospital.   In sciatica its efficacy has been evident.5
   By Velpeau it has been proposed to cure aneurism by acupunc-
turation.   In performing some  experiments on animals, he  found
that arteries punctured by the needle became the seat of a coagu-
lum, and were ultimately obliterated.   In 1830, he  read  a  paper
before the  Academie des Sciences, of Paris, proposing the opera-
tion in the cases in question.6  He found, in his experiments, that
whenever  the needle remained three days in the flesh, the trans-
fixed artery was completely obliterated.
   M. Bonnet, Chirurgien-en-chef  to the Hotel  Dieu at  Lyons,7
  1 Bulletino  delle Scienze Medich. Ottobre, 1838, cited in Brit, and For. Med. Review,
Jan. 1840, p.  252.            a Medico Chirurg. Rev. April, 1841, p. 501.
  3 Northern Journal of Medicine, April, 1845, cited in Braithwaite's Retrospect, Amer.
edit. xi. 180.  New York, 1845.
  * Art. Acupuncture, Cyclop. Pract. Med. Amer. edit, by  the author, Philad  1845.
  s Renton, in Edinb.  Med. and Surg. Joum. for 1H30, xxxiv. 100; and Graves, in
Lond. Med. (iaz. July,  1831, and Lond. Med. and Surg. Journal, April, 1833.
  8 Lond. Med. Gaz. cited in Amer. Journal of Med. Sciences, Aug. 1831, p. 510.
  1 Bulletin General de Therapeutique,cited in Dunglison's American Medical Intelli-
gencer, for Dec. I, 1837,p. 317. 
58
ACUPUNCTURA.
treated eleven cases of varicose veins by introducing pins through
their cavities, and allowing them to remain there some time.  Nine
of these cases were cured.   The same treatment was applied to
herniary sacs.  He passed three or four pins through the herniary
envelopes close to the inguinal ring; and in order that  they might
exert a certain degree of compression, as well  as of irritation, on
the sac, he twisted the points and heads upwards so as to give them
a circular direction.  The inflammation and pain  usually com-
menced on the third or fourth day after the operation, and the pins
were removed a few days afterwards.   M. Bonnet had treated four
cases of inguinal hernia  by acupuncturation.   In two, the hernia
was small, and three weeks sufficed  for the cure: the third was
more troublesome.   Caution is of course requisite not to injure the
spermatic cord.
  In a subsequent communication, M. Bonnet inculcates the neces-
sity of causing the obliteration of the veins  in several  places se-
parated from each other by short spaces.1
  Acupuncturation has been revived 3 in the treatment of hydrocele
by Mr. Lewis, Mr. King,3 and  others.  It consists  in carrying a
common sewing needle—of the size used for sewing  a button to a
shirt—through the  skin, the dartos and  cremaster, into the bag
containing the fluid, so that a drop of the fluid follows the instru-
ment as it is  withdrawn.   It is executed  in nearly the  same man-
ner as the ordinary method  of tapping with a trocar, except that
the needle, which should  be oiled, cannot be plunged in  so easily as
that instrument.   Mr. King suggests  that the needle should be
fixed in a handle,  by which means it  can  be  made  to enter with
comparative facility.  After  the  operation, a compress, moistened
with a discutient lotion,  may be kept on the scrotum, and the pa-
tient may walk about or remain at rest, as may best suit  him.  The
phenomena which present themselves  in a few hours  are as fol-
lows:—the swelling begins to be less circumscribed, and to lose its
tenseness, and the areolar tissue of the scrotum becomes gradually
more  and more infiltrated with the fluid, which before distended
the tunica vaginalis, and which, in the space of from twenty-four
to forty-eight  hours, will, according to Mr. King, have entirely
changed place.  In five  or six days, the infiltration disappears, and
the patient is cured.  Mr. Lewis first introduced the  method as
a palliative,  but  he has seen cases where a  radical cure was ef-
fected  by it.4  He considers  the principle of puncturing with a fine
pointed needle not only applicable to promote the absorption of the
fluid in hydrocele, but in every case of encysted dropsy.5
  1 Arohives Generates de Mcdecine, Mai, 1839.  See, also, Dodd, in  Medical Gaz.i
Dec. 20, 1839.
  a Travers. in Lond. Med. Gazette,  Feb. 1837, p. 737.  Lewis, Ibid.  Feb. 1837, p.
788   Mr. Robert Keate, Ibid. p. 789.    3 British Annals of Medicine, No. 1, p. 13.
  4 Davidson, in  Edinb. Med. and Surg. Journ. for Jan. 1838.
  1 Lancet, May  7, 1836, and Jan. 14, 1837.  See a case of Ovarian Dropsy, in which 
ACUPUNCTURA.
59
   Reference has already been made to the use of acupuncturation
in anasarca.  The author has used  it advantageously to drain off
the fluid from the areolar membrane.  In such cases larger needles
are  needed; some prefer them  to  be of the size of an ordinary-
glover's needle, and of a triangular shape; a puncture of this kind
being less likely to close.1
   In the mass of cases, it need scarcely be said, this course can act
merely in  a palliative manner,—the  cause of the dropsical accu-
mulation persisting.  Still, as Dr. Graves has remarked, under fa-
vourable circumstances,  and in a  good constitution, the simple
operation of evacuating the fluid by punctures  made through the
skin, has been, of itself, sufficient  to effect  a  cure.   In a lady,
under his care, general anasarca came on after fever, and resisted
every form of  treatment he  could  devise.   When he  had made
many  fruitless  attempts to produce absorption by means of internal
remedies, another practitioner was  called in, who  practised acu-
puncturation of the lower extremities, and succeeded completely.
   Mr. Vowell2 has published a  case in which acupuncturation was
successfully employed for the removal of a ganglion.   A young
lady under his care had been affected with  a  ganglion of consi-
derable size on the extensor tendons of the foot, which produced
not only disfiguration, but some  uneasiness.   Mr. Vowell applied
blisters, and afterwards iodine ointment and pressure, for  above a
month, without  benefit.   He then inserted  the tambour porte-
aiguille of his patient.   Pressure was applied, and within a wreek
the tumour had completely  disappeared.
   M. Wiesel,3 has narrated a case of fracture of the two bones of
the forearm, in which, reunion of the bones not having taken place
at the end of nine weeks, he had recourse to acupuncture with full
success.  He introduced between the  two moveable fragments of
the ulna two needles, sufficiently long to traverse the  false arti-
culation from side to side,  and kept  them  in  that  position for
the  six  following days, after which  he  withdrew them, because
they had excited by their presence considerable swelling of the part
and  severe pain.   Fifteen days afterwards, he traversed in the same
manner the false articulation of  the radius, with two other needles,
which,  at the end of  a few days, caused sharp pain and slight sup-
puration.  He then applied a simple bandage to  the limbs, and in
the space of six weeks complete consolidation had taken place.
   When acupuncturation is conjoined with electricity or galvanism,
it constitutes electro-puncture, and galvano-puncture.

it was employed by Robert D. Thompson, in Lancet,  May 25,  1839, p. 344; and one
of Ascites, by Mr. Campbell, Lond. Med. Gaz  Nov. 1838.
  1 Graves, Lond. Med. Gaz. Oct. 1838.   See, also,  King, Ibid  Oct.  7, 1837, and
Nov. 25, 1837.                 2 Lancet, Aug 25, 1838,  p. 770.
  " Gazette des Hopitaux, Dec. 1843, cited in Braithwaite's Retrospect, Amer. edit. ix.
186.  New York, 1844. 
60
.ETHER HYDROCYANICUS.
             IX. iETHER  HYDROCYANICUS.
 Synonymes.  iEther Prussicus, Hydrocyanic, or Prussic Ether, Hydrocya-
  nate of Etherine, Cyanuret of Ethyle.
 French. Ether Hydrocyanique.
 German. Cyanather,  Cyanwasserstoffather, Hydrocyanather.

   This preparation was discovered some years ago  by Pelouze,1
 and, according to Magendie,2 it  resembles in its effects hydro-
 cyanic acid, without  being so violent a poison, and, consequently,
 he  esteems it  worthy of regard  as an addition to the materia
 medica.

                   METHOD OF PREPARING.
   Equal parts of sulpho-vinate of baryta and cyanuret of potas-
 sium are mixed intimately together;  put into  a glass retort, to
 which a tubulated receiver is adapted, and exposed to a moderate
 temperature.  By distillation, a colourless, or slightly yellowish
 fluid is obtained, which  separates into two distinct strata.  The
 lighter consists  chiefly of hydrocyanic ether, which is not pure,
 however,  but mixed with water, alcohol, sulphuric ether, and hy-
 drocyanic acid.  In order to purify it,  it must be strongly shaken,
 and, with four or five times its bulk  of water, must  be  exposed
 for some  time to a  temperature of 60° or 70° centigrade;  it must
 be again agitated with a little water, decanted, suffered to remain
 in contact with chlorinated lime for twenty-four hours, and then
 distilled.  The  ether  thus  obtained is pure.  It is a colourless
 fluid, of  a  penetrating, disagreeable  garlicky  odour.   Specific
 gravity 0.78.   It boils at 82° centigrade;  is  very slightly soluble
 in water,  but soluble in every proportion in alcohol and sulphuric
 ether.   In its pure  state, it does not disturb a solution of nitrate
 of silver.   It inflames very readily, and burns with a blue light.
 Potassa decomposes it with difficulty, and only when highly con-
 centrated.

                EFFECTS ON  THE  ECONOMY.
  Six  drops of this ether placed  in the  throat of a dog, occasioned,
 in a short time, deep respiratory efforts: the animal fell on its side,
 and convulsions  succeeded, with considerable motion of the  paws.
 This condition continued  for four  minutes, after w7hich the effects
gradually  disappeared, and in the course of half an hour ceased.
Six drops  injected into the jugular vein rapidly caused death, with
symptoms similar to those induced by hydrocyanic acid.  Accord-
ing to.  Magendie, these experiments were  frequently repeated  by
him with different modifications  after which he ventured upon its
administration in disease.  lie added  six drops of the ether to a

 1 Journal de Pharmacie, xx. 339. Paris, 1833.    a Formulaire:—derniere edition. 
iETHER SULPHURICUS.
61
mucilaginous linctus, and prescribed it to a patient labouring under
hooping-cough, who, in the course of a few days, derived signal
benefit  from it, and  without complaining of its penetrating, dis-
agreeable odour.   The same good  effects happened  to  several
patients to whom he gave it in the Hotel Dieu.  But although the
results were favourable in cases in which the hydrocyanic acid was
indicated, he found it often necessary to discontinue it, on account
of the invincible nausea which its smell induced.  Magendie ad-
vises it in those  diseases in which  mixture of hydrocyanic  acid
have been found of service.
                  iETHER SULPHURICUS.
Synonymes. iEther Vitriolicus, Naphtha Sulfurica, Oleum Vitrioli dulce,
  Vitriol Naphtha, Sulphuric Ether, Lethcon.
French.  Ether Sulfurique.
German. S c h w e fe 1 a. t h e r.
  It is  only within the  last few years, that a class  of agents has
been introduced into the Materia Medica, which have received the
name of Anaesthetics, a term used by Dr. Pereira1 synonymously
with narcotics, anodynes and  paregorics, as " agents which dimi-
nish sensibility or relieve pain;" but he adds, that the term is com-
monly applied to agents which diminish common sensibility, or
sensibility to pain.  As remarked elsewhere,2 however, it is most
generally employed to designate such agents, when received into
the lungs in the form of vapours or gases; and the  vapours most
used are those of ether and chloroform.
  It has been long known, that the vapour of ether would cause
exhilaration and intoxication when  breathed  from  a bladder, a
practice which, as the author has  been  informed, was a popular
diversion thirty  or forty years ago  in Philadelphia.   As long ago
as the year  1805, it was used to relieve  the distress in the last
stage of pulmonary inflammation in  the case of a gentleman in
Boston: in like cases it  has been frequently prescribed since, and
it was so prescribed in  the year 1812, to a member of Dr. J. C.
Warren's family, who experienced great relief from it.  The mode
of applying it was by moistening a handkerchief and placing  it near
the face of the patient.   It was not, however, until October, 1846,
that it was brought forward  prominently as an  anaesthetic in sur-
gical operations.  Dr. W. F. G.  Morton, a dentist of Boston, about
the middle of that  month, informed Dr. Warren, that he had pos-
session of a means for accomplishing the object;—that he had made
trials of its efficacy in the extraction of teeth, and was  desirous
  1 The Elements of Materia Medica and Therapeutics, 3d edit., i. 203. Lond. 1849
  2 General Therapeutics and Mat Med., 4th edit, i. 344.  Philad.,  1^50.
        5 
62
.ETHER SULPHURICUS.
 that  Dr. Warren  should test its  power in surgical operations.1
 Accordingly, at the  Massachusetts  General Hospital, its  merits
 were tested by Drs. Warren  and Hayward, and the results being
 satisfactory, the trials were soon repeated  there and elsewhere, in
 this country and abroad; and  very speedily " etherization "—as it
 was termed—came to be regarded as one of the most important
 gifts presented .by science to  humanity.   Although, however, it
 was first promulgated at the period above  described, it is affirmed
 by Dr. C. W. Long,2 of Jefferson, Jackson co., Georgia, that as
 early as  the  30th  of March, 1842, he removed a tumour from a
 patient who inhaled the vapour of ether from a towel, without any
 pain being experienced.3

                    METHOD  OF  PREPARING.
   The officinal sulphuric ether of the pharmacopoeias is usually era-
 ployed for inhalation.  The specific gravity of that of the Pharma-
 copoeias of the  United States  and London is .750; of the Dublin,
 .765; and of the Edinburgh,  .735, or under.  The last is the best
 for the purpose.  The article  employed by Dr. C. T. Jackson was
 prepared as follows.  The strongest  and purest rectified  sulphuric
 ether, which  can usually be  obtained from  the druggists,  is agi-
 tated with water for the purpose  of removing all acid.  It is then
 freed from the water it may have taken up by chloride of calcium.
 The specific gravity of the product is about .725.4

            EFFECTS ON THE ECONOMY IN HEALTH.
   The effects of all  ansesthetics  are essentially alike; and since
 their recent introduction numerous experiments have been made with
 them by distinguished  physiologists and surgeons,—as by a commit-
 tee of  the  Surgical Society  of Ireland,5 by  Flourens,6  Longet,7
 Amussat,8 Holmes Coote  and Thomas Taylor,9 Ville,10  Gruby,11
Thomas Wakley,12 Gerardin  and Verrier,13 Snow,14  Chambert,15
 Buchanan,16 Black,17 Schuh, Jorg, Von Bibra, Harless'8 and others,

  1  Etherization, with Surgical Remarks, by John C.Warren. M. D., p. 4,Bost, 1849.
 See, on the origin of the inhalation of etlier as a means  of preventing pain in surgical
 operations, the Report of the Board of Trustees of the Massachusetts General Hospital,
 Boston. 1848.            2 Southern Medical and Surgical Journal, Dec. 1849.
  * On the history of ether inhalation, see Dr. Ranking, in Half-Yearly Abstract, Amer.
edit. v. 328, Philad. 1847, and Report of the Committee on Surgery in Transactions
of the Amer. Med. Association, i. 179, Philad. 1848.
  * Warren, Op. cit. p. 93.      5 Dublin Medical Press, Feb. 10, 1847.
  5 Lancet, April 17, 1847.      * Archives Generates de Medecine, Mars, 1847.
  • Comptes Rendus, 22 Fevr. 1847.      9 Lancet, June 19, 1817.
  i° Ibid. July 10, 1847.              '» Lond. Med. Gazette, Dec 24, 1847.
  12 Lancet, Jan. 1, 1848.            13 Comptes Rendus, 27 Dec., 1847.
  14 Lond. Med. Gazette. Jan. 1848.
  ,s Bouchardat. Annuaire de Therapeutique, pour 1848, p. 36.
  •• Lond. Med. Gaz. April, 1847.  " Provincial Med. and Surg. Joum. May 5, 1847.
  >» Canstatt und Eisenmann, Jahresbericht, u. s. w., im Jahre, 184f, iv. 159,ErIangcn,
1848. 
JETHER SULPHURICUS.
63
  and the results have been carefully noted.1  All of them, when re-
  ceived into the lungs, readily enter the pulmonary blood vessels, and
  proceed to the great nervous centres, to exert on these their appro-
  priate agency.  As a general rule, perhaps, the intellectual and mo-
  ral manifestations first exhibit their influence through the excitant
  action of the anaesthetic on the great cerebral and cerebellar gang-
  lia, so that a kind of intoxication supervenes, with imperfect power
  of regulating the movements. The sensory ganglia become subse-
  quently or simultaneously affected, and sensation  and motion are
  suspended; and ultimately, if the quantity inhaled  be sufficient, the
  medulla oblongata has its action  suspended or destroyed; respira-
  tion ceases, and death is the consequence.   Yet great irregularity oc-
  curs in the supervention of these phenomena, as  in the hysteroid
  condition induced  by the  animal magnetizer.  At times,  the in-
'  tellect appears to be but little affected, whilst  ordinary sensation
  is obtunded; and, at  others, morbid sensation or pain is blunted,
  whilst ordinary feeling persists.   The supervention of anaesthetiza-
  tion is known by  closure of the eyelids, if they have  been pre-
  viously open; failure to respond to questions, and  muscular  relaxa-
  tion.   Whilst the patient is under the influence, the pulse and the
  respiration must  be carefully attended to.   If they fail, or if the
  pupil, after  having been  contracted, becomes dilated, the  inhala-
  tion must be immediately discontinued,  and the face be sponged
  with cold water,  ammonia be applied as an excitant to the nostrils
  and throat, and frictions to the extremities; and  M. Ricord2  recom-
  mends, in cases of threatened death from chloroform, the  immediate
  inflation of the lungs, by applying the mouth to the patient's lips.
    It would  appear from the experiments  of Mr.  Nunneley, M.
  Jules Roux3 and  others, that the local application of  anaesthetics,
  as of narcotics in general, deadens the sensibility and  power of
  motion of a part,  whilst the nervous centres, and the nerves distri-
  buted to other parts of the body, may be unaffected.   Mr. Nun-
  neley instituted an extensive series of experiments on animals, and
  found, that by immersing a limb in a small quantity of the fluid,
  or by applying the vapour topically for  a limited period, it might
  be rendered  perfectly incapable of motion and feeling, and be  fixed
  in any desired position.
     It  was but natural to suppose, that the indiscriminate employ-
  ment of so potent an  agent, should, in some cases, give rise to un-
  pleasant, .and even  fatal results.   Yet when we reflect on the im-
  mense number of persons who have been  subjected to the  inhala-
  tion of ether, the  surprise is, that so few examples  of injurious
  consequences should have been recorded.

    1 See H.J. Bigelow, Anaesthetics, their mode of exhibition, and physiological effects
  in Transactions of the  Amer. Med. Association, ii. 197, Philad. 1848.
    a Rankings Half-Yearly Abstract, xi. 191.  Amer. edit Philad. 1850.
    ' Gazette des Hopitaux, 7 Nov. 1848. 
64
iETHER SULPHURICUS.
   The most remarkable  ill  effects  noticed  by Dr. Warren,1 were
of two kinds; first, those caused by the exclusion of oxygen; and
secondly, those from excessive etherization of the nervous centres,
—the principal morbid effect from  the latter cause being general
convulsions—at times, so violent as to threaten life; but generally
by suspending the inhalation,  and  employing the free affusion of
cold  water,  the  convulsions ceased.   Cases in which  distressing
nervous and  other phenomena supervened are related by Dr. War-
ren, Mr.  South, Professor Syme,3 Professor Murphy,3 Mr. Law-
rence of Montrose,4 Mr.  Copeman,5 Dr. Bennett,6 Mr. Eastman,7
Dr. H. J. Bigelow,s Dr. N. R. Smith,9 and others.    Accidents
have,  however, been ascribed to it on no foundation.   Thus, Dr.
Pickford10 states, that a medical  friend in Dublin  informed him,
that of thirty fatal cases following operations in which ether had
been  employed in the various hospitals of that  city, eight were
found to be the subjects of recent tubercles  of the lungs,—the un-
doubted   product, it  was  believed,  of inhalation,—a statement
which Mr. Macdonnell11  denounces as altogether groundless.
   Professor  Syme, Dr. Roberts1* and  others, witnessed inconve-
nient effects from the  inhalation of  ether, and the editor  of the
Monthly  Journal  of the  Medical Sciences observed great excite-
ment,  cough, with expectoration  of pus, haemoptysis, and convul-
sions.  In some cases, erotic feelings, and  even nymphomania oc-
curred in  females: in others, hysterical symptoms, or those  of de-
pression,  or intense  headach, which continued several  days;  and
similar phenomena have presented themselves to the author.   Fa-
tal cases, too,  have occurred, which have been ascribed to the in-
halation,  by  M. Jobert, M.  Roux, Mr. Nunn,Dr. Maclagan, Mr.
Robbs, M. Blandin,13 M. Piedagnel,14 Dr. Paul F. Eve,13 Dr. J. W.
B.  M'Ciellan,10  and  others.   Fatal  cases are,  however,  much
more rare than  they were some time ago; and this is probably  owing
to more care being taken in  its  administration, and in the discrimi-
nation of  cases for which it  is adapted.
   It is proper  to remark, that from tables published by Professors
Simpson and Malgaigne,  showing the mortality of surgical opera-
tions in the British and French hospitals, where anaesthetics had
  1 Op. cit. p. 24.            a Monthly Journal of Med. Science, Aug. 1847.
  3 Lancet Nov. 27,1847.     4 Monthly Journal, June, 1847.
  5 Provincial Med. and Surg. Journal, Feb. 10, 1847.   G Monthly Jour., June, 1S47.
  1 Lond. and Edinb. Monthly Journal, June, 1847.
  8 Transactions of the American Medical Association, i. 209, Philad. 1848.
  5 Ibid. ii. 214,  Philad. 1849.         10 Edinb. Med. & Surg. Joum. July,  1847.
  11 Provincial Med. and Surg. Journ., July 14, 1847.
  >a Monthly Journal of Medical  Science,'April, 1847.
  13 Gazette des Hopitaux, 23 Nov. 1847.  See, also, the details of a case at the Hotel
Dieu, of Paris, in Journ. des Connois Medico Chirurg., cited in Ranking's Half-Yearly
Abstract, Amer. edit. vii. 191. Philad. 1848.
  14 Cited in the Amer. Jour, of the Med. Sciences, April, 1848, p. 558.
  15 Southern Med. and Surg. Journ. June, 1849.
  i° Transactions of the Amer. Med.  Association, i. 192, Philad. 1848. 
.ETHER SULPHURICUS.
65
been used, and where they had not, it would appear that the mor-
tality was decidedly greater where  they were not employed; and
hence it has been inferred, that where  the employment of chloro-
form has sacrificed one life, it may have preserved a hundred.1
   During the inhalation of ether, the blood has been observed to
lose its florid  colour by Mr. Pring,2 M. Amussat, Dr.  Ranking,3
and numerous others.  M. Lassaigne,4 however, states that such
was not the result of his observations.
   The morbid appearances presented by animals killed by the in-
halation of ether have been similar to those observed in asphyxia;
fluidity of the blood;  accumulation of that fluid on the right side
of the heart  and large veins, with  engorgement of the internal
viscera.   In a fatal  case, seen in the Royal Infirmary of Edin-
burgh, there were found double pneumonia, bronchitis, and secon-
dary purulent deposits in the joints.  In a case recorded by Mr.
Nunn, cerebral congestion, engorgement of the lungs posteriorly,
and uniform fluidity of the blood, were found.  In another case there
was no great congestion; but the blood was fluid throughout.  The
observations of MM. Amussat and Lassaigne showed, that in every
case it loses its power of coagulation, although, with  the exception
of the presence of a minute quantity of ether, its chemical charac-
ters are unchanged.5
   From a careful comparison of  the effects produced on the eco-
nomy  by different anaesthetics,  Dr. Haywardfi  decidedly  prefers
sulphuric  ether to either chloric ether or chloroform,—its great
advantages being, in his opinion, "its entire  safety,  the ease with
which  it is administered, and the slight inconveniences which fol-
low its administration."

           EFFECTS ON THE ECONOMY IN  DISEASE..
   It was in severe surgical  operations that anaesthetics were first
employed in the way of inhalation; and until the discovery of chlo-
 roform, sulphuric ether was used  almost solely, and generally with
the most  gratifying results.   As  soon as the intelligence reached
Europe it was at once laid hold of  by  the most  distinguished  sur-
geons, by Messrs. Liston, Key,  Ferguson, Lawrence, Skey,7 and
others, in England; by MM. Malgaigne, Velpeau, Roux, Robert,
Paul Guersant, Leroy d'Efoilles, and  others,8 in France;  and by
Blumhardt,  Dieffenbach,  Schuh, Heyfelder, and others, in Ger-
many.
   1 Report of the Committee on Surgery. Dr. N. R. Smith, Chairman, in Transact of
the Amer. Med. Association, ii. 215. Philad. 1849.      a Lancet, May 1, 1847.
   » Half-Yearly Abstract. Amer. edit v. 335.  Philad. 1847.
   4 Cited in Provincial Med. and Surg. Journ., May 5, 1847.
   5 Monthly Journal of Medical Science, April, 1847.
   ' Remarks on the Comparative Value of the Different Ansesthetic Agents. Boston, 1850.
   7 Amer. Journal of the Med. Sciences, April, 1847, p. 50G.
   • Bouchardat, Annuaire, 1848, p. 35. 
66
iETHER SULPHURICUS.
   Not long after its introduction in this country, nineteen cases of
surgical operations performed on patients rendered insensible by it
were recorded by  Dr. J. Mason Warren,1 of Boston;  and since
then the  testimony in  its favour has  been so overwhelming and
numerous, that it is impracticable even to enumerate the different
authorities.  Mr. Wells, of the English navy, soon  reported  the
favourable results of one hundred and six cases.2   Fractures and
dislocations were happily  arranged  under its  influence, by Dr.
Warren, Dr. Parkman,' Mr. Dehane,4 J. Caunt,5 and others.  Mr.
Lawrence'' reported that it had been used  in St. Bartholomew's
Hospital in all descriptions of operative  procedures between two
and three thousand times without a single unpleasant result.  Dr.
Snow,7 too, appears to have been most fortunate in his cases;  for
with the exception of headache on  one or two occasions, the only
unpleasant effects he had witnessed were  sickness  and vomiting,
and these only occasionally.  Mr. Humphrey," in several hundred
cases in which ether or chloroform  had been  inhaled, saw serious
neuropathic phenomena in only four or five cases; and beyond these
never witnessed more than headache, sickness, and giddiness, last-
ing for a few hours;  and these symptoms supervened but occasion-
ally;  whilst in one  hundred and six cases  Mr. Wells9 saw no
serious ill effects in any.
   There is scarcely a painful operation practised by the surgeon,
oculist, or dentist, in which ether inhalation has not been employed.
Among the earlier recorded cases were an amputation of the thigh
by Dr. J. M. Warren; extirpation of a tumour of the mamma by
Dr. J. C. Warren; an operation for necrosis of the tibia  by Dr.
Townshend; reduction of strangulated hernia by Dr. J. M. War-
ren,1' anrl Dr. Hosack;11 sounding for stone, and lithotrity,  by Dr.
J. C. Warren; stricture of the urethra, with fistulous openings,
by Mr. Liston; lithotomy, by Mr. Tatutn; an operation for fistulous
sinuses by the side of the rectum, by Mr. Keate;ls the removal of
tumours in various parts, by Mr. Syme;13 extirpation of themam-
ma, by Dr. Jas. Bryan;14 amputation of the thigh, by Dr. Mutter ;15
extirpation of the eye, by Mr.  Lawrence and M. Velpeau;16 and
it  has been inhaled in all cases of removal  of tumours and  plastic
operations on the eyelids; but in operations, such  as strabismus,

  1 Boston Med. and Surg. Journal, March 24, 1847.
  2 Lond. Med. Gazette, Sept., 1847.         a Warren, Op. cit., pp. 44 and 4G.
  4 Provincial Med. and Surg. Journal, Sept., 1847.   ' Lond. Med. Gaz., June 4, 1847.
  6 Amer. Journ. of the Medical Sciences. April, 1848, p. 551.
  T On the Inhalation of the Vapour of Ether in Surgical Operations, &c.  Lond., 1847.
  8 Provincial Med. and Surg. Journ., Aug. 9, 1848.  9 Lond. Med. Gaz., Sept, 1817.
  ,0 J. O. Warren, Etherization, with Surgical Remarks, p. 53.  Boston, 1848.
  " Boston Med. and Surg. Journ., Aug. 11,  1847.
  12 Snow. Op. cit, and Ranking's Half-yeaily Abstract, Am. Ed., vi. 97, Philad., 1848.
  '*Monthly Journal of Medical Sciences, Aug. 1^, 1817.
  14 Med. Exam., June, 1847, p. 332.  " Ibid., Jan., 1848, p. 14. ,6 Ranking, vii. 248. 
.ETHER SULPHURICUS.
67
which require, at times, the exercise of volition, anaesthetics are
not indicated; and in those for cataract, artificial pupil, &c, Mr.
Wilde' considers the amount of pain does not demand their use.
   The following  list, drawn up by Klencke,3 will give a view of
many of the operations in which it is recorded to have  been used
in the year  1847:
   1.  Extirpations:—Of encysted tumours, by Schuh, Strode 1
and Hornig.
   Of cancer and similar tumours, by Schuh, Pitha, Heyfelder,
Opitz, Haller, Hayward, Pereshaw, Clement, Velpeau, Malgaigne,
Landouzy, Ricord, Roux, Sedillot.   Of cancer of the lip, by Pitha,
Heyfelder, Maison-neuve.  Of ranula, Heyfelder.
   Of condylomata,  by  Thomson, Fergusson, Bruns,  Mikschik,
Flor, Schubert and Kraus, and Von Brunner.
   Of telangiectasis, by Schuh and Pitha.
   Of nasal polypus, Schulz.
   Of glands.—Mammary gland, by Liston, Leblanc, Brookes,
Bouchacourt, Goyrand.   Parotid  gland, Heyfelder.   Tonsils,
Roux.
   2.  Herniotomy.—Key, Partridge, Schuh, Pitha, Von Riffel,
Heyfelder.   Radical operation (after Gerdy), Kraus, of Prague.
   3.  Lithotomy.—Morgan, Guersant, Balassa, Lithotrity, Leroy
d'Etiolles.
   4.  Strictures.—Fergusson.   Operations for fistula, Pitha,
Heyfelder.
   5.  Urethrotomy.—Pelrequin.
   6.  Phimosis.—Fergusson, Thomson,  Schuh,  Sigmund, Opitz,
Reisinger, Balassa, Von Riffel.
   7.  Castration.—Sigmund and Bonnet.
   8.  Hydrocele.—Ricord, Jobert, Opitz, Schuh, and  Balassa.
   9.  Harelip.—Heyfelder, Pitha.
   10. Ligature  of the Crural Artery, by Von Riffel.
   11. Amputations.—Of the thigh, Hayward, Lansdown, Cole-
man, Liston, Malgaigne, Jobert,  Th. Bell, Chiari, Raymonet,
Duncan, Schuh, Pitha.
   Of the leg.  Hawkins, Leblanc, Sedillot, Haller, Pitha, Dum-
reicher, Opitz, Reisinger.
   Of the arm.  Velpeau,  Schuh, Sigmund.
   Of the forearm.  Liston.
   Of the hand.   Velpeau, Goyot, and Duval.
   Of the finger.   Petrequin, Kraus,  Martin,  Heyfelder,  Pitha,
Sigmund.
   Of the teeth.   Fairbrother, Tracy.
   12.  Exarticulations.—Of the foot-joint,  Pitha.   Of  the
teeth, Pitha, Sigmund, Opitz.   Of the finger, Guersant, Voille-

  1 Dublin Quart Journ. of Med. Science, May, 1848.
  1 Canstatt und Eisenmann, Jahresbericht, u. s. w., im Jahre, 1847, iv. 163. 
68
JETHER SULPHURICUS.
mier, Macmurdo, Von  Riffel, Liston, Cooper, Velpeau, Maison-
neuve, Pitha, Opitz, Kraus of Prague, Sigmund, Kahler.
  13.  Resections.—Removal  of sequestra,  Miller, Pitha, Sig-
mund,  Dumreicher, Sedillot.  Of the shoulder,  Nelaton.   Head
of the  humerus, Pitha, Heyfelder.   Of the ulna, Pitha.   Of the
head of the os femoris, Sigmund.   Of the tibia, Sedillot.   Of the
ankle-bone, Pitha.   Of the lower jaw, Wattmann, Pitha, Tracy.
  14.  Cartilaginous Concretions in the Joints.—Sigmund.
  15.  Myotomy and Tenotomy.—Dumreicher, Schuh, Sigmund,
Pitha, Behrend, Heyfelder.
  16.  Rhinoplasty.—Dieffenbach.  Stomatoplasty, Liston.
  17.  Operations on the Eye.—Blepharoplasty, Sedillot, Brett.
Extirpation of a tumour, Bigelow, Jiingken, Hammer.   Cyst in
the Orbit,  Monod.   Strabotomy,  Brett,  Malgaigne,  Lorinser,
Heyfelder,  Hammer.
  Cataract, Brett, Cotton.   Extirpation of the bulb, Lawrence.
Staphyloma, Arlt.  Arlt also operated for Trichiasis, Blepharo-
phimosis, and  Fistula lachrymalis.
  Of the bloodless operations—unblutige Operationen—the
following were performed under the narcosis induced  by ether:
  1. Reduction of incarcerated hernia, by  Pitha,  Opitz, and
Hornig.
  2. Reduction of Luxations, by Velpeau and Dumreicher.
  3. Introduction  of the Catheter and Bougies, Fergusson.
  The list of patients who inhaled ether or chloroform for surgical
operations  in the  Massachusetts  General Hospital to April 1st,
1848,  as reported by Dr. H.  J. Bigelow,1 numbered 154;  and in-
cluded 9 amputations  of the  thigh, 11 of the leg, 4 of the arm,
and  12 of the  breast.   Thirty-seven cases  are reported  by Dr.
Watson,2 as having been treated in the First and Second Surgical
Divisions of the New York Hospital; 13 cases at the  Clinic of the
University of Pennsylvania are reported by Dr. H. H. Smith;3 and
45 at the Clinic of the Jefferson Medical College by Dr. Mutter.4
In 32 of these ether  was employed;  in the  remainder  chloro-
form.
  When the practice  had been followed less than  a  year, Mr.
Lawrence reported, that the  trials with ether in a single London
hospital amounted to between two and three thousand cases. One
dentist in that  city, up to the middle of July, 1848, had adminis-
tered anaesthetics more than three thousand times.
   The physician  has  recourse to etherization in all cases which
require the employment of other  powerful narcotics and antispas-
modics.  It was found especially valuable in  all the
   JYeuroses, by Kalinsky.5

  1 Transactions of the American Medical Association, i., 215.  Philad., 1848.
  2 Ibid., p. 218.              3 Ibid, p. 220.              4 Ibid., p. 221.
  5 Canstatt und Eisenmann, Jahresbericht, u. s. w., iv. 167.  Erlang, 1849. 
JETHER SULPHURICUS.
69
   Tetanus.—It has been  employed  successfully for the  relief
 of tetanic  spasm;  but, as  properly  remarked  by Dr. Warren,1
 whilst it may mitigate the distress of the muscular contractions, it
 cannot be expected  to overcome the morbid condition of the spinal
 membranes, or the medulla they envelop, which he—in the absence
 of adequate evidence and of probability — considers to be inflamma-
 tory.   In cases related  by Dr. W. H. Ranking2 and M. Roux,3 of
 Cherburg, it appeared to act injuriously ; and in  anotherin which
 it was tried in France, death—it was  conceived—was  unques-
 tionably  hastened by it; whilst in others, reported by Dr. Brady4
 and Mr. Broughton,5 it did  not avert the fatal result.   Cases are,
 however, recorded of its successful  administration in tetanus,  by
 Dr. Pertusio and Mr. Hawkesworth;6 but they  are  regarded  by
 Dr. Ranking7 as by no means satisfactory.  In  cases  related  by
 Mr. Bransby Cooper,8  Dr.  Crawford,9 and Dr. T. L. Ogier,10  al-
 though it afforded  temporary relief, it  did not arrest  the  progress
 of the disease  towards  a fatal termination.  A case, however, is
 related by Mr. Hopgood,11 in a boy nine  years of age, which was
 successfully treated  by it; another by Mr. Chalmers;12 another  by
 Dr. Theobald,13 of Baltimore; and another  by Dr. Isaac Parrish;14
 and one of  Tetanus  rheumaticus, by Reichert.15
   Hydrophobia.—A case is recorded by Mr. Allen,16 in which the
 spasms were temporarily relieved  by  ether inhalation, without,
 however, the fatal event being averted.
   Convulsions in a boy eleven years of age, were much  relieved
 by it under  the direction of Dr. Wyatt;17  and a case in a child,
 five months' old, was completely cured  by Dr. Sabin.18
   Delirium tremens.   A case is related by  Dr. Upham,19 in which
 sleep and quiet were induced by it; and similar cases are recorded
 by Dr. Anderson.20   Dr. Stedman, too, used it with good effect.21
   Insanity.   Ether has been inhaled  under the  direction of M.
 Cazenave, of Pau, and of M. Jobert22  and   Dr. Boyd; and it ap-
  ' Etherization, with Surgical Remarks, p. 54.  Boston, 1848.
  2 Provincial Medical and Surgical Journal,  April 21, 1847.
  J London Medical Gazette, Sept., 1848.
  4 Dublin Med. Press, cited in Ranking's Half-yearly Abstract, v. 340. Philad., 1847.
  5 Provincial Medical and Surgical Journal,  May 5, 1847.   6 Ibid , May 19, 1847.
  1 Half-yearly Abstract.   Amer. Edit, v. 341.  Philad.,  1847.
  8 Lond. Med. Gaz., Aug. 6, 1847.
  9 British American Journal of Medical and Physical Science, Dec, 1847.
  10 South. Journ. of Med. and Pharm., Nov., 1847.   " Med. Times, Jan. 15, 1848.
  a Provincial Medical and Surgical Journal,  June 30, 1847.
  " Amer. Journ. of the Med. Sciences, Jan., 1848.
  14 Transactions of the College of Physicians of Philad., vol. ii., No. 4.
  15 Canstatt und Eisenmann, Jahresbericht, u.  s.  w., im  Jahre  1848, iv.  177.  Er-
lang, 1849.   '" Lancet, Oct 15, 1847.  " West.  Journ. Med. and Surg., Ap., 1848.
  18 Boston Medical and Surgical Journal, April,  1848.
  ,s Prov. Med. and Surg. Journ., Dec. 15, 1847.        20 New York Annalist.
  2' J. C. Warren, Etherization, with Surgical Remarks,  p. 83.  Boston, 1848.
  22 Cited in Med  Gaz., May, 1847, and Brit, and For. Med. Rev., April, 1817. 
70
^THER SULPHURICUS.
 pears to  have occasionally tranquillized, without  any evil  conse-
 quences.1
   JVeuralgia.   Its  good effects in this disease have been deposed
 to by Kalinsky,2 especially in hemicrania ; and by Morris,3 Sem-
 ple,4 Honore, Christison,5 and others.   N
   Hysteria.   A case in which  the inhalation of ether proved suc-
 cessful in subduing hysteric symptoms after every kind of treatment
 had been used for four days without effect, is related by Mr. Wil-
 kinson ; and another fortunate case by Ducros.6
   Asthma.  Dr. Willis7 and Mr. Cantrell8 have employed it suc-
 cessfully.   The  latter states that he had long used it prior  to its
 recent introduction  as an anaesthetic.   In
   Obstinate Hiccough, it was prescribed with  advantage by Dr.
 Christison;9 and in
   Hooping-cough,  it is  spoken favourably of by  Dr. Willis10 and
 Max. Simon.11
   Laryngismus  stridulus.   A  very severe  case  was  materially
 benefited by the use of a sponge saturated with ether.   Dr.  Ran-
 king'2 saw  the case  with Mr. Image, who reports  it.   It  has also
 been used successfully in
   Colica Pictonum, by M. Bouvier ;13 and  in  flatulent  colic by
 Horing.
   Renal Calculi.  In the  intense suffering attending the  passage
 of a renal calculus—nephritic colic—inhalation of ether has been
 prescribed with signal advantage  by Dr. Ware14 and Dr.  Griesin-
 ger: and in
   Dysmenorrhea,  by Dr.  Griscom.15
   Ophthalmia.   In violent cases, M. Guersant18 has employed at
 the  Hopital des Enfans Malades, of Paris, a collyrium composed of
 one  part of nitrate of  silver, and four  parts  of  water,  with great
 advantage.  The pain is often, however, so great, that he has had
 recourse to the inhalation of ether with  marked success to enable
 him  to make the application.  Dr. Mackenzie17 advises the inhala-
 tion in many forms  of ophthalmia, especially where there is much
 photophobia ; but the duration of the ophthalmia did not seem to be
 curtailed;  and  Dr.  Smith,18 of Cheltenham, by its agency, was

  ' Drs. Ray and Bell, cited in Trans, of the Amer. Med. Assoc, iii. 79. Philad., 1850.
  2 Canstatt und Eisenmann, Jahresbericht, u. s. w., iv 167. Erlang., 1849.
  * Medical Times, cited in Ranking's Half yearly Abstract.  Amer.  Edit., v. 341.
 Philad., 1847.                            * Lancet, March 27, 1847.
  5 Dispensatory, Amer.  Edit, by R. E. Griffith, p. 152.  Philad  , 1848.
  B Lancet. July 3, 1847.                          ' Ibid., March 20, 1847.
  8 Prov.  Med. and Surg. Journ., May 19,1847.        9 Op. cit       ,0Op.Cit
  11 Canstatt und Eisenmann, Jahresbericht, u. s. w., im  Jahre,  1848,  iv. 177. Er-
langen, 1849.     '2  Half-yearly Abstract Ac, Amer. Edit, v. 342.  Philad , 1847.
  " Canstatt und Eisenmann, Op. cit. iv. 177.
  '* Boston Med. and Surg. Journ., May 1,1847.
  15 Transactions of the College of Physicians of Philadelphia, April, 1849.
  16 London Medical Gazette, June, 1847.       ,1 Ibid.
  '« Wilde, Report on Ophthalmic Surgery, in Dublin Quarterly Journal of Medica)
Science, May,  1848. 
iETHER SULFHURICUS.
71
 enabled to examine and manipulate on the eyes of young children
 affected with strumous ulcerations of the eye.
    Intermittent Fever.   It is affirmed that  Mr. J. W. Freer,1 a
 pupil in the Chicago Hospital, employed ether in this malady with
 the most delightful results.   Two or three inhalations invariably
 arrested  the  paroxysm instantaneously during  the cold  stage;
 brought on diaphoresis; and  in cases where  there was no unusual
 exertion,  the  paroxysms did not recur.
    Phthisis.  In the last stage of this fatal malady the inhalation
 of ether has been prescribed by Dunker,2 and it has exerted a mani-
 festly soothing influence: it has been ably and forcibly urged, too,
 by one' who  has  had  much to do with the introduction and pro-
 mulgation of  anaesthetics in  the  treatment of disease,  that  in in-
 curable affections, when the melancholy termination approaches, it
 may be highly desirable to administer them with the view of ren-
 dering death easy,—of inducing euthanasia*
   Feigned diseases.   Ether  inhalation has been employed to de-
 tect them.   M. Baudens"' records two cases—one of simulated, the
 other of real infirmity—in which it detected the fraud.   If volition
 be overpowered  by  it, the  deception  can no longer be main-
 tained.  M. Bayard,8 however—and  the  Editor of the Medico-
 Chirurgical  Review for October, 1849, accords  with him—is of
 opinion, that owing to the occasional results which follow the  use
 of anaesthetics, especially of chloroform, and the uncertainty of the
 revelations obtained through  their  aid, they ought not—and the
 remark applies especially to chloroform—to be employed  for  the
 detection  of simulated disease.
   The obstetrician has  largely employed the inhalation of  ether
 and other anaesthetics to relieve the intense suffering that  accom-
 panies  severe  labour; and experience  seems to have shown, that
 whilst  it  effects this,  and aids in the relaxation of the parts, it
 does not  materially—or at all—diminish  the parturient  efforts.
 Professor  Simpson,7 of Edinburgh, was, perhaps, the first to em-
 ploy the inhalation of ether in  this relation, and was a strong advo-
 cate for its use until he had tested the virtues of chloroform, which
 he now employs exclusively.   His opinion of  the value of  ether
 is supported by the testimony  of Paul Dubois,8 Professor Siebold,9
 M. Roux,10of Toulon, Dr. Channing,11 Dr. Parkman,1-' M. Chailly,13
  ' Illinois and Indiana Med. and Surg. Journ. for Oct. and Nov., 1847.
  'Canstatt und Eisenmann, Jahresbericht, u. s w., im Jahre, 1848,  iv. 177.  Er-
 langen, 1849.                     ' J. Q. Warren.
  4 Etherization, with Surgical Remarks, p. 09.  Boston, 1848.
  ' Comptes rendus, 8 Mars, 1847.        6 Annates d'Hygicne, xiii. 165—201.
  7 Monthly Journal of Medical Science, March, 1847; and Notes on the Inhalation of
Sulphuric Ether in the Practice of Midwifery.      8 Lancet, March 6, 1847.
  9 Lond. Med. Gaz., June II, 1847.   ,0 Gazette Medicate de Paris, OOctobre, 1847.
 ," A Treatise on  Etherization in Child-birth.   Boston, 1848.
  12 American Journal of the Medical Sciences, April, 1849, p. 343.
  13 Archives Generates de Medecine, Avril, 1847. 
72
iETHER SULPHURICUS.
Dr. Lloyd,' Mr. Lansdown,2 Dr. Protheroe Smith,3 Dr. Jonathan
Clark,4 Dr. Lindsly,5 Dr. Trask,"  and numerous  others.   Objec-
tions  have  been brought against its  use, many of which  do not
merit much notice.  The strongest, perhaps, is the one urged by
Drs. Radford,7 Meigs, and  others, that in instrumental deliveries
more especially, "as in lithotomy and lithotrity,"  the sensibility of
the patient  is a safeguard against injury of the soft parts;  but the
argument is more specious, perhaps, than solid, as a careful opera-
tor could scarcely perpetrate such a blunder.8  It has been very
largely and successfully employed in instrumental  and complicated
labours.  Two cases of placenta prcevia were treated under its
agency by Dr. Protheroe Smith ;9 and examples of its value where
turning was required, are recorded by him as  well as by Mr. Gor-
don,10 Mr. Pickens,11 and others.   In numerous cases of puerperal
convulsions, and in forceps and  craniotomy  cases, its value has
been  manifested.12
                   MODE OF ADMINISTRATION.
   Various forms of inhaling apparatus have been  devised.  Many
are referred to by Dr. Ranking ;'" and some of  them by the author14
in another work, with figures representing them.   The vapour is
most conveniently inhaled from a soft sponge,  hollowed out on one
side,  to receive the projection of the nose, and saturated  with the
purest ether.   The sponge, thus prepared, is applied over the nos-
trils, through which the inhalation must be made,  leaving the
mouth free  to receive atmospheric air, and thus prevent the  dan-
ger of asphyxia.
   The time required to produce etherization is  usually from  three
to  five  minutes, and the quantity generally found necessary, is
about two fluidounces; but the effects must  be carefully  watched.
Dr. Warren15 remarks, that  after careful inspection of two hundred
cases of both sexes,  of all ages, in a great variety  of conditions of
health and  disease, etherized through  a sponge, without  reference
to  quantity, he  has seen no immediate  or consequent symptoms,
  1  Medical Times, March 27, 1847.          * Lancet, June  5, 1847.
  *  Lancet, May 1. and July 31, 1847.
  4  Medical Examiner, October, 1847. p. 4^9, and March, 1848.  p. 153.
  'Transactions of the American  Medical Association, vol. i., Philad., 1848; and
Medical Examiner, June, 1848, p. 339.
  6  American Journal of the Medical Sciences, October, 1850, p. 341.
  1  Lancet, April 7, 1847.
  8  Answer to the Religious Objections advanced against the Employment  of Anaes-
thetic  Agents  in Midwifery and Surgery, Edinburgh, 1848; and Anaesthesia, or  the
Employment of Chloroform and Ether in Surgery, Midwifery, &c, by J. Y. Simpson,
M. D., &c, Philad., 1848; and a  Correspondence between Professors Simpson and
Meigs, in  Medical Examiner, March, 1848, p. 145—April, 1848. p 205—and May,
1848, p. 269.       9  Lancet, July 31, 1847.       ,0 Ibid., July 14, 1847.
  11 Provincial Med. and Surg. Journ., Sept. 23, 1847.    a Charming, Op. cit.
  13 Half-yearly Abstract of the Medical Sciences, v. 330, Amer edit  Philada. 1847.
  14 General Therapeutics and Materia Medica, 4th edit. i. 383.  Philad. 1830.
  " Etherization, &c p. 77. Boston, 1848. 
JETHER SULPHURICUS.
73
which would lead him to embarrass the patient  and the surgeon
with a complex apparatus; and  similar views are  entertained by
Dr. Hayward.1  The irritability of the parts," the latter remarks,
"with which the ether comes in contact, is by degrees overcome;
then the sponge may be applied  directly to the face, and, if neces-
sary, compressed in some measure so as to exclude to a greater de-
gree the atmospheric  air.   When the  desired effect is  produced,
which is usually in  from three to five minutes, the  patient has no
control over the voluntary muscles; he cannot speak; he cannot open
his eyes, when directed to do  so; his muscles become  completely
relaxed, and the pulse, which, at the beginning of the inhalation,
is frequent, and often rises during the process to one hundred and
forty beats in a minute or more,  becomes slower, and 1 have very
often known it fall to sixty.   The  patient is then insensible, and
unconscious: and the surgeon may begin his operation with great
confidence that he will inflict no suffering.   The sponge should
then  be removed, and reapplied, from  time  to  time,  as circum-
stances  may require.  If the ether is not pure, longer time  is ne-
cessary to produce the desired effect: the brain and nervous  sys-
tem are more excited, and the patient is occasionally violent for a
time, and  with difficulty controlled.   Before  using  the ether, the
sponge should be dipped  in warm water, and  then  strongly com-
pressed, leaving it slightly damp.  The evaporation seems  to go
on better in this way, than when a  sponge is  used  that has not
been previously moistened.   In the  first instance, the ether should
be poured  over  the inside of the sponge:  about  two  ounces  is
enough.   When more is required, it should be applied to the out-
side, as it  is best not to remove the  sponge from the face."
  It has likewise been administered per anum, and M.Pirogoff,2
of St. Petersburg, thought that the anaesthetic effects of the vapour
were produced more speedily and with much less  trouble to the
patient.  He found, that in from two to four  minutes the odour of
the vapour was perceptible in  the breath, and the  wonted effects
supervened in  from  three to five  minutes.   The quantity of ether
used varied from half an ounce to  two ounces.   Similar experi-
ments were made by MM. Roux and Parchappe;  and according
to M. Velpeau, the former preceded  M. Pirogoff.

  1 Remarks on the Comparative Value of the Different Anaesthetic Agents.  Boston,
1850.
  ■ Gazette Medicate de Paris, 8 Mai, 1847 
74
ALUMINAS SALES.
                 XL ALU'MINjE SALES.
Synonymes. Salts of Alumina.
French. Sels d'Alumine.
German. Thonerdensalz e.

   In  making  experiments on the agency  of  various  substances
as antiseptics,  M. Gannal1 discovered that the  aluminous salts are
alone possessed of the  property of preserving  animal  matters,—
"their bases combining with  geline to  form a  special  compound,
the acid being set free."   He found  the aluminous deliquescent
salts to be, of  all saline substances, those that afford the most satis-
factory results.  The acetate of alumina and chloride of alu-
minium succeeded perfectly.   A mixture of equal parts of chloride
of aluminium  at 20° Beaume (a.  g. 1161,) and of the acetate of
alumina at 10° (s. g. 1.075,) proved as good an injection as we
possess for the preservation of dead bodies.
   The preservation of animal substances  appears to depend upon
the combination of geline with  alumina :  but  the  acid sulphate
does not possess enough of the preservative element;  and hence
M. Gannal was driven to the employment of the salts of alumina
that are richer in alumina,  and  more soluble  in water.  Of all
these, the sulphate of alumina was found to merit the  prefe-
rence, owing to its being of simple  preparation and moderate price.2
It may be made  by the direct combination of  alumina and sul-
phuric  acid;  and contains 30 per cent,  of the former to 70 per
cent,  of the latter.   A  kilogramme—about two pounds, eight
ounces, and  a  dram and a half troy—dissolved in two quarts of
water, and costing twenty cents, M. Gannal found to be sufficient,
in winter, to preserve a body fresh by injection for three months.
To preserve  it for a month or six weeks, it was not  even  neces-
sary to inject the blood-vessels,—an enema of  one  quart, and the
same quantity  injected into the oesophagus  being sufficient for the
purpose.  In  hot  weather, the solution  must  be stronger, or in
greater quantity, and it should be  injected into  the carotids.
   The  acetate of alumina, of which M. Gannal made use, was
prepared by the addition  of acetate of lead to sulphate of alu-
mina and potassa.  The acetate of alumina, thus prepared, at
18° of  Beaume's  areometer, and in the quantity of five or six
quarts, was sufficient  to preserve  a  body for five or six months.
This salt of alumina is, however, too costly; and, therefore, can-
not be employed in amphitheatres, where large quantities are re-
quired.
   In  the report  on M. Gannal's memoir presented to  the Insti-
tute of France, the commission adduce, in  favour of his plan,the
  1 History of Embalming, &c. by J. N. Gannal, Paris,  1838, translated by R. Harlan
M. D., p. 203.  Philad. 1840.            ' Ibid, p, 233. 
aluminje sales.
75
 experience of MM. Serres, Dubreuil, Bourgery, Azous, Velpeau,
 and Amussat.   " In the month of June, 1836," says M. Serres,
 "in the amphitheatre of the hospital, the body of a man, 22 years
 of age, was injected.   Left to the open air, in a room exposed to
 the south, and  upon a wooden table, it was  preserved  until the
 month  of September, and  was  ultimately mummified.  In the
 month of July, eight bodies were injected for dissection, and  kept
 fifteen days.  During the months of August and September, sixty
 subjects were injected.  They were kept for twenty days." From
 these experiments, M. Serres concluded, that the liquid furnished
 by M. Gannal, permitted the dissection of bodies during summer,
 which had  not been practicable in the  anatomical  schools of the
 hospitals of Paris; and that it gave to the instruction in operative
 medicine a development which it had not previously enjoyed; for,
 during  the  months of August and September, they were enabled
 to have  thirty bodies at a  time on the  tables  as in  the middle of
 winter, so as to enable them to repeat before the students all the
 operations required in a regular course of operative surgery.  For
 his  discovery the  Institute  of France  awarded M. Gannal   the
 grand Monthyon prize of 1600 dollars, which was established for
 the discovery of any means calculated to remedy the unwholesome-
 ness of any  art or profession.
   A useful application of M. Gannal's process is said to have  been
 made by the police of Paris, in preserving bodies for many weeks
 in the Morgue or dead-house, where suspicions of murder required
 an unusual retention of  the body above ground.1
   Specimens of pathological anatomy, preserved in  the liquid of
 the  injection,  were not  exempt, according to Dr. Harlan, from
 the usual  inconvenience attached to similar preparations in a solu-
 tion of chloride of sodium and other salts,—being equally liable to
 incrustations, so as to require a change or renewal of the solution.
   The salts of alumina  have been used in this city with the view
 of temporarily preserving the dead ; and a case has been published
 in which the acetate was employed; but the corrosive chloride of
 mercury was used along with it, which was unnecessary.  In the
 afternoon  of the day on which the individual died, the abdominal
 aorta was injected  upwards and downwards with a saturated so-
 lution of corrosive chloride in alcohol; and on the following day, a
 saturated solution of acetate of alumina  was thrown in, "which,"
 says Dr.  Sharpless," "had  the immediate  effect  of  giving  the
 whole body a manifest rose colour, making it resemble life in a re-
 markable  degree."
   The salts of alumina have been chiefly employed to prevent pu-
trefaction  in the dead body; but they might be used  with eminent
advantage as external applications in cases  that  require the  topi-
  ' Harlan, Appendix to Gannal, Op. cit, p. '254.
  1 Medical Examiner. Aug. 13,1842, p. 513. 
76
AMMONIiE PHOSPHAS.
cal use of antiseptics.   At  the author's suggestion, they were so
used at the Philadelphia  Hospital, and were found to have an ex-
cellent effect in ulcers requiring antiseptic and detergent applica-
tions.1   Two  drams of the sulphate to half a pint  of  water is a
good wash in such cases; but it may be made much stronger than
this.  Dr. George Johnson, of Georgia, used an injection of the
sulphate with the happiest results in cases of fetid discharges from
the vagina?   After handling  pathological specimens, the  author
has found a saturated solution of the salt remove  the offensive
odour from his hands  more speedily and effectually than any other
antiseptic.
               XII. AMMO'NLE PHOSPHAS.
Synonymes. Ammonium phosphoricum, Phosphate of Ammonia.
French. Phosphate d'Ammoniaque.
German. Phosphorsaures Ammonium.
  Phosphate of ammonia has been recommended  in  some of the
unofficial  pharmacopoeias and  formularies, as  an excitant, dia-
phoretic  and discutient;3 but it could scarcely  be said to be em-
ployed in medicine, when it was brought forward by Dr. Thomas
Buckler, of Baltimore, on chemical considerations, as " a new re-
medy for gout and rheumatism, as a solvent of uric acid calculus,
and  for diseases, acute .and chronic,  connected  directly with the
lithic acid diathesis."*

                   METHOD OF PREPARING.
  Neutral phosphate of ammonia may be made by saturating  a
somewhat concentrated solution of phosphoric acid with ammonia,
applying  heat, and setting  the solution aside, that crystals may
form.  Or, it may be formed  by saturating the excess of  acid in
superphosphate of lime by carbonate  of ammonia.   Phosphate of
lime will  be  precipitated, and  phosphate of ammonia obtained in
solution, which, being concentrated by a gentle heat, affords, on
cooling, the salt in crystals.

                 EFFECTS  ON THE ECONOMY.
  From  the facts of the frequent existence of lithuria in gout and
rheumatism, and the  sudden elimination of uric acid,—and that
when chemists have examined the structural thickenings in those
diseases, they have found  a variable abnormous  per centage of
earthy matter, consisting for the most part of soda and lime,—and
from other considerations, Dr. Buckler infers,  that uric acid exists
in the blood,—not in a free state, or  it would be  passed continu-
  ' M.J. Pennypacker, Med. Ex., April  1, 1843, p. 63. 3 Ibid. May 27, 1843, p. 112.
  3 Merat and De Lens, Diet  Univ.de Mat. Med. &c, edit, de Bruxelles, 1, 115.
Bruxelles, 1838.      4 American Journal of Medical Sciences, Jan., 1846, p. 108. 
AMMONIA PHOSPHAS.                   77
ously, but in a state  of combination with soda  or lime, or  both.
The predominance of lithic acid in the urine, he considers,  gene-
rally heralds recovery from an acute  attack  of  gout or rheuma-
tism.  " Taking into account," he observes," these two prominent
facts, namely, the excess of lithic acid found in  the  urine at the
period of convalescence from an  attack  of  gout or rheumatism,
and the subsequent deposit of soda and lime  in the  white tissues,
it occurred to me, that during the existence of these diseases, the
lithic acid might exist in the blood in  a state  of  combination with
soda and lime, in the form  of insoluble compounds, which the kid-
neys and skin refuse  to eliminate.  If, then, any agent  could be
found capable of decomposing the lithates of soda and lime  exist-
ing in the blood, and of forming in their  stead  two  soluble  salts,
which would be voided by the kidneys and skin, we  should there-
by get rid of the  excess of fibrin in  the  blood, the  symptomatic
fever and the gouty and rheumatic inflammation, wherever seated,
which have been excited by the presence of these insoluble  salts:
it occurred to me that phosphate of ammonia might  be the agent,
provided it could  be given  in doses sufficient to answer  the end,
without producing any unpleasant physiological symptoms.   If
our theory were  true, phosphate  of  ammonia seemed to be the
proper reagent,  for it would form, in place of the insoluble lithate
of soda, two soluble salts, the phosphate of soda, which is remark-
ably soluble, and the lithate of ammonia, which is  also soluble,
and both capable of being readily passed by the  skin and kidneys.
The excess of uric acid would thus be got rid of in the form of
lithate of  ammonia, and the soda floating in the round of the cir-
culation, instead of being deposited, as it were, like an alluvial
formation in the substance  of the fibrous and  cartilaginous tissues,
would be  taken  up by the phosphoric acid and eliminated  from
the circulation."
   With such views  Dr.  Buckler  administered  the  phosphate  of
ammonia, and found that thickening of the white tissues, of long
standing,  disappeared under its continued use; that  it was de-
cidedly serviceable in attacks of gout and acute rheumatism,
and that in many old hospital cases of chronic rheumatism, the
patients, without a single exception,  declared themselves better,
and begged for a continuance of the medicine.  In every instance,
in the cases reported, it was found that where lithic  acid was pre-
sent in the urine, it at once disappeared under the use of the  phos-
phate of ammonia.   From this rapid disappearance of the acid
from the urine, in every case, he was  led  irresistibly to  the con-
clusion, that the phosphate of ammonia must  prove the best  agent
for dissolving uric acid calculus; but he had had no opportunity
for testing its efficacy in this respect.
   The cases adduced by Dr. Buckler  do not demonstrate to  us, so
strongly as they do to him, the  marked efficacy of  phosphate of
       6 
78                   AMMONIiE PHOSPHAS.
ammonia in the  cases in question.  It is proper also to remark
that, according to the analysis of Berzelius, this salt exists  in the
urine in health, and we have no reason to bdieve that it is not pre-
sent in gouty and rheumatic  diseases also.   Moreover, although
there may be generally a predominance of uric acid in the  urine,
in gout and rheumatism, it is by no means clear that these diseases
are dependent on contamination of the  blood with undischarged
urea and uric acid, as has been maintained by many.1  " Several
considerations," say Messrs. Ballard and Garrod2—able chemists
—" prevent our subscribing fully to this doctrine,  which we are
not aware to be established upon aught but hypothetical grounds."
Phosphatic deposits are frequently, indeed, observed in conjunc-
tion with gouty affections, and in many instances, it would  seem,
that tophaceous concretions contain no urate of soda, but  in  its
stead phosphate of lime.  In  numerous cases of gout, the phospha-
tic predominance is  indeed marked.3   Keller,4 again, in  animad-
verting on the  views of Mr. A. Ure, referred to  under  Acidum
Benzoicum, remarks, that Mr. Ure " is certainly too hasty  in re-
commenmng  benzoic acid as a remedy for the gouty and calculous
concretions of uric acid.  He seems to suppose that the uric acid
has been employed in the conversion of benzoic acid into hippuric
acid ; but as  his observations were made on a gouty patient,  it may
be supposed that the urine, even without the internal use of ben-
zoic acid, would have been found to contain no uric acid."
   M.Mattei5 of Bastia, has published some cases which appeared
to him to exhibit the valuable agency of the phosphate in gout and
rheumatism  in the dose of about 30 grains ; and Dr. S.Edwards,6
confirms its advantages in diseases which appear to depend upon
the  presence of an  excess of lithic acid or lithates in the  blood.
In chronic articular rheumatism, it appeared  to be especially be-
neficial.   As a solvent  of lithic calculi his experience does not en-
able him to pronounce upon it, but his observations lead  him to
depose positively as to its powers to arrest  the  increase and per-
haps the formation of them.  In lithic acid gravel, he has fre-
quently used it; and experience has taught  him, that it creates a
very rapid decrease and disappearance of the red crystalline sedi-
ment.
   Sufficient  time has not  elapsed for experiments to have been
made on a great scale, to test  the qualities of the phosphatic  salt in
the cases described by Dr. Buckler.   It has been already seen, that

  ' Williams, Principles of Medicine, Amer. edit by Clymer, p. 131.  Philad. 1844.
   2 Elements of Mat. Med. and Therap., p. 352.  Lond.  1845.
  3 A. Ure, Provincial Med. and Surg. Journal, Feb. 11, 1843; cited in Braithwaite's
Retrospect, vii. 47.  Lond. 1843.
  * Liebig's Animal  Chemistry, Amer. edit, p. 315.  Cambridge,  1842.
  s Revue Medico-Chirurgicale, Dec. 1847.
  • Provincial Med. Journal, Nov. 17, 1847; and Amer. Journ. of  the  Med. Sciences,
Jan. 1,1848, p. 239. 
AMMONliE PHOSPHAS.
79
in the case of the  benzoic acid, examples were  not wanting  to
prove its efficacy in lithuria;  although no one now can believe that
it could have exerted any efficacy in the manner suggested.  So
far as the phosphate of  ammonia has  been given,  it does not seem
to have generally fulfilled.the expectations excited by Dr. Buckler.
In a trial made with it by Dr. C. Voigt,1 in the dose of only about
three grains, a series of alarming and highly irritative phenomena
succeeded, caused,  he  thinks, by the  violently irritating action of
the salt on the stomach; yet Dr. Voigt  had good reason to suppose
that the preparation employed was pure.
   In commenting on this case, Dr. Ruschenberger,3 of the United
States  Naval  Hospital, New York, states that he  has employed
 phosphate of ammonia in nine cases in doses of ten grains, repeated
 every four hours.   In no case was the article used  for less than a
 week, and  in several it was continued  three, four, and  even six
 weeks.  The urine was tested before the medicine was prescribed,
 and during its use; but no change in  its constitution was detected
 by reagents, nor was there any  modification in its quantity or spe-
 cific gravity.   In one case only did any amelioration occur in the
 symptoms after the use of the salt;  but whether this was  owing
 to it he could not decide.  Inasmuch, however, as  no perceptible
 effects  were induced in  any of the other cases, his  impression was
 that  the  phosphate is  useless  in the treatment of chronic rheu-
 matism.
   Since then Dr. H. Hartshorne,  resident physician at the Penn-
 sylvania  Hospital,3 has reported  some cases  of rheumatism  in
 which the phosphate was prescribed by Dr. Pepper.   The smallest
 dose given to an  adult was ten grains, and  in several  cases it
 reached thirty grains, continued three times  daily for a number of
 days.  In  two or three,  in  doses of twenty grains, it disordered
 the alimentary canal.   Several  of the cases  recovered; but addi-
 tional treatment was generally  used—as Dover's powder at night,
  the warm bath, cupping, blisters  dressed with  morphia, mercurial
  ointment combined with narcotics, veratria ointment, &c.    These,
  Dr. Hartshorne considers, may  perhaps claim much of the credit
  of the cures, which were mostly very slow.  The phosphate, he
  says, has been used by his father, Dr. Joseph  Hartshorne, with
  such results  as to incline him to think that it may be a valuable
  addition to our means of treatment of  rheumatism.
                  MODE OF ADMINISTRATION.
    The dose of the phosphate  of ammonia  is  from ten to twenty
  grains, which may be given, dissolved  in water,  three times a day.
   i Med. Examiner, May, 1846, p. 289.           2 Ibid. June, 1846, p. 342.
   3 Ibid. July, 1846, p.  397;  and January,  1849, p. 49. 
80
AQUA AMYGDALARUM CONCENTRATA.
                  XIII. ANTHRAKOKALI.1
  Synonyme.  Lithanthrakokali.
  German.  Steinkohlenkali.
  This article was  first proposed by Polya, of Pesth, in the year
1837.
                   METHOD OF PREPARING.
  Two forms are employed, the simple  and  the sulphuretted.
The former is prepared by dissolving carbonate of potassa in 10
or 12 parts of boiling water, and adding as much slaked lime as
will separate the potassa.  The solution thus obtained contains only
caustic  potassa.  The  filtered liquor  is placed  on the fire in an
iron vessel, and suffered to evaporate until neither froth nor effer-
vescence occurs, and the liquid presents a smooth surface like oil.
To  this is added the levigated coal in the proportion of 160 parts
to 192 parts  of potassa. The mixture is stirred and removed from
the fire, and  the stirring is continued  until a  black homogeneous
powder results.  This powder is kept in a dry place.
  To obtain the sulphuretted anthrakokali, 16 parts of sul-
phur must be mixed accurately with the coal, and the mixture be
dissolved in the potassa as directed above.

           EFFECTS ON THE ECONOMY IN DISEASE.
  Polya affirms, that Anthrakokali exerts its  influence on the
skin generally, and especially on chronic cutaneous affections.  It
has also been given beneficially by Felsach in scrofula and chronic
rheumatism.
  The dose of the  simple and sulphuretted preparations is 10 cen-
tigrammes (gr. iss.) three times a day.
  M. Gibert employs it externally in chronic cutaneous affections,
in the form of  ointment, which may be made  of one drachm of the
anthrakokali to from one to three ounces of lard.2

  Fuligokali is an analogous substance.
      XIV. AQUA AMYGDALA'RUM CONCENTRATA.
  Synonymes.  Water of Bitter Almonds.
  French.  Eau d'Amandes Ameres.
  German.  Bittermandelwasser.

  The water of bitter almonds has been received into many of the
modern Pharmacopoeias;—into  those of Bavaria, Paris, Ferrara,
Hanover, Hesse, and Prussia for example.
  1 From av6Q*£,' coal,'and kali, 'potassa.'  Sec MM. Jacobovics, in Gazette Medicale
de Paris, Nos.9 and 12; and Riecke, Die neuern Arzneimittel, u. s. w. 2te Auflage, S.
37, Stuttgart, 1840; also, Duhamel, American Journal of Pharmacy, Jan. 1843.
  3 Aschenbrenner, Die neuern Arzneimittel, u. s. w. S. 23, Erlangen, 1848. 
aqua amygdalarum concentrata.
81
                   METHOD OF  PREPARING.
  The Pharmacopoeia of Prussia directs it to be prepared in the
following manner.—Take two pounds of bitter almonds, bruise
them well, and add—whilst triturating them—ten pounds of spring
water, and four ounces  of highly rectified  spirit of wine.    Let
the mixture rest for twenty-four hours in a well closed vessel, and
then distil two pounds. The product must be kept in a well stopped
bottle.   Giese  found the  quantity of hydrocyanic  acid  con-
tained in the product of  the above formula half less  than that in
cherry laurel water; and Jorg, from his experiments upon himself
and others, proved  it to be much  weaker and more uncertain.
   Neither this preparation, nor  the distilled aqua lauro-cerasi, is
much employed in this country, or in Great Britain.
   The inequality in the  strength  of the Aqua lauro-cerasi and of
medicinal hydrocyanic acid suggested this preparation, which was
extolled  by Hufeland for its uniformity.  Its effect is entirely like
thai of Aqua lauro-cerasi, but its greater regularity in strength
and action has not been confirmed.   Owing, indeed, to  the uncer-
tainty in strength of both these preparations, Liebig thinks,  that
physicians would act very judiciously were they to  discard  them,
and substitute a certain  amount of amygdalin dissolved  in water,
and mixed with emulsion of sweet almonds; as the remedy, pre-
pared fresh every time when it is to be administered, will always
possess the same   composition.   Seventeen grains  of amygdalin
yield one of anhydrous hydrocyanic acid; consequently, by mixing
34  grains of amygdalin  with 66 grains of emulsion of  sweet al-
monds, so that  the  total amounts  to 100 grains, a fluid is obtained
corresponding to the medicinal hydrocyanic  acid of the Prussian
Pharmacopoeia (2  per  cent.)  A third of a  grain  of amygdalin
corresponds to one grain of medicinal acid:  the solution of one
grain of amygdalin in three fluidounces  of emulsion  of  sweet
almonds  contains, consequently, one grain of medicinal acid in every
fluidounce of the mixture.1
   Water of bitter  almonds has been used  by Dr. Hodgkin3 as a
means of allaying  distressing itching,  as in  prurigo senilis.  In
some cases, it produced  immediately a beneficial effect;  in others,
it was of no benefit, and caused smarting and irritation.   Mr. May
keeps a solution of  oil of bitter almonds in the proportion of one
part to seven of alcohol.   This he uses as a substitute for hydro-
cyanic acid for internal administration; he gives about half a drop
for a dose.   Externally, he employs it of the strength  of a drop
of the solution  to an ounce of water.

  ' Ranking's Half-yearly Abstract of the Medical Sciences, pt. ii., vol. 1, p. 346.  Amer.
edit.  New York, 1846.
  a Pharmaceutical Transactions, Sept. 1841; and Amer. Journ. of Pharmacy, Jan.
1812, p. 352. 
82
AQUA BINELLII.
                    XV. AQUA BINELLII.
  Synonymes.  Aqua Balsamica Arterialis.
  Italian.  Acqua Binelli, Acqua Balsamica Arteriale.
  French.  Eau de Binelli.
  German.  Binellisches  Wasser.
   Many years ago, this  Italian nostrum was vaunted throughout
Europe as a styptic in every kind of hemorrhage, both when  em-
ployed internally and externally.   By several Italian physicians—
Cotugno, Antonucci, Santoro and others—it was found highly ser-
viceable; and Von Grafe1  thought that he had observed good ef-
fects from it.  This opinion was confirmed by the observations of
Kosch, Vrolick, Metzger,2  and  Lesser.   Subsequently, however,
not only Von Grafe, but Simon,3 Dieffenbach,4 and Dr. John Davy5
found that it was not possessed of more efficacy than simple cold
water.6   This hgemastatic received its name, Acqua Binelli, from
Dr. Fideli Binelli, the inventor.   The first public trials to test its
efficacy were instituted at Turin, in 1797, by order of the govern-
ment ;  the results of which were esteemed favourable.   Soon after
this Binelli died; the secret of the composition and of the mode of
preparing the nostrum were, however, communicated before  his
death to Gaetano Pironti, and Andrea Ferrara, who carried  on a
profitable trade with it for some time.   The secret appears to have
been lost; but in  the  years 1829, and  1830, it was affirmed to
have been rediscovered, and fresh experiments were instituted, and
over and over again repeated in Germany.   Various blood-vessels
were divided on animals,—the femoral and carotid arteries, and the
jugular veins,—and the cuts were made in every direction,—longi-
tudinally, obliquely, and  completely across;  and  in all  cases the
hemorrhage yielded as soon as charpie or lint steeped in the Acqua
Binelli was  applied and pressed gently against the wound for  five
or ten  minutes.  Encouraged by these experiments, the liquid was
tried on man and with seeming advantage; but it was soon found,
that the  results were not  owing  to any properties of the liquid,
but rather to the cold, moisture, and appropriate  pressure.
   The author has given at  length  in another work7 the  results of
the experiments and observations of Dr. Davy.   They convey  in-
teresting  information as  regards the physiology, pathology, and
therapeutics  of wounded  vessels, and impart a useful lesson to the

  1 Gr'afe's Journal, Bd. xvii. S. 650.               ' Ibid. Bd. xxvii.
  5 Horn's Archiv. 1833, Sept und Oct. S. 926.
  4 Hecker's Literarische Annalen, 1833,S. 486.
  * Edinb. Med. and Surg. Journ., July, 1833, or Researches Physiological and Anato-
mical, Amer. Med. Library edit p. 379.  Philad. 1840.
  6 E. Griife, Art. Kreosot, in Encyclopad. Wbrterbuch der Medicin. Wissensch. Bd.
xx. S 536.  Berlin, 1839.
  1 General Therapeutics and Mat. Med. 4th edit. ii. 112.   Philad. 1850. 
AQUA BINELLII.
83
inquirer,—not to deduce inferences  from inadequate data, without
having  investigated  every collateral circumstance  that may bear
upon  a question.  The  results of Dr. Davy's experiments show
how hemorrhage from wounding a  large artery, which would be
speedily fatal, may  be  arrested by moderate  compression  with
several folds of linen or cotton moistened with plain water;  and
they  further show  how, under this  moderate compression, the
wound in  the  artery may heal, and the vessel remain  pervious,
without the supervention of aneurism.   Dr. Davy lays great stress
on moderate pressure, such as may allow the  blood  to continue to
pass through the artery.
   At the meeting of the British Association in 1839, Dr. Macart-
ney, of Dublin,1 in alluding to the  powers which nature possesses
to repress  hemorrhage, provided the surfaces be treated as an open
wound with cold applications, related a  case in which, after ampu-
 tation of the hand of a child, the stump was dressed with lint kept
 wet with cold water, and in which  no ligature  was applied or re-
quired.  This  Dr. Macartney believed  to  be the first case on re-
cord  in which amputation had been performed  without the appli-
 cation of a ligature.
   The  Acqua  Binelli   is a  perfectly  transparent  fluid, almost
 tasteless, and having a slightly empyreumatic odour; but neither
 the presence of salt, alkali, earth nor acid could be  detected by the
 senses.  It has been generally considered to be  indebted for its
 fancied  haemastatic  property to creasote in  some form; but Dr.
 Davy's explanation  appears to be sufficient to account for the phe-
 nomena.
    M. Bouchardat2  gives the following complex  formula for the
 Acqua Binelli or Acqua Monterossi, of which, he says, great use
 is made in the civil  and military hospitals of Naples.  Take  of the
 roots of calamus aromaticus, bistort, consolida officinalis, and
 tormentilla—each 250  parts; oak bark, log  wood,  of each
 500 parts; leaves  of greater plantain; eupatorium  of Avi-
 cenna; athanasia  marilima; European  sanicle; alchemilla
 vulgaris; sumac; and nettle; flowering tops of rosemary, and
 sage; of each  1000 parts; flowering tops of teucrium marum;
 dittany  of Crete, peppermint,  of each 250 parts;  flowering
 tops of pennyroyal,  catmint, lesser centaury; and  achillea
 millefolium,  of each  1000 parts;  balsamide,  250 parts; Cy-
 prus nuts, 1000 parts; white agaric and black pitch, of each
 500 parts.  All the ingredients must be cut into  small fragments,
 and be macerated in a sufficient quantity of  water for twenty-four
 hours.   When the liquid is wholly absorbed, a fresh  quantity is
 added, so that the  mass may be covered with water to the height

    1 London Atheneeum, Aug. 31, 1839, or Med. Intelligencer, Oct. 15, 1839, p. 217.
    » Annuaire de Therapeutique, &c, pour 1843, p. 227.  Paris,  1843. 
84
AQUA BROCCHIERII.
of about four or five inches.  It is then distilled so as to draw over
about two thirds of the fluid employed.
  The product of this distillation is, however, possessed of more
marked properties than those of the Acqua Binelli described above.
It is said to be astringent, and to corrugate  bleeding  and injured
tissues, causing the formation of coagula, which prevent a farther
discharge.   It coagulates albumen.  It is also employed internally
in the various profluvia.
  A  substitute for the  Acqua Binelli prepared  by Professor
Schultz is the following.1

                 Acqua Binellii  factitia.
                  Factitious Acqua Binelli.
                R.  01. empyreumat. tabaci f ^ij.
                    ----animal. Dippel. gtt. xij.
                   ----Aq. destillat. f gviij.  M,
  Used externally only.
                XVI. AQUA BROCCHIERII.
Svnonymes. Brocchieri, or Brocchiari water.
Italian. Acqua Brocchieri.
French. Eau de Brocchieri ou Styptique de Brocchieri.
German. Brocchierisches Wasser.

  This water strikingly resembles the Binelli water, both in sen-
sible properties and action; and the same discordance of sentiment
in regard to its  virtues has existed  amongst observers.   It  was
largely used in  Paris  upwards of fifteen years ago; and  the pro-
fession generally appear to have decided at  that time that it  was
devoid of efficacy.   Dr. Paris9  examined it, but it appeared to him
to be nothing more than water perfumed by some vegetable essence.
"This supposed styptic," he remarks, "has made much noise in
Paris, and  is said to be even capable of arresting the flow of blood
from a divided  carotid artery !   The method of applying it is to
saturate tow with the liquid, and slightly press it upon the bleed-
ing  vessel,  where it is to remain for fifteen or twenty minutes:  the
rapidity with which a coagulum is said to form, and the tenacity
of it, are attested to be most extraordinary.   In order to ascertain
the fact, having procured a supply of it from  Paris, through  the
kindness of my  friend, Dr. Badham, I proceeded to  the Veterinary
College, and with the assistance of  the professional gentlemen of
that establishment,  I  made a very  careful experiment upon an ass
without the least effect."
  1 Bouchardat, p. 229.
  a Pharmacologia, Amer, edit from the 9th London edit, by Lee, p. 122.  New York,
1844. 
AQUA BROCCHIERII.
85
  A few years ago, a gentleman who had visited Paris brought it
over to this country, and it was again subjected to various trials,
and whilst some deposed most strongly to its potency as a haema-
static, others considered it to possess slight power; and others, again,
denied that it had any styptic virtues whatever.  Experiments, it
is affirmed, were instituted before MM. Blanqui, Amussat, Lisfranc,
and others,1 of Paris, in which  the effusion of  blood from the ca-
rotid artery of a sheep was speedily arrested by it.  Similar experi-
ments  were tried in New  York by Dr. Barrabino, of the United
States navy, and others; and in Charleston, by Dr. J.  Lawrence
Smith, and S. D. Sinkler, editors of the Southern Journal of Medi-
cine and Pharmacy.2  These last gentlemen  thought it certain,
that it  arrests hemorrhage in a most marked manner,  without
either being styptic or cauterizing in its action.   They considered
that both it  and ergotin "operate by a peculiar action  upon the
blood,  or upon the walls of the  artery.  In the case of the Broc-
chieri water, nothing decisive is yet known, although it is stated,
that the caliber of the artery is  restored to its natural integrity,"
and they add:—"The composition of  this water is unknown.  It
is colourless; of very slight acid  reaction, very little taste, and this
not astringent.  Its odour is aromatic, and the only idea we are
yet capable of forming of its nature, is, that it is water containing
the volatile  principle of some  plant, over which it has  been dis-
tilled."
  In a subsequent communication, however,3 after having experi-
mented farther with the Brocchieri water, as well as with ergotin
and creasote, they arrive  at  the  following conclusions:—First.
When  Brocchieri water, ergotin, or a watery emulsion of creasote
is applied to the wounded artery of a sheep, it  depends  greatly, if
not altogether, upon the manner in which the lint is applied to the
wound of the artery whether the  hemorrhage  is arrested or not.
If it be placed immediately upon the orifice of  the  cut vessel, the
success is certain; if, however, the vessel shrink from contact with
the lint, the animal is almost certain to bleed to death.  Secondly.
By a small pledget of simple lint placed immediately  upon the  in-
cision  made into the carotid artery of a sheep, the hemorrhage is
arrested in a few moments: and  after a lapse of from twenty to
thirty minutes, the animal may be let loose, without any apprehen-
sion of the return of the hemorrhage.   If the lint be applied  so as
not to touch the wound  in  the  artery, all effort to arrest the he-
morrhage will be ineffectual.  " From these results, it will be seen
how many difficulties often  attend the simplest experiments; and
how important it is to leave no point, not the most apparently tri-
vial, without  close examination : it  is true, it  requires  both time
and trouble, but  both are more  than compensated for, by a know-
  1 Boston Medical and Surgical Journal, Jan. 14, 1846, p. 480.
  s See the No. for March, 1846, p. 158.         3 Ibid. July, 1846, p. 406. 
86
AQUA BROCCHIERII.
ledge that we become in possession of truths that are important to
ourselves and to others."   Thirdly. The  sheep  is an  unfit ani-
mal to try the hemastatic powers of substances as regards the hu-
man subject;  for although sheep will bleed to death by a wound
in one of the  larger arteries, still, by the  application of  a small
pledget of lint, sustained with a  little pressure  immediately upon
the wound in the vessel, the hemorrhage will cease, and the ani-
mal survive.   The same, they are convinced, may be said of  all
the like experiments upon the lower classes of animals, as in many
of them the hemorrhage from a large vessel will be arrested spon-
taneously.  This is true—they say—of the dog, and so far as their
knowledge extends, the sheep is more ready to bleed to death than
any other quadruped.  " Furthermore, the blood of an  animal is
more plastic, coagulating  with  far  greater rapidity than  that of
man; and as the arresting of the hemorrhage in these experiments
is dependent upon the formation of a clot around the opening, and
in the cavity  of the  vessel, it ought, therefore, to happen more
readily in them  than in man."   Fourthly and lastly;  they con-
clude, that if the hsemostatic virtues of the agents, which they em-
ployed, are to  be  correctly ascertained, it is only by experiments
upon the human subject; and  no value, they think, should be given
to those made in any other way.   Whether the Brocchieri water,
ergotin, and creasote will  stand  the test, they are not as yet pre-
pared to  say, owing  to the discordant character of the  results of
experiments.   They have no doubt that these  substances hasten
the coagulation of the blood, and  that they may, under some cir-
cumstances, arrest hemorrhage  from the smaller arteries; but in
the case of the larger vessels,  they are of no manner of use, at least
not more so than the lint without them.   The  experiments made
on the human subject that have come to their notice are:—wound
on the hand; oozing for some time after the  operation for hydro-
cele; oozing from a tumour on  the back tried  with  Brocchieri
water.   In the first case there seemed to be no effect;  in the last
two some slight effect:  the oozing in the  case of the  hydrocele,
although  diminished, could not  be arrested.  Hence they think,
there is no danger of the ligature of vessels being supplanted by it.
   Professor Mott, in a clinical  lecture delivered on the 10th of
January, 1846,1 has the  following remarks:—" I knew M. Broc-
chieri when I wTas in Paris:  he is an uneducated man, and a per-
fect charlatan.   When his discovery was made known in  Paris, it
created some stir; and I made several experiments with it, in con-
nexion with several  other gentlemen, one  of whom was  engaged
in the preparation of the water.   The subjects of the experiments
were strong  and healthy sheep, upon whose carotid arteries we
operated, and we found  that its  power  to stop  hemorrhage was
next to nothing, and where the bleeding was arrested, it was prin-
                1 New York Medical and Surgical Reporter. 
AQUA BROCCHIERII.
87
cipally from the pressure made by the large quantities of lint, with
which the  wound was  filled.  Therefore, I  say, as the result of
my experience, that the styptic powers of this preparation are not
to be relied upon for a moment; that it is infinitely less useful than
an infusion of rhatany or tannin, and  that it can  never take the
place of needles and ligatures.  The other qualities that have been
ascribed  to it of curing  disease, and arresting hsemoptysis are
equally non-existent."
   The Acqua Brocchieri was brought to the notice of the Medico-
Chirurgical Society of Louisiana, at its sitting in March, 1846, by
a communication from one of the venders of  the nostrum, accom-
panied by some bottles of the article, with the request that the So-
ciety would examine  and  report  upon its styptic  powers.   The
Society,  on the  ground  that it would be setting a bad precedent,
declined  the  proposition.   Several of the  members, however, de-
termined to avail themselves of the earliest opportunity to test its
properties, and  Dr.  A. Mercier has published the result of his
experiments.1   After detailing two  cases of wounds, on which it
was used as a haemastatic, he remarks:—" The pain which these
two patients experienced from the application of the Eau Brocchieri,
a pain incomparably greater than that from the application of strong
salt and water, or any other styptic solution, together with its utter
inefficacy  in  cases of hemorrhage, have  induced me to abandon
any farther trials with it, except, perhaps, in cases of hemorrhage
from mucous membranes, as from the nose, rectum, &c.  &c, which
are so common  in this country."
  With the same view of testing the virtues of this famous fan-
cied haemastatic, the author's  friend and colleague, Professor
Mutter, in the presence of the late Dr. Kearney of the United States
Navy, Dr. King of the Army, Dr. J. W. Wallace, and several
other medical gentlemen, conducted  a series of experiments on
some ten or twelve sheep, the  results of which were  as follows:
   " When the carotid artery," says Professor Mutter, in a letter
to the author, "was opened, especially if  the incision ran parallel
to the long diameter of the  vessel, and the Acqua Brocchieri was
freely applied, the haemorrhage ceased in the course of  ten, fifteen,
or  twenty minutes; and the sheep, recovering  speedily from its
prostration, would eat with avidity.  On examining the wound, it
was found  filled with a coagulum, but there was no adhesion be-
tween it and the walls of the vessel, and of course no organization
could be detected. Similar results were  obtained with several
other styptics,  such as creasote, tincture of chloride  of iron, oil
of turpentine, &c. &c.  On  the whole I  was led to consider this
agent a tolerably good styptic, but not better than those  already
in daily use.  To test  the  vis medicatrix naturae, Dr. Wallace
       'New Orleans Medical and Surgical Journal, May, 1846, p. 816. 
88
AQUA BROCCHIERII.
divided completely both carotids, and applied nothing to the wound;
yet iecovery took place  in  the  course  of 30 minutes, the animal
walking  about  and  eating with the  others.  When  the vessel
was partially divided, so as to prevent contraction  and retraction,
death speedily ensued."
   It is proper to add, that the first experiments of Drs. Smith and
Sinkler satisfied them, "that a  sheep would bleed  to death with
his carotid cut, and that no application  of water, even in  the form
of ice, could arrest the hemorrhage."   With this conviction on
their minds, they considered themselves "fully prepared to form
just conclusions  concerning  the two experiments"  which they
made on sheep.   Yet in Dr. Wallace's case, it will be observed,
the  sheep  recovered  after  both carotids had been divided ; and
without any application whatever.
   A committee  of the Medical  Society of  Virginia, consisting of
Dr. C. P. Johnson, G. G.  Minor and  R. W. Haxall1 appointed
to investigate the qualities of the Acqua  Brocchieri, reported, as the
results of  their experiments,  First, that it has  no power of  co-
agulating blood.  Secondly,  that it has no power of producing
contraction of the coats of an artery.   Thirdly, that it does not
arrest hemorrhage from an incised wound sooner than the unaided
power of nature would  accomplish the same result.  Fourthly,
that in the case of incised arteries, its application is no more to be
depended upon to arrest  the hemorrhage than that  of simple cold
water.   The committee are of opinion that the true and only cause
of  the arrest of the hemorrhage in their experiments, "as in all of
the  cases  which have been reported,  is pressure, the  pressure
being  continued for a sufficient length of time to  allow a coagulum
to form which  will  be firm enough  to resist the  impulse of the
blood  from  the orifice in the vessel."
   On  the whole, the  remarks  made on  the Acqua Binelli apply
equally to  the Acqua Brocchieri.  Neither,  it would seem, is pos-
sessed of the haemastatic virtues  that have been ascribed to it.
   According to M. Martius,2 Brocchieri water may be  made as
follows:—Macerate for  twelve  hours  pine  wood (bois de  sapin)
cut small and bruised, in double its weight of water.  Then distil
until a product  is obtained equal in weight to the wood employed.
Leave  this distilled water  at  rest for  twenty-four  hours; after
which the  volatile oil that  collects on the surface  must  be sepa-
rated.  Before  using the water  it is necessary to shake it.
   M.  Deschamps has  proposed  the following  substitute  for it.
Take  of turpentine, 500 parts; water,  600 parts.   Boil for  a
quarter of an hour,3 then  add  a sufficient  quantity of  water to
obtain 1000 parts of  turpentine and water.   Let it  become cold,
and filter.

  1 American Journal of the Med. Sciences, July, 1846, p. 146.
  2 L'Abeille Medicale, Fevrier, 1846, p. 54.
  3 Bouchardat, Nouveau Formulaire Magistral, 3e  6dit p. 291. Paris, 1845. 
AQUA PICIS L1QUIDJE.                   89
  Another haemastatic water, under the name Eau hemastalique de
Tisserand, has been experimented with in  Paris, and M. Freroy,
Interne at the Hotel  Dieu, reports several cases in its favour.  M.
Recamier has also used it, and considered it to be possessed of the
same properties as the Acqua Brocchieri: he esteems it to be even
more advantageous, and affirms that he has succeeded with it in
cases of hcemoptysis, intestinal hemorrhage, and  dysentery.  The
following formula is given  by M. Bouchardat1 for a haemastatic
water  which may be  substituted for the Eau hemastatique de Tis-
serand.
              R.  Sanguin. Dracon.
                 Terebinth (des Vosges,) aa §iij.
                 Aquas Oij.
   Digest for twelve  hours, and filter.
             XVII. AQUA PICIS  LIQ'UID/E.
Synonymes.  Aqua Picis eeu Picea, Infusum Picis  Liquids  seu  Picis
  Empyreumaticse Liquidae, Potio Picea, Tar Water.
French. Eau de Goudron.
German. Theerwasser.
  This preparation,  at  one time so much extolled, and recom-
mended on  the authority of the celebrated Bishop Berkeley, but
which had almost fallen into total disuse, has been revived,  more
especially since it has been  found to contain creasote.  It was first
employed extensively in England about the middle of the last cen-
tury, and was drunk not simply as a therapeutic but as a prophy-
lactic agent, so that Riecke facetiously remarks, almost as  much
tar-water was  consumed by the  inhabitants  of London, as beer
and other  drinks.2
   As commonly happens in such cases, practitioners passed from
one extreme  to the  other, and as they gradually found  that  tar
water was  not  capable of accomplishing all that had been ascribed
to it, they ultimately neglected it altogether.  Still formulae for its
preparation exist in many Pharmacopoeias—in those of Dublin,
Bavaria, Brunswick, Paris, Russia, Saxony, Sweden, and Wirtem-
berg, for example.

   Water takes up from tar a small portion  of  acetic  acid, crea-
sote, and resinous matter.  Tar-water was formerly much praised
as a remedy in pulmonary consumption, and  as a diuretic; its
virtues, however, appear to rest almost wholly on  the contained
creasote.   Some  years ago, Arnheimer, of Duisburg, recalled  the
attention of practitioners to it as a remedy in many chronic cutaneous
affections, especially of the herpetic kind; and asserted, that he
found no remedial agent  more valuable when its  use was perse-
     1 Op. cit.         * Die neuern Arzneimittel, S. 38.   Stuttgart, 1837. 
90
AQUA PICIS LIQUIDS.
vered in for one or two months  to the  extent of a pint or two
daily.   Arnheimer directed patients  to prepare it for themselves
in the following manner.   A  pound of tar was put  into a  deep
porcelain dish, and a  quart of water was poured  upon it; for
half an hour it was stirred with  a spoon; the mixture was  then
allowed  to  stand  for  twenty-four hours; the tar  remaining on
the surface of the  water was skimmed off, and  the  clear fluid put
into well stopped bottles.  He advises, that a large quantity should
not be prepared at once, as the water in time becomes ropy, and
its golden yellow colour is changed to a darker hue.   It is  gene-
rally taken without any repugnance.  The process in the Dublin
Pharmacopoeia is the following:—Take of Tar, two pints; Water,
a gallon: mix, and stir with a wooden  rod for  fifteen minutes;
then, when  the tar has subsided, filter the liquid, and keep  it in
well closed jars.
   Since  the discovery of creasote, tar-water has  received  fresh
consideration, and it  is not improbable  that  it may come  again
into more general use, as it  appears,   from  experiments,  that
there are cases where  it would seem to  merit a preference over
creasote.  M.  Petrequin has  made  some trials with  both,  in
chronic catarrh, and in different  stages of phthisis.1  The num-
ber of cases reported by him is twenty-three; of these seven were
of chronic catarrh, in  which creasote was given: generally the
cough was mitigated by it, but in two no effect was  produced on
that symptom.  The  expectoration  was usually diminished or
facilitated ; in two cases, however, nO advantage was derived  from
it, and in one case the  sputa were  bloody.  In the majority, the
dyspnoea ceased: in others, it continued;  and in the same number
of cases  the pain in the  breast was relieved.   As  to its  effects
on the digestive organs, it several  times  excited thirst; but the
most marked result was the sensation of burning, which it caused
in the majority of  cases, in the digestive tube, or in  the breast.
In two cases, it exhibited no influence  on an existing diarrhoea,
whilst in two  others, it appeared  to diminish the number of the
evacuations.  In two, it excited vomiting, and commonly produced
nausea.   On the  whole, in the  greater  number, it appeared to
render good service, but in one it was of  no avail, and in another
it seemed to aggravate the affection.
  In  four cases of incipient phthisis treated with creasote, M.
Petrequin obtained the following  results.   Although, in one in-
stance, the cough  was aggravated, in the majority the opposite
was the  fact.  The expectoration was  facilitated, but diminished
in quantity: the dyspnoea was more or less improved,  and in two
cases  the pain  in  the  chest was  relieved.  In this  disease, also,
creasote  excited burning in  the epigastrium or chest,  and in one
instance fugitive sensations of heat and creeping in the limbs.  In
            1 Gazette Medicale de Paris, No. 45, Nov. 5, 1836. 
AQUA PICIS LIQUIDS.                   91
one case, the benefit was striking;  in  two, the  improvement was
to a less  extent, and  in one the disease was augmented.   Four
other cases were of advanced  phthisis.  In most, the cough was
more or less improved,—never increased; the oppression remained
much  the same, but  in  one  case it became  more  severe.  As
regards the effects upon the digestive organs, they were much the
same as in the first class of cases.   The improvement in one case
was insignificant; in two others but slight, and in the fourth the
affection was aggravated.
  M. Petrequin directs tar water to be  prepared by  digesting  an
ounce of tar  in  a  quart (pinte) of  water for eight days, and then
filtering.  It is taken mixed  with milk to the  extent of from
eight to  twelve ounces in the day.  With this  preparation, he
treated three cases of chronic  catarrh.  The cough was always
improved by it; the  expectoration diminished or facilitated; the
dyspnoea  alleviated  or removed, and  the  pains in the chest were
improved or dissipated.  In two cases, it  appeared to act benefi-
cially on vomiting which accompanied the cough.  The appetite
was improved,  and in one case  diarrhoea seemed  to be dimi-
nished, whilst in two others existing constipation yielded  during
its use.  In all the cases, sleep was restored.  On the urinary se-
cretion it exerted no  influence, and it neither excited thirst nor
nausea like creasote.   In three cases of  incipient phthisis,  its ac-
tion was more beneficial  than  that of  creasote.   The cough was
always ameliorated, the  expectoration  facilitated or diminished,
and the dyspnoea and thoracic pain  relieved.   In  one  case,  it
seemed to act favourably on accompanying emesis, and in another
to quench thirst.  It excited or improved  the appetite, and aided
digestion.  In one case of  advanced phthisis, the alleviation pro-
duced by tar water was beyond all expectation, but in another
the disease had  proceeded so far that it was wholly unsuccessful.
   So  far, then, as  M.  Petrequin's  experiments go, they would
seem  to show that  advantage  may  be derived,  in  the cases  in
question,  from the administration of creasote and tar water; and
that the latter is perhaps possessed of properties which the other
has not—to  the same degree at least.  The cases are, however,
too few to enable us to deduce  any thing entirely satisfactory.
Fresh experiments will doubtless be instituted,  which may enable
us  to  infer positively  on matters that must as yet be considered
involved  in  doubt.1   The author  has administered  it freely  in
phthisis, as well as in chronic bronchitis.   In the latter affection,
it has relieved cases in which the accustomed excitant expectorants
are  found to be serviceable.   The same  has been the fact in the
former disease; but farther than  this no  advantage  has accrued
from its administration.
   In  a French periodical,2 some cases are  published from the
           1 Deslandes, Diet de Medec. et de Chirurgie Prat. xi. 233.
           s La Lancette Franchise, 8 Avril, 1637. 
92
ARGENTI PRjEPARATA.
records of  the hospitals for 1829 and 1830, during the attendance
of the late Professor Dupuytren, in which injections of tar water
were  successfully administered  in  catarrhus vesicae, along with
the use of pills of  turpentine.  The tar water was made  by in-
fusing in the cold, for a night, a  pound of tar in ten  pounds of
spring water, filtering and warming the solution before using  it.
Large quantities of this were injected through an elastic gum ca-
theter, which was forthwith withdrawn  and  the  patient  directed
to retain the injection  as long as possible.   The injection was re-
peated daily, and Venice  turpentine was administered  internally
in the form of pill.
   A  syrup  of tar  may  be made by dissolving  sugar  in tar
water.1
            XVIII. ARGEN'TI  PR^PARA'TA.
Synonymes. Preparations of  silver,
French. Preparations d'Argent.
German. Silberprapara te.
  Of the preparations of silver, the nitrate is the only one that has
been much used, and this chiefly as an external application.  The
attention of physicians has, however, been directed to the internal
use of many of those preparations, and especially by M. Serre,2
professor of surgical clinics at Montpellier.   This gentleman com-
menced his first trials in May, 1835, in  the civil and military hos-
pital of St. Eloi.   At that time, there was an unusual number of
syphilitic  patients in  the wards, of which  the  most  severe and
appropriate were  selected for  treatment  by the preparations of
silver—the chloride, cyanuret, and iodide.   Trials were also made
with  divided  metallic  silver,  oxide  of  silver  and  chloride of
ammonia and silver.  At  first, they were administered iatraleip-
tically; the chloride, the cyanuret, and the iodide  in the quantity
of one-twelfth of a grain; the chloride of silver and  ammonia in
the quantity of one-fourteenth of a grain; and the oxide of silver,
and the divided silver, in the  dose of one-eighth, and  one-quarter
of a grain, respectively.   M. Serre  soon found  that  these doses
were generally too small: he, therefore,  raised that of the  chloride
and iodide to one-tenth, and to one-eighth of a grain, without the
slightest inconvenience  resulting.  The  other  preparations were
also increased in the  same proportion, with the exception of the
chloride of silver  and  ammonia, which  requires more precaution
than  any of  the  other preparations.   M.  Serre did  not  restrict
himself to the iatraleiptic administration of these substances, but
           1 Soubeiran, Journal de  Pharmacie, Janvier, 1842, p. 70.
          2 Bulletin  General de Therapeutique, 1836. 
ARGENTI PRiEPARATA.
93
employed them internally in the form of pill, and  externally as
local applications.
  M. Serre  describes several cases of syphilis in which the pre-
parations of silver were administered.   The first patient was a sol-
dier, 26  years old, of athletic constitution, who, at the time of his
admission  into  the  hospital, had several  extensive  chancres on
the prepuce, so  close  to each other as to seem to form one large cir-
cular ulceration, five or six lines in diameter.  After a few days'
rest, and the use of  baths, M. Serre ordered the chloride of silver
in friction on the tongue in the  quantity of one-twelfth of a grain.
The  ulcers were treated  with simple cerate^{ceratum Galeni)
spread on lint.   After the second rubbing, the patient experienced
violent colicky  pains, which were not  severe enough, however, to
induce a discontinuance of the  remedy.   Scarcely had a grain of
the chloride been employed, when the  secretion from  the ulce-
rated parts became less; the surface of the chancres lost the kind
of grayish border which  they .possessed,  and cicatrization  pro-
ceeded rapidly.   The frictions  were continued, and  the condition
of the patient went on improving.  At the end of two months, he
left the hospital.   In the  five subsequent cases, the same plan of
treatment was  pursued.   The  chloride was used exclusively ac-
cording to  the iatraleiptic method.   The symptoms were various;
in addition to chancres, there was in one case di suppurating bubo;
in another, syphilitic vegetations at the margin  of the  anus;  and
in a third, fissures in the same part.  In the seventh case, in which
there were  chancres, gonorrhoea, and extensive rugous blotches
on the nates, the chloride  of silver was rubbed on the tongue, and
applied topically in  the form of ointment.  The eighth patient,
who suffered with large  condylomata, as well  as with ulcers in
the neck, took  the chloride in pills to the extent of nine grains in
the course  of the treatment: frictions  with the ointment of silver
were also applied to the affected parts.
   M.  Serre deduces  from all his  experiments  the  following
amongst  other conclusions.  First. The preparations of silver
have this great advantage over those of mercury, that  they never
occasion Salivation, nor  do they induce in the intestinal canal or
in the respiratory  organs the  disagreeable  effects that  are too
often caused by mercury.   Secondly.  Should their  therapeutical
agency be confirmed by experience, and they be  introduced  into
hospital  practice, great advantage will be derived as respects the
purity of the wards, and  the  cleanness of the  bed-clothes,  &c.
Thirdly. Patients  can be treated by  them in  secret as  well
as when travelling, without fear of  detection.   Fourthly. The
preparations of gold are to be  preferred  in these  respects; but
gold has the disadvantage of exciting too much, and cannot, there-
fore, be exhibited to those of a nervous and impressible tempera-
ment, or who have weak and delicate chests.  In such cases the
       7 
94                   ARGENTI CHLORIDUM.
preparations of silver  merit the preference.   Fifthly.  The pre-
parations of silver are much cheaper than those of gold, and are,
therefore,  more available in  practice  amongst  the poor, and in
large hospitals;  and,  moreover, they  are  more  easily prepared,
which is a consideration of some moment as regards the pharma-
ciens of small towns.   Sixthly, and  lastly. There are cases  in
which mercurial and gold preparations fail, and where preparations
of silver might be of advantage.
   The  observation of others has not  confirmed the assertions of
M. Serre.   M. Ricord1 employed the various preparations, made
after the formulae  given  by M. Serre,  in the same doses;  but not
being able to observe any effect that  could  be fairly ascribed to
these agents, he ventured upon considerably larger doses—as much,
for example, as twelve grains a day of  the iodide and cyanuret,—
but without any marked results.
   In this country, the preparations  of  silver have been but little,
if at all, used in syphilis; nor do they appear to merit  special
favour.2
             XIX.  ARGEN'TI CHLO'RIDUM.
Synonymes. Argentum Muriaticum seu Salitum seu Chloratum, Chlo-
  ruretum Argenti, Chloride, Chloruret or Muriate of  Silver.
French. Chlorure d'Argent.
German. Salzsaures Silber, Chlorsilber, Hornsilber, Silber-
  chloriir.

  Chloride of silver is prepared by the decomposition of a solution
of nitrate of silver by an excess of a solution of chloride  of so-
dium.  The resulting product or chloride of silver appears under
the form of a flaky,  clotted, very  thick precipitate:  it must be
washed repeatedly with boiling water, and be exposed to the heat
of a sand-bath, so that it  may dry as speedily as  possible.
  Chloride of silver, prepared in this way, is of a white colour, de-
void of taste, and not  soluble  in water, but soluble in  ammonia.
In the light it speedily changes, especially when  much divided, or
when moist;  and  assumes  a somewhat  dark violet  hue,  as  the
chlorine is given off.   It suffers no decomposition  when  united
with  vegetable  matters.  It must  be  dried and  kept protected
from the light.3   Its uses have been referred to under the head of
the preparations of silver.
  As nitrate of silver is probably always converted into chloride
of silver by meeting with the chiorohydric acid in the stomach, it

  'J. J.  L. Rattier, La Lancette Franchise, No. 122, Oct 13,  1836.
  3 W. P. Johnson, Medical Examiner, Nov. 23, 1839, p. 743.
  3 On the mode of forming the various preparations of silver, see Chamou, in Bulletin
General de Therapeutique, No. xvi. Aug. 30, 1836. 
ARGENTI ET AMM0NLE CHLORIDUM.
95
occurred to Dr. Perry,1 at the time resident physician of the Phila-
delphia Hospital, to administer the chloride, which he did with ad-
vantage in  epilepsy, chronic dysentery, chronic diarrhoea,  and
other affections in which nitrate of silver is prescribed  internally.
Twelve grains given  daily for three months produced no unplea-
sant symptoms; and  in no case did  discoloration of the skin suc-
ceed.   In epilepsy, three grains, given four or five times a day, pro-
duced effects similar to those of nitrate of silver, but  more  marked.
In  chronic dysentery, half  a grain to three  grains, taken three
times a day, produced immediate diminution in the number of the
evacuations, and relieved the tormina; inducing, at the same time,
an  improvement  in  the character of  the stools and other symp-
toms.   Similar testimony is afforded by Kopp, and  others.   The
author  has very  frequently  prescribed  the  chloride  ; and on  the
whole it has  appeared to him to  be equal  to the nitrate of silver
in the cases mentioned by Dr.  Perry.
   It has been affirmed that a combination with iodine will prevent
the discoloration of the skin;  and that the use of iodine will re-
move it where it  has  already occurred;  but farther  experience  is
necessary to establish this.  See Argenti Iodidum,  (p. 98.)
                  Pulvis argenti  chloridi.
                 Powder of chloride  of silver.
                   R.  Argent, chlorid. gr. j.
                       Irid. florent. pulv. gr. ij. _
  Reduce to a fine powder,  and divide into eight or ten portions;
to be rubbed on the tongue.                            Sei^re.
      XX. ARGENTI ET AMMO'NLE CHLO'RIDUM.
Synonymes. Argentum Muriaticum Ammoniatum, Chloruretum Argenti
  et Ammoniae, Chloride or Chloruret of Silver and Ammonia, Ammonio-
  chloride of silver.
French. Chlorure d'Argent et d'Ammoniaque.
German. Silbersalmiak,  Salzsaures Silberammonium.
  This preparation  is obtained, when we saturate, by the aid of
heat,  liquid ammonia,  with freshly precipitated  and  carefully
washed chloride of  silver.   The operation must be accomplished
at such a degree of heat, that the fluid shall  boil once; for if the
boiling be continued  a few moments and in the open air,  no crys-
tals will be deposited on cooling.  If the fluid, whilst in full ebul-
lition  and preserved  from the  light, be filtered, very regular crys-
tals will be  deposited on cooling, which  may be  dried  between
blotting paper, and should be kept in a well stopped bottle.
1 American Medical Library and Intelligencer, Feb. 1841. 
96
ARGENTI ET AMMONITE CHLORIDUM.
   Chloride of silver and ammonia  has a bluish white colour, the
 peculiar smell of ammonia, and a  burning, almost caustic, taste.
 In the air, it gradually exhales ammonia, and acquires all the pro-
 perties of simple chloride of silver, without, however, losing the
 form of  the original composition.   If the crystals be kept in the
 ammonia in which they  were formed, they  do  not experience the
 slightest change in their colour from the influence of light.   When
 treated with distilled water, the chloride is decomposed.   A por-
 tion saturated with ammonia is again dissolved; yet a much greater
 portion remains  undissolved; this  contains  only a small quantity
 of ammonia.  It experiences the same  decomposition  through the
 influence of heat, as when it is exposed to the open  air, except that
 the decomposition takes  place more rapidly.  It displays  nothing
 extraordinary when  rubbed with organic matters.
   This remedy, as before remarked, has been used  with advantage
 by Serre in cases of syphilis.
   Another  preparation,  Liquor argenti muriatici ammoniati,
 has been long recommended by Kopp, in cases of chronic nervous
 affections.  It  is prepared according to the following formula:—
                   R.  Argent, nitrat. fus. gr.  x.
                      Aquas destillat. f gij.
   Soluto  filtrato instilla liquoris natri muriatici, (Sodii chloridi,) q. s. ad
 prsecipitandum.   Prascipitatum sedulo  ablutum  solve in liquoris ammon.
 caust. §iss: adde  acidi muriatici giij. vel q. s. ut prsecipitatio evitetur et
 argentum muriaticum in statu solutionis permaneat.   Pondus fluidi fil-
 trati aequale sit unciis duabus cum dimidia.1
   This preparation is transparent;  but, under  the effect of light,
 it suffers black  flakes  to be  deposited.   It is  therefore necessary
 to preserve it in small bottles, painted black, in a dark place.   In
 using it, acid substances should  be avoided.
   Kopp found   the  liquor argenti  muriatici ammoniati of
 great efficacy in St.  Vitus''s dance.  It may be given to children
 of about ten years of age, morning, noon,  and night, in doses of
 three drops, gradually raised to  six, in  a spoonful of distilled wa-
 ter.
          Pilulae  argenti et  ammonia chloridi.
          Pills  of  chloride of silver and ammonia.
        R.  Argent, et ammon. chlorid. gr. j.
            Irid. florent. pulv. gr. ij.
        Conservas flor. tilise q. s. ut fiat massa in pilulas xiv. dividenda.
   For external use.                                     Serre.

  1 "Take  of fused nitrate of silver, ten grains; distilled  water, two ounces:—Into the
filtered solution drop enough of a solution of chloride of sodium to precipitate.  Dissolve
the carefully washed precipitate in an ounce and a half of caustic liquid ammonia; add
three drams of muriatic acid, or enough to avoid precipitation, and that the chloride of
silver may remain in a state of solution. The weight of the filtered fluid should be equal
  two ounces and a half." 
ARGENTI CYANURETUM.
97
             XXI. ARGENTI CYANURETUM.
Synonymes. Argenti Cyanidum, Argentum Cyanogenatum seu Cyanicum
  seu Hydrocyanicum, Cyanuretum Argenti, Cyanide or Cyanuret of
  Silver.
French. Cyanure d'Argent.
German. Blaustoffsilber,  Cyansilber, Cyansaures  Silber-
  oxyd.
   Cyanuret of silver is obtained by permitting a weak solution of
hydrocyanic acid to act on a solution of nitrate of silver.}  The
very light white precipitate, formed  thereby, must be repeatedly
washed with distilled ivater, and be reduced to dryness in a mo-
derately  heated oven.   In the preparation of  the cyanuret of sil-
ver, as of the iodide, it  is essential to pour on only so much of the
fluid in the formation of the precipitate as may be required for the
complete  decomposition of the nitrate of silver.  If too much hy-
drocyanic acid  be used, a  part of the precipitate will  be separated
in the form of hydrocyanate of silver.  If, instead of hydrocyanic
acid, hydrocyanate of potassa be used, the  latter, if  added in too
great proportion, will unite with the cyanuret  of  silver, and form
a soluble  double salt.
   Cyanuret  of silver is  of a white colour, devoid  of taste, not
soluble in water, but soluble in ammonia.   In  the air, the surface
very soon becomes of a  dark violet hue, similar to that of the chlo-
ride of silver under like  circumstances.  It is dry, and should be
kept preserved  from light. It experiences no decomposition when
mixed with neutral vegetable  matters.
   From experiments made by Dr. Letheby,2 he concludes, that it
is a local  irritant, producing  great vomiting and a congested state
of the vessels of the stomach;—that when it has been dried before
its introduction into the system, no other ill effects follow: but if
it be administered in a moist state, it is then capable  of being ab-
sorbed and perhaps  decomposed, " for an albuminous  solution has
the property of dissolving the cyanide, and, moreover, the contact
of it with any  of the chlorides of the systemic fluids would pro-
duce a double decomposition,  and  the formation of a  soluble cya-
nide, whose effects would be'similar  to'that of cyanide of potas-
sium."
   The dose capable of killing a dog is five grains: its specific ac-
tion appeared to  Dr. Letheby to be on the brain, producing occa-
sional convulsions, always coma, paralysis,  a peculiar sighing re-
spiration; a  fluttering,  irregular, and tumultuous action  of the
heart, and it ultimately kills by a  gradual exhaustion of the invo-
luntary acts, death taking place in from  one to three hours after
its administration.
             1 Pharm. of the United States, p. 77. Philad. 1842.
            2 London Med. Gaz. Jan. 9, Feb. 4 and 17, 1845. 
98                     ARGENTI IODIDUM.
  Its use in disease has been referred to under the preparations of
silver.
                XXII.  ARGENTI IODIDUM.
Synonymes. Argentum Iqdatum, Ioduretum Argenti;  Iodide or Ioduret
  of Silver.
French.  Iodure d'Argent.
German. Iodsilber, Silberiodiir.
   Iodide of silver is obtained by mixing a solution  of nitrate of
silver with one of iodide of potassium.   The yellowish flakes,
produced  by  the admixture of the two fluids, are  then washed se-
veral times with distilled  water,  and dried in an oven.  In this
preparation,  also, it is important, that only so much of the reagent
should be added as is necessary for the complete decomposition of
the salt of silver.  A surplus of the iodide  of potassium would
form, with the already precipitated iodide of silver a soluble and
crystallizable double salt of iodine,  whereby the quantity of  the
product, which it might be  desirable to  obtain,  would  be  dimi-
nished.
   Iodide of silver is  of a very  pale yellow colour; but becomes,
under the action of light and air, of  a deeper yellow.   It has no
taste, and is  neither  soluble in water nor  ammonia.   The  latter
property serves to distinguish it from the chloride and the cyanu-
ret of the  same metal.  Like the chloride, the iodide must be kept
in a dry dark place.  Neutral vegetable substances appear to exert
no action upon it.  Its properties have been enumerated under  the
head  of the  preparations of silver.  It may be added, however,
that Dr. Chas. Patterson has been convinced of its decided efficacy
in hooping-cough.
   It has  been already remarked  that a combination with iodine
is said to prevent the discoloration apt to be induced by nitrate of
silver.1  The following form for this purpose is given by Dr. Pat-
terson :—
             Pilulae  argenti  iodidi composite.
             Compound pills of iodide of silver.
              R.  Argenti iodid.
                  Potassa? nitrat. aa gr. x.
              Tere simul ut fiat pulvis subtil, dein adde.
                  Glycyrrhiz. pulv. gss.
                  Sacchar. 9j.     ,
                  Mucilag. acaciae q. s. ut fiant pil. xl.
   Dose.—One, three times a day.
1 Patterson, Dublin Medical Press, Aug. 25, 1842, and April 19, 1843. 
ARGENTI OXIDUM.
99
                XXIII.  ARGENTI OXIDUM.
Synonymes. Argentum Oxydatum, Oxydum Argenti.
French. Oxide d'Argent.
German. Silberoxyd, Oxydirtes Silber.
   Oxide of silver is obtained by the reaction  of potassa on a so-
lution of nitrate of silver.   The alkaline fluid must be added in
excess, and the oxide, which is the product of the decomposition,
be washed several times  in a considerable quantity of water, and be
dried by moderate heat,  and  preserved from the light.
   The following form has been given:1—
                R. • Argent, nitrat. crystallizat. 5]'.
                    Potassa? §vij.
                   Aqua? ^xviij.
   Dissolve the  nitrate of silver in two or three  ounces of the
water, and the potassa in the remainder:  mix the two  solutions;
stir with a glass rod, and throw the whole upon a filter.  Lastly,
wash the precipitate from adhering alkali, and dry it carefully.
   In the state of hydrate, the oxide is black; when anhydrous, it
appears as an olive greenish  brown powder: it is  tasteless, and
capable of absorbing carbonic acid from the air.  Under the long
continued influence of light,  it is blackened ;  and at a heat below
obscure red, it is reduced to the metallic  condition.   To  be  kept
for a long time in the pure state, it must be  protected  from the
light in a well stopped bottle.
   This preparation, which was also recommended by M. Serre,
has been used by Van Mons in syphilis.*
   Dr. Lane3—under the idea, that nitrate of silver is always de-
composed  in the stomach by chlorohydric acid, whence results
chloride of silver, which enters into the circulation, is  conveyed
to  the  cutaneous surface, and is converted into an oxide by the
action of light and by its strong  affinity for albumen—has admi-
nistered the oxide of silver, and with advantage, in diseases of the
uterine  system, in which there is undue  secretion and  great irri-
tation.   He gave it for two months,  at intervals, without the
slightest tendency to discoloration;  and Dr. Golding Bird has pre-
scribed it for four  months  without any bad effects.  Dr. Lane
found it very beneficial in half-grain doses,  twice a day, in cardi-
algia  and pyrosis;  gastrodynia ; irritability of the stomach,
accompanied by gnawing and constant pain, nausea, &c.  It seemed,
likewise, to be beneficial in uterine hemorrhage, both in the im-
pregnated and unimpregnated state.                      '
   Dr. Lane* gives the oxide  to subdue undue secretion, whether of

         1 A. Duhamel, Amer. Jour, of Pharmacy, July,  1842, p. 100.
         a Riecke, Op. cit. S. 440.
         3 London Lancet, July 10,1841.
         4 Lond. Med. Gaz., April, 1846, p. 640. 
100                   ARGENTI OXIDUM.
 a sanguineous or other character.   In epistaxis and hcemoptysis,
 especially when they occur in chlorotic females; and  in  the pro-
fuse purulent expectoration and  colliquative perspirations
 of phthisis he has found its employment of much advantage.  He
 esteems it to be essentially sedative, and employs it both internally
 and  externally.  In  cases of irritable  ulcer, its action is highly
 beneficial; and he thinks it decidedly preferable to the nitrate,
 when the stimulant caustic action of the latter is not required.  In
 external forms of ophthalmia, an ointment, of the strength of a
 dram to the ounce, often exerts a rapid influence.  In ulceration
 of the cornea, with thickening and congestion of the eyelids, it has
 proved  highly beneficial.  The ointment of the oxide of silver is
 softened to the consistence of thick cream by the addition of olive
 oil, and  is applied to the eye by means of a  camel's hair pencil.
 When a patient is taking it for any length of time, he considers it
 well to  suspend its administration for a  few days every month.
  Sir James Eyre1 found the oxide uniformly successful in curing
 pyrosis ; but he gave at the  same time a cathartic pill of the com-
 pound extract of colocynth and extract of hyoscyamus every night.
 He found similar successful results in hcematemesis and hcemopty-
 sis : he does not, however, restrict himself to  the oxide,  but
 assists  it by bleeding,  blistering,  and other  means.   Having
 found the remedy much superior to all other agents during an ac-
 tive professional life of upwards of thirty years, Sir James urges a
 trial of it.   In the cases detailed by him the dose never exceeded
 three grains a day.   Its employment is not advised where  febrile
 action exists.
  In addition to its value in  gastrodynia, pyrosis, haemoptysis,
 haematemesis, and menorrhagia, Sir James says it will  be found
 of infinite benefit in restraining hemorrhage from the intestinal
 canal, obstinate chronic diarrhoea, colliquative perspirations,
 and leucorrhoea.*
  Dr. Thweatt3 confirms the observations of Dr. Lane and Sir Jas.
 Eyre as to the advantages to be derived from it in menorrhagia.
 He goes, indeed, much farther; and, whilst he does not pretend to
 claim for it the appellation of a specific, he " is persuaded that,
 casteris paribus, all that is claimed for mercury in syphilis, or qui-
 nine in  intermittent fever, can be claimed for the oxide of silver in
 menorrhagia in its different forms!"  He considers it best adapted
 for those forms of menorrhagia which depend on  an undue excita-
 tion of  the  uterine organs, unaccompanied by high inflammatory
 action.
   The  ordinary dose of the oxide is half a grain three times a day.
 Dr.  Thweatt combines it with a small quantity of opium or mor-
 phia.
         ' Dublin Journal of Med.  Sciences, May, 1845.
         2 See, also, Allnatt, Lond. Med. Gazette, May 2, 1845.
         3 Amer. Jour, of the Med. Sciences, July, 1849, p. 69. 
ARGILLA PURA.
101
               Unguentnm oxidi  argenti.
                 Ointment of oxide of silver.
           R.  Argent, oxid. gr. xx.
               Adipis gj.  Misce ut fiat unguentum.
  When the iodide or cyanuret is substituted for the oxide of sil-
ver, ten  or twelve grains of  one of these may be added  to  the
ounce of lard.                                        Serre.
               XXIV. ARGENTUM DIVI'SUM.
Synonymes.  Metallic Silver, in a state of division.
German.  Zertheiltes Sil ber.
  Pure oxide of silver is placed in a porcelain crucible, and the
fire is increased  to dull redness.   The product is then allowed to
cool, is rubbed in an agate mortar, and sifted through a close sieve
or bolting cloth.  In this condition, divided silver forms a very fine
powder, of a dullish white colour:  the air has no influence upon
it, unless when impregnated with sulphureous  vapours.
  Besides the use of this preparation in  syphilis, already referred
to, it may be remarked, that the filings of silver, Argentum lima-
tum, which agree with it in chemical relations, had been adminis-
tered  many years before,  in  cases of intermittent fever, by  Dr.
Meyer, of Biickeburg.1
  Notwithstanding the testimony adduced in its favour, it is pro-
bably wholly inert, or exerts  but a mechanical agency.
                  XXV. ARGIL'LA PURA.
Syjjonymes.  Alumina pura, Oxidum aluminii, Terra aluminosa pura,
  Terra  aluminis, Terra bolaris  seu argillacea pura seu  depurata seu
  hydrata, Pure Argil or Alumina.
French.  Alumine factice.
German.   Reine  Thonerde;  reine Alaunerde; gereinigte
  Alaunerde oder Thonerde.
  This  substance was known  in olden times by the names Arme-
nian Bole, Terra sigillata, &c, in which  forms it was always,
however, mixed  with lime and  iron.   It was highly extolled as an
absorbent, demulcent, diaphoretic and astringent; w7as employed in
hemorrhage, diarrhoea and dysentery, phthisis, poisoned wounds,
&c, and was  also applied externally in cases of erysipelas.  It
had almost fallen into  complete oblivion, when its use was resumed
by some of the German practitioners.  With us, it is scarcely ever,
or never, prescribed.
1 Riecke, Op. cit. S. 436. 
102
ARGILLA PURA.
                   METHOD OF PREPARING.
  The purest argil is prepared by drying sulphate of alumina and
ammonia, and exposing it for 20 or 25 minutes to a red heat in a
crucible: the sulphuric acid and ammonia  are  driven  off, and the
argil remains behind in the form of a white powder.   Formerly, it
was prepared by dissolving alum in water, and precipitating the
argil from the solution by means of carbonate of potassa or of soda,
or by potassa.   It  is  affirmed, however, that generally, more  or
less sulphuric acid remains with the earth, so that it requires to be
purified by repeated washing, until there is no longer any acid re-
action.   If a still higher degree of purity be needed, the precipi-
tate is dissolved in muriatic acid, and the argil precipitated by am-
monia.
   The  powder, prepared by these  methods, is of  a white colour,
and devoid of smell  or  taste; but it communicates to the  tongue
a feeling of astringency.   When breathed  upon, it yields a pecu-
liar earthy smell.   It is insoluble in water, but  attracts  moisture
greedily from the air, and forms with it a  gelatiniform mass.

           EFFECTS ON  THE ECONOMY IN DISEASE.
   Pure argil was highly recommended  by Percival in indigestion
attended with predominance of acidity ; and  it was in such cases
extolled by Ficinus and Seiler.1  According to the former, it merits
a preference over all other absorbents, inasmuch as it forms astrin-
gent salts with acids.  H»found it especially useful in diarrhoea and
dysentery,  particularly in  children.  Seiler recommends it in the
vomiting of infants, which is usually accompanied by acidity, and
in  the diarrhoea of older children.   Neumann2 found it successful
in checking diarrhoea, which neither starch glyster, nor opium, nor
any other  therapeutical  agent had succeeded in diminishing.  He
made  a mixture of two  drams of argil, and four  ounces of a de-
coction of  logwood, and  administered  it to children by the tea-
spoonful.  Weese3 also employed  it successfully in several  cases
of infantile diarrhoea where there was evidently a predominance
of acid.  One of the latest encomiasts of argilla depurata is Diirr,
who, for several years, administered it in the diarrhoea and  cholera
of infants, and  found it highly efficacious.
   The chemical reasons, urged by Ficinus and others, merit atten-
tion.   The article  is worthy of employment in affections of the
intestinal  tube,  in which astringents are indicated.   The  chloro-
hydric and the  acetic or  lactic acid are always in the stomach when
any alimentary or  other  matter is present there;  these acids can-
not fail, consequently, to  unite with the  argil, and  the resulting
compound  must possess astringent  properties.
  1 Zeitschrift fiir Natur. und Heilkunde der Dresdner Professoren, B. 1, H.  1, S. 82.
  2 Bemerkun^en iiber die gebrauchlichsten Arzneimittel, von Dr. Karl Georg Neu-
mann, S. 55,  Berlin, 1840.       ' Rust's Magazin, B. xii. H.2, S. 247. 
ARNICA.
103
                 MODE OF ADMINISTRATION.
  The dose, in the 24 hours, for a very young child, is from 3ss.
to 3J. | for older children, from sj. to 3ij.   Small doses are of little
or no avail.  The vehicle is commonly an emulsion.
  The following forms are given by Riecke.1—
                      Mistura  argillae.
                       Mixture of argil.
          R.  Emuls. sem. papav. (ex ^ss. parat.) giiiss.
              Argillae purse Qij.
              Syrup. altha?33 f §ss.  M.
  Dose.—A teaspoonful to a  child  two  years old affected with
diarrhoea.
          R.  Argill. pur. ^ss.
              Acacias 3j.
              Sacch. 31J.
              Aq. fcenicul. f ^iij.  M.
  Dose.—The same  as the last to a child one year old.
          R.  Emuls. oleos. cum vitell. ovor. parat. %].
              Syrup, alth. f §j.
              Argill. depurat. £ss.
              Aq. cinnam. simpl. f 3J.
              Extract, conii gr. ij.  M.
  Dose.—The same as  the last two to a  child three months old,
affected with cholera infantum.                         Durr.
                       XXVI. ARNICA.
Synonymes.  Arnica Montana seu  Plauensis, Doronicum Germanicum,
  Panacea  Lapsorum,  Ptarmica Montana,  Caltha  Alpina, Calendula
  Alpina, Narda Celtica  altera, Doronicum plantaginis folio, Leopard's
  Bane.
French.  Arnique, Tabac ou Betoine des Savoyards, Tabac de Montagne,
  Doronic d'AUemagne, Tabac des  Vosges.
German.  Wohlverlei,  Fallkraut.
   This plant, which  belongs, in the sexual system, to Syngenesia
polygamia superflua,  and to the natural order Compositse  Synan-
thereae, is in the  secondary  list of the Pharmacopoeia of the United
States, but it is not much used in this country; nor does there ap-
pear  to  be any  clear  appreciation of the  cases for  which it  is
adapted.3  Such, too, appears to be the sentiment of  the  French
practitioners.  "It may be  concluded,"  say MM. Merat  and De
Lens,3 " that we have as yet insufficient data to  pronounce posi-
tively on the affections in which arnica can be unequivocally effi-
cacious ; we must, consequently, always bear in  mind its heating
and active qualities when we prescribe it."
  1 Die neuern Arzneimittel, S. 41.   Stuttgart, 1837.
  2 Wood, in Dispensatory of the United  States, by Wood and Bache, Art. Jirnica.
  1 Dictionnaire Universel de Matiere Medicale, &c. i. 4123. Paris, 1829. 
104
ARSENIAS AMMONLE.
  According to Sir George Lefevre,1 the Germans  class arnica
among sacred  remedies; and  its virtues are extolled throughout
two pages of the Pharmacopoeia Ruthensis.   Sir George was much
disappointed in its effects.   It is much  more uncertain than strych-
nia  in its  operation, and  he  has known  it  given in large doses
without producing any sensible results.
  In  Germany, the flowers and root are much employed  in para-
lysis, as an excitant to the nervous system; and it is chiefly to in-
troduce the  volatile  oil—the  oleum  aethereum florum  arnica,
Germ. Wohl verleiol,  Aetherisches  Wohlverleiblu-
nen61,—to  the attention of the profession, that we refer to the
arnica at all.  This oil is obtained from the flowers, and has been
much recommended by Schneider in old cases of paralysis, which
are the result of the apoplectic condition.  He himself often ad-
ministered it with  evident success; the paralytic limbs becoming
warmer, more  active, and more  serviceable under its use.   He
recommends it also in indurations, especially of the abdomen.8  He
mixes four drops of arnica oil with half an ounce of spirit us aetheris
sulphurici compositus or spiritus cetheris nitrici, and of this gives,
for  a dose, from four to twelve drops several times a day.   The
mixture has an agreeable smell and  taste.   Four  drops of the oil
to four ounces of sugar form a good elaeosaccharum.3
              XXVII. ARSENIAS AMMO'NLE.
Synonymes.  Ammonium  Arsenicum seu  Arsenicicum, Arseniate of
  Ammonia.
French.  Arseniate d'Ammoniaque.
German.  Arseniksaures Ammonium, Arseniksaures Am-
  mo ni ak.
  This preparation of arsenic has been highly recommended, since
the year 1818, by Biett, in several cutaneous diseases, and  espe-
cially in psoriasis inveterata.4

                   METHOD OF PREPARING.
  It may be prepared by taking arsenic acid one part, dissolving
it in water, and adding pure  ammonia or  carbonate of ammonia
sufficient to saturate the acid ;—or, as follows:—Take of arsenious
acid, one part; nitric acid, four parts,muriatic acid,half apart;
saturate the solution with carbonate of ammonia, and let  the  ar-
senical salt crystallize.

  1 An Apology for the Nerves, p. 292.  Lond. 1844.
  2 Aschenbrenner, Die neueren Arzneimittel, u. s. w. Erlangen, 1848.
  3 Riecke, Die neurn Arzneimittel, u. s. w. S. 337.  Stuttgart, 1837.
  4 Cazenave, in Diet, de Medec. 2de edit. iv. 33; and Cazenave and  Schedel's Prac-
tical Synopsis of Cutaneous Diseases, translated by R. E. Griffith. Philad. 1829. 
ARSENIAS AMMOtfLE.
105
           EFFECTS ON THE ECONOMY IN DISEASE.
   A  grain of this  salt may be dissolved in an ounce of distilled
water;  and of the  solution from  twenty to twenty-five drops be
given daily, gradually increasing the dose until it reaches a dram or
more in the twenty-four hours.
   There does not seem to be much difference between the effects
of this preparation  and those of other forms of arsenic,  that have
been received into the Pharmacopoeias.   Arsenious acid itself, as
well as arsenite of potassa and arseniate of  soda—the offici-
nal solution of the former well known every where under the name
of " Fowler's Solution;" that of the latter known, in continental
Europe especially, under the name "Aqua Arsenicalis  Pear-
sonii " or Solution de Pearson—are possessed  of precisely the-
same properties as  arseniate  of ammonia, and, like it, have been
found equally efficacious in obstinate diseases of the skin.   Nor is
the knowledge of the agency of arsenical preparations in cutaneous
affections new.  In India, the efficacy of arsenic in those diseases
has been long known :  and, in Europe, attention  was attracted to
it by Fowler,1  and Girdlestone,3  and  subsequently by Willan,3
Pearson,4 and others; but no one  administered the  arsenical pre-
parations more extensively in these diseases than Biett and  Rayer
of Paris, whose situations afforded them ample opportunities  for
testing the virtues of the different articles of the  Materia Medica
in skin complaints.  They succeeded by means of the arsenical
preparations, and especially of the one now under consideration, in
removing several inveterate affections of  the skin, that had re-
sisted every other remedy.  The author has found equally  benefi-
cial results from this practice in his own experience.   All chronic
cutaneous diseases are dependent upon an alteration in the functions
of the capillary vessels,  or system of nutrition of the part  af-
fected;  and there appear to be but two ways in which  these can
be reached, so that a new action  may be impressed upon them ; —
in the one case, through the medium of the general circulation;
and, in the other, through the agency of topical applications, made
to come in contact  with the diseased surface.  Arsenic,—like io-
dine, mercury in small doses, and  certain other alteratives,—acts
in the former way, modifying, after a  protracted exhibition, the
fluid of the circulation, in such manner, that it makes  an  altered
impression on the system of nutrition, and breaks in upon the dis-
eased catenation.  In  no  case, however, have  we observed these
salutary  effects, until  the use of the  arsenical  preparation  had
been persevered in for several weeks.   These diseases are chronic

  1 Medical Reports.  London, 1780.
  2 Essays on the Hepatitis, &c, of India.  London, 1787.
  3 Description and Treatment of Cutaneous Diseases. London, 1798,
  4 Observations on the Effects of various articles of the Materia Medica in the Vene-
real Disease, 2d edit.  London, 1807. 
106                   ARSENICI iodidum.

in their nature, and they require a chronic medication.  Time is,
indeed, in every case, an element in the cure.
               XXVIII. ARSENICI IODIDUM.
Synonymes.  Arsenici Teriodidum, Ioduretum Arsenici,.Arsenicum Ioda-
  tum, Hydriodas Arsenici, Iodide, Teriodide, or Hydriodate of Arsenic.
French.  Iodure d'Arsenic.
German.  Iodarsenik,  Arsenikiodiir,  Iodarsen.

   Of late years, this preparation has been highly extolled by Biett,
in the same class of affections as the last;—applied  externally.

                  METHOD OF PREPARING.
   The iodide is prepared, according to Magendie,1 in two ways:
1. By heating in a glass alembic a mixture of sixteen parts  of ar-
senious  acid and one hundred parts of iodine.  The combination
sublimes in the form of orange-coloured needles.  2. Thirty parts
of pulverized arsenious acid, and  one hundred parts of iodine
are boiled  in one thousand parts of  water.  As soon as the liquid
becomes  colourless, it is filtered, and the filtered solution is evapo-
rated to  dryness.  If it be thought advisable, this can be sublimed.
   A formula, employed by Plisson,  is to digest three parts of ar-
senious  acid, in fine powder, with  ten parts  of iodine, and  one
hundred  and nine parts of water, until the odour of iodine is no
longer manifested.  The clear  liquid is  then decanted, and sub-
jected to evaporation.   At a certain degree of concentration, the
iodide forms in red crystals:  or, the  solution may be evaporated to
dryness,  and then  sublimed in close  vessels without decomposition,
when it forms beautiful crystalline scales.
   Water, in  large quantity, dissolves  it wholly; but if  it be di-
gested with  a small quantity,  it is decomposed, hydriodic acid
being formed in solution, and white  crystalline scales, composed of
water, acid, and iodide in variable proportions.2

                 EFFECTS ON THE ECONOMY.
   When iodide of arsenic is  injected into the veins, it  does not
exert so  strong  an action on the heart as might be  expected from
so poisonous a  substance.  Dr.  Blake3 twice  injected solutions,
containing each six grains  of this substance, into the jugular vein
of a dog, without producing the slightest appreciable effect on the
heart.  On injecting a solution  containing fifteen grains, the ac-
tion of the heart was immediately arrested.
  Professor A. T. Thomson  has employed it in several cases of

  1 Formulaire, edit. cit.
  2 A.Duhamel, American Journal of Pharmacy, October, 1840, p. 187.
  * Edinburgh Medical and Surgical Journal, April, 1839, p. 336. 
ARSENICI IODIDUM.                   107
lepra and impetigo, with very great success.1  He begins with
one tenth of a grain doses, three times a day, and increases them
to a*quarter of a grain.   In some cases, he had  not been able to
exceed two-thirds of a grain, as symptoms of poisoning  came on,
and the medicine had to be given in diminished doses.
   Dr. Neligan's2 experience  leads him to place more reliance on
the iodide, in  these  and similar chronic cutaneous  affections,
than in any other preparation  of arsenic;  but although he found
it  alone capable of curing many cases of psoriasis and lepra, he
considers that its beneficial action is much augmented by combining
it  with iodide of potassium and iodine.                 ♦
   It has been given with success in a case of cancerous disease
of the breast, by  Dr. F. C. Crane.3   The dose was an  eighth of
a grain, which was reduced to one-twelfth, and gradually increased
to a third of a grain, beyond which it could  not be borne.   In a
case of inveterate  lepra vulgaris, it was carried to the extent of
one grain for a dose,  with the most decided curative effects.
   Biett has frequently applied an ointment of it in cases of phage-
denic tuberculous cutaneous diseases.4

                 MODE OF ADMINISTRATION.
   Mr. Erichsen thinks with Dr. A. T. Thomson, that iodide of ar-
senic is most  advantageously exhibited in combination  with  the
extractum conii, which appears to sheathe its irritating  qualities,
and prevents it from exciting too powerfully the mucous membrane
of the stomach.  By  the addition of red iodide of mercury, a com-
pound  pill may be  formed,  which  resembles, in its effects, the
iodide of arsenic and mercury, and has been much, and successfully,
employed by Dr. A. T. Thomson  in  the  treatment of lupus  and
other diseases of the skin, and which Mr. Erichsen has found of
particular service in certain syphilitic  eruptions, of the  squamous
kind more especially.5
                Unguentnm  arsenici  iodidi.
                Ointment of iodide of arsenic.
                    R.  Arsenic, iodid. gr. iij.
                        Adipis §j.  M.
                                                      Biett.

   An extemporaneous preparation, which is considered to combine
the virtues of both arsenic  and iodine, is  said to have  been  era-
ployed successfully in Philadelphia.6   It is formed as follows:

  i Lancet, .1 an. 19, 1839, p. G21.
  2 Dublin Quarterly Journal of Med. Science, Nov. 1849.
  'Lancet, Aug. 31, 1839.
  ' See, also, Ballard and Garrod, Elements of Mat. Med. &c, p. 357.  Lond.  1845.
  5 Lond. Med. Gaz., May 12, 1843.
  6 A. Duhamel, Amer. Journ. of Pharmacy, Oct 1849, p. 187. 
108
ARTEMISIA VULGARIS.
                 R.  Liquor iodin. compos, f ,^i.
                     ------potassa? arsenit. f %iv.  M.
  When mixed together in these proportions, a change is observed
in  the appearance of the  mixture, which is  instantaneously  ren-
dered almost colourless.  The dose is five drops.
             XXIX. ARTEMISIA VULGA'RIS.
Synonyme.  Mugwort.
French.  Armoise Commune.
German.  Beifuss, Gemeiner Beifuss.
  Almost all the species belonging to the genus artemisia are pos-
sessed of bitter and aromatic properties, and several afford "worm-
seed."   Artemisia vulgaris was employed by many of the  older
physicians, but  it had fallen  into  oblivion, when its use was re-
vived in  Germany, by Burdach, a physician at Triebel, near So-
race,1 who recommended  it strongly as a preventive of epilepsy.
Since that time, it has been much prescribed in that country, but
its employment has not extended much to other countries of Eu-
rope, or to this side of the  Atlantic.  The root is  the part pre-
ferred:—formerly the herb and the tops were  solely used.  The
root was employed in epilepsy, centuries ago, but it  had been neg-
lected, or was  only  exhibited as a  nostrum, when Burdach en-
tered upon his investigation, of which the following  is a summary.
  The root of the artemisia should be dug up in autumn, after the
stalk has become dry, or in the spring before  the stalk has shot
up;  but  perhaps the latter  half of November is as  good a period
as any.  It must be freed from  the adherent earth by shaking.
Burdach regards washing to be objectionable, as the root may lose
some portion of its  efficacy thereby.  The old, ligneous, mouldy
and  damaged parts of each root must be carefully removed, and
the fresh young side roots (fibrillce,) which are distinguished by
their smell, clear colour,  and greater juiciness, must be spread on
paper, and dried in the shade, and as soon as  they  become brittle
they must be carefully preserved.  Besides the fibrillae, the soft,
sound, and juicy parts of the root, especially the fleshy rind of the
thicker roots, must be used.
  The period  required for drying them varies; in moist weather,
it may be two months: but late in the ye^r the desiccation may be
aided by the gentle warmth of the sun, or of a stove; the latter
must never, however, rise  higher  than from sixty-four to  sixty-
eight degrees of Fahrenheit.   If put away too early, the root be-    »
comes spoiled; if too late, it loses  many of its  volatile  parts.
When powdered, it ought  not to.be kept too long, as the volatile
                 ' Hufeland's  Journal, B. lviii. St. 4 und 5. 
ARTEMISIA VULGARIS.
109
portions escape, and it soon becomes devoid of smell. Even during
the process of pulverizing, loss is sustained, and the fresh powder
has a much  feebler odour than the entire  root, so that Burdach
advises, for distant patients, that the  root in substance should be
sent to them, and that they should be recommended to pound it for
use in a well  covered mortar.   By pulverizing, the inner,  hard,
woody parts are separated from  the  smaller roots; they must be
removed and thrown away, as the powder of the cortical substance
of the small radicles has alone been found efficacious.  The smell
of the well dried root is very strong, pungent  and peculiar, espe-
cially when we open a vessel in  which it has been stored away in
quantity.   The taste is sweetish, sharp and nauseous.
          EFFECTS ON  THE ECONOMY IN DISEASE.
   It has been already remarked, that Burdach1  recommends ar-
temisia especially in epilepsy;  and he  affirms that it requires no
preparation or special attention.   It is most efficacious when given
about half an hour before the attack, which it usually prevents;
but if this be impracticable, it may be given as soon as the patient
comes to.   The dose is a heaped up tea-spoonful, (from  fifty to
seventy grains,) which may be administered in  w7arm beer; the pa-
tient should be put to bed immediately, be  covered up warm, and
allowed warm small beer to drink, so as to occasion diaphoresis—
care being taken that he does not expose himself  to cold.   This
course is to be repeated so long as there are any traces of mischief.
When the  remedy,  however, acts favourably, Burdach asserts,
that frequent repetition is not often  necessary.  At times it hap-
pens, that when the  dose has been raised to .a dram and a half, and
thrice repeated, no critical sweat follows:  Burdach then aids the
operation by giving the liquor cornu cervi succinatus, {spirilus
ammoniae  succinatus,)  in  an  infusion of serpentaria, valerian
root and arnica flowers;  but the effect, he says, was always better
when the diaphoresis was produced  by artemisia alone.   One im-
portant advantage in the  use of this  agent  is, that a judgment can
be speedily formed  of its utility: when  much may be expected
from it, a marked  improvement usually occurs  after the first closes
In those cases of epilepsy which recur every  day, and sometimes
even from  three  to  fifteen times  a day, and especially where the
paroxysms are so violent and frequent as  to  leave little interval
for the patient to be restored to consciousness, the artemisia  has
proved more  certain in its operation, either in removing or miti-
gating the disease.  In such cases, two doses were given  on the
first day, and afterwards  one tolerably strong dose daily till  the
third day.   In  those forms  of epilepsy whose attacks recurred
twice daily, morning and  evening, the artemisia acted very  benefi-
cially;  the paroxysms soon became somewhat  weaker and shorter,
              ' Casper's Wochenschrift, Oct. 22, 1830, S. 675.
       8 
110
ARTEMISIA VULGARIS.
and were postponed a day or two.  In such cases it is advisable to
continue the remedy for some weeks.  Infants at the breast bear
artemisia especially well.  It is equally efficacious in the epileptic
attacks of young females from twelve to fifteen  years of age, and
prior  to the establishment of menstruation.  Under its use, the
catamenia have generally taken place, and the epilepsy has disap-
peared.   On the other  hand, it was  found to aggravate  cases of
epilepsy occurring as a disease  of growth, (Entwickelungs-
krankheit,)  in  young persons from seventeen  to twenty-two
years old, and  as  a consequence  of great  corporeal  development.
It was equally unfortunate in cases of epilepsia  nocturna, where
the paroxysms came on irregularly at an interval of about five, ten,
or fifteen days, and generally about midnight; as  well  as  in that
form in which,—after the patient had suffered  for six, seven, or
eight weeks, under violent symptomatic sweats,—a morbid condi-
tion ensued  from two to three times every twenty-four hours, con-
sisting of repeated epileptic  attacks, with great  prostration in the
intervals.
  These are the main results of  the communications of Burdach.1
The number of his experiments and observations was considerable,
and the results appear to have been frequently most happy, espe-
cially in the case of females, who  seem to have exhibited  them-
selves more beneficially impressed by the remedy than males; the
proportion of cures being as  three to  two.   Tosetti3 gives the pro-
portion of cases in women and children to  that of men, as eight to
six.                                                       ,
   In the Berlin Charite, artemisia is said  to have  been  used with
equal success.   The German journals contain numerous cases, on
the authority of E. Grafe,3 Wagner,4 Van Maanen,5 Wolf,6 Osann,
Bonorden,7  Schluter, Bird,8 Lowenhard,9  Geis,10  and others.11
But  few physicians, according to  Riecke, have  been disappoint-
ed in it, and, where they  have,  he ascribes the  failure to its
having  been given in cases for which  it was inappropriate, or to
the preparation of the artemisia not having been  properly attended
to.13
   In  consequence of a  German  physician  having recommended
Artemisia  absinthium to Professor A. T. Thomson, Dr. Elliot-
son13 was induced  to try it  in  epilepsy.  The  patient to whom
he gave it wTas a girl, seventeen  years of  age, who had been af-

  1 Riecke, Die neuern Arzneimittel.'u. s. w. S.  49. Stuttgart, 1837.
  3 Diss, inaug.de Radice Artemis, vulg. remed. antiepilept. Berolin, 1827; and Osann
in Art. Artemisia, Encyc. Wdrterb. iii. 313.  Berlin, 1829.
  * Grafe und Walther's Journal, B. vi. H. 2.
  ' Hufeland's Journal,  lix. S. 6.
  • Ibid.ki. 5.               6 Ibid. lxii. 3.               ' Ibid. Ix.  1.
  8 Ibid. lxv. 3.              9 Ibid. lxv. 3.              ,0 Ibid. lxv. 3.
  " Richter's Specielle Therapie, B. x. S. 377.  Berlin, 1828.
  n Op. cit. S. 49,            " Lancet, July 9, 1836. 
ARTEMISIA VULGARIS.
Ill
    fected with epileptic fits for four months—three or four occurring
    daily.  A dram of the powder was given three times a day.  This
    was on the 30th of March.   On the 9th of April, the dose was in-
    creased to two drams, when the fits became less frequent, but not
    less severe.  On the 16th, the dose was repeated every four hours.
    She had only one slight fit in the course of twelve days; and, on
    her dismissal, on the 24th of May, had had no fit for twenty-six
    days.  Dr. Elliotson  was of opinion, that the  strong  infusion
    would be less offensive to the patient, and  quite as effective as the
    powder.
      Besides epilepsy, artemisia has been used  with advantage  in
    other diseases,  as in  St. Vitus's  dance?   Wutzer  employed  it
    successfully in the convulsive diseases of childhood,  and it was
    recommended by Biermann2 in  eclampsia  infantum, occurring
    during the period of dentition.  He advised it  to be given to chil-
    dren in gradually increasing doses, commencing wTith half a grain;
    and giving, an hour afterwards, a grain, and,  in two hours, two
»  '  grains, which is usually the last dose required.   The gradual aug-
    mentation, of  the  dose he considers  advisable, " to  prevent the
    crisis which the  artemisia  induces from  being too  turbulent."!
    Kolreutter, of Carlsruhe, administered artemisia in different dis-
    eases, with great success.  He prefers the extractum  resinosum
    radicis artemisice vulgaris,  German, Biefusswurzelextract,
    to the root in substance.  This is prepared in the  following  man-
    ner.   A quantity  of the dried and powdered root is covered with
    alcohol, and permitted to digest for some time; the filtered liquor
    is then evaporated in an  earthenware vessel, until it has  attained
    the  consistence of an  extract.  Kolreutter employed this advan-
    tageously in the eclampsia of children, (in certain cases after the
    application of leeches;) in tormina, unaccompanied by inflamma-
    tion ; in the diarrhoea  of children and adults, in sporadic cases of
    cholera morbus, and  in  dysentery, after  the  bloody evacuations
    had ceased;  in gastric fevers, on  their  assuming a nervous cha-
    racter; and in dysphagia, cardialgia, chronic  vomiting, scirrhus
    of the stomach, chronic cephalalgia  and  neuralgia of the face;
    in  cldorosis,  and in obstruction  of the catamenia, as well as in
    epilepsy.  The dose, in the twenty-four hours, is from 3ss. to 3j.;
    to small children, a  few grains.
      Such is the chief testimony adduced in  favour  of artemisia  by
    the  German  writers mainly.  It is. to  be feared, that  the ad-
    vantages to be derived from it in epilepsy have been exaggerated.
    Where there is  no organic disease of the  encephalon, substances,
    which, like it, are nauseous, bitter and aromatic,  may be produc-
    tive of advantage as  tonics  and  revellents.    In one case of this
    nature it was employed by the author, but the results were not
     1 Gittermann, in Hufeland's Journal, lxii. 1. Bonorden, Op. cit.
     J Riecke, Op. cit. S. 50. 
112
ARTEMISIA VULGARIS.
striking.  When aided by other means and  appliances, it appears
to be powerfully diaphoretic; and, doubtless, therefore, in appro-
priate cases, especially where there is much nervous impressibility,
it may be productive of the good effects ascribed to it by Burdach,
Kolreutter, and others.   Yet, as Osann has remarked,1 it must be
improper where  polyEemia, or a tendency to active hypersemia, is
present.  The analysis of Hergt, Hummel, and Janike  afforded,
along with  traces of volatile  oil, some  balsamic resin,  both of
which are excitants to the living economy.

                 MODE  OF ADMINISTRATION.
   The  following forms- for its administration  have been adopted
by some of the German  authorities: —
                    Tinctnra artemisia.
                     Tincture  of Mugwort.
            R.  Artemis, vulg. rad. concis. §v.
               Alcohol, dilut. Oij.  M.
   Digest for three days;  express and filter.  Dose,—half a drachm
to two drachms, four or  five times a day, in epilepsy.
                                              Rademacher.2
                   Decoctum  artemisise.
                    Decoction  of Mugwort.
            R.   Artemis, vulg. rad. concis. §j,
                Coque cum aquas q. s. per semihoram
                ad. colat. Oj.
   Half a tea-cupful of this may be taken, every  two hours, in cases
of epilepsy.                                     Hildenbrand.
                     Pulvis  artemisise.
                     Powder of Mugwort.
                R.   Artemis, vulg. rad. pulv. jjj.
                   Sacch. alb. 9j.  M. et fiat pulvis.
   The powder to be administered daily in the evening, in warm
beer, in cases of epilepsy.                        Lbwenstein.
                    Mistura  artemisise.
                     Mixture  of Mugwort.
                R.   Ext. artemis. vulg. alcoholic, gr. iv.
                   Acacias 9j.
                   Sacch. giij.
                   Mist, amygd. f ^iij.
   A coffee-spoonful3 to be  given every half  hour in  eclampsia
infantum.   The dose  may be gradually  raised to  two coffee-
spoonfuls.                                        Kolreutter.

   1 Art. Artemisia in Encyc. Worterb. iii. 313.  Berlin, 1829.
  a Aschenbrenner, Die neueren Arzneimittel, u. s. w. S. 37.  Erlangen, 1848.
  3 About two ordinary tea-spoonfuls. 
ATROPIA.
113
                      XXX.  ATROP'IA.
  Synonymes.  Atropina, Atropium, Atropinum, Atropine.
  French.  Atropine.
  German.  Atropin.
  This is the active principle of Atropa belladonna, and was dis-
covered many years ago in the leaves by Brandes.  To it is pro-
bably owing the whole  of the medicinal efficacy of the plant.  In
1825, M. Pauquy found it in the root, and affirms, that  he de-
tected  it  also in the stalks of datura, hyoscyamus, and solanum.1
                   METHOD OF PREPARING.
   The most  approved  processes for  extracting this alkaloid, ac-
cording to Dr. Pereira,2 are those of Mein, Thomson, and Richter.
The process of Mein is contained in  the Pharm. Central-Blatt,
fiir 1833.  The  following is given  in the United States Dispen-
satory,3 from the Journal de Pharmacie, vol. xx., p. 87.—The
roots of  plants two or  three years old are selected; of these, re-
duced to an extremely fine powder, twenty-four parts are digested
for twelve days, with 60 parts of alcohol, of  86 or 90 per  cent.
The liquid having been separated by strong evaporation, the resi-
due is  then treated  anew with an equal quantity of alcohol; and
the tinctures, poured together and  filtered,  are mixed  with one
part of hydrate  of lime, and frequently shaken for twenty-four
hours:  the copious precipitate  which now forms is separated by
filtering; and diluted sulphuric acid is added, drop  by drop, to
the filtered liquor till  slightly  in excess.  The sulphate  of lime
having been separated by a new filtration, the alcoholic liquor is
distilled to one half, then mixed with six or eight  parts of pure
water, and evaporated with a  gentle heat till the whole of the
 alcohol  is driven off.   The  residual liquid is filtered, cautiously
 evaporated to one-third, and allowed  to cool.  A concentrated
 aqueous solution of carbonate of potassa is then gradually added,
 so long as the  liquid  continues  to  be rendered turbid, and the
 mixture is afterwards suffered to  rest some hours.  A yellowish
 resinous substance, which opposes the crystallization of the atropia,
 is  thus precipitated.   From this the  liquid is carefully decanted,
 and a small additional  quantity of the solution of the carbonate is
 dropped  into it, till  it no longer becomes turbid.   A gelatinous
 mass now gradually forms, which, at the end of twelve or twenty-
 four hours, is  agitated, in  order  to  separate  the mother waters,
 then thrown upon a filter,  and dried by folds of unsized paper.
The substance thus  obtained, which is atropia in an impure state,

   ' Merat & De Lens, Diet. Universel de Mat. Med. Art. Atropine.  Bruxelles, 1838.
   1 Elements of Mat. Med. and Therap., 2d Amer. edit. ii. 312.  Philad. 1846.
   3 Sixth edition, p. 138.  Philad. 1845. 
 114                        ATROPIA.
                                           I
 is dissolved in five times its weight of alcohol;  and the solution,
 having been  filtered, is mixed with six or eight  times  its bulk of
 water.   The liquor soon becomes  milky,  or is rendered so by
 evaporating the excess of alcohol, and, in the course of twelve or
 twenty-four hours, deposits the atropia in the form of light-yellow
 crystals, which are rendered entirely pure and colourless by wash-
 ing with  a few drops  of water, drying  on  blotting paper, and
 again treating with alcohol, as before.
   By this process, Mein obtained, from twelve ounces of the root,
 twenty grains of pure alkali—according to the authors of the Dis-
 pensatory,—not quite twelve grains, according to Dr. Pereira.
   Atropia  crystallizes  in transparent silky  prisms, is  devoid  of
 odour,  and  is soluble  in alcohol  and  ether;  very slightly so  in
 water.   It dissolves in  acids, with which it unites to form  salts.
 At a temperature of 212° it  is volatilized.
   As atropia is an expensive article, and therefore very liable to
 adulteration, Mr. Donovan,1 to insure its  purity, advises that a
 dram of commercial atropia be  dissolved in  an  ounce of alcohol.
 If there be a residuum, it must be  separated; and six ounces of
 distilled water be  added, shaking the mixture.   No change ap-
 pears  at  first; but, after twelve  or eighteen  hours, the  atropia
 crystallizes  in beautiful stellated  groups, which adhere to the
 sides of the  vessel.   These, after  pouring off the liquor, must be
 collected on  bibulous paper, and dried.

                 EFFECTS  ON THE ECONOMY.
   Atropia is a most virulent poison.  When given  to  dogs and
 cats, it causes vomiting, dilatation of the pupil, stupor and death.
 A tenth of a grain produced, on man, manifestly poisonous phe-
 nomena.  When Brandes applied a "minimum" quantity of the
 sulphate to the tongue, headache, with alternate chills and flush-
 ing, trembling, oppression of breathing, and weakness  and small-
 ness of the pulse  supervened.9  An imponderable  quantity, applied
 to the  eye, occasions dilatation of the pupil.  Reisinger3 used it
 for this purpose,  dissolving a grain in two scruples of water; and
 it  has  been  proposed  by Mr. W. W. Cooper,4  surgeon to the
 North   London Ophthalmic  Institution, and by  M. Bouchardat,5
 as a substitute for  belladonna for dilating  the pupil in  cases of
cataract, &c.   Mr. Cooper affirms that  he has  used it, with the
 greatest satisfaction, in a considerable number of cases,—the pro-
 portions being two grains of atropia dissolved in a dram of alcohol
 and seven drams  of distilled water.  A colourless solution is the
 result,  which—Mr. Cooper  affirms —is  equally  efficacious in its
  1 Ranking's Half-Yearly Abstract, July to December, 1818, Amer. edit., p. 215.
  "Oesterlen, Handbuch der Heilmitellehre. S. 784.  Tubingen. 1845.
  3 Aschenbrenner, Die neueren Arzneimittel, u. s. w. S.  41. Erlangen, 1848.
  4 London Lancet, June 8,1844.
  5 Annuaire de Therapeutique, &c, pour 1847, p. 19.  Paris, 184f. 
ATROPIA.                       115
action as, and much more elegant than, the ordinary preparations
of belladonna,—a full drop, placed  in  the  eye producing  speedy
and  complete dilatation of the pupil in the generality of cases,
although, in some instances, a stronger solution may be required.
He has never seen ill effects from its use, although he  has tried it
in the proportion of four grains to the  ounce;  but, he  thinks, two
grains will be found to answer every purpose.  He directs a drop
to be used night and morning, where he is  desirous of  keeping up
the dilatation of the pupil.  An objection, which does  not seem to
be a very forcible one, has been made to this  preparation,—that
it involves the necessity for the addition of alcohol.  Mr. J. Lloyd
Bullock1  proposes, therefore,  to substitute the salts  of atropia,
which are neutral and soluble in distilled water.   Dr.  Jacob2 con-
siders it more effective and convenient than any extract or tincture
of belladonna.
   In experiments made with it by Messrs. Bouchardat and  Stuart
Cooper,3  they found it, in the  dose of a centigramme—gr.  .1543,
produce on man all the severe symptoms of the active solanacese—
as delirium, coldness of the surface, syncope, depravation of sight,
and aphonia; yet they consider it, owing to the facility of adminis-
tering it and of regulating the  dose, to  be a most valuable agent in
every case in which belladonna and other solanacese are beneficial.
   Its dose is about one-twelfth of  a grain; or it may be employed
endermically.
                     Tinctura atropine.
                      Tincture of atropia.
                  {Gouttes ou Teinture a"1 Atropine.)
              R.  Atropia? gr. xv. (1 grammfy)
                  Alcohol. 85 per cent. p;x.  (40 grammes.)  M.
   Dose—one to five drops.
                    Unguentnm  atropia1.
                      Ointment of atropia.
                      {Pommade d'Atropine.)
              R.  Atropiae gr. iv. (25 centigr.)
                  Adipis 3j. and gj. (5 grammes.)  M.
   The size of a pin's head to be introduced, night and morning,
between the eyelids, in cases of adhesion of the iris to the lens.
                                                 Bouchardat.*
   An ointment, composed of five grains of atropia to three drams
of lard, has been  much used in neuralgia.5
   Atropia is so lethiferous, that it is not much employed internally.

  1 Lond. Lancet, June 15, 1844, p. 393.
  ' Dublin Medical Press, cited in Med. Examiner, October,  1848, p. 652.
  ' Bouchardat, Annuaire de Therapeutique, pour 1848, p. 10; and Ibid,  pour 1849,p.7.
  4 See, also, Cunier, in Bouchardat, Annuaire pour 1848, p. 10,  Paris, 1848.
  5 Brookes, Lancet, Jan. 30, 1847. 
116
AURI PRJEPARATA.
                XXXI. AURI PR^EPARA'TA.

  Synonymes.  Preparations of Gold.
  French.  Les Preparations d'Or, Les Composes auriferes.
  German.  Goldpraparate.
  The administration of gold in medicine is not modern.  In the
times of  alchemy, it was frequently used in nervous diseases, con-
vulsions, hypochondriasis,  mental affections, profuse salivation,
&c.   Paracelsus, Horst, and Poterius recommended it, united with
corrosive sublimate,  in syphilis.   Its  violent  effects,  however,
brought  it into discredit, and during the decadency of alchemy it
fell  into entire disuse.1  It is probable, too, that many prepa-
rations were brought forward as containing gold, which had none
of it, and this  may partly account for the discredit  into which  it
lapsed.3  M. J. A. Chres'tien3  was the first who—in more modern
periods,  (about the year 1810,)—recalled tbe attention of practi-
tioners to the preparations of gold, and after him many physicians
employed them, so that the published results of their observations
have furnished  us with a considerable amount of evidence in rela-
tion  to  their therapeutical  properties, and  they have, in conse-
quence, been received  into many of the modern pharmacopoeias.4
  As the different preparations agree in their  effects on the econo-
my,  it may be well to make a few observations which apply to all.

           EFFECTS ON THE ECONOMY IN  HEALTH-
  Orfila  made many  experiments to discover the  action of the
preparations of gold on%nimals.  Three dogs, into whose jugular
veins he injected  a small  quantity  of the chloride dissolved  in
water, died speedily—death  being preceded by difficulty  and
rattling  in  breathing, cough, symptoms of suffocation and  slight
vomiting; these results supervening immediately  after the injec-
tion  had  entered the blood-vessels.  On dissection, the lungs were
found livid, engorged with blood, and  without  any crepitating
noise when  cut into;  wrinkled, discoloured,  and  scarcely lighter
than water; the heart was of a violet colour; the left auricle and
ventricle full of black blood, and the  right  cavities empty and
contracted.   The effect of  the salt supervened with such rapidity
that the blood of the crural artery—which was opened  a few
minutes after death—was of a brownish red, almost black, colour.

  1 Richter's Specielle  Therapie, x. 504, Berlin, 1828; and Nachet, Art. Or, in Diet.
des Sciences Medicales, torn, xxxvii.
  2 Riecke, Die neuern Arzneimittel, S. 53.  Stuttgart, 1837.
  3 Recherches et Observations sur les effets des preparations d'Or du Dr. Chrestien, &c.
Paris, 1821.
  4 See Art. Gold, in Encycl. Worterb der Medicinisch.  Wissenschaft, B. xv. S.  77,
Berlin, 1837. 
AURI PR^PARATA.                   117
In two dogs, to which he gave the chloride, a torpid condition
was induced, which terminated fatally in  a couple of days.   The
mucous membrane of the stomach was found inflamed and ulcerated.
  The effects on man of agents so potent, in appropriate doses,
have  been  investigated  by  many  observers.  Experiments on
animals had already exhibited the powerful influence which  they
are capable of exerting  on the organs and functions of organic
life.   One of the  most striking  effects  is said  to  be, an in-
crease of the various  secretions;  commonly, the urinary secre-
tion  is largely augmented, as  well  as the transpiration, and the
intestinal and salivary secretions.   Not  unfrequently,  under the
continued administration of  the gold, actual  salivation  ensues,
which differs, however, from that  induced by mercury.  It is
always slow in appearing,  and is  by no means  so exhausting;
nor do troublesome ulcers occur; and the saliva is thinner, and not so
tenacious.  Like mercury, the preparations  of  gold occasion ex-
citement  in the organism,  which  often  ends in a true febrile
condition.  After they have been taken for some time in moderate
doses, there is generally a  feeling of increased warmth in  the
stomach, and an augmentation of the appetite.   The pulse is ren-
dered fuller and more active, and the animal heat and vital activity
are augmented, so that in such as are predisposed to  the affection,
hemorrhage is apt  to take  place.   The catamenia  recur sooner
than  usual  under  their influence, and the quantity lost may be
greater.1  Sooner  or  later, a regular attack of fever not unfre-
quently supervenes,—as indicated by shivering, and  pains in  the
limbs, back, and stomach,—which may continue for a few hours,
but sometimes lasts for days, and at length ends by sweating, depo-
sitions in  the urine, and occasionally by salivation.
   In  very large doses, certain of the preparations of  gold are cor-
rosive poisons.  The symptoms, caused by their use, when  they
act as such, are—oppression in the region of the stomach; nausea,
vomiting, pains in the abdomen and  diaphragm, a metallic taste in
the mouth, augmented secretion of saliva,  without  the teeth or
gums being affected, pulse excited, and breathing oppressed.3   As
a general rule, they are not esteemed proper for impressible  indi-
viduals ; on the other hand, in persons of torpid constitutions, they
would appear to have  exerted an excitant influence  even on  the
generative system.  Certain persons, according to Chrestien  and
Niel, are  not susceptible of this action; and, again, there are some,-
according to Cullerier, junr.,  who  cannot  tolerate them in  any
form.
   When too large a dose has been  given, the remedy should be
entirely discontinued for some time, or the dose be diminished;  and
the effects will soon disappear.  One of  the greatest recommen-

  1 Riecke, Op. cit. S. 55.            2 Grotzner, in Rust's Magazin. xxi. 3. 
118                    AURI PR^PARATA.
dations of gold over mercury, in the eyes of many, is that it does
not act so destructively on the organism, and never induces such a
cachectic condition as the  latter occasionally does.1

           EFFECTS  ON THE ECONOMY IN DISEASE.
   The diseases, in which the preparations of gold  have been ad-
ministered, in modern  times, are chiefly the following.
   Syphilis.—They have been occasionally used in primary sores,
but  have  been mainly  employed  in  secondary  syphilis, espe-
cially in old  cases, where  a doubt often exists, whether more of
mercurial cachexia or syphilis be present.  They are given, also,
where there is a scrofulous complication, and where it is desirable
to exhibit some other remedy than mercury;  and lastly, their use
is  indicated  where  mercury  has  failed  to  remove   syphilis.3
Many practitioners doubt whether  the  preparations of gold should
be esteemed much inferior to those of mercury.  Numerous expe-
riments instituted, amongst others,  by Chrestien,3 Cullerier, junr.,4
S. L.  Mitchill,5 Niel, Biett, Lallemand,6 Wendt,? and  Legrand,8
have shown, that their employment has  been  most advantageous
in the different forms of  syphilis, and that they have rarely disap-
pointed expectation.   Alibert found  them especially useful in sy-
philitic eruptions.   It must be borne in mind, however,  that when
they are given in  syphilis, their operation is slow, and that, in the
first instance, the symptoms may appear aggravated: they are not,
therefore, adapted for cases in which it is important to act speed-
ily, so as to arrest the disease at once,  and  prevent its farther de-
velopment.
   Gonorrhoea.—In protracted  cases of gonorrhoea, several phy-
sicians9 have extolled the preparations  of gold;  others, as Wendt
and Ritter,  have advised  them for the sequelae  of gonorrhoea
(Trippernachkrankeiten:) it  is  not  probable,   however,
that they could be of much use in gonorrheal affections, which, as
is well known, are curable without  any mercurial  preparations.
   Scrofula.—The efficacy of the preparations of  gold  in scrofula
was deposed to by Chrestien, Eberle, Niel, Legrand,10 Herrmann,
and Kopp.11   According to observation, it would appear that they
effect improvement in the mildest cases,  and  are beneficial where
there is much torpor, but that they ought to be avoided  in irritable
subjects.   In scrofulous  ophthalmia, and in scrofulous porrigo,
they would seem to have been most efficacious.
   The preparations of gold have  been  employed by M.  Baude-
  1 Riecke, Op. cit. S. 56.   2 Eberle, Treatise on the Mat. Medica, 2d  edit. i. 247.
  3 Op. Uitat. p. 6; see, also, Lettre a  M. Magendie sur leg  preparations  d'Or, &c.
Paris, 1828.            * Diet, des Sciences Medicales, Art. Or., torn, xxxvii.
  s Dyckman's Dispensatory, p. 201, and  Eberle, Op. cit.
  s Journal Universel des Sciences Medicales, t xxvii.
  1 Rust's Magazin, Bd. xvi. St. I.
  8 Gazette Medicale de Paris, Oct. 30, 1837.          ' Grotzner, Op. cit.
  10 Bulletin General de Therapeutique. No.  xv. 15 Aout, 1837.
  11 Denkwiirdigk. in der arztl. Praxis, Hi. 351. 
                        AURI PR.EPARATA.                   119

 locque, at the Hopital des Enfans Malades, and by M. Velpeau
 at La Charite.'   At the  former  institution, they were  given in
 enormous doses.   M. Baudelocque gave the chloride and the stan-
 nate in doses of from ten to twelve grains, without producing any
 effect on the disease, and without any apparent injury to  the con-
 stitution of the children subjected to  the  experiment.   The oxide
 prepared by  potassa was carried as high as twenty grains during
 the  day.  At La  Charite, Velpeau gave  fifteen, eighteen,  and
 twenty grains  of  the  chloride and  oxide during  the  day,—and
 higher doses were not tried, solely on account of the expense of
 the medicine.  These  results  differ greatly from those of Orfila
 and  Devergie, the former of  whom  affirms, that the chloride is
 more active than the corrosive chloride of mercury; and the latter
 states, that in  the dose of one-tenth  to one-twentieth of a grain,
 it  produces more or less inflammation of the lining membrane of
 the stomach and intestines.
   Scirrhus and cancer.— The utility  of the preparations of gold
 appears to have been most decided in scirrhous induration of the
 tongue, according to the observation of Wendt, Helm, and others;
 in such case, they are rubbed  on  the tongue; this, indeed, is the
 most common form of administration.  H. Hoffmann relates a case
 of scirrhus of  the  pylorus, in which the chloride was  entirely
 successful; and frictions with the chloride, or the oxide  on  the
 labia pudendi have been  recommended  by Hufeland, Herrmann,
 Meissner, Grotzner, Gozzi,2 and others,  in cases of scirrhus and
 cancer  of the uterus.  In the  same affections, Krimer has advised
 them to be applied  to  the  os  uteri.   Scirrhosities, it  is affirmed,
 have been dispersed through their agency; and even in open cancer
 marked improvement has been  perceptible.
   In tumours of the  bones, and  in  like  affections, the prepara-
 tions of gold have been employed successfully by some practitioners,
 and especially when the cases  originated  in syphilis.
   Several forms of  lepra have been treated with them by  Alibert,
 and A. T. Chrestien, and with  the best effects.
   In  amenorrhea, Carron du Villards  employed the cyanuret
 successfully, beginning before the expected menstrual  period.
   Lastly.—Wendt, Delafield,  and  Grotzner  have administered
 them with benefit as diuretics in dropsy.   With  others, however,
 they have failed.  According to Riecke,3  the results of experience
 would seem  to  show, that they are  especially  adapted for dropsy
 dependent upon organic  disease of some viscus.
   None of the preparations of gold are much employed at the pre-
sent day.   Their expense  is, indeed,  a weighty objection, unless
there were  striking  advantages in  adopting them  in special cases
of disease in preference to other articles of the Materia  Medica.
  1 L'Experience, No. Ixxxvii ; and Lancet, March 23, 1839, p. 31.
  2 Soprarusodialcuniremediiaurificinellemalattieveneree.  Bologn. 1817;  and Omo-
dei,Annal. Univers. di Medicin., vol. v.                  = Op. cit S.58. 
120
AURI CHLORIDUM.
                XXXII. AURI  CHLO'RIDUM.

Synonymes.  Aurum Chloratum seu Muriaticum  seu Oxydulatum Mu-
  riaticum, Chloretum  seu  Murias Auri, Aurum Salitum, Chloruretum
  Auri, Auri Terchloridum, Muriate of Gold, Chloride of Gold, Terchloride
  of Gold.
French.  Chloride d'Or, Muriate d'Or.
German.  Salzsaures Gold,  Chlorgold,  Goldchlorid, Salz-
  saures Goldoxydul, Hydrochlorsaures Goldoxyd, Gold-
  k r y s t a 11 e.

   This preparation is received into several of the European Phar-
macopoeias,  and is usually formed by digesting  one part of gold
leaf in  three  parts  of  nitro-muriatic acid,  in  a sand bath,
and evaporating gently to dryness.   Magendie,1 however, recom-
mends the following method, which has been adopted in the French
" Codex."   Take one part  of fine leaf gold, divide it  into small
portions, and put it into a vial of white glass; pour upon it three
parts of nitro-muriatic acid—formed of one  part of nitric acid,
and two parts of muriatic acid—and heat  the  whole  in a small
sand bath, so arranged, that in case the retort breaks, the fluid may
be  recovered without loss.   The solution  of the gold  will soon
take place.  The fluid  must be then evaporated until the smell of
chlorine is perceptible.  This point can be  readily  determined, as
after the decomposition of the nitro-muriatic acid there is a period
during which the nitrous acid is  alone given off.  The disengage-
ment of chlorine indicates  the commencement of  the decomposition
of the chloride  formed.  The vessel must  now be removed from
the fire and  suffered to  cool.  The chloride appears immediately
as a crystalline mass,  in the form of a multitude of beautiful yellow
needles.  In this condition,  chloride of gold is as pure  as it need
be: it contains no excess of muriatic acid, and is not deliquescent.
It can be preserved in the same vessel  in which it  has  been pre-
pared—by merely stopping it with  paper—without any  danger of
undergoing decomposition.
   Chloride of gold, prepared according to Magendie's formula, is
very acid, but  this property  is not owing to its containing any free
acid.   The taste is also styptic and disagreeable.  It only attracts
moisture from  the air  when  it contains an excess of muriatic acid,
as is the case in Wendt's preparation.  It is readily soluble in wa-
ter, with which it forms a solution  of a beautiful yellow colour.
Many animal  and vegetable substances,—and especially the epi-
dermis—are coloured  by it of a  purple violet when  it is placed in
contact with them.   Exposed to a  moderate heat, it passes to the
state of protochloride.  When heated  to a greater degree in close
vessels, chlorine is disengaged and metallic  gold left behind.
                           1 Formulaire. 
AURI CHLORIDUM.
121
  The chloride  is one of the most active  of the  preparations of
gold.  It belongs to the class of corrosive poisons,1 and greatly
resembles the corrosive chloride of mercury in its operation on the
economy.  It must consequently be administered with  caution:—
even a tenth of a grain has been known to induce  unpleasant irri-
tation of the stomach.2  It has been given both internally and ex-
ternally  in syphilis, dropsy,3 and glandular affections.
  M. Chavannes, a pupil of M. Petrequin,4 of 'Lyons, has published
an account of the great success of the latter in the treatment of the
ulcerated form of lupus, lupus exedens, by means of  this agent,
which he has found of great  utility in other forms of  cutaneous
disease, when they assume an  ulcerated form, as  carcinoma of
the face, eczema, tuberculous syphilide, &c.  It is made of one
part of pure  laminated gold, three parts  of chlorohydric acid,
and  one  part of nitric acid.  It produces a temporary, sharp pain,
and  coagulation of the albuminous  matters on the surface of the
ulcer, which  changes its colour successively from an orange yellow
to a purple, violet, and black; a crust forms, and, under it, healing
takes place without  a cicatrix, unless the parts have been deeply
destroyed.
  In the form of ointment, it is said to relieve the pain of rheu-
matic gout, often  in a truly wonderful  manner.   The purple
stains caused by it are speedily removed by washing the part with
a little wine—a fact that was discovered by accident.5
  The dose is from  one-sixteenth to one-twelfth of a  grain, once
or twice a day, gradually but slowly increased.   In the like quan-
tity  it has been  rubbed upon the  tongue and gums.   Externally,
it has been applied in  the form of ointment or watery solution—
the latter more particularly in ophthalmia, especially of the scro-
fulous kind, in which Jahn found it very efficacious; and in  chronic
granular eyelids, Dr. W. Clay Wallace6 found a solution of six
or eight grains of it in an ounce of water, vastly superior to the
nitrate of silver.   In recent cases, however, it was inferior.
   The following are some of the forms in which it has been pre-
scribed :—
                     Boli  anri chloridi.
                 Boluses of chloride of gold.
             {Boli antisyphilitici) Pharmacopoeia Batava.)
                      Antisyphilitic Boluses.
         R.  Auri chlorid.gr. ss. ad gr. ij.
             Extract, aconit. gr. vj.ad gr. xij.  Fiant boli sex.
   Two  of these to be  taken for a dose, and repeated three times a
day.
  1 Orfila, Toxicolog. i. 593.                     2 Magendie, Formulaire.
  3 Wendt, in Rust's Magazin, B. xxv.
  4 Revue  Medicale, iii. 45—70, pour 1848; cited in Brit, and For. Medico-Chirurg.
Rev. April, 1849, p. 539.
  8 YYilczecoski, in Medicin. Zeitung, cited in Lond. Med. Gaz., Mar. 7, 1845.
  8 Boston Medical and Surgical Journal, Nov. 3, 1847. 
122
AURI ET SODII CHLORIDUM.
                   Pilulrc  auri  chloridi.
                   Pills of chloride of gold.
         {Pilulae chlorureti auri, Ph. Amstelodamensis nova.)
                 R.  Auri chlorid. gr. x.
                     Glycyrrhiz. pulv. giij.
                     Syrup, q. s. ut fiant pilulsecl.
  Dose.—One daily, gradually augmenting the quantity.
    R.  Auri chlorid. gr. i.
       Lycopod. pulv. gr. xv.  M. fiat pulv. in part. xvi. dividend.
  One of the powders to be rubbed upon the  tongue and gums
daily.                                            Chrestien.

  Gradually, the same  quantity of the chloride may be divided
into twelve, and afterwards into ten parts, and be used.in the same
way.
                Ungoentum  auri chloridi.
                Ointment of  chloride of gold.
                     R.  Auri  chlorid. gr. iv.
             Misce intime cum
                         Ung.  rosae gj.
                                                    Wendt.
                 Collyrium  auri  chloridi.
               Collyrium of chloride of gold.
                   R.  Auri chlorid. gr. ij.
          Solve in
                       Aquae destill. f ^vj.
                         F. collyrium.
  To be applied by means of  linen compresses, or dropped into
the eye.t                                   Jahn o/  Fischer.
         XXXIII. AURI ET SODII CHLO'RIDUM.

Synonymes. Aurum Muriaticum (Pharmac. Borussic.) seu Aurum Muri-
  aticum Natronatum seu Chloratum Natronatum, seu Sesquichloratum
  Natronatum, Sodii Auro-Terchloridum, Perchloruretum Auri e4 Sodii,
  Chloretum Auri cum Chloreto Natrii, Murias Aurico-natricum,  Chloru-
  retum Auri et Sodii, Chloride of  Gold and  Sodium, Hydrochlorate or
  Muriate of Gold and Sodium, Auro-terchloride of Sodium.
French. Chlorure  d'or  et de Sodium, Hydrochlorate ou Muriate d'Or et
  de Soude.
German.   Salzsaures  Goldnatrium,  Chlorgoldnatronium,
  Goldnatriumchlorid, Natriumgoldchlorid, Sodahaltiges
  Salzsaures Gold, Salzsaures Goldoxynatrium, Chlorgold-
  natrium, Figuier's Goldsalz.

  This preparation is in the Pharmacopoeias of  Prussia, Ferrara,
Sweden, &c.   M. Figuier directs it to be made  in the following
manner.1   Dissolve four parts of gold in nitro-muriatic acid,

  1 Annates de Chimie, Fevrier, 1822, and Riecke, Die Neuern Arzneimittel, S. G3,
Stuttgart, 1837. 
AURI ET SODII CHLORIDUM.               123
  and  evaporate the  solution to dryness; add  thirty-two  parts of
  ™ater> and one part of chloride of sodium, and evaporate to one
  half.  On cooling, crystals will form, which consist of 69.3 parts
  of chloride of gold ;  14.1 parts of chloride of sodium, and 16.6 of
  water.  In the French " Codex,"  it is directed to be made by dis-
  solving 85 parts by  weight of chloride of gold, and 16  parts of
  chloride of sodium, in a small quantity of distilled water.  The
  solution is evaporated by a gentle heat until <a pellicle forms, and
  is then put aside to crystallize.
    The formula of the Prussian Pharmacopoeia  is as  follows:
                 R. Auri partes vj.
    Solve in
                     Acidi muriatici q.  s.
    Acidi nitrici quantum ad auri solutionem requiritur, guttatim addenda
  Tunc admisce.
                    Natri muriatici sice. part. x.
    Et post solutionem leni igne evaporando in pulverem flavum redige."
    This preparation has a beautiful yellow colour, and appears un-
  der the form of four-sided  prisms.   It attracts moisture from the
  air, but to a less degree than the chloride of gold with excess of
  sulphuric acid.
    The Aurum Muriaticum  Natronatum  of the Germans is
  milder than the preceding preparations, and  is more frequently ad-
  ministered, especially in Germany, than  any preparation of gold.
  It is used both internally and externally.  The dose is about the
  same as that of the last preparation, but it may be carried higher.
   Kopp3 affirms, that he has frequently employed it with  advan-
  tage, in small doses, in scrofulous tumefaction of the upper lip.
  He prescribed  daily,  and once  or twice a day, from one twenty-
 fourth to one-thirteenth of a grain of it, reduced to powder, with
  two grains of sugar,  and rubbed by means  of the finger  on the
  inner side of the affected lip.  In cases of scrofulous, thick, sen-
  sible, and slightly  inflamed nose, in the  adult, Riecke3 recom-
  mends the ointment, described below, to be applied to the nasal fossa?;
 and three  times a day a powder composed of from one-sixteenth
 to one-twelfth of a  grain of the salt of gold to two grains of sugar
 of milk, to be rubbed  on the gums with the moistened finger.  The
 salts of gold, according to Riecke, appear to have  a specific ac-
 tion on the organs in  the mouth, gums and nose!!
                 Pulvis  et sodii   chloridi.
           Powder of chloride of gold and sodium.
                R.  Auri et sodii  chlorid, part, iij.
                    Irid. florent. in pulv. subtil, part. ix.
  ' Take of gold six parts:
   Dissolve a sufficient quantity of
    M uriatic acid, adding as much nitric acid as is required to dissolve  the gold  Then
nux ten parts of the dry chloride of sodium; and after evaporating the solution over a
slow fire reduce it to a yellow powder.
  3 Op. cit. B. iii. S. 351.           'Die neuern Arzneimittel, u. s. w. S. 442 
124
AURI ET SODII CHLORIDUM.
   Three grains of  this represent three-quarters  of a grain of the
salt of gold.   These three grains are  divided  into thirty frictions
for the weakest doses, and into  three for the strongest.   Starch
may be substituted for powdered orris root.          Legrand.

              Liquor  auri  et sodii  chloridi.
          Solution of chloride of gold and sodium.
                R.  Auri et sodii chlorid. gr. ij.
                    Aquae destillat. f ^j.  M.
   Ten drops  to be given every two  or three hours, in  cases of
dropsy.                                          Grotzner.

              Pilulae  auri  et  sodii chloridi.
            Pills of  chloride of gold and sodium.
      R.  Auri et sodii  chlorid. in aquae destillat. q.  s. solut. gr. iv.
          Extract, aconiti Qss.
          ------dulcam. 3J.
          Althaea? pulv. q. s. ut fiant pilulae lxxx.
   Three pills to be taken  three times a day.        Grotzner.

      R.  Amyli. solan, tuberos. gr. iv.
          Acaciaa gj.
    In mort. vitr. exacte mistisadde terendo
          Aur. et sod. chlorid.—in 3j. aq. destillat. solut.—gr. x.
          Fiant  pilulae cxx.
   Each of these contains about one-twelfth of a grain.
                                             A. T. Chrestien.

             Pastilli  auri  et  sodii  chloridi.
           Lozenges of chloride of gold and sodium.
              R. Auri et sodii chlorid. gr. v.
                 Sacchar. pulv. §j.
     Misce exacte in mortar, vitreo et adde.
                 Mucilag. acacia? q. s. ut fiant pastilli lx.
   Each of these will  contain about one-twelfth  of a grain of the
salt.                                        A. T. Chrestien.

          Unguentum  auri  et sodii  chloridi.
           Ointment of chloride of gold and sodium.
          R.  Aur. et sod. chlorid. gr. iij.—iv.
              Adipis ^ss.
      Misce exacte.  Fiat unguentum.
   Used in friction.                                  Grotzner.
          R.  Aur. et sod. chlorid. gr. iiss.
              Adipis 5iss.  M.
   The size of a bean to be placed in the nasal  fossae in scrofulous
cases? along with the iatraleiptic  use of the  powder before de-
scribed.                                              Riecke.

                        1 See p. 123. 
AURI CYANURETUM.                    125
               XXXIV. AURI CYANURETUM.
Synonymes. Auri Cyanidum seu Tercyanidum, Aurum Cyanicum seu
  Cyanogenatum seu Cyanatum seu Hydrocyanicum, Cyanuretum auri-
  cum seu Auri, Cyanuret, Cyanide or Tercyanide of gold.
French.  Cyanure d'Or.
German.  Blausaures  Goldoxyd, BlaustofTgold, Cyangold,
  Goldcyanid.
  The mode of preparing this  combination, recommended by M.
0. Figuier,1 of Montpellier, is as follows.   He decomposes  chlo-
ride of gold by cyanuret of potassium, but  states, that many pre-
cautions are necessary to procure it in a pure state.  The chloride
must be as neutral as  possible, which can only be effected by re-
crystallizing the salt several times.  The cyanuret must not be al-
kaline,  or contain any formiate or carbonate of potassa, and it is
to be added  to the solution of  the  chloride of gold very cautiously
as long as  there is any precipitate, taking care that there is not
the slightest excess of the cyanuret, as this wTould cause a solution
of part  of  the product, and the formation of soluble double cyanu-
rets.   The cyanuret, thus made, is  to be wTell washed with pure
water, and dried in a dark place.  \
  The process in the French " Codex" consists essentially in add-
ing very carefully a solution of pure  cyanuret of potassium to a
solution of chloride of gold, until a precipitate—which is cyanuret
of gold—ceases to be formed.   The  chloride of gold, prior to so-
lution, should be deprived of all excess of acid by heating it in a
salt water  bath.  It  is  a yellow  powder, which is insoluble in
water.2
  In some experiments, Magendies found, that cyanuret of gold
is one of the substances that promote the coagulation of the blood.
Where, consequently, it is desirable to  impress a modification on
that fluid in  chronic cutaneous, and  other  affections, its  adminis-
tration  might perhaps be found useful.   M. Pourche,4 who has
used it successfully in syphilis and scrofula, recommends its ad-
ministration—in the form of frictions on  the tongue—mixed with
powdered orris root, well washed in alcohol, and dried.
                   Pulvis  auri  cyanureti.
                  Powder of cyanuret of gold.
                R.  Auri cyanur. gr. j.
                    Irid. florent. pulv. gr. iij.   M.
                                                   Chrestien.
  1 Journal de  Pharmacie, xx. S. 90, and Amer.  Journ. of  Pharm. vi. 82.  Philad.
1833—4.  See, for another mode of preparing it, Deferre,  in Bulletin General de
Th6rapeutique, Fevrier, 1838.
  * Pereira, Elements of Mat. Med. &c, 2d  edit.  i.  686.  Lond. 1842; or 2d  Amer.
edit, by Carson, Philad. 1846.
  ' Lemons sur le Sang, &c, and Translation, in Lancet, January 20, 1839, p. C36.
  ' Journal de Pharmacie, xx. 5'J9 and 649.
        9 
126                     AURI IODIDUM.
  In pills he prescribes it as follows:—
                  Pilulee  auri  cyanureti.
                  Pills of cyanuret of gold.
               R.   Auri cyanur. gr. j.
                   Ext. mezereon. gr. iij.
                   Althaeae pulv. q. s. ut fiat massa.
  Each pill to weigh five grains.
  To children, the dose at first should never exceed one-fifteenth
of a grain.
   Mistura seu Liquor seu  Solutio  auri cyanureti.
           Mixture or solution of cyanuret of gold.
               R.   Auri cyanur. gr. iij.
                   Aquae alcoholisat. f §viij.  M.
  Dose.—A tea-spoonful  twice  a day, gradually increasing  the
dose.                                               Chrestien.
                  XXXV.  AURI  IODIDUM.
Synonymes. Auri Ioduretum, Aurum Iodatum, Iodide or Ioduret of Gold.
French.  Proto-iodure d'Or.
German. Iodgold, Goldiodiir, Goldiodid.
   According to the French Codex, this is made by adding a solu-
tion of pure iodide of potassium to a solution of chloride of gold,
collecting the iodide  of gold, which falls down, on a  filter, and
washing it with alcohol to remove the excess of iodine, which pre-
cipitates with it.  M. Meillet1 recommends the following process
in preference.  To a  solution of gold as neutral as possible is add-
ed by degrees neutral hydriodate of  ammonia  so long as a preci-
pitate falls.  The solution must not  be too far diluted.  A small
quantity of alcohol must now be added, not more than about one-
third of the whole volume of the liquid..  After some hours' rest,
this is decanted, when a precipitate of a blackish colour is obtained,
composed  of iodine and iodide of gold.   It is then washed by de-
cantation  with a little  alcohol;  when  an almost  white and half
crystalline iodide of gold is obtained.   This is dried in the open
air on plates, and  is  kept free from light  in stopper  bottles.   In
this process, the  gold is completely  precipitated,  which  never
occurs  when the iodide of potassium  is employed; and  the iodide
has an  invariable composition.2
  This has been used in the same cases as the  other preparations
of gold, in the dose of one-fifteenth to one-tenth of a grain.

  ' Journal de Pharmacie, Nov. 1841, p. 605.
  2 For another process for forming the iodide of gold, see M. J. Fordos, Journal de
Pharmacie, Nov. 1841, p. 653. 
AURI OXIDUM.                    127
               XXXVI. AURI NITROMU'RIAS.
Synonymes. Aurum Nitrico-Muriaticum, Nitromuriate of Gold.
French. Nitromuriate d'Or.
German. Salpetersalzsaures Gold^

  Nitromuriate of gold has been recommended, of late years, by
Recamier, whose attention was  directed to it by accident.   A
worker in gold had a cancerous tumour on the  back, which, as it
incommoded him, he touched frequently with the hand;  this oc-
curred whilst he was dissolving gold in aqua regia;  after this the
tumour soon presented another appearance, and  went away in a
short time.  Recamier thought it probable that the workman had
received some of the solution  upon his fingers, which had thus been
applied to the tumour.   Under such  impressions, he employed it
in the case of a female, who was affected with an extensive cancer;
the disorganized parts resumed their natural texture, and completely
healed, although  the cancerous dyscrasy  ultimately  proved  fatal.
In the case of a female, \v\[h fungus of the neck  of the vterus, a
complete cure was  effected by it; and  in cancer of  the uterus he
found it advantageous.
  Recamier prepares it by dissolving six grains of  pure chloride of
gold in an ounce of nitromuriatic  acid:  and he applies it like other
corrosive agents, taking care to confine  it to the parts to be acted
upon.  When the object is to cauterize, it must be applied to the
affected parts, until a whitish scab or crust is formed, which falls
off in three or four days; after which the application may be re-
peated as often as may be necessary.   The pain  caused by the ope-
ration is generally insignificant, and in cases where it is violent it
can be allayed  by pledgets  dipped in laudanum.
                 XXXVII.  AURI OXIDUM.
Synonvmes. Auri Teroxidnm seu Peroxidum, Aurum Oxydatum, Oxide
  of Gold,  Peroxide of Gold, Auric Acid.
French.  Oxide d'Or.
German. Goldoxyd, Oxydirtes Gold, Goldsaure.

  Oxide of gold, prepared by calcination, is the crocus solis of the
Wirtemberg Pharmacopoeia.  The oxide is  received also into the
Pharmacopoeias of Ferrara and  Hanover.
  Magendie1 recommends the  following  as one  of the modes of
preparation.  Take  any quantity of chloride of gold, put  it into
a flask of  white glass and  pour upon it six or seven times its weight

                         1 Formulaire, &c. 
128
AURI OXIDUM.
of boiling water, to dissolve the chloride; then add crystallized
baryta gradually, until the liquid is no longer acid, as shown by a
strip of litmus paper.   The liquid is then boiled, permitted to cool,
and filtered.   The precipitate is washed  several times with warm
water: the water of the various washings is brought together and
evaporated nearly to dryness;  the saline mass, when cool, is then
dissolved in water, and in  this way more and  more oxide of gold
is  obtained, which may be added to the other.  The oxide is now
washed with boiling water, until  the water  no longer affords a
precipitate on the addition of nitrate of silver.  It is then washed
once or twice with water  acidulated  with nitric  acid, to remove
the small quantity of carbonate of baryta formed  during the ope-
ration, and which may remain mixed with the oxide.   These wash-
ings are repeated with cold water, until the instillation of sulphuric
acid occasions  no longer  any  white  precipitate, which  indicates
that it is free from baryta.  The oxide is then dried at a heat of
from 167°  to 190° of Fahrenheit, after which it is kept in a cool
and dark place in a well-stopped bottle.
   The  process recommended  by M.  Cottereau is the following:
An excess of magnesia must  be boiled with a dilute solution of
chloride, of gold, till the  solution loses its colour; "the  whole is
then to be filtered, and the precipitate wrell  washed; the result,
which is aurate of magnesia, is to be treated with an excess of
dilute nitric acid, which removes  all the magnesia, and leaves
the oxide in a pure state.   This is to be  again well washed, and
dried between  sheets of bibulous  paper, but without compression
or exposure to light or heat.1
   In the French "Codex" it is directed to be prepared by boiling
four parts of calcined  magnesia with one part of terchloride of
gold and forty parts of water.   It  is then washed, first with water,
to remove  the chloride  of  magnesium, and afterwards with dilute
nit'ic acid, to dissolve the excess of magnesia.3
   In  the  condition  of hydrate, the oxide of gold is of a yellow
colour;  when  dried, of a blackish-violet.   It is  never entirely
soluble in  chlorohydric acid, always  leaving  behind a small por-
tion  which is  reduced to the metallic state  during desiccation.
Neither sulphuric nor nitric acid has any action upon it.
   Oxide of gold has been administered  by many  physicians, and
especially by Westring, Niel,  Chrestien,3  and Legrand,4 in the
same diseases as the other preparations.

  1 Amer. Journ. of Pharm. 2d series, ii. 110.  Philad. 1837.
  » Pereira, Elements of Materia Medica, 2d edit. i. 085.   Lond. 1842; or 2d Amer.
edit, by Carson,  Philad. 1846.                   3 Op. citat.
  ' Op. cit., and De l'Or, de son Emploi dans le traitement de la Syphilis, &c.  Paris, 1828. 
AURUM METALLICUM.
129
              XXXVIII.  AURUM METALLICUM.
    Synonymes.  Metallic Gold.
    French.  Or Metallique.
    German.  Metallisches Gold.
    Metallic gold is either  administered  in  the form  of aurum
  limatum, " gold filings,"—formed by filing the finest gold with a
  fine-toothed file—or in that of pulvis auri, aurum divisum seu
  pulveratum,  (French, Or  divise— Germ. Goldpulver,  Fein
  zertheiltes oder praparirtes Gold,) which is obtained
  by amalgamating gold with quicksilver, and driving off the quick-
  silver by  heat.1  According to Trommsdorff, a  very  fine gold
  powder may likewise be obtained by precipitating the gold from a
 .dilute solution of the metal in nitro-muriatic acid by means of
  green sulphate of iron.  The precipitate,  thus  formed,  when
  washed  and dried, is of a brownish colour, but when  polished,
  exhibits  the most beautiful golden splendour.2
    It may also be prepared by rubbing leaf gold with sulphate of
 potassa,  sifting and  washing  with boiling water  to remove the
 sulphate.3
    MM. Chrestien and Niel have exhibited metallic gold largely,
 and, they affirm, successfully; but, according to Wendt,  it has no
 action on the economy.   It  is not easy, indeed, to  conceive, that
 a substance so difficult of oxidation can have much,  if any, effect.
 The former gentlemen and Gozzi  regard it as  the  mildest of the
 preparations of gold,  but equally efficacious with the others, al-
 though more tardy in  producing its effects.
    It has been administered  in  the dose  of  from  a quarter  of a
 grain to a grain, three or four times a day, in the form of powder
 or pill,—the dose being gradually increased ; and has been rubbed
 daily upon  the tongue, in the quantity of from one to three grains
 mixed with starch powder, or  powder of lycopodium.   Where
 the condition of the tongue and of the interior of the mouth  does
 not admit of this, Niel advises that a blister should  be applied on
 the side  of the neck,  and that the  denuded surface  should be
 dressed with a  mixture of a grain of gold amalgamated with mer-
 cury, and half a dram  of lard; gradually augmenting the  quantity
 of gold to two grains.   In syphilitic ulcers  and excoriations,
 metallic gold is applied externally, amalgamated with the proper
 quantity of mercury,  and united with  unsalted butter,  lard, or
 cerate^ in the proportion of  twelve  grains  to one  ounce.   In
 syphilitic excrescences,  frictions with  gold powder mixed  with
 saliva are said to have been  serviceable.
  * Jourdan, Pharmacopee Universelle, ii. 215. Paris, 1828.
  ' Riecke, Die neuern Arzneimit. S. 58.  Stuttgart, 1837.
  ' Pereira, Elements of Materia Medica and Therapeutics, 2d edit. i. 682, Lond 1842-
or 2d Amer. edit, by Carson, Philad. 1846.                                ' 
130                   BALLOTA LANATA.

  The following formulae are given by Riecke :y
                Pulvis  Auri  Compositus.
                  Compound Gold powder.
               R.  Auri divis. gr. vj.
                   Amyli gr. lxvj.
                     M. f. pulv. in part. xij. Eequales divid.
  A powder to be given four times a clay,
               R.  Auri divis.
                   Lycopod. aa. gr. ij.
                     M. f. pulvis.
  A powder to be rubbed  once  a day upon the tongue.
                      Syrupus  Auri.
                       Syrup of Gold.
               R.  Auri divis. 9j.
                   Syrup, acaciss, gj.  M.
  Employed to pencil ulcers of the pharynx, and as a dressing to
chancres.                            Hopital de Montpellier.
                      Pomatum Auri.
                      Ointment of Gold.
               R.  Auri divis. gj.
                   Adipis §ss.   M.
  To be rubbed on buboes, and  applied to blisters.   Legrand.
               XXXIX.  BALLOTA LANATA.
  Synonymes.  Leonurus Lanatus.
  French.  Ballote Cotonneuse.
  German.  Wolliger Wolfstrapp,  Wollige Ballota.
  This plant belongs to the Natural Family, Labiatae; Sexual
System, Didynamia Gymnospermia.  It grows  exclusively and
commonly in Siberia, in dry mountainous regions.   In its native
country it  has been long  administered  as  a powerful  diuretic,
especially in dropsy.  Both Gmelin  and Pallas refer to it in this
relation in their travels in Siberia.   Of late  years, its use has ex-
tended elsewhere; and it is now frequently employed in Russia,
Germany and Italy.   It is said  to be often adulterated with
leonurus cardiaca, ballota nigra, and marrubium f and it is im-
portant that  the  genuine Siberian plant should  be used, as the
observations  of  Brera have shown the cultivated plant  to be
powerless.   For  medicinal  purposes, the whole  plant has been
employed, with the exception of the  root.  It contains, according
to Orcesi, tannic  acid, a  bitter, resinoid, aromatic matter—picro-
  ' Die neuern Arzneimit. S. 59, Stuttgart, 1837.
  2 Schmidt's Jahrbuch der in-und auslandisch gesammt. Medicin. B. iv. S. 275. 
BALLOTA LANATA.
131
ballotin—a green, waxy substance, chloride of sodium, nitrate of
potassa,  and salts of iron and lime.1
   The  diseases  in which ballota  lanata  has been  administered
abroad—for it has not been  employed in this country—are the
following :2
   Dropsy.—Rehmann prescribed  it several times with decided
advantage; and,  where organic disease prevented the  cure, the
urinary  secretion was always largely augmented  by it.  The
chemical condition of the  urine was likewise  strikingly  changed
during its use: at first, it was  whitish, afterwards darker, and,
ultimately, almost black, or of a deep brown, like the darkest beer.
At times, when the accumulation of fluid was pretty well removed,
a pain would occur in the  hypochondres, which indicated  that its
use should be laid aside.   Schilling, in Werchny-Udinsk, asserts,
that he cured several cases of dropsy by it.  Rupprecht and Muhr-
beck administered it with the best  effects, and  Brera3  found  it
extremely serviceable in  hydropic conditions, especially where
they had been preceded  by, or were complicated with, rheumatic
or gouty affections.   Luzzato prescribed  it with  equal  success;
and Heyfelder, who gave  it  according to  the  prescription of the
Russian  physicians, observed  the urine  to be of a blackish-yellow
hue at the commencement, and, afterwards, of a very dark colour.
He found, however, that, to keep up the diuresis, it was  requisite
to combine it with other diuretics, or to change it for other agents.
   Rheumatism and Gout.—In these diseases, ballota is  adminis-
tered in Siberia.  Brera, as well as his compatriots, Ghidella, Fon-
tebuoni,  Santini and Luzzato, have tested  its efficacy by  repeated
trials.   The pains generally soon disappeared under its use, and a
cure took place, without relapse.
   Adiposis.—In a case of  this kind, it was exhibited in St. Peters-
burg, by Dr. Weisse.  The fatness was inordinate, and the remedy
acted most favourably.  It did not,  however, occasion diuresis, but
under its use a hemorrhoidal flux returned, which had previously
been arrested.

                 MODE  OF ADMINISTRATION.
   Decoction  is^the  best form for  administering the plant;  from
  ss. to gj. to  gviij. of water;—this portion to be  divided into
two halves, and to be  taken in the  course of the day.  Rehmann
boils giss. to ^ij. of the coarsely powdered plant in Oij. of water,
down to  half; to  which he  adds, according to circumstances, some
diffusible excitant, or a few drops of laudanum.   Of this mixture,
he directs a cupful  to be  taken morning  and  evening, gradually
increasing the dose.

 1 Bouchardat, Annuaire de Therapeutique, pour 1850, p. 78.
 5 Riecke,  Op. cit. S. 68.        a Antologia Medica,  No. 2, Febbrajo, 1835. 
132
BARII IODIDUM.
                   XL. BA'RII IODIDUM.
Synonymes.  Barium  Iodatum, Barytium Iodatum, Ioduretum Barytii,
  Iodide of Barium.
German.  Iodbaryum,  Baryumiodiir.
In solution, Barytas Hydriodas, Hydras Barii Iodati, Baryta Hydriddica,
  Hydriodate of Baryta.
German.   Iodwasserstoffsaure Schwererde;  Hydriod-
  saurer Baryt.
  This preparation has been introduced of late years.
                   METHOD OF PREPARING.
  Iodide of barium is obtained by boiling baryta earth in a solu-
tion of iodide of iron in water, (made  by taking one part of pure
iron filings,  and four parts of iodine, pouring upon them from six
to eight parts of water, agitating frequently, and applying warmth
gently, until the fluid appears  clear and  almost colourless,) or,
what  is cheaper, by boiling  a solution of iodide of iron with car-
bonate of baryta, which must be added in  small portions as long
as there is any effervescence.
  The fluid obtained by either  process,  after  filtering, must  be
clear  and neutral, and yield no bluish or blue precipitate with the
ferrocyanuret of potassium: if  it yields a precipitate, the decom-
position of the  salt  of iron is  incomplete.   Should the solution,
formed in the  first manner, have an alkaline reaction, the excess
of baryta must be removed by exposing  the  mixture to the air,
wThereby it becomes  converted  into a carbonate, and falls to the
bottom.   The  solution is then  evaporated until a pellicle forms,
the heat being  gentle; the crystals are  placed quickly between
printing  paper, and kept in a  well-stopped glass vessel.   They
form  white radiated plates, which easily deliquesce in the' air, and
on that account  cannot be prescribed in the  form of powder, but
may be dissolved in some aromatic water.
                 EFFECTS  ON THE ECONOMY.
  Jahn instituted several experiments with  iodide of barium, on
plants, animals and man, in  a state of health and disease.   In con-
siderable doses,  it acts as a poison on the organism,  and as one of
the acrid class.   Administered  in very small  doses, and with  great
circumspection, he found  it to  be serviceable in scrofulous and
similar morbid conditions, and as an alterative in morbid growths,
hypertrophy,  chronic  inflammation, &c,  in which  conditions
it  proved equally useful with chloride  of barium, mercury or
iodine.1   Jahn's observations, it appears, did  not lead him to speak
positively regarding its advantages or defects;  and he adds the
caution—" Caute, per Deos, incede,  latet ignis sub cinere doloso."
1 Riecke, Op. cit. S. 71. 
                          BEBEERIA.                      133

Jahn's observations were published in 1830,  and,  according  to
Riecke, he has been since  silent on the subject.  Rothamel ad-
ministered the iodide in a desperate case of scrofula, occurring in
a patient twenty-one years of age, with great success.  He began
with one-eighth of a grain three times a day,  and increased the
dose gradually during a protracted administration of the article,
until three grains were taken four times daily.
   Biett has  administered  it frequently in  cases of  scrofulous
swellings, and at  times externally, according to the  following
form:—
                  Unguentum  barii iodidi.
                Oiritment of iodide of barium.
                 R.  Barii iodid. gr. iv.
                     Adipis gj.  M. ut fiat unguentum.
                      XLI. BEBEERIA.
Synonymes. Bebeerina; Bebeerinum; Bebeerine; Bebeerin.
French.  Bebeerine.
German. Bebeerin.
   A tree known in Demarara  by the Indian name Bebeeru, and
by the  Dutch name Sipeeri, had been observed by M.  Rodie, a
surgeon in the British navy, to possess a bitter-tasted bark, which,
on examination,  was found by him to contain a vegetable  alkali, to
which he gave the name Bebeerine.  From this alkali he  prepared
a  sulphate, which he  exhibited with success  as an antiperiodic*
Dr. Maclagan having received some of the bark, and likewise some
of the fruit of the plant, subjected them to chemical examination.
The bark  occurs in large, flat pieces, from one to  two feet long,
and varying in breadth from  one to six inches.  It is about four
lines thick, of a  cinnamon-brown colour, without aroma, pungency,
or acrimony, but of a strong, persistent, bitter taste, with consi-
derable  astringency.   The fruit is a nut, with two plano-convex
cotyledons, of the size and figure of a wralnut.   The plant is un-
known.   It was supposed, by Mr. Lindley and Sir William Hooker,
to whom the fruit was sent, to be lauraceous;  but  Dr. Maclagan
could not discover any genus or tribe of  lauraceee to which it could
be referred.  Dr. Ranking refers it  to  Nectandra Rodiei.1  The
timber of the tree is well  known by the  name of greenheart.  It
is much employed by ship-builders.
                   METHOD OF PREPARING.
   Dr. Maclagan treated  the  bark with water  acidulated with
sulphuric acid;  precipitated the alkaloids by ammonia;  dried the
precipitate over  a water-bath, and purified  them by redissolving,
 ' Half-yearly Abstract of the Med. Sciences, i. 221. Amer. edit.  New York, 1845. 
134
BEBEERIA.
by means of sulphuric acid ; treating with animal charcoal, and
reprecipitating by ammonia. In this way the alkaline matter is ob-
tained in the  form of a hydrate, nearly quite white.   If  this be
dissolved in alcohol, it forms a clear orange solution, which, on eva-
poration, leaves a shining, totally uncrystalline matter, a good deal
resembling in appearance a transparent  resin.  This, however, is
not a homogeneous product, for in some parts it seems pale yellow,
in others, orange brown, and if  agitated with anhydrous ether is
separated into two portions, one soluble, the other insoluble  in that
fluid.  Both of these are distinct vegetable alkalies.   To the  former
Dr. Maclagan applied M. Rodie's name—Bebeerine ; the other he
called Sipeerine, from the Dutch name of the tree.
  As obtained by evaporating its solution in ether or alcohol, be-
beeria is in thin layers, in the form of a transparent, yellow, shining
film; but when in  mass, or powder, it is opaque.   The alcoholic
solution  has a strong alkaline reaction on litmus paper.   Its taste
is strongly and permanently bitter, with a slight resinous flavour,
and it evolves feebly a corresponding odour when united with sul-
phuric acid.   Bebeeria is soluble  in five times its weight of abso-
lute  alcohol, and dissolves with great facility in alcohol—pure and
diluted.   Ether takes up a thirteenth  of its  weight.  It is very
sparingly soluble in  water,  requiring 1766 parts of hot,  and 6650
of cold water for  its solution.  It  forms, with the sulphuric, mu-
riatic and acetic acids, yellow, shining, uncrystallizable salts, all of
which are very soluble in wrater, and intensely and  durably bitter,
with  a slight degree of  astringency on the tongue.   Sipeerine is
that portion  of the alkaline precipitate which  is insoluble in ether.
It is of a dark brown, shining appearance, and forms neutral com-
pounds with acids, some of which are crystallizable.  Dr. Macla-
gan had not, however, obtained it in quantities sufficient to  enable
him  to examine its properties minutely.1
  Sulphate of bebeerine, according to  Messrs. Ballard  and Gar-
rod,3  is an article of commerce, usually found in brown, crystalline
scales, soluble in water,  sparingly so in alcohol, and possessing an
intensely bitter taste.  The solutions of the salt are neutral, and
ammonia precipitates the alkaloid.   Dr. Maclagan was  led to in-
stitute experiments,  with a view of ascertaining how far, in point
of cheapness, the salts of the alkalies of bebeeria might  be  substi-
tuted for quinia ;  and he found that, by a modification of the ordi-
nary  processes for sulphate of quinia, he could prepare a sulphate
of bebeeria,  which could be sold at a price below  the average of
sulphate of quinia, during late years.   The process  for obtaining
it for medicinal  use  in Edinburgh  is essentially the same  as that
of the  Edinburgh  Pharmacopoeia for sulphate  of  quinia.  The

  ' Transactions of the Royal  Society of Edinburgh, vol. xv., pt. 3, or  London and
Edinburgh Monthly Journal of Medical Sciences, July, 1843, p. 053.
  2 Elements of Materia Medica and Therapeutics, p. 411.  Lond. 1845. 
BEBEERIA.
135
bark is first freed from tannin and colouring matter, by boiling it
with carbonate of soda: it is then  exhausted by boiling  in water
acidulated  with sulphuric acid, and the alkaline matter is thrown
down from the concentrated acid liquor by means of carbonate of
soda.  The impure  bases, thus separated, are washed, dissolved,
and  neutralized  with weak sulphuric acid,  and the solution is
treated with  animal charcoal, concentrated,  filtered again, and
finally evaporated in thin layers in flat vessels.1
   Owing to the great improvement in the manufacture of the arti-
cle for medical use, it is said to be sold at less than half  the price
of the sulphate of quinia.3
           EFFECTS ON THE  ECONOMY IN DISEASE.
   Dr. Maclagan sent some of  the sulphate to Demarara, where it
was tried with marked success in the treatment of intermit tents.
It appears, indeed, to possess all the antiperiodic properties of the
sulphate of quinia, and has,  accordingly, been found of great ser-
vice  in  intermittent  and remittent  fevers,  neuralgia, &c.
Many such cases are related by Dr. Maclagan as occurring in his
own  practice,3 as well  as in  that of Dr. Watt, of  Georgetown,
Demarara; of Dr. J. Anderson and Mr. D. Falconer, and of Pro-
fessor Simpson, of Edinburgh.   The last gentleman made trial of
it in  periodic neuralgia, occurring  during  utero-gestation, and
 with beneficial  results.4   Dr.  Gairdner, of Edinburgh,  has also
 given the particulars of a case of intermittent headach occurring
in a young, and recently married lady, who,  there was some rea-
 son to suspect, was pregnant,  which was cured by the sulphate of
 bebeeria.  In strumous ophthalmia, it  has been recommended,
 by Dr. Llewellyn Williams,5 as a substitute for sulphate of quinia,
 not only on account of the moderate price of the drug as compared
 with the sulphate, but also,  because, according to the testimony of
 Dr. Maclagan and others, it is better adapted  to some constitutions
 and affections than  it;  not being so liable to excite the circulation,
 or affect the nervous  system.  He gave  it  in  the dose of two
 grains night and morning.
   According to Dr. Christison,  it is in general use in  Edinburgh
 and other places in  Great Britain, and it is said not to produce the
 unpleasant phenomena that  occasionally follow the use of the  sul-
 phate of quinia.
   Dr. Maclagan  states, lhat a secret preparation, sold under the
 name of " Warburg's Fever Drops"  appeared, from chemical
 examination, to be a tincture of bebeeria,—probably of the seeds of
 bebceru ;  but this is not the conclusion to which a corammission of
   1 Christison's Dispensatory, Amer. edit, by R. E. Griffith, p. 969.  Edinb. 1848.
   2 Edinburgh Med. and Surg. Journal, April, 1845.
   ■ Lond. and Edinb.  Monthly Journal, Aug. 1843, p. 685.
   ' Edinb. Med. and Surg. Journal, April, 1845.
   1 Provincial Medical and Surgical Journal, Oct. 18, 1848. 
136
BERBERINA.
pharmaciens arrived, from a recent examination of it.  According
to them, its chief constituents are,—sulphate of quinia, aloes, saf-
fron, camphor, zedoary and angelica.1
                 MODE OF  ADMINISTRATION.
   Sulphate of  bebeeria  may be given in the same manner as sul-
phate of quinia.  The dose as a tonic is from one to three grains;
as an antiperiodic, from  five grains to a scruple.
                     XLII.  BERBERINA.
Synonymes.  Berberinum, Berberine, Berberin,
French. Berberine.
German. Berberin,  Berberisgelb, Sauerdornbitter.
   The inner bark of Berberis vulgaris is of  a yellow colour, and
a bitterish, somewhat astringent  taste.   It is cathartic, and was
formerly used in jaundice;  originally, perhaps, in consequence of
the " signature " of the yellow colour.2   In more modern times,
it has  been again recommended in the same disease on the  faith of
experiments.*
  The bitter principle of the root was discovered a few years ago
by Buchner and Herberger, and its  properties have been  investi-
gated  by Brandes.4   Buchner first recommended, at  a meeting of
the German Association of Naturalists and Physicians, in the year
1834,  that it should be received into the Materia Medica; but
hitherto few  experiments have been made with it.

                   METHOD OF PREPARING.
  An  alcoholic extract of the root of berberis vulgaris  is pre-
pared, to which water is added.  This throws  down a pulveru-
lent brown substance; the fluid is poured off; and the  substance
dried;  it is then treated with alcohol, which takes up the berbe-
rin, leaving a small portion undissolved.   By evaporating the al-
cohol,  the  berberin remains.5
  Thus prepared, berberin resembles an extract: it is of a  brown-
ish-yellow  colour, translucent, and smells like the root; its taste
is a pure bitter, and  it  becomes soft in the air.   Buchner6 suc-
ceeded in obtaining  the  bitter principle pure, and in  a crystalline
form.  Its reaction is neither alkaline nor acid;  it is soluble in al-
cohol and water, but not so readily in the latter as in the  former.
When  crystallized, it requires 600 parts of water for its solution;
whilst  in  alcohol, at a  medium temperature, it is soluble in 100
  ' Fuchs, cited  in Canstatt und Eisenmann's Jahresbericht, u. s. w.  im Jahre, 1849,
Bd. V. S. 138.
  2 Ray, Historia Plant, ii. 605.          3 Lond. Med. Repos., new series, i. 38.
  4 Archiv. der Apothekervereins.ii 29.    5 Riecke, Op. cit. S. 442.
  6 Journal de Pharmacie, xxi. 309,  and Philadelphia Journal of Pharmacy, vii. 328.
Philadelphia, 1835, 
BIGNONIA CATALPA.                  137
parts.   It approximates the alkaloids in its nature, as with certain
acids it forms crystallizable compounds.  It is not  soluble in ether.
The brownish-yellow solution formed by it is turned of a reddish-
brown by alkalies, like  the infusion of rhubarb, and  acids restore
the colour.
                 EFFECTS ON THE ECONOMY.
   According to Buchner, no injurious consequences are to be ap-
prehended  from the administration of berberin as a therapeutical
agent.  Of this he had an opportunity of satisfying himself both
on his own person and  on others.  When labouring under indi-
gestion, he took it with the best effects; not only  was the dys-
pepsia removed, but also a yellow hue of the skin which had pre-
viously existed.  He recommends it, therefore,  as an excellent
stomachic, especially when there is disturbance of the functions
of the liver.   In doses of two, five or ten grains, it only  aids the
appetite;  but in larger doses—fifteen to twenty grains—it acts
upon the bowels without inducing tormina, and therefore not as a
drastic.
   Within the last few  years, Koch  has  published some observa-
tions on the use of berberin.   He treated several  cases with it as
prepared by Buchner himself, when  he found all his results con-
firmed, and  that it merited  a  high  rank amongst bitter agents.
He gives two cases of marked disturbance of the digestive func-
tion, in which berberin afforded essential service; and recommends
it  highly in  convalescence from  typhus, cholera, &c*
              XLIII.  BIGNONIA  CATAL'PA.
Synonymes. Calalpa, Catalpa Cordifolia seu Arborescens seu Arborea, Ca-
  talpa or Catawba Tree.
French. Catalpa.
German. Katalpa, B ignon i e nbau m.
   Bignonia Catalpa belongs to the Natural  Family, Bignonia-
cese;  Sexual System, Didynamia  Angiospermia.  It is  a tree
well known in this country, but is not  applied  to  any medicinal
use.  According to Kampfer and Thunberg, the Japanese physi-
cians consider the pods {siliqiiae) to  be  a powerful remedy in  dif-
ferent asthmatic affections.  This gave occasion to several Nea-
politan physicians—and especially Professor Antonucci—to insti-
tute experiments  in reference  to its virtues, and their  report was
decidedly favourable.  Brera  also extols it in  asthma.   As to
the precise mode in which it acts, we have no exact information.
Dierbach and Richter- place it amongst the Acria; whilst, accord-
ing to the analysis of Grosso,3 it seems  more likely that its active
principle is of a fatty nature, resembling the butter of the cacao.
  1 Bouchardat, Annuaire de Therapeutique. pour 1850, p. 181.'
  * Riecke. Op. cit. S. 72.            3 Gazette Medicale de Paris, 1834, p. 8., 
138                    BOLETUS LARICIS.
It is probable, that it possesses no other virtues than those of a
simple demulcent, and that the properties ascribed to it have  been
mainly, if not wholly, derived from the substances associated  with
it.  Brera, for example, administered it with the following addi-
tions :*
                R.  Catalp. siliquar. ^ss.
                   Aquas q. s. ad. colatur. f ^viij.
      Adde
                Oxymel. scillae f ^ss.
  Or,
                R.  Catalp. siliquar. gss.
                   Senegse rad. ^ij.
                   Aquae q. s. ad colatur. f ?viii.
      Adde
                   Oxymel. scillae f ^j.
  To be taken by little and little.                      Brera.
                 XLIV. BOLETUS LA'RICIS.
 Synonymes. Boletus purgans seu albus, Agaricus albus, Fungus Laricis,
   Polyporus officinalis, Fungus of the Larch, White Agaric.
 French. Agaric blanc.
 German.  L e rschenschwamm.
   This fungus grows on the stem and larger branches of the larch.
 Formerly, it was administered as a cathartic, but in this respect it
 has become obsolete.   Still, it has been retained in  many Phar-
 macopoeias; for example,  in those of Amsterdam, Bavaria, Bruns-
 wick,  Paris, Ferrara,  Geneva, Hamburgh, Hanover, Oldenburg,
 Poland, Prussia, Saxony, Sweden,  Wirtemburg,  and Wurzburg.
 Latterly, it has been administered frequently in the colliquative
 sweats of phthisis.  Barbut, of Nismes, made many trials with
 it,3 which were favourable; and the experience of Andral was si-
 milar.3  More recently, however, he has expressed the opinion,
 that no great advantage has been derived from it.4  By several of
 the  German physicians equally advantageous results have been
 obtained—as by Toel and Trautzsch—so that, according to Riecke,5
 it deserves, perhaps, to be better known  and investigated.  Kopp
 has added his testimony in its favour.6
   Formerly, as a cathartic, half a dram to a dram of the powdered
 boletus was given.   In profuse diaphoresis  it is  administered in
 doses of from  two  to six  grains.  The  dose, repeated for a few
evenings, according toxBarbut, arrests the sweating, which, Riecke
 1 Riceltario Clinico, Pad. 1825.
 2 Burdach. jn Journal der 1'raktisch. Heilkund. von Hufeland, Mars.  1830.
 3 Journal de Pharmacie, vol. xx.
 4 Cours de Pathologie Interne, &c, recuelli et redige par A. Latour, p. 157.  Edit.
Bruxelles, 1837.                                  • Op. cit. S. 73.
 • Denkwurdigk. in der arztlich. Praxis. Frankf. 1836, S. 344, cited by Riecke. 
                  BRAVERA ANTHELMINTICA.                139

thinks, is effected through its revellent excitation of the abdominal
nerves; for which reasons he suggests, that the propriety of the
union of opiates with it,  to  prevent  its  purgative effect, may be
questionable.   Kopp gives it in the dose of three grains, morning,
noon, and  night; and Pisson1  in from four to six, eight, and ten
grains.   If it acts upon the  bowels, which is rarely the case, the
dose must be diminished, or a'small quantity of opium or laudanum
be added.
            Pilulae  boleti laricis  cum  opio.
               Pills ofivhite agaric and opium.
                R.   Bolet. laricis gr. xv.
                    Extract, opii gr. iiss.  M. et
                      divide in pil. vjJ
   One or two  at bed-time in the colliquative siveats of phthisis.
                                                    Bayer.3
           XLV. BRAY'ERA ANTHELMINTICA.
Synonymes.  Hagenia Abyssinica, Banksia Abyssinica, Kosso, Kousso,
  Cousso, Cusso, Habbi.
  This plant is a native of Abyssinia, and belongs to Nat. Ord.
Rosacea?  Sanguisorbese  (Decandolle,)  Sex. Syst.  Icosandria
Digynia.  It was first taken  from Abyssinia to  Europe by Dr.
Brayer, from whom it received its name.  The  flowers  are the
parts  used in medicine, and yield, on examination, an extractive
matter, containing tannic acid,  which is most readily taken up by
hot water; and, consequently,  the decoction is  the best  form of
preparation.
  In  Abyssinia, the flowers of brayera are said  to have been em-
ployed with great success in tapeworm.  It would seem, that the
taenia solium especially is endemic in many parts of that country,
—so  much so, indeed, that few of the natives are exempt  from it.
They are in the habit of taking  the anthelmintic every two months,
children commencing at the age of five or six years, and continuing
it through life.  Being a drastic cathartic, it cannot be thus taken
indiscriminately with  impunity, and prolapsus ani is often  induced
by it.  The dose varies from  six to eight drams, and is taken in
cold water, early in the  morning.  It usually acts on  the bowels
in about a couple of hours, the  worm—or a part of it, being gene-
rally  expelled in the third or fourth evacuation.3
  In  Europe, no experiments had been made with them until Dr.
Plieninger,  having become acquainted  with a missionary  from
  ' Annales de Therap. Oct. 1847.
  9 Bouchardat, Annuaire de Therapeutique, p. 8, Paris, 1842.
  • Transactions of the Med. and Physical Society of Bombay, cited in Dublin Journ.
of Med. Science, March, 1845; and in Ranking's Half-Yearly Abstract, Amer. edit.,
Part I., p. 88.  New York, 1845. 
140
BRAYERA ANTHELMINTICA.
Abyssinia, and heard his description of their wonderful effects, ob-
tained some of them from  him,1 which he submitted to Dr. Kurr,
who detected, on examination, the constituents above mentioned.
With  the  rest of the flowers, Dr. Pheninger  made trial  in  two
cases.   He took a handful  of the blosso?ns, about ^j. or ^iss. and
boiled them in 5xvi. of water  down  to  one half, adding to the
strained liquor as much honey as  counteracted, in some measure,
the objectionable taste.  This decoction was taken by a delicate
woman, about thirty years of age, who had previously used the
extractum fllicis maris in pilular form, according to Peschier's
plan,  without success.  In  the  course of  the day, she passed
numerous fragments of taenia, mixed with mucous discharges, with-
out  experiencing  any striking  inconvenience  from the remedy.
From  this time, she remained free from the parasite.
   A robust man, thirty-eight years of age,  who had taken large
quantities of tartrate of antimony and  potassa, in consequence of
violent inflammation of the lungs,—whilst he lay sick of this dis-
ease, discharged a great many portions of taenia, without  having
previously experienced any inconvenience  from the presence of the
entozoon.   In July, 1834, he took the  same  decoction.   Since
then, he has had no appearance of taenia in his evacuations.
   Although but-few cases had then occurred  in which brayera
had  been administered in European practice, Dr. Plieninger con-
sidered it a valuable addition  to the materia medica, inasmuch as
it  can  be administered to delicate  persons and children, without
violence being done to the whole organism, as is the  case  with
many of the true anthelmintics; but the article had not been im-
ported in sufficient  quantities  into Europe to admit of the neces-
sary trials for  fully testing  its efficacy.  Since  then, a quantity of
the flowers was brought  to  Europe  by M. Rochet d'Hericourt,
and trials were made with  it in Paris, in the service of MM. San-
dras and  Chomel,  which  were  entirely successful.   M. Sandras
followed the  directions given him by M. Rochet d'Hericourt,
and having kept  the patient  fasting  the evening before the in-
tended  afdministration  of the  remedy,  he  gave, on the following
morning, the  whole of an infusion made from 20  grammes—
about  five drachms—of the  flowers coarsely pulverized, to 250
grammes—about  eight ounces of warm water.  At the expira-
tion of about an hour, the  cathartic action of the medicine com-
menced ; the first evacuations generally contained portions of the
parasite; and, in the third or fourth, it  was found expelled entire.9
It has also been used successfully in three cases, by Drs. Budd and
Todd.3
   So far as the author knows, this anthelmintic has not been intro-

  ' Riecke, Op. cit. S. 73.
  2 Bouchardat, Annuaire de Therapeutique pour 1847, p. 256.  Paris, 1847; and
Ibid, pour 18411, p. 254.             * Medical Times, April 20, 1850. 
BR0MINUM.
141
duced into this country, where  taenia is rare.  Should  the plant
be considered worthy of cultivation, it is said that a supply can be
readily obtained at Massowah, on the Red Sea.  Being of a hardy
nature, it might bear to be transplanted into Europe or this coun-
try.  Hitherto, the great drawback to the use of Kousso has been
the difficulty of procuring it, and  its enormous cost.  " At  the
time when it could be purchased in Paris," says Dr. Pereira,1 " its
price was  £1  los. per ounce, or 17s. 6d. per  dose.  M. Rochet
d'Hericourt, the sole holder of the medicine, at the present time,
refuses to sell any quantity less than his entire stock, at  the rate
of one guinea  per ounce.  His nephew tells  me that his uncle pos-
sesses 1400 lbs. of it, which, at one  guinea  per  ounce, will cost
22,400 guineas!  The impossibility  of  effecting a sale  on such
terms will, I doubt not, ultimately compel the holder to reduce his
demands to something approaching to reason."
                    XLVI. BRO'MINUM.
Synonymes.  Bromium,  Bromum,  Brominium,  Bromineum,  Bromina,
  Muride, Murina, Bromine.
French.  Brdme.
German.  Brom,  Bromin,  Murid,  Murin,  StinkstofT.

  This elementary substance was discovered in 1826, by Balard,
of Montpellier.   In its chemical properties it is allied to chlorine
and iodine;—to the former more than to the latter.2   Balard de-
tected  it  whilst  occupied in  some investigations on the water of
salt-ponds, and gave it the name bromine—from /3p"/"oj, " a stench
or smell,"—on account of its disagreeable odour.   It is  met with
chiefly in sea water, and in certain animal and  vegetable sub-
stances that live therein.   It has likewise  been found  in  many
mineral waters, of this and other countries, and especially in salt
springs—as in those of Salina, by Professor  Silliman, and of Ke-
nawha, by Professor Emmet.   It is in the secondary list of the
Pharmacopoeia of the United States, (1842.)

                  METHOD OF PREPARING.
   Balard's  mode of preparing bromine consists in  passing  a cur-
rent of chlorine through bittern, after which ether is added, and
the two  liquids are  strongly agitated.  The chlorine decomposes
the bromide of magnesium—the form in which bromine  exists in
the bittern—and converts the  bromide  into a  chloride of mag-
nesium, setting the bromine free. The ether dissolves the evolved
bromine, the mixture assuming a hyacinth-red colour.  The ethe-
real solution is agitated with caustic potassa, by which bromide
  1 Pharmaceutical Journal, July, 1850;  or,  The American  Journal of Phannacy,
Oct. 1850.           2 Glover, Edin. Med.  and Surg. Journ., July, 1842.
       10 
142
BROMINUM.
 of potassium and bromate of potassa are generated;  the ether be-
 coming colourless and pure, and fit to be used for dissolving fresh
 portions of bromine.  When a sufficient quantity  of the  bromide
 has been obtained, it is  mixed in a retort with peroxide of man-
 ganese,  and acted  on by  dilute  sulphuric  acid, by  which  the
 bromine is given off.  The  sulphuric acid  sets free hydrobromic
 acid, which, at the moment of its disengagement, is deprived of
 its hydrogen by the oxygen of the peroxide of manganese, and
 is thereby converted into  bromine.  The bromine passes over in
 reddish vapours, and is made to condense  under water contained
 in an appropriate receiver.
   M. Bussy1 prefers  the  following form.   The  mother waters
 of kelp,  {Soude de Varecq,) after iodine  has been precipitated
 from them by means of chlorine, contain bromine in the state of
 a metallic bromide, when care is taken  to  add no more chlorine
 than is required to precipitate all the iodine.   To  1250 parts  of
 these mother waters, 32 parts of peroxide of manganese in pow-
 der, and 24 of common sulphuric acid  at 66° are  added.  The
 mixture is then put into a  tubulated glass retort, to which a tubu-
 lated receiver is adapted, and to the latter a tube, which dips into
 a flask.   The  retort and  receiver, as well as the  tube, must be
 ground so as to fit  accurately without lutes or corks, which would
 be destroyed by the chloride.  Every thing  being arranged, the
 retort is heated until the liquid is made to boil, when the bromine
 condenses in the receiver under the form of red, oily  striae, with a
 small quantity  of water.  The  operation must be arrested when
 the red vapours cease to be produced.   By  slightly heating the
 receiver, without dismounting the apparatus, the bromine may be
 made to pass over  into the  flask, in which  it will  condense  on
 cooling.   The  mother waters used in this preparation should not
 be rejected, until it is evident, on the addition of a fresh quantity
 of sulphuric acid and oxide of manganese, that they contain  no
 more bromine.
   Bromine, at  the  ordinary temperature, is a fluid of a blackish-
 red colour, when regarded in quantities,—but of a  hyacinth-red
 when placed in a thin layer between  the eye and  the light.  Its
 smell is strong, peculiar, acrid and disagreeable, resembling that
 of chlorine.  Its taste is acrid.   It colours  the skin  yellow—the
 colour gradually disappearing of itself.  Its specific  gravity  is
 2.966.  It is readily set free; and, when volatilized, assumes the
 form of dark-red vapours.   It boils at 117°;  is sparingly soluble
in water, and the solution is of a yellow colour.  It is more solu-
ble in alcohol, and still more so in ether.  In its chemical relations
with other bodies, bromine,  as before  observed, resembles chlorine
and iodine;  but chlorine  appears to have more power,  and iodine
less than bromine,—as bromine is separated from all its combina-
              1 Journal de  PhaTmacie, Janvier, J 837. 
BROMINUM.                      143
tions by chlorine, whilst it decomposes the compounds of iodine,
and assumes the  place of the latter.  It forms  acids both  with
oxygen and hydrogen.   Its  test is  the  production of an orange
colour with starch.
           EFFECTS ON THE ECONOMY IN HEALTH.
  Experiments  have been instituted  to discover the influence of
bromine on the animal economy,- and especially by Barthez.1  In
this  respect also  it resembles iodine, and, like it, belongs to the
class of irritant poisons.   Twelve grains,  dissolved in water, and
injected into the jugular vein of a dog, destroyed it almost instan-
taneously.  Cough ensued;  the  respiration  and circulation  were
accelerated; the pupils  dilated; the  male organ was erect; and
these signs were followed  by involuntary discharge of the excre-
ment, and, at times, stiffness of the upper and lower extremities.
On dissection, Barthez found the cavities of  the heart full of coa-
gulated blood, and the  lungs gorged with the same  fluid; in the
venae cav;e there were dark  coagula;  and  in the stomach and in-
testines, small, bloody, blackish cylinders, similar to sticks of  lunar
caustic.   The same quantity, introduced into the stomach, caused
death in three or four days, when the  oesophagus was tied; when,
however, the animal was able to vomit, fifty to  sixty drops  were
requisite.  The  poison  acts less intensely when it is given in con-
junction with aliment;  it produces  coughing, excitement, nausea
and vomiting.   Constant sucking of the tongue was noticed, with
frequently extraordinary restlessness and anxiety,  and  debility
gradually  augmenting  until  death.    On opening  the body, the
stomach has been  found contracted;  the mucous membrane  wrin-
kled, at times softened,  and frequently the  seat of roundish ulcera-
tions, of an ashy-green  colour.   Near the  pylorus, Barthez found
black spots, which could  be  readily scraped off  with the back of
the scalpel, and left gangrenous ulcers exposed.  Barthez recom-
mends  magnesia as an antidote  to bromine, but he  rests his re-
commendation  on  a single  observation only.   Butzke  obtained
similar results from his experiments.   In one case, only, in which
a dog died a few hours after a dose of three drams,  he found the
intestines  unchanged, and death could only  be ascribed to the
paralyzing influence of the poison on the nervous system.3
   Two series of effects, according to Dr. Glover, are produced by
its introduction, in large doses, into the stomach: one, arising from
the volatilized bromine  getting  into  the fauces and  air-passages;
and,  the  other,  from  its corrosive and  irritant  action on the
stomach  and intestines.   Another  series, he conceives, may be
due to  its entrance into  the circulation.  It  appears to be more
irritant when diluted than when pure.
  1 De l'Action du Brome, Ac, (These) Paris, 1828.  See, also, Fournet, in Bulletin
Gen6ral de Therapeutique, Fevrier, 1838.
  2 Christison on Poisons, 3d edit. p. 186. 
 144                       BROMINUM.

   The vapours of bromine do not seem to exert any organic in-
 fluence on the workmen who prepare it.1

            EFFECTS ON THE ECONOMY IN  DISEASE.
   Pourche first used both pure bromine and bromide of potassium
 for  therapeutical  purposes.    He  found  it very  efficacious  in
 scrofula, especially in  dispersing strumous swellings, both when
 given internally and applied externally.2   In  a case of very large
 goitre, it was highly serviceable.   According to  Pourche's obser-
 vation, it excited heat in the face, headach, dryness of the throat,
 &c, which, however,soon disappeared.  Pourche  gave it internally,
 diluted with forty parts of distilled water,  beginning with five or
 six drops of this mixture, and gradually raising  the dose.  It has
 also been added in a dilute state to lotions  and cataplasms.   The
 remedy is not, however, much used.
   Magendie frequently administered bromine, but more commonly
 some of its preparations.  He prescribed it in cases in which iodine
 did not appear to exert the proper efficacy, or where the patient
 had become accustomed to its use.   The  chief  diseases in which
 he gave it were scrofula, amenorrhea, and  hypertrophy of the
 ventricles of the  heart.   It  has also been  administered by M.
 Fournet,3 in chronic arthritis, both internally and externally; but
 his facts, as he himself remarks, were too few to  enable him to de-
 duce any general  conclusions as to the therapeutical value of the
 remedy in those affections.  He always gave  it in a pure state,  in
 the form of mixture, with a solution of gum : and,  externally it was
 applied in the form of "alcoholic mixture" to the affected joints.
 The dose was at first two drops in four ounces of the vehicle; and
 it was gradually  increased by two drops at  a  time, until  as  much
 as sixty drops were given in the twenty-four  hours.
   The alcoholic mixture, used by M. Fournet  as an external
 application, consisted, at the commencement,  of  ten drops of bro-
 mine  to  an ounce of alcohol: this was  augmented daily by five
 drops until it reached one hundred and twenty drops.
   Dr. Glover4 considers  a solution of bromine  in  water an ele-
 gant and useful application in scrofulous, syphilitic, and specific
 ulcers, as well as in eczematous eruptions.   He gives a case  of ob-
 stinate tuberculous eruption, where an ointment of bromine and
 bromide of potassium,—eight minims of bromine,  and half a dram of
 the bromide to an  ounce of lard effected a  cure; and  also, a case
 of sarcomatous  tumour of the  knee  removed  by a  similar but
 stronger ointment.  He thinks that, physiologically, bromine and
 the bromides are  nearer  the group of chlorine  and the chlorides,
' than that of iodine and the iodides.  He maintains, that  the che-

   1 A.  Chevallier, Annales d'Hygiene Puhl. &c, Avril,  1842.
   a Bulletin General de Therapeutique, iNo. 14.  30 Juillet, 1837.
   » Ibid. Fevrier, 1838.             * Edinb. Med. and Surg. Journal, Oct. 1842 
BRUCIA.
145
mical and  physiological relations  are alike, and that the same is
true of  the medicinal properties.1
  The preparations of bromine are described in other parts of this
volume.
                       XLVII.  BRUCIA.
Synonymes. Brucina, Brucinum, Brucium, Caniramium, Caniraminum,
  Pseudangusturiaum, Vomicina, Brucine.
French. Brucine.
German.  Brucin, Kanimarin.
  This alkaloid was discovered by Pelletier and Caventou,in 1819,
in the bark of the false angustura—Brucea antidysenterica.   It is
found also in small quantities in nux vomica, and in St. Ignatius's
bean.
                   METHOD OF PREPARING.
  An alcoholic extract of false angustura bark is prepared, which
is dissolved in a large quantity of  cold water, and  filtered, in  order
fo separate the fatty matter.   The colouring matter is precipitated
by acetate of  lead ;  the excess of this is thrown down by sulpho-
hydric acid gas, and  the  brucia  by an alkaline  base, for which
purpose magnesia may be employed.  The  precipitate from the
magnesia is then washed, dried, and treated with alcohol, which lays
hold of the brucia : this is obtained by  evaporation.   As brucia is
somewhat soluble, the precipitate ought  not to be washed too much.
Brucia, thus obtained, is coloured, but it may be procured colour-
less  by forming an oxalate of brucia, and treating it  with a mix-
ture of equal  parts of alcohol and ether.  The  oxalate is thus de-
prived of its  colouring matter; after which  it is decomposed by
magnesia: brucia  is thus obtained wholly pure and devoid of co-
lour.
   Pure brucia is  of a white colour, and in regular crystals of the
form of oblique  prisms,  having  a  base representing a  paralle-
logram; it has a  pearly lustre, very bitter  taste,  and is  soluble in
500 parts of  boiling water, and in 850 parts  of cold.  In alcohol
it dissolves readily, from which solution it is obtained  in  the crys-
talline form.   When exposed to the influence of heat, it melts at
a temperature very little above that of boiling water.  At a higher
temperature,  it is  decomposed, and affords the same products  as ve-
getable  substances  that  do  not  contain  nitrogen.   With  acids,
brucia forms neutral salts, which differ from the salts of strychnia.
The sulphate of brucia crystallizes  in very fine  needles, and re-
sembles  the   sulphate of morphia, but  it has a much more bitter
taste.   Nitrate of brucia  does not crystallize, which constitutes
an  essential  difference between  brucia and strychnia.  With an
  1 Edin. Med. and Surg. Journal, Oct. 1842, and Lond. and Edinb. Monthly Journal of
Med. Science, Nov. 1842, p. 1011. 
146
BRUCIA.
excess of nitric  acid, the  salt  has a  beautiful  pearly {nacre)
aspect.
                 EFFECTS ON THE ECONOMY.
   Brucia acts  energetically on the animal economy in the same
manner as false angustura, but  much more strongly.  It is similar,
in its operation, to strychnia, but is considered to be weaker in the
proportion of one to ten, according to Pelletier ; one to twelve, ac-
cording to Magendie;1 and one to twenty-four, according to An-
dral.3   It requires four grains to kill a rabbit, whilst half a grain
of strychnia is sufficient.  A tolerably strong dog,  to which three
grains of brucia had been given, was affected with symptoms re-
sembling tetanus, but did not die.
   Pelletier is of opinion that brucia, or rather the alcoholic extract
of false  angustura, might  be substituted in practice  for  the extract
of nux vomica ; its operation is nearly the same, whilst there is no
danger  of its  acting  too  violently.   Andral  has  frequently  pre-
scribed  it, and his  deductions  are, that  it is far more under our
control  than strychnia.  Like strychnia, it has been given in cases
of paralysis with varying success.   It would  appear to have acted
most beneficially in that resulting  from  lead  poisoning.   M. Bri-
cheteau, from his observations on man, and  M. Bouchardat,3 from
his on animals, infer that  brucia is more active than is usually ad-
mitted.   In paralysis succeeding apoplexy, the former employs
it with  much advantage, and accords with M. Andral  in its being
more manageable than strychnia.  He is of opinion, that no be-
nefit is  to be expected from it in paralysis until  six  months  have
elapsed  from  the attack  of apoplexy.   Earlier  than this  it may
induce serious effects,  owing to its  toxical influence on the cerebro-
spinal system.   He commences with  about  the sixth of a grain,
(im centigramme,) and increases the dose each day by the same
quantity, so long as no effect  is induced.   Should  convulsions su-
pervene, it must be discontinued, until the effects are decidedly di-
minished, when it must be again augmented  by a sixth of  a grain
in the day.   M. Bricheteau has found some patients  bear as much
as three grains in the day.  Magendie administered it with success
in two  cases of atrophy, one of the leg,  and  the  other of the
arm.
                 MODE OF ADMINISTRATION.
   Brucia, according to Magendie,  may be given either in pills or
tincture, gradually augmenting the  dose.   Andral  raised it from
half a grain  to five grains.   Magendie recommends, that the  alka-
loid should always be that obtained from false angustura,—the bru-
cia of nux vomica being mixed with a portion of strychnia, which

   1 Formulaire, &c, des Nouveaux Medicamens, &c.
   0 Journal de Physiologie de Magendie. iii. 207, Juillet, 1823.
  1 Annuaire de Therapeutique,  &c, pour 1847, p. 42.  Paris, 1847. 
CAINCJE RADIX.
147
adds to its activity, and renders it difficult to determine the dose.
The following formulae are recommended by him:—
                       Pilule  brucia:.
                       Pills of brucia.
          R.  Bruciae pur. gr. xij.
              Confect. rosa3 3ss.  M. exactiss. et fiant pilulse xxiv.
   One pill to be begun with twice a day.           Magendie.
                      Tinctura bruciae.
                      Tincture  of brucia.
                   (French, Alcool de Brucine.)
        R.  Alcohol (36° Areon., s. g. 847,) f gj.
          Bruciae gr. xviij.  M.
   Of this tincture, from six to twenty-four drops may be given, in
the form of mixture,  in any vehicle.                Magendie.
                      Mistura bruciae.
                      Mixture of brucia.
                        {Potio Stimulans.)
        R.  Bruciae gr. vj.
            Aquae destillat. f ^iv.
            Sacchar. ^ij.   M.
   Dose.—A table-spoonful night and morning.      Magendie.
                 XLVIII. CAIN'C^ RADIX.
Synonymes. Rad. Chiococcse, R. Cainanae, R. Caninanas, R. Cahincee, R.
  Kahincae, R. Serpentariae Braziliensis; Cainca Root.
Portuguese. Raiz Crusadinha, R. Preta.
German. Caincawurzel.
   The  plant which  furnishes the root introduced into Europe of
late years, and which has since become known as a remedial agent,
is  Chiococca  anguifuga, of the  Family  Rubiaceae;  Sexual
System, Pentandria Monogynia.1   The shrub grows wild in the
forest of Brazil, especially in the province of Minas Geraes, and
the root is used there against the bites of serpents.   This is of the
thickness  of the finger, round, and knotty ; the surface smooth or
irregularly wrinkled;  the wood tough, and of a whitish colour ;
the smell  disagreeable, especially that of the fresh root; and the
taste at first like that of coffee, but afterwards nauseous and pun-
gent.   The bark of the root alone possesses efficacy, the woody
portion having no action.  The bark separates readily from the
wood ;  it  is thicker on the root  itself than on  the branches;  and,
on the outside, is of an amber, or brownish yellow green  colour;
yellower and brighter on the youngest parts; the epidermis is not
easily separated.   According  to  the  chemical investigations of
  1 Art. Chiococca, in Encyclopad. Worterb. vii. 531.  Berl. 1831 ; and Von Martius,
Spec. Mat Med. Brasil, i. 18, 
148
CAINCiE RADIX.
Pelletier and Caventou,1 the following are found to be the consti-
tuents of the bark:—1. A bitter principle, crystallizable in small,
white, silky, shining needles;  inodorous, and very soluble in hot
alcohol, which communicates to the whole  plant  a  degree of as-
tringent  bitterness,  and at the same  time has an acid reaction on
litmus paper.  In  order to separate  this acid, which has  been
termed by those chemists—acidum cahincicum seu  cainanicum
seu cainanium seu cainanum, German, Caincasaure, Cain-
ca bitter—in a pure state, the alcoholic extract of the root must
be dissolved in water, filtered, and precipitated by lime, until the
fluid loses all its bitterness;  the precipitate is then decomposed  by
oxalic acid, and boiling alcohol or acetic or muriatic acid may be
dropped  into an aqueous decoction of the  bark of the root, and,
in the course of a few days, the acidum cahincicum will separate in
the form of small crystals.  With cahincic  acid, prepared in this
way,  however, some colouring matter is still united.   2. A fatty,
green, nauseous-smelling substance,  which  communicates to the
plant  its odour. 3.  Yellow colouring  matter;  and 4.  A viscid co-
louring  matter.3
                 EFFECTS ON THE  ECONOMY.
   The effect of cainca  root  seems to  be especially exerted on the
digestive and urinary organs.   It occasions watery evacuations,
and diuresis.   From the experiments, however, of Albers,3 made
on a great  number of dropsical patients in the Charite, at  Berlin,
he was  induced  to deny its  diuretic  powers, and  to place it
amongst the drastic purgatives, by the  side of helleborus  niger.
Wolff was of the same opinion.  According to Von Langsdorff,4
it  is a highly efficacious emmenagogue, possessing, also—to use
his own language—considerable  resolvent virtues, and  hence em-
ployed in dropsies that are connected with obstructions in the
abdomen.   Riecke5 asserts that he had  occasion  to employ it in
two cases of ascites complicated with induration of the liver.  He
had no expectation of effecting a radical cure, but it afforded  no
palliation;  diuresis was not excited, whilst nausea, colic, and diar-
rhoea  supervened,  so that he discontinued it: he gave it in decoc-
tion.  Others have observed the same inconvenience from  its use,
or have  found  it wholly ineffectual;   for example, B. Heyfelder,
Reinhardt, Bartels,6 and others.   Riecke suggests the possibility,
in these cases, of adulteration  of the  drug.   On  the other hand,
cainca has been highly extolled  by Frangois,  Ribes, Wagner,
Solieer, Lowenstein,7 &c, but  particularly by Von Langsdorff.
   The main diseases in which cainca is recommended, are, 1. Drop-
  1 Journal General de Medecine, Mai, 1830, and Phila. Journ of Pharmacy, iii. 165.
Philad. 1831.                  2  Journal de Pharmacie, xvi. 405.
  5 Medicin. Zeitung. No. iv. Sept. 1832.
  * Hecker's Litter. A nnal. B. iv. S. 305, and Rust's Repertorium, B. xiv. S. 458.
  5 Die neuern Arzneimittel, u. s. w. S. 84.  Stuttgart, 1837.
  s Griife und Walther's Journal der Chirurgie, u. s. w. xxiv. S. 470.  Berlin, 1836.
  ' De Radice Caincae ejusque in morbis hydropicis virtute.  Berol. 1828. 
CAINCA RADIX.
149
sies, in which many favourable  trials  have been  made by Von
Langsdorff, Spitta,1 Guddoy, Engler, Francois, Wagner, Solieer,
Beral, Robredo,2 &c.  2. Intestinal  worms, against  which it
appears to act like other drastics.   3. Obstructed menstruation:
on this subject, however, farther trials are needed.  When  it ope-
rates as an emmenagogue, it is probably altogether like cathartics
that act more especially on the lower part of the  bowels, that is,
by  contiguous sympathy.  4. M. Francois  has recommended it
highly in catarrhus vesicae,  but  the experience of others has not
confirmed this.3   It may be mentioned, that, in its  native country,
it is used for rheumatic pains;  in a peculiar kind of pica  expe-
rienced  by  the  negroes of South America; and,  as  already re-
marked, against the bites of serpents.
                 MODE OF ADMINISTRATION.
  Cainca  is given  in  various  forms—powder,  infusion, and
decoction; and, besides these, a  tincture and an extract have
been made  of it.  A syrup  and a wine have also been recom-
mended.   To form the latter, one ounce of the powdered root is
infused in a pint of wine: the tincture is made with one part of the
root and eight parts of alcohol at 20°.  The alcoholic extract
is considered to be the most uniform in strength, and  has, there-
fore,  been  preferred  by  many.  The  syrup  is formed by dis-
solving 3iiss. of the extract in a little alcohol, mixing this with a
pint of hot simple syrup, and allowing it to boil for some time, in
order that the alcohol may evaporate.   The dose of the powder is
from 9j. to  3ss. in the twenty-four hours.  It appears, however,
to be the most objectionable form, and to give rise  to unfavourable
symptoms more frequently than the others.   Opinions  vary as  to
whether the infusion or the decoction should be preferred.  Ac-
cording to  Caventou and Pelletier, boiling extracts very well the
efficacious parts of the root, and there are cases in which the decoc-
tion has rendered essential service after the infusion had  been admi-
nistered without success.  Of the decoction, from f 3j. to f 3iij. are
given in the day.   Of the extract, the dose, in the twenty-four
hours, is from twenty to thirty grains; of the tincture, f <5j. to f 3ij.4
  The decoction used by Spitta and others was made as follows:
                 Decoctum  radicis   caincae.
                  Decoction of cainca root.
              R.  Caincae rad.gij.
        Coque cum aqua? Oiss. ad dimidiam partem, et cola.
  Dose.—A table-spoonful three times a day.
                             Von Langsdorff'0  c/ Franpois.
  1 Hecker's Litterar. Annal. iv. 396.
 2 Journal dela Academia de Medicina de Megico,  Oct. 1836; cited in Brit, and For.
Med. Review, p. 502, Apl. 1838.
 * Bulletin General de Therapeutique. No. 13, Juillet, 1837.
 ' Journal de Chimie Medicale, Mai,  239-242. Paris, 1827.
 ' Hufeland und Osann's Journ. B. lxii. St. 2. 
150
CALENDULA OFFICINALIS.
  By others, the following form has been employed:
              R.  Cainc. rad. |jj.
                  Aquas Oij.
        Coque ad dimidiam partem et cola.
  Dose.—Two table-spoonfuls three or four times a day.
                                                    Engler.
  Dr. John H.  Griscom,1 of New York, considers there is a re-
markable analogy between cainca  and apocynum cannabinum.
  The Acidum cahincicum, described  above, is said  to possess
tonic, cathartic  and  diuretic powers, and  has been used success-
fully in some cases by Francois, in the dose of six grains gradually
increased to fifteen.
            XLIX. CALENDULA OFFICINA'LIS.
Synonymes.  Calendula Sativa, Caltha Sativa, Verrucaria, Chrysanthe-
  mum, Sponsa Solis, Single Marigold, Garden Marigold.
French.  Souci, S. Ordinaire.
German.   Ringelblume,  Gemeine  Ringelblume,  Tod-
  ten b 1 n m e.
  This plant belongs to Family Synanthereae;  Sexual System,
Syngenesia  Necessaria.  It is much cultivated  in the gardens of
southern Europe more especially, and grows  wild there.  The
whole plant has a feeble aromatic smell, which is not, however,
unpleasant.   The taste is  bitter and somewhat pungent.  It was
examined chemically by Geiger and Stoltze,2 who found in it a pe-
culiar  glutinous matter, readily soluble in  alcohol, insoluble in
ether, and in ethereal  or volatile oils, and but little in water: to
this they gave the name calendulin.

                 EFFECTS ON THE ECONOMY.
  The term officinalis indicates, that the calendula was formerly
received into the  lists of  the Materia Medica as an "officinal;"
but it had  become entirely  obsolete, when Westring,3 a Swedish
physician, in 1817, recalled  attention  to it.  He  recommended it
particularly in cases of cancer of the  breast and uterus, having
noticed its  good  effects  by  accident.   Visiting an aged  female,
who had suffered for  a long time under an extremely painful indu-
ration of one mamma, he found she was able to allay the burning
pain by the application of  the fresh plant.   This induced  him to
try  it in several cases of cancer, and from the results he was led to
infer, that it is perhaps the best agent that can  be employed in
that frightful malady.   He never, however, employed it alone, but
associated with it other active remedies, so that  but little attention

 .' Amer. Journal of the Medical Sciences, for May, 1838, p. 55.
  * Berlin. Jahrb. d. Pharmac. B. xxi. S. 282.
  3 Erfahrung iiber die Heilung der Krebsgeschwiire, u. s. w.  Translated from the
Swedish into German, by K. Sprengel. Hal. 1817. 
CALENDULA OFFICINALIS.
1/51
was paid to his  recommendation;—a great portion of the efficacy
of the agents employed, being—it was thought probable —ascriba-
ble to the associated articles.
   Some  time  after Westring's  publication, the remedy was  used
by  others,  and his observations were confirmed.  Rudolph1 em-
ployed it with  advantage  internally, in  a  case  of induration of
the mamma  in a young  female; but the acetate of iron was at
the same time applied externally in solution    Fehr2  found it
highly useful  not only in incipient, but  in  advanced scirrhus:
Stein praises  it in cancer of the integuments, (Hautkrebs.)
He forms the expressed juice of the young plant  and flowers into
an ointment with  fresh butter, and applies it once or twice a day
by means of lint,  having previously washed the ulcers with a de-
coction of the plant.   Internally, the calendula is prescribed in the
form of decoction, made with milk or water, or of a mellago pre-
pared  from the fresh juice, dissolved in  an  aromatic water;  or
made into pills.   When the salve is applied, a sense of burning
arises, which  speedily becomes  absolute pain.  This soon,  how-
ever, abates, and almost wholly disappears; and if it be  too vio-
lent, more  butter may be added; the ichorous discharge becomes
improved;  the offensive odour  corrected, and in from fourteen to
twenty-one days,  the ulcer is converted  into one  of  a benign and
readily cicatrizable character.
   Rust,  also, frequently administered the  extractum calendulas
in cancerous ulcers, and as a discutient in chronic indurations,
in combination, however, with   other efficacious agents.   Schnei-
der affirms, that he prescribed  the extract with the best effects in
induration of the stomach, and in tumefaction and  decided
induration of the glands and uterus.   He  employed a decoc-
tion of the flowers and plant in cancer  of the  uterus, and  found
it an excellent soothing and discutient  agent.   Muhrbeck3 used
 the extract with  eminent  success in  chronic vomiting; Carter'
 in extremely obstinate vomiting; and  De Camp in a case of car-
 dialgia, where the excitability of the stomach was  so great, that
 every remedial agent was  rejected before it had  opportunity to act.
 Fehr also  extols  it in amenorrhoza, in which disease it was ce-
 lebrated with the older physicians;  but, as Riecke5 has remarked,
 the amount of experience with  calendula  is yet small—too small
 for us to pronounce whether it merit a fixed place in the lists  of the
 materia  medica.

   ' Hufeland und Osann's Jour, der prakt. Heilk. B.  lviii. St. 1, S. 119.
   2 Verhandlungen der verein. arztlich. Gesellschaft. der Schweiz.  Jahrg. 1831, and
 Dierbach,  in Heidelberger Annalen, B. x. H. 4, S. 501.  Heidelberg, 1834.
   * Hufeland's Journal der prakt Heilk. B. lxii. St. 5, S. 128.  Rust's Magazin. der
gesammt. Heilk. B. xi. S. 350.
   4 London Med. Rep. April, 1826, p. 347. See, also, Link und Osann, in art. Calen-
dula, in Encyc. Worterb. u. s. w. B. vi. S. 520. Berl.  1831.    ' Op. cit. S. 101. 
152
CALENDULA OFFICINALIS.
                 MODE OF ADMINISTRATION.
   The extractum calendulas is contained in the Hanoverian and
 Saxon Pharmacopoeias; in  the latter it is directed to be prepared
 in the following manner: —
                R.  Calendul. officinal, part. j.
                    Aquae part. viij.
   Macerate for twenty-four hours; then boil for a quarter of an
 hour, and  strain forcibly;  boil  the remainder with four parts of
 water; mix the two liquors, and, after twenty-four hours' rest,
 evaporate  to the proper consistence.1
   The dose of the extract is different according to different obser-
 vers.  Muhrbeck gave four grains five times a day.  Fehr allows
 3ij to  3vj.  Phobus directs the dose of the extract, prepared ac-
 cording to the  Prussian Pharmacopoeia, to be from eight to sixteen
 grains, gradually increasing it to 3ss and  more, from two to four
 times a day.  It may be given either in the form of pill or mixture.
 Externally, the extract is used in solution, to moisten the dressings
 of ulcers, and to form ointments.   The dose of the decoction of the
 fresh plant is f ^j. to f %\y
   The Sardinian Pharmacopoeia has a Conserva florum calen-
 dulas,  made by beating together one part of the flowers and two
 parts of powdered sugar.  It has, also, an Acelum florum calen-
 dulae,  made of one part of the petals digested in four parts of vi-
 negar;  and the Wirtemberg Pharmacopoeia has an Unguentum
florum calendulae,  made of four ounces  of the petals boiled in a
 pound  of fresh butter,  until the mixture  is entirely evaporated.
 This is used as an emollient and resolvent.
                     Pilulae calendulae.
                      Pills of calendula.
                 R. Ferri  subcarb.
                     Calend. pulv.
                     Extract, calend. aa. gj.
                     Mucilag. acac. q. s. ut fiant pilulae xc.
   Dose.—Five to eight, three times a day, as a soothing agent in
 cancerous ulcers.                                     Rust.
             R.  Hydrarg. chlorid. mit. 9ss.
                 Antim. sulphur, aur. ^j.
           *   •   Extr. calendul.
                 ----conii, aa. ^ij.  M. f pil. pond. gr. ij. sing.
  Dose.—Five pills, three times a day, as a discutient in chronic
 indurations.                                          Rust.
                Lotio   extracti calendulae.
            Lotion of the extract of calendula.
               R.   Extract, calend.
                   ------anthemid. aa gij.

            1 Pharmacopee Universelle, &c, par Jourdan, ii. 536. 
                       CALX CHL0R1NATA.                   i-OO

            Solve in
                   Aq. lauroceras. f ^ij.
            Adde
                   Tinct. opii f jj.
  As a dressing wash (Verbandwasser) in  cancerous ulcera-
tions.                                                Rust.
  It is obvious that the precise agency of the calendula cannot be
tested in any of these formulae, the substances associated with it
being themselves active agents.  In this country, it is never per-
haps  used.
                  L. CALX CHLORINATA.
Synonymes. Calcis Chloridum seu Hypochloris, Oxychloruretum Calcii,
  Protochloruretum Calcii, Chloruretum Oxydi  Calcii, Bichloruretum
  Calcii, Oxymurias Calcis, Calx Oxymuriatica,  Calcaria Chlorata  seu
  Chlorica seu Chlorinica, Chlorum Calcariae, Chloretum Calcariae, Chlo-
  rinated Lime, Chloride, Chloruret, Hypochlorite, Chlorite or Oxymu-
  riate of Lime, Tennant's Bleaching Powder.
French. Protoxichlorure  de Calcium,  Oxichlorure  de Chaux, Chlorure
  d'Oxide de Calcium, Bichlorure de Chaux, Oximuriate de Chaux, Mu-
  riate Suroxigene ou Oxigene de Chaux, Chlorate ou Souschlorate de
  Chaux, Poudre de Blanchement. Poudre de Tennant.
German. Kalkchlori d, Chlo rkalk, ChlorigsaurerKalk,Chlor-
  calciumoxyd, Oxydirt  Salzsaurer Kalk, Bleichpulver.
   Chlorinated lime is a compound of chlorine and oxide of cal-
cium.
                   METHOD OF PREPARING.
   It  may be  prepared either  in the dry or moist way.   In  the
former case, chlorine is made to act on hydrate of lime in a pul-
verulent form; in the  latter, chlorine, in a gaseous state, is passed
into lime water.  For technical purposes, the  latter is most used ;
for pharmaceutical, the former.  In the  London Pharmacopoeia, it
is directed to be  prepared as follows:—Take of hydrate of lime
a pound; chlorine, as much as may suffice; send  in the chlorine
to the lime in a proper vessel, till it is saturated.  Chlorine is very
easily evolved from binoxide of manganese, mixed with chlorohy-
dric acid, by a gentle heat.1   It is  generally, however, prepared
in large chemical establishments for the  use  of Heaoliers, and is
therefore in the list of the  Materia  Medica in the Pharmacopoeia
of the United States, (1842.)
   Chlorinated lime has the appearance of a white, loose powder,
of a sour, bitterish and somewhat  biting taste, exhaling a marked
smell of chlorine, and dissolving with tolerable  facility in water,
at the same  time giving off much chlorine gas.2  Its nature and
   • Brande's Dictionary of Materia Medica, p. 135.  Lond. 1839.
   2 Link, Art. Chlor, in Encvc. Worterb. der Medicin. Wissenschaft, vii. 579. Berlin,
1831. 
154
CALX CHLORINATA.
composition are a subject of dispute, and  hence the term " chlori-
nated lime," which has been  adopted by  the London, Edinburgh,
and United States Pharmacopoeias, in place of chloride of lime.
   M. Hunoux Desfontenelles' affirms, that  having prepared  pills
of chlorinated lime, extract of opium and honey, they  experienced
a spontaneous combustion a short time  after they were prepared ;
and he states, that the reaction took place at times whilst the  mix-
ture was being  made.  He  found, that  powdered marshmallow
root and liquorice, when  united with chlorinated lime and honey,
produced the same result.   It would hence appear that chlorinated
lime and organic substances ought not to be associated in  the same
prescription.
                  EFFECTS ON THE ECONOMY.
   The action of chlorinated  lime is generally esteemed to be  ana-
logous to that of liquid chlorine ; Hufeland, however, assimilates it
to that of chloride of calcium.  The data have  been considered as
scarcely, perhaps, sufficient to determine its precise operation.  It
appears, however, to act mainly by means  of its chlorine, which,
being loosely  combined, is readily disengaged,—all acids, even the
carbonic, occasioning its separation.   It is not much employed in-
ternally ; but, according to Cima, it  occasions  slight  pains in the
abdomen, burning in the stomach, and at  times  diarrhoea.
   As to lis internal administration, Cima gave it in cases of scro-
fulous swellings.   By  Cloquet,  it was used  both internally and
externally  in  gangrenous ulcers;  and  by  Grafe,  Deschamps,
Graves,3 and  the author in fcetor oris.  In a case of pectoral dis-
ease, with great fcetor of the breath and expectoration, it was ad-
ministered by Drs. Graves and Stokes with remarkable benefit—a
pill of three grains with one of opium  being  given three times a
day, and the quantity being increased to twelve grains a  day: the
bed was  also sprinkled with a solution of it.  It has been used  with
advantage by the author in a similar case; and in gangrene of the
lungs.   By Reid,3 it was  prescribed in  dysentery, and in a bilious
typhus  occurring in summer; by Copland4 in the last stage  of
typhus fever, when  the evacuations were  highly offensive, given
in draughts of aromatic water with mucilage.   Dr. Pereira5 also
states that he can  bear testimony to the good effects of it in bad
cases offerer; but the same results were not observed in the fever
of Edinburgh.5   It, was likewise  given  by  Groh,  Cohen, and
Schlesier7 in phthisis, and  by Grafe  in gonorrhoea.   In none of

  1 Jour, de Chimie Medicale, and Soubeiran, Jour, de Pharmacie, Fevrier, 1842, p. 121.
  a Dublin Hospital Reports, vol. v.
  a Transactions of the Association of Fellows and  Licentiates of the College of Physi-
cians in Ireland, vol. v. 18:48.
  4 Houlton's Appendix to translation of Magendie's Formulary, p. 163.
  s Elements of Materia Medica,  &c, 2d edit.  p. 593, Lond. 1842; or 2d Amer. edit,
by Carson. Philad. 184f>.
  6 Christison. Dispensatory, d. 242.  Edinb. 1~42.
  1 Casper's Wochenschrift fur die gesammte Heilkunde, No. 37, 1838. 
CALX CHLORINATA.
155
these cases is it presumable, that chlorinated lime possesses virtues
not contained in liquid chlorine.
   For external use it has been adopted in various cases, and espe-
cially in ulcers.  According  to Trusen, an aqueous solution  is
proper for torpid ulcers of almost  all kinds—the phagedenic, the
scrofulous, &c.  In syphilitic ulcers, it appears to be of use when
the chancre is sloughing, and  eats  deeply into the flesh.1   Trusen
employed a  solution formed  by rubbing from  3iij. to siv.'with a
pint of water,  pouring off the supernatant fluid after it had stood
a quarter of  an hour, and applying it by means of pledgets of lint
to the ulcer,  renewing  the application whenever the lint  became
dry.   In this way, he found the profuse ichorous secretion from old
ulcers diminish, the offensive odour abate, and fresh and healthy gra-
nulations spring up.  By the same kind of treatment, phagedenic,
herpetic and  scrofulous ulcers generally cicatrized speedily and per-
manently.2   Trusen  employed, at  the same time, crude  antimony
with  cathartics;  and in all cases he directed strict repose,  and  re-
gulated diet.
   Trusen's  observations  have been  confirmed  by many  modern
physicians, amongst  whom may be mentioned Labarraque, Lis-
franc, Ekl, Lemaire, Heiberg, and  Kopp.   In ozcsna, good effects
were observed from  it   by  Horner,3  Awl,4  Heron,5  Detmold,'5
and  Strathing: and a solution of it, in  the form  of injection, was
found serviceable in fistula, by Trusen and Ricord.  In cancerous
ulcers, recourse has been had to it by Heiberg, Labarraque, Du-
parcque, Martinet, &c, and, in all  cases, it corrected the offensive
odour, and, at times, the  ulcer  itself assumed  a  more favourable
appearance.  Dr. Frohlich 7 used it with advantage in a cancerous
affection of the face, in the strength of one part  to sixteen parts
of water.  In  such cases it  has been  recommended, in order to
have the concentrated action of the chloride, that it  should  be
formed into  a  paste by admixture with water, and  be applied in
this manner.
   It has been prescribed, also, in cases of ulceration of the mouth,
by Kopp, Angelot, Heiberg, &c, applied either in the form of so-
lution or of a soft paste.   In  cases of wounds,  the application of a
solution of it has been recommended by  many, as by Trusen, Ekl,
Lisfranc,8 to promote cicatrization after the inflammation has sub-
sided.  In a case of punctured wound received  in dissecting,
and when the inflammation was proceeding up the arm with alarm-

  ' Mene, in Gazette Medicale, Feb. 11, 1832.
  J Sec. also, Houlton's Appendix to Magendie's Formulary, p. 162.
  3 Amer. Jour,  of the Medical Sciences, No. xi.
  4 Ibid. No. xxii. for Feb. 1833, p. 543.              ' Ibid. Nov. 1836, p. 271.
  * Holscher's Annalen, 1840, Bd. v. Heft. 1; cited  in Brit, and For. Med. Rev., Oct.
1841, p. 549.
  ' Medicin. Jahrbiicher des k. k. bsteerreich. Staaten. B. xvii. S. 1C8.  Wien, 1834.
  ' Bulletin General de Therapeutique, Juillet, 1838. 
156
CALX CHLORINATA.
 ing rapidity, and  the pain and tension were extreme, the patient
 experienced immediate relief from a solution employed as a lotion,
 combined with the free use of leeches.1
   Gubian'3  has proposed to apply it to prevent pitting from small-
 pox.   The  maturated pustules are to be opened, and washed with
 a  weak solution;  desiccation takes place very promptly, and, it is
 said,  no marks or pits are left.
   On account of its antiseptic properties, it has  been applied  in
 cancrum oris,  by  Labarraque, Richter, Berndt, and numerous
 others, and  in sloughing affections of the female organs of gene-
 ration, of  an analogous nature, by Labarraque and Ekl; in hos-
 pital gangrene,  by Percy,  Labarraque, Siedmogrodzki, Delpech,
 and Renard; and  in gangrene of the scrotum, as well as in ordi-
 nary gangrene,  by Heiberg  and Trusen;  in all  of which it was
 of decided efficacy.3  In such  cases it may be applied either in the
 form  of the paste above mentioned, or in  strong  solution—gij to
 Oj of water.
   In  barns of the  second and  third degree, when they are not
 spread over too great a surface of the body, a solution of chlori-
 nated  lime,  according to Trusen,  markedly diminishes the pain,
 moderates the too great suppuration, and excites, especially in the
 second degree, sound granulations; in the third, speedy separation
 of the dead  portions, and in both cases a smooth and firm  cicatrix.
 Either a solution united with mucilaginous substances, or a  liniment
 prepared of it, may  be applied.
   Lisfranc's observations4 entirely accord with those of  Trusen.
 He applies  compresses spread with cerate  over the burnt  parts;
 the compresses having holes in them so that the burnt surfaces are
 exposed;  they are then covered with lint  soaked in a solution of
 chlorinated  lime,  which is  kept in situ, and moistened as  it be-
 comes dry.  ^ A solution of it, as well as of chlorinated soda, may
 be  applied,  indeed, with advantage  in the first stage of a burn or
 scald; and Mr. Holt5 affirms that he knows nothing so efficacious
 in a (lblack  eye."   Dr. Chopin,6 too, affirms, that in wounds pro-
 duced by contusion, laceration, or by the explosion of gunpowder,
 where there is much pain, speedy and certain relief is produced by
 keeping the dressings constantly wet with a solution of it: he found
it, as  well as chlorinated soda, very serviceable  in cases of sore
 nipples.
   In  chilblains, it has  been used in the form of solution  and of
 liniment  with advantage,  not  only in  ulcerated chilblains,  but
 where the skin was unbroken, by Trusen, Lisfranc,  Grafe, and
  * Alcock, Essay on the Use of the Chlorurets, &c.  London, 1827.
  ' Journal de Chimie Medicale, vi. 315.
  * Riecke, Die neuern  Arzneimittel, u. s. w.  Stuttgart, 1837.
  4 Gazette Medicale, Mars 21, 1835.  See, also, Bulletin General de Therapeutique,
Juillet,  1838; and Clinique Chirurgicale de l'Hopital de la Pitie, Paris, 1841.
  ' Lancet, April 6th, 1834.                « Gazette Medicale, Oct. 31, 1835. 
CALX CHLORINATA.
157
others.   In  many cases, however, it  has  been found advanta-
geous  to diminish the inflammation first  by the  application  of
leeches.   In cases of deeper frost-bites it has likewise  proved be-
neficial.
   In salivation caused  by mercury, it has been valuable,1 espe-
cially when administered at the beginning of the increase of secre-
tion.  When  the  ptyalism  has  proceeded  to a  greater extent,
Trusen uses, at the same time, sulphureous baths.  A collutory of
chlorinated lime not  only  diminishes the  excessive secretion from
the  salivary glands, but speedily mitigates the sense  of burning
in the mouth, induces the healing of the erosions of the mucous
membrane, and corrects the mercurial fcetor.   In such cases, the
author has frequently employed  it  with advantage, although the
affection is not much under the control of medicine.
   In offensive odours from  the mouth, arising from carious teeth,
Regnard employed  a solution of it, but it excited the salivary
glands in a disagreeable manner.  On the other hand, E. Grafe
recommends it strongly in this very case, and even in caries, both
inwardly and externally, as a collutory and tooth powder.  In the
latter form, it is said to remove speedily the tartar and yellow de-
positions on the teeth.   By Chevallier and Kluge, it  is  strongly
recommended for cleansing the mouth.   The latter gives a formula
for a collutory, which will be found amongst the prescriptions at
the  end  of this article.   It effectually cleanses, whilst it does no
injury to the enamel of the teeth.
   In scarlatina, a solution of chlorinated lime may be employed
 most advantageously as a  gargle, and in the form of ablution to the
 surface.2
   In  scrofulous swellings  of the  glands, according  to  Cima, it
 may be applied with advantage  in the form of ointment;  and by
 Grafe it is recommended in  swellings of the joints.  It has like-
 wise been used successfully  by Werneck in goitre.
   In several chronic eruptions, it has  been much extolled—as
 in herpes, by Kopp; in itch, by  Heiberg, Derheims,3 Cluzel, Fan-
 tonetti,4  Hospital,5  Wittzack,6  and  Napoli.7   Dr.  Christison8
 affirms, that  he never uses any other remedy in itch;—a solution,
 containing  between  a  fortieth and a  sixtieth part of  chlorinated

   '  Elliotson, in  Houlton's Appendix to translation of Magendie's Formulary, Amer,
 edit. p. 162.  Philad. 1834.
   4  Copland, in the Appendix to Houlton's edition of Magendie's Formulary, p. 163,
 S. Jackson, of Northumberland,  (now of Philadelphia,) in Amer. Journal of Medical
 Sciences, xii. 261 and 550, and  Ibid, for May, 1838, p. 56. (Dr. J. uses chlorinated
 soda.)                 3 Journal de Chimie Medicale, ii. 575.
   4 Bulletin de Therapeutique, 1833; and American Journal of the Medical Sciences,
 August, 1833, p. 533.
   •  Amer. Journal of the Medical Sciences, Nov. 1834, p. 240 (extracted.)
   6  Casper's Wochenschrift, Feb. 4, 1837,  S. 79.
   1  Journ. de Chimie Med., cited in Amer. Jour, of Pharmacy, July, 1841, p. 172.
   '  Dispensatory, Amer. edit, by R. E. Griffith, p. 302.  Philad. 1848.
         11 
158                   CALX CHLORINATA.
 lime, applied  five or  six times a  day, or  continuously with wet
 cloths, allays,  he says, the itching in the  course of  twenty-four
 hours, and  generally accomplishes a cure in eight days.  He has,
 also, found  the same lotion useful in most other eruptions attended
 writh itching, which symptom it allays even where it  does not re-
 move the disease.  In pruritus pudendi muliebris,\\. has been
 advised by Darling; and in tinea, by Trusen, Roche, Cottereau,
 Kopp,  and  Ebermeier.  In  the last disease, it is applied  in  the
 form of liniment; in the others, in solution; but in the itch often
 also in  the form of ointment.  Michaelsen recommends the follow-
 ing method of treating itch:  Take of chlorinated lime  from two to
 four ounces, according to the degree in which the disease  exists,
 and  the length of time it has been  in the system;  put this in a
 common flask or bottle full of rain  or river water, so that as much
 as possible may be dissolved.   In using it, the patient must shake
 the bottle well, in order that  some of the undissolved  lime may be
 taken up.   With this he washes  the  parts  affected three or four
 times a day.  Every third or fourth day, when the skin  becomes
 somewhat  rough or irritated, he is made to take a tepid  bath, or
 to wash himself with warm soap and water;  and this until the cure
 is accomplished.   The internal management is the same as in other
 plans of treatment.   In the  case of young children,  the mixture
 must of course be weaker—about one  ounce  to a pint of water.
 By this plan, the patient, it is said, is entirely cured,  without any
 unpleasant concomitants, in from seven to ten days.
   Chlorinated lime has likewise been applied in purulent ophthal-
 mia.  Varlez1 cured contagious  blennorrhoea  of the eye, by
 dropping upon it a solution of it.   Colson, Delatte, and Reynaud2
 also saw good effects from it, both in acute purulent ophthalmia,
 and in chronic ophthalmia with granulations, obscurity of the
 cornea, and especially in copious secretion from the Meibomian
 glands.  Guthrie3 applied a solution successfully in  three cases
 of ophthalmia neonatorum; and Pereira4 advises a weak solu-
 tion  in the same cases.   Farvagnie  used it beneficially in scro-
fulous and catarrhal ophthalmia.5
   Dr. Radclyffe Hall6 has treated purulent ophthalmia, both in
 the adult and in children, with success, by a  saturated solution.
 His  plan of using it is as follows.  The eyelids are   slowly and
 gently separated, until the cornea  can be seen, when that is prac-
 ticable;  and all secretion is wiped  away with a fine, soft sponge.
 A large, bushy camel's hair pencil, charged with the  strong solu-

  ' Cited in American Journal of Med. Sciences, i. 459.
  a Journal fiir Chirurgic, u. s. w. B. xiv. H. 4.
  3 Medical and Physical Journal, Nov. 1827,
  * Elements of Mat. Med. 2d edit., i. 593, Lond. 1842; or,  2d Amer. edit, by J. Car-
 son, Philad. 1846.
  6 Verhandlung. der vereinigt. arztlich. Gcsellschaft. der Schweiz. Jahr. 1829. Zurich,
 1830.                      * Provincial Med. and Surg. Journal, Dec. 1844. 
CALX CHLORINATA.
159
 tion, is then insinuated beneath the upper eyelid, and swept round
 the front of the eye; the pencil is again charged with the solution,
 and applied to the lower  eyelid everted.  Unless  plenty of the
 fluid be thus applied, it will be less effectual, but equally painful.
 There is considerable pain, of a smarting, burning  character, for
 half  an hour or longer, and  the  already swollen eyelids become
 still  more tumid.  In a few hours, a  serous discharge oozes out
 from between the eyelids, and the  swelling partially subsides.
 This is followed by a secretion of matter; but, after two or three
 applications of the solution, it is in perceptibly  diminished quan-
 tity, and the discharge gradually loses  its characteristic  yellow
 colour, and is seen in flakes on opening the eyelids.   After three
 or more applications, the eyelids no longer swell, and  the  pain  is
 much less.   As  the  inflammation  lessens, the eyes  must be kept
 clean with warm  water, and  matter must  never be  suffered to
 collect  beneath the upper eyelid; a little spermaceti ointment  is
 smeared on the edges of the eyelid, and the strong solution is ap-
 plied once in every twenty-four hours, until the secretion ceases to
 be in the least degree puriform.  The longest period required for
 the cure was a month; the shortest, four days.
  It  has likewise been  employed  advantageously in other blen-
 norrhozas besides the one mentioned, and especially in  the gonor-
 rhoeaV  Grafe, of Berlin,2 affirms,  that he  succeeded with  it
 when copaiba and cubebs had failed.  He used it  both in the form
 of pill,  made as described hereafter,  and of injection—the injection
 being made  by dissolving gr. xxiv. in f ^vj. of water, and  add-
 ing 3ss. of wine  of opium.  His  observations are  confirmed by
 Dr. Radclyffe Hall,3 who observes, that in the treatment of diseases
 attended with a  contagious discharge, it is  desirable not only to
 lessen the inflammatory  action which causes the secretion, but, at
 the  same  time,  to alter the contagious character of the  matter
 secreted; and  he advises chlorinated  lime as capable of fulfilling
 these indications.  In the  first stage of gonorrhoea, before  the
 discharge has become completely puriform,  or the scalding great,
 a single injection of about  two fluidrams of a saturated solution
 in water, will  always, he says, put a stop to the disease.  In the
 second  stage, where there is a considerable discharge of pus, and
 more pain, several injections  are  required.   In  gleet, also, pro-
 vided the discharge  be not kept up  by some structural change
 in the  urethra,  the  strong injection  is useful, but  not to  so
 striking a degree.  The effects of  injecting this strong solution
 are,—sharp pain, and often erection for the moment; slight puffi-
 ness  and eversion of the orifice of the  urethra, and  tenderness

  1 Alcock, Essay on the Use of Chlorurets, &c.  Lond. 1827.
  2 American Journal of Medical Sciences, and Amer. Journal of Pharmacy, 2d series,
vol. ii. 86. Philad. 1838.  See, also, M. Roussf, Bulletin Gonera] de Therap. Jan v. 1842.
 * Op. cit. 
160                   CALX CHLORINATA.
on pressure, with a feeling of unusual  firmness  for two or three
inches down the corpus spongiosum, where these  did  not already
exist.   In a short time the pain subsides, and in a quarter or half
an hour, a serous discharge issues from the mouth of  the urethra.
Occasionally, oedema of the prepuce, with its attendant sense of
numbness in the part, ensues.   There is scalding, but, usually, not
to any very great degree, for the first two or three times of pass-
ing the urine, which may be, in a great measure, obviated by in-
jecting a little oil of almonds a short time  previously.  In about
eighteen or  twenty-four hours, the lips  of the urethra are found
to be separated by a clot of firm, yellow pus.   This is removed
by the stream of urine, and may, or may nof; form a second time.
If the disease be only in its first stage, it will now, according  to
Dr. Hall, be  cured;  but if more  established,  the injection will
have to be repeated as often as the peculiar tingling sensation and
gonorrhceal secretion reappear.  In this  case, the small, firm clot
is not formed; but, in its stead, there is a discharge of more fluid
pus.  The number of injections, and, consequently, the length of
time required for cure, depend  chiefly upon the  anterior duration
of the disease.  In the acute stage of a  first  attack, where both
pain and discharge are considerable, Dr.  Hall has never seen any
harm from employing  this strong injection,—using, at the same
time, mild  aperients, tartrate of antimony and potassa and opium
internally, enjoining perfect rest and abstinence, and frequently
washing out the urethra with  some weak, astringent solution, as
that of acetate of zinc, formed by the double decomposition of sul-
phate of zinc and acetate of lead.  On the contrary, the course of
the disease has appeared  to be  materially shortened.   When the
inflammation  is subacute, but  the discharge still  purulent, as  in
persons habituated to the disease, or after a certain period of a
first attack, copaiba or cubebs  have been  given in the usual way,
but the injection has been manifestly of service.  In gleet, a sin-
gle injection has sometimes cured, after the failure of almost every
other kind of injection.   More frequently, several injections have
been  required.  In  a few instances,  the chlorinated lime has
wholly failed; but, in these cases, no other injection has succeeded
afterwards.
  But one of the most important of the applications of chlorinated
lime is as an antiseptic and disinfecting  agent.1   It  is admirably
adapted  for  preventing  and checking putrefaction,  and for cor-
recting  the offensive odour of parts already putrefied:3 and hence
its application is most useful in anatomical investigations.3  Some
time  before  dissection,  the  body  may  be enveloped  in a cloth
wetted  with  a solution  of it, (C'ale. chlor'in. 5ss., Aquas Oj.,)
which must be kept wet by sprinkling  it from  time to time:  in
  1 Labarraque, on the Use of the Chlorides of Soda and Lime, translated  by Jacob
Porter.  New Haven, 1829.    a*Alcock, Op. cit.    2 Magendie, Formulaire, &c. 
CALX CHLORINATA.
161
 this  manner the  offensive  odour  is  speedily  corrected.   It  is
 equally well  adapted for purifying the air of the wards of hospi-
 tals,  jails or ships; a little of the solution  being  sprinkled, from
 time  to time, on the floors; or shallow vessels, containing it, being
 placed in different parts of the room.  It is used, moreover, for
 neutralizing contagious miasmata dispersed in the air, or contained
 in  clothing, furniture, &c, care being taken, in all  these cases,
 that  due ventilation be practised.  It has been  properly doubted,
 however,1 whether its use be productive of any  advantage in pre-
 venting the spread of infectious, contagious, or epidemic diseases.
 It  has been  affirmed, indeed, to  be positively injurious, by dete-
 riorating the atmosphere, and in  this there may be truth, unless
 the precautions, mentioned above, be taken.  In various cases, in
 which such diseases have prevailed, it has destroyed  all offensive
 odour,—acted,  in  other words, as an  antibromic or deodorizer,—
 but the extension of the malady has not been prevented.2
                  MODE OF  ADMINISTRATION.
   Chlorinated lime has been  given  internally both in the form of
pill,  solution and troches, the dose being from gr. ij. to gr. vj.
 four  to six  times a day.   Externally, it  is  generally  applied  in
 solution of different strengths, (from 3j. to £iv. to eight ounces of
 water)—being decanted  to remove  the particles of lime from it,
 unless where it is considered advisable to employ the turbid solution.
  In  cases of very offensive evacuations from the  bowels, ten or
 fifteen grains may be added to a common enema.   It is, likewise,
 applied in the form of ointment, and of liniment, and also of paste
 made by admixture with water.
   The following forms have been given for its administration :3
               Troehisci  calcis  chlorinate.
                 Lozenges of chlorinated lime.
                    R.   Calcis chlorin. gij.
                         Sacchar. §viij.
                         Amyl. gj.
                         Tragac. 3J.
                         Carmin. gr. iij.
                    M.   Fiant troehisci. pond. gr.  iij.  sing.
   One of these  to be taken three or four times a day, and allowed
 to dissolve in the mouth, in cases of fcetor oris.  Deschamps.
                Mistura  calcis  chlorinatae,
                 Mixture of chlorinated lime.
                    R.  Calcis chlorin. 3J.
                         Mist, amygd. f  g vij.
                         Syrup, acaciae f 5J.  M.
  A table-spoonful every three hours in gonorrhoea.—E. Grafe.*
  1 Observations on the Chlorides and Chlorine as " disinfecting agents," and as Preven-
tives of Cholera, by  H. Bronson.  Boston, 1832.   See, also, American Journal of the
Medical Sciences, for Feb. 1833, p. 481 ; Albers, in London Med.  Gaz.  viii. 410, (as
to its inefficacy in cholera;) and Pereira, Elements of Mat. Med., &c, 2d edit, i. 591.
Lond. 1H42; or 2d Amer. edit., by Dr. Carson, Philada. 1846.   2 Pereira, Ibid. p. 592.
  * Kiecke, Op. cit. S. 94.      4 Journal fiir Chirurgie, u. s. w. B. xiv.  8t. 2. 
162 A
CALX CHL0R1NATA.
                Pilule  calcis chlorinate.
                  Pills of chlorinated lime.
                    R.  Calcis chlorin. 5fj.
                        Ext. opii gr. ix.
                        Mucilag. acac. q. s.
                          Divide in pilulas liv.
  Dose.—One,  every two or three  hours, in gonorrhoea, gra-
dually increasing the  dose until eight, ten or twelve  are  taken
every hour.                                           Grafe.
            Collutorinm  calcis  chlorinate.
                Collutory of chlorinated lime.
                 R.  Calcis chlorin. grs. xv. ad gss.
                      Mucil. acac. f %\.
                      Syrup, aurant. f  ^ss.  M.
  A little  of this  solution to be applied  by means of a mop of
charpie to  ulcers in the mouth.                    Angelot.
                    R.  Calcis chlorin. giij.
                        Aquas destillat.
                        Alcohol, aa. f  ^ij.
                        01. rosae gu- iv.
                Solve et filtra.
                                                 Chevallier.

  A tea-spoonful of this  solution is mixed with a glass of water,
and  used in fcetor oris.  According  to  Riecke,1  an  analogous
nostrum  has been sold at a high price  under the name—Pnev-
mokatharterion.
                    R.  Calcis chlorin. ^j.
                  Solve, leniter terendo, in
                        Aquae destillat. Ovj.
                 tunc adde
                        Alcohol. (.830) f fviij.
  Mist, reponatur in loco frigido per horas xxiv.; tunc filtretur et reserv.
in lagena bene obturata..  (" Let the mixture be put aside in a cold place
for twenty-four hours; then let it be filtered and kept in a well stopped
vessel.")

  It has been recommended that the mouth should be rinsed with
this after the teeth have been brushed.—Freyburg von Kluge.
                    R.  Calcis chlorin. ^ss.
                  Solve exactiss. trituratione in
                        Aq. f gij.
                  et post limpid, clarificat. admisce
                        Alcoholis f ^ij.
                        01. rosae g»- iv.  M.
  The mouth is  rinsed, in cases  of salivation, with a mixture
made by adding a tea-spoonful of the  solution to  a glass of water.
                                                     Trusen.
  The Pharmacopoeia of Sweden has  an antiscorbutic collutory,
called Linctus ad stomacacen seu oxymuriatis calcici,  which
is formed as follows:
1 Op. cit. S. 94. 
CALX CHLORINATA.
163
                     R. Solut. calcis chlorin. ^ss.
                        Aquas,
                        Mellis, aa. £vj.  M.
              Dentifricium  calcis  chlorinate.
                 Dentifrice of chlorinated lime.
        «             R. Calcis chlorin. in pulv. gr. iv.
                        Corallinae rubra ^ij.  M.
    A  new tooth-brush should be slightly wetted, then  dipped in
 this powder, and rubbed over the teeth.  Employed to give their
 natural colour to teeth.                          Magendie.

                 Solutio  calcis chlorinate.
                 Solution of chlorinated lime.
                     R.  Calcis chlorin. jiij.
                  Solve in
                        Aqua? destill. Oi.
                  Adde
                        Tinct. opii crocat. vel
                        Vini opii f £j. ad f ^ij.  M.
   Applied to frost-bites.                            Trusen.

                    R.  Calcis chlorin. gss.
                    Tere invicem et sensim  affunde
                        Aq. (seu Aq. rosae)  Oj.
                    Et post clarificat. limpid, admisce
                        Mucil. acac. (seu sem. cydon.) ^ij.
   Applied, by means of linen rags, in cases  of burns.— Trusen.
                    R.  Calcis chlorin. gij. ad giij.
                        Aquae Oj.  Solve.
   To  be applied, by means of rags kept constantly wet, in cases
 of hospital gangrene; the mixture being shaken.
                                             Rust 8r Kluge.
                    R.  Calcis chlorin. giij.
                        Aquae destillat. Oj.
              Solve  et cola.
   Used as a lotion in cases of  itch on the thighs, legs and arms,
 twice  or thrice daily.  In general, six or eight days are sufficient
 to effect a cure.      .                            Magendie.
   The disinfecting liquor of Labarraque, Liqueur  desinfec-
 tante de Labarraque, is made by adding ten parts of  water to
 one part of chlorinated lime divided in a mortar; suffering the
 solution to settle, and then filtering.

              Collyrium calcis  chlorinate.
               Collyrium of chlorinated lime.
               R.  Calcis chlorin. gr. iv. ad vj.
                    Vin. opii rn„x.
                    Mucilag. acac. f jiss.
                    Aq. rosae f i$ij.  M. et filtra.
   To be dropped on the eye, in cases of catarrhal and scrofu-
lous ophthalmia.                               Farvagnie. 
164
CANNABIS INDICA.
        Injectio  calcis chlorinate  composita.
          Compound injection of chlorinated lime.
                  R.  Calcis chlorinat. gij.
                      Decoct, kramer. f 3~xiij.  M.
  Half  an ounce of this to be injected into the nose three or four
times a day, in cases of ozsena.        Detmold, of Hanover.

             Cataplasma calcis  chlorinate.
              Cataplasm of chlorinated lime.
             R. Calcis chlorin.
                Sodii chlorid. aa. 3*ss.
                Aqua? destill. Oss.
                Farinae sem. lin. q. s. ut fiat cataplasma.
  Used  in cases of scrofulous swelling of the joints.  Grbfle.

             Unguentum calcis  chlorinate.
               Ointment of chlorinated lime.
             R. Calcis chlorin, gj.
                Adipis gj.  M. et fiat unguentum.
  To be rubbed in, in cases  of scrofulous swellings.   Cima.
             R. Calcis chlorin. jss.
                Adipis gj.  M. et f. unguent.
  Used  in goitre.                                Werneck.
             R. Adipis ^j.
                Sodae  borat.
                Calcis chlorin. aa. £j.  M. exactissime.
  In cases of chilblains.                           Trusen.
             R. Sulphuris 3*iss.
                Calcis chlorin. bene tritur. 3*ij.
                Adipis gx.  M.
  In itch, morning and evening.                   Hospital.

            Linimentum calcis  chlorinate.
               Liniment of chlorinated lime.
                R.  Calcis chlorin. gss.
             Tere in mortario vitreo et sensim affunde
                    Aq. rosae (seu fontanae) 1.3j.
             Et post, limpid, clarificat. admisce
                    01. amygd. fgj.
  To be applied, by means of a pencil, in cases  of tinea capitis.
                                                 Trusen.
                LI.  CANNABIS INDICA.

Synonymes. Indian hemp, Gunjah, Haschisch.
French. Chanvre Indien.
 German. H a n f.

  Cannabis,  which grows in India, and has  been  described by
some botanists under the name Cannabis Indica, does  not appear 
CANNABIS INDICA.
165
to possess any specific differences from the common hemp, Canna-
bis sativa;  and accordingly by many botanists they have been re-
garded as identical.1
   The term "Indian hemp" has long been assigned,in the United
States, to Apocynum cannabinum: this has given occasion in Eu-
rope, and occasionally in this  country, to confusion in regard  to
the two articles, which are very distinct in their natural  and me-
dical characters.3
   The narcotic effects of cannabis have been long known to the peo-
ple of Southern Africa, South  America, Turkey, Egypt, Asia Mi-
nor, India, and the adjacent countries of the Malays, Burmese, and
Siamese, by whom it is used in various forms to induce intoxica-
tion.   It is, likewise, extensively employed in popular practice  in
various diseases.  In Western  Europe its use is unknown, and it
is questionable, whether the hemp of that region or of this coun-
try be possessed of the same properties.   Dr. O'Shaughnessy, of
Calcutta, states, that the extraordinary symptoms produced by the
oriental plant  depend upon a resinous  secretion  with which it
abounds, and which seems to  be wholly  absent in  the European
plant.  The absence of the resinous secretion, and consequent want
of narcotic power, he ascribes to difference of climate.  M. de
Courtive3 has submitted  to analysis cannabis procured from Al-
giers, or from Indian seeds reared in France.  He finds the active
principle to  reside in  resin, which he extracted  by a complicated
process of maceration  and the action of  alcohol.   From 9 to 10
parts of this resin—cannabine—were procured from 100 parts of
the plant: the Algerian article  furnishing it in greater abundance;
and he affirms, that a grain and two-thirds, or even half the quan-
tity, produced  in some temperaments an equal effect with half a
dram  of the thick extract.- The  Cannabis  sativa  of  Italy  fur-
nished an active but  much weaker resin. The resin obtained by
M. de Courtive is of a deep greenish-brown colour, of an aromatic
but nauseous odour, and of a hot, acrid, and enduring taste.  It is
soluble in cold ether, alcohol, and volatile oils; insoluble in water
and dilute alcohol.
   The Messrs. Smith, of Edinburgh, satisfied themselves that the
resin concentrates in itself the whole properties of the plant.   The
following is their mode of preparing it.  Digest bruised  gunjah
in successive portions of warm  water  until the expressed water
comes away colourless, and again for  two days at a moderate  heat
in a solution of carbonate of  soda, in the proportion of one part
of the salt to two of  gunjah.   Colouring matter, chlorophyll and

  1 Royle, Mat. Med. and Therap., Amer. edit,  by J. Carson, p. 551.  Philad. 1847,
and Pereira, Elements of Materia Medica, 2d edit. p. 1066.  Lond.  1842.
  a Farre, in Lond. Med Gaz., May 5, 1843, p. 209.
  3 Bouchardat, Annuaire de Therapeutique, pour 1849, p. 52.   Paris, 1849; and Ran-
king's Half yearly Abstract, viii. 214, Amer. edit.  Philad. 1849. 
166
CANNABIS INDICA.
 inert concrete  oil, being thus removed, express and wash the resi-
 duum, dry it, and exhaust it by percolation with rectified  spirit.
 Agitate with the tincture  milk  of lime containing an ounce of
 lime for every  pound of gunjah; and, after filtration, throw down
 excess of lime  with a little sulphuric acid.   Agitate with the fil-
 tered liquor a  little animal charcoal, which is afterwards to be
 removed  by filtration.   Distil off most of the spirit:  add to the
 residual  tincture twice  its weight of water in a porcelain  basin,
 and let the  remaining spirit evaporate gradually.   Lastly, wash
 the resin with  fresh water till it comes away neither acid nor bit-
 ter ; and  dry it  in thin layers.   Dry gunjah yields six or seven
 per cent, of it;  and  its strength  as  a narcotic corresponds with
 this proportion.1
   In certain seasons and in warm countries, a resinous  juice ex-
 udes, and  concretes on the leaves, slender stems and flowers of
 cannabis.   This  constitutes the churrus of Nipal  and Hindoo-
 stan, and  in it  resides the powers of all the preparations of hemp.
 This resin—cannabine, haschischine"2—is very soluble in alcohol
 and ether; partially soluble in alkaline, but insoluble in acid, solu-
 tions.  When pure it is of a blackish-gray colour; it is hard at90°
 of Fahrenheit, but softens at higher temperatures, and fuses readi-
 ly.  It is soluble in the fixed and in several volatile oils.  Its odour
 is fragrant  and narcotic; taste  slightly warm, bitterish and acrid.
 The dried hemp plant, which  has flowered, and from which the
 resin has not been removed, is called Gunjah or Haschich.  It is
 made into bundles of 24 plants each.   These bundles are 2 feet in
 length, and 3 inches in  diameter.3  It yields to alcohol twenty per
 cent, of resinous extract, composed of the resin—churrus—and
 green colouring matter.   The  Gunjah is used for smoking.   The
 larger leaves and capsules, without the stalks, constitute Sidhee,
 Subjee, or  Bang, which is used to  form with water an intoxi-
 cating drink.   When the plant is distilled with a  large quantity of
 water, traces of volatile oil pass over, and the distilled liquor has
the powerful narcotic odour of the plant.4

                 EFFECTS  ON  THE  ECONOMY.
   Cannabis Indica, raised in India, appears  to  have the greatest
activity.   Mr. Donovan made  numerous experiments  with hemp
cultivated by himself, and was satisfied that domestic hemp is des-
titute of the principle " which renders the Indian plant so desira-
ble an extract  to the voluptuous people of the East."
  The effects  of this  remedy  would  appear to have been well
known to the1 Arabian and  Persian physicians of both modern and
  1 Christison, Dispensatory, Amer. edit. p. 973.  Philad. 1848.
  3 Bouchardat, Annuaire de Therapeutique, pour 1850, p. 10.
  * Ballard and Garrod, Elements of Mat. Med. and Therap., p. 413.  Lond. 1845.
  4 For the history of the Haschisch, see Moreau, Louradour and Bouchardat, in Bou-
chardat, Annuaire pour 1847, p. 11.  Paris, 1847. 
CANNABIS INDICA.
167
ancient periods; but the  first  person,  who seems to  have well
tested  its properties was Dr. O'Shaughnessy.1  In his various ex-
periments, he did not observe the least  indication of  pain, or any
degree  of  convulsive movement.  They all, he  affirms,  " led to
one remarkable result,—that while carnivorous  animals and fish,
dogs,  cats, swine, vultures, crows,  and adjutants invariably  and
speedily exhibited the intoxicating influence of the drug, the gra-
minivorous,—such  as the horse,  deer, monkey,  goat, sheep, and
cow,—experienced but  trivial effects from any dose that was admi-
nistered."   Encouraged by these results, he felt  no hesitation as
to the perfect safety of giving the resin of hemp an  extensive trial
in cases in which its apparent powers promised the greatest degree
of utility.  The general effects  observed on man were alleviation
of pain in  most cases,  remarkable augmentation  of the appetite,
aphrodisia, and great mental  cheerfulness.  The  more  violent ef-
fects were a  peculiar form of delirium, and a cataleptic state.
   Under the influence of fourteen grains of the  resinous extract
taken at bed-time, Mr. Donovan3 awoke  early in the morning, with
a rush of  strange sensations  through  his head, accompanied by a
crackling  and singing noise, and  a vibratory motion through the
whole body.   These gradually subsided, and whilst dozing off, he
thought an explosion took place in his head, followed by the same
rushing noise and vibration as before, and afterwards by a strange
metallic sound.  Various  other  noises  succeeded.   His sense of
touch  and  feeling  had  gradually  become more and  more  obtuse,
until at length  he  lost all feeling, unless he  pinched  himself  se-
verely.  " The effects," says Mr. Donovan, " were now at their
height, and the consequences wrere surprising.   I absolutely lost
the consciousness of having a body, and my corporeal existence,
appeared to be comprised within the head, and a small  portion of
my chest near the throat: in  these  spots I  felt as  much  alive as
ever, but all other parts were without feeling, and,  to my percep-
tion, annihilated.   My  intellect  was  not  in  the  least  disturbed;
memory was as good as ever.   I reasoned well enough; was con-
scious of external objects as in perfect health; but I had some no-
tion that if I gave way to sleep, I should never wake in this world;
yet, strange  to say, I felt  perfectly resigned to this sudden termi-
nation of existence." Similar phenomena  have appeared in others
from a much smaller dose.3
   On trying  an alcoholic extract, sent to Dr. Christison* by Mr. An-
drew  Robertson of Calcutta,5 for toothache, he found, that about
  1 On the Preparations of Indian Hemp, or Gunjah, {Cannabis  Indica,) &c, Cal-
cutta, 1839; and Brit, and For. Med. Rev., July, 1840, p. 224.
  2 Dublin Journal of Med. Science, Jan. 1845.             3 Op. cit.
  * See the author's General Therapeutics and Mat. Med. 4th edit. i. 380.  Philad. 1850.
  4 Op. cit. p. 973.
  * For an account of this extract, see Pharmaceutical Journal, cited in American Jour-
nal of Pharmacy, for August, 1847, p. 195. 
168
CANNABIS INDICA.
four grains, taken at three A. M., caused, in an hour, cessation of
pain, a pleasant numbness in the limbs, giddiness, a rapid succes-
sion of unassociated ideas,  and impossibility to follow a train of
thought, frequent intervals of sleep, and slight increase in the force
of the pulse.  Next morning there was an ordinary appetite, much
torpidity, great defect and shortness of memory, extreme apparent
protraction  of time, but no  peculiarity of articulation  or other ef-
fect, and these symptoms lasted until two P.  M., when they en-
tirely ceased in a few minutes after taking lemonade.  The results,
however, of different observers, in regard to this agent, are by no
means in accordance.  Whilst some believe it capable of replacing
opium, where the latter disagrees, others have  found it fail where
opium had failed.   Dr. Lawrie, of Glasgow,1 has reported its ef-
fects in  twenty-six  cases,  from which  he drew  the following con-
clusions.   First. It seems  to belong to that class of narcotics,
which rapidly induce  excitement and intoxication, followed by
sleep—neither sound nor  refreshing.   Secondly. In a full dose it
acts powerfully on  the heart, causing palpitation, and  a  rapid,
weak, intermittent  pulse; and on the nervous system, producing
delirium, coma, convulsions  and dilated pupils.  Thirdly.  Its ef-
fects are generally transitory.  In  one case, however, the intoxi-
cation and dilatation of the  pupils lasted nearly forty-eight  hours.
Fourthly.  It is a very uncertain agent, in some cases producing
the most violent and seemingly dangerous  symptoms; in others,
being nearly inert.   Fifthly. It very frequently causes vomiting,
which,  whether  it  occur spontaneously, or from  emetics, very
speedily  relieves its unpleasant, and  perhaps  dangerous  effects.
Sixthly.  Applied around the eye, it does  not dilate the pupil.
Seventhly. It exerted little influence on the few patients to whom
it was given in the form of enema.  Eighthly.  He does not think
it a valuable addition to our  narcotic medicines.  In very few cases
did it act as an  agreeable soporific and  anodyne.    In none did it
succeed when opium had failed; and  in one  case only was  it pre-
ferred to opium.  He  does not  think  it  is  to  be  trusted to.
Ninthly. So far from acting generally as  an anodyne, its effect
was so disagreeable, that  the majority of those who took it once,
only did so  a second time on compulsion,  and  this  was the more
remarkable, as the patients on whom he experimented belonged to
a class to whom stimulants  of all kinds were familiar, and who
would greedily swallow opium and spirits to  an unlimited  amount.
Tenthly. It seemed useful in two cases of subacute rheumatism;
and, lastly,  it caused an immediate craving for food, and, in  a few,
permanently increased  the appetite.
  Professor Miller,2 of Edinburgh,  believes cannabis to be compa-
ratively valueless as an anodyne, as well as hypnotic,  in ordinary
  1 Lond. and Edinb. Monthly Journal of Medical Science, Nov. 1844, p. 497.
  3 Ibid. Jan. 1845. 
CANNABIS INDICA.                    169
circumstances.   Its virtue seems to him  to consist in a power of
controlling inordinate muscular  spasm.  This  it exhibited in  a
case of traumatic tetanus  reported by  him.   Many cases have
been published, in which its anti-convulsive power was confirmed.
In opposition, however, to Professor Miller, Dr. Clendinning1 has
no hesitation in affirming, that its exhibition has usually, and with
remarkably few substantial exceptions, been followed by manifest
effects as a soporific or hypnotic, in conciliating sleep;  as an ano-
dyne, in  lulling irritation;  as an antispasmodic, in checking cough
and cramp; and as a nervine  stimulant, in removing languor and
anxiety,  and  raising the  pulse  and  spirits;  and these effects have
been  observed  by him in both acute  and  chronic  affections,  in
young and old, male and female.
   Dr. Corrigan2 believes, that the  action  of cannabis is primarily
on the motor nerves; its influence he inclines to think being trans-
mitted along these  to the sensorium,  and nerves  of  sensation.
Speaking of its peculiar advantages as  a sedative, he affirms, that
even in over-doses it does not  produce  the dry tongue, or the de-
rangement of the digestive organs,  which occasionally follows the
use of opium.  Its effects on  different persons, however,  he re-
marks, are very different.   In the case of  a  lady who had long
suffered from neuralgia of the face, neck and head, twenty drops
of the tincture caused temporary loss of  power in almost  all the
raulscles,  followed by sleep; while a similar dose has been taken by
other patients three  times daily, for weeks, with impunity and
advanlage.
  Dr. Pereira3 experimented on some  specimens of Gunjah and
Nipalese churrus, which were  sent  to him by Dr. O'Shaughnessy.
He tried  them both on animals and man, and gave  specimens  of
them to medical friends; but their  effects were found to be com-
paratively slight.  "Whether,"—says  Dr.  Pereira,—"this   be
owing to the preparations having undergone some deterioration in
their passage, or to the comparative phlegmatic temperament  of
the English, I know not.   My experiments on animals were made
in the lecture-room of the London  Hospital before the students of
the Materia  Medica class; and  the trials on the human  subject
were made in the wards of the hospital."
  Messrs. Ballard and Garrod4 state, that  when the dose was large,
they have observed the urine acquire an odour something like that
evolved when the tincture is  mixed with water, and in  part like
that of the Tonquin bean.5

  ' Provincial Med. and Surg. Jour., May 27, 1843, and Med. Chirurg. Trans., xxvi. 208.
  2 London Med. Times, cited in Med. Examiner for Sept. 1845.
  3 Elements of Mat. Med. 2d edit. ii. 1098.  Lond. 1842.           4 Op. cit.
  s For the experiments of M. Lieautaud and Brierre de Boismont, and of  M. E. de
Chaniac, see Bouchardat, Annuaire de Therapeutique, pour 1845, p. 29, Paris, 1845,
and Ibid, pour 1846, p. 13.  See, also, Lieautaud, cited in Ranking's Abstract, p. 342.
Amer. edit.  JN'evv York, 1846. 
170
CANNABIS INDICA.
  Indian hemp was prescribed by Dr. O'Shaughnessy in various dis-
eases.   In rheumatism,  acute and chronic, the results were not
very satisfactory.   In one case, the most marked catalepsy super-
vened along with the usual intoxicating effects.   In a case  of hy-
drophobia, the soothing influence  of the remedy was very  great;
but the  disease  terminated fatally.  In cholera, he considered its
agency to be " promising, and to deserve the attention of the prac-
titioner ;"  and since then it has  been extolled  in that disease by
MM. Aubert-Roche, Chaniac, Willemin,1  Gastinel, Legroux2 and
others.
  The testimony is strongest in regard to its influence in traumatic
tetanus^ of which Dr. O'Shaughnessy refers to fourteen cases ; of
these, nine appear to have recovered.   It is well remarked, how-
ever, by Messrs. Ballard  and Garrod,4 that it is no easy matter to
determine  the claims which a medicine holds forth to control teta-
nus; and  that we  should be cautious of advancing statements in
reference to the subjugation of such a formidable disease unless on
the most unexceptionable evidence.   "Tetanus has been occasion-
ally recovered from  under a variety  of treatment, and hence the
disappearance of it in a few cases during the  treatment by this
drug must  not rashly be used as a decided evidence of its curative
capabilities.   Of two cases lately  treated with it in the University
College  hospital,  one died, and the other recovered:  the  former
was traumatic ;  the latter idiopathic.   However, it is  difficult to
say how far it influenced  the favourable termination ; inasmuch as
full and repeated blood-letting and colchicum were also employed."
This difficulty exists in most of  the reported cases.   In but few
has cannabis been given  alone.   It is  proper, too, to add,  that in
the  hands  of Mr. Stafford,5  Mr.  Potter,6 and Dr. Babington,
it failed, or, at the most, afforded only temporary relief, although
the utmost care was taken to obtain the article in a state of purity.8
From the results of his cases, Dr. O'Shaughnessy concludes, that
the resin of hemp, given boldly and  in large doses, is capable of
arresting effectually the progress  of that formidable disease, "and
in a large  proportion of cases, of effecting a perfect cure ;"—and
further;  "that in hemp the  profession has gained an anti-convul-
sive remedy of the greatest value."
  The commendations  of Dr. O'Shaughnessy gave occasion to the
employment  of  cannabis  by  many  practitioners.   Mr. Ley  pre-
scribed it with advantage in various spasmodic diseases,—chorea,
sciatica, &c, which gave him the most  perfect confidence in its
  1 Bouchardat. Annuaire de Therapeutique pour 1849, p. 51.
  2 Ibid, pour 1850,  p. 10.
  8 See, also,  cases by Ley, Lond. Lancet, April 1, 1843, and Isaac Heister, Bost. Med.
and  Surg. Journal, June 17, 1846, p. 394.                 4 Op. cit. p. 414.
  6 Lond. Med. Gaz.. April 29, 1845.     6 Lond. Lancet, Jan. 11, 1845, p. 36.
  7 Ibid. Dec. 14, 1844, p. 352.
  8 Charlton,  Retrospective Address, in Transactions of the Provincial Med. and Surg.
Association, xiv. 20.   Lond., 1846.
t 
CANNABIS INDICA.                    171
power to produce  relaxation  of the muscles, heavy sleep,  and
during its action, abatement of pain;1  and Wolff2 and  Ruhbaum,3
found it valuable in neuralgic affections.  Mr. Lynch* likewise
prescribed it with success in a case of neuralgia above and  around
the right orbit; and in an  epidemic neuralgia of the head, but
especially of the jaw, which prevailed around Rathenow in the last
quarter of the year 1847, Ruhbaum5 found great benefit from 16
to 20 drops of the  tincture of cannabis, which contained about a
grain of the alcoholic extract.   It has  also been given  in mania
with advantage, by M. Moreau.6   Dr. Conolly, it  appears,  in a
clinical lecture upon mental disorders, remarks, that  he believes
there is very little  of  the  genuine  Indian hemp now in Europe.
He thinks, that if his observation  of its effects in  the Hanwell
Asylum be not altogether erroneous, it must become an important
article of commerce.  After some careful trials of the tincture, he
feels justified in speaking well of it.   It is chiefly useful, he thinks,
in chronic cases.  A dram and a half, and  sometimes two  drams,
have frequently been given  in chronic cases of recurrent mania,
and although generally with good effects,  sometimes without any
whatever.7   By Dr. Corrigan, cannabis has been administered with
great success in chorea, in the Richmond Hospital, Dublin.
   With such evidence in its favour,  it is certainly important, that
Indian hemp should be  subjected to  a full and fair trial;  and even
admitting that it may fall short of the character given of it  by  Dr.
O'Shaughnessy  and others, it can scarcely  fail to be an important
addition to our Materia Medica.
   Dr. Churchill8 speaks favourably of  the powers of  cannabis in
checking uterine hemorrhagic discharges, from his own experience,
as well as from that of others.   The largest  class of cases in which
he found it of the  most unqualified  benefit was of menorrhagia,
where  the discharge,  although excessive,  is fluid, and  but little
mixed with clots, and "when the uterus is not enlarged.   In many
such cases, five drops of the tincture, three times a day, arrested
the  flow in  from twenty-four to forty-eight  hours.  In several
cases of threatened  abortion, when  employed  sufficiently early, it
succeeded remarkably well.  He prescribed it, too, in three cases
of cancer uteri, at  a tolerably early period, on account of conti-
nued draining of blood; and  he thought temporary relief  was
afforded.  It appeared to him to  exert an astringent power in
hemorrhages from mucous surfaces, and to have a sedative or ano-

  1 Provincial Med. and Surg. Journ., Aug. 20, 1842.
  * Schmidt, Op. cit. s. 155.
  3 Schmidts Jahrbiicher u. s. w., No. 9, Jahrgang, 1848, S. 277.
  ' Provincial Med. and Surg. Journ., April 1,  1843.
  s Schmidt's Jahrbiicher der gesammten  Medicin. Jahrgang-, 1848, No. 11 ; S. 155.
  6 Du Hachisch et  de l'Alienation Mentale,  Etudes Psychologiques;  Paris, 1845.
Noticed by Dr. Pliny Earle, in Amer. Journ. of the Med. Sciences, April, 1846, p. 423.
  ' Amer. Journal, loc. cit.            " Medical Times, May 12, 1849. 
172
CANNABIS INDICA.
dyne effect.   The preparation he invariably used was Mr. Dono-
van's tincture of the resin, with which  he begins  in  the dose of
five drops, three times a day, increasing it, in a few cases, to ten,
but  seldom more.   The effects  are very soon  seen, generally in
twenty-four or forty-eight hours;  often much  sooner.   In  some
cases, indeed, the effect was instantaneous.
   In consequence of Dr. Churchill's belief, that  cannabis possesses
powers similar to ergot in arresting hemorrhage from the uterus,
Dr.  Simpson' was induced to try, whether it is possessed of any
oxytocic property;  accordingly, he gave it in several cases of te-
dious labour,  and he states that parturient action  seemed to be
very markedly and  directly increased after its exhibition; but, far
more extensive and careful experiments would  be required before
a decided opinion could be attained in regard to its possessing such
powers, and their amount.
                 MODE OF ADMINISTRATION.
   The preparations used by  Dr. O'Shaughnessy are the follow-
ing:—
        Extractnm cannabis Indice alcoholicum.
         Resinous or alcoholic extract of Indian hemp.
   This  is prepared  by boiling the rich adhesive tops of the dried
Gunjah in alcohol  (-835) until all the  resin is dissolved.  The
tincture, thus  obtained, is evaporated to dryness in a vessel placed
over a pot of boiling water.   The mode of preparing the resin by
the Messrs. Smith,  of  Edinburgh, is given before.   The ordinary
dose of  the extract  is from two  to five  grains;  that of the  pure
resin of Messrs. Smith  appeared to them to be  active in  the dose
of two-thirds of a grain, although made with old gunjah.3
   In hydrophobia, the  resin  in soft pill, to the amount of ten to
twenty grains, is directed to be chewed by the patient, and to be
repeated according to the effect.

                Tinctura cannabis Indice.
                   Tincture of Indian hemp.
            R.  Extract, cannab. Indie, alcohol, gr. xxiv.
                Alcohol, dilut. f ^j.
   Of this a dram  is given in tetanus every half hour, until the
paroxysms cease, or catalepsy is induced.   In cholera, ten drops
given every half hour were often found to check  the vomiting and
purging, and  bring  back warmth to the surface.  Dr. O'Shaugh-
nessy's experience leads  him to prefer small doses of the remedy
in order to excite rather than narcotize the patient.

  * Monthly Journal of the Medical Sciences, July, 1850.
  a See, on all this subject, Bouchardat, Annuaire de Therapeutique, pour 1849, p. 51—
60.  Paris, 1849. 
CARB0 ANIMALIS.
173
                 Haustus cannabis Indice.
                  Draught of Indian hemp.
                 R.  Tinct. cannab. Indie, trt^ xv.
                     Alcohol, m, xlv.  M. ut f. haustus.
                                                 JDonovan.
  Mr. Donovan1 recommends that the patient should either swal-
low the whole of this directly from  the bottle, to avoid loss—or
pour it into a little water, and  instantly swallow it off.  If it be
not taken instantly, the resin will be precipitated—will adhere to
the vessel, and  thus escape  being swallowed, which always hap-
pens when the prescriber directs water to be mixed in the draught
by the apothecary; and Mr. Donovan says he has seen several dis-
appointments in consequence.
                  LII.  CARBO ANIMA'LIS.
Synonymes. Carbo Carnis, Caro Vitulina Tosta, Animal Charcoal.
French. Charbon Animal.
German. Thierische Kohle, Fleischkohle, Thierkohle.
  Animal charcoal is an ancient remedy, which has been revived
amongst ns.  The older physicians used several kinds, and recom-
mended them  in various diseases,  but  without  having any fixed
principle:  the  circumstances, indeed, that suggested their exhibi-
tion, in many cases, are entirely unintelligible to us of  the present
day.   In the old Wirtemburg Pharmacopoeia, we find  the Erina-
ceus combustus, or  "burnt hedgehog," as  an antihydropic;  the
Sericum tostum, or " burnt silk," and  the Hirundines combustce,
or "burnt  swallows," as antiepileptics; the Lepus combustus, or
" burnt hare," as an antilithic; the Reguliusti, or " burnt wrens,"
advised in nephritis and  calculous affections; and the Talpce com-
bustce, or  " burnt moles," at one  time much extolled in erratic
gout, lepra, scrofula, ulcers and fistulas!  All have properly fallen,
however,  into  oblivion  with  the profession, although there  may
yet be some who cling with pertinacity to  these relics of ancient
ignorance,  and  superstition.   The  "cancer remedy"  of Cosme,
into the composition  of which burnt shoe-soles entered, appears to
have  kept  up the employment of animal charcoal, as well as  the
" burnt sponge," Spongia usta, in which, however, the  charcoal
is of but little efficacy compared with the iodine it contains. These
were, perhaps,  the only forms in which animal charcoal was used
at the time when Weise, a German physician, revived its employ-
ment; and many physicians soon came forward to attest favourably
in regard to it.
                            1 Op. cit.
12 
174
CARBO ANIMALIS.
                   METHOD OF PREPARING.
   Weise gives the following method of preparing it:  Cut ribs of
 veal, with the flesh attached, into small pieces, and  put them into
 a drum for roasting coffee—turning the drum constantly whilst it
 is placed over the fire.   When  inflammable air begins to pass off,
 which is distinguished by the flame playing around the drum, the
 combustion must still be kept up a quarter of an hour longer.  If
 it be continued as long as  any inflammable air is disengaged, the
 preparation is inefficacious.  The  substance, most commonly met
 with under the name of " animal charcoal," is obtained by burning
 bones.  'The residue, when reduced to powder, is the well known
 substance bone black or ivory black.  This generally contains more
 or less phosphate of lime, according to the kind of bone from which
 it has been procured.  It is directed in the London Pharmacopoeia,
 and in the last edition of the Pharmacopoeia of the United States
 (1842,) to be  purified  by digestion in dilute muriatic acid, as fol-
 lows : Take of animal charcoal, a pound;  muriatic acid and water,
 each twelve fluidounces.    Mix the muriatic acid with the water,
 and gradually pour it upon  the charcoal;  then digest for two days
 in a gentle heat, occasionally agitating. Set aside, and pour off the
 supernatant liquor; then wash the charcoal  with repeated portions
 of water till no traces of acid are perceptible; lastly dry it.1  Char-
 coal, prepared  in this way, should be a combination of carbon, car-
 bonate and phosphate of  lime, hydrogen,  and nitrogen.  From an
 analysis, which Meurer made of animal charcoal, prepared accord-
 ing to Weise's formula, it contains, also, chloride of sodium and a
 little carbonate of soda, as well as a portion of iron.

                 EFFECTS ON  THE ECONOMY.
   In the case of a young man of scrofulous diathesis, Weise saw
 a tumour, of the  size of a hazelnut, and very painful, situate under
 the  nipple, disappear under the use of animal charcoal.  Accord-
 ing to him, its  efficacy is  strongly exerted on the uterus and mam-
 mas.  Rothamel  and Hohnbaum extol it in dyspepsia and gastri-
 cism, as well as in cases of diarrhoea.  In obstinate chronic glan-
 dular indurations, especially of the mammary glands, Weise affirms
 it to be a certain  remedy: he, at the same time, however, considers
 a regulated diet to be indispensable.  Scirrhus of the lips, he sa) s,
 also disappears under its use, and even scirrhous goitre, when the
 charcoal is associated  with  burnt sponge.   On  cartilaginous
polypi, it  is said  to have exerted a beneficial agency, and to have
diminished the  tendency of mucous polypi  to return  after opera-
tion.   Even  open cancer, it is  asserted,  has been healed by  it.2
On these  recommendations  of Weise, animal charcoal has been
  1 For the mode of preparation on the large scale, see Pereira, The Elements of Mate-
ria Medica and Therapeutics, 3d edit. i. 312.  Lond. 1S49.
  3 Riecke, Die neuern Arzneimittel, u. s. w. S. 104. 
CARBO ANIMALIS.
175
used by several German physicians, especially by Wagner, Kopp,
Pitschaft, Radius, Rothamel, Hesselbach, Gumpert,  Hohnbaum,
Fricke, Michaelsen, and Siebenhaar; and, as a general  result of
their observations, it would seem not to be devoid of therapeutical
agency; although many of  the experimenters failed in noticing
any  sanative effect from it.   Fricke, for example, did not observe
the least benefit in the very cases mentioned by Weise.   He gave
it, also, in  the  way of experiment, in several other cases,  but
without detecting the slightest influence on the organism.  Olher
physicians saw advantages from its use  in open cancer, but  these
were only transient.   On  the other hand,  the experience'of Wag-
ner, Kopp, Michaelsen, and  Rothamel would seem to show, that
it was  effectual in removing incipient scirrhus of the mamma.
Kopp employed it  successfully in scirrhous goitre, and  Pitschaft
in a case of what  he terms struma varicosa.  Radius  dispersed
under its use a considerable swelling of the submaxillary glands.
In scrofulous affections, especially in  scrofulous indurations  of
the glands, it is said to have proved useful in the hands of Kopp,
Rothamel, Speranza, Kuhn,  and others; but Baudelocque did  not
find it  possess any therapeutical property.1   Pitschaft,  in a deli-
cate, strumous woman, who was suffering  constantly under ozcena,
found it of eminent service after other remedies had failed. Radius
thought it aided the  absorption of a disintegrated cataract,  and
Siebenhaar saw g©od effects  from it in induration of the pancreas.
Riecke3  suggests, that farther trials may  show, that  it might  be
used in the place of iodine, which it appears to resemble in its ac-
tion on the economy, whilst it affects the organism less injuriously.
It is doubtful, however, whether the properties of the two sub-
stances can  be  regarded as  at all analogous, and whether animal
charcoal  be  possessed of any other properties than those usually
ascribed to prepared charcoal—carbo ligni.
                 MODE OF  ADMINISTRATION.
   Carbo animalis is given in doses of  from  half a grain to three
grains twice a day—commonly in the form of powder with sugar,
or with powdered' liquorice root.   Weise advises it to be sprinkled
on the  hard edges of cancerous ulcers, and Speranza  extols  an
ointment  made of charcoal, and oil, or simple cerate, as a discutient
in scrofulous swellings.
                 Pulvis  carbonis animalis.
                  Powder of animal charcoal.
                    R. Carbon, animal, gr. ij.
                        Glycyrr. pulv. gr. v.
                  F. pulvis.

  1 Dubois (d'Amiens.) Traite de Pathologie Generate, 2eme edit. p. 206.  Bruxelles'
]>:r>.                                        ' Op cit. 
176
CARBONIS SESQUI-IODIDUM.
      A powder to be given morning and evening in induration of the
    mamma.                                        Michaelsen.
                       R.  Carbon, animal, gr. vi.
                           Spofig. ust. gr. xij.
                           Glycyrrhiz. pulv. £ss.
                  M. f. pulv. in partes vi. aequales dividendus.
      A powder to be taken night and morning in scirrhous goitre.
                                                        Riecke.
                 R. . Carbonis animal, gr. iv.
                     Glycyrrh. pulv. 9iv,  M. et divide in part. viij.
      One of these to be  taken dry, morning  and evening, a  little
    water being drunk afterwards, in cases of scirrhous indurations
    of the mammas.  After the eight powders  have been taken, the
    dose may be increased gradually by half a grain, until it ultimately
.    attains four grains.   At the  same time, unirritating and spare diet
    should be inculcated.
                  Bolus carbonis  animalis.
                     Bolus of animal charcoal.
                 R.  Carbon, animal, gr. iij.
                     Ammon. muriat. pulv. 9j.
                     Ext. conii gr. ij.
                     ----glycyrrhiz. q. s. ut fiat bolus.
      One of these to be given three times a day;—in cases of swell-
   ing  and scirrhus of the prostate, and of the mucous membrane
   of the urethra.                                  Magendie.
            LIII.  CARBO'NIS  SESQUI-IODIDUM.
Synonymes.  Carbonis Sesqui-ioduretum, Iodidum Carbonis, Ioduretum
  Carbonii, Carbonei ioduretum, Iodoformum, Iodoforma, Carbonium seu
  Carboneum iodatum, Sesqui-iodide or Sesqui-ioduret of Carbon  Iodo-
  form.                                                 '
French.  Iodure de Carbone, Iodoforme.
German.  Iod kohlenstoff, Iodkohlenwasserstoff, Iodatherid,
  Formylsuper iodid.
  This preparation is  made by mixing concentrated alcoholic
solutions of iodine and potassa until the former loses its colour.
A solution is obtained, from which  the  addition of water  throws
down a yellow precipitate—the sesqui-iodide  of  carbon, which is
soluble ir. alcohol and ether, but insoluble in water.   The ethereal
solution yields large yellow crystals by slow evaporation.  It has
a sweet  taste,  and  a  strong, saffron-like odour.   Mitscherlich1
considers the taste very disagreeable.   M. Bouchardat gives the
following form  for its preparation.3  Take, of iodine, 100 parts;
bicarbonate of potassa, 100 parts; water, 750 parts;  alcohol,
  1 Traite de Chimie, traduit par Valerius.
  2 Annuaire de Therap. pour 1844, p. 116.  Paris, 1844;  and Nouveau  Formulaire
Magistral, p. 333.  Paris, 1845. 
CETRARINA.
177
250 parts: mix  the whole in a flask, which must be placed in a
water bath, the heat of which must be gradually raised, to favour
reaction.  When the liquor has lost its colour (sera decoloree,)
add, of iodine, 25 parts;  heat again; renew the addition of iodine
when the liquor has  lost its colour;  and, a short  time after the
point  has been passed at  which it no longer changes  by heat, add
a few drops of  a solution  of potassa, to deprive the liquor of
colour.   Filter, and wash  the precipitate produced, which will
consist  of crystalline  plates of iodoform, of a beautiful  citrine
colour.   The evaporated  liquor will yield a  large  quantity  of
crystals of pure iodide  of potassium.
   According  to M. Bouchardat, iodoform furnished  by this pro-
cess, will be as economical as any other product of iodine; and, he
does not doubt, it will occupy a useful rank amongst the prepara-
tions  of iodine employed  internally.
   Fifty grains, given by  Dr. Cogswell,1, to a strongly made terrier
dog, proved fatal; and, on dissection, the large vessels were found
congested;  the inner membrane was closely corrugated, and  the
apices of the rugae  were of a rose-red colour.  M. Bouchardat
gives it  in  the form of  pill, united with  extractum  absinthii in
scrofulous affections, and of lozenges.
           EFFECTS ON THE ECONOMY  IN DISEASE.
   The dose of iodoform is one grain three  times a day.  Dr.
Litchfield3  used  it with  advantage in  five  cases  of enlarged
glands;  in two of lepra, and three of porrigo, in the form  of
ointment composed of 3ss.  of the powder to 3vj. of simple cerate.
            Pulvis  carbonis  sesqui-iodidi.
              Powder of sesqui-iodide of carbon.
                        (Iodoform powder.)
              R.  Carbon,  sesqui-iodid.
                  Elaeosacchar. Vanill. aagij.
                  Sacchar. pulv. ^ij.  M.
   Dose.—Fifteen grains, three times a day, in scrofula.
                                              Bouchardat.3
                     LIV. CETRARINA.

Svnonymes.  Cetrarinum, Cetrarium, Cetrarin, Cetrarine.
French.  Cetrarin.
German.  Cetrarin, Moosbitter, Flechtenbitter der  Island-
  ischen Flechte.
  This substance was extracted from Cetraria  Islandica, by M.
Herberger, a pharmacien at Kaiserslautern.4

  » Essay on Iodine, p. 122.  Edinb. 1837.
  2 Lond. Med. Gaz., Aug. 183(5.
  * Annuaire, &c, pour 1842, p 129.
  4 Buchner's Repertorium, B. viii. H. 1, 1837. 
178
CETRARINA.
                   METHOD OF PREPARING.
  The coarse powder of celraria  is boiled for half an  hour in
four times its weight of alcohol at .883;  it is then left at  rest
until vapours cease to be given off, to  avoid the loss of the alco-
hol; when it is strained and pressed.   Three drains of muriatic
acid, previously diluted with water, are now added to  each pound
of the moss; this is mixed with from four times and a quarter to
four times and a half its bulk of water, and  the mixture is left at
rest for a night in a closed flask.   The next  day, the deep yellow
fluid, which swims above the copious deposite obtained, is poured
off; this deposite is the  impure cetrarin, the colour of  which is
more or  less greenish.  It is  now collected on a filter {chausse,)
left to drain as little as possible, and subjected to pressure.   To
purify it, it must  be divided  into  small fragments,  and  washed,
whilst still  moist, with  alcohol or ether, which deprives  it of
colour; it  is then  treated with  two hundred times its weight of
boiling  alcohol, in which the inorganic matter, that has hitherto
accompanied it,  is  scarcely soluble.  The  greater part of the
cetrarin  is gradually precipitated on the cooling of the  alcoholic
solution.   The  portion  which  still  remains in solution  may be
separated by the evaporation of the alcohol.
   One pound of cetraria, according to  Messrs. Ballard and  Gar-
rod,1 yields about two drams and a half of cetrarin.
   Pure  cetrarin is, at times, in  the state of a white  powder, re-
sembling magnesia; at others, in small globules united  in the form
of arborizations, which do not present—even under the microscope
—any crystalline  texture.  When gently  compressed,  it has a
slight  silky splendour.  It is neuter, light, unalterable in the air,
inodorous, and has a very intense, bitter  taste, especially in the
alcoholic solution.   Its best solvent is absolute alcohol, one hun-
dred  parts dissolving 1.70 of it at the boiling temperature, but
only 0.28 at 14° centie.  (58°  Fahr.)   Alcohol, at  .830 dissolves
0.44 when boiling; 0.28 at 25° cent. (77° Fahr.,) and only 0.04
at 14° cent. (58° Fahr.)   It is still less soluble in boiling and in
cold water, the essential  oils, creasote, &c.  It is somewhat more
soluble in ether, but insoluble in the fixed  oils.2

            EFFECTS  ON THE ECONOMY IN DISEASE.
   Miiller, of Kaiserslautern,3 details two  cases in which he  has
administered cetrarin.  One of these was a quartan,  the other,  a
tertian intermittent.   The effects appeared to be exerted more
slowly than those of quinia, but it  seemed to him not  to affect the
stomach  as  much.[?]  Its price must be considerably less, as M.

   1 Elements of Mat. Med. and Therap., p. 365.  Lond. 1845.
   * Journal de Pharmacie. xxiii. 505.   Paris, 1837; and  Bulletin General de Thera-
 peutique, No. 18, Sept. 30, 1837.
   3 H. Bruck, in Bulletin General de Therapeutique, No. 17, 15 Sept., 1837. 
CHIMAPHILA.
179
Herberger succeeded in obtaining, from a pound of cetraria, 135
grains of very pure cetrarin.  It has also been prescribed success-
fully in intermittents, by Regatelli and Von Lippich.1
  It has not been given, so far as the author knows, in this country.
                  MODE OF ADMINISTRATION.
  Miiller gave it in the form of powder, according to the following
prescription:—
              R.  Cetrarin.
                  Acacias aa. gr. ij.
                  Sacchar. Qss.  M. et fiat pulvis.
  Dose.—One of these every two hours, during the apyrexia.
  Bruck,2 suggests, that if dissolved in alcohol, its action may be
incomparably more potent, and that it may more  speedily arrest
the paroxysms of an intermittent, than when given in powder.
                LV.  CHIMAPHILA (FOLIA.)
Synonymes.  Chimaphilae vel Chimophilae Umbellatse Folia, Chimaphilse-
  Corymbosae Folia, Pyrola, Pyrolae  Umbellatse Folia, Winter Green,
  Umbellated Winter Green, Pipsissewa.
French.  Herbe a. pisser, Pyrole eh Ombelle.
German.  Die Blatter des  holdenbluht igen Wintergriins,
  Wintergrun-Blatter.
  This plant is  not  new to us; but numerous trials have  been
mad^ with it of  late  in Europe.   It is admitted  into  the Phar-
macopoeia of the  United  States, is a beautiful evergreen, and is
indigenous in the northern  parts  of Europe, Asia, and America.
It belongs to the Natural Family Ericinese of Decandolle; Pyro-
laceaB Lindley; Sexual System, Decandria Monogynia.  A  good
description of it is given by Barton.3
  The  leaves  have a bitter-sweetish taste, with some  degree of
astringency.  The taste of the stems and roots is, in addition, con-
siderably pungent.  Boiling water and alcohol extract the virtues
of the plant.  The constituents, so  far as ascertained, are  bitter
extractive,  tannic acid, resin, gum, lignin, and  saline  matters.
The active principle has not been determined.  It probably resides
in the bitter extractive—the resin  and  tannic acid, however, con-
tributing to its effects.4
            EFFECTS ON THE ECONOMY  IN DISEASE.
  The leaves of Chimaphila  were long  used by the Indians of
this continent, and from them the American physician was induced

  1 Aschenbrenner, Die neueren Arzneimittel, u. s. w. S. 71.  Erlangen, 1848.
  ' Op. cit.
  * Medical Botany, i. 17; see, also, Art. Chimaphila, in Wood and Bache's Dispensatory.
  4 Pereira's Elements of Materia Medica, &c, ii. 1333.  Lond. 1842; or 2d  Amer.
edit., by Carson.  Philad. 1846. 
180                      CHIMAPHILA.
to employ them.  The first regular treatise respecting the plant is
said to have  been a thesis of Dr.  Mitchell, published in the year
1803.1   In Canada, it is said to have been long used in diseases
of the urinary passages, especially calculus; in dropsy, and in
chronic gout and rheumatism; its effects appearing to resemble
—but not  to exceed—those marvellously ascribed to  uva ursi.2
Somerville3 and Barton extol it as an excellent diuretic in different
forms of dysuria, and in dropsies, especially such as succeed  to
acute diseases; in nephralgia as a palliative, especially when the
paroxysms are occasioned by gravel which has accumulated in the
kidney;  and even in vesical calculus.  During its use, the appe-
tite has improved, and the digestive powers have augmented ; the
patients  often experiencing—immediately after it was taken—an
agreeable sensation in the stomach, and in the  region of the kid-
neys.  Radius* found  it especially serviceable in  dropsy, gout,
and rheumatism; and in inordinate activity of the secretory
function of the mucous membranes—chronic catarrh,phthisis
pituilosa, &c.   According  to  him,  it  is  contraindicated  where
there is much fever, disposition  to diarrhoea, gastricism,  and great
debility of the stomach.   Heyfelder affirms, that it appears to be
advantageous in the debility of the digestive organs attendant
upon dropsy, but its diuretic effect is not considerable or enduring,
so that it requires to be associated  with more powerful agents.
   Experiments, which have been made in the Burger-hospital,  at
Pesth, and which  have been collected  by St. Rochus,  and pub-
lished by Windisch,  the director of the hospital, are extremely
favourable  to  the  chimaphila.   Within two years,  nearly two
hundred dropsical cases are said to have been radically cured by
it.   Windisch recommends it most  strongly to the attention of his
colleagues; he asserts  it to be one of the best diuretics we possess;
that it does not impair digestion;  moderately accelerates the cir-
culation ; gently encourages the action of the bowels, and power-
fully augments  the urinary secretion; that the patients willingly
take  it, and that it induces no nausea.   It was administered with
advantage in dropsies  unaccompanied  by fever, and not  dependent
upon organic mischief, upon " corruption of the humours or para-
lysis  of the lymphatic textures."  In febrile conditions and inflam-
matory diatheses, it is said to have been always injurious, as well
as when it was administered prior to the resolution of obstructions
remaining after long protracted intermittents; but when these are
removed, and no excitement exists,—more, according to Windisch,
is to be expected from  it than  from any other agent, and  he

   1 Barton's Collection, ii. 2.
   2 See the author's General Therap. and Mat. Med., 4th edit. i. 276.  Philad. 1850.
   * Medico-Chirurgical Transactions, v. 340.
   * Auserlesene Heilformeln zum Gebrauche fur praktische Aerzte und Wundiirzte,
u. s. w. S. 175. Leipz. 1836. 
CHIMAPHILA.
181
strongly advises, that careful trials should be made with it in the
proper cases.   He advises, also, that its use  should  be persevered
in, in order that good effects may be derived from it.
   The  author has frequently administered  chimaphila  in  public
and private practice, and has found it serviceable, where a tonico-
diuretic was indicated.   It is probably owing to its tonic proper-
ties, that it has been  found occasionally serviceable in scrofula.
                  MODE OF ADMINISTRATION.
   Chimaphila is given either in infusion, or, what  is preferable,
in decoction;  the dose in the day being from half an ounce to an
ounce of the  drug.  Where it does not  act sufficiently on the
bowels, Radius advises,  that a few senna leaves should be added.
In affections of the chest, he found the  addition of the  spirit of
nitric ether advantageous.  Generally, however, he gave it alone.
Windisch found a  combination of it with tartrate of antimony and
potassa, sulphuret of potassium, muriate of ammonia, squill, and,
in very great weakness, cinchona and preparations of  iron, ser-
viceable.   Radius often  administered, also, the  aqueous or  spirit-
uous extract.
                   Decoctnm chimaphilae.
                   Decoction ofpipsissewa.
             R.   Chimaph.il. ^j.
                  Aquae Oij.  (Oiss, Ph. U. S. and Lond.)
             Coque ad colatur. Oj.
   To be used daily in dropsy.                   Somerville.
   Dr. Joy1  adds to this two drams of Liquor Potassae Carbo-
natis, and directs  four table-spoonfuls of  the mixture to be taken
three  times a day.  He  recommends it "in  dropsy and  chronic
affections of the urinary organs," as if all these affections were
identical or even analogous pathological conditions!
             R.   Chimaphil. §ss. ad §j.
            Coque cum aquae f ^xij. ad reman, f ^vj.
            Coctione finita adde
                  Spiritus frumenti {gin, malt spirit or whisky) f §ij.
              Digere frigide per horas vj. et cola.
   Dose.—Two spoonfuls, to be taken four times a day, in dropsy
and gout.                                         Radius.
             R.   Chimaphil. ^vj.
            Coque cum aq. f §xij. ad reman, f §vj.
            Sub finem c'octionis adde
                  Fol. sennse gij. et cola.
   Dose.—A spoonful to be taken every two  hours.   Radius.
   A fermented decoction was used by Dr. Parrish, in the  Penn-
sylvania  Hospital, in  cases of  strumous disease, particularly
white swelling and similar affections of the joints.  According

  1 Tweedie's Library of Medicine, 2d American edit- vol. iii. p. 692.  Philad.  1842. 
182
CHLORINUM.
to Dr.  Carson,1 it makes an agreeable beverage.  A decoction or
infusion is first  formed with half a pound of chimaphila leaves,
to a gallon of water: a pound of sugar or half a pint of molasses,
half an ounce of powdered ginger, and some yeast are then added.
This mixture is placed in a tight vessel, and kept in a warm place,
until fermentation is accomplished.   Instead of the  ginger, or, in
addition to it, essence of spruce may be used.
  The dose is half a tumblerful three or four times daily.
                                               J. Parrish.
                    LVL  CHLORINUM.
Synonymes.  Chlorinium, Chlorineum, Chlorum, Chlorine, Murigene,
  Acidum  Muriaticum Oxygenatum  seu  Marinum  Dephlogisticatum,
  Spiritus Salis Marini Dephlogisticatus, Dephlogisticated Muriatic Acid,
  Oxygenated Muriatic Acid.
French.  Chlore.
German.  Chlor, Chlorgas.
  Uncombined  chlorine is  employed medicinally not  only in the
gaseous but in the liquid  state.   Each of these will be treated
in succession.   The forms  for evolving it in the  gaseous state, as
well as the gaseous chlorine itself, have  had various names as-
signed them  expressive of their  chemical  or medical properties.
They have been termed, respectively, Acidum muriaticum oxy-
genatum  ad  contagia;  Fumigatio muriatico-oxygenata;
Fumigatio Guyton-Morveauniana; Pulvis ad fumigationes
muriaticus;  Species pro vaporibus superoxydi muriatici;
Suffitus  oxymuriaticus; S. chlorini; Alexiterium Chlori-
cum, Fumigation de Chlor, F. de Guyton, F. Guytonienne,
F. Hygienique, &c.
                   METHOD OF PREPARING.
  Chlorine is obtained from  chlorohydric or  muriatic acid.   For
this purpose, one part of well pulverized peroxide of manganese
with five or six parts of concentrated muriatic acid, is put into
a retort, to which heat is applied, and the gas  received over water.
Or, it may be obtained from a mixture of one part of peroxide of
manganese, four parts of kitchen salt, two  parts of concen-
trated sulphuric acid, and four  parts of water.
  Chlorine is a greenish-yellow  gas; of a peculiar, strong, disa-
greeable, stifling odour.  The flame of a lighted taper introduced
into it becomes at first pale, afterwards red, and is ultimately ex-
tinguished.  It remains  unchanged in the highest  temperatures.
It has a great  affinity for hydrogen, so that  it  abstracts this gas
from every substance that contains it, and forms with  it  chlorohy-
dric acid.   Hence  it  decomposes  all  the  gases  that  contain hy-
drogen, and all organic colouring  matters, as well as—it is con-
ceived by many—miasmata and contagious matters.
  1 Pereira's Elements of Mat. Med. and Therap., 2d Amer. edit p. 391.  Phila. 1846. 
CHLORINUM.
183
                 EFFECTS ON  THE ECONOMY.
  Chlorine, when diluted, and  received into the  lungs, occasions
coughing, and symptoms of suffocation, to which a protracted ca-
tarrh often succeeds:  not unfrequently, too, we observe  in  those
who are compelled to be exposed to it, bronchitis and pneumonia.
Animals soon die when they are immersed in it.1   In Mr. Brough-
ton's experiments, mice exposed to it fell dead in less than thirty
seconds.  On opening them, the heart was found  palpitating; the
peristaltic motion of the intestinal  canal continued, and could be
kept up  by irritating it with  a  probe.   The vessels of the brain
were  collapsed.  The lungs  were  tinged with the  yellow colour
of  the  gas, and  the peculiar odour of chlorine was  perceptible
throughout their structure.   Coagulation of the  blood took place
as  under ordinary circumstances.   A rabbit, two or three weeks
old, was immersed in it, and  died in less than half a minute.   On
opening the thorax, the  heart  was found  acting freely, and on
puncturing the  aorta, the blood  jetted out forcibly to a  con-
siderable distance.   The peristaltic motion of the bowels was also
going on.  The vessels of the  brain  were in a  collapsed state.  The
lungs were very  much  distended,   tinged yellow, and, when re-
moved from the chest to a distance, emitted  the odour of chlorine.
The right ventricle of the  heart was distended with dark blood.
The eyes were much glazed  in  each experiment.  "It  has  been
generally thought," adds Mr. Broughton, " that  chlorine is inca-
pable of passing the epiglottis" [the glottis] "but from the above
observations it is evident that this  gas enters the bronchial tubes
in  the  act of  inspiration.   A  portion  of  it probably circulates
through the brain, suspending  the cerebral  functions  without di-
rectly destroying the action of the  involuntary organs,—contracti-
lity remaining long after the destruction of animal life, as is evinced
by the activity of the heart and of the intestinal  canal."3
    These very  facts, however, seem to show, that but little of the
gas enters the lungs;, probably no more than what passes imme-
diately preceding the closure of the glottis  by the forcible contrac-
tion of the arytenoidei muscles.  When inhaled  in a dilute state,
it is absorbed; and, according to Mr. Wallace, the urine acquires
bleaching properties.   It would appear, also, that, in  manufacto-
 ries, the chief  consequences from exposure to an atmosphere of it
are acidity, and other stomach  complaints,  which  the men gene-
rally remove by  taking  chalk:3 this fact  is confirmatory of the
 view, that acidity of the stomach is usually, if not  always, depen-
dent upon  excess in  the secretion   of the gastric acids, the most
important of which is the chlorohydric   When chlorine is inhaled,

   ' See Christison on Poisons, Amer. edit. p. 152.  Philad. 1845.
   2 Journal of the  Royal Institution, from Jan. to June,  1830.
   ' Pereira, Elements of Mat. Med. &c.,2d edit. i. 228, Lond. 1842; or 2d Amer. edit
by Carson, Philad. 1846. 
184
CHLORINUM.
it is reasonable to suppose that more of this acid may be secreted
in the stomach.
   The  irritating effects of chlorine become less and less, where
persons are exposed to the fumes, and workmen are able to carry
on their operations with impunity in an atmosphere impregnated
with it, where one unaccustomed to such exposure could not re-
main with impunity for more than a few minutes.1
                  MODE OF ADMINISTRATION.
   1. By  inhalation.—In  the way of inhalation, chlorine gas is
never administered in a state of purity, but always diluted with
atmospheric air; often, too, it is united with watery vapour.  Gan-
nal affirms, that the workmen in a  bleaching  establishment, who
suffered under diseases of the chest, were visibly improved, and
ascribed the amelioration  to  the  inhalation of air containing it.
He,  therefore, instituted various experiments on consumptive in-
dividuals, from wThich good results, he conceived, followed.  Sir
James Murray2 also mentions, that  a friend of his had  observed
similar effects among his workmen  who were exposed to the inha-
lation of watery vapour strongly impregnated with chlorine.  The
experiments, however, which were instituted at La Charite, in
Paris, on this mode of treating phthisis, were by no  means en-
couraging ;  and the same may be said of those at the Hotel Dieu
of that  city, instituted by Rullier.3  In  many cases, indeed, the
disease appeared to be aggravated.   Bayle, likewise, thought the
inhalation of it generally unfavourable, although he asserts that he
cured a  case of tubercular phthisis with it.  Since then, it has
been recommended by Cottereau.   Professor  Albers,*  of Bonn,
who administered it repeatedly, and carefully watched its effects,
conceives, that it acts  as a stimulant when  applied  to the  mem-
brane, but that, when  it gets into the blood, its effects are anti-
phlogistic; and he is of opinion, that when there is no hsemoptysis
or violent local irritation present, chlorine inhalations may be used
in  diseases of the lungs and air-passages.   Its stimulant  effect
gradually diminishes, and,  after a time, the  mucous surfaces of the
lung become less sensible to its exciting influence.    In tubercles
of the lung, chronic catarrh, chronic inflammation, and ul-
ceration  of the  bronchial mucous membrane,  and in  dilata-
tion of the bronchi, he found it of no service; and, in most  cases,
it could not be borne, in  consequence of the irritation it  induced;
but  its  operation was very salutary in pure ulceration of the
lungs, or vomica.  It had always, however,  to be  administered

 1 Christison, A Treatise on Poisons, 1st Amer. edit. p. 616.  Philad. 1845.
 2 A Dissertation on the Influence of Heat, &c, Lond. 1829; cited in the Dub. Jour.
of Medical Science, for March, 1839, p. 96.
 3 See, also, Pereira, Op. cit. p. 229; and E. J. Coxe, Practical Treatise on Medical In-
halation, p. 83.  Philad. 1841.
 4 Hannoversch, Annalen, 1836, cited in Brit, and For. Med. Rev. July, 837,  p. 215. 
CHLORINE.
185
cautiously and experimentally.  Dr. Stokes always found chlorine
inhalations prejudicial in phthisis, as they produced, in every case,
increase of bronchial irritation, dyspepsia, and arrest of the pul-
monary secretion.   In his trials of the remedy in gangrene of the
lungs,1 he found  it decidedly beneficial, correcting the fcetor  of
the breath  and  expectoration, and, therefore, calculated to obviate
not only the local but  the constitutional symptoms.   Sir James
Clark2 is of opinion, that the inhalation of chlorine has only pro-
duced relief in  persons whose lungs have been diseased to a very
limited extent.   Dr. A. T. Thomson3 considers it " the best topi-
cal expectorant, and the most salutary excitant to  the  mucous
membrane  of the lungs that has yet  been inhaled;" and Dr. Chris-
tison4 affirms, that he has tried the  practice repeatedly; and al-
though, like Dr. Elliotson, he has  witnessed "such amelioration
as he never saw before  under the  use of narcotics or any other
means," he has not met  with any instance where the amelioration
was permanent.   Such,  likewise, has been the  experience  of the
author.  Dr Pancoast informed him, that a case of aphonia oc-
curring in a young lady, in which there was but little voluntary
power over the diaphragm, was cured by the inhalation of chlorine,
after the galvanic  plates and  the electro-magnetic apparatus had
been used in vain.
   Chlorine may be inhaled from a common dish or inhaling appa-
ratus, by dropping any of  the acids on a mixture  of chlorinated
lime, so that the gas may be disengaged slowly; but the best me-
thod of inhaling it, as well as iodine, is that  recommended by Dr.
Corrigan.5   He properly remarks, that, in order for inhalation  to
have a fair trial, it is requisite, first, That the apparatus  should
be simple in its construction, and easily kept in order.  Secondly,
That it should  be  capable of keeping up a supply of vapour for
any length of time, and that  the evolution of the vapour should  be
steady and  easily  regulated.   Thirdly, That it should also fur-
nish a sufficient supply of aqueous vapour to prevent any irritation
of the larynx, or lining membrane of the air-tubes; and, fourthly,
and most important of all, that its  employment should entail nei-
ther trouble nor fatigue  on the invalid.

  1 Dublin Hospital Reports, vol. v.
  2 Treatise on Tubercular Phthisis, p. 84, Lond. 1834; also, Amer. edit. Philad. 1835.
  3 Elements of Mat. Med. and Therap. 2d edit. Lond. 1835.
  ' Dispensatory, p. 312.  Edinb.  1842.
  s Dublin Journal of Medical Science, March, 1839, p. 94.
v 
186
CHLORINE.
                                    To  fulfil  these objects,  Dr.
                                 Corrigan advises the apparatus
                                 represented  in  the marginal fi-
                                 gure.  It consists of a light open
                                 iron-wire frame, about  eighteen
                                 inches  high, at the  bottom of
                                 which is a spirit-lamp, A: at the
                                 proper height above it is an  eva-
                                 porating porcelain dish, about six
                                 inches  in  diameter,  B:  above
                                 this is a glass globe, C, with its
                                 neck downwards.   In  the neck
                                 of the globe is a cork, D, bored,
                                 and  through   the   opening  is
                                 drawn, moderately tight, a short
                                 plug of cotton  wick, such as is
                                 used in a spirit lamp: in the glass
   mmmmmMimm.   globe at E,  opposite the neck, is
drilled a pin-hole,  to  allow air  to  pass in, according  as  the fluid
within drops out through the neck.   To use it, the porcelain  dish
is filled with hot water, the spirit  lamp is lighted, and as soon as
the water  in the dish has begun to boil, the glass globe containing
chlorinated lime, (if  this be the substance  used,) is placed as in
the illustration.   The rate, at which the fluid in the globe shall
percolate the cotton  wick and.drop  into the hot water beneath, is
easily regulated.   If it should  not drop  with sufficient  .rapidity,
one or two of  the  threads of cotton may  be removed.   Should it
drop  too rapidly, this is  corrected   by pressing in the  cork more
tightly, or introducing one or two  additional threads of wick.
   Eight ounces of a  saturated solution of chlorinated lime may
be poured  into the glass  globe; and into the  water of the  porce-
lain dish, two ounces of the diluted sulphuric acid of the phar-
macopoeia.   As the  solution drops, the  acid  seizes on the lime,
and the chlorine is evolved in connexion with  aqueous vapour.1
   Chlorine is but little used in this form, and  can  only be adapted
for cases in which  the pathological condition of the bronchial  mu-
cous membrane, or neighbouring parts,  requires the  exhibition of
an excitant.2   In  this way, it  may be occasionally serviceable in
chronic bronchitis;  but its administration requires great caution.3
In cases of poisoning by hydrocyanic acid, as well as by sulphu-
retted hydrogen, it is a most efficacious agent.  Chlorinated lime
may be used for this purpose.

  1 London Medical Gazette, April 6, 1839, p. 49.
  s Toulmouche, in Revue Medicale, Avril, 1834. See, on  the various modes of inha-
lation, Sir C. Scudamore, in Lond. Med. Gaz., Feb. 7, 1840,  and E. J. Coxe, Practical
Treatise on Inhalation.  Philad., 1841.
  8 Archives Generates, Avril, 1834; and a communication on the excellent effects of
chlorine vapour in catarrh, in Gazette Medicale de Paris.  June, 1838. 
CHLORINUM.
187
  2. By Fumigation.—Fumigations of chlorine have been par-
ticularly recommended by Dr. Wallace, of Dublin.1   They appear
to resemble, in  their action,  the nitrous  and nitro-muriatic acid
baths, and  have  been especially employed in liver  diseases, un-
accompanied by inflammation, but in which there is a disturbance
of the biliary secretion.  According to Wallace, they are more
certain than ablutions and  baths of nitro-muriatic acid, and have
the advantage, that their  application subjects the patient to less
inconvenience.2   The good effects of chlorine, in such cases, have
likewise been tested by  Zeise,3  in his bathing  establishment at
Altona.   WThen chlorine is brought in contact with the  skin, in
this way, it soon occasions a  pricking sensation;  increase of tran-
spiration;  great afflux of  fluids  to  the surface of the body, and
sometimes a pustular eruption;  increased secretion of saliva, urine,
and bile;  slight inflammation of the mouth and fauces, and  im-
peded respiration and circulation.  Dr. Mettauer is disposed to re-
fer the action of the compound, in  every case, to the presence of
chlorine, and to believe, with Dr. Scott, of India, who first intro-
duced the  nitro-muriatic acid  to notice,  about thirty-three years
ago, (1817,) that a solution of chlorine in  water will  answer, in
all cases, as well as the acid.   In the last edition of  the Pharma-
copoeia of the United States, the following formula has been intro-
duced for  the preparation  of  the  Acidum  Nitro-muriaticum.
Take of Nitric acid, f giv.,  Muriatic acid, f Sviij.  Mix them
in a glass  vessel,  and, when effervescence has ceased, keep  the
product in a well stepped glass bottle, in a cool and dark place.
   Dr. Wallace found chlorine fumigations serviceable not only in
hepatic diseases with disordered secretion of the liver, but in
several other morbid conditions, as hypochondriasis, cachexia,
and in all  affections in which a prolonged excitation of the skin,
and a restoration  of its suppressed  or impaired  functions are es-
teemed serviceable,—hence,  in  old cases of syphilis, scrofula,
chronic catarrh, and rheumatism.  Generally, cathartics were
combined  with  the  fumigations, and the  evacuations  were con-
stantly observed to present a highly bilious character. In chronic
cutaneous affections, as in  lepra, psoriasis, and  scabies, these
fumigations have been found  useful;  but, generally, fumigations of
sulphurous acid are employed in  preference, in consequence of the
greater facility with  which they can be prepared.4
   Injections of chlorine gas have been employed for the radical
cure of hydrocele by M. Deblois, of Tournay, and M. Deconde.s

  1 Researches respecting the Medical  Powers of Chlorine, &c.  Lond. 1822.
  2 See. on the Nitro-Muriatic Mixture, as a remedial agent, J. P. Mettauer, American
Journ. Med. Sciences, Feb. 1840, p. 291.
  ' Nye Hvgea udsived af C. Otto, 1825, and Hufeland und Osann's Journ. der prakt.
Heilkund. 15. Ixiii. St. 1.
  ' Green on Diseases of the Skin, American Library edit. Philad. 1838.
  1 Bulletin Medical Beige, Janvier, 1836. 
188
CHLORINUM.
The gas is contained in a bladder, to which is attached a pipe and
stop-cock adapted to the canula of the trocar, into which it is fixed
after the fluid is evacuated; the stop-cock is then turned, and the
bladder pressed so as  to force  the gas into the tunica vaginalis.
When  this is distended, the pipe and bladder are removed, and the
thumb is placed over the mouth of the trocar, so as to prevent the
issue of the gas for the space of two minutes;  it is then allowed to
pass, and two or three repetitions of the injection are made, which
are sufficient for the cure.   It would appear, that risk must be in-
curred from the injection of such an acrid  substance, but M. De-
conde says not.
   Fumigations of chlorine, with the view of destroying the mat-
ter of contagion, and  of preventing  the spread of contagious
diseases, have long been used.1  As long ago as the year 1773,
they were proposed for these  purposes;  and were subsequently
extensively used by Guyton  de  Morveau; hence  they have been
called the ll Guy Ionian," or " Guyton Morveau fumigations."
In  fumigating the extensive general  penitentiary at Milbank,
Westminster, Dr. Faraday adopted the following method.  One
part of common salt was intimately mixed with one part of black
oxide  of manganese; the mixture  was placed in a  shallow
earthen pan, and  two  parts of oil of vitriol, previously diluted
with"two parts by measure of water, were poured upon it,—the
whole being stirred with a stick.  Chlorine was liberated for four
days.   The quantities  of the  ingredients employed were 700
pounds of common salt, the same quantity of oxide of manganese,
and  1400 pounds of sulphuric acid.2
   Whatever may be the  virtues of chlorine fumigations  as an
antibromic or smell destroyer,  experience would seem  to have
shown that they are useless in  preventing the spread of zymotic
diseases.  Possessed, as all the preparations of chlorine are, of po-
tent antibromic virtues,  it was natural to suppose, that they might
equally destroy morbific miasmata, and therefore be valuable pre-
ventives of cholera, and other zymotic maladies.  In the fever of
the Niger, they wrere fully tried and totally failed, and there is no
reason to believe that  they are more effective  in other forms.
Some years ago, chlorine was employed at the Small Pox Hospi-
tal, London, with the view of arresting  erysipelas in the wards.3
The offensive smell was  removed as usual, but the propagation of
the disease appered to be unaffected.  During the progress of cho-
lera  on the  continent  of Europe, in 1831 and  1832, extensive
trials were made with  it, but without any beneficial result.4  At

  1 Link, Art. Chlor. in Encyclop'ad. Worterb. der medicin. Wissenschaft. B. vii. S. 575.
Berlin, lf-31.                                a Pereira, Op. cit. p. 228.
  3 Pereira, Op. cit., 3d edit., i  371, Lond. 1849.
  4 Dierbach, Die Neuesten Entdeckungen in der Materia Medica, i. 411, Heidelberg
und Leipzig, 1837. 
CHL0RINI AQUA.
189
a time  when the Cholera  Hospital at Moscow, was filled with
clouds of chlorine,1 the greatest number of attendants was attacked;
and similar facts were noticed  by distinguished observers in Ber-
lin and elsewhere.2
  When chlorine is evolved in the  manner  above described, it is
liable, like all the  acid gases, to the objection, that it is extremely
irritating when respired.  It cannot, therefore, be used in the sleep-
ing apartments of the sick, although it may be employed  benefi-
cially after they have  been  withdrawn, and the object is to disin-
fect the chamber.  It  ruins all polished surfaces, but  this can be
effectually obviated  by  painting  them over with  a compost of
starch.   The chlorides are not liable to the same amount of objec-
tion, as they exhale the chlorine slowly.
                  LVII. CHLO'RINI AQUA.
Synonymes.  Aqua Chlorinii seu Chlorinei seu Chjorata seu Chlorinica
  seu Chlori seu Oxymuriatica seu Oxygenata muriatica seu Oxygeno-mu-
  riatica, Liquor Chlori seu Chlorini seu Acidi Muriatici Oxygenati seu
  Alexiterius Oxygenatus, Chlorum liquidum, Solutio Chlorinii seu Alexi-
  teria Oxygenata, Solution of Chlorine, Liquid Oxymuriatic Acid.
French.  Chlore Liquide, Eau de Chlore.
German. Chlorwasser,  Wasseriges Chlor, Chlorflussigkeit,
  D ephlogistisirte oder Oxydirte Salzsaure, Uebersaure
  Salzsaure, Oxydirt Salzsaures Wasser.

  This  preparation  is contained in many of the foreign pharma-
copoeias.  It is in those of Austria and Anvers;  and in the Bata-
vian, Bavarian, Belgian, Danish,  Dublin, Edinburgh, Parisian,
Finnish, Hanoverian, Polish, Prussian and Swedish.3  It has been
more extensively administered on the continent of Europe than in
this country or in Great Britain.
                   METHOD  OF PREPARING.
  The  Prussian Pharmacopoeia directs chlorine gas, made after
the manner before  described, to be passed into  the bottles of a
Woulfe's  apparatus  filled with distilled water, until two-thirds
of the water are displaced : the bottles are corked under water, and
the water is agitated until it takes up the gas.  The liquid is then
drawn off into small bottles,  which are well filled,  and kept in a
dark place.   In this way, liquid  chlorine may be kept  for a long
time undecomposed.   In its preparation, some little chlorohydric
acid is formed, so that it  has  at times to be purified by treating it
with a solution of nitrate of silver.

  1 A lbers, Lond. Med. Gazette, viii. 40.
  2 Gerardin and Gaimard, Du Cholera-Morbus, 3 erne edit., p. 110, Paris, 1833, and the
author, in Report of the Sub-Committee on Cleansing the city (Philad.,)  p. 15, Phila.
1849.                  " Pharmacopce Universale, i. 405. Paris, 1828.
       13 
190
CHLORINI  AQUA.
   The process of  the  Dublin Pharmacopoeia is  similar to this.
That of the Edinburgh Pharmacopoeia differs;  and is as follows:
Take of Chloride of sodium, sixty grains; Sulphuric acid (com-
mercial,)  two fluidrams; Red oxide of lead, three hundred and
fifty grains;  Water, eight fluidounces.  Triturate the chloride of
sodium and oxide together; put them  into the water contained in
a bottle with a glass stopper; add the acid, and agitate occasionally
till the red oxide  becomes almost  white.   Allow the insoluble
matter to  subside before using the liquid.
           EFFECTS ON THE ECONOMY IN  HEALTH.
   From  experiments made by Orfila1  on  dogs, it appears, that
considerable doses of a moderately concentrated solution of chlorine
prove  fatal by  exciting, sooner or later,  inflammation  of the
stomach, accompanied with great languor;  and when death takes
place very rapidly, signs of organic alteration are met with in the
stomach.   In its  action on the economy, chlorine  is closely allied
to the acids, and  especially to the chlorohydric.   Introduced into
the stomach  in  moderate doses, solution of chlorine  excites  an
agreeable feeling of warmth,  which soon spreads over the whole
of the body: in strong doses, according to L. W. Sachs, a kind of
intoxicating stupor is induced  by it,  soon succeeded by prostration.
It has been  conceived  to act  equably as a  moderate excitant of
the nervous system, and thereby to moderate inordinate action in any
part; and is, to a certain extent,  antiphlogistic, without possessing
any of the debilitating qualities of  the  antiphlogistics proper.
In the opinion of some  of the German  pathologists, it powerfully
stimulates the organic actions, especially the lymphatic and glandu-
lar systems, moderating inordinate secretion.  Its antiseptic pro-
perties are likewise considerable.  It would appear, however, that
the  number  of observations   has  not been  sufficiently great—
although they have been by no means few—to allow of any com-
prehensive appreciation of its exact modus  operandi  on the hu-
man organism.2

           EFFECTS ON THE ECONOMY IN DISEASE.
   Although solution of chlorine is properly no new remedy, it is
only of late  years  that it  has been frequently administered.   At
the present day,  in some countries, it is in common use.  It is not
long since Meurer maintained, that it  is impossible to administer
chlorine internally, and that in every case in which it was believed
to have been  given, the article really taken was chlorohydric or
muriatic acid; for,  owing to  the affinity  of chlorine  for hydro-
gen, whenever any union takes place between it and organic mat-
ters, the chlorine, he affirmed, disappears, and chlorohydric acid
alone exists, as he  had proved by repeated  experiments.  In this

  1 Toxicologic Gen6rale, i. 141.
   * Riecke, Die neuern  Arzneimittel, u. s, w. S. 30, Stuttgart, 1837. 
CHLORINI  AQUA.
191
assertion, however, he was opposed by many observers.   Herzog
and Barmann came forward with experiments, to show that Meu-
rer had gone too far in his deductions; and, from all the experi-
ments, it would  appear, that in prescribing aqua chlorini many
mistakes had been, and—we may add—still are, committed.   From
Barwald's experiments, it w7ould appear,  that if water which has
rested on aromatic or other vegetable substances be chosen for the
dilution of the solution of chlorine instead of distilled water, a dif-
ference is produced  in the  rapidity of the decomposition.   In a
mixture of aqua chlorini, distilled water, and simple syrup, the de-
composition takes place tardily; but if, in  place of  syrup, a muci-
laginous juice be substituted—for example, the syrupus althseae—
acids are speedily formed; as well as when a decoction of althaea
is substituted for distilled water; whereas a mixture of decoction
of salep, (gr. v. to  water  gj.) syrup, and  aqua chlorini, in well
stopped bottles, remained undecomposed above twenty-four hours.
In these experiments, however, the  persistence of the smell and
taste of the chlorine exhibited, that the whole of it had not been con-
verted into  chlorohydric acid.  In the same manner as in the case
of the decoction of marsh-mallows, the addition of  infusum sennse
and infusum Valerianae, as well as of the solutions of extracts, and
especially of liquorice, destroyed the smell of the aqua chlorini in-
stantaneously, even when  the  taste of chlorine could  still  be de-
tected.  When  the  solution  wTas  combined with remedial agents
that  contained  much colouring matter,  the  decomposition took
place with great rapidity.  From the results of these experiments,
Barwald advises aqua chlorini  to be  given in admixture with dis-
tilled water and simple syrup,  as in  this  way only can we be sure
that the patient has  taken the chlorine undecomposed.   Herzog
lays it down as  a rule, that the solution of chlorine should only be
mixed with  colourless transparent substances—water, simple syrup,
gum  Arabic or decoction of salep.
   In  respect to its administration in  disease, it may be well to
speak first of its internal use, which, in several  morbid conditions,
seems to have rendered good, and in some cases eminent, service.
The  following are the diseases  in which it has been chiefly recom-
mended :—■
   Irritative fever,—as in the  violent  irritative fever that occurs
during the period  of dentition; in which  it has been administered
with  great success by  Kopp,  Mehlhausen, Goden, Trusen, and
Riecke.1  Dangerous determinations  to  the  head have  been, in
this way, obviated, along with  the unpleasant complications which
are  apt  to be occasioned thereby.  ToeTe exhibited it in  convul-
sions during dentition, which  were accompanied by too great ac-
tivity of vessels ;  and he affirms, that he has prescribed no remedy,
which, in all respects, answered so well.
   ' Op. cit. S.  30.           2 Archiv. d. med. Erfahrung. Marz und April, 1825. 
192
CHLORINI AQUA.
  Mrvous fever, especially when tending to the putrid character.
In the  plague,  according to Wagner, it is of no  avail; but in
putrid fever, according to Kopp, it is highly useful.  Spangenberg
observed good effects from it in an epidemic typhus with hepatic
derangement.   It is likewise extolled  in  typhus by Wolf, Braun,
Hufeland, and others; and by Sacco in  the fever called petechial,—
itself a  typhus.  Of late, it  has been much used in Germany in
typhus  abdominalis, which  corresponds to our typhoid fever, to
oppose  the origin and  development  of the  intestinal ulcerations;
but when the disease is farther advanced it has been found useless.
It is especially recommended in this  disease by Clemens, but he
commonly  premised the use of  an emetic.   Trusen considers  the
emetic unnecessary.  He first applies  leeches to the epigastrium,
and  then prescribes immediately  aqua  chlorini in considerable
doses;—in lighter  cases, a  dram every two  hours; and if the
disorder of the head be  already great,  the tongue chapped and  the
peculiar expression of  countenance present, he  gives two drams
every  two hours.   Bartels  is  less satisfied with  the action of
chlorine in abdominal typhus.  It raises,  he  says, the sinking
powers very speedily, but often excites the sanguiferous system,
and not unfrequently increases the abdominal symptoms so palpa-
bly, that the  physician is  compelled  to have  recourse  to other
agents.  Riecke1 thinks, however, that it may be of essential ser-
vice in  this disease, which so frequently mocks the best directed
efforts of the practitioner; and  he suggests, that farther experi-
ments  are highly desirable, especially as those instituted by Trusen
and others are not  free  from objection, by reason of their having
associated substances with chlorine that quickly decompose it.
   Carbunculus  malignus  (Milzbrandkar bunkel.)—In  the
variety of malignant anthrax caused by handling the skins of cat-
tle, the  internal and external use of chlorine  has  been found of
essential service by Ettmiiller, Herbst, Stumpf, and  Hoffmann.
The benefit derived from its use externally, in this and similar
affections, induced  Dr. Cramer3 to try its effects on  bad furuncu-
lous sivellings, the progress of  which  was surprisingly expedited,
and the extension of the ulceration much limited, compared with
what occurs under  the use of poultices.
   Scarlatina.—Pfeufer, Wendt, Kopp, and Trusen extol it highly
in this  disease for which, on theoretical grounds, it would seem
to be   appropriate, by reason  of the great  turmoil in  the  san-
guiferous system,—indicated  by rapidity of pulse and inordinate
evolution of heat,  which bear but little direct ratio to  the degree
of vital energy.  Braithwaite, who, it is asserted, was one of the
earliest, if not the earliest, that  advised chlorine in scarlatina, sup-
  ' Op. cit. S. 33.
'  2 Casper's Wochcnschrift, No. 8, cited  in Brit, and Foreign Medico-Chirurg.  Rev.
July, 1850, p. 278. 
CHLORINI AQUA.                    193
posed that it acted as specifically as the bark in intermittent, or
mercury in syphilis !  and Trusen asserts that it may  be  advan-
tageously used in cases where other remedies have been found
ineffectual.  It is especially recommended by Braun and Spiritus
in malignant scarlatina.  Dr. Watson1 says, that from several dis-
tinct and  highly respectable sources, chlorine has been strongly
pressed upon his  notice as a most valuable remedy in the severest
forms  of  scarlatina.  His informants have stated, that  whereas
they formerly dreaded to be summoned to cases  of that disease,
they now, having had experience of the virtues of chlorine, felt no
misgivings in undertaking its treatment.  Dr. Watson himself has
not had opportunities enough for trying it to  speak confidently of
its sanative power, but presumes that its disinfecting properties may
account in part  for the good  it does.   It probably deprives the
foul secretions of their noxious quality.   The author has often used
it, but, in highly malignant forms of the disease, like every other
agent, it fails.   He  gives it internally;  sponges the surface with
it; and employs it, or a solution-of chlorinated lime or chlorinated
soda, as a gargle. Dr.  Cramer saw great relief follow its applica-
tion  to the neck, in  a  case of this disease in a child, in which
suffocation was impending.  He kept compresses well soaked in it
to the  part.
  In other febrile affections—small-pox, measles, rubeola, &c.—
it has been prescribed  with advantage; and Dr. SchneiderJ strongly
recommends it as a gargle in small-pox and angina.  He  applies
it diluted  with water,  and finds it exert a remarkable ectrotic effect
over variola  when affecting the tongue and throat; and over an-
gina in general.   In putrid dysentery,  (faulige Ruhr,) it  is
extolled by Nysten and Kopp; and in  intermittent, by Kopp and
Kretschmar.   Trusen recommends it in  the  irregular, and  espe-
cially in the  anticipating forms, where danger exists of their be-
coming continued.  Under its use, he found the paroxysms  become
regular, with perfect  apyrexia, so that the ordinary febrifuges could
be  given  advantageously.  In gastric fever, Trusen trusted to it
solely  for the removal of the disease; he found  that it corrected the
morbid secretions from the mucous membrane of the digestive tube.
Other  physicians have also derived equally favourable results from
its administration in that malady.
  In gastromalacia, it has been  prescribed  by Rhades,  Blasius,
and  Winter,  but  as Riecke,3—from whom this detail of the expe-
rience of the German practitioners has been chiefly taken,—properly
observes^ farther observation is necessary before we can decide as
to its efficacy in  such cases.
  In erysipelas,  especially of children, it has been recommended
by Kopp.

  1 Lectures on the Principles and Practice of Physic, 2d Amer. edit., p. 1024.  Philad.
1845.
  2 Cramer, Op. cit.                        3 Op. cit. S. 34. 
194
CHLORINI AQUA.
           In inflammation of the liver, favourable results were  obtained
        from it in the Children's Hospital at St. Petersburg;  and it exhi-
        bited, in these cases, the analogy to  calomel  in its action, which
t       has  been pointed out by many observers.
           In hydrophobia, it has been used both internally and externally
        as a preventive, especially by the Italian physicians Brera, Previ-
        tali,1 Ghisaldoni, Agliati, Arrigoni, Narcisi, and Anelli,  whose
        experience is in its favour.   Wendelstadt and Ruppius have like-
        wise published favourably regarding it.  It is obvious, however,
        that much fallacy may arise as to the precise agency of reputed
        preventives.  Every one, for example, who  may  be  bitten by a
        mad dog is not attacked with hydrophobia; and, unless great cau-
        tion be used, any article may be  regarded as a preventive.  This
        is the  main reason  why we have  so many preventives of this and
        other diseases.
           Solution of chlorine has been advised by Ruppius and Mertzdorf
        in dropsy, especially such as supervenes on the acute exanthemata.
           In the diathesis phthisica, it has been recommended by Goden,
        and has been affirmed to moderate the hectic in phthisis, and  to
        make  the   remissions more  marked.   In  these cases, it  requires
        to be  given in  large doses, and to be exhibited for a considerable
        time.
           In many cases of chronic cutaneous affections with diminished
        plastic energy, it has been used with success  by Kopp.
           In noma  or  cancrum oris, and  in fcetor  of the mouth, it has
        been recommended internally as  well as topically; and, according
        to the experiments of Persoz, Nonat, and others, it  renders emi-
        nent service in cases of poisoning by hydrocyanic acid.
           Externally, it is used either pure, diluted with water, or in com-
        bination with oil.  Godier affirms, that he cured strumous swell-
        ings of the glands  by a  cerate of  chlorine.  Eisenmann,  Culle-
        rier, and Blache recommend it—at times pure, at others  diluted—
        in the way of injection, in gonorrhoea and leucorrhoea.   It is em-
        ployed, also, in flabby, putrid, and offensive ulcers,  in  carbuncu-
        lus malignus, and  in chronic cutaneous affections—as  tinea capitis,
        itch (Deimann,) herpes (Alibert,) asthenic aphtha, &c.
           In large abscesses  and in buboes, great advantage  was derived
         by  Mr.  Cramer2 from its external use.  The matter  was at times
        absorbed,  and when this was not  the case, the progress of the case
         was still very favourably influenced.
           Lastly: ablution with a solution of chlorine, or of the  chlorides,
         has been  advised  as a preventive of venereal infection. . In can-
         cerous ulcers, it corrects the unpleasant odour, and excites a new
         action in the part, causing the secretion of better pus: farther than
         this, we cannot expect much from it.  Baths of it are recommended
         by  Wagner  as  an excellent means for  preventing the plague.
           1 Pratiche  Osservazioni sull' Idrofobia, &c. Milan, 1820.       2 Op. cit. 
CHLORINI AQUA.                    195
Schonlein advises, that in scarlatina the whole surface of the body
should be washed with a mixture of aqua chlorini and water, which
he prefers to ablution with cold water.
  Finally: aqua chlorini is occasionally sprinkled in the sick cham-
ber, to purify the atmosphere during the prevalence of contagious
or other diseases.
                 MODE  OF ADMINISTRATION.
  As already remarked,  whenever  aqua chlorini is prescribed, its
facility of  decomposition  must be  borne in mind.  It is, for this
reason, best to prescribe it, for internal  administration, with wTater
only,1  or at  most with the addition of  simple syrup.  For exter-
nal use, water alone should be associated with it.  As to the pre-
cise mode in which chlorine is affected by fatty substances, we  have
as yet  no accurate knowledge; it maybe calculated, however, that
part undergoes decomposition.  Such combinations have, notwith-
standing, been found useful.
  The solution should never be prescribed in quantity larger than
is necessary  for  twenty-four  hours, as  by frequently opening the
vessel  in which it is contained, decomposition readily ensues.  The
vessel  should be put in a dark place, and be surrounded  by black
paper.
  The average dose for an adult, in the twenty-four hours, may be
fixed at an ounce, although much larger quantities may  be given
without inconvenience.   It is scarcely necessary to say that the
precise dose must vary with the degree  of concentration.

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

              linimentum  aqurc  chlorini.
                     Liniment of chlorine.
                 R.  Aqua? chlorin. fgj.
                     Olei olivae f |j.  M.
  Externally, in obstinate itch, tinea capitis, and herpes.
                                  Deimann £f G. A. Richter.
                   R.  Cerae  albse gij.
                I^ni calor. liquef. adde
                       01. amygdal. q. s.
                ut flat linimentum cui refrig. adde
                       Aq. chlorin. ^iss. M.
  Used externally in ulcers.                         Ludwig.
  ' Lepage, Journ. de Chimie Med. cited in Encyclop. des Sciences Med. Janv. 1842.
p. 22. 
196                     CHLOROFORMUM.

               Gargarisma  aqua  chlorini.
                      Gargle of chlorine.
               R.   Tragac. pulv. gr. xij.
                    Aquae f §iv.          >
                    Aquae chlorin.
                    Syrup, aa. f ^ss. M.
  To be used as a gargle in ulceration and chronic inflammation
of the mouth and fauces.                             Ratier.1
                 LVIII.  CHLOROFORMUM.
Synonymes.  Chloroforma, Carboneum chloratum, Superchloridum for-
  mylicum, Chloroform, improperly called, by some, Chloric ether,2 and
  Terchloride of Carbon.
French. Chloroforme.
German. Chloroform, Fo rm yl superchl o r id.
  This preparation, which was admitted  into the Supplement of
the last edition of this work, has acquired  fresh interest, in conse-
quence of its introduction and extensive employment as an anaes-
thetic in the same cases'as sulphuric ether; which it has indeed, in
the practice of many, wholly supplanted.
                   METHOD OF PREPARING.
  Chloroform was discovered separately and about the same period
by Mr. Guthrie,3 M. Soubeiran,4 and Liebig.5  It is obtained in
the following manner, according to  the process of  Mr. Guthrie.
Into a clean copper still put three pounds of chlorinated lime, and
two gallons  of  well  flavoured alcohol,  s. g. -844,  and distil.
Watch  the process, and  when  the product ceases  to come  over
highly sweet and aromatic, remove and cork it up closely in glass
vessels.  The remainder  of the spirit should be distilled off for a
new operation.   These  proportions  are  not essential:  if more
chlorinated lime be used, the ethereal product will  be increased;
nor is it  necessary  that the proof of the spirit should be very high.
Mr. Guthrie says he " has commonly used the above  proportions
and proof, and has  every reason to be satisfied with them." From
the above  quantity he has commonly obtained  about a gallon of
ethereal  spirit.
  It may be obtained also in the following manner.6  One part of
hydrate  of lime is suspended  in  24 parts of cold  water,  and
chlorine is passed through the mixture until nearly the whole  lime
is dissolved.   A little more hydrate is then  added to  restore the
  1 Formulaire Pratique  des Hopitaux Civils de Paris, 3eme edition.  Paris, 1827.
  1 Dierbach, Die neuesten Entdeckungen in der Materia Medica, iii. 930, Heidelberg,
und Leipzig, 1847.
 . 3 Silliman's Journal, xxi. 64, Jan. 1832. ~~~
  4 Annales de Chimie et de Physique, xlviii. 131. Paris, 1831.
  6 Ibid. xlix. 146.  Paris, 1832.
  * Fownes, Elementary Chemistry, p, 339.  Philad. 1845. 
CHLOROFORMUM.
197
 alkaline reaction: the clear liquid is mixed with one part of alcohol
 or wood spirit, and after an interval of 24 hours is cautiously dis-
 tilled  in  a very spacious vessel.   A watery liquid containing a
 little spirit, and a heavy oil collect in  the  receiver;  the  latter,
 which  is the  chloroform,  is agitated with water, digested with
 chloride of calcium, and rectified in a water bath.
 * The most fragrant form is obtained by the action of chlorinated
 lime on alcohol.  Dr. Christison1 gives the following mode of pre-
 paring the article, which he and others  have used so successfully
 as an anaesthetic.  One pound avoirdupois of bleaching powder,
 with three  pounds of water and three  ounces of rectified spirit,
 yields, by distillation  in  a  roomy vessel, about nine  fluidrams  of
 crude  chloroform of the density 1-220.  After this, the residuum
 begins  suddenly to froth up.   The  crude chloroform, which  is
 covered in the receiver by a stratum of weak spirit, is purified by
 shaking with it half its volume of sulphuric acid, gradually added;
 and  water and alcohol being thus removed, the strong chloroform
 is freed of  a little sulphuric acid by redistilling it from milk  of
 lime or baryta.   The product, which is pure chloroform, if the
 process be well conducted, amounts to about half a fluidounce. Dr.
 Christison has  not  found the  quantity to be increased, as some
 have represented, by increasing the quantity of alcohol.
  Chloroform  is a  transparent, colourless fluid, of the specific
 gravity 1*480; of a  peculiar, fragrant, ethereal odour, resembling
 that of apples; and of an ethereal, slightly acrid, intensely sweet,
 taste.   It  speedily  evaporates; and boils at 140° Fahr.   It  is
 readily soluble in alcohol and  ether, but  only  in  2000 parts  of
 water.   It  dissolves volatile oils, camphor, caoutchouc, wax, and
 resins.  Its most frequent  adulteration is with  alcohol, which  is
 easily detected by the reduction of its density.
  Dr.  W. Gregory,2 however,  ascribes the injurious effects of the
 chloroform  in ordinary use  to the presence of certain volatile oily
 impurities, which must  be  removed before it can be  safely em-
 ployed.  These oils contain chlorine, have a disagreeable  smell,
 and, when inspired or smelt, cause distressing headache and  sick-
 ness.  The test  recommended  by Dr. Gregory  for these impuri-
 ties is  to agitate the chloroform with sulphuric acid, which should
 be quite colourless, pure, and of the full density of 1*840 at least.
 This, when agitated with impure  chloroform, becomes yellow  or
 brown, from its  action on the  oils, which it  chars and destroys.
 Any change of colour is readily seen  by the  contact  with the
 colourless chloroform that  floats above.  Pure chloroform gives
no colour to the acid.   Dr. Beatty3 accords with Dr. Gregory  in

 ' Dispensatory, Amer. edit, by R. E. Griffith, p. 974.  Philad. 1848.
 2 Monthly Journal of Med. Science, May, 1850, p. 414; or Amer. Journ. of Pharmacv
Oct 1850, p. 328.                                                 y'
 ' The  Dublin Quarterly  Journal of Med. Science, August, 1850. 
198
CHLOROFORMUM.
the belief, that we have thus in our power a very simple means of
testing and purifying chlorofbrm before employing it.
                EFFECTS ON THE ECONOMY.
   The medical properties of chloroform are like those of sulphuric
ether, than which, when  sufficiently diluted,  it possesses a more
agreeable taste, so that it is readily taken even by children.  Dr.
H. Hartshorne1 experimented with it on himself and others when
in health.  He found that seventy-five drops gave him a sensation
of general diminution of  consciousness and  sensorial  capacity.
Sight, hearing, and touch were made less impressive; but no feel-
ing  of exhilaration  or perversion  occurred.  He was drowsy.
The pulse was not at all  accelerated; it was, indeed,  two beats
slower in the minute;  and the same effects were observed in two
other medical gentlemen, from two or three  times  the quantity.
One took over two hundred drops.  He became very heavy, and,
in a short time, passed into a sound sleep.   In all of them, the
influence had departed after an hour or two.  No one felt as if he
had taken alcohol, and in none was the pulse increased; and the
conclusion with all of them was, that it is a direct sedative to the
encephalic nervous system,—a sedative narcotic.
   Chloroform is said to have been used with advantage in asthma,
spasmodic  cough, atonic isthmitis, " and  other  diseases in
which a  grateful and composing medicine is indicated."2 In cases
of cancer it has been given internally in the dose of two or three
drops  by Mr. Tuson,3 and  has produced sleep and perfect  ease.
As a local application to the cancerous part its action was of a
sedative character.   He  also gave it with advantage  in uterine
irritation or neuralgic affections of the uterus.  In  such cases,
he prescribed  it  internally, but in others, attended with obstinate
discharge, it ought to be injected aswTell.  In obstinate vomiting,
three drops have  " at once taken effect;" and in such cases Mr.
Tuson has  found benefit  from applying it to the pit  of the sto-
mach.  In cancer of the pylorus, "it has proved most efficacious
in preventing the  return of the food, and in relieving the pain and
suffering of the patient."  In sloughing ulcers, he has  used  it
extensively, and he is not  acquainted with a remedy more bene-
ficial.   " In phagedasna,  there cannot be  a  more useful local
application;  but  care  should  be  taken to apply  it only to the
sloughing parts."   " In fungoid disease,  the application of the
chloride  of carbon has  been very remarkable."  Mixed  with
water, it is said  to form a very useful gargle in foul ulcerated
sore-throat, removing the fcetor, and giving the ulcers a  healthy
appearance.  It is also, according to Mr. Tuson, of the greatest use
   1 Amer. Journ. of the Med. Sciences, p. 353, Oct. 1848.
   2 Dispensatory of the United States, 6th edit., p. 1212.  Phrlada. 1845.
   5 Lond. Lancet, July 15, 1843, p. 553, and The Structure and Functions of the Fe-
male Breast, p. 410.  Lond.  1846. 
CHLOROFORMUM.                     199
in affections of the gums and teeth, " removing the unpleasant
stinging pains produced by the exposure of some nervous filament;
and its use not  only gives ease, but removes any unpleasant fcetor
from  the  breath."  Such is a picture—doubtless overdrawn by
Mr. Tuson—of the efficacy of chloroform as a remedial agent.
   As a narcotic, chloroform has been given internally in asthma?
spasmodic cough, cancer, uterine irritation, hysteria,2 neuralgia,3
chronic vomiting from nervous causes, such as that which occurs
in pregnancy,  and  in  short wherever sulphuric ether  has been
found of service.
   As a sedative  and soothing external application it  has been
used  in open cancer, sloughing ulcers, orchitis,4 neuralgia,5 neu-
ralgic tooth-ache,6 lumbago,'2 painful pelvic tumours;8  and as a
collutory in fcetor oris; and internally it has been prescribed in neu-
ralgia,9 flatulent colic; in cough, as an addition to  pectoral mix-
tures; and by M. Delcoux, in intermittent fever, who ascribes to
it febrifuge and antiperiodic virtues.   Soon  after its discovery, it
was  prescribed by the Doctors Ives,10 of New Haven, in asthma,
spasmodic cough, scarlatina, and atonic quinsy, and with favour-
able results.
   But its  most  interesting and important  application  is as an
anaesthetic agent administered in the way of inhalation.   As long
ago as the year 1832 it was employed  in this manner by Professor
Ives,11 of New Haven, in a pulmonary affection attended with great
debility and dyspnoea, which was effectually relieved  by it; but no
farther attention  appears to have  been paid to it until Professor
Simpson,12 of the University of Edinburgh, instituted trials with
it, and other anaesthetic agents, and found it infinitely more effica-
cious  than any.   In his first publication, after having tried it on
upwards of fifty individuals,  he detailed  some  striking  cases  of
midwifery and  surgical practice, in which it had been inhaled with
the  most  satisfactory results.   The   main advantages which he
conceived it to possess over sulphuric ether, were ;—that a much
less quantity is needed;  that its action is much more rapid and

   * M. Guillot, cited in Christison, Op. supra cit.; and Dispensatory of the United States,
8th edit., p. 1243.   Philad. 1849.
   3 Formby, Christison's Dispensatory, p. 975. Philad. 1848.
   3 Mr. Tuson, Op. cit: also Wahu, Annuaire de  Medecine, et de Chirurgie pratiques,
pour 1850, p. 15.
   4 Buisson, L'Union Medicale, No. 4, cited in Brit, and Foreign Medico-Chirurg. Rev.
July, 1850.
   'Ranking, Half-yearly Abstract, ix. 219, Amer. edit.  Philad. 1849.  Tuson, Op.
cit.; Hays and Bond, Transactions of the College  of Physicians of Philadelphia, vol. 2,
No. 6; "and Laroque, Bulletin de Therapeutique, Mars, 1849, p. 209.
   6 Pigeolet, cited by Wahu, Annuaire  de Medecine, et de Chirurgie pratiques, pour
1849. p. 247.
   1 L'Union Medicale, 21 Oct. 1848.                8 Ibid. 31 Octobre, 1848.
   9 H. Hartshorne, Amer. Journ. of the Med. Sciences, Oct. 1848, p. 353.
   10 Silliman's Journal, xxi. 406.           " Ibid.
   Ia Account of a new anaesthetic agent as a substitute for sulphuric ether in Surgery,
Edinb. 1847. 
200
CHLOROFORMUM.
complete, and generally more persistent; its inhalation more agree-
able and pleasant; and that being required in much less quantity,
it is more portable  and transmissible than  sulphuric  ether;—that
recovery is usually more speedy, leaving fewer unpleasant feelings ;
and  that  it does not excite irritation of  the bronchial tubes, is
pleasant to the taste, and does  not leave a  disagreeable  taint of
the breath.  As soon  as the  discovery  was promulgated by Dr.
Simpson, the inhalation of chloroform was largely employed in all
cases in which the inhalation of ether had previously been directed.
Experiments were made by numerous  observers,—by Dr. Simpson1
himself, Dr. Snow,2 M. Sedillot,3 Mr. Wakley, jun.,4 Mr.  Gruby,5
MM. Dumeril  and Demarquay, M.  Amussat,6 M. Gerdy,7 M.
Jobert,8 Mr. F. Sibson,9  M. Coze,10  and  others, to  determine its
physiological action; from  all of which it  appears, that whilst
chloroform is a  much more potent agent than sulphuric ether, its
action as an anaesthetic is essentially the same ; MM. Dumeril and
Demarquay in their experiments on animals  state, that ether  and
chloroform  are  rapidly fatal, when inhaled in very large quantity.
Dogs were destroyed in thirty-five or forty-five minutes, and even
in less time, by  chloroform.  When the inhalation  of chloroform,
like that of ether, is carried beyond a certain point, it is capable
of producing death; and  if not  to this extent, convulsions  and
profound insensibility.  Certain  persons appear, too, peculiarly
susceptible to its influence, so that disagreeable, and even  danger-
ous  phenomena  may present  themselves, when  least  expected.
Many  such cases  have been recorded;—the disagreeable effects
being chiefly,—vomiting, especially when the inhalation has been
used soon after eating; headache, continuing  for several hours;
hysteric or  tetanic convulsions, and formidable depression of the
heart's  action.   The ordinary effects are described  by Dr. Chris-
tison11 as follows:—When inhaled in the dose of twenty or thirty
minims  from a  handkerchief, it speedily occasions  whizzing  and
pulsation in the head ;  a change in the apparent colour of objects;
pleasurable ideas and  visions;  loss  of consciousness, or  a semi-
conscious state, and either soft sleep,  or tendency to laughter and
jocularity, or propensity to  incoherent talking, or boisterous tur-
bulence;  and when this state passes off, which  happens in five or
six minutes  at  most, there is little or no recollection of what has
passed, and no  remembrance of pain,  even although pain may have
  1 Monthly Journal of Med. Science, Dec. 1847.
  a Lancet, Feb. 12, 1848, and May 13, 1848.   3 Comptes rendus, p. 802. 4 Ibid.
  5 Bulletin des Academies.                 6 Comptes rendus, Nov.  29, 1847.
  1 Comptes rendus, p. 803.
  * Ibid. p. 806.  See, also, Amer. Journ. of the  Med. Sciences, July, 1848,  p. 227.
  9 Lond. Med. Gaz., Feb. 1848.
  10 Bouchardat, Annuaire de Therapeutique. pour 1850.  p. 38.
  11 DispensatoryJAmer. edit., by R. E. Griffith,p. 975, Philad. 1848. See, also, a let-
ter from Dr. Christison to M. Dumas, in Bouchardat, Annuaire de Therapeutique, pour
1849, p. 76. 
CHLOROFORMUM.
201
been expressed.   These  phenomena closely  resemble  in  nature
and variety the effects of the inhalation of nitrous oxide gas.  The
effect on the heart's action is variable.  The most frequent devia-
tion, witnessed by Dr. Christison, is, some increase in the frequency
and  diminution in  the force of the pulse; but often  no distinct
change takes place, and occasionally the  pulse is  strengthened.
When a dose of a fluidrarr^ or more is inhaled in  the  same man-
ner, the most frequent effect is the rapid induction  of  coma, with
complete relaxation of  the  muscles; slow and often  stertorous
breathing; upturning and fixing of the eyes, and total insensibility
to agents which cause, in ordinary  circumstances, the most acute
suffering. The pupils are variously affected, but always contractile.
Frothing at the mouth is not unusual.  Slight convulsive twitches
of the face and limbs are more rare.  The insensibility may begin
in fifteen seconds, and is rarely postponed beyond two minutes, if
the chloroform be skilfully applied.  It continues usually between
five and ten  minutes, but sometimes for two hours, if the inhala-
tion has been kept up for some time by renewing the chloroform on
the handkerchief.  Sometimes quiet sleep succeeds; more generally
a drowsy, dreamy state, but not unfrequently rapid, complete con-
sciousness  and  activity.   In general, no recollection  is retained
of any  occurrence during the state of insensibility.  For the most
part, there is no remarkable  subsequent effect; no lassitude;  no
headache; no sickness; no loss of appetite; but occasionally there
is a little weariness or sickness.
  Such is the statement of one who is partial to the administration
of chloroform.  He admits, however, that other results have been
observed, which he regards as anomalies,  depending upon consti-
tutional  peculiarities or  impurities in  the  chloroform.   "I  have
witnessed," he remarks, "violent tetanic spasm twice in the healthy
state;  and  once in delirium tremens, but without  any ill conse-
quence : hysteric agitations, contortions, and screaming, have also
been witnessed, but without any ultimate harm; and during both
of these affections there has  been no  recollection afterwards of
any  uneasiness. Sickness and vomiting have sometimes occurred,
chiefly, according to my observation, when the remedy was used
too continuously so as greatly to obstruct the breathing.  Relaxa-
tion of the  sphincters is an untoward  accident, which  is not so
frequent as might be expected.  The only  really formidable affec-
tion is sinking of the pulse, as in the case adverted to above;  and
this seems a rare occurrence."
  It is undoubted, however, that unpleasant and  even alarming
phenomena  have  been produced by it  in  the experience of Mr.
Beales,1  Mr.  R. Stewart,2 Mr. W.  W. Gull,3 Dr. Mitchell,4 Dr.

  1 Lond. Med. Gaz., Dec. 24, 1847.     * Ibid. Jan.  1848.    3 Ibid. Dec. 1847.
  4 Ibid. Jan. 1848, from Dublin Med. Press. 
202
CHLOROFORMUM.
Nevins,1 Dr. Reed,2 Mr. Tomes, Dr. Webster,3 (insanity induced,)
Dr.  John Snow,4 Dr. C. H. Cragin,5 M.  Miction,6 Delarue,7 and
others, and fatal cases ascribed to its deleterious agency have been
recorded by Mr. Meggison,8 Dr.  R. Jamieson,9 Mr. Robinson,10
M. Gorre,11 Dr. Anderson,12 M. Robert,13 R. O. Johnston,14  M.
Confevron,15 and others.18
   According to  M.  Gruby, during the, inspiration  of chloroform,
the arterial blood retains its florid hue, and  if, under asphyxia,  it
assumes  the dark venous  character,  the red colour  is speedily
restored; yet by others17 a highly venous appearance of  the blood
issuing from the arteries has been noticed; and M. Robin18 ascribes
the anaesthesia induced by it and ether to their preventing the com-
plete conversion of  venous into arterial blood.  Like ether, chlo-
roform is capable of inducing  local  anaesthesia,19 by dipping the
part in it,  or  applying it  externally by  means  of  lint,—a fact,
which  was noticed before it was  employed as an anaesthetic in the
way of inhalation, and led to its use as a local agent by Mr. Tuson
and others.   Its influence  in  deadening  the sensibility of a part
has been recorded also by M. Gruby,20 Mr. Nunnely,21  Dr. Simp-
son,22 Mr. Spry,23 M. Jules Roux,24 Mr. Higginson25 and others.
   No sooner were the anaesthetic properties promulgated by Prof.
Simpson than it  was employed in all the cases in which the inhala-
tion of ether had been prescribed.   It was given in the  various
   Neuroses.   In

  1 Lond. Med. Gazette, Mar. 1848.      a Lancet, April 29, 1848.
  1 Lond. Med. Gazette, Jan. 1850, and Psychological Journal, April, 1850.
  4 Edin. Med. and Surg. Journal, cited in Amer. Journ. of the Med. Sciences, July,
1850, p.  169.        v '     s Med. Examiner. April, 1848, p. 223.
  6 Archives Generates de Medecine, Juillet, 1850, p. 370.
  'Ibid.  Sept. 1850, p. 105.
  • Med. Times, Feb. 5, 1848.          9 Lond. Med. Gaz., Feb. 26, 1848.
  10 Medical Times,  cited in Ranking's Half-yearly Abstract,  Amer. edit. viii. 220,
Philad. 1848.
  11 Lancet, July 4, 1848.  See a fatal case, occurring in Cincinnati, in Western Lan-
cet, Mar. 1848; and another at Hyderabad, in Scinde, in ibid., July 22, 1848.  n Ibid.
  13 Cited in Medical Times, July 22,1848.
  14 Provincial Medical and Surgical Journal, July 26, 1848.
  '• Cited in Lancet, Nov. 17, 1849.
  18 Lond. Med. Gazette, Jan. 1849.  See, on the injurious and fatal effects of chloroform,
J. C. Warren, Amer. Journ. of the Med. Sciences, April, 1849, p. 379; and Effects of
Chloroform and of strong Chloric Ether, as narcotic agents, Boston, 1849; Dr. Snow and
others, in Amer. Journal of the Med. Sciences, July, 1849, pp. 274-278 ; also, a Dis-
cussion before the Academy of Medicine of Paris, on the action of Chloroform, by MM.
Malgaigne, Amussat and Guerin, cited in Med. Times, Nov,25, and Dec. 2,1848, and
Lancet, Feb. 2, 1849; and  in Bouchardat, Annuaire de Therapeutique, pour 1849, p. 90.
  " Provincial Med and Surg. Journ., Feb. 9, 18K
  18 Archives Generates de Medecine, Fevrier, 1850, p. 238.
  18 Boston Med. and Surg. Journal, April, 1848.
  20 Lond. Med. Gazette, Dec. 24, 1847.
  21 Provincial Medical and  Surgical Journal, June 28,1848.
  23 Monthly Journal of Med. Science, 1847-48, p. 451.
  53 Provincial Medical and Surgical Journal, Aug. 28, 1848.
  M Gazette des Hopitaux, 7 Nov., 1818.
  24 Lond. Med. Gazette, Jan. 1849. 
CHLOROFORMUM.
203
   Tetanus, successful cases were recorded by  Mr. Geo. Sloman,
Mr. R. L.Baker3 and Dr. E. H. Clarke.3   M. Forget4 and M.Jules
Roux5 refer to seven cases of cure, against six  of want of success.
Dr. C. A. Worthington6 has reported a case in which it  afforded
great relief, but  did not prevent the fatal termination.
   Hydrophobia.  One case of this almost intractable malady has
been  recorded in which it  was  successful; and others7 in which
it greatly relieved the intense suffering  from the spasms; but  on
the other hand, in a  case by Mr. S. B. Denton8 it augmented them.
A case of hydrophobic mania was  treated happily with it by Mr.
R. Y. Ackerley;9 and  one of presumed hydrophobia, under the
care  of  Professor Jackson10 of Philadelphia, is reported as having
been cured by it.  Dr. Jackson inclines  to the belief  that the case
was  one of true hydrophobia;  but the  published details do not
lead  the author  to the same conclusion.   In
   Neuralgia, it was prescribed with advantage, by Dr. Protheroe
 Smith,  Mr. Sibson11 Dr. D. Brainard,12  and others; and in
    Chorea, by Mr. Harris13 and Mr. Sibson.14
   In delirium  tremens, by Dr. P. Smith; and it was used  with
great success  in inducing sleep, by Dr. Joseph Parrish15 and  Dr.
Whiting.'6
   Insanity.   Dr. M'Gavin17 and Dr. E. B.  Moore'8  found  it an
excellent sedative and hypnotic; and  in sick  headache, Dr. P.
Smith prescribed it with advantage.  It  was also given with great
benefit in typhus, as a sedative and hypnotic,by Dr. Fairbrother,19in
   Asthma,  by Mr. Chandler,20 Mr. Greenhalgh,21  and Dr. Cra-
gin;22 in
   Hooping cough, by Dr. Protheroe Smith; in
    Colic, by  the same gentleman, and by Dr.  Cragin;23 in
    Nephritic colic,  by Drs. Bowditch and A. Stille;24 in

   1 Provincial Med. and Surg. Journ., Sept. 5, 1849.
   3 Ibid , May 31,1848, and Lancet, June 3, 1848.
   3 Amer. Journ. of the Med. Sciences, July, 1849, p. 75.
   4 Cited in Canstatt und Eisenmann's Jahresbericht, u. s. w. im Jahre, 1849, v. 190,
  Erlangen, 1850.      i
   1 Revue Medico-Chirurg. Nov. 1848, cited in Bouchardat, Annuaire de Therapeutique,
  pour  1849, p. 101.          • Provinc. Med. and Surg. Joum., April 19, 1848.
   1 Ranking's Half  Yearly Abstract, &c, viii. 212,  Amer. edit., Philad. 1848, and T.
  T. Smiley, Med. Examiner, April, 1848, p. 223.
   8 Provincial Med. and Surg. Journ., Oct. 31, 1849.     9 Lancet, July 29, 1848.
   10 Transactions of the College of Physicians of Philadelphia for January and April,
  1849.                      n London Med.  Gazette, March 31, 1848.
   12 North-Western Med. and Surg. Journal, Sept.  1849.
   13 Lancet, June 3, 1848.               " London Med. Gaz., Feb. 4, 1848.
   Is New Jersey Medical Reporter, July, 1848.
   '« Ohio Med. and Surg. Journ,, March, 1849.  See, also, Zeitschrift fur die Gesammt.
  Medicin, April, 1,-50,  No. 4, S, 553,
   " Report of Montrose Asylum, 1848, cited in Monthly Journal of Med. Sci., Oct. 1848.
   18 Boston Med. and Surg. Journal, April 4, 1849.
   " Lancet, Jan. 28, 1848.      " Provinc; Med. and Surg. Journal, Jan. 29, 1848.
   81 Lancet, Dec. 4, 1847.     *■ Medical Examiner, April, 1848,  p. 227.   *  Ibid.
   14 Transactions of the College of Physicians of Philadelphia, vol. ii. No. 6. 
204
CHLOROFORMUM.
   Biliary calculus, by Dr. P. Smith; in
   Dysmenorrhcea, by the same  gentleman, and by Drs. J. H.
 Bennett1 and Dr. Withers;2 in
   Bronchitis, by Mr. Brown;3  in
   Cholera morbus,  it has been  employed  successfully by  Mr.
 Brady and Mr. Plummer;4 and in
   Cholera, by Dr.  James Hill, Dr. Ferguson,5  and Dr. A. Bour-
 nonville.fi  With others, however, as Dr. W. Robertson,7  it has
 only succeeded in relieving the distressing cramps.  Lastly, in
   Feigned diseases, it has  been  used in  the way of detection;
 but the  same objections apply to  it  as  to other  anasthetics.
 (See page 71.)
   In regard  to the employment of  the inhalation of chloroform as
 an anaesthetic in  surgical operations, the same remarks are appli-
 cable  as were made on  sulphuric  ether.   Wherever a  powerful
 anaesthetic,  anodyne  and relaxant was needed,  chloroform  has
 been had recourse  to,  and the  highest testimonials have been
 brought forward  in its favour by  the most distinguished  surgeons
 of all countries.   On this side the  Atlantic, ether inhalation is,
 perhaps,  more employed,-and  is generally considered safer;  but
 there  are many  who  prefer chloroform.8  In obstetrical  practice
 it has  been  largely administered; and  the  same objections have
 been urged against  its employment  in a natural process, as in
 the  case  of  sulphuric ether.9   Since its first introduction by  Dr.
 Simpson, it has been extensively used in Edinburgh, to subdue the
 sufferings of  childbearing; and it is impossible to extol any agent
 more highly than it has been.  " Its effect," says Dr. Christison,10
 " is  perfect,  and may be maintained  uninterruptedly for  many
 hours, without influencing the frequency or  force of the uterine
 contractions,  and without any  eventual harm.   It is only when
 the deepest coma, with suffocative stertor, is brought on, that the
 uterine contractions are apt to be arrested for a time;—a property
 which may be taken advantage of to facilitate  the  operation of
 turning."
   From a careful and dispassionate inquiry into its effects in such
 cases, Dr. Murphy11 is of opinion, that it does not  interfere with

  1 Lancet, Feb.  19, 1848.     2 Western Journal of Med. and Surg., Feb. 1849.
  3 Lancet, Dec. 4, 1847.
  4 London Med. Gazette,  Sept. 16, 1848.  6 Dublin Med. Press, Nov. 8 and 18,1848.
  3 Medical Examiner, Aug. 1849.   * Monthly Journal of Med. Science, Dec. 1848.
  8 On the Value of Anaesthetics, and especially of Chloroform in Surgery.  See Sur-
gical Experience of Chloroform, by James Milter, F.R.S.E.  Edinburgh, 1848.  Prof.
 Lizars, Med. Gazette, June 8, 1849, and the Reports of the Committees on Surgery in
Transactions of the American Medical Association, vols. i. and hi. Philad. 1848-50.
  * See page 72,  and Ranking's Half-yearly  Abstract, vii. 252.  American edition,
Philad. 1848, for  the views of Drs. Ranking, Simpson,  Roland,  Tyler, Smith, and
others; and Ibid. viii. 241.  Philad. 1849.
  10 Dispensatory, edit. cit. p. 976. Philad. 1848.
  11 Chloroform in the  Practice of Midwifery, cited in Ranking,  loc. cit., and Monthly
Journal of Medical Science, Dec. 1849.                               ' 
CHLOROFORMUM.
205
the parturient action of  the uterus, unless given in large and un-
necessary doses;—that it causes greater relaxation of the passages
and perineum, and a greater secretion from the mucous membrane
of the vagina;  subdues nervous irritation, caused by  severe  pain;
restores nervous  energy; secures the  patient  perfect  repose for
some hours after  delivery,—and that its injurious effects, when an
ordinary dose is given, seem to be dependent  upon constitutional
peculiarities or improper  management.
   Its value in natural labour  and  operative midwifery has  been
deposed to by numerous  observers;—by Mr. Brown,1 Dr.Nevins,3
Messrs. Clifford,  Fearn,  Wilson,  M.  Richet,3  Dr.  Protheroe
Smith,4 and  by Drs. Keith, Moir,  Malcolm, Thompson, Purdie,
Cumming, and numerous others, cited by Dr. Simpson,5 as well as
by Dr. Denham,6 Dr.  Henry  Bennett,7 Dr. Geo. N. Burwell,8 Dr.
J. P. White,9 Dr. Channing,10 Dr. C. H. Cragin," Dr. Lindsly,12
Dr. Beatty,13 Dr. Trask,14 and others.
   In  labours complicated with puerperal convulsions,  good
effects have resulted from it in  the practice of Mr. W. J. White,15
Mr.  Fearn,16  Mr. Clifton,  Dr.  J. P. White,17 Dr. Channing,18 Dr.
S. N. Harris,19 Dr. Harding,20  Dr. Keith,21 and others.
   Dr. Ranking22  has recently remarked, that if he may judge from
the tenor of numerous private  communications, there seems to be
a growing indisposition,  in  England at least, to the  employment
of anaesthetics in natural labour, although he  is not  prepared to
say, that the  trouble attending the use of the agent has not some-
thing to do with  the objection.   In instrumental and other forms
of complicated labour, he believes they are still much employed
by the leading accoucheurs of England; whilst, in Scotland, the
withholding of them,  even in natural labour, is almost  the excep-

  ' Lancet, Dec. 4, 1847.             2 London Med. Gazette, March, 1848.
  8 Ranking's Half-yearly Abstract, vii. 255.  Philad. 1848.
  4 Lancet, Nov. 27, 1847.
  " Monthly  Journal of Med. Science, October, 1848; and Ranking,  op. cit., viii. 242.
Philada. 1849.              6 Dublin Quart. Journal of Med. Science, Aug. 1849.
  * London Journal of Med., March, 1850.      8 Buffalo Med. Journal, Nov. 1848*
  9 Ibid. Sept. 1848.   ,0 Dr. Parkman.  Amer. Journ. of Med. Sci., July, 1849, p. 41
  11 Medical Examiner, April, 1848. p. 228.
  )2 Ibid. June, 1848, p. 340; and Report of the Committee of Obstetrics, Dr. Lindsly
Chairman, in Trans of the  Amer. Med. Association, i. 228, Philada. 1848, and  Sup-
plement, containing 'he favourable Testimony of Prof Channing, Dr.  E. J. Marsh, Dr.
J. C. Bennett, Dr. M.  B. Wright, Dr. Moultrie, Dr. Gross, Dr. Jas. Stewart, &c; alsoj
Report of the same Committee,  Dr. Gilman, Chairman, in Transactions, &c, ii. 241'
Philad. 1849.
  13 Dublin Quart. Journal of Med. Science, Aug. 1850, p. 341.
  '* Amer. Journal of the Med.  Sciences, July, 1850, p. 341.
  15 Lancet.  March. 1848.            ,6 Lond. Medical Gazette, Feb. 11, 1848
  " Buffilo  Med. Journal, Sept., 1848.   -
  18 A Treatise on Etherization  in Childbirth, Boston, 1848.
  19 Charleston Med. Journal, Sept.. 1848.
  "" Boston Med and Surg. Journal, Feb. 21, 1849.
  21 Monthly Journal  of Med. Science, August, 1850.
  82 Half-yearly Abstract, &c., x. 266, Amer. edit.  Phila. 1850.
        14 
206
CHLOROFORMUM.
tion.   Dr. Rigby is satisfied, that a sufficient immunity from suf-
fering may be attained without annihilating  consciousness, and
advises, that not more  than ten  or fifteen drops should be used at
a  time, by which the patient  may have  the  sensations  of pain
much mitigated,  and, at the same time, be perfectly conscious of
its occurrence;  and a similar  view  is  entertained by Professor
Lindsly,1  of Washington, and by Professor T. E. Beatty,2 of Dub-
lin.   It would appear, from the observations of Drs. Murphy and
Beatty, that  the first  effect of  a good  dose of  chloroform is  to
arrest uterine action for a short  time, so that if the pains be slow
and feeble, they may be  more certainly interfered  with; and  to
obviate this result,  Dr. Beatty3  associates with it ergot, which he
has found to answer a valuable purpose.
                  MODE OF ADMINISTRATION.
   The dose in which Mr.  Tuson administers chloroform  is from
one to four or five drops;  but others go as high as a tea-spoonful,
diluted with water, or  sugar and water, or mucilage.   In neural-
gic affections  it appears to have given the greatest relief in the
form  of liniment, composed of linimentum saponis seu lini-
mentum  camphorae, f  ^ij.,  chloroform, f gj., to be carefully
rubbed over the  affected part; or the chloroform may be applied
by means of a rag wetted with it.
   As a wash, injection, and gargle,  Mr. Tuson  prescribed it di-
luted with water, in the proportion of  one  or two drams  to the
pint;  but as an application to the sound skin,  it is generally used
undiluted—being applied  by means of lint or soft rags, covered
with  oiled  silk  to  prevent evaporation.   When  employed un-
diluted, it ought  to  be  pure, as,  according to  Mialhe  and others,
when it contains  absolute  alcohol it  acquires  caustic  properties,
and excoriates the  surface with which  it is made to come in con-
tact.   Dr. Hayward,4 indeed, ascribes such properties  to the chlo-
roform itself.
   The dose for  inhalation is a  fluidram at a  time, which must
be renewed in two  minutes, if  the desired effect  be not induced.
According to Dr. Christison,5 there seems  to  be no  limit to the
safe repetition of it.  Dr.  Simpson has used eight  fluidounces in
thirteen hours, in a case of labour.  The  patient, he  says, ex-
periences  least annoyance,  and  is least apt to show a precursory
stage of excitement, when  a full  dose is used at once.   Professor
S. Jackson6 has related the case of a lady, labouring under stricture
of the upper portion of the rectum, with convulsions and peculiar
spasms, who,  by gradually  increasing the quantity  as the  effects

  1 Medical Examiner, June, 1848, p. 340.
  3 Dublin Quarterly Journal of Med. Science, Aug. 1850, p. 6.    3 Ibid. p. 8.
  4 Remarks on the Comparative Value of the different Anaesthetic Agents. Bost. 1850
  s Dispensatory, American edit., by R. E. Griffith,  p. 977.  Philad. 1848.
  6 Transactions of the College of Physicians of Philadelphia, vol. ii.  No. 6. 
CHLOROFORMUM.
207
diminished, inhaled, in the course of an evening, two ounces; then
two ounces more, and another ounce in the course of the night—
making five  ounces,  from  5 o'clock, p.  m. until  10 o'clock the
next morning.   Dr. Jackson, having been sent for in consequence
of the mother's alarm at the quantity of chloroform used, found
her with a feeble pulse,  diminished  temperature of the body, and
considerable mental excitement.   She remained  cold  and nearly
pulseless for forty-eight hours, when the  effects disappeared.
   As in the case of the inhalation of sulphuric ether, various forms
of apparatus have  been invented for the inhalation of chloroform,
some of which have been figured in another work.1  They are all,
however,  admitted to be unnecessary.   A small muslin  or  silk
handkerchief,  twisted into  a hollow cone, or into the form of a
bird's nest, moistened with chloroform,  and held  near the nose or
mouth of the patient, is the arrangement adopted by Dr. Simpson,
and most operators.  In this way, a due admixture of atmospheric
air may be  insured, and  the risk of apnosa avoided.   When  the
effect produced is  greater than is desired, the patient should be
placed in the horizontal posture; cold air  be fanned across the face,
and  cold water  be  clashed or poured over the forehead  and head.
Ammonia may be inhaled; and, in more  urgent cases, it has been
advised, that the physician should blow into the mouth  of the pa-
tient for the purpose of artificial respiration, if no apparatus be at
hand.  It has been suggested, too,  that  it would not  be  an idle
provision to have an electro-magnetic machine in operation.   As
soon as the patient  is  able to swallow, stimulants may be adminis-
tered internally; but  under the apprehension that the  respiration
might otherwise be farther embarrassed,2 it has been recommended
that they should not be given until he has revived in some measure.3
   Like ether, chloroform vapour has been administered per anum
by Pirogoff, Bromme, Korner, and Seifert.4

   Under the names concentrated chloric ether, and  strong
chloric ether, a  compound of pure chloroform and nearly ab-
solute alcohol, composed of one-third of the former  to  two-thirds
of the latter has been employed by Dr. J. C.Warren5 and others;
but  Dr. Bache6 has properly suggested  that, as the name chloric
ether was  originally applied  by Dr. T. Thomson to the " Dutch
liquid,".or "chloride  of olefiant gas," it would be well  to abandon
the  appellation  for either chloroform or its union  w'ith  alcohol.
Correct  names, as  he remarks, for  the latter combination would

   1 General Therapeutics and Mat. Med. 4th edit. i. 386.  Philad. 1850.
  * C. H. Cragin, Med. Examiner, April, 1848, p. 237.
  3 Christison, Dispensatory, p. 977.
  ' Canstatt und Eisenmann's Jahresbericht, u. s. w. im Jahre 1849, v. 190, Erlangen
1850.
  " Effects of Chloroform and of strong Ch'oric  Ether, as narcotic agents.  Boston, 1849.
  6 The Dispensatory of the United States of America, 8th edit. p. 1245. Philad. 1849. 
208
CHLOROFORMUM.
be  either alcoholic solution of chloroform,  or  tincture of chloro-
form.
   By Dr. Warren, and others, this preparation has been regarded
as safer than chloroform, and more agreeable than sulphuric ether;
but if the unpleasant effects of chloroform be owing, as has been
supposed by some, to its not being pure, it is not easy to see how
the chloric  ether can  De safer than chloroform.1   The preparation
sold  in London and elsewhere under the name  " chloric ether," is
said to be a weak tincture of chloroform, of variable quantity, con-
taining at most but 16 or 18 per cent, of chloroform, and at times
not more than 5 or 6 per cent.
   According to a Report of the Standing Committee on Surgery of
the American  Medical Association, of which  Dr.  Mussey was
chairman,2  there are two kinds of chloric ether—the chloric ether
of commerce, consisting of one  part of chloroform  to fifteen  of
alcohol;  the other, more  concentrated, composed of chloroform
one part, and alcohol nine  parts—the latter, the one employed for
anaesthetic  purposes.  It is  a  much  weaker article than  those
above mentioned.   Cases of the  successful use of chloric ether, as
an anaesthetic in surgical operations, are given  by Dr. Warren;3
and Dr. Channing4 employed  it successfully in obstetric practice.
Dr. Hayward,5 however, states that he cannot divest himself of
the belief, that  chloric ether is an unsafe anaesthetic, when he con-
siders that  it is simply chloroform diluted with  alcohol.   " It  is
true," he remarks, " that as far as we  know, no fatal effects have
hitherto followed its  inhalation; but it is also true, that it has as
yet been used  to  a very limited  extent, and in  all  the cases in
which it has been exhibited, that  have  come to my knowledge,  it
has been managed with great caution and judgment.   But I fear,
that if it be  used with the same freedom that  sulphuric ether is,
we shall  soon  have  to record  some very different  results.  We
cannot feel confident that it will  always be confided to skilful
hands only, nor by any means certain that death, when not looked
for, may not follow its exhibition."
   When  it comes  in contact with the unprotected  skin, it acts
upon it—Dr. Hayward says—in the same manner as chloroform.
He thinks, too,  that it is more apt to induce  disagreeable encepha-
lic disorder  than ether.

  '  Hayward, Remarks on the Comparative Value of different Anaesthetic Agents. Bos-
ton, 1850.                                     .                  ,
  2 The Transactions of the American Med. Association, iii. 323, Philad. 18o0; and
Amer. Journ. of the Med. Sciences, April, 1849, p. 379.
  3 Op cit. and Transactions of the Amer. Med. Association, iii. 385.
  4 A Treatise  on Etherization in Childbirth, illustrated by five hundred and eighty-one
cases, Boston, 1848; and Dr. S. Parkman,  Amer. Journ. of the Medical Sciences, July,
1849, p. 42.
  1 Remarks on the Comparative Value of the different Anaesthetic Agents.  Boston,
1850. 
CHLOROFORMUM.
209
  A compound ether has also been employed, which consists of a
solution of chloroform  in sulphuric ether.  It was formed on the
suggestion that ether alone is too slow and uncertain, whilst  chlo-
roform itself is too rapid and hazardous in its effects; and hence,
the union of the two, it was conceived, might act more gradually
and  safely.   Under its  influence, amputations were performed  by
Dr.  Cox at the Bellevue Hospital with favourable results.1
  Sulphuric  ether, chloroform, and  chloric ether, and compound
ether are the anaesthetics most frequently employed; and it maybe
interesting to state the preferences of different practitioners for one
or other of them, as enumerated in the  Report of the Standing
Committee on  Surgery of the American  Medical Association, of
which Dr. Mussey, of Cincinnati, was chairman.2   Dr. Hayward,
of Boston, expresses a  strong  preference for sulphuric ether.  It
is preferred, too, by Dr. Horner, of Philadelphia.  Dr. J. C. War-
ren, and his  son,  Dr. John Mason Warren, Professor Knight, of
Yale College,  and Dr. A. L. Pierson, of Salem, Massachusetts,
employ chloric ether exclusively.  Dr. D. M. Reese,  of the Belle-
vue  Hospital, New York, uses a mixture of one part of chloroform
with two parts of sulphuric ether, by weight;  and when the pa-
tient is less impressible, chloroform alone.   Dr. Pope, of St. Louis,
employs either chloroform alone or in combination with ether.
Dr. Brainard, of Chicago, uses pure ether, or three parts of  ether
to one of chloroform.  Dr. Washington  L. Atlee, two  parts of
ether to one of chloroform, liquid measure.  Dr. Howard, of Co-
lumbus, Ohio;  Dr. Twitchell, of New Hampshire;  Dr. Eve, of
Augusta,  Georgia, now of Louisville; Dr. Gross, of Louisville,
now of New York; Dr. Shipman, of  Syracuse,  New York; Dr.
Hamilton, of Buffalo, and Dr. Mussey, prefer chloroform; and the
last  gentleman remarks, that were he  to employ any other anae-
sthetic than simple chloroform, he would  select the mixture of it
with ether—one measure to two, as employed by Dr. Atlee; as
from several trials he has made, he thinks the pulse is rather better
sustained than under chloroform alone.
  It appears then that  each of these anaesthetics has its advocates;
and, perhaps, under  careful management no  decided preference
need exist.
  The vapours of sundry other substances—of chlorohydric and
nitric ethers, of  bisulphuret of carbon, of chloride of olefiant
gas, of benzin, aldehyde,  light coal tar naphtha,3  (fee. &c,

  1 Channing, a Treatise on Etherization in Childbirth, p. 30.  Boston, 1848.
  2 Transactions of the American Medical Association, iii. 323.  Philad. 1850.
  * Professor Simpson,  Monthly Journal of Medical Science, April, 1848.   Bouchardat,
Annuaire de Therapeutique pour 1849, p. 107—111. H.J. Bigelow, Transactions of the
Amer. Med. Association, i. 197, Philad. 1848; and Report of the Committee on Surgery,
Dr. N. R. Smith, chairman, Ibid. vol. 2, p. 213. Philad. 1849. 
210
CHONDRUS.
have been inhaled, and produced anaesthetic effects analogous  to
those of ether and chloroform, but they are not employed.1
                       LIX. CHONDRUS.
 Synonymes. Fucus Crispus seu Irlandicus, Lichen Carrageen, Chondrus
   Crispus seu Polymorphus, Sphserococcus Crispus, Ulva Crispa,'Irish
   Moss, Carrageen, Carragaheen or Corigeen Moss.
 French. Mousse d'Irlande, Mousse Perlee.
 German.  Krauser  Tang,  Seetang,  Carragaheenmoos, Ir-
   landisch Moos, Irlandisch Perl-oder Seemoos. Geperl-
   tes  Seemoos, Krauser Knorpeltang.
    Although Carrageen or Irish moss has long been used in Ireland,
 it was but  little employed  in  other parts of Europe,  or in this
 country, until within the last few years.   Of late, it has been used
 precisely in  those cases  in which  Lichen  Islandicus or Iceland
 moss has been deemed appropriate.  In Germany, the first  trials
 were made with it in the year 1833, by Von Grafe of Berlin, and
 the results were  given to the world in his report for that year,3 of
 the  Clinical, Surgical and Ophthalmic Institute, attached to the
 Frederick  William University.
    Chondrus, which belongs to  the Natural Family Algae, exists
 in the Atlantic Ocean, on the coasts of England, Ireland, western
 France,  Spain, and Portugal, and as far as the tropics.  It is also
 said to be  a native of the  United States.   It  is met with  more
 abundantly,  however, in Ireland, especially in Clare, where it is
 used by  the poor as an article of diet.  It is thrown on the shore
 by the waves, and is gathered at the time of the ebb.3
    Irish  moss,  when fresh, is  of a purple-brown  or purple-red
 colour, and somewhat resembles Iceland moss; but when dried, as
 we meet with it in commerce, it is mostly yellowish or dirty white,
 but intermixed with purplish-red particles, and resembles lamina?
 of horn: it is  crisped, translucent, and frequently contains small
 shells, calcareous concretions,  and grains  of  sand.   It has not
 much  taste; the smell seems  to betray iodine, which,  however,
 has not  been detected  in it.  When the moss is chewed, it feels
 like so much cartilage, but, by  the  moisture and warmth of the
 mouth, it soon loses its brittleness.   It contains a little chloride of
 sodium.4
   The jelly  obtained  from  it is transparent and colourless, its
  1 Amer. Journ. of the Med. Sciences,  April, 1849,  p. 528.  Nunneley, Provincial
 Med, and Surg. Journ. March 7, 1849.
  2 Bericht Uber das klinische chir. augenarztliche Institut. der k. Friedr. Wilh. Univers.
fiir d. J. 1833.  Berl.  1834.
  3 Pereira, Elements  of Materia Medica and Therapeutics, ii. 874.  Lond. 1842; or
2d Amer. edit., by Carson. Philad. 1846.
  4 E. Grafe in Art. Fucus. Encyclopiid. Worterb. dermedicinischen Wissenschaft. xiii.
S. 1.  Berlin, 1835. 
CHONDRUS.
211
taste  is by no means disagreeable; it keeps several  days, and is
not converted  by muriatic acid into mucus, like the jelly which
is obtained from land .plants.   It exists in the proportion of  79.1
per cent., and  has been considered  to  consist of pectin in large
proportion,  and starch; but  Dr.  Pereira1  esteems  it a  peculiar
principle, and gives it the name Carrageenin.  It is easy of di-
gestion, is readily  borne by weak and irritable stomachs, and ex-
erts a soothing influence on  the  air-passages and the  intestinal
canal.   In  order  to obtain it,  the  moss is cut  small,  carefully
cleared from impurities, boiled with  the  selected   vehicle, and
strained.  Von  Grafe obtained  from nine ounces of milk boiled
with half a dram of the moss, five ounces of jelly;  and as much
from a dram and a half of the moss  and twelve ounces of water.
The  formula, commonly used by  him,  is given below.   To this
jelly may be added any dietetic or remedial agent, which may be
considered indicated  in the particular  case.2
   Chondrus is in the secondary list of  the  Pharmacopoeia of the
United  States,—cetraria in the primary; but the assignment ap-
pears to be  arbitrary, as one  is perhaps as valuable  an agent as
the other.3
                 EFFECTS ON THE  ECONOMY.
   Chondrus  is used in the affections that are  considered to  be
benefited by Iceland moss.   As a diet, it is given in consumptive
cases, and wherever there is erethism in the respiratory or di-
gestive apparatus.  It is sometimes  prescribed in  diarrhoea,
along with astringent or other remedies.  The jelly has been ad-
vised  as a diet  in  scrofulous cases.  Von  Grafe affirms, that  he
has often found it  serviceable  in hoarseness, dry  spasmodic
cough, consumption, diarrhoea, and dysentery, in the intestinal
pain  which remains after  inflammation and ulceration of
these parts, and after poison has  been taken;  in  diseases ac-
companied  by much emaciation,  and in the prostration en-
suing on serious diseases and operations.  In similar  affections
it  has been extolled  by Hufeland.4  On the other hand, Heyfelder
affirms, that he, and many physicians of his acquaintance, have used
the moss without either good or evil  results in phthisis, as well as
in  erethism of the respiratory and digestive  organs; and
Riecke5  remarks,  that as it  makes a very  agreeable jelly,  when
boiled with milk, and with the addition of a little of the aqua, lau-
rocerasi, it may do for cases where we must prescribe " ut fecisse
aliquid  videamur."   The  truth is, that it can  render  no  more
service than other substances that  contain a similar principle; and,
  1 Op. cit.
  2 L. Feuchtwanger, in Philad. Journ. of Pharm. vi. 204.  Philad. 1833-4.
  * See the author's General Therapeutics and Mat. Med., 4th edit. i. 253. Philad. 1850.
  4 Hufeland und Osann's Journ. der practisch. Heilkund. B. 77, St. 5, p. 135.
  5 Die neuern Arzneimittel. Stuttgart, 1837, S. 235. 
212                      CIMICIFUGA.

accordingly, but few prescribe it with  any other  view than  as  a
demulcent and nutritious aliment in cases where such is needed.

                 MODE OF ADMINISTRATION.

                    Decoctnm  chontlrh

                   Decoction of Irish moss.

                R.   Chondri (elect, et concis.) £ss.
                   Lact. recent, f gix.
                   Coq. ad remanent, colatur. f gv.
              Adde
                   Sacchar. gss. ad gj.
                   Aq. amygdal. amar. concentr. 9 j.
   To be taken in the course of the day.           Von Grafe.
                R.  Chondr. (elect, et concis.) £iss.
            Coq. cum aq. font, f gxij. ad remanent, colat. f.gv.
                    Syrup, rubi idsei f giss. ad f gij.
                    Aq. amygd. amar. concentr. 9j.
   To  be used through the day.  When  employed as diet, Von
 Grafe allows from ten to eighteen ounces of the jelly in the day.
                R.  Chondr. (elect, et concis.) ^ss.
            Coque cum aq. font. q. s. ad reman, f gvj.
            Colatur.  adde
                    Sodee phosphat. giss.
                    Syrup opii f ^ij. ad f ^iij.
   Dose.—A spoonful every two hours in cases of haemoptysis,
 between the attacks.                                Clarus.
                R.  Lactis f gxxiv.
                    Chondr. (elect, et concis.) giv.
                    Sacch. gj.
                    Cinnam. cont. 9j.
       Coque per minut. x.  leni igne ; filtr. et exprime.
                                                     Biral.
                R.  Chondr. (elect, et concis.) gij.
                Coque  cum lactis Oj. ad consist, gelatin.
               Tere cum
                    Sacch. gij.
                    Amygdal. amar.  No. 2.
   To be used in the course of the day,  and daily.   Hufeland.
                     LX.  CIMICIFUGA.
Synonymes.  Cimicifuga Racemosa  seu Serpentaria, Actaea Racemosa,
  Macrotrys Racemosa, Black Snake-root, Cohosh, Bugbane, Cohort.
French.  Actee, Herbe Saint Christophe.
German. Traubenformiges Christophskraut, Schwarze
  Klapperschlangenwurzel.

  This plant is  a native of the United  States, growing in shady
and  rocky woods from  Canada  to Florida.   Sexual System,
Polyandria  Di-Pentagynia;  Natural  Order, Ranunculaceae.
The root is the  part used  in medicine.  It yields its virtues to 
CIMICIFUGA.
213
boiling water, and was found by Mr. Tilghman, of Philadelphia.
to contain gum, starch,  sugar, resin, wax,  fatty matter, tannic
and  gallic acids, a black  colouring  matter, a  green  colouring
matter, lignin, and salts of potassa, lime, magnesia, and iron.1
                 EFFECTS ON THE ECONOMY.
   Cimicifuga belongs to the class of acro-narcotics.  Until re-
cently, it is said to have been employed chiefly in domestic prac-
tice, as a remedy in rheumatism, dropsy, hysteria, and in va-
rious affections of the  lungs, especially such as resemble con-
sumption.9   It  is noticed here, however, chiefly in consequence of
the encomiums that have been passed upon it,  of late, as a remedy in
chorea.   Several cases  of this  disease, reported by  Dr. Jesse
Young to have  been  cured, were  published some years ago;  and
at the same time it was stated,  that Dr. Physick had known it
prove successful in  many  instances.3   Dr. Wood4  also states,
that  he  administered  it in a case of chorea, which rapidly reco-
vered under its use, after the  failure of purgatives  and  metallic
tonics.   He also remarks, that he had derived the happiest effects
from it in a case of  convulsions, occurring periodically, and con-
nected with uterine disorder.  Dr. T.  S.  Kirkbride,5 has  pub-
lished some  cases of success, obtained in  the  same disease, from
its administration,  after  free  purging had  been employed.   In
one   successful  case, in   a girl,  nine years old, whose mental
faculties  were  much disordered,  and who  had  lost  nearly  all
power over both her  left extremities,—there  being, at the  same
time, irregularity of  the bowels, headache,  and pain  frequently
shooting down  the left arm, cups were applied to the back of the
head and neck once; stimulating pediluvia were prescribed, with
friction with salt over the surface of the  body, and she was mode-
rately purged  every day for a week before the Cimicifuga was
begun with.  Dr. Kirkbride refers to a very intractable case, that
fell under the care of Dr. Otto, and that yielded ultimately to this
drug.   He  always  purges  before  he  has recourse  to it, and
general  frictions with salt or the flesh brush, and pustulation with
 croton  oil over the  spine, he believes to  be of much  value in
chronic  cases.   Dr. Beadle" of New York treated a case success-
 fully in a girl eighteen years of age.  There  was considerable
gastric derangement, with suppression of the caiamenia, for
nearly five months, from pregnancy.  She was put  upon the  use
of Cimicifuga, five grains of the powder being given every three
   ' Journal of Philadelphia College of Pharmacy, vi. 20; and Wood, in Dispensatory
of the United States, by Wood and Bache, Art. Cimicifuga.
   2 F. J. Garden, Amer. Med. Recorder, Oct 1823.
   3 Amer. Journ. of the Med. Sciences, ix. 310.                * Op. citat.
   6 American Journal of the Medical Sciences, February, 1840, p. 289.
  6 New York Journal of Medicine and Surgery, July, 1840, p. 191.  See also C. C.
Hildreth, Amer. Journ. of the Med. Science, Jan- 1843, p.  61; and F. J. Garden, Ibid.
p. 247. 
214
CIMICIFUGA.
hours, and no other remedy except an occasional dose of sulphate
of magnesia.  There was little improvement in her condition during
the day, for nearly a week, after which  she improved rapidly and
was well in three weeks.  The medicine produced no  sensible
effect.
   Allusion  has been made to  the employment of Cimicifuga in
popular practice, in cases of rheumatism.  Like other narcotico-
acrids, when pushed  so as to produce  catharsis, and even slight
narcosis, it may unquestionably be of service in acute  forms of the
disease.1  Dr.  F. N. Johnson  has,  at  different times,  selected
more than twenty cases of acute rheumatism, including the se-
verest forms, and treated  them with  cimicifuga for the purpose of
testing its powers in that disease.  The results were in the highest
degree satisfactory, "" every vestige of the  disease disappearing in
from two  to  eight  or  ten days, without  inducing any  sensible
evacuation, or leaving behind a single bad symptom."  These trials
were repeated by Dr. Johnson,  Dr. N. S. Davis, and  others, until
they had  no more doubt of the efficacy of  cimicifuga in the early
stages of  acute rheumatism than they had of  the power of vacci-
nation as a preventive of variola!   Dr. Johnson found the most
acute and severe cases yield to its influence not only more speedily,
but  more perfectly, and with less  danger  of metastasis to other
organs, than to  any other form of treatment.2   The author  has
always classed it among sedatives; and  the  observations of  Dr.
Davis are in favour of this.
   In some  parts  of  the country, cimicifuga  has become  a very
popular remedy in coughs; and Dr. E. G. Wheeler3  affirms, that
he  has found it  useful in several  cases of severe and protracted
cough; especially in the  chronic cough or bronchitis of  old peo-
ple.  Dr. Wheeler  states farther, that  by some eminent  physi-
cians, it has been thought to be a  good  substitute  for  ergot in
parturition, being dissimilar, however, in  its mode  of action,—
relaxing the parts, and thereby rendering  labour short and easy.
This, however, requires confirmation.
   It has been advised by Dr.  C. C. Hildreth4  in " acute phthisis,
uncomplicated with much inflammation in the vesicular structure,
or  pulmonary mucous or serous membranes;" who states, that he
has " often seen the most  prompt action of  the decoction alone, in
throwing off febrile  excitement or the  hectic paroxysm, allaying
cough,  reducing the rapidity and force of the  pulse, and  inducing
gentle  perspiration."  " In  those intercurrent  congestions  and
  1 E. A. Anderson, and Alexander Vedder, in American Medical Intelligencer, vol. ii.
p. 296, Philadelphia, 1839.  Also, Boston Medical and Surgical Journal, Oct. 2,1839,
p. 126.
  5 Report of the Committee on Indigenous Botany; Dr.  N. S. Davis, Chairman; in
Transactions of Amer. Med. Association, i, 353, Philad., 1848.
  3 Boston Med. and Surg. Journal, Sept. 4,1839, p. 65.
  4 Amer. Journ. of the Med. Sciences, Oct. 1842, p. 288. 
CINCHONIA.
215
inflammations, so frequent in the  second and third stages  of
phthisis, from atmospheric exposures,"  he states, that he has
"often seen the same happy influence exerted ;" but the testimony
in regard to its beneficial action in these cases is certainly wanting
in precision.1

                 MODE OF ADMINISTRATION.
   The  dried  root of cimicifuga  may be  given  in  powder.  Dr.
Kirkbride  administered it in  the dose of a tea-spoonful; and Dr.
Wheeler in the dose of 3j. from three to five times a day.  Dr.
Davis  recommends it  in  the dose of from thirty to sixty drops of
the tincture, or twenty grains of the powder repeated every two
hours " until  its effects are  manifest."   It is most  commonly,
however, given in the  form of the

                   Dccoctum cimicifugae.
                 Decoction of black snake-root.
                   R.  Cimicifug. contus. gj.
                Coque paulisper in
                       Aquae Oj.
   Dose.—One or two  fluidounces—two to four  table-spoonfuls—
several times a day.
                   Tinctura cimicifiigse.
                 Tincture of black snake-root.
                   R.  Cimicifug. contus. giv.
                       Alcohol. (.835,) Oj.
   Dose.—Twenty drops three or four times a day.  An  idea pre-
vails, that the stronger the alcohol the better is the preparation;
but this may be questioned.
                    LXI. CINCHONIA.
Synonymes. Cinchonina, Cinchoninum, Cinchonin, Cinchonine.
French. Cinchonine.
German. Cinchonin.
  Although  Duncan,  of  Edinburgh,  Reuss, of  Moscow,  and
Gomez,2 of Lisbon, had  endeavoured to separate the active prin-
ciple  of  the cinchonas, and had given  the term  cinchonine  to a
resinous  extract  obtained  in their investigations, the honour of
discovering both cinchonia and quinia, and  of applying them to
practical purposes, belongs to the  French chemists—Pelletier and
Caventou.3
  Cinchonia is commonly obtained from the gray or pale varieties

  1 See the author's General Therapeutics and Mat. Med., 4th edit. ii. 196. Philad. 1850.
  1 Richter's Specielle Therapie, B. x. S. 325, Berlin, 1828; and Magendie's Formulaire.
  ' Annales de Chimie et de Physique, xv. 289 and  337. 
216
CINCHONIA.
of cinchona; the  yellow furnishing the  quinia, and the red both
cinchonia and  quinia.  It is an alkaloid strikingly analogous  to
quinia in its chemical and medical relations, but  is not as much
used.
                   METHOD OF PREPARING.
   Cinchonia is obtained  by  boiling cinchona in alcohol, until it
loses all its bitterness; the alcoholic solution is then evaporated to
dryness  in a water bath; the extract, thus obtained, is dissolved
in boiling  water, strongly acidulated with muriatic  acid; an
excess of calcined magnesia is added, which, after a few minutes'
boiling, will fix all the red colouring matter, and render the liquid
clear.   When  cold, the liquid is filtered, and the magnesian pre-
cipitate washed with cold water;  it is then dried in a stove, and
all the bitterness  separated by  repeated  digestions  in boiling
alcohol; the alcoholic liquors are mixed, and the cinchonia crys-
tallizes as the fluid cools.  Cinchonia, thus obtained, still contains
a green fatty matter, which may be separated by solution in a very
weak acid.   If the acid be too strong, it will  dissolve  a  part  of
the fatty matter, and  the intended  object will thus be defeated.^
   Cinchonia may also be obtained by treating pulverized pale
cinchona by weak sulphuric acid, precipitating the  solution  by
means of lime in  excess; collecting  the precipitate  on a filter,
washing, and treating it, after drying, with boiling alcohol.2
   Cinchona is white, translucent, crystallizing in needles; requiring,
for its solution, 700 parts of cold  water, according to Magendie;
according to others, 2500 parts of boiling water.  On account of
its very sparing solubility in  water it has but a slightly bitter taste.
In alcohol, it is readily soluble, and the solution is extremely bitter,
as well  as the salts formed by its union with acids, which resemble
the salts of quinia.   It does not dissolve readily in fixed or vola-
tile oils, or in ether.   At a  certain temperature, it volatilizes; a
great part, indeed, is destroyed by the  operation, yet a  sensible
portion escapes the decomposing power of the caloric.
   In medicine, pure cinchonia, as well as the sulphate  and acetate,
is prescribed.  The  sulphate is soluble in 54 parts of water, and
in 6.5 parts of alcohol (s. g. .815:) it is  not soluble  in ether.   It
forms crystals and tastes bitter.   The acetate, on the  other  hand,
does not crystallize;  and is less soluble in water than the sulphate;
but an excess of acid facilitates the solution.

                 EFFECTS ON THE ECONOMY.
   It is not necessary to say  much on  the application of cinchonia
and its  preparations to disease, as they have been almost wholly
superseded by quinia and its salts.  It  is  a weaker  article, and
1 Magendie, Formulaire, &c.
a Pharmacopge Universelle, i. 414, Paris, 1828.] 
CINCHONIA.
217
therefore requires*to be given in larger doses; Magendie and Git-
termann assert that it has been found ineffective as an antiperiodic
Bally,1 Chomel,3 Mariana,3 Wutzer,4 and  others, however, have
exhibited  it successfully.5  Dufresne6 frequently prescribed it, and
he assigns it this claim to preference, that it is almost tasteless, or
at least that the bitter taste is but tardily developed; and that it
need not be given in combination with acids, as the acid contained
in the  gastric secretions  will  render  it  soluble.7   He  gave it in
intermit tents, during the apyrexia,in the quantity of from six to
twenty grains, and found it of marked  use in the  cases of gastral-
gia  with formation of acid, which are so often met with in
young females, and are not unfrequently associated with leucorrhoea,
hypochondriasis, melancholy, &c.

                  MODE OF ADMINISTRATION.
   The following formulae have been recommended, but, as before
remarked, they are  rarely used, the preparations  of quinia being
now almost universally  prescribed.

                    Syrupus cinchonia.
                      Syrup of cinchonia.
                 R.  Cinchoniae sulphat. gr. xlviii.
                     Syrup Oj.  M.
  Used in  the same cases as the Syrupus quinice ; a table-spoon-
ful for a dose.                                      Magendie,
                      Vinnm  cinchonirc.

                      Wine of cinchonia.
                 R.  Cinchoniae sulphat. gr. xviij.
                     Vini Maderens.  Oij.   M.
                                                   Magendie.
                      Tinctura cinchonice.
                 R.  Cinchoniae sulphat. gr. ix.
                     Alcohol (34° or  s.g.-847,) fgj.  M.
                                                   Magendie.
   Magendie recommends, that this tincture should be  used for
preparing, extemporaneously, wine  of cinchonia, by adding two
ounces of the tincture to a pint of Madeira  wine.
  ' Nouv. Biblioth. Medicale. ix. 189.     * Nouv. Joum. de Medecine, Mars, 1821.
  * Osservaz. sulla Pratica del Solfato de Cinconina, &c.
  ' Rust und Casper's Krit. Repert. B. xxi. and Bulletin des Sciences Medic. Sept. 1827.
  * Art. Cinchonine, in Merat and  de Lens, Diet, de Mat. Med.
  e Bibliotheque Universale, Mai, 1831. p. 89.
  1 See, also, Ganz, in Bulletino delle Scienze Mediche di Bologna, Agosto et Settembre,
1836, p. 121. 
218
CODEIA.
                   Boli cinchonia.
                  Boluses of cinchonia.
                      Boli antifebriles.
                      Febrifuge boluses.
             R.  Cinchoniae sulphat. gr. iij.
                 Micae panis,
                 Mellis,
                 Glycyrrhiz. aa. q. s. ut fiat bolus.
Dose.—One, every two hours.                     Brera?
                  Mistura cinchonia;.
                  Mixture of cinchonia.
             R.  Cinchoniae sulphat. gr. vi. ad xlviij.
                 Potassae acetat.
                 Sacchar. aa. gss.
       Solve in
                 Aquae anthemid. gvj.
Dose.—A table-spoonful every two hours, in intermit tents.
                                                Sandelin.
  For the iodide and other preparations of cinchonia, see the cor-
responding preparations of Quinia.
                       LXII.  CODEIA.
Synonymes. Codeina, Codeinum, Papaverinum, Codeine.
French. Codeine.
German. Kodein.
  Although opium had been repeatedly examined by the chemists,
and certain of  its  active  constituents separated from it, it was not
until within the last twenty years, that the article, whose name is at
the head of this paragraph, had been  obtained  from it.  It was
discovered by Robiquet in 1832,2 and as it has  been exhibited as
a therapeutical agent, it  requires notice.
                  METHOD OF PREPARING.
  According to Winkler,3 this  new alkaloid  may be  prepared in
the following manner. Morphia is first thrown down from a solu-
tion of opium, made in the cold, by means of ammonia;  the me-
conic acid is precipitated by the chloride of calcium; for the re-
moval of the colouring matter, the fluid is then treated with the
extract or subacetate of lead; and the extract  of lead, contained
in the fluid poured off from the precipitates, is afterwards decom-
posed by sulphuric acid;  the fluid, separated from the sulphate
  1 Ricettario Clinico di Brera.  Padov. 1825.
  2 Journal de Pharmacie, xix. 91 and 162.  Paris, 1833.
  3 Buchner's Report, xlv. p. 459, cited .in Journal de Pharmacie, xxi. 251.  Paris,
1835. 
CODEIA.
219
of lead, is now treated with an excess of caustic alkali;  the mix-
ture is exposed to the air until the  excess of free alkali has at-
tracted carbonic acid from it:  it is then agitated and digested with
ether, and left to evaporate spontaneously, after which a yellow-
ish,  highly transparent,  but  not crystalline compound  remains,
which forms with muriatic acid  a crystalline salt, and resembles
exactly the codeia of Robiquet.
  Merck1  procures codeia  in  a  very simple  manner.   He treats
morphia, precipitated  by soda, with cold alcohol; the spirituous
tincture is carefully saturated  with  sulphuric  acid;  the alcohol
drawn off, and the residue treated  with cold water as long as it
is turbid;  it is then filtered,and  the filtered liquid evaporated un-
til  it has  the  consistence of  syrup: on  cooling, ether is  poured
over it  in  a  large flask;  caustic alkali is added in  excess, and
the whole strongly agitated.   The ethereal mixture is then so sa-
turated, that codeia crystallizes from  it in  a few hours.  By eva-
porating the ether, and treating  the residue with alcohol, the co-
deia is obtained, by degrees, wholly pure,  and  separated  from an
oily matter, which is a great obstacle  to crystallization.
  Codeia, according to Pelletier, consists of 31 parts of carbon; 40
parts of hydrogen; 5 parts of oxygen, and 2 of nitrogen.   It is
an alkaloid, soluble in water,  alcohol  and ether;  but not so in al-
kaline solutions.  It unites readily with acids, and, with the chlo-
rohydric especially, forms a salt, which crystallizes with great fa-
cility.   When the crystals of codeia are heated on a plate of  pla-
tinum, they burn with  a flame without leaving  any  residue.
Heated in  a tube, they melt at about  150° centigrade; and, if al-
lowed to cool immediately, form a crystalline mass; if, however,
the heat be continued, the oleaginous  fluid rises along  the sides of
the tube, appearing  to shun the heat;  but it does not volatilize.
When dissolved in water, codeia communicates to it decidedly al-
kaline properties.  1000 parts of water at  60° Fahrenheit, dis-
solve 126 parts of it; the same quantity at 100°, 37 parts, and
at 212°, 58-8 parts.   If  more codeia  be added to boiling  water
than can be taken up, the surplus melts, and forms, like meconin,
an oleaginous layer on the bottom  of the vessel.  This  aqueous
solution, by careful refrigeration, affords a  translucent and uncom-
monly well  defined metal.  Tincture  of  galls  forms a copious
precipitate with a solution of codeia, in which  respect, the latter
differs essentially from  morphia,  as  it  does in  many other of its
properties,—as in being soluble in ether, but insoluble in a solution
of potassa; in not decomposing iodic acid, nor forming a red com-
pound with nitric acid ; wThilst it  is not precipitated from the dilute
solution of its salts by means of ammonia.2

  1 Journal de Pharmacie, cited in American Journal of Pharmacy, new series, i. 171
Philad- 1835.
  * Ballard and Garrod, Elements of Mat. Med. and Therap. p. 169.  Lond. 1845. 
220
CODEIA.
                EFFECTS ON THE  ECONOMY.
  As morphia does not represent the whole of the activity of opium,
Robiquet concluded, that other substances might concur therewith,
and he conjectured that codeia might be one of them.   Under this
idea, Kunkel1 instituted experiments with  it on rabbits and dogs,
from which he obtained the following results.  First. Codeia dif-
fers from morphia in this—that it does not, like the latter, paralyze
the lower extremities.   Secondly.  It appears to  exert a power-
fully excitant action.  It occasions convulsions of the limbs, and
muscles of the neck, and when  it  produces death, this seems to
be owing to its action on the cerebellum and medulla oblongata;
twice, he noticed symptoms of backward progression under its use,
and those parts after death were found turgid  with blood.  To
judge from the condition of the heart  and lungs,  it affects likewise
the circulatory organs.   It occasions inflammation of the tissues,
with which it comes in  immediate contact.  Its action is more ener-
getic, when introduced into the  areolar membrane, than into the
stomach.  It seems,  also, to exhibit a  special action on the urinary
organs, for  animals to  which it is  given   never evacuate their
bladder as long as they are  under its  influence.   Thirdly.  Co-
deia differs from  the watery extract  of opium,  in not  paralyzing
the hinder  extremities ;  but  it  approximates  it in  this,  that it
acts,  as has been  said, more powerfully  when  introduced  into
the areolar membrane than into the stomach, and accelerates respira-
tion and circulation.   Kunkel, however, remarks upon the results
of his experiments, that they demand repeated trials for confirma-
tion, as he was only able to  experiment with a very small quan-
tity of  the  substance.  Robiquet observes  that Kunkel's  experi-
ments have led to  the  inference, that  when codeia is combined
with acids,  it loses much of its efficacy—the very opposite, by the
way, to the inferences of Magendie.
   Barbier2 has taken considerable pains to fix the value of  codeia
as a remedial agent.  He prescribed it in the dose of one  or two
grains in a syrup, prepared with the  aqueous solution of the alka-
loid, of such strength  that a  table-spoonful of half an  ounce con-
tained one  grain  of codeia.   In his opinion, it exerts a peculiar
agency on the nerves of the  ganglionic system, whilst it appears
to possess but little influence on  the hemispheres of the brain, and
to  make  no impression  upon the spinal marrow.  In the epigas-
tric region, he  remarks, its agency  is powerfully  manifested;
and here in the  centre of the ganglionic  system, its effects may
be  investigated,  and  their  extent and  magnitude  appreciated.
If a spoonful, or, at an interval of from one to two  hours, two
spoonfuls of syrup of  codeia be administered to one affected with
the symptoms to  be  described  immediately,  it will  be  found,
  1 Journal de Chimie Medicale, ix. 223.       s Gazette Medicale, 8 Mars, 1834. 
CODEIA.
221
that it exhibits a considerable and  remarkable  effect upon  the
economy.   If the person complains of pain in the epigastric re-
gion, beneath the lower extremity of the sternum, and stretching
to the sides and back; and if, with these symptoms,  there is com-
bined a feeling of heat, with indescribable anxiety, marked debili-
ty, paleness, decided  alteration of the features, a sense of painful
traction sometimes on one side, at others on  the other,  of the epi-
gastric region,  with  tendency to syncope,  frequent sighing, de-
spondency, and more or less sensibility to pressure in  the epigas-
tric region, &c, Barbier considers the seat of the disease to be the
epigastric nervous plexus; and in such cases, he says,he has found
no remedy superior to syrup of codeia.   He has observed it afford
decided relief,  where the coats of the stomach were manifestly in
a state of degeneration.   A  common  effect of  codeia  is sleep;
which is never accompanied  by heaviness of the head, nor by de-
termination of blood to  the  brain.   When the  persons  awake
from the sleep produced by it, the countenance is bright and lively,
and there  is  a  tendency to laughter.  Barbier was led to believe,
that it does not affect the nervous cords connected  with the ver-
tebral portions of the centre of the nervous  system.  In his obser-
vations at  the  hospital  of Amiens, he often  noticed  the  neuralgic
affection of the abdomen above mentioned  to be accompanied by
pains in the head, loins, and limbs, and whilst  codeia  relieved the
abdominal  uneasiness, it left the others untouched,—a singular cir-
cumstance, if true, but requiring fresh  observation before we can
esteem it to be established.  He remarks farther, that almost all
the patients who were benefited by codeia had used  laudanum un-
successfully.    Codeia, he adds, occasions no manifest change in
the circulation and  respiration;  it does not disturb the digestive
function; seems merely to diminish the feeling of hunger, and oc-
casions no constipation.  During  its use, itching of the surface is
frequently experienced.  When applied to  the skin, it induces no
 striking phenomena.  When placed, in  the quantity  of two grains,
 on  a  blistered surface, it excites a painful sensation of burning,
 without any other change,—the neuralgic  pains, for the removal
 of which it  may have  been thus employed, not appearing to be
 modified by it.
    Dr. W. Gregory made experiments  upon himself and some  of
 his pupils  with nitrate of codeia.  None of them  experienced
 any effect from a dose  of three grains and under; from four to six
grains,  however,  occasioned striking  symptoms—quickness  of
pulse, sense  of heat in the head and face, remarkable excitement,
like that following the use of intoxicating liquors; agreeable, and
apparently permanent, stimulation,  accompanied  by considerable
itching, which  began at the head and extended over the whole
body.  To this succeeded, in the course of a few hours, a dis-
 agreeable  sense of relaxation, with nausea, and  often  vomitino-. 
222                         CODEIA.
None of the experimenters felt the slightest inclination to sleep,
until after the feeling of relaxation.  Riecke1 thinks that these ex-
periments  confirm Kunkel's observations,  that  codeia  loses its
efficacy when combined with acids.
   In the year 1834, M. Martin Solon, at one of the sittings of the
Acaderaie Royale de  M'decine, when the experiments of Barbier
with  codeia were the subject of discussion, confirmed his views
regarding its soporific property.   It appeared to him to allay the
cough of the consumptive.  He remarked, however, that he had
not observed the effects on the ganglionic -nervous system, which
Barbier had witnessed.
   Magendie2 took a grain of codeia, dissolved it in a little water,
and injected it into the jugular vein of a middle-sized dog, which
was immediately  thrown  into  profound sleep—readily  broken,
however,  by any strong noise made in the vicinity of the  animal;
but the interruption was of  brief duration,—sleep soon recurring.
This condition persisted  for  several hours without being accom-
panied by any unpleasant symptoms. The effect was not the same
with the muriate of codeia:  a single grain of this salt, introduced
in the  same manner  into the organism, suddenly induced  deep
sleep;  but,  after the animal  had  slept five  or six hours, it  died.
Several similar experiments afforded a like result.   Magendie ad-
ministered codeia  in  the  Hotel Dieu  to different patients.    He
found  that  one  grain,  given once or twice, succeeded,  in many
cases, in inducing  a quiet and  soft sleep, to which no confusion
succeeded the next day, as  is commonly the  case with morphia.
As respects  intensity of action, he compares one grain of codeia  with
half a grain of  morphia.  Two grains often excited  nausea, and
even vomiting.    Magendie   found the  muriate to be decidedly
stronger than pure codeia.   Two grains commonly induced, be-
sides sleep,  vertigo, nausea, and even vomiting;  but this dose suc-
ceeded like  a charm, in cases  of neuralgia faciei and in sciatica,
that had resisted the most valued  agents.3
   Dr.  Miranda, of the Havana, has published4  the results of his
experience with codeia in what he calls powerful nervous irrita-
tions of the mucous  membrane of the stomach, and he affirms,
that he cured eleven cases by the syrup of codeia alone.   He be-
gan with a  dram,  night and  morning, and  gradually increased it
to an ounce in the twenty-four hours.   His success was so striking
that he is induced to " regard the discovery  of codeia  to be fortu-
nate for humanity, especially in climates like that of the Havana,
in which  gastritesare so  multiplied."

  1 Die neuern Arzneimittel, u. s. w. S. 140.  Stuttgart, 1837.
  2 Formulaire pour la preparation et l'emploi de plusieurs nouveaux medicament  Edit
3me. Paris. 1836.
  » GullvV Translation of the 8th edit, of Magendie's Formulaire.  Lond. 1835.
  4 Journal de Pharmacie, xxiv. 145. Paris, 1838. 
COLCHICUM.
223
                     Syrupns  codeiae.
                      Syrup of codeia.
  This is  directed by M. Cap1 to be prepared  in  the following
manner: —
                  R.  Codeise gr. xxiv.
                      Aquae destillat. f giv.
                      Sacchar. gviij.
  Reduce  the codeia to an impalpable  powder in a glass or por-
celain  mortar.   Triturate with one-third of the water,  allow it
to settle and decant.  Treat the residuum w7ith another third of
the water, and again with the remainder.  Put the whole  into a
small  raattrass,  covering  the  opening with a piece of moistened
parchment perforated with a pinhole.   Heat in a water bath until
the codeia has entirely disappeared.  Remove the  mattrass from
the fire to add the sugar; cover the opening again ; agitate, and put
the vessel again in the bath, until the sugar is completely dissolved.
Each ounce of the syrup contains two grains of codeia.
   M.  Levrat, aine,a of Lyons,  obtained excellent effects from the
use of the syrup in the " ataxic form " of typhoid fever.   He gave
it to adults  in  the  dose  of two drams,  and* of one dram to a
child.
  Muriate of Codeia has been used in this city, but it  has not
been found to possess  any virtues which the salts of morphia do
not; whilst its  price  has been enormous—as much, we are  in-
formed, as four dollars the dram.
                   LXIII.  COL'CHICUM.
Synonymes. Colchicum  Autumnale, Meadow Saffron.
French. Colchique, Tue-Chien,  Mori aux Chiens, Safran des Pres, Safran
  Butard, Vieillotte.
German.  Herbstzeitlose,  Zeitlose, Wiesensafran,  Herbst-
  blume, Wilder Safran, Spinnblume.
  Meadow saffron is a well-known plant in the temperate parts of
Europe,  where it grows wild  in moist meadows.  It belongs to
the Family Colchicaceae: Melanthacese {Lindleyi) and to Sexual
System  Hexandria Trigynia.  It  is avoided by cattle; and  its
active  poisonous properties  have  been long known;  fatal cases,
indeed, still  occur every now and then from its employment, not
only in  animals, but  in consequence of its too free use in the
treatment of gout.   Reynolds, the  inventor of the wine of Col--
chicum, commonly called "Reynolds's Specific" is said to  have
killed  himself by an  overdose of it.  A case is given of a man
          '  Journal de Pharmacie, xxiii. 418. Paris, 1837.
          3  Archives Generates de Medecine, Mai, 1847, p. 112. 
224
COLCHICUM.
 who took, by mistake, an  ounce  and  a half of the  tincture,
 and died in forty-eight  hours, after  suffering much from vomit-
 ing, acute  pain in  the stomach, colic,  purging, and delirium.1
 The cases of  two children are also on record, who were  poisoned
 by a handful  of the seeds, and who died in the course of  the day,
 death  being  preceded  by violent vomiting and purging.   Consi-
 derable  redness of the mucous coat of the stomach  and  small in-
 testines  was found: in other cases, no morbid appearance  has been
 detected.2
   A fatal case has been published by Dr. Blumhardt, from the
 papers of Dr. Neubrandt.  The patient,  a man aged thirty-two,
 took, by mistake, a decoction  made of a large table-spoonful of the
 seeds to three pints of wrater.  He was soon afterwards  attacked
 by vomiting,  purging, and died two days  afterwards under symp-
 toms of narcosis and endo-enteritis.   Another fatal case, which
 was caused by the leaves,3  is referred to in the same Journal ;4
 and, more recently, one, from the administration of the  tincture,
 has been published by Professor A. T. Thomson.5
   Colchicum  is  not  of modern  introduction.  It is  the  Hermo-
 dactyl  of the ancients.  It had, however,  almost wholly fallen
 into neglect,  when its use was  revived in  Great Britain, in the
 first quarter of the present century, as an  excellent agent in rheu-
 matic and gouty affections.   That it  is highly esteemed as a the-
 rapeutical agent, is shown by the number of  officinal works into
 which it has been admitted:  amongst  others, the  Pharmacopoeias
 of the United  States, Austria, Amsterdam, and Anvers, and in the
 Batavian, Belgic, Brunswick, Danish, Dublin, Spanish, Edinburgh,
 Paris, Ferrara, Geneva, Hamburg, Hanoverian, London, Lisbon,
 Russian, Saxon, Swedish, and Wirtemberg.
   Several chemists have investigated the composition of the plant.
 Pelletier and  Caventou  believed, that  they had found veratria  in
 it;  but,  from  the  examinations of Geiger and Hesse,  it  appears
 that the alkaloid, discovered by those gentlemen, was not  veratria,
 but a peculiar principle, colchicia or colchicine,  which  is found
 in every part of the  plant; crystallizes in slender needles; is in-
 odorous, and  of a very  bitter, and, afterwards, biting taste. In-
 troduced into  the nose, it does not occasion sneezing like veratria.
 It has a feeble alkaline reaction; but neutralizes acids completely,
 and  forms with them crystallizable salts, which  have  also a bit-
 ter, pungent taste.   It dissolves  with tolerable facility in  water.
  For therapeutical purposes, the root or bulb, {cormus,) as well

  1 Edinb. Med. and Surg. Journal, xiv. 2G2.
  2 Christison on  Poisons, 3d edit. p. 791.  Edinb. 1836.
  3 See a case of over-dose of Colchicum, by T. A. Henderson, in London Med. Gaz.,
 Aug. 17, 1839, p. 763.
  4 Medicinisches  Correspondenzblatt, 1840, cited in Encyclographie  des Sciences
Medicales, Mai, 1840, p. 492.
  5 London and Edinb. Monthly Journal of Med. Science, June, 1843, p. 537. 
COLCHICUM.
225
as the flowers and seeds, have been administered.   The fresh root
has a somewhat disagreeable smell, and  a bitterish  acrid  taste.
When chewed  for any length of time, it excites the  secretion  of
saliva and  thirst;  destroys  the sense of feeling in  the tongue;
causes a sense of burning in the  mouth and lips; constriction of the
fauces, hiccup, violent pains in  the abdomen, vomiting, diarrhoea,
and discharge of blood upwards and downwards.
   By drying,  the  cormi  lose somewhat  of their efficacy.  Dr.
Houlton1  recommends the following  method to ensure  their dry-
ing spontaneously without being sliced.  They are to be stripped
of their loose, dry coats, and the bud  or little bulb, the rudiment
of the future plant, is to be  carefully picked out.  This part, ac-
cording to him, has a high  vital  endowment; is very tenacious
of life, and, unless removed, the  cormi will not readily become
dry:  yet, when it  is removed, and they are put  in  a dry place,
they  will  dry without any trouble, and in  a short time.
   The seeds have of late come much  into  use.   They are inodo-
rous,  but  of a very acrid taste.   Their agency is like that of the
bulb,  and—some think—they are  more equable  in their effects.
To ensure this, however, they must be gathered wholly ripe, when
they first  become entirely  black.   They have been highly recom-
mended by Dr. Williams and others.
   The flowers  are the mildest part of the plant.   They have been
successfully  administered by  several English physicians.

           EFFECTS  ON THE ECONOMY IN HEALTH.
   In  its effects, colchicum resembles digitalis in one thing, that it
renders the pulse less frequent,2 according to Thomson and Willis;
but, in  other respects, Osann and Riecke3 think it  agrees  more
with  squill.4  In moderate doses, the different parts of the  plant
that  have  been mentioned  act as  diaphoretics, diuretics, and
cathartics.  On the digestive organs, they are conceived to pro-
duce  less  debilitating effects  than squill.
   Sir Everard  Home ascribes much of the griping and nauseating
effect which sometimes follows the use of the vinous and other tinc-
tures  of colchicum that have not been carefully filtered, to the
sediment which  forms in them,  and which may be removed  with-
out injury to the desired effect  of  the  medicine.5  Sir C. Scuda-
more,0 however, found the sediment to be inert.   Several experi-
ments were  made with colchicum on healthy individuals.  In the
first case, 160 drops of the vinous tincture of the seeds were taken

  1 Pharmaceutical Transactions, July 1,  1844.
  * Art. Colchicum, Encyc. Worterb. der Med. Wissensch. viii. 136.  Berlin, 1832.
  3 Op. cit. S. 142.
  4 See the author's General Therapeutics and Materia Medica, 4th edition, i. 290
Philada. 1850.
  5 Brande's Dictionary of Materia Medica, p.  189.  Jjondon, 1839.
  6 Treatise on Gout, 3d edit. p. 513. 
226
COLCHICUM.
in 24 hours, by a young man aged 18;—the first dose being 50
drops, the  last, 60.   Seven  copious  evacuations  were produced,
with loss of appetite and debility for twenty-four hours.   In  the
second  case, a youth, 17 years  old, took 170 drops in 9 hours, in
doses of 70, 60, and 40 drops: nausea and vomiting, and  six
copious evacuations followed. Third  case; a youth, aged 15, took
130 drops  in 10 hours,  in 4 doses;  the first, of 40 drops, and,  the
last three, of 30; vomiting and only one evacuation were the result.
Fourth case;  a  youth,  aged  12, took 60 drops in two doses, after
an interval of eight hours:  nine copious watery  evacuations were
produced.   Fifth case;  a youth, aged  17, took 40 drops at bed-
time, 30 drops next morning, and 30 drops seven hours after,—in
all, 100 drops in 19 hours: vomiting and faintness, and five copious
evacuations were the result.  The same boy afterwards took 70
drops at one dose, which were followed by vomiting and headach,
but  not by purging.  Sixth case;  a boy, aged 10, took 80 drops
in 24^  hours, in four doses, of 20, 15, 25,  and  20 drops: great
sickness and vomiting,  and nine evacuations resulted.
   Dr. John Aid ridge1 states, that he has seen three cases in which
profuse ptyalism followed the use of half a dram of the tincture of
the seeds taken for some time thrice  a day.  In one of these cases
at least, mercury had never  been taken ; nor had the patient ever
been salivated.   They  were all cases of ophthalmia.
           EFFECTS ON THE ECONOMY IN DISEASE.
   The diseases in which colchicum is recommended, are as follows:
   In gouty and rheumatic cases, it has  been  supposed to be
almost a specific.   Numerous  practitioners  have testified  to its
valuable agency in  such affections;  among these, may be  named
Mr. Want, Dr.  Johnson, Dr. Williams, Mr. Battley, Dr. Arm-
strong, Sir Everard Home, Sir C.  Scudamore,  Mr. Haden, Dr.
Copland, Dr. Graves, Sir Henry Halford, Dr. Wallis, Dr. Barlow,2
Mr. Wigan,3 Dr.  Holland,4 Dr. Gairdner,5 Dr. Seymour,6 and
others in England; and Locher-Balber, Kahleis, Gumpert,  Plasse,
Weber, Klokow, Biermann, &c, in  Germany.7   Colchicum is pre-
sumed to be the active  ingredient of the celebrated gout remedy—
Eau  mtdicinale d'Husson—which  has  been  considered to  be
formed of two  ounces of  colchicum root,  macerated in eight
ounces of sherry wine; the  dose being from  twenty to eighty
 drops.
   1 Dublin Hospital Gazette, Oct. 1, 1845; cited in Amer. Journal of the Medical
 Sciences, Jan. 1846, p. 215.
   2 Art. Gout, in Cyclopaedia of Practical Medicine, Amer. edit.  Philad. 1845.
   3 Lancet and Med. Gaz., June 30,  1838.
   4 Medical Notes and Reflections, 2d edit, p. 124, Lond. 1840.
   * On Gout; its History, its Causes, and its Cure.  London, 1849.
   6 Thoughts on the Nature and Treatment of several Severe Diseases of the Human
 Body, i. 93.  London, 1847.
   1 Riecke, Op. cit, and Richter's Specielle Therapie, x. 180.  Berlin, 1628, 
COLCHICUM.
227
    Dr. R. B. Todd1  considers colchicum  to  be chiefly applicable
 to the sthenic form of gout, which occurs in robust constitutions,
 and in the prime of  life, and that it is almost  inadmissible in per-
 sons  advanced in years, who  have had  several  attacks, and  in
 whom the malady would seem  to be too deeply rooted to be in-
 fluenced by the temporary administration of this remedy; and Dr.
 Seymour  affirms, that  " in  gout,  especially  in  gout originated
 from  excess;  in strong, violent, painful gout, it may be given not
 only without fear, in moderation, but with almost an absolute cer-
 tainty of relief,  without, any bad effects either immediately  or
 remotely following its use."
    In acute rheumatism, as well as in  various inflammatory
 affections, colchicum was proposed by the author's friend, Mr.
 Charles T. Haden,3 as  an excellent sedative to  reduce excited
 organic action, which he conceived it capable of effecting to such
 an extent, that  blood-letting  might generally  be rendered un-
 necessary in febrile  and inflammatory disorders;4  yet, in the very
 cases in which it was  esteemed so appropriate by Mr. Haden and
 by Carminati,5 it is regarded unadvisable by others.  Thus, Riecke,6
 speaking of its  use  in acute rheumatism,  says, that it was at one
 time given in  that disease under the most  opposite circumstances,
 but that it was soon found  necessary to  restrict  its employment
 within narrower limits, and to pretermit it when any considerable
 febrile condition existed.
    The  author has often  exhibited  the different  preparations  of
 colchicum in  gout, and, frequently, with  decided  advantage; but
 very often it has failed  altogether.  In  his  own person,  it has
 never appeared to prevent or to modify the paroxysm. In acute—
 and the same may be said of chronic—rheumatism, its advantages
 have  not been by any means clearly marked  in  his  experience:
 many physicians, however, testify  most   strongly in its  favour.
 Like  other acro-narcotics, as  the cimicifuga, when pushed to the
 extent of slightly affecting the system, as shown  by nausea, with
 some  cerebral confusion, it  has, at times, effected  a revulsion,
 which has broken in upon the morbid chain in acute rheumatism.
 A severe case, under the author's care, yielded rapidly to it  when
 pushed to  the extent of inducing painful diarrhoea, accompanied
 by distressing tenesmus.  In  this case, twenty-five  drops of the
 tincture of the  seed were given  three times a day.  When the
 bowels become affected,  the remedy must  be discontinued altoge-
r tber,  or the quantity be diminished.   By attending to these  rules,
 Dr. Christison7 affirms, that he has never  had occasion to observe

   1 Practical Remarks-on Gout, Rheumatism, Fever, &c, p. 105.  Lond. 1843.
   2 Op. cit p. 93.
   3 Pract. Obs. on Colchicum Autumnale in Inflammatory Diseases.  London, 1820.
   4 See also Dr. Lewins, in Edinb. Med. and Surgical Journal, for April, 1837, or  in
 Brit, and For. Med. Review, for Oct. 1837, p. 565.
   4 Mcmor. dell' Instituto del Regno Lombardo-Venet. 1819.       6 Op. cit. S. 43.
   ' Dispensatory, p. 355.  Edinb. 1842. 
228
COLCHICUM.
any unpleasant effects from its use, or any symptoms which a dose
of opium  did  not readily subdue.  He  adds, that he  has  never
seen a case of rheumatism essentially  benefited,  till  the patient
suffered from colic and diarrhoea, on the one hand, or from frontal
headach and giddiness, on the other.   The ill success which some
practitioners have encountered in using colchicum, he thinks, may
have  arisen from inattention  to  this  circumstance.   In chronic
rheumatism, it has exhibited  less marked results;  yet  there is no
agent, perhaps, which is so much  employed in rheumatic cases in
general.   In none of these, according to most observers, need any
sensible evacuation be produced by it, although some, it has been
seen, have affirmed—and such is the result of the author's  obser-
vation—that it is more  efficient when it evinces its influence upon
the alimentary canal.1  Such, too, is the experience of M. Monne-
ret,3 who found that the powerful revulsion on the bowels, caused
by the tincture  in  the  dose  of one dram to  four  drams in the
twenty-four hours, given  in  one, two  or  four divided  doses, was
sufficient  to suspend or remove  the disease,— the improvement
always coinciding with the diarrhoea; and  Dr.Wigan3  asserts,that
he gives colchicum powder in rheumatic gout in the dose of eight
grains every hour, until  " active vomiting, profuse  purging, or
abundant  perspiration takes  place, or,  at  least, until the stomach
can  bear  no more," and, when thus administered, he pronounces
it to be " the  most easily managed, the most universally applica-
ble,  the  safest,  and  the  most certain  specific [?]  in the  whole
compass  of our  opulent  [London] pharmacopoeia."    Yet, Dr.
Upshur4  has  recently declared, that,  in chronic  rheumatism, he
thinks he has sometimes derived  great  benefit from it, but, in the
acute form, never.  ' He adds,  that it may  be he has been " so un-
fortunate  as always to  get hold  of an inferior preparation,"—a
qualification which, however, applies equally to the results of his
experience in  the chronic form of the disease.
   Mr. Anthony  White,5 himself  a sufferer from  gout, relies ex-
clusively  on a combination of colchicum and calomel, according to
the formula given  hereafter.   He is of opinion,  that  "the main
object to be  pursued towards the effectual  cure  of the  gouty
paroxysm, by the removal of  its  immediate cause,  is the restora-
tion of the natural  functions of the liver, as indicated by a copious
discharge of bile through the bowels."  On the other hand, Dr.
Gairdner6 maintains, that  colchicum   never more effectually re-
lieves the patient than  when  it acts silently and peacefully, with-
out  producing any evacuation whatever, or in any way disturbing
the  patient's  comfort  and ease.  It  has  been demonstrated, by

  1 See Wood and Bache's Dispensatory, Art. Colchicum; and Lewins. Op. citat.
  * Archives Generates de Vied , Mar. 1844, cited in London Med. Gaz.. May, 1844.
  3 London Med. Gaz. June 30, 1838.       4 Medical Examiner, Oct 1850, p. 580.
  6 London Medical Gazette, August  18, 1818.               s Op. cit. 
COLCHICUM.
229
Drs. Douglas  Maclagan, Chelius  and  Lewins, that it causes a
more copious discharge of urea from the system, and Dr. Gairdner
found, in repeated investigations,  that the increase  of urea was
attended by a great diminution of the urates in the urine.
   The  vinous  tincture of  the seeds  has been extolled in  the
tetanus of warm climates, by Dr. W. G.  Smith,1  of Port-au-
Prince.   He begins with 3ss.  and  increases the dose  every half
hour,  repeating it until  emesis or catharsis has  been produced.
It is then discontinued.
   In dropsy, colchicum was used of old with  good  results;  and
it has been  employed  in  modern times.  Carminati gives the de-
tails of a case of dropsy supervening  on scarlatina, and Plasse,
one of hydrothorax, in which it was  advantageously prescribed.
In such cases, it may be well  to push  the remedy until it affects
the bowels.   In chronic bronchitis, it has  been given with ad-
vantage by many physicians,  and especially by Drs. Armstrong2
and Hastings,3  and  Dr.  Pereira4  found  it  of great  service in
humoral asthma and other chronic bronchial affections, espe-
cially  when these complaints were accompanied with  anasarcous
sivellings.   By Drs. Eisenmann and Ficinus,5 the vinum colchici
has been given in gonorrhoea.  The latter prescribes from twenty-
five to thirty drops three  times a day, combined with  tinctura
opii, low diet, the warm bath, &c.   These means were attended
with unprecedented success in the treatment  of gonorrhoea and
other inflammatory discharges  from the urethra in the  male, and
from the vagina and uterus, in the female.
   By  Ritton6  it has been  advised  as an extremely  efficacious
remedy in leucorrhoea, in the dose of  five grains of  the powder
three times  a day;  and in several spasmodic diseases it has been
extolled by Raven.  Tait7 speaks in exalted terms of it in scar-
latina—the dose, to children from four to six years of age, being
three  or four  drops  of the vinum colchici every three or  four
hours.   Mr. Fosbroke  advises it  in  ischuria;  Elliotson  saw
favourable effects from it in obstinate prurigo;  Bullock gave it in
erysipelas; by Chisholm  and Baumbach8 it was exhibited success-
fully against tape-worm, and  Dr.  Chapman9 states that from ten
drops  of the tincture  of  the root  repeated several times in  the

  ^ American Journal of the Medical Sciences, for Nov. 1835, p. 66.
  2 Pathology of Consumptive Diseases.  London, 1822.
  3 Inflammation of the Mucous Membrane of the Lungs, London, 1821.
  4 Elements of Materia Medica, &c, ii. 947, London, 1842; or 2d  Amer. edit  bv
Carson,  Philad. 1846.                                              y
  6 Casper's Wochenschrift, Aug. 26, 1848; cited in Lond. Med. Gazette.
  6 Lancet, Aug. 2. 1844.
  7 Amer. Journ. of the Medical Sciences, May, 1838, p. 205.
  8 Rust's Magazin, B. xxi S. 270; and Osann, in Art. Colchicum, in Encyc. W6r-
terb. der Medicin.  Wissenschaft. B. viii. S. 136.  Berlin, 1832.
 .9 Lectures on the more Important Diseases of the Thoracic and Abdominal Viscera
p. 299.  Philad. 1844. 
230
COLCHICUM.
twenty-four hours, and  persisted in for some time, as much may
be "anticipated in functional constipation, with a view merely
to the restoration of the lost susceptibility of the bowels, as from
any  thing  else  within  his  experience.   He has rarely, indeed,
seen it fail.
   Colchicum is sometimes  applied  externally  as  a liniment to
rheumatic joints, in the form of the tincture of the seeds or bulb.1
It has been recommended  by Mr. Wansborough in gout f  two
drams of the tincture of the seeds being added to f ^iv. of a spirit
lotion.  It is affirmed, however, that the  local use of morphia had
the same effect,3—the part being bathed in hot water for a minute,
and then lint applied, spread with simple cerate, on which about
three grains of acetate of morphia were distributed.
   Mr. Laycock4 has advised the tincture of the root as an exter-
nal application in rheumatism, alone or combined with tinctura
camphoras.  It was used in the author's  Clinic at the Philadel-
phia Hospital, and  often with advantage;  but whether much, or
any of the benefit was produced by the colchicum, he was unable
to decide.
                 MODE OF ADMINISTRATION.
   Colchicum is not so frequently given  in  substance, although  it
is often prescribed in this form.   The dose of the powdered root
is from three grains to  ten, several  times in the  day.  The offici-
nal preparations of this  country  and  Great Britain are :—acetum
colchici (United States  and London;) oxymel colchici (Dublin;)
syrupus colchici (Edinburgh ;) vinum  colchici radicis (United
States and London;) and extractum colchici aceticum (London;)
than which, Dr. Holland5 affirms, he knows  no  preparation more
certain in effect, or better  capable of fulfilling the  peculiar pur-
poses of the medicine.   These are made  from the bulb.
   The officinal preparations from the seeds are tinctura colchici
seminis (United States and Dublin;) and  vinum colchici seminis
(United  States.)  The London Pharmacopoeia has  likewise  a
spiritus seminis colchici ammonia/us or tinctura colchici
composita, which is much used by the English physicians, and
is formed by macerating two ounces and  a half of bruised colchi-
cum seeds in a pint of aromatic spirit of ammonia.  Mr. Bat-
tley recommends an extractum colchici e succo bulborum re-
center expresso, and such a preparation is in the Pharmacopoeia
of Austria.3  The dose  is two grains every two hours.
   Dr.  A. T. Thomson  recommends  a  saturated vinous tincture,
made by macerating an ounce and a half of the dried bulb in twelve

  ' Diet, de Matiere Medic, par MM. Merat and De Lens, ii. 361.
  2 Lancet, July 29, 1837.                       3 Ibid. Aug. 5, 1837.
  4 London Medical Gazette, March 16, 1839, and June 8, 1839, p. 388.
  5 Medical Notes and Reflections, 2d edition, p. 153. London, 1840.
  s Jourdan, Pharmacopee Universelle, i. 436.  Paris, 1828. 
COLCHICUM.
231
ounces of white wine.   From thirty to sixty minims are given to
gouty patients when in pain.
  The dose of the powdered root  or seed  is, as was  said, from
three to ten grains; of the acetum colchici, from thirty minims to
one fluidram;  of the syrupus colchici, from one fluidram to half
a fluidounce ; of the vinum colchici radicis, from fifteen minims to
one and a half fluidrams; and of the vinum colchici seminis from
one to two fluidrams.
  Dr.  Copland1 suggested the use of the fresh flowers in the form
of vinegar, tincture, &c, as milder than the seeds or bulbs, and yet
equally efficacious in rheumatic and other affections;  but they are
not employed.
             Haustns colchici et  magnesiee.
                   R.  Vin.  rad. colchic. 9j.
                       Magnesias J^ss.
                       Mist, camphor, gx. M.
                 Fiat haustus.
               To be taken twice a day in gout.
                                                 Seymour.
                     Mistura colchici.
                   Mixture of colchicum.
                      Scudamore's mixture.
                 R. Magnes. sulphat. ,§j. ad ^ij.
             Solve in
                    Aquae menth. crisp, f Ix.
             Adde
                    Acet. colchic. f 3J. ad f §iss.
                    Syrup, croc, f §j.
                     Magnes. Qviij.  M.
  To be well shaken.   Three table-spoonfuls to be administered,
so that from four to six evacuations may be produced in twenty-
four hours.  Given in paroxysms of gout.      Sir C. Scudamore.
               Guttse  colchici composite.
               Compound drops of colchicum.
                 R.  Extract, aconit. 9j. ad gss.
             Solve in
                    Vin. colchic. sem. f ^ss.   M.
  Fifteen, twenty, thirty, or  forty drops to be given three times a
day.                                                Weber.
                 R.  Tinctur. colchic. sem.
                    -----guaiac. aa. f jiij.  M.
  Dose.—Thirty or forty drops three times a day in chronic rheu-
matism.                                         Blasius.
                 R.  Tinct. colchic. sem.
                    ------digit, aa. f £ij.
                    Sp. aether, nitric,  f gss.  M.
  Dose.—Twenty drops, on sugar.              Hildenbrand.
1 Lond. Med. Repos. 1823. 
232
COLLODION.
                      Pilulae  colchici.
                     Pills of colchicum.
                 R.  Colchic. pulv. gr. iij,
                     Saponis q. s. ut fiat pilula.
  Dose.—Three daily, increasing the quantity to five or six.
                                                    Ritton.
               Pilulse  colchici  composite.
               Compound pills of colchicum.
                 R.  Extract, colchic. acet. gr. iij.
                     Pulv. ipecac, comp.
                     Ext. colocynth. comp. aa.gr. j—ij.  M.
                 et fiat pilula.
  In gout.                                 Sir H. Halford.
                 R.  Ext. colchic. acet.
                     Hydrarg. chlorid. mit.
                     Aloes, aa. gr. j.
                     Ipecac, pulv. gr. ij.   M.
  Dose.—One every four hours in gout.   Two or three are gene-
rally enough " to produce  a considerable disgorgement of the liver."
This is assisted by one or two doses of compound decoction of aloes.
                                                 A. White.
           Linimentum colchici et  camphorse.
           Liniment of colchicum and camphor.
                 R.  Tinctur. colchic. rad.
                     1------camphorae, aa. partes aequales.  M.
                                                  Laycock.
                  LXIV. COLLO DION.
      Synonymes.—Collodium, Ethereal Solution of Gun Cotton.
  Professor Schonbein appears to have first shown the solubility of
gun  cotton in sulphuric ether.  He states, that long before it was
employed in this country, he had recommended for surgical  use a
fluid, which he termed, " liquor constringens " and "ether glue;"
and that it had been  employed in  Switzerland three years previous
to any notice of it in America.1   Specimens of the solution  were
exhibited  by Dr. C. F. Jackson before the Boston Society for
Medical  Improvement, in December, 1846, or January,  1847, to
illustrate its  use as a brilliant varnish.   Soon afterwards, Dr. H.
J. Bigelow3 prepared a bottle of the solution according to Dr.
Jackson's directions,  and whilst  employing it as a  varnish,  he
accidentally smeared  it  on  a fresh  wound of the  finger.  The
smarting that resulted drew his attention  to the wound, and  he
immediately endeavoured to  rub  it off,  but it had  dried almost
instantaneously,  and  remained on; the smarting  soon ceased, and
          1 Lancet, Mar. 17, 1849.
          s Boston Medical and Surgical Journal, Mar. 22, 1848. 
COLLODION.
233
when the film was removed, union had taken place.  Dr. Bigelow
at once had recourse to it as a dressing for wounds, especially such
as it is desirable to unite rapidly by the first intention.
   About the same time  a young medical student, Mr. George P.
Maynard,1 of Boston, exhibited a similar liquid adhesive substance,
which he had introduced as a substitute for the common adhesive
plaster, over which it seemed to possess many advantages, and to be
applicable to cases in which  the latter is not; and in a letter to Dr.
John D. Fisher, read  before  the Boston  Society, Mr. Maynard2
stated, that he had used the adhesive liquid, and seen  it used by
his preceptor, Dr. Whitney, in  more than one hundred cases  of
surgery, some of them serious,—and in all successfully.    Mr. May-
nard  appears to  have first  used it  surgically  in January, 1847:
and it was, in consequence, known for some time under the name
of "Maynard's adhesive liquid;" but, subsequently, it received
the name  Collodion—from  xovko., ' glue;' — by which it  is now
known.
                  METHOD OF PREPARING.
   The formula generally adopted for  the preparation of collodion
is that of M. Mialhe.   The plan recommended by Mr. Maynard
was to treat cotton with nitric and  sulphuric acids; washing
the substance thoroughly, and afterwards dissolving it in pure sul-
phuric ether.  Several French chemists, on repeating the process,
failed to procure the cotton in a state in which it could be dissolved
by ether, when M. Mialhe8  ascertained, after many trials, that it
was much more readily procured by using a mixture of nitrate of
potassa and sulphuric acid.  M. Mialhe's process is as follows:—
Take of finely powdered nitrate of potassa 40 parts by weight;
concentrated sulphuric acid 60 parts, carded cotton, two parts.
Mix  the nitric  with the  sulphuric acid  in a porcelain vessel; add
the  cotton, and agitate  the mass for three minutes by the aid of
two glass rods.   Wash the  cotton, without first pressing it, in  a
large quantity of water, and when all acidity is removed, as indi-
cated by litmus paper, press it firmly in a cloth.   Pull it  out into
a loose mass,  and dry it in  a  stove at a moderate  heat.  The
compound,  thus obtained, is not pure fulminating cotton—French,
fulmicoton: it always retains a small quantity of sulphuric acid ;
is less inflammable  than gun cotton, and leaves  a carbonaceous
residue after explosion ;  but it possesses, in a  remarkable degree,
solubility in ether, especially when mixed with a little alcohol.  The
collodion' is made of  this prepared cotton, 8 parts  by weight;
rectified sulphuric ether, 125 parts ; and alcohol, 8  parts.  The
cotton is  put with the ether into a  well-stopped  bottle,  and the
mixture is shaken for some  minutes.  The alcohol is added  by
   1 Amer. Journal of the Medical Sciences, April, 1848.
   3 Boston Medic.il and Surgical Journal, Mar. 29, IS 18.
   3 Lond. Med. Gazette, cited in Amer. Journ. of Pharmacy, Jan., 1849, p. 42. 
234
COLLODION.
  degrees, and the mixture is shaken until it acquires a  syrupy con-
  sistence.   It may be then passed through a  cloth, the residue be
  strongly pressed, and the liquid kept in a well-secured bottle.
    Other modes of preparing it are given by Mr. J. B.Edwards,1 and
  by Messrs. Charles S. Rand'1 and Edward Parrish.3  Gun cotton will
  also  dissolve in equal  parts of ether  and  alcohol, and form as
  adhesive a solution as that in ether alone.  It of course dries more
  slowly, and  whilst it may not be as well adapted  for  holding  the
  edges of incised wounds together as the latter, it may be preferable
  in certain cases,—as an application to abraded  surfaces, for example.
    Collodion has been used extensively by the surgeon as a reten-
  tive adhesive compound in all cases of solution  of continuity,—
  either applied directly to the  part, by being brushed  over with a
  camel's hair pencil, or spread on strips of cotton.   On ulcers and
  abraded surfaces—as  in superficial burns it acts as an excitant;
  the ether evaporates, and a film is left, which  protects them against
  the irritating and desiccative influence of the air.4  It was sug-
  gested in burns by Dr. Payne, dentist, of Montreal; and Dr. Craw-
 ford5 of that city employed it successfully, and since then its utility
  has been confirmed by others.6 M. Briquet7 used  it successfully in
 a case of erysipelas of the abdomen; and Dr. J. W. Freer,8 of Illi-
 nois, in an epidemic erysipelas, which prevailed there in the spring
 of 1839, applied it, by means of a  feather, over the affected part.
   By Mr. Erasmus Wilson9 it was prescribed in various cutaneous
 diseases,  and  wTith advantage, — for example,  in chronic  ery-
 thema of the face, intertrigo, chapped nipples  and  chapped
 hands ; herpes  labialis, h. prasputialis, and h. zoster; lichen
 agrius ; lupus non exedens, and l.exedens; acne vulgaris, and
 several affections of the sebiparous organs.   In these  cases, it
 has the same action as in burns;  and besides by its contraction,
 during the evaporation of the solvent, pressure is  exerted on the
 part, which may be of  essential service.   As elsewhere remarked
 by the author,10 in cases  of acne and follicular affections of the
 skin in general, he has seen advantage from it.   Occasionally, it
 has induced  an  inflammatory  condition of the follicles, and  at
 first  seemed  to  aggravate the  affection; but, subsequently, good
 has resulted from the modified nutrition induced.  As a protect-
  1 Lond. Pharmaceut. Journ.: cited in Amer.  Journ. of Pharmacy, July, 1849, p.233.
  s Amer. Journ. of Pharmacy. July, I84'.t. p. 209.    3 Ibid. October,  1849, p. 289.
  4 For a summary of the surgical and other cases in which it had  been until tfrat time
 employed, see Bigelow and Maynard, op. cit, and Lond. Journ. of Medicine, Feb., 1849;
 or Ranking's Half-yearly Abstract, Amer. edit., ix. 100, Philad., 1849.
  'British Amer. Journ., Aug. 1848.
  6 Lambert,  Gazette  Medicale  de Lyon; cited in Bouchardat, Annuaire de Thera-
 peutique, pour 1850, p. 241; and Liman in Casper's Wochenschrift, Juli 27, 1850,cited
 in Keller und Tiedemann's JNord Amerikanischer Monatsbericht fur Natur—und Heil-
 kunde, S. 188, Nov. 1850.
  * Bulletin de Therapeutique, xxxviii., 322; cited in Brit,  and For. Medico-chirurg.,
July, 1850, p. 275.
  ' North Western Medical and  Surgical Journal, Jan., 1850.  » Lancet, Nov.,  1848.
  10 General Therapeutics and Mat. Med., 4th edit., i. 497, Philad., 1850. 
COLLODION.
235
 ing, supporting  and compressing agent, it appears to have been
 applied with advantage by M. Caballero1 over a large  aneurismal
 tumour  of the subclavian artery;  and Dr. Brainard2 used it with
 advantage for the cure of erectile  tumours {ncevi) without opera-
 tion.  Dr. John Evans,3 disheartened  by the general want of suc-
 cess in preventing suppuration in mastitis, and satisfied  that the
 most prominent  indication of cure is to overcome the freedom with
 which blood is sent into the mamma, and by compression cause the
 absorption of  the effused plasma, employed a coating of collodion
 to obtain  the benefit of its contraction;  and  he affirms, that in no
 case, except  one, had  the  slightest suppuration supervened.   In
 every one, the relief -was prompt,  and  no inconvenience  resulted
 in any, except the slight smarting caused by its application.   Mr.
 Wilson, as well  as others,  found that the film left by the  eva-
 poration  of the solvent is  liable to crack from  want of elasti-
 city, and consequently to peel off, a defect which is remedied  by
 combining a  certain  portion  of oil with  it:  by this means, the
 film is sufficiently elastic to follow the motion of the part to which
 it is applied, without separating  into flakes.   A farther improve-
 ment was considered to be effected  by giving the solution a  flesh
 colour.  The coloured solution has  been  called collodium tinctum.
   Dr. Simpson4 employed it with perfect success in some cases of
painful fissures at the base of the nipple.   Having brought to-
 gether the edges, he applied the  collodion, which formed a  protec-
 tion against  all  irritating influences, and  permitted the  child to
 suck.  The  healing process took  place rapidly.   Equally good
 effects in  cases of sore nipple were  obtained  by Mr. Brown.5
   Dr. T. R.Mitchell6 considers  it superior in ulceration of the os
 and cervix xderi to nitrate of silver.   It forms an artificial cover-
 ing to the ulcer, and permits the healing process to go on beneath.
 In cases of simple abrasion, three applications have proved  suffi-
 cient; in more obstinate cases, he has employed caustics first, and
 then  covered the eschar with collodion,  and has in this way cured
 extensive ulcers  in half the  lime required by  other methods.   He
 has likewise found it  beneficial  in  inflammation  of the  vagina
 without  ulceration.  In cases of chancres,  which have  become
 clean, and are  in process of reparation,  H. Lippert has seen  the
 cicatrization  rapidly effected by the application of collodion, seve-
 ral times  a day, by means of a camel's hair pencil.7
   In bleeding from leech bites, the hemorrhage was restrained bv
 Mr. Tucker,8  by compresses of lint dipped in collodion, and it

  1 Wahu, Annuaire de Mcde ins et de Chirurgie pratiques, pour 1850, p. 215.
  * North Western Medical aid Surgical Journal. Sept., 1849.   3 Ibid., Sept., 1850.
  4 Monthly Journal of Med. Science, July, If 19.         5 Lancet. Dec. 24,1848.
  6 Dublin Med. Press, Oct 4, 1848.                 ' Lancet, Dec. 9,  1848.
  "Casper's  Wochenschrift, Pi Febr.. 1850, No. 7, cited in Keller und Tiedemann
Op. cit., Dec, 1850, p. 221. 
236
COLLODION.
succeeded also with Mr. R. T. Wylde.1   Dr. W. H. Ranking2 ap-
plied it advantageously with the same view in the incisions made in
cupping.   By Dr. Muirhead3 it was employed with great benefit in
bed sores;  and by Dr. W. H. Ranking1 it has been suggested as a
valuable application to the face for the purpose of excluding the
air, and preventing pitting in variola.   As a stopping for  teeth,
it was used by Mr. Ancell, and by Mr.  J. Robinson,5 dentist; the
latter of whom affirms,  that he has frequently applied collodion in
severe cases of toothache, arising from exposure of the nerve, with
perfect success, where  no persuasion could  induce  the patient to
submit  to extraction.
  By M. Hairion8 it  has been employed to glue the eyelids to-
gether, where it has been desirable, as in keratitis and conjuncti-
vitis, to protect the inflamed surface  from  the contact of air, to
prevent the movements of the eyelids over it, or to retain topical
applications in contact with it.  He usually applies it to the eyelids
of one eye,  and afterwards, if both eyes are diseased, to the other.
The adhesion  never continues longer than forty-eight hours.  A
little space  may be left at the angle of the eye for the discharges
from the inflamed surface to escape.   In perverted states of the
eyelids—as trichiasis, districhiasis, entropion, ectropion, &c, the
ease wilh which the desired rectification can  be secured renders it,
M. Hairion considers, a  most valuable palliative and even curative
agent.
  In pharmacy, collodion  has been employed  as a coating for
pills.   The pill is placed on the point of a needle and dipped in
the solution.   M.  Durden7 employs one  of the  specific gravity
.810, and two immersions are sufficient. Pills of aloes and colo-
cynth, thus coated, can be taken without the slightest taste of those
nauseous articles being perceived.

  Cantharidal Collodion, Collodium vesicans seu  canthari-
dale ;  French, Collodium cantharidal.  Under this name, a  vesi-
cating agent has been proposed by M. Uisch,8 of St. Petersburg.
It is prepared by exhausting, by the method  of  displacement, a
pound of cantharides coarsely powdered, with a pound of sulphuric
ether and three ounces  of  acetic  ether.  In  this  manner, a satu-
rated solution of cantharides is obtained.  In  two ounces of this
solution twenty-five grains of cotton powder are dissolved.  It
may be preserved unchanged in well-stopped bottles.9
  1 Lancet, Jan. 6, 1849.                       a Ibid., January 13, 1849.
  3 Ibid.. Jan. 27, 1849.         4 Op. cit.         s Lancet, Dec. 30, 1848.
  "L'Union Medicale, Nov. 29 &'31; cited in Brit, and  For. Medico-chirurg. Rev.
July, 1849.
  * Bouchardat, Annuaire de Therapeutique, pour 1850. p. 243.
  * Canstatt und Eisenmann's  Jahresbericht iiber die Fortschritte in der Heilkunde lm
Jahre 1849, S. 178.  Erlangen, 1850, and Pharmaceutical  Journal, Mar. 1, 1850, cited
in Amer. Journ. of Pharmacy.  July, 1850, p. 229.
  9 Bouchardat, Annuaire de Therapeutique, pour 1850, p. 101. 
COMPRESSIO.                      237
  Mr. Charles S. Rand,1  of Philadelphia, who has made  many
experiments with this preparation, confirms the statements of M.
Ilisch  in its favour.   Some improvements, he  thinks, might  be
made  in his formula.   The  proportion of cantharides is unneces-
sarily large, a tincture made with double the amount of ether being
found  to vesicate with equal power.
  In employing M. Ilisch's preparation, it is sufficient to paint the
part with a camel's hair pencil dipped in it; and if, after desiccation,
which takes place in less than a minute, it appears that the skin
is not entirely covered, the operation must be repeated.   A more
certain and rapid action is obtained, if the part be covered with a
little lard or simple cerate.  No longer time  is  required for the
blister to be produced than in the case of the Emplastrum cantha-
rides;  and  it has  the advantage  of not  being disturbed  by the
movements of the patient.
   According  to Mr. Rand, the contraction induced by it, as in the
case of simple collodion, is a serious objection,—owing to its not
only causing  pain  in  the sensitive vesicated surface, but retarding
the necessary action;  but the addition of Venice turpentine to the
amount  of about one per cent, effectually obviates  this, " and
renders the preparation  perfect."  When the blister is formed, the
film of collodion  loosens, and, curling at  the  edges, may, by a
slight  effort, be detached without rupturing the membrane beneath.
If it be simply painted upon the skin, and the ether be allowed to
evaporate, vesication  does  not take place  sooner than  with the
officinal  plaster; but  if immediately on its application a piece of
oiled silk be bound upon the part, and suffered to remain an hour,
so as to  prevent rapid desiccation, a blister will be formed in three
hours, sometimes more quickly; and in one instance it formed in
one hour.2
   The cantharidal collodion has been frequently employed, and has
 met with much favour.
                   LXV.  COMPRESSIO.
Synonymes. Compression, Methodical Compression.
German.  D r u c k .
  This valuable method of modifying  the  condition of the capil-
lary or intermediate system of vessels, and, through it, the function
of nutrition, has become more extensively employed in the treat-
ment  of disease.   As a sorbefacient, in various hypertrophies and
dropsies, anasarca, ascites, ovarian dropsy,3 chronic hydrocephalus,4

  ' Amer. Journ. of Pharmacy, Jan., 1850, p. 20.            2 Rand, Op. cit.
  3 Mr. Isaac Brown, London Lancet, May 9, 1844, and April 5, 1845.
  4 Hirsch,X}asper's Wcchenschrift, cited in Provincial Med. and Surg. Journ. April 29,
1843.  Engelmann, cited from Gaz. Med. de Paris, Jan. 28, 1843, in Amer. Journ. of
the Med. Sciences, Oct. 1843, p. 458.
       16 
238
COMPRESSIO.
 &c, it has long been used wherever its agency was applicable, and
 its effects have been decided.1   Of late years, it has been proposed
 in inflammatory and other affections, in  which it had  been pre-
 viously esteemed inapplicable.   Upwards of twenty years ago, it
 was highly recommended in rheumatic affections, by Dr. William
 Balfour,3 of Edinburgh; and  numerous  cases were  brought  for-
 ward by  him,  and by others, to attest its efficacy.  Since then, it
 has been  advised by Guerin,3 in the cases  of phlegmonous erysipe-
 las of the extremities; by Velpeau,4 in severe burns, and phlebitis,
 and in inflammation of the synovial  apparatus f and Mr. James
 Allan 6 has related three cases of phlegmasia benefited  by a simi-
 lar treatment—twTo were of erysipelas of the lower extremities,
 and one of the face.   In these, compression was of speedy and per-
 manent benefit—the pain caused by it  being very transient.   He
 states,  moreover, that he has found  the bandage of very  great ser-
 vice in removing the pain  and swelling of joints affected with
 acute rheumatism, after the more  active degree  of inflammation
 had passed away.
   In cases of external inflammation, compression acts probably in
 two w7ays,—first, by diminishing the circulation  in the interme-
 diate system of vessels  concerned  in  the pathological  condition;
 and, secondly, by restoring tone to the over-dilated vessels; for it
 is in erysipelatous  affections, in which  this form of hyperasmia
 more especially exists, that it has been found of greatest advantage.
 Numerous cases of erysipelas of the extremities have been treated
 by the author by compression, and with  great benefit.  He  is con-
 stantly, also, in the  habit of employing compression, under the cir-
 cumstances mentioned by Mr. Allan, in arthritic affections attended
 with great effusion, and  with the most satisfactory results.
   From  an  observation of the  good  effects resulting from com-
 pression in analogous cases, it occurred to  Dr. Fricke,7 of Ham-
 burg, that, it might be employed with advantage in cases of orchitis
 or swelled testicle  (hernia  humoralis;) wThich is frequently vejr
 tedious, and requires means that are by no means easy of applica-
tion.   He, accordingly, had  recourse to it, and the result wTas sa-
 tisfactory: he found, that " the disease could be removed by it in a
simple, easy, and surprisingly rapid way."   Dr. Fricke was not,

  1 Clinique Medicale de l'Hopital  Neckar, p. 247. Paris, 1835; or the author's transla-
tion in American Medical Library, first year. See, also, the author's General Therapeu-
 tics, p. 228, Philad. 1836; or his General Therap. and Mat. Med. 4th edit. ii. 285, Philad.
 1850; likewise, Morelli, Annali Universali di Medicin.  Marzo, 1840, cited in Brit, and
 For. Med. Rev. Jan. 1841, p. 237.
  2 A new mode of curing Rheumatism and Sprains without Debilitating. Edinb. 1817.
  3 Journ. Analvt. i. 90.
  4 Ibid, and Bulletin General de Therapeutique, No. 16, Aout 30, 1836.
  5 Nouv. Bib. Med. Aout, 1826;  and Merat  and De Lens, Diet, de Mat. Med., art.
 Compression.                  6 British Annals of Medicine, Jan. 27, 1837.
  1 Zeitschrift fUr die gesammt. Medicin. B. i. H.  1,  Hamburg, 1836. See, also, Brit.
 and For. Med. Rev. for July, 1836, p. 253. 
COMPRESSIO.
239
however,  the  first  to employ compression  in  this disease.  It
would seem, that as long ago as the year 1803, itwTas used at the
Pennsylvania Hospital, by Dr.  Physick, and  by Dr. Hartshorne.1
Dr. Fricke is of opinion,  that, generally  speaking, compression
may be employed in every kind of inflammatory engorgement of
the testicle, whatever may have been its cause, and at all stages of
the disease.  In many cases, the pain was, at first, in some degree,
increased; and in some, especially when applied too .tightly, it in-
duced great suffering; but this never continued long—the  patient,
in a short time, finding himself so much relieved as  to be able to
leave his  bed and walk about the room.  In many cases of recent
origin, a single application of the compression was sufficient; but
when the disease was of longer duration, say from three  to eight
days, it was found  necessary to  repeat it two tor three times.
Swelling of the spermatic cord, if not very considerable,  did not
contra-indicate its use; nor did other coexistent local affections, as
buboes, ulcers, &c.  When a general febrile state accompanied the
orchitis, compression was found to be the best means for removing
it, where  the vascular action was not too considerable; although,
in extremely" rare cases, such a state  was  the effect of the com-
pression itself.   When the pain was very severe, it was generally
owing to  the compression having  been too strong, and the same
was the case with certain signs of gastric derangement, that occa-
sionally supervened.  In these  cases, it was necessary to  suspend
the  remedy until the derangement was removed by the use of an
emetic, or the application of a  poultice to  the stomach.  Such
cases were, however, extremely  unfrequent.   The  good  effects
exhibited  themselves  very soon   after its  employment,  and the
speedy abatement of the pain was always the  surest sign of its effi-
cacy.   If it continued for some hours  in any considerable degree,
a general disorder of the system might  be looked for to explain the
failure of success.
   In the summer of 1835, Dr. Fr-icke  treated, in  this   manner,
seventeen cases.  Of  these were cured, in  one day, one;  in three
days, four; in  four days, two; in five days, three; in  nine days,
one: and  in ten days, two.  The last three were severe and unfa-
vourable  cases.  For the purpose of  compression,  he employed
sticking plaster, made very adhesive, but not of too irritating ma-
terials, and spread on strips of  linen, of the breadth of the thumb.
No preparatory measures, as leeches, cataplasms, &c, are required.
In slighter cases, the patient may stand  before the surgeon, lean-
ing  against the wall, or he may  sit on the edge of a bed  or sofa,
so  that the scrotum may hang freely down.   If the scrotum and
neighbouring parts are much covered with hair, it must be removed;
but, generally speaking, this is unnecessary.            <

           ' American Journal of the Med. Sciences, Jan. 1842, p. 258. 
240                      COMPRESSIO.
   The following is the method adopted by Dr. Fricke for apply-
ing the compression:—The surgeon  takes the scrotum in one
halid, and  separates the diseased  from the sound testicle; whilst,
with the  other, he gently stretches the skin of the scrotum over
the former.  The spermatic cord  is isolated in the same manner.
If the swelling of the testicle be considerable,  it must be held by
an  assistant.  The surgeon now  applies the first strip over the
isolated spermatic cord, about a finger's breadth above the testicle,
holding the end  of the strip with his thumb, and passing it round
the cord.   He proceeds in the same manner with the second  strip,
which must cover the former either in part or altogether.   The
first part of the process  must be carefully done; the strips must
compress the cord closely; for this purpose, the cord must be kept
approximated to the skin, which must be tightly stretched  over
it;  otherwise, when the  other extremity of the  testicle is  com-
pressed, the  upper end will be apt  to slip upwards through the
loose rings of adhesive plaster, which  will not  only  occasion pain,
but render the  whole operation  abortive.   In this manner, the
surgeon proceeds, applying strip after  strip, the last  always  lying
over its  precursor by a  third of its width, until the thickest part
of the testicle, where  it  begins rapidly to decrease  in diameter, is
reached.   The  mode of procedure is  now  changed—the surgeon
lays hold of the part of  the testicle  already covered,  and  passes
his strips  longitudinally from  above  downwards over the lower
portion of the testicle.   In this way, the  rest of  the testicle is
closely enveloped and compressed.  The proper degree of com-
pression will be indicated, in most cases, by the speedy disappear-
ance of the pain which had previously existed.  When both testi-
cles are affected, they  must both be included in the circular strap-
ping—the testicle already covered  serving as a point  of support
for the other, as there is not room  enough for the  application  of
the circular strips over the second, in the  same way as  over the
first.   In  some  cases, where the  skin is  irritable, ulcerations take
place: small slits may then be cut  in the plaster, and  a Goulard
lotion be  applied.  Generally speaking, the patient may  leave his
bed immediately after the strapping has been attached, and walk
about the room; and,  where the inflammation  has not been great.
he may even attend  to light labour out of doors.  When the strap-
ping becomes loose, it may have to be reapplied, but often one ap-
plication is sufficient.
   In orchitis, caused by blows  or pressure, compression  is re-
garded  by Dr.  Fricke as  the best agent.   If the inflammation
runs very  high, he  usually applies  leerhes, in the first  instance.
and keeps on poultices for a clay or two; but,  in slighter cases, he
has recourse immediately to compression.  The principal advan-
tages which  he  considers  this  mode  of treating orchitis has
over others, are: First. The speedy removal of the pain; Secondly. 
COMPRESSIO.                      241
The quick removal of the disease itself; Thirdly. The simplicity
of the plan, and the-slight trouble given  thereby to the patient;
Fourthly.  Its small expense:  and, Fifthly. The comparatively
slight  care  and attendance required  on the part of the surgeon.
The last  two points, as he properly remarks, are of considerable
importance in hospital practice.
   Since this plan of treating orchitis was  suggested by  Fricke, it
has been successfully employed by our hospital and other surgeons,
although it has  been by no means extensively adopted.  Several
cases,  too, have been  mentioned by M. Dechange,1 of Liege,
formerly chef de clinique chirurgicale at  the Hopital de Baviere.
Of twelve cases of acute orchitis, thus treated, three were cured
in three days; and  the remainder  before  the seventh day.   Mr.
Langston Parker2 has also extolled this remedy, not only in ordi-
nary swelled testicle, but in chronic  or subacute inflammation
of the testes, whether dependent on  syphilitic causes or not; and
a more recent writer3 affirms, that he has  adopted the practice in
many cases, and  can speak most unequivocally in its praise.   It
may be employed, he  remarks, in very acute forms; and  he has
seen several instances, where the patients had not lain in  bed an
hour,  "whilst  under the  ordinary antiphlogistic treatment they
would  have been confined from ten days to a fortnight."
   Methodical compression has been employed with advantage  in
mammary abscess, by MM. Trousseau and Contour.4  They found
it  frequently produce a cure when used  at the  commencement
of the inflammation;  relieve the pain when suppuration  was esta-
blished;  and of great service after the abscess was emptied.   The
compression was made  by means of strips of diachylon plaster,
an inch  broad, and several feet  long, carried round the body, so
as to produce regular compression of the whole breast.5
   M.  Brachet, of Lyons,6 has reported four cases of spermator-
rhoea  treated by compression of the  prostate gland.   He states,
that pressure cannot be employed indiscriminately in every case;
often, by removing the cause we can cure the disease; bul he thinks
it will succeed  in  all cases of atony produced  by venereal  ex-
cesses, onanism  or blennorrhagia.  The effects produced by
compression are, in his opinion,  of two kinds.  In the first place it
keeps  the seminal fluid in its reservoirs, which are thus accustomed
to its  contact and  enabled to retain it longer; and in the second
place,  it modifies the condition of the  urethra, prostate, and semi-
nal excretory ducts.   The bandage  is composed of a waist-band

  1 Bulletin M6dical Beige, Aout, 1838, p. 218.
  2 London Lancet, July 25, 1840, p. 640.  Fee also, J. Dixon, Lond. Lancet, Dec. 5,
1840.                     3 Brit, and For. Med.  Rev., Oct.*1840, p. 393.
  4 Journal des Connai-sances Med. Chirurg., Fevrier, 1841.  See, also, J. Bell, Lond.
Med. Gaz., orMcd. intelligencer, Dec. 1841, p. 121.
  5 See. also, Littre, Journal des Connaiss. Med. Chirurg., Janvier, 1841.
  6 Medical Times, May 21, 1845. 
242
COMPRESSIO.
of leather, the extremities of which unite on the abdomen:  from
its centre behind a strap descends, which, on reaching the genital
organs, bifurcates, and is finally  buckled in  front to the cincture.
On the descending strap a small cushion is placed opposite the part
on which pressure  has to be made.   Dr. Batchelder,1 of Utica,
affirms, that he has been in the habit of using compression of the
perinseum as a remedy in this affection for upwards of twenty years.
   Compression of the arteries, as an antiphlogistic agent, has
been  revived  by  Goyrand,  Malapert, and  others;  the object
being  to  prevent  the afflux of blood  to a part labouring under
hypersemia.  The origin of this idea  has been  a matter of con-
troversy;2 but, as  Dezeimeris3 has remarked,  it certainly is not
due to the gentlemen who have engaged in it.   Blaud compressed
the  carotid in  brain fever;  Autenrieth did  the  same, before
Blaud, in cases  of convulsions.  Earl, in epilepsy; Livingston
and  Kellie, in rheumatism; Ludlow, in gout; and Parry, of
Bath, half a century earlier, employed  compression of the vessels
in different diseases, with the clearest  appreciation of its modus
operandi.
   Compression of the carotids has been used by M. Strohlin4 in
hysteric convulsions, and has almost  always  succeeded  in modi-
fying the form of the attack.  He used  it in two cases of epilepsy
with  similar success.   Compression of the carotids  at the com-
mencement of the  paroxysm always caused them to cease  in a
minute afterwards.
   M. Allier5 has published a case of intermittent neuralgia of
the lobe of the  right ear, cured  by compression of the  primitive
carotid  of the same side: half an hour before the paroxysm, the
compression was exerted, with interruptions of five minutes every
quarter of an  hour.   He has, also, reported  a case of neuralgia
of the orbito-frontal nerve; and, subsequently, of the nervus
pudendus superior,  respectively cured by compression of the
carotid, and abdominal aorta.  The compression of the carotid of
the affected side was continued the whole forenoon', with pauses of
five minutes every quarter of an hour.  For the pudic neuralgia,
the abdominal aorta was  compressed for the space of three quar-
ters of an hour: the neuralgia, in both instances, gradually ceased.
M. Dufresne6 has  published a  case of hemicrania and facial
neuralgia of the right side,  cured by  the same means. Compres-
sion of the right primitive carotid for  ten seconds occasioned in-
stantaneous disappearance of  the pain, which returned in one
minute  after  the removal of the pressure.   Compression of the

  1 New York Medical and Surgical Reporter, cited in St. Louis Med. and Surg. Journ.,
June, 1846, p. 43.
  2 Gazette Medicale de Paris, No. 46, 18 Nov., 1837, cnl No. 47.         ' Ibid.
  ' Archives General, de Medecine, Mars, 1811.
  : L'Exoerience. No. 16. 20 Jan., 1838.        ° Ibid. No. exxviii. Dec. 1339. 
COMPRESSIO.
243
 same vessel for twelve seconds also  caused immediate cessation of
 the pain, but it shifted to the posterior part of the head.  This pain
 ceased with the removal of the pressure, and in two minutes after-
 wards the original  pain  reappeared on  the right  side.  When
 graduated  compression was  made on the same vessel  for thirty
 seconds, the  pain, as before, moved  to the posterior'and left part
 of the skull.  M. Dufresne  then pressed on the left carotid, and,
 increasing  the  force as he  diminished  that on the right side, the
 posterior pain  disappeared,  and  no  return  of either had  taken
 place ten minutes afterwards.  The patient  slept well  and made
 no complaint of pain in the morning.
   The employment  of compression  of  the epigastrium to arrest
 hiccup was recommended by Bordeu, but it had  fallen into obli-
 vion.  It has  been revived,  however, and was suggested  to  M.
 Rostan1 by an old physician of Paris, whose wife was subject to
 attacks  of  hysteria, during  which  she suffered  from incessant
 hiccup, and in which he  had observed, that she experienced  re-
 markable relief from strong compression on the epigastrium with
 the hand.  Since then, M. Rostan has employed it in many cases
 of the same kind, and constantly with good effect, whatever might
 have been the cause of the hiccup.   To render the pressure con-
 stant, he  has  employed a  pad with  a truss-spring as a substitute
 for the hand; and JVL Boyer2 has recorded three  cases of painful
 and  obstinate hiccup instantly relieved by the same means.
   Compression of the abdominal aorta  has been  revived  by M.
 Baudelocque, and  many others, with the  view of arresting uterine
 hemorrhage occurring in labour, as well as the hemorrhage which
 follows wounds of the arteries of the inferior half of the body.3
 In a case of uterine hemorrhage, detailed  by Dr. Ehrenreich,1
 external compression by the  hand on the abdomen, which  is the
 only way of acting on the aorta when any obstacle exists to the
 introduction of the hand into the uterus, was tried without suc-
 cess, owing to the thickness of the abdominal parietes.  The he-
 morrhage was, however, completely controlled by introducing the
 entire right hand into  the uterus, and  making forcible pressure
 with the fingers in a conical shape on the aorta immediately above
 its bifurcation.   Many similar cases have been published and  re-
 ferred to by  M.  Piedagnel,  in a  memoir communicated to the
 SociiU Medicate d'Emulation, of  Paris, on which  an excellent
 report was read by MM. Velpeau and Britre de Boismont, giving
 a history of the process.   It  is necessary at times that  the  com-
pression should be continued for a considerable period, even for an
  ' I-.a Lancette Franchise, 20 Fevr. 1817.
  " Revue Medico-Chirurg. Juillet, 1847.
  3 See an account of  Baudelocque's views, by J. C. Christophers, in Lancet, July 20,
!839, p. 599.                                              .
vie' MJdjdnis^ titling, No. xxxvii.  1539, cited in  British and Foreign Medical Re- 
244
COMPRESSIO.
hour or two, should the case seem to require it.  The gentlemen
last cited advise that it should  be associated with ergot.1
  The  mode  adopted by M. Seutin2 for compressing the aorta in
such cases is as follows.   The woman  is to be placed on a ho-
rizontal plane, with the head and shoulders raised, and the thighs
flexed  upon the pelvis, in order to relax the abdominal muscles as
much  as  possible, and to avoid  mechanical  engorgement of the
uterine vessels. The surgeon, placed on the right side of the patient,
uses the left hand  to compress the vessel, keeping the  right dis-
engaged for any other purpose which  the case may demand.  The
intestines  being pushed on  one side  by  gentle manipulation, the
three fingers of the left hand  are pressed firmly and deeply be-
hind and to the left of the uterus, nearly on a level with  the um-
bilicus.  By this plan, the  aortic pulsations will be evident, and
farther pressure is then to be made in a direction downwards and
backwards.  In  order that  the operator may not be too much fa-
tigued  by continued exertion, his hand  may be compressed by
those of an assistant.
  Lastly: M. Allier3  employed  compression of both carotids in
a case of hydrophobia at the  commencement of an attack; imme-
diately, the convulsion ceased,  and the patient became apparently
exanimate.   The  family were alarmed,  and would not permit a
repetition of the experiment.   The case ended fatally.
  In paroxysmal  diseases,  the ratio medendi of compression is
not the same as in inflammatory diseases.   In the latter, the flow
of blood towards  the inflamed  part is prevented  by the compres-
sion of the arterial vessels proceeding to it; but when compression
is exerted on  the vessels in neuralgia and congenerous diseases,
the new impression  caused by the  resulting irregularity in  the
circulation, and the modification in the nervous functions  induced
thereby, break in  upon the morbid  catenation  like the  different
agents that are classed under the head of antispasmodics, of which
class wre have elsewhere endeavoured to show7—what, by the way,
is not  now contested  by any eminent therapeutist—that we  have
none that can be regarded in any other light  than as indirect
agents.4

  ' La  Lancette Franoai?e, 12 Mai, 1840.
  2 Bullet.de l'Acad. Med. Beige, cited  in Ranking's Abstract, pt. 1, p. 180, Amer. edit.
New York, 1845.              3  L'Experience, No. xvi., 2!) Janv., Id38._
  4 See the author's General Therapeutics, p. 380; or his General Therapeutics and
Mat. Med. 4th edit. i. 395.  Philad. 1850. 
CONTRA-IRRITATIO.—AMMONIATED COUNTER-IRRITANTS. 245
                 LXVI. CONTRA-IRRITATIO.
Synonymes. Counter-irritation, Courrter-action.
French.  Contre-irritation.
German. Gegenre izung.
   It is  not the object of the author to enter into  an explanation of
the therapeutical application of counter-irritants, or  revellents in
general:  this he has  done at considerable length elsewhere j1 but
to refer to some  agents not  mentioned  in the body of this work,
to which  attention has been revived, or  first directed, of late years
more especially.

              AMMONIATED COUNTER-IRRITANTS.
Gondret's ammoniacal  ointment; Granville's  counter-irritants
  —Antidynous3 counter-irritants—Raspail's counter-irri-
  tant.
   Ammonia has  long been used in different formulae  for exciting
rubefaction and  vesication of the  cutaneous  surface.   When two
parts of liquid ammonia are united with one part of suet, and one
of oil of sweet almonds, the  mixture forms the Pommade ammo-
niacale of Gondret, which has been used  for a long time to excite a
speedy revulsion  in cases of chronic affections of the brain, incipi-
ent cataract, amaurosis? &c, as well as to cauterize  the  integu-
ments deeply.4   To the advantages of this preparation, as well as
of derivation in various diseases, M. Gondret has called the atten-
tion of practitioners in an ex professo treatise.5
   The  formula, given  above, is that of the French Codex;  but,
according to M. Trousseau,6 it is much too hard for use, unless
the  weather  is  warm.  He  proposes  two  different  formula?,—
one for summer, and  the  other for winter.   In the former, he di-
rects three parts of lard, one of suet, and four of liquor ammonice;
in the latter, equal parts of lard, and liquor ammonice.
   M.  Gondret  has communicated to  M. Miquel a  formula for
his Pommade, which differs from that  of the Codex, and accord-
ing to him, succeeds much  better.   It is as follows:—Take of
lard, 32 parts:  oil of sweet  almonds, 2 parts.    Melt  by a gentle

   * General Therapeutics, p. 333; or General Therapeutics and Mat. Med. ii. 217.
   - A term coined by Dr. Granville. It ought to be "Antodynous," from avii,'- against,"
and cdvvtj, "pain."
   3 Bouchardat, Annuaire de Therapeutique pour  1844, p. 215, Paris, 1844, and Lis-
franc, Ibid.  845, p. 1255, Paris, 1845.
   4 Considerations sur l'emploi du feu en medecine, suivies de l'expose d'un moyen epis-
pastique propre a suppleer la cauterisation, et a remplacer l'usage  des cantharides.  Paris*
1819; and Nouv. Biblioth. Med. iii. 441, Paris, 1828.
   ' Traite theorique  et pratique dela Derivation contre les affections les plus communes,
en general, telle que la Plethore, l'lnflammation, l'Hemorrhagie, &c.   Paris, 1837.
  6 Journ. des Connaiss. Med., cited in Medico-Chirurgical Review,  July,  1840, and
Trousseau and Pidoux, Traite de Therapeutique, &c, 3eme edit. i. 366.  Paris, 1847. 
246  CONTRA-IRRITATIO.--AMMONIATED COUNTER-IRRITANTS.

heat; and add liquid ammonia  at 25°, 17 parts, stirring until it
becomes cold.1
  Since the  appearance of M. Gondret's treatise, Dr. Granville2
has published  one  on  counter  irritation,  which  gave  rise  to
much attention on  both sides of the Atlantic,—partly in conse-
quence  of the strong  encomiums he  passed on certain  counter-
irritant  applications employed by him; and  still more in conse-
quence  of the nrystery which he threw around them, by  keeping
their preparation a secret, until the united voice of the profession
had expressed the  mingled feelings  of surprise, indignation, and
regret, which such conduct on the part of an individual,  holding
an elevated position in the ranks of the profession, naturally en-
gendered.  It is due, however, to  Dr. Granville  to remark, that
on subsequently  publishing his formula?,  he stated, that he ad-
dressed  his work to the public to impress all with the value of the
agency, but that it would have been unwise in him to give precise
formula? to those who could  not estimate the proper proportions
of the ingredients; that every physician can apportion them; and
that he had  never concealed the formula? from his friends, and
always intended to give them to  the world.3
  Dr.  Granville describes two  sorts of  ammoniated  lotions,  of
different degrees of  power, which  are prepared  in  the following
manner: Each kind  of lotion consists of three ingredients:—1st.
The strongest liquor  of ammonia,  A.  2d. Distilled spirit  of
rosemary, B.  od. Spirit of camphor, C.   These  are  made  as
follows:—
   A. The strongest  Liquor of Ammonia.—Saturate  a  given
quantity of distilled water, contained  in a glass receiver surrounded
by ice, with  ammoniacal  gas obtained in the usual way from a
mixture of equal parts of muriate of ammonia and recently slacked
lime, both reduced to a fine powder.  The water may be  made to
take up nearly 800 times its bulk of ammoniated gas under the
circumstances described;  its specific gravity will then be  about
.872, and 100 parts of it will contain thirty-three parts of real
ammonia, according to Sir H. Davy's  tables.   This solution of am-
monia will, therefore, be more than three times the strength of the
liquor  ammonice of the Pharmacopoeia of London, 100 parts  of
which, at a specific gravity of .960, contain only ten parts of real
ammonia.  Dr. Granville, therefore,  called this "liquor ammonia?
fortissimus."  The liquor ammonia? fortior of the last United States'
Pharmacopoeia (1842,) which is  of the specific gravity .882, is of
sufficient strength.

  1 Bouchardat, Op. cit. 1845, p. 254.
  3 Counter irritation, its Principles and Practice, illustrated by one hundred Cases of
the most painful and important Diseases effectually cured by External Applications. Lon-
don. 1S38; or Amer. Med. Lib. edition. Philad. 1838,
  3 Lond. Lancet, Oct. 27, 1838. 
     CONTRA-IRRITATIO.—AMMONIATED COUNTER-IRRITANTS.  247

  B. Distilled Spirit of Rosemary.—Take two pounds of the
tips  or small leaves of fresh rosemary, and eight pints of alcohol;
leave the whole in infusion for twenty-four hours  in a well co-
vered vessel, and after adding as much water as will just prevent
the empyreumatic smell, distil over seven pints.  The Pharmaco-
poeias of London and the United States direct the essential oil of
rosemary to be  distilled  with  alcohol to form  the  spirit of rose-
mary.   Such a  preparation Dr. Granville found unsuited  for his
purpose.
  C. Spirit of Camphor.—To four ounces of pure camphor add
two  pints of alcohol, so  as to dissolve the camphor,  and filter.
  The  three ingredients, thus prepared, should be kept  always
ready at hand, in well-stoppered glass bottles, so  as to  be  able
to make, extemporaneously,  a counter-irritating lotion  of  any
requisite  strength, according  to the nature of the case.  But,
for  ordinary purposes, Dr. Granville advises that  both a  milder
and  a stronger ammoniated lotion  should  be kept, prepared for
use.
                Lotio  ammoniata mitior.
                  Milder ammoniated lotion.
  Assuming the quantity of lotion desired to be divided into eight
parts, the proportion of the ingredients will stand thus:—
  A—four-eighths.   B—three-eighths.   C—one-eighth,  or as
follows: —
                 R.  Liq. ammon. fort, f 5J.
                     Spirit, rosmarin.- f gvj.
                     Tinct. camphor, fgij.  M.

                Lotio  ammoniata fortior.
                  Stronger ammoniated lotion.
   If the quantity desired be also divided into eight parts, then the
 proportion of the ingredients will run as follows:—,
   A—five-eighths.   B—two-eighths.  C—one-eighth, or as fol-
 lows :—
                   R.  Liq. ammon. fort. fjx.
                        Spirit, rosmar. f ^ss.
                       Tinct. camph. f jij.   M.
   Although the changes of proportion  may be deemed  trifling,
 yet  the strength of this lotion  is such, that Dr.  Granville never
 employs  it, except in cases of apoplexy, and for the purpose of
 cauterization.
   Directions for  Mixing the Ingredients—A and B are gradually
 mixed together.   The mixture becomes opalescent and somewhat
 turbid,  and  a  peculiar, highly agreeable,  ethereal  smell is given
 out, different   from the  individual odour  of  either  ingredient,
 although the  extreme pungency of the ammonia is still discerni- 
248 CONTRA-IRRITATIO.--AMMONIATED COUNTER-IRRITANTS.

ble.   " I  have strong  reasons to believe,"  says Dr. Granville,
" that, at this point of the operation, some particular change takes
place, which imparts to the mixture of the two ingredients some
of its valuable peculiarities as a counter-irritant  described in my
work; but what that change is, it is not my business to enter upon
in this place: suffice it to say, that in a great number of experi-
ments made with the ingredients separately (for each of them acts as
a counter-irritant on the skin,) and with them  combined, the effects
were uniformly different; those in the former case  being found
unequal to the production of those complete results which  I trust
I have  justly promised to the profession.   Ammonia  alone (how-
ever  strong) w7ill not  give rise to the effects I have  described,
though it has often stopped internal  pain,  and produced  small
blisters; but never  has it succeeded in almost immediately pro-   !
 ducing a  full  vesication, as I have  seldom  failed to produce with
the  two ingredients mixed together, particularly after  the third
ingredient had been  added."   Before, however, the  third ingre-
dient is so added, it is  desirable  to clear the  previous mixture, by
the addition of a small quantity of alcohol, and  to set  the whole
in a cool place.  All the various precautions here mentioned may,
upon an emergency, be dispensed with, when an  immediate action
is required, either to  arrest pain or relieve deep-seated inflamma-
tion.   But  for the  more delicate uses,  particularly for instanta-
neous vesication, Dr. Granville recommends,  that the  preparations
should  be  obtained in the manner specified.  The  lotion must
always be kept in bottles with a glass  stopper.
   M. Raspail1 has recommended the following lotion, the effects
of which, he says, are often instantaneous  in relieving intolerable
 headach:
               R.  Liquor, ammon. p. 100.
                    Aquae destillat. p. 900.
                    Sodii chlorid. purif. p. 20.
                    Camphor, p. 2.
                    Essent. rosar. q. s.
   The  whole to  be mixed cold.
   A piece of linen is to be steeped in  this  solution, and  applied
over the  part of the  head wriich is the seat of pain, care being
taken that none of the fluid passes into the eyes.

            EFFECTS ON THE ECONOMY IN HEALTH.
   The  various counter-irritants, described above,  act  essentially
in the same manner; differing only in the intensity of the counter-
irritation  which they induce.  In all, liquor  ammonia? is the main
effective  ingredient.   The stronger  of Granville's  lotions  is a
powerful  agent.   It  gives rise, in a  few minutes, to  vesication
over  the whole surface to which it is applied; almost as rapidly,
indeed, as if boiling water were placed upon  the  part.
1 L,Exp6rience, 24 Juillet, 1840. 
    CONTRA-IRRITATIO.—AMMONIATED COUNTER-IRRITANTS.   249

  It need scarcely be said, that the strength of these lotions may
be regulated so  as  to  produce either full vesication, or simply
rubefaction, by varying the quantity of liquor ammonia?.
  The mode of applying these liquid counter-irritants  is, as in the
case of Oleum Sinapis—first to impregnate with them a piece of
cotton or linen, folded  six or seven times, or a piece  of thick or
coarse flannel; and then lay either of these on the  spot, pressing
with the hand, at the same time, very steadily and firmly on the
compress,  over which  there  should  be  placed  a thick towel,
doubled  several  times,  so that not only  the evaporation of the
lotion  may be  impeded, but  the hand employed  in pressing the
application  to the part may not suffer  from direct or indirect  con-
tact with the liquid.  Care must be taken that the ammonia  does
not reach  the  eyes or nose.1   As a general rule, the application
should seldom be kept on longer than from one  to six  or eight
minutes; and, Dr. Granville affirms, it has often happened to him
to find, that less than a minute was sufficient to produce the de-
sired alleviation of  pain and spasm.   But, in order to excite the
higher degrees of counter-irritation, vesication and  cauterization,
as many as ten or twelve minutes may be necessary.

            EFFECTS ON THE ECONOMY IN DISEASE.
   There can be no doubt  that the  ammoniated counter-irritants
are valuable agents in all those diseases which are capable of being
benefited by a sudden  and powerful  revulsion.   It is chiefly, as
elsewhere stated,2 when the diseased  action has  been prolonged
for a considerable period,  and in affections which belong to the
neuralgic class, that rapid revulsions are productive of the most
marked  advantage.   When the disease is  of an acute  character—
as  in  the  different phlegmasia—revellents which are more  pro-
longed in  their action,  are—as a general rule—preferable.  It is
in the first class of affections, chiefly, that his lotions  are extolled
 by Dr. Granville;  he urges the importance of the sudden vesica-
tion effected by them in the treatment of  many serious disorders;
and affirms that they  arrest  " nervous and muscular pain
almost immediately, provided  it does not depend on  structural
disease."-5   There  is  perhaps  no agent—he  remarks—except
boiling water, which can, in the space of between  three and ten
minutes, give rise to as ample a vesication.   But,  as  powerful
and effective a revulsion can be accomplished by the actual cautery
in various  forms, and  especially in that of the moxa.  This we
say from  observation;  and it is a  result to which  just  theory-
would lead us.   The ammoniated  lotions are, however, devoid of

  1 Granville. Op. cit., Amer. edit. p. 39.
  a General Therapeutics, p. 341; and General Therapeutics and Materia Medica. 4th
edit., ii. 221.  Philad, l-.V).
  1 Lancet, Oct. 27, I.S3S. 
250  CONTRA-IRRITATIO.—AMMONIATED COUNTER-IRRITANTS.

the painful mental impression, which the dread of actual fire occa-
sions;  although we doubt not that, in many of the cases above
referred  to,  such mental impression  may  exert an  important
agency in the cure.
   Dr. Granville gives the following, not very classically arranged,
list of  diseases, which, in the course of nine  years, have appeared
to him to be  benefited by his counter-irritants.
                          DISEASES.
     A.  Principally affecting the Nervous System.

   1.  Acute neuralgia f permanent } Tic douloureux-
     c          )          { Epilepsy.
   2.  Spasms     I including J St. vitns's Dance.
   3.  Convulsions J       & J Hysterics.
   4.  Cramp.
   5.  Brow-ague.
   6.  Tetanus or Lock-jaw.
   7.  Highly acute toothach.
   8.  Nervous headach.
B. Principally affecting the  Muscles and Tendinous Tissues.
   9.  Rheumatism.
  10.  Lumbago.
  11.  Swelled and highly painful articulations.
       C. Principally  affecting  the  Circulation.
  1 2.  Headach from fulness of blood in the head.
  13.  Congestions and sudden attacks of blood in the  head.
  14.  Sore-throat.
  , _  -p,  , . n   Ca. of the trachea and bronchia,     )   rr,__A-„ .„
  15.  Early innam-} ,   c.i,  i       a .u  •     i       f*   lending to
         *. j    ^ ft. of the lungs and their membranes, >„„„„„.„ .fnn
      mation     )    f .■•   .  °.   .    ■   i-        ' v consumption.
                (_c. oi the heart and pericardium.     j       r
           D.  Diseases  of  a  mixed  character.
                    a. affecting the heart.
,„  „       ,   , C a. affecting the heart.
16. Suppressed gout £ ^ affectin| the storaach.
 17. Genuine gout.
 18. Parylitic debility.
E. Accidental, mechanical and Cutaneous Derangements.
 19. Violent sprains.
 20. Pimples.
 21. Biles.
 22. Ringworm.
  Dr. Granville does not affirm that all these disorders, and their
modifications, have yielded to the ammoniated counter-irritants;
or that the counter-irritants were always the sole agents employed.
On the contrary, a few of them, he says, on particular occasions,
resisted  that agency;  others were only momentarily benefited;
and a  few more  required  the simultaneous  employment of ordi-
nary internal remedies to assist in, and complete the cure. Among
the exceptions  to the  general rule of  success,  he  enumerates 
                  CONTRA-IRRITATIO.—FIRING.               251

 chronic tic douloureux;  chronic rheumatism of long  standing;
 epilepsy dependent on organic mischief in the encephalon, or any
 part of the spinal apparatus; and rheumatic gout, in persons whose
 constitutions had  been completely shaken by that disorder, or by
 any other previous disease, although, even in this case, some good
 was obtained from using  the ammoniated counter-irritants.   The
 second and  fourth  of these disorders  are  of  the number  that
 require, in addition to the ammoniated applications, an appropriate
 internal  treatment.   The other two Dr. Granville  has found to
 be  only partially relieved, but never cured, by counter-irritating
 lotions.1
   In' many of the disorders, referred to by Dr.  Granville in the
 table given  above,  the ammoniated counter-irritants have been
 employed, both in public  and private in  this country.  They have
 been largely used  by the  author, and their effect in nervous  and
 spasmodic diseases, in neuralgic  and deep-seated  rheumatic
 vains, has, at times, been  very striking.   Severe  pains  have
 yielded rapidly, as  described by Dr.  Granville;  hyperemias of
 particular organs  have been diverted  elsewhere, especially after
 blood-letting  and  sedatives  had  been  premised; and,  in  short,
 whenever revellents, sudden  and  rapid  in  their action, have been
 demanded, ammoniated counter-irritants  have effected every thing
 that similar powerful revellents were capable of accomplishing,—
 but no more.  The author has been in the  habit of having re-
 course to the moxa  in congenerous affections, and with equally
 satisfactory results.   There is one objection, too, that applies to
 the use of these strong lotions:—the sloughs and  sores induced by
 them are often considerable, and remarkably difficult  to heal.
 This, it is true, may be  partly prevented, by being careful that
 the application is not too  long continued;  but, with the greatest
 caution, these results will, at times, supervene. When such is the
 case, simple dressings, with  emollient poultices, will be found the
 best applications.

   Not long ago, Dr. Corrigan,3 of Dublin, strongly recommended
 a mode of producing counter-irritation  as an admirable remedy in
 lumbago and analogous  affections in other parts of the  body. It
 consists in a species  of "firing" performed by an iron instrument
 which is  very portable, and  consists of a thick  iron wire shank,
 about two inches long, inserted in a small wooden handle,  having
 on  its extremity,  which  is slightly curved,  a disc  or button of
 iron, a quarter of an inch thick, and half an inch in diameter, the
 whole instrument  being  only six inches in length.  The  face of
the disc for application is quite flat.  The only other portion of
apparatus required is a small glass spirit lamp, so small that it can
be carried in the waistcoat pocket.  To use the  instrument, the
1 Op. cit, p. 29.
- Dublin Hospital Gazette, March, 1846, 
252
CORTEX ADSTRINGENS BRASILIENSIS.
lamp must be lighted, and  the button held over the flame, keep-
ing the forefinger of the hand  holding the instrument at the dis-
tance of about  half an inch  from the button.   As soon as  the
finger feels uncomfortably hot, the instrument is ready for use, and
the time required for heating it  to this  degree is only about a
quarter of a minute.  It is applied as quickly as possible, the skin
being tapped successively at  intervals of half an  inch  over  the
affected  part as lightly and as rapidly  as  possible; care  being
taken to bring the flat surface of the disc in contact with the skin.
In  this way, the process of firing  a whole limb, or the  loins,
making about one hundred applications, does not occupy a minute,
and once  heating the lamp  suffices.   The iron is never rendered
red hot; it is very little hotter than boiling water, and an eschar
is never made by it, and rarely a blister.  The pain produced by
its  application is so slight, that, according to Dr. Corrigan, some
of  the resident clinical clerks in the hospital preferred it, in their
own cases, when  suffering under local muscular  rheumatism,
to  any other  method  of counter-irritation,—it  being,  in their
opinion, the least troublesome, most  rapid, least painful  and most
effectual.  In sprains of the muscles of the  back and other parts,
and in  sciatica, he  has seen it render valuable service, as well
as in neuralgia of the fifth pair, and in paralysis of the portio
dura.   Even delicate females, he  says, will not object to its fre-
quent repetition, when required.
  The method of Dr. Corrigan has been extensively tried by Dr.
M'Cormack,1 who  has reported very favourably in regard to its
powers, and  by  others.
    LXVII.  CORTEX ADSTRIN'GENS BRASILIENSIS.

Synonymes.  Cortex adstringens Brasiliensis verus, Cortex adstringens
  verus, Astringent Bark of Brazil.
German.  Adstringirende Brasilianische Rinde.
  This bark was  introduced into Germany, in the year 1818, by
Schimmelbusch, a merchant, who carried it from Brazil, where
it had  long been used  internally, as well as  externally, as an ex-
cellent astringent.2  According to Von Martius,3 it is  the bark of
Acacia jurema, but this is not certainly determined.4  Oesterlen5
assigns it to mimosa  (acacia)  cochliacarpa  seu virginalis.
MerremB affirms, that the genuine  bark is in more or less flat
pieces; at times, in half, or complete rolls, from four to twelve

  1 Lancet, Jan. 5, 1847.
  a Von Schlectendal, in Encyclop. Worterb. der Medicin. Wissenschaft. B. viii. S. 538.
Berlin, 1822.                             3 Reise, ii. 788.
  4 Riecke, Die neuern Arzneimittel, S. 146.
  * Handbuch der Heilmittellehre, S. 484.  Tubing. 1845.
  G Ueber den Cortex adstringens Brasiliensis.  Kbln, 1828. 
              CORTEX ADSTRINGENS BRASILIENSIS.            <*0O

inches long; from  an inch to two inches and a half broadband
from  one to four lines thick; these are more frequently straight
than crooked.   The  bark  may be separated into  two parts; an
outer, which is rough, and an inner rind, of a smooth, fibrous cha-
racter :  the two are but loosely connected together.   The  outer
bark  is of a grayish-brown colour, traversed by longitudinal and
transverse furrows, having, here and  there, white and  grayish-
white crusty growths, covered  with a foliated lichen.  The inner
bark  is of a dark-red brown, on its outer surface, and, after the
outer bark has been separated, is somewhat smooth:  on the inner
side,  it is of a bright reddish-brown, and, probably owing to the
laceration of the woody splinters, somewhat fibrous.  The younger
bark  is smooth in the  fracture, and  of a dull  splendour.   The
older  bark, which  is thicker, is unequal, and may often be sepa-
rated into fibrous layers, which  are  readily lacerable.  When
chewed, it has a tolerably strong, astringent, somewhat bitter and
disagreeable taste, but it  does not excite nausea, nor leave any
arriere-gout.   It  has  scarcely any smell.   In its chemical  rela-
tions, it resembles  rhatany.1
   Merrem, who made numerous experiments with the bark, af-
 firms,  that, whilst it possesses the properties  of astringents  in
 general, and to a high  degree,  it is rather sedative than exciting;
 agrees with the digestive  organs, and  aids  the  peristaltic action.
 He employed it, first, with more or less success, in hemorrhage—
 in epistaxis, hcemoptysis, and metrorrhagia; and  Giinther2 found
 it very efficacious  in  profuse menstruation  arising from  atony  of
 the uterus.  Secondly; in mucous discharges, as leucorrhoea, blen-
 norrhoea, &c.   Thirdly;  in inflammatory and   exanthematous
 affections—as cynanche, urticaria, and in periodical erysipelas  of
 the face.  Fourthly; in  nervous  diseases, especially when asso-
 ciated with disturbance of the menstrual function, and leucorrhoea:
 and, fifthly, in weakness and catarrhs  of the  genital organs,
 bladder and rectum.  The Indians consider, that the bark affects
 especially the  generative apparatus, and, from the experiments of
  Merrem, it would seem, that its agency is more  particularly ex-
 erted in cases of leucorrhoea; and in many, after cinchona had
  been administered without effect.3
                   MODE  OF ADMINISTRATION.
    Merrem prescribed  it in various forms.  He gave the powder
  in doses of from 9j. to  3ss., three or four times a  day, mixed with
  water.   It appeared  to  him  to  act most beneficially in cases of
  mucous  discharges unaccompanied  by disorder  of the  digestive

    1 See the analysis by Hofrath Trommsdorff, in Brandes, Archiv., 3. xxxiii. S. 260 ;
  and  Dierbach, in Heidelberg. Annalen,  B. x. H. 3, S. 3o7. Heidelb. 1834.
    3 In Harless  Rein-Westphal. Jahrbuch,  B. viii. St. 1, S. 72;  and Brandes, Archiv
  Band, xi. S. 200.
    s Osann, in Encyc. Worterbuch der Medicin. Wissensch. viii. 541.
         17 
*
254                 CORYLUS ROSTRATA.

functions ; and he found that the powder was better borne by some
than the decoction, which is singular, as the woody matter is more
apt, in such cases, to disagree.   He rarely gave it combined with
aromatics, and  never found the combination of use.  To form the
decoction, an  ounce of  the coarsely  powdered bark was boiled
with  sixteen ounces of water, down to f ^viij.;  and  to  this an
ounce of syrup was added.  The dose was from one to two spoon-
fuls every two hours.  Merrem also prepared an extract, and a
tincture, in the same manner as these preparations are made of
cinchona; of the former, he took from one to two drams, dissolved
it in six ounces of an aromatic water, and  added  ^ss.  of syrup.
Of the mixture, a spoonful  was given every hour.
  Externally, the decoction was injected  three  times a day in
leucorrhoea  and blennorrhcea;  or, in the former disease, a sponge
imbued with the decoction was introduced, and  kept there for
some time.  It has been  applied, also, as an astringent to tdcers.

    Mistura  corticis Brasiliensis  adstringentis.
         Mixture of the astringent bark of Brazil.
            R.   Decoct, cort. adstring. Brasil. f 3*vij.
                Copaib. cum vitelli ovi q. s. subact.
                Tinct. ferri pomati, aa, f gij.
                Syrup, balsam, f 3J.  M.
  Dose.—A spoonful every two  hours, in obstinate gonorrhoea
and leucorrhoea.                                 Merrem.
            R.  Cort. adstring.  Brasil, gss.
          Coque cum aquae fontan. q. s.
          Sub fin. coction. adde
                Sabin. gss.
         Colaturas f 3*viij. adde
                Syrup, aurant. cort. f §j.
  Dose.—A spoonful every hour in cancer of the uterus, and
in the hemorrhage thence  arising.                 Merrem.
             LXVIII. CORYLUS  ROSTRA'TA.
Synonyme.  Beaked Hazel.
  Beaked hazel is a shrub two  or  three feet high; Natural
Order,  Amentaceae; Suborder,  Cupuliferse;  Sexual System,
Moncecia Polyandria; which grows in the mountainous regions ot
North America.  The nut which it produces is of an ovate shape,
surrounded by a coriaceous and  scaly involucre or cupula, termi-
nating in a tube an inch and a half long, covered with short and
thick  bristles, very similar to those of mucuna or cowhage.1
' Duhamel, Amer. Journal of Pharmacy, Jan. 1843. 
CREASOTUM.
255
                 EFFECTS ON THE ECONOMY.
  The short, stiff bristles have been found to possess similar an-
thelmintic virtues with  mucuna, and  to be equal to it  in all re-
spects.   Mr. Duhamel  states, that Dr. Heubener, of Bethlehem,
Pennsylvania, from whom he obtained the specimen  described by
him, had  employed it in cases of worms, and was much pleased
with it.
                 MODE OF ADMINISTRATION.
  It may be given, like mucuna, in syrup, molasses  or other con-
sistent vehicle, and in the same doses.
                   LXIX.  CREASOTUM.
Synonymes.  Creasoton, Creosoton, Creosotum, Kreosoton, Kreosotum,
  Oxyhydro-carburetum ex oleo pyroxilico paratum, Creosote, Creasote,
  Kreosote, Kreasote.
French.  Creosote.
German.-  Kreosot.
  This substance was first discovered, several  years ago, by Rei-
chenbach, of Blansko, and is extensively employed as a therapeu-
tical  agent.   Its marked chemical  properties suggested,  that it
might be possessed of a decided  influence on the economy, and
numerous experiments were immediately instituted to test  the  ac-
curacy of the notion.  These were of the most opposite character;
and it is  not surprising, as in every similar case, that there should
have  been great discrepancy in the results, and  in the opinions
deduced  therefrom.   There can be no doubt, however, that crea-
sote forms a valuable addition to the list of our remedial agents.

                   METHOD  OF PREPARING.
   The process  given by Koene,1 is esteemed one of the best for
preparing it on a  large scale,—almost  the  only way in which it
is formed:  we, consequently,  meet with it  only in commerce.
Hence it is in the  Materia Medica list of the Pharmacopoeia of
the United  States (1842,)—not amongst the preparations.  Tar,
derived from pit-coal, is distilled in a retort provided with a long
tube  having a  large mouth.   Under this is  placed  a receiver.
The oil, which comes over first, swims on water; and it is neces-
sary to remove,  from time to time, the products of the distillation,
until  an oil is obtained, which sinks in water.   When this is  the
case,  the product is collected.   The heavy oil, obtained during  the
distillation, condenses not  only in the receiver, but  in the tube of

  i Annalesde Chimie et de Physique, Juillet, 1835. See Cormack on Creasote, p. 36,
Lond. 1836; or the Amer. edit, in American Medical Library; also, Turner's Chemistry,
5th edit. p. 872, and Christison, Dispensatory, p. 374, Edinb. 1842. 
256
CREASOTUM.
the retort, where it unites  with the naphthalin, forming  a buty-
raceous  substance.   By applying a  gentle heat, the mass drops
into the receiver.   The product is now allowed to remain in a cool
place for some hours, after which  it is pressed.  The  expressed
naphthalin still contains oil, which is separated by heating it with
its own weight of acetic acid, until it melts.   After allowing it to
cool,  the crystallized naphtha is pressed, and the acid adhering to
the creasote is saturated with carbonate of potassa.   The creasote
is now7 to be shaken for a quarter of an hour with phosphoric acid,
—the proportions  being half an  ounce  of the  acid  to twenty
ounces of the oil.   The mixture  ought  then to be agitated with
its bulk of water, and afterwards be distilled with a graduated heat,
care  being  taken to separate  the oil which floats on the surface.
The rectified oil is now to be dissolved in its own volume of a hot
solution of caustic potassa, s. g. 1.120.  When it has been allowed
to cool for half an  hour, the supernatant oil is removed, and  the
heavy oil again treated with caustic  potassa, only a fourth part of
the solution being,  however, employed this time.   On uniting the
solutions of potassa, a slight excess  of diluted phosphoric acid is
added, and  the free creasote, which floats on the surface, is sepa-
rated.  It is again  rectified; and the first  product, which is chiefly
water, being rejected, the creasote comes over pure.  M. Koene
recommends the substance, thus prepared, to be preserved in bot-
tles covered with black paper.
   A protracted and complex process,  like the  above, necessarily
makes the drug expensive, especially as the quantity obtained is
but small.  M. Koene  procured by  it  ten drams from thirty-two
ounces of tar.   M. Lemere, one of the first Parisian pharmaciens
who made pure creasote, obtained from eight hundred pounds of
tar about six pounds of creasote.
   Reichenbach generally prepared it from the tar of the beech by
six distillations; dissolving it afterwards in a solution of caustic po-
tassa three  times, and setting it free successively by sulphuric acid.'
   Giordano2 has recommended the following simplified mode for
obtaining it.   Distil wood  tar from the willow, at  an elevated
temperature, from a tinned copper retort,  until the residue has the
consistence  of  soft pitch.   Re-distil  the  liquor passed over till its
residue resembles the former.   The liquor, neutralized by carbon-
ate of potassa, or lime-water, is re-distilled till  all the oil of crea-
sote has passed over.  The oil is dissolved in caustic potassa, from

   1 For an account of this and other products of the destructive distillation of vegetable
matter, see Cormack, Op.  cit.  Reichenbach's observations and experiments are contained
in a work entitled " Das  Kreosot in chemischer, physischer und medicinischer Bezie-
hung. von Dr. K. Reichenbach, u. s. w. zweite mit Nachtragen und Zusatzen von
Schweigger-Seidel verm. Ausgabe. Leipz. 1835;" see, also, Annales de Chimie, liii. 325.
Paris,  1833.
  2 Annali  di  Medicina, Aprile, 1835, cited in Brit, and For. Med. Rev. July,  1836.
p. 283.  For the process of Calderini, see Edinb. Med. and Surg. Journ, for Oct. 1834 
CREASOTUM.
257
which, after  simmering a little  in a porcelain vessel, and cooling,
the eupione, which floats, is easily separated.  The same  opera-
tion is  repeated with the eupione, to remove all  the oil  that is
united with it.  The saponaceous liquor, treated with dilute sul-
phuric acid, is  distilled  into water, from which  the creasote is
separated, and the water saturated with creasote is kept for exter-
nal use, or re-distilled for a concentrated  acetic acid of a pungent
and most agreeable odour.  Gozzi* has given the following sim-
ple method of procedure:  Distil tar  into a cylindrical vessel, half
full of water.  Pour off the watery liquid  at the top; add to the
heavier liquid at the  bottom sulphuric acid  diluted with half  its
weight of water; heat the mixture till it boils; expose the super-
natant creasote for three days to the air, stirring it frequently; and
distil the product thrice for thorough purification.
   Creasote is a colourless, transparent fluid.  Its refractive power
is very great, and in angular glass vessels it  is beautifully irides-
cent.  Its odour is penetrating, and disagreeable, but not offen-
sive : many compare it to that of castor.  It adheres to every thing,
and is somewhat permanent.  Its taste at first is very burning and
caustic to the tongue; but on admixture with the saliva, it becomes
somewhat sweetish.  It has an  oleaginous feel, and is of about the
consistence of oil of almonds.   Its specific gravity, at 68° Fahr.,
is stated by Reichenbach to be  1.037; but Dr. Christison2 affirms
that he has never found it lower than 1.065, or higher than 1.067.
The fact is, of course, of interest in relation to its adulterations.
It boils at 397°, and at—17° does not congeal.  When placed  on
paper, it forms a greasy spot, which, however, disappears  after a
while, and can  be  removed by the application of a heated body
without any residue.   It  is a non-conductor of electricity.   With
water at  68°, it unites in two different  proportions—one of the
combinations consisting of IJ of creasote  and  100 of water; the
other of 10  parts of water and 100 parts of  creasote.  The taste
of the first mixture—creasote water—is very burning at first, and
afterwards sweetish, like  that of pure creasote, but of course weak-
er.   A drop of creasote in 10,000  parts of  water  produces a
marked  impression on the tongue, and has a smoky smell.  Lit-
mus and turmeric paper are  not in the least changed by it; so that
it has neither an acid  nor an alkaline reaction.  At both poles of
the galvanic battery, it furnishes numerous and  striking combina-
tions.  It does not possess the property of the ordinary empyreu-
matic oils,  of  becoming  yellow and inspissated.   It  dissolves
iodine, phosphorus, and sulphur.  Acetic acid at 1.070, and alco-
hol, dissolve it in all proportions, and with the latter it is often adul-
terated.3   Ether and petroleum  likewise combine with it in  all

  1 Journal de Chimie Medicale, cited in American Journal of Pharmacy, Jan. 1839,
p. 339.                                2 Dispensatory, p. 374, Edinb. 1842.
  * Journal de Chim. Med. and Amer. Journal of Pharmacy, July, 1841, p. 112. 
25S
CREASOTUM.
proportions.  With  potassa, it forms two or three combinations,
one of which crystallizes.   Resins and resinous  bodies either de-
compose creasote, or it decomposes them.   With  balsams, fixed
and volatile oils, camphor, and  the vegetable  alkaloids, it unites
readily.  It coagulates albumen, and  its antiseptic property is
most  remarkable, whence  its name, from xpsaj, ' flesh,' and <?»£«,
!I preserve'—auttjp, ' preserver.'   Fresh meat, placed in creasote
water for half an hour or an hour, and then  taken  out  and dried,
may be exposed to the heat of the sun without undergoing putre-
faction.  Nay, when flesh  has  begun to be putrid, the process
ceases after it has been washed with creasote water, and if suffered
to remain immersed in  it for an hour, it does not subsequently pu-
trefy.   There can be  but little doubt, consequently, that creasote
is the main antiseptic  and  conservative  principle of pyroligneous
acid and tar water.  From the experiments made by Reichenbach
to determine the exact components of the flesh  on which the crea-
sote acts, he arrived at the following results.  It unites with the
albumen of the blood in the flesh, which it coagulates, and with the
red particles without acting on the fleshy fibre, which serves merely
as the frame-work for the coagulated matters; and it is well known
that dried albumen does not putrefy, but  becomes hard, brittle, and
transparent.

           EFFECTS ON THE ECONOMY IN  HEALTH.
   Reichenbach  has  properly remarked,  that the excessive burn-
ing pain in the tongue, which creasote causes,  must have at once
suggested it to be a  poisonous substance.   It wTas soon found that
plants, sprinkled with creasote water, died: that  fish  placed  in it
were convulsed;  and that  small animals, as wasps  and flies, died
when touched with the pure article.  If a small quantity of it be
spread  upon  the hand, and washed off  a minute afterwards, the
place is found to present a white appearance, but without pain or
inflammation.   In the course of  a few  days,  the  place becomes
dry, and the cuticle desquamates.  When creasote is applied to a
part where the  epidermis  is deficient, or to  a  wound, instantane-
ously an extremely violent burning pain is experienced, which
continues for eight or ten minutes;  but if the part be carefully
washed, it gradually ceases.   The cause of this is conceived to be
the property which creasote possesses of coagulating albumen; and,
where blood is flowing, of arresting it.   If  the rapid disturbance
which it excites, affects important organs, death results  sooner or
later, according to their importance in the economy: relief, how-
ever, may be  afforded by those substances that dissolve coagulated
albumen, as caustic alkalies, acetic acid, &c.  It is probable, how-
ever, that the poisonous properties result from  its acrid character.
   To appreciate the physiological effects of  creasote, experiments
have been undertaken  by many individuals.   Miguet gave a 
CREASOTUM.                     259
young dog, for eight days, an ounce a day of distilled water con-
taining four drops of creasote, without any effect.  When, how-
ever, he doubled  the dose, nausea, languor, subsultus tendinum,
and  tremors occurred, followed,  in  the course of a few days, by
marked emaciation.  On discontinuing the creasote, the functions
gradually resumed  their pristine condition, and  the animal reco-
vered its flesh.  To another dog, he gave at once  t\vo drams  in
half an ounce of water, and  immediately  thereafter great prostra-
tion of the  muscular system ensued—vertigo, fixed eyes, stupor,
dyspnoea, accumulation of mucus in the  air passages, spasmodic
cough, discharge of large quantities of foamy saliva, with  vomit-
ing  of a milky matter, although the animal had taken nothing
of  the  kind.   After  two  hours'  suffering, it  died  of convul-
sions.   The body w7as immediately- opened:  all the tissues,  except
the liver, exhaled a strong smell  of creasote; and the whole of the
mucous membrane of the intestinal canal was inflamed.   The mat-
ters contained in the stomach coagulated when placed  in contact
with albumen.   When heated, they yielded  a thick smoke, and a
marked smell of creasote.   In  the heart and large vessels, the
blood was more firmly coagulated than usual: the lungs were gorged
with blood; in the brain there was no evidence either of congestion
or hemorrhage.  In another dog,  into whose carotid equal portions
of water and creasote were injected, death  resulted with  similar
phenomena, but more  rapidly.   The  precise quantity of creasote
used in this experiment is not stated.
   Simon, in his experiments, found that  when ten drops of crea-
sote, diluted, were injected into a vein, scarcely any effect resulted.
Reiter  and Miiller, who  likewise made experiments on animals,
agree with  Simon as to  the result of injections of creasote  into
the veins;  no special symptom^  were induced by it, but this ap-
peared to be owing to the blood  heing instantaneously coagulated
by it, which not only prevented  the farther progress of the crea-
sote, but also of the blood; hence, no evil consequences resulted;
and, it is probable,  as  Riecke has suggested,1 that the weaker the
solution of  creasote, within certain  limits, the greater may be its
effect on the mass of blood.
   Corneliani,2  an Italian physician, has also instituted a series of
experiments with creasote on lambs, rabbits, &c.  All these ani-
mals bore  small doses of creasote—however unwillingly it might
be  taken—without  any remarkable  results, and without  loss  of
appetite.   Large doses, however, immediately  occasioned general
torpor, sudden inclination to pass the urine, paralysis—especially
of the lower extremities—with  or without  convulsions, and  fre-
quently the  ejection of a bloody foam.   When  the  doses were
  1 Die neuern Arzneimittel, u. s. w. S. 153.
  1 Giornale delle Scienze Medico-Chirurgiche, No. 8, Febrajo, 1835; cited in Brit, and
For. Med. Review, p. 265, Jan. 1836. 
260
CREASOTUM.
large, and it was but  little diluted, death  took place in a few
minutes, and on examination, the  inner lining of the stomach was
generally found corroded, yet  not so constantly as to  allow of
death being ascribed to that circumstance.   It  followed, farther,
from his  experiments, that pure  creasote applied  to  a denuded
nerve, or injected only in  small quantities into a vein, may occa-
sion death suddenly; and that  the application of the creasote to
extensive wounded surfaces in the same animals maybe ultimately
followed by fatal consequences.   Where a very large dose of crea-
sote was administered, immediate death  was  produced  without
organic lesion.
   In the  trials made with it by Dr. Elliotson1 he found no action
produced upon  the bowels;  but  it sometimes augmented  the
quantity of urine.   He once saw it, in the dose of a minim three
times a day, cause micturition nine times in an hour.  In  another
case, in doses of three minims, it produced severe strangury.
   According to  Simon, when  applied to  the muscles,  it destroys
the surface like caustic.  Miiller and Reiter, in their experiments,
found, that  it  speedily rendered  the  muscular  fibres  of a  dirty-
whitish appearance, and readily lacerable.   When  applied to  the
fresh blood  of  the hog, it converted the colour in an instant to an
ashy-gray;  after which it became black  and quickly coagulated.
Mixed  either pure or diluted with blood, it thickens it; the mix-
ture assumes a brown-red colour, and is found studded with small
white  points, which are nothing more than coagulated  albumen.
On exposing the coagulum to the air, it assumes a yellowish-red
colour.   Reich, on the other hand, who appears to have  made many
experiments with creasote, both in internal  and  external diseases,
affirms,  that he has never observed  any caustic effect from it:
from which  assertion, as Riecke has remarked,3  the only inference
to be deduced is, that he must always have applied it largely diluted.
Fremanger likewise asserts, that when pure creasote is applied
to the  epidermis, it does not destroy it;  but  merely  occasions
more or  less  redness  of  the skin.   When  applied to  a suppu-
rating surface, it caused, instantaneously, the formation of a white
pellicle, owing  to its  coagulating the albumen  contained in the
secretions from  the wound.  Adventitious  tissues, with which it
is brought in contact,  are destroyed by it.   When placed between
the lips of  a wound, it prevents  healing by the first intention, by
coagulating the albumen;  and, consequently, it may be employed
in all cases where it is desirable to  prevent the  growing together
of parts.  Fremanger is, indeed,  disposed  to  refer all its efficacy
to the action which it exerts on albumen.
   Its  long continued use often occasions  an inflammatory condi-
tion which, as Dr. J.  L. Da Luz3 observes, has nothing in com-
   1 Medico-Chirurg. Transac. vol. xix.  Lond. 1835.           * Op. cit. S. 154.
   3 Journal da Sociedade das Sciencas Medicas de Lisboa, torn. v.Lisboa, 1837; re-
viewed in Zeitschrift fiir die gesammte Medicin.  Oct. 1838, S. 224. 
CREASOTUM.
261
mon with  the  disease for the cure of which it may have been
prescribed.  In  a case of porrigo favosa,  treated with it by the
author,  febrile  irritation supervened, and  the head  was  covered
by  an  artificial  eruption, which induced, however, a new action
in the system of nutrition  of the  scalp, and, after its, subsidence,
the porrigo was cured.
  Dr. Cormack, of Edinburgh, instituted  various experiments on
the  lower animals to test its physiological   effects.1   In three
experiments, about twenty-five drops of pure creasote were in-
jected  into the  venous  system  of dogs.   All the animals died.
In every case of poisoning by it, which he has observed, Dr. Cor-
mack found the following to be the symptoms.—Its first  delete-
rious action was a powerful one  of sedation  on  the heart;  the
vital energies of that organ  seeming to be instantaneously para-
lyzed.   In some instances, hurried and  sonorous respiration went
on for more than a minute after the heart had ceased to beat.  In
general, one or two convulsions, resembling the tetanic, preceded
death;  and, almost invariably before expiring, the animal  uttered
one or more shrill cries.   In  every instance the atony of the heart
immediately after death.was  very striking.
  From other  experiments  it  appears, that  when  it is  injected
into the arteries the deleterious effects are  of  a much milder cha-
racter,  and if the  dose be not  large, the  animal may experience
but little  inconvenience,—a  circumstance  which proves  the  im-
portance of a thorough admixture with the blood' before the poi-
sonous article reaches the heart; such admixture not taking place
to the necessary extent, when the poison is injected into the veins,
but being readily effected when injected into the arteries, and con-
sequently  distributed through the system of nutrition.
  When taken for any length of time, the  urine acquires a black-
ish  hue, and in some cases creasote may be recognised in it.2

           EFFECTS ON THE ECONOMY IN DISEASE.
  Creasote has been  administered in various diseases; the follow-
ing may be esteemed  a summary of the chief  therapeutical expe-
riments made with it.
  Hemorrhage.—The discovery of creasote happened at a time
when  the Acqua Binelli  enjoyed more  confidence  as a  styptic
than it  does now; and  the fancied probability, that  the nostrum
was indebted to creasote for  its properties, gave rise to many ex-
periments with the latter in cases of hemorrhage.  One of the first,
who instituted experiments with it  on rabbits, was G. Simon.  Not
being able to obtain any striking  results from the Acqua Binelli,
he tried creasote, pure, as well as in the  form of creasote water,
and of an emulsion prepared with gum Arabic;  and from the results

  1 Op. cit. p. 66.            2 Macleod,  in Med. Gaz. xvi. 599, and xvii. 653. 
262
CREASOTUM.
of these he wTas led to affirm, that although creasote occasioned
the coagulation of  the albumen of the blood, it acted no better as
a styptic than cold water.   With the  Acqua Binelli he was  not
able to coagulate albumen.   The rapid  separation of the albumen
in the  form of a reddish-gray coagulum under  the influence of
creasote, he found to be of no advantage, as the mass remained soft
and pulpy; and the wound in the vessel would not close, but was
immediately  opened  by  the stream of blood.   Neither did he
esteem it adapted for arresting trifling hemorrhages; for, when very
much diluted, it was still too exciting  to the injured parts, and
greatly delayed their  union.   This, indeed, might, he thinks, be
expected from the fact, that pure creasote, when placed on the skin
for ten or twenty minutes, induces superficial inflammation.  The
experiments of other physicians have been decidedly more favour-
able.   Miiller  and  Reiter,1 for  example, in theirs,  found that
creasote was far more efficacious than the Acqua Binelli; for, when
the latter was prescribed, it was always necessary  to have recourse
to other agents, before  the hemorrhage was arrested.  In their
experiments on dogs, they found the hemorrhage from a divided
crural vein quickly  cease, when a compress of cotton wetted, with
creasote was  placed   on the vessel with a  moderate degree of
pressure.   Three days afterwards, the crural artery was exposed
on the same dog, and divided;  but it was afterwards necessary to
tie it, as the creasote, in consequence of the excessive hemorrhage,
could not be brought  into immediate contact with the vessel, but
merely acted on the superficial layer of blood, and therefore did
not arrest  the  hemorrhage.  The crural artery of a young and
tolerably strong dog was cut a short distance above its division,
compression being at the same time exerted upon the trunk.  The
artery did not bleed.   Nine minutes  afterwards,  a compress  of
cotton soaked in  creasote was applied immediately to the divided
extremity of the artery, with  some degree  of pressure.  When
the compress was  removed, the bleeding was entirely arrested,
and the wounded surface was dry, and had an ashy-gray hue.  In
an old dog, hemorrhage from a divided  crural artery was arrested
by the same means, but  not so speedily.  When  the artery was
examined, it was found to be wholly closed, having a navel-like
depression  at the extremity, which disappeared when the vessel
was  pressed  upon,  and  ultimately  became  conical.   Within the
vessel there was a  conical coagulum, which  could be readily de-
tached; and for the space of a line, the artery appeared inflamed
through its  coats.   In arteries that had been divided for a longer
time, the union was likewise complete;  but there was this differ-
ence, that the inflammation at the end of the vessel had disappeared,

  1 Schmidt's Jahrbuch. cited in Encyclographie des Sciences Medicales, Mars, 1837.
See, also, Burdach,'Medicin. Zeitung.  Jahrgang, 1840, No. 31, cited in Lond. and
Edinb. Monthly Journal of Med. Science, May, 1842. 
                                                           ♦
                          CREASOTUM.                      263

and a pointed fibrous caruncle wTas observed in  the  vessel, which
was doubtless the fibrinous portion of the previous coagulum.
  From their experiments, Muller  and Reiter  were led to  con-
firm the haemastatic properties of creasote, both when the hemor-
rhage  occurs from  veins and from arteries.  The  arteries divided
were of considerable size, larger than the radial  artery of an adult
male.   They consider pressure indispensable to occasion the crea-
sote to  act immediately on the artery ; and  the arrest of the hemor-
rhage, they ascribe, not alone to the coagulation of the blood, but
to the  contraction  of the  arteries.   In parenchymatous hemor-
rhage, creasote water was  generally sufficient; as well as in tole-
rably extensive wounds of  the surface.   Horing, also, obtained
satisfactory  results from his experiments  on animals.   He  ex-
posed, on an old cat, the crural artery and  vein of the right side;
made a small incision into  the latter, and pressed upon it to stop
the copious flow which ensued : he then applied over the wound,
for two minutes, a  small compress of lint,  wetted with a solution
of creasote—two drops to one hundred of water—and the bleeding
ceased. ' The artery was  now  opened, and  a  similar  compress
placed upon  it with the same result.   Two days afterwards, a se-
cond experiment was made of the same kind, except that, owing to
the struggles of the animal, a larger opening was made into  the
crural  artery.  In  this case, it was  necessary to apply the  com-
press for four minutes before  the hemorrhage ceased.   In another
cat, a large transverse incision was made into the inner surface of
the right thigh,  above  the  middle, by which muscles, arteries,
veins, and  nerves were divided.   Two large compresses of lint,
wetted  with  a solution of creasote, were then pressed on  the parts
for five minutes, and the bleeding entirely ceased.   The like re-
sult was obtained in the case of an  old horse, whose jugular vein
was opened.  But  the creasote solution did not succeed in wholly
arresting  the hemorrhage  in the  same horse, when  an opening
was made  into the  crural vein and artery.
   To these experiments on animals may be added some that wrere
instituted on the human  subject,  which testify, more or less, to
the  efficacy of creasote as  a hasmastatic.  Hahn  applied it in
some insignificant cases, but saw no better effect from it than from
cold water.  Most  found it speedily arrest  slight hemorrhage from
small vessels.  Horing applied it successfully in cases of epistaxis,
which  had obstinately resisted other agents,—two plugs of lint,
dipped in a solution of creasote, being inserted in the nostrils, after
which  the hemorrhage  soon ceased.   Fichtdauer  employed it
with equally advantageous results in violent" bleeding from leech
bites, after several  haemastatics had  been used in vain; and Hey-
felder extols it for arresting hemorrhage from large wounded sur-
faces.   Berthelot differs with Fremanger  and Simon, who affirm
that union by the first intention is prevented by it.   The results 
264                      CREASOTUM.

of his  observation  were  opposite.  Miguet  applied  it  success-
fully  as a  haemastatic  in fresh  wounds on  man  and  animals.
Both pure creasote and a solution  of it were, however, unsuccess-
fully used by Bardili in hemorrhage from the arteria tibialis pos-
tica, which he ascribed to the blood having lost its albumen, owing
to the excessive discharge.  Reich and  Hauff found injections
with creasote water useful in hcemorrhagia uteri.  Schneider had
a case of hemorrhage that had  continued for seven hours in a man
eighty years old, which proceeded from the gums of the upper
jaw; the blood oozing as from  the pores of a sponge.  He directed
the man to take as much creasote  water into his mouth as he  was
able;  and after three  repetitions the hemorrhage ceased, and did
not recur.   Kohler1 endeavoured to test the haemastatic operation
upon  himself.   He made an incision in his forearm an inch long,
and three or four lines deep, to which  he applied creasote water.
A lancinating pain was  felt  in  the wound, but no other sensible
effect.   A drop of pure creasote was now let fall between the lips
of  the wound:  this was followed by  a sensation of  burning and
drawing; for a moment coagulated flakes of a whitish-gra'y colour
covered the wound, and there  was a temporary cessation to the
flow: it' soon,  however, recurred.  After a time, the  hemorrhage
ceased ; but not sooner—Kohler thinks—than  if cold water  had
been applied.   The feeling of burning  and drawing continued,
however, for some time; the edges of the wound were somewhat
swollen, and oedematous, and,  in about  four hours, were covered
with a yellowish-brown  lymph; but there seemed to  be  no delay
in the cicatrization.
   In  a case of lithotomy, it was found impossible to arrest the
hemorrhage  by any of the usual means, and  no particular vessel
could be discovered from which the  blood flowed.   The patient
was at last  reduced  to  the lowest ebb, from the continued  loss
of  blood, and  had already lost  consciousness, when a  sponge,
dipped  in  pure creasote,  was  introduced  into the  wound,  and
pressed against the bleeding parts for an instant or two.   The
hemorrhage  was immediately  arrested.  No particular pain was
experienced;  no  unpleasant  symptoms occurred;   thin eschars
were   thrown  off, and  the patient recovered.2  J.  L.  da  Luz3
found it an excellent  styptic in capillary hemorrhage; but in he-
morrhage from great vessels  it did  not  prevent a recurrence of
the bleeding.   In  hemoptysis, its internal use  has  been found
beneficial.   Santini4 prescribed it in  a desperate case with  com-
plete  success, and with  Schmalz it was equally effective; on the
other hand, it  was o*f little  avail in Guitti's  hands.   In hcema-

  1 Neue Wissenschaftlich. Annalen, u. s. w. B. i.  H. 3. S. 285.  Berlin, 1835.
  2 Daser, Edinb. Medical and Surgical  Journal, Oct. 1841.            3 Op. cit.
  4 Gazetta Terapeutica di  Verona, Mars, 1834; cited in  American  Journal of the
Medical Sciences, Feb. 183G, p, 502. 
CREASOTUM.
265
temesis,  it  succeeded with  Dr. Isaac Parrish of Philadelphia.1
after the  remedies  generally employed in such cases had  failed
to produce any effect.  Dr. Wm. T. Wragg,2 employed it  inter-
nally with advantage in  a variety of hemorrhages—as flooding
after  abortion; flooding where there was no pregnancy: hemor-
rhage  from  the  stomach and  bowels;  hemorrhage  from the
bladder, and hcemoptysis; and the result of his observations in-
duces him to conclude, that, on  the whole, they "entitle the remedy
to a place amongst the means upon which reliance may be placed
in the treatment of  a class of  diseases, in  the  management of
which we are often  embarrassed."  He extols it also as  a hae-
mastatic in traumatic hemorrhage;  and a case is given by Drs.
J. L. Lawrence Smith and S. D. Sinkler,3 in which a  mixture of
creasote, " a watery emulsion of creasote," (the formula for which is
given hereafter,) with proper pressure by means of a dossil of lint,
arrested  the hemorrhage produced by an oblique slit in  the carotid
of a sheep.  They express their  belief, however, that when the
emulsion of creasote  is applied to the divided artery of the  sheep,
it depends  greatly, if not altogether, upon the manner in which
the lint is applied to  the wound in the artery, whether the hemor-
rhage  is  arrested  or not.  If it be placed  immediately  on the
orifice of the cut  vessel, success is certain; "if,  however, the
vessel  shrink from  contact with the lint, the animal  is almost
 certain to bleed to  death."
   Its effects as a haemastatic suggested it to Dr. E. W. Faulcon,4
of North Carolina, as a remedy in a case of mercurial  salivation,
in the form of gargle made by half a dram of creasote to a pint of
 sage tea, which was  used  every hour during  the  first day.   The
 effects were excellent.
   Burns.—Most  used creasote with decided relief in burns  of
 the second and third degree, applied  by means  of rags wetted
 with creasote water.   Berthelot also cured two cases quickly with
 it; the slightly burnt places becoming desiccated; the more severe
 healing by the formation of a crust.   Guitti applied both creasote
 water and creasote  ointment with advantage in burns  which had
 proceeded to profuse suppuration; and Dr. Sutro5 strongly  recom-
 mends an ointment  of creasote,  the formula for which is given
 hereafter; and advises it to be kept ready prepared under the name
 of * burn ointment.'
   In profuse suppuration, it has been advised,  on the authority
 of Levrat and Berthelot; but,  according to J. L. da Luz,6 it has no
 marked influence on the secretion of pus, and is  therefore  useless
 in suppurating abscesses.  In otorrhcea it  has  been  especially
 beneficial.
   • Medical Examiner, Aug. 10, 1839, p. 501.
   a Southern Journal of Medicine and Pharmacy, March, 1846,  p. 128.
   s Ibid., Julv, 1846, p. 403.            * Medical Examiner, Nov. 1848, p. 656.
   s Medical Times, Jan. 4, 1845, p. 314.              B Op. cit. 
266
CREASOTUM.
   Lesions of the integuments.—According  to  Reichenbach,
 creasote is of essential  service in the intertrigo of children, as
 well as in excoriations induced  by lying—bed sores.   In the
 latter  case,  Guitti used it with   success.   Hahn also  frequently
 employed  it.   In cases  where ulceration had not taken place, he
 washed the parts several times a day with creasote water, and was
 of opinion that he had prevented,  in some cases, the occurrence of
 ulceration.   Where ulceration had already taken  place, he covered
 the parts  with linen  rags, folded twTo or three  times, wThich he
 soaked in creasote water, and fixed them on by means of adhesive
 straps.  The superficial ulcers soon healed; and the deeper were
 transformed  into hollow surfaces, secreting a homogeneous  serous
 fluid, but no pus.
   Horing  employed  creasote water  with advantage in sore nip-
 ples; and creasote ointment has been  recommended by Dr. Fife,1
 in sprains and contusions.
   In chilblains, whether ulcerated  or not, Hahn3 used  creasote
 washes successfully ;—the affection yielding in  a few  days; and
 Dr. Herndon3 regards  creasote  ointment as the best  remedy in
 that affection with which he is acquainted.   M. Devergie also ex-
 tols an ointment of creasote, subacetate of lead and  opium in the
 proportions given hereafter.
   Ulcers.—Fissures  of the skin  and superficial ulcers, accord-
 ing to  Hahn, were changed, under the  application of creasote wa-
 ter, into a  blackish-brown scab, which adhered for  a long time,
 and, when it fell off, left the parts healed, orj by occasioning too
 much shrinking, gave  rise to fresh inflammation and suppuration.
 Deeper ulcers  were affected in the same manner as those caused
 by long lying.  Its efficacy in atonic and varicose  ulcers, especial-
 ly of the leg, has been attested by Levrat, Berthelot, Rossi, Hechen-
 berger,and others; but Guitti, Heyfelder, and Schmalz were less
 satisfied with it.   A case of indolent ulcer between  the knee and
ankle, accompanied with a good deal of inflammation, was cured by
 Dr. Crary, in five weeks, by the application of a solution of creasote
 (ten drops  to the  ounce of water,) with  methodical compression
 of the limb, by means of a bandage.*  Bresciani de  Borsa5 consi-
 ders it a 'sovereign remedy' for indolent and  obstinate ulcers.
 He applies it in  the form of a lotion, consisting  of  six drops of
 creasote to four ounces of water, gradually increasing the strength
to 10 or 20 drops.   Meister found the  application of creasote wa-
ter, in  cases  of carious, scrofulous, syphilitic, fistulous, and
sanious  ulcers, to be strikingly and almost uniformly advanta-

  1 Lond. Med. Gaz., April 7, 1838, p. 66.    2 Gazette Medicale de Paris, Dec. 1834.
  3 American Med.  Intelligencer, March 15.1838, p. 425.
  * Boston Medical  and Surgical Journal, July 3, 1839, p. 332.
  5 Gazette des Hopitaux, Sept.  19,1846; in Ranking's Half-yearly Abstract, January
to July, 1847, p. 199, 
CREASOTUM.
267
geous.   Heyfelder, likewise, found  it extraordinarily  useful in
scrofulous ulcers, and Dr. Cormack1 states, that he had  an op-
portunity of seeing a case of the kind treated by Dr. Shortt, in
the Royal  Infirmary  of Edinburgh, where an extensile scrofu-
lous  ulcer of the  hip, after resisting a variety of treatment, at
last yielded to creasote, and was ultimately completely cicatrized.
On the other hand, Otto tried both pure creasote and  the watery
solution in ulcers of various kinds, especially  the scrofulous: the
ulcers very generally  put on, in the course of twenty-four hours,
a cleaner appearance; still  they did  not cicatrize;  on which ac-
count Otto prefers, in  old ulcerations at least, the use of a solution
of chlorinated lime; for notwithstanding creasote diminished and
improved the character of the suppuration  from scrofulous ulcers,
and rendered them cleaner, it did not ameliorate the general con-
dition;—after the diminution of the suppuration, local pains, loss
of sleep, and slight febrile movements generally supervening. On
these accounts, Otto does not think creasote applicable to scrofu-
lous ulcers in general.
   Many observers depose to the  good effects  of  creasote in scro-
fulous  caries.  Among these may be mentioned  Hahn,  Coster,
Ritgen, Fremanger and Hauff.  In fistulous ulcers— also of syphi-
litic  origin—several  physicians  have employed it beneficially.
Dr. Fife,2 of Newcastle-upon-Tyne, found  it useful  not merely in
obstinate but in  malignant ulcers.   In no case of  ulceration, he
affirms, in which he tried it, did it disappoint his expectations.
In a  sloughing carbuncle, the alcoholic solution, (thirty drops to
the ounce,) mixed with carrot  poultices, was  applied with advan-
tage  by Dr. Herndon,3 of Culpeper C. H., Virginia.  In scurvy and
in scorbutic ulcers, M. Coen4 found its use followed by excellent
 results, and he refers to cases in which it has been administered
 internally with very great  advantage.  J. L. da Luz5 considers it
 an excellent  cleansing  remedy in atonic ulcers, but its prolonged
 use,  he thinks, retards cicatrization.   In  hospital  gangrene, he
 esteems it the best antiseptic,  and the most  powerful  means for
 checking its terrific progress. In gangrenous  or  sloughing ulcers,
 Hahn  used it.  Several times a day he pencilled the slough with
 pure  creasote, and,  in the  intervals, fomented it  with  creasote
 water.   According to  Reichenbach, two  offensive affections of
 the  labia pudendi—the consequences of  infiltration  of  blood—
 were cured by it;  and Reich and Sir Francis Smith6 treated with
 success cases of cancrum  oris;  and  the former, one of scorbutic
 ulceration of the gums.   In herpetic ulcers, Horing and Ber-
   1 Op. cit. p. 106.                a Lond. Med.  Gaz., April 7, 1838, p. 65.
   ' Amer. Med. Intelligencer, March 15, 1838, p. 425.
   4 Giornale per servire, &c, di Venezia, 1836.
   6 Jornal da Sociedade das Sciencas de Lisboa, T. v. Lisboa, 1837; noticed in Zeit-
schrift fur die gesammte Medicin. Oct. 18-8, S. 224.
  • Dublin Journal of Med. Science, for May, 1837. 
268
CREASOTUM.
thelot observed favourable effects from creasote water; and it has
been found  especially useful  in  carcinomatous  and syphilitic
ulcers, in which  it has been often employed.   In  cancer of the
uterus, "Vyolff injected it, in two cases, into the vagina.   In one,
the pain was so great, that,  on  the  ninth  day,  after six pints
of creasote  water had been used, it was obliged to be discon-
tinued.   In the  other case, the treatment was continued twenty-
six days, and sixteen  pints were used: in it, also, the pain was
sensibly aggravated.   The secretion was  not improved in either
case, nor was hemorrhage prevented by it; for one of  the patients
died immediately after an attack of this kind : the other lingered a
long time.   Heyfelder found injections of creasote water, in con-
junction with the extractum  calendulae, of no use  in cancer uteri.
On the other hand, in a case of superficial ulceration of the os uteri,
with copious discharge  of a puriform mucus, which  had  been
treated unsuccessfully  by other agents, for  several  months, Hahn
found an  injection  of creasote water effectual  in  fourteen  days.
Tealier1  has likewise  reported  a  case of superficial ulcerations
around the  os uteri, to which nitrate of silver had  been applied at
least twenty times without inducing a cure.  By touching the ulcers
with lint fixed upon the end of a probe, and  dipped in a mixture
of one part  of creasote and three  parts of water, excessive pain was
induced ; but this gradually passed away, and  in six days the signs
of ulceration had disappeared.  It is more than doubtful, however,
whether either of the last two cases was carcinomatous.  In a case
of cancer of the breast, a solution of creasote was  applied by the
same gentleman.   This  excited,  instantaneously, violent pain, but
after a time the pain ceased, and relief was obtained.  Rossi saw a
cancerous ulcer of the face healed by creasote ointment, but it
soon broke out  again.   The same gentleman cured a fungous
tumour on the alveolar margin  of the  right os maxillare—which
had occasioned the loss of all the teeth of that side  except one, and
which even the actual cautery had not prevented  from  returning
—by a collutory of six drops of creasote  in  six ounces of water.
Heyfelder saw creasote used without effect in a case of cancer of
the skin,  and Cormack2 in  one of lupus of the nose.  Guitti
cured an  ulcer, in appearance  cancerous, by  the application of
pure creasote, for which, at a later period, the  solution  was sub-
stituted, and Marchal has published a case of cancer of the lip,
the  cure of  which  he believes he  accomplished  by means of
creasote.3   Garbiglietti  cured a  fungous  ulcer with caries  of
the fibida  by creasote,  but it is questionable  whether the ulcer
was carcinomatous; and Meisinger saw cancer of the face  im-
proved by the use of creasote ointment.   It  has  been before re-

  1 Revue M6dicale, Fevrier, 1834.  For  similar cases, see Friese, in Berlin. Medicin
Zeitung, Nro. 13, 1837.                              a Op. cit. p, 115.
  3 Gazette Medicale de Paris, Fev. 1835. 
CREASOTUM.
269
marked,  that Meisinger used creasote with advantage  in  syphi-
litic ulcers.  Hahn also applied creasote water in primary  syphi-
litic sores; the small, superficial ulcers healed soon; the  larger and
deeper remained  stationary.  In a phagedenic ulcerated bubo, the
spreading was arrested, but this was all.  According to Heyfel-
der, creasote—probably  pure—excited, in a  case of  primary
syphilitic ulcer, in a  plethoric individual, violent inflammation,
and so much sensibility, that it was obliged to  be discontinued.
Berthelot  cured a chancre, which had resisted  caustics and other
cicatrizing agencies, in a few days,  by creasote water.   Rehfeld,
also, treated secondary syphilitic ulcers successfully with it, giving
however, at  the  same time,  the  corrosive chloride of mercury
inwardly.   Chronic venereal ulcers have in  some cases  yielded
to it, after they had resisted every other kind of treatment.1  Dr.
Biirkner, of  Breslau,2 reports a case, which, after  having proved
rebellious  to  every kind of general and local management that
could be devised, at length yielded to the application of pure crea-
sote by means of a  camel's hair brush.   The character of the se-
creted pus immediately improved; the wound  began  to heal  by
granulations from the  base; and,  at the end of  four weeks, Dr.
Biirkner  found his  patient  quite well.  In condylomata, it has
been equally  successful.   By the  application  of creasote water,
Hahn found them contract and disappear; but  the more obstinate
required to be pencilled with pure  creasote.   Heyfelder,  Reich,3
Fricke, and Coen,4  also found  creasote efficacious in  these cases.
The last gentleman but one had the most frequent opportunities
for observation ;  by him creasote, in a dilute state,  was applied to
the top of the condylomata by means of a pencil.  In cases of small
condylomata, touching them once  or twice was sufficient for their
removal; of larger,it had to be more frequently repeated.  In some
obstinate cases, it required two or three weeks before they disap-
peared;  but when once they fell off, they did not return.
   Gonorrhoea and Leucorrhoea.— Most extols  creasote water as
a remedy in gleet.  He applies it either in the way of injection,
or  by small tents wetted with  it and introduced  into the urethra.
In  leucorrhoea,  he strongly  recommends both its  internal and
external  use.  Reich  injected creasote water in  a case of gonor-
rhoea, and in one of malignant leucorrhoea; yet its  agency in
these cases was doubtful, as copaiba was given at  the  same time.
Hahn5 also used injections  of creasote water in  the second  stage
of  gonorrhoea and in gleet; but he did not  think that the dis-
charge ceased sooner  under its agency  than  under the ordinary
  1 Cormack, Op. citat.  p. 107; and  in Lond. and  Edinb. Monthly Journ. of Med.
Science, Oct. 1842.  See, also, Kiinchel, in Bulletin Gener. de Therapeutique. p. 313,
Paris, 1833.                a Casper's Wochenschrift, Sepr. 9, 1837, S. 5tf3,
  a Hufeland's Journal, Jan. 1831. and Revue Medicale, Mai, 1834.
  ' Giornale perServire, &c, di Venezia, An. 1836.
  8 Gazette Medicale de  Paris, Dec. 1834.
        18 
270
CREASOTUM.
means;  whilst, in some cases,  the inflammation was even aug-
mented.   In two cases of benign filuor albus, after  many other
remedies had  been  employed in vain, Schmalz  saw good  effects
from  the use of a solution of creasote;  but, in a third case it
afforded no relief.   Dr. Elliotson1 gave  it internally to a female
labouring under gonorrhoea,—at first, in the dose of two minims,
to an ounce of water, and, afterwards, in the dose of four, six, and
even eight minims,  but no good resulted from it.   Dr. R. H. All-
natt2 ha°s used creasote injections in gonorrhoea and in  leucorrhoea
with very satisfactory results.   He proposes the remedy also for
cases of gleet occurring  in flabby leucophlegmatic males.  The
formula for an injection used by him is given hereafter.
   The author has administered it not unfrequently in  leucorrhoea
and other mucous discharges, and, when persevered in, it has at
times appeared  to be  of decided  service.3  Dr.  Robert  Dick,4 of
Glasgow, has called the attention of the profession to  its use in
the  chronic stage of gonorrhoea, and  in gleet.   He  thinks  its
beneficial effects are  more obvious than  those  of copaiba.  He
administered it in doses of two  drops with loaf sugar beaten into
a syrup with  water;  and M. Em. Rousseau5 has  used  it success-
fully in the  acute stage  of gonorrhoea  in  the proportion of
gr. xvss. of creasote to half an ounce of water.   The dose of this
was three or four drops, from four to six times a day,  in a wine-
glassful of sugared water; injecting, five or six times  a  day, three
drops in a glassful of decoction  of raarshmallow.
   Cutaneous affections.—Br. Fahnestock,8 of Pittsburgh, uses
creasote in erysipelas, as a local remedy, and so successfully, that,
in a practice of many years, he  has not  seen a  case  that did  not
yield to it.  In every case  of local erysipelas of the face or else-
where, he applies  pure creasote, with a camel's hair brush, over
the whole of the affected  surface, and  to some distance  beyond
the seat of inflammation;  and, at the same time, prescribes calomel,
followed by jalap in  sufficient  quantity to induce free  catharsis.
In the majority of cases, this is all that is needed.  In the phleg-
monous form, it  is necessary to repeat the  application more  fre-
quently than  in the simple, with the addition of a bread and water
cataplasm, applied nearly cold, and well  sprinkled with water
strongly impregnated  with creasote; or a cloth  may  be kept con-
stantly wet with the solution, especially when the face is the  seat
of the affection.   The creasote  should  cause the parts to  become
white immediately: and it  is worthy of observation, that the skin

   1 Lancet, for Dec,  1835, p. 435.       ' London Lancet, Dec. 31,1842, p-504.
   3 See, also, Coen, in Giornale per Servire, &c, di Venezia,  1836;  and Dr. Wm.T,
 Wragg, Southern Journal of Medicine and Pharmacy, March, 1846, p. 128.
   ' Edinb. Med.  and  Surg. Journal, April, 1838; p. 602.
   '- L'Abeille Medicale, Avril. 1847, p. 96.
   * American Journal of the Medical Sciences, July, 1848, p. 152. 
CREASOTUM.
271
does not remain in the least marked by the application, no matter
how often it  is applied.   Reich treated a case of crusta lactea
externally by  creasote, and internally, by the  mild  chloride and
the black sulphuret  of  mercury.  The  result was  favourable.
In itch, it was recommended  by its discoverer.  Wolff, too, saw
three cases  of not very recent  itch cured in  eight  days by lo-
tions of creasote  water.   Reich and Coen1 extol the water and
the  ointment  in inveterate itch.  J. L. Da Luz3 considers it  as
valuable  as sulphur,  but  Otto did not find  the water particu-
larly efficacious.  He gives  strong  testimony,  however, in its
favour, in herpetic eruptions:  in a very short time it induced
evident improvement, and often removed the affection in from
eight to  fourteen days.   When the cases were more chronic,
a longer  time was, of course, required  for  the cure.   He  never
administered it, however, without attaining his object.  His rule
was, to bathe  the affected parts twice a day with creasote water,
and in particular cases he directed, in addition, general baths of
warm water.  The eruption  commonly  disappeared very rapidly
under  this management, but  it  speedily recurred, unless general
bathing was used  at the same time.  It again yielded, however,
very readily to  creasote  water.  Grandjean, Reich, and Kohler,
also applied the water successfully in herpes; and  Guitti  found
both the  water and  the  ointment  most  serviceable in  herpetic
affections when combined with appropriate  internal treatment.
Heyfelder recommends that  alterative  drinks, as the decoctum
sarsaparillae, should  be  combined  with  them.   Even in  herpes
exedens,  the external application of creasote was found effectual
by  Ritgen, Grandjean,   and  Rossi.  Wolff3  cured  a case  of
ancient impetigo in about eight weeks, by a solution of creasote
{Creasol. f gss.;  Jlq. destillat. f gv.)   At first, the  application
caused so much heat and inflammation,  that in eight  days it was
obliged to be discontinued, and afterwards it was  alternated with
fomentations of warm water from day to day until the cure was
completed.  Dr. Herndon, of Culpeper C. H., Va.,  derived much
benefit from  the  ointment in psoriasis.   In a case of acne
rosacea of seven years' standing, accompanied  with  headach, ner-
vousness, thirst in the morning and acid  eructations, for which the
patient—a female—was  put under treatment for a month, without
success, Dr. Elliotson4 determined  on trying creasote.  The ad-
vantage was  soon manifest,  as  in  three days the eruption was
evidently diminished. At first, she took two  minims three times
a  day;  this was  gradually augmented to twenty minims,—the
farther increase of the dose being  prevented  by the supervention         »
of giddiness and  tremors.  At the end of seven months, she was
  1 Op. cit.
  * Jornal da Sociedade das Sciencas Medicas de Lisboa, torn. v. Lisboa, 1837, noticed
in Zeitschrift fiir die gesammte Medicin. Oct, 1838, S. 224.
  3 Medicin. Zeitung, u. s. w. No. 30,  1834.      4 Lancet, July 4, 1834, p. 459. 
272
CREASOTUM.
 discharged;  the eruption being scarcely perceptible, and the dys-
 peptic symptoms entirely removed.  In a chronic pustular dis-
 ease, not curable by antiphlogistics, the same gentleman observed
 better effects from it than from any remedy previously prescribed.1
 Dr.  Copland found a saturated solution in water answer well as a
 lotion in porrigo favosa?  The author  has often  used  it in
porrigo, both  creasote water and  creasote ointment,  (see the
 formulae at the end of the article;) they  have always appeared to
 him  sufficiently strong, and  when the quantity of creasote was
 increased, so much inflammatory irritation was induced, that they
 had  to be discontinued for a time.
   In cases of chronic inflammation of the free edge of the
 eyelids, cures were effected by Coster, and G. T. Black3; by the
 former, from the use, twice a day, of a dilute solution of creasote
 [Creasot. gtt- xij.;  Jiq. destillat.  f |ij.) applied  by means of a
 camel's hair pencil.   The cure was complete in ten days.  The
 formula  for  the lotion used  by Mr.  Black  is given  afterwards.
 An ointment of it  has  also been found of essential  service in
 various forms of strumous ophthalmia, by Dr.  C. C. Hildreth,
 of Zanesville, Ohio.4  In different kinds  of ophthalmia, M. San-
 son used creasote, but never observed  the  disease to  be modified
 by the treatment.5
  In cases of prolapsus vaginse,  Schlesier tried the external use
 of a  solution  of creasote.  After astringent injections, and the ap-
 plication of decoctum krameriae by means of a sponge, had been
 used in vain, he injected diluted creasote for seven weeks, omit-
 ting it only at  the  time of menstruation.   It excited  a burning
 sensation of a few  minutes'  duration.   At the expiration of the
 time mentioned, the prolapsus had strikingly diminished, and the
 great sensibility of the prolapsed parts had disappeared.  Owing,
 however, to the supervention of irritation in the urinary bladder,
 it had to be discontinued, when  there was every prospect of ulti-
 mate success.
  Dr. Buttmann6 has given the case of  an old lady, upwards of
 seventy years of age, who  had laboured for several years under
 oedema of both legs to such  an extent as to interfere  materially
 with progression.  She experienced lancinating pains in both feet,
 and  irregular paroxysms of fever.   Many external and internal
 remedies had been used in vain, when, by way of experiment, he
 applied cataplasms of creasote, soon after which the swelling, very

  1 Medico Chirurg.  Transact, xix. 237.  Lond. 1835.
  2 Gully's edition of Magendie's Formulary, p. 204.  Lond. 1835. See, also, Sir F.
 Smith, in Dublin Med. Jour, for May, 1837, and J. L. Da Luz, Op. cit.
  " London Lancet, Aug. 7, 1841.
  * Amer. Journ of the Med. Sciences, Oct. 1842, p 364.
  * Compte rendu des Seances de la Societe de Medecine, Seance du 7 Mars, 1834.
  8 Beitragen zum Sanitats Berichte das Frankfurter Regierungs-Bezirks: cited in
Medicin. Zeitung, Dec. 7, 1836, S. 252. 
CREASOTUM.
273
much to his astonishment, gradually disappeared, and with it the
febrile attacks.
   In toothach from carious teeth, creasote has  often been  used,
being applied  to  the hollow of the tooth by means of a pencil, or
of cotton imbued with it.   The testimony in  its favour has been
very great.   It has been extolled  by Coster, Reich, Hahn, Knei-
sel,  Heyfelder, Fitchbauer, Hauff, Otto, Guitti,  Kohler, Meisin-
ger,1 and  numerous  others.   Some have advised  a  collutory of
creasote,  but this is more disagreeable, whilst  it is less  efficacious
than creasote applied  immediately to the carious tooth.  It  ex-
cites instantaneously acute pain and a considerable  secretion of
saliva.   The pain of toothach is often relieved by it, but it gene-
rally recurs;  and perhaps  the advantage derived from this agent
is not greater than from any of the stronger essential oils.   As a
palliative, it is very useful.   In rheumatic toothach, the insertion
of a little cotton, imbued  with creasote, in  the ear of the  same
side, has been found serviceable.2  Although, however, it alle-
viates the pain of toothach, it has  been  considered  to hasten  the
destruction of the tooth.3
   In deafness, apparently  owing  to deficient secretion from  the
ceruminous follicles,  advantage  has  been found  from  its  use,
after the ear had been  syringed.   Perhaps as  good a form as any
is that recommended  by Mr. Curtis,4 which consists  of one  dram
of creasote to four drams of lard.   A little of this  oil is  inserted
into  the meatus,  night  and morning, with a camel's hair pencil.
He considers the preparation contra-indicated in cases of otorrhcea
attended by pain  or inflammation.   Dr. Partridge,5 who has seen
many excellent effects from creasote in such  cases, prefers to com-
mence with half  a dram to four drams of oil of almonds, applied
by means of a camel's  hair brush.    After a few days, he usually
increases  the quantity of  creasote as  the occasion may require,
often using it as strong as one part to three of oil.
   In cases of ncevi, Dr. Thornton6 found it the  most effectual of
all applications.   He applies it two or three times daily, more or
less diluted: excoriation, ulceration, and gradual  disappearance of
the naevus ensue,—the cicatrix being always smooth and sound.

   Thus far, we have spoken mainly of the external use of  crea-
sote.  Reference  has been made  to its internal administration in
cases of hcemoptysis, hcematemesis  and leucorrhoea.  In the  fol-
lowing diseases, it has been chiefly given internally:—
   Phthisis.—Reichenbach excited considerable expectations from
  1 Medicin. Jahrbiich. des k. k. osterreich. Staates, B. xv. S. 553.  Wien, 1834.
  1 Riecke, Op. cit. S.  167.
  3 Cormack, Lond. and Edinb. Monthly Journal of Med., Oct., 1842.
  ' London Lancet, vol. i. p. 328, 1838-9; and Mr. Wright, ibid. p. 580.
  5 Medical Examiner,  May 30, 1840, p. 348.
  • Northern Journal of Medicine, Dec. 1844;  cited in Braithwaite's Retrospect, xi. 186,
Amer. edit, N. Y., 1845. 
274
CREASOTUM.
its use in phthisis,—pulmonary, laryngeal and bronchial; and as
in so intractable  a disease every suggestion is  immediately and
eagerly embraced, numerous  trials  were  instituted  with it, the
results of which were by no means  accordant.   Reich1 affirmed,
that he gave it both in laryngeal and tubercular phthisis with dis-
tinguished success.  In a case, in which the disease appeared to
be considerably advanced, the offensive expectoration was changed
into one of a tasteless, mucous character, although  the fever and
the  night sweats  experienced  no  modification.   Subsequently,
haemoptysis supervened,  with violent fever; on which account the
dose was diminished.  Under the use of the  remedy the condition
of the patient appeared to improve,—except the cough, which was
not mitigated;  an  anodyne was  consequently substituted for the
creasote;  under which his patient—a female—improved so much,
that he was led to believe she might be saved, although the cough
still  remained severe and frequent.  In another case, creasote al-
layed the hectic fever, and  transformed  the  purulent expectora-
tion  into one of a  mucous character; yet, although the general
condition of the patient  seemed  to  be improved, the cough and
uneasiness of the chest continued almost unchanged.   Grandjean,
also, had a case of phthisis in the third stage, the expectoration of
which was soon diminished; the pain in  the side removed;  the
appetite, sleep  and strength restored under its administration, but
the result of the  case was not  known.   Levrat asserts, that he
found it highly useful in  chronic bronchitis, and in some kinds
of phthisis.  Hechenberger saw good effects from the inhalation
of creasote in the form of vapour in a case of  " ulcerated lungs;"
five, ten, or fifteen drops, according to the degree of tolerance of
the lungs, being dropped into hot water in an appropriate vessel,
and the vapour received  through the tube of an  inverted funnel.
He was of opinion, that  this mode of  exhibiting it prevented the
disagreeable  effects apt  to be induced by its internal use; and
farther  experiments  have  confirmed  his  view.  On  the  other
hand, Elliotson2 derived  no favourable results from his trials with
creasote in  phthisis; even  inhalation  of  the vapour was  gene-
rally unattended with any advantage; yet, he  is of opinion, that
it  may be useful where there are only one or  two  ulcers in the
lungs, and  there is no  tendency to their farther  production, as
well as  where there is much secretion  from the bronchial mucous
membrane.  Either no  advantage, or  an  injurious  influence fol-
lowed its use in phthisis, by Rehfeld, Haupt,  Treumann, Giinther,
Schmalz,  Meisinger, Otto,  Kohler,3 and  others.  The published
experiments by Wolff, in the Charite, at Berlin, cannot be es-
teemed  more favourable.   It was tried in eleven cases of luber-

  1 Hufeland's Jour., Jan. 1834; and Revue Med., Mai, 1834.
  3 Medico-Chirurg., Transact, xix. 221.  London, 1835.
  * Hecker's neuern Wissenschaft. Annal. B. i. H. 3. 
CREASOTUM.
275
  cular phthisis, of which one was  in the first;  eight were  in the
  second, and  two  in the  third stage.  In  two  cases, there was
  scarcely any  advantage, after it had been given for fourteen days.
  In one case, it had to be discontinued on the eleventh  day, owing
  to the supervention of obstinate  vomiting.   The case ultimately
  terminated unfavourably.  In six cases, the symptoms  appeared to
  be aggravated, and the patients died soon afterwards.   In two, in
  which  the  disease was in  its second stage, death supervened un-
  expectedly early, on the fourth and the seventh days of the treat-
  ment,—in  one case, by suffocation; in  the  other, by  sudden  hy-
  drothorax.  The pulse, according to Wolff, was generally quick-
  ened under its use; the hectic  augmented;  the urinary secretion
  diminished; the  expectoration  neither  changed in  quantity nor
  quality; the cough was not mitigated; nor the dyspnoea  diminished:
  in four cases,  on the other hand,  they were manifestly increased:
  once, epistaxis occurred,  and twice haemoptysis.   From the re-
  sults of all his trials, Wolff is disposed  to  think, that creasote
  should  be  banished from our list of  agents employed in phthisis;
  both as respects the radical and the palliative treatment;1 but al-
  though they may not sanction us  in placing  much value on it  in
  the treatment  of phthisis,  it  may  be improper to ostracise it alto-
  gether,2 as, according to  the testimony of others, it would  seem
  to have rendered  service.   Rampold and Spath assert, that they
 have derived advantage from it in  confirmed phthisis where no in-
 flammatory complication was present; the expectoration and col-
 liquative sweats being diminished under its use; and M. Petrequin,3
 from his trials  with it, considered  its effects to be more beneficial
 —as might be presumed—in incipient than in confirmed phthisis;
 but in no case  did  he observe any thing approaching the radical
 cures described by some.   He, indeed, gives the preference to tar
 water, (see Aqua Picis Liquidje.)
   In bronchorrhcea, or that  state of the bronchial mucous membrane
 which consists in a  profuse secretion without inflammation, the in-
 halation of creasote has been found  of essential service.4  In the
 chronic mucous affections  of the lungs of old people, it  appears to
 have been especially useful.
   Rheumatism and Gout.—The success obtained by Reich5  from
 tincture of  soot in gouty and rheumatic affections, and  the proba-
 bility that its efficacy  might depend chiefly on the creasote it con-
 tained, induced him to prescribe  the  latter  remedy internally in
 those diseases.   He made the first  trial upon  himself.   After ex-
 posure to cold, he was attacked with lancinating pain in the right

  ' See, also, Kohler, in Rust's Magazin, B. xlvi., cited in Amer. Journal of the Med
Sciences, February,  1837, p. 497.                  * Riecke 0p. cit., S. 170.
   Gazette Medicale de Paris, Nov., 1636.
  4 Elliotson, in Med. Chirurg. Transact, xix. 221.  Lond. 1835.
  • Hufeland's Journal, Jan. 1834, and Revue Med., Mai, 1834. 
276
CREASOTUM.
 leg, for the removal of which the ordinary remedies were employed
 in vain:  it yielded to the use of creasote given for nine days.   He
 relates another case of  rheumatism, and one of atonic gout,  in
 which it was equally successful.   Marcus, of Hadersleben, recom-
 mends it in cases of rheumatism, unaccompanied by excitement of
 the vascular system, or tendency to congestion and febrile reaction.
 It is proper, however, to observe that  he combined other agents
 with it, so that his experiments are by  no means decisive as to its
 efficacy.   Of the three patients to whose  cases he refers, one only
 was  cured: the other experienced  improvement.  Karsten  found
 none of the advantages described  by  Reich, in rheumatic and
* gouty cases,  from its use.    In  a  case  of rheumatic headach,
 Tschopke found surprising benefit  from frictions of creasote, and
 plugging the ear with cotton dipped in it.   It immediately excited
 acute pain, and some  rubefaction of the skin;  and as the burning
 ceased, the  pain ceased along  with it.   In Most's experience,
 lotions of creasote water greatly  alleviated the pain of the  joints
 in rheumatism and atonic gout.
    In vomiting, not  arising from inflammation  or  other organic
 disease of the  stomach,  Elliotson x found creasote very efficacious.
 In the vomiting of pregnancy it has  been highly valuable.   If
 the sickness comes on  regularly after rising in the  morning, Dr.
 Cormack2  prescribes  two or three  drops  to be taken five or ten
 minutes before getting out of bed.   This he has generally  found
 effectual;  but  if it should not be, the patient is directed to repeat
 the  dose in two  hours.  In  more troublesome  cases, when  the
 sickness occurs at intervals during the day, one or two drops are
 given every two, three, or four hours.  He has also found it ser-
 viceable  in the sickness and  vomiting following a drinking de-
 bauch.   Even in Asiatic cholera and  in  sea-sickness, it appeared
 to allay the vomiting.   In various  affections of the  stomach, as in
 cardialgia and gastrodynia, it may be useful.3   In vomiting from
 nervous excitability, it has been affirmed  to excel all known medi-
 cines.4  After Dr. Elliotson had recommended it, Dr. Shortt tried
 it in about a  dozen cases, and found it  equally successful,  as did
 also  Dr. A. T. Thomson, of London, Dr.  Bodington, of Erdington,
 in Warwickshire,  Dr.  Christison,5  and  many  others.  Dr. John
 Walker, of Glasgow, in a case published  by him,6 does not appear
  to have been  equally  fortunate; and  with Dr.  Paris it  entirely
  failed.7   The  author's own success has been by no means as great
    ' Medico-Chirurgical Transactions, vol. xix., or Lancet, Aug. 20, 1836.
    0 London and Edinb. Monthly Journal of Med. Science, Oct., 1842.
    3 Riecke, Op. cit. S. 172.                  * Cormack, on Creasote, p. 133.
    * Dispensatory, p. 377.  Edinb. 1842.
    6 Lancet, Dec. 19, 1835, p. 447. See, also, Taylor, ibid. Aug. 15,  1835, and Macleod,
  in Lond. Med. Gazette, xvi. 598, and  xvii. 653.
    1 Pharmacologia, 8th edit, append.   Lond.  1838. See, also, Pereira, Elem. of Mat.
  Med. and Therap. 2d edit. p. 420, Lond. 1842; or 2d Amer. edit, by Carson, Philad.
  1846. 
CREASOTUM.
277
as that of Dr. Elliotson.   In many cases, indeed, it has developed
irritability of the stomach, where this  did  not  previously exist.1
Dr. Elliotson admits, that in large doses it seems to excite vomit-
ing, and that when given in such quantities wTith a view to check
it, no good, but evil, results from a large dose.   As a preventive
of sea-sickness, it has been extolled by  Dr.  Elliotson, and by Mr.
A. B. Maddock.2  It has been  administered, also, as an excitant
to relieve gastrodynia and flatulence, and where hydrocyanic acid
and creasote have been separately tried  unsuccessfully, Dr. Elliot-
son recommends that they should be combined.  Dr. J. B. Wilmott3
has extolled its use in injections in camp dysentery.  One was ad-
ministered every night composed of a dram to  twelve ounces  of
starch; and  more recently it has been suggested in the  same form
by Dr.  Flint4 in chronic  dysentery.
   Several portions of taenia having been observed to be discharged
after the administration of creasote, Kraus was induced to prescribe
it as a powerful anthelmintic.   This he did in numerous cases, and
with the  best success;—from five to eight  drops being given  to
adults with castor oil; or  where the bowels were not freely opened,
with half a drop or a drop of croton  oil.
   In  diabetes  mellitus, it was first  given  by Berndt,5 and  with
striking success.  One or two cases of  the same  kind  are related
by Gadolin; but Rehfeld used it without advantage.  Dr. Elliot-
son agrees with Berndt in the opinion,  that it is sometimes of use
in diabetes, and may even  be greatly instrumental in accomplishing
a cure.6
   Dr. Elliotson7 tried it  in  nervous disease.  In some  cases  of
epilepsy, the paroxysms appeared to be rendered less frequent and
more mild; but in the generality of cases, they returned with fresh
violence.  In  some, the  remedy had no influence on the disease;
in others, it  appeared to aggravate it.   In neuralgia, great advan-
tage was  at times derived  from it,  although  here, again, it was
frequently of no service.8   A severe case offacial neuralgia, was
cured by Mr. Thomas Kelly,9 by three drops made into a pill with
crumb  of bread, and  given every three hours.   Inoculation  with
a mixture consisting of 10  or 15 grains of  acetate of morphia  in
one dram  of creasote, was employed with much advantage in the
same disease by Mr. Rynd.10  Punctures were made over the nerves
affected, and the solution was introduced.   In a very short space
of time the pain was relieved or wholly disappeared.  Dr.  Elliot-

   1 Cormack, Lond. and Edinb. Monthly Journal of Med. Science, Oct. 1842.
  1 Amer. Journ. of the Med. Sciences, Feb. 1838, p. 496.
  3 London Medical Gazette, May 23, 1845, p. 162.
  4 Buffalo Med. Journal, cited in Med. Examiner, April, 1850, p. 252.
  5 Kleinert's Repertorium, Jan.  1835, and Lancet,  July 18, 1835.
  s Medico-Chirurgical Transactions, xix. 132-135.  Lond. 1835.       ' Op. cit.
  8 Cormack, loc. cit.                 " Dublin Medical Press, Sept. 13, 1849.
  10 Dublin Medical Press, March 12, 1845. 
278
CREASOTUM.
son also observed good effects from it in hysteria, where there was
no inflammatory complication,  in  spasmodic erethism of the ner-
vous system, and in palpitation;  and  Dr. Herndon,1 of Virginia,
used it with much benefit as an  inhalation in hysteric croup (thirty
drops to  the  quart of hot water.)  In  asthma, dependent upon
morbid  excitability of the bronchial mucous membrane, Dr. Elliot-
son2 found its inhalation often useful.
  In  two cases of  chronic glanders, the  same gentleman3 accom-
plished  a cure in the course of  a few weeks, by the sedulous use
of an injection  of  a dilute solution of creasote {Creasot. gtt. j;
Aquae f §j.) thrown up the affected  nostril;  combining the treat-
ment, in one of the cases, with the internal use of the remedy; and
a similar case of success is given in a  more recent number of a Bri-
tish medical periodical.4
                 MODE OF ADMINISTRATION.
  The  dose  for internal  use  is one or two drops, given several
times a day,  in  gum water.5   In  cases  of ta,pe-worm, the dose
should  be  larger.  Some  give  it in emulsion, but this form is ob-
jectionable on account of its disagreeable taste.   It is best admi-
nistered in pill.   Externally, it  is at times applied pure; at others,
diluted,—commonly with water, with or  without the  addition of
alcohol,—or in the form of ointment.  Carminati6  affirms that oil
and  mucilage, when  combined  with  it, render it milder, but that
vinegar increases its  action.  Dr.  Cormack,7 however, doubts the
assertion in regard  to vinegar.  In three comparative experiments,
which he made with  a view of  testing the justice  of Carminati's
conclusion, there was no apparent  difference in the  activity of cre-
asote, when given with acetic acid or alone.   He was led to be-
lieve, however, that the addition of albumen caused it to act more
powerfully, which, if true, would be  singular.
  The inhalation of creasote  vapour may be  accomplished by dif-
fusing a few drops of creasote  through water, or  a mucilaginous
liquid, in an ordinary inhaling vessel, or in the mode described under
the head of Chlorine.8

                      Pilulae  creasoti.
                       Pills of creasote.
                R.  Creasoti ttl  x.
                   Glycyrrhiz. pulv. ^j.
                   Mucilag. acac. q. s. ut  fiat massa
                in pilulas xx. dividenda.
  Dose.—Two  pills three times  a day.   In neuralgia, atonic

  1 Amer. Med. Intelligencer, March 15, 1838, p. 425.                2 Op. cit
  3 Lancet, for June 20, 1833.                  4 Ibid. Jan. 20, 1839, p. 145.
  6 It may be well to remark, that the  fluidram  contains one hundred and fifty drops of
creasote.        6 Op. cit.        ' Op. citat p, 88.        8 See page 186. 
CREASOTUM.
279
rheumatism, and chronic bronchitis.   The number of pills may
be gradually increased to eight or ten at a time.          Joy.
                R.  Creasot. srj.
                    Ext. glycyrrhiz.
                    Galban. aa. £ss.
                    Althseae pulv. gij.
                Fiat massa in pilulas cxx. dividenda.
   Dose.—Six pills, four times a day.  In consumption.
                                                      Reich.
                R.  Creasoti,
                    Ext. glycyrrhiz. aa. £j.
                    Althseae pulv. gij.
                Fiat mass,  in pil. cxx. dividend.
   Dose.—Five pills, morning and evening, in atonic gout.
                                                      Reich.
                     Haustns  creasoti-
                      Creasote draught.
                R.  Crseasot. r\ i.
                   Aquae camphorae,
                    Infus.  gentian, compos, aa. f^vj.
                M.  flat haustus.
   To check vomiting.
                     Wistnra creasoti.
                    Mixture of creasote.
                R. Creasot. gtt. v.
                   Mucilag. acacias f giij.
                   Syrup, althaeas f §j.  M.
   Dose.—A spoonful, every three hours, in hcemoptysis.
                                                    Santini.
             Tinctura creasoti  pro  gingivis.
              Tincture of creasote for the gums.
                R.  Creasot. f 3j.
                    Alcohol, fgij. M.
   As  much of this is to be added to cold water as is necessary to
give it a piquant taste.   The  teeth may be washed with it, and
the mouth rinsed.  Used in cases of fcetor of the mouth from ca-
rious teeth, and to limit the caries.                   Buchner.
                R.  Alcohol. (36° B.)fgiss.
                    Creasot. f 3J.
                    Tinct. cocci f ^vj.
                    01. menthae gtt. xxxvj.
   Used for toothach: and, diluted, as a wash for the gums.
                                                    Righini.2
                R.  Creasot.
                    Alcohol, aa. sjss.  M.
   To be applied to carious teeth.                     Radius.

  1 Tweedie's Library of Medicine, v. 282.  Lond.  1840; or 2d Amer. edit. vol. iii.
Philad. 1842.                        2 Journal de Chimie Med. Avril, 1841. 
280                       CREASOTUM.

                R.  Creasot. p. i.
                    Alcohol, p. viij.  M.
   This is the ordinary strength of  the tincture.  Used where
fractions of a drop of pure creasote are prescribed.

                       lotio creasoti.
                      Lotion of creasote.
                R.  Creasot. ijss.
                    Aquae destillat. f^v.   M.
   Used as a lotion in impetigo sparsa and itch.         Wolff.
                R.  Creasot. f gj.
                    Acaciae pulv. ^j.
                    Aquae f ^viij.  M. et fiat emulsio.
   This is " creasote emulsion,"  used as a hsemastatic.
                                            Smith fy Sinkler.

   The author has occasionally found  a lotion composed of f 3ss.
 to Oj. of water too  irritating.
                R.  Creasot. gtt. xij.
                    Aq. destillat. fgij.   M.
   To be applied by means of a  camel's hair pencil twice a day to
 inflamed eyelids.                                      Coster.
                 R. Creasot.  r\ iij.
                    Tinct.  lavand. compos. «!, xx.
                    Aquae destillat. f5ss.  M.
                                                 G. T. Black.
                 R. Creasot.  gtt. iv.
                    Aq. destillat. f 3ij.  M.

   In irritation of the gums.                     Fremanger.
                 R. Creasot.  f ^ss.
                    Acacia? §iss.
                     Aquae camphor, f §xss.  M.
   Used  every two hours  in cases of  aphthous ulceration of the
  mouth.                                            Magendie.
                 R.  Creasot.  gtt. x.
                     Aceti  f £ij.
                     Aquae fgij.  M.
    Used  in cases of phagedenic ulceration, and to chancres; applied
  by  means  of a camel's hair pencil.                     Shortt.

                     Unguentum  creasoti,

                       Ointment of creasote.

                  R. Cerati,
                     01. amygdal. aa.  %\.
                      Creasot. gtt. xxx.  M.
    A dressing in scrofulous  caries.                FrSmanger.

    The  Unguentum  Creasoti  of  the  London and United States

                        1 Cormack, Op. cit. p. 112. 
J
CUBEBA.
281
Pharmacopoeias is composed of half a  fluidram of creasote to an
ounce of lard;—that of the Dublin Pharmacopoeia,(1850,) of one
dram to seven.

           Unguentum  creasoti compositnm.

               t Compound ointment of creasote.
           R.  Creasot.
               Liq. plumb, subacetat. aa. gtt. x.
               Extract, opii gr. iss.
               Adipis gj.  M.
  An application  to chilblains.                     Devergie.

           R.  Creasot. £ss.
               Carbon, animal, praeparat. £].
               Alcohol, f giss.
               Ung. cetacei ^iss.  M.

  A "burn ointment."  This may be modified according to age
as follows:—for  children under five years of age, it should be
weakened by mixing it with four times its  bulk of spermaceti
ointment; for children from five to ten with  twice its bulk; and so
on, gradually increasing the strength according to the age of the
patient.  In protracted cases, the  strength should  be gradually
increased.                                          Sutro.

                  Linimentum  creasoti,

                    Liniment of creasote.

             R.  Creasot. gtt. v.—xx.
                 01. oliv. f gss.   M,
  To be rubbed two or three times  a day on the diseased parts in
chronic herpes.                                Corneliani.
                      Injectio  creasoti.

                    Injection of creasote.

             R.  Creasot. m, xx.
                 Liq. potass, f gij.
                 Sacchar. gij.
           Tere in mortario, et adde gradatim
                 Aquae f ^viij.  M.
  The injection to be used three times a day.   R. Ji. .Mllnatt.
                      LXX. CUBEBA.

Stnonymes.  CubebaB, Piper Cubeba seu  Cubebarum seu Caudatum,
  Cubebs.
French.  Poivre a queue, Cubebe.
German.   Cubeben,   C ub e benpfef f er,  Kube benpf effer,
  Schwanzpfeffer, Sc hwindelkorner.

  Cubebs are the fruit of Piper cubeba, which grows in India, Java, 
282
CUBEBA.
Guinea,  &c.   Sexual  System,  Diandria Trigynia;  Natural
Order, Piperaceee.  The corns of this plant have been long known
in the shops;  and in the old Wirtemberg  Pharmacopoeia  they
figure as calefacient, inciting, discutient, antinervous, and carmina-
tive agents, which seem to have a  specific action in vertigo: hence
they obtained the name "Schwindelkorner" or " grains for
vertigo."  They had,  however, fallen  into oblivion,  until  they
were reintroduced in modern times into practice, especially by the
English physicians and surgeons.
   The  shell  of  the dried  berry has a  weak taste,  but smells
agreeably;  and the kernel has a bitter aromatic flavour, which is
biting at first, but afterwards cooling.  The corns were analyzed by
Tromsdorff and by Vauquelin ;x but the most recent analysis is by
Monheim.2   He  found in 100 parts,—lignin 65;  extractive  mat-
ter 6;  Cubebin (Piperin) 4.5; matter  like wax, 3; green volatile
oil 2.5; yellow volatile oil 1.0; balsamic resin—which, according
to Vauquelin, is very analogous to balsam of copaiba—1.5; chloride
of sodium 1.0, and 15.5 parts  loss.   Cubebin  appeared to Mon-
heim to be identical with piperin, but to  be  united with an acrid
soft resin.  The volatile oil may be obtained separately by distilla-
tion with water.
                 EFFECTS ON THE ECONOMY.
   In  addition to the  general  excitant properties  of the peppers,
the action of cubebs is exhibited on the urinary and genital organs.
Under their use, the  secretion of  urine is augmented;  it becomes
of a darker  colour, and assumes an aromatic odour.  Cubebs  have
been  advised, in modern times—first, in cases of gonorrhoea, in
which they have been esteemed a specific by many.  Yet the consi-
derations that apply to copaiba are equally applicable to cubebs.
Although the revulsive effect induced by both on the kidneys may
mitigate the  inflammatory condition of  the lining membrane of
the urethra, which constitutes gonorrhoea;  yet, in violent  inflam-
matory cases, and in the early stages of ordinary  cases, they may
be injurious; and there are many instances on record in which bad
consequences appear to have resulted from their improper adminis-
tration.   Still, there are physicians who administer both them and
the copaiba in every stage of the disease.   Of 50 patients, treated
by Mr. Broughton3 by  cubebs, 10 were cured in from  2  to 7
days; 17 in from 8 to 14; 18 in from 15 to 21; 1 on the 55th day;
and in 4 only was no success  obtained.   In the chronic stage of
gonorrhoea,  M.  Ricord4 prescribes cubebs in combination  with
sesquioxide of iron; and in addition the patient is directed to inject,
four times a day, a solution composed of Aq.  destillat.  f ^viij.,
Argent,  nitrat. gr. ij.
  1 Memoir, du Museum, vi. 225.            2 Journal de Pharmacie, xx. 403.
  * Medico-Chirurgical Transactions, xii. 1.  Lond. 1822.
   4 La Lancette Frangaise, No. 33. # Paris,  1838. 
CUBEBA.
283
  It has been affirmed, that different  evils have ensued from the
use of cubebs: which ought to suggest care in their administra-
tion;—for example,—ardor urinae; fever; inflammation of'the ure-
thra, bladder, and testicles ; retention of urine ; cutaneous  erup-
tions, &C.1
  In the blennorrhcea of females, cubebs are equally extolled by
many practitioners, as  well as in leucorrhoea.2
   Spitta found  them very efficacious in old and obstinate  cases of
coryza, when given in the form of lozenges: they are said, like-
wise, to have been  administered with  advantage in defective au-
dition,  caused  by a catarrhal affection  of the  Eustachian
tube.  Rosin  found the  chewing of cubebs very serviceable in
aphonia.  They have also been prescribed successfully in  chronic
rheumatism.  Piil3 gave them with striking advantage in inter-
mittent fever; and in India, they are  regarded to be  aphrodi-
siac.4
   According to Dr. Paris, it is important to  keep the bowels open
during their use, for when hardened fasces are allowed to  accumu-
late, the spice insinuates itself into  the mass, and occasions exco-
riations of the rectum.5
                  MODE OF ADMINISTRATION.
   Cubebs are commonly given  in the form  of powder, and in
doses of from 1 to 2 and  even 4 drams, repeated once or oftener in
 the day.   Lozenges,  boluses, and  electuaries, are  likewise  pre-
 pared of them; and the London, Dublin, and United States Phar-
 macopoeias have a Tinctura  Cubebje (Cubeb.  giv., Alcohol.
 dilut. Oij. Dose, f Z\.—f 3ij.")   In consequence of the disorder at
 times induced by them in the  digestive function, Velpeau proposed
 that they should be given in the form of glyster, to  the amount of
 one or two drams  of the powder, suspended in five  or six  ounces
 of  an oily vehicle; and  this method has its advantages.6   To at-
 tain the same object, M. Dublanc, Jour., prepared an oleo-resinous
 extract, one sixteenth part of which possessed equal virtues with
 one part of cubebs; five grains, three times a day,  acting like the
 ordinary dose of powdered cubebs.7  He prepares it by adding oil of
 cubebs to the resinous extract, wdiich is prepared by digesting the
 cake left after the distillation of the oil in alcohol, and distilling off
 the spirit. The process of Mr. Wm. Procter, Jr.,is considered to be
   ' Lond. Med. and Physical Journal, Mar. 1832, and Merat and DeLens, Diet. Uni-
 vers. de Matiere Medicale, &c, art. Piper Cubeba.
   2 Edinb. Med. and Surg. Journal, xviii. 319. Blunder!, Diseases of Women, p. 158,
 Lond.;  or American Medical Library edition, Philad. 1840; also,  Lisfranc by Pauly,
 translated by Lodge, p. 243, Boston, 1839; and Iticord, Practical Treatise  on Venereal
 Diseases, by Drummond. Amer. edit.  Philad. 1843.                     «
   3 Reoueil de Med. Chirurg. et Pharm. Militaire, xvi.
   4 Merat and De Lens, Art. cit.         »*
   s Brande, Dictionary of Materia Medica, p. 205.  Lond. 1839.
   6 Archives Generates de Medecine, xiii. 47.
   ' Joum. de Chimie Medicale, iii. 491, and Journ.de Pharmacie, xiv. 40. 
284
CUBEBA.
a better one. He exhausts cubebs by ether, in a displacement appa-
ratus,  and submits the  ethereal  tincture to distillation in a  water
bath.  The residual ethereal extract of cubebs contains all the vo-
latile oil, cubebin and resin, as well as most of the waxy matter, but
none of the extractive.   One dram of it  is equal to one ounce of
cubebs.   It may be administered in the form of  emulsion, pills, or
capsules.   Dose, from gr. v. to ^ss.1
   The volatile oil  is sometimes given in the  dose of 10  or 12
drops, suspended in water by the aid of sugar, or associated with
oil of  copaiba.   Gelatinous capsules of cubebs, containing the
oil, are sometimes taken.
   M.  Piorry2 has strongly recommended  an Infusion of Cubebs
{Cubeb. ^j., Aquae Oij.) to be used six or eight times a day as an
injection in urethritis  and vaginitis.

                Pulvis  cubebrc   compositus,
                  Compound powder of cubebs.
                R.  Cubebaepulv. :f j.
                    Ergotas pulv. gss.
                    Pulv. aromat. Qij.
                    Sacchari !jj.
          Divide in chartulas  viij.
   Dose.—One, three or four times  a day, in  gonorrhoea, leu-
corrhoea, gleet, prostatic and involuntary seminal discharges.
                                                      Ryan.3
            R.  Cubeb. pulv.  gij.
                Aluminis pulv. |jss.   M. et divide  in chart, ix.
   One to be taken three times a day.                 Ricord.*

                    Electuarinm  cubebse.
                      Electuary of cubebs.
                R.  Cubeb. pulv. §ss.
                    Mellis despum. q. s.
              Fiat electuarium.
   Dose.—A tea-spoonful, three or four times a day, in catarrhus
vesicae, c. urethras, &c.                              Radius.
                R.  Copaib. givss.
          Subige cum
                    Vitello ovi unius, et
          Adde
                    Cubeb. pulv. ^ivss.
                    Confect.  rosEe ^ss.
          M. et fiat electuarium.
   Dose.—A tea-spoonful three or  four times a day.      Vogt.

  * Pereira, Elements of Mat. Med and Therap. 3d edit,vol. 2, Pt.l, p. 1265. Lond. 1850.
  2 Gazette des Hopitaux. Mai, 1842.  *  '
  * Universal Pharmacopoeia,  or a Practical Formulary of Hospitals, both British and
Foreign, by Michael Ryan. M. D„ Ac. &c. 3d edit. p. 160.  Lond. 1839.
  ' Mathieu, Journal des Connaiss. Med. (Jhirur. Juin, 1840. 
CUBEBA.
285
                R.  Copaib.
                    Cubeb. pulv. aa. ^ij.
                    Aluminis %].
                    Extract, opii gr. v.  M.
  Dose.—-A dram,  night  and morning, in  the pulp of a prune.
The quantity may be rapidly increased to two drams morning and
evening.
                R.  Copaib. part. i.
                    Cubeb. pulv.  part. xij.
                    Tinct. vanillae q. s.  M.
   Dose.—3j. three times a day.                   Cazenave.1
                     Jrochisci cubebae.
                       Lozenges of cubebs.
                R.  Cubeb. pulv. gij.
                    Tolut. gr. vj.
          Ad misce
                    Syr. myroxyl.
                    Ext. glycyrr.  aa. %].
          Acaciae q. s. ut fiat massa in trochiscos pond. gr. x. dividenda.
   Used in coryza.                                    Spitta.
                         Boli cubeba.
                       Boluses of cubebs.
                R.  Copaib.
                    Acac. pulv. aa. jij.
                    Aquae flor. aurant. Qij.
          Terendo bene mixtis adde
                    Cubeb. pulv. £ij.
          Misce, et fiant boli  No. vj.
   Dose.—One, three times a day.                   Henschel.
   M. Labelonye2 has recently proposed  the following method for
separating all the principles of cubebs from  the ligneous matter.—
 Cubebs, reduced to coarse powder, are placed in an apparatus for
 displacement and  exhausted by ether, which dissolves the wax,
 volatile oils and balsamic  resin.  The residue is  submitted to the
 action of dilute alcohol at 20° (.935,) which dissolves the extrac-
 tive principle, and chloride of sodium.   The alcohol and ether are
 separated by distillation in  part, and separately.   Evaporation of
 the hydro-alcoholic solution is then carried on in a wrater bath until
 it possesses  the consistence of a soft extract, to which the ethereal
 product is added; the evaporation being continued for a short time,
 the ether is completely volatilized, and a strongly aromatic extract
 is obtained, as consistent as honey.   This it is improper to subject
 any longer to the  action of heat, on account of the contained vola-
 tile oils; the presence of which in all cases interferes with complete
 desiccation.
   1 Bouchardat, Annuaire de Therapeutique pour 1842,  p. 44. Paris, 1842.
   5 Bulletin General de Therapeutique, cited  in Amer. Journ. of Pharmacy, 2d series,
 vol. 2, p. 31G.  Philad. 1837.
          19 
286
CUBEBA.
  One part of this extract is conceived to be equal to five of the
cubebs.  It can be readily mixed with water by means of muci-
lage, and can be administered in potions, injections, &c.
  The best form of exhibition, according to M. Labelonye, is in
lozenges, or in  an emulsive syrup.

 Troehisci  extracti  hydro-alcoholici cetherei  cubeba.
   Lozenges of the ethereal hydro-alcoholic extract of cubebs.
          R. Extract, hydro-alcohol, aether, cubeb. ^viij.
             Alcohol. Oij.
    Solve et adde
             Sacchar. in pulv. ten. lbj.
             01. menthae pip. gtt. xviij.
  Pour the mixture into flat vessels upon a stove, and allow the
alcohol to evaporate at a moderate  heat.  When the mass is com-
pletely desiccated, reduce it to a fine powder, and add a sufficient
quantity of mucilage of gum  tragacanth to form  lozenges—18,12,
9, or  6 grains each.  Most persons, M. Labelonye says, can swal-
low with  facility those weighing eighteen grains, and  containing
six grains of the extract: ten  of these are  equivalent to half an
ounce of the powder.

    Syrupus  extracti  hydro-alcoholici  aUherei cubeba.
   Syrup of the ethereal hydro-alcoholic extract of cubebs.
            R.  Ext. hydro-alcohol. a?ther. cubeb. §iij.
      Suspende ope mucilaginis in
               Aq. menthae pip. Oj.
      Adde
                Sacchar.  lbij.   M.

  Four ounces of this syrup contain two drams of extract,  equi-
valent to ten of powdered cubebs.
  Dose.—A tea-spoonful.
  M.  Labelonye also envelops  the extract in  sugar, as in the
ordinary sugar-plum.
  An extract of cubebs has  been recommended to be prepared
as follows:—Cubebs are exhausted by repeated digestion  in al-
cohol, which  readily takes  up  all the  active   principles of the
pepper; viz., a resin resembling  that  of  copaiba, and  a coloured
resin, with an almost concrete essential volatile  oil.   The alcohol
is distilled  from those tinctures  at a temperature so moderate as
not to volatilize the  essential oil. When the operation can be car-
ried no further in this manner, the  evaporation must be continued
in an  open vessel by the  aid of a water bath, at  a still lower de-
gree of heat; a little finely pulverized Spanish  soap must now be
added  to  prevent the separation of the  resin,  and preserve the
extract of a uniform consistence. 
DELPHINIA.
287
  The ordinary dose of this in blennorrhcea is about fifteen grains
three times a day.1
  Dr. Puche3  employs  a  liquid aqueous  extract of cubebs;  a
liquid  alcoholic  extract;  a syrup of the  alcoholic  extract;
a bolus of cubebs; and one of cubebs, copaiba and turpentine.  The
last he covers with a gelatinous mixture to obviate the unpleasant
taste.
                     LXX1. DELPHINIA.
Synonymes.  Delphinina, Delphininum,  Delphininium, Delphium, Del-
  phina, Delphia, Delphinine, Delphine.
German.  Delphinin, Delphin.
  This alkaloid was  discovered in 1819, by MM. Feneulle and
Lassaigne,3 and, almost at the same time, by Brandes,4 in the seeds
of delphinium  staphisagria, in which it is united with acetic acid.
As  a therapeutical  agent,  it has  been chiefly recommended by
Turnbull;  but he did not employ it in its pure state.
                  METHOD OF PREPARING.
  The plan recommended by Magendie5 is to boil a portion of the
seeds of delphinium, cleared of their coverings, and reduced to a
fine  paste, in  a little  distilled water;  to pass the  decoction
through  linen cloth, and filter.   Pure magnesia is  now added,
and the mixture is boiled for some minutes;  the  filtration is re-
peated; and the residues are washed carefully and digested  in
alcohol.  On evaporating the alcoholic tincture, delphinia is ob-
tained in the form of a white powder, having some crystallized
points.
  This is esteemed the most simple mode; but if a large quantity
be required, the following plan is advised—on  account of the  time
and  patience necessary to decorticate the seeds.   Submit  the un-
clean seeds, when well bruised, to the action of weak sulphuric
acid.   Precipitate the liquor by  ammonia, and redissolve  in
alcohol the delphinia, which is still slightly  coloured.   To purify
it, draw off the alcohol  by distillation, dissolve the  residuum in
muriatic acid, and boil  with magnesia.
  The plan recommended by  Couerbe, and  adopted by Turnbull,6
is to evaporate a saturated tincture of the seeds to the consist-
ence of a thin extract, and then to  treat it with water acidulated
with sulphuric acid.  This solution, when filtered, is to be pre-

  ' Judd, Medico-Botanical Transactions, vol. i. p. 4.  Lond. 1830.
  * Journ. de Connaiss. Medical. Aout, 1840; and Bouchardat, Nouveau Formulaire
Magistral. 3eme. edit. p. 129.  Paris, 1845.
  3 Annates de Chimie, torn. xi. xii., or Journal de Pharmacie, vi. 47 and 366.
  ' Schweigger's Journal der Chimie, xxv.  36L).             5 Formulaire, &c.
  ' On the Medical Properties  of the Natural Order  Ranunculaceae, chapter  11
Lond. 1835. 
288
DELPHINIA.
cipitated by ammonia.  The precipitate—after being freed from
its water—is  to  be taken  up by alcohol, and  again  reduced to
the consistence of an extract, which is likewise  to be dissolved in
acidulated water; to this solution, filtered, a  small quantity of
nitric acid is added, as  long as any precipitate is thrown down.
The liquid, freed from this precipitate, is again to be subjected to
precipitation by ammonia, and the powder is dried.   This is the
delphinia of commerce; but, like veratria, it is a compound sub-
stance, and consists of  resinous matter, staphysagrin  and del-
phinia;  the  delphinia is obtained by treating  the  powder with
ether, which takes up the delphinia,  and leaves the staphysagrin.
  When  in a state of purity, delphinia is wThite, pulverulent, and
devoid of smell;  but, like veratria, when  applied  to the mucous
membrane of the nose, it occasions sneezing, along with an  abun-
dant  secretion of mucus.   Its taste is at first  bitter,  and  after-
wards acrid, and  it acts upon animals in the same manner as—but
more energetically than—the seeds whence it is prepared.   It is
very sparingly soluble in  water, but  yet  in sufficient quantity to
communicate a bitter taste to the  fluid.   In  alcohol and ether it
dissolves readily; and these solutions have the property of render-
ing syrup of  violets green, and of  restoring the blue  colour of
litmus, when reddened  by acids.   It combines readily with  acids,
and  forms neutral salts, which  are possessed of much bitterness
and acridity;  and it may be precipitated  from  solutions of these
in the form of a jelly by the addition of an alkali.

                 EFFECTS ON THE ECONOMY.
  From  the experiments  of  Orfila,1 delphinia  appears to belong
to the class of acro-narcotic poisons.  In the dose of about five
grains, it proves fatal to dogs; and the fatal result is more speedily
induced when the delphinia is dissolved in weak acetic acid; the
animal, in the latter case, dies in the space of from  forty to fifty
minutes.    When diffused  through water  introduced into the sto-
mach of a dog, and retained there by a ligature placed  around the
gullet, efforts  to vomit supervened, with  restlessness, giddiness,
immobility, slight convulsions, and death  in two or  three hours.
In this case, the  mucous membrane of the stomach was generally
found injected.
  From  his  administration of delphinia and its  salts,  Turnbull
concludes, that the pure  alkaloid  has little effect on the mucous
membrane of the stomach and bowels.  It may be given, he says,
in some cases, to the extent of three or four grains a day, in doses
of half a  grain each, without exciting vomiting; in this quantity,
however,  it sometimes  operates upon the bowels, but causes very
little irritation.   In most instances, it acts as a diuretic, and occa-
sions a considerable flow  of pale urine.   When  taken  to the ex-
         1 Nouveau Journal de Med. x.; and Toxicologie Gen. i. 739. 
DIGITALINA.
289
tent of a few grains, it induces heat and tingling  in various parts
of the body, similar  to  those produced  by rubbing it upon  the
skin; and its other effects are very nearly the same as those of the
salts of veratria.
   The preparations of delphinia have been used in the same dis-
eases as  those of veratria, and they appear to exert a similar ac-
tion: the test laid down by Turnbull, in  the case of veratria,  ap-
plies equally to  delphinia;—namely, unless a  solution of delphinia
in alcohol, in the proportion of four grains to a dram, occasions a
distinct sensation of heat and pricking, when rubbed for three or
four minutes on the forehead, the specimen ought not to be used,
as no beneficial effect would arise  from its  application.   When
rubbed upon the skin, it gives rise to a sensation of burning,  not
unlike that which  manifests itself a short time after the application
of a blister, but  not to an unpleasant degree, unless the friction  has
been carried too far.   The effects of delphinia differ from those of
veratria  in being generally more  powerful  and durable.
   The  diseases in which delphinia has been chiefly  employed,
like veratria, are—tic douloureux, paralysis, and rheumatism.
In the first of these, when the affection is seated in the tongue, or
at the point where the infra-orbitar nerve escapes from  its fora-
men, the use of delphinia, according to Turnbull, is to be preferred,
because it  can  be  applied  to the tongue,  or rubbed on the gums,
without occasioning irritation of the mucous membrane.  He thinks
it also, upon the whole, better adapted for the treatment of para-
lytic cases than veratria, but principally on account of the property
it has " of exciting the circulation in the diseased part."
                  MODE OF ADMINISTRATION.
   The manner of applying delphinia is the  same as that recom-
mended  for veratria.   It may be used  either in the form of oint-
ment or in solution in alcohol; and the proportions to be  em-
ployed, in either case, may vary  from ten  to thirty or more grains
to the ounce, according to the  severity of the  affection, for  the
treatment of which it is prescribed.  The duration of the friction
should be regulated in the same manner, or it should be continued
until the pungent sensation  produced  by the  rubbing exhibits
itself.
                    LXXII.  DIGITALINA.
Synonymes.  Digitalin, Digitalia, Digitalinum, Digitaline.
French.  Digitaline.
German.  Digitalin.
  The  active principle  of digitalis was supposed to have been
separated by Le Royer, and by  Lancelot;1  yet these substances

  1 Pereira, Elements of Mat. Med and Therap., 2d Amer. edit. ii. 297, Philad., 1846;
and Art. Digitaline, in Merat and De Lens, Diet, de Mat. Med.
I 
290
DIGITALINA.
excited but little attention  either from the pharmacien or the
physician.   Subsequently, MM. Homolle and Quevenne separated
it, and it has received  much notice, especially from M. Bouchar-
dat,1 who has entered fully  into its  pharmaceutical and remedial
properties.
                   METHOD OF PREPARING.
   The following formula is given by M. Bouchardat.2  One kilo-
gramme (about 2 lbs. 8 oz.) of dried digitalis leaves of the year,
coarsely powdered and previously moistened, is put into a displace-
ment apparatus, furnished with its plug of carded cotton, and is
treated with cold water so  as to obtain a concentrated solution.
The liquid must be immediately precipitated by a slight excess of
subacetate of lead, and be  thrown  upon a filter, when it will pass
through, limpid and colourless.   A solution of carbonate of soda
is now added until a precipitate  is no  longer thrown  down;  and
the filtered liquor is deprived of the magnesia, which it still retains,
by phosphate of ammonia.   The  filtered solution is again pre-
cipitated by tannic acid in excess, and the precipitate, collected
on a filter, is mixed, whilst  still moist, with one-fifth of its weight
of powdered oxide of lead,  (litharge.)   The  resulting soft paste,
placed between unsized paper, dried on a stove and pulverized, is
exhausted  by concentrated  alcohol, in  a  displacement apparatus.
The alcoholic solution, deprived of colour by means of animal
charcoal, leaves  as a residue of evaporation a granular yellowish
mass, which, when washed with a little  distilled water, drained and
treated by boiling alcohol,  suffers the digitalis  by evaporation to
be deposited  on the  parietes of the  capsule  under  a granular
mamraillated form.3
   When drained and dried, the digitalis ought still to  be twice
treated with boiling concentrated ether, which separates from it,
among other substances, a white crystalline matter, traces of green
matter, and an odorous principle.4
   Digitalin is a neutral product, not an alkaloid, as said by some;5
having the appearance of  a white  powder;  a  confused or amor-
phous crystallization, and is but  little  soluble in water; insoluble
in ether, but very soluble  in  alcohol;  and of an intensely bitter
taste, so much  so, that the 15th of a grain is  sufficient to com-
municate a decided  bitterness  to two quarts  of water.   When
diffused in small quantity  in the air,  it  causes violent  sneezing.
It is not susceptible of any combination with acids or bases.

   1 Annuaire de Therapeutique et de Mat. Med. &c., pour 1845, p. 60.  Paris, 1845.
   1 Op. cit. p. 69.
   * See, farther, on the preparation, properties, &c, of this substance, Bouchardat,
Annuaire de Therapeutique, pour 1846, p. 89, Paris, 1846; and, for recent Researches
of MM. Homolle and Quevenne, Sandras and Bataille, the Annuaire of M. Bouchardat,
for 1850, p. 106.
   ' Oesterlen, Handbuch der Heilmittellehre, S. 769.  Tubingen, 1845.
   ' Bouchardat, Op. cit. pour 1845,  p. 60. 
DIGITALINA.
291
           EFFECTS ON THE ECONOMY IN HEALTH.
  MM. Bouchardat and Sandras1 injected into the subcutaneous
veins of the abdomen of a robust dog one tenth of a grain of impure
digitalin, dissolved in a few drops of alcohol, and about two fluid-
ounces of water.   Scarcely was  the  dog untied,  when  it made
several attempts to  vomit; walked in a straggling manner, like an
intoxicated individual; evacuated the bowels with much straining,
and, in a few minutes, fell down.   Whenever it was  raised up, it
staggered, and renewed its efforts to vomit.   During this time, the
pulsations  of the heart exhibited the  greatest  irregularity in
their  rhythm.  They were jerking (brusques) and strong;  se-
veral  of them succeeding each other rapidly, and then a manifest
interval occurring.  The number of pulsations, which in the nor-
mal state was from 100 to 120 a minute, was reduced to 36  or 40.
The dog died at the expiration of four hours.   The whole venous
system was found gorged with black blood, the clots of  which
distended  the principal  veins.  There was no  other  appreciable
disorder.
  In another dog, pure  digitalin furnished by MM. Homolle and
Quevenne, was injected  in the same quantity and dissolved in the
same manner into the external jugular vein.   The  animal walked
for an  instant as if  giddy; it then stopped and  suddenly fell; the
pulsations were slow, unequal, and about 40 per minute.  The dog
died in  about a minute and a  half after the injection.  No appre-
ciable disorder was observed on dissection.
  Other experiments were  made by administering  digitalin  by
the mouth, and the same phenomena ensued.  They injected it also
into the venous system of animals, and conclude, from the whole
of their experiments, that it is unquestionably an excessively  active
substance, especially when pure.  It modifies in a singular manner
the circulation, and is capable of exciting intense irritation  of the
digestive organs,  when taken by the mouth.

           EFFECTS ON THE ECONOMY IN DISEASE.
   Having satisfied themselves as to the energy and modus operan-
di of digitalin, it became important to obtain its sedative effects
on the circulation, without its acrid action on the digestive organs.
By means of mucilage and  marsh-mallow  powder,  MM. Bou-
chardat and Sandras made pills, each  of which contained a demi-
centigramme  (the 10th  part of a  French grain)  of digitalin.
These pills they gave under their own eyes to patients to whom a
retardation of the circulation  might be useful, and when there was
nothing dangerous to be apprehended from the use of an agent capa-
ble  of irritating the digestive  tube.  In all, the pulse was marked-
ly retarded ;  and irregularity  was induced.  In only one case were
* Bouchardat, Op. cit p. 60. 
292
DIGITALINA.
 they told  of any increase in the  urinary  secretion.  When the
 toxical effects appeared,  they were indicated  by disorders of the
 senses, disturbance of the head, distressing  dreams, and hallucina-
 tions, which  were  soon  followed  by diarrhoea, or  more or less
 bilious vomiting.   When  these phenomena  appeared, the digitalin
 was  stopped, but, in spite of  every precaution, the vomiting con-
 tinued at times for two  or three days.
   The investigations of M. Rayer, as reported by M.  Hervieux,1
 have led  him to sum up the  physiological  effects of digitalin as
 follows.   First.  In doses of the  twenty-fourth to  the sixteenth
 of a  grain it  renders the  circulation slower, and increases the se-
 cretion of urine.   Secondly.  Doses of one-twelfth  to one-eighth
 of a  grain may give rise to serious disturbance  of the  nervous
 centres, and the digestive  organs; and, thirdly. Beyond an eighth
 of a  grain, intolerance  always supervenes,  and death might ensue
 if this limit were overstepped, or if  the experiment were continued
 too long.
   It  would appear from these  observations that digitalin represents
 digitalis in all its active  properties, and that  it may be administered
 in every morbid condition in which the plant has been found ser-
 viceable.2   By employing it—as properly remarked by MM. Bou-
chardat and Sandras—the physician  always knows exactly the
 quantity of the active principle which he  administers.
   When applied endermically, its  action is so  irritating that it
 can scarcely be  used in  that manner.3
                 MODE OF ADMINISTRATION.
   Comparative trials satisfied  M. Bouchardat4 that 4 milligrammes
 (gr. .0616 Troy) of digitalin,  correspond  in energy of action with
 about 40  centigrammes (gr.  6. 176 Troy)  of powdered digitalis,
prepared with the greatest care.   It  is  a  hundred fold stronger
than  the most active preparation  of digitalis.
   The following formula?  have been recommended.5
                     Pilulae  digitalinBe.
                      Pills of Digitalin.
          R.  Digitalin. gr. .7720 (5 centigrammes.)
              Acaciae pulv.
              Mucilagin. acaciae. q. s. ut fiant  pilulae XX.
  Dose.—1 to 4 daily in hypertrophy of the heart.   Bouchardat.
                    Qrauula digitalinae.
                    Granules of digitalin.
          R.  Digitalin. gr. 15-44 (1 gramme.)
              Sacchar. §iss. (50 grammes.)
  1 Bouchardat, Annuaire de Therapeutique, pour 1849, p. 149.
  2 Strohl, Gazette Med. de Strasbourg, Aout et  Octobre,1849, cited in Archiv. Gene-
rales de Medecine, Janv. 1850,  p.  100.
  » Bouchardat, Annuaire, &c, pour 1846, p.  92.            4 Op. cit. p. 77.
  * Bouchardat, Op. cit. p. 76; and Nouveau Formulaire  Magistral, 3eme edit. p. 237.
Paris, 1845. 
DIOSMA.
293
  Make into one thousand  granules like comfits.  Each of these
contains a milligramme (gr. .0154) of digitalin.
  Dose.—Four to six in the 24 hours.  Homolle 4r Quevenne.

                   Syrupus digitalinee.
                     Syrup of digitalin.
          R. Digitalin. gr. iss. (10 centigrammes.)
             Syrupi O 2| (1500 grammes.)
  Dissolve the digitalin in alcohol, and add the syrup.   In every
15 grammes (40 grains) of the syrup there is a milligramme (gr.
•0154) of digitalin.
  Dose, four to  six spoonfuls in the  day, or in some appropriate
infusion.                              Homolle <§r Quevenne.
                   Mistura digitalinae.
                     Mixture of digitalin.
          R. Digitalin. gr. -0770 (5 milligrammes.)
             Aquas lactucae giiU (100 grammes.)
             Syrup, flor. aurant. ^viss.  (25 grammes.)
  Dissolve  the  digitalin in a few drops of alcohol;  then add  the
distilled water and the syrup.
  To be taken by table spoonfuls in the 24 hours.
                                      Homolle fy Quevenne.

                  Unguentum digitalina\
                    Ointment of digitalin.
          R. Digitalin. gr. -770 (5 centigrammes.)
   Dissolve in a few drops of alcohol  at 22° (s. g. -923;) and in-
 corporate in lard {axonge balsamique) 10 grammes (3iiss.)
                    LXXIII.  DIOSMA.
Synonymes. Diosma Crenata (folia;) Barosma Crenata (folia;) Agothos-
  ma Crenatum (folia;) Bocchoe, Bocho, Boocho, Buokha, Buchu Leaves.
French. Diosmee cienelee.
German. Buccublatter; Duftstra uchbla tter.
  Diosma crenata  is indigenous at the Cape of Good  Hope.  It
belongs to the  Natural Family Rutacese;  Sexual  System
Pentandria Monogynia.  The smell of the leaves is penetrating
and peculiar, but resembling that of rue and camphor.  By some
it has been compared to that of oil of juniper;  by others, to
rosemary;  by others, to cummin, and by others again, to that of
the urine  of the  cat.  The  name is,  therefore, by  no  means
expressive,—Sto5, "divine," and  o<jf«i, "odour."  The taste of
the leaves is aromatic; somewhat pungent; and, in  the opinion
of Buchner, resembles that of peppermint; without any parti- 
294
DIOSMA.
 cular bitterness, yet  disagreeable.   According to the analysis of
 Buchner, Brandes, and Cadet,  the  most important constituents
 appear to be a volatile oil  of a greenish-yellow colour, a peculiar
 principle—diosmin,  and a semi-resinous substance.  Diosmin is
 a very tenacious adhesive matter, similar to Peruvian balsam, and
 can be drawn out  in fine threads.  It has the same smell as the
 leaves,  only somewhat weaker; the taste is pungent and bitter.
 The  semi-resinous matter has  a  resinous lustre;  is of a  dark
 brown  colour,  becomes fluid  when heated, and  burns with a
 flame.  Its  odour is not  remarkable;  taste, somewhat pungent
 and sourish.1
           EFFECTS  ON THE ECONOMY  IN HEALTH.
   The Hottentots have long used the leaves of several varieties of
 diosma  both internally and externally; but they give the prefe-
 rence to  diosma  crenata.-  Through  them  its virtues  became
 known to the European settlers.   It was  first brought  to the no-
 tice of British practitioners by the  notorious Richard Reece, who
 is more known for the part he took in the farce of Joanna South-
 cote than for any thing else.   In Germany,  it was chiefly promul-
 gated by Jobst, who published an  extract  from Reece's obser-
 vations  in the Repertorium of Buchner.2   Bardili instituted ex-
 periments for testing  its action on the healthy organism.  It first
 acts—he  says—as an excitant on  the stomach,  w7hence arises a
 feeling of increased heat in that organ, and the appetite becomes
 augmented :  from  the stomach, the  excitement spreads to the vas-
 cular system; the heat of the body is increased; the pulse becomes
 more frequent,  and the  transpiration is favoured.  It acts,  like-
 wise, on the urinary  secretion;  the urine is  separated in larger
 quantity,  contains flocculi, deposits a purulent (?)  sediment, and
 exhales an aromatic odour.  On the digestive function, it seems
 to produce somewhat of  a constipating  effect.   Bardili thinks,
 that  he has also witnessed  some narcotic  operation in his experi-
 ments.
  The same  results were produced by diosma on  animals.

           EFFECTS  ON THE ECONOMY  IN DISEASE.
  The inhabitants of the  Cape  administer this  agent as a sto-
 machic, and the Dutch physicians give it with success in indiges-
 tion.   It is said also  to have afforded essential service in chronic
 cases of rheumatism and gout.  Autenrieth extols it in rheuma-
 tic pains, which have had their foundation in repelled itch (?);
and its  utility  in  chronic  rheumatism  has  been confirmed by
numerous  others.  It has been extolled, moreover, in hematuria,
 calculous pains, and in irritated and suppurative conditions of

   1 Journal de Chimie Medicale, iii. 13, and Journal de Pharmacie, xiii. 106.
   » Band- xxii. S. 51. 
DIOSMA.
295
the bladder, urethra, and prostate.  The author has repeatedly
administered it, but has observed  no other effects than those of a
moderate excitant diuretic and  tonic.  Reece says he found it
efficacious in incontinence of urine, and  in cat'arrhus vesicae;
and he gave it—united with  tincture  of cubebs—in spasmodic
stricture of the urethra, gonorrhoea, swelling of the prostate,
and impotence.
   At the Cape of Good Hope, buchu leaves are often applied ex-
ternally, in  the form of liniment and baths, as well as of fomen-
tations and cataplasms, in luxations and rheumatic pains,—and
in wounds,  especially the contused.
   It  may be remarked, that  this—like almost every similar re-
medy—has  been given in  cholera; and, as the Riga physicians
assert, frequently with favourable results.
                 MODE OF ADMINISTRATION.
   The dose of the powder is  3ij. in the clay: this, at least, is the
common  dose at the  Cape.   The infusion  necessarily  contains
more of the  volatile oil than the decoction; but, on the other hand,
the latter has more of  the diosmin :  as respects their action, how-
ever, there is not much difference.  A vinegar, oxymel, liniment,
extract, and tincture of diosma have been  advised.
   The London, Edinburgh, Dublin, and United States Pharmaco-
poeias have  an Infusum Diosma (|ss. of the leaves to Oss. of
water, Pharm. U. S.;) dose, f §iss : and the Dublin, a Tinctura
Buchu (§ij. of the leaves  to  Oj. of proof spirit;) dose, f 3tj. or
f3iij.
              Infnsum diosmae compositum,
                Compound infusion of buchu.
            R.  Diosm.
                Uvae ursi aa. ^ss.
                Aq. bullient. Oss.
     Digere leni calore in vase clauso per semihoram.  Colaturse adde
                Syrup, seneg. f §ss.
   Dose.—One or two spoonfuls  every two hours in blennorrhoea,
 and in atony and paralysis of the bladder.            Clarus.
                R. Infus. diosmae f^vij.
                   Tinct.  diosmae,
                   ----Cubebae, aa. f ^ss.  M.
   Dose.—Two table spoonfuls three times a day.  This formula
is recommended  by Dr. Joy' " in chronic diseases of the prostate,
bladder, kidneys, gravel, &c," as if the pathological condition to
be rectified were, in all these cases, identical!

   1 Tweedie's  Library of Medicine, v. 311.  London, 1840; or 2d American edit. voL
iii. Philad. 1842. 
296
ELECTRO-M AGNETISMUS.
           ELECTRICITAS, see GALVANISM US.

            LXXIV. ELECTRO-MAGNETISMUS.
Synonymes.  Electro-magnetism, Magnetic Electricity.
  Electro-magnetism has  been introduced amongst therapeutical
agencies as adapted for the same  cases as electricity  and gal-
vanism.  Various forms of  apparatus  have been  designed; coil
machines, and  magneto-electric machines:1 but, perhaps,  as Dr.
Pereira has remarked,2 the most convenient, simple, and  powerful
is the magneto-electric machine of Mr.  E. M. Clarke, of London;
which consists  of a battery of six curved permanent magnets, and
an  intensity armature, around whose cylinders 1500 yards  of fine
insulated copper wire are coiled.  The ends of this wire commu-
nicate respectively with a pair of directors, each holding a piece
of sponge, dipped in vinegar, or a  solution of common salt.  When
the armature is rotated, and a portion of  the body is interposed
between the directors, a succession of shocks is  experienced.  As
this machine is  not affected by the moisture of the atmosphere,
and acids are not required  to excite it, it is possessed of advantages
which the galvanic battery has not.

           EFFECTS ON THE ECONOMY IN DISEASE.
  Electro-magnetism has been employed in all cases in which vol-
taic electricity has been deemed advisable.   Mr. E. S. Clarke, who
applied it in the wards of Dr. Graves at the Meath Hospital, states
that he found it act more quickly in neuralgia3  than in any other
disease.  Some varieties it removed  in  two or three applications,
but  others  often required a feeble  electro-magnetic  current for
many successive days.   Next in order of facility came " rheumatic
and sciatic cases; then cases of deafness; after those, some varie-
ties of catamenial suppression.   It also acted readily on  certain
curable forms of amaurosis; then in partial  paralysis, and with
greater difficulty in hemiplegia than in  almost  any other form."
Dr. Golding  Bird,4 and  Dr. Neligan5 found electro-magnetism of
immense advantage in many forms of paralysis; whilst in Dr. Bence
Jones's6 trials of it, in the same disease,  no benefit was derived in
the majority of the cases.  Dr. Wm. Davis7 found it of great value
in rheumatic paralysis, in  a case of subacute articular rheumatism,
which had produced such changes in the locomotive organs, that

  1 See the author's General Therapeutics and Mat. Med. 4th edit. i. 510. Philad. 1850.
  a  Elements of Mat. Med. and Therap. 3d edit. vol. i. p. 56.  Lond. 1849.
  *  Graves, System of Clinical Medicine, p. 434.  Dublin, 1843.
  4  London Lancet, June 13, 1846, p. 649.
  »  London and Edinburgh Monthly Journal of Med. Science, April, 1846.
  B London Journal of Medicine, No. 2, 1849.
  T Provincial^Medical and Surgical Journal, Nov. 15,1848. 
ELECTRO-MAGNETISMUS.
297
the patient was unable to walk or use her hands; and Professor
Kubik* bears equally favourable testimony to it in the same affec-
tions.
   An anomalous case belonging  to the neuroses  was laid before
the Sheffield Medical Society;  a summary of which is given  by
Mr. Law.3   A lady, 51  years of age,  had suffered from neuralgia
of  the  right inferior  maxillary nerve,  when  she was  suddenly
seized with vomiting; fainted, and lost power over the arms when
in the upright,  but not when in the recumbent  posture.  Soon
afterwards she found it  impossible to swallow, and  the  sickness
subsided: after this, she  had paralysis  of theleft side of the face,
and of the right arm and leg.  Nothing could be introduced into
the stomach except through an oesophagus tube.  Electro-magnetism
was applied to the back of the neck and chest in the course of the
oesophagus, to the  left side of the face, and from the spine in the
course of the nerves to the right arm and leg.  This was  done for
one hour at least, three  times a day for a month, and afterwards
twice a day.   Nutritious and stimulating substances were passed
down into the stomach, and quinia and other tonics were adminis-
tered.   Under this management she completely recovered.  "With
respect to treatment," says Mr. Law, " the writer  doubts whether
the electro-magnetism is  entitled to the credit of  having effected
the cure;  or  whether this should  be attributed to  the quinine,  sti-
mulating tonics and great attention which was paid  to'the digestive
organs.   Paralysis  occasionally  terminates  favourably quite irre-
spectively of  medical treatment,  and the acknowledged obscurity
in which the proximate cause, in the case under consideration, was
involved, demands especial caution in assigning to  each of the  va-
rious means employed in  the treatment its due share of credit.   It
is by no means  impossible, that the electro-magnetism, instead of
having carried off the complaint, retarded the cure, and that this
was  ultimately  accomplished by nature  assisted  by the  general
treatment.  Until a  series of cases treated with electro-magnetism,
have been contrasted with a parallel series treated without, it
would be unphilosophical to  pronounce a decided opinion on this
principle  as a curative agent in paralysis.   Although the writer
has employed electro-magnetism in a  variety of cases during the
last twelve months,  yet he has hardly  been  able to verify  a single
observation of any  one  of its numerous and  zealous advocates.
Dr. Shearman used  either the negative or positive pole, as chance
directed.   Now, Retter asserts,  that the former diminishes, whilst
the  latter augments the powers of life; and  J.  D. Humphreys,
medical galvanist, with  Chas. Woodward and others, says, that
the positive  pole exerts a salutary influence, by exhilarating  the

  ' Prag. Vierteljahr, v, 4, 1848; cited in Schmidt's Jahrbiicher, u. s. w. No. 2, p. 159.
Jahrganor. 1849
  * Provincial Medical and Surgical Journal, May 15, 1844. 
298
ELECTRO-MAGNETISMUS.
spirits, and infusing  feelings of energy and strength;  while the
negative excites  a sense of exhaustion and'of irritation.  These
writers  distinctly state, that the only  effect of the negative  pole,
if applied to the seat of a disease, would be  to aggravate its worst
symptoms.  How are these opinions  to  be reconciled with Dr.
Shearman's belief, that he" had cured his patient by the indiscriminate
use of the oxidating and deoxidating electricities?  Dr. Wilkinson,
Dr. Hodgkin, Mr. Ware, and Mr. Carpue, ascribed wonderful power
to electro-magnetism in diseases affecting respiration, circulation,
digestion  and  secretion.   According to these  gentlemen, there is
hardly a complaint which it will  not either cure or relieve, or an
indication  in therapeutics,  which it will  not satisfactorily fulfil.
The writer can reconcile  the discrepancies between the statements
of authors and   his own experience only by supposing, that the
publications on  this subject contain many errors.  With respect,
however, to the case under consideration, it  is right to say the so-
ciety (Sheffield Medical,) generally  agreed with Dr. Shearman, in
ascribing the cure to electro-magnetism; and that Dr. Abercrombie
speaks rather favourably  of this agent."
   This case was doubtless  one of  the large  class  of anomalous
nervous  maladies, which  require new nervous  impressions, and a
tonic system of medication.   To fulfil the former indication, nothing
could be  more appropriate  than electro-magnetism.  The  same
may be said of a  case of hysterical convulsions, which occurred to
Dr.  Byrne,1 in a  girl, twelve years  of age, who was aroused  from
each paroxysm by having the poles of an ordinary electro-magnetic
battery applied—the one to the occiput, the other to the sacrum.
   Mr. Tuson 2 has recorded observations of a very favourable cha-
racter in regard  to the benefit of this  agent in certain local neu-
ralgic affections, the consequence of injury; and  it has been ex-
tolled  by Dr. William Cumming3 in constipation, and  in certain
irregularities of the functions of the bowels.
   Dr.  Hays,4 who,  as remarked under Galvanismus, found gal-
vanism the most  useful remedy in certain cases of amaurosis which
fell  under his care, employed  electro-magnetism in several  cases
in Wills' Hospital, and in a number in private practice, but with-
out its seeming to be productive of the slightest benefit in a single
instance; whence he too  hastily infers, that for remedial purposes
a regular and constant galvanic current would appear to be  more
useful  than the violent shocks  produced by interrupted currents,
such as  are induced by the electro-magnetic apparatus.   This is
obviously  a non sequitur, for the shocks may be diminished so as
scarcely to be felt;  and, moreover,  theory would suggest, and ex-

  1 Charleston Medical and Surgical Journal, cited in  Ranking's Abstract, January to
July. 1849, p. 49.
  ' Medical Times, Feb. 24,1849.         3 London Med. Gazette, Dec. 7, 1849.
  4 American Journal of the Med. Sciences, Aug.  1840, p. 288. 
ELECTRO-MAGNETISMUS.
299
perience has shown, that there are numerous cases in which the
excitant and revulsive effect of properly graduated shocks is more
serviceable than the regular and constant current.
   Dr. Kramer1 has employed  the magneto-electric  or electro-
magnetic current  as a remedy for deafness and  tinnitus aurium.
He found it a decided excitant to the organ of hearing, its action
being  manifested  by convulsive twitchings, pains in the ear, mo-
mentary increase  in the hearing distance, and aggravation  of the
tinnitus, either at  the time or afterwards; but it  did not seem to
have any strengthening effect  on  the nerves, and required to be
used with the greatest precaution, and in the mildest manner. The
action was  strongest  when the current was  conveyed  from the
mouth of the Eustachian tube to the external meatus of the affected
ear, instead of from one auditory passage to the other.
   Dr. Thomas Radford2  employed galvanism with great success
in the treatment  of cases of uterine hemorrhage, accidental or
unavoidable, accompanied by  exhaustion,  and occurring before,
during, or after labour.   He considers,  from positive trial, that it
will be found a most important agent in tedious labour, depending
upon want of power in the uterus, and where no mechanical  obsta-
cles exist.3   He also suggests the probability of its proving valua-
ble in originating  uterine action de novo in cases  where it may be
deemed necessary  to induce premature labour; and that it may be
worthy of trial in certain cases of menorrhagia  in the ungravid
state, where, on examination per vaginam, the uterus is  found to
be atonic, as evidenced by its large, flaccid condition, and the patu-
lous state of the os uteri.   His mode of applying it is as follows.
Slight shocks are  carried through the long axis of the uterus  by
means of a  conductor introduced along  the vagina to the os uteri,
another being placed externally over the fundus.   Shocks may be
also passed transversely  through the uterus by applying simulta-
neously the conductor on each  side of the abdomen.  The applica-
tion must be made at intervals, so  as to approximate, as nearly as
possible, its effects to the natural labour pains; and be continued
so as to meet the  exigencies of the case.  Successful cases are re-
lated by Messrs. Thomas  Dorrington,4 H.Wilson,5 Mr. Cleveland,6
and others.
   In a case of amenorrhcea, electro-magnetism was used with suc-
cess by  Dr. Collins.7   He had applied the electro-magnetic ma-

  ' Beitrage zur Ohrenheilkunde, Berlin, 1845; cited in Brit, and For. Med. Review,
July, 1847, p. 22.
  * Provincial Medical and Surgical Journal, Sept. 18, 1844, p. 386; and Dublin Quart.
Journal, May, 1847.
  s See a case by Mr. Clarke, Dublin Hospital Gazette, March 1, 1845, cited in Braith-
waite's Retrospect, January—June, 1846. p. 423.
  4 Provincial Med. and Surg. Journal, March 11 and 18, 1846.   5 Ibid. Ap.29,1846.
  • Dr. G. Bird, Lectures on Electricity and  Galvanism, in London Medical Gazette,
June 11, 1847.                    * London  Lancet, Jan. 25, 1845, p. 91. 
300
ELECTRO-MAGNETISMUS.
chine in some other cases with  the happiest effects; and was in-
duced to try it in  this.   He applied one  of the  buttons on the
lumbar region of  the spine, and the other in front  over the pubic
region, using the negative  and  positive poles alternately to the
spine and abdomen: the  remedy was continued  five clays, from
five to ten minutes each day, when  the catamenia were fully re-
established.   Dr.  Collins adds,  that he  has used  it with good
effect in rheumatism.
   It has likewise  been employed  with success in amenorrhcea and
dysmenorrhcea, by Dr. Robert L. M'Donnell, of Montreal,1 and
by Dr.  Walkly, of Mobile.2  The  former  prefers  the apparatus
sold under the name of the vibrating magnetic machine.   When
this is in operation, one of the buttons at the free extremity of the
electrodes is  applied by the  physician to the lower portion of the
spinal column, corresponding to the point of exit of the sacral
nerves,  and the other is applied by the  patient herself, or by a
female  attendant, immediately over  the  pubes.  In order to pro-
tect the patient  from the  inconvenience of receiving the shock
through the  hand  which holds the button, a thick glove should be
worn.  Having desired  that one button be  kept  firmly  pressed
upon the os pubis, the physician  commences by passing the other
button along the spine from the occiput to the os coccygis.  After
this has  been done slowly  four or five  times, the  button is kept
for five or six  minutes immediately over  the sacrum,  and the
electricity is thus  passed in an uninterrupted current through the
uterus.   It is not  necessary to put the patient to great torture by
increasing the strength of the shocks.  More benefit, according to
Dr. M'Donnell, will be derived from an uninterrupted and steady
transmission  of a  moderate  current than  by occasional shocks of
great intensity.    The  current  may also  be sent transversely
through the pelvis, by placing a button on each  hip, above the
great trochanter.
   Dr. Walkly3 thinks  electro-magnetism as  a parturifacient  far
preferable to ergot, for the reason, that the pains induced by it are
regularly intermittent, as in natural labour, and hence not likely to
injure either the  mother or  the  child.    The  electricity  may be
applied  by placing the negative electrode in a foot-bath with the
feet, whilst the positive electrode is placed over the  lumbar region,
and a succession of shocks passed for from three to five minutes.
The application of galvanism  to induce  and increase parturient
contractions  of the uterus has  often, indeed, been  proposed.  It
was suggested by  Herder4 in 1803, and by Dr. F. Ramsbotham in
  1 British American Journal, cited in Ranking's Half-yearly Abstract, July to Decem-
ber, 1846, p. 170.
  a New Orleans Med. and Surg. Journal, July, 1846, p. 52.
  3 Op. cit.
  4 Diagnostische Praktische Beitr'age zur Erweiterung der Geburtshulfe, Leipz. 1803,
cited by Professor Simpson, in Monthly Journal of Medical Science, July, 1846, p. 33. 
ELECTRO-MAGNETISMUS.
301
1834,1 but does not  appear to have been  employed  by  them.
Several  trials  were instituted  by Professor  Simpson, of Edin-
burgh, with the view of ascertaining the exact degree of influence
which galvanism possesses over the contractile action of the uterus
during labour,  and consequently the amount of aid which may be
expected to be derived from  it in any  case in which its assistance
is had recourse to.  His general results were not favourable to it.
In  one  instance the pains were  more frequent in  their  recur-
rence, but shorter in their  duration during the application of gal-
vanism ; in five other cases, it  neither increased the  average fre-
quency of the pains, nor their average duration.  In  one  case, the
pains ceased whilst the galvanism was applied, and returned upon
its removal.   In another,  the  action ceased  whilst the galvanism
was  applied, and did not return on  its withdrawal, nor  for 24
hours afterwards.  Professor Simpson concludes, that as employed
at  the present time  and  in its present mode, it is  not a means
 which can be in any  degree  relied  on to  directly  excite or in-
 crease the contractile action of the uterus;  " and  is so far practi-
 cally and entirely useless as a  stimulant to the parturient action of
 the uterus."
    There can be no doubt, however, from the mass  of testimony,
 much of which has been  collected  by Dr. Channing,2 of Boston,
 that uterine contractions may  be excited by the powerful stimula-
 tion which interrupted electro-magnetic currents are capable  of
 inducing.
    In the opinion of Dr. Golding Bird,3  electricity  is the only
 really direct emmenagogue with which experience  has furnished
 us.   " I do not think," he  remarks, " I have  ever known it fail
  to excite  menstruation when  the  uterus is capable  of performing
  this function."  " The rule," he adds, " for ensuring success in the
  great mass of cases of amenorrhcea is sufficiently simple.  Improve
  the general health by exercise and tonics; remove the  accumula-
  tions often present in  the bowels by appropriate purgatives; and
  then a  few electrical shocks,—often a single one will be sufficient to
  produce menstruation, and at once to restore the previous deficient
  function."  As the author has elsewhere4 remarked, however, im-
  provement of the general health is itself an efficient agency  in the
  removal of amenorrhcea.  An admirable  mode  of using it, ac-
  cording  to Dr. Channing, is the  hip-bath, in which one.of the
  poles of the electro-magnetic or galvanic  apparatus is immersed
  near the organs to be especially acted upon.   The  other handle is
  applied in the course of  the  spine, or in the bath on  the  opposite

       1 Simpson, Op. cit
       2 Notes on the Medical Application of Electricity.  Boston, 1849.
       3 Lond. Med. Gaz., June 11, 1847.
       4 General Therapeutics and Mat. Med., 4th edit, i. 422.  Philad. 1850.
          20 
302
ELECTRO-M AGNETISMUS.
side  of the body.   Dr. Tracy E. Waller 1 recommends it  as  a
valuable agent in prolapsus uteri.
  An interesting case of poisoning by opium is recorded  by Dr.
Thomas S. Page,2 of Valparaiso, in which electro-magnetism was
successfully employed to cure the patient.   The  breathing had
become short  and  hurried;  the mouth  widely extended, and jaw
fallen;  nothing  seemed  capable of rousing him; the exhaustion
was  extreme; the pulse could be felt feebly at the wrist, and
was  maintained  there,  in Dr.  Page's  opinion,  by the  agitation
which  he had undergone.  Electro-magnetism was now applied.
Whilst  an assistant rapidly rotated the wheel, Dr. Page  applied
the balls at first to each side of the neck, and ran them down be-
hind the clavicles.  The arms and body moved  convulsively, but
the  patient lay as  unconscious as before.   He  now passed one
ball  over  the region  of  the heart, and the other  to a corre-
sponding point on the right side.   In an instant the eyes opened,
and  with a ghastly expression  of countenance the head  and  body
were thrown convulsively toward  Dr. Page, and he groaned. He
now sank  back into his reclining posture, and was again asleep.
The  balls wrere reapplied in the same situation with similar results
a third  and a  fourth time, when he cried out:—" no more!"   Re-
action was now positively established.
  Dr.  Page  suggests,  that  electro-magnetism will not only be
found a most  useful agent in cases like the above; but in highly
congestive forms  of disease, where oppression of the nervous sys-
tem  prevents reaction and speedily destroys life.  In all cases of
asphyxia he considers it will  be useful, and believes that in very
many instances  it might be applied with  the happiest  effects in
asphyxia neonatorum.
  When employed—as every form of electricity occasionally is—
to modify the function  of  nutrition  for  the  removal of morbid
growths, or to promote the absorption of effused fluid, as in hy-
drocele;3 magneto-electricity is most commonly administered in the
way of electro-puncture; yet excellent effects are not unfrequently
induced by the employment of the  magneto-electric influence  in the
shape of shocks passed through the part affected  for a  longer or
shorter period.

  1 Medical Examiner, April, 1848, p. 238.
  * Amer. Journ. of the Medical Sciences, Aug. 1843, p. 301.
  3 Ogier, in Southern Journal of Medicine and Surgery, No. 3, and Frost, Charles-
ton Med. Journal, July, 1848. 
ELECTRO-PUNCTURA AND GALVANO-PUNCTURA.
303
LXXV. ELECTRO-PUNCTURA, GALVANO-PUNCTURA.

Svnonymes. Electro-puncture, Electro-puncturation,  Galvano-punctura,
  Galvano-puncture, Galvano-puncturation.
German. E lectropunctur, Gal vanopunctur.
  Electro-puncture consists in a union of acupuncture with 'elec-
tricity.   The  idea of the conjunction  appears to have originated
with  Berlioz; but Sarlandiere was, doubtless, the first who put it
in practice, although J. Cloquet has  contested  the priority with
him—a matter, by the way, as in all such  cases, of extremely
small moment.  The operation consists in employing acupunctu-
ration in the usual way, either with a  single needle, or with two
or more; and  making  a  communication   between  them  and  the
prime conductor of  an  electrical machine in action;  or they may
be made to form part of the  circuit in the discharge of a Leyden
jar.   In this way, the electrical influence may be graduated from
the simple aura to a full shock.  Sarlandiere appears to have em-
ployed electro-puncture with great success; but he restricts its use
to rheumatic or neuralgic pains, uncomplicated  with organic mis-
chief or inflammation:  when  such  complications exist, he advises
that bloodletting and general antiphlogistics should be premised.
Guersent thinks it better, in  all these cases, to use  simple acu-
puncturation, and only  to employ electro-puncture when  the first
proves to be inadequate, as in paralysis,  and  in tremors produced
by the immoderate use  of mercury; in all cases, indeed, in which
the  malady depends on a  diminution of the nervous  energy.   A
case of success from its use in paralysis of the right arm, in which
voluntary  motion  and  sensibility were destroyed, has been pub-
lished.3   The  patient was, in the  first instance, subjected  to  the
use of blisters and moxas along the course of the radial nerve, from
which he obtained some advantage. The remedy which succeeded
best, however, was electro-puncture  along the nerves from  the
shoulder to the hand.   At first, the punctures were but little felt;
but  afterwards they were very painful.  The sensibility, mobility,
and  strength of the fingers and hand gradually returned; and, three
months after his admission, the patient left the hospital completely
cured.
   Galvano-puncture has likewise  been  used by M. Joberf for
the treatment of deafness dependent  upon paralysis of the acou-
stic  nerve.  He introduces Itard's sound  through the nasal fossae

  1 E. Grafe, art. Electro-punctura, in Encyclop'ad. Worterb. der'Medicinisch.Wissensch.
x. 550.  Berlin, 1834.
  a La Lancette Franchise, Dec 20, 1836; cited in Amer. Med. Intel., Oct. 16, 1837
p. 265.
  ' Cited from L'Examinateur Medicale, in Lond. Med. Gaz., June 2, 1843, p 356. 
304      ELECTRO-PUNCTURA AND GALVANO-PUNCTURA.

into the  Eustachian tube; and into this  sound a long  thin acu-
puncture-needle is passed,  so  as  to fix  itself in a point of the
parietes of the tube, whilst the other extremity projects  from the
end of the sound.  Another acupuncture-needle is implanted in the
membrana tympani.  This  being  done, one  of the conducting
wires of a galvanic battery, the trough  of which is filled  with
water and chlorohydric acid, is passed through the eye of one of
the needles, and  the end of the other conducting wire is made to
touch the opposite needle.   M. Jobert has used  in the beginning
eight pairs  of plates of the battery; afterwards, ten  and  twelve
pairs, and as high as eighteen; and he asserts, that he has patients
who have been acted upon by the entire pile, which contains forty
pairs.  At the moment the poles are placed in contact, there is a very
painful shock in the ear and head, with  convulsive  movements;
but the shock and pain usually cease immediately. In one patient,
the impression was felt for  eight  days; but it never  exceeded  a
slight pain, and ceased of itself.   When the patient was irritable,
only one shock was given;  but  he has given two and even three
shocks to persons whose sensibility was obtuse, and who had been
already subjected  to electro-puncture.  In  general,  he permitted
eight days to elapse between each  trial.   He relates four cases of
well marked deafness, which were  completely cured, one  after  a
single shock; another after two shocks; and a third after two sit-
tings, eacti consisting of three galvanic shocks.
   The author has frequently used  both electro-puncture and gal-
vano-puncture in rheumatic and neuralgic affections; but he
does not think the advantages were more marked than those of
simple acupuncture, whilst  the  suffering from the operation was
certainly greater.   Magendie regards electro-puncture as  the re-
medy par excellence  in the treatment of obstinate  neuralgia}
In rheumatism of the chronic form, it has afforded almost in-
stantaneous relief; and M. Raciborski2 found it of essential  advan-
tage in cases of sprains.
   Magendie affirms, that he has treated many cases of incomplete
amaurosis with  great  success by galvano-puncture.   He fixed
a needle in  the frontal nerve, and  another in the superior max-
illary, making  these communicate respectively with the poles of
a galvanic pile of twelve pairs  of plates, each six inches square.
Whenever the contact was made, the patient experienced  a  painful
commotion in the  course of  the  nerves, and at the bottom of the
orbit;  light became better appreciated, and  the pupil  contracted.
A case has  been reported by Dr. Dacamina3  of palsy of the
  1 Medico-Chirurg. Rev. July, 1841, p. 202; see, also, Dr. Shuster,cited in Lond. and
Edinb. Monthly Journ. of Med. Science, June, 1844, p. 510; and Dr. Cowan, in Address
before the Provincial Med. and  Surg. Association, cited in Braithwaite's'  Retrospects,
Amer. edit. xii. 36. N. Y. 1845.
  2 Cited in Southern Medical and Surgical Journal, July, 1846, p. 436.
  ' Psychological Journal, January, 1849. 
          ELECTRO-PUNCTURA AND GALVANO-PUNCTURA.      305

tongue, which was cured by it.   In 1813,  an old woman was
seized with  general paralysis of sensation  and  motion in  conse-
quence of fright.  This passed away, except as regarded the arms,
head and tongue.  She was unable to articulate a word. Twenty-
three years  afterwards, Dr.  Dacamina had  recourse  to galvano-
puncture,—one pole of the apparatus being applied to the occipital
nerve by means of a needle introduced into the neck, and the other
to the tip of the tongue. After two applications, the patient could
raise the organ; and after the third, she could reply to some ques-
tions intelligibly, although with difficulty.   After this, the points
of contact were varied,  and the electricity was applied  to different
parts. The patient gradually recovered her speech, and the other
palsied parts were also cured.
   In cases of asphyxia, galvano-puncture has been proposed  to
arouse the dormant energies.   The effect of electricity, in the dif-
ferent forms in which it is adopted in medicine, on the functions
of sensibility and muscular contraction, could not fail to suggest it
early to observers as a fit agent  for this purpose:  but  it is rarely
at hand, and, therefore, seldom available.  J. P. Frank, Thillaye,1
and  others have highly recommended it;—the latter  gentleman,
on the strength of numerous experiments on  animals.   As the ob-
ject, in these cases, is to arouse  the  respiratory muscles to action,
the electric shock may be passed  through the  shoulders or the chest
in any  direction.   Neither   common  nor galvanic electricity is
possessed of much—if any—power to restore the action of the in-
voluntary muscles.  The  author has  frequently attempted to re-
excite the action of the  heart, intestines, fibres of  the  uterus, &c.
soon after the cessation  of respiration and circulation, by means of
the galvanic stimulus, but without the slightest  success, although
the  voluntary  muscles responded to it  energetically.  Besides,
were the action of the  heart  re-excited by  it, this could  be but
momentary.   A necessary stimulating agency  to that  viscus is
distention by the  proper  fluid,  and unless  the respiratory move-
ments were  restored, and conversion of venous to arterial blood
effected, so that the latter could reach the left heart, the action of
that organ could not be maintained.  Every  attempt,  therefore, is
properly made to restore the action  of the respiratory muscles, so
that hsematosis may be  accomplished.2
   M. Leroy d'Etiolles3 has suggested galvano-puncture in a man-
ner  which, at the first aspect, appears most formidable; but which
is really less so than it seems to be, in consequence of the impu-
nity with which fine needles can be made to  penetrate, as has been
  1 Archives Generates de Medecine, torn. xii.
  8 Art. Asphyxia, by the author, in  the  American Cyclopedia of Practical Medicine,
partx. p. 486, Sept, 1836; and in his Practice of Medicine,  3d edit. i. 475. Philad. 1848.
  * Magendie's Journal de Physiologie, torn. vii. torn. viii. and torn, ix.; also, Recherches
Experimentales  sur  I'Asphyxie,  Paris, 1829; and Bourgeois, Observations sur' la
possibility du retour a la vie dans plusieurs cas d'Asphyxie. Paris, 1829. 
306      ELECTRO-PUNCTURA AND GALVANO-PUNCTURA.

seen,1 even  the  most important organs.   He introduced an acu-
puncture needle on  each side, between the eighth and ninth ribs,
until it reached the fibres of the diaphragm.  He then established
a galvanic  current  between the  needles  by means of a  pile of
twenty-five or thirty pairs  of plates, an inch in diameter.  The
diaphragm immediately contracted, and an inspiration was  accom-
plished.  He  then  interrupted the circle, when the diaphragm,
urged by the weight of  the  abdominal viscera, and, aided by gen-
tle  pressure made on the  abdomen  by the hand, returned to  its
former position, and an expiration was effected.   In this way, the
two respiratory acts were made to succeed each other, and regular
respiration  was reinduced.   A continuous  current was likewise
employed  in  some  cases;  but the respiratory movements  were
irregular, and  nothing like natural respiration  resulted.  Leroy
tried  his method on animals asphyxied by submersion;  and when
they had not been under water more than five minutes, they were
often restored.
  These experiments were  witnessed  by Magendie.3  On different
occasions, M. Leroy asphyxied animals of the same kind, and ap-
parently of the same strength, and while  those  that were  left  to
themselves  perished, those  that  were treated  by galvanism re-
covered.  As an aid, therefore, to pulmonary insufflation,  and  an
important one, galvanism,—combined  or not with acupuncturation,
—might be advantageously employed in  asphyxia,  but,  as has
been already remarked, it can rarely be available.  Certainly, no
time should be lost in adopting the other  energetic and indispen-
sable measures that are demanded.3   It has been  recommended,
that as only a very small apparatus  is necessary, batteries, con-
sisting of a few plates, might be kept wherever there are station-
houses for  the reception of  persons in a state of asphyxia.*  The
suggestion  is good; and they might  also with  propriety form a
part of the cabinet of apparatus  of the private practitioner; but
whilst an assistant is preparing the apparatus for action, the prac-
titioner should be assiduously engaged in employing  other means
of resuscitation.5
  In  a paper  read before  the French Academy of Sciences, in
January,  1843, Dr. Shuster6 reported the following conclusions
as the  result of  his employment  of  electro-puncture in disease.
First, Electricity is only useful as a therapeutical agent when in-
troduced into  the substance of the  affected organs  by means of
acupuncture.   Secondly, Galvanic   electricity  and  the electro-
magnetic fluid, when employed  by  acupuncture,  constitute the
  1 See art. Acupuncture, p. 51.                   2 Journal de Physiologie, ix.
  a See art. Asphyxia,  Op. cit. p. 486.
  4 Kay, in Edinburgh Med. and Surg. Journal, xxix., and in his work on Asphyxia.
London, 1834.
 '' See Most, Art. Galvanismus, in  Encyklopad. der gesamrnten medicin. und chirur-
gisch. Praxis, u. s. w. 2te Auflage.   Leipz. 1836.       6 Op. cit. 
         ELECTRO-PUNCTURA AND GALVANO-PUNCTURA.      307

most powerful and harmless agents that we possess.   Thirdly,
The affections in which  electro-puncture may be employed suc-
cessfully are:—First, hydrocele, ascites (idiopathic  or  sympto-
matic of curable lesions,) hydrothorax, and articular  dropsies.
Its use  may  be extended to chronic hydrocephalus, dropsy  of
the pericardium, and the  greater part of dropsical effusions.
Secondly, lipomatous, steatomatous, atheromatous, melice-
rous, serous and  synovial cysts.  Thirdly,  congestions and
indurations, chiefly those of the lymphatic glands, of  the testi-
cles and epididymis;  indurations of the areolar  tissue in the
neighbourhood of certain kinds of ulcers, and in the  walls of fistu-
lous passages, and certain  indolent tumefactions; and there
would be nothing  irrational, he  properly remarks, in attacking
cancerous affections in  the  same way.    Fourthly, goitre.
Fifthly, varicose  dilatations, especially when electro-puncture
can be aided  by rest and  compression; and he does  not despair to
employ  it with  advantage  in  cases of aneurism and erectile
tumours.  Sixthly, chronic rheumatism,  neuralgia, and cer-
tain nervous diseases.  Seventhly, paralytic affections in ge-
neral, but especially those of the retina,  (amaurose asthenique,)
and of the muscles of the voice, (mutisme paralylique.)
   M. Zenobi Pechioli1 has  detailed a case  of double hydrocele
in which he  employed electro-puncture.  Two needles  were in-
serted, one into  the upper,  the other into the under, part of the
tumour.  These  were  connected  to opposite poles of  a voltaic
pile, and the electric  fluid was passed in a continued current for
five minutes,  when it had to be discontinued in consequence of the
right testicle  becoming painful.   Five minutes after the  removal
of the needles, both hydroceles  disappeared  completely.  In the
evening, redness and heat of the  scrotum occurred, and the right
side of  the scrotum became cedematous.  The  operation was re-
peated in ten days, and was followed by a like result.  Ten days
afterwards, it was again  resorted  to, after which he  had  no return
of the disease.  M. Pechioli is of opinion, that the openings made
by the  common  mode of acupuncturation are too small to allow
the fluid to escape, and  he thinks, that by passing a current of
electricity through the hydrocele, the contained fluid is forced out
through the sac into the  areolar tissue of the scrotum, whence  it
is removed by absorption.
   M. Petrequin,2 of Lyons, has applied electricity  to the cure of
aneurism in three cases.  Two of these he had lost  sight of be-
fore the influence of the treatment could be duly appreciated.  In
another  case, of aneurism  of the temporal artery,  galvano-

  1 Bulletin delle Scienze Medic, di Bologna, Sept., 1841; cited in Dublin Journal of
Med. Sciences, November, 1842, p. 311.
  2 Amer. Journal of the Med. Sciences, Jan. 1846, p. 229; cited  from Med. Times,
Nov. 15, 1845; and Revue Medicale, Nov. 1846, p. 340. 
308      ELECTRO-PUNCTURA AND GALVANO-PUNCTURA.

puncture was performed  by the introduction into the  tumour  of
two sharp steel pins crossing  each  other  at  right angles; the
heads  of  the pins were then placed  in  communication with the
wires of a voltaic pile,  and a  shock and  sharp pain were ex-
perienced, the pain  increasing with  the  intensity of the  electric
action.   The operation lasted ten minutes, and fifteen plates were
employed.   The  pulsations gradually diminished in the  tumour
during the operation, and, at its close, had  entirely disappeared.
No accident followed the experiment; and in ten  days  neither
tumefaction nor pulsation could  be detected in  the spot where the
aneurism  had  existed.   M.  Petrequin  lays down  the following
precepts,  an  observance  of which, he thinks,  will  ensure a com-
plete coagulation  of  the blood contained in an aneurismal tumour.
First, compression of the  artery between the aneurism and the
heart during the application of the galvanic agency.   Secondly,
the pins introduced  into  the tumour should be numerous, cross
each other at right angles, and  their  surface should be protected
by  a coat of varnish, in  order to prevent unprofitable  loss of the
electric fluid.  Thirdly, after the operation, ice should be applied
to the tumour.   Successful cases of its employment in aneurism
are given by Drs. Bellingham, O'Shaughnessy,1 Abeille,2 Borelli,3
and others;  but it has been  unsuccessful in the hands of  Liston,
Phillips and  others, and  has been very unfavourably reported on
by  M. Gimelle,4 before the Academy of  Medicine  of  Paris, who
is so impressed with the numerous dangers and  the ill success of it,
that he desired the Academy to pass  an absolute condemnation of
it.   This was, however,  regarded as  too  extreme a  measure, since
cases in which the ligature could  not be employed, or had been
so  usually without  success,  might sometimes  be  benefitted  by
this procedure.
   There  can be no doubt that  electro-puncture is  capable of ma-
terially modifying the nutrition of the part on which it is prac-
tised, and that it  will, consequently, be found to exert  power over
morbid depositions, solid as well as fluid.

  1 Ranking's Half-yearly Abstract, January to July, 1847; Amer. edit, p. 196; and
Ibid. July to December, 1847, p. 203.
  a Annales de Therapeutique, Novembre, 1847; cited in Ranking, Op. cit., January
to June, 1848, p. 107.
  * Schmidt's Jahrbiicher, Bd. lxiv., S. 75; cited in Canstatt und Eisenmann, Jahres-
bericht, u. s. w.  im Jahre, 1849, v. 145.  Erlangen, 1850.
  4 Bulletin de l'Academ. xv. 572-82; cited in  British and  Foreign Medical Review,
July, 1850, p. 268. 
EMETIA.
309
                      LXXVI. EMET'IA.
Synonymes.  Emetina, Emeta, Emetinum, Emetium, Emetine.
French.  Emetine, La Matiere Vomitive.
German.  Emetin, Brechstoff.
  In the year 1817, MM. Pelletier and Magendie,1 by a series of
chemical and physiological experiments, discovered, that the vari-
ous kinds of ipecacuanha are  indebted for their emetic properties
to a peculiar substance to which they gave  the name Emetine.
This substance possesses the emetic power in a very concentrated
state, and  has neither  the  disagreeable smell,  nor the  nauseous
taste of ipecacuanha.   They considered, therefore, that  it might
be advantageously substituted for ipecacuanha on all occasions.
   There are two varieties of the active principle—the  coloured
and the pure—which, as Magendie remarks,2 bear the same rela-
tion to each other as moist sugar does to the white  and crystal-
lized.  Ipecacuanha, derived from cephaelis ipecacuanha, contains
the most emetia.
   Emetia has been received into many of the Pharmacopoeias, as
the Parisian, Batavian, Hanoverian, &c.
                   METHOD OF PREPARING.
   1.  Coloured Emetia.—Powdered ipecacuanha  is digested
in ether  at  60° (.720)  to dissolve the fatty matter whence it
derives its  disagreeable odour, and  which  possesses no  emetic
virtue.   When the powder yields nothing more to  ether, it is ex-
hausted by means of alcohol:  the alcohol is then evaporated in a
water-bath, and  the residue is dissolved in cold water.   It thus
loses  some  of the wax, and a  little  fatty matter, which still  ad-
hered  to it; it is then only necessary to mix it with carbonate of
magnesia, whereby it loses its  gallic acid,—to redissolve it in
alcohol, and to evaporate to dryness.
   By a similar process, M.Boullay obtained from the roots, leaves,
 flowers  and seeds of Viola odorata, an  active, alkaline, bitter
 and acrid principle, similar to emetia from ipecacuanha,  which he
 denominates emetine of the violet, indigenous emetine or vio-
 line.  According to Orfila, it possesses highly poisonous  qualities.3
   2. Pure emetia—Cepha'elinum,  of Bischoff.—This is obtained
 by substituting calcined magnesia for the carbonate used in the
 process  just described, in such quantity, that the  acid existing in
 the liquid may be neutralized, and that which  is  associated with
 the emetia  be separated from it.   The precipitate of magnesia and
emetia must  now be washed with a little very  cold water, to re-
move the colouring matter, which is not combined  with  magnesia;

   1 Journal de Pharmacie, iii. 145; and Magendie's Formulaire pour la preparation de
plusieurs nouveaux medicamens, &c.                         ' Op. cit.
   ' Journal De Pharmacie, Janvier, 1824. 
310
EMETIA.
and, after being carefully dried, it must  be treated with alcohol,
which dissolves the emetia.   The emetia  obtained  by the evapo-
ration of the alcohol, must then be dissolved in a dilute acid, and
treated with pure animal charcoal.   After this purification, the
emetia must be precipitated by a salifiable base.  The waters used
to wash the magnesian precipitate still contain emetia, which may
be separated by a second series of operations.
   Coloured emetia appears in the form of reddish brown, trans-
parent scales; is almost inodorous, and of a bitter, but not nau-
seous taste.   It can withstand  the  heat  of boiling water without
experiencing change;  is very deliquescent, soluble in water, and
not crystallizable.
   Pure emetia has a white and frequently a somewhat yellowish
appearance; is pulverulent, and does  not deliquesce, like the for-
mer, in the  air.  In cold water, it is but little soluble; more so in
warm.  In  ether  and alcohol, it  dissolves readily.  Its taste is
feebly bitter.  It has an alkaline  reaction, is dissolved by all the
acids—diminishing  their acidity, but  without wholly neutralizing
them.   With  the  acids  it forms crystallizable  compounds, from
which it may be precipitated  by galls, which are  the best agents
for obviating the effects of emetia, when  given in too large a dose.
           EFFECTS ON THE ECONOMY IN HEALTH.
   According to Magendie,1 from half a grain to  two or three
grains of coloured emetia given to  dogs  and  cats, excited vomit-
ing, at times followed by long sleep.  In larger doses,—ten grains,
for example,—it  occasioned, in dogs,  repeated  vomiting, after
which the  animal  fell asleep, and  generally  died in twenty-four
hours.  On  dissection, violent inflammation was found in the lungs,
and in the mucous membrane of the stomach and bowels through-
out their whole extent.   The effects were   the same  when the
emetia was  injected into the jugular vein, or absorbed from any
part of the body.   In  a  healthy man,  two grains of coloured
emetia taken  fasting, produced repeated vomiting, to which suc-
ceeded a decided disposition to sleep.   Even a quarter of a grain,
at  times, induced  nausea  and vomiting.  It acted  also on the
bowels.
   The effects of pure emetia are analogous, but more  powerful:
two grains  were sufficient to kill a  strong dog.
            EFFECTS ON THE ECONOMY IN DISEASE.
   The same effects are induced on the  morbid  as on the healthy
economy.   Magendie  recommends the administration of coloured
emetia—as  the pure is much too dear—in every  case where it is
desirable to excite  vomiting, and  especially where ipecacuanha is
indicated.   It has not, however, been much  used, except by Ma-
gendie himself.  M. Lerminier, who prescribed it, says that one or
                           1 Op. citat. 
EMETIA.
311
two grains of coloured emetia are equal in strength to from ten to
twenty of ipecacuanha; but that  he observed no difference in their
operation, and  Dr. Domeier1 appears to have arrived at the  same
conclusion.   The obvious advantages it  possesses are—the con-
venient and  agreeable  form under which it may be administered,
and the circumstance that several  spurious sorts of ipecacuanha
are frequently  passed  off in commerce, and  occasion, in conse-
quence, considerable disappointment in the mind of the practitioner.
The employment of the active principle of course precludes  these
inconveniences.2
   Prollius has  frequently administered  pure  emetia, which he re-
commends as a substitute for ipecacuanha, on the grounds above
mentioned; and he properly adds, that the price is not a matter of
so  much  moment as it might seem to  be, by reason of the  very
small quantity  required to produce the desired effects.
   When  made into an ointment, with lard, and rubbed  on the
skin, it produces  a great number  of small painful pustules, which
neither suppurate nor leave pits.  It may be used in all cases in
which  the unguentum antimonii is needed; and where it cannot be
applied, as on the face.  It has  been rubbed on  the chest in dis-
eases of the lungs, nervous palpitation, and rheumatic pains.3
                 MODE OF ADMINISTRATION.
   To produce  vomiting, three  grains of coloured emetia  may be
dissolved in any vehicle, and given in divided doses, at short in-
tervals.   In  several cases, with Dr. Domeier,4 one  grain  was
amply sufficient.  Of pure emetia, Magendie found,  in  a  man
eighty-five years  of  age, one-sixteenth of a grain enough to in-
duce vomiting.   He remarks, however, that  the man was easily'
made to vomit.   Prollius  found the medium dose of pure emetia,
for an  adult, to be from two-sixteenths to three-sixteenths  of a
grain;  sometimes  it was requisite  to give another  sixteenth. Very
rarely  had he to  give more than  four-sixteenths, or one-fourth of
a grain.  As, on  account of its  sparing  solubility, pure  emetia,
when given alone, might  be restricted  in  its operation, Prollius
adds an equal portion of tartaric acid, and a little sugar.
               Mistura  euietisB vomitoria.
                 Emetic mixture of emetia.
               R.   Emet. colorat. gr. iv.
                    Infus. flor. aurant.  f ^ij.
                    Syrup, flor. aurant. f §ss.  M.
   Dose.—A  dessert-spoonful every half hour,—to  excite vomit-
ing.  Any simple distilled  water and  syrup  may be  substituted
for those of orange flowers.                       Magendie.
  1 London Medical Gazette, Sept. 14, 1839, p. 229.
  a Clinique Medicale,  vol. i.  Paris, 1823.
  * Aschenbrenner,  Die neueren Arzneimittel, u. s. w. S. 108.  Erlangen, 1848.
  ' Op. citat 
312
EMETIA.
              Pastilli emetic pectoriales.
                 Pectoral lozenges of emetia.
             R.   Emetiee colorat. gr. xxxij.
                  Sacchar. ^iv.
           Mucilag. q. s. ut fiant pastilli, pond. gr. ix. sing.
  These lozenges are commonly coloured red, to distinguish them
from those of ipecacuanha.  A little carmine  may be added  for
this purpose.
  Given in cases of catarrh, hooping-cough, chronic diarrhoea,
&c.
  Dose.—One lozenge occasionally.                Magendie.
                Pastilli  emetise  vomitorii.
                  Emetic lozenges of emetia.
             R.  Emetia? colorat. gr. xxxij.
                  Sacch. §ij.
            Mucilag. q. s. ut fiant pastill. pond. gr. xviij. singul.
  Dose.— One  of these lozenges,  taken  fasting, is  generally
enough to make a child vomit:  three or four are required  for an
adult.                                            Magendie.
         Mistura emetise  purificatae  vomitoria.
             Emetic mixture of purified emetia.
              R.  Emetise purif.—in pauxil. acid. nitr. solut.—gr. j.
                  Infus. flor. tiliae f §iij.
                  Syrup, al'thsese f §j.  M.
  Dose.—A dessert  spoonful  to be given every quarter of an
hour, until vomiting is induced.
                    LXXVII. ER'GOTA.
Synonymes. Secale Cornutum  seu  Luxurians  seu  Clavatum, Clavua
  Secalinus, Calcar, Secalis Mater, Semina Monstrosa Secalis Cerealis,
  Ustilago, Clavus Siliginis, Spurred Rye, Corned Rye, The Spur, Ergot,
  Horn seed.
French.  Seigle ergote, Ergot de Seigle, Ble cornu, Clou de Seigle, Mere
  de Seigle, Bled avorte, B. farouche, Faux Seigle, Seigle cornu ou cor-
  rompu, S. a eperon, S. ergotise, S. ivre, S. noir.
German. Mutterkorn, Gebarpulver, Afterkorn, Schwarzkorn,
  Aetzroggen, Hahnensporn.

   The effects which this substance is capable of exerting on the
uterus are so wTell known as  not  to need any lengthened  descrip-
tion.  Its employment in parturition  having been revived in this
country, there are but few who are ignorant of its reputed proper-
ties.  Certain other effects have, however, been ascribed to it, in
very recent times, which require mention.
   Spurred rye or ergot—the latter being the common name, from 
ERGOTA.
313
its "spurred" appearance1—is usually considered to be the result
of a disease in rye, occurring most frequently when a hot summer
succeeds  a rainy spring.3  Decandolle, however, regards it as a
parasitic fungus, which  he terms Sclerotium clavus; whilst Le-
veille esteems it to be a  fungus  giving a coating to the diseased
grain—the medical virtues residing  in the coating.   This fungus
he  calls Sphacelia  segetum.   Brande refers it to the Natural
Order  Fungacese, and terms it Spermo'edia clavus; and  in  the
last edition of the London Pharmacopoeia, it is referred to Acinula
clavus of Fries;3 but, according to Lindley, Fries has no such plant
in any  of his works; and the only species  of Acinula known, Aci-
nula  candicans, is found  on the rotten  leaves of the  common
alder, and among melting snow; its organization is of another kind
from that of the spermoedia; and Fries, who regards the other as
a morbid state of the grain of certain grasses, regards acinula as
a true fungus.4   M. Debourge considers,  that ergot is an  animal
product of the telephorus family.   The insect deposits a  liquid of
its own  formation  on  a grain  of rye, and produces the  ergot;
whence it follows,  he conceives, that ergot may be produced at
pleasure  by expressing this  liquid upon all the grains of rye  that
are within a certain period of their maturity.5
   Mr.  Smith6 and Mr. Quekett,7 however, maintain that ergot is
not a fungus but a diseased  state of the grain occasioned  by the
growth of a  fungus not previously  detected: to this fungus  the
latter gives the  name Ergotastia8 abortans or  Ergotsetia abor-
tifaciens.   By  the microscope, they discovered sporules, sporidia,
or jointed bodies, which  appeared to be the reproductive particles
of the fungus.9
   Mr.  Francis  Bauer,10 who has made ergot a  subject of parti-
cular study, and  who,  many  years ago, undertook, at  the  sug-
gestion of Sir  Joseph  Banks, a  series oT  careful  microscopical
  1 French, ergot, a  " spur."
  1 Dr. Wright, Edinb. Med. and Surg. Journ., Jan. 1841.        »Syst. Mycol.
  * Brande's Dictionary of the Materia Medica, p. 233, Lond. 1839. See, also, Venus,
 Grundriss der Medicin. Receptirkunst, u. s. w. S. 347, Weimar,  1838; and the opinions
 of Schreber, De Geer, Parmentier, Buffon,  Von Munchausen, Tessier, Zuckert, Rbssig,
 Hube, Aymen, Robert, Tillet, &c, in Wright, op. cit.
   6 Societes Savantes, in Encydographie des Sciences  Medicales, Avril, 1838; and
 A. Richard, Elements d'Histoire Naturelle Medicale, 4eme edit. ii. 13, Paris, 1849.
   6 Transactions of  the Linnean Society of London, xviii. Pt. 3, p. 449.   Lond. 1840.
  * Ibid. p. 453, and London Lancet, June 22, 1839, p. 465.   See also an abridgment
 of a communication  read by Mr. Quekett before the Linnean Society, Dec. 4,1838, with
 illustrative woodcuts, in American Journal of Pharmacy, for July, 1839, p. 116. For
 remarks  on an insect met with in the diseased grain, see a paper by Mr. MuUer, of
 Butler county. Pa.,  with comments by Dr. Carson, in Amer. Journal of Pharmacy for
 Jan. 1839, p. 269.
  ' From ergota, and aerta, " cause."
  8 See the views of Quekett, Zink, Corda and others on the fungus, to which Dr. Pe-
 reira has given the name Oidium abortifaciens, ergot-mould, from uov, "an egg."
 and eido(, " resemblance;" in Pereira's Elements of Mat. Med. and Therap. 3d edit vol.
 2, Pt. i., p. 944.  Lond. 1850.
   10 Transactions of the Linnean Society of London, xviii. Pt. 3, p. 481.  Lond. 1840. 
314                         ERGOTA.
 observations with a view to determine the nature and cause of that
 singular production, does not consider the question as to the cause
 of the ergot to be finally and satisfactorily settled.  He states that
 he is  not convinced  that  the  filamentous  fungi with  numerous
 sporidia, pointed out by various recent observers, are the cause or
 the consequence of the ergot:—because, first—every gramineous
 plant is equally infected with that minute filamentous fungus, yet
 very few of these  plants  produce ergots,—amongst agricultural
 grains, the rye being the only one that is subject to the disease; and
 secondly, in  autumn  all decaying plants  are infected with  such
 filamentous fungi and minute sporidia.   M. Bauer's investigations
 led him, however,  to determine the ergot to be a morbid condition
 of the seed.
   Ergot is in grains, from a third of an inch to an inch and a half
 long, and from a line  to three  lines in diameter, usually  curved
 like the  spur of a cock, having  commonly two  longitudinal fur-
 rows,  and often irregularly cracked and fissured.   Externally, it
 is of a  dingy-purple hue; internally of a pale grayish-red or gray-
 ish-white.  Its odour is peculiar, fishy and  nauseous; taste ob-
 scurely acrid and disagreeable.   Unless excluded from the air, it
 swells and softens, acquiring a deep black colour and heavy smell;
 and  becoming infested  by a little acarus, which is about one-fourth
 the size of the mite of cheese, and destroys the interior of  the er-
 got, leaving the grain as  a mere  shell.  In four  months, seven
 and a half ounces of fecal matter of the acarus were formed from
 seven pounds of ergot.1  The powder becomes quickly damp, and
 full of animalcules.  It ought, therefore, to be fresh: certainly not
 to be kept for a longer period than two years.
   To prevent the formation of the parasites, Mr. Rowle2 keeps a
 small piece of camphor in the stopper bottle which contains the
 ergot.   This soon annihilates the whole race  of insects, and adds
 greatly to the certainty of the effect of the medicine.  The plan had
 been  recommended  before  by Dr. Bright.3   It has been advised
 that the camphor should  be mixed with the ergot, in  the propor-
 tion  of a grain to a  scruple.4
   It has  been proposed to dip the dried ergot in a concentrated
 solution of gum Arabic; to dry this on a plate of white iron; and
 when  it is dry, to  repeat  the process  two  or three times; keep-
 ing it afterwards  in  a well stopped  bottle.5  A recent  writer6
 has advised  the following method for preserving it in good con-
dition for several years.  First. To reduce  fresh well dried ergot

  1 Pereira, Elements of Mat. Med. and Therap. ii. 916. Lond. 1842 ; or 2d Amer. edit.
 by Carson, Philad. 1846.                 2 Lond. Lancet, Aug. 10, 1844.
  a Edinb. Med. and Surg. Journ. No. 141, and Lond. Lancet, Aug. 24, 1844.
  ' Mr. Simpson, Lond. Lancet, Sept. 7, 1844.
  8 M. Martin, Journ. de Chim. Med., Avril, 1841.
  6 V.Legrip, in Journal de Chimie Medicale, cited in Lond. and Edinb. Monthly Journ.
of Med. Science, April, 1845. 
ERGOTA.
315
to powder.  Secondly. To expose the powder to a temperature
of 112°  or 120° Fahrenheit, in  order to  dry it  thoroughly and
quickly.    Thirdly. To put  it into glass bottles  not  exceeding a
hectogramme, (about three ounces) in size, and seal them herme-
tically.  Fourthly.  To withdraw it  from the action of light by
shutting it up either in a  dark place, or by covering  the  bottles
with black paper.
   Mr. R.  M. Nunn, of Wexford, extols the following plan of pre-
servation,  of which  he speaks from experience.1   Procure a choice
specimen of ergot;  reduce it to powder; have in  readiness  a  suffi-
cient number of two dram bottles;  into each bottle put one dram
of sulphuric ether, (alcohol may do as well) and then press in two
drams of  the powdered drug : (if the buttles are of the  proper
size, a slight pressure will  be necessary to make them hold this
quantity:) then cork well, and either  seal  with wax or cover with
bladder.   When  required for use, put the contents of one of the
bottles into a tumbler; and pour on them a small quantity of boiling
water: violent effervescence takes place, which speedily subsides,
and  during which  the ether is evaporated.   As much  boiling
water may then  be added as is  necessary.  It is instantly fit for
use.
   As it  is important to judge between a good  and a bad specimen
Dr. Wright remarks,2 that if it be clear  and  smooth on the sur-
face; not powdery;  of  a  deep  purple colour;  neither entirely
 black nor  light brown; having a full strong odour; breaking clear-
 ly ;  exhibiting a  pink blush interiorly; unpunctured by  insects;
 burning with a clear jetting flame, and of a less specific gravity
 than wTater, its activity may be trusted.
   It has been affirmed, as  the result of  actual  trials, that  ergot
 picked from growing rye is much more powerful than that which
 is gathered on the barn floor after the grain  had been threshed.3
    When  examined  by the  microscope, the  internal structure  of
 ergot is found to consist  of  minute roundish cells, many of which
 contain particles  of oil.  The bloom  seen, at times, on its surface,
 seems to  be  composed of the sporidia of the fungus,, to which it
  is believed by many to owe its origin.4
    Chemical analysis has thrown no  light on  the cause of its pro-
  perties.   According  to the analysis of Vauquelin5  it contains a
  colouring matter of a yellowish hue;  a white oily substance; a vio-
  let-colouring matter insoluble in alcohol; a  free acid, which is
  in part phosphoric; a very abundant vegeto-animal matter, which is
  greatly disposed to  putrefaction, and furnishes much  thick oil and
  ammonia on distillation: and a small  quantity  of free ammonia,
   1 London Lancet, cited in Med. Examiner, Oct. 19, 1844, p.  251.
   2 Edinb. Med. and Surg. Journ. Oct. 1839, p.  296.
   * Bdttcher and Kluge, cited by Christison, Dispensatory, p. 414. Edinb. 1842.
   « Christison, Op. cit., p. 411.  Edinb. 1842.
   » Memoir, du Museum, iii. 198,  Paris, 1817.
% 
316
ERGOTA.
which may be obtained at the temperature of boiling water.  A
more recent analysis  has been made by Maas,1 of Hamburg.  He
found it contain gluten; ammonia or a peculiar alkali; acetic acid;
a violet-colouring matter: resin ;  fixed oil; an alkaline acetate;
but  neither starch,  hydrocyanic  acid, narcotina, nor phosphoric
acid, which some had discovered in  it.2   It  has likewise been
analyzed  by Bonvoisin, Pettenkofer, Winkler, Robert, Wiggers,3
Legrip,4  and   others.   The  analysis of Wiggers  is very  elabo-
rate.  The results   were,—a  thick  white  oil,  35.000;  white
fatty matter,  1.0456 ;  cerin,  0.7578 ;  fungin, 46.1862 ; ergotin,
1.2466; osmazome, 7.7645;  sugar, 1.5530;  gum  extractive and
colouring matter, 2.3250; vegetable albumen, 1.4600;  phosphoric
acid and phosphate of potassa, 4.4221; phosphate of lime and traces
of iron, 0.2922; silica, 0 1394.   Dr. Wright's5 analysis furnished
him with the following  constituents and their proportions in 100
parts of ergot; thick white oil, 31.00; osmazome, 5.50 ; mucilage,
9.00; gluten, 7.00 ; fungin, 11.40 ; colouring matter, 3.59; fecula,
26.00; salt,  3.10;  loss,  3.50.   Ergot appears to him to  differ
from sound rye, chiefly in the presence of oil, osmazome and fun-
gin.   He  gives the  following process for  preparing the  oil of
ergot.6  Digest ergot in liquor potassae, at a temperature of from
120° to 150°, until a perfect saponaceous mixture is formed.  The
liquid must then be diluted with half its weight of water, be accu-
rately neutralized by sulphuric acid, and submitted to distillation
from a salt-water or oil bath.  The product is white, adhesive, and
fatty-looking, almost free from empyreuma, and nearly tasteless.
The readiest  and  best, but most expensive mode of obtaining it,
is to pass ether through  ergot in fine powder  by the process of
displacement.   By allowing the ether to evaporate spontaneously,
the oil is left in its purest form.7  This Dr. Wright  considers to
be  the  active  matter of ergot;  and  he states—as  the result of
positive experiment—that it has the same effect in inducing power-
ful  uterine contractions as ergot itself.

                 EFFECTS ON THE ECONOMY.
   The effects  produced  on  the animal economy by ergot, when
 eaten as  food, are extremely injurious: the aggregate of the symp-
 toms has  been termed  Ergotism.  At times  they are limited to
 vertigo, spasms, and convulsions, with a peculiar tingling or for-
 mication in the arms and legs, which has  given the affection the

   1 Bulletin des  Sciences  Medicales de Ferussac, xix. 332; and Merat and De Lens,
 Diet, de Mat. Med. art. Ergot.
   a For Mr. Battley's Analysis, see Lond. Med. Gaz., Feb. 1831, and for that of Wig-
 gers, Lancet, Nov. JO, 1832,cited from Allgem. Med. Zeitung.
   a  Wright, Edinb. Med. and Surg.  Journal, Oct. 1839, p. 298.
   4 Bouchardat, Annuaire de Th6rapeutique, pour 1845, p. 44.  Paris, 1845.
   ' Op. cit                  " Edinb. Med. and Surg. Journal, July, 1840.
   7 Duhamel, Amer. Journal of Pharmacy, July,  1841, p. 95. 
ERG0TA.
317
name among the Germans ofKriebclkrankheit or "creeping
disease."  Most commonly, the limbs waste away, lose sensation
and the power of motion, and separate from the body by dry gan-
grene—constituting gangrenous erethism or mildew mortifica-
tion.1   These, however, are  the toxical, not the  therapeutical,
effects of the agent.2
   The  extraordinary property, ascribed to ergot, of assisting the
parturient efforts, has long been  credited in Germany.  Its old
German names, Mutterkorn ("womb-grain") and Gebarpul-
v e r (^'parturient powder," pulvis ad partum,) are sufficient evi-
dences of this notion; but, for a long time, this was rather a mat-
ter of popular than of scientific belief, although the "pulvis partu-
rientis" of the  Marburg Pharmacopoeia consisted principally of
ergot.3
   Upwards of forty years ago, it was recommended in  this country
by Dr. John Stearns, of Saratoga county, New York, and since that
time the-weight of  testimony  adduced in its favour on both sides
of the Atlantic has  been overwhelming.  Still, there are many dis-
tinguished individuals, who deny it all power over the uterus both
in the unimpregnated  and the impregnated state, and  who affirm,
that it acts only indirectly on that viscus through the  general dis-
turbance it occasions; and that, therefore—like every other internal
agent administered as  an  abortive—it ought to be esteemed rather
indirect than direct in  its  action.   Such  is the decided opinion of
Jorg,4 whose attention has  been directed to the  effects produced
by different medicinal  agents on the sound and diseased economy,
and who goes so far as to affirm, from his experiments and obser-
vation, that there is no " farther connexion  between  these  dege-
nerate grains and the uterus, than the  word Mutter  ('uterus')
which is common to both."  From  his various and varied experi-
ments, Dr. Jorg infers, that ergot, when given  in small doses, pro-
duces little or no effect upon  the  functions; but that when fresh
dried in an oven, and  administered in large doses, it oppresses the
stomach,  occasioning  nausea,  vomiting,  colic,  liquid evacuations;
destroys the appetite, and injures the digestive powers;  these effects
being  accompanied  by a  sense of weight in the head, vertigo, ce-

  1 See articles, Convulsio  cerealis, and Ergotism, in the author's Medical Lexicon,
7th edit, Philad. 1848; also, his  Therapeutics, p. 272, Philad. lb3C;  or his General
Therapeutics and Mat. Med., 4th edit. ii. 197, Philad. 1850 ; and a case of K r ie b el-
k r a n k h e i t, induced by ergot, in Med. Times for July, 1847, recorded by Dr. 11. R.
Nuttall.
  a ;Sce Christison on Poisons,  3d edit. chap. xl.  Wright, op. cit. p. 307, and Jan.
1840, p. 9.
  3 Wright, op. cit. p. 22.  See, on the history of Ergot, Ramsbotham, Principles and
Practice of Obstetric Medicine and Surgery; appendix, Amer. edit. Philad. J845.
  4 Dass  der Gebrauch inner Reizmittel zur Beforderung der Geburt des Kindes unno-
thig, fruchtlos, und gesunden Frauen  sogar schadlich sei; u. s. w. S. 40, Zeit. 1833.
See, also, Pereira, op. cit. p. 919, and Bonjean, in  Rapport de MM. Bussy, Pelletier,
Dubail, Fremy pere et F. Boudet, in Journ. de Pharmacie, Fevrier, 1842, p. 175.
        21 
318
ERGOTA.
phalalgia, and by general torpor of the system.   Under these cir-
cumstances, he  thinks, it is not difficult to  understand, that the
connexion between the foetus and the uterus may be modified, and
abortion take place.   The  researches of M.  Arnal,1 satisfied him,
that the first action of ergot is on the  intestinal canal, in the mu-
cous membrane of which it  produces an inflammation sui generis
(?), and  anatomical lesions, which  remind the observer of those
seen in typhoid  fever; whilst the greater part of the phenomena
seen towards the termination of poisoning by it resemble many of
those of the same malady.  The composition of the blood he found
greatly altered.  It was rendered more diffluent;  a portion of its
fibrin was removed;  and, if long continued, it produced softening
of the gums, and pathological  phenomena, analogous to those of
scurvy.
   The  author caused  various  experiments to be  instituted with
ergot in doses of  half a  dram,  and  a scruple, of the powder,
and in the  form of  the  oily matter referred  to  below.  These
were made  on both  males  and females; and the  general effects
were those described  by Dr. Jorg;—when the dose wTas too large,
nausea or vomiting often resulting, with signs of narcosis.   They
were made, at the author's desire,  by Drs. Cottman and M'Kee,
at the time resident physicians at the Philadelphia Hospital.2  A
case of narcosis, produced by this drug-in the dose of thirty grains
—administered for the purpose of  restraining a  real or supposed
tendency to hemorrhage after the expulsion of  the placenta—was
communicated to the  author by Dr.  Beckwith, of  Raleigh, North
Carolina.3
   DrN Hooker, of New Haven,4  found, when  a quantity of pul-
verized ergot was macerated for several days in  sulphuric ether,
and the  liquid evaporated  in a  glass  vessel  until it  no longer
afforded  a smell of  ether,  that  there  remained at the bottom of
the  vessel a small quantity of thick heavy oil, resembling in ap-
pearance  fish oil;  above this was a lighter oil, much more abun-
dant than the former, of a light reddish brown colour, and  of a
sweetish nauseous taste.  The light oil was found  to be possessed
of decidedly narcotic properties.  In two experimental cases, the
effects of ergot continued apparent  for nearly a week;  the pupils
of the eye were dilated: the pulse, respiration, and capillary action
were very slow,  and  the skin livid,—with loss of appetite, general
languor and lassitude, and  rigidity and  soreness of the muscles;

  1  See a Resume, by M.  Piorry,  of the Me'moire of M. Arnal, in Bouchardat, An-
nuaire de Th6rapeutique pour 1849, p. 124.
  2 Amer. Med. intelligencer, Sept  1, 1839, p. 161.  See, also, M. Cordier, in Joum.
Gen. de Med. Avril, 1823, and C.  T. De Gravina, in Annali Universali di Medicina,
Ottobre, 1839, cited in Brit, and For. Med. Rev. Oct. 1840, p. 555.
  3 Amer. Med Intelligencer, Oct. 15, 1839, p. 213. See, also, Trousseau and Pidoux,
Traite de Therap. i. 546, Paris, 1837.
  * Boston Med. and Surg.  Journal, x. 298, Boston, 1837. 
ERGOTA.
319
those of the thighs and other parts of the lower extremities being
more particularly affected.  For three days, the pulse continued
below fifty, with a proportionate infrequency of respiration.1
   In the experiments  made with this  substance, by Dr. M'Kee,2
he found that in every case, when given in doses of from  ten to
forty drops, it at first  produced  slight exhilaration of the spirits
with increase of circulation;  but these symptoms were soon  fol-
lowed by sedation, and in the larger doses by nausea, also.   The
sedative  properties  were  equally exhibited in  experiments insti-
tuted  on the  healthy  individual,  by Dr.  Q. Gibbon,3  of  Salem,
New Jersey, with  the  decoction, extract,  and  oil.   The experi-
ments of Dr. De  Gravina,4 led him to infer that ergot  is a direct
sedative, like digitalis, and hence he considers it a good antiphlo-
gistic remedy, and well calculated to lower the vital powers.
   An ethereal solution has been  prepared by Dr. Rees,  by  digest-
ing  four ounces of powdered ergot  in  four fluidounces of ether
for seven days.   The ether .dissolves the fatty matters  contained
in the drug.  It is then poured  off, evaaporated to dryness,  and
the residue again dissolved in two fluidounces of ether.  Repeated
trials of this preparation have been made by Mr. J.  C. W. Lever,*
who affirms that it acts most powerfully on the parturient powers
of the uterus during and  after labour.  What is singular,—Mr.
Lever remarks,—whilst all the other preparations of ergot not un-
frequently produce acro-narcosis, he has not once seen these symp-
toms supervene on the  use of the  ethereal solution.  He  thinks
they are  most probably caused by some constituent of the drug,
which ether does not dissolve,—a view which cannot  be  recon-
ciled with the results of the  experiments  detailed  above.  Each
ounce  of the preparation,  Dr. Rees thinks,  may  be  considered
equivalent to two ounces of ergot;  or fifteen drops to half a dram
dose  of the powdered  drug.  Mr. Lever  gave it, dropped upon
sugar, in doses varying from fifteen drops to  thirty, and  found
that uterine action commenced in twenty minutes or half an hour.
   Although ergot is capable of producing the acro-narcotic effects
described above," their supervention is  not  desired  by those who
regard it to be possessed of peculiar powers  by which it  causes

   1 See Amer. Med. Intelligencer,  Dec. 15, 1837, p. 329.  A case has been recently
published, by Dr. Myddleton Michel, of sudden death, which he ascribes to ergot taken
with the view of producing abortion in one who, owing to her having been previously
afflicted, in two attacks, with well-marked opisthotonos and emprosthotonos and nervous
depression of the vital energies, was a fit subject for the occurrence of  such fatal re-
sults.   It does not, however, appear to the author as clearly as it  does to the  nar-
rator of the case, that the sudden—immediate—death, was owing to the toxical influence
of the ergot.  Charleston Med. Journal and Review for  Sept. 1850.
  1 Ibid. Sept  1, 1839, p. 161.
  ' Amer. Journ. of the Medical Sciences, Jan., 1844, p.  244.          4 Op. cit.
  ' London Medical Gazette, April 10, 1840, p. 108.
  « Bonjean, cited in Bouchardat, Annuaire de Therapeutique, pour  184?, p. 85.
Paris, 1843. 
320
ERGOTA.
 contraction of the uterine fibres of the parturient female, and who
 administer it with that view.  When given  in appropriate  and
 properly repeated doses, the uterine action, they assert, becomes
 more energetic, and the contractions constant and almost unremit-
 ting; but there is no accompanying disorder.  Cases are on record1
 in which it has  appeared to induce  rupture of the uterus, where
 the  obstacles to delivery were invincible.  It  has been  largely
 administered, and  in no country, perhaps, more than  in this.
 Practitioners of eminence—here and elsewhere—have placed the
 fullest reliance on its powers to excite contraction of  the  uterine
 fibres, and although in many of the  cases which fell under their
 observation, the  parturient efforts might have  recurred  without
 the agency of the ergot, this could  scarcely have  been the case
 with the remainder.   From the  results,  therefore, of these cases,
 we seem compelled  to admit, that  ergot is possessed of expulsive
 properties  by which it acts upon the parturient uterus; but that
 it is  capable of producing  any effect upon  the unimpregnated
 uterus, or  upon  the impregnated, at any time  except when par-
 turition has commenced, is denied by many.  It has been affirmed,
 indeed, that in the neighbourhood of Trois Croix, in France, there
 was,  during the season of 1841, an epizootic abortion amongst
 the cows, which had produced much consternation amongst the
 farmers; and that M. Bodin,2 director of the school of agriculture,
 had discovered that  the grains of  rye, and of many other of  the
 gramineae,  contained a considerable  quantity of ergot.   This, he
 concluded, was the cause of the  epizootic.  On  the  other hand,
 the experiments of Dr. Wright,3 and of Dr. De Gravina,4 seem to
 exhibit the singular fact, that ergot appears to have  the power
 of prolonging  gestation in the guinea pig and rabbit, when  ad-
 ministered  for a considerable  period !5  The result of all observa-
 tions precludes  the   belief, that  the increased parturient efforts
 resulting from  its  agency are produced indirectly  by violence
 done to the constitution of the mother,  inasmuch as, in most  of
 the recorded cases of benefit  accruing from its administration, no
such violence would  appear to have  been perpetrated.   Yet, ad-
mitting the  full  power ascribed to ergot, in these cases, it can be
rarely necessary to have  recourse to it;  and it is doubtless often
employed, where the propriety of the administration of it, or of
any other agent, is extremely questionable.   A "writer, who places
the discovery of its  powers in the  same rank  with that of  the
vaccine virus, states, that he has administered it in 1500 cases !fi
  But the  effect produced by ergot upon the mother has not been
  1 Dclmas, Journal de Medecine de Montpellier, and Journal de Pharmacie, Juin, 1842,
p. 546.
  ' Journal de Med. et Chirurg. Pratiq. Oct 1841.      * Op. cit.     4 Op. cit.
  * Brit, and For. Med. Review, Oct 1840, p. 556.
  6 Wardleworth, Essay on the Chemical, Botanical, Physical and Parturient Proper-
ties of the Secale Cornutum. London, 1840. 
ERGOTA.
321
the only topic of interest in regard to its use  in  parturition.  It
has  been  maintained by many, that, since  its introduction, the
number of the still-born has augmented, and that observation has
sufficiently shown, that  where  it  is  given  to expedite  delivery,
more or less danger always accrues to the offspring j1 either by the
induction of asphyxia, or of positive  death, owing to the violence
of the uterine  contractions, or  to the deleterious  agency of the
drug on  the foetus  in  utero.3   Observations  by  Dr. Hardy,3 of
Dublin, show, that it exerts a powerful  sedative  influence on the
action of the heart of both mother and foetus.  But even were we
to admit its prejudicial effect on the foetus to be true—and it has
been deposed to by many obstetricians—and  that the number of
the  still-born is greater than formerly—which, however, appears
to be by no means the case—its  influence could be but small, and
could not account for the statistical  differences  that have  been
noticed.4
   Mr. Braithwaite5 affirms, that in  order that ergot should act
perniciously on the child, it is necessary that its  action  on the
uterus should be  uninterrupted.  He has  seldom  or never seen
any  bad  effects on  the  child when  the patient  had some rest
between the pains.  In  many cases,  it has  been largely adminis-
tered, and yet the child has been born alive.  Dr. James Patterson,"
of Glasgow, details the  particulars of a case  in which the enor-
mous quantity of four ounces was given, yet the movements of the
child continued  lively;  and he refers to an excellent paper, now
before the author,  by Professor Von Busch,7 of Berlin, which
contains a reference to  one hundred and seventy-five  cases, in
which it  was given  on  account of deficient  labour-pains.   One
hundred and seventy-seven children were born; of these, one hun-
dred and forty-two were born alive; eighteen in a state of asphyxia,
which was removed by appropriate treatment; and  seventeen still
born.   Of the  seventeen dead, seven had  evidently died before
labour, and  were more or less putrid;  and ten, during labour; of
these, two lost  their lives from  turning;  one from presentation of
the  breech; two from prolapsus of the funis; one from narrow pel-

  1 Chevasse, in Transact of the Provincial Med. and Surg. Association, iv. 306, Lon-
don, 1836.  Huston, North American Med. and Surg. Journal, 1829; and Chatto, in
London Med. Gaz., July 13, 1839, p. 575; also, Reports of Med. Society of London,
in Lancet, Oct. 26,1839, p. 168, and Wright, Edinb. Med. and Surg. Journal, Jan.,
1840, p. 25.
  8 Mojon, in Gaz. Med. de Paris, 19 Janv., 1839; and T. E. Beatty, Dublin Journal
of Med. Science, May, 1844, p. 218.
  3 Dublin Journal of Medical Science; cited in Med. Examiner, for Jan., 1848, p. 75.
  4 Avery, in Transact, of the Med. Society of the State of New York, vol. iii. Pt  2
p. 185, Albany, 1837.                                                 '
  * Retrospect of Pract. Med. and Surg., vol. i. No. 1, p. 181, 3d edit London, 1842.
  6 Lond. Med. Gaz., June 1, 1839, p. 337.  See, on this subject, E. Warren, New
England. Quarterly Journal of Medicine and Surgery, July, 1842, p. 10.
  * Die gebiirtschulfliche Klinik an der koniglichen Friedrich-Wilhelms-TJniversit'at zu
Berlin, in neue Zeitschrift fiir Geburtskunde, u. s. w. B. v. H. i. S. 107. Berlin, 1837. 
322
ERGOTA.
 vis and detention of the head therein;  one from the long duration
 of the fourth stage of labour; one  from a difficult forceps case,
 which required  perforation  afterwards;  one  from a peculiar de-
 formity of  the extremities; and one  from no assignable cause; so
 that, of the one hundred and  seventy-seven cases, there was but
 one which  could be referred to the agency of  ergot, and  there
 was no reasonable ground for such reference.
   A recent writer1 is disposed  to think, that ergot, improperly ad-
 ministered, produces puerperal convulsions as a remote effect,—and
 that it gives rise to hour-glass contraction, and to a  predisposition
 to hydrocephalus in  the early stage of infantile life ! The chief or
 only cases in which Dr.  Catlett seems  to think it admissible are,
 when  there is serious hemorrhage,  owing to  detachment of the
 placenta, accompanied by deficient uterine tone;  and in the latter
 stage of labour, in checking hemorrhage from whatever cause.
   Dr. Frank Ramsbotham,2 who regards ergot as capable of ex-
 erting specific powers on the uterus at all periods of utero-gestation,
 and who  has referred to several cases of premature labour, induced
 in his own  practice  by its use, is  disposed to conclude, that al-
 though it may bring on labour without  having  recourse to any
 operation, yet that it does not present a more likely, or indeed, so
 probable  a  means of saving the  infant  as the  older method of
 puncturing  the  membranes*,  and he infers, from his experience,
 that whatever might have been the quantity administered, unless
 it  exerted a decided  influence over the uterus, the child  suffered
 no detriment.3
   Dr. Paterson4 and Mr. Heanes have  directed ergot successfully
 in large  doses  with  the view of inducing premature labour.
 The former of  these  gentlemen  is  disposed  to think,  that its
 abortive properties are not exerted  upon  the impregnated uterus
 at an early  period of utero-gestation, but  that, at a certain  stage
 of development, the uterine fibres are capable of being excited by
 it  so as to expel the foetus.   It would be strange were its agency
 to be thus restricted.
   When ergot was found to be possessed of the power of exciting
 uterine contractions,  it was philosophical to employ it in  retention
 of the placenta, in after-pains,*  and in  cases  of uterine hemor-
 rhage, and of convulsions1 in the parturient state, accompanied by
 atony of the uterus.8   In such cases, means of more speedy action

  1 Catlett, Edinb. Med. and Surg. Journal, Jan. 1842.
  1 London Med. Gaz., June 15th, 1839, p. 420. See, also, Ibid. June 28, 1834.
  3 See, on this subject, J. J. Kelso, in London Lancet, June 22, 1839, p. 462; and
 Duparcque, in Revue Medicale, Mars, 1838.
  4 Lond. Med. Gaz., June 1, 1839, p. 332.  See, also, Ibid., Sept., 1838.
  1 Ibid., Jan. 26, 1839. For various opinions  on this subject, see Dr.  Wright, in
Edinb. Med. and Surg. Journal, Jan. 1840, p. 27.
  s Hoffman, in Berl. Med. Zeitung, June 29,  1836; and Beatty, in Op. infra cit
  ' Duparcque, Revue Med. Mars, 1838.         8 Von Busch, Op. cit i. 105. 
ERGOTA.
323
are needed;  but still, cases might arise in which its administration
might be serviceable, and several such, attesting the benefit ren-
dered  by it,  have been  published.1   It has  been strongly recom-
mended, likewise, for the prevention  or removal of uterine he-
morrhage,   by Stearns,2  Dewees,3 Bradley,4 Abraham,5 Kisch,
Trousseau,B  T. E. Beatty,7 and others.   In  a case  of copious
hemorrhage from the uterus connected with polypus, Mr. Moyle8
administered two  drams of the  tincture, which was  repeated at
intervals, with the effect of inducing  uterine contraction  and the
expulsion of the polypus, " which equalled in size two large pla-
centas."  He was equally  successful  in  a similar case.   Other
cases, in which  the effect of the  ergot was  to force  down the
polypus so  that a ligature could be applied to it, have been re-
lated by Dr. Somerville and Dr. M'Farlane.9
   The employment of ergot has been extended to amenorrhcea,10
and dysmenorrhoea, and  to uterine hemorrhage in the unimpreg-
nated female, and  many cases  have been published in confirmation
of its  being  possessed of decided virtues.11   It was thought, also,
that it might be  serviceable,—and was found so by  Bazzoni,12
Negri, Langlet,13 and others,—in leucorrhoea,  and in gonorrhoea,1*
dysentery,15  &c; and  again, as it proved  to  be  useful  in  uterine
hemorrhage, it was conceived  that  it might exhibit like powers in
other hemorrhages; and, accordingly, it  was given  in cases of
epistaxis,16 hcemoptysis, haematemesis, haematuria, &c.   In these
last cases, it has not been so  often employed.17   The author has
frequently administered it in them, but  has never  had  reason to
believe that  it exerted  any efficacy; and  such has been the case
with MM. Trousseau  and  Pidoux,18  Dr.  Pereira,19 and  others.20
  1 Camps, London Med. Gaz., Jan. 13, 1843.
  1 Philada. Journ. of Med. and Phys. Science, v. 44.      ■ * System of Midwifery.
  4 Lancet, April 15, 1837.                          ' Ibid. April 22, 1837.
  s Journal des Connoissances, 1839.
  ' Dublin Quarterly Journal of Med. Science, May, 1846, p. 322.
  8 Lond. and Edinb. Monthly Journ. of Med. Science, June, 1841.   8 Ibid. Aug. 1841.
  w Enriotti, in  Repertorio Med. Chirurg. del  Piemonte, cited in Journ. des Connois-
sances,  Mars, 1838.  Langlet, Bulletin  Medical Beige, Juin, 1839, p. 125.  Dewees,
Midwifery, chap. Amenorrhcea; Locock, Cyclop, of Practical Medicine, i. 70. Nauche,
Nouveau  Diet,  de Med. et Chirurg., art. Ergot;  and Dr. Wright, in Med. and Surg.
Journal, Jan. 1840, p. 34.  See, also,  Churchill,  (with whom  it  failed,) Diseases of
Females, Amer. Med. Library edit. p. 54.  Philada. 1839; and G. Fyfe, Med. Gazette,
June 18, 1841.
  11 G. Fyfe, Op. cit.; and John Yale,  Boston Med. and Surg. Journal, July 8, 1846,
p. 459.
  ,a Annali Universali di Medicina, Feb. 1831; and Ryan, Medical Formulary, p. 264,
3d edit  London, 1839.                       13 Op. citat.
  14 Miiller, in  Rust's  Magazin, B. xl. H. iii., cited in Amer. Journal of the Medical
Sciences, Feb. 1835, p. 527;  Ryan, Op. cit.  and Desruelles, Gazette  des Hopitaux,
2 Juin, 1842.
  " Mojon, Op. cit                          16 John Yale, loc. cit.
  11 Duparcque, Op. cit., and De Gravina, Annali Universali di Medicina, Ottobre 1839.
  18 Traite de Therap. i. 546.  Paris, 1837.
  19 Elem. of Mat. Med. and Therap. ii. 925.  Lond. 1842.
  ao See the author's General Therap.  and Mat. Med., 4th edit ii. 198.  Philad. 1850. 
324                        ERGOTA.
 The narcotic or sedative property, however, which it  exhibits in
 certain cases and doses, and the sedative action which it exerts in
 others, may  render  it, at  times,  serviceable in these affections,
 whatever may have  been the process of reasoning which led ori-
 ginally to its employment.1
   Where hysteria depends  upon  simple atony of the  generative
 system; or of the nervous and  generative systems combined, Dr.
 Nardo3 found the internal administration of ergot followed by the
 rapid  removal  of the  disease.   His  practice  consists in giving
 about a scruple of the powder mixed with sugar, in divided  doses
 each day, intermitting the dose every third or fourth day.  Many
"cases  are  related by him to show the efficacy of the practice,—
 the hysteria, and the  irregularity or  absence of the menstrual
 secretion being removed at the same  time.   In spermatorrhoea,
 too, dependent upon atony or excessive irritation of the genital
 organs, it has been useful in the dose of from  three to five grains
 three  times a day.3
   Dr. Wright4 affirms, that when applied to an abraded  surface,
 it  gives  rise to profuse  sloughing.  He  tried  it  on  wounds
 nearly healed, and in less than 24 hours they discharged  purulent
 matter abundantly, which was generally of an offensive character;
 and the wounds, thus treated, even under the application of proper
 curative means, were long and tedious in healing.  In the form of
 powder, he found it very serviceable in  arresting hemorrhage;
 and not simply  in a mechanical  manner, as was proved by experi-
 ment.  Even in  the form of infusion, it  possessed the power in
 an extraordinary degree.   Miiller divided  the  popliteal artery in
 the sheep, and  completely arrested the bleeding  by lint dipped in
 an infusion of ergot.   The  caudal artery, and the anterior crural
 artery of a horse were cut, and the bleeding was similarly subdued.
 Dr. Wright says, that he has several times  divided  the  external
 jugular and the saphena major veins, and has never failed to arrest
 the hemorrhage by an infusion of ergot, although with arteries he
 has been  generally less successful. In the greater number of his
 experiments,  he used a dilute solution of ergot, in the  place of
 warm wTater, to sponge the bruised parts, and always succeeded in
 preventing that continued  flow  of blood, which is often a serious
 obstacle to the safe direction of the knife.  He consequently re-
 commends it  as a valuable means of  preventing troublesome he-
 morrhage from  small vessels in the course  of surgical  operations;
 and, upon the same  principle, believes  the injection  of a similar
 solution into the uterus, in cases of flooding, will be found to an-
 swer every practical  end that can be  desired.   The decoction has

  1 See some remarks on this subject, by the author, in his Amer. Med. Intel, vol. i. p. 219
  3 Cited in Edinb. Med. and Surg. Journal, Jan., 1843, p. 225, and in Bouchardat,
 Annuaire de Therapeutique pour 1843, p. 93. Paris, 1843.
  3 Ibid, pour 1848, p. 80.  Paris, 1848.           * Op. cit, Jan. 1840, p. 20. 
                            ERGOTA.                        325

proved  to  be an equally efficacious  haemastatic in the hands of
others.1
  In a severe case  of epistaxis, Dr.  Wright2 arrested the hemor-
rhage by injecting up the nostrils equal parts of very dilute spirit
and oil of ergot; and he has little doubt, that in the severe cases
of uterine hemorrhage  that follow delivery, the injection of the
oil diffused through water into the uterus would be productive of
the happiest  results.   It proved also serviceable in arresting he-
morrhage after the extraction of a tooth, and from leech-bites.  It
will be  seen, presently, however, that the styptic properties of the
ergot have been supposed to reside chiefly, if not exclusively, in
the ergotin,  or extract of ergot.
   Snuffed up  the  nose, powdered ergot  was  observed,  by M.
Cowperat,3 to have the  power of removing the dilatation of the
pupil caused by belladonna.   Dr. *J.  F. M'Evers4 repeated the
experiment,  and found  that it did not cause  any change  when
employed on  the same day with the belladonna; but, in every case,
on the subsequent morning, whilst the pupils were still largely
dilated, the  ergot  had  a marked effect in  a few minutes.   In a
case of mydriasis  he prescribed it with success.
   Dr. Wright found the oil  a valuable external application in cases
of local rheumatism.  In three instances, it was  entirely suc-
cessful.  The affected  part was well rubbed with it for a quarter
of an  hour,  night  and morning until  relief was obtained.   He
states, farther, that it is one of the most valuable remedies with
which he is acquainted in toothach, and has repeatedly known it
subdue  the pain when creasote had failed.   By M. Lisfranc,5 the
powder wTas  employed in the dose of from two to eight grains, in
cases of hypertrophy of the uterus of various kinds, whenever
reduction of  the organ to a less size seemed to be the prominent
indication; and Dr. Perrine6 has published some cases of periodi-
cal disease, in which it was administered with advantage during
the intervals; but no farther results appear-to have been elicited.
   JVI. Payan7 thinks  it demonstrated, that ergot is primarily and
essentially an excitant of the  spinal marrow;  and he conceives,
that its action on  the uterus, bladder,  and  muscles  of the  lower
extremities is but secondary, from a reflex action transmitted from
the spinal marrow  to those organs through the nerves distributed
to them.   He has  given the details of some cases of paraplegia,
which seemed to be relieved by it; an infusion of fifteen grains in

  1 Wright, cited in Liston's Lectures, London Lancet, Aug. 31, 1844, p. 691.
  * Edinb. Med.  and Surg. Journ., July, 1840.
  3 London Medical Gazette, Sept., 1848.
  4 Dublin Quarterly Journal of Med. Science, November, 1848.
  5 Pauly's Lisfranc, translated by Lodge, p. 330.  Boston, 1839.
  8 American Journal of the Medical Sciences for Nov., 1833, p. 279.
  ' Revue Medicale, Fevrier et Mars, 1839; and Journal de  Pharmacie, Juin, 1842,
p. 545. 
326
ERGOTA.
water being given at first  in the course of the day, and the dose
being gradually augmented.1
  M. Allier, fils,2 from  having observed, as he believed, contrac-
tion of the fibres of the bladder under the administration of ergot,
has recommended  it highly in  cases  of  retention of urine;  and
feels himself justified in inferring, from the results of varied ob-
servation, that it  is  capable of restoring  to the  bladder the con-
tractility it  may have lost, owing to immoderate distention of its
coats by accumulation of urine;—that its action has been evinced
in cases  in  which this  kind of paralysis  has  resisted all  known
therapeutical  agents; and  that, owing to the fugacious character
of its operation, it ought to be administered at short intervals, in
broken doses, and these be  long continued.  He recommends, that
it should be commenced in the quantity of a scruple in the day,
divided  into six equal parts;  that the dose should be afterwards
raised to forty grains, and  then gradually  diminished to a scruple;
and afterwards discontinued by degrees in eight or ten days after
the cure, in  order to consolidate  it.  A case of retention in the
male, cured  by ergot, is recorded by Dr. Kingsley,3 of Roscrea.
Ten grains were  given three  times a day.  Similar testimony is
afforded  by Dr.  J. J. Ross,4  of  Cambusmore, Dr.  Houston, of
Dublin, Dr. Sainmont,5  and others.6
  It has been recommended by Dr. Steinbeck,7 in incontinence of
urine, from want of power in the sphincter of the bladder.   It was
associated, however, with extract  of belladonna, nux vomica, and
phosphoric acid; so that it is impossible to say what precise influ-
ence was exerted  by it.
  Lastly, in the Annates de la Societe de Medecine de Gand, M.
Guersant8 has published  two  cases in which  he administered it
with the greatest advantage  to effect the  expulsion of fragments
of calculi after the  operation  of lithotrity.  Twenty-four  grains
were first given in three doses during the day; but no effect having
been produced, the dose was increased to thirty grains, when the
patient experienced frequent desire to pass the urine, followed  by
pain in the hypogastric region, pricking  in the limbs, and slight
derangement of vision.   After  using  the  medicine for five days,
fragments of calculi were  passed, and, during twenty-four hours,
in three times the quantity that had  been discharged during the
whole previous period  subsequent to the  operation.

  1 See, also, Petrequin, Bulletin de Therapeutique, Mars, 1840.
  2 Journal des Connoissances M6dico-Chirurgicales, Nov. 1838.
  * Dublin Medical Press, April 26, 1843.
  4 London and Edinburgh Monthly Journal of Med. Science, Jan. 1844, p. 43.
  8 Gazette des Hopitaux, Juillet, 1848, cited in Schmidt's Jahrbiicher, u. s. w. No. /,
S. 17.  Jahrgang, 1849.
  8 Provincial Medical and Surgical Journal,  April 24,1844.
  ' Medicin. Zeitung, cited in Lond. Lancet,  March 4,1843.
  8 Journal de Medicine et de Chirurg. Pratiq. Novembre, 1839, 
ERGOTA.
327
                 MODE OF ADMINISTRATION.
  The great difference which has been observed  in the effects of
ergot has led to the belief, that there must  be much difference in
the article, and  that every care must be taken to have  it good.
Dr. Ryan,1 indeed, affirms that not one druggist or chemist in a
hundred has it genuine.   According to Dr. Wright, if it be clear
and smooth on its surface; not powdery; of a deep purple colour;
neither entirely black, nor light brown;  have a full strong odour;
break clearly, exhibiting a pink blush internally; be unpunctured
by insects; burn with a clear jetting flame, and be of less specific
gravity than water, its activity may be trusted.
   It  must be recently pulverized, too, if we are desirous to count
upon its action when given in this form.2
   When prescribed with the view of augmenting parturient energy,
it is most commonly perhaps given in powder, in  the dose of from
ten  to twenty  grains, repeated  every twenty minutes until  the
effect upon the uterus is elicited.   By many, as  by M. Arnal,3 it
is considered more active than any of its preparations.   Professor
Von  Busch4  found the best results when  it was given in the  dose
of ten grains  at short intervals—from ten  to fifteen minutes.   In
one case it was requisite to repeat it eight times; in four cases, six
doses were sufficient; in twelve, five;  in thirty-three, four, and in
the remainder of the  one hundred and  seventy-five cases, three
and less:  the smallest quantity exhibited was a single dose of ten
grains; the largest, nine doses of ten grains.  Dr. Ryan5 says the
maximum dose is a dram and a half;  but it, obviously, cannot be
thus limited.
   Dr. Samuel Hardy, of Dublin,6 has observed, that it has always
commenced  its  action within twenty-five minutes at the farthest,
when the child has been expelled alive; and that if a longer  time
than  this has elapsed, instruments  have been necessary, and  the
child has been born  dead.   The beneficial effects of ergot are evi-
denced" by the pains running into one another without any appre-
ciable interval.  Professor Beatty, of Dublin, affirms that when
delivery was not effected  within two hours from its exhibition, the
child's life was generally lost;  and such is the result of the obser-
vations of Dr. Hardy.7   Several cases are, however, reported by
Mr. J. Pratt, which disprove this statement.   In one, three hours
elapsed between the taking of the medicine and  delivery; in  ano-
ther, five hours; in  another, three and a half; and in a fourth, six
hours; and, in all the cases, fine healthy children  were born.8
   Dr. Hooker,  who considers, that the  ecbolic  and the narcotic
 #' Formulary, p. 264.                          2 Allier, op. cit.
 ' * Bouchardat, Annuaire de Therapeutique pour 1849,  p. 124.   4 Op. cit. S. 106.
  * Op. cit.                 6 Dublin Journal of Medical Science, May, 1845.
  ' Dublin Journal of Med. Science, cited in Med. Examiner, Jan. 1848, p. 76.
  8 Dublin Hospital Gazette, cited in Amer. Journ. of the Medical Sciences, Jan. 1846,
p. 244. 
328
ERGOTA.
properties of ergot may be separated, recommends, in these cases,
the clear infusion, which  possesses, he conceives, the former pro-
perty only.   The powder of course contains both.
  Dr. Bishop, of New Haven,1 asserts, that he has seen but once
any unpleasant effects from ergot, and then he gave it in powder;
the labour was protracted and narcotism induced.  In New Haven,
it is the general practice to administer the infusion,  and in that
form it is considered safe and  effective in parturition.   It is not
easy, however, to see  how the fixed oil  can be  taken up by hot
water.2  The infusion is termed in France, " The" de Seigle noirci
des sages-femmes Americaines"!3  By some, as will  be seen
hereafter, the sedative and other properties of  ergot have been af-
firmed to exist in the aqueous extract or ergotin.   It is proper to
remark, that the form of infusion, as well as of  decoction, was
found  by Dr. Jorg to  be highly unpleasant to  the stomach, and it
could  not  be repeated in his experiments—which, it  must  be
remembered, were  not made on the parturient female—in large
doses for  any length of time, without irritating  the bowels, pro-
ducing loss of appetite, and general  impairment of the digestive
function.
  Dr. Wright4  recommends  the oil of ergot  to  be given in  the
dose of twenty to fifty drops in  tea, weak spirit  and water, some
aromatic water, or made into an emulsion with mucilage and syrup.
It would seem to be the most advisable form of exhibition, as the
oil  retains its properties for several years, if kept in well closed
bottles excluded from light.  As to the  form of tincture, Mr.
Battley affirms,  that alcohol will not extract the active property,
and Dr. Ryan5 states,  that he  has certainly  found  the  tincture
to fail in the majority of cases.   Mr. Battley prefers  the watery
extract.
  For the purpose of  inducing premature labour, it has been  ne-
cessary to give ergot in larger doses.   Dr. Paterson6 gave it in the
form of infusion, until the patient took six drams of the medicine.
The infusion was likewise given by  Dr. F. Ramsbotham,7 and the
quantity which each of his patients took varied from two to twelve
drams.
  As  a parturifacient,  Dr. W. R.  Gore8  has recommended  the
ammoniacal solution of ergot, a formula for which is given here-
after.  This, he says, contains all the active principles in a conve-
nient  form, and with increased efficacy, the ammonia  causing  the
ergot  to act more rapidly, and with greater certainty.
  When ergot is given wTith other views, the usual dose is 10 or
  1 Amer. Med. Intel. Dec. 15, 1837, p. 330.
  2 See the author's General Therapeutics and Mat. Med. 4th edit. i. 429. Philad. 1850.
  3 Journal de Pharmacie, Fevrier, 1842, p. 177.
  4 Edinb. Med. and  Surg. Journal, July, 1840.
  5 Op. cit. p. 266.                6 Lond. Med. Gazette, June 1, 1839, p. 333.
  1 Ibid. June 15,1839, p. 421.      s Medical Times, Nov.5, 1842. 
ERGOTA.
329
 15 grains of the powder, three or four times a day: the results of
 the observations of Dr. Cottman1 have shown, however, that  in
 30 grain doses its  sedative effects are more marked.   This, too,
 was the dose in which it was administered by Dr. Hooker.  In
 such cases, the tincture, and the light oil described by him may
 also be prescribed;—the latter, in the dose of ten to thirty drops.

                       Infusum  ergotse.
                        Infusion of ergot.
                 R.  Ergot, gj.
                     Aquas bullientis f giv.
             Infunde.
    Dose.—One third, to be repeated  every 15 or 20 minutes in
 deficiency of uterine contractions.
                 R.   Ergot, ^ss.
                    Aquae bullientis f gxxiv.
             ColaturEe adde
                    Syrup, simpl. f gj.
    Dose.—Two  ounces every three or four hours, to  induce pre-
 mature labour.                                    Paterson.
                R.  Ergot, £ss.
            Infunde  per semihoram in
                 -   Aquae bullientis fjiss.  et cola.
   This quantity to  be taken for a  dose, and repeated  everv four
 hours-                                      F. Ramsbotham.
              R. Ergot, gss.
          Infunde in
                 Aquae bullient. f ^iij.
          Cola et adde
                 Ergot, in pulv. gr. x.—gr. xv.  M.
   This quantity sweetened with  sugar to be  taken for a dose.
 To be  repeated in  twenty  minutes; and if the  uterus should not
 contract well, to be given  a third time.          S.  L. Hardy,
               R.  Ergot, in pulv. crass, 31 j. (avoirdupois.)
                 Aquaa bullient. ^ix.
   Infuse for an hour in a covered vessel and strain.
   The  product should measure about eight ounces.
                           Dublin Pharmacopoeia of 1850.

               Liqnor   ergotae  ammoniacalis.
                 Ammoniacal solution of ergot.
   Into  half a pint of spiritus ammoniae  aromaticus put four
ounces  of fresh ergot,  bruised coarsely.  Let them stand for a
month,  frequently stirring with a  glass rod, after which squeeze
out every drop of the spirit.  In a glass stoppered bottle, it may
be preserved for any length of time without deterioration.
  Dose.—Thirty drops  in  a wineglassful of cold water,  every

           ' American Medical Intelligencer, Sept. 1, 1839, p. 161. 
330                      ERFOTA.

ten minutes, until the action required is sufficient, applying at the
same  time a  gentle  pressure with the flat  of  the  hand on the
abdomen.  When the pains are present, three doses are usually
enough.                                        W. R. Gore.
                     Decoctum  ergotae.
                      Decoction of ergot.
               R.  Ergot, gj.
                   Aquae Oijss.
      Coque ad Oij. et cola.
   Dose.—A table-spoonful every quarter of an hour.

                     Tinctura  ergots.
                      Tincture of ergot.
          R.  Ergotae in pulv. crass, gviij.  (avoirdupois.)
              Alcohol, dilut. Oij. f Jxl.
  Macerate for fourteen days, and strain; express, and filter.

   Five fluidrams contain one dram of ergot.
                           Dublin Pharmacopoeia of 1850.
               R.  Ergot, gijss.
                   Alcohol, dilut. Oj.
      Macera per dies quatuordecim et cola.
   Dose.—Twenty minims to two fluidrams,  two or  three times a
day, as a sedative agent.                    Guy's  Hospital.

                     Syrupus  ergotse.
                        Syrup of ergot.
                  (Shop de Calcar.—Desgranges.)
               R.  Ergot, gr. xx.
                   Extract, opii. gr. f.
                   Syrup, f §viij.  M.
  Dose.—Two table-spoonfuls (one ounce) in cases  of engorge-
ment of the uterus.                              Lisfranc.

              Pulveres  ergots  compositi.
                 Compound powders of ergot.
                (Antihemorrhagic powders.—Ryan.)
                 R.  Ergot. 3ss.
                     Pulv. aromat. ^ss.
                     Sacch. ^ss.
       M. et divide in chartulas x.
  Dose.—One, every hour or every second or third  hour, in ac-
tive hemorrhage from any outlet. In leucorrhoea and gleet, one
may be given  three or four times a day, and should  they fail the
following may be substituted.
                 R.  Ergot, pulv. 9ij.
                     Cubeb. pulv. gj.
                     Pulv. aromat. ^ss.
                     Sacchar. gj.
                 M. et divide in chartulas. viij.
  Dose.—One, three  or four times a day.              Ryan. 
ERGOTA.
331
                       Pilulse ergotae.
                        Pills of ergot.
              R. Ergot, pulv. gr. ix., xij. vel xviij.
                 Ext. hyoscyam. gr. i.
                 Potass, nitrat. gr. xv.
                 Camphor, pulv. gr. iij.  M. et divide in pil. xl.
  Two to four, every two hours, in cases of urethritis of the
prostatic or membranous portion of the canal.      Desruelles.

                       Vinum ergotae.
                        Wine of ergot.
                R.  Ergot, contus. Jij.
                   Vini Oj.
  Macerate for  14 days, shaking occasionally; then express, and
filter through  paper.
  Dose.—f 3j. to f 5ij.                 Pharm. U. S. 1842
                      Injectio  ergotae.
                       Injection of ergot.
              R. Ergotae gss.
                 Aq. bullient. Oss.
  Used in cases  of erythemoid vaginitis and urethritis.
                                                Desruelles.
                    Extractum  ergotae.
                 Extract of ergot.—Ergotin.
           (Ergotine ou Extrait hemostalique, of Bonjean.)
  Powdered ergot is exhausted by water, by the process of  dis-
placement, and the watery solution is heated in a  water bath.  At
times it coagulates, owing to the presence of a portion of albumen;
at others, it does not.   In the former case, the coagulum is sepa-
rated by the filter, and the filtered liquor  is evaporated  in a water-
bath, until it has the consistence of a clear syrup.   A considerable
excess  of alcohol is then added, which precipitates all the gummy
matters.   The mixture is  left at rest, until the wThole of the gum
is precipitated, and  the liquid has assumed a state of  limpidncss.
The liquor is then decanted to reduce  it  in a water-bath to the
consistence of a  soft extract.  In the latter case,  the watery solu-
tion is  brought directly to a half syrupy state, and is treated by
alcohol as mentioned  above, to obtain from it the extract,  which,
procured by this process, is soft; of a red or brown colour;  very
homogeneous;  of an agreeable  odour of roast  meat, and  of a
slightly piquant  and bitter taste, more or less analogous to that of
damaged wheat. It forms with water a limpid solution of a beau-
tiful red colour.  500  parts of ergot furnish from 70  to 80 parts
of extract.
  M. Bonjean affirms, contrary, as has been seen, to the opinions
of other observers,  that whilst ergotin contains  the medicinal 
332                        ERGOTA.

property of  ergot, the oil and the  resin  contain the poisonous
properties.  He  considers it a real specific  [?]  in hemorrhage
in general.  "When  my  ergotin," he remarks, "shall have been
tried, observers  will  be struck with the immediate effect  it pro-
duces in the most frightful  {foudroyantes) hemorrhages:  the
most  rebellious  cases of haematemesis  yield  in a  short time
under its use; and relapses are generally rare,  especially when
the precaution is taken  to  continue  its employment  some time
after the cessation of the symptoms."   To be convinced that  the
ergotin  is also the obstetrical principle, we have only to treat pow-
dered ergot with  ether, by the process of displacement, until  the
whole of the matter that is soluble in the  liquid  is exhausted: in
this manner the poison is  removed,—that is all the oil of ergot and
the resin.  A powder remains, which is no longer unctuous, but
rough like sand, without any disagreeable taste or poisonous influ-
ence, and which  in the dose of 6 or 8  grains, powerfully excites
uterine  contractions, in every case of inertia of the womb, in
which the  employment of ergot would be esteemed proper.1
   Dr. Sachero,3 Professor of clinical medicine in the University
of Turin, prepared two extracts of ergot, the one aqueous, and the
other alcoholic.   The former had the characters described  above,
whilst the  latter was of a deep brown colour, with no particular
smell, and  was very pungent and slightly bitter to the taste. The
watery  extract he regards as a hyposthenic remedy, well adapted
for cases of hemorrhage;  the resinous extract, he thinks, probably
acts as  an excitant; whilst the oily is the poisonous principle.—
"The action of the ergot," he remarks,  "when administered in its
natural  state, appears to  be of two kinds; the one, as in  labour,
affects the sanguineous system, the  energy of which it diminishes
[hyposthenises,) by means of the ergotin: the  other  affects the
nerves of the uterus, which it stimulates by its resinous principle.
To this double   action must be  added a third,  equally hypos-
thenic,  that of the oily or poisonous principle."
   Dr. Ebers3 found  ergotin  of very marked advantage in ute-
rine  hemorrhage.   He  employed  it  "with the most  perfect
success" in those forms  that are attendant  upon cancer  of  the
uterus,  and which so greatly exhaust the  patient's strength, and
lead rapidly to death.  These he treated  exclusively  with ergo-
tin, in  doses of  two  grains every two hours.  In almost all  the
cases, twelve doses were  sufficient to arrest the hemorrhage.  In
uterine hemorrhage occurring at different periods of life, in youth,
and especially at the critical period, he  has found it of equal  ad-
vantage.

  1 Bouchardat, Annuaire de Th6rapeutique, pour 1843, p. 88, & pour 1844, p. 21.
  2 Cited in Lond. and Edinb. Monthly Journ. of Med. Science, Aug. 1844, and in
the Amer. Journ. of the Med. Sciences, Oct. 1844, p. 463.
  * London Medical Gazette, Nov. 1845. 
ERGOTA.
333
  It is proper to remark, that Drs. J. Lawrence Smith  and S.
D. Sinkler infer, from the results  of  a trial of ergotin  on the
divided carotid of a sheep, that it depends greatly, if not  altoge-
ther, upon the manner in which the lint is applied to the wound
of the artery, whether the hemorrhage is arrested or not.  If it
be placed immediately upon the orifice of the cut vessel, " success
is certain: if, however, the vessel shrinks from  contact with the
lint, the animal is almost  certain to bleed to death."1  Such, also,
is the opinion of  M. Velpeau,2 and of M. Bouchardat3, the latter
of whom had done much  to disseminate the views of M. Bonjean.
He has concluded, that the facts adduced by M. Bonjean, in "sup-
port of his discovery, are very far  from presenting the  charac-
ters of demonstration."  "As regards the success on animals," he
remarks, " it is well  known how plastic their tissues are, and with
what ease they are repaired after serious injuries; and as respects
the effects of ergotin on wounds in individuals of the human  spe-
cies, those that  have  been  hitherto  published may be attributed
with  probability  to  the circumstances  that were associated with
the application of the  remedy almost as much as to the action of
the remedy itself."4

                 Mistura extracti  ergotae.
                 Mixture of extract of ergot.
                       {Potion d'ergotine.)
                   R. Extracti ergotae'gr. xv.
                       Aquae f giij.
                       Syrup, flor. aurant. seu limonis f §j.  M.
  Dose.—A  table-spoonful every quarter of  an  hour, in cases of
hemorrhage, or of inertia of the uterus.   In very violent cases
of hemorrhage the quantity of ergota must be increased, and  the
doses be given more  frequently.                     Bonjean.

                 Syrupus  extracti  ergotae.
                   Syrup of extract of ergot.
                        (Strop d'ergotine.)
               R.   Extract, ergot, ^iiss.
           Solve in
                    Aq. flor. aurant. seu
                    Aq. rosae f ^j.
                    Syrupi f §xvj.
            Coque syrupum et adde solutum.
  Dose.—Two to four table-spoonfuls a day, more or less, accord-
ing to the urgency of the case.                      Bonjean.

  1 Southern Journal of Medicine and Pharmacy, July, 1846, p. 406.
  a Comptes rendus, 6 Juillet, 1846.
  s Annuaire de Therapeutique, &c, pour 1847, p. 49. Paris,  1847.
  ' Annuaire, &c, pour 1848, p.  81. Paris, 1848.
       22 
334
EUPHORBIA LATHYRIS.
               Pilulae  extracti ergots.
                 Pills of extract of ergot.
                    [Pilules d'Ergotine.)
             R.  Extract, ergotae gj.
                 Glycyrrhiz. pulv. q. s. ut fiant pil. i.
Dose.—Six to ten in the day.                     Bonjean.
            LXXVUI. EUPHORBIA  LATH'YRIS.
Synonymes.  Cataputia Minor, Lathyris, Tithymalus Latifolius, Caper
  Spurge, Garden Spurge, Mole Plant.
French. Epurge, Catapuce.
German. Kleines  Springkraut, Purgirko mer-Euphorbie.
  The  oil of spurge—Oleum Euphorbia  Lathyridis—has
been recently recommended  in medicine.  Although  the  euphor-
bia is not a native of this  country,  it is sometimes met  with  in
situations where it has  the appearance of growing wild.  It  is
easily cultivated, and in some parts of New Jersey, where it has
been introduced, is found in abundance.1
  The  oil obtained from the seeds  resembles in colour oleum
ricini, but is less dense.   It has no  odour when newly prepared,
and no perceptible taste.  It is soluble in sulphuric ether, insoluble
in alcohol, and forms a soap with the alkalies.   Its s. g. is .920.
           EFFECTS ON THE ECONOMY IN DISEASE.
  Dr. Charles Calderini found, that, in the dose of from four  to
eight drops, it acted as a cathartic on the adult, without occasion-
ing colic or tenesmus.  In  half the  quantity, it proved cathartic
to children.   He  gave it in sugared water, or in the form of  an
emulsion; and was of  opinion  that  it  might be advantageously
substituted for castor oil, especially for children.  After him, it
was employed by M. Grimaud, and subsequently by M. Bally,2
who carried the dose as far as ten drops, and by M. Martin Solon,3
at the  Hotel-Dieu of Paris, who uses it with excellent effects  as
a hydragogue cathartic in various diseases, in the dose of from 23
to 46 grains—or one and a half to three grammes. Louis Frank4
has  suggested its  employment  in cases of  taenia, hysteralgia,
ascites, &c.
   It would  appear, from the remarks of Mr. Scattergood, that the
oil obtained from the beans  grown  in  this country, does  not pos-
sess the mild qualities ascribed to the European article.  Six, eight,
  1 Scattergood, in Philad. Journ. of Pharmacy,  iv. 124, Philad. 1833.  See, also, Joum.
de Chimie Med. ii. 178.     2 Journal Universel des Sciences Medicales,  xli. 264.
  3 Bullet. General de Therapeutique, Aout, 1848.
  4 Journ. de Pharm. xi. 273: and Merat and De Lens, Diet, de Mat. Med. iii. 183.
Paris, 1831. 
FERRI PRiEPARATA.                    335
ten, and twelve drops were  given to several individuals as a ca-
thartic;  and although administered in conjunction with aromatic
oils, and in one or two cases with an alkali in the form of soap, it
invariably produced nausea, and even vomiting.   Mr. Scattergood
adds,  that he has been informed by the manufacturer, Mr. Thomas
Bellangee, of Crosswicks, New Jersey, that when  administered
in small quantities, and  repeated  at  intervals of half an hour  or
an hour, it operates  on  the  bowels freely as a cathartic, without
producing much nausea.
   Pichonnier1 has proposed  the following formula for a cathartic
mixture.
                  Mistura  olei euphorbiae.
                 Mixture of oil of euphorbia.
              R.  Olei euphorb. lathyr. gtt. viij.
                  Acac. pulv. gj.
                  Sacchar. ^ij.
                  Aquae destillat. f giij.  M.
               LXXIX.  FERRI PRIEPARATA.
Synonymes. Preparations of Iron.
French. Les Preparations de Fer.
German. E isenpraparate.

  Metallic Iron has long  been employed in the cases in wThich
chalybeates in general are indicated.   The French Codex directs it
to be formed into an impalpable powder prepared by porphyrizing
bright and clear iron filings without water.  Of late years, it
has been proposed by M. Quevenne to reduce the sesquioxide by
means of  hydrogen, which is done by passing a stream of  the gas
over the oxide, contained in an iron or porcelain tube heated to low
redness.   The iron, thus prepared, Ferri pulvis2—Lefer rSduit
par Vhydrogene—must be kept in a dry, well stopped, bottle, on
account of its great liability to oxidation.  Mr. Wm. Procter pre-
pares it by placing precipitated carbonate of iron on layers  of iron-
gauze in  a tube of  wrought iron;  passing a stream of hydrogen
through it heated  to a dull red; maintaining this for some hours,
and keeping up a small current of gas till cool.3
  MM. Miquelard and Quevenne combine it with sugar and choco-
late, and  form it into granules  and pills.4  M. Raciborski5 has
strongly recommended it in  ansemic and, especially, in chlor otic
  ' Journ. de Chimie Medicale.  Paris, 1827.
  a A formula for this is introduced into the last edition (1850) of the Dublin Pharma-
copoeia.
  ' K. E. Griffith, Universal Formulary, &c, p. 199. Philad. 1850.
  4 Trousseau and Pidoux, Traite de Therapeutique et de Matiere Medicale, i. 2. Paris,
1847.                           ' De la Paberte, &c.  Paris, 1844. 
336
FERRI ARSENIAS.
cases:  and it  is a  favourite chalybeate  with the author's  col-
league, Professor Meigs.1  The ordinary dose is about two grains
three times a day in the form of pill made with sugar and gum. It
has not appeared to the author to possess  any marked  advantage
over the carbonate  or sesquioxide.
                LXXX.  FERRI ARSENIAS.
Synonymes. Ferrum Arseniatumseu Arsenicicum Oxydulatum, Arseniate
  of Iron, Arseniate of Protoxide of Iron.
French. Arseniate de Fer.
German.  Arsensaures Eisenoxydul, Arseniksaures Eisen-
  oxydul.
  This preparation  has been recommended  by Mr. Carmichael,3
who  often  applied  it externally in cases  of cancerous ulcers.
Naturally, it presents  itself in small, clear, bluish-green crystals,
of a regular octahedral shape, and is  called scorodite.  Artificially,
it is formed by double decomposition.
                  METHOD  OF PREPARING.
  Glaser gives the following formula for its preparation:—Eight
ounces of semivitrified ivhite arsenic, sprinkled with a little  spirit
of wine, and  reduced to fine powder, are mixed with as much
purified saltpetre.   The mixture is then placed  in an uncovered
Hessian  crucible,  which  should only be half filled  with it,  and
then be placed in a wind furnace.  At first, a  slight degree of heat
is  applied, under which the mass soon melts, giving off copious
red fumes, the inhalation of which should be carefully avoided.
The process had better, therefore, be carried on in the open air, or
in a laboratory that  has a chimney with a good draft.  When the
mass no longer gives off  red fumes, and flows tranquilly, the cru-
cible  must be  carefully removed from  the fire,  the contents be
suffered to cool somewhat, and boiling distilled water  be poured
upon  them:  under  active  boiling  they will dissolve altogether.
Hot water, sufficient  to  fill  the  crucible, is now added, and the
whole is allowed  to remain at rest  for twenty-four  hours;  at the
expiration of w7hich  time  a considerable quantity of beautiful crys-
tals of acid arseniate of potassa is found on the sides of the crucible.
The fluid, holding the salt in solution, is now filtered into a clean
porcelain or glass vessel;  the crystals are collected, dried carefully
in the shade, and  put  away amongst the poisons as  the  Arsenias
potassae acidus.
  The fluid, poured from the crystals and  filtered, is now diluted
with  distilled water, and  a solution of pure sulphate of iron
  1 Females and their Diseases, p. 371.  Philad. 1848.
  2 An Essay on the Effects of the Carbonate and other Preparations of Iron upon Can-
cel,  2d edit.  Dublin, 1809. 
FERRI ARSENIAS.
337
added  thereto so long as any precipitate is thrown down.   The
bluish-green precipitate, insoluble in water, is the ferri arsenias,
which  must be collected on a filter, washed and dried in the shade.
The process must  be conducted with  the greatest care, and the
vessels used be cautiously cleansed or broken, for  fear that mis-
chief may  arise.  In  these chemical operations, the  acid of the
saltpetre is decomposed by being heated with the arsenious acid or
white  arsenic, a part of its oxygen is taken by the latter, and ar-
senic acid is thereby formed, which unites with the potassa of the
saltpetre and forms acid  arseniate of potassa: the  nitric acid be-
ing converted into nitrous acid is given off in the form of red fumes:
by admixture of a solution of sulphate of iron with the solution of
the acid arseniate of potassa, a double decomposition ensues, the
result  of which is the formation of  sulphate of potassa and  arse-
niate of iron, which last, being insoluble, falls to the bottom of the
vessel
                 EFFECTS ON THE ECONOMY.
  According to  Carmichael, this preparation acts more powerfully
on the vitality of cancerous formations than any other agent, and
the dead slough caused by it is much deeper than that caused by
the application—which was at one time so much celebrated—called
"Plunkel's caustic."  He allows, however, that the  greatest cau-
tion should be observed in its use.   Of late, he has employed  a
compound of arseniate of iron with phosphate of iron; half a dram
of the former to two drams of the latter.  This mixture must be
applied very thin by means of a camel's hair pencil, and  not over
the whole  surface of the ulcer when it is extensive.   It  has also
been administered internally in cancerous affections and lepra,
by Cazenave; and Biett1 recommends it in lupus, elephantiasis,
psoriasis, chronic eczema and  lichen.
                 MODE OF ADMINISTRATION.
   Arseniate of iron may be applied externally in the form of oint-
ment,  composed of from Bj. to 3ss. to from gss. to §j. of lard; or
the compound,  just mentioned, may be applied  in the following
manner:—
        Unguentum  ferri arseniatis  compositum-
           Compound ointment of arseniate of iron.
                R. Ferri arseniat. gss.
                   ----phosphat. gij.
                    Cerat. cetacei gvi.   M.
   This ointment must be spread on lint and applied to the ulcer.
                                   Carmichael 4*  fVerneck.
   Werneck gives it the preference over all the usual arsenical pre-
parations.   The dose is from TVth to r^th of a grain, made into  a
pill.
        1 Aschenbrenner, Die neueren Arzneimittel, S. 131.  Erlangen, 1848. 
338                   FERRI BROMIDUM.

  The following formula may be  used in  cancerous and other
affections.

           Pilulae ferri arseniatis  compositae.
             Compound pills of arseniate of iron.
               R.  Ferri arseniat. gr. iij.
                   Extract, gentian., gj.
                   Glycyrrhiz. pulv. spj.
                   Syrup, cujusvis q. s. ut fiat
               massa, in pilulas xlviii. dividenda.
  Dose.—One, three  times a day.
               LXXXI. FERRI BROMIDUM.

Synonymes.  Ferrum Bromatum seu Perbromatum, Brometum Ferricum,
  Bromated Iron, Bromide of Iron;—in solution, Hydrobromate of Iron,
  Ferri Hydrobromas, Ferrum Hydrobromicum Oxydatum.
French. Bromure de Fer.
German. Bromeisen, Eisenbromid,  Bromwasserstoffsaures
  E isenoxy d.
                   METHOD OF PREPARING.
  This  preparation is made by heating equal parts of bromine
and  iron filings  under water.  As soon as the fluid  becomes of
a greenish colour it is  filtered  and evaporated to  dryness:  the
reddish   residue—again   dissolved   in  water and  evaporated—is
bromide of iron.   It has a brick-red colour;  dissolves readily in
water, is deliquescent in the air, and has a very styptic taste.'

EFFECTS ON THE ECONOMY, AND MODE  OF ADMINISTRATION.
  Magendie  has  prescribed it successfully, in cases  in which  the
preparations of bromine have been indicated.  (See Brominum,
p. 142.)   He recommends the following formula.

                   Pilulae  ferri  bromidi.
                   Pills of bromide of iron.
               R.  Ferri bromid. pulv. gr. xij.
                   Confect. rosaj gr. xviij.
                   Acaciae pulv. gr. xij.
            Fiat massa in pilulas xx. dividenda.
  Dose.—Two, morning and evening.               Magendie.

               R.  Ferri bromid. 3J.
                   Extract, glycyrrhiz. q. s.
           ut fiat massa in pilulas lx. dividenda.

  Dose.—One or two, morning  and evening, in cases of scrofula,
and hypertrophy—of the uterus especially.        Werneck.

  1 Magendie, Formulaire pour la preparation, &c, de plusieurs nouveaux me'dicamens,
demiere edit. 
FERRI CARBURETUM.
339
             LXXXII.  FERRI  CARBURETUM.
Synonymes. Ferrum Carburetum seu Carbonatum seu Supercarburetum ;
  Carburetum Ferri Nativum, Graphites, Plumbago, Plumbum Nigrum,
  Carbo Mineralis, Cerussa Nigra, Black Lead, Carburet of Iron.
French. Carbure de Fer, Graphite, Crayon noir, Plombagine.
German.  Kohlen stoffeisen, Graphit, Reissblei, Mineral-
  ische Kohle.
  This well known  substance  was  formerly considered  to  be
slightly astringent  and desiccative.   By Weinhold,1 it  has been
advised strongly in certain cutaneous affections, but although it
has  been  received into various pharmacopoeias  of continental
Europe, as the  Antwerp, Bavarian, Brunswick, Spanish, Parisian,
Finnish, Prussian,  Saxon, and Swedish, it has never been recog-
nised as a therapeutical agent in this country or in Great Britain.
                  METHOD OF  PREPARING.
  As crude graphite is  frequently very impure from the attached
matrix, the Prussian Pharmacopoeia has a formula for its purifica-
tion, the product of which bears the name graphites depuratus.
With this  view, the graphite must  be  very finely  pulverized: a
pound  of it is  boiled in a proper  quantity of common water  for
an hour; the water  is  then  decanted,  and two ounces  of nitric
acid and of muriatic acid, and eight ounces of common water are
poured upon the graphite.   This mixture is digested for twenty-
four hours, frequently shaking it; the acid fluid is then  poured
off, and, after the  residuum  has been washed by an appropriate
quantity of common water, it is dried.
                EFFECTS ON THE  ECONOMY.
  The internal use of graphite produces no perceptible change on
the organic functions, except that, according to Weinhold, under
its protracted use, the urinary secretion  is augmented, and a dis-
position to micturition excited.  He found, however, that in her-
petic and  other cutaneous affections, it  occasioned a very favour-
able modification  in  the  eruption,  and wholly removed  it.  In
consequence of the  results  of his observations, he published a
monograph in which he recommended  it to physicians jn those
diseases.  He employed it as well internally as externally.  The
urine,  he asserts,  after its  administration, commonly began  to
make a deposit, and  this  continued until some change in the cu-
taneous affection announced its approaching  cure.  In cases  of
complication of herpes  with  other affections, Weinhold  combined
it with other remedies;—in syphilitic eruptions, adding corrosive
sublimate, &c.
  The efficacy of graphite in herpetic and other cutaneous affec-
tions has also been attested by many other  respectable physicians,
     1 Der Graphit als ein neu entdecktes Mittel gegen Flechten. Leipz. 1809. 
340
FERRI CARBURETUM.
as Horn, Heim, Ruggieri, Brera, Bernstein, Hildenbrand, Richter,
Hufeland,  Marc,1 &c.   This circumstance gave occasion to  its
admission into the Prussian  Pharmacopoeia; yet it has not the
confidence  of physicians, even in those countries into the pharma-
copoeias of which it has been received, and  is consequently but
little prescribed.  Its use in chronic cutaneous diseases is said to
have  been  suggested by the circumstance, that in Venice the
makers' of crayons are speedily cured  of any such affections under   *
which they may labour.2
                 MODE OF ADMINISTRATION.
   Internally, graphite  is given in doses of from  five to fifteen
grains, from two to  four times daily; and the dose may be aug-
mented, according to circumstances, to a dram in the day.   It is
given in powder or in the pilular form.   Externally, it is applied
in the form of ointment or plaster—from  3ij- to 3vj. of the gra-
phite to an ounce of the constituent.

                 Pulvis  ferri  carbureti.
                 Powder of carburet of iron.
                  R.  Ferri carburet.
      '                Sacch,  aa. ^ss.  M.
              Divide in paries eequal. vi.
   Dose.—One, every two hours, in lichen lepro'ides.
                                          Von Hildenbrand.
              Electuarium ferri carbureti.
                 Electuary of carburet of iron.
                  R.  Ferri carburet, ^ss.
                      Mellis despumat. ^ij. M.
              Fiat electuarium.
   Dose.—A coffee-spoonful, morning and evening.— Weinhold.

                  Pilulae  ferri   carbureti.
                  Pills of carburet of iron.
                  R.  Ferri carburet.
                      Extract, dulcamar. aa. 3J.
              M. fiant pilulas pond. gr. ij. sing.
   Dose.—Six, three times a  day.                     Marker.
                  R.  Ferri carburet, gij.
                      Zinci oxid. gss.
                      Adipis  gj.  M.
                                                      Mayer.

  1 Riecke, Die neuern Arzneimittel, u. s. w. Stuttgart, 1837, S. 214; see, also, Wein-
hold, in Hufeland's Journal, B. xxxiv. St. 1, S. 118: Heim in Horn's Archiv. 1810,
xii. 326, and Ibid. 1811, B. 1, S. 91;  Huber, in Med. Chir. Zeitung, 1811, No. 68, S.
282; Hufeland, Journ. der prakt. Heilkunde,  B. xxxviii. St. 6; Bernstein, Ibid. B. xli.
St. 5; Mayer, Ibid. B. Ix. St. 2, and Osann, in Encyclop. Wbrterb. der Med. Wissensch.
x. 434.  Berlin, 1834.
  1 Merat and De Lens, in Diet, de Mat. Med., art. Carbone. 
FERRI CITRAS.
341
 Unguentum  ferri carbureti.
  Ointment of carburet of iron.
    R.  Ferri carburet.
        Sulphur, aa. 31 j.
        Adipis q. s. ut fiat unguentum.
                                      Brera.
Emplastrum  ferri carbureti.
    Plaster of carburet of iron.
    R.  Ferri carburet, ^ij.
        Emplast. sapon. sjiv.
Misce intime.
                                   Weinhold.
      N         LXXXIII.  FERRI CITRAS.
Synonymes.  Ferrum citricum, Citras ferricus, Citrate of Iron.
French.  Citrate de Fer.
German.  Citronsaures  Eisenoxydul, Citronensaures Ei-
  senoxyd.
  Two citrates of iron have been proposed, of late years, by M.
Beral1—the one the sesquicitrate or  citrate  of the sesqui-
oxide of iron ;  the  other, the citrate of the protoxide of
iron.  An  ammonio-citrate, a potassio-citrate, and a sodio-
citrate have likewise been introduced.
                  METHOD OF PREPARING.
  The citrate of the sesquioxide, according to Mr.Duhamel,2 is
prepared as follows:—Take of Citric  acid, crystallized, 5iij. or
three parts;  Hydrated  oxide of iron, dry, 5ij. or two  parts;
Distilled water, ^xij. or twelve parts. If the moist hydrate be
used, about ^vj.  are required; but as the degree of moisture is not
always the same, Mr. Duhamel suggests, that the oxide should be
in excess.  The  water may  be heated  to  about  180°: a  boiling
temperature should  be  avoided, as it renders the  sesquioxide less
readily soluble.3   The  solution is filtered, and the filter washed
with  distilled  water sufficient to obtain twelve  parts of  liquid.
This  forms what is kept  by the French Pharmaciens under the
name Liquid Citrate of Iron, marking 24° of Beaume. It holds
in solution  one-third of its weight of  dry citrate of iron.  The
solution is  evaporated  to the consistence  of thick syrup.  It is
then spread out on  glass or porcelain plates, where  it speedily
dries in thin layers, which are separated  and broken into fragments.

  1 Journ. de Chimie Medicale;  cited in Amer. Journ. of Pharm., April, 1841, p. 72.
  2 Amer. Journ. of Pharmacy, Oct., 1842, p. 225.
  1 W. Procter, cited in Dispensatory of the United States, 8th edit., p. 1246. Phila., 1848. 
342                     FERRI CITRAS.

  Its taste is acid, but not disagreeable, and it is said to be, of all
chalybeate salts, the least unpleasant to the taste.
   Citrate of protoxide of iron is prepared  by M. Beral,1 by
treating iron filings with citric acid previously dissolved in dis-
tilled water.    It has a  strongly marked chalybeate  taste.
   Citrate of sesqui-oxide of iron is a somewhat  insoluble salt: it
occurs in transparent laminae of  a garnet hue, which are perma-
nent  in  the  air.   Citrate of the protoxide  is of a dark-green
colour; soluble, and the solution does not change its green colour
by  exposure to air.
  Ammonio-citrate of iron, Citrate of iron  and ammonia,
Ammoniae ferro- citras, A. ferrico-cilras, Ferri et ammo-
niae  citras,  Ferrum  citricum cum ammoniaco,  Ferrum
ammoniaco-citricum;  German, Eisenoxyd mit  Ammo-
nia k, is  prepared  by neutralizing the excess of acid in pre-
paring the nitrate of the sesquioxide  by ammonia, and evaporating
as before.2  It is a much more soluble salt than the citrate of the
sesquioxide, and is slightly deliquescent.  If the acid or  the citrate
be neutralized by  soda or potassa in  place of ammonia,  the sodio-
citrate, and  the potassio-citrate of  iron, are formed, which
greatly resemble the ammonio-citrate.3  The ammonio-citrate—
Ferri ammonio citras—is officinal in  the  last Dublin Pharma-
copoeia.4
  A citrate of magnetic  oxide of iron is prepared by com-
bining the  magnetic oxide with citric acid.
  Mr. Edward  Parrish5 makes a syrup of citrate of iron as fol-
lows.  He first  prepares a moist  protocarbonate of  iron, by mix-
ing together solutions of sulphate of iron and carbonate of soda,
precisely as directed for Vallet's  ferruginous mass,  and washing
with  sweetened water.   This is  then dissolved by means  of a
slight excess of  citric acid in water,  and is evaporated to dryness.
A greenish deliquescent,  freely soluble, uncrystallizable salt results,
the taste of which is ferruginous, but  not very unpleasant.  To
make the syrup, one ounce, Troy, of this  salt is dissolved in five
fluidounces of simple syrup.  The solution is easily effected, and
forms a dark greenish-brown liquid.  The dose is from thirty drops
to a tea-spoonful.  The syrup of citrate of iron  of Beral, is a sac-
charine solution of the citrates of ammonia and sesquioxide of iron.
           EFFECTS ON THE ECONOMY IN HEALTH.
  The citrates of iron resemble,  in  their properties, the tartrate
and the lactate of iron, and may be given in the same cases.  The
  1 Amer. Journ. of Pharm., April, 1841, p. 72.
  a For forms of preparation see Redwood, in his edition of Gray's Supplement to the
Pharmacopoeias. 2d edit., London, 1848.
  3 Ballard and Garrod, Elements of Mat. Med. and Therap., p. 389.  London, 1845.
  4 The Pharmacopoeia of the King and Queen's College of Physicians in Ireland,
1850, p. 43.  Dublin, 1850.
  1 Amer. Journ. of Pharmacy,  October, 1848, p. 649. 
FERRI citras.
343
author has used the citrate largely, and is much pleased with it.
It is unquestionably one of the most agreeable of the chalybeates,
and equally effective perhaps with any.

                 MODE OF ADMINISTRATION.
  The dose of citrate of iron may be the same as that of the salts
above mentioned.  The author generally prescribes it in  the quan-
tity of ten grains three times a day.  The citrates are not decom-
posed by alkalies, and hence may be given with them if desirable.
The ammonio-citrate, according  to MM. Ballard and Garrod, is
the most  used, and may be conveniently administered  in porter,
which conceals its taste, without its own flavour being impaired.
  It has long been  administered in wine, of which the  following
are two forms;—the  first from the Hamburg, and the latter from
the Wirtemburg, Pharmacopoeia.

           Vinum  ferri  citratis  aromaticnm.
              Aromatic wine of citrate of iron.
                 R.  Ferri limatur. fj.
                     Limon. succ. giij.
              Macera per noctem, et adde
                     Gentian, gss.
                     Cinnam. sp'j.
                     Vinif gxvj.
  Dose.—Of the decanted wine, f jss. to f ^ij. and more.   This
preparation, or one  analogous to it, is said to be prescribed  by
certain physicians of this country—of Charleston, for example.1
  Take of Iron filings, four  ounces;  Bitter  oranges,  four.
Remove the  peel, the white,  and the seeds;  beat them in a stone
mortar, and let the  paste remain at rest for  two days;  then pour
upon it Madeira wine, ten  ounces, and Spirit of orange peel,
two ounces.   After sufficient digestion, express and filter.   This
preparation is called, in the Wirtemburg Pharmacopoeia, Tinctura
Ferri Aurantiaca seu Tinctura Martis cum Vino Malvatico
et Pomis Aurantiis.2   According to Mr. Gore,3 it possesses the
most agreeable odour and  taste of any medicinal compound ever
introduced into  practice.   It is aromatic, carminative and tonic;
and, he adds, that he  has no doubt it will  supersede the prepara-
tions  in general use, when  once it  has been  fairly tried.  In
strumous habits; in passive uterine hemorrhage; in anasarca
from general debility; in  chlorosis;  in malignant disease, in
which  iron has been extolled; and  in all diseases that arise from a
general deficiency of tone, Mr. Gore  considers this preparation
to be " of exceeding utility, from its  agreeable and chalybeate
qualities."  He suggests, also, its use in chronic bronchitis, in
which he gives it in combination with ipecacuanha wine.

  1 Duhamel, loc. cit.     3 Jourdan, Pharmacopee Universelle, i. 545.  Paris, 1828.
  ! Dublin Medical Press, April 29, 1840. 
344
FERRI ET MAGNESLK CITRAS.
              Aqua  chalybeat'a  effervescens.
                 Effervescing chalybeate water.
                R.  Aquae Oiss.
                    Ferri citrat. sice. 9j.
                    Acid, citric.^iv.
                    Sodae bicarb. 9 v.
   Add first the citrate of iron and citric acid, then the bicarbonate
of soda,  corking the  bottle at once, and securing the cork.1  This
is  a delicate  but active chalybeate.   It may be formed, also, con-
veniently and agreeably, by dissolving 5 to 10 grains of the citrate
in f gvj. of the mineral water of the shops, and flavouring with
syrup of orange peel.  It is said, however, to be apt to excite un-
pleasant  eructations.2 It has been called ' Chalybeate Champagne?

   A citrate of iron and magnesia, Ferri et Magnesia Citras,
is  prepared  by dissolving hydrated  oxide of iron  in a solution of
citric acid, saturating the  liquid with carbonate of magnesia, and
evaporating  to dryness.3  The salt  presents itself in the form of
brown brilliant scales, of a sweetish and feebly  inky and not disa-
greeable taste.  It is perfectly soluble in water,  and has the advan-
tage over the ferro-citrate  of ammonia, that it is not deliquescent,
so that it can be given in  powder.    Moreover, it does not induce
constipation, like most of the salts of iron.   The dose is from 4 to
15 grains in solution.  It may also be given in  powder or pill.
           Syrupus  ferri et  magnesia;  citratis.
             Syrup of citrate of iron and magnesia.
                R.   Ferri et magnes. citrat. p. x.
             Solve in
                     Aq. flor. aurant. p. xx.
                    Syrup, p. cc.  M.
                                             Van den Corput.
            Pulvis  ferri et  magnesia;  citratis.
             Powder of citrate of iron and magnesia.
              (Saccharure de citrate de fer et de magnesie.)
                R.   Ferri et magnes. citrat. p. v.
                    Sacchar. pulv. p. xl.
                     Canellse alba? p. v.  M.
   Dose.—Fifteen grains.                     Van den Corput.
          Troschisci  ferri et magnesia; citratis.
            Lozenges of citrate of iron and magnesia.
                R.   Ferri et magnes. citrat. p. v.
                     Sacchar. pulv. p. xl.
                     Vanill. Sacchar. (Saccharure  de vanille.) p. 2.
                     Mucilag. tragacanth. p. v.  M.
   Each lozenge to contain fifteen grains.      Van den Corput.
   1 Bullet, de Therap. cited in Provincial Med. and Surg. Journ. Dec. 10, 1842.
   2 Pereira, Elements of Materia Medica and Therap.  3d edit.  i. 791. Lond. 1849.
  8 Van den Corput, cited  in Bouchardat, Annuaire de Therap. pour 1850,"p. 186.  The
formula of Van den Corput, with remarks by  Mr. Wm. Procter, Jr. is given  in Amer.
Joum. of Pharmacy, October, 1850, p. 314. 
FERRI FERROCYANURETUM.
345
   M. Beral has likewise introduced a Citrate of Protoxide of Iron
and Quinia-^-F ekri et  Quinlk Citras, Ferrum et Chininum
citricum]  German,  Citronensaures Eisenchinin; which is
ibrmed by the union of four parts of Citrate of iron with one part
of Citrate of quinia  in  solution, and evaporating.   It  may be
given  in  the form of pill, wherever a combination of these tonics
is needed.  An extemporaneous formula may be made by uniting
citrate of iron,  and  citrate or even sulphate of  quinia together,
which may be given either in pills or solution;
        LXXXIV.  FERRI FERROCYANURETUM.
Svnonymes. Ferri Cyanidum seu Cyanuretum seu Borussias seu Sesqui-
  cyanidum seu Ferrosesquicyanidum seu Percyanidum  seu  Ferrocy-
  anas, Ferrum Cyanogenatum seu Cyanuretum seu Zooticum seu Bo-
  russicum seu Hydrocyanicum seu Oxydulatum Hydrocyanicum, Cee-
  ruleum Boru'ssicum seu Beroliniense, Prussiate or Cyanide or Cyanu-
  ret of Iron, Prussian Blue, Berlin Blue.
French.  Trito-hydro-ferro-cyanate de Fer; Deutoxicyanure de Fer Hy-
  drate, Tritohydrocyanate  Ferrure  de Fer, Prussiate de Potasse et de
  Fer, Bleu de Prusse.
German.  Cyanei sen, Blaustoffeisen, Blausaures Eisenoxy-
  dul, Eisenblausau res Eisenoxyd, Blausaures Eisen,  Ei-
  sencyanurcyanid,  Berliner Blau, Pariser Blau.
  In commerce, this preparation, with us, bears the name of "Prus-
sian blue," but in Germany it is called "Pariser blau."  It is not
in a state of purity, and, consequently, that which the apothecary
prepares is best adapted for internal use.

                  METHOD OF  PREEARING.
  The form given by Buchner is as good as any.   Ferrocyanuret
of potassium, as commonly met with in commerce, is dissolved in
warm distilled water, and to the clear filtered solution is gradually
added, in a glass vessel, a solution  of chemically pure sulphate of
iron so  long as a precipitate is thrown down.  After the precipi-
tate has fallen to the  bottom of the vessel, and the supernatant
fluid, which contains sulphate of potassa, has been poured off, the
precipitate is first digested with dilute sulphuric or muriatic acid,
in order to dissolve the excess of oxide of iron; the beautiful dark
blue precipitate is then collected  on a filter, carefully washed with
boiling water, and dried.
   The following form for the preparation  of "pure Prussian blue,"
is admitted into the last edition of the Pharmacopoeia of the United
States:—Take of Sulphate of iron, §iv.; Sulphuric acid, f ^iiiss.;
Nitric acid, f 3yj., or a  sufficient quantity; Ferrocyanuret of Po-
tassium, ^ivss. I Water,  Oij.  Dissolve the sulphate of  iron  in a
pint of water, and, having added the sulphuric acid, boil  the solu-
tion.  Pour it into the nitric  acid in small portions, boiling the 
346                FERRI FERROCYANURETUM.

liquid  for a minute or two after each addition, until it no longer
produces  a dark colour;  then allow the liquid to cool.   Dissolve
the ferrocyanuret of  potassium in the remainder of the water, and
add this solution gradually to the first liquid, agitating the mixture *
after each addition; then pour it upon a filter.   Wash the precipi-
tate with  boiling water until the washings pass tasteless.   Lastly,
dry it  and rub into powder.1
   Ferrocyanuret of  iron is  of  a  beautiful deep blue colour, and
devoid of odour and taste.   It is decomposed by heat, and is  inso-
luble  in water, alcohol, ether, oils and dilute acids.  Potassa and
soda decompose it.   It adheres firmly to the tongue, which Rieckfc
thinks is owing to its containing argil.
                 EFFECTS ON THE ECONOMY.
   Of the effects of ferrocyanuret of iron on the  human  economy
in  health we have no  evidence.   Coullon gave it to various ani-
mals, but  observed no action from it.  It has been given, however,
and not without success, in several diseases;  and Dr. L. W. Sachs,
who has  not unfrequently administered it, considers it one of the
most important chalybeates with which we  are acquainted.  He
thinks it probable, that the hydrocyanic acid has not much agency;
yet it  certainly seems to differ from all  the other preparations of
iron.   It  has  been especially recommended in epilepsy by Kirck-
hoff,2 of Ghent; and more recently by M. Faivre d'Esnans.3  In
very obstinate cases, not  dependent upon organic mischief, Kirck-
hoff succeeded entirely with  it;  with the adult, he  commenced with
half a  grain daily, and raised the dose gradually to three, four, and
even six grains and upwards.  When the patient was plethoric,
he premised blood-letting, or applied leeches, from time to time, to
the temples.   Hildenbrand  and Gergeres confirm its efficacy in
epilepsy.   M. Faivre d'Esnans used the following formula:—
                R. Ferri ferrocyanuret. gr. xv.
                    Ext. Valerian, gr. xlv.
                M.   et divide in pil. xxiv.
   One pill to be taken  three  times a day, at an interval of six
hours, and  each pill to  be followed by a wineglassful of infusion
of valerian.
   It has  also been administered by Dr. Zollickoffer4 successfully
in a case  of  chorea; three grains  being given  in  the form of pill,
three times  a day.   In  six days, the  girl, twelve years old, was
entirely cured, after camphor, opium, quinia, and asafcetida, nitrate
of silver,  and subcarbonate  of iron had been  given in vain.  In

  ' Pharmacopoeia of the United States, p. 109.  Philad. 1842.
  a Journal de Chimie Medicale, iii.  285.  See, also, Joum. des Connais. Med. Chirur.
Aout, 1841; or Encycl. des Sciences  Med. Sept. 1841, p. 468.
  s Journal de Medecine et de Chirurgie Pratiques, cited in Amer. Journ. of the Med.
Sciences, July, 1850, p. 202.
  4 Medical  Examiner, May 16, 1840, p. 314. 
FERRI FERROCYANURETUM.
347
intermittent fever,  Dr. Zollickoffer1 found it so efficacious, that
he even gave it the  preference over cinchona:  and his experience
has been confirmed by that of Eberle,2 Hosack,3 J. E. Craighead,4
Hasse,5 and others.  Wutzer, in Germany, also exhibited it suc-
cessfully ; and Stosch gave it advantageously, in combination with
cinchona and rhubarb, in a case of obstinate intermittent.   Sachs
likewise tried it frequently, but as often without, as with, success.
When it has proved efficacious in intermittents, the dose has been
by no means large.  Some have given six or eight grains every
four hours during the apyrexia, and even as much as a scruple has
been administered.  Sachs found it several times efficacious, when
four doses of two grains each were taken; and  Riecke6  affirms,
that his father obtained essential service from it in the leucophleg-
matic conditions resulting from intermittent fever.  Zollickoffer
extols the ferrocyanuret also in remittent fever; and  there  may,
doubtless, be periods  when it may be  administered with benefit;
but it is not often used.  He recommends it, likewise, in dysentery,1
when the inflammatory  condition has passed away, either sponta-
neously or  under the efforts of art; and  Sachs  remarks, that  in
atonic  conditions of the intestinal  canal, which supervene  on
dysentery,  it may doubtless be of great service.  Gergeres admi-
nistered it successfully in chronic diarrhoea.  L. W. Sachs enters
into a  long theoretical disquisition on the precise action of the
remedy, in which there is, doubtless, much that is speculative.
He  used  it, he  says, with success, in  many cases which it would
be difficult  to classify under any formal nosology;  their  common
bond, however, was,  that they were  dependent upon " nervous
disorders, especially of the plastic functions of the abdominal organs,
the  mischief appearing first of all to be gastric."  In such affec-
tions he  found a combination of the  ferrocyanuret of iron with
 rhubarb especially serviceable.   He gave  it in not less  than two
 grain doses, which were gradually augmented to six, three  times
 a day.  Dr. Moll saw decidedly good effects from its use in a case
 of immoderate menstruation from atony of the uterus, with gene-
 ral  elevation of nervous excitability, after he  had employed the
 remedies, commonly recommended,  unsuccessfully.   He  found it
 also extremely beneficial  to children of a strumous habit, and  of
 great torpor.   Stosch found it serviceable  in a  case of scrofula, in
 which haematosis was imperfectly accomplished;  and Dr. Bridges8
 obtained great advantage from it in a case of severe and protracted
facial neuralgia.

   1 American Medical Recorder, v. 540.         3 Materia Medica, 2d edit. i. 233.
  8 New York Medical and Physical Journal, 1823,
  ' American Medical Intelligencer, May, 1842, p. 230.
   6 Aschenbrenner, Die neueren Arzneimittel; u. s. w. S. 122. Erlangen, 1848.
  s Op. citat.  S. 217.             ' Chapman's Philadelphia Journal, Aug. 1823.
  • Wood and Bache's Dispensatory, art. Ferri Ferrocyanuretum. 
348
FERRI FERROCYANURETUM.
  It has been also recommended as probably more effective  than
any other  remedy in inveterate  cases of ascarides in the rectum.
With this view, five grains of the  salt may be  rubbed up in two
ounces of  warm water or mucilage of gum arabic, and be thrown
up into the rectum, to be retained  there  " until the next regular
defecation."  This must be repeated daily, gradually increasing
the quantity of the cyanuret, until perfect and permanent relief is
afforded.2
  Externally, the ferrocyanuret has been used in the form of oint-
ment, in cases of ill-conditioned, torpid and  foul ulcers, and
even of noli me tangere.  Stosch applied it in a case of fungous
ulcer with marked advantage;  making it into a paste with water
and using it in that form.

                 MODE OF ADMINISTRATION.

              Pulvis ferri  ferroeyanureti.
              Powder of ferrocyanuret of iron.
          R. Ferri ferrocyan. gr. iij. ad. xxxvj.
             Sacchar. gij.  M.  et divide in pulveres vj.

   Dose.—A powder, two or three times a day, in epilepsy.
                                                 Kirckhojf.
          R. Ferri ferrocyan. gr. j., iv., vj., ad xij.
              Sacch. 3J.
          Fiat pulvis in partes xij. aequales dividendus.
   Dose.—A powder, every two hours, in epilepsy.
                                         Von Hildenbrand.
          R.  Ferri ferrocyan.
              Guaiac. pulv. aa. gj.
          Misce et divide in chartulas Xij.
   Dose.—One, three times a day.—Employed  successfully in in-
 termittents.3

               Pilula? ferri  ferroeyanureti.
                Pills of ferrocyanuret  of iron.
                  R.  Ammoniac.
                      Rhei
                      Ext. taraxac. aa.. gj.
                      Ferri ferrocyan. gr. xviij. ad. xxxvj.
                  M. et fiat massa in pilulas lx. dividenda.
    Dose.—Four to six, twice a  day, in disorder of the ganglionic
 system.                            L. W. Sachs, fy Radius.

            Unguentum ferri  ferroeyanureti.
              Ointment of ferrocyanuret of iron.
                   R.  Ferri ferrocyan. 3J.
                      Unguent, cetacei %]. M. et  fiat unguentum.

        * Amer. Journ. of the Medical Sciences, Jan. 1847, p. 247.
        * Ellis's Formulary, 8th edit p. 186.  Philad. 1846. 
FERRI IODIDUM.
349
                 LXXXV.  FERRI IODIDUM.
 Synonymes. Ferri  Ioduretum, Ferrum Iodatum, Iodated Iron, Iodide or
   Ioduret, Protoioduret, Protoiodide or Protiodide of Iron.
 French. Iodure de Fer, Protoiodure de Fer.
 German. lode isen.
 In solution,  Ferri Hydriodas, Ferrum  Hydriodatum seu Hydroiodicum
   Oxydulatum, Hydriodated Iron, Hydriodate of Iron, Hydriodate of Pro-
   toxide of Iron.
 French. Hydriodate de Fer.
 German. Hydroiodsaures  Eisenoxydul, Iodeisen, Iodwas-
   serstoffsaures Eisenoxydul, Eiseniodiir.
   Although attention had been directed, several years ago, to this
 preparation, it was not much used, until Prof. A. T. Thomson,1
 of the London University, recommended it strongly in a special
 monograph several years since.  It has been received into different
 Pharmacopoeias.
                   METHOD OF PREPARING.
   The following  method is recommended by  Dr.  Thomson.  One
 part of iron  wire should be rubbed in a porcelain or wedgewood
 mortar with about three or four parts of iodine, gradually adding
 distilled water, until fifteen parts of the fluid have been used; the
 whole is then to be introduced into a Florence  flask,  with  an ad-
 ditional portion of wire and of distilled water.  This excess of iron
 is a matter of indifference  in the preparation  of  the  hydriodate,
 and in that of the iodide it  is necessary  for preserving the combi-
 nation from decomposition during the evaporation  of the solution.
 These materials are next to be boiled together, until the fluid ac-
 quires a pale greenish colour, when it must be filtered.  This solu-
 tion contains  a hydriodate of the protoxide of iron;  and, if the
 exact quantity of  the iodine be  previously ascertained, so  as  to
 enable the solution to be procured of a definite strength, it may be
 kept  in this state for medicinal use.   In general,  however, the
 solution is evaporated to dryness, and, for this purpose, it may be
 poured into  a clean  flask,  containing a  piece of  iron wire  suffi-
 ciently long to reach from the bottom to the surface of the fluid,
 and  the boiling should be continued until the  bulk of  the solution
 is reduced,  to one-third.   It must  then be filtered, after  which
 the evaporation  should be continued to dryness.  It is necessary
 to break the flask as soon as the mass is cold, in order to  obtain
 the solid  iodide, which should be  immediately transferred  to a
 dry bottle, accurately fitted with a  ground  stopper.   The  bottle
should not hold  more  than two ounces of the preparation; for
 when it  is large and  not  full, the iodide  deliquesces nearly as
rapidly as when it is exposed to the free  action of  the atmosphere.

  ' Some Observations on the Preparation and Medicinal Employment of the Ioduret
and Hydriodate of Iron, 8vo. p. 64.   Lond. 1834.
         23 
350
FERRI IODIDUM.
  When the flask is broken, and the iodide  bottled before the mass
 x is cold, deliquescence also takes place, a peroxide of the metal is
  formed, and iodine is evolved.
     The form for the preparation of the solid iodide recommended
  in the last edition of the Pharmacopoeia of the United States is the
  following:—Take of  Iodine, gij., Iron  filings, |i., Distilled
   uJater, a pint and a  half.   Mix the iodine with a pint of the dis-
   tilled water in a porcelain or glass vessel, and  gradually add the
   iron filings, stirring constantly.   Heat the mixture  gently  until
   the liquid  acquires a light greenish  colour;  then filter, and after
   the liquid has  passed, pour upon  the filter half a pint of the  dis-
   tilled water boiling hot.   When this shall have passed, evaporate
   the filtered  liquor, at a temperature not exceeding 212°, in  an iron
   vessel, to dryness.   Keep the dry iodide in a closely stopped  bot-
   tle.1
      The plan proposed  by  Mr. Durand,2 of Philadelphia, after that
   by MM. Baup and  Caillot,3 for preparing the solution of the  pro-
   tiodide of iron (hydriodate of protoxide of iron) is the following:—
   Take of Iodine, Zx.,  Iron filings, perfectly pure and unoxidized,
   Jv., Distilled water, Jxiiss. Put the iodine into a porcelain cap^
   sule, with one half  the quantity of water, and add the iron filings
   by small portions, stirring the mixture with a glass rod. The com-
   bination soon takes  place; heat is evolved with the disengagement
   of a small quantity of vapour of iodine, and  the mixture acquires
   an orange colour, which  gradually deepens to a dark  red.   When
   the whole of the iron has been added, the capsule is put in a sand
•   bath, or over the flame of a spirit lamp, and heated slowly;  con-
   tinuing to stir the liquid.  An ioduretted hydriodate of iron is first
   produced, which, under the  action of heat, soon passes to the state
   of a simple hydriodate.   This point is indicated by the entire dis-
   coloration of the solution.   In  this state it is filtered; and the
   dregs  and  filter are carefully washed with the remaining half of
   the distilled water,  previously heated to the boiling point.  In
    this manner, a solution forming  twelve and a half fluidounces is
   afforded, one ounce of which represents one dram of iodide of iron.
      The solution, which is at first colourless, acquires a deep red
   colour by standing, and  precipitates some oxide of iron; by which
   it is reduced to the state of an ioduretted hydriodate  of iron; but
   it  may be easily restored to its  former state  by heating  it again
   with a small  quantity  of  iron filings, until the liquid  becomes
   colourless: or, to prevent these changes, a coil of soft iron wire
   may be kept immersed in it; a fact  which has been  long known,4
   but which M. Dupasquier has recently rediscovered.5

        1 Pharm. of the United States, p. 110.   Philad. 1842.           '
       2 Philad. Journ. of Pharmacy, iv. 2-7.  Philad. 1833.          Ibid. i. 201.
       • Squire. Annals of Philosophy, May, 1836, p. 79.
        ' Journal de Pharmacie, Mars,  1842, p. 224. 
FERRI IODIDUM.
351
  The iodide of iron  is obtained  by evaporating to dryness the
filtered  solution, taking care, towards the end, to stir incessantly
with  an  iron spatula,  and  to detach the salt from the bottom  of
the capsule as it forms.  The heat must be managed most  care-
fully, diminishing it gradually, and removing the  capsule quickly
from  the  fire as soon  as the odour of iodine  is  evolved.  The
solution of this  salt, when the iodide is well prepared, is of a pale
greenish  colour, and deeper in proportion  to  the decomposition
which some parts  may have undergone towards the end of the
operation.
   Iodide of iron requires  to be well  secured from the influence
of  the atmosphere, both on account of its  deliquescent property,
the rapid oxidation which the metal undergoes when deliquescence
occurs, and the  consequent  decomposition which takes place.   It
is important to  prevent this, as the  peroxide of iron is compara-
tively inert as a medicinal agent; whilst the free iodine extricated
during its oxidation, according to Dr. Thomson, alters altogether
the virtues  of the  medicine.  This partial  decomposition  of the
iodide is rendered immediately apparent on  dissolving it in twenty
times its weight of distilled water, and filtering: instead of a per-
manent,  clear,  very pale greenish-yellow,  we  obtain  an ochre-
coloured,  completely insoluble precipitate.   Much of the  iodide
usually prepared is of this description, and to this may, doubtless,
be referred some of the disappointment and discrepancy amongst
practitioners as  to  the  operation of the medicine  in  cases  appa-
rently similar.   Even when  the iodide has been carefully prepared,
it often contains a  little free iodine; but, according to Thomson,
it is chiefly owing to the carelessness of assistants and apprentices
in compounding prescriptions, by frequently exposing the  iodide
to  the  air, that its  properties, and, consequently, its medicinal
powers, are impaired : hence, it is preferable to keep it in solution,
or  in the form of hydriodate, which it becomes, whenever water
is added to it.
   If the  solution be prepared with a definite quantity of iodine,
as described, it  will keep without changing its characters; but  as
it is  usually made  by dissolving the  iodide in distilled water, it
requires to be rendered neutral by the following  means:—Intro-
duce into a flask the solution of any given  strength, and  place in
it two or three doubles  of clean and soft iron wire, sufficiently long
to extend to the surface of the  fluid;  boil  for a few minutes, and
then leave it at  rest, until the solution becomes clear,  after which
it may be either decanted off from the precipitate-which forms,  or
filtered:  no farther change  takes place in a solution thus treated,
however long it may be preserved, provided it be  kept in a  black-
ened  or a  green bottle.  In  this process,  the  wire affords iron
to saturate any  free iodine present in the solution, or that may
have been extricated  by the formation of the peroxide of iron  in 
352
FERRI IODIDUM.
the iodide;  and a perfectly neutral  solution being thus obtained,
by the immediate conversion of the newly formed  iodide into the
hydriodate of the protoxide, no subsequent change takes place so
long as the  solution is kept secluded from the  light.   The best
proportions, according to Dr. Thomson, for forming the medicinal
solution, are three  grains of the dry solid iodide to each fluidram
of distilled  water.  If the water be not either distilled or filtered
rain  water,  perfectly  free  from foreign ingredients, and particu-
larly if it contain  any earthy or saline carbonates, decomposition
instantly takes place, iodine is extricated, and a carbonate of iron,
which  rapidly passes into the state of a peroxide of that metal, is
precipitated.
   To  protect  the  solution of iodide from decomposition, it has
been advised to associate it with sugar, w7hich  appears  to  exert
the same protective  agency  as it  does on  the protocarbonate.
With this view, the following preparation has been proposed by
Mr.  Procter.1  Take of Iodine, eleven drams; Iron filings, four
drams; Syrup, Uncrystallizable  honey, or Uncrystallizable
sugar, four ounces; Distilled water, a sufficient quantity.  Mix
the  iodine  with  eight  fluidounces  of the distilled  water, and
gradually add  the  iron  filings, stirring  constantly; then apply a
gentle  heat  until the solution shall  have acquired a light green
colour, or shall not give a blue colour to a solution  of starch; then
add whichever of  the three protecting saccharine substances may
be chosen; continue the heat a short time and filter. Lastly, wash
the filter with as much distilled water as will make sixteen fluid-
ounces of solution of iodide of iron.
   Liquor  Ferri Iodidi, or  Solution of Iodide  of Iron of the
last  edition  of the  Pharmacopoeia of the United  States (1842,) is
essentially the  same as this.   The  saccharine matter employed in
it is  prepared  honey.   The solution, thus obtained, is of a  pale-
greenish colour.  It has little or no sediment.
   M.  Oberdorffer, of Hamburg,2 gives the following form for the
preparation  of the sesqui-iodide of iron; whose effects, and mode
of administration  are the same as those of the iodide.   It may
be preserved a long time without undergoing decomposition. Mix
in a  glass vessel  half an ounce of iodine; a dram and a half of
iron filings;  and an  ounce of water.  When the reaction is com-
pleted, the  mixture is to be slightly  shaken, until it becomes of a
clear green  colour, which is due to the iodide of iron.   It is then
diluted with four  ounces  of  water, filtered,  and  some water  is
passed through.the filter.   To the  solution two drams of iodine
are afterwards added, which  are readily dissolved.  A deep red-
dish-brown  liquid  results, to which a sufficient quantity of water

  1 American Journal of Pharmacy, for July, 1840, p. 13; and Ibid, for January, 1841,
p. 323.
  a Zeitschrift fiir die gesammte Medicin. Juin, 1840, 
FERRI IODIDUM.
353
is added to make the weight of the whole ten ounces.  Each dram
contains about four grains and a half of iodine.
  When iodide of iron is carefully prepared, it is of an iron-gray
colour,  foliated texture, brittle, and exhibits a crystalline arrange-
ment similar to metallic antimony, except that  it  is darker.   In
the dry state, it is inodorous; but, when  moist, it smells somewhat
of iodine:  the  taste, when  dry, is simply styptic; when moist,
somewhat  acrid, before it  impresses the  gustatory organs.   At
350° of Fahrenheit it fuses; and, at a higher temperature, is de-
composed—the  iodine being volatilized, and the iron  remaining
in the state of  oxide.  It dissolves in all proportions in water,—
the changes supervening, which have been already indicated.  It
is  decomposed  by  chlorine, the mineral  acids,  oxide of arsenic,
meconic acid—consequently  by opium  and laudanum—gallic  and
tannic acids,  the pure and carbonated alkalies, different metallic
salts, and  by the infusions of digitalis, belladonna, hyoscyamus,
tobacco, amylaceous substances,  &c.:   such articles  ought  not,
therefore, to  be given in combination with it.

           EFFECTS ON THE ECONOMY IN  HEALTH.
   From experiments made on his own person, Dr. Thomson states
the following  to  be the physiological  effects of  iodide of  iron.
When taken in doses of from  three to  five grains, it makes no
sensible impression  on the  stomach,  although  it sharpens  the
appetite, and improves the digestive function : it seems  to stimu-
late moderately the  digestive canal through its entire length ; for
it opens the bowels; and, whilst  it  produces the black  colour of
the alvine discharges, characteristic of all the preparations of iron,
it corrects  their fcetor.   When it does  not  affect  the bowels, it
augments the action of  the  kidneys, increasing the  flow  of urine;
and if the solution  be taken two or three times a day, for several
days in  succession,  the presence of both  the  iodine and the  iron
can  be  readily  detected in  the urine.   The temperature of the
skin is  moderately elevated, and  the  insensible perspiration in-
creased.  On one occasion,  having taken ten grains for  a dose, it
almost immediately caused an uneasy sensation at the epigastrium,
accompanied with nausea, that continued for several hours, and a
slight degree of headach.   These symptoms were relieved  by a
copious evacuation, which was perfectly black.   Two hours after
taking  the medicine, a large quantity of  urine  was discharged;
which,  on being tested, displayed the presence of both iodine and
iron.  The experiments on  animals, made by Dr. Cogswell,1 in-
duced him  to infer:—1. That it acts as a local stimulant, possess-
ing the  power of affecting peculiar disorganization.—2. That its
action is more particularly directed  to  the tract of  the alimentary
canal.
              1 Essay on Iodine, p. 132.  Edinburgh, 1837. 
354
FERRI IODIDUM.
  When added to blood out of the body, it promotes its coagula-
tion.1
           EFFECTS ON THE ECONOMY IN DISEASE.
  From the chemical composition  of iodide of iron, Dr. Thomson
considered it might  be specially adapted for  cases in which aug-
mented activity of  the  capillary or  intermediate system, with a
tonic effect,  might  be  indicated, and  particularly in scrofulous
affections, tabes  mesenterica, chlorosis,  incipient scirrhus,
rickets, amenorrhcea, bronchocele,  atonic  dyspepsia,—indeed
in all cases accompanied  by debility.   In such affections, he con-
ceives the iodide will  act more  efficiently  than any  of the other
preparations of iron. In secondary syphilis, it may be combined,
he suggests,  with iodide of potassium; and  in incipient cancer,
its efficacy is aided  by the administration of arsenic  at  the same
time.   Dr. Thomson has found it serviceable in atonic gastric
dyspepsia, when combined with bicarbonate of potassa, and taken
at the moment of admixture, in the dose of from  three  to eight
grains or more.2  A great advantage it possesses is its ready solu-
bility, owing to which  it  can enter the circulatory system with
facility, and  modify the condition of the fluids.   In chronic scro-
fulous cases, it produces all the good  effects of the preparations
of iron, without any of the concomitant and subsequent symptoms
that are so apt to supervene, especially in  impressible individuals.
Where the case is  accompanied by  vascular  erethism, or fulness,
it must be reduced before the iodide  can be esteemed  appropriate.
In chlorosis, occurring in strumous habits, it has been found
most serviceable.   Dr. Ashwell3 prescribed it with success in such
cases, in association with  colomba  or gentian,  according to the
formula given hereafter.   Its efficacy in cancer is  elucidated by
Dr.  Thomson, by the details  of a case of  scirrhous mamma,
which, after protracted and fruitless treatment by other agents—
as by other preparations of iron combined with conium—ultimately
yielded  to a combination  of  iodide of  iron  and conium.  Some
cases are also detailed in which  it was very effective  in  removing
old syphilitic affections, especially  of the skin.   M. Baumes,*
who employed the iodide with the most satisfactory results in old
and obstinate syphilitic ulcers, especially when the patient was
feeble and scrofulous, gave it in the form of  pills with extract of
opium,—increasing the dose of  the  iodide from  two or three  to
twelve or twenty grains in the twenty-four hours.   Along with
the  cicatrization  of the sores,  the  improvement of the general
health was most remarkable.
  1 Magendie, Lecons sur le Sang, &c.; or translation in the Lancet,  Jan. 26, 1839.
  3 London Dispensatory, and Brande's Dictionary of Mat. Med., p. 252. Lond., 1839.
See, also, Solon, in Diet, de  Med. et de Chirurg. Pratiq., art. lode;  and  Ashwell, in
 Guy's Hospital  Reports, pt. i. 128; and pt. iii. 555.
  3 A Practical Treatise on the Diseases Peculiar to Women, American edit., p. 32.
Philad., 1845.                    * Medico-Chirurgical Rev., Oct., 1840. 
FERRI IODIDUM.
355
  Prior to the publication of Thomson, Pierquin had given the io-
dine in cases of leucorrhoea, and amenorrhcea ; and Eager1 had
recommended it in scrofula.   Ricord2 found the very best effects
from its internal use in cases where tonics required to be combined
with antisyphilitic remedies, especially where any scrofulous vice
[lymphatisme) constituted a complication.  He administered it,
likewise,  with  great success,  to  remove  the  consequences of
syphilis;  and found  it advantageous in atonic ulcers of the legs,
and in spreading ulcers of the throat, which had been aggra-
vated or had not yielded to mercury.  The strength of M.Ricord's
solution was half a dram of the iodide to |viij. of water, given,
we presume, in the twenty-four  hours.  M. Ricord3 also uses it in
the form of injection  in cases of  blennorrhcea:  wherever, indeed,
tonic astringent injections are needed, the  iodide, in his opinion,
should  occupy the first  rank.   Its use,  he thinks, can only be
contraindicated when there is much inflammation or pain in pass-
ing the urine, or when cystitis  exists.  The  strength  of the in-
jection should be  three grains to the fluidounce of water.
   In consequence of its  promoting the coagulation of the  blood
 out of  the body,  Magendie4 prescribed it  in the form of injection
 (f 3L to Oij. of water,) several times a  day in a case of severe
 uterine hemorrhage.   The hemorrhage ceased.
   A case  of confirmed diabetes5 was treated in  the  Hotel-Dieu of
 Paris, by  the iodide given in the form of  pill, each pill containing
 five grains.   Four pills were taken in the twenty-four hours.  In
 this  case, the iodide  must have  been efficacious, for the usual
 animal diet recommended in such cases had failed previously to do
 good, until the iodide was associated with it.
   It has likewise afforded apparent benefit in cases of tubercular
phthisis,  and in  the mass of  such cases is as well adapted for
 modifying the morbid action of  the system of nutrition, so deeply
 implicated in that fatal  malady, as any other agent, with the ex-
 ception, perhaps, of  cod liver oil.  The syrup is the best prepara-
 tion.
    Dr.  C.  J. B. Williams6  considers  the  iodide to answer better
 than any other  chalybeate in  chorea.   It pervades  the system
 more rapidly, he thinks, and keeps the secretions more free.  He
 gives it in doses of one  grain three times a day, increased to four
 or five grains, taking care, at the same time, that the bowels are
 open.

   1 Dublin Joum. of Med. Science, 1834; also, Cogswell on Iodine, p. 138. Edinb. 1837.
   * J. J. L. Rattier, in La Lancette Francaise, 4 Fev., 1837.
   3 J. J. L. Rattier, Ibid.  16 Fev., 1837; see, also, Revue Medicale, Janvier, 1838,
 cited in Amer. Med. Intel., Sept. 15, 1838.                     * Op. cit.
   * Cited in Provincial Med. and Surg.  Journal, Nov. 5,1842. The results obtained
 in the Hotel-Dieu are referred to in London Lancet, July 8, 1843, p. 517; see, also,
 M Boissiere, Gazette Med.de Paris, 24  Dec, 1842;  cited in  Amer. Journ. of the Med.
 Sciences, April, 1843, p. 454.         6 Medical Times, May 24, 1845, p. 133. 
356
FERRI IODIDUM.
  Mr. B. Phillips1 prefers it in scrofula to any of the preparations
of iodine.  The minimum dose was a grain twice a day; the max-
imum, three grains, three times a day.  In 232 cases, it was only
necessary to  intermit  its use for a few days in three cases.   In
one, it excited  ptyalism.  About once a week he gave an aperient
or cathartic.   In cases of scrofulous ulceration, as a consequence
of abscess, or from other causey, he employed, with the best effect,
a lotion containing  three or four grains of the  iodide to an ounce
of distilled water.  Where  parts are irritable, he  usually recom-
mends the ointment of iodine to be applied to the part on lint.
  Stauss2 gives the case of  a young female affected with ascites,
hydrothorax and anasarca, who had been tapped for the ascites,
and had taken gratiola  and lactuca virosa without  any benefit,
who was cured by a  mixture  of  Tinctura ferri iodid., Tinct.
cort. aurant. aa. 3ij., and  Aq. flor. aurantior. gij., of which a
spoonful was given four times a day.  Under this, the status
hydropicus  disappeared.
   The author  has  frequently given  this  remedy in public  and
private practice, and has considered it especially adapted for those
cases in which there appears to  be torpor in  the system of nu-
trition, as in asthenic dropsy, old visceral engorgements, and
indeed  of hypertrophy  of any  kind,  accompanied by defi-
cient action in the system of nutrition.  In oligaemia, where
there is paucity of red  corpuscles of the blood, and the fluid is alto-
gether too thin, it would seem  to be especially indicated, from  its
property, mentioned above, of promoting the coagulation of the
blood, and, therefore, of inspissating  it.   Hence, in all cases of
scorbutic, hydropic and other dyscrasies, and in hemorrhages
occurring in such pathological conditions, the author has pre-
scribed it largely, and with excellent effects.   It appears to him
to be the best remedy we possess wherever a eutrophic and tonic
is indicated.
                 MODE  OF ADMINISTRATION.
   The dose of iodide of iron, administered in the  cases above
referred to was generally three or four grains two or three times
a day.
                    Pilula; ferri  iodidi.
                    Pills  of iodide of iron.
   These pills may be  prepared in the following manner, according
to a formula communicated by Mr. Robert  Leslie, of  Glasgow, to
Dr. Christison of Edinburgh.3  Take of iodine, 127  grains;  iron

  1 London Med. Gazette, Jan. 10, 1840; see, also, Scrofula; its Nature, Causes, &c.
by B. Phillips, F. R. S., Amer. edit, p. 248.  Philad. 1846.
   2 Casper, Wochenschrift, No. 24, cited in Canstatt und Eisenmann's Jahresbericht
iiber die Fortschritte in der Heilkunde im Jahre 1848, V. 13c.
  3 Pharmaceut. Transact., Aug. 1, 1844, p. 79. 
FERRI IODIDUM.
357
 wire, of about the thickness of a thin quill, half an  ounce; dis-
 tilled water, 75 minims.  Agitate them briskly together in a strong
 ounce phial provided with a well fitted glass  stopper, until the
 froth which forms becomes white.   This will happen in less than
 ten minutes.  Pour the liquid upon  two drams of finely powdered
 loaf sugar in a little water, and triturate immediately and briskly
 for a few minutes;  add gradually a mixture of the following pow-
 ders,—liquorice powder, half an ounce; powder of gum Arabic, a
 dram and a  half; flour, a dram>  Divide the mass into 144 pills.
 Each pill will contain about a grain  of iodide of iron.

                     Vinum ferri  iodidi,
                     Wine of iodide of iron.
                      R.  Ferri iodidi ^ss.
                          Vin Bordgalens. Oj.  M.
   Dose.—A tea-spoonful, morning and evening.

                   Tinctura ferri iodidi.
                  Tincture of iodide of iron.
                  R.  Ferri iodidi £ij.
                      Alcohol is,
                      Aquee, aa. f Jij.  M.
   Dose.—A tea-spoonful, morning and evening.

             Mistura ferri  iodidi  composita.
           Compound  mixture of iodide  of iron.
                R.  Ferri iodidi gr. xvj.
                    Tinct. colomb. seu
                    ------gentians comp. f ^j.
                    Aquas destillat. f gvij.  M.
   Dose.—Two table-spoonfuls two or three times a day.
                                                   Ashwell.
                    Syrupus ferri  iodidi.
                  Syrup  of iodide of iron.
   Various forms  have been given  for  this  preparation.0   The
following is  the one admitted into the last  edition of the  Edin-
burgh Pharmacopoeia:—Take of Iodine (dry,) 200 grains;  Fine
iron wire, recently cleaned, 100  grains; White sugar in powder,
four ounces and a half; Distilled water, six fluidounces.  Boil the
iodine, iron and water together in a glass matrass, at first gently,
to avoid the expulsion of  iodine vapour, afterwards  briskly till
about two fluidounces remain.   Filter this quickly, while hot, into

  1 Journal de Chimie Medicale, p. 310, Mai, 1831.
  2 Frederking, Repertor. fiir die Pharmacie, 1839, cited in Amer. Journ. Med. Sciences,
Feb. 1840, p.499; Dupasquier, Journ. de Pharm. Mars, 1841, p. 116, and Mars, 1842,
p. 225; F. Boudet, ibid. Sept. 1841, p. 335;  Beral. Journ. de  Chim. Med. cited in Amer.
Joum. of Pharmacy, April, 1841, p.74; A.T.Thomson, Lond. Pharmac. Transactions,
Aug. 1841; and Leistner, Joum. de Pharmacie, Fevrier, 1842, p. 122.
Pierquin?
Pierquin. 
358
FERRI IODIDUM.
a matrass containing the  sugar; dissolve the sugar with a gentle
heat, and add distilled water to make up six fluidounces.
   Twelve minims of this syrup  contain one grain of the iodide.
It ought to be nearly colourless or pale yellowish-green, and with-
out sediment.  Dr. Christison states, that it will always be defect-
ive in strength "when made with British iodine, as now commonly
met with in  the market, unless allowance  be made for the water,
which it very generally contains in large proportion."1

                    Troehisci  ferri  iodidi.
                 Lozenges of iodide of iron.
                  R.  Ferri iodidi gss.
                      Croci pulv.  sp'j.
                      Sacchar. ^iv.
                M. fiant troehisci No. 120.
   Dose.—Six to ten, daily.                         Pierquin.
                     Solutio  ferri iodidi.
                  Solution of iodide of iron.
                 (French, Eau d*Hydriodate de Fer.)
                  R.  Ferri iodidi gss.
                      Aquas Oij.  M.
   Added to enemata, lotions and injections.
                  R.  Ferri iodidi ^ss. ad ^ij.
                      Aquae destillat. Oj.  M.
   To be added to a general bath in cases  of leucorrhoea, amenor-
 rhcea, &c.
                     Injectio  ferri  iodidi.
                  Injection of iodide of iron.
                  R. Ferri iodid. gr. iij.
                      Aquse destillat. f %v\.  M.
    The quantity may be  increased  to  nine grains  to the ounce of
 water, care being taken  to avoid irritation.
    Used in gonorrhoea.                                Ricord.2
                    Unguentum  ferri iodidi.
                  Ointment of iodide of iron.
                R. Ferri iodidi ^iss.
                     Adipis §j.  M. ut fiat unguentum.
    A piece the size  of a hazelnut to be rubbed, morning and even-
 ing, on the inner  part of the  thigh,  in cases of  leucorrhoea  and
 amenorrhcea.
   ' Dispensatory, p. 431. Edinb. 1842.
   * A Practical Treatise on Venereal Diseases, translated by Drummond, Amer. edit. p.
 237,249. Philad. 1843. 
FERRI LACT AS.
359
                 LXXXVI. FERRI  LACTAS.
Synonymes.  Ferrum lacticum, Lactas ferrosus, Lactate of Iron, Lactate
  of Protoxide of Iron.
French.  Lactate de Fer.
German. Milchsaures Eisenoxyd, MilchsauresEisenoxydul.
•  This preparation was recommended by MM. Gelis and Conte,
internes at La Charite, in  Paris, and has been favourably reported
upon by M. Bouillaud, in  the name of a committee, consisting of
MM. Bally, Fouquier, and Bouillaud.1
                   METHOD OF PREPARING.
  MM. Gelis and Conte prepare lactate of iron by treating pure
iron filings with lactic acid, diluted with water.  M. Louradour2
extracts lactic acid from whey, which he collects from the dairies
in the neighbourhood of Paris, where  much cheese is made.   The
whey, exposed a long time to fermentation under the influence of
an  elevated  temperature,  becomes charged with a  large quantity
of lactic acid.   It is evaporated to one-third  or one-fourth of its
volume, decanted and  filtered;  and is  then saturated with milk of
lime, which  produces  an abundant deposit, chiefly of phosphate of
lime.  The  filtered solution is precipitated  by oxalic acid,  and
again filtered, and then concentrated to a syrupy consistence.   It
is now diluted  with alcohol, which precipitates the lactine and the
salts.  The solution, on being filtered,  and the alcohol distilled  off,
yields pure lactic acid.  Lactate of protoxide of iron is pre-
pared by digesting in a sand-bath, at a low temperature, this acid,
diluted  with  water, upon iron filings.  At the end of six or seven
hours of reaction, the  liquid is  boiled, filtered, and concentrated;
when, on cooling, it deposits crystals.   These crystals, drained on
a funnel, and  washed with alcohol  by displacement, should be
dried rapidly, and  be  preserved from any contact with air.   The
salt presents itself under the form of  crystalline plates, which are
very white, and but slightly alterable.   It is sparingly soluble in
water;  reddens litmus  paper, and possesses the ferruginous taste in
a tolerable degree.  When dissolved in water, it attracts oxygen,
and quickly  becomes yellow.
  The sparing solubility of the lactate  has permitted M. Loura-
dour to simplify still more  his process, by omitting the purification
of lactic  acid by alcohol, and  treating it immediately with iron
filings: the liquor, suitably evaporated, affords  crystals of the
lactate: the foreign salts  and  the lactine remain  in  the  mother
waters, which are rejected.

  1 Journal de Pharmacie, cited in Amer. Journal  of Pharmacy, July, 1840, p. 121. See,
also, Beral, Journ. de Chimie Medicale, cited in Amer. Journ. of Pharm. April, 1841, p.
74;  and Gelis and Conte, in Bouchardat,  Annuaire de Therapeutique pour 1848, p.
166.  Paris, 1848.
  " Bulletin General de Therapeutique, Mars, 1840. 
360
FERRI LACTAS.
   As the lactate would  seem  to be often adulterated with efflo-
resced sulphate of iron,  or the same precipitated with alcohol, or
with starch or sugar of milk, M. Louradour recommends, that no
lactate should be used except what is under the form of crystalline
plates, which do not readily admit of fraud.1

                  EFFECTS ON THE ECONOMY.
   Lactate of iron has been used in cases in which protocarbonate
of iron  is employed, and chiefly in chlorosis.  MM. Gelis  and
Conte are  disposed  to  refer the beneficial agency of the proto-
carbonate to  its becoming lactate of iron in  the stomach, by
uniting  with the lactic  acid, which has been presumed to be one
of the healthy gastric acids.   This idea led them to administer
lactate of iron ready formed.   In chlorosis  the  remedy  has  been
given  by MM.  Fouquier, Bally, Beau, Rayer, Nonat, Andral,
Bouillaud, Gerdy, Franz, and others, who have collected a great
number  of  cases, which   show  its success in  that disease.2   M.
Bouillaud3  made trial of it in twenty-one cases, fourteen of which
were treated at  La Charite.   One of the last cases not being de-
cidedly chlorotic may be excluded.  Of the thirteen,  ten were
females, and  three  males.   Of  the ten females, eight  presented
well marked chlorosis; two were rather  of anaemia.  The dose was
carried  to six, eight, ten, twelve, and  fifteen lozenges, each con-
taining about five centigrammes of the  salt (gr.  f) in the'twenty-
four hours.    It was well borne, and always sensibly increased the
appetite; but, as Mialhe4 and Pereira5  remark, there seems to be
no evidence of its superiority over the citrate or  tartrate  of iron.

                  MODE  OF ADMINISTRATION.
   MM.  Gelis and Conte form freshly prepared lactate of iron into
lozenges, in which the  sugar prevents  the superoxidation of the
iron, and preserves the medicine; whilst, at the same time, a form
is given, which  allows of great facility of administration.  MM.
Andral  and  Fouquier seldom exceed twelve grains of the lactate
in twenty-four hours; and M.  Bouillaud never  gives  more  than
twenty.
   The following formula; have been proposed by Mr. Cap:6

  1 Journ.de Pharmacie, and Amer. Joum. of Pharmacy. Oct. 1840, p. 230. Wohler's
process is given by Christison,Dispensatory, Amer. edit, by R. E. Griffith, p. 978. Philad.
1848.  F. Roder's process, which resembles it, is given in Dierbach. Die neuesten Ent-
deckungen in der Mat. Med. 3er Band. 2te Abth. S. 856.  Heidelb. und Leipz. 1847.
See, also, on this subject, Dispensatory of the United States, 8th edit. p. 1278.  Philad.
1849.
  2 Bulletin Gen6ral de Therapeutique, Mars, 1840; also, La Lancette Francaise, cited
in London Lancet, Feb. 8, 1840, p. 707.
  * Encyclographie des Sciences Medicales, Mars, 1840, p. 226.  Academie Royale de
Medecine de Paris, Seance  du 4  Fevrier, 1840.
  4 Traite de l'Art. de formuler,  p 184.  Paris, 1845.
  • Elements of Mat.  Med. and Therap. 3d edit. i. 790. Lond. 1849.
  * Journal de Pharmacie, and Amer. Journ. of Pharmacy, Oct. 1840, p. 228. 
FERRI NITRAS.
361
                  Troehisci  ferri  lactatis.
                   Lozenges of lactate of iron.
            R.  Ferri lactat. gvij. gr. 43 (30 grammes.)
                Sacchar. gxiss. (360 grammes.)
                Mucilag. acaciae q. s.
   Make into lozenges, each weighing gr. x. (65 centigrammes}
which will contain gr. I (5 centigrammes) of the salt.

                   Syrnpns  ferri lactatis.
                  Syrup  of lactate  of iron.
            R.  Ferri lactat. ^i. (4 grammes.)
                Aquse destillat. bullient. ^viss. (200 grammes.)
                Sacchar. alb. Jxiij. (400 grammes.)
   M.  Cap considers the  use of this syrup to be more  convenient
than  that of the  lozenges, because the ferruginous taste does not
remain so long in the mouth.

                    Pilulae  ferri  lactatis.
                    Pills of lactate of iron.
            R.  Ferri lactat.
                Althaeas pulv. aa. gr. xvss. {Igramme.)
                Mellis q. s. ut fiant pil. xx.
   Chalybeate bread has been  administered  in  one of the largest
hospitals of Paris  to chlorotic patients, and with the best effects.
From four to five grains of lactate of iron may be mixed with every
three  and a  half ounces of bread, without giving it any unpleasant
taste or injuring its quality.1
                LXXXVII. FERRI NITRAS.

Synonymes. Ferri Pernitras, Ferrum Nitratum seu Nitricum Oxydatum,
  Nitras Ferri, Nitras Ferricus, Nitrate of Iron, Pernitrate of Iron.
French. Nitrate de Fer.
German. Salpetersaures Eisenoxyd.

             LIQUOR FERRI PERSESQUINITRA'TIS.
Synonymes. Liquor  seu  Solutio  Nitratis  seu  Pernitratis Ferri, Liquor
  Ferri Nitrici Oxydati, Solution of Persesquinitrate of Iron, Solution of
  Nitrate of Iron.
                   METHOD OF PREPARING.
   This preparation, which has been introduced of late years into
practice, may be formed in the following manner:
   Take of small chips or pieces of Iron wire, an ounce and a half;
Nitric acid,  three  ounces  by measure; Water,  twenty-seven
ounces; Muriatic acid, one dram.  Put the iron into an earthen-
ware vessel,  and pour  on the nitric acid,  previously diluted with
fifteen ounces of the water.  Set the vessel aside till the whole of

            ' Provincial Medical and Surgical Journal, June, 1841. 
362
FERRI NITRAS.
the acid has united with the iron, so as to form a persesquinitrate;
then  decant  the liquid  from  the portion of iron, which remains
undissolved;  strain, and filter.   Add the muriatic acid wTith the
remainder of the water, or with as much of that liquid as will in-
crease the whole solution to  thirty ounces.  When the process is
finished—which  takes  some hours—the liquid has a red  colour,
so  dark, that  when viewed  by  reflected light, it seems almost
black.
  Three ounces of nitric acid of the usual strength (1.4) generally
dissolve an ounce of iron, so  that when  the process is completed,
a portion of the  metal remains  undissolved.   The solution then
consists  entirely of  persesquinitrate of iron ; and, if speedily
decanted, it  may be preserved in that  state;  but if allowed to
stand for a few hours longer on the iron, it will undergo a farther
change, becoming gradually converted into pernitrate and protoni-
trate  of  iron.   The first  of these  is insoluble, and  render's the
liquid turbid;  and the latter,  which remains dissolved has not the
medicinal properties  that  render  the  persesquinitrate valuable.
When the  solution contains  nothing but nitric  acid and peroxide
of iron, it slowly undergoes decomposition on standing, so that, at
the end of a few weeks, the whole liquid  begins  to  become tur-
bid.  The addition of some  muriatic  acid  prevents  this  decom-
position, and the quantity sufficient for  this purpose  is  too  small
to affect  the medicinal powers of the persesquinitrate.   The solu-
tion, when properly  prepared, is of a beautiful dark  red  colour,
when viewed with transmitted light.  Its taste is very astringent,
and not at all caustic.1
   A formula, since given by Mr. Kerr, is the following.   Take of
Iron wire, (No. 17,) one ounce; nitric acid, three fluidounces;
water, fifty-seven  ounces;  muriatic  acid,  a dram.   Mix the
nitric acid with fifteen ounces of water in an earthen vessel, capa-
ble of holding three or four times the quantity.  Put  into this the
iron wire broken into a number of pieces: cover the vessel lightly.
In eight or twelve  hours, the solution must be poured off, and the
remainder of the water, with  the  muriatic acid, be added.
  The formula admitted into the last edition of the Dublin Phar-
macopoeia2 is the following.   Take  of  fine Iron wire, free from
rust, ?j, (avoirdupois;) pure  nitric acid, three fluidounces; dis-
tilled water, a sufficient quantity.  Into the acid first diluted with
§xyj. of the water introduce the  iron wire, and leave  them in con-
tact until gas  ceases to be disengaged.   Filter, and add as much
water as will make the bulk one pint and a half, (f ^xxx.)

  1 Kerr, in American Journal of the  Medical Sciences, for May, 1832, cited from the
Edinb. Med. and Surg. Journal.
  a The Pharmacopoeia of the King and Queen's College of Physicians in Ireland, 1850,
p. 88.  Dublin, 1850. 
FERRI NITRAS.                    363
                 EFFECTS ON THE ECONOMY.
  This  preparation greatly resembles solution of chloride of iron
in its medicinal properties.  Mr. Kerr considers, that to  an as-
tringent power it unites that of diminishing the irritability  and
tenderness of the mucous membranes with which it comes in
contact; and, of late, he has called attention to it as a remedy in
cholera.1  In chronic diarrhoea an experience of eighteen years
has proved its great value;  but he has not found it serviceable
where ulceration of the bowels is present; and, therefore, he thinks
it not applicable in the diarrhoea of phthisis.   Kopp adminis-
tered it with the greatest success in many cases of chronic diar-
rhoea, that had resisted every approved remedy.   The faeces were
blackened  by it, as by  the preparations of iron  in general.  He
remarks that it must  be continued for some time.  The dose he
gave was  ten drops  several times a  day in  oatmeal gruel, and
this was gradually raised to twenty and twenty-five drops.  When
the cure was accomplished, the remedy was gradually diminished,
until it was left  off altogether.2  Dr. Graves3 speaks  in equally
high terms of the persesquinitrate  in these cases; and Dr. T. C.
Adam,  of  Lenawee County, Michigan, has recorded  the  remark-
able  assistance which he  has derived from its use  in  the"treat-
ment of several  diseases,  especially diarrhoea and  other  affec-
tions of the mucous membranes accompanied by discharges.4
In chronic diarrhoea, depending mainly  on an excess in the sen-
sibility  of the organic nerves which  supply the digestive  tube,
Dr.  Adam rarely  orders less than fifteen  drops  at the commence-
ment, and after  a few days' employment of the remedy, he in-
creases  the  quantity to twenty,  twenty-five, and  thirty drops.
In leucorrhoea, occurring  in such as are pale, exanguious, feeble,
and  languid, the internal, conjoined with  the  external, use of the
persesquinitrate has  been  found very advantageous.  In  these
cases, Dr.  Adam adds such a quantity of water  as  a diluent as
will still leave in  the vagina a gentle  degree of heat or smarting.
Dr.  Adam recommends it, also, in cases of aphthous sores; and
he  affirms  that its application  has afforded  relief  in toothach.
Dr.  J.W.Williams5 employed it successfully in the diarrhoea and
intestinal hemorrhage of typhoid fever.
   Mr. Kerr gave it in a case of urticaria, which yielded speedily,
after having resisted  other remedies.  He found it also potent in
allaying hiccough.
   It is, doubtless, a powerful  astringent, but it is questionable
whether it possesses any advantage over the tincture of chloride of
iron.
      1 Monthly Journal of Med. Science, Jan. 1848.
      2 See,  also. Twining on the Diseases of India, i. 217.  Calcutta. 1835.
      3 Clinical Lectures, Amer. Med. Library edition, p. 128.  Philad. 1838.
      * Amer. Journal of the Medical Sciences, May, lb39, pv61.
      ■ Boston Med. and Surg. Journal, April 7,  1841. 
364
FERRI OXIDUM HYDRATUM.
           LXXXVIII. FERRI  OXIDUM  HYDRATUM.
  Synonymes. Ferri Sesquioxidum Hydratum, Ferrugo, Hydras Ferricugj
    Ferrum Oxydatum Hydratum, F.'O. Hydricum, Oxidum Ferri seu Ferri-
    cum Hydratum, Hydro-oxide of Iron,  Hydroxide of Iron,  Hydrated
    Oxide of Iron, Hydrated Peroxide of Iron, Hydrated Tritoxide of Iron,
    Hydrated Sesquioxide of Iron, Oxyhydrate of Iron.
  German.  Ei s e n o xy dhy dr a t, Wa sserhal tige s Eisenoxyd.

    Hydrated  oxide of iron has  been introduced into practice as an
  antidote to white arsenic.  Dr. Bunsen, of Gottingen, had already
  made frequent experiments with it,  which satisfied him, that it was
  an efficacious agent; but, along wTith  Dr. Berthold,1 he subjected
  it to fresh trials.  The results of their investigations were published,
  and since then it  has received attention every  where.
                      METHOD OF PREPARING.
    The  best  mode of preparing it, according to Dr. Bunsen, is  to
  take  a solution of pure sulphate of iron, increase the dose of oxy-
  gen by treating it with nitric  acid, and precipitate the oxide by
  adding pure ammonia in excess,—washing the precipitate.  In or-
  der not to  deprive the precipitate  of its water, and to diminish its
, loose state of aggregation as  little as possible,  it is not filtered, but
 is put aside for a few days, until  the precipitate  is wholly deposit-
  ed, after which  the  supernatant fluid is poured off.  It is then kept
 in well-stopped vessels.
    Riecke2  has added the formula for  pharmaciens,  which is re-
 commended by Von Specz:—
   R.  Vitrioli ferri puri crystallizati libram; teratur in pulv. subtiliss. et
 detur in vas. porcellan. aut murrhinum, impositum balneo arenas ; dein
 adde acidi nitrici  concentrati lbss.; terantur ope baculi vitrei usque dum
 massa resolvitur in pultem; nunc, igne animato, massse pultacese calidae
 affunde sensim terendo, sensim  acid,  nitric, concentrat. q.  s. donee nullum
 amplius evolvatur gas nitrosum.  Massa  tunc leni  igne  evaporetur ad
 siccitatem et solvatur demum in aq.destill. q. s.; solutioni filtratae instil-
 letur ammoniae pura q. s. donee praecipitatio cesset;  stent  nunc per horam
 unam alteramve et liquor limpid us a sedimento bruneo decantetur; mas-
 sa3 residua? fundum petenti adfunde aq. destillat. lbiij. et agitentur; nunc
 filtra, et praecipitatum in filtro aq. destill.  q. s. edulcora donee aqua in-
 sipida defluat.  Prsecipitatum bene edulcoratum in umbr& siccatum con-
 vertat. in  pulv. subtilissim. qui servetur vase vitreo bene clauso.3
   1 Das Eisenoxydhydrat ein Gegengift der arsenigen Siiure.  Gdtting. 1834.
   a Die neuern Arzneimittel, S.  227.  Stuttgart, 1837.
   3 " Take  of pure crystallized sulphate of iron a pound; rub it into a subtle pow-
 der, and place  it in a porcelain or glass vessel in a sand-bath;  then add half a pound of
 concentrated nitric acid; stir them with a glass rod until the  mass is resolved into a soft
 paste ; then—the fire being raised—pour gradually on the hot pultaceous mass concen-
 trated nitric acid, until no more nitrous gas is evolved. Let the mass be evaporated by
 a gentle heat to dryness, and at last be dissolved in a sufficient quantity of distilled water.
 Into the filtered solution drop pure ammonia so long as any precipitate occurs; let it now
 stand for an hour or two, and then pour off the limpid liquor from the brown sediment.
 On the residuary  mass remaining at the bottom, pour three pounds of distilled water, and
 shake them together: filter and wash the precipitate on the filter with distilled water, until
 the water is tasteless.  The well-washed precipitate dried in the shade forms a subtle
 powder, which may be kept in a well closed vessel." 
FERRI OXIDUM HYDRATUM.
365
   Lassaigne advises it to  be prepared as follows:—Take iron
filings; pour gradually upon them four times their weight of the
nitric acid of commerce in small portions.  Heat is thereby deve-
loped, and deutoxide of nitrogen, which is transformed by the atmo-
spheric air into nitrous acid vapours.  When the evolution of gas
has ceased, ten or twelve parts of water are added; the mixture is
then filtered, and ammonia added until the mixture begins to exhi-
bit an alkaline reaction.   The precipitate, thus  formed, is the hy-
drated oxide of iron, which is collected on the  filter, and washed
with boiling water until it is tasteless, and ceases  to exhibit any
alkaline characters.
   The mode of preparation recommended by Majeste, agrees with
this, except that he boils  one part of iron  filings with four of
nitric acid and four of muriatic acid.
   The following form was advised  by the  late Dr. William R.
 Fisher,1 who asserted that  it was  subjected to practice by Mr.
 Durand, an able pharmacien of Philadelphia, who obtained a per-
fect result, with a satisfactory economy of material.  Take of sul-
phuric acid, (67° Baume,) 8 oz. or 16 parts; iron wire, 8 oz. or
 16 parts; ni-iric acid, (49  Baume,)  5|  oz. or 11 parts;  water of
 ammonia, as much as is sufficient; water, a gallon and a half, or
384 parts.   Mix the sulphuric acid with the water in a glass ves-
sel.  Add the iron, and, after the effervescence  has ceased, filter.
Add the nitric acid in  divided portions, and apply heat so" long as
orange-coloured fumes are given off.  To the heated solution, pour
 in the water of  ammonia until a decided excess has been added;
 then wash the precipitate by decantation, until the washings  give
 no precipitate with nitrate of baryta.  The  water is  then to be
 drawn off until just enough remains to give the consistence of thick
 cream.
   It has been supposed  that this preparation  is not injured by
 keeping; but some  careful  experiments by Mr. Wm. Procter,
 Junr.,2 show, that even when kept under water its power of neu-
 tralizing  arsenious acid gradually decreases ; that if kept in the
 form of a thick magma, it will retain its properties longer  than
 when mixed with much water;  and that this decrease of power is
 probably owing to a change in the relative proportion of the ox-
 ide, and  the water chemically combined with it, as well as to an
 alteration in its state of aggregation.  Mr. Procter advises, that
 a ferruginous solution similar to that directed in the United States
 Pharmacopoeia  should be  kept  in  every shop  as a  source for
 obtaining the peroxide;  that  the  solution of ammonia should
 be added  to it when the demand  occurs, and  the peroxide be
 separated in the manner advised  in  the  Pharmacopoeia.  In this
 mode  the first  doses  may be given in ten or fifteen  minutes.  In
          1 American Journal of Pharmacy, vol. vi. No. 1, April, 1840.
          2 Ibid. April, 1842, p. 37.
        24 
366
FERRI OXIDUM HYDRATUM.
the mean time, however, the moist peroxide prepared according
to the  Pharmacopoeia should be given, and if recently prepared
it may be sufficient; but for the reasons adduced by Mr. Procter
it  is advisable that the recent  oxide  should always be adminis-
tered,  especially where  the amount  of  poison taken  has been
large.1
   The form for  this preparation admitted into the last edition of
the Pharmacopoeia of the United States (1842,) is the following:
Take of Sulphate of iron, giv.; Sulphuric acid, f 3iijss.;  Nitric
acid, f 3yj.,  or a sufficient  quantity;  Solution of ammonia, a
sufficient  quantity; Water, Oij.  Dissolve  the sulphate  in  the
water, and, having added  the  sulphuric  ach], boil the solution;
then add  the  nitric acid in small portions, boiling the  liquid  for
a minute  or two after each addition, until the acid ceases to pro-
duce a dark  colour.   Filter the  liquid, allow it to cool, and add
solution of ammonia in excess, stirring the mixture briskly.   Wash
the  precipitate  with  water, until  the washings cease to  yield a
precipitate with chloride of barium, and 'keep it  in close  bottles
with water sufficient to cover it.a
                  EFFECTS ON THE ECONOMY.
   If a solution of arsenious acid  be decomposed by freshly preci-
pitated oxyhydrate of iron suspended in water, traces of arsenic can
no longer be detected in the filtered liquid  made  acid and tested
by a stream of  sulpho-hydric acid gas.  To throw down one part
of arsenic, in this  manner, requires a quantity  of  the   oxyhy-
drate, which  contains at least ten or twelve parts  of oxide  of iron.
Yet,  even where  a  smaller quantity  is employed, the arsenious
acid is almost  wholly separated, as  a  stream of sulphc-hydric
acid  gas  affords  only very slight traces of sulphuret of arsenic
in the  filtered  and acidulated  liquid.  When  the  substances  are
previously heated, or the arsenious  acid  is exposed in small por-
tions to the precipitating agent, the reaction is still slighter. If a
few drops of  ammonia be added to water in which the oxyhydrate
of iron is suspended, and the mixture be digested with finely pow-
dered arsenious acid, an  insoluble arsenite of iron is  formed;  a
circumstance, which would  encourage the belief—even had it not
been sanctioned by experience—that  freshly prepared oxyhydrate
of iron may serve as an antidote to arsenic;—the union between it
and arsenious acid forming—as has been seen— an insoluble com-
 pound, devoid of all poisonous  influence on  the economy, and only
exciting gastric oppression when given in large doses.
   Accurate   microscopical investigation,  in experiments  on  ani-
mals that had taken  arsenious acid in the  solid form mixed with
 the oxyhydrate,  exhibited to the  discoverer of the antidote, that
        1 Procter, loc. citat.
        a Pharmacopoeia of the United States, p. 112.  Philad. 1842.
\ 
FERRI OXIDUM HYDRATUM.
c67
under the influence of animal  heat and the  peristaltic motion, it
had become completely converted into subarseniate of protoxide of
iron, and thus  rendered innocuous.  Such was  the  result of the
observations of Boulet,1 Orfila,  Chevallier,  Lassaigne, Soubeiran
and Miquel,2 Nonat, Borelli and Demaria,3 Lesueur, Boulay, fils,4
Monod,5 Von Specs, Mackenzie,6 D. Maclagan,7 and others.8  On
the other hand, the  experiments of Brett,9 Reginald Orton,10 and
Cramer, were  unfavourable; but  Messrs. Bunsen  and  Berthold
remark, that the experiments of those gentlemen could not be ex-
pected to be successful, as  they were made  with, doses of  arsenic
of from two to nine grains; and the stomach of the rabbit cannot
retain more than from one-ninth to one-half the quantity of the an-
tidote, prepared according to their formula,  which is necessary to
neutralize  that quantity of the poison.11
   Messrs.  Bunsen and Berthold, from the  results they  have ob-
tained, recommend the oxyhydrate as the chief antidote in all cases
of poisoning by arsenic; and they advise emetics to be associated
with  it—along with the agents hitherto employed; first,  when the
quantity of the poison  taken has been considerable, and, therefore,
a very large quantity of the antidote is demanded; secondly, when,
at the same time, substances containing tannic acid, as infusion of
green tea,  or  sulpho-hydric acid  developed after  the   eating of
eggs, may  be suspected in  the alimentary  canal,—as these sub-
stances are closely related  to the antidote, and  may weaken its
action;  and, thirdly, when, prior to taking the poison,the stomach
has been  overloaded with  food, and is, therefore, capable of re-
ceiving only a small quantity of the antidote.  But, whether vomit-
ing may be excited or not, recourse must be had to the oxyhydrate
as speedily as  possible.   Tepid  mucilaginous drinks may  also be
given  to envelop the  particles of arsenic that may exist in the
compartments of the stomach.  If the quantity of the poison taken
be unknown, the  antidote may be  administered in a considerable
dose, and  if  the patient  should  vomit,  it  may be given after-
wards in smaller quantity.   But, if no vomiting should arise, it is
recommended that he should continue to take the oxyhydrate until
the arsenite of iron formed has had time to pass into the  intestinal
tube; and even after this it may be persevered with in small doses
for a time, as portions  of arsenic may possibly remain behind un-
changed.  With the same view, the oxyhydrate may be thrown up
  1 Gaz. Med. de Paris, 1834.
  * Bullet. General de Therap. Dec. 1834.
  3 Br. and For. Med. Rev. April, 1836, p. 594.
  4 Journal Hebdom. des Progres des Sciences Medic. 14  Mara, 1835.
  s Gazette Medicale, 22 Aout, 1835, and Annales d'Hygiene, &c. xiv. 135.
  8 London Lancet, April4, 1840.
  ' Edinb. Med. and Surg. Journal, July, 1840.
  • T. R. Beck, Amer. Journ. of the Medical Sciences, July, 1841, p. 00.
  9 London Medical Gazette, xv. 220.             "^Lancet, Nc.8, 1834.
 " See, also, Maclagan, op. cit 
368               FERRI OXIDUM HYDRATUM.
in the way of clyster, whenever  it is  presumable that the com-
pound, formed by the oxyhydrate and the arsenic, has reached the
lower  portion of the bowels.  To aid  this, cathartics may be ad-
ministered.   Of these, castor oil, which would first suggest itself,
might interfere, it has been  conceived, with the operation of the
antidote.  Sulphate of magnesia, or any of the neutral salts, should
have the preference.
  The antidote may be  given suspended  in water.  Experience
has shown Messrs. Bunsen and Berthold, that from ten to twenty
parts of hydrated oxide of iron are more than sufficient to convert
one part of arsenious acid into the basic salt of iron.
  As the  quantity of arsenic  in  the stomach  and intestines  can
scarcely ever be appreciated, it is  considered by them advisable,
to allow the patient to take as large doses of the oxyhydrate as the
stomach can tolerate; and it is of essential importance that it should
be taken as hot as it can be borne.  When the  arsenious acid  has
been swallowed in the undissolved state—in the form of  powder,
or in  larger or smaller pieces—it is necessary, in  order to aid its
solution, and to effect a  speedy union with the oxide  of iron, to
add a  small quantity of pure  ammonia to the antidote, until a
slight alkaline re-action  is  evinced.  As the ammonia does  not
enter  into  the composition of the salt  formed,  and, consequently,
only plays a secondary part, ten or twenty drops may be sufficient
for the purpose.  In the uncertainty as to the precise quantity of
poison that has been taken,  it has been recommended, that  to an
adult a table-spoonful, and to children a dessert-spoonful should be
given every five or ten minutes until relief from the urgent symp-
toms is obtained.1
  The various experiments  that  have been instituted on  animals
have shown the protective  power of the hydrated oxide: it must
be borne in mind, however, in all such experiments made on dogs,
that they readily reject the  poison by vomiting; but if the poison
be retained in the stomach  by a  ligature passed round the oeso-
phagus, it  exerts its accustomed deleterious  effects.2  It would
seem, also, that the same result occurs if the dose of the arsenic
be too small to  induce  vomiting.  The animal may then die of
the poison.3
  It w7ould appear, that  cases  have occurred,  in which this anti-
dote has saved the lives  of some who  might have been destroyed
without its agency.   Buzorini4 had a case in which about thirty-
five grains of arsenic had been swallowed, and where  it was suc-
cessful, although twenty-four  hours had elapsed since the poison
had been taken;  but this cannot be regarded as very satisfactory,
  1 T. R. Beck, Amer. Journ. of Med. Sciences, July, 1841, p. 95.
  a MM. Miquel and Soubeiran, Bullet. General de Therapeutique, Dec, 1834. See,on
this subject, Dr. Joseph E. Muse in Amer. Med. Intelligencer, for April 2, 1838.
  3 Robert B. Hall, in Amir. Med Intelligencer, for Sept. 15, 1838, p. 181.
  * La Lancette Frangaise, Nov. 17,  1835. 
                   FERRI OXIDUM HYDRATUM.               <J°J

inasmuch as the patient might probably have been saved by ordi-
nary means.   In another case, which was also treated by the anti-
dote at a late period, marked alleviation of the  suffering was in-
duced.   Three cases are related by Majeste, two by Bineau,1 one
by Benoist, and one by Geoffroy2 of Paris, which were treated suc-
cessfully in the same manner.  The subject of the last  was a hair-
dresser,  thirty-five years of age, who, in  a paroxysm of delirium
tremens, swallowed a dram and a  half of  arsenic.   Half an  hour
afterwards, the antidote was given suspended in water.  He drank,
in twelve  hours, all  the hydrated oxide produced by the decom-
position of five ounces and five drams  of the sulphate of iron.  He
had no  violent colic; and, twenty-four hours afterwards, experi-
enced scarcely any uneasiness.  A successful case has,  also, been
related  by Mr. John Robson,  house-surgeon to the  Warrington
Dispensary.3
   Dr. Richard  H. Thomas, of Baltimore,4 has  published  a case,
in which it was believed that twenty grains of  arsenic had  been
taken, which was relieved  by the  hydrated oxide, administered
six hours after the poison was swallowed: there  was no  vomiting;
but thirst,  burning pain, and exquisite tenderness at the epigastrium
existed, denoting  endo-gastritis.  Half a fluidounce  of hydrated
oxide, which was in  the wet state, and about the  consistence of
thick cream, was given in  a tumbler of cool water, and the dose
was  directed to be repeated every ten or fifteen minutes  in  two
ounces of water, eight ounces of  the  suspended  oxide were taken
in the twenty-four hours, after which  the  patient seemed free from
disease.  " The  length of time—six  hours"—says Dr. Thomas,
" before any very severe symptoms  supervened, and  before the
antidote was administered, at first  caused me to think that the
patient  might  have  been  deceived.   Professor Von  Specs, of
Vienna, however, asserts, 'that a drarn of arsenic, in powder, does
not produce  its deadly effect on the system in less than six or
eight hours, while  the  same quantity, dissolved in warm water,
destroys life in a  much  shorter time.'   In the present instance, it
 was  swallowed  in a dry state, covered with sugar.  The prompt
 relief which followed the  exhibition  of the  peroxide is also con-
 firmatory  of the impression that the poison was  really taken."
   A case  has been  published by M. Deville,5 which was treated
by this  remedy, but as the  patient vomited much, and the vomited
matters were not examined, it is doubtful what was its agency.

  i Journal des Connaissances Medico-Chirurgicales, Nov. 1835.
  2 Journal de Med. et de Chirurg. Pratiq. Sept. 1835; cited  in Brit, and For. Med.
Rev., April, 1836, p. 572.
  3 Lond. Med Gaz. Nov. 5,1836.
  4 American Medical Intelligencer, for July 16, 1838, p. 167.
  1 Revue Medicale Francj. et Etrangere, Sept. 1838; see, also, Br. and For. Med. Rev.
and Johnson's Med.-Chir. Rev. for April, 1839; and Amer. Journ. of the Med. Sciences,
May, 1839, p. 243. 
370               FERRI OXIDUM HYDRATUM.
Between five and six hours  elapsed  before it could  be procured.
These remarks apply still more forcibly to a case reported by Dr.
Chaloner,1 the subject of which took  at eight o'clock, p. m. about
half an ounce of arsenic, after which he vomited incessantly, and
did not take the hydrated oxide until three p. m. on the day fol-
lowing.   He got well; and the vomiting appeared to  be relieved
by it.   More recently, several cases of the successful exhibition of
the hydrated  oxide have been  published ; one by M. Ansroul, of
Brussels;2  seven by Puchelt,3 of Heidelberg;  one  by Dr. Mac-
donald;4 one by Dr. Chilton;5 and one by  Dr. Murray,6 of India,
Drs. Smiley and Wallace,7 of Philadelphia,  administered it to a
family  of  eight  persons.  Death  followed  in two cases.   The
antidote could not  be retained by  them, but was rejected  imme-
diately.   In all the other cases,  which  recovered, the symptoms
were mitigated.
   As  recommended  in  the  Pharmacopoeia of the United States,
the hydrated oxide should be kept in the shops, ready  mixed with
a definite quantity of water, in order that it  may be always  at
hand, so as to be administered without delay; and the recommen-
dation is good.   Even if not to be  trusted to alone, the evidence
is quite sufficient to show, that it ought  to be regarded as an im-
portant element  in the treatment of  every case  in which arsenic
has been taken.
   A  commission of the Academie Royale de Medecine/composed
of MM. Deville, Sandras, Nonat and Guibourt, recommend  that
four  ounces of dry hydrated oxide  of  iron,  the subcarbonate of
iron of the shops, or sesquioxide  of iron, should be  suspended  in
twenty-four ounces of water, and a good  glassful of the mixture
be taken every  ten minutes.  After four ounces are consumed,
fresh  doses of the same mixture  may be administered  in like
manner, and the patient  should not  be  considered out of danger,
until he has taken at  least half an ounce of the peroxide for each
grain  of arsenious acid supposed to have remained in the stomach.
   Instead  of pure hydrated oxide, Von Specs9  employed  sub-
stances in which the  peroxide is known  to exist in considerable
quantity, and  which  require no  previous preparation, as rust of
iron, and haematite, (red iron ore,) and, from his experiments, he
is led to conclude that although  these substances  do  not prevent

   1 Medical Examiner, April 18, 1840, p. 251.
   2 Annales de la Societe de Medecine de Gand, Avril, 1840, cited in  Encyclographie
des Sciences Medicales,  Mai, 1840, p. 494.
   3 Heidelberg Medicinisch. Annal. B. v.; cited in Encyclographie des Sciences Medi-
cales, Mai. 1840.
   * New York Journal of Med. and Surg.  iii. 205.            ' Ibid. p. 54.
   6 Calcutta Med. Journ. Dec. 1837, cited  in Amer. Journ. of the Med Sciences, Feb.
1839. p. 503.                       ' Philad. Med. Examiner, iii. 679.
   8 Revue Medicale, Mai et Juin, 1839.
   9 Med. Jahrbiicher des k. k. 6. St., B. xix.  S. 621.  Wien, 1836; and Ibid. B. xx.
 S. 149.  Wien. LSiO.  Cited in Brit, and For. Med. Review, July,  1837, p. 237. 
FERRI PROTOCARBONAS.
371
 all  the  bad effects of  arsenic on  the  system, they may—in  the
 absence of the hydrated oxide—be employed as antidotes to that
 poison.   The rust of iron has the advantage of being  readily pro-

   A case has been published by M. Batilliat,1 which induced him
 to infer, that the hydrated  oxide, dried in the air, is as efficacious
 as that which is kept moist.   It certainly  would  seem that  the
 dry  hydrated oxide—the Ferri Su bear bonus  of the Pharma-
 copoeia of the United States,  (1842,)—possesses the power to a
 considerable  extent, of neutralizing  arsenious acid;2  and hence
 it ought to be used in the absence of the moist and  fresh prepa-
 ration.  The  latter, however, as  already  remarked,  may be ob-
 tained in a condition fit for use in ten or fifteen minutes, by using
 a solution of the persulphate  of iron.3   The experiments of M.
 Guibert4  would  seem to show, that the subcarbonate of iron, as
 ordinarily prepared, is about three times less active in neutralizing
 arsenic than  the dry hydrate  prepared with  ammonia,  and six
 times less active than the same hydrate  in the moist state.
   A case has been reported by Dr.  Spath, of Esslingen,4 in which
 the hydrated  oxide was administered as an antidote to Scheele's
 green— Arseniate of Copper.   A  boy, three years of age, poi-
 soned himself  by licking a shell covered with  the  poison.  Half
an hour afterwards, he became pale: violent vomiting  soon came
on, with  diarrhoea, pain in the  abdomen  and  burning thirst.   The
hydrated oxide was given in  divided doses in warm water, and in
half  an hour the vomiting, diarrhoea, colic and  thirst  ceased, and
the next day all the symptoms had disappeared.
            LXXXIX. FERRI PROTOCARBONAS.

 Synonymes.  Ferri Carbonas, Protocarbonate of Iron, Carbonate of Iron.
 French.  Protocarbonate de Fer.
 German.  Kohlensaures  Eisen.

   Precipitated carbonate of iron contains but little  carbonic  acid
 —the remainder being chiefly peroxide of iron.   The name has
 indeed been changed-in  the last London  Pharmacopoeia-to
  sesquioxide of iron."  The protocarbonate readily absorbs oxy-
 gen, and, consequently, becomes converted  into the sesquioxide'
 and this is an  objection commonly urged both against the Mis'-

  ' Journal de Chimie Medicale, Janvier, 1840.        » T. R. Beck, loc. citat
   W  Procter, Jum Amer. Journ of Pharmacy, April, 1842, p. 37, and the Report
of the Committee of the College of Pharmacy on his paper, Ibid. p. 39          P
Oct  lU84e2,tm! deTh^aP-'Dec-' 184l>cited i" Amer. Journal of the  Med. Sciences,
  ■ Journal des Connaissances Medico-Chirurg., Mars, 1840. Archives de Medecln*
Fevrier, 1842j cited in Journal de Pharmacie, Mars, 1842, p. 269.        Me**ine. 
372
FERRI PROTOCARBONAS.
tura Ferri Composita, and  the  Pilulae  Ferri Composite, of
the Pharmacopoeias.  M. Vallet has  discovered a method of ob-
viating the objection, which consists in mixing the protocarbonate
with saccharine matter.

                   METHOD OF PREPARING.
  The following method is given by Mr. Procter1 as a simplifica-
tion of M. Vallet's process.  Take of Protosulphate of iron,
(pure,)  sixteen parts;  Carbonate of Soda,  (crystallized,) nine-
teen parts; Pure honey, nine  parts; Syrup, a sufficient quantity.
Dissolve the sulphate in half a gallon of water, at the temperature
of 180° Fahrenheit, and the carbonate of soda in a like quantity;
to each of these solutions  add four ounces  of  syrup; and then
mix them  in  a  jar, which should afterwards  be entirely filled
with sweetened water, and the access of air be prevented.   After
the precipitate has subsided,  decant  the  supernatant fluid, and
wash it  with  sweetened water, in the jar, until deprived of the
adhering sulphate of soda.   After the carbonate is thus purified,
throw the precipitate on a flannel cloth; express forcibly, and mix
it with the honey.   The mixture should then be reduced by eva-
poration as rapidly  and carefully as possible, to a pilular consist-
ence.  The mass constitutes  the "Ferruginous Pills" of M.
Vallet.
  The following form, founded on the  above, has been introduced
into the Pharmacopoeia of the  United States,  (1842.)

                Pilulse  ferri  carbonatis.
                 Pills of carbonate of iron.
                   [ValleCs Ferruginous Pills.)
  Take of Sulphate of iron, §iv.; Carbonate of soda, 3 v.; Cla-
rified honey, giiss.;  Syrup, Boiling water,  each a sufficient
quantity.  Dissolve the sulphate of iron and carbonate of soda,
each, in  a pint of the water, and to each solution add a fluidounce
of syrup; then mix  the two solutions in a bottle just large enough
to contain  them, close it accurately with a stopper, and set it by
that the  carbonate of iron may subside.  Pour off the supernatant
liquid,  and having wrashed  the  precipitate  with warm water,
sweetened  with  syrup in  the proportion  of a  fluidounce of the
latter to a pint of the former, until the washings no longer have a
saline  taste, place it upon a flannel cloth, and express as much of
the water as  possible; then immediately mix it with the honey.
Lastly, heat the mixture by means of a water bath, until it attains
a pilular consistence.
  A formula for the  Ferri Carbonas  Saccharatum is intro-
duced into the last edition of the Edinburgh Pharmacopoeia.  On
the continent of Europe the preparation is known  under the name
1 Amer. Journ. of Pharmacy, Jan., 1839, p. 272. 
FERRI PROTOCARBONAS.
373
of Klauer's Ferrum Carbonicum Saccharatum.1  It is in the
Pharmacopoeia of Baden.2
  When  prepared in this manner,  the protocarbonate has a dark
olive colour, strong ferruginous taste, contains about SO per cent.
of protoxide  of iron, and, if carefully prepared, dissolves wholly
and  directly in acids.
                  EFFECTS ON THE ECONOMY.
  The pills of M. Vallet have been prescribed in most of the dis-
eases in which chalybeates in general  are considered to  be indi-
cated;- and  especially in  chlorosis and amenorrhcea.3   It has
been affirmed, that in cases in which the  alterative effects of iron
are proper, Vallet's  preparation  is superior to any other derived
from that metal.4  This can only be decided  therapeutically; and
as yet the trials have been too few.  The author has exhibited it
freely, but has not had reason to assign it any pre-eminence.   It
is certainly preferable to any other  form of preparing the proto-
carbonate  for medical  use, in  consequence of its stability,  but  it
has to be determined, whether the  conversion into the sesquioxide
renders it less efficacious as a medicine.   Blaud, as will  be seen
presently, says distinctly not.   Fifteen grains of this preparation
have been observed  to occasion sickness;  and  ten  grains, twice a
day, have  produced  headach and a sense  of fulness in the head.4
The author has never witnessed such  effects  from its administra-
tion.
                  MODE OF ADMINISTRATION.
  The mass of pilular consistence,  described above, may be made
up into pills, each weighing three grains, and containing  some-
what less than a grain and a half of proto-carbonate.   They may
be given to the extent of eight or ten pills daily, and be continued
for weeks, if  necessary.

  A medicine which greatly resembles the Pilulas Ferri  Com-
positas of the Pharmacopoeias,  and in which  the  iron, when  it  is
newly prepared, is  in the state  of protocarbonate, has acquired
great celebrity in the south of France on account of its beneficial
effects in  chlorosis.   It is given  in the form  of pill, and is  called
after its inventor,—M. Blaud, senior physician to the Hospital  of
Beaucaire,—" Blaud's Pills."  Blaud's formula for the prepara-
tion  of his pills is  as  follows:—Take of Gum  tragacanth,  in
powder, six grains;  Water, one dram.   Macerate in a glass  or
  1 Pereira, Elements of Materia  Medica, &c, 2d edit., p. 861.   London, 1842, or  2d
Amer. edit.  Philad. 1846.
  a Oesterlen, Handbuch der Heilmittellehre, S. 457.  Tubing. 1845.
  3 Soubeiran, Rapport sur les nouvelles pilules ferrugineuses de M. Vallet, in Bulletin
Gen6ral de Therapeutique, Mai, 1838, cited in Amer. Journ. of Pharm., x. 244.  See,
also, Berthcmot, in Bull. General  de Therapeut. Juillet, 1839.
  ' Wood and Bache's Dispensatory of the United States, 8th edit.  Phila. 1849.
  1 Christison, Dispensatory, p. 426. Edinb., 1842. 
374
FERRI PROTOCARBONAS.
porcelain mortar, until a thick mucilage is formed; and if it be de-
sired to prevent the formation of peroxide of iron, and to make
the pills similar to those of Vallet, substitute—says M. Blaud—a
dram of powdered  sugar for the  mucilage.   Add, afterwards, of
Sulphate of iron, in powder, half an ounce.  Beat well, until the
mixture is quite homogeneous; and add, of Carbonate of potassa,
half an ounce.   Beat until the mass, which soon becomes of a yel-
lowish-green colour, passes  to a deep green, and assumes a soft
consistence.  Divide into  48 pills  or  boluses; which M. Blaud
considers sufficient  for the cure of avchlorotic  patient.1  M. Gui-
bourt substitutes the bicarbonate for the simple carbonate  or sub-
carbonate; and he gives as reasons:  First, the avoidance of a very
alkaline salt, an excess of  which may prove prejudicial to the
stomach;  and,  Secondly, the formation of a double carbonate of
potassa and iron, which is, of all the compounds of iron, the most
fitted for absorption by the economy, as it is not only soluble, but
not astringent.  His form is the  following:—Take of pure  crys-
tallized sulphate of iron, crystallized bicarbonate of potassa,
each four drams; powdered gum Jlrabic, one  dram; powdered
marshmallows, half a dram. Mix and divide in ninety-six pills.2
   A proper objection made to Blaud's pills is their excessive size;
and farther it has been urged, that a chemical change quickly occurs
in the  mass; the carbonate of the  protoxide being,  after  a  short
time, converted into the  sesquioxide of iron.3  Blaud,4 howTever,
maintains properly, that the  virtue of  medicines  cannot be appre-
ciated  from chemical experiments: " It is," he remarks, " to thera-
peutical trials,  and not to chemical experiments that we must have
recourse, to learn accurately the medical properties of any agent.
What  signifies it to practitioners that my pills contain little or no
protoxide of iron, provided they cure chlorosis?"   To prove that
they do possess this power,  Blaud adduces a long list of cases in
which a cure was obtained in three or four weeks.   To prevent,
however,  the  change to which  the chemists object,  but which
Blaud appears rather to regard with favour, M. Adorne has sug-
gested the addition of sugar, and the  pulvis althaeae according to
the  following  form:—Take of Sulphate  of iron,  recently pre-
pared, according to the method of Bonsdorff,5 which  is a pure sul-
phate;  Carbonate of potassa, or,  what is better, Carbonate of
soda;  Powdered root of marshmallow and Sugar, each, half
an ounce;  Mucilage of gum Arabic, as much as is sufficient.—
Make  into ninety-six  pills, which  must be  covered with a very
fine  layer of gum and sugar, aromatized with essential oil, to cor-
rect the disagreeable  odour.6  With similar views, M. Simonin,
  1 Revue Medicale, Mars, 1832, Dec. 1838.
  ' Pharmacopee Raisonnee, i. 383; cited in Amer. Journ.of Pharm., April, 1839,p.61.
  8 Soubeiran, Bull, General  de Therap., Mai, 1838.              4 Ibid.
  * See Wood and Bache's Dispensatory, 4th edit., p. 906.  Phila., 1839.
  6 Bulletin  Medical du Midi, Janvier, 1839; cited in Encyclographie  des Sciences
Medicales, Mars, 1839. 
FERRI PROTOCARBONAS.                 375
of Nancy, has proposed the following formula for the preparation
of Blaud's pills, which, he considers, has the double merit of prompt
and  easy execution, and of furnishing  pills which keep without
undergoing alteration.  Take of Protosulphale of iron and Pure
carbonate of potassa, each equal parts.  Reduce them separately
to a fine  powder;  mix  accurately by triturating them  together
until they begin to liquefy; then add  enough  clarified  honey to
give the mixture  complete liquidity: afterwards, heat  the  mass
over a  very gentle  fire, until it has acquired the pilular consistence.
This process was  repeated by M.  Felix  Boudet,1  by employing
pure crystallized sulphate of iron, 100 grammes;2 pure carbonate
of potassa,  100 grammes; white honey,  50 grammes;  from
which  he obtained 130 grammes of a deep green mass, very duc-
tile, and easily rolled into pills, as M. Simonin had said.  The ad-
dition  of the honey prevents the farther oxidation of the iron.
   Dr. W. H. Robert, of Madison, Georgia,3 who considers Blaud's
pills to be a capital remedy in chlorosis, the best  he has ever  used,
recommends that after pulverizing  the  sulphate of  iron  and the
carbonate of potassa,  they should  be mixed intimately, and be
formed into a pilular mass with freshly made corn bread.   If fluid
be added, the mass will  be entirely too soft to be divided into
pills.
   M. Blaud commences with his " antichlorotic pills," in  the dose
of one  a day; and, in the  course of a  few days, gives two, and
afterwards, three, daily.
   Mr.  Donovan4  recommends the  protocarbonate  of iron to be
administered in the following manner, for extemporaneous use:—
Blue sulphate of iron,  in fine powder, half an  ounce; Calcined
magnesia, two scruples; Water, six ounces; Tincture of quas-
sia, two drams.  Divide into six draughts, one to be given  night
and  morning.
   Mr. Carmichael,5 of Dublin, has advised the following mode of
exhibiting  the precipitated carbonate:—Take  one dram of Bi-
carbonate  of soda, dissolved in four  ounces of Spring water,
and  add a dram of tincture of chloride of iron.  This  draught
to be  taken three times a day during effervescence.  Mr. Car-
michael remarks, that although the quantity of carbonate of iron
formed is not considerable, yet  it is in such a state of minute sub-
division, and  combined  with a  solution of chloride of sodium
equally minute—"the saline most congenial to the system of red-
blooded animals, as it renders the hematosine active and vivifying,"
that, thus given, he always found it answer the object of a chaly-
beate much better  than the large doses of from one to two drams
           ' Journal de Pharmacie, Mars, 1841, p. 153.
           a A gramme is gr. 15.444 Troy.
           3 Southern Med. and Surg. Journal, July, 1846.
           4 Dublin Journal of Medical Science, March, 1840, p. 159.
           1 Dublin Medical  Press, March 4, 1840. 
376                  FERRI SUBCARBONAS.
of the subcarbonate.  If ulceration existed, it was very generally
improved ;  and he has seen many cases of lupus attacking the face
cured by its joint internal and external use.  He formerly thought
the phosphate of iron, administered internally,  possessed superior
advantages to the carbonate; but now thinks the carbonate given
during the precipitation answers every purpose of a chalybeate,
without causing any derangement of stomach.  Dr. Stegmann1 has
recommended the carbonate  in the  treatment of hooping cough,
in the dose of half a grain at least, to be taken  every three hours
with sugar, and  increased to as  many grains as, and  even more
than, the  number of  years in the child's age.   It should not, he
advises, be administered in the first stage of the  disease; and in
all cases should be preceded  by  an emetic.   Similar testimony is
said to have been afforded by Ghisholme,2 and recently it has  been
strongly advised  by R. Froriep,3  who gives it in the same doses in
which it is prescribed in chlorosis, and has succeeded in removing
the disease in two weeks, or, at the farthest, in six.
               XC.  FERRI  SUBCAR'BONAS.
Synonymes.  F. Carbonas seu Carbonas PrEecipitatus, Ferrum Carbona-
  tum Prsecipitatum seu Carbonicum Oxydulatum, Oxydum  Ferri Fus-
  cum, Ferri Oxidum Rubrum seu Sesquioxidum, Deuto-carbonas Ferri
  Fuscus, Crocus Martis Aperiens, Subcarbonate of Iron, Sesquioxide of
  Iron, Peroxide of Iron.
French.  Souscarbonate de Fer, Safran de Mars Aperitif.
German.  Kohlensaures  Eisenoxydul, Kohlensaures Eisen,
  Kohlensaures Eisenoxyd, Braunes Eisenoxyd.
   This preparation, which is officinal in the British, United States
and other Pharmacopoeias, is formed by adding a solution of car-
bonate of soda to a solution of  sulphate  of iron: the precipitate is
the subcarbonate, or—as it is now7 called in the London Pharma-
copoeia—the  sesquioxide of iron, which  must be washed  with
water, and dried.
                 EFFECTS  ON THE  ECONOMY.
   Subcarbonate of iron  possesses the properties of chalybeates in
general, and has been highly  recommended as a tonic, wherever
such remedies are indicated.  It  is introduced  here mainly on
account of the favour which it has  received, of late years, as a
remedy for neuralgia. Nearly forty years ago, its use was strongly
advised in cancer and carcinomatous ulcerations of the uterus, by

  1 Horn's Archiv., 1835, Juli and August, S. 651; and Medicin. Correspondent Blatt,
cited in Gazette Medicale de Paris, 20 Juin, 1838.
  1 Trousseau and Pidoux, Traite de Therapeutique, &c, 3me edit., i. 26. Paris, 1847.
  3 Tasrsberichte, Mars, 1850, No. 48; cited in Keller and Tiedemann's Nordamerikan-
ischer Monatsbericht fiir Natur und Heilkunde, Sept., 1850, S. 104. 
FERRI SUBCARBONAS.                  377
Mr.Carmichael,1 and,subsequently,by Rust,V61ker,and Kopp; as
well as in a case of lupus of the ala nasi, by Key:2 but, in similar
cases, it proved unsuccessful in the hands of Clarke, El. Von Sie-
bold, Meissner, Richter, and others.3  In chronic nervous diseases,
of a spasmodic nature, and especially in tic douloureux of the face,
it was first  highly extolled  by Dr. Benjamin  Hutchinson, about
thirty  years  ago,4 who published several cases of cure effected  by
its  agency.   Soon afterwards, cases,  equally  fortunate  in  their
termination, were  published  by various observers, by Drs.  A. T.
Thomson,5 Stewart Crawford,6 R. Macleod,7  Mr. J. E. Beale,8
and many others, and its efficacy is now almost universally admit-
ted.   Dr. Rowland9 has often witnessed the most happy results
from its exhibition, even after various powerful medicines Jhad been
tried in vain.  Dr. Elliotson 10 published several cases, in which it
had been efficacious in large doses; and he remarks, that true chro-
nic neuralgia, not arising from cold, and coming on  in a violent,
stabbing,  plunging form, aggravated  by the  least shake of  the
patient, and by touching the surface, is  best treated by subcarbo-
nate of iron. He observes, however,in a more recent publication,11
that he does not recollect  that he ever cured  the disease, but  in
almost every case improved it, and caused it to disappear for a time.
In  one of the severest cases of neuralgia under the form of hemi-
crania, which  the author ever witnessed, and which had rendered
the patient's life  miserable for years, the subcarbonate, in large
doses,  proved  entirely successful.   The patient had been bled  re-
peatedly;  and when the author saw her, she was under  the  most
favourable circumstances for the exhibition of the remedy,—with
the surface pale and  cool;  the pulse small; complaining much of
debility, and yet suffering under the most intense headache, which
the least  light and noise rendered almost intolerable;  yet, after she
had persevered in  the  use of the remedy  for  a month, in  large
doses, the symptoms gradually disappeared, and she  has since re-
mained entirely well.   It  need scarcely be said, that where ple-
thora  exists, or febrile irritation supervenes, it  must  be  removed:
the subcarbonate rarely, however, disagrees with the  stomach, and
where it  does, the inconveniences are removed  by the addition of
 an aromatic, or the administration of a cathartic.
    Subcarbonate of iron, in large doses, has, likewise, been  found

   1 An Essay on the Effects of the Carbonate and other Preparations of Iron upon Can-
 cer, 2d  edit. Dublin, 1809.                 2 Lancet, xiv. 92.
   3 Osann, in Encyclop'ad. VVorterb. der Medicinisch. Wissensch. x. 424.  Berlin, 1834.
   ' Cases of Tic Douloureux successfully treated.  Lond. 1820.
   6 Medical and Physical Journal. Feb. 1823.
   s Ibid.               ' Ibid. June, 1823.             e Ibid. Sept. 1823.
   9 Treatise on Neuralgia, by Richard Rowland, M. D. p. 84.  Lond.  1838; or the
 reprint  in the author's American Medical Library.
  10 Medico-Chirurgical Transactions, xv. 161.
  " Principles and Practice of Medicine, &c. by John Elliotson, M. D.; with Notes. &c.
 by Nathaniel Rogers, M. D. p. 507.  Lond. 1839. 
378
FERRI SUBCARBONAS.
a valuable agent in a kindred condition of the nervous system—
chorea.   Dr. Elliotsonx affirms, that  he has had—he should sup-
pose—forty cases, in succession, all cured by it; but perseverance
in its use is demanded, the affection generally disappearing when
the remedy has been given about six weeks or two months; but in
some obstinate cases it has been necessary to continue it for twelve
weeks.
   Like  other tonics, it has been prescribed  in intermittents, and
not long ago, M. Gimon,2 physician at Thouars, published two
cases elucidative of the  effects of large doses in long protracted
inter mittents, complicated with ascites and enlargement of the
spleen.   One  of these occurred in a  boy, nine years old, and the
other in a young man of twenty-one.  Both had taken  the  sul-
phate of quinia, in large doses, but ineffectually.  To the former,
he prescribed twelve grains of the subcarbonate in the twenty-four
hours, augmenting the dose  by six grains daily.  The treatment
was commenced in the latter end of July, 1835, and the quantity
taken in the day  was pushed progressively to one ounce.  In six
months the traces of ascites  and splenocele  had disappeared, and
the cure was  complete.   The medicine was discontinued by gra-
dually diminishing the dose.  In the second case, the same dose
was prescribed in the first instance; and it  was ultimately carried
to six drams, with complete success.
   The great efficacy of this preparation—as of every tonic—in dis-
eases that are  paroxysmal, appears to consist in the new impres-
sion which it makes upon the nerves  of the stomach, and, through
them, upon those of the  whole system; but to effect the revulsion
to the requisite extent, it appears to be necessary—as  in the cases
of artemisia and indigo in epilepsy—to keep up the effect of the
remedy by gradually increasing the dose.

                  MODE OF  ADMINISTRATION.
   The  dose of subcarbonate of iron,  in cases of neuralgia  and
chorea, should  be large.   Dr. Hutchinson  prescribed it in the
quantity of 5ss. to 3ij-, twice a day; but where it fails to remove
the complaint in  those doses, Dr. Elliotson  recommends, that it
should  be increased gradually to one or two ounces.   The best
vehicle  for it is molasses.  The following formulae have  been re-
commended :3
               Pulvis  ferri  subcarbonatis.
               Powder of subcarbonate of iron.
                R.  Ferri subcarb. gr. x.
                    Pulv. aromat. gr. v.
            M.  Fiat pulvis mane et meridie sumendus.

      1 Op. citat. p. 515.
      2 Journal des Connaissances M6dico-Chirurgicales, Mai, 1837.
      ' Brande, Dictionary of the Materia Medica^ p. 248,  Lond. 1839. 
FERRI TANNIS.
379
                Boli  ferri subcarbonatis,
              Boluses of subcarbonate of iron.
               R.  Ferri subcarb. gr. x.
                   Valerianae pulv. gss.
                   Syrup, zingib. q. s.
           Fiat bolus.

               PiluIbb ferri  siibcarbonatis.
               Pills of subcarbonate of iron.
               R.  Ferri subcarb.
                   Extract, anthemid. aa. gss.
      Misce et divide in pilulas xij. quarum sumat binas terquotidie.

               R.  Ferri  subcarb. 3j.
                   Pilul. aloes cum myrrha, £ss.
      Misce et divide in pilulas xviij.: duae bisterve indies sumendaj.

       Pilulae  ferri  subcarbonatis et  hydrargyri.
         Pills of subcarbonate of iron and mercury .
               R.  Ferri sulocarbonat. gj.
                   Hydrargyr. spj.
                   Confect. rose, ^iij.
   Rub until the globules are  no longer seen.
   This formula is proposed  as a substitute for blue pill.  It is
made in five minutes, whilst  blue pill  requires  a week.   Dr.
Collier1 recommends it as especially eligible for the  strumous, the
irritable, and for reduced anaemic  constitutions  requiring mer-
cury.
   Five grains of the subcarbonate are sufficient to amalgamate and
divide a large quantity of mercury; but Dr. Collier  proposes the
larger quantity  as a remedy.

           Electuarium ferri  subcarbonatis.
             Electuary of subcarbonate of iron.
           R.  Ferri subcarb.
               Confect. aurant.  aa. 3J.
                Syrupi zingib. q. s.
   ut fiat electuarium cujus sumatur cochleare minimum bis vel ter die.
                   XCI.  FERRI TANNIS.

Synonymes. Ferrum Tannicum.
French. Tannate de Fer, Tannate de Peroxyde de Fer.
Girman. Gerbesaures  Eisenoxyd.
  Tannate of iron has  been  recently employed  internally in dis-
eases in which chalybeates are indicated.

  1 From his second edition of the London Pharmacopoeia, cited in Lond. Lancet,Mar.
24,1843 
380
FERRI VALERIANAS.
                   METHOD OF PREPARING.
  To a  boiling solution of 90 parts  of pure tannic acid  add
gradually 440 parts of subcarbonate  of iron prepared from pure
sulphate of  iron and carbonate of soda  dried at a moderate heat.
Agitate the  solution until the effervescence ceases.   Evaporate at
176° Fahr., in a  porcelain  vessel, until  it becomes  thick;  and
spread it on glass or porcelain  to dry in a  stove at 95° Fahr.  It
is  usually obtained, however, by adding a solution of a  salt of
sesquioxide of iron, as the persulphate, to  a decoction of nut-
galls.  The result is a tanno-gallate of iron, as in common  ink.
  Tannate of iron is of a blue colour, tasteless, and insoluble in
water.   It is possessed of tonic and astringent properties;  and has
been highly extolled in chlorosis  by Benedetti,1 and been  used
wherever chalybeates, especially astringent chalybeates, are indi-
cated ; but it does  not appear  to possess any special virtues.  As
an  external application  in herpes  circinnatus or ringworm, ink
has been long a popular remedy.
                 MODE OF ADMINISTRATION.
   The dose of tannate of iron is from 10 grains to half a dram in
the day, given in syrup or in the pilular form.
                 Syrupus ferri  tannatis.
                  Syrup of tannate of iron.
                R. Syrup, g xij.
                    ----aceti giv.
                   Ferri oxidi magnetici citrat. £ijss.
                    Ext. gallse. jj.  M.
   This preparation was first proposed by MM. Trousseau  and Pi-
doux,2 and  as  the iron, they remark, " is in the state of  ferroso-
ferric tannate, and associated with an acid, it is soluble, sapid, and
susceptible of useful applications."
                XCII. FERRI  VALERIA'NAS.
Synonymes.   Ferrum Valerianicum, Valerianate of Iron, Valerianate or
  Sesquioxide of Iron.
French. Valerianate de Fer.
German. Baldriansa ures Eisenoxyd.
  This salt  may  be formed, according  to Ruspini,3 by putting
clear iron filings into a wedgewood mortar, adding gradually an
equal weight of valerianic acid, and stirring continually.   In an
hour, add  distilled water; pour the  whole into a flask;  warm
gently, and  filter.  The surface exposed  to the air becomes co-
  * Bouchardat, Annuaire de Therapeutique, pour 1847, p. 186.  Paris, 1847.
  * Traite de Therapeutique et de Mat Medicale, 3eme edit. j. 7. Paris, 1847.
  * Bouchardat, Annuaire de Therapeutique pour 1847, p. 54. 
FILIX MAS.
381
vered with a crystalline layer of valerianate of iron.  Collect this
on a filter, and  repeat the process as long as crystals are formed.
It is a dark, brick-red, loose,  amorphous powder, of feeble taste
and smell of valerianic acid.  It is insoluble in water.1  It has been
given in the form of pill, in the  dose of from two to four grains in
hysterical symptoms complicating cfilorosis. The salt is officinal
in the last Dublin Pharmacopoeia.2
                     XCIII. FILIX MAS.
Synonymes. Filix, Nephrodium seu Aspidium seu Athyrium seu Poly-
  podium seu Polystichum Filix Mas, Male Fern, Male Shield Fern.
French.  Fougere Male.
German. Farrenkraut,  Johanniswurzel, Mannlicher Far-
  renkraut,  Farr enkr autmannlein, Mannlicher Nieren-
  farm, Bandwurmwaldfarrn, Mannleinwurmtiipfelfarrn.
   The  rhizoma of male fern, which is indigenous in this country,
and in the secondary list of the Pharmacopoeia of the United States,
has long  been celebrated—since the time of Dioscorides indeed—
as an anthelmintic; and  especially for the destruction of  taenia.5
For these properties,  it has been introduced  into most  of  the
Pharmacopoeias. It was the basis of Madame Nuffer's or Nouffer's
celebrated remedy for tasnia, which was purchased by Louis XVI.,
in 1775, for 18,000 francs.4  It is noticed here on account of the
proposition of Peschier,5  of Geneva, to administer the ethereal
extract, which has since been carried into effect, and apparently
with the  best  results.6  It appears to  possess  the advantage of
being by no means  unpleasant to the taste, and to be accompanied
by none of the disagreeable  effects that are associated with  the
action of most of the other  vermifuges.
   To  prepare the extract,  the root is cut  small, and digested for
ten or twelve days, in the cold, in a sufficient quantity of sulphu-
ric ether: the tincture is then pressed, concentrated by distillation,
and the ether thereby  fully removed.   From a pound of the root,
about eighteen drams of a brownish-green thick extract are ob-
tained, which possesses the repulsive odour of the plant,  and  has
an acrid taste.
   1 Aschenbrenner, Die neueren Arzneimittel und Arzneibereitungsformen, S. 132. Er-
langen, 1848.
   1 The Pharmacopoeia  of the King and Queen's College of Physicians in Ireland, 1850,
p. 166.  Dublin, 1850.
   ' Merat and De Lens, Diet, de Mat. Med. art. Polypodium.
   4 For the  various forms in which it has been given as an anthelmintic against taenia,
as well as for the methods of Von  Beck, Herrenschwand, Matthieu, Measeed, Nuffer,
Odier, and Wawruch: see Linke, Vollstandiges Recept-Taschenbuch, u. s. w. i. 232.
Leipzig, 1840.
   * Nouvelle Bibliotheque Medicale, Sept. 1828, p. 151, and Biblioth. Univer. 324,  1826.
   s Rayer, Annal. de Therap., Mai, 1847, cited in Schmidt's Jahrbucher, u. s. w. No. 5,
p. 162.  Jahrgang 1848.
        25 
382
FILIX MAS.
   In Germany, the extract is generally prepared according to the
 formula of the Prussian  Pharmacopoeia, which  is as  follows:—
 Take an ounce of the powdered root, and pour thereon eight ounces
 of the sulphuric ether of commerce; close the vessel, shaking it
 occasionally, and let it stand until the fluid has acquired a yellow-
 ish colour; then  separate the fluid  as  before described;  distil off
 the sulphuric ether until only a  third remains, and evaporate the
 remainder in a water bath, until a thin  brownish-yellow coloured
 extract remains.
   This extract contains  not only the volatile oil of  the fern, but
 also a fixed oil, tannic acid, acetic and gallic acids, a muco-saccha-
 rine matter, green and red colouring matter, and a semi-resinous
 substance.   By some  it is called oleum filicis maris.  The ac-
 tive constituents of the fern are highly  concentrated in it;  and as
 the result of numerous trials, it was found, that from eighteen to
 twenty grains, given at night, and the same quantity in the morn-
 ing, fasting, destroyed taenia; so that, on  the administration of
 a cathartic, the parasite was discharged—often  in the form  of a
 ball.   Not unfrequently, indeed, it was voided before  the cathartic
 was given.
   In Germany, this new preparation has been  chiefly recommend-
 ed by Hufeland, who  maintained, that  in rapidity, certainty, and
 gentleness of action, it exceeds all known means, and many other
 physicians have testified to the accuracy of this opinion.   Radius,1
 who frequently prescribed it, says he never gave it without bring-
 ing away large pieces of the worm, but frequently the head re-
 mained  behind.2   Peschier had found  it to be successful in  one
 hundred and fifty cases when he wrote;3 Ullersberger had used it
 in  sixty cases, and a  medical friend of  his  in two hundred cases,
 with  invariable success.   It is affirmed  to have proved more  suc-
 cessful in.cases of Bothriocephalus latus than of Taenia solium;
 and a part of the discrepancy of results amongst observers has been
 ascribed to this circumstance.  For example, it has not been found
 as effective in the treatment of taenia at Paris, and the taenia most
 common there is Taenia solium.4
   Buchner5 thought,  that the extract might be prepared with al-
 cohol, but many physicians have objected to  this menstruum—that
 it does  not dissolve the fixed oil.
   The male fern is preferred by M. Rouzel6 to the bark of pome-
 granate root in the treatment of taenia.
  1 Auserlesene Heilformeln, u. s. w.  Leipz. 1836.
  " See, also, Ebers, in Hufeland und Osann's Journal, lxvi. St. 1, S. 43, cited in Gazette
de Sante, Sept. 25, 1828.                  3 Merat and De Lens, loc. cit.
  ' Christison, Dispensatory, p. 451. Edinb. 1842.
  » Repertorium fiir Pharmacie, xxiii. 433, xxvii. 337, and Funk, in Medicin. Zeitung.
 17 Mai, 1837, S. 102.
  « Revue Medicale, Oct. 1840.  See, also. M. Wawruch,  Oesterreich.  Med. Jahrbuch.
cited in Encycl. des Sciences  Med. Nov. 1841, p. 264; Brit, and  For. Med. Rev. Oct
 1844; and M. Daumerie, Archives de la Med. Beige, Sept 1841, p. 5. 
FUCUS AMYLACEUS.
383
                 MODE OF ADMINISTRATION.
  The extract is commonly given in the form of pill: an emulsion
does not answer, because the active constituents are apt to be en-
veloped and masked in this form.   In Geneva, it is now frequently
united with castor oil, which renders  it  unnecessary to give a ca-
thartic  after  it.  For the cathartic, when  needed,  they advise, in
Bern,  infusion of senna with Epsom salts, manna, and  aniseed.1
To children,  it maybe given  in syrup.
   An ethereal tincture of the buds (one  part of the buds to eight
of ether) has been used with  advantage as  an anthelmintic;2 and a
decoction (one ounce of the rhizoma to a pint of water) has been
occasionally prescribed.
                     Mel  filieis maris.
                      Honey of male fern.
              R. Ext. aether,  filieis maris gss.
                 Mel. rosae gss.  M.
   Half of this to be taken on going to bed; the other half early in
the morning fasting.
               XCIV.  FUCUS AMYLA'CEUS.
Synonymes. Plocaria Candida, Gracilaria seu Sphaerococcus seu Gigartina
  seu Fucus lichenoides, Ceylon Moss, Marine Moss, Jaffna Moss, Edi-
  ble Moss.
  The attention of physicians has been directed to this vegetable
by Messrs. Sigmond and Farre,3  and by Dr. O'Shaughnessy, of
Calcutta.4   Like Chondrus, (p. 210,) it belongs to the Natural
Order Algae, and was first introduced, some years ago, into Eng-
land from India.  As met with in commerce, it is white, filiform, and
fibrous, and has  the usual odour of sea-weeds.   When analyzed
by Dr. O'Shaughnessy, it was found to be composed as follows:—
Of vegetable jelly, 54.50; true starch, 15; wax, a trace; ligneous
fibre, 18; gum, 4; sulphate of soda, and chloride of sodium, 6.50;
sulphate and phosphate of lime, 1; iron, a trace; loss, 1:—Total,
100.  When  boiled in water, a  liquid results, which  gelatinizes
on cooling.  It has also been  examined  chemically by Guibourt,
Wonneberg and Kreyssig, Bley and Riegel.5
                 EFFECTS  ON THE ECONOMY.
  The medical properties of fucus amylaceus are similar to those
of chondrus.  The decoction is an agreeable, light, nutritious arti-
cle of  food.  According  to Dr. O'Shaughnessy, its  nutritive quali-
ties are best obtained  in the following manner:—Put into a clean
stew-pan a table-spoonful of prepared marine moss, add to  it a
  1 Hufeland  und Osann's Journal, Ixiv. St. 1, S. 133.
  'London Lancet, for 1834-5, ii. 597.        3 The Ceylon Moss. Lond. 1840.
  4 Medico-Botan. Transactions, vol. i. pt. iv. p. 184.
  ' Cited in Pereira, Elements of Mat. Med. and Therap. 3d edit, ii. 913. Lond. 1850. 
384
FUCUS AMYLACEUS.
 pint and a half of hot or cold water, and boil gradually for twenty
 minutes;  then take a little in a spoon, and let it cool for a minute
 or two, to see if the liquid is sufficiently boiled to congeal firmly;
 if not, let it boil until it is; then strain it through a cloth into an-
 other stew-pan while it is warm, so as to draw all the liquid from
 the sediment  produced  by the moss.  The sediment must be well
 squeezed.   Add  to the liquid a table-spoonful of  fine loaf sugar,
 half a table-spoonful of lemon juice, a table-spoonful of honey, or
 not, at the option of the maker; add a small piece of lemon peel,
 and  a very  small piece of cinnamon: boil the whole gradually for
 ten minutes, and pass  it once or twice  through a piece of flannel
 into a basin or tumbler, and in ten  minutes  it will  be fit for use.
 Should it  be required to be very clear and transparent—which is
 not  considered necessary for an invalid, as by clarifying it partly
 loses its strength—add the white of an egg, well beaten into froth,
 before the second boiling; taking care, that after the second  boil-
 ing it rests  for some minutes by the fire-side, with some hot char-
 coal on the cover of the stew-pan so as to render it perfectly clear;
 otherwise, by adding  the whole of  an egg, it will have  a milky-
 white appearance, which is not so pleasing to the eye, although its
 quality may be the same.  When clear, and of a lemon colour, it
 may be passed two or three times through a flannel bag.  It may
 then be suffered to cool, or be taken in a liquid state, if preferred
 by the patient.
  The jelly is as good for the table as for the sick chamber.  Blanc-
 manger and Italian cream  can be made with it without isinglass;
 but  in such case, the  jelly must be made much stronger before it
 is mixed; and  at all times it must be blended whilst warm.   The
 quantity it  takes for a mould of either  is two table-spoonfuls  of
 moss to a quart of water, which must be reduced to half a pint.
  Ceylon moss has  the advantage  over isinglass and the other
 mosses, that it will stand  firm and  good for twenty-four hours  in
 the hottest days  of India; whilst neither isinglass nor any other
jelly will stand firm for half an hour, even with the aid of ice.   It
 also  possesses  the  advantage, that  a delicious jelly can  be made
 from it in  about fifteen or twenty minutes.   It  has been  pro-
 nounced by all  the medical faculty of Calcutta to be unequalled for
 its delicate  and nutritious qualities, and has been especially and
 highly recommended for the use of the sick.   When all other nou-
 rishment has failed, this has proved  successful; and Dr. O'Shaugh-
 nessy says he has no doubt, that when the article is better known
 by the faculty  in England, it will be much more appreciated, and
 receive the same  patronage and support, which it has done from
 the whole of the faculty in India  for the last fifteen or sixteen
years.1
  1 Braithwaite's Retrospect of Pract. Med. and Surg. No. 1, Jan. to June, 1840, 3d edit
 [>. 70. Lond. 1842; and Sigmond  and Farre on the Ceylon Moss.  Lond. 1840. 
FULIG0.                         385
                        XCV. FULI'GO.
 Synonymes. Fuligo Splendens seu Fornacum seu Ligni, Soot, Woodsoot.
 French.  Suie.
 German. Glanzruss, Spiegelruss, Kaminruss, OfenrusSj Russ.
   The discovery of creasote, and its  extensive  application to the
 treatment of disease, gave occasion to the  resuscitation  of  this
 article—much  employed  by the  ancients, but subsequently fallen
 into oblivion.   The older physicians frequently used it  as an ex-
 citing diaphoretic agent in cachexice of every kind, in chronic rheu-
 matism, cutaneous  affections, and especially  in  the evil results of
 their sudden repercussion; in glandular indurations, rickets, exos-
 toses, &c. It has also been employed as a domestic remedy, in colic,
 and in the simple and dysenteric diarrhoea, and cholera of children.
 Several  modern  recommendations—as by Schiitte and Weisen-
 berg—remained unheeded until  the attention of physicians was
 drawn to it, especially by  Blaud.1  He  is of opinion, that  the
 costly—and by no means easily prepared—creasote may be wholly
 replaced by soot.   Both are products of the dry distillation of
 organic substances;  their odours are analogous,  and as  soot is
 much cheaper and more easily obtained, it deserves, he  thinks, to
 be tried more extensively  in therapeutics.   Soot has a nauseously
 empyreumatic, more or less  bitter, and acrid,  saline taste.
                  EFFECTS ON THE ECONOMY.
   Blaud2 has exhibited soot in different diseases, especially in the
form of ointment, or in decoction, with excellent  and rapid effects,
in herpes, itch, tinea, gutta rosea, and pruritus vulvae;  and he
asserts, that he even healed  cancer of the breast  by frequent ablu-
tions with a tepid decoction of it, and an ointment composed of
equal parts of lard and soot with  one-eighth part of the extract of
belladonna; but the  same applications were of no benefit in a case
of cancer of the nose,  and  in one of cancer of the  uterus.    He also
cured a scabby eruption of the mucous membrane of the nose by
an ointment of  it.   In diphtheritis, he used, in  two  cases, a de-
coction, as a mouth-wash, with the best effects.   In confirmation
of Blaud's remarks, Voisin asserts, that he cured a case of cancer
of the face by soot ointment.
   Dr. J. R.  Marinus3 has found it very  efficacious  in chronic
eruptions (dartres,) and in  tinea; and his observations have been
confirmed  by MM. Nobele4  and Le Montagnier.5 M. Nobele's
  1 Revue Medicale, Juin, 1834, et Janvier, 1835, and E. Grafe, in Grafe  und Wal-
ther's Journal, xxiii. 310.  Berlin, 1835.
  ' Journal des Connaissances Medico-Chirurg. Mai, 1834.
  3 Bulletin Medical Beige, Nov. 1838, p. 289.  For farther testimony in its favour, see
London Lancet, Nov. 25,  1843.
  4 Annales de la Societe de Medecine de Gand, Gazette Medicale, or Encyclographie
des Sciences Medicales, Mars, 1840, p. 540.
  5 Bullet. Gener. de Therap. Nov. 1840, or Encycl. des Sciences M6d., F6v. 1841, p.
299. 
386
FULIGO.
conclusions are,—1. That it cannot be  applied, with any expec-
tation of success, until  the crusts have been removed, and the ir-
ritation of the parts has been diminished  by means of emollient
applications.   2. That the gray layer, left by it on the skin, whe-
ther it be used in the form of ointment or of decoction, should be
removed  by a weak wash of soap and water.   3. That in chil-
dren an ointment, made^with  equal parts of soot and  lard, is fre-
quently too irritating for the small wounds exposed by the falling
off of the crusts; that  it is better to  commence with one part of
soot to three  parts of lard;  and  lastly, that wood soot is  alone
useful,—soot  from  coal being devoid of any agency.
   Dr. Ebers,  of Bourdeaux,1 has employed a decoction of soot
with great advantage  in a case of severe burn in which the pa-
tient was suffering  from the profuse discharge.  A handful of soot
was boiled in  eight pounds of water, until the  fluid was reduced
to two pounds.  Lint was then soaked  in it and applied  to the
granulating surface.
   Carron du Villards*  advises a collyrium prepared from soot in
cases of strumous  ophthalmia.   He infuses two ounces in boiling
water, filters  and evaporates to dryness;  the shining residuum is
then infused in very strong  boiling vinegar, and to every twelve
ounces of the liquid,  twenty-four grains of extract of roses are
added.   A few drops  of this solution, in a glass of  tepid water,
form an  excellent resolutive collyrium,  which  may be  made
stronger or weaker  at pleasure.   He  has, also, in cases of spots
on the cornea, used soot—either blown into the eye alone, or mixed
with powdered sugar-candy, and  has seen  good effects from it.
United with butter, it forms an eye-salve, not inferior perhaps, he
says, to any other.   As in the treatment of specks on the cornea,
by dropping laudanum into the eye, the organ quickly becomes ac-
customed to it, Carron du Villards advises, that the eye should be
excited to a  more  lively action by means of the combination of
soot and tincture of opium given below.  It is, he says, an energetic
agent, and may be applied by means of a pencil to granulations on
the  cornea.   He likewise recommends a decoction of soot  as an
injection in discharges, which are the  consequence of chronic
inflammation of  the vagina.
   M.  Andre  Gibrin3 has detailed to the Acad6mie Royale de
Medecine of Paris, six cases of chronic inflammation of the bladder,
in which soot was  beneficially used in the way of injection.  M.
Gibrin took  from the chimney two ounces of compact soot, broke
it up, washed it, and boiled it in  a pound of water.  The decoc-

  ' Journ. de Med. et Chirurg. Pratiq. Juin, 1841, cited in Amer. Journ. of the Medical
Sciences, Jan. 1842, p. 231.
  "Gazette Medicale, Janvier, 1831; see, also, Baudelocque,on its Use in Scrofulous
Ophthalmia, in Bulletin General de Therapeutique.   Mars, 1834.
  3 Bulletin de 1'Academic 15 Mars, 1837. 
FULIG0.
387
 tion was filtered through paper, and injected into the bladder twice
 a day.  The good effects supervened so closely on the administra-
 tion of the remedy, that there could be no doubt as to the cause.
 The pain ceased, and the patient obtained sleep, to which he had
 been for some time a stranger.  The urine gradually became clear,
 and recovered its natural appearance.
   To  these  remarks may be added, that, according  to  Schutte,
 an ointment composed of two parts of fresh butter or hog's lard,
 and one part of soot—is a popular and efficacious remedy on the
 Rhine for cases of porrigo, itch, and herpes;  not more than a
 dram being rubbed in at a time.   Weisenberg ascribes to the soot
 a protective power against  contagious affections of the skin, and
 recommends, especially, lotions of soot water,—partly, as a pre-
 ventive agent, and partly as a therapeutical application in itch.
   Employed as an injection, an infusion of soot was found by
 Dr. Hewson, of Philadelphia, an efficacious remedy in  ascarides
 vermiformes?
   But  soot has not been  used, of late, externally only; its in-
 ternal use, in the form of the old "tincture of soot," has been re-
 vived.   This was  long known under the name of "soot drops,"
 "hysteric mixture," and  "fit drops," and was employed as an
 anti-spasmodic in hysterical and other affections; but its em-
 ployment has been extended, and it is given in chronic rheuma-
 tism, chronic affections of the  chest, suppressed cutaneous
 eruptions,—in many cases under precisely the  same notions that
 prevailed years ago.   From thirty to sixty drops of the following
 tincture are given several times in the course of the day.

                 MODE OF ADMINISTRATION.
                    Mistura  fuliginis.
                       Mixture of soot.
                   Tinctura Fuliginis Clauderi.
                 R. Fulig. §ss.
                     Potassae carbonat.  ^iss.
                     Ammoniae carb. sjij.
                    Aq. sambuc. f ^ix.
    Digere leni calore, et filtra.
   Dose.—From thirty to sixty drops, several times a day.

   A similar preparation has been used  in Philadelphia, under the
names medical lye,  soot tea, alkaline solution, and dyspeptic
lye, as a popular remedy in dyspepsia.  It is made by infusing a
pint of clean hickory ashes and a gill of soot in half a gallon of
boiling water, allowing it  to stand for twenty-four hours, and
then decanting.   Of this, a small wine glassful  is taken  three or
four times a day.
         1 United Stales Dispensatory, 6th edit p. 1297.  Philad. 1845. 
388
FULIGO.
                      Lotio fuliginis.
                        Lotion of soot.
                 R.  Fulig. manip. maj. ij.
      Coque cum aq. Oi. per semihoram. Cola cum expressione.
   Used as a wash, several times a day, in herpetic, psoric  and
syphilitic ulcers.                                    Blaud.

                   Unguentum  fuliginis.
                      Ointment of soot.
                 R.  Fulig.
                     Adipis  aa. ^ss.
                     Extract, belladon. gj.  M. exacte.

  To be spread upon lint or  tents in case of cancer.    Blaud.

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

  As a dressing in cases of tinea and of foul ulcers.   Blaud,

                 R.  Fulig.
                     Cinchon. flav. aa. Sjss.
                     Carbon, pulv.
                     Sulph.  aa. .f j.
                     Cerati  simplicis q. s. ut fiat unguentum.

  A dram to be rubbed in, once  or twice a day, in cases of tinea.
                                       Carron du  Villards.
                 R.  Fulig. 3§ss.
                     Opii "Iij.
                     Caryoph. 3j.
                     Aq. cinnam, f §viij.
                     Alcoholis f giv.
   Digest in a gentle heat for six days; filter and express the residuum.

  Applied in cases  of specks of the cornea.
                                       Carron du  Villards.
                 R.  Fulig. 3iss.
                     Zinci sulphat. gvj.
                     Adipis giv.  M.

  Applied in cases of tinea.  It is the Pommade contre la teigne,
of Bories.1
                   Cataplasma  fuliginis.
                     Cataplasm of soot.
                 R.  Fulig. gij.
                     Alb. ovi No. vj.
      Tere simul.

  As a dressing for herpes and tinea.  It is the Pommade reso-
lutive of Sainte Marie.3

  1 Formulaire de Montpellier.   Montpellier, 1822.
  a Nouveau Formulaire Medicale et Pharmaceutique.  Paris et Lyon, 1820. 
FULIGOKALI.
389
                     XCVI. FULIGOKALI.
  Synonyme.  German. Russkali.
    This new remedy called from fuligo, 'soot,' and kali, 'potassa,'
  has been introduced as an analogous preparation to anthrakokali
  (p. 80.)'
                    METHOD OF PREPARING.
    Fuligokali is prepared as follows:—Take of Potassa, 20 parts;
  Shining soot, in powder, 100 parts; Water, a sufficient quantity.
  Boil for an hour;  suffer the decoction to cool; dilute with water
  so that filtration may be better accomplished ; filter, evaporate, and
  dry, in order to obtain the fuligokali in scales or powder; and en-
  close it in  dry  and  warm bottles.

    A sulphuretted fuligokali has been prepared as follows:—
  Take of Fuligokali, 60 parts; Potassa, 14 parts;  Sulphur, 5
  parts.   Dissolve the sulphur and potassa in a little  water; then
f  add the fuligokali; evaporate, dry, and enclose in dry and warm
  bottles.
            EFFECTS ON THE ECONOMY IN DISEASE.
   Fuligokali has  been  employed  by M. Gibert at  the Hopital
 Saint-Louis of Paris, both internally and  externally, but  chiefly
 in the latter mode, in various chronic cutaneous diseases.  An
 ointment may be made of either the simple or  the  sulphuretted
 article, by  mixing  one or two parts with thirty of lard.  M. Gi-
 bert ascribes to these ointments  resolvent, detergent  and slightly
 excitant virtues.2
   Mr. E. Wilson3 thinks it probable, that both anthrakokali and
 fuligokali owe much of their therapeutic value to the  alkali which
 forms their basis.   He has employed fuligokali in several  cases,
 and especially in psoriasis palmaris, and with better  success than
 he has obtained by the usual remedies.   The preparation referred
 to on the last page but one, as having been used  in  Philadelphia
 under the names of medical lye, &c, may be regarded  as a weak
 solution of fuligokali.4

   1 Journ. des Connaiss. Med. Chir. and Encyclogr. des Sciences Med., Juillet, 1842,
 p. 9.
   3 See, also,  Duhamel, Amer. Journ. of Pharmacy, Jan. 1843, p. 284,  and Deschamps,
 in Bouchardat, Annuaire de Therapeutique, pour 1843, p. 153.  Paris, 1843.
   3 A Practical and Theoretical  Treatise on the Diagnosis, Pathology, and Treatment
 of Diseases of the Skin, p. 397.  Lond. 1842 ; or Amer. edit. Philad. 1843.
   • Duhamel, op. cit. 
390
GALEOPSIS GRANDIFLORA.
           XCVII.  GALEOPSIS  GRANDIFLORA.
Synonymes. Galeopsis Ochroleuca seu Prostrata seu Villosa seu Segetum
  seu Angustifolia seu Dubia, Herba Sideritidis.
German.  Grossbliithiger  Holzahn,  Grossblumige  Hanf-
  nessel, Gelbe grossbluthige  Hundsnessel, Katzermaul.
  This plant, which belongs to Natural Family Labiatae, Sex-
ual System Didynamia Gymnospermia,  grows in the western
part of Germany, in sandy corn-fields.1
                EFFECTS ON THE ECONOMY.
  The fresh  plant  has a peculiar,  feeble,  balsamic  smell, and  a
somewhat bitter and saltish taste, and has been considered, in
Germany, to be  worthy of a distinguished  place  amongst the
" bitter resolvents."  It has been much sold as a nostrum under the
name of " Blankenheimer Tea,"  (Blankenheimer Thee,)
or " Lieber's pectoral and phthisical herbs,"  (Liebersche
Brust  oder Auszehrungskrauter,)   and  enjoyed
great repute.  In the Ardennes also, particularly in the district of
Malmedy, it has been long  employed  as a popular  remedy. In
the year 1828, Lejeune2 directed attention  to its therapeutical im-
portance.   According to his observation, it is very useful in dis-
eases of the mucous membrane of the respiratory and digest-
ive organs, and especially in chronic pulmonary catarrh, even
when it exists to such a degree  as to merit the name Phthisis
mucosa (Schleimschwindsucht.)  In actual phthisis,
the affection  seemed  to him to  be diminished by it;  the hectic
being moderated, the expectoration rendered easier, or the cough
assuaged.   Lejeune generally boiled half an ounce of the plant
in a pint of water down to half; sweetened the decoction with
sugar  or honey,  and directed  the whole to  be  taken in the
twenty-four hours.  In other cases, in which a milk diet was ap-
propriate, the decoction was made with an  equal quantity of milk.
Wesener3 found it advantageous in phthisis mucosa and chronic
pulmonary catarrh.   Giinther, who had many opportunities for
observing  the action of  the  remedy, affirms that the Lie ber-
schen Krauter not unfrequently produced some amelioration
in phthisis, especially in scrofulous phthisis, but he never saw
any actual recovery therefrom.  It  seemed  to him to moderate the
colliquative sweats, and to facilitate and diminish the expectora-
tion.   In one case especially, of scrofulous phthisis in the last
stage, it appeared to  be of essential service, and to prolong life;
and from all his observations he is  disposed to  infer, that if it be
not the sole or the main remedy to be employed in every stage of

  1 Von  Schlechtendal, in Encyclop'ad. Worterb der Medicin. Wissenschaft. xiii. 115.
Berlin, 1835.     a Annates Generates des Sciences Physiques, p. 331, Sepr. 1820.
  * Hufeland und Osann's Joum. der Pract. Heilk. 1823, 1824. 
                   GALEOPSIS GRANDIFLORA.                391

phthisis, it may be used with advantage throughout the disease
as a supporting agent.
   Riecke1  asserts, that  he has  seen many cases in  which  the
Lieberschen  Krauter  were of great service in thoracic
affections threatening phthisis.  In one  case, which  promised
to terminate unfavourably in a short time, owing to the complica-
tion of violent haemoptysis ivith hectic fever, and in which an
experienced physician had exhausted every  effort of art, they
were given with the best effect.  The thoracic affection ceased,
and at that time—a period of five or six years since the use of the
remedy—the patient—an officer—was capable of performing his
military duties without  difficulty.  On  the other  hand, Richter
affirms, that in two cases in which he administered the  galeopsis,
no benefit  resulted from it.  In this country, it has not been em-
ployed ;  so that  we have  chiefly the testimony afforded by the
German writers.   This,  as they themselves  admit,2 is not yet suf-
ficient to enable them to  lay down any positive  rules  as to the
exact indications  and  counter-indications that must  regulate its
employment.  It is probably of no farther service than  as a mild
bitter; and its place may be supplied, perhaps advantageously, by
many of the tonics that are admitted into the lists of our remedial
agents.   Geiger3 subjected it  to  analysis, and found in it 2.765
parts of fatty matter,  wax  and chlorophyll;  0.247 of a brown,
bitterish resin, insoluble in ether; 0.312 of a yellowish, stimulating
and bitter resin, soluble in ether; yellow, bitter extractive matter,
soluble in ether, and a  brownish matter,  insoluble therein ; phos-
phate and malate of lime; salts of potassa ;  muco-saccharine mat-
ter and  fecula, and 65.882  of ligneous matter.
                 MODE  OF ADMINISTRATION.
           Decoctum galeopsidis grandiflorse.
              R.  Galeopsid. grandifl. summitat. 3J.
          Coque in Aqua? Oj. per minut. xv. et cola.
   To be used  in the twenty-four hours.             Wesener.
                  R.   Galeop. grandifl. summitat.
                      Althaea? aa. §j.
                      Glycyrrhiz. 3ij.  M.
   A fourth part of this to be boiled in a  pint and a half of water :
to  be used daily in chronic catarrh, and  in the expectoration
produced by the softening of pulmonary  tubercles.—Radius.4
   Galeopsis  versicolor,  and galeopsis  villosa, which have
also been  examined by Geiger,5 appear to be possessed  of the
same virtues as galeopsis grandiflora.5
       ' Reicke, Die neuern Arzneimittel, u. s. w. S. 241.  Stuttgart, 1837.
       ' Ibid.
       3 Magaz. fiir Pharmacie, ix. 134.
       4 Auserlesene Heilformeln, u. s. w. S. 274.  Leipz. 1836.
       s Al.'gem. Med. Annalen, S. 1141.  1825.
       • Richter's Specielle Therapie, B. x.  S. 397. Berlin, 1828. 
392
GALVANISMUS.
                  XCVIII. GALVANISMUS.
Synonymes.   Electricitas Animalis seu Galvanica seu Metallica, Irrita-
  mentum Metallorum seu Metallicum, Galvanism, Voltaism, Galvanic
  Electricity.
French.  Galvanisme.
German.  Galvanismus, Volt'a'sche Electricity t.

  The ordinary effects of common and galvanic electricity and of
electro-magnetism are so well known as to require but little com-
ment.   They are decidedly excitant; and, like all excitants, when
applied to a  part of the  frame, are counter-irritant or revellent.
All  have been employed  in paralysis,—general and local,—
amaurosis,  deafness  and dumbness1  of recent  duration,
asthma, rheumatism, neuralgia, amenorrhcea,2 incontinence
of urine,3 sprains,* &c.   The effect, however, which galvanism
exerts on the contractility of the muscular fibre, and the great simi-
larity in its agency to the nervous influence,5 has led to its employ-
ment more frequently in the various nervous and spasmodic diseases
referred to, and in others belonging to the same class.6   Resting on
his  views of the absolute  identity between the  nervous and gal-
vanic fluids,7 Dr. Wilson Philip employed it in many diseases, and
especially in asthma.   In a paper read by him before the Royal
Society of London, in January, 1816, he details some experiments,
which  he made on  rabbits.  The eighth pair or pneumogastric
nerves were divided by incisions made in the neck.   After the
operation, the parsley, which the animals had  eaten, remained un-
changed in their stomachs, and, after evincing much  difficulty of
breathing, they seemed to die of suffocation.   But when, in other
animals, whose nerves had  been divided, the galvanic  agency was
transmitted  along the nerve, below its section, to a disc of silver,
placed closely in contact with the skin of the animal,  opposite to
its  stomach, no difficulty  of breathing occurred.  The  galvanic
action  being kept up for twenty-six hours, the rabbits were killed
and the parsley was found digested.
  The removal of dyspnoea, in these cases, led Dr. Philip to era-
ploy galvanism as a remedy for asthma;  and, by transmitting its
influence from the nape  of  the neck to the pit of  the stomach, he
gave decided relief in every one of twenty-two cases, of which four
were in private practice, and eighteen in the Worcester Infirmary.

  1 See a case of aphonia cured by galvanism, cited in London Lancet, May 27,1843.
  1 G. Bird, Guy's Hospital Reports, April, 1841, p. 84.
  3 Froriep, cited in Edinb. Med. and Surg. Journ., 1844, p. 491.
  ' Raciborski, Gaz. Med. Chirurg.; cited in Med. Chir. Rev., April, 1846.
  6 See the author's Human Physiology, 7th edit, i. 118.  Philad., 1850.
  8 Pereira, Elements of Mat. Med., 2d edit., p. 42.  Lond. 1842; or 2d Amer. edit,
Philad. 1846. See, also, the author's General Therapeutics  and Mat Med., 4th edit.,
i. 509.  Philad. 1850.
  1 Experimental Inquiry into the Laws of the Vital Functions.   London, 1817. 
GALVANISMUS.                     393
The power employed varied  from ten to twenty-five pairs of
plates.   Since  then, galvanism has been repeatedly used in such
cases, and at times with manifest relief.  Commonly, however, the
plates, described  hereafter, are employed for  this purpose.   The
disease, in the majority of cases, appears to be dependent  upon
erethism of the pneumogastric nerves;  all the phenomena  indi-
cating that there is a spastic  constriction of the small bronchial
tubes,  occasioned  by irritation at the extremity, or in the course
of the  nerve.  The new impression, made by the galvanic agency,
breaks in  upon the concentration  of nervous action,  by exciting
other portions of  the nervous  system, in the  same manner as we
observe  spasms or ordinary cramp relieved,  or paroxysmal dis-
eases warded off,  by agents that are capable of  suddenly impress-
ing some part of the nervous system.
   Not long after these  researches of Dr. Philip, galvanism was
employed  satisfactorily by Mr. Mansford1 in  a  congenerous dis-
ease—epilepsy—and his plan was afterwards—although tardily—
extended to some  other paroxysmal disorders.   The mode of ap-
plication  recommended by him is as follows.   A portion  of the
cuticle, of the size of a sixpence, is removed by means of a small
blister on the back of the neck, as close to the root of the hair as
possible, and a similar portion is removed from  the hollow beneath,
and on the inside of the knee, as the most convenient place.   To
the excoriated  surface on  the neck, a plate of  silver, varying—
according to the age of the patient—from the size of  a sixpence
to that of half a crown,  is applied, having  attached to its back
part, a handle or shank, and to its lower edge—and parallel with
the shank—a small staple, to which  the  conducting wire is fas-
tened.   This wTire passes down the  back, until it reaches a belt of
chamois  leather,  buttoned  round the waist; it  then follows the
course  of the belt to which it is attached, until it arrives opposite
the groin of the  side on which we desire to  employ  it;  it  then
passes  down the inside of the thigh, and  is fastened  to  the zinc
plate in the same manner as to the silver one.   The  apparatus,
contrived in this way, is thus applied.   A small piece  of sponge,
moistened in water, and corresponding in size to  the blistered part
of the neck, is first placed directly upon it; over this, a  large piece,
of the  same size as the metallic plate, also moistened,  is laid, and
next to this, the plate  itself, which is secured  in its situation by a
strip of adhesive plaster passed  through the shank on its back;
another above, and another below it.  If these be properly placed,
and the wire which passes down the back  be  allowed sufficient
room,  that it may not drag, the  plate will not be moved from its
position  by any ordinary motion of the body.   The zinc plate is
fastened  in the same manner, but in place of the second layer of

     '  Researches into the Nature and Causes of Epilepsy, &c.  Bath, 1819. 
394
GALVANISMUS.
sponge, a piece of muscle  answering in size  to the zinc  plate is
interposed;  that is, a small piece of moistened sponge being first
fitted to the exposed surface below the knee,  the piece of muscle
moistened, or—what has  been found  equally effectual and  less
inconvenient—a piece of moistened flannel1  follows, and on  this
the plate  of zinc.
  The apparatus, thus arranged, will continue, according to Mr.
Mansford, in  gentle and  uninterrupted  action  from  twelve to
twenty-four hours, according to circumstances.  " This last is the
longest period that it can be allowed to go unremoved; the sores
require cleaning and dressing, and the surface of the zinc becomes
covered with a thick oxide, which  must be removed to restore its
freedom of action : this may be done by scraping or polishing; but
it will be better if removed twice a day, both for the greater se-
curity of a permanent  action, and for the additional  comfort of the
patient."
   The adoption of this plan of treatment in cases of tic  doulou-
reux; the confidence  reposed by Laennec in  the use of plates on
the breast and back  in angina pectoris, and similar  neuralgic
affections of the chest; and the  communications  of Drs. Thos.
Harris and Chapman,  brought it into extensive use, so that ample
trial was  given to it in this country,  both in public and private
practice.  In three cases, it was—to employ the language of Pro-
fessor Chapman2—" triumphantly directed" by Dr.  Harris; but it
was only found effectual  in affections of  the face; and  in these
cases it had to be persevered  in for some time before any marked
benefit was experienced.3   About  the same  period, this mode of
applying  galvanism was recommended by Dr. Miller,4 formerly of
Washington University, Baltimore, and a case of paraplegia and
another of general paralysis, wTere published by him, in which it
was found efficacious.  A similar  arrangement, employed for the
purposes  of counter-irritation, has  been described by Dr. Golding
Bird5 under the title of the "electric moxa."  It was long ago
observed  by Humboldt, and afterwards by Grapengiesser, that when
a simple galvanic arc was applied  to a blistered surface,  the  part
opposed to  the most oxidizable metal  was more irritated than that
to which the negative plate was applied. In adopting such an arc
in the treatment of paralysis, Dr. Bird was struck with the re-
markable effects produced, and such a combination of its results
induced him to propose the following  ready mode of establishing  a
discharge from the surface of the body.  Two small  blisters, the
size of a shilling, are applied to any part, one a few inches below
the  other.  WThen the cuticle is raised, it must be snipped, and to

  ' Dr. Chapman says soft buckskin or parchment. American Journal of the Medical
Sciences, Aug. 1834, p. 311.                     " Op. citat. p. 311.
  3 Dr. Harris, in American Journal of the Med. Sciences, Aug. 1834, p. 384.
  4 Ibid. p. 321.                   ' Lond. Med. Gazette, June, 1847. 
GALVANISMUS.
395
the one whence a permanent discharge is required, a piece of zinc
foil must be applied ;  and to the other a  piece of silver.  They are
then connected by a copper wire, and  covered with  a common
water-dressing and oiled silk.  If the zinc plate be raised  in a
few hours, the surface  of the  skin will  look  white, as if rubbed
over with nitrate of silver.  In forty-eight hours, a decided eschar
will appear, which, if the plates  are  still kept on, will begin  to
separate at the edges in four or  five  days.  A common poultice
may now be applied, and a healthy sore, freely discharging pus,
will be left.
   Confirmation of the  advantage to be derived from this method
of applying galvanism has been afforded  by Mr. Wells,1 who re-
cords the results of hisfreatment in  the Civil Hospital at  Corfu.
The cases, in  which its efficacy was tested, were thirty of ulcers;
five of fistulas; five  of fungous growths; and  five of nervous
disorders.  Mr. Hinton,2 however, does not give so favourable  an
account as Mr.  Wells of  the action of the galvanic plates.   The
scar left by the slough, he says, has a  very uneven surface, and
would not be  borne in many cases.
   The effect of galvanism on the uterus has been referred to under
Electro-Magnetismus.
   M. Matteucci,3 from his researches, is induced to think, that pa-
ralysis and tetanus  are the diseases  in  which galvanism is most
likely to prove  beneficial.  In its application, however, in  these
diseases, he considers it necessary to  bear in  mind two electro-
physiological facts.   The first is, that an electric current, if trans-
mitted through a nerve for a certain time, destroys the  sensibility
of the nerve,  or in other words paralyzes it;  but if the nerve  be
allowed to remain at rest, after a certain interval it recovers its ex-
citability.  But it has been  ascertained by M. Matteucci, that the
excitability may be restored in a much shorter period by passing a
second  current  through the nerve in  the reverse  direction.   The
second fact to be  borne in  mind is, that if the nerves of a living
animal be subjected to the passage of an electric current, renewed
at short intervals, tetanic contractions are excited; and if the ex-
periment be continued for some time, the nerves entirely lose  tlreir
excitability.   "These facts,"  says M. Matteucci, "independently
of all  theory  or hypothesis, should guide us in the therapeutical
application of the electric current  to paralysis.  It may in fact  be
admitted that, in some cases of paralysis, the nerves of the affected
limb are in a  condition  similar to  that produced by the continued
passage of an  electric current.   We have seen, that to restore the
excitability to a nerve which had been deprived of it by an electric

  1 Lond. Med. Gazette, May 26, 1848.
  * Ibid., July, 1848, and Banking's Half-yearly  Abstract, July to Dec. 1848.  Amer.
edit. p. 216.
  8 Cited in Med. Chirurg. Rev. April, 1845, 
396
GALVANISMUS.
current, it is requisite to conduct the current in the opposite direc-
tion.   Hence, to cure the paralysis, the current should be passed
in a contrary direction to that which has produced it.  In a para-
lysis of motion, the inverse current should be employed; whilst,
on the contrary, in a paralysis of sensation, the direct  current
should be used.  In a case of complete paralysis—that is, of both
motion and  sensation, there is no reason to prefer the one current
to the  ether.  Theory also teaches a  rule in its application: never
to continue the passage of the current too long, lest we augment the
disease we wish to cure.  The more intense the current, the shorter
should be its duration; and  as we have  seen  that the passage of
the electric current in the  nerves, repeated at short  intervals of
time,  considerably  enfeebles their  sensibility  when continued for
a long time, we  must take care and not pass from one extreme to
another.  Theory advises us to apply the electric  current of an in-
tensity which should vary with the degree of the malady, and con-
tinue its passage for two or three minutes at intervals of some se-
conds.  After these two or three  minutes,  during which  we shall
have communicated from twenty to thirty shocks,  we should leave
the patient  at rest for some time, and then  renew the treatment."
  It is affirmed  that Dr. Krusell,1 of St. Petersburg, has employed
galvanism successfully in the treatment of syphilitic ulcers.  To
this method  he  gives the name "electrolytic."   It is not clearly
described by the translator—and the author does  not possess the
original article; but it would  appear, that  of forty-three patients
whose treatment commenced between the 4th of July and the 11th
of September, 1844, inclusive, twenty-one  were free from all ap-
pearances of disease on the 13th of September, and all the others,
with the exception of three or four, were in the best condition,—
the sores being  nearly healed.  Dr.  Krusell employs an  uninter-
rupted current.
  Dr.  Hays has stated, that the most useful remedy in certain
cases of amaurosis, which  fell under his care,2 was unquestiona-
bly galvanism.  This was evinced not  only in the improvement
which  followed  its application, but  in  the "still more  striking
fact,"  that the patient saw better whilst subjected to the galvanic
action.  Dr. Hays found a Cruikshank's battery  of fifty pairs of
plates  three  inches  square—when  in full activity—too powerful
for the purpose, so that  only one-half or two-thirds of the plates
were  usually employed.   The connexion was made by means of
leaden wire conductors, to one end of which was soldered a slip of
copper, and  to  the  other a hemisphere  of  brass,  the flat surface
of which was filed into grooves crossing  at right angles, so as to
form a number of sharp points.   Over these were  tied thin  discs

  * Journ, fur Chirurg. und Augenheilkunde von Walther und Ammon. Bd. v. S. 92:
cited in Lond. Med. Gaz. June.5, 1846, p. 1015.
  2 American Journal of the Medical Sciences, Aug. 1840, p. 288. 
GALVANISMUS.
397
of sponge, wThich were kept moist with a solution of common salt,
and when it was considered desirable to introduce  strychnia into
the system,  the sponge attached  to the negative pole—and some-
times that to the positive pole, also—was  moistened with a solu-
tion of it.   When the whole force of the battery was not wanted,
instead of putting the slips in the extreme cells, they were placed
in cells more or less remote, according to the power required; and
the force was easily regulated.   The galvanic  current  may be
made to pass from the  mastoid process to the superciliary ridge.
Dr. Hays expresses his persuasion, that galvanism, properly em-
ployed, is a valuable and  effective  remedy for certain forms of
amaurosis.  There are doubtless—as already observed—cases of
disease, in which the excitant and revulsive agency of galvanism
may be  employed with  advantage, but they are  not so numerous
as was at one time believed.  The author has used the plates ex-
tensively—in neuralgic cases especially—but has not experienced
so much success as to induce him to advise them frequently, under
the inconveniences that necessarily accompany their employment.
   The  ordinary modes  of  applying  galvanism are  referred to in
another work.1   An  apparatus has been devised by Mr. Coad, of
Philadelphia, which enables galvanism to be communicated  either
continuously, or in an uninterrupted manner, and the dose to be re-
gulated  according to  the wishes of the practitioner.  It is conve-
nient, and well adapted for all cases in which it may be deemed
advisable to apply galvanism.2
   Recently, M.  Duchenne,3 of Boulogne, has  published  a long
mbnoire on what he terras a new method of galvanization, Gal-
vanisation  localisee.  He states, that if the skin and the excitors
(excitateurs)—as he terms metallic  bodies communicating with
the poles of a  galvanic apparatus, which are placed on parts to be
galvanized—are perfectly dry, and the epidermis of considerable
thickness, the two electric  currents are recomposed at  the surface
of the epidermis, without traversing the derma; and cause  sparks
and a peculiar crepitation without physiological phenomena.   But
if we  place  on the skin one excitor moist and the  other dry, the
individual experiences, in the point where the second  excitor had
developed only physiological effects,  a superficial sensation  evi-
dently cutaneous.   This is  owing to the contrary electricities  be-
ing recomposed in the point of the dry epidermis, but after having
traversed the skin by the moist excitor. Again, if we moisten very
slightly the skin where  the epidermis is very thick in  the  points
on which  the metallic excitors are placed, a  superficial sensation
is experienced,  stronger than the preceding, without sparks or

  1 General Therapeutics and Materia Medica, 4th edit. i. 509.  Philad. 1850.
  "Art. Galvanism, in Cyclop, of Practical Medicine, Amer. edit, by the author.  Philad
1845.
  * Archives Generates de Medecine, Juillet, 1850, p. 257, and Aout, 1850, p. 420. 
398
GALVANISMUS.
crepitation.   Here  the  electric recomposition takes place in  the
substance of  the skin.   Lastly, if the skin  and excitors are very
moist, neither sparks, crepitation, nor sensation of burning is expe-
rienced, but very variable phenomena of contractility or sensibility
present themselves, according as  we  act on a muscle or a fasci-
culus of  muscular fibres;  on a nerve or a bony surface.   In  the
last case, an acute pain of a very peculiar character is experienced;
and consequently great care ought to  be had not to place moist ex-
citors over bony surfaces.   M. Duchenne infers from these phe-
nomena,  that the electric power may be arrested at will in the skin ;
and  that, without any incision or puncture, it may be  traversed,
and  the action of electricity be limited to the organs which it co-
vers, to  the nerves, muscles and even the bones.
   Some  years ago, Professor Von Hildenbrand, of Pavia,1 recom-
mended,  in cases of frontal neuralgia, an anodyne metallic or
galvanic brush, which appears to have been as  effectual in  his
hands as the galvanic plates in those of Dr.  Harris.   It consists of
a  bundle of metallic wires not thicker than  common knitting-nee-
dles, firmly tied together by wire of the  same  material, so as to
form a cylinder  of about four or  five inches long, and an  inch or
three-fourths of an inch in diameter.  This is applied to the pained
part, which has been previously moistened with a solution  of com-
mon salt; and, according to Von Hildenbrand, it at times produces
relief so  instantaneously, that it appears to  the patients to act  like
a  charm. In his first experiments, he employed brushes construct-
ed of two kinds of metal,—for instance, of silver and copper wire,
copper and zinc wire, or zinc and brass wire, the individual wires
being mutually  commingled ; but he subsequently ascertained,  that
 bundles  of wires of one  and the same metal produced an effect
 scarcely less speedy, and that solid metallic bodies act in  a similar
manner, but in a much feebler degree.   The  nature of the metal,
 he thinks, occasions no difference.
   It is not probable, that, in these cases, galvanism is the agency
 concerned.  Like  the  metallic tractors of Perkins, the effect is
 probably induced by the new nervous impression made  through
 the excited imagination of the patient.

   Animal Magnetism, Mesmerism, Neurogamia, Biogamia,
 Biomagnetismus, Zoomagnetismus,  Tellurismus, Exoneu-
 rism, as it has been termed—exerts an anodyne  influence in  pro-
 bably the same manner.   In highly impressible persons, more or
 less prolonged  impressions made upon the senses—as by the  ope-
 rator looking steadfastly in  the  eyes of the  patient, holding the
 thumbs  or hand at the same time, or making passes in front of the
 patient—will induce an hysteric or hysteroid  condition, in which
1 Edinburgh Medical and Surgical Journal, April, 1833. 
GENTIANA CHIRAYITA.
399
the patient may fall into what is called "magnetic sleep," of a
very sound, and at times cataleptic character.  During the existence
of this sleep, the patient may be insensible to certain irritants,
and yet extremely alive to others, so that operations—as the ex-
traction of teeth, and even some of a more serious character—may
be performed without eliciting the ordinary evidences of feeling.
In  cases of delirium tremens, accompanied by watchfulness, in
which the whole nervous system is extremely impressible, sleep
may be at times induced by the employment of this agency, which
had resisted the ordinary anodynes.1
  It has been proposed to  introduce into the rectum, in  cases of
constipation, a kind of galvanic suppository, made of two metals
—zinc and  copper—and various forms of instruments have been
devised by  the  prolific imaginations of the  inventors; those in-
tended for the  rectum  simply were doubtless of advantage, at
times, by virtue of  the excitation they induced in the nerves of the
mucous membrane.   Others, shaped  somewhat like a bassoon—
and so arranged as  to have one metal in the mouth and the other
in the rectum connected together by metal—did not appear  to act
differently from  those of the simpler form.  Both have gone into
disuse, and if their efficacy on the frame has not been well marked,
they have not failed to administer to the pockets of the inventors.
             XCIX.  GENTIANA CHIRAYITA.
Synonymes. Henricea Pharmacearcha, Swertia Chirayila, Agathotes Chi-
  rayta, Chiretta, Chirayita, Chirayta.
  Gentiana  chirayita is a native of  the  northern  part of India,
whence it is imported into England, tied  up in bundles.   It has
been long in use there.
                 EFFECTS ON THE ECONOMY.
  The herb and root are intensely bitter, and produce on  the eco-
nomy the ordinary effects of the pure bitters.  They strikingly
resemble gentian, and are employed in India in dyspepsia, and as
an antiperiodic in intermittents.2   The plant has been highly ex-
tolled by Drs.  Currie,  Sigmond, and  others.  These gentlemen
consider  that the secretion from the liver improves under its use;
and the latter advises it not only in torpor of the digestive function,
but he prefers it to sarsaparilla where  the latter  is considered to
be indicated: as after large quantities of mercury have been taken
or where profuse salivation  has been induced.   Dr. Jackson, for-
merly of Calcutta, informed Dr.  Christison, that he found it often
have the effect of restoring the healthy alvine evacuations in costive

  1 Dr. Vedder, American Medical Intelligencer, Feb. 1, 1839,  p 331
  a J. Johnson, Influence of Tropical Climates, 3d edit. p. 58. 
400                      GLYCERINA.
habits;  and he adds, that frequent trials made in  Edinburgh con-
firm all that has been said by the practitioners of  Bengal as to its
efficacy as a tonic and  stomachic.1   It has also been  advised in
atonic leucorrhoea.
                  MODE  OF ADMINISTRATION.
   Gentiana chirayita yields its virtues to alcohol and water.  (Gent.
chirayit. §ss.; Aq. bullient. Oj.) Dose, f Ij. to f gijj.  The tincture
is made by macerating five ounces of the chirayita for fourteen
days in two pints of diluted alcohol.  Dose,  a teaspoonful.  The
dose of the powder is one scruple.3
                       C. GLYCERINA.
Synonymes.  Glycerinum, Glycerine, Glycerin:—improperly  cited as
  Glycyrrhine,3 Hydrate of oxide of Glyceryl.
French.  Glycerine.
German. Glyzerin, Glyceryloxyd, Oelsuse, Scheel' sches
  Suss.
   This substance forms a base to the oleic, stearic, and margaric
acids of the fat oils and tallow, and is separated when these acids
are made to combine with an alkali, or any metallic oxide in the
saponification of the oils.
                    METHOD OF PREPARING,
   Glycerin is obtained by heating together olive or other suitable
oil, oxide of lead, and water, as in the manufacture of the common
lead plaster:  an insoluble salt of lead is formed, and  the glycerin
remains in the aqueous liquid.   This is treated with sulphohydric
acid; digested with animal charcoal; filtered, and evaporated in
vacuo at the temperature of the air.
   In  a  pure state, glycerin forms a nearly colourless and very viscid
liquid; s. g. 1.27.  It has an  intensely sweet taste, and mixes with
water and  alcohol in all proportions;  but is insoluble in ether.4

                 EFFECTS ON THE  ECONOMY.
   Glycerin has  been introduced  by Mr. Startin,5  as a new re-
medy for  the cure  of certain cutaneous diseases; and its useful-
ness is presumed to be most probably dependent upon  its property
of resisting evaporation even at a considerable temperature.   Mr.
Startin  affirms, that a common plate  wetted with it may be  kept
in an  oven, side by side with a joint of meat,  till the meat is cooked,

  * Dispensatory. Amer. edit. p. 364.  Philad. 1849.
  a See " Note upon Gentiana Chirayita," by Dr. Carson, in Amer. Journ. of Pharmacy,
new series, vol. vi. No. 1, A pi.  1840, p. 20.
  * Braithwaite's Retrospect, xiii. 306, Amer. edit. New York, 1846.
  * Graham's Elements of Chemistry, Amer. edit, by Dr. Bridges, p. 596. Philad. 1843,
and Fownes's Elementary Chemistry, Amer. edit, by the same, p. 399. Philad. 1845.
  » Med. Times, Feb. 8,  1846. 
GLYCERINA.                     401
without  any  sensible diminution in the quantity of the liquid.
Hence, when applied to the skin it remains moist, forming a coating
or varnish, which is not distinguishable from the ordinary secretion
of the part.  A lotion composed of half an ounce to ten fluidounces
of water effectually prevents the skin from becoming  dry.  When
employed in its pure state, it makes  the part stiff and uncomforta-
ble;  and  consequently answers  best diluted.   It  is also  added
with  advantage  to  poultices,  and even to  baths.   Mr. Startin
speaks of its use chiefly in psoriasis,  pityriasis, lepra, and ichthy-
osis,  in all which diseases he describes it as producing excellent
palliative effects;  and in  such  cases the author has  employed  it
with  marked advantage.  It keeps the part moist, and prevents
the formation of scabs.
   It  is probable,  that glycerin might be used with much advantage
in burns, and wherever it is desirable to prevent the desiccative in-
fluence of  the air from irritating an exposed surface.
   In  consequence of the  publication,  by Mr.  Yearsley,1 of some
cases of deafness, in which the tympanum had  been perforated by
ulceration, having been astonishingly benefited  by the insertion of
wetted cotton into the meatus,  Dr. Turnbull2 and Mr. Thomas H.
Wakley,3 under the idea that the benefit resulted from the moisture
and not from the cotton, thought of  glycerin as an agent, which
would retain its moisture and  lubricate the auditory  canal.   Mr.
Wakley accordingly used  it in three  hundred cases, and in a num-
ber of them the power of hearing was restored.  "Contrary," he
says,  " to what might have been anticipated, the use of the remedy
was successful in  persons in whom the deafness had been of many
years' duration—one, for example, thirty years; and  also in cases
where the existence of the malady could be traced to  the eruptive
fevers of childhood.   In instances of deafness caused by inflamma-
tion, followed first by suppuration, and then by a horny dry con-
dition of the auditory canal, the  application of glycerin has been
attended  with signal advantage.  Equally marked and  peculiar is
the success when  it is used in cases where there  is a  partial or total
absence of ceruminous secretion.  In  many instances of deafness
belonging to these classes of cases, the employment of glycerin has
been followed by  a perfect restoration of the power of hearing.  In
other examples of deafness, where the membrana tympani had  evi-
dently become thickened and hardened,  and  an examination with
the speculum  denoted a whitish or pearly appearance, the use of
the glycerin was followed by strikingly beneficial and gratifying
effects.  It is evident, therefore, that  the  application of glycerin
is equally admissible, whether the tympanum [membrana tympani,]
be in a sound state, or whether it has  been destroyed  by ulcera-
tion."
  * Lancet, July 1,1848.          2 Lond. Med. Gazette, June 1,1849, p. 962.
  ' Lancet, cited in Med. Examiner, Sept, 1849, p. 561. 
402
GRANATUM.
  Dr. Paterson,1 of Edinburgh, obtained some improvement in one
of three cases in which he used it.

                 MODE OF ADMINISTRATION.
                R.  Glycerin, f gj.
                    Tragacanth. pulv. gij. ad §ss.
                    Liquor, calcis f §iv.
                    Aq. ros. f giij.   M.
  As a liniment or embrocation in prurigo, lichen, strophulus,
lepra, psoriasis, pruritus, &c.                        Startin.
                R.  Glycerin, f §ss.
                    Acid, nitric, dilut. f ^ss. ad £j.
                    Bismuth, subnit. gss.
                    Tinct. digital, f £j.
                    Aq. rosae f gviiss.  M.
  As a lotion; to  be used by dabbing the part for chapped nipples
or hands, fissures of the lips, irritation of the skin of any  kind,
as after shaving, exposure to the sun, in pityriasis, &c.
                                                     Startin.
                R.  Glycerin, f ^ss.
                    Sodas borat. gss. ad gj.
                    Aq. ros. gviiss.  M.
  To be  used by dabbing the affected part  in alopecia following
fevers; in dryness or want of action of the scalp,thinness of the hair,
&c.                                                  Startin.
                R.  Glycerin, f^ss.
                    Sp. ammon. aromat. f gj.
                    Tinct. cantharid. f 3J. ad f gij.
                    Aq. rosmarin.f ^vij.  M.
  As a lotion to be used  with a wet hair-brusb once or twice a
day in rheumatism or gout,  neuralgic pains, sprains,  bruises,
stiffness, &c
                R.  Glycerin, f jss.
                    Lin. sapon. comp. f §iss„
                    Ext. belladon. 3J.  M.
  As an embrocation; to be  used twice a day in the ordinary  man-
ner.                                                  Startin.
                      CI.  GRANATUM.
Synonymes.  Punica Granatum, Malogranatum, Pomegranate.
French.  Grenadier, Balaustier.
German. Granatbaum, Granatapfelbaum, Apfelgranate.

  Punica  Granatum appears to be a native of the northern coast
of Africa, whence it was transported to Italy at the time of the
Carthaginian wars.  It  is now cultivated in all civilized regions,
where the climate is sufficiently warm to allow the fruit to ripen.

  1 Monthly  Retrospect, Aug. 1849; cited in Amer. Journal of the Med. Sciences, Oct
1849, p. 461. 
GRANATUM.
403
It belongs to the Natural Family Myrtaceas, and, in the Sexual
System, to Icosandria Monogynia.                 #     #
   All the parts of the plant contain more or less tannic acid.  The
bark of the root  is externally of a yellowish-gray or  ash colour;
internally yellow, and has an astringent taste.  According to La-
tour de Trie,1 it contains wax, chlorophyll, a considerable quantity
of resin, gallic acid, tannic acid, fatty matter, and a peculiar matter
called Grenadin; in German, Granatin.
   Grenadin, in its pure state, is of a white colour;  inodorous, and
of a sweetish taste; so much so, indeed, that according to Magendie,
it might be presumed to be a variety of sugar, except that it differs
from ordinary sugar in being devoid of the property of fermenting.
According to the degree of its purity, it crystallizes in  grains, tufts
or stars.  When thrown on red hot coals, it consumes without any
residuum, and smells like burnt bread.  It is fusible, and by a mo-
derate heat may be almost wholly sublimed.  It neither  reacts as
an acid nor an alkali, and is readily soluble in water. Cold alcohol
dissolves only traces of it, but boiling alcohol dissolves it readily:
a property which is to be taken advantage of in the formation of
crystals.   In  ether it  is insoluble.  Nitric acid, with the assist-
ance of heat, converts it into oxalic acid.  An ounce  of the bark
yields six grains of grenadin; but it  is not settled, whether it con-
tains the whole of the medical properties of the bark.   Cenedella,2
from whom we have  the  most recent analysis of the  bark of the
pomegranate root, also found  the grenadin discovered by Latour.
This substance is readily prepared.   The bark in powder is treated
with ether, and afterwards with boiling alcohol, and  the fluid is
evaporated  to the consistence of a soft extract.  By treating this
extract with water, grenadin is dissolved without difficulty, and
it may be purified by  suffering it to crystallize frequently from  al-
cohol.
                 EFFECTS ON THE ECONOMY.
   The therapeutical properties of the different parts of the pome-
granate tree were known  to the writers of antiquity.  They em-
ployed  not only the bark of  the root as a remedial agent, but also
the flowers, {Flores Balaustiorum, Balaustes, Balaustia,Balaus-
tine Flowers,) the whole fruit,  (Poma Granati, Malogranaia,
Granata,Mala Punica, Pomegranate:  Fr. Grenades,)  the rind
of the  fruit (Malicorium, Malichorium, Malacorium,) and the
seeds.   Dioscorides, Pliny, Celsus and Marcellus Empiricus speak
of the  employment of the bark of the root in taenia.3   In  more
modern times, Punica  granatum  had been  greatly neglected, al-

   1 Journal de Pharmacie, Fev. 1828, p. 109.
  * Giornale de Farmacia, Agosto, 1831, p. 55.  See, also, Journal de Pharmacie, ix.
219; x. 352; and xvii. 503; and Dierbach, in Heidelberg Klin. Annalen, B. x.  H. 3, S.
365." Heidelb. 1834.
  ' Merat and De Lens, Diet, de Mat. Medical, art. Punica Granatum. 
404
GRANATUM.
though the juice of the fruit was recommended by Frederick Hoff-
man against worms in children.   In India, it has  been long held
in great estimation  as a  remedy in tapeworm; and its efficacy
having been noticed  by some English physicians, it was recom-
mended to the attention of Europeans, especially  by Buchanan,1
Fleming and  Breton.2   About  the same time, a monograph was
published by Gomez, a  Portuguese physician, which appears to
have had  considerable  agency  in extending  the  reputation of
the remedy, especially in  Germany,  where the monograph  was
translated  into the Journal  of  Gerson and Julius.3  Gomez  di-
rects two ounces of the  fresh rind of the root to be boiled in a
pint and a half of water down to a pint; and of this decoction two
or three spoonfuls to be taken for a dose; the first, early in the
morning, fasting, and then  every half hour until the whole is used.
The efficacy of this preparation he tested in fourteen cases, from
which it appeared, that  the worm could not withstand  its action
more than forty-eight  hours.   He found  it  exert most efficacy
when portions of the worm were perceptible in the evacuations, a
period when the patient  generally suffers most inconvenience.  If
the exit of the worm did not take place on the first day after the
use of the agent, the decoction was continued  on the second day,
when the worm was generally discharged.   Did this not happen,
however, a farther continuance of the  remedy was of no avail; and
he  thought it  better to  intermit it until  the appearance of fresh
portions of the worm in the evacuations.  Gomez also administers
the dried rind in pills.  If  the dose be  too large, or the appropriate
dose  be too frequently repeated, nausea, vomiting and diarrhoea
at times supervene:  should this be the case, the proper course is
obvious.
   In countries where the fresh  rind can be obtained, Gomez ad-
vises, that it should  be used; in  colder countries,  the dried rind,
which is obtained from more southern  regions,  will have to be em-
ployed.   According  to  Breton, the latter acts more powerfully.
The  dried  rind loses more than half its weight, and two  ounces
of it may be esteemed equal to three of the fresh.
   The  strong testimony adduced in  its favour by Gomez, gave
occasion to numerous trials with it in  England, France, Germany,
and Italy, which were generally attended with favourable results.
Such testimony has been  afforded by Boiti, Marchese, Calabro,
Majoli,  Chevallier,  Deslandes,  Merat,4  Pichonnier,  Mandrux,
Claret, Bayle,  Delaporte, Gendrin,  Grimaud, Chapotin, Bour-

  1 Edinb. Med. and Surg. Journal, iii. 22,  1827.
  a Medico-Chirurg. Transact, xi. 31.
  ' Magazin, u. s. w. vi. 427, or Journal Complementaire des Sciences Medicales, xvi.
24, 1823.
  4 Du Taenia, &c., et de  sa cure radicale par  l'ecorce de la racipe de Grenadier.
Paris, 1832; and  Merat and De Lens, op. cit.; and in Supplement au Dictionnaire,
vol. 7, Paris, 1846. 
GRANATUM.                      405
geoise, Housson, Goupil, Ferrus, Wolff, Kostler, Meisinger, Ber-
thold, Schmidt, Miiller,1 and others.2  On the other hand, Keibel3
complains of its uncertainty;  and in the Polyclinical Institute of
the University of Berlin, it was given without advantage;  but
Osann, in  his  report of  that institution, is disposed to  refer the
want of success to some imperfection in the rind employed, which,
he remarks, is found to vary greatly in its  character, as met with
in the shop of the apothecary.  It would  appear, also,  that it is
not unfrequently mixed with the rind of the root of the Box tree
and Guelder rose.
   To introduce more precision on this matter, Wolff recommends
that  the druggists should purchase the bark of the root of the
genuine East  India, or, at all events, the Portuguese tree.  Boiti4
advises that the root should be obtained from mountainous regions,
where the tree grows wild;  that it should  be taken only from
young trees, and that it should not  be  more  than an inch thick;
that it should be carefully separated  from the woody portion,  and
be collected in the spring  of the year, when the tree has most sap,
and  be dried  in  the shade.  Chevallier,5 also advises, that only
the rind of the root of the wild  tree should  be used.   Gendrin,
Montault and Pichonnier affirm, that the fresh rind was alone cer-
tain in its operation; the dry frequently disappointing them.   Ac-
cording to Breton, the rind of the trunk is  to be preferred to that
of the root,  because  it preserves its virtues longer.   Chevallier
recommends, before  the decoction of the  pomegranate tree bark
is administered, that  a gentle  cathartic of castor oil with lemon
juice should be premised.   This may be taken the evening before,
the patient fasting  during the  following  day.   He directs  the
decoction to be made of two ounces of the rind macerated for
twenty-four hours in two pints  of  water, and then boiled until
a pint of the strained  liquor remains.  This must be divided into
three portions, which are taken in  half hourly doses.   The first
and  second doses with many  persons excite vomiting, but  this
need  not prevent the administration  of the third, as it rarely pro-
duces the same effect.  This quantity of the decoction commonly
occasions three or four  evacuations, preceded by slight colic pains;
at other times, but one  evacuation  is produced, with which  the
worm is usually expelled.  The  period  that elapses between the
administration of the last dose of the remedy and the commence-
ment of its operation  is from a  quarter of an hour to a whole hour
—rarely longer.
   M. Merck6 states that,  when properly administered, it never

  1 Hannov. Annal., viL, 1847;  cited in Schmidt's Jahrbiicher, No. 8, S. 161. Jahr-
gang 1848.
  1 Riecke, Die neuern Arzneimittel, S. 247.
  3 Rust's Magazin, xvi. St. 3, S. 566.            *  Revue Encyclop. xxxii. 234.
  » Journal de Chimie Medicale, i. 378; 1825.
  s Revue Medicale, cited in Medical Times, Jan. II, 1845, p. 323. 
406
GRANATUM.
fails.   The mode he recommends is the following.—Whenever a
patient has evacuated portions of taenia, he must take, on the same
day, or the next, a decoction of two ounces of  the fresh bark in a
pint and a half of water, reduced to a pint, in three doses, leaving
an  interval of half an hour between each dose.   The worm will
be evacuated at the  utmost in twenty-four hours, and no relapse
need be feared.   Want of success, he affirms, is owing to the fact
that sometimes  the  dry  bark is employed;  and sometimes it is
adulterated with other kinds of  bark;  or that it is taken too long
after  the  portions of taenia have  been expelled;  or because  the
dose was too weak, or combined with purgatives, &c.  Where this
bark  is used, a purgative is  not  necessary.   Filix mas, on  the
other hand, requires a cathartic.
   Cenedella advises, that the bark of the root should be macerated
before boiling; that the decoction  should be made in earthen,  not
in metallic, vessels, and that it should be filtered or strained whilst
hot,—different constituents, which  are probably efficacious, being
deposited as the liquor cools.
   According to M. Constant, the decoction is commonly prepared
in France in  the following manner:—The rind of the fresh root
—or  the bruised root dried—is macerated through the night in
from  a pint and a half to a quart of water; the liquor is then boiled
to one half;  strained; and, in the morning, a third part is taken
lukewarm, fasting, and repeated every three hours until the whole
has been  administered.  The quantity of the  rind, used for  the
decoction, is, in the case of the adult, 5j.; of children, from six to
fifteen years  old, gvj.; and of those under six years of age, ^ss.
At times, however, it has been administered in much larger doses.
A girl, twenty-four years of age, had  suffered from taenia from
her infancy, and had frequently passed fragments of worms in  her
evacuations.   She took  two  ounces of the bruised bark of the
pomegranate root, boiled in two pounds of water, at thrice, with
half  an hour's  interval between   the  doses, but without effect.
The dose was now increased to three ounces, and two tapeworms
were  expelled;  so that, in  two days, and without  any abdominal
disturbance, the patient  took the  decoction of five ounces of the
bark  of the root.1
   To ensure the  proper action of  the decoction, it must be given
as directed above, without  the  addition of sugar or syrup, which
changes its properties.   During its operation,  the  patient should
drink nothing except when the tormina are  urgent, and then a
little  of any aromatized water, without sugar, may be taken.  The
remedy should be given only on days in which portions of taenia
are evacuated, or on the following morning;  and the alimentary
canal should  be free from every evidence of inflammatory irrita-
  1 Forget, in Gazette des Hopitaux, 19 F6vrier, 1839, or London Medical Gazette,
April 20, 1839. 
GUAC0.
407
tion.  By some, as by Latour de Trie and Ferrus, an  infusion of
the rind has been found  serviceable;  and Deslandes recommends
an Extractum spirituosum, and an Extractum aquosum cor-
ticis radicis granati.
   MM. Ferrus, Berthold, Goupil, and others, have published cases
in which, along with  the expulsion of taenia, various neuroses
were  removed under  the use  of the rind, and accordingly it has
been thought that it might be usefully employed  in such affections
where no taenia exists; in epilepsy and hysteria, for example.
                  METHOD  OF PREPARING. ,
          Decoctum granati  radicis  corticis.
            Decoction of pomegranate root bark.
                 R.  Granati radicis corticis ^ij.
                     Aquse Oij.
            Boil to a pint and a half.
   Dose.—5ij. every half hour.   Three or four doses are usually
sufficient to expel the  worm.1  The formula given by Dr. Ains-
lie,2 directs the decoction to be prepared with ^ij. of the fresh
bark, boiled in a pint  and a half of water, until only three quar-
ters of a pint remain.
    Electuarinm extracti granati radicis corticis,
      Electuary of extract  of pomegranate root  bark.
             R.  Extract, alcohol, granat. rad. cort. gvj.
                 Aquae florum tiliae,3
                 Succi limon. aa. f ^iij.
                 Tragac. q. s. ut fiat electuarium.
  Dose.—One-half, from half hour to half hour.    Deslandes.

    Mistnra  extracti  granati  radicis  corticis.
       Mixture of extract of pomegranate root bark.
             R.  Extract, alcohol, granat. rad. cort. gvj.
                 Aquae menthae,
                 ----flor. tiliae,
                 Succ. limon. aa. f §ij.  M.
   To be  divided  into four parts, one  of which  may be taken
every quarter of an hour.                        Deslandes.
                        CII. GUACO.

Synonymes.  Huaco, Eupatorium Huaco.
  It would appear, that  owing to some extracts in the A 11 g e-
meine  Zeitung, the attention of the German  physicians
had been directed to this article as an important agent in the cure

       1 Jourdan's Pharmaeopee Universelle, i. 638.  Paris, 1828.
       5 Materia Indica, ii. 175. London, 1826.
       * Any simple aromatic water may be substituted for this. 
408
GUACO.
  of epidemic cholera; and various testimonials have been brought
  forward in its  favour, which, as Riecke1 properly suggests, may
  not be confirmed by farther experience; and yet the circumstance
  may have led to the introduction of a valuable  article  into the
  catalogue of medicinal agents.
     Many species of the  genus Eupatorium,  and of the kindred
  genus Mikania,—which has been recently separated from it,—be-
  longing to the Natural Family Compositae (Synanthereae, sub-
  division Corymbiferae,) and in the Sexual System, to Syngenesia
  iEqualis,  have been prized in various parts of America, parti-
  cularly in cases of  bites  of serpents.  This is especially the
  case with Eupatorium ayapana (E. triplinerve.) According to
  Von Martius, a quantity of the bruised leaves is applied to the
  scarified wound, and the application of fresh  leaves is renewed,
  over and over again, until the patient is freed from the dangerous
  symptoms, and especially from the violent suffering.  At the same
  time, a few spoonfuls of the expressed juice are administered every
  now and  then.  The Mikania  opifera  (Eupatorium crena-
  tum,)—in Brazil termed Erva da cobra—and the Eupatorium
  saturejasfolium (Mikania saturejasfolia,) also  belong to many
  Synanthereae, which, in  South  America, are reputed  specifics
  against the bites of serpents.  The most important  species ap-
  pears to be that called in  Peru Guaco or Huaco, which is held
  there in high consideration, as  well  as  in  New  Grenada,  and
  Venezuela,  not  only in these cases,  but in the  prevention of
  hydrophobia.2  This is  presumed to  be  the Mikania guaco of
  Humboldt.  Dr. Hancock, however, affirms, that the names Guaco
  and  Bejuco de Guaco  were  given—in the parts of  America
  where he  sojourned—to different species of Aristolochia.
     Guaco  was made known, forty or fifty years  ago,  by Mutis,3
  who refers to its effects in cases of the bites of serpents.
                   EFFECTS ON THE ECONOMY.
     Of the efficacy of the  guaco in Indian  cholera, M. E. de
  Chaniac, Officer de Santi in the French  navy, and Dr. Chabert,
  physician  to the military hospital in Mexico, have  published the
'  results of their experience.  When the  brig Adonis, on her voyage
  from Havana to Mexico, in the year 1833, arrived at Vera Cruz,
  some of her crew were  attacked with cholera, which prevailed
  at the time in Mexico.  Of all the remedies employed, the guaco
  was found most beneficial; its effects,  indeed, were so  wonderful,
  that it  was regarded almost as  a specific.  Its action is chiefly
  exerted on the heart and  the  circulation, which it renders more

    ' Die neuern Arzneimittel, u. s. w. S. 250. Stuttgart, 1837.
    a See Prof. W. R. Johnson, in Silliman's Journal, xxiv. 272 and 388, New Haven,
  1833; and ibid, xxvii. 171, New Haven, 1835; also, Dr. Hancock, in Quarterly Jour-
  nal of Science, &c, from January to June, 1830, p. 333.
    * Virey, in Bulletin de la Societe de Pharmacie,  vi. 241; and Riecke,  op. cit 251. 
GUACG.
409
energetic.  All the patients to whom it was exhibited in the com-
mencement of the disease were saved, and even of those in whom
the cholera had  already reached a certain stage, the greater part
were saved, as soon  as a free  and complete reaction was estab-
lished.   Dr. Chabert, who first administered guaco in cholera, as
well as in yellow fever, observes on its use in the former disease:
—In simple  cases, a small  teacupful of a warm decoction was
given  every  half hour,  until a general  diaphoresis  and  proper
warmth of surface supervened,  which was kept up for some days,
when the remedy was gradually discontinued.  To allay the thirst,
the  decoction was given, diluted with two-thirds, or half, water.
In dangerous cases of cholera algida, with coldness, loss of pulse,
&c,  a spoonful  of the  tincture  was mixed with six  or eight
spoonfuls of  water, and, every quarter of an hour, a spoonful of
this mixture was given  alternately with  a small cupful  of the
decoction.  When  the  pulse returned,  the  warmth  became  re-
stored and the perspiration re-established, the tincture was omitted,
and the decoction continued alone  at longer intervals.   In the
majority of cases, after  the  cessation  of the cholera symptoms,
pain  was  experienced in the  epigastrium, with  burning thirst,
which yielded when the  decoction was diluted with half or two-
thirds water.  When the decoction could not be retained  by the
stomach, it was  given  in clyster.   Blood-letting, general and
local, was employed along with other external means, but nothing
was given internally except the guaco.  To make the decoction;
—two drams of the stalks, and half a dram of the leaves, were
boiled in two pints of the water, down  to one.  The tincture
was prepared like other tinctures.
  In consequence of the communications of Chabert  and De
Chaniac, as well  as of the parallel drawn by Harless1 between the
cholera and the effects of the bites of serpents, Professor Beckers
of Munich recommended that  experiments should be made with
guaco; and it was accordingly tried in  Munich, but not with as
favourable results as had been expected.   Romerio asserts that it
was given in  the  stadium apphydicum in the form of infusion,
made of half an ounce of the stalks, but with uncertain results. It
appeared to combine the effects of valerian and ipecacuanha, yet it
excited less vomiting  than the latter.  The tincture appeared to
render greater service. It was given in the dose of a coffee-spoon-
ful every half hour, and, subsequently, every hour, and every two
hours.  It would appear, that in the district of Prague, its admi-
nistration was attended with very favourable consequences.2  To
account for the different results, it is affirmed, that different drugs
are met with in commerce under  the name guaco.  Riecke says,
that M. Jobst had sent him two kinds, which were evidently from

  1 Die Indische Cholera, u.  s. w. Braunschweig, 1831.    3 Riecke, op. cit. S. 256. 
410
HIPPOCASTANUM.
different plants: the one variety was obtained from Hamburg and
Bourdeaux; the other, from Paris: descriptions of these are given
by Riecke.  The truth, probably, is, that  this, like  most of the
cholera specifics which have been brought  forward, is efficacious
in certain  cases of the disease, but that its agency has been egre-
giously exaggerated.
            CIII. HIPPOCASTANUM (CORTEX.)
Synonymes.   jEsculus Hippocastanum, Castanea Equina seu Pavina,
   Horse Chestnut, Buck Eye (the Bark.)
French.  Marronier, Marronier d'Inde.
German.  Rosskastanie, Pferdekastanie,  Rosskeste, Pfer-
   dekeste.
   The tree whence  this bark is derived is iEsculus Hippocasta-
num  or Horse Chestnut—of the Natural Family Hippocasta-
neae; Sexual System,  Heptandria  Monogynia—which is wild on
the mountains of Asia Minor and Persia, and  grows in this coun-
try as well  as in Europe.   The bark has a very astringent taste;
is somewhat bitter,  and contains  a great deal of tannic  acid.
Canzoneri thinks he discovered a peculiar principle in it, which he
calls  aesculine, but the existence of this is contested.
                 EFFECTS  ON THE ECONOMY.
   The Cortex hippocastani has Jong been advised as an astringent,
but without receiving much attention.1   In modern  times, it has
been  proposed by Zannichelli, Hufeland, Voigtel, and others, as
the best  substitute  for  cinchona.   These recommendations  have
caused the  bark to be  more frequently administered  of late, in
Europe, by  which means it has  been discovered to accord almost
entirely in its effects with that of the willow: the latter, however,
appears to be more effective, and to agree  better with the digest-
ive organs.   In the  wars of  Napoleon, when bark was very scarce,
it was much employed.  Hufeland  and Voigtel recommended it
especially in intermiltents.  Sinogowitz2 advises that it should
be given after the removal of intermittents by quinia, to prevent a
relapse; and, also, in combination with diuretic agents, in the cases
of dropsy which often succeed to that disease.  Krugelstein found
it always extremely efficacious in atonic gout, and in  removing
the  weakness of the digestive apparatus  that  remains  after
attacks of gout.  The Austrian, Brunswick, Danish, Russian and
Saxon Pharmacopoeias3 have an aqueous extract of the  bark,
which Voigtel administered with good results in  intermittent
fever, and often found  serviceable in chronic discharges from

             1 Merat and De Lens, art. ./Esculus Hippocastanum.
             2 Rust's Magazin, B. xxix. H. i. p.  84.
             3 Pharmacopee Universale, ii. 14.   Paris, 1828.
% 
HIPPOCASTANUM.
411
the mucous  membranes.   It  agrees better  with  the  stomach
than the powder or the decoction.   Externally, the decoction has
been advised as a good  astringent.

                MODE OF ADMINISTRATION.

       Pulvis corticis  hippocastani compositus,
         Compound powder of horse chestnut bark.
                    Pulvis China? Factitius.
                   Factitious Powder of Bark.
                   R.   Hippocast. cort.
                       Salic, cort.
                       Gentian rubr. cort.
                       Calam.
                       Caryophyll. aa. 3]j-
               Misce et fiat pulvis.
   Hufeland1 affirms, that this powder is an adequate substitute for
cinchona in three cases out of four.
                 Hufeland, and Prussian Pharmacopoeia.

            Decoctnm corticis hippocastani.
              Decoction of horse chestnut bark.
                   R.   Cort. hippocastan. .giss.
  Coque cum aquae f ^xviij. ad reman, colat. f ^ix.; cui refrigerat. adde
                       Spir. aether, sulph. f 3J.—gij.
                       Syr. cort. aurant. f^j.  M.
   To be used during the apyrexia.                Voigtel.

               Decoctum  chinae factitiae.
                Decoction of factitious bark.
                   R.   Salic, cort. pulv. crass.
                       Hippocast. cort. aa. gss.
                       Calam.
                       Caryophyll. aa. gij.
             Coque cum aq. fontan. f ^xvi. ad reman, colat. f §viij.
                                Prussian Pharmacopoeia.
             Decoctnm hippocastani acidum.
              Acid decoction of horse  chestnut.
                   R.  Hippocast. cort. pulv. gv].
                 Coque cum
                       Acid, sulphur, dilut. f gj.
                       Aquae f %x.
                ad.  colat. f ^vj.
   Used in the after  treatment of intermit tents.—Sinogowitz,

           Electuarium  corticis hippocastani.
              Electuary of horse chestnut bark.
                   R. Hippocast. cort. pulv. §ss.
                       Calam. gss.
                       Roob. juniperi giij.  M. ut fiat electuarium.
   A tea-spoonful to be taken every hour, or every two hours,  in
 dropsies supervening on intermittent fever.—Sinogowitz.
              1 Armenpharmacopoe 4te Ausgab. Berl. 1825. 
412               HYDRARGYRI BROMIDUM.
              HYDRARGYRI PRiEPARA'TA.
Synonymes.  Preparations of Mercury.
French.  Les Preparations de Mercure.
German.  Quecksilberpraparate.

            CIV. HYDRARGYRI BROMIDUM.
Synonymes.  Hydrargyrum Bromatum, Brometum Hydrargyrosum seu
  Hydrargyri, Protobromuretum Mercurii, Bromide of Mercury.
German.  Bromquecksilber, Quecksilberbromiir.
  Mercury unites with bromine in more than  one proportion.   A
solution  of hydrobromate of potassa produces with a solution of
nitrate  of protoxide of mercury a white  precipitate, which re-
sembles  calomel;  and appears to be  a bromide of quicksilver, an-
swering  to the proto-chloride (Hydrargyrum Bromatum, Hy-
drargyri Protobromidum; German, Quecksilberbromiir,
Bromquecksilber,  Protobromiire  des Quecksil-
bers.)  On the  other hand, the bromide, which is formed by the
direct union of bromine with mercury, corresponds  probably to
the bichloride. A white substance results, which can be sublimed
by heat, is  soluble in water, alcohol, and especially in ether; is
coloured red or yellow by the alkalies, and exhibits considerable
resemblance to corrosive sublimate;—(Hydrargyrum perbroma-
tum, H bibromatum, H.perbromidum, H. deutobromidum
seu bibromidum; German, Quecksilber-deuto-bromiir,
Bromquecksilber in  maximum.)

                EFFECTS ON THE ECONOMY.
  The effects of  these preparations on the sound and diseased or-
ganism are  not yet well known.   They have, however, been em-
ployed  by some physicians.  The protobromide strongly resem-
bles calomel in its properties.  In the dose of one  or two grains,
it  produces no effect in  health, even when taken  fasting.  In a
higher dose—four or five grains, and upwards—it purges mode-
rately,  augmenting,  at the  same time, the  secretion of  urine.
When used in primary syphilitic affections, in  the way of
friction  on  the gums, or internally in  pill, it  removes them like
calomel; but it does not seem to affect the mouth as speedily or as
severely as it.1
  The deutobromide or bibromide, Hydrargyri perbromas
seu bibromas, Hydrargyrum perbromatum,  Brometum hy-
drargyricum, Bromidum seu deutobromuretum mercurii;
German, Doppeltbromquecksilber, Quecksilber-
bromid, resembles  the bichloride of mercury in its action,—
producing, in too strong a dose, vomiting and purging, with colic

        1 Bulletin Gen6ral de Therapeutique, No. 14, 30 Juillet, 1837. 
HYDRARGYRI CYANURETUM.
413
and  cramp  of the stomach;  affecting the mouth,  and exciting
violent  salivation.1  Werneck,  of Austria,  has administered it
frequently in syphilis.   In recent cases, he prescribes it in  the
form of pill, beginning with one-twentieth of a grain.   This dose
he increases by one-twelfth every two days;  the chancres being
covered at the same time with compresses, wetted with a  solution
formed  of six  grains of the same substance to a pint of  distilled
water.   After a few days' treatment, he remarked that the sores
assumed a better  appearance;  and from  twenty to  thirty days
were sufficient to  effect their  entire  cicatrization.  The total
quantity of  the bromide administered was about five  grains; it
was rarely necessary  to carry it as high as ten or twelve grains.
It has been believed, that deutobromide of mercury is less liable to
act  on  the  salivary glands than  the corrosive chloride,  and to
affect less severely the stomach  and chest.3
   Desorgues  has  recommended the second (?) preparation as a
prophylactic and curative agent in syphilis.   It  was doubtless,
also—Riecke  suggests—the second preparation which was admi-
nistered with  excellent  effects  by Prieger  in porrigo favosa of
an obstinate character.   He terms the preparation bromas mer-
curii, but the true bromate is probably insoluble in ether.3  The
first of the following formulae is recommended by Prieger.
            Guttce hydrargyri deutobromidi.
            Drops of deutobromide of mercury.
    R.  Bromatis mercurii, (vel potius hydrargyri perbromidi,) gr. vj.
Solve in
                   iEther. sulphuric, f ^iij.  M.
  Dose.—Ten  to twenty drops, according  to  the age of  the  pa-
tient, daily,  in water.
               R.  Hydrargyr. deutobromid. gr. j.
                   iEther.  sulphuric, f £j.  M.
  Dose.—Ten to twenty drops in  barley water, a short time after
taking dinner;—in syphilis.          Werneck and Prieger.
         CV. HYDRARGYRI CYANURETUM.
Synonymgs.  Hydrargyri Cyanidum seu Prussias seu Bicyanidum seu
  Borussias, Hydrargyrum Cyanogenatum seu Cyanatum seu Cyanicum
  sen Borussicum seu Zooticum seu Hydrocyanicum, Cyanuretum seu
  Cyanetum Hydrargyri, Mercurius Hydrocyanicus, Cyanidum Mercurii,
  Cyanide or Prussiate or Hydrocyanate or Bicyanide of Mercury.
French.  Cyanure ou Hydrocyanate ou Prussiate de Mercure.
German.  Cyan quec k s i lbe r, Blau s t o rTqu e ck s ilbe r,  Blau-
  saures  Quecksilberoxyd, Quecks i lbercyanid .

  This mercurial preparation is contained in the Pharmacopoeias
of the United States, Dublin, London, Belgium, Paris, Ferrara, &c.

  1 Glover, Edinb. Med. and Surg. Journ., Oct., 1842.             2 Ibid.
  » Die neuern Arzneimittel, S. 261.  Stuttgart, 1837, & 2te Auflage, S. 37J.  Stutt-
gart, 1840.
       27 
414
HYDRARGYRI CYANURETUM,
                   METHOD OF PREPARING.
  According to Proust and  Gay-Lussac, two parts of good and
finely powdered Prussian blue must  be  boiled with  one part  of
deutoxide of mercury and eight parts of  water, until the  mixture
acquires a bright-yellowish tint.   It is then filtered, and the fil-
tered liquor, which is the hydrocyanate of deutoxide of mercury
—containing, however, some iron—is digested or boiled with an
excess of deutoxide of mercury, whereby  the oxide of iron is com-
pletely precipitated.  As, however, the hydrocyanate is combined
with an excess of oxide of mercury, this must be saturated with
free  hydrocyanic acid, and the solution be evaporated to induce
crystallization.  In this mode the cyanuret is formed.
  The  formula of  the Pharmacopoeia of the United  States is the
same as that adopted  in the Codex  Medicamentarius of Paris,
which was recommended by Berzelius.   It is as follows:—Take
of Red oxide of mercury, three  ounces, or  a  sufficient quantity;
Ferrocyanuret of iron, four ounces; Distilled water, three pints.
Put  the ferrocyanuret of iron, and three ounces  of the oxide of
mercury,  previously  powdered and  thoroughly  mixed together,
into a glass vessel; and  pour upon them two pints of the distilled
water.  Then boil the mixture, stirring  constantly, and if, at the
end of half an hour, the blue colour remains, add small portions of
the oxide of mercury, continuing the ebullition until the mixture
becomes of  a  yellowish  colour; after which filter through paper.
Wash the residue in a .pint of the distilled  water, and filter as
before.   Mix the solutions,  and  evaporate by the fire till a pelli-
cle appears; then set the liquor aside that crystals may form. To
purify the crystals, dissolve  them in distilled water; filter; evapo-
rate the solution, and set it  aside to crystallize.1   Dr. Christison2
does not approve of this preparation.  He regards it as a " need-
less  incumbrance of the London and Dublin Pharmacopoeias." "It
was introduced,"  he remarks, " into the latter,  as  the  source of
the hydrocyanic acid; which may now be obtained more cheaply,
and  equally well, from other materials."  Schrader directs it to
be prepared by mixing a solution of red oxide of mercury with
hydrocyanic acid, filtering and evaporating.3 .
   Cyanuret of mercury forms white,  opake, four-sided prisms;  is
inodorous, and its taste is extremely disagreeable  and metallic. It
is decomposed by heat;  is  readily soluble in water, and becomes
converted thereby  into hydrocyanate  of mercury.  It is insoluble
in  alcohol.  It contains, at times, ferrocyanuret of potassium, pro-
ceeding from the Prussian blue, with which it has been prepared.4
  • Pharm. of the United States, p. 118.  Philad., 1842; see, also, Mr. Ellis, in Journal
of the Philadelphia College  of Pharmacy, vi. 24.  Philad., 1834-5.
 2 Dispensatory, p. 519.  Edinb. 1842.
  8 See a new process for its preparation,  by MM. Chevallier  and Deleschamps, in
Journ. de Chimie Medicale, Janv. 1830.
 4 Orfila, Toxicologic, i. 331. 
HYDRARGYRICYANURETUM.
415
                 EFFECTS ON THE ECONOMY.
  According to Coullon, the poisonous action of this salt is  as
rapid as that of hydrocyanic acid.   A fatal  case has been pub-
lished.1  In the dose of from two to five grains, M. Ittner found
it produce on  dogs only signs of indisposition, tremors, &c.2   It
is one of the  substances which Magendie,3  in  his  experiments,
found to promote the coagulation of the blood.
  Parent,4 who frequently used this preparation, prefers it greatly
to corrosive sublimate, in consequence of its greater solubility, and
the capability of more readily affecting the organism by it.  Ac-
cording to his  experience, syphilis yields more  readily under  its
use, than under that of any other of the mercurials.  He did  not
observe pains  in the abdomen accompanying its  protracted em-
ployment, which he so frequently witnessed when the corrosive
chloride was  taken.  Another advantage which  it possesses  is,
that it is not so readily decomposed.  No salt, no alkali—not even
caustic alkali—disturbs it; neither do substances that contain nitro-
gen or gallic acid,  which speedily convert the  corrosive chloride
into calomel.   Moreover, cyanuret  of  mercury appears to act  on
the animal textures differently from  the corrosive chloride.  When
the  latter is  placed in  contact with  flesh, it becomes quickly
changed, in part, into calomel; whilst  the cyanuret  preserves the
flesh equally well,  without being decomposed.   The hydrocyanic
acid appears to play no  important  part  in the  action of the  re-
medy.  According to Olivier's experiments,5 the cyanuret, like
the corrosive chloride,  acts as a powerful excitant to the  tissues
on which it is applied.   He saw a man destroyed by inflammation
of the intestines, who had taken twenty-three grains of it.
  Cyanuret of mercury was first, perhaps, recommended in Italy,
by  Brera, and  in Spain.   Mendoza  especially made many trials
with it, from which he was induced to  conclude, that it is the best
agent we possess in venereal affections—an opinion in which he
was joined by several of his professional brethren in  Malaga.  He
advises, that laudanum should be added to  it, on account of its
liability to excite vomiting.   WThen too large doses were adminis-
tered, or when the patient was unusually impressible,  he found
that the nervous system became especially disordered—as indicated
by  syncope,  oppression,  anxiety,  and  convulsions.  Chaussier,
likewise,  as well as Thaer and Horn, proposed the  cyanuret as a
remedial  agent at an  early period.   On the other  hand,  Wendt,

  '  Thibert, cited by T. R. Beck, in Amer. Journ. of the Med. Sciences, April, 1842,
p. 490.
  *  Merat and De  Lens, Diet, de Mat. Med., art. Cyanogene.
  8  Legons sur le Sanar; and translation in Lond. Lancet, Jan. 20th, 1839, p. 636.
  4  Journ. de Chimie Medicale, viii. 473.
  6  Journ. de Chimie Medicale, i. 269; see, also, Lethehy, Lond. Med. Gaz., Jan. 9,
and Feb. 14 and 17, 1845. 
416
HYDRARGYRI CYANURETUM.
 Cullerier and Plisson complain of its little efficacy; whence it has
 been inferred that the preparation  must differ.1
   Neumann2 advises it in chronic inflammation of the lungs,
 of the  membranous organs of the chest and abdomen, and
 of the ovaries.  In particular cases, its use  has to be soon pre-
 termitted, in  consequence of its powerful  action on  the salivary
 glands, even in small doses—as one-eighth of a grain, three times
 a  day.  In  other  cases,  it can be  continued  long  without  the
 supervention of any unpleasant consequences.   In the Charite, at
 Berlin, it was used with advantage in a case of obstinate cepha-
 lalgia, the origin of which was syphilitic.   Biett has employed
 it externally—in the form  of the ointment given below—in humid
 tetter, accompanied with  inflammation  and  itching.   Parent re-
 commends it to be applied in chancre, and Brera uses it in solu-
 tion, as a gargle, in syphilitic ulcerations  of the fauces.   Dr.
 StrohP cures  chancres,  even when  complicated, usually within
 twelve days, with  an ointment composed of  two  grains of  the
 cyanuret to a dram of lard.  The ointment is spread upon a piece
 of lint of the size of the sore:  the  dressing is apt to be painful at
 first, and  it must be taken off occasionally, after it has been on
 for an  hour or  two,  and  be  applied in a  weaker  form.   The
 pain is said to be most violent in  half  an hour or an hour, and
 frequently ceases in  two  or three  hours.  When the chancre is
 extensive and painful,  after the ointment has been  on for from
 four to ten hours, according to the sensibility of the  patient, it is
 dressed with mercurial ointment or opium cerate.  By Carron du
 Villards it was used in the form of ointment in scrofulous con-
junctivitis; and by Desmarres in the blepharitis glandulosa of
 scrofulous  individuals:  and  Fischer  and  Diihrsen observed good
 effects from the use  of an  ointment composed of it in the hydro-
 cephalus of children.4
   Such is the chief testimony recorded  in favour of the medical
 action of  the cyanuret of  mercury.   Dr. Christison5 thinks, that
 " the few trials hitherto made of its effects in disease  scarcely jus-
 tify its introduction as a remedy."  Although, however, it has been
 but little used  in Great Britain, many trials have been made with
 it, on the continent of Europe  more especially.
                 MODE OF ADMINISTRATION'
   Cyanuret of mercury may be given in  pills  or in solution.  Horn
 prescribed it  in  powder, but this form is less  appropriate.  The

  1 Riecke, Die neuern Arzneimittel, u. s. w. S. 264.  Stuttgart, 1837, & 2te Auflage,
 S. 376. Stuttgart, 1840.
  2 Hufeland and Osann's Journal, lv. 66.
  3 Oesterreich, Med.Wochenschrift, cited in Lond. Med. Gaz., Nov. 1842. ^Gaz. Med.
 de Strasbourg, Nos. 15, 17; or Encycl. des Sciences Med. Sept. 1841, p. 525.
  4 Aschenbrenner, Die neueren Arzneimittel, u. s. w. S. 147.  Erlangen, 1848.
  6 Dispensatory, p. 519.  Edinb. 1842. 
HYDRARGYRICYANURETUM.
417
dose is from one-sixteenth of a grain to a grain, several  times  a
day.   As  a  gargle, half a grain to a grain  may be dissolved in
f |j. of water;  as an ointment, from one and a half to two grains
may be united with 3j- of lard.   Chaussier used it in friction on
the soles of the  feet, in the same way as the corrosive chloride.

               Liquor hydrargyri cyanureti.
                (Liqueur Anlisyphilitique de Chaussier.)
                R.  113-drargyri cyanur. gr. viij.
                    Aquae destillat. Oj.
   Each ounce contains half a grain  of the cyanuret.
                                     Chaussier1 and Parent.
                R.  Hydrarg. cyanuret. Qss.
            Solve in
                    Aq. destillat. Oj.
            Adde
                    Tincturse opii f gj.  M.
   Dose.—Morning and evening,  a spoonful, in a decoction of sar-
saparilla or barley.                     Mendoza and Parent.

              Pilula? hydrargyri eyanureti,
                 Pills of cyanuret of mercury.
               R.  Hydrarg. cyanuret. gr. v.
                   Opii Qss.
                   Micas panis 3J.
                   Mellis q. s. ut fiant pilulae xcvj.
  Dose.—One to four, three times a day.              Parent.

           Gargarisma  hydrargyri cyanureti.
                Gargle of cyanuret  of mercury.
               R.  Hydrarg. cyanur. ^ss.
                   Decoct, ten. sem.  lini,  (vel rad. althasae,) Oj.
           M. et fiat gargarisma.
    R. Hydrarg. cyanur. Qss.
       Decoct, hordei Oj.
       Mellis rosae gj.  M. et fiat gargarisma.

Unguentum hydrargyri cyanureti.
   Ointment  of cyanuret of mercury.
    R. Hydrarg. cyanur. gr. xij.
       Adipis %\.  M. ut fiat unguentum.
Parent.
Brera.
Brera.
              R.  Hydrarg. cyanur. gr. xvj.
                  Adipis gj.
                  01. limonis gtt. xv.  M.
 From half a dram to a dram, to be rubbed in, in cases of tetter.
                                                     Biett.
1 Rattier, Formulaire Pratique des Hopitaux Civils de Paris, 3eme edit Paris, 1823. 
418
HYDRARGYRI IODIDUM.
              CVI. HYDRARGYRI IODIDUM.
Svnonymes. Hydrargyri Proto-iodidum seu Proto-ioduretum seu Subiodi-
  dum, Hydrargyrum Iodatum flavum, Iodidum seu Ioduretum Hydrar-
  gyrosum, Hydrargyrum Iodidulatum seu Subiodatum seu Iodatum, (in
  contradistinction to the Periodatum,) Iodidum seu Iodetum Hydrargy-
  rosum, Proto-ioduretum  mercurii, Protiodide, Proto-iodide, Proto-
  ioduret or Subiodide of Mercury.
French.  Proto-iodure de Mercure.
German. Gelbes oder einfachlodquecksilber, GelbesQueck-
  silberiodid,  Protoiodiir des Quecksilbers, Quecksilberio-
  didul, Quecksilberiodur, Iodquecksilber  in minimum
  des Iod s.
                   METHOD  OF PREPARING.
   According  to Tiinnermann, the best method of  preparing the
iodide is the following:—Take of nitrate of protoxide of mercury
(not tinged yellow by the admixture of nitrate of peroxide,) 28.25
parts; iodide of potassium, 16.5 parts; rub them together for some
minutes  in the  dry state, and  afterwards with a  little distilled
water, gradually adding  the water so as to dissolve the saltpetre
formed.   The mixture is then passed  through the  filter, and the
yellowish-green precipitate of iodide of mercury is well washed, and
dried by a gentle heat.   The objection to this process is the diffi-
culty of obtaining  the mercurial salt at a minimum of oxidation,
and the consequent liability of  the resulting compound to contain
uncertain quantities of the red  iodide.  M. Boutigny,1  to avoid
these disadvantages, recommends the  following form:—Take of
mild chloride of mercury, three ounces and five drams; iodide of
potassium, two  ounces and four drams: pulverize the iodide in a
glass mortar, and add  the calomel; place the mixture in a porcelain
capsule, and pour over it ten  or twelve ounces of boiling distilled
water.  After cooling, decant the fluid, collect the  precipitate on
a filter, and wash with distilled water.   Dry in the shade, and
keep in a well-stopped bottle.
   The  iodide, thus prepared, may, according to  M. Boutigny,
sometimes contain a minute portion of free mercury  or of the mild
chloride, but the quantity of  either is so small as to be of no mo-
ment.
  In the London  and United States  Pharmacopoeias,  it is pre-
pared by rubbing together an ounce of mercury and five drams of
iodine, adding gradually as much alcohol as may be  sufficient until
globules are no  longer visible.  The  powder is dried  immediately
by a gentle heat, access of light being excluded;  and it is kept in
a well-stopped vessel.2
  Iodide of mercury, according to Thomson, consists of 250 parts

  1 Bulletin General  de Therapeutique, cited in Amer. Journ. of Pharmacy, 2d vol. 2d
series, p. 326. Philad. 1837.
  2 Pharm. of the  United States, p. 119.  Philad. 1842. 
HYDRARGYRI IODIDUM.
419
 of mercury, and  156  parts of iodine.   It has a  greenish-yellow
 colour, and  is a preparation holding the  same relation to iodine
 and mercury, that the mild chloride  holds to chlorine and mer-
 cury; it is  more volatile, however, than the mild chloride,  but
 like it is almost insoluble in water.

                  EFFECTS ON THE ECONOMY.
   This  preparation has been  less used than the  red iodide to be
 described next.   Tunnermann remarks, as the results of his expe-
 rience, that  its action in respect to the mercury  is analogous to
 that of the mild chloride, except that it appears to excite more the
 lymphatic and glandular  systems.   When  given in  conjunction
 with a generous animal diet, he found it very efficacious in a case
 of scrophulosis, where colliquative sweats had appeared; and in a
 second case, also, it rendered essential service.  In one of the cases,
 he gave it internally in the dose of from one-twelfth to half a grain,
 three times  a day;  in the other, of from half a grain  to a grain.
 He directed it also to be rubbed, in the form of ointment, on tume-
fied glands of the neck.   Pelletan found it serviceable  in the cure
 of  obstinate glandular swellings, when  used  in the form of oint-
 ment in combination with morphia, as well as in obstruction of the
 liver.  Biett recommends  an ointment of the iodide in the treat-
 ment of chronic venereal ulcers, the cicatrization of which it expe-
 dited ; Lugol1  advises it in  phagedenic scrofulous ulcers, which
present a syphilitic aspect; and Poiret2 recommends it  strongly in
cases of psoriasis;  the  patient  using, at  the same time,  simple
alkaline or water  baths alternately.   According to the experience
of Ricord,3 in the  syphilitic affections of children, especially of a
cutaneous character, it is to be preferred to other  forms of mercu-
rial, and is not apt to be  followed  by the  bad  effects, which, in
adults, often supervene on  the use of other preparations.4

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

  1 Essays on the Effects of Iodine in Scrofulous Diseases, &c, by O'Shaughnessy, p.
 170.  Lond. 1831.
  a Gazette des Hopitaux, 20 Juillet, 1837; see, also, Bulletin General  de Therapeu-
tique, Juillet, 1837; and C. A. Porter, in Amer. Journ. of the Med. Sciences, Nov. 1839,
p. 68.                          s La Lancette Franchise,  No. 65, 1834.
  4 Cogswell's Essay on Iodine, p. 158. Edinb. 1837. See, also, Ricord,  Practical Trea-
tise on Venereal Diseases, translated by Drummond,  Philad. 1843, and Hocken's Com-
parative Value of the Different Preparations of Mercury and Iodine, &c. &c. in Edinb.
Med. and Surg. Joum. April, 1844. 
420
HYDRARGYRI IODIDUM.
                 Pilulae  hydrargyri  iodidi.
                  Pills of iodide of mercury.
               R.  Hydrarg. iodidi gj.
                   Confect. rosae caninae giij.
                   Zingiberis pulv. 3J.   M.
  Dose.—From five to ten grains.         London Pharmac.

          Pilulae  hydrargyri  iodidi composite.
             Compound pills of iodide of mercury.
               R.  Hydrarg. iodid. gr. vj.
                   Extract, opii gr. iv.
                   Lactucarii gr. xxiv.
                   Ext. guaiac. gr. xlviij.
          M.  Fiant pilulee xlviij.
  Dose.—For a child, half a year old, one pill; for older children,
two, three, or four.   In the syphilis of children.     Ricord.

            R. Hydrarg. iodid. gr. j.
               Ext. junip. gr. xij.
               Glycyrrhiz. pulv. q. s.
      Divide in pil. viij.
  Dose.—At first, two, morning  and evening:  afterwards, three
or four.                                 Magendie 4* Biett.

            R. Hydrargyri iodid. ^ij.
               Guaiac. pulv. gj.
               Thridac. £ss.  M. et divide in pil. xlviij.
  Dose.—One a day in scrofula, syphilis,  &c.         Biett.1

              Pulveres  hydrargyri  iodidi.
               Powders of iodide of mercury.
            R.  Hydrarg. iodid. gr. i. (iv., vj.,  vel viij.)
              _ Magnes. J$j. _
      M. et divide in pulv. xij.
  Dose.—A powder,  three times a day.

             Unguentum  hydrargyri  iodidi.
               Ointment of iodide of mercury.
           R.  Hydrargyr. iodid. gj,
               Ceras albae §ij.
               Adipis ^vj.   M.
                                            Lond. Pharm.
            R.  Hydrarg. iodid. gr. vj.
               Morphiae acetat. gr. viij.
               Adipis gj.   M.
  In obstinate glandular swellings.               Pelletan.

           R.  Hydrarg. iodid. 9j.
              Adipis fiss.a M.
  In old venereal ulcers.                Magendie Sf Biett.
1 Duhamel, Amer. Joum. of Pharm. July, 1841, p. 105.
* Tiinnermann uses only §ss. 
HYDRARGYRI IODIDUM  RUBRUM.
421
            R.  Hydrarg. iodid. gij.; (vel iij. vel iv.)
                Adipis |ij.  M.
   As a dressing to phagedenic and scrofulous ulcers.  Lugol.

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

   To be rubbed morning and evening on the parts affected.
                                                   Poiret.
            R.  Hydrarg. iodid. gi.
               Sapou. medicin. gss.
               Aquae rosae gij.
               Unguent,  rosae gvj.  M.
   This ointment is said not to turn rancid so rapidly as the com-
mon ointment.                                      Riecke}
        CVIT. HYDRARGYRI IODIDUM RUBRUM.

 Synonymes. Hydrargyri Deuto-iodidum seu Deuto-Ioduretum seu Perio-
  didum seu Biniodidum, Hydrargyrum Iodatum Rubrum seu Biiodatum
  seu Periodatum, Iodidum seu Iodetum Hydrargyricum, Deuto-ioduretum
  Mercurii, Red Iodide, Deutiodide, Biniodide or Periodide of Mercury,
 French. Deuto-Iodure de Mercure, Periodure de Mercure.
 German. Rothes  Iodquecksilber, Iodquecksilber in  Maxi-
  mum, Quecksilber-iodid, Deuto-IodiirdesQuecksilbers,
  Doppelt  Iodquecksilber,  Quecksilberdeutiodiir,  Iod-
  quecksilber in Maximum.

                  METHOD OF PREPARING.

  The process of the Pharmacopoeia of the United States consists
in dissolving an  ounce of corrosive chloride of mercury in a pint
and a half of  distilled water; and ten drams of iodide of potas-
sium, in half  a pint  of distilled water.  The solutions are then
mixed, and the precipitate is collected on a filter, washed with dis-
tilled water, dried with a moderate heat, and kept in a well-stopped
bottle.
  The following  is the process recommended in the London Phar-
macopoeia:—An  ounce of mercury and ten drams of iodine are
to be  rubbed  together, alcohol being gradually added until the
globules are no longer visible.  The powder is to be dried with a
gentle heat, and kept in a well-stopped vessel.

         1 Bouchardat, Annuaire pour 1844, p. 140.  Paris, 1844. 
422
HYDRARGYRI IODIDUM RUBRUM.
  The Edinburgh Pharmacopoeia triturates two ounces of mercury
with two ounces and a half of iodine, adding occasionally a little
alcohol till a uniform red powder is obtained.  The product is re-
duced to fine powder, and dissolved in a concentrated solution—a
gallon by measure—of chloride of sodium, with the aid of brisk
ebullition.   It  is then filtered, if necessary, through calico, keep-
ing the funnel hot.   The crystals, which form on cooling, are then
washed and dried.
  Red  iodide of mercury is a beautiful vermilion-coloured pow-
der, which, when moderately heated, becomes yellow, but, when
exposed to the  air,  is gradually restored to  red, and is volatilized.
When volatilized,  it crystallizes  in  beautiful rhomboidal  leaves,
which, at a higher  temperature, are of a golden-yellow hue; but
at the ordinary  temperature, of a shining red. It is insoluble in wa-
ter; but soluble in alcohol and ether;  and in solutions of iodide of
potassium, and  chloride of sodium.  It contains 250 parts of mer-
cury, and 312 of iodine.

                 EFFECTS ON THE ECONOMY.
  This preparation, which was introduced into practice  by the
French physicians,  has been particularly recommended in syphilis
complicated with  scrofula.  Biett  found  it  very  efficacious  in
scrofulo-venereal ulcers, in syphilitic swellings of the  lympha-
tic glands, and  in  inveterate itch.   He administered it also in-
ternally, dissolved in alcohol or ether, in scrofulous affections com-
plicated with syphilis, and with advantage.   In its effects, it re-
sembles the corrosive chloride, whilst the iodine resembles the mild
chloride.   Rayer,1  indeed, considers the red  iodide more active
than  the corrosive chloride.  Paillard found it very efficacious in
chronic cutaneous eruptions.   He dipped a camel's hair pencil in
a weak solution of it in ether, and pencilled the parts with it three
or four times a day.  In this way, he cured several squamous, tu-
berculous, and other eruptions.  It scarcely excited any pain. As,
however, this mode of applying it  often failed, he employed 3j«
mixed with ^j. of oil of almonds in the same manner. If the cor-
rosive action was considerable, a  sense of heat soon arose in the
part, which gradually terminated in  burning pain.  The neigh-
bouring  parts were also  hot, painful, and tumefied; and, in the
course of an hour, an infusion of serum took place; but in four or
five hours, the pain  always disappeared.  If applied on the cheeks
or lips, salivation at times ensued  suddenly.   Scabs formed, which
fell off in a few days, and exposed a red surface much disposed to
cicatrize.  When frequently applied, symptoms occurred, which

  1 Treatise on Skin Diseases, by Dr. Willis, p. 79.  See, also, Puche, Journal des Con-
naissances Medicales, Oct.et Nov. 1838, and Janvier, 1839. 
HYDRARGYRI IODIDUM RUBRUM.
423
were probably the  consequences of its  being  absorbed,—-namely,
fever, colic, diarrhoea, and dysentery.   Breschet1 applied it, in the
form of ointment, with great success, in a case of obstinate ulcera-
tion at the angle  of the eye, presumed to  be carcinomatous.
Blasius advises  it  internally and  externally in lupus, and it has
been  recommended highly by  Dr. J. W. Schmidt, Junr., of New
York,2 in cases  of the same affection, and especially in the dartre
venerienne.  Both the iodide  and red  iodide were given internal-
ly.  These cases, as well as syphilitic sore throat of long stand-
ing, which had  been previously treated by mercury without suc-
cess, Dr. Schmidt found to yield invariably to a pill of a quarter of a
grain of the iodide, and a  grain of extractum conii, given night and
morning, and  afterwards three times daily. After using these pills
for from four  to eight weeks, he  substitutes the solution of iodide
of polassium, — changing,  in  the first place, the  action of  the
parts by cauterizing the throat with the solid argenti  nitras.  Dr.
Schmidt has  not found it necessary to carry the iodide so far as
to touch the mouth, but should it accidentally do so,  he stops the
mercury, and  goes  on with the iodide of potassium.  Tunnermann
used it with advantage, in  the form of ointment, for the removal
of furuncular inflammation  of the glands  of the  neck.
Riecke,3 likewise, employed it, with  great success, as  a discutient,
(gr. xvj. to §j.  of  lard,) in a  case of ganglion in the region of
the  knee, from which violent pain proceeded along the  nerves
when it  was pressed upon—and in two cases of goitre.  When-
ever it has to be applied  over  an extensive surface, as in  the dis-
ease last mentioned, it has generally to be discontinued soon, in
consequence of  the supervention of inflammation of the cutaneous
surface.  In the form of a weak ointment—composed of red iodide
gr. ij., cerate 9ij.,  almond oil Bj.—it has been used in opacity of
the cornea.4
   Kopp has published some favourable cases of'the therapeutical
application of  the  red iodide.  The ointment, given below,  he
found very efficacious in luxuriant, chronic, scrofulous, and
syphilitic sores,  as well  as in condylomata,  and  venereal
blotches.   No  less useful did  he  find it in many other skin dis-
 eases, and particularly in herpes.   In one case, in which he ad-
 ministered it in the last affection, he  found  a co-existent goitre,
 which had been there for several years,  almost wholly disappear;
 and he, consequently, afterwards prescribed it frequently for the
 latter affection. He also used it, with excellent effect, in ophthal-

   1 Lugol's Essays  on Iodine, by O'Shaughnessy, p. 204.
   a American Journal of the Medical Sciences, Feb. 1840, p. 301.
   * Die neuern Arzneimittel, u. s. w. S. '270.
   'Grafe und Walther's Journ. fiir Chirurg.  Bd. xiii.,cited by Pereira, Elements of
 Materia Medica,  2d edit. i. 762. Lond. 1842, or  2d Amer. edit.   Phila. 1846. 
424
HYDRARGYRI IODIDUM RUBRUM.
mia tarsi, and, where there was a disposition to the formation of
hordeolum, a little of the second ointment, the form for which is
given hereafter, was applied at  bed time to the edges of the eye-
lids.  Lastly, he advises friction with the first ointment in chronic
rheumatic pains, and in  cases of induration of the glands,
especially of the liver.   After the friction has been continued for
some time, an eruption occasionally appears.
   Both the iodide and red iodide, in the form of ointment, have
been found, by Dr. Moj'sisovics,1 of Vienna, exceedingly useful in
promoting absorption. The strength of the ointment of the iodide,
recommended  by him, is  gr. x. to  3ij- of simple ointment, which
quantity is to be daily rubbed into the part affected.  The strength
of the ointment of red iodide used by him is 3j. to gj.  of simple
ointment.  This ointment spread upon leather vesicates; and the
cuticle separates in the  form of a  crust.   Its efficacy has been
great in bronchocele: according to M. Moj'sisovics, on the falling
off of the dried cuticle, the size has  been found to be sensibly di-
minished.  No preparation of iodide, he thinks, is comparable in
this disease to the red iodide."  "It performs in one month what
the other forms will scarcely do in three or four."   He has treated
goitres of enormous size with it, and at the first application all the
threatenings  of suffocation or apoplexy—wrhere  they  existed—
ceased.   Condylomata  about  the anus and perineum, or even
within the rectum and vagina, were  cured by this ointment;  and
unless they were very extensive and indurated, a single applica-
tion—which  is very painful—combined  with the internal use of
iodine, has been found sufficieat.
   The author has frequently administered  the red iodide in pub-
lic and in  private practice, in cases where an active modifier of
the system of nutrition appeared to be needed, and where a com-
bination of remedies  so  potent  as mercury and iodine  suggested
itself.  In chronic glandular enlargements, especially of the
liver and spleen, and in  habits where the use of mercury was not
contra-indicated, both the red iodide and iodide have, in  his hands,
proved extremely serviceable.  Perhaps there are no preparations,
which, under the circumstances in question, merit more attention.

                 MODE  OF ADMINISTRATION.
   Red iodide of mercury is given internally in the form of pow-
der or pill, or dissolved in alcohol or ether, in the dose of one-six-
teenth to one one-fourth of a grain, gradually increased daily.  Ex-
ternally, it is applied in the form of ointment.

  1 Darstellung einer sicheren und schnellen Heilmethode der Syphilis durch Iodpra-
parate, Wien, 1845: noticed in Brit, and For. Med. Rev., April, 1845, p. 516. 
                HYDRARGYRI  IODIDUM RUBRUM.            425

              Pilulae  hydrargyri iodidi  rubri.
                Pills of red iodide of mercury.
            R.  Hydrarg. iodid. rubr. in syrup, commun.
      pauxill. terendo bene distribuend. gr. v.
                Micae panis alb.
                Sacch.  pulv. aa. q. s. ut fiant pilulae lx.

   Dose.—Two, morning and evening, drinking afterwards a cup-
ful of oatmeal gruel.   The dose  to be raised gradually.
                                                  Blasius.

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

     Syrupns hydrargyri iodidi  rubri  compositus.
         Compound syrup of red iodide of mercury.
           R.  Hydrarg. iodid. rubr. gram. i. (gr. 15.44 Troy.)
               Potass,  iodid. gram. 50.
               Aquas, gram. 50.
    Dissolve, filter through paper, and add
               Syrup. (30° when  cold,) gram. 2400.
  A table-spoonful of this syrup is a dose. It represents, provided
it holds  25 grammes of the  syrup, a centigramtne  of red iodide
of mercury, and 50 centigrammes of iodide of potassium.
                                                  Giber t.1
   iEther sulphuricus cum hydrargyri iodido rubro.
        Sulphuric ether with red iodide of mercury.
           R.  Hydrarg. iodid. rubr. ►)].
               iEther/sulph. f giss.  M.
  Administered like the last.             Magendie &? Biett.

          Dngucntum hydrargyri iodidi rubri.
            Ointment of red iodide of mercury.
           R.  Hydrarg. iodid. rubr. in pulv. subtiliss. gr. vj.
               Adipis sjvj.   M.
                                                    Kopp,
           R.  Hydrarg. iodid. rubr. in pulv. subtilissim. gr. £ to \.
               Adipis §ij.
               Cerse albae gr. ij.
     M. fiat unguentum.
  For an eye-salve.                                  Kopp.
           R.  Hydrargyri iodid.  rubr. gr. xv.
               Adipis jf ss.
     M. exactissime.  Fiat ung.
  As a dressing in lupus.                           Blasius.

              1 Journal de Pharmacie, Oct. 1841, p. 634. 
426                  HYDRARGYRI NITRAS.

            R.  Hydrarg, iodid. rubr. gr. xv.
                Adipis |ij.
                01. bergamot. gtt. x. M.
   To be rubbed on the parts in chronic cutaneous affections,
                                                      Biett.
            R.  Hydrarg.  iodid. rubr. T)j.
                Adipis J;iss.  M.
                                                      Biett.
   To be spread on lint in old venereal ulcerations.
   The unguentum hydrargyri biniodidi of the London College
is prepared like the ung. hydrarg. iodidi.
              CVIII.  HYDRARGYRI NITRAS.
Synonymes. Hydrargyrum nitratum.
French. Nitrate de mercure.
German. SalpetersauresQuecksilber.
  There are two nitrates of mercury employed in medicine:

                I. HYDRARGYRI PROTONITRAS.
Synonymes.  Hydrargyrum nitricum oxydulatum, Mercurius nitrosus fri-
  gore paratus, Nitras hydrargyrosus, Protronitrate of mercury, Neutral
  Nitrate of suboxide of mercury.
French. Protonitrate de mercure.
German. Salpetersaures  Que cks ilbe roxydul,   Kaltberei-
  tetes  Salpetersaures Quecksilber.
                   METHOD OF PREPARING.
  This salt is formed by  digesting excess of mercury in cold di-
lute nitric acid, until short prismatic  crystals are formed.  It is
soluble without  decomposition in a small quantity of water; but in
much water its  crystals are decomposed into a yellow powder—
bibasic nitrate of suboxide of mercury, and an acid  liquor, which
contains a soluble supernitrate.
                 EFFECTS ON  THE ECONOMY.
   The effects of protonitrate of mercury, according to Dr. Perei-
ra,1 may be considered intermediate  between those of calomel and
corrosive sublimate;  and  he  considers  it  probable, that  after
its ingestion it becomes converted into calomel by the action of the
alkaline  chlorides in  the alimentary canal;  and Mialhe2  states,
that if atmospheric oxygen and an excess of alkaline chloride be
present, a portion of corrosive sublimate is formed.   Sundelin3 em-
ploys it  in  all cases in which the corrosive  chloride is  used, and
  1 Elements of Mat. Med. and Therap. 3d edit. i. 873.  Lond. 1849.
  2 Traite  de l'Art de Formuler, p. 72. Paris, 1845.
  * Horn's Archiv., Jahrgang. 1827, St.l, p. 164; cited in Dierbach,Die neuesten Ent-
deckungen in der Mat. Med. 3er Band, lste Abth. S. 302.  Heidelb. und Leipz. 1845. 
HYDRARGYRI NITRAS.
427
especially in  the  different forms of chronic syphilis; and Caze-
nave extols it as an excellent antisyphilitic.   It is not often given,
however, internally.  Externally, it has been  used  by Biett and
others in chronic cutaneous diseases in the form of ointment.
                 MODE OF ADMINISTRATION.
   The dose of the protonitrate of mercury is from one-sixteenth to
one-eighth of a grain in the form of pill, made with extract of liquor-
ice.   Sundelin gave it in the dose of from one-eighth of a grain to a
grain.
            Liquor hydrargyri protonitratis.
             Solution of protonitrate of mercury.
             (Liq. Hydrargyri Nitrici, Ph. Boruss. 1847.)
            R.  Hydrargyri protonitrat. §j.
               Aquee destillat. ,|viij.
               Acid, nitric. Qiiiss.
   Mix the acid and water before the protonitrate is added; filter, and add
water, if necessary, to make the liquor of the sp. gr. 1.100.  Preserve it
carefully in a stopped vessel.
   Dose, three drops.
             Pilulffi hydrargyri  protonitratis.
              Pills of protonitrate of mercury.
            R.  Hydrarg. protonitrat. gr. vj.
          Solve in Aquae destillat. pauxiilo; et adde
                Succ. glycyrrhiz. pulv.
                Rad. Althaeae pulv. sing. &J.
          M. et fiant pilulae xcvj.
   Dose.  Two pills twice  a day.                   Sundelin.
          Unguentum hydrargyri  protonitratis.
             Ointment of protonitrate  of mercury.
            R.  Hydrarg. protonitrat. gr. xv.
                Adipis gj.  M.
   In chronic cutaneous diseases.        Biett fy Cazenave.

               II. HYDRARGYRI DEUTONITRAS.
 Synonymes.  Hydrargyri Dipernitras  seu Supernitras, Hydrargyrum Ni-
   tricum Oxydatum, Mercurius Nitrosus calide paratus, Nitras  Hydrar-
   gyricus.
 French. Deuto-nitrate seu Dipernitrate de Mercure.
 German. Salpetersaures Quecksilberoxyd, Heissbereitetea
   Quecksilberoxyd.
                   METHOD OF PREPARING.
   A solution of  this salt is formed by boiling  mercury in strong
 nitric  acid until  the  liquid, when diluted with water, ceases to
 yield a white precipitate (calomel) on the addition of a solution of
 common salt.  By evaporating, crystals are formed.
                  EFFECTS ON THE ECONOMY.
   This salt is more acrid and caustic than the protonitrate.  It is 
428
HYDRARGYRI NITRAS.
 considered to be converted into corrosive sublimate by the alkaline
 chlorides with which it comes in contact in the intestinal canal;
 and the action of the two substances may, therefore, be regarded as
 the same.  It is  scarcely ever administered internally;  but when
 so, the close may be one-sixteenth  of a grain.  It is often, how-
 ever, used externally, and especially in the form of  Liquor Hy-
 drargyri Supernitratis seu Pernitratis, Nitras Hydrargy-
 ricus Acido-Nitrico Solutus, Solution of Supernilrate of Mer-
 cury, Liquid  Acid Deutonitrate of Mercury, Acid Nitrate
 of Mercury: French, Deutonitrate Acide de Mercure Liquide,
 Nitrate  Acide de Mercure; which is made, according to the Pa-
 risian Codex, by  dissolving  100 parts by weight of mercury  in
 200 parts by  weight of nitric acid, sp.  gr. 1.321, and evaporating
 the solution to  225 parts.1
   The following  formula for the  preparation of the Hydrargyri
 Pernitratis  Liquor is given in  the last Dublin Pharmacopoeia.2
 Take of pure  mercury, §ij. (avoirdupois;)  pure  nitric  acid,
 ^iss; distilled water, liss.   In the acid, first diluted with the wa-
 ter, dissolve the mercury, with the application of heat, and evaporate
 the solution to  the bulk of two ounces and a half.  It is chiefly as
 a caustic that this solution has been used, as by Biett, Petrequin,3
 and others, in lupus; and, by the French surgeons especially, for
 the purpose of cauterizing the ulcerated cervix uteri.*  Biett ap-
 plies it to the extent of a  five-franc piece, by means of a camel's-
 hair  pencil; and  then applies lint  dipped in the solution to the
 cauterized surface.   The  parts immediately become white, and  a
 yellowish eschar forms, which apparently adheres strongly to them,
 but gradually separates.5  By Chardon it has been employed suc-
 cessfully  as an injection in gonorrhoea, a few drops  being added
 to a glassful of water, and thrown up four times a day.6   By De-
 vergie it was applied beneficially in tinea favosa ; and by Camus in
freckles.   Godard  used it  successfully in herpes scrophulosus
 exedens; and in various obstinate cancerous ulcers, and other
 chronic cutaneous affections, it has been prescribed with  good
 results; and Godemer7 has strongly advised it as  a cauterizing >
 agent to the pharynx in cases which require such  applications.
 He  employs a  solution of one part of the acid nitrate to four or
 five of water, and applies it, by means of a camel's-hair pencil,
 passed once over  the part, and gargling  immediately afterwards.
  ' Traite de Therapeutique et de Mat. Med. 3e 6dit. i. 185.  Paris, 1847.
  3 The Pharmacopoeia of the King's and Queen's College of Physicians, 1850, p. 89.
 Dublin, 1850.
  3 Revue Medicale, Paris, 1848, cited in Brit, and For. Medico-Chirurg. Review, April,
 1849, p. 538.
  4 J. H. Bennett, A Practical Treatise on Inflammation, Ulceration and Induration of
 the Neck of the Uterus, Amer. edition, p. 106.  Philad. 1847.
  6 Dierbach, Op. cit. S. 304.
  6 Froriep's Notizen, B. 28, No. 3, p. 46, cited by Dierbach.
  * Journal de Medecine de la Cote d'Or, Mai, 1847, cited in Bouchardat, Annuaire de
 Therapeutique, pour 1848, p. 184. 
HYDRARGYRI ET ARSENICI IODIDUM.          429
  Constitutional  effects are said to have supervened on its local
employment.   Breschet saw salivation induced  by a single appli-
cation of it to trie neck of the uterus.1   To prevent this the  part
may be washed well after it has been touched.
  The well-known Unguentum Hydrargyri Nitratis, Citrine
Ointment, of the Pharmacopoeia  of the United States, is formed of
the deutonitrate of mercury.
      C1X. HYDRAR'GYRI  ET ARSENICI  IO'DIDUM.
 Synonymes. Arsenici et Hydrargyri Iodidum, Hydriodas Arsenici et Hy-
   drargyri, Iodide or Hydriodate of Mercury and Arsenic, Double Iodide
   of Arsenic and Mercury, lodo-arsenite of Mercury, Donovan's Solution.
    Mr. Donovan2  has  proposed this new compound, which he re-
 gards as more efficacious than either the iodide of mercury or the
 iodide of  arsenic.
                   METHOD OF  PREPARING.
    Triturate 6.08 grains of finely levigated metallic arsenic ; 14.82
 grains of mercury, and 49 of iodine, with one fluidram of alcohol,
 until the mass has become dry, and, from  being deep brown, has
 become  pale  red.  Pour on eight fluidounces of distilled  water;
 and after  trituration for a few moments, transfer the whole  to a
 flask; add half a dram of hydriodic acid, prepared  by the  acidifi-
 cation of two grains of iodine, and boil for a few moments.  When
 the solution is cold, if there be any deficiency of the original eight
 ounces, make  it exactly that measure with distilled water.  Finally
 filter.3
   By the  long continued  trituration of arsenic,  mercury,  iodine,
 and alcohol, the metals are converted into iodides, which combine.
 The mass, by solution in water, is converted into a hydriodate of
 arsenic and mercury.  The quantities of the  two  metals  are so
 adjusted, that, when  converted into protoxides by  decomposition
 of a portion of the water in which they are dissolved, there will
 be eight grains of arsenious acid, and sixteen of protoxide of mer-
 cury.  The quantity  of water is such, that each dram by measure
 of the solution will  contain exactly one-eighth of a  grain of arse-
 nious acid, and one-fourth of a grain of protoxide of mercury.  Mr.
 Donovan  conceives,  that the  quantity of mercury ought  to be
 double that of the arsenic, in order  to ensure a slow, and  mode-
rate, yet adequate mercurial action, along with the proper effect of
 the arsenic.
  On repeating Mr. Donovan's process, M. Soubeiran4 found, that
a portion of  arsenic remained undissolved, and he therefore  pro-
           1 Op. cit. p. 191.
           3 Dublin Journal of Medical Science, Nov. 1839, p. 281.
           3 Donovan, Dublin Journal. Nov. 1842, p. 171.
           4 Journal de Pharmacie, xxvii. 744. Paris, 1841.
       28 
430           HYDRARGYRI ET ARSENICI IODIDUM.
posed  the following mode of preparation:—Take of teriodide of
arsenic, gr. xxxv.; biniodide of mercury, gr. xxxv.; boiling dis-
tilled water, f ^viij.   Triturate until dissolved, and  filter; and, if
necessary, add  sufficient water to make ^viij.  of the solution.  A
similar formula has been recommended  by Mr. Procter,1 of Phila-
delphia, who employs 36 grains of the teriodide of arsenic, and
34 grains of the biniodide to ^viij. of water.
   Of the preparation above described, which  Mr. Donovan  calls
liquor hydriodatis arsenici et hydrargyri, (liquor arsenici et hy-
drargyri iodidi seu hydrargyri iodo-arsenitis,) each dram by mea-
sure consists of water, one dram;  arsenious acid, one-eighth of a
grain; peroxide of mercury, one-fourth of a  grain;  iodine, con-
verted into hydriodic acid, about three-fourths of a grain.  The
colour of the solution is  yellow,  with  a pale tinge  of green:  its
taste is slightly styptic.   It is incompatible with tincture of opium,
or with sulphate,  muriate, or acetate of morphia.
   The test of the perfection of the preparation, according to Mr.
Donovan,2  is, that the whole of the iodine, arsenic  and mercury
shall disappear, and be dissolved  during  the  process of preparing
it.   This cannot happen unless the three elements employed  have
been chemically pure, and unless the trituration has been sufficiently
long continued.
                  EFFECTS ON THE ECONOMY.
   Numerous trials have been made with this preparation in  cuta-
neous diseases, especially in psoriasis, lepra and lupus;  and the
testimony of some of the most  eminent of Mr. Donovan's coun-
trymen has been brought forward in its favour.  Mr. Carmichael
has  given it  in five or six cases of lupus,  and  in one of psoriasis,
with decided benefit.3  Mr. Colles administered it in two extreme
cases of scrofulous ulceration in the adult with some benefit: Dr.
Croker gave it internally, and applied it externally, with complete
success, in a case  of psoriasis guttata:  Dr. Graves treated with it
a very inveterate  case of psoriasis with  decided advantage; Dr.
Irvine completely cured  by it a most virulent case  of  the  same
affection; Mr. Cusack found, that venereal eruptions yielded rapidly
to half dram doses, three times a  day;  and Sir Henry Marsh had
a case of impetigo figurata, of strumous origin, covering the face,
chest, arms, and thighs, but particularly well marked at the flexures
of all the joints, which  was cured by the administration of fifteen
minims, twice a day, gradually increased to one scruple, and finally
to half a dram.   The treatment  was cautiously pursued for some-

   1 A merican Journal  of Pharmacy, June, 1847, p. 93.  A form for the preparation of
the Arsenici et Hydrargyri Hydriodatis Liquor has been introduced into the last edi-
tion of the Dublin Pharmacopoeia, 1850.
  1 Dublin Journal, Sept. 1840, p. 106.
  * Dublin Medical Press, Jan. 18, 1840. 
HYDRARGYRI ET ARSENICI IODIDUM.
431
what less than a month, with a gradual amendment of the disease,
which subsequently disappeared entirely.
  Since those cases were published, Mr. Donovan has given nu-
merous others from the practice of Dr. Charles O'Reilly, Sir Henry
Marsh,  Dr.  Robert J. Hickson,  Dr. J. D. White, Mr.  Richard
Jones, Dr. Bigger, Mr. O'Ferrall, Dr. Ferguson, Dr. Osbrey, Dr.
W. T. Hamilton, Dr. Graves, Dr. Kirby, Mr. Gabriel Stokes, and
Dr.  C. P. Croker, which lead  him to infer, that  the diseases  in
which the preparation has been found of most service are the va-
rious forms of psoriasis, impetigo, porrigo, lepra, venereal erup-
tions—both papular and scaly, pityriasis, sycosis, ephelis, lupus,
sibbens, and some uterine diseases.1  In several of the cases, slight
ptyalism was induced.
  Dr. Isaac E. Taylor, of New York,2 prescribed this preparation
in a  number of cutaneous diseases; and  he testifies, that it pro-
duces a more  marked and prompt effect than the various  remedies
usually  resorted to in lupus, rupia, psoriasis, secondary syphilis,
&c.   It is also spoken of in high terms by Dr. Gerald Osbrey,3 in
inveterate psoriasis, lichen urticatus, and scrofulous ophthalmia.
                 MODE OF ADMINISTRATION.
  The  dose  of the liquor arsenici et hydrargyri iodidi  is from
fifteen minims to half a  fluidram, two or three times a day.  Mr.
Donovan4 recommends the following form:—
     Ilaustus  liquoris  arsenici et hydrargyri iodidi.
      Draught of solution of iodide of arsenic and mercury.
                R,  Liq.  arsenic, et hydrarg. iodid. gij.
                   Aquae destillat. f ^iiiss.
                   Syrup, zingib. f 3jss.  M.
          Divide in haustus iv.
  Dose.—A  draught, night and morning.
  The division into draughts, Mr. Donovan considers necessary—
first, to ensure accuracy of the dose; and next, to prevent injury
to the ingredients by the use of a metallic spoon, as a measure;—
the  general  way  in which  doses of medicine are administered.
When applied externally in cutaneous affections, it may be diluted
with an equal portion of water, or farther—should a weaker lotion
be indicated.   Mr. Donovan states, that  the employment of this
preparation was rapidly extending, as  shown by the fact, that within
two years and a half, about three hundred pints of it  had been
sent out of his establishment alone, which, as he properly remarks,
is a  vast quantity  of an  article prescribed in minim doses.5

  1 Dublin Journal of Medical Science, Nov. 1842. p. 199, and Erichsen, London Me-
dical  Gazette, May 12, 1843. p. 2:^8, and May 19, 1843, p. 241.
  a American Journal of the Medical Sciences, April, 1843, p. 319.
  * Dublin Journal of Medical Science, July, 1842.
  •Ibid. Nov. 1839, p. 282.
  1 Ibid. Nov. 1842, p. 199. 
432
INDIGUM.
  A double iodide of mercury and morphia, French, Iodure
double de mercure et de  morphine, has been  recommended  by
M.  Bouchardat.1  It is obtained  by treating in boiling alcohol, a
mixture of equal parts of  red iodide of mercury, and  iodhydrate
or hydriodate of morphia.  On cooling, crystallized grains are
deposited of a double compound,  having a white, slightly yellow-
ish  colour.  According to M. Bouchardat, it is almost as energetic
as the red iodide  of mercury, and  ought to  be employed  with
great caution.   A quarter of a  grain is a  dose, which may be
given once a day in the form of pill in constitutional syphilis; gra-
dually increasing the  dose, especially in syphilitic pains of the
bones.
                        CX. INDIGUM.
 Synonymes. Indicum, Indicus Color, Pigmentum Indicum, Indigo.
 French. Indigo.
 German. In dig.
   This well-known colouring material is obtained from several
 species of  the genus Indigofera (I. tinctoria, 1. anil, I. disperma,
 1. argentea, and I. hirsuta,) belonging to the Natural Family
 Leguminosae, and, in the Linnaean System, to Diadelphia Decan-
 dria.  As  we receive it, it is in  small, solid, brittle masses, of a
 deep azure colour, without smell or taste,  and assuming a coppery
 lustre on  being rubbed.   It is entirely soluble in sulphuric acid,
 and  is wholly  consumed on  burning coals.   According to  the
 analysis of Chevreul, 100 parts of Guatemala indigo of commerce
 contain only 45 parts of pure indigo, or indigo-blue—with which
 no therapeutical experiments have as yet  been made:  the greater
 part of the residue  consists of a  green matter soluble in spirit of
 wine (indigo-green ;)  and a  red resin (indigo-red;) the rest  is  ex-
 tractive matter, gum,  and some carbonate of lime, oxide of iron,
 and argillaceous and siliceous earth.   With hydrogen, pure indigo
 forms isatic acid, which has considerable resemblance to the hydro-
 cyanic.
                 EFFECTS ON THE ECONOMY.
   The natives of the countries where the different kinds  of indigo
 grow, employ it occasionally as a therapeutical agent, especially
 in diarrhoea  and intermittent fever.   It  is only within  the last
 twenty  years that attention has been paid  to it in Europe.   Prof.
 Von Stably,2 of Ofen, appears to  have first employed it with suc-
 cess in  various spasmodic diseases, especially in epilepsy.   To
 these cases Lenhossek alludes, in  detailing certain trials which he
himself  had made with it.  In 1833,  Grossheim3 made known a

           1 Nouveau Formulaire Magistral, p. 303.  Paris, 1845.
           a Hecker's Neue Annalen, B. i. H. 1.  Berlin, 1835.
           3 Medicinische Zeitung, No. 51, 1833. 
INDIGUM.
433
 case in which he found it extremely useful.  A lady, twenty-eight
 years of age, had suffered for eleven years with violent hysterical
 convulsive attacks, for which she had employed almost every re-
 medial agent.   They began with a feeling of heaviness over the
 whole body, with slight convulsive twitchings of the  limbs, which
 extended to  the trunk; and  were followed by total, or almost total,
 loss of consciousness:  this, after an uncertain period, terminated in
 a comatose state, from which she was gradually restored—but in
 a languid condition—to  perfect consciousness.  Under the use of
 indigo for half a  year, with  pediluvia—which had been previously
 employed without advantage—she completely recovered.
   These results  gave occasion to the institution  of  experiments,
 touching the remedial  properties of indigo, in the Charite at Berlin,
 the results of which have been given by Roth.1   In most of  the
 cases,  it excited nausea, and  even vomiting, preceded  by a metallic
 taste on  the tongue.   At times, the vomiting was so violent and
 prolonged, that it was necessary to discontinue it; but generally
 on  continuing  its use, the vomiting ceased in  three or four days,
 and diarrhoea took its  place.   All the patients did  not vomit, and
 many escaped the diarrhoea.   When once diarrhoea  occurred, how-
 ever, it commonly persisted  as long as the indigo was used.  The
 evacuations were  seldom  entirely fluid, but usually semifluid, and
 of a dark bluish-black colour.  While the vomiting and purging
 continued, more or less uneasiness was experienced in  the digestive
 apparatus.  The  vomiting and diarrhoea were frequently accompa-
 nied by pains in  the stomach and bowels, which were  commonly
 slight,  but occasionally so violent that it  had to be discontinued.
 In every patient at the Charite, the urine was of a  dark violet hue.
 Von Stahly affirmed that the perspiration was coloured  blue, but this
 Roth never observed.   He remarked, moreover, that after its use
 for several weeks, certain patients were easily thrown into slight
 convulsions, similar to  those caused by the use of nitrate of strych-
 nia, and  that they were affected wTith slight subsultus tendinum.
 Almost all the patients, indeed,  who  took it, were at  first more
 frequently attacked with spasms than  prior to the use of  the re-
 medy.   In the beginning, the attacks of the disease were, in all
 cases, stronger, but of less duration, than previous to its employ-
 ment.   These changes continued for one, two,  three, and even  as
 long as eight weeks, whether  the patients  took  small or large
 doses.   At the expiration of this time, all the epileptic symptoms
 were diminished  in intensity and duration, until  the  last attacks
 were mere premonitions.
  The number of epileptic cases, treated  by it, which Roth  had
an  opportunity of observing in the Charite, was  twenty-six; of
these, nine were cured, eleven improved, and six remained.

           •  Hecker's Neue Annalen, B. i. Heft 1.  Berlin, 1835. 
434
INDIGUM.
  Dr. Ideler,1 who instituted the experiments at the Charite, has
also given publicity to the  results; and  his  testimony accords
with that of Roth.  It is proper to observe, however, that, of the
nine  cases  cured, three experienced  relapses  in  from eight to
twelve  months;  but from causes, according to Riecke,2 which of
themselves might have induced epilepsy.
  Dr. Strahl,3 of Berlin, likewise experimented  with indigo, but
his  results were by no means favourable.   In  ten  cases  of old
standing epilepsy, it was not of the slightest service, and the same
may be said of two cases of St. Vilusys dance.  In four cases of
hysteria, it excited violent  nephralgia, and in one of the  cases,
only after the affection of the  kidney was removed, was the pa-
tient  cured.   It acted, however,  markedly on the uterus;  in two
cases of spasmodic  affections, complicated with  amenorrhcea, the
latter derangement was removed,  whilst the spasms  still continued,
even  after the  recurrence  of the catamenia.   In the Charite, of
Berlin,  the purest Guatemala indigo of commerce  was used, and
it has  been a question, whether Strahl did  not employ  one of
feebler  powers.  It is worthy of  remark, that he observed a dark
green colour of the urine during its use, whilst in the cases in the
Charite, a dark violet hue was constantly noticed.
  Favourable  cases are also  detailed  by Drs. Mankiewicz of
Nackel,*  and  Hohnhorst, of Frankfort.5  M. Podreca6 found it
especially efficacious when associated with asafcetida and castor.
  Dr. Noble,  of Versailles,7  administered it  in three cases, in
which the disease had  continued for four, twelve  and twenty
years respectively.  At the time of making known the results, a
month had elapsed in the first case, and two months in the second,
since  an attack  had been experienced, and the  last case he con-
sidered  entirely cured.  In  the first patient, who was eighteen
years old, four drams occasioned vertigo, slight  depravation of
vision, and convulsions  similar to those produced by strychnia;
and in both the other cases, diarrhoea was induced, which ceased,
however, as soon as the indigo was discontinued,  or the dose re-
duced one-half.  He  gave it in the  dose of one dram gradually
increased  to four drams daily.
  The observations of Rech, of Montpellier, were  not as favour-
able to it.  In none of the epileptics to whom he  gave  it was
there any thing more than a slight amelioration.   In the Hospice
d'Hommes Incurables  du Faubourg St. Martin, trials were made

  1 Medicinische Zeitung, No. vi. cited in Lancet, June 6, 1835.
  s Op. cit. S. 276, and 2te Auflage, S. 389. Stuttgart, 1840.
  3 Hecker's Neue Wissenschaft. Annalen,  1836; cited in Edinb.Med. and Surg. Jour.
1837.                     < Medicin. Zeitung, 31 Mai, 1837, S. 109.
  5 Ibid. S. 110, and Medicin. Zeitung des  Vereins fiir Heilkunde  in Preussen, 1837,
No. 22.
  6 Bouchardat, Annuaire de Therapeutique, pour 1843, p. 69.  Paris, 1843.
  ' Bulletin General de Therapeutique, 1836. 
INDIGUM.                       435
with it by Dr. Blanche.   Of ten cases, five were either cured or
improved.   One  of these  had existed for three  years, and  the
paroxysms recurred every five or six days; but after the adminis-
tration of the indigo, he had  no return at the expiration of five
months;  in a second case, a  youth, fifteen years old—who had
been epileptic from birth, and had regularly one or two paroxysms
a day, from the 19th of July, when its exhibition was begun with,
until the middle of August, when the results were published—had
only two insignificant attacks.   The  improvement  in  the  other
three cases was not as  marked, yet it  was unquestionable.   The
other five  children  experienced  no improvement, yet  no incon-
venience was sustained, although the indigo was given in doses of
four, six, and eight  drams in the  day.   It was  administered in
water or in a tisane; and in one or two cases it excited vomiting,
but after having  been  discontinued, it was  borne subsequently.
In all it induced tormina, and acted upon  the  bowels, but did not
interfere with the  appetite or any of the other functions.
   Dr. Benjamin F.  Hardy,1 one of the senior resident physicians
at the Philadelphia Hospital, published the results of some trials
made with it, which, so far as they  go, confirm its antiparoxysmal
power.   Two of the seven cases reported were apparently cured,
two ameliorated,  and three without  any decisive  results—the
medicine not having been continued perhaps for a sufficient length
of time.   In these cases, it was commenced  in  the  dose of 3j.,
which was usually doubled daily until the  patient took  ^ij^ daily,
which quantity was persevered in  for some weeks.   In some of
the cases, the feces, urine, and perspiration were all coloured blue.
  In other trials, instituted in the same charity, wTith  indigo, the
results were not  as favourable.2   It  is  obvious, indeed,  that a
wide difference must exist amongst  cases of epilepsy, and  that
where the organic modifications are considerable, as indicated  by
concomitant  mania, or idiocy, little  can be  expected from any
remedy;  but even in such hopeless cases, the number of paroxysms
appear to  have  diminished under  its  use.  Where  the cerebral
affection is slight, and more functional  than organic, like artemisia
and other  remedies  extolled in epilepsy, it  may be  useful.   Its
main efficacy, perhaps—as has been said of the Ferri Subcarbonas
(p. 378,)—consists  in  the  new  impression  which  it makes, in
adequate doses, upon the nerves of the  stomach, and through them
upon those of the whole system; but to effect  the revulsion to the
proper extent, it is necessary that the  dose should be  augmented
day by day, and the remedy be  continued in large  doses for a
sufficient length of time.
  Dr. Pereira,3 states that he has tried it in  a considerable num-

  ' American Medical Intelligencer for July 15, 1839, p. 122.
  a William H. MKee, in American Med. Intelligencer, Sept. 16, 1839, p. 177.
  * Elements of Materia Medica, &c., 2d edit. p. 1620.  Lond. 1842; or 2d Amer. edit.
Philad. 1846. 
436         INJECTIONS INTO THE EUSTACHIAN TUBE.
ber of epileptic  cases  at  the  London  Hospital, but without de-
riving the least benefit from it.
                 MODE OF ADMINISTRATION.
  As indigo is extremely light, 'the powder is too bulky for admi-
nistration;  it is taken with disgust, and is apt to excite vomiting.
On this account the form of electuary was selected in the Charite.
It was  generally  combined with  pulvis  aromaticus,  or  pulvis
ipecacuanhas et opii.   As to the dose, Roth advises that it should
be commenced in grains,  but be elevated to drams,—nay, even to
one or more ounces in the day.   In the Charite, the following
formulas were generally employed : —
                      Pulvis  indigi.
                      Powder of indigo.
               R.  Indig. in pulv. subtilissim. gss.
                   Pulv. aromat. gr. v.  M. et fiat pulvis.
  A powder to be given four times a day.
                Pilulae  indigi composita.
                  Compound pills of indigo.
                      (Antiepileptic Pills.)
                     R.   Indig. gr. lxxv.
                         Asafcetid. gr. xv.
                         Castor, gr. vij.  M.
            et divide in pilulas xx.
  One to be given every  hour.                     Podreca.
                  Eleetuarium  indigi.
                    Electuary of indigo.
             R.  Indig. pulv. aqua? guttis nonnullis subact. ^ij.—§ss.
                 Pulv. aromat. gss.
                 Syr. simpl. f ^j.
      M. et fiat electuarium.
  To be used in  the course of the day.                 Ideler.
CXI.  INJECTIONS  OF AIR, VAPOUR  OF ETHER, ETC.,
            INTO THE EUSTACHIAN TUBE.
  An important improvement in the understanding and treatment
of diseases of the ear has resulted from the attention that has been
paid to the pathological  condition  of the  Eustachian tube, and
the means, through it, of rectifying certain morbid states of the
organ of hearing.  A mystery has been thrown, or attempted to
be thrown, over the  diseases of the ear, and, as  a consequence,
they have furnished  largely to empiricism; so that an exclusive
aurist has been, too often, perhaps, esteemed synonymous with an
exclusive  empiric.   Now that  the  physiology of the outer and
middle ear is better understood, their pathological relations are no 
INJECTIONS INTO THE EUSTACHIAN TUBE.
437
longer environed with the same difficulties.   The attention of the
surgeon has to be first directed to the meatus externus, and if he
discovers  any obstacle,—as hardened cerumen,—which prevents
the vibrations  of a sonorous  body from reaching the membrana
tympani, such obstacle must be removed.   Should no defect exist
there, he  inquires into the state of the Eustachian tube, to detect
whether it be pervious, so as  to  permit a free passage for the air
from the throat to the middle ear—any impediment to which is a
common cause  of deafness; and,  lastly, if the tube be found  in a
state of integrity, his attention  is turned to the condition of the
nerve, to  discover whether the defect—organic or functional—be
seated there.  Such are the main subjects of investigation in cases
of deafness;  although the condition of the membrana tympani, of
the ossicles,  and the mastoid cells, become interesting  incidental
objects of inquiry.   Chronic inflammation  of the Eustachian
tube occasionally gives rise to stricture or narrowness of the tube;
at others, to  obstruction of the tube by means of mucus, or to ac-
cumulation of mucus in the tympanic cavities.  In the former case,
catheterism is demanded; in the latter, injections of air, in addition.
   For the purpose of catheterism, various instruments  have been
employed.  The catheter of  Itard is  a conical silver tube, curved
at the extremity, with a slight enlargement to prevent^ laceration
of the membrane.  Kramer's  instrument is  a modification of that
of Itard;  the curve is more  gradual, and the enlarged or button
point is omitted.   It is made of  silver, six inches  long, and is of
a calibre varying from the size of a small crow-quill to that of a
large goose-quill.  The extremity is well rounded, and it is curved
only to the distance of five  lines from the  point, exactly at an
angle of 144°, so as  to  correspond to the lateral situation of the
Catheter of Itard, (Reduced one-half.)
mouth of the Eustachian  tube.   It is nearly of the same calibre
throughout its whole length, and provided with a funnel-shaped
dilatation at the outer extremity, half an inch in length, to admit
the pipe of the  injecting  syringe, &c.   To  this part is  added a
ring, on the same level with the beak of the catheter, by means
of which the situation  of  the beak  can be ascertained, when the
instrument is introduced.  The  catheter is  farther graduated in
inches, which is convenient in  repeated introductions.1  When it

  1 Kramer, on Diseases of the Ear, chap. 2, Amer. Med. Library edit.  Philad. 1838. 
438         INJECTIONS INTO THE EUSTACHIAN TUBE.
is requisite to sound the Eustachian tube, a piece of catgut  may
be passed through the instrument.
  The  catheter  recommended  by Mr. Pilcher1 admits  of being
passed farther into the tube, and has a more gradual curve.   De-
leau2 employs a flexible elastic gum catheter, which the patient
learns  readily to pass into  the Eustachian  tube, and  by turning
down the outer extremity, is able to inflate the tube with his own
breath.  This the  author has  seen  repeatedly done.   The silver
instrument, slightly warmed and oiled,  is introduced, with its  con-
vexity upwards,  along the floor of the nostrils until  the  point
reaches the pharynx; it is then gently turned, so that  the point
shall be outwards and a little upwards, the aperture of the Eusta-
chian tube being above the level of the floor of the nose: in this
way the tube enters, and  is readily felt by the operator to  have
done so.  The instrument is then carried onwards, until its farther
progress is prevented by the narrowness of the tube.  Mr. Pilcher's
instrument is of such dimensions  as to frequently occupy three-
quarters of an inch of the  tube;  but if it  be pushed  beyond the
fibro-cartilaginous portion—or that part of the tube which readily
admits it—the mucous membrane may  be lacerated, and pain will
certainly be produced.3   When  Mr.  Pilcher's  catheter  is fairly
introduced, it will remain without support,  an advantage it  pos-
sesses—in the  opinion  of its proposer—over those of Itard and
Kramer, which  requires a frontal bandage  to retain them in situ.
Itard's bandage is  represented in the  next  figure.  It consists of
Frontal Bandage of Itard.
a middle piece made of metal, bent so as to fit the arch of the fore-
head, and slightly padded within; to this are attached two straps,
which fasten with a buckle.   To the  centre of the middle  piece,
a pair of forceps  are  attached, which move in a ball and socket
joint, and the blades of  which are  brought together by a screw.
The bandage is applied before  the  catheterism  is  commenced;
and when the instrument is  introduced, the forceps  are  brought
down, and screwed tight on the catheter, so as to retain it in posi-
tion.   Through the catheter, thus introduced, aurists were  in the
habit of sending  lukewarm  water  through the Eustachian tube
into the cavity of the tympanum ;4 but owing to certain objections

  1 A Treatise on the Structure, Economy and Diseases of the Ear, p. 304.  London,
1838.              a Op. cit. p. 305.              3 Op. cit. p. 305.
  4 See some cases of deafness relieved in this way, by John H. Dix, in Boston Medical
and Surgical Journal; Sept. 25,  1839, p. 105. 
INJECTIONS INTO THE EUSTACHIAN TUBE.         439
 that apply to the employment of fluids, Deleau1 suggested the air-
 douche, or injections of air for the purpose of clearing the cavity;
 and this is regarded by Kramer2 as a great improvement.   With
 the view of increasing and  regulating the force with which the air
 is sent into the cavity, both these gentlemen invented air-presses
 or condensers.   The marginal figure represents that of Kramer.

   c b is a cylinder, 10£ inches
 high, made of molten brass; the
 diameter of its calibre  is 4|
 inches, and it is fastened at b
 with strong screws, on a strong
 oaken  stand of the height of an
 ordinary stool.  Within the cy-
 linder  c b is a pump  barrel of
 wrought brass screwed into it,
 which measures IO3  inches in
 height, and 2£ inches in diame-
 ter, rising, at da, 3 inches out of
 the cylinder, so that the whole
 machine a 6 is about 13 inches
 high. In the piston of the pump
 barrel, there is a valve for  the
 passage of theair,which besides
 passes  in at the opening situate
 at d.  There is a second valve
 in the bottom of the pump barrel,
 through which the air is forced
 into the interior of the cylinder.
                                      Air-press of Kramer.
   When air  is injected  into  the tympanum, it may be heard  to
strike  against the membrane, and  to rush  through the cavity into
the mastoid  cells, and thus  may become a means of exploring the
condition of the middle ear.
   Mr. Pilcher3 observes, that—from  his  daily experience of the
 great  facility with which  air and  fluids may be  introduced into
the  tympanum, and regulated, both as to quantity and force, by
means of a common syringe accurately fitted to the catheter—he
does not hesitate to  declare his  conviction, that the ceremony and
inconvenience  of the  air-press may be  dispensed  with.  He re-
commends that the operator should merely steady the instrument
 with his left hand, whilst he  uses the syringe with his right.  By
this means, any fluid or gas injected through the catheter  may be
brought into contact with the mucous  membrane, and thus stimu-
late the nerves of the cavity.   Nor is the air-press entirely devoid
of  danger.   Inflammation  and even  suppuration is sometimes
caused  by the air douche.  This occurred, in  seven  cases, to M.

  1 Sur  le Catheterisme de la trompe d'Eustache, &c.  Paris, 1828; Itard, in M<Sm. de
I'Academ. Royale de Medecine, Tom. v. Fasc. 4.  Paris, 1836; and translation in
Medical  and Surgical Monographs, vol. i. p. 75, of Amer. Med. Library, p. 86. Philad
1838-               ' Op. citat. p. 164.               » Op. cit. p. 307.
 
440        INJECTIONS INTO THE EUSTACHIAN TUBE.
Itard; and Mr. Henry Savage1 refers to five  cases, which came
under his cognizance, where perfect deliquium  was caused, which
continued for several  hours.  A case, too, has been  detailed, in
which, after " pumping air" four times  through the nostrils into
the Eustachian tube, immediately  on removing  the  instrument
from the nostril, the patient fell back in the chair and never spoke
afterwards.3  The sudden shock to the nervous  system was pro-
bably the cause of death; and it has been suggested that, to avoid
too great a degree of pressure, the  nozzle  of the tube of the air-
press should be held, during the operation, so loosely in  the di-
lated end of the catheter, that there may  be room for air to regur-
gitate,3 and, likewise, that instead of sending in the air by douches
or charges—it should be transmitted  in a gentle and continued
stream.   Another circumstance, which shows  the importance of
care, is the fact, that the mucous membrane may be  ruptured, and
serious emphysematous tumefaction be occasioned.
   It is proper to observe, that the results of  258  cases, treated
by Itard,4 are far from encouraging.  Of these, but two of cure are
said to have been effected, and in this result, according to Itard,
other caused concurred ; whence he infers,—first, that as a means
of exploring  obstructions of  the  tympanum  by  the  crepitation
which often accompanies them, douches of air  can afford no cer-
tain index; and secondly, that  as a mechanical agent for deterging
or evacuating obstructing matters, they can only dislodge and force
them  together; and, consequently,  that  both  in  the second and
first point of view, douches of air do not deserve the confidence of
the profession.
   The vapour of acetic ether has  been  injected  into the  mid-
dle ear in cases of nervous deafness, of which Kramer5 makes two
varieties; noise in the ear constituting the essential point of dif-
ference between them.   This noise  belongs, without exception, to
the erethitic form; whilst it is foreign to the torpid.  In cases of
nervous  deafness, Itard proposes to  introduce ethereous vapour
through  the catheter, and to generate this vapour in an apparatus
in which the ether is dropped on a saucer of red  hot iron, by the
heat of  which it is vaporized.   The ether is, however, decom-
posed in  this manner, so that it is not  ethereous vapour which
enters the tympanum, but an  acrid, very irritatin'g kind of gas,
which, according to Kramer, is well suited to  the torpid form of
nervous  deafness, but is positively injurious in the erethitic varie-
ty.  He considers the attempt to vaporize  acetic ether in a flask,

  1 Lond. Med. Gaz. for July 20, 1839,  p. 616.  M. Lynch, in Lancet, Aug. 3, 1839,
p. 683, and ibid.  p. 690; and Joseph Williams, Treatise on the Ear; including its
Anatomy, Physiology and Pathology, &c. p. 242. Lond. 1840.
  a Lond. Med. Gazette, July 6, 1839, p. 538.
  3 British  and Foreign Medical Review, July, 1839, p. 95.           * Op. citat
  * See, on this subject, T. Wharton Jones, in Lond. Med, Gaz., Aug. 3, 10, 17, and
24: 1839.                                                    ». 
injections into the eustachian tube.         441
 placed  in warm water, and  connected  by means of  a  tube with
 the  cavity  of the tympanum,  to  belong to  the  same class  of
 methods which act  in  too irritating  and  injurious a manner,
 owing to the vapour  being given
 off far too rapidly.   This incon-
 venience he proposes to remedy in
 the erethitic form of nervous  deaf-
 ness, in the following way: —A
 large  glass flask—represented in
 the accompanying figure—holding
 about ten  quarts, is  firmly  and
 closely stopped with a cork through
 which are passed two  brass tubes,
 each provided with a cock;  one
 of these tubes is connected above
 with a funnel for dropping in the
 fluid, and the  other with an air-
 tight tube  to conduct  the vapour,
 generated and enclosed within the
 flask, into the  cavity of the tym-
 panum.  When the apparatus is
 to be used, the cork is to be firmly
 fixed into the neck of the flask, with
 two tubes attached, and the cocks
 closed; the proper quantity of ether
 is  then  to  be  poured into  the
funnel, and forced into  the flask by
Vapour Apparatus of Itard.
                                  a gentle  expiration, where it
 is converted  into thin vapour at the  ordinary temperature of the
 room.  This vapour fills the interior of the flask equably, and  is,
 indeed, in a state of slight condensation, so that when the metallic
 tip of the  tube  is connected with the catheter,  and the  cock is
 opened, the vapour issues with a whizzing sound.
   Having  previously introduced the catheter  through the  nose
 into the mouth of the Eustachian tube, and placed it in connexion
 with the tube of fhe vapour apparatus, the patient is to sit near a
 table, leaning his arm  upon it, and with the corresponding hand
 he is to hold the tube of the  apparatus, in such manner that it
 may remain in close  connexion with the catheter.   Each  sitting
 occupies a quarter of an hour, and is repeated daily,  applying the
 vapour alternately to the right and to the  left ear.   It is unne-
 cessary to  make use of warm water to pour into the flask, as the
 ordinary temperature of the room is sufficient to vaporize the ether.
   In  the torpid form  of nervous deafness,  this method  of  pro-
 cedure does not  answer, owing to the necessity for greater excita-
 tion than it is capable of effecting.  In such a case, a modification
of the apparatus of  Itard has been proposed by Kramer.   Owing
to the  metallic saucer in Itard's  becoming cool more  than once
 during a single sitting,  and  requiring to be  exchanged for a hot 
442         injections into the eustachian tube.
one, as  a necessary consequence  the temperature  of  the vapour
generated never  remains for a moment the same, but varies  ex-
tremely;  immediately after the  insertion of the red-hot saucer,
Vapour Apparatus of Kramer.
the vapour issues burning  hot into  the  ear, and in a few minutes
sinks to a very low temperature.   These evils Kramer  proposes
to rectify in the following manner.—For the floor on which  the
bell-glass of the apparatus rests, a thin  metal plate is substituted,
which is warmed at pleasure by an  oil lamp  placed beneath, so
that the ethereous fluid falling on it is thus conducted through  the
catheter into  the middle ear.  Through the  cover of the appa-
ratus, a  thermometer, with a metallic scale, passes  down almost
to the bottom, and  indicates the temperature at which the ethere-
ous vapour passes into  the ear.   After  a sitting  or two—if  the
individual is to be benefited  by the plan in either form  of deaf-
ness—an improvement ought to be perceptible.
   This  course of treatment, aided, occasionally, by attention to
the state of  the system, has, in Kramer's  hands, been  attended
with satisfactory results, and has been adopted with advantage by
others, with a more or  less modified apparatus.1   In a more re-
cent work, however,13 he states, that his mode of treating nervous
deafness is essentially the same  as  that previously  described by
him—the introduction  of stimulating vapours  into  the  cavity of
the tympanum;  but, instead of the vapour of acetic ether, which
he formerly recommended, but which, of late years, he had found
too stimulating, and therefore not so well borne, he now advises

  * Pilcher, op. cit. p. 318.  See some observations mi this subject, with  two, by no
means satisfactory, cases, by T. Wharton Jones, in Lond. Med. Gaz. for Aug. 3f, and
Sept. 7, 1839.
  * Beitr'age zur Ohrenheilkunde, Berlin, 1845; cited in Brit, and For. Med. Review,
July, 1847, p. 39. 
INDIGUM.
443
the vapour of  Aqua assafetidee  simplex, of musk,  of Aqua
amygdal. amar. sine spiritu parata, and the  like; and, as else-
where remarked, after all the revival that had taken place in re-
gard to aural medicine and surgery, chiefly through the writings
of Deleau, Itard, Kramer and others, it would seem that but little
permanent benefit has resulted from the new methods of treatment;
unless where there has been partial obstruction of the Eustachian
tube; and then perhaps the most valuable agent is the elastic gum
catheter of M. Deleau, which the patient can be readily taught to
pass  into  the tube  through  the  nose, and if the  outer extremity
be bent down and inserted into the mouth, the middle ear can be
inflated by the  patient's breath.   Temporary improvement  in
hearing follows the insufflation, and as a palliative method, where
nervous deafness exists, it may  be  serviceable.   " Every honest
surgeon must, however, express his disappointment in the methods
that  were so strongly urged  some years ago;  and admit that the
benefit derived from them in nervous deafness has been exceedingly
limited; yet the mercenary  and  unprincipled have  reaped a rich
 harvest, from the  noise which  they created, by acting  upon the
 credulity of the public."1
   A case of the successful application of the acetic ether in erethi-
 tic deafness was published  by  Dr. Bolton, of Richmond,  Vir-
ginia.2  The hearing distance was amazingly improved by it, and
the success far exceeded the operator's most  sanguine expecta-
 tions.   The vapour certainly proves  at  times, too  irritating, or
 occasions  results by no means   to be desired.  The author was
 applied to in one  case in consequence  of inflammation having
 supervened in the  mucous  membrane, which subsequently ex-
 tended, in the erysipelatous  form, over the cutaneous surface.  It
 yielded to appropriate treatment.
   On the whole, then, the treatment of deafness by injection is by
 no means so effective as was at one time supposed.
                      CXII. IO'DINUM.

Synonymes.  Iodinium, Iodium, Iodum, Iodina, Iodine.
French.  lode.
German.  I o d .
   Iodine was accidentally discovered, in the year 1812, by Courtois,
a manufacturer of saltpetre at Paris, but it was chiefly through the
labours of Gay-Lussac and Sir Humphrey Davy,3 that the chemi-
cal relations of  this elementary body  were appreciated.  The dis-
coverer first detected it in the mother  waters of soda obtained from

  1 The author's Practice of Medicine, 3d edit., ii. 345.  Philad. 1848,
  2 An.erican Medical Intelligencer, April 1, 1839, p. 1.
  * Annales de Chimie, lxxxviii. xc. and torn, xci.,and Philos. Transact. 1814 and 1815. 
444
IODINUM,
sea-weed, (kelp;) and as it was found to exist chiefly in several of
the sea-weeds, and  especially in  the sponges, it struck Coindet,1
that experiments might  be made with it in  goitre: from  these  he
obtained such striking results, that its reputation soon spread abroad,
and it  was  employed in various other diseases,—often with  the
most marked advantage.  By experience, too, the injurious effects
which it is considered by many capable of inducing were appreci-
ated, so that it could  be administered  more satisfactorily than at
an earlier period.
   By the continued investigations of the chemist, iodine was found
to be more largely distributed than  was at first imagined.   It was
discovered in many of the marine  mollusca, in sea-water, and in
several mineral waters.
                    METHOD OF  PREPARING.
   Iodine is  obtained  from the mother waters of the soda derived
from sea-plants, in which it exists—it  is believed—in the form of
iodide of sodium.    The waters are procured by burning different
kinds of weeds wThich grow on the sea-shore, lixiviating the ashes,
and  concentrating the liquor.   To  obtain iodine from this  liquor,
an  excess of concentrated sulphuric acid  is  added to  it, and  the
whole is  boiled  gently in  a glass retort furnished  with a  receiver.
The sulphuric acid lays  hold  of the base of the hydriodic  salt, and
of the hydrogen of the  hydriodic acid; whence result sulphate of
soda, water,  sulphurous acid and iodine; the last passing over into
the receiver  in violet fumes with a little acid, and  there becoming
condensed.   To purify the iodine,  it may be washed with water
containing a  little potassa, and be redistilled.2  It  is manufactured
in large quantity,  in Scotland, from the kelp of the Hebrides  and
Orkney Islands.3   According to Dr. Traill, the greatest  quantity
is produced  by kelp made from  driftweed, which is  in   a great
measure composed of Laminaria digitata, and Himanthalia lorea;
—cuUceed, which  consists  of F. vesiculosus and F. serratus, yield-
ing much less of it.   One hundred  tons of Caithness  kelp afford,
according  to the  experience of one manufacturer, one thousand
pounds of iodine,  or about a 224th  part.4   It  is always prepared
on the large  scale, and hence is placed in  the Materia Medica  list
of the Pharmacopoeia  of the United States.
   Iodine  is solid at  the ordinary temperature; of a foliated appear-
ance, and metallic lustre; of a grayish or bluish-black colour simi-
lar to that of plumbago; and friable. It is soluble in 7000 parts of
water, and the solution has an orange-yellow colour.   Its specific
gravity is 4.946 at 62° of Fahrenheit.   Its smell is similar to that

  1 Bibliothtque Universale, Juillet, 1820, p. 190.
  a For the method employed by Soubeiran, see Journal de Pharmacie, Janvier, 1837;
and for that by Rarruel, see Bussy, ibid.
  8 Christison, Dispensatory, Amer. edit. p. 591.  Philad. 1848.
  ' Christison, loc. cit. 
I0DINUM.                        445
of chlorine, with which it accords in  its property of destroying
vegetable colours.   It possesses, in a high degree, electro-negative
properties.  It colours the skin  yellow, which colour gradually
disappears.  It  fuses at 220° Fahrenheit.  The vapour is of a
beautiful violet colour, whence its name (/»<J^s,  ' blue.')  It is
soluble in ether and in alcohol; forms  an acid both with oxygen
and hydrogen, and enters  into numerous chemical combinations.1
   In consequence of its high  price,  iodine is very liable to adul-
teration; and it is said, that coal, black lead, oxide of manganese,
and charcoal have been added to it; but neither Dr. Christison2
nor Dr. Pereira3 has met with  any of these impurities, which
would remain behind when heat was applied, and admit, therefore,
of easy detection.   Water is the chief  adulterant, and its unusual
presence may be  suspected if the iodine adheres to the sides of the
bottle in which it is kept.   Dr. Christison states, that until within
the eighteen months before he wrote,  he had  not  met with any
British iodine that did not contain between 15 and 20 per cent.
of water.
           EFFECTS ON THE  ECONOMY IN HEALTH.
   Soon after the discovery of iodine, and the accurate  investiga-
tions of  Gay-Lussac, Magendie4 instituted a series of experiments
in order  to appreciate its action on the  animal organism.  It was
injected into the veins without  any apparent effect.   Several dogs
were made to swallow it;  they vomited, but it exerted no farther
influence.  He himself swallowed a coffee-spoonful of the tincture,
and  perceived  no other result than  a disagreeable taste, which
continued for several hours, but gradually disappeared.  In larger
doses, however,  the effects were markedly  injurious.   Orfda,5
likewise  instituted  several  experiments on dogs, from which  he
concludes:—that, introduced into  the stomach in moderate quan-
tity, it acts as a gentle stimulant,  but may excite vomiting:—that
in the dose of a dram, it almost always killed  the  animal in four
or five days, when the oesophagus had been tied to prevent vomit-
ing, and  that in the part of the mucous membrane with which it
came in  contact, ulcers were gradually formed ;—that  when ad-
ministered  in the  dose of from two to three  drams, the oesophagus
not being tied, it excited vomiting for several hours, even when a
part of the poison  had been evacuated by the bowels;—that it
seldom caused death when  given in the  dose of one or two drams
the animal rejecting it by repeated vomiting;  that it does not de-
stroy life when applied  externally, and that it must  be  classed

  1 See, on Iodine and its Combinations, Duhamel. in Philad. Journal of Pharmacy  vi
101.  Philad. 1823-4.               " Dispensatory, p. 533.  Edinb 1842.
  3 Elements of Mat.  Med. and Therap. i. 235.  Lond. 1842; or 2d Amer edit- bv
Carson. Philad. 1846.                                      "    ' y
  ' Formulaire pour la preparation, &c, de plusieurs nouveaux Medicamens.
  1 Toxicologie, i. 556.
       29 
446
IODINUM.
amongst the irritant poisons.   Dr. Cogswell,1—in repeating  one
of Orfila's experiments, in which seventy-two  grains of iodine
were introduced into a wound on the back of a dog without much
effect on the  health  of the animal,—did not attain exactly the
same results.  He introduced a scruple of iodine into the areolar
tissue of the  thigh of  an adult  rabbit, through a small  opening
made in  the skin.  The animal manifested no symptom of pain,
and was able to make use of the limb as freely as before the ope-
ration, but, in the course of a fortnight, it gradually lost  flesh,
exhibiting an emaciated look, and  the hair dropped off from many
parts of  the head.  At the end of this time, thick, adhesive  pus
wras  found distending  the  cavity  of the wound, from which  the
iodine had entirely disappeared.   Dr. Cogswell properly suggests,
however, the  possibility, that the irritation of a large abscess
might have been  the sole origin of the animal's unhealthy appear-
ance.
   To discover the effects which  it induces  on  man, Orfila took
two grains fasting.   An extremely disagreeable  taste, with some
nausea,  was the  only consequence.   On the  next day, early, he
took  four  grains, when he immediately  experienced a  sense of
constriction and heat in the throat, which continued for a quarter
of an hour, and  soon  afterwards he vomited a  liquid  yellowish
matter,  in which iodine was easily perceptible.   Except a slight
degree of oppression felt during the  day, he  observed no change
in any of the  functions.   On the  second  day thereafter, he took
six grains fasting,  after which he soon  experienced a  sense of
heat, constriction of the throat, nausea, eructation, increased flow
of saliva, and pain at the pit of the stomach: ten  minutes after-
wards he was attacked with copious bilious vomiting, and slight
colic  pains, which continued for an  hour, and were  removed  by
two  emollient glysters.  The pulse, which, prior  to the experi-
ments, beat sixty times in the  minute, became more frequent,
beating   from  eighty three to ninety, and was  much stronger.
The  breathing was tolerably free; but from time to time, there
appeared to be a  great  obstacle to the dilatation of  the chest on
inspiration.  The urine was higher coloured.  All the symptoms
were  removed by the copious use of gum water as drink, and of
emollient glysters.
   Dr. Gully, on  the other  hand, says, that he has given as much
as three drams of the tincture daily, and did not observe any effect.
Dr. Kennedy,2 of Glasgow, exhibited, within eighty days,  nine
hundred  and  fifty-three grains of iodine in the form of tincture,
the doses having been so proportioned,  that, towards the last, the
patient—a girl—did not seem  to be in any way particularly af-

  1 Experimental  Essay on Iodine and its Compounds, page 21.  Edinb. 1837.
  aLond. Med. Repository for 1822. 
IODINUM.
447
 fected; and Dr. Buchanan1 gave half an  ounce of iodide of po-
 tassium within twelve  hours, without any unpleasant result, dilu-
 ents being largely taken at the same time.  See Potassii Iodidum
   It has been conceived that, when iodine proves mischievous, it is
 owing to its being in a free state, and that it then operates as a
 corrosive poison.  The tincture and the ioduretted iodides are
 esteemed objectionable on  this account.2  It does not appear, that
 the vapours of iodine exert any injurious effect  on  the workmen
 concerned in its preparation.3
   From experiments, instituted  by Jorg4 on himself and on other
 healthy individuals, it seemed to him, that  iodine, first of  all, acts
 as a stimulant on the intestinal canal; soon afterwards  it excites,
 also,-the different glands in the cavity of the mouth  and stomach,
 the pancreas, the liver, and the urinary  and genital  organs.  An
 afflux of  blood  to the respiratory organs  likewise ensues, which
 extends even as far as  the Schneiderian membrane.
   There is no doubt  whatever, that it enters into the blood, and,
 in this way, doubtless produces its modifications  on the system of
 nutrition.   Two drams of iodide of starch, according to Dr. Bu-
 chanan,5 were given to a young man labouring under gonorrhoea,
 and, as soon as the  medicine made  its appearance in  the urine,
 blood was drawn from the  arm.   On examining it, both  the serum
 and the crassamentum were found deeply impregnated with iodine.
 The same dose was  given  to a  boy affected with dropsy of  the
knee-joint.  About five hours after the dose  had been taken, a very
small puncture was made  in the joint,  and upwards  of twelve
ounces of synovia were  drawn off by a cupping-glass.  The syno-
 via contained iodine in abundance.   To an old  man, who had  a
very large hydrocele, two drams of iodide of potassium were given
over night, and the same quantity the following morning; on tap-
ping him some hours after  he had taken  the last  dose, more than
thirty ounces of serum were drawn off, containing a large quantity
of iodine.6
  Dr. Gairdner7 observed  the action of iodine on  the human body
when administered in particular doses, and pointed out the disad-
vantages attendant upon its improvident use.  The most striking
inconveniences were induced in the  digestive organs: it  excited
diarrhoea, and, at  times, obstinate constipation;  gastrodynia and
violent vomiting,  especially when  food was received into  the
stomach.   The emaciation occasioned by it is, according to some,

  1 Lond. Med. Gazette, July, 1836. . See, also, Fuster,in Bullet. General de Therap.
Fev. 1837, and Sept. 1837.
  a Brande's Dictionary of the Materia Medica, p. 323.  Lond. 1839.
  3 A. Chevallier, Annates d'Hycriene Publiq. &c, Avril, 1S42.
  * Materialen zu einer kiinft. H< ilmittellehre. u. s. \v. i. 473.  1824.     '  Op. cit.
  " Brande, op. citat. p. 321.   Lond. 1839.  See, also, Cantu, in Journal de Chimie
Medicale, ii. 291 and 394; and Bennerscheidt. ibid. iv. 383.
  ' Essay on the Effects of Iodine, &c. Lond. 1824. 
448
IODINUM.
a striking phenomenon, and  may attain an incredible extent; yet
it is proper to remark, that Lugol1 in his  frequent  employment of
it in scrofula, never observed this result:  he affirms, indeed, that
emaciated  patients became stronger under its use;  that  the  stout
did not grow leaner, and that they who held the medium position
in these respects acquired strength under its employment,—results
which have been confirmed  by others,2 and which would, there-
fore, seem  to show that  this, as well as some of the other unplea-
sant effects  ascribed  to iodine,  may have  been owing  to an in-
cautious use of the article.
   In addition to the above phenomena, Dr. Gairdner noticed anxi-
ety, depression of spirits, and other  symptoms similar to those of
hypochondriasis; obscurity of vision;  hardness of hearing;  palpi-
tations; and tremors of the limbs, particularly of the hands, which
last symptom indicated the full effect of iodine  on the constitution.
He  found,  however, that the remedy was extremely variable  in
its  effects;  and  that it might frequently  be given in large doses,
for a long  time,  without disadvantage; whilst, at  other times, the
unpleasant  symptoms supervened rapidly, indicating that much
must depend upon the peculiar impressibility of  the individual.
Coindet,3 who, as already remarked, first used iodine as a  thera-
peutical agent, speaks of many of the above-mentioned phenomena
as  resulting from its administration:  these he  considers evidences
of the saturation of the organism, as the effect on the mouth is an
index of the same thing  in the case of mercury.  It appears, how-
ever, to be  never  necessary, in  the administration of  iodine,  to
induce  saturation of the organism, in  order that the full sanative
influence  of the  remedy  shall  be  elicited.  On  the contrary, it
seems to be  advisable to avoid such  saturation: and, accordingly,
whenever there are the  slightest  indications of it, the dose should
be  diminished, or it should be discontinued for  a time; after which
—according to the results of numerous cases—its curative agency,
when  it  is resumed, is  exerted afresh,  and  more  decidedly.
Several physicians, indeed,  advise  that  frequent intermissions
should  be  made  in the use of the agent, in order that  its  action
may be more certain.
    According to the observations of Coindet and Formey,4 iodine,
administered internally, occasions increase of appetite ;   but no in-
fluence is perceptible on the condition of the  bowels and urinary
organs, or  on  the perspiratory  apparatus.  On  the other  hand,
when breathed  for  a few instants, the vapours of iodine  caused
twice in  M. Chevallier5  violent colic, which readily  yielded  to
  1 Memoire sur l'emploi de l'iode dans les Maladies Scrofuleuses. Paris, 1829; and
Observations on the Effects of Iodine, p. 17, Johnson's translation. Lond. 1824.
  » B. Phillips, Lond. Med. Gazette, January 10, 1840; and Scrofula, its Nature,
Causes. &c,  Airier, edit.  Philad. 1846.
  * Bibliotheque Universelle, Mars, Avril, Mai, et Septembre, 1821.
  4 See, also, Ricord, op. cit.                 • Journ. Gener. de Med. ciii. 336. 
IODINUM.
449
 gum water and  laudanum.  Raspail, however, under  analogous
 circumstances, experienced no other inconvenience than a disagreea-
 ble taste in the back part of the mouth.  According to Lugol, the
 vapour, disengaged from tincture of iodine  poured into the water
 of a bath,  is liable to induce a state  of " iodic intoxication" and
 even of cerebral congestion.  He affirms, that it exerted  a pow-
 erful diuretic influence  on all his patients, the urinary secretion
 being so much  augmented, that many of them, contrary to  their
 usuai habit, were compelled to rise from bed  several times in the
 night to discharge their urine.   In upwards of a third, it had a
 cathartic effect, producing six or seven evacuations in the day, and
 occasionally tormina.   In several, ptyalism  ensued.   Others, and
 especially females, complained of gastrodynia, which was  always
 removed by the wine of cinchona, of which two or three  ounces
 were  taken shortly after the iodine.  Iodide of potassium would
 seem to act more powerfully on the kidneys.  A patient of M.
 Ricord,1 at the Hopital des Veneriens, Paris, whilst under its in-
 fluence, passed  daily from forty to fifty litres or quarts of urine,
 drinking, however, in an equivalent ratio.   This enormous secre-
 tion always ceased whenever the use of the iodide was suspended.
 In its character the fluid differed little from ordinary urine,  except
 in containing evident traces of the salt.
   Dr. Manson,2 who used the tincture of iodine,  found it occa-
 sionally produce sickness of the stomach, and M. Delisser affirms,
 that, in two months, he gave one thousand and nineteen grains  of
 the  iodide to a female affected with  cancer of the mamma,—the
 doses, at certain periods, amounting to thirty grains in the twenty-
 four hours.  The consequences were anorexia, quick pulse, ulcera-
 tion of the mouth, and  fcetor of  the  breath—of a  different kind,
 however, from that which arises from mercury.
   M. Ricord3 affirms, that of all the tissues  of the body, the skin
 is decidedly the most susceptible of the action  of iodine, and that
 there is scarcely a variety of cutaneous disease, which, in different
 idiosyncrasies, may not be excited by iodide of potassium, although
 they may mostly be made to disappear under the  discontinuance
 of the medicine.   The author has not often  observed such  results
 from it.
   It would  appear that  the effects of the remedy vary according
 to the form in which it is administered, and it is proper to observe,
 in viewing the different results obtained by Lugol  and Coindet,
 that the latter commonly gave the tincture, whilst the former pre-
 scribed  the  solution in  water, with  a little chloride of sodium.
 Lugol observes, that the appetite of his  patients was very much
 increased  by it.   Eager, who likewise administered the  watery
solution, rarely observed diarrhoea and emaciation; in general, in-
  ' Bulletin de Therap. Sept. 1842: cited at length in Provincial Med. Joum. March 18,
 1843.    a Medical Researches on the Effects of Iodine.  Lond. 1825.    " Op. cit. 
450
IODINUM.
deed,  the appetite and  nutrition improved under it.   At  times,
ulceration took place in the mouth, whereby the breath assumed
a mercurial fcetor; and  salivation has been observed from  it, ac-
cording to Manson,1 Winslow,2 Ely,3 Mackall,4 Sir F. W. Smith,5
and others; but Riecke6 suggests, that this, perhaps, only occurred
in those who, along with the use of iodine internally, had employed
iodide  of mercury externally.   Ricord, however,7 affirms that
salivation is a common effect;  and  that, at times, the quantity of
saliva secreted is equal to that in the highest degree of mercurial
ptyalism; but it would appear to be of a different character.  He
says it resembles greatly the ptyalism of pregnant women.   The
saliva  is  not viscous, and it seems not  only  to  emanate  directly
from the  mouth, but to be regurgitated.   The mucous  membrane
of  the mouth may be a little cedematous and irritable; but no in-
flammation or ulceration is perceptible  as in mercurial  ptyalism;
neither,  according to him,  is the  breath tainted, nor  are  the
salivary glands the seat  of any tumefaction.
   On the genital organs, Eager found iodine act as an excitant; it
augmented  the activity of the uterus, and  rendered the  catamenia
more  abundant; it is asserted, too, to have increased the sexual
appetite,  but this is questionable: during its use,  indeed, the testes
in men, and the mamma?  in women, have been observed to disap-
pear:8 but this, as will be seen hereafter, is certainly not a common
occurrence.9   It has been imagined, also, to cause sterility.  Two
cases are detailed  by  Dr. Robert H. Rivers,10 in  which barrenness
succeeded its  administration.  Magendie, on  giving it  as an em-
menagogue  to a  young lady of unsuspected virtue, brought on
abortion.11  Krimer several times observed, even when the tincture
was given  in small  doses, considerable metrorrhagia, epistaxis,
hsemoptysis, obstinate diarrhoea, leucorrhoea, &c, supervene under
its  use.   Dr. J. B. Biddle12 exhibited five grains of the iodide of
potassium,  four times a day, to a female patient, aged 35.   After
thirty-five  grains had been  taken, he  was  suddenly called, and
found  her suffering from intense  cephalalgia, considerable  nervous
disturbance, nausea, and  remarkable tumefaction of the whole face.
Jahn13 found, in the bodies of two persons who had long made use
  '  Op. citat. p. 61.      2 Lond. Med. Gaz. for 1836, p. 401.     a Ibid. p. 480.
  •  Medico-Chirurg. Rev. Jan.  1836.
  6  Dublin  Journal of Med. Science, July, 1840, and Jan. 1841.
  6  Die neuern Arzneimittel, u. s. w. S. 282.                   * Op. cit.
  8  Christison, Treatise on Poisons, p. 180; Cogswell on Iodine, p. 47.  Edinb. 1837.
  8  Pereira,  in Lond. Med. Gaz. vol. xvii.;  or Diet, de Mat. Med. par Merat and De
Lens, art. lode.     ,0 American Journal of the Medical Sciences, Aug. 1831, p. 546.
 11  Formulary, Gully's edit. p. 105.
 12  Philad.  Med. Examiner, Jan. 29,1842, p. 65.  See, also, R. Coates, Ibid.; J. C. L
Carson., New York Med. Gaz. Dec. 1, 1841, p. 333, and the Report of a Conversation
on the Occasional Injurious Effects of Iodine, at the London University College Med.
Society, in Med. Examiner, Jan. 15, 1842, p. 48.
 13  Archiv. fiir Medicin. Erfahrung, i. 342, 1829; and Journal  Complement, du Diet
des Sciences Medicales, xxxv. 362. 
I0DINUM.
451
of it, wasting of the fat;  softness and  laxity of all the organs
and tissues; diminution and disappearance of the glands, and glan-
diform bodies,—the mesenteric glands, suprarenal capsules, &c—
and the areolar tissue  appeared  to exist  in smaller quantity.  In
the case of a female, who died from the excessive use of the tinc-
ture, Zinck1 found the bowels inflated with  gas; in some  parts,
highly inflamed; in others, exhibiting an  approach to sphacelation,
both within and without: the inner membrane of the stomach dis-
played  redness, growing deeper  from the cardiac towards the py-
loric orifice, where the organ  looked as if it had undergone  corro-
sion; the  liver was large and reddened; and there was ecchymosis
of the spleen.  Dr. Christison2  is of opinion, that iodine is capa-
ble of inflaming the latter organ.
   Professor J. K. Mitchell3 affirms, that he  has not unfrequently
witnessed very distressing  effects  not only  from  an extravagant
quantity,  but from  the  too prolonged use of even moderate por-
tions of iodine.  As regards iodide of potassium—he properly re-
marks—large doses have  been  given so often  and so long as to
show, that while there is hazard and  injury, the danger has been
greatly overrated.
   The author has administered  iodine very freely, but he has sel-
dom seen unpleasant phenomena ensue, which he was  disposed to
refer to it; with the exception of  such as so  nauseous an  article
was likely to  cause  in the stomach;  yet, from  the testimony of
many observers it can scarcely be doubted that iodine disease,
iodosis, iodinia or  iodism, as  it has been  termed, may become
dangerous to life: generally,  it  is not really so  much so as it ap-
pears—and is considered—to  be, and the evil consequences may be
readily avoided by proper  foresight.   Cases, however, are related
in which .its use seemed to have been followed by fatal results;4
hence the necessity of  circumspection in the employment of so
energetic a therapeutical agent.   The author has never witnessed
the vascular  injection and tumefaction  of the  conjunctiva, with
oedema and infiltration of the  adjacent subcutaneous areolar tissue,
described  by M. Ricord.5   In this inflammation, he says, there is
little or  no  tendency to suppuration,  and it is a phenomenon
 which  most usually appears only at the commencement of a course
 of iodide  of potassium, and  rarely recurs;  but it is important to
 avoid mistaking it for  a  venereal or gonorrhceal ophthalmia, to
 which  it  appears to bear some analogy.   A  somewhat similar af-
fection, under the  use of  the iodine, he observes, sometimes ex-
tends to the mucous membrane  of the nose, producing coryza, but
unattended with sneezing, and without any disposition to pass into
 a suppurative stage.
   1 Journ. Complem. du Diet, des Sciences Medicales, xviii. 231.
   - Treatise on Poisons.              ' Medical Examiner, Aug. 1846, p. 460.
   4 Sir B. Brodie, Lancet, March 30, 1839.                    * Op. cit. 
452
IODINUM.
  Under the idea, that the unpleasant symptoms which the iodides
of potassium and iron  " are sometimes said to produce," are owing
to the presence of free iodine in them, Dr. C. J. B. Williams1 re-
commends that the  patient should  eat a piece of  bread or biscuit
after  each dose:  " the starch of  this, combining with the free
iodine, removes its injurious property."
  To avoid evil consequences, Wutzer advises that  iodine should
he immediately discontinued, whenever a feeling of increased heat
in the pharynx and  stomach is experienced immediately after it is
swallowed; but as this evidence cannot be available in small chil-
dren,  attention should  be paid  to observe,  whether, after the
medicine  has been  taken, the  temperature of the skin becomes
more elevated; the pulse quicker, and whether there is any evi-
dence of pain when pressure  is  made on the epigastric  region.
He, moreover, advises, that it  should not be  given internally to
children at the breast.
  It has been affirmed, that if iodine be combined with small doses
of opium, all the disadvantages, immediate and  remote, may be
avoided;  and it is generally considered more  advisable to give it
in small doses for a longer, than in large doses for a shorter period.
At  times, it will happen, that in chronic affections—in which it is
chiefly used—its beneficial agency may not be decidedly manifested
until after the lapse  of four or five  months;  and it is important to
bear this in mind, as both practitioner  and patient are apt to be-
come  dissatisfied, unless the  remedy exhibits its action  more
speedily.   When  it acts beneficially,  the appetite is  augmented,
or is not deteriorated; digestion improves, so that the patient is
able to take more food,  and experiences less inconvenience there-
from:  the secretion  of the bile is increased, and the evacuations
are more copious  and of a  yellower hue;  the peristaltic action
goes on more energetically, and the patient gains strength.  Such,
at least, are the signs that are considered by many  to indicate that
iodine agrees;  but the absence of all disagreeable  consequences is
a sufficient index.
  To remove  the symptoms of  iodine disease, general or local,
blood-letting has been employed; with warm bathing; the use of
milk;  emulsions of gum Arabic, and the like; rigid diet and rest.
The preparations of hydrocyanic acid have also been  given with
advantage in the palpitation, tremors, and other nervous symptoms
that sometimes follow its use.
  Precaution is requisite in the case of impressible, and also,—it
has been conceived—of robust persons,2 to avoid the supervention
of hyperaemia.  It is advisable, too, during  its administration, to
let the diet be sparing, and devoid of all heating qualities*   Kol-
  1 The Library of Practical Medicine, arranged and edited by Alexander Tweedie.—
Practical Medicine, vol. iii. p. 124, art. Pleurisy, by Williams. Lond. 1840.
  a Riecke, op. cit. S. 284. 
IODINUM.
453
ley1 remarks, that it  occasionally exerts a most unfavourable in-
fluence on the nervous system, so that, in  those who  are easily
excitable,  unusual pains may be  brought  on by the use of even
three or four drops of the tincture;  these  pains, at times, ending
in violent spasms.   Such persons  exhibit the impressibility, even
under very minute doses, by fidgetiness or restlessness of the limbs,
so that they  can scarcely be kept quiet: after a time, numbness and
heaviness in all the limbs; heaviness of the head, and a species of
inebriation2  succeed, with  violent cephalalgia, spasms, tremors  of
the  limbs, paralysis,3  prostration, spasms,  depravation of vision,
and disposition to lamentation and distress.   Some of these nervous
symptoms the author has  occasionally noticed, when the  dose of
iodine  has been rapidly augmented.   Where the person is liable
to gastric uneasiness, caution is  requisite  in the use  of the remedy,
as it not unfrequently occasions dyspepsia and violent gastrodynia.
All febrile and purely  inflammatory diseases, according  to  Kolley,
forbid its use.
   Dr. Andrew Buchanan4 affirms,  that  he  has  never witnessed
any of the unpleasant symptoms that have been ascribed to iodine.
He asserts, that he has never seen its use "followed by wasting of the
testicles or mammae, by palpitations, faintness, excessive debility,
hurried, anxious breathing, dinginessof the surface, copious clammy
sweats,  increased menstrual  discharge, or  an oily  appearance  of
the urine, which are enumerated amongst the symptoms  character-
izing the supposed affection, termed iodism."   As  regards the
wasting of the mammas and testicles, Dr. Pereira suspects it to  be
very rare.   He has seen iodine administered, he  remarks, in some
hundreds of  cases, and never  met with  one  in which atrophy  of
either organ  occurred.   Magendie, also,  states, that he has never
witnessed these effects, although they are said to be frequent  in
Switzerland.5   The author's own experience accords with that of
those  gentlemen.   He has  prescribed,  and  seen  it prescribed,
largely, both in public and in private; yet  no such  results have
ever supervened.   In   the  Philadelphia  Hospital, great attention
was paid to the condition of the testes, in several cases in which
it was administered, yet no case of atrophy occurred.6  M. Cul-

  1 Journal Complementaire, xvii. 307.
  * Giddiness was observed by Manson, (Researches on  the Effects of Iodine, p. 61.
Lond. 1825;) Ashwell, (Guy's Hospital Reports, i. 136;) and Lugol, (Essays on  the
Effects of Iodine in Scrofulous Diseases, O'Shaughnessy's translation, p. 73.  Lond.
1831.)
  * Sir B. Brodie, Lancet, 1832; Manson, op. citat; and Sir A. Cooper, Lancet, ii. 147.
  4 Lond. Med.  Gaz. July 2, 1836.
  •Pereira, Elements of Mat. Med. and Therapeutics, i. 238.  Lond. 1842;  or 2d
Amer. edit. Philad. 1846.
  * A. M. Vedder, in American Medical Intelligencer, for Sept. 1, 1838.   See, also,
J. Davies, Practical Remarks on the Use of Iodine locally applied in various Surgical
Diseases and External Injuries,  &c, Lond., 1839.  Reprinted in American Med.
Library, 1839-40. 
454
IODINUM.
lerier,1 however, who has had much experience with iodine and
its various preparations, lays down  the  proposition, that it  seems
to exert a more direct action on the mamma? and testes when it is
given to  an individual  in health, than when the constitution is
deteriorated.
   Dr. J. Adair Lawrie,3 of  Glasgow, has  advanced  the opinion,
that the iodides of potassium and starch exert a poisonous influ-
ence on the raucous membrane of the air passages, not as  direct
irritants,  but  indirectly  through  the circulation, in  the form of
acute inflammation.  He admits, however, that he has never seen
them act  as irritants to the gastro-intestinal mucous membrane,
nor has he  ever known  them induce emaciation, atrophy of the
mammse  and  testes, hectic  and  the other symptoms described
under the term iodosis.
            EFFECTS ON THE ECONOMY IN DISEASE.
   Iodine exhibits itself  as a most  efficacious  remedy in a variety
of diseases, in which it is desirable to modify the condition of the
function of  nutrition.   It doubtless has  often had effects ascribed
to it to which it was in no way entitled; and not the least singular
has been  recorded lately.  M. Delfraysse,8 at a recent sitting of
the Academie des Sciences of Paris, reported cases, both  in  ani-
mals  and in the human female, in which " ioduretted preparations,
administered in the latter period of gestation, arrested the develop-
ment of the foetus," and hence, that  they must be valuable agents
when narrowness of the pelvis would render the expulsion of a
foetus of the ordinary size dangerous or impracticable!
   In referring to  the use of  iodine in the  following  diseases, the
remarks  apply not only to pure iodine, but to the iodides of the
metals of the alkalies, especially the  iodide  and ioduretted  iodide
of potassium; the medical properties of which accord with those
of iodine.
   Bronchocele.—The very  first  experiments  made  with  iodine
were on goitre.   Coindet recommended  it  strongly in that affec-
tion,  and Formey* first introduced  it  into  Germany.  Coindet,
gave, in the first instance, the tincture internally; and he remarked,
that  about  a  week after the  commencement of its use, the skin
over  the goitre  generally became less tense, the  substance of the
tumour felt  softer, without the tumefaction having abated; the par-
ticular portions of the gland became  more distinct, separated from
each  other, and less and less hard, until  gradually  a diminution
was perceptible.  Frequently, the goitre disappeared completely,

  * M4moires de la Societe de Chirurgie de Paris, Tom. i. Fascia 1 and 2, Paris, 1847;
cited in British and Foreign Medico-Chirurgical Review, Jan. 1848, p. 129.
  » London  Medical Gazette, July 3, 1840, p. 590.
  3 Archives Generates de Medecine.  Juin, 1850, p. 232.
  * Bemerk. iiber den Kropf, u. s. w. Berlin, 1820; and Hufeland's Journal, B. li.St.
4, S. 91. 
IODINUM.
455
in the space of from six to ten weeks, under the continued use of
the remedy.  At an after  period, he employed iodine  externally,
in which form of administration the evil  consequences sometimes
induced by it are less to be apprehended; and  often combined its
internal and externa] administration.
   The efficacy of  iodine in bronchocele has  received  the  most
ample confirmation.  Cases  have been  published by Hufeland,
Grafe, Baup, Helling, Ziegler, Vollmer, Reiss, Paulitsky, Hirsch,
Ulrich, Jager, Barchewitz, Meissner, Vogel, Wutzer, Seiler, Fici-
nus, Nieustadt, Hoffman,  De Carro, J. Reid,  Manson, Elliotson,
Lugol, Bardsley,1  Copland,2 and numerous others.3   Mr. Bram-
ley, whilst in Nepal, amongst the Himalaya mountains, and under
unfavourable circumstances, cured 57 out of 116 cases, and brought
34 more into a fair way towards ultimate  recovery.4  The author
has administered it in a great  many cases of soft goitre, and in
every one  the disease was removed.  In two it recurred, but the
hypertrophy was again dispersed under the use of the  remedy.5
It has been recommended  by some, that its exhibition  should  be
preceded  by bleeding;  and as the  abstraction of blood facilitates
absorption, bleeding may be advisable; and more especially where
but little, if any, effect seems to be induced by it, after  it has been
administered  for some time.   Reid advises, that we should com-
mence with its external  administration;  and,  at  a later period,
conjoin this with the internal.
   Although cases have  been published, in which iodine has not
answered the purpose of the prescriber, there can be no question
that it is the most efficacious agent in goitFe in the  lists  of the
Materia Medica; but when the tumour has acquired a cartilaginous
hardness, although it may  be diminished  under the use of the re-
medy, it can rarely, or  never, be wholly  removed.  Under  such
circumstances, however,   every other remedy would be  found
equally fruitless.
   It is worthy of recollection, that burnt  sponge, which contains
iodine, was long celebrated for its powers over gottre, before iodine
was discovered;  and the  same was the  fact in regard to certain
brine springs, as that of Salzhausen, which also contain iodine.
   Glandular affections.—Besides the affections  of the thyroid
gland, there  are others of  different  glandular bodies,  in which
iodine exhibits itself efficacious.   Jahn used  friction with it with
advantage,  in induration  of the liver.   Wutzer  gave it in two
cases of induration of the spleen, but no precise deductions could

  1 Hospital Facts and Observations, p. 121.  Lond. 1830.
  3 Diet, of Pract. Medicine.
  ' Richter's Specielle Therapie.  Berlin, 1828, S. 214; Dictionnaire de Matiere Me-
dicale, <ftc, par MM. Merat and De Lens, art. lode; and Osann, art. Iod, in Encyclo-
p'ad. Worterb. der Med. Wissensch. Bd. xix. S. 17. Berlin, 1838.
  4 Christison, Dispensatory, p. 556.  Edinb. 1H42.
  • See the author's Practice of Medicine, 3d edit. ii. 455.  Philad. 1848. 
456
IODINUM.
be made as to individual efficacy, owing to its  having been com-
bined  with  other remedies.   Milligan1 relates  three cases  of
enlargement of the liver or spleen in children,  in which he gave
the tincture with  success, after mercurials had  been used ineffec-
tually.   In several cases of chronic  disease  of the  liver attended
with jaundice,  Dr.  Abercrombie2 found  an ointment composed of
3ss. of iodine, and an ounce of lard, of great benefit.  M. Eusebe
de Salle3 and Jahn employed  it with  success in enlargement of the
testes; Riecke,4 too, found  it  of essential service in a case of great
induration and enlargement  of the testicle, which, in the opinion
of several physicians, would  require an operation; and Jahn, in a
case of strumous induration of the submaxillary  gland, and in
one of tumefaction of the prostate, the consequence of mismanaged
gonorrhoea.   Krimer employed it beneficially  in cases of tume-
faction and induration of the  mesenteric glands:  and Cerchari5
found an ointment,  composed of a scruple of iodine and an ounce
of unguentum rosatum, very efficacious in the cure  of enlarged
tonsils.   He applied it to the tonsils,  morning and evening,  by
means of a small brush;  and he  asserts, that  under its  use  the
tonsils will, in two months, be restored to their natural dimensions.
Inflammation must be  subdued before the ointment can be had
recourse  to.  Sir. B. Brodie6 has used  it successfully  in  similar
cases; the enlarged  tonsils  being touched every  day with a camel's
hair pencil dipped in the tincture.    Delfiz7 details a case of hyper-
trophy of the mammae, which resulted favourably; and in hyper-
trophy of the  thymus  gland, iodine baths have been  advised  by
Dr.  Fingerhuth.  In.induration of the female mammce, not of a
malignant nature, Riecke8  found it frequently of essential service;
and  Dr.  Pereira9 states, that in the chronic mammary tumour,
described  by Sir Astley Cooper, he has seen it afford great relief,
allaying pain, and keeping the disease in check.  In Bubo, paint-
ing over the surface with the tincture  of iodine, or with a solution
composed of a scruple of iodine, two  scruples of iodide of potas-
sium, and a fluidounce  of wrater, has been of great service.  The
effect of the latter application, according to Mr.Langston Parker,10
is " almost magical."   Mr.  Stafford,11  affirms, that he has em-

  1 Cogswell, op. cit. p. 83; see,  also,  Casey, New York Journal of Medicine, Oct.
1840, p. 324; and Christison, Dispensatory, p. 557.  Edinb.  1842.
  9 On the Stomach, Edinb. 1828; or Amer. edit. Philad. 1830.
  3 Journal Complement, xix.  193, and Journal Universel, xi. 346.
  ' Die neuern Arzneimittel, u. s. w. S, 286.
  * American Journal of Pharmacy, 2d series, ii. 83.  Philad. 1837.
  ' Lancet, March 30, 1839, p. 38.
  8 Froriep's Notizen, B. xiii.  H. 5, S. 33.                   8 Op. cit S. 292.
  9 Elements of Mat. Med. and Therap. 2d edit. i. 224.  London, 1842; or 2d Amer.
edit.  Philad. 1846.
  10 Provincial Med. and Surg. Journ., April 1, 1843.
  " Essay on the Prostate Gland, noticed in Brit and For. Med. Review, Oct., 1840,
p. 529. 
IODINUM.                        457
ployed it in nearly all cases of enlargement of glands, excepting
those from  malignant diseases, and has  found it of the greatest
service:  " indeed, its use, in some instances, has been attended  by
almost a miraculous effect, so  rapidly has the  swelling been re-
duced."   In active scrofulous swellings of the lymphatic glands
of the neck, Dr. Wm. B. Diver1 has  applied  a plaster made  of
lodin. p. i.; Balsam Canadens. p. iij.; Picis abietis, p. iij.   The
iodine is triturated with  the balsam;  the pitch  is melted with a
gentle heat, and when  about  to cool,  the  w7hole  is  mixed, and
spread upon kid for immediate use.   He prefers this plaster when-
ever the extreme sensitiveness  of the parts precludes the employ-
ment of inunction.
   Scrofula.—Soon after the  introduction of  iodine, it was  used
externally in  scrofulous  affections; and at an  early  period was
prescribed  by  Gordon,  Sir A. Halliday,2 and others, especially
combined with mercury.   Their observations were  confirmed
by  Magendie,  Baup,3 Sablairoles,4 Baron,  Brera, Manson, and
others.   Wutzer  used it in many cases of scrofula, and found  it
especially useful in the lympathic (pastosen) form.   In irritable
cases, he was cautious of employing it, as well  as  in  hyperasmic
conditions;  and he found, that  when aggravation of the symptoms
occurred,  some concealed inflammatory disposition was the cause.
Lugol5 has  contributed to the more extensive employment of it in
scrofula, and has especially recommended the  watery solution in-
ternally, and baths externally.   The fortunate results of his trials,
in the Hopital St. Louis, were corroborated by a committee ap-
pointed for  the  purpose by the Royal Academy of Sciences.  It
afforded  eminent service in the different forms of scrofula; but in
scrofulous caries it merely induced improvement, never entire cica-
trization.   Lugol regards it as the most efficacious remedy we pos-
sess in scrofula.   Eager,6 in speaking of Lugol's method of mana-
ging scrofula, properly lays great stress on the accompanying regi-
men—nutritious diet, cleanliness, bathing and  exercise in the open
air—which  he  regards as indispensable to a fortunate issue.  He
prefers the watery solution internally to all other remedies.  Lugol
and Eager  unite, with the  internal use  of iodine, the external  in
the form  of ointment, or solution: for example,  in  fistula? they
employ it as an injection.  To excite ulcers to cicatrization, after
appropriate pressure and injections have failed, Eager recommends,
that  the skin,  which  has separated at  the  margins of the ulcers
from  the subjacent parts, should be destroyed by caustic or removed
  1 Med. Examiner, Sept., 1845. p. 529.
  * Lond. Med. Repos. Sept. 1821.
  3 Bibliotheque Universelle, Dec 1821.
  * Bulletin des Sciences Medicales, Fev. 1824.
  8 Essay on the Effects of Iodine, &c, p. 48; and Researches on Scrofulous Diseases,
translated by A. S. Doane.  New York, 1844.
  ' Dublin Journal of Medical Science, July, 1834, p. 344. 
458                        IODINUM.
by the knife, but that this should not be practised until the scro-
fulous tendency has been somewhat got under.  As a  caustic, he
directs calcis viv- 3vj., potass. 3v., to be  made into a  paste with
alcohol, and  to be applied a few lines thick: it destroys the skin
in about five minutes.  According to the same observer, iodine has
exhibited  its  efficacy  in  various cases of periostitis,  scrofulous
swellings of the joints, and necrosis.   In scrofulous ophthalmia,
it was less beneficial.  It will be seen hereafter, however, that in
the last affection, the application of the tincture to the  eyelids has
been beneficial.   In scrofulous discharges from the nose and ear,
iodine injections were commonly of service.  Baudelocque1 like-
wise extols the preparations of iodine in scrofula; but in scrofu-
lous uffections of the bones, and especially in caries, as well as in
scrofulous diseases of the skin, it appeared to him  to  be ineffica-
cious.  Dr. Isaac Parrish3 found the iodide of potassium servicea-
ble  in certain diseases of the eye, which had a constitutional origin,
or were closely allied to a scrofulous or cachectic condition of the
general system.  The dose in which  he  gave it was from two to
six  grains  three times a  day in a table-spoonful of the compound
syrup of sarsaparilla.  The author has found excellent effects from
it in such  cases, when  given  in  simple syrup.  Many  cases have
been related by Zinck, Maunoir, Manson, Weihe, Benaben, Bayle,
and others, in which while swellings of the joints, of a scrofulous
character,  were removed  by its use.   Wutzer has  likewise offered
favourable testimony in regard to it  in affections of the bones, some
of which were of a strumous nature.   In  several cases, so much
disorganization had occurred, that the loss of the whole limb was
to be  apprehended, yet the iodine arrested  the destructive process,
and the limbs were preserved.   In various scrofulous affections, the
tincture was given by Dr. Kuhne3 with great  success, and without
any evil  consequences.    He made it, howeverj of half the usual
strength, beginning with  three drops,  and gradually increasing the
dose to fifteen.  In  tumefaction of the joints, iodine, administered
externally, has afforded essential service.   Wutzer was  of opinion,
that the tincture might frequently be applied externally with greater
advantage than the  ointment; the alcohol readily evaporating and
leaving the iodine on the skin: for which reason he  recommends,
that the tincture should  be applied  repeatedly by means of a  ca-
mel's hair pencil.   Commonly, in  every form of cachexia  espe-
cially, it  is necessary that iodine, or its preparations, should be
given for a considerable  time.   The disease  is often chronic, and
a chronic system of medication is demanded.   Occasionally, how-

  ' Etudes sur la Maladie Scrofuleuse. Paris, 1834; and London Lancet. May 25,1839,
p. 350: see, also, Cogswell on Iodine, p. 75; and Lisfranc, Annales de Therap., cited in
Med. Times, Jan. II, 1845.
  2 Med Examiner, Ap. 16, 1842, p. 241.
  ' Medicinische Zeitung, No. 34, Aug. 24, 1836.  Berlin.
1 
lODlNfJM.
459
ever, it would appear to have  acted  speedily.  Professor J. K.
Mitchell1 relates the case of a man who had  an enormous tume-
faction of  the thyroid gland, and  of the lymphatic glands of
the neck, accompanied by severe dyspnoea, and difficult deglutition,
threatening dissolution.  " We proposed then," says Dr. Mitchell,
" to  try  iodine,  a remedy in which  neither of us," Dr. Mitchell
and a skilful surgeon, " had much direct knowledge.   Within a
single day, the patient breathed better, and became thoroughly
convinced of approaching recovery,  and at the end of a week ex-
perienced very little  inconvenience  from, though  still deformed
by his malady.   In a few months  the thyroid  no longer  hung
 over his sternum;  not an  abnormal gland  could  be  felt  in  his
 neck, and  he recovered  both his health and personal  appearance
 entirely."
   In combination  with calomel, iodine appeared to Drs. Bennett,
 Willshire2 and Malin3 to have the power of controlling scrofulous
 inflammation and its effects.
    Tubercles.—The reputed efficacy of iodine  in scrofulous affec-
 tions gave rise to the belief, that it  might be serviceable in tuber-
 cles.   Brera and Calloway administered it frequently in mesenteric
 tubercles with success, and the observations of Krimer, referred
 to above,  correspond with theirs.   It has also been  given with
 advantage in cases of pulmonary tubercles.   It was  suggested, in
 such affections, by Dr. Baron, and a case is related by Mr. Haden
 of apparent tubercles in which  it wras markedly useful.4  Similar
 examples are detailed by Jahn,  Waldack, and others;  and it has
 been recommended, in conjunction with decoction of cimicifuga, by
 Dr. C. C. Hildreth,5of Zanesville, Ohio; but the evidence adduced
 by him is not strong.
   Berton  affirms,  that  he found inhalations of the vapour of
 iodine of decided efficacy in confirmed phthisis, as well as in  cer-
 tain forms of catarrh.  They have likewise been advised in phthisi-
 cal affections, by  Sir James Murray,6 and  Sir C.  Scudamore.7
 The addition of a little tincture of conium was found  by the latter
 gentleman to be  beneficial in subduing the  irritating qualities  of
 the  gas.   His first  formula was  the  following:—R. Iodin. gr.
 viiij., Potass, iodid ,  gr. iij., Alcohol. Iss., Aqua destillat. gvss.
 M.   Of this  solution, from one dram to  six, and from twenty  to
 thirty-five minims of a  saturated tincture  of conium, were used

   ' Med. Examiner, Aug.  1846, p. 46.
   = Medical Times, July and August, 1847.
   5 Schmidt's JahrbOcher. u. s. w. No. 2, S. 164.  Jahrgang 1849.
   ' Formulary—the author's edition, p. 37. Lond. 1^24.
   ' American Journ. of the Med. Sciences, Oct. 1842, p. 280.
   6 On Temperature, Aliment. &c., 1829.
   1 Cases  Illustrative of the Efficacy of  various  Medicines  administered by Inhalation
  in Pulmonary Consumption, 2d edit. London; and Lond. Med. Gaz. Feb. 17, 1838, p
  801. 
460
IODINUM.
 in  each inhalation, which  was  continued  from half an  hour to
 forty minutes.  Sir Charles  considered it better  to  add the co-
 nium at the  time of employing the inhalation.  At the tempera-
 ture of 90°,  the volatile properties of iodine are given  off very
 sensibly, but  conium requires more  heat,  and that of 120° is not
 too much for the iodine.  Subsequently, Sir  Charles  published
 the results of his farther observation with this remedy, of which
 he has as high an opinion  as ever.   He  has somewhat  modified
 his formula, however.1  He now recommends the following:—R.
 Iodin. pur., Potass, iodid. aa.  gr.  vj., Aquae destillat.  §v. 3VJ.,
 Alcoholis, 3ij. M.  He prefers to  add  the conium at the time of
 mixing the iodine solution with the water, and recommends that
 it should  be a saturated  tincture,  prepared with genuine dried
 leaves.   In the  commencement of  the treatment, he  advises very
 small proportions of the iodine mixture;—for example, from half
 a dram to a dram for an inhalation of eight or ten minutes' dura-
 tion, and this to  be repeated two  or three times  a day.   Of the
 tincture, to which  Sir Charles  gives the  epithet  "soothing," he
 directs  half a dram, which he  usually finds to be sufficient;  but
 it may  be  increased, if the cough be very troublesome.   He soon
 augments  the quantity of  the iodine mixture, progressively from
 3j. to 3iv.; and at the same time prolonging the period of inhaling,
 he divides the iodine dose,  putting two-thirds at first, and the rest
 after the expiration of seven or eight minutes.   Although  the
 temperature of 120°  is the  most favourable for volatilizing  the
 active  principles  of the  iodine and  conium mixed with some
 watery vapour, Sir Charles considers the approximation will be
 sufficient, if equal  parts of boiling  and cold water be used, with
 which the inhaler should not  be  quite half filled.   Care should be
 taken, however, to prepare the inhaler for  this temperature by first
 washing it out with tepid water.  During the process, the inhaler
 should  be kept immersed in a vessel containing water of a rather
 higher  temperature than 120°.  The feelings of  the patient will
 be a great guide as  to the  strength  of the inhaling mixture in any
 particular  case.  A reviewer  in the British and Foreign Medical
 Review,2 affirms, that his own experience leaves  him no doubt as
 to the great value of this practice as a palliative in phthisis, and
 as an important remedy in bronchitis.   It is  true, however, he
 adds, that  the relief has often been as great from  the simple aque-
 ous as from the medicated  inhalation.   The author's own expe-
 rience has  not been favourable to it,3 and Dr. Pereira4 says he has
 repeatedly tried it in phthisis as well as in other  chronic pulmo-

  1 London Medical Gazette, Feb. 7,  1840, p. 750.  See, also, E. J. Coxe, Practical
Treatise on Medical Inhalation, pp. 51-85.  Philad. 1841.
  2 April, 1838, p-606.
  s Practice of Medicine, 3d edit. i. 416. Philad. 1848.
  * Elements of the Materia Medica, i. 245. Lond. 1842; or 2d Amer. edit. Philad. 1S46- 
I0DINUM.
461
nary complaints, but never with the least benefit.   The inhalation
may be practised in the method  recommended under the head of
Chlorine (page 186.)  It has been dreaded, because, in some in-
stances, troublesome irritation of the larynx has followed its use;
but Dr. Corrigan1 considers, that this injurious effect has resulted
from the defective means of inhalation hitherto employed.  Used
in the manner he has  recommended under the  article  referred to
above—gradual in its evaporation,  and ultimately combined with  a
large  portion of aqueous vapour—it is,  he says, positively free
from any injurious irritative  effects.   The vapour he found to di-
minish most remarkably the profuse and wasting purulent expec-
toration of phthisis.  The effects of iodine, thus  used, on the di-
gestive function were also very gratifying.  In all the cases  in
which he  employed  it, the  appetite  and  state of the  intestinal
canal were improved.   It acted as a useful tonic to the digestive
organs, without any of the irritation which its internal  use, in the
ordinary form, at times  produces.   It likewise greatly alleviated
the cough, so that the  patient was enabled  to obtain hours of sound
and refreshing  sleep;  and he, consequently, considers, that even
should its use  be of little avail against  the destructive scrofulous
ulceration, which constitutes  phthisis, the palliative good which
is derived from  it renders  it a  valuable  addition to  our  list  of
remedies.   Dr. Corrigan has had his apparatus at work from eight
to twelve hours in the twenty-four; and his mode of managing it
is as follows:—At night, when the patient is settling to sleep, the
apparatus is suspended from  the roof of the bed;  and,  when once
arranged, it continues its work quietly and silently for four or five
hours, while the patient, asleep, is  all this  time inhaling the medi-
cated  air.  In  the  morning, for three  or  four hours  before the
patient rises, it is again at work; and, if necessary, in the mid-day,
while  the patient reclines on  the  bed,  with the curtains  drawn
round three of the sides.  The  rate of evaporation, which gene-
rally gives a sufficiently strong  impregnation to the air, is when
the  tincture of iodine drops  from the cotton wick at the rate  of
from six to eight drops per minute.  At this rate, about six drams
of the tincture will be evaporated in an hour, and as every particle
of iodine is diffused in watery vapour through the air, there are
thus diffused, in the minutest state of division through the air, in
every hour, about thirty grains.   " If we suppose the  patient to
inhale only one-twentieth of the iodine  evaporated, he will inhale
in each hour, and apply to the diseased  surfaces, one grain and  a
half of iodine in a state of the most minute division or solution."
" This quantity, we know,"—adds Dr.  Corrigan—" is quite suffi-
cient to exert  a decided action upon  scrofulous ulceration; for
we find, on reference to Lugol's valuable work on the employment

         1 Dublin Journal of Medical Science, for March, 1839, p. 103.
        30 
462
IODINUM.
 of iodine  in scrofula, that in external scrofulous ulceration, the
 preparation of iodine, which is found beneficial, is a solution which
 contains only about  three grains of iodine in each pint of fluid."
 The duration of the inhalation can, of course, be extended at plea-
 sure.
   Fontana affirms,  that  he has  observed  decided  benefit from
 iodine in a case of phthisis mucosa; when  given in the form of
 syrup, and combined with the external application of the ointment
 of tartarized antimony.   Duverney has communicated some cases,
 which appeared favourable to the prophylactic agency of iodine in
 incipient or threatened phthisis, but he himself considers, that bis
 observations have not  been sufficiently numerous to effect the de-
 monstration.   The author has frequently administered it, in various
 forms, in pulmonary  tubercles, but, it must be confessed, not with
 that decided advantage, which the well known eutrophic virtues
 of the remedy, and the  recorded observations of others, might seem
 to promise.  He has never witnessed, on the other hand, the evil,
 which Rieckex mentions,—that it may, under particular circum-
 stances, occasion  the speedy development of phthisis,  where tu-
 bercles exist in the  lungs.   Riecke refers to a case by Haser  as
 corroborative of his  opinion.  A  woman, fifty years old, was af-
 fected  with anchylosis spuria, for which an ointment  of iodine
 was recommended; but it had not  been  employed more than three
 weeks, and not more than a dram of iodide of potassium had been
 rubbed in, when symptoms  of tubercular phthisis rapidly super-
 vened, which, in half a year, terminated in  death.   There does
 not  appear, however, in this  cTlse, to  have been any thing more
 than a coincidence.
   Mr. Leigh2 directs the patient to apply a  sufficient quantity of
 iodine  ointment on the ribs and under the axillae, and to cover the
 head with  the bed-clothes, in order to breathe the iodine volatilized
 by the heat of the body.   The ointment produces counter-irritation
 on the skin where it  is placed, and must be repeated  according to
 circumstances.   This method, Mr. Leigh thinks, has arrested the
 progress of phthisis.
   Pneumonia.—In  the advanced  stage of pneumonia, iodide of
 potassium  has been strongly  recommended by Dr. George L. Up-
 shur,3 of Norfolk, Va., on the strength of several observed cases
 The indications for its use  he has found to be the following:—
 First,  In  cases of pneumonia occurring in  ansemic  individuals,
 where the  disease is characterized in its  early stages by adynamic
 symptoms.  Secondly, In cases where inflammatory action, in the
commencement high, has been reduced by antiphlogistic treatment,

  ' Die neuern Arzneimittel,  u. s. w. S. 289; see, also,  Gunther, in Harless's Neue Jahrb.
 H. xii. St. 3, S. 161.
  * London Medical Gazette, May, 1841.
  ■y Med. Examiner, June 29, 1841, p. 145: and June, 1845, p. 323. 
I0DINUM.
463
and the suppurative stage is just beginning.  ^" This stage is easily
recognised by a  sudden depression of the vital powers, by a soft
but irritable  pulse, and by  the bronchial respiration being accom-
panied  by a harsh mucous  rhonchus."  Lastly, In  cases  grafted
upon long continued intermittents, " which  have left the blood in
a degree impoverished."   The iodide was given in the dose  of a
scruple in the twenty-four hours.   In spasmodic asthma, it has
also been found  very beneficial by Dr. W. S. Oke,1 Dr. Casey,2
and others.   Dr. Casey gave it in  upwards of five and twenty
cases, and in no instance, where a fair trial was made, did it fail
"to afford unequivocal and decided relief."   The dose varies from
two to five  grains three times a day.  Dr. W. A. M'Murry3 has
used iodide of potassium, with great advantage, in hooping-cough.
He employs, however, a compound formula.
           R.  Potass, iodid. gr. vj.; Mucilag. acac. |vij.
               Syrup. Senegae, gij.; Tinct. lobel. 3J.  M,
  Dose.—For a child two years old, a tea-spoonful four times a day.
   In chronic engorgements of the larynx, iodine was used in two
cases by  Trousseau and  Belloq;4  once without success, but the
second time with marked advantage; and in tubercles of the liver
it has been regarded worthy of special consideration.5
   Dropsy.—Owing to its powerful eutrophic agency, many trials     '
have been made with iodine in  cases of dropsy.6   Drs. Bradfield
and  Bardsley exhibited it frequently with success in hydrothorax
and  ascites;  and  Dr. Kissam, in a case of dropsy, dependent pro-
bably upon induration of the liver.   Dr. Coster7 says he has re-
moved many dropsies by giving internally from six to fifteen drops
for a dose of a mixture composed of iodin. gr. iii., potass, iodid.
gr. vi., aquae f ^j. *, aided by an  ointment composed  of fifteen
grains of  iodine, with  double the quantity of iodide of potassium,
to an ounce of lard.  This is  to be placed  inside the thighs after
removing the cuticle by a blister.   The arm-pits and soles of the
feet were also rubbed with the ointment.   The same plan  is re-
commended  by Dr. Osborne.8  Jahn, also, regards iodine  as an
extremely valuable antihydropic.9   He first used  it in a case o:~
hydrocele, in which it was doubtful whether degeneration of Wn-

  1 Provincial Med. Joum. April and May, 1844.
  ■ Boston  Med. and Surg. Journal, 1845.                                      /
  • Saint Louis Medical and Surgical Journal, March and April, 1848.
  ' Traite Pratique de la l'hthisie  Laryngee, p. 371.  Paris, 1837; and translation H
 Warder, Amer. Med. Library edit. p. 145.  Philad. 1839.
  » Riecke, op. cit. S. 290.
  • Wm. Stokes, in Amer Journal of Medical Sciences,  May, 1834, p. 543, cited froin
 Lond. Med. and Surg. Journal.              * Journal de Pharmacie, 1834.
  • On the  Nature and  Treatment of Dropsical Diseases, 2d edit. p. 48.  Lond. 1837.
 or Amer. Med. Library  edit.  Philad. 1838.
  » Elliotson, in Lancet, 1830-31. See, also, P. Spalding, in Boston Med. and Sti^
 Journal, Dec. 25, 1839, p. 314. 
464
IODINUM.
testicle had not been a precursor,  The effect of the ointment of
iodide of potassium left nothing to be desired; and, accordingly,
he afterwards employed it in all cases of hydrocele of the tunica
vaginalis, which  he met  with,—even in the new-born,—united
with mercury or extract of conium;  and in every case which was
not of too chronic  a  character, it exhibited its  sanative powers.
The only unfavourable effects induced by it were a temporary dis-
appearance of the testicle, in some cases ; and a  humid cutaneous
eruption of the scrotum.   He  also found iodine extremely useful
in hydrothorax and ascites; and especially in cases of dropsy that
succeeded to exanthematous diseases,—and it acted more speedily
and  powerfully when combined with some diuretic.  He found,
farther, that it was followed by the  most beneficial results in the
hydrocephalus of children—as well chronic as  acute—especially
when the latter form had attained  its full development,—that is,
when  the  inflammatory stage was over,  and the accumulation of
fluid was the prominent condition.   In these cases,  he commonly
used iodine in the  form of  iodide of potassium made into an oint-
ment, and  rubbed on  the  head.  Frequently, however, he gave
iodine also internally, in combination with calomel  and  digitalis;
but it may  be objected to this combination, that iodine with calomel
forms corrosive chloride, iodide and red iodide of mercury; so that,
in very  small  doses, it might  affect  the stomach  too violently.1
Dr. Roser,2 of Wurtemberg, likewise advocates the use of iodide
of potassium, in large doses, in cases of acute hydrocephalus or
tubercular meningitis, where the ordinary remedies  have failed,
paralysis has occurred, and death appears to be  impending; and
three successful cases have been recorded  by  Mr.  C. Fluder.3
The ordinary means had  been employed in vain, when he  sug-
gested  a trial of iodide of potassium in half grain  doses, every two
or three hours.  In  all the cases, there was speedy diuresis, and
dribbling of  the saliva.   A similar successful case  has been re-
corded  by Dr. John  Christie.4   The child wTas  eight years old,
and  before Dr. Christie saw him had been ill a week.  He had
experienced an attack of convulsions the  evening before.  He lay
with the eyes half closed, moaning frequently, and now and  then
uttering a loud scream;   the pupils were fixed; the  urine  was
passed  involuntarily;  there were frequent automatic  movements
of the  left  arm  and  leg, and the pulse was  rapid and weak.
Dr. Christie determined to make a trial of iodine in a mode men-
tioned  by  Drs. Evanson  and  Maunsell,5 and prescribed a mix-
  ' Riecke, op. cit. S. 291. *
  3 Hufeland's Journal, for April, 1841, S. 84 ; cited in Lond. and Edinb. Monthly Journ.
of Med. Science.  See, also, Dr. Fluder, in Lond. Med. Gaz. Sept. 30, lS42,and K. G.
Zimmermann, Zeitschrift fiir die gesammte Medicin., Aug. 1842, S. 418.
  3 Lond. Med. Gaz. Sept. 30, 1842.
  4 Lond. and Edinb. Monthly Journal, March, 1843.
  5 On Diseases of Children. 
I0DINUM.
465
 ture consisting of iodide of potassium, sixteen grains; iodine, four
 grains; and water, one ounce;  of which  a teaspoonful  was or-
 dered every four hours.  The head was also directed to be rubbed
 with a  weak ointment of red iodide of mercury.  Good effects, in
 a similar case, resulted from  the internal use of iodide of potassium
 in  the  practice  of Dr. Barbour, of St. Louis;1  and Dr.  Malin2
 prescribed a combination of  iodine and calomel in oedema menin-
 gum and hydrocephalus acutus with advantage.
   M. Ricord3 employed iodine with success in five cases of hy-
 drocele;—the tincture being diluted with distilled water, and ap-
 plied by means  of compresses wetted with it, in which the scro-
 tum was enveloped.   He used it of four different strengths—3j.,
 3ij., 3iij., and gvj. of the tincture, to f giij. of water.
   In hygroma or dropsy of the bursas mucosae of the joints, an
 ointment of iodide of potassium (3ij., ad adipis ^j.) has  been suc-
 cessfully used by M. Reynaud.4  The limb is kept  at  rest, and
 morning and evening, or three times a day, friction is made with
 this quantity of ointment; after which the knee—the joint com-
 monly affected—is covered with a large flaxseed  poultice.   From
 some trials  made with  iodide of lead,  there was reason to believe
 it more efficacious than iodide of potassium.   The treatment was
 generally successful in about a fortnight.
   Intermittent Fever.  In obstinate intermittents, which  had
 resisted quinia and other antiperiodics,  M. Seguin5  found  the
 tincture of  iodine a  very   valuable and  effective remedy.  He
 prescribed  it in  doses of thirty drops in  a little sweetened wa-
 ter, gradually increasing the quantity to  forty,  fifty, and even
 sixty drops.  Three doses were given in the apyrexia.   He did
 not find it equally effectual  in recent cases.
   Typhus  and Typhoid  Fever.  Dr. Morrison6 states, that
 there is a condition in typhus fever, which  is  materially benefited
 by  iodide of potassium.   It  is marked by a dry, parched, brown
 or black tongue; by dark sordes on the teeth and gums; by a dis-
 position to dark fetid discharges  from the bowels;  by a weak and
 compressible pulse; $and by  the ordinary signs of depraved secre-
 tions, vitiated fluids,  and debility.   The  dose  which  he is in
 the  habit of administering   is three  grains every four or  five
 hours,  dissolved in water,  or mixed with wine, &c.   A case
 of typhoid fever is reported  by Dr. C. B. Voigt,7 in which iodide
 of potassium was apparently beneficial.

  * Boston Medical and Surgical Journal, Jan. 1846.
  2 Schmidt's Jahrbiicher, u. s. w. No. 2, S. 164.  Jahrgang  1849.
  8 Journ. des  Connaissances Med. Chirurg., Janvier, 1833.
  * Cabissol, in Bulletin General de Therapeutique, Fev. 1838.
  * Journal des Connaissances Medicales Pratiques, Dec. 1846, cited in Amer. Jourri.
of the Medical Sciences, July, 1847, p. 223.
  6 Dublin Medical Press, Oct. 21, 1840.
  " Medical Examiner, Dec. 1845, p. 715. 
466
IODINUM.
   Variola.  Iodine has been  successfully employed in variola
to prevent pitting.  Dr. Crawford,1 of Montreal, tried the compa-
rative merits  of tincture of iodine and nitrate of silver, and gives
the preference to the former.  He found the application " very
manageable and very bearable."   Dr. Jackson,2 formerly of North-
umberland, Pa., now of Philadelphia, informs the author, that he
was led to make an experiment of aborting small-pox by the tinc-
ture of iodine, from having contemplated its wonderful influence
over erysipelas.   He applied  it in April, 1845, to one  arm of a
child eleven months old, in confluent small-pox, on the  third day
of the eruption, and to the arm which appeared the worst, rubbing
it freely on with a sponge three times that day and twice the next.
On the 11th day,  when the pocks over the whole body were
at their height, elevated, with  hard bases, those on the  arm to
which the  iodine  had been  applied were entirely flat,  with thin
purulent matter under the  dead  cuticle without  any swelling of
the part.   The abortion at the time was considered to be complete.
There were, however, some very slight pits to be seen afterwards,
but they were very inconsiderable compared  with those on  the
other arm., Dr. Sargent stated to Dr. Jackson, that  he had sub-
sequently used iodine on one side of the face in 25 cases: the swell-
ing, soreness and tenderness were  very much less than on the side
not covered:  each  pock remained flattened,  but he  could  not
say that pitting  was  prevented.   Dr. Goddard  tried it  in five
cases; " not one  of the patients  showed the least pit or mark;
none of them had  been vaccinated, and the disease was confluent
in most of them."    Dr. Jackson considers, that no fair trial of its
ectrotic powers in variola can be had without  applying  it on the
first day of the eruption, and continuing it for several days,—say
five or six.   More  recently, Dr. Sargent3 instituted other expe-
riments with it.   It was painted  over one half the face only, in
order that the appearance of the surface, thus protected, might be
fairly compared with that of the other side.   Having been tested
in this manner in a great many cases, of  which thirty were care-
fully noted, the effects were found to be as follows:—The side of
the face which was covered  with the tincture was comparatively
little  swollen; the eruption  was  flattened, so as to  be scarcely
higher than the surface,  whilst on  the other side the vesicles first,
and subsequently  the  pustules, were full and swollen ; there was
much less heat and soreness in the protected side than in  the other,
and much less tenderness when this side was  touched.  When pits
were left on the unprotected side of the face after the disengage-
ment of the scabs,  and the healing of the little ulcers thus exposed,
those on the protected side were found to be  less numerous and
perhaps less deep;  but in no instance could Dr. Sargent certainly
       1 Montreal Medical Gazette, April 1, 1844.
       a Medical Examiner, August, 1846, p. 464.
       3 American Journal of the Medical Sciences, April, 1849, p. 373. 
IODINUM.
467
affirm that pitting was entirely prevented by the iodine, in cases
in which there were pits on the opposite surface.
   Dr. Schreiber x states, that he has  found the administration of
iodine useful in preventing the family  of a person labouring under
variola from  being infected.[?]   The formula employed by  him
was as follows:
                  R.  Potass, iodid. gr. viij.
                      Tinct. iodin. g»- xvi.
                      Aquae f gij.   M.
   A teaspoonful of this was given night and morning.  Dr. Schrei-
ber invites practitioners to a farther investigation of the anti-vari-
olous power of iodine.
   Measles and Scarlatina.  It has been already remarked, that
M. Ricord considers that iodine determines diseased action to the
skin; and it has been affirmed J that in cases of suppressed measles
and scarlatina, it will frequently induce  a healthy reaction under
the most desperate circumstances.   One or two grains of iodide  of
potassium—according to the age of the  patient—when under twelve,
maybe dissolved in sugared water, and be administered repeatedly as
an ordinary drink, the whole quantity being taken in the 24 hours
for three or four days.   In measles, a small plaster to«the chest is
said to assist the peculiar action of the iodine.  In  scarlatina, the
compound tincture  of iodine, diluted  with three  or four parts  of
water,  may be frequently applied, by means  of a  camel's hair
brush,  to the  front and sides of the throat and neck.
   JVervous Diseases.—As to the efficacy of iodine in these diseases,
testimony is somewhat  discordant.  Drs. Manson3 and Elliotson4
found it useful in paralysis, but Dr. Bardsley failed with it.  Chorea
was removed  by Gibney,5 Bardsley, Manson, Oke,8 and Miiller;7
and Franklin,8 by very large doses, relieved  a case of epilepsy.
Dr. Bennett9 found the iodide of potassium of great use in cases of
nervous headache, when the circulation was not affected; and the
local use of the tincture of iodine has been beneficial in neuralgia.10
In a patient,  whose  life  had been imbittered  for five years with
neuropathic maladies, and who suffered  at the  time from a very
painful affection of the head and neck, with occasional and frequent
pain of the arms and legs, Prof. J. K.  Mitchell11 gave seven grains
of iodide of potassium three times a day, which speedily relieved,
and within six weeks completely cured  the patient, after  arsenic,

   ' Northern Journ.of Med., July 1844,cited in Braithwaite's Retrospect,x. 187. New
York, 1845.            2 London Lancet, Jan. 21, 1843, p. 632.
   » Op. cit.            4 Lancet, 1830-31.            ' Ibid. 1827-8, p. 54.
   e Provincial Med. and Surg. Journal, April and May, 1844.
   ' Gazette Med. de Paris, No. 19, cited by Gorup-Besanez, in Canstatt und Eisen-
tuann's Jahresbericht liber die Fortschritte in der Heilkunde im Jahre 1848, S. 135.
   8 Lancet, 1836, and Cogswell, op. cit. p. 24.  See, also, Scott, Provincial  Med. and
Surg. Journ., April 3, 1844, p.  9.            9 London Lancet, Dec. 21, 1839.
   10 Crawford, Montreal Med. Gaz. April 1,1844.
   " Medical Examiner, Aug. 1846, p. 460. 
468
IODINUM.
mercury, and  most of the  narcotics had  been prescribed in vain.
An equally beneficial  and speedy effect was produced in a case of
protracted erratic pains.
  Recently, like many other agents, iodide  of potassium has been
proposed  as  a prophylactic  in cholera.   In this relation, it  has
been  recommended by M. Marchandier.   M. Bouchardat,1 how-
ever,  knew a  case  of cholera supervene  in a person who was at
the time under its use.
  The intimate affinity between iodine and the urinary organs has
given occasion to its employment in
   Incontinence  of Urine, of which Corter cured  two cases by
the tincture.
   Chronic Diseases.—  Cases  of dry, scaly  tetter were  treated
by  Tiinnermann with an  ointment of iodide of potassium,  ap-
plied  to  the affected parts three or  four  times a day.   For
the most part, an  increase of the evil was at first a pretty sure
harbinger of a radical cure; when this  attained a certain degree, a
change in the organic actions of the skin succeeded ; the  remedy
was then pretermitted,  and  the parts were washed a few times
with  soap, when  the eruption  faded  and gradually disappeared.
In  moist tetter,  Tiinnermann  applies only a  very weak salve,
with  which the parts are touched daily, two or three times: in the
intervals, he  envelops them in a dry linen rag.   The pain, which
is always induced by the application, soon passes away.   Magen-
die, Giraelle, and  Jeffray2 have likewise  applied it successfully
in tetter.   In chronic cutaneous diseases in general, the  various
preparations  of iodine are valuable remedies.   They enter, as we
have  seen, the mass of  blood, modify the condition of that fluid,
and, in this  manner, exert  a  new impression  upon the  morbid
tissues.  The author has often employed them  in these cases
with  success; and like testimony has been afforded by MM. Biett,
Gimelle, Kolley, Locher-Balber, Kennedy,3 and  others.  Brehme
succeeded in removing,  rapidly and completely, a case of invete-
rate porrigo  favosa, and ophthalmia thereon dependent,  by an
ointment of iodine.  Dr. G. Billingslea, of Alabama,  asserts,4 that
for twelve years he had  used the tincture with the happiest effect,
as a local application in the troublesome cases of herpes circinatus
or ring-worm that are so common in the  southern part of this
country.  He adds, that he  does not  recollect a case in which  it
had been  employed, which was not radically cured; and in porrigo
of the scalp it is highly  extolled by Drs. Graves, and J. J. Ross.5
Dr. Graves advises that it should  be strongly rubbed into each
spot by means of a small piece of sponge covered with fine linen,

  1 Annuaire de  Therapeutique, pour 1850, p. 196.
  1 Cogswell, op. cit. p. 80.       3 London Med. Gazette, May 8, 1840, p. 260.
  4 Afnerican Medical Intelligencer, May, 1839, p. 34.
  5 London and Edinb. Monthly Journ. of Med. Science, Sept. 1842, p. 292. 
IODINUM.
469
 and tied to the end of  a quill or slender stick.   When effectually
 done the application must not be  repeated  oftener  than once a
 week;  and immediately  after the  application the scald  must be
 covered with a spermaceti  dressing, which must be renewed at
 least four times daily, so as to keep the head constantly moistened
 with it.  The head is not washed for three days after  the appli-
 cation of the tincture, when it may be well to wash it gently with
 yellow soap and water twice  a day, taking care to cover it as
 before with spermaceti  dressing after each washing.  Dr. Barosch1
 cured an inveterate dartrous  eruption,  affecting the perinseum
 and scrotum, by a lotion consisting of fifteen grains of iodine, and
 two scruples of iodide of potassium dissolved in five fluidounces of
 distilled water, and one  fluidounce  of  alcohol.  In lupus, the
 tincture applied  locally has proved highly beneficial.  Under its
 use, the process of ulceration has stopped, and cicatrization taken
 place.  It is recommended to be applied  not only to the ulcerated
 portion, but to the parts around.2   Some inveterate cases  yielded
 to  the use of iodide of potassium, given in large doses, by M.
 Maisonneuve.3
   A case of elephantiasis, or enormous  enlargement of the  leg,
 has been recorded  by M. Cazenave,4  which was cured  by iodine,
 associated with  other  remedies.   The patient—a woman—was
 ordered a strong decoction of guaiac  and mezereon;  the leg  was
 carefully bandaged  from  the toes, and every other day the ban-
 dages were removed,  and an  ointment of  iodide of  potassium
 rubbed  on.  She was put  on generous diet and wine, and  kept in
 bed.   This treatment was continued  for a little more than three
 months, by which time the leg was reduced to its former dimen-
 sions.  M. Cazenave states, that he has  met with several similar
 cases, which have been all more or less benefited, and some even
 cured by this plan of treatment.
   M. Ogier Ward5 cures  itch by  a simple  lotion of iodide of
 potassium, a single washing with which,  in some instances, com-
 pletely eradicated the disease.  To ensure complete success he ap-
 plies sulphur ointment at night, and the lotion during the day.
 It  usually effects a cure in  seven days.   The lotion  consists of
 one dram  of the  iodide to eight or  sixteen  fluidounces  of fluid,
 according to the delicacy of the cutaneous surface.
   Amenorrhcea.— According to Coindet, iodine is a  powerful
 emmenagogue, and the possession  of this property has  likewise

  1  CEsterreich, Medicinisch.Wochensch. cited in Provincial Med. and Surg. Journal,
 April 29, 1843, p. 99.
  a Pereira, Elements of Mat. Med. and Therap. i. 246.  Lond. 1842, or 2d Amer.
edit.  Philad. 1846.
  3 Bulletin de Therapeutique, Jan. 1849; cited in Canstatt und Eisenmann's Jahres-
bericht, u. s. w.'im Jahre 1849, V. 159.  Erlangen, 1850.
  4 L'Experience. Oct. 19, 1843, cited in Edinb. Med. and Surg. Journal, April, 1844.
  ' Lond. Med. Gazette, April 3, 1846, p. 608. 
470
IODINUM.
been ascribed to it by Brera1 who frequently administered it suc-
cessfully in amenorrhcea;  and Formey,  Nieustadt,  and Ashwell2
confirm their observations.   Sablairoles cured three cases by fric-
tions with  iodine ointment on the breast, conjoined with the inter-
nal use of  iodine.  It was necessary, however, to give, it in  large
doses,  and  for a long time.   Dr. Aldridge,3 of Dublin, states, that
benefit may be  expected from  its use, when the absence of the
catamenia  is dependent upon uterine  irritation, whether from ex-
posure to cold, mental emotion or other causes, and  accompanied
by  pain in  the  loins, headache, palpitation, &c.   Locher-Balber4
and Golis  found iodine of value, at  times, in  those troublesome
cases which occasionally precede  the  establishment  of menstrua-
tion; the latter  was, however, often deterred from its use, in such
cases,  by the evil  consequences it  produced  on the respiratory
organs,—such  as dry cough, or cough accompanied  by  bloody
sputa.
  Degeneration of the Ovaries.—Rochling  observed a marked
effect  from the use of iodine in induration of the ovary.   Jahn
cured,  by an ointment of iodine  and mercury, an enormous dege-
neration of the  ovaries, which gave rise to two tumours, each the
size of the head; and Messrs. Thetford,5 Klaproth,6 Jewel,7 and
Ashwell8 were equally successful.  Baron employed it beneficially
in a case of dropsy of the ovarium.
  In hypertrophy of the ventricles of the heart, Magendie recom-
mended it  long ago.
  In scirrhus of the uterus, mammae, &c, it has  been advised
by Heun, Klaproth, Hennemann, Von dem Busch,9 Ullmann, Hill,
Benaben, Magendie, Hammer, Elwert, Wagner,10 Copland,11  Zim-
mermann ;12 and from their recorded observations, it would seem,
that great  efficacy ought to be ascribed to it, both when internally
and externally  administered.  A case is published by Dr. Thet-
ford13  in which  the uterus was of bony hardness, and so large as
nearly to fill the pelvis; yet it gave  way in six  weeks to the use
of iodine.   Seven  cases of hard tumours of the uterus are  like-
wise reported by Dr. Ashwell,14 which were removed by it,  with
occasional  depletion, and regulated diet.   It was given internally,
and at the  same time  applied externally in  the form of ointment,
(lodin. gr. xv., Potass, iodid. Qij., Ung. cetacei ^ss.,) of which
a piece of  the size of a nutmeg  was introduced into the vagina
  1 Saggio Clinico sull' Iodio.
  * Guy's Hospital Reports, No. 1.  Lond. 1836, and Cogswell, op. cit., p. 43.
  3 Dublin Hospital Gazette, Oct. 1, 1845.
  4 Hecker's  Litter.  Annal. i. 275; and Cogswell on Iodine, p. 77.
  6 Transactions of the Dublin College of Physicians, v. 510.  Dublin, 1828.
  6 Revue M edicale, Mars, 1824.           ' Op. cit.
  8 Guy's Hospital Reports, vol. i.          9  Hufeland's Jour. B. Ix. St. 2, S. 81.
  10 Revue Medicale, Juin, 1833.           "  Diet, of Pract. Med., art. Cancer.
  " Journal de Pharmacie, Juin, 1842, p. 598.
  13 Trans, of the King and Queen's College of Physicians of Ireland, vol. v. u Op. cit 
                            IODINUM.                       471

  and rubbed into the cervix uteri  for ten or twelve  minutes every
  night.  The average time required for the removal of these tumours
  was from  eight  to  sixteen  weeks.   In congestion,  erosion  or
  ulceration of the cervix  uteri, Dr. Churchill1 found iodine, used
  according to the formula  given hereafter, the best application of
  all that he has tried.  He usually commences with a single appli-
  cation of nitric acid, or the  acid nitrate of mercury, and then,
  after a few days, paints the entire  cervix with iodine, which  he
  repeats once or twice a week.   The application occasions no pain
  unless the orifice of the vagina should be touched.  Jahn extols
  it much in incipient scirrhus of the stomach, when  combined with
  the application of leeches.  Riecke asserts, that his father found
  an ointment of iodine extraordinarily useful in a case of induration
  of the pancreas;  and, also, in  one of scirrhus of the  pylorus.
  Magendie extols  it in cancer of the tongue;  and Benaben and
  Triistedt  employed it  successfully in stricture  of the urethra,
  supervening on badly managed gonorrhoea.  In a case of scirrhous
  tumour, of  large size, seated in the neck, and protruding into the
  isthmus faucium, which was attended by a prolonged ceaseless pain
 of an aching and depressing character,  Professor J. K. Mitchell2
 found  the most marked relief follow the administration of eight
 grain doses of iodide of  potassium.   " After the second  dose the
 pain ceased for some  days, although  the tumour continued  to
 enlarge.  The pain returned at irregular intervals, but was always,
 as speedily as at first, relieved by  iodide of potassium."
   Leucorrhoea and gonorrhoea.—A Parisian physician made the
 observation, that during the employment of iodine in goitre, obsti-
 nate and protracted leucorrhoea  disappeared : this induced him  to
 try the remedy in  the latter disease, and he found it  efficacious.
 Goden  and Broglio, likewise, observed it  useful in malignant fluor
 albus;  and Benaben, Richond,3  De  Salle, Caswall,4 and  Broglio,
 in gonorrhoea.   The last  two  individuals gave it especially  in
 those cases,  in which, without any marked inflammation, a deeply
 rooted  gonorrhoea existed, with ulcers in the urethra and  prepuce,
 not apparently of a syphilitic character.  In chronic fluor albus,
 it was  used  by Miiller5 with marked  success.   A young female
 had long  suffered  under this affection,  which  had  reduced her
 strength, and did not  yield to any of the means that had been
 employed, when the ointment of iodide of potassium was rubbed
 —morning and evening—on the  inner surface of the thighs.  After
 this plan  had been  continued  for four weeks, the disease entirely
 ceased.   MM. Gimelle and Jewell are also advocates for it."  M.
  * Medical Times, May 19, 1849.        ■ Medical Examiner, Aug.  1846, p. 462.
  • Archives Generates de Medecine, vol. iv.  * Lond. Med. Gazette, for 1834.
  • Wochenschrift. fiir die gesammte Heilkunde, No. 40, S. 633, Oct. 1836. '
  6 Revue Medicale, vii. 249; and Practical Observations on Leucorrhoea, &c.,by Geo
Jewell, p.  80,  Lond. 1830.  See, also, Solon, in Nouv. Diet, de Med. et  Chirurg. art 
472
IODINUM.
Ricord,1 however—who considers that the genito-urinary organs
are amongst those that are most susceptible of the action of iodide
of potassium—says, that he has been able to trace the fresh access
of blennorrhoeas ineffectually got rid of previously, or the exaspe-
ration of those actually existing, so frequently to its use,  that he
regards the existence or recent  presence  of a blennorrhcea as its
temporary contra-indication.   " Perhaps, however," he adds, (on
the  principle similia similibus probably,) " advantage  may be
derived from the iodide of potassium in some cases of blennorrhcea."
A dilute tincture of iodine  has  been  used by M. Steenkiste with
great  success in cases of obstinate chronic leucorrhoea.  He dis-
solves a dram of iodine in twelve fluidounces of alcohol; and adds
about forty fluidounces of water.  About a  fluidounce of this is
thrown into the vagina as an injection;  which is  repeated every
day, or every other day, according to the excitement it occasions.
   In discharges from the nose, iodine, in the form of iodide of
potassium, has been used with advantage  by Dr. Elliotson2 and by
Mr. George Fayrer,3—given internally, as well  as employed in
the form of injection Oj. ad aquae f 3iv.)
   In secondary syphilis, iodine  has been recommended by Tyrrel,
Saville,  De Salle, Schlesier,4 Dietrich,5 A.  Cade,6 Acton,7 and
numerous  others;—especially when  the  disease  is complicated
with scrofula, and  the effects of mercurials.   Wallace8 has like-
wise communicated some fortunate results from the administration
of iodide of potassium in secondary syphilis, and Ebers,9 Ricord,10
Von Haselberg,11 Cullerier and others have confirmed his observa-
tions.  Benecke12 has employed iodide of potassium, with the best
effects, in every form of syphilis—primary, secondary and tertiary.
Mr. Bullock13  has reported  the particulars  of  eleven cases of
secondary syphilitic diseases, of a formidable character, relieved
by iodide of potassium given internally, in doses of eight grains
three times a day, in camphor mixture.   The symptoms were:—
destruction of the  vulva and soft palate;  or nodes,  with nocturnal
  1 L'Experience, cited in Lancet, Jan. 28, 1843.
  3 Lancet, Feb. 10, 1838, p. 725.                  3 Ibid. Feb. 24, p. 786.
  4 Casper's Wochenschrift. Feb. 4, 1837, S. 78.
  * Journ. des Chirurg. und Augenheilkunde, von Grafe und Walther, cited in Ency-
clog. des Sciences Med.  Jan. 1841, p. 165.
  s Bull. Gen. de Therap. Mai, 1841, and Encycl. des Sciences Med. Aout, 1841,
p. 319.                               ' London Lancet, Jan. 31,1846.
  8 Treatise on the Venereal Disease.  Lond. 1833.
  s Medicinische Zeitung, Oct, 5, 1836, S. 201 and 207.
 10 J. J. L. Rattier, La  Lancette Francaise, No. 34, 19 Mars, 1839. Gazette des Ho-
pitaux, Mars, 1839, and Langston Parker's Modern Treatment of  Syphilitic Diseases,
&c,  &c.  Amer. Med. Library edit. p. 77.  Philad. 1840.
  11 Medicinische Zeitung, No. 48 and 49. Berlin, 1837.
  13 Cited in Schmidt's Jahrbiicher der in-und-auslandischen gesammten Medicin, Jahr-
gang 1848, No. 8, S. 185.
  ,a Edinb. Med. and Surg. Journal,  Jan. 2, 1837.   See,  also, Cogswell on Iodine,
p. 80; Laycock, Lond.  Med. Gaz, March 2, 1839, p. 821; and Lisfranc,  cited in Med.
Times, Jan. 11, 1845. 
IODINUM.                        473
pains in the tibia, ulna, frontal  and malar bones, and  affection of
the bones of the  nose, or rupia, and  other tubercular eruptions.
The period of cure was from  one to two months.   Mr. Mayo1
has described it as efficacious in certain  disorders, which are the
consequences of syphilis, as emaciation,  with ulcers of the skin;
ulcerated throat, affections of the  bones, &c, occurring in those
to whom mercury had been given  ; and  M. Michel2 gave it with
great advantage for the  removal of tertiary symptoms, in the dose
of four grains in  the day, dissolved in an ounce of tar  water.
   Iodide of potassium has been used with much success  by M.
Ricord,3 in deep-seated syphilitic tubercles.  Before the tubercles
have become inflamed or softened, whilst they are still indurated,
he has constantly succeeded in dispersing them by iodide of potas-
sium,  with  small  doses  of iodide  of  mercury.  Very commonly,
however, he employs iodide of potassium alone; and when the
tubercles have become ulcerated, he still  relies upon it as his prin-
cipal remedy.  M. Ricord4 considers  its  results to be  most happy
in the tertiary forms of syphilis, in which he regards it as the
great remedy.  He employs it in gradually increasing doses, com-
mencing with ten grains dissolved in  three fluidounces of distilled
water, given at intervals during the day in any convenient vehi-
cle.   When  the remedy agrees, which it most commonly does, if
the stomach be healthy, the dose  is  increased  ten grains every
two or three days, till it is  carried to a dram, a dram  and a half,
or even more, in the course of the day.   In the great number of
patients who have been treated  by M. Ricord, the  beneficial effects
of the iodide were constantly exhibited,  but  not always with the
same degree of rapidity.   By the  same plan Jagerschmits5 treated
successfully two cases of constitutional syphilis, after the mercurial
treatment had failed.   In one of the cases, the iodide of potassium
was given with the iodide of quicksilver;  in the other, the iodide
of potassium alone.
   From an examination  into the  comparative value of the differ-
ent preparations  of mercury and  iodine, and the best  modes  of
administering them, Dr.  Hocken6  concludes, that iodine is inert in
almost all the symptoms of primary syphilis, with the  exception
of some forms of phagedcena,  attended  with great  debility and
derangement of the  health ;—that in constitutional  syphilis it is

  1 Lond. Med. Gaz., xi. 249.   See, also, a Treatise on Syphilis, by Herbert Mayo,
F. R.S.  Lond. 1840.
  ' Bouchardat, Annuaire de Therapeutique pour 1848, p. 193.  .Paris, 1848.
  8 Langston Parker, op. cit. p. 77.
  4 Traite Pratique des Maladies Venkriennes, &c.   Paris, 1838; also, Acton, Com-
plete Treatise on Venereal Diseases, &c.  Lond. 1841; or Amer. edit., New York,
1846;  M. Lafargue, Encycl. des Sciences Med. rTevrier, 1841, p. 359, and M. Seguin.
Bull. Gen. de Therap. Dec. 1841.
  5 Bulletin de Therapeutique,  Janv. 1849; cited in  Canstatt und Eisenman's Jahres-
bericht u. s. w. im Jahre 1849, v. 159. Erlangen, 1850.
  6 Edinb. Med. and Surg. Journal, April, 1844, p. 325. 
474                        IODINUM.
a less valuable  remedy, in the majority of secondary symptoms,
than mercury, with the exception of some severe cases of pustular
eruptions, phagedenic sore throat, rupia, and secondary ulcerations
of a bad character, all of them marked by a cachectic and debilitated
constitution ; whilst in  tertiary symptoms iodine is far more valu-
able than mercury, and its effects more certain and decided  than
in any other set of symptoms;—that mercury and iodine are most
advantageously combined, in cases presenting both secondary and
tertiary symptoms; and that the only form of iodine, safely appli-
cable to  the treatment  of  syphilis, is the iodide of potassium,
which should never be  carried  beyond moderate doses; and hence,
that however valuable  the  iodide  of potassium  may be in  some
forms of syphilis, it cannot be substituted  with advantage for
mercury in  the  great majority.
  JVocturnal pains  in the  bones,  and diseases of the bones and
periosteum  have likewise been particularly benefited by the iodide:1
the  latter, when localized for a longer or shorter period,  have
yielded *ooner when  blisters have been applied over  the affected
parts.   Mr. A. Ure2 reports a case of periostitis of the left  ulna,
of two months' standing, which, after leeching, blistering, &c, had
been employed, was  cured  by two grains  of iodide of potassium
given twice a day in  a  compound infusion of gentian,  with a grain
of opium at bed-time for  a fortnight;—bran  poultices  being ap-
plied to the arm.
  An iodine suppository  appeared  to Mr. Keate3 to be  beneficial
in enlarged prostate;  and iodide of potassium was  administered
successfully in  the same disease by Dr. Casey.4   In enlargements
of the third lobe of the prostate, Mr. R. A. Stafford,5 has recom-
mended it to be applied, by  charging a bougie at its point with
iodine,  or iodide of  potassium,  and then  dipping it into melted
tallow, so that a coating may be formed upon  it.  The bougie
having  been passed so  as to reach the desired spot, its point is
allowed to rest upon  the  diseased part, when the tallow gradually
melts, and  brings the  iodine  or iodide of potassium into contact
with it, and, by drawing the  bougie  gently  backwards  and for-
wards, the  necessary friction is produced.   He has  found it ad-
visable  to be very cautious as  to the strength of the application,
as the prostate will not bear a strong preparation either of iodine
or iodide of potassium at  first.   He has found it  necessary to

  ' Wm. B. Casey, in New York Journal of Medicine and Surgery. October, 1840, p.
320; and J. M. Ferrall, Lond. Med. Gazette, April 18, 1840, W. S. Oke, Provincial
Med. and Surg. Journ. April  24, 1844; and Henry Hartshorne, Amer. Journ. of thi
Medical Sciences, Jan. 1849, p. 47.  ,
  * London Medical Gazette,  March 21, 1845, p. 785.
  ' Lanct. for 1832-3, p. 672.
  4 New York Journal of Medicine, Oct 1840, p. 324.
  • Brit, and For. Med. Rev.  Oct 1840, p. 529, being a notice of Mr. Stafford's Em*J
on the Prostate Gland. 
IODINUM.
475
employ belladonna, opium, hyoscyamus, &c.,**o quiet  irritation
and pain.  When these have subsided, be begins  carefully by in-
troducing iodide of potassium in the proportion of one grain to a
dram of unguentum cetacei, and increasing  it as  the  patient can
bear it.   He then goes  on with two, three, four, five, and even
as far as ten grains or  a scruple to the dram, according as the case
requires it.  After this, he adds iodine to it;—half a grain, one,
two, three, four, or even more grains in the same manner.
   In different forms of rheumatism, iodine has  been given with
success  by Dr. Clendinning,1 in the  Mary-le-bone  Hospital, and
a series of cases in which it was employed  has been published by
him.  Sir B. Brodie2  twice relieved rheumatism by the tincture,
 although, in one  of the  cases, only temporarily.  Cases of acute
 rheumatism, treated successfully by iodide of potassium,  used in-
 ternally and externally, have been  published  by  Dr.  Mackey,3
 Mr. Wardleworth4 and  M.  Bouyer.5  Dr.  Cowan0  gave  the
 iodide of potassium in  fifty-two  cases, in  average doses of  five
 grains three times a day.   In  no  instance  was either bleeding or
 leeching prescribed.   Its action in rheumatism he considers to be,
 on the whole, satisfactory:  in many cases it may be  regarded as
 heroic, while in others, not a priori distinguishable, almost negative.
 In chronic rheumatism its  success appears to have been equally
 decided ; given alone in  full doses—six grains, for example, three
 times a day—or associated with sarsaparilla.   This  combination
 has been highly extolled by Dr. Graves in sciatica and lumbago:7
 and by Dr. Heygates in chronic rheumatism, secondary syphilis;
 &c.9  When rheumatism  assumes the chronic  form, or  if there
 should exist a strumous  or syphilitic  taint, no  remedy, according
 to Dr. George  L. Upshur,10 will be found  equal to the iodide of
 potassium, of  which he usually prescribes five grains four times a
 day in hop tea, the bowels, in the mean time, being opened every
 day by  the black draught  or other cathartic.   He has rarely seen
 the most obstinate cases  resist this treatment.  In gout, too, it has
 been prescribed.   Jahn  found  it extremely effective  in dispersing
 gouty tophi.   Valentin observed,  that  when  iodine was given
 in a case of goitre complicated with gout, the tumefaction  of the
 joints and the depositions gradually disappeared.  Adopting the

   1 London Med. Gazette, May, 1835.               " Lancet, for 1832-3.
   • Ibid. March 2, 1839, p. 830.                    l Ibid. March 30, 1839.
   ' Gazette Med. de Paris,No. 32. 1840; see, also, Davies, op. cit. p. 317, and Craw-
 ford, Montreal  Medical Gazette. April 1, 1844.
   6 Provincial Med. and Surg. Journ. May 27, 1843.
   * Dublin Journal of Med. Science, Nov. 1H40, and M. Ebrard, Journ. de Med. et Chi-
 rurgie Pratiques, Nov. 1845, cited in Amer. Journ. of the Medical Sciences, July, 1846.
 p. 225.
   B London Lancet, Mar. 6, 1841; see, also, E. D. Connor, American Medical Intelli-
 gencer, Dec. 1. 1840, p. 257.
   * See. also, W. S. Oke, Provincial Med. and Surg Journ. May 1, 1844, p. 54.
   K Medical Examiner, Oct  1850, p. 581. 
476
IODINUM.
hint, he gave it in several cases of gout, with the effect of always
mitigating the disease, and, at times, of  completely curing  it.
Gendrin used iodine not only in chronic gouty swellings with suc-
cess, but also in acute cases.  Ebers likewise confirms the efficacy
of iodine in gout.   In coxalgia, Buchanan recommends the tincture
of iodine to be applied by means  of a  small  brush, as well as in
cases of false joint, of which he has detailed a successful instance.
A similar case has also been given by Treusen.   Painting the  af-
fected surface with it, even in acute rheumatism, has been  found
useful.1   In various rheumatic affections of the joints, especially
of the  chronic  kind,  Dr.  R. B. Todd2 has employed "with  un-
questionable benefit," the local application of iodine to the affected
joints,—both in the form of the tincture, and of a stronger com-
pound, used at  the King's College Hospital, London,  under  the
name of "Iodine Paint;" the formula for which is given hereafter,
(see Potassii Iodidum.)   The mode of application is to paint the
part freely by means of a camel's hair pencil.   More or less smart-
ing is produced, and frequently vesication, or an herpetic eruption
may ensue.   The  painting may be repeated as  often as circum-
stances demand.    Dr. Todd  considers  it to be extremely useful,
when  an effusion has taken  place into synovial membranes  or
sheaths;  yet Dr.  Gros,  of Wesserling,3 affirms, that  before  he
recently recommended the tincture of iodine,  it had never been
employed in chronic rheumatic affections of the joints!  In adi-
posis, Von Grafe * prescribed it, and not without advantage.   The
case was accompanied by great voracity and  sense of suffocation.
Bleeding and cathartics were premised.  In stomacace  or a scor-
butic state of the gums, the use of iodine has been  recommended
by Friedrich ; as well as in mercurial salivation, by Kluge, Knod,5
Klose,6 Graves,7 Asmus,8 and others;  yet its  efficacy appears  to
be somewhat doubtful in the last affection.   Heyfelder found it of
no value in three cases.  Dr. H. D. Holt9  found, that every case
of nurses' sore mouth, which he treated with five grain doses  of
iodide of potassium three times a day, yielded within forty-eight
hours.  In a case of stricture of the oesophagus, it was given with
much benefit by Dr.  dimming, of New York.10  A bougie had
been  previously used, but  without advantage.   An adventitious

  1 Cowan, Provincial Med. and Surg. Journal, May 27, 1P43.
  2 Lond. and Edinb. Monthly Journal of Med. Science, Dec. 1843, p. 1084; and Craw-
ford, Montreal Med. Gazette, April 1, 1844.
  3 These de Strasbourg, cited in Archives Generates de Medecine, Fevr. 1850, p. 214.
  * Walther und Griife's Journal fiir Chirurgie, B. ix. St. 3, S. 367.
  5 Gazette des Hopitaux, July, 1837.
  ' Medicinische Zeitung, No. 34, 1836.  See. also. Amer. Journal Med. Scienres, Feb.
1834, p. 533.                    ' Dublin Journ. Med. Science. Jan. 1834.
  8 Casper's Wochenschrift. fiir die gesammte Heilkunde, No. 45. 1838, and Encyclo-
graphie des Sciences Medicales. Juillet, 1839.
  9 New York Journal of Medicine, May, 1848.
 10 New York Journal of Medicine and Surgery, No. 2, Oct. 1839, p. 451. 
IODINUM.
477
  membrane was brought up in scales soon after  commencing the
  iodine.  For two or three weeks, the medicine was laid asid'e, but
  it was necessary to resume it.  In affections of the mucous mem-
  brane of the middle ear, it has been used by Dr. Manson, and also
  by Mr. T. Wharton Jones;1 by the former with advantage ;  by
  the latter without any marked effect.   Dr. Manson  likewise suc-
  ceeded in curing chronic dacryocystitis by it.
    In cases  of  hydrocele, Velpeaua prefers a solution of iodine to
  wine as an  injection.   He employs the tincture in the proportion
  of from one to two, and even four, drams to an ounce  of water.3
  Mr. J. R. Martin,4 of India, appears, however,  to have anticipated
  him m this application of the remedy.  Up to the time of the pre-
  sentation of his paper to the Medical and Physical Society of Cal-
  cutta, (January, 1835,) he had used it successfully in upwards of
  ninety cases, and subsequently, he communicated to  the Medical
  and Physical  Society of  Calcutta the results  of his after expe-
  rience.   The number treated since  March, 1832, at the Native
  Hospital, was seven hundred and  seventy-seven:  of these, seven
  hundred and sixty-six had a solution of tincture of iodine injected.
    In order  to  ascertain whether it was by mere  stimulation that
  the cure by the tincture was  obtained, Mr. Martin treated ten
 cases with a common urethra-syringeful  of undiluted port wine,
 and one  with diluted tinctura lyttae, in  the same proportion as that
 of iodine,—3ij. to water gvj.  Of this, two drams were injected
 and retained; the  pain  during twenty-four hours was  excessive
 and the inflammation, although not proportionate to the pain, was
 much longer in  subsiding than when the tincture of iodine solution
 was used: this  was also remarkably apparent in the cases treated
 with undiluted port wine.  Of seven  hundred and sixty-six cases
 it does not appear that more than  four  failed.5
   For hydroceles containing from  six to thirty ounces of fluid, two
 drams of the solution of tincture of iodine are sufficient; for those
 containing from thirty to sixty ounces, three drams; and for those
 of a larger size, four to five drams.  When the  hydrocele contains
 Jess than  three ounces, a dram of the injection is sufficient.6   The
 cure is effected much sooner by iodine; and if any infiltration takes
 place it is readily absorbed.  Highly favourable results  have also
 been obtained  by MM.  Oppenheim7  and Fricke,8 and by  Mr.

233L°"d' Med' GaZ" A"S' 17'  1839'p" 754'and  Amer> Med'Intel- Nov- ]> ]839, P.
  » Archives Centrales de Medecine, Jan. 1837; La Presse Me'dicale, Mai 1837 See
also Amer.  Med. Intell.gencer, July 15, 1837, p. 138; and Oct. 16, p. 263        '
   Bouchardat,  Annuaire de Therapeutique pour 1844, p. 338. Paris 1844
   Amer. Journal of the Medical Sciences, Nov. 1837 p 238       '
  'Quarterly Journal of the Calcutta Med. and Physical Society, for Jan  1837- «♦«*!
in American Journal  of the Medical Sciences,  for Feb. 1839 p  485         '   d
  • Dujat, m Gazette Medicale de Paris, Sept. 1838.
  1 Zeitschrift fiir die gesammte Medicin. Aug. 1838, S. 389.
  ' Ibid. S. 405.
       31 
I
478
IODINUM.
Bransby Cooper,1 and the method  has  been largely employed in
this country with equal advantage.2   Two successful  cases  are
reported by Dr. Stewart.3
   Encouraged by the success which attended the use of iodine in-
jections  in  hydrocele, M. Velpeau4 has  adopted a similar mode of
treatment for various  kinds  of serous cysts, enlarged bursce, &c,
about the knee, in  the axilla, breast, neck  and other parts.  He
punctures the cyst with a trocar proportioned to its size; emptying
it in this manner, and  then injects through  the cannula  a mixture
of one part of tincture of iodine and two parts of water.  In a few
seconds this is  drawn off.   In a day or two, the  cyst  inflames,
though never  greatly, and it ultimately shrivels  and disappears.
Since then  he has  used the  injection successfully in five cases of
goitre, which is often formed of cysts  filled with a thin serous or a
blackish fluid.  In  hydrarthrosis, the  operation  appeared to him
to be  more formidable.  He practised  it in two cases;  one reco-
vered ;  the  other did not.5  The plan has  been employed  by M.
Bonnet,6 of Lyons, in one case of hydrarthrosis.   He prefers for
the injection a watery solution, consisting  of one part  of iodine,
two parts of iodide of potassium, and eight of wrater, in order to
avoid the possible coagulation of the effused fluid by the alcohol of
the tincture.  He only withdraws through  the  trocar a portion of
the fluid; and the quantity of injection thrown in is nearly the same
as that of  the fluid which has been withdrawn.   In all M. Bon-
net's cases, the acute arthritis which supervened subsided within a
few days, and was  never followed by suppuration.  Recently, M.
Velpeau7 has expressed himself more decidedly in  regard  to the
beneficial effects of this plan; and he states  that at least fifty cases
treated by  different surgeons, are now on record, in none of which
were any alarming symptoms developed.  Dangerous and fatal con-
sequences had resulted, according to him, in  M. Boyer's cases, from
the joint having been laid widely open,  and irritating fluids several
times thrown in, whilst in the modern operation the smallest possi-
ble trocar is employed, and in the majority  of cases a single injec-
tion is  sufficient.   He is now of opinion, that there is  not more
danger in injecting  a joint than the tunica vaginalis.
   M. Velpeau likewise tried the effect of iodine injections into the
  ' Medico Chirurg. Rev. Apl. 1841, p. 541.
  a A. C. Post, New York Journal of Medicine, April, 1840, p. 369, and G. W. Norris,
Amer. Journ. of the Med. Sciences, Feb. 1839, p. 299.
  3 India Journal of Medicine, May,  1836.
  ' Bulletin General de Therapeutique, Nov. 1841.
  ' Recherches sur les Cavites closes,  &c, pp. 112—165, and Bourchardat, Annuaire de
Therapeutique pour 1843, p. 256. Paris, 1843.
  * Braithwaites Retrospect, vii. 231;  cited from Medico-Chirurgical Review, Apl. 1843;
also, Traite des Maladies des Articulations, &c.  Paris, 1845; reviewed in Brit, and For.
Med. Rev. July, 1846, p. 71.  This Review, by the way, contains a condensed account
of the difleren t cases in which the injection had until then been employed in hydrarthrosis.
  ' Gazette des Hopitaux, cited in Brit, and For. Med. Chirurj. Rev. July, 1850, p. 268. 
IODINUM.
479
sac of  a reducible hernia, and  repeated  the  experiment on  two
other cases;  but the  difficulty of reaching the sac with certainty,
and the unsatisfactory results obtained in these three cases, have
been regarded as serious objections to the practice.  The plan has
been  adopted by  Prof. Pancoast,  who  has,  likewise,  used the
tincture of cantharides for the material of the injection.
   M. Velpeau1  was  disposed to go even farther, and, as he con-
sidered it to  be  proved  by his  experiments, that the tincture  of
iodine does not induce either suppuration or gangrene when thrown
into serous cavities; he suggested whether we might not hope that
certain varieties of spina bifida, hydropericardium,  hydrothorax
and ascites  may  respectively find  an efficacious remedy  in this
kind  of medication ?   " It  would, doubtless," he remarks,  " be
rash to reply affirmatively to this question,  before having invoked
experience and direct observation;  but the  facts which I possess,
and analogy, are sufficient, I think, to justify fresh trials  in this
direction.  I may add, that the iodine  injection  has succeeded
with  me  in  purely liquid haematocele as well as in hydrocele."
A case of spina bifida  has, indeed,  been treated successfully by
Dr. Brainard,2 with injections of iodine.   The patient, a girl, thir-
teen years of age, had a tumour at  the  top of the  sacrum, nine
inches in circumference and about three in length, with thin walls.
She had been paralytic in the lower limbs, but within three years
had acquired a partial use of them.   Through a small puncture, a
solution of a grain of iodide of potassium with  half a grain of
iodine in a fluidram of water, was thrown  into the sac; compresses
and a bandage were  applied to prevent the escape of the fluid;
and methodical  compression  by a bandage was exerted  on the
tumour.  A  month afterwards the injection was repeated, of half
the strength  of  the first, and in about a fortnight the fluid in the
sac was in great part absorbed.   A spring truss was now applied,
and the fluid became  entirely absorbed.
   Since then, Dr. Brainard3  has treated three cases, all associated
with  hydrocephalus,  and therefore incurable.   He  is  of  opinion
that the disease  is generally curable by this  plan of treatment, and
that, compared with every known method, it is "safe and efficient."
He advises that, at the commencement, not  more than the thirty-
second part of a grain of iodine, and three times as much iodide of
potassium, dissolved  in distilled water, should  be used.  As long
as it produces moderate inflammation, the quantity should  not be
increased.  Collodion  is subsequently  applied and reapplied as lone
as the tumour continues to decrease; and when it ceases to decrease,
or increases, the injection is  repeated.
   A case of ovarian  dropsy has been published  by Dr. Benjamin

  1 Bouchardat,  Annuaire de Therapeutique pour 1844, p. 132.  Paris, 1844.
  ' Illinois and Indiana Med. and ^urg. Journal, Jan. 1848.
  • North-Western Med. and Surg. Journal, July, 1850. 
4^0
IODINUM.
A. Allison,1 of Indiana, in which a solution of iodine—the strength
is  not mentioned—was  injected into the dropsical sac.   "The
symptoms that followed were truly alarming, and could not be
entirely controlled.2   They subsided, however, in a few days, and
she continued improving.  The discharge rapidly  increased until
it almost  entirely ceased."  A similar plan has been used success-
fully in some cases of ascites.3
   In a case  of empyema  after paracentesis, Dr. Suytgaerens, of
Puers, repeatedly injected  the pleura with an iodine solution, and
the patient recovered.  In a case of ascites, M. Dieulafoy, of Tou-
louse, threw a quantity of iodine injection into the peritoneum, and
after  diffusing it over  the entire cavity drew off  about half the
quantity injected.  About  a month after, half the cavity seemed
obliterated; but the fluid having again collected, the injection was
repeated  with similar consequences.  A third injection was em-
ployed about six weeks afterwards:  after this the ascites disap-
peared.4   Another case is related5 in which a cure was effected
in the same  manner.   The patient—a child, seven years of age,
—had been  tapped  several times, but  the  abdomen  had always
become filled again, and he was in an almost hopeless state when
this course was resorted to. The case was one of asthenic dropsy,
without   any apparent complication of disease of the  heart or
other viscus; and M. Leriche, of Lyons,  has published two cases in
which a single injection, after the complete evacuation of the fluid,
was sufficient for the cure.  M. Boinet presented a memoir before
the Societe de Chirurgie, in which he enumerated  eighteen cases,
from various sources, wherein  different substances, as gases, water,
iodine, &c, were injected.   Fifteen of these were  successful, and
only one  died; iodine seeming to be the  preferable material for the
injection.  "M. Morel, reporting upon  this  paper,  pronounced
an almost unqualified opinion  in favour of the practice;  but  MM.
Vidal, Gosselin, Robert and others, protested against drawing any
such hasty conclusions from cases the history of which had been
imperfectly given, and have to be confronted with  others in which
a fatal termination has resulted, an example of which has recently
occurred  in Paris."6
   Dr. Brainard  states,7 that in December, 1845, he threw into
  1 Medical Examiner, June, 1846, p. 336; and August, 1847, p. 459.
  * Gazette des Hopitaux, Fev. 1845.  See, also, on this case and  subject, Proceedings
of the Royal Academy of Medicine of Paris, Jan. 27, 1846, in Medical Times, Feb. 7,
1846, p. 363.
  3 Rul-Oges, of Antwerp, cited by Thirion, in Gazette Medicale  de Paris, 10,1849;
and in Schmidt's Jahrbiicher, u. s. w. No. 11, S. 169.  Jahrgang 1849.
  4 British and Foreign Medical Review, July, 1846, p. 78.
  ' Gazette Medicale de Paris, 4 Mars, 1848.
  « British and  Foreign Medico-Chirurgical Review, July, 1850, p. 270, cited from
L'Union Medicale, Nos. 17, 18, 19, and 20.
  1 North-Western Medical and Surgical Journal, July, 1850, cited in Amer. Journal
of the Med. Sciences, Oct. 1850, p. 560, and in the Ohio Medical and Surgical Journal,
January, 1851, p. 249. 
IODINUM.
481
 the peritoneal cavity fifteen grains of iodide of potassium dissolved
 in one fluidounce of distilled water, after he had evacuated  the
 fluid of ascites by tapping.   Acute smarting pain followed, which
 subsided in a few minutes without any subsequent evidence of in-
 flammation.  The patient returned  home, and  Dr.  Brainard lost
 sight of him.  In another case, Dr. Hagemann injected the cavity
 twice without the supervention of inflammation.   In the winter of
 1850, Dr. Brainard injected the abdomen of a patient affected with
 anasarca, as well as ascites, from cardiac disease, with four grains
 of iodine, and eight of  iodide of potassium  in  solution, without
 drawing off the fluid.  The injection was followed by no signs of
 inflammation, but the fluid in the peritoneum was absorbed, and a
 great amelioration of the symptoms followed.  Dr. Brainard refers
 to cases  treated in a similar manner by Dr. M'Clure, of Dundee,
 Illinois, and by Professor Mussey, with similar results; whence he
 concludes, it may be  considered an established fact, that  injections
 of this kind may be made, with  suitable  care, without danger of
 producing inflammation.
   Iodine is said  by Coindet and  Formey to have been efficacious
 in cases  of impotence;  and Mr. Key1 regards  it as one of  the
 most efficacious  remedies we possess  in checking or controlling
 the ulcerative process—the most active phagedenic ulcers often
 yielding in a surprising manner to its influence, and  assuming a
 healthy, granulating  appearance.  M. Lisfranc3 employed  iodide
 of potassium with success in atonic ulcers of long standing, which
 had resisted other modes of treatment.   The only topical applica-
 tion used  by him was simple cerate and charpie.   The iodide was
 prescribed in doses of a scruple daily, which was subsequently in-
 creased to six grains  every six hours.
   Dr.  John Davies3 has published at length the results of his ex-
 perience with the local application of iodine—especially the tinc-
 ture—in various diseases.  In erysipelas, no matter where present
 or of what description, he found the  tincture, " painted " over  the
 part with a camel's  hair  brush, preferable to leeches, lotions, in-
 cisions, scarifications,  or caustic.4   Mr. Wm.  Reeves5 uses  in
 these cases the compound  iodine  ointment.   In phlegmon,  where
 pain and  throbbing only  exist, one  application of the tincture of
 the full strength cut  short  the  disease;  and where suppuration
 had commenced,  its  repeated use not  only checked  its  progress,
 but caused the deposited matter to be absorbed.   Not a single case
 of failure  occurred, where the tincture was applied in superficial
  1 Medico-Chirurgical Transactions, vol. xix.
  ' Cited in London Lancet, Jan. 7, 1843.
  ' Practical  Remarks on the Use of Iodine  Locally Applied, &c. &c. London, 1839;
or Amer. Med. Library, 1839-40.
  ' See,  also, Burns, in Philad. Med. Examiner, Nov. 6, 1841; and Crawford, Mon-
treal Medical Gazette, April 1, 1844.
  ' London Lancet, Oct. 22, 1842, p. 119. 
482
IODINUM.
 phlegmon before suppuration took  place, and even  then the pus
 was much less  in quantity than where poultices were used.  In
 extensive sloughing of the areolar membrane, after phlegmonous
 erysipelas of  the lower extremities, the  tincture proved  to be a
 most valuable application.  Whilst the  usual remedies  had  no
 effect in checking  the inflammatory process, the iodine arrested
 it at once, and gave  the living parts a chance of casting off the
 dead slough.
   In acute  inflammation of the joints it was more efficacious
 than any of the ordinary local applications.  Over the knee—if the
 skin be  delicate—it may be applied at first about half strength,
 and be increased gradually as required.   When the hip is affected,
 the  strong tincture  must be painted all round the upper part of
 the thigh and  groin.   In these cases, Dr. Davies prefers leeching
 the joint, and then using the iodine as  the  bleeding ceases.  Mr.
 William  Reeves1 employs the  compound iodine ointment  in these
 cases.  In mastitis or inflammation of the mamma, the tinc-
 ture, of full strength, must be laid  extensively over the part, as
 soon as  the disease is discovered;  and if an abscess  should form,
 its extent will be limited.  In gout, its application cuts short the
 attack; and in anomalous pains of the joints, supposed to  be
 gouty or rheumatic,  its effect has been marked.  In these cases,
 Dr. Davies  dilutes the  tincture to about  two-thirds of its full
 strength.  In  chronic inflammation and enlargement of the
joints, such as of the hip and knee, leeches are first employed,
 and then  the diluted tincture is laid extensively over the part, and
 the application is repeated every two or  three days according  to
 its effects on the skin.   In the ankle or wrist, where  the  enlarge-
 ment is of old  standing, an iodine lotion—composed of 32 grains
 of iodide of potassium, dissolved in a fluidounce of distilled wa-
 ter, to which  eight grains of  iodine are added—is  preferred  to
 the  tincture  by Dr. Davies;—a rag being wetted in  it three  or
 four times a  day, and laid round the  joint, and the strength of the
 lotion being  determined  by the  discretion of the attendant.  In
 inflammation of the absorbents,  the strong tincture, applied
 along the track  of  the vessels,  is generally sufficient to  subdue
 the affection.  Employed in anthrax, before  or after incisions,
 it  dispels the  inflammation, and enables the parts to cast off the
 dead  areolar tissue, and form  granulations.  It is equally appli-
 cable to boils and buboes,—cutting short the progress of the latter;
 or, if used after suppuration, limiting the extent of the abscess.  The
 suppurative process in cases of abscesses being well established, and
 the acute inflammation of surrounding  parts  repressed by cataplasms,
 M. Borelli,2of  Turin, after opening the abscess in  its most depend-
  ' Op. cit.
 3Omodei,  Annali, ex xviii. 79—154, cited in  British and Foreign Med. Chir.Rev.
July, 1850, p. 269. 
IODINUM.
483
ing part, and  evacuating the contents as far as practicable, intro-
duces  the  nozzle  of a small  syringe  through the aperture, and
throws in  pure tincture of iodine with some force, allowing it to
remain in,  when the pain is not too great, about half a minute.
He now waits three or four days, to see whether the plastic effu-
sion into the cavity will effect its occlusion, which is rarely the
case, unless the abscess is very small, and the engorgement of the
surrounding tissues slight.  The injection  will require, therefore,
repetition every two or three days, according to the amount of re-
action produced, and, when this is in excess, emollient cataplasms
are required.   M. Borelli has never seen any ill effect, local or ge-
neral, from this mode of using the iodine.   He reports, also, a case
of ranula, which  yielded to the iodine injection, after simple punc-
ture had repeatedly  failed.
   In lupus or noli  me tangere, the strong tincture laid upon the
ulcerated surface has cured the disease without the use of internal
remedies.  In malignant ulcers of the tongue and tonsils, the
tincture, of full strength, brushed all over  the  parts, arrested the
affection, no matter how  threatening.   The only internal remedy
was the ioduretted solution,—in doses of ten drops twice a day, in
water.   In scrofulous swellings of the glands, it either resolved
the inflammation and caused absorption of the morbid deposits, or
limited the formation of matter and assisted in the cicatrization of
the sore.   In  whitlow, the strong tincture  must be  immediately
painted over the whole finger or thumb, and the application be re-
peated in twelve hours, unless the morbid  sensation has  ceased.
Where this has been done prior to  suppuration, it never fails, ac-
cording to Dr.  Davies, to subdue the disease.   Should  matter
have been formed, a free incision must be made, and  the tincture
be applied over the finger or hand, if swollen.   In chilblains, the
tincture, of full  strength, is to be applied  over the part affected,
and beyond the boundary of the surrounding inflammation.  This
must be repeated daily for sometime, and the affected parts should
be immersed every night in water as hot as can be borne.  When
the ulceration looks  healthy, and the skin around has lost its livid
colour, the strength of the tincture may be reduced.   After each
application, the sore, if any, should be  dressed with some stimu-
lating  ointment.   In cases where the inflammation spreads along
the foot or leg, the affected parts must be painted with the strong
tincture.  Mr. James  Henderson1 has likewise found a compound
preparation of iodine useful in  chilblains.  The form  is  given
hereafter.  Three  applications have generally been sufficient.
   In  lacerated, contused, and punctured wounds, the- tincture
was found  by Dr.  Davies to be  preferable  to every  plan of local
treatment.   When the accident was one of simple laceration—after
1 London Lancet, April 18,1840. 
484
IODINUM.
the blood or dirt had been wiped away, every point of the surface
of the wound was touched over with the  tincture, generally of the
full  strength, and the application wras extended  a little distance
beyond.   After allowing it to dry, the edges of the wound were
brought  together with adhesive  plaster,  which was not  renewed
for three or four days.   At the end of this time, part of the wound
was found to be united,  and the rest granulating.   The  granula-
tions with the surrounding skin were washed over and then dressed
with common w7ax ointment.   The cure was generally rapid.
Where contusion only exists, the tincture is applied by Dr. Davies
every day or two to the surface: this quickly occasions the absorp-
tion of the extravasated blood.   Where there is a combination of
laceration and contusion, the treatment is compound. The surface
of the wound and contusion is brushed over, and the edges of the
former are approximated, and kept together by  a plaster or a
roller.  In punctured wounds, from whatever cause, the tincture,
liberally applied, is used with the same success it exerts in local
diseases, and injuries attended with inflammation.   In such cases,
it should be allowed to insinuate itself freely into the  wound, and
be  thickly painted upon the surrounding  skin.  In burns and
scalds, it appears to act as in erysipelas.   When  the integuments
are not destroyed, although the cuticle may be in blisters, one or
two applications of the tincture, of moderate strength, subdue the
pain and  redness, after which the  parts  only require to be kept
free from  injury.  Lastly:—the remedy is  said by Dr. Davies to
be eminently successful in ulcers.  Several cases of chancre yielded
sooner than to the ordinary treatment; and in malignant ulcera-
tions about  the  lips, tongue  or tonsils, no  topical remedy would
seem to be equal to  it.   In  all  cases of irritable or sloughing
sores, the  tincture, of full strength, must  be applied to the surface
and surrounding skin.   After being  allowed to remain some  time,
the ulcer must be covered with simple ointment in preference to a
poultice.   The application must be repeated daily till the sore be-
comes clean and healthy, when the granulations may be touched
with the diluted tincture every two or three days.  Under this plan,
the cavity of the ulcer fills up rapidly.   Mr. Ferguson1 has pub-
lished a  most obstinate  case of old ulcers, which were cured by
the use of the corrosive chloride of mercury internally, and the tinc-
ture of iodine externally.  M. Ricord2 considers the tincture  to be
the very best topical application in phagedenic chancres, and Dr.
Samuel  Jackson, of Philadelphia, (formerly of Northumberland,
Pa.,) has found it an admirable remedy in  the irritable ulcer with
inflamed surface and erijsipelatoid margins.   It soon fills the
surface, and with this the whole inflammation disappears.  A lit-
tle lunar caustic then disposes the ulcers to  granulate.

  1 London Lancet, Nov. 13, 1841.  See, also, Lisfranc, cited in Med. Times, Jan. 11,
1845.           2 Bulletin Generate de Therapeutique, 15 et  18 Fevrier, 1841. 
IODINUM.
485
    In snake bites, as in  those of the rattlesnake, viper, and  cop-
  perhead, in both man and animals, the  tincture of iodine has  been
  successfully used by  Dr. Whitmire1 with the effect of putting an
  entire stop to the swelling and pain in from twelve to sixteen hours.
  He paints the bitten  part  and the whole swelling with  three or
  four coats of the tincture twice daily, and should the swelling ex-
  tend, which it  almost always does after the first  application if
  made soon after the infliction of the wound, he repeats it.
    Besides these affections, the tincture has  been employed  with
  good effect in gouty and rheumatic swellings of the small joints
  from thickening of their ligaments, fistulous openings, malig-
  nant warts ox adventitious excrescences, ganglions, the sting-
  ing of wasps, diseases of the spine, ununited fractures, or-
  chitis,  inflamed urethra  and chordee, inflammation  of the
  bursas, chronic ophthalmia, granulations of the eyelids,2 and
  opacities of the cornea,3 (being much diluted,) in strumous oph-
  thalmia, when  applied to  the outside of the eyelids,4 in  ulcera-
  tions of the tonsils and fauces, specific  or non-specific,5 and in
  dissection ivounds.  The strength of the remedy, in the several
  cases, must depend upon the judgment of the practitioner."  It has
  also  been used  as a counter-irritant in many internal affections.
  Painting the trachea  and larynx with a strong  tincture of iodine
 has been found beneficial  by Mr. E.  Copeman7 in inflammation
 of the air passages.  Dr.  Willige8 extols it highly in  cases of
 croup; and in bowel complaints, an iodide liniment, in the pro-
 portion of a scruple to the  ounce of olive oil, has been employed
 most advantageously by Mr. M'Diarmid.9   He directed the entire
 surface of the abdomen to be smeared over with it, and the ope-
 ration to be repeated as soon as the liniment is absorbed,  and  the
 skin has  again become dry and colourless, or almost  so.  In  the
 acute form of diarrhoea of  infants, in which the surface of  the
 abdomen feels hot and dry,  somewhat tender and full, with great
 irritability of the bowels, and frequent watery evacuations, change-
 able  in colour, and  offensive, with general febrile phenomena, an
 almost magical effect was produced by the liniment in a few hours.
   Iodine has been employed  by M. Reiniger10 to remove sparks of
 iron from the cornea.   A small particle of steel struck  the eye
  la -North-western Medical and Surgical Journal, Jan.  1849.
  * Fromont, cited in Wahu, Annuaire de Medecine, &c. pour 1849, p. 246.
  * See, also, Lohsse, Medicinisch. Zeitung, Mar. 3, 1841; cited in Brit, and For Med
 Rev. July, 1841, p. 258; also, W. S. Helmuth, Med, Examiner, Kept. 11, 1841, p. 583*
  4 Furnivall, Lancet, Dec. 10, 1842, p. 405.
  ' J. J. Loss, Lond. and Edinb. Monthly Journ. of Med. Science, Sept. 1842, p 792
  8 Provincial Medical and Surgical Journal, August 12, 1843.
  1 British and Foreign Medical Review, Oct. 1839, p. 523.  See, also, Langan, Lon-
don Lancet, June 27, 1840, p. 484.                              b '
  8 Schmidt's Jahrbiicher, No. 7, 1847; and Lond. Med. Gaz. Jan. 1848.
  9 British Amer. Journal of Med. Sciences, Nov. 1846.
  10 Journal de Pharmacie etde Chimie, Juin, 1845. 
486
IODINUM.
of a cutler whilst at work, and fixed itself in the substance of the
cornea, from which it was found impossible  to remove it either by
the forceps or  the needle.   It soon  excited  inflammation, and
after eight days, the  eye was still red, hot and painful, and the
patient complained of a  pricking sensation on moving it.  The
fragment of steel could be  distinctly seen retaining its polish.
As a strong magnet  also failed  to  remove it, it was resolved to
have  recourse  to a chemical solvent, but  one  which  would not
injure the eye.  A weak solution of iodine and iodide of potassium
was therefore  used as a collyrium, and its very first  application
sensibly deadened  the lustre of the spark of steel.  By its  conti-
nued use, the steel was rendered soluble, and gradually removed.

   With regard to the relative value of the  preparations of iodine,
Dr. A.  Buchanan1 is inclined to place them  in the following order:
—Iodide of starch, hydriodic acid,  (iodine,) and iodide of potas-
sium;  although he  admits  that  the superiority he ascribes to the
first is  perhaps owing to his  having prescribed it most frequently.
The operation of all of these is, however, similar. The only  mode,
he thinks, of explaining the similarity of  action on  the  body of
substances so dissimilar in nature, is by considering the hydriodic
acid as  the active principle—'free iodine being immediately con-
verted  in the stomach into hydriodic acid.
   Mr. B. Phillips2 prefers the iodide of iron in  all cases.
   M. Moj'sissovics, of Vienna," considers iodide of potassium and
the iodides of mercury to be decidedly the most  valuable prepara-
tions, when pure: but they are often, he affirms, given  in prescrip-
tions with matters that decompose them.
   In the Glasgow Infirmary, they are in the habit of preparing a
liquid hvdriodic acid, by dissolving three hundred and  thirty
grains  of iodide of potassium in f 5iss. of distilled water; and
two hundred and  sixty-four grains of tartaric acid in a like quan-
tity; the solutions are then  mixed, and when the bitartrate of po-
tassa has subsided, the fluid  is filtered. Water enough is then add-
ed to make 3yj. and 31J.4  Each dram of this liquid acid  contains
five grains of iodine.   The acid, thus prepared, is, however, very
liable  to change, and is necessarily variable in its effects.5
   Lastly; from his researches on the effects of the various prepa-
rations of iodine, Dr. Cogswell6  infers, 1. That iodine and  iodide
of potassium act very much in the same way, but that there  is still
a difference, not merely in point of power,  but  of specific proper-
ties.   2. That, whatever be the proper action of the iodide  of sul-
   ' Medical Gazette, July 2,1836.
   * London Medical Gazette, Jan. 10, 1840.
   ' Oesterreich, Med. Jahrbuch., cited in Encyclog.des Sciences Med. Avril, 1841, p. »•
   4 Buchanan, op. cit.                                              ,
   4 Guibourt, in Revue Medicale, Aout, 1837; and Bull Gen. de Therap. Sept 1837.
   6 Essay on Iodine, p. 106.  Edinb. 1837. 
IODINUM.
487
 phur, its facility of decomposition gives it a resemblance to iodine.
 3.  That the iodides of carbon, so far as examined, have an action
 peculiar to themselves; and, 4. That in those metallic iodides which
 were submitted to examination, the preponderance of power is on
 the side of the metals.
                  MODE OF ADMINISTRATION.
   Iodine is  not easily given internally in substance—in  the form
 of pill or powder; neither are these forms to be  recommended.
 Coindet preferred it in the form of tincture; and this is one of the
 most common modes in which  it  is administered.   When, how-
 ever, the tincture  is  taken with water, a great part of the iodine
 is  thrown down, and, it  has been conceived, it may thus exert a
 noxious influence on the stomach; but in the small doses  in which
 it  is taken, such an  effect can scarcely be anticipated.   It would
 seem, however, that, in the generality of cases, when iodine  has
 disagreed, it has been in the form of tincture.   For this reason, it
 has been  given  more, of late years, in  watery solution; and, to
 promote  the  solution, iodide of potassium  is added;  or a little
 chloride of sodium, according to  Lugol's prescription.   An ethe-
 real solution is also  prescribed.   Externally,  it is  applied in  the
 form of tincture, ointment, or watery solution, or in baths, or fu-
 migations.   Frictions with  iodine  readily occasion considerable
 irritation  of the skin, which commonly  soon  passes away when
 the friction is suspended for a time.   After bathing  a part, painful
 rubefaction of the skin often ensues, which is usually followed  by
 perspiration and  sleep.  Iodine  is given  internally in  the dose of
 one-eighth of a grain to a grain, twice or thrice a day.
   In Dr. Pereira's opinion,1 the most effectual method  of employ-
 ing iodine externally is the endermic, in the form  of an ioduretted
 ointment  to the  cutis vera after the epidermis  has been  removed
 by a blister.   The plan is not, however,  often used.
   Under  the idea that the virtues of cod  liver  oil  might be owing
 to the small quantity of iodine it contains, rather than to the fatty
 matter, which—as has been elsewhere shown—is probably not  the
 case: iodine has been added to olive or almond oil, and the  results
 have not appeared to the  author to be less favourable  than when
 cod liver oil has  been given.  Such a preparation—iodized oil—
 has superseded—it seems—the other forms  of iodine at  the Val-
 de-Grace, in Paris.   M. Marchal (de Calvi2) found, that in  this
 way far larger doses of iodine can be administered without irritating
 the stomach.   The trials  made by him with the iodized  oil have
 been very satisfactory in their results, the progress  of  the cure of
buboes  and other glandular enlargements having  been much  ex-
pedited.  M.  Ricord, too,  exhibited  it  with  benefit  in  tertiary
  1 Elements of Mat. Med. and  Therap. 2d edit. p. 242. Lond. 1842, or 2d Amer.
edit.  Philad. 1846.
  a Gazette des Hopitaux, Fevr. 1848. 
488
IODINUM.
syphilis, caries syphilitica, and M.Marchal directs the iodine, as
wanted, to be dissolved in fresh almond oil, in the proportion of one
part to fifteen.   The minimum dose is a grain of the iodine.
  The following are some of the forms in which pure iodine is
administered internally and externally:—
                      Tinctura iodini.
                      Tincture of iodine.
                    Tinctura seu Alcohol Iodii.
               R.  Iodini gr. xlviij.
          Solve in
                    Alcohol. 35° (s. g. .842) gj.
  Dose.—Ten drops in some mucilaginous or saccharine fluid, or
in wine and water.                     Coindet Sf Magendie.
  The tinctura iodini of the Pharmacopoeia of the United States
consists of an ounce of iodine to a pint of alcohol.
  Mr. Durand, an able pharmacien  of Philadelphia, finds, that
forty grains of iodine, and gx. of alcohol form a saturated solution.
Based on this fact, the  following  formula has been given, which
does not seem, however, to possess any advantages over the simple
tincture.
                R.   Iodin. Qij.
                    Alcohol, gj.
                    Spirit, lavand. comp. gij.
  Dose.—Five to ten drops, twice a day, gradually increasing it.1
                 Tinctura rcthcrca iodini.
                  Ethereal tincture of iodine.
            Tinctura iodii atherea.—French. Ether iodure.
                R.   iEther. sulphuric, f ji.
                    Iodini gr. iv.   M.
  Dose.—Eight  or ten drops, two or  three times a day.
                                                 Magendie.
     Pulvis iodini cum  hydrargyri  chlorido  mite.
                Powder of Iodine and Calomel.
                R.   Hydrarg, chlorid. mit. gr. viij.
                    Iodin. gr. j.
                    Sacchari albi gr.  lxxx.  M.
      et divide in partes xij.
  One to be taken  every four hours, to control scrofulous inflam-
mation and  its effects.                   Bennett fy  Wilshire.
        Decoctum  cinchona  cum  tinctura iodini,
         Decoction of cinchona with tincture of iodine.
                R.   Decoct, cinchon. f  £x.
                    Tinct. iodin. g" xc. M.
  Dose.—Two spoonfuls, three times a day.  In scrofulous ulcers.
                                                       Rey.
          ' Ellis's Medical Formulary, 8th edit. p. 113.  Philad. 1846. 
Henry,
                           IODINUM.                       489

                       Mistura  iodini.

                      Mixture of iodine.
                R.  Iodin. gr. v.
                   Alcohol, f 31J.
          Solve et adde
                   Aq. cinnam. f  ^iiss.
                   Syrup, simpl. f §iss.   M.
  To be taken in twenty-four hours, in  dram doses.

                      Syrupus  iodini.

                       Syrup of iodine.
                R.  Tinctur. iodin. gr. vj.
                   Syrup, simpl.  f ^ij.  M.

                  Liquor iodini,   (Lugol's.)

                      Solution of iodine.
                      (1.  For internal use.)
                     French.  Boisson iodee.
                              A.      B.       C.
            R.   Iodin.        gr.  i.    gr. ■§.    gr. j.
                Sodii  chlorid.  gr.  xij.  gr. xij.   gr.  xij.
                Aquae destill.  Oj.      Oj.      Oj.
                                              Solve.
                      (2. For external use.)
                              A.      B.      C.
            R.   Iodin.        gr. ij.   gr. iij.    gr.  iv.
                Aq. destillat.  Oj.    Oj.      Oj.
                                              Solve.
  Lugol  gives  formulae for the solution of the  three  different
strengths above.
                         Lotio  iodini.

                       Lotion of iodine.
                R. Tinct. iodin. f gss.
                   Ferri iodid. gr. xij.
                   Antim. chlorid. gss.   M.
  Used for corns.  To be applied by means of a camel's hair pen-
cil, after the corns have been well pared.   James Henderson.

                R. Iodin. 3j.
                   Potass, iodid.  ^ij.
                   Aq. destillat.
                   Alcohol, aa. gij.  M.

   As a  local application in congestion  and ulceration of the os
uteri.                                              Churchill.
                     Gargarisma  iodini.

                       Gargle of iodine.
                R. Tinct. iodin. f 3J.—gij.
                    ----opii f ^i.
                   Aquas f |vj.   M.
   To be used three or four times a day.            J. J. Ross. 
490
IODINUM.
                    Unguentum iodini.
                     Ointment of iodine.
 Unguentum Iodatum.—French, Pommade d'lode.—German, Iodsalbe.
               R.  Iodin. gr, iij,
                   Adipis ^ij.   M.
   The Unguentum Iodini of  the Pharmacopoeia of the United
States, (1842,) is made as follows:—
               R.  Iodini gr. xx.
                   Alcohol. v\ xx,
                   Adipis gj.
   Rub the iodine first with the alcohol, and then with the lard,
until they are thoroughly mixed.
                    Linimentum  iodini.
         *
                     Liniment of iodine.
               R.  Linim. sapon. f ^j.
                   Tinct. iodin. f gj.  M.
                                                 Manson.
                   Cataplasma iodini.
                    Cataplasm of iodine.
               R.  Tinct. iodin. f gss.
                   Lin. pulv. gj.
                   Avenae farin. ^iij.
                   Aquae destillat. q. s. ut fiat cataplasma.
   Used as a cataplasm in scrofulous tumours, and goitre.

   Iodide  of  Ammonium, Io'didum seu Iodure'turn Ammo'nii,
Ammonium Iodatum seu Hydroiodicum, Hydriodas Ammonia,
Hydriodate of Ammonia,  Ioduret  of Ammonium;  German,
Iodammonium—is  formed by saturating liquid  hydriodic
acid with  caustic ammonia  and evaporating  the  solution.  It
crystallizes with difficulty, and is deliquescent.   It was introduced
into medical practice by M. Biett, of Paris, as a valuable thera-
peutical agent in certain diseases of the skin.   Several successful
cases of its employment in lepra and psoriasis, by M. Biett,  are
given by Dr. Pennock,1 accompanied  by interesting remarks  by
the latter.  It is administered in the form of ointment,—from a
scruple to a dram of the iodide being added to an ounce of lard—
the weaker ointment being used in milder or more acute, and  the
latter in more inveterate cases.  The ointment should  be freshly
prepared, or kept excluded from the air, as it is readily decomposed.

   Iodide  of  Starch, Io'didum  seu Iodure'turn Am'yli, Amy-
lum Iodatum.; French, Iodure d'Amidon; German,  Iodstdrk-
mehl,  Iodstdrke,  Starkmehl-oder-Satzmehlio-

           1 Amer. Journ. of the Med. Sciences. Feb. 1835, p. 374. 
I0DlNt)M.
491
diir, has been extolled  by Dr. Andrew Buchanan,1 of Glasgow.
It is prepared of iodine,  gr. xxiv.; starch,  in  fine powder,  ^j.
The iodine is  first triturated with a  little water, and  the starch is
gradually added, the trituration being continued till the compound
assumes a uniform blue colour.   The iodide  is then dried with a
heat so gentle as not to  drive off the iodine, and it must be after-
wards kept in a well stopped bottle.
   Iodine, in the usual forms of exhibition, is  not in general given
in larger doses than four or six grains daily, whilst, in the above
formula, Dr.  Buchanan  has given as much as seventy-two grains
daily.  Professor Forget,  of Strasburg, has published the case of
a youth, seventeen years of age, who took, in  48 days, 139 ounces,
 or nearly nine pounds, of  this iodide, containing 3336  grains, or
 nearly six ounces^ of iodine,—being nearly sixteen grains a day.12
 Pauli3 thought it inert; but it is proper to state, that Dr. Laurie,
 of Glasgow,4 was of opinion, that it proved fatal in  a case, in which
 not more of the iodide than corresponded to a grain of iodine,  had
 been given twice  a day  for five days.  It has been proposed by M.
 Burguet5 to cover the abdomen in a case of  ascites with  a thick
 layer of iodide of starch, made of about 9j. of iodine', to twelve
 ounces of starch.   He found the iodine absorbed, and the dropsical
 effusion disappear.
    Iodic  Acid,  Ac"idum  lod'icum;  French,  Acide  Iodique;
 German, Iodsdure.  This is obtained by boiling iodine  with
 nitric acid;  or by decomposing iodate of baryta by dilute  sul-
 phuric acid.  It is a white, transparent solid,  slightly deliquescent,
 and very soluble in  water.   It was proposed in medicine by  Mr.
 Monks,6 of Norwood, England, who gives it in combination with
 sulphate of quinia, rendered soluble by sulphuric acid, as  a  tonic,
 excitant  and eutrophic in hoarseness consequent on catarrh, in
 scrofula, incipient phthisis, chronic inflammation, syphilis, &c.
 Unlike iodide of  potassium, it  can  be given  in combination with
 sulphuric or nitric acid  without  suffering decomposition.
    The close for children, from seven to fourteen  years of age, is
 three  grains; for adults, from three to six grains, or more.   Its
 general effects on the system are those of iodine.7
    Iodide  of Chloride   of  Mercury,  Iod'idum Hydrar'gyri
 Chlo'ridi,  Hydrargyrum  iodatum cum Chlorido  Mercurii;
 French,  Iodhydrargyrite  de  Chlorure  Mercureux;  German,
   ' Lond. Med. Gaz. July 2,1836; see, also, Soubeiran, in Revue Medicale, Aout, 1837.
   ' Gaze'te des Hopitaux, 19  Fev., 1839.
   3 Aschenbrenner, Die neueren Arzneimittel, u. s. w, S. 22, Erlangen, 1848.
   * Lond. Med, Gazette, July 3, 1840, p. 590.
   ' Journal de Med. et de Chirurgie Pratiques, cited in Annuaire de Therapeutique
 pour 1848, p. 194.
   6 Medical Times. Oct 3, 1846.
   1 Pereira, The Elements of Materia Medica and Therapeutics,  3d edit. i. 398.
 Lond. 1849. 
492
IODINUM.
Iod-Chlor-Quecksilber.   This  preparation, discovered
by M. Boutigny,1 is made by the reaction of iodine on mild chlo-
ride of mercury, (calomel.)  Two iodides may be prepared in this
manner—the iodide and the biniodide.  The iodide is prepared of
one equivalent of  iodine, and one of chloride of mercury.  The
calomel is coarsely  powdered, put into a matrass, (matras d'es-
sayeur,) heating  gently, and agitating it, until it  begins  to sub-
lime: the iodine is then added in small portions.
   The  combination is effected  with noise,  without any  sensible
loss of iodine.
   The biniodide is prepared of  one equivalent of iodine, and one
of the mild chloride of mercury.   It may be run in cylinders
like nitrate of silver.
   The effects of  both these preparations  are those of violent irri-
tants.  The biniodide especially is a most  powerful caustic.  They
are said2  to have  been used as secret remedies, in France, in ob-
stinate scrofulous affections of the glands.   The iodide has been
given internally in the same cases:  the  biniodide has only been
used  externally, like nitrate of silver, in scrofulous and certain
syphilitic  ulcerations.  M. Rochard3 employs the iodine,  in scro-
fula, in the form  of ointment—one part of the salt to twenty of
lard,  varying  the proportion according to the sensibility of the in-
dividual.   Of this ointment  he  uses  a piece, of the size of a pea,
which he  applies lightly, and arrests it, if too great pain and irri-
tation /supervene.   In this way he has found  nutrition  modified
locally and generally.  He  rubs it on the tumefaction, applies it
lightly to ulcers, or rubs it  in the axilke, the inner  part of the
thigh, or  on the back or chest.
           Pilulae  Iodidi Hydrargyri  Chloridi.
            Pills  of Iodide  of Chloride of  Mercury.
                R.  Iodid. hydrarg. chlorid. gr. v.
                    Acacias pulv. gr. xvj.
                    Micse panis ^ij.
                    Aq. flor. aurant. q. s. ut fiant pil. 100.
                                                  Boutigny.
        Unguentum iodidi  hydrargyri chloridi.
           Ointment of iodide of chloride of mercury.
                  (Unguentum contra Scrophulosin.)
                R.  Iodid. hydrarg.  chlorid. gr. xv.
                    Adipis |ij.
                                                   Boutigny.
   The other preparations of iodine are described in different parts
of this volume.
  1 Bouchardat, Annuaire de Therapeutique, pour 1848, p. 186.
  * Aschenbrenner, Die neueren  Arzneimittel und Arzneibereitungsformen, S.  150.
Erlangen, 1850.
  * Bouchardat, op. cit. p. 188. 
JUGLANS EEGIA.
493
                  CXIII. JUGLANS  RE'GIA.
Synonymes.  Walnut Tree.
French.  Noyer.
German.  Wallnussbaum,  Baumnuss, Konigswallnuss,
  Nussbaum, Walschenuss.
   The walnut tree, Sexual System, Moncecia Polyandria: Na-
tural Order, Terebinthacese or Juglandese, is a native of Persia,
whence it was carried to Greeee, Italy, France, &c.
                  EFFECTS ON THE ECONOMY.
   The leaves of the walnut have been highly extolled by M. Ne-
grier1 as superior to  all other antiscrofulous remedies.  He pre-
scribed them to 56 patients affected with  different forms of scro-
fula. Of these,  31 were  unequivocally cured, 18 experienced a
very manifest improvement, and the majority  were in course of
cure.  Four derived  no benefit  as regarded their  sores.   Four
children  died  during the treatment,—two of tubercular phthisis;
one of acute  encephalitis,  and the fourth of double pneumonia.
The  extract of the leaves, which may be ranked  in the class of
slightly aromatic  bitters, M. Negrier found to be almost constantly
efficacious in scrofulous affections, and in no case did he observe
it exert any unpleasant  action  on the economy.
   The preparations of walnut leaves excite, in the first instance,
digestion and circulation, and,  according to M. Negrier, communi-
cate remarkable energy  to all the functions; and he is disposed to
think that  they have a  special action on the  lymphatic system.
In his last essay,2 he arrives at  the following corollaries.   First.
Scrofulous affections are, in  general, radically cured by the pre-
parations of the  leaves of the walnut.   Secondly.  Their  action
on the economy is sufficiently constant to enable us to reckon upon
the cure  of the majority of patients treated by them.   Thirdly.
Their action  is slow, unobjectionable  and  durable.   Fourthly.
The first effects of the treatment on the economy are general; its
local  influence comes afterwards.  Fifthly. Scrofulous  affec-
tions of the skin, mucous 'membranes, lymphatics and  lym-
phatic ganglions are cured as easily, promptly and certainly as
by any other known agent.   Sixthly.   Affections of the osseous,
cartilaginous, and ligamentous  systems, whose essence is a
scrofulous vice, are at  times radically cured by the preparations
of the leaves of the walnut  alone.   Lymphatic subjects  always ex-
perience good  effects from them ; the profound modifications which
they experience often cause the  cure  of caries of the bones and

  ' Archiv. General, de Medecine, Avril et  Mai, 1841, Fevr. 1844; Fcvr. 1850, p. 173,
and Avril, 18">0, p. 447. The last two memoirs have been given at length in the Edinb.
Med. and Surg. Journ. for October  1850, p. 271 to 318.
  2 Archives &c. Avril, 1850,  p. 466.
      32 
494
JUGLANS REGIA.
their appendages.  The same affections of the bones in dry ner-
vous subjects are not sensibly modified  by the treatment.   Liver
oil is then preferable,  associated with infusions of the leaves  or
fruit of the walnut, (the green shell,) and seventhly,  scrofu-
lous inflammations of the eyes are certainly and speedily cured
by a treatment, the basis of which is the preparations of the leaves
of the walnut.
  Favourable reports of the action of the walnut leaves in scrofula
are quoted by M. Negrier from Nasse, of Bonn, M. J. Kreutzwald,
and  Borgiali.   They have likewise  been given  successfully by
Mirault, Jurine and Hauser in the same affection; and have been re-
commended in helminthiasis, otorrhcea, fluor albus, scrophulo-
sis;  chronic bronchitis; cutaneous diseases, as impetigo, tinea
capitis, herpes, and chronic eczema, by Kreutzwald, Nasse and
Hauser;  and  in the  after treatment (Nachbehandlung)  of
cachectic conditions,—scrofula, gout,  syphilis, mercurial cachexia,
&C.1
                MODE OF ADMINISTRATION.
  The preparations used by M. Negrier are the following:—

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

                Decoctnm juglandis regise.
                Decoction of walnut leaves.
   The decoction  may  be made by boiling, for ten or fifteen mi-
nutes, a small manipulus (poignSe) of  the leaves in Oijss. (un
kilogramme) of water.  It is advantageously used  as a lotion;
and  as a dressing  to scrofulous ulcers,—lint being wetted with
it and applied to them.  It has, also, been used as a  partial and
general bath; and as an injection into fistulous openings.

               Extractum juglandis regime.
                 Extract of walnut leaves.
   This extract is prepared by the method of displacement.

                Syrupus juglandis rcgiae.
                  Syrup of walnut leaves.
  The syrup is prepared from  the extract by mixing six grains
with an ounce of simple syrup.  A  syrup may, also, be made of
the green leaves, which is more aromatic than  that formed from

  1 Aschenbrenner, Die neueren Arzneimittel, u. s. w. S. 159.  Erlangen, 1848. 
JUGLANS REGIA.
495
the extract.  To little children M. Negrier gives two or three
dessert-spoonfuls  in the 24 hours; to adults he has never given
more than two ounces.  The ordinary dose for  the last is from
eight to ten drams.
             Pilula;  extracti juglandis regise.
              Pills of extract of walnut leaves.
   Each of these may be made of three grains of the extract ren-
dered solid by a sufficient  quantity of the powder of the leaves.
Two are given by M. Negrier in the day.   He has  never exceeded
four.
   Where it  has  been  necessary to have  recourse  to frictions  on
the diseased part, he has employed the following ointment:
          Unguentum extracti juglandis regise.
             Ointment of  extract of walnut leaves.
            R.  Extract, juglandis regiee 5L
                Adipis gx.
                01. bergamot. rr^ iij.
   The friction must be gentle, and for about a quarter of an hour,
twice a day.
                  Vinnm  juglandis regise.
                    Wine  of walnut leaves.
   M. Negrier directs  this to be prepared  by macerating from  an
ounce and a half to two ounces of the fresh leaves, or ten to twelve
walnuts covered writh their drupes, cut in fragments, in a quart of
Malaga or Lunel wine.  In winter, it may be prepared of from
half an ounce to five  drams of the extract to the  quart of wine.
   The dose is a spoonful or more, after eating, night and morning.
   M. Negrier properly remarks, that in  all such deeply  rooted
affections, it may be necessary to persevere in the remedy for some
time; as not only have the effects of  the disease to be  combated,
but a profound modification to be induced in  the  constitution of
the individual.1
   Injections of a very  concentrated decoction of walnut leaves, of
the temperature of the room, whatever may be  the season, have
been used with much success in leucorrhoea by M. Vidal.2

  1 Archiv. General, de Medecin,Mai, 1841.
  2 Essai sur un Traitement  Methodique de quelques Maladies  de la Matrice, &c
Paris, 1840; noticed in Brit, and For. Med. Rev. for July, 1841, p. 215. 
498
LACTUCARIUM.
                   CXIV.  LACTUCARIUM.
Synonymes.  Lettuce opium, Thridace.
German. Lattigopium, Lattigmilchsaft,  Lattigbitter.
   The ancient Greek and Roman physicians were well aware of
the hypnotic property of the common garden  lettuce (lactuca sa-
liva,) the milky juice of which contains lactucarium.  It would
appear, however, that Dr. J. R.  Coxe, of Philadelphia, was  the
first to propose the use of the inspissated juice in medicine.1  Dr.
Duncan, Senr., of Edinburgh, subsequently paid particular atten-
tion to the subject, and  recommended it  as a  remedy in phthisis,
in place of opium.2   The properties of the juice have also been in-
vestigated by M. Francois,3 a French physician.

                   METHOD OF  PREPARING.
   There  are three kinds of lactucarium.   The first and best, but
the most  costly, is  obtained from incisions made into the stalks,
whence the juice exudes, which is  subsequently dried in the air.
This preparation has  a bitter taste, soon becomes of a brown colour,
and solid; has a gummy fracture, but absorbs moisture from  the
air,  becoming soft and clammy.  The second variety is obtained
by expression of the  selected stalks, and subsequent desiccation of
the obtained fluid, either in the air or by artificial warmth.   This
is said to  be the variety  most commonly met  with  in  commerce;4
and the third variety is  prepared in the same manner as any com-
mon extract, from all parts of the plant.  This is  the Thridace
of some.  It is unworthy  of confidence.
  The first is the strongest and most uniform, and  therefore to be
preferred.
   Chemical examination shows that lactucarium contains neither
morphia nor narcotina, as  had been  supposed.  It  has been exa-
mined by  M. Aubergier,5 who found it to have the  following com-
position:—Bitter crystallizable matter; mannite; asparamide; free
acid; brown colouring matter; resin; cerin; myricin; albumen, and
gum; nitrate of potassa; chloride of potassium ; and phosphates of
lime and  magnesia.   M. Aubergier regards the crystalline matter
as  the active principle of the  lactucarium.6   M. Quevenne7 also
analyzed  it,  and found it  to  contain a bitter principle, soluble in
water and in  alcohol, insoluble in ether, and not  precipitable by

  1 Wood and Bache's Dispensatory, 6th edit. p. 424. Philad. 1845.
  s Observations on Consumption, 2d edit.  Edinb. 1816.
  8 Archiv. General, de Medecine, 1825.  Journal Univer. xl. 254, and xli. 147.  See
also, Fischer, in Rust's Magazin. B. liii. Heft. 1.
  4  Riecke,  Die neuern Arzneimittel, S. 313; und 2te Auflage, S. 473.  Stuttgart, 1840.
See, also, Merat and De Lens, Diet, de Mat. Med. art Lactuca Sativa.
  6 Joum. de Pharm. Jan.  1^42, p. 78.
  8 Bouchardat, Annuaire de Therapeutique pour 1843, p. 14. Paris, 1843.
  ' A. Richard, Elements d'Histoire Naturelle Medicale, 4eme edit, iij, 94, Paris, 1849. 
LACTUCARIUM.
497
the salts of lead; albumen; caoutchouc; wax;  a vegetable acid,
(lactucic;) chloride of calcium; phosphate of lime;  potassa; gum
and acetic acid.
                 EFFECTS ON THE ECONOMY.
   To investigate these, Rothamel1 instituted experiments with the
Paris lactucarium.   Half a grain to a grain produced little or no
effect.  From three to five grains occasioned a peculiar indescriba-
ble feeling of lightness over the whole body, without any narcotic
symptoms or modification in the pulse: from six to eight grains in-
creased this sensation, and  caused  dilatation of the  pupils.  The
same doses, repeated at intervals of three  or four hours through
the day, diminished the number of pulsations of the heart, and the
sleep was disturbed.   From ten to fifteen grains  caused more in-
disposition, nausea, oppression  at  the  epigastrium, cold sweats,
anxious respiration,  cold  sensation in  the chest, great dulness,
vertigo, considerable dilatation of the pupils, yawning and stretch-
ing, slow  pulse, disturbed sleep, general prostration;  the tongue
coated with  mucus; disagreeable taste;  loss of appetite; pains in
the shoulders and bones, and uncertain  gait; all  which symptoms
were speedily removed by a few drops of acetic ether, or a glass of
Rhenish wine.   Coffee was much  less efficacious.
   Lactucarium has been extolled by numerous physicians as equally
effective with opium, whilst it is  not—they assert—followed  by
the signs of narcosis  and other inconveniences,  so  often induced
by the latter.  Accordingly, it is  frequently given  where  a pure
sedative is needed—to allay cough', and where much nervous ex-
citement is present.  It has also been used  topically, in the form
given  below, by Rau,a of Berlin, in catarrhal ophthalmia, and a
solution, in the proportion of four grains to the ounce, has been
advised in acute inflammation of the  conjunctiva, by Guibert.3
   The results of the author's experience  with lactucarium have
been negative.   He is unable to affirm, that it is possessed  of any
marked sedative and hypnotic  powers ;* and such would seem to
have been the general results of extensive trials  made  with it by
others.5
                  MODE OF ADMINISTRATION.
   Lactucarium is given internally, either in the  form  of solution
or pill, in the dose of from one-third of a grain to three grains.
Externally, it has been applied in  plaster or ointment.

  1 Ferussac's Bulletin des Sciences Medicales, xxii. Paris, 1830.
  * Berliner. Medicin. Central-zeitung, Nov. 2, 1838.
  * Froriep's Notizen, Bd. xxi. S. 320, and Osann, art Lactuca,  Encyclop'ad. Worterb.
der Medicinischen Wissenschaften, xx. 697.   Berlin, 1839.
  • General Therapeutics and Mat. Med. 4th edit. i. 376, Philad. 1850.
  1 Bouchardat, op. cit p. 26, and M. Homolle, in Bouchardat's Annuaire, &c, pour
1845, p. 27.  Paris, 1845. 
498
MAGNES.
                    Mistura  lactucarii.
                  Mixture of lactucarium.
             R.  Lactucar. 9j.
                 Mucilag. acac. q. s. ad subactionem.
             Perfecte unitis adfunde
                 Aq. f gvj.
                 Syrup, rub. idsei f gss.  M.
  Dose.—Two spoonfuls, every two hours, in spasmodic cough,
sleeplessness and hysteria.               Von Hildenbrand.
             R.  Acid, boracic. gij.
                  Lactucarii Qj.
          Solve in
                  Aq. destillat.  f gvj.
                  Syrup, papav. f gss.  M.
  Dose.—A small spoonful—in cases of "spastic haemoptysis."
                                                Rothamel.
                    Collyrium lactucarii.
                   Eyewash of lactucarium.
              R.  Lactucar. gr. iij.
                  Aq. destillat. f ^iij.
                  Mucilag. cydon. gtt. xx.  M.
                                                       Rau.
  M. Aubergier1  considers  the alcoholic extract to be the best
form  of preparation.  The  lactucarium  is twice successively  di-
gested in alcohol of  .922:  the fluids are then mixed, distilled, and
evaporated in a  water bath.    During evaporation the fluid must
be constantly stirred.  The extract, thus procured, is of a brown
colour, and  very bitter.  It  may be given in pills, or in the form
of syrup.  For  the  latter—syrupus lactucarii—M. Aubergier
recommends that every 501 parts should contain one of the extract.
He gives it  either alone or in association in  the quantity of from
f giss. to f §ij. in the twenty-four hours, in cases of  bronchitis or
phthisis.
                       CXV.  MAGNES.
Synonymes,  Magnetes, Magnet,
French.  Aimant, Pierre d'Aimant.
German.  Magnet,  Magnetstein.
   The  natural  magnet was employed of old both externally and
internally, and in the most diversified forms and affections.2  The
artificial' magnet has been used within the last century only.  It
is  generally on  the diseased part, or around it, that it is applied,
and the application is made for a longer or shorter time according
to circumstances—being  at times drawn along the nerves of the
affected part; at others applied in a more prolonged manner.

  * Bouchardat, Annuaire, &c, pour 1845.
 2 Art Aimant, in Diet. Univers, de Matiere Medicale, par Merat & De Lens. 
MAGNES.
499
   It has  been  affirmed,1 that  magnets of 10 pounds supporting
 power, when drawn along the body downwards, without  contact,
 produce certain sensations in a certain, or rather uncertain, propor-
 tion of human beings.  Occasionally, in  twenty persons  three or
 four sensitive individuals are found;  and in one case out of twenty-
 two females, examined by Von Reichenbach, eighteen were sensi-
 tive.  The sensation is said  to be rather unpleasant than agreeable,
 and is like an aura, in some cases warm, in others  cool; or it may
 be a  pricking, or a sensation  of the creeping of insects on the
 skin;  and at times headach  rapidly supervenes.  These  effects,
 it is said, occur when the patient does not  see the magnet or know
 what is being done.  They  ensue both in  males  and  females, but
 more frequently in the latter: they are sometimes  seen in strong
 healthy people, but oftener in those whose health,  although good,
 is  not so vigorous, and  in nervous  persons.  Children are often
 found to be  sensitive.   Persons  affected with spasmodic diseases—
 epilepsy, catalepsy, chorea, paralysis and hysteria are especially
 sensitive, a^d lunatics and somnambulists, he says, are uniformly so.2
   It is, then, on the nervous system that the magnet exerts its effi-
 cacy.   Accordingly, the  class  of diseases in which  it has been
 found most beneficial are those termed "nervous and spasmodic."
 This is strikingly shown by the published observations of MM.
 Andry and Thouret,3 Commissioner of the Societe Royale de Me-
 decine, appointed to examine into the matter.   In cases of spasms,
palpitations, convulsions, epilepsy, tremors,  cramps, neuralgia,
 rheumatism, &c, the only agent employed was the magnet, and it
 was wholly  successful.  These gentlemen  were disposed  to infer,
 that the magnet exerts  an incontestable  magnetic action on the
 nervous system, to which, in part at least, the curative  agency
 must be ascribed, and their conclusions were thought  to be corro-
 borated  by cases observed  by MM. Alibert, Cayol, Chomel, Re-
 camier, &c.   The celebrated Laennec,4 who employed the magnet
in the manner recommended  by Halle,—that  is,  by establishing a
magnetic current through  the diseased parts by  means of several
magnetized  plates, affirms,  that  he frequently found  it moderate
the pain in pulmonary neuralgia, diminish the  oppression in ner-
vous asthma, suspend spasmodic hiccough, and exhibit its utility
in simple neuralgia of the heart, and in angina pectoris.   In the

  1 Abstract of Researches on Magnetism and certain allied Subjects, &c, by Baron
Von Reichenbach; translated by W. Gregory: or notice of the same in the Bulletin of
Med. Science.   Philad. July, 1846, p. 217.
  2 See on all this curious subject, Baron Charles Von Reichenbach, Physico-physiologi-
cal Researches on the Dynamics of Magnetism, Electricity, Heat, Light, Crystallization,
and Chemism in their  relation  to Vital Force,—translated, &c. by John Ashburner'
M.D.  London, 1851. ^
  3 Mem. de la  Societe  Royale de Medecine de Paris, pour 1776, p. 531, and Thouret,
art. Aimant, in Encycloped. Method.  Partie Medicale, i. 421.  Paris, 178G; also Du-
mont, in Bouchardat, Annuaire de Therapeutique pour 1843, p. 79. Paris,  1843.
  ' Traite de l'Auscultation Mediate, 2de 6dit. torn. ii. 
500
MAGNES.
last  disease, the application of a  small  blister under the anterior
plate appeared to render the effects of the magnet more marked.
  It is not many years since considerable interest was excited in
London, by the success said to have been obtained in the treatment
of neuralgia, toothach, and other affections of the nerves, by
the  application of the ordinary magnet or  " mineral magnet,"
as it was termed by Dr. Blundell who  employed  it.1  It would
seem, too,  that owing to a considerable demand  for loadstone, the
conductors of the Bulletino delle  Scienze Mediche,2 of Bologna,
were led  to  make  inquiries  concerning the uses to which it was
put.   From these it appeared, that the Ex-Bey of Algiers, whilst
at Leghorn, in 1831, mentioned to a Catholic  dignitary, Father
Campagnoli, who was suffering under gout, that the application
of the loadstone was an oriental remedy for the disease, and of cer-
tain  efficacy.   He  immediately procured a  piece of loadstone, as
he had  been subject to regular and frequent attacks of gout since
1805, and  its, application removed the next paroxysm.  Since this
time, he has  always had recourse to the  same remedy, and has
found, that the attacks come on less  frequently and severely, and
that they  invariably yield, so that he has  rejected all his former
plans of treatment.   On the first symptom he goes to bed, and
places the  loadstone in close contact with the pained part; he pre-
sently falls asleep, and awakes free from  pain, and able to walk.
The loadstone, which he uses, weighs five pounds, and has smooth
sides.   He has recommended this plan to other  gouty individuals,
who have experienced similar relief.
   The  author has witnessed the application of the mineral mag-
net repeatedly in nervous diseases,  in  persons of highly impres-
sible habits; but except in such, and apart from the effects of the
imagination, he has seen no beneficial results from it.
   It  has  been affirmed,3 that in the  workshops of Fairbairne in
Belgium,  an artificial magnet was put up  some years ago at the
level of the eye; and at. every instant a turner, or an adjuster, or
some other workman, who has had a particle of iron driven into
his eye, is seen running to the magnet, which draws it out as soon
as the eyelids are separated,  and the eye is  held near its pole.

   For Electricity, see Galvanismus ; and for Magnetic Elec-
tricity, see Electro-Magnetismus.

  1 See Lancet for 1833, cited  in Amer. Journ. of the  Med. Sciences, Nov. 1833, p.
247.
  2 Marzo et Aprile, 1835; cited in Brit, and For. Medical Review, July, 1836, p. 246.
  * Gazette des Hopitaux, 14 Juin, 1842; cited in Brit, and For. Med. Rev., Oct 1842,
p. 557. 
MAGNESIiE CITRAS.
501
                CXVI.  MAGNESIiE CITRAS.
 Synonymes.  Citrate of Magnesia.
 French.  Citrate de Magnesie.
 German.  Citronensaures  Magnesia oder Bittererde.

   This preparation has  been introduced as an agreeable cathartic,
 by M. Roge Delabarre.1
                   METHOD OF PREPARING.
   Citrate of magnesia may be prepared  by  saturating a solution
 of citric acid with either  magnesia or carbonate  of magnesia.
 Dr. Pereira2 finds  that 9j. of  the  crystallized acid of  commerce
 saturates about fourteen grains of  either light or heavy carbonate
 of magnesia.   Another mode of  preparing it  is  by double decom-
 position from sulphate of magnesia and citrate of soda.
   Neutral citrate of magnesia is  a  white, pulverulent, insipid salt,
 and when aided by the  addition  of a slight  excess of the acid, is
 soluble in water.   The solution has an acid taste, and has not the
 disagreeable bitter taste  of the magnesian  salts.  It is a mild lax-
 ative, in the dose of from an ounce to ten drams.
   It is, however, in solution, and in the effervescing state,  that it
 is best known and preferred.   Four drams of citric acid, and three
 and  a  half drams  of carbonate of  magnesia,  dissolved  in  a suffi-
 ciency of water, yield rather more  than an ounce of solid citrate
 of magnesia.
   Dr. Pereira gives the following  formulae for,  first, the  simple
 solution, acidulated with citric acid and flavoured with syrup of
 orange peel, called magnesian lemonade; and, secondly, the effer-
 vescing solution, called effervescing magnesian lemonade.

               1. liquor magnesise  citratis.
               Solution of citrate of magnesia.
                  R.  Acid citric, gss.
                      Magnes. carb. 9j.
                      Syrup, aurant. ^ij.
                      Aq. destillat.  §ij.  M.

       8.  Liquor  magnesise citratis  effervescens.
         Effervescing solution of citrate of magnesia.
                  R.  Acid citric, gss.
                      Aquas destillat. %].
                      Syrup, aurant. gij.  M.
   To be taken with f 3x. of Dinneford's solution of bicarbonate of
magnesia in a state of effervescence.
   Various modes  of preparing  the  effervescing solution  of the

  * Journal de Pharmacie, Juin, 1847, Bouchardat, Annuaire de Therap. pour 1848,
p. 118; and Amer. Journ. of Pharmacy, August, 1847, p. 218.
  1 Elements of Materia Medica  and Therapeutics, 2d edit. i. 619.  Lond. 1849. 
502
MAGNESIiE CITRAS.
citrate have been  proposed  by MM. Roge  Delabarre,  Bardet,
Massignon, Garot,  Marchand,  Duclou,  Dorvault, V. Gamier,
Maury, Cadet Gassecourt, and others.1   Mr. Edward Parrish,2
of Philadelphia,  prepares it  by forming a slightly acid citrate "of
magnesia—about an ounce and a  half of the  salt to a pint of
water—which is introduced into ordinary Saratoga water bottles,
containing the requisite quantity of lemon syrup, until nearly full,
and  the remaining  space is filled with moist, recently prepared,
carbonate  of magnesia, immediately after which  the  bottles are
well  corked.   On  mixing the  contents of the  bottle,  the carbo-
nate of magnesia is  decomposed by  the free citric acid in the solu-
tion, and the evolved carbonic acid is retained  by the  close cork,
and absorbed by the liquid.
   The formula of M. Rabourdin3 has been  recommended.  It is
as follows: —
                R.   Magnes. carbon, gr. 292.
                     Acid citric, crystallizat. gr. 446.
                     Aquae f gx.
                     Syrup, limon. f ^ij.
   Dissolve 138 grains of the  carbonate in two fluidounces of
water holding in solution 170 grains of  citric acid, and pour it
into  a twelve ounce mineral-water  bottle.   The remaining 154
grains are then triturated with  the  remainder of the water, and
also poured into the bottle.   185  grains  of citric acid are now
added, and the bottle is immediately and strongly corked and tied
over.   The citric acid  reacts with a portion  of  the carbonate, and
forms citrate of  magnesia, whilst  the other  portion is converted
into bicarbonate of magnesia by the liberated and compressed car-
bonic acid.   As soon  as, with  occasional  agitation,  the  opake
fluid  becomes but  slightly milky, the cork  is  carefully removed,
and the solution filtered and  reintroduced into the bottle, along
 with  two fluidounces of lemon syrup and 91 grains of citric acid.
The cork  is then securely replaced and wired.
   These quantities  produce twelve fluidounces of the solution, each
 ounce containing about a dram of the citrate.  If the carbonate of
 magnesia  and citric acid are free  from  impurities,  there  is no
necessity  to filter after  the second addition of acid, as the solution
 becomes clear a few hours after the last portion of acid has been
 added.
   The dose is from a  half to a whole bottle.   It is certainly an
 agreeable laxative, and is much employed.

   1 Bouchardat, Annuaire de  Therap. pour 1848, p. 118, 123, and Ibid, pour 1849,
 p. 188, 189, 192, 193 and 194.
   2 Amer. Journal of Pharmacy, Nov. 1847, p. 264.   ' Ibid. July, 1848, p.  2o4. 
MANNITA.
503
                     CXVII. MANNITA.
Synonymes.   Mannitum, Saccharum Mannas, Mannite, Sugar of Manna.
German.  Mannit, Mannazucker, Mannastoff.
   This principle, which was first discovered by Proust, belongs to
the varieties of sugar that are not susceptible of fermentation, and
constitutes the chief ingredient of manna.   Its presence is not con-
fined, however, to that substance.   It is met with in several other
vegetable juices—cucumbers, melons, celery, beets, &c.   Yet in
these it is first found after fermentation, so that chemists have been
disposed to  regard it as a product of fermentation.1

                   METHOD OF PREPARING.
   Mannite is commonly procured from manna.   Manna in lachry-
mis, as  it is obtained in commerce, is treated with boiling alco-
hol, filtered, and suffered to crystallize: by rest and refrigeration,
mannite  is  precipitated in small, beautiful, white  needles.   The
manna in tears consists almost wholly of Mannite.  Common manna,
on the other hand, contains but  little thereof, and in its place has
a  yellow extractive matter to  which  cathartic properties have
been assigned: coarse manna consists almost wholly of the latter.
To obtain mannite, consequently, the manna in tears is selected.
   Should the administration of mannite as a remedial agent become
more common, it  may be worth the trouble to inquire, whether it
might not be advantageous to prepare it from  the vegetable juices
above mentioned.                     • m-
   Mannite,  prepared  in  the above manner, is of a white colour;
soluble in five parts of cold  water, and in almost every proportion
in  boiling water;  it seems to be entirely insoluble in cold absolute
alcohol; is somewhat more so in boiling alcohol, and still more so
in boiling alcohol which contains water.  At from 221° to 230°
Fahrenheit, it melts into a  colourless, adhesive  fluid, and crystal-
lizes on cooling.  When more  strongly heated, it burns, and is
decomposed like sugar.   From  its  alcoholic solutions  it  separates
on cooling,  in white, silky, shining, needle-shaped crystals,  col-
lected  in stelliform roundish masses.   When mannite  is dissolved
in an equal weight of boiling water, and the fluid is evaporated by
a strong fire and  rapid  ebullition, until a small  portion placed on
a cold glass plate rapidly becomes solid, it may be poured out  into
shapes.
   The taste of the sugar of manna is feeble, but agreeably sweet:
it  is inodorous, or at least  nearly so.  According to Liebig, man-
nite consists of 40.0228 of carbon, 7.6234 of hydrogen, and 52.3537
of oxygen.
   Granatin or Grenadin of pomegranate root agrees so much with

          1 Art Mannite, in Merat and De Lens, Diet, de Mat. Med. 
504
MANNITA.
mannite in its properties that both have been regarded as the same
substance.
                 EFFECTS ON THE ECONOMY.
  According to Magendie,1 mannite may be advantageously sub-
stituted for manna, as  it possesses the cathartic property without
the nauseous flavour.   The dose is two drams for a child, and,
at times, as much as half an ounce; but, in the latter dose, Magen-
die always found the catharsis  too active: for  this reason he con-
siders it to be the best dose for the adult.  He recommends, that
a syrup should be prepared from it, and that this should be pre-
scribed both  as a cathartic for children  at the breast, and as  an ad-
dition to other articles in cases of pulmonary catarrh.   M. Solon
has likewise  spoken favourably of the  therapeutical advantages of
mannite.  He administered it in three  cases of gastricism—in two
of them combined with castor oil—in which it induced, in a few
hours, critical evacuations;  and in a case of peritonitis occasioned
by obstinate constipation its use was followed  by the best effects.
In the last case, the inflammation completely disappeared, and the
constipation  yielded without any other agency.   It  was  found,
likewise, of essential service in convalescence from bronchitis and
pneumonia.   Only  in  two cases of females—the one  labouring
under  ascites—the  other under  phlegmatia dolens, did mannite
fail to have  any  aperient agency.   This,  it was presumed, was
probably owing to  both of the patients  having  been  habituated
to the use of powerful  cathartics, and to there not being enough of
the preparation to admit of the administration of the appropriate
quantity.
   According to  M. Solon, mannite may be given in the dose of
one or two ounces dissolved in  from two to four ounces of a hot
aromatic water, the solution to be taken warm, otherwise it forms
a  stiff, adhesive  mass; or it may be  added to ordinary cathartic
potions.  He assigns it the preference over manna and castor oil;
first, because it  has an agreeable saccharine taste, and secondly,
because  it is always  equally good;   whilst those substances are
often deteriorated, and on that  account uncertain in their effects.
It  appeared  to him to be peculiarly adapted for cases in which it
was desirable to evacuate the intestines with as little excitation as
possible.
   Magendie, in his lectures on the blood, classes mannite amongst
the substances that  promote the coagulation of that fluid.2

'  Formulaire, &c., dern. edit.
1 Lecjons sur le Sang, &c. &c Translation in Lond. Lancet for Jan. 26,1839, p, 6j6. 
MATIAS.
505
                       CXVIII. MATIAS.
                  Synonymes.  Malambo, Melambo.
    A paper on the Matias  bark was read before the Medical Sec-
 tion of the British Association for the Advancement of Science at
 their meeting in 1840, by Dr. Mackay.   The  plant, from which
 the bark was obtained, grows in great abundance in South Ame-
 rica; but its botanical characters  have not  been given.   From
 what Dr. Mackay heard, it would seem to belong to the genus
 Wintersonia.  It contains an intensely  bitter extractive  matter,
 and  yields, on distillation, two distinct essential oils, which differ
 in  specific gravity, and are soluble  in  alcohol and ether;  and but
 very sparingly so in water.  The principal characteristic substance
 derived from it  was a bitter  resinous matter.   No  alkaloid  was
 discovered in it.  Mr. Ure1 considers it  to be identical with ma-
 lambo, the Indian name for the bark of a tree which grows  in
 New Grenada, and islield in high esteem by the natives as an an-
 tiperiodic, and stomachic.   He describes  the bark as three  or four
 lines thick; brittle, although somewhat fibrous; of a brown  colour,
 and covered  with an ash-coloured tuberculated epidermis.
   Malambo bark was analyzed by Cadet, and  afterwards by Vau-
 quelin,  who found it  to contain  resin, a light volatile oil, and an
 extract very soluble in water.   No tannic acid  was found in it;
 scarcely any gallic acid, and none of the alkalies of the  cincho-
 nas.2
                  EFFECTS ON THE ECONOMY.
   In its native country, matias bark is extensively used as a sub-
 stitute for cinchona in  intermittents.   Its principal therapeutical
 properties are tonic, aromatic and astringent.   Dr. Mackay stated,
 that it had been exhibited with marked success in  dyspepsia accom-
 panied by loss of appetite, which it quickly restored.  In phthisis,
 where tonics  were admissible, it supported the strength and pre-
 vented  rapid  sinking.  In dropsy,  it was found   to be a valuable
 adjunct to diuretics; and, in intermittents, to deserve  its native
 reputation  of being a  good substitute for cinchona.
   The  virtues ascribed to it by Dr. Mackay are  confirmed  by Dr,
 Neubigging, who has  used it  extensively.3  Mr. Ure  has often
 administered it with good  effect  as  a substitute for cinchona.  In
 scrofulous ophthalmia, after having removed feculent accumula-
 tions from  the bowels,  he has known  an  infusion, made with two
 drams of the bark to a  pint of wafer, cause a speedy and complete
 removal of the  inflammation and morbid sensibility of the eyes.

  ' Pharmaceutical Journal, vol. iii. No. 4, f>. 170.
  * Annates de Chimie xcviJ13: and Journ. de Pharmacie, ii.  172.  See, also, Merat
and De Lens, Diet, de  Mat. Med. &c, art. Malambo.
  ' Lond. Athenaeum, Oct. 1840; cited in Amer. Journ.Med. Sciences. Jan. 1841 p 209 
506
MAT1C0.
The dose of  the  infusion was from  one to two  fluidounces, re-
peated twice  or thrice  in the  course of the day.  " It may, in
some instances,  be advantageously conjoined with salts of iron or
of mercury, with both of which it is compatible.   The addition of
a little syrup of orange peel, and compound tincture of cardamoms,
forms a draught by no means disagreeable."
                       CXIX. MATICO.
Synonymes. Piper Angustifolium seu  Elongatum, Stephensia seu Artan-
  the Elongata, Matico plant, Soldier's Weed or Herb.
Spa7iish. Yerba del Soldado.
  The name of this plant is said to have been derived from a Spa-
nish soldier  called Matico, who, lying desperately wounded, and
bleeding to death, caught  accidentally hold of some of its leaves,
and by  their application arrested the hemorrhage.
  At a meeting of the Medico-Botanical Society of London, held
in 1827, Mr. Frost brought a specimen  of this plant  before their
notice;  which  appeared to him to be a species  of pepper.1  A
specimen of Matico leaves was brought from  Peru to the United
States,  in  1834,  by  Dr.  Ruschenberger,  of  the  United  States
Navy, wrho has since  received other  specimens from  Lima, with
a portion of which he kindly favoured  the author.   The  leaves
are considered to be  those of Piper  angustifolium, of Ruiz and
Pavon ;2 but Dr.  Ruschenberger  observes,  the properties  of the
plant, so far  as we can judge from the imperfect dried specimens,
differ somewhat from  the pepper  family, when we compare dif-
ferent  parts  of the plants.   The  dried  leaves are  deeply  reticu-
lated, and  of a greenish ashy-gray colour;  the stem is herbaceous
and' jointed ; but  the specimens  are so much broken,  as to render
it difficult, if not  impracticable, to form an accurate  idea  of the
plant.   It has been introduced of late years into Great Britain, and,
according  to Messrs. Ballard and Garrod,3 promises  to  maintain
the reputation it has enjoyed  in South  America as a most  powerful
styptic.
   Dr. Carson4 states, that the specimens he has examined  consist
of  the broken, and, in most cases, crumbled leaves, with portions
of  twigs, and flower spikes or fruit;   and such is the  character of
the specimens examined by the author.  Dr. Hodges has  seen two
samples,—the one consisting of the dried leaves, whilst another,

  1  London Medical and Physical Journal, cited  in  the  North American Medical and
Surgical Journal, iv. 419.  Philad. 1827.
  2 Persoon, i. 32, Cramer's  edit, cited by Jeffreys  in Transactions of the Provincial
Med. and Surg. Association, xi. 351.   Lond. 1843; Carson, 2d. Amer.  edit, of Pereira's
Elements of Mat. Med. and Therap. ii. 222.  Philad. 1846: and Ballard  and Garrod,
Elements of Mat. Med. and Therap. p. 411.  Lond. 1845.             * Op. cit.
  !  Op. cit. 
MATICO.
507
which  he procured more recently, had mixed with  the  leaves a
considerable quantity of  the flowering  twigs, and woody stems of
the plant compressed  together, and flattened  into a cake.  The
leaves, according to him, have a strong aromatic and slightly as-
tringent taste;  and the smell and taste of their infusion in water
very much  resemble  those of the tea prepared by the country
people  in  Ireland  from the leaves,  of  the  indigenous Salvia
verbenaca.   Dr. J. H. Scrivener, in a letter to  Dr. Ruschenberger,
dated  Lima, April 30, 1845, says, that Matico grows abundantly
along the sides of the  mountains of Monobamba and Huanuco in
the department of Junin.  There are  three species, distinguished
by the  colour of their stems, which  are red, brown and  white.
The red is considered superior to the others, and is carried to Lima
in large  quantities  by  the  Indians, and  sold  to the druggists.
When the Flora Peruana was published,  the medicinal properties
 of the  plant were unknown.  Their  discovery  is attributed to a
  oldier, who was wounded on the 9th of December, 1824, at the
 battle of Ayacucho.1
   The specimens examined by the author had no marked sensible
 properties.
   When analyzed  by Mr. Clay, of Liverpool,2  Matico seemed to
 have  gallic  acid  in its composition;  but from the experiments
 of Dr. Hodges, he concluded, that besides the  ordinary constitu-
 ents of leaves, it contains a  soft, dark-green  resin, some aromatic
 volatile oil,  and a bitter principle, to which he gave  the name
 maticin.   Its virtues  are  imparted to dilute  alcohol, and  to hot
 and  cold  water.   Decoction, according  to  Messrs. Ballard  and
 Garrod, volatilizes the essential oil, and if so, it would be an im-
 proper mode of preparation.  Dr. Ruschenberger, however, affirms,
 that the oil  is heavier than a saturated solution  of common salt.3
                 EFFECTS  ON THE ECONOMY.
    Matico,under the name Yerba del Soldado, ('Soldier's Weed,')
 has a popular  reputation in  Peru of being a remarkably powerful
 styptic;  and it is said, that  soldiers on going to battle carry with
 them a supply  of  it to stanch  the  blood.  It is  asserted, and
 popularly believed, that a Matico leaf applied at once, will arrest
 hemorrhage in a fowl after decapitation.  It is very generally used
 in Lima, and along the coast, in cases of hemorrhage, and of all
 kinds of ulcers.  The leaves are well pounded, and then  applied
 to the wound:  the vessels  contract, and the hemorrhage ceases.
 An infusion of the plant is used as  a wash to ulcers, and after
 washing a small quantity of the powder is applied;  but it  does
 not appear  that Matico has ever been used in Lima as an internal
 remedy.  In the province  of  Chequas,  however, in  the  eastern

   ' Ruschenberger.                       a Jeffreys, op. cit.  p. 352,
   » Med. Exam , July, 1846, p. 401. 
508
MATICO.
extremity of Bolivia, where it is  equally regarded as a valuable
hsemastatic, it  is said to  be  given as a diuretic.1  In a case  of
hemorrhage from the  tongue, occurring in a lad of the hemor-
rhagic diathesis, Mr. J. Hamilton, of Dublin, arrested the flow of
blood  by the application to the under surface of a small piece of
Matico leaf.
   In one case, Dr. Ruschenberger employed the leaves to arrest
hemorrhage after an  operation below the angle of the jaw, where
there was considerable  bleeding, and difficulty in taking up the
vessels, owing to the indurated condition of the parts, attributable
to inflammation of  long standing, caused by  the pressure of a mo-
lar tooth, which had been driven  in  by a musket ball to a point
between the base of the tongue and the angle of the jaw.  The
tooth was removed by incision, and the application of the Matico
was successful.  The wound,  an  inch and  a half in depth, was
filled with leaves  moistened with water, and the bleeding ceased
almost instantaneously.
   In enlarging a burrowing bubo, Dr. Ruschenberger divided the
arteria ad cutem abdominis, which  bled freely.   He directed that
an attempt should be made to arrest the  hemorrhage  by lint and
pressure.   After a trial of ten minutes, which totally failed, he
directed moistened Matico leaves  to  be applied.   The  assistant
reported, in a few moments, that the Matico exerted no influence,
and proposed to secure the bleeding vessel by ligature.  Dr. Rus-
chenberger now visited  the patient, who had  lost six  or  eight
ounces of blood, and was still bleeding.  Coarsely powdering some
Matico leaves in the palm  of his hand, he formed the mass into a
paste with cold water.   He then removed a clot, through which
the arterial blood had  formed a passage of the  size  of  a crow's
quill: the blood flowed  per saltum, forming a jet at  least three-
fourths of an inch high.   The paste was applied lightly  with the
fingers, and filled the wound.   The surrounding skin was imme-
diately sponged clean: the hemorrhage ceased instantly, and not
a single drop of blood flowed afterwards.  No pressure was  used,
nor dressing applied.  On  the  first application,  which failed, the
entire Matico leaf had been simply dipped in water and applied.
  A cupper and leecher, in Brooklyn, informed  Dr. Ruschenber-
ger that he  found Matico,  applied  as described above, arrest,
instantly, bleeding from leech-bites in  children, which, before  he
obtained the leaves, often caused him great anxiety.  He expressed
himself perfectly satisfied, that there  need be no difficulty in ar-
resting hemorrhage from leech-bites where Matico can be obtained.
Mr. Edward Young9 has also found it a valuable  agent in arrest-
ing the bleeding in such cases.

  ' Jeffreys, Lond. Lancet, Jan. 5,  1839, p. 567.
  a Dublin Hospital Gazette, cited in Braithwaite's Retrospect, xii. 179, Amer. edit.
New York, 1845. 
MATICO.
509
  When first introduced into England, it was found by Dr. Jef-
freys1 to  possess the  power  of  controlling obstinate  accidental
hemorrhages; such as arose from leech-bites, the removal of naevi,
incisions,  &c, when the under side of the leaf was applied to the
bleeding surface.  Testimony of its hsemastatic  powers was also
furnished by Dr. Kendrick,2 Dr. Monroe,3 Dr. Scott, Mr. Hamil-
ton,4 and others.
   The  stump of an arm, amputated near the shoulder, bled to a
dangerous amount from the whole surface. Pressure having  failed,
a  paste was made  by moistening powdered Matico, which  was
spread  over the part.  It acted as an  artificial  coagulum,  and
checked  the flow  of blood, which  did  not subsequently  recur.
The only other  remedy would have been to tie  the  subclavian
artery.5
   Possessed apparently of powers as a styptic, it was soon ad-
ministered  internally in cases where astringents  appeared to be
indicated.  By Dr. Jeffreys  and others, it was found to be valu-
able in gonorrhoea, leucorrhoea, menorrhagia, hemorrhoids, catar-
rhus vesicae, &c.  In a case related by Dr. Jeffreys, the patient
had been subject for two months to excessive discharges of blood
and coagula from  the vagina, occurring every  ten  days  or a
fortnight, and followed by a serous or muco-purulent discharge.
The usual treatment had been unsuccessful;  when a wine-glassful
of infusion of Matico was given four times daily;  and in ten  days
 she recovered  from  all severe symptoms.  In another case  of
discharge of blood from the bowels, with  scarcely any feculent
 matter in the evacuations, a decoction of Matico, in the proportion
 of half an ounce to  the pint, was prescribed, of which two table-
 spoonfuls were taken every four or six hours.   Three doses were
 sufficient for the cure.   In  melaena, occurring in  the course of
 adynamic fever, Dr. Watmough6 found a combination of  it with
 senna  particularly beneficial.  Two drams of each were infused
 in a pint qf water;  and a wine-glassful  of the infusion was given
 frequently.
    Dr.  Hunter  Lane7 found the infusion  and  tincture very ser-
 viceable in similar cases.   In chronic diarrhoea, it did  not prove
 of very eminent service, but as an injection in leucorrhoea,  it had,
 he thought, all the advantages, and none  of the disadvantages of
 a solution  of  nitrate of silver.  He also found it serviceable in

   1 London Lancet, Jan. 5,1839, p. 567.             2 Jeffreys, op. cit. p. 357.
   3 Provincial Med. and Surg. Journal, June 18, 1842, p. 209, and London and Edin-
 burgh Monthly Journal of Medical Science, Aug. 1842, p. 737.
   * Monthly Journal of Med. Science, for Nov. 1846, cited in Amer. Journ. of the Med.
 Sciences, Jan. 1847, p. 142.
   6 H. Hartshorne, Amer. Journ. of the Med. Sciences, Jan. 1850. p. 112.
   6 Provincial Medical Journal, March 10,1847.
   7 Lond. Med. Gazette, Oct. 6, 1843, p. 9,
        33 
510
MATICO.
menorrhagia, and in the varicose and ulcerated  condition  of the
rectum for which Dr. Houston proposes the topical application of
nitric  acid.1   (See  Acidum  Nitricum.)  Mr. Butler0  used the
Matico infusion internally, and by injection, with the best results,
in two cases of uterine hemorrhage accompanying abortion.  Mr.
Edward Young3 also found great benefit from it in leucorrhoea, in
the form of injection, made by boiling an ounce  of the leaves in a
pint of water for ten minutes;  and  he considers it unsurpassed as
an external application in hemorrhoids, when made into an oint-
ment with opium, according  to the form  given hereafter, and
applied night and morning.
   Dr. Ruschenberger used the tincture advantageously in a  case of
haematemesis, after other plans of treatment had been resorted to
ineffectually.   In several  cases of gonorrhoea, its impression was
very slight.   He does not think it equal to cubebs.   He used the
syrup  in teaspoonful doses, with decided advantage, in leucorrhoea
of long standing.  In certain cases  of chronic ophthalmia, where
astringent applications were  indicated, he  prescribed  the watery
infusion, dilute  tincture, and watery solution of the  extract, and
in every case  with beneficial results.
   From the whole of the testimony, then, there is encouragement
to expect beneficial results from Matico. The difficulty, however,
of establishing  the action of styptics is considerable, as is suffi-
ciently exemplified in the history of the Acqua Binelli and the
Acqua Brocchieri.   The same  difficulty likewise exists in  regard
to the determination of its powers as an internal astringent.   After
the discharge of an uncertain amount of blood, hemorrhage gene-
rally ceases spontaneously;  and hence  any article that may have
been administered  may acquire a hemastatic  reputation.  This is
probably the history of  the employment of chloride of sodium  to
check  the flow  of blood in haemoptysis.   Doubtless, however,
Matico is worthy of more\extensive  trials, although its sensible
properties, taken alone, would  not  encourage us to place more
faith in it than in the overrated hemastatic  ' Waters' referred to.

                 MODE  OF ADMINISTRATION.
   Matico may be given internally in powder, in  the dose of from
half a dram to a dram, in infusion, decoction, tincture, syrup,  or
extract.   Externally, it has been employed in the first three forms;
and also in ointment.  In epistaxis, the powdered  herb, used  as
snuff, has been found a convenient mode of application.*

  1 See, on this subject, Dr. O'Ferrall, Dublin Hospital Gazette, Oct. 1, 1845; cited in
Braithwaite's Retrospect, xii. 203, Amer. edit., New York, 1846.
  3 London Lancet, Jan. 18, 1845.                        3 Op. cit.
  4 Jeffreys, Provincial Med. and Surg. Journal, June 12, 1844, p. 161. 
MATICO.
511
             Infusum piperis  angustifolii.
                    Infusion of matico.
               R.  Piper, angustifol. fol. %].
                   Aquae bullientis Oj.
  Infuse for two hours.  Dose, two table-spoonfuls twice or thrice
a day, or oftener.                                  Jeffreys.
                        Infusum matico.
               R.  Piper,  angustifol. fol. concis. ^ss. (avoirdupois.)
                   Aquae bullientis Oss. (f %x.)
            Infunde per horam et cola.
  The product should measure about eight ounces.
                          Dublin Pharmacopoeia of 1850.

            Decoctum  piperis angustifolii.
                    Decoction of Matico.
               R.  Piperis angustifol. §j.
                   Aquae Oj.
    Boil for ten or fifteen minutes, and strain.
  Dose, the same as that of the infusion.             Jeffreys.
             Tinctura piperis angustifolii.
                     Tincture of matico.
               R.  Piperis angustifolii fol.  ^iij.
                   Alcohol, dilut. Oj.
    Digest for fourteen days, and filter.
  Dose from 30 to 60 drops in water.               Jeffreys.

  The Dublin Pharmacopoeia of 1850 has a Tinctura Matico,
formed of Jviij., avoirdupois, of matico leaves, in coarse powder,
to a quart (f 3x1.) of proof spirit.

              Syrupus  piperis  angustifolii.
                      Syrup of matico.
               R.  Piperis angustifol. fol. ^iv.
                   Alcohol, dilut. Oj.
    Exhaust by displacement; evaporate to one half, and add the proper
      quantity of sugar.
  Dose, a tea-spoonful or  two.               Ruschenberger.

             Extractum  piperis  angustifolii.
                     Extract of matico.
    This is made by treating Matico with alcohol  and with water succes-
      sively," and reducing to the consistence of  a fluid extract.
  Dose—ten to twenty grains.              Ruschenberger.

        Unguentum  piperis  angustifolii  et  opii.
               Ointment of matico and opium.
               R.  Piper, angustifol. fol. pulv. giij.
                   Opii pulv. gr. iij.
                   Adipis £i.  M.
  Applied night and morning in hemorrhoids.         Young. 
512
MONESIA.
                       CXX.   MONESIA.

   This vegetable substance has been imported into Europe, from
 South America, within the last twelve years, and, in consequence
 of the trials that have been made with it, by the  French  practi-
 tioners more especially, it  was introduced in the  year 1840 into
 this country.   It is imported into France, in  the form  of hard,
 thick cakes, weighing upwards of twenty pounds.   These cakes
 or loaves are much flattened, and have a yellowish coloured paper
 strongly adhering to  them.1   They are composed  of an extract,
 prepared in South America from the bark of a tree.  It would seem,
 that a French merchant, who had dwelt for a long time in  the in-
 terior of South America, and had witnessed the surprising effects,
 in certain diseases, from the employment of an extract which the
 natives made from the bark of a tree of the country, determined to
 import it into France, and to submit it to the experiments  of his
 medical and pharmaceutical countrymen.3  A quantity of the drug
 was accordingly sent to Paris, and placed in the hands of M. De-
 rosne.  About  a year and  a half after this, he obtained some spe-
 cimens of the bark of the tree, from which he procured an extract
 presenting all the  characters  of that  previously sent to him, and
 identical in composition.   This hark is said  by M. Derosne to be
 called  by some travellers Goharem, and, by others, Buranhem and
 Guaranhem ; and the  naturalists, wTho have examined it there, think
 that the tree which furnished it is a chrysophyllum—chrysophyl-
 lum Buranhem seu glycyphlaeum? It is smooth and grayish,
 like that of the plane tree; but with this difference, that it is much
 thicker;  its fracture  is imbricated, and its sweet  taste  contrasts
 singularly with the bitterness  of the thin laminae that are detached
 from the plane  tree/"  The extract—monesia—is of a deep brown
 colour.  It is very friable, and its fracture presents the same  ap-
 pearance as that of a well torrefied cacao nut.  It is wholly soluble
 in water, and its taste,—which is at  first sweet like liquorice,—
 soon becomes astringent,  and leaves behind a  well-marked and
 enduring acrid impression, which is felt especially in the tonsils.
   Chemical analysis  of the bark has detected the following sepa-
rate principles:—chlorophyll;  vegetable wax;  fatty and crystal-
 lizable matter;  glycyrrhizin;  an acrid and slightly bitter matter;
 a little tannic acid ; an organic acid, not studied;  a red colouring
 matter, analogous  to  that  of cinchona;  phosphates  of  lime and
 magnesia; and salts of lime, with an  organic acid.4   The extract

   ' Martin Saint-Ange, Gazette Medicale de Paris, 19 Oct., 1839.
   a Bernard Derosne, Notice sur le Monesia.  Paris, 1839; Sigmond, Lond. Lancet,
 1840; and A. Richard, Elements d'Histoire Naturelle Medicale, 4eme edit  iii. 3.
 Paris, 1849.
   3 See a translation of a communication by M. Saint-Anjre, in American Journal of
 Pharmacy, July, 1840, and  in Amer. Med. Intel.  March, 1840, p. 363.
   * Bernard Derosne, and O. Henry, in Notice sur le Monesia, par B. Derosne; and in 
MONESIA.
513
—monesia—contains  nearly 8 per cent, of glycyrrhizin, and 20
per cent, of acrid matter (monesin;) and no difference was found
by M. Derosne on analysis between the imported extract and that
prepared from the bark.
   An analysis by M. Persoz,1 Professor at the Academie des Sci-
ences of Paris, gave the following as the constituents of the ex-
tract:—tannic acid, rendering  iron blue, 52; gum or mucilage, 10 ;
sweet matter, 36;  loss, 2.
   It  has been suggested,  that the bark of the tree which fur-
nishes  monesia is  the same with  that of  quillaia  saponaria  of
Chili.   Neither the  bark  nor the extract would seem, however,
to be identical, although  in certain respects  they resemble  each
other: moreover, the analysis of quillaia was made by MM. Henry,
fils, and Bourtron-Charlard, and if monesia and quillaia were the
same, the  identity could  not  have failed to be detected by these
able chemical analysts.3
            EFFECTS  ON THE ECONOMY IN HEALTH.
   When monesia  is  exhibited internally, in the dose of from 15
grains to a scruple daily, for eight or ten days, it exerts at first a
direct operation on the digestive passages, and accelerates in a re-
markable manner the action of the stomach.   If the dose be pushed
to a dram or more in  the day, and  it be  continued for fifteen or
twenty days, the appetite increases, but a feeling of  heat is expe-
rienced in the epigastric region; and  tenesmus and obstinate con-
stipation may likewise supervene.3  Its action is manifestly excitant,
and slightly astringent, and  as such  it may be adapted for many
pathological conditions in which such agencies are  indicated.

            EFFECTS  ON THE ECONOMY IN DISEASE.
   Being possessed  of the properties described above, monesia has
been  used in the various profluvia, and especially in such as are of
an atonic character.   In  chronic bronchitis, and bronchorrhcea,
it has been  successfully employed by  Alquie, Daynac, Manec, and
others,—sometimes alone, at others associated with opium;  and,
in the majority of cases,  benefit has  appeared to  accrue from its
use.   The same has been the  result in  haemoptysis, according to
Alquie. On phthisis, it of course exerted  no direct efficacy ; but
its administration appears to have been  followed by increased tone
of stomach  and  facility of expectoration.  The first of these re-
Tableau  Synoptique, &c, du Monesia, par M. Saint-Ange.  See,  also, Saint-Ange, in
op. cit., and MM. Bernard Derosne, O. Henry, and J. F. Payen, in Journal de Pharma-
cie, Janvier, 1841, p.20.
   1 Forget, Bulletin General, de Therapeutique, Avril, 1839.
   a See, on this subject, Drs. Chaloner and Ruschenberger, in Amer. Med. Intel. Sept.
15, 1840, p. 184-187.  Merat and De Lens,  art. Quillaia; and the analysis of Quillaia,
by Boutron-Charlard, and Henry, fils, in Journal de  Pharmacie, xiv. 247; and in Amer.
Journ. of Pharmacy, for Oct. 1840, p. 210, with remarks by Carson.
  * Martin Saint-Ange, op. cit. 
514
MONESIA.
suits has led to its use in languor of the digestive functions; and
it  has been given as a tonic to females who have been exhausted
either by antecedent maladies, or by uterine hemorrhage.  In one
case,1 where the debility was  so great that syncope was induced
on the least movement of the body, the extract was given in pills
in the dose of sixteen grains  in the course of the day, with the
best effect.  In chronic enteritis, it has been prescribed by Alquie,
Baron, Manec, Monod and others, and in  many cases with decided
advantage.   Its  success is said  to  have  been most marked in di-
arrhoea, especially  when owing to improper diet, and several  for-
tunate results have* been published by M. Adrien;3 and  by Dr.
Q. Gibbon, of Salem, N. J.,3 and a pupil of the author, (1851,)
Mr. J. Hendley Kennon, informs him, that his father, Dr. H. C.
Kennon, of Greene county, Alabama, and himself, have employed
it  successfully in some very obstinate cases.  Even in the colliqua-
tive diarrhoea of phthisis it has acted beneficially.   B. Derosne
affirms, that surprising results have followed its administration in
the diarrhoea of phthisis with intestinal ulceration, after all astrin-
gents had been employed to no purpose.   Notwithstanding the dis-
advantageous circumstances in such cases, monesia is said to have
constantly mastered the diarrhoea.   Dr. Joseph G. Nancrede4 gave
it  successfully in a case of diarrhoea  of long standing, and  Dr.
Burns5 in  two cases of chronic  diarrhoea succeeding to cholera in-
fantum.  In leucorrhoea, the efficacy of monesia, as of every other
astringent, is less marked than in diarrhoea.   Where the internal
treatment is alone  employed, the astringent has probably to pass
into the mass of blood, and in this manner to act upon the parts con-
cerned, whilst in every form of chronic enteritis, it can come into
immediate contact with the seat of the disease.  Injections of mo-
nesia have accordingly been more advantageous in leucorrhoea.  M.
Baron, after having employed  all the  ordinary means in a case of
inflammation of the vagina, had recourse to them,  and arrested
the discharge.  M. Payen gives a  case in which, when taken in-
ternally, it augmented the discharge, but when it was employed in
the form  of injection, the  discharge yielded, and  did  not recur.
In all the cases of metrorrhagia or uterine hemorrhage, in which
monesia has been given, it is said to have succeeded in moderating or
suppressing the flow more perfectly than  any other agent.  It has
been given, with  excellent effects,in these cases by MM. Daynac,
Payen, Alquie, and Martin Saint-Ange.   In an obstinate case of
menorrhagia, of seven weeks' duration, after the usual agents had
been employed in vain, Dr. Chaloner6 administered the  extract in

  1 Bernard Derosne, Notice sur le Monesia, p. 7.
  J Journ. des Connoiss. Med. Chirurg. Nov. 1840.
  3 American Medical Library, Jan. 1842, p. 143.
  ' Medical Examiner, April 4, 1840, p.  215.        ' Ibid. Aug. 15, 1840, p. 517.
  6 Ibid. July 11, 1840, p. 441. 
                          MONESIA.                      510

the dose of three grains in the form of pill, every hour and a half,
until an  effect on the discharge was manifest.  After three pills
had been taken, benefit was experienced, and the patient was di-
rected to take three more,—one every two hours.  The cure was
complete.  It is  proper to add, that perfect rest and cold drinks
were used at the same time;  and the same may be said of a suc-
cessful case reported by Dr. Burns.1   In blennorrhcea, it has ex-
erted but little action when administered by the stomach; but when
injected into the urethra it  effected a cure in half the cases, and
diminished the amount of the discharge in the other half.2  In a
case of well  marked scorbutus, with petechia of the inferior ex-
tremities, soft  and bleeding gums, and  frequent epistaxis, which
had required  plugging of the  nasal fossae, M. Laurand obtained  a
complete cure, by giving, daily, from 24 to 40 grains of the extract
in the form of  pill, washing  the mouth, at the same time, with a
collutory formed of a dram of the tincture to four ounces of honey
and water, and inhaling, by  the nostrils, acidulated  water con-
taining an ounce of the tincture to a pint of water.  In two cases
of scrofula, the tincture was   used internally by M. Daynac, and
with excellent effects.
   In ulcers of a bad character, monesia has been applied externally
with advantage;—sometimes, in the  form of ointment; at others,
of the powdered extract.   In  venereal and scrofulous ulcers, ex-
cellent effects were obtained  from it by MM. Baron and  Martin
Saint-Ange.  M. Manec used it with benefit in an obstinate ser-
piginous ulcer of long duration. M. Monod cured a phagedenic
ulcer by it, which had resisted the use of nitrate of mercury and
the arsenical paste.   M. Payen was equally successful with  an
ulcer on the lower jaw, which, for ten months, had resisted  all
treatment, internal as well as external.   He employed it likewise
with much success in ulcerated chilblain ; in two cases of stoma-
titis? one of a gangrenous character; and in cases of fissure of
the anus, the result of inflammation from hemorrhoids.  Two
cases of purulent ophthalmia  were cured by M. Saint-Ange;
and M. Laurand was equally fortunate in a case of gangrenous
sloughs on the region of the sacrum.   M.  Buchey, surgeon den-
tist, has employed it  in cases of caries of the teeth, the progress
of  which it  appeared to him  to retard,  and,  when united with
opium, it seemed  to assuage  the pain more  than when  the latter
was given singly.  He recommends the use of the tincture to main-
tain a good state  of the gums.*
   Such are the chief diseases  in which monesia has been used. Its
employment  can readily be extended to  others, by bearing  in mind
the nature of its powers.  It would appear, that experiments have
  1 Medical Examiner, August 15, p.  517.
  a Martin Saint-Ange, op. cit.             ' See, also, J. G. Nancrede, op. cit.
  ' Bernard Derosne, Notice sur le Monesia, &c. &c. 
*
516                       MONESIA.

been made in Dublin, and that much benefit had been derived from
it as an astringent.1  Still, pt is not much used.
                 MODE OF  ADMINISTRATION.
  Monesia is generally given in pills in the dose of from twelve to
forty grains a day;—the medium dose, in  the  twenty-four hours,
being fifteen to twenty grains, taken at twice or thrice.   M. Martin
Saint-Ange has given it  to the extent  of forty-five grains a day.
  The syrup,  which contains  six  grains of extract to the ounce,
is given less frequently.   It  is esteemed to  be less active than  the
pure extract, and is preferred only  in the case  of infants.
  The  Hydro-alcoholic Tincture, which contains thirty-two
grains to  the ounce, has been most commonly used in injections,
in the proportion of a dram to a dram and a half  to six ounces of
water.   It has also been prescribed internally in  the dose of one
or two drams a day in a bitter infusion.
  For external use, an  ointment, containing one-eighth part of
its  weight of monesia, has been applied to ulcers; at others, pow-
dered monesia; and at others again, the acrid matter itself referred
1o in the  analysis.
                  MORPHIA ET EJUS SALES.
Synonymes. Morphia and its Salts.
French. Morphine et Sels de Morphine.
German. Morphin und  Morphinsalze.

                      CXXI.  MOR'PHIA.
Synonymes. Morphina, Morphinum, Morphium, Morpheum, Morphine,
  Papaverine.*
German. Morphin, Mohnstoff, Opiu malkaloid.
  The discovery of this principle is ascribed to Seguin and Sertiir-
ner, w7ho were engaged in the chemical analysis of opium  upwards
of forty years ago;  but although the former may have  first de-
tected it, the latter deserves the credit of having improved our ac-
quaintance with it, and of having attracted to it  the attention of
chemists and physicians.
                   METHOD OF PREPARING.
  The following is M. Robiquet's method.3  He boils a very con-
centrated solution  of opium with a small quantity of magnesia
—ten grains of the latter to a pound of opium—for a quarter of
an hour.  By this means, a tolerably  copious, grayish precipitate
is formed, which is collected on the'filter, and  washed with cold

  1 Sigmond, op. cit.  See, also, Forget, Bulletin General de Therapeutique, Avril, 1839.
  a Jahn's Handworterbuch der Chimie, B. iii.  S. 150.
  3 Annales de Chimie et de Physiq. v. 276. 
MORPHIA.
517
   water.   The well dried precipitate is then digested with weak al-
   cohol for some time, at a temperature short of ebullition ; by which
   means a very small quantity of morphia, and a considerable quan-
   tity of colouring matter, are separated.   The liquid is then filtered,
   and the residue washed with a  little cold alcohol.  It is then boiled
   for some  time in pure alcohol, and filtered again, whilst the liquid
   still boils.   On  cooling,  the morphia is obtained, which by repeat-
   ed crystallization may be freed from the attached  colouring matter.
     The process  of Hottot is greatly followed in France.  It is a
   modification of that used by Sertiirner, and similar to that adopted
   in the Pharmacopoeia of the United States.   In this, opium is ex-
   hausted by tepid water, and the  clear liquid  is evaporated  to a
   density of 2° of Beaume.  Whilst the  liquid is still tepid, a small
   quantity  of ammonia is added, in order  to render it neutral or even
   slightly ammoniacal.  In  this manner, a brown, resinoid precipi-
   tate is thrown down, which contains only traces  of  morphia and
   narcotina.   The liquor is filtered, and by the  addition of a  fresh
   quantity  of ammonia to it when cold, crystalline morphia is thrown
   down, which, when collected, dissolved  in alcohol, and evaporated,
   is set  aside to crystallize.1  The process of the  U. S. Pharmaco-
   poeia  is essentially the same  with that  of Dr. Edward Staples,
   which was published in the Journal of the Philadelphia College of
   Pharmacy.2
     Mr. Brande considers the process proposed by Robertson and
   Gregory to be the simplest and the best.3   Chloride of calcium is
   added  to a strong aqueous solution  of opium to precipitate the
   acids by which the alkaloids are held in  solution; it is then filtered
   and  evaporated to the consistency of syrup, and set aside to crys-
\  tallize; the crystals are strongly pressed to squeeze out the mother
   liquor, which contains narcotina and other impurities.  The pressed
   crystals are then purified by solution,  crystallization,  and  the
   action  of  animal charcoal, till  they are  obtained  colourless;  they
   consist of the chlorohydrates of morphia  and codeia; these are dis-
   solved  in hot water,  and  ammonia is added, which throws down
   morphia,  which,  being separated upon a filter,  may be redissolved
   in boiling alcohol,  and  obtained  in  crystals.   The  liquor, from
   which  the morphia has been precipitated, contains codeia, together
   with chlorohydrate  of  ammonia, and some  morphia; it  must be
   evaporated until  it crystallizes, and the  crystallized mass  be  dis-
   solved  in  a small quantity of water, and be decomposed by excess
   of a  solution of caustic potassa ; codeia is throwndown, and, when
   redissolved in ether, may be obtained in crystals.

    1 Journal de Pharmacie, x. 479.
    2 Vol. i. p. 15: see Dispensatory of the United States, 6th edit. p. 1035. Philad. 1845.
  For Faure's process, see Journal of the Philadelphia College of Pharmacy, ii. 71. Philad.
  1831; and for Mohr's process, Journal de Pharmacie, cited in American Journal of Phar-
  macy, April,  1641, p. 60.     3 Dictionary of Materia Medica, p, 383.  Lond. 1839. 
518
MORPHIA.
  In the London Pharmacopoeia, morphia is directed to be prepared
from the hydrochlorate or muriate.  Take  of Hydrochlorate of
morphia,  §j.;  Solution of ammonia, f 3V.; Distilled water, Oj.;
(imperial measure.)   Add the hydrochlorate of morphia, dissolved
in a pint of water, to the solution  of ammonia diluted with an
ounce of water, and agitate.  Wash the precipitate with distilled
water, and dry with a gentle heat.
  Tilloy, Petit, and others, have  obtained morphia  on the large
scale from domestic opium.1
  The  crystals are completely white, translucent, almost trans-
parent, and slightly opaline; they are wholly inodorous.  In the
form of powder,  morphia is of loose texture, and as fine as mag-
nesia.   It melts  at a trifling  degree of heat, and very much re-
sembles in this state  melted sulphur; but  crystallizes again on
cooling.   It is sparingly soluble in hot water; and in cold water
scarcely at all so.   Boiling water, according to Choulant, dissolves
one eighty-second part;  according  to Jahn, only one four-hun-
dredth;  and, according to Bally,2 it is even less soluble  than
strychnia, which, he says, requires  6000 parts of water for its
solution.  It is more readily soluble in alcohol, and still more so
in ether, as well as in  fixed and volatile oils: the solutions have  a
nauseous, bitter taste.  It is alkaline in its nature.  The crystals
appear to be rectangular  four-sided prisms.   With all the acids, it
forms peculiar, readily soluble, and very bitter salts, of which the
sulphate,  acetate, and muriate are the most used.
           EFFECTS ON  THE ECONOMY IN HEALTH.
  Generally—it  has been affirmed—morphia acts  on  the  nervous
system  like opium, but does not  exert the same agency on the
vascular system.   Magendie3 asserts, that it possesses all the ad-
vantages  of opium without any of its disadvantages.    Bally4 took
especial pains to  investigate the effects of morphia on the organ-
ism, and the results were communicated  to the Academic Royale
de  Medecine, of  Paris.   The most striking was its action  on the
brain, which, when sufficient doses  were administered,  appeared
to  cause death by sanguineous apoplexy, as Bally had an opportu-
nity of observing, in one  case, on dissection.  In  this, there were
no  traces of injection of the membranes of the brain,  whilst under
the arachnoid  much albuminous serum  was effused, and there was
an  extravasation of blood into the left hemisphere of the brain.
   This result  is especially to be  apprehended in  those who have
experienced an apoplectic attack previously.  Bally found, more-
over—which  does not accord with  the  author's experience—that
morphia was more soothing and soporific in  small doses than  in
  1  Art Morphine, in Merat and De Lens, Diet, de Mat. Med.
  2  Memoires de l'Academie Royale de Medecine, i. 99.
  '  Formulaire pour la Preparation, &c. de plusieurs nouveaux M^dicamens.
  '  Revue Medicale, Fev. 1824; and Mem. de la Societe Royale de Medecine, i. 142. 
MORPHIA.
519
 larger.   It  occasioned, in the latter case, cerebral confusion, ver-
 tigo, perversion of the senses, and  a feeling of electric agency,
 which commenced in different parts  of the trunk, and also in the
 extremities; but no delirium supervened, and the intellectual facul-
 ties experienced no alteration.   In consequence of these effects on
 the sensorium, the  energy of the motory apparatus suffered.  By
 long administration, morphia, like opium, excited troublesome tre-
 mours.  He found  the pupils contracted under its use when larger
 doses were  given, which is opposed  to the ordinary effect  of nar-
 cotic agents.   Not unfrequently, when  morphia was  continued,
 the soothing and soporific effect* was preceded, for some days, by
 restlessness, and loss of sleep.  Very often  it  excited headach.
 On  the  vascular system  it did not act as an  excitant—neither
 rendering the pulse quicker, more frequent, nor  tenser.   The op-
 posite effect seemed, indeed, to be induced.   It has  no action,
 Bally affirms, as an emmenagogue; produces  no diaphoresis—
 which does not, by the way, at all  accord with the  author's ob-
 servation—does not even augment the animal heat, or redden the
 face, but frequently causes  itching  either  over  the whole surface
 of the body or topically; in the latter case, the sensation  being
 chiefly felt in the face, neck,  loins or  genitals.  At times, the
 itching is associated with an eruption of conical wheals or bumps,
 which are either red or of the ordinary colour of the skin, and can
 generally be detected more  readily by the touch than the sight.
 On  the  organs of respiration, morphia  exerts  no influence; and
 as to its effects on  the digestive organs, it may be remarked, that
 it has no effect on  the mouth, pharynx, or oesophagus, except that
 ptyalism has been observed to  result from  it.   The tongue is not
 made red or dry, nor are the tonsils.  It  does  not excite  thirst;
 but, at times, there is a sense of bitterness in the mouth, which is
. a forerunner of its effects on the stomach.   The appetite is not
 diminished, except when its emetic properties are developed in  a
 high degree.   Vomiting is not caused by large doses only, but in
 many individuals by small  doses,  and  it may be  very violent.
 Commonly,  morphia causes  constipation, on  which, at  times,
 diarrhoea supervenes.   Very frequentlv, also, colic is induced by it.
    Morphia possesses,  according  to Bally, vermifuge properties.
 In men, he found it frequently excite ischuria, but not in women.
 The urine,  however, exhibited no change  of character.1
    The author's own view of its action—when no  idiosyncrasy
 interferes with its ordinary operation—is, that it exerts a decided
 sedative influence on the  nervous and sanguiferous  systems;  and
 this  accords  with  the experiments  instituted on animals  by Dr.
 Blake.9   He  found, when it was introduced into the veins, that it

    ' Richter's Specielle Therapie, 2te Auflage, S. 358.  Berlin, 1828.
    a Edinb. Medical and Surgical Journal, April, 1839, p. 344. 
520
MORPHIA.
exhibited  its effects upon the heart, by rendering its pulsations
slower, and diminishing the pressure of the arterial system.
  As in the case of opium, the system may, under excessive pain
or long continued use, be so habituated to its action as to bear very
large doses.  Mr. Lingen,1 of Hereford, has published a  case in
which a female, under a painful affection, took scruple, and, ac-
cording to her own report, half dram doses of the acetate; and Mr.
Teevan,2 of London, one of a gentleman, labouring under a dis-
ease of the spinal cord, attended with violent spasms of the muscles
of the chest, abdomen, and  inferior extremities, who took, on one
occasion, twenty-five grains in the twenty-four hours.
           EFFECTS ON THE ECONOMY IN DISEASE.
   Morphia may often be administered advantageously, not only
where opium is  indicated, but, it is  thought,  where it disagrees.
Riecke 3 remarks, that where diaphoresis is needed, it cannot sup-
plant opium ;  but in this we apprehend he is mistaken, at least in
febrile and inflammatory diseases.  In such cases, the author has
observed a sedative dose of opium  succeed in restoring the cuta-
neous transpiration more effectually than any other agent, by al-
laying the pathological condition on which the suppression of per-
spiration was dependent.   With many persons, and in many cases,
it  possesses decided advantages  over opium,  but the author has
often found, where opium disagreed, that morphia and  its prepara-
tions did so likewise.
   As  a general rule, it  may be  said,  morphia  is proper  where
opium, in sedative doses, is demanded; hence it is had recourse to
in febrile and inflammatory diseases, where there is much pain
or sleeplessness—singly or combined, and in the various neurotic
affections.
   On account of the very sparing solubility of morphia  in water,
it is but seldom  prescribed; although Bally, in opposition to many '
experimenters, asserts, that he has found it equally efficacious with
its salts.   As, however, this result is doubtless owing to the exis-
tence of acid in  the stomach, and, consequently, is liable to uncer-
tainty, it  is advisable  to give the  salts of morphia  the preference.
These are administered in nearly the same doses as pure morphia
itself.
   It has been likewise proposed  to  inoculate with morphia and
its salts.   If the point of a lancet, dipped in  an aqueous solution
of morphia, be inserted horizontally about  one line in depth be-
neath the epidermis, and be allowed to remain there a few seconds,
the following effects, according to M. Lafargue, are observed:—
About a minute and a half after the operation, a small pimple ap-

                1 London Lancet, Jan. 26, 1839, p. 680.
                a Ibid, for February 9, 1839, p. 738.
                 3 Die neuern Arzneimittel, u. s. w. S. 327. 
MORPHIA.
521
pears,  with a diffuse  rosy areola,  and slight itching: in about
twenty minutes, the pimple becomes about four lines in diameter,
and  one line  in thickness, and is  flattened:  its  colour is some-
what deeper than  that of the skin; it is hard; the areola very red,
and about an inch and a half in diameter; its heat is increased, but
the sensation of itching remains about the same.   During the first
hour, the pimple and its areola  are  at  the  highest degree of de-
velopment,  after which  they gradually disappear.   The  general
effects, which M.  Lafargue  experienced  from thirteen punctures
thus made on the  anterior part of his  forearm, were,—heaviness
of the  head, frequent yawnings, clamminess of the mouth, and an
invincible desire to sleep; yet the quantity of muriate of morphia
employed could not have exceeded a quarter of a grain.  He con-
siders  that the inoculation of morphia  may supersede  the  use  of
blisters and ammoniacal plasters, and that it deserves employment
more particularly  where the object  of  the physician is to produce
the local effects of morphia.  Its influences as a rubefacient are
marked, and hence its probable utility in superficial neuralgia
and in chronic rheumatism.1
   The experiments of M. Lafargue were repeated by  M. Martin
Solon, with nearly the same results.2
   M.  Jaques of Anvers,3 and  Castiglioni,4 an Italian physician,
also recommend inoculation with morphia — the sulphate—in neu-
ralgia.  In one  case,  the former made  about  forty punctures
over the seat of pain.   The same plan was used in sciatica,—the
inoculations being made the whole length of the  sciatic nerve.
Poultices are useful in  subduing the  irritation  produced  by the
punctures.  The latter employs the acetate in a similar manner.
He uses a solution of three grains of the salt in half an ounce of
distilled water, and makes numerous  punctures  in the course of
the affected nerve.  Dr. A. T. Thomson5 has drawn the following
conclusions in regard to the utility of the endermic use  of the salts
of morphia in certain articular affections.   First,  In painful,
swollen, and contracted joints, depending on rheumatism, or other
causes, the  topical application  of muriate or acetate of morphia to
a blistered surface, on the affected joint, is capable of reducing the
swelling, abating  pain,  and restoring the motion  of the joints.
Secondly, These  salts seem to  produce their beneficial results  by
reducing the sensibility of  the nerves of the  joint, and favouring
absorption by their counter-irritant influence.   Thirdly, They do
not act as narcotics until the joints are relieved: (?) and, fourthly,

  1 Rev. M6d. Chirurg. ii. 163, Gibbon, American Medical Intelligencer, July, 1841, p. 1.
  2 Bulletin de l'Acad6mie Royale de Medecine, Nos. 1 & 7, 1836-7.
  8 Bouchardat, Annuaire de Therapeutique, pour 1844, p. 24.
  ' Provincial Medical and Surgical Journal, July 3, 1844, p. 208.
  1 London and Edinburgh Monthly Journal of Medical Science, Oct. 1845, p. 774. 
522
MORPHIA.
 they frequently excite a pustular eruption over the body; but this
 appears spontaneously soon after the use of the topical application
 is discontinued.   Mr. Rynd,1 too, has  found  the inoculation  of
 morphia triumphantly successful in rebellious  cases of neuralgia.
 He associates the acetate of morphia, however, with creasote;  in
 the proportion of ten or fifteen grains of the salt of morphia,  to
 a dram of creasote.  In a  case of inveterate facial neuralgia,
 the  solution  was introduced into  the  supra-orbitar  nerve, and
 along the course of the temporal, malar, and  buccal nerves, by
 four  punctures  of an instrument made  for  the purpose.   In the
 course  of a minute, all pain, except that caused by the operation,
 which was very slight, had ceased.  In another case—of sciatic
 neuralgia—the fluid was introduced by one puncture behind the
 trochanter, and another half way down the thigh.   The man was
 instantly relieved from  pain.  Should the pain return, the  fluid
 must be again introduced.
   M. Ebrard, of Bourg,3 has employed, with signal success in the
 cure  of toothach, the muriate of morphia, by friction on the gum
 of the pained part.   These frictions  are made in the following
 manner.  The patient takes upon  the moistened extremity of his
 fingers  13  milligrammes,—about  one-fifth of a grain, Troy,—of
 the salt, and applies it for two or three minutes to the pained gum.
 Then, while inclining the head  on  that  side, taking  care not to
 swallow or eject the  saliva which  holds the salt  of morphia dis-
 solved,  he must allow the saliva to be  in contact with the gum
 for five or  ten minutes.   He may afterwards swallow the saliva.
 Should  there  be no  relief,  and  symptoms of narcosis  be absent
 after  a period of two hours, the application may be repeated; but
 the repetition is rarely required.
   In frontal  neuralgia, M. Ebrard has found a successful treat-
 ment to consist in causing the patient to take as a pinch of snuff,
 from four-tenths, to three-fourths of a grain, of muriate of morphia,
 He advises, however, that  great caution should be used in em-
 ploying this powerful agent.

                  MODE OF ADMINISTRATION.
   Pure morphia  is only given internally in  the form of powder
 or of pill, beginning  with from  one-sixteenth to  one-fourth of a
 grain once or  twice a day, and gradually increasing  the dose to a
 grain and a half.  If its use has been discontinued for some days,
 the dose, when  resumed, must  be  again small, and  be gradually
increased.   Its salts—as is shown hereafter—have  been introduced
into  the system  both endermically and iatraleiptically,  and by
inoculation.

  1 Dublin Medical Press, March 12, 1845.
  1 Gazette des Hopitaux, cited in Amer. Journ. of the Med. Sciences, July, 1846, p. 220. 
MORPHIA ACETAS.
523
                    Haustus  morphia;,
                    Draught of morphia.
                       (Potto Narcoiica.)
                   R.  Morphiee gr. \.
                       Syrup, papav. f ^j.  M.
                       Aq. destillat. f gj.
  To be taken at bed-time.
                     Enema  morphia}.
                    Injection of morphia.
                       (Injectio leniens.)
                   R.  Morphia; gr. ij.
                       01. amygdal.
                       — lilior aa. §ss.
  To allay pain in the ear, the suffering in acute blennorrhagia,
and the tenesmus in  hemorrhoids, &c.                Brera.1
                  Linimentum  morphia.
                    Liniment of morphia.
                   R.  Morphiae gr. iij.
           Solve in
                       01. amygdal. gi.—31'ss.
  To be rubbed  on the neighbourhood of the eye, as an anodyne,
in cases of cancerous and other painful affections of the eye.
                                                  A. Poli.2
               CXX1I.  MORPHINE  ACETAS.
Svnonymes.  Morphinee Acetas, Morphium Aceticum, Acetas Morphii,
  Acetas Morphicus, Acetate of Morphia.
French.  Acetate de Morphine.
German.  Essigsaures Morphium,  Morphiumacetat.
                  METHOD OF PREPARING.
  Acetate of morphia may be obtained by mixing morphia, acetic
acid and distilled  water in  an  appropriate vessel, and  gradually
evaporating to dryness, at a  temperature  of about 90° Fahr.3
This mode of preparation is required, owing  to  the difficulty of
obtaining the acetate crystallized, in  consequence of its extreme
deliquescence.  Crystallized acetate of morphia may, however, be
prepared by dissolving morphia in alcohol, saturating with acetic
acid, filtering the  solution, and evaporating gradually in a vessel
covered over with thin rag,   The acetate crystallizes in an arbo-
rescent manner on the sides  of the vessel.
  Acetate  of morphia is one of the substances, which, in the ex-

  1 Ricettario Clinico.   Padova, 1825.
  ' C. G. Lincke, Vollstandiges Recept-Taschenbuch, u. s. w. ii. 288. Leipz. 1841.
  * Pharmacopoeia of the United States, p. 144.  Philada, 1842. 
524
MORPHIJE ACETAS.
periments of Magendie,1 were  found to promote the coagulation
of the blood.
   This salt of morphia has been highly recommended in arthritis
and  nervous affections, by  M. V. Cristin,2 of the Hospital St.
John, Turin, according to a form given  below.  When the pains
are relieved, or sleep is about to commence, the intervals between
the doses are  increased, or it is suspended altogether.   Its good
effects  in neuralgia have been extolled by many others;—the
effect of the remedy being kept up for days and weeks, if necessary.
Mr.Braithwaite3 remarks, that Dr. Cristin prescribes it in the dose
of one-tenth of a grain every hour, but that he has generally found
it necessary  to give much  larger  doses without any  other  bad
effect than  severe sickness, which  was easily  abated by creasote
or excitants—as  the spiritus  ammoniae aromaticus.    He pre-
scribes  one-fourth or one-sixth of  a grain  every hour or two, in
severe  cases, until  the system is completely under its  influence,
and  then keeps  up its  effects by smaller,  and less  frequently
repeated, doses.   It is questionable, however,  whether  the ace-
tate  be  superior  to opium.   M. Gerard, of Avignon,  has found
it so highly useful  in Asiatic  cholera,  that he prefers  it to all
other remedies.  Of ninety-nine patients, treated thereby, eighty-
one were cured.   He found, when  given early, that it especially
checked the  vomiting,  and moderated  the subsequent  reaction,
after  which the other symptoms gradually ceased.   When, how-
ever, the resources of art had  been long postponed, the effects of
the remedy were  less marked; the vomiting and the other symp-
toms  persisted longer;  the supervening  reaction was much more
tardy, and frequently ended in a state of collapse, which, under
the  most trifling imprudence,  produced an unfortunate result.
Gerard administered the acetate at  first  in the dose of one-fourth
of a grain every half hour, until  the serious symptoms were re-
moved, and he omitted it as soon as the  spasms and the diarrhoea
and vomiting had ceased, or as soon as reaction ensued.
   In  the treatment of chronic gastralgia, M. Valleix4 derived the
greatest benefit from the employment of small doses of the acetate.
Its use  in that disease is not new, but he modifies the usual mode
of its administration.   Instead  of giving it before a meal, he pre-
scribes it after, and in this way has  relieved cases that had resisted
all other treatment.  He  orders a grain of  the acetate  to be dis-  ,
solved in thirty drams of distilled water  and nine drams of syrup,
and directs a teaspoonful to be taken immediately after each meal.

  1 Legons sur !e Sang, &c, and translation in London Lancet, Jan. 26,1830, p. 636.
  a Repertorio Medico-chirurgico del Piemonte, cited in British and Foreign Medical
Review, Jan. 1840, p. 252.
  8 Retrospect of Practical Medicine and Surgery, vol. i. Jan. to July, 1840, 3d edit.
p. 15.  London,  1842.
  4 Revue Medico-Chirurgicale, ii. 100, cited in Brit and For. Med. Chir. Review,
Jan. 1848, p. 275. 
MORPHIiE ACETAS.
525
Under the use of these small doses, the bowels, instead of being
very constipated, are better regulated.
   Acetate of morphia  has been much  used endermically, in the
diseases  mentioned  under the head  of  Morphia.   A quarter or
half a grain or more is placed in some part of the skin whence the
cuticle has been removed; and it may be repeated, as the case may
require.   In  the severer neuralgic and neurotic cases, the quantity
applied in this way  has been  sometimes very large.  In a case of
hydrophobia, reported  by Dr. Burne,1 of London, ten grains at  a
time were sprinkled on  a blistered  surface, with  excellent  tran-
quillizing effects.   At times, when applied  to a blistered surface
for several  days in succession, a papular eruption has  been  ob-
served,  which quickly  becomes  vesicular,  proceeding  from  the
edges of the blister, and gradually spreading over the entire sur-
 face.2  A case of traumatic tetanus has been  published, which
 was cured by the internal and endermic use of the acetate.3
                  MODE OF ADMINISTRATION.
   The dose  of acetate of morphia is from a quarter of a grain and
 less to a grain  or more.  Its  strength does not vary materially
 from that of pure morphia.
                 Liquor morphiae  aeetatis.
                 Solution of acetate of morphia.
                  R.  Morphia? acetat. gr. xvj.
                       Acid, acetic,  f 31J.
                       Aquee destillat. f gvj.  M.
   This  formula was  proposed by  the author4 as a substitute for
 the " gouttes calmantes " of Magendie,5 which permit the depo-
 sition of the morphia when  kept for a short time.  The dose  is
 from six to  twenty-four  drops.
                   R.   Morphias acetat. gr. xvj.
                       Acid,  acetic, gtt.  iij. vel iv.
                       Alcohol, f 3J.
                       Aquae destillat. f 33.  Fiat solutio.
                                                    Magendie.
                 Mistura morphia  aeetatis.
                 Mixture of acetate of morphia.
                   R.  Morphias acetat. gr. i.
                       Syrup, acaciae f ^i.
                       Aquae destillat. f giv.  M.
    ]3ose>—A spoonful every hour  in arthritis and nervous affec-
  tions, until the pains are removed.                     Cristin.
   1 London Medical Gazette, April 14, 183F.
   1 A. T. Thomson, in London Lancet, for Jan. 19,  1839, p. 632.
   3 L.' Piquot, Journ. des Connais. Med. Chirurg. Dec. 1840.
   ' Formulary, &c, translated from Magendie, by C. T. Haden, 2d edition, by Robley
  Dunglison, p. 14.  Lond. 1824. Amer. edit., Philad. 1825.
   8 Formulary, &c.
         34 
526
MORPHIiE ACETAS.
                Syrupus  morphia;  aeetatis.
                 Syrup of acetate of morphia.
                  R.  Morphiae aeetatis gr. iv.
                      Syrupi simplic. Oi.
  Dissolve the salt in half a dram of water acidulated with a few drops
of acetic acid; filter, and add it to the syrup.
   This syrup is recommended and  used in Paris, in place of the
syrupus  papaveris.   It has the advantage  of  being always  of
uniform strength.                                  Magendie.

   It has been suggested,1 that the syrup of the acetate or sulphate
of morphia should always be made of  the strength of one grain  to
the ounce;  and it is certainly  desirable  that  uniformity  should
prevail in this respect.  If this exist, it matters but little what the
proportion is, within certain limits.
   The acetate  may, also, be applied in the form of  ointment;
and  it is frequently  added to , glysters,  in  chronic diarrhoea.
Hildenbrand recommends the following ointment to be rubbed on
the pubes in  cancer of the uterus:—

               Unguentum  morphias  aeetatis.
                Ointment of acetate of morphia.
                    R.  Morphiae acetat. gr. iv.
                        Ung. hydrarg. ciner.
                        ----simpl. aa. gij.  M.
   A piece, the size of a pea, to be rubbed on twice daily.
   A solution of acetate of  morphia, which he terms liquor opii,
has been  proposed by Mr. Houlton.2   He prepares it as follows:
—Take two ounces and a half of the best  Turkey opium;  thirty-
two  fluidounces of Beaufoy's acid, of the strength of pickling
vinegar:  macerate with a  gentle  heat for  six days, frequently
shaking the vessel; then filter, and evaporate the fluid  to the con-
sistence of the extracts of the pharmacopoeia, finishing the  evapo-
ration  by the spontaneous method.  This  Mr. Houlton  employs
under  the name extractum opii  aceticum.  To the above extract
he adds, alcohol, five  fluidounces; distilled water, thirty-five fluid-
ounces; macerating for eight days, and filtering.
  This liquor opii is about the strength  of  the tinctura opii in
sedative property, and Mr. Houlton affirms, from his observations,
that it is in no respect inferior to Battley's liquor opii sedativus,
—a secret preparation which has been much used.

  ' Duhamel, Amer. Joum. of Pharmacy, for Oct. 1840, p. 187.
  0 Lond. Medical Gazette, Aug. 12, 1837.  See, also, Buchner, pere, in Journal de
Pharmacie, Fevrier, 1842, p. 48. 
MORPHIA MURIAS.                   527
             CXXI1I. MORPHIA HYDRIODAS.
Synonymes.  Hydriodate or Iodhydrate of Morphia — called by some
  Iodide or Ioduret of Morphia.
French.  Iodhydrate ou Hydriodate de Morphine.
German.  Iodwasserstoffsaures Morphin.

  An Ioduret or Iodide of Iodhydrate of Morphia, has been
introduced of late years.  It is prepared  by mixing a solution of
acid sulphate of morphia, with a solution of ioduretted iodide of
potassium, keeping the liquors for an  hour at a temperature of
140°: the liquid is then poured off; and the residuum washed, col-
lected on a filter, and dried.
  The iodide of hydriodate of morphia is in small brilliant spangles,
(paillettes,)  of a beautiful deep purple colour.  It is insoluble in
water, very soluble in alcohol, and very little so in ether.  It ap-
peared  from the few trials  made of it  by M.  Bouchardat,1 to
possess the narcotic properties  of morphia, without diminishing
the appetite.   It requires  to  be  given in double the dose of the
other preparations of morphia.
               CXXIV.  MOR'PHI^J  MU'RIAS.
Synonymes. Morphinse Murias seu Hydrochloras. Morphias Hydrochloras,
  Morphium Muriaticum,  Murias seu Chlorhydras Morphicus,  Hydro-
  chloras Morphicus, Murias Morphii, Muriate of  Morphia, Hydrochlo-
  rate of Morphia or Morphine.
French. Hydrochlorate ou Muriate de Morphine.
German.  Salzsaures  Morphium,  Hydrochlorsaures  Mor-
  phium.
                   METHOD OF  PREPARING.
  According to the last Pharmacopoeia of the United States, mu-
riate of morphia  is prepared  as  follows:—Take of morphia in
powder, ^i.; distilled water Oss.; muriatic acid, a sufficient quan-
tity.   Mix the morphia with the water; then carefully drop in the
acid, constantly stirring till the morphia is saturated and dissolved.
Evaporate the solution by means of  a  water bath, so that it may-
crystallize  on  cooling.   Dry the  crystals on bibulous paper.
  In  the London and Edinburgh Pharmacopoeias, morphia is first
separated from opium in the form of the muriate.3
  Muriate of morphia  is in snow-white feathery crystals, which
are wholly soluble in water.

  1 Nouveau Formulaire Magistral, p. 70.  Paris, 1845.
  2 For Wm. Gregory's mode of preparing the muriate, see Edinb. Med. and Surg.
Journal, for April, 1831; or Philad. Journal of Pharmacy, iii. 124.  See, also, M. Ro-
bertson, in Edinb. Med. and Surg. Journal, for April, 1832; and A. T. Thomson, Lond.
Pharmaceut. Joum. and Transact., or Amer. Journal of Pharmacy, July, 1842, p. 154. 
528
MORPHIA MURIAS.
                 MODE OF ADMINISTRATION.
  It may be  given in the same cases and doses as the other salts
of morphia.
  The following preparations are directed in the Edinburgh Phar-
macopoeia.
                    Troehisci morphise.
                      Morphia lozenges.
                  R.   Morphiae muriat. Qi.
                     Tinct. tolut. f gss.
                     Sacchar. §xxv.
  Dissolve the muriate of morphia in a  little hot water; mix  it
and the tincture of tolu with the sugar;  and with a sufficiency of
mucilage form a proper mass for making  lozenges; each of which
should weigh about 15 grains.1   Each lozenge contains about one-
fourth of a grain of muriate of morphia.   Dr. Pereira2 states, that
the  morphia  lozenges of the  shops  usually contain one-twenty-
fourth of a grain of the muriate.  It is a  good mode of employing
morphia with the view of allaying cough.
           Troehisci morphiae  et  ipecacuanha.
             Morphia and ipecacuanha lozenges.
             R.   Morphias muriat. ^i.
                 Ipecac, in pulv. subtil. JJi.
                 Tinct. tolut. f ^ss.
                  Sacchar. gxxv.
  Proceed  as for Troehisci Morphiae.
  Each lozenge contains about one-fourth of a grain of muriate of
morphia, and one-thirteenth of a grain of ipecacuanha.   They are
used in  the same cases as the last.
               CXXV. MORPHINE SULPHAS.
Synonymes. Morphinae Sulphas, Morphium Sulphurieum, Sulphas Mor-
  phii seu Morphicus, Sulphate of Morphia or Morphine.
French. Sulfate de Morphine.
German. Schwefelsaures  Morphium, Mo rp hi umsulphat.
                   METHOD OF PREPARING.
  Morphia is dissolved in dilute sulphuric acid.   The solution
is then evaporated by heat, and  suffered to  crystallize, which it
does in silken tufts, or snow-white feathery crystals that are wholly
soluble in water.
                 EFFECTS  ON THE ECONOMY.
  The general effects of sulphate of morphia on the economy in

  1 Christison, Dispensatory, p. 643. Edinb. 1842.
  2 Elements of Mat. Med. and Therap.  ii. 1782.  Lond. 1842;' or 2d American  edi-
tion, by Carson.  Philad. 1846. 
MORPHIJE SULPHAS.
529
health  and disease resemble those of the acetate, to which it is
perhaps to be  preferred  on  account of its  greater uniformity.
There  is an advantage, however, in retaining both preparations in
the Materia Medica, as when the system becomes accustomed to
the one, the other may be substituted.
  In his experiments on the blood, Magendie1 found  that the sul-
phate of morphia—unlike the acetate and  the muriate—opposed
the coagulation of that fluid.
  A syrupus morphia sulphatis, a liquor morphiae sulphatis,  and
an unguentum morphiae sulphatis may be formed in the same man-
ner as wTith acetate of morphia.   The common form for the solu-
tion of sulphate of morphia is the following: it is that of the Phar-
macopoeia of the United States; and it is to be regretted, that  the
strength is not the  same as that of the Liquor Morphias Aee-
tatis.
               Liquor morphia; sulphatis,
              Solution of sulphate of morphia.
               R.  Morphias sulph. gr. viii.
                   Aquae destillat. Oss.   Fiat solutio.
  Dose.—A tea-spoonful (which is considered to be equivalent to
about twelve or fourteen drops of laudanum,) to be repeated as  oc-
casion  may require.
       Lotio morphiae  sulphatis et  sodae  boratis.
     Lotion of sulphate of morphia and borate of soda.
           R.  Morphiae sulphat. gr. vj.
               Sodae borat. §ss.
               Aquae rosae f ^viij-  M.
  To be applied thrice a day  to the affected parts by  means of a
piece of sponge, or a piece of linen, in pruritus vulvas, taking  the
precaution first  to wash the  surface with tepid water and  soap,
and to  dry them before applying the lotion.            Meigs.2
  Citrate of Morphia is occasionally used ;  but it possesses no
advantage  over  the preparations described above.  Many years
ago, Dr. Porter, of Bristol, recommended a liquor  morphias ci-
tratis to be prepared in the following manner:—Beat four ounces
of the best  crude opium  in a  mortar, with two ounces of crys-
tallized citric acid; mix well  with a pint of boiling water; and
filter after twenty-four hours' maceration.  Dr. Paris speaks well
of this  preparation.3   Magendie recommends the substitution of
the following process:

  1 Leeons sur le Sang, &c; or translation in London Lancet, January 26,1839.
  11 A Treatise on the Diseases and Special Hygiene of Females, by Colombat de l'lsere,
translated by C. D. Meigs, p. 272.   Philad. 1845.
  3 Pharmacologia, 4th American  from the 7th London edit.  By J. B. Beck, p. 439.
New York, 1831. 
530
MORPHIJE SULPHAS.
            R.  Morphiae pur. gr. xvj.
               Acid, citric, crystalliz. gr. viij.
                Aquae destillat. f ^j.
               Tinct. cocci, q. s.  Fiat solutio.
  Dose.—Six to twenty-four drops in the twenty-four hours.

  A Tartrate of Morphia was suggested by Mr. Haden1 as a
substitute for the liquor opii sedativus of Battley.   Mr. Haden
made it by macerating the dregs, remaining after making the tinc-
ture of opium, in a solution  of tartaric acid.   Forty drops  acted
in all respects like twenty of the liquor opii sedativus.  It neither
stimulated nor induced costiveness.
   The bimeconate of morphia has been brought before the no-
tice of the profession by Mr. Squire.2  It may be  prepared  by
adding freshly precipitated morphia, to meconic acid in solution.
It occurs in minute  crystals of a white colour, soluble in water,
—the solution giving the reaction due to meconic acid and mor-
phia.  It is an acid salt;  for meconic acid is tribasic; and in the
bimeconate of morphia, there are two equivalents of morphia, and
one equivalent of water to each equivalent of acid.3
   Impressed with  the idea, that the combination  of the active
principle of opium, as  prepared by  nature, would prove more be-
neficial as a therapeutical agent than the artificial salts, Mr. Squire
instituted a number of experiments, with the view of procuring the
bimeconate as free from the other ingredients of opium as possible;
and  he asserts, that  at length he obtained a tolerably pure salt,
which, from the trials that have  been made with  it, has fully an-
swered  his  expectations  as  to its superior medicinal power over
the other preparations of opium. - The salt is given  in  solution
made nearly of the same strength as laudanum.  The dose of the
bimeconate is gr. \ and upwards.
   Dr. Macleod, who made trial of it, asserts, that it  appeared to
him to be a very mild and  efficient  preparation, rarely producing
headach or other discomfort; and that it repeatedly answered, in
the most satisfactory  manner, where opium had disagreed, and suc-
ceeded  in some cases where other salts of morphia—the acetate
and the muriate—had failed to give relief.   Equally strong testi-
mony in its favour is afforded by Dr. A.  T. Thomson, who de-
tails three  cases—one of neuralgic pain  of the left side of the
face;  another of wakefulness, without any apparent cause, and a
third  of anomalous  pain  of the hip and thigh,  all  benefited
strikingly by its use.

   A  preparation termed M'Munn's Elixir of Opium has been

  1 Translation of Magendie's Formulary, 2d edit. By Robley Dunglison, p. 19. Lond.
1824.                     a Lond. Med. Gaz.. Mar. 9,1839.
  * Ballard and Garrod, Elements of Mat Med. and Therap. p. 406.  Lond. 1845. 
MOXA.
531
introduced into,American practice with  many testimonials  in  its
favour; but the  formula for  its preparation is kept secret; and
therefore, it merits no farther notice  here.

   M. Bouchardat1 speaks of a double muriate of  morphia and
codeia;  French,  Chlor hydrate  double de morphine et de co-
deine ou  Set de Gregory, which is  obtained directly in the pre-
paration of morphia by the process of  Dr. Gregory.  It  is not
used in France, but, he says, it is much employed in England,[?]
where it is considered to enjoy decidedly sedative properties.  It
is given  in  the same cases as the salts of morphia, from which it
differs but little.
                       CXXVI. MOXA.
Synonyme.  Moxiburium.
   By the term moxa, the Chinese and Japanese designate a cot-
tony substance, which they prepare by beating the dried leaves of
Artemisia Chinensis, a kind of Mugwort.   Dr. Lindley, however,
states, that it is made from A. Moxa.2   With this down they form
a cone, which is  placed  upon the part  intended to be cauterized,
and is set fire to at the top.   This mode of exciting counter-irri-
tation has  been long practised by the  Chinese and Japanese, and
by the ruder  nations of the old world ;  but it was not much em-
ployed in Great Britain and France until about the commencement
of the seventeenth century, when it was introduced through  the
agency of a Dutch physician3 who had resided  in India.  It fell
again, however, into disuse,  until attention was  redirected  to  it,
during the last  century, by Pouteau4  and Dujardin, and, at the
commencement of this century, by Percy and Laurent,5 and others.6
                   METHOD OF PREPARING.
   Various agents have been used by different  people, in " moxi-
bustion,"—for so the mode of cauterization has  been termed,
which consists in placing some  combustible  substance on a part
of the body, and suffering it  to burn  down.  From  the earliest
ages, the Nomades employed the fat wool  of their flocks, as well
as certain  spongy substances growing  upon oaks,7 or springing

  1 Nouveau Formulaire Magistral, p. 70.  Paris, 1845.
  2 Flor. Med. 463.
  3 Ten Rhyne,  Medit. de Veteri Medicin.; Dissert, de Arthritide, Lugd. Bat. 1672; and
Kaempfer's History of Japan, translated by Scheuchzer, vol. ii. append, sect. iv. Lond.
1728.                               * Melanges de Chirurgie, p. 49.
  s Dictionnaire  des Sciences Medicales, art. Moxibustion.
  6 See, for a history of the Moxa, the author's translation of Baron Larrey's Memoir on
the Use of the Moxa.   Lond. 1822.
  ' Hippoc. lib. de Affect cap. xxx. 
532
MOXA.
from  the hazel:1 the  Indian, the  pith  of  the  reed,2 and flax or
hemp impregnated with  some combustible  material ;3 the Persian,
the dung of the goat; the  Armenian, the  agaric of the oak; the
Chinese and Japanese, the down of the artemisia; the Thessalian,
dried moss ;*  the Egyptians, the Arracanese, and several oriental
nations, cotton ;s the Ostiaks3 and the  Laplanders,7  the agaric of
the birch;  and the aborigines of  this continent, rotten  and  dried
wood.   Hippocrates8 was in the habit of.employing fungi and flax
for the same purpose.
   In modern times, also, various substances  have been used for
the fabrication of moxas.   Whatever  article is  selected, it ought
to be a spongy, light,  vegetable matter; readily  combustible, and
so prepared as to burn down slowly.   In Germany, they use the
tinder—amadou—which is known to be  an  agaric prepared for
the purpose;  and it is not uncommonly employed in our hospitals,
—a small  disc  or cylinder being placed on the part, and  set fire
to.   It has  been generally used in the French  hospitals.9   The
 match  used  by  artillerists  was  recommended by Percy,10 after
 Bontius:11 it is composed of hemp steeped in  a solution of nitre.
 He likewise proposed the pith of the sun-flower—helianthus an-
 nUus—recommending that the stalk should be cut into cylinders
 of the  desired length, the bark being left on; so that, when ignited.
 it may burn in the centre and  be  held with the  hand.12  This he
 called  moxa  de voleurs.13   These moxas, called Percy's moxas,
 prepared by Robinet,  are found in the London shops.   They con-
 sist of  pith, rolled in cotton and enveloped in muslin.14
   The moxa, used  by Larrey,  and very  generally employed by
 many practitioners, is made by taking a quantity of  cotton wool,
 pressing it. somewhat  closely together, and  rolling over it a piece
 of fine linen, which is fastened  at the side  by a few stitches.   Lar-
 rey advises, that it should  have the shape of  a truncated  cone—
 the form usually adopted—and be about an inch long.  Commonly,
 the  cylinder is shorter than  this; six or  eight lines—as, when
 above  six lines high,  the combustion  is not felt—and about four
 or five lines broad.  The moxas employed  by Dr. Sadler,15 of St.

   > Paulus ^Eginet. lib. vi. cap. 49.                         ^
   3 Ksempfer, vol. ii. app. sect. iv. p. 36.       3 Bontius, De Medicina Indorum, p. ii.
   1 Percy in Pyrotechnie Chirurgicale Pratique, p. 12.
   ! Prosper. Alpin. de Medicina iEgyptiorum, lib. iii. cap. 12.
   6 Voyages de M.  Pallas, iv. 68.                                       .
   ' Acerbi's Travels through Sweden, Finland, and Lapland, ii. 291; and Linnaeus,  n.
 Lachesis Lapponica, translated by Sir James Smith, i. 274.      8 De Affect, cap. vin.
   8 Bulletin General de Therapeutique,  Juillet, 1840.
   10 Op. cit. p. 77.  Paris, 1811.           # ,   " Op. cit. p. 32.  Pans, 1645.
   13 Art. Moxibustion, in Diet, des Sciences Medicales.
   13 Merat and De Lens, Diet, de Mat. Med. art. Moxa.
   " Pereira, Elements of Mat. Med. 2d edit. p. 1352.  Lond. 1842; or 2d Amer. edit.
 by Carson.  Philad. 1846.                         ..  .  , .   n u- u   l F„r
   15 Zeitschrift fiir die gesammte Medicin.'B. iii. H.u. & m., cited in  British ana r or.
  Med. Review, July, 1837, p. 217. 
MOXA.
533
Petersburg, are about half an inch in diameter; and three-quarters
of an inch in height.  They are composed of  a nucleus formed of
the pith of  the sun-flower wrapped in layers of cotton of various
thickness, and surrounded with an external envelope of thin mus-
lin ;  both of the latter beiri£ previously steeped  in  a solution of
nitre.   They are held,  while  burning, by  means  of two long
hair-pins, the legs of which  are slightly bent, in  order to  accom-
modate them to the shape of the moxa; and when  the latter is
burned down to the place where it is held by the first hair-pin,
it can be held with  the other, and retained in its proper position.
   With this last view, Larrey1 has a special porte-moxa, consist-
ing of a ring to receive the cylinder, with a handle attached to it,
and  three  small supports or knobs of ebony, placed  beneath the
ring, to prevent the heated  metal from  acting upon the surface.
Mr. Leney2 soaks a piece of lint in a strong solution of nitrate of
potassa, dries it, and cuts off pieces of the size of the thumb nail,
which he fastens with thin adhesive plaster over the seat of pain;
sets fire to  the opposite extremity, and then applies the blow-pipe.
The pain during the process is very severe, but he  affirms, that
the  Irish prefer it greatly to the application of a blister.  Pro-
fessor Grafe3 employs moxas made  of  wafers, dipped in a mixture
of three parts of oil  of turpentine, and  one part of sulphuric ether.
Before applying this inflammable matter to  the  skin, it is neces-
sary to remove carefully  the superfluous liquid.  These moxas are
said  to ignite  readily, burn promptly and uniformly, and not to
crepitate.
   A plan for raising vesication on the  surface  has been adopted,
which, as Dr. Granville  remarks, must be regarded  as a  kind of
moxa.4  This  he admits to be equally successful with the one he
proposes, and which has  been already described (p. 248,) in form-
ing a rapid vesication : " but it is, at the same time, so complicated,
and  attended by such intense pain," that, in  practice, he  says, it
will not bear  comparison with the preparations  which he recom-
mends.  A piece of linen or paper, being cut  of the requisite size,
is immersed in spirit of wine, or brandy.   It  is then  laid  on  the
part to be blistered, care being taken,  that the moisture  from  the
paper or linen does not wet  the surrounding  surface.  The flame
of a lighted taper is applied quickly over the surface, so as to pro-
duce a general ignition, which is exceedingly rapid.   At the con-
clusion of  this operation, the cuticle is found detached  from  the
true skin beneath.  In cases of convulsions, the region of the spine
has been treated in this manner, and with good effects.5

   1 The author's translation of his Essay .on the Moxa, p. 5.
   8 Lond. Med. Gaz., July 15, 1842.  '   3 La Lancette Franeaise, 26 Jan., 1839.
   « Counter-irritation, its Principles and Practice, Amer. Med. Library edit., p. 21 and
p. 42.  Philad. 1838.
   5 C. J. Edwards, in Provincial Med. and Surg. Journal, Jan. 1842. 
534
MOXA.
  Dr. Osborne, of Dublin,1 avails himself of the high temperature
produced by lime in the act of slaking, for the purpose of a moxa.
Some quicklime in powder is placed to the  depth  of about half
an inch within a strip of card, bent  and tied so as to form a cir-
cle.   Water is then dropped  on the lime, and mixed with it.  In
about two minutes, it swells,  and becomes dry; and, at  the same
time, a degree of heat is produced, which—according to some ex-
periments—may amount to 500° Fah.   He  considers this moxa
superior to all others;—first, from the  intensity of the heat, and
secondly, from  its convenience,—not requiring the  assistance of
any  heated  substance, and being unaccompanied  by the emission
of sparks or smoke, which frightens the patient.  When the quan-
tity  of lime used is smaller than that mentioned above, or if it be
not kept on long, an appearance results, resembling that produced
by acetic acid; and a  thick crust is formed, which separates as the
new skin  is  perfected beneath.  But  if the quantity of  lime be
large, and it be kept on as long as the heat continues, a complete
destruction of the skin ensues; and in this manner issues  may be
made of greater depth, and in a much shorter time, than by the
usual cauterants.  Dr. Osborne gives a case of apparent ulceration
of the upper part of the rectum and sigmoid flexure of the colon;
in which all the symptoms of internal ulceration disappeared after
the application of a lime moxa, of about the size of a crown, over
the region of the sigmoid  flexure.  In a case of incipient soften-
ing  of tubercles; and in another apparently of purulent infil-
tration  after pneumonia, its  effect  in arresting the  ulcerative
process was  most decided.   In a case  of hip-joint  disease, in
which there was great pain, and consequent loss of sleep, the pa-
tient slept well  on the following night, and, in  a  few days, had
gained much power over  the  limb;  and in  another case of the
same disease, which had proceeded to destruction of the joint, and
extensive enlargement pf the parts around  it, great  relief  was ob-
tained.   The size of the ulcer formed by it is always much larger
than that of the lime applied.   When  the lime is prepared from
calcareous spar, the heat, produced  on the addition  of water, is
sudden and intense, and the pain is proportionably urgent.  For
ordinary purposes, however, well selected  pieces  of lime from a
lime-kiln answer well if fresh, but not otherwise.
  In the application  of the various  moxas, or of most of them,
their agency can be so graduated as  to produce either simple ru-
befaction, vesication or the formation of an eschar.  Where it  is
desirable to produce the first result only,  the cylinder of cotton
may be removed when the pain becomes somewhat severe; or the
burning material may be held  close to the  surface, and  be moved
gradually along it. In this manner, a counter-irritant effect may
' Dublin Journal of Medical Science, Jan. 1842. 
NARCOTINA.
535
be exerted along the spine or any extensive surface.  Any burn-
ing substance—a lighted coal, for example—will  answer for  this
purpose.  When vesication is needed, it must be kept on longer;
and if it be desirable to produce an eschar, the moxa may have to
remain on until it  is wholly consumed.  Larrey,1 indeed, advises,
that the blowpipe  should  be  occasionally  employed to hasten the
combustion.  When the integument has once become disorganized,
the slough will be thrown off in due time, leaving an ulcer.   Lar-
rey says the sloughing can be prevented by the application of liquid
ammonia 2 to the burnt surface, after the moxa has been removed.
This  will do when the  disorganization is partial; but we know,
from  experience, that it often fails.
           EFFECTS  ON THE ECONOMY IN DISEASE.
   Moxa—in its  different forms—is doubtless  a most valuable
agent, when rapid counter-irritation is indicated.  It resembles,
indeed,  in its action, the ammoniated counter-irritants of which we
have  already treated,  and is applicable to the same diseases;—the
only difference  between  them—when cauterization is effected—
being, that the agent in the case of the ammoniated lotion is a po-
tential,  in that  of moxa an actual, cauterant.
   The  moxa must be regarded as one of our most valuable re-
vellents.
                   CXXVII.  NARCOTINA.

 Synonymes.  Narcotinum, Narcotin, Narcotine, Opiane, Matter or Salt
  of Derosne.
 French.  Matiere ou Sel de Derosne, Sel Essentiel d'Opium.
 German. Narkotin, Opian,  Deros ne'sches Opiumsalz.

  In regard to the precise properties of this substance, which is
 one of the immediate principles of opium, and has attracted  the
 attention  of many chemists and therapeutists, much  uncertainty
 exists.  It seems, that it  has  not  hitherto been found  except in
 opium.
                   METHOD OF PREPARING.
  It is commonly  obtained, either  from crude extract of opium,
 by means of ether, which  only dissolves the narcotina, and con-
 sequently  requires  but to be evaporated to obtain it; or from crude
 opium,  which has been  exhausted  by cold water: it may hence be
 obtained  from the residue after the preparation of the aqueous
extract  of opium of the shops.  With this view, the opium or re-
sidue is twice treated with boiling acetic acid at 2° or  3°; it is pre-
cipitated by ammonia, and the washed  precipitate  is  purified  by
treating it with hot alcohol at 40°, and a little animal charcoal;
1 Op. citat. p. 5.                  3 Ibid. p. 9. 
536
NARCOTINA.
the liquid is then filtered, and the pure narcotina is precipitated on
cooling.
   It  crystallizes in very  white  needles;  is devoid of taste  and
smell; fusible in the manner of resins, and  very slightly soluble in
wrater; soluble with the aid of heat in alcohol, and in the volatile
and fixed oils; very soluble in  ether, which  distinguishes it from
morphia; very soluble also in cold acetic acid, whence it is pre-
cipitated on heating the solution—another mode of separating it
from  morphia—and soluble in  dilute acids.   It  is coloured  of a
vivid red by nitric acid; and is analogous,  in some respects, to the
crystallizable resins or sub-resins of M. Bonastre.1
   Narcotina is generally reckoned amongst the vegetable alkaloids;
but by some it is considered to be neuter.2  Dr. Christison3 states,
that " opium contains no fewer than seven crystalline  principles;
—morphia, codeia, and paramorphia, narcotin,  narcein, porphy-
roxin and meconin, of which the first three are alkaline and  the
others neutral."
   Dr. O'Shaughnessy 4 prepares muriate of narcotina by taking of
Bengal opium, two pounds; Alcohol, 20 pounds.  These are rubbed
together in a large mortar, adding the spirit by degrees, until the
opium is exhausted of its  soluble parts.   The solution is then de-
canted, and the insoluble portion pressed. To the alcoholic solution
as much ammonia is  added as renders  the liquid slightly turbid.
Fifteen pounds of the alcohol are then distilled from a common
alembic;  and the fluid in the still is  drawn  off, and set aside to
cool.  On cooling, a  mass of coloured crystals is  deposited, com-
posed of narcotina, meconate of  ammonia,  and  resin.  This is
washed with water, which dissolves the meconate of ammonia, and
afterwards with  a  quart of water and  a dram of muriatic acid,
which dissolves the narcotina and leaves the resin.  The solution
is then filtered, and evaporated to dryness.
   Muriate of narcotina, thus prepared,  is  a transparent resinous
mass, of rosy colour, and  brittle vitreous  texture.   It is  very
soluble in distilled water and  spirit; and its salts  are intensely
bitter.
          EFFECTS ON THE  ECONOMY  IN  HEALTH.
   These  have been so contradictory, that  it has been conceived
the same preparations cannot have been  used by different obser-
vers.5  According  to Magendie,6 morphia  is the anodyne prin-
ciple of opium, and narcotina the exciting.   Wrhen a grain of nar-
cotina dissolved in oil was given  to a dog, it  produced a state of
stupor, which superficial  observers might readily confound with
  1 Merat and De Lens, Diet, de Mat. Med. art. Narcotine.
  a Christison, Dispensatory, Amer. edit. p. 702.  Philad. 1848.
  3 Ibid. p. 701.
  * Calcutta Quarterly Journal, and Lond. Lancet, July 20, 1839, p. 606.
  8 Ibid, and Diet, des Sciences Medicales, xxxiv. 298.
  6 Formulaire pour la Preparation, &c, de plusieurs nouveaux Medicamens. 
NARCOTINA.                      537
sleep;  but  it  differed evidently  from sleep;  the animal's eyes
were open;  the respiration was not deep, as in sleep, and it was
impossible   to  arouse  it from its  sluggish condition.   Death
generally took  place in twenty-four hours.   When combined with
acetic  acid, it  produced quite different  effects.   Animals could
bear a dose of even twenty-four grains without dying, and, whilst
under its influence, they were  agitated by  convulsions like those
which  camphor induces—exhibiting the same signs of fright, the
same backward motions, foaming  at the mouth, convulsions of the
jaws, &c.   When morphia and narcotina  were both given at the
same time, the different effects of each occurred together.  A grain
of morphia, for example, and  a grain  of narcotina, dissolved  in
acetic acid,  were placed in the pleura of a dog.   The animal soon
became drowsy, and fell asleep under the influence of the morphia ;
but a singular and remarkable strife appeared to go on for an hour
and a half,  between the stimulating effects  of the narcotina  and
the anodyne effects of the morphia.   At length, however, the ani-
mal slept soundly, being probably, Magendie suggests, under the
influence of the  morphia alone.   His opinion is, that narcotina is
injurious when not united with an acid,  and very exciting when
so  united.  M. Orfila—the celebrated  toxicologist—has  enter-
tained, it appears, various views upon the action of narcotina; at one
time considering it inert, at another to possess the same action as
morphia; and at another, to concur, when combined with morphia,
in the  properties of opium, but to a  slight  degree—since opium,
deprived of narcotina, is not  less deleterious—and to possess  a
different modus operandi from  opium, without, however, our being
able to regard  it as the exciting principle.1
  Owing to all these uncertainties connected with it, narcotina is
little  if  at  all  employed in medicine.  It would seem, however,
that the exciting properties of opium do not appertain exclusively
to it; for, as has been elsewhere remarked, there are many persons
who are as  disagreeably affected by morphia alone as they are by
opium, which contains both morphia and narcotina.
  The  salts of narcotina—the muriate  and the sulphate—have
been employed successfully as  antiperiodics, especially in intermit-
tents,2 and Dr.  O'Shaughnessy3 has laid before the Medical Society
of Calcutta the results of  his experience  with them.  Sixty cases
were treated, of which all but two were  successful.   He remarks
farther,  that, besides the sixty cases recorded, more than  one hun-
dred ague patients had been treated by his pupils and acquaintances
with perfect success by the remedy.
  1 Merat and De Lens, op. cit., and Orfila, Toxicologic Generate, ii. 69.
  1 Roots, London Lancet, Sept. 1832, and T. W. Jeston, ibid. Oct. 6, 1832, p. 41.
  ! India Journal of Medical Science, Sept. and Nov. 1838, cited in British and Foreign
Medical Review, No. xv. for July, 1839, p.  263. 
538
NUX VOMICA.
                  CXXVIII. NUX  VOMICA.

 Synonymes. Vomic Nut, Poison Nut, Bachelor's Buttons.
 French. Noix Vomique.
 German. Krahenaugen, Brechnuss.

        EXTRACTUM NUCIS VOMICAE ALCOHOLICUM.
 Svnonymes. Extractum Nucis Vomicae Resinosum seu Nucis Vomica?
   Spirituosum, Spirituous, Resinous or Alcoholic Extract of Nux Vomica.
 French. Extrait Alcoolique de Noix Vomique.
 German. Geistiges  Extrakt der Krahenaugen.

   In the year  1809, Magendie discovered that one entire class of
 vegetables—the bitter strychnos—has  the power  of exciting  the
 spinal marrow without implicating, except indirectly, the functions
 of the brain.1   Since then, many have  confirmed the observations
 of Magendie, and have attended especially to its agency in various
 diseases.   The preparation of the strychnos most  used, if we ex-
 cept the active principle—has been  the alcoholic extract of the nux
 vomica.
                   METHOD OF PREPARING.
   Take any quantity ofrasped nux vomica; exhaust it by repeated
 macerations in alcohol of 40° (.817,) and evaporate it slowly to the
 consistence of an extract.   Alcohol of  less strength may  be used,
 but, according  to Magendie, the product will be  proportionally
 less active.   A dried alcoholic extract  is made by dissolving in
 water the alcoholic extract made by means of alcohol at 36° (.837;)
 filtering and  evaporating in appropriate dishes, as  in making the
 dry extract of  bark.
   The Extractum Nucis  Vomicae of the Pharmacopoeia of the
 United States is directed to be prepared as follows:—Take of Nux
 vomica, a pound; Alcohol, a sufficient quantity.  Expose the nux
 vomica  to steam till it is softened, then, having sliced and  dried it,
 grind into powder.  Introduce it into  an apparatus for displace-
 ment, and pour alcohol  upon it  gradually until the  liquid passes
 without bitterness.  Distil off the greater part of the'alcohol from
 the filtered liquor, and  evaporate  the residue to the proper  con-
 sistence.2
                  EFFECTS ON THE ECONOMY.
   According to Magendie, a grain  of this extract, absorbed from
 any part of the  body, or mixed  with food,  promptly destroys a
dog of considerable size,  by inducing paroxysms of tetanus, which,
 by their continuance, arrest respiration  sufficiently  long to induce
complete asphyxia.   When the dose is much stronger the animal

 ' Examen de Taction de quelques vegetaux sur la moeT.e epiniere. Paris, 1809; and
 Pormulaire, &c.
 * Pharmacopoeia of the United States, p. 352.  Philad. 1842. 
NUX VOMICA.
539
appears to die entirely from the action of the nux vomica on the
nervous system.1  If an animal be touched whilst under the action
of the substance, it experiences a commotion similar to that  of a
strong electric shock, and  this takes place each time the contact is
renewed.   On dissection,  no morbid appearances exist which can
account for death.   When introduced into the frog's stomach, Dr.
Lombard,2 of Geneva, found, that it produced tetanic convulsions,
which, in a few hours, caused death.   The contractions of the  heart
were sometimes strong and complete, sometimes irregular, tumul-
tuous  and  intermitting;  always diminished  in  frequency.   Ap-
plied to the heart itself, it slightly stimulated it, rendering the pul-
sations more energetic  and frequent,  whence Dr. Lombard con-
cludes, that nux vomica cannot be used with advantage in any
diseases of the heart; for, although it diminishes the frequency of
the pulsations, it renders  them irregular.
   The action of the extract on healthy man is the same  as that
described by Magendie, and if the dose be sufficiently large,  death
speedily follows with the  same symptoms.3   In those that are af-
fected with paralysis, the  effect is also the same; but, what is sin-
gular, it is particularly manifested in the paralyzed parts by tetanic
convulsions, and a feeling  of creeping, which indicate the operation
of the remedy; and a local perspiration is also often observed to  break
out on some parts of the body.  When administered  in  cases  of
hemiplegia, the  contrast between the twro sides of the body is ren-
dered striking:  whilst the sound side remains at  rest, the  other
may be violently agitated; tetanic shocks may  supervene, and  a
copious perspiration break out.  In a female, Magendie  saw the
affected side covered by a peculiar eruption, whilst  the other side
afforded no trace of it.   There is a difference even between the two
sides of the tongue, a decidedly bitter taste being occasionally per-
ceived on the one, whilst  the other exhibits nothing similar.   If a
much larger dose be given, both sides of the body participate, but
unequally, in the tetanic  spasms, so that the patient is sometimes
thrown out of  bed  by  the violence of the contractions.   When
given in very small doses,  it has no perceptible effects immediately,
and some days elapse before its advantageous or noxious properties
can be  appreciated.
   x^ccording to Magendie,4 the extract  may be given in all dis-
eases that  are  attended with debility,  general or local, and in
paralysis of all kinds,  general or partial.   He himself  observed
excellent effects from it in debility of the genital organs, inconti-
nence of urine, &c.   He  also used  it with advantage in several
   1 Srgalas, in Journal de Physiologie, par Magendie, Oct. 1822.
   1 Gazette Medicale de Paris, 18 Oct., 1835.
   • Sec the details of two cases of poisoning by nux vomica, in Lond. Med. Rep. xix.
448 and 456; Christison on Poisons, and Brande, Diet, of Mat. Med. p. 375. Lond. 1839.
See also, A. S. Taylor on Poisons, Amer. edit, by R. E. Griffith, p. 620.  Philad. 1848.
   ' Formulaire pour la Preparation, &c, de plusieurs nouveaux M6dicamens, &c. 
540
NUX VOMICA.
cases of partial atrophy of the upper and lower extremities.   As
regards its administration in  cases of paralysis succeeding  to
apoplexy, he remarks, that it should not be given until some time
after the coup de sang in the brain, which occasioned the palsy;
and  that even then beneficial results can  be expected only when
no marked organic  mischief  exists:  indeed, in  the latter  case,
he considers the disease  irremediable, and that bad  effects might
result from pushing the remedy.   The efficacy of the alcoholic
extract of nux vomica in various forms of paralysis  has been con-
firmed by many observers.   Even  before Magendie had employed
it, Fouquier1 had  given  it in several cases, with the  most satisfac-
tory results.  Since  then, we  have the testimony of Chauffart,2
Gendron,3 Perrussel, Recamier, Mauricet, Baxter,4 Galli, Hauff,
Wenneis, Burkard, Petrequin,5 Gellie,6 Debreyne,7 and numerous
others in its favour.  The author's own experience with it in cases
of hemiplegia has not been limited; yet although he has succeeded
in inducing tetanic movements in the limb, he has not been satis-
fied  that much advantage was derived  from it;8 and in some cases,
it appeared to induce serious encephalic  excitement.   After effu-
sion  has  occurred into  the encephalon, time  is  required for its
absorption,  and but little beneficial agency can be expected  from
any  remedy.  Nor are the results of the experiments and obser-
vations of Jahn by any means in accordance  with those of the
practitioners above mentioned.  He  tried it in  numerous cases of
paralysis, but affirms that he  did  not see any good  effect from
it; and, with the exception of two cases, did not notice the slightest
action, although the extract was carefully prepared according to the
formula given by Magendie.  Yet, he remarks, he was by no means
sparing in the dose.  In the two cases in which a change seemed
to be induced, there was  an evident increase of the paralysis.  This
discrepancy, as well as other evidences of the same contrariety of
experience, may doubtless have been partly owing to difference in
the strength and quality of the preparation;  and hence, according
to some, the great value of strychnia—its active principle—which
is not liable to so much  uncertainty.9  Dr. Christison,10 however,
affirms, that " there  seems no particular  reason why the  powder
and  extract should have been displaced by the principle strychnia;
for their effects are precisely the same;  and the  principle is not

  ' Bulletin de la Faculte de Medecine, &c, vol. v. 1818.
  a Journ. Gener. de Med, Oct. 1824.                   3 Ibid. Nov. 1829.
  * New York Medical Repos. vol. viii.
  6 Gazette  Medicale de  Paris, 27 Oct. and 3 Nov., 1838, and  Bulletin General de
Th6rapeutique, Mars, 1840.           6 La Lancette Francaise, 29 Aout, 1837.
  1 Braithwaite's Retrospect, Amer. edit. x. 26.  New York, 1845; cited from Med.
Chir.  Review, Oct. 1844, p. 384-396.
  8 See the  author's Practice of Medicine,  3d edit, ii, 167.  Philad. 1848.  Also,
Chauffart. in op. cit.
  9 Richter's Specielle Therapie, u. s. w. B. x. S. 352.  Berlin, 1828.
 "° Dispensatory, p. 658.  Edinb. 1842. 
NUX VOMICA.
541
only troublesome  to  prepare, but likewise, being seldom pure, is
liable to  the  objection of  irregular strength, which is  brought
against  the Galenical preparations of the drug.
   In cases of partial paralysis, as in colica pictonum, amaurosis,1
palsy of the rectum, &c, both the alcoholic extract of nux vomica
and its active principle have  been used with good effect.   (See
Strychnia.)   M. Barez3 affirms, that he has succeeded in readily
removing prolapsus ani in the  young, after diarrhoea, &c, by
means of an  aqueous solution  of nux  vomica.  Four scruples of
salep are  boiled for twenty minutes in three ounces and a half of
water, and after straining, three-fourths of a grain of the aqueous
extract  of nux vomica are added.   A spoonful of this mixture is
given at intervals, so that the whole is taken in twenty-four hours.
It need  hardly be said that in  the  case of young  children, this
potent article should be used with great caution.
   It has been given with  good results  by M. Duclos,3 in impo-
tence and spermatorrhoea.   He divides seventy-five grains of  the
alcoholic extract  into one hundred pills.  During five  days, he
gives one every night; then, for five days more, one, morning and
night;  for five days more,  two,  night and morning; and for five
days more, two at morning, and three at night, until four are taken
night and  morning.   The liniment, for which a formula  is  given
hereafter, rubbed  on the loins, and on the inside of the thighs, is
a useful  auxiliary.
   Dr. Cerchiari4 treated two cases of incontinence of urine suc-
cessfully with the extract.   The first  was that of a girl nineteen
years of age—who, from  her infancy, had passed  her urine  in-
voluntarily every  night in her  sleep.  She was ordered  the  third
of  a grain of  the  extract  in pill, three times a day;  and in  eight
days the cure was complete.   The second  case was that of a
young married female, whose  urine flowed involuntarily, day and
night, after her first delivery.   As there was no fistulous opening
to account for the involuntary discharge, and it appeared to arise
from weakness of the neck of  the bladder, in  consequence of con-
tusion by the  head of the  child, the extract was administered in
the same doses as in the preceding  case, and  in fifteen days  the
cure was complete.   Mondiere,  in cases of incontinence of urine,
dependent upon atony, prescribed it advantageously in association
with black oxide of iron ;5 and M. Petrequin6 found, that  local

  ' Petrequin and Miquel, in Bulletin General de Therapeutique, Juillet, 1838.  De-
freyne, op. cit.
  * Journ. de Medecine, July, 1845, cited in Edinb. Med. and Surg. Journ. July, 1846,
p. 2r>6.
  ' Bulletin de Therapeutique, xxxvi.  529-33; cited in Brit, and For. Med. Chir.,
Oct. 1849, p. 564, and in Bouchardat, Annuaire de Therapeutique pour 1850, p, 24
  • Gazette Medicale, 14 Avril, 1838.
  8 Bouchardat, Annuaire de Therapeutique pour 1841, p. 8.  Paris, 1841.
  6 Bulletin General de Therapeutique, Mars, 1840.
        35 
542
NUX VOMICA.
anaesthesia or loss of sensibility in a  part yielded, in numerous
instances, to embrocations of the tincture referred to hereafter.
   Cazenave gave the extract successfully in a case of St. Vitus's
dance,  which  had resisted  every  other remedy;  and Professor
Trousseau  relates several cases of cure, from the employment of
the alcoholic extract in the dose of about three-quarters of a  grain;
or of strychnia, in the dose of one-sixth of a grain.   Sir Charles
Scudamore, M. Roclants,1 and  Mr. Pidduck,2 found it useful in
neuralgia,  the former in neuralgia faciei especially.   Vogt gave
it—not  without advantage—in cardialgia; Hildenbrand, in epi-
lepsy:  by the Russian and Polish  physicians it  was  administered
advantageously in cholera  diarrhoea,  and by  many it has been
strongly advised in  chronic diarrhoea  and dysentery,2 as well as
in dyspepsia, in the varieties termed pyrosis and  gastrodynia,
especially  when they appeared  to  proceed from morbid irrita-
bility of the nerves of the stomach,* as in the vomiting of the
pregnant female?   The  addition of a small  portion of the ex-
tract has been suggested by M. Boult as  a remarkably powerful
adjuvant to cathartics.   He generally prescribes it in pill, accord-
ing to the  formula given hereafter; and Dr. Ranking6 affirms,that
he has been in the habit of combining strychnia  with an aperient
extract, with considerable advantage,  in habitual constipation.
Two cases of obstinate constipation are recorded by M. Ossieurs,7
which,  after having resisted other means, yielded at  once to nux
vomica.  Recently, Mr. C. F. Gream8  employed it, at the sug-
gestion  of  Mr. Hammerston, of St. George's Hospital, London,
in the  cure of hay fever—summer  bronchitis, with the best
effects.  He gave the tinctura  nucis vomicae of the Dublin  Phar-
macopoeia  in doses of ten drops, gradually increased to  twenty,*
three times a day; at the same time applying to the  lining  mem-
brane of the nostrils, as high up as possible, an ointment composed
of  a dram  and a half of Goulard's extract, two ounces of
spermaceti cerate,  and a few drops  of oil of bergamot.   (See
the article Strychnia.)

  1 Med-Chir. Review, from Edinb. Med. and Surg. Journal, Oct. 1843.
  * London Med. Gazette, Aug. 7, 1840.
  3 Most's Encyclopadie, 2te Auflage, art. Dysenteria, i. 573.  Leipz. 1836.  Geddings,
N. American  Archives, No. 2, Nov. 1834. Roots, in St. Thomas's  Hospital Reports,
No. iii. for April, 1836; Hufeland, in Bally, Bulletin General de Therapeutique. Fev.
1838; and Nevin3, Lond. Med. Gaz., Dec. 15,1848.
  4 Mellor, in  Med. Gaz., March 4,  1837, p. 850.   H. S. Melcombe, ibid. March 25,
1837, p. 964;  cited in Amer. Med. Intel. July 1, 1837, p. 124; and M. Huss, in Zeit-
schrift fiir die gesammte Medicin. May, 1837, p. 393, cited in Amer. Med. Intelligencer,
Aug. 1, p. 162.
  5 Kroyher, cited in Annuaire de Therapeutique, pour 1842, par Bouchardat, p. 3J.
Paris, 1842.
  6 Half-Yearly Abstract, &c, from July to December, 1848, p. 215.
  'Med. Times, May 26, 1849.
  ■ Lancet, June 8, 18C0. 
NUX VOMICA.                    543
                  MODE OF ADMINISTRATION.
   The best  form for exhibiting the alcoholic extract of nux vo-
 mica, according to Magendie, is  in pill, when we are desirous of
 inducing the tetanic convulsions.  Each pill may contain a grain.
 One or two pills may be given at first, and the dose be daily aug-
 mented until the  required effect is induced.  It may then be  dis-
 continued, to avoid accidents.   It is better, he thinks, to give the
 pills in the evening, as night is the most favourable time for ob-
 serving the  phenomena we are  desirous of inducing.  It is some-
 times  necessary to increase the dose  to twenty or thirty grains,
 before the tetanic effects  supervene, but commonly from  four to
 six grains are  sufficient.   Esquirol saw two cases, in one of which
 death took  place after eighteen grains; in  the  other, after five:
 the  stomach  and bowels were found  inflamed.   Dr. Elliotson
 began with  half a grain of a well prepared extract, and increased
 the dose  every day,  or every other day, by a quarter of a grain;
 but none  of the patients bore a greater quantity than seven grains,
 and few  more  than four.   If, from any cause, the administration
 of the remedy has been interrupted for some days, it is necessary
 to recommence with  the small doses, and to increase them gradu-
 ally as before.  When  it is  desirable to produce  only the  slow
 effects of the  remedy, a grain or half a  grain daily is  sufficient.
 M. Petrequin1 begins with one-eighth of a  grain for a dose, and
 gradually increases it to two, three, and even  five  grains in the
 course of the day.
   Magendie directs a tincture to be made from  the extract—the
 Tinctura Nucis Vomicae,  T. Strychnos, T. Nucum Vomica-
 rum, which has been introduced into, some of the pharmacopoeias.
^It is made by taking three grains of dried alcoholic extract of
 nux vomica, and dissolving it in an ounce of alcohol at 36° (.837.)
 It: is given by  drops,  and in mixtures,  in those cases in which the
 alcoholic  extract itself is indicated.  M. Petrequin3 also employs
 a tincture of nux vomica,  which he prepares with  four ounces of
 the powder and  a quart of brandy.   This is used  altogether ex-
 ternally as an  embrocation to, and around, palsied parts.   The
 tinctura  nucis  vomicae of  the Dublin  Pharmacopoeia is made of
 two ounces  of rasped nux vomica to  eight ounces of rectified
 spirit, (alcohol.)
            Tinctura nncis vomica)  composita.
              Compound tincture of nux vomica.
             R. Extract, nuc. vomic. alcohol,  gr. xxiv.
                Camphorae gj.
                Tinct. pyrethri f gj.  M.
   Dose.—Twenty drops,  four  times  a  day, with  arnica tea, in
 cases of paralysis.                                    Vogt.
               1 Op. cit                    a Op. citat. 
544                      NUX VOMICA.

            R. Tinct. nucis vomicae,
               ----cantharid.
               Naph. phosphorat.' £)ij.  M.

   Dose.—Thirty drops, three or four times a day, with arnica tea,
in the paralysis of torpid subjects.                   Vogt.

                  Mistura   nucis  vomicae.

                   Mixture of nux vomica.

            R.  Extract, nuc. vomic. alcohol, gr. ij.—iv.—vj.
                Mucilag. acac. f gss.
                Aquas melissae f §vj. M.

   Dose.—Two spoonfuls, every two hours, in epilepsy.
                                              Hildenbrand.
   A similar form is recommended by Richter3 in dysentery.  Two
table-spoonfuls every two hours.

            R.  Tinct. nucis vomicae gtt. ij.
                Aquae lauroceras. s;j.  M.

   Dose.—Ten  drops every morning and evening  in the vomit-
 ing of pregnancy.                                Kroyher.

                   Pilulae  nucis  vomicae.

                     Pills of nux vomica.

            R.  Ext. nuc. vomic. alcohol. Qj.
                Ext. glycyrrhiz. 9vij.
       Misce et fiant pilulae lxxx.

   Dose.—Two to six, two or three times a day, in paralysis.

            Pilulae  nucis   vomicae  ferruginosae.

               Ferruginous pills of nux vomica.

            R.  Extract, nucis vomic. alcohol, gr. vj.
                Ferri oxid. nigr. £j.  M.
                  et divide in pil. xxiv.

   Dose.—Three, daily, in incontinence of urine dependent upon
 atony.                                           Mondiere.

             Pilulae  nucis  vomicae et  quiniae.

               Pills of nux vomica and quinia.

            R.  Ext. nucis vomicae gr. xij.
                Quiniae sulphat.
                Ext. hyoscyam. aa. gr. xxiv.   M.
                  et fiant pil. xxiv.

    Two to be taken an hour before meals, in gleet.
                                                Ch. Johnson.

   ' Naphtha phosphorata, JEther sulphuricus phosphoratus, is  made by dissolving
 twenty-eight grains of phosphorus in four ounces of rectified ether.
   2 Die Specielle Therapie, ii. 133.  Berl. 1821. See, also, Joy, in Tweedie's Library
 of Medicine, v. 296.  Lond. 1840; or 2d Amer. edit.  Philad. 1842. 
                   OLEUM JECORIS ASELLI.                545

            Pilulae  nucis  vomicae  et aloes.
               Pills of nux vomica and aloes.
           R.  Nucis vomicae gr. ss.
               Aloes
               Ext. rhei aa. gr. §.  M.
                 et f. pilula.
  Dose.—One at bed time, as a cathartic.  To increase its chola-
gogue power, a grain of calomel may be added.        Boult.

                 Pulveres  nucis vomicae.
                  Powders of nux vomica.
           R.  Ext. nucis vomicae alcohol.
               Bismuth, sub-nitrat. aa. gr. ss.
               Magnes. carbonat. gr. iij.
               Sacch. gr. xv.
               01. menth. pip. gtt. ij.
      Misce, et fiat pulvis.
  Dose.—One every three hours, in cramp of the stomach.
                                                   Vogt.
           R.  Nucis vomic. pulv. gr. iij.
               Acaciae,
               Sacchar. aa. gr. xij.  M. et fiat pulvis.

  Dose.—One of these powders to be repeated according to cir-
cumstances during the twenty-four hours, in diarrhoea and dysen-
tery.                                         Hufeland.

       Linimentum  nucis  vomicae compositum.
            Compound liniment of nux vomica.
           R.  Tinct. nucis vomicae
               ----arnicae seu
               ■---■ melissa? aa. partes lx.
               ----lyttae part. xv.  M.
  To be rubbed on the loins and inside of the thighs in impotence
and spermatorrhoea.                              Duclos.

               Embrocatio nucis  vomicae.
               Embrocation of nux vomica.
           R.  Tinct. nucis vomicae f ^j.
               Liquor, ammon. f ^ij.  M.
  To be rubbed on the paralyzed limbs, and on the surface, in
cholera.  See Strychnia, and its preparations.
           CXXIX.  O'LEUM JECORIS ASELLI.

Synonymes.  Oleum Morrhuae seu Jecinoris Aselli, Codliver Oil, Cod Oil.
French.  Huile de Morue, Huile de Foie de Morue.
German.  Stockfischlebe rt hran,  Bergerthran,  Gichtthran,
  Leberthran, Kabl iauthran.

  The animal fat, which appears under this name in commerce, is
obtained from several of the fishes belonging  to the genus Gadus, 
546
OLEUM JECORIS ASELLI.
'order Malacopterygii thoracici, but especially from  the codfish,
 (Gadus morrhua;) the  Trosk, (Gadus callarias;) the  Coalfish,
 (Gadus Carbonarius,) and the Burbot, {Gadus lota.)   At Ant-
 werp, it is said by M. Gouzee1 to be prepared from the  liver of a
 species of Ray—the Raja Pastinaca—and of the Skate.  Skate-
 liver oil is by some preferred to cod-liver  oil as a therapeutic
 agent.   The  disagreeable odour and taste of cod-liver oil led  to
 the substitution of the oil obtained from the liver of the skate—
 Raia clavata and R.  Batis; German, Rochenleberthran.
 In Holland and Belgium this oil is  preferred to that of the cod,
 both as being  less disagreeable to the taste, and  also more effica-
 cious in its therapeutic effects.3
   Several  varieties of the oil  are met with in commerce, which,
 differ  from each  other by their  brighter or darker hue, and by
 their greater or less transparency.   The clearest sort is  admitted,
 into the shops of continental Europe especially, under the name
 Oleum jecoris aselli album seu depuratum: as a remedial agent
 it is more used than  the darker variety, although several physi-
 cians affirm, that they have found the latter more efficacious.3

                    METHOD  OF PREPARING.
   According  to Riecke,4 the  oil is  obtained by exposing to the
 sun the livers  of the fishes above mentioned, cut in slices, and col-
 lecting the fixed oil that runs out.   That which is first obtained
 resembles fine olive or poppy oil, and is called  " yellow cod-liver
 oil "—Oleum  jecoris aselli flavum, (German, Hellblanker
 Leberthran.)   If the livers are running gradually to putre-
 faction, the oil becomes of a chestnut-brown colour—Oleum jecoris
 aselli subfuscoflavum—(German, Braunkbl. anker Thran:)
 and, again, after the  oil  has been obtained  by the above methods,
 some can still  be procured by boiling the livers, which constitutes
 the Oleum jecoris aselli fuscumf but between the finest pale-
 yellow or almost colourless oil, and the  dark-brown  cod-oil used
 by curriers, there is an  almost infinite variety of shades, so that
 no absolute difference can be founded on colour only.6   At New-
 haven, near Edinburgh,  the fishermen  simply boil the livers in an

   ' Bullet. Med. Beige, Janvier, 1838.
   2 Edinb. Med. and Surg. Journal, Oct. 1842, p. 504, and Gobley, Archiv. General.
 de Med.,  Mai, 1842, p. 111.
   3 See Taufflied,  in Gazette Medicale de Paris, 12 Aout, 1837.
   4 Die neuern Arzneimittel, u. s. w. S. 351, and 2te Auflage, S. 538.  Stuttgart, 1840.
   6 For the Analysis of the yellow and brown varieties, by Marder, see Riecke, op. cit.
 2te Auflage, S. 541.  Stuttgart, 1840; or Pereira, op. cit. p. 1865; and  of the three
 varieties, see De Jongh, The Three Kinds of Cod-liver Oil, by E.Carey, Amer. edition,
 p. 79. Philad. 1849.
   * Pereira, Pharmaceutical Journal, Feb. 1849. See, also, a full account of the dif-
 ferent kinds offish oils in  Dierbach, Die neuesten Entdeckungen in der Materia Medica,
 3er Band. 2te  Abth. S. 1292. Heidelb. und Leipz. 1847. 
OLEUM JECORIS ASELLI.
547
iron pot, and then filter the oil through a towel containing a little
sand.1
   Mr. Donovan3 recommends the following process.   Take any
quantity of livers of cod; throw them into a very clean iron pot;
and place it on a slow fire; stir them continually until they break
down  into  a  kind of pulp:  water and  oil  will have  separated.
When a thermometer plunged in the pulp shall have risen to 192°,
the pot should be taken from the fire, its contents transferred to a
canvass bag, and a vessel placed underneath.  Oil and some water
will run through: after twenty-four hours, separate the former by
decantation, and filter through paper.
   The properties of cod-liver oil are said to be different in the dif-
ferent varieties met with in commerce.   The colour varies from a
bright yellow  to a reddish-brown;  and the oil is sometimes clear,
but, at others, more or less turbid. The bright has the consistence
of poppy oil;  the  brown is thicker.  The smell is weaker in the
former; in the latter,  it resembles that of old salt herrings.   The
taste of the brown  is an empyreumatic bitter; and  resembles train
oil; is somewhat acrid, and remains for a time on the tongue; that
of the clearer oil is much  less  disagreeable. Litmus paper is feebly
reddened  by  the clear,  considerably so by  the  brown variety.
Both sorts are soluble in  alcohol  and ether.   A good  deal of the
difference in the appearance,  and other sensible properties of the
different varieties would  appear, from  the  observations  of Mr.
Donovan,3 to be owing to the comparative freshness, or the  con-
trary, of the oil, or of the livers from which it has been prepared.
   To test its purity,  Mr. Hockin4 mixes, on a porcelain slab, four
parts of the oil and one of strong sulphuric acid. If it be genuine,
a rich violet hue  is produced, which in a few minutes passes  gra-
dually to  a dirty brown.   This characteristic, he says, is not pos-
sessed by any other  oil,  either  animal  or vegetable.   From the
researches,  however, of  Dr.  Pereira,5 it would appear, that al-
though sulphuric acid is a test  for liver oils, probably owing  to
the presence in them of one of the constituents  of bile, it does
not  distinguish one liver oil  from another, neither does it distin-
guish good cod-liver oil from bad; for it produces its characteristic
reaction both with  common brown cod-oil and with the  finest and
palest qualities; but it serves  to distinguish oil procured from the
liver from  oil obtained from  other parts of the animal.   In com-
merce it is said to be extensively  adulterated with  other fish  oils;

  1 J. H. Bennet, cited by Pereira, Elements of Mat. Med. and Therap. ii. 1866; or
2d Amer. edit, by Carson.  Philad. 1846.
  2 Dublin Journal of Medical Science, July, 1840, p. 363.  See, also, for a full account
of the article, Mr.  Donovan, ibid. Sept. 1845.
  2 Op. cit. Sept. 1845.
  4 Pharmaceutical Journal, Sept. 16,  1848; cited in Ranking's Half-Yearly Abstract,
July to December, 1848, Amer. edit. p. 213.
  * Pharmaceutical Journal, 1848. 
548
OLEUM JECORIS ASELLI.
scarcely a tenth—it is believed—of what is sold under that name
is genuine, being either refined whale or sea elephant oil.1
  According  to  Messrs.  Gouzee and  Gmelin, the  brightest oil
ought to be employed internally; but MM. Trousseau and Pidoux2
think that  the limpid oil has no  medical virtue.   They prefer
either the second, or that  which is obtained by ebullition, and has
a disagreeable acrid taste.   Such, too, appears to  be the opinion
of Richter,3 Delcour4 and others.  On the other hand, Dr. J. C.
B.Williams5 prefers the pale oil, as free from taste and smell as it
can be  procured.   To obtain this he advises, that the livers of the
fish should be obtained as fresh as possible, the pale  plump livers
being preferred.   These should be  beaten into a pulp, mixed with
water at 120°, and filtered.   After standing, the oil must be de-
canted, cooled to 50°, and again filtered.   The process is to be
performed quickly and in  close vessels.    *
   The  oil, prepared by Mr. Donovan's process, is of a pale-yellow
colour; its smell is weak, and  resembles that of a cod boiled for
the table when in excellent condition.   Its taste  is bland, by no
means  disagreeable, and  totally devoid of rancidity.  It is very
liquid.   Its specific gravity,  in Mr. Donovan's trials, was 0.934,
although in all the published  tables of specific gravities it is stated
to be 0.923.6  In cold weather, it  deposits  much  stearine, which
ought not to  be separated.  Mr. Donovan  has obtained as much
as a  gallon of pure oil from twenty-eight  pounds of liver, the
produce of fifty  cods; and he concludes, that in preparing the oil
for medical purposes, three great points are to be attended to,—
1. The livers must be perfectly healthy; 2. they must be as fresh
as possible, the least putrescency being  injurious; and,  3. The
heat at which the separation  of the oil is effected must not exceed
192°.   This  pale oil is the  only kind that Mr. Donovan7 has sup-
plied so abundantly to the profession for the last three years;, and
its efficacy, he says, has been in many  cases most surprising.
   Much of the oil used in this country is prepared in Boston.8

                  EFFECTS ON THE ECONOMY.
   Cod-liver oil has long  been used as a popular remedy in north-
ern  Germany, especially in Westphalia—as well as in  Holland
and England; it fell, however, into disuse in the British isles, but
in Germany it has maintained its character to the present day.
In England, it appears to have been  first recommended by Perci-

  1 Report of the Committee on adulterated drugs, Dr. Huston chairman, in Transac-
tions of the Amer. Med. Association, vol. iii.  Philad. 1850.
  2 Traite de Therapeutique, &c, 2d partie, p. 111.
  3 Medicinisch. Zeitung, No. 26, July, 1835.
  4 Bulletin Medical Beige, Juin, 1841, p. 249.
  5 London Journal of Medicine, Jan. 1849.
  6 Donovan, op. cit.                         * Op. cit.
  1 Dispensatory of the United States, 8th edition, p. 1209.  Philad. 1849. 
OLEUM JECORIS ASELLI.
549
 val,1 and in  Germany by Schenck.2   In Percival's time,  it was
' so largely employed in Manchester, in  the  hospital of that town,
 that  nearly a  hogshead  of it  was  consumed annually.  When
 administered internally, it excites a disagreeable taste in the mouth,
 and nausea.   Yet  patients soon  become  accustomed  to it;  and
 children frequently  take it without repugnance. When the nausea
 is once  overcome,  the oil  does not  oppress  the  stomach, except
 when the organ is embarrassed, or the digestive powers are greatly
 enfeebled.  Nor does it seem to destroy the appetite by continued
 use.   Yet  many persons,  especially adults—less  so children—
 reject it immediately.  It is necessary for the digestive powers to
 be energetic when it has to be given for any length of time.    To
 those whose digestive organs are very irritable, Kopp recommends
 that  Bourdeaux wine should be taken after it.
    Cod-liver oil has no manifest„effect on any  of the secretions, ex-
 cept  occasionally on the urinary and cutaneous depurations;  and
 on the healthy organism it  appears to  excite no  marked change.
 In strumous  affections, however, its favourable influence  is said
 to be striking, as well as in rhachitic,  rheumatic, and gouty dis-
 orders.  In such cases, it is said, by the German writers, to excite
 powerfully the reproductive or nutritive functions, when adminis-
 tered for a proper length of time.3 The favourable effects are, in
 general, not  rapidly exhibited ; and  to produce a cure, according
 to Kopp, the remedy must  be persisted in for at least four  weeks,
 and commonly for some months.   Kopp suggested, that owing to
 the similarity of the effects of this oil to those of iodine, its effi-
 cacy  might be owing to its  containing  the  latter;  and some che-
 mical investigations made by him  in the year  1836  confirmed  the
 suggestion.4  The  quantity is extremely small, but—Kopp  sup-
 poses—like iron in  chalybeate waters, as the iodine is commingled
 naturally with the  oil, it may exert a much greater effect  than if
 it were added artificially in  the like quantity.   This is the opinion
 also of Dr. J. H. Bennet,5 but Delcour6 and  Panck7 think  it very
 problematical.  Experiments by L. Gmelin8 seemed to show, that
 the genuine oil contains iodine, whilst the  spurious  does  not.
 Iodine has likewise been detected in it by Hausmann, Bley, Brandes,

   1 Essays, Medical, Philosophical and Experimental   Warrington. 1790. Vol. ii.
   2 Hufeland's Journal, 1822 and 1826.
   3 Riecke, Die neuern Arzneimittel, S. 352, und 2te Auflage, S. 542.  Stuttgart, 1840;
 also Klencke, cited in Brit, and For. Med. Review, Oct. 184xJ, p. 443.
   4 Hufeland und Osann's Journal, 1836; Annalen der Pharmacie, xxi. und xxii.;  and
 Bulletin G6neral de Therapeutique, No. xx. 30 Oct., 1837,
   5 Treatise on the Oleum Jecoris Aselli or Cod  Liver Oil, &c &c.  Lond. 1841.
   6 Bulletin Medical Beige, Juin, 1841, p. 254.
   ' Zeitschrift fiir die gesammte Medicin, July, 1842, p. 282.
   1 Bulletin General de Therapeutique, Mai, 1840. 
550
OLEUM JECORIS ASELLI.
Springmuhl,1 and W. Stein.2  Herberger3 found both iodine and
bromine in it, and analyses made by De Jongh4 showed, that the
light-brown  oil contained the largest quantity of iodine.
  Owing to  skate-liver oil appearing to be more efficacious thera-
peutically  than  cod-liver oil, MM. Girardin and  Prisser were
induced to analyze it carefully, when  they found it to contain a
per centage  more of iodide  of  potassium.   They,  consequently,
recommend  it as a valuable  substitute for  the more nauseous
article in use.5  On the other hand, Mr. Donovan6  is of opinion,
that every known fact impugns the notion that the  curative prin-
ciple  is iodine.  In the  first place, he  says, many patients who
have  been cured  by the oil were not in the least benefited by a
previous course of iodine,—as shown by Dr. Taufflied.   Secondly.
Chemical analysis has discovered only minute traces of iodine in
some  specimens, whilst others were entirely destitute of it.  One
analysis, indeed, referred to by Dr. Bennett, gave 0.324 per cent.,
and another, 0.162:  others gave still less.   Thirdly.   " The ten-
dency of iodine is to render the person thin who uses it, while the
effect of cod oil is to fatten."  Lastly.  None of the oil prepared
by them, when agitated with alcohol, communicated any impres-
sion of iodine, although the oil was eminently successful as a me-
dicine, and its  colour contra-indicated the presence of free iodine.
  Again, it has been affirmed, that equally beneficial effects have
followed the use of oil that contained no iodine.   The author has
for many years stated to his clinical classes, that such had been the
result of his observation, and that vegetable oils had appeared to
him to exert a similar action; and recently cases have been published
confirming this, view of the  subject.7   Testimony has also been
afforded in favour of the good effects of other animal oils.8  M.
Bretonneau9 regards common train oil  to be equally efficacious.
In a  recent  report  (1849,) of the Hospital for  Consumption and
Diseases of the Chest, which is highly favourable to the use of cod-
liver  oil, it is stated, that other animal oils, not derived from the
liver, and vegetable oils, were tried; but the experiments thus far
made  there  had not  shown them  to  possess the same  powers:
they had not, however, been sufficiently often repeated to warrant
decided conclusions.
  Dr. J. C.  B. Williams10 does not esteem it necessary to discuss
the question  whether  the  oil owes its efficacy to the iodine con-

  * Riecke, op. cit 2te Auflage, S. 541.  Stuttgart, 1840.
  a Journal fur  Praktische Chemie, B. xxi., or Journal de Pharmacie, Fev. 1841, p. 94.
  3 Pereira, op. cit. p. 1866.
  * The three kinds of Cod-liver Oil, &c. by E. Carey, Amer. edit. p. 79. Philad. 1849.
  ' Edinb. Med.  and Surg. Journ. Oct. 1842, p. 504.       6 Op. cit Sept 1845.
  1 Dr. P. M. Duncan and Mr. Nunn, London Medical Gazette, Feb. 1850.
  s See Drs. Bagot and Stapleton, in Dublin Medical Press, March 6, 1850.
  9 Bulletin de Therapeutique, cited in Medical Examiner, Sept. 1847, p. 579.
 10 London Journal of Medicine, Jan. 1849. 
OLEUM JECORIS ASELLI.                551
tained in it.   " To suppose," he says, " that the minute proportion
of this ingredient could be the curative agent would savour of the
absurdities of homoeopathy;  and besides most of the patients had
taken iodine in one form or other previously to taking the oil."1
   The author has elsewhere remarked,2 that the effect which cod-
liver oil induces upon the system of nutrition, when cachexia exists,
is similar to  that of eutrophics in general.  It doubtless furnishes
a modified chyle, and of  consequence a modified blood.   This in-
duces a new action in the tissues which it laves,—acting  in these
respects,  like sugar, both  dietetically and  therapeutically;  and
probably  its main action, as maintained by Dr. Bennett and by M.
Bouchardat,3 is  that of  a fatty  aliment.   Dr. Williams thinks
" there is much reason to believe that it proves serviceable by
supplying the fat molecules, which appear to be essential to healthy
nutrition  in forming the nuclei of the primary cells: thus supplying
a fat, which  is capable of being readily  absorbed and converted into
a better plasma, as well as more readily conveyed by the blood to
the vicinity  of the tubercular deposits, the absorption of which it
favours by dissolving the irregularly concreted fat of which  the
masses are partly composed."
   The following results of the use of cod-liver oil in the  medical
ward of the Pennsylvania Hospital, during  six months, reported
by Dr. Levick, one of the resident physicians, have been published by
Dr. Gerhard.4  First. The light coloured oil can be taken  without
difficulty by  patients who have steadily  rejected the brown  oil.
Secondly.  A few of the patients took it without any thing to dis-
guise its taste.  Its nauseating properties are corrected by its ad-
ministration  with milk;  but its  taste is most effectually disguised
by the froth of porter.  Thirdly. As  a general rule it was taken
before meals; but in four cases where it was not tolerated before
meals, it was readily taken after them.  Fourthly.  Patients have
increased  in'flesh, weight and strength under its  use:  the cough
and expectoration have diminished, and with some hectic and rigours
have wholly  disappeared.  Six were so much benefited as  to leave
the hospital, and resume their former occupations.   A patient, who
entered the hospital with cough, copious purulent expectoration,
extreme emaciation, inability to leave his bed, and with the physical
signs of  a cavity under  the  left clavicle, after six months' use of
the oil left  the  hospital  weighing 140 pounds, with little or no
cough, no hectic nor rigors, and with  an  almost entire absence of
expectoration;  and  the  physical  signs  had  greatly diminished.
  1 See Pereira, Pharmaceutical Journal, 1848.
  3 General Therapeutics and Materia Medica, 4th edit. ii. 316. Philad. 18o0.
  3 Annuaire de Therapeutique pour 1849, p. 253.
  ' The Diagnosis, Pathology, and Treatment of Diseases of the Chest, 3d edit. p. 241.
Philad. 1850.  See, also, Notes of Cases of Phthisis Pulmonalis, treated in the Penn-
sylvania Hospital, with Remarks on Cod-liver Oil  and its uses in Tubercular Disease,
by Dr. Levick, in American Journal of the Medical Sciences, Jan. 1S51, p. 21. 
552
OLEUM JECORIS ASELLI.
Fifthly. The improvement of the physical signs was not coincident
with that of the general symptoms.   Sixthly. That in those cases
which terminated fatally, the appetite", nutrition and strength ap-
peared for  a time to be  decidedly increased: life appeared to be
temporarily protracted; but for a few weeks immediately preceding
dissolution the remedy seemed to have entirely lost its value; and
lastly, To be of decided permanent benefit, its use must be steadily
persevered in, even after the most striking symptoms of the disease
have in a great measure disappeared.
   As respects the administration of cod-liver oil in disease, it has
been employed—especially  in Germany—as a remedy in
   Rheumatism, in which its  reputation has  been  favourable.
In the year  1782, it  was highly recommended  in  chronic rheu-
matism by Dr. J. Percival,1 and in  1807 by Dr. Bardsley,2 who
states, that it was in high repute in Lancashire.  In the year 1835,
Brefeld wrote a monograph on  it, in which, resting upon nume-
rous indigenous and foreign experiments, he maintained  it to be a
remedy of great  and specific efficacy in every form of chronic rheu-
matism; and since then  his  testimony has  been corroborated by
that  of Spiritus,3 Moning,4 Schiitle,5  Wesener,6 Osberghaus,7
Gunther,8 Volkmann,9 Kopp, Rust,10 Moll,11 Panck, W. O. Chalk,12
and Bradshaw.13  By many, its use  has likewise been advised in
gouty affections; but Brefeld esteems it ineffectual in actual gout;
and Taufflied14 affirms,  that it is of no avail in gouty arthritis.
   Scrofula  and Rickets.—In  these  diseases  it  would seem to
be more efficacious than  in rheumatism.  Brefeld, indeed, asserts
that he has found no  remedy equal to it, in cases where the osseous
tissue is permanently affected,—as in the different forms of rick-
ets, arthrocace,  spina ventosa,  and  caries  scrophulosa:u and
Kreebel16  is of opinion  that its  efficacy is  most marked  in scro-
fulous affections of the bones and in  atrophia  infantum.   Next
to these, it has been extolled in affections of the chyliferous ves-
sels and internal glands, especially when they present themselves
under the  chronic form of atrophy.   In affections of the external
glands, its efficacy was  less striking and  rapid; Taufflied, indeed,
states, that it  is of no  avail in the swellings  of  any lymphatic
glands excepting those of  the abdominal  cavity.   Its action is

   1 Lond. Med. Journ. iii. 393.
   a Reports from Hospital Practice, p. 18.  Lond. 1807.
   3 Rust's Magazin, Band. xvi. 566.           4 Ibid.
   1 Horn's Archiv. 1824 (July  and August.)
   8 Hufeland's Journal, 1824, Heft 1. (May.)    ' Ibid. 1825, Heft. iii. (September.)
   s Ibid. 1824, Heftii. (August.)             9 Ibid.
  10 Rust's Magazin. xx. 563.     " Richter's Specielle  Therapie, x. 468. Berl. 1828.
  Ia Lond. Med.  Gaz. Dec. 29,1843, p. 414.
  13 Provincial Medical and Surgical Journal, Dec. 31, 1845, p. 753.
  14 Gaz. Med. Nov. 9, 1839.
  ls Sourzac, Journ. de Med. et Chir. Prat. Mars, 1842, p. 110.
  15 Schmidt's Jahrbiicher, u. s. w. No. 9, S. 287. Jahrgang  1849. 
OLEUM JECORIS ASELLI.
553
almost null in scrofulous affections of the skin, ophthalmia, dis-
charges from the ear,  &c, unless when applied  externally, in
which cases, as well as in external glandular swellings of a scro-
fulous character, it was especially useful.  The slighter forms of
scrofulous eruptions disappeared, without any unpleasant sequela?,
by simply smearing them with the oil;  the more obstinate forms,
by the simultaneous use of appropriate internal agents, of which
 Brefeld  prefers sethiops antimonialis  to  all others.   Scrofulous
 inflammation of the eyes disappeared  frequently and  rapidly by
 simply smearing the eyelids with the oil.1  Where, in  the case of
 scrofulous  ophthalmia, there is  inflammation of the eyelid with
 photophobia, Brefeld recommends,  that the free edges of the  eye-
 lid  should be anointed with  pure  cod-liver oil.   Cunier advises
 it in association with the extract of belladonna, one  part of the
 latter to two of the former.   Introduced between the eyelids by
 means of a camel's hair pencil, it acts, he says, beneficially on
 scrofulous ulcers of the cornea, and hastens in a remarkable man-
 ner the absorption  of the opacities of that membrane.   In the in-
 terciliary ulcerations, it  is likewise very useful.   In such cases,
 as well as in opacities of the cornea; following vascular pannus
 in  cellular pannus, atonic  ulcerations,  &c, Cunier found  an
 ointment, the formula for which is given hereafter, very useful/
 Mr. WTilde, of Dublin,3 states, that in cases of pannus and long con-
 tinued chronic ophthalmia attended with granular lids, &c, where
 the constitutional powers had fallen below par, as shown by dimi-
 nution in volume, and increased quickness of pulse, pallor  of coun-
 tenance, coldness of the  extremities, a clammy condition of skin
 during the day, and heat, and restlessness at night; together with
 loss of appetite, and " a large flabby, putty coloured tongue, which
 is usually attendant on such broken down strumous patients," he
 had found it a most useful remedy,—in fact, in all cases in which
 tonics and nutrients were indicated.
    Kopp extols it in  scrofula and  rickets, both when internally
 and externally exhibited.  Numerous trials with it by other phy-
 sicians—as by Schenck, Schutte, Von  dem Busch, Gumpert,  Fehr,
 Rosch, Schmidt, Knod von Helmenstreit, Heineken, Miinzenthaler,
 Beckhaus, Spitta,  Gunther,  Roy, Gouzee,4 Taufflied,5 Jungken/
 W. O. Chalk,7 Daumerie,8 and others, confirm its great efficacy in

    1 Piffard, Bullet. G6n<§ral de Th6rap.  Mai, 1840.
    a Journal fiir Kinderhrankheiten, cited from Annales d'Oculistique, Mai, 1845, and
  in Braithwaite's Retrospect, xii. 234, Amer. edit.  New York, 1846.
    3 Donovan, Dublin Journal, &c, Sept. 1845.
    4 Bulletin Medical Beige, Janvier,  1838, p. 6.
    6 Gazette Medicale de Paris, 12 Aout, 1837; and 9 Nov., 1839.
    6 Lond. Med. Gaz. April 20, 1839, p. 126.                    , Op.  cit.
    8 Joum. de Brux., Fevr. et Mars, 1847, cited in Schmidt's Jahrbiicher, u. s. w. No.
  5, S. 161.  Jahrgang 1849. 
554
OLEUM JECORIS  ASELLI.
scrofulous and rachitic  affections.1   Schenck,2 indeed, esteems it
as certain a remedy in scrofula and rickets as cinchona is in inter-
mittent fever!  In the Pennsylvania Hospital, in scrofulosis, when
there was no reason to suspect the existence of pulmonary tubercles,
the improvement in the  patient's health was very decided.3
   The efficacy of  the oil in  scrofula suggested its administration
in cases  of—
   Tubercles ;—and, accordingly, it was  prescribed  by Hankel,
whose experiments led him to advise a further trial of it.  Riecke4
refers to a  case of the kind, confirming Hankel's observations,
which occurred to  Dr. Pagenstecher, of Elberfeld; and Richter, of
Weisbaden, Professor Alexander of Utrecht, and Haser, of Jena,5
seem to  have experienced  equally satisfactory results.   M. Tauf-
flied,6 however, considers its action to be doubtful or null in scro-
fulous phthisis when at all  advanced.   Both Kopp and Brefeld
recommend it highly in phthisis pulmonalis of strumous origin,
occurring especially in  youth, and Raye7  speaks in  the highest
terms of its efficacy in chronic inflammation of the lungs and
stomach.
   Of late years, great  attention has been given to it  as a remedy
in tuberculous cachexia; and the  testimony in  favour of it has
been overwhelming.   At the present day, there is no single article
of the Materia Medica so fashionable; and hence it has been em-
ployed too indiscriminately.  Of those who have recently given the
strongest evidence in favour of its great efficacy in  phthisis, may be
mentioned, Drs.  Madden,8 Blakiston,9 Ranking,10  and Trumbull.11
   Dr. J. C. B. Williams12 prescribed it in  above 400  cases of tu-
berculosis of the  lung in its different stages, and of these he kept
notes of 234.  Of this  number the oil disagreed  and  was discon-
tinued in only 9.   In 19 it appeared to do no good, whilst in the
large proportion of 206 out of 234, its use was followed by marked
and unequivocal improvement,—such improvement varying from a
temporary retardation of the progress of the disease, up  to a more
or  less complete  restoration  to  apparent health.   He found the
most striking advantage from the oil  in the third stage of phthisis,
even when far advanced, where not only the lung was excavated,

  1 Riecke, op. cit. S. 356, und 2te Auflage, S. 542.  Stuttgart, 1840.  See, also, Tauf-
flied, in Gaz. Medicale de Paris, Nov. 1839.
  ' Hufeland's Journal der Praktisch. Heilkunde, Mars, 1833.
  3 Levick, in Gerhard, op. cit. p. 242.                   * Op. cit. S. 356.
  s Hufeland's Journal, B. Ixxxvi. 1838.       6 Gazette Medicale, 9 Nov. 1839.
  1 Annales de la Societe des Sciences, Nat. de Bruges in Encyclographie des Sciences
Medicales, Mars, 1840, p. 100; and Sept. 1840, p. 10.
  8 Lond. Med. Gazette, Sep. 17, 1847.
  9 Practical Observations on certain Diseases of the Chest, Lond. 1848.  Amer. edit.
Philad. 1848.
  10 Half-yearly Abstract, &c, from July to Dec. 1848.  Amer. edit. p. 213.
  11 Lond. Journ. of Med. Feb. 1850, cited in Amer. Journ. of the Med. Sciences, July,
1850, p. 182.                    ia London Journal of Medicine, Jan. 1849. 
OLEUM JECORIS ASELLI.
555
but the body was rapidly wasting, with copious purulent expectora-
tion,  night  sweats,  colliquative diarrhoea, &c.  Of the  power of
the oil in this stage of the disease he quotes several decided cases.
The total number amounted to 62, in 34 of which the improve-
ment was known to have continued up to a recent period.   Eleven,
after temporary improvement, relapsed,  and  terminated  fatally.
From the report of the physicians of the Hospital for consumption
and diseases of the chest, for 1849, it appears that 542 cases were
treated with it.  In about 63 per cent, the symptoms improved ;
in 18 per cent, the disease  was arrested; and  in 19 per cent, it
went on unchecked.
   Chronic cutaneous diseases.—In  these affections,  cod-liver
oil has been given with advantage by Richter;  and it is suggested,
that  the greater  success  obtained by him than  by Brefeld may
have been owing to  his having administered the remedy in  much
larger doses.   Richter's  trials  were numerous, and  were  made
through a period  of three  years ; they are, therefore, highly de-
serving of attention.   He says;—that the impure, yellowish-brown,
and odorous oil  should be selected, as it is the  most active ;—that
at least six, and never more than ten spoonfuls should be adminis-
tered daily to adults;—that it must be continued for a long time,
as the first traces of a favourable impression are generally somewhat
late in presenting themselves,—commonly four  weeks, and, in very
obstinate cases, later;—so that usually from six to twelve weeks are
required for  a  cure;  and, lastly, that the diet must  be regulated,
and  every thing difficult  of digestion, flatulent,  fatty,  strongly
salted, or acid, be carefully avoided.  In this manner,  he treats
tetter, inveterate itch, and tendency to the formation  of  boils.
Kopp's experiments agree with those of Richter, as to the internal
use of the oil  in tetter; he esteems it to act by "improving the
humours."  He found it, also,  of use in cases of dry tetter, when
rubbed on the part, and in porrigo.  A severe case  of  lupus in
a young female  was successfully treated  by M. Gibert1  with the
oil.   The face was  eaten  away  by tuberculous  ulceration, the
fleshy parts  of the nose being completely destroyed.  Independ-
ently of this, scrofulous abscesses  existed  in the neck, with caries
of the malar bone, and white swelling of the wrist.  Cod-liver oil
was prescribed both  internally  and externally  with  success, after
iodine had been used in the same manner without effect.  The treat-
ment  was, however, continued for more  than a year.   But the
strongest testimony in its favour in lupus  is given  by M. Emery.a
In a severe case, which had resisted other remedies, he gave it in
large doses—from  a pint to a pint and a half in the day.   In two
months a  cure was effected.  He  subsequently employed it in a

  1 Bulletin de l'Academie, Nov. 1844.
  1 Revue Med. Chirurgical, Aout, 1848; cited in Ranking's Half-yearly Abstract, July
to Dec. 1848, p. 77, 
556
OLEUM JECORIS ASELLI.
great number of cases, commencing every one with  one hundred
grammes—nearly 25  drams—and quickly increasing it to fifteen
or twenty ounces in the day.   If vomiting supervened, its use was
suspended for a few days, and then re-commenced as before   Sixty-
four cases were treated  in this  manner, the  majority of which re-
ceived essential benefit,  and twenty-four were completely cured.
M. Devergie,1  however, is  of opinion, that  M. Emery has over-
estimated the beneficial effects of the oil in lupus, and properly re-
gards it as a great error to depend  upon any one agent for  the
cure of diseases, especially of the skin, which may be single or
complicated, and yet bear the same name.
   In some  troublesome affections of the skin, especially of the
hands, conjoining  the  characters of impetigo, with  erysipelatous
redness and swelling, and inducing the most severe sufferingj Dr.
Marshall Hall2 speedily succeeded in restoring the  textures to a
healthy condition by  the external  use of cod-liver oil, after  all
other remedies  had been tried fruitlessly.  For rhagades and chaps,
he says, it is a preventive, and a speedy cure; and it is productive
of great benefit in eczema, and other diseases inducing excoriation
and fissures  of the skin.3
   Carron  du  Villards4  extols  cod-liver  oil in  opacities of the
cornea, whether resulting from  slight  ulcerations, or from inter-
lamellar effusion.   It is only applicable after the inflammation has
disappeared.   A drop or two of the oil is then placed  on the cor-
nea with a camel's hair pencil.    Sometimes, even the  white oil is
too stimulating:  it is  then necessary to dilute it with oil of sweet
almonds: in other cases, the white oil is not sufficiently stimu-
lating, and the brown must be used.
   In cases of tumours of the mammas in  young females Kopp
found the  oil  useful, when administered for some time, conjoined
with the application of leeches to the affected part.
   In the  Charite", at Berlin, the oil was  given with advantage
in coxarthrocace, in  doses of four ounces  every morning;—the
mouth  being rinsed afterwards with peppermint tea, followed  by
a cupful of this tea, or of coffee.
   Kopp also affirms,  that he cured a case of chorea by it, which
had supervened an attack of gout.
   Lastly.—Dr. Day5 states, that he has used cod-liver oil exten-
sively for several  years, his attention having been first directed to
it by Dr. Bennet, in 1840; and he can confidently bear out the
statement of Mr. Donovan, that it " is a most  useful addition to
our Materia Medica;  that it produces effects of  which no other

  > Bulletin de  Th6rapeutique, xxxv. 466, cited in British and Foreign Med. Chirurg.
Rev. April, 1849, p. 538.  '               aLond.  Med. Gaz. Sept. 1832.
  3 W. O. Chalk,  op. cit.          4 Bullet. Gener. de Th6rap. 30 Oct., 1835.
  1 Report on Materia  Medica, &c, in Ranking's Abstract of the Med. Sciences, pt. 2,
p. 340, Amer. edit New York, 1846. 
OLEUM JECORIS  ASELLI.
557
   known remedy is capable; and that it is well worthy of the atten-
   tion of the medical profession."
                    MODE OF ADMINISTRATION.
     The dose of cod-liver oil for an adult  is from half a spoonful
   to three  spoonfuls, two or  three times a  day.   To children, it is
   given in tea-spoonfuls.  Dr. Williams begins, in adults, with a
   tea-spoonful, gradually increasing to a table-spoonful; and he advises
   it to be taken about an hour and a half after each meal.   The au-
   thor has always been in the habit of directing it to be given midway
   between breakfast and dinner, and  between dinner and supper; the
   first dose being taken  in the morning on rising ; so that three doses
   are taken in the day.   He begins with a dessert-spoonful.   Its un-
   pleasant taste can scarcely  be corrected by admixture with other
   agents; for which reason, many prefer to  give it in the pure state,
   taking afterwards some peppermint lozenges.  It is also recommend-
   ed to be given united with coffee, or with lemon juice, or in  the form
   Of emulsion, or in thin flaxseed tea flavoured with lemon peel; and M.
   Fredericq1 states, that a simple and effectual means is to masticate a
   morsel of dried orange peel just before and  just after swallowing
   the  dose.   Kopp prescribes it  in the pure state, advising that
   the mouth should be  rinsed with water, and that some dry bread
   should be eaten  after it.
     Dr.  Ure2 has suggested the adoption of cod-livers  as a diet  for
   patients who are  advised to take the oil.   In order to prevent the
   loss of oil during the process of cooking, he recommends the livers
   to be immersed entire in boiling water, to which a sufficient quan-
   tity of salt has been added to raise the boiling point to about 220°
   Fahr.  The sudden application of this high temperature coagulates
   the albumen of the liver, and prevents the  escape of the oil. When
   the liver is cut, the oil exudes, and mashed  potatoes  may be used
   as a vehicle.  Dr.  Ure states  that, having been advised'to take
   cod-liver oil,  he  found the nauseous flavour very objectionable,
«  until he contrived this  plan,  which answered extremely  well.
   It would  appear, from the observations  of Dr. Stapleton,3  that
   amongst the Norwegian fishermen the liver of the cod has been
   found peculiarly efficacious  in rheumatism.
                   Mistura olei  jecoris  aselli,
                      Mixture of cod-liver oil.
               R.  01. jecor. aselli f gss.
                   Liquor potassae gtt.  xl.
                   Aq. menth. pip. f gss.  M.  et fiat haustus.
     The draught to  be washed down with a  tea-spoonful of lemon
   juice to liberate the oil in the stomach.              Percival.

     1 Revue Med. Chirurg. v. 114: cited  in Brit, and For. Medico-Chirurg.  Rev., July,
   1849, p. 299.                a Pharmaceutical Journal,  Nov. 1, 1842, p. 361.
     * Dublin Medical Press, Mar. 6, 1850,
          36 
558                 OLEUM  JECORIS ASELLI.

            R.  01. jecor. asell. f gj.
                Liq. potass, carb. f jij.
                01. calami gtt. iij.
                Syrup, cort. aurant. f^i.  M.
  Dose.—One or two tea-spoonfuls, morning and evening, in cases
of rickets.                                               Fehr.
            R.   01. jecor. aselli,
                 Syrup, cort. aurant.
                 Aquae anisi, aa. f §j.
                 01. calam. aromat. glt- iij.  M.
  Dose.—A spoonful, morning, noon, and  night, in gouty swell-
ings, rickets, &c.                                      Rosch.

                Emnlsio  olei  jecoris  aselli.
                   Emulsion of cod-liver oil.
            R.   01. jecor. asell. alb.
                Vin. Hungaric. (vel Malag.) aa. f ^iv.    -iis
                Acac. ,§j.
          Fiat emulsio, cui adde
                Syrup, cort. aurant. f ^j.
                Elasosacchar. menth. pip. f gij.1
  Dose.—Two table-spoonfuls, two  or three times a day; shaking
the mixture.                                          Brefeld.
                  Sapo  olei jecoris  aselli.
                      Soap of cod-liver oil.
            R.  01. jecoris aselli part. cxx.
                Sod. caust. part. xvj.
                Aquae part. iv.  M.
  To be given in the form of pill; or made into a kind of opodel-
doch with an equal quantity of alcohol.           Deschamps.2
               Syrupus olei  jecoris   aselli.
                     Syrup  of cod-liver oil.
            R.  01. jecor. asell. fgviij.
                 Acac. pulv. ^v.
                Aquee f fxij.
                Syrup, commun. f S;iv.
                Sacchar. gxxiv.
  Make an emulsion of the first four ingredients; dissolve the sugar at a
moderate heat; clarify, and add
                Aq. flor. aurant. f ^ij.
                                                      Duclou?
              Unguentum  olei  jecoris aselli.
                    Ointment of cod-liver oil.
            R.   Olei jecoris aselli f ^i.
                 Hydrarg. oxid. rubr. gr. iv.
                 Cerat Bij.  M.
                                                       Cunier.

  1 The elseosaccharum or oleosaccharum  menthse piperitm is officinal in the Pharma-
copoeias of Austria, Denmark, Hanover, Oldenburg, Prussia, &c.  It is made by tritu-
rating eight drops of the essential oil of peppermint with an ounce of sugar.
  Q Aschenbrenner, Die neueren Arzneimittel, u. s. w. S. 135.  Erlangen, 1848.
  ' Journal de  Pharmacie, Sept. 1837. 
                   OLEUM SINAPIS.                      559

          Linimentum  olei  jecoris  aselli.
               Liniment of cod-liver oil.
         R.  01. jecor. aselli f^ss.
             Plumbi acetat. gij.
         Vitell. ovor, (seu adipis,) ^iij.  M.
For external use in cases of ulcers, fistulae, &c.   Brefeld.
                 CXXX.  OLEUM SINA'PIS.
Synonymes, Oleum iEthereum seu Volatile Seminum Sinapis, Oil of Mus-
  tard Seed,
French. Huile Volatile de Moutard.
German. ./Etherisches  Senfol.
   This preparation has  been  recommended  to the  notice  of
practitioners in Germany, by Dr. Meyer, of  Minden, especially;
at whose  suggestion numerous experiments were made with it  at
the Charite  in  Berlin, the favourable results of which have been
published  by Dr. Wolff.1
                  METHOD OF PREPARING.
   M. Faure, in France, and M. Hesse, in Germany, found that if
bruised  mustard seed be placed in  a  still with cold water, much
more essential oil is obtained than if hot  water or steam had been
at once employed.  M. Hesse, indeed, advises, that the seed should
be macerated with cold water for several hours before the distil-
lation is commenced.  It would seem, too, that acids, alcohol, &c,
exercise the  same influence in preventing the  separation of the oil.
          EFFECTS ON THE ECONOMY IN HEALTH.
  Volatile oil  of mustard is of a yellowish-white colour.  It ex-
hales so strong a smell of mustard, that the attempt to test its
odour instantaneously excites  a violent pungent  sensation in the
nose, and tears in the eyes.  Its acridity is so great, that its appli-
cation to the sound skin immediately occasions a sense of burning,
and intense redness and vesication in the  parts with which it comes
in contact.
          EFFECTS ON  THE  ECONOMY IN  DISEASE.
  Mustard seed oil  may be applied either externally  or internally.
For  the first  object, Dr. Meyer advises a  solution  in alcohol
(twenty-four drops to the ounce,) or in oil of almonds (five or six
drops to the dram.)  In Berlin, the former of these is used. Even
this solution exhales so strongly the characteristic odour of mus-
tard, that simply smelling it induces a sense of  pungency in the
nose, as well as tears in the eyes.  Owing to the great volatility
of this oil, its  property and efficacy is soon lost;  and the strength
of the  spirituous solution  becomes  less and  less when the fluid is
                 1 Schmidt's Jahrbucher, 1837. 
560
OLEUM SINAPIS.
preserved for a long time in vessels that are not accurately closed
or are frequently opened for the administration of the remedy, and
afterwards not carefully attended to.   It  is therefore advisable in
practice, that only small quantities should be prescribed at a time,
and that these should  be kept  in well-closed vials, and in a cool
place.
   The modes of external administration maybe one of two—accord-
ing to the sensibility of the skin, and the effect it may be desirable
to induce.  It may consist either in rubbing  the liquid on a part
of the surface, or in applying strips of linen wetted with it.  The
first method  is advisable where the skin is delicate—as in the case
of women and  children,  and  in  those  whose  healthy  sensibility
has  not  been diminished—as by paralytic affections.   The  fluid,
when rubbed on the surface, very quickly evaporates, and excites
a vivid sensation of burning, with  bright redness of the surface,
which disappears in   the course of a  few hours at the farthest.
The augmented sensibility, produced by friction with the solution
of the oil, continues  generally for a  longer  period; and, conse-
quently, if  a fresh application be  needed  at  a  short  interval—
say in from four to six hours—it must be made on the neighbour-
ing parts, avoiding those  first  implicated.  It is sufficient to use
the remedy in this  manner two or three times  a day.
   The application  of the oil by means of strips of linen is adapted
for skins, such as those of  men, which are thicker,  and less sensi-
ble, as well  as for morbid cases  in which the healthy sensibility
has been depressed.   The size and shape of the strips  must be
determined  by circumstances.   The linen,  dipped in the oil, is
placed upon  the  prescribed  portion of the  skin, and suffered to
dry, which  generally  happens  in about eight  minutes.   Burning
pain immediately succeeds, and is often so insupportable,  that the
patients  object to wait until the linen is dry, and it has, therefore,
to be removed earlier.  Besides the  more violent  pain  produced
by this mode of applying  the oil, the redness of the  skin is much
greater, and  in many cases vesication succeeds.   If the application
be made twice a day, morning and evening, this is sufficient for
the treatment of chronic diseases; but friction cannot be made on
the same part of the surface on the same day, on account of the
severe pain  and vesication which would be induced.  This me-
thod of applying the oil is considered to be especially proper in
the case  of the trunk and the extremities;  whilst the first method
is  generally  to be  preferred, where it  is desirable to use it upon
the face, behind the ears, or on the neck.
  The Oleum sinapis is  indicated wherever a counter-irritant or
local  excitant is demanded.   Riecke1 advises it in chronic cases
unaccompanied by  fever,  as  well as in light febrile  affections,

   1 Die neuern Arzneimittel, S. 341; und 2te Auflage, S. 519. Stuttgart, 1840. 
OLEUM TIGLTI.
561
where a gentle excitant may be needed;  and in such fevers as are
conjoined with a torpid state of the system, and which require the
use of excitants.   He regards  its  powerfully excitant action as
constituting it a most useful article  in our lists of antagonizing or
derivative, as well  as of excitant agents.   In the first relation,
Wolff employed it  with advantage  both in sub-inflammatory dis-
eases, and in nervous affections  not of an inflammatory character
—as  in subacute rheumatism of the joints, aponeuroses and mus-
cles,  and  in  chronic  rheumatism of those parts, where blisters
would  be serviceable; and for  which it may be  substituted  with
advantage, in consequence of its not being attended with the in-
conveniences  occasionally  produced by the latter  on the urinary
organs.   He  employed it,  likewise,  in  rheumatic neuralgia,
otalgia, odontalgia, prosopalgia, and ischias,—blood-letting being
prescribed or not, according to circumstances; and, also, as a pal-
liative  in chronic neuralgia, colic  of the hysterical  kind,  and
gastrodynia.
   As an excitant to arouse the  vital activity in debilitated parts,
Wolff used the solution of the oil in paralysis, in the sequelae of
protracted rheumatism, and  in neuralgia, which  was probably
the result of exsudation into the neurilemma, &c.  He gave it, also,
internally several  times with  good  effect,  in disorders of the
stomach, accompanied by too great  a secretion of mucus, (Vers-
chleimung  des Magens,) and producing complete loss of
appetite.  Two drops wrere formed  into a mixture of six ounces,
by the aid of gum Arabic and sugar; and of this  a table-spoonful
was given every two hours.
  In  cases of atonic dropsy, it has been conceived that advantage
might, in many cases, be derived from the internal use of this oil;
as in  the majority of those to whom it was given internally, the
urinary secretion was largely augmented by it.1   Kuhn,2 indeed,
exhibited it with signal benefit in a case of atonic dropsy, the sequel
of intermittent fever.
  The oleum  sinapis  has been  received into the  Hamburg Phar-
macopoeia.
                 CXXXI. OLEUM TIG'LII.
Synonymes.  Oleum Crotonis seu Seminis Crotonis, Croton Oil.
French.  Huile de Pignon d'Inde.
German.  KrotonSl,  Crotondl. Granatillol.
  The seeds of Croton  Tiglium or purging croton—a tree indi-
genous in the  Molucca  Isles,  Ceylon, Java, &c, which  belongs
in the Sexual System to Moncecia Monadelphia, and  to the

      1 Riecke, op. cit S. 343, and 2te Auflage, S. 520. Stuttgart, 1840.
      ' Medicinische Zeitung, No. 38, Sept. 21, 1836, S. 191. 
562
OLEUM TIGLII.
Natural Family Euphorbiacese—are characterized by their acrid
drastic  properties—which, indeed, belong  to  the whole family.
These seeds were carried  by the Dutch to Europe, two centuries
ago, and were admitted into  the old Pharmacopoeias under the
names  Gram Tiglii,  G. Tilii, G. Moluccas, &c, being pre-
scribed as a drastic  cathartic,  but owing to their too violent ope-
ration,  which frequently induced unpleasant results, they fell sub-
sequently into entire disuse.  The oil of croton was also introduced
into Europe  about  the same period, and  was occasionally used
internally.   It had, however,  sunk into total neglect, when atten-
tion was recalled to it by  Dr.  Conwell, a physician in the English
East India  Company's  service  at Madras, by whom its employ-
ment was  reintroduced  into  Europe; and, in a short time, it ac-
quired so much repute as  an active cathartic, that it was received
into various pharmacopoeias.1
   Croton oil is a thickish fluid, of a honey-yellow colour, has a
disagreeable  smell,  and a very acrid  burning taste, so that it ex-
cites inflammation of the tongue and fauces.  It is a  fixed oil,
having a very acrid  matter associated with it, which appears  to
possess acid qualities—crotonic acid.  In ether and  turpentine it
is wholly soluble;  in alcohol, partially so.   It is imported chiefly
from Madras, but partly from  Bombay, and is prepared like castor
oil, being strained,  however,  instead of being  boiled.  It is like-
wise expressed in England.2  About fifty per cent, may be obtained
in  this way; and ten  per cent, more may  be removed  by  the
solvent action of sulphuric ether, which is afterwards expelled by
a gentle heat.3  Being an expensive article and readily adulterated,
it is often found impure and  comparatively inert.  The adultera-
tion  generally consists  in mixing it with  a large proportion either
of olive oil, or of oil of almonds.4
    According to Dr. Pereira,5 two kinds are found in the London
market, one imported from India and Ceylon; the other, expressed
in  London, which differ somewhat from each other.

                  EFFECTS ON THE ECONOMY.
    Croton oil holds  a distinguished place  amongst cathartics, inas-
much as it can be given in small doses; and in cases of great torpor
of the intestines, its action  is very  certain.   Even a drop  com-
monly produces eight  or ten fluid  evacuations;  but, at times, in
 unusual torpor  of the  canal, as many as  four or five  drops, and

   1 Recherches sur les Proprietes Medicinales et l'Emploi de l'Huile du Croton Tiglium,
' &c. Paris, 1824.                                   ,    mn    „. .
   * Pereira, Elements of Mat. Med. and Therap. ii. 1116.  Lond. 1842; or 2d Amer.
 edit, by Carson.  Philad. 1846.
   3 Christison, Dispensatory.  Edinb. 1842.                        .
   4 Report of the Committee on Adulterated Drugs, Dr. Huston, Chairman, in trans-
 actions of the American Medical Association, vol. iii.  Philad. 1850.
   • Elements of Mat. Med. and Therap. 3d edit., vol. ii. p. 1279.  Lond. 1850. 
OLEUM T1GLII.
563
even more, have been given in the course of ten or twelve hours.
Like most of the drastic cathartics, it occasions tormina, but these
are less distressing than the burning sensation  which it commonly
excites in the  pharynx, and which  is least felt  when  the oil is
given in the form of pill or lozenge.  Not unfrequently,  also, it
causes nausea, often ending in vomiting, in delicate persons,  or
•where the dose has been large, but  without interfering materially
with the cathartic effect.   At times, it is formed into a  soap with
caustic soda—Sapo olei tiglii—which is  given in doses of from
one to three  grains.  This soap is said to be less excitant,  and  to
occasion less pain than the pure oil, and it has  the advantage, that
the dose can be better  apportioned.
   As with other cathartics, the incautious employment of croton
oil may occasion  inflammation of the intestinal canal, and,  there-
fore, it need scarcely be said, its use during inflammation of the
canal, is contraindicated.   It does not appear to  affect  any other
secretory organs than  those of the bowels, although some physi-
cians  affirm, that  they have remarked an increase of the  urine
after its use.   Occasionally, when rubbed, in the  quantity  of four
or five drops around the umbilicus, it would seem  to have acted
as a cathartic,  and even its odour has been known to produce the
same effect.
   Like other active cathartics, it has been employed as an  anthel-
mintic, especially in cases of tape-worm, by Poccinotti, and  others,
and with success.1
   It has been  recommended in dropsy by Dr. Geo. Fife2 as pos-
sessing one very decided advantage over elaterium; viz.:—that
even when its extreme  action is manifested, " it is not followed by
the depression inseparable  from the effective action of the latter;
but that where the greatest vis inertias has prevailed, accompanied
by absolute incapacity for exertion, a sensible amelioration in these
respects has followed its continued employment."
   Croton oil has been used externally as a revellent or counter-
irritant, and  at times to induce a cathartic effect; but in  this re-
spect it is uncertain.3
   Rubbed on the surface in small  quantity, it induces inflamma-
tion of the skin, which gradually disappears of itself.   When the
friction is longer  continued, pustules are caused,  which,  when
they are numerous, run together or are confluent, and around the
spot where the  confluent eruption  is seated, papulae or pimples
appear over  a  wider extent, which  are transformed into pustules,
and are surrounded by a red base or areola.  When the pustules
are discrete, they dry up  more rapidly than  when  they  run  to*

  1 Richter's Specielle Therapie, B. x. S. 248.   Berlin, 1828.
  2 Provincial Med. and Surg. Journ. Sept. 25, 1*44, P- 397.
  3 See a case of ileus cured  in this manner, by Dr. Susewind, in Casper's  Wochen-
schrift. fiir die gesammte Heilkunde, June 24, 1837, S. 404, 
564
OLEUM TIGLII.
gether; and in the latter case they commonly form  scabs.   Fric-
tion readily excites pustulation on the head, face, neck, chest, and
on those parts of the extremities where the skin is thin.  Where
it is thicker, the effect is of  course  induced with  more  difficulty.
Commonly, the  eruption is  perceptible in twelve hours after the
first friction, but at times not till a later period; very rarely is the
second friction ineffectual.   In the  course of from three to six
days, the eruption again disappears.  The pain usually commences
in about an hour after the rubbing, being  at  first  nothing more
than a slight itching and burning, which gradually, but decidedly,
augments;  yet the eruption  is never so painful as that caused by
the ointment of  tartarized antimony, or by the plasler of the same
agent, with  which  it  is  capable  of fulfilling  like  indications.
These frictions with croton oil are adapted  for all cases in which
local counter-irritation  is required.   It is important,  however, to
bear in mind, that it may in  this manner  act  on the  bowels, and
hence, that it may not be adapted for intestinal disorders, in which
it is not desirable to produce  such  an effect.  Frictions with it
have  been  recommended  by many physicians—as by  Andral,1
Elliotson, Hutchinson,2 Short, Landsberg,  Romberg, and  others,
in the following affections:—in chronic inflammations, and such
as  have  a  tendency to  exsudation;  in chronic  rheumatic, and
gouty diseases, in aphonia3 and chronic hoarseness,* in phthisical
affections, especially in incipient phthisis;  and in the neuroses—
as spasmodic asthma, hooping-cough, paralysis,5 &c.  Gunther6
advises them as almost  specific in  rheumatic odontalgia and in
otalgia.
  In  neuralgia  faciei, the  cause of  which is considered by Sir
Charles Bell7 to be  seated primarily in the intestinal canal, and
remotely in the  fifth pair of nerves, croton oil  has been  recom-
mended as  a superior purgative, and this, as wrell as  other forms
of neuralgia8 would seem to have been removed by it,—doubtless
by  the revulsion it excites upon the intestinal nerves.  But it need
scarcely be  said, that it possesses no specific virtue, as has been
imagined by some.   The same remark applies to its  employment
as  a purgative  in acute rheumatism by Dr. Geo.  L. Upshur, of
Norfolk, Virginia,9 who is disposed to believe  " that  the  efficacy
of Croton oil does not depend entirely upon its cathartic properties.

  1  Gazette Medicale, Jan. 1832, and Archives G6nerales, Aoiit, 1833.
  2 London Lancet,  May, 1833, and Sauer, in Medicin. Zeitung, Aug. 10, 1830, S.
158. cited in Amer. Med. Intel. Nov. 1, 1837, p. 286.
  3  Romberg, in Wochenschrift. fiir die gesammte Heilkunde, 1835.  4 Sauer, op. cit
  s Boileau, (Paralysis of the Facial Nerve,) Bulletin Medical du Midi. Avril, 18J9.
  6 Berliner Medicin. Central-Zeitung, Nov. 19, 1838.
  1 Practical Essays.  Edinb. 1841,  p. 101.  See, also, Allnatt  on Tic Douloureux.
London, 1841.
  8 J. Cochrane, Lond. and Edinb. Monthly Journ. of Med. Science, July, 1841; J. A.
Easton, London Lancet, Jan. 29, 1841; and  Newbigging, Edinb. Med. and Surg.
Joum. Jan. 1841, cited in Amer. Journ. Med. Science, Jan. 1841, p. 209.
  8 Medical Examiner, Oct. 1850, p. 580. 
OLEUM TIGLII.
565
It possesses—he thinks—a power over the disease beyond these,
and  apparently not dependent  upon them; for other cathartics,
which act as powerfully and as promptly, producing similar watery #
stools, do not bring a like  amount of relief to the patient.   "I do
not  say," he adds, " that it is a specific, for I am  not a believer
in the doctrine of specifics  in medicine:  that doctrine has put more
stumbling-blocks in the way of medical progress than  all the open
quackery of the past half century.   I merely desire to state, that
after a fair trial, in a number of cases accurately observed, where
there was scarcely a possibility of falling into error, I  believe that
the  croton oil is the best single  remedy in the treatment of acute
rheumatism; and I am thoroughly convinced, that  it is as justly
entitled to the  term specific  in  this disease, as is quinine in mias-
matic fever."  Yet the cases reported by Dr. Upshur, in which
other favourite anti-arthritic remedies—as colchicum and sulphate
of quinia—were also prescribed, are far from impressing  the  au-
thor as  strongly as they  do him.   In the only case of  genuine
tic in which Dr. Christison  tried it, no benefit whatever was  de-
rived. In delirium tremens it has  been advised  by Dr. Prankerd1
as an efficacious remedy, in which disease  it acts, he conceives, as
a direct sedative to the nervous system.   The testimony is, how-
ever, inadequate  to establish the position:  and  but  little reliance
ought therefore to  be reposed in it.
   Croton oil has likewise  been  used as a  direct excitant.   Cam-
panelli2 gives a case of paralysis of the upper eyelid, which was
promptly  relieved by the application of four drops to  the affected
lid, and to the eyebrow.   It has been employed also,  as proposed
by M. Lafargue,3 by Mr. A. Ure,4 in the way of inoculation  for
the removal of a naevus or erectile  tumour, at the inner  angle of
the  right upper  eyelid.   Several  minute punctures  were made,
with a cataract needle besmeared with  oil, over the  surface of the
nsevus.   These gave rise to redness and swelling, which lasted a
few  hours; and subsequently to small points of suppuration.  The
operation was repeated at  the interval of a week.  A rapid dimi-
nution, with withering of the  tumour, took  place.   A common
lancet may be used for the purpose as in vaccinating.
                 MODE OF  ADMINISTRATION.
   Internally, the dose is  from  one-fourth or one-half a  drop to
two  drops, given every three or two hours, or more frequently if
necessary.  The dose is rarely carried higher, except  in desperate
cases, and in mental affections, for which it is peculiarly appro-
priate.  It may be prescribed either in  the form of emulsion or of
pill.   Hahnemann5 and Hufeland recommended it as a substitute
       * Provincial Med. and Surg. Journ. April  29,1846.
       3 Annali Universali di Medicina, July, 1835.
       8 Cited in  Provincial Med. and Surg. Journal, Feb. 17, 1844, p. 393.
       4 London Med. Gaz., March 21, 1845, p. 7e0.
       6 Apotheker Lexicon, B. ii. Apth. 1, S. 203. 
566                     OLEUM TIGLII.

for castor oil, which  is expensive  in  Germany,—advising that a
drop of croton oil should be added to an ounce of oil of poppies,
and that  the  mixture should be  called Oleum Ricini Officinale.
This preparation is well adapted for emulsions.
   In apoplexy, or other comatose  diseases, it may be given on a
piece  of sugar, which may be introduced into the  throat, or  be
simply placed on the back of the tongue.  When applied exter-
nally to excite an eruption, from four to six drops, or even more,
may be rubbed in twice a day.  For women and children a single
application may be sufficient; but  if the skin  be thick and insensi-
ble, it will be wTell to rub it previously with  flannel, or  to apply
first a rubefacient, especially when it  is desirable to produce the
effect speedily.   On  the other hand, where the skin is excitable,
the croton oil should be mixed with from one to four or five parts
or more of olive oil, oil of turpentine, or soap liniment.1

                    Pilule  olei  tiglii,
                      Pills of croton oil.
                R.  Olei tiglii gtt. iv.
                    Micae panis q. s. ut fiant pilulse viij.
   Dose.—One, or two, or more.
                R.  Olei tiglii gtt. v.
                    Saponis,
                    Acaciae pulv. aa. 9j.
                Misce et fiant pilulae xx.
   Dose.—One to three.                            Sundelin.
                R.  Olei tiglii gtt. ii.
                    Micae panis
                vel
                    Saponis J)j.
                M. et divide in pilulas viij.
   Dose.—One to four.
              PilulsB  olei  tiglii  composite.
                 Compound pills of croton oil.
                R.  Olei tiglii gtt. x.
                    Ext. colocynth. comp. gi.
                    01. menthae piper, gtt. viij.  M.
                et fiant pil, xviii.
   Two for a dose—to be repeated at  short intervals, in cases of
obstinate  constipation.
                   Haustus  olei  tiglii.
                    Draught of croton oil.
                R. Tinct. ol. tiglii f^ss.
                   Syrup.
                    Mucil. acacias, aa. f 3ij.
                   Aquae destill. f^ss. Fiat haustus.
   After swallowing a little milk, this draught must be taken very
quickly, and be  washed down with the same diluent.—JVimmo.
  ' See the Author's Gen. Therap. and Mat. Med. 4th edit. ii. 262.  Philad. 1850. 
                         OLEUM TIGLII.                      56'

                   Emulsio  olei tiglii.
                   Emulsion of croton oil.
                R. Olei tiglii gtt. iij.
                   Olei amygdal. f^ss.
                   Acac. pulv. £ij.
                Misce sensim terendo cum
                   Syrup, flor. aurant. f §j.
                   Aq. anthemid. f §v.  M.
  Dose.—A spoonful every two hours until it operates—shaking

the vial.                                             Pmus"
                R. Olei tiglii gtt. 1.—ij.
                   ----anthemid. gtt. ij.
                Terendo misce cum
                    Mucilag. acaciae
                    Syrup, amygdal. aa. f §ss.  M.
  Dose.—A tea-spoonful every two hours—shaking the vial.
                                                   Lockstddt.

                    Mistura  olei  tiglii.
                     Mixture of croton oil.
                R.  Olei  tiglii gtt. ii.
                    Mucilag. acac. f ^ij.
                    Aquae fgj.   M.
  Dose.—A fourth part, every two hours, until the desired effect

is induced.
              Mistura  olei  tiglii  saponacea.
              Saponaceous mixture of croton oil.
                R.  Olei tiglii gtt. viij.
                    Potassae gr. vj.
                    Aquae destillat. f^ij.   M.
   This is a substitute for the Sapo Olei  Tiglii, which is trouble-
some in the preparation.
   Dose.—Three to six drops.2
                 R.  01. tiglii gtt. ij.
                     Sacchar. ^ij.
                     Acaciae pulv. gss.
                     Tinct. card, f gss.
                     Aquae destillat. f £x.  M.
   Dose.—Two dessert-spoonfuls, to children; to be repeated every
 three or four hours,  if necessary.

                    Troehisci olei  tiglii.
                     Lozenges of croton oil.
                 R.  Olei tiglii gtt. ij.
                     Sacchar. gj.
                     Mucilag. acaciae q. s. ut fiant
                 troehisci, non torrendi No. viij.

    Dose.—One every two  hours, until the desired effect is induced.
                                                        Seiler.3
   1 Handbuch der Arzneiverordnungslehre, Th. ii.  Berlin, 1836.
   3 Ellis's Medical' Formulary, 8th edit, by Dr. S. G. Morton, p. 58.   Philad. 1846.
   3 Hufeland's Journal, B.lix. St.4, S.134; und Rust's Magazin, B. xviii. St. 2, S. 358. 
568
OLEUM TIGLII.
                     Sapo  olei  tiglii.
                      Soap of croton oil.
                          Sapo crotonis.
                R.  Olei tiglii partes ij.
                    Liquor, potassae partem j.
  Triturate in the cold, and when the mixture has acquired the proper.
consistence, run it into moulds of pasteboard, and, in the course of a few
days, remove it by slices.
  Dose.—Two or three grains in water, or in the form of pill.
                                                   Caventou.
                 Linimentum  olei  tiglii.
                    Liniment of croton oil.
                       Linimentum crotonis.
                R.  Ol. tiglii p. i.
                    — olivae p. v.  M.
  To be rubbed on  the skin night and morning, until  pustulation
is induced.
                R.  Olei tiglii
                    Liq. potassae aa. f §ss.
  Mix intimately by agitation.
                R.  Soluti hujusce rn^xxx.
                    Aquae rosae f gi.  M.
  To be rubbed on the  part night  and morning, or even three
times a day, until the peculiar eruption is induced.
                                               James Allen.1
  The  Linimentum Crotonis of the Dublin Pharmacopoeia2 con-
sists of one part of croton oil to seven of oil of turpentine.

Embrocatio  olei tiglii cum  antimonii et potassae tartrate.

Embrocation of croton oil with tartrate of antimony and potassa.

                R.  01. tiglii rri^xx.
                    Antim. et potass, tartrat. 9j.
                    Liq. potassae f gi.
                    Aquae f £vij.   M.
  Used to keep up  a mild rash  upon the skin.          Morris.

                  Unguentum  olei  tiglii.
                    Ointment of croton oil.
                R.  Olei tiglii irLx.—xxx.
                    Adipis ^ss.   M.
  A little of  this to be  rubbed on  the part so as to excite the
peculiar eruption.
                  Emplastrum  olei  tiglii.
                     Plaster of croton oil.
                       Sparadrap de croton.
  M. Bouchardat melts,  over a very gentle  fire, four  parts of

  1 Provincial Medical and Surgical Journal, Oct. 28, 1843, p. 75.
  B The Pharmacopoeia of the King and Queen's College of Physicians in Ireland, 1850,
p. 77. Dublin, 1850, 
PAULLINIA.
569
 diachylon plaster; and when it is in a semi-fluid state, he mixes
 with it one part of croton oil.   This he spreads upon linen, so as
 to form an adhesive and irritating plaster.
   M.  Caventou  prefers the following  form, as he considers the
 degree of  heat employed  in the process of M. Bouchardat may
•interfere with the powers of the  oil.
                R.  Adipis p. iiss.
                    Ceree p. ss.
                    01. tiglii p. i.
  The wax and lard must be  melted, and when nearly cold  the oil be
 incorporated.1
   A stronger  plaster is  also  advised  by  M. Bouchardat.2  He
 melts  over a gentle fire eight parts of diachylon plaster, and when
 it is semi-fluid  mixes it with  twenty parts of croton oil.  The
 resulting  plaster must be spread  thickly on muslin.  It  produces
 considerable irritation of  the skin,  and may be  employed in all
 cases in which revellents are required.  It does not, he says, cause
 such severe pain as many other counter-irritants,  and  may be ap-
 plied over an extensive surface, if desirable.

   Pope3 recommends a tinctura granorum tiglii, or a tincture
 of the seeds, to be made of two ounces of the seeds from which the
 rinds have been carefully removed, to one ounce of alcohol.  This
 is allowed  to  digest  for  six  days,  and is then filtered.   The
 smallest dose for an adult is twenty drops.   This  preparation, he
 says, has the advantage of excluding the more acrid drastic mat-
 ter contained in the epidermis and husk, whilst the kernel affords
 cathartic material enough to  act  powerfully and certainly.
                    CXXXII.  PAULLINIA.

Svnonymes. Guarana, Guarana Pasta, Pasta Seminum Paullinia?.
French. Pate ou Extrait de Guarana ou Paullinia.
German.  Guarana-Samenteig.

   Paullinia is an extract from  the plant of the same name, a native
of Brazil.  It is prepared by the Indians, and  seems to possess
considerable excitant powers.  M. Gavrelle presented a specimen
of it to the Societe de Medecine of Paris, as well as a new alkali,
which had been separated from it by two chemists of Paris.  Both
Paullinia and  the alkali are very bitter, and somewhat  resemble
cafein.   M.  Gavrelle  states, that  Paullinia  is  obtained from
Paullinia sorbilis; Guarana officinalis, Family, Sapindaceee.   M.

  ' Bulletin General de The'rapeutique, Mars, 1842, or Journ. de Pharm, Avril  1842'
p. 453.                                                    '
  3 Annuaire de Therapeutique, &c., pour 1844, p. 210.  Paris 1844.
  3 Medico-Chirurgical Transactions, vol. xiii. p. 1.
t 
570                      paullinia.

de Chastetus found it to be composed of a gum, starch, a resinous
matter of  a reddish-brown  colour, a fat  oil,  tannic  acid, and  a
crystallizable substance possessing the chemical properties of ca-
fein.
            EFFECTS ON THE ECONOMY IN DISEASE.
   In Brazil and the  neighbouring countries, it is given in the form ■
of  tisane—the powder being mixed with cocoa—in diarrhoea and
dysentery; and in the same affections it has been administered, in
France,  by Lallemand.   As a tonic,  M. Gavrelle has employed  it
successfully in chlorosis, tedious convalescence, paralysis, the col-
liquative diarrhoea of phthisis, and hemicrania.
   According to Von Martius, an extract is  prepared in Brazil
from Paullinia sorbilis, which is known  there  under the name of
Guarana, and is administered in similar  pathological cases.1  It  is
probably the same substance.

                  MODE OF ADMINISTRATION.
   M. Gavrelle has  given formulas  for  Lozenges,  Syrup, Pills,
Powder, Tincture, and Ointment of  Paullinia.2
                     Troehisci paulliniae.
                      Lozenges of paullinia.
                 R.   Paulliniae gvss.
                     Sacchar. (vanilla odorizat.) BSiss.
   Make into lozenges  each containing ten grains.
                      Syrupus  paulliniae.
                       Syrup of paullinia.
                 R.   Paullin. giiss.
                     Syrup. Oij.
   Half a  fluidounce may be given in the 24 hours.
                      Pilulae  paullinia.
                       Pills of paullinia.
                 R.  Paullin. q. s.
   To be made into pills, each containing a grain and a half.
                      Pulveres paulliniae.
                      Powders of paullinia.
                 R.  Paullin. in pulv. £i.
                     Sacchar. aromatizat.  §ss.  M.
    For a dose.
   1 See art. Guarana, in Diet. Univers. de Mat. Med. par Merat et De Lens, torn, ii., p.
 365.  Bruxelles, 1838; Journ. de Pharmacie, cited in Amer. Journ. of Pharmacy, Jan.
 1841, p. 340; Dechastetus, Journ. de Pharm. Aout, 1840;  J. J. Virey, ibid.; Von
 ScbJechtendal, Encyclopiid. Worterb. der Medicin. Wissenschaft. xxvi. 433. Berlin,
 1841; and A.Richard, Elements d'Histoire JNaturelle Medicale, 4eme edit iii. 511.
 Paris, 1849.
   " Journal de Chimie Med,, cited in American Journal of Pharmacy, Oct. 1840, p. 20^- 
PHLORIDZINA.
    Tinctura paulliniae.
     Tincture of paullinia.
R.  Paullin. gi.
    Alcohol. (22°) Qi-  M.
   Unguentum  paulliniae.
    Ointment of paullinia.
R.  Paullin. gij.
    Adipis 3 ij.  M.
                 CXXXIII. PHLORIDZINA.1

Synonymes.  Phloridzinum, Phloiorrhizinum, Phlorrhizinum,  Phloior-
  rhyzinum,  Phlorrhizin, Phloridzia, Phloridzine, Phlorizin, Phloridzin.
German. Phloridzin, Phloiorrhizin.

  This bitter principle exists in the bark  of both the trunk  and
the root of the apple, pear, cherry, and plum tree.
                   METHOD OF PREPARING.
  The following plan  is recommended by  M. de Koninck, its dis-
coverer (1834 or 1835.)—The fresh bark of the root of the apple
tree is to  be boiled for  two hours with sufficient water to cover
it:  the decoction is to be decanted, and a second one made by the
addition of more water.   On uniting  the two decoctions, and per-
mitting them to stand  for twenty-four hours, a deposition  of phlo-
ridzin, in  granular crystals,  takes place.   These are to be treated
with  distilled  water  and animal charcoal to purify them.   An
additional quantity is obtained by evaporating the  mother waters
to one-fifth.  At this degree  of concentration, all the phloridzin
is deposited.  This method affords  about one part in  three hun-
dred.  Another plan yields five per cent.   It consists in digesting
the fresh root in weak alcohol, at a temperature of 120°, for about
eight or ten hours, distilling off the greater part of the alcohol, and
crystallizing the residue.2
   Phloridzin  crystallizes in silky spicula  of a dead-white colour
when in masses, or in long slender prisms or tables when  crystal-
lized with care.   One thousand parts  of  water, at a temperature
from 32°  to 71°, only dissolve about one part; but at from 71° to
212°, water dissolves it in all  proportions.  It is also very soluble
in pure alcohol at ordinary temperatures, although but slightly so
in  ether,  even when  boiling.   It has no action  on test papers.
S. g. 1.429.3
  '  From <pXoo$, inner bark, and £«?a, root.
  * Journal  de Pharmacie, xxii. 78, cited in Amer. Joum. of Pharmacy, vol. ii. new
series, p. 240.  See, also, M. Boullier, in Gazette Medicale de Paris, 17 Juin, 1837,
and Marchand, Joum. de Chim. Med., Avril, 1841.
  '  For some elaborate chemical researches on Phloridzine, see M. J. S. Stass, Annales
de Chimie et de Physique, Dec. 1838. 
572                       PIPERINA.

           EFFECTS ON THE ECONOMY IN DISEASE.
   M. de Koninck found, that from ten to fourteen grains given
for a dose, with a dram of sugar, produced the most marked effect
in intermittent fever, where sulphate of quinia had failed.1   Jn four
cases, reported  by Van Mons,2 of Bruxelles,  the disease was ar-
rested by  the first sixteen grains: other cases required  sixteen
grains a few hours before the first paroxysm;  twelve grains before
the second; six before the third; and four before the fourth.  Five
successful Cases are likewise given by M. Mathysen,3 eleve interne
at the Hospital  St. Pierre, Bruxelles;  and M. Lebaudy4 affirms,
that its efficacy is so decided, that we cannot  hesitate  to class it
with the most powerful febrifuges; and that it has this advantage
over quinia, that it never induces gastralgia;  yet M. Leonhard5
is satisfied, from his various trials, that phloridzin does not possess
any febrifuge virtue!
                  MODE OF ADMINISTRATION.
   It may be given in the form of pill or powder, like the sulphate
of quinia.   It was administered at the hospital at Bruxelles, in one
case, in the way of lavement;—twenty-four grains being given in
three lavements.   The paroxysm  returned, but was  less violent.
In two days afterwards, the same quantity was administered in the
same manner, and the fever did not recur.
                    CXXXIV.  PIPERINA.

Synonymes. Piperinum, Piperium, Piperine, Piperin.
French. Piperin.
German.  Piperin, Pfefferstoff.

   This  substance was  discovered  by M.  Oersfadt,  in  the year
1819, in black pepper, Piper nigrum?   It is found, also, in Piper
longum, and it has been presumed to be the same, or an analogous
principle, with the cubebin of Piper cubeba.   It has been affirmed,
that it exists only in black,  and not  in white pepper; but this is
an error.  Dr. Christison7 invariably obtained  it from the latter
in larger quantity than from the former,  and  more easily, because
it is  combined with less  resin.   M. Oerstadt at  first regarded it as

  1 See, also, Prince Louis Lucien Bonaparte, cited in Bouchardat, Annuaire de The-
rapeutique pour 1843, p. 203.  Paris, 1843.
  a Bulletin Medical Beige, Mai, 1836,
  s Ibid. Oct. 1835.
  ' Journal des Connaiss. Med. Chirurg. cited in Braithwaite's Retrospect of Medicine
and Surgery, No. 5, p. 129, Lond. 1842, where it is  termed erroneously Phloridrine;
and whence it is copied into the Amer. Journ. of the Medical Sciences, and the Amer.
Journ. of Pharmacy, for Jan. 1843, under the name Pliloridine.
  5 Encyclographie des Sciences Medicales, Mai, 1838.
  s Journ. de Physique, No. 2, 1820, and Gazette de Sante, 25 Mai, 1820.
  1 Dispensatory, p. b'9d.  Edinb. 1842. 
PIPERINA.
573
a vegetable alkali, but M. Pelletier subsequently analyzed  it, and
proved  it not to be such, but  to  bear a considerable  analogy to
resins.1
                   METHOD OF PREPARING.
  Let two pounds of black pepper, bruised, be digested, at a gentle
heat, in three pounds of alcohol at 36° (.837.)   This mixture must
afterwards be raised to ebullition, then suffered to remain at rest,
and  grow cold; when it must be decanted, and the operation be
repeated with fresh alcohol.  The two solutions must then be mixed
together, and two pounds of distilled water and three ounces of
muriatic acid be added.   The  liquor becomes turbid, and a preci-
pitate, of a deep gray colour, is thrown down, which is  composed
in a great measure of fatty matter.  The deposit being separated,
crystals may be collected on  the filter and  sides of the vessel.
These are piperin.   On adding water, until the liquor is no longer
rendered turbid, a fresh quantity is obtained.
   The above process, which is  that of Meli,is the same  as one de-
scribed by M. Pelletier.   He has  likewise procured it by the fol-
lowing method:—After having exhausted pepper by alcohol, and
evaporated the alcoholic tinctures, a  fatty or resinous matter is ob-
tained : this must be subjected to the action of boiling water, which
must be added again and again, until it passes off colourless.   By
dissolving this fatty  matter—thus purified by washing—in alcohol,
by the aid of heat, and leaving the solution to itself for some days,
a multitude of crystals are obtained, which may be purified by  so-
lution in alcohol and ether, and by repeated crystallization.  The
alcoholic mother waters, left to  themselves, will furnish fresh crys-
tals.   This crystalline matter is piperin.
   Piperin presents itself  in the form of  four-sided prisms,  two of
which—parallel  to  each other—are  evidently broader than  the
others.  In the  pure state, it is of a white colour, and translucent:
it is frequently, however, coloured  yellow by portions of resin
being combined  with it.   It has been affirmed, that when piperin
is quite pure,it is bland;2 but Dr. Christison3 states, that the very
whitest crystals he was able to obtain were as acrid as those which
are brownish, and they emitted an intensely irritating vapour when
thrown on a heated  iron plate.   It is inodorous, and of a  feeble
taste of pepper; fuses readily by heat; is not volatile, and is scarcely
soluble in cold water, but  somewhat  more so  in hot.  In  respect
to its solubility  in alcohol, testimony is discordant.   According to
Magendie, it dissolves very readily therein;  according to C. G.
Gmelin,it is soluble only in small quantity in  cold, but in tolerable
proportion in hot alcohol, as wrell  as  in  ether  and in the volatile
oils.   The solutions taste acrid and peppery, and do not react on

  ' Examen Chimique du Poivre, par J. Pelletier, 8vo. Paris.
  a Dispensatory of the United States of America, 4th edit.  p. 512.  Philad. 1839.
  8 Op. cit. p. (397.
        37 
574
PIPERINA.
    vegetable colours;—which shows that it is not an alkaloid, as the
    discoverer conceived.   With acids it  forms no intimate chemical
    combinations;  acetic  acid, indeed, dissolves  it  in considerable
    quantity; it is, however, in great part, precipitated  by water, and
    by evaporation the whole of the acid escapes.  It is related to the
    resins.
                     EFFECTS ON THE ECONOMY.
      Piperin has been exhibited chiefly by the  Italian physicians for
    the cure of intermittent fever.  Its employment was doubtless
    suggested by the use of pepper-corns as a popular remedy in that
    disease.  According to Riecke,1 the antiperiodic virtue of pepper
    is exhibited upon the healthy economy,—a few pepper-corns, taken
    before the  expected  appearance of the menses, arresting them for
    several days.   Of this, he himself has had no experience; but he
    affirms, that the females in a district  of  southern Germany  have
    great confidence in their virtues.
      Meli,2 who treated many cases of intermittent with piperin, con-
    siders it the best of all febrifuges, quinia not excepted.  He forms
    twenty grains  into ten pills, and gives these  at  intervals during
    the apyrexia.  He ascribes the efficacy of the oleum acre piperis
    in the same complaint  to the piperin it contains.
      The  febrifuge virtue  of piperin has been confirmed by  many
    other Italian physicians,—by Brandolini,  Bertini, Gordini, Torelli,
    and others.   According  to Brandolini, from  forty to fifty grains
    are generally required to effect a cure.   Bertini gave it in three
    doses during the apyrexia, to the  extent of a scruple, made into
    pills with a bitter extract: after two or three doses, the fever was
    generally arrested.  Gordini  affirms, that relapses occurred  less
    frequently  after the use of piperin than after that of  the sulphate
    of quinia.  On the other hand, in  the  hospital at  Turin,  Christin
    was disappointed in  it, and such seems to have been  the result of
    the trials made  by Chiappa.3   In the year 1823, he administered
    it in ten or twelve cases,  but was unable  to detect any great anti-
    periodic property; not more than a fourth part of  the sick expe-
    rienced benefit, whilst on the others cinchona acted like a charm.
    In general, a  burning  sensation was experienced in the  stomach
    after taking  it,  as well  as  in  the throat, with the same kind of
'    feelino- occasionally in  the rectum, and in  the whole abdomen ; and
    in two young individuals, the eyes were made red, and the eyelids,
    nose, and lips were swollen.
      Piperin has been employed by others besides the Italian physi-
    cians.   Dr. Blom, of  Utrecht, has given it in intermittents, but
    not with as much success as quinia.   According to him, the remedy,

      ' Die neuern Arzneimittel. S. 361; und 2te Auflage, S. 522.  Stuttgart, 1840.
     a Nuove Esperienze, &c. Milan, 1823,8vo.; and Annali Universali di Medicina, xxvii.
    161, and xxviii. 22.
     3 Riecke, op. cit. S. 361; und 2te Auflage, S. 553.  Stuttgart, 1840. 
PLATINI PRiEPARATA.
575
soon after it is taken, particularly in very impressible persons, oc-
casions a sense of internal heat, especially in the epigastric region,
and not unfrequently it causes perspiration, especially on the upper
lip.   Blom is, however, doubtful whether these effects be ascriba-
ble to the piperin, or to a  portion of the resin of the pepper re-
maining united with it.   He is of opinion, that both in general de-
bility and in debility of the digestive  apparatus, piperin merits a
preference  over sulphate of quinia, both because it can be better
borne by the stomach, and  because it acts more tonically upon it.
It has been given  in intermittent fever, with great success, by
Dr. Hartte,1 Port  of Spain, West Indies.  He prescribed  it as  soon
as the sweating stage was  established, until 18 grains  had been
taken, and, on the following day, when the  intermission  was com-
plete, he  directed  the same quantity every three hours.  It  suc-
ceeded, in every case, in checking the paroxysm, and  as soon as
this was accomplished he gave, for some days, pills composed of
Pilulas  Hydrargyri,  Piperin, and Sulphate of Quinia, the formula
for which is given below.
   In inflammatory intermittents, as well  as in  those with gastric
complications, piperin is to be avoided.
   Magendie suggests that it should be given in blennorrhcea, in
place of cubebs.
                METHOD OF ADMINISTERING.
                     Pilulae piperinae.
                       Pills of piperin.
                  R.   Piperin. gr. xij.
                       Extract, gentian, q. s. ut fiant pilulae xij.
Dose.—One every hour, during the apyrexia of fever.
              Pilulae  piperinae compositae-
                 Compound pills of piperin.
                     R.  Pil. hydrarg. gr. i.
                          Piperin. gr. ij.
                          Quinias sulphat. gr. ij.
                          Syrup, q. s. ut fiat pilula.
  One to be taken morning, noon, and night.          Hartte.
             CXXXV. PLATINI PR^PARATA.
Synonymes.  Preparations of Platinum or Platina.
French.  Les Preparations de Platine.
German.  Platinpraparate.
                 EFFECTS ON THE ECONOMY.
  The preparations of platinum  have  not been much  used in
medicine.   Experimental researches were  undertaken by M. F.
       1 Edinb. Medical and Surgical Journal. Jan. 1841, p. 98. 
576                  PJLATINI PREPARATA.
Hofer,1 in regard to their employment as physiological and thera-
peutical agents; and the following were the main results.  Experi-
ments were made on  rabbits, dogs, and  on himself, with the view
of discovering the physiological action of the perchloride of pla-
tinum or chloroplatinic acid, of the chloroplatinate of sodium
or the double chloride of platinum and sodium ; of the chloro-
platinate of potassium, and the chloroplatinate of ammoni-
um.   He found—First. That the chlorides  of platinum are poi-
sonous,—the perchloride in the dose of 15 grains; the chloroplati-
nate of sodium in that of gss.   Secondly. The chlorides of plati-
num  are less poisonous than the chloride  of gold and corrosive
sublimate.   Thirdly. The perchloride of platinum, in concentrated
solution, produces violent itching or irritation of the skin, followed
by a slight eruption on the part to which the  solution  has been ap-
plied.   Taken internally, it first of all irritates the raucous mem-
brane  of the stomach, occasions  headache, reacts on  the nervous
centre, and through  it exerts a special alterative action  on the
fluids  of the economy.   Fourthly. The chloroplatinate of sodium
produces no local irritation on the skin.   Taken internally, it does
not react on the  nervous centres in  as  manifest  a manner as the
simple perchloride.   It more especially increases the urinary secre-
tion.   Fifthly. The perchloride of platinum  is a very efficacious
remedy in the treatment of syphilitic diseases, and  especially  in
those  that   have  been of  long duration,  and  are inveterate.
Sixthly. The chloroplatinate of sodium is  more proper for the
treatment of recent syphilitic diseases.  It is also very efficacious
in the treatment of rheumatic affections.  Seventhly. Platinum
ought to be ranked in the class of alterative  remedies, by  the side
of gold, iodine, and arsenic.   It differs from mercury in previously
inducing  excitement, whilst its  administration is not followed by
any  of the  disagreeable consequences  induced  by mercury.
Eighthly,  and lastly. Platinum is preferable, as an alterative, to
mercury and gold.
   The preparations of platinum have been used by others in syphi-
litic affections with success, but the observations of Fricke were
unfavourable to  them:  by Cullerier, they were  given in gonor-
rhoea and leucorrhoea.
   Mr. Tuson3 remarks, that from what he was led  to believe of
the effects of the chloride of platinum on scirrhous  tumours, as
stated to him by a medical gentleman whom he met in consulta-
tion,  he fully expected some most striking results from it, but that
he had been disappointed on every occasion where it had been pre-
scribed.  Still it was his intention to watch carefully its effectson
some future opportunity.  From what he had seen, he had little faith
in its  use, either as a local application  or as  an internal  remedy.

   1 Gazette Medicale de Paris, No. 48,1840; or Journ.de Pharmacie, Avril, 1841,p.2l3-
   * The Structure and Functions of the Female Breast, p, 428.  Lond. 1846. 
PLATINI BICHLORIDUM.
577
  The preparations of platinum  have been prescribed by Dutten-
hofer and Prevost in scirrhus of the stomach ; and by the latter
in epilepsy.1   They are, however, but  little  employed  at  the
present day.
            CXXXVI. PLATINI BICHLORIDUM.

 Synonymes. Platini Perchloridum, Platina Muriatica, Platinum  Bichlo-
  ratum, Chloridum Platinae, Bichloride or Perchloride or Chloride of
  Platinum.
 French. Bichlorure ou Perchlorure de Platine.
 German.  Chlorplatin,  Platinchlo r i d , Salzsaures  Platin-
  oxyd.

  This preparation is made by dissolving platinum in aqua regia,
 and evaporating  the  solution  to dryness.  A  very  gentle heat
 ought to be used;  otherwise the bichloride  may be  decomposed;
 and the  protochloride, or even reduced platinum, be the result.
   Bichloride of platinum in concentrated  solution or in  the solid
 state is of a deep  red colour.   It  is very deliquescent, very solu-
 ble in water, and soluble also in alcohol.

               Mistura platini  perchloridi.
            Mixture of perchloride of platinum.
                        (Potion plaiinique.)
                R. Platin. perchlorid. sice.  gr. iss.
                    Mucilag. acac.
                    Aquae aa. f §iij.

  To be taken by table-spoonfuls in the  course of the 24 hours.

                Pilulae platini  perchloridi.
               Pills of perchloride of platinum.
                       (Pilules Platiniques.)
                   R.  Platin. perchlorid. gr. viij.
                      Guaiac resin, gi.
                       Glycyrrhiz. pulv. q. s. ut fiant pil. xx.

  Dose.—One, two, three, or four, morning and evening.

            Unguentnm platini perchloridi.
            Ointment of perchloride of platinum.
                      (Pommade platinique.)
                   R.  Platin. perchlorid. gr. xv.
                       Extract, belladon. gss.
                       Adipis %i.

  To be applied to indolent ulcers.

  ' Dierbach, Die neuesten Entdeckungen in der Materia Medica, 2er Band. S. 1173.
Heidelberg und Leipzig, 1843;  and Aschenbrenner, Die neueren Arzneimittel, u. s. w.
S. 226. Erlangen, 1848. 
578
PLUMBI IODIDUM.
          CXXXVII.  SODII CHLOROPLAT'INAS.
Synonymes.  Platina Muriatica Natronata,  Chloroplatinate of Sodium,
  Double Chloride of Platinum and Sodium.
French.  Chloroplatinate de Sodium, Chlorure Double de Platine et de
  Sodium.
German.  Chlorplatinnatrium, Natriumplatinchlorid.
  The chloroplatinate  of sodium is prepared by dissolving bichlo-
ride of platinum and very pure chloride of sodium in proper
proportions in water, evaporating and crystallizing.  It is soluble
in water and  in  alcohol, and  crystallizes in  beautiful transparent
prisms of an intensely yellow colour.
             Mistura sodii chloroplatinatis.
           Mixture of chloroplatinate of sodium.
                (Potion de chloroplatinate de sodium.)
                  R.  Platin. perchlorid. gr. v.
                      Sodii chlorid. pur. gr. viij.
                      Mucilag. acac.
                      Aquae aa. f ^iij.
  To be taken by spoonfuls in the 24 hours.
            Injectio sodii  chloroplatinatis.
          Injection of chloroplatinate of sodium.
              (Injection de chloroplatinate  de sodium.)
                 R.   Sodii chloroplatinat. crystalliz. gss.
                      Decoct, papaveris  Oss.
  The experiments  of  M. Hofer with the salts of platinum have
not been numerous; but they confirm the assertions of Magendie,
that they possess properties analogous to those of the salts of gold.
              CXXXVIII.  PLUMBI IO'DIDUM.
Synonymes.  Plumbi Ioduretum seu Iodatum seu Hydriodas seu Hydro-
  iodas seu lodhydras, Plumbum Iodatum seu Hydroiodicum, Iodide or
  Ioduret of Lead.
French.  Iodure de Plomb, Iodure plombique.
German.   Bleiiodid, Iodblei, Bleiiodur, Einfach  Iodblei,
  Hydroiodsaures oder Iodwasserstoffsaures Blei.
                  METHOD OF PREPARING.
  This preparation may be made by adding a solution of one hun-
dred parts of iodide of potassium to a  solution of seventy-five
parts of acetate of lead.
  The London Pharmacopoeia of 1836, gives the following form:
—Take of acetate of lead, nine ounces;  iodide of potassium,
seven ounces;  distilled water, a gallon  (imperial measure:) dis-
solve the  acetate  of lead in six  pints of  the  water, and filter: 
PLUMBI IODIDUM.
579
 to these add  the iodide of potassium, previously dissolved in two
 pints of the water: wash the precipitate and dry it.
   In the Edinburgh  Pharmacopoeia,  it  is directed to be prepared
 by the double decomposition of nitrate of lead and iodide of po-
 tassium.   Dr. Christison1 considers, that the nitrate is preferable
 to the  acetate  of lead,  as being more uniform  in composition,
 and  free from any excess of oxide of lead, which interferes with
 the purity of the product.
   Iodide of lead is of a bright yellow colour.   According  to Sou-
 beiran,2 it is soluble in 1235 parts of cold water; and is somewhat
 more soluble in boiling water, which, on cooling, deposits the iodide
 in minute, shining, yellow, crystalline scales.   Riecke3  says it is
 soluble in  1200  parts of cold water, and  in 200 of hot.   When
 heated  it  melts, and  is  dissipated in  vapours, which are  at first
 yellow, and afterwards violet.

                  EFFECTS ON THE ECONOMY.
   Iodide of lead is not an irritant, when applied even to a denuded
 surface.4   M. Paton5  administered twelve  grains of it to a cat of
 moderate size.  In four hours the animal did not appear to expe-
 rience any inconvenience; twelve more grains were then  given; in
 twelve  hours, the animal became uneasy,  and  constantly  refused
 every kind of food.  It appeared to suffer  in the kidneys.   Sub-
 sequently,  it was attacked with  violent colic, which caused it  to
jump to great heights.   Three days after taking  the  iodide, it
died, suffering dreadfully.  The dissection was  made twelve hours
 afterwards, when  no  traces of  irritation were perceptible.   M.
 Paton examined the exterior of the stomach chemically, but was
 unable to detect any of the iodide, nor could any portion of it be
 discovered in  the  fseces.   He then boiled the intestines  and their
 contained matters in  distilled water;  the liquid was filtered and
 decolourized by charcoal, but no effect wras  induced by the tests
 for lead.   The matter remaining on the  filter was  digested in di-
 lute nitric acid: the solution was filtered, and a precipitate obtained
 on pouring in a solution of chromate of potassa.  The liquid was
 evaporated; the residue calcined along with what was left by the
 evaporation of the water, and the whole brought in contact with
 dilute nitric acid.  Nitrous gas was  disengaged, and the solution
 responded  to re-agents like the solutions of the salts of lead.   M.
 Paton infers, that iodide of lead introduced into the stomach is
 partly absorbed, and that it is this portion which causes death,—
 the remainder passing into  the  intestines, and admitting of detec-

  1 Dispensatory, p. 711.  Edinb. 1842.
  * Traite de Pharmacie, cited in Dispensatory of the United States of America, 6th
 edit. p. 1076.  Philad. 1845.
  3 Die neuern Arzneimittel, u. s. w. 2te Auflage, S. 563.  Stuttgart, 1840.
  4 Eager, Dublin Journal for 1834.
  » British Annals of Medicine, Mar. 3, 1837. 
580
PLUMBI IODIDUM.
tion by the method described.   When given internally, in the dose
of a quarter or half a grain, Velpeau thought, that it  occasioned,
in one instance, irritation in the alimentary canal; but Dr. O'Shaugh-
nessy thinks that this result must have been owing to idiosyncrasy,
as ten-grain doses  can be borne  with perfect impunity.  The ex-
periments of Dr. Cogswell1 show, that it is by no means an active
agent, and that its physiological operations do not correspond with
its  therapeutical  effects;  as, in continued  doses, it produced the
constitutional action of lead, and not at all that  of iodine.
   Owing to its not exciting cutaneous irritation—like iodine and
iodide of potassium—iodide of lead has been  applied  externally.
Velpeau2 treated three cases of enlarged glands with very grati-
fying success,  although the patients  had used frictions with other
preparations of iodine ineffectually.   Similar good effects were ob-
served by  Guersent, Roots, Cottereau, Baudelocque,  Delisle, and
others.3   Dr.  Pereira,4 however, used it in two cases  of enlarged
cervical glands without benefit.   Dr. Christison5 has seen it  re-
peatedly useful to  appearance in obstinate  ulcers, especially when
" consecutive to mercurio-syphilitic eruptions  in strumous habits."
The dose is three, four, or  more grains.  Bally has  given  30
grains at a dose.
                     Pilulae plumbi iodidi-
                     Pills of iodide of lead.
               R.   Plumbi iodid. gr. iv.
                   Confect. rosae §j.  M. et divide in pilulas xij.
   Dose.—One, night and morning, in scrofulous affections of the
glands,  joints, &c.  The dose may be gradually increased  to'three
or  four pills, or more.                      Cottereau and  Joy.6
                   Unguentnm plumbi iodidi-
                   Ointment of iodide of lead.
               R.   Plumbi iodid. §j.
                   Adipis § viij.  M.
   Applied to scrofulous and other indolent swellings in the form
of friction.7                                     Lond. Pharm.
                CXXXIX. PLUMBI  TANNAS.
Synonymes.  Plumbum Tannicum seu Scytodepsicum, Tannate of Lead.
French.  Tannate de Plomb.
German.  Gerbe stoffblei, Bleitannat.

  1 Essay on Iodine, p. 142.  Edinb. 1837.
  1 Lugol, Essays on Iodine, &c. by O'Shaughnessy, p. 206.
  3 Riecke, Nachtr'age zu ersten Auflage der neuern Arzneimittel, S. 78. Stuttgart, 1B4U,
and Aschenbrenner, Die neueren Arzneimittel u. s. w. S. 229, Erlang. 1848.
  1 The Elements of Mat. Med. and Therap. 3d edit. i. 744. Lond. 1849.
  s Dispensatory, p.  712.  Edinb.  1843.                       .
  6 Tweedie's Library of Medicine, v. 320.  Lond. 1840, or 2d American edit. vol.
iii. Philad. 1842.                                         n „  . 1Q.„
  1 Trousseau and Pidoux, Traite de Therapeutique &c 3eme edit. l. 142. Pans, 184^. 
POTASSA CHLOR AS.                  581
                   METHOD OF PREPARING.
   Tannate of lead  is formed  by precipitating  an infusion of oak
 bark by acetate of lead, according to the following formula: " Take
 of oak bark, in coarse powder, an ounce; boil  in eight ounces of
 water, until, when strained, four ounces remain:  add acetate of lead
 as long as any precipitate falls; filter the liquor through bibulous
 paper, and dry the precipitate remaining on the paper to the con-
 sistence of a thin ointment."
                 EFFECTS ON THE ECONOMY.
   Autenrieth1  has  strongly recommended tannate of lead in cases
 of paratrimma ad decubitum or sores produced by lying, and its
 advantages have been confirmed by others; and Dr. Tott has ad-
 vised  it in cases of decubitus gangraenosus or sloughing sores pro-
 duced by lying.2   In one case, in which  it appeared  to  be ineffi-
 cacious, he took two drams of the dried precipitate, mixed it wTith
 an ounce of unguentum rosatum, and used this unguentum plum-
 bico-tannicum with success.  M. Ossieur has spoken highly of it
 in the same affection.
   As  a means of preventing chapped nipples it  has  been highly
 extolled by M. Leon.3  He advises every pregnant woman, who
 has  reason  to fear  this  painful affection, to  apply the following
 ointment, during the month preceding delivery, over  the nipple
 once a day, washing it previously with warm water.   Should the
 ointment  be too irritant, the oil of roses may be left  out, as it is
 only employed  to " aromatize " it.
                Unguentum plumbi tannatis.
                Ointment of Tannate of  lead.
             R.  Plumbi tannat. £j.
                 Cerat. ^j.
                 01. ros. gtt. ij. M.
                                                       Leon.

                CXL. POTASS^ CHLORAS.
Synonymes.  Kali Chloricum seu Oxychloricum seu Chlorinicum  seu
  Oxymuriaticum seu Muriaticum Hyper-oxygenatum, Chloras Kalicus
  Depuratus seu  Potassicus, Alcali Vegetabile Salito-dephlogisticatum,
  Chloruretum Potassae Oxidatum, Haloidum Oxygenatum, Murias Potassae
  Hyper-oxygenatum  seu Oxygenatum, Oxygeno-chloruretum  Potassii,
  Potasses  Euchloras, Chlorate of Potassa, Chlorate of Protoxide of Potas-
  sium, Oxymuriate or Hyperoxymuriate of Potassa.
French.  Chlorate de Potasse.
German.   Chlorsaures Kali', Oxydirt  oder Hyperoxygenirt
  Salzsaures  Kali.
                   METHOD OF PREPARING.
   In the  chemical  manufactories, chlorate  of potassa is  usually
  1 British Annals of Medicine, June 2, 1837; and Joum.de Chim. Med., Mars, 1837.
  2 Grafe und Walther's  Journal der Chirurgie, B. xxiv. S. 676. Berlin, 1836;  and
Gazette Medicale, Jan. 1837.
  " Gazette Medicale, cited in Abeille Medicale, I Octobre, 1848, p. 217. 
582
POTASSiE CHLORAS.
prepared  b£ passing" chlorine gas into a  solution of carbonate of
potassa.  In this way, chlorate of potassa is obtained mixed with
more or less chloride of potassium.   The salt prepared in the labo-
ratories, before it is adapted for medical use, should be purified by
recrystallization.1  It is to be observed, that when  the adequate
quantity of chlorine gas is not employed in the preparation, the
resulting compound is analogous to chlorinated  soda  and chlori-
nated lime, and in action it agrees  rather  with those  preparations
than with true chlorate of potassa.  This may tend to explain
the discrepancy in the experience of different physicians.
   Chlorate of potassa  crystallizes  in white leaves having  the
splendour of mother-of-pearl, or in four or six-sided tables having
a specific gravity of 1.989.   It is permanent in  the air, and has a
cool, saline, disagreeable taste, similar to that of saltpetre.   Six
parts are soluble, at the ordinary temperature, in 100 parts of water.
When exposed to heat, oxygen escapes, and chloride of potassium
remains.   When beaten forcibly in  a mortar, it crackles, and emits
light and sparks.  Rubbed lightly with  inflammable substances,
or when struck, it inflames readily, and hence its well known em-
ployment in the formation of matches.

                  EFFECTS ON THE ECONOMY.
   These have  not been completely tested,—in the opinion of some
at least.2   L. W. Sachs, who has frequently  administered it, is of
opinion, that in this salt the direct effect of the  alkali is rendered
milder by the  chloric acid, whilst  the  alkali modifies that of the
acid: in this manner, the caustic property of the alkali is destroyed;
and the liquifying or resolvent (fluidisirende) property is mo-
derated, but  not removed.  On  the other hand, by  the union of
the chloric acid with  the alkali, the powerful excitant action on
the nerves, which the former exerts, is at the same time manifestly
moderated, although  certainly not destroyed: the mode  in which
it is exerted, he thinks, is probably changed.   By such a union, a
medicine has been supposed to  be  formed, which acts chiefly on
the nervous system, and which is capable of  mitigating and pro-
bably of removing any morbid erethism therein,  with hyperesthe-
sia  thereby induced.
  Such is the  opinion of certain therapeutists.   Others imagine,
that it is capable of purifying the mass of blood  in consequence of
the chlorine it  contains; but a salt of chloric  acid is not possessed
of the same properties as chlorine; and, accordingly, when the au-
thor has found occasion to administer  it, he  has never witnessed
any of the effects ascribed to it; nor has he  seen any evidence of
the modus operandi on the nervous system mentioned above, or of

  1 For various forms of preparation see Pereira, Elements of Materia Medica and The-
rapeutics, 3d edit. i. 490. Lond. 1849.
  a Riecke, Die neuern Arzneimittel, S. 300, und 2te Auflage, S. 451.  Stuttgart, 1840, 
POTASS^ CHLORAS.
583
 its imparting oxygen to the  blood as  supposed by some.1  The
 saline powder given below, which was  considered by Dr. Stevens
 to be so useful in many febrile affections, is affirmed by Mr. Braith-
 waite~  to have been very beneficial in typhous cases, marked by
 dry, parched, brown or black tongue;  dark sordes on the  teeth
 and  gums, &c,  &c.  In  almost every case, he  found the dark
 appearances in the  mouth altered in an incredibly short time.
    From its excitant properties, and under the notion that it may
 act upon the blood, and through the blood on the function of nu-
 trition as an excellent  alterative, chlorate of potassa has been re-
 commended in chronic cutaneous diseases in general, as well as
 in hepatic and syphilitic  affections.   It has also been occasion-
 ally administered in  chronic asthenia.
    Kohler3 employed it  in several cases of tubercular phthisis, and
 notwithstanding the general results of his  experiments were un-
 favourable, he thinks it ought to be admitted  into the number of
 those remedies that are useful in phthisis, although its stimulating
 action  on the circulating and pulmonary systems cannot be denied.
 Its use is contraindicated where the fever runs high, and where
 there is  any sign of inflammation of the lungs, or tendency to
 haemoptysis.   Dr. Christison4 states, that he has tried  the effects
 of seven-grain doses three times a day in phthisis, but could not
 observe any physiological or therapeutical action whatever.
   Sachs, in  accordance  with the views before mentioned in regard
 to its antineuropathic properties, has advised  it in cases of proso-
palgia.  He affirms, that, in a great many instances, it afforded
 essential relief.   Chisholm  appears to have been one of the earli-
 est to prescribe it in neuralgia faciei;  and, after  him,  Herber,
 and subsequently, B. Schaffer, Jos. Frank,  Meyer, and others,
 employed it both as a curative and palliative agent in that disease.
 It has likewise been advised in obstinate rheumatism of the ner-
 vous kind by Knod von Helmenstreit; and Eyr has extolled it in
 ulceration of the mouth after violent salivation.
   In  cancrum oris and phagedena of the cheek, both of which
Dr. Henry Hunt5 regards as identical, varying  only in the degree
of severity, and proceeding from a cachectic condition of the system,
he has found chlorate of potassa, freely given, followed by the best
results,—the beneficial  influence of the salt being generally appa-
rent within 48 hours after its first administration:  and it seldom
failed to arrest the progress of the disease, and to effect a cure, if
administered before  the patient was much  exhausted.   He gave it

  ' See Stevenson the Blood, p. 296.  London, 1832; and Pereira, Elements of Mat.
Med. and Therap. 2d edit. i. 514.   Lond. 1842; or 2d Amer. edit, by Carson, Philad.
 1846.
  2 Retrospect of Practical Medicine and Surgery, July  to December, 1840, p. 275.
  3 Rust's Magazin, B. xlvi.           * Dispensatory, p. 739.  Edinb. 1842.
  1 Lond. Med. Gaz. April 7,  1843, p. 76, and Medico-Chirurgical Transactions, xxvi.
142. 
584
P0TASS.3E chloras.
in the dose of from gj. to gij., according  to the age of the child,
in twelve hours.  It appears to have been employed successfully
in the same affection in Romberg's Poliklinik, in  Berlin.   For
children, some years old, eighteen grains were dissolved in three
ounces of water, with half an ounce  of syrup; and of this mixture
a table-spoonful was given  three times a day.   A few  days were
sufficient for the cure.1
   Dr. Watson2 affirms,  that he has  been in the  habit of directing
a solution of chlorate of potassa in water {Potass, chlor. 3j- *ftq.
Oj)  as a drink  for patients in scarlet fever, and  in  the typhoid
forms of continued fever ;  a practice which  was suggested to
him by  Dr. Hunt, who  informed  Dr. Watson that he had long
employed it with advantage.  Under  the use of a pint or a pint
and a half of the solution daily, he  noticed, in  many instances, a
speedy improvement of  the tongue, which, from being furred, or
brown or dry, became cleaner and  moist.  Dr. Scruggs, of Ger-
mantown, Te.3 extols it both as an  internal remedy and a collu-
tory in  the erysipelatous inflammation of the mouth and fauces,
which occurs in the  ' black  tongue ' of the Western States; and
Mr. J. Allison* speaks highly of it as  an internal remedy in cases
of mercurial salivation.  He cautions the practitioner, however,
to watch its effects;  for if its exhibition, he says, be not disconti-
nued at  the proper time, a  state of the system may be induced
characterized by the phenomena of true inflammation.

                  MODE OF ADMINISTRATION.
   Sachs prescribed  it in the dose  of from three to six grains,
three or four times a day, but some give it in much  larger quan-
tity.  It may be administered either in the form of powder or of
solution.
   It would appear,  as  Dr.  Pereira5 has  properly remarked, that
most of  the uses of this salt have been founded on certain views
of chemical  pathology,  some of which are now  considered un-
tenable.   It passes  through the kidneys  unchanged, and conse-
quently  the notion that  it furnishes oxygen  to the  system must
be discarded.   Frotn the results of  the author's  numerous trials
with it, he  is  disposed  to  accord  with  Dr. Christison,8  that no
evidence has yet been published of such a nature as to entitle it to
admission into the pharmacopoeias: yet it is officinal in the London
Pharmacopoeia.
  1 Mlttheilungen des badischen "arzlichen Vereins.  Karlsruhe, Nr. 5, Marz 13, 1850;
cited in JNordamerikanischer Monatsbericht  fiir Natur und Heilkunde, Dec. 1, 1850,
S. 216.
  2 Lectures on the Principles and Practice of  Physic, 2d Amer. edit. p. 1024. Philad.
1845.
  3 Medical Examiner, for April, 1849.
  * London Med. Gazette, cited in Amer. Joum. of the Med. Sciences, for Jan. 1847,
p. 169.
  5 Op. cit. 3d edit  i. 493, Lond, 1849.            8 Ibid. p. 738.  Edinb. 1842. 
POTASSII BROMIDUM.
585
         Pulvis  potassa] chloratis  compositus.
          Compound powder of chlorate of potassa.
                     (Stevens's saline powder.),
             R.  Potassae chlorat. gr. viij.
                 Sodii chlorid. gr. xx.
                 Soda? bicarbonat. gr. xxx.  M.
  One of these to be given every two or three hours in low febrile
cases.                                               Stevens.

                Liquor  potassa;  chloratis.
               Solution of chlorate of potassa.
       Solutio muriatis potassae oxygenati, Liquor ad ulcera atonica.
             R'.  Potassa? chlorat. 55 j.
                 Aquse destillat. f^xij.  M.
  To be applied to indolent ulcers, by means of lint, or of a camel's
hair pencil, dipped in it,  to  excite the tissues.—Swediaur.1

                 Potus  potassse  chloratis.
                Drink  of chlorate of potassa.
            Potus oxygenatus.—French: Tisane  oxygenic
             R.  Liquor, potass, chlorat. Oij.
                 Aquae Oiv. "M.
  Given internally in cases  of general asthenia.
  Dose.—One  or two pints a day.                 Swediaur.

               Mistura potassa; chloratis.
               Mixture of chlorate of potassa.
             R.  Potassae chlorat. giss.
                 Aquae destill. f §iv.
         Solve.
  Dose.—A spoonful, every two hours.     Von Helmenstreit.
  Eyr dissolves twenty-five grains of the chlorate in four fluid-
ounces of distilled water, and administers a  spoonful three times
a day.
             R.  Potass, chloral, gj.
                 Syrup,  althaeae f ,fj.
                 Aquae destill. f^iv.  M.
  Dose.—A table-spoonful  four times a day.          Kohler.
               CXLI.  POTASSII  BROMIDUM.

Svnonymes.  Kalium Bromatum,  Bromuretum  Potassicum, Brometum
  Kalii, Brometum seu Bromuretum Potassii, Bromide of Potassium. In
  solution, Potassae Hydrobromas, Kali Hydrobromicum,  Bromhydras
  Potassae, Hydrobromate of Potassa.
French.  Bromure de Potassium.
German.  Bromkalium,  Kal iu mbromid,  Kaliumbromiir,
  B romwasserstof fsaures oder  Hydrobromsaures Kali.
' Pharm. Med. Pract.  Bruxelles, 1817,2d edit. 
586
POTASSII BROMIDUM.
                    METHOD OF PREPARING.
    According to Liebig, this preparation can be  readily made  by
 dissolving bromine in alcohol, and adding potassa until the spirit
 begins to change colour, then evaporating and heating to redness.
 In the London Pharmacopoeia, it is directed to be made by addino-
 first an  ounce  of iron filings,  and afterwards  two  ounces  of
 bromine, to a pint and a half of distilled water.  The mixture is
 set aside for half an hour, and frequently stirred with a spatula;
 a  gentle heat is then  applied, and when a greenish colour  is pro-
 duced, two ounces and a dram  of  carbonate of potassa, dissolved
 in a pint and a half of water, are poured  in.  What remains is
 filtered and washed with two pints of boiling distilled water, and
 again  filtered.   The mixed solutions are  then evaporated,  that
 crystals  may form.
    Liebig says it crystallizes in  four-sided  shining  tables; but ac-
 cording  to  Ballard,1 commonly in cubes, and  at  times in long
 rectangular parallelopipedons.  It has a pungent  taste like  that
 of common salt, but more acrid; and is devoid of odour.   By heat,
 it  crepitates, and melts  into a red-hot flux,  without  experiencing
 change.   It is more soluble in hot  than in cold water; producing,
 during its solution, evident  cold, and  becoming  converted  into
 hydrobromate of potassa.   It is also soluble in alcohol, although
 in  small quantity.  The solution of bromide of potassium dissolves
 no more  bromine than pure water.
                  EFFECTS ON THE ECONOMY.
    Bromide of potassium excites the same phenomena as bromine,
 but with less certainty and intensity.2   From a dram and  a half
 to  two drams is  needed to kill a dog.  The  animal appears to
 suffer;  is restless, and  gradually falls into a state of  prostration.
 In  smaller doses, it appears to act powerfully  on  the human
 stomach.  The bromide, like bromine, seems first to have been
 applied to  therapeutical purposes  by Pourche.3   Two cases of
 scrofulous tumours are reported by him to have been removed by
 friction with an  ointment  composed thereof,  and a cataplasm
 sprinkled with an  aqueous solution.  In a third patient, chronic
 oiorrhoea and scrofulous tumefaction  of the testicle yielded  to the
 same agency, combined with the internal  use of bromine.  A very
 large goitre was reduced two-thirds by it.   Pourche prescribed it
 internally in the form of pill, in the dose  of four to eight grains in
 the day.
  Magendie4 employed the  preparations of bromine in scrofula, in
amenorrhcea,  and in hypertrophy of  the ventricles of the heart.

  1 Annales de Chimie, torn, xxxii.
  a Bouchardat, Annuaire de Therapeutique pour 1847, p. 237.  Paris, 1847,
  3 Journ. de Chimie Medicale, iv. 594; see, also,  Bulletin General de Therapeutique,
No.  14, 30 Juillet. 1837.
  ' Formulaire, ed. cit. 
POTASSII BROMIDUM.
587
Prieger recommended an ointment of " Kali bromicum"  in inve-
terate porrigo favosa as well as in obstinate and malignant tetter,
and with  good success; and  Dr. Williams1  in cases of enlarged
spleen.   The last gentleman suggests, that it possesses " unusual,
if  not  specific (?) powers in the cure of diseases of the spleen."
It was owing to these results that the bromide was introduced into
the London Pharmacopoeia of 1836.2  Dr. Williams also  gave it
with success in a  case of ascites.
   The low price  of the bromide compared  with that of the iodide
of potassium induced M. Ricord  to substitute it in the treatment
of secondary syphilitic affections.  He gave it in the  same  dose.
The therapeutical effects were found to be identical, but  induced
more slowly.   The results of the experience of others has, how-
ever, been less satisfactory.  Dr. Egan, from  extensive observa-
tion, has satisfied  himself, first, that the iodide of potassium exerts,
in the majority of instances of secondary and tertiary syphilis, an
instantaneous,  decided, and  always  beneficial action, contrasted
with the bromide; the  effects of which are  slow, unsatisfactory,
and frequently unsuccessful.  And, secondly,  that the iodide seems
to act favourably not only upon  the  disease for  which it  is pre-
scribed, but also  upon the constitution in  general, increasing the
appetite and improving the powers of digestion,  thereby enabling
the patient to  gain  flesh when  under its influence;  whilst the
bromide not unfrequently produces nausea, impairs  the appetite,
and deranges the  digestive organs; and, lastly, that every form of
secondary  and  tertiary syphilis, with the exception  of iritis,  is
amenable  to the action of the iodide,  whilst that  of the bromide is
extremely circumscribed.
   Similar  views  to  those  of Dr. Egan are maintained by  Drs.
Stapleton and Geoghegan.3
                 MODE OF ADMINISTRATION.
                 Liquor  potassii  bromidi.
              Solution of bromide of potassium.
              R.   Potassii bromidi gr. vi.—viij.—x.
                  Aquae lactucae f ^iij. -
                  Syrup althaeae f %\.   M.
   To be given in the course of twenty-four hours, in table-spoon-
fuls.                                              Mage\idie.
              Unguentum  potassii bromidi.
              Ointment of bromide of potassium.
              R.  Potass, bromid. gr. xxxiv.
                  Adipis gj.  M.
  1 Elements of Medicine, i. 338.
  1 Pereira, Elements  of Mat. Med. and Therap. 2d edit. i. p. 499.  Philada. 1842; or
2d Amer. edit, by Carson.  Philad. 1846; and  Brande's  Diet, of Mat. Med.  p. 126.
Lond. 1839.
  3 Dublin Medical Press, May 19,1847; cited in Amer. Journal of the Med. Sciences,
July, 1847, p. 206. 
588
POTASSII CYANURETUM.
From half a dram to a dram to be rubbed on scrofulous swell-
gs.                                            Magendie.
M. Pourche employs 3j. of the bromide to the ounce of lard.
     Unguentum  potassii bromidi  compositum.
       Compound ointment of bromide of potassium.
            R. Bromini gr. vi. ad xij.
               Potassii bromid. gr. xxiv.
               Axung. 3j.  M.
                                               Magendie.
            CXLII. POTAS'SII CYANURETUM.
Synonymes.  Potassii Cyanidum, Kali Hydrocyanicum seu Cyanogena-
  tum sen Cyanatum seu Borussicum, Kalium Cyanogenatum, Cyanu-
  retum seu Cyanidum Potassicum seu Kalii, Cyanidum seu Cyanetum
  Kalii,  Hydrocyanas sen Cyanhydras Potassae seu Kalicus, Cyanide or
  Cyanuret of Potassium.
French.  Cyanure de Potassium.
German.  Cyankalium,  Bl austoff kalium, Kaliumcyaniir,
  Kaliumcyanid  Hydrocyansaures Kali, Cyanwasser-
  stoffsaures Kali, Blausaures  Kali.
  This  preparation was  proposed by  MM. Robiquet  and Viller-
me,1 as  a substitute for hydrocyanic acid.  It is, in their opinion,
far more certain in its effects than that.
                   METHOD OF PREPARING.
  Cyanuret of potassium is formed whenever  potassa is calcined
with an animal matter, as in  the preparation of Prussian blue.
It is commonly prepared  after the process of Robiquet, by ex-
posing  to long continued heat the ferrocyanuret  of potassium.
The cyanuret of  iron is  completely decomposed, and  that  of po-
tassium remains.  The residuum, after  this strong calcination, con-
stitutes  a solid, blackish mass, which consists wholly of cyanuret
of potassium, soiled by the iron and the charcoal  belonging to the
cyanuret of  iron.    The mass is dissolved in water, when the iron
and charcoal are deposited; the cyanuret of potassium dissolves,
and is transformed into hydrocyanate of potassa.   When the pro-
cess has been  well  conducted, the solution is perfectly colourless, (
and retains no portion  of iron.   M. Chevallier2 prepares the salt
by calcining the ferrocyanuret of potassium, and then separating
the cyanuret from the quadricarburet of iron by pure alcohol:  on
distilling this,  the cyanuret is obtained very pure.  Dr. Hamilton
and Mr. Mackenzie, of Baltimore,3 recommend the following pro-
cess as most convenient and simple:—Expose—say—four  ounces
of the dried ferrocyanuret of potassium in a common Hessian cru-
cible to a red heat,  until nitrogen ceases to pass over; (this gene-
  1 Bulletin de la Societe Medicale d'Emulation, Juillet, 1823. See, also, James Ham-
ilton and Thos. G. Mackenzie, in Maryland Med. and Surg. Journ., April, 1841). p. 201.
  2 Journ. de Chimie Medicale, and journ. of Philad. College of Pharmacy, 1832.
  ' Op. cit. p. 203. 
POTASSII CYANURETUM.
589
rally takes from one and a half to two hours;) then, breaking the
crucible, powder the black mass quickly, and  add—say—sixteen
fluidounces of alcohol, stirring the mixture repeatedly, until it ac-
quires the temperature of about 1503 Fahr.; then filter, and eva-
porate by a sand  or water bath, regulated  so as  to be below the
boiling point of alcohol; for if heated above this temperature, oil
of wine is formed, which'is gradually decomposed during the pro-
cess, and carbon is deposited, which blackens the mixture.   The
evaporation should be»carried on so as to have as great an extent
of surface exposed as  possible.  The ferrocyanuret will be found
to have  yielded six or seven  drams of the cyanuret, which is dry,
inodorous, and perfectly white.
   The  following process  is  directed in the last  edition  of the
Pharmacopoeia of the United States, (1842:)—Take of ferrocy-
anuret  of potassium, in powder, § viij.; Distilled water,  f Jvj.
Expose  the  ferrocyanuret to  a  moderate heat until  it becomes
nearly white, and is wholly deprived of its water of crystallization.
Put the  residue in an earthen retort,  with the beak loosely stopped,
and expose it to a red heat for two  hours, or till gas ceases to be
disengaged.  Withdraw the  retort from  the fire, close the orifice
with lute, and  then let the whole remain until quite cold.   Break
the retort; remove the black mass, and reduce it to coarse powd»,
introduce it into a bottle of the capacity of twelve fluidounces, and
then add the distilled water.  Agitate the mixture occasionally
for half  an hour, throw it on a filter, evaporate the filtered solu-
tion rapidly to dryness, and keep the dry mass in a closely stopped
bottle.
   Pure  cyanuret of potassium is white  and transparent: it may
be fused in the fire without being decomposed, and keeps for an
indefinite period, provided it  be preserved dry.  It is very soluble
in water, but sparingly so in  alcohol.   All  acids decompose it,
even the carbonic: hence the solution, when  exposed  to  the air,
emits the smell of hydrocyanic acid; and carbonate of potassa is
formed, in  the  place  of the  hydrocyanate of potassa.   It  has a
sharp, somewhat alkaline, and bitter almond taste, and an alkaline
•reaction.
                 EFFECTS ON THE ECONOMY.
   MM.  Robiquet and Villerme  performed some  experiments on
animals  in the  presence of  Magendie.1   A tenth  of  a grain  de-
stroyed a male linnet in a minute;  less  than a grain  killed  a gui-
nea-pig in two or three minutes:  a small  drop of the hydrocyanate
of potassa, containing only  the hundredth  part of a grain  of  the
cyanuret in solution, caused  a linnet to drop down dead in  half a
minute.   Half a  dram, containing five grains of the cyanuret,
killed a dog of large size in a quarter of an hour;  and three grains

  1 Formulaire pour la Preparation, &c, de plusieurs Nouveaux Me'dicamens, &c.
       38 
590
POTASSII CYANURETUM.
proved fatal to a man in three quarters of an hour.1 Dr. Letheby2
states, as the  result of  his experiments on animals, that with  the
exception of hydrocyanic acid,  of  the strength of four per cent.,
cyanuret of potassium  is the most virulent  and active of all  the
compounds into which cyanogen enters.
   Magendie proposes, that  the cyanuret of potassium should be
dissolved in eight times its weight of distilled water, when it  be-
comes transformed  into hydrocyanate of potassa.  To this solution
he gives the  name medicinal hydrocyanate  of potassa, and  ad-
vises that it should be given under the same circumstances, and in
the same doses, as the medicinal hydrocyanic acid, (see pages 24
and  35.)  He farther  suggests, that to render it wholly indepen-
dent of the action of the small  portion of alkali contained  in  the
cyanuret, a few drops of some vegetable acid may be  added, or it
may be prescribed with an acid syrup.
   The dose of the  cyanuret is a quarter of a grain at first, gra-
dually increased to  a grain and  more.  M. Bally gave it to fifty-
two  individuals labouring under different diseases: it produced no
effect on thirty-five; and,  on the others, the result was  neither
constant nor salutary, so that he  is not inclined  to  place more
reliance upon the cyanuret than upon  hydrocyanic acid.
*  By M. Lombard,3 of Geneva, it has been  applied  externally,
with success,  in some cases of facial  neuralgia.   He uses it  by
friction, in the form of watery solution, or of ointment, according
to circumstances.   The watery  solution is in the strength of from
one to four grains to the ounce of water;  and the ointment is com-
posed of from two to four  grains of the cyanuret to an ounce of
lard.   The aqueous solution, however, is considered by Dr. Lom-
bard to be the most-prompt in its effects.  He regards the cyanu-
ret to be contraindicated where the  nervous  affection is compli-
cated with inflammatory action.  He has found it a useful remedy,
also, in chronic  rheumatism.  In sciatic  neuralgia, it was not
successful.  In white swelling, attended with acute  pains, poul-
tices, moistened with the solution, gave great relief.  Dr. Lombard,
indeed, affirms, that the soothing  properties of the cyanuret  are
superior to those of any remedy known.   Lotions of hydrocyanic
acid  are  not to be compared with it,—the acid being  decomposed
with facility,  and not devoid of danger.
   In a case of acute rheumatism attacking the articulations of a
chlorotic  young female, M. Malherbe,4  after leeching,  applied
compresses  over the joints  affected, moistened with a  solution of
the cyanuret—ten  grains to the  ounce of  distilled water.   In
forty-eight  hours the pain  ceased.  It is probable, however, that

     1 See Christison on Poisons,  first Amer. edit p. 503.  Philad. 1845.
     a London Medical Gazette, Jan. 9,  and Feb. 4 and 17, 1H45.
     3 Gazette des Hopitaux, and  Lond. Med. Gaz., Sept 1831.
     4 Journal des Connaissances Medico Chirurgicales. 
POTASSII CYANURETUM.
591
much of the good effect was  owing  to  the compression.  MM.
Trousseau and Rullier1 also recommend the  cyanuret, in the pro-
portion of four grains to an ounce of water,  as a local application
in various forms  of neuralgia.  In the quantity of nine grains to
eight ounces of water, it is employed by M. Cazenave,3 as a lotion
in pruritus ani et vulvae.
   M. Andral3 employed it with  complete success in a case of  in-
tense cephalalgia, which, for  ten  months, had  resisted the most
powerful remedies, as bleeding, a seton  in the  neck, blisters and
sinapisms.  It was given in solution, in the proportion of from six
to eight grains to the  ounce  of distilled water;  and compresses,
wet with the  solution,  were applied, for eight days, to the fore-
head and temples.
   WThen nitrate  of silver has been long used in affections  of the
eye, it turns the  conjunctiva of a dark olive colour, and greatly
disfigures the patient.  Mr. Guthrie4 states,  that a solution of the
cyanuret, {Potass, cyanur. gr. vj.; Jlquae f ^j.,) applied by drops,
every other day,  is an admirable remedy.  It is  also equally effec-
tive in removing  the  stain made by iodine on the skin.
                 MODE OF ADMINISTRATION.
              Mistura  potassii   cyanureti.
             Mixture  of cyanuret  of potassium.
                 Mixture of hydrocyanate of potassa.
                   Pectoral mixture of Magendie.
              R.   Potass, hydrocyan. med. f 3L
                  Aquae destillat. Oj.
                  Sacchar. §iss.  M.
   Dose.—About five drams (a table-spoonful,) night and morning.
                         (Pectoral potion.)
              R.   Potass, hydrocyan. med. gtt. xv.
                  Infus. heder. terrestr. f §ij.
                  Syrup, allhaeae i\§j.   M.
   Dose.—Five grammes (a tea-spoonful,) every three hours.
                                                   Magendie.
              R.   Potass, cyanur. r/r. %.
                  Syrup, althaeae f %).
                  Aqua; lactucse f 3ij.   M.
   Dose.—Five drams (a  table-spoonful,) every  two hours.
                                                   Magendie.
              R.  Tinct. castor.
                  Moschi,
                  Potassae nitrat. aa. gr. iv.
                  Potassii cyanuret. gr. ij.
                  Aquae flor. tiliae sen
                  ----cinnamom. f 3 viij.
  1 Lond. Med. and Surg. Journ. Dec.  15, 1832; cited in Amer. Journal of the Medi-
cal Sciences, Mny. 1833, p. 23H.
  » Ranking's Half-Yearly Abstract, July to Dec. 1846, p.  199.
  * Gazette Medicale, Jan.  1832.
  ' Cited in Amer. Journ. of the Med. Sciences, Oct. 1844, p. 517. 
592
POTASSII HYDRARGYRO-IODIDUM.
   To be taken in the course of the twenty-four hours, in chorea.
                                                  Fouquier\
               Syrupus potassii  cyanureti.
              Syrup of cyanuret of potassium.
              R. Potass, hydrocyanat. medic, f £j.
                 Syrupi Oi.
   This syrup must be  added  to pectoral draughts, and  may be
substituted for other syrups, in appropriate cases.
               Pi 1111 sb  potassii cyanureti.
               Pills of cyanuret  of potassium.
              R. Potassii cyanur.
                 Amyli aa. gr.  iv.
                 Syrup, q. s. ut fiat massa in pilulas viij. dividenda.
   Dose.—A pill, night and morning, in convulsions, dyspnoea, &c
                                      Hospital of La Pitie.1
                Lotio  potassii  cyannreti.
              Lotion of cyanuret of potassium.
              R. Potass, cyanuret. gr. xij.
                 Mist, amygdai. f gvj.   M
   To be used in lichen, and other chronic eruptions attended with
much itching.                                        Louis.
              R. Potass, cyanur. gr. vj.
          Solve in
                 Aquae destillat. f^j.  M.
   Compresses to be wetted with  this, and applied in cases of
neuralgia faciei, hemicrania, &c.
                           Recamier,  Trousseau, Blouquier.2
             Unguentum  potassii  cyanureti.
             Ointment of cyanuret of potassium.
              R. Potass, cyanur. gr. ij.—iv.
                 Adipis gi.  M.
   The size of a hazelnut to be rubbed in, in cases of neuralgia.
                                                  Lombard.
      CXLIII.  POTASSII HYDRARGYRO-IODIDUM.

Synonymes.  Potassii lodo-Hydrargyras, Hydrargyro-iodidum Potassii;
  Hydrargyrum Biiodatum cum Kalio-Iodato, Kali Iodatum Hydrarjryra-
  tum, Kalium  Hydriodatum Hydrargyratum, lodo-Hydrargyrate of Po-
  tassium, lodhydrargyrate of Ioduret of Potassium, Hydrargyro-iodide
  of  Potassium,  Hydrargyro-biniodide of Potassium, Dihydrargyro-bln-
  iodide of Potassium.
French.  lodhydrargyrate de Potassium.
German.   Quecksilberiodidkalium.

     1 Ryan's Formulary, 3d  edit. p. 3f)2.  Lond. 1839.
     a Lincke, Vollstandiges Recept-Taschenbuch, ii. 91.  Leipz. 1841. 
I
                 POTASSII HYDRARGYRO-IODIDUM.            593

   Dr. A. Channing,1 who has highly extolled this preparation in
 various diseases, affirms, that this, with other new salts, was dis-
 covered by Bonsdorff, of the University of Finland, in 1826; and
 it is a fact well known  to the chemist, that iodine, chlorine, &c,
 enter into combinations  so as to form both acids and bases.  By
 experiment, Dr. Channing  ascertained, that a  solution of eight
 grains of pure  iodide of potassium, in  ten or fifteen  minims of
 water, would combine with a fraction  less than  eleven grains of
 red iodide of mercury,  and  maintain the  combination in solution,
 when diluted with water or alcohol to any extent.  If more than
 eleven grains of red iodide be added, although a small excess may
 be dissolved in the concentrated  solution,  on diluting with water,
 it is  promptly precipitated.  It would appear,  therefore, as Dr.
 Channing has remarked, that in preparing this salt for administra-
 tion,  the  labour of crystallizing it, in order to obtain  a solution of
 a definite strength, is wholly unnecessary; inasmuch as a solution,
 combining a fraction more  than eight grains of the iodide of po-
 tassium with eleven grains of the iodide of mercury,  may be used
 as containing twenty grains of the hydrargyro-iodide of.potassium.
   If it be desirable to obtain the preparation in a crystallized form,
 it is important that the definite proportions  of the two iodides should
 be observed, and particularly, that there be no excess of iodide of
 mercury; for the saturated solution of eight grains of iodide of po-
 tassium will dissolve, and enter into combination with, more  than
 thirteen grains of iodide of mercury, forming similar crystals soluble
 in alcohol, but in water precipitating more than two  grains  of
 iodide of mercury.
   This double salt may  also be formed by dissolving  one equiva-
 lent of bichloride or of pernitrate of mercury in a solution of four
 equivalents of iodide of potassium, evaporating to   dryness, and
 dissolving the double iodide  from the chlorohydrate   or nitrate of
 potassa by means of alcohol.  When made from the  pernitrate of
 mercury, it is liable, however, to  contain  nitre, which may be de-
 tected by  its insolubility in strong alcohol.2

                EFFECTS ON THE  ECONOMY.
   These are similar to  those of the iodides of mercury, but, ac-
cording to Dr. Channing, in a less degree.   The hydrargyro-iodide
is not, however, much employed, experience seeming to have shown,
 that- it possesses no essential, if, indeed, any advantages over those
preparations.  It  has been  highly extolled by Dr. Charles C.
Hildreth,3 of Zanesville, Ohio, in several diseases in which  a com-
 bination of iodine and mercury might be expected to  be beneficial.
In ordinary dyspepsia, his faith in its remedial powers is so strong

     1 American Journal of the Medical Sciences, Feb. 1834, p. 388.
     ' Ambrose Smith, American Journal of Pharmacy, Jan. 1841, p. 271.
     * American Journal of the Medical Sciences, Aug. 1840, p. 314, 
594
POTASSII HYDRARGYRO-IODIDUM.
that he had prescribed but little else for the previous four or five
years.   He speaks highly of it, also, in enlargement of the spleen,
amenorrhcea, dysmenorrhcea, leucorrhoea, dropsy, and glandular
enlargements of a scrofulous character.  In these last cases, he
combines the internal use with the external, according to the form
of ointment given below.
   Puche1 has recommended it as not being  so subject to produce
salivation or pains in the bones, as the other combinations of mer-
cury and iodine.

                 MODE OF  ADMINISTRATION.

         Mistura  potassii  hydrargyro-iodidi-

        Mixture of hydrargyro-iodide of potassium.

              R.  Hydrarg. iodid. rubr. gr. iv.
                  Potassii iodid. 9j.
                  AquaB destillat. f gj.  M.

   Dose.—Five drops, three  times a day.          Channing.

              R.  Hydrargyri iodid. rubr.
                 Potassii iodid. aa. gr. iv.
                 Aquae f ^i.  Solve.

   The dose of this is from two to six drops, equivalent  to from
about the thirteenth to the twelfth of a grain of the double salt.2

              R.  Hydrarg. iodid. rubr. gr. viij.
                  Potassii iodid. gr. viij.
                 Aquae destillat. fgviij.   M.

   Dose.—f 3ij. to f ^ij. in twenty-four  hours.         Puche.

        Tinctura  potassii  hydrargyro-iodidi.

        Tincture of hydrargyro-iodide of potassium.

              R. Potass, hydrargyro-iodid. gr. j.
                  Alcohol,  dilut. fgj.  M.

   Dose.—Ten drops, three times a day.           Channing.

          Pilula  potassii hydrargyro-iodidi.

         Pills of hydrargyro-iodide of potassium.

              R.  Hydrarg. iodid. rubr. gr. viij.
                  Potassii iodid. gr.  viij.
                  Sacchar. lact. gr. Ixiv.
                  Mucil. acac. q. s.  ut fiant pilute xxxij.

   Dose.—-One to eight, daily.                        Puche.

  1 Journal des  Connaissances Medicales, Oct., Nov. 1838, Janvier, 1839; and An-
nates de Chimie, Oct. 1838.
  : Ambrose Smith, American Journal of Pharmacy, Jan. 1841, p. 270. 
POTASSII IODIDUM.
595
       Unguentum  potassii  hydrargyro-iodidi-
       Ointment of hydrargyro-iodide of potassium.
             R.  Hydrarg. iodid. rubr. gr. vij.
                 Potass, iodid. Qij.
                 Adipis----3j.
  To be  applied to tumours, two or three times a day.  Should
it prove  too irritating, the proportion of lard must  be increasd.
                                                  Hildreth.
               CXLIV. POTASSII IODIDUM.
Synonymes. Kalium  Iodatum,  Iodidum  Kalii, Kali Hydroiodinicum,  K.
  Hydroiodicum, Hydroiodas Kalicus seu Lixi visa, Ioduretum Potassicum,
  lodhydras Kalicus seu  Potassae, Potassii Ioduretum, Iodide or Ioduret
  of Potassium.  In solution—Potassae Hydriodas, Potassii Proto-hydrio-
  das seu Protoxidi Hydriodas, Hydroiodas Kalicus seu  Lixiviae, lodhy-
  dras Kalicus seu Potassae, Hydriodate  of Potassa.
French. Hydriodate de Potasse, Iodure de Potassium.
German. Iodkalium,  Iodwasserstoffsaures Kali,  Kalium-
  iodiire,  Iodinwasse rstoff  Kali,  H yd ri od sau re s  oder
  Hy d riodinsaure s Kali, Kalihydr oiodat.
                   METHOD OF PREPARING.
  The process of Dr. Turner is, to take any quantity of  solution
of caustic potassa, and to add to it gradually, at a gentle heat,
iodine sufficient  to neutralize the  alkali;  then evaporating  to
dryness,  calcining strongly, dissolving  in water, and crystallizing.
Dr. William Gregory1  suggested an  improvement 'on this process,
which has been regarded as  one of the simplest.2  lHe adds iodine
to a hot  solution  of potassa until the fluid assumes a yellowish-
brown colour; then evaporates, and heats the residuum to low red-
ness in a  platinum crucible.   The mass, which at first consists of
iodide of potassium  and iodate of potassa, thus loses  all its oxygen,
and becomes converted into  iodide of potassium.
  The formula of Caillot and Baup  is to take ten parts of iodine
and fifty  of distilled water ; put them into a matrass, and  add,
in small  successive  portions, of pure  iron filings, five parts,—
shaking the vessel each time.  The liquor is then heated until it loses
its colour, is filtered, and the substance on the filter  is washed with
boiling water, until the liquid is tasteless; the liquor and the vari-
ous liquids used  in the washings are united, and  the whole is
heated in a sand  bath.   When the  temperature approaches that
of ebullition, enough of a solution  of carbonate  of potassa is
added to precipitate all the  oxide  of iron as  carbonate; it is then
filtered,  and  the  substance  on  the filter washed until it  is com-
pletely exhausted.   All the liquors are then  united,  tested  by
reddened litmus paper, and if there be any excess of base, a little
hydriodic acid is added.  It is then evaporated in a sand  bath,
         1 Edinb. Med. and Surg. Journ.,  xxxvL 369. for Oct. 1831.
         1 Cogswell on Iodine, p. 85. 
596
POTASSI  IODIDUM.
until a slight pellicle forms;  the fire is now discontinued, and the
salt is suffered to crystallize.   Lastly,  the crystals  are washed
with a little water, and dried.1
   Iodide of potassium  is in white or transparent  crystals.  These
are readily fused, and  are volatilized at a red  heat.   They do not
decompose, even when  heated, with access of air.  They are readily
soluble in water, and  in alcohol, and the  addition  of the iodide
facilitates greatly the solution of the iodine in water.   The odour
is slightly that of iodine, from the  salt containing a  little  of that
element  uncombined.   Taste acrid and saline.
   It would seem that a slight contamination of iodide of potassium
with  carbonate of potassa is exceedingly common, as it can  with
difficulty be avoided in the manufacture of the salt; but Dr. Chris-
tison2 affirms,  that he has  examined specimens, where the carbo-
nate, with  its accompanying water, amounted to 90 parts in the
100.   " Can we wonder, then," he asks, " that practitioners should
complain of the iodide of potassium, that they have given it for
months, nay, even for  years, without observing any effect either
on the  constitution, or on the disease for which it  was  adminis-
tered 1"   It is sometimes adulterated, too, with nitrate of potassa,
and the  chlorides of potassium and sodium.3

                  EFFECTS ON THE ECONOMY.
   As respects the action of iodide of potassium, and its administra-
tion in  disease, it is scarcely necessary  to do more  than refer to
what has been said under the head of iodine.  On the whole, its
effects appear to accord with those  of iodine; at least no difference
is perceptible  on the organism.  It has  been supposed,  that it is
better than pure iodine, where  the  object  is to act especially on
the urinary organs.4   For  external  use, iodide  of  potassium  is
usually preferred to iodine.  It is constantly given internally, and
often in  combination with the latter; the  solubility of  which, as
was before remarked,  is aided by it.  Many of the  subjoined for-
mulas contain  both  one and the other.  As remarked under iodine,
it is now administered in very large doses in a multitude of diseases
of different nature, and often,  doubtless, where it can render little
or no service.
   Dr. Buchanan asserts, that he has given  it in doses of ^ss., and
the only precaution he observed was to make  the  patient  drink

  1 Jourdan's Pharmacopee Universelle, i. 662.  Paris, 1828; also the London Phar-
macopoeia, and Brandes Dictionary of Materia Medica, p. 317.  Lond. 1839. This is
essentially the process of the Pharmacopoeia of the United States (1842.)
  a Edinb. Med. and Surg. Journal, April, 1838; and Dispensatory, p. 253.  Edinb.
1842; also,  Pereira, Elements of Mat. Med. and Therap. 2d edit. i. 491.  Lond. 1842;
or 2d Amer. edit, by Carson.   Philad. 1846.                        ,
  3 Report of the Committee  on adulterated drugs, Dr. Huston, chairman, in Transac-
tions of the Amer. Med. Assoc, iii., 291.  Philad. 1850.
  4 Riecke, Die neuern Arzneimittel, u. s. w. S. 306.  See, also,.Cogswell on  Iodine,
p. 96. 
POTASSII IODIDUM.
597
 freely of diluents.  It was chiefly to determine some physiological
 questions that he administered it in such large doses.   Two drams
 of it were taken  by a young man affected with gonorrhoea, and as
 soon as the medicine made its appearance in the urine, blood was
 drawn from the  arm.  On examining  the  blood, both the serum
 and  crassamentum were found  deeply impregnated with iodine.1
 On  the other hand, Dr. Lawrie, of Glasgow,2 considers it very un-
 certain, and at times dangerous, although he esteems it by far the
 best of the recent remedies, and prescribes it  more frequently  than
 any  other medicine; and Mr.  Mayo3  affirms,  that no  medicine,
 where it does good, produces amendment, in constitutional syphi-
 lis, so speedily as it.   Lugol and others appear to have used it
 mainly as a solvent to iodine, and Lugol considers it inferior to the
 latter as a therapeutical agent;  but no chemical or other prepos-
 session can set aside  the testimony just cited; or that of such ob-
 servers as Ricord,4 C. J. B. Williams,5 Joy, and a host of others.
 In the author's hands, it has appeared to afford as much benefit as
 any of the preparations of iodine, and  M. Dorvault6 regards  it as
 embodying all the  excellencies of iodine without its defects.   For
 the  testimony in regard to its beneficial and injurious effects, see
 Iodine, page 454.
   Cases  of salivation  from  its  use  have been  published by Sir
 Francis W. Smith.7
   According to the experiments of Magendie,8 iodide of potassium
 is one of the substances that promote the coagulation of the blood.
                  MODE OF ADMINISTRATION.
                   Liquor  potassii   iodidi.
                Solution of iodide of potassium.
     Potio resolvens ex  lodio, Solution de Coindet, Coindet's Solution.
            R. Potassii iodidi gr. xxxvj.
                Aquae destillat. f  ^j.  Solve.
   Dose.—The same  as that.of the tincture of iodine.
                                          Coindet #• Magendie.
            R.  Potassii iodidi gj.
                Aquae destillat. f  § j.  Solve.
   Dose.—Fifteen drops three times a day, gradually increased  to
forty-five, in  cases  of ovarian dropsy,—frictions with iodine oint-
ment being used at the same time.                   Elliotson.
  1 London Medical Gazette, July 2, 1836.        B Ibid. July 3, 1840, p. 591.
  s A Treatise on Syphilis, by Herbert Mayo, F. R. S.  Lond. 1840.
  4 Practical Treatise on Venereal Diseases, translated by Drummond, Amer. edit Philad.
1843.  Parker, Modern Treatment of Syphilitic Diseases, Amer. Med. Lib. edit. p. 77,
Philad. 1840; and Bulletin General de Therap. Juillet, 1840.
  5 Lectures on the Physiology and Diseases of the Chest,  Bell's Medical Library edit.
p. 246.  Philad. 1839.
  6 Iodognosie ou Monographic Chimique, Medicale et Pharmaceutique, deslodiques en
general, etien particulier de l'lode et de l'lodide de Potassium.   Paris, 1850; cited in
Brit, and Foreign Med. Review, Jan. 1851, p. 92.
  ' Dublin Journal of Medical Science, July, 1840, and Jan. 1841.
  ' Lecons sur le Sang; and translation in Lancet, for Jan. 26, 1839, p. 636. 
598
POTASSII IODIDUM.
          Liquor potassii  iodidi  composilus.
           Compound solution of iodide of potassium.
                        (LugoVs solution.)
            R.  Iodin. 9j.
                Potassii iodid. Qij.
                Aq. destillat. f ^vij.  Solve.
  Dr. Bache1 remarks, that "in the original it is seven ounces, but
from the context of the author, this is evidently a misprint for se-
ven drams."  It is proper, however, to observe, that many of the
successful cases  were treated  by the weaker solution, six drams of
which contain only ^ of a grain, whilst six of the other  contain
f-ths of a grain.
  Dose.—Six drops early in  the  morning, and in  the middle of
the day, in a glass of sugared water, in tetter,  scirrhus, &c.
                                                      Lugol.

  Lugol has a solution of three strengths for internal use:
                                 I.         II.        III.
            R.  Iodin.          gr. -£.        gr. i.       gr. 1£.
                Potass, iodid.    gr. iss.      gr. ii.      gr. iiss.
                Aq. destillat.     f^viij.      f ^viij.     fgviij.
  Dose.—Two-thirds, daily, at first;  afterwards, the whole.
  Lugol recommends this threefold solution in  the  same cases as
his  threefold  solutionvof  iodine; the first  being  continued from
fourteen days to three weeks;  the second,  from the fourth or fifth
week of the treatment to its termination; the third, the strongest,
he did not often use.  As Riecke has observed, it would be better
to have in  the  hospitals  but one solution, which  might  be pre-
scribed in varied doses.
            R.  Iodin. gr. v.
                Potass, iodid. gr. x.
                Aquas destillat.  f %xx.   M.
   Dose.—f 3ij. to f =jvj.             London Pharmacopoeia.
                Liquor  iodini   compositus.
                  Compound solution of iodine.
                         (LugoVs solution.)
            R.  Iodin. £vj.
                Potass, iodid. 5iss.
                Aquae destillat. Oj.
  Dissolve the iodine and iodide of potassium in the water.
   Dose.—Ten  to twenty drops, three times a  day.
                                       Pharm. United States.
            R.  Potassii iodid.
                Iodin. aa.  gr. 78. (5 gram)
                Alcohol, at 90° C. gxiij. (50 gr.)
                Aquas destillat. giij. (100 gr.)
       * Dispensatory of the United States, 4th edit p. 374. Philad. 1839. 
POTASSII IODIDUM.
599
   Rub the iodine and iodide of potassium in a mortar with a little of the
 water.  Add the alcohol and the remainder of the water.
   This has been proposed as a substitute for the  mixture of tinc-
 ture of iodine and water, used by M. Velpeau, with so much suc-
 cess, in the surgical treatment of dropsies.1           Guibourt.
                Tinctura iodini  composita.
                  Compound tincture of iodine.
            R.  Iodin. gj.
                Potass, iodid. §ij.
                Alcohol. Oij.  M.
   Dose.—Ten minims.                Lond. Pharmacopoeia.
   The Pharmacopoeia of the United States adopts the same quan-
 tities; but  the pint Imperial measure contains  about one-fourth
 more than the pharmacopoeial pint of the United States.
                          (fodine paint.)
            R.  Iodin. gr. lxiv.
                Potass, iodid. gr. xxx.
                Alcohol, f l\.  M.
   Applied in rheumatic affections of the joints,  by painting  the
 parts freely with a camel's hair pencil.  King's College Hospital.
          Mistura  potassii iodidi  composita.
          Compound  mixture of iodide of potassium.
            R. Iodin. gr. ss.
               Potass, iodid. £ss.
               Syrup, papav. f ^ss.
               Aq. destillat. Oss.
   Dose.—Two table-spoonfuls, three times a day, in cases of com-
plication of syphilis with scrofula.                   Tyrrel.
            R. Iodin. gr. iss.
               Potassii iodid. gr. iij.
      Solve in
               Aquee menth. pip. f ^iv.
   Dose.—A spoonful  two or three times a day;—to children,  a
tea-spoonful.  In cases of cancrum oris; also, in dropsy,gleet, and
leucorrhoea.  On renewing the prescription, the dose of the iodine
may be increased one-half, and of  the iodide one grain, each time.
                                         Coster fy Freidrich.
            R. Potass, iodid. £iv.
               Syrup, althaea? f ^j.
               ----menth. pip. f  ^ij.
               Aquae lactucae f ^ viij.
   Dose.—A spoonful, morning  and evening, in a little water, in-
creasing-the dose to two spoonfuls.   In cases of hypertrophy of
the ventricles  of the heart.                         Magendie.

    1 Bouchardat, Annuaire de Therapeutique pour 1847, p. 244.  Paris,  1847. 
600
POTASSII IODIDUM.
            R.  Potass, iodid. £pv.
                Tinct. digit, f %]. ad f £ij.
                Syr. althaea? f §iss.
                Aq. lactuc. f ^viij.
                — flor. naph. f £ij.  M.
   Dose.—Morning and evening, a spoonful, in a little water.  In
hypertrophy of the ventricles of the heart with quickening of the
heart's action.                                    Magendie.
            R.  Quassiae,
                Gentian, aa.. gj.
                Aquae bullient. f %x\],
          Macera per horam et cola.
          Liquor colat. add.
                Potass, iodid. gr. xxxvj.
                Potassa? carbonat. gij.  M.
   Dose.—A table-spoonful, three times a day, in a glass of water.
                                                  Cumming.
                  Pilula;  potassii iodidi.

                  Pills of iodide of potassium.
            R.  Potass, iodid. gr. xv.
                Aq. destillat. q. s.
                Spong. ust.
                Ext. dulcamar. aa. gij.
                Glycyrr. pulv. q. s.
      Fiant pilulae clxxx.
   Dose.—Six, two or three times  a day, in scrofula, goitre, &c.
                                                       Vogt.
             Unguentum  iodini  compositum.
      Compound ointment of iodine.—Ioduretted ointment.
            R.  Iodin. gss.
                Potass, iodid. gj.
                Alcohol, f 3J.
                Adipis gij.
  Rub the iodine and iodide with the alcohol, and mix with the lard.
                              Pharm. Lond. <§r  United  States.

               Unguentum  potassii  iodidi.
               Ointment of iodide of potassium.
            R.  Potass, iodid. gss.
                Adipis ^iss.  M.
  Half a dram at first, and  subsequently  a whole dram, to be
rubbed in, in goitre, scrofulous glandular affections, &c.
  This ointment is generally too  weak, unless combined with the
internal use of iodine in some form.                Magendie.
            R.  Potass, iodid. 9j.
                Adipis gss.  M.
  The parts to be smeared with it two or three times a day, in
moist tetter—serpigo.   Between the applications  to be  dressed
with dry lint.                                  Tiinnermann.
  In dry  tetter, the ointment applied is formed  of 3j. to sjiss. of
the iodide to §j. of lard. 
POTASSII IODIDUM.
601
         (Unguentum kali hydroiodici.  Pharmacop. Borussic.)
           R.  Potass, iodid. gj.
               Magnes. carb. gr. vj.
               Aq. destillat. guttas nonnullas.
      M. terendo cum
               Ung. rosat. ^j.
   Or,
           R.  Potass, iodid.
               Sodae carbon, depur. sice. aa. gss.
               Ung. rosat. giv. ad £vj.  M.
   A piece, of the size of a small bean, to be rubbed in, morning
and evening, in  chronic enlargement of the testis.
                                                 Walther.

   Messrs. T. and H. Smith,1 of Edinburgh, having found it im-
practicable to make a neat ointment of iodide of potassium by the
ordinary method, have recommended the following: Dissolve the re-
quisite quantity  of the iodide in its own weight of distilled or some
perfumed water, and then  mix thoroughly in a mortar with the
proper quantity  of lard.   The two will incorporate perfectly  with
a very little heating, and form a smooth ointment.
             R.  Potass, iodid. £ss.
                 Ext. opii Qss.
                 Cerat. gj.  M.
  As a dressing to  malignant cancerous ulcers.

      Unguentum potassii iodidi  compositum.
        Compound ointment of iodide of potassium.
             R. Iodin. gr. xij.
                Potass, iodid. J)iv.
                Adipis §i>.  M.
  In scrofulous ophthalmia, ulcers, fyc.             Lugol.
             R. Iodin. gr. xv.
                Potass, iodid. gj.
                Tinc.t. opii f gij.
                Adipis gij.  M.
  In painful scrofulous ulcers, lohite sivellings, fyc.  Lugol.

      Unguentum potassii iodidi et hydrargyri.
      Ointment of iodide of potassium and mercury:
             R. Potassii iodid. gr. xij.—xv.
                Ung. hydrarg. ciner. Jss.  M.
  In herpes exedens.                              Blasius.

        Unguentum  potassii  iodidi  anodynnm.
         Anodyne ointment of iodide of potassium.
                   (Pommade iodee calmante.)
             R. Potass, iodid. gr. xv.
                Morphiae muriat. gss.
                Adipis gx.  M.
1 London and Edinburgh Monthly Journal of Medical Science, Oct 1841, 
602
POTASSII IODIDUM.
  Applied to painful tumours of the mammas, night and morn-
ing.                                              Chomel.
      Emplastrum  potassii iodidi compositum.
         Compound plaster of iodide of potassium.
             R.  Iodin.
                 Potass, iodid. aa. ^ss. ad 9j.
                 Emplastr. hydrarg. seu
                 --------saponis. ,§ij.   M.
  Applied in syphilitic and gouty swellings of the bones.
                                                    Ebers.
              Linimentum potassii iodidi.
              Liniment  of iodide of potassium.
                       (Baume hydriodate.)
              R.  Potassii iodid. £].
                  Alcohol. (20°) f|iv.  M.
              R.  Sapon. ex oleo animal, confect. §iss.
                „ Alcohol. (20°) f giv.  M.
  Mix these two solutions together: aromatize with a small quan-
tity of oil of lavender, and before the mixture congeals pour it
into wide-mouthed vials.1   This liniment has been much used at
Lausanne under the name Gelee pour le goitre.
            Lotio  potassii, iodidi  composita.
          Compound, lot ion of iodide  of potassium.
             R.  Iodin. gr. i. ad ij.
                 Potassii  iodid. gr. ij. ad gr. iv.
      Solve in
                 Aquae destillat. f gviij.
  This solution was commonly  used by Lugol  externally, inject-
ed under the eyelids in strumous ophthalmia, fistulas, Sue.
                                                    Lugol.
             R.  Iodin. §ss.
                 Potassii iodidi §j.
      Solve in
                 Aq. destillat. f §vj.
  This "rubefacient solution  of iodine," may be  used two or
three  times a week, when  the last prescription  loses its effect, or
when it is desirable to stimulate  more actively.   It is also added
to baths—three or four  ounces to an ordinary bath—as well as to
poultices, being mixed with  an ordinary cataplasm.     Lugol.
             R.  Iodin. %\.
                 Potass, iodid. ^ij.
      Solve in
                 Aquae destillat. f ^ij.
  This " caustic iodine  solution"  may be used  when the last

  1 F. Boudet, Journal de Pharmacie. Avril, 1842, p. 335; and Duhamel, in Amer.
Journal of Tharmacy, July, 1842, p.  102. 
QUINIA.
603
loses its efficacy.  It occasions a crust on  the parts.   Lugol em-
ploys it chiefly when the skin on the edges of the ulcers is greatly
hypertrophied, red,  and fungous,  as  well  as  in phagedenic or
spreading tetters.  It may be applied two or three times a week,
or daily, should the case require it.                    Lugol.
        Collyrium  potassii iodidi compositum.
        Compound collyrium of iodide of potassium.
             R.  Iodin. gr. ss. ad gr. i.
                 Potassii iodid. Qss.
      Solve in
                 Aq. rosae f ,^iij.  M.
  To be applied, four times a day, in cases of scrofulous ophthal-
mia, with ulceration of the conjunctiva and cornea.
                                                Magendie
                   QUINIA ET EJUS SALES.
 Synonyme. Quinia and its Salts.

                       CXLV.  QUINIA.
 Synonymes. Quinina. Quina, Quinirmm, Quinium, Chininum, Chininium,
  Chinium, Kinium, Sal Essentiale Corticis Peruviani.
 French. Quinine, Kinine.
 German. Chinin, Quinin, Chinastoff.

   Quinia is  a  most important  gift  from modern  analytical, che-
 mistry to medicine.   About thirty years have elapsed since the
 discovery of this substance,  and, by general consent, it  is re-
 garded  as one of the most valuable remedies in  the catalogue of
 the  materia  medica.   The honour of the discovery—which had "
 been facilitated by the  investigations of other chemists, as 1o the
 composition of the  cinchona barks—belongs to Pelletier and Ca-
 ventou, (1820,1)  and so rapidly and extensively was' its  efficacy
 promulgated, that in  the  year 1826, in two laboratories in Paris
 for  the preparation  of quinia, fifty-nine thousand  ounces  of the
 sulphate —the form best known, and most frequently prescribed—
 were prepared.   For this  discovery, the Royal Academy of Sci-
 ences of Paris  awarded MM.  Pelletier and Caventou the  Mon-
 thyon prize often thousand francs.
   It would appear, from the observations of Henry and Plisson,
 that cinchonia  and  quinia  exist in cinchona bark  in  combination
 with kinic acid and also with cinchonic red, which is an insoluble
 red colouring matter.2

  ' Annales de Chimie et de Physique, xv. 280 and 337.
  a Jour de I'harmacie, xiii 2li'J and 3<>). and  Pereira, Elem. Mat. Med. and Therap.
ii. 13U7.  Lond. 1842; or 2d Amer. edit, by Carson.  Philad. 1846. 
604
QUINIA.
   Quinia is obtained from yellow bark by a similar process to the
 one described for the separation of cinchonia.1  In the pure state,
 it is of a white colour, and commonly appears in the form of pow-
 der; it crystallizes, however, in silky, shining tufted needles.   In
 both cases, it contains  from three to four per cent, of water.   By
 a gentle heat this escapes, and quinia melts into a transparent fluid,
 which, on cooling, is  translucent,  and similar  to  resin.  When
 melted in vacuo it has a crystalline appearance.   In a strong heat
 it is decomposed.  It has a very bitter taste, and is soluble in 200
 parts  of boiling water; a  portion  being precipitated  on  cooling.
 It requires a much larger proportion of cold water to dissolve it.  In
 alcohol it is far more soluble than in water.   It is, likewise, solu-
 ble  in  ether, and somewhat so in oils.   It exhibits an alkaline re-
 action,—restoring the  colour of  reddened litmus paper, and  neu-
 tralizing acids.
   Impure quinia {quinine brute) is prepared by treating cincho-
 na with muriatic acid, lime and  alcohol, as in the preparation
 of sulphate of quinia ; but  instead of acidulating the alcoholic li-
 quor, it is distilled without this addition.   The product is a plastic
 mass,  of firm consistence, which is  formed of a mixture of quinia,
 cinchonia, and  fatty and colouring matters.  It  is not  sensibly
 bitter.  500 grammes, or  about 11  ounces, of good  Calisaya
 bark, yield nearly 16 grammes or about four drams of quinine
 brute.2
   The observations of Piorry and  Lavollee3  and of Quevenne,4
 show,  that quinia, as well as its  sulphate, passes into the urine of
 patients who use it in any considerable quantity.
                  EFFECTS ON THE ECONOMY.
   Of  the effects of quinia we shall speak  at length under  the
 head of sulphate of quinia,  with   which it  seems  to accord
 entirely in medicinal agency.  Several physicians, who have ex-
 perimented in regard to the efficacy of pure quinia and  its salts,
 have found the  first in  no respect inferior to the last.   Such was
 the  experience of Niewenhuis and  Elliotson, the latter of whom
 exhibited  quinia in large doses—as  much as five grains every four
 hours.  A  French  physician, M.  Blegnie,5 even  gives  the  pre-
 ference to pure quinia,  because it possesses, he thinks, equal effi-
 cacy, is cheaper, easier taken, and better borne than the sulphate.
 He  advises,  that after each dose  an  acidulous drink should  be
 taken, to render its solution in the stomach more rapid.   Wutzer"
 and  Harles7 have also recommended the more frequent use of pure

  * See p. 216.
  ' Trousseau and Pidoux, Traite" de Therapeutique, &c. i. 208.  Paris. 1847.
  * Gazette Medicale, 1836, p. 73.              4 L'Experience, Juillet, 1838.
  ' Riecke, Die neuern Arzneimittel, S. 118,  See, also, Bally, in Magendie's Journal
de Physiologic ii 236.                   " Isis, p. 441, 1829.
  ' Heidelberg Klinisch. Annalen, B. v. H. 4, 573. 
QUINIiE ACETAS.
605
quinia: and M. Bouchardat1 states, that he has often administered
impure quinia, and has been satisfied with the excellent effects it
produces in a small dose.  It is likewise  highly extolled by  M.
Trousseau,2 who thinks  it more active  than the sulphate; and,
owing to  its being insoluble in the  saliva, and almost devoid of
taste, he prefers it in the diseases of children.  He esteems it, indeed,
the most useful of the preparations of cinchona.
   After the administration of quinia  and its salts, quinia  may be
detected in  the  blood and  in the excrements.3   It may be given
either in the form of powder or pill, or in alcoholic solution.  The
dose  of impure quinia is from 10 to 30 grains.
                      Tinctura quiniffi.
                      Tincture of quinia.
              R.  Quiniae 9j.
        Solve in
                  Alcohol, f gss.
   Dose.—Twenty to forty drops every two hours.   Wutzer.
            R.  Quiniae impur. 3vij| (30 gram.)
                Alcohol.
                Aq. destillat. aa. ^xj^ (350 gram.)
        Misce et cola.
   Two spoonfuls of this  solution are  considered to represent  fif-
teen grains of sulphate of quinia.  In this dose it has been admi-
nistered in many cases of hypertrophy of the spleen; and it is  af-
firmed, the spleen diminished under its use with greater rapidity
than under that of the sulphate of quinia.4            Piorry.
  For some observations on amorphous quinia, see the appendix
tO the SALTS OF QUINIA.
                CXLVI.  QUI'NLE  ACETAS.
Synonymes. Quininae Acetas, Chinium Aceticum, Chininum Aceticum,
  Acetas Chinii seu Chinini seu Chinicus seu Quinicus, Acetas Quiniae
  seu Quinae seu Quinini seu Quinii seu Kinini,  Quina Acetica, Acetate
  of Quinia or of Quinine.
French. Acetate de Quinine.
German. Essigsaures Chinin.
   This preparation is not much employed.   It is made  by satu-
rating quinia with pure acetic acid diluted  with water, and eva-
porating the neutral solution, by gentle heat, to crystallization.  It
appears  in  the form of very delicate, needle-shaped,  snow-white^
satiny, and shining  crystals;  tastes very bitter; and is with diffi-
culty soluble in cold water, but readily  so in hot.
  1 Nouveau Formulaire Magistral, 3d 6dition, p. 2G4. Paris, 1845.
  * Cited in British and Foreign Medical Review, Oct. 1842, p. 560.
  3 Landerer, Chem. Gazette, i. 147.
  4 Bouchardat, Annuaire de Therapeutique, pour 1847, p. 179. Paris, 1847.
         39 
606
QUINIiE ARSENIAS.
  Wutzer  and Sundelin1 assert, that it acts like the other salts of
quinia, but merits no preference.
               CXLVIL QUININE ARSENIAS.
Synonymes.   Quininae seu  Quinee  Arsenias, Chininum Arsenicosum
  seu Arsenicicum, Arseniate of Quinia or of Quinia or of Quinine.
French. Arseniate de Quinine.
German. Arseniksaures Chinin.

                   METHOD OF  PREPARING,
  To obtain the salt, dissolve half an ounce of  sulphate of quinia
in barley  water,  and precipitate by liquid ammonia, which will
produce  upwards of two drams  and a  half of very pure  quinia
when washed and dried.  Dissolve 46 grains of arsenic acid in about
three ounces of distilled water.  The quinia is insoluble in water,
but under the  influence of arsenic  acid  and ebullition it  becomes
soluble.   A combination  takes place, and, on  cooling, crystals of
arseniate of quinia are formed.  The crystals are then dissolved
in distilled  water, and  recrystallized by evaporation, in  order to
obtain the salt pure,  and free from any excess of acid.
  Well prepared arseniate of  quinia is  a white, light  salt, crys-
tallized in silky, brilliant needles.   It is  soluble  in water; but in
greater proportion  in boiling water than in cold;  it  is soluble in
weak alcohol;  dissolving less readily in alcohol.   It is insoluble
in ether.2

                 EFFECTS ON THE ECONOMY.
  Arseniate of quinia has been employed by M. Bourieres in ob-
stinate intermittents, in  the dose of from three  quarters of a
grain to a grain and  a half in the 24 hours.  M. Bodin3 has insti-
tuted some  trials to determine  the relative value of this  salt and
arsenious acid.    He did not exceed from one to two-fifths of a grain
of the arseniate for a dose, taken at once or  in two doses; and
could detect no superiority of action in this salt of quinia, whilst it
had the inconvenience of being excessively bitter.  He infers, there-
fore, that so far arsenious acid  ought to  have the preference.
  It may  be given  in solution in distilled water, to which a  little
simple syrup may be added.

  ' Isis, p. 441, 1829; also, Heidelb. Klinisch. Annal. B. v. H. 4, 575.
  2 Journal de  Chimie Medicale, xi. 283.
  3 Bouchardat, Annuaire de Therapeutique pour 1846, p. 208.  Paris, 1846. 
QUINIJE CITRAS.
607
               CXLVIII.  QUININE AR'SENIS.
          Synonymes.  Quiniae Di-arsenis, Arsenite of Quinia.
          French.  Bi-arsenite de Quinine.
  This salt has been lately proposed by Dr. Kingdon.1
                 METHOD OF  PREPARING.
  Dissolve  sixty-four  grains of arsenious acid,  and thirty-two
grains of subcarbonate of potassa, in four ounces of distilled water,
by boiling it for about  half an hour, and making the quantity four
ounces, by the addition of  water; so that each dram may contain
two  grains of arsenic.   To five drams of this solution  add two
scruples of  disulphate of  quinia, previously dissolved in  boiling
distilled water.   A white curdy precipitate is immediately formed,
which is the di-arsenite. This is poured on a filter and dried.  It
is uncrystallizable, and insoluble in water, but soluble in alcohol.
                 EFFECTS ON THE ECONOMY.
  Arsenite of quinia has been highly extolled by Dr.  Kingdon as
a eutrophic in chronic  cutaneous affections especially; and he has
no doubt that it would be  equally efficacious in  ague and the
various forms of neuralgia.  It possesses the medicinal qualities
of a mineral and a vegetable tonic; and when  the system has be-
come habituated to either one or the  other, the former  action is
kept up by its administration, whilst, at the same time, a new one
is introduced into the system.
  The dose is one-third of a grain twice a  day, and gradually
three and four times a day, in  the form of pill or powder, mixed
with a little sugar or gum.
                 CXLIX.  QUINIA CITRAS.

Synonymes.  Quininas seu Quinini seu Quiniae seu Quinaa seu Quinii seu
  Chinini seu Kinini Citras,  Citras Chinii  seu  Chinicus  seu Quinicus,
  Chinium  seu  Chininum Citricum,  Quina Citrica, Citrate of  Quinia
  or of Quinine.
French.  Citrate de Quinine.
German. Zitronsaures Chinin, Citronsaures Chinin, Citro-
  nensaures Chinin.
                   METHOD OF PREPARING.
  This  preparation is formed, like the acetate, from an aqueous so-
lution of citric acid, and pure quinia; or by  the decomposition
of a hot solution of sulphate of quinia, by means of an acid ci-
trate of soda.2  It forms needle-shaped prisms, of a white colour,
which are by no means readily soluble  in water.
  1 Provincial Medical and Surgical Journal, August 25, 1847.
  * Guleani, in Annali Universali di Medicina.  Luglio, 1832, and Heidelb, Klinisch
Annal. B.  x. H. i. S. 34.  Heidelb. 1834. 
60S
QUINIiE FERROCYANAS.
                 EFFECTS ON THE ECONOMY.
  The acetate and the citrate of quinia have been highly esteemed ;
and  are  considered  to be adapted  for those excitable  persons
with whom the sulphate does not seem to agree.  The citrate has
been prescribed by many Italian  physicians, and found to be very
efficacious.1   The author is  not aware that it  is ever prescribed
in this country.   Magendie considers  it, when it  contains an ex-
cess  of acid, advisable for  those cases where the union of a tonic
with an antiseptic property is indicated.  He considers, that the
following syrup  may be substituted, in  certain cases, for  the sy-
rupus antiscorbuticus, which is directed by the  Codex Medica-
mentarius of Paris  to be prepared in  the following manner:—
Take of the fresh leaves of  cochlearia, water trefoil, cress, horse-
radish, and bitter oranges, cut, of each one pound;  cinnamon,
an ounce  and a half, white wine, four  pints.   Macerate for  two
days in a tin  cucurbit, covered with a well luted  capital.  Distil,
in a sand-bath, a pint of fluid; to which add twTo pounds of white
suo-ar and make into a syrup.   Pass through a  cloth, without
straining, what remains in the cucurbit; let the liquor rest;  decant;
and  boil  to the  consistence  of syrup, with  two pounds of white
sugar.   When cold, clarify,  and mix with the other.

                 Syrupus  quiniae citratis.
                 Syrup of citrate of  quinia.
              R.  Syrup. Oi.
                 Quiniae citrat. acid. gr. xxxvj.  M.
  Dose.—Two spoonfuls in  the  twenty-four hours.

  A citrate of  quinia and iron is referred to elsewhere, (p. 345.)
               CL. QUININE FERROCY'ANAS.

Synonymes.  Quininea Ferrocyanas, Chinium  Ferrocyanogenatum seu
  Ferrohydrocyanicum, Ferrocyanas Chinii, &c, Ferrocyanate or Hydro-
  cyanoferrate of Quinia or of Quinine.
French.  Ferrocyanate de Quinine.
German.  Eisenblausaures  Chinin.

                   METHOD  OF PREPARING.
  This is  obtained by the decomposition of sulphate of quinia,
by means of a solution of ferrocyanuret of potassium; after which
the impure salt is treated with warm alcohol, and the clear solu-
tion is evaporated.2  It forms needle-shaped, confused crystals, of

  1 Beraudi, in Bulletin General de Therapeutique, Nov. 1840.
  a See Bertozzi's method, in Journal de Pharmacie, xix. 45, and Philada. Journal of
Phrmacy, vol. ii. new series, p. 82. Philad. 1837.  See, also, Donovan, in Dublin
Journ of Med. Sciences July,  1840, p. 440, 
QUINIiE FERROCYANAS.
609
 a  greenish-yellow  colour, and very bitter taste, recalling that of
 hydrocyanic acid.  It dissolves readily in alcohol, not so in water;
 and is decomposed  by hot water.

                  EFFECTS ON THE ECONOMY.
    In this combination, the antifebrile properties of the quinia  are
 said  to be even superior to those of the  other preparations; yet the
 remedy has not got into much use.  It has been employed mainly
 by a few of the  French practitioners.   Cerioli1 and Zaccharelli,
 Italian physicians, speak in high terms  of its efficacy in periodical
 diseases, even where  the sulphate has  failed.   Cerioli  gave  it  in
 the dose of from two  to eight grains in the day.  Gouzee2 details
 the history of three cases  completely cured by  the administration
 of a  single grain, half an hour  before the  paroxysm; and Dr.
 H. V.  Wooten,3 of Alabama, affirms, that he  has  prescribed it in
 about  fifty cases, and  has found  it, when pure, " act uniformly
 without those unpleasant effects  which generally arise from the
 use of the sulphate;"  and in cases  in which there is febrile excite-
 ment or inflammation  he uses  it  altogether;  and, he adds,  with
 full confidence, in all cases where he wishes to exert  " a sedative
 and alterative or regulating power upon the nervous  system."

                  MODE OF ADMINISTRATION.
   The  following formulae have been recommended :

             Hanstus  quiniae  ferrocyanatis.
              Draught of ferrocyanate of quinia.
              R.  Quiniae ferrocyanat. gr.  iv.
                  Alcohol, f gj.
        Solve et adde
                  Aquee camphor, f £vij.  M.
            et fiat haustus.
   To be taken as occasion may require, first shaking the vial.
                                                  Donovan*.
              Pilulae  qninifB ferrocyanat  is.
                Pills  of ferrocyanate of quinia.
              R.  Quiniae ferrocyanat. gr. xxiv.
                  Mucilag. acaciae q. s.
            ut fiat massa in pilulas xij. dividenda.
   Two for a dose.                                 Donovan.

  : Annali Universali de Medicina, Luglio, 1832, cited in Archives Generates de Me-
decine,  Dec. 11\!0.
  2 Observateur Medical Beige, Jan. 1834.
  s Southern Medical and  Surgical Journal for April, 184G.
  'Op. citat 
610
QUINIiE HYDRIODAS.
                CLI. QUININE  HYDRI'ODAS.
Synonymes.  Chininum Hydroiodicum, Hydriodate or  Iodhydrate of
  Quinia; called also  Ioduretum seu Iodidum Quiniae, Ioduret or Iodide
  of Quinia.
French.  Hydriodate ou Iodhydrate de Quinine, Iodure de Quinine.
German.  Iodwasserstoffsaures  Chinin.

  Hydriodate of quinia may be formed by  precipitating sulphate
of quinia by means of iodide of potassium.   The  precipitate is
of a yellow colour, soluble in alcohol, and  crystallizes from this
solution in quadrangular prisms.1
  Dr. Kingdon2 employs an  " iodide " and  a " biniodide of
quinia."   The  former is made  by dissolving equal  weights of
sulphate of quinia and iodide of potassium in boiling distilled
water, and  allowing the mixture to cool, when beautiful fasciculi
of needle-shaped crystals are deposited, which are insoluble in cold
water,  but  soluble  in  alcohol.   The  latter is made  by  mixing
twice the weight of iodide of potassium with sulphate of quinia
in boiling distilled wafer, evaporating to  one-third in a sand-bath,
and  allowing  the residue  to cool,—when a resinous substance is
deposited, of a light straw colour, which, by exposure to the air,
becomes darker, and of a greenish hue, not crystallizable, sparingly
soluble in cold water, readily soluble in alcohol, and then not pre-
cipitated when mixed with water.   He has given this  preparation
in several  cases  of  scrofulous  enlargement of the glands  with
very great benefit.  In the case of a child between three and four
years of age, when the glands of the neck were in a state  of sup-
puration, half a grain was given twice a day, and  at the end of
six months  the  swellings were wholly removed, and the  general
health much improved.
  More recently, Prof. A. T. Thomson has prepared an " iodide
of quinia," and an  " iodide of cinchonia ;" the former made by
triturating together, in a mortar, 164.55 grains of pure quinia, and
126.3 of iodine;  the  latter  being added to the former until the
whole is  intimately mixed,  and  then  boiling  the  mixture  in  a
moderate quantity of  distilled water at first, adding more by de-
grees, until as much is added as will give one grain of the iodide
for each fluidram of the  solution. During the boiling,  a  deep
brown resinoid substance is formed, apparently insoluble in wafer,
which subsides  to the bottom  when  the  solution cools.  This
substance  is  brittle,  tasteless,  inodorous,  and  affords  no  indi-
cation of the  presence of either iodine or quinia.  It  is partially
soluble  in  boiling alcohol.  Dr. Thomson  has not been  able to
ascertain its nature.   It shows, however, by the appropriate tests,
that  it contains both iodine and  quinia.

  ' Journal de Chimie Medicale, Mars, 1836.        * Med. Times, July 29,1843; 
QUINliE LACTAS.
611
  Iodide  of cinchonia is  prepared in the same  manner, taking
156.55 grains  of  Ihe alkaloid.  The  quantity  of  the  resinoid
matter is less than in the case of iodide of quinia; but it closely
resembles it  in  its  physical  characters, insolubility in water, and
solubility in alcohol.   The solution is nearly inodorous, and has
the bitter taste of cinchona.   It answers to the same tests as the
iodide of quinia.
  Dr. Thomson had not crystallized either of the salts, nor does
he seem to have administered  them.  He thinks the tonic  influ-
ence of the  quinia or cinchona may prevent iodism.1

  A n Iodide of Iodhydrate of Quinia, (French, Iodure d'Iod-
hydrate de Quinine,) is prepared by pouring into an acid solution
of quinia, a solution of iodide of iron, containing a  slight excess
of iodine.  The precipitate which  forms is treated  w7ith boiling
alcohol.   The liquor is filtered, and, on cooling, the iodide of iod-
hydrate  of  quinia is deposited, which is  in beautiful scales of a
deep  greenish colour.   It is insoluble  in  water,  and  soluble  in
alcohol; possesses the properties  both of quinia  and iodine, and
has been employed with much success in rebellious intermittents.
  All these preparations  are well adapted for diseases in which
iodine and a  tonic are indicated, and  hence  may be given with
success in many cases  of scrofulous and other cachexiae.

  Under the name Hydriodate of  Iron and Quinia, Mr. Bat-
tley2 has introduced a new  article  into  the lists  of the materia
medica, in which the iron exists in  the form of a protosalt.  The
iodine  also,  being in the state  of hydriodic acid, acts—it is con-
ceived—more mildly than  the  tincture and its other compounds.
The preparation is a syrup, sugar being  required to prevent the
conversion of the protosalt of iron  into peroxide.   The propor-
tions  are  such,  that each fluidram contains a grain and a half
of quinia, a  grain of iron, and a grain of iodine as hydriodic acid.
The dose is from twenty to thirty drops.
                  CLII.  QUINIA LACTAS.
Synonymes.  Quinae Lactas, Chininum Lacticum, Lactate of Quinia.
French.  Lactate de Quinine.
German.  Milchsaures  Chinin.
  By saturating lactic acid with quinia, and subjecting the solu-
tion to spontaneous evaporation in a flat vessel, groups of silky
needles of the lactate are obtained, which are more flattened than
those of the sulphate.
  1 Pharmaceutical Journal, March, 1845, cited in Ranking's Abstract, Amer. edit. i.
349.  New York, 1845,
  3 London Med. Gazette, May 12, 1848. 
612
QUINIA LACTAS.
  Lactate of quinia does not crystallize as readily as the sulphate
and valerianate, and it is more soluble than either of those salts.
  Prince Louis Lucien Bonaparte, Beraudi and Bouchardat have
found the lactate possessed of great  energy, and M. Conte has
proposed to replace the sulphate  by it.1
                 MODE OF ADMINISTRATION.
                 Pilulse  quiniae lactatis.
                   Pills of lactate of quinia.
              R.  Quiniae lactat. gss.
                  Extract, junip. q. s. ut fiant pil. xx.
  Dose.—Two to six in the day in intermittents.—Bouchardat.
                 Mistura  quiniae  lactatis.
                 Mixture of lactate of quinia.
              R.  Quiniae lactat. gr. vii.
                  Aq. menth. f £v.
                  Syrup, caryophyll. f 31.
                  Aqua? f 3iiiss.  M.
  Dose.—One-third.  The whole  to be taken during the interval
in pernicious intermittents.                      Bouchardat.
                 Syrupus  quiniae  lactatis.
                  Syrup of lactate of quinia.
              R.  Quiniae lactat. gr. xv.
Solve in

   adde
Aquae f|j.
               Sacchar. .^ij.  Solve.
Dose.—A coffee-spoonful in the intermittents of children.
                                              Bouchardat.
                 CL1II.  QLTNLE MU'RIAS.
Synonymes.   Quininae  Murias, Chininum Muriaticum seu Salitum seu
  Hydrochloricum, Hydrochloras seu Murias Chinii seu Chinicus seu
  Quinicus, Chlorhydras Quinicus, Muriate of Quinia or of Quinine.
French.  Muriate ou Hydrochlorate de Quinine.
German.  Salzsaures Chinin,  Hydrochlorsaures  Chinin.
  Perhaps, next to the sulphate of quinia, this salt has most fre-
quently been employed in practice.
                   METHOD OF  PREPARING.
  It is obtained by dissolving pure quinia in dilute muriatic acid,
or by the decomposition of sulphate of quinia dissolved in warm
water, by means of a  solution of chloride  of barium, which is
added so long as a white  precipitate is thrown down; the hot
mixture is  then filtered;  the  precipitate washed, and  the  clear
1 Bouchardat, Nouveau Formulaire Magistral, p. 264.  Paris, 1845. 
QUINIiE PHOSPHAS.
613
fluid evaporated, by a  gentle  heat, to crystallization, so long as
crystals  shoot on  cooling;  these are  collected, washed in cold
water, and purified by repeated crystallization.   It  forms fine,
needle-shaped, white,  silky crystals, of a mother-of-pearl lustre;
and does  not dissolve  readily in water, but more so  than the
sulphate.
                 EFFECTS ON THE ECONOMY.
  In this respect, the muriate  agrees with the sulphate of quinia,
and by those  of weak digestive powers is borne better.   Spiel-
man1 asserts that it is a  more  speedy and effectual  remedy for
intermittent fever than the sulphate, and is more soluble.   It  is,
however, more expensive.  The  dose is  generally considered  to
be the same as that of the sulphate.   It is better given in solution
than in powder.  Spielman rates the  dose at from half a grain to
a grain.
                  CLIV.  QUI'NLE NITRAS.
Synonymes.  Quininae  Nitras, Chinium  seu Chininum Nitricum, Nitras
  Chinii; &c.  Nitrate  of Quinia or of Quinine.
French.  Nitrate de Quinine.
German.  Salpetersaures  Chinin.
                   METHOD OF PREPARING.
  This salt is obtained, like the muriate, by the addition of nitric
acid to quinia; or by the  decomposition  of nitrate of baryta by
sulphate of quinia.   It is,  at first,  a  fluid,  oil-like mass,  which
gradually becomes  solid.   In  union  with  water it forms crystals.
It dissolves with difficulty in water, but readily in alcohol.
                 CLV. QUI'NLE PHOSPHAS.
Synonymes.   Quininae Phosphas, Chinium seu Chininum Phosphoricum,
  Phosphas Chinii seu  Chinini,  Phosphate of Quinia, of  Quina or of
  Quinine.
French.  Phosphate de  Quinine.
 German.  Phosphorsaures Chinin.

                   METHOD OF PREPARING.
   In mode of preparation, it accords with  the preceding  forms;
dilute phosphoric acid  being added  to  quinia, or  phosphate of
baryta to sulphate of quinia.2  It appears in the form of needle-
shaped prisms, of a mother-of-pearl lustre, which, like the muriate
cf quinia, are readily soluble in water and alcohol.  Harles,3 how-

  1 Allgemein. Medicinisch. Zeitung, cited in Journal des Connaiss. Me'dic. Fe"v. 183C-
see, also, Dierbach, in Heidelb. Klinisch. Annal. B. x. H. i. S. 33.  Heidelb. 1834.
  3 Winkler, in Biichner's Repert. and Philad. Journ. of Pharmacy, new series vol ii
p. 12.  Philada. 1837.
  3 Heidelb. Klinisch. Annal. B. x. H. i. S. 36. Heidelb. 1834; and Journal de Chimie
Medicale, 1837. 
614                    QUINIA SULPHAS.

ever, affirms, that in the neutral condition it dissolves, with diffi-
culty, in water.
  The phosphate is regarded by some to stand next  to  the sul-
phate in medicinal efficacy.
                CLVI.  QUI'NIiE SULPHAS.

Synonymes.  Quininae Sulphas. Quinae Disulphas seu  Sulphas, Chinium
  seu Chininum Sulphurieum, Sulphas Chinii seu Quinicus, Sulphate of
  Quinia, of Quina or of Quinine.
French.  Sulfate de Quinine.
German. Schwefelsaures Chinin,  Chininsulphat.

  This preparation of quinia is by far the most  frequently admi-
nistered.  It  is in fine, silky,  flexible  needles,  and  at times in
rectangular  columns.  Its taste  is extremely  bitter,  and  resem-
bles that  of yellow bark.   Exposed to a moderate heat,  it loses
its crystalline form, in consequence of the escape of  its water of
crystallization.  It is only slightly soluble in cold water, requiring
740 parts at the ordinary temperature, and 30  parts of  boiling
water  for its solution.   In alcohol, it is very soluble, but only
slightly so in ether. With sulphuric acid, it forms a super-sulphate,
which is  much  more soluble in water than the  neutral salt, and
hence  a few drops of dilute  sulphuric acid are  usually added to
mixtures of sulphate of quinia.

                   METHOD  OF PREPARING.
   This salt is generally prepared on a large scale in the chemical
laboratories.  A formula was admitted, however, into the Phar-
macopoeia of the United States (1830,) which  was taken from the
process of M. Henry, Junr.,1 for which he received  a prize from
the Academie Royale des  Sciences, of Paris.  It is as follows:—
Take of yellow bark, in powder, a pound;  lime, in  powder, four
ounces; sulphuric acid, alcohol, animal charcoal, distilled water,
each a sufficient quantity.   Boil the bark  for half an hour with
eight pints  of distilled  water, acidulated with  a  fluidounce of the
sulphuric acid.   Strain the decoction through linen:  then  boil the
residue with the same quantity of acidulated water,  and filter as
before.  Mix the  filtered liquors, and  gradually  add  the lime,
stirring constantly.  Wash the  precipitate  with distilled water,
and, having  dried it, digest in alcohol with a moderate  heat.  Pour
off the tincture, and repeat  the digestion  several times,  till the
alcohol is no longer rendered bitter.   Mix the tincture, and distil
over the alcohol, till a brown viscid liquid  remains in the retort.
Upon  this substance, removed  from the retort, pour as much sul-
phuric acid, largely diluted with water, as may be sufficient for its
               1 Journal de Pharmacie, vii. 296. Juillet, 1821. 
QUINIJE SULPHAS.
615
perfect  saturation.  Then add the animal charcoal, and having
evaporated  the liquor sufficiently, filter while hot, and set it aside
to crystallize.  In the last edition (1842,) the form has been modi-
dified as follows:—Take of yellow bark, in coarse powder,lbiv.; mu-
riatic acid, f §iij.; lime, in powder, gv.; water, fivegallons; sul-
phuric  acid, alcohol, animal charcoal, of each a sufficient quantity.
Boil the bark in one-third  of the water mixed with one-third  of
the muriatic acid, and strain through linen.   Boil the residue twice
successively with  the same quantity of water  and  acid as before,
and strain.   Mix  the decoction, and while  the liquor is hot, gra-
dually add  the lime, previously mixed with two pints of water,
stirring constantly, until  the quinia  is  completely precipitated.
Wash the precipitate with distilled  water, and, having pressed
and dried it, digest  in boiling alcohol.   Pour off the liquor, and
repeat the digestion several times, until  the alcohol is no longer
rendered bitter.    Mix the liquors, and distil off  the alcohol, until
a brown viscid mass remains.   Upon this substance, removed from
the vessel, pour about half a  gallon of distilled water, and having
heated  the mixture to the boiling point, add as much sulphuric acid
as may be necessary to dissolve the impure alkali.   Then add  an
ounce and a half of animal charcoal, boil for two minutes, filter the
liquor while hot, and set it aside to crystallize.  Should the liquor,
before filtration, be entirely neutral, acidulate it very slightly with
sulphuric acid: should it, on  the  contrary, change the  colour  of
litmus paper to a  bright red, add more animal charcoal.   Separate
the crystals from the liquor, dissolve them in boiling water slightly
acidulated with sulphuric acid; add a little animal  charcoal, filter
and set aside to crystallize:  wrap the crystals in bibulous paper,
and dry them with  a gentle heat.  The mother  waters may be
made to yield an additional quantity of sulphate of quinia by pre-
cipitating the quinia with  solution of ammonia, and treating the
precipitated alkali with  water, sulphuric acid, and animal charcoal
as before.1
   It  results from the calculation of Pelletier and  Caventou, that
from a  quintal of cinchona, two pounds, one dram and thirty grains
of sulphate of quinia may be obtained, which makes two drams,
sixty-six grains and a sixth per pound, or thirteen grains and two-
sixths per ounce; and as the sulphate is composed of nine parts and
nine-tenths of sulphuric acid  to  ninety and  a tenth  of quinia, it
follows that if the dose  of cinchona in substance be two drams, we
should  administer to the patient three grains  and  nine thirty-
secondths of a grain of sulphate of quinia;  not taking into account
a small quantity of sulphate of cinchonia, which may be mixed with
it.  Four grains of the  salt are, consequently, more than an equi-
valent  for the dose  of the cinchona often prescribed in  substance.
 Those  practitioners, therefore, who prescribe thirty-six or seventy-
             1 Pharm. of the United States, p. 174.  Philad, 1842. 
616
QUINIiE SULPHAS.
two grains of the sulphate, give the representative of about twenty-
seven drams of cinchona in the former case, and of fifty-four in the
latter.1
   Sulphate of quinia is liable to be adulterated,—for example, by
mannite, which is similar in external appearance, but—as elsewhere
shown—is destitute of all its properties.   This adulteration can be
readily  detected by means of pure alcohol, which dissolves the
quinia alone, but  leaves  the  mannite untouched, which is freely
soluble in water, and is known by its characteristic  sweet taste.
It is  also  adulterated with gypsum, the presence of which may
likewise be detected by alcohol, which does not dissolve it.2
   Some idea of the immense consumption may  be formed,  when it
is stated, that  from 40,000 to 50,000 ounces of sulphate of quinia
were  probably made during the year 1845, in Philadelphia.
   The sulphate of quinia of commerce is said to be not unfrequently
adulterated with salicin.   If the proportion of the salicin  be one-
half,  or even one-fourth,  M. Pelletier3 states, that  the fraud may
be detected  by the addition of concentrated sulphuric acid, which
produces with  salicin a characteristic red colour.   But if no more
than one-tenth of salicin be mixed with the sulphate, the red colour
is not developed by the addition  of sulphuric acid.  In order to
detect the  presence of salicin in this or a still less proportion, the
salicin must be separated.   For  this purpose, take three  or four
grains of the suspected sulphate of quinia, and pour on it about six
times its weight of concentrated sulphuric acid, which dissolves the
salt, and if salicin  be present forms a solution of a brown colour,
like sulphuric acid  soiled  by some vegetable matter.   To this some
distilled water  must be carefully and gradually added, until a white
precipitate appears.  This  will probably be salicin, which will not
dissolve in  a moderately dilute acid solution  of  sulphate of quinia.
Filter the liquid, and collect the precipitate  on a  watch-glass, and
it will now produce, upon the addition  of concentrated sulphuric
acid,  the bright red colour  characteristic of salicin.   If too much
water be added, the precipitate  will dissolve, and only  a loose
gelatinous  precipitate will form, very difficult to  separate.
   One evidence of the value  of this discovery  of the sulphate of
quinia, has  been mentioned by the  author  elsewhere.4 He was
informed a few years ago, that although the best cinchona bark
could not be purchased, at  the time, in Philadelphia,  for less than
one dollar and thirty-seven cents per pound, and in powder for less
than one dollar and fifty cents,—cinchona powder, so called, might
be obtained  for ten  cents  a  pound!  This consisted of the false
and other barks, with the cinchona or true barks;  and generally,

      1 Jourdan, Pharmacopee Universelle, ii. 373.  Paris, 1828.
      2 Vallet & Dubail, Journal de Pharmacie, Janvier, 1840.
      3 Journ. de  Chimie Medicale, cited in London Lancet, Jan. 11, 1845.
      * Practice of Medicine, 3d edit. ii. 424.  Philad. 1848, 
QUINLE SULPHAS.                    617
 perhaps, not a particle of the latter could be detected in it.   Yet
 the appearance of the true and the spurious powder was so nearly
 alike, that no difference could be discovered, even by an experienced
 eye.   From July 1848  to April, 1849, inclusive, Dr. Bailey,1 in-
 spector of drugs at the port of New York, rejected 34,000 pounds
 of spurious and worthless cinchona  barks, which contained none,
 or but a trace, of the alkaloids of the true barks; and  he affirms,
 that  the cost  of these barks, delivered in that market, was, at the
 time, about six cents a pound, whilst the genuine cost eighty cents!
                 EFFECTS ON THE ECONOMY.
   The effects of the preparations of quinia on the healthy organism
 have not  been much investigated.   According to Caventou, they
 produce a  general excitement, similar to that caused by coffee, and
 Wittmann affirms, that the sulphate induces an excitement similar
 to that of  a paroxysm of fever.  Hirschel,2 too, asserts, that in a
 child, four years of age,  to whom  the sulphate was given in a case
 of intermittent, a general chilliness  of some minutes' duration
 supervened immediately on taking the remedy, succeeded, in the
 course of half an hour, by general heat, and  this again by a gentle
 perspiration, in  all  respects  resembling  a  mild  attack of fever.
 The excitant action of the salts of quinia formed by the vegetable
 acids is said to be less striking.
   Sulphate of quinia, in  large doses,  appears, in some cases, to
 possess narcotic properties.   It has even proved fatal, when given
 in excessive doses, and Dr. Baldwin,3 of Alabama, from all he can
 gather, is disposed to think, that from fifty to  eighty grains of a
 pure  article, given in solution at one  dose, will produce death nine
 times out of ten, in  healthy  adults,  and that occasionally smaller
 doses will have the same result.  " How  far,"  he adds, " its ope-
 ration may be modified by morbid action  is  a  matter for conside-
 ration at the bed-side."  M. Recamier4  ordered a man  in the Hotel
 Dieu, affected with acute rheumatism, 48 grains of the sulphate in
 12 powders—one to  be  taken every  hour.  The next day, 72
 grains were ordered,—six to be taken every hour; but after the
 eighth dose, the patient was suddenly seized with violent agitation,
 followed by furious  delirium, and died in a few  hours.   On  ex-
 amination,  evidences  of  severe inflammation [?]  of  the cerebral
 membranes were  discovered.   An analogous case, in which very
 dangerous  symptoms supervened  on the  administration  of  four
 scruples of the sulphate in twelve  hours, occurred  about the same
 time  in the wards of  M. Husson.5   It has  often, however, been

  1 Report on the practical operation of the Law relating to the Importation of adulterated
and spurious Drugs, Medicines, &c.   New York, 184'J.
  2 Hufeland's Journal, B. lxi. St. 6, S. 140.
  * x\merican Journal  of the Medical Sciences, April, 1847, p. 307.
  4 Bouchardat, Annuaire de Therapeutique, &c. pour 1843, p. 170.  Paris, 1843.
  s Gazette des Hopitaux, 8 Decembre,  1842. 
618
QUINLE SULPHAS.
administered in considerable quantity without the supervention of
any disagreeable  results.   Bally1 gave it to the  extent cf 110
grains in the day without any inconvenience.  Dr. Thomas Fearn/
who administered  it  largely, regards it to be more narcotic than
sedative,—usually, he  thinks,  stimulating in small doses, but in
large doses the stimulant effects not being obvious, but rather the
reverse; and such appears  to be the view  of  Dr. A. Flint.3   It is
affirmed, that  when administered for some days in large doses, the
pulse became greatly retarded, fell below fifty in the  minute, and
great  debility was experienced.4   This  decisive sedative action
has been observed  by the  author5 over and over again, when the
sulphate of quinia has  been given in free doses; but  Dr. George
Mendenhall,6 of Cincinnati, affirms, from  experiments made  upon
himself, that in all cases the  pulse was  increased in fulness and
hardness, even when it decreased in frequency.  " When ten grains,
and  also twenty grains were  taken, the ringing in the  ears was
very great, with some considerable deafness for several hours; also
a general feeling of the body, such as would be excited by riding
in a railroad car."  M. Favier took, in twelve days, 280 grains
of the sulphate,  commencing with  six grains, and doubling the
dose every three days.   The first three doses  produced  no other
effect  than an  evident diminution in  the number of the pulsations,
and a  degree of activity in the nutritive functions; the three fol-
lowing, which were of 12 grains, still acted on the pulse, the force
and  frequency of  which were  diminished.   From  time to  time,
ringing  in  the ears supervened, with frequent  hunger.   The sub-
sequent doses acted still more in reducing  the activity  of the circu-
lation, and caused  disorder of  the mind, somnolency, tinnitus au-
rium, and so much debility, that M. Favier was almost unable to
stand; and after he  had discontinued the  experiment, he did not
recover his muscular strength  for six or eight days.7
   When Mr. Scott,8 a medical gentleman and a  martyr  to  dys-

  1 Revue Medicale, v. 244, Juillet, 1821.
  2 Transylvania Journal of Medicine, October, November and December, 1836, p. 798;
cited in  American  Medical Intelligencer, June 15, 1837, p. 109.
  * American Journal of Medical Sciences, Oct. 1841, p. 277.
  4 Bouchardat. op. cit. p. 170.  See, also, on  its  sedative properties, J. W. Malone,
Amer. Jour, of the Medical Sciences, Oct. 1843, p. 376; Boling, ibid. July,  1844, p. 89;
Legroux, Joum. de Med.in Encyclog. Med. Avril, 1845: cited in Ranking's Half-yearly
Abstract, i. 218. New York, 1845; J. Bell, in  Stokes and Bell's Lectures on the The-
ory and Practice of Physic, 3d edition, ii. 638.  Philad. 1845; A. N. Bell, Medical Ex-
aminer,  May, 1846, p. 283; M'Cormick, New Orleans Medical Journal, September,
1845; J. Harrison, ibid. Nov. 1845. See, also,  on this subject, Dickson, Southern Jour.
of Medicine and Pharmacy, January,  1846; T. D. Mitchell, New Orleans Medical
and Surgical Journal, July, 1846, p. 25; Briquet, Annuaire de Therapeutique pour
1849, p. 205; and G. L. Upshur, Medical Examiner, March, 1847, p.  143.
  5 Medical Examiner, April, 1845, p. 538, and his General Therapeutics and Materia
Medica, 4th edit. ii. 85.  Philad. 1850.
  B American Journal of the Medical Sciences, July, 1846, p. 79,
  1 Bouchardat, Annuaire de Therapeutique pour 1850, p. 172.
  8 London Medical and Physical Journal, March, 1833. 
QUINIiE SULPHAS.
619
pepsia, took  quinia  in very large doses, under the idea that his
malady was intermittent neuralgia, he found several singular phe-
nomena  induced  thereby.   He  was  directed  to  commence with
two grains three times a day, until he arrived at twenty grains for
a dose,—that is, a dram a day.  Until the doses were increased to
fourteen or sixteen grains, he did not  experience any peculiar ef-
fects, but now began to feel heat  of  skin, dryness of mouth and
fauces, and obstinate constipation.  He likewise.lost the power of
naming  substantives; was obliged for a  long while to  consider
what familiar things were called, and was  unable to cast up aline
of  six or  eight  figures correctly.  His perceptions of  quantity
were likewise impaired, so that  in  prescriptions he wrote ounces
for drams, drams for grains, &c, &c.  He  still, however, perse-
vered with the quinia, until he took Bj. four times a day; but he
was unable to  continue  these  large doses long, the untoward
symptoms  augmenting, so  that he was often  unable to  stand, and
fell several times in the street.
   Very similar Results to those observed by  Mr. Scott, and  espe-
cially as regards the inability of utterance—which, in their cases,
was complete—are recorded by M.  Menage,1 and  Mr. G. O.
Heming.2   Cases of  deafness caused  by large doses have  been
detailed by Dr. Joseph Williams, of London,3 Mr.  C. R. Bree,4 of
Stow-market, England; M. Fr.  Lugeol, of Havanna,5  and  Prof.
Giacomoni,6 and cases of blindness, induced by large doses, are re-
corded by  Dr. John M'Lean,7 and Dr. Wm.  Alex.  Thom.8
   MM. Trousseau and Pidoux9  refer to the case of a soldier who
took 4S grains of the sulphate for the cure of  spasmodic asthma,
which returned daily at  a certain  hour.   Four hours afterwards,
he  experienced  buzzing in  the  ears,  diminished sensibility,  gid-
diness, and violent vomiting.   Seven hours after taking it, he was
blind and  deaf, delirious,  incapable of walking by reason of the
giddiness, and vomited bile copiously.   He  was, in fact, in  a state
of intoxication.   The symptoms gradually  subsided.  Usually, the
action of the sulphate does not extend beyond  twenty-four hours,
and its maximum effects are experienced two or three hours  after
taking it.10
   In impressible individuals, the sulphate and  the  muriate—even
in  moderate doses—not unfrequently induce a sense of anxiety,
restlessness, vertigo, confusion, depravation of  vision, tinnitus au-

  1 Gazette Medicale de Paris, 25 Avril, 1840.
  * London Lancet, and Medical Examiner, July 18,1840, p. 468.
  » London Lancet, July 25, 1840, p. 639.
  4 Ibid. August 22, p. 786.
  1 Bullet Gen. de Therap. Mars, 1842.
  6 Annali di Medicin. Feb. 1841, and Journal de Pharmacie,  Sept. 1842, p, 209.
  1 Illinois and Indiana Medical and Surgical Journal, Dec. 1846.
  8 Medical Examiner, April, 1847, p. 217.
  9 Traite de Therapeutique, ii. 217.
  ,0Trollier;  in Bouchardat, Annuaire de Th6rapeutique pour 1847, p. 17C.   Paris,
1847. 
620                    QUINIiE SULPHAS.
rium, and, in many cases, transient deafness—cinchonism,quinism.,
quininism,—all which symptoms appear to be of a neuropathic cha-
racter ; and, it has been affirmed, occur more frequently in females,
especially those who are pregnant or suckling—and  in  persons of
slender and delicate conformation.l   In certain cases, quinia  and
its salts seem to have caused ptyalism—the saliva being inodorous,
and  the teeth firm; and, when calomel has been given along with
it, it has been conceived that ptyalism has ensued sooner than it
otherwise might have done.
   M. Melier2 in conjunction  with M. Magendie  has investigated
the toxical  properties of quinia.   They found,  in animals, conges-
tion of the lungs and deficient coagulability of  the blood.  These
were the principal post mortem phenomena.  Its action was much
more energetic when given fasting, and in acid solution.  Its ab-
sorption and elimination were rapid.
   The most striking agency of quinia and its  salts  is in cases of
periodical diseases of all kinds; and especially in  intermittent
fever;  they have now, indeed, almost wholly  taken the place of
the  cinchona, over which  they possess many points of preference.
In the first place, their  bulk is  much less; they therefore do not
oppress the stomach so much, whilst the impression of the cinchona
on that organ not unfrequently interferes with its antipyretic pro-
perties.   In malignant fevers, too, it is often impossible to in-
troduce the requisite quantity of cinchona into the organism to pre-
vent the succeeding paroxysm, and the life of the patient is con-
sequently placed in danger.   In this case, sulphate of quinia is in-
valuable, possessing, as it does, the antiperiodic  virtues of cinchona
in such a concentrated state, that but a small quantity is required to
produce equal efficacy with a large quantity of powdered cinchona.
In such cases, indeed, the  latter is apt to disagree with, or be re-
jected by the stomach, before its full influence can be exerted.  In
those pernicious fevers, that occur especially  in Italy and  Hol-
land, sulphate of quinia has  supported  life in  innumerable cases
where cinchona, in substance, might have failed,  and has thereby
best exhibited its sanative agency.3    In such cases  quinia is ad-
ministered without regard  to  complications, which, in less  urgent
cases, might be allowed to interfere with its administration.   An-
other advantage  ascribed to  quinia is, that in cases of paroxysmal
fevers, in which the attacks follow each other so closely that the
second commences before the first has terminated, it  may be given
durino- the paroxysm,—a time at which cinchona would be apt to
occasion oppression of the stomach and vomiting.
   Of late,  a  salutary change has  occurred  in the  treatment of
southern fevers, and  indeed of yellow fever, by the  liberal admi-
  1 Riecke, Die neuern Arzneimittel, S. 120.
  2 Mem. de l'Academie Royale de Medecine, torn. x.  Paris, 1843.
  3 Repertorio Med. Chirurg, por l'anno 1822, Torino. No. 12;  Med. Chirurg. Zeitung,
B. ii. S. 137,1823; and Richter's Specielle  Therapie, B. x. S. 326,  Berlin, 1828. 
QUINIiE SULPHAS.
621
 nistration of sulphate of quinia, which is now regarded by south-
 ern practitioners as "the Samson article of the Materia Medica,"
 in place of calomel, on which the epithet was previously lavished.
 In the congestive fever of the Western States, Dr. Charles Par-
 ry1 found.the sulphate of quinia "the remedy;"  and  such has
 been  the result of the experience of others.2  Great success has
 followed the use of sulphate of quinia,  in doses of from a scruple
 to a dram in yellow fever, in the practice of Drs. Hunt, Beattie,
 Farrel, Mackay, and others,3 but Dr. W. A. Van Buren, U. S. A.,
 never witnessed any decided and permanent good effects from it; and
 in the hands of others it has failed signally.   In the remittents of
 the South and West, it has been an admirable remedy in the prac-
 tice of Drs. J. B. Porter,4 Wm. M. Boling,5 Wm. A. Van Buren,6
 Prof. Dugas,7 Dr. R. L.Scruggs,8 and others.9 Dr. T. D. Mitchell,10
 indeed, lays down the position, that all fevers "possess one common
 property, which confessedly under the  control of the sulphate of
 quinia in the case of common  ague  and fever, is not less  so in
 typhoid, typhus, congestive, yellow, and it may be  all the fevers
 named in the books; and  he assumes  the  position  "plainly and
 boldly," that "there is but one feature or element in either of the
 fevers named, that is essential to  its  pathology, and that feature,
 or property, or element bows before  the potent sway of the sul-
 phate of quinia, and for this  reason  only we cure the patient." !
 M. Guerard11 employs it at the commencement of all febrile affec-
 tions.  " W henever a person is attacked with typhoid fever, variola,
 or any other acute febrile affection, which is attended at the  onset
 with encephalic disturbance threatening a severe form,—as delirium
 with  aberration of the senses, particularly of the sense of sight,
 which is  most appreciable by the physician, he prescribes, before
 every  thing, two grammes or about 31 grains  of  the sulphate of
 quinia, to be taken by spoonfuls through the twenty-four hours.
 This  dose  has  to be given  the next day, and at times also on
 the day following."   The encephalic symptoms, he affirms, are im-
 mediately dissipated; the pulse  becomes  regular, and  the disease
 assumes a mild  character.  He states, also,  that  he has used it

  1 American Journal of the Med. Sciences, July, 1843, p. 32. See, also, C. E. Lavender,
 American Journal of the Med. Sciences, July, 1848, p. 51.
  * Tuck, New Orleans Med. and Surg. Journ., cited in Med. Examiner, Dec. 1845,p. 749.
  3 Medical Examiner, Oct. 19, and Oct 26, 1839.
  4 American Journal of the Medical Sciences, Oct. 1845, p. 296,
  6 Ibid. July, 184G, p. 18.
  6 Cited in Medical Examiner, Feb. 1846, p. 139.
  1 Southern Med. and Surg. Journal, cited in Med. Examiner, for Feb. 1847, p. 107.
  8 Med. Examiner, Dec. 1848, p. 716.
  9 See a discussion on the powers of quinia in remittent fevers, in Med. Examiner,
Feb. 1850, p. 78.
  10 Western Lancet,  cited in Examiner, June, 1845, p. 386. See, also, New Orleans
Med. and Surg. Journ. July, 1846, p. 22.
  11 Bouchardat, Annuaire de Therapeutique pour 1849, p. 212.
       40 
622
QUINIJE SULPHAS.
successfully in tinnitus aurium  not accompanied  by febrile phe-
nomena and dependent upon cerebral congestion.
  Dr. Scruggs holds it to be a most important fact connected with
the use of the sulphate of quinia, "that it should never be given
upon a rising fever,—that is, until the fever has attained its climax,
or has been arrested by  the use of the lancet  or other remedial
agents, and has a downward tendency.   Then, although the pulse
may  have  mounted  up to  one   hundred and forty beats to the
minute, and have declined only ten beats, quinine may be given in
large and repeated doses, combined with ipecacuanha, not only with
safety, but with the most decidedly beneficial results."  On the
other hand, Dr. R. S. Holmes1 affirms, that as a remedy for perio-
dicity quinia is to  be given regardless of any existing  state of in-
flammation.
   In the typhoid fever of children it was found serviceable by
MM. Rilliet and Barthez.2  Trials of the  remedy have likewise
been made at  the  Hopital  Cochin in Paris, by  M. Blache, in the
typhoid fever of adults, the results of which were favourable.
The cases, however, were not numerous, and in certain of them
other remedies were  prescribed either before or in conjunction with
the sulphate of quinia.  Afterwards, some  of the patients of M.
Husson at the same  hospital were subjected to  the same mode of
treatment, and the results were  published by M. Laurent.3   The
dose  of  the medicine usually prescribed  was three quarters  of a
grain  every hour:  at times, the  dose was  larger,  and given
less  frequently; and, in several instances,  two drams and more
were given in the twenty-four hours for several days together. In
thirteen cases no other remedy was administered, but although the
patients  recovered, the results did not show any great superiority
over other modes of management.   In no instance were the  phe-
nomena  arrested  by the quinia.   Of ten patients, who had the
disease mildly, all recovered but one, whose death was attributed
by M. Laurent to the quinia.   Of three patients, labouring under
the disease in a severe form, one only recovered ; and he was for
a time in great danger from intestinal hemorrhage.   The report
of M. Laurent is not very favourable to the  beneficial effects of the
sulphate of quinia in typhoid fever.  By Dr. A. N.  Bell4, it has
been given  in the same disease; with  the  effect of reducing the
frequency of the pulse, but without appearing to affect in the  least
the duration of the disease.
   Of late, it has been prescribed by M. Leudet,5 in large doses as a
preventiveofpuerperalfever,andDr.W.M.BoIing,6ofAlabama,has

  ! Amer. Journ. of the Medical Sciences, Oct. 1846, p. 304.
  * Archiv. General de Med. Juin, 1841.         3 Ibid.,  Sept. 1842.
  4 Med. Examiner, May, 1846,  p. 282.
  ' L'Union Medicale, 8 Avril, 1848; and Wahu, Annuaire de Medecine, &c.,pour 184!',
p,299,          * Amer. Journ. of the Medical Sciences, July, 1844, p. 110. 
QUINIA SULPHAS.
623
adduced what he esteems reasons for the belief, that it is "pecu-
liarly" applicable to the treatment of the inflammatory affections
of malarious districts,—and this he  considers is owing  to  the
combination with its antiphlogistic properties  of a power to con-
trol the periodicity of morbid action.  " As an antiphlogistic remedy
in elevated and  healthy localities," he remarks, "it will probably
never  supersede the  lancet, antimonials,  &c, though it may in
many  cases be brought to their aid;  but in malarious regions, ere
long, it will generally be looked upon as the safest and  most  ma-
nageable  contra-stimulant we possess, and, at the  same time,  one
sufficiently powerful, while  other agents of the same class will only
be used to fulfil some casual  indication  or as adjuvants to this the
powerful  remedy."
   It  is scarcely  necessary, however, to  say that quinia and its
preparations are not universally admissible.  The stomach is occa-
sionally so irritable as not to  retain it.   In such cases, it is true, it
may be given  in the form of enema.   In remittents, too, that  are
accompanied  with hypersemia  of  important  organs,  such hyper-
semia  must be  removed  before it  can   exert  its wonted efficacy.
" Those," says Prof.  Dickson,1 " deceive  themselves, who regard
quinine as a universal  and infallible febrifuge even in  malarious
fevers."
   Sulphate of  quinia has  likewise  been  found advantageous in
large doses—twelve to thirty grains  and more daily—in  engorge-
ment of  the spleen,  consequent on  intermittent fever;3  and  M.
Levy3 has seen the dropsical effusions, that not unfrequently super-
vene on neglected cases of the same disease,  yield readily to  the
sulphate in full doses.4  In  a  memoir presented to  the Academy of
Sciences of Paris, by M. Piorry, a few years ago, he laid down
the astounding opinion, that sulphate of quinia, dissolved in a small
quantity of sulphuric acid and administered in moderate doses, acted
so rapidly on  the  spleen,  that in the course of 40 seconds a notable
diminution in  the size of the organ  took  place.   As might have
been presumed, there would seem  to be some source of fallacy in
his observations;  and M. Gouraud5 has boldly maintained, as the
result of  accurate inquiry into the phenomena, that the  disappear-
ance of dulness in the  splenic region under such  circumstances is
dependent upon the ingestion of fluid with the sulphate of quinia,
which produces a development of gas, rather than  upon  the action
of the sulphate of quinia, and M. Gouraud's observations have
been  confirmed  by M. Valleix.6
   Its  use has been recommended in asthma by Dr. B. R. Hogan T
   1 Southern Journal  of Medicine  and Pharmacy, Jan. 1846.
   * For the  opinions of Bally, Nonat, and Piorry on this subject, see Medico-Chiruri?
Rev. July, 1840,  from La Lancette Franoaise.            3 Op. cit.
   * Bulletin  General de Therapeutique, 30 Nov., 1837, and Levy, Gazette 'Med No
xxii.                s Cited in Medical Examiner, Sept. 1845, p. 577.
   • Monthly Journ.of Med. Science, July, 1847; and Med. Examiner, Nov 1847 n fi«7
   ' American Medical Intelligencer, Feb. 1842, p. 153.                   'v 
624
QUlNIiE SULPHAS.
 who gave it in doses of from  two to eight grains, repeated in an
 hour, if relief did not follow.  He also affirms, that in the forming
 stage of croup, in the case of a child, two years old, two  grains
 of the sulphate and  a snuff plaster on  the  chest warded off the
 attack.   It has been administered successfully in the same disease
 by M.  Puis1 in the form of lavement in the dose  of 60 centi-
 grammes—gr. 91—in the day.   Where there was  a malarious
 complication it was more decidedly efficacious.
   In  hiccough, when at all periodical, M. Mondiere  has found the
 disease  promptly and decisively cured by the free  use of quinia,
 after it had resisted every other mode of treatment.   He has  also
 used it with good results in many cases of severe cardialgia.   In a
 case of traumatic tetanus it was administered along  with sulphate
 of morphia  in  large sedative doses, with much  success, by Dr.
 Bishop;2  and  in marsh  cachexy—cachexie  paludeenne—it  was
 found, by M.  Duclos,  most advantageous.   In these  cases,  it is
 associated with chalybeates by Professor Trousseau.3
   Sulphate  of quinia, like cinchona, has been given  largely in
 acute rheumatism—a disease which is peculiar, and in the author's
 view, largely  neuropathic.4   Some years ago,  M. Briquet  an-
 nounced that he had cured acute articular rheumatism, accompa-
 nied with violent  pain, swelling, redness, fever, &c, in two or
 three  days, with sulphate of quinia, in doses of about a dram and
 a half daily.   In such cases, and  especially in the subacute form,
 the author has prescribed from twenty to  thirty  grains in  the
 twenty-four hours with  marked advantage.   Its  antiperiodic
 virtues are clear, and instead of its acting as  an excitant, it  pro-
 duces sedative  effects.5   In  obstinate cases,  a  combination with
 opium—three  or four  grains  in  the twenty-four hours—proved
 most  decidedly  salutary.  Given after  the use of the lancet, in
 highly inflammatory cases, or after powerful purgation with  cro-
 ton  oil, it has been productive of the happiest effects in the hands
 of Dr. Geo.  L. Upshur,6  of Norfolk, Va,
   Some years ago, M. Gueneau  de Mussy,7 in  the name of a
 committee, made a report on different  papers  that had  been  for-
 warded to the French Academy,  on the  treatment of acute rheu-
 matism by large doses of sulphate of quinia.   The committee con-
 cluded, that it should not be given in the high doses  of four to six
 scruples, advised by M. Briquet; and they affirmed, that the same
 therapeutic effects may be obtained from ordinary  doses.   The

  1 Bouchardat, op. cit. p. 214.
  a New York Journal of Medicine, Sept. 1847.
  3 Bouchardat, Annuaire, &c. pour 1849, p. 215.
  4 Practice of Medicine, 3d edit. ii. 611. Philad. 1848;—and Med. Examiner, Sept.
 1845, p. 538.
  * See  Legroux, Journal de Med. in Encyclographie Med. Avril, 1845, cited in Rank-
ing's  Half-yearly Abstract, Amer. edit. i. 218.  New York, 1845.
  8 Med. Examiner, Oct. 1850, p. 581.             ' Ibid. July 8, 1843, p. 156. 
QUINIA SULPHAS.
625
sulphate of quinia plan of treatment is followed by MM. Andral,
Monneret, Legroux,  and Professor Trousseau,1 at  the Hopital
Necker, and is recommended by M. Vinet.3
  Of late, it has been strongly advised by many of the French
practitioners as a prophylactic against cholera; but the  observa-
tions made at the Hopital  Cochin, in Paris, were  by no  means
favourable to those pretensions.3  In large doses, it has  been pre-
scribed with  speedy  and  good effect  by M. Piorry,4 in certain
cases of insanity, in  those  especially in which the disease has
seemed to have been connected with certain changes of  the func-
tions of the organs of sense, especially of hearing;  and in the case
of hypochondriasis, with certain  abdominal sensations.   Periodi-
city is  a characteristic in many of these cases,  and hence the
utility of quinia.
  Besides their antiperiodic  property, the salts of quinia possess a
tonic virtue that adapts  them  for numerous cases in which that
class of remedies is indicated.  Yet there are many who  think
that cinchona is better calculated for such cases than quinia, and
who administer the latter  to prevent the paroxysms of an inter-
mittent, but have recourse  to  cinchona when  they are  desirous
of fortifying the system  to  prevent a relapse.  There are cases,
too, which resist quinia and its  preparations, and which subse-
quently yield  to cinchona in substance; but this may be  owing to
the quantity of lignin, or woody matter in the  bark in substance
aiding the quinia of the cinchona in  producing  that new impres-
sion on the nerves of  the stomach, which is necessary to  break in
upon the paroxysmal  catenation.  In  its antiseptic virtues, also,
sulphate of quinia is  inferior to cinchona.  It has been doubted,
indeed, whether it has any such virtues.
  Lastly:  there  is an  advantage possessed by sulphate of quinia,
—that in irritable or impressible persons  it may be exhibited en-
dermically, and thus no disorder be induced in the digestive actions.
It need scarcely be said, that cinchona  is not well adapted for this
mode of administration.
                 MODE OF  ADMINISTRATION.
  Sulphate of quinia  may  be  given  internally  in  the form of
powder or pill, and in solution in water, alcohol, or syrup.  The
average dose, in the twenty-four hours of apyrexia, is  from four
to ten grains; yet it has been given frequently to a much  greater
extent.  As  in the case of cinchona, it has also been advised, that

  1 Trousseau and Pidoux, Traite de Therapeutique, &c, 3eme ed. ii. 322.  Paris, 1847;
See, also, Med. Examiner, May, 1848, p. 330.
  2 Union Medicale, No. 43; cited in British and Foreign Med.-Chirurg., July, 1848,
p. 259.
  8 Bouchardat, Annuaire de Therapeutique pour 1850, p. 196.
  4 Gazette des Hopitaux, No. 86; cited in British and Foreign Med.-Chirurg. Review,
Oct. 1848, p. 554. 
626
QUINIiE SULPHAS.
a large dose  should be given immediately before the  expected
paroxysm, so as to render the frequent administration during the
apyrexia  unnecessary:  this  dose need  not be  so great as the
combined doses would amount to, so that there may  be  economy
in the plan.  Dupasquier, Elliotson,1 the author, and many others,2
have  found this course eminently successful; but some object to it.
In ordinary intermittents, the author is in the habit of administer-
ing the sulphate in the form of the mistura quiniae sulphatis, given
hereafter.   As the antiperiodic virtues of the remedy are exerted
through the nervous system, he  considers it advisable to impress
not only the nerves  of the  stomach but those of  gustation,  which
cannot  be effected  by the  pilular form.   Half the mixture—or
five grains  of the sulphate—is given about an hour before the
paroxysm, and the remainder half an hour afterwards; and if signs
of the paroxysm appear notwithstanding, he directs fifty or sixty
drops of the  tincture of opium to be given.   This course  rarely
fails.3  The advantages of the solution over the pilular form have
been  confirmed by the observations of M. Briquet.4  He  considers
it more active by  one-half.
  A  case of  severe remittent  has been  detailed by  Dr. Thomas
Fearn,5  in  which he  gave, at one dose, three tea-spoonfuls—
weighing thirty-two grains.  At  the end of an hour, there was a
diminution in the  frequency of the pulse—" the invariable effect
of large doses of  quinia, when its operation is  favourable."  The
dose  was repeated,  and at  the end of another hour, it was again
given, making ninety-six  grains  in two  hours.  Dr. Fearn  re-
marks, that his usual practice in remittent fever  had  been to give
three doses  of twenty grains each, with an interval of an hour
between.
   Of late years, it  has been the practice with  many physicians to
administer it in very large  doses—gr. xx. to gr. xl.—in ordinary
intermittent fever;6  and there may be cases in which after the dis-
ease  has resisted the  usual doses it may  yield to these; but the
author has  not met with many.   It has been  stated, indeed, that
M. Piorry, who was formerly an advocate for large doses of  the
sulphate  in  intermittents, now affirms, that  he  obtains  the same
results from doses of fifteen grains, as he did from those of seventy
and ninety.7  Dr. Upshur,8 of Norfolk, gives it in doses of three
or  five grains, every two  hours, commencing  as soon as there is
the slightest diminution in the hot  stage, and continuing  it until
the patient complains of noises in  the ears.  He found that, when
administered in large doses in the hot stage, so far from exciting
  1 Medico-Chirurgical Transactions, xri. 543.  Lond.  1824.
  2 Thomas Stratton, R.  N., Edinb. Med. and Surg. Journal, April, 1844.
  » See the author's Practice of Medicine, 3d edit. ii. 424, Philad. 1848.
  * Bouchardat, Annuaire de Therapeutique pour 1849, p. 211.       * Op. cit
  * A. Flint, in American Journal of the Medical Sciences, Oct. 1841, p. 278.
   T Philad. Med. Examiner, Fetx 4,1843, p. 24.       * Ibid. Feb. 1846, p. 8&. 
QUINIiE SULPHAS.
627
the circulation, it acted as a decided sedative—the pulse, in every
instance, being lessened in force and frequency under its influence.1
A medical friend of Dr. Dickson,2 of Charleston, assured him that
in Alabama, he had administered "thirty grains of  a solution of
sulphate of quinia, every hour for  seventeen successive hours,"
and he states that  he  had heard  authentically of a western  phy-
sician, " who  emptied into  the stomach of  a patient  labouring
under bilious  remittent, an  ounce bottle in  one  night."  Even
larger doses than  these are recorded.   Dr. B. Rush  Mitchell,3 in
a  case  of congestive fever,  gave thirty grains every half hour,
until  240 grains were  taken in about four hours;  and the patient
recovered.   Generally, between the paroxysms several  doses are
administered; and, according to the  particular case, the  efficacy of
the salt of quinia  is attempted to be increased by  the addition of
antimonials, laxatives, carminatives, &c,  and—in pernicious or
malignant intermittents especially—of opium  or morphia.
   By many, a combination of quinia with moderate doses of cin-
chona is  highly recommended.  Chapman advises its union  with
piperin: a combination with the alcoholic extract  of cinchona has
also been prescribed.
   Mr. Sherwin,4 of Hull, affirms, that a piece of apple, chewed
for a  moment, immediately annihilates  the  bitter taste  left by it,
and MM. Des Vouves, Dorvault, Quevenne  and  Bouchardat5
state, that an  infusion of roasted coffee  masks  the  bitterness so
completely, that children—not the most docile—take  it without
repugnance.  M.  Thelu6 has found, that an infusion of  black tea,
which possesses the same astringent principles as coffee, has the
like effect.  Perhaps the  tannic acid contained in them is the active
agent; inasmuch as Dr. Richard H. Thomas,7 of Baltimore, noticed
that the addition of two grains of the  acid to ten of the sulphate
of quinia in a mixture  deprived it of its bitterness.
   It  is stated,8 that quinia,  given  in infusion of senna, is  more
efficacious as a tonic, notwithstanding the cathartic nature of the
mixture, than almost double the quantity given in pill.
   Sulphate of quinia may be used in the way of enema, and en-
dermically,  when the condition of the stomach  forbids its internal
employment.   As  an  enema,  three  times the ordinary dose, or
more, may be mixed with starch,  and be  thrown  up a short  time
before the paroxysm, or  at the inception of the same.  In this
way it has been found efficacious.9

  1 Medical Examiner, March,  1847, p. 146.             * Dickson, loc. cit.
  3 New Orleans Med.  and Surg. Journal, July, 1846, p. 20.
  4 Lond. Med. Gaz. April 1, 1837.
  ' Annuaire de Therapeutique pour 1848, p. 153.  Paris, 1848.
  5 Bouchardat, op. cit. p. 157.
  1 American Journal of the Medical Sciences, April, 1850, p. 541.
  9 Lond. Lancet, Nov. 4, 1843.
  3 Richter, Op. cit S.  331.  Berlin. Medicin. Zeitung, Jan. 4, 1837. 
628                    QUINIA SULPHAS-
  In administering the sulphate or muriate of quinia endermically,
a space on the  surface of the body is deprived of its cuticle by
means of a blister, and on this denuded portion the agent is applied,
either in the  form of powder or of ointment. To testify in regard
to the efficacy of  this mode  of administering the salts of quinia,
many observers  have come forward,—Lesieur, Lembert, Martin,
Wesche, Lehmann, Reilingh, Stratingh, Lieber, G. Lane Corbin,1
and  others.  From four to eight grains may be placed on the
denuded part once or oftener in the day.   Dr. Lieber, of Berlin,
seems to  have  prescribed  the salt  most frequently in  this way:
he mentions, that of sixty cases, in which he employed it, only
eight or ten were  unsuccessful; and there was reason to believe,
that  in these the internal  administration  of  sulphate  of quinia
would have failed also.   In the case of adults, he applies a blister
in the evening—of the size of a dollar—over the epigastric region;
in the morning,  during the apyrexia, the blister is cut; the cuticle
removed, and five or six grains—in children two  grains—of the
sulphate are sprinkled over the denuded surface.   The whole  is
then  covered with  adhesive plaster,  which must extend to the
breadth of a finger  over  the  edges of  the blistered  part.  The
sprinkling of the sulphate  always  occasions a violent burning sen-
sation,  but if it be applied  in the form  of ointment, this evil  is
avoided, or at least diminished. The  pain, however, speedily dis-
appears.  Some hours after the application, oppression is felt  in
the stomach, with a desire to vomit,  without, however, vomiting
actually supervening; borborygmi, or uneasiness in the bowels,
and frequently fluid dejections, with augmented secretion of saliva,
which,  in some  cases, continues for several days.   In  the course
of from twelve  to twenty-four hours  after  the application, a very
bitter taste is usually perceived over the whole tongue, similar  to
that of quinia;  and if the application has been made sufficiently
long before the anticipated paroxysm,  it may be entirely prevented,
or rendered much milder.  After the effect  has been produced, the
adhesive  plaster may be kept  applied for  some days, and, if the
sore is not healed, it may be dressed with simple applications.   In
only two cases did Dr. Lieber observe any extensive or offensive sup-
puration ; and both cases healed under simple dressings with dry lint.
At times^ the blistered surface is made much more  extensive, and
the quantity  of the sulphate of quinia much larger.  Dr. Wooten,2
for example, does not apply less than  two drams in the  case of an
adult, when  the endermic use of the remedy is required, which,
of course, is not often.  In  a  case related by  Dr. Corbin3  of
intermittent  of eighteen  months' duration, which had  resisted
various measures, a blister was applied to each extremity, and one
over the epigastrium, an hour  before the expected paroxysm; and
  1 American Medical Intelligencer, Aug. 1841, p. 26.
  2 Southern Medical and Surgical Journal, July, 1846,  p. 414.       ' Op. cit. 
QUINIA SULPHAS.
629
 to the exposed cutis, an ointment, composed of five drams of the
 sulphate to four ounces of simple cerate.  The whole of this was
 spread on cloths, and  laid on the  blistered surfaces eight hours
 after the blisters had  been applied;  and  the  dressings were  not
 disturbed  until the parts were healed.   The  cure was complete.
 It is affirmed  by M. Martin Solon,1 that when sulphate of quinia
 has been  applied endermically, in no case could it be detected in
 the urine.
   Rubbing  quinia  or  its  salts on the  gums  has, likewise, been
 occasionally recommended, as well  as frictions with  the alcoholic
 solution, or with an ointment, on these as well as other portions
 of  the  surface of the body—the  thighs, :groins, and  pit of the
 stomach ;2 and it has been advised in cases of  intermittent cepha-
 lalgia, and in iralgia, to  be snuffed up the nostrils.3   M. Ducros4
 makes the strange assertion, that doses of about three quarters of a
 grain, dissolved in sulphuric ether, and applied with friction to the
 lining membrane of the mouth—"par la  methode buccale "—cause
 a stronger and more rapid action than  half a  dram given  by the
 stomach or rectum; and that they are not liable to induce quinin-
 ism.  This rapidity of action he regards as peculiarly important
 in malignant intermittents.   " Sulphate of quinia,  administered
 in pills or  enema, requires five or six hours for its action, [?] but
 when administered  by friction in the  mouth, half an hour before
 the third paroxysm, which is often fatal, reaction has  time to take
 place."
  Dr. Guastamocchia5 has succeeded in arresting intermittents by
 dissolving eight grains of sulphate of quinia in half an  ounce of
 alcohol, and rubbing it, in  two doses, with an interval of a quarter
 of an hour between them, along the spine.   This should be done
 at the beginning of the cold stage.   It very often  prevented a
 recurrence of the paroxysm.
               Mistura   quiniae  sulphatis.
               Mixture of sulphate of quinia.
              R.  Quiniae sulphat. gr. x.
                  Acid, sulph. dil. gtt. viij.
                  Aquse vel
                  Aquae cinnam. f ^iiss.
                  Syrup, fgij.   M.
  Dose.—One-half to be taken  an  hour, and the other half, half
 an hour  before the  expected paroxysm of an intermittent, or the
 whole to be taken in divided doses during the apyrexia.
  1 Cited in Medical Examiner, Nov. 1845, p. 695.
  1 Schuster, cited in American Journal, May, 1832, p. 242; and Antonini, Journa
 des Connaissances, &c., Oct. 1838.
  ' B. St Hilaire, in Gazette Medicale de Paris, 26 Mars, 1836,
  * Comptes Rendus, cited in Western Lancet, July, 1846, p. 138; and Bouchardat,
 Annuaire de Therapeutique pour 1847, p. 179, Paris, 1847.
  4II Filiatre  Sebezio, Agosto, 1841, cited in  British and Foreign Medical Review,
Jan. 1843, p. 236. 
630
QUINIA SULPHAS.
              Syrupus  quinise  sulphatis.
                Syrup of sulphate of quinia.
             R.  Quiniae sulphat. gr. xvj.
                 Syrup, f :| viij.  M.
  Dose.—A spoonful.                            Magendie.

        Syrupus quiniae  sulphatis  compositus.
          Compound syrup of sulphate of quinia.
             R.  Quiniae sulphat. gr. xvj.
                 Acid, sulphur,  dilut. gtt. v.
                 Syrup, limonis f^viij.  M.
  Dose.—Same  as the last.

                  Mel  quinia-  sulphatis.
                Honey of sulphate of quinia.
                       (Miel de quinine.)
             R. Quiniae sulphat. gr. viij. (50 cent.)
                 Acid, sulphur,  aromat. gj.
                 Mel purificat. ^iss.   M.
  Dose.—A tea-spoonful  in the intermittents of children.  It is
generally taken  without repugnance.                Petzold.1

              Tinetnra quinine  sulphatis,
               Tincture of sulphate of quinia.
             R. Quiniae sulph. gr. vj.
        Solve in
                 Alcohol. 34° (.847) f | j.
  Dose.—f 3j. or f 3ij. immediately before an attack of intermit-
tent.                                            Magendie.
           Guttse  quinine sulphatis et  opii.
          Drops of sulphate of quinia and opium.
             R. Quiniae sulphat. (seu acetat.) gr. xij.
        Solve in
                 Alcohol, (seu sp. aether, sulph. comp.) f §ss.
        Adde
                 Tinct. opii  gtt. xij.
  Dose.—Morning and evening, twenty  drops, in the summer
fevers of Europe.                                Schmidt.
               Pulveres  quiniae  sulphatis.
               Powders of sulphate of quinia.
             R. Quiniae sulphat. gr. iij. ad xij.
                 Sacchar. tjij.
        Misce et fiat pulvis in partes vj. aequales dividendus.
  Dose.—A  powder,  morning and evening, in  nervous  debility
and in intermittents.

  Radius2 advises, that the powders should be taken in coffee, by
which means the bitter taste is almost wholly counteracted.

       1  Annuaire de Therapeutique, &c,pour 1847, p. 178.  Paris, 1847.
       a Auserlesene Heilformeln, u. s. w. S. 186.  Leip. 1836. 
                      QUINL3E SULPHAS.                   631

  Pulveres quinia} sulphatis  et  soda?-  carbonatis.

   Powders of sulphate of quinia and carbonate of soda.
             R.  Quiniae sulphat. gr. j.—ij.
                 Sodae carbonat. gr. iv.—v.
                 Sacch. 9j.
       Misce et fiat pulvis.
  Dose.—A powder, morning and evening, in scrofulous ophthal-
mia.                                         Von Ammon.

Pulveres quiniae  sulphatis et antimonii et potassae tartratis.

Powders of sulphate  of quinia and tartrate of antimony and
                          potassa.
             R.  Quiniae sulphat. gr. x.
                 Antim. et potass, tartrat. gr. iij.
                 Sacchar. gr. xxiij.
       Misce exacte, et divide in partes sex aequales.
  Dose.—One,  every two hours, during the  apyrexia, in cases of
obstinate intermittents.                              Gola.1

          Pulveres  quiniae  snlphatis  et  opii.

        Powders of sulphate of quinia and opium.
             R.  Opii  puri gr, j.
                 Quiniae sulph. gr. iij.
                 Satfchar.
                 Acac. aa. gr. vj.  M. et fiat pulvis.
  To be taken a short time before the paroxysm  in  malignant
intermittents.                                   JYeumann.

 Pulveres  quiniae  sulphatis  et  morphia?  sulphatis.

  Powders of sulphate of quinia and sulphate of morphia.
             R.  Quiniae sulph. gr. ij. ad. vj.
                 Morphiae sulph. gr. ss. ad. j.
       Divide in dos. iv.
                                                Magendie.

        Pulveres  quinia?  sulphatis  compositi.

          Compound powders of sulphate  of quinia.
             R.  Quiniae sulph. gr. j.
                 Cinchon. pulv. gr. xv.
                 Rhei pulv.
                 Oleosacchar. menth. aa. gr. v.
       Misce et fiat  pulvis.
  Eight of these to  be given in cases of intermittent fever.
                                                JYeumann.
             R.  Quiniae sulph. gr. \.
                 Chocolat. gr. vij.
                 Sacchar. lact. gr. ij.
       Misce.  Fiat pulvis tertiis omnibus horis sumendus.
  In debility of the stomach.                        Kopp.
               1 Annali Univers. di Medicina, torn.  35. 
632                    'QTJINL& SULPHAS.

                Pilula?  quinia?  sulphath.
                 Pills of sulphate of quinia.
             R. Quiniae sulphat. gr. v.—xij.
                 Ext. glycyrrhiz. gi.
        Misce et fiant pilulas xij.
  To be given, according to prescription, in nervous diseases.
                                                    Radius.
  A form for pills of sulphate op  quinia is admitted into  the
Pharmacopoeia of the United States:
             R. Quiniae sulphat. §j.
                 Acaciae in pulv. gij.
                 Syrup, q. s.
  Mix  together the sulphate of quinia and  the gum;  then  beat
them with the  syrup  so  as to a form a mass, to be divided into
four hundred and eighty pills.
  Each pill contains a grain  of the sulphate.

          Pilula? quinia?  sulphatis  composita?.
            Compound pills of sulphate of quinia.
             R. Quiniae sulphat. gr. x.—Xv.
                 Acid, phosphoric, sice. ^ij.
                 Althaeae  (vel rhei,) pulv. £)iv.
                 Ext. centaur, minor, vel gentian, ^ij.
        Misce et fiant pilulae lx.

  Dose.—Three f o six pills,  two or three times  a day, in cases of
nervous debility with disposition to hemorrhage,—as after abor-
tion.                                               Radius.
             R. Quiniae sulphat. gr. xv.
                 Cinnam. pulv. gss.
                 Extract, cinchonae q. s. ut fiant pilulae xxx.

  Dose.—Four pills every two to four hours.        Henschel.

              R. Quiniae sulphat. gr. xij.
                 Extract, trifol. J}j.
                 Calam. pulv. q. s.
        Fiant pilulae xij.
  Dose.—One or two every  two hours.          Hildenbrand.

      Pulvis  sternutatorius  ex  quinia?  sulphate,
         Sternutatory powder of sulphate of quinia.
              R.  Quiniae sulphat. gr. xv.
                 Tabaci sternutator. com. %].  M.

  To be snuffed up the nostrils in the course of five or six days,
in cases of intermittent headach.
              R.  Quiniae sulphat. gr. vj.
                 Sacchar. pulv. gj.
                 Irid. rad. pulv. giss.   M.

  Small pinches of this to be snuffed  up  the nose at night.
                                             B. St. Hilaire. 
QUINIJE VALERIANAS.
633
              Unguentum  quinia? sulphatis.
               Ointment of sulphate of quinia.
              R. Quinias sulphat. §j.
                 Alcohol (38° ad 40°) q. s. (|ij.)
                 Acid, sulphuric, q. s. (gtt. Ixxx.)
                 Adipis giv.  M.
  Half an ounce at a time to be rubbed on  the  groins in malig-
nant intermittents.   It may  be likewise placed in the axillae.
                                                  Antonini.
  An ointment composed of gj. of sulphate of quinia and |ij. of
lard has been rubbed with success into the axilla in cases of ague
in children.1
                       Vinum  quinia?.
                       Wine of quinia.
                 R.  Quiniae sulphat. gr. xij.
                     Vin. Mader. Oij.
  Wine of quinia may, also, be made extemporaneously, by add-
ing  two ounces of the tincture to a  pint bottle of wine.
              CLVII.  QUINLE  VALERIANAS.
    Svnonymes.  Chininum Valerianicum, Valerianate of Quinia.
    French.  Valerianate de Quinine.
    German.  Valeriansaures  Chinin.
  This salt was first formed of late years by Prince Louis Lucien
Bonaparte.
                   METHOD OF PREPARING.
  A cold solution of valerianic acid in distilled water is saturated
by a concentrated solution of quinia in alcohol at 36° (s.g. .847;)
and the valerianate of quinia thus formed is subjected to sponta-
neous evaporation.2   Or, it  may be made by adding freshly pre-
cipitated quinia to a hot  solution  of valerianic acid, and then
crystallizing.   The  crystals are  in thin, colourless  rhomboidal
plates, of a mother of pearl  lustre,  or in needles.  It is not very
soluble in water, but more so in alcohol and ether.  It has a smell
of valerianic acid, and a very bitter  taste.3
  Another method of preparing it is the following.  Into an alco-
holic and concentrated solution of quinia a slight excess of vale-
rianic acid is poured ; the whole is then  suspended in twice its
bulk of distilled water; and the  mixture is carefully stirred, and
subjected to evaporation in a stove at a temperature not exceeding
50°.  When the evaporation of the  alcohol has taken place, the
  1 Lond. Med. Gaz., April 3,1840.
  3 Bouchardat, Nouveau Formulaire Magistral, p. 263. Paris, 1845.
  3 Ballard and Garrod, Elements of Materia Medica and Therapeutics, p. 409.  Lond.
1845.  See, also, Galvani, cited in Med. Examiner, April, 1846, p. 241). 
634
QUINIA VALERIANAS.
valerianate presents itself in the form of beautiful crystals, some-
times isolated;  at others grouped together.   It may also be pre-
pared by double decomposition,  by mixing sulphate of quinia
with chloride of calcium, or chloride of barium,—both being
dissolved in weak alcohol.1   The Dublin College prepare it by the
double decomposition of muriate of quinia and valerianate of
soda.2

                  EFFECTS ON THE ECONOMY.
   Prince L. L. Bonaparte  administered the valerianate of quinia
to  two  inhabitants of the  Maremma district, in Italy,  and found
that it did not produce the same neuropathic phenomena  that occa-
sionally  follow  the use of sulphate of quinia.   Since  then, the
salt has  been employed by different observers.  M. Devay,3  of
Lyons, infers, as the result of his  observations, that  it is a more
powerful antiperiodic than the sulphate, even when given in smaller
doses.   M. Castiglioni* gave it in eighteen cases of intermittent
or  remittent fever: in fifteen it effected a  cure, and in three it
produced only temporary relief.   In two of the last cases the sul-
phate of quinia had been  employed without success;  and in one
the most vaunted remedies  had  proved useless.   The  minimum
dose for curing  the disease  was six grains; the  maximum thirty-
five ; the medium quantity about ten grains and a half.  The mini-
mum time  required for the  cure  was two  days;  the maximum
eight days, and the mean three days and a half.  The high price,
however, of the salt, will  necessarily prevent it from being much
used.
                  MODE OF ADMINISTRATION.
   Valerianate of quinia being easily decomposed, it is best to ex-
hibit it in the most simple form.   M. Devay dissolves  30 centi-
grammes, (about gr. 4|,) in 632 grammes, (about f ^iij,) of gum
water; and directs it to be taken at three times, in cases of rebel-
lious fevers.   It may also  be given in pills, and  as it  dissolves
readily in oil, one gramme (gr. 15.44,)  may be dissolved in  60
grammes (about  gij,) of olive oil, to form a liniment, which may
be rubbed  over  the  region of the spleen.   When  administered
in  the form of enema, 5 decigrammes (gr. 5.7,) may be dissolved
in  200 grammes  (f gviss,) of water.

   1 Gazette Medicale de Paris, cited in Provincial Med. and Surg. Journ. Dec. 24,1844;
 and Bouchardat, Annuaire de Therapeutique pour 1845, p. 136.
   *The Pharmacopoeia of the King and Queen's College of Physicians in Ireland, lfc.r.;'
p. 167. Dublin, 1850.
   * Journal de Pharmacie, cited in Pharmaceutical Journal, March, 1845.
   ' Bouchardat, op. cit. p. 138. 
QUINIiE ET CINCHONIJE TANNAS.             635
      CLVIII. QUININE ET CINCHO'NLE  TANNAS.
.Synonymes. Chininum Tannicum, Tannas Chinii seu Cinchonicus seu
  Quinicus, Tannate of Quinia and Cinchonia.
German. Ger b s toffsaure s Chinin,  Gerbesaures  oder  Tan-
  ninsaures Chinin.

  Dr. Otto1 has drawn the attention of physicians to the efficacy
of the tannates of quinia and cinchona as  recommended by Dr.
Ronander, the Secretary  to  the  Swedish  Medical  Association.
He regards them as the most active ingredients in the cinchonas;
and  affirms that he  has  cured by their agency several cases of
obstinate intermittent, which had resisted the use of sulphate of
quinia  and  other  powerful remedies.   He found them likewise
useful in typhus, and in states of general weakness and tendency
toputrescency, where sulphate of quinia seemed  to be ineffectual.
Dr. Ronander's  experiments establish the belief, that the tannic
acid  of the cinchonas may be instrumental in developing their full
febrifuge  powers.2  Tannate of quinia has  been found successful
in typic or intermittent neuralgia, where sulphate of quinia had
failed.3   M. Oesterlen,4 however, considers it a superfluous prepa-
ration.  It is  a cheaper remedy than the sulphate.
             OTHER PREPARATIONS OF QUINIA.
  On separating quinia from cinchona by  means of acids, a resin-
ous constituent of the  bark  remains  behind, which affords no
more quinia, but yet possesses considerable anti-periodic power, and.
on that  account  has been  much  used  by the Dutch  physicians.
Two  grains of this  residuum are said to act as well as one grain
of quinia.  Truessink adduces a series of observations of different
physicians, all of which  confirm this, and he cites the experience
of American physicians with  the  residuum.  According  to Dr.
Chapman,5 a grain of this may be  given  every two hours during
the apyrexia, in the form of pill.   Strathing ascribes its efficacy
to the quinia still contained in it. In Italy, several physicians
have  found the mother  waters or lees after the  preparations of
quinia, when boiled to the consistence of syrup, very efficacious
in intermittents;  and Roux recommends  it  highly  in practice
amongst the  poor.   Buchner advises the lees, evaporated to dry-
ness—which he terms Chininum Resino-sulphuricum—to be
introduced as a cheap, and, at  the  same time, efficacious prepara-

  ' Dublin Journal of Medical Science, Sept, 1836.
  • Revue Medicale, Mai, 1837, cited in Amer. Med. Intelligencer, Oct. 16,1837, p. 270.
  * Hauff, cited  in Northern Journal of Medicine, Dec. 1835, from Oesterlen's Jahr-
buch, and in Braithwaite's Retrospect, Jan.—June, 1846.
  4 Handbuch der Heilmittellehre, S. 442.  Tubing. 1845.
  5 Elements of Therapeutics, 6th edit. ii. 292. Philad. 1831. 
  636              QUINIA ET CINCHONIJE TANNAS.

  tion  of cinchona, which may be used  in charitable institutions,
  rubbed up with sugar as a powder, or dissolved in alcohol, in place
  of sulphate of quinia.  These experiments  and propositions, as
  Riecke1 observes, merit more consideration  than they have  yet
  received;  for quinia, notwithstanding its price  is much  less than
  formerly, is yet so dear, that its administration  does not adapt it
  well  for eleemosynary institutions, whilst the residue, which pos-
  sesses valuable properties, is generally thrown  away, and in this
  manner the price  of quinia is enhanced.
    Serturner2 thinks he  discovered, besides quinia and cinchona,
  other alkaloids of cinchona, especially one  wThich he  called Chi-
  nioidine,  Chinoidine, or Quinoidine,  and  which excels, he con-
  siders, in medicinal properties, all  the other preparations of cin-
  chona.   Henry and Delondre—the French chemists—affirm, that
  chinioidine is nothing  more than quinia,  cinchonia, and a  peculiar
  yellow resinous matter, intimately adherent to the alkaloids, and
  rendering  them uncrystallizable.   It appears, also, from the ex-
  periments of different  physicians with the presumed new alkaloid,
  that it  essentially resembles the preparations already mentioned
  in its medical properties.3   A resina chinas prasparata  is re-
  commended by Plagge, which is prepared from the mother waters
 or lees of quinia, by means of precipitation by a carbonated alkali,
 extraction  by alcohol,  and removal of the alcoholic liquor by dis-
 tillation.  It is said, likewise, to possess markedly curative powers
 in intermittents.
    The Pharmacopoeia  of the  United States of 1830 gave a formula
 under the title Quinle Sulphas Impurus, which consisted in eva-
 porating the liquor poured off the crystals of sulphate of quinia to
 the consistence of  a pilular mass.   This has been  known for years
 in Philadelphia under the name Extract  of Quinia, and its active
 ingredients appear to be sulphate of quinia  and sulphate of cinchonia,
 which are prevented from crystallizing by a peculiar resinoid sub-
 stance united with them.  Dr. Wood4  asserts, that he has seldom
 found intermittents resist twenty-four grains of the impure sulphate,
 given between the  paroxysms; although a larger quantity  may be
 employed with safety and greater certainty of success;  and more
 recently,  Bertini' has considered these residual extracts after the
 preparation of sulphate  of quinia to be highly efficacious in masked
 intermittents, as well  as in those cases of relapse in which the salts
 of quinia, from  long use, have become powerless.  He remarked,
 moreover, that intermittents  cured  by this agent were less liable
 to relapse.  These preparations, however, become important from
  1 Die neuern Arzneimittel, u. s. w. S. 130.
  a Hufeland's Journal, Jan ,  1829.
  * Radius, Auserlesene  Heilformeln, S. 191. Leipz. 1836,  and Lincke, Vollstandiges
Recept-Taschenbuch, i. 455, Leipz. 1840.
  ' Wood and Bache's Dispensatory, 4th edit. p. 1032.  Philad., 1831).
  1 Bouchardat, Annuaire de Therapeutique pour 1847, p. 184.  Paris, 1847. 
SALICINA.
637
recent investigations of Liebig, which show that their active princi-
ple is  really quinia, amorphous quinia;—that  the  substance in
fact described  by Sertiirner, Henry, and Delondre is simply the
alkaloid quinia in an amorphous or uncrystalline state, and bearing
the same relation to quinia, that uncrystallizable sugar does to cane
sugar.  "The testimony of Dr. Sertiirner, and of Henry and De-
londre, on the  therapeutic effects of their alkaloid," says a recent
writer1—"becomes  therefore a matter of some interest,  as Liebig
tells us a large quantity has probably accumulated,  and, if so, it
may be obtained at  a far cheaper  rate than the price sulphate of
quinia now bears in the market.2  This amorphous quinia is adver-
tised in the English journals, as a most efficacious and cheap anti-
periodic.
                      CLIX.  SALICINA.
Synonymes.  Salicinum, Salicinium, Salicine, Salicin.
French.   Salicine.
German.  Salicin,  Weidenstoff, Weidenbitter.
   The tonic virtues of the bark of the  wTillow have been known
for ages, and it has been regarded as one of the  best substitutes
for cinchona in eleemosynary institutions.  It was not much valued,
however, in more modern  times, until the discovery of an  active
principle in it again attracted  to  it the attention of practitioners.
This discovery, if not made, was perfected by Leroux,3 an apothe-
cary at Vitry, in France, who  first obtained  salicin in a pure state
in 1828, after it had  been procured in an impure form  by some
German and Italian chemists.1   It is prepared, by preference, from
Salix helix, but  is found likewise in the barks of other willows
—Salix alba, S. vitellina, S. purpurea, S. Lambertiana, S. pentandra,
S. polyandra, S. fragilis, S. viminalis, &c, and in  the leaves and
barks of several varieties of poplar, Populus tremula, P. tremuloi-
des,5 P. alba, and P. Graca.5
                   METHOD OF  PREPARING.
   According to the method of Leroux,  three pounds of dried and
powdered willow bark (salix helix) are boiled for three-quarters
of an hour in fifteen pounds of water, to which four ounces of carbo-
nate of potassa have been added.  To the cold decoction are add-
ed two  pounds  of  liquid  subacetate of lead.    The mixture  is
  1 London Lancet, May 28, 1846.
  2 London Medical Gazette, June 26, 1846, p. 1117, and Bouchardat, op. cit. pour
1848, p. 159.
  * Annales de Chimie, &c. xliii., and Journal de Chimie  Medicale, torn. vi.
  * Dictionnaire de Mat. Med. par Merat & De Lens, art. Salicine.
  ' See L. Turnbull, on Populus Tremuloides, White Poplar or  American Aspen, in
American Journal of Pharmacy, Jan. 1843, p. 275.
  • Riecke, Die neuern Arzneimittel, S. 365, und 2te Auflage, 572.  Stuttgart, 1840.
       41 
638
SALICINA.
 permitted to settle, filtered, treated with sulphuric acid, and the
 remaining lead is precipitated by a stream of sulphuretted hydro-
 gen gas.  The excess of acid is neutralized by carbonate of lime :
 the mixture is again filtered, and the fluid inspissated and neutral-
 ized by dilute sulphuric acid.   It is deprived of its  colour by
 ivory black, and  filtered whilst boiling.   It  is then  twice crys-
 tallized—if still coloured after the first  crystallization—and dried
 in the dark.   This process yields about an ounce of salicin.
    Braconnotl obtains it by adding subacetate of lead to a decoction
 of the bark, precipitating the excess of lead by sulphuric acid, eva-
 porating the colourless liquid that remains, adding near the  end of
 the process a little animal charcoal  previously washed, and filtering
 the liquor while hot.   Salicin is deposited, on  cooling, in a crys-
 talline form.3
    The following plan was advised by Messrs. Fisher and Tyson,
 of Baltimore.3  Willow bark is boiled with caustic lime in water;
 the decoction filtered, and sulphate of zinc added, so  long as it
 produces a precipitate.   The liquid, having been again filtered, is
 evaporated  to the  consistence of  an  extract, and  the residue is
 treated with alcohol.  The tincture, thus obtained, if carefully eva-
 porated, yields crystals of salicin, which may be purified  by  wash-
 ing with a saturated solution of the same principle  in cold water.
    Salicin forms very fine silky masses  of white  crystals,  which
 have the appearance of mother-of-pearl.   It bears a distant resem-
 blance to sulphate of quinia, yet it is not so loose and delicate.  It
 is permanent in the air, inodorous, and has a strong, enduring bitter
 taste, with a striking accompanying balsamic flavour, like the bark
 of the willow.*  One hundred parts of cold water dissolve six parts
 of salicin.  In warm water, it is more soluble, and also in alcohol;
 but it is not soluble  either in ether or the essential oils.   It excites
 no alkaline reaction.  By admixture with sulphuric acid it acquires
 a  beautiful red colour.5
                  EFFECTS ON THE ECONOMY.
   The well known  effects of the bark  of the  willows gave occa-
 sion to the immediate  employment of salicin in cases of intermit-
 tent fever.   Miquel6 appears to have been one of the first—if not
 the first—who instituted experiments with it; and he satisfied him-
 self, that it merits a distinguished place amongst our antiperiodic
 agents, although it requires larger doses than quinia.  Soon  after-
 wards  it was  given by other physicians—by Husson and Bally,
  1 Journal de Chimie Medicale, Janvier, 1831.
  " For Peschier's method, see Annales  de Chimie, vol. xliv., and Amer. Journ. Med.
 Sciences, May, 1831, p. 256.
  * Journal of the Philadelphia College of Pharmacy, iii. 214.
  * Pelouze and Jules Gay Lussac, in Annates de Chimie, vol. xliv.
  * For an elaborate account of the chemical relations of salicin, see M. R. Piria, Annales
de Chimie et de Physique, Novembre, 1838.
 c Gazette  Medicale do Paris, Janv. 1830; see,"also; Annales de Chimie, xliii. and xliv. 
SALICINA,
639
Girardin, Magendie, Andral, Blaincourt, Graff, Linz, Stegmayer,
Amelung, Stam, Van Sneek, Blom, Grafe, Von dem Busch, Kromb-
holz, Pleischl, and  others.  The sentiments respecting its value
are discrepant;  some classing it far beneath quinia, whilst others
assign it even a  higher position.  Its general properties are  cer-
tainly analogous to those of quinia;  but it in no respect merits a
preference,1 not  even in the article of price: for, although an equal
weight of salicin may cost less, it requires so much more to  pro-
duce the same effect, that the cost is  perhaps equal.   Still, as M.
Pleischl,2 of Prague, has suggested, even if salicin were much the
dearer of the two, it might be better to use it, because it is of home
manufacture, and can  be obtained in war as well as in peace.
   From all  the testimony brought forward, M. Richard3 is of
opinion, that  we may conclude; first, that salicin possesses anti-
periodic virtues; secondly, that  its efficacy is in  an inverse ratio
with the duration  of the  fever; thirdly, that  when its febrifuge
virtues are not realized  after the fourth dose, it  is well to abandon
its use, as it  will probably prove inefficacious;  fourthly, that in
intermittents  of the tertian type it cures nine cases in ten;  and in
those of the  quotidian type five and  a  half times in ten; fifthly,
that the quantity necessary for the cure of an intermittent is  two
or three  times greater than that of sulphate of quinia; sixthly,
that it ought  not to be prescribed in  pernicious intermittents, the
second or third paroxysm of which may be fatal;  seventhly, that
it has never been rejected by the stomach; and has never increased
diarrhcea, nor "exasperated the sensibility of the stomach,"  and
hence it should be employed in preference to the sulphate of quinia
in intermittents complicated with gastric or intestinal irritation;
eighthly and  lastly, that it has appeared to diminish, in a marked
manner, the circulation during the apyrexia, even when it did not
prevent the paroxysm; and during convalescence, when the parox-
ysms had ceased, the pulse has frequently fallen thirty beats  in a
minute.
  Comparative trials with salicin and sulphate of quinia have been
directed by the able head of the  medical department of the army,
Dr. Lawson,so that we may be enabled to learn their relative va-
lue as antiperiodics.  Such an examination was made by Dr. E. D.
Fenner,4 of New Orleans, who arrived at the conclusion that "the
average amount of quinia required to  cure 20 cases of intermittent
fever, and costing twenty-five cents, is fully three  times  as  effica-
cious as the average amount of salicin required in a like number
of cases, and costing  seventy-five  cents."   Dr. Fenner's  report
  1 Richelot, in Archives Generates de Medecine,  Sepr. 1833; see, also, Dierbach, in
Heidelb. Klinisch. Annal. B. x. H. 1, S. 62.  Heidelb. 1834.
  * Medicinisch. Jahrbiicher des k. k. o. Staat. 1835; cited in Br. and For. Med.  Rev.
for April, 1836, p. 576.
  * Elements d'Histoire Naturelle Medicale, 4eme edit. i. 232.  Paris, 1849.
  4 New Orleans Med, and Surg. Journ. Nov.  1845. 
640
SALICINA.
bears the stamp of accurate and impartial observation and induc-
tion ; and it is certainly far from according with the statement of
Bertinix and others, who consider that salicin is wholly inert in the
treatment of periodical fevers.

                  MODE  OF ADMINISTRATION.
   The ordinary dose of salicin, in a case of intermittent, is about
four or six  grains every three  hours during the period of inter-
mission : in  the febres larvatae or masked fevers, smaller doses
may be given; but in the  very violent  fevers at Calvi, in the Island
of Corsica, Levy  found it  often necessary to give  from forty to
fifty grains in  twenty-four  hours.  Of thirty cases of quotidian
and tertian intermittents, twenty were cured by the use of salicin;
but ten required afterwards the sulphate of quinia.  He considers
it preferable to sulphate of quinia in intermittents that are accom-
panied by irritation of the primse viae: he never saw it rejected or
produce vomiting; and in cases of manifest irritation of the diges-
tive tube, it was borne perfectly well.2
   Salicin is generally given in intermittents in the form of powder.
In other affections, to obtain its antiperiodic or  tonic agency, one
or two grains may be given four or five times a day—gradually
augmenting the dose.   In  cases of asthenia of the digestive organs,
Von dem Busch prescribes  a powder of salicin and sugar with the
addition of cinnamon; and lozenges of salicin, sugar, gum Arabic, and
oil of peppermint.  In cases of copious secretion from the mucous
membranes, especially in chronic  bronchitis and leucorrhoea,^ he
directs salicin to be combined with a decoction of polygala amara,
or of lichen islandicus.   In intermittents, Stegmayer advises it to
be associated with small doses of tartrate of antimony and potassa.
                       Pilulae   salicins,
                       Pills of salicin.
            R.  Salicin.
                Ext. gentian, aa. gr. xxiv.
                Glycyrrh. pulv. q. v,
      ut fiant pilulae xij.
                                                   Vavasseur.
                     Pulveres salicine.
                      Powders of salicin.
            R.  Salicin. gr.  xij.
                Sacch. Qij.   Misce
      et fiat pulvis in partes iv. eequales dividendus.
   Dose.—One, three times a day.                 Krombholz.

  1 Bouchardat, Annuaire de Therapeutique pour 1847, p. 184.   Paris, 1847.
  2 Archives Medicales de Strasbourg, and Gazette Medicale de Paris, 25 Fev., 1837. 
                      SAPO MOLLIS.                     641

           Pulveres salicinse  compositi,
              Compound powders of salicin.
         R.  Salicin. gr. xv.
             Antim. et potass, tartrat. gr. j.
             Sacchar. Q iiss. Misce
    et fiat pulvis in partes x. aequales dividendus.
Dose.—A powder, every two hours.           Stegmayer.
                   Mistura  salicinse,
                   Mixture of salicin.
         R.  Polygal. amar. rad. 3yj.
       Coque cum aquae f ^xij. ad remanent, f ^viij.
       Colaturae adde
             Salicin. gr. viij. ad. x.   M.
Dose.  One or two spoonfuls every two hours.
                                         Von dem Busch*
                    CLX. SAPO MOLLIS.

Svnonymes. Sapo Viridis seu Niger seu Kalicus seu Domesticus Mollis
  seu ex Olivse Oleo et Potassa Confectus, Kali elainicum.
French.  Savon Noir, Savon Mou, Savon h base de Potasse.
German.  Schmierse ife,  Grune  Schmier seife,  Kaufliche
  Kaliseife,Schwarze Seife, Oelsaures Kali.

  Under this name a soap is used, which is formed by a union of
oil with potassa.   It is the "sapo ex oleo et potassd confectus" of
the London Pharmacopoeia, has of late years been brought forward
in Germany as a  remedial  agent in cases  of itch,1 and been em-
ployed in many hospitals.

                 MODE OF ADMINISTRATION.
  The treatment  of itch by soft soap is  directed by Pfeuffer to be
carried into effect in the following manner.  Attention is  paid to
the general health of the patient for a day before the soap is ap-
plied.   The whole body, with the exception of the head, face, and
genital  organs, is then besmeared with it, and  the application is
repeated,  morning and  evening, for six days.   At first, two rub-
bings, of from four to six ounces, are used:  at the third and fourth,
from two to three  ounces; and from the fifth to the seventh inclusive,
from half an ounce to an ounce; but after this, the soap is applied
only on those parts which are affected with the eruption or itching.
On the eighth day the patient takes a bath of tepid soap and water;
and the body and bed linen, which  have not been shifted during
the cure,  may  now  be changed for cleaner.   In dry and warm
seasons, the patient is able to leave the infirmary on the tenth day,

  1 Pfeuffer, Beobachtungen iiber die Kratze und ihre Behandlung durch die Schmier-
oder grime Seife.  Bamberg, 1833. 
642
SAPO MOLLIS.
cured; but in moist and cold, not until the twelfth or fourteenth.
The cure of the eruption is generally effected in seven days,—that
is by fourteen rubbings.   During the period of treatment, he must
remain in bed,  avoid exposure to draughts of air, and reside  in a
chamber, whose temperature is from 73° to 77° of Fahrenheit.
On account of the strong  smell of soap, not more  than ten patients
ought to be allowed to occupy the same room.   Full diet may be
allowed.
  From six to  eight hours after the first or second rubbing, a sense
of tension and pricking is  felt in the skin, which, at times, gradually
augments until  it amounts to a feeling of burning heat.  About the
fifth or sixth rubbing, the skin appears  of a scarlet hue, without
the temperature being materially elevated.   In several cases, irri-
tative fever ensues, which disappears in  the course of twenty-four
hours, with augmented secretion  of urine.   Miliary vesicles form
in groups; sweating takes place freely; the sleep, which may have
been disturbed  for a night or two, recurs; the skin desquamates,
and the patient does not find his strength in the least exhausted.
Should  the inflammation of the skin occur earlier than the sixth
rubbing, the friction must be pretermitted.  Pfeuffer,  however,
never observed this to be  the case.
  In scrofulous syphilitic dyscrasies,  the  friction may have to
be repeated once more, and  the patient have to remain from two
to four  weeks in the institution.   It  very generally happens that
this plan excites inflammation of the skin and desquamation of the
cuticle: when this is not the  case, no  change  whatever is produced
in the eruption.
   In order to mitigate the distressing feeling of burning produced
by  the rubbing, one part  of flowers  of  sulphur may be  added to
two parts of the soft soap.
   In cases, in which the disease has existed for years, with  greater
or less intervals, and in  those who were strumous in their youth,
or were at a subsequent period affected with syphilis;—in all cases,
indeed, in which the cutaneous affection has become, as it were,
habitual, Pfeuffer  directs, that a cathartic should be premised, and
that in the course of the cure, a quart of the decoction of the woods
should  be  taken.   This  mode of treatment, according to him, is
contraindicated by febrile conditions, especially of the synochal
kind; by acute cutaneous affections; pulmonary  and abdominal
catarrhs; pulmonary and abdominal phthisis;  chronic  headach;
and hereditary or acquired tendency to  epilepsy.  In such  cases
he prefers the internal and external use  of sulphur: and, after the
cure, the establishment of issues.  The great recommendation of
this plan in hospitals and infirmaries, is  said to  be its cheapness,
although it strikes us, that there cannot be any marked difference
in this respect between it  and the treatment  by sulphur, which is 
SODA CHLORINATA.
643
greatly used, on this very ground, in many of the eleemosynary
establishments of Germany at this time.1
  The efficacy of Pfeuffer's plan of treatment has been confirmed
by numerous observers,—by Graff, Bermann, and  Cramer, who is
said to have first recommended soap in scabies;  and by Sicherer,
Seyffer, Cless, and others, all of whom agree as to its excellence:
they regard it as one  of the best methods of treatment in use.  Soft
soap forms an ingredient in many of the  officinal and other itch
ointments.2
                CLXI.  SODA CHLORINATA.

Synonymes. Sodae Chloridum seu Chloruretum  seu Hypochloris seu
  Oxymurias, Chloruretum  Oxidi Sodii, Natrum Chloratum sen Chlo-
  ricum seu Oxymuriaticum, Chlorinated Soda, Chloride, Hypochlorite,
  Chloruret, Chlorite or Oxymuriate of Soda.
French. Chlorure de Soude, Chlorure d'Oxide de Sodium.
German.  Chlornatron, Chlorsaures Natrum, Chlornatium,
  Oxydirt oder Hyperoxygenirt Salzsaures Natrum.
  This preparation resembles in almost all  respects chlorinated
lime.   Both it and chlorinated potassa were associated by Berthol-
let under the common name Eau de Javelle or ' bleaching liquor;5
and it has of late generally received the name of Liqueur de La-
barraque or Labarraque's Soda Disinfecting Liquid.

                  METHOD OF PREPARING.
  Labarraque 3 recommended it  to be prepared directly by passing
a current of chlorine gas into a solution of carbonate of soda.  The
following is  the formula in the last London Pharmacopoeia for the
Liquor  Sodae  ChlorinataB,  Liquor Sodae  Chloridi seu   Sodae
Oxymuriaticae  seu Chloreti seu  Chlorureti  JVatri seu  Soda,
JYatrum Chloratum Liquidum, Liquor seu Aqua JVatri Oxymu-
riatici seu JVatri Chlorati, Hypochloris Sodicus Aqud Solutus;
German, Oxyd ir t salzsaures Natronwasser,  Chlor-
sodafliissigkeit  or  Labarraque's  Disinfecting  Liquid.
" Take of Carbonate of soda, a pound; Distilled water, forty-
eight  fluidounces;  Chloride of sodium, four ounces; Binoxide of
manganese,  three ounces; Sulphuric acid, four ounces. Dissolve
the carbonate of soda in two pints (imperial measure) of the water;
then put the chloride of sodium and binoxide of manganese, rubbed
to powder, into a retort, and add to them the sulphuric acid, pre-
viously mixed with three fluidounces of water, and cooled.   Heat
and transmit the chlorine first through  five fluidounces of water,

  * Vezin, Ueber die Kr'atze und ihre Behandlung nach der Englischen Methode. Os-
nabrtlck, 1836.  See, also, Amer. Med. Intelligencer, Aug. 15, 1839, p. 158.
  3 Riecke, Die neuern Arzneimittel, u. s. vv. 2te Auflage, S. 584.  Stuttgart, 1840.
  * Gazette de Sante, 25 Avril, 1826, 
644
SODA CHLORINATA.
and afterwards into the solution of carbonate of soda above  di-
rected."
  The following form is given in the last edition of the Pharma-
copoeia of the United States (1842:)—" Take of Chlorinated lime,
aj.; Carbonate of soda, ffiij.;  Water, a gallon and a half.  Dis-
solve the carbonate of soda in  three pints of the water, with  the
aid of heat.  To the remainder of the water add, by small portions
at a time, the chlorinated lime, previously well triturated, stirring
the mixture after each addition.  Set  the  mixture  by for several
hours, that the dregs may subside'/then decant the clear liquid,
and mix it with the solution of carbonate of soda.   Lastly, decant
the clear liquor from  the precipitated  carbonate of lime, pass it
through a linen cloth, and keep it in bottles secluded from the light."
   When the solution  of chlorinated soda is properly prepared, it
is devoid of  colour;  has a sharp, saline, and astringent taste,  and
an  odour of  chlorine.   By careful  evaporation, it yields crystals,
which produce the original liquid when re-dissolved.  "When  the
solution is exposed to the air, and allowed to evaporate spontane-
ously, it gives out chlorine, and yields crystals of carbonate of soda.1

                 EFFECTS ON THE ECONOMY.
   Iii its general remedial agency, chlorinated soda resembles chlo-
rinated lime, and has  been  administered both internally and exter-
nally in the same cases;  It is preferred for internal, whilst chlo-
rinated lime is generally chosen for external, use; and this chiefly,
perhaps, owing to its being obtained more conveniently, and cheaply.
Dr. Pereira  states, however, that he has carefully prepared  and
tried the  two chlorides, and  gives  a decided  preference to the
chloride of soda.  Labarraque, likewise, preferred it  as  an anti-
septic, on the ground, that  by the process of disinfection it becomes
chloride of sodium, which is not a deliquescent salt; whilst chloride
of calcium, formed by chloride of  lime, attracts water from the
atmosphere, and thereby furnishes one of the conditions—moisture
—necessary for the putrefactive process.   Hence, he thinks, whilst
 chloride  of  lime will serve equally well for simple  disinfection,
chloride of soda is to be preferred where we wish at the same  time
to prevent a renewal of putrefaction.2
    By  Bouillaud, Chomel  and  others, chlorinated soda has  been
 given, with advantage, in typhous fevers; and by Kretschmar,3
 Lalesque, Colson, and Gouzee/ in intermittents.5  Ten cases are
 reported by the last  named  gentleman;  in two, the intermittent

   4 Faraday, Quarterly Journal of Science, N. S. ii. 84, cited by Brande, Dictionary of
 the Materia Medica, p. 508.  Lond. 1839.
   a Pereira, Elements of Mat. Med. 2d edit. p. 540.  Lond. 1842; or 2d Amer. edit.
 by Carson.  Philad. 1846.
   3 Venus, Grundriss der Medicin, Receptirkunst, S. 67.  Weimar, 1838.
   4 Revue Medicale, Fev. 1836.
   1 Riecke, Die neuem Arzneimittel, S. 334, und 2te Auflage, S. 511. Stuttgart, 1840. 
SPIRITUS PYRO-ACETICUS.                645
yielded immediately; two others were cured after a slight return;
in one, there were four attacks, gradually diminishing; in two cases,
the severity of the paroxysms abated, but it was thought necessary
to have recourse to sulphate of quinia; in  two others, no effect
was produced, and in one, the  disease was aggravated.  Gouzee
infers, that these cases prove the febrifuge properties of chlorinated
soda to be less marked than those of sulphate of quinia, and, there-
fore, that it ought not to be trusted to, except in the slighter cases,
and where the patients are easily susceptible of the effects of medi-
cine,—as women and children.  In like manner, it has been found
useful in scrofulous affections, and  in various diseases in which
chlorinated lime has proved serviceable.  See Calx Chlorinata.
                 MODE OF ADMINISTRATION.
   From ten drops to a dram mixed with  plain or sugared water
may be given internally for a dose.
   The form in which it was prescribed by Gouzee in intermittents
was a mixture, composed of half a dram to four ounces  of distilled
water.   This was taken by spoonfuls during the apyrexia; so that
the last dose should be swallowed  shortly  before the next  parox-
ysm was expected.   The patients were restricted to their beds, or
at least to their chambers.
   When applied externally, it is  rarely used pure or diluted with
so little as one half water, except in cases of asphyxia, and gan-
grene, and for dressing old ulcers, &c.  Most commonly it is di-
luted  with ten or thirty parts of water, and in  this strength is ap-
plied to ulcers of various kinds, burns, cutaneous diseases, &c.
When used as a disinfecting agent, it is generally diluted with ten,
twenty or thirty times its weight of water.1
           CLXII. SPIRITUS PYRO-ACETICUS.

Synonymes.  ^Ether Pyro-aceticus seu Lignosus,  Pyro-acetic  Spirit,
  Pyro-acetic Ether, Acetone, Mesitic Alcohol, Bihydrate of Mesitylene;
  called, also, Naphtha, and Wood Naphtha.
French.  Acetone, Esprit Pyro-acetique.
German. Essiggeist, Mesitalkohol, Essigalkohol.

  There has been some confusion amongst therapeutists in regard
to the  article  meant by naphtha or wood naphtha, which  Dr.
John Hastings2 brought forward of late years as an important re-
medy in tubercular phthisis.  The term naphtha, according to Dr.
Pereira,3 had  been applied, but erroneously, to pyroxylic, or as
he writes it, pyroxilic spirit; and it is this article naphtha, which,

  1 Payan, Revue  Medicale, Aout, 1839.
  - Pulmonary Consumption successfully treated with Naphtha. Lond. 1843.
  3 Elements of Mat. Med. and Therap. 2d Amer. edit, by Carson, i. 355.  Philad. 1846. 
646
SPIRITUS PYRO-ACETICUS.
according to Messrs. Ballard and Garrod,1 was given by Dr. Has-
tings.  In this they are in error; and the confusion has probably
arisen from Dr. Hastings having also given the erroneous name
"naphtha," to the pyro-acetic spirit, which was the article really
used by him.
                  METHOD OF PREPARING.
  Pyro-acetic spirit may be prepared by distilling a mixture of
two parts of crystallized acetate of lead and one part of quick-
lime in a salt glaze jar (graybeard)  the lower part of the jar being
coated with fire clay, and a bent glass tube, half an inch in dia-
meter, being adapted to the mouth  by a cork so as to form a dis-
tillatory apparatus.  The jar is supported on the mouth of a small
furnace, by which the lower part only is heated to  redness, and
the vapours are conducted into a Liebig's condenser.  The pro-
duct is repeatedly redistilled from quick-lime, until its boiling point
is constant at  1320.2
  It is a colourless, volatile, inflammable liquid, having a peculiar
penetrating odour, and a pungent taste like that of peppermint. Its
specific gravity is 0.792.   As  found in  the shops, its  density is
generally not  lower than 0.820.  It is miscible with water, ether
and alcohol in all proportions.   If, when mixed with water, it be-
comes turbid,  it has not been freed from empyreumatic oil.
                 EFFECTS  ON  THE ECONOMY.
  Dr. Hastings3  states, that the  reason why he was induced to
deviate from the line of  medical treatment of phthisis, which has
so universally, and for so long  a period,  been in vogue, and to ad-
mit a new method of management, was the fatal termination of all
cases, whatever was the treatment  adopted, during an experience
of upwards of twenty years.  "I was led," he  says, "to the con-
clusion, from a careful survey of the chemical analyses of tubercle
made by  Thenard, that it was  defective, inasmuch as the compo-
sition of the animal matter, which  amounted  to upwards of 98
parts out  of 100, had not been investigated.  From the greasy na-
ture of tubercle in its crude state, there  did not exist the slightest
doubt in my mind, that carbon entered largely  into its formation,
and that its composition had a striking resemblance to fatty matter.
In consequence of the loss of fat, so remarkable in the earlier stages
of consumption, I determined to employ those  compound agents,
rich in carbon and hydrogen, which had not been previously used
in medicine; not with the idea that  they would make up the defi-
ciency which  the system had sustained in the progress of the dis-
ease, but  that such a change would, by  that means, be introduced
into the constitution as would  act on the forces of the  organism,

  1  Elements of Mat. Med. and Therap. p. 391. Lond. 1845.
  2 Bache, Dispensatory of the United States, 6th edit. p. 1291.  Philad. 1845.
  3  Op. cit.      « 
SPIRITUS PYRO-ACETICUS.               647
at the point of departure from health, whether that took place in
the stomach, blood or elsewhere; that change tending to such an
affinity in the elements within the body, that the carbon, hydrogen,
oxygen and nitrogen, instead of assisting in the formation of pro-
ducts which  threaten  life, would  tend to develop those materials
only which are required for the preservation of health  and the
prolongation of existence."
   Thirty-six cases, presenting all  the phenomena of tubercular
phthisis, are stated by him to have been cured by the pyro-acetic
spirit—the cough, expectoration, sweats, &c,  disappearing for the
most  part within a few weeks, and the physical signs indicative of
structural lesions disappearing soon after.   The statements of Dr.
Hastings were very properly doubted by the  best observers; but
still it was deemed advisable to give the remedy a fair  trial, and
the result has been far  from confirming them.   In  the  author's
experience no good has resulted from its use except  what  follows
the employment of ordinary excitant  expectorants, as creasote.
Testimony in its favour from others has not, however, been want-
ing.  Mr. D. Wilson1 narrates cases which appeared to exhibit all
the functional and  physical phenomena of phthisis, and were cured
or relieved by it.
   In enumerating  the cases  in which he recommends the use of
"naphtha,"  Dr. Hastings2  observes, that the  less  complicated
phthisis  may be  with other  affections, the  more suitable is it for
treatment by this agent.  When the pulse is at the ordinary stand-
ard or thereabouts; when the hectic is slight;  laryngeal and peri-
toneal disease absent;  the functions of the stomach and bowels not
much impaired ;  the constitutional  disturbance inconsiderable, and
the physical  signs denoting only a slight  deposit of tubercles in
one lung; the prognosis is favourable, and a speedy recovery may
be anticipated.   In many cases, this mild character of the disease
is never  witnessed, howsoever early they may be  seen: for want of
close  observation, too, this period frequently escapes notice; hence,
success depends upon an early and correct  diagnosis.  If naphtha
be given in acute phthisis, when the cough is very harassing, with
slight frothy expectoration; respirations 30  to  40  per minute; pulse
120 to 140; hot skin; profuse night sweats; great thirst; appetite
deficient or altogether wanting; and the physical  signs denoting an
extensive deposition of tubercles in both lungs, it will be found, he
says, injurious rather than beneficial.  If it be  employed in chronic
phthisis co-existing with disease in other  organs, its value is di-
minished in proportion to the extent of the complications, and their
vitiating influence on the constitutional powers; and if it be perse-
vered with in certain cases in which improvement had followed its
use, after the appearance of intercurrent pneumonia, bronchitis or
pleurisy, it will  do great  mischief.   Many such cases, says Dr.
  1 London Lancet, June 3d, 1834, p. 344, and Nov. 25, 1843,  p. 250.   a Op. cit. 
648
SPIRITUS PYRO-ACETICUS.
Hastings, give way to a short course of treatment with antimony,
digitalis, &c, and then the pyro-acetic spirit may be again employed
with the greatest  advantage.  Where hsemoptysis is present, or
where it  has recently existed, it is generally  contra-indicated.
When phthisis is complicated with dyspepsia, little or no benefit
will accrue from its use, until the latter affection is removed;  yet
Dr. Hughes Bennettx ascribes all its agency in phthisis to its power
of calming the  irritability  of the stomach, which  occurs often
in the disease, and for which, according to his experience, naphtha
is the best remedy.   Dr. Hastings states farther, that the disease
is not amenable to the plan of treatment when the patients are in
crowded hospitals, or in other situations where the atmosphere is
impure.
   If doubt may be entertained in  regard to the  efficacy of pyro-
acetic spirit in phthisis, there would seem to be none, that in cases
of chronic bronchitis resembling phthisis it has produced,  and
may be expected to produce, benefit.  Mr. Procter2 has related a
case, in which, after acute bronchitis, difficulty of breathing, cough,
with well marked purulent expectoration,  and nocturnal perspira-
tion existed, with great emaciation and occasional haemoptysis.   A
mixture  was prescribed of pyro-acetic spirit f |j; liquor opii se-
dativus f sij.; of which the patient  took fifteen  drops three times
a day in  a little water.  The medicine  was continued for about
two months, when the patient reported himself well.  In the  Re-
port of the Hospital for Consumption and  Diseases of the Chest,
(Lond. 1849,) it is stated, that in some cases of  bronchitis with
profuse secretion it seemed  useful,  but it  was not otherwise pro-
ductive  of benefit, and  often proved  hurtful.3   It is in chronic
bronchial affections that the pyro-acetic spirit will probably be
almost wholly employed, provided it retains its place in the cata-
logue of the materia medica; and hence it has  been classed else-
where by the author with creasote, the balsams, &c, amongst ex-
citant expectorants.4
   M. Lavirotte, of Lyons, and Drx David W. Yandell5 have re-
commended it in diarrhoea.   In 23 cases—16 of diarrhoea, and
7 of dysentery—the results were favourable.   Dr. Yandell gives
it in the  dose of twenty drops at intervals of three hours.
   Dr. Hastings6 has also extolled it highly in gout, and in acute
and chronic rheumatism.   " For upwards of twelve months,
he says,  " I have employed pyro-acetic  spirit in these affections,

   1 On Cod-liver Oil.  Edinb. 1848.
   2 Lond. Med. Gazette, Nov. 17,1843, p. 213.
  * British and Foreign Medico-chirurg. Rev. for  April, 1850, p. 321.  See, also, the
similar sentiments of Dr. Theophilus Thomson, Dr. Golding Bird, and others, in Lancet,
 January 15, 1848.
   * General Therapeutics and Materia Medica, 4th edit. i. 240. Philad. 1850.
   6 Western Journal of Medicine and Surgery, Sept. 1849.
   6 Cited in Amer. Journ. of Pharmacy, New Series, xiii. 66,   Philad. 1847. 
STRYCHNIA.
649
and my treatment has been attended with a success quite  extra-
ordinary, far exceeding the results usually obtained by colchicum,
&c."   His overstrained eulogies, however, of its effect in phthisis
will render the profession slow to credit this assertion.
                MODE OF ADMINISTRATION.
  The dose in which Dr. Hastings generally administers the pyro-
acetic  spirit  is from ten  to twenty drops  three times a day in a
small quantity of water.  After the second or third day he aug-
ments the dose by about one-fourth, regulating its increase  or  de-
crease according to the absence or presence of nausea, vomiting,
or any other untoward symptom resulting from its use.  As  the
disease advances he raises the  dose to 40 and even 50 drops, and
administers it four times instead of three times a day.
               STRYCHNIA ET EJUS SALES.

Svnonyme. Strychnia and its salts.

                   CLXIII.  STRYCHNIA.

Synonymes. Strychnium, Strychninum, Strychna, Strychnine, Vauque-
  line.
French.  Strychnine.
German. Strychnin,   K rahenaugenstof f,  Krahenaugen-
  bitter.
  This alkaloid was discovered by Pelletier and  Caventou1  in
nux vomica, St. Ignatius's bean, upas tieute, and in the wood of
strychnos colubrina; and experiment has shown, that these sub-
stances are indebted for their medicinal properties to it.2   In them,
strychnia is found associated  with another principle analogous  to
it in its properties—brucia.3   In St. Ignatius's bean, there is less
brucia than in nux vomica, so that it is  best adapted for  the pre-
paration of strychnia;  but it is not as easily  obtained, and conse-
quently nux vomica is almost always used.
                   METHOD OF PREPARING.
  According to one form of  preparation, liquid subacetate of lead
is added to a solution  of the alcoholic  extract of nux vomica in
water, until a  precipitate is  no longer thrown down; the foreign
matters being thus  precipitated, the strychnia remains  in solution
with  a  proportion of colouring matter, and sometimes an excess of
acetate of lead.  The lead is now separated by sulphuretted hydro-
gen;  and  the  fluid is  filtered and boiled with  magnesia, which
unites with the acetic acid, and precipitates  the strychnia.   The

  1 Annales de Chimie, torn, viii. ix. and x.
  1 Magendie, Annales de Chimie, x. 176. 1819.           3 See page 146. 
650
STRYCHNIA.
precipitate is next washed in cold water, and redissolved in alco-
hol to separate it from the excess of magnesia, and by evaporating
the alcohol, the strychnia is obtained.  If it be not perfectly white,
it must  be dissolved in acetic, or hydrochloric  acid, and be repre-
cipitated by means of magnesia.
   The  modes of preparation recommended in  the Pharmacopoeias
of London, Edinburgh,  and the United States, differ from each
other.  The following is that contained in the last work (1842:)
—Take of nux vomica, rasped, ftiv.;  lime, in powder, ^vj.; mu-
riatic acid, f §iij.; alcohol, dilute sulphuric acid, solution of am-
monia,  purified animal  charcoal, water, each a sufficient quantity.
Digest  the nux vomica in two gallons of water, acidulated  with a
fluidounce of the muriatic acid,  for twenty-four  hours; then boil
for two hours, and strain with expression  through a strong linen
rag.  Boil the residuum twice successively in the same quantity of
acidulated water, each time straining as before.   Mix the decoc-
tions, and evaporate to the consistence of thin  syrup; then add the
lime previously mixed with a pint of water, and boil for ten minutes,
frequently stirring.  Pour the mixture into a double linen bag, and,
having  washed the precipitate  well  with water, press, dry, and
powder it.   Treat the powder repeatedly with boiling alcohol
until deprived of its bitterness; mix the liquors;  and distil off the
alcohol by means  of a water bath.  Mix the residue with water,
and,  having applied heat, drop in sufficient diluted sulphuric acid
to neutralize and dissolve the strychnia; then  add purified animal
charcoal, boil for a few minutes, filter,  evaporate and crystallize.
Dissolve  the  crystals in water, and add sufficient solution of am-
monia to  precipitate the strychnia.   Lastly, dry the precipitate on
bibulous paper.1
   As thus prepared, it is in the  form of a white powder.
   Strychnia, obtained by crystallization from an alcoholic solution,
which  has been diluted with a small quantity  of water, and left to
itself, appears under the form of microscopic crystals,  constituting
four-sided prisms, terminated by pyramids with  four  flattened or
depressed faces.   When crystallized rapidly, it is white and granu-
lar, is insupportably bitter to the  taste, and leaves  an after taste
similar  to that caused  by certain  metallic salts;  it  has no smell,
and is not changed by exposure to the air; is neither fusible nor
volatile ;  for, when subjected to the action of heat, it does not fuse,
until the  moment of its decomposition and carbonization, and it is
decomposed by a  degree of heat inferior to that which destroys
most vegetable substances.   When  exposed  to the naked  fire, it
swells, becomes  black,  and yields an  empyreumatic oil, a little
water,  acetic acid, carbonic acid and carburetted hydrogen.   Dis-
tilled with oxide of copper, it gives out much carbonic acid, and
only slight traces of nitrogen.   It is composed of oxygen, hydro-
             1 Pharm. of the United States, p, 184.  Philad. 1842. 
STRYCHNIA.
651
gen, carbon and  nitrogen.   Although  strychnia has  so  strong a
taste, it is scarcely soluble in water.   At 50°  Fahr., 6667 parts
of water dissolve but one of it; boiling water dissolves  a little more
than double, so that it may be said to be soluble in 2500 parts of
boiling water.   It is remarkable, however, that a  solution made
in the cold, and containing therefore only s^th P31"* of its weight,
may be diluted one hundred times, and still retain  a very decided-
ly bitter taste.   It is more soluble in  strong alcohol, little so in
weak, and not much so in ether or fixed oils, although they acquire
a bitter taste from it.  On the other hand, it  is very readily soluble
in volatile oils, and the hot saturated solution, on cooling, deposits
crystals.  It has an alkaline reaction and forms, with acids, salts
which are mostly crystallizable, and  insupportably  bitter, and are
more  soluble than pure strychnia.1
   Strychnia, being sold  at a high  price, is liable to adulteration.
A respectable druggist of Philadelphia  informed the  author, that
one of his customers was offered strychnia by another house at  a
price  considerably lower than what he had to pay  for it  when
purchased even in large quantities from  respectable sources.   He
bought an eighth of an ounce of it at the rate of five dollars  the
ounce; when pure strychnia could not be offered at less than nine
dollars per ounce.  Some of this  was tested,  when  it was found to
consist of equal parts of flour or starch, and  pure strychnia.

      EFFECTS ON THE ANIMAL ECONOMY IN  HEALTH.
   The effects of  strychnia on man and  animals resemble, on  the
whole, those of the spirituous extract of nux vomica, except that
they are more  intense.   According to Magendie, one-eighth of a
grain  is sufficient to kill  a strong  dog.   Pope, who made experi-
ments on dogs, found that one-twelfth of a  grain was enough to
paralyze the lowTer limbs of a small dog in  four or five minutes,
and in half an hour to kill it.  Christison2 considers strychnia the
strongest  poison  after hydrocyanic acid.  He  injected a solution
of a third of a grain in alcohol into the thorax of a wTild boar,  and
in ten minutes  the animal died.   A dog was destroyed by one-
sixth  of a grain in two minutes;  and he believes, that the same
effect would be induced on man  by half a grain introduced into a
wound.   Lembert3 observed similar  results  from  placing a grain
in the thorax of a small  dog, and from three grains introduced
into the areolar tissue of a larger animal, on  which tetanic spasms
were  induced in the thoracic muscles.  Dr. Blake4 injected a grain
of strychnia, dissolved in a small quantity of acetic acid, into  the
veins of a dog.   The first effect  of the poison was to induce gene-

  1 Magendie's Formulaire, &c.
  1 Treatise on Poisons, 3d edit. Edinb. 1836; and Dispensatory, p. 895.  Edinb. 184'.'.
  ' Essai sur la Methode Endermique. Paris, 1828. h'vo.
  4 Edinb. Med. and Surg. Journal, April,  1839, p. 338. 
652                      STRYCHNIA.
ral convulsions in about thirty seconds after its injection, the action
of the heart being at the same time rendered  irregular, which Dr.
Blake presumes was owing  to  the  convulsive struggles of the
animal.   All external signs of life ceased in about a minute and a
half after the injection of the poison, but the heart still continued to
beat.  He found that when strychnia was introduced into the cir-
culation in so small a  quantity  as not to produce  any general
symptoms, it did  not appear to exert the least influence  on the
heart.
   That the action of strychnia is analogous to that of nux vomica,
has been proved by the experiments  of Segalas,1 Andral,2 Bards-
ley,3 Redlich, Sandras, Luders, Henneraann, and numerous others.4
It affects especially the vesicular matter of the spinal marrow, the
reflex system of Dr. M. Hall,—less strikingly the  brain: small
doses, according  to  some,5 excite the ganglionic system;  larger,
the  spinal marrow; consequently, it has been  imagined, that it
mio-ht be  an efficacious  remedy in  nervous diseases, which are
dependent upon spasmodic disorder  of the  ganglionic system, or
upon diminished sensibility and torpor of the  nerves of motion.6
   The observations of Cartoni led him to  infer, first, that strych-
nia has a special elective action on the nerves  of motion in general,
and chiefly on those which are concerned in the  movements of the
iris: secondly, that its  action  is diametrically  opposed to that of
substances, which occasion, and keep up, abnormous dilatation of
the pupil;  and lastly, that " it is a precious and efficacious agent
in certain diseases  of the eyeball, which depend upon  vital and
organico-vital modifications of the system of  ciliary nerves."7
   The following are the effects observed  by Oppler from the in-
ternal use of nitrate of strychnia :—a sensation of warmth and
itching in the epigastrium; eructation; nausea;  vertigo; slight ex-
citement like  that of intoxication;  great vividness, with more or
less confusion of mind;  dull pain over the eyes;  spots before the
same;  dilatation of the pupils; diplopia; tinnitus aurium; difficult
articulation and deglutition;  slight trismus;  sense of formication
in the paralyzed parts, with convulsive motions or twitchings, at
times, in them; at others, over the whole  body, similar to electric
shocks; tremors of the muscles; occasionally,  violent spasms; teta-
nus; asthma;  palpitations; febrile heat; general  sweating; prostra-
tion;  pale or livid countenance; pulse sometimes full and frequent,

  1 Mao-endie's Journal de Physiologie, ii. 4.            3 Ibid. Juillet, 1823.
  3 Hospital Facts and Observations, Illustrative of the Efficacy of Strychnia, Brucia,
&c. Lond. 1830.
  4 Petrequin, Gazette Medicale de Paris, No. 44, Nov. 1838.
  5 Stumpf. art. Strychnos, Encyclopad. Worterb. der Medicin. Wisscnsch. xxxii. 480.
Berlin, 1844.
  6 See, on this subject, Pickford, of Heidelberg, cited from  Gazette Med. de Pans,
5 Juin, 1844, in Amer. Journal of the Med. Sciences, July,  1844, p. 201.
  ' Bouchardat, Annuaire de Therapeutique, &c. pour 1847, p. 38.  Paris, 1847. 
STRYCHNIA.
653
at others, small  and contracted;  great  sensibility over the whole
body;  involuntary laughter,  succeeded always  by difficulty  of
breathing and convulsions.  The  sleep was generally interrupted
by convulsions;  the secretion of urine  scanty,  and occasionally
suppressed.   These symptoms came on gradually, and disappeared
in the same manner, when the dose was moderate, in the  course
of some hours.  Large doses, he says, induce death by a sudden
shock to  the nervous  system; smaller doses, when continued for
a long time, may destroy  by causing apoplexy, of which he saw
many examples in his experiments on animals.1
   Dr. Blumhardt2 has  recorded a case of poisoning by strychnia,
which occurred  to  him in Stuttgart.  He was called to a young
man, seventeen  years  old, who  had swallowed  two scruples of
strychnia after  dinner.  A short time  afterwards, experiencing
great restlessness, he repented of what  he had  done, and  imme-
diately took  four grains of tartar  emetic, which excited considera-
ble vomiting.  When the physician arrived, about a quarter of an
hour after the strychnia had been taken, he found the patient  on
his back in bed, with his head thrown back, rigid and incapable of
motion, but  with a constant inclination to turn towards  the right
side.  He could only move the upper limbs freely.   The counte-
nance was pale and haggard; the temperature  of the skin natural,
and the pulse quick and contracted.  Consciousness remained  un-
affected ;  the speech was  rendered difficult by an occasional con-
traction of the muscles that move the lower jaw ; but it could  not^
properly be  said to be interrupted:  deglutition was unaffected.
The trismus, however, became more and more frequent  and vio-
lent, and the  respiration thereby unequal and suspended; the pulse
was small, suppressed  and  quick.   The remedies—employed to
save him—as tincture of iodine and  acetate of morphia, were of no
avail.  With the periodical trismus  was now associated spasmodic
agitation  of  the whole body, to  which—after a short  interval—
succeeded opisthotonos with violent symptoms of suffocation ;  the
trismus  attained the highest degree, and  the  upper extremities
were deprived of the influence of volition.  With the increase of
the general tonic spasm, the respiration  was always more difficult
and oppressed, and  for a time wholly ceased ;  the pulsation of the
heart and arteries  became irregular, less distinct,  and  at  length
imperceptible.  In  this condition, the skin acquired a bluish  ap-
pearance ; the countenance was puffed  and of a violet hue;  the
lips dark-blue, the neck swollen,  the eyes protruded, fixed and di-
rected towards the right side; the pupils enlarged and immovable,
and the  conjunctiva injected.  At this period,  the patient was en-
tirely unconscious ;  but from this  condition he  awoke once, and all

  1 See, also, Tanquerel  des  Planches, E^sai sur la  Paralys:e de Plomb.  Pr.ris, 1834.
  - Med'icinisch. Correspondenz-Blatt, in Encyclog. des Sciences Medicales, Sept. J 837,
          42 
654
STRYCHNIA.
the symptoms became mitigated ; during this remission, the mus-
cles influenced  by the spinal marrow  remained cramped, except
the upper extremities, which could be moved voluntarily.  In a
quarter of an hour, the tetanic attack returned in its violence, with
intense commotion of the whole  body; this ended in asphyxia,
from which he again recovered to  consciousness.   The same thing
happened in a third attack.  In the fourth, he succumbed under
the power of the poison.   The whole scene, from the  taking of
the poison to the occurrence of  death, lasted an hour and a half.
   During the last attack, as doubt existed whether he was really
dead,  the  median vein of the left  arm,  which was turgid, was
opened, and after the vessel was emptied of its thick, black blood,
which resembled that of an animal, several bubbles of air, from
the size of a pea to  that of a small cherry, were forced  out by
pressure.  The dissection was made twenty hours after death. In
spite of the elevated summer heat, there were no signs of putrefac-
tion.   The whole of the body was uncommonly rigid.  The mus-
cles of the back were of a brownish-red colour, almost like that of
smoked meat.  On opening the spinal canal, a considerable quan-
tity of thick, dark-coloured blood, like that of an animal, flowed
out.   The plexus venosi spinales were turgid with the same kind
of blood, as well as the vessels  of the pia mater.  Under this
membrane,  especially in the  cervical portion, some  watery fluid
was effused.  The upper portions of the spinal marrow were soft,
pappy in some places, but lower down it became gradually harder.
Within the cavity of  the  cranium, the same turgid condition of
vessels existed;  all the veins of the dura mater appeared as if in-
jected; the veins of the pia mater were likewise engorged; and the
whole mass of the brain indicated an unusual supply of blood, so
that the cortical  substance  appeared quite blue.  The cerebellum
was softer than usual.   In the cavities of the abdomen and thorax,
a  striking  poverty  of blood was perceptible.   The  heart was
shrunken and empty, as well as the large vessels of the thorax.
The stomach was full of solid  food, which appeared to have un-
dergone no change;  its blood-vessels contained a  considerable
quantity of blood, and the mucous coat exhibited marked  redness
over its whole surface; but this was especially concentrated about
the cardia and the fundus; the small intestine was likewise  redder
than  natural, as is commonly the case in those who  have died
whilst digestion was  going on.   The liver was tolerahjy supplied
with  blood; the gall-bladder empty.1
   When  strychnia is used endermically,  as is  not unfrequently
the case,  the  course of the phenomena  is somewhat  different.
G. H. Richter employed it in this way in many cases of hemiple-
  1 For other cases, see Christison  on Poisons, 1st Amer. edit. p. 685.  Philad. 1845;
and James Wilson, London and Edinburgh Monthly Journal of Medical Science, Dec.
1845; cited at length in Amer. Journal of the Med. Sciences, April, 1846, p. 528; and
Taylor, On Poisons, Amer. edit, by R, E. Griffith, p. 622. Philad. 18 J 8. 
STRYCHNIA.
655
gia, in one of which it occasioned symptoms of actual poisoning.
When the dose exceeded a quarter of a grain, a feeling arose in
the part to which it was  applied as if needles were run into the
skin; this gradually spread over the wThole limb; the temperature
of the body was augmented;  the  pulse was quickened, full  and
hard;  the breathing constrained;  pain was experienced in the
same side of the head ; the  secretion  of urine was  increased, and
a general perspiration broke out, which persisted  for about an
hour, after which the pricking of the surface, and the excitement
of the vessels ceased.   To these  symptoms—and seldom  later
than two hours after the application of the agent — convulsive
movements succeeded in the paralyzed limbs like those induced by
electricity, which  augmented in  violence and in  frequency with
the increase of the dose,—being strongest and most severe during
the night, at which time  the limbs  were moved  involuntarily.
When awake, a feeling  of stiffness  was experienced in  all the
limbs,  which passed off  when they were  used.   On digestion,
defecation, and the appetite, the nitrate of strychnia  seldom ex-
erted any influence.  Only in one case—in which no effects were
induced on  the nervous  system, when  the  dose was gradually
carried to three grains—was obstinate  constipation induced.   In
general, when it was begun with in the dose of one-eighth of a
grain, and on the next day one-fourth was given, on the third day
one-half, and afterwards  the  dose was increased daily  by one-
fourth  of a grain,  until one and a quarter were taken,—the fol-
lowing unpleasant symptoms supervened. The patient experienced
twitchings earlier  than before, and first in the paralyzed  limbs.
As  these  became, from minute to  minute, more violent, a pene-
trating pain was  felt in  the occiput, with  vertigo and  tinnitus
aurium.  The  twitchings now extended over  the  affected arm,
and, subsequently, to the  sound side, whereupon the vertigo  and
headach increased, and insensibility, with difficult and stertorous
breathing, ensued.   The  pulse now became very full,  hard, slow,
and  intermitting;  the countenance  bluish-red and turgid; the
paralyzed lowTer extremities of a marbled blue; the  pupils very
much dilated, and  the mouth open,—the convulsions  being occa-
sionally so strong as to  toss him to and fro on the bed.   When
these phenomena declared themselves, Richter removed the dress-
ing from the surface, which appeared inflamed, and still contained
a quantity of  strychnia that had not been  absorbed  ; the parts
were then washed  and sprinkled immediately—according to Lem-
bert's and Lesieur's recommendation—with two grains of  acetate
of morphia; the face was washed with cold water, the  soles of the
feet brushed, and other excitants administered.1

  1 See some Experiments relative to the action of Strychnia on the Nervous System,
by H. Stannius, in M tiller's Archiv. Heft. ii. 1831; cited in Brit, and For. Med. Review,
for Jan. 1838, p. 221, 
656
STRYCHNIA.
   Dr. Christison1 considers, that strychnia is  not a cumulative
poison;  yet  the  author has seen one  or two cases which would
favour the contrary opinion,2 and Dr. F. A. Gebhard,3 of Moscow,
under view of the dangerous effects it often  induces, thinks  that
some  other remedy should be sought for, even in those cases in
which it has  been found  advantageous.  The continued employ-
ment of strychnia in small doses, or its administration  in  larger,
appears to him to cause, in some unknown manner, such a change
in the blood  as to result unexpectedly and suddenly in a powerful
reaction in the nervous system, marked by  convulsions,  tetanus,
exhaustion, paralysis and death.   Dr. Gebhard proposes, as a sub-
stitute, one of the most energetic articles of the materia medica—
veratria.
   Morphia appears to be the  most powerful antidote: under its
use the dangerous symptoms rapidly disappear; consciousness re-
turns; the patient sleeps for some hours, and a general perspira-
tion breaks out, after which he awakes with a  feeling of  dulness,
and with stiffness of the  limbs, which soon, however, vanish.  In
respect to the topical  application  of  strychnia  by  the endermic
method, A. L. Richter4 remarks, that  the preparations of strych-
nia produce much more powerful  local effects than those  of mor-
phia ; they maintain the abraded portions of the skin in an in-
flamed state, promote suppuration more than morphia, and occa-
sion violent itching and burning, with  a feeling as if needles were
run into  the skin.   Artus recommends, from  his investigations,
pure  baryta  (Aetzbaryt) as an antidote.   It forms  an inso-
luble  precipitate  with strychnia, and he esteems it to be more cer-
tain  than  the  tinctures of iodine and bromine recommended by
Donne,5 the  chloride of  barium, or the infusions of  tar and galls
recommended by Raspail.6
   The effects, referred to above, were chiefly obtained from the
administration of the nitrate, but they  may be esteemed applicable
to all the preparations of strychnia, as we know nothing of  any
difference in  their action.  It is probable, however, that the salts
of  strychnia, owing  to  their greater  solubility,  may have more
action than  strychnia itself, although  the  muriatic and acetic, or
lactic acids,  which are  almost  always present in the stomach, it
mio-ht be presumed, would readily unite with it.
           EFFECTS ON  THE  ECONOMY IN  DISEASE.
   The following remarks apply equally to pure strychnia, and its
  * Dispensatory, p. 895.   Edinb. 1842.
  1 See, also, Pereira, Elements of Mat. Med. and  Therap. n. 1310.  Lond. 1842; or
2d American edition, by Carson.  Philad. 1846.                  ...»
  3 Zeitschrift fiir Therapie,  u. s. w. Freiburg, Dec. 1844, No. 3, cited in Amer.
Journal of the Medi.al Sciences, Jan. 1846, p. 202.
  4 Die Endermatische Methode, u. s. w.  Berlin,  1835.
  5 Journal de Chimie Med. v. 494.  Paris, 1829,
  s Nouveau Systeme de Chimie Organique.  Paris, 1833, 
STRYCHNIA.
657
salts, and to the alcoholic extract of nux vomica, (see page 538,)
which is preferred by some.1  It has been administered in
  Paralysis,  especially in that arising  from the action  of lead,
in which Bally, Lembert, Bardsley, Andral, Rayer, and Tanquerel2
have employed it beneficially.   In paraplegia and hemiplegia it
has been prescribed  by Lesieur, G. H. Richter, Romberg, Bards-
ley, Bally, Lafaye, Oeslerlen, Reinhardt, Heyfelder, Faye, Mart,
Schaible, Raciborski, A. T. Thomson,3  Gellie,4 Petrequin,5 Toul-
mouche,6 Badeley,7 and  numerous others.8  From  the results of
their observations it would seem, that  strychnia is most efficacious
in paraplegia ; less so in hemiplegia, although it is said  to have
been  given with advantage in the latter  affection; but its adminis-
tration in hemiplegia requires special  circumspection, particularly
when the paralysis has succeeded to apoplexy.9
  The results of the observations of M. Toulmouche induce him
to believe, that  strychnia will only succeed in paralysis or other
affections " that proceed from some lesion of spinal  innervation,
occasioned  by excessive masturbation or indulgence in  venereal
pleasures, by  the  abuse of spirituous or narcotic liquors, by the
action of the  emanations of lead," &c.;  and  that it is never suc-
cessful in paralysis which is owing to an inflammatory condition
of the brain or spinal marrow.  He is of  opinion that strychnia has
a directly excitant effect upon the spinal marrow, and secondarily
on the organs that receive their nerves from it.  Romberg affirms
that, as a general rule, in cases of paralysis  dependent upon  dis-
ease of the central organs of the nervous system, he has  never
seen  any striking effect  from the endermic use of  strychnia,  and
that great care is needed  lest it should react injuriously on  the
brain.  He considers it  especially adapted for cases of  paralysis
that are dependent upon some affection of the spinal marrow in-
duced by mechanical concussion; as well as for the local paralysis
that succeeds  to rheumatism,  suppressed exanthems, &c.
  In paralysis of the upper eyelid, it has been employed suc-
cessfully by M. Saint Martin, in the  way of  inoculation, as pro-
posed by M.  Lafargue in the case of morphia (note page 520,)
two centigrammes—from one-fourth to one-third of a grain—of
the sulphate being introduced into twelve small punctures around
the orbit.  The operation was continued for six days, with com-

  ' Petrequin, Bulletin General de Therapeutique, Mars, 1840.
  s Gazette Medicale pour 1835, p. 383.
  » Lond. Med. Gaz. April, 1831.
  « La Lancette Franchise, 29 Aout, 1837.                    ' Op. citat.
  e Gazette Med.  de Paris, No, 5, 1841.
  ' Lond. Med. Gaz. July 12, 1846, p. 496.
  ' Petrequin, Gazette Medicale, Nov. 1838; and l'Expenence, Oct. 1843.
  » See Bally, Considerations sur la Strychnine, &c, in Bulletin General de thera-
peutique, Fev. 1838. 
658
STRYCHNIA.
 plete success.1  The same result, as shown hereafter, has followed
 its use by inoculation in amaurosis.
   Dr. Favell2  contends, that  the  forms of paralysis most likely
 to be benefited by it are those dependent upon  cold, poisons, and
 certain molecular changes in the brain and nerves, altogether inap-
 preciable  by post mortem  examination.  He considers, that  the
 most dangerous symptoms resulting from an over dose are gene-
 rally caused by the influence of the drug on the nerves distributed
 to the  heart.  Dr. Benton, of Illinois,3  affirms,  that he has em-
 ployed it with the happiest results in some forms of coma attend-
 ing fevers in malarious districts.  The phenomenon occurred in re-
 mittent fever, and seemed  wholly independent of organic lesion ;—
 the secretions being natural, the tongue and skin moist, and all the
 symptoms improving, excepting those referable to the encephalon.
 In such cases, strychnia in doses of one-twelfth  of a grain, every
 six hours, afforded relief in from 24 to 48 hours.
   Dr. Pereira4 has seen  it  very serviceable in  that shaking or
 trembling  action of the muscles, which is produced by habitual
 intoxication.   G. H. Richter cured  a case of aphonia by it, and
 Dr.  P. H. Clarke,5 of West Tennessee, considers, that it not only
 proved  beneficial in loss of voice caused  by relaxation of  the
 muscles of the larynx, but in chronic  bronchitis.  It has been
 much used internally, and  successfully, in amblyopia and amau-
 rosis, by Short, Liston,6 Guthrie,  Middlemore,7  Henderson, Fur-
 nari,8 Mart,  Petrequin,9  Dusterburg,10  Debreyne,11  and others.
 Mr.  Tyrrell and  Mr. Lawrence,12 however,  affirm that they have
 found it inefficacious in amaurosis.   In these cases, it is generally
 used endermically on the  temporal  region.  Dr. Stevensonl3  de-
 rived benefit from  it—when applied in this way—in cases of
 amaurosis of many  years' duration.   Half  a  grain was repeated
 twice a day until tremors  of the limbs were produced.  He em-
 ployed it  in the same manner in other cases of  local paralysis.
 In cases  of amaurosis, Henderson advises,  in addition, that a
 solution of  strychnia should be dropped into the eye;  and it  has
 likewise been' used  in the form  of inoculation, in the manner
 described hereafter.  It has been given  successfully in paralysis
 of the  bladder by Schaible,  Bally, Hennemann, Behrend,14 and
   1 Bouchardat, Annuaire de Therapeutique pour 1849, p. 70.
+  a Provincial Medical and Surgical Journal, Dec. 31, 1845.
   3 Bullet, of Med. Science.                       4 Med. Gazette, vol. xix.
   5 Illinois and  Indiana Med. and Surg. Journ. April and May, 1847.
   e Lond. Med. Gaz. v. 541 and 575.
   7 Midland Medical and Surgical Reporter, May and August, 1831.
   3 Bouchardat, Annuaire de Therapeutique, pour 1841, p. 8.  Paris, 1841.
   9 Bulletin General de Therapeutique, Juillet, 1838.
   10 Cited in London Medical  Gazette, August 5, 1842, p. 733.
   " Noticed in Medico-Chirurg. Review, Oct. 1844.
   '.* A Treatise on Diseases of the  Eye, Amer. edit, by Hays, p. 519. Philad. 1S-4S,
   13 Transactions of the Medical and Physical Society of Calcutta, vol. v.
   " Medicin. Zeitung, Sept. 1837, S. 190. 
STRYCHNIA.
659
 others; and in paralysis of the facial nerve, by Drs. O'Brien,1
 Beales,2 and Joslin.3  In two cases of paralysis of the rectum in
 elderly people, accompanying a disordered state of the bowels, the
 author found the best effects from  the endermic use of strychnia—
 in the quantity of a  quarter of a  grain, night and morning, to a
 blistered surface on  the sacrum.  In high grades of paraplegia,
 the internal use of the remedy is to  be preferred,  but  in  general
 the endermic administration is  more  advisable.  In paralysis of
 the limbs, a spot is selected in the vicinity of the  spinal marrow.
   Strychnia is likewise given in other affections.   Very favoura-
 ble reports have been made, as  to  its efficacy in irregular gout,
 by Wendt, who rubs on the affected  parts  an ointment composed
 of a grain and a half of nitrate of strychnia to two drams of
 lard;  and in
   Neuralgia,  Mart found  it beneficial in tic douloureux and
 in nervous headach ; Magnus in a case ofneuralgia of the arm;
 and several successful cases have been published by Dr. Pidduck.4
 The sulphate of strychnia, in  doses of one-twelfth of a  grain, two
 or three times a day, occasionally combined with sedatives and
 quinia, has been highly recommended  by Dr. John Waters.5
   Traumatic Tetanus.  In this  disease it has  been extolled by
 Liiders, and  a case, occurring in a negro girl, which terminated
 favourably under its use, in the dose of one-twelfth of a grain every
 twTo hours, has been  reported by Dr. P. M. Kollock.6
   In hysteria, hypochondriasis, and dyspepsia? it has been ad-
 vised by Schmidtmann, and  Basedow, but  morphia  appears to
 render more  essential service.
   In chorea, Romberg and Professor Trousseau,8  Dr. A. Ross,9
 Dr. Griscom,10 and Dr. B. R. Hogan,11 saw good  effects from it.
 Professor Trousseau  administers a syrup of the sulphate during or
 after meals, in cautiously increased  doses  until convulsive move-
 ments take place.  These are to be kept up for about eight  days,
 when, by diminishing the dose, a mere muscular stiffness should be
 maintained for a similar period,  and the remedy be persevered  in
 for eight or ten days after all irregular movements have  ceased.
 Eight  cases are cited  in proof of his assertions; but Dr. Cowan12
  1 Med. Chirurg. Review, and L'Experience, Nov. 1838.
  2 New York Journal of Medicine and Surgery. July, 1839, p. 201.
  3 Amer. Journ. of the Med. Sciences, Oct. 1842, p. 322.
  4 Lond. Medical Gazette, Aug. 7, 1840, p. 759.
  5 Cowan's Address, Trans, of the Provin. Med. and Surg. Ass. p. 62. Lond. 1845.
  r Southern Medical and Surgical Journal, Oct. 1847.
  " Melcombe, in London Medical Gazette, for March 4, 1837, p. 850.
  3 Journal de Medecine de Beau, Juin et Juillet, 1844, and Traite de Therapeutique
 &.c, i. 798. Paris, 1847.  Also, Union Medicale, Juin, 1849, cited in Ranking's Half-
yearly Abstract, July to Dec. 1849.  Amer. edit. p. 41.
  9 London Lancet, June 7, 1845, p. 636.
  10 American Journal of the Med. Sciences, April, 1846, p. 47L
  " New Orleans Med. and Surg. Journal, Sep. 1846.
  " Retrospective Address, in Transactions of the Provincial Medical and Surgical As-
sociation, xiii 58.  Lond. 1845. 
660
STRYCHNIA.
doubts whether success should justify the employment of a remedy
so difficult  to  regulate, especially in cases which seldom  resist
ordinary and well known treatment.  The experience of Professor
Trousseau is confirmed  by that of M. Rougier.1   More recently,
M. Trousseau2 has published his mode of administering this power-
ful article.  This consists in employing very small doses, increasing
them by regular gradations, until slight tetanic rigidity is produced;
then suspending the medicine or continuing the last dose, but never
increasing it beyond that point.   He states, that an itching of the
skin and scalp generally precedes the rigidity,  and that the masse-
ter muscle is  first  affected.  Hence he advises,  that the child
should  be frequently  asked whether it  has any difficulty in open-
ing the mouth, and  thus the earliest toxical effects may be recog-
nised.
   In retention of urine from loss of power after parturition, Dr.
Cory3 administered  a  sixteenth of a grain of strychnia  three times
a day, with apparent  advantage;  and it was given, with good re-
sults, in a case of retention of urine following scarlatina, by Dr.
Geo. L. Upshur, of Norfolk, Va.4
   It has likewise been advised in epilepsy5 and catalepsy.   In a
successful case related  by Dr. Weyland, nitrate of strychnia was
taken in such quantity as to produce the peculiar tetanic effects of
strychnia.  Fricke has administered it successfully in—
   Syphilitic Osteocopi.   It has also been given with benefit in
cases of
   Dysentery and Diarrhoea, by Bardsley, Recamier, Geddings,6
and others;  and has been  used endermically in cholera—two  or
three grains being applied to the blistered surface on  the nape of
the  neck.  By MM.  Dreyfus, Grimaud  d'Angers and Potton  it
was given internally in the same affection  to allay  vomiting:
—a quarter to a half a grain being added to three ounces of water,
and prescribed in the  dose of a spoonful every hour.7  Dr. Ryan8
asserts, that he has repeatedly known a few of the pills—the for-
mula for which is  given below—check a  profuse diarrhoea with
rice-coloured evacuations,  and even when the extremities  were
blue, in  malignant cholera.   In the same  disease  Mr. C. E. Jen-
kins9 gives a pill of one-eighteenth of a grain every quarter of  an
hour, washing it down with copious draughts  of cold water.  He

  1 American Journal of the Medical Sciences, Oct 1844 ; cited from Medical Times,
Aug. 31, 1844.              a Revue Medico-chirurgicale, Janv, 1850.
  * Medico-Chirurgical Review, July, 1839.
  * Medical Examiner, April, 1847, p. 213.
  * Brofferio, in Repertorio Medico-Chir. di Torino, 1825, and Revue Medicale, iv. 488.
Paris, 1825; and Weyland, Wochenschrift fiir die gesammte Heilkunde, cited in Enoyc.
des Sciences Med. Janv. 1851,  p. 65.
  6 N. American Archives, No. 2, Nov. 1834.
  1 Merat and De Lens, Diet, de Mat. Med. art. Strychnine.
  8 Formulary, 3d edit. p. 335.  Lond. 1839.
  9 London Lancet, Sep. 2,  1848. 
STRYCHNIA.
661
 finds the first three or four pills probably ejected, but the subse-
 quent doses are retained, and their good effect is speedily perceived.
 On the other hand, Dr. Rankingx combined it  with an aperient
 extract with advantage in habitual constipation;  and M. Ho-
 molle2 relates three cases  in which he found milligramme—gr.
 .0154—doses, repeated every  hour,  completely  efficacious, after
 various other means  had been used  in  vain, in  relieving  urgent
 symptoms of internal strangulation.
    It has likewise been beneficial in nervous vomiting  and gas-
 tralgia, in the former of  which two teaspoonfuls of a solution of
 5  centigrammes—gr. £,—in  100 grammes—|iijj—of water,
 are given every quarter of an hour.   M. Debout  has seen the vo-
 miting arrested  after the fourth or fifth  dose.   In gastralgia  he
 gives the same dose night and morning only.3
   In gleet, unaccompanied by stricture, Dr. C. Johnson4 has found
 good effects from an  injection of strychnia, according to the for-
 mula given hereafter.
   Amenorrhcea.   Of twelve cases of suppressed menstruation,
 treated  by Dr. Bardsley, ten were cured, and two relieved.  Dr.
 Churchill5 also had two cases, in  which the cure by  it was com-
 plete and permanent.   Lastly. From its efficacy in analogous af-
 fections of the digestive mucous membrane, Dr. Stokes6  thinks
 there is good reason to hope that it may prove useful  in  bronchi-
 tis.  It has  been employed, indeed, in all the cases in which the
 alcoholic extract of nux vomica has been found of service, than
 which it is of course to be more relied upon, in consequence of its
 greater uniformity,—nux vomica itself being often found unequal.
   Intermittent Fever.   This powerful agent has been  recently
 recommended in this disease by Dr. S. E. M'Kinley,7 of Tennessee,
 who states, that  no remedy acts " with more certainty,  as a per-
 manent  cure, if persisted in for two or more weeks."  He  gives
 from one-sixteenth  to  one-eighth of a grain every three  hours,
 gradually augmenting the dose, " until, in some  cases, one grain
 may be  given three or four times a day,  and without  any toxical
 symptoms arising whatever."  It need scarcely be said, however,
 that so potent an article must be administered with the  greatest
 caution, and the cases must be rare in which it need be had recourse
 to to such an extent as to  cause apprehension of the unpleasant
 results that appear  to be produced at times by its cumulating  in
 the system.

  1 L'Union Medicale, No. 138-9, 1848, cited in Brit, and For. Med. Chir.  Rev. April,
 1849, p. 539.                                     a Ibid.
  * Bouchardat, Annuaire de Therapeutique pour 1849, p. 71.
  ' American Journal of the Medical Sciences, April, 1850, p. 541.
  ■ Outlines of the Principal Diseases of Females, Amer. Med. Library edit. p. 54.
Philad. 1839.
  6 Treatise on Diseases of the Chest, p. 125.  Dublin, 1837, or Amer. Med. Library
edit.  Philad. 1838.
  ' Medical Examiner, July, 1850, p. 382. 
662
STRYCHNIA.
  In very obstinate cases, Dr. Keller,1 of Philadelphia, prescribes
the extract  of nux vomica in  combination  with arsenic, sulphate
of quinia and extract of quassia.
                 MODE OF ADMINISTRATION.
  Pure strychnia is best exhibited  internally, in the form of pill,
or in spirituous solution; but if a little acid, especially the acetic,
be added to it, it may be given in watery solution, as in this way
a salt of strychnia may  be formed extemporaneously.   The  dose
is from  one-sixteenth to  one-eighth of a grain, which may be gra-
dually increased until a grain is taken.  In ordinary cases it will be
sufficient to raise the dose to half a grain, two or threctimes a day;
but if any circumstance should arise to cause its discontinuance, it
ought  not  to  be recommended in  doses as large as the last, but
with small doses, as at  the beginning.   In  the endermic applica-
tion of  the remedy, we sprinkle, twice a day, a quarter of a grain
on the denuded surface, and slowly increase the quantity to half a
grain or more  should this be  necessary.   If the larger doses do
not act more beneficially, it will be  advisable  to  discontinue it
for a   few  days—after  which  the   smaller  doses   may  again
exert a signal influence—rather than to carry the dose  still higher.
M. Petrequin2 thinks  that the  endermic  use  of strychnia fre-
quently fails, owing to the vesicated surface to which it is applied
becoming covered  with a layer  of coagulable  lymph, in  conse-
quence of which the strychnia is unable to make its  appropriate
impression.   This  layer of lymph  should  be  removed  as far as
possible at  each application;  and as the vesicated surface daily
becomes less  and less sensible, the dose must  be proportionally
increased.   M. Petrequin recommends, that a third or a fourth of
a grain of strychnia should be mixed with two or three grains of
powdered nux vomica,  and the  compound be  sprinkled on  the
surface; but it would seem to  be preferable to increase the  dose
of strychnia than to place so much insoluble and irritating pow-
der on the sensitive surface.
  It has also been introduced by inoculation in the neighbourhood
of the  eye  in cases of  amaurosis?  A  grain of the sulphate
was in  one case dissolved in two  drops of water: the first day
twelve inoculations were practised,—six above the eye in the course
of the  supra-orbitar nerve; and six under and on the side of the
nose, where the  ethmoidal filaments and nasal branch terminate,
and whence arise the filaments that go  to  the iris.   On that day,
there was no effect; but the next day slight tremors  occurred in
the neighbourhood of the inoculated spots.   After a  rest of two

  ' Nord Amerikanischer Monatsbericht fiir Natur und Heilkunde, Sept. 1,1850, S. 103.
  2 Bulletin G6neral de Therapeutique, Mars,  1840.
  8 Verlegh, Gazetta Medica di Milano, April, 1844, cited in London and Edinburgh
Monthly Journal of the Medical Sciences, Aug. 1844, p. 713. 
STRYCHNIA.
663
days, the inoculations were repeated, and the number of punctures
increased to eighteen.  The patient now became sensible of a slight
haziness.   After five successive inoculations, carried to the length
of thirty punctures, the patient began to distinguish objects; after
the eighth, vision was completely restored, the contraction of the
pupil gradually increased, and the other symptoms diminished, after
five grains of the sulphate had been used.   During the same time,
inoculations were had recourse to in the neighbourhood of  the
other eye.   After the  lapse of two months, the patient was  per-
fectly restored.
                    Pilulae strychniae.
                      Pills of strychnia.
              R. Strychniae pur. gr. ij.
                 Confect. rosae gss.
              Divide in pilulas xxiv.
   Dose.—One to two, morning and evening.        Magendie.
              R. Strychniae gr. j.
                 Confect. ros. ^ss.
                 Glycyrrhiz. pulv. Qss.
              Divide in pilulas xij.
   Dose.—One,  night  and morning.   The quantity may be  in-
creased to four or five daily.                           Ryan.
              R. Strychniae gr. ij.
                 Ext. valerian, q. s.
              ut fiant pil. xxxij.
   Dose.—One, every morning, fasting, for five days:—afterwards
one, morning and evening, in torpid amaurosis.      Furnari.

                   Tinctura  strychniae.
              R. Strychniae pur. gr. iij.
                 Alcohol 36° (.837) fgj.  M.
   Dose.—Six to twenty-four drops, twice or thrice a day.
                                                  Magendie.
                    Mistura strychniae.
                    Mixture of strychnia.
                       (Potion stimulante.)
              R. Aq.  destillat. f^ij.
                 Strychniae gr. i.
                 Sacch. £ij.
                 Acid. acet. gtt. ij.   M.
   Dose.—A dessert-spoonful, morning and evening.—Magendie.

                   Collyrium  strychniae.
                   Collyrium of strychnia.
              R.  Strychniae gr. ij.—iv.—vj.—viij.
                 Acid. acet. dil.
                 Aq. destillat. aa. fgj.  M.
   Two drops to be let fall into  the  eye, a few times a day, in
 amaurosis.                                       Henderson. 
664
STRYCHNIA ACETAS.
                   Injectio strychniae.
                   Injection of strychnia.
             R.  Strychniae gr. ij.
                 Acid, nitric, fort. gtt. iv.
                 Aquae fgij.   M.
  A dram to be injected three times a day in gleet.
                                      Christopher Johnson.
                  Unguentum  strychniae,
                   Ointment of strychnia.
             R.  Strychniae gr. xvj.
                 Adipis 3j.  M.
  Used in friction on paralyzed parts.             Sandras.1
  It may be well to dissolve  the strychnia, before admixture, in a
little alcohol.
                 Linimentum  strychniae.
                   Liniment of strychnia.
             R.  Strychniae gr. xxiv.
                 01. oliv. I).  M.
  Twelve drops of the oil  to be rubbed on the temples four times
a day in  cases of amaurosis.                         Cunier.
             CLXIV. STRYCHNINE ACE'TAS.

Synonymes.  Strychniae Acetas, Strychnium seu Strychninum Aceticum,
  Acetas Strychnii seu Strychnicus, Acetate of Strychnia or Strychnine.
German.  Essigsaures Strychnin, Strychninacetat.
  In  addition to the acetate, formed  extemporaneously, as men-
tioned under Strychnia, the proper acetate of strychnia has been
administered, especially by Liiders and Fricke.   It may be made,
like the acetate of quinia, from the direct combination of strychnia
with acetic  acid.   According to Thenard, it is very soluble, and
crystallizes  with difficulty.   Even when diluted  40,000 times, its
solution occasions a sense of bitterness on the tongue.
  The following formulas have been given by the physicians cited.

               Guttae  strychniae  aeetatis.
               Drops of acetate of strychnia.
              R.  Strychniae acet. gr. iij.
                 Alcohol, f 3J.
                 Aq. cinnam. f ^vij.   M.
  Dose.—Five drops, twice  a day, gradually increasing the dose.
                                                    Luders.
1 Bouchardat, Nouveau Formulaire Magistral, p. 113.  Paris, 1845. 
STRYCHNIA IODAS.
665
              Tinctura  strychniae  aeetatis.
              Tincture of acetate of strychnia.
             R.  Strychniae acet. gr. iss.
                 Alcohol, fgsa.  M.
  Dose.—From three or four to twenty  or  thirty drops to be
taken at  bed-time in cases of syphilitic pains  of the bones.
                                                    Fricke.
               CLXV.  STRYCH'NIiE  I'ODAS.
Synonymes.  Strychninee  Iodas, Strychnina Iodata, Strychnium seu
  Strychninum Iodicum,  Iodas  Strychnii seu  Strychnicus, Iodate  of
  Strychnia or Strychnine.
German.  Iodsaures Strychnin,  Strychninjodat.
                  METHOD OF PREPARING.
  The preparation of this salt, according to Magendie, is easy.  It
is sufficient to add a concentrated solution of iodic  acid to  pow-
dered strychnia: in a moment, the mass swells up, absorbs water,
becomes thicker, and at times very consistent.   It is now treated
with boiling alcohol, filtered, and left to spontaneous evaporation.
In this way, beautiful crystals of iodide of strychnia are obtained.
The iodic acid, proper for this preparation, is procured, according
to Geiger, in the  following manner.  Nine parts of iodide  of
baryta are boiled  with two parts of oil  of vitriol, previously
diluted with ten times as much water, for half an hour. It is then
filtered, and evaporated by a gentle heat to the consistence of a
thin syrup, and is exposed to the air for spontaneous evaporation.
  Iodate of strychnia may likewise  be formed  by double  decom-
position, by mixing a soluble iodate, as iodate of soda, with a so-
lution of sulphate or muriate of strychnia.   The iodate of strych-
nia is precipitated, which  may be treated with boiling alcohol, and
crystallized as above directed.
  The iodide is of a white colour, and crystallizes in beautiful
prismatic needles:  it is but slightly soluble in cold water, but more
so in boiling water and  alcohol.
                 EFFECTS ON THE ECONOMY.
  "This salt," says Magendie,  "is one of the most active poisons
with which  I am  acquainted.   A single grain is sufficient to  de-
stroy a  strong dog with tetanic symptoms.  It  acts, likewise,
powerfully on the diseased organism.   I  gave it  to several persons
with a success which far exceeded  my  expectations.  It proved
effectual in some old paraplegic affections, which had been esteemed
incurable, and after  all  the usual remedies had  been administered
in vain."  He gave it in  pills, each of which contained one-eighth
of a grain.   One of these was prescribed night and morning, and
the  dose was  gradually  increased,  until ultimately a grain was 
666                   STRYCHNIA IODAS.
taken in the twenty-four hours.  The greatest circumspection was,
however, necessary in its use.
  Magendie is of opinion, that the hydriodate of strychnia, strych-
nium hydroiodicum, hydriodas seu iodhydras strychniae seu strych-
nicus; Germ. Iodwasserstoffsaures Strychnin, iodwas-
serst off Strychnin, might be advantageously introduced into
medicine.   It is prepared  by mixing a solution of iodide of po-
tassium with a  concentrated  solution of acetate of strychnia:  a
white crystalline powder is  precipitated, which is soluble in alco-
hol, and is pure hydriodate of strychnia.
   It  does not appear to have been used as yet  in medicine.

   An iodide of  iodhydrate of  strychnia ;  French, Iodure
d'Iodhydrate de strychnine,  has likewise  been proposed.  It is
prepared by  pouring  a solution of ioduretted iodide of potassium
into  a solution of a  salt of strychnia.  A flocculent  precipitate
is formed  of  a light chestnut hue, which is dried and treated with
boiling alcohol.   On cooling, the alcohol suffers crystals of iodu-
retted iodhydrate  of  strychnia to be deposited.  It has the form
of semi-transparent needles,  of a deep ruby red colour; is soluble
in alcohol and ether; but completely insoluble in water, even when
slightly acidulated.
   M. Bouchardat1 has administered  this preparation to dogs, in
the dose of three decigrammes (gr. 4.63.)  It poisoned them like
strychnia, but the action was much longer in developing  itself.
In the dose of five  centigrammes, (gr. .771,) it occasioned, in about
an hour, convulsive shocks, which persisted for some time; but the
animal  completely recovered.  He thinks  the advantage it pos-
sesses over strychnia  is in being less poisonous and  more persist-
ent.  It is always identical in  composition,  and easy to  obtain
pure.
   The dose  is a centigramme (about a sixth of a grain)  a day,
gradually increasing it.

   A double iodide of zinc and strychnia has also been prepared,
which, according to M. Bouchardat, is  a well defined salt, crystal-
lizing regularly in beautiful needles of a brilliant white colour.  It
is composed of one  atom  of iodhydrate of strychnia, and  one of
iodide of zinc,  and  is soluble in water  and  in alcohol.   When
given to animals, it acts like strychnia  and its  salts; but requires
double the dose.  It  is prepared  by digesting for several days, in
hot  water, the iodide of iodhydrate of strychnia and zinc; the
boiling liquid is filtered, and, on cooling, the salt crystallizes.  M.
Bouchardat3 thinks it may replace strychnia with advantage,—be-
ing more manageable ; and he suggests, that it may be a valuable
agent in many serious neuroses, and especially in epilepsy.

   1 Nouveau Formulaire Magistral, p. 114.  Paris, 1845.^         * Ibid. p. 114. 
STRYCHNIiE NITRAS.
667
              CLXVI. STRYCHNINE NITRAS,

Synonymes. Strychninae Nitras, Strychnium seu Strychninum Nitricum,
  Nitras Strychnii seu Strychnicus, Nitrate of Strychnia or Strychnine.
German, Salpetersaures Strychnin, Strychninnitrat.
   This preparation of strychnia has been more used in Germany
than any other.1   It has been received  into the Prussian Pharma-
copoeia, (Landespharmakopoe,) where it is directed to be
prepared in the following manner:

                 METHOD OF PREPARING.

  On eight pounds  of nux vomica, sixteen pounds of spirit of
wine (Ko r n b r a n n t w e i n) are poured, and the liquid is distilled
to one-half.   The nux vomica is then  freed from the liquor  by
filtering, dried and reduced to coarse powder.  This is digested
two or three times, with a sufficient quantity of the spirit, and after
digestion it is strained.   The tinctures are then subjected to dis-
tillation, and what remains is evaporated along with the fluid that
remained after the boiling: to this acetate of lead, dissolved in a
sufficient  quantity of distilled water, is added so long  as  a pre-
cipitate falls.  The fluid, separated as much as possible from  the
precipitate, by means of the filter, is now evaporated to one-half,
by a gentle heat.   When  cold, it is mixed  with two  ounces  of
calcined magnesia, and suffered to stand three days, when  the de-
posit  is separated by  the aid of the filter, washed, and dried.
This, after having been rubbed to powder, is digested two or three
times in alcohol, and the tinctures are subjected  to distillation, until
only a few  ounces remain.   The strychnia, which, on  cooling,
appears in the retort in the form of a white powder, is separated
by the filter, washed two or three times with rectified spirit of
wine diluted with an equal quantity of common water, and  neu-
tralized by a proper quantity of dilute  nitric acid.   The  filtered
fluid is evaporated by a gentle heat so as to allow the formation of
crystals.   These crystals are needle-shaped, colourless, of a silky
splendour, and a very bitter taste: they are soluble with difficulty
in alcohol, but dissolve in ether.

                 MODE OF ADMINISTRATION.

 . The dose and mode of administering the nitrate of strychnia are
the same as in the case of pure strychnia.  Its endermic application
will sometimes succeed when the internal  administration has  been
more  limited in its results.   The experiments instituted  by Dr.
Stannius, and others, and referred to  in a former page,  were with
nitrate of strychnia.

  1 Stumpf. art. Strychnos, Encyclop'ad. Worterb. der Medicin. Wissench. xxxii. 464
Berlin, 1844. 
668
SULPHTJRIS CARBURETUM.
  Magendie found, in his experiments, that this salt completely
prevented the coagulation of the blood.1
             CLXVII. STRYCH'NLE SULPHAS.

Synonymes. Strychninae Sulphas, Strychnium seu Strychninum Sulphuri-
  eum, Sulphas Strychnii seu Strychnicus, Sulphate of Strychnia or
  Strychnine.
German. Schwefelsaures Strychnin, Strychninusulphat.
  The same effects have been observed from this preparation as
from the others.  It is also dispensed in the same forms and doses.
It may be  obtained  by the simple  union of strychnia with  sul-
phuric acid.  According to Pelletier, 100 parts of the alkaloid
saturate  10.486 of the acid.  It is soluble in less than  sixteen
parts of  cold water, and crystallizes, when neutral, in transpa-
rent cubes; when acid, in needles.  Its taste is extraordinarily bit-
ter.  It is  decomposed by every soluble salifiable base.
  Sulphate of strychnia is much used by M. Trousseau, (see page
570:) he prescribes it in the form of
              Syrupus strychniae  sulphatis.
               Syrup of sulphate of strychnia.
                 (Strop de strychnine.—Trousseau.)
             R.  Strychniae sulphat. gr. 3.85 (25 cent.)
                 Syrup. Oj. (500 grammes)  M.
                                                 Trousseau.
          CLXVIII.  SUL'PHURIS CARBURETUM.

Synonymes. Sulphuretum Carbonii seu Carbonei, Carbonium seu Carbo-
  neum Sulphuratum, Alcohol Sulphuris, Bisulphuretum Carbonii, Car-
  bonii Bisulphuretum, Sulfidum Carbonii, Sulphuret of Carbon, Bisulphu-
  ret of Carbon, Sulphide of Carbon,  Carburet of Sulphur, Alcohol of
  Sulphur.
French. Sulfure de Carbon,  Carbure de  Soufre, Soufre Carbure, Alcool de
  Soufre.
German. Schwefelalkohol, Schwefelkohlenstoff, Fliissiger
  Kohlenschwefel, Kohlensulfurid.
  Carburet of sulphur or sulphuret of carbon was discovered by
Lampadius in the year 1796.   It is a transparent  and colourless
fluid at the ordinary temperature; has a very penetrating  and dis-
agreeable odour;  and a taste cooling  at first,  but afterwards
burning, acrid, and somewhat aromatic.  Its  specific gravity is
1.272.  It boils at 106° of Fahrenheit.   It is not decomposed  at

  1 Lerjons sur le Sang; or translation in Lond. Lancet, Jan. 26, 1839, p. 637. 
SULPHURIS CARBURETUM.
669
the highest temperatures; but  volatilizes rapidly in  the  air, and
burns readily.   It is not soluble in  water, but is so in  alcohol,
ether, and the fixed  and volatile oils.  Water  separates it im-
mediately from those solutions.  It unites intimately with the
alkalies;  but, of  the acids,  aqua regia—which is  a mixture of
the nitric and muriatic acids—alone lays hold of it.   It  dissolves
potassa, camphor,  sulphur, and phosphorus.   Lampadius, in the
first instance, regarded sulphuret of carbon  as a compound of sul-
phur and hydrogen ; it is now, however, decided, that it  consists
ofsidphur and carbon,—according to Vauquelin, in the proportion
of 85 or 86 to 15  or 14;  according  to Berzelius and Marcet, of
84.84 to  15.16.

                   METHOD OF PREPARING.

   The following method is recommended by Mitscherlich :2
   The temperature at which sulphur enters into ebullition is not
sufficient to make the two substances combine, but if burning  coals
be placed in contact with  vapours of sulphur, the combination
takes place immediately.  With this view, a  tube  of porcelain
may be  used, or, what is better, one of cast iron, lined internally
with a coating of clay by running it several times through a paste
of clay and water, and heating the tube each time.   In this  man-
ner, the crust of dry clay will  become  strong enough to  prevent
the sulphur from attacking the iron.   The tube is then filled  with
strongly calcined coals, and is heated  to redness in  an oblong fur-
nace.  One end of the tube is closed by a cork, and a small  hole
is made at the upper part of  the tube, through which the  sulphur
is introduced, and  which is  closed by  a  plug.  The other  end,
which has passed through the furnace, is likewise closed by a large
cork, traversed  by  a glass tube.   To  make the stoppers close the
tube hermetically, they are boiled with glue.  The long glass tube
passes  into a large jar,  through a hole in which it is  adapted
hermetically by means of a  cork.  The ordinary aperture of the
jar is closed by a cork in  which a tube is fitted  hermetically, which
passes  through the window.  At the bottom  of the jar  is  con-
tained a little water.  The long tube passing from  the furnace to
the jar  may be kept cool by water made  to drop upon it, or by
covering it with snow or ice.  When  the charcoal is heated to red-
ness, small fragments of sulphur are dropped in, from time  to time,
by means of the aperture before mentioned, which must  be care-
fully closed each time afterwards.  The sulphur, on melting,  runs
towards the hottest parts of the tube, to which  a  slight inclination
has been given on  placing it in  the furnace.   It enters into ebulli-
tion, and is transformed into  sulphureous vapour, which, by pass-
ing over the hot coals, combines with  them: the sulphuret of car-
  1 Elemens de Chimie, traduits par M. B. Valerius, i. 156.  Bruxelles, 1835.
43 
670                 SULPHURIS CARBURETUM.
bon or  carburet of sulphur, formed, condenses in  the  long tube,
from which it runs into the jar, and falls to the bottom of the wa-
ter.   As the  coal always  retains a little hydrogen, the sulphur
likewise unites with it, to form a gaseous body, which is  carried
off by the tube passing through the window.
   Carburet of sulphur  is  preserved in well-stopped bottles, and
is covered with about an inch  of water, whence it can be best ob-
tained for use by means of a small glass or ivory syringe.
                  EFFECTS ON THE ECONOMY.
   Dr. Snowx diffused its vapour through air, and noticed the ef-
fects  on mice.  He concludes  that a single deep inspiration of air
saturated with it, at a summer temperature, would produce instant
death.   It  did not cause muscular relaxation  before dissolution;
but tremulous convulsions continued until the last.  They super-
vened, or were threatened, almost as soon as complete insensibility
to external  impressions  was established.
   Carburet of sulphur holds a place amongst the transient or dif-
fusible stimulants.2   Its most  marked effects are said to consist in
its "  exciting the function  of cutaneous transpiration  to  copious
sweating; increasing the  secretion  of  urine,  elevating the tem-
perature of the body, quickening the pulse, and causing congestions
towards the head and those parts of the body  whose vitality may
have  been  already  somewhat augmented."3   Its  most striking
agency is exhibited  in the more active exercise of the functions of
the skin.  According to Mansfeld, it acts likewise as an emmena-
 gogue; but, in this  respect, probably only like similar excitants.
 On account  of  its  great  volatility, it produces  on the skin  the
 feeling of considerable  cold.
   The discoverer of the carburet of sulphur first recommended it
 as a  remedial agent.4   He  particularly advised it, both internally
 and externally, in rheumatic  and gouty affections.  In Freiburg,
 a mixture  of one part of camphor, two of carburet of sulphur,
 and four of alcohol,  is a very  common external application in rheu-
 matic pains.  Kappe found decided advantage from it  in gout and
 rheumatism; and Mansfeld and Wutzer, resting upon a series of
 observations, maintain, that  in rheumatism unaccompanied by
fever, or where the fever  is slight, it exceeds every other.remedy
 of the class.  Dr. Otto,5 of Copenhagen, prescribes four drops of
  a mixture composed of one part of carburet of sulphur, and  four
  parts  of highly rectified spirit of wine, to be  taken every two

   ' London Med. Gazette, June 23, 1848.
   » Wutzer, Journ. de Chimie Med.;  cited in Amer. Journ. Med. Sciences, Nov.18.il,
  P. 215.                                                        .
   * Riecke,Die neuern Arzneimittel, S. 109; und 2te Auflage,S. 166.  Stuttgart, 1?4U.
   * Lampadius, in Bulletin des Sciences Medicales de Ferussac, xi. 315.
   ' Ann.iles de Chimie Medicale, cited in American Journal of the Medical Sciences,
  for Nov. 1836, p. 222. 
SULPHURIS CARBURETUM.
671
hours:  and he  directs the affected part to be rubbed with an em-
brocation, composed of one part of sulphuret of carbon, and four
parts of olive oil.   The  cure, he  states, is  ordinarily effected  in
from eight to fifteen days.   In deep-rooted dyscrasies, however,
these gentlemen found no advantage from it.   On  the other hand,
in trials at the Berlin  Charite, it was  found to  be  of no avail  in
chronic rheumatism, although it was  used  for a  long  time, and
given in by no means  small doses.1
   Mansfeld, also, employed it in cases of after-pains, rubbing  it,
without admixture, on the abdomen;  and  he affirms,  that good
effects resulted  from it, even when ergot had failed.  In hysteric
fainting, the same gentleman found it useful when internally ex-
hibited.   Lampadius likewise recommended it in fainting, as well
as in asphyxia.   Krimer found it extremely efficacious in asphyxia
from carbonic acid, but he frequently  thought it necessary to pre-
mise blood-letting.  In this way, he treated eleven cases, and only
one—in  which apoplexy had  already  supervened—terminated
fatally.  The same physician exhibited it in some cases of drunk-
enness, attended with  loss of consciousness, and found  its  effects
very beneficial.   He gave it with great advantage once^in a case
of goitre; and, in incarcerated hernia, no agent, he  says, facilitates
so much the taxis as  the cold produced by dropping carburet  of
sulphur on the tumour.2  Lampadius found, that slight burns were
instantaneously  cured by  it.   Dr.  Turnbull  affirms, that the
vapour of this  substance was useful  in  cases of indurated lym-
phatic glands, and for the removal of deafness, dependent upon
wa-nt of nervous energy, and deficiency of cerumen.  It is applied
by means of a bottle having a proper  sized mouth, and containing
a  fluidram  of the bisulphuret, imbibed by a piece of sponge.   In
the  case of indurated lymphatic glands, the part is first well moist-
ened with water.  When the vapour is applied to the ear, the
bottle, the neck of which  must be small to fit the  meatus, is held
close to the organ, until considerable warmth is induced.3   Clarus
recommends it in hypertrophy of the coats of the stomach, and in
contractionof the oesophagus—when administered according to the
formula given below.   Every thing, indeed, says Riecke, encourages
its farther  trial as a remedial  agent.4   It has  been employed  re-
cently lay Dr. Simpson,5 of Edinburgh, as an anaesthetic.   By one
or two to whom  it was exhibited, it  was declared to  be  more
pleasant than chloroform;  but in several it produced disagreeable
encephalic disorder.  Its effects  as an anaesthetic  were powerful,
  * G. Simon, art. Schwcfelkohlenstoff, Encyclopad. Wdrterb. der Medicinisch. Wi<sen-
schaft. xxxi. 270.  Berlin, 1843.
  - Journal de Pharmioie, and American Journal of Pharmacy, ix. 264.
  3 Pharm. Journ. and Transact, ii. 352; cited in Dispensatory of the United Slates
6th edit, p 1235.  Philad. 1H45.
  ' Die neuern Arzneimittel, u. s. w. S. 110.
  * Pharmaceutical Journal, vii. 517. 
672                SULPHURIS CARBURETUM.

and very rapid, but difficult of regulation;  and its deranging in-
fluence continued for some time after it was exhibited.  Dr. Simp-
son employed it in obstetrical  cases, when the same objections
were found to apply to it.
                MODE OF ADMINISTRATION.
   Carburet of sulphur may be  given internally in doses of from
one drop to four, every five or  ten minutes, in cases of fainting
and asphyxia; but where such a rapid  analeptic agency is not de-
manded, it may be  given every two or three hours.  It may be
administered  dropped on sugar or in a spoonful of sugared water
or barley water.   Clarus thinks it is best given in cow's  milk.
   Externally, it is either applied pure, when a rapid development
of cold is needed—as in cases of burns  and  incarcerated  hernia—
or dissolved in alcohol or oil.
               Guttse  sulphuris  carbureti.
                Drops of carburet of sulphur.
            R. Sulphur, carbur. f ^ij.
               ^ther. sulphur, f gj.  M.
   Dose.—-Ji few drops on sugar.                 Lampadius.
            R. Sulphur, carbur. f £j.
               Alcohol, f gss.  M.
   Dose.—Four to six drops, every two hours, in rheumatism.
                                                   Wutzer.
            R. Sulphur, carbur. f 3J.
               Alcohol, f 3ij.  M.
   Dose.—Five, ten, or fifteen drops, three times a day, in cases
 of rheumatism.                                    Wutzer.
              Mistura  sulphuris  carbureti.
               Mixture of carburet of sulphur.
            R.  Sulphur, carbur. 9j.
               Lact. vaccin. f ^vj.
                Sacch. 3ij. M.
   Dose.—A table-spoonful, four times a day, or oftener.
                                                    Clarus.
            Embrocatio sulphuris  carbureti.
              Embrocation of carburet of  sulphur.
            R. Sulphur, carbur. gss.
                Olei amygd. dulc. §j.  M.
   To be rubbed in, in cases of old gouty nodes.
                                        Mansfeld and Otto.1
            R.  Sulphur, carbur. f 31 j.
                01. oliv. seu
                Linim. ammon. camphor, f gij.  M.
   To be rubbed in, in cases of rheumatism.          Wutzer.

   1 Bibliothek for Laeger, 1835; cited in Brit, and For. Med. Review, July, 1836, p. 252. 
                      SULPHURIS IODIDUM.                 D/<5

           R.  Camphor, gij.
      Solve in
               Sulphur, carbur. f §ss.
      Adde
               Alcohol, f gj.  M.
  To be used in friction, in cases of rheumatism, and especially
in rheumatic odontalgia.                        Lampadius.
             CLXIX. SULPHURIS  IO'DIDUM.

Synonymes. Sulphuris  Ioduretum, Sulphur Iodatum seu Ioduratum,
  Ioduret or Iodide of Sulphur.
French. Soufre Iodure, Iodure de Soufre.
German. Iodschwef el,  I o d i n sch wef e 1, S c h w ef eliodiir.

                  METHOD  OF PREPARING.
  Iodide of sulphur is prepared by heating slightly a mixture of
four parts of iodine, and one of sublimed sulphur.  The excess of
iodine is driven off, and the iodide of sulphur remains as a grayish-
black mass,  very deliquescent, and readily decomposed by water.
M. G. Van Melekebeke J has proposed the following form:—Take
of iodine, two parts; washed  sulphur, one part.  Bruise them
together, and  introduce the mixture into a  glass tube, pressing  it
down until the tube is well filled ;  then  seal hermetically.  Heat
at first gently, until the mixture  begins  to  become of a darker
colour; then augment the heat so  as to fuse the iodide; keep  it
for some time in this state, and turn the tube constantly,  that the
action may  be uniform; remove it from the fire, and shake it until
the iodide begins to congeal, and until vapours of iodine no longer
form;  open the tube, and  compress again the iodide, in  order to
have  it in  fine cylinders.  M. Van Melekebeke recommends this
as a very expeditious process, and one which  enables the phar-
macien to prepare  the  iodide in very small quantity.  The com-
mittee of the Societe des  Sciences Medicales et JVaturelles of Ma-
lines approve of the  process, but  suggest, that the proportion  of
iodine to sulphur should  be three to one.
   The following form for its preparation has been introduced into
the last edition of the Pharmacopoeia of the United States:—Take
of iodine, giv.; sulphur, gj.   Rub the iodine and sulphur together
in a glass, porcelain, or marble mortar, until they are thoroughly
mixed.  Put the mixture into a matrass; close the orifice loosely,
and apply a gentle  heat so as to darken the mass without melting
it.   When  the colour has  become uniformly dark throughout, in-
crease the heat so as to melt the iodide; then incline  the matrass
in different  directions, in order to return into the mass any portion
of iodine which may have  condensed on  the inner surface of the
1 Archives de la Medecine Beige, Mars, 1842, p. 307. 
674
SULPHURIS IODIDUM.
vessel:  lastly, allow the matrass to cool, break it, and put  the
iodide into bottles, which are to be well stopped.
                 EFFECTS ON THE  ECONOMY.
   Biett has  used this agent in  squamous, pustular, and papular
diseases of  the  skin.   It has been  found especially effective in
psoriasis, in  the form of friction.   Patients, who had  been long
affected with diseases of this kind, which had resisted every other
remedy, were cured in four  or  five  months  by iodide of sulphur
alone.  To prevent relapses, Biett advises that the frictions should
be continued after  the  eruptions have  scaled  off.  He found it
equally efficacious in the lepra vulgaris of Willan; and in acne—
the gutta rosacea of Alibert—when the inflammation of the skin
had passed away.   Even acne indurata was often completely cured
by it.1   He  found it  also beneficial  in inveterate  porrigo  of the
scalp.2   At  times, after the rubbing, a diffuse red  inflammation of
the skin arises, with subsequent  desquamation;  and, in  particular
cases, the inflammation extends even to the subjacent areolar mem-
brane.   In old standing lepra, Rayer3 prefers  it  for externa] use
to calomel and white precipitate; and he ranks it highly, with the
iodides  of mercury, for the cure  of lupus non exedens; and by  Dr.
Vol mar* it has been used, with great success, in herpes pustulosus
labialis.   It is likewise extolled by  Lugol as a very active thera-
peutical agent.   Cless affirms, that in chronic squamous affections
of the skin, especially in psoriasis, he  has employed it with ad-
vantage,  but he  was not able to cure lepra  vulgaris with it.  It
has been  strongly recommended in tinea capitis, in the proportion
of ten grains of  the iodide to  an ounce of lard.  A  writer in an
English periodical5 affirms, that  he was induced to make trial of it
in some obstinate cases, and was much astonished  at the remarka-
ble power it possessed over the disease.   He  rubbed it on the head,
night and morning, and increased the strength of the ointment ac-
cording as the affected  part was able to bear  the stimulus, until
the iodide bore the proportion of half a dram to the ounce of lard
or  spermaceti cerate.  Dr. Wilson  has recommended,  that  the
surface in porrigo, after ablution with warm water, should be rubbed
gently twice a day with a liniment composed of iodid. sulphur 3ss.,
ol. oliv.,  ^j.   In porrigo decalvans it has been found  beneficial,
made into" an ointment with 18 or 20 parts of lard, and  rubbed on
very  gently night and morning.  Dr. W. Davidson,6 too, has ex-
  1 See, also, Rayer, Traite Theorique et  Pratique des Maladies de la Peau; and Cop-
land, Dictionary of Practical Medicine, art. Acne.
  0 Cazenave et Schedel, Maladies de la Peau, p. 219; and Cogswell on Iodine, p. 120.
Edinb. 1837.                  3 Diseases of the Skin, p. 634.
  4 Die neuesten Entdeckung. in d. Mat. Med.; cited by Pereira, Elements of Mat. Med.
ii. 477,2d edit.   Lond. 1842;  or 2d Amer. edit, by Carson.  Philad.  1846.
  1 London Medical Gazette, for Sept. 9,  1837, p 879. See, also, M. Cazenave, cited
ii American Journal of the Medical Sciences, Oct. 1841. p. 460.
  ' London and Edinburgh Monthly Journal of Medical  Science, Dec. 1841: also, J.
J.  Ross, ibid. Sept. 1842, p. 792. 
UREA.
675
tolled it  highly.   He  affirms, that although it  does  not  seem to
have so much power over lepra and psoriasis as over porrigo, it
has succeeded more frequently than  any agent he  has tried, with
the exception of blistering by cantharides.  The author has certain-
ly obtained far more satisfactory results  from the  use of iodide of
sulphur in chronic cutaneous diseases in general, and  especially in
porrigo, eczema,  and psoriasis,  than from  any other external
agent; and  such  is the  result of the observations  of M.  Es-
colar.1
   The inhalation  of the vapour of this substance has been  em-
ployed  in  humoral asthma  by Dr. Copland,2  with temporary
benefit; and  fumigations of iodine  and sulphur have been used ad-
vantageously in certain atonic  ulcers  and chronic cutaneous  dis-
eases.3  With this view, the sulphur and iodine may  be combined
extemporaneously,—say four parts of iodine to one part of sulphur.
                 MODE OF ADMINISTRATION.
               Unguentum sulphuris iodidi.
                Ointment of iodide of sulphur.
             R.  Sulphur, iodid. ^j.—£ss.
                 Adipis gj.   M. et fiat unguentum.
                                            Biett.—Bayer.
                       CLXX.  URE'A.
Synonymes. Ureum, Uricum, Nephrine, Nephrin.
French. Uree, Extrait Savonneux de l'Urine.
German. Harnstoff.
   This immediate principle of the  urine of man and quadrupeds
was discovered in an impure state by Rouelle, in 1773; and since
then it has been studied by Cruickshanks, Fourcroy and Vauque-
lin, Berzelius, Proust, and Liebig more especially.4
                   METHOD OF PREPARING.
   Urea is obtained by placing a mixture of equal volumes of urine,
reduced to the consistence of syrup, and nitric acid at 20° in a re-
frigerative bath; by which means crystallized nitrate  of  urea  is
precipitated.   On dissolving this in cold water, and decomposing
by carbonate of potassa, reducing it almost to dryness, and treating
the residue  by alcohol at  40°, which  takes  up the urea, crystals
may be obtained  by  evaporation, which may subsequently be pro-
cured colourless by the agency of animal charcoal.

  ' Bouchardat, Annuaire de Therapeutique pour 1848, p. 196.  Paris, 1848.
  a Diet, of Practical Medicine, art. Asthma.
  ' London Lancet, vol. i.  1838.
  ' Annales de Chimie et de Physique, x. 369, and Merat and De Lens, art. Uree. 
676
UREA.
  M. Henry,1  who was not satisfied with  the scanty product
yielded by this process, recommends the following:—Add to fresh
urine a slight excess of subacetate of lead; a precipitate  is thus
formed, which consists of oxide of lead united to the various acids
of the  urine, together with  the mucus, and  a great  part of the
animal matter; the decanted liquor is  then treated with sulphuric
acid in slight excess to separate the lead,  and, afterwards, in the
progress of the evaporation, to decompose the salts of soda and
lime that may have  been formed.  After having  separated the
white precipitate, concentrate rapidly  over a steady fire, adding a
portion of animal charcoal during the  ebullition. When the whole
has become a clear syrup, pass it through linen of  close texture,
and  then reduce  it  one-third by evaporation.  On  cooling, the
liquid is converted into a yellow mass, crystallized in needles, and
formed of a great  proportion of urea  and  some salts.  The crys-
tals, being drained and pressed, are added to those  obtained from
the mother waters treated in a similar manner.   They are next
treated with a very small quantity of  carbonate of soda, with the
viewT of separating any remaining acetate of lime, and  then digest-
ed in alcohol of 38° to 40°.  The alcoholic solution being  filtered,
and the alcohol separated by distillation, the urea remains, which
may be crystallized afresh from water, if necessary.2
   Urea, thus obtained,  is in silky or prismatic needles, is very
soluble, and  of a cooling taste.
   The following improved  method of preparation has been pro-
posed by Prof. Liebig.3   Twenty-eight parts of ferrocyanuret  of
potassium perfectly  dried are mixed  with fourteen parts of per-
oxide of manganese, both being  reduced  to  as fine a powder  as
possible; the mixture is then heated on an iron plate,  not in a cru-
cible, over a coal fire to a feeble red heat.   At this temperature it
inflames, and is  gradually extinguished.   By  shaking  it  several
times, at intervals, it is prevented from becoming agglutinated, and
the access of air is facilitated.  The  mass, on  cooling, is  treated
with cold water, and the liquor is mixed with twenty parts and a
half of dry sulphate of ammonia of commerce, prepared by satu-
rating sulphuric acid with carbonate of ammonia, and evaporating
it to dryness.  It is well to  put to one side the first concentrated
washings afforded by the ferrocyanuret of potassium; to  dissolve
in the last washings, in  the cold,  the sulphate of ammonia, and to
mix them with the first.   Commonly, an  abundant precipitate of
sulphate of potassa forms immediately.  The supernatant  liquid is
poured off, and  evaporated in a  salt water  bath, or rather in a

  1 Journal de Pharmacie, xi. 161.   Paris, 1829.
  3 Manual of Materia Medica and Pharmacy; by H. M. Edwards and P. Vavasseur,
p. 231.  Philada. 1829.
  ' Annalen der Chimie und Pharmacie, B. xxxviii.; and Journal de Pharmacie, Aout,
1841, p. 502. 
UREA.
677
warm place,—care being taken to prevent ebullition.  Fresh crys-
talline plates of sulphate of potassa are deposited, and the liquor
is decanted  as far as possible.  The decanted liquor is then eva-
porated  to  dryness,  and the  residuum is treated  with  boiling
alcohol of eighty to  ninety  per cent.   This dissolves the  urea,
which crystallizes by the cooling and evaporation of  the  alcohol,
whilst the sulphates do not dissolve.

                  EFFECTS ON THE ECONOMY.
  The experiments of M. Segalas have established, that  urea is
devoid of any noxious action on animals into whose veins it  has
been injected, and, consequently, that we cannot  ascribe the serious
symptoms to it which arise from the absorption  of urine in certain
morbid  cases.   They demonstrate,  farther,  what has been con-
firmed by the trials of Fouquier, that urea  is a diuretic, and, there-
fore, might  be useful  in dropsy, and  it has been so prescribed  by
him and  by M.  Segalas.  Fouquier employed it, also, but unsuc-
cessfully, in diabetes.1  Laennec used it with advantage in a case
of dropsy.  In  two  cases reported  by Mr. Kingdon,'2  he found
that Nitrate of Urea,—JVitras Ureae, Urea  JVitrica;  French,
Nitrate d'Uree;  German, Salpetersaures Harnsto f f—
acted as  a very powerful diuretic;  reducing, in a comparatively
short time, anasarcous swellings of some standing, when ordinary
diuretics had failed.   In the  first case, he  gave one grain of  the
nitrate with one grain of calomel, in the form of pill,  every night
and  morning for twelve  days.  The urine  became  copious, and
the swelling disappeared.  In  the second  case,  a grain and a half
of the nitrate was given  alone three times a day.   The like suc-
cess attended this case: in ten  days the anasarca had disappeared.
Urea was also prescribed by  M. Piorry in  albuminuria.3
  According to  Prof. Fee,4 urea is  received into the  lists of  the
Materia  Medica in the  Batavian  Pharmacopoeia,  and  in  some
others less known.  It  has also been  admitted into  the  French
Pharmacopoeia.
                 MODE  OF ADMINISTRATION.
  Urea has  been given in solution  in distilled water, sweetened,
in the dose  of twenty-four to thirty grains, and even as  high as
several drams, in the  day.

  1 Journal de Physiol, de Magendie, ii. 344, and Magendie, Formulaire pour la Pre-
paration, &c, de plusieurs nouveaux Medicamens.
  * London Lancet, Sept. 7, 1844, p.  729.
  • Aschenbrenner, Die neueren Arzneimittel, S. 268.  Erlangen, 1848.
  * Cours. d'Hist Naturelle Pharm. ii. 764; cited in Merat  and De Lens, Diet, de
Mat. Med. art Ur6e. 
678
VERATRIA.
                     CLXXI.  VERATRIA.
    Synonymes.  Veratrina, Veratrinum, Veratrium, Veratrine.
    French.  Veratrine.
    German.   Veratrin, NiesswurzstofT.

   This alkaloid, which was discovered in 1819, by MM. Pelle-
 tier and Caventou,1 and almost at the same  time by Meissner,2 is
 commonly prepared from the seeds of veratrum sabadilla—Saba-
 dilla  or Cevadilla  of the  Pharmacopoeia of the  United States.
 It is contained in several of the plants belonging to the family
 Colchicaceae.
                   METHOD OF  PREPARING.
   Cevadilla is repeatedly treated with boiling alcohol.  The tinc-
 tures,  filtered when almost boiling, allow whitish flakes of wax to
 be deposited on cooling; the  dissolved matters, brought to the con-
 sistence of an extract, are now dissolved  in cold water, and filtered.
 whereby a  small quantity of fatty matter remains on the filter.
 The solution is then slowly evaporated, when a  yellowish orange-
 coloured precipitate is formed,  which possesses  the characters of
 the colouring  matter found  in almost all woody vegetables.   On
 adding a solution of acetate of lead to the  still deeply coloured
 liquid,  a new and very abundant  yellow precipitate is thrown
 down, which can be separated by means of the filter.   The liquor,
 now nearly colourless, contains, besides other substances, acetate
 of lead, which had  been  added  in  excess;  this is separated by
 means of a stream of sulphuretted hydrogen;  the liquor is then
 filtered, and concentrated by evaporation;  treated  by  magnesia,
 and again filtered.  The magnesian precipitate is digested in boil-
 ing alcohol, and on evaporating the alcoholic liquors, a pulveru-
 lent, extremely acrid matter is obtained, which possesses all  the
 properties of the alkalies.   It appears at first yellowish; but by
 solutions in  alcohol, and  subsequent  precipitations,  caused by
 pouring water into the alcoholic  solutions, it is obtained in  the
 form of a very white and perfectly inodorous powder.3
  Veratria has been  received into the  London  and United States
 Pharmacopoeias.4  In these it is  directed to  be prepared as  fol-
 lows:—Take of cevadilla,  bruised, two pounds;  alcohol, three
 gallons; diluted sulphuric acid, solution of ammonia, purified
 animal charcoal, magnesia, each a  sufficient quantity.   Boil
 the cevadilla in a gallon of the alcohol,  in a retort with a receiver
 attached, for an hour, and pour off the liquor.   To  the residue

  1 Annales de Chimie et de Physique, xiv. 69.
  3 Gilbert's Annalen der Physik, lxv. 335.
  3 Magendie's Formulaire pour la Preparation, &c, de plusieurs nouveaux M^dicamens.
  4 Pharm. of the  United States, p. 237.  Philada. 1842.  For Righini's method  of
 obtaining what M. Soubeiran calls "medicinal veratrine? see Journal de Pharmacie,
Oct. 1837. 
VERATRIA.
679
 add another gallon of the alcohol, together with  the  portion  re-
 cently distilled, again  boil  for  an hour, and pour off the liquor.
 Repeat  the  boiling a third time with the remaining alcohol, and
 with that distilled  in the previous operation.   Press the cevadilla,
 mix and strain the liquors, and  by means of a water  bath distil off
 the alcohol.   Boil the residue  three or four times in water acidu-
 lated with sulphuric acid, mix and strain the liquors, and evapo-
 rate to the consistence of syrup.   Add  magnesia in  slight excess,
 shake the mixture  frequently;  then  express and wash  what  re-
 mains.   Repeat the expression and  washing two or three times,
 and, having dried the residue, digest  it with a gentle heat several
 times in alcohol, and  strain  after each  digestion.   Distil  off the
 alcohol from the mixed liquors; boil the residue for fifteen minutes
 in water with a little sulphuric acid and  purified  animal  charcoal,
 and strain.   Having thoroughly washed what  remains, mix the
 washings with the  strained liquor, evaporate with a moderate heat
 to the consistence of syrup, and  drop in as much solution of ammo-
 nia as may be necessary to precipitate the veratria.  Lastly, sepa-
 rate and dry the precipitate.
   The following is the rationale of  this process.  The cevadilla
 gives up its veratria united with  a vegetable acid to the alcohol;
 and when the alcohol extract is treated  with water and sulphuric
 acid, an impure solution of sulphate of veratria is obtained.  The
 magnesia decomposes this, setting free the veratria, which is taken
 up by alcohol.   The alcohol  is  then  distilled off, and the  extract
 is boiled in water with sulphuric acid and  animal charcoal: the
 acid unites  with the veratria, whilst the charcoal  abstracts the
 colouring matter.  Ammonia,  added to the strained solution, unites
 with the sulphuric  acid, and the veratria is precipitated.1
   Veratria—commercial or medicinal veratria—as  prepared
 by the last process, is pulverulent, of a grayish-white colour, in-
 odorous, and of a bitter acrid  taste, causing a sensation of tingling
 with numbness in the tongue.  It is scarcely  at all soluble in cold
 water;  but  boiling water dissolves  one  thousandth  part of  its
 weight, and  becomes  sensibly acrid.   It is very soluble  in ether,
 and still more so in alcohol.   It is not soluble  in alkalies, but  is
 so in all the vegetable  acids:  with these it forms uncrystallizable
 salts, which, on evaporation, present  the appearance  of gum.  The
 sulphate alone  affords  rudiments  of  crystals when  its acid  is  in
 excess.  Nitric acid combines with it;  but, if added in excess, it
 does not colour it red, as in the case of morphia, brucia, and im-
 pure  strychnia, but very rapidly  resolves the vegetable substance
into its elements, and gives rise to a yellow detonating matter.
   Veratria has an  alkaline reaction.   When  exposed to  heat, it
 liquefies at a  temperature of 122° Fahrenheit, and has  a waxy
  ' Pereira, Elements of Mat. Med. anl Therap. 2d edit. ii. 961; or 2d Amer. edit, by
 Carson.  Philad. 1846. 
680                       VERATRIA.
appearance.   On cooling, it forms a translucent mass, having the
appearance of amber.  When distilled on the naked fire, it swells
up, is decomposed, forms wrater,  much  oil, and leaves behind a
bulky coal.
   According  to Couerbe,1  when  prepared  in  the  modes above
mentioned, it  still contains  several other substances, sabadillina,
veratria,  gum-resin of  sabadilla, and a black greasy substance,
which unites  the other  matters,  and conceals their  properties.
These may be separated  from each other by the successive action
of water, ether  and  alcohol, as in the following table:
                                      )1.  Sabadillina,   which
                                         crystallizes on cooling
                                      2  Ravin nf iip.ratrin. Ipi
Commercial
  veratria,
                                      2. Resin of veratria, left
                                         in the cold solution.
             -{                       [ 3.  Veratria,  soluble  in
                   l  hi  '   h •]•    I    ether.
                                  °-{ 4. Gum resin of veratria,
                                         insoluble  in  ether, but
                                         soluble in alcohol.
   On  account of its very high price, and  want  of well defined
external characters, the veratria of the shops is said to be very
subject to adulteration; and there would not seem to be any good
criterion for ascertaining its  degree of purity.2
   Simon, an apothecary of Berlin, has affirmed, that he has found
two alkaloids in veratrum album ; one of which possesses the pro-
perty of being precipitated  from its solution  in  acetic  or phos-
phoric acid  by sulphuric acid and its salts, like  baryta;  hence he
has given it the name barytin?
            EFFECTS  ON THE ANIMAL ECONOMY.
   Regarding the effects of veratria on animals, Magendie4 has the
following remarks :—A very small quantity of the acetate placed
in the  nostrils of a dog, instantly excited violent sneezing, which
continued for a  long time.   One or two  grains,  placed in the
mouth, immediately occasioned profuse ptyalism.   When a small
quantity was introduced into any part of the intestinal canal, and
the body was opened  to notice its  effects, the intestine was ob-
served to be much indurated, and to relax  and contract alternately
for a certain length of time.  The part of the  mucous membrane
with which the veratria is made  to come  in contact, is inflamed ;
the irritation spreads, and vomiting and purging are excited.  In

  1 Annales de Chimie et de Physique, ii. 308.
  a Christison,  Dispensatory, p. 806.  Edinb. 1842.  See, as regards its adulteration
with lime, Versmann, cited in Med. Examiner, Oct. 1845, p. 626.
  8 Pharmaceut. Centralblatt,  1837, p. 191, and Medicinische Annalen, B. iv. H. i.;
S. 9. Heidelb. 1838.
  * Journal de Physiologie Experimen. i. 56; and Formulaire pour la Preparation, &c.
de plusieurs Medicamens. 
VERATRIA.
681
much stronger doses, the circulation is accelerated, as well as the
respiration ; and tetanus supervenes, soon followed by death.  The
effects are still more rapid, if one or two grains be thrown into
the cavity of the pleura, or tunica vaginalis.   In less than  ten
minutes death occurs, preceded by tetanic convulsions. The same
quantity,  thrown into the jugular vein, induced tetanus and  death
in a few seconds.   Dissection showed, that, even in this case, the
veratria had acted on the intestinal canal, the mucous membrane
of which was  found injected.  The lungs, also, exhibited traces of
inflammation and engorgement.
   Veratria, in large doses, would,  doubtless, exhibit  the  same
effects on the human  organism.   The  taste is  very acrid,  but
without bitterness: it excites a copious flow of saliva, even  when
a small quantity only has been introduced into the mouth.    Al-
though it  has  no  smell, it must not be brought too  close to  the
nose, when in the  state of powder, as it occasions, even  in very
minute quantity, violent sneezing, which may prove dangerous.
A quarter of a grain immediately induces copious evacuations, and,
in a somewhat larger dose, more or less violent vomiting.
   According  to Turnbull,  who has  immoderately extolled this
remedy, its effect is very different, according as  it is  exhibited
internally  or externally.  Externally, it may be applied for weeks
and months, without the supervention of  any of the  effects that
succeed its internal administration.   Exhibited in this  way, it
diminishes internal  nervous  excitement;  assuages  pain, but does
not act on the intestinal canal.  In dropsical cases, it  is stated to
be one of  the greatest promoters of the urinary secretion that we
possess.  The  part of the skin on which it is rubbed, either in
solution or ointment, even when the friction has been continued
for a long  time, exhibits no evidence of irritation; when, however,
the dose has attained a certain extent, the patients feel a conside-
rable degree of heat, and a kind of pricking sensation in the rubbed
part, whence it may be  concluded, that the article is  active, pure
and genuine:  under more prolonged use, this feeling of warmth
and pricking extends over the surface of the whole body; and, in
some  cases, involuntary twitchings have been observed in  the
muscles of the mouth and eyelids.   These symptoms, however,
pass off, when the  frictions  are discontinued for  a day or two.
Only in a  few  cases, according to Turnbull, was any  eruption in-
duced by its application.  The endermic use of the remedy always,
however, excited so much irritation as to prevent its repetition.
   Thus much  for Turnbull:—His views and experience have by
no means  been confirmed by the  generality of observers.  The
external application of  veratria cannot always  be used without
local irritation ensuing.   An English  physician, labouring under
rheumatism of the arm, rubbed upon  it an ointment composed of
twenty grains  of veratria to an ounce of  lard; and, immediately 
682
VERATRIA.
afterwards, so  much pain was induced jn  the part,  that he was
obliged to  take opium to obtain rest; an eczematous eruption sub-
sequently  appeared on  the arm,  but the  rheumatism' remained.
Ebers applied it endermically, but witnessed nothing  more than a
violent burning in the part, such as is commonly the case with
other agents.  He frequently observed the pricking sensation men-
tioned  by  Turnbull, and it was  often to such  an  extent  as  to  be
almost insupportable.   According  to the trials of Ebers, its diu-
retic effect was not restricted to dropsy, but was usually evinced
in other diseases.   The sensorium  appears never  to have been
implicated, but when applied in  small doses  over the pit of the
stomach, it produced striking effects on the  spinal marrow, and
the nerves connected therewith,—as  the nerves of the thorax and
abdomen:  violent pain was experienced, which spread  through the
whole extent of the nerves  distributed  to  the parietes of the ab-
domen, with a sense of  traction  along the spinal  marrow, twitch-
ings,  great anxiety, orthopncea, nausea and vomiting, and a feel-
ing which  the patient was  unable to describe,  except  that it was
almost intolerable.
   When given internally, veratria speedily caused nausea,  retch-
ing, vertigo, and  complete loss of  appetite;  so that  Ebers soon
abandoned its internal use, and, like Turnbull,  gave the preference
to the external.
   Owing to its presumed effects on the nervous system, and es-
pecially on the spinal marrow, and the nerves connected with  it,
it was  suggested in  nervous diseases—particularly in neuralgia,
prosopalgia, and ischias—in which it is said  to  have been most
efficacious, by  Turnbull,  Ebers,1  Briick,  Suffert,2 Professor  S.
Jackson,3  Cunier,4  Calve,5  F. A. Gebhard,6  and others.   In  no
class  of diseases, according to the first of these writers,  have the
beneficial effects  of the  ointment of veratria exhibited themselves
more  strikingly, and by  no other remedy has the same amount of
relief  been induced in so short a time.  Even in tic douloureux,
a single friction is said to have been  sufficient to remove the dis-
ease without relapse.  Two circumstances  chiefly have here to be
borne in mind,—first, the  extent of the pain, for when  it  is not
concentrated on  a point, but spreads along the  branches of the
nerves, the cure  is easier, and a weaker ointment is needed; and,
secondly, the duration of the affection.   In long protracted  cases,
  1 Casper's Wochenschrift. 1837, No. 47.
  a Berlin, Medicin. C^ntralzeitung,  1837, p. 673, and Heidelberg. Medicin. Annal.
B. iv. H. 1,S. 11.
  3 American Journal of Pharmacy, vol. iii. new series, p. 186.  Philad. 1838.
  ' Bulletin Medical  Beige, Dec. 1^37, and Bullet. General de Therap., D-e. 1F3S
See, also, Forcke, Phy^i do^is^h tlinrapautBche Untersudiun^nn uber das Ve atria,
Hannov. 1S37; cited in  Bib. Goner de, Encyclog. des Sciences Medicale5!, Aout, 1838.
  s Cited in Braithwaite's Retro-ipe^t, x. 24, Amer. edit.  New York,  1M5.
  s Zeitschrift fiir Therapio und Pharmacodynamic Freiburg, Doc. 1841; ciied in
Amer.  Journ. of the Med. Sciences, Jan. 1S46, p. 203. 
VERATRIA.
683
a complete  cure  is  far more difficult, and  can, in general, be
effected only after a long period.   The paroxysms, however, may
be relieved  by an  ointment composed of from twenty to forty
grains to an ounce of lard.  In  this  case, it  must be strongly
rubbed in, so as  to  excite itching,— care  being taken, however,
that  the ointment does not touch  the conjunctiva, as the smallest
quantity of veratria  would induce violent inflammation.  In many
cases of prosopalgia M.  Lafargue1 introduced it  by inoculation
with singularly good effects.  The plan he pursues is nearly the
same as  that for  vaccination.  Several  punctures are  made with
the point of a lancet charged with a  saturated solution of the
alkaloid. Each puncture becomes at once the seat of a sharp pain,
which is  usually compared by the patient to a continued deep
pricking  with the point of  a needle.   This unpleasant sensation
lasts for from five to fifteen  minutes, and then gradually subsides;
and with it  the red  areola that has formed around  the punctured
spot.  M. Lafargue recommends, that  in severe cases the inocu-
lation should be repeated morning and  evening; and that as many
as ten or twelve  punctures  should be made at a time.  He has
used the  same method with decidedly good effects, in several cases
of partial paralysis.
   Ebers, likewise, found advantage from its use in  chorea, hypo-
chondriasis and  hysteria;  and  Turnbull, and F.  A. Gebhard,2
in paralysis.   Both Ebers  and  Turnbull extol it in rheumatism
and goid, in relation to which Ebers remarks, that it has appeared
to him more efficacious when the nervous system, or some nervous
branches were  predominantly affected,  and when the  gastric af-
fection was  entirely removed.  In the cases treated with it, relief
was sooner obtained, and  the cure was more speedy and complete,
than when other agents, were employed; the secretion of urine was
augmented; restlessness disappeared; and sleep returned, without
any  evidence of narcosis.   As regards acute rheumatism, Turn-
bull  remarks, that veratria is not to be preferred to antiphlogistics;
in these cases, a weaker ointment must be used (ten grains to the
ounce:) in chronic cases, the quantity may be carried much higher;
and—especially when extensive  organic changes have supervened
in the parts—it must be continued for a great length of time. In
lumbago, ischias and  rheumatism of the  chest,  not more  than
one or two rubbings were  generally necessary.  In gout, according
to Turnbull, it may be exhibited  both  internally and externally;
in the former mode of administration, he compared its efficacy with
that  of colchicum:  the latter has been  recommended by Sir C.
Scudamore.  It  was likewise found,  by Bardsley,3 very advan-
tageous in chronic rheumatism.   In cases of severe  local suffer-

   ' Cited in Edinb. Med. and Surg. Journal, Oct. 1843.            a Op. cit.
   3 Hospital Facts and Ob.-ervations, illustrative of the Efficacy of Strychnia, Brucia,
Veratria, Iodine, &c.  Lond. 1830. 
684
VERATRIA.
 ing, the ointment composed of veratria  and opium, the form for
 which  is given  hereafter, has  afforded  marked  relief.  In two
 epidemics of hooping cough, Dr. F. A. Gebhard1 found that great
 benefit was experienced, where the second stage was of protracted
 duration, from rubbing it over the vertebras of the neck and upper
 part of the  back.   Dr. Bushnan has strongly recommended the
 ointment in dysmenorrhcea, which  he supposes may be frequently
 owing to perversion of the nervous action of the lower portion of
 the spinal nerve;  and in certain spasmodic affections of the larynx,
 presumed by Dr. Tunstall2 to be connected with a morbid condi-
 tion of the superior portion of the spinal marrow, it is asserted to
 have been efficacious.   It has also been used in amaurosis, the
 ointment being  rubbed  on  the  temples  and forehead for a few
 minutes, once or  twice in twenty-four hours.  The friction should
 be continued until it causes redness, heat, and stinging.  Messrs.
 Lawrence3 and Tyrrel, however, affirm,  that it is wholly ineffica-
 cious.
   Veratria  would seem to have been most efficacious in cases of
 dropsy. " Unadulterated veratria," says Ebers, " acts often on the
 urinary secretion  with magical powers, and it may seem fabulous,
 when I state, that friction with a  very weak ointment two or three
 times in the  twenty-four hours on  the inner part of the thigh, or
 the back, epigastric region, or around the navel, has excited such
 a copious secretion of urine, that the patient, under its long conti-
 nuance, began to  feel weak; and  the anasarca, and even the drop-
 sical accumulation in the abdomen, in a  short time  almost disap-
 peared—circumstances which indicate the caution that ought to be
 observed in  apportioning the dose, when we are satisfied of the
 goodness of  the  article."  He properly  remarks, however, that
 veratria, by augmenting the secretion of urine, may not remove the
 dropsy;  still, by  occasioning the  absorption of the fluid, it allows
 the physician to  examine as to the existence of organic mischief.
 Ebers gave it in many of the lighter hydropic cases, which fol-
 low  intermittents  and other forms of fever, and often with
 great and rapid  success; likewise, in twenty-four more serious
 cases, fifteen  of which recovered,  and one  experienced relief: eight
 very complicated  cases terminated fatally, and in four of these di-
 uresis occurred ;  in  four not.  Dr. F. A.  Gebhard4 found more
marked effects from it in dropsies consequent  upon long  and
exhausting disease; and particularly in  cases which  supervene
on a severe typhoid  epidemic, which  he witnessed.  Fricker5

  1 Op. cit.              a Provincial Med. and Surg. Journal, Aug. 14, 1841.
  * A Treatise on the Diseases of the Eye, Amer. edit, by Hays, p.519. Philad. 1843.
  4 Op. cit.
  5 Wiirtemb. Medic. Correspondenzblatt, B. vi. S. 157 and 341; and Heidelb. Medicin.
Annal. B. iv. H. i. S.  15. 
VERATRIA.
685
likewise obtained very good effects from the use of an ointment of
it in dropsy; but, on the other hand, Spath found it of no avail.
  Turnbull observed, from the internal use of veratria, as well as
from its application to the pit of the stomach, a diminution in  the
frequency and force of the  pulsations of the  heart; and, in cases
where they were more excited than natural, restoration of a regu-
lar  circulation.  He exhibited it, consequently, in heart diseases,
especially in those  of gouty and, rheumatic diathesis, in simple
nervous and gouty palpitation, and  as a diuretic in organic
heart diseases, in  which it frequently seemed to afford relief.
  The  observation of Turnbull—that the external application of
veratria, in  chronic rheumatism with swellings of the joints,
caused  them to disappear—induced him to  try it in glandular
swellings:  he found, that in goitre, swellings of the mammary
glands  unaccompanied with pain,  buboes, and scrofulous  tu-
mours  of various parts, even  in cases in which iodine had failed,
it rendered essential service.  It has, according to him, the advan-
tage, that the skin is not subsequently irritated by it, and when, after
the rubbing, the superfluous ointment is washed off with soap and
water, the affected parts can soon afterwards be exposed  to  the
air.  Of an  ointment formed of ten grains of veratria to half an
ounce of lard, a  piece, about the size of a nut, is rubbed  in for  ten
minutes twice a day, and every week the strength of the ointment
is increased.
  Magendie1 recommends, that veratria should be given, also, as
a drastic cathartic, especially where a speedy action on the bowels
is needed.   Prescribed with this view, it has been found effective
in several aged  persons, in whom a collection of excrement had
formed in the large intestine.   Turnbull advises it in  the dose of
half a grain—in the opposite condition of the bowels—diarrhoea
—a disease, in  which, it is well  known,  our ordinary cathartics
often prove  serviceable.
  It would appear, as before remarked, that veratria  is an article
which is frequently adulterated.  Such, at least, is the  opinion of
many practitioners, and in this way they account for the  discord-
ance amongst observers as to its virtues.2   The article with which
Ebers made  his first trials was obtained from  the French labora-
tories;  and it exhibited the whole power of this heroic agent:  on
employing, however, a new preparation, he found  the latter  en-
tirely useless; whilst from another he derived all the benefit ob-
tained from the first.  The observations of Ebers would  induce us
to make farther trials with it, but the author must confess that  his
experience, thus far, has by no means  confirmed the eulogiums of

  1 Formulaire pour la Preparation, &c, de plusieurs nouveaux Medicamens.
  1 Ebers;  and Riecke, Die neuern Arzneimittel, u. s. w. S. 407, and 2te Auflage, S.
641.  Stuttgart, 1840.
44 
686
VERATRIA.
 Turnbull; and this, he thinks, is the general sentiment of the pro-
 fession.1   It has often been used externally by him as well as by
 other American physicians, but it has almost  always fallen short
 of the mark.3
                   MODE OF ADMINISTRATION.
   Veratria  may be given either in pill or in spirituous  solution ;
 the  dose being from one-twelfth to one-sixth of a  grain several
 times a day.  Externally, it is best administered in the form of
 ointment, or endermically.
                       Liquor veratria.
                       Solution of veratria.
             R.  Veratriae gr. j.
                 Aq. destillat. fgij.   M.
   A dessert-spoonful to be taken in one or two ounces of sugared
 water, in cases of tic douloureux.                 Magendie.
                       Pilulae  veratriae.
                        Pills of veratria.
             R.  Veratriae gr. ss.
                 Acaciae 9j.
                 Syrup, acac. q. s. ut fiant pilulas vj.
   Dose.—One pill, to be  repeated two or three  times a day, ac-
 cording to circumstances.                           Magendie.
             R.  Veratriae gr. j.
                 Glycyrr. pulv. gr. xii,
                 Ext. hyoscyam. gr. vj.
             M. fiant pilulae xij.
   Dose.—One, three times a day.                    Turnbull.
                      Tinctnra veratriae.
                      Tincture of veratria.
             R.  Veratriae gr. iv.3
                 Alcohol, f ^j.   M.
   Dose.—Ten, fifteen, twTenty, to  twenty-five drops in a glass of
 water.—Given in dropsy.                          Magendie.
   Magendie recommends  that the tincture  should also be  used
 externally, in cases of dropsy or gout.
                    Linimentum  veratriae.
                     Liniment of veratria.
             R.  Veratriae gr. viij.
          Solve in
                 Alcohol.
                 Tinct. sapon. camphorat. aa. f ^ss.  M.

  1 Gully's translation of Magendie's Formulary; and Joy, in Tweedie's Library of Me-
dicine, v. 289.   Lond. 1840; or 2d Amer. edit.  Philad. 1842.
  a See, on the preparation, employment, action, and medicinal virtues of Veratria,
Ebers, in Hufeland's Journal, B. lxxxvi. 1838.
  a In the Pharmacopee Vniverselle of Jourdan, (ii. 643,) there is the serious error of
directing §iv. in the preparation of this tincture, in place of four grains! 
VERATRIA.
'687
                      (Huile de Veratrine.)
           R.  Veratriae gr. xvss. (1 gram.)
               Olei jecoris aselli ^viss. (25 gram.)  M.
  Used in the form of friction in inveterate neuralgia.1
                                                 Jourdain.   ■
                   Unguentum  veratriae.
                    Ointment of veratria.
           R,  Veratriae gr. v. x. vel xx.
               Adipis §j.
         Misce intime.
  For external  use.   The  size of a  hazel-nut  to  be carefully
rubbed in, morning and  evening, or oftener, for from five to fif-
teen minutes.                                     Turnbull
          R. Veratriae ^j.
       Tere cum
              01. olivae 3J.
       Et adde
              Unguent, cetacei ^vij, Misce.
              Unguentum veratriae  et  opii.
              Ointment of veratria  and opium.
           R.  Veratriae £ss.
               Opii pulv. gi.
               Adipis giss.  M.
  To be  rubbed on the part  in severe  bodily suffering from rheu-
matism.
  The uncertainty in the action of the ointment of veratria having
attracted the  attention  of M. Sauvan,3 he found, by accident, that
the difference did not proceed from the veratria, but from the fatty
matter employed.   With fresh pure lard, the ointment was of bad
quality;  whilst with bad or rancid lard, a satisfactory ointment
was obtained.
  Sulphate of Veratria— Veralrix Sulphas—possesses the
same virtues as veratria.   Magendie gives the following form for
internal administration;—
               Solutio veratria sulphatis.
               Solution of sulphate of veratria.
           R. Veratriae sulphat. gr. j.
               Aquae destillat. f ^ij.   Misce.
  Dose.—f 3j. to f 3iv. in a mixture.  The preparation has been
suggested as a substitute for the Eau medicinale d'Husson.

  1 Bouchardat, Annuaire de Therapeutique, &c. pour 1847, p. 3a  Paris, 1847.
  8 Ibid, pour 1843, p. 43.  Paris, 1843, 
688
ZINCI CHLORIDUM.
               CLXXII.  ZINCI CHLORIDUM.
Synonymes. Zinci  Chloruretum, Zincum Chloratum  seu  Muriaticum
  Oxydatum seu Salitum, Chloruretum Zincicum  seu  Zinci,  Chlore-
  tum Zinci seu Zincicum, Butyrum Zinci, Murias Zinci seu Zincicus,
  Chloride, Chloruret, Hydrochlorate, Muriate, or Butter  of Zinc.
German. Zinkchlorid, Salzsau res od er C hlo rwas se r sto f f-
  saures Zink, Salzsaures Zinkoxyd,  Chlorzink,  Zink-
  chloriir, Zinkbutter.
                   METHOD OF  PREPARING.
  Chloride of zinc results,—when to any given quantity of pure
muriatic acid, pure oxide of zinc is added, by the aid of gentle
heat, until no more is dissolved:  the  solution is then filtered, and
evaporated in a porcelain dish to  dryness; whereby  a jelly-like—
and  by high drying,  firm  white,  and by careless  drying, light
brownish—substance,  remains, of  an  austere, sourish,  metallic
taste, which  must  be rubbed to powder, and  preserved in a close-
ly-stopped vessel.   In  the  last edition of the Pharmacopoeia of
the United States  (1842) it is directed to be prepared as follows:
—Take  of zinc,  in small  pieces,  3iiss.; nitric  acid, prepared
chalk, each  3'u',  muriatic acid, a sufficient  quantity.  To  the
zinc, in a glass or  porcelain vessel, add gradually sufficient muria-
tic acid to dissolve it;  then strain; add the nitric acid, and evapo-
rate to dryness.  Dissolve the dry mass in water, add the chalk,
and, having  allowed the  mixture to  stand for twenty-four hours,
filter, and again evaporate to dryness.
  Chloride of zinc is very deliquescent in the air, forming butler
of  zinc (butyrum zinci, German, Zinkbutter.)   It  is very
soluble in water, alcohol,  and ether.
                 EFFECTS ON THE  ECONOMY.
  Chloride of zinc has been exhibited both  internally and exter-
nally, but  chiefly  in the latter mode, especially in  this country.
Papenguth1 found  a very dilute solution, applied in the form of lo-
tion, useful in flabby  scrofulous ulcerations; and  in sinuous
ulcers, in the form of injection.  It  has been especially recommend-
ed  as  a caustic that  does  not exert any disagreeable  influence,
like corrosive sublimate, arsenic, or potassa fusa;—neither causing
violent pain in  the affected parts, nor any kind of irritative fever;
nor disordering the digestive organs, as some  of the articles  just
mentioned.   Hancke, indeed,  advises, that arsenic should be en-
tirely banished from therapeutics as a caustic agent, and that chloride
of zinc should be substituted for it.   He employed it with success
in old atonic ulcerations of the  feet, in the strength of two grains
to the fluidounce of distilled water:  with this he wetted lint, and
applied it two or three times a day.  With like success, he used it

                  1 Nouveau Journal de Medecine, 1819. 
ZINCI CHLORIDUM.
689
in old syphilitic ulcers, with extremely morbid surfaces and
secretions: the chloride destroyed the degenerate formations, and
effected  cicatrization.  In scrofulous and malignant  herpetic
ulcers, he prescribed a concentrated solution; in pityriasis he used
it as a wash, and in wounds and  ulcerations with fungous for-
mations, he applied it in a concentrated state: in phagedenic ulcers
of the face, it effected a more certain  cure than the method of
Cosme,—the chloride being  strewed, a line thick, in a  dry state,
over  the whole surface of the ulcer, the  edges surrounded w7ith
adhesive plaster, and a plaster placed over the chloride of zinc, with
compresses and an appropriate bandage.   In  nasvi materni, an-
giectasis, &c, he applied it in the same manner, as well as in the
pustule maligne, (Milzbrandkarbunkel.)  Mr. Carmichael1
States, however, that  he has  used it in  several instances, and
has come to the conclusion, that, although not so objectionable as
the arsenious acid, on account of the  poisonous nature of the latter,
it excites as much pain and  inflammation,2 without destroying, to
the same extent, the carcinomatous  substance.
   A case of phagedenic ulcer of the septum narium, which had
resisted all the topical applications made to it—corrosive chloride
of mercury, arsenious acid, red oxide of mercury, sulphuric acid,
nitric acid, &c, was treated by Dr. Zwerina of  Vienna, with a
solution of chloride  of  zinc,—a grain and  a half of the salt to an
ounce of distilled water,—with entire success.   The scabs being re-
moved, the  sore was pencilled over several times  a day with the
solution.  At the end of a fortnight, a healthy granulating surface
was found beneath the thick crust, which  now covered  the sore,
and this  being  removed from  time  to time, and  the solution re-
applied, at the  end of five weeks the cicatrix wTas perfect and the
patient well.3
   The chloride has also been prescribed internally in cases of can-
cerous ulcerations, and with apparent benefit.  Mr. Tuson* gives
cases in which  its internal and external use combined was produc-
tive of great advantage.  He gave half a grain  of the chloride
every  morning after  breakfast in  a wine-glassful  of  carraway
water.
   By Mr. Guthrie, chloride of zinc has been used in necrosis to
penetrate the hardened case of new bone.  It attacks the animal
tissue of the bone, destroys it, and thus causes the  earthy matter
to soften and become detached.  The sequestrum is by this means
exposed  with  little  pain or  disturbance of the  part, and may be

   1 Dublin Medical Press, March 4, 1840.
  1 See, also, Vogt, Pharmakodynamik, i. 363,  2te Auflage; cited by Pereira, Elements
of Mat. Med. i. 821, 2d edit  Lond.  1842, or 2d Amer. edit.  Philad. 1846.
  2 Cited in Lond. and Edinb. Monthly Journal of Medical Science, July, 1843, p. 650.
  * London Lancet, Jan. 13, 1844, p. 502; and Tuson on  the Female Breast, p. 399.
Lond. 1346. 
ego
ZINCI CHLORIDUM.
dealt with according to circumstances.1   Mr. Callaway,3 of Guy's
Hospital, London, employed it  with considerable success in  the
cure of  cutaneous and subcutaneous naevi  materni.  It was
directed  to be rubbed  on the part until  the  skin  became  slightly
discoloured,  and to be repeated at intervals.   Mr. Alexander Ure
and Mr. Liston,3 found it extremely useful in the varieties of ero-
sive ulcers called lupus, which were often speedily checked, and
the disease permanently cured by the local use of it.   They applied
it in a paste, made with one part of the chloride and two or three
parts of the anhydrous sulphate of lime—a modification  of Can-
quoin's formula (see below,) recommended some years ago.4  One
or two applications of the paste were  generally sufficient to pro-
duce a proper eschar, and when this was detached, the sore was
treated with water dressing.5   A case is related by Dr. Davidson,6
of malignant ulcer under the left  ear, which  was cured by the
unmixed chloride of zinc, applied repeatedly until the ulcer assumed
a healthy character.   Hancke used it likewise for the formation
of issues, which it established in  from six  to  eight  hours;  and,
lastly, to excite rubefaction on the surface, either applied in the
form of  solution of the chloride  in water or wine, or mixed with
oil or  lard into  an ointment, and rubbed on the skin: in this way,
a gritty kind of eruption of a scarlet hue is induced, which is said
to have afforded  relief in paralysis of the limbs.
   Wendt, Vogt, and Canquoin have highly extolled the chloride
as a caustic, and it has been largely employed by the  physicians
and surgeons of this continent, especially in  the Philadelphia Hos-
pital,  and Pennsylvania Hospital,  in similar cases to those men-
tioned above.   Dr. Davidson7 is of opinion, that it is only superior
to many other caustics in cases where the destruction of a consi-
derable  thickness of  texture is required, or  where the removal of
an excrescence by a caustic is preferred by the patient to the knife:
the  nitrate  of  silver  seems, he considers, to  be  superior in pro-
moting  a sound  action, when the  unhealthy surface or stratum of
the  ulcer is  superficial.
   Hancke8  has  used the chloride internally, with advantage, in
cases  of epilepsy, as  well as in St. Vitus's dance; and  has pre-
scribed it, united with hydrocyanic  acid, in prosopalgia.  Hufe-
land, also, extols a solution of it in all  those neuroses in which the

  1 James, Retrospective Address before the Provincial Medical Association, in the Trans-
actions of the Association.  Lond. 1840.
  2 British Annals of Medicine, May 19, 1837.
  3 London Lancet, Sept. 21, 1844, p. 775.
  « London Medical Gazette, Dec. 19, 1835.
  5 Lond. Med. Gaz., Dec. 3, 1836.  See a case of noU me tangere of the nostril, and
one of phagedenic ulcer of the arm, cured, in  London Lancet, cited in Boston Med. and
Surg. Journ. Nov. 4, 1840, p. 215.
  6 Edinb. Medical and Surgical Journal, Jan. 1838.
  ' Op. cit., and American Journal of the Medical Sciences, May, 1839, p. 238.
  8 Rust's Magazine, xxii. 373; and Journal de Pharmacie, xvi. 549. 
ZINCI CHLORIDUM.
691
oxide of zinc is indicated, and especially in such  patients as are
not readily impressible.1   By Dr. Stanelli,2 when  liquefied by ex-
posure to the air, it is considered an excellent remedy in toothach.
By means of a camel's hair pencil, a small quantity is applied to
the cavity of the tooth, and in the space of a few minutes the most
acute sufferings are  said to be  appeased.  Before using it, it is
indispensable to surround the tooth carefully with  cotton wadding,
and when it has been applied, to fill the cavity well  with the cotton.
The mouth is finally  washed with a little  warm water.
   M. Gaudriot3  considers, that  when  properly  diluted, it has
great effect  in curing simple blennorrhcea of the urethra and
vagina.  To remove the disease readily in men, it is  generally
sufficient to  use the  injection given below thrice a day for two
or three days.  The first injections are  almost  always followed
by more or less swelling  of the  glands, but this does not prevent
their continuance.  In women,  four or six of the suppositories
mentioned  below are sufficient to produce a cure.   The  first ge-
nerally occasions swelling, with  more or  less  heat of the vulva;
but these symptoms soon disappear.
   Several years since, a patent was obtained by Sir William Bur-
nett for a process, discovered by him, for  preserving timber, can-
vass, &c, from dry rot, mildew, &c.  The preserving  substance is
chloride of zinc in  solution.  It was entirely effectual.   Since then
the  solution  has been employed  as a disinfectant  of dead bodies,
and the testimonials of  Messrs. Bowman, Sharpey,  and W. V.
Pettigrew, have been publicly  given in its favour.4   Mr. Petti-
grew, in a letter to Sir William, dated March 24, 1846, says, "I
have now used extensively your preparation  for  the preservation
of animal matter, and find that it succeeds most completely.   From
the 3d to the 28th of February, I lectured upon  the superior ex-
tremity.  The arm, when received, was green in colour, and highly
offensive.  I injected the arteries with the  fluid, mixed  in  the
proportion of one  pound of chloride of zinc to  three gallons of
water, and as the dissection proceeded, the surface of the limb was
sponged about every  alternate day with  the solution.  It was per-
fectly restored to its  former  fresh condition.   I have also placed
various portions of the  body in the solution,  and they at present
remain quite free from putrefaction.  All our  subjects are now in-
jected with the fluid, immediately they  arrive; and I do not hesi-
tate to say, that our  dissecting room is  more free from unpleasant
odour than any room of  the kind in the metropolis, and the great
advantage this fluid possesses over all others we  have as yet tried

   1 See Merat and De  Lens, art. Zinc (chlorure de.)
   2 Cited in London Medical Gazette, Feb. 16, 1844, p. 672.     ,„»„,„
   8 Journ. des Connaissances Med. Sept. 1840; cited m Brit, and  For. Med. Rev.

   1 London Medical Gazette, cited in Medical Examiner, June, 1846, p. 374. 
692
ZINCI CHLORIDUM.
JS)—that it has no effect upon the knives.  I cannot but consider it
one of the greatest boons conferred upon  the  profession.   Dis-
section may  be carried on  in  the  hottest weather, without the
slightest  injury to the breath, or offence from smell."
  The value of chloride of zinc as an antiseptic  has been fully es-
tablished in the dissecting rooms of Philadelphia and elsewhere; but
there is no reason for believing  that it is a disinfectant in the sense
of destroying contagious or other morbific miasmata.  It is an ex-
cellent antibromic, but as it does not give off any antiseptic vapour,
its action is restricted to the substances with which it  is brought
into immediate contact.  Dr. Stratton,1 however, is disposed to be-
lieve, that it  acted  as a true disinfectant  by destroying miasmata
in the Quebec Marine and  Emigrant Hospital, of which he had
charge in the autumn of 1847.   He found,  that one ounce  of the
strong fluid was sufficient for every ten persons.   This strong fluid,
known under the name of Sir William "Burnett's Disinfecting
and  Antiseptic  Fluid,"  contains  25 grains of zinc in  every
fluidram; and  in using it one  pint is mixed with five gallons  of
water.2  He  removes the disagreeable odour in  hospital wards
full of typhus  and dysentery cases, by waving  flannel cloths wet
with a dilute fluid—one part to 40 of water—two or  three times
a day, for  a few minutes at a time, and by sprinkling some of it
on  the floor.   "Next to perfect ventilation," he says, "I would
place the use of Burnett's  solution of  the  chloride of zinc.  On
many occasions, as in badly  constructed buildings, in cold weather,
and on board ship in stormy weather, ventilation is impracticable,
and recourse  must be had  to some other means of improving the
quality of the air, and it appears to me, that the chloride of zinc
solution  is much  superior  to all the other artificial  methods  of
doing so, including Ledoyen's solution of the nitrate of lead."
(See Plumbi Nitras.)
  Dr. Stratton saw a case of lupus, in  which the " Burnett fluid "
was as effectual as, and more convenient than, the solid chloride
of zinc.  The fluid diluted—one to 130 parts of water—was found
very  beneficial as an application to chronic and scrofulous ulcers
by  Dr. Allan, Mr. Erasmus Wilson, and others; and in mercurial
sore  throat  by Mr. Flynn.   In the proportion of one part to sixty
or eighty of water—it is said to be an excellent lotion in erysipe-
las, and  a valuable lotion or bath in psora,prurigo,pruritus, and
other cutaneous diseases.  When introduced of the full strength
on  the point  of a pen into the cavity  of a  tooth, it has proved ser-
viceable  in some cases of toothach.   Diluted  with one  hundred
and forty parts of water, it removes  the fcetor from gangrenous
frost-bites.   Dr. Stratton  has no doubt, that  it will  be found a
good remedy,  when diluted with one-hundred  and forty parts of
            ' Edinb. Med. and Surg. Journ.  Oct. 1848, p. 287.
           3 Pharmaceutical Journal vii., 60 and 107, Lond. 1847. 
                       ZINCI CHLORIDUM.                   693

water as an injection in fetid otorrhcea ; and as a gargle in some
throat diseases.   It has also been used as an injection in gonor-
rhoea.   The action of the diluted fluid  on cancerous and other
sores, is like  that  of other antiseptics; it removes the fcetor, and
induces a new action in the part  of the system  of nutrition im-
plicated in the ulceration.
                  MODE  OF ADMINISTRATION.
                    titittic zinci chloridi.
                  Drops of chloride of zinc.
                          JEther Zinci.
                 R.  Zinci chlorid. gr. j.
                     Sp. aether, muriat. seu sulphuric, f gij.  Solve.
   Dose.—Five drops, every four hours, in a little sugared water;
gradually increasing the  dose  to ten drops, in chorea, epilepsy,
prosopalgia, &c.                         Hufeland fy Hanke.1

                    Lotio zinci  chloridi;
                  Lotion of chloride of zinc.
              R.  Zinci chlorid. gr. viij.
                  Ext. aloes aquos. J)ij.
                  Aquae destillat. f Jiv. Solve.
   Applied to  the  dressings,  in cases of atonic scrofulous ul-
cers.                                                  Vogt.
   Qr, the aloes may be admitted.

                   Injectio  zinci  chloridi.
                 Injection of chloride of zinc.
              R.  Zinci chlorid. liquid.2 gtt. xxiv.—xxxvi.
                  Aquae destillat. f giv.
   Filter through paper.   A small quantity of this to be injected
about an inch along the urethra, two or  three times a day.
                                                   Gaudriot.
                Suppositorium  zinci chloridi.
                Suppository of chloride of zinc.
              R.  Zinci chlorid.  liquid, gtt. v.
                  Morphiae sulphat. gr. ss.
   Mix  with  three drams  of the following paste;
              R.  Mucilag. tragacanth. p.  vj.
                  Sacchar. pulv. p. iij.
                  Amyli pulv. p. ix.
   One of these must be introduced every day, or every other day.
                                                   Gaudriot.

  1 Lincke, Vollstandiges Recept-Taschenbuch. u. s. w. ii. 780.   Leipz. 1841.
  3 "Liquid chloride of zinc consists of a concentrated solution of pure zinc in pure chlo-
rohydric acid."—Lincke, loc cit. 
694
ZINCI CYANURETUM.
   Chloride of zinc may be applied  as a caustic, by means of a
moistened hair pencil, either alone or mixed with an equal portion
of oxide of zinc, or sulphate of lime, or according to the following
forms:—
                    Pasta zinci chloridi.
                   Paste of chloride of zinc.
                        Pate de Canquoin.
                      Canquoin's caustic paste.
                                 A.     B.    C.
              R.  Zinci chlorid.  p. i.    i.    i.
                  Farinae tritici p. iv.   iij.   ij.
                  Aquae fontan.1 q. s. ut fiat pasta.
              R.  Zinci chlorid. p. j.
                  Farina? tritici p. iss.
                  Antimonii chloridi p. ss.
                  Aq. font. q. s. ut fiat pasta.
             CLXXIII. ZINCI CYANURETUM.
Synonymes. Zinci Cyanidum, Zincum Cyanogenatum seu Cyanatumsen
  Borussicum seu Zooticum seu  Hydrocyanicum seu Hydrocyanicum
  sine Ferro, Cyanetum seu Cyanuretum Zincicum seu Zinci sine Ferro,
  Cyanetum Zinci, Prussias seu Hydrocyanas seu Cyanhydras Zinci seu
  Zincicus, Hydrocyanate, Prussiate, or Cyanuret of Zinc.
French. Cyanure de Zinc.
German. Cyanzink, Blausaures Zink oder Zinkoxyd, Blau-
  stoffzink, Zinkcyanur.
  This preparation was used in Germany for a long  time before
the process was made known.2
                   METHOD OF PREPARING.
  According to Kunze, it is directed in the Leipzic  shops to be
prepared as follows:3—Any  quantity of pure sulphate of zinc is
dissolved in ten  times as  much distilled water; the fluid is then
filtered, and decomposed by a solution of cyanuret of potassium,
or cyanuret of calcium, added by drops so long as a precipitate
is formed.   This precipitate, which consists of  cyanuret of zinc,
must be carefully washed, dried, and preserved in a glass jar, from
which  the  entrance of light is prevented.4
  It is admitted into the Parisian " Codex."
  Cyanuret of zinc has the appearance of a white, tasteless pow-
der, which is insoluble in water and alcohol, but dissolves  in the
stronger acids, with the disengagement of hydrocyanic acid.   Well
  1 To each ounce of the chloride of zinc twenty-four to thirty drops of water may be
added.
  2 Magendie, Formulaire pour la Preparation, &c. de plusieurs nouveaux  Medica-
mens, &c.
  3 Riecke, Die neuern Arzneimittel, u. s. w. S. 410.   Stuttgart, 1837.
  4 For M. Pelletier's method, see Magendie, Formulaire, &c. 
ZINCI FERROCYANURETUM.
695
prepared and  rubbed, it has a strong odour of hydrocyanic acid,
and when moistened, or exposed to heat, it gives off hydrocyanic
acid.
  As to its medicinal effects, and mode of administration, they are
analogous to those of the following  preparation:  they are there-
fore given together.
         CLXXIV. ZINCI FERROCYANURETUM.
Synonymes. Zinci Ferrocyanidum seu Ferrohydrocyanas, Cyanetum seu
  Cyanuretum Zinci et Ferri seu Ferrosozincicum, Cyanuretum Ferro-
  zincicum, Zincum Ferrohydrocyanicum  seu  Ferroborussicum  seu
  Ferrocyanogenatum seu Ferrocyanatum, Prussias Zinci et Ferri, Hy-
  drocyanas Zinci Ferruginosus, Ferrohydrocyanas Zinci, Ferrocyanuret,
  Ferro-hydrocyanate or Ferrocyanate of Zinc.
German. Eisenblausaures Zink, Blausaures Eisenzink, Ei-
  senhaltiges Blausaures Zink, Blausaures Eisenoxy-
  dul-Zinkoxyd,  Zinkeisencyaniir,  Eisenzinkcyanur,
  C yaneisenzink.
                  METHOD OF PREPARING.
  According to Schindler,1 this preparation is best made by the
mutual decomposition of boiling hot solutions of eighty-three parts
of sulphate of zinc, and sixty parts offerrocyanuret of potassi-
um.  If the sulphate of zinc be  not entirely free from iron, the
salt will have a bluish lustre, which, after long washing with  lime
water, becomes of a reddish hue.  If the bluish colour be mani-
fested, some more sulphate of zinc must be  added, and it must be
digested until the precipitate appears entirely white.
  Ferrocyanuret of zinc forms a white, insoluble, almost inodorous
powder, which is somewhat soluble in the stronger acids, without
exhaling a smell of hydrocyanic acid in the cold; but by boiling,
hydrocyanic acid is slowly disengaged.
                 EFFECTS ON  THE ECONOMY.
  Hufeland recommends the cyanuret, or perhaps, the ferrocya-
nuret of  zinc in nervous diseases.   According to him, from one
to four grains may be given for a dose, two or three times a  day,
without  any injurious effects;—the  only inconvenience being, at
times, slight nausea, but no diarrhoea, or disposition to obstruc-
tions, and no narcotic symptoms.   In cardialgia, it afforded, in
his  hands, essential service, as well  as  in some cases of epilepsy
and  in paralysis.  Henning,2 likewise found it  useful in cramp
of the stomach, hysteria, and spasmodic diseases of children
induced by worms.   In epileptic attacks from teething, he
also gave it with advantage; the dose being from half a grain to a
grain, three or four times a day.   Clarus gave cyanuret of zinc in
       1 Riecke, op. cit. S. 411, und 2te Auflage, S. 646. Stuttgart, 1840.
       a Hufeland's Journal, 1823, 
696
ZINCI FERROCYANURETUM.
 epilepsy, but he observed no other result than less frequent and
 less severe attacks.  Pohl saw no very decided effect from  it in
 the dose of from one-fourth to half a grain.   In the Berlin Poly-
 clinic  Institute, advantage  accrued from it  in  two cases of St.
 Vitus's dance; it was begun with in  the dose of one-third of a
 grain  twice a day, which was gradually raised to fourteen grains
 a day.  Klokow gave  the cyanuret of zinc—which Riecke sug-
 gests1  was the  cyanuret of zinc  and potassium, (Cyanzink-
 cyankalium,) in spasmodic  affections,—beginning at first
 with one-tenth of a grain,—as larger doses occasioned colic, diar-
 rhoea, and vomifing—and, when the patient became accustomed to
 it, gradually augmenting the dose to half a grain.   Success, he
 affirms, followed its administration.2  Muhrbeck  gave  it in violent
 periodical cephalalgia  in the region of the left frontal sinus with
 great  benefit.   He began with one-twelfth of a grain, and gradu-
 ally raised the dose to  a grain and a half.   Miiller  and Gunther
 confirm  the reports of its  efficacy in St. Vitus's dance: the first
 gave daily a grain; the latter, from  half a  grain to a grain, four
 times a day.  Kopp, who distinguishes the two preparations from
 each other, instituted experiments with both.  He used  the ferro-
 cyanuret of zinc with advantage in cramp of the stomach, general
 nervous  disorder, nervous  debility, neuralgia, nervous headach,
 and nocturnal pains in  the bones.   He gave  it in the form of pow-
 der, with  sugar of milk, every two hours, or four times a day, in
 doses of one-twelfth to  one-eighth of a grain, gradually increasing
 them.   According to his  observations, it occasions,  with  many
 persons, obstructions, but does not disorder  the  stomach.   Kopp
 found  the cyanuret still  more efficacious in the same  disorders.
 Impressible patients, who suffered under unusual sensibility  of
 the abdomen, took four powders daily, of one-sixteenth of a grain
 each, with marked  benefit.   In one case of neuralgia,  in a man,
 he raised the dose very  gradually to half a grain, four times a day.
 When, however, this quantity was exceeded, and the patient took
 five-eighths of a  grain four times a day, hyperemia  occurred in
 the  head, with constipation.   In  two cases  of chorea of one side
 of the body, the ferrocyanuret had no effect whatever.  Riecke3
 asserts that his father used it several times with advantage in scir-
 rhus of the pylorus.
   The cyanuret was applied externally, by Von Ammon, in scro-
fulous and incipient rheumatic inflammation of the eyes, as well
 as in catarrhal inflammation of the eyelids: he  prescribed it sus-
 pended by means of gum  Arabic in a mixture of cherry-laurel
 water  and  laudanum.  M. Carrier4 believes, that preparations of
 hydrocyanic acid  have  great efficacy in healing ulcers of the cor-
 nea, and causing the  absorption  of opacities.   The compound
 1 Op. cit S. 413. s Hufeland  und Osann's Journal, B. lxx. St. 2.  3 Op. citat. S. 414.
 ' Cited in Provincial Med. and Surg. Journal, Feb. 10,1844, p. 378. 
                   ZINCI FERROCYANURETUM.               697

which he prefers  is one part  of cyanuret of zinc to twenty-five
of lard.
                 MODE OF ADMINISTRATION.
   On  account of the insolubility of both the cyanuret and ferro-
cyanuret, they are best given in pill or powder.
   The common dose of the cyanuret is from one-sixteenth to one-
twelfth of a grain several times a day, gradually increasing it to a
quarter of a  grain: of the ferrocyanuret, the dose is from one to
four grains, two or three times a day.  Riecke1 advises—to pre-
vent confusion—that when  these articles are ordered, they should
be respectively denominated Zincum hydrocyanicum sine ferro
and Zincum ferro hydrocyanicum.

                   Pilulae  zinci cyanureti.
                   Pills of cyanuret of zinc.
             R.   Zinci cyanur. gr. xv.
                 Ext. glycyrrh. srij.
          Misce et fiant pilulae lx.
   Dose.—One, morning, noon, and  night, gradually increasing
the quantity.                                          Kopp.
             R.  Zinci cyanuret. gr. vj.
                  Magnesise gr. iv.
                 Cinnam. pulv. gr. iij.  Misce.
   This dose to be repeated every four hours, in nervous affections
of the stomach, especially in cases of cramp.        Henning.

              Mistura  zinci ferroeyanureti.
              Mixture of ferrocyanuret of zinc.
             R.  Zinci ferrocyanur.  gr. iv.
                  Aquae destillat. f gij.  M.
   Dose.—A fourth part, four times a day, in chorea.  Lincke.2

             Pulveres  zinci ferroeyanureti.
              Powders of ferrocyanuret of zinc.
             R.   Zinci ferrocyanur. gr. ij.—viij.
                  Sacchar. £j.  M. et divide in part. vj.
   Dose.—One to be given every two hours in cardialgia.
                                           Von Hildenbrand.

               Pilulae zinci ferroeyanureti.
                Pills of ferrocyanuret of zinc.
              R.   Zinci ferrocyanuret. gr. xv.
                  Valerian, pulv. £ss.
                  Extract, valerian, q. s. ut fiant pil. Ix.
   Dose.—One, morning and evening, in chorea.
                                    Rosensteil fy HeckenrotK.3
   1 Op. citat.
   ' Vollst'andiges Recept-Taschenbuch, ii. 778, Leipz. 1841.      * Lincke, op. cit. 
698
ZINCI IODIDUM.
                  CLXXV.  ZINCI IODIDUM.

 Synonymes.  Zincum  Iodatum,  Zinci Ioduretum, Iodetum  Zinci seu
   Zincicum, Protoioduretum Zinci, Iodide or Ioduret of Zinc.
 German.  Iodzink,  Zinkiodiir.
   This preparation is made by boiling together  iodine and zinc
 in atomic proportions, or rather with  an excess of zinc, in a flask
 of water,  to dryness, and subliming the residue.   Iodide of zinc
 is thus procured in beautiful, colourless, prismatic crystals.1  It is
 very deliquescent, and cannot easily be retained in the solid form.
 When heated in open vessels, it is resolved  into iodine  and oxide
 of zinc.  It is very liable to undergo  spontaneous decomposition,
 and, to prevent  this, Dr. A. T. Thomson proposes  that  a syrup
 should be made of it, on the same plan as the syrup of iodide of
 iron.
                 EFFECTS ON THE ECONOMY.
   Iodide of zinc has  a  caustic taste, and when  applied to a  de-
 nuded surface gives rise to  considerable smarting.   Dr. Ure2 re-
 commends  an ointment,  formed of a dram to an ounce of lard, in
 cases where the  external use of iodide of potassium is  indicated.
 Proutet advises it as  a collyrium in scrofulous ophthalmia, of the
 strength of fifteen  grains to  six fluidounces of distilled water;
 and  it has been employed to form an astringent injection, in the
 proportion of one or two grains to  an ounce of water,  in gonor-
 rhoea.  Dr. J. J. Ross3  used a solution of from 10 to 30 grains to
 the fluidounce of water, with much advantage, in enlarged tonsils.
 It was applied by means of a  sponge tied to a quill.   After the
use of the solution for some time, he applied the iodide, rendered
liquid by deliquescence, by means of a camel's hair brush.
   A double iodide of zinc and morphia ; French, Iodure double
de zinc et de morphine, is described by M. Bouchardat.4  It is ob-
tained by boiling a gramme (gr. 15.44,) of iodide of iodhydrate
of morphia, with  59 grammes (nearly f 5ij.) of water, and 10
grammes (3iiss.) of zinc,  after they have acted upon  each other
for some days.  The boiling  liquor is filtered; and  a  salt is  ob-
tained, which crystallizes readily in needles arranged in  beautiful
radiated groups.   The salt is the iodide of zinc and morphia, which
is very soluble in water and in alcohol.   The compound is con-
sidered to combine  the properties of morphia and the salts of zinc.
M. Bouchardat has prescribed it as an anodyne and anti-spasmodic.
He makes about a grain and a half into eight pills, of which he

 * Annales de Chimie, xci.
 s Dictionary of Chemistry, 2d edition, p. 516.
 8 Cited in United States Dispensatory, 6th edition, p. 1267.  Philad. 1845.
 * Nouveau Formulaire  Magistral, p. 70.  Paris, 1845. 
                      ZINCI VALERIANAS.                   699

gives one or two in the day, in  gastralgia "and  other  nervous
affections."                  ______
  For the Double Iodide of Zinc and Strychnia, see Strych-
nia.
                CLXXVI.  ZINCI VALERIANAS.

 Synonymes.   Zincum Valerianicum, Valerianate of Zinc.
 French.  Valerianate de Zinc.
 German. Valeriansaures Zinkoxyd, Baldriansaures Zink.
    This salt was first proposed by Prince Louis Lucien Bonaparte.
 It has been  much used by  the  Italian physicians, and  has been
 more recently introduced into  medical practice  in  France  and
 elsewhere.
                    METHOD OF PREPARING.
    Valerianate of zinc is prepared by saturating valerianic acid
 with the carbonate, or, still better, with perfectly pure oxide, of
 zinc recently precipitated.   The action is assisted by heat;  and
 the hot solution is filtered, and allowed to crystallize on a gently
 heated sandbath.1   It may also be prepared by double decomposi-
 tion from valerianate of baryta  and sulphate of zinc,2—or, after
 the formula of the Dublin  college, by the double decomposition of
 valerianate  of soda and sulphate of zinc.3
    The crystals form light pearly plates of a brilliant white colour.
 Cold water dissolves one-fiftieth of its weight of the salt,  and boil-
 ing water  one-fortieth.  It  is scarcely soluble  in ether.   One
 hundred parts of  boiling alcohol dissolve  six  parts.4   On  these
 points, however, chemists are not in exact accordance.
                  EFFECTS ON THE ECONOMY.
    The " physiological effects" of  the valerianate of zinc, accord-
 ing to M.  Devay,5  are scarcely more marked than  those of vale-
 rian or zinc taken  separately.  A dose  of  15 centigrammes (gr.
 2.316) which would be sufficient to check  a paroxysm of neural-
 gia, and to moderate an attack of violent hemicrania, produces on
 the healthy economy only slight headach, transient  giddiness, and
 slight depravation  of hearing.  It  has  been chiefly prescribed in
facial neuralgia and hemicrania, which have resisted  the ordi-

  ' See a note on the preparation of the valerianate of zinc, by Wm. Procter, Jr., in the
 American Journal of Pharmacy, April, 1845; and Bouchardat, Annuaire  de Therap.
 &c, pour 1845, p. 95.  Paris, 1845.                                   '
  3 Bouchardat, op. cit. p. 87.  Paris,  1845; and in Nouveau Formulaire Magistral r»
 107.  Paris, 1845.                                          6     l
  8 The Pharmacopoeia of the King and Queen's College of Physicians in Ireland, 1850
 p.  169.  Dublin, 1850.                                          '
  4 Journal de Pharmacie, Aout, 1844: Chemical Gazette, Nov. 1, 1844; and Lond.
 and Edinb. Monthly Journ. of Med. Science, Jan. 1845.
  » Gazette Medicale de Paris, 29 Juin, 1844. 
700
ZINCI VALERIANAS.
nary antispasmodics and antiperiodics, and M. Devay, in such cases,
has found it eminently successful.  Four cases of obstinate neu-
ralgia  are recorded  by Mr. Joseph Bell,1 which yielded to this
remedy after the failure of other powerful agents.   He gave it in
half-grain  doses every six hours.  It has also been prescribed in
other neuroses,—nervous headach, for example, by Boccacini and
Heiberg.3  In epilepsy, M. Devay prescribed  it, but had not  given
it for a sufficiently long period to be able to deduce any thing posi-
tive in regard to its action.   M. Cerulli3 gave it in three cases of
supra-orbitar and infra-orbitar neuralgia.  It proved success-
ful in doses of a grain and a half  daily, taken  at  the  moment of
the accession of the paroxysm.   Its effect does not seem, however,
to have been energetic; for, in one case, the cure was not complete
under thirty days;  in another under forty, and in the third  under
fifty.   It has been suggested, however, that notwithstanding its
reputed  brilliant success, it may be questioned,  whether it  be in
reality a more efficacious remedy than the ordinary salts of zinc,
and whether much of its success amongst a certain class be not in
a great degree attributable to the rarity, and the high price of the
drug.4   That such is the case, Dr. Johnson  says, is  to a certain
extent proved by the observations of Dr. Fario, an Italian phy-
sician, cited  and commented  on in  a French  periodical.5  Dr.
Fario has employed it externally in certain affections of the eye,
as blennorrhcea of the  eyelids, ulcers, or recent spots on the
cornea, as well as in  cases of chronic conjunctivitis,  in which a
mild astringent and sedative agent is indicated.6

                 MODE  OF ADMINISTRATION.
  The dose of valerianate of zinc given by M. Devay was 10 cen-
tigrammes (gr. 1.54) in the day;  but there is no reason, he says,
why it should not be  carried much  higher—to 40 centigrammes
(gr. 6.17)  for example.   The Italian physicians, who would seem
to have obtained the most success from its  administration, do not,
however, give it in a larger dose than a grain  and a half.  It is
best administered in the pilular form.    For external use, as a col-
lyrium, from two to four grains may be dissolved in two ounces of
distilled water.

  1 Cited in Ranking's Half-yearly Abstract, January to June, 1846, p. 173.
  a Aschenbrenner, Die neueren Arzneimittel, u. s. w. S. 281, Erlangen, 1848.
  5 Gazette Medicale de Paris, Jan. 1844.
  * Dr. Geo. Johnson, in Ranking, op. cit. p. 348.
  * Gazette Medicale de Paris, Jan. 1844.        6 Aschenbrenner, op. cit. S. 282. 
SUPPLEMENT.
   CLXXVII. Ac"idumChro'micum, Chromic acid, Peroxide of Chro*
mium: French,Acide chromique; German,Chromsaure.  Chromic
acid nearly pure may be obtained by the following process.   One hun-
dred measures of a cold saturated solution of bichromate of potassa are
mixed with one  hundred  and fifty measures of oil of vitriol, and the
whole is suffered to cool.  The chromic  acid crystallizes in brilliant
crimson-red prisms.   The mother liquor  is poured off, and the crys-
tals are placed to drain upon a tile closely covered  by a glass or bell
jar.1   They are of a ruby-red colour, prismatic and  deliquescent, of
a sour, acrid, and metallic taste, soluble in water,—the solution being
constantly reduced by contact with organic matter.
   It is in consequence of chromic acid being a powerful oxygenizing
agent,—yielding half its oxygen readily to organic substances, and be-
ing reduced to sesquioxide,—that Dr. Ure3 has employed it as an es-
charotic.   It is,  he says,  exceedingly convenient of application, as it
consists of a thick crystalline pap, which,  when rightly managed, does
not spread beyond the prescribed limits:  and its erodent operation
terminates with  its passing into the state  of inert pulverulent sesqui-
oxide.  In a case of external hemorrhoids, the acid was applied twice
at an  interval of  two  days.   It caused acute burning pain both times,
destruction to a considerable amount of the diseased texture, conso-
lidation of  the remainder, and  permanent relief.   The troublesome
sores produced on  the hands and arms of dyers, who use bichromate
of potassa, are  ascribed  by  Dr. Ducatel,3 of Baltimore,  to  the action
of the free chromic acid.

   CLXXVIII.  Ac"idum  Ni'triciim,  Nitric acid; French, Acide ni-
trique; German, Salpetersaure.  Nitric acid,of the specific gravity
1.500, destroys instantaneously the vitality of the surface to which it is
applied.   The depth of the slough which is to follow may be regulated,
in some degree, by the quantity of acid laid on the part; and its extent,
laterally, may be confined with sufficient  precision to the limits  of its
first application  by instantly smearing the whole over with olive oil,
which neutralizes its  farther corrosive  powers by  combining and
forming with  it a new, but no longer corrosive, compound.   The se-
paration of the slough after the application of nitric acid leaves a healthy
suppurating surface, which contracts and  heals over very quickly.

  1 Warrington, Proceedings of Chem. Soc. i. 18, cited in Fownes's Elementary Che-
mistry, Amer. edit. p. 245.  Philad. 1845.
  3 London Medical Gazette, March 21, 1845, p. 787.
  3 Manual of Practical Toxicology. Baltimore, 1833.
     45 
702          SUPPLEMENT.—ADANSONIA DIGITATA.

  Such is the testimony of the late Dr. Houston, of Dublin,1 in regard
to the action  of nitric acid  as an escharotic.   He has proposed it as
such in certain forms of hemorrhoidal affections, and especially in that
which he terms " vascular tumour" and which  he regards as an af-
fection of the mucous and submucous tissue exclusively, having usual-
ly for its basis a knuckle  or bunch of varicose veins;  but it may also
be a distinct and independent growth, the result of some other irrita-
tion in the region,  but giving rise ultimately to the formation of a  va-
ricose condition of the part.  In such cases,  he has found the appli-
cation of nitric acid, s. g.  1.500, of eminent service.   It combines, he
affirms, all the advantages  possessed by excision or ligature, without
any of the disadvantages.  He  directs the application to be made in
the following  manner:—Let the patient strain as in the night chair,
so as to bring the tumours fully into view : and while they are so down
let  him either lean over the back of a  chair, or lie  down in  the bent
posture, on the side  on which the disease exists,  with the nates over
the edge of the bed.   Let a piece of wood, cut into the shape of a dress-
ing-case spatula, be dipped in the acid ; and then, with as much of the
acid adhering to it as it will carry without dripping, let it be rubbed
on  the tumour to  the desired extent.  The due  effect of the  acid on
the part is shown by its  becoming of a grayish white  colour.  If a
superficial slough  be all that is required, a single application  may be
enough; if a more deep one, then two or three  applications  may be
required;  and if  a still  more  deep one, two or three applications
of  the wood dipped in the acid may be  made in  quick succession,
which being finished the  part may be well  smeared  over with olive
oil.  The  prolapsed parts should then  be pushed back within  the
sphincter, the patient put  to bed, and an opiate administered.  The
pain is  sharp and burning at first, but it goes off in two or three hours,
and does not return  again in the same form.   In  no case has he heard
of  serious consequences from the use of the remedy; and the symp-
toms usually following its application are so  mild as hot absolutely to
require confinement to bed more than a few hours.  On the third or
fourth day, Dr. Houston  recommends that a cathartic draught should
be  given;  when the bowels will be  found to yield to the medicine,
generally without  either pain or prolapsus of the rectum.  In a sub-
sequent communication,3 he urges, that the only  case  which the nitric
acid will serve is the internal bleeding pile ;—"that  soft, red, straw-
berry-like elevation  of the  mucous membrane," for  which he uses the
term, " vascular tumour.'''
   The  safety and efficacy of this mode of practice have been con-
firmed by the testimony  of Mr.  Cusack, of Dublin.

   CLXXIX. Adansonia Digitata, Baobab  Tree.   The bark of this
tree is anative of Senegal; of the Natural Order, Bombacese: Sexual
System, Monadelphia Polyandria.  It has been brought forward as a
valuable antiperiodic by Duchassaing, who thinks it a  fit substitute for
cinchona.   It is mucilaginous, and has scarcely any taste or smell.  It
           1 Dublin Journal of Medical Science, March, 1843.
           3 Ibid. Sept. 1844, p. 32. 
SUPPLEMENT.—APIS  MELLIFICA.            703
is  recommended  by M. Duchassaing in decoction ;  half an  ounce of
the bark being boiled in a pint of water until the liquid is reduced to
two-thirds.   From the quantity of mucilage it contains, it is apt to un-
dergo decomposition. This may be prevented by adding a small quan-
tity of sulphuric acid, which precipitates the mucilage, or by the addi-
tion of spirit.  In a great many cases in which It was prescribed by
him, it rendered eminent service.1  Its employment was suggested by
the negroes, who make constant use of it in the marsh fevers of the
country.  M. Saint-Pierre3 has prescribed it in the last two years in a
locality in Burgundy, where intermittents are endemic.  He was only
able, however, to give it in seven cases, owing to his not being pos-
sessed of a sufficient quantity of the remedy;  but they all terminated
favourably.   According to him, " the taste of  the decoction is in no
respect disagreeable, and its  action is unaccompanied by any of the
inconveniences that may follow the action of the sulphate of quinia."

   CLXXX.  Apis Mellif'ica, A. Domestica, Bee, Honey Bee; French,
Abeille mellifique,A. Domestique; German, Biene, Honig-biene.
The bee appears to have been employed in medicine in the middle
ages in cases of alopecia.  It was dried or grilled and reduced to pow-
der ;3 and in this form was mixed, in the dose of half a dram, with ex-
tract of juniper, and  extolled as an excellent diuretic.   " No one ven-
tures at the present day," says M. H. Cloquet,4 " to  propose such a
remedial agent; for  although the  Materia Medica has still need of an
extensive reform, both in its agents and language, it no longer admits
such absurdities ;  and scarcely dare  we add, that the distilled water
of bees has been also recommended, and in the same cases,—that an in-
fusion of them in diuretic wine  or in  oenogala was  all-powerful in
dropsy and calculous affections, and cured ischuria ; that the remains
of those found dead  in honey strengthened the eyes and the ears, and
was applied with success in cancerous ulcers of the  lips.   All these
follies and a thousand others which Pliny and Galen first published,
have been repeated by Houiller, Alexander Benedictine, and a crowd
of other authors  of  the middle age of medicine, who have  given us
their reveries in the  place of theories founded on experience, and have
contributed  to  perpetuate errors  rather than  dissipate  them.   The
belief that the  prolonged use of those insects might produce sterility;
that by immediately  crushing them upon a wound all its consequences
might be obviated, and that  they were capable of inciting to love, was
not less ridiculous."5
   Yet the employment of the bee as a therapeutical  agent has been
revived.  Dr. F.  H. Gordon,6 of Wilson County, Tennessee, affirms,
that he succeeded in removing the strangury, which was a common
attendant on an epidemic metritis by an infusion of the bee, made as

   1 Pharmaceutical Journal, cited in American Journal of Pharmacy, Oct. 1848, p. 328.
   ■ Archives Generates de Medecine, AoAt, 1850, p. 535.
   3 Schroderi Dilucidati Zoologia; and the second volume of the works of Ettmuller; fol.
Latin, p. 304.   Lyons, 1690;  cited  in Faune des Medecins, par H. Cloquet,  i. 93.
 Paris, 1822.                                   4 Op. cit.
   • See, also, M6rat and De Lens, art. Abeille, Diet, de Mat. Med. et de Therap.
   8 Western Journal of Medicine and Surgery, Nov, 1845, p. 392, 
 704          SUPPLEMENT.—BISMUTHI VALERIANAS.

 follows:—" Sweep forty to sixty bees into a pan of water, so  as  to
 make them manageable: put the whole into a teacup:  pour one gill
 of boiling water on them, and cover the cup securely.  When  it has
 remained twenty minutes, pour off the infusion, and let the patient
 take the whole at a draught."  This remedy, he asserts, relieved the
 strangury in from two to fifteen  minutes with great certainty. He
 refers to other practitioners, who have " given the remedy  numerous
 fair trials,"  and, so far as he has learned, all estimate it highly. He
 has tried it repeatedly in retention of urine from inflammation  of the
 bladder, and from  the effects of cantharides, and found it to be more
 prompt  and certain  than any other  remedy;  and he  says, "there
 can be no question that 'bee tea' will prove a valuable accession  to
 our Materia Medica.   How  far it may be found useful in ischuria
 and dysuria from every variety of cause  remains  to be tested; and
 its known value affords  abundant encouragement for farther investi-
 gation."  Dr. Gordon affirms that it  was introduced into medicine
 some years ago by an old woman in the habitual practice of mid-
 wifery, in the County of Smith, Tennessee; but it is doubtless one  of
 those cases  in which  a remedy formerly in use  has been abandoned
 by the profession, but retained by the people.
   Since the publication of Dr. Gordon's communication, the infusion
 has been used by others.  Dr. Flint, of Buffalo,1 states, that it had
 been  recently tried in that city  with  immediate relief, in  a  case  in
 which the introduction of the catheter had been attempted without
 success; and that it was subsequently repeated daily, with the same
 results, until the occasion for its  administration ceased.
   Dr. Gordon considers the infusion to act as a narcotic; and that its
 properties  are  probably owing  to  the virus  ejected with  the sting.
 The  tea, when  recently made, has a smell identical with that of the
 incensed bee, and is then efficacious;  but if the infusion be  permitted
 to stand and cool, and especially to remain uncovered, the character-
 istic odour and  taste  disappear, and it is correspondingly inefficient.
 Hence,  he infers, the  virus is volatile, and requires care  to prevent its
escape.   " Whether," he adds, " this valuable  virus may not be col-
lected and concentrated, or combined with some chemical element,
so as  to render it portable and convenient, is a matter of interest, and
well worth the attention of the chemist."

  CLXXXI. Bismu'thi  Valeria'nas, Bismuthum Valerianicum,
German, Valeri ansa ure s  Wismuth—is formed by mixing a
neutral solution of nitrate of bismuth with valerianate of soda, washing
the precipitate with water, and drying with a gentle heat.  It forms
a white  powder, which is insoluble in water;  and  has  been recom-
mended by Righini2 in  gastrodynia, chronic gastralgia, and especially
in neuralgia and nervous palpitation.
  The dose is from half a grain to two grains,  three  or four times a
day, in the form of powder or pill.

  1 Buffalo Journal,  cited in New York Journal of Medicine, Sept. 1846, p. 265.
  a Aschenbrenner, Die neueren Arzneimittel, u, s. w. S. 51,  Erlangen, 1848. 
             SUPPLEMENT.—CARBONIS TRICHLORIDUM.         705

   CLXXXII. Cadmi'i Sulphas, Sulphas Melini seu Klaprothii, Cad-
 mium seu Klaprothium seu Melinum Sulphurieum,  Sulphas Cad-
 micus, Sulphate of Cadmium; French,  Sulfate de Cadmium; German,
 Schwefelsaures Cadmium, Schwefelsaures Klaprothium,
 is  obtained  by dissolving carbonate of cadmium in dilute sulphuric
 acid, and evaporating the neutral liquid so that it may crystallize.  The
 crystals are colourless, rectangular prisms, which effloresce in the air,
 and are readily soluble in water.
   Sulphate of cadmium, which was referred to in a former edition of
 this work,1 has been almost  exclusively prescribed of late in different
 diseases  of the eyes.  Rosenbaum,9 Kopp,3 Grafe,  Ansiaux, Radius4
 and others,5 employed  it successfully  in specks  of the  cornea.   In
 chronic ophthalmia, accompanied by a scrofulous, syphilitic or other
 dyscrasia, it was used with advantage by Daynac and Giordano; and
 by Lincke,6 it was  prescribed as an  injection in torpid chronic in-
flammation  and blennorrhcea of the  meatus auditorius, membrana
 tympani and middle ear, being thrown both into the meatus and the
 Eustachian tube.
   It does not  appear to differ materially in  its  medicinal properties
 from sulphate of zinc.
   To  form a collyrium,  from one to eight grains may be  dissolved in
 an ounce of water.  As  an eye ointment, Radius used it in the quan-
 tity of from  one to two grains to 9iv. or jj.  of lard.  As  an injection
 in otorrhcea, Lincke employed it in the strength of from J}j. to 3ss.in
 §iv. of infusion of roses.

   CLXXXIII. Carbo'nis Trichlo'ridum, Carbonis Sesquichloridum,
 Carboneum Trichloratum, Trichloretum Carbonei, Carbonicum Chlo-
 ratum, Terchlorideor Sesquichloride of Carbon ; French,  Trichlorure
 ou Sesquichlorure de Carbon; German, Dreifach Chlorkohlen-
 stoff,  Kohlenstofftrichlorid, is formed by the action of chlorine
 or chlorohydric ether, under the influence of sunlight.  It  is in needle-
 shaped crystals, pulverizable, colourless or white; tasteless, and of a
 peculiar eamphoraceous aromatic odour.  It is  very sparingly solu-
 ble in  water; soluble in  alcohol, and still more so in ether; and dis-
 solves  in fixed  and volatile  oils.   It may be obtained, likewise, by
 the action of chlorine on  the Dutch liquid or  chloride of olefiant gas.
   Terchloride of carbon has  been employed by Dr. King with advan-
 tage in cholera morbus, and it is affirmed by Dr. Jones  Lamprey,7
 that it  was originally used as a remedy  in the treatment of cholera by
 a physician of Calcutta.   It had  been also prescribed,  in 1843,  in

  * Third edit, preface, p. iv., Philada. 1841.
  2 Merat &. De Lens, Dictionnaire  Universel de Mat. Med. i. 320.  Bruxelles, 1838.
  3 Dierbach, Die neuesten Entdeckungen in der  Mat. Med. i. 541.  Heidelb. und
 Leipz. 1837.
  * Auserlesene  Heilformeln, S. 123.  Leipz. 1836.
  ' Riecke, Nachtr'age zur ersten Auflage der neuern Arzneimittel,  S. 27, Stuttgart,
 1840; Aschenbrenner,  Die neueren Arzneimittel, u. s. w. S. 54.   Erlangen, 1848;
and Pereira, The Elements of Mat. Med. and Therap. 3d edit. i. 722.  Lond. 1819.
  s Vollst'andiges Recept-Taschenbuch, L 311.  Leipz. 1840.
  " Medical Times, Jan. 6, 1849. 
706
SUPPLEMENT.—CONIA.
London, as an excitant and antiseptic.  Mr. Tuson had found it effec-
tual in correcting the factor of foul ulcers.'  M. Troschel, chief phy-
sician to a cholera hospital in  Berlin, having read the observations of
Dr. King, determined upon submitting it to trial in cholera, and  he
was encouraged to this course by the results of experiments made by
the Russian physicians in St. Petersburg.   The substance  being, at
first, of high priee, and obtainable only in small quantity, M. Troschel
administered it in the moderate dose of about four grains, repeating it
every half hour, or every two or  three hours, according  to  circum-
stances; and he affirms, that in many cases  he succeeded in breaking
and shortening the asphyxial  period, and establishing reaction.3  M.
Manget also appears to have found it of great advantage under the
same  circumstances; and he had numerous opportunities for testing
its efficacy as physician to  the Bureau de Bienfaisance of the fifth
arrondissement of Paris, where cholera made great ravages.   He gave
it in the same dose, in a spoonful of syrup  of gum.  M. Manget re-
gards it as one of the most powerful diaphoretics we possess.3
   Like many other  anticholeric  remedies, its  merits have doubtless
been greatly exaggerated.

   CLXXXIV.  Coni'a, Coniinum, Conicinum, Cicutinum, Cone'ine,
Conine, Conicine,  Cicutine;   French,  Coneine;  German, Coniin.
The active principle of conium or hemlock was discovered and care-
fully examined by Geiger, in  1831;  but it had not  attracted much at-
tention from therapeutists.  It is most easily obtained, according to Dr.
Christison,4 by cautiously distilling from a muriate of lime bath a mix-
ture of  strong  solution of potassa with the alcoholic extract  of the
unripe fruit.  The  alkaloid passes over with  the  water, and floats
upon it  like  an oil.   It contains some water, which may be removed
by chloride  of calcium, and also a little ammonia, which is separated
by keeping it for a few hours  in vacuo.  It is a colourless oleaginous
fluid,  of an intense, peculiar,  suffocating odour; and  an extremely
acrid benumbing taste; is sparingly  soluble  in water; very soluble in
alcohol and  ether, and in fixed  and volatile oils.  It is a most ener-
getic poison, appearing to act on the nervous centres—the spinal cord
particularly—like  hemlock, but unlike strychnia, which irritates the
spinal marrow, and induces  violent and permanent  spasms  of  the
muscles.5  A few drops kill a small animal in  a few minutes—the effects
being gradual  paralysis,  slight convulsive  tremors, and death from
suspension  of the respiration, without any  apparent alteration in the
blood, or  depression of the heart's action.  The salts of conia, from
being more  soluble, are even more energetic than it.6
   When conia is administered in  medicinal doses, it acts as a sedative
on the nervous  centres;  and  may cause incoherence  and even deli-
rium;  the movements are enfeebled, and paralysis may succeed;  the
pulsations of the heart are less strong  and  less frequent, and the re-
  ' Medical Times, Dec. 2, 1848.                    9 Dr. Lamprey, op. cit.
  5 Annuaire de Therapeutique pour 1850, p. 50.
  4 Dispensatory, Amer. edit, by R. E. Griffith, p. 410.  Philad. 1848.
  * Richard, Elements d'Histoire Naturelle Medicale, iii.  184.  Paris, 1849.
  * Christison, op. cit; and A Treatise on Poisons, Amer. edit. p. 655.  Philad, 1845^ 
              SUPPLEMENT.—cotyledon umbilicus.         707

spiratory organs  feel the influence of  this state of nervous  stupor.
According to Nega,1 the  phenomena that indicate the narcotic influ-
ence  succeed each other in the following order :—feebleqess, paraly-
sis of the voluntary muscles, anaesthesia, general indisposition, vomit-
ing, paralysis of  the stomach, diminished frequency and force of the
pulsations of &e  heart, stupor, vertigo and syncope.
   The diseases in which Nega employed it with benefit were hyper-
esthesia, neuralgia, and spasmodic affections.—He instances parti-
cularly, hypersesthesia of the fifth and tenth pairs of nerves, and the
accidents resulting from them, otalgia, odontalgia, tic douloureux of
the face, photophobia and spasms of the eyelids, for which it had been
recommended by Fronmiiller, and has since been given by Spengler,2
sthenic nervous  affections of the  larynx, brachial, intercostal, and,
particularly, sciatic neuralgia; and, in short, all diseases  in which
pain  is a symptom, or a complication  of any gravity;  and it is af-
firmed that, like conium, it renders ulcers of a malignant nature less
painful, and of a better appearance; aids in the resolution of scrofu-
lous  tumours, and  prolongs  the first  stage  of  the  development of
tubercles, and  he found it of  service in hooping-cough.   In inter-
mittent fever,  it  produced no  result.   Such,  however,  was  not the
result of the observations of  Wertheim,3 of Vienna, who  appears
to have obtained  excellent  effects from  it in  that disease, when the
pulse was  full and  hard, indicating an inflammatory state.   On the
other hand, when it was feeble  and accelerated, and the fever was
asthenic, he prescribed leukolein, described hereafter.
   Conia may be given either in watery, alcoholic or ethereal solution,
or united with dilute  acids.   Wertheim  always  prescribed  it in
watery solution,—one sixty-fourth or one thirty-secondth to  one-six-
teenth of a grain  in six ounces of distilled water, of which two spoon-
fuls (cuillerees a  bouches)  were given every two hours.   Fronmiiller
dissolved  three or four drops in a scruple of  alcohol; and added half
an ounce of distilled water. Of this, from fifteen to thirty drops were
given three times a day.   It has  also been used endermically—in the
dose  of two drops  mixed with acetic  acid—and in enemata, to  the
extent of three drops.4

   CLXXXV.  Cotyle'don Umbili'cus, Cotyledon Umbilicus Veneris,
Navelwort, Venus's Navelwort;  French,Nornbrilde Venus;  Family,
Crassulaceae;  Sexual  System, Pentandria Pentagynia.  This  plant,
which grows in Europe on old walls and rocks, has been long used
in medicine, but  was almost unknown to practitioners of the present
day, when  its  employment was  revived in  a  new  direction.   The
leaves are emollient, and have been applied externally to hemorrhoids
and to inflamed parts.  Of late, the inspissated juice has been brought

   ' Zeitschrift fiir Klinische Medicin. H. 1. Breslau, 1850; cited in Archives Gene-
rales de Med. Juin, 1850, p. 224.
   » Cited by Von Gorup-Besanez, in Canstatt und Eisenmann's Jahresbericht, u. s. w.
im Jahre 1849, v. 171.  Erlang. 1850.
   s Archives Generates de Med. loc. cit.; Gazette Medicale de Paris, 1849, p. 748, and
Bouchardat, Annuaire de Therapeutique pour 1850, p. 177.
   * Aschenbrenner, Die neueren Arzneimittel, u. s. w. S, 89,  Erlangen, 1848. 
I
708              SUPPLEMENT.—FEL BOVINUM.

forward  to  swell the  uncertain crowd of antiepileptic remedies, by
Mr. Salter1 and Dr. Bullar.  "Encore un remede contre I'epilepsie!"
exclaims M. Bouchardat.3   The juice was first used with advantage;
and afterwards an  extract was  prepared  from it, which exerted the
same effects.  Dr. Bullar3 urges  its  protracted use.  He has pre-
scribed it in a considerable number of cases—several l»f which were
of  a very hopeless kind,—and in all there was a marked diminution
in  the violence and frequency  of the attacks.  In  many  cases  he
thought it was "certainly" nervo-tonic,—the improved nervous tone
being  shown by quieter sleep, fewer dreams,  better spirits,  more
ability to take exercise, and a consciousness of general improvement.
He is not aware that it has any other action on the body.
   The juice is obtained by bruising the  leaves and leaf-stalks in a
mortar, and  expressing  it from  the  bruised  mass  through a cloth."
One tea-spoonful of this is given twice a day.  Of the extract, Dr.
Bullar has prescribed five grains twice, and occasionally, thrice, a day.
   As in  the case of artemisia,4 it is to be feared, that the virtues of
cotyledon umbilicus have been exaggerated. Dr. Ranking5 is properly
of  opinion, that the cases  given in illustration are too few in number
to be worthy of much confidence; and he is " disposed to agree with
Dr. Marshall  Hall, that there is no  ' medicine specially adapted to
the cure of epilepsy;  and that the only rational treatment consists in
a judicious employment of hygienic measures, including diet, exer-
cise,' " &c.  It was not necessary to affiliate this view on  Dr. Hall,
as  most  intelligent practitioners had arrived  at the  same  conclusion,
and not  a few had promulgated it to the world.  In a note  from the
author's  friend, Dr. Francis  G. Smith, dated,  Philadelphia, Jan. 9,
1851, he  states, that he had  used the extract in two cases,—the one,
that of a  female approaching puberty;—the  other, that  of a  young
man twenty-five or twenty-six years of age;  but in neither case was
the slightest benefit  perceptible:—the young lady, indeed,  became
worse whilst taking it; "for  whilst there was no diminution  in the
frequency or severity  of the  paroxysms, she  became desponding in
the highest degree—in this  last  respect the case resembling some re-
ported by the English practitioners."   Dr. Smith gave the  extract in
doses  of five grains three times  a day.  The author has never used it.

  CLXXXVI. Fel Bovi'num, Fel bovis, Fel tauri, Bilis taurina, Ox
gall, Ox bile; French, Bile ou  Fiel de Bceuf;  German,  Ochsen-
galle,  Rindsgalle.   Ox-gall is by no means  of modern intro-
duction.   It, as well  as the  bile of many other animals,  has been
employed in medicine in all  ages;6 but as its administration appears
to   have  been  somewhat  revived, it  may be  worthy of a  passing
notice.   It has long entered into many officinal pharmacopoeias and

  1 Medical Gazette, March 2, 1849.
 "  Annuaire de Therapeutique pour 1850, p. 59.
 » Provincial Med. and Surg. Journ. May 23, 1849.           « Page  111.
  * The Half-Vearly Abstract of the Medical Sciences, No. 9, from Jan. to  June, 1849;
Amer. edit. p. 200.
 6 H. Cloquet, Faune  des Medecins,  ii. 365.  Paris,  1822; and C. Clay,  cited in
Medico-Chirur. Rev. July, 1842, p. 279. 
SUPPLEMENT.—FEL B0VINUM.
709
formularies of the continent of Europe ;  and has been regarded  as  a
stomachic and anthelmintic.  The Fel lauri inspissatum, Extractum
Bilis seu Fellis, is referred by Jourdan1 to no fewer than seventeen
pharmacopoeias; and the Globuli carminativi seu Pilulae  bilis are in
the pharmacopoeias of Manheim and Wirtemberg.
   Ox-gall is a'greenish-yellow fluid, more or less thick and viscid, of
a  peculiar  nauseous smell, and a bitter  disagreeable taste.   The
chemical characters of bile, respecting which, as Simon2 has remarked,
there is no subject  in the whole domain of animal chemistry that is
more perplexing and intricate, have been given—so far as known—
in another work.3  Its uses in the economy have been inquired into
in the same.4  The author has  there  remarked, that as to the mode
in which the biliary fluid acts on the chyme, we have not much more
than conjecture to guide  us; and that it is more than doubtful, whether
it has the property of soliciting the peristaltic  action of the intestines
so as to produce the evacuation of their contents.   It was  natural,
however, that it should  be regarded as a plausible remedy for  cases
in which a deficiency of bile  is  presumed  to  exist, although it  may
be by no means easy to discriminate  them; and that therefore it should
be given in cases of intestinal torpor, which have so often been hy-
potheticaliy regarded as dependent upon a deficiency of secretion
from the liver.  Its  bitterness, and  alkalinity, too, suggested its em-
ployment as a tonic, and antacid.
   Of late years, ox-gall has been strongly advised in various diseases,
and  often  on  very  loose physiological  and  pathological notions.5
Jaundice,  it is  known,  when not owing to organic  disease of the
biliary apparatus, generally terminates spontaneously in health.   Dr.
Johnson6 ascribes the cure of several cases to inspissated ox-gall given
in the dose of five grains, gradually increased to ten, three  times a
day;  and he explains the action of the remedy on the principle, that
ox-bile is the best substitute which can be found for the human secre-
tion;  as  if jaundice necessarily consisted in a deficient secretion of
that fluid!
  Many years  ago, ox-gall was employed by Dr. Copland,7  who
speaks highly of its therapeutical  properties, both when given in
clysters, and when  combined  with aloes, taraxacum,^] soap, extract
of gentian, &c, in restoring the healthy functions of the bowels, and
digestive organs generally.  One  of the  strongest advocates for its use
is  Dr. Charles Clay,8 o'f Manchester.  He  was  first led  to test its
powers to relieve pain in cancer, from noticing the fact that Dr.  Pea-
cock, of Darlington, had  observed, when the system was impregnated
with bile  in cancerous   affections, that  the  pain was  remarkably re-
lieved.^)  In a case of cancerous ulcer, that had destroyed  the greater
portion of the nostrils, he ordered, as a forlorn hope, a mixture com-

  1 Pharmacopee Universelle, i. 268.  Paris, 1828.
  a Animal Chemistry, Sydenham edition, i. 49.  Lond. 1845.
  8 Human Physiology, 7th edit. ii. 318.  Philad. 1850.         4 Vol. l. p. 611.
  6 Lincke, Vollst'andiges Recept-Taschenbuch, i. 594.  Leipz. 1840.
  6 London Lancet, Dec. 19, 1840, p. 447.
  * Art, Constipation, in Diet, of Practical Medicine,
  8 Op. cit., cited in Braithwaite's Retrospect, vi, 94.  Lond. 1843. 
710              SUPPLEMENT.—FEL BOVINUM.

posed of inspissated ox-gall, two drams; oil of caraway, ten minims;
carbonate of magnesia, enough to form a mass,—to be divided into
thirty-six pills.  Of these two were given three times a day.  Marked
relief was afforded after the pills had been-taken for one day;  and in
four the pain had ceased.  He states, that before giving it in this case,
the evacuations were peculiarly white;  and  the  bowels very much
constipated  with acid  eructations.   Dr. Clay, likewise, refers to its
beneficial  influence in dyspepsia.  In all the  cases reported by him,
he considered " deficiency in quality or quantity of  bilious secretion
was the prominent  and prevailing accompaniment," and he regards
the ox-gall  to  be "not  a cathartic," but "a direct solvent to  the
accumulated hardened faecal mass, the consequence  of deficiency  of
quality or quantity of bile in the alimentary canal7"
   Dr.  Clay observed, also, that inspissated gall has a remarkable ten-
dency to  counteract the  constipating effects of opium.   He recom-
mends it, moreover, in all cases of atrophy, whether  of children or of
adults.  In  acidity  of the stomach in children,  he says, it affords
'* most decided, effectual, and  immediate relief."  Its action on  the
system, is not, as before remarked, cathartic, but is a mere solvent of
the material contained within the intestinal canal, producing no excite-
ment to propel, but facilitating  excretion by liquidizing the mass.   It
is also, he says, tonic; and in children, to a moderate extent, diuretic;
but less so in the adult.
   The views of Dr. Clay are, in the main, concurred in by Dr. R. H.
Allnatt,1 especially those  in  regard  to the use of ox-gall in constipa-
tion and its effects in obviating the constipating tendency of opium.
The latter gentleman3 gave it in a case of constipation  during preg-
nancy, in the form of enema, which succeeded in relieving the bowels,
after vvarm  water enemata had failed.  A dram of inspissated ox-gall
was dissolved  in about a pint of warm water.   The relief  was in-
stantaneous :—a mass of scybala being expelled, which had evidently
lain impacted in the colon.   Dr. Chapman3  also has found it benefi-
cial as "a laxative" in constipation.
   The  preparation  used by Dr. Clay and  Dr. Allnatt is simply the
recent gall  of the ox slowly evaporated to the  consistence of an ex-
tract—the  Fel  tauri  inspissatum,  Extractum Bilis  seu  Fellis;
French, Extrait de Bile ou deFiel: Germ. Eingedickten  Galle.
This may be made into pills.   One gall-bladder of a moderate-sized
ox, according to  Dr. Clay, will afford as  much extract as will make
one hundred four grain pills, and it is an article both cheap and easy
to procure.
   Dr. Lane4 desiccates the gall and makes it into pills.   To desiccate
it he allows it to remain at  the same temperature used in forming the
inspissated  article, until there remains a dry, bright green, friable, pu-
rulent, slightly aromatic mass, in which state the substance loses none
of its medicinal  virtues;  its deliquescent character is nearly lost.   It
can be easily preserved in closely stopped bottles, and is readily made
   1 London Lancet, June 7,1845, p. 635; and Lond. Med. Gaz. June 20,1845, p. 343.
   3 London Medical Gazette, Feb.  6,  1846, p. 253.
   " Lectures on the more Important Diseases of the Thoracic and Abdominal Viscera, p.
301. Philad.  1844.             « London Lancet, July 5, 1845, p. 27. 
           SUPPLEMENT.—FERRI ET ALUMINA SULPHAS.        711

 into pills, particularly with any spirituous fluid or essential oil.  M.
 Blanch1 has tried both the inspissated and  the desiccated ox-gall, and
 very decidedly deposes  in favour of the latter as the more efficacious,
 and less nauseous.   The pills, too, he says, do not run together as
 when made of the inspissated article.
   As an addition to simple clysters it has been recommended to weak,
 emaciated, nervous  individuals,  who  are subject to  pains in the
 bowels.2
   The dose of ox-gall is gss. to 3L in the day, made into pills.

   CLXXXVII.  Inspissated Bile of the  Swine, Bilis Porcina, has
 been used in the same cases as the bile of the ox, by Dr. Mettauer,3 of
 Virginia, who thinks its employment as a therapeutical agent original
 with him.   It has, however, been long used in medicine!  so long ago as
 the time of Pliny,4 who extolled it in diseases of the spleen.  "At the
 present day," says M. H. Cloquet,5 " it is, we may say, out of use, and
 will never probably resume any share of favour."   It is said to contain
 neither picromel nor any nitrogenized matter; but in addition to seve-
 ral salts is  formed principally of resin and soda.   It differs,  conse-
 quently, considerably from the  bile of man, and that of the ox: yet,
 according to Dr. Mettauer, it seems to be adapted for cases of diseases
 in which the biliary secretion is  defective.  "We were induced to
 resort to it first," he  says, "in the low depressing states of continued
fever, with  the design of acting especially on the gastro-intestinal mu-
 cous  membrane,  which, we  believed,  became disorganized in such
 cases in a great  measure from the want of the biliary influences, and
 in these cases it always acted with decided  benefit.  It served to sub-
 stitute the action of the  bile.   Simply heating the bile  over a sand-
 bath until it became dry  and pulverizable was our mode of preparing
 it.  It is a  valuable agent in dyspepsia, and in many chronic affections
 attended with defective biliary secretion.  In chlorosis,  amenorrhcea,
 some  forms  of dysmenorrhcea, and constipation, we have  also em-
 ployed it with decided advantage.   Dr. Mettauer gave it with benefit
 in the adynamic stage of fever above referred to—two or three grains
 of the  inspissated, or  more properly desiccated, bile, being associated
 with  one of ipecacuanha, and two of carbonate of potassa.   "This
 compound," he says, "seemed to act with  decided effect, as  a sup-
 porting and secerning remedy upon -the mucous membrane of the sto-
 mach and intestines, and as a  diaphoretic at the same time."   It was
 especially valuable in cases attended with a denuded raw tongue, which
 always becomes more healthy after its administration.   In such a com-
 bination, however, it  is  obviously impracticable to test the precise
 agency of the bile.

  CLXXXVIII. Ferri  et Alumina Sulphas, Sulphate of Iron and
 Alumina.   This salt has  been introduced by Sir James Murray,6 of

  1 Cited in Braithwaite's Retrospect, xii. 93, Amer. edit. New York, 1846.
  3 Ann. Therap. Juin, 1848; cited  in Schmidt's  Jahrbiicher, 11. s. w. No. 5, S. 160.
 Jahrgang 1849.     3 American Journal of the Med. Sciences, July, 1843, p. 52.
  4 Hist. Nat. xx viii. 13.
  * Faune des Medecins, ii. 377.  Paris, 1822.  See, also, Merat and De Lens, Diet.
de Mat. Med. &c, art. Sus.          6 Dublin Medical Press, Mar. 14, 1849. 
712              SUPPLEMENT.— HiEMOSPASI a.
Dublin, as a valuable addition to the class of astringent remedies.  The
bisulphate of iron and alumina—as he terms it—is readily made by
treating bicarbonated solution of soft iron  and carbonated solution of
pure washed alumina with sulphuric acid after separating the arsenic
and other ingredients, which are too often found  in the vitriolic  acid
of commerce.
   Sir James considers this salt to be a superior astringent in the treat-
ment of chronic diarrhoea, dysentery and cholera morbus; leucorrhoea,
and the colliquative diarrhoea and sweats  of the consumptive.   It is
also a  valuable anthelmintic; destroying the parasites, and correcting
the morbid condition of the alimentary canal, which favours their gene-
ration.  Occasional  cathartics are needed  during its administration  as
an anthelmintic.  Applied externally it is a powerful styptic, and  may
be used in epistaxis, and in hemorrhage from leech bites.   It has been
found, too, an excellent gargle in relaxation of the uvula and fauces,
in the  cynanche  of scarlatina; and in  diphtheritis.   It forms, like-
wise, a good collyrium; abates salivation, and improves the appear-
ance, and corrects  the fcetor of foul or flabby ulcers.  Injections  of
the salt are  good astringents in excessive hemorrhage from outlets
with which, they can be made to come in contact.
   The dose  is from five to ten grains in  any aromatic water, or  in
molasses.

  CLXXXIX. H^emospa'sia ; French, Hemospasie.   This is a mode
of revulsion which has been strongly urged of late  years by M. Junod,
for his essays on which he has twice received the Monthyon prize.
It has been  properly described as a means for  producing a powerful
derivation of the blood from  one part of the body, by removing the
atmospheric pressure from a large extent of surface, as from one or
both extremities.  It is, as the author has expressed it  elsewhere,1 dry
cupping on a large scale.
  An air  pump bath has been employed, in which the atmospheric
pressure is diminished over a greater or less surface of the body, and
the application of vapour has been  associated with this, constituting
the air pump vapour bath, which has been used  in gout, paralysis,
and other affections.  In 1832, Sir James Murray,2 gave a description
of an apparatus for  abstracting part of the atmospheric pressure from
almost the entire surface of the  body.   For the purpose of insulating
the patient's body from the external air,  a small oval bath of tin,  zinc
or copper, was employed by  him,—its lip furnished with a groove to
contain luting for connecting the lid or cover.  In this lid is an aper-
ture to pass over the patient's head, and around this opening is fitted
a margin of air-tight cloth, which applies itself so as to embrace the top
of the chest, and the back of the neck.  The patient sits upon a  seat,
with  his  head uncovered, the body and limbs only being enclosed.
When the bath is thus adjusted it is to be partially rarefied, either by
the condensation of  a little hot air or steam, or by a few strokes of a
suction pump.3
  ' General Therapeutics and Mat. Med. 4 th edit. ii. 254.  Philad.  1850.
  3 London Medical and Surgical  Journal, July 14,1842.
  » Observations on the Medical and Surgical Agency of the Air-pump, p. 41. Dub. 1836. 
SUPPLEMENT.—H.SMOSTASIS.               713
   At a meeting of the south-western branch of the Provincial Medical
 and Surgical Association held at Plymouth in 1844, Dr. Marsden' ex-
 hibited M.  Junod's apparatus for exhausting the air over a large sur-
 face, or for  his " System of Dry Cupping," as it has been termed.   It
 is made of copper, in the shape of  a boot, and is applied as one, hav-
 ing an Indian rubber tip to tie around the thigh, and render it air-tight.
 The air is then exhausted with a syringe.   By the application of this
 apparatus, the leg may be distended to double its ordinary size: the
 pulse is at first quickened, but is gradually reduced both in frequency
 and strength, and even  syncope may supervene.   Very little pain at-
 tends the  operation.   After the removal of the apparatus, the blood
 gradually returns to its course, and  in a couple of hours  the  swelling
 of  the leg subsides.  Experience has proved that sixty operations on
 the same  leg, with one or two days' interval, may be attended with no
 injurious  effects on the nervous system.  Dr. Marsden described an
 establishment under the superintendence of M. Bonnard, of Paris, en-
 tirely devoted to the application of this instrument.  He referred to
 the success  which had attended its employment by M. Cerise, and de-
 tailed  the histories of several cases in which he had himself wit-
 nessed beneficial results,—as of amaurosis, deafness,  sore throat,
 chlorosis, amenorrhcea, croup, phthisis, &c.  In  1835  M. Magendie
 greatly extolled it in cases in which  it  is important to  attract the
 blood from  the  internal parts towards  the surface of the body with-
 out causing  any loss of the vital fluid; — and its effects certainly en-
 title it to great attention.  It has  been objected, that when the appa-
 ratus is removed,  a violent reaction  will ensue, and the  blood  be
 propelled  with greater force than ever to the seat of the disease; but
 the results of experience do not confirm this ; " for as the haemospastic
 injection or  plethora takes  place chiefly in the capillary vessels, the
 turgescence  induced by it is found to  subside very slowly and gradu-
 ally."2  The effects of haemospasia resemble those of haemostasis: the
 diminished pressure, induced over a greater or less surface, must not
 only affect the circulation, but induce  a new action  in  the nervous
 system, and hence act as an energetic revellent.

  CXC.  HjEMOs'tasis,  French,  Hemostase,  Hemostasie;  Germ.
 Stockung des  Blutes  in den Gefdssen, has been long used
 to signify "stagnation of blood," and also any agency which arrests the
 flow of blood, but  it has been applied by Dr. Thos. Buckler of Balti-
 more,3 to  a particular mode of arresting the flow of blood in the super-
ficial vessels, which he brings forward as a novel therapeutical agency.
  It has been long the custom at the commencement of the cold  stage
of intermittents, to  apply ligatures—as the tourniquet,4—to the extremi-
ties ; and  this  unquestionably has  appeared, in many cases, to give oc-
casion  to a  subsequent mild hot  stage, and abridged duration of the
whole paroxysm.   As to the mode in which the ligature of vessels acts

  * Provincial Med. and Surg. Journal, July 10,1844, p. 224.
  1 Gazette Medicale, cited in Med. Chir. Rev. Jan. 1844, p. 281.
  2 Maryland Medical and Surgical Journal, March, 1843, p. 265.
  4 Kelhe, Annals of Medicine, vols. i. and ii. 
714
SUPPLEMENT.—HiEMOSTASIS.
 under such circumstances, there has been difference of sentiment.  By
 some, as by Dr. Kellie, it has been supposed, that the obstruction to
 the circulation in the veins of the extremities causes an accumulation
 of blood in these  vessels, and a consequent  increase in the action of
 the heart; but the  true modus operandi is probably that suggested by
 Dr.  Mackintosh;'  the  tourniquet or ligature, by confining the blood
 in the extremities,  " prevents so much at least of the congestion in in-
 ternal organs ;" and in this manner exerts an analogous effect to the
 withdrawal of the same quantity of fluid from the vessels.   A case de-
 scribed by Sir Geo. Lefevre, and referred to elsewhere,3—in which a
 disposition to syncope  in the erect attitude, appeared  to be owing to
 varicose veins of the lower extremities robbing the brain of its usual
 quantity of blood,  and  which was prevented by the application of ap-
 propriate  bandages,—is confirmatory of this view of the subject.
   Dr. Buckler applies his ligatures upon  one or  more of the ex-
 tremities,  according to  the effect which he desires  to  induce.  If a
 bandage, he  remarks, be applied around  a  limb sufficiently tight to
 arrest completely the venous circulation, and at the same  time allow
 the arteries to pulsate,  the blood within the  distended vein is cut off,
 as it were, from the general circulation ; a depletory effect is  in  this
 manner induced, and if the arrest of the venous circulation be prac-
 tised on all  the extremities at once, the skin becomes relaxed; the
 force of action of  the heart and arteries is weakened; and if the liga-
 tures be applied when the heart and arteries have been deprived of a
 portion of their ordinary amount of blood, owing either to anaemia or
 to bleeding, so that the  vessels are  partially empty, it is found, accord-
 ing to Dr.  Buckler, that the exhalants of the  skin pour out the most
 copious perspiration,—that the patient complains of a feeling of light-
 ness in the head;  of weakness and sickness of the  stomach; and if
 the carotids be pressed upon, they are found to be scarcely pulsating,
 and  all the phenomena  of syncope  supervene.
   An agent possessed  of such powers  at once suggested itself as a
 valuable remedy in the  phlegmasia more especially; and it has been
 so urged upon  the attention of the profession by Dr. Buckler.   He
 considers it capable of exerting, under given conditions, a more power-
 ful control over the circulation than the lancet, antimony or digitalis,—
 controlling the action of the heart, without exhausting the vital forces,
 or giving rise to any other inconvenience.
   Many  cases are  brought forward by Dr. Buckler,  in  elucidation of
 the beneficial action of haemostasis and its  power of  sedation.   He
 suggests, also, another  application of it,—bandaging the extremities
 from  the fingers to  the toes, in cases where an individual has lost so
 much blood, that there is  only enough left in his system to supply the
 organs essential to  life—the heart, brain, and lungs,—and to the ex-
tremities of ansemic females in protracted labour, where, owing to the
 pressure  of the uterus on the iliac veins, so much is  cut off from the
central circulation, as to deprive the brain of its  normal supply, and
 thus  render the pains weak, feeble,  and inefficient.
  1 Principles of Pathology and Practice of Physic, 2d  Amer. edit, by Morton, i. 155.
Philad. 1^7.
  3 The author's General Therapeutics and Mat Med. 4th edit. ii. 177. Philad. 1850. 
          SUPPLEMENT.—HYDRARGYRI ET QUINliE, &C       715

  CXCI. Hura  Brasilien'sis, Assacou, Assacu  or  Ussacu, is  a
poisonous tree of Brazil,  belonging  to  the family Euphorbiaceae,
the juice of which, and the decoction of its bark, cannot be employed
without danger, in a high  dose.   The juice is  anthelmintic, and at
Santarem, in Brazil, the bark is given in elephantiasis, and at Para,
the  natives regard it as a specific in lepra.  The physicians of Brazil
administer the extract of assacou in pills, in the dose of a sixth of a
grain to a grain in the day, gradually augmenting it still farther.  They
have also prescribed it as a drink  in the  form of infusion—a scruple
of the bark to a quart (pinte) of water;  and in baths.  When given
in too large a dose it excites vomiting.
  The bark—Casca de Assacu—is hard, thick, of a grayish colour, and
inodorous: the epidermis is covered with a lichen of the genus lecanora.'
It had not been subjected to investigation until recently, when having
been taken by a leper to Saint-Marie-de Belem, Para, it was examined
by a commission of medical men appointed by the authorities  of the
country, who reported upon it favourably as  a remedy in lepra.  The
results were communicated by Dr. Malcher, through the French consul
at Saint-Marie-de Belem, to the Academie de Medecine, of Paris; to
which body M. Gibert reported, that the active properties of assacou,
and its marked effects on the solids and fluids, and  especially on the
diseased skin, and the acrid emetic and cathartic properties it possesses,
prove it  to be  a powerful remedy,  and encourage hopes that it has the
remedial powers ascribed to it by the Brazilians.
  M. Bouchardat2 is of opinion, that if  introduced into the pharma-
cies, it may render great service to therapeutics.

  CXCII. Hvdrar'gyri et Qui'ni.e Protochlo'ridum.  A combina-
tion of mild chloride of mercury and quinia, has been prepared by Mr.
M'Dermott, which  has been found beneficial in some  obstinate skin
diseases that had resisted other remedies.  The bichloride employed
in the combination is said to perform the part  of an acid,—the alka-
loid quinia  forms the base; hence a double  salt,  a protochloride of
mercury and  quinia, is  obtained—not mechanically, but  chemically
combined.  On subjecting it to the strictest analysis, no trace of  the
bichloride could be detected.3  Several cases are  reported  by Mr.
Hamilton, which had been  treated at the Richmond Hospital, Dublin.
A grain  of the protochloride was given three times  a day.  In a case
of lupus superficialis of the arm of a labourer, aged  forty, a rather pro-
fuse salivation set  in  when twenty-one grains  had been taken.   A
great improvement, however, had occurred in the local disease.  The
medicine was omitted for a few days, and then resumed in  the dose
of a grain night and morning.   He was cured,—nothing but a simple
dressing having been applied to the ulcers.  The disease  had existed
twelve months before the treatment was commenced.

  1 Merat and Gibert, Journal de Pharmacie, xiv. 422.
  * Annuaire de Therapeutique pour 1849, p. 71;  and Ibid, pour 1850, p. 26,
  3 Dublin Medical Press, INo. 275. 
716               SUPPLEMENT.—LEUKOLEINUM.
   CXCIII. Ibe'ris Ama'ra, Bitter Candytuft; French, Passerage; of
 the/'amz7vCruciferae,is found plentifully in the gardens of Great Britain,
 where it is cultivated for its brilliant milk-white  flowers.   According
 to Dr. Silvester,1 it was known to the ancients, and is mentioned by
 Pliny, Aetius, Paulus  of iEgina, and  Oribasius, by whom it  is ex-
 tolled as an excellent internal and external remedy in various diseases.
 It may admit, however, of question, whether the chapter in Aetius,
 headed "De Iberide sive Cardamine quae et Lepidium vocatur,"3 refers
 to the plant in question.  Mr. Adams regards the Lepidium of Paulus
 to be Lepidium latifolium or Pepperwort.
   The leaves, stem, and root of Iberis amara,  appear to possess si-
 milar properties; but  from convenience and greater relative strength,
 the  seeds were chiefly employed.  Dr. Williams, of St. Thomas's
 Hospital, London, appears to  have  brought to light the properties of
 the plant, in a course of therapeutical researches at that hospital.  He
 observed its good effects in asthma, bronchitis, dropsy, and more es-
 pecially in hypertrophy of the  heart.  It did not  seem to diminish
 the velocity of  the heart's action like digitalis, but controlled the  vio-
 lence and sharp action  of the organ, and softened the pulse: hence its
 great value in hypertrophy with dropsy.   Dr. Silvester had prescribed
 it for  ten  years in numerous cases of the diseases  above mentioned,
 "always with some benefit, and sometimes  with almost magical  effi-
 cacy."   Its properties appeared to him to be analogous  to those of
 digitalis and  belladonna.   It occasionally caused sickness, giddiness,
 or diarrhoea;  but its control over the abnormous action of the heart
 was equally evinced, whether these effects were present  or absent.
   Iberis amara  was prescribed in powder in the  dose of from one to
 three grains, generally mixed with bitartrate of potassa, which con-
 cealed the nauseous taste, and secured a perfect trituration and division
 of the tough seed.

   CXCIV. Leukolei'num, Chinoleinum, Leukol, leucoleine, Leuko-
 leine, Leucolein, Chinoleine, Chinolein, Chinolin.   This substance  has
 not been found ready formed in nature.  A.  Hoffmann obtained it as
 the product of the dry distillation of coal, mixed with picolin,anilin,  and
 other substances, in mineral tar.   Subsequently, it  was procured by
 Gerhardt  and Bromier, by heating quinia, cinchonia, and strychnia
 with as  concentrated a ley of potassa as  could be made.   In  what-
 soever manner  obtained, it is  heavier than  water;  of an  oleaginous
 consistence; and, in the state of purity, is  completely colourless,  and
 limpid as  water.  Its  specific gravity is  1.081; and it  is  slightly
 soluble  in water, and  miscible in all proportions with alcohol,  ether,
and essential oils.3   Wertheim prescribed it internally in combination
with sulphuric acid—the pure leucolein being dissolved in a very small
quantity of pure  sulphuric acid.  Externally, he  applied a solution of
pure leucolein in a  small quantity of alcohol, diluted with a considera-

  1 Provincial Medical and Surgical Journal, July 28, 1847.
  3 The Seven Books of Paulus ^Egineta, translated,  &c,  by Francis  Adams.  Sy-
denham Soc. edit. iii. 212.   Lond. 1847.
  3 Fownes, Elementary Chemistry, 3d Amer. edit, by R. Bridges, p. 437.  Philad. 1850. 
SUPPLEMENT.—LITHIiE CARBONAS.            717
ble quantity of water.  The most evident effect produced by leucolein
if, on the pulse, which, like conia, it depresses.  Wertheim affirms,
however, that conia acts in this manner when the pulse is full and
hard; and when the fever has a sthenic character;—leucolein on the
contrary, when  the pulse  is feeble  and accelerated, and  the fever
assumes an asthenic form.1
   Like conia, it has been  given in intermittents as a substitute for
the sulphate of quinia; but  observations thus far made are inadequate
to  fix its therapeutical value.2

- CXCV.  Lith'i^e Car'bonas, Lithium Carbonicum, Carbonate of
Lithia; French, Carbonate de Lithine;  German, Kohlen sau res
Lithon oder Lithion.  This substance has been found in various
mineral waters, as  those of Toplitz, Franzensbad, Marienbad, Karls-
bad, some of which have proved serviceable in calculous affections.
This fact suggested to Mr. Ure,a as it had done to Lipowitz, to inves-
tigate the solvent  powers  of carbonate of lithia  with reference to
lithic or uric acid and its compounds, at the ordinary temperature of
the human body;  and he found that its  solvent power is more than
double that of carbonate of  potassa or borate of soda, and about eight
times that of bicarbonate of soda, which is the active ingredient in
the Vichy water.  An experiment was made on a human urinary cal-
culus, composed of uric acid.with alternate layers of oxalate of lime.
It was allowed to stand for four hours in two ounces of the  natural
Vichy water, from  the Hopital spring, which contained  three grains
and a half of carbonate of soda; when it was found to have parted with
two-tenths of a grain of uric acid ; whilst a portion of the same calcu-
lus, placed under precisely similar circumstances, at the same  time,
in a solution of gr. 1.6 of carbonate of lithia to two ounces of distilled
water, afforded nine-tenths of a grain of uric acid; thus demonstrating
its superior solvent agency.  Mr. Ure is of opinion, that of all the
various menstrua  hitherto  recommended, none appears to promise
more favourably than the carbonate  of  lithia, from the  promptitude
and energy with which, in dilute solution, it attacks calculi of the uric
acid description; and  he adds: "If by means of injection we can re-
duce a stone at the rate of a grain or  more an hour,  we shall not
merely diminish the positive bulk of the calculus, but farther loosen
its cohesion, disintegrate it, so to speak, causing it to crumble  down
and be washed away  in  the stream of the urine."
   The extreme  scarcity of the carbonate of lithia has  prevented it
from  being much  employed in practice.   It may be  obtained by
adding a strong  solution of carbonate of ammonia to a solution of
either  sulphate of lithia  or chloride of lithium; or by decomposing
sulphate of lithia  by acetate of baryta, and calcining the acetate
of lithia  formed,  which  is  thus  converted  into  the carbonate.
As usually met with, it is a white  powder, like carbonate of mag-
nesia;  has a  slight  alkaline taste; and  is  soluble  both in hot

  1 Bouchardat, Annuaire de Therapeutique pour 1850, p. 177.
  • See Conia, p. 706.
   7 Pharmaceutical Journal, iii. 2, cited in Medical Examiner, Oct. 28, 1843,  p. 25Q
        46 
718         SUPPLEMENT.— MANGANESII SULPHAS.

and cold water, but insoluble in alcohol.  About  100 parts of cold'
water dissolve one part.
  It has been suggested as an internal remedy in lithuria;1 and, ac-
cording to Aschenbrenner,2 may be given in the dose of from five to
ten grains in  the day.

  CXCVI.  Lupuli'na, Lupulinum, iMpvlin,  Lupulinic glands;
French, Lupuline; German, H o p f e n m e h 1, H o p f e n s t a u b. Of this
substance, presumed to possess all the virtues ascribed to the hop, the
author has spoken in another work.3  As a bitter tonic he has made
favourable mention of it, but as a hypnotic both it  and  hops have
disappointed  him.   It is introduced here, however, in consequence of
its having been recently brought forward in a new relation.   Some
years ago, Dr. Wm. Byrd  Page4 introduced it to a limited  extent into
the Blockley Hospital as a preventive of  nocturnal erections in dif-
ferent forms of acute venereal disease.  It was successful in the pre-
vention of chordee ; and by preventing erection in acute gonorrhoea, it
exercised a soothing influence on the inflamed urethra, and facilitated
the operation of curative agents;  relieved the troublesome perineal
pain in chronic gonorrhoea, and during the treatment of stricture by
the bougie; prevented the occurrence of erections during treatment of
chancres of the male organ, which interfere so much with the process
of cure; and after the operation for phimosis had an excellent effect in
the same manner.   In spermatorrhoea it prevented the occurrence of
nocturnal emissions so long as the patient was  freely under its in-
fluence.   Dr. Page refers to  Dr. F. G. Smith, and Dr. Edward
Hartshorne, in confirmation of its antaphrodisiacal virtues.  The dose
he  prescribes is from five to ten  grains,  to be repeated as occasion
may require.  The  latter dose rarely requires a repetition during the
night.   It may be given in powder or  pill.  It causes no headach,
constipation,  nervousness, or any other unpleasant consequence.

  CXCVII. Mangane'siiSulphas, Manganum sulphurieum oxydu-
latum, Sulphas Man ganaiiseuManganosus, Sulphate ofmanganese;
French, Sulfate de manganese; German, Schwefelsaures Man-
ganoxydul.  The salts of manganese have been employed chiefly
as external remedies in cutaneous diseases; but they have almost
fallen into disuse.  " The sulphate of manganese"—say MM. Merat
and de Lens,5 " appears to have been  used externally, under the form
of ointment, in the treatment of cutaneous diseases ; but on this head,
as on the whole therapeutical history of the preparations of the metal
in question," [manganese,] " we may say, that we  have  many more
assertions than proofs ; many more chimerical views, based upon the
large quantity of oxygen, which the oxide of manganese is supposed
to be able to  furnish to the living economy, than  well observed facts
or truly practical deductions."

  1  Pereira, Elements of Mat. Med. and Therap. 3d edit. p. 571.  Lond. 1849.
  a  Die neueren Arzneimittel, u. s. w. S. 178.  Erlangen, 1848.
  3  General Therapeutics and Mat. Med. 4th edit i. 378.  Philad. 1850.
  4  Medical Examiner,  May, 184!), p. 284.
  ' Diet, de Mat. Med. &c, art. Manganese, 
SUPPLEMENT.—MANGANESII SULPHAS.          719
   By the Germans, this salt— which may be obtained by dissolving
 carbonate of manganese in diluted sulphuric acid, filtering and eva-
■ porating  the solution so as to yield crystals—has been given internally
 ini syphilitic affections, and in chronic cutaneous diseases, in the dose
 of  two or three grains [!] in watery solution.  It has been used also
 externally in itch, in the form of ointment, made  of a dram of the
 salt to an ounce of fresh unsalted butter—a piece of the size of a bean
 being rubbed on  the  affected  part  four times a day.1   Dr. A. Ure,a
 who has  proposed many articles as  therapeutical agents on  chemical
 considerations  chiefly, but few of which will probably stand the test
 of  accurate therapeutical observation, has  recommended the sulphate
 of manganese as a cholagogue cathartic.   If a dram, he says, be dis-
 solved in  about half a pint of water, and swallowed before breakfast,
 it will generally occasion, after the lapse of an hour or so, one or more
 liquid evacuations.   With the view of testing whether bile was thus
 discharged  to  any amount, a portion of loose feculent matter was di-
 gested with strong alcohol, in order to separate the mucus, and thrown
 upon a filter; a limpid  olive-coloured  solution  was obtained, which,
 after evaporation in a water bath to the consistence  of honey, yielded,
 on the addition of boiling chlorohydric acid, a notable quantity of bi-
 liary resin, together with a little fatty matter,—affording unequivocal
 proof of the excretion of bile.  He does not show, however,  that the
 quantity was greater than when other or no agents were administered;
 hut he infers, that the salt is "essentially cholagogue in the strict sense
 of the word."  Its action is said to be prompt, and soon over; and it
 is recommended by Dr. Ure as a valuable cathartic  in gout, in which,
 he says, there is generally a deficient action of the liver.[?]
  The communication of Dr. Ure attracted the attention of Dr. Gool-
 dens3 to this salt, who instituted some trials to test its virtues.   When
 taken upon an empty stomach, in the  dose of one or two drams, he
found it invariably induced vomiting in less  than three hours, gene-
rally within one  hour, and the matter vomited consisted of a very
large quantity of  yellow bile.  After a meal,  the same effect  took
place, but not invariably.   It very rarely acted as a cathartic alone;
and after it had been given for several days  he  was often obliged  to
have recourse to other cathartics.   After the first dose, it seldom acts
as an emetic.   The evacuations, which are sometimes dark-coloured,
soon become yellow and loaded with healthy bile ; but if it be  con-
tinued for four or five days, they become lighter, and ultimately show
a total absence  of bile, "appearing like jaundiced stools of the colour
of parchment;  but there  is no jaundice either in the skin or urine.  If
fhe  medicine be discontinued, the yellow colour of the stools returns."
  The dose, according to Dr. Thomson,4 may be from half an ounce
to an ounce as  a cathartic; but Dr. Ure has always  found a much
smaller quantity suffice.   Like other saline  cathartics, it acts  most
efficiently when dissolved in a considerable quantity of water.
  ' Kapp.in Hufeland's Journal der Pract. Heilkund.  Bd. xix. St. 1, S. 176; and Bd. x.
St. 4, S. 178: cited by Osann, in Encyclop'ad. Worterb. der Medicin. Wissenschaft
xxii. 358.  Berlin, 1840.           2 Lond. Med.  Gazette, Nov. 8, 1844, p. 190
  ' London  Medical Gazette, Feb. 14, 1845, p. 646.
  * Chemistry of Inorganic Bodies, ii. 587, cited by Dr. Ure. 
720              SUPPLEMENT.—NAPHTHALINA.
   Of late, the preparations of manganese have been brought forward
 byM. Hannon and M. Petrequin, either as adjuvants or succedanea to
 the preparations of iron. As asuccedaneum for iron the peroxide of man-
 ganese had been employed by M. Gendrin.   It would appear,  too,
 that a  formulary, printed  at  Leipzig in 1847, under the title  Vade-
 mecum  Clinicum, by Dr. J. Kovasy, contains formulae for  the  em-
 ployment of the oxide of manganese in chlorosis and  amenorrhcea,
 and according to M. Ducoux, the  mineral wafers of Cransac, which
 are well-known to be efficacious in anaemia, chlorosis,  &c, contain a
 considerable amount  of sulphate of magnesia  and sulphate of iron.
 M. Hannon has  recommended manganese most  extravagantly as an
 almost infallible  specific (?) in anaemia, whatever may be its origin.
 M. Petrequin more judiciously suggests it as a succedaneum for iron
 in chlorosis, where the latter fails or loses its influence; or where the
 disease removed  by iron returns.  It would appear, however, that in
 only one of the four cases  published by him was the  salt of manga-
 nese, the subcarbonate, used alone ; in the other three, the manganese
 was associated with  iron.3
   Kapp has used it externally in the form of ointment composed of
 5J. of the sulphate to gij. of lard.

   CXCVIII.  Naphthali'na, Naphthalihum,  Naphthalen,  Naph-
 thalin;  French,  Naphthaline; German, Naphthalin.  In the dis-
 tillation of coal-tar, when the last portion  of the volatile oily product
 is collected apart, and left to stand, a quantity of solid crystalline
 matter separates, which is principally composed of naphthalin.  This
 substance formslarge, colourless, transparent, brilliant, crystalline plates,
 which exhale a faint and peculiar odour, compared  to that of the nar-
 cissus.   It is insoluble in cold water, but soluble  in it to a slight degree
 at a boiling temperature.   Alcohol and ether dissolve it readily.3
   When applied  to  the tongue, naphthalin causes a peculiar hot and
 pricking sensation, which extends down the throat and bronchial tubes,
 exciting a spasm of the latter, and  ultimately inducing cough "of a
 kind very efficacious in clearing  the air cells and canals of accumula-
 tions of mucus.   It is, therefore, a remedy  highly suitable in the asth-
 matic coughs of old people, and others, who, from debility, are unable
 to expel the matters which clog the pulmonary membrane."*
  According to M.  Rossignon,5  naphthalin possesses  many of  the
 physical and medical properties of camphor;  for which it may be
substituted.   With  weak alcohol it forms  a tincture, which has  all
 the properties of camphorated spirit at one  half the price.

  1 Etudes sur la Manganese, &c.  Bruxelles, 1849; cited in Canstatt und Eisenmann's
Jahresbericht, u. s. w. im Jahre 1849, S. 162.  Erlang. 1850.  See, on some pharma-
ceutical preparations of manganese, W. Procter, Jr. in American Journal of Pharmacy,
 Oct. 1850, p. 297.
  - Gazette Medicale de Paris, Sept. 1849, and Archives Generates de Med., Janvier,
1850, p. 97.
  3 Bouchardat, Annuaire de Therapeutique pour 1844, p. 46.  Paris, 1844.
  * London Lancet, July 8, 1843, p.  515.
  s Bouchardat, op. cit. pour 1843, p. 64.  Paris, 1843. 
SUPPLEMENT.—OLEUM CADINUM.
721
    M. Emory,1  of the  Hdpital  Saint Louis, Paris, had his attention
  directed to the different products of tar as remedial agents in skin dis-
  eases, from the successful employment of tar in these diseases, and its
  unpleasant odour.  Of these the concrete naphthalin appeared to him
  to be the best.   He employed it in 14  cases.  In two,  one of psoria-
  sis gyrata, and another of lepra vulgaris, it failed; but in 12 it proved
  more serviceable; of these, two were lepra vulgaris, and ten psoriasis.
    The dose is from 8 to 30 grains, given  in emulsion or syrup, and
  repeated pro re natd.   M. Dupasquier  employs a looch, a syrup, and
  lozenges.   The ointment of M. Emory consists of two parts of naph-
  thalin to 30 parts of lard.3

    CXCIX. Oleum Cadinum, Juniperi oleum  empyreumaticum;
  French, Huile de  Cade ou  de  Genevrier;  German, Brenzliches
  Wachholder-Oel,  Cade-Oel.  This oil is obtained by the com-
  bustion of the wood of Juniperus phcenicea and J. oxycedrus; French,
  Cade, Oxycedre.   A sort of liquid tar  results, which is of a blackish
  colour, fetid, and has been employed in France by farriers in the itch
  and ulcers of horses, as well as in the itch of sheep.  It  would appear,
  however, that the  oil of turpentine has been  very generally substituted
  for it, and has received the name of huile de cade.5  The true oil has
  been long employed in toothache, and M. Serres* states, that he has seen
  the most excruciating pain relieved by the introduction of  a drop into the
  cavity of a carious tooth. It is also a popular domestic remedy in cases
  of worms, in the dose of from 20 drops to a dessert spoonful, accord-
  ing to the age of  the child.   It is rubbed, too, on the  upper lip, the
  interior of the nostrils,  temples  and neck, in order that  it may enter
  the lungs with the air of inspiration.
    It  has been long prescribed by Alibert and Cartheuser as an anti-
  scrofulous and antiscorbutic remedy, given  internally;  and was, em-
  ployed with advantage in chronic ophthalmia by Van  Wij;  and by
  Rosenstein  in scabies and eczema.5
    Of late, M. Serres has revived its use in scabies, and now employs
  it  altogether in  that disease; three or four frictions with it being ge-
  nerally sufficient in recent cases.  It is  affirmed, too, by him, that va-
  rious  cutaneous affections,—eczematous, papular, lichenoid,  &c.—
  are cured by its application  every other day.  A pellicle appears to
  be formed by it, which  falls off on the ninth or tenth day, leaving the
  diseased surface healed or in the way of cure.  It is in scrofulous oph-
  thalmia, however, that  M. Serres has  observed  the best effects—in
  those  obstinate cases that  had  resisted other means.   In infants, he
  applies it on the forehead, temples, or cheeks, and on the outer surface
  of the eyelids; and at times he adds the introduction of a  drop into
 each nostril.  He  has used it too with  advantage in tinea, otorrhcea,

   1 Cited in London and Edinburgh Monthly Journal of Medical Science, Jan. 1843,
, p. 68.
  1 Bouchardat, op. cit., and Nouveau Formulaire Magistral, p. 122.   Paris, 1845.
  • Merat and De Lens, Diet. Univ.  de Mat. Med. ii. 489.  Bruxelles, 1838.
  4 Bouchardat, Annuaire de Therapeutique pour 1847, p. 65.
  * Aschenbrenner, Die neueren Arzneimittel, u. s. w. S. 162.  Erlangen, 1848. 
722           SUPPLEMENT. — PLUMBI CHLORIDUM.
pruritus ani, &c.'   It effectually destroys, according to M. Sully, the
parasites which infest  the  hairy scalp in tinea; and he affirms, that
it occasionally cures this loathsome and obstinate disease almost mi-
raculously.
   As a remedy in chronic cutaneous diseases it has been extolled also
by M. Devergie,3 who  has found it most successful, however, in  ec-
zema, both in the  simple and impetiginous form.  In squamous af-
fections and in lupus he has also used it;  but beyond this, he  thinks,
"there is uncertainty or deception."
   M. Sully3 prescribes the  following'ointment in tinea:
               R.  Olei cadin. ^iss.
                   Essent.  anis. gtt. v.
                   Adipis gij.  M.

   CC. Piscid'ia Erythri'na, Jamaica Dogwood.  Dr. Hamilton,*
 during a visit to the Antilles, was struck with the powerfully narcotic ef-
 fects produced on fish by the bark of the  root of this tree.   Inferring
 that it might be useful as a  medicine, he prepared a tincture, made by
 macerating the bark of the roots, gathered during the period of inflores-
 cence, and before the appearance of the leaves, in four times " its weighs
by measure" of rectified spirit for 24 hours, and  filtering.  Of  this
 mixture he took, when much afflicted with  toothache, a fluidram in a
tumblerful of cold water, drank  it off, and watched its  effects,  which
 were anodyne and hypnotic; and on awaking from sleep, his pain had
 wholly disappeared.  He subsequently used it as  a topical applica-
tion to carious  teeth, introducing it on a dossil of cotton into the  dis-
eased cavity;  and after a single application, he never heard of a re-
 turn of pain in  that tooth.
   The formula for Dr. Hamilton's  tincture is one ounce of the bark
 to  four fluidounces of alcohol.   Dose, f 3j.  and less, in  a glass of
 water.

   CCI.  Plumbi Chlo'ridum,  Chloride  of Lead;  French, Chlorure
 de Plomb; German, Chlorblei,  Hornblei.  Chloride  of lead is
 formed when oxide of lead is digested in muriatic acid.  It also falls
as  a white  precipitate  when  a salt, of lead is added  to any  soluble
 chloride.  In  the  London  Pharmacopoeia it is directed to be formed
 as follows:—Take of acetate  of lead,  19  ounces; boiling distilled
 water, three pints, (imperial measure;) chloride of sodium, six ounces.
 Dissolve  separately the acetate of lead and chloride of sodium—the
 former in three pints of distilled water, the latter in one pint.   Mix
 the solutions; wash the precipitate after it has become cool with  dis-
 tilled water, and dry it.   The chloride  crystallizes in long, flattened
 acicular crystals, which are anhydrous.    Its solubility in water is va-
 riously stated.  Generally, it is said to dissolve in 135 times its weight
 of cold water, and to  be more soluble in hot.5 By the  London Col-
   1 Bouchardat, Annuaire de Therap. pour 1849, p. 122.
   a Ibid, pour 1850, p. 65.                      ' Ibid, pour 1849, p. 122.
   ' Pharmaceutical Journal.  Aug. 1, 1844; cited in Med. Chir. Rev., Oct 1844.
   • Graham's Elements of Chemistry, Amer. edit. p. 409.  Philad. 1843; Fownes's Ele-
 mentary Chemistry, American edit. p. 242.  Philad. 1845. 
SUPPLEMENT.—PLUMBI NITRAS.
723
lege, it is  said to be soluble in 30 parts of water at 60°, and in  22
parts at 212V  It was admitted into the London Pharmacopoeia as
one of the substances employed in the preparation of the muriate of
morphia.
   Mr. Tuson,2 has employed chloride of lead in cancerous ulcerations,
both in the form of lotion  and ointment, with some success.   As a lo-
tion, it is of use, he  says, in producing a healthy surface of the sore,
removing fcetor, and relieving pain; and when the ulcer has not been
extensive, it has healed under its application.   In "painful neuralgic
tumours"  it proved very beneficial in relieving the pain.  When ap-
plied to any great extent by rubbing it over  the part in  the form of
ointment, it has produced  a numbness of the arm ; and from the obser-
vations which Mr. Tuson made, on watching the effect of the applica-
tion, he was induced to think, that the pain was removed  by paralyzing
the nerves of the adjacent parts.   From what he has seen of the effect
of  the  remedy he is inclined to  believe, that combined with other
applications and assisted by internal treatment, it may be of very con-
siderable service in certain cancerous affections.

   CCII. Plumbi  Nitras,  Plumbum nitricum, Nitras plumbicus,
Nit rum saturninum, Nitrate of Lead;  French, Nitrate de Plomb;
German, Salpetersaures Bleioxyd.  This salt is officinal in the
Edinburgh college; and is directed to be prepared as follows:—Take
of litharge, 3VSS«> diluted nitric acid,  a pint.  Dissolve the acid to
saturation with the aid of a gentle  heat.   Filter, and set the liquid
aside to crystallize.  Concentrate  the residual liquor to obtain more
crystals.  It forms beautiful tetraedral and  octaedral crystals, nearly
opake, white, and of adamantine lustre, which are permanent in the
air, and soluble in somewhat  more than four parts of water.3
   Hitherto, nitrate of lead has not been much used in  Great  Britain
or this country, in medical  practice;  and it was introduced into the
Edinburgh Pharmacopoeia merely as the best  salt of lead from  which
to prepare the iodide.  It has the same constitutional and local action
as the  other soluble salts of lead.   The property, however, which it
possesses, of coagulating albumen, and of decomposing the compounds
of chlorine, and the sulphohydrates, renders it a valuable antibromic;
and  it has been prescribed as an excitant antiseptic to  wounds.  In
1773, it was  in  use as an  antiepileptic, and  was  especially  recom-
mended by Osterdyk-Schacht and Gessner.4  Dr. Pereira5  states,
that in active haemoptysis  he has sometimes prescribed a pill of sugar
of lead and opium, and a mixture containing nitric acid.  Nitrate of
lead would thus  be formed  in the  stomach.  With this  combination

  1 The Dispensatory of the United States of America, by Wood and Bache, 6th edit.
p. 1075.  Philad. 1845.
  a London Lancet, Jan. 13, 1844, p. 502; and The Structure and Functions of the
Female Breast, p. 426.  Lond, 1846.
  * Christison, Dispensatory, Amer. edit, by R. E. Griffith, p. 739.  Philad. 1848.
  4 Dierbach, Die neuesten Entdeckungen in  der Mat. Med. 3er Band, lste Abtheil.
S. 610.  Heidelb. und Leipz. 1845.
  ' Elements of Mat. Med. and Therap. 3d edit i. 745.  Lond. 1849. 
724
SUPPLEMENT.—POTASSjE NITRAS.
he has succeeded in getting the system under the influence of lead in
a much shorter time than by the sugar of lead only.
  Its main use, until of late, has been as an  application to wounds,
ulcers, cancerous  affections, chronic  cutaneous diseases, chaps, &c.
According to Volz, it is the active constituent of a secret remedy by
Liebert, of Paris, for cracked  nipples.1  Volz employed it with ad-
vantage in these and similar cases, in  the quantity of ten grains to the
ounce of water.
  The most recent circumstance of interest connected with the nitrate
of lead, owing to which it is introduced here, is, that it is the admitted
basis of  " Ledoyen's disinfecting fluid," which attained so much
celebrity  a few years ago, that the British government directed expe-
riments to be instituted with it for disinfecting the subjects of spread-
ing diseases, as well as  infected localities.   It is a  solution of one
dram of nitrate of lead in a fluidounce of water; and it certainly de-
stroys the unpleasant odour of animal and vegetable substances that
are evolving sulphuretted hydrogen and hydro-sulphates of ammonia;
but  there  is no evidence that it has  any destructive power over the
emanations that give occasion to disease.3  Dr. Stratton3 is of opinion,
from observation  of the effects of the two fluids, that the Ledoyen is
inferior to the  Burnett fluid.4  He  affirms,  too, that it is liable to
exert a depressing influence when applied to the body, or used in the
room in cases of typhus; and two cases of lead colic, arising from its
application to ulcers, have been recorded.5
   By Lemaitre de Rabodanges the nitrate of lead has been employed
both as a destroyer of putrid odours,  and for the preservation of ani-
mal substances,—of the dead body, for example,6 as in embalming;
yet its antiseptic power has been denied.7   The commission, consist-
ing  of Dr. Southwood  Smith, Mr. Toynbee and  Mr. Grainger, to
whom, in connexion with the discoverer, the fluid was submitted for
examination by Lord Morpeth, reported, that it does not possess any
peculiar  power in, preserving  the  dead  body  from  decomposition,
whilst they admit its efficacy as an antibromic.8

   CCIII. Potassje Nitras, Nitrate of potassa, Nitre;'French, Nitrate
depotasse; German, Salpetersaures Kali. This salt is noticed here
in consequence of the revival of its use in large doses, within the last
twenty years.   As  a general rule, nitrate of potassa is a dangerous
and rapid irritant poison in the dose of an ounce; yet there are cases
in which this and even a larger  quantity have  been borne with im-
punity,9 especially  when dissolved in a large quantity of water.
   As long ago as the year 1764,  Dr.  Brocklesby, a celebrated British

  1 Dierbach, op. cit. 2er Band, S. 1224.  Heidelb. und Leipzig, 1843.
  * British Amer. Journal of Med. and Phys. Sciences, December, 1847, and the author's
General Therapeutics and Mat. Med., 4th edit.  ii. 371.  Philad. 1850.
  3 Edinb.  Med. and Surg. Journal, Oct 1848, p. 293.          4 See page 691.
  « Brit. Amer. Journal, March, 1848.                       6 Pereira, op. cit.
  ' Academie des Sciences, 8 Juin, 1846; cited by Pereira; and Aschenbrenner, Die
neueren Arzneimittel, u. s. w. S. 230. Erlangen, 1848.
  8 Amer. Journal of Pharmacy, November, 1847, p. 269.
  • Christison, Treatise on Poisons, Amer. edit. p. 189.   Philad. 1845. 
SUPPLEMENT.—POTASS^ NITRAS.
725
 army physician, urged the value of this salt, in large doses, in acute
 rheumatism,—as much as ten drams being given during the day and
 night.   The practice was followed by others,—and, in 1833, Messrs.
 Gendrin and Martin Solon revived it in Paris; sixteen cases are re-
 corded, the average  period of treatment of which was eight days.
 The mean quantity given in one day  was an ounce in three quarts of
 water,—the total average quantity, eleven ounces  They recommend,
 that it should  be begun in the quantity of two  drams and a half to a
 quart of fluid.
   Twelve  successful cases  are also recorded by M. Aran.'   The
 mean dose was  thirty-six grains in three pints  of fluid, and  the ave-
 rage total  quantity, 374 grains.   The mean duration of the disease
 was also eight days.3  Dr. Henry Bennet, who was clinical clerk and
 house physician under M. Gendrin, at La Pitie, states, that for nearly
 three years, which he spent there, all the cases of acute rheumatism
 which came into the wards were treated with nitre, in doses varying
 from six to twelve, or sixteen drams in the twenty-four hours, ac-
 cording  to  the  age, sex,  or constitution  of  the patient;  so that  Dr.
 Bennet thinks he must have seen treated at La  Pitie, in this manner,
 at least seventy or eighty persons.  The salt was always administered
 dissolved in a large quantity of  barley water, sweetened with sugar,
 —the proportion being about half an ounce to a pint and a half or two
 pints of fluid.  This was the only beverage allowed the patient.   The
 secretions  of the skin and kidneys  were generally augmented, and
 sometimes those of the intestinal canal;  but the principal action of
 the nitrate appeared to be sedative, the pulse generally falling rapidly,
 both as regarded frequency and strength—or, in other words, the salt
 seemed to act as a contrastimulant.   Neither  M. Gendrin, nor M.
 Martin  Solon, nor Dr. Bennet, observed any renal inflammation in-
 duced by it, as had been stated by  some.  Dr. Bennet3 states, that he
 has not only administered an ounce or more of nitre in the twenty-
 four hours, for  many days consecutively in acute rheumatism,  but
 also in puerperal fever and other inflammatory  diseases, with, he
 thinks, marked benefit, and without observing any toxical phenomena;
 and in a  subsequent communication4 he asks, whether nitre, thus ad-
 ministered, may not prove a valuable  sedative in febrile and  inflam-
 matory diseases.  In  chronic rheumatism  he found it of little avail.
 Dr. W. R. Basham5 gave it in acute  rheumatism  in the quantity of
 one, two and three ounces, largely  diluted—in two quarts of water—
 in the twenty-four hours.
  The testimonies in favour of large  doses of  nitrate of potassa in
 acute rheumatism are certainly not few; but, as  the  author  has re-
 marked elsewhere,6 it  must be borne in mind, that the disease is self-
 limited in many instances, or, in  other words, appears to run a defi-

  ' Journal des Connaissances Medico-Chirurg. 1841, or Gazette Medicale, Mars, 1841.
  1 Cowan, Provincial Med. and Surg. Journal, May 20, 1843, p. 144.
  5 London Lancet, Feb. 10, 1844, p. 638.        4 Ibid. June 15,1844, p. 374.
  4 Proceedings of the Royal Medical and  Chirurgical Society, Nov. 14, 1848; cited
in Amer. Journ. of the Med. Sciences, Jan. 1849, p. 184.
  • General Therapeutics and Mat Med. 3d edit. ii. 212. Philad. 185a 
726         SUPPLEMENT.—SANICULA MARILANDICA.

nite course, greatly uninfluenced by medicine.  The action of seda-
tion, ascribed  to it, may result indirectly from its revellent operation
on the stomach; but farther observations  are  needed to establish the
fact of such action, before we attempt to explain the modus operandi.
  It may  be  proper to add, that Dr. Young,' of Chester, Pa., has
found  that nitrate of potassa, given in  ten grain  doses, every three
hours, to  the  adult, had an excellent  effect in incontinence of urine.
It succeeded in several cases, in which the tincture of cantharides Rad
failed.  To a boy between nine and ten years of age, " who rarely in
his life had escaped wetting the bed one or more nights in the week,"
Dr. Young ordered ten grains three times a day for a week.  During
this time  he escaped.   It was now omitted for three days, and then
directed to be given four days in the week, omitting it three.  It was
thus continued five weeks, when it  was entirely abandoned.  The
boy had no incontinence from the time of taking the nitre, nor whilst
he  was under Dr. Young's notice, for more  than a year after.  Dr.
Young supposes, that the modus operandi of the nitre in these  cases
may consist in increasing the irritating properties of the  urine, so  as
to make it more stimulating to the bladder or its sphincter.   If so, he
suggests, whether other preparations  of potassa and  soda may not
succeed, in cases  in which the  nitrate fails.   M. Delcour, however,
who speaks favourably of the nitrate, as recommended by Dr. Young,
thinks it  acts rather by diminishing  the  excitation of the bladder.9
Here,  again,  farther experience  is desirable.

   The fumes  produced by the deflagration of nitrate of potassa with
paper  have been  inhaled with  advantage in asthma.  For this pur-
pose  bibulous paper may be  dipped  in a saturated solution of nitre,
and afterwards dried; in  this way  is obtained what  is called touch
paper.  The fumes may be inhaled either by setting fire to the paper
on  a plate, or. rolled up and placed  in a candlestick, and permitting
the fumes to  escape into the room;  or by smoking  the  paper in a
tobacco pipe.   The beneficial effects  are generally experienced in ten
or fifteen  minutes.3

   CCIV. Sanic'ula Mariland'ica, Sanicle, Maryland Sanicle, Black
Snakeroot; French, Sanicle du Maryland.   This plant—of the um-
belliferous family—is indigenous, and common in woods and  copses.4
Dr. Stephen  W.  Williams5 says, " it is supposed to be astringent,
partially  tonic and diuretic, and it has been used with success  in
dropsy; and in decoction in dysentery, leucorrhoea and hemorrhages.
It is also  pulmonary and  balsamic."  The Indians—it is affirmed—
and, after their example, physicians of the country, employed it " in

  1  American Journal of the Medical Sciences, April, 1843, p. 371.
  ■ Journal de Medecine de Bruxelles, cited in Medical Times, Jan. 4, 1845, p. 303.
  * Lond. Med. Gazette, Sept 4, 1846, p. 431; and Pereira, Elements of Mat. Med.
and Therap. 3d edit i. 514,  Philad. 1849.
  4 Gray's Manual of the Botany of the Northern United States, p. 156.  Boston and
Cambridge, 1848.
  * Report on the Indigenous Medical Botany of Massachusetts, in Transactions of
Amer. Med. Association, ii. 871. Philada. 1849. 
SUPPLEMENT.—SOD.K HYPOSULPHIS.           727
syphilis and diseases of the lungs."[  It is introduced here, however,
in consequence of its having been highly recommended by J. B. Za-
briskii2—[in some of the French works metamorphosed into Labriski,]
—in cases of  chorea.   The root is fibrous, aromatic, and  possesses
the active  matter of the  plant.   Dilute  alcohol extracts the  active
principle  in some degree;  but  the  best  form of  administering it,
according to Dr. Zabriskii,  is the powder of the  dried  root.  He
regards it  as  highly tonic, and states, that it is used in popular prac-
tice as a favourite remedy in intermittent fever.
   In chorea he gives it to children eight or ten years of age  in the
dose of half a dram  three times a day.

   CCV.   SodjE Hyposulph'is,   Hyposulphite of   Soda;  French,
Hyposulfite de Soude.   There  are several  modes of preparing this
salt, which is largely used  for photographic purposes.   One  of the
best is to form neutral  sulphite of soda, by  passing a stream of well
washed sulphurous  acid gas into a  strong  solution of  carbonate of
soda, and then to digest the solution with sulphur at a gentle heat for
several days.   By careful evaporation at a moderate temperature, the
salt is  obtained in large and regular crystals, which are very soluble
in water.3
   It is said to have been administered with constant  success by phy-
sicians of Paris, who are the  most versed in the treatment of cuta-
neous diseases.   It was first employed by  MM. Chaussier, and  Biett,
under the name sulfite sulfure de soude, but it had fallen into neglect
when its use  was revived  by M. Quesneville,  and  the  results have
been entirely conformable to those obtained by MM. Chaussier and
Biett.  It is highly extolled by  them in  chronic  cutaneous,  and in
scrofulous affections, and is said to be a most efficacious auxiliary to
external sulphurous  preparations.4
   The best mode of exhibiting it is in syrup, the formula for  which
is given below,—Hyposulphite of soda, 45 grammes, (about 3xiss.;)
Distilled Water, 255 grammes, (about f § viij.;) Sugar, in coarse pow-
der,  1000 grammes, (about B>ij.)  Dissolve the hyposulphite   in the
distilled water wheri cold;  and  form into a syrup at  the  ordinary
temperature.
   Thirty  parts of the syrup contain one  part of  the hyposulphite.
From 30 to 125 grammes, (one  ounce to four,) may be given  in  the
twenty-four hours.
            R. Soda? hyposulph. ^xiss. (45 grammes.)
                 Aq. destillat. f ^ viij. (255 grammes.)
                 Sacchar. in pulv. crass. Oij.  (1000 grammes.)
            fiat syrupus.
                                                  Emile Mouchon.'

  ' Merat and De Lens, Diet. Universel  de Mat. Med. iv. 142.   Bruxelles, 1838.
  4 Amer. Journ. of the Med. Sciences, Oct. 1846, p. 374.
  • French Codex for 1839, and Fownes's Elementary Chemistry, p. 198. Phila. 1845.
  4 Abeille Medicale, 1844, p. 210, and Juin,  1845, p. 151.
  1 Journal de Pharmacie du Midi, cited in Abeille Medicales, Septembre, 1845, p. 237. 
728
SUPPLEMENT.—SUCCUS LIMONIS.
   CCVI.  SoDiE Phosphas,  Phosphate  of Soda; French,  Phos-
phate de Soude; German, Phosphorsaures  Natron.   This salt
has been long known under the name of " tasteless purging salt"
and a formula for its preparation is given in the Pharmacopoeia of the
United  States.  It  has  been urged  as  a  remedy  in lithuria, under
similar views to those that suggested  the employment of phosphate of
ammonia.  If sufficiently diluted,  according to  Dr. Golding Bird,' it
is sure to enter the  circulation,  and be excreted  by the  kidneys,  thus
furnishing  to  the urine  an energetic solvent of uric acid, as Liebig
has shown it to be.  It is true, he says, that this indication can gene-
rally be fulfilled by the pure alkalies and their carbonates; "but they
too often exert the  injurious effect of materially interfering with the
digestive organs, and  thus directly  affecting the integrity of those
functions most intimately connected with  the production, of the mor-
bid deposit."   The phosphate of soda, according to Dr. Bird, may be
given in doses of Qj. to  3ss. thrice a day in broth or  gruel, without
any other apparent effect than that  of slightly relaxing the bowels,
and the urine  becomes charged with  the salt. We may thus, he says,
hope to obtain uric acid  in solution,  and gain time for the enjoyment
of those remedies which  are best adapted for the treatment of the uric
acid diathesis; " for it must never be forgotten, that in merely giving
a remedy to  hold a urinary deposite dissolved, we are merely treat-
ing an effect and not a cause."   Dr.' Bird states, that he has adminis-
tered the salt  in two very chronic cases of uric acid gravel, and in
one with the effect of rapidly causing a disappearance of the deposit.
The triple salt, ammonia-phosphate of soda, he thinks, might  per-
haps be a more active remedy than the simple phosphate, but its dis-
agreeable  flavour constitutes one objection to its employment.   Dr.
Buckler  suggests the  phosphate  of ammonia  in preference to the
phosphate of soda;  the urate of soda  formed by the latter in the blood
being insoluble; whilst,  when  phosphate  of ammonia  is given, "a
double reaction and decomposition take place, and two new salts are
formed, both  of which  are  readily soluble and  capable of being
evolved."3—(See Ammonle Phosphas.)

   CCVII.  Succus  Limo'nis,   Lemon juice;  French, Sue de
Limon;  German, Citron ens a ft.  This familiar article  has been
brought forward by Dr.  Owen Rees on chemical considerations, to
swell the catalogue of undoubted  cures of acute rheumatism.3  Dr.
Rees first had  recourse to it in rheumatic  gout, from a belief that the
vegetable acids—probably owing to the excessive quantity of oxygen
entering into their composition—contribute to effect the transforma-
tion of the  tissues generally, and  because  lemon juice  was the most
palatable form in which  such  class  of remedies  could be applied.
Moreover,  it  appeared  to him probable  that  the supercitrate  con-
tained in the juice, although in  small quantity, was a form of alkaline

  1 London Medical Gazette, Aug. 23, 1844, p. 689; and Urinary Deposits, &c,
Amer. edit.  Philad. 1845.
  a American Journal of the Medical Sciences, Jan. 1846, p. 120.
  1 See Cimicifuga, page 214, and Colchicum, page  228. 
SUPPLEMENT.—SUMBULI RADIX.
729
salt likely to contribute to the alkalinity of the blood in its  trans-
formations; as the examination of the urine shows that such organic
compounds become converted iito carbonates.   He seems to regard
retained uric acid as the materies morbi  in  rheumatism;  and thinks
that the citric acid of the lemon juice yields oxygen, which, with the
elements of water, converts uric acid into urea and carbonic acid;—
an hypothesis which is by no means admitted.1
  In his earliest communication, Dr. Reesa reported several prominent
cases of  cure; and stated that the early relief from pain was such,
that had any one unacquainted with  the remedy in use watched the
progress  of the cases, they would almost inevitably have concluded
that sedatives had been resorted to.  Subsequently, he published a
pamphlet,8 in which he gives eight cases illustrative of the practice.
The forms of rheumatic disease in which the greatest benefit was de-
rived were acute rheumatism and rheumatic gout.  In  pure gout,
with  highly  inflammatory symptoms, more advantage  was obtained
than in the chronic forms of the disease. In doses of half an ounce
to  an ounce, three times  a day, it appeared  to exert a  marked
sedative influence on the  circulation.  In the cases of  rheumatism
related by Dr. Rees, the  urine was  never rendered  alkaline  by the
use of the lemon juice;  and in  one case, in which the urine was
alkaline before treatment,  it became acid  after the juice was employed.
Dr. Ranking* speaks  favourably of  the article;  and  others  have
afforded  similar testimony.5
  Additional evidence  is however needed, before this article—which
every gouty individual is, from  experience, afraid of—can  be re-
garded as an appropriate  remedial agent in arthritic affections;  as
Mr. Dalrymple, however, has remarked, " should it stand the test of
time and hospital practice, and we be able  to  avoid either half poi-
soning our patients with  colchicum, stupifying  them with opium, or
enervating them with mercury, a great boon will be conferred on the
suffering multitudes of this variable climate,"—(that of England.)

  CCVIII. Sum'buli  Radix, Sumbul  root,  Jatamansi; German,
Sumbulwurzel, M oschu s wu rzel, Spicanard.   A root
introduced into notice of late years—the mother plant  undetermined,
but presumed to belong  to the Umbelliferae  Family, and allied  to
Archangelica officinalis.6  According to Erdmann and  Von Lede-
bour,  and the English botanist, Mr. Robert Brown, it  comes from
Bucharia; whilst Guibourt says it is obtained  from  Siberia.?   It ap-

  1  British and Foreign Medico-Chirurgical Review, Oct 1849, p. 530.
  *  London Medical Gazette, Jan. 26, 1849.               .
  3  The Treatment of Rheumatic Diseases by Lemon Juice, with Illustrative Cases,
from Hospital Practice.   Lond. 1849.
  4  The Half-yearly Abstract of the Med. Sciences, No. 11, Jan. to July, 1850. Amer.
edit, p. 19; and No. 12, July to Dec. 1850, p. 33; Amer. edit.  Phila. 1851
  •  Lond. Med. Gaz. June 15, 1849, and Mr. D.  Dalrymple, Lancet, Sept. 1850.
  8  Aschenbrenner, Die neueren Arzneimittel, u. s. w. S. 256.  E'l.angen, 1848-
  '  Dierbach, Die neuesten Entdeckungen  in der Materia Medica,  3er Band, 2te
Abth.  S. 1153.  Heidelb. und Leipz. 1847. 
♦
730             SUPPLEMENT.—SUMBULI RADIX.

pears in commerce either uncut or in slices from one to four inches
in diameter, and  from half an inch  to  two inches thick; having a
strong, musky odour, and a strong, bitter calamus-like taste.   When
examined  by Reinsch, it was found to  contain  an odorous  ethereal
oil,  which did not smell of musk;  a  colourless balsam, and two
peculiar  acids, (Sumbulams'aure  and  Sumbulolsaure;)
aromatic resin, bitter principle, &c.   According to  Schnitzlein and A.
Frickinger,1 a soft  resin oozes from the wood and concretes, which
possesses the characteristic  smell of the root in a high degree, and
has a taste between that of musk and calamus.   It is soluble  in alco-
hol, and is in great part thrown down in a milky form by the addi-
tion of water.
   Sumbul is said to have been used in dropsy and atrophy; but it has
recently been brought forward in Germany as  a gentle excitant of the
nervous  system, and through it of all the organic actions.  Thielmann
prescribed it in the nervous stadium of typhoid fever; and in chorea,
delirium tremens, flatulence  of  the  stomach  as  a  consequence of
tonic spasms, in anaesthesia of the nerves of the bladder, enuresis,
ischuria renalis  spastica, diarrhoea and cholera morbus; and he sug-
gests that it may be found a valuable  prophylactic and curative agent
in cholera.   He prescribed it  also in a case of violent vomiting in
the  convalescent  stage of typhus; in diabetes  insipidus;  and in
tubercular phthisis; and it seemed to him to improve  the condition
of a patient in the last  period of prof use  suppuration from caries with
hectic fever.  It  has been prescribed, indeed, in  the most  heterogene-
ous cases;3 and there is too much reason to believe that effects have
been assigned to it to  which it is little or  not  at all entitled.  It
was given by Dupuis,3 of Mainz, in  cardialgia, colic, disordered
digestion  in  pregnancy, and in  convalescence; and  Von Kieter,4 of
Kasan, prescribed  it generally with advantage in  cholera typhus and
in the later periods of cholera.  Recently, it has been introduced into
England, by  Dr. Granville, of London, with a title to his essay on it
which is sufficient to cast distrust on his testimony,—"The Sumbul; a
new Asiatic remedy of great power against nervous disorders,spasms of
the stomach,  cramp, hysterical affections, paralysis of the limbs and
epilepsy; with an account of its physical, chemical and medicinal cha-
racters, and specific [?[] property of checking the progress of collapse-
cholera, as first ascertained in Russia!"   In this,  Dr. Granville gives
a history of the  article, and of its various applications to the treat-
ment of disease.5  " We do not find,"  says Dr. Ranking,6 " that Dr.
Gjranville's observations have been confirmed.   Should there be any
thing in the medicine, it will doubtless soon be known."

  1 Dierbach, Die neuesten  Entdeckungen in der Materia  Medica, 3er  Band, 2te
Abth. S. 1156.
  a Aschenbrenner, Ibid. S. 257.
  ' Schmidt's Jahrbucher, Jahrgang 1849, S. 294.                 4 Ibid.
  * A full notice of Dr. Granville's pamphlet is contained in  Edinburgh Medical and
Surgical Journal, for Oct. 1850, p. 459.
  • The Half-yearly Abstract of the Medical Sciences, No. 12, July to December, 1850,
Amer. edit. p. 184.  Philada. 1851. 
SUPPLEMENT.—SUMBULI RADIX.
731
  It has been given as an antispasmodic in epilepsy, by Dr. Todd;'
but the  results have not been published.
  It is prescribed in powder, in the dose of half a scruple and more,
several  times a day; in infusion—half an ounce of the  root to six
ounces  of water—dose, a table-spoonful.—In decoction, in water or
hock, half an ounce of the root to  eight ounces of water or wine,
boiled  down to six ounces,—dose, a table-spoonful ;■ and in infuso-
decoctum—half an ounce of the root being infused in five ounces oi
boiling  water; digested for a quarter of an hour in a closed vessel;
strained ; and the residue boiled for a quarter of an hour in sufficient
water to leave three ounces.   The strained  liquors must then be
mixed, and given like the infusion and decoction.   A tincture of it is
also prepared, like the tinctura Valeriana;; dose—fifteen to twenty-
five drops ; and an extract, the dose of which is  from five to ten
grains.*

      :  Cited,  from  London Lancet, in Med. Examiner, July, 1850, p. 437.
       Aschenbrenner, loc. cit. 
 
                           INDEX

                               OF

DISEASES    AND   THEIR   REMEDIES.

     (For Index of Remedies, see the commencement of the volume.)
Abdomen, inflammation of the (hy-
    drarg. cyanur. 416.)
Abortion,  hemorrhage  from  (ma-
    tico, 510.)
Abrasions (collodion, 234, 235.)
Abscess,  mammary  (compressio,
    241.)
Abscesses, large, (chlorin aq. 194;
    iodinum, 482.)
  Suppurating (creasoton, 265.)
Absorbents, inflammation  of  the
    (iodinum, 482.)
Acidity of the stomach (argilla, 102,
    fel bovinum, 710.)
Acne (acid, hydrocyan. 33,36;  sul-
    phur, iodid. 674.)
  Indurata (sulphur, iodid. 674.)
  Rosacea  (acid,  hydrocyan. 33.
    creasoton, 271.)
  Vulgaris (collodion,  234.)
Adiposis (ballota lanata,  131; iodi-
    num, 476.)
After pains (ergota, 322; sulphuris
    carburetum, 671.)
Air passages, diseases of the (chlo-
    rinum, 184.)
  Inflamed, (iodin, 485.)
Albuminuria, (acid, gallic. 22; acid.
    tannic. 41; benzoate of ammo-
    nia, 19; urea, 677.)
Alopecia, (glycerin, 402.)
Amaurosis (acid, hydrocyan. 34; acu-
    punctur. 56; ammoniated coun-
    ter-irritants, 250; electro-mag-
    netism, 296, 298;  electro-punc-
    tura,  304;   galvanismus,  392,
    396; haemospasia, 712; nux vo-
    mica, 541; strychnia, 658, 662.)
  Incomplete (electro-punct. 304.)
Amblyopia (strychnia, 658.)
Amenorrhcea (artemisia, 111; auri
    praparat. 119; brominum, 144;
    cainca; radix, 149;  calendula,
     151;  electro-magnetism,  296;
        47
Amenorrhcea
    ergota, 323; galvanismus, 392;
    haemospasis, 713;  ferr.  proto-
    carbonas, 373; ferr. iodid. 354;
    iodinum, 469; manganes prae-
    par.  720;   potassii   bromid,
    586; potassii iodohydrargyras,
    594; strychnia, 661;  sulphuris
    carburetum, 594.)
Ansemia (ferri pulvis. 335; ferri iodi-
    dum,  356;  ferri  subcarbonas,
    379.)
  during parturition (Ehemostasis,
    714.)
Anaemic habits (ferri subcarbonas,
    379.)
Anaesthesia,local (nuxvomica,542;
    sulphuris   carburetum,  671;
    sumbuli, 730.)
Anasarca (acid, hydrocyan. 32; com-
    pressio, 237; acupunct. 56; col-
    chicum, 229; ferri citras, 343;
    ferri iodid. 356;  urea, 677.)
Anchylosis spuria (iodin.  462.)
Aneurism  (acupunct. 57;  electro.
    puncture, 307.)
Angiectasis (zinci chlorid. 689.)
Angina pectoris (galvanism, 394:
    magnes. 499.)
Anthrax (iodinum, 482.)
  Malignant (chlorin. aq. 192.)
Aphonia (chlorin, 185; cubeb. 283;
    galvanism, 392; ol. tiglii, 564;
    strychnia, 658.)
Aphthae, asthenic (chlorin. aq. 194.)
Aphthous sores (liq. ferr. persesqui-
    nit. 363.)
  Ulceration  (creasoton, 280.)
Apnrea, see Asphyxia.
Apoplexy (ol. tiglii, 566.)
Arsenic, poisoning by (ferri oxidum
    hydratum, 367.)
Arthritis (brominum, 144; compres-
    sio, 238; morphiae acetas, 524.) 
734
INDEX OF DISEASES.
 Arthrocace (ol. jecinor. aselli. 552.)
 Ascarides vermiformes (ferri ferro-
     cyanuretum, 348; fuligo, 387.)
 Ascites (acupunct. 56; caincae radix,
     148; compressio, 237; electro-
     punctur. 307; euphorb. ol. 334;
     ferri iodid. 356; ferri subcarb.
     378; iodinum, 463, 479;  potas-
     sii bromidum, 587.)
 Asphyxia (acupunct. 56;  electro-
     magnetism, 302; galvano-punc-
     tur. 305; soda chlorinata, 645;
     sulphuris carburetum, 671.)
   Neonatorum (electro-magnetism,
     302.)
 Asthenia, chronic (potassae chloras,
     583.)
 Asthma (aether. 70; bignonia catal-
     pa, 137; chloroform, 198, 199,
     203; creasoton, 278 ; galvanism,
     392; iberis  amara, 716;  naph-
     thalin. 720; ol. tiglii, 564; po-
     tassae nitras, 726; quinia sul-
     phas, 623.)
   Humoral (colchicum, 229; sulphur
     iodid. 675.)
   Nervous (magnes. 499.)
   Pulverulentum  (acid,  hydrocy.
     32.)
   Spasmodic (acid, hydrocyan. 32;
     iodinum, 463; ol. tiglii, 564.)
 Atheromatous  cysts  (electro-punc-
     tura, 307.)
 Atony from venereal excesses,(com-
     pressio,  241.)
 Atrophy (brucia, 146; ol. jecinor.
     aselli, 552;  sumbul, 730.)
   Of children (oleum jecoris aselli,
     552.)
   Partial (nux vomica, 540.)
 Bed-sores (collodion, 236; creasotum,
     266.)
 Biles (iodinum,  482; ammoniated
     counter-irritants, 250; ol.  jecor.
     aselli, 555.)
 Bites of serpents (cainca,  149.)
 Black eye (calx chlorin. 156.)
 Bladder, atony of the (diosma, 295.).
   Catarrh of the(acidum benzoicum,
     18;  cort. adstring. Brazil. 253.)
   Diseases of the (diosma, 294.)
   Inflammation of the (fuligo, 386.)
   Irritation of the (acid, benzoic. 19.)
   Paralysis of the (diosma, 295.)
Bleedingfrom leech bites (collodion,
    235] creasoton, 263.)
Blennorrhagia, acute (morphia, 523.)
 Blennorrhcea (acid, hydrocyan. 34;
     acidum tannicum,45; calx chlo-
     rin. 159; chimaphila, 180; cort.
     adstring. Brazil. 253;  cubeba,
     283,287; diosma, 295; iodin. 472;
     ferr. iodid. 358; monesia, 515;
     piperina, 575; salicina, 640;
     zinci chloridum, 691.)
   Of the bladder (diosma, 295.)
   Of the eye (calcis chlorid. 158.)
     See Gonorrhoea.
 Blepharitis glandulosa  (hydrargyri
     cyanuretum, 416.)
 Blotches, syphilitic (argent, praepa-
     rat.93; hydrarg.iodid. rubr.423.)
 Boils, see Biles.
 Bones, diseased (iodinum, 474.)
   Pains in the (zinci ferrohydrocy-
     anas, 696; iodin. 474.)
   Tumours of the (auri praepar. 119;
     potass, iodid.  602.)
 Bowel complaints (iodinum, 485.)
 Bowels,  painful  affections of the
     (acid, hydrocyan. 32;  fel bovi-
     num, 710.)
   Irregular action  of the  (electro-
     magnetism, 298.)
 Brain,  chronic  affections  of the
     (ammoniated  counter-irritants,
     250.)
 Breast, cancer of the (arsenic, iodid.
     107.)
 Bronchia, dilatation of the (chlorin.
     184.)
   Inflammation of the (ammoniated
     counter-irritants, 250.)
 Bronchial  affections  (colchicum,
     229.)
 Bronchitis  (acid,  hydrocyan.  31;
     chloroform, 204; iberis amara,
     716; iodinum, 460; lactucarium,
     498;  mannita,  504;  spiritus
     pyro-aceticus,   648;  strychnia,
     661.)
  Chronic  (aq. picea, 91;  Chlorin.
     184;  cimicifuga, 214;  colchi-
     cum, 229; creasoton, 274; ferri
     citras,  343; galeopsis, 390; ju-
    glans regia, 494; monesia, 513:
    salicina,   640;   spiritus pyro-
    aceticus,  648;  strychnia,  658.)
  Convalescence from (man nit.504.)
  Summer (nux vomica, 542.)
Bronchocele (ferr. iodid. 354.) See
     Goitre.
Bronchorrhma (creasoton, 275; mo-
     nesia, 513.) 
INDEX OF DISEASES.
735
Brow-ague  (ammoniated  counter-
    irritants, 250.)
Bruises (glycerin, 402.)
Bubo  (chlorin.  aq.  194; iodinum,
    456, 482; veratria, 685.)
  Ulcerated (creasoton, 269.)
Burns (calcis chlorin. 156, 163 ; col-
    lodion,  234;  creasoton,   265,
    281; fuligo, 386; iodinum, 484;
    glycerina, 402; sodas chlorid.
    645; sulphuris carburetum,671.)
  Severe (compressio, 238.)
Bursas, inflammation of the  (iodi-
    num, 485.)
  Enlarged (iodinum, 478.)
Cachexia  (acid.  acet.  empyr.  14;
    chlorin. 187; fuligo, 385; iodide
    of iodhydrate of quinia, 611.)
  Marsh (quiniae sulphas, 624.)
  Mercurial (auri praepar. 119; jug-
    lans, 494.)  See Dyscrasy.
  Tuberculous (ol. jecor. aselli, 554.)
Calculous  diathesis (acidum ben-
    zoicum, 18.)
  Pains (diosma, 294.)
Calculus  (chimaphila,  180;  lithiss
    carbonas, 717.)
  Biliary  (chloroform, 204.)
  Expulsion of fragments of (ergo-
    ta, 326.)
  Phosphatic (acid. lact. 38.)
  Uric acid  (ammoniae phosphas,
    77.)
  Vesical (chimaphila, 180.)
Cancer (acid. acet. empyr. 15 ; aur.
    nitrico-muriat.  127;  auri prae-
    par. 119; calcis chlorid. 155; ca-
    lendula,  150;  electro-punctura,
    307;  fel bovinum,  708; ferr.
    arseniat.  337;  ferr. subcarb.
    376; ferr. iodid. 354; fuligo, 388.)
  Of the breast (arsenici iodidum,
    107; calendula,  150; creasoton,
    268;  fuligo, 385.)
  Of  the  face (calx chlorin. 155;
    Creasoton, 268;  fuligo, 385.)
  Of  the  integuments  (calendula,
    151.)
  Of the lip (creasoton, 268.)
  Of the nose (fuligo. 385.)
  Open (carbo animalis, 174;  chlo-
    roform, 199.)
  Of the pylorus (chloroform, 198.)
  Of the skin  (creasoton, 268.)
  Of the tongue (iodin. 471.)
  Of  the  uterus (acidum hydrocy-
    anicum, 33;  auri nitromurias,
  Cancer of the uterus
    127; calendula, 150; cannabis,
    171; creasoton, 268: ferri sub-
    carb. 376; morphiae acetas, 526.)
Cancerous tumour (auri nitro-mu-
    rias, 127.)
  Ulcers (acid, hydrocyan. 36; acid.
    tannic. 42; calendula, 151; calx
    chlorin.  155; carbo animalis,
    175; chlorini aq. 194; fel bovin.
    708; ferri subcarb. 376; plumbi
    chlorid. 723; potass, iodid. 601;
    zinci chlorid. 689, 693.)
  Of the face (creasoton, 268.)
Cancrum oris (acid. acet. empyr. 15;
    calcis  chlorin. 156; chlorin. aq.
    194;  creasoton,  267;  potassae
    chloras, 583;  potassii iodidum,
    599.)
Carbuncle,  sloughing  (creasoton,
    267.)
Carbunculus  malignus (aq. chlorin.
    192, 194.)
Carcinoma of the face (auri chlorid.
    121.)
Cardialgia (argenti oxidum, 99;  ar-
    temisia,  111;  calendula,  151;
    creasotum,  276;  nux  vomica,
    542; quiniae sulphas, 624; sum-
    bul,  730;  zinci  ferrohydrocy-
    anas, 695.)
Carditis (ammoniated counter-irri-
    tants, 250.)
Caries of bones (acid. acet. empyr.
    15;  juglans,  493;  ol.  jecor.
    aselli. 555.)
  Of the fibula, &c. (creasoton, 268.)
  Scrophulosa  (ol.  jecoris aselli,
    552; creasoton, 267, 280; iodinj
    457.)
  Syphilitica (iodinum, 488.)
  Of the teeth, (calcis chlorid. 157;
    creasotum, 279; monesia, 515.)
Catalepsy (strychnia, 660.)
Catamenia, obstruction of the.   See
    Amenorrhcea.
Cataract (atropia, 114.)
  Disintegrated  (carbo animalis,
    175.)
  Incipient (ammoniated  counter-
    irritants, 250.)
Catarrh, chronic f(acid.  hydrocyan.
    31; aq. tannicum, 41; aq. picea,
    90, 91; chimaphila, 180;  chlo-
    rin. 184, 187; emetia,  390;  ga-
    leopsis grandiflora} 390; iodin.
    459.) 
736
INDEX OF
DISEASES.
Catarrh, pulmonary (galeopsis, 312;
    mannitum, 504.)
Catarrhus urethra? (cubebae, 284.)
  Vesicae (acid, benzoic, 18; aq. pi-
    cea, 92; caincae radix,  149; cu-
    bebae, 284; diosma, 295; matico,
    509.)
Cellular membrane, sloughing of the
    (iodinum, 482.)
Cephalalgia (acupunct. 57.)
  Chronic (artemisia, 111.)
  Intense   (potassii  cyanuretum,
    591.)
  Intermittent (quiniae sulphas,629.)
  Nervous (acid, hydrocyan.  33;
    chloroform,  203; zinci ferrocy-
    an. 696; zinci Valerianae, 700.)
  Periodical (zinci ferrohydrocyan.
    696.)
  Syphilitic (hydrarg. cyanur. 416.)
    See Headach.
Cerumen,  defective (acid. acet. em-
    pyr. 16; creasoton, 273; glyce-
    rin, 401.)
Chalkstones  (acidum  benzoicum,
    18.)
Chancre  (acidum tannicum,  43;
    argenti prseparat. 416; collodion,
    235; creasoton, 269', 280; hy-
    drarg.  cyanur. 416;  iodinum,
    484.)
  Phagedenic  (iodinum, 484.)
Chaps (collodion, 234; glycerin, 402;
    ol. jecin. aselli, 556.)
Chest, diseases of the (chlorin. 184.)
  Affections of the (fuligo, 387.)
  Neuralgic affections of the (gal-
    vanism, 394.)
Chilblains  (calx  chlorin, 156,  164;
    creasotum, 266, 281; iodinum,
    483.)
  Ulcerated (monesia, 515.)
Chlorosis (artemisia, 111;  ferri ci-
    tras, 343 ;  ferri pulvis, 335;  ferr.
    iodid. 354; ferr. protocarbonas,
    373; ferr.  lactas, 360; ferri tan-
    nas, 380;  ferri valerianas, 381;
    haemospasia,  713;   mangane-
    sium, 720; paullinia, 570.)
Cholera (cannabis indica, 170,  172;
    carbonis  trichloridum,  705;
    chloroform,   -204;  creasotum,
    276;  diosma, 295; guaco,  408;
    morphiae  acetas,  524;   ferri
    nitras, 363;  iodin.468; nux vo-
    mica, 542; quiniae sulphas, 625;
    strychnia. 660; sumbul, 730.)
Cholera morbus (artemisia,l 11; chlo-
    roform, 204; carbonis trichlori-
    dum,  705;  ferri  et  alumin.
   .sulph. 712;  sumbul, 730.)
  Infantum (argilla pura,  102;  fu-
    ligo, 385; monesia, 514.)
Chordee  (iodinum, 485;  lupulina,
    718.)
Chorea (acid, hydrocyan. 32; can-
    nabis indica,  170;  chloroform,
    203; cimicifuga, 213; ferri sub-
    carb. 378;  ferri ferrocyanur.
    346; ferri iodidum, 355; iodi-
    num, 467;  nux  vomica, 542;
    ol.  jecor. aselli,  556;  potassii
    cyanuretum, 592; sanicula ma-
    rilandica, 726; strychnia, 659;
    sumbul, 730; veratria, 683; zin-
    ci chlorid. 690;  zinci  ferrohy-
    drocyanas, 696.)
Colic  (fuligo, 385; sumbul, 730.)
  Flatulent (aether, 70;  chloroform,
    199, 203.)
  Hysterical (ol. sinapis, 561.)
  Nephritic (aether, 70;  chloroform,
    203.)
Colica pictonum  (aether, 70; nux
    vomica, 541)
Coma  (strychnia,  658; ol.  tiglii,
    566.)
Concretions, tophaceous, (nux  vo-
    mica, 542;  acid, benzoic. 18.)
Condylomata (argent, praeparat. 93;
    creasoton, 269; Hydrarg. deuto-
    iodid. 423.)
Congestions   (electro-magnetism,
    302;  electro-puncture. 307.)
  In the head (ammoniated counter-
    irritants, 250.)
Conjunctivitis (collodion, 236; lac-
    tucarium, 497; zinci valerianas,
    700.)
  Scrofulous (hydrargyri cyanure-
    tum,  416;  potassii  iodidum,
    603)
Constipation (aq. picea, 91; colchi-
    cum, 230;  electro-magnetism,
    298;  fel bovinum,  710;  galva-
    nism,  399; mannit. 504; nux
    vomica, 542;  ol.  tiglii, 566;
    strychnia, 661 ; veratria, 685.)
Consumption, see  Phthisis.
Contagion (calx chlorin. 160; chlo-
    rin,  188; plumbi nitras, 724;
    zinci chlorid.  691.)
Contractions, muscular, (acupunct.
    56.) 
INDEX OF DISEASES.
737
Contusions (acupunct. 57;  creaso-
    ton, 266; iodinum, 484.)
Convalescence (berberina,  137.)
  Tedious (paullinia, 570.)
Convulsions  (aether sulphuric. 69;
    cimicifuga,  213; ammoniated
    counter-irritants,  250;   auri
    praepar.  116;  magnes.  499;
    moxa, 533;  compression of ar-
    teries, 242;  potass,  cyanur.
    592.)
  During dentition  (chlorin. aq.
    191.)
  Hysterical   (compressio,   242;
    electro-magnetism, 298;  indi-
    gum. 433.)
  Parturient  (chloroform,  205; er-
    gota, 322; ether, 72.)
Convulsive affections (acupunct.56.)
  Diseases of childhood (artemisia,
    111.)
Cornea, granulations on the (fuligo,
    386 )
  Inflamed (collodion, 236.)
  Obscurity  of  the (calx chlorin,
    158.)
  Opacity of  the (acid, hydrocyan.
    34; Hydrarg. iodid. rubr. 423;
    iodinum, 485; ol. jecor.  aselli,
    553, 556; zinci ferrocyanuret.
    696.)
  Sparks on the (iodinum, 485.)
  Specks on the (cadmii  sulphas,
    705; fuligo, 386.)
  Scrofulous  ulcers of the (ol. jecor.
    aselli, 556.)
  Spots  on the  (fuligo, 386; zinci
    valerianas, 700.)
  Ulcers of  the (argenti  oxidum,
     100; ol. jecor. aselli, 553; zinci
    ferrocyanuret.  696;  zinci vale-
     rianas, 700.)
 Coryza (cubebae, 283.)
 Cough  (chloroform,  199;  potassii
     iodidum, 603;  cimicifuga, 214;
     lactucarium, 498.)
  Asthmatic (naphthalin, 720.)
  Nervous (acid, tannic. 41.)
  Spasmodic (chloroform, 198; chon-
     drus, 211; lactucarium, 198.)
  Spasmodic, dry (fucus  crispus,
     211.)
 Coxalgia (iodinum, 476.)
 Coxarthrocace (ol. jecor. aselli, 556.)
 Cramp  (ammoniated counter-irri-
     tants, 250; magnes, 499;  Sum-
     bul. 730.)
Cramp of the stomach (nux vomica,
    545;  zinci  ferrohydrocyanas,
    695.)
  Writers'  (electro-magnetismus,

Croup  (haemospasia, 713:  iodinum,
    485; quiniae sulphas, 624.)
  Hysteric (creasoton,  271, 278.)
Crusta lactea (creasoton. 271.)
Cutaneous  diseases  (acid, hydro-
    cyan.  33;  anthrakokali,  80;
    arsenias  ammoniae,  105; aqua
    picea.  89;  arsenic,  iodidum^
    107;  auri chlorid.  121 ; auri
    cyanidum, 125; calx chlorin.
    157: chlorin. 187; chlorin. aq.
    194; creasoton,  270;  ferr. car-
    bur. 339; fuligo, 385; fuligokali,
    389; glycerina,  400; hydrarg.
    deuto-iodid. 422; hydrargyri-
    protonitras, 427; hydrarg. deuto-
    nitras,428; hyd.et aisen. iodid.
    431; hyd. et  quiniae protochlo-
    ridum,715; iodidum ammonias,
    490; iodid. sulph. 674; iodinum,
    408: juglans, 494; manganesii
    sulphas,  719; naphthalin, 721;
    oleum cadinum, 722; ol. jecor.
    aselli, 555; potassae chloras, 583;
    potassii  cyanuret. 592; quiniae
    arsenis, 607; soda  chlorin. 645;
    sodae hyposulphis, 727; sulphur
    iodid.  674.)
  Syphilitic  (hydrarg. iodid.  rubr.
    592.)
Cynanche  (chlorin.  aq.  193;  cort.
    adstring. Brazil. 253.)
  Tonsillaris, see Sore Throat.
  Of  scarlatina (ferri et  aluminae
    sulphas, 712.)             .  '
Cyst, serous, &c. (electro-punctura,
    307; iodinum, 478.)
Dacryocystitis (iodinum, 477.)
Dartrous eruption (hydrarg. iodid.
    rubr. 423; iodinum, 477.)
Deafness  (acid.  acet.  empyr.  15;
    creasoton, 273;  cubeba, 283;
    electro-magnetism,  296; elec-
    tro-punctura, 296;  galvanism,
    392; glycerin, 401; haemospasia,
     713; injections of air, &c, in,
    437 ;  sulphuris  carburetum,
     671.)
   Erethitic,  nervous (injections of
    vapour of acetic ether, 437.)
   Nervous, torpid (injections of va-
     pour of ether, 437.) 
738
INDEX OF DISEASES.
 Debility (ferr. iodid. 356; nux vom-
     ica, 539; piperina, 575.)
   General (quiniae et cinchonas tan-
     nas, 635.)
   Nervous (acid, tannic, 41; quiniae
     sulphas, 630.)
   Paralysis  (ammoniated counter-
     irritants, 250.)
 Decubitus gangrasnosus (plumb, tan-
     nas, 581.)
 Delirium tremens (aether sulphuric.
     69;  animal  magnetism, 399;
     ol. tiglii, 565; chloroform, 203;
     sumbul, 730.)
 Dentition (chlorin. aq.  191.)
 Depositions, morbid  (electro-punc-
     ture, 308.)
 Diabetes insipidus (sumbul, 730.)
   Mellitus  (creasoton, 277;  acid.
     tannic. 40; ferri iodidum, 355;
     urea, 677.)
 Diarrhoea (acid. acet.  empyr.  15;
     acid, tannic. 44; aq. picea,  91;
     argilla,  101;   artemisia, 111;
     carbo animalis, 174;  chondrus,
     211; ferri etalumini sulph. 712;
     fuligo, 385; indigum, 432;  liq.
     ferr. persesquinit. 363; monesia,
     514;  mix vomica, 542; paulli-
     nia, 570; Spiritus pyroaceticus,
     648;  strychnia,  660; sumbul,
     730; veratria, 685.)
  Bloody  (acid,  gallic, 21.)
  Choleric (nux vomica, 542.)
  Chronic (acid, tannic. 41; argent.
     chlorid. 95; argent, oxid. 100;
     emetia, 312; ferr. cyanuret. 347;
     ferri iodid. 363; ferri et alumin.
     sulphas, 712; matico, 509; mor-
     phiae acetas, 526; nux vomica,
     542.)
  Of phthisis (ferri nitras, 363; mo-
     nesia, 514.)
     Of infants (iodinum, 485.)
Diathesis  phthisica  (chlorin.  aq.
     194.)
Digestive function, torpor of the
     (cainca, 148;  chimaphila, 180;
    gentiana chirayita, 399 ; hippo-
    castanum, 410;  monesia, 514.)
Diplopia (acupunct. 57.)
Discharges from the meatus audi-
    torius(acid.acet.empyreum. 15.)
  Mucous (cortex adstringens Brazil,
    253; creasoton, 270; hippocas-
    tanum,  410;  ferri  et aluminae
     sulph. 712;  fuligo, 385.)
Discharges  from the nose and ear
     (iodinum, 458, 472.)
  Offensive (acid. acet. empyr. 15.)
  From the vagina (fuligo, 386.)
Disinfection (chlorin. 188; chlorin.
     aq. 194; zinci chlorid, 691.)
Districhiasis (collodion, 236.)
Dropsy (acid, hydrocyan. 32; acid.
     acet. empyr. 15; aur. chlorid.
     121;  auri et sodii chlorid, 124 ;
     auri praeparat. 119; ballota la-
     nata, 131;  benzoate of ammo-
     nia,  19;  caincae  radix, 148;
     chimaphila,  180;  chlorin. aq.
     194;  cimicifuga, 213;  colchi-
     cum, 229 ;  compressio,  237;
     electro-punctura,307;ferr.iodid.
     356;  hippocastanum, 411; ibe-
     ris,.?^; iodinum, 480; ol. sina-
     pis, 463; ol. tiglii, 563 ; potassii
     iodohydrargyras, 594; sumbuli
     radix, 730;  urea, 677; veratria,
     684, 686.)
  After intermittents (quiniae  sul-
     phas, 623; ferri iodid. 363.)
  Of the bursae (iodin, 465.)
  Encysted (acupunct.  58.)
  Of the joints (electro-punct. 307.)
  Of the  ovary (compressio, 237;
     iodin. 479.)
  Of the pericardium (electro-punc-
     ture,  307.)
  After scarlatina (colchicum, 229;
     iodin. 464; potassii  iodid. 597)
Drunkenness(sulphuris carburetum,
     671.)
Dumbness (galvanism, 392.)
Dyscrasy (ferr.  iodid. 356; sulphu-
     ris carburetum, 671.)
  After intermittents (ferr. cyanur.
     347.)  See Cachexia.
Dysentery (aq. brocchieri, 89; ar-
    genti chloridum, 95; argilla, 100;
    artemisia, 111; calx chlorinata;
     154; chondrus, 211; eau hemas-
     tatique  de   Tisserand, 89; er-
    gota,  323;   ferr. cyanur. 347;
     ferri et aluminae sulphas, 712;
    fuligo, 385; nux vomica, 542;
    paullinia, 570; strychnia, 660.)
  Camp  (creasotum, 277.)
  Chronic (creasotum, 277.)
  Putrid  (chlorin. aq. 193.)
Dysmenorrhcea (aether.  70; chloro-
     form, 204; ergota, 323 ; electro-
     magnetism,  300; potassii iodo-
     hydrargyras, 594; veratria, 684.) 
INDEX OF DISEASES.
739
 Dyspepsia (acid. lact. 41; acid, tan-
     nic. 41; argil, 102; berberina,
     137; carbo animalis, 174; chi-
     maphila, 180; diosma,  294 ;  fel
     bovinum, 710; ferr. iodid. 354;
     fuligo, 387; gentiana chirayita.
     399; hippocastanum, 410; ma-
     tias, 505 ;  nux vomica, 542;  ol.
   '  sinapis, 561; piperina, 574; po-
     tassii iodohydrargyras, 593; qui-
     niae sulphas, 618 ; salicina, 640;
     strychnia, 659; sumbul, 730.)
 Dysphagia (artemisia, 111.)
   Spasmodic (acid, hydrocyan. 32.)
 Dyspnoea (galvanism, 392; potass.
     cyanur, 592.)
 Dysuria (acidum benzoicum, 18;
     apis mellifica, 704; chimaphila,
     180.)
 Ear affections (cadmii sulphas, 705.)
   Middle, affections of the  mucous
    membrane of the (iodinum, 477.)
   Pain in the (morphia, 523.)
 Eclampsia  infantum  (artemisia,
     111.)
 Ectropion (collodion, 236.)
 Eczema (auri chlorid. 121; bromi-
     num, 144; ferri arsenias, 337;
     juglans,  494;  ol. cadinum, 72;
     ol. jecoris aselli, 556;  sulphur.
     iodid. 675.)
 Effused  fluid (electro-magnetism,
     302.)
 Effusions, rheumatic  (electro-mag-
     netism, iv.)
 Elephantiasis (ferri  arsenias,  337;
    iodinum, 469; hura Brasiliens.
     715.)
 Emaciation (chondrus, 211.)
 Empyema (iodinum, 480.)
 Engorgements, visceral (ferr. iodid.
    356.)
 Enlargements, glandular, scrofulous
    (potassii iodohydrargyras, 593.)
 Enteralgia  (acid, hydrocyan. 32.)
 Enteritis (acid, hydrocyan, 31.)
  Chronic (monesia, 514.)
 Entropion (collodion, 236.)
Ephelis (hydrarg.  et  arsen. iodid,
    431.)
Epilepsy (acid, hydrocyan. 32; acu-
    punct. 57; ammoniated counter-
    irritants, 250;  argenti  chlori-
    dum, 95; artemisia. 108;  com-
    pression of arteries, 242 ; conia,
    708; creasoton, 277; ferr. cya-
    nur. 346; galvanism, 393; gra-
 Epilepsy
     natum,407; indigum, 432: iodi-
     num,  467; magnee.  499; nux
  »•   vomica,  542;  monesia, 515;
     platinum, 577; Sumbul, 730;
     strychnia, 660; iodide of zinc
     and strychnia, 666; zinci vale-
     rianas, 700; zinci chlorid. 690;
     zinci ferrohydrocyanas, 695.)
 Epistaxis  (argento oxidum, 100;
     cort. adstring. Brazil. 253; crea-
     soton, 263; ergota, 325; matico,
     510; ferri etalumini sulph.712:
     monesia, 515.)
 Erectile tumours  (collodion, 235;
     electro-punctura, 307; ol. tiglii,
     565.)
 Erections,  nocturnal (lupulina, 718.)
 Erethism,  morbid (creasotum, 278;
     potassae chloras, 582.)
 Ergotism, 316.
 Erysipelas (argilla, 101; chlorin. aq.
     193; colchicum, 229; compres-
     sio, 238; creasoton, 270; iodin.
     481; ol. jecoris aselli, 596; zinci.
     chlorid. 692.)
  Of the face (cort. adstring. Brazil.
     253.)
 Erythema, chronic (collodion, 234.)
 Eustachian tube, obstructed (injec-
     tions of air, &c. 437.)
 Exanthemata, febrile (chlorin. aq.
     192.)
 Exanthematous diseases (cort. ad-
     string. Brazil. 253.)
 Excitability (acid, tannic. 41.)
 Excoriation from lying (creasoton,
     266.)
  Of the skin (oleum jecoris  aselli,
     556.)
  Syphilitic   (aurum  metallicum,
     129.)
 Excrescences,  adventitious  (iodi-
     num, 485.)
  Syphilitic   (aurum  metallicum,
     129.)
 Exostosis (fuligo, 385.)
 Expectoration, excessive   (acidum
     gallicum. 22.)
  Of phthisis (argenti oxidum, 100;
     iodin. 461.)
  Fetid (calx chlorinata, 154.)
Eye, black  (calcis  chlorid.  156.)
  Cancer of the (morphia,  523.)
  Diseases of the  (cadmii  sulphas,
     705; iodinum, 458; potass, cy-
     anuret. 59.) 
740
INDEX OF
DISEASES.
Eye, painful affections of the (mor-
    phia, 523 )
  Strumousulcerationsof the (aether
    sulphuric. 71.)
Eyelid, inflammation of the  (crea-
    soton, 272;  ol.  jecoris  aselli,
    553;  zinci  ferrocyanuret. 696;
    zinci valerianas, 700.)
  Granular (auri chlorid, 121; calx
    chlorin, 158;  iodin, 485; ol. je-
    coris aselli, 553.)
  Perverted states of the (collodion,
    236.)
Fainting, hysteric (sulphuris carbu-
    retum, 671.)
Fauces, ulcerated, (iodinum, 485.)
Febrile affections (chlorin. aq. 193;
    colchicum,  227; potass, nitras,
    725.)
  Diseases (morphia, 520.)
Feigned diseases (aether sulphuri-
    cus, 71; chloroform, 204.)
Fetid  discharges (aluminae  sales,
    76.)
Fever, brain (compression  of arte-
    ries, 242.)
  Congestive (quiniae sulphas, 621.)
  Of  Edinburgh  (calx  chlorinata,
    154.)
  Gastric (artemisia, 111;  chlorin.
    aq. 193.)
  Hectic   (acid,  hydrocyan.  31;
    chlorin. aq. 194.)
  Intermittent, see intermittent.
  Irritative (chlorin. aq. 191.)
  Masked (salicina, 640.)
  Malignant (quiniae sulphas, 620.)
  Nervous (chlorin. aq. 192.)
  Paroxysmal (quiniae sulphas, 620.)
  Pernicious, (quiniae sulphas, 620.)
  Petechial (aq. chlorin.  192.)
  Putrid  (acid.  acet. empyr.  15;
    chlorin. aq. 192.)
  Puerperal (potass, nitras, 725.)
  Remittent, see Remittent.
  Summer (quiniae sulphas, 630.)
  Typhoid, see Typhoid.
  Typhous (sodae chloridum, 644.)
  Yellow (guaco, 409; quin. sulphas,
    621.) "See Typhus.
Fissures of the  anus  (acid, tannic.
    42, 41; monesia, 515.)
  Of the  nipple  (collodion, 235.)
  Of the lips (glycerin, 402.)
  Of the  skin  (creasoton, 266; ol.
    jecor. aselli, 556.)
Fistulae (acid, hydrocyan. 33; calcis
     chlorid.  155; galvanism, 395;
     ol. jecoris aselli, 559;  potass.
     iodid. 602.)
Fistulous openings (iodinum, 485.)
Flatulence (creasoton, 277 ; juglans
     regia, 494; sumbul, 730.)
Fluor albus, see Leucorrhoea.
Fluxes (acid,  gallic. 22.)
Fcetor oris (calx chlorin. 154, 161,
     162; chlorin. aq. 194; chloro-
     form, 199; creasotum, 279.)
Follicular affections  of  the skin
     (collodion, 234.)
Fractures, ununited  (acupuncture,
     59;  iodinum, 485.
Freckles (hydrargyri deutonitras,
     428.)
Frost bites (calx  chlorin. 157, 163.)
  Gangrenous, (zinci chlorid. 692.)
Fungoid disease  (chloroform, 198.)
Fungous  tumour (creasoton, 268;
     galvanism, 395;  zinci chlorid.
     689.)
Fungus of the neck  of the  uterus
     (aur. nitrico. muriat. 127.)
Furunculous swellings (aq.chlorin.
     192.)
Ganglion (acupunct.  59; hydrarg.
     iodid. rubr. 423; iodinum, 485.)
Ganglionic system, disorder of the
  (ferr. cyanur. 348.)
Gangrene  (acid.  acet. empyr. 14;
     calcis chlorid. 156;  soda  chlo-
     rinata, 645.)
  Hospital (calx  chlorin. 154, 156,
     163; creasoton, 267.)
  Of the lungs (chlorin.  185.)
  Of the scrotum (calx chlorin. 156.)
Gangrenous sloughs (monesia, 515.)
Gastralgia (bismulhi valerianas,704;
     cinchona, 217; morphiae acetas,
     524; strychnia, 661; zinci iodid.
     698)
Gastricism  (carbo  animalis,  174;
    mannitnm, 504.)
Gastritis (codeia, 222.)
Gastrodynia (acid, hydrocyan. 32;
     acupunct. 57; argenti  oxidum,
     99; bismuthi  valerianas, 704;
     creasoton,  276;  nux  vomica,
    542;  ol. sinapis, 561.)
Gastromalacia  (acid. acet. empyr.
     15;  chlorin. aq. 193.)
Genital orjrans, atony of  the (cube-
     bap, 282; cort. adstiimr. Brazil.
     253 ; nux vomica, 539.) 
INDEX OF
DISEASES.
741
Genital organs, catarrh of the (cortex
    adstringens, 253.)
Glanders, chronic  (creasoton, 278.)
Glands,  enlarged  (carbon,  sesqui-
    iodid. 177;  iodinum,  457,459;
    plumbi iodid. 580.
  Induration of  the (fuligo, 385;
    hydrarg. deuto-iodid.  422, 424.)
  Mammary,  enlarged   (veratria,
    685.)
  Meibomian,copious secretion from
    the (calx chlorin. 158.)
  Mesenteric, enlarged  (iodinum,
    456.)
  Of the  neck, inflamed  (hydrarg.
    iodid. rubr. 423.)
  Scrofulous swellings of the (calx
    chlorin. 157;  chlorin. aq. 194;
    iodide of chloride of mercury,
    492; iodinum, 457, 483.)
  Submaxillary,  enlarged,   (carbo
    animalis, 175; iodinum, 456.)
  Tumefied,  strumous   (hydrarg.
    iodid. 419; potassii hydrargyro-
    iodid. 594.)
Glandular affections (auri chlorid.
    121; fuligo, 385; iodinum, 455;
    veratria, 685.)
Gleet (calx chlorin.  159; creasoton,
    269; cubebae,  284; ergota, 330;
    nux vomica, 544; potassii iodi-
    dum, 599.)
  Old  (tanninum,  144; strychnia,
    661.)
Goitre (brominum, 144; calcis chlo-
    rin.  164; electro-punctura, 307;
    hydrarg.  deuto-iodid. 423;  io-
    dinum, 454, 475; potassii bro-
    mid. 586; potass, iodid;  600.)
  Scirrhous  (carbo  animalis,  174,
    176; sulphuris carburetum, 671;
    veratria, 685.)
Gonorrhoea  (acidum tannicum, 41;
    argenti praeparat. 93; auri prae-
    par.  118; calcis chlorin. 154,
    159,  161,  162; chlorin. aq.
    194; colchicum, 229;  creaso-
    ton, 269; cubebae, 282; diosma,
    295; ergota,  323;  ferri iodid.
    358; hydrargyri deuto-nitras,
    428; iodin. 471; lupulina, 718;
    matico,  509; platinum, 576;
    zinci chlorid.  693;  zinci iodid.
    698.)  See blennorrhcea.
fioiil (aconit. 49; acupunct. 56; am-
    mon. phosphas, 77; ammoniated
    counter-irritants, 250; ballota
        48
Gout
    lanata, 131; benzoate of ammo-
    nia, 226, 231; colchicum, 131;
    compression  of  arteries,  242;
    creasoton, 275 ;  glycerin, 402 ;
    haemospasia, 712; iodinum, 475;
    magnes. 482; manganesii' sul-
    phas, 719; moxa, 531; ol. tiglii,
    564;  ol. jecinor.  aselli, 549;
    spiritus pyroaceticus, 648 ; suc-
    cus limonis, 729; sulphuris car-
    buretum, 670; veratria, 683.)
  Atonic (creasotum, 276, 279; hip-
    pocastanum, 410.)
  Chronic (chimaphila, 180; colchi-
    cum, 228: diosma, 294 ; ol. tig-
    lii, 564; succus limonis, 728.)
  Irregular (strychnia, 659.)
  Rheumatic (auri chloridum, 121.)
  Suppressed (ammoniated counter-
    irritants, 250.)
Gouty diathesis (acidum benzoicum,
    18; veratria, 685.)
  Swellings of bones (iodin. 475;
    ol. jecoris aselli, 558;  potass.
    iodid. 602.)
  Of the joints (iodinum, 475.)
Gravel (diosma, 295.)
Gravel, uric acid (ammon.   phos-
    phas, 78; soda? phosphas, 728.)
  White (acid. lact.  38.)
Growths,  morbid  (barii  iodidum,
    132;  electro-magnetism, 302;
    galvanism, 395.)
Gums, affections of the (chloroform,
    199.)
  Sponginess  of  the (acid, tan-
    nic. 41  44.)
Gums, scorbutic ulcerations  of the
    (creasoton,  267,  280;  icdiri.
    476; monesia, 515.)
Gutta  rosacea (fuligo, 385;  sulph.
    iodid. 674.)
Haematemesis (argent,  oxid. 100;
    creasoton,  265; ergota, 332;
    matico, 510.)
Haematocele (iodinum, 479.)
Hematuria  (acidum gallicum, 21;
    creasoton,  265; diosma, 294;
    ergota, 323.)
Haemoptysis (acidum gallicum, 21;
    chondrus, 212;  aq. Brocchieri,
    89;  argent,  oxid.  100; cort.
    adstring.  Brazil. 253;  creaso-
    ton, 265; eau hcmastatique de
    Tisserand, 89; ergota, 323; ga-
    leopsis, 391; lactucarium, 498; 
742
INDEX OF
DISEASES.
Haemoptysis
    monesia,  513; plumbi nitras,
    723;  tannin, 42.)
Hair, thinness of the (glycerin, 402.)
Headach,  intermittent  (bebeeria,
    35; quiniae sulphas, 632.)
  Rheumatic, (creasoton, 276.)
  Nervous (strychnia, 659 ; ammo-
    niated counter-irritants,  250;
    iodin. 467 )  See Cephalalgia.
Hearing,  defective, from otorrhcea
    (cubebae, 233.)
Heart, diseases of the, (aconitia, 50;
    veratria, 685.)
  Enlargement of the (acid, hydro-
    cyanic, 32.)
  Hypertrophy of the (brominum,
    144; iodin. 470 ; potass, bromid.
    587;  potass, iodid. 599.)
  Neuralgia of the (aconitia, 50.)
  Spasmodic affections of the. (acid.
    hydrocyan. 32.)
Hectic fever  (acid, hydrocyan. 31;
    chlorin. aq. 194.)
Helminthiasis (juglans, 494.)
Hemicrania (acid,  hydrocyan. 33;
    aether, sulph. 70;  aconit.  51;
    compression  of arteries,  242;
    ferri  subcarb.  377; paullinia,
    570;  potassii cyanuretum,592;
    zinci  valerianas, 699.)
Hemiplegia(electro-magnetism,296;
    nux  vomica,  540;  strychnia,
    657.)
  Rheumatica  (electro - magnetis-
    mus,  iv.)
Hemorrhage (acid, hydrocyan. 31;
    aq. Binelli, 82; aq. Brocchieri,
    89;   acid,  tannicum,  40,  44;
    argilla, 101; cort. adstring. Bra-
    zil. 253 ; creasoton, 261; ergota,
    323, 332;  ferr. iodid. 356; ferri
    et alumin. sulphas, 712; matico,
    507.)
  After abortion (creasoton, 265.)
  From arteries of the lower limbs
    (compression of the aorta, 243.)
  Active  (acid, hydrocyan. 31; er-
    gota,  330.)
  Capillary (creasoton. 264; mati-
    co, 505.)
  From the gums (creasoton, 264.)
  Intestinal (aqua Brocchieri,  89;
    argenti oxyd. 100;  creasoton,
    265; eau hemastatique de Tis-
    serand, 89;  ferri nitras,  363;
    matico, 509.)
    lorrhage from leech-bites (crea-
    soton, 263; ferri et aluminae sul-
    phas, 712; matico, 508.)
  From the lungs.  See  Haemopty-
    sis.
  Passive (acid, gallic. 22.)
  Traumatic  (creasoton,  265.)
  Uterine  (acidum gallicum, 21;
    acid, tannic. 40, 43, 44; canna-
    bis indica, 171; creasoton, 264;
    argent, oxidum,  99; compres-
    sion of the aorta,  243 ; electro-
    magnetism, 299; ferr. iodid.
    355; haemostasis, 714; matico,
    510; monesia, 514; ergota, 322,
    332; ferri citras,  343.)
  From  the   vagina, and  tongue
    (matico, 508.)
Hemorrhagic diathesis (acid.tannic.
    41;  matico, 508.)
Hemorrhoids (acid, tannic. 41, 42;
    acid, chrom. 701; acid, nitric.
    702; cotyledon umbilicus, 707;
    matico, 509; monesia, 515.)
Hepatic diseases.  See Liver Affec-
    tions.
Hernia humoralis.  See Orchitis.
  Incarcerated (sulphuris carbure-
    tum, 671.)
  Reducible  (iodinum, 479.)
Herniary sacs (acupunct. 58.)
Herpes (acid, hydrocyan. 33; aqua
    picea,  89; calcis chlorin. 157;
    chlorin. aq. 194, 195; creasoton,
    271; collodion. 234; ferr.carbur.
    339; fuligo, 385;  hydrarg. cya-
    nur. 416; hydrarg. deuto-iodid.
    423; iodin. 468;  juglans,  494 ;
    ol. jecinor. aselli, 555 ;  potass.
    bromid. 587; potass,  iodid. 598;
    sulphur,  iodid. 674.)
  Circinnatus (ferri tannas, 380.)
  Exedens (creasoton, 271; potassii
    iodidum, 601.)
  Phagedenic (arsenic, iodat.  107;
    potassii iodidum,  603 )
  Scrofulosus exedens (hydrargyri
    deuto-nitras, 428.)
Herpetic ulcers (acid. acet. empyr.
    14; creasoton, 267.)
Hiccough,  spasmodic  (aether, 70;
    compressio, 243; ferri nitras,
    363;   magnes.  499;  quinias
    sulphas.  624.)
Hip-joint disease (moxa,  534.)
Hoarseness (chondrus.  211; iodic
    acid, 491;  ol.  tiglii,  564.) 
INDEX OF DISEASES.
743
 Hooping-cough (acid, hydroc'yan.31,
     35; acid, tannic. 41; aether hy-
     drocyan. 61; aether sulphur. 70;
     argent,  iodid. 98;  conia, 707;
     chloroform, 203;  emetia, 312;
     ferr. carb. 376;  iodin. 463; ol.
     tiglii, 564 ; veratria, 684.)
 Hordeolum  (hydrarg.  iodid.  rubr.
     424.)
 Hydrarthrosis ( electro - punctura,
     307; iodinum, 478.)
 Hydrocele  (acupunct.  58; electro-
     magnetism, 302;  electro-punc-
     ture, 307; chlorin. 187; iodinum,
     463, 477.)
 Hydrocephalus  (compressio,  237;
     electro-punctura, 307; hydrar-
     gyri cyanuretum, 416; iodinum,
     464.)
 Hydrocyanic  acid,  poisoning  by
     (chlorin. 186; chlorin aq. 190.)
 Hydropericardium   (electro  punc-
     tura, 307; iodinum, 479-)
 Hydrophobia (aether sulphuric.  69;
     cannabis indica, 170, 172; chlo-
     rin. aq. 194; chloroform, 203;
     compression of the arteries, 244;
     guaco,  408; morphiae  acetas,
     525.)
 Hydrothorax (acid, hydrocyan.  32:
     colchicum, 229;  electro-punct.
     307; ferri iodid. 356; iodinum,
     463, 479.)
 Hygroma (iodinum, 465.)
 Hyperaemia (ammoniated counter-
     irritants, 251.)   See Inflamma-
     tion.
 Hyperaesthesia (conia. 706.)
 Hyperemesis (acid, tannic. 42.)
 Hypertrophy  (barii  iodidum,  132;
     compressio, 237; ferr. bromid.
     338; ferr. iodid. 356.)
  Of the  coats  of  the stomach
     (sulph.  carburet. 671.)
  Of the heart (bromidum, 144;  di-
     gitalina, 292; iberis amara, 716;
     iodin. 470; potass, bromid. 586;
     potass, iodid. 599, 600.)
  Of the mammae (iodinum, 456.)
  Of the spleen (iodin. 455; quiniae
     sulph. 605.)
  Of the thymus (iodin. 456.)
  Of the uterus (ergota, 325.)
  With dropsy (iberis, 716.)
Hypochondriasis (auri praeparat.l 16;
    chlorin. 187;quiniae sulphas,625;
    strychnia, 659; veratriae, 683.)
Hysteralgia (euphorb. ol. 334.)
Hysteria (aether sulphuric. 70; cimi-
    cifuga, 213;  creasoton,  278;
    ergota, 324; ferri valerianas,381;
    fuligo, 387;  granatum, 407; in-
    digum, 434; lactucarium, 498;
    strychnia,  659; sumbul,  730;
    veratria, 683; zinci ferrohydro-
    cyanas, 695.)
Hysteric croup (creasoton, 278.)
  Fainting (sulphuris  carburetum,
    672.)
  Convulsions (electro-magnetism,
    298; indigum, 433.)
Hysterics (ammoniated counter-ir-
    ritants, 250.)
Ichthyosis (glycerina, 401.)
Impetigo (acid, hydrocyan. 33,  36;
    arsen. iodid. 107; creasoton, 280;
    hydrarg. et  arsen. iodid. 430;
    juglans regia, 494; oleum cadi-
    num, 722; ol. jecin.aselli, 556.)
Impotence (cubebae, 284; diosma,
    295 : iodinum, 481; nux vomi-
    ca, 541.)
Incontinence of urine (diosma, 295;
    ergota, 326; galvanismus, 392;
    iodin. 468;  nux vomica,  539,
    541; potassae nitras, 726.)
Indigestion.  See Dyspepsia.
Indurations of the abdomen (arnica,
    104.)
  Glandular, chronic (carbo anima-
    lis, 174; electro-punctura, 307;
    fuligo, 385;  hydrarg.  deuto-io-
    did.  424.)
  Of the  liver (iodinum, 455 )
  Of the  mammae (calendula, 151.)
  Of the  pancreas  (carbo animalis,
    175; iodin. 456.)
  Of the spleen (iodinum, 455.)
  Of the  stomach (calendula, 151.)
  Of the  testes (iodinum,  456.)
  Chronic (calendula, 151.)
          Of the mammae  (carbo
    animalis, 175.)
Inflammation (acid, hydrocyan. 31;
    aconitia, 48; compression of ar-
    teries, 238; conia,  707.)
  Of the absorbents (iodinum, 482.)
  Of  the air passages (iodinum,
    485.)
  Of the bursae (iodinum, 485.)
  Of the bronchia.  See Bronchitis.
  Chronic  (acid,  hydrocyan.  31;
    barii iodidum, 132; iodic acid,
    491;  ol. croton. 564.) 
714
INDEX OF
DISEASES.
Inflammation, chronic, of the Eusta-
    chian  tube (injections into the
    Eustachian tube, 436.)
                 Of the lungs and
    stomach (ol. jecor. aselli, 554.)
  Of the cornea (collodion, 236.)
  Of the mouth and fauces (chlorin.
    aq. 196.)
  External (compressio, 238.)
  Of the heart.  See Carditis.
  Internal  (acid, hydrocyan. 31.)
  Of the joints (iodinum, 482.)
  Of the liver (chlorin. aq. 194.)
  Of the lungs (ammoniated coun-
    ter-irritants, 250.)  See  Pneu-
    monia.
  Of the mamma (iodinum, 482.)
  Of the pleura (ammoniated coun-
    ter-irritants, 250.)
  Scrofulous (iodinum, 488.)
  Synovial (compressio, 238.)
  Thoracic (acid, hydrocyan. 31.)
  Of the trachea (ammoniated coun-
    ter-irritants, 250.)
  Of the vagina (collodion, 235.)
Inflammatory diseases (colchicum,
    226; compressio, 238; cort. ad-
    string.  Brazil. 253;  morphia,
    520; ol. sinapis,  561;  potass.
    nitras, 725.)
Insanity (aethersulphuric. 69; chloro-
    form, 203; quiniae sulphas,625.)
Integuments, lesions of the (creaso-
    ton, 266.)
Intermittent   (adansonia  digitata,
    703; aether, 70; argent, limat.
    101; bebeeria, 135; cetrarina,
    178; chlorin. aq.  193;  chloro-
    form, 199; cinchonia, 217; co-
    nia, 707; cubeba, 283; ferr. sub-
    carb. 378;  ferrocyanur.  347;
    gentiana chirayita, 399; hippo-
    castanum,  410;  indigum, 432;
    iodin.  465; matias,  505; nar-
    cotina, 537;  phloridzina, 572;
    piperina, 574; quinia, 604; qui-
    niae arsenias, 606; quiniae arse-
    nis, 607; quinia, iodide of iodhy-
    drate of, 611;  quiniae  lactas,
    612; quiniae murias, 613; qui-
    niae sulphas, 617, 623, 629 ; qui-
    niae valerianas, 634; quiniae et
    cinchon. tannas, 636; quiniae sul-
    phas impurus, 636; resina chi-
    nae praepar. 636 ; salicina, 638 ;
    eanicula marilandica, 726; soda
    chlorin. 644; strychnia, 661.)
Intertrigo of  children  (collodion,
     234; creasoton, 266.)
Intestines, atony of the  (ferri ferro-
     cyanur. 347.)
  Ulceration of the (monesia, 514.)
Todina, 451.
Iodine disease, 451.
Iodine, stain from  (potassii cyanu-
     retum, 591.)
Iodism, 451.
Iodkrankheit,  451.
lodosis, 451.
Iralgia (quiniae sulphas, 629.)
Iris, adhesion  of to  the lens (arte-
     misia, 115.)
Iron, sparks of,  removed  from the
     eye (iodinum, 485.)
Irritable habits  (ferri subcarbonas,
     379.)
Ischias (oleum sinapis, 561; veratria,
     682.)
Ischuria (apis mellifica, 704;  col-
     chicum, 229;  sumbul, 730.)
Issues, formation of (zinci chlorid.
     690.)
Isthmitis, atonic (chloroform, 198;
     ferri et  aluminae sulphas, 712.)
Itch (calx chlorin, 157, 163; chlorin.
     aq. 194,  195;  creasoton, 271;
     fuligo, 385; iodinum, 469; man-
     ganesii  sulphas, 719; sapo mol-
     lis, 641; oleum cadinum, 721;
     zinci chlorid. 692.)
  Inveterate (hydrarg.  iodid. rubr.
     422; ol. jecor. aselli, 555.)
Itching (aquaamygdalarum concen-
     trata, 81.)
Jaundice (fel bovinum,  709.)
  With  liver  disease   (iodinum,
     456.)
Joints, inflamed (iodinum, 482.)
  Anomalous pains of the (iodinum,
     482.)
  Chronic  inflammation  and  En-
     largement of the (iodinum, 482.)
  False (iodinum, 476.)
     Rheumatic,  (iodin.  476;  mor-
     phia, 521.)
  Swelled (ammoniated  counter-
     irritants, 250; chimaphila, 181;
     calx chlorin. 157,164; iodinum,
     458; veratria, 685.)
Keratitis (collodion, 236.)
Kidneys, diseases of the (diosma,
     295.)
  Bright's disease of the (acid, gal-
     lic. 22.) 
INDEX OF
DISEASES.
745
Kriebelkrankheit, 317.
Labia pudendi, infiltration of (crea-
    sotum, 267.)
  Offensive affections of (creasoton,
    267.)
Labour, premature, inducing (ergo-
    ta, 322, 329.)
  Tedious  (cannabis indica, 172;
    electro-magnetism, 299.)
Languor  (acid, tannic. 41.)
Laryngismus  stridulus (aether, 70.)
Larynx,  chronic engorgements of
    the (iodinum, 463.)
  Nervous affections of the (conia,
    707.)
  Spasmodic  affections of the (vera-
    tria, 684.)
Leech-bites, hemorrhage from (crea-
    soton, 263;  matico, 508.)
Lepra (arsen. iodid. 107; auri prae-
    parat. 119; carbon, sesqui-iodid.
    177; chlorin. 187; ferri arsenias,
    337; glycerina, 401; hura Bra-
    siliensis,  715;  hyd. et  arsen.
    iodid. 430;  iodidum ammonii,
    490; naphthalin, 721; sulphur.
    iodid. 674.)
Leucophlegmatia  after intermit-
    tent   (ferri  ferrocyanuretum,
    347)
Leucorrhoea (acidum gallicum, 22;
    acid.tannicum,41; argent, oxyd.
    100; chlorin.  aq. 194;  colchi-
    cum, 229; cort. adstring. Bra-
    zil. 253;  creasoton, 269; ferri
    et alumin. sulph. 712; gentiana
    chirayita, 400; cubebae, 283;
    ergota, 323,330; ferr. iodid. 355,
    358; iodinum, 471; juglans re-
    gia, 494;  liq. ferr. persesquinit.
    363; matico, 509; monesia, 514;
    platin. 576;  potassii iodhydrar-
    gyras,  594; potassii iodidum,
    599; salicina, 640.)
Lichen (ferri arsenias, 337; glycerin.
    402;   potassii   cyanuretum,
    592.)
  Leproides (ferr. carbur. 340.)
  Urticatus  (hydrarg.  et  arsenic.
    iodid. 431.)
Lipomatous cysts (electro-punctu ra,
    307.)
Lip6, chapped {glycerin. 402.)
Lithuria  (acidum  benzoicum,   18;
    ammon.  phosphas,  78;  leuco-
    lein, 717; lithiae carbonas, 717;
    sods phosphas, 728.)
Liver, affections of  the (potassae
    chloras,  583; berberina,  137;
    chlorin. 187; iodin. 456.)
  Enlarged (iodinum, 456.)
  Induration of the (hydrarg.deuto-
    iodid. 424; iodinum, 455, 463.)
  Inflammation of the (chlorin. aq.
    194.)
  Obstruction of the (hydrarg. iodid.
    419.)
  Tubercles of the (iodinum, 463.)
Lumbago (acupunct.57; ammoniated
    counter-irritants, 250, 251; chlo-
    roform, 199; emetia,311; iodin.
    475; veratria, 683.)
Lungs, affections of the (cimicifuga,
    213; chlorinum, 184.)
  Gangrene of  the (chlorin.  185.)
  And stomach, chronic inflamma-
    tion of the (ol.  jecor.  aselli,
    554.)
  Mucous  affections of the (crea-
    sotum, 275.)
  Ulceration of the (chlorinum, 184;
    creasotum, 274.)
Lupus (auri chlorid.  121; collodion,
    234; ferri  arsenias, 337;  ferri
    protocarb. 376;  hydrarg. et ar-
    sen. iodid. 430; hydrarg. deuto-
    iodid.  425; hydrarg. deuto-ni-
    tras, 428;  hydrarg. et  quiniae
    protochlorid. 715;  iodin.  469,
    483; oleum cadinum, 722; ol.
    jecoris aselli, 555; zinci chlo-
    rid. 690.)
  Non exedens (collodion, 234; sul-
    phur, iodid. 674.)
  Of  the ala  nasi  (ferr. carb. praec.
    377.)
  Of the nose (creasoton, 268.)
Luxations (diosma, 295.)
Lymphatic glands, indurated  (sul-
    phuris carburetum, 671.)
Lymphatism (ferr. iodid. 355.)
Malignant disease (ferri citras, 343.)
Mammary tumour, chronic(iodinum,
    456; potassii iodidum, 602;  ve-
    ratria, 685.)
Mammae, hypertrophied (iodinum,
    456; potassii iodidum, 602.)
  Indurated  (carbo  animalis,  176;
    iodinum, 456.)
  Inflamed (iodinum, 482.)
  Painful tumours of the  (potass,
    iodid.  602.)
Mania (cannabis indica, 171.)
  Hydrophobic (chloroform,  203.) 
746
INDEX OF DISEASES.
 Mastitis (collodion, 235;  iodinum,
     482.)
 Measles (chlorin.  aq. 193;  iodin.
     467.)
 Melaena (matico, 509.)
 Melicerous cysts (electro-punctura,
     307.)
 Membranes, false (acid, tannic. 41.)
 Meningitis, tubercular (iodin. 464.)
 Menorrhagia (acidum gallicum, 21;
     argent, oxid. 100 ; cannabis in-
     dica,  171;  cort. adstring. Bra-
     zil. 253;  electro-magnetism,
     299; ferr. cyanur. 347; matico,
     509; monesia, 514.)
 Mental  affections  (auri  praeparat.
     116; ol. tiglii, 505.)
 Mesenteric  glands.   See  Glands,
     mesenteric.
 Metritis (acid, hydrocyan. 31.)
 Metrorrhagia (cort. adstring. Brazil,
     253; monesia, 514.)   See  He-
     morrhage, uterine.
 Miasmata, destroying  (calx chlorin.
     157.)
 Milzbrandkarbunkel   (chlorin.  aq.
     192; zinci chlorid. 689.)
 Mortification, mildew, 316.
 Mouth, inflammation of the, chronic
     (chlorin. aq. 196.)
   Offensive conditions of the (calx
     chlorin. 157.)
   Ulcers in the (calx chlorinata,
     162.)
 Mucous membranes, irritability and
     tenderness of the (liquor ferri
     persesquinitrat. 363.)
   Inordinate secretion from (chima-
     phila,  180;  ol. sinapis, 561.)
 Mutism, paralytic (electro-punctur.
     307.)
 Mydriasis (ergota, 325.)
 Naevi (collodion, 235; creasotum,
     273; ol. tiglii, 565; zinci chlo-
     rid. 689.)
Necrosis (iodinum, 458; zinci chlo-
     rid. 689.)
Nephralgia (chimaphila, 180; chlo-
     roform, 203.)
Nephritis (acid, hydrocyan. 31.)
Nervous coughs  (tanninum, 41.)
   Diseases  (acidum  hydrocyani-
    cum, 32; ammoniated  counter-
    irritants, 251;  auri praeparat.
     116; cort. adstring. Brazil. 253;
    creasoton, 277; electro-punctur.
    307; ferr. carb. praec. 377; ferr. |
Nervous coughs, diseases
    cyanur. 347; fuligo, 387; gal-
    vanism,  395;  iodinum, ,467;
    magnes.  499;  morphia,  522;
    morphiae acetas, 524; ol. sina-
    pis, 561; quiniae sulphas, 632;
    sumbul,  730;  veratria, 682 ;
    zinci ferrohydrocyanas, 695.)
  Chronic (acid, hydrocyan. 32; liq.
    argent, muriat. ammoniat. 96.)
  Excitement (lactucarium, 497.)
Neuralgia (acid, hydrocyan. 32, 33;
    aconitia, 49,  51; acupunctura,
    56;  aether  sulphuric. 70; am-
    moniated counter-irritants, 252;
    atropia, 115; chloroform, 199,
    203;  bebeeria, 135;  bismuthi
    valerianas, 704; cannabis indi-
    ca, 169;  compression of arte-
    ries,  242;  conia, 706 ;  contra-
    irritatio,  249;  creasoton, 277;
    delphinia, 289; electro-magnet.
    296, 298;  electro-punct. 303;
    ferr. carb. praec. 376; ferr. ferro-
    cyanur. 347; galvanism, 392;
    glycerin, 402; iodin. 467; mag-
    nes. 499;  morphia,  521; mor-
    phiae acetas, 524; morphiae bi-
    meconas, 530; moxa, 534; nux
    vomica,  542; ol. sinapis, 561;
    ol. tiglii, 564;  potass, cyanur.
    590; quiniae arsenis,607; strych-
    n ia, 659; veratria, 682,686; zinci
    ferrohydrocyanur. 696.)
  Of the abdomen (codeia, 222.)
  Of the arm (strychnia, 659.)
  Of the chest  (galvanism, 394.)
  Faciei  (acid,  hydrocyan. 33;
    artemisia,  111;  codeia, 222;
    compression  of  the arteries,
    242;  conia,  707;  creasotum,
    277;  ferri  ferrocyanur. 347;
    morphia, 522; nux vomica, 542;
    potassae chloras.  583;  potassii
    cyanuretum, 590, 592.)  See
    Tic Douloureux.
  Frontal (galvanism, 398; morphia,
    522.)
  Of the  head (cannabis  indica,
    171.)
  Of the heart (aconitia, 50; magnes.
    499.)
  Of the nervus pudendus superior,
    (compression of  the  arteries,
    242.)
  Obstinate    (zinci    valerianas,
    700.) 
INDEX OF DISEASES.
747
 Neuralgia  of  the  orbitar  nerves
     (compression  of the arteries,
     242.)
   Pulmonary (magnes. 499.)
   Rheumatic (eleclro-magnetismus,

   Sciatic  (morphia,  523;  potassii
     cyanuret.  590.)
 Neuralgic tumours (plumbi chlorid.
     723.)
 Neuropathic   diseases   (iodinum,
     467.)
 Neuroses   (aether  sulphuric.  68;
     chloroform,  202; electro-mag-
     netism, 297;  granatum, 407;
     ol. tiglii,  564; iodide  of zinc
     and strychnia, 666; zinci chlo-
     rid. 690.)
 Nipples,  excoriated  (acid.  acet.
     empyr.  13;  acid,  tannic.  42;
     calx  chlorin.  156;  collodion,
     234 ; creasoton,  266; glycerin,
     402; plumbi tannas, 581.)
 Nodes, gouty (sulphur, carb. 672.)
 Noli  me tangere  (iodinum, 483;
     zinci chloridum, 690.)
 Noma (chlorin. aq. 194.)
 Obstetrics (aether,  70; chloroform,
     205.)
 Odontalgia  (chloroform,  199; am-
     moniated counter-irritants, 250;
     conia,  707;  ol.  sinapis,  561.)
     See Toothach.
  Rheumatic   (sulphuris  carbure-
     tum,  672 ;  ol. croton. 564.)
 Odour, offensive (calx chlorin. 157.)
 (Edema (creasoton, 272 )
  Of the. feet (acupunct. 56.)
  Meningum (iodin. 465.)
 CEsophagus, stricture  of the  (iodi-
    num, 476 ; sulphuris carbure-
    tum, 671.)
Offensive evacuations, (calx chlorin.
     154.)
Oligaemia (ferri iodidum, 356.)
Ophthalmia (acid, hydrocyan. 34;
    acupunct.  56, 57; aether, 70;
    argent,  oxid.  100;  creasoton,
    272; ferri et aluminae  sulphas,
    712; iodin. 468.)
  Catarrhal (calx chlorin. 158, 163;
    lactucarium,  497.)
  Chronic  (cadmii sulphas,  705;
    calx chlorin. 158; iodinum 485;
    matico, 516; oleum cadinum,
    721.)
  Egyptian  (acid, tannic. 42.)
 Ophthalmia, neonatorum (calx chlo-
     rin. 158.)
   Purulent (calx chlorin. 158; mo-
     nesia, 515.)
   Rheumatic (zinci ferrohydrocyan.
     696.)
   Scrofulous  (auri  praeparat.  118;
     auri chlorid. 121; calx chlorin.
     163; hydrarg.  et arsen. iodid.
     431; iodin. 458; oleum jecoris
     aselli,  553; potass, iodid. 602,
     603 ; quiniae sulphas, 631; zinci
     iodid. 698.)
   Strumous (bebeeria, 135; creaso-
     ton, 272; fuligo, 386;  hydrarg.
     et  arsenic, iodid.  431;  iodin.
     485; juglans, 494; matias, 505;
     ol. cadinum, 721; potassii iodid.
     601 ; ol. jecor. aselli, 553.)
   Tarsi  (acid. acet.  empyr.  15;
     creasoton, 272; hydrarg. deuto-
     iodid. 424; zinci ferrohydrocy-
     anas, 696 ; zinci iodidum, 698.)
 Orchitis (chloroform, 199; compres-
     sio, 238;  iodinum, 485.)
 Os uteri,ulcerations of the(collodion,
     235; creasotum, 268; iodinum,
     489.)
 Osteocopi,  syphilitic (hydrarg. et
     arsenic, iodid. 432; iodin. 474;
     strychnia, 660;  strychniae ace-
     tas, 665;  zinci  ferrocyanur.
     696.)
 Otalgia (conia, 706; ol. sinapis, 561;
     ol.  tiglii,  564.)
 Otorrhcea (cadmii   sulphas,  705;
     creasoton, 265,  273;  cubebae,
     283 ; juglans, 494 ; oleum cadi-
     num,  721;  potassii   bromid.
     586.)
 Otorrhcea, fetid (zinci chlorid. 693.)
 Ovaries, degenerated (iodin. 470.)
  Dropsy of the (iodin. 470.)
  Indurated (iodin. 470.)
  Inflammation of  the  (hydrarg.
    cyanur. 416.)
Ozasna  (calx  chlorin. 164;  carbo
    animalis,  175;  iodinum,  472.)
Pain, anomalous, of  hip and thigh
    (morphiae bimeconas, 530.)
  Nervous and muscular (ammoni-
    ated  counter-irritants,   249;
    moxa, 535.)
  Nocturnal, in the bones (hydrarg.
    et  arsen.  iodid. 432; iodinum,
    474 ; zinci  ferro-hydrocyanas,
    696.) 
748
INDEX OF DISEASES.
Pain, rheumatic (cainca, 149; dios-
     ma, 295.)
   Severe (acid, hydrocyan. 33, 34.)
Pains, After (ergota, 332; sulphuris
     carburetum, 671.)
   Erratic (iodinum, 468.)
Palpitations  (acidum  hydrocyani-
     cum, 32; bismuthi valerianas,
     704 ; creasotum, 278;  emetia,
     307 ;  magnes. 499;  veratria,
      85.)
Palsy, see Paralysis.
Pancreas, induration of the (carbo
     animalis, 175; iodin. 471.)
Pannus, cellular (ol. jecoris aselli,
     553.)
   Vascular (ol. jecoris  aselli, 553.)
Paralysis  (acupunct.   57;  arnica,
     103;  brucia,  146;  delphinia,
     289; galvanism, 392;  electro-
     punct. 303, 307;  haemospasia,
     712; iodinum, 467;  nux  vo-
     mica, 539;  ol.  sinapis, 561 ;
     ol. tiglii,  564; sumbul, 730;
     paullinia, 570; strychnia, 657;
     veratria,  683;  zinci  chlorid.
     690;  zinci ferro-hydrocyanas,
     695.)
   Of the  bladder  (diosma, 295;
     ergota, 326;  strychnia, 658.)
   Of the rectum (nux vomica, 541.)
   Of the upper  eyelid (ol. tiglii,
     565; strychnia, 657.)
   Of the rectum (strychnia, 658.)
   Of the tongue  (electro-puncture,
     304.)
   Of the facial nerve (electro-mag-
     netismus, iv.;  strychnia,  658.)
   Of the portio dura (ammoniated
     counter-irritants, 252.)
   Lead (brucia, 146.)
   Partial (electro-magnetism, iv.,
     296; nux vomica, 541 ;  strych-
     nia, 65S; veratria,  683.)
   Rheumatic  (electro-magnetism.
     296.)
   Of the forearm  (electro-magne-
     tism, iv.)
   Succeeding to  apoplexy (brucia,
     146; nux vomica, 540.)
Paralytic  debility  (ammoniated
     counter-irritants, 250.)
Paraplegia (ergota, 325; galvanism,
     394; strychnia, 657; strychniae
     iodas, 665.)
Parasites (oleum cadinum, 722.)
Paroxysmal diseases (ergota, 325.)  |
 Parturient efforts,  defective  (can-
     nabis indica, 172; cimicifuga,
     214; ergota, 312.)
 Pelvic  tumours,  painful  (chloro-
     form, 199.)
 Pericarditis  (ammoniated counter-
     irritants, 250.)
 Periodical diseases  (ergota,  325;
     quiniae ferrocyanas, 609; quiniae
     sulphas, 620.)
 Periostitis (iodinum,  458.)
 Periosteum, diseased (iodin. 474.)
 Peritonitis from constipation (man-
     nita, 504.)
 Phagedaena (chloroform, 198; crea-
     sotum,  280;  iodinum,  473;
     zinci chloridum,  689.)
  Of the cheek (potass© chloras,
     583.)
 Phagedaenic  tuberculous  diseases
     (arsenic, iodid. 107.)
 Phimosis (lupulina, 718.)
 Phlebitis (compressio, 238.)
 Phlegmasia  (compressio, 238; hae-
     mostasis, 714.)
 Phlegmon iodinum, 481.)
 Phosphatic depositions (acid. lactis,
     38.)
 Photophobia  (conia, 707.)
    "lisis (acid,  hydrocyan.  31,34;
     acid. acet. empyr. 15;  acid.
     tannic. 41; aether, 71; aq. pi-
     cea, 89; argilla, 101; calx chlo-
     rin. 154;  chlorin,  184;  chon-
     drus,  211;  cimicifuga,  214;
     creasoton,  273; ferri iodidum,
     355;  fucus crispus,  211;  gale-
     opsis,  390; haemospasis,  713;
     iodic acid, 491;  lactucarium,
     498;  iodinum, 459, 462; mati-
     as,  505;  monesia, 513; ol. tig-
     lii,  564; ol. jecor. aselli, 550,
     554;  paullinia,  570;  potassae
     chloras, 583 ; sumbul, 730; spi-
     ritus pyro-aceticus, 647.)
  Cough of (codeia, 222.)
  Mucosa (galeopsis,  390; iodinum,
     462.)
  Pituitosa (chimaphila, 180.)
  Sweats of (acid, gallic. 22;  bole-
     tus laricis, 138; acid,  tannic,
     42; argenti. oxid. 100; galeop-
    sis, 390; iodin. 461.)  «
  Threatened (galeopsis, 390.)
Pica (caincae radix,  149.)
Pile, bleeding  (acidum nitricum,
    702.) 
INDEX OF DISEASES.
749
 Pimples (ammoniated counter-irri-
   tants, 250.)
 Pitting from smallpox (calx chlorin.
     156;  collodion,   236;  iodin.
     466.)
 Pityriasis (glycerina, 401; hydrarg.
     et arsen. iodid. 431; zinci chlo-
     rid. 689.)
 Placenta praevia (aether sulphuricus,
     72.)
   Retention of the (ergota,  322.)
 Plague (chlorin. aq. 194.)
   Prevention of (chlorin. aq.  194.)
 Pleuritis,  see  Inflammation of the
     Pleura.
 Pleurodyne (acupunct. 57.)
 Pneumonia (iodine, 462; mannita,
     504.)
   Chronic (hydrarg. cyanuret. 416.)
   Convalescence   from   (mannit.
     504.)
   Purulent, infiltration after (moxa,
     534.)
 Poisoning-, by  arsenic (ferri  oxyd.
     hydrat. 367.)
   By arseniate of copper (ferri oxi-
     dum hydratum, 371.)
   By hydrocyanic acid (chlorin. aq.
     194.)
   By  opium  (electro-magnetism,
     302.)
 Polypi, cartilaginous (carbo anima-
     lis,  174.)
   Mucous (carbo animalis,  174.)
   Uterine (ergota, 323.)
 Porrigo (acid. acet. empyr.  14; car-
     bon, sesqui-iodid.  177; fuligo,
     387; iodin. 468; juglans, 494;
     sulphur, iodid. 674;  ol. jecor.
     aselli, 555;  hydrargyri deuto-
     nitras, 428; hydrarg. et arsen.
     iodid. 431;  oleum  cadinum,
     721.)  See Tinea.
   Decalvans  (sulphur,  iodid. 674.)
   Favosa (creasoton, 272; hydrarg.
     bromid.  413;  iodinum,  468;
     potassii bromid. 587.)
  Scrofulous (auri praeparat. 118;
     monesia, 513.)  See Tinea.
Profluvia (aqua Binelli, 84.)
Prolapsus ani (acid, tannic. 41; nux
    vomica, 541.)
  Uteri (electro-magnetism, 302.)
  Vaginae (creasoton, 272.)
Prosopalgia (ol. sinapis, 561 ; po-
    tassae  chloras, 583;  veratria,
    682; zinci chlorid. 690.)
        49
 Prostate, disease of the  (diosma,
     295.)
   Enlargement of the (carbo anima-
     lis, 176; iodinum, 456, 474.)
 Prostatic discharges (cubeba, 2-j4.)
 Prurigo (colchicum, 229-;  glycerin,
     402; zinci chlorid. 692.)
   Senilis (aq. amygd. concentrata,
     81.)
 Pruritus (glycerin, 402; zinci chlo-
     rid. 692.)
   Pudendi muliebris (calx chlorin,
      158.)
   Vulvae (fuligo, 385; potassii cya-
     nuret. 591.)
 Psora, see Itch-
 Psoriasis (chlorin,  187; creasoton,
     271; ferri arsenias,  337;  hy-
     drarg.  iodid.  419; glycerina,
     401; hydrarg. et arsen. iodid.
     430; iodidum  ammonii,  490;
     naphthalin, 720; sulphur, iodid.
     675.)
   Palmaris (fuligokali, 389.)
 Pulmonary    complaints,   chronic
     (iodinum, 460.)
 Pupil, dilatation  of the, caused by
     belladonna (ergota, 325.)
 Pustular eruptions (cretfeoton,  272 ;
     iodinum, 474.)
 Pustule maligne (zinci chlorid. 689.)
 Putrefaction, checking (calx chlo-
     rin, 160.)
 Putrescency, tendency to  (quiniae
     et cinchoniae tannas, 636.)
 Pyrosis  (argenti oxidum, 99; nux
     vomica, 542.)
 Ranula (iodinum, 483.)
 Rectum, catarrh of the (cort. ad-
     string. Brazil. 253.)
   Paralyzed (nux vomica,  541.)
   Ulcerated  (moxa, 534.)
   Varicose condition of the (matico,
     510.)
Remittent fever (bebeeria,  135; ferr.
     cyanur.  347; quiniae  sulphas,
     621; quiniae valerianas, 634.)
Retention of urine (ergota, 326.)
Rhagades (ol. jecor. aselli, 556.)
Rheumatic gout (colchicum, 228.)
Rheumatic effusions (electro-mag-
    netismus, iv.)
  Pains (cainca, 149; emetia, 311;
    hydrarg. deuto-iodid. 424.)
  Swellings of the joints (iodinum,
     176, 485; potassii iodidum, 598;
    sulphuris carburetum,  671.) 
750
INDEX OF DISEASES.
Rheumatism  (aconitia,  49;  acu-
     punct. 56; ammoniae phosphas,
     77;  ammoniated  counter-irri-
     tants, 250;  anthrakokali, 80;
     ballota  lanata,  131;  caincae
     radix,  149;  cannabis indica,
     170; chlorin. 187;  cimicifuga,
     213;  colchicum,  226;  com-
     pressio,  238;  compression  of
     arteries, 242;  creasoton,  275;
     delphin.  289;  electro-magne-
     tism,  296, 300;  electro-punct.
     303; ergota, 325;  fuligo,  387;
     galvanism, 392; glycerin, 402;
     iodinum,  475;   magnes.  499;
     morphias  acetas, 524;  moxa,
     534; ol. tiglii, 564;  ol. jecinor.
     aselli.  549; ol. sinapis,  561;
     ol. tiglii, 565;  platinum,  576;
     potassa?  chloras, 583; potass.
     nitras, 725; potass, cyanur. 590;
     quiniae sulphas,  624 ; sp. pyro-
     aceticus, 648; succus limonis,
     728; sulphuris carburetum, 670;
     veratria, 683, 685.)
  Atonic (creasotum, 278.)
  Chronic (aconitia,  51 ; ammoniae
     phosphas, 77, 78; anthrakokali,
     80; chimaphila, 180; colchi-
     cum, 231; cubebae, 283; diosma,
     291; electro-punctura, 307; fu-
     ligo, 385; iodin. 475; morphia,
     521;  ol.  sinapis, 561; potassii
     cyanuretum, 590; veratria, 683;
     spiritus pyro-aceticus, 648.)
Rickets (ferr. iodid. 354; fuligo, 385;
     ol. jecor. aselli, 549, 553.)
Ringworm (ammoniated counter-ir-
     ritants, 250.)
Roseola (chlorin. aq.  193.)
Rubeolae (chlorin. aq. 193.)
Rupia (iodinum, 474; hydrargyri et
     arsenic, iodid. 431.)
Scalp, dryness of the (glycerin, 402.)
St. Vitus's dance (ammoniated coun-
     ter-irritants,  250; liq.  argent.
     muriat. ammon. 96; artemisia,
     111; indigum,434; nux vomica,
     542;  zinci chlorid.  690.)   See
     Chorea.
Salivation, mercurial (acid.  acet.
     empyr. 15; calx cnlorin.  157.)
  Mercurial (creasotum, 265;  iodi-
     num,  476;  potassae  chloras,
     584.)
  Profuse (auri praeparat. 116; ferri
    et  aluminae sulphas, 712.)      I
Sarcomatous tumour of the  knee
     (bromin. 144.)
Scabies (acid. acet. empyr. 15; chlo-
     rin.  187.)
Scalds (iodinum, 484.)  See Itch.
Scarlatina  (acid. acet.  empyr. 15;
     calx chlorin.  157;  chlorin. aq.
     192,195; colchicum, 229; iodin.
     467; potassae chloras, 584.)
Sciatica (acupunct. 57 ; cannabis in-
     dica, 170; ammoniated counter-
     irritants, 252; codeia,  222; io-
     din. 475;   electro-magnetism,
     296; morphia, 521; potass, cy-
     anur. 590.)
  Gouty (acid, hydrocyan. 33.)
  Rheumatic (acid, hydrocyan. 33.)
Scirrhus (auri piaepar.  119;  calen-
     dula, 151; ferr. iodid. 354; iodi-
     num, 470;  platinum, 576; po-
     tass, iodid.  598.)
  Of the lips (carbo  animalis,  174.)
  Of the mammae (calendula,  151;
     carbo animalis, 275; ferri iodid.
     354; iodin.  470.)
  Of the prostate  (carbo animalis,
     175.)
  Of the pylorus (acid, hydrocyan.
     33; auri praeparat.  119;  iodin.
     471;  zinci  ferrohydrocyanur.
     696.)
  Of the stomach (artemisia, 111  ;
     iodin. 471; platinum, 576.)
  Of the  tongue (auri praeparat.
     119.)
  Of the uterus (acid,  hydrocyan.
     33;_auri  praepar.  119;  iodin.
     470.)
Scorbutus  (acid. acet. empyr. 15;
     iodin. 476;  monesia, 514; ol.
     cadinum, 721.)
Scrofula (acid, pyrolign. 15; anthra-
     kokali,  80;  auri cyanur.  125;
     auri praspar. 118; barii iodidum,
     132;  brominum,  144;  carbo
     animalis, 175; chimaphila, 181;
     chlorin.  187;  chondrus,  211;
    ferr. bromid. 338; ferr. cyanui.
    347;  ferr.  iodid.  355;  fucus
    crispus, 211; hydrarg. iodid.419;
    hydrarg. iodid. rubr. 422;  iodi-
    num,  457;  iodic  acid,   491;
    oleum  cadinum, 721;  juglans
    regia, 494;  monesia, 515; oi.
    jecoris  aselli,   549 ;  potassii
    bromid.  586;   potass, iodid.
    600.) 
INDEX OF DISEASES.
751
 Scrofulous  affections  (acid.  acet.
     empyr. 15;  auri  et sodii chlo-
     rid. 124;  carbon, sesquiiodid.
     177; ferri iodid. 354;  juglans,
     493; soda chlorin. 645;  sodae
     hyposulphis, 727.
   Caries (creasotum, 280.)
   Diathesis (carbo animalis,  174.)
   Discharges from the nose and ear
     (iodinum, 178.)
   Diseases  (barium iodatum,  133.)
   Habit (auri et sodii  chlorid. 123 ;
     ferr. cyanur. 347.)
   Inflammation (iodin. 459.)
   Swellings (barii  iodidum   133;
     brominum, 144;  calx  chlorin.
     154; carbo animalis, 175;  chlo-
     rin. aq. 194; conia, 707; iodid.
     quiniae, 611; iodinum, 458, 483 ;
     potassii bromidum, 588; plum-
     bi  iodid.  580, 586;   potassii
     iodhydrargyras, 594;  veratria,
     685.)
             Of  the glands  (calx
     chlorin. 157;  iodinum,   102;
     potassii  iodhydrargyras,   594;
     potassii iodidum,  600; quiniae
     hydriodas, 610; veratria, 685.)
             Of  the  joints  (calx
     chlorin. 164.)
   Tumefaction of the  testicle (po-
     tassii bromidum, 586.)
   Tumefaction of the upper lip (aur.
     et sod. chlorid. 123.)
   Ulcers (potass, iodid. 601;   hyd.
     et  arsen.  iodid. 430;  juglans
     regia, 494; monesia, 515 ; zinci
     chlorid. 689, 692.)
Scurvy (creasoton, 267.)  See  Scor-
     butus.
Sea sickness (creasoton, 276.)
Sebiparous organs, affections of the
     (collodion, 234.)
Secretion, undue (argenti  oxidum,
     99.)
Sensibility,  unusual, of the abdo-
     domen(zinci ferrohydrocyanas,
     696.)
Serous cysts (electro-punctura, 307;
     iodinum, 478.)
Serpents,  bites of  (caincae radix,
     149; guaco, 408; iodin. 485.)
Serpigo (potass, iodid. 600.)
Sibbens (hydrarg. et arsen. iodid.
    431.)
Skin, irritation of  the  (glycerin,
    402.)
 Sleeplessness  (lactucarium,  498;
     magnetism, animal, 499 ; mor-
     phias bimeconas, 530.)
 Sloughing of  cellular  membrane
     (acid.  acet.  empyreum.  16;
     iodin. 482.)
   Of the  female organs (calx chlo-
     rinata, 156.)
   Gangrenous (monesia, 515.)
   Ulcers  (calx chlorin. 155.)
 Small pox, pitting from (calx chlo-
     rin. 156; chlorin. aq. 193; io-
     din, 466.)
 Sore mouth, nurses'  (iodin. 476.)
 Sore  throat (ammoniated  counter-
     irritants,   250;   haemospasia,
     713.)
   Phagedenic (iodin. 474.)
   Mercurial  (zinci  chlorid.  692;
     creasotum, 269.)
   Ulcerated (chloroform, 198.)
 Sores, bed (collodion,  236; "plumbi
     tannas, 581.)
   Sloughing, gangrenous  (acidum
     pyrolign. 14; iodinum, 484.)
   Syphilitic   (hyd.    deuto-iodid.
    423.)
 Spasmodic diseases (acid, hydro-
    cyan. 32; acupunct. 56 ; canna-
     bis indica, 170; colchicum, 229;
    conia, 707; indigum, 432; mag-
     nes, 499; zinci  ferrohydrocya-
    nas, 695.)
   Erethism (creasoton, 278.)
 Spasms (acupunct. 57 ; ammoniated
    counter-irritants, 250; magnes,
    499.)
  Of the muscles of  the face (elec-
    tro-magnetismus, iv.)
 Specks of the cornea (fuligo, 386.)
 Spermatorrhoea  (compressio,  241;
    cubeba, 284 ; ergota, 324 ; nux
    vomica, 541 ; lupulina, 718.)
 Sphacelus (acid. acet.  empyr.  14.)
Spina bifida (iodinum, 479.)
  Ventosa (ol. jecor. aselli, 552.)
Spine, diseases of the (iodinum,
    485.)
Spleen, diseases of the (potass, bro-
    mid. 587.)
  Engorgement of the  (quiniae sul-
    phas, 605, 623.)
  Enlarged  (ferri  subcarb. 378;
    hydrarg.deuto-iodid.424; iodin.
    456; potassii hydrargyro-iodid.
    594.)
  Indurated (iodinum,  455.) 
752
INDEX OF DISEASES.
 Sprains (creasoton, 266 ; galvanism,
     392;  glycerin.  402;  electro-
     punctura, 304.
   Violent (ammoniated counter-irri-
     tants, 250.)
 Staubasthma (acid, hydrocyan. 32.)
 Steatomatous  cysts  (electro-punc-
     tura, 307.)
 Stiffness (glycerina,  402.)
 Stings of wasps (iodinum, 485.)
 Stomacace (iodinum, 476.)
 Stomach, coats of the, hypertrophy
     of the (sulph. carbur. 671.)
   Induration  of  the   (calendula,
     151.)
   Irritability of  the (argenti  oxi-
     dum, 99 ;  nux vomica,  542; sp.
     pyroacet.  648.)
   Irritation  of (codeia, 222.)
   Neuropathic disorders of  (acid.
     hydrocyan. 32.)
   Scirrhus of the (artemisia, 111;
     iodin. 471.)
   Spasms of the (sumbul, 730.)
 Stomatitis (monesia, 515;  potassae
     chloras, 583.)
 Strangulation,  internal  (strychnia,
     661.)
 Strangury (apis mellifica, 703.)
 Stricture of  the Eustachian tube
     (catheterism for, 437.)
   Of the oesophagus (iodin.  476.)
   Of the urethra (iodin. 471; lupu-
     lina, 718.)
   Spasmodic.of the urethra (diosma,
     295.)
 Strophulus (glycerina, 402.)
 Struma varicosa  (carbo animalis,
     175.)
 Strumous habits (chimaphila, 181 ;
     ferri citras, 343; ferri subcar-
     bonas, 378.)
   In children   (ferri  ferrocyanure-
     tum, 347.)
 Suffocation,  sense of, (acid, hydro-
     cyan. 32.)
 Suppuration,  profuse  (creasoton.
     265; sumbul, 730.)
 Surgical operations  (aether  sulphu-
     ric. 66;  chloroform, 204.)
 Sweating,  profuse (acidum  galli-
    cum, 22;  acid, tannic.  42; ar-
    gent, oxyd. 100; boletus lari-
    cis, 138; ferri et alumin. sul-
    phas, 712.)
Sycosis  (hydrarg. et arsen. iodid.
   ' 431.)
 Synovial cysts (electro-punctura,
     307.)
 Syphilide, tuberculous (auri chlorid.
     121.)
 Syphilis (argenti praeparat. 94; arg.
     et ammon. chlorid. 96 ; arg. ox-
     idum, 99;  auri cyanur. 125;
     auri chlorid. 121;  auri praepa-
     rat. 116; aurum  muriat. 121;
     chlorin. 187;  hydrarg. bromid.
     412; hydrarg. cyanur. 415;  hy-
     drarg. deuto-bromid. 413;  hy-
     drarg.deuto-iodid.423; hydrarg.
     proto-nitras,  427;  hydrarg. et
     arsen. iodid.  431; iodic acid,
     491; manganesii sulphas, 719;
     platinum, 576;  potassae  chlo-
     ras, 583.)
   Consequences of  (ferri iodidum,
     355.)
   Of children (hydrarg. iodid. 419.)
   Secondary  (ferr. iodid. 354;  hy-
     drarg. et arsenic, iodid. 431;
     iodinum, 472; potassii bromi-
     dum, 587.)
   Tertiary (iodin. 473, 487; potassii
     bromidum,  587; potass, iodid.
     597.)
   With scrofula (potass, iodid. 599;
     hydrarg.  iodid. rubr. 422; sapo
     mollis, 642.)
 Syphilitic affections  (potassae chlo-
     ras, 583.)
   Eruptions (arsen. iodid. 107; ferr.
     carb. 339; hyd.  et arsen. iodid.
     430.)
   Excoriations (aurum metallicum,
     129.)
   Excrescences(aurum metallicum,
     129; platinum, 576)
   Osteocopi  (hydrarg.  et  arsenic.
     iodid. 432; strychnia, 660.)
   Sore  throat (hyd. deuto-iodid.
     423.)
   Swellings of the  bones (potass.
     iodid. 602.)
   Tubercles (iodin. 473.)
   Ulcers  (auri nitro-murias, 12P;
     creasotum, 269.)
Tabes mesenterica (ferr. iodid.354.)
Taenia (acid, hydrocyan. 34 ; braye-
     ra anthelmintica,  139;  colchi-
     cum, 229 ; creasoton, 277 ; eu-
     phorb. ol. 334; filix mas, 382;
     granatum, 407; ol. croton. 563.)
Tarsi, inflamed, chronic (creasoton,
     272.) 
INDEX OF DISEASES.
753
 Tartar of the teeth (acidum tanni-
      cum, 44; calx chlorin. 157.)
 Teeth, affections of the (chloroform,
      199.)
   Caries of the (calx chlorin.  157;
      creasotum,  279;  monesia,  515;
      piscidia erythrina, 722.)
   Stopping for (collodion, 236.)
 Tenesmus (morphia, 523.)
 Testes, enlarged (iodinum, 456; po-
      tass, iodid. 601.)
   Scrofulous swelling of the (potas-
      sii bromid. 586.)
 Tetanus (acid, hydrocyan. 32;  acu-
      puncture, 57; aether sulphuric.
      69;  ammoniated counter-irri-
      tants,  250;  cannabis  indica,
      169, 172; chloroform, 203; col-
      chicum,   229;   galvanismus,
      395.)
   Traumatic (cannabis indica, 169;
     morphiae  acetas,   525;  quiniae
     sulphas, 624; strychnia, 659.)
 Tetter (iodinum, 468.) See Herpes.
   Humid (hydrarg. cyanuret. 416.)
 Thoracic inflammation (hydrargyri
     cyanur. 416.)
 Throat diseases (zinci chlorid. 692.)
   Relaxation  of  the (acid, tannic.
     41.)
 Thymus, hypertrophied (iodin .456)
 Thyroid gland,  swelled (iodinum,
     458.)
 Tic  douloureux  (acid, hydrocyan.
     33;  aconitia, 49;  ammoniated
     counter-irritants,  250; delphi-
     nia, 289; galvanism, 394; strych-
     nia, 659;  veratria,  682, 687;
     zinci  valerianas,  699.)   See
     Neuralgia.
 Tinea (calx chlorin.  158, 164; chlo-
     rin.  aq. 194, 195; fuligo, 385;
     iodid. sulph. 674.)  See Porrigo.
 Tinnitus  aurium  (electro-magne-
     tism, 299.)
 Tone, general, deficient (ferri citras,
     343.)
 Tongue, induration of the (auri prae-
     parat, 119.)
  Malignant ulcers of the(iodinum,
     483.)
  Paralysis of the (electro-punctura,
     304.)
Tonsils,  enlarged  (iodinum, 456,
    483; zinci  iodid. 108.)
  Malignant ulcers of the (iodinum,
    485.)
 Toothach (acid, hydrocyan. 33; acid.
      acet. empyr.  14;  acid, tannic.
      42; acupunct. 57; collodion, 236;
      creasoton, 273; liq. ferr. perses-
      quinit. 363; magnes. 500; mor-
      phia, 522; oleum cadinum, 721;
      piscidia  erythrina, 722;  zinci
      chlorid. 692.)
   Rheumatic (creasoton, 273; ergota,
      325; sulph. carbur. 673.)
 Tophi, gouty  (acidum benzoicum,
      18; iodinum, 475.)
 Tormina (artemisia, 111.)
 Torpor in children (ferri ferrocyanur.
      347.)
 Tremors (magnes.  499;  strychnia.
      658.)
   From  mercury   (electro-punct.
      303.)
 Trichiasis (collodion, 236.)
 Trismus  (acupuncture, 57;  ammo-
      niated counter-irritants, 250.)
 Tubercles (iodinum, 450; ol. jecor.
      aselli, 554.)
   Of the lungs (chlorin. 184; conia,
     707; iodinum, 459.)
   Mesenteric (iodinum, 459.)
   Softening of (moxa, 534.)
   Syphilitic (iodin. 473.)
 Tuberculous eruptions (brominum,
     144.)
 Tumefactions,   indolent  (electro-
     punctura,  307.)
 Tumours of the bones  (auri praepa-
     rat. 119.)
   Erectile (ol.  tiglii, 565.)
   Hemorrhoidal (acid,  tannic. 41.)
   Indolent (plumbi  iodid. 580.)
   Of the mammae (ol. jecor. aselli,
     556.)
   Scrofulous (iodid. quiniae,  610;
     iodinum, 483; veratria, 685.)
   Vascular (acid, nitric. 702.)
 Typhoid fever  (aq. chlor. 192; iodi-
     num, 465; quiniae sulph. 622.)
 Typhus (calx  chlorin. 154; chloro-
     form, 203;  codeia, 223; chlorin.
     aq.  193;  iodin. 465; potassae
     chloras, 583; quiniae et cincho-
     niae tannas, 635; sodae chlori-
     dum, 644;  sumbul, 730.)
  Abdominalis (chlorin. aq. 193.)
  Bilious (calx chlorin. 154.)
  Convalescence   from  (sumbul,
     730.)
Ulceration of the mouth (calx chlo-
     rin. 155.) 
754
INDEX OF DISEASES.
Ulceration of the  rectum  (moxa,
    534.)
Ulcerative process (iodinum, 481.)
Ulcers (acid. acet. empyr. 16; calx
    chlorin.  155; chlorin. aq. 194;
    collodion, 234;  cortex adstrin-
    gens, 254; creasoton, 266; iodi-
    num, 484; matico, 507;  mone-
    sia, 515; ol. jecor. aselli, 559;
    soda chiorin. 645.)
  Atonic (creasoton, 266; ferri iodid.
    355;  iodinum,  4S1;  ol. jecoris
    aselli, 553; sulph.  iodid. 675;
    zinci chloridum, 688.)
Ulcers, cancerous (acid, tannic. 42 ;
    calx chlorin. 155; carbo anima-
    lis,  175; creasotum, 266;  ca-
    lendula, 151;  chlorin. aq. 195;
    fel bovinum, 708; ferr. subcarb.
    376; hydrarg. deuto-iodid. 423;
    hydrargyri  deuto-nitras, 428;
    potassii iodid. 601; zinci chlorid.
    689.)
            Of the face  (creasoton,
    268;  plumbi  chlorid.  722; fel
    bovinum, 709; soda chlorin.645.)
  Carious (creasoton, 266.)
  Erosive (zinci chlorid. 689.)
  Fistulous (creasoton, 266.)
  Flabby (acid.  acet. empyr.  14;
    chlorin.  aq. 194;  ferri et  alu-
    min. sulph. 712.)
  Foul (acid. acet. empyr. 16;  alu-
    minae sales, 76; carbon, trichio-
    rid. 706; ferri et alumin. sulph.
    712; fuligo, 388; zinci chlorid.
    689.)
  Fungous (acid. acet. empyr.  14;
    creasotum, 268.)
  Gangrenous  (calx chlorin.  154;
    creasoton, 267)
  Herpetic, &c. (acid. acet. empyr.
    14; calx chlorin. 155; creasoton,
    268;  fuligo, 388.)
  Ill-conditioned (ferri ferrocyanur.
    348.)
  Indolent (creasoton, 266;  platin.
    577.)
  Irritable (argent, oxid. 100; iodin.
    484.
  Interciliary  (ol.  jecoris  aselli,
    553.)
  Malignant (conia, 707; creasoton,
    267; iodinum, 484;  monesia,
    515; zinci chlorid. 689.)
  Obstinate (creasotum, 266; plumbi
    iodid. 580.)
Ulcers of the mouth, after salivation
    (calx chlorin.   162;  hydrarg.
    iodid.  rubr.  423; iodin.  481;
    potassae chloras, 583; soda chlo-
    rinata. 645.)
  Offensive (chlorini aqua, 194.)
  Old (iodinum, 484.)
  Phagedenic (calx chlorin.  155;
    creasotum, 280; hydrargyri io-
    didum, 420; monesia, 515; zinci
    chlorid. 689.)
  Psoric (fuligo, 388.)
  Putrid (chlorini aqua, 194.)
  Sanious (creasoton, 266.)
  Scorbutic (creasoton, 267.)
  Scrofulo-venereal (hydrargyri io-
    didum rubrum. 422.)
  Scrofulous (brominum, 144; calx
    chlorin.  155; creasoton,  266;
    hyd. et arsen.  iodid. 430; hy-
    drarg. iodid.  419,  421;  hy-
    drarg. iodid. rubr. 423;  juglans
    regia, 494; iodinum,  488; mo-
    nesia, 515;  zinci chlorid, 688.)
  Serpiginous (monesia, 515.)
  Sinuous (zinci chlorid. 688.)
  Sloughing (acid. acet. empyr. 14;
    chloroform, 199; creasoton, 267;
    zinci chloridum, 689.)
  Sloughing, from lying (plumb, tan-
    nas, 581.)
  Specific (brominum, 144.)
  Superficial (creasotum, 266.)
  Syphilitic  (argent,  praepar. 93;
    aurum  metallicum, 129;  bro-
    minum,  144; calx chlorin. 155;
    creasoton, 266, 269; ferr. iodid.
    354; fuligo, 388; galvanismus,
    396; hydrarg.  cyanuret.  416;
    hydrarg. iodid. 419; hydrarg.
    iodid. rubr. 423, 426; iodinum,
    473; iodide of chloride of mer-
    cury, 492; monesia, 515.)
  Syphilitic, old (zinci chlorid. 689.)
  Torpid, foul,  &c.  (calx  chlorin.
     155; ferr. cyanur. 348.)
  Varicose (creasoton, 266.)
 Ulceration  of os uteri (collodion,
     235; hydrargyri deuto-nitras.
     428; iodin. 471.)
 Urethra, diseases  of the (diosma,
     295.)
  Inflamed (iodin. 485.)
  Mucous membrane of the,  tume-
     fied (carb. anim. 176.)
 Urethritis (cubeba,  284;  ergota,
     331.) 
INDEX OF DISEASES.
755
Uric acid calculus (ammoniae  phos-
    phas, 77; sodae phosphas, 728.)
  Diathesis  (acidum  benzoicum,
    18.)
Urinary  organs,  diseased (cainca,
  148;  chimaphila,  180.)
Urine, incontinence of (diosma, 295;
    ergota, 326; iodin. 468; potass.
    nitras, 726; sumbul, 730.)
  Retention of (apis mellifica, 704;
    ergota, 326;  strychnia, 660.)
Urticaria  (cort.  adstring.  Brazil.
    253; ferri nitras, 363.)
Uterine  contractions, excitant  of
    the, 322, 329.
  Irritation, (chloroform, 198.)
Uterus, cancer of the  (cortex ad-
    stringens,  254;   ferr.  subcarb.
    376.)
  Diseases of the (argenti oxidum,
    99;  hydrarg. et arsen. iodid.
    431.)
  Engorgement of the (ergota, 330.)
  Hard  tumours of  the  (iodidum,
    470.)
  Hypertrophy of the (ergota, 325;
    ferri bromidum, 338.)
  Induration of the glands of the,
    (calendula, 151.)
  Inertia of the (ergotin, 332, 333.)
  Neck  of the, fungus of the (aur.
    nitricomuriat. 127.)
  Neuralgia of the (chloroform, 198.)
  Pain of the (acid, hydrocyan. 32.)
  Spasmodic pains of the (acid, hy-
    drocyan. 32.)
  Ulcerated (iodin. 471.)
Uvula,  relaxed (ferri et  aluminae
    sulphas, 712.)
Vagina,  discharges  of  blood from
    the, 509.)
  Inflammation of the  (collodion,
    235; fuligo, 386; monesia, 514;
    zinci chlorid. 691.)
  Fetid discharges from the (alumi-
    nae sales, 76.)
Vaginitis (cubeba, 284; ergota, 331.)
Varicose condition of the rectum
    (matico, 510.)
Varicose veins (acupunct. 58; elec-
    tro-punctura, 307.)
Variola, see Small-pox.
Venereal, see Syphilitic.
  Infection, prevention  of (chlorin.
    aq. 194.)
Vomica (chlorinum. 184.)
Vomiting (acid, hydrocyan. 33; aq.
    picea, 91; argilla, 102; creaso-
    ton, 276; strychnia, 650; sum-
    bul, 730.)
  Chronic (artemisia,  111; calendu-
    la,  151.)
  Obstinate (calendula,  151; chlo-
    roform, 198.)
  Of infancy (argilla,  102.)
  Of  pregnancy  (creasotum,  276;
    nux vomica, 542.)
Wakefulness (bimeconate of  mor-
    phia, 530.)
Warts, malignant (iodinum, 485.)
White swelling (chimaphila, lsl;
    iodinum, 458; ol. jecor. aselli,
    555; potassii cyanuret.  590;
    potassii iodidum, 601.)
White  tissues,  thickening  of the
    (ammoniae phosphas, 77.
Whitlow (iodinum, 483.)
Womb,  inertia of the (ergotin, 332,
    333.)
Worms (caincae radix, 149; corylus
    rostrata, 255; ferri et alumin.
    sulphas, 712; filix  mas, 382;
    granatum,  407;  juglans,  494;
    ol.  tiglii, 563;  zinci ferrohy-
    drocyanas, 695.)
Wounds (calx chlorin. 156.)
  Contused  (calx chlorin. 156;  di-
    osma, 295;  iodinum, 483.)
  From dissection (calx chlor. 155 ;
    iodinum, 483, 485.)
  From  gunpowder  (calx chlorin.
    156.)
  Lacerated (iodinum,  483;  calx
    chlorin. 156.)
  Painful (acid, hydrocyan. 33.)
  Poisoned  (argilla, 101.)
  Punctured (iodinum, 483.)
Zymotic diseases (chlorinum, 188.)
THE  END. 
/ 
OCTOBER, 1852.
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and  Library sent to advance-paying subscribers.
   Gentlemen, therefore, who remit their annual  subscriptions  before the first of
January,  1853,  will receive, for the small sum of Five Dollars,

   THE  AMERICAN  JOURNAL  OF THE MEDICAL SCIENCES
                               AND
           THE  MEDICAL  NEWS  AND LIBRARY,
Embracing  about  Fifteen Hundred large  octavo pages, mailed to  any part of
                    the United States, free of postage.
   Those who remit after the first of January, will receive, free of postage, all the
numbers  remaining to be sent, of both periodicals; the publishers thus agreeing
to prepay everything for which they have been paid in advance.
   The advantages of a remittance before 'the opening of the year 1853 will thus
be apparent.
                                     Philadelphia, October 1, 1852. 
BLANCHARD AND LEA'S PUBLICATIONS.
5
                       NEW AND ENLARGED EDITION OF

   NEILL  &  SMITH'S  COM PEN DIU M-(NOW  READY.)


            AN  ANALYTICAL   COMPENDIUM

    OF THE VARIOUS BRANCHES  OF MEDICAL  SCIENCE,
            FOR THE USE  AND EXAMINATION  OF  STUDENTS.

                         BY JOHN NEILL,  M. D.,
  Surgeon to the Pennsylvania Hospital; Demonstrator of Anatomy in the University of Pennsylvania.
                                      AND
                   FRANCIS  GURNEY SMITH, M. D.,
             Professor of Institutes of Medicine in the Pennsylvania Medical College.
                     Second Edition, Revised and Improved.
  In one very large and handsomely ■printed volume, royal 12mo., of over 1000 large pages, with
            about 350 illustrations, strongly bound in leather, with raised bands.
                        PREFACE TO THE NEW  EDITION.
  The speedy sale of a large impression of this work  has  afforded to the authors gratifying evi-
dence  of the correctness of the views  which actuated them in its preparation. In meeting the
demand for a second edition, they have therefore been desirous to render it more worthy of the
favor with which it has been received.  To accomplish this, they have spared neither time nor
labor in embodying in it  such discoveries and improvements as have been made since its first ap-
pearance, and such alterations as have been suggested by its practical use in the class and exami-
nation-room.  Considerable modifications have  thus been introduced throughout all the depart-
ments  treated of in the volume, but more especially in the portion  devoted to the " Practice of
Medicine," which  has  been entirely rearranged and rewritten.  The authors therefore again
submit their work to the profession, with the hope that their efforts may tend, however humbly,
to advance the great cause of medical education.
  Notwithstanding the increased size and improved execution of this work, the price has not been
increased, and it is confidently presented as one of the cheapest volumes now before the profession.
             COOPER'S SURGICAL LECTURES—(Now Ready.)

                           LECTURES ON THE

  PRINCIPLES   AND  PRACTICE   OF  SURGERY.

                    BY  BRANSBY B. COOPER,  F. R. S.,
                           Senior Surgeon to Guy's Hospital.
             In one very large octavo volume, of seven hundred and fifty pages.
  For twenty-five years Mr. Bransby Cooper has been surgeon to Guy's Hospital; and the volume before us
may be said to consist of an account of the results of his surgical experience during that long period.
  We cordially recommend Mr. Bransby Cooper's Lectures as  a most valuable addition to our surgical
literature, and one which cannot fail to be of service both to students and to those who are actively engaged
in the practice of their profession.— The Lancet.
  A gootl book by a good man is always welcome; and Mr. Bransby Cooper's book does no discredit to its
paternity.  It has reminded us, in its easy style and copious detail, more of Watson's Lectures, than any
book we have seen lately, and we  should not be surprised to see it occupy a similar position to that well-
known work in professional estimation.  It consists of seventy-five lectures on the most important surgical
diseases.  To analyze such a work is impossible, while so interesting is every lecture, that we feel ourselves
really at a loss what lo select for quotation.        .    .,  ,     ,
  The work is one which cannot fail to become a favorite with the profession; and it promises to supply a
hiatus which the student of surgery has often to deplore— Medical Times.
               MALGAIGNE'S SURGERY.—(Just Published)


             OPERATIVE   SURGERY,

 BASED  ON NORMAL AND  PATHOLOGICAL  ANATOMY.

                           BY J.  F. MALGAIGNE.
                  TRANSLATED  FROM THE  FRENCH,

          BY FREDERICK BRITTAN,  A. B., M.D., M.R.CS.L.
              WITH NUMEROUS ILLUSTRATIONS ON WOOD.
                   In one handsome octavo volume of nearly 600 pages.
  This work has, during its passage through the columns of the " Medical  News and Library"
in 1850 and 1851, received the unanimous approbation of the profession, and in presenting it in
a complete form the publishers confidently anticipate for  it an extended circulation.
 Certainly one of the best books published on operative surgery.—Edinburgh Med. Journal.
 We  can strongly recommend it both to practitioners and students, not only as a safe guide in the dissecf-
Ing-room or operating-theatre, but also as a concise work of reference for all that relates to operative sur-
p.rv__Forbes's Review.
 Dr  Brittan has performed his tasK of translator and editor with much judgment.   The descriptions a»e
norfectlv clear and explicit; and the author's occasional omissions of important operations proposed by
British surgeons are judiciously supplied in brief notes.—Medical Gazette. 
6
BLANCHARD & LEA'S PUBLICATIONS.—(Surgery.)
              GROSS  ON URINARY ORGANS—(Just Issued.)

                     A PRACTICAL  TREATISE ON  THE

   DISEASES  AND  INJURIES   OF  THE  URINARY  ORGANS.

                         BY S.  D. GROSS,  M. D., &c,
                      Professor of Surgery in the New York University.
       In one large and beautifully printed octavo volume, of over seven hundred pages.
                          With numerous Illustrations.
  The author of this work has devoted several years to  its preparation, and has endeavored to
render it complete and thorough on all points connected  with the  important subject to which it is
devoted.  It contains a large number of original illustrations, presenting the natural and patholo-
gical anatomy  of the parts under consideration, instruments, modes of operation, &c. &c, and in
mechanical execution it is one of the handsomest volumes yet issued from the American press.
  Dr. Gross has brought all his learning, experience, tact, and judgment to the task, and has produced a
work worthy of his high reputation. We feel perfectly safe in recommending it lo our readers as a mono-
graph unequalled in interest and practical value by any other on the subject in our language; and we can-
not help saying  that we esteem it a matter of just pride, that another work so creditable to our country has
been contributed to our medical literature by a Western physician.—The Western Journal of Medicine and
Surgery.
  We regret that our limits preclude such a notice as this valuable contribution to our American  medical
literature merits. We have only room to say that the author deserves the thanks of the profession for this
elaborate production; which cannot fail to augment the exalted reputation acquired by his former works,
for which he has been honored at home and abroad.—N. Y. Med. Gazette.
           COOPER OX DISLOCATIONS__New Edition—(Just Issued.)

                               A TREATISE ON

DISLOCATIONS  AND  FRACTURES  OF THE  JOINTS.
              By Sir  ASTLEY P. COOPER, Bart., F. R. S., &c.
                Edited by BRANSBY B. COOPER, F. R. S.,  &c.
           WITH ADDITIONAL OBSERVATIONS  BY PROF. J. C. WARREN.
                   A  NEW   AMERICAN  EDITION,
           In one handsome octavo volume, with numerous illustrations on wood.
  After the fiat of the profession, it would be absurd in us to eulogize Sir Astley Cooper's work on Disloca-
tions. It is a national one, and will probably subsist as long as English Surgery— Medico- Chirurg. Review.
                   WORKS  BY THE  SAME  AUTHOR.
COOPER (SIR ASTLEY) ON THE ANATOMY AND TREATMENT OF ABDOMINAL HERNIA.
  1 large vol., imp. 8vo., with over 130 lithographic figures.
COOPER ON THE STRUCTURE AND DISEASES OF THE TESTIS, AND ON THE  THYMUS
  GLAND.  1 vol., imp. 8vo., with 177 figures on 29 plates.
COOPER ON  THE ANATOMY AND  DISEASES  OF THE  BREAST, WITH TWENTY-FIVE
  MISCELLANEOUS AND SURGICAL PAPERS. 1 large vol., imp. Svo., with 252 figures on 36 plates.
  These three volumes complete the surgical writings of Sir Astley Cooper. They are very handsomely
printed, with a large number of lithographic plates, executed in the best style, and are presented at exceed-
ingly low prices.
                    LISTON & MUTTER'S  SURG ERY.

    LECTURES  ON  THE  OPERATIONS OF SURGERY,

AND  ON  DISEASES AND ACCIDENTS  REQUIRING OPERATIONS.

            BY  ROBERT  LISTON,  Esq., F. R. S., &c.
                 EDITED, WITH NUMEROUS ADDITIONS AND ALTERATIONS,
                           BY T. D.  MUTTER, M. D.,
              Professor of Surgery in the Jefferson Medical College of Philadelphia.
          In one large and handsome octavo volume of 566 pages,  with 216 wood-cuts.
STANLEY ON THE BONES.—A Treatise on Diseases of the Bones. In one vol. 8vo., extra cloth.  286 pp.
BRODIE'S SURGICAL LECTURES—Clinical Lectures on Surgery. 1 vol.8vo., cloth. 350 pp.
BRODIE ON THE JOINTS.—Pathological and Surgical Observations on the Diseases of the Joints.  1 vol.
  8vo.. cloth. 216 pp.
BRODIE ON URINARY ORGANS.—Lectures on the Diseases of the Urinary Organs. 1 vol. 8vo., cloth.
  214 pp.
          *»* These three works may be had neatly bound together, forming a large volume of "Brodie'g
              Surgical Works."  7S0 pp.
RICORD ON VENEREAL.—A Practical Treatise on Venereal Diseases. With a Therapeutical Summary
  and Special Formulary. Translated by Sidney Doane, M. D.  Fourth edition.  1 vol. Svo.  340 pp.
DURLACHER ON CORNS, BUNIONS. &c—A Treatise on Corns, Bunions, the Diseases of Nails, and
  the General Managementof the Feet.  In one 12mo. volume, cloth. 134 pp.
GUTHRIE ON THE BLADDER, &c—The Anatomy of the Bladder and Urethra,and the Treatment of the
  Obstructions to which those Passages are liable.  In one vol. 8vo.  150 pp.
LAWRENCE ON RUPTURES.—A Treatise on Ruptures, from the fifth London Edition.  In one 8vo. vol.
  sheep.  480 pp. 
BLANCHARD &, LEA'S PUBLICATIONS.—(Surgery.)
                 LIBRARY OF  SURGICAL KNOWLEDGE.


       A  SYSTEM   OF   SURGERY.

                       BY  J.   M.  CHELIUS.
                     TRANSLATED FROM THE GERMAN,
          AND ACCOMPANIED WITH ADDITIONAL NOTES AND REFERENCES,
                           BY  JOHN F.  SOUTH.
Complete in three very large octavo volumes of nearly 2200 pages, strongly bound, with raibed
                              bands and double titles.
wXh we ™™^&?S^&&i&&Zr «"*«*«"*• -y««» «f modem surgery with

A^nmdM^n^
 KoSte M^vwsVmS f%W°rk °n Surg6[^that WOrk Sh0uld be CheIius's._S«. Louis Med. Journal.
 ThSfiniLTJ system of Surgery can well be.-Southern Medical and Surgical Journal.
 It ™'t iJi,8JL iVTm of.Sur&ery »» 'he English language.- Western Lancet. *
 No w^rk STh Fn "lf.S°i?plete sys,emaUc treatise now extant-Edinburgh Medical Journal.
cin^nTsurgical ^^SLW^SL'6 ***> "* ^^ °f informali°" «**" to operative medi-
 A complete encyclopedia of surgical science-a very complete surgical library-by far the mo«t comDlete
and scientific system of surgery ,„ the English language.- N. Y. Journal ofMedUin?          complete
 ThTm^t^^^


    A  TREATISE  ON   THE  DISEASES  OF  THE  EYE.

                       BY  W. LAWRENCE, F.R.S.
 A new Edition.  With many Modifications and Additions, and the introduction of nearly 200 Illustrations,
   t                        BY ISAAC HAYS, M.D.
     In one very large 8vo. vol. of 860  pages, with plates and wood-cuts through the text.
                           JONES ON THE  EYE.

                  THE  PRINCIPLES~AND  PRACTICE

     OF   OPHTHALMIC  MEDICINE  AND   SURGERY.
              BY T.  WHARTON  JONES,  F. R. S.,  &c. &c.
                     EDITED BY ISAAC HAYS, M. D., &c.
In one very neat volume, large royal 12mo. of 529 pages, with  four plates, plain or colored, and
                         ninety-eight well executed wood-cuts.
            A NEW TEXT-BOOK ON SURGERY—(Now Ready.)


        THE   PRINCIPLES  AND TRACTICE  OF  SURGERY.

                      BY WILLIAM PIEKIE,  F.E.S.B.,
                  Regius Professor of Surgery in the University of Aberdeen.
                        Edited, by JOHN  NEILL,  M. D.,
    Demonstrator of Anatomy in the University of Pennsylvania, Lecturer on Anatomy in the Medical
                              Institute of Philadelphia, &c.
         In one very handsome octavo volume, of 780 pages, with 316 illustrations.
  The object of the author, in the preparation of this volume,  has been to present to the student a
 complete text-book of surgery, embracing both the principles and the practice in their mutual rela-
 tions, according to the latest state of scientific development.  In accomplishing this, his aim has been
 to combine simplicity of arrangement, and conciseness and clearness oi description, with the eluci-
 dation of sound principles and the modes of practice which his  own experience and the teachings o.
 the best authorities have shown to be the most successful.  The Editor has, therefore, found but
 little to add respecting European surgery, and his efforts consequently have been directed towards
 introducing such improvements as have been pointed out by the practitioners of the United States
 and such further information as may be requisite for the guidance of the student in this country.__
 Of the very numerous illustrations, the greater portion are from preparations in theauthor's mu-
 Beum, or from patients under  his care.  These have been  reproduced with great  care, and the
 whole is presented as an original and highly practical work,  and at the same time a s a handsome
 specimen of typographical execution.

MAURY'S DENTAL SURGERY.—A Treatise on the Dental Art, founded on Actual Experience. Illus-
  trated  by 241 lithographic figures and 54 wood-cuts. Translated by J. B. Savier. In 1 8vo. vol.,sheep. 266 pp
DUFTON ON THE EAR—The NatureandTreatmentof DeafnessandDiseasesof theEar; and the Treat-
  ment of the Deaf and Dumb.  One small 12mo. volume. 120 pp.
SMITH  ON FRACTURES —A Treatise on Fractures in the vicinity of Joints, and on Dislocations.  One
  vol. Svo., with 200 beautiful wood-cuts. 
8            BLANCHARD  & LEA'S PUBLICATIONS.—(Surgery.)
       NEW AND IMPORTANT  WORK  ON PRACTICAL SURGERY.—(JUST  ISSUED.)


   OPERATIVE    SUEGEEY,

                   BY FREDERICK  C. SKEY, F. R. S., &o.

   In one very handsome octavo volume of over 650 pages, with about one hundred wood-cuts.

  The object of the author, in the preparation of this work, has been not merely to furnish the
student with a guide to the actual processes of operation, embracing the  practical  rules required
to justify an appeal to the knife, but also to present a manual embodying  such principles as might
render  it a permanent work of reference to the practitioner of operative surgery, who seeks to
uphold the character of his profession as a science  as well as an art. In its composition he has
relied mainly on his own experience, acquired during many years' service at one of the largest of
the London hospitals, and has rarely appealed to other authorities, except so far as personal inter-
course  and a general" acquaintance with the most eminent members of the surgical profession
have induced him to quote their opinions.
                       From Professor C. B. Gibson, Richmond, Virginia.
  I have examined the work with some care, and am  delighted with it.  The style is admirable, the matter
excellent, and much of it original and deeply interesting, whilst the illustrations are numerous and better
executed than those of any similar work I possess.
  In conclusion we must express our unqualified praise of the work as a whole. The high moral tone, the
liberal views, and the sound information which pervades it throughout, reflect the highest  credit upon the
talented author.  We know of no one who has succeeded, whilst supporting operative surgery in its proper
rank, in promulgating at the same time sounder and more enlightened views upon  that most important of
all subjects, the principle that should guide us in having recourse to the knife.—Medical Times.
  The treatise is, indeed, one on operative surgery, but it is one in which the author throughout  shows that
he is most anxious to  place operative surgery in iis just position.  He has acted as a judicious, but not
partial friend; and while he shows throughout that he is able and ready to perform any operation which the
exigencies and casualties of the human frame may require, he is most cautious in specifying the circum-
stances which in each case indicate and contraindicate operation. It is indeed gratifying to perceive tha
sound and correct views which Mr. Skey entertains on the subject of operations in general, and the gentle-
manly tone in which he impresses on readers the lessons which he  is desirous  to inculcate.  His work is a
perfect model for the operating surgeon, who will learn from it not only when and how to operate, but some
more noble and exalted lessons which cannot fail to improve him as a moral and social agent.—Edinburgh
Medical and Surgical Journal.
                      THE  STUDENTJS  TEXT-BOOK.


THE  PRINCIPLES  AND   PRACTICE  OF  MODERN  SURGERY,

       BY ROBERT DRUITT, Fellow of the Koyal College of Surgeons.

    A New American,  from  the last  and improved London Edition,

       Edited bt F. W. SARGENT, M.D.,  Author of "Minor Surgery," &c.
          ILLUSTRATED WITH ONE HUNDRED AND NINETY-THREE WOOD EN&RAVINGS.
               In one very handsomely printed octavo volume of 576 large pages.
                         From Professor Brainard, of Chicago, Illinois.
  I think it the best work of its size, on that subject, in the language.
                       From Professor Rivers, of Providence, Rhode Island.
  I have been acquainted with it since its first republication in this country, and the universal praise it has
received I think well merited.
                          From Professor May, of Washington, D. C.
  Permit me to express my satisfaction at the republication  in so improved a form of this most valuable work.
I believe it to be one of the very best text-books ever issued.
                             From Professor McCook, of Baltimore.
  I cannot withhold my approval  of its  merits, or the expression that no work is better suited to the wants
of the student,  I shall commend it to my class, and make it my chief text-book.
                FERGUSSON'S OPERATIVE SURGERY.—(NEW EDITION.)


  A   SYSTEM   OF   PRACTICAL   SURGERY,

                   BY WILLIAM FERGUSSON,  F. R. S. E.,
                     Professor of Surgery in King's College, London, &c. &c.
               THIRD  AMERICAN, FROM  THE LAST ENGLISH EDITION.
                              "With 274 Illustrations.
       In one large and beautifully printed octavo volume of six hundred and thirty pages.
  It is with unfeigned satisfaction that we call the attention of the profession in this country to this excellent
work.  It richly deserves the reputation conceded to it, of being the best practical Surgery extant .at least in
the English language.—Medical Examiner.
                         A NEW   MINOR SURGERY.


ON  BANDAGING AND  OTHER  POINTS  OF  MINOR  SURGERY.
                          BY F.  W. SARGENT,  M. D.
        In one handsome royal 12mo. volume of nearly 400 pages, with 128 wood-cuts.
                             From Professor Gilbert, Philadelphia.
  Embracing the smaller details of surgery, which are illustrated by very accurate engravings, the work
becomes one of very great importance to the practitioner in the performance of his daily duties, since such
information is rarely found in the general works on surgery now in use. 
BLANCHARD & LEA'S  PUBLICATIONS.—(Surgery.)           9
     THE  GREAT  ATLAS  OF  SURGICAL  ANATOMY.
                               (NOW COMPLETE.)


    suegioal"anatomy,

                      BY JOSEPH MACLISE,  Surgeon.

                 IN ONE VOLUME, VERY LARGE IMPERIAL QUARTO,
  With Sixty-eight  large and splendid Plates, drawn In the best style, and
                               beautifully colored,

       Containing one  hundred and ninety Figures, many of them the size of life,
                   TOGETHER WITH COPIOUS EXPLANATORY LETTER-PRESS.

Strongly and handsomely bound in extra cloth, being one of the best executed and cheapest surgi-
                        cal works ever presented in this country.

  This great work being  now complete, the publishers confidently present it to the attention of the
profession as worthy in every respect of  their  approbation and  patronage.  No complete work
of the kind has yet been published in the English language, and it therefore will supply a want
long felt  in this country  of an accurate and comprehensive Atlas of Surgical Anatomy to which
the  student and practitioner can  at all times  refer,  to ascertain the exact relative  position 01
the  various portions of the human frame towards each other and to the surface, as  well as their
abnormal deviations.  The importance of such a work to  the student in the absence of anato-
mical material, and to the practitioner when about attempting an operation, is evident, while the
price of the book, notwithstanding the large size, beauty, and finish of the very numerous illustra-
tions, is so low as to place it within the reach of every member of the profession.  The publishers
therefore confidently anticipate a  very extended circulation for this magnificent work.
  To present some idea of the scope of the volume, and of the manner in which its plan has been
carried out, the publishers subjoin a very brief summary of the plates.

Plates 1 and 2.—Form of the Thoracic Cavity and Position of the Lungs, Heart, and larger Blood-
   vessels.
Plates 3 and 4.—Surgical Form of the Superficial Cervical and Facial Regions, and the Relative
   Positions of the principal Bloodvessels, Nerves, &c.
Plates 5 and 6.—Surgical Form of the Deep Cervical and  Facial Regions, and Relative Positions
   of the principal Bloodvessels, Nerves, &c.
Plates 7 and 8.—Surgical Dissection of the Subclavian and Carotid Regions, and Relative Anatomy
   of their Contents.
Plates 9 and 10.—Surgical Dissection of the Sterno-Clavicular or Tracheal Region, and Relative
   Position of its main Bloodvessels, Nerves, &c.
Plates 11 and 12.—Surgical Dissection of the Axillary and Brachial Regions, displaying the Relative
   Order of their contained parts.
Plates 13 andl4.—Surgical Form  of the Male and Female  Axilla? compared.
Plates 15 and 16.—Surgical Dissection of the Bend of the Elbow and the Forearm, showing the
   Relative Position of the Arteries, Veins, Nerves, &c.
Plates 17, 18 and 19.—Surgical Dissections of the Wrist and Hand.
Plates 20 and 21.—Relative Position of the Cranial, Nasal, Oral, and Pharyngeal Cavities, &c.
Plate 22.—Relative Position of the Superficial Organs of the Thorax and Abdomen.
Plate 23.—Relative Position of the Deeper Organs of the Thorax and those of the Abdomen.
Plate 24.—Relations  of the Principal Bloodvessels to the Viscera of the Thoracico-Abdominal
   Cavity.
Plate 25.—Relations of the Principal Bloodvessels of the Thorax and Abdomen to the Osseous
   Skeleton, &c.
Plate 26.—Relation of the Internal Parts to the External Surface of the Body.
Plate 27.—Surgical Dissection of the Principal Bloodvessels, &c, of the Inguino-Femoral Region.
Plates 28 and  29.—Surgical Dissection of the  First, Second, Third, and Fourth  Layers  of the
   Inguinal Region, in connection with those of the Thigh.
Plates 30 and 31.—The Surgical Dissection of the Fifth, Sixth, Seventh and Eighth Layers of the
   Inguinal Region, and  their connection with those of the Thigh.
Plates 32, 33 and 34.—The Dissection of the Oblique or External and the Direct or Internal Ingui-
   nal Hernia.
Plates 35,36,37 and 38.—The Distinctive Diagnosis between External and Internal Inguinal Hernia,
   the Taxis, the Seat of Stricture, and the Operation.
Plates 39 and 40.—Demonstrations of the Nature of Congenital and Infantile Inguinal Hernia, and
   of Hydrocele.
Plates 41  and 42.—Demonstrations of the Origin and Progress of Inguinal Hernia in general.
Plates 43 and 44.—The Dissection of Femoral Hernia, and the Seat of Stricture.
Plates 45 and 46.—Demonstrations of the Origin and Progress of Femoral Hernia, its Diagnosis, the
   Taxis, and  the Operation.
Plate 47.—The Surgical  Dissection of the principal Bloodvessels and Nerves of the Iliac and Fe-
   moral Regions.
Plates 48 and  49.—The Relative Anatomy of the Male Pelvic Organs.
Plates 50 and 51.—The Surgical Dissection of the Superficial Structures of the Male Perineum.
plates 52 and  53.—The Surgical Dissection of the Deep Structures of the Male Perineum.—The
   Lateral Operation of  Lithotomy. 
BLANCHARD & LEA'S PUBLICATIONS.—(Surgery.)
         MACLISE'S SURGICAL ANATOMY—(Continued.)

Plates 54, 55 and 56.—The Surgical Dissection of the  MRle  Bladder and Urethra.—Lateral and
   Bilateral Lithotomy compared.
Plates 57 and 58.—Congenital  and Pathological Deformities of the Prepuce and Urethra.—Struc-
   ture and Mechanical Obstructions of the Urethra.
Plates 59 and 60.—The various forms and positions  of Strictures and other Obstructions of the
   Urethra.—False  Passages.—Enlargements and Deformities of the Prostate.
Plates 61 and 62.—Deformities of the Prostate.—Deformities and  Obstructions  of the  Prostatic
   Urethra.
Plates 63 and 64.—Deformities of the Urinary Bladder.—The Operations of Sounding for Stone, of
   Catheterism, and of Puncturing the Bladder above the Pubes.
Plates 65 and 66.—The Surgical Dissection of the Popliteal Space, and the Posterior Crural Region.
Plates 67 and 68.—The Surgical Dissection of the Anterior Crural Region, the Ankles, and the Foot.

   Notwithstanding  the  short  time in which this work  has been before the profes-

sion, it has received the unanimous approbation of all who have examined it.   From

among  a very  large  number of commendatory notices  with  which they have been

favored, the publishers select the  following:—

                                From Prof. Kimball, Piitsfield, Mass.
  I have examined these numbers with the greatest satisfaction, and feel bound to say that they are alto-
gether the most perfect and satisfactory plates of the kind that I have ever seen.

                                 From Prof. Brainard, Chicago, HI.
  The work is extremely well adapted to the use both of students and practitioners, being sufficiently exten-
sive for practical purposes, without being so expensive as to place it beyond their reach.  Such a work was
a desideratum in this country, and I shall not fail to recommend it to those within the sphere of my acquaint-
ance.
                                From Prof. P. F. Eve, Augusta, Ga.
  I consider this work a great acquisition to  my library, and shall take pleasure in recommending it on all
suitable occasions.
                                From Prof. Peaslee, Brunswick, Me.
  The second part more than fulfils the promise held out by the first, so far as the beauty of the illustrations
is concerned ; and, perfecting my opinion of the value of the work, so far as it has advanced, I need add
nothing to what I have previously expressed to you.
                                From Prof. Gunn, Ann Arbor, Mich.
  The  plates in your edition of Maclise answer, in an eminent  degree, the  purpose for which they are
intended.  I shall take pleasure in exhibiting it and recommending it to my class.
                                From Prof. Rivers, Providence, R. I.
  The plates illustrative of Hernia are the most satisfactory I have ever  met with.
                              From Professor S. D. Gross, Louisville, Ky.
  The work, as far as it has progressed, is most admirable, and cannot fail, when completed, to form a most
valuable  contribution  to the literature of our profession.  It will afford me great pleasure to recommend it to
the pupils of the University of Louisville.
                           From Professor R. L. Howard, Columbus,  Ohio.
   In all  respects, the  first number is the beginning of a most excellent work, filling completely what might
be considered hitherto a vacuum in surgical literature.  For myself, in behalf of the medical profession, I
wish to express to you my thanks for this truly elegant and meritorious work.  I am confident that it will
meet with a ready and extensive sale.  I have spoken of it in the highest terms to my class and my profes-
sional brethren.
                               From Prof C. B. Gibson, Richmond, Va.
  I consider Maclise very far superior, as to the drawings, to any work  on Surgical  Anatomy with which I
am familiar, and I am particularly struck with the exceedingly low price at which it is sold.  I cannot doubt
that it will be extensively-purchased by the profession.
                             From Prof. Granville S. Patlison, New York.
  The profession, in my opinion, owe you many thanks for  the publication of this beautiful work—a work
which, in the correctness of its exhibitions of Surgical Anatomy, is not surpassed by any work with which
I am acquainted; and the  admirable manner in which the lithographic plates have been executed and
colored is alike honorable to your house and to the arts in the United States.
                              From Prof. J. F. May, Washington, D.  C.
  Having examined the work, I am pleased to add my testimony to its correctness, and to its value  as a
work of reference by  the surgeon.
                               From Prof. Alden Marsh, Albany, N. Y.
  From what I have seen of it, I think the design and execution of the work admirable, and, at the proper
time in my course of lectures, I shall exhibit it to the class, and give it a recommendation worthy of its great
merit.
                              From H. H. Smith, M. D., Philadelphia.
  Permit me to express my gratification at the execution of Maclise's Surgical Anatomy. The plates are, in
my opinion, the best lithographs that I have seen of a medical character, and the  coloring of this number
cannot, I think, be improved.  Estimating highly  the contents of this work, I shall continue to recommend it
to my class as I have  heretofore done.
                                From Prof D. Gilbert, Philadelphia.
  Allow me to say, gentlemen, that the thanks of the profession at large, in this country, are due to you for
the republication of this admirable work  of Maclise.  The  precise relationship of the organs in the regions
displayed is so perfect, that even those who have daily access to the  dissecting-room may, by consulting
this work, enliven and confirm their anatomical knowledge prior to an operation. But it is to the thousands
of practitioners of our country who cannot  enjoy these advantages that  the perusal of those plaies,  with
their concise and accurate descriptions,  will prove of infinite value.  These have supplied a desideratum,
which will enable them to  refresh their knowledge of the important structures involved in their surgical
cases, thus establishing their self confidence, and enabling them to undertake, operative procedures  with
every assurance of success. And as all the practical departments in medicine rest upon the same basis, and
are enriched from the  same sources, I need hardly add that this work should be  found in the  library of every
practitioner in the land. 
BLANCHARD  &,  LEA'S  PUBLICATIONS.—(Surgery.)             ]1
         MACLISE'S  SURGICAL  ANATOMY—(Continued.)

                 .            From Professor J. M. Bush, Lexington, Ky.
  1 am delighted with both the plan and execution of the work, and shall lake all occasions to recommend it
to my private pupils and public classes.
  The  most accurately engraved and beautifully colored plates we have ever seen in an American book—
one of the best and cheapest surgical works ever published.- Buffalo Medical Journal.
  It is very rare that so elegantly printed, so well illustrated, and so useful a work, is offered at so moderate
a price.— Charleston Medical Journal.
  A work which cannot but please the most fastidious lover of surgical science.  In it, by a succession of
plates, are brought to view the relative anatomy of the parts included in the important surgical divisions of
the human body, with that fidelity and neatness of touch which is scarcely excelled by nature herself.  While
we believe that nothing but an extensive circulation can compensate the publishers for the outlay in the
production of the work—furnished as it is at a very moderate price, within the reach of all—we desire to see
it have that circulation which  the zeal and peculiar skill of the author, the utility  of the work, and the neat
style with which it is executed, should demand for it in a liberal profession.—N. Y. Jour, of Medicine.
  This is an admirable reprint of a deservedly popular London publication.  Its plates can  boast a superi-
ority that places them almost beyond the reach of competition.  And we feel too  thankful to the Philadel-
phia publishers for their very handsome reproduction of the  whole work, and at a rate within everybody's
reach, not to urge all our medical friends to give it, for their own sakes, the  cordial welcome it deserves, in
a speedy and extensive circulation.— The Medical Examiner.
  When  the whole has been published it will be  a complete and beautiful system of Surgical Anatomy, hav-
ing an advantage which is  important, and not possessed  by colored  plates  generally, viz., its cheapness,
which places it within the reach of every one who may feel disposed to possess  the work.  Every practi-
tioner, we think, should have a work of this kind within reach, as there are many operations requiring imme-
diate performance in which a book of reference will prove most valuable.—Southern Med.  and Surg. Journ.
  No such lithographic illustrations of surgical regions have hitherto, we think, been  given.  While the ope-
rator is shown every vessel and nerve where an operation is contemplated, the exact anatomist is refreshed
by those  clear and distinct dissections which every one must appreciate who has a  particle of enthusiasm.
The English medical press has quite exhausted the words of praise in recommending this admirable treatise.
Those who have any curiosity to gratify in reference to the perfectibility of the lithographic art in delinea-
ting the complex mechanism of the  human body, are invited to examine our copy.  If anything will induce
surgeons and students to patronize a book of such rare value and every-day importance to them, it will  be a
survey of the artislical skill exhibited in these fac-similes of nature.—Boston Medical and Surg. Journal.
  These  plates will  form a valuable acquisition to  practitioners  settled in the country, whether engaged
in surgical, medical, or general practice.—Edinburgh Medical and Surgical Journal.
  We are well assured that there are none of the cheaper, and but few of the more expensive works on
anatomy, which will form so complete a guide to the  student or practitioner as these plates.  To practitioners,
in particular, we recommend this work as  far better, and not at all more expensive, than the heterogeneous
compilations most commonly in use, and which, whatever their value  to the student preparing for examina-
tion, are as likely to mislead as to guide the physician in physical examination, or the surgeon in the  per-
formance of an operation.—Monthly Journal of Medical Sciences.                  .
  We know of no work on surgical anatomy which can compete with it.—Lancet.
  This is  by far the ablest work on Surgical Anatomy that has come  under our observation.  We know of
no other work that would justify a student, in any degree, for  neglect of actual dissection.  A careful study
of these plates, and of the commentaries on them,  would almost make an anatomistof a diligent student. And
to one who has studied anatomy by dissection, this work is invaluable as a perpetual remembrancer, in mat-
ters of knowledge that may  slip from the memory. The practitioner can scarcely consider  himself equipped
for the duties of his profession  without such a work as this, and this  has no rival, in his library.  In those
sudden emergencies that so often arise, and which require the instantaneous command of minute anatomical
knowledge, a work of this kind keeps the details of the dissecting-room  perpetually fresh in the memory.
We appeal to our readers, whether any one can justifiably undertake the practice of medicine who is not
prepared to give all needful assistance, in all matters demanding immediate relief.
  We repeat that no medical library, however large, can be complete  without Maclise's Surgical Anatomy.
The American edition is well entitled to the confidence of the profession, and  should command, among them,
an extensive sale.  The investment of the amount of the cost of this work will prove to be a very profitable
one, and if practitioners would qualify themselves thoroughly with such important knowledge as is contained
in works  of this kind, there would be fewer of them sighing for employment.  The medical profession should
spring towards such an opportunity as is presented in this republication, to encourage frequent repetitions of
American enterprise of this kind.— The Western Journal of Medicine and Surgery.
                     MILLER'S PRINCIPLES  OF  SURGERY.
             NEW AND BEAUTIFULLY ILLUSTRATED EDITION—(Now Ready.)


         PRINCIPLES~OF   SURGERY.
                 BY  JAMES  MILLER,  F. R. S. E.,  F. R. C. S. E.,
                        Professor of Surgery in the University of Edinburgh.
      THIRD AMERICAN,  FROM  THE SECOND  AND  ENLARGED EDINBURGH  EDITION.
                Revised,  with Additions, by F. "W. SARGENT, M.D.,
                                 Author of " Minor Surgery," &c.
      In one very large and handsome  octavo volume, of seven  hundred and fifty-two pages,
              WITH ABOUT TWO HUNDRED AND FIFTY EXQUISITE WOOD ENGRAVINGS.
  The very extensive additions and alterations which the author has introduced  into this edition
have rendered it essentially a new work.   By common consent, it has been pronounced the  most
complete  and thorough exponent of the present state of the science of surgery in the English lan-
guage, and  the  American publishers in the preparation  of the present edition  have endeavored to
render it in all respects worthy of its extended reputation. The press has been carefully revised
by the editor, who has introduced such  notes and observations as the rapid  progress of surgical
investigation and pathology have rendered necessary.  The illustrations, which are very numerous,
and of a high order of merit, both artistic and practical, have been engraved with great care, and
in every point of mechanical execution it is confidently presented as one  of the most beautiful
volumes as yet published in this country.
                              BY  THE SAME  AUTHOR.

             THE  PRACTICE  OF  SURGERY.
                              In one octavo volume, of 496 pages. 
12            BLANCHARD  &  LEA'S PUBLICATIONS.—(Anatomy.)


   SHARPEY AND  QUAIN'S ANATOMY.—(Lately Issued.)



         HUMAN    TN  ATOMY.

                 BY   JONES   QUAIN,  M.D.

           FROM   THE   FIFTH   LONDON   EDITION.

                                      EDITED  BY

 RICHARD QUAIN,  F. R. S.,  and WILLIAM SHARPEY, M. D., F. R. S.,
             Professors of Anatomy and Physiology in University College, London.

       REVISED,  WITH  NOTES  AND ADDITIONS,

                      BY  JOSEPH  LEIDY,  M.  D.
          Complete in Two large Octavo Volumes, of about Thirteen Hundred Pages.

    Beautifully Illustrated -with over Five Hundred Engravings on Wood.
  We have here one of the best expositions of the present state of anatomical science extant.  There is not
probably a work to be found in the English language which contains so complete an account of the progress
and present state of general and special anatomy as this.  By the anatomist this work must be eagerly
sought for, and no student's library can be  complete without it.— The N. Y. Journal of Medicine.
  We know of no work which we would sooner see in the hands of every student of this branch of medical
science than Sharpey and Quain's Anatomy.— The Western Journal of Medicine and Surgery.
  It may now be regarded as the most complete and best posted up work on anatomy in the language.  It
will be found particularly rich in general anatomy.— The Charleston Medical Journal.
  We believe we express the opinion of all who have examined these volumes, that there is no work supe-
rior to them on the subject which they so ably describe.—Southern Medical and Surgical Journal.
  It is one of the most comprehensive and best works upon anatomy in the English language.  It is equally
valuable to the teacher, practitioner, and student in medicine, and to  the surgeon in particular.—The Ohio
Medical and Surgical Journal.
  To those who wish an extensive treatise on Anatomy, we recommend these handsome volumes as the best
that have ever issued from the English or American Press.—The N. W. Medical and Surgical Journal.
  We believe that any country might safely be challenged to produce  a treatise on anatomy so readable, so
clear, and so full upon all-important topics.—British and Foreign Medico-Chirurgical Review.
  It is indeed a work calculated to make an era in anatomical study, by placing before the student every de-
partment of his science, with a view to the relative importance of each; and so skillfully have the different
parts been interwoven, that no one who makes this work the basis of his studies will hereafter have any ex-
cuse for neglecting or  undervaluing  any important particulars connected with the structure of the human
frame; and whether the bias of his mind lead him in a more especial manner to surgery, physic, or physiolo-
gy, he will find here a work at once so comprehensive and practical as to defend him from exclusiveness on
the one hand, and pedantry on the other.—Monthly Journal and Retrospect of the Medical Sciences.
  We have no hesitation in recommending this treatise on anatomy as the most complete on that subject in
the English language; and the only one, perhaps, in any language, which brings the state of knowledge for-
ward to the most recent discoveries.— The Edinburgh Medical and Surgical Journal.
  Admirably calculated to fulfil the object for which it is intended.— Provincial Medical Journal.
  The most complete Treatise on Anatomy in the English language.—Edinburgh Medical Journal.
  There is no work in the English language to be preferred to Dr. Quain's Elements of Anatomy.—London
Journal of Medicine.

                     THE STUDENT'S  TEXT-BOOK OF ANATOMY.
             NEW AND  IMPROVED EDITION—(JUST  ISSUED.)



   A    SYSTEM   OF   HUMAN   ANATOMY,

                   GENERAL   AND  SPECIAL.

                         BY  ERASMUS WILSON,  M. D.

        FOURTH AMERICAN FROM THE LAST ENGLISH EDITION.

                  EDITED BY PAUL  B.  GODDARD,  A. M., M. D.
                      WITH  TWO HUNDRED AND  FIFTY  ILLUSTRATIONS.
          Beautifully printed, in one large octavo  volume of nearly six hundred pages.
  In many, if not all the Colleges of the Union, it has become a standard text-book. This, of itself, is sufficiently
expressive of its value.  A work very desirable to the student; one, the possession of which will greatly
facilitate his progress in the study of Practical Anatomy.—Neio  York Journal of Medicine.
  Its author ranks with the highest on Anatomy.—Southern Medical and Surgical Journal.
  It offers to the student all the assistance that can be expected from such a work.—Medical Examiner.
  The most complete and convenient manual  for the student we possess.—American Journal of Med. Science.
  In every respect this work, as an anatomical guide for the student and practitioner, merits our warmest
and most decided praise.—London Medical Gazette.
                SIBSON'S MEDICAL ANATOMY—(Preparing.)


                  MEDICAL  ANATOMY;

Illustrating the Form, Structnre, and Position of the Internal Organs in Health and Disease,

                       BY FRANCIS SIBSON, M.D., F.R.S.,
                              Physician to St. Mary's Hospital.
                     With numerous and beautiful colored Plates.
                In Imperial Quarto, to match " Maclise's Surgical Anatomy." 
BLANCHARD & LEA'S PUBLICATIONS.—(Anatomy.)           13
                       HORNER'S  ANATOMY.
    MUCH IMPUOVED J1JYU EJS'EJIUGED EDlTIOn\—(Just Issued.)



   special   mkimm   m%   histology.

                    BY WILLIAM E. HORNER, M. L\,
                Professor of Anatomy in the University of Pennsylvania, &c.
                                EIGHTH EDITION.
                    EXTENSIVELY REVISED AND MODIFIED TO 1851.
     In two large octavo volumes, handsomely printed, with several hundred illustrations.

  This work has enjoyed a thorough and laborious revision on the part  of the author, with the
view of bringing it fully up to the existing state of knowledge on the subject of general and special
anatomy.  To adapt it more perfectly to the wants of the student, he has introduced a large number
of additional wood engravings, illustrative of the objects described, while  the publishers have en-
deavored to render the mechanical execution of the work worthy of the extended reputation which
it has acquired.  The demand which has carried it to an EIGHTH EDITION is a sufficient evidence
of the value of the work, and of its adaptation to the wants of the student and professional reader.
                       NEW AND CHEAPER EDITION OF

        SJMTU  Sf  HORJTEIVS  JlJTJlTOMICJlI. jlTLJiS.



              AN    ANATOMICAL    ATLAS,


ILLUSTRATIVE OF  THE STRUCTURE OF THE HUMAN BODY.

                BY HENRY H. SMITH, M. D., &o.
                           UNDER THE SUPERVISION OF

                    WILLIAM E.  HORNER, M.D.,
                  Professor of Anatomy in the University of Pennsylvania.

    In one volume, large imperial octavo, with about six hundred and fifty beautiful  figures.

 With the view of extending the sale of this beautifully executed and complete "Anatomical Atlas," the
publishers have prepared a new edition, printed on both sides of the page, thus materially reducing its cos?,
and enabling them to present it at a price about forty per cent, lower than former editions, while, at ihe same
time, the execution of each plate is in no respect deteriorated, and not a single figure is omitted.
 These figures are well selected, and present a complete and accurate representation of that wonderful
fabric, the human body. The pi an of this Atlas, which renders it so peculiarly convenient for the student, and
its superb artistical execution, have been already pointed out.  We must congratulate the student upon the
completion of this Atlas, as it is the most convenient work of the kind that has yet appeared ;  and we must
add, the very beautiful manner in which it is "got up" is so creditable to the country as to  be flattering
to our national pride.—American Medical Journal.
                     HORNER'S  DISSECTOR


THE   UNITED  STATES  DISSECTOR;

    Being a new edition, with extensive modifications, and almost re-written, of

             "HORNER'S PRACTICAL ANATOMY."
In one very neat volume, royal 12mo., of 440 pages, with many illustrations on wood.
           WILSON'S DISSECTOR, New Edition—(Just Issued.)



              THE   DISSECTOR;

   OR, PRACTICAL  AND SURGICAL  ANATOMY.

                         BY ERASMUS WILSON.

              MODIFIED AND  RE-ARRANGED BY

                       PAUL BECK GODDARD, M. D.
                   A NEW EDITION, WITH REVISIONS AND ADDITIONS.

   In one large and handsome volume, royal 12mo., with one hundred and fifteen illustrations.

  In passinf this work again through the press, the editor has made such additions and improve-
ments as the advance of anatomical knowledge has rendered necessary to maintain the work in the
high reputation which it has acquired in the schools of the United States as a complete and Saithfu.1
guide to the student of practical anatomy.  A number of new illustrations have been added, espe-
cially in the portion  relating to the complicated anatomy of Hernia.  In mechanical execution the
work will be found superior to former editions. 
14
BLANCHARD  & LEA'S PUBLTCATIONS.-(P^sfo^y.)
                  WORKS BY  W. B.  CARPENTER, M, D.

              NEW AND ENLARGED EDITION—(Now Ready.)


  PRINCIPLES   OF   HUMAN    PHYSIOLOGY,

                       WITH THEIR CHIEF APPLICATIONS TO
     PATISOILOCJY,  HYGIENE, AID FORENSIC MEDICINE.
            Fifth American from a New and Revised London Edition.
                  Revised, with Notes, by F. G. SMITH,  M. D.,
             Professor of Institutes of Medicine in the Pennsylvania Medical College.
                       With over Three Hundred  Illustrations.
       In one very large and handsome octavo volume, of about nine hundred pages.
  This edition of Dr. Carpenter's very popular work will be issued simultaneously with the new Lon-
don edition, and therefore may be regarded as fully up to the most recentstate of the subject. It will
thus be found materially altered and improved, the author having used every exertion to incorpo-
rate in it all the changes which the very numerous and important observations of the last few years
have caused  in this rapidly advancing science.  To accomplish this, he has  been compelled to
re-wrile many portions, and to re-cast others, so that the present editijjji may be looked upon as
almost a new book. The passage of the work through the press has been carefully superintended
by Prof. Smith, who has made such additions as were required to adapt it more particularly to the
wants of the American student; and, with  a  greatly improved  series  of illustrations,  and very
superior style of mechanical execution, the publishers confidently present  this edition as worthy
a continuance of the universal favor with which this work has been received as a standard text-
book for the  student and practitioner.
  As a text-book it has been received into all our Colleges, and from a careful perusal we can recommend it
to the student and 1o ihe profession at large, as the  best exposition of the present condition of Physiology
within their reach.—JV. Y. Journal of Medicine.
                   COMPARATIVE  PHYSIOLOGY*.

PRINCIPLES   OP  PHYSIOLOGY,
              GENERAL   AND  COMPARATIVE.
                           NEW AND IMPROVED EDITION.
  In one very handsome octavo volume, with several hundred beautiful wood-cuts.  (In Press.)
  A truly magnificent work.  In itself a perfect physiological siudy— Ranking's Abstract.
           CARPENTER'S  MANUAL  OF  PHYSIOLOGY.
                    NEW AND IMPROVED EDITION—(Just Issued.)


      ELEMENTS   OP   PHYSIOLOGY,
                INCLUDING  PHYSIOLOGICAL ANATOMY.
               SECOND AMERICAN, FROM A NEW AND REVISED LONDON EDITION.
      With One Hundred and Ninety Illustrations.  In one very handsome octavo volume.
  In publishing the first edition of this work, its title  was altered from that of the London volume,
by the substitution of the word " Elements'' for that of " Manual," and with the author's sanction,
the title of " Elements" is still retained as being more expressive of the scope of the treatise.  A
comparison of the present edition with the former one will show a material  improvement, the au-
thor having revised it thoroughly, with the view of rendering it  completely on a level with the
most advanced state of the science.  By condensing the less important portions, these numerous
additions have been introduced without materially increasing the  bulk of the volume, and while
numerous illustrations have been  added, and the  general execution of the work improved, it has
been kept at its former very moderate price.
  To say that it is the hest manual of Physiology now before the public, would not do sufficient justice to the
author —Buffalo Med. Journal.
  In his former works il would seem that he had exhausted the  subject of Physiology. In the present, he
gives ihe essence, :is it were, of the whole.— N. Y. Journal of Medicine.
  The best and most complete expose of modern physiology, in one volume, extant in the English language.
—St. Louis Med. Journal.
  Those who have occasion for an elementary treatise on physiology, cannot do better than to possess them-
selves of the manual of Dr. Cnrpenter.—Medical Examiner.
          A New Work by Dr. Carpenter—(Preparing.]

       THE  VARIETIES  OF  MANKIND;
Or, an Account of the Distinctive Characters of the Various Races of Men.
           WITH  NUMEROUS  ILLUSTRATIONS ON WOOD.
                  In one handsome royal 12mo. volume. 
BLANCHARD & LEA'S PUBLICATIONS— (Physiology.)
15
                    DUNGLISON'S   PHYSIOLOGY.
          !Vew and much Improved Edition.—(Just Issued.)


  HUMAN    PHYSIOLOGY.

                       BY ROBLEY DUNGLISON,  M. D.,
      Professor of the Institutes of Medicine in the Jefferson Medical College, Philadelphia, etc. etc.
                                   SEVENTH EDITION.
                 Thoroughly revised and extensively modified and enlarged,
                      W*ith nearly Five Hundred Illustrations.
      In two large and handsomely printed octavo volumes, containing nearly 1450 pages.
  On no previous revision of this work has the author bestowed more care than on the present, it
having been subjected to an entire scrutiny, not only as regards the important matters of which it
treats, but also the language in which  they are conveyed ; and  on no former occasion has he felt
as satisfied with his endeavors to have  the work on a level with the existing state of the science.
Perhaps at no time in the history of physiology have  observers been more  numerous, energetic,
and discriminating than within the last  few years. Many modifications of fact and  inference have
consequently taken place, which it has been necessary for the author to record, and to express his
views in relation  thereto.  On the whole subject of physiology proper, as it applies to the functions
executed by the different organs, the present edition, the author flatters himself, will therefore be
found to contain the views of the most distinguished physiologists of all periods.
  The amount of additional  matter contained in this edition  may be estimated from the fact that
the mere list of authors referred to in its preparation alone extends over nine large and closely printed
pages.  The number of illustrations has been largely increased,  the present edition containing four
hundred and seventy-four, while the last had but three hundred  and sixty-eight; while, in addition
to this, many new and superior wood-cuts have been substituted for those which were not deemed
sufficiently accurate or satisfactory.   The mechanical  execution of the work has also been  im-
proved in every respect, and the whole is confidently presented as worthy the great and continued
favor which it has so long received from the profession.

                     TODD  &  BOWMAN'S  PHYSIOLOGY.


            THE   PHYSIOLOGICAL  ANATOMY
                      AND  PHYSIOLOGY  OF  MAN.

                         BY R. B.  TODD AND  W.  BOWMAN.
            Parts I  II. and lit., in 1 vol. 8vo. of 552 pages,  with Lr3 wood cuts.
   The distinguishing peculiarity of this work  is, that the authors investigate for themselves every
can obtain it by mail, on remittance of $2 50 to the publishers
          KIRKES  AND PAGET'S PHYSIOL,OGY.-(Iiately Issued.)


            LMUAL   OF   PHYSIOLOGY,

                   FOR  THE   USE  OF  STUDENTS.
          BY  WILLIAM  SENHOUSE  KIRKES,  M.  D.,
                            Assisted by  JAMES PAGET,             .
            Lecturer on General Anatomy and Physiology in St. Bartholomew's Hospital.    ,
          In one handsome volume, royal 12mo., of 550 pages, with 118 wood-cuts.
 An excellent work, and for siuden.s one of the best within rezcU.-Boston Med'caland Surgtcal Journal.
 One of the best little books on Phys.ology which we W™**--?™*™'? ?a^$'£*n Physiology -
 Particularly adapted to those who desire to possess a concise digest of the facts of Human l-h> sioiogy.
British and foreign Med.-Chirurg. Review.                    ...  r „~,7„», HT„,r,rnl anzette
 One of the best treatises which can be put into the hands of the student.- London M dual fraze"*-
 We^conscientiouslyRecommend it as an admirable » Handbook of l>hys,ology.»-£<mtf<m Jour, of Medicine.

                           SOLLY ON  THE  BRAIN.

  THE  HUMAN BRAIN;  ITS  STRUCTURE,  PHYSIOLOGY,  AND DISEASES.
         WITH A DESCRIPTION OF THE TYPICAL FORM OF THE BRAIN IN THE ANIMAL KINGDOM.
                        BY SAMUEL SOLLY, F. R. S., &c,
                    Senior Assistant Surgeon to the St Thomas' Hospital, &c.
     From the Second and much Enlarged London Edition.  In one octavo volume, with 120 Wood-cuts.

HARRISON OX THE NERVES—An Essay towards a correct theory of the Nervous System. In on

itTTTrKUCCino\N9lTvLXC; BEINGS.- Lectures on the Physical Phenomena of Living Beings. Ed:: ■■!
  i ,i>^.ra  In one neat royal.12mo. volume, extra cloth, with cuts—38>, pages.
RO^ET^I 1MIYSIOLOGY- A Treatise on Animal and Vegetable Physiology, with over 400 illustrunons on
   *  l 'in i wo oct'ivo volumes, cloth.
„X°rTOm':n ivi.'^—Outlines ot" I'h vsioloarv and Phrenology.  In one octavo volume, cloth—516 paf>.
ON THE[CONNECTION BETWEEN  PHYSIOLOGY  AXD  INTELLECTUAL. SCIENCE. Imi.e
  12mo. volume, paper, price 25 cents. 
16          BLANCHARD &, LEA'S PUBLICATIONS.—(Pathology.)
                            NEARLY READY.

  AH  ATLAS  OF  PATHOLOGICAL  HISTOLOGY.
                      BY GOTTLIEB GLUGE,  M. D.,
         Professor of Physiology and Pathological Anatomy in the University of Brussels.
      Teanslated, with Notes and Additions, by JOSEPH LEIDY, M. D.
                      In one volume, very large imperial quarto,
    WITH THREE HUNDRED AND TWENTY FIGURES, PLAIN AND COLORED, ON TWELVE PLATES.
 The great and increasing interest with which this important subject is now regarded by  the profession,
and the rapid advances which it is making by the aid of the microscope, have induced the publishers to pre-
sent this volume, which contains all the most recent observations and results of European investigations.
The text contains a complete exposition of the present state of microscopical pathology, while the plates are
considered as among the most truthful and accurate representations which have been made of the pathologi-
cal conditions of the tissues, and the volume as a whole may be regarded as a beautiful specimen of mechan-
ical execution, presented at a very reasonable price.

          WILLIAMS' PRINCIPLES—A»ew and Enlarged Edition.


  PRINCIPLES   OF   MEDICINE;
         Comprising General Pathology and Therapeutics,
                        AND A BRIEF GENERAL VIEW OF
   ETIOLOGY,  NOSOLOGY.  SEMEIOLOGY,  DIAGNOSIS,  PROGNOSIS,  AND  HYGIENICS,
            BY CHARLES J. B. WILLIAMS, M. D.,  F. R.  S.,
         Edited,  with Additions, BY MEEEDITH  CLYMER, M. D.,
         THIKD AMERICAN, FROM THE SECOND AND ENLARGED LONDON EDITION.
                        In one octavo volume, of 440 pages.

                    SIJIIOJY'S  PATHOLOGY—(JYou) Beady.)


        GENERAL   PATHOLOGY,

                                AS CONDUCIVE TO

  The Establishment of Rational Principles for the Diagnosis and Treatment  of Disease;
A Course of Lectures, delivered at St. Thomas's Uospital, during the Summer Session  of 1S50.

                         BY JOHN SIMON, F. R. S.,
        One of the Surgical Staff of that Hospital, and Officer of Health to the City of London.
                       In one neat octavo volume, extra cloth.


  MANUALS   ON  THE  BLOOD  AND  URINE,
In one handsome volume royal 12mo., extra cloth, of 460 large pages, with numerous illustrations,
                                  CONTAINING
I. A Practical Manual on the Blood and Secretions of the Human Body.  BY JOHN WILLIAM
  GRIFFITH, M. D., &c
II. On the Analysis of the Blood and Urine in health and disease, and on the treatment of Urinary
  diseases. BY G. OWEN REESE, M. D., F. R. S.,  &c. &c
III. A Guide to the Examination of the Urine in health and disease. BY ALFRED  MARKWICK.
                         NEW EDITION—(Just Issued.)


             URINARY  "DEPOSITS;

TIEIR MABNDSIS, PATHOLOBY, AND THERAPEUTICAL INBIGATMS.

                 BY GOLDING BIRD,  A. M., M. D., &c.
          A NEW AMERICAN, FROM THE THIRD AND IMPROVED LONDON EDITION.
            In one very neat volume, royal 12mo., with over sixty illustrations.
 Though the present edition of this well-known work is but little increased in size, it will be found essen-
tially modified throughout, and fully up to the present state of knowledge on ils subject. The unanimous tes-
timony of the medical press warrants the publishers in presenting it as a complete and reliable manual for
the student of this interesting and important branch of medical science.

ABERCROMBIE ON THE BRAIN.—Pathological and Practical Researches on Diseases of the Brain and
 Spinal Cord.  A new edition, in one small 8vo. volume, pp. 324.
BURROWS ON CEREBRAL CIRCULATION.—On Disorders of the Cerebral Circulation, and on the
 Connection between Affections of the Brain and Diseases of the Heart. In 1 Svo. vol., with colMpl's. pp. 216.
BLAKISTON ON THE CHEST—Practical Observations on certain Diseases of the  Chest, and on the
 Principles of Auscultation.  In one volume, 8vo., pp. 3S4.
HASSE'S PATHOLOGICAL ANATOMY—An Anatomical Description of the Diseases of Respiration and
 Circulation.  Translated and Edited by Swaine.  In one volume, 8vo.. pp. 379.
FRICK ON THE URINE—Renal Aflections, their Diagnosis and Pathology. In one handsome volume,
 royal 12mo.. with illustrations.
COPLAND ON PALSY—Of the Causes, Nature,  and Treatment of Palsy and Apoplexy. In one volume,
 royal 12mo.  (Just Issued.)
VOGEL'S PATHOLOGICAL ANATOMY.—Pathological Anatomy of the Human body. Translated by
 Day. In one octavo volume, with plates, plain and colored.
BILLING'S PRINCIPLES.—The Principles of Medicine.  Second American, from the Fifth and Improved
 London Edition. In one octavo volume, extra cloth. 250 pages. 
BLANCHARD  &  LEA'S  PUBLICATIONS— (Practice of Medicine.)    17
THE    PRACTICE    OF    MEDICINE.

                                  A  TREATISE ON

       SPECIAL  PATHOLOGY  AND THERAPEUTICS.
                                  THIRD EDITION.

                      BY ROBLEY DUNGLISON, M. D.,
Professor of the Institutes of Medicine in the Jefferson Medical College ; Lecturer on Clinical Medicine, &e.

                   In two large octavo volumes, of fifteen hundred pages.
  The  student of medicine will find, in these two elegant volumes, a mine of facts, a gathering
of precepts and advice from the world of experience, that will nerve him with courage, and  faith-
fully direct him in his efforts to relieve the physical sufferings of the race.—Boston Medical and
Surgical Journal.
  Upon every topic embraced in the work the latest information will be found carefully posted up.
Medical Examiner.
  It is certainly the most complete treatise of which we have any knowledge.  There is scarcely a
disease which the student will not find noticed.—Western Journal of Medicine and Surgery.
  One of the most elaborate treatises of the kind we have.—Southern Medical and Surg. Journal.


               NEW AND IMPROVED EDITION—(Now Ready.l

              THE HISTORY, DIAGNOSIS, AND TREATMENT OF THE

      FEVERS   OF   THE   UNITED   STATES,

                     BY  ELISHA BARTLETT, M.D.,
Professor of Materia Medica and Medical Jurisprudence in the College of Physicians and Surgeons, N. Y.

                      Third Edition, Revised and Improved.

                   In one very neat octavo  volume, of six hundred  pages.

  In preparing a new edition of this standard  work, the author has availed himself of such observ-
ations and investigations as have appeared since  the publication  of his last revision, and he has
endeavored in every way to render it worthy of a continuance of the very marked favor with which
it has been hitherto  received. *
  The masterly and elegant treatise by Dr. Bartlett is invaluable to the American student and practitioner.
—Dr. Holmes's Report to the Nat. Med. Association.
  We regard it, from the examination we have made of it, the best work on fever extant,  in our language,
and as such cordially recommend it to the medical public.—St. Louis Med. and Surg. Journal.



   DISEASES   GF  THE  HEART,  LUNGS,  AUD APPENDAGES;

               THEIR  SYMPTOMS  AND  TREATMENT.

                          BY W.  H. WALSHE, M.D.,
        Professor of the Principles and Practice of Medicine in University College, London, <yc.
                         In one handsome volume, large royal 12mo.



     THE  CYCLOPEDIA  OF  PRACTICAL   MEDICINE;

                                    COMPRISING
Treatises on the  Nature and Treatment of Diseases, Materia Medica, and Thera-
    peutics, Diseases of "Women and Children, Medical Jurisprudence, &c. &c.
                                     EDITED BY

    JOHN FORBES,  M. D., F. R. S., ALEXANDER TWEEDIE, M. D., F.R. S.,
                          AND JOHN  CONOLLY, M. D.J
                               Revised, with Additions,

                      BY ROBLEY DUNGLISON, M. D.
        THIS WORK IS NOW COMPLETE, AND FORMS FOUR LARGE SUPER-ROYAL OCTAVO VOLUMES,
Containing Thirty-two Hundred  and Fifty-four unusually  large  Pages  in Double Columns, Printed
                       on Good Paper, with a new and clear type.
          THE WHOLE WELL AND STRONGLY BOUND. WITH RAISED BANDS AND DOUBLE TITLES.
   This work contains no less than FOUR HUNDRED AND EIGHTEEN DISTINCT TPvEATISES,

                    By Sixty-eight distinguished Physicians.
  The most complete work on  Practical Medicine extant; or, at least, in our language.—Buffalo Medical
and Surgical Journal.
  For reference, it is above all price to every practitioner.— Western Lancet.
  One of the most valuable medical publications of the day—as a work of reference it is invaluable.—
Western Journal of Medicine and Surgery.
  It has been  to us, both as  learner and teacher, a work for ready and frequent reference, one in which
modern English medicine is exhibited in the most advantageous light.—Medical Examiner.
  We rejoice that this work is to be placed within the reach of the profession in this country, it being unques-
tionably one of very great value to the practitioner.  This estimate of it has not been formed from a hasty ex-
amination  but after an intimate acquaintance derived from frequent consultation of it during the past nine or
ten years.' The editors are practitioners of established reputation, and the list of contributors embraces many
of the most eminent professors and teachers of London, Edinburgh. Dublin, and Glasgow.  It is, indeed, the
great merit of this work that ihe principal articles have been furnished by practitioners who have not only
devoted especial attention to the diseases about which they have written, but have also enjoyed opportunities
for an extensive practical acquaintance with them,—and whose reputation  carries the assurance of their
eompetencyjustly to appreciate the opinions of others, while it stamps their own doctrines with high and just
authority.—American Medical Journal. 
18       BLANCHARD & LEA'S  PUBLICATIONS.—(Practice of Medicine.)
                  WATSON'S PRACTICE OF MEDICINE—(New Edition )

                            LECTURES ON  THE

 PRINCIPLES'  AND  PRACTICE   OF  PHYSIC.

               BY  THOMAS WATSON,  M. D., &c. &c.

            Third American, from the last  London Edition.

      REVISED, WITH  ADDITIONS, BY  D. FRANCIS  CONDIE,  M. D.,
                     Author of ■' A Treatise on the Diseases of Children," &c.
                               IN ONE  OCTAVO  VOLUME,
      Of nearly ELEVEN HUNDRED LARGE PA&ES, strongly bound with raised bands.
 To say that  it is the very best work on the subject now extant, is but to echo the sentiment of the medloal
press throughout the country.— N. O. Medical Journal.
 Regarded on all hands as one of the very besi, if not the very best, systematic treatise on practical medi-
cine extant.— St. Louis Med. Journal.
 As a text-book it has no equal; as a compendium of pathology and practice no superior — X. Y. Annalist.
 We know of no work better calculated for being placed in the hands of the student, and for a textbook;
on  every important point the author seems to have posted up his knowledge to the day.—Amer. Med. Journal.
 One of the most practically useful books that ever was presented to the student.—N. Y. Med. Journal.
                    NEW AND IMPROVED EDITION-(Now Ready.)


         ON   DISEASE S~O F   THE   SKIN.

                           BY ERASMUS  WILSON, F. R. S.,
                              Author of ■' Human Anatomy," &c.
                   THIRD AMERICAN FROM THE THIRD LONDON EDITION.
                       In one neat octavo volume, extra clolh, 480 pages.
Also, to be had with fifteen beautiful steel plates, embracing 165 figures, plain
  and colored, representing the Normal Anatomy and Pathology of the Skin.
                       ALSO, THE PLATES SOLD SEPARATE, IN BOARDS.
  This edition will be found in  every  respect much improved  over the last.  Considerable addi-
tions have been made, the arrangement altered, and the whole revised so as to make it fully on a
level with the existing state of knowledge on the subjects treated.
  As a practical guide to the classification, diagnosis, and treatment of the diseases of the skin, the book is
complete. We know nothing, considered in tliis aspect, better in our language ; it is a safe authority on all
the ordinary matters which, in this range of diseases, engage the practitioner's attention and possesses the
high quality—unknown, we believe, to every  older manual—of being on a level with science's high-water
mark—a  sound book of practice.—London Medical Times.
                         WILSON ON SYPHILIS-(Now Ready.)

    ON  CONSTITUTIONAL  km  HEREDITARY  SYPHILIS |
               AND  ON   SYPHILITIC  ERUPTIONS.
                       BY  ERASMUS WILSON,  F. R. S.,
                   Author of " Human Anatomy," " Diseases of the Skin," &c.
         In one very handsome volume, small 8vo., with four beautiful colored plates,
Presenting accurate representations of more than thirty varieties of Syphilitic Diseases of the Skin.
  This work is the  result of extensive practical  experience in the treatment of this disease, and
presents some new views on this difficult and important subject, illustrated by numerous cases.
BENEDICT'S CHAPMAN.—Compendium of Chapman's Lectures on the Practice of Medicine. One neat
  volume, 8vo., pp. 258.
BUDD ON THE LIVER.—On Diseases of the Liver. In one very neat Svo. vol., with colored plates and
  wood-ruts. pp. 392.
CHAPMAN'S  LECTURES.—Lectures on Fevers, Dropsy, Gout, Rheumatism,&c. &c.  In one neat8vo.
  volume, pp. 450.
THOMSON ON THE SICK ROOM.—Domestic managementof the sick Room, necessary in aid of Medical
  Treatment for the cure of Diseases.  Edited by R. E. Griffith, M. D. In one large royal 12mo. volume, with
  wood-cuts. pp. 300.
HOPE ON  THE HEART.—A Treatise on the Diseases of the Heart and Great Vessels.  Edited by Pen-
  nock.  In one volume. Svo , with plates, pp. 572.
LALLE.MAND ON SPERMATORRHOEA.—The Causes, Symptoms, and Treatment of Spermatorrhoea.
  Trar slated and Edited by Henry J McDougal. In one volume, Svo., pp. 320.
PHILIPS ON SCROFULA.—Scrofula: its Nature, its Prevalence, its  Causes, and the  Principles of its
  Treatment. In one volume, fivo., with a plate, pp. 350.
WHITEHEAD ON ABORTION, &c—The Causes and Treatment of Abortion  and Sterility: being the
  Result of an Extended Practical Inquiry  into the Physiological and Morbid Conditions of the  Uterus.  In
  one volume, 8vo., pp 308.
WILLIAMS ON RESPIRATORY ORGANS.—A Practical Treatise on Diseases of the Respiratory Or-
  gans; including Diseases of the Larynx, Trachea, Lungs,  and Pleurae.  With numerous Additions and
  Notes by M. Clymer. M.D. With wood-cuts.   In one octavo volume, pp. 508
DAY ON OLD AGE.—A Practical Treatise on the Domestic Management and more important Diseases of
  Advanced Life.  With an Appendix on a new and successful mode of treating Lumbago and other forms
  of Cihronie Rheumatism.  1 vol. 8vo., pp. 226
CLYMER  ON FEVERS.—Fevers, their Diagnosis, Pathology, and Treatment. Prepared, with large Ad-
  ditions, from  '• Tweedie's Library of Practical Medicine." In one vol  8vo , pp. 604. 
BLANCHARD  & LEA'S PUBLICATIONS— (Diseases of Females.)      19
  MEIGS ON FEMALES,  New and Improved Edition—(Lately Issued,)



WOMAN;   HER    DISEASES- AND   THEIR   REMEDIES;

           A   SERIES   OF   LETTERS   TO  HIS  CLASS.

                             BY  C.  D. MEIGS,  M.  V.,
    Professor of Midwifery and Diseases of Women and Children in the Jefferson Medical College of
                                   Philadelphia, &c. &c.
    In one large and beautifully printed octavo volume, of nearly seven hundred large pages.

  " I am happy to offer to my Class an  enlarged and amended  edition of my  Letters on the Dis-
eases of Women ; and I avail myself of this occasion to return my  heartfelt thanks  to them, and
to our brethren generally, for  the flattering manner in which they have accepted this fruit of my
labor."—Preface.

  The value attached to this  work by the profession  is sufficiently proved by the rapid ex-
haustion of Ihe first edition, and consequent demand for  a second.   In preparing this the
author has availed  himself of the opportunity thoroughly to  revise and  greatly  to improve
it.  The work  will  therefore be found completely brought up to the day,  and in every way
worthy of the reputation which it has so immediately obtained.
  Professor Meigs has enlarged and amended this great work, for such it unquestionably is, having passed
the ordeal of criticism  at home and abroad, but  been improved thereby ;  for in this new edition the author
has introduced real improvements,  and increased the value and utility of the book immeasurably.  It presents
so many novel, bright  and  sparkling thoughts; such  an exuberance of new ideas on almost every page,
that we confess ourselves to have  become enamored  with the book and its author; and cannot withhold
our congratulations from our Philadelphia confreres, that such  a teacher is in their service. We regret that
our limits will not allow of a more  extended notice of this work, but mu-t content ourselves with thus com-
mending it as worthy of diligent perusal by physicians as well as students, who are seeking to be thoroughly
instructed in the  important practical subjects of which it treats—N. Y. Med. Gazelle.
  It contains a vast amount of practical knowledge, by one who has accurately observed and retained the
experience of many years, and who tells the result in a free, familiar, and pleasant manner.—Dublin Quar-
terly Journal.
  There is an off-hand fervor, a glow and a warm-heartedness infecting the effort of Dr. Meigs, which is en-
tirely captivating, and which absolutely  hurries the reader through from beginning to end. Besides, the
hook teems with solid instruction, and it shows the very highest evidence of ability, viz., the clearness with
which the information is presented. We know of no better test of one's understanding a subject than the
evidence of the power of lucidly explaining it.  The most elementary, as well as the obscurest subjects, un-
der the pencil of Prof.  Meigs, are isolated and made to stand out in such bold relief, as to produce distinct
impressions upon the mind and memory of the reader.—The Charleston Medical Journal.
  The merits of the first edition of this work  were so generally appreciated, and with  such a high degree of
favor by the medical profession throughout the Union, that we  are not surprised in  seeing a second edition
of it.  It is a standard  work on the diseases of  females, and in many respects is one of the  very best of its
kind in the English language. Upon the appearance of the first edition, we gave the work a cordial recep-
tion, and spoke of it in the warmest terms of commendation.  Time has not changed the favorable estimate
we placed upon it, but has  rather increased our convictions of its superlative merits.  But we do not now
deem  it necessary to  say  more than to commend this work, on the diseases of women, and the remedies
for them, to the attention of those practitioners who have not supplied themselves with it. The most select
library would  be imperfect without it.— The Western Journal of Medicine and Surgery.
  He is a bold  thinker, and possesses more originality of thought and style than almost  any American writer
on medical subjects.  If he is not  an elegant writer, there is at least a freshness-a raciness in his mode of
expressing himself—that cannot fail to draw the reader after him, even to the close of his work : you cannot
nod over his pages; he stimulates rather than narcotises your senses, and the reader cannot lay aside these
letters when once he enters into their merits.  This, the second edition, is much amended and enlarged, and
affords abundant evidence of the author's talents and industry.— JV. O. Medical and Surgical Journal.
  The practical writings of Dr. Meigs are second to none — The JV.  Y. Journal of Medicine.
  The excellent practical directions contained in this volume give it great utility, which we trust will not be
lost upon our older colleagues ; with some condensation, indeed, we should  think it well adapted for trans-
lation imo German.—Zeitschriftfur die Gesammte Medecin.

                     NEW AND IMPROVED EDITION—(Lately Issued.)


A TREATISE   ON   THE  DISEASES  OF  FEMALES,

                    AND ON  THE  SPECIAL HYGIENE OF THEIR SEX,

                BY  COLOMBAT  DE   L'ISERE,  M.D.

   TRANSLATED, WITH  MANY NOTES  AND  ADDITIONS, BY C. D.  MEIGS, M. D.
                        SECOND EDITION, REVISED AND IMPROVED.
   In one large volume, octavo, of seven hundred and twenty pages, with numerous wood-cuts.
  We are satisfied it is destined to take the front rank in this department of medical science.  It is in fact a
complete exposition of the opinions and practical methods of all the celebrated practitioners of ancient and
modern times.— New York Joum. of Medicine.

         ASHWELL ON THE DISEASES  OP  FEMALES.


A PRACTICAL  TREATISE  BN THEllSEASES  PECULIAR  TO  WOMEN.
           ILLUSTRATED BY CASES DERIVED FROM HOSPITAL AND  PRIVATE PRACTICE.

      BY SAMUEL ASHWELL, M. D.  With Additions by PAUL BECK GODDARD, M. D.
                Second American edition.  In one octavo volume, of 520 pages.

  One of the very best works ever issued from the press on the. Diseases of Females.— Western Lancet.

ON THE CAUSES AND TREATMENT OF  ABORTION AND STERILITY.  By James Whitehead,
           M. D., &c.  In one volume octavo, of about three  hundred and seventy-five pages. 
gg___.   BLANCHARD  & LEA'S PUBLICATIONS.-(Z)i«e«n« of Females.)

                      NEW AND IMPROVED EDITION.


                 ON THE  DISEASES  OF  WOMEN,


 INCLUDING  THOSE  OF  PREGNANCY   AND   CHILDBED.

            BY FLEETWOOD CHURCHILL, M. D., M. R. I. A.,
            Author of "Theory and Practice of Midwifery," "Diseases of Females," &c.

                A New American Edition, Revised by the Author.

         With  Notes and Additions, bt  D. FRANCIS CONDIE,  M. D.

           In one large and handsome octavo volume of 684 pages, with wood-cuts.

  To indulge in panegyric, when announcing- the fifth  edition of any acknowledged medical authority, were
to attempt to " gild refined gold."  The work announced  above, has too long been honored  with the terra
u classical" to leave any doubt as to its true worth, and we content ourselves with remarking, that the author
has carefully retained the notes of Dr. Huston, who edited the former American edition, thus really enhanc-
ing the value of the work, and  paying a well-merited  compliment. All  who wish to be "posted up" on all
that relates to the diseases peculiar to the wife, the mother, or the maid, will hasten to secure a copy of this
most admirable treatise.—The Ohio Medical and Surgical Journal.
  We know of no author who deserves that approbation, on " the diseases of females," to  the same extent
that Dr. Churchill does.  His, indeed, is the only thorough treatise we know of on the subject, and it may be
commended to practitioners and students as a masterpiece in its particular department. The former editions
of this work have been commended strongly in this journal, and they have won their way to an extended,
and a well deserved popularity. This fifth edition, before us, is well calculated to maintain Dr. Churchill's
high reputation.  It was revised and enlarged by the author, for his American publishers, and it seems to us,
that there is scarcely any species of desirable information on its subjects, that may not be found in this work.
— The Western Journal of Medicine and Surgery.
  We are gratified to announce a new and revised edition of Dr. Churchill's valuable work on the diseases
of females. We have ever regarded it as one of the very best works on the subjects embraced within its
scope, in the English language; and the present edition, enlarged and revised by the author,  renders it still
more entitled to the confidence of the profession. The valuable notes of Prof. Huston have been retained,
and contribute, in no small degree, to enhance the value  of the work. It is a source of congratulation that
the publishers have permitted the author to be, in this instance, his own editor, thus securing all the revision
which an author alone is capable of making.— The Western Lancet.
  As a comprehensive manual for students, or a work  of reference  for practitioners, we only speak with
common justice when we say that it surpasses any other that has ever issued on the same subject from the
British press.— The Dublin Quarterly Journal.
              Churchill's  Monographs on Females.—(Lately Issued.)


   ESSAYS  ON  THE  PUERPERAL  FEVER,  AND  OTHER  DISEASES

                        PECULIAR   TO  WOMEN.
 SELECTED FROM THE WRITINGS OF BRITISH AUTHORS PREVIOUS TO THE CLOSE OF
                           THE EIGHTEENTH CENTURY.

              Edited by  FLEETWOOD CHURCHILL, M. D.,  M. R. I. A.,
                     Author of "Treatise on the Diseases of Females," &c.

              In one neat octavo volume, of about four hundred and fifty pages.

  To these papers Dr. Churchill has appended notes, embodying whatever information has been laid before
the profession since their authors'time. He has also prefixed to the essays on puerperal fever, which occu-
py the larger portion of the volume, an interesting historical sketch of the principal epidemics of that disease.
The whole forms a very valuable collection of papers by professional writers of eminence, on some of the
most important accidents to which the puerperal female is liable.—American Journal of Medical Sciences.
         REJSWETT  O.V THE  UTERUS—(JVcw Edition, JYjw Ready.)

                   A   PRACTICAL  TREATISE  ON

INFLAMMATION  OF THE  UTERUS AND  ITS  APPENDAGES,

       AND  ON  ULCERATION AND INDURATION OF THE NECK OF  THE UTERUS.

                        BY HENRY BENNETT,  M. L\,
                       Obstetric Physician to the Western Dispensary.
                             Third American Edition.
                 In one neat octavo yolume of 350 pages, with wood-cuts.

  Few worksissue from the medical press which are at once original and sound in doctrine; but such, we
feel assured, is the admirable treatise now before us.  The important practical precepts which the author
inculcates are all rigidly deduced from facts. .  . . EveTy page of the book is good, and eminently practical.
So far as we know  and believe, it is the best work on the subject on which it treats.— Monthly Journal oj
Medical Science.


         A  TREATISE  ON THE  DISEASES  OF  FEMALES.

                          BY W. P. DEWEES, M. B.
                                  NINTH EDITION.
                     In one volume, octavo.  532 pages, with plates. 
BLANCHARD &  LEA'S PUBLICATIONS.—(Diseases of Children.)       21
MEIGS  ON  CHILDREN—(Just Issued,)
                           OBSERVATIONS  ON


CERTAIN  OF   THE  DISEASES  OF   YOUNG   CHILDREN,

                        BY  CHARLES  D.  MEIGS, M. T>.,
      Professor of Midwifery and of the Diseases of Women and Children in the Jefferson
                          Medical College of Philadelphia, &c. &c.

                      In one handsome octavo volume of 214 pages.

  While this work is not presented to the profession as a systematic and  complete treatise on In-
fantile disorders, the importance of the subjects treated of, and the interest attaching to the views
and opinions of the distinguished author must command for it the attention of all  who are called
upon to treat this interesting class of diseases.

  It puts forth no claims as a systematic work, but contains an amount of valuable and useful matter,
scarcely to be found in the same space in our home literature.  It can not but prove  an  acceptable offering
to the profession at large.—N. Y. Journal of Medicine.
  The work before us is undoubtedly a valuable addition to the fund of information which has already  been
treasured up on the subjects in question.  It is practical, and  therefore eminently adapted to the general
practitioner. Dr. Meigs' works have the same fascination which belongs to  himself.—Medical Examiner.
  This is a most excellent work on the obscure diseases of childhood, and will afford the  practitioner and
student of medicine much aid in their diagnosis and treatment.— The Boston Medical and Surgical Journal.
  We take  much pleasure in recommending this excellent little  work to the  attention of medical practition-
ers.  It deserves their  attention, and after they commence its perusal, they  will not willingly abandon it,
unul they have mastered its contents.  We read the work while suffering  from a carbuncle, and its fasci-
nating pages often beguiled us into forgetfulness of agonizing pain. May it teach others  to relieve the afflic-
tions of the young.— The Western Journal of Medicine and Surgery.
  All of which topics are treated with Dr. Meigs' acknowledged ability and original diction.  The work is
neither a systematic nor a complete treatise upon the diseases of children, but a fragment which may be con-
sulted with much advantage.—Southern Medical and Surgical Journal.
NEW WORK  BY  DR. CHURCHILL.
                                      ON   THE

DISEASES    OF   INFANTS   AND    CHILDREN.
          BY FLEETWOOD  CHURCHILL, M. D.,  M. E. I. A.,

             Author of "Theory and Practice of Midwifery," "Diseases of Females," &c.

                 In one large and handsome octavo volume of over 600 pages.

  From Dr. Churchill's known ability and industry, we were led to form high expectations of this work;  nor
were we deceived. Its learned author seems to have set no bounds to his researches in collecting informa-
tion which, with his usual systematic address, he has disposed of in the most clear and concise manner, so
as to lay before the reader every opinion of importance bearing upon the subject under consideration.
  We regard this volume as possessing more claims to completeness than any other of the kind with which
we are acquainted.  Most cordially and earnestly, therefore, do we commend it to our professional brethren,
and we feel assured that the stamp of their approbation will in due time be  impressed upon it.
  After an attentive perusal of its contents, we hesitate not to say, that it is one of the most comprehensive
ever written upon the diseases of children, and that, for copiousness of reference, extent of research, and per-
spicuity of detail, it is scarcely to be equalled, and not to be excelled in any language.—Dublin Quarterly
Journal.
  The present volume will sustain the reputation acquired by the  author  from his previous works.  The
reader will find in it full and judicious directions for the management of infants at birth, and a compendious,
but clear, account of the diseases to which children are liable, and the most successful mode of treating them.
We must not close  this notice without calling attention to the author's  style, which is perspicuous and
polished to a degree, we regret to say, not generally characteristic of medical works.  We recommend the
work of Dr. Churchill most cordially, both to students and practitioners, as a valuable and reliable guide in
the treatment of the diseases of children.—Am. Journ. of the Med. Sciences.
  After this meagre, and we know, very imperfect  notice, of Dr. Churchill's work, we shall conclude by
saying, that it is one that cannot fail from its copiousness, extensive research, and general accuracy, to exalt
still higher the reputation of the author in this country.  The American reader  will be particularly pleased
to find that Dr. Churchill has done full justice  throughout his work, to the various American authors on this
subject.  The names of Dewees, Eberle, Condie, and Stewart, occur on nearly every page, and these authors
are constantly referred to by the author in terms of the highest praise, and with the most liberal courtesy.—
The Medical Examiner.
  We know of no work on this department  of Practical Medicine which presents so candid and unpreju-
diced a statement or posting up of our actual knowledge as this.—JV. Y. Journal of Medicine.
  Its claims to merit, both as  a scientific and practical work, are of the highest order.  Whilst we would
not elevate it above every other treatise on the same  subject, we certainty  believe that very few are equal
to it, and none superior.— Southern Med. and Surg. Journal. 
BLANCHARD & LEA'S PUBLICATIONS.—(Diseases of Children.)
                            New and Improved Edition.


                      A PRACTICAL TREATISE ON THE


DISEASES    OF     CHILDREN.

                        BY B. FRANCIS CONDIE,  M. B.,
                          Fellow of the College of Physicians, &c. &c.

     Third edition, revised and augmented.  In one large volume, 8vo., of over 700 pages.

  In the preparation of a third edition of the present treatise, every portion of it has been subjected
to a careful revision.  A  new chapter has been added on Epidemic Meningitis, a disease which,
although not confined  to children, occurs far more frequently in them, than in adults.  In the other
chapters of the work,  all  the more important facts that have  been developed since the appearance
of the last edition, in reference to the nature, diagnosis, and treatment of the  several diseases of
which they treat, have been incorporated.   The great object of the author has  been to present, in
each succeeding edition,  as full and connected  a view as  possible of the actual  state of the  pa-
thology and therapeutics  of those affections which most usually occur between birth and puberty.
  To the present edition  there is appended a list of the several works and essays quoted or referred
to in the body of the work,  or which have been consulted in  its preparation or revision.

  Every important fact  that has been verified  or  developed since the publication of the previous edition,
either in relation to the nature, diagnosis, or treatment of the diseases of children, have been arranged and
incorporated into  the body of the work ; thus posting  up to  date, to use a counting-house phrase, all the
valuable facts and useful information on the subject.  To the American practitioner. Dr. Condie's remarks
on the diseases of children will be invaluable, and we accordingly  advise those who have failed to read this
work to procure a copy, and make themselves lamiliar with its sound principles.—The New Orleans Medical
and Surgical Journal.
  We feel persuaded that the American Medical profession will soon regard it, not only as a very good, but
as the very best " Practical Treatise on the Diseases of Children."—American Medical Journal.
  We pronounced the first edition to be the best work on the Diseases of Children in the  English language,
and, notwithstanding all that has been published, we still regard it in that light.—Medical Examiner.
                        From Professor Wm. P. Johnston, Washington,  D. C.
  I make use of it as a text-book, and place it invariably in the hands of my private pupils.
                         From Professor D. Humphreys Storer, of Boston.
  I consider it to be the best work on the Diseases of Children we have access to, and as such recommend it
to all who ever refer to the subject.
                           From Professor M.  M. Palien, of St. Louis.
  I consider it the best treatise on the Diseases of Children that we possess, and as such have been in the
habit of recommending it to my classes.

  Dr. Condie's scholarship, acumen, industry, and practical sense  are manifested in this, as in all his nu-
merous contributions to  science.— Dr. Holmes's Report to the American Medical Association.
  Taken as a whole, in our judgment, Dr. Condie's Treatise is the one from the perusal of which the practi-
tioner in this country will rise with the greatest satisfaction.— Western Journal of Medicine and Surgery.
  One of the best works upon the Diseases of Children in the English language.— Western Lancet.
  We feel assured from actual experience that no physician's library can be complete without a copy ofthis
work.—JV.  Y. Journal of Medicine.
  Perhaps the most full and complete work now before the profession of the United States; indeed, we may
say in the English language.  It is vastly superior to most of its predecessors.—Transylvania Med Journal.
  A veritable paediatric encyclopaedia, and an honor  to American medical literature.— Ohio Medical and Sur-
gical Journal.
                WEST OJT DISEASES OF  CHILDREN.


                                LECTURES ON THE


DISEASES   OF    INFANCY   AND    CHILDHOOD.

                           BY CHARLES WEST,  M. B.,
                   Senior Physician to the Royal Infirmary for Children, &c. &c.
                                   In one volume, octavo.
  Every portion of these lectures is marked by  a general accuracy of description, and by the soundness of
the views set forth in relation to  the pathology and therapeutics of the several maladies treated of.  The lec-
tures on the diseases of the  respiratory apparatus, about one-third of the whole number, are particularly
excellent, forming one of the fullest and most able accounts of  these affections,  as they present themselves
during infancy and childhood, in the English language. The history of the several forms of phthisis during
these periods of existence, with  their management, will  be read by all with deep interest.— The American
Journal of the Medical Sciences.
  The Lectures of Dr. West, originally published in the London Medical Gazette, form a most valuable
addition to this branch of practical medicine. For many years physician to the Children's Infirmary, his
opponunities for observing their  diseases have been most extensive, no less than 14,000 children having been
brought under his notice during  the past nine years.  These have evidently been studied with great care,
and the result has been the production of the very best work in our language, so far as it goes, on the dis-
eases ofthis class of our  patients. The symptomatology and pathology of their diseases  are especially
exhibited most clearly; and we are convinced that no one can read with care these lectures without deriv-
ing from them instruction of the  most important kind.— Charleston Med. Journal.
                                   A  TREATISE

ON THE  PHYSICAL AND MEDICAL TREATMENT  OP CHILDREN.
                             BY W. P. DEWEES, M. D.
                     Ninth edition.  In one volume, octavo, of 548 pages. 
BLANCHARD  &  LEA'S PUBLICATIONS.— (Obstetrics.)           23
              NEW AND IMPROVED EDITION—(Now Ready.)



                    OBSTETRICS:

      THE   SCIENCE   AND   THE   ART.

                       BY  CHARLES B. MEIGS,  M.B.,
   Yrofessor of Midwifery and the Diseases of Women and Children in the Jefferson Medical College,
                                   Philadelphia, &c. &c.
         Second Edition, Revised and Improved, with 131 Illustrations.

     In one beautifully printed octavo volume, of seven hundred and fifty-two large pages.

  The rapid demand for a second edition of this work is a sufficient evidence that it has supplied
a desideratum of the profession, notwithstanding the numerous treatises on the same subject which
have appeared within the last few years.  Adopting a system of his own, the author has combined
the leading principles of his interesting and difficult subject, with a thorough exposition of its rules
of practice, presenting the results of long and extensive experience and of familiar acquaintance
with all the modern writers on this  department of medicine.   As an  American treatise  on Mid-
wifery, which has at once assumed the position of a classic, it possesses peculiar claims to the at-
tention and study of the practitioner  and student, while the numerous alterations and revisions
which it has undergone in the  present edition are shown by the great enlargement of the work,
which is not only increased as to the  size of the page, but also in the number.  Among other addi-
tions may be mentioned
             A NEW AND IMPORTANT CHAPTER ON "CHILD-BED FEVER."
  As an elementary treatise—concise, but, withal, clear and comprehensive—we know of no one better
adapted for the use of the student; while the young practitioner will find in it a body of sound doctrine,
and a series of excellent practical directions, adapted to all the conditions of the various forms of labor
and their results, which he will be induced, we are persuaded, again and again to consult,  and always with
profit.
  It has seldom been our lot to peruse a work upon the subject, from which we have received greater satis-
faction, and which we believe to be better calculated  to communicate to the student correct and definite
views upon the several topics embraced within the scope of its teachings.—American Journal of the Medical
Sciences.
  We are acquainted with no work on midwifery of greater practical value.—Boston Medical and Surgical
Journal.
  Worthy the reputation of its distinguished  author.—Medical Examiner.
  We most sincerely recommend it, both to the student and practitioner, as a more complete and valuable
work on the Science and Art of Midwifery, than any of the numerous reprints and American editions of
European works on the same subject.—JV. Y. Annalist.
  We have, therefore, great satisfaction in bringing under our reader's notice the matured views of the
highest American authority in the department to which he has devoted his life and talents.—London Medical
Gazette.
  An author of established merit, a professor of Midwifery, and a practitioner of high reputation and immense
experience—we may  assuredly regard his work now before us as representing the most advanced state of
obstetric science in America up to the time at which he writes.  We consider Dr. Meigs' book as a valuable
acquisition to obstetric literature, and one that will very much assist the practitioner  under many circum-
stances of doubt and perplexity.— The Dublin Quarterly Journal.
  These various heads are subdivided so well, so lucidly explained, that a good memory is all that is neces-
sary in order to put the reader in possession of a thorough knowledge of this  important subject. Dr. Meigs
has conferred a great benefit on the profession in publishing this excellent work.—St. Louis Medical and
Surgical Journal.
                      TYL.ER SMITH  ON  PARTURITION.


                  ON    PARTURITION,

AND   THE   PRINCIPLES  AND  PRACTICE  OF   OBSTETRICS.

                         BY  W.  TYLER  SMITH, M. B.,
                Lecturer on Obstetrics in the Hunterian School of Medicine, &c. &c.
                       In one  large duodecimo volume, of 400 pages.
  The work will recommend itself by its intrinsic merit to every member of the profession.— Lancet.
  We can imagine the pleasure with which William Hunter or Denman would have welcomed the present
work; certainly the most valuable contribution 1o obstetrics that has been made since their own day.  For
ourselves, we consider its appearance as the dawn of a new era in this department of medicine. We do
most cordially recommend the work as one absolutely necessary to be studied by every accoucheur. It will,
we mav add. prove equally interesting and instructive to the student, the general practitioner, and pure ob-
stetrician.  It. was a bold undertaking to reclaim parturition for Reflex Physiology, and it has been well per-
formed.— London Journal of Medicine.
                            LEE'S CLINICAL MIDWIFERY.


             CLINICAL    MIDWIFERY,

mMPRI^lNG THE HISTORIES OF FIVE HUNDRED AND FORTY-FIVE CASES OF DIFFI-
     CULT, PRETERNATURAL, AND COMPLICATED LABOR, WITH COMMENTARIES.

                     BY  ROBERT LEE,  M. B.,  F. R. S., &c
                            From the 2d London Edition.
                    In one royal 12mo. volume, extra cloth, of 23S pages.
  More instructive to the juvenile practitioner than a score of systematic works.—Lancet.
  An invaluable record for the practitioner—JV. Y. Annalist.
  A storehouse of valuable facts and precedents.—American Journal of the Medical Sciences. 
24
BLANCHARD  & LEA'S PUBLICATIONS.—(Obstetrics.)
 CHURCHILL'S MIDWIFERY, BY CONDIE, NEW AND IMPROVED EDITION—(Just Issued.)





THEORY   AND   PRACTICE   OF   MIDWIFERY.

                 BY FLEETWOOB CHURCHILL, M. B., &c.

        A NEW  AMERICAN FROM THE  LAST  AND  IMPROVED  ENGLISH  EDITION,
                          EDITED, WITH NOTES AND ADDITIONS,

                      BY D.  FRANCIS  CONDIE, M. D.,
                 Author of a " Practical Treatise on the Diseases of Children," &c.

      WITH  OJVE HUJYBREB 4JVB TMRTY-JYIJVE ILLUSTRATIONS.

                           In one very handsome octavo volume.

  In the preparation of the last English  edition, from which this is printed, the  author has spared
no pains, with the desire of bringing it thoroughly up to the present state of obstetric science.
The labors of the editor have thus been light, but he has endeavored to supply whatever he has
thought  necessary to the  work,  either as respects obstetrical  practice in this  country, or its
progress in Europe since the appearance of Dr. Churchill's last edition.  Most of the notes of the
former editor, Dr. Huston,  have been retained by him, where they have not been embodied by the
author in his text.  The present edition  ofthis favorite text-book is therefore presented to the  pro-
fession in the full confidence of its meriting a continuance  of the great  reputation which it has
acquired as a work equally well fitted for the Btudent and practitioner.

  To bestow praise on a book that has received such marked approbation would be superfluous.  We need
only say, therefore, that if the first edition was thought worthy of a favorable reception by the medical pub-
lic, we can confidently affirm that this will be found much more so. The lecturer, the practitioner, and the
student, may all have recourse to its  pages, and derive from their perusal much interest and instruction in
everything relating to theoretical and practical midwifery.—Dublin Quarterly Journal of Medical Science.
  A work of very great merit, and such as we can confidently recommend  to the study of every obstetric
practitioner.—London Medical Gazette.
  This is certainly the most perfect system extant. It is the best adapted for the purposes of a text-book, and
that which he whose necessities confine him to one book, should select in preference to all others.—Southern
Medical and Surgical Journal.
  The most popular work on Midwifery ever issued from the American press—Charleston Medical Journal.
  Certainly, in our opinion, the very best work on the subject  which exists.—JV". Y. Annalist.
  Were we reduced to the necessity of havingbut one work on Midwifery, andpermitiedtochoose,vre would
unhesitatingly take Churchill.— Western Medical and Surgical Journal-
  It is impossible to conceive  a more useful  and elegant Manual than Dr. Churchill's Practice of Midwifery.
— Provincial Medical Journal.
  No work holds a higher position, or is more deserving of being placed in the handsof the tyro, the advanced
student, or the practitioner.—Medical Examiner.
          JYJEW Ii BIT I ON OF RAJUSBOTHAJII OJY PARTURITIOJY.


                  THE PRINCIPLES  AND  PRACTICE OF


   OBSTETRIC   MEDICINE   AND   SURGERY,

                 In reference  to the Process of Parturition.

            BY  FRANCIS  H.  RAMSBOTHAM,  M. B.,
                      Physician to the Royal Maternity Charity, &c. &c.

                SIXTH AMERICAN, FROM THE LAST LONDON EDITION.
     Illustrated with One Hundred and Forty-eight Figures on Fifty-five Lithographic Plates.
        In one large  and handsomely printed volume, imperial octavo, with 520 pages.

  In this edition the plates have  all  been redrawn, and the text carefully read and corrected.  It
is therefore presented  as in every way worthy the favor  with which it  has so long been received.

                     From Professor Hodge, of the University of Pennsylvania.
 To the American public, it is most valuable, from its intrinsic undoubted excellence, and as being the best
authorized exponent of British Midwifery. Its circulation will, I trust, be extensive throughout our country.

 We recommend the student, who desires to master this difficult subject with the least possible trouble, to
possess himself at once of a copy ofthis work.—American Journal of the Medical Sciences.
 It stands at the head of the long list of excellent obstetric works published in the  last few years in Great
Britain, Ireland, and the  Continent of Europe.  We consider this book indispensable to  the library of every
physician engaged in the practice of Midwifery.—Southern Medical and Surgical Journal.
 When the whole profession is thus unanimous in placing such a work in the  very first rank as regards the
extent and correctness of all the details of the theory and practice of so important  a branch of learning, our
commendation or condemnation would be of little consequence; but, regarding it as the most useful of all works
of the kind, we think it but an act of justice to urge its claims upon the profession.—JV. O. Med. Journal.
                           DEWEES'S  MIDWIFERY.

     A  COMPREHENSIVE  SYSTEM  OF MIDWIFERY.
           ILLUSTRATED BY OCCASIONAL CASES AND MANY ENGRAVINGS.

                        BY WILLIAM P. DEWEES, M. D.
Tenth Edition, with the Author's last Improvements and Corrections. In one octavo volume, of 600 pages. 
  BLANCHARD & LEA'S  PUBLICATIONS.—(Materia Medica and Therapeutics.)  25

            PEREIRA*S MATERIA JHEBICA—VoI. I.—(JYow Ready.)
        NEW EDITIOX,  GREATLY  IMPROVED AND ENLARGED.

                         THIS  ELEMENTS OF

     MATERIA   MEDICA AND    THERAPEUTICS.

            BY  JONATHAN PEREIRA,  M. B.,  F. R. S. and L. S.

                         THIRD AMERICAN EDITION,
 ENLARGED AND IMPROVED BY THE AUTHOR, INCLUDING  NOTICES OF MOST OF THE MEDICINAL SUB-
        STANCES  IN USE IN THE CIVILIZED WORLD, AND FORMING AN ENCYCLOPEDIA OF
                                  MATERIA MEDICA.
                     EDITED BY  JOSEPH  CARSON, M. D„
          Professor of Materia Medica and Pharmacy in the University of Pennsylvania.
        In two very large volumes, on small type, with about four hundred illustrations.

  The demand for  this new edition of" Pereira's Materia Medica" has induced the publishers
to issue the First Volume separately.  The Second Volume, now at press, and receiving important
corrections and revisions from both author and editor, may be shortly expected for publication.
  The third London edition of this work  received very extensive alterations by the author. Many
portions of it were entirely rewritten,  some curtailed, others enlarged, and much new matter in-
troduced in every  part. The edition, however,  now presented  to the  American profession, in
addition to this, not only enjoys the advantages of a thorough  and accurate superintendence by the
editor, but  also embodies the additions and alterations suggested by a further careful  revision by
the author, expressly for this country,  embracing  the most recent investigations, and the result of
several new Pharmacopoeias which have  appeared since the publication of the London edition of
Volume I.  The notes of the American editor have been prepared with reference to the new edi-
tion of the  U. S. Pharmacopoeia, and contain such matter generally as is requisite to adapt it fully
to the wants of the profession in this country, as well as such recent discoveries  as have escaped
the attention  of the author. In this manner the size of the work has been materially enlarged,
and the number of illustrations much increased, while its mechanical execution has been greatly
improved in every respect.  The  profession may therefore rely on being able to procure a work
which, in every point of view, will not only maintain, but greatly advance the very high reputation
which it has everywhere acquired.
  The work, in its present shape, and so far as can be judged from the portion before the public, forms the
most comprehensive  and complete treatise on materia medica extant in the English language.
  Dr. Pereira has been at great pains to introduce into his work, not only all the information on the natural,
chemical, and commercial history of medicines, which might be serviceable to the physician and surgeon,
but whatever might enable his readers to understand thoroughly the  mode of preparing and manufacturing
various articles employed Sither for preparing medicines, or for certain purposes in the arts connected with
materia medica and the practice of medicine.
  The accounts of the physiological and therapeutic effects of remedies are given with great clearness and
accuracy, and  in a manner calculated to interest as well as instruct the reader.— The Edinburgh Medical
and Surgical Journal.
                      ROYIiE'S MATERIA MEMCA.


     MATERIA   MEDICA  AND   THERAPEUTICS;
                                   INCLUDING THE
Preparations of the PharmacopoBias of London, Edinburgh, Dublin, and of the United States,
                          WITH MANY NEW MEDICINES.
                  BY  J.  FORBES ROYLE,  M. B.,  F. R. S.,
           i-r& lessor of Materia Medica and Therapeutics, King's College, London, &c. &c.
                        EDITED BY JOSEPH CARSON, M. D.,
           Professor of Materia Medica and Pharmacy in the University of Pennsylvania.
                      WITH NINETY-EIGHT ILLUSTRATIONS.
                 In  one  large octavo volume, of about seven hundred pages.
      Being one of the most beautiful Medical works published in this country.
  This work is, indeed, a most valuable one, and will fill up an important vacancy that existed between Dr.
Pereira's most learned and complete systemof Materia Medica, and ihe class of productions on the other ex-
treme which are necessarily imperfect from their small extent.—British and  Foreign Medical Review.
             POCKET DISPENSATORY  AND  FORMULARY.

A DISPENSATORY AND THERAPEUTICAL REMEMBRANCER.  Comprising the entire lists.
  of Materia Medica, with every Practical Formula contained in the three British Pharmacopoeias.
  With relative Tables subjoined, illustrating by upwards of six hundred and sixty examples, the
  Extemporaneous  Forms and Combinations suitable  for the different Medicines.  By JOHN
  MAYNE, M. D.,  L. R. C. S., Edin., &c. &c.  Edited, with the addition of the  formulae of the
  United States Pharmacopoeia, by R. EGLESFELD GRIFFITH, M. D.  In one 12mo. volume,
  of over three hundred large pages.
  The neat typography, convenient size, and low price ofthis volume, recommend it especially to
physicians, apothecaries, and students in want of a pocket manual. 
26       BLANCHARD & LEA'S PUBLICATIONS.—(Materia Medica, $c.)
            NEW UNIVERSAL FORMULARY.—(Lately Issued.)


A    UNIVERSAL^   FORMULARY,

                                  CONTAINING THE

    METHODS  OF  PREPARING  AND ADMINISTERING

             OFFICINAL  AND  OTHER  MEDICINES.

    THE  WHOLE  ADAPTED  TO  PHYSICIANS  AND  PHARMACEUTISTS,

                    BY R. EGLESFELB GRIFFITH,  M. B.,
                          Author of "American Medical Botany," &c.
                  In one large octavo volume of 568 pages, double columns.

  In this work will be found not  only a very  complete collection  of  formulae and pharmaceutic
processes, collected with great care from the best modern authorities  of all countries, but also a
vasframount of important information on all collateral subjects.  To insure the accuracy so neces-
sary to a work ofthis nature, the  sheets have been carefully revised by Dr. Robert Bridges, while
Mr. William Procter, Jr., has contributed numerous valuable formulae, and useful  suggestions.
  The want of a work like the present has long been felt in this country, where the physician and
apothecary have hitherto had access to  no complete  collection of formulas, gathered from the
pharmacopoeias and therapeutists  of all nations.  Not only  has this desideratum been thoroughly
accomplished in this volume, but  it will also be found to contain a very large number of recipes for
empirical preparations, valuable to the apothecary and  manufacturing chemist, the greater part of
which have hitherto not been accessible in this country.  It is farther  enriched with accurate ta-
bles of the weights and  measures  of Europe ;  a vocabulary of the  abbreviations and Latin terms
used  in Pharmacy; rules for the administration of medicines ; directions for officinal preparations ;
remarks on poisons and their antidotes;  with  various tables of much practical utility.  To facili-
tate reference to the whole, extended indices have been added, giving  to the work the advantages
of both alphabetical and systematic  arrangement.
  To show the  variety  and importance  of the subjects treated of, the publishers subjoin a very
condensed

SUMMARY  OF  THE  CONTENTS,   IN  ADDITION  TO  THE  FORMULARY  PROPER,
  WHICH EXTENDS TO BETWEEN THREE AND FOUR  HUNDRED LARGE DOUBLE-
  COLUMNED  PAGES.

PREFACE.
INTRODUCTION.
  Weights and Measures.
    Weights of the United States and Great Britain.—
    Foreign Weights—Measures.
  Specific Gravity.
  Temperatures for certain Pharmaceutical Ope-
      rations.
  Hydrometrical Equivalents.
  Specific Gravities of some of the Preparations
      of the Pharmacopoeias.
  Relation between  different Thermometrical
      Scales.
  Explanation of principal Abbreviations used in
      Formula.
  Vocabulary of Words employed in Prescriptions.
  Observations onthe Management of the Sick room.
    Ventilation of the Sick room.—Temperature  of
    the Sick room—Cleanliness in the Sick room.—
    Quiet in the  Sick room.—Examination and Pre-
    servation of the Excretions.—Administration  of
    Medicine.—Furniture  of a Sick room.—Proper
    use of Utensils for Evacuations.
  Doses of Medicines.
    Age. — Sex. — Temperament. — Idiosyncrasy. —
    Habit.— Stale of the System.—Time of day.—In-
    tervals between Doses.
  Rules for Administration of Medicines.
    Acids.—Antacids.— Antilithics and Lithontriptics.
    Antispasmodics — Anthelmintics. — Cathartics.—
    Enemata — Suppositories.—Demulcents or Emol-
    lients—Diaphoretics.—Diluents.—Diuretics.—
    Emetics — Emmenagogues. — Epispastics.— Er-
    rhines. — Escharolics. — Expectorants. — Narco-
    tics— Refrigerants — Sedatives.—Sialagogues.—
    Stimulants.—Tonics.
  Management of Convalescence and Relapses.
DIETETIC  PREPARATIONS NOT INCLUDED
    AMONG THE PREVIOUS PRESCRIPTIONS.
LIST OF INCOMPATIBLES.
POSOLOGICAL  TABLES  OF THE MOST IM-
     PORTANT MEDICINES.
TABLE  OF  PHARMACEUTICAL  NAMES
     WHICH DIFFER IN  THE  U. STATES
     AND BRITISH PHARMACOPOEIAS.
OFFICINAL  PREPARATIONS  AND  DIREC-
     TIONS.
  Internal Remedies.
   Powders.—Pills  and  Boluses.—Extracts.—Con-
   fections, Conserves,  Electuaries—Pulps.—Sy-
   rups.—Melliles or Honeys—Infusions.—Decoc-
   tions.—Tinctures.—Wines.—Vinegars.-Mixtures.
   Medicated Waters.—Distilled, Essential, or Vola-
   tile Oils.—Fixed  Oils and  Fats.—Alkaloids-
   Spirits.—Troches or Lozenges.—Inhalations.
  External Remedies.
   Baths—Cold Bath—Cool Bath.—Temperate Bath.
   —Tepid Bath —Warm Bath.—Hot Bath.—Shower
   Bath.—Local Baths—Vapor Bath.—Warm Air
   Balh.—Douches.—Medicated Baths —Affusion.—
   Sponging.—Fomentations.—Cataplasms, or Poul-
   tices.—Lotions, Liniments, Embrocations — Vesi-
   catories,  or  Blisters.—Issues. — Setons. — Oint-
   ments.—Cerates.—Plasters.—Fumigations.
  Bloodletting.
   General Bloodletting.—Venesection.— Arterio-
   tomy.—Topical Bloodletting—Cupping. -Leech-
   ing.— Scarifications.
POISONS.
INDEX OF DISEASES AND THEIR REMEDIES
INDEX OF PHARMACEUTICAL AND BOTANI-
     CAL NAMES.
GENERAL INDEX.
  From the condensed summary of the contents thus given it will be seen that the completeness
ofthis work renders it of much practical value to all concerned in the prescribing or dispensing
of medicines. 
_______BLANCHARD & LEA'S  PUBLICATIONS.—(Materia Medica, $c.)        27


      GRIFFITH'S  MEDICAL FORMULARY—(Continued.)

  From a vast number of commendatory notices, the publishers select a few.

n.,mJr«,?f «JLaC9uisIti0Ilt0 ,he medical practitioner, and a useful book of reference to the apothecary on
numerous; occasions— American Journal of Pharmacy.
h»».r,',,7/,i^ lh.f *'ormu larvif worthy of recommendation, not only  on account of the care which has been
Examiner          estimable author, but for its general accuracy, and the richness of its details.-Medical

■>™,hf fordially we recommend this Universal Formulary, not forgetting its adaptation to druggists and
u^w?"  /'wh0 ^uldDfind themselves va«'y improved by a familiar acquaintance with  this every-day
book of medicine.-The Boston Medical and Surgical Journal.
  ^re-eminent among the best and most useful  compilations of the present day will be found the work before
us, which can have been produced only at a very great cost of though! and labor.  A short description will
sumce tostiow that we do not put too high an estimate on this work. We  are not cognizant of the exigence
ol a parallel work.   Its value will be apparent to our readers from the sketch of its contents above given.
  vve strongly recommend  it to all who are engaged either in practical medicine, or more exclusively with
its literature.—London Medical Gazette.
  Avery' useful work, and a most complete compendium on the subject of materia  medica. We know of no
work in our language, or any other, so comprehensive in all its details— London Lancet.
  Ihe vast collection of formulas which is offered by  the  compiler of this  volume,  contains a large number
which will be new  to English practitioners, some of ihem from the novelty of their ingredients, and others
tromtne unaccustomed mode in which they are combined; and we doubt  not that  several of these might be
advantageously brought into use.   The authority for every formula is given, and the list includes a very nu-
merous assemblage of Continental, as well as of British and American writers of repute.  It is, therefore,
a work  to which every practitioner may advantageously  resort for hints to increase his stock of remedies
and of forms of prescription.
  The other indices facilitate reference to every article in the "Formulary;" and they appear to have been
drawn up with the same care as that which the author has evidently bestowed on every part of the work —
The British and Foreign Medico-Chirurgical Review.
  The work before  us is all that it professes to  be, viz.: " a compendious collection of formulae and pharma-
ceutic processes^"  It is such a work as was much needed, and should be in the hands of every practilionei
who is in the habit of compounding medicines — Transylvania Medical Journal.
  This seems to be a very comprehensive work, so far as the range of  its articles and combinations is con-
cerned, with a commendable degree of brevity  and condensation in their explanation.
  It cannot fail to be a useful and convenient book of reference to the two classes of persons to whom it
particularly commends h?elf in the title-page.— The N. W. Medical and Surgical Journal.
  It contains so much information that we very cheerfully recommend it to the profession.— Charleston Med.
Journal.
  Well  adapted to supply the actual wants of a numerous and varied class of persons.—JV. Y. Journal of
Medicine.
                CHRISTISON & GRIFFITH'S DISFENSATORY.-(A New Work.)


             A   DISPENSATORY,
  OR, COMMENTARY  ON THE  PHARMACOPOEIAS OF GREAT BRITAIN AND THE UNITED
       STATES: COMPRISING THE NATURAL HISTORY, DESCRIPTION, CHEMISTRY,
             PHARMACY, ACTIONS, USES, AND DOSES OF THE ARTICLES OF
                                  THE MATERIA MEDICA.
               BY ROBERT  CHRISTISON, M. B., V.  P. R.  S. E.,
 President of the Royal College of Physicians of Edinburgh; Professor of Materia Medica in the University
                                      of Edinburgh, etc.
                        Second Edition, Revised and Improved,
   WITH A SUPPLEMENT CONTAINING THE MOST IMPORTANT  NEW REMEDIES.
                          WITH COPIOUS ADDITIONS,
         AND  TWO HUNDRED AND THIRTEEN LARGE WOOD  ENGRAVINGS.
                       BY  R. EGLESFELD GRIFFITH,  M. D.,
                               Author of "A Medical Botany," etc.
 In one very large and handsome octavo volume,  of over one  thousand closely-printed pages, with
      numerous wood-cuts, beautifully printed on fine white paper, presenting an immense
                         quantity of matter at an unusually low price.
  It is enough to say that it appears to us as perfect as a Dispensatory, in the present state of pharmaceuti-
 cal science, could be made.—The Western Journal of Medicine and Surgery.

                         CARSON'S SYNOPSIS—(JTust Issued.)

                                 SYNOPSHTOF  THE

    COURSE  OF  LECTURES  ON MATERIA MEDICA AND PHARMACY,
                    Delivered in the  University  of Pennsylvania.
                              BY JOSEPH CARSON, M. D.,
            Professor of Materia Medica and Pharmacy in the University of Pennsylvania.
                        In one very neat octavo volume of 208 pages.
  This work, containing a rapid but thorough outline of the very extensive subjects under consideration, will
be found useful, not only for the matriculants and graduates of the institution for whom it is more  particu-
larly intended, but also for those members of the profession who may desire to recall their former studies.

            THE THREE  KINDS   OF COD-LIVER  OIL,
Comparatively considered, with their Chemical and Therapeutic Properties, by L. J. DE JONGH,
  M. D.   Translated, with an Appendix and Cases, by EDWARD  CAREY, M. D.  To which is
  added  an article on the subject from " Dunglison on  New Remedies."  In  one small 12mo.
  volume, extra cloth. 
28   BLANCHARD & LEA'S PUBLICATIONS— (Materia Medica and Therapeutics.)


                  DUNGLISON'S   THERAPEUTICS.

         NEW AND IMPROVED  EDITION.—(Xately Issued.)



GENERAL  THERAPEUTICS^D   MATERIA   MEDICA;

                         ADAPTED FOR A MEDICAL TEXT-BOOK,

                   BY  ROBLEY BUNGLISON,  M.B.,

Professor of Institutes of Medicine, &c, in Jefferson Medical College; Late Professor of Materia Medica, Ac.
            in the Universities of Maryland and Virginia, and in Jefferson Medical College.

                            FOURTH EDITION, MUCH IMPROVED.

           With One Hundred and Eighty-two Illustrations.

                    In two large and handsomely printed octavo volumes.

  The present edition  of this standard work has been subjected to a thorough revision both as re-
gards style and matter, and has thus been rendered  a more complete exponent than heretofore of
the existing state of knowledge on the important subjects of which it treats.   The favor with which
the former editions have  everywhere been received seemed to demand that the present should be
rendered still more worthy of the patronage of the profession, and of the medical student in particu-
lar, for whose use more especially it is proposed;  while the number of impressions through which
it has passed has enabled the author so to improve it as to enable him to present it with some de-
gree of confidence as well adapted to the purposes for which it is intended. In the present edition,
the remedial  agents of recent  introduction have been inserted  in their appropriate places; the
number of illustrations has been  greatly increased, and a copious index of diseases and remedies
has been appended, improvements which can  scarcely fail to add to  the value of the work to the
therapeutical inquirer.
  The publishers, therefore, confidently  present the work as it now stands to the notice of the
practitioner as a trustworthy book of reference, and to the student, for whom it was more especially
prepared, as a full and reliable text-book on General  Therapeutics and Materia Medica.
  Notwithstanding  the increase in size and number of illustrations, and the improvements in the
mechanical execution  of the work, its price has not been increased.
  In this work of Dr. Dunglison, we recognize the same untiring industry in the collection and embodying of
facts on the several subjects of which he treats, that has heretofore distinguished him, and we cheerfully
point to these volumes, as two of the most interesting that we know of. In noticing the additions to this, the
fourth edition, there is very little in the periodical or annual literature of the profession, published  in the in-
terval which has elapsed since the issue of the first, that  has escaped the careful search of the author. As
a book for reference, it is invaluable.— Charleston Med. Journal and Review.
  It may  be said to be the work now upon the subjects upon which it treats.— Western Lancet.
  As a text book for students, for whom it is particularly designed, we know of none superior  to it.—St.
Louis Medical and Surgical Journal.
  It purports to be a new edition, but it is rather a new book, so greatly has it been improved both m the
amount and quality of the matter which it contains.—N. O. Medical and Surgical Journal.
  We bespeak for this edition from the profession an increase of patronage over any of its former ones, on
account of its increased merit.—N. Y. Journal of Medicine.
  We consider this work unequalled.—Boston Med. and Surg. Journal.
NEW AND MUCH  IMPROVED EDITION—Brought up to 1851.—(Just Issued.)




              NEW     REMEDIES,

    WITH FORMUL/E  FOR   THEIR  ADMINISTRATION.

                       BY  ROBLEY  BUNGLISON,  M. B.,
   PBOFESSOX OF THE INSTITUTES OF MEDICINE, ETC. IN THE JEFFERSON MEDICAL COLLEGE OF PHILADELPHIA.

                     Sixth Edition, -with extensive Additions.

            In one very large  octavo volume, of over seven hundred and fifty pages.

  The fact that this work has rapidly passed to a SIXTH EDITION is sufficient proof that it has supplied a
desideratum to the profession in presenting them with a clear and succinct account of all new and impor-
tant additions to the materia medica, and novel  applications of old remedial agents. In the preparation of
the present edition, the author has shrunk from no labor to render the volume worthy of a continuance of the
favor with which it has been received, as is sufficiently shown by the increase of about one hundred pages
in the size of the work.  The necessity of such large additions arises from the fact that the last few years
have been rich in valuable gifts to Therapeutics; and amongst these, ether, chloroform, and other so called
anaesthetics, are worthy of special attention.  They have been introduced since the appearance of the last
edition of the " New Remedies."  Other articles have been proposed for the first time, and the experieuce of
observers has added numerous interesting facts  to our knowledge of the virtues of remedial  agents pre-
viously employed.                                          ,,.,,     .        ,   • . j   j
  The therapeutical agents now first admitted into this work, some of which have  been newly  introduced
into pharmacology, and the old agents brought prominently forward with novel applications, and which may
consequently be regarded as New  Remedies, are the following:—Adansonia digitata, Benzoate of Ammonia,
Valerianate of Bismuth, Sulphate of Cadmium, Chloroform, Collodion, Cantharidal Collodion, Cotyledon Um-
bilicus  Sulphuric Ether, Strong  Chloric Ether, Compound Ether, Hura Braziliensis, Iberis Amara, Iodie
Acid, Iodide of Chloride of Mercury, Powdered Iron, Citrate of Magnetic Oxide of Iron, Citrate of Iron and
Magnesia, Sulphate of Iron and Alumina, Tannate of Iron, Valerianate of Iron, Nitrate of Lead, Lemon
Juice, Citrate of Magnesia, Salts of Manganese, Oleum Cadinum, Arsenite of Quinia, Hydriodate of Iron and
Quinia, Sanicula Marilandica, and Sumbiil. 
BLANCHARD & LEA'S PUBLICATIONS.—(Materia Medica, <J-c.)       29
     BIOHR, REDWOOD,  AND  PROCTER'S PHARMACY.-(Lately Issued.)


         practical"phaemacy.

COMPRISING  THE ARRANGEMENTS, APPARATUS, AND MANIPULATIONS OF THE
                   PHARMACEUTICAL  SHOP  AND LABORATORY.

                             BY FRANCIS  MOHR, Ph.D.,
             Assessor Pharmacia; of the Royal Prussian College of Medicine, Coblentz;
                            AND THEOPHILUS REDWOOD,
              Professor of Pharmacy in the Pharmaceutical Society of Great Britain.
       EDITED, WITH EXTENSIVE ADDITIONS, BY PROFESSOR  WILLIAM PROCTER,
                          Of the Philadelphia College of Pharmacy.
  In one handsomely printed octavo volume, of 570  pages, with over 500 engravings on wood.

  To physicians in the country, and those at a distance from competent pharmaceutists, as well as
to apothecaries, this  work will  be found of great value, as embodying much important information
which is to be met with in no other American publication.

  After a pretty thorough examination, we  can recommend it as a highly useful book, which should
be in the hands of every apothecary.  Although no instruction of this kind will enable the beginner to
acquire that practical skill and readiness which experience only can confer, we believe that this work will
much facilitate their acquisition, by indicating means for the removal of difficulties as they occur, and sug-
gesting methods of operation in conducting pharmaceutic processes which the experimenter would only
hit upon after many unsuccessful  trials; while there are few pharmaceutists, of however extensive expe-
rience, who will not find in it valuable hints that they can turn to use in conducting the affairs of the shop
and laboratory.  The mechanical execution  of the  work is in a style of unusual  excellence.  It contains
about five hundred and seventy large octavo pages, handsomely printed on good paper, and illustrated by
over five hundred  remarkably well-executed wood-cuts of chemical and pharmaceutical apparatus.  It
comprises the whole of Mohr and Redwood's book, as published in London, rearranged and  classified by
the American editor, who has added much valuable new matter, which  has increased the size of the book
more than one-fourth, including aboutone hundred additional wood-cuts.— TheAmerican Journ. of Pharmacy.
  It is a book, however, which will be in the  hands of almost every one who is much interested in pharma-
ceutical operations, as we know of no other publication so well calculated to fill a void long felt.— The Medi-
cal Examiner.
  The country practitioner who is obliged to dispense his own medicines, will find it a most valuable assist-
ant.—Monthly Journal and Retrospect.
  The book is strictly practical, and describes only manipulations or methods of performing the numerous
processes the pharmaceutist has to go through, in the preparation and manufacture of medicines, together
with all the apparatus and fixtures necessary thereto. On these matters, this work is very full and  com-
plete, and details, in a style uncommonly clear and lucid, not only the  more complicated and  difficult pro-
cesses, but those not less important ones, the most simple  and common.  The volume is an octavo of five
hundred and seventy-six pages.  It is elegantly illustrated with a multitude of neat wood engravings, and
is unexceptionable in its whole  typographical appearance and execution.  We take great satisfaction in
commending this so much needed treatise, not only to those for whom it is more specially designed, but to
the medical profession generally—to every one, who, in his practice, has occasion to prepare, as well as ad-
minister medical agents.—Buffalo Medical Journal.
           NEW ANB  COMPLETE JO.EBICAI, BOTANY.


                 MEDICAL" BOTANY;

DR. A DESCRIPTION OF  ALL THE MORE  IMPORTANT PLANTS  USED  IN MEDICINE, AND
          OF THEIR  PROPERTIES, USES, AND MODES OF  ADMINISTRATION,

                 BY K.  EGLESFELD  GRIFFITH, M. D., &c. &c.
 In one large 8vo. vol. of 704 pages, handsomely printed, with nearly 350 illustrations on wood.

 One of the greatest acquisitions to American medical literature.  It should by all means be introduced, at
the very earliest period, into"our medical schools,  and occupy a place in the library of every physician in the
land.—Southwestern Medical Advocate.
 Admirably calculated for the physician and student—we have seen no work which  promises greater ad-
vantages to the profession.—JV. O. Medical and Surgical Journal.
 One of the few books which supply a positive deficiency in our medical literature.— Western Lancet.
 We hope the day is not distant when this work will not only be a text-book in every medical school and
college in the Union, but find a place in the library of every private practitioner.—JV. Y. Journ. of Medicine.
           ELLIS'S MEDICAL FORMULARY.—(Improved Edition.)


                THE   MEDICAL   FORMULARY:
BEING A COLLECTION OF PRESCRIPTIONS, DERIVED FROM THE WRITINGS AND PRACTICE OF MANY OF THE MOST
                        EMINENT PHYSICIANS OF AMERICA AND EUROPE.
To which is added an Appendix, containing the usual Dietetic Preparations and Antidotes for Poisons,
      THE WHOLE ACCOMPANIED WITH A FEW BRIEF PHARMACEUTIC AND MEDICAL OBSERVATIONS.
                        BY  BENJAMIN  ELLIS, M.  D.

        NINTH EDITION, CORRECTED AND EXTENDED, BY SAMUEL GEORGE MORTON, M. D.
                         In one neat octavo volume of 268 pages.
               CARPENTER  ON ALCOHOLIC LIQUORS.—(A New Work.)

A Prize Essay on the Use of Alcoholic Liquors in Health and Disease. By William B. Carpenter,,
       M. D.  author of " Principles of Human Physiology," &c.  In one 12mo. volume. 
30            BLANCHARD  &  LEA'S  PUBLICATIONS.—(Chemistry.)
       NEW EDITIOJV OF GR.MAJfPS CHEMISTRY—(Now Ready.)


          ELEMENTS   OF  CHEMISTRY;

       INCLUDING  THE APPLICATIONS OF THE SCIENCE IN THE  ARTS.

                   BY  THOMAS  GRAHAM,  F. R. S.,  &c.

    Second American, from the Second, entirely Revised, and greatly Enlarged London Edition.

                With Notes and Additions by ROBERT  BRIDGES, M. D.

        To be complete in one very large octavo volume, with several hundred beautiful illustrations.

  PART I, now ready, of about 450 large pages, with  185 illustrations.
  PART II, completing the work, preparing for early publication.

  The great changes which the science of chemistry has undergone within the last few years, render a new
edition of a treatise like the present almost a new work.  The author has devoted several years to the revi-
sion of his treatise, and has endeavored to embody in it every fact and inference of importance which has
been observed and recorded by the great body of chemical  investigators who are so rapidly changing the
face of the science.  In this manner the work has been greatly increased in size, and the number of illus-
trations doubled ; while the labors of ihe editor have been directed towards the introduction of such mailers
as have escaped the attention of the author, or as have arisen since the publication of the first portion ofthis
edition in London, in 1850  Printed in handsome style, and at a very low price, it is therefore confidently pre-
sented to the profession and the student as a very complete and thorough text-book of this important subject.
              NEW AND IMPROVED  EDITION—(lately Issued.)


  ELEMENTARY    CHEMISTRY,

                THEORETICAL  AND  PRACTICAL.

                        BY GEORGE FOWNES, Ph. D.,
               Chemical Lecturer in the Middlesex Hospital Medical School, &c. &c.
                         WITH  NUMEROUS ILLUSTRATIONS.
        THIRD AMERICAN, FROM A LATE LONDON  EDITION.  EDITED, WITH ADDITIONS,

                         BY  ROBERT BRIDGES, M. B.,
  Professor of General and Pharmaceutical Chemistry in the Philadelphia College of Pharmacy, &c. &c.
In one large royal 12mo. vol., of over 500 pages, with about 180 wood-cuts, sheep or extra cloth.
  The work of Dr. Fownes has long been before the public,  and it* merits have been fully appreciated a«
the best text-book on Chemistry now in exisience.  We do not, of course, place it in a rank superior to the
works of Bratide, Graham, Turner, Gregory, or Gmelin, but we say that, as a work for siudents,it is prefer-
able lo any ofthem.— London Journal of Medicine.
  The rapid sale of this Manual evinces  its adaptation to the wants of the student of chemistry, whilst the
well known merits of its lamented author have constituted a guarantee for its value, as a faithful exposition
of the general principles and most important facis of the science to which it professes lo be an introduction.
— The British and Foreign Medico-Chirur^ical Review.
  A work well adapted to the wants of the student.  It is an excellent exposition of the chief doctrines and
facts of modem chemistry, originally intended as a guide to the  lectures of the author, corrected by  his own
hand shortly before his death in IS'19 and recently revised by Dr. 3ence Jones, who has made some additions
to the chapter on animal chemistry. Although not intended to supersede the more extended treatises os
chemistry, Professor Fownes' Manual may, we think, be often used  as a work of reference, even !>y those
advanced in the study, who may be desirous of refreshing their  memory on some forgotten point.  The size
of the work, and slill more the condensed yet perspicuous style in which it is wriuen, absolve it from the
charges very properly urged against most manuals termed popular, viz., of omitting details of indispensable
importance, of avoiding technical difficulties, instead of explaining them, and of treating subjects of high sci-
entific interest in an unscientific way.—Edinburgh Monthly Journal of Medical Science.

                   BOWMAN'S MEDICAL CHEMISTRY-(Lately Issued.)


     PRACTICAL  HANDBOOK  OF   MEJ1ICAL  CHEMISTRY.

                        BY  JOHN  E. BOWMAN,  M. D.
                In  one neat volume, royal 12mo., with numerous illustrations.
  Mr. Bowman has succeeded in supplying a desideratum in medical literature.  In the little volume before
us, he has given a concise bul comprehensive account of all matters in chemistry which the man in praettce
may desire to know.—Lancet.
            MY THE SAME  AUTHOR—(Irately Issued.)

INTRODUCTION TO  PRACTICAL CHEMISTRY, Including Analysis.
             With Numerous Illustrations.  In one neat volume, royal 12mo.
                       GARDNER'S MEDICAL CHEMISTRY.


               MEDICAL   CHEMISTRY,

       FOR  THE  USE   OF  STUDENTS   AND  THE  PROFESSION;
BEING A MANUAL  OF THE SCIENCE.  WITH  ITS  APPLICATIONS TO TOXICOLOGY,
                   PHYSIOLOGY, THERAPEUTICS,  HYGIENE, &c.

                   BY D.  PEREIRA GARDNER, M. D.
                In one handsome royal 12mo. volume, with illustrations.
SIMON'S  ANIMAL  CHEMISTRY, with Reference  to the Physiology and Pathology
                   of Man.  By G. E. Dat.  One vol. 8ve.,700 pages. 
BLANCHARD & LEA'S PUBLICATIONS.
31
      TJtlTJLOR'S MEDICAL  JWTRISPRUnEJVCE.


 MEDICAL     JURISPRUDENCE.

                         BY ALFRED S. TAYLOR,
          SECOND AMERICAN, FROM THE THIRD AND ENLARGED LONDON EDITION.
     With numerous Notes and Additions, and References to American Practice and Law.

                        BY R. E. GRIFFITH,  M. D.
                             In one large octavo volume.
  This work has been much enlarged by the author, and may now be considered as  the standard
authority on the subject, both  in  England and this country. It has been thoroughly revised, in
this edition, and completely brought up to the day with reference  to the most recent investigations
and decisions.  No further evidence of its popularity is needed  than the fact of its having, in the
short time that has elapsed since it originally appeared, passed to three editions in England, and
two in the United States.
  We recommend Mr. Taylor's work as the ablest, most comprehensive, and, above all, the most practically
useful book which exists on the subject of legal medicine. Any man of sound judgment, who has mastered
the contents of Taylor's "Medical Jurisprudence," may go into a court of law with the  most perfect confi-
dence of being able to acquit himself creditably.—Medico- Chirurgical Review.
  The most elaborate and complete work that has yet appeared.  It contains an immense quantity of cases
lately tried, which entitle it to be considered what Beck was in its day,—Dublin Medical Journal.
                        TAYLOH  ON  POISONS.


                   ON   F Ol  S  O  N  S,

 IN  RELATION TO  MEDICAL  JURISPRUDENCE  AND MEDICINE,

                  BY  ALFRED S. TAYLOR,  F.  R. S., &c.
         Edited, with  Notes and Additions, BY R. E. GRIFFITH, M. D.
                       In one large octavo volume, of 688 pages.
 The most elaborate work on the subject thatourliteraturepossesses.— Brit, and For. Medico-Chirur Review.
 One of the most practical and trustworthy works on Poisons in our language.— Western Journal of Med.
 It contains a vast body of facts, which embrace all that is important in toxicology, all that is necessary to
the guidance of the medical jurist, and all that can be desired by the lawyer.—Medico- Chirurgical Review.
 It is, so far as our knowledge extends, incomparably the best upon the subject; in the highest degree credit-
able to the author, entirely trustworthy, and indispensable to the student and practitioner.—JV. Y. Annalist.
        A NEW WORK ON THE SKIN—(Now Ready.)


PRACTICAL  TREATISE  ON  DISEASES  OF  THE SKII.

                   BY J. M.  NELIGAN, M. D.,
        Author of "Medicines, their Uses and Modes of Administration," &c.
                    In one neat volume, royal 12mo.
TIE  LAWS OF HEALTH IN RELATION  TO MIND ANB B038Y.
     A SERIES OF LETTERS FROM AN OLD PRACTITIONER TO A PATIENT.

            BY  LIONEL JOHN BEALE,  M. R. C. S., &c.
              In one handsome volume, royal 12mo., extra cloth.
   LETTERS  TO   A  CANDID   INQUIRER


                ON    ANIMAL   MAGNETISE,

               BY WILLIAM  GREGORY,  M. D., F. R. S. E.,
                  Professor of Chemistry in the University of Edinburgh, &c.
                     In one neat volume, royal 12mo., extra cloth.

                         PROFESSOR  DICKSON'S ESSAYS,


      ESSAYS ON  LIFE, SLEEP,  PAIN, INTELLECTION,  HYGIENE,  AND DEATH

                    BY SAMUEL HENRY DICKSON, M.D.,
        Professor of the Institutes and Practice of Medicine in the Charleston Medical College.
                       In one very handsome volume, royal 12mo.


                                                                       nd Locality,
                                                                       , on healthy
                                                                  .._ additions. By
 Roblev Dunglison, M. D , &c. &c.  In one octavo volume of 4G4 pages.
DUNGLISON'S MEDICAL  STUDENT.—The Medical Student, or Aids to the Study of Medicine.  Revised
 and Modified Edition.  I vol. royal 12mo . extra cloth.  312 pp.
BARTLETT'S PHILOSOPHY OF MEDICINE.—An Essay on the Philosophy of Medical Science.  In
 one handsome Svo. volume.  312 pp.
BARTLETT ON CERTAINTY IN MEDICINE-An  Inquiry into the Degree of Certainty in Medicine,
 and into ihe Nature and Extent ol its Power over Disease.  In one vol. royal 12mo.  84 pp. 
32
BLANCHARD  & LEA'S PUBLICATIONS.
    THE GREAT  AMERICAN  MEDICAL  DICTIONARY.
                     New and Enlarged Edition—(Now Ready.)



              MEDICAL "LEXICON;


A  DICTIONARY   OF   MEDICAL   SCIENCE,

         Containing  a Concise Explanation of the various Subjects and Terms of

  PHYSIOLOGY, PATHOLOGY,  HYGIENE, THERAPEUTICS,  PHARMACOLOGY,
                   OBSTETRICS, MEDICAL  JURISPRUDENCE, &c.

         WITH THE FRENCH AND OTHER SYNONYMES.

NOTICES OF  CLIMATE AND  OF CELEBRATED  MINERAL WATERS;

     Formulas for various Officinal, Empirical, and Dietetic Preparations, &c.

                BY ROBLEY  DUNGLISON,  M. D.,
         Professor of Institutes of Medicine, &c. in Jefferson Medical College, Philadelphia, &c.

                       NINTH  EDITION,  REVISED.

In one very thick 8vo. vol., of 927 large double-columned pages, strongly bound, with raised bands.

  Every successive edition ofthis work bears the marks of the industry of the author, and of his determina-
tion to keep it fully on a  level with the most advanced state of medical science. Thus the last  two editions
contained about nine thousand subjects and terms not comprised in the one immediately preceding, and the
present has not less than foub thousand not in any  former edition.  As a complete Medical Dictionary,
therefore, embracing over fifty thousand  definitions, in all  the branches of the science, it is presented a*
meriting a continuance of the great favor and popularity which have carried it, within no very long space of
time, to an eighth edition.                                                  .
  Every precaution has been taken in the preparation of the present volume, to render its mechanical exe-
cution and typographical accuracy worthy of its extended  reputation and universal use.  The very exten-
sive additions have been  accommodated, without materially increasing the bulk of the volume, by the employ-
ment of a small but exceedingly clear type, cast for this purpose.  The press has been watched with great
care, and every effort used to insure the verbal accuracy so necessary to a work of this nature. The whole
is printed on fine white paper; and while  thus  exhibiting  in every respect so great an improvement over
former issues, it is presented at the original exceedingly low  price.

  On the appearance of the last edition of this valuable work, we directed the attention of our readers to its
peculiar merits ; and we need do little more than state, in  reference to the present re-issue, that notwith-
standing the large additions previously made, to it, no fewer than four thousand terms, not to be found in the
preceding edition, are contained in the volume before us.   Whilst it is a wonderful monument of its author's
erudition  and industry,  it is also a work of great practical  utility, as we can testify from our own expe-
rience; for we keep it constantly within our reach, and make very frequent reference to it, nearly always
finding in it the information we seek.—British and Foreign Medico-Chirurgical Review, April, 1852.
  Dr. Dunglison's Lexicon has the rare merit that it certainly has no rival in the English language for ac-
curacy and extent  of references.  The terms generally include short physiological and pathological de-
scriptions, so that, as the  author justly observes,  the reader does not possess in this work a mere dictionary.
but a book, which, while it instructs him in medical etymology, furnishes him with a large amount of useful
information. That we are not over-estimating the merits ofthis  publication, is  proved by the fact that w«
have now before us the seventh edition. This, at any rate, shows that the author's labors have been pro-
perly appreciated by his  own countrymen ; and we can only  confirm their judgment, by recommending this
most useful volume to the notice of our cisatlantic readers.  No medical  library will be complete without n.
—The London Med. Gazette.                                  %                    .
  It is certainly more complete and comprehensive than any with which we are acquainted in the English
language. Few, in fact, could be found better qualified than Dr. Dunglison for the productionof such a work.
Learned, industrious, persevering, and accurate, he brings to the task all the peculiar talents necessary for
its successful performance: while, at the same time, his familiarity with the writings of the ancient and
modern " masters ofour art," renders him skilful to note the exact usage of the several terms of science, and
the various modifications which medical terminology  has undergone with the change of theories or the pro-
gress of improvement.—American Journal of the Medical Sciences.
  One of the most complete and copious known to the cultivators of medical science.—Boston Med. Journal.
  This most complete Medical Lexicon—certainly one of the best works of the kind in the language.—
Charleston Medical Journal.
  The most complete Medical Dictionary in the English language.— Western Lancet.
  Dr. Dunglison's Dictionary has not its superior, if indeed its equal, in  the English language.—St. Louts
Med. and Surg. Journal.
  Familiar with nearly  all the medical dictionaries now in print, we consider the one  before us the most
complete, and an indispensable adjunct to every medical library.—British American Medical Journal.
  We repeat our former declaration  that this  is the best Medical Dictionary  in the English language,—
Western Lancet.
  We have no hesitation to pronounce it the very best Medical Dictionary now extant.—Southern Medical
and Surgical Journal.
  The most comprehensive and best English Dictionary of medical terms extant.—Buffalo Med. Journal
                     HOBLYN'S  MEDICAL DICTIONARY.

A  DICTIONARY  OF THE TERMS  USED   IN  MEDICINE
                    AND  THE  COLLATERAL SCIENCES.

              BY RICHARD  D.  HOBLYN,  A.  M., Oxon.
    REVISED, WITH NUMEROUS ADDITIONS, FROM THE SECOND LONDON EDITION,
BY ISAAC HAYS, M. D., &c.  In one large royal 12mo. volume of 402 pages, double columns.
  We cannot too strongly recommend this small and cheap volume to the library of every student and prac-
titioner.— Medico-Chirurgical Review. 
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